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Measurements of hepatic iron concentration (HIC) are important predictors of transfusional iron burden and long-term outcome in patients with transfusion-dependent anemias. The goal of this work was to develop a readily available, noninvasive method for clinical HIC measurement. The relaxation rates R2 (1/T2) and R2* (1/T2*) measured by magnetic resonance imaging (MRI) have different advantages for HIC estimation. This article compares noninvasive iron estimates using both optimized R2 and R2* methods in 102 patients with iron overload and 13 controls. In the iron-overloaded group, 22 patients had concurrent liver biopsy. R2 and R2* correlated closely with HIC (r2 > or = .95) for HICs between 1.33 and 32.9 mg/g, but R2 had a curvilinear relationship to HIC. Of importance, the R2 calibration curve was similar to the curve generated by other researchers, despite significant differences in technique and instrumentation. Combined R2 and R2* measurements did not yield more accurate results than either alone. Both R2 and R2* can accurately measure hepatic iron concentration throughout the clinically relevant range of HIC with appropriate MRI acquisition techniques.

Iron cardiomyopathy remains the leading cause of death in patients with thalassemia major. Magnetic resonance imaging (MRI) is ideally suited for monitoring thalassemia patients because it can detect cardiac and liver iron burdens as well as accurately measure left ventricular dimensions and function. However, patients with thalassemia have unique physiology that alters their normative data. In this article, we review the physiology and pathophysiology of thalassemic heart disease as well as the use of MRI to monitor it. Despite regular transfusions, thalassemia major patients have larger ventricular volumes, higher cardiac outputs, and lower total vascular resistances than published data for healthy control subjects; these hemodynamic findings are consistent with chronic anemia. Cardiac iron overload increases the relative risk of further dilation, arrhythmias, and decreased systolic function. However, many patients are asymptomatic despite heavy cardiac burdens. We explore possible mechanisms behind cardiac iron-function relationships and relate these mechanisms to clinical observations.

We searched expressed sequence tag databases with conserved domains of the short-chain alcohol dehydrogenase superfamily and identified another isoform of 17 beta-hydroxysteroid dehydrogenase, 17 beta HSDXI. This enzyme converts 5 alpha-androstane-3 alpha, 17 beta-diol to androsterone. The substrate has been implicated in supporting gestation and modulating gamma-aminobutyric acid receptor activity. 17 beta HSDXI is colinear with human retinal short-chain dehydrogenase/reductase retSDR2, a protein with no known biological activity (accession no. AAF06939). Of the proteins with known function, 17 beta HSDXI is most closely related to the retinol-metabolizing enzyme retSDR1, with which it has 30% identity. There is a polymorphic stretch of 15 adenosines in the 5' untranslated region of the cDNA sequence and a silent polymorphism at C719T. A 17 beta HSDXI construct with a stretch of 20 adenosines was found to produce significantly more enzyme activity than constructs containing 15 or less adenosines (43% vs. 26%, P < 0.005). The C719T polymorphism is present in 15% of genomic DNA samples. Northern blot analysis showed high levels of 17 beta HSDXI expression in the pancreas, kidney, liver, lung, adrenal, ovary, and heart. Immunohistochemical staining for 17 beta HSDXI is strong in steroidogenic cells such as syncytiotrophoblasts, sebaceous gland, Leydig cells, and granulosa cells of the dominant follicle and corpus luteum. In the adrenal 17 beta HSDXI, staining colocalized with the distribution of 17 alpha-hydroxylase but was stronger in the mid to outer cortex. 17 beta HSDXI was also found in the fetus and increased after birth. Liver parenchymal cells and epithelium of the endometrium and small intestine also stained. Regulation studies in mouse Y1 cells showed that cAMP down-regulates 17 beta HSDXI enzymatic activity (40% vs. 32%, P < 0.05) and reduces gene expression to undetectable levels. All-trans-retinoic acid did not affect 17 beta HSDXI expression or activity, but addition of the retinoid together with cAMP significantly decreased activity over cAMP alone (32% vs. 23%, P < 0.05). Cloning and sequencing of the 17 beta HSDXI promoter identified the potential nuclear receptor steroidogenic factor-1 half-site TCCAAGGCCGG, and a cluster of three other potential steroidogenic factor-1 half-sites were found in the distal part of intron 1. Collectively, these results suggest a role for 17 beta HSDXI in androgen metabolism during steroidogenesis and a possible role in nonsteroidogenic tissues including paracrine modulation of 5 alpha-androstane-3 alpha, 17 beta-diol levels. 17 beta HSDXI could act by metabolizing compounds that stimulate steroid synthesis and/or by generating metabolites that inhibit it.

Cognitive impairment in Alzheimer's disease (AD) is not fully explained. PET indicates reduced cerebral metabolic rate for glucose. Since glutamate neurotransmission (GNT) consumes more than 80% of the ATP generated from metabolism, a pilot study was carried out to determine the neuronal tricarboxylic acid cycle (TCA) based on the hypothesis that reduced GNT could contribute to cognitive impairment in AD. Three AD patients with cognitive impairment (mini-mental state exam: 24 vs 30, P<0.05) and significant reduction in both N-acetyl aspartate (NAA)/Creatine (Cr) ( P<0.009) and NAA/myo-inositol (mI) ratio ( P<0.01), and three age-matched controls each received 0.014-0.016 g/kg/min 99%1-13C glucose IV. Quantitative (1)H and proton-decoupled (13)C MR brain spectra were acquired from combined posterior-parietal white matter and posterior-cingulate gray matter every 5 min for 140 min.(13)C magnetic resonance spectroscopy (MRS) measures of glucose oxidation and neuronal TCA rate, including prolonged time to (13)C enrichment of glutamate (Glu2) ( P<0.004) and bicarbonate (HCO(3)) ( P<0.03) as well as reduced relative enrichment of Glu(2)/Glu(4) between 60 and 100 min ( P<0.04), were significantly different in AD patients vs. controls. (13)C measures of GNT, glutamine (Gln)(2)/Glu(2) ( P<0.02) and rates of glutamate enrichment (Glu(2)/glucose: 0.34 vs 0.86, P=ns and Glu(4)/glucose 0.26 vs 0.83, P=ns), were also reduced.(13)C MRS measures of neuronal TCA cycle, glucose oxidation and GNT were significantly correlated with measures of neuronal integrity: NAA/Cr, [NAA] and mI/NAA as determined by (1)H MRS ( R(2)=0.73-0.95; P<0.05-0.01), suggesting that impairment of GNT may be a contributing factor in the cognitive impairment characteristic of AD.

Humans have very close interactions with working, food-producing, and companion animals. According to the American Veterinary Medical Association, there are more than one hundred million cat and dog pets in the United States. Furthermore, non-traditional pets like reptiles and exotic birds are not unusual companion animals in households. In addition to sharing with animals our living and/or working space and time, we also share, unfortunately, many disease causing microorganisms. In the past few years, we have become aware that several enteric pathogens that were thought to be mostly restricted to animals are a major cause of human disease. Examples of such pathogens include the protozoan parasite Cryptosporidium parvum and bacteria such as Campylobacter spp. This review will examine the characteristics of zoonotic enteric pathogens including bacterial (Helicobacter spp., Campylobacter spp., Salmonella spp., and verotoxin-producing Escherichia coli); parasitic (Toxoplasma gondii, Giardia spp., Cryptosporidium spp.); and viral (rotavirus, norwalk-like virus, hepatitis E virus), and the status of our knowledge with regard to the impact of such pathogens on human health.

Two genome segments, M2 and S1, were preferentially selected in reassortants isolated in Vero cells. Analysis with monoclonal antibodies (MAbs) against RAM-1 strain showed that the 39-kDa protein encoded by the genome segment S1 contained epitopes involved in neutralisation of virus infectivity for both Vero and chicken kidney (CK) cells. The 39-kDa protein appeared to have two major epitopes that are attachment sites for cell receptors, one interacting only with CK cell receptors and the other with both CK and Vero cell receptors but principally Vero cell receptors. These results suggest that the strain RAM-1 may have developed an epitope for Vero cell receptors owing to mutation in the S1 genome segment, but still retained the epitope responsible for infection of CK cells.

Objectives: To assess the efficacy of the vaccination procedure and the effect of the transfer of maternal antibodies to progeny chickens on reovirus pathogenicity., Design: To vaccinate chickens and challenge progeny chickens with high doses of homologous and heterologous viruses., Procedure: High doses of reovirus strains RAM-1, 1091 and 724 were used to induce tenosynovitis lesions. High doses were produced by concentration of viruses grown in cell culture. Then similar doses of viruses were used to challenge immunised chickens progeny., Result: Vaccination of breeding hens with the RAM-1 strain of avian reovirus, which resulted in the passive transfer of neutralising antibody to progeny chickens, completely prevented the development of tenosynovitis in 80% of progeny chickens infected with the homologous virus. Even though multiple injections of hens resulted in broadening of the normal type-specificity of the neutralising antibody response against heterologous serotypes of avian reovirus, only marginal protection against strains of two heterologous serotypes of avian reovirus was obtained., Conclusions: A model for assessing the efficacy of vaccination against avian reovirus strains on clinical sign such as tenosynovitis was developed that overcome the normal low virulence of Australian strains of avian reovirus. Breeding hens can be immunised with Australian strain of avian reovirus with passive transfer of antibody via the yolk to the progeny chickens. Although the neutralising antibody response to three injections of inactivated virus decreased the specificity of the neutralising antibody response against antigenically heterologous strains of avian reovirus, the protective immunity appeared to retain type-specificity.

Monoclonal antibodies against two virion proteins of the RAM-1 strain of avian reovirus neutralized virus infectivity; antibody against a 124-kDa (lambda B) protein caused broadly specific neutralization and antibody against a 39-kDa (sigma C) protein caused neutralization of greater type-specificity. The neutralizing activity of the monoclonals also exhibited host cell specificity: antibodies against the lambda B protein inhibited virus infectivity in Vero cells and not chicken kidney cells; one monoclonal antibody against the sigma C protein neutralized virus in only chicken kidney cells, whereas two other monoclonals against the sigma C protein neutralized virus in both Vero and chicken kidney cells but had greater neutralizing activity in Vero cells.

Our group initiated a program of coronary angioplasty (CA) in patients with symptomatic one vessel disease, or multivascular lesions with a critical "culprit" stenosis. In a 16 month period we have performed CA of 28 lesions in 25 patients (20 men) with a mean age of 54 +/- 10 years. Stable angina was diagnosed in 14 patients, unstable angina in 7, and post-myocardial infarction residual angina or stenosis in 4 patients treated with streptokinase. Successful dilatation was obtained in 23 (82.1%) of 28 stenotic segments, reducing the stenosis from 90 +/- 8% (range 70-100) to 9 +/- 12% (range 0-30; p less than 0.00001). In 4 cases with total occlusion, dilatation was not obtained, and in one case the procedure was complicated by fatal brain embolism. There were 4 complications due to coronary occlusion or spasm, all of them resolved during CA without sequelae. The 20 cases with primary success have been followed during an average of 8.6 months. In three cases (15%) restenosis was detected; two of them underwent surgery, and CA was repeated successfully in the other. Disappearance of myocardial ischemia was confirmed in 14 patients, and functional improvement in the other three. In conclusion, CA is an effective and relatively safe therapeutic alternative in different clinical forms of coronary heart disease with a single vessel stenosis, or in selected cases of multivascular lesions with a critical stenosis.

Eighty-three children with Down syndrome were submitted to hematological and biochemical studies; 69 normal children were included as controls. The variables analyzed were: HbF, HbA2, serum B12 vitamin (B12), folates, total iron and iron binding capacity, hematic cytology, and the red blood cell enzymes adenosine deaminase (ADA), glucose-6-phosphate dehydrogenase (G6PD) and superoxide dismutase (SOD). The most relevant results were: macrocytosis, normal leucocytes, HbF, B12 and folates, as well as high levels of the enzymes ADA and G6PD. An indirect association between macrocytosis, ADA and G6PD is discussed.