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Title: Twenty five years of the National Academy of Medical Sciences of Ukraine - progress and priorities for future of radiation medicine and biology.
Author: Bazyka D.
Journal: Probl Radiac Med Radiobiol; 2017 Dec; 22():10-14. PubMed ID: 29286493.
Abstract:
After the creation of the Academy of Medical Sciences of Ukraine in 1993 the Research Center for Radiation Medicine was among the first institutions to join the Academy (fig. 1). Estab lishing the Academy was among the first steps of the independent Ukrainian government and aimed to provide a high level health care for population. It was extremely needed for the minimization of Chornobyl medical consequences. This choice was related to a growing recognition of the scientific research in fulfilling the Сenter's mission - study of the effects of low dose radiation on human body and radiation protection of the exposed population.The Center entered the Academy as a potent insti tution. Director General Dr. Anatoly Romanenko and his first deputy prof. Oles Pyatak were lucky to concentrate in three institutes of the Center a talent ed workforce including director of the Institute of Clinical Radiology prof Volodymyr Bebeshko, director of the Institute of Epidemiology and Prophylaxis of radiation Injuries prof. Volodymyr Buzunov, director of the Institute of Experimental Radiology prof. Mikhail Rudnev. Drs. T. Azaren kova, S. Galkina, V. Boer, T. Treskunova were appointed as scientific secretaries. Dosimetry divi sion was headed by brilliant prof Ilya Likhtarev and his staff Drs. I. Los, V. Korzun, V. Repin, O. Pere voznikov, O. Bondarenko, V. Chumak and others.The Center met creation of the Academy with expe rienced research and clinical staff encountering 1587 members, including 272 research staff, 28 doctors of science and 98 PhDs, modern diagnostic and labo ratory equipment, 300 beds in clinical departments and construction of hospital and out patient hospi tal in Svyatoshin. Scientific staff included experi enced prof. I. Khomaziuk, prof. B. Prevarsky, prof. V. Zamostian, prof. P. Chayalo, prof. M. Omelya nets, prof. A. Prysyazhnyuk. Dr. A. Niagu, Dr. E. Stepanova, Dr. A.Chumak, Dr. V. Klymenko, Dr. D. Komarenko, M. Pilinska, L.Ovsiannikova, O. Pi rogova. were among the first academic supervisors in studies of Chornobyl health effects and got professor certificates in this new area. First PhD theses were successfully passed by Dr. E. Gorbov, and Dr. of Sciences - by Dr. D. Bazyka. Basics of future aca demic research directions were elaborated that time by Drs. O. Kovalenko, Zh. Minchenko, V. Talko, I. Holyavka, D. Belyi, D. Yakimenko, E. Mikhai lovska, V. Malyzhev, V. Sushko, A. Cheban, K. Lo ganovsky, K. Bruslova, I. Dyagil, T. Liubarets, O. Kucher, G. Chobotko, and others. Later the major ity of these studies formed a background for Chornobyl legislation, regulatory directives, pre sented as dissertations.A quarter of century passed. The Center as a part of the National Academy of Medical Sciences resisted the challenges and moved forward, was recognized worldwide and fulfilled its main mission - providing highly qualified health care to radiation exposed. Staff numbers decreased (1,091), but work amount has increased. Since 2000, new premises were installed - a hospital with the biggest in Ukraine outpatient clin ic, new laboratory facilities, the last of which was in troduced in 2013. The Academy became a national one and since 2011 the Center was recognized as a national research institution (NRCRM), staff mem bers received 3 State Awards of Ukraine in the Field of Science and Technology, numerous personal awards.During this period, NRCRM staff conducted and published priority research data on radiation risks and molecular mechanisms of leukemia, including chronic lymphocytic, myelodysplastic syndrome, multiple myeloma, thyroid cancer, breast cancer in Chornobyl accident cleanup workers. Studies of the mechanisms of non tumor pathology - cardio vascular, cerebrovascular, cognitive disorders are in process. Of high importance are studies of possible transgenerational effects of radiation. The devel oped new technologies and protocols for the advanced care of radiation exposed were intro duced to the general health care system, the addi tional departments of oncology and chemotherapy were equipped and started activities, databases of cancer cases in exposed population and separate groups of exposed were introduced, as well as an international database of radiation injuries. The Clinical and Epidemiological registry of the NRCRM is in function and developed. An adapta tion of research directions with a respect to the pathomorphosis of radiation induced diseases in the remote period after irradiation will continue.Performed complex studies of the effects of incorporation of 131I on the fetus and the next gen eration of experimental animals became important for understanding the mechanisms of formation of radiation effects. Introduction of new foodstuffs and supplements with radiation protective proper ties was of positive effect for population protection during the first years.In the area of dosimetry a substantial progress has been achieved in reconstruction of thyroid doses in the Ukrainian population, dosimetric passportisation of settlements, radiochemistry, the creation of new methods for reconstructive dosimetry for cleanup workers - SEAD, RADRUE, and ROCKVILLE. All developments are implemented to practice, tens of thousands of doses have been restored. International recognition has received for the method of in utero doses reconstruction. As editor in chief, I regard it successful to incorporate our bilingual edition «Problems of Radiation Medicine and Radiobiology» into the NCBI MedLine, SCOPUS and other data bases, that creates an unique opportunity to widely disseminate results of the Center's research.Strategies for the future. Ukraine belongs to countries with a priority development of nuclear energy. Even with the increase in the production of clean energy, there is no other way than the further deployment of a complete nuclear fuel cycle and energy industrial complex, the expansion of the nuclear technologies to all sectors of the economy.The main potential threats to radiation safety include the aging of the material base of the NPPs with the prolongation of the working life for nuclear reactors with the expired terms of exploitation; the existence of a «nuclear legacy» sites of the former USSR in the territories of enterprises for the extrac tion and processing of uranium ores. About 5,000 institutions and enterprises use more than 25,000 sources of ionizing radiation in general. The use of radiological technologies and sources of ionizing radiation in medicine is increasing, in particular the burden on patients and staff in invasive cardiac sur gery. This will require significant efforts from the NRCRM to ensure an adequate radiation protec tion of the population, taking into account the experience collected during the mitigation of health effects of Chornobyl. Radiological threats of malev olent use of nuclear technology hasn't be forgotten.The mission of the NRCRM is to expand basic research of the health effects of ionizing radiation, elaboration and implementation of the care and radiation protection of population. Background for future is paved by a successful implementation of a special program of medical and biophysical control of personnel during transformation of the Shelter object into an environmentally safe sys tem, the State social program of increasing safty, labor hygiene and environment for 2014-2018; many years of successful cooperation with the State Nuclear Regulatory Inspectorate, the Natio nal Commission for Radiation Protection, «Ener goatom» company, the relevant departments of the Ministry of Health, international organizations such as WHO, UNSCEAR, IAEA, IARC, the US National Cancer Institute, IRSN, Nagasaki, Hiroshima, Fukushima universities and others.From the editorial board I congratulate the staff of the Center with the twenty fifth anniversary of the Academy. I would like also to wish the National Academy of Medical Sciences of Ukraine new ad vances in medical science and practice, sustainabil ity, unity, development and worldwide recognition. Pislia stvorennia Akademiï medychnykh nauk Uk raïny v 1993 r. Naukovyy̆ tsentr radiatsiy̆noï medytsyny buv odniieiu z pershykh ustanov, iaki pry iednalysia do Akademiï (rys. 1). Zasnuvannia Akademiï bulo sered pershykh krokiv Uriadu nezalezhnoï Uk raïny ta bulo spriamovano dlia nadannia vysokok valifikovanoï medychnoï dopomogy naselenniu. Tse bulo kray̆ vazhlyvym dlia minimizatsiï medychnykh naslidkiv Chornobyliu. Pryiednannia Tsentru stalo rezul'tatom zrostaiuchogo vyznannia naukovykh do slidzhen' v galuzi efektiv ionizuiuchoï radiatsiï u liu dyny ta radiologichnogo zakhystu postrazhdalogo na selennia.Tsentr pryy̆shov do Akademiï, iak potuzhna naukova ustanova. General'nomu dyrektoru akademiku Ana toliiu Romanenku ta y̆ogo pershomu zastupnyku prof. Olesiu P’iataku vdalosia skontsentruvaty u tr'okh instytutakh Tsentru blyskuchyy̆ kolektyv, vkliuchaiuchy dyrektora Instytutu klinichnoï radiologiï prof. Volo dymyra Bebeshka, dyrektora instytutu epidemiologiï ta profilaktyky radiatsiy̆nykh urazhen' prof. Volody myra Buzunova, dyrektora instytutu eksperymen tal'noï radiologiï prof. Mykhay̆la Rudnieva, vchenymy sekretariamy bulo pryznacheno T. Azarenkovu, S. Galkinu, V. Boiera, T. Treskunovu. Viddil dozymetriï bu lo dorucheno blyskuchomu prof. Illi Likhtar'ovu z y̆ogo spivrobitnykamy doktoramy nauk I. Losem, V. Korzu nom, O. Perevoznikovym, V. Repinym, O. Bondarenkom, V. Chumakom ta inshymy. Na moment stvorennia Akademiï v Tsentri pratsiuvalo 1587 spivrobitnykiv, v t.ch. 272 – naukovogo personalu, 28 doktoriv ta 98 kandydativ nauk, vykorystovuvalosia suchasne diag nostychne ta laboratorne obladnannia, 300 lizhok v klinitsi, provodylosia budivnytstvo kliniky ta poliklinik u Sviatoshyni. Sered naukovykh spiv robitnykiv buly dosvidcheni profesory I. Khomaziuk, B. Prevars'kyy̆, V. Zamostian, M. Omel'ianets', A. Pry siazhniuk, zaprosheni doktory nauk A. Niagu, Ie. Stepa nova, A. Chumak, V. Klymenko, D. Komarenko, M. Pilins'ka, L. Ovsiannikova, O. Pyrogova. Vony buly sered pershykh naukovykh kerivnykiv u doslidzhenniakh Chornobyl's'kykh efektiv ta otrymaly profesors'ki zvannia u tsiy̆ noviy̆ naukoviy̆ galuzi. Pershu kandy dats'ku dysertatsiiu bulo zakhyshcheno Ie. Gorbovym, doktors'ku – D. Bazykoiu. Osnovni napriamky nauko vykh doslidzhen' v toy̆ chas bulo zakladeno O. Kovalen kom, Zh. Minchenko, V. Tal'ko, I. Kholiavko, D. Bilym, D. Iakymenkom, O. Mykhay̆lovs'koiu, V. Malyzhevym,V. Sushkom, A. Chebanom, K. Loganovs'kym, K. Brus lovoiu, I. Diagil', T. Liubarets', O. Kucher, G. Chobot' kom, V. Ferents, N. Strapko, N. Rubel' i bagat'okh inshykh. Tsi doslidzhennia piznishe bulo vprovadzheno iak bazys dlia zakoniv, normatyvnykh dokumentiv, dyser tatsiy̆nykh robit.Proy̆shla chvert' storichchia. Golovnym ie te, shcho v skladi Natsional'noï akademiï medychnykh nauk Ukraïny NTsRM vystoiav ta rozvyvavsia, otrymav svitove vyz nannia, vykonuvav osnovne zavdannia – nadannia vyso kokvalifikovanoï dopomogy postrazhdalym. Spivro bitnykiv stalo menshe (1091), ale roboty pobil'shalo. Z 2000 r. pratsiuie nova klinika z nay̆bil'shoiu v Ukraïni poliklinikoiu, novymy laboratornymy korpusamy, ostanniy̆ z iakykh vvedeno u 2013 r. Akademiia stala natsional'noiu, a z 2011 r. Tsentr vyznano natsional' noiu naukovoiu ustanovoiu (NNTsRM), spivrobitnyky NNTsRM staly laureatamy 3 derzhavnykh premiy̆ Uk raïny v galuzi nauky i tekhniky, otrymaly chyslenni personal'ni nagorody.U NNTsRM za tsey̆ period provedeno ta opubliko vano priorytetni doslidzhennia radiatsiy̆nykh ryzykiv i molekuliarnykh mekhanizmiv ley̆kemiï, vkliuchaiuchy khronichnu limfotsytarnu, miielodysplastychnogo syn dromu, mnozhynnoï miielomy, raku shchytopodibnoï za lozy, raku molochnoï zalozy v uchasnykiv likvidatsiï naslidkiv Chornobyl's'koï avariï. Rozvyvaiut'sia doslidzhennia mekhanizmiv nepukhlynnoï patologiï – sertsevo sudynnoï, tserebrovaskuliarnoï, kognityv nykh porushen'. Vazhlyvymy staly rozgornuti doslidzhennia mozhlyvykh transgeneratsiy̆nykh efektiv oprominennia. Vprovadzhenniam naukovykh doslid zhen' staly novi tekhnologiï i protokoly likuvannia postrazhdalykh, vidkryttia dodatkovykh viddilen' on kologiï ta khimioterapiï. Stvoreno bazy danykh vy padkiv onkologichnykh zakhvoriuvan' u naselennia ta okremykh grup postrazhdalykh, mizhnarodnu bazu da nykh radiatsiy̆nykh urazhen'. Prodovzhuiet'sia funk tsionuvannia Kliniko epidemiologichnogo reiestru NNTsRM. Adaptatsiia napriamiv doslidzhen' do pato morfozu radiatsiy̆no indukovanykh zakhvoriuvan' u viddalenomu periodi pislia oprominennia bude pro dovzhuvatysia.Vazhlyvymy dlia rozuminnia mekhanizmiv formuvan nia radiatsiy̆nykh efektiv staly kompleksni doslid zhennia diï inkorporovanogo 131I na plid ta nastupne pokolinnia eksperymental'nykh tvaryn. U pershi ro ky vneskom do radiatsiy̆nogo zakhystu stalo vprovad zhennia produktiv i domishok z radiozakhysnymy iakos tiamy.V galuzi dozymetriï dosiagnuto znachnogo progresu u rekonstruktsiï doz na shchytopodibnu zalozu u nase lennia Ukraïny, dozymetrychniy̆ pasportyzatsiï, radiokhimiï, stvorenni novykh metodiv rekonstruktyv noï dozymetriï dlia likvidatoriv – SEAD, RADRUE, ROCKVILLE. Vsi rozrobky vprovadzheni v prakty ku, vidnovleno desiatky tysiach doz. Mizhnarodne vyz nannia otrymala metodyka vidnovlennia doz vnut rishn'outrobnogo oprominennia. Iak golovnyy̆ re daktor, vvazhaiu uspikhom vkliuchennia nashogo dvo movnogo vydannia «Problemy radiatsiy̆noï medytsy ny ta radiobiologiï» do bazy danykh PubMed/Medline, SCOPUS, INIS ta inshykh, shcho stvoriuie mozhlyvosti dlia shyrokogo rozpovsiudzhennia naukovykh dosiag nen' Tsentru.Strategiia na may̆butnie. Ukraïna nalezhyt' do kraïn z priorytetnym rozvytkom iadernoï energetyky. Navit' vrakhovuiuchy zrostannia vyrobnytstva «chystoï» energiï, nemaie inshogo shliakhu, nizh podal'she rozgortannia pov nogo iadernogo palyvno energetychnogo ta promyslo vogo kompleksu, rozshyrennia vykorystannia iadernykh tekhnologiy̆ u vsikh galuziakh gospodariuvannia.Osnovni potentsial'ni zagrozy radiatsiy̆niy̆ bezpetsi vkliuchaiut' starinnia material'noï bazy AES z podov zhenniam strokiv roboty atomnykh reaktoriv, u iakykh zakinchyvsia termin ekspluatatsiï; isnuvannia «iadernoï spadshchyny» kolyshn'ogo SRSR na terytoriiakh pidpry iemstv z vydobuvannia ta pererobky uranovykh rud. Blyz'ko p’iaty tysiach ustanov ta pidpryiemstv vyko rystovuiut' zagalom bil'she 25000 dzherel ionizuiucho go vyprominiuvannia. Zrostaie obsiag vykorystannia ra dioaktyvnykh rechovyn i dzherel ionizuiuchogo vypromi niuvannia v medytsyni, zokrema navantazhennia na pa tsiientiv i personal pry invazyvnykh kardiokhirurgichnykh vtruchanniakh. Tse potrebuvatyme vid NNTsRM znachnykh zusyl' u zabezpechenni nalezhnogo radiatsiy̆nogo me dychnogo zakhystu naselennia, z urakhuvanniam dosvidu likvidatsiï medychnykh naslidkiv Chornobyliu. Ne treba zabuvaty y̆ pro zagrozu zlovmysnogo vykorystannia iadernykh tekhnologiy̆.Zavdanniam NNTsRM prodovzhuiut' zalyshatysia fundamental'ni doslidzhennia efektiv oprominennia u shyrokomu diapazoni doz i rozrobka ta vprovadzhennia tekhnologiy̆ likuvannia i radiatsiy̆nogo zakhystu naselen nia. Fundament may̆butn'ogo zakladeno uspishnym vy konanniam spetsial'noï programy medychnogo ta bio fizychnogo kontroliu personalu v protsesi peretvoren nia ob’iekta «Ukryttia» na ekologichno bezpechnu systemu, Zagal'noderzhavnoï sotsial'noï programy polipshennia stanu bezpeky, gigiieny pratsi ta vyrobnychogo seredovy shcha na 2014–2018 roky; bagatorichne uspishne spivro bitnytstvo z Derzhavnoiu inspektsiieiu iadernogo reguliu vannia, Natsional'noiu komisiieiu radiatsiy̆nogo zakhystu, NAEK «Energoatom», vidpovidnymy pidrozdilamy ministerstva okhorony zdorov’ia, mizhnarodnymy or ganizatsiiamy – VOOZ, NKDAR OON, MAGATE, IARC, Natsional'nym instytutom raku SShA, IRSN, univer sytetamy Nagasaki, Khirosimy, Fukusimy ta in.Vid kolektyvu redaktsiy̆noï kolegiï khochu pozdorovy ty kolektyv Tsentru z dvadtsiatyp’iatyrichchiam Akademiï. Khochu pobazhaty Natsional'niy̆ akademiï medychnykh na uk Ukraïny novykh dosiagnen' u medychniy̆ nautsi ta praktytsi, stiy̆kosti, iednosti, rozvytku i svitovogo vyznannia.

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