Development of a conductive biocomposite combining graphene and amniotic membrane for replacement of the neuronal network of tissue-engineered urinary bladder.

Tissue engineering allows to combine biomaterials and seeded cells to experimentally replace urinary bladder wall. The normal bladder wall however, includes branched neuronal network propagating signals which regulate urine storage and voiding. In this study we introduced a novel biocomposite built from amniotic membrane (Am) and graphene which created interface between cells and external stimuli replacing neuronal network. Graphene layers were transferred without modifying Am surface. Applied method allowed to preserve the unique bioactive characteristic of Am. Tissue engineered constructs composed from biocomposite seeded with smooth muscle cells (SMC) derived from porcine detrusor and porcine urothelial cells (UC) were used to evaluate properties of developed biomaterial. The presence of graphene layer significantly increased electrical conductivity of biocomposite. UCs and SMCs showed an organized growth pattern on graphene covered surfaces. Electrical filed stimulation (EFS) applied in vitro led additionally to increased SMCs growth and linear arrangement. 3D printed chamber equipped with 3D printed graphene based electrodes was fabricated to deliver EFS and record pressure changes caused by contracting SMCs seeded biocomposite. Observed contractile response indicated on effective SMCs stimulation mediated by graphene layer which constituted efficient cell to biomaterial interface.

[Clinical and morphological characteristics of thyroid tumors in children of the Chelyabinsk Region]. / Kliniko-morfologicheskaia kharakteristika opukholei shchitovidnoi zhelezy u detei Cheliabinskoi oblasti.

OBJECTIVE: To carry out a clinical and morphological analysis of thyroid cancer cases in the children of the Chelyabinsk Region. SUBJECT AND METHODS: Thyroid tumor pathology was verified in 50 of the 196 patients aged 7-17 years, who had been operated on in 2000-2016. Clinical and morphological features, including immunohistochemical and ultrastructural characteristics of thyroid cancer, were studied. RESULTS: Over the past 17 years, there has been a decline in the number of children with surgical thyroid diseases, including thyroid carcinomas. There is a predominance of papillary carcinoma (70%) that is characterized by more aggressive clinical and morphological signs than follicular and medullary thyroid carcinoma. The immunophenotype of follicular cell tumors in children is characterized by the expression of growth factors (TTF-1, EGFR-384) and malignancy markers (mesothelial cell, AMACR (P504S), S 100). CONCLUSION: The vector change (decrease) in the long-term unfavorable trend toward an increasing incidence of thyroid cancer in children of the Chelyabinsk Region is currently accompanied by the pathomorphism of thyroid carcinoma.

Unexpected malignant uterine pathology: Incidence, characteristics and outcome in a large single-center series of hysterectomies for presumed benign uterine disease.

OBJECTIVE: Hysterectomy is a frequently used therapeutic option for benign gynecological conditions. The purpose of this study was to investigate the incidence and characteristics of unforeseen malignant pathologies of the uterine corpus in a large population-based, single center cohort. METHODS: Patients who underwent hysterectomy for presumed benign conditions between 2003 and 2016 were identified. In cases of unexpected malignancies of the uterine corpus (UUM), available tissue samples were collected and a specialized gynecopathological review was performed. RESULTS: A total of 10,756 patients underwent hysterectomy for benign indications. After chart and gynecopathological review, 45/10,756 (0.42%) cases of unexpected uterine malignancies were confirmed. 33/45 (73.3%) were endometrial carcinomas (UEC) and 12/45 (26.7%) were uterine sarcomas (UUS). 27/33 (81.8%) UEC were FIGO IA, 5/33 (15.2%) FIGO IB and 1/33 (3%) FIGO stage II disease. Endometrioid and serous histotype were present in 31/33 (93.9%) and in 2/33 (6.1%) cases, respectively. 8/12 (66.7%) USS were early stage (FIGO IA or IB); only 3/12 (25.0%) were diagnosed at an advanced stage (≥FIGO II). Fatal outcome was observed in 1 patient diagnosed with UEC and 3 patients diagnosed with UUS. CONCLUSION: Our study shows that diagnosis of UUM is rare (0.42%). The majority of UUM tend to be early stage, making preoperative diagnosis difficult. In case of UEC, patient outcome is generally favorable. Nevertheless, the appropriate surgical approach for hysterectomy for a benign indication should be chosen carefully, taking all preoperative findings into account. Patients should always be informed about the residual risk of UUM.

[Preventability of perinatal losses by the example of the large industrial cities Chelyabinsk and Novosibirsk]. / Predotvratimost' perinatal'nykh poter' v Cheliabinske i Novosibirske.

Perinatal mortality rate is an indicator that characterizes the quality of medical care, as well as the social and economic situation in the region. OBJECTIVE: to audit perinatal losses in large regional centers of the Russian Federation with a population of over 1 million inhabitants, such as Chelyabinsk and Novosibirsk. MATERIAL AND METHODS: A comprehensive postmortem examination of 309 cases of perinatal losses in 2016 was made, which was supplemented with an assessment of preventability according to the Scandinavian-Baltic classification. RESULTS: The rate of preventable deaths in Chelyabinsk and Novosibirsk amounted to 91 and 81.5% of cases, respectively; the deaths were due to stillbirths at more than 28 weeks' gestation and to dead newborns in almost half of cases. The proportion of intranatal deaths was shown to increase in Chelyabinsk; the number of neonatal deaths at more than 33 weeks' gestation rose in Novosibirsk. CONCLUSION: Supplementing the traditional clinical and postmortem analysis with an assessment of the preventability of perinatal loss makes it possible to ensure a unified approach to evaluating these conditions and the comparability of autopsy results in different subjects of the Russian Federation and to determine regional reserves for reducing perinatal mortality rates.

Contamination-free Ge-based graphene as revealed by graphene enhanced secondary ion mass spectrometry (GESIMS).

In this study, we demonstrate that graphene grown on Ge does not contain any copper contamination, and identify some of the errors affecting the accuracy of commonly used measurement methods. Indeed, one of these, the secondary ion mass spectrometry (SIMS) technique, reveals copper contamination in Ge-based graphene but does not take into account the effect of the presence of the graphene layer. We have shown that this layer increases negative ionization significantly, and thus yields false results, but also that the graphene enhances, by an order of two, the magnitude of the intensity of SIMS signals when compared with a similar graphene-free sample, enabling much better detection limits. This forms the basis of a new measurement procedure, graphene enhanced SIMS (GESIMS) (pending European patent application no. EP 16461554.4), which allows for the precise estimation of the realistic distribution of dopants and contamination in graphene. In addition, we present evidence that the GESIMS effect leads to unexpected mass interferences with double-ionized species, and that these interferences are negligible in samples without graphene. The GESIMS method also shows that graphene transferred from Cu results in increased copper contamination.

Large-area high-quality graphene on Ge(001)/Si(001) substrates.

Various experimental data revealing large-area high-quality graphene films grown by the CVD method on Ge(001)/Si(001) substrates are presented. SEM images have shown that the structure of nano-facets is formed on the entire surface of Ge(001), which is covered by a graphene layer over the whole macroscopic sample surface of 1 cm(2). The hill-and-valley structures are positioned 90° to each other and run along the <100> direction. The hill height in relation to the valley measured by STM is about 10 nm. Raman measurements have shown that a uniform graphene monolayer covers the nano-facet structures on the Ge(001) surface. Raman spectroscopy has also proved that the grown graphene monolayer is characterized by small strain variations and minimal charge fluctuations. Atomically resolved STM images on the hills of the nanostructures on the Ge(001) surface have confirmed the presence of a graphene monolayer. In addition, the STS/CITS maps show that high-quality graphene has been obtained on such terraces. The subsequent coalescence of graphene domains has led to a relatively well-oriented large-area layer. This is confirmed by LEED measurements, which have indicated that two orientations are preferable in the grown large-area graphene monolayer. The presence of large-area coverage by graphene has been also confirmed by low temperature Hall measurements of a macroscopic sample, showing an n-type concentration of 9.3 × 10(12) cm(-2) and a mobility of 2500 cm(2) V(-1) s(-1). These important characteristic features of graphene indicate a high homogeneity of the layer grown on the large area Ge(001)/Si(001) substrates.

[Actually a routine matter: ischemia after catheterization of the radial artery]. / Eigentlich eine Routinemaßnahme : Ischämie nach A.-radialis-Kanülierung.

A 76-year-old patient developed necrosis of the index finger after placement of a radial artery catheter. This article discusses the risks associated with invasive blood pressure monitoring and treatment options in cases of critical ischemia. The authors conclude that there is no consensus concerning optimal treatment and that a discussion on options for preoperative risk assessment and quickest possible recognition of such complications is worthwhile. Despite the risk of ischemia invasive blood pressure monitoring is an indispensable procedure.

[Thyroid morphology in a children population living in the environmentally polluted area].

Comprehensive study of the "normal" thyroid gland in fetuses and children of different age groups in the Chelyabinsk region revealed a number of changes characteristic of the so-called dysregulation pathology. The role of ecological factors and outcome of resuscitation and intensive therapy in these changes is discussed. It is shown that the development and manifestation of tumoral and non-tumoral diseases of thyroid gland prone to a combination of various diseases are delayed till the school age.

Primary anastomosis vs Hartmann's procedure in patients undergoing emergency left colectomy for perforated diverticulitis.

OBJECTIVE: Comparison of primary anastomosis (PA) and Hartmann's procedure (HP) in perforated diverticulitis is biased as the patient groups are different in age, comorbidity and severity of disease. Still, PA has been advocated as the procedure of choice. The aim of this study was to compare the two surgical procedures after eliminating this selection bias using a propensity score model. METHOD: Sixty-five HP and 46 PA patients who underwent emergency laparotomy for perforated diverticulitis were analysed. Multivariate logistic regression using the Mannheim peritonitis index, Colorectal Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity, Charlson comorbidity index and Hinchey score was performed to determine the propensity score. RESULTS: Patients with HP had significantly higher scores, median age and were more often on immunosuppressive medication. Unadjusted logistic regression for outcome showed a significant risk of HP vs PA for nonsurgical morbidity (odds ratio 3.25, 95% CI: 1.26-8.43; P = 0.015), but not for mortality and surgical morbidity. After adjusting for the propensity score, outcome was not significantly different. Patients with PA had a clinical leak rate of 28% and none of the patients with leakage had a protective ileostomy. Patients with PA and leak had higher Charlson scores whereas all other scores were similar to nonleak patients. CONCLUSION: The theory that PA is generally superior to HP cannot be supported. HP remains a safe technique for emergency colectomy in perforated diverticulitis, especially in elderly patients with multiple comorbidities. If PA is performed, a protective ileostomy must be considered.

Effect of bisacodyl on postoperative bowel motility in elective colorectal surgery: a prospective, randomized trial.

BACKGROUND: Postoperative ileus is a common condition after abdominal surgery. Many prokinetic drugs have been evaluated including osmotic laxatives. The data on colon-stimulating laxatives are scarce. This prospective, randomized, double-blind trial investigates the effect of the colon-stimulating laxative bisacodyl on postoperative ileus in elective colorectal resections. MATERIALS AND METHODS: Between November 2004 and February 2007, 200 consecutive patients were randomly assigned to receive either bisacodyl or placebo. Primary endpoint was time to gastrointestinal recovery (mean time to first flatus passed, first defecation, and first solid food tolerated; GI-3). Secondary endpoints were incidence and duration of nasogastric tube reinsertion, incidence of vomiting, length of hospital stay, and visual analogue scores for pain, cramps, and nausea. RESULTS: One hundred sixty-nine patients were analyzed, and 31 patients discontinued the study. Groups were comparable in baseline demographics. Time to GI-3 was significantly shorter in the bisacodyl group (3.0 versus 3.7 days, P = 0.007). Of the single parameters defining GI-3, there was a 1-day difference in time to defecation in favor to the bisacodyl group (3.0 versus 4.0 days, P = 0.001), whereas no significant difference in time to first flatus or tolerance of solid food was seen. No significant difference in the secondary endpoints was seen. Morbidity and mortality did not differ between groups. CONCLUSION: Bisacodyl accelerated gastrointestinal recovery and might be considered as part of multimodal recovery programs after colorectal surgery.

[Membrane plasmapheresis in complex treatment of endogenous intoxication in diffuse peritonitis of appendicular genesis in children]. / Membrannyi plazmaferez u kompleksnomu likuvanni endohennoï intoksykatsiï pry rozlytomu perytoniti apendykuliarnoho henezu u diteï.

With the aim to lower the degree of endogenous intoxication in 9 children with diffuse peritonitis of appendicular genesis the membrane plasmapheresis with the plasma exchange was used in complex of postoperative treatment. Depending on severity of clinical course of the disease there were conducted two procedures on the 2-3 and 5-7 postoperative day to every patient. Application of the membrane plasmapheresis in complex of treatment had promoted the reduction of the endogenous intoxication degree due to influence on its main pathogenetic chains and the immune systemic reactivity raising.

[Influence of hyperbaric oxygenation on clinico-immunologic indices in children with acute diffuse peritonitis]. / Vplyv hiperbarychnoï oksyhenatsiï na kliniko-imunolohichni pokaznyky u ditei z hostrym rozlytym perytonitom.

The impact of hyperbaric oxygenation (HBO) on clinical-immunologic indexes in complex treatment of an acute diffuse peritonitis of appendicular genesis in children was studied up. Efficacy of the HBO application in moderate immunodepressive state, registered in this disease, was noted.

[The influence of intra-abdominal electrophoresis and enteral sorption on the immune indices in children with peri-appendicular abscess]. / Vplyv vnutrishn'oabdominal'noho elektroforezu ta enterosorbtsiï na imunni pokaznyky u ditei z periapendykuliarnym abstsesom.

Comparative characteristic of application of different methods of intratissue electrophoresis and their influence on immune indexes in children with perioappendicular abscess was presented. Application of complex treatment with usage of intraabdominal electrophoresis and enterosorption had guaranteed an effective correction of systemic and local immune disorders, the peritoneal macrophages activation, improvement of cytokines cooperation of cells in the immune answer.

[Complications in children with ulcerative colitis after total colectomy and J-pouch]. / Komplikationen bei Kindern mit Colitis ulcerosa nach totaler Kolektomie und J-Pouch-Anlage.

Our experience with proctocolectomy and the J-pouch procedure in eight children with ulcerative colitis is reported. The mean age at diagnosis was 8.4 years, and the mean time between diagnosis and colectomy was 2.2 years. We decided on a three-stage operation. The protective ileostomy was removed after approximately 4 months pouch-training. Two patients suffered pouchitis as a specific complication. An ileus occurred in two patients, one patient had a serious eosinophilic enteritis, and two children had multiple abdominal wall abscesses. All patients showed a significant increase in height velocity and the prepubertal patients experienced catch-up growth after the colectomy. All patients are continent during the day. Our experience suggests that proctocolectomy and the ileoanal-J-pouch procedure provide improved growth, continence and a low incidence of surgical complications.