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

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

Taser guns are considered less lethal weapon than pistols. However, several cases and animal experiments reported injuries associated with Taser guns. This report describes the case of a patient who suffered a penetrating eye injury after being shot by a Taser gun. It is important for the emergency physician to understand potential injuries that can be caused by Taser guns.
Animal Experimentation ; Emergencies ; Eye Injuries, Penetrating ; Firearms ; Humans ; Weapons

It is important to have adequate knowledge of the circumstances surround ing the death before the start of an autopsy, as identical autopsy findings may be interpreted quite differently under different circumstances. Clothes worn by homicide victims, especially those whose deaths involed blunt force. sharp instruments or firearms, should be carefully examined to detect traces of the murder weapon. The body surface should also be carefully examined to determine the exact nature of the wounds. Certain patterns of injury in cases of suicide versus homicide are outlined. Clues in establishing causal relationship in cases of compensation medicine are investigation is emphasized.
Autopsy ; Compensation and Redress ; Firearms ; Homicide ; Suicide ; Thoracic Injuries* ; Thorax* ; Weapons ; Wounds and Injuries

Shotguns were developed as an alternative to single-missile rifle or handgun in order to enable gunner to spray a wide area with shot and thus kill birds and small animals too difficult to hit with single-missile weapons. As the popularity of shotguns grew, ammunition was developed for large game. The use of shotguns on humans has been markedly increasing in various manner of death. In forensic aspect, the shotgun wounds have characteristic findings due to their own characteristics and medical examiners may determine the range, distance, direction and kinds of gun. When the muzzle of the shotgun is placed tightly against the surface of the abdomen or thorax, the consequent wound of entrance will be single in number and circular in shape, and will have a diameter approximately equal to that of the bore of the weapon. However, when the wound is made over a site with underlying bone, especially in the scalp, the wound may have a different appearance, showing star shaped entrance due to tears from the sides of the wound and accompanying soot and burn effect. When the muzzle is held short to mid-range, considerable variation occurs in the appearance of the wound. We report two cases of shotgun wounds which showed typical findings of contact shots and distant shots.
Abdomen ; Animals ; Birds ; Burns ; Coroners and Medical Examiners ; Firearms ; Humans ; Scalp ; Soot ; Thorax ; Weapons ; Wounds and Injuries*

Shotguns were developed as an alternative to single-missile rifle or handgun in order to enable gunner to spray a wide area with shot and thus kill birds and small animals too difficult to hit with single-missile weapons. As the popularity of shotguns grew, ammunition was developed for large game. The use of shotguns on humans has been markedly increasing in various manner of death. In forensic aspect, the shotgun wounds have characteristic findings due to their own characteristics and medical examiners may determine the range, distance, direction and kinds of gun. When the muzzle of the shotgun is placed tightly against the surface of the abdomen or thorax, the consequent wound of entrance will be single in number and circular in shape, and will have a diameter approximately equal to that of the bore of the weapon. However, when the wound is made over a site with underlying bone, especially in the scalp, the wound may have a different appearance, showing star shaped entrance due to tears from the sides of the wound and accompanying soot and burn effect. When the muzzle is held short to mid-range, considerable variation occurs in the appearance of the wound. We report two cases of shotgun wounds which showed typical findings of contact shots and distant shots.
Abdomen ; Animals ; Birds ; Burns ; Coroners and Medical Examiners ; Firearms ; Humans ; Scalp ; Soot ; Thorax ; Weapons ; Wounds and Injuries*

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*