Frequency of Leishmania spp. infection among HIV-infected patients living in an urban area in Brazil: a cross-sectional study.

BACKGROUND: There is little information about the frequency of Leishmania infection in asymptomatic people living with HIV (PLWH) and about the performance of laboratory diagnostic methods in coinfected patients in Latin America. The main objective of this study is to evaluate the frequency of Leishmania spp. infection in HIV-infected patients living in an urban area in Brazil. METHODS: To detect Leishmania infection, diagnostic tests were performed to detect anti-Leishmania antibodies (ELISA using Leptomonas seymouri antigens; ELISA using rK39 antigens; ELISA using rK28 antigens; indirect fluorescent-antibody test (IFAT); direct agglutination test (DAT)) and Leishmania DNA (polymerase chain reaction (PCR) with the target genes kDNA and ITS-1). RESULTS: The frequency of at least one positive test was 15%. For ELISA using Leptomonas antigens and IFAT, there was an association between CD4+ T lymphocyte counts and test positivity, with a higher positivity of these tests in more immunosuppressed patients (CD4+ T cell count < 200/mm3). CONCLUSIONS: According to our data, there was a high prevalence of Leishmania spp. infections in this population living with HIV. Although there is the possibility of cross-reaction, some tests that are considered highly specific for the diagnosis of Leishmania infection were positive. There was also an association between the positivity of some tests studied and lower values of CD4+ T lymphocytes.

Hypoxia acclimation and subsequent reoxygenation partially prevent Mn-induced damage in silver catfish.

This study investigated if hypoxia acclimation modifies the hematological and oxidative profiles in tissues of Mn-exposed silver catfish (Rhamdia quelen), and if such modifications persist upon subsequent reoxygenation. Silver catfish acclimated to hypoxia (~3mgL-1) for 10days and subsequently exposed to Mn (~8.1mgL-1) for additional 10days exhibited lower Mn accumulation in plasma, liver and kidney, even after reoxygenation, as compared to normoxia-acclimated fish. Hypoxia acclimation increased per se red blood cells count and hematocrit, suggesting adaptations under hypoxia, while the reoxygenation process was also related to increased hematocrit and hemoglobin per se. Fish exposed to Mn under normoxia for 20days showed decreased red blood cells count and hematocrit, while reoxygenation subsequent to hypoxia increased red blood cells count. Hypoxia acclimation also prevented Mn-induced oxidative damage, observed by increased reactive species generation and higher protein carbonyl levels in both liver and kidney under normoxia. Mn-exposed fish under hypoxia and after reoxygenation showed decreased plasma transaminases in relation to the normoxia group. Moreover, acclimation to hypoxia increased reduced glutathione levels, catalase activity and Na+/K+-ATPase activity in liver and kidney during Mn exposure, remaining increased even after reoxygenation. These findings show that previous acclimation to hypoxia generates physiological adjustments, which drive coordinated responses that ameliorate the antioxidant status even after reoxygenation. Such responses represent a physiological regulation of this teleost fish against oxygen restriction and/or Mn toxicity in order to preserve the stability of a particular tissue or system.

Protective effects of the exopolysaccharide Lasiodiplodan against DNA damage and inflammation induced by doxorubicin in rats: Cytogenetic and gene expression assays.

The lasiodiplodan (LS) is a ß-(1→6)-d-glucan produced by the fungus Lasiodiplodia theobromae and some of the biological activities of LS were reported as hypoglycemic, anticoagulant, anti-proliferative and anticancer action; however, its effects on DNA instability and modulation of gene expression are still unclear. Aims of study were investigate the genotoxic effects of lasiodiplodan, and its protective activity against DNA damage induced by doxorubicin (DXR) and its impact on the expression of genes associated with DNA damage and inflammatory response pathways. Therefore, Wistar rats were treated (15 days) orally with LS (5.0; 10 and 20mg/kg bw) alone and in combination with DXR (15mg/kg bw; administrated intraperitoneally on 14th day) as well as their respective controls: distilled water and DXR. Monitoring of DNA damage was assessed by comet and micronucleus (MN) assays and gene expression was evaluated by PCR-Arrays. Treatments with LS alone did not induce disturbances on DNA; when LS was given in combination with DXR, comet and MN formations were reduced to those found in the respective controls. Moreover, LS was able to reduce the disturbances on gene expressions induced by DXR treatment, since the animals that receive LS associated with DXR showed no alteration in the expression of genes related to DNA damage response. Also, DXR induced several up- and down-regulation of several genes associated to inflammatory process, while the animals that received LS+DXR had their gene expression patterns similar to those found in the control group. In conclusion, our results showed that LS did not induce disturbances on DNA stability and significantly reduce the DNA damage and inflammation caused by DXR exposure. In addition, we give further information concerning the molecular mechanisms associated to LS protective effects which seems to be a promising nutraceutical with chemopreventive potential.

Driven flow with exclusion and transport in graphenelike structures.

We study driven flow with exclusion in graphenelike structures. The totally asymmetric simple exclusion process (TASEP), a well-known model in its strictly one-dimensional (chain) version, is generalized to cylinder (nanotube) and ribbon (nanoribbon) geometries. A mean-field theoretical description is given for very narrow ribbons ("necklaces") and nanotubes. For specific configurations of bond transmissivity rates, and for a variety of boundary conditions, theory predicts equivalent steady-state behavior between (sublattices on) these structures and chains. This is verified by numerical simulations, to excellent accuracy, by evaluating steady-state currents. We also numerically treat ribbons of general width. We examine the adequacy of this model to the description of electronic transport in carbon nanotubes and nanoribbons or specifically designed quantum-dot arrays.

Oxidative stress parameters in silver catfish (Rhamdia quelen) juveniles infected with Ichthyophthirius multifiliis and maintained at different levels of water pH.

The aim of this study was to determine oxidative stress parameters in the liver, gill and muscle of silver catfish juveniles infected with Ichthyophthirius multifiliis and maintained at pH 5.0 or 7.0 for three days. Juveniles were infected by adding one I. multifiliis-infected juvenile and water containing theronts to tanks. After the appearance of white spots on the skin, infected juveniles exposed to pH 5.0 and 7.0 showed significantly higher thiobarbituric acid reactive substances (TBARS) levels in the liver and gills compared to uninfected juveniles. Liver of infected juveniles exposed to pH 7.0 showed higher catalase (CAT) and lower glutathione-S-transferase (GST) activities, but those maintained at pH 5.0 showed significantly higher GST activity than uninfected juveniles. The gills of infected juveniles showed significantly higher CAT (day two) and GST activity at both pH 5.0 and 7.0 compared to uninfected juveniles. Muscle of infected juveniles showed significantly lower CAT and GST activity and TBARS levels (at day three) when maintained at both pH 5.0 and 7.0 compared to uninfected juveniles. In conclusion, I. multifiliis infection induces liver and gill damage via lipid peroxidation products in silver catfish, but higher antioxidant enzyme activity could indicate a greater degree of protection against this parasite.

Análise dos componentes da síndrome metabólica antes e após a suplementação dietética com farinha da casca do maracujá, em pacientes diabéticos / Analysis of components of metabolic syndrome before and after dietary supplementation with flour passion fruit peel in diabetic patients

A Síndrome Metabólica (SM) é caracterizada pela reunião de vários fatores de risco para doenças cardiovasculares (DCV): obesidade central (OC), hipertrigliceridemia, hipercolesterolemia e hipertensão arterial. Tendo conhecimento de que, além da terapia medicamentosa atual, o uso de fibras dietéticas tem demonstrado ser uma alternativa na redução dos fatores de riscos para as DCV. Este trabalho objetivou avaliar o efeito da farinha da casca do maracujá amarelo (Passiflora edulis f. flavicarpa Deg.) rica em fibra solúvel nos componentes da SM. Foi realizado ensaio clínico de fase II com 43 voluntários com idade entre 57 e 73 anos, de ambos os gêneros. Durante 60 dias, os participantes diariamente fizeram uso de 30 g do produto estudado e em todos eles foras determinados antes e após a suplementação com a farinha: glicose, hemoglobina glicada, frações lipídicas, além da antropometria e pressão arterial. Após a suplementação, existiu uma diferença significante (p,0,05) nos valores de OC, pressão arterial, glicose, hemoglobina glicada e triglicerídeos. Em relação ao colesterol total e LDL-c, não foram observadasa alterações estatisticamente significantes, enquanto o HDL-c apresentou aumento em suas concentrações de maneira significativa. Os resultados mostraram que a suplementação utilizada exerceu efeito positivo na maioria dos componentes da SM, sugerindo seu uso como terapia complementar dos tratamentos convencionais.

miRNApath: a database of miRNAs, target genes and metabolic pathways.

MicroRNAs (miRNAs) are small non-coding RNAs that regulate target gene expression and hence play important roles in metabolic pathways. Recent studies have evidenced the interrelation of miRNAs with cell proliferation, differentiation, development, and diseases. Since they are involved in gene regulation, they are intrinsically related to metabolic pathways. This leads to questions that are particularly interesting for investigating medical and laboratorial applications. We developed an miRNApath online database that uses miRNA target genes to link miRNAs to metabolic pathways. Currently, databases about miRNA target genes (DIANA miRGen), genomic maps (miRNAMap) and sequences (miRBase) do not provide such correlations. Additionally, miRNApath offers five search services and a download area. For each search, there is a specific type of input, which can be a list of target genes, miRNAs, or metabolic pathways, which results in different views, depending upon the input data, concerning relationships between the target genes, miRNAs and metabolic pathways. There are also internal links that lead to a deeper analysis and cross-links to other databases with more detailed information. miRNApath is being continually updated and is available at http://lgmb.fmrp.usp.br/mirnapath.

Repeated-batch xylitol bioproduction using yeast cells entrapped in polyvinyl alcohol-hydrogel.

Xylose-to-xylitol conversion was investigated in a bench-scale bioreactor using Candida guilliermondii cells entrapped within polyvinyl alcohol-hydrogel beads in a system operated in repeated-batch mode with cell recycling. Yeast-viable cells were immobilized in the support using the freezing-thawing method. Bioconversion assays were performed in a stirred tank reactor operated at 400-rpm agitation speed, 30 degrees C temperature, and 1.04-vvm air flow rate. The system was explored during six successive cycles, and a small decrease in the conversion performance in the fifth cycle was observed, but the biocatalytic activity of the microorganism was recovered in the sixth cycle after washing the particles. During the process, the hydrogel beads maintained their shape and size without appreciable deterioration. Xylitol production, yield factor, and volumetric productivity increased with progressive recycling of cells and achieved their maximum values (P(F) = 39.7 g l(-1); Y(P/S) = 0.77 g g(-1); Q(P) = 0.53 g l(-1) h(-1), respectively) after the third cell recycling, probably because of cells' adaptation to the medium.

Bacterial productivity distribution during a rainy year in an estuarine system.

Bacterial density and productivity were investigated along four salinity gradients within the estuary Ria de Aveiro. Bacterial variables and environmental parameters were measured at three to four stations spanning the entire salinity gradient of the four channels. The rather high variation in bacterial productivity (0.16-7.6 microg C L(-1) h(-1)) along the profiles of salinity indicates that bacterial activity shows a reactive behavior to environmental changing. Bacterial density (0.5-11.2 x 10(9) cells L(-1)) with a comparative smaller variation showed a more conservative behavior, mainly reflecting the phytoplankton distribution. Contrary to expectation, minimal values of bacterial productivity were not observed in November-December but in June. In fact, in November-December, the deep zone near the mouth showed the highest values of bacterial activity. At the upper stations, the highest values were observed in October. The relatively high values of bacterial production during the cold rainy season suggest that allochthonous substrates leached out from the surroundings by rain controlled the distribution of bacterial activity in the estuarine system. The substantial decrease in salinity during the rainy season negatively affected bacterial productivity, namely in the marine zone, where water column was highly stratified. Salinity seems to play an indirect role in the regulation of estuarine bacteria because there are different bacterial communities adapted to a wide salinity range.

miRNApath: a database of miRNAs, target genes and metabolic pathways

MicroRNAs (miRNAs) are small non-coding RNAs that regulate target gene expression and hence play important roles in metabolic pathways. Recent studies have evidenced the interrelation of miRNAs with cell proliferation, differentiation, development, and diseases. Since they are involved in gene regulation, they are intrinsically related to metabolic pathways. This leads to questions that are particularly interesting for investigating medical and laboratorial applications. We developed an miRNApath online database that uses miRNA target genes to link miRNAs to metabolic pathways. Currently, databases about miRNA target genes (DIANA miRGen), genomic maps (miRNAMap) and sequences (miRBase) do not provide such correlations. Additionally, miRNApath offers five search services and a download area. For each search, there is a specific type of input, which can be a list of target genes, miRNAs, or metabolic pathways, which results in different views, depending upon the input data, concerning relationships between the target genes, miRNAs and metabolic pathways. There are also internal links that lead to a deeper analysis and cross-links to other databases with more detailed information. miRNApath is being continually updated and is available at http://lgmb.fmrp.usp.br/mirnapath.

Activity and growth efficiency of heterotrophic bacteria in a salt marsh (Ria de Aveiro, Portugal).

Bacterial utilization of monomers is recognized as an important step in the biogeochemical cycling of organic matter. In this study we have compared the heterotrophic activity of bacterial communities from different micro-habitats within a salt marsh environment (Ria de Aveiro, Portugal) in order to establish spatial patterns of bacterial abundance, monomer turnover rates (Tr) and bacterial growth efficiency (BGE). Differences in bacterial abundance and activity could be found between distinct plant rhizospheres. BGE tended to be lower at Halimione portulacoides banks, when compared to Sarcocornia perennis subsp. perennis banks which, on the contrary, showed the highest bacterial densities. Experiments of amendment of natural samples with organic and inorganic supplements indicated that salt marsh bacteria are not strongly regulated by salinity but the increased availability of labile organic matter causes a significant metabolic shift towards mineralization.

Relationship of bacterioplankton production with primary production and respiration in a shallow estuarine system (Ria de Aveiro, NW Portugal).

The response of bacterial growth to phytoplankton production and planktonic respiration (RESP) variation was examined over different stations and dates in the shallow estuarine system Ria de Aveiro. The temporal and spatial profiles of bacterial productivity (2.7-744.2mg Cm(-3)d(-1)) did not coincide with those of primary production (PP) (0.2-19.1 g Cm(-3)d(-1)) and RESP (0.1-8.2 g Cm(-3) d(-1)). The bacterioplankton production/PP ratio varied differently, depending on the season and location. The heterotrophic zones, with the lowest values of PP, exhibited the most intense bacterial secondary production. Moreover, the variation of PP in the system was rather small when compared with that of bacterial secondary production. These suggest that, in a large extension of the lagoon and throughout the year, bacterioplankton growth is largely dependent on non-phytoplanktonic carbon sources. Benthic PP and/or allochtonous organic matter from land have a fundamental role in the dynamics of the planktonic compartment of the estuarine system.

Short-Term Responses of the Natural Planktonic Bacterial Community to the Changing Water Properties in an Estuarine Environment: Ectoenzymatic Activity, Glucose Incorporation, and BiomassProduction.

The possibility that two principal bacterial communities expressing different levels of heterotrophic activity might coexist in an estuarine ecosystem (Ria de Aveiro, Portugal) and could quickly respond to tidal fluctuations of environmental factors was experimentally tested in diffusion chambers by swapping the dissolved components of the natural water between the two communities and comparing their reactivity against the unaltered controls. The results for ectoenzymatic activity (Leu-aminopeptidase and b-glucosidase), glucose incorporation and biomass production after transference of the marine bacterial community to brackish water showed maxima in the range of 241-384% of the control values. The opposite transference of the brackish-water bacterial community to marine water produced maximal decreases to 0.14-0.58% of the control values. In a reverse experiment, designed as the return to the initial conditions after 2 hours of the first exposure, the marine community rapidly re-acquired the characteristic low profile of activity. Contrastingly, the negative effects of 2 hours of exposure to marine water on the activity of the brackish water bacteria persisted, at least for 4 hours, after return to their own water. The apparent short-term irreversibility of the decline in activity of the brackish water bacteria when exposed to marine water, in parallel with the quick and reversible positive response of the marine water bacteria to the brackish water, suggests the development of two distinct bacterioplankton communities adapted to the environmental conditions prevailing at distinct sections of the estuary. The reactivity to environmental changes demonstrated by the two communities allows the prediction of estuarine profiles of bacterial activity steeper than those expected from the conservative transport of bacterial cells associated with tidal currents.

Loss of Estuarine Bacteria by Viral Infection and Predation in Microcosm Conditions.

The bacterioplankton density in Ria de Aveiro, a shallow estuarine ecosystem, varied in the broad range of 1.9-10.6 x 109 cells L-1. The range of values was about 2 times higher in brackish water than in marine water. At high tide bacterial abundance was 2-3 times lower than at low tide. The overall variation in virioplankton was in the range of 2.4-25.0 x 1010 particles L-1. Brackish water was about 2 times richer in viral particles than the marine water. Near low tide the virioplankton was 2-3 times higher that at high tide. Viral density followed the pattern of bacterial abundance (it explained 40% of virioplankton variation). The viruses to bacterium ratio varied, throughout tidal cycles, by a factor of about 10 establishing the range 4.7-55.6 (average 17.6). This ratio was rather similar in the two estuarine zones. We compared the effects of infection and predation on the control of bacterioplankton size in the two zones of the estuary. The approach to this question was conducted in experimental microcosms, set up in six combinations of plankton variables affecting the presence/absence of predators, virus-to-bacterium ratio (10-fold increase), virus-to-bacterium distance (2.2-fold increase), and bacterial growth rate. The results showed that predation was similar, in a percent basis, in marine (69%) and brackish water (73%). Viral infection was, however, higher in brackish water (59%) than in the marine water (36%). We conclude that the bacterioplankton along the salinity gradient evolves under biological pressures that are in different balance in the marine and brackish water zones. The effect of viral lysis on bacterial communities with enhanced growth (after yeast extract addition) was masked even when the initial ratio was 10-fold greater than in the natural samples. The high density of the virioplankton did not preclude the large and rapid increase in bacterial density. We suggest that the dynamics of the equilibrium between bacteria and viruses in the environment is driven to higher numerical levels during periods of intensive bacterial growth. On the contrary, at low bacterial growth rates the temporarily increased virus-to-bacterium ratio may drive the equilibrium to its lowest levels.

Factors Influencing Bacterial Production in a Shallow Estuarine System.

The bacterioplankton of the marine and brackish water zones of the complex system Ria de Aveiro was characterized as profiles of bacterial abundance and biomass productivity. During the warm season, total bacteria ranged from 0.2 to 8.5 x 109 cells L-1 and active bacteria number from 0.1 to 3.1 x 109 cells L-1. Total and active bacterial numbers were, on average, three times higher in brackish than in marine water. Bacterial productivity on different dates and different tides in the marine zone varied from 0.05 to 4.5 mg C L-1 h-1. Here the average productivity (1.1 mg C L-1 h-1) was 3.5 times less than in brackish water (average 3.8 mg C L-1 h-1; range 0.7-14.2 mg C L-1 h-1). Specific productivity varied from 0.05 to 2.61 fg C cell-1 h-1, a range that was similar throughout the ecosystem. However, specific productivity per active cell was 19% higher in brackish water. Bacterial production variation was best explained by the number of active bacteria, which, in turn, was highly associated with total bacterial number, temperature, and particulate organic carbon. In the marine zone, bacterial production was also influenced by depth and salinity. In the brackish zone, the set of independent variables explained a smaller percentage of bacterial production variation than in marine zone, suggesting greater importance of other variables. In the marine zone, and mainly near low tide, productivity was significantly higher (average 3.3 times) at the surface (down to 0.5 m) than in the deeper layers of the water column. This stratification of bacterial productivity was linked to the increased specific productivity per active cell, as no modification in the proportion of active cells in the population could be detected. The vertical profile of bacterial production in the deeper zone of this estuarine ecosystem, in which no clear salinity or thermal stratification occurs throughout the tidal cycle, seemed to reflect a biochemical stratification generated by increased phytoplankton exudation and/or by photochemical transformation of semilabile or recalcitrant organic compounds. Shallower water masses tend to blur this surface effect. The relative importance of photochemical transformation in the pattern of estuarine bacterial production will therefore tend to vary with the bathymetry of the system.

Potassium and sodium intake and excretion in calcium stone forming patients.

OBJECTIVE: To determine mean potassium (K) intake and its correlation with urinary calcium (uCa) and citrate excretion, as well as uCa, sodium (Na), and K levels of calcium stone forming patients. We determined the K-rich foods most commonly consumed by these patients. DESIGN: Case-control. SETTING: University-affiliated outpatient renal Lithiasis Unit. PATIENTS AND CONTROLS: One hundred hypercalciuric calcium stone forming patients (CSF, 54 men/46 women), 37 with associated hypocitraturia, were sequentially enrolled in the study that was performed before the initiation of any care for their renal stones. The control group consisted of 100 age-matched healthy subjects (HS, 47 men/53 women) who were laboratory employees with no history of renal stones. INTERVENTION: The analyses consisted of a 3-day dietary record to determine the mean K and calcium (Ca) intakes, and a 24-hour urine sample with measurements of K, Ca, Na, and citrate. MAIN OUTCOME MEASURE: K and Na intake determined by dietary record. RESULTS: uCa and Na levels and the Na/K ratio were significantly higher for CSF versus HS (238 +/- 118 v 148 +/- 74 mg/24 hours, 238 +/- 100 v 181 +/- 68 mEq/24 hours, 6.6 +/- 3.5 v 5.1 +/- 2.3, respectively, P < .05). The mean citrate excretion was lower in CSF than in HS patients (410 +/- 265 v 530 +/- 240 mg/24 hours). Mean uCa did not differ between groups. CSF patients showed a higher sodium chloride intake compared with HS (14 +/- 4 vs 8 +/- 3 g/day). The mean Ca intake of CSF and HS were 559 +/- 327 and 457 +/- 363 mg/day, respectively. The mean K intake of CSF and HS were 58 +/- 17 and 51 +/- 27 mEq/day. A positive correlation was observed between uCa and urinary sodium (r = .40 and r = .65, P < .05), urinary potassium and urinary citrate (r = .25 and r = .53, P < .05), uCa and Na/K (r = .33 and r = .56, P < .05) respectively for CSF and HS. The following were the K-rich foods consumed at least once a day by these groups: beans (by 70% of CSF and 75% of HS), tomatoes (by 42% of CSF and 50% of HS), oranges (by 30% of CSF and 55% of HS), and bananas (by 42% of CSF and 23% of HS). CONCLUSION: Despite the consumption of K-rich foods at least once a day, the mean K intake by CSF patients was 58 mEq/day. This intake can still be considered to be low, although it meets recommended daily dietary allowance requirements. Therefore, we describe herein a population of CSF with high-Na intake and normal- to low-K intake, which may contribute to stone formation.

Parasuicide and mental disorders.

This study aims to provide a better follow-up of parasuicidal subjects, focusing on their diagnostic profile with regard to whether the parasuicide intention was death or not. A total of 235 parasuicidal out-patients (PS) and a comparison group of 235 non-parasuicidal out-patients (CG) were surveyed. A structured interview was applied to both groups. Parasuicide intention was appraised by means of the Suicide Intent Scale of Beck. The PS patients were divided into two groups, depending on whether their intention was death (PSD) or not (OPS), and they were matched with their CG counterparts. The diagnostic profile of each group was analysed and differences in diagnosis distribution were found. The rates of major depression, alcohol dependence and schizophrenia were higher among PSD than in OPS patients. The same was true for comorbidity of major depression and alcohol dependence. On Axis II, borderline personality ranks first among PSD patients. The diagnostic profile of PSD approaches that of completed suicide as shown in retrospective and prospective studies. The methodology employed here could therefore be recommended for estimating parasuicide intention. As well as the diagnosis, a detailed profile could also be obtained in the light of that intention. Bearing in mind such a profile among PSD patients could contribute to a drop in the suicide rate among these subjects.

Successful reversal of pulmonary hypertension in Eisenmenger complex.

We present a case of a 19-year old female with systemic pulmonary artery (PA) pressure due to a congenital ventricular septal defect (VSD) and atrial septal defect (ASD). She was pink at rest and cyanotic on exercise. Lung biopsy revealed grade IV pulmonary vascular changes. As a preliminary step PA was banded to increase right-to-left shunt and decrease aortic (Ao) saturation with consequent decrease in PA saturation. After one year, when she was no longer cyanotic, even on exercise, lung biopsy revealed total regression of pulmonary vascular changes. As a definitive procedure VSD and ASD were closed and PA was debanded. Cardiac catheterization one week postoperatively showed PA pressure to be 50% of systemic pressure. We postulate that reversal of pulmonary vascular changes were due to lowered PA saturation. We further believe that lower PA pressure could have contributed to this regression of pulmonary vascular changes. We performed the same procedure in six more patients with similar positive clinical response. This new concept brings renewed hope to many children who otherwise are candidates for heart lung transplantation.

Partial left ventriculectomy to improve left ventricular function in end-stage heart disease.

We present a case of a 34-year-old male with dilated cardiomyopathy in whom we performed a new surgical procedure; i.e., ventricular volume reduction to improve function. This initial human experience was preceded by a series of ten sheep in which we demonstrated that by enlarging the left ventricle (LV), the ejection fraction was reduced, and by restoring normal diameter, the LV function returned to normal.