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British Journal of Radiology (2003) 76, 246-253
© 2003 British Institute of Radiology
doi: 10.1259/bjr/82373369
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Initial medical management of patients severely irradiated in the Tokai-mura criticality accident

T Hirama, MD, PhD1, S Tanosaki, MD, PhD1, S Kandatsu, MD, PhD2, N Kuroiwa, MD1, T Kamada, MD, PhD2, H Tsuji, MD, PhD2, S Yamada, MD, PhD2, H Katoh, MD, PhD2, N Yamamoto, MD, PhD2, H Tsujii, MD, PhD2, G Suzuki, MD, PhD3 and M Akashi, MD, PhD1

1 Research Center for Radiation Emergency Medicine, 2 Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan and,3 Radiation Effect Research Foundation, Hiroshima, Japan



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  		Figure 1. The positions and postures of the victims of the accident at the moment when criticality was triggered, reconstructed by interviewing Workers B and C.

 


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  		Figure 3. CT image of the chest of Patients A and C. Arrows show the relevant areas stated below. (a) Day 1, Patient C. Note bilateral subpleural thickening, more severe in the right side, in the dorsum of the lower lobes of the lung. Adjacent to the thickening, restiform or rough reticular shadow can be seen. These findings were also observed in the dorsum of the upper lobes (not shown). (b) Day 6, Patient C. Remarkable improvement of the initial findings is obvious. (c) Day 60 of Patient C. Only equivocal reticular shadow remains. (d) Day 1, Patient A. Note bilateral crescent form shadows. The density of the area is higher than that of water, indicating proteinacious exudate or soft tissue thickening.

 


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  		Figure 2. Haematologic data of the patients. (a) Peripheral blood counts of Patients A, B and C during the first 11 days are depicted with diamonds, rectangles and triangles, respectively. (b) Haematologic data of Patient C during the whole admission period. The dynamics of neutrophil (upper left), platelet (middle left), lymphocyte (lower left), haemoglobin (upper right), reticulocyte (middle right) and serum iron (lower right) are shown.

 




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