The clinical activities, led by James Fang, MD, are based at UH Case Medical Center and extend to Harrington-McLaughlin Heart & Vascular Institute programs at 16 sites throughout Northeast Ohio. Our faculty are nationally and internationally recognized authorities in cardiovascular conditions including atrial fibrillation, interventional cardiology and heart failure. University Hospitals has a unique reputation for personalized yet sophisticated cardiovascular care with a multidisciplinary approach.

We believe that discovery and innovation are essential to advance patient care. We encourage all faculty members and fellows to be engaged in some aspect of research and discovery within Case Western Reserve University School of Medicine. Under the leadership of Mukesh Jain, MD, the Cardiovascular Research Institute (CVRI) has soared. The strengths of the CVRI include vascular biology, gene regulation, hypertrophy, arrhythmia, electrical remodeling, and new programs in cardiovascular development and stem cell biology. Within the UH Harrington-McLaughlin Heart & Vascular Institute's Center for Research & Innovation, we have cutting-edge translational and clinical research activities with particular strengths in stem cell and regenerative medicine, cardiovascular imaging, electrophysiology, interventional cardiology drug and device trials. Total committed grant support from the NIH now exceeds $16 million.

Our strong education programs are under the leadership of Brian Hoit, MD. We have 15 general cardiology fellows, 4 electrophysiology fellows, 2 interventional cardiology fellows, 1-2 heart failure fellows and 1-2 imaging fellows rotating at UH Case Medical Center and the Louis Stokes Cleveland VA Medical Center.

The Division has been recognized nationally and internationally for many years for its academic contributions to endocrinology. As such, we have been on the US World & News Report list of "Best Hospitals" for several consecutive years. The Division has made important clinical contributions to patient care including diabetes mellitus, thyroid cancer and other thyroid illnesses as well as diseases of the pituitary and adrenal glands that have achieved national and international recognition.

At Case Western Reserve University School of Medicine our Division excels in pituitary-adrenal diseases, thyroid cancer and diabetes research. Of special interest is a clinical trial on diabetes with a focus on the prevention of cardiovascular disease and another on the treatment of diabetes mellitus.

We offer two tracks of fellowship education in Endocrinology and Metabolism. The first is a two-year clinical stream while the second is a three-year research concentration. Endocrine research is ongoing in the Departments of Biochemistry, Molecular Biology, Pharmacology and Physiology, and Biophysics. Training also includes instruction in preparation of grant applications. Trainees in this track maintain a continuity clinic throughout the three years of training.

Our long-term research goal is to develop a strategy to decrease the excess myocardial injury in elderly patients following an acute myocardial infarction. At Case Western Reserve University School of Medicine we study this problem in the elderly Fischer 344 rat model. The isolated, buffer perfused elderly heart sustains greater injury after ischemia and reperfusion compared to the adult heart. At baseline, aging-defects in the mitochondrial electron transport chain occur in only one population of heart mitochondrial in elderly Fischer 344 rats. Following ischemia there is further damage to the interfibrillar mitochondria. We have demonstrated that aging-related defects in mitochondrial oxidative metabolism present at baseline in the elderly heart predispose to the subsequent increase in injury during ischemia compared to the adult heart, decrease in energy charge and an excess of oxidative damage accounts for the increase in injury observed in the aging heart. We devised a therapy that corrects the mitochondrial defect in the aged heart. The hearts from the treated rats only sustain ischemic injury similar to the young, adult rats. The mechanism of this effect is proposed to involve acetylation of a key mitochondrial ribosomal protein resulting in increased mitochondrial protein synthesis.

We offer clinical diagnostic tests for evaluation of mitochondrial diseases and for disorders of fatty acid oxidation. A unique procedure is the isolation of intact mitochondria from skeletal muscle in patients with mitochondrial disease. We study oxidation phosphorylation and metabolite pathways followed by detail enzymatic studies of the components of the electron transport chain.

The Division has a long history of clinical excellence. The revision is dedicated to providing state-of-the-art patient care, being thought leaders and developing the next generation of leader's through our educational programs. Our Medical Intensive Care Unit has over 1600 admissions a year and is a national leader in critical care, recognized with an AACN Beacon Award four years in a row, the only ICU in the nation to achieve such recognition.

Our cystic fibrosis center has one of the largest adult populations in the country. Our lung cancer program is a leader in diagnostics and therapeutics through its multi-disciplinary program with the UH Ireland Cancer Center. The control of breathing research group has been a focus of the division for over 20 years. Research at Case Western Reserve University School of Medicine includes sleep disordered breathing, pulmonary epithelial cell biology and lung injury, the signalling mechanism activated by protein C [APC], neurol control of breathing in acute long injury [ALI], acute respiratory distress syndrome [ARDS] and mechanical ventilation. Clinical research is focused on pulmonary artery hypertention [PAH], acute lung injury and hyposemia.

The philosophy of our fellowship education is to produce excellent clinicians with a research focus to succeed as leaders in academic medicine. The program has an 18 month clinical component and an 18 month research component. The program encompasses both the Louis Stokes Cleveland VA Medical Center and UH Case Medical Center. The entire Pulmonary and Critical Care faculty mentors the trainees during their clinical training.

The Division of Rheumatology treats a host of rheumatic diseases, directs a number of local and national research projects on basic and clinical rheumatology and trains post-doctoral fellows. Our services include treatment of Systemic Lupus Erythematosus, Sj�gren's syndrome, Fibromyalgia, inflammatory muscle diseases and common arthritic problems, such as osteoarthritis.

We deliver personalized patient care so that patients benefit from the most recent diagnostic and therapeutic care of rheumatic diseases. The Division of Rheumatic Diseases at Case Western Reserve University and University Hospitals of Cleveland has deeply devoted to the care of patients with osteoarthritis [OA], rheumatoid arthritis [RA] and related disorders. Investigations on cartilage and chondrocytes biology, autoimmunity, T cell biology and animal models of RA and OA are the cornerstone of our research programs. The modulation of immune response/inflammation by dietary constituents, and integrated research with School of Dental Medicine on the relationship of periodontitis and rheumatoid arthritis have been innovative in our division.

Our fellows are trained as investigative diagnosticians, cutting-edge researchers and compassionate clinicians. Our graduates are highly sought after, and they continuously maintain successful careers in research, patient care, industry and clinical practice settings. We take a great deal of pride in teaching and training leaders in rheumatology. Division members, have diverse, collective backgrounds and are themselves noted rheumatologists and published researchers. Urban and suburban clinical training opportunities plus participation in division agenda-planning - via faculty meetings and continuous faculty interaction - offer fellows a well-rounded, unmatched opportunity in rheumatology education.