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PubMed2002

The effect of loss and trauma on substance use behavior in individuals seeking support services after the 1995 Oklahoma City bombing.

In this study, we examined the effect of trauma exposure on substance use behaviors, specifically tobacco and alcohol use, in a group of 84 individuals who sought supportive services after the 1995 Oklahoma City bombing. A self-report instrument was used to assess demographics, sensory exposure, injury, interpersonal exposure through relationship with victims, peritraumatic reaction, grief, posttraumatic stress, worry about safety, functional impairment, and changes in smoking and drinking. Those who reported increased smoking had higher scores on peritraumatic reaction, grief, posttraumatic stress, worry about safety, and trouble functioning. Those who reported increased alcohol intake had higher scores on injury, peritraumatic reaction, grief, posttraumatic stress, worry about safety, and trouble functioning. Sensory exposure and interpersonal exposure were not significantly different between those with and without increased smoking or drinking. Although no causal relationship can be assumed, our findings indicate an association of grief and posttraumatic stress with increased substance use behaviors in disaster victims.

Adult↗
PubMed2003

Long-term effects of the Dresden bombing: relationships to control beliefs, religious belief, and personal growth.

Aftereffects of the Dresden bombing of February 1945 on 47 survivors were investigated using a comprehensive framework of trauma sequelae including pathogenetic, salutogenetic, and further mediating or moderating variables. A relatively low rate of PTSD symptomatology was noted. Traumatic exposure was related to current PTSD symptoms and to personal growth, with no systematic relationships between the 2 outcome variables. PTSD symptoms were primarily related to external control, whereas personal growth was primarily associated with internal control. Religious belief in the afterlife moderated effects between exposure and posttraumatic avoidance or personal growth. Furthermore, belonging to particular age groups at traumatization (adolescents, middle-aged adults) was associated with increased posttraumatic intrusions at the time of data collection.

Aged↗
PubMed2004

Teachers' psychological reactions 7 weeks after the 1995 Oklahoma City bombing.

This study assessed teachers' reactions to the Oklahoma City bombing. Peritraumatic reactions, the interaction of media exposure with stress from media coverage, feelings toward the perpetrators, and worry about safety predicted posttraumatic stress. Twenty percent reported difficulty handling demands; 5% sought counseling. Outreach efforts should assess and assist teachers.

Aged↗
PubMed2003

Measuring fast neutrons in Hiroshima at distances relevant to atomic-bomb survivors.

Data from the survivors of the atomic bombs serve as the major basis for risk calculations of radiation-induced cancer in humans. A controversy has existed for almost two decades, however, concerning the possibility that neutron doses in Hiroshima may have been much larger than estimated. This controversy was based on measurements of radioisotopes activated by thermal neutrons that suggested much higher fluences at larger distances than expected. For fast neutrons, which contributed almost all the neutron dose, clear measurement validation has so far proved impossible at the large distances (900 to 1,500 m) most relevant to survivor locations. Here, the first results are reported for the detection of 63Ni produced predominantly by fast neutrons (above about 1 MeV) in copper samples from Hiroshima. This breakthrough was made possible by the development of chemical extraction methods and major improvements in the sensitivity of accelerator mass spectrometry for detection of 63Ni atoms (refs 8-11). When results are compared with 63Ni activation predicted by neutron doses for Hiroshima survivors, good agreement is observed at the distances most relevant to survivor data. These findings provide, for the first time, clear measurement validation of the neutron doses to survivors in Hiroshima.

Copper↗
PubMed2003

Monoclonal gammopathy of undetermined significance in atomic bomb survivors: incidence and transformation to multiple myeloma.

Among 6737 atomic bomb survivors who did not have monoclonal gammopathy at the first examination, 112 developed monoclonal gammopathy of undetermined significance (MGUS) between 1985 and 2001. The crude incidence rate was 164 per 100 000 person-years in the overall study population, with a sharp increase in incidence after age 60 years. The incidence was not significantly associated with radiation dose (P = 0.91), although the incidence at less than 80 years of age showed a marginally significant association (P = 0.05). Among 75 patients with MGUS detected in 1985, 50 patients (67%) had died by 2001, 16 (21%) of these deaths were due to multiple myeloma (MM). MM mortality among MGUS patients was 2284 per 100 000 person-years while the rate in the total population was 14.6 per 100 000 person-years. The risk of MM mortality was greater in the older generation. The transformation from MGUS to MM was faster in exposed persons than in non-exposed persons, but this was not statistically significant.

Age of Onset↗
PubMed2001

Can models of post-traumatic stress disorder contribute to the application of cognitive therapy by nurse therapists when dealing with individuals affected by the Omagh bombing? An overview.

As mental health professionals practising in an evolving multidisciplinary trauma and recovery team in Omagh, Northern Ireland, the by now infamous Omagh bombing of 15 August 1998 brought abruptly to attention the potential for adverse psychological consequences resulting from exposure to such trauma. As nurse therapists, this event provoked interest in the entity of post-traumatic stress disorder (PTSD) as being one of the possible negative psychological consequences, and the relevance and application of cognitive theory and practice in its treatment. Whilst recognizing that there is no single cognitive theory or model of anxiety disorder, this paper focuses on the approach of Beck and allied approaches when referring to cognitive theory and practice. It is intended to proffer a broad overview of areas the authors consider relevant in order to develop an appreciation of the entity of PTSD, and its evolution, having given a synopsis of the event that provoked interest. Finally, acknowledgement and a brief explication of some of the theoretical models of PTSD to date will be made, and the relevance and application of cognitive theory and principals in the treatment of the disorder will be considered.

Cognitive Behavioral Therapy↗
PubMed2000

[Ocular injuries and triage after the bombing attack on the United States embassy in Nairobi (Kenya)].

BACKGROUND: As a result of the terrorist bombings of the United States Embassies in Daressalam (Tansania) and Nairobi (Kenya) on August 7, 1998, over 200 people were killed. 5000 persons were injured severely. The purpose of this article is to provide a review of our experiences in the evaluation and treatment of patients with multiple simultaneous ocular injuries sustained in the Nairobi attack. PATIENTS AND METHODS: We treated eight survivors of the assault, four of them with extremely severe eye injuries. A three-tiered system of triage developed. The first level occurred on scene, in which minor injuries were treated locally and more severe injuries were transported by aeromedical evacuation to Landstuhl Regional Medical Center (LMRC), in Germany among other locations. Surgical exploration of all patients arriving at LRMC was performed and surgical repair was undertaken when appropriate and technically possible. Patients requiring vitreoretinal surgery were transferred either to Saarland University Eye Hospital, Homburg, Germany, or Walter Reed Army Medical Center, Washington, DC. RESULTS: Only one eye required enucleation, due to an almost complete extrusion of the retina. It was possible to stabilize even severely injured eyes with multiple intraocular foreign bodies. CONCLUSIONS: Modern microsurgical techniques such as temporary keratoprothesis, perforating keratoplasty, and pars plana vitrectomy can now save eyes and often allow restoration of usuable visual acuity where this once have been deemed impossible.

Adult↗
PubMed2002

Disarming the mustard oil bomb.

Plants are attacked by a broad array of herbivores and pathogens. In response, plants deploy an arsenal of defensive traits. In Brassicaceae, the glucosinolate-myrosinase complex is a sophisticated two-component system to ward off opponents. However, this so-called "mustard oil bomb" is disarmed by a glucosinolate sulfatase of a crucifer specialist insect, diamondback moth, Plutella xylostella (Lepidoptera: Plutellidae). Sulfatase activity of this enzyme largely prevents the formation of toxic hydrolysis products arising from this plant defense system. Importantly, the enzyme acts on all major classes of glucosinolates, thus enabling diamondback moths to use a broad range of cruciferous host plants.

Amino Acid Sequence↗
PubMed1980

Search for mutations affecting protein structure in children of atomic bomb survivors: preliminary report.

A total of 289,868 locus tests, based on 28 different protein phenotypes and using one-dimensional electrophoresis to detect variant proteins, has yielded one probable mutation in the offspring of "proximally exposed" parents, who received an estimated average gonadal exposure of 31 to 39 rem in the atomic bombings of Hiroshima and Nagasaki. There were no mutations in 208,196 locus tests involving children of "distally exposed" parents, who had essentially no radiation exposure.

Dose-Response Relationship, Radiation↗
PubMed1995

Direct detection and isolation of restriction landmark genomic scanning (RLGS) spot DNA markers tightly linked to a specific trait by using the RLGS spot-bombing method.

We have developed a technique for isolating DNA markers tightly linked to a target region that is based on RLGS, named RLGS spot-bombing (RLGS-SB). RLGS-SB allows us to scan the genome of higher organisms quickly and efficiently to identify loci that are linked to either a target region or gene of interest. The method was initially tested by analyzing a C57BL/6-GusS mouse congenic strain. We identified 33 variant markers out of 10,565 total loci in a 4.2-centimorgan (cM) interval surrounding the Gus locus in 4 days of laboratory work. The validity of RLGS-SB to find DNA markers linked to a target locus was also tested on pooled DNA from segregating backcross progeny by analyzing the spot intensity of already mapped RLGS loci. Finally, we used RLGS-SB to identify DNA markers closely linked to the mouse reeler (rl) locus on chromosome 5 by phenotypic pooling. A total of 31 RLGS loci were identified and mapped to the target region after screening 8856 loci. These 31 loci were mapped within 11.7 cM surrounding rl. The average density of RLGS loci located in the rl region was 0.38 cM. Three loci were closely linked to rl showing a recombination frequency of 0/340, which is < 1 cM from rl. Thus, RLGS-SB provides an efficient and rapid method for the detection and isolation of polymorphic DNA markers linked to a trait or gene of interest.

Animals↗
PubMed2006

Neuralized-2 regulates a Notch ligand in cooperation with Mind bomb-1.

Mutations in Drosophila neuralized (Dneur) result in a variety of developmental defects that closely resemble those of Notch mutants and other Notch pathway mutants. However, mice with disrupted neur1 do not show any aberrant cell fate specifications in neurogenesis and somitogenesis. Thus, we speculated that other vertebrate neur homolog(s) might compensate for loss of the neur gene. Here, we report the paralog of mouse Neur1, named Neuralized-2 (Neur2), which is a ubiquitin-protein isopeptide ligase (E3) that interacts with and ubiquitinates Delta. Both murine Neur1 and Neur2 have similar degrees of homology to DNeur, and neur2 is expressed in patterns similar to those of neur1 in embryos, suggesting potential functional redundancy. Interestingly, two distinct classes of E3 ligases, Mind bomb-1 (Mib1) and Neur2, have cooperative but distinct roles in Delta endocytosis to Hrs-positive vesicles, i.e. Mib1 functions in the initial step of Delta endocytosis, and Neur2 is required for targeting endocytosed Delta to Hrs-positive vesicles. Thus, our study provides a new insight into how distinct E3 ligases work together in the endocytic pathways for Notch signaling.

Amino Acid Sequence↗
PubMed2004

Otologic consequences of blast exposure: a Finnish case study of a shopping mall bomb explosion.

OBJECTIVE: On 11 October, 2002, in the Myyrmanni shopping mall, Vantaa city, Finland, an explosion by a suicide bomber killed 7 people and injured at least 160,44 of whom had ear trauma. We investigated the acute and subacute otologic consequences of the explosion. MATERIAL AND METHODS: Otologic examination of the 29 patients treated for ear trauma at the ENT clinic of the University Hospital of Helsinki was performed during the first month after the explosion, and a questionnaire was completed regarding subjective aural symptoms. Symptoms occurring directly after the explosion and for up to 1 month afterwards were assessed. RESULTS: Of the 29 patients, 66% had tinnitus as the initial symptom, 55% hearing loss, 41% pain in the ears and 28% sound distortion. Tinnitus and hearing loss in combination were experienced by 12 patients (41%). Eight patients who had been situated<10 m from the center of the explosion had a rupture of the tympanic membrane. This supported the initial evaluation by the authorities that the bomb had consisted of approximately 3 kg ammonium nitrate, equivalent to approximately 0.5 kg of trinitrotoluene. It was estimated that some kind of ear injury was likely for individuals situated<70 m from the center of the explosion. CONCLUSIONS: People often think that tinnitus and hearing impairment are naturally occurring phenomena after blast exposure, and if their symptoms resolve they do not seek medical advice. However, some of them may have substantial hearing impairment, particularly at high frequencies. Otologic consultation, or at least an audiometric screening test to exclude hearing impairment, should be performed regardless of symptoms, on the basis of exposure data only. Some symptoms, such as tinnitus and hearing loss, may be permanent consequences of a blast injury and their effect on quality of life may be substantial.

Adolescent↗
PubMed2006

Biologically based analysis of lung cancer incidence in a large Canadian occupational cohort with low-dose ionizing radiation exposure, and comparison with Japanese atomic bomb survivors.

Lung cancer incidence is analyzed in a large Canadian National Dose Registry (CNDR) cohort with individual annual dosimetry for low-dose occupational exposure to gamma and tritium radiation using the two-stage clonal expansion model (TSCE) and extensions of the model with up to 10 initiation steps. Models with clonal expansion turned off provide very poor fits and are rejected. Characteristic and distinct temporal patterns of excess relative risk (ERR) are found for dose response affecting early, middle, or late stages of carcinogenesis, that is, initiation with one or more stages, clonal expansion, or malignant conversion. Both fixed lag and lag distributions are used to model time from first malignant cell to incidence. Background rates are adjusted for gender and birth cohort. Lacking individual smoking data, surrogate annual smoking doses based on U.S. annual per capita cigarette consumption appear to account for much of the birth cohort effect, leaving radiation dose response relatively unchanged. The mean cumulative exposure for males receiving nonzero cumulative doses of gamma and tritium radiation was 18.2 mSv. The males have a significant dose response with 33 out of a total of 322 lung cancer cases attributable to radiation. There were 78 incident lung cancer among females, (with mean cumulative exposure of 3.8 mSv among females with nonzero exposure). The dose response for females appears smaller than for males but does not differ significantly from zero or from the male dose response. Findings for males include significant dose-response relationships for promotion and malignant conversion, but not initiation, and a protraction effect (sometimes called an inverse-dose-rate effect, where risk increases with protraction of a given dose). The dose response predicted by our analysis appears consistent with the risk for lung cancer incidence in the Japanese atomic bomb survivors cohort, provided that proper adjustments are made for duration of exposure and differences in background rate parameters.

Canada↗
PubMed2000

Derivation of low-dose extrapolation factors from analysis of curvature in the cancer incidence dose response in Japanese atomic bomb survivors.

PURPOSES: To assess the degree of overestimation in low-dose cancer risk when models linear in dose are fitted to cancer data. MATERIALS AND METHODS: Examination of the quadratic and the linear coefficients (in dose) in the Japanese atomic bomb survivor cancer incidence data, based on follow-up to 1987 and taking separate account of random errors in DS86 neutron and DS86 gamma dose estimates and systematic errors in Hiroshima DS86 neutron dose estimates. RESULTS: When the 0-4Gy dose range is used, the low-dose extrapolation factor for all solid tumours, assessing the degree to which low-dose cancer risks are overestimated by fitting a model linear in dose, is 1.06 (95% CI 0.78, 1.62) and so is not significantly different from 1; the associated ratio of the quadratic to the linear coefficients is 0.06 Sv(-1) (95% CI -0.22, 0.67). The best estimate of the low-dose extrapolation factor for leukaemia is 2.47 (95% CI 1.24, > 1,000). The ratio of the quadratic to the linear coefficients is 1.81 Sv(-1) (95% CI 0.21, > 1,000). When various types and groupings of solid tumours are considered there is not generally any strong evidence for upward curvature; for only two out of the six solid tumour groupings are there indications of appreciable upward curvature in the dose response, and in no instance is this statistically significant. Consideration of a lower dose range (0-2Gy rather than 0-4 Gy) results in the low-dose extrapolation factor for solid tumours increasing to 1.21 (95% CI 0.81, 2.45), with corresponding increases for solid tumour subtypes; the corresponding quantity for leukaemia decreases to 1.73 (95% CI 0.79, 147.67). Three out of the six solid tumour subtypes now show appreciable upward curvature. If there is additional adjustment of the Hiroshima neutron dose estimates over the 0-2 Gy dose range, the low-dose extrapolation factor for all solid tumours increases still further, to 1.43 (95% CI 0.97, 2.72), whereas for leukaemia this quantity is further reduced, to 1.58 (95% CI 0.90, 10.58). CONCLUSIONS: There is marked upward curvature in the dose response for leukaemia. For solid tumours there is little indication of upward curvature in the dose response over the 0-4 Gy dose range, although over the 0-2 Gy dose range and after adjustment of Hiroshima DS86 neutron dose estimates the upward curvature is more pronounced. Uncertainties in the likely adjustments to the Hiroshima DS86 neutron dose estimates imply that these findings should be treated with caution.

Dose-Response Relationship, Radiation↗
PubMed1990

Accelerator mass spectrometry of 36Cl produced by neutrons from the Hiroshima bomb.

Accelerator mass spectrometry was performed at the Munich tandem laboratory to determine 36Cl/Cl ratios of samples from a tombstone exposed to neutrons from the Hiroshima bomb. The ratios were determined from the surface to deeper positions. The depth profile of 36Cl/Cl can be used for estimating the neutron energy distribution and intensity near the hypocentre in Hiroshima.

Chlorine↗
PubMed1990

Severe mental retardation after large prenatal exposures to bomb radiation. Reduction in oxygen transport to fetal brain: a possible abscopal mechanism.

Reasonable expectations, based on the normal physiology of the human fetus, cast new light on the possibilities of extrapolation from the finding of severe mental retardation (SMR) in Japanese bomb survivors after maternal exposure to 1.8-5.5 Gy T65DR Gy. After such large exposures the fetal haematopoietic tissues (DS86 dose 0.9-2.2 Gy) cannot escape severe damage and a consequent reduction in erythropoiesis. Diminished fetal erythropoiesis will diminish oxygen transport from placenta to fetus. Impaired oxygen transport to the developing forebrain will augment the localized forebrain damage caused directly by large radiation doses. Linear extrapolation of an observed linear dose response for SMR after large radiation exposures is unlikely to be a valid method for predicting the frequency of SMR after much smaller exposures causing minimal damage to the fetal haematopoietic tissues.

Female↗
PubMed1990

Apparently beneficial effect of low to intermediate doses of A-bomb radiation on human lifespan.

Among about 100,000 A-bomb survivors registered at Nagasaki University School of Medicine, 290 male subjects exposed to 50-149 cGy showed significantly lower mortality from non-cancerous diseases than age-matched unexposed males. This was deduced from the fitting of a U-shaped dose-response relationship. Reasons for this effect in males, but not in females, are discussed with reference to selection of individuals and to hormesis.

Dose-Response Relationship, Radiation↗
PubMed1993

Radiation-related small head sizes among prenatally exposed A-bomb survivors.

Of 1566 individuals prenatally exposed to the atomic bombings of Hiroshima and Nagasaki, 1473 had the circumference of their head measured at least once between ages 9 and 19. Among these 1473 individuals, 62 had small heads--the circumference of the heads was two standard deviations or more below the observed specific-age-at measurement mean. Of 26 cases with severe mental retardation, 15 (58%) had small heads. Most (86%) of the individuals with small heads were exposed in the first trimester (about < 12 weeks postovulation) or second trimester (about 12-24 weeks postovulation)--55% in the former period and 31% in the latter. Various dose-response relationships, with and without a threshold, have been fitted to the data grouped by the trimester or postovulatory age (weeks after ovulation) at which exposure occurred. A significant effect of radiation on the frequency of individuals with atypically small heads is observed only in the first and second trimesters and for the intervals postovulation of 0-7 weeks and 8-15 weeks. Although the risk of a small head at 0-7 weeks postovulation increases significantly with increasing dose, no increase in risk for severe mental retardation is noted in this period. No excess risk of a small head was seen in the third trimester (about > or = 25 weeks postovulation) or among individuals exposed at 16 weeks or more postovulation. The mean IQ values of mentally retarded cases with and without small heads were 63.8 and 68.9, respectively. No significant difference exists between these two IQ means, but both were significantly smaller than 96.4, the IQ value for individuals with small heads without severe mental retardation and 107.8, the value for the overall sample.

Female↗