Purpose: To study the effect of the phenomenon of mutual aggravation on the early diagnosis of the severity of acute radiation bone marrow syndrome (ARBMS), which develops within the framework of combined radiation-mechanical injury (CRMI). Material and methods: According to the general blood test data, the dynamics of the relative and absolute number of lymphocytes in 36 patients was studied during the first 10 days after receiving polytrauma. There are 35 men and one woman among them. The average age of the victims at the time of injury was 40.24 ± 4.07 years. The number of studied blood tests in one patient varied from one to 16 during the specified follow–up period (on average, 6). The dynamics of the absolute number of lymphocytes at the same time was also studied in 11 patients (men, average age – 30.00 ± 2.01 years) diagnosed with acute radiation syndrome (ARS) I and in 15 men diagnosed with ARS II (average age – 28.47 ± 2.03 years). Statistical processing of the material was performed using the IBM SPSS Statistics software package.23 using the Kraskal–Wallis criteria and the Mann–Whitney U-test for independent samples. The differences between the obtained results were considered statistically significant at p < 0.05. Results: Relative lymphopenia was detected in 25 (69.4 %) patients diagnosed with polytrauma. A combination of absolute and relative lymphopenia was found in 15 (41.7 %) patients. Only transient relative lymphopenia was detected in 10 patients. The depth of absolute lymphopenia detected in polytrauma was compared with a similar indicator at the same time in ARS I and ARS II. The depth of absolute lymphopenia in trauma without exposure to ionizing radiation at the time when it is usually studied to determine the severity of ARBMS reached the indicators characteristic of ARS I and ARS II (up to 0.3–0.5 × 109/L.). At the same time, the nature of the dynamics of the absolute number of lymphocytes in trauma is radically different from that in acute radiation exposure. Conclusion: The data obtained allow us to consider the possible deepening of absolute lymphopenia in CRMI in 42 % of cases as one of the manifestations of the phenomenon of mutual aggravation, which can lead to an early aggravation of the predicted severity of the developing ARBMS. The data obtained indicate that this weighting may be + 1, in rare cases +2 degrees of severity of ARS to the true degree of severity corresponding to the absorbed dose of radiation exposure.

Purpose: to present the materials of long-term (38 years) monitoring of the health status of a group of patients who had underwent acute radiation syndrome (ARS) in 1986 as a result of the Chernobyl accident and had been living in the territory of the Russian Federation. Materials and methods: the results of cytogenetic dynamic observation of 74 direct participants in the Chernobyl accident who had been examining at the clinic in the period from 1986 to 2012, as well as the results of dynamic inpatient observation of 10 of them permanently residing in Moscow, are summarized. Medical supervision consisted of annual planned hospitalizations in connection with patient requests, or emergency hospitalizations in connection with the detection of acute or exacerbation of a chronic disease. Laboratory and instrumental examination of organs and organ systems critical to the effects of radiation, as well as an extended cancer search, was carried out. Results: according to cytogenetic studies for all degrees of severity of ARS, starting from the 1st degree, the frequency of translocations in blood lymphocytes significantly exceeds the spontaneous level. The initial level of translocations depends on the initial dose estimate. The time of decrease in the frequency of translocations due to the presence of part of the translocations in unstable cells, from the initial value to an established constant level, apparently occurs in the first 5-8 years. Analysis of individual blood curves revealed transient moderate cytopenia, most often thrombocytopenia. Myelodysplastic syndrome (MDS) and leukemias were detected in 5 patients (2- Moscow group, 3- Ukranian group) from the entire group who underwent ARS as a result of the Chernobyl accident, which significantly exceeds the expected level. The diagnosis of radiation cataract was established in 11 patients. Two patients underwent surgical treatment. In the acute period ARS local radiation injuries (LRI) was detected in 59 patients. By 2005, 38 patients with the effects of LRI were observed (33 in Ukraine and 5 in Moscow). The most severe long-term consequences in the form of pronounced cicatricial atrophic changes, radiation fibrosis, and late radiation ulcers were detected in patients with grade III – IV LRI. 1 out of 10 observed patients developed primary multiple metachronous cancer of the genitourinary system, 2 patients – prostate cancer, 1 – metastatic lesion with an undetected primary tumor, 3 – multiple foci of basal cell skin cancer. The causes of death in 8 out of 10 patients were: cardiovascular pathology, MDS and leukemia, cirrhosis of the liver, oncological disease with undetected primary localization of the tumor, suicide in an oncological patient. Conclusions: The experience of providing medical care to victims of the Chernobyl accident with acute radiation injuries and further in the period of long-term consequences indicates the need to maintain constant readiness to provide medical care in case of a radiation accident, as well as adequate information during and after the accident, which will reduce the long-term consequences. Patients who have undergone ARS need lifelong medical supervision and the provision of necessary medical care. The main causes of permanent disability of patients who have undergone ARS are the consequences of LRI (recurrent late radiation ulcers, radiation fibrosis, contractures, scars, etc.). Radiation cataract is the cause of temporary disability (before surgical treatment). Patients who have undergone ARS need adequate social adaptation. The revealed effect of exposure to relatively uniform radiation is an increase in the frequency of MDS and leukemia.

Psychophysiological examination was carried out on two patients, former border guards, who suffered on October 05, 1982 as a result of accidental contact with a source of gamma radiation (137Cs) while on duty while serving on the Iranian-Azerbaijani border in the ranks of the Soviet army. They suffered ARS of the 1st degree with extremely uneven gamma irradiation in the form of local radiation injuries of the hands of varying severity. The assessment of the aver -age dose for the whole body according to the frequency of dicentrics in cultures of peripheral blood lymphocytes in patient No. 1 and patient No. 2 is the same and is 0,26 Gy. Psychophysiological research was carried out in dynamics in 2001-2013 using the automated software and methodological complex «Expert». According to the MMPI data, both victims have a hyperthymic type of psychophysiological adaptation with varying degrees of severity. Patient No. 2 is a chronically hyperthymic personality with a significant increase in the profile on the 9th scale and with its gradual increase in dynamics, which reflects the persistence of hyperthymic personality traits and causes an overstrain of mental adaptation, with an increase in the dynamics of the tendency to explain their difficulties and problems by somatic distress (1Hs). Patient No. 1 has a hyperthymic personality type with a moderate increase in profile dynamics on the ninth scale. A personality trait is indicated by a high, growing in dynamics, indicator on the K scale, which determines behavior depending on social approval and concern for one’s social status. The appearance in dynamics (2013) of a peak on scales 1 (preoccupation with the state of health) and 4 (emotional tension in direct behavior) determines the insufficient ability to internalize the social norm, i.e. insufficient ability to perceive this norm as part of one’s own settings (a combination of profile peaks on scales 4 and 9). The presence of profile peaks on the 7th scale and the scales of the neurotic triad reflect the tendency to various options for the implementation of antisocial attitudes in a socially acceptable way, the desire to appear in a favorable light (scale L). Sufficiently high intelligence and demonstrative behavior determine good adaptation to the environment with self-confidence, high social adaptability, and resilience in overcoming difficulties.

Purpose: To study the effect of the radiation dose rate on the dynamics of peripheral blood indicators in various periods of chronic radiation syndrome (CRS), which developed as a result of professional prolonged radiation exposure in a cohort of former employees of the Mayak plant who underwent inpatient examination at the clinic of the A.I. Burnazyan Federal Medical Biophysical Center of the FMBA of Russia in the period up to 1995. Material and methods: The study of the dynamics of absolute peripheral blood indices in former employees of Mayak plant who were exposed to prolonged industrial radiation with a dose rate of less than 0.001 Gy/day (25 people), 0.003‒0.007 Gy/day (12 people) and 0.008‒0.07 G/day (15 people) during the periods of formation, outcomes and immediate, as well as long-term consequences of CRS. Statistical processing of the material was performed using the IBM SPSS Statistics software package 23.0 using the Kruskal–Wallis criteria and the Mann–Whitney U-test for independent samples. The results obtained were considered statistically reliable at p < 0.05. Results: In a group of patients irradiated with a dose rate of 0.008‒0.07 Gy/day during the periods of formation, as well as the outcomes and immediate consequences of CRS, platelet-, leuco- and deep neutropenia were noted. A decrease in the number of erythrocytes and hemoglobin was detected only in the period of outcomes and immediate consequences. The development of agranulocytosis and anemic syndrome are signs that distinguish the course of CRS in this group of patients from the clinical picture of typical CRS. In the period of long-term consequences, 60 % of patients (9 out of 15) developed oncohematological diseases. At an irradiation power of 0.003‒0.007 Gy/day anemic syndrome was found in 4 out of 12 patients. Leukopenia was observed in the periods of outcomes and immediate consequences. Granulocytopenia was detected in all three periods of the course of CRS. In the long term, 2 patients from this group developed oncohematological diseases At an irradiation power of less than 0.001 Gy/day shallow thrombocytopenia and neutropenia are noted in the periods of outcomes and immediate consequences of CRS. In the period of long-term consequences, all the average values of peripheral blood indicators correspond to normal levels. Conclusions: With prolonged irradiation of a person with a dose rate of 0.008‒0.07 Gy/ day or more, with the accumulation of a total dose of 1.7‒9.6 Gy and a contact duration of 6‒96 months, one can expect the development of CRS with a peculiar subacute clinical course of bone marrow syndrome (BMS), manifested by the defeat of all three hematopoietic sprouts, the development of agranulocytosis, anemia and, probably, in 60 % of cases of leukemia development with an unfavorable prognosis for the patient’s life. The main factor determining this feature of the course of BMC CRS is the dose rate, which exceeds 0.008 Gy / day (2 Gr/year). At a dose rate of 0.003‒0.007 Gy / day (0.7‒1.7 Gy / year), the course of CRS with the development of agranulocytosis is possible in 25 %, anemia – in 33 % of observations. This course of the disease is most likely with a dose rate approaching the upper limit of the named range and high total doses. In other cases, the course of the disease is favorable. In the long-term period, moderate, transient leuko-, neutro- and thrombocytopenia are possible. With prolonged irradiation with a dose rate of less than 0.001 Gy / day (0.25 Gy / year), the course of the disease is relatively favorable with almost complete restoration of hematopoiesis in the long term.

Purpose: to study the features of the state of the bone marrow according to cytological and histological studies at different periods of the course of CRD, caused by exposure to different dose rates, which developed as a result of professional prolonged exposure in a cohort of former employees of a radiation hazardous enterprise who underwent inpatient examination at the clinic of the A.I. Burnazyan Federal Medical and Biomedical Center in the period up to 1995. Material and methods: the study of the results of cytological and histological studies of the bone marrow was carried out in former workers of the Mayak Production Association who were exposed to long-term industrial exposure with a dose rate of 0.008−0.07 Gy / day (15 people), 0.003−0.007 Gy / day (12 people) and less than 0.001 Gy/day (25 people), during periods of formation, outcomes, immediate and long-term consequences of CRS. At the stage of studying the results of histological examination of the bone marrow, 54 more patients with CRS were added to the third group, irradiated with a dose rate of less than 0.001 Gy / day. Statistical processing of the material was carried out using the IBM SPSS Statistics software package.23 using the Kruskal‒Wallis test and the Mann‒Whitney U-test for independent samples. The results obtained were considered statistically significant at p < 0.05. Results: At a dose rate of 0.008−0.07 Gy / day during the formation period, the myelogram revealed narrowing of the granulocyte and expansion of the red germs, acceleration of maturation of granulocytes with a normal erythrocyte maturation index and leuko-erythroblast ratio. In peripheral blood – agranulocytosis. In the period of outcomes and immediate consequences − narrowing of the granulocytic, expansion of erythrocyte germs, acceleration of maturation of neutrophils with other myelogram parameters within normal limits. In the blood − agranulocytosis, anemic syndrome. In the long term, in the case of restoration of hematopoietic function, narrowing of the granulocytic germ with other myelogram parameters within the reference values. However, with a similar course of CRS in 60 % of patients in periods of outcomes and long-term consequences, the development of myelodysplastic syndrome with transformation into acute leukemia or aplastic anemia is possible. At an irradiation dose rate of 0.003−0.007 Gy / day in the period of CRD formation, the myelogram revealed an expansion of the granulocytic germ, with other indicators within the normal range. In the period of outcomes and immediate consequences, an acceleration of maturation of granulocytes and an increase in the leuko-erythroblastic ratio were found. In the long term, a narrowing of the granulocytic and expansion of the erythrocyte sprouts, a slight acceleration of the maturation of granulocytes were found. Hystological examination: polymorphocellular bone marrow – in 11 out of 25 patients, hypoplasia – in 9 out of 25, signs of hyperplasia – in 5 out of 25. In the long term, 2 patients from this group developed oncohematological diseases. At an irradiation power of less than 0.001 Gy / day, during all periods of CRD, normal values of granulocytic and erythrocyte sprouts were noted in the myelograms of patients. In the period of CRD formation, the normal size of the granulocytic germ was achieved due to the accelerated maturation of neutrophils. The leuko-erythroblastic ratio in the period of long-term consequences was significantly higher than the norm (5.29 and 4.5, respectively). Hystological examination: 32 out of 64 patients had polymorphocellular bone marrow, 22 out of 64 had hypoplastic bone marrow, 7 out of 64 had bone marrow hyperplasia. Conclusion: regular changes in hematopoietic tissue and peripheral blood in CRD can serve as diagnostic criteria, based on which it is possible to assume the dose rate of radiation to which the patient was exposed, and also on their basis, it is possible to predict the outcome and long-term consequences of CRD that developed as a result of this exposure.

For a long time, the attention of researchers studying combined radiation-mechanical injuries (CRMI) has been focused on the study of individual syndromes: mechanical trauma and acute radiation syndrome. To diagnose and assess the severity of each syndrome, tests used for isolated injuries are recommended. However, the results of tests based on counting the number of different peripheral blood cells in an initially healthy person and in an injured patient who has experienced severe bleeding will be different. Accordingly, the assessment of the severity of developing acute radiation disease these patients will differ. The possibility of predicting the severity of developing radiation injury in CRMI using a lymphatic test during the first week after exposure is also being evaluated. In this report, based on the literature data, the dynamics of the absolute number of lymphocytes in patients with multiple mechanical injuries is considered. The results of numerous clinical and experimental studies indicate that severe and multiple injuries, starting from the first hours and during the first week of observation, are characterized by instability of the number of lymphocytes in peripheral blood with significant absolute lymphopenia on the first day. It is shown that the depth of lymphopenia and the rate of recovery of the number of lymphocytes to normal values depends on the severity of the mechanical injury. In addition, the deepening of lymphopenia is also caused by urgent medical measures that are standard in the provision of medical care for severe trauma with blood loss: massive infusion therapy and the appointment of corticosteroids. Thus, the use of a lymphocytic test in CRMI to assess the radiation dose without taking into account the significance of the trauma suffered will lead to a false prognosis of the degree of developing acute radiation damage, as well as to the lack of differentiation between the effects of radiation and non-radiation factors, and, consequently, to errors in patient management tactics.

Purpose: To assess toxic pneumosclerosis caused by inhalation intake of plutonium aerosols in a patient who worked in contact with plutonium at the Mayak Production Association from 1948–1954. Material and methods: Patient Sh., born in 1924, higher education, at the age of 24, began working as a chemical engineer at MPO Mayak from 1948 to 1954 under conditions of increased occupational hazard of ionizing radiation (exposure to gamma rays and ingestion of plutonium aerosols). During her work, she received 389, 624 R: (1950 ‒ 83, 57; 1951 ‒ 187, 29; 1952 ‒ 70, 24; 1953 ‒ 48, 14). Carrying plutonium. Results: А clinical description of toxic pneumosclerosis of a severe degree of a progressive course, caused by the intake of mainly transportable plutonium aerosols against the background of a combined effect of external relatively uniform gamma radiation, is given. The carriage of plutonium and its removal from the body were established and confirmed. For diagnostic and therapeutic purposes, the patient underwent pentacin inhalations in 2 stages for 3 days. The excretion of plutonium-239 in the urine increased to a maximum of 940 units / min ‒ 1150 units / min (06.04.1957‒06.06.1957) and 464 units / min (06.14.1957), in feces ‒ 308 units / min ‒ 252 units / min (06.07.1957‒ 06.11.1957) and 236 units / min (18.06.1957). The assessment of the amount and alpha activity of the received in the lungs, liver, bones, and other organs was carried out according to the biophysical study of the organs of the corpse of the patient Sh. Conclusion: The clinical picture of the patient was determined by toxic plutonium pneumosclerosis of a severe degree of progressive course as a consequence of chronic exposure to plutonium. Hypoxia (hypoxemic and tissue). Pulmonary heart. Focal pneumonia. Upex lungs. Violation of the vasomotor and respiratory centers. Moderate oppression of hematopoiesis and asthenic syndrome as a consequence of chronic radiation sickness II degree. The disease progressed with damage to the main critical organs (lungs, liver, bones). The patient died from heart failure, which developed as a result of pneumosclerosis with symptoms of asphyxia.

Purpose: The purpose of the work is to assess acute radiation sickness of moderate severity from short-term external extremely uneven gamma-neutron irradiation and local radiation injuries of the lower extremities and right hand of III and IV severity. Material and methods: Patient T., born in 1940, at the age of 25, began working from 1965 to 1968 as an apparatchik in plant No. 1 of department 20 at Production Association «Mayak» in contact with plutonium. On December 10, 1968, at 11:30 p.m., the accident occurred. The victim was at a distance of about 50 cm from the source, which was below and mostly to the right of him. The patient was exposed to short-term exposure to neutrons and gamma radiation. A few minutes later, numbness appeared in the right half of the trunk and extremities. Twenty-five minutes later, vomiting appeared, vomiting was repeated: 8 times before admission to the hospital, at the health center, after washing in the shower, in the hospital. Made gastric lavage, intravenous administration of pentacin, diphenhydramine, glucose, bloodletting (500 ml), twice transfused blood (250 ml each), polyglucin (500 ml), promedol, atropine. On examination, slight hyperemia of the right half of the face, injection of the sclera was noted. In the blood test, made for the first time after 2 and a half hours from the start of the events, there were 9000 leukocytes, lymphocytes – 15 %. On the morning of December 11, 1968, the patient complained of a burning sensation in the right half of his face; repeated vomiting. There were 7600 leukocytes at that time. The victim was offered to go to the 6th Clinical Hospital in Moscow (Sector No. 9 of the Institute of Biophysics), the patient agreed. Examination results: A clinical description of acute radiation sickness of moderate severity from short-term external extremely uneven gamma-neutron irradiation and local radiation injuries of the lower extremities and right arm of III and IV severity is given. The features of the clinical picture of radiation sickness were entirely determined by the nature of the acting radiation factor and the position of the radiation source in relation to the victim and the associated topography of the lesion. Irradiation was directed from bottom to top and from right to left, hence the difference in exposure doses: on the right, the dose changed from bottom to top from more than 2500 rad (foot, lower leg, right hand) to less than 250–300 rad (in the head region), while in the middle – in the area from the iliac crest to the costal arch – the dose exceeded 500 rad on the left; from bottom to top, the drop occurred from a dose close to 2000 rad (foot and lower third of the lower leg) to 460 rad (in the anterior spine of the left ilium). The neutron nature of the acting radiation factor caused damage to surface tissues and visceral organs and bone marrow, the latter to a lesser extent due to the smaller contribution of the gamma factor to this accident. Conclusion: The primary reaction and laboratory data of the first days of the disease indicated a severe lesion. However, the hematological syndrome was not severe. If it were not for the pain syndrome associated with an extremely severe local injury, the general condition of the patient would not have been so severe. Local trauma, which endangered the life of the patient, led him to a deep disability. Therefore, despite the average severity of the hematological syndrome, this form of acute radiation sickness was regarded as severe. The weakening of the hematological syndrome, apparently, was caused by the extreme severity of the local injury, which played the role of a hematopoiesis stimulator.

Purpose: A retrospective analysis of the clinical observation of chronic radiation sickness (CRS) culminating in the development of aplastic anemia. Material and methods: The object of the examination was the medical history of a 25-year-old man, an apparatchik at the Mayak Production Association, who worked under conditions of external exposure and internal intake of radionuclides from July 1948 to December 1949. Results: When he was employed, he was practically healthy. During the work, according to the data of individual dosimetric control, he received external relatively uniform exposure in a total dose of 1.72 Gy. During the entire observation period (2 years 4 months) in the 2nd therapeutic department of the Medical Unit No. 71 (from 12/15/49 to 01/15/52) and then in a special clinic of the IBP of the Ministry of Health of the USSR (from 01/17/52 to 03/24/52). It was noted the excretion of radioactive substances in the daily urine 8.3‒28.3 Bq, in the feces – 13.3–1133.3 Bq, without a decrease in their number in subsequent studies. Sick since August 1949. Taking into account the professional history, the presence of sepsis, severe hemorrhagic syndrome, complete aplasia of the bone marrow, long-term carriage and release of radioactive substances, in 1952 the final clinical diagnosis was formulated: Chronic recurrent form of radiation injury due to ingestion of radioactive substances, in a state of exacerbation. Aplastic anemia. Septicopyemia. General hemorrhagic syndrome. Parenchymal changes in internal organs. Meningoencephalitis. Myocarditis. Left-sided pneumonia with pleurisy. Residual effects of subarachnoid hemorrhage. Trophic ulcers of the left buttock. Pyoderma with necrosis of both elbows. Infiltration of the upper third of the right thigh along the back surface. On March 24, 1952, the patient died. The clinical diagnosis fully coincided with the pathoanatomical diagnosis. Conclusion: The case history of patient E. is a vivid illustration of the subacute course of CRS with a rapid lethal outcome. The presence of a significant internal intake of osteotropic radionuclides led to the predominance of destructive processes in the bone marrow over regenerative ones and, accordingly, predetermined the development of aplastic anemia with a fatal outcome.

Purpose: To describe the clinical observation of chronic radiation sickness (CRS) of severe course, caused by relatively uniform external gamma exposure and inhalation intake of plutonium-239 aerosols, and its long-term consequences. Material and methods: A clinical description of the observation of CRS, which developed from the combined effect of external gamma radiation and inhalation of plutonium-239 aerosols, was given in a former employee of the Mayak Production Association, who was treated for 45 years in a specialized clinic of the Institute of Biophysics of the Ministry. Conclusion: The clinical picture of CRS in the patient was determined by manifestations of plutonium pneumosclerosis II degree, emphysema, respiratory failure II degree, liver cirrhosis in the active phase, organic changes in the brain in the form of stem vestibular manifestations, osteoalgic syndrome. Significant amounts of plutonium-239 were noted. She was an invalid of group II due to the underlying disease. The disease progressed with damage to the main critical organs (lungs, liver). In the period of long-term consequences, the patient developed peripheral cancer of the lower lobe of the right lung (poorly differentiated adenocarcinoma).

Purpose: A socio-psychophysiological assessment of the adaptation of two patients with local radiation injuries (LRI) of the hands of severe and moderate severity and acute radiation sickness (ARS) of the 1st degree, according to the characteristics of their individual mental adaptation and the stages of the course of local radiation injuries (30 years of observation). Material and methods: Psychophysiological examination was carried out on two patients, former border guards, who were injured on October 5, 1982 as a result of accidental contact with a source of gamma radiation (cesium – 137) while on duty while serving on the Iranian-Azerbaijani border in the ranks of the USSR army. They suffered grade I ARS with extremely uneven gamma irradiation in the form of local radiation injuries of the hands of varying severity. The assessment of the average dose to the whole body by the frequency of dicentrics in the cultures of peripheral blood lymphocytes in patient No. 1 and patient No. 2 is the same and amounts to 0.26 Gy. One of them, patient No. 1, had a local radiation injury of the left and right hand of the III degree of severity. In 1984 – 1985, he underwent amputation of the nail phalanges of the 1st and 2nd fingers of the left hand; in 2003, skin grafting was performed for late radiation ulcer of the 3rd fingers of the left hand. Patient No. 2 had grade III-IV LRI in both hands with severe and extremely severe sequelae of local radiation damage to both hands. Amputation stumps 1 – 5 fingers of the right and left hand. Rough cicatricial – atrophic changes in the skin of the left hand with a violation of its function. Condition after multiple surgical interventions, including autotransplantation of full-thickness flaps on vascular pedicles. Psychophysiological research was carried out in dynamics in 2001, 2003, 2008, 2009, 2011, 2013 using the automated software and methodological complex “Expert”, designed to study personal properties of a person, cognitive and intellectual characteristics of a person according to the MMPI method, the Cattell,s 16-Personality Factor Questionnaire (16PF), Raven’s Progressive Matrices test, sensorimotor reaction (SSR, СSR) and reaction to a moving object (RMO). Results: According to MMPI data, both victims have a hyperthymic type of psychophysiological adaptation with varying degrees of severity. Patient No. 2 is a chronically hyperthymic personality with a significant increase in the profile on scale 9 and with a gradual increase in dynamics, which reflects the persistence of hyperthymic personality characteristics and causes an overstrain of mental adaptation, with an increase in the dynamics of the tendency to explain their difficulties and problems with somatic ill-being (1Hs). Characterological features were determined by high emotionality (factor A – 9.8 stan), sufficiently high intelligence (factor B – 7.3 stan), sufficient integration and sthenism of behavior, high dominance and freedom of behavior (factor F – 8.5 stan), due to a propensity for increased self-esteem, a high propensity to take risks (H – 9.3 stan), down-to-earth interests (factor M). Very high extroverted behavior (factor F2 –--- 9.9 stan). High rates of the Raven test and sensorimotor reactions. Thus, the personality profile of patient No. 2 has the form of a pronounced chronic hyperthymic personality, which determines the overstrain of mental adaptation, with manifestations of psychosomatic hypochondria. Patient No. 1, according to the data of psychophysiological examination, revealed a hyperthymic personality type with a moderate increase in the dynamics of the profile on the ninth scale. The personality trait is also indicated by a high, growing in dynamics, indicator on the K scale, which determines behavior depending on social approval and concern for one’s social status. On the first three scales (1, 2, 3) there is a type of conversion V – this is a combination of unpleasant physical sensations with vegetative anxiety and with a predominance of demonstrative tendencies aimed at overcoming difficulties caused by the state of health (scales 1 and 3). The appearance in dynamics (2013) of a peak on scales 1 and 4 determines the insufficient ability to internalize the social norm, i.e. insufficient ability to perceive this norm as part of their own attitudes (combination of profile peaks on scales 4 and 9). The presence of profile peaks on the 7th scale and on the scales of the neurotic triad reflect the tendency towards various options for the implementation of asocial attitudes in a socially acceptable way, the desire to look in a favorable light (scale L). A sufficiently high intelligence and demonstrative behavior determine good adaptation to the environment with self-confidence, high social adaptability, and resilience in overcoming difficulties. Conclusion: Psychophysiological assessment of personality and current mental state determined individual personality traits in two patients with hyperthymic type of psychophysiological adaptation of varying severity, who underwent ARS, severe and extremely severe local radiation injuries 30 years after the radiation incident, respectively. A significant increase in the profile on the 9th scale in patient No. 2 was constantly detected, reflecting the persistence of the described personality traits characteristic of chronically hyperthymic individuals. A high level of hyperthymic activity causes him to overstrain his psychophysiological adaptation, with manifestations of psychosomatic hypochondria A moderate increase in the profile on scale 9 and scale 3 characterized patient No. 1 as an optimistic, energetic and capable of high activity person, concerned about his social status (high values ​​on the K scale). The appearance in the dynamics (2013) of a peak on the 1 (concern with the state of health) and 4 on the scale (emotional tension in direct behavior) determine the insufficient ability to internalize the social norm, i.e. insufficient ability to perceive this norm as part of one’s own attitudes (combination of profile peaks on scales 4 and 9). The presence of profile peaks on the 7th scale and the scales of the neurotic triad reflect the tendency for the implementation of asocial attitudes in a socially acceptable way.