Downregulation of telomerase in rat during the aging process

Telomerase is an RNA-dependent DNA polymerase that maintains the tandem arrays of telomeric repeats at the eukaryotic chromosome ends. Because of its ability to replenish lost telomeric sequences, telomerase is thought to be required for cell proliferation. At present, very little information on the role of telomerase in aging is available. In the present study, we tested the telomerase activity of Fischer 344 rat testis and liver at 6, 12, 18 and 24 months of age. As the testis is an androgen-dependent tissue, we also investigated the changes of testosterone and mRNA levels of androgen receptor in this tissue. Our results show that the telomerase activity of Fischer 344 rat testis significantly reduced at 24 months of age compared to 6 months of age, and that the mRNA level of telomerase protein component 1 (TLP-1) show a corresponding decrease with the telomerase activity. Interestingly, this down-regulation was not observed in the liver. The testosterone level in testis increased until 18 months of age, but reduced by 50% at 24 months of age. Our conclusions are that the telomerase activity is age-dependent and its change is a tissue-specific phenomenon.

Diverse fine specificity and receptor repertoire of T cells reactive to the major VP1 epitope (VP1230-250) of Theiler's virus: V beta restriction correlates with T cell recognition of the c-terminal residue

Theiler's murine encephalomyelitis virus induces chronic demyelinating disease in genetically susceptible mice. The histopathological and immunological manifestation of the disease closely resembles human multiple sclerosis, and, thus, this system serves as a relevant infectious model for multiple sclerosis. The pathogenesis of demyelination appears to be mediated by the inflammatory Th1 response to viral epitopes. In this study, T cell repertoire reactive to the major pathogenic VP1 epitope region (VP1233-250) was analyzed. Diverse minimal T cell epitopes were found within this region, and yet close to 50% of the VP1-reactive T cell hybridomas used V beta 16. The majority (8/11) of the V beta 16+ T cells required the C-terminal amino acid residue on the epitope, valine at position 245, and every T cell hybridoma recognizing this C-terminal residue expressed V beta 16. However, the complementarity-determining region 3 sequences of the V beta 16+ T cell hybridomas were markedly heterogeneous. In contrast, such a restriction was not found in the V alpha usage. Only restricted residues at this C-terminal position allowed for T cell activation, suggesting that V beta 16 may recognize this terminal residue. Further functional competition analysis for TCR and MHC class II-contacting residues indicate that many different residues can be involved in the class II and/or TCR binding depending on the T cell population, even if they recognize the identical minimal epitope region. Thus, recognition of the C-terminal residue of a minimal T cell epitope may associate with a particular V beta (but not V alpha) subfamily-specific sequence, resulting in a highly restricted V beta repertoire of the epitope-specific T cells.

Gulf War Veterans' Health Registries. Who is most likely to seek evaluation?

Since the Persian Gulf War ended in 1991, many veterans have sought medical evaluation in the Department of Veterans Affairs Persian Gulf Veterans' Health Registry (VA registry) or the Department of Defense's Comprehensive Clinical Evaluation Program (DoD registry). Using combined data collected from 1993 to 1997 from the VA and DoD registries, the authors compared the characteristics of registry participants (n=74,653) with those of all Gulf War veterans (n=696,531) to determine the personnel most likely to seek medical evaluation. Using multiple logistic regression, the authors found that service branch and type were strongly associated with registry participation, with Army (adjusted odds ratio (OR)=4.7, 95% confidence interval (CI) 4.6-4.9) and National Guard (OR=2.6, 95% CI 2.5-2.6) personnel at highest odds compared with reference category personnel. Registry participants also were more likely to have been stationed in the Gulf War theater during the fighting (OR=2.2), to be older (>31 years/<22 years OR=2.1), to have been an enlisted person (OR=2.0), to have been construction workers (OR=1.3), to be female (OR=1.3), and to have been hospitalized during the 12-month period before the war (OR=1.2). These findings are useful in generating hypotheses regarding postwar morbidity. They also suggest that subpopulations of Gulf War veterans have a higher prevalence of symptoms and merit further study.

Taurine can ameliorate inflammatory bowel disease in rats

We previously reported that the protective effect of taurine against indomethacin-induced gastric mucosal injury was due to its antioxidant effects which inhibited lipid peroxidation and neutrophil activation. In this study, we examined the effect of taurine on reducing the inflammatory parameters of trinitrobenzene sulfonic acid (TNBS)-induced inflammatory bowel disease (IBD) in rats. To induce IBD, rats were given ethanolic TNBS intracolonically. The rats then received 500 mg/kg/day of taurine per orally. The rats were sacrificed one week after IBD induction. Ulceration and inflammation of the distal colon with formation of granuloma in the vehicle-treated IBD rats after two days of administration of TNBS were observed. Treatment with 0.5 g/kg of taurine by the oral route ameliorated colonic damage and decreased the incidence of diarrhea and adhesions. Colon weight (an index of tissue edema) was markedly increased in the IBD rats after administration of TNBS, but was significantly lower after taurine treatment. Myeloperoxidase (MPO) activity in the vehicle-treated IBD rats was substantially increased compared with that of the control. The taurine-treated animals showed reduced MPO activity (35% lower) when compared with that of the vehicle-treated animals. Taurine treatment decreased basal and formyl-methionyl leucyl phenylalanine (FMLP) stimulated reactive oxygen generation in colonic tissue of the IBD rat compared with vehicle treatment after one week. These results suggest that administration of taurine reduced the inflammatory parameters in this rat model of IBD by increasing the defenses against oxidative insult.

A case of adrenal cavernous hemangioma

Adrenal hemangiomas are rare tumor. Only 29 surgical cases have been reported. Although rare, adrenal hemangiomas should be included in the differential diagnosis of adrenal neoplasms. We report an additional case of adrenal hemangioma that was removed surgically, and the pertinent literature is reviewed.

A case-control study of lung cancer among Vietnam veterans

Because of concerns among veterans over Agent Orange exposure, the Department of Veterans Affairs (VA) has conducted a series of studies of specific cancers among Vietnam veterans. Lung cancer is the topic of investigation in this report. The VA's Patient Treatment File (PTF) was used to identify 329 Vietnam era veterans with a diagnosis of lung cancer made between 1983 and 1990. The PTF is a computerized hospitalized database of inpatient records, including patients' demographic data, and diagnoses. A record is created for each patient discharged from any one of the VA's Medical Centers. Variables abstracted from the military record include education, race, branch of service, Military Occupational Specialty Code, rank, and units served within Vietnam. Two hundred sixty-nine controls were randomly selected from the PTF file of men hospitalized for a reason other than cancer. A second control group numbering 111 patients with colon cancer was also selected from the PTF file. Data were also gathered on exposure to Agent Orange through the location of each individual ground troop veteran's unit in relation to an area sprayed and the time elapsed since that area was sprayed. The crude odds ratio between service in Vietnam and lung cancer was of borderline significance (odds ratio = 1.39 with 95% confidence interval = 1.01-1.92). The relationship disappeared when the confounder year of birth was considered. We conclude from these data that there is no evidence of increased risk in lung cancer associated with service in Vietnam at this time.

Mortality among Army Chemical Corps Vietnam veterans

Army Chemical Corps personnel who served in Vietnam were among those service personnel with the greatest potential for exposure to herbicides. An earlier evaluation of the mortality experience of 894 Army Chemical Corps Vietnam veterans found a statistically significant excess risk of dying from digestive disease, primarily due to cirrhosis of the liver, and from motor vehicle accidents. That study was expanded to include 2,872 Vietnam veterans who served with the Army Chemical Corps and a comparison cohort of 2,737 veterans who never served in Southeast Asia but who did serve in the same occupational category. The results of the analysis comparing the Vietnam cohort to the non-Vietnam cohort support the earlier finding of a significant excess of deaths from digestive diseases (adjusted relative risk (RR) = 3.88, 95% C.I. = 1.12-13.45) primarily due to liver cirrhosis. Non-significant elevated relative risks were observed for all cancers combined, digestive and respiratory systems cancers, skin cancer, lymphopoietic cancers, and respiratory system diseases. Compared to the mortality rates in the general population, the non-Vietnam Army Chemical Corps veterans had a statistically significant deficit in mortality from all causes combined, which is consistent with a 'healthy selection bias' seen among military populations (SMR = 0.79, 95% C.I. = 0.66-0.94). For the Vietnam veterans, patterns of elevated but nonsignificant SMRs persisted for diseases of the digestive and respiratory systems and for selected cancer sites.

Hepatic undifferentiated embryonal sarcoma: MR findings

We report the MR findings of undifferentiated embryonal sarcoma of the liver. A 15-year-old boy presented with a palpable mass in the right upper quadrant of the abdomen. A T1-weighted MR image showed a well defined hypointense mass with scattered high signal intensities in the left hepatic lobe. On T2-weighted imaging, the tumor changed to a hyperintense mass. Postcontrast T1-weighted imaging showed irregular enhancement of the solid portion of the mass. MR findings are correlated with those of angiography, US, CT, and pathology.

Mortality among U.S. veterans of the Persian Gulf War

BACKGROUND

Since the 1990-1991 Persian Gulf War, there has been persistent concern that U.S. war veterans may have had adverse health consequences, including higher-than-normal mortality.

METHODS

We conducted a retrospective cohort study of postwar mortality according to cause among 695,516 Gulf War veterans and 746,291 other veterans. The follow-up continued through September 1993. A stratified, multivariate analysis (with Cox proportional-hazards models) controlled for branch of service, type of unit, age, sex, and race in comparing the two groups. We used standardized mortality ratios to compare the groups of veterans with the general population of the United States.

RESULTS

Among the Gulf War veterans, there was a small but significant excess of deaths as compared with the veterans who did not serve in the Persian Gulf (adjusted rate ratio, 1.09; 95 percent confidence interval, 1.01 to 1.16). The excess deaths were mainly caused by accidents (1.25; 1.13 to 1.39) rather than disease (0.88; 0.77 to 1.02). The corresponding rate ratios among 49,919 female veterans of the Gulf War were 1.32 (0.95 to 1.83) for death from all causes, 1.83 (1.02 to 3.28) for accidental death, and 0.89 (0.45 to 1.78) for death from disease. In both groups of veterans the mortality rates were significantly lower overall than those in the general population. The adjusted standardized mortality ratios were 0.44 (95 percent confidence interval, 0.42 to 0.47) for Gulf War veterans and 0.38 (0.36 to 0.40) for other veterans.

CONCLUSIONS

Among veterans of the Persian Gulf War, there was a significantly higher mortality rate than among veterans deployed elsewhere, but most of the increase was due to accidents rather than disease, a finding consistent with patterns of postwar mortality among veterans of previous wars.

The postwar hospitalization experience of U.S. veterans of the Persian Gulf War

BACKGROUND

Since the Persian Gulf War ended in 1991, many veterans of that conflict have reported diverse, unexplained symptoms. To evaluate the health of Gulf War veterans, we studied their postwar hospitalization experience and compared it with that of other military personnel serving at the same time who did not go to the Persian Gulf.

METHODS

Using a retrospective cohort approach and data from Department of Defense hospitals, we studied hospitalizations of 547,076 veterans of the Gulf War who were serving in the Army, Navy, Marine Corps, and Air Force and 618,335 other veterans from the same era who did not serve in the Persian Gulf. Using multivariate logistic-regression models, we analyzed risk factors for hospitalization both overall and in 14 broad diagnostic categories during three periods from August 1991 through September 1993 (a total of 45 specific comparisons).

RESULTS

After the war, the overall odds ratio for hospitalization of the Gulf War veterans was not higher than that of the other veterans, even after adjustment for selection effects related to deployment. In 16 of the 42 comparisons involving specific diagnoses, the risk of hospitalization among Gulf War veterans differed significantly from that among other veterans. Among these 16 comparisons, Gulf War veterans were at higher risk in 5: neoplasms (largely benign) during 1991, diseases of the genitourinary system during 1991, diseases of the blood and blood-forming organs (mostly forms of anemia) during 1992, and mental disorders during both 1992 and 1993. The differences were not consistent over time and could be accounted for by deferred care, postwar pregnancies, and postwar stress.

CONCLUSIONS

During the two years after the Persian Gulf War, there was no excess of unexplained hospitalization among Americans who remained on active duty after serving in that conflict.

Feasibility of an epidemiologic study of submariners who received radium irradiation treatment

Thousands of World War II veterans reportedly received nasopharyngeal irradiation with radium-tipped applicators for treatment of middle ear pressure problems known as aerotitis media. Because of concerns about adverse health effects of radiation exposure, including the increased risk of head and neck cancer, the feasibility of identification of a large number of veterans with documented exposure for an epidemiologic study was investigated. The irradiation treatments were found to have occurred at the New London Naval Medical Research Department, at several Naval Hospitals, and aboard ships during the period from 1945 to 1952. Documentation of the treatment on veterans' medical records was sparse and inconsistent. Only 8 of 668 records reviewed were found to have evidence of the radium treatment: 7 from 33 self-reported veterans and 1 from 635 names on submarine school class rosters and submarine muster rolls. There appears to be no practical way to identify from military service and medical records a large number of submariners who received the treatment.

Tandem repeats 3' of the IGHA genes in the human immunoglobulin heavy chain gene cluster

The human IGH constant region spans 350 kb and includes nine genes and two pseudogenes. All of the constant region gene cluster has been cloned except for sequences between the IGHD and IGHG3 genes, between the IGHA1 and IGHG2 genes, and the 3' region downstream of the IGHA2 gene. The regions 3' of the IGHA genes, which are not cloned, are of interest since transcriptional control elements were found downstream of the IGHA genes in the rat and the mouse IGH loci. In addition, by pulsed-field gel electrophoresis mapping, CpG islands were identified approximately 30 kb downstream of each IGHA gene, within the uncloned portion of the human IGH. These findings indicate that the regions 3' of the IGHA genes are candidate regions for additional transcriptional elements of the human IGH genes. In an effort to characterize these regions, we screened five different libraries and determined the regions 3' of the IGHA genes to be unclonable by standard cloning methods. Therefore, we applied the Inverse-PCR technique to amplify the sequences flanking the IGHA genes. We obtained 1418 bp of new sequence 3' of the IGHA1 gene. The new sequence included tandem repeats of 20 bp, which we propose is the cause of the unclonability of this region.

Experimental study of self-expandable metallic inferior vena caval stent crossing the renal vein in rabbits. Radiologic-pathologic correlation

RATIONALE AND OBJECTIVES

The authors evaluate in the rabbit the radiologic-pathologic changes of the inferior vena cava and the renal vein and the functional changes of the kidneys after placement of a self-expandable metallic stent in the inferior vena cava where the renal vein empties.

METHODS

One self-expandable metallic stent was placed in the inferior vena cava in each of 12 rabbits; the rabbits were divided into four groups of three rabbits each. The inferior vena cava and renal vein were examined angiographically and pathologically at intervals of 1 week, 2 weeks, 1 month, and 3 months. Vena cavography was performed to evaluate changes in the inferior vena cava before and after stenting. Laboratory tests were performed to determine blood urea nitrogen and creatinine levels, and radioisotope renal scans were performed to evaluate possible changes in renal function before and after stenting.

RESULTS

No stent migration was noted in 11 of 12 rabbits; however, migration of the stent to the subdiaphragmatic level was noted in 1 rabbit. All stents were patent angiographically. Statistical analysis showed no significant change in renal function after stenting (blood urea nitrogen, P = 0.9; creatinine P = 0.5). In addition, radioisotope scans revealed no abnormal findings in perfusion and excretion. Pathologic examination of both kidneys showed no abnormal findings. Neointimal proliferation over the stent was first noted at 1 week after the stent was placed, was most prominent at 1 month, and regressed substantially by 3 months.

CONCLUSIONS

The self-expandable metallic stent was relatively well adapted to the inferior vena cava. Renal function was not affected by the inferior vena cava stent, which crossed the orifice of renal vein.

The risk of suicide among wounded Vietnam veterans

OBJECTIVES

This study was undertaken to determine whether an association exists between combat trauma and risk of postservice suicide among Vietnam veterans.

METHODS

Risk of suicide for 34,534 veterans who were wounded in Vietnam was evaluated for severity of wound and number of times wounded.

RESULTS

There was a trend of increasing risk of suicide with increased occurrence of combat trauma, the highest relative risk (1.82, 95% confidence interval [CI] = 1.12, 2.96) being observed for those veterans who were wounded more than once and hospitalized for a wound. In comparison with the US male general population, veterans hospitalized because of a combat wound or wounded more than once had a significantly increased risk of suicide (standardized mortality ratios [SMRs] of 1.22 [95% CI = 1.00, 1.46] and 1.58 [95% CI = 1.06, 2.26], respectively). Those wounded more than once and hospitalized had the highest increased risk of suicide (SMR = 1.73, 95% CI = 1.10, 2.60).

CONCLUSIONS

This study suggests that, among wounded Vietnam veterans, there is an increased risk for suicide associated with increased occurrence of combat trauma.

Vital status ascertainment through the files of the Department of Veterans Affairs and the Social Security Administration

Veterans of US military service are a valuable resource for epidemiologic studies, and the Department of Veterans Affairs (VA) files provide an effective way to gather mortality information on veterans, so long as these files provide reasonably complete death reporting. To determine the completeness of VA death reporting, we assembled an independent sample of known veteran deaths among males born between 1936 and 1955 and assessed the performance of VA death reporting in this sample. We also compared VA death ascertainment to Social Security Administration (SSA) ascertainment. Based on the more than 4300 deaths in our study, we found VA death reporting to be approximately 90% complete by itself and 96% complete when used in conjunction with SSA death reporting. In addition, we found no evidence that VA death reporting changed substantially after passage of the Omnibus Budget Reconciliation Act of 1981, which limited eligibility for VA death benefits. Because veterans make up a large segment of the US population, our findings have particular relevance for studies in which mortality is a primary end point.

Mortality patterns among Vietnam veterans: a 24-year retrospective analysis

The mortality experience of 33,833 US Army and Marine Corps Vietnam veterans who died during 1965-1988 was compared with that of 36,797 deceased non-Vietnam veterans using proportionate mortality ratios (PMRs). Military service information was abstracted from military personnel records and cause of death information recorded from death certificates. Army Vietnam veterans had statistically significant excesses of deaths from laryngeal cancer (PMR = 1.38) and lung cancer (PMR = 1.08). There was an excess of external causes (PMR = 1.03), including motor vehicle accidents (PMR = 1.03) and accidental poisonings (PMR = 1.17). In contrast to Army Vietnam veterans, the results for Marine Vietnam veterans varied according to the referent population used. When compared with non-Vietnam veterans, Marine Vietnam veterans had significantly elevated PMRs for lung cancer (PMR = 1.17) and skin cancer (PMR = 1.33). There was also a significant excess of external causes of death (PMR = 1.06), accidental poisonings (PMR = 1.19), and homicides (PMR = 1.16) compared with all non-Vietnam veterans.

Traumatic bilateral carotid-cavernous fistulas treated with detachable balloon. A case report

A 29-year-old male developed ptosis and progressive pulsating protrusion of the right eye, accompanied by conjunctival injection and tinnitus following a bicycle accident. MR angiography revealed dilation of both superior ophthalmic veins and facial veins. Right internal carotid angiography demonstrated right carotid-cavernous fistula (CCF) at the C3 portion of the right internal carotid artery with abnormal venous drainage. After right carotid balloon occlusion test had been performed, a detachable balloon was introduced into the right CCF while preserving the lumen of the right internal carotid artery. A left CCF, which was detected after closure of the right CCF, was also closed with a detachable balloon. Follow-up carotid angiographies showed complete closure of both CCFs and no abnormal venous drainage. After 1 year no abnormal physical manifestations, or abnormal neurologic signs or symptoms were present.

Visual outcome of excimer laser photorefractive keratectomy for myopia. A comparison of three laser delivery systems in Australia

PURPOSE

To compare the performance of the three excimer laser delivery systems in correcting myopia.

METHODS

The first generation excimer laser systems produced by Summit, VISX and LEI were examined. The first 40 consecutive eyes with six-month refractive results were selected from the LEI centre. Forty consecutive eyes, matched for age and attempted corrections, were then selected from each of the Summit and VISX centres. The postoperative visual results were examined retrospectively and compared among the three groups.

RESULTS

At six-month follow-up, the mean and standard deviation of the spherical equivalent refraction were +0.27 (SD, 0.65) dioptre in the Summit group, -0.33 (SD, 0.83) dioptre in the VISX group and -0.62 (SD, 0.89) dioptre in the LEI group (P = 0.0001, ANOVA). Thirty-five eyes (88%) in the Summit group, 33 eyes (83%) in the VISX group and 28 eyes (70%) in the LEI group achieved corrections within 1 dioptre of intended corrections (P = 0.131, chi 2 test). Four eyes (10%) in the Summit group, two eyes (5%) in the VISX group and one eye (3%) in the LEI group were overcorrected by more than 1 dioptre at six-month follow-up. Unaided visual acuity (Snellen equivalent) was 6/12 or better in 37 eyes (93%) in the Summit group, 34 eyes (85%) in the VISX group and 34 eyes (87%) in the LEI group (data missing in one eye). Loss of one or more lines of best corrected visual acuity (Snellen equivalent) was found in 6 of 39 eyes (15%) in the Summit group, 10 of 40 eyes (25%) in the VISX group and 4 of 36 eyes (11%) in the LEI group (P = 0.258, chi 2 test). Regression between one and six month follow-up differed significantly (P = 0.001, ANOVA) among the groups, with the mean of -1.25 (SD, 0.94) dioptres in the Summit group, -0.59 (SD, 1.01) dioptre in the VISX group and -0.40 (SD, 0.99) dioptre in the LEI group.

CONCLUSIONS

Statistically comparable results were found in the three groups in terms of refraction and visual acuity six months after myopic photorefractive keratectomy. No statistical differences were found between the groups in terms of significant overcorrection or loss of best corrected acuity. The group treated using the Summit system demonstrated significantly greater regression than the other groups, necessitating larger initial hyperopic shifts.

Military service in Vietnam and the risk of death from trauma and selected cancers

The postservice mortality of a cohort of 10,716 US Marine veterans who served in Vietnam was compared with that of 9,346 Marine veterans who did not serve in Vietnam. There was a significant excess of death for Vietnam Marines from all causes and all external causes. After adjustments for age and rank in military, overall mortality continued to be statistically significant, with a relative risk of 1.15 (95% confidence interval (CI) = 1.02 to 1.29) for Vietnam Marines compared to non-Vietnam Marines. All external causes was also significant, with a relative risk of 1.21 (95% CI = 1.00 to 1.47). The excess overall mortality was mainly due to excess deaths from external causes. The risks for several site-specific cancers were elevated but not statistically significant. Periodic follow-up of this Marine cohort should continue to determine whether there are statistically significant differences in the mortality patterns of Marine Vietnam and non-Vietnam veterans, especially for cancers.

Hodgkin's disease and Vietnam service

Earlier studies that showed an association between exposure to phenoxy herbicides and the risk of malignant lymphomas have sparked concerns among Vietnam veterans over Agent Orange exposure. The Department of Veterans Affairs (VA) undertook a hospital-based case-control study to examine the association between military service in Vietnam and several histologic types of malignant lymphomas. This is a report of 283 Vietnam-era veteran patients who were treated in one of 172 VA hospitals from 1969 to 1985 with a diagnosis of Hodgkin's Disease (HD). Four hundred and four Vietnam-era veteran patients with diagnosis other than malignant lymphoma served as a comparison group. Military service in Vietnam was not associated with any significant increase in the risk of HD (adjusted odds ratio = 1.28; 95% confidence interval = 0.94, 1.76). Surrogate measures of potential Agent Orange exposure such as service in a specific military branch, in a certain region within Vietnam, in a combat role, or extended Vietnam service time were not associated with any significant increased risk of HD.

Cancer mortality risk among military participants of a 1958 atmospheric nuclear weapons test

OBJECTIVES

This study was undertaken to determine if Navy veterans who participated in an atmospheric nuclear test in 1958 were at increased risk of death from certain cancers.

METHODS

Cancer mortality risk of 8554 Navy veterans who participated in an atmospheric nuclear test in the Pacific was compared with that of 14,625 Navy veterans who did not participate in any test. Radiation dosage information was obtained from film badges for 88% of the test participants.

RESULTS

The median radiation dose for the test participants was 388 mrem (3.88 millisieverts [mSv]). Among participants who received the highest radiation dose (> 1000 mrem, or 10 mSv), an increased mortality risk for all causes (relative risk [RR] = 1.23; 95% confidence interval [CI] = 1.04, 1.45), all cancers (RR = 1.42; 95% CI = 1.03, 1.96), and liver cancer (RR = 6.42; 95% CI = 1.17, 35.3) was observed. The risk for cancer of the digestive organs was elevated among test participants (rate ratio = 1.47; 95% CI = 1.06, 2.04) but with no significant dose-response trend. Many of the cancers of a priori interest were not significantly elevated in the overall test participant group or in the group that received the highest radiation dose.

CONCLUSIONS

Most of the cancers suspected of being radiogenic were not significantly elevated among the test participants. Nevertheless, increased risks for certain cancers cannot be ruled out at this time. Veterans who participated in the nuclear weapons tests should continue to be monitored.