Evaluation of myocardial iron during iron chelation therapy is not feasible by repeated endomyocardial biopsies owing to the heterogeneity of iron distribution and the risk of complications. Recently, we described a noninvasive method based on magnetic resonance imaging. Here, the method was used for repeated estimation of the myocardial iron content during iron chelation with deferrioxamine in 14 adult nonthalassemic patients with transfusional iron overload. We investigated the repeatability of the method and the relationship between the myocardial iron estimates and iron status. The repeatability coefficient (2s D ) was 2.8 mol/g in the controls (day-to-day) and 4.0 mol/g in the patients (within-day). Myocardial iron estimates were elevated in 10 of all 14 patients at first examination, but normalized in 6 patients after 6 to 18 months of treatment. If liver iron declined below 350 mol/g all but one of the myocardial iron estimates were normal or nearly normal. At start (R 2 ‫؍‬ 0.69, P ‫؍‬ .0014) and still after 6 months of iron chelation (R 2 ‫؍‬ 0.76, P ‫؍‬ .001), the estimates were significantly and more closely related to the urinary iron excretion than to liver iron or serum ferritin levels. In conclusion, our preliminary data, which may only pertain to patients with acquired anemias, suggest the existence of a critical liver iron concentration, above which elevated myocardial iron is present, but its extent seems related to the size of the chelatable iron pool, as reflected by the urinary iron excretion. This further supports the concept of the labile iron pool as the compartment directly involved in transfusional iron toxicity. (Blood. 2003;101:4632-4639)

Long-term follow-up data are presented on changes in peripheral blood counts and Hb requirements of 11 patients with myelodysplastic syndromes (MDS) during iron chelation treatment with desferrioxamine for up to 60 months. The erythroid marrow activity was indirectly evaluated by repeated determinations of the serum transferrin receptor concentration. The efficacy of iron chelation was evaluated by repeated quantitative determination of the liver iron concentration by magnetic resonance imaging. Reduction in the Hb requirement ( > or = 50%) was seen in 7/11 (64%) patients. Five patients (46%) became blood transfusion independent. Platelet counts increased in 7/11 (64%) patients and the neutrophil counts in 7/9 (78%) evaluable patients. All patients in whom iron chelation was highly effective showed improvement of erythropoietic output accompanied by an increase in the serum transferrin receptor concentration. It is concluded that reduction in cytopenia in MDS patients may be accomplished by treatment with desferrioxamine, if the iron chelation is efficient and the patients are treated for a sufficiently long period of time. Exactly how treatment with desferrioxamine works remains a challenge for further investigation.

We draw from the literature on economic geography and from the thematic offshoring literature, and propose three hypotheses that rest on the assumption that the choice of offshoring location is based on the fit between the attributes of different destinations and the attributes of the offshored business activities. The study reveals a multi-faceted location pattern in which firms' location strategies, to some degree, follow a logic whereby manufacturing is relocated to low-cost destinations, and research and development is relocated to high-cost destinations. However, the picture is more nuanced when distinguishing between standardized and advanced activities. Asia attracts as many advanced activities as Western Europe while North America attracts more advanced activities even in manufacturing. Central and Eastern Europe attract offshoring in manufacturing and IT, but the activities that are offshored to these regions are typically not advanced. One important theoretical implication of this study is that a more detailed understanding of the nature of offshored activities is needed, since such attributes appear to be an important determinant of location choice.

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The role of iron overload as cause of liver dysfunction has never been studied in detail in patients without concomitant hepatotropic infections who receive multiple transfusions. We therefore investigated the relationship between the extent of hepatocellular injury as reflected by serum levels of aminotransferases (

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The extent to which an intermolecular charge-transfer (CT) state can influence excited-state relaxation dynamics is examined for the system wherein 1-methylnaphthalene (MN) interacts with molecular oxygen. The MN-O2 system is ideally suited for such a study because excited states can be independently accessed by (i) irradiation into the discrete MN-O2 CT absorption band, (ii) direct irradiation of MN, and (iii) the photosensitized production of triplet state MN. Changing the solvent in which the MN-O2 system is dissolved influences the MN-dependent photoinduced production of singlet oxygen, O2(a1Delta(g)), which, in turn, yields information about fundamental concepts of state mixing. Results of experiments conducted in the polar solvent acetonitrile differ substantially from those obtained from the nonpolar solvent cyclohexane. The data reflect differences in the energy and behavior of the solvent-equilibrated MN-O2 CT state, CT(SE), and the extent to which this state couples to other states of the MN-O2 system. In particular, the data are consistent with a model where both the MN triplet state and the MN-O2 CT(SE) state are immediate precursors of O2(a1Delta(g)). Although the work reported herein is of direct and practical significance for the wide variety of systems in which O2(a1Delta(g)) can be produced upon irradiation, it also serves as an accessible model for a study of general issues pertinent to state mixing and the solvent-dependent dynamics of CT-mediated excited-state relaxation.