International Medical Cooperation for the Radiation Exposed Population (Hibakusha) in Semipalatinsk, Kazakhstan : A Challenge from Hiroshima, the City of the World's First Atomic Bombing 【Report】

The main objective of this report is to describe the activities of a non-governmental organization(NGO), the Hiroshima Semipalatinsk Project (hereafter the Hiro-Semi Project or the Project), that sup-ports medical aid to those who were exposed to radiation from the nuclear bomb tests in Kazakhstan.The Project has carried out medical cooperation activities five times and dispatched medical missions ofdoctors, nurses, and medical technicians four times. In this report, we attempt to show the purpose of the foundation of the Hiro-Semi Project. In addition, we show the final goal of the Project. We also reporton the medical activities of the Hiro-Semi Project and touch upon the medical items provided by theHiro-Semi Project and the medical examinations from the medical missions sent by the Project. As isgenerally known, medical cooperation is an important part of international cooperation. For example,the activities of Medecins Sans Frontieres Japonand The Association of Medical Doctors of Asia arewell known. It is possible for those who are not medical doctors to conduct medical cooperation. In fact,the Hiro-Semi Project plans and conducts medical aid and dispatches medical missions. The mostimportant matter is to establish a strong cooperative relationship with specialists or experts in that field.The Hiro-Semi Project endeavors to establish such a relationship. As people concerned with internation-al cooperation, we should pay more attention to the activities of medical cooperation done by grass rootsmovements, keeping in mind that there are many approaches to international cooperation. This reportwill outline one approach and one possibility of international cooperation

Noninvasive Positive Pressure Ventilation in Treatment of Non-COPD Related Acute Respiratory Failure Cases

We used Noninvasive Positive Pressure Ventilation (NPPV) in nine patients with acute respiratory failure (ARF), not related to chronic obstructive pulmonary disease (COPD). After separating the nine patients into a hypercapnic group (five patients) and a non-hypercapnic group (four patients), we investigated its effectiveness in physiological improvement and avoiding intubation. Dyspnea, physiological findings and ABG improved rapidly in both groups without serious adverse effects. The intubation avoidance rate was 66.7% (6 of 9) in total, and 80% in the hypercapnic group and 50% in the non-hypercapnic group. The ratio of PaO_2 to FiO_2 (P/F ratio) increased during NPPV in most cases where intubation could be avoided. It is worthwhile to use NPPV as a bridging therapy between O_2 therapy and invasive ventilation in patients with non-COPD related ARF, regardless of the existence of hypercapnia. Careful monitoring of the P/F ratio and complications is needed to make an appropriate decision whether avoiding intubation will be possible or not

Some Approaches to Treatment of Patients with Thyroid Nodular Diseases in the Semipalatinsk Region of Kazakhstan

It was determined by experts that in the region adjacent to the Semipalatinsk Nuclear Test Site thyroid nodular prevalence was significantly associated with radiation dose from nuclear weapons testing. The medical rehabilitation of patients is of special practical and scientific importance in this region. Some patients have contraindications for surgery and radioiodine or refuse them for various reasons. Percutaneous intranodular injection therapy by "Paoscle" (PIITP) was used for treatment of patients with benign thyroid nodular diseases. The study group included a total of 107 patients (mainly "pretoxic" and "compensated" nodules). Seventyfour patients received PIITP on an out-patient basis. Seventy-two of them were women and 2 men, mean age, 52.9±1.3 years; range 26 to 77 years. Thyroid ultrasound examination, fineneedle aspiration biopsy, thyroid function tests and cytopathology were performed in all patients to evaluate the effectiveness of treatment. The nodule volume reduction rate for patients with thyroid adenomas was 56% on average and 60.2% in the case of colloid nodules. The reduction rate of thyroid adenomas with necrotic and cystic degeneration was higher and reached 72%. The suggested method is indicated for cases of benign nodular thyroid diseases (cysts, adenomas, adenomas with necrotic and cystic degeneration, colloid nodules, polynodular goiter). We did not reveal any complications or thyroid test abnormalities after the treatment. A tendency to normalization of the blood serum thyroglobulin level and antibodies to thyroglobulin was documented. Analysis of the treatment results revealed that this approach is effective, inexpensive, safe, well tolerated and can be used on an outpatient basis

A case of pulmonary asbestosis presenting with temporal arteritis involving multiple medium-sized vessels

A 76-year-old woman with pulmonary asbestosis was admitted with fever and polymyalgia. She subsequently developed a visual disorder, hemoptysis, and hemoperitoneum. A biopsy of the temporal artery revealed the presence of giant-cell arteritis. CT and angiography showed hemorrhaging from the bronchial and abdominal arteries. These observations suggested temporal arteritis in which medium-sized vessels were involved. This case implies the association between vasculitis and asbestosis, and suggests a problem in the classification of vasculitides

セミパラチンスク核実験場近郊住民の被曝線量推定と健康影響研究

研究期間:平成15-16年度 ; 研究種目:基盤研究B2 ; 課題番号:15406002原著には既発表論文の別刷を含む