The morphological changes of mucous membrane of stomach and duodenum of contractor organization personnel, which works in radiation hazard conditions at the object Shelter of Chornobyl NPP. / Morfologichni zminy slyzovoi obolonky shlunka ta dvanadtsiatypaloi kyshky u personalu pidriadnykh pidpryiemstv, iakyi pratsiuie u radiatsiino-nebezpechnykh umovakh na ob'iekti Ukryttia Chornobyl's'koi AES.

UNLABELLED: Аim: The determination of morphological features of stomach and duodenum mucous of membrane (MM) damage at a personnel that works in radiation hazard conditions at the object of "Shelter" of Chornobyl NPP (OS) by the endoscopic monitoring with biopsy material inspection from a gastro-duodenal zone on the stages of check - in (InC) and the special medical control (SpC). MATERIALS AND METHODS: the complex clinical-endoscopic and morphological examination with the biopsy of MM of stomach and duodenum in 126 workers of OS (man in the age from 20 to 59) was carried out. Doses of external radiation exposure were from 0,14 to 79,6 mSv, доза internal radiation exposure were from 0,1 to 3 mSv/Results: For the personnel of OS contract organisations differently directed pathomorphological changes of MM at InC and increase of frequency of their exposure at an inspection during SC, that generally correspond to chronic H.pylori-associated pangastritis with violation of microcirculation and trophism, disregeneration changes of epithelial layer. CONCLUSIONS: for the personnel of contract organizations, which participated in radiation hazard works on ОS a presence of chronic H.pylori-associated pangastritis with the increase of frequency of atrophic changes of MM (nonmetaplastic or metaplastic type) and development of erosive-ulcerous defects of gastro-duodenal zone was founded out.For workers, who had previous influence of ionizing irradiation the greater frequency of disregeneration (hyperplasia / intestinal metaplasia) changes of epithelium that accordingly promotes the risk of neoplasmes transformations was clarified.Providing of EGDFS (at a necessity with the biopsy of MM) is at InC and next stages of medical control for personnel, that executes radiation hazard works on ОS is the highly informative evidential and necessary method of inspection for determination of form and degree of pathological changes of overhead departments of gastrointestinal tract for warning of progress of disease and development of complications, maintenance of workers health and workability.

Structure of comorbid diseases in patients with non-alcoholic fatty liver disease, exposed to ionizing radiation as a result of the Chornobyl NPP accident. / Struktura komorbidnoi' patologii' u hvoryh na nealkogol''nu zhyrovu hvorobu pechinky, jaki zaznaly vplyvu ionizujuchogo vyprominjuvannja vnaslidok avarii' na ChAES.

Objective - to study of the structure of comorbid diseases in patients with nonalcoholic fatty liver disease (NAFLD), exposed to ionizing radiation due to the Chornobyl accident, and in the groups of comparison. Materials and methods. Array of surveyed males was divided into 4 groups: the main group - 136 patients with NAFLD affected by the Chornobyl NPP accident, the first comparison group (І CG) - 28 affected by Chornobyl NPP accident without liver disease, the second comparison group (II CG) - 50 patients with NAFLD not exposed to factors of the Chornobyl disaster, and the third comparison group (III CG) - 16 unexposed persons without liver disease. Results. A significant amount of co-morbid pathology was found in all studied groups but III CG: at the average from 4.1 ± 0.4 diseases in II CG to 5.2 ± 0.2 in the main group of patients (p < 0.05), among which in 6.6-7.1 % of cases more than 10 diseases were established. The most common disorders were cardiovascular and cerebrovascular and endocrine diseases. Structure of comorbid pathology in NAFLD in the main study group differed from this in II CG by a significantly greater frequency of detection of cerebrovascular diseases (73.5 and 56 %, p < 0.05). As for features of the metabolic syndrome in Chornobyl accident sufferers essential hypertension (71.3 % ), discirculatory encephalopathy (48.5 %) and thyroid diseases (47.1 %) were more frequent than in II GC: correspondingly 58 % (p < 0.001), 28 %, (p < 0.01), and 30 %, (p < 0.05). Essential hypertension in only 35.7 % patients without NAFLD (I CG) was detected (71.3 % in the study group, p < 0.01), and chronic cerebrovascular insufficiency in 71.4 % (39.7 % in the study group, p < 0.01). Conclusion. Structure of comorbid pathology in NAFLD patients sufferers of the Chornobyl NPP accident was different both in a large number of identified diseases and nosological structure. The most common disorders were cardiovascular, cerebrovascular, and endocrine diseases. Significantly higher incidence of essential hypertension, vascular encephalopathy, and thyroid disease was determined.

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.