Document mBxXk2zqdKx1jmnn4jrZj1yDQ

roisonmg in japan by Censyu Umeda The most serious PCS catastrophe the world has known took place abo it four years ago in Japan, where thousands of pi rsons are said to have dis played symptoms characteristic of PCB intoxica tion. Gensyu Umeda describes the disease here. W,v In March of 1968 a great many cases of a strange, previ* ously unknown disease appeared in the northern and western parts of the Japanese island of Kyushu, particularly in the Fukuoka and Nagasaki prefectures. and chemical analyses were performed and in August it was determined that the disease was brought on by some kinds of organic chlorides. In November it was discovered that the specific cause of the disease was a contaminant in Kanemi Rice Oil, a common food-stuff. The oil was manufactured by the Kaoemi Rice Oil Co. Ltd. The contaminaot was identified as Kaitechlor 400, which is the brand name for a particular PCB (polychlorinated biphenyls). The disease was named "Kanemi Yusho". There are an estimated 15,000 victims of the disease. However, only 1,081 persons have been officially diagnosed as victims of Kanemi Yusho. Local governments and the central government refuse to officially recognize many of the victims who should, in all fairness, be supported fi nancially by these government bodies. CLINICAL ANALYSES Clinical analyses of Kanemi Yusho victims revealed that there are four types of the disease. Latent type The patient has no significant physical symptoms and no subjective symptoms of Yusho. Nontheless, PCB has been detected in patients of this category. For example, when analysis was performed on materials removed surgically, PCB was found. And when women with no obvious symp toms gave birth to babies who displayed typical symptoms of the disease, it became obvious that those women were contaminated. Another example: babies fed with mother's milk displayed pathological symptoms in six months or later. A baby newly born of n contaminated mother of the latent type displays some cliatacleristic physical symptoms such ns hypersecretion of chcese-like or mucoid discharge from the eyes; disturbance in growth; and pigmentation of the skin and nails and of the mucous membrane of the eye and mouth. :* Visceral Type The patient of this type has no characteristic dermatological signs. Instead there are complaints of complicated symp toms as welt as physical signs of pathological processes is the viscera. Examples of these are general fatigue, unit or vomiting, mild jaundice indicating liver injury, colic-like attacks of abdominal pain, diarrhea, productive cough, chronic bronchitis or bronchiectasis, asthmatic attacks, and pneumonia. The occurrence of pathological changes of this kind has been demonstrated by x-ray analysis. In cases of the visceral type, PCB is detected In sputum, blood or material surgically removed, and in maoy in stances there is an increase in the concentration of trigly cerides and prebc/alipoproteins in the blood. Latent and visceral types are seldom officially recognized as victims of PCB contamination and are seldom diagnosed as Yusho. But these cases are of great significance with regard to the disruption of the environment by PCB and the contamination of the human body by PCB which art liable to occur in the near future. Manifest type Many of the cases generally known by the term "Yusho" belong to this type. The characteristic physical signs and subjective symptoms include chloracne, comedo-like erup tions and follicular accentuation as seen in the photo oo the opposite page aod the photo on page 134. Other symptoms are dark-brownish pigmentation of skin and noils and of the mucous membrane of the eye and mouth; hyper secretion of cheese-like discharge from the eyes; loss of hair; loss of libido; general fatigue; numbness of the ex tremities or neuralgia-like pain; headache; stomachache; abdominal pain; nausea; vomiting; dizziness; disturbances of higher nervous activities (c.g. forgetfulness); local im pairment of blood circulation; vomiting as a result of changes in conditioned reflexes to disturbance from fatty MOWS 084696 Photo* on opposite poge and on page 133: chloracn*, comedo like eruption* and follicular accentuation. Sea colour photo* on insida back covar of Japanese palitnta with soma of the symptom* of th* manifest type of Kanemi Yusho. *MftlO, AUGUST 1972 HONS 084699 133 foods; flattening or deformation of nails; deformities of joints sad bones; poor development of teeth in children; morphological changes of teeth of a pathological nature. Id addition, other pathologically complicated chaoges have been observed recently. Although patients suffering from these symptoms are typical Kanemi Yusho cases, many of them have not yet been officially recognized as victims of the disease. Tardive Type Some cases of a delayed (tardive) type have been observed. Physical signs and symptoms specific to Yusho are mani fested, regardless of the amount of PCB the patient ingested. The symptoms appear one to three years later. The reason for this is not clear at this time (i). TREATMENT AND PROGNOSIS Yusho is very difficult to treat and its prognosis is not always benign. Treatments administered in attempts to ameliorate the suffering and complicated symptoms of the potients are generally not successful... with one exception. Patients are slightly ameliorated when human placentas that have been kept in cold storage are administered by injection or transplant. These measures arc especially effective with regard to the nonspecific symptom complex or the nonspecific reactions of the organism as a whole. Acupuncture and moxibustion (used in the Katnpo medical approach, a Chinese method of treatment) is re cognized to be more effective in dealing with pain such as headache, stomachache, stiff shoulders, low back pain, and pain or numbness of the extremities (2). Concerning the prognosis, the following symptoms ore in my opinion the most serious ones; 1. Functional disturbance of the higher parts of the central nervous system particularly of the cerebral cortex. This is especially serious in young children, who may display symptoms at birth or during the first years of life. 2. Changes in the cardiovascular system are being observed. This is an important tendency at the present time. The changes may relate both to the function of the heart, as demonstrated by EKG analysis, and to the peripheral cir culation. The occurrence of signs of local impairment of blood circulation was already mentioned. 3. A new tendency that has recently been discovered is the deformity of bones; especially deformities of the fingers, toes, ankles, wrists or vertebrae. The deformities are ac companied by pain. 4. In some cases changes have been observed in the teeth, e.g. breakdown, loss or sudden snapping of teeth (3). References end Note*; 1. G- Umeda, Inoii 67, pp, 6--9 (1972). 2. G- Umeda, Win irtn lryo 14. pp. 17--3? (1970) 3. G. Umeda. Clinicr.l As/itcrt of I'CP Peiioninx (Abstract of the 4Jth Congress of the Japanese Association of Industrial Health, Tokvo, April, 1972). ` Gensyu Urneda. M. 0-, U head of the Department ol Clinical Pathology at the Kitafcyusyu Research Institute for Environnjental Pollution In Japan, m HONS OS', 7 00 HONS 0 8 4 7 0 1