Late Gadolinium Enhancement by Cardiac Magnetic Resonance Imaging and Major Adverse Coronary Events

Background: Coronary artery disease is the most common type of heart disease. CAD encompasses atherosclerosis and arteriosclerosis and is the leading cause of death in the United States in both men and women. This disease process involves the blood vessels responsible for supplying blood to the heart. Arteriosclerosis is described as a hardening of the vessels, while atherosclerosis is the obstruction of vessels due to genetics and dietary/lifestyle activities. In the long-term, these abnormalities can lead to myocardial infarction (MI), valvular heart disease, chest pain or angina, and heart failure. Standard practice of care currently involves the use electrocardiogram (ECG), computed tomography (CT), and echocardiogram in order to monitor cardiac function. A new emerging imaging study, cardiac magnetic resonance with late gadolinium enhancement, has shown to be a promising prognostic tool in evaluating patient’s risks for major adverse coronary events (MACE). CMR is a medical imaging technology for non-invasive assessment for the function and structure of the heart. Gadolinium is a contrast agent that can be injected during the CMR study that localizes in cardiac cicatrix tissue. If the imaging study has a positive result, it may lend evidence that cardiac function is below optimal and may put patient at risk for MACE in the future. Methods: An exhaustive search of available medical literature was performed using the following databases: MEDLINE-OVID, MEDLINE-Pubmed, and CINAHL-EBSCO Host. Articles were discovered using the following terms: MRI, Coronary heart disease, gadolinium, LGE, and cicatrix. Relevant articles were assessed for quality using GRADE. Results: Three studies met the inclusion criteria and were included in this systematic review. All three of these cohort studies demonstrated that the presence of scar tissue, identified by late gadolinium enhancement (LGE), had a positive predictive value of major adverse cardiac events (MACE) in patients with symptoms or signs suspicious of coronary artery disease (CAD). Studies demonstrated hazard ratios for MACE in LGE positive patients ranging from 4.69 to 11.48. Conclusion: The use of late gadolinium enhancement as an adjunct to cardiac magnetic resonance (CMR) testing has shown to be a valuable asset in predicting major adverse coronary events such as myocardial infarction and cardiac death. These events were followed for an accumulative median of 19 months, spanning from 6 months to 4.7 years. From the high-quality evidence gathered, LGE was a strong predictor of MACE and may have an invaluable future in stratifying risk among patient populations with clinical CAD. Keywords: MRI, coronary heart disease, gadolinium, and cicatrix

CAG expansion affects the expression of mutant huntingtin in the Huntington's disease brain

AbstractA trinucleotide repeat (CAG) expansion in the huntingtin gene causes Huntington's disease (HD). In brain tissue from HD heterozygotes with adult onset and more clinically severe juvenile onset, where the largest expansions occur, a mutant protein of equivalent intensity to wild-type huntingtin was detected in cortical synaptosomes, indicating that a mutant species is synthesized and transported with the normal protein to nerve endings. The increased size of mutant huntingtin relative to the wild type was highly correlated with CAG repeat expansion, thereby linking an altered electrophoretic mobility of the mutant protein to its abnormal function. Mutant huntingtin appeared in gray and white matter with no difference in expression in affected regions. The mutant protein was broader than the wild type and in 6 of 11 juvenile cases resolved as a complex of bands, consistent with evidence at the DNA level for somatic mosaicism. Thus, HD pathogenesis results from a gain of function by an aberrant protein that is widely expressed in brain and is harmful only to some neurons

The hydrophobic patch of ubiquitin is required to protect transactivator–promoter complexes from destabilization by the proteasomal ATPases

Mono-ubiquitylation of a transactivator is known to promote transcriptional activation of certain transactivator proteins. For the Sacchromyces cerevisiae transactivator, GAL4, attachment of mono-ubiquitin prevents destabilization of the DNA–transactivator complex by the ATPases of the 26S proteasome. This inhibition of destabilization depends on the arrangement of ubiquitin; a chain of ubiquitin tetramers linked through lysine 48 did not display the same protective effect as mono-ubiquitin. This led to an investigation into the properties of ubiquitin that may be responsible for this difference in activity between the different forms. We demonstrate the ubiquitin tetramers linked through lysine 63 do protect from proteasomal-mediated destabilization. In addition, we show that the mutating the isoleucine residue at position 44 interferes with proteasomal interaction in vitro and will abolish the protective activity in vivo. Together, these data implicate the hydrophobic patch of ubiquitin as required to protect transactivators from destabilization by the proteasomal ATPases

Recepte von Dr. Chase, oder, Belehrung für jedermann : eine sehr werthvolle Sammlung von ungefähr 800 praktischen Recepten für Kaufleute, Specereihändler, Salonhalter, Aerzte, Apotheker, Gerber, Schuhmacher, Sattler, Anstreicher, Goldarbeiter, Grobschmiede, Flaschner, Büchsenmacher, Thierärzte, Barbier, Bäcker, Färber, Renovirer, Farmer und Familien im Allgmeinen, ebenso enthaltend : eine gründliche Behandlung von Brustsellentzündung, Lungenentzündung ec., sowie der Krankheiten des weiblichen Geschlechts /

Includes index.Format and illustrations similar to English editions.Mode of access: Internet.Black cloth binding; gilt spine title.ACQ: 35669; Janice B. Longone; Gift; 6/21/2001