Medical Radiology and Radiation Safety. 2024. Vol. 69. № 2


I.B. Ushakov

Review of the Monograph by Yu.A. Klassovsky «The Effect of External and Internal Irradiation in the Conditions of Formation of Radioactive Traces of Nuclear Explosions. Questions of Etiology and Pathogenesis»

A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia

Contact person: I.B. Ushakov, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.


In memory of our teachers and the founders of the relevant fields of radiobiology, who studied the consequences and developed protection against the combined effects of external radiation and radionuclides on the body

The material included in Yuri Alexandrovich Krasovsky's monograph, designed and published posthumously, is addressed to specialists in radiobiology and medical radiology. It represents unique data that, at the time of their receipt, should be characterized as promising in terms of methodological approach, scientific novelty and meaningful author's generalization, and in modern conditions of time – as non-reproducible and relevant in solving problems of universal value. The reason for this lies in the original methodological approach of the author and his interpretation of the data obtained.

The published work contains the plan, nature, form and completeness of the presentation of the data stated by the author as due from the standpoint of a medical view of a complex problem. In the sections and appendices where the direct factual material is presented, a generalizing analysis of it is carried out while preserving the descriptive features of each individual case. Thus, possible scientific followers of the author are left with the opportunity for further meaningful work with the unique factual data included in the monograph.

The following methodological approaches and scientific provisions established, developed or systematized by the author have reason to be attributed to the materials included in the monograph claiming priority.

First, it is the identification and persistent convincing introduction into science of the concept of "combined radiation damage" with a description and systematization of its inherent clinical and pathogenetic features.

As a result, the concept itself, the classification term and the position of the author, together with the conclusions of other researchers, have become entrenched in medical radiology as a textbook.

Secondly, it is the methodological demonstrativeness with which the author, developing the concept of the critical organ, detailed and brought it to the concept of the critical tissue of the critical organ. The author's first publications with histoautoradiographic research materials on this topic date back to the sixties of the last century and relate to the deterministic effects of combined radiation damage. Now this position is recognized by the international scientific community as decisive in relation to the blastomogenic effect of ionizing radiation. The author's own data on blastomogenic action within the framework of the developed concept are presented in the monograph with protocol details.

Finally, thirdly, the factual position formulated by the author and confirmed by the materials included in the monograph about the advanced appearance of tumors in the tissues of the endocrine system during the subsequent development of multiple tumors of other organs with an attempt at a pathogenetic explanation of what is happening.

The material received by the author and included in the peer-reviewed monograph was prepared, but not defended as a dissertation. Nevertheless, references to it as a completed scientific work have been repeatedly cited by reputable experts as an evidence base for official advisory acts when making decisions on issues at the state level.

The problem of assessing the effects, damage mechanisms and long-term consequences of the combined effects of external radiation and internal irradiation of organs and tissues from radionuclides incorporated in them, especially acute for the conditions of formation of a radioactive trace, appeared immediately after the start of nuclear test explosions and still remains relevant. The urgency of the problem increases significantly in connection with the counteraction carried out by the Russian Federation to the trends of the "sliding" of the world order towards a lighter attitude towards threats related to testing, the use of nuclear weapons, and the deliberate destruction of nuclear-hazardous facilities with the anti-human purpose of polluting the habitat and environment with nuclear fission products. An objective forecast of the medical and environmental consequences for the population living in the adjacent territories under these threats is necessary to minimize damage to the country's economy and maintain its defense capability. Therefore, the publication of the peer-reviewed monograph by Yu.A. Klassovsky, devoted to the etiopathogenetic study of radiation effects on the body when combined with general external radiation with internal radiation of individual critical organs and tissues, is timely and relevant.

Despite a significant amount of work devoted to the study of the ways and mechanisms of dose formation in various organs of the irradiated body, the integral assessment of equivalent levels of combined radiation exposure is still the subject of scientific discussions among radiobiologists, biophysicists and hygienists. For example, the harmonization of domestic and foreign standards for the rational limitation of such effects on humans requires in-depth analysis, correct generalization and extrapolation of a set of theoretical and experimental data obtained both in model laboratory and field experiments on laboratory animals of various biological species. However, objective data from medical and radiobiological studies for a convincing conclusion about the consequences of adverse effects of ionizing radiation with various combinations of external and internal radiation sources in the specialized literature were extremely few, not systematized and often contradictory.

The results of a long-term study of lifelong consequences in their connection with the clinical and morphological severity of the immediate effects of external radiation and radioactive products ingested (experimental animals) in full-scale tests at the Semipalatinsk test site, presented in the formulation chosen by the author, are unique and have not been widely covered in the available literature for objective reasons to date. This allows us to state with confidence the undoubted and enduring value of the data obtained by the author of multidimensional experiments with an assessment of the functional and morphological significance of the main pathoanatomical changes in the pathogenesis of combined radiation lesions and the lifelong consequences of such pathological conditions of biological objects.

The descriptive value of the monograph is given not only by a scrupulous presentation of the quantitative characteristics of clinical, hematological, physiological, biochemical, immunological and pathoanatomical indicators. The author also presented a rich atlas of pathological changes in the organs of internal secretion, reproductive, hematopoietic, excretory systems, gastrointestinal tract, etc. registered visually and using light microscopy, as well as historadiography. in experimental irradiated animals. Models of full-scale and simulated variants of combined radiation exposure were used. These truly unique and vivid illustrative materials are difficult to overestimate for current and future researchers in the field of radiation biology and medicine.

Despite the solid period of almost half a century since the completion of Yu.A. Klassovsky's qualification work, this monograph has not only not lost its relevance, but should also be a matter of well-deserved pride among Russian specialists in the field of medical radiology, radiation biology, hygiene and military medicine. In the research materials, the author emphasizes that the leading contribution to carcinogenesis at sublethal doses of exposure is made by internal irradiation with incorporated radionuclides. At the same time, the features of the effects that are the consequences of combined radiation lesions in such conditions turned out to be a relatively short period of tumor development and their more malignant course. Thanatogenesis as the outcome of radiation exposure to biological objects in supralethal doses, on the contrary, is ranked as having a greater significance of the contribution of external irradiation. Y.A. Klassovsky comes to such important conclusions with an understanding of their scientific, but also pragmatic significance. This complements the priority of the author's position and the contribution of the scientific provisions of the published monograph to the development of the theory, methodology and practice of research on the etiology and pathogenesis of radiation-induced acute, delayed and long-term consequences of combined exposure to ionizing radiation.

It should be noted the unique style of presentation of materials in the reviewed monograph, reflecting its specific orientation and the diversity of the author's interests. An attempt at a wide comprehensive coverage of independent research areas from pathogenetically justified requirements for tissue dosimetry to demonstrative examples of dose distribution and its significance in the pathogenesis of radiation lesions, being an undoubted advantage of the work, was fraught with limitations arising from these advantages. The medical approach stated by the author created a subordinate structuring of work on the sections of pathological anatomy and pathogenesis of combined radiation lesions. The author did not put forward goals requiring multivariate statistical analysis in epidemiological terms, understanding the limited samples of experimental animals due to the variability of conditions subordinated to the priority goals of planning field experiments. Under these conditions, the author found his solution, focusing on the description of the phenomenology of the processes of manifestation of various forms of radiation damage in animals and it was with this that he associated estimates of the long-term lifelong predetermined consequences of acute combined exposures. However, this circumstance in no way detracts from the undoubted advantages of the monograph. According to the style of presentation of materials, the work of Yu.A. Klassovsky approaches classical works. The logic, concreteness and coherence of the presentation of the results in all five sections of the monograph, the reliability of the conclusions and the validity of the conclusions are beyond doubt.

One can only regret that the presented work of Yu.A. Klassovsky as a result of selfless work, as a research and human feat of a scientist, has been in demand by the scientific community for a long time, and has been published only now. The problem of objectification of the effects of combined radiation exposure raised in the monograph will be in demand by a wide range of specialized researchers for a long time. In addition, the book will be useful to students and young professionals interested in radiation biology and medicine, as well as to anyone who seeks to include in their scientific horizons achievements in the field of etiology and pathogenesis of the radiation effects of combined exposure to radiation on a living organism. It can be assumed that by combining modern computer modeling capabilities and a thorough in-depth numerical analysis of the presented unique data from real field experiments, this monograph by Yu.A. Klassovsky will serve more than once as a productive source for revealing hidden patterns so far. They may consist in the multidisciplinary origin of the features revealed during the reconstruction of various options for the joint action of internal and external sources of radiation. Armed with this knowledge, future researchers will be able to rationally apply the data presented in the monograph, developing new approaches to protecting and overcoming the consequences of such a complex type of radiation exposure.

I support the content, the prospects for further scientific application and the enduring value, as well as the established timeliness of publication of the materials included in the monograph by Yu.A. Klassovsky.


President of the Radiobiological Society of the Russian Academy of Sciences
Academician of the Russian Academy of Sciences,
Doctor of Medical Sciences Professor
I. B. Ushakov



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