Search

Objectives: This study aimed to investigate the association between time to percutaneous coronary intervention (PCI) and hospital mortality in non-ST-elevation myocardial infarction (NSTEMI).Methods: Adult patients with NSTEMI were enrolled from November 2007 to December 2012 at 28 emergency departments (EDs) in Korea, excluding those who met the following criteria: age less than 20 years, PCI not performed or performed after 72 hours, cardiac arrest at ED presentation, and unknown outcome. Exposure variable was defined as early PCI (<6 hours after ED arrival) and late PCI group (≥6 hours). The primary outcome was hospital mortality. The adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) for late vs early PCI on mortality were calculated in original data set and propensity score-matched data set using multivariable logistic regression models with/without interaction term (PCI group and time from symptom to ED arrival within 12 hours, or S2D).Results: A total of 4363 patients were analyzed as early (n = 1109) and late (n = 3254) PCI groups. The mortality rates were 2.4%, 5.4%, and 1.5% for the total, early, and late PCI groups, respectively. Adjusted ORs (95% CIs) of late PCI for hospital mortality were 0.36 (0.22-0.61) in the original cohort and 0.29 (0.27-0.48) in the propensity score-matched cohort, respectively. Adjusted ORs (95% CIs) in the propensity score-matched subset were 0.28 (0.17-0.45) in the short S2D group and 0.50 (0.18-1.37) in the long S2D group, respectively.Conclusions: Percutaneous coronary intervention earlier than 6 hours after ED presentation was associated with higher hospital mortality than PCI 6 hours later in NSTEMI. However, the effect disappeared in the long S2D group. [ABSTRACT FROM AUTHOR]

JUMONJI (JMJ) is a nuclear factor that is critical for normal cardiovascular development, evidenced by the analysis of jmj homozygous mutant mice. However, the molecular function of JMJ remains to be elucidated. In the present study, we investigated whether JMJ is a transcriptional modulator. Reporter gene assays using the GAL4-DNA binding domain fused to JMJ and a reporter gene consisting of the GAL4 binding sites upstream of a luciferase reporter gene indicated that JMJ functions as a powerful transcriptional repressor. The DNA binding motif of JMJ was determined using CASTing experiments by incubating a random oligonucleotide library with the GST-JMJ fusion protein coupled to agarose beads. Among the selected binding oligonucleotides, the high affinity DNA binding sequences were identified by gel retardation assays. JMJ repressed expression of the reporter genes containing the high affinity JMJ binding sequences, indicating that JMJ is a DNA-binding transcriptional repressor. The domains for transcriptional repression, DNA binding, and nuclear localization signal were mapped by mutational analyses using reporter gene assays, gel retardation assays, and immunostaining experiments, respectively. The present data demonstrate for the first time that JMJ functions as a DNA-binding transcriptional repressor. Therefore, JMJ may play a critical role in transcription factor cascade to regulate expression of heart-specific genes and normal cardiac development. [ABSTRACT FROM AUTHOR]

In order to identify key genes involved in the development of atherosclerotic lesions, differentially expressed genes in atherosclerotic plaques obtained from diet-induced hypercholesterolemic rabbit aorta were screened using the differential display (DD) RTPCR technique. Aortic RNAs were isolated from rabbits fed cholesterol-supplemented (2% cholesterol in lab-chow, w/w) chow diet for 12 weeks, followed by the synthesis of cDNAs by reverse-transcription using 2- base anchored oligo(dT) (S'-TuVN) as 3'-primers. Synthesized cDNAs were amplified by PCR using arbitrary 10-mers as S'-primers and the same 3'primers used in the reverse-transcription. Amplified cDNAs sized between 0.2 to 0.5 kb obtained from control and cholesterol-fed rabbit aortas were displayed on the 6% DNA-sequencing gel for comparisons. The cDNA bands showing distinctive differences in patterns of display or in density of the band were extracted from the gel. A total of 66 differentially displayed cDNAs was isolated and subjected to the reverse-Northern and Northern blot analyses in order to confirm the differences. Through the extensive confirming processes, three cDNAs were finally selected (designated CRGRA-l through -3) and their nucleotide sequences were determined. Two of those (CRGRA-l and -2) were determined to be upregulated and the other (CRGRA-3) was downregulated by the cholesterol-feeding. Upon homology search on databases for the identification of the genes, the first cDNA (CRGRA-l) turned out to be a part of a novel gene, the second one (CRGRA-2) was homologous (82 %) to the corresponding segment of mitochondrial NADH dehydrogenase subunit 4 gene, and the last one (CRGRA-3) was identified to be homologous (94%) to a segment of human small GTPbinding protein (Rab7) gene. [ABSTRACT FROM AUTHOR]

Background context The hyoid bone is used as a landmark in anterior upper cervical spine operations and is supposed to represent the level of C3 body. However, this correspondence between hyoid bone position and cervical level is not static and changes during surgery (extension after anesthesia). Purpose To find the cervical level corresponding to the position of hyoid bone before and after anesthesia and to evaluate the adequacy of its usage as a surgical landmark. Study design A retrospective study. Patient sample One hundred twenty-eight patients with degenerative cervical diseases who had undergone anterior cervical discectomy and fusion. Outcome measure Radiologic measure. Methods For each patient, preanesthesia neutral, preanesthesia extension, and postanesthesia induction extension C-spine lateral image were obtained. The level of cervical vertebra that midline of hyoid bone indicated was measured by radiological method. A cervical vertebra was divided into three segments, consisting of upper half, lower half, and disc space, and each of these segments was considered as one level. The differences between pre- and postanesthesia induction hyoid positions were classified as minimal change (one level or less) and significant change (two levels or greater). Relationship between positional change of hyoid bone to gender, obesity, and age were respectively investigated. Results There were 20 cases of one-level distal displacement of the hyoid bone, 40 cases of two-level distal displacement, 34 cases of three-level distal displacement, 16 cases of 4-level distal displacement, and two cases of five-level distal displacement. In eight cases, there was no level change, and in the remaining 8 cases, the hyoid bone had been displaced proximally. There were 34 cases of minimal change. The remaining 94 cases (73.4%) had significant changes. No respective relationship was found between sex, obesity, age and pre-and postanesthesia induction positional change of hyoid bone. Conclusions Among the 128 cases studied, 73.4% hyoid bone positions had changed by more than one cervical vertebra body between the pre- to postanesthesia induction X-ray images. Sex, age, and body mass index were not associated with statistically significant differences in these positions. The hyoid bone should not be trusted as a landmark for upper cervical operations, and the cervical level to be operated should be confirmed by a radiological method before a skin incision is made. [ABSTRACT FROM AUTHOR]