МОРФОЛОГІЧНІ ЗМІНИ ЕКВІВАЛЕНТА СТРОМИ РОГІВКИ, ОТРИМАНОЇ МЕТОДОМ ДЕЦЕЛЮЛЯРИЗАЦІЇ

Introduction. Diseases and injuries of the cornea are a major cause of vision impairment and blindness. Currently, the best treatment for restoring vision in patients with corneal blindness is transplantation with donor-derived corneal tissue.  Decellularized corneas are among the most promising materials for engineering corneal tissue since they replicate the complex structure and composition of real corneas. Decellularization is a process that aims to remove cells from organs or tissues resulting in a cell-free scaffold consisting of the tissues extracellular matrix. Due to the deficiency of the donor human cornea and the low efficiency of its transplantation in some types of corneal pathology, the search for alternative materials for keratoplasty is relevant, which has stimulated the search for different methods of manufacturing and using xeogenic grafts. The aim of the study – to learn the morphofunctional changes of the equivalent of the stroma of the cornea, removed from the eyes of pigs and obtained by the method of decelularization in order to further its use as a material for keratoplasty. Research Methods. The corneal membrane obtained from the removed eyes of pigs is placed in a tissue culture medium, after which it is decelerized. Treated with 0.5 % solution of sodium dodecyl sulfate with constant shaking; treated with ultrasound (three times), incubate in the presence of an enzyme solution of papain; washed with buffer solution (pH 6.5), centrifuged. Place in a solution of polyvinylpyrrolidone for storage. Results and Discussion. The morphofunctional state of the equivalent of the corneal stroma obtained by the method of decelularization was studied. Microscopically in histological preparations of the equivalent of the corneal stroma obtained by the method of decelularization, the destruction of the anterior and posterior epithelium of the cornea is detected. The surface of its own substance is limited by a dense anterior border plate (Bowman's membrane), there are remnants of multilayered squamous non-keratinized epithelium. Histological examinations showed that the homogeneity of its structure is lost in the corneal's own substance, the connective tissue plates are stratified, and the corneal's own substance acquires a reticular appearance. In some areas of the histological section of the decelularized cornea in the spaces between the bundles of collagen fibrils of its own substance, destructively altered oblong fibroblasts are microscopically observed, their nuclei are intensely basophilic, the cytoplasm is not contoured. Conclusion. Thus, it is histologically established that the decelularization of the cornea leads to significant changes in its morphological state, associated with the destruction of the cellular component of epithelial tissues and the defibering of collagen bundles of substantia propria with the formation of a network. These microscopic changes indicate that the use of developed technique of decelularization is effective to obtain the equivalent of the xenocorneal stroma for transplantation. Further development and improvement of these methods, wider introduction into clinical practice is one of the most relevant and promising areas of ophthalmotransplantology.Вступление. Использование ксеногенного трансплантационного материала в современных ус­ловиях широко признано в различных сферах медицины. На фоне резкого увеличения человеческого травма­тиз­ма, нарушения экологического баланса биосферы растет доля патологий роговицы, поэтому возникла проблема дефицита донорского материала в офтальмологии. В связи с дефицитом донорской чело­веческой роговицы и низкой эффективностью ее пересадки при некоторых видах роговичной патологии, актуальным является поиск альтернативных материалов для кератопластики, что и стало стимулом к ​​поиску различных методик изготовления и применения ксеногенных трансплантатов. Цель исследования – изучить морфофункциональные изменения эквивалента стромы роговицы, удаленной с глаз свиней и полученной методом децелюляризации, с целью дальнейшей возможности ее применения в качестве материала для кератопластики. Методы исследования. Роговицу, полученную из удаленных глаз свиней, размещают в среде для культивирования ткани, после чего проводят ее децелюляризацию. Обрабатывают 0,5 % раствором додецилсульфата натрия при постоянном встряхивании; обрабатывают ультразвуком (трижды), осуществляют инкубацию в присутствии ферментного раствора папаина; промывают буферным раствором (pH 6,5), центрифугируют. Помещают в раствор поливинилпирролидона для хранения. Результаты и обсуждение. Исследовано морфофункциональное состояние эквивалента стромы роговицы, полученной методом децелюляризации. Микроскопически в гистологических препаратах эквивалента стромы роговицы, полученной методом децелюляризации, выявляют деструкцию переднегои заднего эпителиев роговицы. Поверхность собственного вещества ограничена плотной передней пограничной пластинкой (мембраной Боумена), есть остатки многослойного плоского неороговевающего эпителия, но эпителиоциты в его составе значительно изменены, плохо контурируются их плазмолемы, в отечной цитоплазме расположены пикнотичные, интенсивно базофильные ядра. Гистологические исследования показали, что в собственном веществе роговицы теряется гомогенность ее структуры, соединительнотканные пластинки расслоенные, собственное вещество роговицы приобретает сетчатый вид. На отдельных участках гистологического среза децелюляризованной роговицы в пространствах между пучками коллагеновых фибрилл собственного вещества микроскопически наблюдают деструктивно измененные продолговатой формы фибробласты, ядра их интенсивно базофильные, цитоплазма не контурируется. Выводы. Гистологически установлено, что децелюляризация роговицы приводит к значительным изменениям ее морфологического состояния, связанным с деструкцией клеточного компонента как эпителиальных тканей, так и собственного вещества, разволокнением пучков коллагена с образованием сетки. Данные микроскопические изменения указывают на эффективность применения разработанной методики децелюляризации с целью получения эквивалента стромы ксенороговицы для трансплантации. Дальнейшие разработка и совершенствование этих методов, более широкое внедрение в клиническую практику являются одним из наиболее актуальных и перспективных направлений офтальмотрансплантологии.Вступ. Використання ксеногенного трансплантаційного матеріалу за сучасних умов широко визнано в різних сферах медицини. На фоні різкого збільшення людського травматизму, порушення екологічного балансу біосфери зростає частка патологій рогівки, тому постала проблема дефіциту донорського матеріалу в офтальмології. У зв’язку з дефіцитом донорської людської рогівки та низькою ефективністю її пересадки при деяких видах рогівкової патології, актуальним є пошук альтернативних матеріалів для кератопластики, що й стало стимулом до пошуку різних методик виготовлення і застосування ксеногенних трансплантатів. Мета дослідження – вивчити морфофункціональні зміни еквівалента строми рогівки, видаленої з очей свиней та отриманої методом децелюляризації, з метою подальшої можливості її застосування як матеріалу для кератопластики. Методи дослідження. Рогівку, отриману з видалених очей свиней, розміщують у середовищі для культивування тканини, після чого проводять її децелюляризацію. Обробляють 0,5 % розчином додецилсульфату натрію при постійному струшуванні; обробляють ультразвуком (тричі), здійснюють інкубацію за присутності ферментного розчину папаїну; промивають буферним розчином (pH 6,5), центрифугують. Поміщають у розчин полівінілпіролідону для зберігання. Результати й обговорення. Досліджено морфофункціональний стан еквівалента строми рогівки, отриманої методом децелюляризації. Мікроскопічно в гістологічних препаратах еквівалента строми рогівки, одержаної методом децелюляризації, виявляють деструкцію переднього та заднього епітеліїв рогівки. Поверхня власної речовини обмежена щільною передньою пограничною пластинкою (мембраною Боумена), наявні залишки багатошарового плоского незроговілого епітелію, але епітеліоцити в його складі значно змінені, погано контуруються їх плазмолеми, в набряклій цитоплазмі розташовані пікнотичні, інтенсивно базофільні ядра. Гістологічні дослідження показали, що у власній речовині рогівки втрачається гомогенність її структури, сполучнотканинні пластинки розшаровані, власна речовина рогівки набуває сітчастого вигляду. На окремих ділянках гістологічного зрізу децелюляризованої рогівки в просторах між пучками колагенових фібрил власної речовини мікроскопічно спостерігають деструктивно змінені подовгастої форми фібробласти, ядра їх інтенсивно базофільні, цитоплазма не контурується. Висновки. Гістологічно встановлено, що децелюляризація рогівки призводить до значних змін її морфологічного стану, пов’язаних із деструкцією клітинного компонента як епітеліальних тканин, так і власної речовини, розволокненням пучків колагену з утворенням сітки. Дані мікроскопічні зміни вказують на ефективність застосування розробленої методики децелюляризації з метою отримання еквівалента строми ксенорогівки для трансплантації. Подальші розробка та вдосконалення цих методів, ширше впровадження в клінічну практику є одним із найбільш актуальних і перспективних напрямків офтальмотрансплантології

A clinical case of small intestinal intussusception caused by metastatic melanoma

Intestinal obstruction is observed in about 9.0 % of patients with acute surgical pathology of the abdominal cavity. The disease occurs at any age, but more often between 25–50 years. Mixed intestinal obstruction is only 3–7 %. The most common form of mixed intestinal obstruction is intestinal invasion. The most common cause of intussusception in adults is an intestinal tumor. Early diagnosis and the optimal amount of surgical treatment are the main components of successful treatment of the patient. Aim: to familiarize practitioners with a rare case of intestinal obstruction in adults and its management strategies in a surgical hospital. Materials and methods. The patient was treated in the surgical department of the Communal Non-Profit Enterprise “City Hospital No. 7” Zaporizhzhia City Consul. The patient underwent preoperative preparation and surgical intervention. Results. The patient underwent an emergency median laparotomy under total intravenous anesthesia with artificial lung ventilation. During the examination of the abdominal cavity, multiple distended loops of the small intestine were visualized. During the revision, at a distance of 1.5 meters from the ligament of Treitz, a volumetric formation of the small intestine of dense-elastic consistency, represented by small-intestinal invasion, up to 10 cm long, was detected. The proximal sections of the small intestine are distended, light purple in color. The sections of the small intestine that were distal to the site of invasion were inflamed. Manual disinvagination of the small intestine was performed. The visual examination showed that the intestine was viable. There was a tumor was found on the antrumeral margin, measuring 1.8 × 2.5 cm, dense in consistency, finely tuberculated, dark purple heterogeneous in color, infiltrating and deforming the wall of the small intestine. Resection of the invaded area of the small intestine with the tumor was performed with the imposition of a small-small intestinal anastomosis “side to side” with two-row nylon sutures. Conclusions. In this clinical case, it was possible to establish the final diagnosis and determine further surgical strategy only intraoperatively. Only early diagnosis of melanoma will allow avoiding the complications identified in this patient

Surgical treatment of patients with nodular toxic goiter

Nodular toxic goiter (NTG) accounts for 7.3 % to 10.0 % of the goiter population. There are difficulties in the preoperative differential diagnosis between NTG and other thyroid diseases. There is also controversy about the benefits of resection surgery over thyroidectomy in patients with NTG. The aim of the study: a comparative assessment of the diagnosis and treatment results of patients with NTG in the early and late postoperative periods after resection surgery and thyroidectomy. Materials and methods. The study enrolled 51 patients with NTG. The mean age of patients in the group was 51.7 ± 12.9 years. Results. Bilateral multinodular lesions prevailed – 34 (66.7 %) patients. Free T3 level was measured only in 15 (29.4 %) patients, 7 (46.7 %) of them had elevated T3 level. 15 (29.4 %) patients underwent hemithyroidectomy including the isthmus, 2 (3.9 %) had subtotal resection, 34 (66.7 %) patients underwent thyroidectomy. Conclusions. Multinodular bilateral thyroid lesions dominated the structure of NTG – 34 (66.7 %) patients who underwent thyroidectomy. Uninodular and multinodular unilateral pathology was diagnosed only in 17 (33.3 %) patients who underwent organ-preserving surgery. The measurements of free T3 level in patients with NTG allowed the diagnosis of T3-thyrotoxicosis in almost half of patients (46.7 %), which is a diagnostic criterion for detection of functional nodal autonomy. Following the organ-preserving surgery, 17 (33.3 %) patients with NTG required the use of hormone replacement therapy with levothyroxine at a mean dose of 25.0 (25.0; 50.0) mcg/day in the late postoperative period (>1 year)

Assessment of the condition severity and prediction of postoperative complications in elderly and senile patients with perforated gastric and duodenal ulcer

Aim. To assess the condition severity and predict postoperative complications and mortality in elderly and senile patients with perforated gastric and duodenal ulcer using the P-POSSUM score. Materials and methods. To conduct a scientific study, 80 (100.0 %) cases of treatment for patients aged 60 to 89 years with a diagnosis of gastric or duodenal ulcer perforation were analyzed. At the stage of hospitalization, the general condition was assessed using the variables of the P-POSSUM score. All patients underwent emergency surgery. Results. The obtained sum of points was compared with postoperative complications and mortality. We defined the discrimination point as >43 points for postoperative complications and >48 points for mortality. Based on the result, the patients were divided into group A with a sum of points up to 43 inclusive – 39 patients (48.8 %), and with a greater number of points – 41 patients (51.2 %) – group B. Evaluation of the detected complications in the postoperative period and comparison with the sum of points significantly confirmed an increase in their frequency in group B (sum of points >43) as compared to group A (sum of points ≤43) – p = 0.0018, U = 474.0. To compare the mortality rate, all the patients were divided into group C – 48 (60.0 %) patients with a sum of points ≤48, and group D – 32 patients (40.0 %) with a sum of points ≥49. In the group of patients with a total score >48 (group D), the mortality rate was significantly increased compared to group C with a score ≤48, p = 0.0002, U = 384.0. Conclusions. Our study has led to the following conclusions: the P-POSSUM score use in elderly and senile patients with perforated gastric and duodenal ulcers significantly confirms the increase in the frequency of postoperative complications, in group A – 6 (15.4 %) patients, while in group B – 23 (56.1 %), p = 0.0018, U = 474.0 and increased mortality, in group C – 6.3 %, in group D – 56.3 %, p = 0.0002, U = 384.0; the P-POSSUM score provides reliable prediction an increase in the risk of postoperative complications and mortality. This, in turn, makes it possible to predict and change treatment approaches and improve the quality of emergency surgical care for elderly and senile patients

Assessment of senile asthenia syndrome using the Frailty and Edmonton frail scales in elderly and senile patients who underwent emergency abdominal surgery

The aim of the work was to compare the effectiveness of the assessment of senile asthenia syndrome using the Frailty and Edmonton Frail scales in elderly and senile patients undergoing emergency abdominal surgery. Materials and methods. The study included 80 patients aged 60 to 89 years with a diagnosis of acute calculous cholecystitis. A correlation was determined between asthenia and the severity of the patient’s condition according to the P-POSSUM scale, the peak value of the increase in the risk of postoperative complications and mortality occurs in patients with a sum of points >32, p = 0.012. The syndrome of senile asthenia using the Edmonton Frail scale was detected in 30 (37.5 %) patients, according to the Frailty scale – 32 (40.0 %), U = 3120.0, p = 0.7862. Results. The main advantage of the Edmonton Frail scale is the examination time of 22 ± 3 min, while with the Frailty scale 360 ± 22 min (U = 24.5, p < 0.0001). Based on the assessment of the severity of the condition using the P-POSSUM scale, we determined a direct correlation of average strength between the presence of asthenia and the number of points: Edmonton Frail subgroup A – rs = 0.81, p = 0.000001. The same results, respectively, on the Frailty scale – rs = 0.78, p = 0.000004. The frequency of complications increases significantly in the category of patients with asthenia, which is confirmed by both the Edmonton Frail scale – 23.3 % (U = 605.0, p = 0.0087), and the Frailty scale – 21.9 % (U = 632.0, p = 0.0150). Conclusions. The frequency of detection of senile asthenia syndrome using the Edmonton Frail and Frailty scale in patients was equivalent (U = 3120.0, p = 0.7862). The Edmonton Frail scale is more convenient to use in urgent situations, and the mean time to diagnose asthenia using it was 22 ± 3 min, while the complete diagnosis using the Frailty scale took 360 ± 22 min (U = 24.5, p < 0.0001). A significant increase in the frequency of postoperative complications was determined in the category of patients with asthenia, confirmed both by the Edmonton Frail scale – 23.3 % (U = 605.0, p = 0.0087), and by the Frailty scale – 21.9 % (U = 632.0, p = 0.0150)

Influence of microorganisms on the underground metal constructions corrosion

Проаналізовано основні аспекти впливу ґрунтових мікроорганізмів на корозію підземних металоконструкцій (трубопроводи, нафтове обладнання). Вснановлено, що крім корозійно-механічної природи пошкодження труб підземних трубопроводів мають і біологічну складову. Вона спричиняє деструкцію захисного ізоляційного покриття під дією асоціатів ґрунтових мікроорганізмів. Доведено, що, корозійний процес нафтогазового обладнання слід розглядати не як лише фізико-хімічне явище процес, а обов’язково враховувати вплив біологічної деградації. Вплив біологічних міркоорганізмів зумовлює окрихчення сталей із подальшим утворенням пітингів та тріщиноподібних дефектів, які можуть спричинити катастрофічне руйнування трубопроводу. Модифікацією бітумно-полімерної мастики МБПІД-1 інгібіторами корозії з класу амінів (А) та четвертинних амонійних солей (ЧАС) отримано біостійкі інноваційні протикорозійні покриття та вивчено їх характеристики. Досліджено бактерицидну активність запропонованих інгібіторів. Адгезія стрічки до мастики не залежить від рецептури композицій ізоляційного покриття. Встановлено, що адгезія мастики до заґрунтованого металу була вищою порівняно з базовою композицією для рецептур з інгібітором (А) та інгібітором (ЧАС) на 36,0 та 24,0% відповідно. Проведено дослідно-промислові випробування розроблених біостійких покриттів у трасових умовах на магістральних газопроводах Західного та Південного регіонів. Результати випробувань підтвердили їх високу ефективність у забезпеченні протикорозійного та мікробіологічного захисту підземних металоконструкцій.Technical problem of the analysis of failure and evaluation of degradation of the structural materials mechanical properties after their operational degradation is of importance for all critical structures, for main oil pipelines in particular. Analysis of the condition of operated pipelines is focused on the condition of the outer surface of the pipe, including the protective properties of coatings and possible damage from the outer surface. However, the pipelines which have been used for a long time are often characterized by multiple corrosion damages of the internal surfaces of pipes, which should also be considered. Corrosion damage to the pipe steel is not a separate problem, but a complex degradation factor, as it causes material embrittlement and hydrogenation. The basic aspects of the soil microorganisms impact on corrosion of underground metal structures (pipelines, oil equipment) have been analysed. It was determined that beside corrosion-mechanic damages the underground pipelines are subject to biological degradation, which causes the failure of the protective insulating coating under associates of soil microorganisms. It was proved, that the corrosion process of gas equipment should be considered not only as a physical-chemical phenomenon process, but the biological degradation impact must be taken into account. The impact of biological microorganisms caused the embrittlement of steels with further pittings and crack- like defects, which can results in the failure of the pipeline. Modification of bitumen-polymer mastic MBPID -1 by corrosion inhibitor class of amines (A) and quaternary ammonium salts (QAS) has resulted in obtaining biostable innovative anticorrosive coating and studying of their characteristics. Bactericidal activity of the proposed inhibitors has been investigated. Adhesion to mastic tape does not depend on the formulation of compositions coating. It was established that adhesion of mastic to primed metal was higher than that compared with the base composition for recipes inhibitor (A) and inhibitor (QAS) by 36.0 and 24.0 %, respectively. A pilot- scale tests of the designed biostable coating in highway conditions of gas pipelines in Western and Southern regions have been carried out. The test results aproved their high efficiency in providing corrosion and microbiological protection of underground metal constructions

The Theoretical Description for Chlorantraniliprole Electrochemical Determination, Assisted by Squaraine Dye – Nano-CuS Composite

The theoretical description for the chlorantraniliprole electrochemical determination, assisted by the hybrid composite of squaraine dye with CuS nanoparticles has been described. The correspondent reaction mechanism has been proposed, and the correspondent mathematical model has been developed and analyzed by means of linear stability theory and bifurcation analysis. It has been shown that the chlorantraniprole electrochemical anodical determination on high potential may be efficiently provided by cupper sulfide nanoparticles, stabilized by the squaraine dye. On the other hand, the oscillatory and monotonic instability is also possible, being caused by DEL influences of the electrochemical stage. DOI:&nbsp;http://dx.doi.org/10.17807/orbital.v13i3.151

Pandemic Boredom: Little Evidence That Lockdown-Related Boredom Affects Risky Public Health Behaviors Across 116 Countries

Some public officials have expressed concern that policies mandating collective public health behaviors (e.g., national/regional "lockdown ") may result in behavioral fatigue that ultimately renders such policies ineffective. Boredom, specifically, has been singled out as one potential risk factor for noncompliance. We examined whether there was empirical evidence to support this concern during the COVID-19 pandemic in a large cross-national sample of 63,336 community respondents from 116 countries. Although boredom was higher in countries with more COVID-19 cases and in countries that instituted more stringent lockdowns, such boredom did not predict longitudinal within-person decreases in social distancing behavior (or vice versa; n = 8,031) in early spring and summer of 2020. Overall, we found little evidence that changes in boredom predict individual public health behaviors (handwashing, staying home, self-quarantining, and avoiding crowds) over time, or that such behaviors had any reliable longitudinal effects on boredom itself. In summary, contrary to concerns, we found little evidence that boredom posed a public health risk during lockdown and quarantine

Intentions to be Vaccinated Against COVID-19:The Role of Prosociality and Conspiracy Beliefs across 20 Countries

Understanding the determinants of COVID-19 vaccine uptake is important to inform policy decisions and plan vaccination campaigns. The aims of this research were to: (1) explore the individual- and country-level determinants of intentions to be vaccinated against SARS-CoV-2, and (2) examine worldwide variation in vaccination intentions. This cross-sectional online survey was conducted during the first wave of the pandemic, involving 6697 respondents across 20 countries. Results showed that 72.9% of participants reported positive intentions to be vaccinated against COVID-19, whereas 16.8% were undecided, and 10.3% reported they would not be vaccinated. At the individual level, prosociality was a significant positive predictor of vaccination intentions, whereas generic beliefs in conspiracy theories and religiosity were negative predictors. Country-level determinants, including cultural dimensions of individualism/collectivism and power distance, were not significant predictors of vaccination intentions. Altogether, this study identifies individual-level predictors that are common across multiple countries, provides further evidence on the importance of combating conspiracy theories, involving religious institutions in vaccination campaigns, and stimulating prosocial motives to encourage vaccine uptake.</p

Predictors of adherence to public health behaviors for fighting COVID-19 derived from longitudinal data

The present paper examines longitudinally how subjective perceptions about COVID-19, one's community, and the government predict adherence to public health measures to reduce the spread of the virus. Using an international survey (N = 3040), we test how infection risk perception, trust in the governmental response and communications about COVID-19, conspiracy beliefs, social norms on distancing, tightness of culture, and community punishment predict various containment-related attitudes and behavior. Autoregressive analyses indicate that, at the personal level, personal hygiene behavior was predicted by personal infection risk perception. At social level, social distancing behaviors such as abstaining from face-to-face contact were predicted by perceived social norms. Support for behavioral mandates was predicted by confidence in the government and cultural tightness, whereas support for anti-lockdown protests was predicted by (lower) perceived clarity of communication about the virus. Results are discussed in light of policy implications and creating effective interventions