Transmyocardial laser revascularization. Early clinical experience

OBJECTIVE: To analyze the initial clinical experience of transmyocardial laser revascularization (TMLR) in patients with severe diffuse coronary artery disease. METHODS: Between February, 1998 and February, 1999, 20 patients were submitted to TMLR at the Heart Institute (InCor), University of São Paulo Medical School, Brazil, isolated or in association with conventional coronary artery bypass graft (CABG). All patients had severe diffuse coronary artery disease, with angina functional class III/IV (Canadian Cardiovascular Society score) unresponsive to medical therapy. Fourteen patients were submitted to TMLR as the sole therapy, whereas 6 underwent concomitant CABG. Fifty per cent of the patients had either been previously submitted to a CABG or to a percutaneous transluminal coronary angioplasty (PTCA). Mean age was 60 years, ranging from 45 to 74 years. RESULTS: All patients had three-vessel disease, with normal or mildly impaired left ventricular global function. Follow-up ranged from 1 to 13 months (mean 6.6 months), with no postoperative short or long term mortality. There was significant symptom improvement after the procedure, with 85% of the patients free of angina, and the remaining 15 % of the patients showing improvement in functional class, as well as in exercise tolerance. CONCLUSION: This novel technique can be considered a low risk alternative for a highly selected group of patients not suitable for conventional revascularization procedures.

Trophic relationships between macroinvertebrates and fish in a pampean lowland stream (Argentina)

The diet and trophic relationships between the macroinvertebrates Phyllogomphoides joaquini Rodrigues Capítulo, 1992 and Coenagrionidae (Odonata), Chironomidae (Diptera), Diplodon delodontus (Lamarck, 1919) (Bivalvia: Hyriidae), and Pomacea canaliculata (Lamarck, 1822) (Gastropoda: Ampulariidae) and the fishes Pimelodella laticeps Eigenmann, 1917 (Heptapteridae) and Bryconamericus iheringii (Boulenger, 1887) (Characidae) in a temperate lowland lotic system in Argentina were assessed on the basis of gut contents and stable-isotope analyses. The feeding strategies were analyzed by the AMUNDSEN method. Relative food items contribution for the taxa studied indicated a generalist-type trophic strategy. In macroinvertebrates, in general, the values of stable isotope confirmed the result of the analysis of gut contents. With the fish, stable-isotope analysis demonstrated that both species are predators, although B. iheringii exhibited a more omnivorous behaviour. These feeding studies allowed us to determine the trophic relationships among taxa studied. Detritus and diatoms were a principal source of food for all the macroinvertebrates studied. In La Choza stream the particulate organic matter is a major no limited food resource, has a significant influence upon the community.

Estudos sôbre nematóides Filarídeos: genótipo de Dipetalonema Diesing, 1861; valor dos gêneros Acanthocheilonema Cobbold, 1870 e Breinlia Yorke & Maplestone, 1926

The author divides the article in thee parts. In the first part he studies the literature on the genotype of Dipetalonema DIESING, 1861 - D. caudispina (MOLIN, 1858), and gives a new generic diagnosis of the Diesing's genus, based upon its type species. In the second one he studies the literature on the validity of Acanthocheilonema COBBOLD, 1870, and, comparing both generic defvinition and type-species description of Acanthocheilonema dracunculoides COBBOLD, 1870 and Dipetalonema caudispina (MOLIN, 1858), concludes that Cobbold's genus Acanthocheilonema must be, definitely, considered as a synonym of Dipetalonema DIESING, 1861. In the third part a comparative study, based on the literature, is made between generic definitions and type-species descriptions of Breinlia trichosuri (BREINL, 1913) and Dipetalonema caudipina (MOLIN, 1858), and the author concludes that Breinlia must be considered as a valid genus, distinguished from Dipetalonema, principally, by the morphology fo the longer spicule.