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ИННОВАЦИОННЫЕ ТЕХНОЛОГИИ В ПЕДИАТРИИ И ДЕТСКОЙ ХИРУРГИИ
THE PRESENT SITUATION AND FUTURE PROSPECT OF THE HEALTH CARE IN FUKUSHIMA IN COMPARISON WITH CHERNOBYL.
Furitsu K.
National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan.
After the accident of Fukushima-No.1 Nuclear Power Plants, at least 4 million residents in the contaminated region were exposed additionally over 1 mSv only during the first year. This number of people living in the contaminated region is comparable to the figure in the case of Chernobyl accident. Already more than 60,000 workers in total worked on cleaning-up operation at the site of the plants. The health and medical care of those who have been exposed to radiation is still one of the unsolved urgent problems in Japan. Though more than six years have passed from the accident, a general medical- checkup system, which is carried out in the contaminated region of Chernobyl, for all the residents in the contaminated region as well as the cleaning-up workers has not yet established. One of the reasons for the omission is misguided view on the health risk of ionizing radiation in Japan.
We also have to consider the difference of public medical system between Japan and the countries of former USSR. The self-pay burden of medical treatment is one of the great problems for the patients.
We will report the problems of health care in Fukushima based on the clinical activities in the region and will discuss the possible direction for the future in comparison with the experience in Chernobyl, Hiroshima and Nagasaki.
THYROID CANCER IN JAPAN AFTER THE CATASTROPHE AT THE FUKUSIMA-1 NPP
Yoshida Y.
Chernobyl Health Survey and Healthcare Support for the Victims — Japan Women's Network, Chiba, Japan
Six years have passed since the catastrophe at the Fukusima-1 NPP. In Fukushima prefecture, Thyroid Ultrasound Screening is carried out to people who were 18 years old or younger at the time of the nuclear accident. The subjects are almost 380 thousand. Thyroid Screening continues every two years until the age of 20, and at 5 year milestones thereafter. This screening in Fukushima is supported by the government.
By the end of March 2017, 191 people with thyroid cancer or suspicious malignancy cases are found. The argument about the effects of radiation continues. However, for the sex ratio of incidence of thyroid cancer in Fukushima, a high morbidity rate of boys is found in even high teens. It differs from a global trend of thyroid cancer incidence. Exploring this reason is also an important issue.
In Japan, regions of soil contamination level comparable to the polluted areas of the Chernobyl accident exist outside of Fukushima Prefecture, but the government has asserted that the implementation of Thyroid Screening
Tests in those areas are not necessary.
A private Fund was organized last year to support children with thyroid cancer not only in Fukushima but also in contaminated areas outside of Fukushima. Author works as a director of this Fund. The Fund found a few cancer cases which have not been counted as the published official ones in Fukushima. Now, it is recognized that the published number of patients are less than the actual one.
As the information gotten by the Fund, the prevalence of distant metastasis in those areas is higher than in Fukushima. Although the Fund cannot show the actual prevalence, the screening test conducted in Fukushima seems to be effective for early detection.
ВОЗМОЖНОСТИ МУЛЬТИСПИРАЛЬНОЙ КОМПЬЮТЕРНОЙ ТОМОГРАФИИ В ДИАГНОСТИКЕ ПОРОКОВ РАЗВИТИЯ ТОЛСТОЙ КИШКИ У ДЕТЕЙ С ХРОНИЧЕСКИМ КОЛОСТАЗОМ
Акилов Х.А., Саидов Ф.Х. Республиканский научный центр экстренной медицинской помощи г. Ташкент, Узбекистан Ташкентский институт усовершенствования врачей г. Ташкент, Узбекистан
Введение. Мультиспиральная компьютерная томография (МСКТ) при патологии толстой кишки у взрослых пациентов используется довольно часто, но у детей в диагностике аномалий развития толстой кишки этот метод пока не нашел широкого применения (не удержание контраста, применение седатив-ных средств, лучевая нагрузка).
Цель исследования. Изучить возможности МСКТ-исследования в диагностике пороков развития толстой кишки у детей с хроническим колостазом.
Материалы и методы. В исследование включено 34 детей с различной патологией толстой кишки, страдающих хроническим колостазом. Среди обследованных детей с хроническим колостазом, 23 (67,6%) пациента были госпитализированы с подозрением на острый аппендицит, у 11 (32,4%) пациентов наблюдалась клиника кишечной непроходимости. При исключении острой хирургической патологии мы применяли в диагностическом плане МСКТ. Из 34 детей у 20 (58,8%) осуществлена МСКТ-виртуальная коло-носкопия, у 14 (41,2%) — МСКТ-контрастная коло-нография. МСКТ-ВКС проводилось с раздуванием толстой кишки воздухом. МСКТ-ККГ введения per rectum контрастного вещества 76% тразографа разведенной физиологическим раствором.
Результаты. МСКТ-ВКС дает возможность определить толщину стенки толстой кишки, получить трехмерное изображение слепка высокого разрешения, а также произвести эндоскопический осмотр просвета толстой кишки. МСКТ-ВКС позволяет определить форму кишки, ширину просвета на всем протяжении, выявить деформацию контура, стенозы, полипы, дивертикулы. МСКТ-ККГ позволяет опре-
РОССИЙСКИЙ ВЕСТНИК ПЕРИНАТОЛОГИИ И ПЕДИАТРИИ, 2017; 62:(4) ROSSIYSKIY VESTNIKPERINATOLOGY IPEDIATRII, 2017; 62:(4)
