Cent Of Grafts Research Articles

Propagation Studies on Different Rootstocks of Jamun (Syzygium cuminii skeels)

Jamun is propagated by seeds as well as vegetatively and the grafts raised on seedling rootstocks of unknown source resulting in variation among the plants. Hence, there is a need to identify the suitable rootstock for propagating jamun to get maximum graft success. The time of grafting is the most important factor for highest graft success and influenced by the climatic conditions prevailing in particular season in addition to the type of rootstocks. Considering the above factors the research was carried out at Kittur Rani Channamma College of Horticulture, Arabhavi during 2018-2019 to study suitable season and rootstock for the jamun variety AJG-85, which is more popular variety in and around Belgaum district. Jamun variety AJG-85 grafted on its own rootstock during October recorded the maximum number of sprouts (3.92, 4.49 and 4.56 respectively), sprout length (7.91, 16.18 and 22.20 cm respectively), per cent graft success (79.39, 88.80 and 90.94% respectively), per cent graft survival (93.96 and 89.30% respectively) at different days after grafting and minimum number of days taken for sprouting (19.15).

Soft wood grafting - A novel and rapid multiplication technique in Coorg mandarin (Citrus reticulate Blanco)

Coorg mandarin is commercially multiplied by shield or T budding. The process of shield budding will takes eighteen to twenty months for the production of quality planting material. Hence present experiment was conducted to standardize soft wood grafting in Coorg mandarin to reduce the nursery phase for rapid multiplication of quality planting materials. In this study, two to three months old terminal shoots of Coorg mandarin were grafted on one, two, three and four months old rootstocks of Rangpur lime.The soft wood grafting on three and four months old rootstocks were recorded cent per cent graft success and higher plant survivability (98%) and minimum was noticed in one month old rootstocks. The plant height (45.77 cm), plant girth (0.60 cm), number of leaves per plant (42.9), number of side shoots per plant (5.65), root length (33.15 cm) and root spread (8.29 cm)were also found maximum on four months old root stocks followed by three month old rootstocks. Age of rootstocks have significant difference (P=0.05) for plant weight, shoot weight and root weight in both fresh and dry weight basis.The above findings revealed that, four months old rootstocks are more suitable for soft wood grafting in terms of graft success and plant traits. Soft wood grafting can be gainfully exploited for rapid multiplication of good quality planting material by reducing the nursery phase.

Soft wood grafting - A novel and rapid multiplication technique in Coorg mandarin (Citrus reticulate Blanco)

Coorg mandarin is commercially multiplied by shield or T budding. The process of shield budding will takes eighteen to twenty months for the production of quality planting material. Hence present experiment was conducted to standardize soft wood grafting in Coorg mandarin to reduce the nursery phase for rapid multiplication of quality planting materials. In this study, two to three months old terminal shoots of Coorg mandarin were grafted on one, two, three and four months old rootstocks of Rangpur lime.The soft wood grafting on three and four months old rootstocks were recorded cent per cent graft success and higher plant survivability (98%) and minimum was noticed in one month old rootstocks. The plant height (45.77 cm), plant girth (0.60 cm), number of leaves per plant (42.9), number of side shoots per plant (5.65), root length (33.15 cm) and root spread (8.29 cm)were also found maximum on four months old root stocks followed by three month old rootstocks. Age of rootstocks have significant difference (P=0.05) for plant weight, shoot weight and root weight in both fresh and dry weight basis.The above findings revealed that, four months old rootstocks are more suitable for soft wood grafting in terms of graft success and plant traits. Soft wood grafting can be gainfully exploited for rapid multiplication of good quality planting material by reducing the nursery phase.

Ten-year myringoplasty series: does the cause of perforation affect the success rate?

To present the results of primary myringoplasty procedures together with the perforation cause, perforation size and site, surgeon's experience, and surgical method, and to investigate how these factors relate to graft 'take' rates. Retrospective chart review of 243 consecutive patients undergoing primary myringoplasty with temporalis fascia underlay over a 10-year period from 1994 to 2004. The overall graft take rate was 95 per cent. The retroauricular approach resulted in a 97 per cent graft take rate, whereas a significantly lower rate (77 per cent) was seen for surgery conducted via the endaural approach, or via an ear speculum. There was no relationship between other factors and tympanic membrane healing. No association was found between perforation cause and graft take rate. The underlay technique is safe and reliable, and the retroauricular approach is preferable as it enables good surgical access and has better results.

Management of Vascular Graft Infections with Soft Tissue Flap Coverage: Improving Limb Salvage Rates–A Veterans Affairs Experience

Graft infections are one of the most challenging issues in surgery with an incidence of 0.7 to 7 per cent, with femoral site infections being the most common (13% incidence). The gold standard treatment has been graft removal, wide débridement, and extra-anatomical bypass. Routine excision of infected peripheral arterial grafts and vascular reconstruction with extraanatomic conduits are associated with mortality rates ranging from 10 to 30 per cent and amputation rates of up to 70 per cent. As a result of the high morbidity and mortality associated with this approach, selective graft preservation techniques have been developed. Newer treatment plans discuss preservation of the graft with débridement and coverage of the infected region. Better wound care, nutrition optimization, and robust flap coverage have led to significantly improved graft salvage, lower amputation rates, and improved outcomes. The objective of this study was to evaluate the Veterans Affairs (VA) experience with flap coverage for femoral vascular graft infections. A retrospective review was conducted of all VA data from 1997 to 2008 with inclusion criteria of patients with deep groin wound infections requiring flap coverage after femoral bypass surgery. Eleven such patients were identified with a mean age of 73 years and with multiple comorbidities (hypertension, malnutrition, diabetes mellitus, chronic obstructive pulmonary disease, coronary artery disease, chronic renal insufficiency). Patients presented with wound drainage, exposed graft, hematoma, perigraft fluid collection, and pseudoaneurysm. Treatment protocol included: 1) aggressive débridement of the wound bed; 2) early soft tissue (flap) coverage; 3) wound vacuum assisted closure device or frequent dressing changes; and 4) skin graft once the bed was prepared. Eighty-two per cent of wounds had positive cultures with equal numbers of patients with Staphylococcus epidermidis, Pseudomonas, Escherichia coli (22%), and higher methicillin-resistant Staphylococcus aureus (33%), whereas in the literature Staphylococcus is the most common (greater than 50%). Average hospital length of stay was 94 days with average follow up at 10 months. Fifty-five per cent graft salvage (one Dacron [50%], two polytetrafluoroethylene [33%], two saphenous vein graft [100%], one cryovein [100%]) was achieved with 91 per cent limb salvage. Complications included graft blowout (two) requiring partial flap loss (one), retroperitoneal hematoma (one), limb loss (one), sepsis (one), and death (one). Infected vascular grafts remain a challenging problem requiring multidisciplinary care. Careful débridement and aggressive wound care followed by selective flap coverage appears to decrease morbidity and increase graft and limb salvage.

Adjuvant distal arteriovenous shunt with femorotibial bypass for critical ischaemia

In a series of 59 femorotibial bypass operations for critical ischaemia an arteriovenous (A-V) shunt was constructed at the distal anastomosis in 36 patients whose pedal angiograms showed an occlusion in the primary pedal arch. Mean blood flow recorded in the grafts without the shunt in the patients whose primary pedal arch was occluded was 83.6 +/- 9.9 ml/min (mean +/- s.e.m.) compared with 152 +/- 16.2 ml/min in those patients whose primary pedal arch was intact (P less than 0.01). This increased to 236 +/- 20.5 ml/min with the shunt open (P less than 0.001). Twelve months after operation the cumulative patency rate for grafts with an A-V shunt was 46.5 per cent compared with 40.5 per cent for grafts in the better risk patients with a patent primary pedal arch who did not receive a shunt. No side effects were observed due to the presence of a shunt. The importance of the primary pedal arch and the rationale of adjuvant distal arteriovenous shunt are discussed. The results indicate that the addition of an arteriovenous shunt at the distal anastomosis of a long femorotibial bypass is of benefit when blood flow through the graft is limited by occlusive disease in the pedal arteries.

Renal transplantation--15 years' experience.

In Australia, it has been logistically possible, with integrated programmes of dialysis and transplantation, to use finite resources optimally for the treatment of patients presenting with terminal renal failure (30 per million population per year). Transplantation is offered as definitive treatment in most instances. Transplantation rates (20 per million per year) will need to increase to meet the continuing demand, if the results of transplantation remain unchanged. Patient survival after transplantation is approximately 80 per cent at year, 50 per cent at 5 years and 20 per cent at 15 years. Most grafts are from cadavers. Graft survival of 60 per cent at 1 year thereafter declines steadily with a 3 per cent graft loss per year. Patient and graft survival are adversely affected by increasing age, and the use of cadaver rather than living donors. Graft survival is superior with a 4 antigen match on HLA A and B matching, and is significantly lower in patients receiving no blood transfusions prior to transplantation. Long term morbidity is significant in two-thirds of patients receiving grafts. Problems include chronic rejection and toxic effects of immunosuppression. The increased tumour risk after transplantation (which in Australia has been mostly skin tumours) is of major concern; 30 per cent of patients by 10 years have developed cancer.

Current techniques for infrainguinal arterial reconstruction

Infrainguinal reconstruction for peripheral vascular occlusive disease comprises an increasingly complex array of interventions which provide unparalleled options for the salvage of threatened limbs. Conventional autogenous saphenous vein bypass remains the most durable revascularization with anticipated graft patency rates approaching 80 percent after five years and excellent long term limb salvage. These excellent results are equally applicable to vein grafts carried to infrapopliteal and even inframalleolar levels, possibly reflecting increased utilization of the in situ method. Although 20 per cent of grafts fail within five years, secondary intervention results in sustained limb salvage in the majority of patients. In the absence of autogenous vein, however, prosthetic material performs poorly such that new interventions consisting of percutaneous transluminal angioplasty, rotary atherectomy devices and laser systems are under aggressive development. Although initial results with these devices are encouraging, long term patency rates remain poor largely due to restenosis. Further progress seems to depend primarily on an increased understanding of the natural healing response of the injured artery.

Cultured epithelium as a skin substitute

Twenty-five burn patients with full or partial thickness skin loss received cultured epithelium (CE), allografts or autografts as part of their treatment. Overall, a 30 per cent graft ‘take’ was achieved irrespective of whether the CE was autograft or allograft, fresh or frozen. In the case of deep dermal burns this figure improved to 50 per cent. The surviving grafts merged with split thickness skin grafts (SSG) and advancing wound edges. When full thickness skin loss was grafted, only a patchy take could be achieved and the surviving islands of CE tended not to spread across the wound. No rejection of CE allograft was recorded either clinically or histologically up to 6 months. The technical problems and clinical implications are discussed.

Endourethral Urethroplasty—Use of a New Catheter

Endourethral split skin grafting following visual internal urethrotomy was done successfully in 7 selected patients with stricture of the bulbomembranous urethra. Open substitution or anastomotic urethroplasty might otherwise have been necessary in these patients. The technique involves the use of a specially designed double balloon catheter, in which the second balloon, when distended, keeps the split skin graft in close opposition with the urethral raw area. This function ensures a near 100 per cent graft take, keeps the strictured area wide open and allows early ambulation of the patient, since no perineal compression dressing is required.

One-stage Penile/Preputial Cutaneous Island Flap Urethroplasty for Urethral Stricture: A Preliminary Report

A 1-stage urethroplasty for urethral strictures is described using a transverse distal penile or preputial island of skin as a flap, which is supplied axially by the superficial external pudendal vessels. This portion of the skin is hairless and the pedicle is constructed so that the skin can reach anywhere from the external meatus to the prostatic urethra for reconstruction as a patch or tube. In 10 cases reviewed urethroscopically for intervals of 5 weeks to 6 months there was 100 per cent graft take with no stenosis at the anastomotic sites and no permanent fistula. There was 1 residual stricture owing to incomplete excision of the original stricture and 3 fine hairs were seen in 2 new urethras. Mucous membrane or mucocutaneous bridges occurred in 4 patients owing to cross-adhesions, which were divided easily.

Effect of HLA-A and HLA-B matching on survival of grafts and recipients after renal transplantation.

Data on the effect of HLA-A and HLA-B matching between unrelated donors and recipients focus mainly on graft survival. After linking the follow-up data of the European Dialysis and Transplant Association and those of the Eurotransplant Foundation, the effect of HLA-A and HLA-B matching on recipient survival could be studied. Recipients of well-matched kidneys--i.e., without mismatches for the HLA-A and B antigens--had 51 per cent graft survival at five years, whereas recipients of grafts mismatched for four antigens had 32 per cent graft survival at five years. The overall P value between the five different mismatch classes was 0.0005. Patient survival at five years was 72 per cent in recipients of a kidney without HLA-A and B mismatches and 54 per cent in recipients of a completely mismatched donor kidney (overall, P = 0.001). These results suggest that matching for the HLA antigens has a beneficial long-term effect not only on renal-allograft survival but also on patient survival.

Significance of new Q waves after bypass grafting: Correlations between graft patency, ventriculogram, and surgical venting technique

New Q waves were observed in 56 (8 per cent) of 671 patients undergoing saphenous vein bypass grafting, with an over-all mortality rate of 1.8 per cent. Forty-two of the 56 (75 per cent) had postoperative ventriculograms and arteriograms and are reported herein. Ventricular venting was used intraoperatively in 17 patients, and atrial venting in 25. Thirty-one patients had new “anterior” and/or “septal” Q waves, while 23 had “inferior” or “infero-lateral” and 2 had “lateral” Q waves. The incidence of new Q waves in patients with ventricular venting was 22 per cent and in those with atrial venting it was 5.8 per cent (p < 0.05). Age, sex, duration of disease, severity of angina, previous myocardial infarction or main left coronary lesions did not affect the incidence of new Q waves. Although new Q waves were more frequent in patients with preoperative cardiomegaly and congestive heart failure, this difference was not statistically significant. However, there was no significant difference in the over-all cardiopulmonary bypass or aortic cross-clamping time in patients with or without new Q waves. Cardiopulmonary bypass time exceeding 100 minutes in patients with double bypasses, and more than 120 minutes with multiple bypasses, were more frequent in patients with new Q waves. Completeness or incompleteness of the revascularization procedure did not affect the incidence of new Q waves. In all but three patients with ventricular venting, new Q waves appeared in a zone of myocardium supplied by a grafted artery. In the three exceptions, the Q waves occurred within the zone of myocardium supplied by diseased but ungrafted vessels. In the ventricular vented group 7 (41 per cent) demonstrated an improved or unchanged postoperative ventriculogram with 7 per cent graft closure and 10 (59 per cent) had deteriorated ventriculograms with 44 per cent graft closure. In 25 patients with atrial venting, 19 (76 per cent) showed improved or unchanged postoperative ventriculogram with 12 percent graft closure and 6 (14 per cent) had deteriorated ventriculograms with 40 per cent graft closure. Although over-all incidence of new Q waves was 22 per cent in patients with ventricular venting as compared to 5.8 per cent in those with atrial venting, the graft closure rate in patients with new Q waves was 27 per cent in ventricular vented group and 15 per cent in those with atrial venting. These findings indicate a poor correlation between new Q waves and graft closure. Improved postoperative ventriculograms correlated well with graft patency despite new Q waves. The etiology of new post-bypass graft Q waves are varied. They include direct ventricular trauma and conduction delays resulting from surgery or venting, as well as true ischemic infarction. Infarction may be due to compromised arterial inflow either in non-operated diseased vessels, in vessels distal to anastomoses with patent grafts, or due to graft closure.

Kidney transplantation in patients with end stage congenital renal disease: Report of eighteen cases and review of the organ transplant registry

Eighteen patients with end stage congenital renal disease requiring kidney transplantation constituted 12 per cent of the transplantation recipients at this institution over the past six years. The post-transplantation course in this group was remarkably satisfactory, with a 94 per cent graft survival at three years. In addition, we analyzed survival data from over 9,900 patients in the Organ Transplant Registry and demonstrated that transplant recipients with end stage congenital renal disease have equal or better five year patient survival compared with those with acquired end stage renal disease. Only those patients with adult polycystic disease had a less satisfactory prognosis, probably because of age-related factors. In contrast, there were few statistical correlations between renal allograft survival, age, and original disease.

Graft copolymers as elastomeric fibers—I synthesis of the graft copolymers

Pre-irradiation grafting, mainly with an ethyl acrylate emulsion system, has been used to produce wool and cellulosic fibers having elastomeric properties. Comparative studies using selected chemically-initiated systems were also carried out. The pre-irradiation grafting-time curves were found to be auto-accelerative and grafting levels in excess of 3000 per cent could be achieved. Circa 1000 per cent graft was required to obtain fibers with high “rubber-like” elasticity. Grafting rates were found to increase substantially with temperature reducing the grafting times necessary to achieve high elasticity to the order of minutes at 35°C compared to 20 hr at ambient temperatures. Reduction of the level of grafting required to obtain elastomeric properties is clearly of interest, and it was found that when rayon fibers containing low levels of graft (below 100 per cent) were subjected to post-treatments with reagents capable of decrystallizing cellulose, the fibers, which heretofore exhibited no significant elastomeric properties, became highly elastic.

Graft copolymers as elastomeric fibers —II. Mechanical properties and morphology of grafted copolymers

Rayon-g-(ethylacrylate) graft copolymers, prepared via pre-irradiation grafting and also via selected chemically initiated techniques, have been characterized with respect to their mechanical properties. Electron microscopy and X-ray diffraction were used to determine the morphological and structural modifications which must be attained in order to achieve elastomeric behavior in the grafted rayon. The onset of high “rubber-like” elasticity at around 1000 per cent graft is accompanied by a large drop in tenacity. This strength loss may be reduced without any loss in elongation by adding small quantities of bifunctional monomers to the grafting solution. Elastomeric properties were attained even at graft levels below 100 per cent by subjecting the grafted fibers to a treatment capable of decrystallizing the cellulose. In order to achieve elastomeric properties, these studies indicate that grafting must occur evenly throughout the fiber cross-section, expanding the fiber and maintaining its crystalline regions in a disrupted state.

Tetrazolium reductase as an index of viability of stored skin

The take or failure of 264 split-skin grafts on burned patients has been investigated; the single most important reason for failure was non-viability of the graft at its time of application, as measured by the relative tetrazolium reductase (TR) activity. There was a high correlation between relative TR activity of less than 50 per cent and graft failure, and between TR activity of greater than 50 per cent graft take. The longest period for which a graft could be stored at −10°C and remain viable was 12 days; a few were non-viable before 10 days. Repeated freezing and thawing of stored skin grafts reduced the length of viability by 40 per cent compared with grafts which had been frozen and thawed only once. The tetrazolium reductase activity provides a quick reliable prognostic indication of whether or not a graft should be applied with the anticipation of a take.

Demineralization of bone transplants in vivo

A standard experimental model was designed by creating midfibular fracture gaps in rats, for the study of grafts of decalcified allogeneic bone matrix (DABM), fresh autologous bone, fresh allogeneic bone, and decalcified xenogeneic bone matrix (DXBM). The results reveal that DABM implants were accepted by the host in fresh and chronic fibular gaps. There was a gradual increase in calcium concentration, which reached normal levels by the eighth postoperative week at fracture gap sites. DXBM grafts demonstrated very small concentration of calcium after 4 weeks, which was mainly due to formation of callus around the grafts; and 55 per cent of these grafts were rejected, as evidenced by exudate and exfoliation. Fresh autologous and fresh allogeneic bone transplants demonstrated a fall in calcium concentration in the initial 3-week intervals, then a gradual increase in mineralization, and the attainment of normal levels by the eighth postoperative week. All autologous bone grafts were accepted, whereas 45 per cent of fresh allogeneic bone grafts were rejected from the mid-fibular implanted sites. The study with autologous bone transplants was repeated, and the implanted bone was isolated from new bone for calcium estimation at various postoperative intervals. The results revealed gradual decrease in calcium concentration up to 4 weeks, and the later intervals could not be estimated because of difficulty in separation of implanted bone from the new bone. The results of these experiments suggest that calcified bone grafts (autologous or allogeneic) undergo partial or complete decalcification in tissues after implantation. Since this decalcification of bone could be accomplished in vitro, it would appear that the DABM grafts are worthy of trials in human osseous deformities.

Modification of cellulose acetate reverse osmosis membranes by radiation grafting

AbstractLarge excesses of a chain transfer agent, carbon tetrachloride, were introduced to a recipe for the mutual radiation grafting of styrene to cellulose acetate film. The effect of the carbon tetrachloride on the molecular characteristics as well as the reverse osmosis and time dependent mechanical properties of resulting graft copolymers was determined. Extremely short side chains were generated as a consequence of the high concentrations of chain transfer agent and the composite results further suggest that the morphology of the grafted films is best described as “destructured” or internally plasticized consequent to grafting in the presence of CCl4. Reverse osmosis fluxes increased with percent graft; salt rejection was high and unaffected by per cent graft up to 40% graft; and the tensile creep under wet conditions was significantly retarded by the grafting. These effects were shown to accrue from grafting per se by control experiments involving α‐methylstyrene which will not propagate to form a polymer under these conditions. These results are compared and contrasted with earlier work on grafting in the absence of CCl4 where long side chains of polystyrene were generated resulting in a structuring of the polymer involving domains of polystyrene‐rich material and domains of cellulose acetate rich polymer.

Angiographic determination of operability in candidates for aorto-coronary bypass.

The results of venous bypass operations upon 57 diseased coronary arteries have been studied, using pre and postoperative angiography.An attempt was made to determine if the angiographically demonstrated caliber of the poststenotic distal segment of the artery was of any significance in deciding which patients were suitable candidates for bypass surgery.Among the 47 arteries having a distal lumen diameter of greater than 1 mm., a 91 per cent graft patency rate was achieved. Among the 10 arteries having a distal lumen diameter of 1 mm. or less, only a 30 per cent graft patency rate could be achieved.Thus it would appear that the coronary arteriogram gives an accurate indication of the actual caliber of the distal segment and that where this is 1 mm. or less, diffuse atherosclerosis is likely to be present, making the outlook for a bypass operation rather unfavorable.