Aim The main aim of this study was to find out standardized
method for preventive stenting of biliary tract anastomosis
with biodegradable self-expandable stent from polydioxanone and
evaluate function of the stent. Materials and methods This
experimental study was performed in four pigs with follow up of
eight weeks. Procedure was done under general anesthesia. The
function of the stent was verified by by clinical stage, blood
test, magnetic resonance cholangiopancreatography and necropsy.
Results Our duodenum sparing technique was described in detail
and photographically documented. All pigs finished follow up
without clinical, laboratory or radiologic signs of biliary
obstruction. Necropsy did not reveal complication of the
procedure or anastomotic stricture. Conclusions In conclusion
this study demonstrated simple new duodenum sparing method of
transanastomotic insertion of biodegradable self-expandable
stent from polydioxanone. We did not find any complication
during follow up. This method will be used in our follow up
study with extended experimental a control group of animals and
longer follow up to verify the preventive function of this
stent.
The main aim of this study was to find a standardized method for preventive stenting of biliary tract anastomosis with biodegradable self-expandable stent from polydioxanone and to evaluate the functionality of the stent. The experimental study was conducted using four pigs with a follow-up of eight weeks. The procedure was done under general anaesthesia. The function of the stent was verified by clinical stage, blood test, magnetic resonance cholangiopancreatography and necropsy. Our duodenum sparing technique was described in detail and photographically documented. All pigs finished the follow-up period without clinical, laboratory or radiologic signs of biliary obstruction. Necropsy did not reveal complication of the procedure or anastomotic stricture. In conclusion, this study demonstrated a simple new duodenum sparing method of transanastomotic insertion of a biodegradable self-expandable stent from polydioxanone. We did not find any complications during the follow-up. This method will be used in our follow-up study with an extended experimental control group of animals and a longer follow-up period to verify the preventive functionality of this stent.
After intervertebral disk surgery we often have to deal with various complications (seizures, gastrointestinal tract (GIT) ulcerations, cystitis, and surgical wound healing problems). These complications may lead to the death of the patient. We performed clinical and laboratory investigations in 161 dogs with an intervertebral disc disease. After that, we performed a cranial (n = 31), caudal (n = 125) or both (n = 5) types of myelography at the same time, and surgery - ventral slot decompression (SLOT) (n = 18) or hemilaminectomy (n = 143). During the postsurgical period we observed seizures, GIT complications, cystitis, and surgical wound healing problems or even death of the patients. These complications appeared to be related to the lesion site, the degree of clinical signs and the type of surgical procedure. In our study we found a higher incidence of seizures after cranial myelography, higher incidence of gastrointestinal (GI) complications particularly in paraplegic dogs, and a higher risk of death in patients after the SLOT surgery. The occurrence of cystitis was not significant ( p = 0.5524, p = 0.1655, respectively). We consider seizures, GI ulcerations, and death the most frequent complications after intervertebral disc surgery. Their incidence depends on the lesion site and the degree of neurologic symptoms.
Arterial occlusion due to thrombosis caused by ruptured atherosclerotic plaques (Baba et al., 1975) has been recognized as a major cause of morbidity and mortality in western populations. Thrombosis may occur in various sections of arterial circulation, peripheral arteries of the limbs, coronary arteries, brain arteries, or both major and minor vessels within the abdominal cavity. The ultimate consequence is varying degrees of organ failure, mostly of ischemic origin. Arterial thrombosis represents a continuous problem, debilitating patients and decreasing their quality of life. Moreover, along with chronic heart failure, it can significantly decrease patient life expectancy. Arterial thrombosis results in ischemia, with serious systemic consequences, such as metabolic breakdown. The major goal of treatment remains fast and efficient recanalization - surgical, interventional or thrombolytic. To be able to prevent acute reocclusion with severe consequences (rhabdomyolysis, compartment syndrome, excessive tissue necrosis leading to limb amputation, etc.), several adjunctive treatment regimens have been advocated. Among others, thrombin inhibitors and platelet inhibitors have been widely used for both prophylaxis and adjunctive treatment. Direct thrombin inhibitors and antithrombin stimulators have been recognized as typical antithrombotic drugs. Direct (antithrombin-independent) thrombin inhibitors can be divided into two main categories: monovalent, active site inhibitors (argatroban, efegatran, inovastan, melagatran) and bivalent (hirudin, hirugen, hirulog, bivalirudin), while antithrombin stimulators represent standard (unfractionated) heparin (UFH) and its depolymerizing products - low molecular weight heparins (LMWH's). Recently, a clear change in the main use of heparin, as well as low-molecular weight heparins has been advocated representing a shift from treatment and prophylaxis of deep vein thrombosis to prophylaxis of thromboembolic disease following vascular, cardiovascular or orthopedic surgery, treatment of unstable angina and prevention of acute myocardial infarction. The main effect of heparins lies in their anticoagulant activity. Heparins are involved in different pathways of the coagulation cascade with anticoagulant, antithrombotic, profibrinolytic, anti-aggregative, as well as anti-inflammatory effects. Moreover, there is a little doubt about their anti-proliferative and anti-ischemic activity (Penka and Bulikova, 2006). Unlike standard heparin, low-molecular weight heparins do not affect the patient's general coagulation profile. Obviously, the difference in molecular weight results in different pharmacokinetic and pharmacodynamic properties of the agents.
The study describes types, absolute and relative numbers of implant failures in flexible bridging osteosynthesis using a six-hole 3.5 mm titanium Locking Compression Plate (n = 9) or a five-hole LCP 4.5 mm titanium (n = 40) selected for the fixation of segmental ostectomy of femoral diaphysis in the miniature pig used as an in vivo model in a study on the healing of a critically sized bone defect using transplantation of mesenchymal stem cells combined with biocompatible scaffolds within a broader research project. Occasional implant failure was evaluated based on radiographic examination of femurs of animals 2, 4, 8, 12 and 16 weeks after surgery. When bone defect was stabilized using 3.5 mm LCP, in 6 cases (66.7%) the screw was broken/lost in the proximal fragment of the femur 2 weeks after implantation (n = 4) and 4 weeks after implantation (n = 2). In 4 cases of these, the implant failure was accompanied also by loosening of the screw in position 3 in the proximal fragment of the femur. During ostectomy stabilization with 4.5 mm LCP, in 3 cases (7.5%) LCP was broken at the place of the empty central plate hole (without inserted screw) at the level of the segmental bone defect. Compared to the six-hole 3.5 mm LCP, the five-hole titanium 4.5 mm LCP is more suitable implant for flexible bridging osteosynthesis of a critically sized segmental defect of femoral diaphysis in the miniature pig. The results of this study will allow reducing implant failures in time- and cost-demanding transplantation experiments focused on bone healing.
Intracoronary cell transplantation during catheter balloon inflations may be associated with adverse events. We studied the effectiveness of an alternative transplantation technique--intracoronary cell infusion.Fourteen pigs, which had survived acute myocardial infarction, were randomized into 2 treatment groups and 2 controls. Three days after infarction, 12 pigs underwent allogeneic intracoronary mononuclear bone marrow cell transplantation using either the standard technique (short-term cell injections during repeat balloon inflations, technique A, n = 6) or continuous intracoronary cell infusion without balloon inflations (technique B, n = 6). Implanted cells were stained with fluorescent dye. After transplantation, the pigs were euthanized and myocardial samples were analyzed by fluorescent microscopy.The mean numbers of fluorescently labeled bone marrow cells in the infarction border zone, in the infarction mid-area and in the center of myocardial infarction were 84, 72 and 55 using technique A, and 29, 57 and 46 using technique B, respectively. The mean cell retention in the infarction border zone of 84 cells for technique A and 29 cells for technique B differed significantly (p = 0.034, two-tailed t test).The continuous intracoronary cell infusion technique is a less efficient cell delivery technique as compared with the standard technique using repeat intracoronary balloon inflations.
