Abstracts of papers on updated radiation effects,immunological effects of nuclear war,medical effects and future dangers of nuclear‐weapon tests

Biological weapons (BW), although outlawed under the 1925 Geneva Convention, were studied in World War II, but were not used except on a small scale by the Japanese in Manchuria. The UN Disarmament Commission in 1959 failed to have BW eliminated because of the absence of agreed international verification. The Pugwash movement carried out trial inspections of microbiological establishments and concluded in 1966 that verification was possible. A WHO assessment in 1969 on chemical and biological weapons was that the effects on civilian populations could be very damaging, but that BW would not be militarily useful except for sabotage. The Biological Weapons Convention (1972) renounced biological warfare but permits relevant research for defence. Research on BW has recently been increased by the USA which claims that the USSR is using genetic engineering for this purpose. Research relevant to BW should not be carried out secretly nor under military auspices.     

Long‐term accumulation and microdistribution of uranium in the bone and marrow of beagle dog

The accumulation and microdistribution of uranium in the bone and marrow of Beagle dogs were determined by both neutron activation and neutron‐fission analysis. The experiment started immediately after the weaning period, lasting till maturity. Two animal groups were fed daily with uranyl nitrate at concentrations of 20 and 100?µg?g^?1 food. Of the two measuring techniques, uranium accumulated along the marrow as much as in the bone, contrary to the results obtained with single, acute doses. The role played by this finding for the evaluation of radiobiological long‐term risks is discussed. It was demonstrated, by means of a biokinetical approach, that the long‐term accumulation of uranium in bone and marrow could be described by a piling up of single dose daily incorporation.     

Long‐term persistence of translocations in stable lymphocytes from victims of a radiological accident

Purpose: To investigate whether translocations in ‘stable’ lymphocytes, i.e. those not containing unstable aberrations in any chromosome including counterstained ones, would have a longer persistence with time compared with those measured in all cells.

Materials and methods: The time‐course of chromosomal aberrations in the three most highly exposed radiation victims of an Estonian accident in November 1994 was followed for 7 post‐accident years encompassing 15 samples. Chromosome painting was performed using probes for chromosomes 1, 2 and 4 with a pan‐centromeric probe, and chromosomal aberrations involving the painted chromosomes were scored using a developed version of the Protocol for Aberration Identification and Nomenclature Terminology (PAINT) nomenclature. Metaphases containing aberrations were captured with an image analyser and stored on a computer. An earlier analysis of aberrations in the painted portion of the genome was performed in all cells, irrespective of the possible aberrations in the unpainted part of the genome. The present analysis has taken into account the ‘stable/unstable’ nature of the complete cell. Evaluation was performed on images, counting all chromosomes and checking the counterstained chromosomes for unstable aberrations, i.e. dicentrics, acentrics or ring chromosomes.

Results: In the original analyses of all cells, a decrease in translocation frequency in the early samples was observed. In the present study of stable cells, the results showed that the yield of translocations is constant with time.

Conclusions: The results show that translocations observed in stable cells are persistent with time. This implies that retrospective dosimetry and calibration should be performed using stable cells. To obtain more information on this issue, the stability status of all cells in any future fluorescence in situ hybridization follow‐up of a radiation accident should be noted.     

Intramural neovascularization and haemorrhages are major long‐term effects of intravascular γ‐radiation after stenting

Structural changes that might influence the structural integrity of the vessel in response to intravascular brachytherapy (IVB) and stenting were examined, focus being on the importance of neovascularization in rabbit stented arteries. Stents were implanted in the infrarenal aortas of rabbits, immediately followed by gamma IVB or a sham radiation procedure, and the arteries harvested at 6 months. Labelling for von Willebrand factor showed an increase in adventitial and medial neovascularization in irradiated versus control arteries group (5.04±0.89 versus 1.51±0.23?mm^?2, respectively; p=0.004). Moreover, intramedial haemorrhages (free hemosiderin deposition) and inflammation (macrophages) were only observed in irradiated arteries. No significant change in expression of matrix metalloproteinase 1, 2 or 3 was observed between the irradiated and control group while collagen content decreased in the irradiated versus the control group (10.05%±1.48% versus 31.92%±3.12%, respectively; p<0.001). The study supports the hypothesis that IVB associated with stenting induces late deleterious effects on the medial layer, characterized by formation of intramural neovessels, haemorrhages and a decrease in collagen content.     

After the war in Nicaragua: A psychosocial study of war wounded ex‐combatants

Despite 150 wars in the Third World since 1945, there have been virtually no psychosocial studies of war wounded ex‐combatants. This community study of 72 such men, on average 4.9 years post‐injury, had both quantitative (General Health Questionnaire [GHQ] and clinical interview) and qualitative (personal narrative) components. Most men were coping adaptively. However their overall GHQ scores were significantly higher than an ex‐combatant control group, suggesting relative psychological vulnerability (P = 0.001). 13 (18 per cent) had post‐traumatic stress disorder (PTSD) though in only three was this clinically significant, two of whom were aggressive alcoholics. Social dysfunction was a better indicator of the minority who needed psychological help than a diagnosis of PTSD. The one in three with a severe physical disability were not at greater risk than the rest of the group. Personal narratives illuminated the ways subjects had registered and reponded to their war experiences. Identification with the social ideals being defended by the war effort had been psychologically bolstering. Ten severely disabled ex‐Contra guerrillas, who had fought on the other side, were also interviewed. The availability of appropriate training/work, and thus the economic fortunes of the whole society, are likely to be major determinants of long‐term psychosocial outcomes. Six illustrative personal histories are appended.     

Survival with pain: An eight‐year follow‐up of war‐wounded refugees

The aim of this study was to investigate the nature of chronic pain in male war‐wounded refugees and to examine the relationship between chronic pain and psychiatric symptoms. A culturally heterogeneous group of 44 war‐wounded refugees were investigated during hospitalization, shortly after arrival, and followed up after two years. This study is an additional follow‐up after eight years. The data collection methods used were structured interviews and physical examination. The measures of outcome were: Visual Analogue Scale (VAS) grading of pain; clinical categorization of pain into nociceptive or neurogenic; Hopkins Symptom Check List (HSCL‐25); Post Traumatic Symptom Scale (PTSS‐10). Chronic pain was found in 32 (73%) out of 44 subjects. The pain was purely nociceptive and neurogenic in 53% and 25%, respectively. The frequency of psychiatric symptoms was significantly related to the mean intensity of pain. War‐wounded refugees display psychiatric symptoms and chronic pain in a complex pattern. Further research is needed as a basis for pain rehabilitation programmes suitable for this group.     

Co‐operation not confrontation: Imperative of the nuclear age

The 1986 National Meeting of Physicians for Social Responsibility (PSR) was held in Philadelphia on March 14–15. The meeting, entitled Winning the Race Against Nuclear Arms, celebrated the twenty‐fifth anniversary of PSR. It was attended by nearly 600 physicians.     

Differing effects of breast cancer 1, early onset (BRCA1) and ataxia‐telangiectasia mutated (ATM) mutations on cellular responses to ionizing radiation

Purpose: The ataxia‐telangiectasia mutated (ATM) gene encodes a protein kinase, the activation of which is an early event in the cellular response to ionizing radiation. One of the many substrates of ATM is BRCA1 (breast cancer 1, early onset gene), which has been associated with susceptibility to breast and ovarian cancer, and has been implicated in DNA repair processes. Various cellular responses to radiation were analysed in cells with mutations in ATM or BRCA1 in an attempt to clarify which effects of ATM can be mediated through BRCA1.

Materials and methods: The response to radiation of cells with mutations in ATM or BRCA1 was examined, as were BRCA1‐mutant tumour cells transfected with an exogenous wild‐type BRCA1 allele. Assays included cell‐survival curves, studies of potentially lethal damage repair, measurement of chromosomal aberrations and of G1 arrest, and Western blot analysis of lysates of irradiated cells to determine the phosphorylation of the product of the human Mdm2 gene (HDM2).

Results: Both ATM and BRCA1 mutations were associated with sensitivity to ionizing radiation, deficient repair of potentially lethal damage and markedly increased chromosomal aberrations. A BRCA1‐mutated tumour cell line HCC1937, like ATM mutant cells, did not exhibit a normal G1 arrest but, unlike ATM mutant cells, did exhibit phosphorylation of HDM2. Expression of wild‐type BRCA1 in HCC1937 cells partially restored radioresistance, restored repair of potentially lethal damage and markedly reduced radiation‐induced chromosomal aberrations. G1 arrest, however, was not restored by expression of BRCA1.

Conclusions: The results are consistent with a model in which ATM phosphorylation of BRCA1 regulates DNA repair functions, particularly those involved in potentially lethal damage repair and chromosomal integrity, but not other aspects of the cellular response to radiation such as G1 cell cycle arrest. To the authors' knowledge, this is the first demonstration of the ability of exogenously expressed BRCA1 to restore the ability to perform potentially lethal damage repair and maintain chromosomal integrity in irradiated cells.     

Low‐dose radiotherapy (LD‐RT) and the modulation of iNOS expression in adjuvant‐induced arthritis in rats

Purpose: Low‐dose radiotherapy (LD‐RT) of arthritic joints applied during the peak of the acute inflammatory response improves the clinical and histomorphological development of adjuvant arthritis. The study was undertaken to investigate the cellular composition of the inflammatory infiltrate and the expression of the pro‐inflammatory and anti‐inflammatory enzymes, inducible nitric oxide synthase (iNOS), cyclo‐oxygenase 2 (COX‐2) and haem‐oxygenase 1 (HO‐1), in response to LD‐RT.

Materials and methods: Adjuvant arthritis in female Lewis rats was induced by intradermal injection of heat‐inactivated mycobacterium tuberculosis on day 0. Both arthritic hind paws were sham irradiated (group 1) or X‐irradiated with either 5×1.0?Gy (group 2) or 5×0.5?Gy (group 3) from days 15 to 19 after induction (15 animals/group). On days 21 (n=12 joints/group) and 30 (n=18 joints/group), cryostat sections were analysed histologically and immunohistologically after specific staining for macrophages, iNOS, COX‐2 and HO‐1.

Results: A total of 5×1.0?Gy or 5×0.5?Gy led to a significant reduction of clinical symptoms from days 21 to 29, and a highly significant reduction of cartilage and bone destruction on day 30. Macrophage‐positive areas could be detected continuously throughout the periarticular infiltrate, and were slightly reduced after LD‐RT on days 21 and 30. This reduction was more pronounced after 5×1.0?Gy. Following LD‐RT, the iNOS score was reduced by about 45–50% on days 21 (p<0.05) and 30 (p<0.001). In contrast, the HO‐1 score was increased by about 50% on days 21 (p=0.08) and 30 (p=0.03).

Conclusions: The clinically and histologically observed prevention of the pro‐gression of adjuvant arthritis after LD‐RT given during the peak of the acute inflam‐matory response and the reduction of cartilage and bone destruction in the chronic phase appears to be related to the modulation of iNOS activity by low X‐ray doses.     

Chromatin‐ and temperature‐dependent modulation of radiation‐induced double‐strand breaks

Purpose: To investigate the influence of chromatin organization and scavenging capacity in relation to irradiation temperature on the induction of double‐strand breaks (DSB) in structures derived from human diploid fibroblasts.

Materials and methods: Agarose plugs with different chromatin structures (intact cells±wortmannin, permeabilized cells with condensed chromatin, nucleoids and DNA) were prepared and irradiated with X‐rays at 2 or 37°C and lysed using two different lysis protocols (new ice‐cold lysis or standard lysis at 37°C). Induction of DSB was determined by constant‐field gel electrophoresis.

Results: The dose‐modifying factor (DMF_temp) for irradiation at 37 compared with 2°C was 0.92 in intact cells (i.e. more DSB induced at 2°C), but gradually increased to 1.5 in permeabilized cells, 2.2 in nucleoids and 2.6 in naked DNA, suggesting a role of chromatin organization for temperature modulation of DNA damage. In addition, DMF_temp was influenced by the presence of 0.1?M DMSO or 30?mM glutathione, but not by post‐irradiation temperature.

Conclusion: The protective effect of low temperature was correlated to the indirect effects of ionizing radiation and was not dependent on post‐irradiation temperature. Reasons for a dose modifying factor <1 in intact cells are discussed.     

Nationalities in Europe: The risk of war and medical responsibility∗

War is often considered to be a way of solving political or economic problems. On the psychological level, war and acts of war are correlated with fear and guilt. In dealing with fear and guilt projection is a common defence mechanism, whereby others are scapegoated as the cause for one's own problems. This article presents an analysis of the relations between socio‐political and economic problems, fear and guilt, and armed conflicts and wars. An alternative strategy is described, whereby people accept responsibility for the situation and work out solutions, based on a mature identity and by democratic processes. Conditions to promote this strategy are discussed. In the introduction some consequences of the last world war and of the work of the National Institute for the Victims of War in the Netherlands are described.     

War‐wounded refugees: The types of injury and influence of disability on well‐being and social integration

The aim of this study is to describe the war injuries and investigate the influence of physical disability on well‐being and social integration in a group of war‐wounded refugees after two years in Sweden. A culturally heterogenous sample of 54 war‐wounded refugees was investigated during hospitalization shortly after arrival, and after two years. Quantitative data were covered by physical examinations, interviews and questionnaires. In addition, qualitative data were collected within semi‐structured interviews on both occasions. The major types of war injuries were: fractures (22%), traumatic amputations (17%), spinal cord injuries (17%), nerve injuries (11%), combinations of fractures and nerve injuries (9%), bilateral eye injuries (9%), brain injuries (7%), other injuries (7%). Regarding the type of injuries and medical complications, the group studied was representative of small unit operations of war with low access to early medical care. The degree of physical disability was not a salient factor for well‐being and social integration after two years in Sweden. The losses and desires to be repatriated were apparent from the qualitative findings, as exemplified by three case reports. The findings of this study are in accordance with previous research on refugees and war‐injured ex‐combatants, but further multidisciplinary research is needed. The results also imply that resettlement countries should pay continuous attention to the broad needs of their war‐wounded refugees.     

Misuse of the term ‘load’ in sport and exercise science

Despite the International System of Units (SI), as well as several publications guiding researchers on correct use of terminology, there continues to be widespread misuse of mechanical terms such as ‘work’ in sport and exercise science. A growing concern is the misuse of the term ‘load’. Terms such as ‘training load’ and ‘PlayerLoad’ are popular in sport and exercise science vernacular. However, a ‘load’ is a mechanical variable which, when used appropriately, describes a force and therefore should be accompanied with the SI-derived unit of the newton (N). It is tempting to accept popular terms and nomenclature as scientific. However, scientists are obliged to abide by the SI and must pay close attention to scientific constructs. This communication presents a critical reflection on the use of the term ‘load’ in sport and exercise science. We present ways in which the use of this term breaches principles of science and provide practical solutions for ongoing use in research and practice.     

Magnetic field (50 Hz) increases N‐acetyltransferase,hydroxy‐indole‐O‐methyltransferase activity and melatonin release through an indirect pathway

Purpose: To examine whether magnetic fields (MF) affect N‐acetyltransferase (NAT) and hydroxy‐indole‐O‐methyltransferase (HIOMT) activity directly or exert their effect through a cellular pathway that indirectly regulates the activity of these enzymes and melatonin release.

Materials and methods: The pineal glands from Wistar rats were isolated at 10:00?h and exposed to MF (50?Hz, 1?mT) for 4?h in vitro, with or without 1?µM norepinephrine. An additional group of pineals was exposed to MF 30?min before norepinephrine addition. The direct effect of MF on the activity of the enzymes was studied in sonicated glands exposed to MF. NAT activity, HIOMT activity and melatonin release were determined.

Results: In pineal glands isolated in the morning, 4‐h in vitro exposure did not affect the basal release of melatonin from the pineal gland as well as the basal NAT and HIOMT activities. Pineal gland exposure to MF 30?min before norepinephrine addition significantly (p<0.05) increased NAT activity, HIOMT activity and melatonin release (p<0.05). These effects were not observed in pineals co‐treated with MF and norepinephrine or in sonicated glands exposed to MF.

Conclusions: The results suggest that in pineals isolated in the morning, 4‐h MF exposure changes melatonin release by affecting the signal transduction pathway leading from the norepinephrine receptor to NAT and HIOMT and not via a direct effect at the enzyme levels.