Annals of the New York Academy of Sciences
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Ann. N. Y. Acad. Sci. · Dec 2005
ReviewAmyotrophic lateral sclerosis and primary lateral sclerosis: The role of diffusion tensor imaging and other advanced MR-based techniques as objective upper motor neuron markers.
Amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, is a motor neuron disease characterized by progressive degeneration of upper motor neuron (UMN) and lower motor neuron (LMN), while primary lateral sclerosis (PLS) is defined by pure UMN involvement. A reliable objective marker of UMN involvement is critical for the early diagnosis and monitoring of disease progression in patients with ALS and PLS. Diffusion tensor imaging (DTI), magnetization transfer imaging (MTI), and magnetic resonance spectroscopy (MRS), which provide insight into the pathophysiological process of ALS and PLS, show great promise in this regard. Further investigation is needed to determine and to compare the utility of various neuroimaging markers.
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Coxiella burnetii is an obligate intracellular bacterium that causes a worldwide zoonosis, Q fever, and can be misused as a biological warfare agent. Infection in animals (coxiellosis) is mostly persistent. Infection in humans is often asymptomatic, but it can manifest as an acute disease (usually a self-limited flu-like illness, pneumonia, or hepatitis) or as a chronic form (mainly endocarditis, but also hepatitis and chronic fatigue syndrome). ⋯ Its intracellular large cell variant, adapted to survive under harsh conditions of phagolysosomes, enables long-term survival and persistence of C. burnetii, namely in monocytes/macrophages. Host factors such as underlying disease and cell-mediated immunity play a decisive role in the clinical expression of C. burnetii infection. Complete genome analysis of C. burnetii will certainly contribute to better understanding of the pathogenesis of C. burnetii infection and will improve Q fever diagnosis and immunoprophylaxis.