Intra-articular injection of bone marrow aspirate concentrate (mesenchymal stem cells) in KL grade III and IV knee osteoarthritis: 4 year results of 37 knees.

Cell based therapies are increasingly used and results of bone marrow aspirate concentrate (BMAC) show encouraging short- to middle term results, superior to hyaluronic acid and platelet rich plasma (PRP). Most studies describe patients with mild to moderate arthritis and results of patients with KL III and IV osteoarthritis of the knee are limited to short term evaluations. Hence, the aim of this prospective study was to investigate the mid-term outcome of BMAC injections in patients with severe osteoarthritis of the knee.

Reorientation technique has benefits in bone marrow aspiration of stem cells.

We treated patients with osteoarthritis of the knee using injections of bone marrow aspirate concentrate (stem cell therapy). Since multiple controversial harvesting methods using different sites, needles, volumes and techniques have been described, we aimed to compare those methods. Four different harvesting sites at the iliac crest, three different types of needles, three different types of volumes and two different harvesting techniques were compared in 48 bone marrow aspirations.

Case Report: Autologous Bone Marrow Derived Intrathecal Stem Cell Transplant for Autistic Children - A Report of Four Cases and Literature Review.

Despite steadily growing numbers of children diagnosed with autism spectrum disorders (ASD), causative treatment is unavailable. Recently, biological cell therapies involving pluripotent cells have raised hopes towards sustained beneficial outcome. We herein report data of four children diagnosed with ASD, who were treated with autologous, bone marrow (BM)-derived, intrathecally and simultaneously intravenously applied, point-of-care stem cell transplant (SCT).

Resuscitation in near drowning with extracorporeal membrane oxygenation.

We report a case of near drowning of a 3-year-old girl, who was admitted to our emergency room with a core temperature of 18.4 degrees C. After rewarming on cardiopulmonary bypass and restitution of her circulation, respiratory failure resistant to conventional respiratory therapy prohibited weaning from cardiopulmonary bypass.

Off-pump coronary bypass operations significantly reduce S100 release: an indicator for less cerebral damage?

Background: Cardiac operations using extracorporeal circulation bear a risk of cerebral complications. The aim of our study was to investigate if off-pump operations without heart-lung machines can reduce cerebral injury.

Methods: S100, a protein specific for cerebral tissue, was used as a marker for cerebral impairment in 108 randomized patients undergoing coronary bypass operation: 67 patients (group A) were operated on with extracorporeal circulation and cardioplegic cardiac arrest, and 41 patients (group B) underwent off-pump beating heart revascularization.

Closing sounds and related complaints after heart valve replacement with St Jude Medical, Duromedics Edwards, Björk-Shiley Monostrut, and Carbomedics prostheses.

Objective: To measure the noise produced and related subjective complaints after implantation of four different mechanical heart valve prostheses and to identify further factors related to the patient and prosthesis that influence noise generation and complaints.

Design: Sound pressure was measured 5 and 10 cm and 1 m from the point of maximal impulse on the body surface by a calibrated meter in quiet rooms with either a decibel(A) filter or octave filters. The patients were asked about their complaints and examined physically.

[Experiences with PTCA at the Klagenfurt Regional Hospital].

From October 1986 to July 31th 1990 343 patients had coronary dilatations (PTCA) at the Landeskrankenhaus Klagenfurt. In total 380 stenoses in the coronary vessels were dilated. In 83% of stenoses "complete revascularization" was obtained.

[Diagnosis of lung sarcoidosis in the hospital].

To confirm the diagnosis of sarcoidosis a characteristic X-ray and a positive histologic pattern is essential. In most cases one can get the histology by a rather simple bronchoscopy. In cases of negative bronchoscopic findings one should perform a mediastinoscopy, which can be done by an expert thoracic surgeon almost on outpatient basis.

[Noise origin and noise-induced complaints after heart valve replacement with mechanical prostheses].

143 patients were investigated in order to determine whether there is a difference in the intensity of the closing click between different mechanical heart valve prostheses. 35 had St. Jude Medical (SJM), 38 Duromedics Edwards (DE), 36 Björk Shiley Monostrut (BSM) and 34 had Carbomedics prostheses implanted.

Noise level and perception of the closing click after heart valve replacement with St. Jude Medical and Björk Shiley Monostrut prostheses.

The metallic click generated by the closure of mechanical heart valve prostheses may severely bother patients, but generated sound energy and the extent of complaints after implantation are not known. In 62 patients, after valve replacement with St. Jude Medical (SJM) (n = 35) and Björk Shiley Monostrut (BSM) (n = 27) prostheses, sound energy was recorded with a calibrated noise level analyzer at 5, 10, and 100 cm distance from patients and correlated with their complaints.

[Subjective noise perception and objective measurement of loudness following heart valve replacement with the St. Jude Medical and Duromedics Edwards bileaflet prostheses].

The performance of heart valve prostheses is generally judged by the rate of valve-related complications and the hemodynamic performance. Patients may be severely bothered by the metallic click generated by the closure of the valve. In 74 patients after valve replacement with Duromedics Edwards (DE) (n = 38) and St.

[Angina pectoris].

Coronary heart disease has many different clinical courses: it can cause rhythm-disturbances, sudden death, pump-failure, no pain at all (silent ischemia) or typical angina. Heart-pain can occur "on demand" after physical or mental stress with a duration of 3 to 5 minutes with typical location and good response to nitrates. It also can cause atypical forms of angina such as angina on rest, mostly due to coronary spasms.

Fibrin glue coating of e-PTFE prostheses enhances seeding of human endothelial cells.

A laboratory study was undertaken to improve the initial count of endothelial cells (EC) adhering to the wall of e-PTFE prostheses when seeding of human EC is attempted. In our experiments pretreatment of the prosthetic wall with commercially available fibrin glue (Tissucol) improved the reliability of the seeding procedure. The number and the distribution of EC seeded onto fibrin glue presealed e-PTFE prostheses was compared to the number and distribution of EC adhering to blood preclotted grafts 24 hours following the initial seeding procedure.

Effect of experimental cardiopulmonary bypass on systemic and transcardiac thromboxane B2 levels.

Systemic and cardiac metabolism of thromboxane was studied in a canine model (n = 13) of standard cardiopulmonary bypass and surgical cardioplegia. Sterile techniques were applied and no donor blood was used. Systemic samples (thoracic aorta) and transcardiac gradients (coronary sinus - aortic root) were obtained (1) 5 minutes after cannulation, (2) 20 minutes after the onset of partial bypass, (3) 5 seconds after the first administration of cardioplegic solution (CP-1), and (4) 5 seconds after the second administration of cardioplegic solution (CP-2).

Influence of coronary artery obstruction on cardiac prostaglandin metabolism during experimental cardioplegic arrest.

In order to test the influence of coronary artery obstruction on cardiac prostaglandin metabolism during surgically induced cardioplegia (CP), we have measured transcardiac veno-arterial gradients of prostacyclin and thromboxane A2 (TXA A2) during experimental canine cardiopulmonary bypass. Cardiac arrest was induced by infusion of 500 ml of hypothermic (8 degrees C), hyperkalemic (25 meq) crystalloid CP solution into the aortic root with (group I) and without (group II) occlusion of the left anterior descending artery (LAD). After 30 minutes of cardioplegic arrest the LAD occlusion in group I was released and a second set of CP infusion was applied in both groups.

Cardiac prostacyclin kinetics during cardiopulmonary bypass.

We have investigated the response of systemic and myocardial prostacyclin metabolism to cardiopulmonary bypass and 30 minutes of hypothermic (22 degrees C), hyperkalemic (25 mEq K+) surgical cardioplegia. Thirteen adult mongrel dogs of either sex (range 21 to 36 kg) underwent sterile cardiopulmonary bypass without donor blood. Prostacyclin levels were obtained after cannulation, 20 minutes after onset of partial bypass, and 5 seconds after the onset of cardioplegia 1 (CP-1) and cardioplegia 2 (CP-2, 30 minutes later).

Angioplasty in stenosis of the innominate artery.

We describe a successful percutaneous transluminal dilatation (PTD) of an innominate artery stenosis in a 40-year-old patient with aortic arch syndrome. Five years earlier both a left central carotid artery occlusion and an innominate and left subclavian artery stenosis were treated by grafting from the aorta to the distal vessels. At recurrence of the neurological symptoms, reocclusion of the graft to the innominate artery and subtotal stenosis of the left carotid anastomosis were noted.

[Transluminal dilatation of innominate stenosis in aortic arch syndrome].

Successful percutaneous transluminal dilatation of an anonyma stenosis is reported. The patient was a 40 year-old male with the aortic arch syndrome. Five years before an occlusion of the central carotid artery, as well as anonyma and left subclavian stenoses were treated by means of vascular grafts.

Aneurysmal bulb dilation of the azygos vein: radiological and clinical significance.

An aneurysm of the azygos vein is usually detected in the course of routine chest X-rays. It presents as a sharply circumscribed tumor shadow in the area of the right tracheobonchial angle or as an enlargement of the upper right mediastinum. A tentative diagnosis is supplemented both by further X-rays in a supine position in combination with the Valsalva and Müller tests and by tomography.

Chronic vascular disease of the upper extremity: radiologic and clinical features.

The major chronic vascular diseases of the upper extremity are (1) subclavian artery occlusions, (2) thoracic outlet syndrome, and (3) angiospastic disease of the hand. Central subclavian artery lesions ease of the hand. Central subclavian artery lesions can have either hemodynamic consequences (subclavian steal syndrome) or, by peripheral embolization, can provoke ischemic symptoms of the hand.