Problemy radiatsiinoi medytsyny ta radiobiolohii最新文献

Objective: analysis of molecular genetic phenotypes, their proliferative activity, degree of spread and differentiation of tumors in breast cancer patients affected by the accident at the Chornobyl Nuclear Power Plant.

Materials and methods: 96 breast cancer patients who were exposed to ionizing radiation as a result of the accident at the Chornobyl Nuclear Power Plant were examined. Clinical, radiological, instrumental, morphological,immunohistochemical research methods were used.

Results and conclusions: In patients who have been exposed to radiation, the frequency with which the moleculargenetic phenotypes of breast cancer occur is somewhat different from the generally known data. Thus, luminal Aphenotype was diagnosed in 17.7 %, luminal B in 56.2 %, HER2/neu expressing in 6.2 % and triple negative (TN)phenotype in 19.8 % patients. Proliferative activity indicators on average in patients with luminal A phenotype wereat the level of 12.7 %, luminal B - 41.5 %, triple negative - 55.6 %, and HER2/neu positive breast cancer - 32.5 %.Patients with different molecular genetic phenotypes are diagnosed with different prevalence values of the TNM criteria. Metastatic lesions of regional lymph nodes (LNs) were diagnosed in 97.9 % of patients belonging to all phenotypes of breast cancer. Ki-67 values that did not exceed 20 % were found in 22.9 % of patients, the main number -17.7 % had the luminal A subtype. In 77.1 % of patients, Ki-67 values were beyond 20 %, which indicates a moreaggressive course of the disease in the majority of patients, which included patients with various molecular genetic subtypes, except for luminal A. A high degree of differentiation of mammary gland tumors was diagnosed in 8.3% of patients. The main number of them, 6.2 %, had the luminal A phenotype. A moderate degree of differentiationwas found in 65.6 %, where 43.7 % of patients had a luminal B HER2/neu negative phenotype. A low degree of differentiation was diagnosed in 26 % of patients, among whom 12.5 % were diagnosed with TN, and 9.4 % had a luminal B HER2/neu negative phenotype.

Patients with breast cancer (BC) are at high risk of cardiotoxicity (CT) due to combination of anticancer treatment.Cardio-vascular (СV) complications lead to the delay or discontinuation of anticancer therapy, which significantlyworsens the prognosis. Anthracyclines (AC) are the main drugs included in most anticancer treatment regimens.Detecting signs of CT at the early stages, when there is no cardiac dysfunction and signs of heart failure (HF), isimportant to develop individualized monitoring and prevention strategies in BC patients.The objective of the study was to investigate the incidence of CT of epirubicin and doxorubicin in the complex BCtherapy, based on monitoring of left ventricular ejection fraction (LV EF), diastolic function of the LV, and to investigate the incidence of signs and symptoms of HF.

Material and methods: The study included 44 BC patients. We analyzed the dynamics of LV EF before the start ofantitumor treatment and within 6 months. A decrease in LVEF of > 10 % (percentage points) or below its thresholdvalue (< 50 %) was considered to be a CT criterion. Patients were divided into 2 groups. Group 1 included patientswith BC who received epirubicin (n = 18), group 2 included BC patients who received doxorubicin in the chemotherapy regimen (n = 26).

Results: Before the start of chemotherapy, LV ejection fraction was normal and did not differ significantly betweenthe groups. During follow-up at 6 months after the start of treatment, in group 1 the proportion of patients with CTaccording to LV EF was 11.1 %, compared with 23.1 % in group 2 (p < 0.05). The number of patients with signsand symptoms of HF was 34.6 % in group 2, that was significantly higher compared with that in group 1 - 11.1 %(p < 0.05). According to the correlation analysis, LV EF in group 2 had an inverse correlation with the dose of doxorubicin (r = -0.67, p < 0.05), with heart rate (r = -0.59, p < 0.05), and with body mass index (r = -0.55, p < 0.05),indicating a negative effect of doxorubicin on the CV system in patients with BC.

Conclusions: The results of the study indicate a significantly higher incidence of LV EF reduction as a CT criterionwhen using doxorubicin in the chemotherapy regimens compared with epirubicin. Myocardial damage as a result ofchronic cardiotoxicity is accompanied by a decrease in LV systolic function and a significantly higher incidence of HF.

Objective: to study the level of psychosocial strain in the able-bodied population of the NPP surveillance zone (SZ) and factors that shape it under the wartime posture and possible terrorist acts.

Methods: sociological (population survey), psychosocial (psychodiagnostic testing), analytical, mathematical i.e. comparison of the generalized characteristics of signs (relative values, averages, pairwise reliability differences according to the Student's t-test, interaction of factors using a pairwise correlation (r)).

Results: It was established that the level of social and psychological strain in population of the NPP SZ during the wartime posture had increased compared to pre-war period according to the average scores of psychodiagnostic tests, namely the GHQ 28, Spielberger (reactive anxiety), vital capacity, self-assessment of the health state.Structure of the GHQ 28 scales has changed compared to the pre-accident period, namely the anxiety scale was the first, social dysfunction scale was the second, somatization scale was the third, and depression scale was the fourth.Mental disorders, diseases of the nervous system, circulatory system, and digestive system prevailed among the newly diagnosed diseases. According to respondents' self-assessments of their health, such factors have had the greatest impact on it as the war components, radiation situation, material well-being, and uncertainty about the future. Parameters characterizing the level of psychosocial strain correlated with factors affecting the state of health. Population of NPP SZ had a high vital capacity according to such indicators as vitality, psychological stability, and physical health support. All the three scores were higher in urban population of the SZ compared to rural one. In all groups of interviewees the psychological stability was higher than parameter of the physical state maintaining.

Conclusion: Social and psychological strain in the NPP SZ population was shaped by the anxiety, social dysfunction, and somatic symptoms. Average parameters of the various population groups differed significantly depending on the place of residence of respondents in the SZ, gender, marital status, and education. The components of war, radiation situation, changes in well-being, and uncertainty about the future have had greatest impact on health. A correlation was established between the parameters of psychosocial strain and average estimates of social factors, in particular those caused by the warfare.

The emergency destruction of the 4th reactor of the Chornobyl nuclear power plant necessitated large-scale emergency work, which involved large contingents of specialists. Analysis the mortality of Chornobyl clean-up workers isan important and relevant basis for planning medical protection measures in conditions of a potential threat ofemergency and other radiation situations.The objective of this work is to determine the levels and relative risks of mortality of Chornobyl clean-up workers in1986-1987 years from major non-tumor diseases depending on the received dose of radiation exposure, taking intoaccount age and time after the accident (period of epidemiological studies 1988-2021).

Materials and methods: The cohort of Chornobyl clean-up workers in 1986-1987 years with a known dose of external γ-irradiation of the whole body, totaling 64,490 male, was divided by age at the date of the accident at theChornobyl nuclear power plant and dose of external γ-irradiation of the whole body. Epidemiological analysis of mortality from non-tumor diseases was conducted for the entire post-accident period and in dynamics over five-yearmonitoring periods.

Results: The highest mortality rate, regardless of age, on the date of the Chornobyl disaster, were from diseases of thecirculatory system, of the digestive and respiratory systems. For Chornobyl clean-up workers 18-39 years on the dateof the accident, relative risks of mortality from non-tumor diseases over the entire observation period were significantly higher in all dose subgroups (from 0.05 Gy to 0.7 Gy) compared to the dose subgroup < 0.05 Gy. In the period1993-1997 (6-10 years after the Chornobyl accident), significantly higher relative risks of mortality from diseases ofthe circulatory system (pulmonary heart and pulmonary circulatory disorders, cardiomyopathy, myocardial infarction)were found; in 26-30 years - from cerebrovascular diseases, including cerebral infarction. The indicated reliabledose-dependent relative risks are characteristic of all dose subgroups relative to the subgroup with a dose < 0.05 Gy.

Conclusions: The overall mortality of Chornobyl clean-up workers from non-tumor diseases tends to increase. Theresults of the risk analysis of dose dependent mortality in the Chornobyl clean-up workers cohort showed a highersensitivity to ionizing radiation of persons of the younger age group (18-39 years old at the date of the accident).The most dangerous period of relative dose-dependent risk of death of Chornobyl clean-up workers due to non-tumordiseases was established - 6-10 years after radiation exposure for all dose subgroups (from 0.05 Gy to 0.7 Gy) relative to the subgroup with a radiation dose < 0.05 Gy.

Brain morphology understanding is essential for radiologists, neurologists, and neurosurgeons. Historically, anatomical learning of brain relied on ex vivo specimens. Modern in vivo brain CT and MRI provide spatial, three-dimensional imaging capabilities crucial to help diagnose diseases, plan surgeries, and monitor treatment progress. Despitethe advancements in imaging, a disconnect exists between traditional anatomical education and contemporary radiological practices.

Objective: This short report aims to illustrate brain anatomy ex vivo, on CT and MRI, to both navigate young doctorsand to refresh the knowledge of experienced radiologists in brain anatomy. Furthermore, a few examples of themacroscopic, CT and MRI of the brain testify to the importance of early access to the radiological study of anatomyand pathology for the new generations of physicians, asking the schools of medicine to implement practical radiological anatomy sessions during anatomy teaching.

Material and methods: The study utilized formalin-fixed brain specimens and corresponding brain CT and MRIimages.

Results: Brain CT and MRI imaging modalities provide unparalleled anatomical detail and functional insights,enhancing the comprehension of complex spatial relationships. The advantages of the integrating of radiolographical images are: non-invasive visualization, detailed anatomical resolution, three-dimensional reconstructions.

Conclusion: The integration of radiology images into the study of neuroanatomy represents a significant advancement in medical science. CT and MRI imaging modalities provide unparalleled detail, functional insights, and educational value, making them indispensable tools in modern neuroradiology. There is a need to include radiology during anatomy studies, helping future physicians better understand anatomy and recognize this clinical disciplineearly on.

Objective: to conduct a clinical and neurophysiological study of Chornobyl clean-up workers and military personnelof the Armed Forces of Ukraine (AFU) with previous coronavirus disease (COVID-19) and individuals of the comparison groups to study the impact of long-term effects of ionizing radiation, psychoemotional stress and previouscoronavirus infection on cerebral functioning.

Materials and methods: A prospective clinical study of Chornobyl clean-up workers and servicemen of the ArmedForces of Ukraine (AFU) who had coronavirus disease (COVID-19) and individuals of the comparison groups. Themain group - 30 males participated in liquidating the consequences of the Chornobyl Nuclear Power Plant (ChNPP)accident with previously verified COVID-19 (Chornobyl clean-up workers). As a nosological control group (NCG), 24men with verified chronic cerebrovascular disorder (CVD) not exposed to radiation sources, war-associated psychoemotional stress, and COVID-19 were examined in 2020-2022. Depending on the history of COVID-19, the AFU servicemen were divided into 2 subgroups: «COVID+» and «COVID-». The diagnosis of neuropsychiatric disorders wasestablished according to ICD-10. Visual and spectral EEG analyses assessed cerebral functions in passive wakefulness (rsEEG).

Results: Chornobyl clean-up workers «COVID+» and NCG groups did not differ significantly in clinical neuropsychiatric features, except for a higher frequency of organic personality disorder (F07) in the group of the Chornobyl cleanworkers «COVID+» (p < 0.001). In the group of the Chornobyl clean workers «COVID+» relative ( %) spectral deltapower of EEG was significantly diffusely increased as well as absolute spectral delta-power in the left posterior-temporal area compared to NCG (p < 0.05). A significant diffuse increase in relative spectral theta-power with a bilateral excess in parietal areas (p < 0.05 - 0.01), as well as a significant increase in absolute spectral theta-power bilaterally in frontal areas (p < 0.05) was found in the group AFU «COVID+», compared to the group AFU «COVID-».

Conclusions: For the first time, a pronounced diffuse slowing of cerebral bioelectrical activity to delta-frequencieswas detected in the Chornobyl clean-up workers being COVID-19 recuperates compared to the comparison groupwith chronic CVD. The AFU servicemen with previous COVID-19 have moderate persistent cerebral dysfunction. Thesechanges require further observation and study.

Objective: to investigate the reciprocal impact on the genome of malignant and normal human peripheral bloodlymphocytes under their co-culture and the possibility to modify the effects by astaxanthin.

Methods: Separate and joint/separate culturing of peripheral blood lymphocytes (PBL) of the chronic lymphocyticleukemia (CLL) patients (n = 6) and conditionally healthy individuals (n = 6), Comet assay method, fluorescencemicroscopy with automated software for the analysis of results, statistical methods.

Results: Both direct and rescue tumour-induced bystander effects were observed under the joint/separate culturing of blood lymphocytes of conditionally healthy individuals (the bystander cells) and blood cells from CLL patients(the inducer cells). The direct effect was characterized by the high level of comets corresponding to the S-phasecells and increased apoptotic activity in the bystander cell cultures. The rescue effect in the culture of inducer cellswas expressed by the increased frequency of cells retained in S-phase, decreased proportion of cells with a high levelof DNA damage and decreased amount of cells in apoptotic stage. Level of both S-phase cells and apoptotic cells inthe cultures of bystander cells significantly decreased under the impact of astaxanthin (p < 0.05). Effect of astaxanthin on the inducer cells was the opposite, namely an increased frequency of S-phase cells and increased apoptotic activity in cultures (p < 0.05) was observed.

Conclusions: Possible modification of manifestations of both direct and rescue tumor-induced bystander effects bythe astaxanthin was established.

Objective: Scientific justification of the methodology for calculating radiation internal doses from 137Cs and 134Cs intake for residents of Ukrainian settlements radioactively contaminated as a result of the Chornobyl (Chernobyl) accident in which measurements of incorporated radiocesium isotopes in humans using whole-body counters (WBC) were not carried out.

Materials and methods: The paper presents a new methodology for reconstructing doses due to internal irradiation from Chornobyl fallout for both surface (in 1986) and root (in 1987-2023) contamination of vegetation with 137Cs and 134Cs and their transfer into the human body. The methodology for calculating the dose due to surface contamination of vegetation was based on the theoretical model of the transfer of radiocesium isotopes through the food chain with further adjustment of this model to the results of WBC measurements carried out between 15 July and 31 December 1986. For root intake, an ecological dosimetric model is used with the parameters determined by the types, quality and completeness of cow's milk and WBC monitoring carried out in radioactively contaminated territories in 1987-2013. In the absence of WBC measurements, the doses were estimated considering the properties and specifics of radioactive contamination of environmental objects in each region: soil type, levels of soil and milk contamination, and milk equivalent.

Results: A new methodology for reconstruction of internal doses from radionuclides 137Cs and 134Cs to residents of the territories of Ukraine radioactively contaminated due to the Chernobyl disaster is substantiated. The methodology is based on the analysis of all data obtained as the result of radioecological and dosimetric monitoring carried out in Ukraine after the accident.

Conclusions: According to the methodology developed in the work, the calculation of annual internal doses to residents of settlements that were not covered by WBC monitoring is based on the measurements of the 137Cs activity in the milk of private farms, which were carried out in these settlements. In the absence of such measurements, a linear regression model which connect the incorporated in human body 137Cs with four groups of soils in the vicinity of the settlement is used for doses calculation. The doses calculated according to the new methodology agree with the dosesderived directly from the results of WBC measurements.