Medication errors are common, although relatively few result in ADEs. However, those that do are preventable, many through physician computer order entry.
Freeze-dried venous interposition allografts with an internal diameter of 1.0 mm and a length of 1.0 cm were placed into the femoral arteries of 17 Sprague-Dawley albino male rats in order to investigate patency and host tissue response. The immediate patency rate was 88%. The epigastric island flap was monitored as a sign of patency in the early postoperative period (defined as 1 to 3 days). Twelve of the 17 subjects were observed for 2 months, at which point 66% (8/12) remained patent. There were two aneurysmal dilatations. Histopathological studies and transmission electron microscopy demonstrated that freeze-dried veins undergo complete remodeling in vivo by a normal reparative process and that they do not induce a cellular immune response in the host.
Arterial allografts of 1.0 mm diameter and 1.0 cm length were freeze-dried and placed into the femoral arteries of 15 Sprague-Dawley albino male rats in order to study patency and tissue reactions of the host. Patency in the first three postoperative days was determined by monitoring viability of the epigastric island flap. All grafts were patent during this early postoperative period. Fourteen of the subjects were surgically explored after 2 months of observation. At that time, 13 (93%) remained patent. Histopathological studies, and transmission and scanning electron microscopy were used to analyze the specimens. These data demonstrated that freeze-dried arteries are remodeled by the host, but do not induce a cellular immune reaction. Dependable freeze-dried microarterial allografts have potential future application in clinical microvascular surgery.
The practice of routinely evaluating the portal vein as part of a right upper quadrant sonography study may have value as a screening mechanism for portal vein thrombosis. Difficulties arise in differentiating thrombosis from tumor as the source of portal vein obstruction. This case study of portal tumor thrombosis (PTT) due to hepatocellular carcinoma is a good example of the use of multiple modalities to arrive at the definitive diagnosis. Many studies have been conducted on the effectiveness of magnetic resonance imaging and computed tomography on the accurate diagnosis of PTT, but few cases have been reported that used a multimodality approach.
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