Ten Years after the Chernobyl Accident: Long-Term Immunological Consequences; Prognosis of Autoimmune Disorders

The Chernobyl tragedy was the biggest accident since the beginning of the nuclear power industry. The aim of this study was to determine the role of immunological mechanisms in the development of autoimmune disorders (thyroiditis and cataract) and cancers among those workers who participated in clean-up operations in 1986. Blood samples from 165 clean-up workers aged 30-65 from Minsk and Kiev who underwent prophylactic medical examinations and from 80 healthy donors were investigated for the presence of autoimmune reactions and the appearance of onco-foetal antigens. The sera of clean-up workers were found to include the thyroid gland antigen, auto-antibodies to thyroid gland and eye antigens, and immune complexes which are normally absent or found in much lower quantities. The appearance of the clinically unmanifested thyroid gland antigen made it possible to generate a concept describing the mechanism for induction and long-term maintenance of auto-antibody production in an organism after irradiation. Lymphocytes from clean-up workers showed normally absent onco-foetal antigens (PSG and CEA). The data obtained indicate that clean-up workers represent a high risk group for autoimmune and cancer diseases. Immunological findings reveal the long-lasting effects of low doses of irradiation and may be used in prognosis and monitoring of human health.

The Language of Political Conflict: A Logico-Semantic Approach

A semantic approach towards political conflict first emerged in the 1930s and provides the methodological foundations for the description of political conflicts, in particular as the correlation between the language of description and reality. Any military or political confrontation presupposes axiological, conceptual and ideological confrontation. The form of adequate description can only be comprehended if the characteristic features of its language (structure) and thesaurus are revealed. Admitting the possibility of different descriptions implies the necessity of analysing this possible ambiguity, i.e. the characteristic features of the language which enable us to form various statements, including mutually exclusive ones. The insoluble task of finding a middle ground between the viewpoints of the conflicting parties should be replaced by soluble procedures of explaining and assessing the conflicting axiologies. For the description of conflict situations, when it is essential to represent various positions within a uniform system, an apparatus of model semantics seems to be the most appropriate one both for generating alternatives and for bringing them together in a modal system of a world in which procedures of transition from one world to another (i.e. the transworld compatibility between them) are also reflected. Reality is reconstructed not as a sort of middle ground between the mutually exclusive approaches nor as their sum, but as a result of the overlapping of various worlds and the procedures of transition from one state of affairs to another. The description of a conflict is therefore seen as a system of worlds connected by modal relations, with a system of worlds emerging as a reality to be described. This approach makes it possible to describe the processes from the points of view of the participating parties and, at the same time, to reveal their basic attitudes. The main idea of this research is shown by the problems analysed: the description of conflict as methodology; language and behaviour (general problems of semiotic description), the logico-semantic analysis of the notions of "problem and conflict", "Genesis and Chronology", "the recurrent model of the (historical) explanation and interpretation of the conflict". Zolyan used data on the Karabagh conflict to demonstrate the dependence of the structure of semio-cultural codes on current political development and considered post-soviet history as a semio-cultural problem. He sought to consider and reveal the logic of manipulations with history, and proposed the logic of preferences as a possible instrument for achieving compromise.

Dystonic movement disorders and spinal degenerative disease

The occurrence of degenerative spinal disease subsequent to dystonic movement disorders has been neglected and has received more attention only recently. Spinal surgery is challenging with regard to continuous mechanical stress when treatment of the underlying movement disorder is insufficient. To characterize better the particular features of degenerative spinal disease in patients with dystonia and to analyze operative strategies, we reviewed the available published data. Epidemiologic studies reveal that degenerative spinal disorders in patients with dystonia and choreoathetosis occur much earlier than in the physiological aging process. Dystonic movement disorders more often affect the spine at higher cervical levels (C(2-5)), in contrast to spinal degeneration with age which manifests more frequently at the middle and lower cervical spine (C(5-7)). Degenerative changes of the cervical spine are more likely to occur on the side where the chin is rotated or tilted to. Various operative approaches for treatment of spinal pathologies have been advocated in patients with dystonic movement disorders. The available data do not allow making firm statements regarding the superiority of one approach over the other. Posterior approaches were first used for decompression, but additional anterior fusion became necessary in many instances. Anterior approaches with or without instrumented fusion yielded more favorable results, but drawbacks are pseudarthrosis and adjacent-level disease. Parallel to the development of posterior fusion techniques, circumferential surgery was suggested to provide a maximum degree of cord decompression and a higher fusion rate. Perioperative local injections of botulinum toxin were used initially to enhance patient comfort with halo immobilization, but they are also applied in patients without external fixation nowadays. Treatment algorithms directed at the underlying movement disorder itself, taking advantage of new techniques of functional neurosurgery, combined with spinal surgery have recently been introduced and show promising results.

The use of focus groups in the development of the KIDSCREEN HRQL questionnaire

There is increasing interest in the public health sector in the health-related quality of life (HRQL) of healthy children. However, most HRQL instruments are developed for children with a chronic illness. In addition, existing questionnaires are mostly based on expert opinion about what constitutes HRQL and the opinions and views of healthy children are seldom included. In the European project KIDSCREEN, a generic questionnaire was developed for children between the ages of 8 and 18 on the basis of children's opinions about what constitutes HRQL. Focus group discussions were organised in six European countries to explore the HRQL as perceived by children. There were six groups in each country, stratified by gender and age. The age groups were 8-9 years, 12-13 years, and 16-17 years, with 4-8 children in each group. Experienced moderators guided the discussions. The full discussions were audiotaped, transcribed and content-analysed. The discussions went smoothly, with much lively debate. For the youngest group, the most important aspect of their HRQL was family functioning. For both younger and older adolescents, social functioning, including the relationship with peers, was most important. Children in all groups considered physical and cognitive functioning to be less important than social functioning. These key findings were taken into account when designing the KIDSCREEN HRQL questionnaire for healthy children and adolescents, with more emphasis being placed on drawing up valid scales for family and social functioning. In addition, items were constructed using the language and lay-out preferred by the youngsters themselves. We conclude that focus groups are a useful way of exploring children's views of HRQL, showing that an emphasis should be placed on constructing valid social and family scales.