As a result of the accident the territory of Ukraine was subjected to considerable radiation contamination and its population was involved to the greatest radiation catastrophes. Kiev, Zhitomir, Rivne and Chernihiv regions with the population of more than 5 million inhabitants.

By the moment of the catastrophe the health state of population in Central-Ukrainian area was influenced by the social and economic peculiarities of the region, by the ecological and anthropogenic load. In rural areas this was wide use of pesticides and mineral fertilizers, in cities- industrial loads with lead, cadmium, manganese etc. One of the peculiarities that greatly influenced the radiation effects especially on thyroid gland was iodine deficiency in Ukrainian Polissia region – the place of Chernobyl nuclear power plant (NPP) location. During the Soviet period special efforts were made to diminish medical consequences, such as hypothyroidism, including the consumption of iodinated salt but the efficiency couldn’t be estimated on the individual level of population in total.

Acute radiation syndrome (ARS) reconvalescents represented the most severely damaged group of the victims. At the time of first decade after the accident 105 from 145 ARS reconvalescents are the citizens and inhabitants of The Ukraine. Follow-up of patients was organized at Research Center for Radiation Medicine.During the period of observation we registered the disorders of haemopoiesis and immunity such as transient and stable leukopenia and leukocytosis and increasing number of oncogematological pathology such as leukemia and erythromyelodisplastic syndrome. The somatic state was characterised by prevalence of chronic pathology of different organs and systems.

Special efforts were performed by health care organisations. Several international and national scientific programs were performed during the years after the accident. Due to the previous results obtained on hibakushi cohorts efforts were made to find the access of stochastic effects leukemia and thyroid cancer in exposed territories of Ukraine, Russia and Bjelorus on the base of published information. An increase of leukemia was detected but no evidence was obtined whether it's related with the irradiation. An increase of thyroid cancers was shown in Ukraine and Bjelorus, but neither in Russia. Later data was obtained about the significant increase of thyroid cancers especially in Ukraine. Joint American-Ukrainian program on Thyroid gland in Chernobyl victims was elaborated. Also joint US-Ukrainian study is now performed on the epidemiology of leukemia. WHO IPHECA projects were elaborated in 1993-1995 in the clinical fields of hematology (Leukemia ), endocrinology ( Thyroid gland ) and psychoneurology (Brain in utero ) for Ukraine, Bjelorus and Russia. These projects were followed by the similar research in the frame of French-German Initiative from 1998.

Obtained data led us to the suggestion that significant changes in the health of the population exposed to a multi-factoral influence of Chernobyl accident had occured during last decades. Today we know that the persistent functional destabilisation along with the individual reparative and compensatory insufficience on the various levels of integration in irradiated patients with dystress and xenobiotic exposure etc. could lead to a total desintegration regulatory syndrome i.e. the primary formation of the functional and preclinical changes on the different levels with the subsequent evolution to distinct clinical pathology. The increase of functional consequences is originated at least in 0,2 - 1 Gy dose limit from the primary initializing defects of regulation predominatly in central and vegetative nervous systems, hormonal-humoral regulation and immune systems interaction. This stand of view supposes the possibility of the low-doses effects diminishment by the use of individual radiation protection.

Radioprotectors are the substances of different origin that increase body resistance to the radiation exposure. Possibility to decrease radiation damage by pretreatment with sodium cyanide and cysteine amino acid was discovered 50 years ago. Since 1949 a lot of such substances were under expertise including mercaptoalkylamines (cystamine, aminoethyl-isothyuronium, gammaphos), indolylalkylamines (serotonine, mexamin), carbamates etc. and some of them were used by military service for radiation effects protection. Majority of these medications had to be injected or digested from 1 to 2 hours before the irradiation and couldn’t be used for a long time period due to the toxic effects. In the case of Chernobyl none of the radioprotectors were used by the radiation-exposed before the accident and most.

The second branch of research was the search of natural compounds that could prevent or diminish radiation effects. Oxidative stress, immunologic deficiency and hemopoetic disorders were revealed as a radiation effects pathways together with elevated frequency of mutations. Additionally disadaptation was the result of psychoemotional stress after the accident and vitamin deficiency due to the nutrition limitations.

Natural compounds and prescriptions possessed actual place in the treatment of radiation exposed during these years due to the several reasons: 
long-time blocking of entry and decorporation of radionuclides, 
strengthening of immunity and other defense systems after the exposure, 
preventive measures of development or seasonal recidives of chronic disorders in large groups of patients living on the contaminated territories, 
necessity of treatment side effects minimization, in particular after cytostatics and radiotherapy of leukemia, lymphomas and oncologic pathology. 

Existence of the established system of health care in our country was supported by the development of the traditional medicine. Its history lasted for thousands of years, scientific examination of medicinal herbs in Ukraine started at the beginning of the XVIII century from the times of Peter the Great. Traditional medicine possessed its actual place and wasn’t replaced by the official pharmacology. To the contrary they interfered and integrated. 192 species of medicinal plants were registered in Ukraine up to 1985. More than 5800 tons of medicinal plants were collected annually since 1975. Botanical characterization, recommendations on collection, preparation and storage were developed and included to the technical documentation such as standards, technical conditions and articles in State Pharmakopea. In our country 45% of all the medications were prepared from the medicinal plants. In treatment of cardiovascular, gastrointestinal, neurological, liver and kidney diseases percentage of medications of natural origin exceeded 80-90%. Investigation of the clinical properties, chemical analysis and characterization were performed on the regular basis before the Pharmacological Committee registration.

RCRM experience includes experimental, preclinical and clinical studies of new medications and nutrition additives in the field of radiation medicine under internationally adopted protocols. Adaptogenous, antioxydative, immunostimulative, antimutagenic and vitaminous preparation were recommended during the first years after the accident. Preparations of ginseng, eleutherococcus, bee poison, beta-carotene, oysters hydrolysate were used during first years. All of them were of complex origin, mild action and practical non-toxicity, so could be used after the exposure.

One of the first tested remedies for the population of the territories, contaminated with the radionuclides was ferrocine (berlin blue), possessing the capacity to reduce cesium - 134 and cesium - 137 entry in a body through gastrointestinal channel. Immunological indices have shown normalization in 28 days and absence of negative changes was reported. Combinations of tropical plants with addition of Echinacea purpurea and Aralia showed their efficiency in transient immunologic deficiencies and infectious and allergic syndrome. Sublimated product of Black Sea mussel’s enzyme hydrolysation also showed antioxydant, radioprotective and anti-oncological properties. Investigation showed the balanced assortment of amine acids, glucoproteids, microelements, tiurine and other biologically active substances, that fix actively free radicals in a radiation-exposed.

Majority of these and other preparations was registered as the nutritive additives and further research was in need to clarify the medical properties and make possible the registration at the Pharmacological Committee.
Uncaria tomentosa (Willd.) DC, was presented in Ukraine in 1996-1997 as a part of different nutritive additives that were supposed to be of immunostimulative, antioxydant and strengthening effect. Common characteristics was the low active substance content and mixture with different other components. So the plant Una de Gato was known but the public and also medical society opinion wasn’t strongly positive at that moment. During 1997 investigations have been started in the hematological and immunological departments of RCRM and Donetsk. Lyophilized extract of Uncaria tomentosa named ManaXX was kindly presented by OMNI-Ukraine the official agent of Liofilizadora del Pacifico Ltda and OMNIAGRO S.A (Peru).
The result was the adoption of the lyophilized extract of a crust of this plant by the Pharmacological Committee as the medical preparation with immunostimulative properties.. The lyophilization seems to be the most effective way of preservation operational a component. 90 mg of an extract are equivalent 3000 ?? of a crust of Uncaria tomentosa. The drug is registered in Ukraine by Pharmacological committee (testimony ?2903 from 25.02.1998 in the medical form of  90 mg tablets.

Multicentric study of ManaXX was performed in Research Center for Radiation Medicine of the Academy of Medical sciences of Ukraine, Donetsk state medical university, Ukrainian Institute of Cardiology, Donetsk state university, Donetsk regional Center of immunology and AIDS protection, Donetsk regional oncological center, Cherniakhov district hospital, Donetsk regional center motherhood and childhood care, Hospital of the Cabinet of Ministries of Ukraine.

For research of clinical efficiency of ManaXX in chronic diseases of the bacterial nature the group of the patients was selected with chronic (not less than 1-2 years) changes of laboratory indices - leukopenia, leukocytosis, lymphocytosis or lymphopenia, monocytosis, that are the signs for the screening of immunodepressive conditions. The clinical symptomatology included pneumonias, tracheobronchites, chronic obstructive bronchitis, and also chronic inflammatory processes of a nasopharynx accompanied with an asthenic syndrome, subfebrile temperature.

ManaXX was prescribed for 25-30 days on 90 mg 3 times per day. Complications and side effects during the treatment were not detected, pathologic process in a nasopharynx was stopped. During the 3-12 months follow- up after the treatment recidives weren’t detected. For all the patients normalization of temperature was marked, which was shown for the last two treatment weeks and at the subsequent follow-up it was within the limits of normal values. The conducted semiquantitative estimation of a patients clinical condition by Karnowsky index has shown authentic increase of efficiency of treatment.

Conducted clinical and experimental research showed anti-viral effect of alkaloids of Uncaria tomentosa. It’s established, that the anti-viral activity is connected to action on DNA-polymerase. In Donetsk regional Center of immunology and AIDS ManaXX was prescribed to 34 HIV-infected patients. The treatment was conducted under 3 schemes: (1) - 90 mg once per day - 3 months; (2) – 90 mg 2 times per day - 3 months; (3) 90 mg 3 times per day - 3 months. The treatment under the scheme ?1 was received by 10, scheme ?2 - 14, scheme ?3 - by 10 patients.

Clinical tests have shown positive outcome for the HIV-carriers and patients with clinical signs of AIDS. It was shown at asymptomatic period and lymphoadenopathy stage along with the improvement of a general condition, absence of negative influence on parameters of a blood and biochemical homeostasis. The increase of ?-helper-inducer levels was detected during a treatment.

In this presentation we summarized the outcomes of treatment of 78 patients with viral infections of a different etiology (Cytomegalovirus, relapsing herpes, genital herpes).
The indications for ManaXX therapy at Cytomegalovirus infection were:
1. Clinical development of the infections (decrease of an index of a clinical-functional condition of a patient by Karnowsky scale;  unmotivated subfebrile conditions; abortions on early terms of pregnancy, pathological changes of a visual analyzer, nervous system);

2. Laboratory signs of immunological insufficiency.
In herpetic infection the indications were the persistence of the process with an ineffectiveness of preceding courses of therapy (anti-herpetic vaccine, acyclovir).

ManaXX was prescribed in 270 mg daily dosage. The duration of therapy varied from 1 about 3 months. As a result of the conducted therapy positive changes of clinical and laboratory parameters were shown in all patients. At cytomegalovirus infection the improvement of a general condition, normalization of temperature within 10-14 days of the treatment was shown. In female patients with early abortions conception occurred and pregnancy finished by birth of healthy children. At 62% of simple herpes patients relapses were not observed during the term of observation (6-9 months), and in 38%  relapses were detected after 3 to 5 months. Repeated course of therapy was in need.
 The clinical improvement was accompanied by positive dynamics of parameters of cellular and humoral immunity, decrease of titers of virus-specific antibodies, normalization of cell activation.
ManaXX efficiency was demonstrated in patients with pathology of infectious-allergic origin. Previously positive effect of Uncaria tomentosa extracts was found in a number of experimental inflammatory conditions and in clinical practice as well (Cabieses, 1994; Obregon Vilches, 1995); with the highest efficiency at extracts application before the influence of an inflammation inducer. These experimental data led to the presumption that ManaXX treatment had to most effective as a prophylaxis drug. Our results in patients with infectious-allergic arthritis have shown ManaXX clinical efficiency as a anti-relapse drug of a preventive maintenance. Complex anti-viral, anti-bacterial and immunomodulatory effect gives chance to check the perspectives of its application at infectious-allergic myocardites caused by herpes simplex virus, cytomegalovirus, enteroviruses and bacterial infections infections. Recent investigations showed that ManaXX implementation in cardiovascular diseases could be wider. Positive effect was demonstrated in patients with rheumatic disease of 1-2 activity grade. 
Clinical chemistry analysis showed cholesterol levels decrease. These findings showed the possibility of action complex action not only on immunological parameters but also on lipid metabolism. Clinical investigation was performed in patients with ischemic heart disease and atherosclerosis. Investigation group received basic treatment and ManaXX 270 mg dayly for 3 weeks. Control group received the basic treatment for the same period. 
Experimental research has allowed to establish, that anti-oncologic effect of Uncaria tomentosa is connected with polyphenol alkaloids, including - epicatechines, procyanidines ?1, ?1, ?2, ?4, isorhynchophilline etc. (Kreutzkamp et al., 1984). It’s revealed that oxyindole alcaloids have the combined effect of oncogenesis and phagocytosis stimulation. Also it was demonstrated that lyophilized extracts have higher efficiency, than separate alkaloids. 

All the data about new methods of oncological patients treatment have to be re-evaluated for several times due to the extreme importance of this problem. We have gained some experience about ManaXX in different kinds of benign and malignant prolipherative disorders  and hope that it would be of interest to scientific audience.

Clinical data from our hematology department have shown that ManaXX can be used as a means of auxiliary therapy at chronic lymphatic leukemia after chemotherapy. It’s efficacy was also seen in patients with CLL 3rd stage who could stand the chemotherapy courses. Cytological research of blast and residual normal cells has found none of the negative effects and no stimulation of leukemia cell clones.

The experience of solid cancer patients  treatment with ManaXX at Donetsk regional oncological center since 1997 had demonstrated no negative side effects, its anti-inflammatory and hemostimulative action after chemotherapy. In a number of patients immunostimulation and analgesive effect was registrated.

Clinical investigation has shown ManaXX efficiency in fibromyoma, especially of interstitial type. Treatment course lasted from 28 to 40 days with daily dosage of 270 mg. Control study in a period of 60-90 days after the treatment has shown clinical improvement and in 11 from- 15 - normalization of menstrual cycle. The clinical efficiency was accompanied by reduction of the node size at ultrasonic investigation from 40 to 70%. 

Clinical data about the Uncaria tomentosa action in oncological disorders arise the problem of action mechanisms in such pathology. Is this action a result of immune system activation and anti-oncological defence? Are immune effects related with the endocrine system changes, there is a complex action? Do these effects predominate or there is some direct action on the malignant cells? The possible answer could include all the possibilities but sophisticated research has to be performed. Experimental chemical studies showed many similar effects of oncosuppression in Uncaria tomentosa derivatives and taxanes. 

The expansion of experimental and clinical efforts would include special program elaboration for antitumor effect studies, injection form preparation, experimental toxicity estimation of new derivatives and full scale preclinical and clinical trials.