Future directions in therapy of whole body radiation injury

Clinicians have long known that marked granulocytopenia predisposed patients to bacterial infections either from pathogens or commensal organisms with which an individual usually lives in harmony. Evidence that infection was of major importance derives from several observations: (a) clinical observations of bacterial infection in human beings exposed to atomic bomb radiation in Hiroshima and Nagasaki, in reactor accidents, and in large animals dying from radiation exposure, (b) correlative studies on mortality rate, time of death, and incidence of positive culture in animals, (c) challenge of irradiated animals with normally non-virulent organisms, (d) studies of germ free mice and rats, and (e) studies of the effectiveness of antibiotics in reducing mortality rate. General knowledge and sound experimental data on animals and man clearly demonstrated that the sequelae of pancytopenia (bacterial infection, thrombopenic hemorrhage, and anemia) are the lethal factors. A lot of research was required to demonstrate that there were no mysterious radiations toxins, that hyperheparinemia was not a cause of radiation hemorrhage and that radiation hemorrhage could be prevented by fresh platelet transfusions

Genetic and hematopoietic effects of long-term tritiated water (HTO) ingestion in mice

The positive effects seen using the somewhat insensitive dominant lethal test system and the effects seen on the blood-forming cells indicates that at least in the mouse there is a hazard in the continuous ingestion of HTO at a concentration of 3 $mu$CCi/ml. A direct comparison of these results to the human drinking an equivalent amount of HTO is impossible due to the obvious differences in water metabolism between the two species. Until further experimentation at lower levels of ingestion are completed, it is difficult to comment concerning the significance of these results as related to current concepts of maximum permissible concentration. Studies are now underway examining the possible effects of lower concentrations of chronic HTO ingestion. (auth

Is natural background or radiation from nuclear power plants leukemogenic

The objective in this review is to provide some facts about normal hemopoietic cell proliferation relevant to leukemogenesis, physical, chemical, and biological facts about radiation effects with the hope that each person will be able to decide for themselves whether background radiation or emissions from nuclear power plants and facilities significantly add to the spontaneous leukemia incidence. 23 refs., 1 tab

Clinical aspects of accidents resulting in acute total body irradiation

That the management of whole body radiation injury involves: (1) watchful waiting, (2) observation of the hematologic parameters, (3) use of antibiotics, platelet red cell and possibly granulocyte transfusions, (4) administration of hemopoietic molecular regulators of granulopoiesis, and (5) bone marrow transplantation as the last line of defense. The clinical indication for the preceding will not be discussed, since this will be a subject of later speakers in this conference. Certainly, if a radiation casualty is fortunate enough to have an identical twin, a marrow transplant may be lifesaving and certainly can do no harm to the patient, and there is little risk to the donor

Acute radiation syndrones and their management

Radiation syndromes produced by large doses of ionizing radiation are divided into three general groups depending on dose of radiation and time after exposure. The CNS syndrome requires many thousands of rad, appears in minutes to hours, and kills within hours to days. The GIS appears after doses of a few hundred to 2000 rad. It is characterized by nausea, vomiting, diarrhea, and disturbances of water and electrolyte metabolism. It has a high mortality in the first week after exposure. Survivors will then experience the HS as a result of marrow aplasia. Depending on dose, survival is possible with antibiotic and transfusion therapy. The relationship of granulocyte depression to mortality in dogs and human beings is illustrated. The role of depth dose pattern of mortality of radiation exposure is described and used as an indication of why air exposure doses may be misleading. The therapy of radiation injury is described based on antibiotics, transfusion therapy, and use of molecular regulators. The limited role of matched allogenic bone marrow transplants is discussed. 52 refs., 13 figs