Post-Chernobyl incidence of papillary thyroid cancer among Belgian children less than 15 years of age in April 1986: a 30-year surgical experience

50 Years of Terrorism against the Nuclear Industry: A Review of 91 Incidents in the Global Terrorism Database

BACKGROUND

The on-going Russo-Ukrainian war has resulted in a renewed global interest in the safety and security of nuclear installations and the possibility of nuclear disasters caused by warfare and terrorism.The objective of this study was to identify and characterize all documented terrorist attacks against nuclear transport, nuclear facilities, and nuclear scientists as reported to the Global Terrorism Database (GTD) over a 50-year period.

METHODS

The GTD was searched for all terrorist attacks against nuclear facilities, nuclear scientists, nuclear transport, and other nuclear industry-related targets in the period from 1970-2020. Analyses were performed on temporal factors, location, target type, attack and weapon type, perpetrator type, number of casualties, and property value loss.

RESULTS

Ninety-one incidents that occurred from 1970 through 2020 were included. Incidents took place in 25 countries and nine world regions, with most (42; 46.1%) occurring in Western Europe.During these 50 years, 91 incidents resulted in 19 fatalities and 117 injuries. One perpetrator was killed during an incident and one other assailant was injured.Bombings and explosions were the most frequently identified attack type (n = 40; 44.0%), followed by facility/infrastructure damage (n = 24; 26.4%) and armed assaults and assassinations (both n = 7; 7.7%).Nuclear power plants and reactors under construction were targeted in 13 (14.3%) and eight (8.8%) incidents, respectively. Most of the attacks took place on other nuclear industry-related sites.

CONCLUSION

Terrorist attacks carried out by non-state perpetrators against nuclear facilities, nuclear scientists, nuclear transport, and other nuclear industry-related targets are rare, with only 91 incidents in a 50-year period. None of the attacks resulted in radioactive fallout or environmental contamination. Most of the attacks took place outside a nuclear power plant.

Systematic Approach to Transboundary Radioactivity Monitoring for Accidents in External Nuclear Power Plants

Past nuclear accidents demonstrated that radioactive materials from an accident in a nuclear power station (NPS) can disperse to other countries or even across the globe. This means all countries need to be prepared to respond to a nuclear power emergency even if they have no nuclear power program. This study aims to propose a structured framework to enable transboundary radio activity monitoring of accidental releases in external NPSs in such a country with limited calculation resources. A trial calculation of a hypothetical release from an interfacing system loss of coolant accident (ISLOCA) in Unit 1 of Fangchenggang NPS during different representative meteorological scenarios is carried out to demonstrate the usability of the proposed framework. It was found that a relatively large release can reach the border of Thailand within 24 h when the wind along the dispersion pathway is basically in northeast direction with significant amount of rainfall, though it may not be able to trigger the alarm at the radiation monitoring stations. However, it is highly likely that the release that fulfills the aforementioned conditions be detected by one of the stations within 48 h-timeframe. As the trial calculation could deliver insightful findings with limited calculation resources, the proposed transboundary atmospheric dispersion calculation framework can be used in other nonnuclear power countries to prepare for emergency response to accidents in external NPSs.

Demographic and onco-epidemiological situation in radioactive contaminated territory of Zhytomyr Oblast

We performed an assessment of demographic parameters of occurrence of malignant tumours and mortality of the population which lives in the radioactive contaminated territory of Zhytomyr Oblast (Yemilchynskyi, Luhynskyi, Narodytskyi, Korostenskyi, Olevskyi, and Ovrutskyi districts) over a 32-year period (1985–2017). The source material for the study of the demographic situation and malignant tumours in the population of the radioactive contaminated administrative districts of Zhytomyr Oblast during 1985–2017 was the statistical data of the Management of Healthcare of Zhytomyr Oblast State Administration, Central Department of Statistics in Zhytomyr Oblasts, reports on occurrences of malignant tumours of the state institution Center of Medical Statistics of the Ministry of Healthcare of Ukraine, data of the Radiological Control Service in Zhytomyr Oblast. It was determined that over 1985–2017 in the radioactive contaminated territory of Zhytomyr Oblast, a natural decline of population was observed, maximum values of which occurred in 2005 (except Narodnytsky district – 2000). The highest levels of occurrence of tumours and mortality caused by them among the adult population were observed 14 years after the Chornobyl nuclear power plant disaster. The peak of the occurrence of malignant tumours among children in the radioactive contaminated territory of Zhytomyr Oblast was observed 9 years after the explosion. A relationship was determined between doses of irradiation of the population and the risk of occurrence of malignant tumours in the radioactive contaminated regions of Zhytomyr Oblast. Taking into account that the method of calculation of passport dose (average annual effective dose of irradiation) was developed 23 years ago, nowadays it can lead to errors. This is related to change in amounts of consumption of different products by the population, which needs to be considered when determining radiological risks. The obtained data indicate that analysis of demographic and onco-epidemiological consequences of the Chornobyl catastrophe remains a relevant issue nowadays and will remain so in the near future.

Deltopectoral flap revisited for reconstruction surgery in patients with advanced thyroid cancer: a case report

Background

We present the cases of 2 patients with invasive thyroid cancer, who underwent reconstructive surgery using a deltopectoral flap. Although the overall rate of extrathyroidal extension in patients with thyroid cancer is quite low, skin invasion is the most common pattern observed. Reconstructive surgery, involving local skin flaps, is required in these patients. The deltopectoral flap relies on the blood supply from intercostal perforators of the internal thoracic artery and usually requires skin grafting to the donor site. The internal thoracic artery is rarely sacrificed in these cases, even in an advanced surgery such as in patients with invasive thyroid cancer.

Case presentation

A 55-year-old man with a distended thyroid gland presented to our hospital. He underwent advanced surgery, including skin excision, because we suspected that his tumor was thyroid cancer. The defect was covered with an ipsilateral deltopectoral flap via transposition of the flap, without skin grafting. In the second case, a 67-year-old woman with thyroid cancer that metastasized to her neck lymph nodes presented to our institution. Although the ipsilateral internal thoracic artery was sacrificed near its origin during tumor resection, the deltopectoral flap was raised in the usual manner without any complications. The skin defect caused by the tumor resection was covered with the flap. The patient had an uneventful clinical course for more than 2 years of follow-up.

These 2 cases show the effectiveness of using the deltopectoral flap as a reconstructive option for patients with thyroid cancer who underwent radical surgery, resulting in a skin defect. The first case shows that this flap does not always require skin grafting to the donor site. To our knowledge, the second case may be the first report of a deltopectoral flap that was safely raised and applied with resection of the bifurcation of the ipsilateral internal thoracic artery.

Conclusions

Although thyroid cancer surgery with surrounding skin excision is a rare procedure, we found that the deltopectoral flap was useful and should be the first choice for patients undergoing reconstructive surgery, whether the bifurcation of the ipsilateral internal thoracic artery is sacrificed.

Electronic supplementary material

The online version of this article (10.1186/s12893-017-0297-8) contains supplementary material, which is available to authorized users.

Contrastive study of two screening criteria for active surveillance in patients with low-risk papillary thyroid microcarcinoma: a retrospective analysis of 1001 patients

Screening out patients who do not require immediate surgery is a growing trend in the field of thyroid research. In this study, we retrospectively compared the application of two surveillance selection criteria in 1001 patients who had undergone surgical treatment of papillary thyroid microcarcinoma (PTMC): low-risk PTMC characteristics defined by Kuma Hospital and CATO consensus on PTMC management of active surveillance. Treatment outcomes were compared between groups. We then analyzed the prognostic indicators of patients who could be managed by surveillance. A total of 724 patients met Kuma screening criteria and 135 met CATO screening criteria. The Kuma low-risk group had a lower incidence of multifocal lesions and CLNM than Kuma high-risk group. We also found more obvious differences in multifocal lesions, CLNM and extrathyroidal extension when evaluating the CATO low-risk criteria in the same manner. On the other hand, patients in the CATO low-risk group had a lower disease progression rate and longer disease-free survival than those in CATO high-risk group. There was no significant difference in prognosis between the Kuma low-risk group and Kuma high-risk group. Our logistic regression analysis showed that a preoperative ultrasound size of >5 mm, male sex, younger age, and malignant lesions without concurrent benign nodules could be predictors of CLNM. In conclusion, patients classified in CATO low-risk criteria had lower proportion of clinicopathological risk factors than the ones in Kuma low-risk criteria. We also found more risk factors may not be suitable for surveillance, such as tumors without concurrent benign nodules.