We compared graft outcome between two types of a novel composite three-layer carp-collagen-coated vascular graft in low-flow conditions in a sheep model. Collagen in group A underwent more cycles of purification than in group B in order to increase the ratio between collagen and residual fat. The grafts were implanted end-to-side in both carotid arteries in sheep (14 grafts in 7 sheep in group A, 18 grafts in 9 sheep in group B) and artificially stenosed on the right side. The flow in the grafts in group A decreased from 297±118 ml/min to 158±159 ml/min (p=0.041) after placement of the artificial stenosis in group A, and from 330±164ml/min to 97±29 ml/min (p=0.0052) in group B (p=0.27 between the groups). From the five surviving animals in group A, both grafts occluded in one animal 3 and 14 days after implantation. In group B, from the six surviving animals, only one graft on the left side remained patent (p=0.0017). Histology showed degradation of the intimal layer in the center with endothelization from the periphery in group A and formation of thick fibrous intimal layer in group B. We conclude that the ratio between collagen and lipid content in the novel three-layer graft plays a critical role in its patency and structural changes in vivo.

• MeSH
• arteriae carotides fyziologie   chirurgie   MeSH
• cévní protézy trendy   MeSH
• kapři MeSH
• kolagen aplikace a dávkování   izolace a purifikace   MeSH
• ovce MeSH
• protézy - design metody   trendy   MeSH
• průchodnost cév fyziologie   MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kolagen MeSH

PURPOSE OF THE STUDY Aseptic loosening of endoprosthetic components is the most frequent reason for total hip arthroplasty revision. This paper aimed to verify the influence of the type of hip-component fixation of total hip replacement in correlation with the age of patients on aseptic loosening of components during mid-term survival. MATERIAL AND METHODS The retrospective, monocentric study statistically evaluated the data of 67 cases of implanted total hip replacements in 66 patients with the loosening of at least one of the components requiring a revision of the total number of 1,488 primary total hip replacements implanted during the 1995 to 2006 period at a single department. The study compares the implants by Johnson&Johnson (Ultima threaded cups, Duraloc sector, Ultima UHMWPE cups. Mecroblock MR, AML and Ultima straight stems, Charnley and Elite plus cups and stems), Fehling Medical AG (HPQ and Müller cups, Müller Geradschaft stems) and Biomet (Mallory-Head and Müller cups, Bi-Metric cemented and uncemented stems) with respect to the age of patients. First-generation and second-generation cementing techniques were used. Primary arthroplasty of revised endoprostheses were indicated for primary and post-dysplastic coxarthrosis not requiring skeletal reconstruction. In order to determine the influence of age, three age categories were considered: under 54 years of age, 55 to 64 years of age, and elderly individuals aged 65 and over. The data was statistically evaluated by the test for two proportions and the Student's t-test. RESULTS The mean age of patients with total hip replacement loosening was lower than the mean age of the other patients (p < 0.05). The age category 55-64 reported a significantly higher failure rate only for HPQ - Müller-Geradschaft endoprosthesis compared to the uncemented and hybrid version of Mallory-Head - Bi-Metric, Duraloc - AML and Charnley group (p < 0.05). Duraloc - Charnley showed worse results than Mallory-Head - Bi-Metric porous (p = 0.0437). Except for HPQ - Müller-Geradschaft endoprosthesis, there were no statistically significant differences in the achieved revision rate of components used in endoprostheses. In the younger age category, only uncemented and hybrid versions were assessed. Hybrid endoprostheses made by Fehling and Biomet failed more often than uncemented Mallory-Head - Bi-Metric porous (p < 0.05) and Duraloc - AML (p < 0.01). For the category of 65 plus, cemented and hybrid endoprostheses were assessed. A higher revision rate was seen only in HPQ - Müller-Geradschaft endoprosthesis compared to the cemented version of Biomet (p < 0.05). No difference was reported in mid-term survival of the applied cemented and uncemented cups. DISCUSSION Despite the development of uncemented versions of total hip arthroplasty components, the current literature includes opinions supporting the cemented technique of total hip replacement. Especially for elderly patients the implant of uncemented components is questionable. The presented study did not identify a higher mid-term revision rate of uncemented implants, namely with respect to acetabular components, not even in the elderly patients. CONCLUSIONS No difference was found in the mid-term revision rate of evaluated endoprostheses for the medium age category of 55-64 years, regardless of whether cemented or uncemented components were implanted. The only exception was represented by hybrid HPQ-Müller Geradschaft endoprosthesis with a higher revision rate of the femoral and acetabular components. The younger age category showed a lower revision rate for uncemented versions than for the used hybrid versions of endoprostheses. For the group of elderly patients, there was no difference between the survival rate of hybrid and cemented joint replacement. Key words:arthroplasty with total hip replacement, cemented joint replacement, uncemented joint replacement, joint replacement failure, aseptic loosening of total replacement, age, joint replacement survival. 046_053_kubinec 20.2.18 14:12 Stránka 46 47/ Acta Chir Orthop Traumatol Cech. 85, 2018, No. 1 PŮVODNÍ PRÁCE.

• MeSH
• hodnocení výsledků zdravotní péče MeSH
• kostní cementy * škodlivé účinky   terapeutické užití   MeSH
• kyčelní protézy škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada kyčelního kloubu * škodlivé účinky   přístrojové vybavení   metody   MeSH
• protézy - design metody   MeSH
• registrace MeSH
• reoperace * metody   statistika a číselné údaje   MeSH
• rizikové faktory MeSH
• selhání protézy etiologie   MeSH
• senioři MeSH
• věkové faktory MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• kostní cementy * MeSH

AIM: The aim of this study was to evaluate short-term patency of the new prosthetic graft and its structural changes after explantation. METHODS: The study team developed a three-layer conduit composed of a scaffold made from polyester coated with collagen from the inner and outer side with an internal diameter of 6 mm. The conduit was implanted as a bilateral bypass to the carotid artery in 7 sheep and stenosis was created in selected animals. After a period of 161 days, the explants were evaluated as gross and microscopic specimens. RESULTS: The initial flow rate (median ± IQR) in grafts with and without artificial stenosis was 120 ± 79 ml/min and 255 ± 255 ml/min, respectively. Graft occlusion occurred after 99 days in one of 13 conduits (patency rate: 92%). Wall-adherent thrombi occurred only in sharp curvatures in two grafts. Microscopic evaluation showed good engraftment and preserved structure in seven conduits; inflammatory changes with foci of bleeding, necrosis, and disintegration in four conduits; and narrowing of the graft due to thickening of the wall with multifocal separation of the outer layer in two conduits. CONCLUSIONS: This study demonstrates good short-term patency rates of a newly designed three-layer vascular graft even in low-flow conditions in a sheep model.

• MeSH
• arteriae carotides účinky léků   MeSH
• cévní protézy MeSH
• cévy - implantace protéz metody   MeSH
• kolagen metabolismus   MeSH
• okluze cévního štěpu farmakoterapie   MeSH
• ovce MeSH
• prospektivní studie MeSH
• protézy - design metody   MeSH
• průchodnost cév účinky léků   MeSH
• zákroky plastické chirurgie metody   MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kolagen MeSH

• Klíčová slova
• American College of Cardiology, American Heart Association, Arterial Revascularization Trial, CardiAQ, Cox lesion set, HeartMate 3, HeartMate II, HeartWare, INTERMACS, Intrepid, MITRAL, MOMENTUM 3, Seattle Heart Failure, Model, Society of Thoracic Surgeons, Tendyne, Tiara, aortic stenosis, atrial fibrillation, axial flow, balloon-inflatable prosthesis, beta blocker, bicuspid aortic valve, bioresorbable stent, bleeding, cardiopulmonary bypass, centrifugal flow, coronary artery bypass grafting, drug-eluting stent, dual antiplatelet therapy, functional capacity, heart failure, levosimendan, left ventricular assist device, heart transplantation, internal mammary graft, left atrial appendage, left atrium, mitral regurgitation, mortality, myocardial infarction, noncardiac surgery, off-pump, on-pump, paravalvular leak, percutaneous coronary intervention, perioperative risk of mortality score, pulmonary vein isolation, quality of life, saphenous vein graft, seizures, self-inflating prosthesis, stroke, surgical ablation, surgical aortic valve replacement, surgical risk, tranexamic acid, transcatheter aortic valve replacement, transfusion, valve-in-ring replacement, valve-in-valve replacement,
• MeSH
• anestezie v kardiochirurgii metody   trendy   MeSH
• chirurgická náhrada chlopně metody   trendy   MeSH
• kardiochirurgické výkony metody   trendy   MeSH
• lidé MeSH
• nemoci koronárních tepen diagnostické zobrazování   chirurgie   MeSH
• nemoci srdečních chlopní diagnostické zobrazování   chirurgie   MeSH
• protézy - design metody   trendy   MeSH
• výkony cévní chirurgie metody   trendy   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

AIMS: Early clinical results after implantation of bioresorbable vascular scaffolds (BVS) in ST-elevation myocardial infarction (STEMI) are encouraging, but long-term data are missing. This study evaluates long-term outcome in STEMI patients with implanted BVS. METHODS AND RESULTS: The PRAGUE-19 study is an academic study enrolling consecutive STEMI patients with the intention to implant BVS. A total of 580 STEMI patients were screened between December 2012 and March 2015; 117 patients fulfilled entry criteria and BVS was successfully implanted in 114 (97%) of them. The primary combined clinical endpoint (death, reinfarction or target vessel revascularisation) occurred in 11.5% during the mean follow-up period of 730±275 days with overall mortality of 4.4%. Definite scaffold thrombosis occurred in two patients in the early phase after BVS implantation; there was no late thrombosis. Quantitative coronary angiography (10 patients) at three years demonstrated late lumen loss of 0.2±0.33 mm and optical coherence tomography showed minimal lumen area of 5.3±1.37 mm2 and neointimal hyperplasia area of 2.9±0.48 mm2. BVS struts were still visible at three years and 99.4% of them were well apposed and covered. CONCLUSIONS: Encouraging clinical and imaging results after BVS implantation in STEMI patients persist during long-term follow-up.

• MeSH
• infarkt myokardu s elevacemi ST úseků terapie   MeSH
• koronární angiografie metody   MeSH
• koronární angioplastika * metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• optická koherentní tomografie metody   MeSH
• protézy - design metody   MeSH
• senioři MeSH
• stenty uvolňující léky * MeSH
• tkáňové podpůrné struktury MeSH
• vstřebatelné implantáty * MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH

BACKGROUND: Fractures of the medial clavicle third are rare injuries. Even in case of significant fracture displacement, their therapeutic management has been nonoperative. Recently, surgical intervention has become mandatory for displaced fractures types to prevent non-union and functional complaints, but the optimal operative strategy is being discussed controversially. CASE PRESENTATION: We describe the case of a 63-year-old male patient with a significantly displaced medial clavicle fracture after failed conservative treatment resulting in restricted, painful shoulder function. The patient underwent open reduction and osteosynthesis with an anatomically precontoured locking compression plate (LCP). One year after surgery the patient is free of complaints and has returned to his preinjury activity level without any functional restrictions. CONCLUSION: As a not yet reported operative approach, anatomically preshaped locking plating seems to be an effective fixation method for displaced fractures of the medial clavicle third. The operative management is described in detail and discussed with the current literature. Based on the presented case, we underline the statement that displaced medial clavicle fractures should be surgically addressed to avoid late damage.

• MeSH
• fraktury kostí * diagnostické zobrazování   chirurgie   MeSH
• hojení fraktur MeSH
• klíční kost * zranění   patologie   patofyziologie   chirurgie   MeSH
• kostní destičky * MeSH
• lidé středního věku MeSH
• lidé MeSH
• obnova funkce MeSH
• protézy - design metody   MeSH
• radiografie MeSH
• špatně zhojené fraktury diagnostické zobrazování   chirurgie   MeSH
• vnitřní fixace fraktury * přístrojové vybavení   metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH