Morpho-anatomy of in vitro germination and cryopreservation of the orchid Cattleya crispa (Orchidaceae Morfoanatomía de la germinación in vitro y criopreservación de la orquídea Cattleya crispa (Orchidaceae) / Morfoanatomía de la germinación in vitro y criopreservación de la orquídea Cattleya crispa (Orchidaceae)

Introduction: Cattleya crispa is an ornamental epiphytic orchid with geographic distribution restricted to the Brazilian Atlantic Forest. Due to predatory extractivism and human-induced habitat loss, this species appears on the Red List of Brazilian Flora. Objective: To characterize morpho-anatomical aspects regarding germination and post-seminal development from C. crispa seeds; as well as studying the effect of cryopreservation on these seeds. Methods: We used light microscopy and electron microscopy to describe the microstructure of a 100 ripe seeds. We evaluated seed viability, seed germination, survival rate and protocorm weight in cryopreserved and non-cryopreserved material, with four replicas per treatment using 20 mg of plant material. Results: The seeds are fusiform, whitish yellow with a length from 700 to 900 µm and a water content of 5 %. Germination began seven days after sowing, the formation of the globular protocorm at 30 days and the formation of the seedling occurred 150 days. The persistent seed coat can compress the protocorm and cause it to collapse. The cryopreserved seeds presented 87.15 % viability, 78.32 % germination, 8.48 % survival and protocorms with 104.27 mg five months after sowing. Data wasn't different to non-cryopreserved seeds. Conclusions: The cryocapability of the seeds shows that cryopreservation can be used for long-term conservation. The results of this work contribute to the overall biology of C. crispa and to the propagation and storage of genetic material for conservation purposes.

Introducción: Cattleya crispa es una orquídea epífita ornamental con distribución geográfica restringida a la Mata Atlántica brasileña. Debido al extractivismo depredador y a la pérdida de hábitat inducida por el hombre, esta especie aparece en la Lista Roja de la Flora Brasileña. Objetivo: Caracterizar aspectos morfoanatómicos de la germinación y desarrollo inicial de semillas de C. crispa; así como estudiar el efecto de la criopreservación de estas semillas. Métodos: Utilizamos microscopía óptica, microscopía electrónica de barrido y microscopía electrónica de transmisión para describir la microestructura en 100 semillas maduras. Evaluamos la viabilidad de la semilla, la germinación de la semilla, la tasa de supervivencia y el peso de los protocormos en el material criopreservado y no criopreservado, con cuatro réplicas por tratamiento de 20 mg de material vegetal. Resultados: Las semillas son fusiformes, amarillo blanquecinas, con una longitud de 700 a 900 µm y un contenido de agua del 5 %. La germinación comenzó siete días después de la siembra, la formación del protocormo globular a los 30 días y la formación de la plántula a los 150 días. La cubierta de semilla persistente puede comprimir el protocormo y provocar su colapso. Las semillas criopreservadas presentaron 87.15 % de viabilidad, 78.32 % de germinación, 8.48 % de supervivencia y protocormos con 104.27 mg a los cinco meses de la siembra. Los datos no fueron diferentes a las semillas no criopreservadas. Conclusiones: La capacidad criogénica de las semillas muestra que la crioconservación puede utilizarse para la conservación a largo plazo. Los resultados de este trabajo contribuyen a la biología general de C. crispa y a la propagación y almacenamiento de material genético con fines de conservación.

Diagnostic Criteria for Meniere's Disease / 대한평형의학회지

This paper presents diagnostic criteria for Meniere's disease jointly formulated by the Classification Committee of the Barany Society, The Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology, the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery, and the Korean Balance Society. The classification includes two categories: definite Meniere's disease and probable Meniere's disease. The diagnosis of definite Meniere's disease is based on clinical criteria and requires the observation of an episodic vertigo syndrome associated with low- to medium- frequency sensorineural hearing loss and fluctuating aural symptoms (hearing, tinnitus and/or fullness) in the affected ear. Duration of vertigo episodes is limited to a period between 20 minutes and 12 hours. Probable Meniere's disease is a broader concept defined by episodic vestibular symptoms (vertigo or dizziness) associated with fluctuating aural symptoms occurring in a period from 20 minutes to 24 hours.

Effect of Herbal Tea Treatment on Meniere's Disease / 日本補完代替医療学会誌

<b>Objective/Design</b>: The purpose of this study was to confirm the effect of herbal tea therapy on Ménière’s disease. We studied 15 patients with Ménière’s disease who came to the International University of Health and Welfare MITA hospital between 2007 and 2008.<br> <b>Methods</b>: According to criteria of the Japan Society for Equilibrium Research, all patients were diagnosed as having Ménière’s disease and underwent otoneurologic examination, audiometric measurements, questionnaires of functional level and tinnitus every month. Moreover, we instructed these patients to keep a record of the number of times vertigo was experienced. After 6 months of general treatment, we treated patients with herbal tea for one year. This herbal tea was effective as a diuretic, in promoting antivertigo, and relaxing. We compared results before and after herbal tea therapy.<br> <b>Result</b>: Herbal tea therapy was effective in about 10 patients, but 5 patients relapsed. However, symptom of the relapsed patients improved after using less medicine, although the quantity of medication was less than before starting the herbal tea therapy. Herbal tea therapy improved their Ménière’s symptoms, especially vertigo after 6 months from starting herbal tea therapy.<br> <b>Conclusion</b>: Our study provides evidence that herbal tea therapy is useful for preventing worsening of Ménière’s disease.<br>

Outcome of Arterial Reconstruction for Intermittent Claudication and Limb-Threating Ischemia / 日本心臓血管外科学会雑誌

To determine the usefulness of arterial reconstruction, we studied the outcome of 430 patients with arteriosclerosis obliterans who had received either arterial reconstructive surgery or medical treatment. Of the 430, 301 patients were treated for intermittent claudication and 162 for limb-threating ischemia (rest pain or ischemic gangrene). Of the intermittent claudication patients 274 underwent arterial reconstruction and 27 were treated with anticoagulant therapy. In limb-threating ischemia, 137 patients underwent arterial reconstruction and 25 were treated with anticoagulant therapy. Among the 274 intermittent claudication patients treated by arterial reconstruction, none required major amputation within 30 days after surgery. Operative mortality was 1.1%. Five- and ten- year comulative patency rates were 95.4%, 94.3% in aortofemoral bypasses, 72.7%, 67.5% in aortofemoropopliteal bypasses, 79.7%, 77.9% in femoropopliteal bypasses and 92.3%, 92.3% in femorotibial bypasses, respectively. On long-term results, 86.4% improved and 5.9% deteriorated. Five patients (1.4%) underwent major amputation during the follow-up period due to graft occlusion. Four of 5 amputations involved patients whose initial reconstruction method was femoropopliteal bypass. In 27 patients treated medically, 77.8% did not show any change in symptoms and 22.2% deteriorated during the follow-up period. Two patients (5.6%) underwent bypass grafting in the late phase. Of 137 patients with limb-threating ischemia treated by arterial reconstruction, 3.3% required major amputation in the early postoperative period. Operative mortality was 5.1%. Five- and 10-year cumulative patency rates were 83.3%, 79.7% in aortofemoral bypasses, 65.5%, 65.5% in aortofemoropopliteal bypasses, 76.2%, 63.9% in femoropopliteal bypasses and 38.6% in femorotibial bypasses, respectively. In long-term results, 62.3% improved and 12.6% deteriorated. Thirteen patients (8.6%) underwent major amputation during the follow-up period. In 25 patients with limb-threating ischemia treated medically, 16.0% died during their hospital stay and 33.3% required major amputation during the follow-up period. Five- and 10-year cumulative survival rates in arterial reconstruction patients were 77.4%, 57.6% in intermittent claudication patients and 64.3%, 41.5% in limb-threating ischemia patients, respectively. The survival rate in limb-threating ischemia was significantly lower than that in intermittent claudication. The results of reconstructive surgery for intermittent claudication were better than those of medical treatment. However, 4 femoropopliteal bysass cases required major amputation in the late phase. This suggests that it is difficult to determine the indications for infrainguinal artery reconstruction in intermittent claudication. Arterial reconstructive surgery for limb-threating ischemia was useful for salvaging the limbs. In these patients, careful perioperative treatment was necessary. Limb salvage rate and survival rate in limb-threating ischemia patients were poorer than those in intermittent claudication patients. We recommend performing arterial reconstructive surgery for disabling claudication before the patient progresses to limb-threating ischemia.

Tibial Bypass Grafting Using a Surgical Microscope: Techniques and Long Term Results / 日本心臓血管外科学会雑誌

Magnification of the surgical field is considered an essential technique for performing accurate surgery on small caliber arteries. For this reason, we use the transmicroscopic technique of vascular surgery on the tibial arteries. We obtained good results in long term patency. Our experience and results in bypass grafting to the tibial artery using a microscope are reported. Forty-four tibial artery bypasses using transmicroscopic techniques were performed in 38 consecutive patients between June 1984 and December 1992. Twenty-seven patients had arteriosclerosis obliterans, 5 had thromboangitis obliterans, 5 had acute arterial occlusion and 1 had traumatic vascular injury. Patient ages ranged from 37 to 78 years old. Thirty-five were men and 3 were women. Twenty-six surgeries were performed for limb threatening and 14 were for disabling claudication. All patients were examined with conventional aortic lower extremity angiography preoperatively. The reversed saphenous vein was used in 38, in-situ saphenous vein in 3 and composite vein to vein graft in 2. All distal anastomoses were performed by the transmicroscopic technique. Continuous sutures were used for recipient vessels larger than 1.0mm in diameter. However interrupted 8-0 sutures were chosen for smaller vessels. Distal anastomosis was made at the proximal portion of the tibial artery in 24 cases, while the distal portion of the tibial artery was used in 20 cases. On preoperative angiography, the condition of the tibial arteries affected the patency rate when runoff was poor or fair. Nine cases were judged to have “poor” runoff. Three of these became occluded during the early postoperative period, and 1 during the late phase. Eight cases were judged to have “fair” runoff. One of these became occluded during the early postoperative period, and 3 during the late phase. There were no graft failures identified throughout the follow-up period in patients with good runoff. Cumulative patency rates were 86.2% after 1 year, 79.0% after 5 years, and 67.7% after 8 years, respectively. The patency rate of the 24 grafts in which distal anastomosis was performed on the proximal tibial artery was 71. 4% after 5 years. The patency rate of the 20 grafts on the distal tibial artery was 93.3% after 5 years. There was no significant difference observed in the patency of these two groups. Hospital mortality was 2.6%. Femorotibial bypass using transmicroscopic technique could save severely ischemic limbs while maintaining hospital mortality at a low level and reducing limb loss. The advantage of microscopic surgery is achieving fine observation because the magnification level is changeable, depending on the field needed. In anastomosis of small caliber vessels like the tibial artery, magnification by 10 times is important to observe the characteristics of the intima of the recipient artery. Subsequently, the procedure is performed by transmicroscopic techniques under magnification by 5 times, which provides much higher accuracy for suture than surgical loupe. High magnification prevents intraoperative technical error and unexpected injury.

Lymphatic Complications Following Abdominal Aortic Surgery. Para-aortic Lymphocyst and Chylous Ascites / 日本心臓血管外科学会雑誌

Two cases of abdominal lymphatic disruption following surgery on the abdominal aorta are presented, one causing para-aortic lymphocyst and the other resulting in chylous ascites. The 1st patient ultimatery received operative drainage into the lymphocyst. The 2nd patient responded to twice paracentesis and total parenteral nutrition for one month. We need to be aware of these complications and pay attention to prevention and early diagnosis.

A case of spontaneous dissection of the superior mesenteric artery / 日本心臓血管外科学会雑誌

A case report of spontaneous dissection of the superior mesenteric artery (SMA) in a 53-year-old man who complained of sudden colic-midabdominal pain is presented. In this case, ultrasonography is very usefull for early diagnosis of dissection, and this is successfully treated by Ao-AMS bypass with excision of the proximal segment of SMA. Postoperatively the patient has no symptoms for 2 years.