RESUMO
We present a patient with unstable angina candidate for coronary artery bypass grafting. Saphenous vein graft was used in obtuse marginal and left internal mammary artery to left anterior descending artery properly. After surgery, the patient experienced flaccid paralysis of lower limb and impaired sensation of touch and warmth of knee and below. A computed tomography angiogram of lower limbs and thoracolumbar magnetic resonance imaging showed no abnormality. Based on the symptom, clinical diagnosis of anterior spinal artery syndrome was considered. The artery of Adamkiewicz is an important supplier to the anterior spinal artery. Internal thoracic mammary artery, used in coronary artery bypass grafting, is suspected as a collateral supplier of the artery of Adamkiewicz and has been accused for cause of spinal infarction.
Assuntos
Síndrome da Artéria Espinal Anterior/etiologia , Ponte de Artéria Coronária/efeitos adversos , Paraplegia/etiologia , Complicações Pós-Operatórias/etiologia , Angiografia , Síndrome da Artéria Espinal Anterior/diagnóstico por imagem , Evolução Fatal , Humanos , Extremidade Inferior/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Artéria Torácica Interna , Pessoa de Meia-Idade , Paraplegia/diagnóstico por imagemRESUMO
Abstract We present a patient with unstable angina candidate for coronary artery bypass grafting. Saphenous vein graft was used in obtuse marginal and left internal mammary artery to left anterior descending artery properly. After surgery, the patient experienced flaccid paralysis of lower limb and impaired sensation of touch and warmth of knee and below. A computed tomography angiogram of lower limbs and thoracolumbar magnetic resonance imaging showed no abnormality. Based on the symptom, clinical diagnosis of anterior spinal artery syndrome was considered. The artery of Adamkiewicz is an important supplier to the anterior spinal artery. Internal thoracic mammary artery, used in coronary artery bypass grafting, is suspected as a collateral supplier of the artery of Adamkiewicz and has been accused for cause of spinal infarction.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Paraplegia/etiologia , Complicações Pós-Operatórias/etiologia , Ponte de Artéria Coronária/efeitos adversos , Síndrome da Artéria Espinal Anterior/etiologia , Paraplegia/diagnóstico por imagem , Imageamento por Ressonância Magnética , Angiografia , Evolução Fatal , Síndrome da Artéria Espinal Anterior/diagnóstico por imagem , Extremidade Inferior/diagnóstico por imagem , Artéria Torácica InternaRESUMO
This study examined the effects of different biofertilizers and manure on the absorption and absorption efficiency of macronutrients by wheat in Alborz Province, Iran. The experimental design was factorial in the form of a randomized complete block design with three replications. The four factors of the experiment were Azospirillum (with 600 g/ha and without), mycorrhiza (with 1 kg/ha and without), Streptomyces (with 0.5 kg/ha and without) and manure (with 30 t/ha and without). To measure N, P and K, plants were harvested one time when grains were at dough stage and another time at plant maturity, oven dried, grinded and analyzed. Azospirillum, mycorrhiza and manure had a significant effect (p ≤ 0.01) on most of the measured traits, but the effect of Streptomyces was not significant. The two-fold and three-fold interactions significantly affected the absorption and absorption efficiency of the three macronutrients. In most cases, four-fold interactions yielded the highest values. Overall, the experimental results indicate that biofertilizers and manure can naturally meet most of the plant's nutritional requirements, improve the efficiency of nutrient absorption and replace part of chemical fertilizers in sustainable agricultural production systems.