• Title/Summary/Keyword: hindrance

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Multivessel Coronary Revascularization with Composite LITA-RA Y Graft (좌내흉동맥-요골동맥 복합이식편을 이용한 다중혈관 관상동맥우회술)

  • Lee Sub;Ko Mgo-Sung;Park Ki-Sung;Ryu Jae-Kean;Jang Jae-Suk;Kwon Oh-Choon
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.359-365
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    • 2006
  • Background: Arterial grafts have been used to achieve better long-term results for coronary revascularization. Bilateral internal thoracic artery (ITA) grafts have a better results, but it may be not used in some situations such as diabetes and chronic obstructive pulmonary disease (COPD). We evaluated the clinical and angiographic results of composite left internal thoracic artery-radial artery (LITA-RA) Y graft. Material and Method: Between April 2002 and September 2004, 119 patients were enrolled in composite Y graft for coronary bypass surgery. The mean age was $62.6{\pm}8.8$ years old and female was 34.5%. Preoperative cardiac risk factors were as follows: hypertension 43.7%, diabetes 33.6%, smoker 41.2%, and hyperlipidemia 22.7%, There were emergency operation (14), cardiogenic shock (6), left ventricle ejection fraction (LVEF) less than 40% (17), and 17 cases of left main disease. Coronary angiography was done in 35 patients before the hospital discharge. Result: The number of distal anastomoses was $3.1{\pm}0.91$ and three patients (2.52%) died during hospital stay. The off-pump coronary artery bypass (OPCAB) was applied to 79 patients (66.4%). The LITA was anastomosed to left anterior descending system except three cases which was to lateral wall. The radial Y grafts were anastomosed to diagonal branches (4), ramus intermedius (21), obtuse marginal branches (109), posterolateral branches (12), and posterior descending coronary artery (8). Postoperative coronary angiography in 35 patients showed excellent patency rates (LITA 100%, and RA 88.5%; 3 RA grafts which anastomosed to coronary arteries <70% stenosed showed string sign with competitive flow). Conclusion: The LITA-RA Y composite graft provided good early clinical and angiographic results in multivessel coronary revascularization. But it should be cautiously used in selected patients.

Anatomical Studies on Root Formation in Hypocotyl and Epicotyl Cuttings of Woody Plants (임목(林木)의 배축(胚軸) 및 유경삽수발근(幼茎揷穗発根)의 해부학적(解剖学的) 연구(研究))

  • Choi, Man Bong
    • Journal of Korean Society of Forest Science
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    • v.52 no.1
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    • pp.1-30
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    • 1981
  • The origin and development of adventitious roots was studied using hypocotyl and epicotyl cuttings of 34 species, 24 genus of woody plants. These cuttings obtained from young seedlings cultured in vials containing distilled water only. The several characteristics of cuttings materials studied are shown in Table 1. The results are summerized as follows: 1. The circumference shapes of cross-sections of hypocotyl and epicotyl cuttings can be divided into six categories, namely, round, irregular round, ellipse, irregular ellipse, square, and triangle. Species differences within a genus did not show any difference of hypocotyl and epicotyl cross-sections shape, however, a noticeable variation among genus or higher taxa. 2. The arrangements of vascular bundles in the cross-sections of hypocotyls or epicotyls were almost all collateral types and generally showed generic characteristics differing one to the other. However, there were some variations between species within the genus. Six models of vascular bundle arrangement were proposed for all the above speices. 3. The rooting portions of hypocotyl and epicotyl cuttings in this experimental materials can be grouped as follows: (1) Interfascicular parenchyma; (Thuja orientalis. T. orientalis for. sieboldii, Acer microsieboldianum, A. palmatum, A. saccharinum, Cercis chinensis, Lespedeza bicolor, Magnolia obovata, M. sieboldii, Mallotus japonicus, Staphylea bumalda) (2) Cambial and phloem parenchyma: (Chamaecyparis obtusa, C. pisifera, Albizzia julibrissin, Buxus microphylla var. Koreana, Cereis chinensis, Euonymus japonica, Firmiana platanifolia, Lagerstroemia indica, Ligustrum salicinum, L. obtusifolium, Magnolia kobus, M. obovata, Mallotus japonicus, Morus alba, Poncirus trifoliata, Quercus myrsinaefolia, Rosa polyantha, Styrax japonica, Styrax obassia) (3) Primary ray tissues; (Euonymus japonica, Styrax japonica) (4) Leaf traces; (Quercus acutissima, Q. aliena) (5) Cortex parenchyma; (Ailanthus altissima) (6) Callus tissues; (Castanea crenata, Quercus aliena, Q. myrsinaefolia, Q. serrata) 4. As a general tendency throughout the species studied, in hypocotyl cuttings, the adventitious root primordia were originated from the interfascicular parenchyma tissue, however, leaf traces and callus tissues were contributed to the root primordia formation in epicotyl cuttings. The hypocotyl cuttings of Ailanthus altissima exhibited a special performance in the root primordia formation, this means that cortex parenchyma was participated to the origin tissue. And in Firmiana platanifolia, differening from the other most species, the root primordia were formed at the phloem parenchyma adjacent outwardly to xylem tissue of vascular bundle system as shown photo. 48. 5. All the easy-to, or difficult-to root species developed adventitious roots in vials filled with distilled water. In the difficult-to-root species, however, root formations seemed to be delayed because they almost all had selerenchyma or phloem fiber which gave some mechanical hindrance to protrusion of root primordia. On the other hand, in the easy-to-root species they seemed to form them more easily because they did not have the said tissues. The rooting portions between easy-to-root and difficult-to-root species have not clearly been distinguished, and they have multitudinous variations. 6. The species structured with the more vascular bundles in number compared with the less vascular bundles exhibited delayed rooting. In the cuttings preparation, the proximal end of cuttings was closer to root-to-stem transition region, the adventitious root formation showed easier. 7. A different case occured however with the mature stem cuttings, in both the needle-leaved and the broad-leaved species. In the hypocotyl cuttings, parenchymatous tissues sited near the vascular bundles become the most frequent root forming portions in general and relevant distinctions between both species were hardly recognizable. 8. In the epicotyl cuttings, root primordia originated mainly in leaf traces in connection with cambial and phloems or callus tissues itself. In the hypocotyl cuttings, interfascicular parenchyma was the most frequent portion of the root primordia formation. The portions of root primordia had more connection with vascular cambium system, as the tissues were continuing to be developed.

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