Performance Investigations of InAs/InP Quantum-Dash Semiconductor Optical Amplifiers with Different Numbers of Dash Layers.

We present here a performance comparison of quantum-dash (Qdash) semiconductor amplifiers (SOAs) with three, five, eight, and twelve InAs dash layers grown on InP substrates. Other than the number of Qdash layers, the structures were identical. The eight-layer Qdash SOA gave the highest amplified spontaneous emission power (4.3 dBm) and chip gain (26.4 dB) at 1550 nm, with a 300 mA CW bias current and at 25 °C temperature, while SOAs with fewer Qdash layers (for example, three-layer Qdash SOA), had a wider ASE bandwidth (90 nm) and larger 3 dB gain saturated output power (18.2 dBm) in a shorter wavelength range. The noise figure (NF) of the SOAs increased nearly linearly with the number of Qdash layers. The longest gain peak wavelength of 1570 nm was observed for the 12-layer Qdash SOA. The most balanced performance was obtained with a five-layer Qdash SOA, with a 25.4 dB small-signal chip gain, 15.2 dBm 3 dB output saturated power, and 5.7 dB NF at 1532 nm, 300 mA and 25 °C. These results are better than those of quantum well SOAs reported in a recent review paper. The high performance of InAs/InP Qdash SOAs with different Qdash layers shown in this paper could be important for many applications with distinct requirements under uncooled scenarios.

InAs/InP quantum dot mode-locked laser with an aggregate 12.544 Tbit/s transmission capacity.

Chip-scale optical frequency comb sources are ideal compact solutions to generate high speed optical pulses for applications in wavelength division multiplexing (WDM) and high-speed optical signal processing. Our previous studies have concentrated on the use of quantum dash based lasers, but here we present results from an InAs/InP quantum dot (QDot) C-band passively mode-locked laser (MLL) for frequency comb generation. By using this single-section QDot-MLL we demonstrate an aggregate line rate of 12.544 Tbit/s 16QAM data transmission capacity for both back-to-back (B2B) and over 100-km of standard single mode fiber (SSMF). This finding highlights the viability for InAs/InP QDot lasers to be used as a low-cost optical source for large-scale networks.

InAs/InP quantum dash buried heterostructure mode-locked laser for high capacity fiber-wireless integrated 5G new radio fronthaul systems.

We have developed and experimentally demonstrated a highly coherent and low noise InP-based InAs quantum dash (QDash) buried heterostructure (BH) C-band passively mode-locked laser (MLL) with a pulse repetition rate of 25 GHz for fiber-wireless integrated fronthaul 5G new radio (NR) systems. The device features a broadband spectrum providing over 46 equally spaced highly coherent and low noise optical channels with an optical phase noise and integrated relative intensity noise (RIN) over a frequency range of 10 MHz to 20 GHz for each individual channel typically less than 466.5 kHz and -130 dB/Hz, respectively, and an average total output power of ∼50 mW per facet. Moreover, the device exhibits low RF phase noise with measured RF beat-note linewidth down to 3 kHz and estimated timing jitter between any two adjacent channels of 5.5 fs. By using this QDash BH MLL device, we have successfully demonstrated broadband optical heterodyne based radio-over-fiber (RoF) fronthaul wireless links at 5G NR in the underutilized spectrum of around 25 GHz with a total bit rate of 16-Gb/s. The device performance is experimentally evaluated in an end-to-end fiber-wireless system in real-time in terms of error vector magnitude (EVM) and bit error rate (BER) by generating, transmitting and detecting 4-Gbaud 16-QAM RF signals over 0.5-m to 2-m free-space indoor wireless channel through a total length of 25.22 km standard single mode fiber (SSMF) with EVM and BER under 8.4% and 2.9 × 10-5, respectively. The intrinsic characteristics of the device in conjunction with its system transmission performance indicate that QDash BH MLLs can be readily used in fiber-wireless integrated systems of 5G and beyond wireless communication networks.

Safe Anastomoses without Ostomies in Cytoreductive Surgery with Heated Intraperitoneal Chemotherapy: Technical Considerations and Modifications.

BACKGROUND: Gastrointestinal complications, predominantly anastomotic leak (AL), are the most frequent source of severe morbidity after cytoreductive surgery (CRS). OBJECTIVE: The aim of this study was to present the technical standards for colorectal anastomoses developed and systematically applied to all patients undergoing CRS in a high-volume tertiary center, and the associated AL rates. METHODS: This was a descriptive study reporting the technical characteristics of a standardized protocol for three types of colorectal anastomoses (colorectal, ileorectal, and ileocolic) in CRS with heated intraperitoneal chemotherapy (HIPEC), and a retrospective analysis of prospectively collected data on anastomotic outcomes. All patients (1172) undergoing CRS with HIPEC from September 2006 to September 2020 were included. The anastomotic complications were classified according to the International Study Group of Rectal Cancer Surgery (ISGRCS) classification. RESULTS: Overall, 1172 patients underwent 1300 procedures and 1359 gastrointestinal anastomoses. An ileocolic anastomosis was performed in 408 patients, colorectal anastomosis in 469 patients, and ileorectal anastomosis in 16 patients, none with diverting ileostomy; 345 other gastrointestinal reconstructions and 82 urinary reconstructions were performed in these patients. The AL rate was 1% (4/408) for the ileocolic anastomosis, 0.85% (4/469) for the colorectal anastomosis, and 0% (0/16) for the ileorectal anastomosis. One patient died postoperatively due to AL. CONCLUSIONS: Systematic application of standardized techniques adapted to ensure optimal tissue healing (stapled anastomoses avoiding overlap, accurate staple deployment, and hand-sewn reinforcement) are associated with a very high level of anastomotic safety in a large cohort of patients undergoing CRS and HIPEC.

A Near-Zero Anastomotic Leak Rate in Cytoreductive Surgery with Heated Intraperitoneal Chemotherapy is Achievable.

Gastrointestinal complications are the main source of severe morbidity after cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC), mainly in the form of anastomotic leak. Reducing the rate of anastomotic leaks is of paramount importance and should be approached both through risk factor understanding and reduction, as well as optimization of surgical team performance. We performed a study that describes the details of a technical protocol for the creation of anastomoses after colorectal resections in CRS and HIPEC and the anastomotic outcomes associated with its systematic application in a high-volume peritoneal surface malignancy center. An extremely low, near-zero anastomotic leak rate (0.85% in colorectal anastomoses, 1% in ileo-colic anastomoses, and 0% in ileo-rectal anastomoses) was observed among 1172 patients. Extremely low, near-zero rates of anastomotic leak after colorectal resections in CRS and HIPEC could be achievable in high-volume peritoneal malignancy centers. The described techniques could be adopted and validated in other high-volume peritoneal malignancy centers.

The Role of Hyperthermic Intraperitoneal Chemotherapy in Pseudomyxoma Peritonei After Cytoreductive Surgery.

Importance: Studies on the prognostic role of hyperthermic intraperitoneal chemotherapy (HIPEC) in pseudomyxoma peritonei (PMP) are currently not available. Objectives: To evaluate outcomes after cytoreductive surgery (CRS) and HIPEC compared with CRS alone in patients with PMP. Design, Setting, and Participants: This cohort study analyzed data from the Peritoneal Surface Oncology Group International (PSOGI) registry, including 1924 patients with histologically confirmed PMP due to an appendiceal mucinous neoplasm. Eligible patients were treated with CRS with or without HIPEC from February 1, 1993, to December 31, 2017, and had complete information on the main prognostic factors and intraperitoneal treatments. Inverse probability treatment weights based on the propensity score for HIPEC treatment containing the main prognostic factors were applied to all models to balance comparisons between the CRS-HIPEC vs CRS-alone groups in the entire series and in the following subsets: optimal cytoreduction, suboptimal cytoreduction, high- and low-grade histologic findings, and different HIPEC drug regimens. Data were analyzed from March 1 to June 1, 2018. Interventions: HIPEC including oxaliplatin plus combined fluorouracil-leucovorin, cisplatin plus mitomycin, mitomycin, and other oxaliplatin-based regimens. Main Outcomes and Measures: Overall survival, severe morbidity (determined using the National Cancer Institute Common Terminology for Adverse Events, version 3.0), return to operating room, and 30- and 90-day mortality. Differences in overall survival were compared using weighted Kaplan-Meier curves, log-rank tests, and Cox proportional hazards multivariable models. A sensitivity analysis was based on the E-value from the results of the main Cox proportional hazards model. Differences in surgical outcomes were compared using weighted multivariable logistic models. Results: Of the 1924 patients included in the analysis (997 [51.8%] men; median age, 56 [interquartile range extremes (IQRE), 45-65] years), 376 were in the CRS-alone group and 1548 in the CRS-HIPEC group. Patients with CRS alone were older (median age, 60 [IQRE, 48-70] vs 54 [IQRE, 44-63] years), had less lymph node involvement (14 [3.7%] vs 119 [7.7%]), received more preoperative systemic chemotherapy (198 [52.7%] vs 529 [34.2%]), and had higher proportions of high-grade disease (179 [47.6%] vs 492 [31.8%]) and suboptimal cytoreduction residual disease (grade 3, 175 [46.5%] vs 117 [7.6%]). HIPEC was not associated with a higher risk of worse surgical outcomes except with mitomycin, with higher odds of morbidity (1.99; 95% CI, 1.25-3.19; P = .004). HIPEC was associated with a significantly better overall survival in all subsets (adjusted hazard ratios [HRs], 0.60-0.68, with 95% CIs not crossing 1.00). The weighted 5-year overall survival was 57.8% (95% CI, 50.8%-65.7%) vs 46.2% (95% CI, 40.3%-52.8%) for CRS-HIPEC and CRS alone, respectively (weighted HR, 0.65; 95% CI, 0.50-0.83; P < .001; E-value, 2.03). Such prognostic advantage was associated with oxaliplatin plus fluorouracil-leucovorin (HR, 0.42; 95% CI, 0.19-0.93; P = .03) and cisplatin plus mitomycin (HR, 0.57; 95% CI, 0.42-0.78; P = .001) schedules. Conclusions and Relevance: In this cohort study, HIPEC was associated with better overall survival when performed after CRS in PMP, generally without adverse effects on surgical outcomes.

Intraperitoneal hyperthermic chemotherapy after cytoreduction in patients with peritoneal metastases from endometrial cancer. The next frontier?

BACKGROUND: Endometrial cancer is the most common malignancy of the female genital tract. For cancers detected at an advanced stage or intraperitoneal relapse, the prognosis is poor. Optimal cytoreductive surgery (CRS) is the most accepted treatment; however, patients with advanced intraperitoneal disease might benefit from hyperthermic intraoperative peritoneal chemotherapy (HIPEC). The aim of this study was to analyze recurrence-free survival (RFS) after CRS and HIPEC in a large series of patients with peritoneal metastases from endometrial cancer. METHODS: Patients with a diagnosis of endometrial cancer with primary or recurrent peritoneal dissemination were included. All patients underwent CRS plus HIPEC. Data were prospectively collected in the Spanish Group of Peritoneal Oncological Surgery (GECOP) database. RESULTS: Forty-three patients with endometrial cancer and peritoneal metastasis were included. Fifteen patients (35%) were diagnosed with G3 endometrioid carcinomas and 28 (65%) with other non-endometroid histologies. A completeness of cytoreduction score of CC-0 was achieved in 41 patients (95%). RFS at 5 years was 23%, being factors related to worse RFS: treatment with preoperative chemotherapy (p = 0.027), resection of more than three peritoneal areas (p = 0.010), cytoreduction of the upper abdominal space (p = 0.023), HIPEC treatment with paclitaxel (p = 0.013), and the presence of metastatic lymph nodes (p = 0.029). CONCLUSIONS: Better RFS rates after CRS and HIPEC were observed for patients with the following characteristics: cytoreductive surgery without preoperative chemotherapy, complete surgery performed with limited surgical maneuvers, treated with cisplatin, and no lymph node metastases. SYNOPSIS: Endometrial cancer has a poor prognosis when diagnosed at advance stage. Patients with intraperitoneal metastases from endometrial cancer may benefit from CRS plus HIPEC with improvement in the recurrence-free survival results.

Passively mode-locked quantum dash laser with an aggregate 5.376 Tbit/s PAM-4 transmission capacity.

This paper presents an InAs/InP quantum dash (QD) C-band passively mode-locked laser (MLL) with a channel spacing of 34.224 GHz. By using this QD-MLL we demonstrate an aggregate 5.376 Tbit/s PAM-4 data transmission capacity both for back-to-back (B2B) and over 25-km of standard single mode fiber (SSMF). This represents the first demonstration of QD-MLL acting as error-free operation at an aggregate data transmission capacity of 5.376 Tbit/s for some filtered individual channels. This finding highlights the viability for InAs/InP QD lasers to be used as a low-cost optical source for data center networks.

Monolithic InAs/InP quantum dash dual-wavelength DFB laser with ultra-low noise common cavity modes for millimeter-wave applications.

We have developed and experimentally demonstrated a novel monolithic InAs/InP quantum-dash dual-wavelength distributed feedback (QD DW-DFB) C-band laser as a compact optical beat source to generate millimeter-wave (MMW) signals. The device uses a common gain medium in a single cavity structure for simultaneous correlated and stable dual-mode lasing in the 1550-nm wavelength range. A record narrow optical linewidth down to 15.83 kHz and average relative intensity noise (RIN) as low as -158.3 dB/Hz from 10 MHz to 20 GHz are experimentally demonstrated for the two optical modes generated by the laser. As a result, the beat note between these two lasing modes generates spectrally pure MMW signals between 46 GHz and 48 GHz. Such an efficient, coherent, and compact optical source is extremely attractive for applications in MMW systems, such as Radar and fiber-wireless integrated fronthaul for 5G and beyond.

Colorectal carcinoma in the frail surgical patient. Implementation of a Work Area focused on the Complex Surgical Patient improves postoperative outcome. / Resultados de morbimortalidad en cáncer colorrectal en paciente quirúrgico frágil. Implementación de un Área de Atención al Paciente Quirúrgico Complejo.

INTRODUCTION: Advanced age and comorbidity impact on post-operative morbi-mortality in the frail surgical patient. The aim of this study is to assess the impact of a comprehensive, multidisciplinary and individualized care delivered to the frail patient by implementation of a Work Area focused on the Complex Surgical Patient (CSPA). METHODS: Retrospective study with prospective data collection. Ninety one consecutive patients, classified as frail (ASAIII or IV, Barthel<80 and/or Pfeiffer>3) underwent curative radical surgery for colorectal carcinoma between 2013 and 2015. GroupI: 35 patients optimized by the CSPA during 2015. GroupII: 56 No-CSPA patients, treated prior to CSPA implementation, during 2014-2015. Group homogeneity, complication rate, length of stay, reoperations, readmissions, costs and overall mortality were analyzed and adjusted by Diagnosis-Related Group (DRG). RESULTS: There were no statistically significant differences in term of age, gender, ASA classification, body mass index, tumor staging and type of surgical intervention between the two groups. Major complications (Clavien-DindoIII-IV) (12.5% vs. 28.5%, P=.04), hospital stay (12.6±6days vs. 15.2±6days, P=0.041), readmissions (12.5% vs. 28.3%, P<0.041), and patient episode cost weighted according to DRG (3.29±1 vs. 4.3±1, P=0.008) were statistically inferior in Group CSPA. There were no differrences in reoperations (6.2% vs. 5.3%) or mortality (6.2% vs. 7.1%). 96.9% of patients of GroupI manifested having received a satisfactory attention and quality of life. CONCLUSIONS: Implementation of a CSPA, delivering surgical care to frail colorectal cancer patients, involves a reduction of complications, length of stay and readmissions, and is a cost-effective arrangement.

Current practice in cytoreductive surgery and HIPEC for metastatic peritoneal disease: Spanish multicentric survey.

INTRODUCTION: Radical Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC), has been proposed as the current standard of treatment for metastatic peritoneal disease by several tumors. Despite its widely utilization, there seems to be a great variability in their organization, clinical practice, and safety among centers. AIM OF THE STUDY: To obtain updated information on clinical practice in different perioperative areas of the CRS-HIPEC. PATIENTS AND METHODS: All 25 members of the Spanish Surface Peritoneal Malignancy (GECOP), were invited to answer an online survey, to describe their usual practice in different perioperative areas of the CRS-HIPEC. RESULTS: Survey was responded by 100% of centers. This study represents more than 800 patients treated annually. Seventy per cent of respondents perform CRS-HIPEC for more than 5 years. The most frequent technique was Coliseum (88%). Routinely non-invasive monitoring of cardiac output is used by 92% of centers. More than 50% of centers administer oxaliplatin (74%), or mitomycin-C (65%) in colorectal cancer; cisplatin in gastric cancer (73%) and mesothelioma (74%). Ovarian cancer is treated with cisplatin and various combinations, in 64% or paclitaxel in 54.5%. Spillage protocol was available in 100% centers. CONCLUSIONS: Data showed an important variability in volume of patients per center, selection of cytostatic agents, professional training and safety measures applied. The standardization of CRS/HIPEC procedures based on the best available evidence, the individualization of patients and the consensus among professionals, constitute an important part of the basis that will allow us to improve results of this complex procedure.

Early- and long-term outcome data of patients with pseudomyxoma peritonei from appendiceal origin treated by a strategy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

PURPOSE: Pseudomyxoma peritonei (PMP) originating from an appendiceal mucinous neoplasm remains a biologically heterogeneous disease. The purpose of our study was to evaluate outcome and long-term survival after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) consolidated through an international registry study. PATIENTS AND METHODS: A retrospective multi-institutional registry was established through collaborative efforts of participating units affiliated with the Peritoneal Surface Oncology Group International. RESULTS: Two thousand two hundred ninety-eight patients from 16 specialized units underwent CRS for PMP. Treatment-related mortality was 2% and major operative complications occurred in 24% of patients. The median survival rate was 196 months (16.3 years) and the median progression-free survival rate was 98 months (8.2 years), with 10- and 15-year survival rates of 63% and 59%, respectively. Multivariate analysis identified prior chemotherapy treatment (P < .001), peritoneal mucinous carcinomatosis (PMCA) histopathologic subtype (P < .001), major postoperative complications (P = .008), high peritoneal cancer index (P = .013), debulking surgery (completeness of cytoreduction [CCR], 2 or 3; P < .001), and not using HIPEC (P = .030) as independent predictors for a poorer progression-free survival. Older age (P = .006), major postoperative complications (P < .001), debulking surgery (CCR 2 or 3; P < .001), prior chemotherapy treatment (P = .001), and PMCA histopathologic subtype (P < .001) were independent predictors of a poorer overall survival. CONCLUSION: The combined modality strategy for PMP may be performed safely with acceptable morbidity and mortality in a specialized unit setting with 63% of patients surviving beyond 10 years. Minimizing nondefinitive operative and systemic chemotherapy treatments before definitive cytoreduction may facilitate the feasibility and improve the outcome of this therapy to achieve long-term survival. Optimal cytoreduction achieves the best outcomes.

Femtosecond gain and index dynamics in an InAs/InGaAsP quantum dot amplifier operating at 1.55 microm.

We report on the characterization of the ultrafast gain and refractive index dynamics of an InAs/InGaAsP self-assembled quantum dot semiconductor optical amplifier (SOA) operating at 1.55 mum through heterodyne pump-probe measurements with 150 fs resolution. The measurements show a 15 ps gain recovery time at a wavelength of 1560 nm, promising for ultrafast switching at >40 GHz in the important telecommunications wavelength bands. Ultrafast dynamics with 0.2-1.5 ps lifetimes were also found consistent with carrier heating and spectral hole burning. Comparing with previous reports on quantum dot SOAs at 1.1-1.3 mum wavelengths, we conclude that the carrier heating is caused by a combination of free-carrier absorption and stimulated transition processes.

Traumatismo encefalocraneano y raquimedular: experiencia inicial: Unidad de Cuidados Intensivos - Hospital Regional Copiapó / Encephalocranial and spine trauma: initial experience: intensive care unit - Regional Hospital Copiapó

Neurotrauma is one of the three causes of mortality. We are showing our initial experience, with neurosurgical support and specifically all of the patients were admited to the Critical Care Unit of the Hospital Regional of Copiapó; at the 3rd region of the country. We described the head trauma and spine trauma cases, and the neurointensive management; now with neurotrauma surgery at all. The goal of this article is to show our initial experience and our capabilities and the proyection in the development of neurointensivism in our center.

Experiencia clínico quirúrgica en 100 casos de síndrome de túnel carpiano / Clinic surgical experience in 100 cases of carpal tunnel syndrome

Se revisan 100 casos de atrapamiento de nervio mediano al nivel de canal carpiano operados entre 1997 y 1999, en el Hospital Regional de Talca. Se describe relación etaria y predominancia por sexo, además del perfil laboral. Además se describe la técnica quirúrgica, lo mismo que las complicaciones y evolución post quirúrgica. Se correlacionan datos clínicos con resultados electrofisiológicos. Se hace hincapié en lo frecuente de ésta patología y además de su presentación atípica

Abordaje anterolateral hacia la base del cráneo: fronto-temporo-orbitozygomático: experiencia inicial y revisión bibliográfica / Anterolateral approach towards the skull base: frontal-temporal-orbitalzigomatic: initial experience and bibliographic review

El presente trabajo tiene por objeto dar a conocer la experiencia en lo que respecta a una de las vías del abordaje lateral de la base del cráneo; cirugía que por lo de más se encuentra en fase inicial en nuestro Servicio. La suma de lo que significa la implementación del instrumental apropiado para este tipo de cirugía, ha hecho posible iniciar una nueva línea de trabajo que se basa en fundamentos que han ído desarrollándose en el transcurso de los años, y que ha dado a conocer una nueva filosofía en lo que respecta al abordaje de las lesiones que comprometen zonas profundas, tanto intra como extracraneales. Esta vía de abordaje es una de las tantas descritas pero como veremos más adelante tiene la ventaja de ser muy versátil y amplia en lo que respecta a la exposición de toda la parte antero lateral de la base craneal, pudiéndo abordar lesiones tanto de la región parasellar, a nivel de la fosa interpeduncular incluyendo procesos expansivos como meningiomas que pudieran comprometer el tercio medio del ala esfenoidal, así como también meningiomas petroclivales igualmente neurinomas trigeminales y aneurismas de la cuadrifurcación de la arteria basilar que son de difícil abordaje mediante los procedimientos habituales. El presente estudio tiene además el objetivo de ilustrar y describir los pasos como se realiza esta vía de abordaje haciendo referencia tambien a otros estudios, los cuales describen tambien sus vías de abordaje característica. Igualmente mostrar el instrumental básico necesario para el desarrollo de este tipo de cirugía. Ya en 1928 Naffziger decía que lo fascinante de la cirugía cerebral descansaba en su dificultad; ya que comprende un abordaje dificultoso a través de estructuras excepcionalmente duras y resistentes, para llegar finalmente a órganos vitales, delicados y fácilmentes traumatizables. Por lo tanto el propósito es mostrar una vía de abordaje lógica, anatómica y que ofrece una mayor zona de trabajo en favor de una menor profundidad del campo operatorio exponiendo zonas profundas de la base del cráneo; mostrar la experiencia inicial, con los problemas surgidos y proponerla como alternativa de abordaje en los diferentes servicios de la especialidad que en algún momento pudieran contar con la implementación apropiada para la realización de la misma. Las lesiones localizadas en la región parasellar tanto anterior como inferior así como también a nivel de la fosa interpendicula...

Evaluación por resonancia magnética de resultados a mediano plazo de angioplastias en coartaciones y recoartaciones aórticas / Angioplasty in aortic Coartation and recoartation MR Imaging

Se estudiaron por resonancia magnética 10 niños para valorar los resultados a mediano plazo del tratamiento de coartación y recoartación de aorta torácica con angioplastia percutánea transluminal, entre 1 y 5 años postprocedimiento. Los Pacientes explorados en secuencias axiales y sagitales oblicuos (eje aórtico) ponderadas en T1 (TR 600, TE 30) en equipo de 0,5 Tesla. Los resultados inmediatos mostraron una reducción del gradiente de 42 ñ 13 a 8 ñ 6 mmHg (p<0,0001). El diámetro de la coartación aumentó de 6 ñ 3 a 12 ñ 4 mm(p,0,001) y de la coartación/aorta descendente (C/D) de 0,4 ñ 0,2 a 0,9 ñ 0,2 (p<0.001). El seguimiento objetivó un diámetro estable en la coartación de 12 ñ 5 mm (NS) y un índice C/10,9 ñ 0,3 (NS) y C/CD 0,8 ñ 0,2 (NS). La RM aparece como un excelente método no invasivo para evaluar los resultados de la angioplastía percutánea transluminal en coartaciones y recoartaciones de aorta torácica

Aterosclerosis coronaria y lesión miocárdica ventricular izquierda: estudio de su grado de asociación / Coronary atherosclerosis and left ventricular myocardial lesion: study of its association grading

Se realizan análisis de correlación de Pearson entre las variables de un sistema biométrico (Carlevaro y Fernández Britto) para el estudio de la lesión aterosclerótica en cualquier sector vascular y las áreas de fibrosis y necrosis encontradas en el músculo cardíaco del ventrículo izquierdo y del tabique de 139 fallecidos necropsiados en el Hospital Militar Central "Dr. Carlos J. Finlay", los que por reunir una serie de requisitos considerados de carácter indispensables constituyen una población. Se disecan los corazones (método de Hudson modificado) y se cortan sagitalmente las paredes del ventrículo izquierdo y del tabique, se calcan en acetato el área total de músculo y las de fibrosis y necrosis cuando están presentes (análisis cualitativo). Se utiliza el método de la pesada y se obtienen tres valores, área total de músculo, área total de fibrosis y la de necrosis. Con estos valores se elaboran los índices de densidad de fibrosis y de necrosis, que son las variables que se utilizarán para las correlaciones con las lesiones arteriales. Se estudian las coronarias en tres ramas (derecha, descendente anterior y circunfleja izquierda y se procesan según técnicas bien establecidas. Se colorean por el método de Holman y se realizan análisis cualitativos identificándose las estrías adiposas, las placas fibrosas y las graves, las que posteriormente se cuantifican (mm cuadrados). Se pretende conocer si existen correlaciones entre las diferentes variedades de lesión aterosclerótica coronarias y las variables que expresan la fibrosis y necrosis miocárdica. Se elabora una hipótesis científica de trabajo que afirma la existencia de estas correlaciones y responsabiliza a las placas graves como las más relevantes. Se concluye que se observan fuertes correlaciones entre los índices de densidad de fibrosis y necrosis y varias variables del sistema biométrico, siendo las más fuertes las de las placas graves (Z), el coseno de y, el índice de obstrucción (omega) y el número de estenosis (P), así como el total de aterosclerosis. Con relación a la edad y al peso del corazón, también se encontraron correlaciones fuertes. Las placas fibrosas y las estrías adiposas presentaron muy escasas asociaciones con los índices estudiados, así como la edad y el peso del corazón

Aterosclerosis coronaria y lesión miocárdica ventricular izquierda: estudio de su forma de asociación (Hospital Militar Central Dr. C. J. Finlay, 1983) / Coronary atherosclerosis and left ventricular myocardial lesion: study of their association form (Hospital Militar Central Dr. C. J. Finlay 1983)

Se realizan análisis de regresión múltiple entre las variables de un Sistema Biométrico (Carlevaro y Fernández Brito) para el estudio de la lesión aterosclerótica en cualquier sector vascular y las áreas de fibrosis y/o necrosis encontradas en el músculo cardíaco del ventrículo izquierdo y del tabique de 139 fallecidos necropsiados en el Hospital Militar Central "Carlos J. Finlay", los que por reunir una serie de requisitos considerados de carácter indispensables constituyen una población. Se disecan los corazones (Hudson modificado) y se cortan sagitalmente las paredes del ventrículo izquierdo y del tabique, se calcan en acetato el área total de músculo y las de fibrosis y necrosis, cuando están presentes (análisis cualitativo). Se utiliza el método de la pesada y se obtienen tres valores, área total de músculo, área total de fibrosis y la de necrosis. Con estos valores se elaboran los índices de densidad de fibrosis y de necrosis, que son las variables que se utilizan para las correlaciones con las lesiones arteriales. Se estudian las coronarias en tres ramas (derechas, descendente anterior y circunfleja izquierda), procesándose, según técnicas bien establecidas, se colorean por el método de Holman y se realizan análisis cualitativos identificándose las estrías adiposas, placas fibrosas y placas graves las que posteriormente se miden en mm**2 (análisis cuantitativo). Se pretende conocer las formas de asociación más características que se presentan entre las diferentes variedades de lesión aterosclerótica y las variedades de lesiones miocárdicas estudiadas al someterlas al procedimiento estadístico multivariado del análisis de regresión múltiple. Se elabora una hipótesis científica que afirma que esta asociación puede estimarse a través de un modelo de regresión lineal y que esta relación está determinada por las placas graves, siendo de utilidad para cumplir este objetivo las variables número de estenosis (P) e índice de benignidad (B). Como resultados más relevantes se observó que mediante un modelo de regresión lineal es posible estimar la relación existente entre la aterosclerosis coronaria y las lesiones miocárdicas, así como que las placas graves (Z) son las máximas responsables de esta asociación. La descendente anterior presentó valores secundarios en esta asociación. Se pone en evidencia la validez y gran utilidad del sistema biométrico para estos estudios