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This Concept Map, created with IHMC CmapTools, has information related to: MELAS, MELAS caused by A3243G mutation in mtDNA, ATP synthase activity reducing ATP levels, oxidation of NADH to NAD+, A3243G mutation in mtDNA alters transcription, reactive oxygen species in the cell causing cellular damage, Disrupts the electron transport chain causes loss of proton gradient, 17 y/o female diagnostic tests include skeletal muscle biopsy, Increasing in NADH:NAD+ ratio inhibiting TCA cycle, reduction of pyruvate to lactate to reform NAD+, tRNA disrupts protein synthesis, Disrupts the electron transport chain by preventing oxidation of NADH, lactate dehydrogenase causing reduction of pyruvate to lactate, PCR indicating MELAS, 17 y/o female presenting with seizures, 17 y/o female diagnostic tests include PCR, oxidation of NADH causes Increasing in NADH:NAD+ ratio, Increasing in NADH:NAD+ ratio promoting anaerobic glycolysis, Translation of altered NADH dehydrogenase protein, MELAS severity partially determined by heteroplasmy, transcription of tRNA