2009/11/28
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Researchers have identified the genes in gum-disease bacteria that allow them to invade and infect human arterial cells, offering one possible explanation for a perceived connection between gum disease and heart disease. Scientists from the University of Florida, Gainesville, present their findings today at the 106th General Meeting of the American Society for Microbiology in Orlando, Florida.
"Aside from lifestyle and genetic factors, there is increasing evidence that bacterial infections may play a role in heart disease. Porphyromas gingivalis, an important bacterium that causes gum disease, is also linked to cardiovascular disease. In this study we have identified and studied four genes of P. gingivalis that allow it to infect and survive inside artery cells," says Paulo Rodrigues, a researcher on the study.
Rodrigues and his colleagues had previously discovered that P. gingivalis had the ability to invade and survive inside human artery cells. In this study they examined the role four different genes play in this ability. They created four strains of the bacterium, each with a different gene mutated to disable it, and tested their ability to invade and survived in artery cells compared to a fully functioning strain of P. gingivalis.
"Our study showed that all four mutated strains were defective in invasion of the artery cells and that their ability to survive inside of the cells was diminished. These results show that these four genes play a role in the invasion and survival of P. gingivalis inside artery cells," says Rodrigues. "The knowledge of how this pathogenic bacterium interacts with artery cells is important and may lead to the development of therapeutics and diagnostic tools for the detection and possibly prevention of heart diseases caused by this association
"Aside from lifestyle and genetic factors, there is increasing evidence that bacterial infections may play a role in heart disease. Porphyromas gingivalis, an important bacterium that causes gum disease, is also linked to cardiovascular disease. In this study we have identified and studied four genes of P. gingivalis that allow it to infect and survive inside artery cells," says Paulo Rodrigues, a researcher on the study.
Rodrigues and his colleagues had previously discovered that P. gingivalis had the ability to invade and survive inside human artery cells. In this study they examined the role four different genes play in this ability. They created four strains of the bacterium, each with a different gene mutated to disable it, and tested their ability to invade and survived in artery cells compared to a fully functioning strain of P. gingivalis.
"Our study showed that all four mutated strains were defective in invasion of the artery cells and that their ability to survive inside of the cells was diminished. These results show that these four genes play a role in the invasion and survival of P. gingivalis inside artery cells," says Rodrigues. "The knowledge of how this pathogenic bacterium interacts with artery cells is important and may lead to the development of therapeutics and diagnostic tools for the detection and possibly prevention of heart diseases caused by this association
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Knockouts in Human Cells Point to Pathogenic Targets
researchers have developed a new type of genetic screen for human cells to pinpoint specific genes and proteins used by pathogens, according to their paper in Science.
In most human cell cultures genes are present in two copies: one inherited from the father and one from the mother. Gene inactivation by mutation is therefore inefficient because when one copy is inactivated, the second copy usually remains active and takes over.
In yeast, researchers have it easier: they use yeast cells in which all genes are present in only one copy (haploid yeast). Now Carette and co-workers have used a similar approach and used a human cell line, in which nearly all human chromosomes are present in a single copy.
In this rare cell line, Carette and co-workers generated mutations in almost all human genes and used this collection to screen for the host genes used by pathogens. By exposing those cells to influenza or to various bacterial toxins, the authors isolated mutants that were resistant to them. Carette then identified the mutated genes in the surviving cells, which code for a transporter molecule and an enzyme that the influenza virus hijacks to take over cells.
Working with Carla Guimaraes from Whitehead Member Hidde Ploegh's lab, Carette subjected knockout cells to several bacterial toxins to identify resistant cells and therefore the genes responsible.
The experiments identified a previously uncharacterized gene as essential for intoxication by diphtheria toxin and exotoxin A toxicity, and a cell surface protein needed for cytolethal distending toxin toxicity.
"We were surprised by the clarity of the results," says Jan Carette, a postdoctoral researcher in the Brummelkamp lab and first author on the Science article. "They allowed us to identify new genes and proteins involved in infectious processes that have been studied for decades, like diphtheria and the flu. In addition we found the first human genes essential for host-pathogen interactions where few details are known, as is the case for cytolethal distending toxin secreted by certain strains of E. coli. This could be important for rapidly responding to newly emerging pathogens or to study pathogen biology that has been difficult to study experimentally."
Brummelkamp sees the work as only the beginning.
"Having knockout cells for almost all human genes in our freezer opens up a wealth of biological questions that we can look at," he says. "In addition to many aspects of cell biology that can be studied, knockout screens could also be used to unravel molecular networks that are exploited by a battery of different viruses and bacteria."
This research was funded by Fundação para a Ciência ea Tecnologia (FCT) Portugal and the Kimmel Foundation.
Thijn Brummelkamp is a Fellow at Whitehead Institute for Biomedical Research, where his laboratory is located and all his research is conducted.
In most human cell cultures genes are present in two copies: one inherited from the father and one from the mother. Gene inactivation by mutation is therefore inefficient because when one copy is inactivated, the second copy usually remains active and takes over.
In yeast, researchers have it easier: they use yeast cells in which all genes are present in only one copy (haploid yeast). Now Carette and co-workers have used a similar approach and used a human cell line, in which nearly all human chromosomes are present in a single copy.
In this rare cell line, Carette and co-workers generated mutations in almost all human genes and used this collection to screen for the host genes used by pathogens. By exposing those cells to influenza or to various bacterial toxins, the authors isolated mutants that were resistant to them. Carette then identified the mutated genes in the surviving cells, which code for a transporter molecule and an enzyme that the influenza virus hijacks to take over cells.
Working with Carla Guimaraes from Whitehead Member Hidde Ploegh's lab, Carette subjected knockout cells to several bacterial toxins to identify resistant cells and therefore the genes responsible.
The experiments identified a previously uncharacterized gene as essential for intoxication by diphtheria toxin and exotoxin A toxicity, and a cell surface protein needed for cytolethal distending toxin toxicity.
"We were surprised by the clarity of the results," says Jan Carette, a postdoctoral researcher in the Brummelkamp lab and first author on the Science article. "They allowed us to identify new genes and proteins involved in infectious processes that have been studied for decades, like diphtheria and the flu. In addition we found the first human genes essential for host-pathogen interactions where few details are known, as is the case for cytolethal distending toxin secreted by certain strains of E. coli. This could be important for rapidly responding to newly emerging pathogens or to study pathogen biology that has been difficult to study experimentally."
Brummelkamp sees the work as only the beginning.
"Having knockout cells for almost all human genes in our freezer opens up a wealth of biological questions that we can look at," he says. "In addition to many aspects of cell biology that can be studied, knockout screens could also be used to unravel molecular networks that are exploited by a battery of different viruses and bacteria."
This research was funded by Fundação para a Ciência ea Tecnologia (FCT) Portugal and the Kimmel Foundation.
Thijn Brummelkamp is a Fellow at Whitehead Institute for Biomedical Research, where his laboratory is located and all his research is conducted.
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2009/09/14
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10:30 PM
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PLEASE VISIT FOR MORE INFORMATIO http://www.worldwidehealth.com/health-article-Heart-diseases-Affecting-Coronary-Arteries-and-Coronary-Veins.html
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2009/09/10
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One Vaccine Shot Seen as Protective for Swine Flu
Defying the expectations of experts, clinical trials are showing that the new H1N1 swine flu vaccine protects with only one dose instead of two, so the vaccine supplies now being made will go twice as far as had been predicted.
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Times Topics: Swine Flu (AH1N1 Virus)
That means it should be possible to vaccinate — well before the flu’s expected midwinter peak — all the 159 million people that the Centers for Disease Control and Prevention estimate are in the high-risk groups: pregnant women, people under 24 years old or caring for infants, people with high-risk medical conditions and health-care workers.
Barring production delays, the government hopes to have in hand 195 million doses by year’s end.
The first convincing trial results from a single 15-microgram dose in adults were published online Thursday afternoon by The New England Journal of Medicine. That trial was done in Australia, but the vaccine maker, CSL Limited, is under contract to supply millions of doses to the United States government, and the president of the company’s American subsidiary said he expected its trials here to have similar results.
The H1N1 swine flu pandemic has now reached 168 countries. It arrived in the United States late in the spring and infected more than one million people. It did not fade out as seasonal flu does, but persisted, especially in summer camps. Nearly 600 people had died by the end of August, according to the disease control agency.
Cases are now surging again, especially in the Southeast where many schools and universities reopen earlier than in the rest of the country.
Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said trials now under way under the sponsorship of the National Institutes of Health were showing that adults who got only a single dose were protected within 8 to 10 days, which he said “corroborates and confirms the exciting data” reported in the Australian study.
Robust protection produced so quickly in high-risk groups means lives will presumably be saved, Dr. Fauci said.
Costs will also be lowered by having a more efficient vaccine, he said, “but I can’t give you a dollar figure.”
Also, more vaccine could be available to poor countries that were largely left out of last spring’s global scramble to sign vaccine makers to contracts. Experts have worried that rich countries would be protected this winter while poor ones — where people are more likely to die because of drug shortages and substandard hospital care — would bear the brunt of the pandemic.
“This is definitely a big deal,” said Dr. John J. Treanor, a vaccine expert at the University of Rochester. “People had been planning for a scenario that would require two doses.”
“This will take the edge off the nail-biting,” Dr. Treanor added.
The results released Thursday were based on the first three weeks of a clinical trial. Healthy adults got one 15-microgram shot, and their blood was tested 21 days later. By that time, 97 percent of the 120 adults had enough antibodies to be considered protected. Another group that got 30-microgram doses had no greater protection.
There were no deaths or dangerous side-effects. Almost half of the participants reported sore arms or headaches, but that is normal with flu shots.
The American trials began about two weeks later, said Paul R. Perreault, president of CSL Biotherapies, the company’s American subsidiary. “My experience with this tells me they shouldn’t be any different,” Mr. Perreault said.
Dr. Fauci said he would discuss the details of the N.I.H. trials at a news conference on Friday afternoon.
Seasonal flu shots are available now, and Federal officials are urging Americans to get one. Little or no swine flu vaccine will be available before late October. There have been no clinical trials of giving both shots at the same time, and Federal health officials have issued no recommendations on that.
Experts had predicted for months that, because the H1N1 swine flu has never been seen before by human immune systems, it would take two doses, administered weeks apart, to get a “take” — antibody levels as high as those produced by regular flu shots.
The authors of the Australian study said the robust response implied that there was some previously unsuspected crossover protection from having had previous strains of H1N1 seasonal flus or from the H1N1 components of seasonal flu shots.
In mid-August, a Chinese vaccine maker, Sinovac Biotech, also reported that one shot of its vaccine gave protection against the flu. But because it released no data about the size of the dose or the composition of its vaccine, it was impossible for American experts to evaluate the claim.
Also, none of the 10 Chinese companies producing swine flu vaccine have licenses to sell in the United States, as CSL does, so their vaccines would have virtually no impact on the spread of the disease here.
Although the Australian trial was in healthy adults only, Dr. Treanor said he believed one dose of the new vaccine would prove effective in everyone from age 9 and up.
Pediatricians usually give two shots to children ages 6 months to 9 years who have never had a flu shot; the first primes the immune system and subsequent shots act as boosters that create new surges of antibodies, though slightly varied each year as strains mutate.
Infants under 6 months old are not normally given flu shots. Pregnant women are, and babies can inherit some temporary immunity from their mothers
Defying the expectations of experts, clinical trials are showing that the new H1N1 swine flu vaccine protects with only one dose instead of two, so the vaccine supplies now being made will go twice as far as had been predicted.
Skip to next paragraph
Related
Times Topics: Swine Flu (AH1N1 Virus)
That means it should be possible to vaccinate — well before the flu’s expected midwinter peak — all the 159 million people that the Centers for Disease Control and Prevention estimate are in the high-risk groups: pregnant women, people under 24 years old or caring for infants, people with high-risk medical conditions and health-care workers.
Barring production delays, the government hopes to have in hand 195 million doses by year’s end.
The first convincing trial results from a single 15-microgram dose in adults were published online Thursday afternoon by The New England Journal of Medicine. That trial was done in Australia, but the vaccine maker, CSL Limited, is under contract to supply millions of doses to the United States government, and the president of the company’s American subsidiary said he expected its trials here to have similar results.
The H1N1 swine flu pandemic has now reached 168 countries. It arrived in the United States late in the spring and infected more than one million people. It did not fade out as seasonal flu does, but persisted, especially in summer camps. Nearly 600 people had died by the end of August, according to the disease control agency.
Cases are now surging again, especially in the Southeast where many schools and universities reopen earlier than in the rest of the country.
Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said trials now under way under the sponsorship of the National Institutes of Health were showing that adults who got only a single dose were protected within 8 to 10 days, which he said “corroborates and confirms the exciting data” reported in the Australian study.
Robust protection produced so quickly in high-risk groups means lives will presumably be saved, Dr. Fauci said.
Costs will also be lowered by having a more efficient vaccine, he said, “but I can’t give you a dollar figure.”
Also, more vaccine could be available to poor countries that were largely left out of last spring’s global scramble to sign vaccine makers to contracts. Experts have worried that rich countries would be protected this winter while poor ones — where people are more likely to die because of drug shortages and substandard hospital care — would bear the brunt of the pandemic.
“This is definitely a big deal,” said Dr. John J. Treanor, a vaccine expert at the University of Rochester. “People had been planning for a scenario that would require two doses.”
“This will take the edge off the nail-biting,” Dr. Treanor added.
The results released Thursday were based on the first three weeks of a clinical trial. Healthy adults got one 15-microgram shot, and their blood was tested 21 days later. By that time, 97 percent of the 120 adults had enough antibodies to be considered protected. Another group that got 30-microgram doses had no greater protection.
There were no deaths or dangerous side-effects. Almost half of the participants reported sore arms or headaches, but that is normal with flu shots.
The American trials began about two weeks later, said Paul R. Perreault, president of CSL Biotherapies, the company’s American subsidiary. “My experience with this tells me they shouldn’t be any different,” Mr. Perreault said.
Dr. Fauci said he would discuss the details of the N.I.H. trials at a news conference on Friday afternoon.
Seasonal flu shots are available now, and Federal officials are urging Americans to get one. Little or no swine flu vaccine will be available before late October. There have been no clinical trials of giving both shots at the same time, and Federal health officials have issued no recommendations on that.
Experts had predicted for months that, because the H1N1 swine flu has never been seen before by human immune systems, it would take two doses, administered weeks apart, to get a “take” — antibody levels as high as those produced by regular flu shots.
The authors of the Australian study said the robust response implied that there was some previously unsuspected crossover protection from having had previous strains of H1N1 seasonal flus or from the H1N1 components of seasonal flu shots.
In mid-August, a Chinese vaccine maker, Sinovac Biotech, also reported that one shot of its vaccine gave protection against the flu. But because it released no data about the size of the dose or the composition of its vaccine, it was impossible for American experts to evaluate the claim.
Also, none of the 10 Chinese companies producing swine flu vaccine have licenses to sell in the United States, as CSL does, so their vaccines would have virtually no impact on the spread of the disease here.
Although the Australian trial was in healthy adults only, Dr. Treanor said he believed one dose of the new vaccine would prove effective in everyone from age 9 and up.
Pediatricians usually give two shots to children ages 6 months to 9 years who have never had a flu shot; the first primes the immune system and subsequent shots act as boosters that create new surges of antibodies, though slightly varied each year as strains mutate.
Infants under 6 months old are not normally given flu shots. Pregnant women are, and babies can inherit some temporary immunity from their mothers
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3 G I FONE
Already, there are reports coming from schools across Florida that kids are being diagnosed with swine flu (also known as the H1N1 virus). And in Georgia, Alaska and Puerto Rico, health officials say swine flu already is widespread.The good news is this: Although swine flu is highly contagious, the World Health Organization says it generally causes "very mild illness" in healthy people.But there are ways to prevent the flu from spreading, mainly by washing your hands.If doctors sound like your mom, who keeps bugging you to wash your hands before you eat, there's a reason."Whenever you're contaminated by touching things that other people have touched — desks or tabletops in the lunchroom — you really should wash your hands before eating or drinking or touching your face," said Dr. Philip Tierno, director of clinical microbiology and immunology at New York University's Langone Medical Center. Eighty percent of all infections are spread when you touch germs and then touch your mouth, eyes and nose.And the flu bug is a survivor. The swine-flu virus can survive on a desk or a doorknob for two to eight hours after it lands there, according to the U.S. Centers for Disease Control and Prevention. That's why hand-washing — and disinfecting lunchroom tables, doorknobs and gym equipment — is so important.However, many kids are bound to get swine flu this year. So here's some advice from the CDC: If you think you're sick, stay home. The symptoms of swine flu include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of those already afflicted also have reported diarrhea and vomiting.Wash handsWash your hands frequently with soap and water. But not so fast, kiddo! You're supposed to wash for 20 seconds — so sing the "Happy Birthday" song to yourself twice to make sure you've washed long enough. And don't just wash your palms. Rub soap on the backs of your hands, between your fingers and underneath your fingernails. Antibacterial soap or plain soap? There's no need to use antibacterial soap — the water washes away the flu virus.Hand Sanitizer 101If soap and water are not available, use hand-sanitizing gel. Pick a brand that contains at least 62percent alcohol, said Tierno, the microbiologist. Most important: Wash hands or use hand sanitizer right before you eat lunch — because when you pick up your sandwich, you could spread germs from your hands to your food and then to your mouth.Coughing and sneezing etiquetteCough or sneeze into a tissue — and then wash or sanitize your hands. If you don't have a tissue handy, sneeze or cough into the crook of your arm or your shoulder — so your germs don't spread through the air. Don't cough or sneeze into your hands! If you do, wash immediately.Don't touch!Avoid touching your eyes, nose and mouth. That's the fastest way to spread germs into your body.Water-fountain phobia?The danger from the water fountain isn't from kids putting their mouths on the fountain — because the stream of water washes away germs. The most contaminated part of the fountain is the handle or button you push to turn it on, say experts. But to be safe during the swine- flu pandemic, it's probably best to send kids to school with their own water bottles. What about handrails, doorknobs or keyboards? It's not practical to ask kids not to touch any surfaces at school. Instead, experts recommend that kids carry their own container of hand sanitizer and use it frequently
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2009/07/15
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7:37 AM
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The meaning of Cycology is 'Motor Bike repairer'
However if you meant to say the meaning of Paychology then it means:
The Definition of "Psychology"
by Gene Zimmer
The word "psychology" is the combination of two terms - study (ology) and soul (psyche), or mind. The derivation of the word from Latin gives it this clear and obvious meaning:
The study of the soul or mind.
This meaning has been altered over the years until today, this is not what the word means at all. The subject of psychology, as studied in colleges and universities, currently has very little to do with the mind, and absolutely nothing to do with the soul or spirit.
It is important to understand that words and ideas are supposed to refer to something. "The large tree in the front yard" refers to an actual thing that can be seen, touched and experienced. "The man walking his little dog last night at sunset" refers to an actual event that can be seen, observed and experienced. The realm of mind is an actual realm that can be experienced, and at one time there were words that accurately referred to this realm.
Let's see what a few dictionaries have to say and how a word could alter and lose its true and actual meaning.
"Psyche" is defined as:
1. The spirit or soul.
2. The human mind.
3. In psychoanalysis, the mind functioning as the centre of thought, emotion, and behaviour.
And defining "soul", we have:
1. the spiritual or immortal elements in a person.
2. a person's mental or moral or emotional nature.
However another meaning which is one that we attributed when I was studying Psychology at University was described as:
academic and applied discipline involving the analytic and scientific study of mental processes and behaviour. Psychologists study such phenomena as perception, cognition, emotion, personality, behaviour, and interpersonal relationships. Psychology also refers to the application of such knowledge to various spheres of human activity including issues related to daily life—e.g. family, education, and work—and the treatment of mental health problems. Psychology attempts to understand the role these functions play in social behaviour and in social dynamics, while incorporating the underlying physiological and neurological processes into its conceptions of mental functioning. Psychology includes many sub-fields of study and application concerned with such areas as human development, sports, health, industry, media, law, and transpersonal psychology.
However if you meant to say the meaning of Paychology then it means:
The Definition of "Psychology"
by Gene Zimmer
The word "psychology" is the combination of two terms - study (ology) and soul (psyche), or mind. The derivation of the word from Latin gives it this clear and obvious meaning:
The study of the soul or mind.
This meaning has been altered over the years until today, this is not what the word means at all. The subject of psychology, as studied in colleges and universities, currently has very little to do with the mind, and absolutely nothing to do with the soul or spirit.
It is important to understand that words and ideas are supposed to refer to something. "The large tree in the front yard" refers to an actual thing that can be seen, touched and experienced. "The man walking his little dog last night at sunset" refers to an actual event that can be seen, observed and experienced. The realm of mind is an actual realm that can be experienced, and at one time there were words that accurately referred to this realm.
Let's see what a few dictionaries have to say and how a word could alter and lose its true and actual meaning.
"Psyche" is defined as:
1. The spirit or soul.
2. The human mind.
3. In psychoanalysis, the mind functioning as the centre of thought, emotion, and behaviour.
And defining "soul", we have:
1. the spiritual or immortal elements in a person.
2. a person's mental or moral or emotional nature.
However another meaning which is one that we attributed when I was studying Psychology at University was described as:
academic and applied discipline involving the analytic and scientific study of mental processes and behaviour. Psychologists study such phenomena as perception, cognition, emotion, personality, behaviour, and interpersonal relationships. Psychology also refers to the application of such knowledge to various spheres of human activity including issues related to daily life—e.g. family, education, and work—and the treatment of mental health problems. Psychology attempts to understand the role these functions play in social behaviour and in social dynamics, while incorporating the underlying physiological and neurological processes into its conceptions of mental functioning. Psychology includes many sub-fields of study and application concerned with such areas as human development, sports, health, industry, media, law, and transpersonal psychology.
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3 G I FONE
2009/07/12
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10:04 PM
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What is the swine flu?
What are the symptoms of swine flu?
What are the CDC recommendations for infectious swine flu?
How can the swine flu infection be controlled?
What is the treatment for swine flu?
Will a face mask protect me from getting the swine flu, and are there differences in face masks?
Read Dr. Charles Davis' H1N1 Influenza Virus (Swine Flu) article (published May 1, 2009)
Why is swine flu now infecting humans?
How is swine flu (H1N1) diagnosed?
What is the history of swine flu?
How can swine (H1N1) flu be prevented?
Is swine flu (H1N1) a cause of an epidemic or pandemic in 2009?
What is the prognosis (outlook) for patients that get swine flu (H1N1)?
Where can I find more information about swine flu?
Timeline update H1N1 2009 swine flu?
Swine Flu (H1N1 Influenza Virus) At A Glance?
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3 G I FONE
2009/06/30
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3:10 AM
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INTRODUCTION: Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos. Most people who develop it have worked on jobs where they inhaled asbestos particles, or they have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos.
About the Author:
Concerning The Author: Richard H. Ealom is the Author of this article and the writer of "Free Articles On Diseases: How To Prevent and Even Cure Them". Need more Facts Please visit us at our websites@Diabetes & Cancer Secrets OR Go To Heart Disease & Obesity Secrets. You have full permission to reprint this article provided this box is kept unchanged.
It is a serious disease with an average survival time of only 1 to 2 years after diagnosis. Unlike lung cancer, there is no association between mesothelioma and smoking. The disease occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. It is also known to occur in those who are genetically pre-disposed to it.
SYMPTOMS: Mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Diagnosing it is often difficult, because the symptoms are similar to those of a number of other conditions. The symptoms include shortness of breath due to pleural effusion (fluid between the lungs and the chest wall) or chest wall pain, and more general symptoms such as weight loss.
Signs of mesothelioma may also include abdominal pain, ascites, or an unusual buildup of fluid in the abdomenal mass in the abdomen, bowel function problems. Other signs of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and high body temperature.
If the disease has spread beyond the mesothelium to other areas of the body, signs may include pain, having trouble swallowing, or swelling of the neck or face.
In severe cases of the disease, the following signs may be present: blood clots in the veins, which may lead to thrombophlebitis, disseminated intravascular coagulation, a situation causing severe bleeding in many body organs, jaundice, or yellowing of the eyes and skin, low blood sugar level, pleural effusion, pulmonary emboli, or blood clots in the arteries of the lungs, severe ascites. These symptoms may be brought about by mesothelioma or by other, less serious diseases.
TREATMENT: There are several types of treatment options available: Radiation, Surgery, and chemotherapy including recently approved medications. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment.
Although the cancer is usually resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms caused by tumor growth, such as obstruction of a major blood vessel. In February 2004, the U.S. Food and Drug Administration approved pemetrexed (brand name Alimta) for treating malignant pleural mesothelioma.
CONCLUSION: Mesothelioma is a type of cancer that is nearly always caused by previous exposure to asbestos. Cancer that affects the pleura can cause these signs and symptoms: A painful chest wall, pleural effusion, or fluid surrounding the lungs, shortness of breath, fatigue or anemia, wheezing, hoarseness or cough, blood in the sputum (fluid) coughed up (hemoptysis).
It is described as localized if the disease is found only on the membrane surface where it began. Screening tests might diagnose it earlier than conventional methods thus raising the survival prospects for patients.
The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibres from the lung are transported to the abdomen and associated organs via the lymphatic system.
It has been suggested that in humans, transport of fibres to the pleura is critical to the pathogenesis of the disease.
Experimental evidence indicates that asbestos acts as a complete carcinogen with the development of mesothelioma happening in sequential stages of initiation and promotion.
Although reported incidence rates have grown in the past 20 yrs, the disease is still a very rare cancer. Incidence of malignant mesothelioma currently ranges from about 7 to 40 cases per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past few decades.
Between 1973 and 1984, there has been a threefold increase in the diagnosis of pleural mesothelioma in Caucasian males. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases are mis-diagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma.
Working with asbestos is the most important risk factor for mesothelioma. However, the disease has been reported in some people without any known asbestos exposure. Besides mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and others, such as cancer of the larynx and kidney.
Smoking modern cigarettes does not appear to increase the risk of developing the disease. The Kent brand of cigarettes used asbestos in its filters for the first few years of production in the 1950s and some cases of mesothelioma have resulted.
SYMPTOMS: Mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Diagnosing it is often difficult, because the symptoms are similar to those of a number of other conditions. The symptoms include shortness of breath due to pleural effusion (fluid between the lungs and the chest wall) or chest wall pain, and more general symptoms such as weight loss.
Signs of mesothelioma may also include abdominal pain, ascites, or an unusual buildup of fluid in the abdomenal mass in the abdomen, bowel function problems. Other signs of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and high body temperature.
If the disease has spread beyond the mesothelium to other areas of the body, signs may include pain, having trouble swallowing, or swelling of the neck or face.
In severe cases of the disease, the following signs may be present: blood clots in the veins, which may lead to thrombophlebitis, disseminated intravascular coagulation, a situation causing severe bleeding in many body organs, jaundice, or yellowing of the eyes and skin, low blood sugar level, pleural effusion, pulmonary emboli, or blood clots in the arteries of the lungs, severe ascites. These symptoms may be brought about by mesothelioma or by other, less serious diseases.
TREATMENT: There are several types of treatment options available: Radiation, Surgery, and chemotherapy including recently approved medications. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment.
Although the cancer is usually resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms caused by tumor growth, such as obstruction of a major blood vessel. In February 2004, the U.S. Food and Drug Administration approved pemetrexed (brand name Alimta) for treating malignant pleural mesothelioma.
CONCLUSION: Mesothelioma is a type of cancer that is nearly always caused by previous exposure to asbestos. Cancer that affects the pleura can cause these signs and symptoms: A painful chest wall, pleural effusion, or fluid surrounding the lungs, shortness of breath, fatigue or anemia, wheezing, hoarseness or cough, blood in the sputum (fluid) coughed up (hemoptysis).
It is described as localized if the disease is found only on the membrane surface where it began. Screening tests might diagnose it earlier than conventional methods thus raising the survival prospects for patients.
The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibres from the lung are transported to the abdomen and associated organs via the lymphatic system.
It has been suggested that in humans, transport of fibres to the pleura is critical to the pathogenesis of the disease.
Experimental evidence indicates that asbestos acts as a complete carcinogen with the development of mesothelioma happening in sequential stages of initiation and promotion.
Although reported incidence rates have grown in the past 20 yrs, the disease is still a very rare cancer. Incidence of malignant mesothelioma currently ranges from about 7 to 40 cases per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past few decades.
Between 1973 and 1984, there has been a threefold increase in the diagnosis of pleural mesothelioma in Caucasian males. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases are mis-diagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma.
Working with asbestos is the most important risk factor for mesothelioma. However, the disease has been reported in some people without any known asbestos exposure. Besides mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and others, such as cancer of the larynx and kidney.
Smoking modern cigarettes does not appear to increase the risk of developing the disease. The Kent brand of cigarettes used asbestos in its filters for the first few years of production in the 1950s and some cases of mesothelioma have resulted.
About the Author:
Concerning The Author: Richard H. Ealom is the Author of this article and the writer of "Free Articles On Diseases: How To Prevent and Even Cure Them". Need more Facts Please visit us at our websites@Diabetes & Cancer Secrets OR Go To Heart Disease & Obesity Secrets. You have full permission to reprint this article provided this box is kept unchanged.
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Technology is changing the face of health care and products that make life easier. Biomedical Engineering is just another way technology is working to improve the quality of life.
Modern technology, especially in the medical field, is advancing by leaps and bounds, in large part through the science of Biomedical Engineering. The combination of engineering and medical technology has made these advances possible. From prosthetics to artificial organs like the Jarvik7 artificial heart to breast implants for cancer patients, biomedical engineering is improving the quality of life for millions of people all over the world. Amputees can walk and even run with the use of biomedical engineering technology. Patients who need heart transplants can rely on technology when real hearts are not available. People who are facing blindness can have their sight restored with biomedical engineering.
Biomedical Engineering Technology
When Dr. Jarvik invented his breakthrough artificial heart, it was through biomedical engineering. The heart is made of materials designed to limit rejection and function much the same as a real heart would, pumping blood into the arteries and receiving oxygenated blood from the lungs. Tiny telescopic lenses can be fitted into the eyes of people who are losing their sight to restore vision. Missing limbs can be replaced with biomedical prosthetics, allowing patients to walk or use their new “hands” in almost the same way the original parts operated.
How Biomedical Engineering Saves Lives
Not only does the Jarvik7 artificial heart save the lives of patients who would otherwise have died from heart disease, but diabetic patients can thank biomedical engineering for a new insulin implant that keeps the right amount of insulin going to the pancreas at a pre-determined rate to prevent insulin shock or diabetic coma. Cochlear implants are part of biomedical engineering that allow deaf people to hear everything from music to TV to sirens and traffic noises, the latter two of which can allow them to travel and even drive with a greater level of safety.
Overview
Biomedical engineering covers many different fields from drugs to imaging to replacement parts. Combining two intensive sciences such as medicine and engineering is proving to be the solution to a variety of problems. Not only is biomedical engineering extending life expectancy, but improving the quality of life for millions. Breast implants for cancer patients are a great quality of life enhancer. Biomedical engineering is especially important to wounded military personnel during wartime. Being able to restore people to their normal quality of life is one of the most important parts of biomedical engineering.
Modern technology, especially in the medical field, is advancing by leaps and bounds, in large part through the science of Biomedical Engineering. The combination of engineering and medical technology has made these advances possible. From prosthetics to artificial organs like the Jarvik7 artificial heart to breast implants for cancer patients, biomedical engineering is improving the quality of life for millions of people all over the world. Amputees can walk and even run with the use of biomedical engineering technology. Patients who need heart transplants can rely on technology when real hearts are not available. People who are facing blindness can have their sight restored with biomedical engineering.
Biomedical Engineering Technology
When Dr. Jarvik invented his breakthrough artificial heart, it was through biomedical engineering. The heart is made of materials designed to limit rejection and function much the same as a real heart would, pumping blood into the arteries and receiving oxygenated blood from the lungs. Tiny telescopic lenses can be fitted into the eyes of people who are losing their sight to restore vision. Missing limbs can be replaced with biomedical prosthetics, allowing patients to walk or use their new “hands” in almost the same way the original parts operated.
How Biomedical Engineering Saves Lives
Not only does the Jarvik7 artificial heart save the lives of patients who would otherwise have died from heart disease, but diabetic patients can thank biomedical engineering for a new insulin implant that keeps the right amount of insulin going to the pancreas at a pre-determined rate to prevent insulin shock or diabetic coma. Cochlear implants are part of biomedical engineering that allow deaf people to hear everything from music to TV to sirens and traffic noises, the latter two of which can allow them to travel and even drive with a greater level of safety.
Overview
Biomedical engineering covers many different fields from drugs to imaging to replacement parts. Combining two intensive sciences such as medicine and engineering is proving to be the solution to a variety of problems. Not only is biomedical engineering extending life expectancy, but improving the quality of life for millions. Breast implants for cancer patients are a great quality of life enhancer. Biomedical engineering is especially important to wounded military personnel during wartime. Being able to restore people to their normal quality of life is one of the most important parts of biomedical engineering.
The History and Techniques of DNA Sequencing
One of the key requirements for developing personalized medicine is a fast and accurate DNA sequencing technology. Learn about the history of DNA sequencing here.
What is DNA sequencing?
DNA sequencing is the process of determining the order of nucleotides in DNA. DNA sequencing is often talked about in the context of the Human Genome Project, in which, the human genome was successfully sequenced in 2001, providing scientists an incredible amount of data. The technology of DNA sequencing has evolved rapidly in the past 15 years. You now can pay companies to obtain your personal genome sequencing. This allows you to access your disease risk and to analyze and compare your genetic traits.
How does DNA sequencing work?
GA_googleFillSlot("BH_Health_HealthCareTech_ATF_Body_LargeRectangle_336x280");
DNA molecules consist of repeating nucleotides, which are the the bases of DNA. Nucleotides consist of adenine (A), thymine (T), guanine (G), and cytosine (C). DNA molecules are double-stranded, with two complimentary DNA strands forming a double helix. DNA sequencing aims to determine the exact order of the bases, A, T, C and G in a DNA fragment.
The basic principle of DNA sequencing is simple and consists of two main steps. In the first step, labeled nucleotides are inserted into copies of a DNA fragment. In the second step, the DNA sequence is derived from the locations of the labeled nucleotides. The first step involves a technique called DNA amplification. First, the original double-stranded DNA is heated and separated into two single DNA strands. Then, these single strands are used as a template for making complementary copies. We then end up with a large number of fragments of different lengths. The second step involves separating the DNA fragments according to their lengths. This is often done by electrophoresis in a polyacrylamide gel. The base at the end of each fragment is identified, allowing reconstruction of the DNA sequence.
History of DNA Sequencing
Prior to 1970s, no progress had been made toward the sequencing of DNA. In the mid 1970s, the technology of DNA sequencing was revolutionized by Sanger, who later on won his second Nobel Prize in chemistry for this invention. The complete DNA sequence of a viral genome was reported by Sanger in 1977. However, Sanger's technique of DNA sequencing was still very slow.
By the begining of 1990s, only a handful of groups were able sequence DNA up to 100,000 bases at extremely high costs. The start of the Human Genome Project had inspired scientists and engineers to come up with automation techniques that not only speed up the process of DNA squencing but also to substantially lower its cost. DNA sequencing is now done routinely all round the world. There are now many laboratories that can sequence 100 million bases or more every year. In addition to the human genome, DNA sequencing is also used to obtain genomes of many organisms, including mice, rats, fruit flies, worms, yeast, fungi, microbes, plants, mosquitos, bacteria and viruses.
Applications of Genomics in Medicine - Personalized Medicine
This series of article introduces readers to existing and potential applications of genomics in improving disease treatment. We focus on the topics of personalized medicine (pharmacogenomics), DNA technology and genetic screening.
1.
COLARIS: A Genetic Test for Hereditary Colon Cancer
2.
23andMe: Personal Genetics
3.
Personalized Medicine and Politics
4.
The History and Techniques of DNA Sequencing
5.
Applications of DNA Sequencing
DNA sequencing is the process of determining the order of nucleotides in DNA. DNA sequencing is often talked about in the context of the Human Genome Project, in which, the human genome was successfully sequenced in 2001, providing scientists an incredible amount of data. The technology of DNA sequencing has evolved rapidly in the past 15 years. You now can pay companies to obtain your personal genome sequencing. This allows you to access your disease risk and to analyze and compare your genetic traits.
How does DNA sequencing work?
GA_googleFillSlot("BH_Health_HealthCareTech_ATF_Body_LargeRectangle_336x280");
DNA molecules consist of repeating nucleotides, which are the the bases of DNA. Nucleotides consist of adenine (A), thymine (T), guanine (G), and cytosine (C). DNA molecules are double-stranded, with two complimentary DNA strands forming a double helix. DNA sequencing aims to determine the exact order of the bases, A, T, C and G in a DNA fragment.
The basic principle of DNA sequencing is simple and consists of two main steps. In the first step, labeled nucleotides are inserted into copies of a DNA fragment. In the second step, the DNA sequence is derived from the locations of the labeled nucleotides. The first step involves a technique called DNA amplification. First, the original double-stranded DNA is heated and separated into two single DNA strands. Then, these single strands are used as a template for making complementary copies. We then end up with a large number of fragments of different lengths. The second step involves separating the DNA fragments according to their lengths. This is often done by electrophoresis in a polyacrylamide gel. The base at the end of each fragment is identified, allowing reconstruction of the DNA sequence.
History of DNA Sequencing
Prior to 1970s, no progress had been made toward the sequencing of DNA. In the mid 1970s, the technology of DNA sequencing was revolutionized by Sanger, who later on won his second Nobel Prize in chemistry for this invention. The complete DNA sequence of a viral genome was reported by Sanger in 1977. However, Sanger's technique of DNA sequencing was still very slow.
By the begining of 1990s, only a handful of groups were able sequence DNA up to 100,000 bases at extremely high costs. The start of the Human Genome Project had inspired scientists and engineers to come up with automation techniques that not only speed up the process of DNA squencing but also to substantially lower its cost. DNA sequencing is now done routinely all round the world. There are now many laboratories that can sequence 100 million bases or more every year. In addition to the human genome, DNA sequencing is also used to obtain genomes of many organisms, including mice, rats, fruit flies, worms, yeast, fungi, microbes, plants, mosquitos, bacteria and viruses.
Applications of Genomics in Medicine - Personalized Medicine
This series of article introduces readers to existing and potential applications of genomics in improving disease treatment. We focus on the topics of personalized medicine (pharmacogenomics), DNA technology and genetic screening.
1.
COLARIS: A Genetic Test for Hereditary Colon Cancer
2.
23andMe: Personal Genetics
3.
Personalized Medicine and Politics
4.
The History and Techniques of DNA Sequencing
5.
Applications of DNA Sequencing
See More About:Personalized medicine, DNA, DNA sequencing history
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While the iPhone 3G may be garnering the most press, Windows Mobile 6.1 goes beyond a flashy campaign and offers true overall functionality. Functions that fully supports a wide range of commercial and business applications for users of every background.
The iPhone is a great device, there really is little debating that fact, although the iPhone 3G had lost some support in the past due to issues with calls dropping randomly. Of course Windows Mobile devices have not always been perfect either. That's why today i'm going to discuss the main differences between the iPhone 3G Operating System and the newly minted Windows Mobile 6.1 OS.
The iPhone is a great device, there really is little debating that fact, although the iPhone 3G had lost some support in the past due to issues with calls dropping randomly. Of course Windows Mobile devices have not always been perfect either. That's why today i'm going to discuss the main differences between the iPhone 3G Operating System and the newly minted Windows Mobile 6.1 OS.
The Need for Speed:
Given the name of the new iPhone the first important aspect to look at is the speed. Under Apple leadership the unit can download up to 3.6Mbps via HSDPA data speeds.
In this respect Windows Mobile 6.1 wins, offering up to 7.2Mbps depending on the device in question and its own limitations. Sure Microsoft depends on the technology of the manufacturers, but it also means the company has created an OS that is easily expandable to a bevy of handsets.
Video Calling:
The Windows Mobile 6.1 interface also allows itself to 3G Video calling, its the reason devices such as the HTC TyTN II have provided an additional VGA camera on the front of such devices. The iPhone on the other hand lacks the secondary camera and the faster download speeds necessary for fulfilling such a task.
Unlocked vs Locked:
Then there's the issue of Unlocked versus Locked devices. Sure you can hack your iPhone, but many Windows Mobile devices come factory unlocked, meaning more worldwide usability. Not to mention a variety of carriers worldwide carry the Windows Mobile 6.1 offering, only select carriers with the "priviledge" of carrying the iPhone 3G are available.
Multi-Touch:
On the other hand the iPhone 3G allows for multi-touch which comes standard on the device. This is one option on the iPhone I really like, it makes zooming in and out on pictures and files easy, and it offers more touch functionality to the unit, something that is sorely missing on Windows Mobile 6.1 Professional devices.
Email:
Email is a big consideration on most devices these days, especially for business purposes. In this case, both units offer Microsoft Exchange support, however Windows Mobile 6.1 Professional offers Server 2007 support, full out of office support directly from your device, and syncing capabilities that really can't be reviled by the iPhone.
Windows Mobile 6.1 devices then fully support editing office documents while also keeping their original format. Sure the iPhone can download your documents easily, but they can't match the prowess Microsoft offers for document viewing and editing.
Third Party Applications:
Next there's the issue of 3rd Party Applications. iPhone offers the Apple Apps Store, a great addition that offers programs from $.99 and up. Sure it's a great feature and all of the programs are approved by Apple before they go live, helping to ensure spyware isn't part of the equation.
However, Windows Mobile offers literally thousands of third party freeware applications, along with the largest catalogue of non-freeware software from companies such as Handango and MobiHand online. If you are looking to diversify your application portfolio Windows Mobile is really the only way to go. But that doesn't mean the iPhone....
Continue to Page 2 for more on third party applications, GPS and browser comparisons.is out of the picture, Apple has always managed to attract some of the worlds most talented programs, and while Microsoft charges upwards of $500 for their software developers kit, Apple offers their developer kit for free and they offer great helpful hints and support to software developers. Plus developers receive a 70% revenue share compared to the 40%-50% offered by Windows Mobile. In all fairness however, the Windows Mobile platform allows developers to reach out to a large pool of users.
I also like the tilt sensor on the iPhone. Sure there are a few devices that offer the same function for WM devices, but the iPhone technology is leaps and bounds above the competition, offering quick transitions between regular and landscape modes, and taking full advantage of video games.
Given the name of the new iPhone the first important aspect to look at is the speed. Under Apple leadership the unit can download up to 3.6Mbps via HSDPA data speeds.
In this respect Windows Mobile 6.1 wins, offering up to 7.2Mbps depending on the device in question and its own limitations. Sure Microsoft depends on the technology of the manufacturers, but it also means the company has created an OS that is easily expandable to a bevy of handsets.
Video Calling:
The Windows Mobile 6.1 interface also allows itself to 3G Video calling, its the reason devices such as the HTC TyTN II have provided an additional VGA camera on the front of such devices. The iPhone on the other hand lacks the secondary camera and the faster download speeds necessary for fulfilling such a task.
Unlocked vs Locked:
Then there's the issue of Unlocked versus Locked devices. Sure you can hack your iPhone, but many Windows Mobile devices come factory unlocked, meaning more worldwide usability. Not to mention a variety of carriers worldwide carry the Windows Mobile 6.1 offering, only select carriers with the "priviledge" of carrying the iPhone 3G are available.
Multi-Touch:
On the other hand the iPhone 3G allows for multi-touch which comes standard on the device. This is one option on the iPhone I really like, it makes zooming in and out on pictures and files easy, and it offers more touch functionality to the unit, something that is sorely missing on Windows Mobile 6.1 Professional devices.
Email:
Email is a big consideration on most devices these days, especially for business purposes. In this case, both units offer Microsoft Exchange support, however Windows Mobile 6.1 Professional offers Server 2007 support, full out of office support directly from your device, and syncing capabilities that really can't be reviled by the iPhone.
Windows Mobile 6.1 devices then fully support editing office documents while also keeping their original format. Sure the iPhone can download your documents easily, but they can't match the prowess Microsoft offers for document viewing and editing.
Third Party Applications:
Next there's the issue of 3rd Party Applications. iPhone offers the Apple Apps Store, a great addition that offers programs from $.99 and up. Sure it's a great feature and all of the programs are approved by Apple before they go live, helping to ensure spyware isn't part of the equation.
However, Windows Mobile offers literally thousands of third party freeware applications, along with the largest catalogue of non-freeware software from companies such as Handango and MobiHand online. If you are looking to diversify your application portfolio Windows Mobile is really the only way to go. But that doesn't mean the iPhone....
Continue to Page 2 for more on third party applications, GPS and browser comparisons.is out of the picture, Apple has always managed to attract some of the worlds most talented programs, and while Microsoft charges upwards of $500 for their software developers kit, Apple offers their developer kit for free and they offer great helpful hints and support to software developers. Plus developers receive a 70% revenue share compared to the 40%-50% offered by Windows Mobile. In all fairness however, the Windows Mobile platform allows developers to reach out to a large pool of users.
I also like the tilt sensor on the iPhone. Sure there are a few devices that offer the same function for WM devices, but the iPhone technology is leaps and bounds above the competition, offering quick transitions between regular and landscape modes, and taking full advantage of video games.
GPS:
In terms of GPS, the iPhone does offer Assisted GPS which uses cell tower information to pinpoint your location. It's very accurate, but not always great for areas with bad cell phone coverage.
Windows Mobile devices however in many cases offer not only AGPS but also built-in Sirf III processors which means GPS use wherever you may be. Plus at the time of this article there is no navigation software available for the iPhone (note, there lastest firmware updates this). With WM 6.1 you can use TomTom, Pharos, CoPilot and a host of other navigation options for all of your GPS needs including Topo Graphs, City Maps, and anything else your heart desires.
Internet Browsers:
Finally, I do like the iPhone Safari internet browser, it trumps the standard Windows Mobile Internet Browser, however Windows Mobile now has the option of Opera Mini 9.5 which helps level the playing field. And while the iPhone and iPhone 3G Safari browser is superior, the slower download speeds hinder the performance of the iPhone browser.
Conclusion:
These are just a few of the major differences between the iPhone and Windows Mobile 6.1 devices.
Personally I believe the iPhone series is moving in the right direction, but there is still a long way to go before Apple can claim the best operating system on the market.
As it currently stands, Windows Mobile 6.1 offers more functionality for a wider audience, and in a fragmented society, that type of breadth is just as important as a sleek design with a cool interface................
In terms of GPS, the iPhone does offer Assisted GPS which uses cell tower information to pinpoint your location. It's very accurate, but not always great for areas with bad cell phone coverage.
Windows Mobile devices however in many cases offer not only AGPS but also built-in Sirf III processors which means GPS use wherever you may be. Plus at the time of this article there is no navigation software available for the iPhone (note, there lastest firmware updates this). With WM 6.1 you can use TomTom, Pharos, CoPilot and a host of other navigation options for all of your GPS needs including Topo Graphs, City Maps, and anything else your heart desires.
Internet Browsers:
Finally, I do like the iPhone Safari internet browser, it trumps the standard Windows Mobile Internet Browser, however Windows Mobile now has the option of Opera Mini 9.5 which helps level the playing field. And while the iPhone and iPhone 3G Safari browser is superior, the slower download speeds hinder the performance of the iPhone browser.
Conclusion:
These are just a few of the major differences between the iPhone and Windows Mobile 6.1 devices.
Personally I believe the iPhone series is moving in the right direction, but there is still a long way to go before Apple can claim the best operating system on the market.
As it currently stands, Windows Mobile 6.1 offers more functionality for a wider audience, and in a fragmented society, that type of breadth is just as important as a sleek design with a cool interface................
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Crohn’s disease is an autoimmune disorder which has no medical cure. However, there are several treatment options that can alleviate symptoms.
What is Crohn’s Disease?
Crohn’s disease is a type of inflammatory bowel disease in which the digestive tract is chronically inflamed, causing a range of gastrointestinal symptoms. Long-term, the inflammation can affect the deep tissue of the digestive tract, and the disease may eventually become life-threatening.
The current thinking on Crohn’s disease is that the immune system is involved in some way. One theory is that Crohn’s disease is a chronic response to an infection with a microorganism such as Mycobacterium avium paratuberculosis, an intestinal bacterium of cattle. Another theory is that Crohn’s disease is an autoimmune disorder.
There is also a possibility of a genetic component to the development of Crohn’s disease. Around 20% of people with Crohn’s disease have a close relative who also has the condition. In addition, people with Crohn’s disease frequently have a mutation in a gene called NOD2/CARD15. This gene codes for a protein which is a component of the immune system.
Symptoms of Crohn’s disease include diarrhea, abdominal cramping, blood in the stool, reduced appetite, weight loss, and ulcers.
Treatment Options for Crohn’s Disease
There is no cure for Crohn’s disease, but there are several options for treatment. Drug therapy can help ease the symptoms of the disease, and in some cases can even cause the disease to go into remission. In some cases, people with Crohn’s disease may eventually require surgery.
Medication
The goal of using medication to treat Crohn’s disease is to reduce inflammation and side effects, and help the digestive tract to heal.
Anti-inflammatory drugs are usually the first line of medication therapy for Crohn’s disease. These drugs are usually non-steroidal anti-inflammatory drugs, but if NSAIDS are not effective, corticosteroids may be indicated for short-term use. When used in conjunction with other medications, corticosteroids can allow the body to enter remission.
Immunosuppressants are drugs that suppress the immune system. These drugs are effective in treating Crohn’s disease symptoms because inflammation is an immune response. Immunosuppressants are often used following corticosteroid treatment to help induce remission.
Antibiotics are used when abscesses or fistulas form, as these are likely to become infected.
Other medications used depend on symptoms. Anti-diarrhea medication, laxatives, pain medication are all recommended by doctors depending on circumstances. Nutritional supplements may also be recommended.
Surgery
For some people, lifestyle changes, medication, and other types of treatment don’t provide relief from symptoms of Crohn’s disease. In these cases, surgery may be indicated.
During surgery, a surgeon may remove a badly damaged part of the digestive tract, and then connects up the ends of the healthy tissue. In another type of surgery, called strictureplasty, sections of intestine that have become narrow due to the formation of scar tissue are widened.
In other cases, surgery might be required to close a fistula or remove scar tissue that might be causing further problems. A fistula occurs when inflammation is so extensive that a hole forms in the digestive tract, forming a “tunnel” from the digestive tract into nearby spaces such as the bladder or vagina.
Successful surgery for Crohn’s disease can help the body enter into a remission that might last several years. However, the benefits of surgery are almost always temporary, as the disease will recur somewhere in the digestive tract. Up to 75% of people with Crohn’s disease require at least one surgery, and of those, around half will undergo two or more separate procedures.
References
Crohn’s Disease information from the National Institute of Diabetes and Digestive and Kidney Diseases at the National Digestive Diseases Information Clearing House
The Mayo Clinic on Crohn’s Disease
What is Crohn’s Disease?
Crohn’s disease is a type of inflammatory bowel disease in which the digestive tract is chronically inflamed, causing a range of gastrointestinal symptoms. Long-term, the inflammation can affect the deep tissue of the digestive tract, and the disease may eventually become life-threatening.
The current thinking on Crohn’s disease is that the immune system is involved in some way. One theory is that Crohn’s disease is a chronic response to an infection with a microorganism such as Mycobacterium avium paratuberculosis, an intestinal bacterium of cattle. Another theory is that Crohn’s disease is an autoimmune disorder.
There is also a possibility of a genetic component to the development of Crohn’s disease. Around 20% of people with Crohn’s disease have a close relative who also has the condition. In addition, people with Crohn’s disease frequently have a mutation in a gene called NOD2/CARD15. This gene codes for a protein which is a component of the immune system.
Symptoms of Crohn’s disease include diarrhea, abdominal cramping, blood in the stool, reduced appetite, weight loss, and ulcers.
Treatment Options for Crohn’s Disease
There is no cure for Crohn’s disease, but there are several options for treatment. Drug therapy can help ease the symptoms of the disease, and in some cases can even cause the disease to go into remission. In some cases, people with Crohn’s disease may eventually require surgery.
Medication
The goal of using medication to treat Crohn’s disease is to reduce inflammation and side effects, and help the digestive tract to heal.
Anti-inflammatory drugs are usually the first line of medication therapy for Crohn’s disease. These drugs are usually non-steroidal anti-inflammatory drugs, but if NSAIDS are not effective, corticosteroids may be indicated for short-term use. When used in conjunction with other medications, corticosteroids can allow the body to enter remission.
Immunosuppressants are drugs that suppress the immune system. These drugs are effective in treating Crohn’s disease symptoms because inflammation is an immune response. Immunosuppressants are often used following corticosteroid treatment to help induce remission.
Antibiotics are used when abscesses or fistulas form, as these are likely to become infected.
Other medications used depend on symptoms. Anti-diarrhea medication, laxatives, pain medication are all recommended by doctors depending on circumstances. Nutritional supplements may also be recommended.
Surgery
For some people, lifestyle changes, medication, and other types of treatment don’t provide relief from symptoms of Crohn’s disease. In these cases, surgery may be indicated.
During surgery, a surgeon may remove a badly damaged part of the digestive tract, and then connects up the ends of the healthy tissue. In another type of surgery, called strictureplasty, sections of intestine that have become narrow due to the formation of scar tissue are widened.
In other cases, surgery might be required to close a fistula or remove scar tissue that might be causing further problems. A fistula occurs when inflammation is so extensive that a hole forms in the digestive tract, forming a “tunnel” from the digestive tract into nearby spaces such as the bladder or vagina.
Successful surgery for Crohn’s disease can help the body enter into a remission that might last several years. However, the benefits of surgery are almost always temporary, as the disease will recur somewhere in the digestive tract. Up to 75% of people with Crohn’s disease require at least one surgery, and of those, around half will undergo two or more separate procedures.
References
Crohn’s Disease information from the National Institute of Diabetes and Digestive and Kidney Diseases at the National Digestive Diseases Information Clearing House
The Mayo Clinic on Crohn’s Disease
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"Pleural effusion is a common complication after bypass surgery", say researchers who recently carried out a study of 400 patients who had undergone bypass heart surgery. Pleural effusion involves the accumulation of fluid within the pleural space in the chest. Pleural space is //the narrow space between the lungs and the chest wall, covered by a thin transparent membrane called the pleura. The study indicated that almost 55% had a pleural effusion one month after the bypass surgery. Around 15 per cent of cases had an effusion that occupied more than 25 per cent of one side of the chest while in most of cases the effusions were small, left-sided and disappeared over time.Patients who suffered large pleural effusions after the surgery complained of severe breathlessness - although not of chest pain or fever. However, these large effusions also disappeared slowly over a year following the surgery.
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A minimally invasive direct coronary artery bypass (MIDCAB) procedure was performed at Pittsburgh while the patient was awake. The operation was done under thoracic epidural anesthesia. This approach may help in discharging the patient early from the hospital. Dr. Zenati from the team of doctors who performed the surgery said that patients who are operated in this way may not have to go to the intensive care unit at all and this surgery may be undertaken as a day case surgery once it is perfected. Speaking about the other profound advances in the bypass surgery Dr.Zenati said, "Elimination of the heart lung machine so that our surgery is done now using beating heart techniques. Then we shrunk the size of the incision. Now we are working on a robotic method that requires only 5-mm pin-size holes. We are basically eliminating incisions altogether, We are eliminating what is not necessary while maintaining the core of the procedure, which is the arterial revascularization. Eventually we want surgical bypass to be the first line of therapy not the last resort when everything else fails." In this specific case the incision was about 2-1/2 inches,
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The Japanese Association of Anatomists has chosen Springer to publish its official journal, Anatomical science International. The first issue will be published at Springer in April 2009. The journal was previously published by Wiley-Blackwell.
Anatomical science International focuses on the morphological sciences in animals and humans. Topics include molecular, cellular, histological and gross anatomical studies. In addition to original research articles, the journal also publishes reviews, essays, case reports, book reviews and commentaries. Dr. Shohei Yamashina, Professor Emeritus at the Kitasato University School of Medicine, is the current editor-in-chief. Dr. Kiyotaka Toshimori, Professor and Chairman in the department of anatomy and Developmental Biology at Chiba University School of Medicine, will take over as editor-in-chief in April 2009.
Editorial Director Dr. Toyoshi Fujimoto, Professor in the department of Molecular Cell Biology at the Nagoya University Graduate School of Medicine, said, "Anatomical science International presents the most up-to-date information on modern anatomy, providing readers with high-impact, original work focusing on pivotal issues. We are excited to be partnering with Springer in the publication of this journal, and we look forward to providing life science researchers worldwide with information resources for their daily work."
Dr. Dieter Czeschlik, Editorial Director for Life sciences at Springer, said, "We are delighted to be working with the Japanese Association of Anatomists, and their journal will be an excellent addition to our publishing program. We are proud to bring the excellent and timely research published in the Anatomical science International to the international community via our online platform SpringerLink, thereby giving both authors and readers the benefit of state-of-the-art global communication."
Anatomical science International<'/>"/>
Anatomical science International focuses on the morphological sciences in animals and humans. Topics include molecular, cellular, histological and gross anatomical studies. In addition to original research articles, the journal also publishes reviews, essays, case reports, book reviews and commentaries. Dr. Shohei Yamashina, Professor Emeritus at the Kitasato University School of Medicine, is the current editor-in-chief. Dr. Kiyotaka Toshimori, Professor and Chairman in the department of anatomy and Developmental Biology at Chiba University School of Medicine, will take over as editor-in-chief in April 2009.
Editorial Director Dr. Toyoshi Fujimoto, Professor in the department of Molecular Cell Biology at the Nagoya University Graduate School of Medicine, said, "Anatomical science International presents the most up-to-date information on modern anatomy, providing readers with high-impact, original work focusing on pivotal issues. We are excited to be partnering with Springer in the publication of this journal, and we look forward to providing life science researchers worldwide with information resources for their daily work."
Dr. Dieter Czeschlik, Editorial Director for Life sciences at Springer, said, "We are delighted to be working with the Japanese Association of Anatomists, and their journal will be an excellent addition to our publishing program. We are proud to bring the excellent and timely research published in the Anatomical science International to the international community via our online platform SpringerLink, thereby giving both authors and readers the benefit of state-of-the-art global communication."
Anatomical science International<'/>"/>
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2009/06/24
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Denaturation (biochemistry)
Denaturation is the alteration of a protein shape through some form of external stress (for example, by applying heat, acid or alkali), in such a way that it will no longer be able to carry out its cellular functiDenatured proteins can exhibit a wide range of characteristics, from loss of solubility to communal aggregation.
Proteins are very long strands of amino acids linked together in specific sequences.
A protein is created by ribosomes that "read" codons in the gene and assemble the requisite amino acid combination from the genetic instruction, in a process known as translation.
The newly created protein strand then undergoes post-translational modification in which additional atoms or molecules are added, for example copper, zinc, iron.
Once this post-translational modification process has been completed, the protein begins to fold (spontaneously, and sometimes with enzymatic assistance), curling up on itself so that hydrophobic elements of the protein are buried deep inside the structure and hydrophilic elements end up on the outside.
The final shape of a protein determines how it interacts with its environment..
For more information about the topic Denaturation (biochemistry), read the full article at Wikipedia.org, or see the following related articles:
Protein folding — Protein folding is the process by which a protein structure assumes its functional shape or conformation. All protein molecules are heterogeneous ... > read more
Protein structure — Proteins, similar to carbohydrates and lipids, are made up of such elements as carbon, hydrogen and oxygen. They are amino acid chains, made up from ... > read more
Protein biosynthesis — Protein biosynthesis (Synthesis) is the process in which cells build proteins. The term is sometimes used to refer only to protein translation but ... > read more
Heat shock protein — Heat shock proteins (HSP) are a group of proteins the expression of which is increased when the cells are exposed to elevated ... > read moreon..................
Proteins are very long strands of amino acids linked together in specific sequences.
A protein is created by ribosomes that "read" codons in the gene and assemble the requisite amino acid combination from the genetic instruction, in a process known as translation.
The newly created protein strand then undergoes post-translational modification in which additional atoms or molecules are added, for example copper, zinc, iron.
Once this post-translational modification process has been completed, the protein begins to fold (spontaneously, and sometimes with enzymatic assistance), curling up on itself so that hydrophobic elements of the protein are buried deep inside the structure and hydrophilic elements end up on the outside.
The final shape of a protein determines how it interacts with its environment..
For more information about the topic Denaturation (biochemistry), read the full article at Wikipedia.org, or see the following related articles:
Protein folding — Protein folding is the process by which a protein structure assumes its functional shape or conformation. All protein molecules are heterogeneous ... > read more
Protein structure — Proteins, similar to carbohydrates and lipids, are made up of such elements as carbon, hydrogen and oxygen. They are amino acid chains, made up from ... > read more
Protein biosynthesis — Protein biosynthesis (Synthesis) is the process in which cells build proteins. The term is sometimes used to refer only to protein translation but ... > read more
Heat shock protein — Heat shock proteins (HSP) are a group of proteins the expression of which is increased when the cells are exposed to elevated ... > read moreon..................
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Sinoatrial Node Dysfunction and Early Unexpected Death of Mice With a Defect of klotho Gene Expression //:
Kyosuke Takeshita, MD, PhD*; Toshihiko Fujimori, PhD*; Yoko Kurotaki; Haruo Honjo, MD, PhD; Hiroshi Tsujikawa, MD; Kenji Yasui, MD, PhD; Jong-Kook Lee, MD, PhD; Kaichiro Kamiya, MD, PhD; Kiyoyuki Kitaichi, PhD; Koji Yamamoto, MD, PhD; Masafumi Ito, MD, PhD; Takahisa Kondo, MD, PhD; Shigeo Iino, MD, PhD; Yasuya Inden, MD, PhD; Makoto Hirai, MD, PhD; Toyoaki Murohara, MD, PhD; Itsuo Kodama, MD, PhD; Yo-ichi Nabeshima, MD, PhD
From the Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (K.T., T.K., S.I., Y.I., M.H., T.M.); Department of Pathology and Tumor Biology, Kyoto University Graduate School of Medicine, Kyoto (T.F., Y.K., H.T., Y.N.); Research Institute of Environmental Medicine and Department of Health Medicine, Nagoya University, Nagoya (H.H., K.Y., J.L., K. Kamiya, I.K.); Department of Molecular Medicine and Clinical Science, Nagoya University Graduate School of Medicine, Nagoya (K. Kitaichi); Division of Pathology, Clinical Laboratory, Nagoya University Hospital, Nagoya (M.I.); and Core Research for Evolutional Science and Technology, Japan Science and Technology Agency (Y.K., Y.N.), Japan.
Correspondence to Yo-ichi Nabeshima, MD, PhD, Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Yoshida-Konoe cho, Sakyo-ku, Kyoto 606-8501, Japan. E-mail nabemr@lmls.med.kyoto-u.ac.jp
"
//-->
Received August 12, 2003; revision received December 3, 2003; accepted December 22, 2003.
Background— Homozygous mutant mice with a defect of klotho gene expression (kl/kl) show multiple age-related disorders and premature death from unknown causes.
Methods and Results— The kl/kl mice subjected to 20-hour restraint stress showed a high rate (20/30) of sudden death, which was associated with sinoatrial node dysfunction (conduction block or arrest). Heart rate and plasma norepinephrine of kl/kl mice, unlike those of wild-type (WT) mice, failed to increase during the stress. Intrinsic heart rate after pharmacological blockade of autonomic nerves in kl/kl mice was significantly lower than that in WT mice (380±33 versus 470±44 bpm; n=7). The sinus node recovery time after an overdrive pacing (600 bpm, 30 seconds) in kl/kl mice was significantly longer than in WT mice (392±37 versus 233±24 ms; n=6). In isolated sinoatrial node preparations, the positive chronotropic effect of isoproterenol was significantly less, whereas the negative chronotropic effect of acetylcholine was significantly greater in kl/kl than in WT mice. There was no degenerative structural change in the sinoatrial node of kl/kl mice. The precise localization of klotho was analyzed in newly prepared klotho-null mice with a reporter gene system (kl–geo). Homozygous kl–geo mice showed characteristic age-associated phenotypes that were almost identical to those of kl/kl mice. In the kl–geo mice, klotho expression was recognized exclusively in the sinoatrial node region in the heart in addition to parathyroid, kidney, and choroid plexus.
Conclusions— In the heart, klotho is expressed solely at the sinoatrial node. klotho gene expression is essential for the sinoatrial node to function as a dependable pacemaker under conditions of stress.
Key Words: genetics • death, sudden • aging • sinoatrial node
Kyosuke Takeshita, MD, PhD*; Toshihiko Fujimori, PhD*; Yoko Kurotaki; Haruo Honjo, MD, PhD; Hiroshi Tsujikawa, MD; Kenji Yasui, MD, PhD; Jong-Kook Lee, MD, PhD; Kaichiro Kamiya, MD, PhD; Kiyoyuki Kitaichi, PhD; Koji Yamamoto, MD, PhD; Masafumi Ito, MD, PhD; Takahisa Kondo, MD, PhD; Shigeo Iino, MD, PhD; Yasuya Inden, MD, PhD; Makoto Hirai, MD, PhD; Toyoaki Murohara, MD, PhD; Itsuo Kodama, MD, PhD; Yo-ichi Nabeshima, MD, PhD
From the Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (K.T., T.K., S.I., Y.I., M.H., T.M.); Department of Pathology and Tumor Biology, Kyoto University Graduate School of Medicine, Kyoto (T.F., Y.K., H.T., Y.N.); Research Institute of Environmental Medicine and Department of Health Medicine, Nagoya University, Nagoya (H.H., K.Y., J.L., K. Kamiya, I.K.); Department of Molecular Medicine and Clinical Science, Nagoya University Graduate School of Medicine, Nagoya (K. Kitaichi); Division of Pathology, Clinical Laboratory, Nagoya University Hospital, Nagoya (M.I.); and Core Research for Evolutional Science and Technology, Japan Science and Technology Agency (Y.K., Y.N.), Japan.
Correspondence to Yo-ichi Nabeshima, MD, PhD, Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Yoshida-Konoe cho, Sakyo-ku, Kyoto 606-8501, Japan. E-mail nabemr@lmls.med.kyoto-u.ac.jp
"
//-->
Received August 12, 2003; revision received December 3, 2003; accepted December 22, 2003.
Background— Homozygous mutant mice with a defect of klotho gene expression (kl/kl) show multiple age-related disorders and premature death from unknown causes.
Methods and Results— The kl/kl mice subjected to 20-hour restraint stress showed a high rate (20/30) of sudden death, which was associated with sinoatrial node dysfunction (conduction block or arrest). Heart rate and plasma norepinephrine of kl/kl mice, unlike those of wild-type (WT) mice, failed to increase during the stress. Intrinsic heart rate after pharmacological blockade of autonomic nerves in kl/kl mice was significantly lower than that in WT mice (380±33 versus 470±44 bpm; n=7). The sinus node recovery time after an overdrive pacing (600 bpm, 30 seconds) in kl/kl mice was significantly longer than in WT mice (392±37 versus 233±24 ms; n=6). In isolated sinoatrial node preparations, the positive chronotropic effect of isoproterenol was significantly less, whereas the negative chronotropic effect of acetylcholine was significantly greater in kl/kl than in WT mice. There was no degenerative structural change in the sinoatrial node of kl/kl mice. The precise localization of klotho was analyzed in newly prepared klotho-null mice with a reporter gene system (kl–geo). Homozygous kl–geo mice showed characteristic age-associated phenotypes that were almost identical to those of kl/kl mice. In the kl–geo mice, klotho expression was recognized exclusively in the sinoatrial node region in the heart in addition to parathyroid, kidney, and choroid plexus.
Conclusions— In the heart, klotho is expressed solely at the sinoatrial node. klotho gene expression is essential for the sinoatrial node to function as a dependable pacemaker under conditions of stress.
Key Words: genetics • death, sudden • aging • sinoatrial node
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2009/06/21
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Germ line gene therapyIn the case of germ line gene therapy, germ cells, i.e., sperm or eggs, are modified by the introduction of functional genes, which are ordinarily integrated into their genomes. Therefore, the change due to therapy would be heritable and would be passed on to later generations. This new approach, theoretically, should be highly effective in counteracting genetic disorders. However, this option is prohibited for application in human beings, at least for the present, for a variety of technical and ethical reasons.Somatic cell gene therapyIn somatic cell gene therapy, the gene is introduced only in somatic cells, especially of these tissues in which expression of the concerned gene is critical for health. Expression of the introduced gene relieves/ eliminates symptoms of the disorder, but this effect is not heritable as it does not involve the germ line. At present, somatic cell therapy is the only feasible option, and clinical trials addressing a variety of conditions have already begun
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Changes at conceptionGenetic engineering is most easily accomplished by making changes just after the egg and sperm have melded but before first division. In this way, the gene will be expressed throughout and will affect the recipients children, grandchildren, and all subsequent generations. Germline engineering is controversial because there is insufficient knowledge about DNA expression to accurately judge what result these changes will have.Changes after birthAs of now, this is likely to take the form of gene therapy. This would not be hereditary unless the sex cells are engineered.
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There are limitations to what current technology can do. Research scientists want to get finer control on how DNA sequences might be added to a host cell. Technologies that could offer this sort of control might well result from a merger of highly engineered/modified viruses with micromechanical technologies, modified to migrate to a particular specified N nucleotide sequence in the host DNA for N significantly large to minimize targeting errors, then precisely and efficiently insert the desired snippet in the correct position in the host. Evidently it would be desirable to allow such a device/organism to feed on available resources in the host in order to migrate from cell to cell and perform this process until a significant proportion of host cells had been transformed; it would then be desirable for the device to disable itself. Also it would be desirable for the device to understand when it had finished with a cell (e.g. after levels of a desired protein reach a critical threshold, though this would be perhaps too slow, i.e. movement via measurement of some sort of chemical gradient) so that it could move on. Certainly such devices could not be user controlled for a large population; they would need to be autonomous.Since DNA sequences vary from individual to individual, and individuals may even be chimeras, also required would be the capability to sequence individual genomes, the ability to target fixes to particular parts of a chimera population, and finally a good understanding of how to avoid disruptive edits- that is, edits that do not disrupt the functioning of some other process in the cell. This requires some level of mastery of the area of proteomics, that is, the understanding of a lifeform's proteome.
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Current technology :
One available method is gene manipulation through virus insertion. The main mechanism by which this operates is a fairly standard one; one is taking advantage of the way viruses hi-jack the cellular machinery to make multiple copies of themselves. The way they do this is by inserting a segment of their genome into the DNA of the host after penetrating the cellular wall, and so use this to instruct the host cell to produce multiple copies of the virus. This process could be utilized as a mechanism to spread new DNA by altering the genome of the virus itself to include the desired new DNA sequence. The altered virus could be injected into a host cell, where it would propagate and eventually spread the new DNA throughout the host’s body. Problems with this approach may be:Randomness of the insertion of the DNA fragment wanted (this might lead, for instance, to a cell turning cancerous, or being more subtly disrupted),Possible lack of control over the immune response to the "retrovirus", andPossible problems getting complete transformation of the target cell population.Another approach is to take advantage of the cell's endogenous ability to undergo homologous recombination wherein an exogenous DNA fragement with ends matching an endogenous gene replaces the target gene by action of enzymes called recombinases. This is the technology used for "knockouts" and "knock-ins" and generally cannot be performed on an intact organism and is therefore only a candidate for germline (i.e. single cell) genetic manipulation. This technology has very widespread usage in mouse genetics wherein genetically altered embryos are grown in a surrogate mother. This could easily be extended to humans in the very near future as there are no major additional technological hurdles remaining to engineer humans versus mice (though minor hurdles certainly remain). The primary hurdle is ethical, as the efficiency of this process can be quite poor and many embryos would be sacrificed in order to produce one genetically modified offspring.
One available method is gene manipulation through virus insertion. The main mechanism by which this operates is a fairly standard one; one is taking advantage of the way viruses hi-jack the cellular machinery to make multiple copies of themselves. The way they do this is by inserting a segment of their genome into the DNA of the host after penetrating the cellular wall, and so use this to instruct the host cell to produce multiple copies of the virus. This process could be utilized as a mechanism to spread new DNA by altering the genome of the virus itself to include the desired new DNA sequence. The altered virus could be injected into a host cell, where it would propagate and eventually spread the new DNA throughout the host’s body. Problems with this approach may be:Randomness of the insertion of the DNA fragment wanted (this might lead, for instance, to a cell turning cancerous, or being more subtly disrupted),Possible lack of control over the immune response to the "retrovirus", andPossible problems getting complete transformation of the target cell population.Another approach is to take advantage of the cell's endogenous ability to undergo homologous recombination wherein an exogenous DNA fragement with ends matching an endogenous gene replaces the target gene by action of enzymes called recombinases. This is the technology used for "knockouts" and "knock-ins" and generally cannot be performed on an intact organism and is therefore only a candidate for germline (i.e. single cell) genetic manipulation. This technology has very widespread usage in mouse genetics wherein genetically altered embryos are grown in a surrogate mother. This could easily be extended to humans in the very near future as there are no major additional technological hurdles remaining to engineer humans versus mice (though minor hurdles certainly remain). The primary hurdle is ethical, as the efficiency of this process can be quite poor and many embryos would be sacrificed in order to produce one genetically modified offspring.
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Introduction:
Intraoperatively, the anatomy of the heart is viewed from the right side of the supine patient via a median sternotomy incision. The structures initially seen from this perspective include the superior vena cava, right atrium, right ventricle, pulmonary artery, and aorta. Medial displacement of the right side of the heart exposes the left atrium and right pulmonary veins. Medial rotation from the left exposes the left ventricle apex, left pulmonary veins, and left atrium.
The overall shape and position of the heart may vary according to the relative size and orientation of each of its parts. For example, a large right ventricle may allow exposure of only a short segment of aorta; this is because of the narrow confines of the middle mediastinal space.
Cardiac Chambers:
Right atrium
The superior vena cava and inferior vena cava drain systemic venous blood into the posterior wall of the right atrium. The internal wall of the right atrium is composed of a smooth posterior portion (into which the vena cavae and coronary sinus drain) and a ridgelike muscular anterior portion. The coronary sinus drains coronary venous blood into the anteroinferior portion of the right atrium. The thebesian valve is located at the orifice of the coronary sinus. The limbus of the fossa ovalis is located on the medial wall of the right atrium and circumscribes the septum primum of the fossa ovalis anteriorly, posteriorly, and superiorly.
The right auricle is separated from the right atrium by a shallow posterior vertical indentation on the right atrium (ie, the sulcus terminalis) and, internally, by a vertical crest (ie, the crista terminalis). The crista terminalis separates the right atrium into trabeculated and nontrabeculated portions.
Congenital anomalies of right atrial components can be associated with clinically significant cardiac malformations. For example, in patients with tricuspid atresia, the eustachian and thebesian valves may be so enlarged that they physically separate the right atrium into 2 distinct sections. Other variations include juxtaposition of both atrial appendages and malpositioning of both appendages.
Left atrium
The 4 pulmonary veins drain into the left atrium. The flap valve of the fossa ovalis is located on the septal surface of the left atrium. The appendage of the left atrium is consistently narrow and long; recognition of this appendage is the most reliable way to differentiate the left atrium from the right atrium. The left atrial appendage is the only trabeculated structure in the left atrium because, unlike the right atrium, the left atrium has no crista terminalis.
Right ventricle
The right ventricle receives blood from the right atrium across the tricuspid valve, which is located in the large anterolateral (ie, sinus) portion of the right ventricle. The right ventricle discharges blood into the pulmonary artery across the pulmonic (semilunar) valve located in the outflow tract (infundibulum). The inflow tract (sinus) and outflow tract (infundibulum) of the right ventricle are widely separated. Internally, both the sinus area and infundibulum contain coarse trabeculations.
The septal portion of the right ventricle has 3 components: (1) the inflow tract, which supports the tricuspid valve; (2) the trabecular wall, which typifies the internal appearance of the right ventricle; and (3) the outflow tract, which itself is subdivided into 3 components, namely, the conal septum, septal band division, and trabecular septum. Of these 3 subdivisions, the conal septum is clinically significant because it can be malpositioned in patients with congenital disorders (eg, double outlet right ventricle).
Lateral to the conal septum, the parietal extension of the infundibular septum and the infundibular fold comprise the crista supraventricularis. Ventricular septal defects (VSDs) commonly occur in the area between the sinus and the outlet tract of the right ventricle. However, because the surface of the right ventricle is trabecular, small defects of the muscular portion of the ventricular septum may be difficult to see.
The tricuspid valve is supported by a large anterior papillary muscle, which arises from the anterior free wall and the moderator band, and by several small posterior papillary muscles, which attach posteriorly to the septal band.
Left ventricle
The left ventricle receives blood from the left atrium via the mitral (ie, bicuspid) valve and ejects blood across the aortic valve in the aorta. The left ventricle can be divided into 2 primary portions, namely, the large sinus portion containing the mitral valve and the small outflow tract that supports the aortic (semilunar) valve. Inflow and outflow portions are closely juxtaposed, unlike in the right ventricle, in which the tricuspid and pulmonic valves are widely separated.
The free wall and apical half of the septum contain fine internal trabeculations. The septal surface is divided into a trabeculated portion (sinus) and a smooth portion (outflow). The sinus area just beneath the mitral valve is termed the inlet septum; the remainder of the sinus area is termed the trabecular septum. The outflow tract is located anterior to the anterior mitral leaflet and is part of the atrioventricular (AV) septum. Both the right half of the anterior mitral valve leaflet and the right aortic cusp attach to the septum. (In the right ventricle, only the septal tricuspid leaflet attaches to the septum.)
The left half of the anterior mitral leaflet is in direct fibrous contact with the aortic valve at the aortic-mitral annulus. The conal septum of the right ventricle is positioned opposite the aortic valve. The mitral valve is supported by 2 large papillary muscles (ie, anterolateral, posteromedial) attached to the free wall. The anterior papillary muscle is attached to the anterior portion of the left ventricular wall, and the posterior papillary muscle arises more posteriorly from the ventricle's inferior wall.1
The superior vena cava and inferior vena cava drain systemic venous blood into the posterior wall of the right atrium. The internal wall of the right atrium is composed of a smooth posterior portion (into which the vena cavae and coronary sinus drain) and a ridgelike muscular anterior portion. The coronary sinus drains coronary venous blood into the anteroinferior portion of the right atrium. The thebesian valve is located at the orifice of the coronary sinus. The limbus of the fossa ovalis is located on the medial wall of the right atrium and circumscribes the septum primum of the fossa ovalis anteriorly, posteriorly, and superiorly.
The right auricle is separated from the right atrium by a shallow posterior vertical indentation on the right atrium (ie, the sulcus terminalis) and, internally, by a vertical crest (ie, the crista terminalis). The crista terminalis separates the right atrium into trabeculated and nontrabeculated portions.
Congenital anomalies of right atrial components can be associated with clinically significant cardiac malformations. For example, in patients with tricuspid atresia, the eustachian and thebesian valves may be so enlarged that they physically separate the right atrium into 2 distinct sections. Other variations include juxtaposition of both atrial appendages and malpositioning of both appendages.
Left atrium
The 4 pulmonary veins drain into the left atrium. The flap valve of the fossa ovalis is located on the septal surface of the left atrium. The appendage of the left atrium is consistently narrow and long; recognition of this appendage is the most reliable way to differentiate the left atrium from the right atrium. The left atrial appendage is the only trabeculated structure in the left atrium because, unlike the right atrium, the left atrium has no crista terminalis.
Right ventricle
The right ventricle receives blood from the right atrium across the tricuspid valve, which is located in the large anterolateral (ie, sinus) portion of the right ventricle. The right ventricle discharges blood into the pulmonary artery across the pulmonic (semilunar) valve located in the outflow tract (infundibulum). The inflow tract (sinus) and outflow tract (infundibulum) of the right ventricle are widely separated. Internally, both the sinus area and infundibulum contain coarse trabeculations.
The septal portion of the right ventricle has 3 components: (1) the inflow tract, which supports the tricuspid valve; (2) the trabecular wall, which typifies the internal appearance of the right ventricle; and (3) the outflow tract, which itself is subdivided into 3 components, namely, the conal septum, septal band division, and trabecular septum. Of these 3 subdivisions, the conal septum is clinically significant because it can be malpositioned in patients with congenital disorders (eg, double outlet right ventricle).
Lateral to the conal septum, the parietal extension of the infundibular septum and the infundibular fold comprise the crista supraventricularis. Ventricular septal defects (VSDs) commonly occur in the area between the sinus and the outlet tract of the right ventricle. However, because the surface of the right ventricle is trabecular, small defects of the muscular portion of the ventricular septum may be difficult to see.
The tricuspid valve is supported by a large anterior papillary muscle, which arises from the anterior free wall and the moderator band, and by several small posterior papillary muscles, which attach posteriorly to the septal band.
Left ventricle
The left ventricle receives blood from the left atrium via the mitral (ie, bicuspid) valve and ejects blood across the aortic valve in the aorta. The left ventricle can be divided into 2 primary portions, namely, the large sinus portion containing the mitral valve and the small outflow tract that supports the aortic (semilunar) valve. Inflow and outflow portions are closely juxtaposed, unlike in the right ventricle, in which the tricuspid and pulmonic valves are widely separated.
The free wall and apical half of the septum contain fine internal trabeculations. The septal surface is divided into a trabeculated portion (sinus) and a smooth portion (outflow). The sinus area just beneath the mitral valve is termed the inlet septum; the remainder of the sinus area is termed the trabecular septum. The outflow tract is located anterior to the anterior mitral leaflet and is part of the atrioventricular (AV) septum. Both the right half of the anterior mitral valve leaflet and the right aortic cusp attach to the septum. (In the right ventricle, only the septal tricuspid leaflet attaches to the septum.)
The left half of the anterior mitral leaflet is in direct fibrous contact with the aortic valve at the aortic-mitral annulus. The conal septum of the right ventricle is positioned opposite the aortic valve. The mitral valve is supported by 2 large papillary muscles (ie, anterolateral, posteromedial) attached to the free wall. The anterior papillary muscle is attached to the anterior portion of the left ventricular wall, and the posterior papillary muscle arises more posteriorly from the ventricle's inferior wall.1
Great Vessels and SeptAorta
The aorta begins at the base of the heart and typically branches to form the coronary arteries just distal to the aortic valve. In patients with cardiac malformations, the aorta almost always can be identified by tracing it back from the brachiocephalic arteries, which only very rarely originate from the pulmonary artery.
Pulmonary artery
The main pulmonary artery branches into the pulmonary arterial system. In patients with aberrant cardiac anatomy with a patent ductus arteriosus, accurate identification of the pulmonary artery can be difficult using angiography because the pulmonary artery becomes opaque during aortic injection. To differentiate the pulmonary artery from the aortic valve, remember that the pulmonary artery almost never gives off brachiocephalic branches.
Ventricular septum
The ventricular septum is divided into a muscular section (inferior) and a membranous section (superior). The muscular portion comprises the left and right ventricular walls. The membranous septum, also termed the pars membranacea, is a fibrous structure partially separating the left ventricular outflow tract from the right atrium and ventricle.
Atrioventricular septum
The atrioventricular (AV) septum, located behind the right atrium and left ventricle, is divided into 2 portions: a superior portion (membranous) and an inferior portion (muscular). Inside the left ventricle, the muscular component comprises part of the outlet septum. The AV node lies in the atrial septum, juxtaposed to the membranous and muscular portions of the AV septum.i:
The aorta begins at the base of the heart and typically branches to form the coronary arteries just distal to the aortic valve. In patients with cardiac malformations, the aorta almost always can be identified by tracing it back from the brachiocephalic arteries, which only very rarely originate from the pulmonary artery.
Pulmonary artery
The main pulmonary artery branches into the pulmonary arterial system. In patients with aberrant cardiac anatomy with a patent ductus arteriosus, accurate identification of the pulmonary artery can be difficult using angiography because the pulmonary artery becomes opaque during aortic injection. To differentiate the pulmonary artery from the aortic valve, remember that the pulmonary artery almost never gives off brachiocephalic branches.
Ventricular septum
The ventricular septum is divided into a muscular section (inferior) and a membranous section (superior). The muscular portion comprises the left and right ventricular walls. The membranous septum, also termed the pars membranacea, is a fibrous structure partially separating the left ventricular outflow tract from the right atrium and ventricle.
Atrioventricular septum
The atrioventricular (AV) septum, located behind the right atrium and left ventricle, is divided into 2 portions: a superior portion (membranous) and an inferior portion (muscular). Inside the left ventricle, the muscular component comprises part of the outlet septum. The AV node lies in the atrial septum, juxtaposed to the membranous and muscular portions of the AV septum.i:
Conduction System:
Sinus node
The sinoatrial (SA) node occupies a 1-cm2 area on the lateral surface of the junction of the superior vena cava and right atrium near the crista terminalis. The sinus node is found superficially at the anterolateral aspect of the junction between the superior vena cava and the right atrial appendage. In rare cases, the SA node may be found medially along the ridge of the atrial-caval junction.
Internodal pathways
The spread of electrical activation from the sinus node extends toward the atrioventricular (AV) node via Purkinjelike pale cells in atrial muscle bundles. Anterior, medial, and posterior interatrial conduction pathways arise from the SA node. The anterior and medial pathways are located anterior and posterior to the foramen ovale; the posterior pathway is situated caudal to the foramen ovale.
Atrioventricular node
The AV node is situated directly on the right atrial side of the central fibrous body in the muscular portion of the AV septum, just superior and anterior to the ostium of the coronary sinus. Measuring approximately 0.1 cm X 0.3 cm X 0.6 cm, the node is flat and oval. The node's left surface is juxtaposed to the mitral anulus.
His bundle and bundle branches
The AV node continues onto the His bundle via a course inferior to the commissure between the septal and anterior leaflets of the tricuspid valve. The bundle follows a course along the inferior border of the membranous septum and, near the aortic valve, gives off fibers that form the left bundle branch. The His bundle is located on the left side of the ventricular septum in 80% of patients. In the 20% of patients in whom the bundle is on the right side of the septum, the His bundle is connected to the left bundle by a narrow stem.
The left bundle branch further subdivides into several smaller branches that begin at the ventricular septal surface and radiate around the left ventricle. The right bundle branch originates from the His bundle near the membranous septum and courses along the right ventricular septal surface, passing toward the base of the anterior papillary muscle.2,3
The sinoatrial (SA) node occupies a 1-cm2 area on the lateral surface of the junction of the superior vena cava and right atrium near the crista terminalis. The sinus node is found superficially at the anterolateral aspect of the junction between the superior vena cava and the right atrial appendage. In rare cases, the SA node may be found medially along the ridge of the atrial-caval junction.
Internodal pathways
The spread of electrical activation from the sinus node extends toward the atrioventricular (AV) node via Purkinjelike pale cells in atrial muscle bundles. Anterior, medial, and posterior interatrial conduction pathways arise from the SA node. The anterior and medial pathways are located anterior and posterior to the foramen ovale; the posterior pathway is situated caudal to the foramen ovale.
Atrioventricular node
The AV node is situated directly on the right atrial side of the central fibrous body in the muscular portion of the AV septum, just superior and anterior to the ostium of the coronary sinus. Measuring approximately 0.1 cm X 0.3 cm X 0.6 cm, the node is flat and oval. The node's left surface is juxtaposed to the mitral anulus.
His bundle and bundle branches
The AV node continues onto the His bundle via a course inferior to the commissure between the septal and anterior leaflets of the tricuspid valve. The bundle follows a course along the inferior border of the membranous septum and, near the aortic valve, gives off fibers that form the left bundle branch. The His bundle is located on the left side of the ventricular septum in 80% of patients. In the 20% of patients in whom the bundle is on the right side of the septum, the His bundle is connected to the left bundle by a narrow stem.
The left bundle branch further subdivides into several smaller branches that begin at the ventricular septal surface and radiate around the left ventricle. The right bundle branch originates from the His bundle near the membranous septum and courses along the right ventricular septal surface, passing toward the base of the anterior papillary muscle.2,3
Cardiac Valves:
Cardiac valves are categorized into 2 groups, based on function and morphology. Mitral and tricuspid valves comprise the atrioventricular (AV) group; aortic and pulmonary valves comprise the semilunar group. On cross section, the aortic valve is located in a central location, halfway between the mitral and tricuspid valves. The pulmonary valve is positioned anterior, superior, and slightly to the left of the aortic valve. The tricuspid and mitral anuli merge and fuse with each other and with the membranous septum to form the fibrous skeleton of the heart.
Mitral valve
The AV valve of the left ventricle is bicuspid. The AV valve has a large anterior leaflet (septal or aortic) and a smaller posterior leaflet (mural or ventricular). The anterior leaflet is triangular with a smooth texture. The posterior leaflet has a scalloped appearance. The chordae tendineae to the mitral valve originate from the 2 large papillary muscles of the left ventricle and insert primarily on the leaflet's free edge.
Tricuspid valve
The AV valve of the right ventricle has anterior, posterior, and septal leaflets. The orifice is larger than the mitral orifice and is triangular. The tricuspid valve leaflets and chordae are more fragile than those of the mitral valve. The anterior leaflet, largest of the 3 leaflets, often has notches. The posterior leaflet, smallest of the 3 leaflets, is usually scalloped. The septal leaflet usually attaches to the membranous and muscular portions of the ventricular septum.
A major factor to consider during surgery is the proximity of the conduction system to the septal leaflet. The membranous septum lies beneath the septal leaflet, where the His bundle penetrates the right trigone beneath the interventricular membranous septum. Moreover, the portion of the septal leaflet between the membranous septum and the commissure may form a flap valve over some ventricular septal defects (VSDs).
Aortic valve
The aortic valve has 3 leaflets composed of fragile cusps and the sinuses of Valsalva. Thus, the valve apparatus is composed of 3 cuplike structures that are in continuity with the membranous septum and the mitral anterior leaflet. The free end of each cusp has a stronger consistency than the cusp. The midpoint of each free edge contains the fibrous nodulus arantii, which bisects the thin crescent-shaped lunula on either side.
The aortic sinuses of Valsalva are 3 dilations of the aortic root that arise from the 3 closing cusps of the aortic valve. The right and left sinuses give rise to the right and left coronary arteries; the noncoronary sinus has no coronary artery. The sinus of Valsalva walls are much thinner than the aortic wall, which is a factor of surgical significance; therefore, aortotomies are typically performed away from this region.
The aortic annulus is situated anteriorly to the mitral valve annulus and the anterior leaflet of the mitral valve. The cranial portion of the left atrium is interposed between the aortic and mitral valves. Anteriorly, the aortic annulus is related to the ventricular septum and right ventricular outflow tract. The His bundle courses beneath the right and noncoronary aortic valve cusps of the membranous ventricular septum. Thus, incision of the aortic annulus or septal myocardium anterior to the right coronary sinus should not interfere with the conduction system.
Pulmonary valve
As with the aortic valve, the pulmonary valve has 3 cusps, with a midpoint nodule at the free end and lunulae on either side; a sinus is located behind each cusp. Compared with the aortic valve, the pulmonary valve has thinner cusps, no associated coronary arteries, and no continuity with the corresponding (anterior) tricuspid valve leaflet. The term used for each cusp reflects its relationship to the aortic valve, namely, right, left, and nonseptal.1
Cardiac valves are categorized into 2 groups, based on function and morphology. Mitral and tricuspid valves comprise the atrioventricular (AV) group; aortic and pulmonary valves comprise the semilunar group. On cross section, the aortic valve is located in a central location, halfway between the mitral and tricuspid valves. The pulmonary valve is positioned anterior, superior, and slightly to the left of the aortic valve. The tricuspid and mitral anuli merge and fuse with each other and with the membranous septum to form the fibrous skeleton of the heart.
Mitral valve
The AV valve of the left ventricle is bicuspid. The AV valve has a large anterior leaflet (septal or aortic) and a smaller posterior leaflet (mural or ventricular). The anterior leaflet is triangular with a smooth texture. The posterior leaflet has a scalloped appearance. The chordae tendineae to the mitral valve originate from the 2 large papillary muscles of the left ventricle and insert primarily on the leaflet's free edge.
Tricuspid valve
The AV valve of the right ventricle has anterior, posterior, and septal leaflets. The orifice is larger than the mitral orifice and is triangular. The tricuspid valve leaflets and chordae are more fragile than those of the mitral valve. The anterior leaflet, largest of the 3 leaflets, often has notches. The posterior leaflet, smallest of the 3 leaflets, is usually scalloped. The septal leaflet usually attaches to the membranous and muscular portions of the ventricular septum.
A major factor to consider during surgery is the proximity of the conduction system to the septal leaflet. The membranous septum lies beneath the septal leaflet, where the His bundle penetrates the right trigone beneath the interventricular membranous septum. Moreover, the portion of the septal leaflet between the membranous septum and the commissure may form a flap valve over some ventricular septal defects (VSDs).
Aortic valve
The aortic valve has 3 leaflets composed of fragile cusps and the sinuses of Valsalva. Thus, the valve apparatus is composed of 3 cuplike structures that are in continuity with the membranous septum and the mitral anterior leaflet. The free end of each cusp has a stronger consistency than the cusp. The midpoint of each free edge contains the fibrous nodulus arantii, which bisects the thin crescent-shaped lunula on either side.
The aortic sinuses of Valsalva are 3 dilations of the aortic root that arise from the 3 closing cusps of the aortic valve. The right and left sinuses give rise to the right and left coronary arteries; the noncoronary sinus has no coronary artery. The sinus of Valsalva walls are much thinner than the aortic wall, which is a factor of surgical significance; therefore, aortotomies are typically performed away from this region.
The aortic annulus is situated anteriorly to the mitral valve annulus and the anterior leaflet of the mitral valve. The cranial portion of the left atrium is interposed between the aortic and mitral valves. Anteriorly, the aortic annulus is related to the ventricular septum and right ventricular outflow tract. The His bundle courses beneath the right and noncoronary aortic valve cusps of the membranous ventricular septum. Thus, incision of the aortic annulus or septal myocardium anterior to the right coronary sinus should not interfere with the conduction system.
Pulmonary valve
As with the aortic valve, the pulmonary valve has 3 cusps, with a midpoint nodule at the free end and lunulae on either side; a sinus is located behind each cusp. Compared with the aortic valve, the pulmonary valve has thinner cusps, no associated coronary arteries, and no continuity with the corresponding (anterior) tricuspid valve leaflet. The term used for each cusp reflects its relationship to the aortic valve, namely, right, left, and nonseptal.1
Coronary Arteries:The 2 main coronary arteries are the right and left. However, from a surgical standpoint, 4 main arteries are named: the left main, the left anterior descending, and the left circumflex (LCX) arteries (which are all branches of the left coronary artery) and the right coronary artery (RCA). The RCA and LCXs form a circle around the atrioventricular (AV) sulci. The left anterior descending and posterior descending arteries form a loop at right angles to this circle; these arteries feed the ventricular septum. The LCX gives off several parallel, obtuse, marginal arteries that supply the posterior left ventricle. The diagonal branches of the left anterior descending artery supply the anterior portion of the left ventricle.
The term dominance is used to refer to the origin of the posterior descending artery (PDA). When the PDA is formed from the terminal branch of the RCA (>85% of patients), it is termed a right-dominant heart. A left-dominant heart receives its PDA blood supply from a left coronary branch, usually the LCX. This is often referred to as a left posterolateral branch (LPL).
Left main coronary artery
The left main coronary artery (LCA) originates from the ostium of the left sinus of Valsalva. The LCA, which courses between the left atrial appendage and the pulmonary artery, typically is 1-2 cm in length. When it reaches the left AV groove, the LCA bifurcates into the left anterior descending (LAD) and the LCX branches. The LCA supplies most of the left atrium, left ventricle, interventricular septum, and AV bundles. The LCA arises from the left aortic sinus and courses between the left auricle and the pulmonary trunk to reach the coronary groove.
Left anterior descending artery
After originating from the left main artery, the LAD artery runs along the anterior interventricular sulcus and supplies the apical portion of both ventricles. The LAD artery is mostly epicardial but can be intramuscular in places. An important identifying characteristic of the LAD artery during angiography is the identification of 4-6 perpendicular septal branches. These branches, approximately 7.5 cm in length, supply the interventricular septum.
The first branch of the LAD artery is termed the ramus intermedius. In fewer than 1% of patients, the LCA is absent, and the LAD and LCX arteries originate from the aorta via 2 separate ostia. As the LAD artery passes along the anterior interventricular groove toward the apex, it turns sharply to anastomose with the posterior interventricular branch of the RCA. As the LAD artery courses anteriorly along the ventricular septum, it sends off diagonal branches to the lateral wall of the left ventricle. Congenital LAD artery variations may include its duplication as 2 parallel arteries (4% incidence) and length variations (premature or delayed distal termination).
Left circumflex artery
The LCA gives off the LCX artery at a right angle near the base of the left atrial appendage. The LCX artery courses in the coronary groove around the left border of the heart to the posterior surface of the heart to anastomose to the end of the RCA. In the AV groove, the LCX artery lies close to the annulus of the mitral valve. The atrial circumflex artery, the first branch off the LCX artery, supplies the left atrium. The LCX artery gives off an obtuse marginal (OM) branch at the left border of the heart near the base of the left atrial appendage to supply the posterolateral surface of the left ventricle. The color contrast between the yellow-orange OM and the adjacent red-brown myocardium may be the most reliable way to identify this artery intraoperatively. In patients with a left-dominant heart, the LCX artery supplies the PDA. Many variations in the origin and length of the LCX artery are noted. In fewer than 40% of patients, the sinus node artery may originate from the LCX artery.
Right coronary artery
The RCA is a single large artery that courses along the right AV groove. The RCA supplies the right atrium, right ventricle, interventricular septum, and the SA and AV nodes. The RCA arises from the right aortic sinus and courses in the coronary (AV) groove between the right auricle and the right ventricle. In 60% of patients, the first branch of the RCA is the sinus node artery. As the RCA passes toward the inferior border of the heart, it gives off a right marginal branch that supplies the apex of the heart. After this branching, the RCA turns left to enter the posterior interventricular groove to give off the PDA, which supplies both ventricles.
The AV node artery arises from the "U-turn" of the RCA at the crux (ie, the junction of the AV septum with the AV groove). At this point, the PDA feeds the septal, right ventricular, and left ventricular branches. The PDA courses over the ventricular septum on the diaphragmatic surface of the heart. Unlike the septal branches off the LAD artery, the septal branches from the RCA typically are short (<1.5 cm). Terminal branches of the RCA supply the posteromedial papillary muscle of the left ventricle. (The LAD artery supplies the anterolateral papillary muscle of the right ventricle.) Near the apex, the PDA anastomoses with the anterior interventricular branch of the LCA.
Common variations involving RCA anatomy include the following:
An RCA originating from the right sinus of Valsalva
The sinus node artery originating from the RCA
The acute marginal (AM) artery crossing the inferior aspect of the right ventricle to supply the diaphragmatic interventricular septum.
The term dominance is used to refer to the origin of the posterior descending artery (PDA). When the PDA is formed from the terminal branch of the RCA (>85% of patients), it is termed a right-dominant heart. A left-dominant heart receives its PDA blood supply from a left coronary branch, usually the LCX. This is often referred to as a left posterolateral branch (LPL).
Left main coronary artery
The left main coronary artery (LCA) originates from the ostium of the left sinus of Valsalva. The LCA, which courses between the left atrial appendage and the pulmonary artery, typically is 1-2 cm in length. When it reaches the left AV groove, the LCA bifurcates into the left anterior descending (LAD) and the LCX branches. The LCA supplies most of the left atrium, left ventricle, interventricular septum, and AV bundles. The LCA arises from the left aortic sinus and courses between the left auricle and the pulmonary trunk to reach the coronary groove.
Left anterior descending artery
After originating from the left main artery, the LAD artery runs along the anterior interventricular sulcus and supplies the apical portion of both ventricles. The LAD artery is mostly epicardial but can be intramuscular in places. An important identifying characteristic of the LAD artery during angiography is the identification of 4-6 perpendicular septal branches. These branches, approximately 7.5 cm in length, supply the interventricular septum.
The first branch of the LAD artery is termed the ramus intermedius. In fewer than 1% of patients, the LCA is absent, and the LAD and LCX arteries originate from the aorta via 2 separate ostia. As the LAD artery passes along the anterior interventricular groove toward the apex, it turns sharply to anastomose with the posterior interventricular branch of the RCA. As the LAD artery courses anteriorly along the ventricular septum, it sends off diagonal branches to the lateral wall of the left ventricle. Congenital LAD artery variations may include its duplication as 2 parallel arteries (4% incidence) and length variations (premature or delayed distal termination).
Left circumflex artery
The LCA gives off the LCX artery at a right angle near the base of the left atrial appendage. The LCX artery courses in the coronary groove around the left border of the heart to the posterior surface of the heart to anastomose to the end of the RCA. In the AV groove, the LCX artery lies close to the annulus of the mitral valve. The atrial circumflex artery, the first branch off the LCX artery, supplies the left atrium. The LCX artery gives off an obtuse marginal (OM) branch at the left border of the heart near the base of the left atrial appendage to supply the posterolateral surface of the left ventricle. The color contrast between the yellow-orange OM and the adjacent red-brown myocardium may be the most reliable way to identify this artery intraoperatively. In patients with a left-dominant heart, the LCX artery supplies the PDA. Many variations in the origin and length of the LCX artery are noted. In fewer than 40% of patients, the sinus node artery may originate from the LCX artery.
Right coronary artery
The RCA is a single large artery that courses along the right AV groove. The RCA supplies the right atrium, right ventricle, interventricular septum, and the SA and AV nodes. The RCA arises from the right aortic sinus and courses in the coronary (AV) groove between the right auricle and the right ventricle. In 60% of patients, the first branch of the RCA is the sinus node artery. As the RCA passes toward the inferior border of the heart, it gives off a right marginal branch that supplies the apex of the heart. After this branching, the RCA turns left to enter the posterior interventricular groove to give off the PDA, which supplies both ventricles.
The AV node artery arises from the "U-turn" of the RCA at the crux (ie, the junction of the AV septum with the AV groove). At this point, the PDA feeds the septal, right ventricular, and left ventricular branches. The PDA courses over the ventricular septum on the diaphragmatic surface of the heart. Unlike the septal branches off the LAD artery, the septal branches from the RCA typically are short (<1.5 cm). Terminal branches of the RCA supply the posteromedial papillary muscle of the left ventricle. (The LAD artery supplies the anterolateral papillary muscle of the right ventricle.) Near the apex, the PDA anastomoses with the anterior interventricular branch of the LCA.
Common variations involving RCA anatomy include the following:
An RCA originating from the right sinus of Valsalva
The sinus node artery originating from the RCA
The acute marginal (AM) artery crossing the inferior aspect of the right ventricle to supply the diaphragmatic interventricular septum.
Coronary Veins:
The coronary sinus is a short (approximately 2 cm) and wide venous channel that runs from left to right in the posterior portion of the coronary groove. The opening of the coronary sinus is located between the right atrioventricular (AV) orifice and the inferior vena cava orifice. The coronary sinus drains all venous blood from the heart except the blood carried from the anterior cardiac veins. The coronary sinus receives outflow from the great cardiac vein on the left and from the middle and small cardiac veins on the right.
The great cardiac vein is the main tributary of the coronary sinus and drains areas of the heart supplied by the left main coronary artery (LCA). It begins at the apex of the heart, ascends in the anterior interventricular groove with the left anterior descending (LAD) artery, and enters the left end of the coronary sinus.
The middle and small cardiac veins drain most of the heart supplied by the right coronary artery (RCA). The middle cardiac vein begins at the apex, ascends in the posterior interventricular groove with the posterior interventricular artery, and empties into the right side of the coronary sinus. The small cardiac vein runs in the coronary groove along with the marginal branch of the RCA; this vein usually empties into the coronary sinus but may empty directly into the right atrium.
Coronary veins of the right ventricle drain directly into the right atrium; thebesian veins drain into the right ventricle. The left ventricle venous return drains into the coronary sinus located next to the septal portion of the tricuspid valve annulus.
The great cardiac vein is the main tributary of the coronary sinus and drains areas of the heart supplied by the left main coronary artery (LCA). It begins at the apex of the heart, ascends in the anterior interventricular groove with the left anterior descending (LAD) artery, and enters the left end of the coronary sinus.
The middle and small cardiac veins drain most of the heart supplied by the right coronary artery (RCA). The middle cardiac vein begins at the apex, ascends in the posterior interventricular groove with the posterior interventricular artery, and empties into the right side of the coronary sinus. The small cardiac vein runs in the coronary groove along with the marginal branch of the RCA; this vein usually empties into the coronary sinus but may empty directly into the right atrium.
Coronary veins of the right ventricle drain directly into the right atrium; thebesian veins drain into the right ventricle. The left ventricle venous return drains into the coronary sinus located next to the septal portion of the tricuspid valve annulus.
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