[en] Nuclear power plant accidents which cause radiation injuries have rarely occurred in the world. In Japan, we have experienced no case of radiation injuries related to nuclear power plant accidents. However, we have experienced several cases of radiation injuries, which have occurred in the field of radiation devices. Medical staffs that treat externally exposed patients have no reason to fear their own exposure to these patients, because external exposure causes no harmful effects to the treating staff if precautionary guide lines are followed. Patients who are contaminated by radioactive substances (¹³⁷Cs, ²³⁹Pu and etc) should be treated carefully. In order to prevent the secondary exposure and contamination by patients, the medical staff should employ the prevention principle (shield, distance and treatment time). Radiation-induced bone marrow injuries can be successfully treated with blood transfusion, some kinds of cytokines (rhG-CSF, etc) and radioprotectors. However, present-day medical treatment is limited for patients suffering from either intestinal or central nervous system injuries. In the case of contaminated radiation burns, life-saving treatment should be the first priority, and then burns should be decontaminated and treated medically. In order to eliminate internally contaminating radioactive substances, many kinds of chelating agents (DTPA for ²³⁹Pu and iodine-chloride for ¹³¹I, etc) can be adopted. The medical staffs that is required to treat exposed and contaminated patients should have full knowledge of radiation injuries and acquire skill in the treatment of radiation contamination. (author)

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[en] A criticality accident occurred at the JCO nuclear fuel processing plant in Tokai-mura, Japan at 10:35 am on September 30, 1999. Three workers while working nearby were exposed to high doses of radiation, especially rich in neutron. They suffered from the acute radiation syndrome and two of them were still under medical treatment. This criticality accident taught us significant lessons of radiation protection for the personnels, e.g. physicians, nurses and firemen who are expected to rescue radiation-exposed patients in radiation accidents. In this article, medical management of radiation accident, e.g. treatment of patient, with high-dosed radiation-exposure and with internal contamination of radioactive nuclides and estimation of individual radiation dose, were briefly explained. The Japanese Association for Medical Management of Radiation Accident was founded on August 29, 1997, in order to promote the mutual communication of physicians who have to be engaged in treatment of radiation-exposed patients. (author)

[en] In our country, the medical emergency programs for the people living near nuclear power stations are well organized, however, preparation of medical staffs who are well trained is considered to be not sufficient. In the USA, on call 24 hours response to a radiological emergency is provided and funded by Department of Energy(DOE) or electric companies. Especially, REAC/TS is a part of DOE response network, in which there are provided well-trained physicians, nurses, health physicists, coordinators and support personnels. In United Kingdom, National Radiological Protection Board(NRPB) is responsible to a radiological emergency program. Each nuclear power station has its own emergency program consisting of a team of physicians, nurses and health physicists. In France, French Atomic Energy Commission (CEA) is a responsible agency for a radiological emergency program. On call 24 hours response to a radiological emergency is provided in Fontenay-aux Roses Institute and Curie Institute. Curie Institute also responds to radiological emergencies in other countries at the request of WHO. In Germany(West Germany), compulsory assurance system covers a radiological emergency program and a radiological protection. There are seven centers in West Germany, in which well-trained medical staffs are provided against radiological injuries. In this report, I tried to propose a new concept about emergency medical programs for nuclear power station accidents in Japan. I think it is a very urgent theme to provide on call 24 hours radiological emergency program, in which patients suffered from acute radiation sickness with internal contamination or contaminated radiation burns will be treated without any trouble. We have to make our best efforts to complete basic or clinical research about radiation injuries including bone marrow transplantation, radioprotectors, chelating agents and radiation burns etc. (J.P.N.)

[en] Biodosimetry, in which exposure doses are estimated using biological samples such as blood, urine and teeth, is important not only in determining the optimum treatment strategy but also in screening patients requiring emergency care in the setting of radiological accident. This article discusses biodosimetry at the time of whole-body exposure and local exposure, together with its usage in actual radiological accidents. Dosimetry at the whole-body exposure is described in terms of the following approaches: (1) changes in blood samples, (2) chromosomal aberration, (3) the frequency of somatic mutation, chromosomal aberration of human spermatozoon, biochemical analysis, electroencephalographic abnormalities, and spin echo resonance. Biodosimetry at the time of local exposure is mentioned in relation to skin exposure. Finally, biodosimetry used in actual radiological accidents of Chernobyl, Goiania, and San Salvador is referred to. (N.K.)

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[en] IAEA has started comprehensive survey in February 1990 by organizing international expert teams. The survey consists of five tasks, including historical survey, environmental survey, dosimetry, health effects, and countermeasures. This is the report of the author's experience in participating in Task 4 as one of the team members. Task 4 had two goals--to survey the present health conditions of inhabitants living in the contaminated areas surrounding the Chernobyl nuclear reactor and to examine what kinds of diseases are influenced by the accidents. Bragin, Veprin, and Korma were chosen as contaminated areas, and Kirovsk and Chodosy as uncontaminated areas. Subjects consisted of the 2-year, the 5-year, the 10-year, the 40-year, and the 60-year age groups. Hematologic examination, ultrasound diagnosis of the thyroid gland, thyroid hormone tests, and serum concentration of lead will be given in the IAEA's final report. From the author's experience, it should be noted that Cs-137 of 17 Bq/body before the departure from Japan increased to 196 Bq/body 18 days after staying in Byelorussia. (N.K.)

[en] The test subjects termed as OK-432 group which consist of 4 patients of Medulloblastoma and 2 of Pinealoma, underwent the whole axis irradiation in combination with OK-432. The control group consisting of 9 Medulloblastoma patients was subjected to the same radiation treatment without OK-432. Six of the nine patients (66.7%) irradiated showed the decrease of peripheral white blood cell counts down to 2,500, whereas, only two of six patients showed a similar decrement in OK-432 group. Three of the nine patients (33.3%) in the control group showed the decrease of white blood cell down to 2,000, but only one of the six patients in OK-432 group. The neutrophil counts decreased below the level of 1,000 in three of the nine patients (33.3%) in the control group, but none in the OK-432 group. The platelet counts decreased below the level of 100,000 in five of the nine patients (55.6%) in the control group during the irradiation period, but only one patient in the OK-432 group showed a decrease down to 100,000 counts. Three of the nine patients (33.3%) in the control group had to be stopped irradiation due to the severe leukopenia and thrombocytopenia, in contrast to the OK-432 group, which completed whole axis irradiation without interruption. These results seem to indicate that OK-432 alleviated the myelosuppression induced in patients by whole axis irradiation. This alleviating action of OK-432 is considered to be applicable to the treatment of Medulloblastoma patients. (J.P.N.)

[en] At the time of radiation exposure accidents, for carrying out medical treatment and for presuming the future of exposed people, the evaluation of personal exposure dose is important. However, due to the uneven exposure in whole body exposure, the possibility of local exposure and so on, the estimation of personal exposure dose is not necessarily easy. Therefore, it becomes necessary to estimate exposure dose using personal body samples. The biodosimetry using the change in peripheral blood, the abnormality in chromosomes and so on becomes necessary. In this report, the outline of biodosimetry at the time of radiation exposure is reviewed. At the time of accidents, there are the possibility of exposure to multiple radiations, the variety of energy, the unevenness in the direction of exposure, the possibility of contamination of dosimeters and so on. In such case, it is unavoidable to estimate dose utilizing the samples obtained from the bodies of exposed people, such as blood, erythrocytes, leucocytes, lymphocytes, genital glands, sperms, skin, hairs, teeth and so on. Biodosimetry in skin exposure, biodosimetry using blood, chromosome abnormality, the measurement of mutation frequency of body cells, biochemistry, brain waves, sperm chromosomes and electron spin resonance are explained. (K.I.)