• Title/Summary/Keyword: Grafting

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Off-pump Coronary Artery Bypass Surgery Versus Drug Eluting Stent for Multi-vessel Coronary Artery Disease (다혈관 관상동맥질환에서의 심폐바이패스를 사용하지 않은 관상동맥우회술과 약물용출 스텐트시술)

  • Lee, Jae-Hang;Kim, Ki-Bong;Cho, Kwang-Ree;Park, Jin-Shik;Kang, Hyun-Jae;Koo, Bon-Kwon;Kim, Hyo-Soo;Sohn, Dae-Won;Oh, Byung-Hee;Park, Young-Bae
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.202-209
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    • 2008
  • Background: The introduction of Drug Eluting Stents (DES) decreased the number of patients referred for coronary artery bypass grafting (CABG). The impact of DES on CABG (Step 1) was studied and compared with the 1-year outcome after CABG with DES (Step 2). Material and Method: Surgical results for patients who underwent off-pump CABG (OPCAB) before the introduction of DES(n=298) were compared with those who underwent OPCAB after the introduction of DES (n=288) (Step 1). Postoperative 30-day and 1-year results were also compared between the patients who underwent percutaneous coronary intervention (PCI) using DES (n=220) and those who underwent OPCAB (n=255) (Step 2). Result: Since the introduction of DES, the ratio of CABG versus PCI decreased. In the CABG group, the number of high risk patients such as elderly patients (age 62 vs. 64, p=0.023), those with chronic renal failure (4% vs. 9%, p=0.021), calcification of the ascending aorta (9% vs. 15%, p=0.043), or frequency of urgent or emergent operations (12% vs. 22%, p=0.002) increased. However, there were no differences in the cardiac death and graft patency rates between the two groups (step 1). During the one-year follow up period, the rate of target vessel revascularization (12.3% vs. 2.4%, p<0.001) and major adverse cardiac events (MACE: death, myocardial infarct, TVR) were higher in the DES than the CABG group (13.6% vs 4.3%) (stage 2). Conclusion: Introduction of DES decreased the number of patients referred for surgery, and increased the comorbidity in patients who underwent CABG. DES increased the rate of target vessel revascularization, and the occurrence of MACE during the 1-year follow-up. However, there was no difference in the incidence of myocardial infarction and cardiac death between the two groups.

Comparison of the One-year Follow-up Results after Coronary Bypass Surgery versus Percutaneous Coronary Intervention with Drug-eluting Stents in Patients with Left Main Coronary Artery Disease (좌주간지 병변에 대한 약물방출스텐트시술과 관상동맥우회수술의 1년 추적결과 비교)

  • Choi, Jin-Ho;Lim, Cheong;Park, Kay-Hyun;Chung, Eui-Suk;Chung, Woo-Young;Chae, In-Ho;Choi, Dong-Ju
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.210-215
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    • 2008
  • Background: Drug-eluting stents are contributing to the exponential growth of percutaneous coronary intervention, and even in the patients with left main coronary artery disease, owing to the decreased restenosis rate. Our study aimed at comparing the one-year results after coronary artery bypass grafting versus percutaneous coronary intervention with drug-eluting stents in patients with left main coronary artery disease. Material and Method: Those patients who underwent coronary bypass surgery or stenting at our hospital under the diagnosis of left main coronary artery disease were divided in two groups. The variables for comparison were the preoperative disease severity, the length of the hospital stay, the early mortality and the cumulative incidence of mortality, myocardial infarction and repeated revascularization. Result: There were 101 cases in the surgery group and 78 cases in the stent group. Age, gender, the risk factors, the left ventricular ejection fraction and the proportion of acute coronary syndrome showed no significant differences between the two groups. The surgery group showed a more severe condition according to the Euroscore, a greater incidence of urgency, a longer hospital stay and a greater incidence of multi-vessel disease. The early mortality and one-year cumulative mortality were not different between the groups. The Euroscore-matched comparison for the surgery group (41 patients) and the stent group (78 patients) showed no significant differences in the Euroscore, age, gender, risk factors and the proportion of acute coronary syndrome. The surgery group in the Euroscore-matched comparison showed more multi-vessel disease and a longer hospital stay. The surgery group showed lower early mortality and lower one-year cumulative mortality, but this was statistically insignificant (0% vs 2.6%, respectively, p=0.55; 0% vs 6.6%, respectively, p=0.30). The rates of repeated revascularization and major adverse events (death or myocardial infarct) were lower in the CABG group, but this was not statistically significant (13.3% vs 6.3%, respectively, p=0.48; 10.0% vs 0%, respectively, p=0.09). Conclusion: Percutaneous coronary intervention using drug-eluting stents in low-risk patients with left main coronary artery disease resulted in a shortened length of the hospital stay, as compared with that of the CABG group of patients. However, the patients who underwent percutaneous coronary intervention using drug-eluting stents showed a tendency for an increased rate of repeated revascularization and higher one-year cumulative mortality. Further studies with large populations and longer follow-up will be necessary to reaffirm our findings.

Changed in Growth and Chemical Properties of Plastic Film House by Earthworm Cast on Gymnocalycium mihanovichii var. 'Ihong' (비모란 선인장(Gymnocalycium mihanovichii var. 'Ihong') 시설재배에서 지렁이분변토시용에 따른 생육특성 및 토양 화학성 변화)

  • Choi, I-Jin;Cho, Sang-Tae;Kim, Young-Mun;Kim, Mi-Seon;Lee, Sang-Kweon
    • Korean Journal of Organic Agriculture
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    • v.22 no.4
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    • pp.731-742
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    • 2014
  • In the current study, we investigated effects of a combination of earthworm casting, environment-friendly by-product fertilizer, and cultivation soil of Gymnocalycium mihanovichii in a heavy fertilizing culture on diameter, height, numbers of tubercles, and chemical properties of soil thereby elucidating optimal mixture ratio for securing production as well as providing nutrients throughout cultivation period. The Gymnocalycium mihanovichii var 'Ihong', one of grafted cactus for export (Rootstock: 9 cm, Scion: $1.5{\times}1.3cm$ grafted cactus) was cultured in plastic houses of Agricultural Technology Center located in Naegok-dong, Seocho-gu, Seoul from June, 2013 through December, 2013. For the control group, a mixture of sand and fertilizer (50:50) was used as this ratio is widely utilized in farmhouses. In contrast, a variety mixtures of sand and earthworm casting that was produced with food wastes was compared; the mixture ratios were 80:20, 60:40, 40:60, 20:80, and 0:100 and pH for these mixtures were found to be similar each other (ranging between 7.1 and 7.4) which is in an appropriate range (pH 6.5-7.5) for cultivation of G. mihanovichii. The organic content was increasing along with increasing contents of earthworm casting ratio while it was lower than the treatment practice group (32-43 mg/kg vs. 55 mg/kg). The content of exchangeable cation was also increasing as the ratio of earthworm casting was elevated; although levels of $K^+$, $Na^+$, and $Mg^{2+}$ were lower than the treatment practice group, the level of $Ca^{2+}$ was higher ($9.1cmol^+/kg$ and $11.5-33.7cmol^+/kg$ in the treatment practice group and the earthworm casting group, respectively). Three months after grafting, diameters of G. mihanovichii were compared with the control group; consequently, there was a significant difference noted in between the earthworm casting group and the control group (31.39 mm vs. 32.46-37.59 mm). After 5 months, growth characteristics of G. mihanovichii were evaluated. Similarly, the diameter of G. mihanovichii was significantly increasing in the group with higher ratio of earthworm casting treatment (32.63 mm vs. 32.49-37.59 mm). The height of tubercles was 2.63 mm in the control group while it was significantly elevating along with the ratio of earthworm casting mixture. The more numbers of tubercles, the more incomes for farm-houses; as results, higher mixture ration of earthworm casting resulted more numbers of tubercles compared to the control group (2.7 vs. 3.2-8.3 ea). In particular, in the earthworm casting groups with 80% and 100% ratios, the numbers of tubercles were 6.2 and 8.3 ea, respectively, which is 2.5 times more than those of the control group. These results indicate that earthworm casting treatment may be utilized in G. mihanovichii farming houses for short term production of tubercles. In the group with 40% and 60% of earthworm casting mixture, the numbers of tubercles were found to be 4.5 and 4.8 ea, respectively which is higher than the control group as well; in these groups, there were no issues with soil drainage as well as moss formation. Given the analysis results of growth characteristics of G. mihanovichii, it was concluded that 40% and 60% of earthworm casting mixture might be the optimal ratios.