Successful Grafting Research Articles

Comparison of the Effect of Platelet-rich Plasma (PRP) and Fat Graft on Autologous Bone Grafting in a Randomized-controlled Experimental Skull Model.

Gold standard method for the treatment of critical-sized bone defects is the autogenous bone grafting procedure. A number of new and potentially useful adjuncts currently are being investigated to enhance the success of bone grafting. We propose to evaluate the effect of the most known and easily obtained 2 biological materials, fat graft and platelet-rich plasma (PRP), on bone graft healing. Twenty-seven New Zealand male rabbits were included in this randomized, controlled study. Two-sided 15-mm diameter bone defects were created in the parietal bones and the bones taken were replaced right-to-left and vice versa with 1 control group, 1 fat graft applied group, and the last one PRP applied group. Histologic evaluation and 3-dimensional maxillofacial computerized tomography were performed and bone density was calculated. In radiologic analysis, bone density was significantly different in the PRP group compared with the control and fat graft group in the 12th week ( P <0.05). In histologic scoring analysis, the PRP group had a better score than the control and fat graft group, while the fat graft group was worse than the control group in the 6th week ( P <0.05). The addition of PRP had a positive effect whereas fat graft had a negative effect on bone graft healing compared with the control group.

A synthesis of styrene-grafted starch accompanied with reaction condition optimization and microstructural and macroscopic property analysis

Styrene grafting is efficient to alter starch macroscopic property. Nevertheless, reaction mechanism, condition and products structure and properties are blurry. A deep exploration is necessary. Herein, K2S2O8 and styrene were chosen for corn starch modification. Reaction conditions involving K2S2O8 and styrene amounts, temperature and period were explored. Concurrently, microstructural and macroscopic properties of modified starches were explored via FT-IR, XPS, 13C NMR, GPC, XRD, SEM, TGA, DSC, CA and water dispersibility analysis. Main results reveal that K2S2O8 and styrene amounts, temperature and period as 3 and 200 wt%, 50 °C and 3 h is an optimized condition for starch grafting styrene, achieving a grafting yield (GY) as 45.8 wt%. GPC, XPS and 13C NMR analysis certified successful grafting and grafting mainly occurred at C-3 site OH within glucose unit. This variation converted starch crystalline shape transformation from A-typed to V-typed accompanied with crystallinity, thermal-stability and swelling characteristic decrease and surface hydrophobicity elevation. With GY increased from 0 to 45.8 wt% crystallinity decreased from 38.7 to 15.1%, thermal-decomposition temperature decreased by 10 °C, gelatinization temperature and CA increased by 50 °C and 70°, respectively. It seems a small amount styrene grafting can alter starch macroscopic property such as hydrophilicity efficiently, readily to manufacture hydrophobic starch. This hydrophobic starch might have a potential use in plastic industry, enlarging starch use application, meaningful.

Auxin signaling in the cambium promotes tissue adhesion and vascular formation during Arabidopsis graft healing.

The strong ability of plants to regenerate wounds is exemplified by grafting when two plants are cut and joined together to grow as one. During graft healing, tissues attach, cells proliferate, and the vasculatures connect to form a graft union. The plant hormone auxin plays a central role, and auxin-related mutants perturb grafting success. Here, we investigated the role of individual cell types and their response to auxin during Arabidopsis (Arabidopsis thaliana) graft formation. By employing a cell-specific inducible misexpression system, we blocked auxin response in individual cell types using the bodenlos mutation. We found that auxin signaling in procambial tissues was critical for successful tissue attachment and vascular differentiation. In addition, we found that auxin signaling was required for cell divisions of the procambial cells during graft formation. Loss of function mutants in cambial pathways also perturbed attachment and phloem reconnection. We propose that cambial and procambial tissues drive tissue attachment and vascular differentiation during successful grafting. Our study thus refines our knowledge of graft development and furthers our understanding of the regenerative role of the cambium.

Integrated transcriptomics and histopathology approach identifies a subset of rejected donor livers with potential suitability for transplantation

BackgroundLiver transplantation is an effective treatment for liver failure. There is a large unmet demand, even as not all donated livers are transplanted. The clinical selection criteria for donor livers based on histopathological evaluation and liver function tests are variable. We integrated transcriptomics and histopathology to characterize donor liver biopsies obtained at the time of organ recovery. We performed RNA sequencing as well as manual and artificial intelligence-based histopathology (10 accepted and 21 rejected for transplantation).ResultsWe identified two transcriptomically distinct rejected subsets (termed rejected-1 and rejected-2), where rejected-2 exhibited a near-complete transcriptomic overlap with the accepted livers, suggesting acceptability from a molecular standpoint. Liver metabolic functional genes were similarly upregulated, and extracellular matrix genes were similarly downregulated in the accepted and rejected-2 groups compared to rejected-1. The transcriptomic pattern of the rejected-2 subset was enriched for a gene expression signature of graft success post-transplantation. Serum AST, ALT, and total bilirubin levels showed similar overlapping patterns. Additional histopathological filtering identified cases with borderline scores and extensive molecular overlap with accepted donor livers.ConclusionsOur integrated approach identified a subset of rejected donor livers that are likely suitable for transplantation, demonstrating the potential to expand the pool of transplantable livers.

A review of the success of free nipple grafts in therapeutic mammoplasty

A review of the success of free nipple grafts in therapeutic mammoplasty

Granular composite of polyvinyl chloride anion exchange resin encapsulated with nano TiO2 for arsenic removal from water

Persistently high arsenic levels in drinking water threaten underprivileged areas worldwide. Although nanomaterials exhibit exceptional arsenic removal properties, their implementation presents challenges. We converted N-methylimidazole-modified polyvinyl chloride into a granular anion exchange resin (PNAXRs) using an environmentally friendly and gentle synthesis method. Additionally, a unified approach for embedding nanomaterials within these resins was proposed, yielding a TiO2 composite resin (TiO2@PNAXRs). Structural characterization confirmed the successful grafting of imidazolium cations with anion-exchange properties onto polyvinyl chloride side chains. BET analysis indicates a high specific surface area of 70.31 m2/g for the PNAXRs. TGA curves demonstrate the successful encapsulation of approximately 24.9% TiO2 within the composite resin. The SEM-EDS results show a uniform distribution of TiO2 in the PNAXRs, which facilitates the effective utilization of TiO2. Adsorption experiments in conjunction with XPS analysis provided insights into the dual role of inner-sphere complexation and ion exchange in the adsorption mechanism of As(V) by TiO2@PNAXRs. In dynamic adsorption tests utilizing high-As(V) groundwater from the Datong Basin as the influent, TiO2@PNAXRs demonstrated the ability to produce effluents that meet the World Health Organization's recommended limit for arsenic in drinking water, with a capacity of 1780 bed volumes. These findings support the use of PNAXRs as ideal matrices for TiO2 and their practical application in As(V) removal processes.

An antioxidant hydrogel dressing with wound pH indication function prepared based on silanized bacterial nanocellulose crosslinked with beet red pigment extract

Maintaining wound moisture and monitoring of infection are crucial aspects of chronic wound treatment. The development of a pH-sensitive functional hydrogel dressing is an effective approach to monitor, protect, and facilitate wound healing. In this study, beet red pigment extract (BRPE) served as a native and efficient pH indicator by being grafted into silane-modified bacterial nanocellulose (BNC) to prepare a pH-sensitive wound hydrogel dressing (S-g-BNC/BRPE). FTIR confirmed the successful grafting of BRPE into the BNC matrix. The S-g-BNC/BRPE showed superior mechanical properties (0.25 MPa), swelling rate (1251 % on average), and hydrophilic properties (contact angle 21.83°). The composite exhibited a notable color change as the pH changed between 4.0 and 9.0. It appeared purple-red when the pH ranged from 4.0 to 6.0, and appeared light pink at pH 7.0 and 7.4, and appeared ginger-yellow at pH 8.0 and 9.0. Subsequently, the antioxidant activity and cytotoxicity of the composite was evaluated, its DPPH·, ABTS+, ·OH scavenging rates were 32.33 %, 19.31 %, and 30.06 %, respectively, and the cytotoxicity test clearly demonstrated the safety of the dressing. The antioxidant hydrogel dressing, fabricated with a cost-effective and easy method, not only showed excellent biocompatibility and dressing performance but could also indicated the wound state based on pH changes.

Interlayer repair with porcine small intestinal submucosa versus internal repair with tragus cartilage in endoscopic tympanoplasty

ObjectiveEndoscopic tympanoplasty includes various surgical methods, such as internal repair, interlayer repair, and external overlay. This technique requires autologous materials, allografts, and xenografts, which are used to repair tympanic membrane (TM) perforation. To obtain good results, appropriate surgical methods and repair materials should be selected. This study aims to assess the efficacy of repairing refractory TM perforations in the porcine small intestinal submucosa (SIS) during transcanal endoscopic type I tympanoplasty. MethodA retrospective chart review was performed on patients who underwent TM perforation repair with porcine SIS and tragus cartilage between January 2022 and September 2022 at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. Perforation size, tympanic status, pre- and postoperative symptoms, follow-up data, wound healing rates, and hearing improvement were analysed. ResultsOf the 115 patients included in the study, 56 underwent interlayer repair with porcine SIS of the TM, and 59 patients underwent internal repair with tragus cartilage. No significant difference was found between the two groups at baseline in terms of age, sex, disease course, perforation side, tympanic status, underlying disease, or preoperative infection. The total postoperative effective rate of interlayer implantation with porcine SIS was 91.07% (51 patients), and that of internal implantation with tragus cartilage was 88.14% (52 patients). No significant difference was found in terms of the graft success rate between the two surgical methods (p = 0.887). Postoperative pure tone auditory (PTA) and air-bone gap (ABG) density significantly increased in both groups compared with before surgery (p < 0.05). However, the postoperative PTA and ABG density were not significantly different 3 months post-surgery between the two groups (p > 0.05). Compared to those in the internal implantation group, the patients in the interlayer group had a shorter operation duration (51.36 ± 6.76 min vs. 59.71 ± 7.45 min, t = 6.298, p < 0.001) and less blood loss (11.91 ± 2.61 mL vs. 15.27 ± 2.57 mL, t = 7.019, p < 0.001). ConclusionsOur study suggests that the porcine SIS, as well as the tragus cartilage, has a high success rate in repairing irreversible TM perforation. Endoscopic tympanoplasty via interlayer implantation with porcine SIS offers distinct advantages, including the absence of donor-site incision and scar formation, and ease of graft modification and manipulation.

MANAGEMENT OF AORTIC OCCLUSION SYNDROME ASSOCIATED TO GRAVES DISEASE

Background :Leriche syndrome or aortoiliac occlusion disease is caused by atherosclerosis and manifests as a constellation of symptoms that include claudication, erectile dysfunction, and the notable absence of femoral pulses. Graves disease (also known as Basedow) is an autoimmune disorder characterized by excessive thyroid hormone production, leading to hyperthyroidism. It often results in symptoms such as weight loss, rapid heart rate, tremors, and an enlarged thyroid gland (goiter).We present a case study detailing a singular occurrence of Leriche syndrome in a patient concurrently diagnosed with Graves disease, emphasizing the intricate nuances encountered in anesthesia management across both surgical procedures. Case presentation: A 53-year-old North African male with history of smoking presented to the ED with critical limb ischemia. The patient exhibited normal vital signs, except for a sinus tachycardia of 140 beats per minute. Initial blood laboratory tests yielded no abnormalities. However, abdominopelvic computed tomography angiography (CTA) revealed an abdominal aortic aneurysm measuring 46mm in diameter and extending over 107mm. This aneurysm was found to be partially thrombosed above the renal arteries, with complete thrombosis noted at the infrarenal level, extending bilaterally to the iliac arteries. The presence of collateral blood vessels supported the diagnosis of Leriche syndrome. Additionally, further investigation into the sinus tachycardia revealed the patients diagnosis of Graves disease, complicating the vascular surgery. After collegial discussion, a two-stage surgical approach was decided upon. Initially, the patient underwent medical treatment using a rapid thyroid hormone blocking protocol to manage the signs of hyperthyroidism. Following achievement of biochemical and clinical euthyroidism, characterized by stable thyroid hormone levels, the first surgery, total thyroidectomy, was performed. Subsequently, a few days later, the patient underwent a bypass surgery. The postoperative course was marked by successful bypass graft surgery, resulting in improved limb function and absence of further complications. The patient was discharged home 10 days after the second surgery. Conclusion : In this case, the challenge lay in managing both conditions while ensuring controlled heart rate and blood pressure to prevent aneurysm rupture, and concurrently administering anticoagulant therapy to prevent thrombus extension. Our findings suggest that in comparable cases, emphasis on thorough physical examination and medical history is crucial, and interdisciplinary collaboration between different specialties enhances patient survival.

Modification of poly(styrene‐b‐isobutylene‐b‐styrene) using hyaluronic acid via surface graft polymerization and cytotoxicity investigation

AbstractPoly(styrene‐b‐isobutylene‐b‐styrene) (SIBS) is a biomedical elastomer with excellent overall properties. However, the low surface energy and the surface hydrophobicity of SIBS have limited its application as a human implantable material. To improve its biocompatibility, in this work, hyaluronic acid (HA) was introduced onto the surface of SIBS. Firstly, glycidyl methacrylate (GMA) and HA were employed to prepare GMA‐modified HA (GMHA) via grafting reaction. Due to the introduction of carbon–carbon double bonds on the side chain of HA, the GMHA could be used for free radical polymerization between SIBS. The effects of UV illumination time, GMHA concentration, and initiator concentration on the grafting ratio were investigated. FTIR, 1H NMR, and XPS confirmed the successful grafting of HA onto SIBS. The experimental results showed that the surface modification method not only ensured that the excellent properties of the SIBS would not be destroyed but also improved its surface properties successfully. Besides, the MTT assay indicated that the GMHA‐modified SIBS was not bio‐toxic, so it could meet the need to expand its use in the biomedical fields.

INDIGENOUS CUCURBITS AND GRAFTING TECHNIQUES AFFECT CUCUMBER PRODUCTIVITY BY MODULATING MORPHO-PHYSIO-BIOCHEMICAL INDICES

Vegetable grafting is a unique surgical horticultural technology for inducing soilborne biotic and abiotic stress tolerance in cucumbers. Indigenous cucurbit germplasm as rootstocks may show more tolerance potential compared to exotic ones. However, it needs evaluation for compatibility testing through various grafting techniques. Therefore, this study was planned to test available cucurbits as rootstocks for graft success vis-à-vis cucumber growth and productivity. It was carried out in the Plant Propagation and Physiology lab at MNS University of Agriculture, Multan, Pakistan. The seeds of the indigenous open-pollinated cucurbits were sown in 64-celled plug trays with peat moss as growing media, followed by shifting to 50-celled plug trays at the first true leaf emergence stage. The seeds of selected scion (cucumber) were sown after the emergence of rootstock seeds. Different grafting techniques were performed at the first true leaf stage of the scion, followed by healing and acclimatization. In this experiment, hybrid cucumber (cv Yalla F1) was grafted on three indigenous cucurbits, namely ridge gourd (Luffa acutangular), bottle gourd (Lagenaria sicearia) and pumpkin (Cucurbit pepo. L) for graft compatibility success by using three grafting techniques: cleft grafting, one cotyledon grafting and hole insertion. Non-grafted cucumber was grown to compare with grafted plants for growth and productivity. Overall, significant (p ≤ 0.5%) results were obtained regarding a 90% survival rate in cucumber plants grafted onto the bottle gourd through cleft grafting compared to the other grafting techniques. Additionally, the cucumber plants grafted on bottle gourd showed the highest morphological (root length, shoot length, root fresh weight, shoot fresh weight and rootstocks, and scion gir th), physiological (photosynthetic rate, transpiration rate, stomatal conductance, and sub-stomatal conductance), biochemical (antioxidants activities, SOD, CAT, and POX) and yield indices (average fruit length, weight, numbers, and yield) as compared to the non-grafted plants. Conclusively, cucumber grafting onto indigenous bottle gourd with cleft grafting technique exhibited maximum compatibility confirmed through physio-chemical attributes and improved plant biomass and yield, thereby suggested for cucumber grafting.

Softwood Grafting of Clementine Mandarin as Affected by Thidiazuron Treatment and Rootstock Type

Background: Citrus are propagated on a commercial scale by budding on different rootstocks species; nevertheless, one of the main problems nurserymen encounter is the slow growth of these rootstocks in the early phases of their growth, which drives up production costs. Therefore, the process of softwood grafting is one of the promising methods for quick propagating species of citrus. Methods: The present study on softwood grafting in clementine mandarin was conducted under lath house conditions during 2022-2023, to illustrate the impact of dipping the scion shoots in Thidiazuron at a concentration of 0, 10 and 20 mg L-1 and types of rootstocks (Sour orange, Rough lemon, Rangpur lime and Swingle citrumelo) on the percentage of grafting success and some vegetative characteristics of resultant saplings. A factorial experiment was executed out utilizing a randomized complete block design (RCBD) with three replications. Result: The two factors of study, particularly the treatment with 20 mg L-1 of Thidiazuron and Rough lemon rootstock, showed significant superiority in all traits, such as earliness in the initiation and completion of sprouting, graft success per cent, graft survival per cent, plant height, scion and rootstock diameter, as well as the number of branches and leaves plant-1. On the other hand, the un-treated with growth regulator and Swingle citrumelo rootstock recorded the lowest values for these traits.

Failure Rates Based on Alveolar Cleft Volume: An Analysis of the Critical-Sized Defect for Alveolar Bone Grafting.

Alveolar bone grafting (ABG) using iliac crest bone graft (ICBG) is best practice for children with complete cleft lip and palate. With the advent of recombinant human bone morphogenetic protein (rhBMP-2) and demineralized bone matrix (DBM), excellent results can still be achieved while avoiding donor-site morbidity. This study aims to determine the critical-sized defects by analyzing graft failure rates for ICBG and rhBMP-2/DBM to guide surgeons performing ABG. A retrospective review was conducted evaluating patients who underwent ABG from 2016-2022. Patients with preoperative and postoperative cone beam computed tomography (CBCT) imaging were included. Volumetric defect sizes were calculated using preoperative imaging. Graft success criteria were based on both clinical and radiographic outcomes. Logistic regressions analyzed graft failure rates to identify an optimal cutoff, which defined the critical-sized defect. Ninety-three patients were included. Bone graft cohorts included ICBG (n=30) and rhBMP-2/DBM (n=63). The critical-sized defects were calculated to be 810 mm 3 and 885 mm 3 for ICBG and rhBMP-2/DBM, respectively. There were significantly higher graft failure rates beyond the critical size compared to below for both ICBG (71.4% vs. 0.0%; p<0.001) and rhBMP-2/DBM (65.0% vs. 14.0%; p<0.001). This study identified critical-sized defects based on alveolar cleft volume for ICBG or rhBMP-2/DBM with higher graft failure rates beyond the predicted thresholds. Distinct ranges in cleft volume were identified where patients might benefit from each select graft option.

Successful shoot tip grafting of cacao (Theobroma cacao L.) due to the application of plant growth regulators on various concentrations

Cacao plays an important role in the Indonesia economy. Therefore, its production and area expansion have to increase to achieve maximum cacao productivity by the quality and superior cacao clones. Shoot tip grafting is one of the propagation methods to obtain superior cacao plants by applying Plant Growth Regulators (PGRs). Research on the effect of several PGRs with various concentrations on cacao (Theobroma cacao L.) shoot tip grafting was conducted at the Integrated Innovation Farmer Group, Belubus, Sungai Talang Village, Guguak District, Lima Puluh Kota Regency, West Sumatra from February until June 2022. This study aimed to determine the interaction between PGR type and concentration on the grafting success and growth of cacao shoot tip grafted seedling. The research was designed by a Factorial Completely Randomized Design with three replications. The first factor was the type of PGR, i.e., synthetic PGR (BAP), young corn seed extract, shallot extract, and young coconut water. The second factor was the concentration of PGR, i.e., 0%, 25%, 50%, 75% and 100%. The results showed an interaction between PGRs with some concentrations on the number of shoots, shoot length, and leaf length on the grafted cacao seedling. The natural PGR from young coconut water at a concentration of 75% gave the best effect on the number of shoots (3.33 shoots) and shoot length (24.50 cm) of cacao seedling.

Antimicrobial and hydrophobic cellulose paper prepared by covalently attaching cinnamaldehyde for strawberries preservation

The demand for paper-based packaging materials as an alternative to incumbent disposable petroleum-derived polymers for food packaging applications is ever-growing. However, typical paper-based formats are not suitable for use in unconventional applications due to inherent limitations (e.g., excessive hydrophilicity, lack antimicrobial ability), and accordingly, enabling new capabilities is necessity. Herein, a simple and environmentally friendly strategy was proposed to introduce antimicrobial and hydrophobic functions to cellulose paper through successive chemical grafting of 3-aminopropyltriethoxysilane (APS) and cinnamaldehyde (CA). The results revealed that cellulose paper not only showed long-term antibacterial effect on different bacteria, but also inhibited a wide range of fungi. Encouragingly, the modified paper, which is fluorine-free, displays a high contact angle of 119.7°. Thus, even in the wet state, the modified paper can still maintain good mechanical strength. Meanwhile, the multifunctional composite papers have excellent biocompatibility and biodegradability. Compared with ordinary cellulose paper, multifunctional composite paper can effectively prolong the shelf life of strawberries. Therefore, the multifunctional composite paper represents good application potential as a fruit packaging material.

Trace cisplatin adsorption by thiol-functionalized sponge (TFS) and Sn/SnO2-coated TFS: Adsorption study and mechanism investigation

To remove trace cisplatin from aqueous solution, commercial sponges were functionalized by esterification with 3-mercaptopropionic acid, followed by reduction with Na2S·9H2O or SnCl2·2H2O. The resulting thiol-functionalized sponges (TFSs), TFS_1 and TFS_2, were tested for the removal of cisplatin (235 μg L−1) achieving maximum removal of 95.5 ± 0.8% and 99.5 ± 0.1% respectively, which were significantly higher than the non-functionalized counterpart. The successful grafting of thiol groups, verified through FTIR, elemental analysis, SEM-EDS, and XPS characterization, facilitated Pt−S complexation during adsorption. The aqua-derivatives of cisplatin, formed through hydration, complexed with thiol sites through ligand displacement. Additionally, the presence of Sn/SnO2 coating on TFS_2 further enhanced the adsorption process. The rapid adsorption process conformed to pseudo-second-order kinetic model, involving both diffusion and chemisorption. While the Langmuir isotherm model generally described the monolayer adsorption behavior of cisplatin, the aggregation of Sn/SnO2 onto TFS_2 at 343 K introduced surface heterogeneity, rendering the Freundlich model a better fit for the adsorption isotherm. Differential pH dependence and the evaluation of mean free energy, derived from the Dubinin-Radushkevich isotherm model, indicated that cisplatin adsorption onto TFS_1 involved physisorption, including electrostatic attraction, while chemisorption predominated for TFS_2. Increasing the temperature notably promoted adsorption by facilitating the thermal-favored formation of Pt−S bonds.

Quantifying Inferior Vena Cava Compliance and Distensibility in an In Vivo Ovine Model Using 3D Angiography.

Synthetic vascular grafts overcome some challenges of allografts, autografts, and xenografts but are often more rigid and less compliant than the native vessel into which they are implanted. Compliance matching with the native vessel is emerging as a key property for graft success. The current gold standard for assessing vessel compliance involves the vessel's excision and ex vivo biaxial mechanical testing. We developed an in vivo method to assess venous compliance and distensibility that better reflects natural physiology and takes into consideration the impact of a pressure change caused by flowing blood and by any morphologic changes present. This method is designed as a survival procedure, facilitating longitudinal studies while potentially reducing the need for animal use. Our method involves injecting a 20 mL/kg saline bolus into the venous vasculature, followed by the acquisition of pre and post bolus 3D angiograms to observe alterations induced by the bolus, concurrently with intravascular pressure measurements in target regions. We are then able to measure the circumference and the cross-sectional area of the vessel pre and post bolus. With these data and the intravascular pressure, we are able to calculate the compliance and distensibility with specific equations. This method was used to compare the inferior vena cava's compliance and distensibility in native unoperated sheep to the conduit of sheep implanted with a long-term expanded polytetrafluorethylene (PTFE) graft. The native vessel was found to be more compliant and distensible than the PTFE graft at all measured locations. We conclude that this method safely provides in vivo measurements of vein compliance and distensibility.

Endoscopic Broad Palisade Cartilage Graft Without Raising a Tympanomeatal Flap in the Repair of Subtotal Perforation.

Objective: This study evaluated the outcome of a broad palisade cartilage graft in the repair of subtotal perforation. Study Design: Prospective case series. Materials and Methods: This was a prospective study of 43 patients with subtotal perforations who underwent an endoscopic broad palisade cartilage graft procedure that did not include raising a tympanomeatal flap. The patients were followed up for 6 months. Results: The 43 patients (43 ears) included in this study had a mean operation time of 38.6 ± 7.4 minutes. Five (11.6%) patients were lost to follow-up; 38 (88.4%) completed the 6 month follow-up. The graft success rate in the latter was 92.1% (35/38). Audiological testing showed no sensorineural threshold shift. The mean preoperative air-bone gap (ABG) was 28.4 ± 5.1 dB, while the mean ABG at 6 months postoperatively was 13.6 ± 3.1 dB; the difference between these values was significant (P < .05; paired samples t test). According to the audiometry assessment, the successful surgery rate (postoperative ABG ≤ 20 dB) was 89.5% (34/38). No graft-related complications (eg, graft lateralization, significant blunting, graft medialization) were encountered during the follow-up period. However, granular myringitis with minimal moistness but without infection was noted in 5.3% (2/38) of the patients. Conclusions: In the repair of subtotal perforation, an endoscopic broad palisade cartilage graft, performed without raising a tympanomeatal flap, is simple and feasible, resulting in a high graft success rate and good hearing restoration.

Gamma radiation-induced grafting of poly(butyl acrylate) onto ethylene vinyl acetate copolymer for improved crude oil flowability

Ethylene vinyl acetate (EVA) copolymers are widely employed as pour point depressants to enhance the flow properties of crude oil. However, EVA copolymers have limitations that necessitate their development. This work investigated the modification of EVA via gamma radiation-induced grafting of butyl acrylate (BuA) monomers and the evaluation of grafted EVA as a pour point depressant for crude oil. The successful grafting of poly(butyl acrylate) p(BuA) onto EVA was verified through grafting parameters, FTIR spectroscopy, and 1H NMR spectroscopy. Treating crude oil with 3000 ppm of (EVA)0kGy, (EVA)50kGy, and (1EVA:3BuA)50kGy yielded substantial reductions in pour point of 24, 21, and 21 °C, respectively. Also, rheological characterization demonstrated improving evidenced by a viscosity reduction of 76.20%, 67.70%, and 71.94% at 25 °C, and 83.16%, 74.98%, and 81.53% at 12 °C. At low dosages of 1000 ppm, the EVA-g-p(BuA) exhibited superior pour point reductions compared to unmodified EVA, highlighting the benefit of incorporating p(BuA) side chains. The grafted EVA copolymers with p(BuA) side chains showed excellent potential as crude oil flow improvers by promoting more effective adsorption and co-crystallization with paraffin wax molecules.

Optimizing Internal Mammary Artery Harvest and Preparation

The left internal mammary artery (LIMA) graft plays a pivotal role in coronary artery bypass surgery, offering unparalleled efficacy in revascularization. This review paper delves into the multifaceted considerations surrounding LIMA utilization, aiming to provide a comprehensive understanding of optimal approaches. The study encompasses the alleviation of spasm, selection of graft harvesting techniques, identification of ideal vasodilators, and exploration of optimal delivery methods. Through an analysis of extensive research spanning the past three decades, this review elucidates critical insights for cardiac surgeons and researchers alike. The review emphasizes the ubiquity of severe spasms in harvested LIMA and examines interventions to mitigate this challenge. Studies highlighting the efficacy of papaverine administration through various routes underscore the need for tailored approaches based on clinical context. The debate between skeletonized and pedicled LIMA harvests is explored, revealing the advantages and complexities associated with each technique. Findings suggest that while skeletonized grafts offer enhanced flow, the decision remains multifaceted due to potential complications. Addressing the quest for the ideal vasodilator, the review juxtaposes papaverine and sodium nitroprusside, presenting both as viable options. Despite ongoing discussions, the cost-effectiveness and accessibility of papaverine have positioned it as the favored choice among clinicians. Optimal delivery methods emerge as a crucial factor in graft success, with perivascular injection showing promise in promoting sustained and improved flow rates. The clinical implications of these findings are substantial. By integrating the evidence presented, cardiac surgeons can make informed decisions, maximizing graft patency and patient outcomes. Further, research avenues are identified, encompassing refined delivery techniques, comprehensive comparisons of vasodilators, and long-term clinical outcome evaluations. In conclusion, this review underscores the intricate considerations essential for successful LIMA utilization. By addressing spasms, selecting graft techniques, choosing vasodilators, and refining delivery methods, practitioners can tailor their strategies to the individual patient, enhancing the efficacy of coronary revascularization.