aaus-list @ ukrainianstudies.org -- [aaus-list] Yushchenko & Dioxin - an immunologist's POV


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From: "Bohdan A. Oryshkevich" <bohdan@ukrainianscholarships.org>
Subject: Mr Yushchenko Poisoning
Date: Sun, 12 Dec 2004 02:32:50 -0500

As I am certain readers here know, Mr. Yushchenko was reported to have high
levels of dioxins in his blood.

This appears to be relatively preliminary information from a medical
standpoint.

Mr. Yushchenko has levels (tissue?, blood?, etc.) that are reported to be a
thousand times higher than some reference population.  The reference
population is not clear.  It is not clear if any of his compatriots have
higher levels since some might have been expected to eat the same food or
have been in the same environment.  It seems that the poisoner would have to
be someone who was trusted to provide food or drink beyond suspicion.

Salo or sushi could be carriers of dioxin.  He could have been fed salo from
a specially bred (poisoned) pig or contaminated fish.  I doubt that dioxin
is commercially available.  It could have been mixed with sour cream, heavy
cream, or full milk.  I do not know why the doctors mentioned soup.  Perhaps
they thought of borscht with sour cream.

The diagnosis came on the following day after Mr. Yushchenko's arrival in
Vienna for a third visit.  This leads me to believe that the diagnosis had
been made earlier and that Mr. Yushchenko traveled to Vienna for related
matters or for the appearance's sake.   The blood tests were made in
Amsterdam and Dr. Korpan appeared to know several days before that evidence
for poisoning was already at hand.  It is also possible that the diagnosis
was known some time ago and Mr. Yushchenko wanted to wait for the opportune
moment to announce it.

Dioxin is rarely measured in the lab, but it is possible that it appears on
spectroscopic methods so it could have appeared before.  It is possible that
blood testing was done on blood left in Vienna or mailed from Kyiv.   I do
not know. A toxicologist in London suggested chloracne on a BBC website
forum.  He apparently diagnosed it from photographs several weeks ago.

It is clear that Mr. Yushchenko suffers from other health problems.  It has
crossed my mind that he could have received dioxin by injection since he has
been receiving opiates through an epidural shunt for serious back pain.
Given that this case, if it is dioxin poisoning, is virtually unique,
attribution of Mr. Yushchenko's other symptoms (besides chloracne and
perhaps hepatitis) is purely speculative.  That is dioxin is not a cause of
all his medical problems.

It is also clear that the release of information has often been poorly
organized, not chronological, and often not persuasive.  The Rudolf----
Clinic was not prepared for such a case. Mr. Yushchenko's team often seemed
to be behind his opponents in dealing with the ramifications of his illness.
That is they were not making their own case.

Having read an official report (on www.ukrpravda.co.uk) of the first visit
of Mr.Yushchenko to Vienna, it is clear that poisoning was not a concern at
the beginning.  The first reports seemed to point to alcohol as a toxin.
That is the term was "...substances not usually considered normal nutrients
.."  That and other statements seemed to be euphemisms for alcohol.  Blood
tests and imaging tests supported these findings.  A variety of tests were
done un-necessarily.  That is the doctors did not pay attention to diagnosis
and the face at all.  They acted as surgeons seeking to intervene rather
than as diagnosticians.  The perception was that Mr. Yushchenko was
suffering from an abdominal surgical emergency.

Some diagnoses appeared to have been played up by Mr. Yushchenko's staff:
sarin, bioterrorist agents, endotoxins. Even today Mr. Yushchenko's team
talked of "yellow rain" and T2 which are totally different toxins.  "Yellow
rain", a mycotoxin is not "agent orange", a dioxin, though the two colors
may be similar. One Yushchenko staff member stated that the liver was twelve
times as big as normal.  That is a physical impossibility.

It is not at all clear that dioxin "kills".  Perhaps, the purpose was to
make Mr. Yushchenko appear grotesque slowly.

Dioxin poisoning is established by total body burdens and not by blood
levels.  That is because dioxins are a family of organic compounds which are
fat soluble.  That is one has to establish a total body burden from samples
primarily in fat tissue.  There are several formulae to do this (by
estimating the amount of fat in the body) and the mechanisms/formulae used
are not clear that this has yet been done.  Dioxins are a by product of
several human activities such as fires or pesticides.

Use of dioxin as a poison is virtually unknown.  A report in the Sunday
edition of the Washington Post states that the Soviet secret services
considered using dioxins in their chemical weapons campaign.  The only
direct problem they cause is chloracne which is a pustular acne like rash
with a green tinge of color.  Acute poisoning has occurred in industrial
settings or accidents such as Seveso usually through inhalation.  Other side
effects are largely tangential.  There seem to be minor increases in some
cancer and in infant malformation.

Mr. Yushchenko has had an evolving illness or illnesses since September.
His facial appearance has changed over the last few months.  It has become
quite characteristic.  In the initial visits the doctors made the diagnosis
of rosacea which can appear quite similar.  I have not seen chloracne in the
past but his lesions appear more granulomatous than pustular.  But it is
quite possible that he is wearing make-up in his public appearances to
smoothe the pustular lesions.  Some doctors have questioned the diagnosis of
chloracne.  Bioxin is present in the skin involved for long after intake.

Despite what the hospital doctors state, I think that it is impossible to
state the date of poisoning.  Dioxin occurs primarily in fatty food: milk,
beef, fish, and oils.  It can also be inhaled.  Since it is fat soluble it
takes a very long time to build up and a long time to decline.  Tissue
levels take time to build up.  There is no medical literature on one dose
intoxication through food intake.  All people have some levels dioxin in
them since it is in the background.  It is not clear what are the usual
levels of dioxin in similar persons in Ukraine.

The half life of dioxin is listed as seven years which means that it will
take seven years or more for Mr. Yushchenko's body burden to decline by
fifty percent (if there is no further intake of dioxin).  I know of no
treatment and this condition is rare enough that I doubt that there is a
mechanism of treatment.  If it is found primarily in his fat so there is no
clear mechanism for it to enter his blood stream and thus leave the body.

Using decision analysis, the prior probability of Mr. Yushchenko's being
poisoned, especially in light of a strange illness and in a country with an
unstable and criminally infected political system, was high.  One does not
need a lot of evidence to increase such probability.  The presence of
greatly increased dioxin levels seems to tilt the probability of Mr.
Yushchenko being poisoned to highly probable.

It is possible that Mr. Yushchenko underwent other dirty tricks with
reference to poisoning.  One poisoning that I had considered was isopropyl
alcohol.  This alcohol is sickening but then is metabolized and leaves
little trace.  It makes the person appear vulnerable to alcohol and thus not
manly in the Ukrainian sense of the world.  It could be an ingredient of
samohon.

The stress of this could have made Mr. Yushchenko more vulnerable to a
herpes virus the cause of facial palsy.

I do not think that he have heard the last word on the poisoning and
illnesses of Mr. Yushchenko.  There is a need for a forensic and criminal
investigation.

Bohdan Oryshkevich, MD, MPH

http://www.greenfacts.org/dioxins/dioxins.htm#90

http://www.greenfacts.org/dioxins/toolboxes/body-burden.htm

http://feql.wsu.edu/esrp532/ESRP532Lecture16PPT.pdf

http://www.ktl.fi/dioxin/general.html#risk

http://www.cchealth.org/sierracrete/append_11.pdf

Sushi as source for dioxins:
http://homepage3.nifty.com/junko-nakanishi/rmg/dxjapan9911.html

Prior to current announcement
Other doctors opinions:
http://www.rangelmd.com/2004/11/have-you-seen-viktor-yushchenkos-face.html

Globe and Mail:
http://www.rense.com/general60/1000.htm

from Yale:
http://www.middletownpress.com/site/news.cfm?BRD=1645&PAG=461&dept_id=10856&newsid=13521923

and in German after the announcement:
http://www.kleine.co.at/nachrichten/politik/artikel/_652363/druck.jsp



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