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PubMed1989

A chromosome study of 6-thioguanine-resistant mutants in T lymphocytes of Hiroshima atomic bomb survivors.

Cytogenetic characterizations were made of lymphocyte colonies established from somatic mutation assays for 6-thioguanine (TG) resistance in Hiroshima atomic bomb survivors. G-banded chromosomes were analyzed in both TG-resistant (TGr) and wild-type colonies. Included were 45 TGr and 19 wild-type colonies derived from proximally exposed A-bomb survivors, as well as colonies from distally exposed control individuals who did not receive a significant amount of A-bomb radiation (18 TGr and 9-wild type colonies). Various structural and numerical chromosome abnormalities were observed in both TGr and wild-type colonies. Aberrations of the X chromosome, on which the hypoxanthine guanine phosphoribosyl transferase (HPRT) locus is present, were found in 6 colonies: 2 resistant colonies from controls (45,X/46,XX; 46,X,ins(X)), 3 resistant colonies (45,X/46,XX/46,X, + mar; 46,X,t(Xq +;14q-); 46,Y,t(Xq-;5q +)), and 1 wild-type colony (45,X/47,XXX) from proximally exposed persons. In cases with exchange aberrations, each of the break points on the X chromosome was situated proximally to band q26 where the HPRT locus is known to be assigned. DNA-replicating patterns were also studied, and it was found that abnormal X chromosomes showed early replicating patterns, while normal X chromosomes showed late replicating patterns.

Aneuploidy↗
PubMed2006

Evaluation of orientation and environmental factors on the blast hazards to bomb suit wearers.

This paper discusses the use of 3-D computational fluid dynamics (CFD) software for simulation of explosive detonations against the wearer of a typical bomb suit. The focus is to demonstrate the utility of the model to assess the differential overpressure loads on the various bomb suit components protecting critical body parts. Since overpressures can vary significantly depending on the position and orientation of the wearer, simulations are performed for a range of orientations including kneeling and standing at common standoff distances. Overpressure loads on the head, neck, and torso regions are predicted for each orientation, capturing ground and other surface reflections that can enhance effects of the blast. This is not normally observed during tests of individual bomb suit components. Direct correlations between the suit orientation and environmental factors to load enhancements are documented, and an effort to address probable injury is made.

Computer Simulation↗
PubMed2005

Unilateral multiple primary tumours in an atomic-bomb survivor.

We report here a case of an atomic-bomb survivor with sequential, unilateral, multiple-organ primary tumours after exposure to direct external radiation. This 67-year-old woman was 8 years old when she was exposed to radiation from the atomic bomb. At the time of the explosion, she was in an open area, but hiding behind a tree, which shielded her left side. Therefore, the right side of her body was exposed to radiation directly and primarily. Since then, she has been diagnosed sequentially with breast cancer, ovarian tumour, thyroid tumour, head skin cancer and lung cancer. In each case, the tumour was on the right side of her body at the ages of 31, 38, 54, 58 and 64 years old, respectively. This case study indicates that the risk of multiple primary tumours should be considered in older atomic-bomb survivors.

Female↗
PubMedDate not supplied

Medical and psychiatric casualties caused by conventional and radiological (dirty) bombs.

Bombing is the preferred method of terrorist attack. Unfortunately, the frequency and prevalence of this form of terrorism/criminal act/means of extortion are increasing in the United States. These attacks result in specific physical and psychiatric trauma, and produce both acute and long-term psychiatric sequelae. It will become increasingly important for trauma surgeons, emergency physicians and psychiatrists to be familiar with the special needs and treatment of these patients. This paper reviews the physical and psychiatric consequences of high explosive and radiological (dirty) bombs, and makes recommendations for the psychiatric management of bombing victims.

Blast Injuries↗
PubMed1997

The spectrum of pediatric injuries after a bomb blast.

The spectrum of pediatric injuries seen after a bomb blast is poorly documented. The pathophysiology of blast injuries differ significantly from other forms of trauma and typically result in large numbers of distinctly patterned injuries. On April 19, 1995, a truck bomb was detonated directly adjacent to the Alfred P. Murrah Federal Building in Oklahoma City, Oklahoma. A total of 816 adults and children were injured or killed as a direct result of the blast. Twenty infants and children were seated by the window of the second floor day care center at the time of the explosion. The injuries incurred by all children involved in the blast were studied. Nineteen children, 16 of whom were in the day care center, died as a direct result of the blast. The injury patterns among the 19 dead children included a 90% (17 of 19) incidence of skull fractures, 15 of those with cerebral evisceration (skull capping); 37% with abdominal or thoracic injuries; 31% amputations; 47% arm fractures, 26% leg fractures; 21% burns; and 100% with extensive cutaneous contusions, avulsions, and lacerations. Forty-seven children sustained nonfatal injuries with only seven children requiring hospitalization. The injuries sustained by the seven hospitalized children included two open, depressed skull fractures, with partially extruded brain, two closed head injuries, three arm fractures, one leg fracture, one arterial injury, one splenic injury, five tympanic membrane perforations, three corneal abrasions, and four burn cases (1 > 40% body surface area [BSA]). After a bomb blast, pediatric patients sustain a high incidence of cranial injuries. Fractures and traumatic amputations are common. Intraabdominal and thoracic injuries occur frequently in the deceased but infrequently in survivors.

Adolescent↗
PubMed1987

New dosimetry of atomic bomb radiations.

The reassessment of the radiation dosimetry from the Hiroshima and Nagasaki atomic bombs is almost complete. Since atomic bomb survivors provide a major source of data for estimates of risk of cancer induction by radiation the impact of the new dosimetry on risk estimates and radiation protection standards is important. The changes include an increase of about 20% in the estimated yield of the Hiroshima bomb and a reduction in the estimated doses from neutrons in both cities. The estimated neutron dose for Hiroshima is about 10% of the previous estimate. The neutron doses are now so small that direct estimates of neutron relative biological effectiveness may be precluded or be much more difficult. There is little change in most of the gamma ray organ doses because various changes in the new estimates tend to cancel each other out. The new estimate of the attenuation of the free-in-air kerma by the walls of the homes is about twice that used in the previous dosimetry. But the transmission of gamma radiation to the deep organs such as bone marrow is significantly greater than earlier estimates. Probably future risk estimates for radiogenic cancer will be somewhat higher because of both the new dosimetry and the new cancer mortality data. New risk estimates should be available in 1988.

Brain↗
PubMed2000

Eye injuries in a terrorist bombing: Dhahran, Saudi Arabia, June 25, 1996.

OBJECTIVE: We report the experience of our institution in the evaluation and care of multiple simultaneous ocular trauma patients after a terrorist bomb attack on a United States military base in Saudi Arabia. DESIGN: Retrospective, noncomparative small case series. PARTICIPANTS: Three patients who received severe ocular injuries after a terrorist bombing. INTERVENTION: All patients underwent surgical repair of the injuries that were inflicted as a result of the terrorist bombing. MAIN OUTCOME MEASURES: Baseline ocular characteristics, intraoperative findings, surgical procedures, and final (3 years after injury) anatomic and visual outcomes were noted. RESULTS: Glass fragments caused by the blast were the mechanism of all the ocular injuries in these patients. All patients had primary repair of the injuries done in Saudi Arabia and were sent to our institution for tertiary care. Three of the four eyes injured had stable or improved visual acuity and one eye was enucleated. Two patients had no serious injury other than the globe trauma. One patient had extensive eyelid trauma and required serial procedures to allow fitting of a prosthesis. CONCLUSIONS: Blast-injury patients are at risk for open globe injury as a result of glass fragments. The types of injury that can occur from terrorist blasts can be extensive and involve all the tissues of the eye, the ocular adnexa, and the orbit.

Adult↗
PubMed1999

Emergency department impact of the Oklahoma City terrorist bombing.

STUDY OBJECTIVE: To collect descriptive epidemiologic injury data on patients who suffered acute injuries after the April 19, 1995, Oklahoma City bombing and to describe the effect on metropolitan emergency departments. METHODS: A retrospective review of the medical records of victims seen for injury or illness related to the bombing at 1 of the 13 study hospitals from 9:02 AM to midnight April 19, 1995. Rescue workers and nontransported fatalities were excluded. RESULTS: Three hundred eighty-eight patients met inclusion criteria; 72 (18.6%) were admitted, 312 (80.4%) were treated and released, 3 (.7%) were dead on arrival, and 1 had undocumented disposition. Patients requiring admission took longer to arrive to EDs than patients treated and released (P =.0065). The EDs geographically closest to the blast site (1.5 radial miles) received significantly more victims than more distant EDs (P <.0001). Among the 90 patients with documented prehospital care, the most common interventions were spinal immobilization (964/90, 71.1%), field dressings (40/90, 44.4%), and intravenous fluids (32/90, 35.5%). No patients requiring prehospital CPR survived. Patients transported by EMS had higher admission rates than those arriving by any other mode (P <.0001). The most common procedures performed were wound care and intravenous infusion lines. The most common diagnoses were lacerations/contusion, fractures, strains, head injury, abrasions, and soft tissue foreign bodies. Tetanus toxoid, antibiotics, and analgesics were the most common pharmaceutical agents used. Plain radiology, computed tomographic radiology, and the hospital laboratory were the most significantly utilized ancillary services. CONCLUSION: EMS providers tended to transport the more seriously injured patients, who tended to arrive in a second wave at EDs. The closest hospitals received the greatest number of victims by all transport methods. The effects on pharmaceutical use and ancillary service were consistent with the care of penetrating and blunt trauma. The diagnoses in the ED support previous reports of the complex but often nonlethal nature of bombing injuries.

Adolescent↗
PubMed2003

Breast cancer risk among the survivors of atomic bomb and patients exposed to therapeutic ionising radiation.

Radiation induced breast cancer is a highly complex phenomenon, which most likely involves the accumulation of several genetic and epigenetic events. Studies of atomic bomb survivors, patients who underwent multiple fluoroscopic examinations during treatment for pulmonary tuberculosis, those who received therapeutic radiation for benign breast disease, such as acute post-partum mastitis, or those with an enlarged thymus or skin haemangioma and patients with Hodgkin's disease treated by mantle radiotherapy established that the risk of breast cancer increases with exposure to ionising radiation. The carcinogenic effect of therapeutic or accidental radiation is highest when exposure occurs during childhood and exposure after age 40 imparts low or minimal risk. The risk of bilateral breast cancer is not significantly increased in the survivors of atomic bomb and therapeutic radiations. Fractionated exposures for therapeutic radiation are similar to a single exposure of the same total dose in their ability to induce breast cancer; this risk remains high for many years after exposure. Younger age at first full term pregnancy confers a protective effect against the risk of breast cancer in the survivors of atomic bomb but long-term data on this beneficial effect after therapeutic radiation is not available.

Age Factors↗
PubMed2002

Implications of Time Bomb model of ookinete invasion of midgut cells.

In this review, we describe the experimental observations that led us to propose the Time Bomb model of ookinete midgut invasion and discuss potential implications of this model when considering malaria transmission-blocking strategies aimed at arresting parasite development within midgut cells. A detailed analysis of the molecular interactions between Anopheles stephensi midgut epithelial cells and Plasmodium berghei parasites, as they migrate through midgut cells, revealed that ookinetes induce nitric oxide synthase (NOS) expression, remodeling of the actin cytoskeleton and characteristic morphological changes in the invaded epithelial cells. Parasites inflict extensive damage that ultimately leads to genome fragmentation and cell death. During their migration through the cytoplasm, ookinetes release a subtilisin-like protease (PbSub2) and the surface protein (Pbs21). The model proposes that ookinetes must escape rapidly from the invaded cells, as the responses mediating cell death could be potentially lethal to the parasites. In other words, the physical and/or chemical damage triggered by the parasite can be thought of as a 'lethal bomb'. Once this cascade of events is initiated, the parasite must leave the cellular compartment within a limited time to escape unharmed from the 'bomb' it has activated. The midgut epithelium has the ability to heal rapidly by 'budding off' the damaged cells to the midgut lumen without losing its integrity.

Animals↗
PubMed2003

Media exposure in children one hundred miles from a terrorist bombing.

This study assessed indirect interpersonal exposure to the 1995 Oklahoma City bombing, broadcast and print media exposure in the aftermath of the explosion, emotional reactions to media coverage, and posttraumatic stress reactions in children distant from the explosion. A survey was administered to 88 sixth-grade students in the public middle school in a community 100 miles from Oklahoma City 2 years after the bombing. Many children reported indirect interpersonal exposure and most reported bomb-related media exposure. Print media exposure was more strongly associated with enduring posttraumatic stress than broadcast exposure. Indirect interpersonal exposure and the interaction of media exposure with emotional reaction to media coverage in the aftermath of the explosion each predicted ongoing posttraumatic stress. The results suggest that children may have lingering reactions to highly publicized terrorist incidents. Concern about the influence of television viewing has long been proclaimed. This study implicates print media exposure as well. Media exposure to terrorist incidents, therefore, should be monitored and those working with children should assess exposure and stress even in children not directly impacted.

Child↗
PubMed2002

The otologic consequences of the Omagh bomb disaster.

OBJECTIVES: The goal of the study was to compare the spontaneous healing rate for traumatic perforation of the tympanic membrane sustained in the Omagh bomb disaster with that of previous reports in the literature. DESIGN AND SETTING: A retrospective study was conducted at Tyrone County Hospital, Northern Ireland, 2 years after the incident. PARTICIPANTS: One hundred thirty-eight patients who sustained otologic injuries from the bomb blast were included in the study. RESULTS: Only 47 of the 124 perforations healed spontaneously. The previously reported spontaneous healing rate for traumatic perforations of the tympanic membrane is 80% to 90%; in our study, the healing rate was unexpectedly low at 38%. CONCLUSION: The massive explosion in a narrow street with hundreds of persons in close proximity to the bomb may account for the poor healing rate.

Adolescent↗
PubMed1998

Greetings: 50 years of Atomic Bomb Casualty Commission-Radiation Effects Research Foundation studies.

The Atomic Bomb Casualty Commission was established in Hiroshima in 1947 and in Nagasaki in 1948 under the auspices of the U.S. National Academy of Sciences to initiate a long-term and comprehensive epidemiological and genetic study of the atomic bomb survivors. It was replaced in 1975 by the Radiation Effects Research Foundation which is a nonprofit Japanese foundation binationally managed and supported with equal funding by the governments of Japan and the United States. Thanks to the cooperation of the survivors and the contributions of a multitude of scientists, these studies flourish to this day in what must be the most successful long-term research collaboration between the two countries. Although these studies are necessarily limited to the effects of acute, whole-body, mixed gamma-neutron radiation from the atom bombs, their comprehensiveness and duration make them the most definitive descriptions of the late effects of radiation in humans. For this reason, the entire world relies heavily on these data to set radiation standards. As vital as the study results are, they still represent primarily the effects of radiation on older survivors. Another decade or two should correct this deficiency and allow us to measure definitively the human risk of heritable mutation from radiation. We look to the worldwide radiation and risk community as well as to the survivors who have contributed so much to what has been done already to accomplish this goal.

Humans↗
PubMed2005

Mind bomb-2 is an E3 ligase for Notch ligand.

The zebrafish gene, mind bomb (mib), encodes a protein that positively regulates of the Delta-mediated Notch signaling. It interacts with the intracellular domain of Delta to promote its ubiquitination and endocytosis. In our search for the mouse homologue of zebrafish mind bomb, we cloned two homologues in the mouse genome: a mouse orthologue (mouse mib1) and a paralogue, named mind bomb-2 (mib2), which is evolutionarily conserved from Drosophila to human. Both Mib1 and Mib2 have an E3 ubiquitin ligase activity in their C-terminal RING domain and interact with Xenopus Delta (XD) via their N-terminal region. Mib2 is also able to ligate ubiquitin to XD and shift the membrane localization of Delta to intracellular vesicles. Importantly, Mib2 rescues both the neuronal and vascular defects in the zebrafish mib(ta52b) mutants. In contrast to the functional similarities between Mib1 and Mib2, mib2 is highly expressed in adult tissues, but almost not at all in embryos, whereas mib1 is abundantly expressed in both embryos and adult tissues. These data suggest that Mib2 has functional similarities to Mib1, but might have distinct roles in Notch signaling as an E3 ubiquitin ligase.

Amino Acid Sequence↗
PubMed2001

Persistent subclinical inflammation among A-bomb survivors.

PURPOSE: To investigate the associations between inflammation tests and radiation dose in A-bomb survivors. SUBJECTS AND METHODS: Subjects were A-bomb survivors who underwent inflammation tests of leukocyte counts, neutrophil counts, erythrocyte sedimentation rate, corrected erythrocyte sedimentation rate, alpha-1 globulin, alpha-2 globulin and sialic acid between 1988 and 1992. Associations with radiation dose (DS86) were analyzed by regression analysis and heterogeneity among inflammatory diseases, anaemia at examination, or history of cancer was also tested. RESULTS: The associations with radiation dose were statistically significant for leukocyte counts (71.0mm(-3) Gy(-1), p=0.015), erythrocyte sedimentation rate (1.58 mm h(-1) Gy(-1) , p = 0.0001), corrected erythrocyte sedimentation rate (1.14mm h(-1) Gy(-1), p=0.0001), alpha-1 globulin (0.0057 g dl(-1) Gy(-1), p=0.0001), alpha-2 globulin (0.0128 g dl(-1) Gy(-1), p=0.0001), and sialic acid (1.2711 mg dl(-1) Gy(-1), p=0.0001) but not for neutrophil counts (29.9 mm(-3) Gy(-1), p=0.17). Heterogeneity was not statistically significant. Among inflammatory diseases, associations were the strongest for chronic thyroiditis and chronic liver diseases. CONCLUSIONS: This study suggests statistically significant association between inflammation in A-bomb survivors and radiation dose of during 1988-1992. The association might contribute, as an epigenetic and/or bystander effect, to development of several radiation-induced disorders.

Aged↗
PubMed2000

A comparison of the degree of curvature in the cancer incidence dose-response in Japanese atomic bomb survivors with that in chromosome aberrations measured in vitro.

PURPOSES: To compare the degree of curvature in the dose-response for chromosome aberrations and for radiation-induced cancer. MATERIALS AND METHODS: Comparison of the ratio of the quadratic and linear coefficients (in dose) in Japanese atomic bomb survivor cancer incidence data, based on follow-up to 1987 and taking account of random errors in DS86 dose estimates with the same ratio in four datasets of chromosome aberrations in peripheral blood lymphocytes measured in vitro and exposed to 60Co gamma radiation. RESULTS: There are no statistically significant differences between the four in vitro datasets in the ratio of the quadratic to the linear coefficients for dicentrics or chromosome translocations, nor are there indications of differences between this ratio for dicentrics and that for complete chromosome translocations (p > 0.1 in all cases). If the 0-4 Gy dose range is used in the Japanese atomic bomb survivor data, the ratio of the quadratic to the linear coefficients for all solid cancers is 0.06 -1 (95% CI -0.22, 0.67) and so is not significantly different from 0; this ratio is statistically highly inconsistent (p<0.0001) with the analogous ratio estimated for the in vitro chromosome aberration data (4.20 Sv-1; 95% CI 3.06, 6.51). By contrast, there are no statistically significant differences (p=0.42) between the ratio of the quadratic to the linear coefficients for leukaemia incidence in the Japanese cohort, 1.81 Sv-1 (95% CI 0.21, > 1,000), with that for chromosome aberrations in vitro. These results are not markedly changed if the 0-2 Gy dose range is used in the Japanese atomic bomb survivor data. CONCLUSIONS: It is unlikely that in vitro chromosome aberrations could be a correlate for the initiating radiogenic lesions leading to radiation-induced solid cancers. However, taken together with certain other biological information, it may not be unreasonable on this basis to use in vitro chromosome aberrations in peripheral blood lymphocytes as a correlate of the radiogenic lesions leading to radiation-induced leukaemia.

Chromosome Aberrations↗
PubMed2005

Prevalence of atherosclerosis in relation to atomic bomb radiation exposure: an RERF Adult Health Study.

PURPOSE: To determine whether exposure to atomic bomb radiation altered the prevalence of asymptomatic atherosclerosis. MATERIAL AND METHODS: In a cross-sectional analysis, we examined aortic arch calcification by plain chest radiography and common carotid artery intima-media thickness (IMT) by ultrasonography among 1804 survivors of the atomic bombing in Hiroshima. We evaluated the association between atherosclerotic changes and radiation exposure, while adjusting for potentially confounding factors. RESULTS: Multivariate logistic regression analysis showed that aortic arch calcification was significantly associated with radiation exposure (p < 0.05). The odds ratio at 1 Gy was 1.30 (95% confidence interval [CI]: 1.05 - 1.53) for men and 1.31 (95% CI: 1.13 - 1.51) for women. Carotid artery IMT did not vary significantly with radiation dose (p = 0.18). CONCLUSION: Radiation dose contributed to the prevalence of aortic atherosclerosis but not carotid artery atherosclerosis in atomic bomb survivors.

Aged↗
PubMed1983

Natural cell-mediated cytotoxicity among A-bomb survivors residing in the United States.

Natural cell-mediated cytotoxicity (NCMC) by lymphocytes from Japanese atomic bomb survivors now living in the United States was measured. Seventy-one individuals were exposed to an estimated '0.00' Gy ('0 rads') (S0 group) and 58 to greater than '0.00 Gy' (S+ group) at the time of the bomb. Of this 58, 51 (88 per cent) received less than 0.50 Gy and 30 (52 per cent) received less than 0.10 Gy. NCMC was measured against 51Cr-labelled K562 target cells. Activity by lymphocytes from S+ group donors was significantly greater than that for the S0 group (p = 0.028 by the stratified Wilcoxon rank-sum test). This difference between the S+ and S0 populations was detected 35 years after exposure to the bomb. It is therefore feasible and important to examine appropriate biologic parameters to elucidate the effects of low doses of radiation in humans.

Aged↗