Heterogeneity in the risk of Mycobacterium bovis infection in European badger (Meles meles) cubs.

The behaviour of certain infected individuals within socially structured populations can have a disproportionately large effect on the spatio-temporal distribution of infection. Endemic infection with Mycobacterium bovis in European badgers (Meles meles) in Great Britain and Ireland is an important source of bovine tuberculosis in cattle. Here we quantify the risk of infection in badger cubs in a high-density wild badger population, in relation to the infection status of resident adults. Over a 24-year period, we observed variation in the risk of cub infection, with those born into groups with resident infectious breeding females being over four times as likely to be detected excreting M. bovis than cubs from groups where there was no evidence of infection in adults. We discuss how our findings relate to the persistence of infection at both social group and population level, and the potential implications for disease control strategies.

Potential safety issues with blood flow restriction training.

The focal point of previous literature was establishing the efficacy of blood flow restriction training with respect to muscular strength, muscular hypertrophy, and muscular endurance. After mounting evidence supporting the efficacy of low-intensity blood flow restriction training, research has shifted to the overall safety of this training modality. The aim of this review was to summarize the research on the overall safety of blood flow restriction training, focusing on the cardiovascular system (central and peripheral), muscle damage, oxidative stress, and nerve conduction velocity responses compared with those observed with regular exercise. Although still sparse, the blood flow restriction training research thus far is promising with respect to safety outcomes. Individuals respond similarly to blood flow restriction training and to regular exercise; however, longer term studies are required to better understand the chronic effects of low-intensity blood flow restriction training and possible safety issues.

Using isolation-by-distance-based approaches to assess the barrier effect of linear landscape elements on badger (Meles meles) dispersal.

As the European badger (Meles meles) can be of conservation or management concern, it is important to have a good understanding of the species' dispersal ability. In particular, knowledge of landscape elements that affect dispersal can contribute to devising effective management strategies. However, the standard approach of using Bayesian clustering methods to correlate genetic discontinuities with landscape elements cannot easily be applied to this problem, as badger populations are often characterized by a strong confounding isolation-by-distance (IBD) pattern. We therefore developed a two-step method that compares the location of pairs of related badgers relative to a putative barrier and utilizes the expected spatial genetic structure characterized by IBD as a null model to test for the presence of a barrier. If a linear feature disrupts dispersal, the IBD pattern characterising pairs of individuals located on different sides of a putative barrier should differ significantly from the pattern obtained with pairs of individuals located on the same side. We used our new approach to assess the impact of rivers and roads of different sizes on badger dispersal in western England. We show that a large, wide river represented a barrier to badger dispersal and found evidence that a motorway may also restrict badger movement. Conversely, we did not find any evidence for small rivers and roads interfering with badger movement. One of the advantages of our approach is that potentially it can detect features that disrupt gene flow locally, without necessarily creating distinct identifiable genetic units.

Direct comparison of sensitivity encoding (SENSE) accelerated and conventional 3D contrast enhanced magnetic resonance angiography (CE-MRA) of renal arteries: effect of increasing spatial resolution.

PURPOSE: To assess the effect of attaining higher spatial resolution in contrast-enhanced magnetic resonance angiography (MRA) of renal arteries using parallel imaging, sensitivity encoding (SENSE), by comparing the SENSE contrast-enhanced (CE) MRA against a conventional CE-MRA protocol with identical scan times, injection protocol, and other acquisition parameters. MATERIALS AND METHODS: Numerical simulations and a direct comparison of SENSE-accelerated versus conventional acquisitions were performed. A total of 41 patients (18 male) were imaged using both protocols for a direct comparison. Both protocols used fluoroscopic triggering, centric encoding, breath-holding, equivalent injection protocol, and lasted approximately 30 seconds. RESULTS: Simulated point-spread functions were narrower for the SENSE protocol compared to the conventional protocol. In the patient study, although the SENSE protocol produced images with lower signal-to-noise ratio (SNR), image quality was better for all segments of the renal arteries. In addition, ringing of kidney parenchyma and renal artery blurring were significantly reduced in the SENSE protocol. Finally, reader confidence improved with the SENSE protocol. CONCLUSION: Despite a reduction in SNR, the higher-resolution SENSE CE-MRA provided improved image quality, reduced artifacts, and increased reader confidence compared to the conventional protocol.

A mechanistic approach to blood flow occlusion.

Low-Intensity occlusion training provides a unique beneficial training mode for promoting muscle hypertrophy. Training at intensities as low as 20% 1RM with moderate vascular occlusion results in muscle hypertrophy in as little as three weeks. The primary mechanisms by which occlusion training is thought to stimulate growth include, metabolic accumulation, which stimulates a subsequent increase in anabolic growth factors, fast-twitch fiber recruitment (FT), and increased protein synthesis through the mammalian target of rapamycin (mTOR) pathway. Heat shock proteins, Nitric oxide synthase-1 (NOS-1) and Myostatin have also been shown to be affected by an occlusion stimulus. In conclusion, low-intensity occlusion training appears to work through a variety of mechanisms. The research behind these mechanisms is incomplete thus far, and requires further examination, primarily to identify the actual metabolite responsible for the increase in GH with occlusion, and determine which mechanisms are associated to a greater degree with the hypertrophic/anti-catabolic changes seen with blood flow restriction.

Inhibition of matrix metalloproteinase-9 activity improves coronary outcome in an animal model of Kawasaki disease.

Kawasaki disease (KD) is the leading cause of acquired heart disease of children in North America. It is characterized by a massive immune activation and multi-system vasculitis, which evolves into a site-specific inflammatory response focused at the coronary arteries. Coronary artery (CA) inflammation leads to elastin breakdown, destruction of the vessel wall and aneurysm formation. We have demonstrated recently the pivotal role of tumour necrosis factor (TNF)-alpha-mediated matrix metalloproteinase (MMP)-9 activity in the pathogenesis of elastin breakdown in a murine model of KD, Lactobacillus casei cell wall extract-induced coronary arteritis. Using this model, we evaluated the in vitro effects of doxycycline, an antibiotic with MMP inhibitory function, in modulating key pathogenic stages of disease leading to CA damage. Doxycycline inhibits T cell activation and TNF-alpha production in peripheral immune cells, as assessed by thymidine incorporation and a TNF bioassay respectively. Additionally, doxycycline inhibits directly MMP-9 enzymatic activity derived from TNF-alpha-stimulated vascular smooth muscle cells as assayed by zymography. More importantly, in vivo treatment of Lactobacillus casei cell wall extract (LCWE)-injected mice with doxycycline reduces significantly the incidence of CA elastin breakdown and reduces loss of elastin. Therefore, doxycycline can mitigate TNF-alpha-induced MMP-9-mediated coronary elastin breakdown and improve coronary outcome. Agents with the ability to inhibit both inflammation and the downstream effects of inflammation, such as MMP-9 activity, offer a promising therapeutic strategy for the management of children with KD.

Malocclusions in the koala (Phascolarctos cinereus).

Malocclusions are a misalignment or incorrect positioning of the teeth when the upper and lower jaws close. These are poorly described in the koala and can result in irregular mastication which can have lifelong effects on body condition and oral health. A total of 370 koalas from two populations in Queensland (295) and one in South Australia (75) were examined for malocclusions. The prevalence of malocclusions in South Australian free-ranging koalas, captive Queensland koalas and Queensland free-ranging koalas was 39% (44), 30% (29) and 22% (29) respectively. Four types of malocclusion were identified based on severity of misalignment of the incisor/canine region, types 1, 2, 3 and 4. Maxillary overbite measurements of the molariform teeth were determined and these anisognathic values were then used to describe malocclusions within familial relationships in captive colonies. Captive koalas with a malocclusion had narrower mandibular width that ranged between 0.5 and 1% less than the normal measurements. The specific malocclusions reported in this study affected individuals by leading to tooth rotation, mobility and erosion with inefficient mastication of food and vegetation compaction. These changes increased the oral cavity pathology, by placing animals at risk of periodontal disease. There was evidence of familial links to malocclusion types in captive animals. Therefore captive breeding recommendations should consider known koala malocclusion traits to minimise their effect on future generations.

Predicting badger visits to farm yards and making predictions available to farmers.

The use of agricultural resources or environments by wildlife may result in opportunities for transmission of infections amongst wild animals, livestock and humans. Targeted use of biosecurity measures may therefore reduce disease risks, although this requires practical knowledge of where such measures would be most effective, and effective means of communicating risks so that stakeholders can make informed decisions about such investment. In parts of Europe, the European badger Meles meles may act as a wildlife reservoir for Mycobacterium bovis, the causative agent of bovine tuberculosis, and badger visits to farmyards may provide potential opportunities for transmission of M. bovis to cattle. Biosecurity measures are effective in reducing badger activity in farmyards, although it is unclear which farms should be targeted with such measures. We used cameras to monitor badger activity in 155 farmyards in south west England and Wales, and related variations in the presence and frequency of badger visits to farm characteristics. Badgers were recorded on camera in 40% of farmyards monitored. However, the frequency of visits was highly variable, with badgers recorded on >50% of nights in only 10% of farms. The presence of badgers in farmyards was positively associated with the density of badger setts, the number of feed stores and the number of cattle sheds, and negatively associated with the distance to the nearest active badger sett, the presence of a house/dwelling and the number of cattle housed on the farm. The frequency of visits was negatively associated with the distance to the nearest active badger sett and the number of cattle housed. Models predicted the presence/absence of badgers in farmyards with 73% accuracy (62% sensitivity, 81% specificity, using a cut off value of 0.265). Models could not distinguish between farms with low/high frequency of visits, although farms predicted as having badgers present typically had a higher frequency of visits than those that were not. We developed and present an interactive web based application: the Badger Farm Assessment Tool (BFAT), to allow users to enter the characteristics of a farm and generate a relative risk score describing the likelihood of badger visits.

Micro magnetic resonance angiography of the finger in systemic sclerosis.

OBJECTIVE: To characterize vascular lesions in SSc disease with high-resolution magnetic resonance angiography (Micro-MRA) of the finger. METHODS: Eight SSc subjects and eight age- and sex-matched healthy controls were recruited for this study. Among the SSc subjects, the mean +/- s.d. age was 54.5 +/- 4.9 yrs, and the mean +/- s.d. duration of disease was 8.3 +/- 8.4 yrs. The numbers of SSc subjects that had telangiectasia, calcinosis and impaired finger flexion were 3, 2 and 3, respectively. The 2D time-of-flight micro-MRA was performed on a 3T clinical MRI scanner using a custom-designed finger coil with an in-plane resolution of 0.16 x 0.21 mm(2) and slice thickness of 1.2 mm. The data for the proper palmar digital artery lumen area, the number of visible dorsal digital veins and a semi-quantitative vascular score, which evaluates the overall integrity of digital vessels, were independently evaluated by two experienced reviewers who were blinded to the status of the subject. RESULTS: Micro-MRA detected significant differences in the digital vasculature between SSc subjects and healthy volunteers. The SSc subjects had a significantly decreased digital artery lumen area (0.13 +/- 0.06 vs 0.53 +/- 0.26 mm(2), P < 0.001), a reduced number of digital veins (0.63 +/- 1.06 vs 3.13 +/- 0.99, P = 0.001) and a lowered overall vascular score (1.75 +/- 1.04 vs 3.5 +/- 0.53, P = 0.001). The study also found that both the digital artery lumen area (Pearson's; r = -0.72, P = 0.044) and vascular scores (Spearman's; rho = -0.75, P = 0.047) of the SSc subjects were inversely correlated with the duration of the disease. CONCLUSIONS: Micro-MRA can be used to identify and quantitatively characterize the vascular disease in SSc fingers. The parameters derived from micro-MRA could potentially be used as prospective biomarkers for clinical evaluation.

Elafin, a serine elastase inhibitor, attenuates post-cardiac transplant coronary arteriopathy and reduces myocardial necrosis in rabbits afer heterotopic cardiac transplantation.

We have related experimentally induced post-cardiac transplant coronary arteriopathy to increased elastolytic activity, IL-1beta, fibronectin-mediated inflammatory and smooth muscle cell (SMC) migration, and SMC proliferation. Since our in vitro studies show that a serine elastase releases SMC mitogens and facilitates IL-lbeta induction of fibronectin, we hypothesized that administration in vivo of the specific serine elastase inhibitor, elafin, would decrease the post-cardiac transplant coronary arteriopathy. Cholesterol-fed rabbits underwent a heterotopic cardiac transplant without immunosuppression and received elafin (1.79 mg/kg per d continuous infusion after a 9 mg bolus, n = 6) or vehicle (n = 6). 1 wk later, hearts were harvested for morphometric, immunohistochemical, and biochemical analyses. A > 70% decrease in the total number of coronary arteries with intimal thickening in elafin-treated compared to control donor hearts (P < 0.002) was associated with reduced vascular elastolytic activity judged by fewer breaks in the internal elastic lamina (P < 0.03), less accumulation of immunoreactive fibronectin (P < 0.02), and reduced cell proliferation quantified by proliferating cell nuclear antigen (P < 0.0001). Despite myocardial lymphocytic infiltration, wet weight of elafin-treated donor hearts was reduced by 50% compared to untreated controls (P < 0.002) and associated with relative preservation of myocyte integrity, instead of extensive myocardial necrosis (P < 0.004). This protective effect correlated with decreased myocardial elastolytic activity (P < 0.0001) and inflammatory cell proliferation (P < 0.0001) and with an elafin-inhibitable elastase in lymphocytes. Serine elastase activity thus appears an important therapeutic target for post-cardiac transplant coronary arteriopathy and myocardial necrosis induced by rejection.

How well do farmers know their badgers? Relating farmer knowledge to ecological survey data.

Knowledge of badger distribution is important for the management of bovine tuberculosis. At the farm level, typically the only information on badger activity available is from the farmers themselves. This study compares how well farmer perceptions of badger activity match data obtained from ecological surveys. Farmer estimates of numbers of badger setts (burrows) surrounding their farms were generally correlated with field survey results, but tended to be underestimates. Farmers correctly recorded 50 per cent of setts recorded in surveys, with larger setts and active setts more likely to be correctly recorded. Badger visits to farm buildings and yards were also monitored using surveillance cameras. The majority of farmers were aware of badger visits to their farm buildings, but in 22 per cent of cases farmers were not aware of badger visits. At the farm level, knowledge of badger activity will be useful in informing vets and animal health professionals of the potential risks of disease transmission, and hence directing management interventions. However, the tendency to underestimate activity, combined with a lack of detailed knowledge of sett locations, means that farmer estimates of badger activity should be interpreted with caution and in isolation may not be sufficient to inform management interventions.

Immunosuppressive therapy in the management of acute myocarditis in children: a clinical trial.

To assess whether steroid therapy influenced the clinical course of myocarditis in a pediatric population, findings in 13 consecutive infants and children (8 female, 5 male) with biopsy-proved myocarditis were reviewed. The mean age was 5.7 +/- 4.8 years (range 1.1 to 14.8). Congestive heart failure was present in all as were ST-T wave changes, cardiomegaly and pulmonary edema on chest roentgenogram. Echocardiography demonstrated pericardial effusion in five patients and mitral regurgitation in eight. Mean left ventricular ejection fraction was 34 +/- 12%. Prednisone was administered to all patients; one patient also received azathioprine. There was one death. All survivors showed clinical improvement with normalization of ECG changes, heart size and systolic function. No significant side effects occurred. Repeat myocardial biopsy in eight patients demonstrated improvement in all eight and elimination of the inflammatory infiltrate in six. Immunosuppressive therapy in this pediatric population appeared useful in improving the clinical course and cardiac function in acute myocarditis with no adverse side effects.

Cardiac manifestations in disorders of fat and carnitine metabolism in infancy.

The prognosis of patients with cardiomyopathy associated with hypocarnitinemia is uncertain. Cardiac hemodynamics, histologic findings and response to oral L-carnitine therapy were retrospectively evaluated in 11 children with cardiomyopathy associated with abnormal carnitine metabolism. Three had systemic carnitine deficiency, two familial hypocarnitinemia with neutropenia, three transient neonatal hypocarnitinemia and three a carnitine insufficiency syndrome. Six had a hypertrophic and five a dilated cardiomyopathy. Hypotonia was present in seven (64%). The cardiothoracic ratio was greater than 0.60 in eight (73%). The most frequent abnormality on the electrocardiogram was ST-T wave inversion in the left precordial leads with various degrees of left ventricular hypertrophy. Echocardiographically, two patients with hypertrophic cardiomyopathy had decreased left ventricular function and two patients with dilated cardiomyopathy had increased thickness of the left ventricular wall. Histologic evaluation (two autopsies and one endomyocardial biopsy) revealed striking lipid accumulation within hypertrophied myocytes. Six of eight patients on carnitine replacement therapy had improvement echocardiographically during a 3 month to 2 year follow-up period. In summary, both hypertrophic and dilated cardiomyopathy can result from abnormal carnitine metabolism. The determination of plasma carnitine concentrations and fatty acid metabolism by-products should be performed in all patients with either form of cardiomyopathy of unknown etiology because carnitine supplementation may lead to improvement.

Temperature changes in dental pulp associated with use of power grinding equipment on equine teeth.

OBJECTIVE: To quantify the temperature changes in the dental pulp associated with equine dental procedures using power grinding equipment. DESIGN: A matrix experimental design with replication on the same sample was followed to allow the following independent variables to be assessed: horse age (young or old), tooth type (premolar or molar), powered grinding instrument (rotating disc or die grinder), grinding time (15 or 20 seconds) and the presence or absence of water coolant. PROCEDURE: Sound premolar and molar teeth from a 6-year-old horse and a 15-year-old horse, which had been removed postmortem, were sectioned parallel to the occlusal plane to allow placement of a miniature thermocouple at the level of the dental pulp. The maximum temperature increase, the time taken to reach this maximum and the cooling time were measured (n=10 in each study). The teeth were placed in a vice and the instrument used on the tooth as per clinical situation. RESULTS: Significant differences were recorded for horse age (P < 0.001), instrument type (P < 0.001), grinding time (P < 0.001) and presence or absence of coolant (P < 0.001). There was no significant difference for tooth type. CONCLUSION: Thermal insult to the dental pulp from the use of power instruments poses a significant risk to the tooth. This risk can be reduced or eliminated by appropriate selection of treatment time and by the use of water irrigation as a coolant. The increased dentine thickness in older horses appears to mitigate against thermal injury from frictional heat.

Continuous measurement of left ventricular volume using a single dimensional transducer: a comparison of two techniques in open chested dogs.

A comparison has been made of the continuous measurement of left ventricular volume in open chested dogs by two simple dimensional transducer systems: a mercury-in-rubber strain gauge measuring epicardial arc length at the ventricular equator and a pair of electromagnetically coupled coils placed on opposite sides of the left ventricle to measure its diameter. The single dimensional measurements were converted to volume measurements after death by filling an intraventricular ballon with known volumes of liquid. The strain gauge proved clearly superior to the coupled coils because it was not possible in practice to position the coils precisely facing each other and they did not remain tangential to the epicardial surface throughout the cardiac cycle. A single epicardial strain gauge can provide sufficiently accurate measurements of left ventricular volume to warrant its use in physiological studies of cardiac function. Although considerable attention to detail is required this technique has the advantages of being inexpensive and producing a continuous record which is easily interpreted.

Reduction of experimental myocardial infarct size by oral administration of alpha tocopherol.

STUDY OBJECTIVE: The aim was to determine whether high dose dietary vitamin E could improve myocardial resistance to ischaemia and reperfusion. Vitamin E is an important physiological antioxidant which can be accumulated to high levels in the myocardium, without toxicity, by chronic dietary supplementation. DESIGN: Subjects were fed a standard laboratory feed and water ad libitum for 10 d, plus either d-alpha-tocopoheryl acetate 200 IU.kg-1.d-1 orally (vitamin E group), or no supplement (control group). The animals then underwent either 60 or 180 min of left anterior descending coronary artery ligation, followed by 6 h reperfusion. The area at risk was identified by colloidal carbon, and necrosis by triphenyl tetrazolium chloride and light microscopy. SUBJECTS: Studies were performed on New Zealand white rabbits weighing approximately 3.5 kg. MEASUREMENTS AND MAIN RESULTS: In the 60 min ligation study, the control group had 30.5 (SD 4.0)% necrosis of the area at risk but the vitamin E group had no necrosis (n = 5 per group, p less than or equal to 0.0001). In the 180 min ligation study, the control group had 74.1 (11.5)% necrosis of the area at risk whereas the vitamin E group had 23.1 (7.2)% (n = 5 per group, p less than or equal to 0.0001). CONCLUSIONS: High dose dietary supplementation with vitamin E can improve myocardial tolerance to ischaemia and reperfusion, significantly reducing myocardial infarct size.

Comparison of ischaemic preconditioning in blood perfused and buffer perfused isolated heart models.

OBJECTIVE: The aim was to compare the effects of ischaemic preconditioning in the buffer perfused and parabiotic blood perfused Langendorff rabbit heart models. METHODS: Isolated hearts were perfused with either Krebs-Henseleit buffer solution or blood from a support rabbit. Hearts were subjected to an initial 30 min stabilisation period followed by 30 min of global ischaemia and 60 min of reperfusion. Ischaemic preconditioned (IP) hearts were also subjected to one cycle of 5 min global ischaemia and 10 min of reperfusion before the 30 min ischaemia. For each experiment, left ventricular function and necrosis were measured. RESULTS: Necrosis, as measured by tetrazolium staining and expressed as a percentage of the left ventricular area, was significantly different between the buffer perfused control [42.5% (SEM 6.9), n = 7] and buffer perfused IP group [22.2% (5.4), n = 7, p < 0.01]. In the blood perfused experiments, the IP group also had less necrosis [9.3% (3.1), n = 9] as compared to controls [22.9%(4.2), n = 9, p < 0.01]. The percentage reduction in necrosis produced by ischaemic preconditioning was not significantly different between the buffer perfused and blood perfused models. Peak left ventricular systolic pressure was not different between the control and IP hearts in either model at any time during the 60 min reperfusion period. In buffer perfused hearts, left ventricular end diastolic pressure at 60 min reperfusion was not significantly different between the IP and the control groups, at 34.3(5.5) mm Hg v 37.8(4.9) mm Hg, respectively. Similarly, there was no statistically significant difference in left ventricular end diastolic pressure in the blood perfused groups at this time: 13.3(2.8) in the IP group v 24.0(6.5) in controls. CONCLUSIONS: In isolated heart models of global ischaemia and reperfusion, in which both recovery of function and necrosis were assessed together, ischaemic preconditioning was highly effective in reducing necrosis in both blood perfused and buffer perfused models. However, ischaemic preconditioning did not significantly improve postischaemic recovery of function in either of the two preparations.

Conductance catheter measurements of left ventricular volume in the intact dog: parallel conductance is independent of left ventricular size.

OBJECTIVE: It has recently been suggested that conductance catheter parallel conductance (alpha Vc) is a function of left ventricular volume. To confirm this, alpha Vc was measured in this study over a wide range of steady state volumes. In addition, conductance derived volumes were compared to those obtained by radionuclide angiography to determine if the conductance catheter can be used to measure absolute left ventricular volume accurately in the intact dog heart. METHODS: Seven dogs were anaesthetised and instrumented with left ventricular conductance and pressure tip catheters, a flow through rho cuvette to continually measure blood resistance, a thermodilution catheter, and a venous catheter for volume infusion/withdrawal. Conductance and angiographic data were acquired at 8(SD 1) variably loaded states. Parallel conductance was measured twice at each state using a saline dilution technique and a new non-linear algorithm that allows variability in the observations of both maximum and minimum conductance volumes. RESULTS: The mean value of alpha Vc was 89.1(18.0) ml (71.8 to 111.3 ml) with a mean within-animal coefficient of variation of 7.3(3.4)%. Multiple linear regression using dummy variables to account for the large interanimal variability did not reveal any relationship between alpha Vc and either maximum or minimum left ventricular volume. Furthermore, no difference was found when alpha Vc values measured at the lowest and highest loading levels in each dog were compared. Linear regression showed good agreement between conductance and radionuclide derived end diastolic volumes (slope = 0.94, R = 0.9, p < 0.001). CONCLUSIONS: While alpha Vc varies between animals, it remains constant within any given animal over a broad range of left ventricular volumes. Thus the conductance catheter can provide reliable absolute left ventricular volume measurements under steady state conditions.

Exogenous substrate preference of the post-ischaemic myocardium.

Myocardial exogenous substrate preference was studied under conditions of increased plasma lactate concentration before and after a severe (halving of tissue ATP concentration, sixfold increase in tissue lactate concentration) but reversible (less than 1% necrosis on reperfusion) global ischaemic stress produced by continuous hypothermic electromechanical arrest of the heart of four hours' duration by aortic cross clamping and multidose potassium cardioplegia. Fatty acid oxidation was studied using 1-14C-palmitate under steady state conditions and under similar isovolumic fixed pressure conditions with the heart at a constant rate using a left ventricular intracavitary balloon. Exogenous free fatty acid oxidation during the pre-ischaemic period with an increased lactate concentration (3.9-5.8 mmol . litre-1) was 0.62(0.21) mumol . min-1 X 100 g-1 (mean (SEM)). This represented a mean of 32% of the total carbon dioxide produced in contrast to a post-ischaemia free fatty oxidation rate of 2.67(0.87) mumol . min-1 X 100 g-1, in the presence of even further increased plasma lactate concentrations (8.47-11.17 mmol . litre-1), representing a mean of 82% of the total carbon dioxide output. These data suggest that the substrate preference of the myocardium, under conditions of increased plasma lactate concentration, shifts to greater oxidation of exogenous free fatty acids after ischaemic stress.

A new technique of experimental heterotopic cardiac transplantation.

Heterotopic cardiac transplantation is a useful method for studying allograft rejection. In this study a new technique of cardiac transplantation was carried out, which involved retroperitoneal anastomoses of the donor ascending aorta and main pulmonary artery with the recipient abdominal aorta and inferior vena cava respectively. The procedure was simple and effective and was accomplished with minimal operative mortality and postoperative morbidity. The method allows better access to the allograft for repeated open myocardial biopsies, obviating the limitations of transvenous fluoroscopically directed endomyocardial biopsy. This technique of retroperitoneal heterotopic cardiac transplantation has important advantages compared with similar procedures performed in the neck, abdomen, or thorax.