Psychophysiological adaptation of the patient with the remote effect of the III degree acute radiation syndrome

Aim: clinical psychophysiological assessment of social and psychophysiological adaptation of the patient with the remote effect of the III degree acute radiation syndrome, with local radiation injuries of heavy degree from the extremely uneven gamma and neutron radiation with the subsequent amputation of both feet at level in top / 3 shins, according to feature of its individual mental adaptation and the periods of its mental adaptation stages. Material and methods. The object of the research was a patient (born in 1939) who worked as an engineer in the National Research Centre (NRC "Kurchatov Institute") from 1963 to 2010, the senior researcher. Psychophysiological inspection of the patient had been organized according to the MMPI test, Kettell's test, Raven in 30 years after radiation accident (1971) in dynamics in 2001, 2002, 2006, 2009 with the use of the automated program and methodical Expert complex intended for research of the properties, cognitive and intellectual features of the personality. Results. Average profile of multilateral research of the personality (MMPI) and the dynamics of indicators according to the years of supervision (2001-2009) points to a disharmonious combination of hypochondriac, disturbing and depressive and demonstrative tendencies to prevalence of a demonstration, as firmness manifestation before a heavy illness at the patient after the III degree acute radiation sickness, and local radiation injuries of heavy degree from the extremely uneven gamma and neutron radiation, am- putation of both shins at level in top / 3, late beam buttock, right hip ulcers, a beam cataract of the III degree of both eyes, stabilized. The assessment of the efficiency of psychophysiological adaptation in dynamics with 2009 indicates emergence of prevalence of hypochondriac tendencies over a demonstration with accession of high uneasiness and autistic lines at preservation of the leading role of an hypochondriac somatization of alarm with considerable decrease in an emotionality, an integration, a freedom of behavior. The changes revealed in dynamics correspond to the specific increase weight of violations of mental adaptation, characteristic for the period of adaptation exhaustion. The high intelligence, good figurative and logical thinking, well-mannered forms of behavior, high control over the emotional sphere, restraint of emotions, independence, self-sufficiency, organization, behavior taking into account environment requirements provided the patient M. firmness before a heavy illness, promoted good adaptation to an environment with confidence in myself, high social adaptability, opportunity successfully to carry out duties, hold the work account (worked 39 years after accident). Comparative assessment of operator ability of the patient M. showed good average time of common and difficult sensorimotor reactions with 2 mistakes, high time of reaction for moving object, however decrease in accuracy of reaction from 10-13% to 2% testifies to manifestation in dynamics of insufficiency of real functional reserves of nervous system. Conclusions. Efficiency of psychophysiological adaptation depends not only on a dose of radiation and weight of the transferred disease, but, mostly, on premorbid properties of the identity of the victim and his social and labor installation

Comparative study of the amount of DNA single-strand breaks and alkali-labile sites in human peripheral blood lymphocytes exposed to 365 nm UV versus X-ray radiation

Aim: to compare the amount of DNA single-strand breaks (SSB) and alkali-labile sites (ALS) induced by DNA 365 nm ultraviolet (UV) versus X-rays radiation in human peripheral blood lymphocytes at in vitro conditions. Material and methods. Blood lymphocytes were isolated in a Ficoll-verografin density gradient. Irradiation of cells was performed using BLX-365 UV-unit (wavelength 365 ± 10nm)and RUSTM1 biological X-ray unit. Analysis of DNA SSB and ALS was carried out using comet assay at alkaline conditions. Results. For the first time it was demonstrated that the amount of SSB and ALS induced by 365 nm UV radiation at a dose of 10 kJ/m2 in human lymphocytes corresponds to the effect of X-rays at a dose of- 1 Gy. Conclusion. Exposure of human peripheral blood lymphocytes to 365 nm UV radiation at a dose of 1 kJ/m2 induces - 100 DNA SSB per cell

Effect of incubation in sodium chloride hypertonic solutions on y-radiation and hydrogen peroxide induced DNA damage in human peripheral blood lymphocytes

Aim: to study the effect incubation in NaCI hypertonic solutions on the yield of DNA single-strand breaks (SSB) and alkali-labile sites (ALS) induced by y-radiation and hydrogen peroxide in human peripheral blood lymphocytes in vitro. Material and methods. The lymphocytes isolated from the peripheral blood of healthy women donors aged 21-26 years were used for the study. Cell irradiation at doses of 1, 2, 3 and 5 Gy was performed using the "AGAT P1" unit (Russia, y-radiation source — 60Co, a dose rate of 1 Gy/min) at 4°C. In case of hydrogen peroxide exposure (25, 50 and 100 uM) the cells were incubated for 15 minutes at 4°C. Analysis of the DNA SSB and ALS was performed using the alkaline DNA comet assay. Results. Incubation of cells in 0.35 M NaCI solution (non-histone proteins dissociation) increases the yield of DNA SSB and ALS induced by v-radiation and hydrogen peroxide at ~ 1.3 times. Increasing the NaCI concentration to 0.6 M (linker histone H1 dissociation) leading to almost double increase in the DNA damage yield (~ 1.7-1.8 times). Further increasing the NaCI concentration leading to disruption of the structure of nucleosomes (1.2 M) and almost complete chromatin deproteinization (2 M) increased the yield of DNA damage not such pronounced as expected (~ 2.2-fold at 2 M concentration). Conclusion. The results showed that incubation in NaCI hypertonic solutions significantly increases the sensitivity of lymphocytes to DNA damaging action of free radicals

Multifocal atherosclerosis in patient after acute first degree radiation sickness.

Purpose: assessment the heavy psychosomatic and all-somatic cardiovascular and cerebrovascular pathology of patient, transferred an acute I degree radiation sickness, from the general evenly gamma-beta radiation. Conclusions. The subdepressive and disturbing-depressive syndrome of patient, transferred an acute radiation sickness (ARS) of I degree, from the general evenly gamma-beta radiation, was independent risk factor of development of multifocal atherosclerosis; Features of development of all-somatic and psychosomatic pathology of patient are based on a combination of genetic prerequisites, environment influences (the stress caused by accident on the ChNPP) and social factors, influencing on him during a course of life, especially during early socialization. Thus at development of psychosomatic frustration the combination of feature of the mental reaction connected with the personal characteristic and special relationship between mental (stress) and physiological (somatic) by aspects of reaction which led to metabolism violation, to aging, decrease in adaptation opportunities of an organism and development age — dependent pathology took place

Proposals on harmonization of the list of the diseases connected with radiation effects as the result of the accident on the CNPP

The lists of the diseases connected with radiation effects existing now at the level not only Russia and Belarus, but also at the Union State in general can be enhanced using cumulative scientific data. There are possible variants, as exceptions in the list of separate nosologies, reasons of which are rather caused not by radiation factors, and as introduction of diseases which radiation nature is confirmed by long-term researches. The conducted researches showed that creation of the single list of diseases within the Union State is a really question solving of which will demand not only significant scientific researches, but also serious legislative initiatives.</p

Features of medical examination of suitability of employees for working at nuclear power plant after myocardial infarction

Aim: examination of professional qualification of NPP personnel suffering from post-infarction cardiosclerosis, to work with sources of ionizing radiation with the formation of proposals of amendments to the order of the health Ministry from 12.04.2011 No. 302-N. Material and Methods. Medical database by making indicators with individual registration forms made from 269 persons with postinfarction cardiosclerosis staff of main and auxiliary production of Russian NPPs (272 men and 7 women), average age of the examined patients was 56.2 ± 7.0 years; the total number the analyzed characteristics, reflected in the generated database was 49 lines. Results. The results of the risk stratification of sudden cardiac death with the formation of risk groups and proposed draft amendments to the Order of the health Ministry of the Russian Federation of 12 April 2011 No. 302-n order differential approach to the assessment of competency in hazardous conditions patients with postinfarction cardiosclerosis. Conclusion. On the basis of clinical examination and assessment of risk for sudden cardiac death, it is necessary to make changes in the List of medical contraindications for admission to works in accordance with section 4 of Annex No. 3 to the Order of Ministry of health, April 12, 2011 No. 302 n in terms of access to work with ionizing radiation to persons suffering from post-infarction cardiosclerosis; to identify among patients postpartum cardiosclerosis persons not fit to continue the work in contact with sources of ionizing radiation, it is necessary referral to additional examination in occupational disease Centers in accordance with the Order of Ministry of health, April 12, 2011 No. 302 N

Economic aspects of telemedical trainings realization in conditions of medical services outsourcing

Economic efficiency of various telemedical services are still a subject of scientific discussion. The article considers approaches to a complex estimation of economic benefit and economic efficiency of services in remote education. Calculations are submitted on the basis of realization of remote trainings series on training to receptions of urgent medical aid and occupational medicine for the medical personnel of the large oil-extracting company. Preparation of the program, materials, including videofragments, presentations and demonstrations, and also realization of trainings were carried out by autsourcing by experts of the foreign organizations.</p

Assessment of the volume activity of α-radioactive wastes on surface and specific contamination by portable γ-spectrometry method

The aim of the study is to evaluate the volume activity of radioactive waste (RW) by surface and specific alpha contamination using portable gamma-spectrometry. Materials and methods. Methods of rapid assessment of the content of α-emitting radionuclides in solid waste of various morphologies using gamma-spectrometers based on germanium detectors are considered. Computational methods for determining the effectiveness of radionuclide registration are presented. Results. The possibility of using portable gamma-ray spectrometry to assess the surface and specific activity of various materials contaminated with α-emitters (232Th,235U,238U,237Np,239Pu,240Pu and241Am) is shown. The calculated values of the registration efficiency of low-energy gamma-emitters obtained by modeling the spatial-energy parameters of the detector are given. To simplify the solution of this problem, the calculation program used 20 standard templates of various geometries (rectangular, cylindrical, conical, spherical, etc.). The main sources of error in the survey of contaminated surfaces, largesized equipment and building structures were investigated. Conclusions. The possibilities of portable γ-spectrometry for estimating the volume of RW based on the surface density of contamination of materials with radionuclides of uranium and transuranic elements are investigated. When using γ-spectrometer with a high-purity germanium detector with a range of γ-quanta extended in the low-energy region, radionuclides such as232Th,235U,238U, 237 Np,241Am were determined by their own radiation or by the radiation of their daughter products. The “problem” element is plutonium, for rapid evaluation of which it is proposed, in accordance with the radionuclide vector methodology, to use241Am, which accumulates during the β-decay of241Pu. According to calculations, the most likely value of the activity ratio239Pu/241Am for the object where the work was performed (scaling factor) varies in the range from 5.0 to 9.0. Based on the results of calculations and experimental studies, the parameters of the efficiency of registration of various α-emitting radionuclides by portable γ-spectrometers. It has been found that for germanium detectors with an absolute efficiency of registering a point source of 7÷15%, it is n×10–5 ÷ n×10–4%. © 2020, Institut meditsiny truda RAMN. All rights reserved

Induction and reparation of double-strand DNA breaks in V79 cells continuously exposed to low dose-rate Y-radiation

Aim: to study the patterns of changes in the number of DNA double-strand breaks (DSB) in mammalian cells continuously exposed to low dose-rate y- radiation. Material and methods. Chinese hamster lung fibroblasts (V79) were used in this study. The y- irradiation of cells at a dose rate of 0.1 mGy/min was performed using the «Gamma-Panorama» unit (Cs-137). The fluorescence immunoassay of the phosphorylated H2AX-histone (y-H2AX) foci was used to investigate the DNA DSBs formation. Frequency of apoptotic cells was evaluated using «DNA halo» assay. 5 (6) — chloromethyl-2,7-dichlorodihydrofluorescein diacetate was used to estimate the reactive oxygen species (ROS) production. Results, it was showed that continuous low dose-rate irradiation of Chinese hamster V79 cells induces an increase of the y-H2AX foci number and ROS production rate at the early stages of exposure time (6-24 h, doses 3.6-14.4 cGy), while increasing exposition time and, therefore, the radiation dose (48-72 h, 28.8-43.2 cGy) caused a decrease in these endpoints to almost the control level. There was observed no significant changes in the frequency of apoptotic cells. Conclusion. It is assumed that the processes causing the DSB amount changes in mammalian cells continuously exposed to low dose-rate y-radiation are associated with the development of oxidative stress and subsequent activation of cellular antioxidant defense systems

Effectiveness of autologous cell products derived from adipose tissue for the treatment of severe local radiation injuries

Aim: to investigate the dynamics of ulcer surface healing depending on type of radiation ulcer and cell product in murine experimental model of severe local radiation injuries after exposure to X-rays. Material and Methods. Mature Wistar rats were used for experiments (males, weight 180-200 grams). Standard model of severe local radiation injuries was used: X-ray irradiation of animals on a modified RAP100-10 device. Isolation of the stromal-vascular fraction carried out by enzymatic treatment of adipose tissue. Autologous cells transplantation performed on day 20 after irradiation in the case of acute radiation injury model (early radiation ulcers) and day 120 in the case of long-term effects of radiation injury model (chronic radiation ulcers). As a positive control allogeneic MMSC derived from rat bone marrow were used. Results. Application of autologous cell products derived from adipose tissue in animal model of severe local radiation injuries was investigated for the first time. It was shown that usage of stromal vascular fraction of adipose tissue for the treatment of early radiation injuries not only leads to better improvement (as compared with the use of MMSCs), but also pronounced therapeutic effect could be observed at an earlier time. On the model of long-term effects of radiation injuries therapeutic effect was observed for all cell products. Conclusion. Cell-based products derived from adipose tissue are promising material for future research and clinical application for treatment of local radiation injuriesK) Described method allows choosing treatment strategy basing on patient's individual characteristics and the type of local radiation injuries