2018.26 (4)

2018, vol XXVI, # 4, page 231

V. A. PRYLYPKO, O. O. PETRYCHENKO, M. N. MOROZOVA, I. V. BONDARENKO

SI «National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine», Kyiv

RESOURCE POTENTIAL OF MEDICAL SUPPORT OF RNPP OBSERVATION ZONE POPULATION

The paper deals with the data analysis focused on medical support of the population living in Rivne NPP observation zone over time. The study was carried out applying statistical data provided by regional information and analytical centers of medical statistics of Rivne and Volyn regions along with data obtained from the study of public opinion concerning negative components of the quality of medical care and their improvement.
The performance of health care institutions in Rivne NPP observation zone is determined by a complex of factors, one part of which lies in the area of social and economic problems (impoverishment of the population), and another one in the area of the implementation of articles of legislative documents of the medical reform.
Keywords: NPP observation zone, healthcare institutions, resource potential, public opinion.

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2018, vol XXVI, # 4, page 239

L. I. SIMONOVA, V. Z. HERTMAN, O. S. PUSHKAR, N. V. LIAKHOVSKA

SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv

PHOTODYNAMIC THERAPY IMPACT ON ENDOGENOUS ANTIMICROBIAL MECHANISMS IN TREATMENT OF INFECTED RADIATION SKIN INJURIES

Purpose. Study of photodynamic effect on endogenous antibacterial protection indices (nitric oxide and enzyme myeloperoxidase) in animals with infected radiation ulcers.
Material and Methods. The study enrolled 90 male rats with local X-irradiation of the hip skin at a dose of 85.0 Gy. When the signs of a radiation ulcer (day 7) appeared, the irradiated area was infected with Pseudomonas aeruginosa strain. One day later, the experimental group animals (30 rats) with the infected radiation ulcers were exposed to photodynamic therapy by means of Barva-LED/630 device with a methylene blue photosensitizer. In blood serum, the total content of stable metabolites of nitric oxide (NO) and myeloperoxidase (MPO) activity in neutrophils was assessed by cytochemical method.
Outcomes. It has been established that the development of “pure” ulcer was accompanied by an increased level of NO metabolites in blood serum (30–40% out of normal) over the entire observation period. Infection of the radiation ulcer signifcantly increased the release of metabolites into blood serum (80%). After PDT, a steady decrease to normal values was observed. At the same time, the development of MPO defciency in neutrophils associated with radiation ulcer was noted. In the case of “pure” ulcer, enzyme activity was decreased (by 20–35%) during 30 days, however by the end of the experiment (day 45) it was restored.
When the ulcer was exposed to infection, there was a progression of decreased activity of MPO by 1.5–2 times, which was signifcantly lower than in just irradiated rats and normalization of the parameters was absent for the entire observation period. In animals with an infected ulcer which was exposed to PDT, MPO activity was restored to normal values almost immediately after elimination.
Conclusions. Applying PDT for antimicrobial therapy of infected radiation skin lesions in experimental animals resulted not only in the destruction of the introduced microbes, but also contributed to the activation of its own endogenous antimicrobial mechanisms in the form of normalization of the level of nitric oxide in serum and the activity of myeloperoxidase in neutrophils, indicating the restoration of their functional properties.
Keywords: Photodynamic therapy, Radiation ulcers, Pseudomonas aeruginosa, nitric oxide, myeloperoxidase.

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2018, vol XXVI, # 4, page 245

L. YA. VASILIEV 1, H. V. KULINICH 1, YE. B. RADZISHEVSKA1, 2

1 SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv
2 Kharkiv National Medical University

LONG-TERM EFFECTS OF RADIONUCLIDE THERAPY IN THYROID CANCER TREATMENT (FIRST INFORMATION STATEMENT)

Purpose. To make an analysis of long-term oncological effects after treatment of patients with thyroid cancer on the basis of catamless data of paper case reports, formalized and transformed into an electronic form for statistical analysis using Data Mining.
Materials and Methods. The study was carried out by means of analysis of 315 case reports, where the information regarding disease course was selected and transformed to the electronic database (100 patients — 86 females and 14 males). There were 43 patients with long-term oncological effects, including: metastases in 22 (51%); second cancer in 8 patients (19%); relapses in 13 patients (30%). In addition to oncological effects, 13 patients in this group also had therapeutic complications, which were also included to the database. Fifty-seven individuals had only therapeutic effects of treatment. Taking into account the therapeutic effects of the patients mentioned above, the total number of therapeutic complications was 218 cases. Statistical processing was carried out using nonparametric statistics using the Statistica Basic Academic 13 for Windows package.
Outcomes. Taking radionuclide treatment (RNT) into consideration, patients without long-term oncological effects had a longer treatment duration, more courses of the RNT, higher total activity during RNT and a longer duration before ablation, compared to patients with long-term oncological effects. These conclusions can be considered as a scientifc basis for the calculation of a single dose of activity during RNT and its duration for patients with a burden of somato-neurological anamnesis. In addition, patients without long-term oncological effects had twice less cases of germination of a tumor through a capsule and lower body mass index. In this case, extrathyroidal extension is a risk factor for long-term metastasis, but it is not a risk factor for local recurrence and the appearance of secondary cancers. A typical histological form for patients with oncologic effects was papillary adenocarcinoma. As a risk factor for the occurrence of local relapses, an increased longevity of lactation in the reproductive period and a lower dose of maintenance therapy has been determined. As a risk factor for the occurrence of secondary cancers, the low duration of maintenance therapy and premenopausаl status for women has been determined. It was shown that the use of RNT as a component of special treatment of thyroid cancer increases the incidence of circulatory system diseases in 2.1 times.
Conclusions. Data Mining statistical analysis made it possible to detect the relationship between long-term oncological effects of thyroid cancer and the characteristics of RNT, the degree of extrathyroidal extension, the dose of maintenance therapy, the duration of lactation in the reproductive period, and some other factors, as well as to note the increase in the incidence diseases of the circulatory system compared with the population data by 2.1 times, in particular the frequency of the most widespread medical entities (CHD and HT) by 2.9 times and 1.85 times respectively.
Keywords: thyroid cancer, treatment long-term effects, statistical analysis, medical informatics.

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2018, vol XXVI, # 4, page 252

O. P. LUKASHOVA

SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv

ULTRASTRUCTURE OF ENDOCRINE ORGAN CELLS IN LONG-TERM PERIOD AFTER TOTAL AND PARTIAL EXPOSURE AT A SMALL DOSE

Purpose. Study of small dose radiation effect on the structural and functional state of endocrine organ cells in the long term after the total and partial fractional irradiation of rats at a dose of 0.75 Gy.
Methods. The ultrastructure of the thyroid gland, spermatogenic epithelium, adrenal cortex, pineal gland and adenohypophysis 6 months after fractional total x-irradiation, individual head irradiation, and individual body irradiation of rats at a total dose of 0.75 Gy were investigated using electron microscopy standard Methods.
Outcomes. It has been found that six months after total exposure, there are noticeable disturbances in the ultrastructure of the examined endocrine gland cells, which indicate the processes of inhibition of the functional activity of these organs. The effect of radiation on the head under the same conditions leads to identical changes; in cases when only the body is irradiated, the structural and functional state of all investigated organs corresponds to the age control.
Conclusions. Ultrastructural disturbances of endocrine cells in experimental animals indicate a decrease in their functional activity in the long term after a general dose of radiation and depletion of the function. Parallel inhibition of the activity of the target organs and regulatory organs of the endocrine system may indicate the secondary nature of the hypofunction of the target glands by reducing the level of the corresponding tropical pituitary hormones. The irradiation of only the heads of experimental animals causes changes in the cells of the endocrine glands, similar to those observed with total irradiation.Ultrastructural disturbances of endocrine cells in the experimental animals indicate decreased functional activity in the long term after a general dose radiation and function depletion. Parallel inhibition of the activity of the target organs and endocrine system regulatory organs may indicate a secondary nature of the hypofunction of the target glands by reducing the level of the corresponding tropic pituitary hormones. The irradiation of only the heads of experimental animals causes changes in the cells of the endocrine glands, similar to those observed in total irradiation. The irradiation of only the body of experimental animals does not lead to radiation changes in the cells of the endocrine organs. The study shows that when exposed to radiation in small doses, the brain is the critical organ, that is, radiophysical areas that are involved in the higher regulation of the endocrine system. When being in the zone of ionizing radiation, head shielding may be useful.
Keywords: irradiation, small doses, long terms, endocrine organs, ultrastructure.

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LITERATURE REVIEW

2018, vol XXVI, # 4, page 262

H. V. KULINICH, N. S. PIDCHENKO, L. V. ROHACHEVSKA

SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv

MALIGNANCY AND DIABETES MELLITUS: INTERRELATION, DIAGNOSIS PECULIARITIES, OBSERVATION (LITERATURE REVIEW)

The article deals with the publications of Ukrainian and foreign authors concerning interrelation of oncological diseases and diabetes mellitus as well as the impact of diabetes mellitus on the risks of neoplasms development, diagnosis peculiarities, treatment and monitoring of the patients. A retrospective assessment of case reports of 870 patients with a combination of oncological pathology and type 2 diabetes mellitus (type 2 diabetes), who were being observed at SI Grigoriev Institute for Medical Radiology of NAMS of Ukraine from 2012 to 2018, is provided. The paper will make it possible to make specialists familiar with multidisciplinary approaches in the treatment of patients with comorbid pathology, to improve the prognosis of the results of treatment of cancer patients.
Keywords: oncologic diseases, diabetes mellitus, clinical features, metabolic syndrome, metformin, survival.

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2018, vol XXVI, # 4, page 271

М. V. KRASNOSELSKYI1, 2, A. N. BELIY1, 2, O. N. ASTAPIEVA2, R. A. PIDLISNIY1

1 SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Science of Ukraine», Kharkіv
2 Kharkiv National Medical University

DIAGNOSTIC ERRORS IN COMPUTER TOMOGRAPHY. THE CASE OF DETECTION OF EARLY COLON CANCER AT SYNCHRONOUSE KIDNEY CANCER

The article describes the case of synchronous cancer of the kidney and colon. At the patient at the diagnostic stage cancer of the right kidney was revealed. A CT-protocol of 3 floors with intavenouse contrasting was performed. Cancer of the descending colon, which was not visualized on CT was detected only with laparotomy. The patient undergone right-sided nephrectomy and Mikulich operation.
Keywords: primary multiple malignant process, colon cancer, kidney cancer, computed tomography, surgical treatment.

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DISCUSSION

2018, vol XXVI, # 4, page 275

S. A. AMIRAZYAN1, 2, A. A. FATIEIEV 2

1 Karazin Kharkiv National University
2 Kharkiv National Medical University

RADIATION MEDICINE IN HIGH SCHOOL

The second wave of the nuclear arms race that we have witnessed can make a nuclear conflict inevitable. Experience teaches that the capacity of modern medicine, both in education and ability, to provide highly specialized assistance to a huge number of victims should not be overestimated.
Until the world recognizes the complete immorality of the arms race and the preparation for a nuclear war, mankind continues to be in danger of extinction.
Keywords: radiation medicine, radiation protection, nuclear conflict, doctor’s role.

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2018, vol XXVI, # 4, page 280

V. P. STARENKIY, I. B. SHUSTOV, L. V. ZABOBONINA, L. L. STADNIK

SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv

MODERN VIEW ON NON-TUMOR DISEASES RADIOTHERAPY

The paper deals with literature review of non-tumor diseases radiotherapy. The treatment efciency in acute inflammatory processes, keloid cicatrices, fbromatosis. autoimmune ophthalmopathy and some other diseases has been proved. However, there is need to provide government-sponsored support scheme and method popularization for X-ray therapy management.
Keywords: radiotherapy, non-tumor disease, government-sponsored scheme.

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2018, vol XXVI, # 4, page 287

O. M.ASTAPIEVA, R. M. SPUZYAK, O. M. PASKEVICH, E. P. STEPANOV, S. A. AMIRAZYAN

Kharkiv National Medical University

QUESTIONS OF ORGANIZATIONAL-PEDAGOGICAL AND METHODOLOGICAL SUPPORT OF TEACHING STUDENTS OF MEDICAL FACULTY OF KNMU

One of the tasks of reforming medical care to the population of Ukraine is the adaptation of work programs in radiology for students of medical faculties of KNMU. Diagnostic radiology involves the use of visualization capabilities of pathological changes in the organs and systems of patients using modern radiological techniques. This is the psychological and pedagogical motivation of medical students. Therapeutic radiology allows to increase the effectiveness of anticancer treatment in 70–80% of cases of malignant tumors. Training of students includes traditional methodological approaches (lectures, practical exercises, independent work of students), as well as the wide use of the Internet. In general, it reflects the development trends of medical science and provides the necessary level of knowledge of future specialists.
Keywords: radiology, work program, information training technologies.

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