Terrorism: The Psychological Impact on Youth

Research on the psychological impact of terrorism on youth is reviewed and evaluated. Children having proximal contact with terrorism show elevated posttraumatic stress, separation anxiety, and/or other symptoms. Following a terrorist attack, youth proximal and distal to the attack are exposed to a vast amount of attack‐related media coverage and exposure to such media coverage is associated with postattack posttraumatic stress disorder (PTSD) symptomatology. However, the research is inchoate, including an insufficient scope and methodological limitations. Research has yet to examine the impact that exposure to an extended context of threat, expectation, and alert has on child development. Importantly, how are children influenced by secondhand terrorism—the context in which cultural influences disproportionately attend to the possibilities, rather than probabilities, of future terrorism? Research is needed to evaluate the impact of terrorism on psychopathology (beyond PTSD), functional impairment, and ethnic stereotyping in youth, and to examine the efficacy of psychological programs that strive to redress the problems of youth affected by terrorism.     

Challenges associated with creating a pharmaceutical stockpile to respond to a terrorist event

The Centers for Disease Control and Prevention (CDC) was called into action to develop a National Pharmaceutical Stockpile (NPS). The NPS was created to respond to terrorism events involving blast, chemical and biological agents. There are many challenges associated with creating, managing and using such an asset. This paper provides a helpful background for clinicians and those planning to develop pharmaceutical and/or medical materiel stockpiles for national use. It also describes major challenges and offers suggestions for meeting those challenges.     

肿瘤放射治疗物理的进展

本文扼要地叙述了目前肿瘤放射治疗物理学的进展，突出介绍了当前肿瘤放射治疗的前沿技术调强适形放射治疗（IMRT）的物理原理和实施方法。     

Child Reactions to Terrorism: Cautions and Next Steps for Research

Comer and Kendall (2007) have provided an excellent review of what is known about the effects of terrorism on children. They have identified correlates, outcomes, and the many gaps in our current knowledge. The present comments focus on two main issues. First, there are many correlates and risk factors that predict deleterious outcomes following exposure to terrorist acts. Our field occasionally moves quickly to intervention work by altering malleable risk factors as if they played a causal role in the outcome or its amelioration. More work is needed to analyze these correlates and the precise role they play, if any, in the outcome. Second, in a relatively new area of research there are very many gaps in our knowledge. I discuss the need to prioritize and limit the focus of our studies. Priorities highlighted include evaluating the similarities among natural and human‐made disasters and evaluating mechanisms of action among correlates that might bear an important role in child outcomes. Apart from the consequences of terrorist acts on children and families, our field must turn to the broader issue. What can our science do alone and in conjunction with other fields to understand and combat the precursors and origins of terrorism? Theory will be wonderful but we will need to have this grounded or tested to ensure we move beyond reasonable ideas or a lavish buffet of untestable interpretations.     

放射治疗相关专业人员个人辐射剂量分析

目的 探讨放射治疗相关各专业工作人员的个人辐射剂量。方法 按照《职业性外照射个人监测规范》的要求,放射治疗各相关专业人员分为放射治疗医师组、放射治疗物理师组、放射治疗定位技师组、放射治疗师组和放射治疗护师组,采用热释光个人剂量计进行监测,2017~2018年每季度采集一次数据,比较各专业人员组与集体均值之间的差异和各专业组两两之间的差异。结果 放射治疗医师组个人辐射剂量为（0.03±0.02）mSv/季度,放射治疗物理师组个人辐射剂量为（0.07±0.02）mSv/季度,放射治疗定位技师组个人辐射剂量为（0.06±0.03）mSv/季度,放射治疗师组个人辐射剂量为（0.04±0.02）mSv/季度,放射治疗护师组个人辐射剂量为（0.06±0.02）mSv/季度;放射治疗师组共检测88人次,以上各组与集体比较,差异无统计学意义（P＞0.05）;放射治疗护师组与集体比较,差异有统计学意义（P＜0.05）;放射治疗物理师组与放射治疗定位技师组之间、放射治疗物理师组与放射治疗护师组之间、放射治疗师组与放射治疗定位技师之间和放射治疗定位技师-放射治疗护师之间分别比较,差异无统计学意义（P＞0.05）;其余各专业组两两比较,差异均有统计学意义（P＜0.05）。结论 监测放射治疗各专业组的个人辐射剂量的个人剂量水平均符合国家标准的规定,各专业组与集体比较,放射治疗医师组与集体均值基本一致,其余各组均高于集体均值;放射治疗师组比放射治疗物理师组和放射治疗护师组个人辐射剂量低,其余各相关专业组间没有显著性差异。     

Communication during radiation therapy education sessions: The role of medical jargon and emotional support in clarifying patient confusion

ObjectiveRadiation oncology consultations involve explanation of complex technical concepts using medical jargon. This study aimed to: analyse types and frequency of medical jargon that radiation therapists (RTs) use during education sessions; identify how patients seek clarification from RTs; and, explore RTs communication strategies.MethodsEducation sessions were audio-recorded and transcribed. Medical jargon was analysed using MaxDictio (a vocabulary analysis programme). A distinction was made between specialised (specialised terms used in RT or cancer) and contextual jargon (common everyday words with a different meaning in RT). Qualitative data were analysed using Framework analysis.ResultsFifty-eight patients and 10 RTs participated. Contextual treatment jargon were the most frequently used jargon (32.2%) along with general medical terms (34.6%). Patients appeared uncertain about the number of treatments, side effects, and the risks of radiation. Patients sought clarification by asking RTs to explain or repeat information. RTs replaced jargon with a simpler word, used everyday analogies, and diagrams.ConclusionUse of medical jargon is common in RT education sessions. RTs used different jargon types to varying degrees, but contextual jargon dominated.Practice implicationsTraining RTs how to tailor information to enhance patients’ understanding would be beneficial. Future research exploring medical jargon used in other (non-) oncology settings is required.     

Biological Profiles of Korean Atomic Bomb Survivors in Residence at Daegu and Kyungbuk, Republic of Korea

In 1945, many Koreans, in addition to Japanese, were killed or injured by the atomic bombs dropped on Hiroshima and Nagasaki, Japan. This study compared the biological profiles of Korean atomic bomb survivors in residence at Daegu and Kyungbuk, Republic of Korea with those of a representative sample of Koreans obtained during a similar period. We evaluated anthropometric measurements, blood pressure, blood cell counts, blood chemistry, and urinalysis of survivors (n=414) and age- and sex-matched controls (n=414) recruited from the third Korea National Health and Nutrition Examination Survey conducted in 2005. Univariate analyses revealed significantly higher systolic blood pressure, white blood cell count, and serum total cholesterol, triglycerides, high-density lipoprotein-cholesterol, and aspartate aminotransferase levels (p<0.01) in the survivors. Conversely, hemoglobin concentration, hematocrit, red blood cell count, and the proportion of positive urine occult blood (p<0.01) were lower in the survivors. Our findings suggest that biological profiles of Korean atomic bomb survivors were adversely affected by radiation exposure.     

小剂量^6^0Coγ射线辐照对小鼠植入后期胚胎发育的影响

本文采用＾６＾０Ｃｏγ射线，在小鼠怀孕６－１５天时进行０．２Ｇｙ／ｄ的照射，在孕期终了（１８天）用足孕期畸形学指标及肠道的免疫组织化学进行分析。结果发现，照射组孕鼠足孕时体重，体重增加数，平均体重变化百分率明显低于对照组，照射组胎仔足孕时平均胎重，身长，尾长均明显低于或短于对照组胎仔，照射组胎仔肠道每平方毫米的５－ＨＴ阳性细胞数明显少于对照组胎仔。孕鼠脑，肝，肾，卵巢等脏器重量及脏器／体重比值，活     

三种高效红外理疗辐射板的研制和临床应用

目的：提高红外理疗疗效。方法：以红外辐射与人体红外吸收光谱相匹配为指导，研制出三种红外理疗辐射板。结果：通过热辐射率谱和疗效观察，显示其具有高辐射率、高疗效等优点。结论：是值得推广的红外理疗辐射板。     

Effect of high NaCl intake on Na+ and K+ transport in the rabbit distal convoluted tubule

Morphological studies have demonstrated that a chronic increase in distal Na⁺ delivery causes hypertrophy of the distal convoluted tubule (DCT). To examine whether high NaCl-intake also causes functional changes in the well defined DCT, we measured transmural voltage (V _T), lumen-to-bath Na⁺ flux (J _Na(LB)), and net K⁺ secretion (J _K(net)) in DCTs obtained from control rabbits and those on high NaCl-intake diets. The lumen negativeV _T was significantly greater in the high NaCl group than in the control group. The net K⁺ secretion (pmol mm^–1 min^–1) was greater in the high NaCl-intake group (54.1±13.0 vs 14.7±5.6). The K⁺ permeabïlities in both luminal and basolateral DCT membranes, as assessed by the K⁺-induced transepithelial voltage deflection inhibitable with Ba²⁺, were increased in the experimental group. The lumen-to-bath²²Na flux (pmol mm^–1 min^–1) was also greater in the experimental group (726±119 vs 396±65). TheV _T component inhibitable with amiloride was also elevated in the high NaCl-intake group. Furthermore, Na⁺–K⁺-ATPase activity of the DCT was higher in the experimental than in the control group. We conclude that high NaCl intake increases both Na⁺ reabsorption and K⁺ secretion by the DCT. This phenomenon is associated with an increased Na⁺–K⁺-ATPase activity along with increased Na⁺ and K⁺ permeabilities of the luminal membrane, and an increase in the K⁺ permeability of the basolateral membrane. Cellular mechanisms underlying these functional changes remain to be established.     

Molecular origin of Na/Li exchanger: Evidence against the involvement of major cloned erythrocyte transporters

Numerous studies have demonstrated heightened Na⁺/Li⁺ countertransport (NLCT) activity in erythrocytes of patients with essential hypertension or diabetic nephropathy. The same carrier also contributes to the therapeutic action of lithium salt, widely used in the treatment of psychiatric disorders. However, the molecular origin of NLCT remains unknown. This study examined the role of major ion transporters in NLCT by comparative analysis of its activity and that of ion transporters providing inwardly directed ⁸⁶Rb, ²²Na and ³²P fluxes. NLCT was below the detection limit in rat erythrocytes and ∼50-fold higher in rabbits compared to humans. Unlike NLCT, the activities of Na⁺,K⁺-ATPase, Na⁺,K⁺,2Cl⁻ cotransporter and anion exchanger were somewhat similar in the erythrocytes of these species, whereas Na⁺,P_i cotransport was in 1:2:6 proportion in rats, humans and rabbits, respectively. Loading of erythrocytes with Li⁺ for NLCT measurement did not affect the activity of Na⁺,P_i cotransporter. Keeping in mind that NLCT is much higher in rabbits vs humans and rats, we compared the set of membrane proteins in these species using 2-dimensional gel electrophoresis. This approach revealed 174 common spots, whereas 132 proteins were detected only in human and rabbit erythrocyte membranes. Among these proteins, we found 17 spots whose expression was higher by more than 5-fold in rabbit compared to human erythrocytes. Thus, our results argue against the involvement of major ion transporters in NLCT. They also show that comparative proteomics is a potent tool to identify the molecular origin of this carrier.     

Understanding the Psychological Impact of Terrorism on Youth: Moving Beyond Posttraumatic Stress Disorder

Comer and Kendall's (2007) comprehensive review of the impact of terrorism on youth organizes this important and burgeoning area of research. The present commentary focuses on youth outcomes associated with proximal contact with terrorist attacks, and highlights several important issues that merit attention. Specifically, the commentary emphasizes the importance of examining youths' postattack outcomes broadly (in addition to posttraumatic stress disorder and its symptoms), assessing traumatic grief and bereavement when mass casualties occur, and evaluating issues of comorbidity and functional impairment. Future research on the impact of terrorism on youth would benefit from adopting a developmental psychopathology perspective in understanding variables that may influence and be influenced by youths' reactions to terrorist events. Implications for research and clinical practice are discussed.     

Bumetanide protects focal cerebral ischemia-reperfusion injury in rat

Objective: Bumetanide has been reported to attenuate ischemia-evoked cerebral edema. However, whether bumetanide can protect cerebral ischemia-reperfusion injury (IRI) in vivo is unclear. In the present study, we aim to determine whether intravenously injection bumetanide can attenuate cerebral IRI and if its protection effect might be related to the modification of cerebral NKCC1 and KCC2 protein expression. Methods: Focal cerebral ischemia was induced by occluding the right middle cerebral artery (MCAO) for 2-h, followed by 3-h, 24-h or 48-h of reperfusion respectively. Brain edema, neurological deficits, and infarction volume were determined by (wet weights - dry weights)/dry weights ×100, 5-point neurological function score evaluation system, and TTC staining, respectively. The expression levels of NKCC1 and KCC2 were determined by immunohistochemical staining. Results: Reperfusion increased brain edema, neurological deficits, and infarction volume. Bumetanide decreased brain edema, attenuated the neurological defects and reduced post-ischemic cerebral infarction. Cerebral ischemia-reperfusion injury increased NKCC1 expression level and decreased KCC2 expression level. Interestingly, bumetanide down-regulated the NKCC1 protein expression level without changing the KCC2 protein expression level in rat brain cortex. Conclusion: These results suggest that bumetanide protects focal cerebral ischemia-reperfusion injury in rat, which might through the inhibition of NKCC1.     

Effects of intracellular Ca2+ chelating compounds on inward currents caused by Ca2+ release from sarcoplasmic reticulum in guinea-pig atrial myocytes

Ca²⁺ release from the sarcoplasmic reticulum (SR) of mammalian cardiac myocytes occuring either due to activation by a depolarization or the resulting transmembrane Ca²⁺ current (I _Ca), or spontaneously due to Ca²⁺ overload has been shown to cause inward current(s) at negative membrane potentials. In this study, the effects of different intracellular Ca²⁺ chelating compounds on I _Ca-evoked or spontaneous Ca²⁺-release-dependent inward currents were examined in dialysed atrial myocytes from hearts of adult guinea-pigs by means of whole-cell voltage-clamp. As compared to dialysis with solutions containing only a low concentration of a high affinity ethylene glycol-bis(-aminoethylether) N,N,N,N-tetraacetic acid (EGTA) like chelator (50–200 M), inward membrane currents (at –50 mV) due to evoked Ca²⁺ release, spontaneous Ca²⁺ release or Ca²⁺ overload following long-lasting depolarizations to very positive membrane potentials are prolonged if the dialysing fluid contains a high concentration of a low affinity Ca²⁺ chelating compound such as citrate or free adenosine 5-triphosphate (ATP). Without such a non-saturable Ca²⁺ chelator in the dialysing fluid, Ca²⁺-release-dependent inward currents are often oscillatory and show an irregular amplitude. With a low affinity chelator in a non-saturable concentration, discrete inward currents with constant properties can be recorded. We conclude that the variability in Ca²⁺-release-dependent inward current seen in single cells arises from spatial inhomogeneities of intracellular Ca²⁺ concentration ([Ca²⁺]_i) due to localized saturation of endogenous and exogenous high affinity Ca²⁺ buffers (e.g. [2]). This can be avoided experimentally by addition of a non-saturable buffer to the intracellular solution. This condition might be useful, if properties of Ca²⁺ release from the SR and/ or the resulting membrane current, like for example arrhythmogenic transient inward current, are to be investigated on the single cell level.     

Epidermal growth factor stimulates Ca2+ uptake of human erythrocytes

To examine the functional significance of epidermal growth factor (EGF) binding sites present on the human erythrocyte membrane [Engelmann et al. (1992) Am J Hematol 39:239–241], the effect of EGF on ⁴⁵Ca²⁺ uptake and on ²²Na⁺ efflux from these cells has been studied. In all cases media contained 1.25 mM Ca²⁺, whereas Na⁺ and K⁺ were varied. In 140 mM Na⁺/5 mM K⁺ medium EGF (250 ng/ml) stimulated ⁴⁵Ca²⁺ uptake by 50%–90% in quin-2-loaded cells, and by up to threefold in untreated cells. Increasing extracellular K⁺ up to 75 mM at the expense of extracellular Na²⁺ stimulated the EGF-induced ⁴⁵Ca²⁺ uptake by about twofold compared to 145 mM Na⁺ medium both in quin-2-loaded and in untreated cells. In 145 mM K⁺ medium, however, no EGF-induced ⁴⁵Ca²⁺ uptake was detectable in quin-2-loaded cells, while in untreated cells Ca²⁺ entry was stimulated twofold by EGF. After increasing intracellular Na⁺ from 6 mmol/l cells to 18 mmol/l cells in untreated cells suspended in 145 mM K⁺ medium, ⁴⁵Ca²⁺ uptake induced by EGF gradually increased. In contrast, in 140 mM Na⁺/5 mM K⁺ as well as in 70 mM Na⁺/75 mM K⁺ medium, ⁴⁵Ca²⁺ uptake accelerated by EGF was largely unaffected by a modified red cell Na⁺ content. When ²²Na-loaded untreated red cells were suspended in 145 mM K⁺ medium EGF stimulated red cell ²²Na⁺ efflux by more than threefold. In 140 mM Na⁺/5 mM K⁺ as well as in 70 mM Na⁺/75 mM K⁺ medium, no ²²Na⁺ efflux induced by the growth factor was evident. The results are consistent with the idea that EGF stimulates (at least) two components of ⁴⁵Ca²⁺ uptake in human erythrocytes. One of the two is unmasked in 145 mM K⁺ medium, inhibited by quin-2 loading, accelerated by intracellular Na⁺ and appears to involve reversed Na⁺/Ca²⁺ exchange.     

Abnormal erythrocyte sodium leak in a subset of essential hypertensive patients

Summary We measured the ouabain- and bumetanide-resistant Na⁺ efflux in Mg²⁺-sucrose medium (passive Na⁺ leak) in erythrocytes from 30 normotensive controls and 72 essential hypertensive patients. The mean values (±SEM) of the rate constant of Na⁺ leak (k_pNa) were not significantly different between normotensives and hypertensives. Nevertheless, using the 95% confidence limits of the k_pNa (in 10^–3.h^–1) in the normotensive group as a cut-off point, 7 (9.7%) essential hypertensives exhibited increased values (58.96±10.12) when compared with the other 65 patients (23.86±0.74). revealing increased passive Na⁺ permeability in the former (leak + hypertensives). Na⁺ fluxes depending on the Na⁺-K⁺ pump, outward Na⁺-K⁺ cotransport, and Na⁺-Li⁺ countertransport were also measured in fresh erythrocytes from the same 72 patients. Three of them (4.2%) exhibited decreased values of ouabain-sensitive Na⁺ efflux and 6 (8.3%) of bumetanide-sensitive Na⁺ efflux, while 8 patients (11.1%) showed increased values of Li⁺-stimulated Na⁺ efflux and, finally, 48 patients (59.7%) did not present any evident abnormality in these Na⁺ transport systems. No differences were observed between leak + hypertensives and the remaining 65 patients when both basal erythrocyte Na⁺ content and clinical parameters of hypertension were compared. However, Na⁺ efflux depending on the outward Na⁺-K⁺ cotransport was significantly higher in the leak + hypertensive subset (299.43±43.18 vs 181.52±10.76 µmol.(l cells.h)^–1;P=0.0078), suggesting a compensatory phenomenon. Enhancement of Na⁺ permeability detected in 3% to 16% of essential hypertensives may be implicated in the pathogenesis of primary hypertension.Abbreviations ATPase adenosine triphosphatase - Dcat difference between the external Na⁺ concentration after incubation at 37° C and at zero time - k_pNa rate constant of passive Na⁺ leak - Leak + hypertensive essential hypertensive patient with abnormally high erythrocyte Na⁺ leak - MOPS 4-morpholinopropanesulfonic acid - OBR ouabain- and bumetanide-resistant - PRA plasma renin activity - sPRA plasma renin activity stimulated after furosemide infusion - SEM standard error of the mean Supported in part by Grant 87/1078 of the Fondo de Investigaciones Sanitarias de la Seguridad Social and Grant PA85/0168 of the Comisión Asesora de Investigación Científica y Técnica     

Aldosterone-regulated ion transporters in the kidney

Summary Madin-Darby canine kidney (MDCK) cells resemble intercalated cells of the renal collecting duct. In these cultured epithelial cells aldosterone activates apical Na⁺/H⁺ exchange, initiating a cascade of intracellular events such as cell growth, epithelial cell polarity, and stimulation of transepithelial ion transport. Transepithelial K⁺ secretion is triggered by the insertion of new ion channels and the activation of previously quiescent channels with increasing cytoplasmic pH. Aldosterone supplies the cell with ion transporters necessary for adequate function of the renal collecting duct when the organism is metabolically challenged.     

Mechanisms of chloride influx during KCl-induced swelling in the chicken retina

An increase in extracellular KCl ([KCl]_o) occurs under various pathological conditions in the retina, leading to retinal swelling and possible neuronal damage. The mechanisms of this KCl_o-induced retinal swelling were investigated in the present study, with emphasis on the Cl^– transport mechanisms. Increasing [KCl]_o (from 5 to 70 mM) led to concentration-dependent swelling in chicken retinas. The curve relating the degree of swelling to [KCl]_o was biphasic, with one component from 5 to 35 mM [KCl]_o and another from 35 to 100 mM. As Cl^– omission prevented swelling in all conditions, the effect of cotransporter or Cl^– channel blockers was examined to investigate the mechanisms of Cl^– influx. The cotransporter blockers bumetanide and DIOA reduced swelling by 68% and 76%, respectively at [KCl]_o 25 mM (K25), and by 14–17% at [KCl]_o 54 mM (K54). The Cl^– channel blockers NPPB and niflumic acid did not affect swelling at K25 but reduced it by 90–95% at K54 (NPPB IC₅₀ 60.7 µM). Furosemide showed an atypical effect, decreasing swelling by 14% at K25 and by 95% at K54 (IC₅₀ 173.9 µM). Na⁺ omission decreased swelling at K25 but not at K54. These results suggest the contribution of cotransporters to Cl^– influx at K25 and of Cl^– channels at K54. At K25, swelling was found in the ganglion cell layer and in the lower half of the inner nuclear layer. With K54, swelling occurred in all inner retinal layers. The ganglion cell layer swelling was due to both Müller cell end-foot and ganglion cell soma swelling. K54 also induced ganglion cell damage as shown by disorganized, pyknotic and refringent nuclei.     

Influence of Mitragyna Ciliata (MYTA) on the Microsomal Activity of ATPase Na+/K+ Dependent Extract on a Rabbit Heart

Mitragyna ciliata (MYTA) (Rubiaceae) inhibits plasmodia activity. MYTA induces a cardiotonicity of the digitalic type on rat''s isolated heart. In this work we studied the effect of MYTA on microsomal Na⁺/K⁺ dependant ATPase (Na⁺, K⁺ ATPase) extracted from the heart of a rabbit since digitalics inhibit Na⁺, K⁺ ATPase. Our results revealed that the Na⁺/K⁺ ATPase has an optimum pH of 7.4 and temperature of 37°C respectively. There is a linear relationship between the organic phosphate formed and the incubation time over 25 mins incubation period. The ATP hydrolysis rate in the presence of MYTA was 0.775 µM/min. LINEWEAVER and BURK plots showed that MYTA did not alter K_M (1.31 mM) but decreased V_MAX. This study shows that MYTA exerts a non-competitive inhibition on the microsomal Na⁺/K⁺ ATPase extracted from rabbit heart with a Ci₅₀ of 48 µg / ml. We conclude that the mechanism of action of MYTA is linked to the inhibition of the Na⁺/K⁺ ATPase like cardiotonics of the digitalic type.