SLEEP QUALITY OF SCHOOLCHILDREN - RESIDENTS OF RADIOACTIVELY CONTAMINATED AREAS DURING THE COVID-19 PANDEMIC. / ЯКІСТЬ СНУ У ШКОЛЯРІВ ­ МЕШКАНЦІВ РАДІОАКТИВНО ЗАБРУДНЕНИХ ТЕРИТОРІЙ ПІД ЧАС ПАНДЕМІЇ COVID-19.

OBJECTIVE: to assess the sleep characteristics of middle school children during the COVID-19 pandemic. MATERIALS AND METHODS: Cross-sectional study of sleep characteristics of children - residents of radioactively contaminated areas of Zhytomyr and Rivne regions, who underwent a routine examination in June-July 2020, after their stay from March to June 2020 in conditions of home isolation due to quarantine restrictions during the COVID-19 pandemic. Ninety six students of comprehensive public schools, aged 10-16, took part in the study. Sleep characteristics were assessed using the Pittsburgh Sleep Quality Index (PSQI-U indicator), translated into Ukrainian. RESULTS AND DISCUSSION: During the period of the introduction of restrictive measures due to the COVID-19 pandemic, certain disturbances of sleep characteristics were observed, the imprint of which was a moderately increased total PSQI-U indicator, which was (3.89 ± 3.20) points. It was established that 19.79 % of children had insufficient total sleep time, and 2.08 % had significant sleep deprivation. The quality of their sleep was described as «rather bad¼ by 32.29 %, and as «very bad¼ by 4.17 %; 35.42 % of children complained about sleep disturbances, 67.71 % of children had signs of daytime dysfunction, 18.75 % had symptoms of insomnia. In the logistic regression model, quite significant prognostic factors of insomnia were: female gender (OR = 2.487; 95 % CI: 1.407-4.397); subjective determination of the negative impact of the pandemic on health, regardless of whether the respondent had COVID-19 or not (OR = 1.166; 95 % CI: 1.112-1.222), as well as living in the city (OR = 1.183; 95 % CI: 1.065-315). CONCLUSIONS: The introduction of restrictive quarantine measures as a result of the COVID-19 pandemic led to a violation of the daily routine of schoolchildren, which modified the characteristics of sleep. In almost a third of the examined children, the duration and quality of night sleep was insufficient for the physiological restoration of the body's reserves. A late choice of the start of sleep and violations of his hygiene had a critical impact on these indicators.

THE ROLE OF HEREDITARY PREDISPOSITION (POLYMORPHIC MARKERS OF GLUTATHIONE-S-TRANSFERASE, CATALASE, ENDOTHELIAL NITROGEN OXIDE SYNTHASE GENES) AND SOME ADVERSE ENVIRONMENTAL FACTORS IN THE DEVELOPMENT OF BRONCHO-OBSTRUCTIVE PATHOLOGY IN CHILDREN LIVING IN RADIOACTIVELY CONTAMINATED AREAS. / РОЛЬ СПАДКОВОЇ СХИЛЬНОСТІ (ПОЛІМОРФНИХ МАРКЕРІВ ГЕНІВ ГЛУТАТІОН-S-ТРАНСФЕРАЗ, КАТАЛАЗИ, ЕНДОТЕЛІАЛЬНОЇ СИНТАЗИ ОКСИДУ АЗОТУ) ТА ДЕЯКИХ НЕСПРИЯТЛИВИХ ЧИННИКІВ ДОВКІЛЛЯ У ВИНИКНЕННІ БРОНХООБСТРУКТИВНОЇ ПАТОЛОГІЇ У ДІТЕЙ, МЕШКАНЦІВ РАДІОАКТИВНО ЗАБРУДНЕНИХ ТЕРИТОРІЙ.

OBJECTIVE: summarizing the results of many years of research by the authors on the influence of gene polymorphisms encoding xenobiotic biotransformation enzymes (GSTТ1, GSTM1, GSTР1), antioxidant protection (С^262Т of the catalase gene), endothelial nitric oxide synthase (4a/4b VNTR polymorphism of the eNOS gene), and some environmental factors on the occurrence of broncho-obstructive disorders and the development of bronchial asthma in children, residents of radioactively contaminated areas. MATERIALS AND METHODS: The examined school-aged children were residents of radioactively RCA who had no clinical signs of respiratory pathology. Deletion polymorphism of catalase gene (CAT C^262T), polymorphism of glutathione-S-transferase gene (GSTТ1, GSTM1, GSTР1) and the polymorphism in the 4th intron (4a/4b) of the eNOS gene were studied in the molecular genetics laboratory of the State Institution «Reference Center for Molecular Diagnostics of Public Health Ministry of Ukraine¼. Molecular genetic studies were performed by polymerase chain reaction. The study of the ventilation lung capacity was carried out by the method of computer spirometry based on the data of the «flow-volume¼ loop analysis. A pharmacological inhalation test with a bronchodilator drug which affects the ß2-adrenergic receptors of the lungs was used to detect early changes in the ventilatory lung capacity - bronchial hyperreactivity. RESULTS AND CONCLUSIONS: One of the leading mechanisms, due to which the implementation of hereditary predisposition to bronchial asthma in children living in radioactively contaminated areas is the polymorphism of certain genes of glutathione-S-transferase, catalase, endothelial nitric oxide synthase. With such polymorphic variants of the GST genes, isoforms of enzymes with reduced activity are produced, which limits their ability to effectively neutralize free radicals, which are formed in excess when free radical oxidation processes are activated due to the constant intake of radionuclides with a long half-life into the body of children. Unfavorable factors that increase the risk of developing broncho-obstructive disorders and the likelihood of their implementation in the form of bronchial asthma in children, residents of radioactively contaminated areas, have been identified. It has been established that among them the leading role is played by hereditary predisposition to this disease. On the part of the child, such negative factors were unfavorable conditions of intrauterine development, the presence of signs of exudative-catarrhal diathesis, manifestations of allergies and frequent respiratory diseases from the first months of life.

CATALASE CRS-262T GENE POLYMORPHISM AND CHANGES IN VENTILATION LUNG CAPACITY IN CHILDREN-RESIDENTS OF RADIOACTIVELY CONTAMINATED TERRITORIES. / POLIMORFIZM SRS-262T GENA KATALAZY I ZMINY VENTYLIaTsIINOÏ SPROMOZhNOSTI LEGENIV U DITEI - MEShKANTsIV RADIOAKTYVNO ZABRUDNENYKh TERYTORII.

OBJECTIVE: to determine the association of catalase С-262Т gene polymorphism with the presence of bronchial hyper-reactivity in children living in radioactively contaminated territories. MATERIALS AND METHODS: There were examined school-age children-residents of radioactively contaminated territories (RCT), who did not have clinical signs of respiratory pathology. Catalase (CAT) С-262Т gene deletion polymorphism was studied in the molecular genetic laboratory of the State Institution «Reference Center for Molecular Diagnostic of Public Health Ministry of Ukraine¼. Determination of the polymorphic variant by the catalase С-262Т gene was performed by Polymerase Chain Reaction (PCR) using specific oligonucleotide primers, followed by Restriction Fragment Length Polymorphism (RFLP) analysis. The CAT С-262Т gene polymorphism in children living in RCT was compared with that in the reference group of practically healthy individuals. Ventilation lung capacity was performed by computer spirometry according to the analysis of the loop «the flow-volume¼. A pharmacological inhalation test with a bronchodilator that acts on ß2-adrenergic receptors of the lungs was used to detect early changes in the ventilatory capacity of the lungs - bronchial hyperreactivity. RESULTS: Comparative analysis showed that in the presence of bronchial hyperreactivity in children living in RCT, the CT genotype was more common than in children without bronchial hyperreactivity, and the frequency of the CC genotype was correspondingly reduced. There was a trend towards a decrease in the frequency of the TT genotype. An analysis of the frequency distribution of allelic variants of the CAT С-262Т gene polymorphism in children living in the RCT revealed a tendency to increase in the frequency of the T-allele and according to the decrease in the frequency of C-allele in the presence of bronchial hyperreactivity.Сonclusions. Thus, among children living in RCT, CT-homozygotes of CAT С-262Т gene polymorphism had bronchial hyperreactivity probably more often than CC-heterozygotes. In the presence of bronchial hyperreactivity, there was a trend towards an increase in the frequency of the T-allele and, accordingly, a decrease in the frequency of the C-allele.

IDENTIFICATION OF MONOAMINOXIDASE-A GENE PROMOTER POLYMORPHISM (MAOA-UVNTR) AND THEIR RELATIONSHIP WITH AGGRESSIVE BEHAVIOR IN UKRAINIAN CHILDREN. / IDENTYFIKATsIIa POLIMORFIZMU PROMOTORA GENA MONOAMINOKSYDAZY-A (MAOA-UVNTR) TA IOGO ZV'IaZOK Z AGRESYVNOIu POVEDINKOIu V UKRAÏNS'KYKh DITEI.

Aggressive disorders have moderate heritability; therefore, identification of genetic influences is important. TheX-linked MAOA gene encoding the MAOA enzyme has a functional polymorphism of 30 bp repeats. in the promoter region (MAOA-uVNTR), which affects aggression. Stressful life events and family misfortune are also known correlates of behavior disorder in children. OBJECTIVE: to investigate the interactive effect of monoamine oxidase-A gene promoter polymorphism (MAOA-uVNTR) and environmental factors on the development of aggressive behavior. MATERIALS AND METHODS: Genotyping of the MAOA-uVNTR polymorphism was performed in 144 boys and girls aged from 10 to 16 years, genotypes were grouped by a high and low transcriptional activity. For the general assessment of the psycho-emotional sphere of children, the projective method «non-existent animal¼ was used, the indicators and forms of aggression were determined according to the method of A. Bass and A. Darky. RESULTS AND DISCUSSION: It was found the predominant allelic variants of the MAOA gene with 3 (S) and 4 (L) tandem repeats. The presence of close relationships between the dependent variable «aggressive behavior¼ and the predictor variables: «family disadvantage index¼ and «MAOA-uVNTR genotype¼ was established. It has been proven that the presence of the highly active allele (L) in the genotype reduces the chances of developing general aggression, delinquent behavior, physical aggression, open aggression, negativism, and externalization. CONCLUSIONS: The MAOA genotype of the high-activity allele (L) moderated the impact of stressful life events, and the low-activity allele S was associated with increased aggression in girls and boys who experienced severe stress.

ROLE OF GENETIC PREDISPOSITION, GENE POLYMORPHISM OF GLUTATHIONE-S-TRANSFERASE (GSTT1, GSTM1, GSTP1) AND SOME ADVERSE FACTORS IN DEVELOPMENT OF BRONCHIAL ASTHMA IN CHILDREN - RESIDENTS OF RADIOACTIVELY CONTAMINATED AREAS. / ROL' SPADKOVOÏ SKhYL'NOSTI, POLIMORFIZMU GENIV GLUTATION/S/TRANSFERAZ (GSTT1, GSTM1, GSTP1) TA DEIaKYKh NESPRYIaTLYVYKh ChYNNYKIV U ROZVYTKU BRONKhIAL'NOÏ ASTMY U DITEI ­ MEShKANTsIV RADIOAKTYVNO ZABRUDNENYKh TERYTORII.

OBJECTIVE: to determine the influence of hereditary predisposition, polymorphism of GSTT1, GSTM1, GSTP1 genes andenvironmental factors on the development of bronchial asthma in children - residents of radioactively contaminat-ed areas. MATERIALS AND METHODS: School-age children-residents of radioactively contaminated areas with bronchial asthma,and those without clinical signs of respiratory pathology were examined. Genetic, medical, biological and social riskfactors were determined based on the study of anamnestic data and medical records. Ventilation lung capacity wasassessed by the method of computer spirometry. Molecular genetic studies were carried out using polymerase chainreaction (PCR) and restriction fragment length polymorphism (RFLP) for further analysis. RESULTS: Molecular genetic studies of the distribution of genotypes and frequencies of polymorphic variants of thegenes GSTT1, GSTM1, GSTP1 were performed in children living under long-term intake of 137Cs by food chains. It wasfound that in children with BA the tendency to frequency of the deletion variant of the GSTT1 and GSTM1 genes incomparison with children without bronchial and pulmonary pathology was increased. The study of distributing theGSTP1 A313G gene polymorphic variants revealed in children with BA a significant increase in the frequency of AG-genotype, compared with the data of reference group. Adverse factors that increase the risk of developing bron-choobstructive disorders and the probability of their implementation in the form of bronchial asthma in children -residents of RCA have been identified. It is established that among them the leading role is played by hereditarypredisposition to this disease. On the part of the child, such negative factors were unfavorable conditions of fetaldevelopment, the presence of signs of exudative-catarrhal diathesis, manifestations of allergies and frequent respi-ratory diseases from the first months of life. It was found that the risk of developing BA was significantly increasedin children with the GSTT1 and GSTM1 gene deletion genotypes; an increased risk of developing BA in children witha combination of the GSTP1 A313G gene polymorphism with deletion polymorphism of the GSTT1 or GSTM1 gene wasdetermined. Сonclusion. Оne of the leading mechanisms, due to which there is a realization of hereditary predisposition tobronchial asthma in children living under constant intake of radionuclides with a long half-life, is the polymorphismof certain glutathione-S-transferase genes, namely, GSTT1, GSTM1 and A313G gene deletion polymorphism and GSTP1gene polymorphism.

ANXIOUSNESS AND QUALITY OF SLEEP IN CHILDREN WHO WERE IN QUARANTINE DURING THE COVID-19 PANDEMIC. / TRYVOZhNIST' TA IaKIST' SNU U DITEI, IaKI PEREBUVALY NA KARANTYNI PID ChAS PANDEMIÏ COVID-19.

OBJECTIVE: to assess the level of anxiety and characterize the quality of sleep in children living in radioactively con-taminated areas in comparison with children who were not affected by the Chornobyl-affected contingents that werequarantined in connection with the COVID-19 pandemic. MATERIALS AND METHODS: The indicators of the level of anxiety were studied using the scale of self-assessment of thelevel of anxiety Ch.D. Spielberger, sleep quality was assessed using a standardized questionnaire for self-completionof PSQI and 137Cs content was measured in children. The main group consisted of 96 children who were quarantineddue to the COVID-19 pandemic and permanently lived in radioactively contaminated areas of Zhytomyr and Rivneregions with a soil contamination density of 137Cs from 18 kBq/m2 to 235 kBq/m2. The age of children ranged from10 to 17 years. Among them were 33 boys and 63 girls. The comparison group consisted of 52 children of similar age,including 26 boys and 26 girls. These children lived permanently in Kyiv and were not victims of the Chornobyl dis-aster. RESULTS: It was found that children who were quarantined for COVID-19 (both residents of radioactively contami-nated areas and children who do not belong to the contingents affected by the Chornobyl disaster) had an increasedlevel of reactive (RA) and personal anxiety (PA). The comparative analysis showed that children of the same sex ofthe main group and the comparison group did not differ in terms of PA and RA. At the same time, studies have shownthat girls, both in the main group and in the comparison group, were characterized by higher levels of PA and RAthan boys. It was determined that poor sleep quality was common in both children living in radioactively contami-nated areas (42.71 %) and children in the comparison group (42.44 %). Among the sleep disorders in children ofboth observation groups, «day dysfunction¼ was most often detected. CONCLUSIONS: There was a direct correlation between the overall PSQI score and the level of reactive, personal anx-iety and the overall PSQI score. Using regression analysis, the presence of a linear association of the level of incorporated 137Cs (Bq) with the indicator of personal anxiety of children living in radioactively contaminated territory (b = -0.716, p < 0.001) was proved.

MOLECULAR GENETIC ASPECTS OF BRONCHIAL HYPERREACTIVITY IN CHILDREN - RESIDENTS OF RADIOACTIVELY CONTAMINATED AREAS. / MOLEKULIaRNO-GENETYChNI ASPEKTY BRONKhIAL'NOÏ GIPERREAKTYVNOSTI U DITEI-MEShKANTsIV RADIOAKTYVNO ZABRUDNENYKh TERYTORII.

OBJECTIVE: to determine the relationship between polymorphisms of glutathione S-transferase gene family andbronchial hyperreactivity in children living in radioactively contaminated areas. MATERIALS AND METHODS: School age children-residents of radioactively contaminated areas (RCA), without clinicalsigns of respiratory pathology were examined. Molecular genetic studies were carried out by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) for further analysis. The GSTT1, GSTM1 gene deletion polymorphism was investigated using multiplex PCR. PCR and PCR-RFLP analyses were performed in the studyof the GSTP1 gene A313G polymorphism. The ventilation lung capacity was examined by the pneumotachographicmethod according to the analysis of «the flow-volume¼ loop. The pharmacologic inhalation test with bronchodilator drug, affecting the ß2-adrenergic lung receptors was used to detect the early changes in the ventilation lungcapacity - the bronchial hyperreactivity (latent and nonlatent bronchospasm). RESULTS: Molecular genetic studies showed that the GSTM1 gene deletion genotype and the GSTP1 gene A313G polymorphism were found significantly more often in the subgroup of children with bronchial hyperreactivity living inRCA than in children without bronchial hyperreactivity and children of the control group. The frequency of GSTT1deletion polymorphism did not have a statistically significant difference in all subgroups. CONCLUSIONS: The GSTM1 gene deletion polymorphism and the GSTP1 gene A313G genotype may be a risk factor fordeveloping bronchial hyperreactivity in children living under adverse environmental conditions, including radioactively contaminated areas.

APPLICATION OF ART THERAPY FOR CORRECTION OF PERSONAL DISORDERS OF PSYCHOEMOTIONAL STATE OF CHILDREN - INHABITANTS OF RADIATION POLLUTED TERRITORIES AND CHILDREN DISPLACED FROM THE ARMED CONFLICT ON THE SOUTHERN EAST OF UKRAINE. / ZASTOSUVANNIa ART-TERAPIÏ DLIa KOREKTsIÏ PORUShEN' PSYKhOEMOTsIY̆NOGO STANU DITEY̆-MEShKANTsIV RADIOAKTYVNO ZABRUDNENYKh TERYTORIY̆ TA DITEY̆, PEREMIShchENYKh IZ ZONY ZBROY̆NOGO KONFLIKTU NA PIVDENNOMU SKhODI UKRAÏNY.

OBJECTIVE: to identify the psycho-emotional state of children - residents of radioactively contaminated territories and children displaced from the zone of armed conflict in the south-east of Ukraine, and evaluate the effectiveness of art therapy application to correct its disturbances. MATERIALS AND METHODS: The psycho-emotional state was determined in 113 children, of which 57 children from radioactively contaminated territories with 137Cs content in the body from 269 Bq to 7024 Bq (group I) and 56 chil- dren displaced from the zone of military conflict in the Southeast of Ukraine (group II). The age of children ranged from 10 to 17 years. The children were hospitalized to the childrens' clinics of the NRCRM because of functional dis- orders and chronic somatic pathology. The psycho-emotional state of children was evaluated using the «non-exis- tent animal¼ test. It was analyzed for three symptoms - anxiety, aggressiveness and neuropsychiatric exhaustion and was evaluated by scoring points. Correction of the psychoemotional condition was carried out by the method of art therapy in the form of a serial drawing. Psychological testing was performed twice: at admission to the hospital and after the end of the art therapy. RESULTS: The results of the primary examination of the psycho-emotional state of children by the «non-existent ani- mal¼ test showed that in children - residents of radioactively contaminated territories the state of anxiety was reg- istered in all 57 children (100 %), the state of aggression - in 38 children (66.7%); exhaustion - in 37 children (64.9 %). In children who have been displaced from the zone of armed conflict in the south-east of Ukraine, the state of anxiety was also registered in all 56 children (100 %), the status of aggression was determined in 53 chil- dren (94.6 %), and the state of exhaustion - in 44 children (78.6 %). It was established that in children displaced from the combat zone in the Southeast of Ukraine, the quantitative indices of anxiety and aggression states were sig- nificantly higher than in children living in radioactively contaminated territories (p < 0.001), whereas nor by frequen- cy, nor by the degree of severity of exhaustion state they did not clearly differ (p > 0.05). Correlation analysis with the definition of Spearman's criterion did not reveal likely association between the content of 137Cs in the body of children - residents of radioactively contaminated territories and the peculiarities of their psycho-emotional state. CONCLUSIONS: The use of the art therapy method in the form of a serial drawing for children - residents of radioac- tively contaminated territories and children moved from the combat zone in the south-east of Ukraine, led to a sig- nificant positive effect, which was characterized by a decrease in the manifestations of symptoms of anxiety and aggressiveness. The state of exhaustion was less well corrected and its indices only had a tendency to improve. Thus, the method of art therapy in the form of a serial drawing is characterized by efficiency, simplicity of execution, low cost, it can be widely used in children's teams to correct disorders of the psycho-emotional state.

FUNCTION OF EXTERNAL RESPIRATION AND MARKERS OF OXIDATIVE STRESS IN CHILDREN-RESIDENTS OF RADIOACTIVELY CONTAMINATED TERRITORIES. / FUNKTsIIa ZOVNIShN'OGO DYKhANNIa I MARKERY OKSYDATYVNOGO STRESU U DITEY̆ ­ MEShKANTsIV RADIOAKTYVNO ZABRUDNENYKh TERYTORIY̆.

OBJECTIVE: to evaluate the influence of processes of lipid peroxidation, and antioxidant protection on the function of external respiration in children-residents of radioactive contaminated territories. MATERIALS AND METHODS: There were examined children of school age, inhabitants of radioactive contaminated ter- ritories (RCT) without respiratory and pulmonary pathology, and patients with bronchial asthma (BA). Examination of the ventilation lung function was performed by the method of pneumotachography according to the analysis of the «flow-volume¼ loop. End products of lipid peroxidation (LPO), reacting with thiobarbituric acid (malondialde- hyde), enzymes-antioxidants - catalase, superoxide dismutase, glutathione peroxidase, glutathione transferase were studied to determine the signs of oxidative stress. RESULTS: Examinations of ventilation lung function in children-residents of RCT without respiratory and pulmonary pathology showed no significant deviations of its parameters beyond the limits of physiological fluctuations; a decrease in bronchial patency at different levels of the bronchial tree was established in children with BA. An increased incidence of bronchial hyperreactivity was noted in both the patients with BA and those who did not have bronchopulmonary pathology. The absence of an increase in the content of LPO products (malondialdehyde) in blood serum of children-residents of RCT with increased activity of catalase and group of glutathione enzymes indi- cates the sufficiency of compensatory possibilities of antioxidant protection. CONCLUSIONS: Studies of correlation between the function of external respiration and markers of oxidative stress determined that the indices of bronchial patency directly correlate with the activity of enzymes-antioxidants of the glutathione group and inversely - with the content of the LPO products in children-residents of RCT. The frequency of bronchospasm inversely correlated with the activity of glutathione group antioxidants. There are inverse correla- tion of 137Cs content in the body with the activity of glutathione transferase and glutathione peroxidase.

FEATURES OF NITRIC OXIDE METABOLISM AND RISK OF DEVELOPING ENDOTHELIAL DYSFUNCTION IN CHILDREN WITH e-NOS GENE 4a/4b POLYMORPHISM UNDER LONG-TERM ENTERING 137Cs TO BODY. / OSOBLYVOSTI METABOLIZMU OKSYDU AZOTU TA RYZYK ROZVYTKU ENDOTELIAL'NOÏ DYSFUNKTsIÏ U DITEI Z 4a/4b POLIMORFIZMOM GENA eNOS PRY TRYVALOMU NADKhODZhENNI 137Cs DO ORGANIZMU.

OBJECTIVE: To determine the features of the nitrogen oxide metabolism and risk of developing endothelial dysfunc-tion in children with e-NOS 4a/4b gene polymorphism, who live under prolonged enter 137Cs to the body. MATERIALS AND METHODS: There were examined 117 children-residents of radioactively contaminated territories and50 children of control group. The level of stable metabolites was defined in blood serum (NO2- and NO3-). The ther-mographic method was used to register the endothelium dependent reaction of the vascular bed to changes in theblood supply. The ventilation capacity of the lungs was evaluated using this method of pneumotachography.Polymorphism in intron 4 of the gene e-NOS was studied by the method of polymerase chain reaction. The contentof 137Cs in the body of children was determined using a human radiation counter Skrynner M-3. RESULTS AND CONCLUSIONS: In children-residents of radioactively contaminated territories with genotype 4a/4b com-paring to children who had genotype 4b/4b, the decrease in the nitric content of in the blood serum, the increase inthe thermographic index of the recovery period of blood circulation to the baseline level after occlusion test werenoted, that is indicative of the decreased NO-synthase active of vascular endothelium in the carriers of the minorallele a in the 4th intron of gene eNOS (genotype 4a/4b), and is a risk factor for development of endothelial dysfunc-tion. It was proved a decrease in the index of lung tissue elasticity and stretchability - FVC / NFVC of the lungs com-paring to children with genotype 4b/4b, there was a reduction of integral index of respiratory tract permeability -FEV1/NFEV1. The inverse correlation dependence between the presence of allele a in the genotype and the values ofFVC/NFVC of the lungs (r = -0.259; p <0.05) and FEV1/NFEV1 (r = -0.2267; p <0.05) was found. Signs of bron-chospasm were found in the carriers of the allele a in 1.5 times more often than in children-carriers of homozy-gotes from allele b.

Experience of correcting endothelial dysfunction in children-residents of radioactively contaminated areas by nitric oxide potential donator citrulline. / DOSVID KOREKTsIÏ ENDOTELIAL'NOÏ DYSFUNKTsIÏ U DITEY̆, MEShKANTsIV RADIOAKTYVNO ZABRUDNENYKh TERYTORIY̆, ZA DOPOMOGOIu POTENTsIY̆NOGO DONATORA OKSYDU AZOTU ­ TsYTRULINU.

OBJECTIVE: to determine the effectiveness of citrulline use for correcting endothelial dysfunction in children resi dents of radioactively contaminated areas. MATERIALS AND METHODS: A group of children residents of radioactively contaminated areas with the presence of clinical and paraclinical signs of endothelial dysfunction was selected to assess the effectiveness of correcting endothelial dysfunction by the usage of NO potential donator - citrulline according to the data of selective screen ing. There were determined the biochemical parameters of the content of NO stable metabolites, L arginine, lipid peroxidation, antioxidant enzymes in the blood serum; the indices of cellular and humoral immunity; the instrumen tal indices of vascular endothelium dependent reaction on occlusion test, the lung ventilation capacity, the bioelec tric activity of the myocardium, the autonomic regulation of the cardiovascular system.Examined children were received a course of citrulline malate. RESULTS AND CONCLUSIONS: An increased content of serum L arginine, nitrite, and amounts of NO metabolites was established in children with endothelial dysfunction who were received a course of citrulline malate. Bronchospasm elimination was noted in the significant part of examined patients after the drug use. Decreased recovery period and increased period of hypercompensation for thermographic circulation index in the test with post occlusion reac tive hyperemia were detected by an evaluation of indicators for vascular endothelium dependent vasodilatation using thermographic method indicating an increased endothelial vasomotor capacity. There was tendency to improve the processes of autonomic regulation of the heart rhythm and repolarization of the heart muscle. The antioxidant effect of used citrulline malate course was determined as: decreased content of serum LPO end products that react with thiobarbituric acid under elevated activity of antioxidant - catalase. An increase in the percentage of T lymphocyte, normalization of their subpopulation composition was noted in dynamics of citrulline malate application.

Efficiency of endothelial dysfunctioncorrection in children residents of radioactively contaminated areas using the method of intermittent normobaric hypoxi therapy. / EFEKTYVNIST' KOREKTsIÏ ENDOTELIAL'NOÏ DYSFUNKTsIÏ U DITEY̆ MEShKANTsIV RADIOAKTYVNO ZABRUDNENYKh TERYTORIY̆ ZA DOPOMOGOIu METODU PERERYVChASTOÏ NORMOBARYChNOÏ GIPOKSYTERAPIÏ.

Objective is to evaluate the effectiveness of intermittent normobaric hypoxi therapy as the means that can posi tively influence on the different links in the pathogenesis of endothelial dysfunction in children residents of radioactively contaminated areas. MATERIALS AND METHODS: Disorders of personal and emotional sphere, symptoms of asthenic vegetative and neurot ic character, the signs of the cardiovascular and respiratory systems, abdominal and dyspeptic syndromes are attrib uted to the clinical signs of endothelial dysfunction. There were determined the biochemical parameters of the con tent of stable metabolites of NO, L arginine, lipid peroxidation, antioxidant enzymes in the blood serum; the indices of cellular and humoral immunity; the instrumental indices of vascular endothelium dependent reaction to occlu sion test, ventilating ability of the lungs, the bioelectric activity of the myocardium. Intermittent normobaric hypoxi therapy (INHT) was performed using the individual device of mountain air of the «Borei¼ type produced by State Research Medical Engineering Center «NORT¼ NAS of Ukraine (Kyiv). RESULTS AND CONCLUSIONS: The clinical examination showed that the administration of additional intermittent nor mobaric hypoxi therapy to the basic treatment of 44 children with endothelial dysfunction who live in the radioac tively contaminated areas, promoted to reduce the frequency of complaints and intensity of clinical manifestations in the mentioned symptom complex. An increase of serum L arginine in the absence of significant changes in the content of NO stable metabolites was revealed in the most examined children residents of radioactively contami nated areas by studying NO system after using the course of intermittent normobaric hypoxi therapy. Positive changes in vascular endothelium dependent reaction to occlusion test, indicating the reduction length of the recovery period for thermographic circulation index after occlusive test, were determined. The decrease in the inten sity of lipid peroxidation processes - a reduction of serum LPO end products content that react with thiobarbituric acid - was observed. The bronchospasm elimination was revealed in a large number of children with the study of the lung ventilation capacity. There were trends to reduce the imbalance of different chain of the heart rhythm man agement. The immunomodulatory effect was detected as: the increase in the functional activity of neutrophils, the normalization of humoral immunity link indices. Intermittent normobaric hypoxi therapy is an effective tool that can positively affect the condition of nitric oxide system and endothelium dependent functions of the organs and systems in children residents of radioactively contaminated areas.

Genetic effects in children exposed in prenatal period to ionizing radiation after the Chornobyl nuclear power plant accident.

AIM: To study the genetic effects in children exposed to radiation in utero as a result of the Chornobyl nuclear power plant accident accounting the total radiation doses and equivalent radiation doses to the red bone marrow. MATERIALS AND METHODS: Incidence of minor developmental anomalies was studied in children exposed to radiation in utero (study group) and in the control group (1144 subjects surveyed in total). Cytogenetic tests using the method of differential G-banding of chromosomes were conducted in 60 children of both study and control groups (10-12-year-olds) and repeatedly in 39 adolescents (15-17-year-olds). RESULTS: A direct correlation was found between the number of minor developmental anomalies and fetal dose of radiation, and a reverse one with fetal gestational age at the time of radiation exposure. Incidence of chromosomal damage in somatic cells of 10-12-year-old children exposed prenatally was associated with radiation dose to the red bone marrow. The repeated testing has revealed that an increased level of chromosomal aberrations was preserved in a third of adolescents. CONCLUSION: The persons exposed to ionizing radiation at prenatal period should be attributed to the group of carcinogenic risk due to persisting increased levels of chromosome damage. This article is a part of a Special Issue entitled "The Chornobyl Nuclear Accident: Thirty Years After".

Influence of eNOS gene 4a/b VNTR polymorphism on development of endothelial dysfunction and respiratory system disorders in children - residents of radioactively contaminated areas. / VPLYV VNTR (4a/b) POLIMORFIZMU GENA eNOS NA ROZVYTOK ENDOTELIAL'NOI DYSFUNKTsII TA PORUShEN' SYSTEMY DYKhANNIa U DITEY - MEShKANTsIV RADIOAKTYVNO ZABRUDNENYKh TERYTORIY.

UNLABELLED: Objective is to study the role of еNOS gene polymorphism in the development of endothelial dysfunction and func tional disorders of the respiratory system in children - residents of radioactively contaminated areas. MATERIALS AND METHODS: Total of 184 children were examined to determine the possible associative links between еNOS gene intron 4m polymorphism and indices characterizing the functional state of the endothelium and the bronchopulmonary system. Of them the main group of children consisted of 135 children residents of radioactively contaminated areas, the control group - of 49 healthy children who lived in "clean" regions by the radioactive con tamination and were not belonging to victims of the Chernobyl accident contingents. The molecular genetic study determining the еNOS gene intron 4 polymorphism was performed. An examination of lung ventilation capacity was evaluated using the pneumotachography method. The thermographic method was used for registering the endothe lium dependent reaction of the vascular bed to changes in blood supply conditions. The levels of nitrogen com pounds (NO2 and NO3 ) were determined by the standard method using Hriss reagent. The level of body incorporat ed 137Cs was determined using human radiation counter Skrynner 3M (Institute of Human Ecology). RESULTS: Children of the main group did not differ from that of control and literature data by the frequency of geno types 4a/b and еNOS gene allele polymorphism. An increase in the duration of circulation restoration up to the ini tial level after occlusion test was noted in children of the main group with genotype 4a/4b comparing to children with genotype 4b/4b; a decrease in the nitrite content was observed in blood serum. The integral indices of elastic ity and tensility of the lung tissue, respiratory permeability were decreased; the signs of bronchospasm were record ed 1.5 times more often. These adverse effects were associated with the presence of genotype allele 4a, the signs of endothelial dysfunction and the level of the incorporated 137Cs. CONCLUSIONS: More pronounced changes in vascular endothelial reaction to occlusion and the significant decrease of serum nitrite level in allele 4a carriers, especially in children who live in adverse ecological conditions, give the right to include them into the risk group for the development of endothelial dysfunction, and to conside pulmonary dysfunction as one of its manifestations.

Gut microbiota among children living in areas contaminated by radiation and having the cardiac connective tissue dysplasia syndrome. / Mikrobiocenoz kyshechnyka u ditej-meshkanciv radioaktyvno zabrudnenyh terytorij iz syndromom dyplazii' spoluchnoi' tkanyny sercja.

Objective. The study examined the gut (colonic) microbiota in children being domiciled in contaminated zones and suffering the cardiac connective tissue dysplasia syndrome (CCTDS). Materials and methods. The study included 99 children living in contaminated zones. Study subjects were divided into subgroup IA (a comparison subgroup) of 44 children with no signs of CCTDS and subgroup IB of 55 children having the CCTDS. The control group included 24 children aged from 7 to 17 years old. Study groups were of the same gender and age. Results. In the absence of any specific complaints the abnormal gut microbiota was revealed in children living in contaminated areas with a high incidence of 96.36 % featuring both quantitative and qualitative abnormalities that can be considered a dysadaptation phenomenon of both digestive system and body as a whole. Under the concomitant CCTDS these disorders are more expressive, being characterized by a significant decrease in the number of obligate gut flora and failure of its protective capabilities. Incidence of dysbacteriosis grade III in children having the CCTDS is significantly higher vs. children of the control group and comparison subgroup. Under CCTDS the gut microbiota abnormalities were represented with a severe bowel contamination by E. coli with altered enzymatic properties, various types of opportunistic microorganisms, and a high identification incidence of genus Candida fungi at the background of a significant depression of normal colonic flora. Presence of 3-5-component associations of opportunistic pathogens in the colon was found with high incidence. Conclusion. According to received results the examination of intestinal bacterial flora is expedient in children living in areas contaminated by radiation. Application of health care arrangements aimed at normalization of gut microbiota is obligate.

Balance of autonomic nervous system in children having signs of endothelial dysfunction, that were born and are domiciled in contaminated territories. / Vegetatyvnyj gomeostaz u ditej z oznakamy endotelial''noi' dysfunkcii', jaki narodylysja ta postijno prozhyvajut'' na radioaktyvno zabrudnenyh terytorijah.

UNLABELLED: Objective. The study examined the features of functional state of the autonomic nervous system in children having endothelial dysfunction and permanently residing in contaminated areas. Materials and methods. Clinical and instrumental examination of 101 children aged 7-18 years that were born and are domiciled in contaminated territories, including 37 persons with signs of endothelial dysfunction (subgroup IA) and 64 ones with no signs of endothelial dysfunction (IB subgroup) was conducted. The control group being comparable to the subgroups IA and IB by age, gender and clinical examination results included 37 children neither been domiciled in contaminated areas nor were belonging to the contingent of Chornobyl accident survivors. There were 20 apparently healthy children also examined. Results. Due to peculiarities of physiological pathways providing adaptive responses the children having signs of endothelial dysfunction are characterized by a more pronounced dysregulation of autonomous nervous system both in a resting state and under a functional load simulation, and also by a high strain of adaptation pathways. The lack of autonomous support of cardiovascular system is caused by inadequate adaptive responses of both central regulatory bodies (hypothalamus, vasomotor center) and peripheral receptors. Mainly the failure of segmental autonomous (parasympathetic) structures was revealed. The mode of their response to stress in this case corresponds to that in healthy individuals but at a lower functional level. There is a reduced aerobic capacity of the organism by the Robinson index, contributing to low adaptive range to non-specific stress in children being domiciled on contaminated territories including children having the endothelial dysfunction. Conclusions. Endothelial dysfunction was associated with more pronounced manifestations of autonomic dysregulation and reduced aerobic capacity of the organism being the risk factors of development of a range of somatic diseases requiring the development of prevention measures in children permanently residing in contaminated areas. KEYWORDS: autonomous nervous system balance, endothelial dysfunction, children, Chornobyl accident.

Peculiarities of gastrointestinal disease concomitant to heart connective tissue dysplasia in children born from persons exposed to ionizing radiation in childhood after the ChNPP accident. / Osoblyvosti patologii' shlunkovo-kyshkovogo traktu u ditej iz syndromom dysplazii' spoluchnoi' tkanyny sercja, jaki narodylysja vid bat''kiv, oprominenyh v dytjachomu vici v rezul''tati avarii' na ChAES.

Study objective. The study examined the peculiarities of upper gastrointestinal tract diseases in children suffering from a syndrome of heart connective tissue dysplasia (HCTDS) born from persons exposed to ionizing radiation in a childhood after the ChNPP accident. Materials and methods. The study included 120 children suffering from HCTDS (group I) and 75 persons having no signs of the syndrome (Group II). Diagnosis of HCTDS was obtained from echocardiography in Band M-modes and Doppler echocardiography. Esophagogastroduodenoscopy was performed using a flexible endoscope "OLYMPUS" model GIF-P3. Abdominal diagnostic ultrasound was used to assay the structure of abdominal parenchymal viscera. Results. Upper gastrointestinal tract diseases (UGITD) manifest earlier in children suffering the HCTDS (beginning from a preschool age). Along with age the systemic pattern of organ and system injury becomes evident i.e. there were 6.8 clinical/nosological entities per one child in Group I and 4.9 in Group II. Clinical presentation of chronic UGITD diseases in children suffering concomitant HCTDS were characterized by more frequent exacerbation after the psychoemotional and physical strain, more frequent intestinal motor dysfunction, nervous system disorders (80 %), and chronic infections (62.2 %). Endoscopic pattern of chronic UGITD with concomitant HCTDS featured a combination of mucosal inflammation (a range of various forms of esophagitis, erythematous and hypertrophic gastroduodenopathy) with abnormal gastrointestinal motor function i.e. gastroesophageal and duodenogastric reflux (73.34 %). Destructive lesions at most of duodenal zone were found in 20 %. Conclusions. UGITD namely chronic gastroduodenitis with typically concomitant involvement of several parts of digestive tract are most prevalent within all digestive system diseases in remote period upon the Chornobyl disaster in children born from persons exposed to ionizing radiation in a childhood. Presentation of UGITD occurs earlier in children suffering HCTDS with evident systemic pattern of organ and system injury along with an age. Refluxes of various nature and localization are the leading factors for UGITD onset in children suffering HCTDS. Thus a range of multidirectional tools of reflux disease prophylaxis is required for inclusion to the disease management.