BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT. PART IV - FETAL RADIATION-INDUCED BINOCULAR VISION DISORDERS: A PILOT STUDY. IMMUNOHISTOCHEMICAL CHANGES OF NON/IRRADIATED EYEBALL MUSCLES AFFECTED BY STRABISMUS. EVIDENCE OF A POSSIBLE MECHANISM OF THE STRABISMUS DEVELOPMENT IN PERSONS EXPOSED TO FETAL RADIATION. / GOLOVNYI MOZOK TA ORGAN ZORU IaK POTENTsIINI MIShENI DLIa VPLYVU IONIZUIuChOGO VYPROMINIuVANNIa. ChASTYNA IV - ROZLADY BINOKULIaRNOGO ZORU PLODA, SPRYChYNENI RADIATsIINYM VPLYVOM IN UTERO: PILOTNE DOSLIDZhENNIa. IMUNOGISTOKhIMIChNI ZMINY NEOPROMINENYKh M'IaZIV OChNOGO IaBLUKA PRY KOSOOKOSTI. MOZhLYVYI MEKhANIZM ROZVYTKU KOSOKOSTI V OSIB, IaKI ZAZNALY PRENATAL'NOGO OPROMINENNIa.

Strabismus is a significant cause of a decrease in the functional capabilities of the organ of vision, additionally, it leads to the deteriorating quality of life. Orbital factors and nervous system changes may play an important role in strabismus pathogenesis. There are few reports on binocular vision disorders in radiation-exposed persons.Functions of the external eyeball muscles might be disturbed based on the changed coordination process of subcortical nerve structures and due to altered metabolism. A carefully conducted research is necessary to clarify the possible pathogenesis of binocular vision disorders in radiation-exposed persons. OBJECTIVE: to assess the peculiarities of the development of strabismus and binocular vision disorders in people who were exposed to ionizing radiation in utero; to investigate the changes in distribution and appearance of myosin, dystrophin, and collagen IV between non-irradiated persons with normal binocular vision and patients with strabismus. MATERIALS AND METHODS: 583 persons, irradiated in utero because of the Chornobyl disaster were examined (at the time of examination average age was 11.3 ± 0.1 years). The control group - 808 people - Kyiv residents. Overall, 15 non-irradiated eyeball muscle samples were examined. 10 were from strabismus patients and 5 were controls. To evaluate morphological structure haematoxylin and eosin staining were used. For the detection of myosin, dystrophin, and collagen IV biotin-avidin (IMH) immunohistochemistry method was performed. Semi-quantitative grading method was used for the evaluation of immunoreactive structure appearance and local distribution. RESULTS: An increased frequency of divergent strabismus (p = 0.04190) and heterophoria (p = 0.002603) was found in the group exposed to prenatal (fetal) radiation because of the Chornobyl disaster compared to the control group. The relative risk of heterophoria was 5.08 (1.42 - 18.13). A decrease in dystrophin, myosin, and collagen IV positive structures was observed in non-irradiated strabismus-affected eyeball muscles compared to the control group. CONCLUSIONS: Detected changes indicate an increased probability in the development of strabismus in persons who had been exposed to fetal radiation. Non-irradiated strabismus-affected eyeball muscles are characterized by diminished myosin, dystrophin, and collagen IV immunohistochemical structures. Additionally, determined qualitative morphological changes in skeletal striated muscle fibers lead to the changed structural organization, indicating possible muscular dystrophy. Thereby, the presence of dystrophic processes in the eyeball muscles may play a significant role in the morphopatogenesis of strabismus. Further morphological studies are necessary to clarify the development of binocular vision disorder and the methods of their correction. These studies would be especially important to populations that were exposed to radiation.

RETINA VESSELS CHANGES IN CHORNOBYL NUCLEAR POWER PLANT EMPLOYEES WHO EXPERIENCED LONG-TERM ABNORMAL RADIATION EXPOSURE AT THE WORKPLACE AS A RESULT OF THE OCCUPATION OF CHORNOBYL NUCLEAR POWER PLANT IN 2022. / ZMINY SUDYN SITKIVKY V SPIVROBITNYKIV ChORNOBYL'S'KOÏ ATOMNOÏ ELEKTROSTANTsIÏ, IaKI ZAZNALY TRYVALOGO NENORMOVANOGO RADIATsIINOGO VPLYVU NA ROBOChOMU MISTsI VNASLIDOK OKUPATsIÏ ChAES U 2022 ROTsI.

During the occupation of the Chornobyl Nuclear Power Plant (ChNPP) in 2022, a group of employees remained in the working town for a long time. These personnel were exposed to long-term radiation and non-radiation factors of the production environment, as well as stress and other factors. These factors could result in negative changes of health.It is known that radiation exposure causes changes in the course and caliber of retinal vessels. OBJECTIVE: to assess the condition of retinal arteries and veins and the level of incorporated 137Cs content in persons who were exposed to prolonged exposure to radiation and non-radiation factors of industrial environment, as they were at the workplace overtime during the occupation of the Chornobyl Nuclear Power Plant in 2022. MATERIALS AND METHODS: A comprehensive ophthalmological examination was carried out. Which included the determination of the diameter of the retinal arteries and veins, the arteriovenous ratio, of 55 people from among the personnel of the ChNPP, who worked under the conditions of the occupation of the ChNPP. All those examined were examined on an expert human radiation counter. The results of the ophthalmological examination were compared with the results of earlier examinations of ChNPP employees of the same age groups. RESULTS: It was established that in the examined group, a decrease in the arterio-venous ratio was observed, mainly due to the expansion of retinal veins. Dilatation of the veins was asymmetric, mainly the branches of the central vein of the retina of the right eye were more dilated. Retinal arteries were narrowed in all examined subjects. When comparing the results with the data of previous examinations, it was established that the arterio-venous ratio in this group was probably lower than in previously examined employees of the ChNPP of the same age groups. At the same time, the maximum registered value of the content of incorporated 137Сs was 713 Bq/organism, none of the examined exceeded the control level of 1,000 Bq/organism. CONCLUSIONS: Violation of blood circulation in the retina was detected - a probable increase in the arteriovenous ratio due to the expansion of the retinal veins in the personnel of the Chornobyl nuclear power plant who worked under the conditions of the occupation of the ChNPP in 2022. Since the examined subjects did not exceed the control level of incorporated 137Сs content (1,000 Bq/organism), the observed effect may be a consequence of the influence of other, both radiation and non-radiation factors.

BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT: PART II - RADIATION CEREBRO/OPHTALMIC EFFECTS IN CHILDREN, PERSONS EXPOSED IN UTERO, ASTRONAUTS AND INTERVENTIONAL RADIOLOGISTS. / GOLOVNYI MOZOK TA ORGAN ZORU IaK POTENTsIINI MIShENI DLIa VPLYVU IONIZUIuChOGO VYPROMINIuVANNIa: ChASTYNA II ­ RADIATsIINI TsEREBROOFTAL'MOLOGIChNI EFEKTY U DITEI, OSIB, EKSPONOVANYKh VNUTRIShN'O/UTROBNO, ASTRONAVTIV TA INTERVENTsIINYKh RADIOLOGIV.

BACKGROUND: Ionizing radiation (IR) can affect the brain and the visual organ even at low doses, while provoking cognitive, emotional, behavioral, and visual disorders. We proposed to consider the brain and the visual organ as potential targets for the influence of IR with the definition of cerebro-ophthalmic relationships as the «eye-brain axis¼. OBJECTIVE: The present work is a narrative review of current experimental, epidemiological and clinical data on radiation cerebro-ophthalmic effects in children, individuals exposed in utero, astronauts and interventional radiologists. MATERIALS AND METHODS: The review was performed according to PRISMA guidelines by searching the abstract and scientometric databases PubMed/MEDLINE, Scopus, Web of Science, Embase, PsycINFO, Google Scholar, published from 1998 to 2021, as well as the results of manual search of peer-reviewed publications. RESULTS: Epidemiological data on the effects of low doses of IR on neurodevelopment are quite contradictory, while data on clinical, neuropsychological and neurophysiological on cognitive and cerebral disorders, especially in the left, dominant hemisphere of the brain, are nore consistent. Cataracts (congenital - after in utero irradiation) and retinal angiopathy are more common in prenatally-exposed people and children. Astronauts, who carry out longterm space missions outside the protection of the Earth's magnetosphere, will be exposed to galactic cosmic radiation (heavy ions, protons), which leads to cerebro-ophthalmic disorders, primarily cognitive and behavioral disorders and cataracts. Interventional radiologists are a special risk group for cerebro-ophthalmic pathology - cognitivedeficits, mainly due to dysfunction of the dominant and more radiosensitive left hemisphere of the brain, andcataracts, as well as early atherosclerosis and accelerated aging. CONCLUSIONS: Results of current studies indicate the high radiosensitivity of the brain and eye in different contingents of irradiated persons. Further research is needed to clarify the nature of cerebro-ophthalmic disorders in different exposure scenarios, to determine the molecular biological mechanisms of these disorders, reliable dosimetric support and taking into account the influence of non-radiation risk factors.

BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT. PART III / FEATURES MORPHOMETRIC RETINAL PARAMETERS, AMPLITUDE AND LATENCY COMPONENTS OF VISUAL EVOKED POTENTIAL IN RADIATION EXPOSED IN UTERO. / GOLOVNYI MOZOK TA ORGAN ZORU IaK POTENTsIINI MIShENI DLIa VPLYVU IONIZUIuChOGO VYPROMINIuVANNIa: ChASTYNA III ­ OSOBLYVOSTI MORFOMETRYChNYKh PARAMETRIV SITChASTOÏ OBOLONKY TA AMPLITUDA I LATENTNIST' KOMPONENTIV ZOROVYKh VYKLYKANYKh POTENTsIALIV U OPROMINENYKh VNUTRIShN'OUTROBNO OSIB.

One of the current problems of modern radiobiology is determine the characteristics of the manifestation of radiation-induced effects not only at different dose loads, but also at different stages of development of the organism. In previous reports, we have summarized available evidence that at certain ages there is a comparative acceleration of radiation-induced pathological changes in the eye and brain, and the study and assessment of the risk of possible ophthalmic and neurological pathology in remote periods after contamination of radioactive areas. Data of irradiated in utero individuals are possible on the basis of observation of the state of the visual analyzer in persons who underwent intrauterine irradiation in 1986. Therefore, a parallel study of retinal morphometric parameters, amplitude and latency of components of evoked visual potentials in irradiated in utero individuals was performed. OBJECTIVE: to evaluate the retinal morphometric parameters, amplitude and latency components of the evoked visual potentials in intrauterine irradiated persons. MATERIALS AND METHODS: The results of surveys of 16 people irradiated in utero in the aftermath of the Chornobyl disaster were used; the comparison group were residents of Kyiv of the corresponding age (25 people). Optical coherence tomography was performed on a Cirrus HD-OCT, Macular Cube 512x128 study technique was used. At the same time, the study of visual evoked potentials on the inverted pattern was performed, and occipital leads wereanalyzed. Visual evoked potentials were recorded on a reversible chess pattern (VEP) - an electrophysiological test, which is a visual response to a sharp change in image contrast when presenting a reversible image of a chessboard. RESULTS: In those irradiated in utero at the age of 22-25 years, there was a probable increase in retinal thickness in the fovea, there was a tendency to increase the thickness of the retina in the areas around the fovea. When recording visual evoked potentials on a reversible chess pattern in this group, there was a tendency to decrease the amplitudes of components (N75, P100, N145, P200) in the right and left parieto-occipital areas and asymmetric changes in latency of these components. CONCLUSIONS: Early changes of fovea recorded in OCT and decreasing amplitudes of components of visual evoked potentials on the reversible chess pattern at the age of 22 25 years may indicate a risk of development in patients irradiated in utero, early age-related macular degeneration, as well as increased risk and increased risk structures of the visual analyzer.

BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT. Part І. THE CONSEQUENCES OF IRRADIATION OF THE PARTICIPANTS OF THE LIQUIDATION OF THE CHORNOBYL ACCIDENT. / GOLOVNYI MOZOK TA ORGAN ZORU IaK POTENTsIINI MIShENI DLIa VPLYVU IONIZUIuChOGO VYPROMINIuVANNIa. Chastyna I. TsEREBROOFTAL'MOLOGIChNI EFEKTY OPROMINENNIa V UChASNYKIV LIKVIDATsIÏ NASLIDKIV AVARIÏ NA ChAES.

BACKGROUND: Exposure to ionizing radiation could affect the brain and eyes leading to cognitive and vision impairment, behavior disorders and performance decrement during professional irradiation at medical radiology, includinginterventional radiological procedures, long-term space flights, and radiation accidents. OBJECTIVE: The objective was to analyze the current experimental, epidemiological, and clinical data on the radiation cerebro-ophthalmic effects. MATERIALS AND METHODS: In our analytical review peer-reviewed publications via the bibliographic and scientometric bases PubMed / MEDLINE, Scopus, Web of Science, and selected papers from the library catalog of NRCRM - theleading institution in the field of studying the medical effects of ionizing radiation - were used. RESULTS: The probable radiation-induced cerebro-ophthalmic effects in human adults comprise radiation cataracts,radiation glaucoma, radiation-induced optic neuropathy, retinopathies, angiopathies as well as specific neurocognitive deficit in the various neuropsychiatric pathology including cerebrovascular pathology and neurodegenerativediseases. Specific attention is paid to the likely stochastic nature of many of those effects. Those prenatally and inchildhood exposed are a particular target group with a higher risk for possible radiation effects and neurodegenerative diseases. CONCLUSIONS: The experimental, clinical, epidemiological, anatomical and pathophysiological rationale for visualsystem and central nervous system (CNS) radiosensitivity is given. The necessity for further international studieswith adequate dosimetric support and the follow-up medical and biophysical monitoring of high radiation riskcohorts is justified. The first part of the study currently being published presents the results of the study of theeffects of irradiation in the participants of emergency works at the Chornobyl Nuclear Power Plant (ChNPP).

CLINICAL TYPES OF CATARACTS IN A LONG-TERM PERIOD AFTER ACUTE RADIATION SICKNESS. / KLINIChNI RIZNOVYDY KATARAKTY U VIDDALENOMU PERIODI PISLIa PERENESENOÏ GOSTROÏ PROMENEVOÏ KhVOROBY.

OBJECTIVE: to describe the clinical types of cataracts in the remote period after acute radiation sickness (ARS). MATERIALS AND METHODS: Twenty four - thirty three years after the emergency exposure, a complete ophthalmolog- ic examination of 53 reconvalescents of ARS conducted. The average age of patients at the time of the examination was (64.6 ± 1.2) years, the average radiation dose of the examined patients was (2.39 ± 0.17) Gy. Ophthalmologic examination included visometry with and without correction, tonometry, autorefractokeratometry, biomicroscopy on a slit lamp, retroillumination photography (infrared and color) of a lens. To evaluate the results of surveys used statistical methods: calculation of average values of quantitative indicators, estimation of probability difference by Student's method. RESULTS: In 10 patients (17 eyes) of the 53 reconvalescents of ARS in the remote period after irradiation artifakia after surgical treatment was recognized. In all other patients, changes in the transparency of the lens were detect- ed, and most patients had combined changes. Radiation cataract with it's characteristic clinical picture was detect- ed in 32 people, and in one more case, it's first signs were recorded. But 14 reconvalescents of ARS in the remote period after irradiation had not radiation cataract. CONCLUSIONS: Radiation cataract has not been detected in 14 reconvalescents of ARS in the remote period after irra- diation; the radiation doses of these patients significantly exceeds the threshold levels. Therefore, the absence of it's signs in the remote period in individuals exposed to doses above 2 Gy may indicate that this well-known radia- tion-induced effect is stochastic. Further analysis of the clinical features of the len's pathology in the reconvales- cents of ARS is promising for the study of the mechanism of damage to the lens in this category of victims of the Chornobyl accident.

Radiation induced violations of blood circulation in the ciliary body and changes of the anterior chamber angle in the pathogenesis of glaucoma in clean up workers of the Chornobyl NPP accident and residents of contaminated areas. / RADITsIY̆NO INDUKOVANI PORUShENNIa KROVOOBIGU V TsILIARNOMU TILI TA ZMINY KUTA PEREDN'OI KAMERY OKA V PATOGENEZI GLAUKOMY V UChASNYKIV AVARIY̆NYKh ROBIT NA ChORNOBYL'S'KIY̆ AES I MEShKANTsIV ZABRUDNENYKh TERYTORIY̆.

OBJECTIVE: Estimate changes blood filling of the ciliary body and changes of the anterior chamber angle; study their influence to glaucoma pathogenesis in irradiated persons. MATERIALS AND METHODS: Used the results of a randomly selected group survey of 41 clean up workers of the Chornobyl NPP accident (clean up workers), and 18 inhabitants of the zone of guaranteed voluntary resettlement; age at the time of the survey was 45-50 years. The control group consisted of 41 persons of the same age had not radiation exposure. State of the anterior chamber angle studied by gonioscopy, which was conducted 35 clean up workers and 35 persons of the control group. Changes of the blood circulation in the ciliary body examine by the ophtalmoreog raphy, what was done on 12 eyes of 6 clean up workers, control was 12 eyes of 6 persons had not radiation exposure. RESULTS: Detection revealed of the blood circulation in the ciliary body in all clean up workers, reography coefficient was probably lower (p < 0.05), than in the control group. The research of the state of the anterior chamber angle revealed a higher relative risk of appearance of involution changes of the anterior chamber angle in clean up work ers of ChNPP accident, in comparison with the control group was 3.5 (1.27; 9.5) χ2 = 7.48, p = 0.031. The same changes are characteristic for inhabitants of radiation polluted territories. CONCLUSIONS: Influence ionizing radiation causes a blood circulation decrease in the ciliary body and development changes of the angle of the anterior chamber. Presence of these changes can explain the features of the pathogene sis of glaucoma in irradiated late manifestation and, at the same time, severe course.

[The efficacy of using thymalin and plasmapheresis in the combined treatment of patients with chronic lympholeukemia]. / Effektivnost' primeneniia timalina i plazmafereza v kompleksnom lechenii bol'nykh khronicheskim limfoleikozom.

Results are submitted of study of the effectiveness of inclusion into the treatment program for patients with chronic lymphoid leukemia of specific (thymalin) and unspecific (plasmapheresis) means and modes of immune correction, which made for more rapid attaining clinical and hematological compensation by comparison with chemotherapeutic agents only. Furthermore, the method of combined use of drugs, attempted for the first time, permitted the functional activity of the lymphoid system to be improved, with the clinical and hematological compensation being achieved in a shorter space of time.

[Thymalin in the combined treatment of patients with chronic lympholeukemia]. / Timalin v kompleksnom lechenii bol'nykh khronicheskim limfoleikozom.

Clinico-immunologic indices were studied in patients with the B-variant of chronic lympholeukemia (Stage II) under conditions of inclusion of thymalin in the complex treatment. It was established that use of thymalin in patients with chronic lympholeukemia favoured improvement of the functional activity of lymphoid cells, reduced the time of reaching clinico-hematological remission. Thymalin is indicated in the complex treatment of the above condition.