Apparatus for performing subselective arteriography or angioplasty on an internal mammary artery or graft which avoids dissection or stenosis of the internal mammary artery or graft. A catheter having a balloon and a proximal port delivers an angiographic dye or a device for treating vascular obstructions to the internal mammary artery or graft from a stable position within the subclavian artery. Method for injecting angiographic dye into an internal mammary artery or graft. A catheter having and a balloon and a proximal port is inserted over a guide wire into a subclavian artery and inflated at a point distal to the junction of the subclavian artery and the internal mammary artery or graft. An angiographic dye is delivered through the proximal port and flows into the internal mammary artery or graft. Method for cannulation of an internal mammary artery or graft which avoids dissection or stenosis of the internal mammary artery or graft. A catheter having a balloon and a proximal port is inserted over a
Archives of cardiovascular diseases - Vol. 110 - N° 12 - p. 646-658 - Iconography : Is bilateral internal thoracic artery grafting a safe option for chronic dialysis patients? - EM|consulte
TY - JOUR. T1 - Human internal thoracic artery grafts exhibit severe morphological and functional damage and spasmic vasomotion due to oxidative stress. AU - Kiss, Levente. AU - Benko, Rita. AU - Kovács, Endre. AU - Szerafn, Tamás. AU - Módis, Katalin. AU - Szabó, Csaba. AU - Lacza, Zsombor. PY - 2011/1/1. Y1 - 2011/1/1. N2 - Background: The internal thoracic artery (ITA) is the first choice for myocardial revascularization, but atherosclerotic lesions and perioperative vasospasm may still limit its functionality. Oxidative stress via the peroxynitrite - poly-(ADP-ribose) polymerase (PARP) cascade plays an important role in the pathogenesis of impaired vascular tone via endothelial injury. We aimed to investigate and describe the histology, PARP activation and functionality of ITA grafts and to assess the possible beneficial effect of PARP-inhibition. Material/Methods: ITA specimens from 47 patients (26 men, mean age 66.2±1.7 years) who underwent coronary bypass surgery were processed for ...
OBJECTIVE To investigate the distribution of the internal mammary artery and its branches by the multi-slice spiral CT angiography, and to explore the feasibility of transferring pedicled transverse rectus abdomials myocataneous (TRAM) flap for breast reconstruction through resection of inferior costicartilages. METHODS 30 female patients received abdominal CT angiography. (1) The distance between internal mammary artery and the sternum midline were recorded; (2) The position and the numbers of branches from bilateral internal mammary arteries at the level of 5th, 6th, 7th rib was observed; (3) The points where the superior epigastric artery gets through the rectus abdominis muscle were located. RESULTS ( The average distance between left internal mammary artery to the sternum midline is from 1. 66 cm (0. 62-2. 39 cm ) to 2.34 cm (0.69-3.36 cm) at the level from 4th to 6th intercostal space. The average distance between right internal mammary artery to the sternum midline is from 1.55 cm(0. 66-2. 29
LITA grafting of the LAD at reoperative CABG was associated with better early and late survival than was SV grafting. It also was associated with decreased hospital mortality and respiratory failure. Most hospital morbidities, however, were similar.. The results of CABG are directly related to graft patency (26), and the better early and late survival observed in reoperative CABG patients with LITA-to-LAD grafts are likely related to superior early and late patency of LITA grafts. At 1 and 10 years after CABG, more than 90% of ITA grafts are patent (16,26-29). This excellent and stable patency is due to ITAs resistance to arteriosclerosis. Less than 4% of ITAs develop arteriosclerosis, and only 1% develop important stenosis due to arteriosclerosis (30-32). SV graft patency is not as robust and stable as LITA patency. By 1 year after surgery, 10% to 20% of SV grafts are occluded, a result of technical errors, thrombosis, and intimal hyperplasia (16,26,33). From 1 to 5 years after surgery, 1% to ...
TY - JOUR. T1 - Wrapping the anastomosis with omentum or an internal mammary artery pedicle does not improve bronchial healing after single lung transplantation. T2 - Results of a randomized clinical trial. AU - Khaghani, A.. AU - Tadjkarimi, S.. AU - Al-Kattan, K.. AU - Banner, N.. AU - Daly, R.. AU - Theodoropoulos, S.. AU - Madden, B.. AU - Yacoub, M.. PY - 1994. Y1 - 1994. N2 - Between May 1989 and March 1990, 36 patients undergoing a first single lung transplantation were randomized to three groups. In the omentum group the bronchial anastomosis was wrapped with an omental pedicle. In the internal mammary artery group, the anastomosis was wrapped in a pedicle of tissue surrounding the internal mammary artery. In the no wrap group, no attempt was made to revascularize the anastomosis. No significant differences were found in the indications for transplantation, recipient age, organ ischemic time, or preoperative steroid use in the three groups. There were two early deaths: one in the omentum ...
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Local drug delivery by coronary stents is of current research interest. Organ culture of human vascular tissue is a model of intimal hyperplasia. We report an ex vivo organ culture model of stented vessels. This allows stent-artery interactions to be studied in living tissue. The recognized anti-restenosis agent paclitaxel was chosen to test the organ culture model. Mammary artery specimens were cultured closed (i.e. without opening them flat) for 72h. Phosphocholine-coated stents, half of them loaded with the anti-restenosis drug paclitaxel, were implanted. The absorption and elution characteristics of paclitaxel were established. Artery tissue remained viable at 72h when cultured closed, despite stent implantation. Specimens developed smooth muscle cell proliferation. The stents absorbed up to 127±29μg of paclitaxel, with a biphasic elution curve. A mean of 13% of the absorbed paclitaxel remained after a 24h perfusion. In mammary artery, these paclitaxel stents reduced or abolished smooth ...
TY - JOUR. T1 - In vitro effects of antihypertensive drugs on thromboxane agonist (U46619)-induced vasocontriction in human internal mammary artery. AU - Tanaka, K. A.. AU - Szlam, F.. AU - Katori, N.. AU - Tsuda, A.. AU - Levy, Jerrold H.. PY - 2004/8. Y1 - 2004/8. N2 - Background. Hypertension is a major problem in the perioperative period of cardiac and non-cardiac surgery. The vascular endothelium plays a crucial role in modulating vascular tone by producing vasodilators as well as vasoconstrictors. Thromboxane A2 (TxA2), a prototypical vasoconstrictor produced by endothelium and platelets, may play an important role in the pathogenesis of hypertension and subsequent ischaemic events. Although multiple drugs are currently available to treat perioperative hypertension, there is a paucity of data comparing these agents. Therefore, we examined the in vitro vascular effects of commonly used antihypertensive drugs on human internal mammary artery (IMA) segments. Methods. Relaxation responses to ...
History: 67 year old male with cough. This is the typical location of vascular clips seen in a patient who has undergone coronary artery bypass graft surgery with the left internal mammary artery. A nice paper on this surgery from 1977 is located here.
Among a cohort of 454 consecutive patients who had undergone coronary revascularization with the internal mammary artery (from November 1984 to October 1987), postoperative angiography was performed in 86 (18.9%) (77 males and 9 females, aged 33-74 years; median age 56 years). The interval between operation and angiography ranged from one week to 26 months (median 47 weeks). The mean patency rate for the internal mammary artery grafts was 83.7% (72 of 86 grafts), the patency rate having increased from 71% in 1984/85 to 92% in 1987. In the same cohort the patency rate of venous grafts was 64.5% (78 of 121 aortocoronary venous grafts). Many asymptomatic patients refused follow-up angiography; the patency rate is therefore likely to have been higher for the entire cohort. The high patency rate and good long-term results for internal mammary artery grafts support the view that this type of graft is preferable to others for coronary revascularization.
Endothelial Cells from the Mammary / Internal Thoracic Artery, and other artery and veins, at Cell Applications, your worldwide provider of human & animal cells, antibodies, & cell culture & molecular biology tools.
A 52 year old man presented with severe myocardial ischaemia 10 days after a Q wave infarction treated with thrombolysis. Coronary angiography revealed severe three vessel disease of the heart with a tight stenosis of the left anterior descending artery and first diagonal branch, and occlusion of the marginal and right coronary arteries. The patient underwent revascularisation using the arterial sling operation, during which the right and left internal mammary arteries were harvested without transection of their proximal end together with a segment of the left radial artery. The radial artery segment (RAD) was anastomosed to the right internal mammary artery (RIMA) and used to revascularise branches from both the right and circumflex arteries (below left). Then the left internal mammary artery (LIMA) was anastomosed to the left anterior descending artery and the diagonal branch. Finally the radial artery segment (RAD) was anastomosed to the LIMA (below right). The patient did well in the ...
An improved technique of free internal mammary artery (IMA) to ascending aorta anastomosis for coronary bypass is described. A small patch vein with a suitable side branch or branches is interposed, connecting the proximal end of a detached IMA to the ascending aorta. A single or double free IMA alone or in combination with an additional saphenous vein graft was performed in 77 patients. A total of 125 free IMA grafts were done. The hospital mortality was 2-7% and late mortality 1-4%. Seventy-one of the 74 surviving patients had no angina and returned to a normal life. Postoperative coronary arteriography in 65 patients showed a patency rate of 96%. On years experience with this technique is very encouraging. However, prolonged follow-up is necessary to determine if free IMA, as used by us, will increase the long-term patency rate.. ...
The use of the internal mammary artery (IMA) in coronary artery bypass graft surgery is an independent predictor of late survival in all subsets of patients and should not be denied to any subgroup. Therefore damage to the IMA during harvesting is a catastrophic complication after which the graft is usually discarded. We present here a simple and safe technique for repair of a damaged left IMA that allowed its rescue for grafting to the left anterior descending artery. (C) 2002 by the Society of Thoracic Surgeons ...
To analyse bilateral differences in the cross-sectional area of the internal mammary artery (IMA) and vein (IMV) in breast cancer patients compared to healthy controls. On 135 breast MRIs the cross-sectional areas of the IMA and IMV were measur
Traditional harvesting of the internal thoracic artery (ITA) for use as a conduit in coronary bypass surgery involves the dissection of a rim of tissue surrounding the artery on either side. Although the benefits of ITA use are well established, there are certain limitations to its routine use. Recent studies, primarily observational, have suggested that skeletonization of the ITA (i.e. harvesting of the ITA alone) may overcome some of these limitations by improving conduit flow, increasing length, and reducing the risk of deep sternal infection in high risk patients. Furthermore, skeletonization of the ITA can potentially preserve intercostal nerves and reduce post-operative pain and dysesthesias associated with ITA harvesting. In order to assess the effects of ITA skeletonization, this is a prospective, randomized, within-patient study design in patients undergoing coronary artery bypass grafting ...
Discussion to The Internal Mammary Artery and Vein as a Recipient Site for Free-Flap Breast Reconstruction: A Report of 110 Consecutive Cases
Objectives: The mechanisms of early vein graft failure after coronary artery bypass graft (CABG) surgery remains unclear. We hypothesized that insufficiency of DNA repair pathway in human vein graft is related to early graft failure.. Methods: Human internal mammary arteries (IMA) and saphenous veins (SV) samples were obtained from coronary artery bypass grafting surgery. Among 118 SV segments, there was 9% vein grafts had early grafting failure within 7 days which is determined by Multichannel-EKG-gated CT angiography (Philips Medical). In contrast, there was no early graft failure in 28 IMA grafts. Human IMA or SV segments (1 X 1 mm) were incubated in organ culture system in the absence or presence of 1% H2O2 for 24 hours with 20% O2. DNA damage was determined by 8-oxoG staining, and DNA repair pathways were investigated by MYH (DNA mismatch repair) immunohistochemical staining. Apoptotic level was evaluated by TUNEL staining and DNA gel analysis. The positive staining rate was determined by ...
The study provided valuable insights about ways to improve surgical outcomes for patients with diabetes, such as the choice of whether to use unilateral or bilateral internal thoracic artery (ITA) grafts. "Despite compelling evidence of survival benefit of bilateral internal thoracic arteries from the authors own institution, the use of bilateral thoracic arteries remains distressingly low," commented Mani Arsalan, MD, and Michael Mack, MD, of the Baylor Research Institute (Dallas, TX) in an editorial. In the registry, only 18% (11% of nondiabetic patients and 7.5% of diabetic patients) received bilateral ITA grafts. They suggest using both ITAs in those patients who are not at inordinate risk and stand most to benefit, such as those who are young and nonobese with a greater than 10-year life expectancy. ...
Sonbol performed a catheter based coronary intervention first, and placed three stents in the arteries to help restore normal blood flow. Strong was immediately taken to the OR where Tripathy performed minimally invasive coronary artery bypass surgery from the left side of the chest, repositioning the left internal mammary artery to the front of the pumping chamber of the heart. The left internal mammary artery is usually the life line of a coronary artery bypass procedure.. ...
Cannulation of the radial artery percutaneously or by cut down is frequently used to monitor blood pressure in infants and children undergoing cardiopulmonary bypass. When radial artery cannulation is difficult because of previous cannulation attempt
We investigated in a physiological salt solution (PSS) containing HCO3- the intracellular pH (pHi) regulating mechanisms in smooth muscle cells cultured from human internal mammary arteries, using the pH-sensitive dye 2,7-bis(2-carboxyethyl)-5(6)-carboxyfluorescein (BCECF) and 22Na+ influx rates. The recovery of pHi from an equivalent intracellular acidosis was more rapid when the cells were incubated in CO2/HCO3(-)-buffered PSS than in HEPES-buffered PSS. Recovery of pHi was dependent on extracellular Na+ (Km, 13.1 mM); however, it was not attenuated by 4-acetamido-4-isothiocyanatostilbene-2,2-disulfonic acid (SITS), indicating the absence of SITS-sensitive HCO3(-)-dependent mechanisms. Recovery instead appeared mostly dependent on processes sensitive to 5-(N-ethyl-N-isopropyl)amiloride (EIPA), indicating the involvement of Na+/H+ exchange and a previously undescribed EIPA-sensitive Na(+)- and HCO3(-)-dependent mechanism. Differentiation between this HCO3(-)-dependent mechanism and Na+/H+ ...
Comparative Effects of Preoperative Angiotensin-converting Enzyme In-hibitor, Statin and Beta-blocker Treatment on Human Internal Mammary Artery Reactivity in Patients with Coronary Artery Disease: A Pilot Study
Recanalization of Acute Left Internal Mammary Artery Graft Failure by Percutaneous Coronary Intervention, Moustapha Diakite, Murat Cimci, Mustafa Cikiri
To investigate the changes in COX-2 activity and expression in bypass conduits after CABG surgery, we studied isolated segments of SV and IMA from the same patients using an organ culture system. After 2 consecutive days in culture, segments of SV and IMA released prostanoids in the order of PGE2≥prostacyclinTXA2, and these segments contained detectable COX-2 mRNA. These results are consistent with the reported high expression of prostacyclin synthase and low expression of TX synthase in vascular smooth muscle22 23 and the ability of PGE2 to be formed nonenzymatically.24 Interestingly, we did not detect mRNA for COX-2 in freshly removed SV or IMA, indicating that vessels from patients, even those with underlying coronary artery disease, do not have a basal expression of COX-2 at the time of surgery. In animal models, mild physical trauma causes COX-2 induction in vivo in rat carotid arteries.9 Thus, the induction of COX-2 we observed in the SV and IMA after 48 hours in organ culture is ...
Sections of arteries in the body can be used as grafts to reroute blood around arterial blockage that cut off blood flow. The internal mammary arteries run along both sides of the back of the breastbone and supplies blood to the chest wall. The radial artery runs along the lower arm on the same side as the thumb and supplies the lower arm with blood. If the internal mammary artery is used, the beginning of the artery is usually left attached to the artery under the collar bone and the end of the artery is attached to the hearts blood vessel supplying blood to the heart. If the radial artery is used, it is removed from the arm completely with one end attached to a good blood supply, usually the aorta, and the other end attached beyond the blockage. As a general rule, arteries used for bypass remain open longer than veins used for bypass.. ...
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Objective: Physiological reaction to competitive flow is considered as the primary mechanism of arterial graft occlusion. Reopening of graft lumen had been also reported, but details remain unknown. We sought to delineate the effect of management of the moderately stenotic targets on the occurrence of competitive flow and clinical results. Methods: Clinical records and angiograms of 3263 bypass grafts in 852 patients, who underwent off-pump coronary revascularization using the internal thoracic artery (ITA) and radial artery without aortic manipulation since 2000, were examined. Dominant flow direction was graded as antegrade, competitive, and no flow (occlusion). Late angiography was performed in 157 patients with 561 bypass grafts for clinical reasons. The follow-up period was 55.5 ± 31.1 months. Results: The early graft patency rate was 98.0% (3197/3263). The rate of antegrade flow was 91.5% (2986/3263), while competitive flow was detected in 6.5% (211/3263). The actuarial patency rates of ...
The coronary artery bypass graft (or CABG... or "cabbage") is the most common procedure in CT surgery. Laymans terms the "x bypass" surgery. For most CT surgeons, this procedure is as mundane as the morning coffee, but for a medical student seeing the procedure for the first time, its pretty fn cool. This one was cool because it was a throwback to my wide-eyed "this is super awesome" pre-med days. It was also cool because it really shows some of the ingenuity employed in surgical techniques. Ive known that the internal thoracic artery (or internal mammary artery) is the most common graft harvested for use during the bypass due to the dual-circulatory blood supply to the anterior thoracic wall. But I always assumed you simply cut out a length of the artery necessary for the bypass and suture in one end to the appropriate coronary artery and the other end into the root of the aorta. In actuality, in most cases things are done slightly differently, with the surgeon dissecting the artery away ...
Coronary artery bypass grafting (CABG) x2, left internal mammary artery to the left anterior descending and reverse saphenous vein graft to the circumflex, St.
Patients with radiation-induced coronary artery disease present in the same way as those without a history of radiation and are usually treated in the same way. Surgical management, however, may be complicated by mediastinal and pericardial fibrosis, concurrent radiation-induced injury to the left internal mammary artery (which is usually used as a graft), and impaired post-operative healing of radiation-damaged tissues ...
BY-PASS Angiography scanner 3D. Double arterial and venous coronary bypass. Aorto-coronary bypass (between the aorta and the anterior interventricular coronary artery) downstream of the stenosis. The left internal mammary artery was used to join those two arteries. Treatment in transparency of the right cavities of the heart (in blue). see. image 1672306 for another view of this bypass. - Stock Image C004/0612
To the best of our knowledge, this is the only prospective, randomized study with long-term results at 7 years in patients with isolated lesions of the proximal LAD treated by either PCI with SES or MIDCAB surgery. There were no significant differences in the composite primary endpoint and individual "hard" endpoints such as cardiac death and myocardial infarction between PCI with SES and MIDCAB. However, TVR was more frequent with PCI.. Current guidelines for revascularization of stable coronary artery disease recommend a stop of the procedure and discussion of further therapy with the patient and the heart team, after the discovery of an isolated proximal LAD stenosis. In American guidelines, revascularization in patients with single-vessel disease and an isolated proximal LAD stenosis PCI has a Class IIb Level of Evidence: B recommendation and surgery with left internal mammary artery a Class IIa B recommendation, whereas in European guidelines PCI has a Class IIa Level of Evidence: B ...
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Diagnostic Techniques and Their Most Important Findings: Standard cine SSFP imaging on a 1.5 T MAGNETOM Aera (Siemens Healthcare, Erlangen, Germany) was limited by significant coil artifact in the right and left internal mammary arteries. Off weak resonance imaging was employed to optimize anatomic definition in this setting; however the flow physiology remained unclear. Four-dimensional (4D) flow imaging was performed following 0.1 mmol/kg gadoterate administration using Siemens WIP 785A with a FOV = 143 x 270 mm2, matrix = 52 x 120, slice thickness = 2.25 mm, TE = 2.2 ms, TR = 38 ms, VENC = 200 cm/sec and flip angle = 15°. Total acquisition time was just under 8 minutes. Arterys version 19.06.2 (Arterys Inc., San Francisco, CA) provided cloud-based post-processing of 4D flow data. Dynamic color flow imaging demonstrated severe restriction of the ventricular septal communication. Left ventricular egress was made possible by LV to RA shunting via regurgitation through the straddling tricuspid ...
In the current issue of ATVB, Shang et al provide compelling evidence for the involvement of LIM domain binding 2 (LDB2) in the transendothelial migration of monocytes in atherosclerosis.1 The article is also of interest because of the systems analyses that led to its identification as a strong candidate.. See accompanying article on page 2068. LDB2 was identified earlier as a key driver of atherosclerosis based on studies of gene expression profiles of tissues obtained from patients.2 Using samples from the Stockholm Atherosclerosis Gene Expression (STAGE) study, the authors profiled gene expression of 5 atherosclerosis-relevant tissues from 114 patients undergoing coronary artery bypass grafting. The tissues collected were distal internal mammary artery, wall of the ascending aorta at the aortic root, anterior hepatic edge, skeletal muscle, and visceral fat. A total of 278 gene expression profiles were used in a coupled 2-way clustering analysis3 to identify 60 gene subnetworks in these ...
Inflammation is a common feature in the majority of cardiovascular disease, including Diabetes Mellitus (DM). Levels of pro-inflammatory markers have been found in increasing levels in serum from diabetic patients (DP). Moreover, levels of Cyclooxygenase-2 (COX-2) are increased in coronary arteries from DP. Through a cross-sectional design, patients who underwent CABG were recruited. Vascular smooth muscle cells (VSMC) were cultured and COX-2 was measured by western blot. Biochemical and clinical data were collected from the medical record and by blood testing. COX-2 expression was analyzed in internal mammary artery cross-sections by confocal microscopy. Eventually, PGI2 and PGE2 were assessed from VSMC conditioned media by ELISA. Only a high glucose concentration, but a physiological concentration of triglycerides exposure of cultured human VSMC derived from non-diabetic patients increased COX-2 expression. Diabetic patients showed increasing serum levels of glucose, Hb1ac and triglycerides. The
Inflammation is a common feature in the majority of cardiovascular disease, including Diabetes Mellitus (DM). Levels of pro-inflammatory markers have been found in increasing levels in serum from diabetic patients (DP). Moreover, levels of Cyclooxygenase-2 (COX-2) are increased in coronary arteries from DP. Through a cross-sectional design, patients who underwent CABG were recruited. Vascular smooth muscle cells (VSMC) were cultured and COX-2 was measured by western blot. Biochemical and clinical data were collected from the medical record and by blood testing. COX-2 expression was analyzed in internal mammary artery cross-sections by confocal microscopy. Eventually, PGI2 and PGE2 were assessed from VSMC conditioned media by ELISA. Only a high glucose concentration, but a physiological concentration of triglycerides exposure of cultured human VSMC derived from non-diabetic patients increased COX-2 expression. Diabetic patients showed increasing serum levels of glucose, Hb1ac and triglycerides. The
The number of blood vessels used will depend on how severe your coronary heart disease is and how many of the coronary blood vessels have become narrowed. If you need 2, 3 or 4 grafts, you may hear your operation referred to as a double, triple or quadruple bypass.. One of the graft vessels is usually taken from your chest (internal mammary artery). Surgeons prefer to use this vessel because it doesnt narrow over time, unlike the blood vessels taken from your leg or arm.. Once all the graft vessels have been removed, your surgeon will make a cut down the middle of your chest so they can divide your breastbone (sternum) and access your heart.. During the procedure, your blood may be rerouted to a heart-lung bypass machine. This takes over from your heart and lungs, pumping blood and oxygen through your body. Your heart will be temporarily stopped using medication while your surgeon attaches the new grafts to divert the blood supply around the blocked artery. After the grafts have been attached, ...
I will be going back to work day after tomorrow after about 7 weeks of 2X CABG with two mammary arteries. I am really looking forward to it. My cardiac functions are fine and feel energetic. I am going...
From: kbuild test robot ,[email protected], To: Roberto Sassu ,[email protected], Cc: [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], Roberto Sassu ,[email protected], Subject: [RFC PATCH] ima: ima_init_ima_crypto() can be static Date: Thu, 6 Feb 2020 07:41:20 +0800 Message-ID: ,[email protected], (raw) In-Reply-To: ,[email protected], Fixes: d49f85a89d4e (ima: Allocate and initialize tfm for each PCR bank) Signed-off-by: kbuild test robot ,[email protected], --- ima_crypto.c , 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/security/integrity/ima/ima_crypto.c b/security/integrity/ima/ima_crypto.c index 7b63a32eefea17..d865e26839ef6d 100644 --- a/security/integrity/ima/ima_crypto.c +++ ...
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Premade cDNA from human internal organ tissues. Very pure, double-stranded cDNA synthesized from premium, high quality poly A Plus RNA.
Premade cDNA from human internal organ tissues. Very pure, double-stranded cDNA synthesized from premium, high quality poly A Plus RNA.
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