Problemy radiatsiinoi medytsyny ta radiobiolohii最新文献

Breast cancer (BC) is one of the urgent problems of health care, which is due to a constant trend of growth. One of the risk factors for the development of breast cancer is ionizing radiation (IR). Numerous epidemiological and experimental studies have shown the high sensitivity of the mammary gland (MG) to this factor. Consideration of models of absolute and relative risks of the occurrence of radio-induced tumors of the MG in irradiated persons showed the importance of such factors as age at the time of irradiation, multiplicity. frequency of exposure, dose level and concomitant non-neoplastic diseases of the mammary and thyroid gland (TG). Excess radiation-induced cases of cervical cancer were found among irradiated women after the atomic bombings of Hiroshima and Nagasaki.Epidemiological features of the development of breast cancer under the influence of IV are presented in detail, which is one of the environmental factors involved in the formation of the modern carcinogenic situation. In con-nection with the significant sensitivity of the MG to the carcinogenic effect of IR, this form of neoplasms attracted special attention after the Chornobyl accident. The effect of small doses of radiation after the Chornobyl disaster led to a wave-like change in the incidence of breast cancer in certain periods of the year, and the radiation-induced incidence of this pathology can occur spontaneously.

Objective: scientific substantiation of the new methodology for estimation of passport doses of the settlementswhich belong to Zone of Unconditional (obligatory) Resettlement, or 2nd zone and Zone of Granted VoluntaryResettlement, or 3rd zone in the framework of dosimetric passportization in accordance with the legislation ofUkraine.

Materials and methods: 37 years after the accident, radioactive contamination of the environment has significantly decreased. However, it is still necessary to carry out ecological and dosimetric monitoring and apply countermeasures in certain territories of Ukraine affected by the accident at the Chornobyl Nuclear Power Plant: restriction of the consumption of locally produced milk, forest products, etc. The methodology, which was since 1996 used to estimate the passport doses of Ukrainian settlements, no longer corresponds to the current level of scientific knowledge about radioactive contamination of environment. The new methods of passport doses calculating presented in the work involves the use of a model whose parameters are determined by the types, quality and completeness of radio-ecological and dosimetric monitoring carried out on the radioactively contaminated territories in 1986-2013. The methodology takes into account the specific of radioactive contamination of each settlement. The passport dose of external exposure is reconstructed only from 137Cs radionuclide, because the contributions of other Chornobyl radionuclides influence the radiation dose only in the first years after the accident. The passport dose of internal exposure is formed as a result of the consumption of 137Cs contaminated food products. It is calculated depending on the availability in the settlement in the current year of the results of measurements of the 137Cs radionuclide activity incorporated in the human body using a whole body counter (WBC) and the activity of 137Cs in the private milk. At the same time, priority is given precisely to the results of WBC measurements of 137Cs.

Results and conclusions: A new methodology (Methodology-2023) for passport doses calculation of Ukrainian settlements was substantiated. A comparison of passport doses based on the results of radioecological and dosimetric monitoring in 2011 calculated by Methodology-2023 and passport doses calculated by Methodology-96 was made.Passport doses calculated by Methodology-2023 increased by 40 % on average compared to doses calculated by Methodology-96. At the same time, passport doses of internal radiation calculated by the new methodologyincreased by 1.5 times, and passport doses of external radiation increased by 1.7 times. The passport dose of 2011, calculated by Methodology-2023, exceeds the legally established limit of 1 mSv in 71 settlements, most of which are located in Korostenkyi raion of Zhytomyr Oblast.

The review presents data from the literature on the role of Tumor necrosis factor-α (TNF-α) and ionizing radiation (IR) in the pathogenesis and treatment of plasma cell myeloma (PCM). There was analyzed disturbance of regulation of functioning of this cytokine, which affects the interaction of the immune system with substrate plasma cells under the influence of negative external factors, including ionizing radiation IR. Modern directions of therapy of this disease using the latest technologies are presented, in particular CAR T-cell therapy, which will allow to optimize in the future treatment of this disease and, thus, improve the quality and life expectancy of PCM patients.

Objective: assessment of clinical-hematological and metabolic-biochemical parameters of the of bone tissue and hormonal regulation depending on the serum iron content and radiation dose values in children living on radiologically contaminated territories after the ChNPP accident in Ukraine.

Materials and methods: Children (n = 271) living on radiologically contaminated territories (RCT) of Ukraine were involved in the study. Three study groups were formed according to the serum iron level (SIL), namely group I with SIL 10.0-22.0 μmol/l (n = 92), group II with SIL 23.0-34.0 μmol/l (n = 144), and group III with SIL above 35.0 μmol/l (n = 35). Diseases in the family tree, bodyweight at birth, complaints on osalgia, bone fractures, jaw anomalies, dental caries, and obesity were accounted. Morphometric parameters of erythrocytes and hemogram elements were analyzed. Creatinine, alkaline phosphatase, calcium, total protein, iron, cholesterol, bilirubin, and transaminases were assayed in blood serum. The urine content of the 19 free amino acids, serum content of the free thyroxine (FT4), pituitary thyroid-stimulating hormone (TSH), and cortisol were assayed both with bone tissue density. Individual radiation doses were calculated.

Results: In 12.9 % of cases the SIL was > 35.0 μmol/l. Relatives with endocrine diseases were often present in the family tree of children with SIL > 23.0 μmol/l. There were increased urine content of the free amino acids (p < 0.05) and signs of protein degradation under high SIL. Contents of amino acids involved in collagen synthesis and antioxidant status (alanine, serine, glutamine, aspartic acid) and iron metabolism (arginine, leucine) were assayed at the highest levels (p < 0.05). Urinary levels of valine, lysine, and methionine, which are associated with iron metabolism, were decreased (p < 0.05). An inverse correlation (rs = -0.58; p < 0.01) was established between the serum TSH and cortisol levels regardless of the SIL. Serum TSH level directly correlated with urine content of amino acids involved in collagen synthesis. An inverse correlation (rs = -0.55; p < 0.001) was established between the serum TSH level and urine content of tyrosine that is essential for the thyroid hormone (triiodothyronine and thyroxine) synthesis.Cortisol was found having a negative effect on protein synthesis. Inverse correlation was established between the serum cortisol level and urine content of the free amino acids essential for collagen synthesis. There was no dependence of the average radiation dose values on the SIL. An inverse correlation was determined between the patient's radiation dose and SIL > 35.0 μmol/l (rs = -0.29; p < 0.05).

Conclusions: The increased SIL in children living on RCT may occur due to both a genetic predisposition and the acquired factors driving protein and mineral metabolism of bone and their hormonal regulation.

In recent decades, several large-scale epidemiological surveys of the eyes have been conducted to determine the global prevalence of retinal degenerative diseases (for example, the Blue Mountains Eye Study). The results of such studies were evaluated several decades, and the studies themselves required significant material resources. Such large-scale projects have not been carried out in Ukraine.Objective of the work is to study the prevalence of age-related macular degeneration in a pilot group of non-irradiated persons of working age to determine the suitability of using the results for further epidemiological studies in Ukraine.

Materials and methods: A retrospective-prospective analysis of the prevalence of degenerative diseases of the retina in a pilot group of persons who underwent an in-depth examination, as they claimed to participate in works in harmful conditions (with ionizing radiation) was carried out. The results of primary ophthalmological examinations of 1,064 people, conducted between January 18, 2007 and October 29, 2009, were randomly selected. The age of the examinees at the time of examination ranged from 18.94 to 67.49 years, the number of persons aged 18 to 30, 30 to 40, and 40 to 50 years was approximately the same. The results of a standardized ophthalmological examination were used.

Results: In the pilot group of people in working age, the prevalence of age-related macular degeneration was 196.4 per 1,000 people. Hazard analysis showed that the relative risk of age-related macular degeneration increased with age and was 1.14 (95% CI 1.07-1.21) for individuals aged 30-39 years; in comparison with persons under the age of 30; 1.3 (95% CI 1.21-1.41) - for persons aged 40-49; 1.3 (95% CI 1.18-1.52) - for persons aged 50-59; 1.86 (95% CI 1.0-3.47) - for persons over 60 years of age. The odds ratio (OR) of having age-related macular degeneration for those aged 30-39 years compared with those younger than 30 years was 3.04 (95% CI 1.79-5.15); for persons aged 40-49 years - 5.49 (95% CI 3.31-9.09); for persons aged 50-59 years - 6.04 (95% CI 3.36-10.88); for persons aged 50-59 years - 6.04 (95% CI 3.36-10.88) and for persons older than 60 years - 13.71 (95% CI 3.68-51.15), p in all cases < 0.0001.

Conclusions: It was established that the prevalence of age-related macular degeneration in non-irradiated individuals determined in the pilot group was high and statistically significantly increased with age. It is shown that the results of primary ophthalmological examinations of a pilot group of persons who applied for participation in works in harmful conditions (with ionizing radiation) are suitable for epidemiological studies of the frequency and course of degenerative retinal diseases in persons of working age in Ukraine. The obtained results are important for practical medicine, as they will allow us to assess the prospects needs for medical care in the s

Prerequisite. In the conditions of a full-scale invasion, the issue of radiation safety and anti-radiation protection in the Armed Forces of Ukraine (AFU) occupies a special place, since the aggressor country violated global geopolitical international decisions, occupied civilian nuclear facilities, in the process of their liberation servicemen mayhave to act in conditions of increased radiation risk, the possibility of using tactical nuclear weapons also is not excluded.

Objective: to investigate the state of the current national regulatory framework for ensuring radiation safety and anti-radiation protection of military personnel during the period of martial law.

Methods: bibliographic, analytical, historical, systematic approach.

Results: The main normative document on the organization of radiation safety and anti-radiation protection of both personnel and the population in Ukraine, as well as military personnel, currently in everyday conditions and in case of radiation accidents since 1998 and until now, are the State Hygienic Standards «Radiation Safety Standards of Ukraine (NRBU-97)». But neither in this document, nor in the transition to NRBU-2021-P, the issue of exposure to such a category as military personnel during the performance of combat (special) tasks is considered. The system of monitoring the radiation situation in Ukraine, documents on the organization of medical support for military personnel, including the Guidelines on the Medical Support of the Armed Forces of Ukraine for a Special Period (2019)and the Guidelines on the Organization of Radiation Safety in the Armed Forces of Ukraine (2020), were analyzed.modules of radiation safety principles in the Armed Forces of Ukraine were proposed.

Conclusion: The unsolved problem of normalization of the radiation factor in the case of man-made and socio-political emergencies can create significant problems in the organization of anti-radiation protection of troops and the population in the case of the use of nuclear weapons or radiation accidents in a special period and requires anurgent solution. It is obvious that there is a need to develop regulatory documents regarding the response and planning of continuous activities to respond to potential nuclear and radiation threats during martial law, including relationships at all levels of the management vertical and methods of communication in the event of a threat.

Despite current research in the development of drugbased cytostatic and targeted therapies in the treatment of breast cancer, radiation therapy (RT) is an important component in the treatment of this pathology in the postoperative period. At the same time, an important problem is the development of pathological changes in the heart in the longterm period, which worsen the quality of life and increase the risk of cardiac death 10 or more years after RT The problem of heart damage due to RT is gaining new significance due to the existing increase in the number of cancer patients requiring radiation exposure in the modern world. RT of malignant tumors of the breast and organs of the chest cavity causes damage to all structures of the heart, including the coronary arteries, valves, conducting system, pericardium. The frequency of heart damage increases in proportion to the time that has passed after RT. According to some authors, the prevalence of clinically significant radiationinduced heart diseases 5-10 years after RT is 10-30%, and the frequency of asymptomatic lesions is 88%. The duration of the latent period can reach 15-20 years. The work has an analysis of longterm studies of the presence of pathological changes that are found in the heart tissues of patients with breast cancer, as a result of radiation therapy.

With limited time for analysing computed tomography (CT) data in medical emergencies, radiologists and clinicians are not always aware of congenital pathologies, especially in asymptomatic cases. We present a case report of heterotaxy syndrome detected incidentally in a 62-year-old female with massive pulmonary embolism, local saccular aneurysm of the aortic arch and COVID-19. The presented case describes an unusual combination of life-threatening conditions and congenital anomalies. Using the CT angiography, we reported the preserved topography and morphology of the heart chambers. The superior and inferior venae cavae were located on the left, draining into a significantly dilated coronary sinus. Disordered abdominal organ arrangement included midline liver, right-sided stomach, the central location of the short pancreas, malrotation of the intestine, polysplenia, and atypical rise of visceral branches of the abdominal aorta. A comprehensive assessment of CT images promoted verification of undiagnosed congenital anomalies. Prompt recognition of heterotaxy syndrome in life-threatening conditions significantly impacts treatment tactics and should be the course of diagnostic and cautious interventions to reduce further complications.

Objective: determining of the functional activity of mice bone marrow hematopoietic progenitor cells, cultivated in gel diffusion chambers, on the stages of hematopoiesis recovery after their prolonged irradiation in the lethal dose in a comparative aspect with the method of colony forming in spleen using mathematical model.

Materials and methods: The method of cell cultivation in gel diffusion chambers, cytological methods, mathematical modeling, and statistical methods of research were used. Bone marrow samples extracted from the femur of mice irradiated with a total dose of 8 Gy with a power 0.0028 Gy/min were cultivated in diffusion chambers with semi solid agar in the abdominal cavity of CBA recipient mice.

Results: Comparative analysis of the colonyforming efficiency of progenitor cells (CFU) was carried out during cultivation in gel diffusion chambers in the process of hematopoiesis recovery for 30 days, as well as in the spleen of lethally irradiated animals, in accordance with the mathematical model. Analysis of colony forming kinetics in gel diffusion chambers after prolonged exposure to ionizing radiation indicated the biphasic nature of hematopoiesis recovery. Thus, in the first few days after the irradiation a drop in the number of CFU is observed compared to the control, which continues until the 9th day. Subsequently there is a sharp increase in the number of CFU in cell culture, which continues until the complete recovery of hematopoiesis. The obtained data, recalculated per mouse femur, correspond to the results of colony forming in the spleen of irradiated animals, described by K. S. Chertkov and taken as a basis while developing our mathematical model, as well as to its parameters, which describe the process of hematopoiesis recovery.

Conclusions: Conformity of the indices obtained during the cultivation using the method of gel diffusion chambers of mice bone marrow prolongedly irradiated at a total dose of 8 Gy with a power 0.0028 Gy/min, to the results of colony forming in spleen of lethally irradiated mice, which were the basis for mathematical model development, is the evidence of the feasibility of using a mathematical model to assess the process of hematopoiesis recovery by progenitor cells of different maturation levels, and the experimental approach of CFU growing in gel diffusion chambers can be considered as an additional method of researching the hematopoiesis recovery along with the spleen colony method.

Background: Rapid development of radiotherapeutic techniques and implementation of radiation therapy (RT) nanotechnologies in practice, taking into account principles of radiobiology, ensures that the planned dose will bedelivered to the target volume with minimal irradiation of healthy tissues while maintaining the guaranteed RTquality. Therefore, further advance of RT involves not only implementation of the new technologies in radiationpractice, but also the intensive developments in fields of radiation medicine and clinical radiobiology.

Objective: search for optimal models of the high-energy (HDR - high dose rate) brachytherapy (BT) using the 192Irsource in comparison with effects of the reference gamma radiation from 60Co, thereby, to increase the effectivenessof chemoradiation therapy (CRT) of gynecological cancer patients (GCPs) with minimal radiation loads on criticalorgans and tissues in the tumor environment. The radiobiological study was aimed to determine the feasibility ofusing the transmembrane potential (TMP) and intensity of reactive oxygen species (ROS) production in peripheralblood lymphocytes (PBL) as predictors of radiosensitivity of non-malignant cells from the tumor environment or itsbed in order to minimize the RT complications in GCPs.

Materials and methods: Patients (n = 115) with cancer stages II-III, T2-3N0-1M0 were managed with comprehensiveconservative treatment. Three groups of patients were selected depending on the applied HDR BT method against abackground of the administered chemosensitizing agents. Blood samples of GCPs (n = 24) before the RT initiationand of apparently healthy individuals (AHIs, i.e. the control group, n = 18) were taken for the radiobiologicalresearch.

Results: Review of the direct results of 60Co or 192Ir sources use in HDR BT and of the follow-up data showed theincreased tumor positive response in the main study groups after CRT course by respectively 16.6 % and 20.1 % incomparison with 60Со HDR BT administration. Concerning local reactions it was noted that grade II radiation reactions were almost absent in the main groups. According to the results of radiobiological studies, it was establishedthat TMP level in PBL of GCPs was 1.36 times higher than in AHIs.

Conclusions: Thus, the emerging of late radiation injuries depended on the accuracy of of individual computer planning and correct reproduction of the planned RT course, timely correction of treatment programs, use of a complexof rational medical prophylaxis, severity of tumor process and concomitant disorders, as well as on the used type ofHDR radiation sources (192Ir and 60Co). Changes in TMP values and intensity of ROS production in PBL of GCPs in comparison with AHIs, and the high values of these parameters in PBL of individual patients are a rationale to specifythem as additional indicators characterizing the possibility o