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1.
Lett Appl Microbiol ; 74(3): 385-394, 2022 Mar.
Article in English | MEDLINE | ID: mdl-34825719

ABSTRACT

Here we studied at a laboratory scale a potential strategy to revalorize the residual rice remaining at the end of a conventional conidia production process in solid-state culture. The conidia production of Trichoderma asperellum Th-T4 (3) and Metarhizium robertsii Xoch-8.1 started with the use of fresh rice (unrecycled rice) as the substrate (cycle one), and continued with the use of recycled rice in successive cycles of conidia production. The rice remaining at the end of the first cycle was reused without any further sterilization or reinoculation. As a result, it was observed that the conidia production and productivity significantly increased in both fungi. Conidia production in T. asperellum Th-T4 (3) increased from 1 × 109 (first cycle) to 2·9 × 109 conidia per gram of initial dry substrate (con⋅gds-1 ) (second cycle using recycled rice), while in M. robertsii Xoch-8.1, this parameter increased form 5·7 × 108 to 1·4 × 109 con⋅gds-1 . Both fungi grew faster and conidiated earlier when recycled rice was used as the substrate, therefore, conidia productivity was also significantly improved. Furthermore, the use of recycled rice did not affect conidia viability. This is the first report about a recycling methodology completely free of extra-processing steps, and useful to increase conidia production and productivity.


Subject(s)
Metarhizium , Oryza , Fermentation , Spores, Fungal
2.
Dis Aquat Organ ; 147: 47-61, 2021 Nov 18.
Article in English | MEDLINE | ID: mdl-34789587

ABSTRACT

Sponges are fundamental components of coral reef communities and, unfortunately, like other major benthic members, they too have been impacted by epizootic and panzootic events. We report on the prevalence of disease-like conditions affecting populations of the giant barrel sponge Xestospongia muta across shallow and mesophotic coral reefs off La Parguera Natural Reserve (LPNR) and Mona Island Marine Reserve (MIMR) in Puerto Rico. Four different conditions affecting X. muta were observed during our surveys, of which 3 have been previously reported: cyclic spotted bleaching (CSB; apparently non-lethal), Xestospongia-tissue wasting disease (X-TWD; apparently lethal), and sponge orange band disease (SOB; sparsely associated with X-TWD infected individuals). Additionally, we describe a fourth condition, Xestospongia-tissue hardening condition (X-THC), a previously unreported disease recently observed along the insular shelf margin off LPNR and MIMR. Within LPNR, a total of 764 specimens of X. muta were inspected and measured. Of these, 590 sponges (72.2%) had CSB, 25 (3.27%) had signs of X-TWD, 7 (0.92%) had SOB, and the remaining 142 (18.6%) were apparently healthy. Three colonies inhabiting upper mesophotic depths on the LPNR insular shelf showed signs of CSB and X-TWD. At MIMR, video-transect surveys revealed a total of 514 colonies, of which 40 (7.78%) had signs of CSB and/or XTWD, 14 (2.72%) were affected by X-THC, while the remaining 460 (89.5%) showed no external signs of disease and appeared healthy. The presence of 4 concomitant disease-like conditions in barrel sponges of Puerto Rico is alarming, and indicative of the deteriorating status of Caribbean coral reefs.


Subject(s)
Anthozoa , Xestospongia , Animals , Coral Reefs , Ecosystem , Puerto Rico/epidemiology
3.
Rev Sci Instrum ; 92(3): 033511, 2021 Mar 01.
Article in English | MEDLINE | ID: mdl-33820108

ABSTRACT

The Scattered Light Time-history Diagnostic (SLTD) is being implemented at the National Ignition Facility (NIF) to greatly expand the angular coverage of absolute scattered-light measurements for direct- and indirect-drive inertial confinement fusion (ICF) experiments. The SLTD array will ultimately consist of 15 units mounted at a variety of polar and azimuthal angles on the NIF target chamber, complementing the existing NIF backscatter suite. Each SLTD unit collects and diffuses scattered light onto a set of three optical fibers, which transport the light to filtered photodiodes to measure scattered light in different wavelength bands: stimulated Brillouin scattering (350 nm-352 nm), stimulated Raman scattering (430 nm-760 nm), and ω/2 (695 nm-745 nm). SLTD measures scattered light with a time resolution of ∼1 ns and a signal-to-noise ratio of up to 500. Currently, six units are operational and recording data. Measurements of the angular dependence of scattered light will strongly constrain models of laser energy coupling in ICF experiments and allow for a more robust inference of the total laser energy coupled to implosions.

4.
Rev Sci Instrum ; 89(10): 10I148, 2018 Oct.
Article in English | MEDLINE | ID: mdl-30399772

ABSTRACT

Fusion reaction history and ablator areal density measurements for Inertial Confinement Fusion experiments at the National Ignition Facility are currently conducted using the Gamma Reaction History diagnostic (GRH_6m). Future Gas Cherenkov Detectors (GCDs) will ultimately provide ∼100x more sensitivity, reduce the effective temporal response from ∼100 to ∼10 ps, and lower the energy threshold from 2.9 to 1.8 MeV, relative to GRH_6m. The first phase toward next generation GCDs consisted of inserting the existing coaxial GCD-3 detector into a reentrant well which puts it within 4 m of the implosion. Reaction history and ablator gamma measurement results from this Phase I are discussed here. These results demonstrate viability for the follow-on Phases of (II) the use of a revolutionary new pulse-dilation photomultiplier tube to improve the effective measurement bandwidth by >10x relative to current PMT technology; and (III) the design of a NIF-specific "Super" GCD which will be informed by the assessment of the radiation background environment within the well described here.

5.
Rev Sci Instrum ; 89(8): 083504, 2018 Aug.
Article in English | MEDLINE | ID: mdl-30184717

ABSTRACT

Supra-thermal (>100 keV) electrons generated by laser plasma interactions can be detrimental to the performance of ignition experiments conducted on the National Ignition Facility (NIF). On a NIF shot, the amount of electrons is estimated by measuring the hard X-rays passing through the hohlraum wall. The primary sources of hot electrons in a hohlraum are Stimulated Raman Scattering (SRS) and two plasmon decay (TPD). While SRS is well diagnosed on the NIF, there has been no diagnosis of TPD. We have designed and implemented a new diagnostic to characterize the time history of TPD on the NIF. The instrument provides a time resolved measurement of the 3/2 ω harmonic emission which is indicative of the presence of TPD. We describe the diagnostic setup, calibration, and the preliminary results obtained on NIF hohlraum experiments. We find evidence of a correlation between measured hard X-rays generated from the hot electron bremsstrahlung and the TPD emission.

6.
Rev Sci Instrum ; 87(11): 11E732, 2016 Nov.
Article in English | MEDLINE | ID: mdl-27910331

ABSTRACT

The newest generation of Gas Cherenkov Detector (GCD-3) employed in Inertial Confinement Fusion experiments at the Omega Laser Facility has provided improved performance over previous generations. Comparison of reaction histories measured using two different deuterium-tritium fusion products, namely gamma rays using GCD and neutrons using Neutron Temporal Diagnostic (NTD), have provided added credibility to both techniques. GCD-3 is now being brought to the National Ignition Facility (NIF) to supplement the existing Gamma Reaction History (GRH-6m) located 6 m from target chamber center (TCC). Initially it will be located in a reentrant well located 3.9 m from TCC. Data from GCD-3 will inform the design of a heavily-shielded "Super" GCD to be located as close as 20 cm from TCC. It will also provide a test-bed for faster optical detectors, potentially lowering the temporal resolution from the current ∼100 ps state-of-the-art photomultiplier tubes (PMT) to ∼10 ps Pulse Dilation PMT technology currently under development.

7.
Appl Biochem Biotechnol ; 175(6): 3038-47, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25588527

ABSTRACT

The ligninolytic enzymes versatile peroxidase (VP) and manganese peroxidase (MnP) have been previously described as efficient oxidizers of the endocrine disrupting chemical (EDC) nonylphenol at high concentrations of the pollutant. Envisaging the application of an enzymatic technology as a tertiary treatment in wastewater treatment plants, it is important to design a continuous reactor that performs the efficient removal of nonylphenol under environmental conditions. In the present research, a two-stage membrane bioreactor based on the production and use of Mn(3+)-malonate (chemical oxidant) was applied. The bioreactor consisted of an enzymatic reactor (R1) for the production of Mn(3+)-malonate by VP, coupled to an oxidation reactor (R2), where the oxidation of nonylphenol by Mn(3+)-malonate took place. The production of Mn(3+)-malonate in R1 was maintained constant: 500-700 µM with minimal deactivation of the enzyme. The oxidation reactor attained nearly complete removal of nonylphenol, even at a hydraulic retention time (HRT) shorter than 20 min. The operation with real wastewater containing nonylphenol at environmental concentrations (454 nM) was also successful, with a nonylphenol removal of 99.5% at a rate of 0.73 µM h(-1). Moreover, when the HRT of R2 was sharply reduced to 6.8 and 3.6 min, the removal of nonylphenol was maintained beyond 99%, which proves the feasibility of the system to remove the target compound present in a real effluent, even at very short HRTs.


Subject(s)
Peroxidase/chemistry , Phenols/chemistry , Water Pollutants, Chemical/chemistry , Water Purification/methods , Biodegradation, Environmental , Bioreactors , Kinetics , Manganese/chemistry , Oxidation-Reduction , Water Purification/instrumentation
8.
World J Microbiol Biotechnol ; 29(5): 805-14, 2013 May.
Article in English | MEDLINE | ID: mdl-23247918

ABSTRACT

Many reports describe the decolourization of dyes by fungal enzymes. However, these enzymes do not contribute to dye mineralization but only to its biotransformation into less coloured or colourless molecules persisting in solution. Therefore, it is essential to analyse the identity of the metabolites produced during enzymatic treatments and its biodegradation into an appropriate system. The present work examines the decolourization/detoxification of a simulated effluent (containing Acid Blue 74) by fungal enzymes and proposes a secondary treatment using an anaerobic system to improve the enzymatic decolourization through the complete mineralization of the dye. Ligninolytic enzymes were produced by solid culture using the thermo-tolerant fungus Fomes sp. EUM1. The enzymes produced showed a high rate of decolourization (>95 % in 5 h) and were stable at elevated temperature (40 °C) and ionic strength (NaCl, 50 mM). Isatin-5-sulphonic acid was identified via (1)H-NMR as oxidation product; tests using Daphnia magna revealed the non-toxic nature of this compound. To improve the enzymatic degradation and avoid coupling reactions between the oxidation products, the effluent was subjected to an anaerobic (methanogenic) treatment, which achieved high mineralization efficiencies (>85 %). To confirm the mineralization of isatin-5-sulphonic acid, a specific degradation study, which has not been reported before, with this single compound was conducted under the same conditions; the results showed high removal efficiencies (86 %) with methane production as evidence of mineralization. These results showed the applicability of an anaerobic methanogenic system to improve the enzymatic decolourization/detoxification of Acid Blue 74 and achieve its complete mineralization.


Subject(s)
Coloring Agents/metabolism , Coriolaceae/enzymology , Environmental Restoration and Remediation/methods , Fungal Proteins/metabolism , Water Pollutants, Chemical/metabolism , Biocatalysis , Biodegradation, Environmental , Coloring Agents/analysis , Coriolaceae/chemistry , Fungal Proteins/chemistry , Textile Industry , Wastewater/chemistry , Water Pollutants, Chemical/analysis
9.
Biol Bull ; 223(3): 278-90, 2012 Dec.
Article in English | MEDLINE | ID: mdl-23264474

ABSTRACT

Resource-monopolization theory predicts the adoption of a solitary habit in species using scarce, discrete, and small refuges. Life-history theory suggests that temporarily stable parental dwellings favor extended parental care in species that brood embryos. We tested these two predictions with the symbiotic crab Tunicotheres moseri. This species exhibits abbreviated development and inhabits the atrial chamber of the scarce, structurally simple, long-lived, and relatively small ascidian Phalusia nigra in the Caribbean. These host characteristics should favor a solitary habit and extended parental care (EPC) in T. moseri. As predicted, males and females of T. moseri inhabited ascidians solitarily with greater frequency than expected by chance alone. The male-female association pattern and reverse sexual dimorphism (males < females) additionally suggests a promiscuous "pure-search" mating system in T. moseri. Also in agreement with theoretical considerations, T. moseri displays EPC; in addition to embryos, females naturally retain larval stages, megalopae, and juveniles within their brooding pouches. This is the first record of EPC in a symbiotic crab and the second confirmed record of EPC in a marine brachyuran crab. This study supports predictions central to resource-monopolization and life-history theories.


Subject(s)
Brachyura/physiology , Symbiosis , Animals , Caribbean Region , Female , Male , Sexual Behavior, Animal , Urochordata/parasitology , Urochordata/physiology
10.
Nanoscale ; 4(1): 298-302, 2012 Jan 07.
Article in English | MEDLINE | ID: mdl-22071562

ABSTRACT

A new approach to deep tissue imaging is presented based on 8 nm CdTe semiconductor quantum dots (QDs). The characteristic 800 nm emission was found to be efficiently excited via two-photon absorption of 900 nm photons. The fact that both excitation and emission wavelengths lie within the "biological window" allows for high resolution fluorescence imaging at depths close to 2 mm. These penetration depths have been used to obtain the first deep tissue multiphoton excited fluorescence image based on CdTe-QDs. Due to the large thermal sensitivity of CdTe-QDs, one may envisage, in the near future, their use in high resolution deep-tissue thermal imaging.


Subject(s)
Cadmium Compounds/chemistry , Fluorescent Dyes/chemistry , Quantum Dots , Tellurium/chemistry , HeLa Cells , Humans , Particle Size , Photons , Spectroscopy, Near-Infrared
11.
Enferm Intensiva ; 22(2): 74-7, 2011.
Article in Spanish | MEDLINE | ID: mdl-21256064

ABSTRACT

The basics caused by the transportation of a patient in serious condition within the same hospital are varied, all of them involving a risk to the patient's stability and a responsibility for the accompanying professionals. The care that supposes the appropriate attention to the patient and the need for coordination among the parties make it necessary to homogenize the transfer criteria and those of the necessary previous maneuvers. This work has been carried out based on the lack of an intervention system that guides this practice. This work describes the possible intrahospital itineraries, the transport of this kind of patient, the phases of this type of transport as well as the most frequent physiologic alterations. The purpose of all this is to develop an action algorithm for the serious patient's intrahospital transportation and to reduce the incidence of adverse events during this transfer. A classification system that makes it possible to calculate the level of risk and to anticipate the care needs that a patient may require during the transfer is presented.


Subject(s)
Transportation of Patients/methods , Transportation of Patients/standards , Humans , Practice Guidelines as Topic
12.
J Hazard Mater ; 160(1): 20-8, 2008 Dec 15.
Article in English | MEDLINE | ID: mdl-18403112

ABSTRACT

Phenolic compounds are abundant in nature and organic wastes. This biomass may be utilised in biogas generation. Phenolics can inhibit the degradation of readily biodegradable organic fractions and their own biodegradation. In this work, assays were carried out under anaerobic conditions to study the inhibition of both gas production and biodegradability due to seven phenolic compounds and to study their adsorption onto sludge and autoxidation in the aqueous medium. Fifty percent inhibition was in the range of 120 to 594 mg of compound/g VSS. An initial enhancement followed by an inhibition of biogas formation was found. The inhibition by the phenolic compounds was found to be influenced by autoxidation, apolarity, type, size and number of substitutions. Biogas production is influenced by concentration rather than any pH change. The concentration of the phenolic compound was partially biomethanized and the degradation of gallic and caffeic acids by this process is reported here for the first time. The maximum total biodegradation of any phenolic compound was 63.85+/-2.73%, and remaining non-biodegradable fraction was autoxidized and adsorbed onto the sludge matrix. Inhibition of methanization and partial inhibition of background gas was found at concentrations between 800 and 1600 mg/L organic carbon.


Subject(s)
Air Pollution/prevention & control , Biodegradation, Environmental , Phenols/chemistry , Sewage/analysis , Adsorption , Anaerobiosis , Biomass , Carbon Dioxide/chemistry , Carbonates/chemistry , Dose-Response Relationship, Drug , Fermentation , Gases/chemistry , Gases/toxicity , Methane/chemistry , Phenols/toxicity
13.
Pharmacogenomics J ; 7(3): 180-9, 2007 Jun.
Article in English | MEDLINE | ID: mdl-16969363

ABSTRACT

The objective of pharmacogenetic research is to identify a genetic marker, or a set of genetic markers, that can predict how a given person will respond to a given medicine. To search for such marker combinations that are predictive of adverse drug events, we have developed and applied two complementary methods to a pharmacogenetic study of the hypersensitivity reaction (HSR) associated with treatment with abacavir, a medicine that is used to treat HIV-infected patients. Our results show that both of these methods can be used to uncover potentially useful predictive marker combinations. The pairwise marker combination method yielded a collection of marker pairs that featured a spectrum of sensitivities and specificities. Recursive partitioning results led to the genetic delineation of multiple risk categories, including those with extremely high and extremely low risk of HSR. These methods can be readily applied in pharmacogenetic candidate gene studies as well as in genome-wide scans.


Subject(s)
Genetic Markers , Pharmacogenetics , Adult , Case-Control Studies , Female , Genome, Human , HLA-B Antigens/genetics , Humans , Male , Retrospective Studies , Sensitivity and Specificity
14.
Anaerobe ; 12(5-6): 254-9, 2006.
Article in English | MEDLINE | ID: mdl-17074517

ABSTRACT

The measurement of biomass concentration is important in biological wastewater treatment. This paper compares the accuracy and costs of the traditional volatile suspended solids (VSS) and the proposed suspended organic carbon (SOC) methods. VSS and SOC values of a dilution system were very well correlated (R(2)=0.9995). VSS and SOC of 16 samples were determined, the mean SOC/VSS ratio (0.52, n=16, sigma=0.01) was close to the theoretical value (0.53). For costing analysis, two hypothetical cases were analysed. In case A, it is assumed that 108 samples are analysed annually from two continuous reactors. Case B represents a batch experiment to be carried out in 24 incubated serum bottles. The savings, when using the SOC method, were 11,987 pounds for case A and 90 pounds for case B. This study suggests the use of SOC method as a time saving and lower cost biomass concentration measurement.


Subject(s)
Biomass , Carbon/metabolism , Waste Disposal, Fluid/economics , Water Purification/economics , Biodegradation, Environmental , Cost-Benefit Analysis/methods , Volatilization
15.
Rev Neurol ; 36(2): 133-6, 2003.
Article in Spanish | MEDLINE | ID: mdl-12589600

ABSTRACT

INTRODUCTION: We describe a patient diagnosed as suffering from a skull base osteochondroma which affected the atlantooccipital joint and originated in the occipital condyle. It also displayed a growth toward the foramen magnum, which was resected using an extreme lateral transcondylar approach. CASE REPORT: Patient aged 35, with a one year history of vertiginous seizures and unsteady gait, associated with cervical pain that irradiated to the right upper extremity, dysphagia, changes in the tone of the voice and distal numbness of the four extremities. The patient was made to lie in the three quarter prone position and an incision was made in the skin from the C3 spinous apophysis to a point 2 cm below the end of the mastoid process, in relation with the transversal apophysis of C1. The intervention continued with early identification and rotation of the vertebral artery; total resection of the tumour (osteochondroma) with its base in the right occipital condyle and growth toward the foramen magnum, in which the greater resection of the posteromedial third of the condyle is included. CONCLUSIONS: The location of osteochondromas can vary widely, and the condyle is one of the least frequent places inside the occipital bone. The approach employed provides excellent access to the region, in particular to the atlantooccipital joint. The width and angle of exposition are increased as compared with the traditional suboccipital approach, which facilitates the radical resection of the lesion with no neural retraction and without any surgical complications.


Subject(s)
Atlanto-Occipital Joint , Neurosurgical Procedures , Osteochondroma , Skull Base Neoplasms , Adult , Atlanto-Occipital Joint/pathology , Atlanto-Occipital Joint/surgery , Foramen Magnum/surgery , Humans , Occipital Bone/pathology , Occipital Bone/surgery , Osteochondroma/diagnosis , Osteochondroma/pathology , Osteochondroma/surgery , Skull Base Neoplasms/diagnosis , Skull Base Neoplasms/pathology , Skull Base Neoplasms/surgery , Tomography, X-Ray Computed
17.
Am J Trop Med Hyg ; 62(1): 122-7, 2000 Jan.
Article in English | MEDLINE | ID: mdl-10761736

ABSTRACT

The geographic distribution of Plasmodium vivax circumsporozoite protein phenotypes from patient blood used to infect colonized Anopheles albimanus and An. pseudopunctipennis was investigated in southern Mexico. Parasite phenotype types were determined in blood samples by a polymerase chain reaction and oligoprobe hybridization or by immunofluorescent assay of sporozoites. The proportion of infected mosquitoes and the number of oocysts per mosquito confirmed previous in vitro observations indicating that An. albimanus is more susceptible to VK210 and that An. pseudopunctipennis is more susceptible to VK247. All patients living on the coast were infected with VK210 and most patients living above 170 meters above sea level had VK247. Both phenotypes infected patients from intermediate altitudes. These results concur with the distribution of the anophelines, indicating that An. albimanus is the main vector of the phenotype VK210, but that An. pseudopunctipennis transmits both phenotypes. These conditions have direct implications on parasite transmission rates and malaria epidemiology in Mexico.


Subject(s)
Anopheles/parasitology , Insect Vectors/parasitology , Malaria, Vivax/epidemiology , Plasmodium vivax/classification , Altitude , Animals , Antibodies, Monoclonal , Antibodies, Protozoan/analysis , Antimalarials/therapeutic use , Chloroquine/therapeutic use , DNA Primers/chemistry , DNA, Protozoan/chemistry , DNA, Protozoan/isolation & purification , Female , Fluoroimmunoassay , Humans , Malaria, Vivax/blood , Malaria, Vivax/parasitology , Male , Mexico/epidemiology , Nucleic Acid Hybridization , Phenotype , Plasmodium vivax/chemistry , Plasmodium vivax/genetics , Polymerase Chain Reaction , Prevalence , Primaquine/therapeutic use , Recurrence , Regression Analysis
18.
Rev Esp Cardiol ; 53(4): 483-9, 2000 Apr.
Article in Spanish | MEDLINE | ID: mdl-10758025

ABSTRACT

The median sternotomy is still the gold standard of cardiac surgery approaches. The main disadvantages of this cardiac access are osteomyelitis and mediastinitis which are infrequent but very serious; the aesthetic impact of a large and visible scar from the median lane and lastly respiratory failure consecutive to pain and sternal dehiscence. Other pathways have been developed in trying to reduce these complications and lessen the length of stay, pain and costs. From the many variants described up until now, the "J" ministernotomy seems to be the most accepted of these techniques. Although there are many published series describing these different cardiac approaches, the lack of prospective, randomized studies comparing conventional and minimally invasive surgery precludes the demonstration of the benefits of the new technique. In spite of this, we think the "J" ministernotomy undoubtedly has aesthetic advantages, smaller complications in patients with respiratory failure, easier repair in case of mediastinitis or osteomyelitis and fewer adhesions in surgical redos.


Subject(s)
Aortic Valve Insufficiency/surgery , Sternum/surgery , Cardiac Surgical Procedures/methods , Humans , Minimally Invasive Surgical Procedures/methods , Postoperative Complications/prevention & control
19.
J Med Entomol ; 37(3): 331-4, 2000 May.
Article in English | MEDLINE | ID: mdl-15535573

ABSTRACT

The susceptibility to two coindigenous Plasmodium vivax Grassi & Feletti phenotypes VK210 and VK247 of three colonized Anopheles albimanus Wiedemann strains (white-striped, green and brown) from southern Mexico was investigated. Mosquitoes of the three strains were simultaneously fed with P. vivax-infected patient blood and examined 1 wk later for the presence of oocysts. The circumsporozoite protein phenotype type (VK210 and VK247) was determined by immunoflorescence of salivary gland sporozoites using monoclonal antibodies. The proportions of specimens infected and the number of oocyst per mosquito indicated that all mosquito strains were more susceptible to the phenotype VK210 than to VK247, but the white-striped strain was more susceptible to both parasite phenotypes than the other two strains.


Subject(s)
Anopheles/parasitology , Plasmodium vivax/pathogenicity , Protozoan Proteins/analysis , Animals , Animals, Laboratory , Anopheles/genetics , Antigens, Protozoan/analysis , Antigens, Protozoan/genetics , Mexico , Phenotype , Protozoan Proteins/genetics
20.
Rev Esp Cardiol ; 52(11): 898-902, 1999 Nov.
Article in Spanish | MEDLINE | ID: mdl-10611804

ABSTRACT

OBJECTIVE: To evaluate our initial experience in the combination of two less invasive procedures for myocardial revascularization, coronary artery bypass grafting without cardiopulmonary bypass and immediate posterior angioplasty, on untreated lesions (hybrid revascularization) as an alternative treatment to conventional surgery in selected patients. MATERIAL AND METHODS: From october 1996 to September 1998, 19 patients received hybrid revascularization. The mean age was 64 (47-76). Two patients underwent urgent surgery. Two patients had left main coronary disease, and 9 three-vessel disease. In general, we considered this procedure for patients with high-risk factors for cardiopulmonary bypass and two or more vessel disease. The internal mammary artery was connected to the left anterior descending artery in all 19 patients. All patients were moved to the hemodynamic ward immediately after surgery in 7 cases and before 48 h in the rest, 24 angioplasties were performed. A mean of 2.6 vessels per patient were revascularized and revascularization was complete in 15 patients (79%). RESULTS: One patient had perioperative myocardial infarction. There was no hospital mortality. Length of stay in the intensive care unit was 44 h (IQR = 49) and global postoperative stay was 8 days (IQR = 3.5). In the postoperative angiographic study, before the angioplasty, 95% of mammary arteries (CI 95% 74-100%) and 100% of saphenous grafts (CI 95% 59-100%) were patent. CONCLUSIONS: Combined revascularization allows almost complete revascularization, avoiding complications of cardiopulmonary bypass and minimizing surgical aggression. At the same time, it secures the graft of internal mammary artery to left anterior descending artery.


Subject(s)
Angioplasty, Balloon, Coronary/methods , Internal Mammary-Coronary Artery Anastomosis/methods , Aged , Angioplasty, Balloon, Coronary/statistics & numerical data , Combined Modality Therapy , Coronary Disease/physiopathology , Coronary Disease/therapy , Hemodynamics , Humans , Internal Mammary-Coronary Artery Anastomosis/statistics & numerical data , Middle Aged , Minimally Invasive Surgical Procedures/methods , Minimally Invasive Surgical Procedures/statistics & numerical data , Risk Factors
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