No abstract available.
Carcinoma, Squamous Cell* ; Humans ; Nuclear Weapons* ; Survivors*

While the use of radioactive materials around the world offers a wide range of benefits in medicine, industry and research, radiation accidents also occur in world-wide. The objective of this article is to provide useful information about radiation accidents to the medical personnel. For this, I attempted to document the circumstances leading to the accident and the subsequent medical treatment and health consequences of the victims. Radiation accidents described in this article are Chernobyl nuclear power plant accident, nuclear weapon accident in bikini atoll, major industrial accidents (Ir-192 Peruvian accident, Ir-192 internal contamination accident in Korea, Tokaimura accident in Japan) and Cs-137 contamination accident in Brazil. After reviewing major radiation accidents, I summarized the lessons to be learned from these accidents and presented the helpful institutes that can offer useful helps when radiation accident occurs.
Academies and Institutes ; Accidents, Occupational ; Brazil ; Korea ; Nuclear Power Plants ; Radioactive Hazard Release* ; Weapons

A case of Lichen planus in 41 year old with predisposing emotional factor is reported here and reviewed therapeutic experiences and reveiwed of literatures. This patient who has been suffering from pruritic, dull erythematous maculo-papular eruptions of trunk and extremites which was preoccupied with imagination as if she were exposed sequela to atomic bomb explosion in Japan, World War II, is presented.
Adult ; Explosions ; Fibrinogen ; Humans ; Imagination ; Japan ; Lichen Planus* ; Lichens* ; Nuclear Weapons ; World War II

In this article, we will examine the theory and practice of encounters between oral history and narrative medicine in view of storytelling. Man is a storytelling animal. Our experience is understood, reconstructed and transmitted as a story and we can find the meaning of life through a story. Oral history is a specific practice and method of research. It refers to the process of recording interviews with people who have something to say, transcribing the record and interpretating the written text to conduct the study of the past. Therefore story is a basic tool of oral history. There has been also growing interest regarding the narrative features of medicine. Especially the illness narrative is one of the most powerful tools in this context. An illness narrative is a patient's story about his illness, including the meaning of the illness in his life. Illness as a specific event of life can only be understood through a story of patient. How can we combine oral history and narrative medicine altogether? We propose two subjects, one is 'healing' and the other is 'the social'. The goal of medicine is healing of suffered people. It is well known that storytelling has a healing effect. Conducting oral history is not only 'recovery history' but also is helping people to have a well organized memory and integrate that into his whole life story. The use of oral history as a means of empowerment should be extended referring the healing effect of medicine. On the other hand, modern medicine has a tendency to reduce the problem of health and illness as an individual one. However story of illness can reveal the dominance of modern biomedicine in the contemporary and have political implications. Oral history deals with memory. Personal memory can only be understood in the context of social and cultural backgrounds. Collective memory is necessary in building community history. Medicine should learn from oral history's social dimensions. In this context, life of KIM Hyeongyul who was activist for second generation Korean Atomic Bomb Victims will be a good example of encounters between oral history and narrative medicine.
Animals ; Hand ; History, Modern 1601- ; Humans ; Memory ; Narration ; Nuclear Weapons ; Power (Psychology)

Public health emergencies caused by infectious diseases are the greatest threat to mankind in the 21st century, and pose an even more significant threat than nuclear weapons. The first step in preparing for and responding to such public health emergencies is to conduct thorough surveillance and rapid epidemiological investigations. Especially in the case of public health emergencies, most information is not smoothly transmitted. Therefore, it is necessary to evaluate the emergency and to collect data quickly and efficiently by defining the minimum necessary data and information. In addition, these data should be analyzed and interpreted promptly, and countermeasures and strategies should be developed and utilized in preparedness and response activities. Epidemiological investigations should also be carried out promptly in accordance with the emergency situation, and in particular, if the infection source is not known, maximal measures should be taken to prevent epidemiologists from becoming infected. In order to carry out surveillance and epidemiological investigations effectively in the future in the event of a public health emergency, continuous efforts should be made to nurture professional manpower, international cooperation, and use of the latest information technology.
Communicable Diseases* ; Disease Outbreaks ; Emergencies* ; Epidemiology ; International Cooperation ; Nuclear Weapons ; Public Health*

The management of nuclear, biological and chemical (NBC) terrorism events is critical to reducing morbidity and mortality in the next decade; however, initial patient care considerations and protective actions for staff are unfamiliar to most front-line clinicians. High explosive events (bomb and blast) remain the most common type of terrorism and are easy to detect. Conversely, some types of terrorist attacks are more likely to be unsuspected or covert. This paper explains the current threat of terrorism and describes clues for detection that an event has occurred. Specific criteria that should lead to a high suspicion for terrorism are illustrated. The manuscript outlines initial actions and clinical priorities for management and treatment of patients exposed to nuclear/radiological, biological, chemical and combined agents (for example an explosion involving a chemical agent). Examples of terrorist events include: a nuclear explosion, an aerosolised release of anthrax (biological), dissemination of sarin in a subway (chemical), and the detonation of a radiologic dispersion device or "dirty bomb" (combined explosive and radiological). Basic principles of decontamination include potential risks to healthcare providers from secondary exposure and contamination. Unique issues may hinder clinical actions. These include coordination with law enforcement for a crime scene, public health entities for surveillance and monitoring, hazardous materials teams for decontamination, and the media for risk communications. Finally, the importance of personal preparedness is discussed.
Biological Warfare Agents ; Chemical Warfare Agents ; Civil Defense ; Nuclear Weapons ; Terrorism

PURPOSE: Emergency physicians utilize multiple computed tomography (CT) scans in acute evaluation of patients with multiple traumas. By its nature, CT involves larger radiation doses than conventional X-ray films do. A significant association was reported between radiation dose and increasing risk of cancer in atomic bomb survivors and radiation workers. The object of this study was to investigate the amount (dose) of CT radiation in patients who activated the trauma team during the first 24 hours of their stay in the emergency department. METHODS: This study was designed as a retrospective analysis of radiologic and medical data. We reviewed 39 trauma patients who activated the trauma team of our emergency department between January 2008 and April 2009. Individual radiation dose reports calculated by the CT scanner were used to determine radiation dose from each CT scan. Radiation doses calculated by CT scanners were converted to effective dose by multiplying by a conversion coefficient. RESULTS: A total of 33 patients were enrolled. Among these patients, 24(72.7%) were male. The mean age was 41.88+/-16.13 years. The mean Revised Trauma Score was 6.94+/-1.16. The mean Injury severity score was 22.85+/-10.34. The mean number of total CT scans was 3.61+/-1.22. The median effective dose of the total CT scans was 68.81 mSv, with an intraquartile range of 56.30 to 88.41 mSv. CONCLUSION: Trauma patients in the emergency department following trauma team activation are exposed to clinically significant radiation doses from CT imaging during the first 24 hours of their stay.
Emergencies ; Humans ; Injury Severity Score ; Male ; Multiple Trauma ; Nuclear Weapons ; Radiation Dosage ; Retrospective Studies ; Survivors ; X-Ray Film

Low dose radiation has been defined as doses in the range under 100 mSv of low linear energy transfer (low-LET) radiation. There are two sources of ionizing radiation: natural and artificial radiation. Medical radiation exposure is the most common artificial radiation exposure. The frequency and volume of medical radiation exposure has markedly increased because of recent developments in medical technology. Radiation protection is now a concern due to the increasing use of computed tomography (CT) scans and diagnostic X-rays. This article introduced several models and hypotheses regarding the possible carcinogenic risks associated with low-LET radiation. Although opinions vary on the health effects of low level radiation exposure, current studies of medical radiation rely on exposure information collected prospectively, including cohort studies such as atomic bomb survivor studies. Although there are differences in perspective, the majority of studies have supported 'linear-no-threshold model without threshold' between low-LET radiation and the incidence of cancer risk. There is a need for further studies on medical radiation exposure including CT and positron emission tomography in order to understand the health effects of low-LET radiation, including the cancer incidence.
Cohort Studies ; Humans ; Incidence ; Linear Energy Transfer ; Nuclear Weapons ; Positron-Emission Tomography ; Prospective Studies ; Radiation Protection ; Survivors

OBJECTIVES: To investigate the accuracy and scientific validity of the current very low risk factor for hereditary diseases in humans following exposures to ionizing radiation adopted by the United Nations Scientific Committee on the Effects of Atomic Radiation and the International Commission on Radiological Protection. The value is based on experiments on mice due to reportedly absent effects in the Japanese atomic bomb (Abomb) survivors. METHODS: To review the published evidence for heritable effects after ionising radiation exposures particularly, but not restricted to, populations exposed to contamination from the Chernobyl accident and from atmospheric nuclear test fallout. To make a compilation of findings about early deaths, congenital malformations, Down’s syndrome, cancer and other genetic effects observed in humans after the exposure of the parents. To also examine more closely the evidence from the Japanese A-bomb epidemiology and discuss its scientific validity. RESULTS: Nearly all types of hereditary defects were found at doses as low as one to 10 mSv. We discuss the clash between the current risk model and these observations on the basis of biological mechanism and assumptions about linear relationships between dose and effect in neonatal and foetal epidemiology. The evidence supports a dose response relationship which is non-linear and is either biphasic or supralinear (hogs-back) and largely either saturates or falls above 10 mSv. CONCLUSIONS: We conclude that the current risk model for heritable effects of radiation is unsafe. The dose response relationship is non-linear with the greatest effects at the lowest doses. Using Chernobyl data we derive an excess relative risk for all malformations of 1.0 per 10 mSv cumulative dose. The safety of the Japanese A-bomb epidemiology is argued to be both scientifically and philosophically questionable owing to errors in the choice of control groups, omission of internal exposure effects and assumptions about linear dose response.
Accidental Falls ; Animals ; Asian Continental Ancestry Group ; Down Syndrome ; Epidemiology ; Genetic Diseases, Inborn ; Humans ; Mice ; Nuclear Weapons ; Parents ; Radiation, Ionizing ; Risk Factors ; Survivors ; United Nations

BACKGROUND: Squamous cell carcinoma(SCC) is the most common skin cancer in Korea and its incidence is increasing. OBJECTIVE: Our purpose was to evaluate the clinical and histopathological characteristics of SCC. METHODS: Forty cases of cutaneous SCC slides were retrieved from the files of the surgical pathology division of the National Medical Center. Hematoxylin and eosin stained sections were re-examined microscopically by two dermatologists independently. For the cases of reconfirmed SCC, clinical characteristics including incidence, age and sex distribution, location and underlying conditions and histopathologic grading by Broder's grade system were evaluated. For 3 control cases controls and 17 cases of the SCCs, cytokeratin expression patterns on immunohistochernical staining using monoclonal antithodies MNF 116, RCK 102 and NCL 5D3 were observed. RESULTS: 1. Of 40 specimens, 33 specimens(73.3%) were histologically reconfirmed as true cutaneous SCCs. 2. The most commonly involved age group was the fifth decade of life and the median age when diagnosis was made was 57.3. 24 male patients and 9 female patients were involved and the ratio of male to female was 2.67: 1. 3. Most commonly involved sites were face and lower extremities and the incidence of occurrence on sun exposed areas increased in accordance with an increase of the age. 4. Underlying conditions such as burn scars, osteomyelitis or atomic bomb exposure were associated in 455% of SCCs. 5. Histopathologic grading of 33 cases of SCCs by Broder's grade was performed as follows.:23 cases(67.7%) of grade I, 8 cases(24.2%) of grade II and 2 cases(6.1%) of grade III. 6. The cytokeratin expressio pattern on immunohistochemical staining for 3 of the control cases and 17 cases of SCCs showed some differences between the highly and poorly differentiated groups of SCCs. CONCLUSION: We evaluated the clinical and histopathological characteristics of primary cutaneous SCCs in the National Medical Center from september 1978 to August 1993.
Burns ; Carcinoma, Squamous Cell* ; Cicatrix ; Diagnosis ; Eosine Yellowish-(YS) ; Female ; Hematoxylin ; Humans ; Incidence ; Keratins ; Korea ; Lower Extremity ; Male ; Nuclear Weapons ; Osteomyelitis ; Pathology, Surgical ; Sex Distribution ; Skin Neoplasms ; Solar System