In 75 knee joints of 46 adult rabbits osteochondral defects of 4 mm diameter were placed by a drill reaching the cancellous bone. Twenty-three defects were left untreated, or closed by collagen foam or fibrin adhesive, or a combination of both. Fifty-two defects were closed with very small autologous cartilage fragments and a special fibrin adhesive. The adhesive differed from commercially supplied types by digested alpha chain of fibrinogen for increase in concentration, and by the addition of alpha-2-macroglobulin as protease-inhibitor. In most cases small pieces of collagen foam were added for hemostasis. In the first group of 23 joints observed over up to 40 weeks, no hyaline cartilage was found histologically in any of the defects. In the second group a rapid proliferation of chondrocytes appeared with development of hyaline cartilage with alcianblue-positive matrix. It resembled juvenile cartilage in its histologic appearance and with regard to the induction of ossification. The phenomenon is interpreted as a "second adolescence" of the adult cartilage induced by the rich nutritional and oxygen supply from the cancellous vessels, which resembles the environmental conditions before the forming of subchondral cortical bone at the end of the growth period. This method enabled us to achieve a complete closure of defects by hyaline cartilage on the very level of the surrounding articular surface.
The overall incidence of proximal endoleak after EVAS is 3.1% after a mean follow-up period of 16 months, with 1.5% occurring within 30 days. Their occurrence is related to patient selection and stent positioning. Early detection and classification is crucial to avoid the potential of sac rupture.
EVAS in the acute setting appears safe and feasible and concordant with the literature for endovascular aneurysm repair. More robust prospective and comparative data are required to establish the position of the technique in the treatment algorithm of acute AAA.
The fascia closure technique during EVAR is safe and has few complications. The low frequencies of pseudoaneurysms and other access site complications make the femoral closure technique a durable alternative.
Background. Blood conservation with antifibrinolytics, topical hemostatics, and strict transfusion triggers are becoming commonplace in cardiac surgery. The aim of this study was to evaluate the effect of a blood conservation protocol centering on standardized intraoperative autologous blood donation (IAD) use in cardiac surgery.Methods. We reviewed charts of patients who underwent cardiac surgery at our hospital over an 8-year period to analyze transfusion tendencies before and after a new blood conservation policy was implemented. Propensity score matching was used to account for population differences in preoperative and perioperative covariates.Results. Over an 8-year period (January 2009 to December 2017) 1002 patients were studied. Three hundred fifty-two patients before the new blood conservation policy (group 1) were compared with 650 patients after the change (group 2). Fewer group 2 patients required
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