PREVALENCE OF AGE-MACULAR DEGENERATION IN PERSONS OF WORKING AGE WHO APPLIED TO PARTICIPATE IN WORK IN ACTION CONDITIONS IONIZING RADIATION: PRELIMINARY RESULTS. / ПОПЕРЕДНІ РЕЗУЛЬТАТИ ДОСЛІДЖЕННЯ ПОШИРЕНОСТІ ВІКОВОЇ МАКУЛЯРНОЇ ДЕГЕНЕРАЦІЇ У ОСІБ ПРАЦЕЗДАТНОГО ВІКУ, ЯКІ ПРЕТЕНДУВАЛИ НА УЧАСТЬ В РОБОТАХ В УМОВАХ ДІЇ ІОНІЗУЮЧОГО ВИПРОМІНЮВАННЯ.

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 secondary and tertiary care.

BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT. PART V - ORGANIC AND FUNCTIONAL CHANGES CORRELATION ON THE EXAMPLE OF CERTAIN DISEASES. / ГОЛОВНИЙ МОЗОК ТА ОРГАН ЗОРУ ЯК ПОТЕНЦІЙНІ МІШЕНІ ДЛЯ ВПЛИВУ ІОНІЗУЮЧОГО ВИПРОМІНЮВАННЯ: ЧАСТИНА V ­ СПІВВІДНОШЕННЯ ОРГАНІЧНИХ І ФУНКЦІОНАЛЬНИХ ЗМІН НА ПРИКЛАДІ ОКРЕМИХ ЗАХВОРЮВАНЬ.

The question about correlation between organic and functional changes in persons, exposed to radiation is still insufficiently studied. Dynamics of morbidity for different forms and classes of non-tumour diseases periodisation, proposed by epidemiologists, suggests the identification of three main periods: «early¼ (the first 6 post-Chornobyl accident years); «distant¼ (12-21 years) and «late¼ (22-30 years). However, the correspondence this periodisation to the results of epidemiological data, without taking into account the clinical features of the diseases, may contribute to the impression, that in the first period after a radiation disaster functional disorders (or autonomic regulation disorders, etc.) prevail in all cases. Meanwhile, the data from ophthalmological and neurological studies, which we aim to demonstrate in this paper, rather indicate the presence of a significant morphological basis for the development of functional disorders in early period after a radiation disaster. The objective of this work is analyse modern experimental, epidemiological and clinical data on the correlation between organic and functional changes, characteristic of radiation cerebro-ophthalmological effects - radiation cataracts, age-related macular degeneration, cerebral small vessel disease, and neurocognitive deficits. Materials and methods. The criteria for inclusion in the analytical review were peer-reviewed publications in PubMed/MEDLINE, Scopus, Web of Science, and manually selected papers; the results of our own research were also used. An additional analysis of the results of examinations conducted in 1991-2004 was performed, which included a total of 11 123 persons irradiated as the result of catastrophy at the Chornobyl NPP. Results. In the first period of radiation cataract development, which is a specific consequence of radiation exposure, morphological changes (lens opacities) are observed, which lead to a decrease in visual function only later. Analysing the correlation between organic and functional changes in the development of diseases, for which ionising radiation exposure is a significant risk factor, we observe a similar picture. For example, CSVD associated with arterial hypertension may be a manifestation of accelerated aging associated with exposure to ionising radiation.Similarly, the initial signs of age-related macular degeneration in radiation-exposed individuals are usually manifested by changes in the morphology of the retina, choroid, and pigment epithelium in the macular area, while functional disorders in the form of decreased central vision and metamorphopsia, etc., occur later.

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.

RESULTS OF WBC MEASUREMENTS WERE MADE AT RADIOACTIVELY CONTAMINATED TERRITORIES OF UKRAINE IN 1986-2014 (REVISION AND ANALYSIS). / REZUL'TATY LVL6VYMIRIuVAN', PROVEDENYKh NA RADIOAKTYVNO ZABRUDNENYKh TERYTORIIaKh UKRAÏNY U 1986-2014 rr. (REVIZIIa TA ANALIZ).

OBJECTIVE: revision, analysis, and significant improvement of quality of the database of WBC measurements made in1986-2014 at radioactively contaminated territories of Ukraine by the use of renewal of informational gaps andimprovement of the model for assessment of internal exposure doses. MATERIALS AND METHODS: Inthe periodfrom 1986 to 2014 experts of the Whole Body Counters Laboratory of NRCRMaccumulated about 1.5 million results of WBC measurementsof radio-cesium incorporated in the body of personsresiding at the territories which are radioactively contaminated due to Chornobyl accident. Most of measurements(~64 %) were made during the first 15 years after the accident. The most of measurements were made in Kyiv (~23 %),Zhytomyr (~36 %), Rivne (~20 %) and Chernihiv (~5 %) Oblasts. Works on revision of database of WBC measurementsincluded: transformation of data saved in paper format into electronic form, checking for correctness and correspon-dence of information, renewal of lacking information at the fields of database, improvement of the model for eval-uation of internal exposure doses by the data of WBC measurements. In the model for evaluation of revised doses,it is assumed uniform content of radio-cesium during a year. Reference values are used of metabolism parametersand anthropometric human parameters recommended in publications of ICRP. RESULTS: Revised doses have been reconstructed for 1,386,585 records of data base of WBC measurements that fitspecially elaborated criterions for estimation of quality of results. Among them 604,215 records are WBC measure-ments of children and adolescents younger than 18, and 782,370 records correspond to adult inhabitants of Ukraine,most of which reside in Zhytomyr, Kyiv, Rivne and Chenihiv Oblasts. CONCLUSIONS: Obtained results serve as a ground for further works on improvement of models for evaluation of pass-port doses and individualized exposure doses of subjects registered in Ukrainian State Register - of persons thataffected due to Chornobyl accident. Evaluated doses can be used for epidemiological, clinical and other research.

RESULTS OF COMPREHENSIVE RADIOLOGICAL - HYGIENIC MONITORING IN SOME SETTLEMENTS OF RADIOLOGICALLY CONTAMINATED AREAS IN RIVNE REGION IN 2017. / REZUL'TATY KOMPLEKSNOGO RADIATsIINO/GIGIIeNIChNOGO MONITORYNGU OKREMYKh NASELENYKh PUNKTIV RADIOAKTYVNO ZABRUDNENYKh TERYTORII RIVNENS'KOÏ OBLASTI U 2017 r.

OBJECTIVE: Identification of the main factors of radiation exposure formation in the residents of surveyed settle-ments of radiologically contaminated territories in Rivne region and estimation of radiation doses in population ata current stage of the accident. MATERIALS AND METHODS: Comprehensive radiological and hygienic monitoring was conducted within 7 settlementsof the Rokytnivsky district of Rivne region, namely in the Stare Selo, Vezhytsya, Perehodychi, Drozdyn', Berezove,Zabolottya, and Hrabun' villages. Assay of the incorporated 137Cs was held using a whole-body counter in residentsof the villages twice a year, i.e. in May and October. Basic foodstuffs were sampled for the assay of 90Sr and 137Cs alongwith interview of residents about the foodstuff consumption. External radiation doses were estimated. Mathe-matical, dosimetric, and radiochemical methods were applied. RESULTS AND CONCLUSIONS: The annual effective exposure doses of population in the surveyed settlements of Rivneregion in the year of study were formed at the expense of internal exposure doses ranging from 0.13 mSv · year-1 to0.32 mSv · year-1, which is below the criterion for radiologically contaminated territories. It has been establishedthat the incorporation of 137Cs by the inhabitants is a principal factor of the internal radiation dose formation. The 137Cs incorporation occurs through the consumption of such basic foodstuffs as milk and forest products, primarilymushrooms, which traditionally occupy a significant part of the diet in the Polissya area. The 137Cs content in thevast majority of milk and mushroom samples significantly exceeded the permissible levels (PL). The maximum con-tent of 137Cs in the collected milk samples was 384.7 Bq · L-1, which is 4 times higher than PL, and 36.9 kBq · kg-1 indried mushrooms being 15 times higher than PL. CONCLUSIONS: The existing radiation and ecological situation in the areas that were exposed to radioactive contam-ination as a result of the Chornobyl disaster requires the continuation of monitoring of levels of radioactive con-tamination of foodstuffs, especially collected in forests, and doses of radiation exposure of the population.

MORPHOMETRIC PARAMETERS OF RETINAL MACULAR ZONE IN RECONVALESCENTS OF ACUTE RADIATION SICKNESS (IN REMOTE PERIOD). / MORFOMETRYChNI PARAMETRY MAKULIaRNOÏ ZONY SITKIVKY U REKONVALESTsENTIV GOSTROÏ PROMENEVOÏ KhVOROBY (U VIDDALENOMU PERIODI).

OBJECTIVE: evaluate the retinal morphometric parameters of the reconvalescents in remote period after acute radi-ation sickness. MATERIALS AND METHODS: A complete ophthalmologic examination was carried out on 7 reconvalescents of acuteradiation sickness. The examined are divided into two subgroups: 1) patients with macular degeneration of the reti-na (8 eyes); 2) patients without clinical signs of macular pathology (6 eyes). Parameters of the retina in the cen-tral retina zone studied using the method of optical coherence tomography. To evaluate the results of surveys usedstatistical methods: average values of quantitative indicators calculation, estimation of probability difference byStudent's method. RESULTS: Optical coherence tomography revealed a statistically significant increase of the thickness of the retina inthe fovea in all reconvalescents of acute radiation sickness. CONCLUSIONS: It was shown that the thickness of the retina in the fovea and paramacular zone in persons who suf-fered acute radiation sickness is significantly higher than in the control. These changes observed in all reconvalis-cents ARS - both in person with sings of macular degeneration, and in those whose clinical manifestations were notdetected. The presence of a correlation between the volume of the retina in the macular zone and the documentedradiation dose of the study group emphasizes the perspectives of next OCT examination of the retina of reconvales-cents of ARS to study the mechanism of retina's damage 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 risk of macular degeneration development in persons antenatally irradiated as a result of Chornobyl NPP accident. / RYZYK ROZVYTKU MAKULIaRNOÏ DEGENERATsIÏ U OSIB, OPROMINENYKh ANTENATAL'NO VNASLIDOK AVARIÏ NA ChORNOBYL'S'KIY̆ AES.

OBJECTIVE: Assess the risk of macular degeneration development in persons exposed in utero as a result of Chornobyl NPP accident. MATERIALS AND METHODS: The object of the study was the state of the macular area of the retina of 84 individuals exposed in utero as a result of the Chornobyl disaster. They were surveyed at the age of 14-30. The results of stan dardized ophthalmic examinations conducted between 2000 and 2016 were used. The control group consisted of 165 persons who have not undergone prenatal exposure and were examined at the same age as the core group. All patients were examined according to the formalized ophthalmic protocol procedure, examination included ophthal moscopy and fundus camera photography (VISUCAM lite Digital Camera, Zeiss). Statistical analysis of the survey results was carried out using the free trial version of «Open Epi 2.2.1¼ software package. RESULTS: It is shown that the prevalence of macular degeneration of the retina at the age of 14-30 for persons exposed in utero was 95.23 ± 32.03 in 1000 and compared with control age (17.86 ± 10.31 in 1000) was significant ly higher (χ2 = 7.827, p = 0.0026). CONCLUSIONS: In the under 30 age group of the antenatally exposed there already appear macular degenerations whose clinical picture resembles age related macular degeneration. It is proved that the prevalence of macular degeneration was significantly higher in the group of antenatally exposed as compared with non irradiated control at the same age.

RETINAL VASCULAR PATHOLOGY RISK DEVELOPMENT IN THE IRRADIATED AT DIFFERENT AGES AS A RESULT OF CHERNOBYL NPP ACCIDENT. / RYZYK ROZVYTKU SUDYNNOi PATOLOGIi SITKIVKY U OPROMINENYKh U RIZNOMU VITsI OSIB VNASLIDOK AVARIi NA ChORNOBYL'S'KIi AES.

OBJECTIVE: To assess the relationship between the age at which a person undergoes radiation exposure and risk of developing eye lesions (case study of the retinal angiopathy prevalence). MATERIALS AND METHODS: The object of the study was the state of the retinal vessels in 2,531 persons (1,948 evacuated from the city of Pripyat under the age of 20 and 583 exposed to radiation in utero as a result of the Chernobyl NPP disaster. The results of standardized ophthalmic examination conducted from 1993 to 2000 within the framework of Clinical and epidemiological registry are used for the analysis. The evacuees were subdivided into different age groups of the exposed to radiation. The cohort of control group formed corresponding age groups of the unirradiated control. Statistical analysis of the survey results was carried out using the free trial version of «Open Epi 2.2.1¼ software package. RESULTS: The results obtained revealed a significant prevalence of retinal vessels pathology in all groups. The difference in angiopathy prevalence in exposed in utero persons was significant compared to age-control. The prevalence of retinal vascular pathology was also significantly higher in all groups of evacuees. Angiopathy prevalence was higher in the group exposed in utero and at the age of 8-12 years, and in the group of people who were exposed at the age of 4-7 years, the risk of angiopathy was lower. CONCLUSION: It is proved that the occurrence of distant radiation effects mainly depends on the age at which a person has undergone irradiation. It should be noted that all the other conditions were approximately the same. If working conditions of the persons who were exposed in utero or were aged 8 to 20 years when the Chernobyl disaster happened are connected with occupational radiation exposure it is necessary to take additional preventive measures.

[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.