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At least 937 records · Page 52Linked to original sources
PubMed1992

A silicone prosthesis for covering a large tracheal defect in patients who underwent surgery for locally recurrent aggressive thyroid cancer.

Following the usual sleeve or window resection of the trachea, reconstruction of the trachea can be carried out without difficulty in patients with aggressive thyroid cancer. When the cancer recurs locally in those patients, reoperation often yields a large tracheal defect, for which a commercially available tracheostomy cannula or a silicone-tube does not fit. By using a technique in the maxillofacial prosthetic field, it has become possible to make a new type of prosthesis which is more comfortable and acceptable to the patients with a large tracheal defect. A new type of silicone rubber prosthesis is made individually from the mold of each patient. Several appointments are required for adjustments by the chair side. It must tightly obstruct the tracheostomy stoma so that the patient can easily breathe, speak and take oral fluids. Patients can easily remove and replace this device by themselves and care of the prosthesis is easy. The practical use of this type of prosthesis in three patients is reported herein.

Adenocarcinoma↗
PubMed1991

Endoluminal prosthesis in protecting high-risk colonic anastomosis: an experimental study.

An experimental study was carried out to evaluate the protective role of an endoluminal prosthesis on high risk colo-colonic anastomoses. One hundred and fifty rats were divided into two groups: Group E with endoluminal latex prosthesis and Group C without. Bursting pressure and collagen concentration in the perianastomotic tissue were tested, respectively, on the 4th, 7th and 12th, and 4th, 7th, 12th, 18th and 38th postoperative days. Bursting pressure was significantly higher in Group E on the 4th postoperative day. There was no significant difference in the anastomotic collagen concentration between the two groups. The presence of the prosthesis did not produce any macroscopic or microscopic evidence of impaired healing or stricture at the suture line. Death due to anastomotic dehiscence occurred in 11/75 (15%) in Group C and in 1/75 (1.3%) in Group E (p less than 0.01). Endoluminal prosthesis appears to have a protective effect on anastomotic healing. The mechanism is probably due to mechanical protection and not to differences in collegen concentration.

Anastomosis, Surgical↗
PubMed1976

[Studies on the surface and new joint capsule of McKee-Farrar prosthesis implanted for several years (author's transl)].

These studies are intended as a critical contribution to the question, wether the McKee-Farrar (MF) prosthesis, on account of its stronger friction and the consequences of this, as compared to other models, still has its justification or wether these "secundary" manifestations indicate that this prosthesis should be abandoned. Studies on primary and secundary alteration of the surface were carried out on exchanged MF prosthesis with the aid of the grid electron microscope. The signs of wear are clearly visible and can be differenciated from production artefacts. The movement and deposit of abraded particles into the new joint capsule was studied qualitatively and quantitatively with the aid of radioisotopes. All samples showed an increased accumulation of chrome in the tissues as compared to cobalt. There is no indication of significant damage. On the basis of the results of these studies and on account of the favourable personal experience from a surgical and clinical point of view -- particulary with reference to minimal preparation of the acetabulum and ready replacement, the MF prosthesis will continue to hold its place as the standard model for total prosthetic hip joint replacement.

Aged↗
PubMed1997

Cardiovascular collapse after femoral prosthesis surgery for acute hip fracture.

PURPOSE: Prosthetic revision of hip fractures may result in embolization of tissue products leading to death. In this report, from cases reported to the Anaesthesia Advisory Committee to the Chief Coroner of Ontario, emphasis is placed on the immediate resuscitative procedures which may offset a fatal outcome. CLINICAL FEATURES: Two elderly patients are reported in whom hip fractures necessitated primary prosthetic hip repair. The first patient, with a history of limited cardiac reserve and syncope, suffered a subcapital hip fracture. Under general anaesthesia, a Moore's prosthesis was inserted. The anaesthetic period remained relatively stable until surgical reaming of the femoral canal. Bradycardia, hypotension and cyanosis developed and quickly proceeded to a fatal cardiac arrest. Autopsy demonstrated diffuse pulmonary embolism of fat and thrombus. The second patient suffered a fracture around the stem of a previously inserted femoral prosthesis. Under general anaesthesia, a new cemented hip prosthesis was inserted, following which hypotension occurred. This was supported with small doses of ephedrine, ventilation was controlled with oxygen and the procedure was quickly terminated. Despite addition of a dopamine infusion, cardiac arrest and death followed. Autopsy disclosed massive fat and bone marrow embolization. CONCLUSION: The combination of hip fracture, activated clotting factors and borderline cardiopulmonary function presents a risk of death from embolization of tissue products released during the placement of a cemented hip prosthesis. While the outcome of this catastrophe is generally poor, all practitioners should be prepared to immediately institute resuscitative procedures to manage the accompanying cardiovascular collapse.

Acute Disease↗
PubMed2005

[Surgical treatment of a displaced femoral head fracture with a cement-free dual-headed prosthesis using a minimally invasive approach. Clinical and radiographic outcome].

One hundred patients treated with a cementless bipolar prosthesis for a displaced subcapital hip fracture were prospectively evaluated for clinical and radiographic outcome. All patients were operated via a minimally invasive approach; in every case we implanted a Zweymuller stem. There were 77 women and 33 men with a mean age of 80 years (29-98 years). The mean duration of the operation was 29 min (20-95 min). Full weight bearing on crutches was allowed 1 day after the operation. The mean follow-up was 2.5 years (6 months to 7 years). Two years after the operation there were 40% of the remaining 65 patients who scored between 90 and 100 on the Harris hip score, 23% between 80 and 89, 20% between 70 and 79, and 17% below 70. No patient complained about thigh pain and up to now there has been no need for femoral revision due to loosening. There was no infection or nerve lesion. In three patients there was a luxation of the prosthesis which could be reduced by closed means. Radiographs from 81 patients showed stress shielding in 97.5% mainly in Gruen zones 1 and 7. Radiolucent lines in two or more Gruen zones were found in two patients. These findings suggest that the noncemented, pressfit, grit-blasted bipolar prosthesis demonstrated similar stability and radiographic results to cemented bipolar prostheses. Stress shielding was common but did not influence longevity of the implant. We did not find any signs of protrusion. Especially in older patients with a history of cardiac disease, the noncemented bipolar prosthesis is a rational alternative to avoid intra- and postoperative complications despite the higher costs for the implant. The minimally invasive approach helps to reduce operation time and intraoperative blood loss.

Adult↗
PubMed2000

The saddle prosthesis in pelvic primary and secondary musculoskeletal tumors: functional results at several postoperative intervals.

The first purpose of this study was to evaluate the saddle prosthesis in patients with periacetabular tumors in terms of the functional results obtained after several postoperative intervals. The second purpose was to evaluate the complications and how they might be prevented in the future. Functional results according to the MSTS functional rating system were evaluated at several postoperative intervals in 15 patients treated with internal hemipelvectomy and reconstruction with the saddle prosthesis because of periacetabular primary (n = 9) or secondary (n = 6) malignancies. All complications were evaluated. Three months postoperatively, 7/9 patients with a primary tumor and 2/4 patients with a secondary tumor were able to walk outside without pain. Median functional results 3 and 6 months postoperatively were 40% and 50%, respectively. Deep infection occurred in 4 patients and fracture of the iliac remnant in 2. Heterotopic ossifications along the interpositional component were seen in 5 patients, but they did not negatively influence the functional outcome. Three (relative) contraindications to reconstruction with the saddle prosthesis could be ascertained: osteoporosis, extended involvement of the iliac wing by tumor, and insufficient soft-tissue quality after previous procedures. (Short-term) functional results after reconstruction with the saddle prosthesis are satisfactory if the above-mentioned contraindications are taken into consideration.

Acetabulum↗
PubMed1997

The Dialine II graft: a new collagen-impregnated warp-knitted polyester arterial prosthesis.

The Dialine graft, a new prototype of knitted vascular prosthesis that uses a different brand of polyester fibers as an alternative to Dacron fibers, has been shown to offer excellent in vitro physical performance and in vivo healing. Although it still requires preclotting, the Dialine prosthesis was made impervious by impregnation of bovine type I collagen cross-linked with vapors of formalin. The purpose of the present investigation was to compare the in vitro physical characteristics of the Dialine II graft with those of the collagen-impregnated Hemashield graft. In addition, we studied the healing performance as a thoracoabdominal bypass in dogs for prescheduled periods of implantation ranging from 4 hours to 6 months. In vitro, the bursting strength, resistance to dilatation, and suture retention strength properties of the Dialine II prosthesis were all shown to exceed those of the Hemashield control graft. In the first weeks after implantation, the Dialine II grafts induced a discrete inflammatory response, as shown by the constant leukocyte counts observed both before implantation and when the animals were killed, as well as by the histologic observation of a few inflammatory cells in contact with the collagen. Consequently, the Dialine II grafts showed a slow rate of bioresorption of cross-linked collagen. At 1 month, a thin internal collagenous capsule was present at both anastomoses, laying over the original collagen coating. At 3 and 6 months, areas of thrombotic deposits and endothelialized areas were observed on the luminal surface. Because results of early clinical trials have been highly satisfactory, this prosthesis may be recommended for use without restriction as a medium- and large-diameter blood conduit.

Animals↗
PubMed1980

Chronic intravascular hemolysis after aortic valve replacement with Ionescu-Shiley xenograft: comparative study with Bjork-Shiley prosthesis.

Twenty patients with a prosthetic valve (Ionescu-Shiley or Bjork-Shiley) in the aortic position were studied for evidence of intravascular hemolysis. Serum lactic dehydrogenase and serum haptoglobin levels were used as the most sensitive indicators of hemolysis. Elevated concentrations of lactic dehydrogenase were found in all 10 patients with an Ionescu-Shiley prosthesis (mean 402 IU/liter) and in 7 of 10 patients with a Bjork-Shiley prosthesis (mean 234 IU/liter). The mean serum haptoglobin was 15 mg/dl (range 10 to 28) in patients with the Ionescu-Shiley valve and 96 mg/dl (15 to 284) for those with the Bjork-Shiley valve. This study indicates the presence of chronic intravascular hemolysis in patients with the Ionescu-Shiley aortic valve. The increase in lactic dehydrogenase was significantly greater in patients with the Ionescu-Shiley prosthesis than in those with the Bjork-Shiley prosthesis, indicating a slightly shorter red cell life span in the former group.

Adult↗
PubMed1983

The bi-articular hip prosthesis for fractures of the femoral neck--a preliminary report.

The bi-articular hip prosthesis (BHP), based on an original design by Bateman, is a bi-polar hemi-arthroplasty which seeks to reduce acetabular wear. We have used this prosthesis to treat 101 elderly patients with displaced intra-capsular fractures of the neck of the femur. The results of the first two years experience with this prosthesis are encouraging. Post-operative hip pain was not significant and did not interfere with mobility. The use of the antero-lateral approach to the hip joint prevented dislocation of the prosthesis, in contra-distinction to reports of series in which the Southern approach was used.

Aged↗
PubMed1991

Osseointegrated implant-supported and magnetically retained ear prosthesis: a clinical report.

Osseointegrated implants were placed in the temporal bone and were used to retain attachments for an ear prosthesis. A screw-retained magnetic alloy casting was used to retain an acrylic resin magnet keeper, to which a silicone ear prosthesis was attached. The keeper provided vertical support for the prosthesis and facilitated orientation for prosthesis insertion. Stability and retention were provided without the use of adhesives.

Ear↗
PubMed1992

Stabilization of an interim obturator prosthesis using a denture duplicator.

Concomitant radiotherapy and chemotherapy given within weeks after major surgical procedures may require that an interim obturator prosthesis be worn for extended periods of time. Interim reline materials used in fabricating the interim obturator prosthesis may become rough and difficult to clean. With a Lang denture duplicator it is possible to easily convert an interim obturator prosthesis to an all acrylic resin prosthesis. A technique is described for this procedure.

Dental Instruments↗
PubMed1993

A fixed-detachable implant-supported prosthesis retained with precision attachments.

The implant-supported, maxillary anterior, fixed-detachable prosthesis is often fabricated with a gingival flange to enhance esthetics and phonetics. However, only the dentist can remove the prosthesis, and the esthetic labial flange invariably impedes patient access for cleaning. A two-piece, fixed-detachable prosthesis that incorporates a substructure retained with conventional set screws and a superstructure retained with precision attachments has been developed. The substructure is contoured to facilitate patient access for oral hygiene because it will be covered by the superstructure and neither esthetics nor phonetics is a concern. The superstructure is easily removed by the patient for routine cleaning and can be designed for favorable esthetics and phonetics. This article reviews and describes the procedures for fabrication of this precision attachment-retained, implant-supported prosthesis.

Dental Casting Technique↗
PubMed1983

Mentor inflatable penile prosthesis.

The new Mentor prosthesis is similar in appearance to the Scott inflatable penile prosthesis, consisting of a pump, a reservoir, and two penile cylinders. The penile cylinders of the Mentor prosthesis are constructed of Bioflex polyurethane, a new polymer which is more durable and less elastic than silicone. The use of Bioflex cylinders should increase device longevity and eliminate cylinder aneurysms. It also may be possible to correct penile deformities produced by silicone cylinders which have formed aneurysms by replacing the dilated cylinders with Bioflex cylinders. The new Mentor prosthesis utilizes snap-on connectors which rely on plastic clamps rather than suture ties to fix tubings to connectors. This method of attaching tubing to connectors will reduce operating time and should reduce the incidence of connector leaks.

Erectile Dysfunction↗
PubMed1986

AMS malleable penile prosthesis.

The American Medical Systems (AMS) malleable penile prosthesis was implanted in 57 patients from January, 1983 to 1985. Fifty-one per cent of the procedures were performed under local anesthesia, and 28 per cent in ambulatory (day) surgery. The prosthesis was evaluated in terms of cosmetic result, patient satisfaction and function, and postoperative complications. Ninety-one per cent of patients were satisfied with their decision to select the malleable prosthesis, and 66 per cent reported no difficulty with concealment. A comparison is made with data available from the alternative Jonas malleable prosthesis.

Adult↗
PubMed1994

Corporeal fibrosis as a result of priapism prohibiting function of self-contained inflatable penile prosthesis.

Corporeal fibrosis and erectile impotence are known sequelae of priapism. Fibrosis following priapism may make subsequent placement of a penile prosthesis, especially inflatable devices, difficult or impossible. A case is described in which a self-contained inflatable prosthesis (Dynaflex) was successfully placed to treat impotence resulting from idiopathic priapism. However, fibrosis of the distal tunica albuginea of the corpora cavernosa rendered them noncompressible, and thus precluded inflation of the device with its distally placed pump mechanism. This anatomic problem is added to the list of potential contraindications to placement of self-contained inflatable penile prostheses, and the advisability of having patients who desire such a prosthesis also choose a secondary prosthesis type is emphasized.

Adult↗
PubMed1992

Cellular reaction to the Vascugraft polyesterurethane vascular prosthesis: in vivo studies in rats.

The biocompatibility of Vascugraft, a polyesterurethane vascular prosthesis manufactured by Braun-Melsungen AG, was assessed by immunofluorescence and histological studies. Discs, 1 cm2, of Vascugraft prosthesis were implanted into the peritoneal cavity of rats. Results were compared with Impra, GORE-TEX and Mitrathane prostheses and a control group. Animals were killed at 1, 2, 6, 9 and 12 wk. Total T cells, T helper cells, T suppressor cells and activated T lymphocytes expressing Interleukin-2 receptors were quantified by a cytofluorometric technique in the peripheral blood of rats. For each period of implantation, all vascular prostheses showed no significant change in the percentage of total T cells, T subsets and T cells expressing Interleukin-2 receptors when compared to the control group. Histological examination of the tissue reaction surrounding the Vascugraft revealed a mild inflammatory reaction, similar to the one observed with both polytetrafluoroethylene grafts. However, the rate and the degree of encapsulation were different between grafts. The Vascugraft prosthesis was well encapsulated 2 wk after implantation, whereas inhibition of fibroblastic proliferation into the graft wall and surrounding both polytetrafluoroethylene grafts was observed for each period of implantation. The Mitrathane prosthesis exhibited a moderate inflammatory response, characterized by a high level of activation on fibroblasts compared to other grafts.

Animals↗
PubMed2005

Voice restoration by primary insertion of indwelling voice prosthesis following circumferential pharyngolaryngectomy with free jejunal graft.

BACKGROUND: Voice restoration after circumferential pharyngolaryngectomy (CPL) with free jejunal graft remains a difficult problem to solve. Few reports have analyzed the success rate and complications following primary insertion of indwelling voice prostheses during CPL with free jejunal graft. PATIENTS AND METHODS: Eight patients who underwent CPL with free jejunal graft had a Groningen voice prosthesis inserted as a tracheoesophageal (TE) shunt at the time of oncological surgery. A 10-point scale was used to assess each patient's speech intelligibility. Complications following the voice prosthesis insertion were also analyzed. RESULTS: Six of the eight patients (75%) achieved excellent speech intelligibility and the remaining two patients (25%) were judged as moderate. Six of the eight patients (75%) used the TE shunt as their major means of daily communication. Leakage through or around the prosthesis, which occurred in six (75%) patients, was the most frequent prosthesis-related complication. CONCLUSIONS: This safe and reliable technique can be effective in improving the quality of life in selected patients undergoing CPL.

Adult↗
PubMed2004

A novel, form-stable, anatomically curved vascular prosthesis for replacement of the thoracic aorta.

PURPOSE: Current replacement of the thoracic aorta performed with straight vascular prostheses may cause kinking, potentially affecting hemodynamics and promoting vortices and thrombus formation. A novel vascular prosthesis, resistant to pressure-related shape deformation, was designed to imitate the curved anatomy of the thoracic aorta. DESCRIPTION: A woven velour prosthesis was trimmed with cross-sutures along a marked line, resulting in a curved-shaped anatomic form, and was compared with conventional straight and thermally fixed curved grafts. The vascular prostheses were fixed at both ends at various base distances (8, 10, 12, 14, and 16 cm) and pressurized. To imitate the neck vessels an abutment was fixed at the upper convexity of the grafts. Radius of curvature or depth of kinking was measured at different pressures (100, 125, and 150 mm Hg). Pressure gradients and flow profiles were further analyzed in an aortic arch glass model. EVALUATION: When pressurized the straight and the thermally fixed protheses showed double kinking before and behind the abutment at all pressures and distances. Kinking depth increased with increasing pressure and less base distance. Transkinking pressure gradients increased with the degree of kinking. In a glass model flow profiles showed postkinking turbulences and vortex formation. The newly designed vascular prosthesis showed no kinking and remained form stable at all test conditions. CONCLUSIONS: This novel curved vascular prosthesis for replacement of the thoracic aorta demonstrates form stability compared with conventional straight and thermally fixed vascular prostheses in an aortic arch model, with smaller pressure gradients and flow disturbances.

Aorta, Thoracic↗