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Fedele F, Bulfoni A, Parazzini F, Busnelli A. Neovagina creation methods in Müllerian anomalies and risk of malignancy: insights from a systematic review. Arch Gynecol Obstet 2024; 309:801-812. [PMID: 37466686 DOI: 10.1007/s00404-023-07086-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 05/19/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE This systematic review aims to provide a data synthesis about the risk of neovaginal cancer in women with Müllerian anomalies and to investigate the association between the adopted reconstructive technique and the cancer histotype. METHODS PubMed, MEDLINE, Embase, Scopus, ClinicalTrials.gov and Web of Science databases were searched from inception to March 1st, 2023. Studies were included if: (1) only women affected by Müllerian malformations were included, (2) the congenital defect and the vaginoplasty technique were clearly reported, (3) the type of malignancy was specified. RESULTS Literature search yielded 18 cases of squamous cell carcinoma and two cases of vaginal intraepithelial neoplasia 3 (VAIN 3). Of these, 3 had been operated on according to the Wharton technique, 8 according to the McIndoe technique, 3 with a split-skin graft vaginoplasty, 2 according to the Davydov technique, 2 with a simple cleavage technique, 1 according to the Vecchietti technique and 1 with a bladder flap vaginoplasty. A total of 17 cases of adenocarcinoma and 1 case of high-grade polypoid dysplasia were also described. Of these, 15 had undergone intestinal vaginoplasty, 1 had been operated on according to the McIndoe technique and 1 had undergone non-surgical vaginoplasty. Finally, 1 case of verrucous carcinoma in a woman who had undergone a split-skin graft vaginoplasty, was reported. CONCLUSION Although rare, neovaginal carcinoma is a definite risk after vaginal reconstruction, regardless of the adopted technique. Gynaecologic visits including the speculum examination, the HPV DNA and/or the Pap smear tests should be scheduled on an annual basis.
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Affiliation(s)
- Francesco Fedele
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of ClinicalSciences and Community Health, Università Degli Studi di Milano, Milan, Italy
| | | | - Fabio Parazzini
- Department of ClinicalSciences and Community Health, Università Degli Studi di Milano, Milan, Italy
| | - Andrea Busnelli
- IRCCS Humanitas Research Hospital, Rozzano - Milan, Italy.
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.
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2
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Teófilo CR, Peixoto RAC, Eleutério RMN, Lima Junior EM, de Moraes Filho MO, Bezerra LRPS, Bruno ZV. Neovaginoplasty With Nile Tilapia Skin: Cytological and Microbiota Evaluation. J Low Genit Tract Dis 2023; 27:275-279. [PMID: 37192410 DOI: 10.1097/lgt.0000000000000740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVES To study the clinical, cytological, and vaginal microbiota findings in patients with Mayer-Rokitansky-Küster-Hauser syndrome who underwent neovaginoplasty using Nile tilapia fish skin. METHODS This is a cross-sectional study with 7 cisgender women with Mayer-Rokitansky-Küster-Hauser syndrome who had previously undergone neovagina reconstruction using Nile tilapia fish skin at a university hospital. Local institutional review board approval and written permission from the patient were obtained. Between August 2019 and November 2021, within 12 to 24 months after surgery, vaginal specimens were obtained for conventional oncotic and hormonal cytology, and for Gram staining. The Nugent scores were calculated. Colposcopy was also performed. RESULTS Squamous cells without atypia were found in all patients. Five patients had intermediate vaginal microbiota (Nugent score of 4), which was determined by the presence of few lactobacilli on Gram staining. In hormonal cytology, 4 patients presented with findings compatible with menacme. No colposcopic change was observed. When postsurgical dilation was performed correctly, a mean vaginal length of 8.3 cm was maintained after 1 year of follow-up. CONCLUSIONS Squamous cells without atypia were present in neovaginas with Nile tilapia fish skin. Most vaginal contents revealed intermediate microbiota and hormonal results compatible with menacme. Studies with a greater number of patients are necessary for a more comprehensive understanding of the microbiome in neovaginas with this new technique, thereby providing support for the treatment and prevention of associated pathologies.
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Affiliation(s)
| | | | | | | | | | | | - Zenilda Vieira Bruno
- Maternidade Escola Assis Chateaubriand - Federal University of Ceará, Fortaleza, Ceará, Brazil
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3
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Das RN, Mandal B, Das M, Sil K, Mukherjee S, Chatterjee U. Perinatal and Fetal Autopsies in Neuropathology: How I do it. INDIAN J PATHOL MICR 2022; 65:S207-S217. [PMID: 35562151 DOI: 10.4103/ijpm.ijpm_977_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Fetal and perinatal autopsies are useful to identify the accurate cause of death and in the process recognize disorders which may require counselling for future pregnancies. Abnormalities of the CNS are an important cause of fetal loss and perinatal deaths. Most of these are structural abnormalities of the CNS, however a smaller portion show changes pertaining to prematurity, infections and even congenital tumors. In this review we evaluate CNS abnormalities of the fetus and the newborn as detected in autopsy series. We also describe our experience in a tertiary care hospital with a specialized neonatology unit over the last 8 years and discuss some of the newer methods like virtual autopsy.
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Affiliation(s)
- Ram Narayan Das
- Department of Pathology, MJN Medical College and Hospital, Cooch Behar, West Bengal, India
| | - Bappa Mandal
- Department of Neonatology, IPGME&R, Kolkata, West Bengal, India
| | - Mou Das
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
| | - Kaushik Sil
- Department of Neonatology, IPGME&R, Kolkata, West Bengal, India
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Bao J, Chen L, Hao Y, Wu H, He X, Lu C, Ji X, Qiao J, Wang Y, Chi H. Prognosis of Congenital Anomalies in Conceptions Following In Vitro Fertilization: A Multicenter Retrospective Cohort Study in China. Front Endocrinol (Lausanne) 2022; 13:900499. [PMID: 35909529 PMCID: PMC9331169 DOI: 10.3389/fendo.2022.900499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/17/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Conceptions following in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) have an increased risk of congenital anomalies. Few studies have explored the prognosis of fetuses with congenital anomalies. This study aimed to investigate the prevalence and prognosis of congenital anomalies in IVF/ICSI pregnancies, and to analyze the influencing factors contributing to poor prognosis. METHODS In this multicenter retrospective cohort study, we followed 405,473 embryo transfer cycles at 15 reproductive centers between January 2010 and December 2019 and enrolled 2,006 intrauterine pregnancies with congenital anomalies. The relatively positive prognosis group with one or more live births and neonatal survival for more than 7 days was compared with the poor prognosis group with poorer outcomes. RESULTS Among the 168,270 ongoing intrauterine pregnancy cycles, the prevalence of congenital anomalies was 1.19%, wherein the malformation rates of cycles with late abortion and delivery were 2.37% (716/30,202) and 0.93% (1,290/138,068), respectively. Among all IVF/ICSI cycles with congenital anomalies, the relatively positive prognosis rate was 61.39%. Moreover, the fertilization failure rate (2 pro-nuclei rate < 25%) in the poor prognosis group was significantly higher than that in the relatively positive prognosis group (10.89% vs. 5.09%, p < 0.001). Multivariate logistic regression analysis revealed no significant differences in the relatively positive prognosis rate among the various IVF/ICSI protocols. The relatively positive prognosis rate of fertilization failure cycles was 0.180 times that of normal fertilization cycles. CONCLUSION Poor fertilization rates during IVF/ICSI treatments are more likely to have poor prognosis in fetuses or neonates with congenital anomalies, and obstetric management should be strengthened in pregnant women, with which pregnant women should be recommended to strengthen obstetric management.
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Affiliation(s)
- Jie Bao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Lixue Chen
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Yongxiu Hao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Hongping Wu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Xiaojin He
- Center for Reproductive Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chuncheng Lu
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xinhua Ji
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Yuanyuan Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
- *Correspondence: Hongbin Chi, ; Yuanyuan Wang,
| | - Hongbin Chi
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
- *Correspondence: Hongbin Chi, ; Yuanyuan Wang,
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Lin X, Li H, Yang T, Liu X, Fan F, Zhou X, Luo Y. Transcriptomics Analysis of Lens from Patients with Posterior Subcapsular Congenital Cataract. Genes (Basel) 2021; 12:1904. [PMID: 34946854 PMCID: PMC8702110 DOI: 10.3390/genes12121904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/19/2021] [Accepted: 11/26/2021] [Indexed: 01/30/2023] Open
Abstract
To gain insight into the aetiology of posterior subcapsular congenital cataract from the perspective of transcriptional changes, we conducted an mRNA sequencing analysis of the lenses in posterior subcapsular congenital cataract patients and in normal children. There were 1533 differentially expressed genes from 19,072 genes in the lens epithelial cells of the posterior subcapsular congenital cataract patients compared to in the normal controls at a cut-off criteria of |log2 fold change| of >1 and a p-value of <0.05, including 847 downregulated genes and 686 upregulated genes. To further narrow down the DEGs, we utilised the stricter criteria of |log2 fold change| of >1 and an FDR value of <0.05, and we identified 551 DEGs, including 97 upregulated genes and 454 downregulated genes. This study also identified 1263 differentially expressed genes of the 18,755 genes in lens cortex and nuclear fibres, including 646 downregulated genes and 617 upregulated genes. The downregulated genes in epithelial cells were significantly enriched in the structural constituent of lenses, lens development and lens fibre cell differentiation. After filtering the DEGs using the databases iSyTE and Cat-Map, several high-priority candidate genes related to posterior subcapsular congenital cataract such as GRIFIN, HTRA1 and DAPL1 were identified. The findings of our study may provide a deeper understanding of the mechanisms of posterior subcapsular congenital cataract and help in the prevention and treatment of this disease.
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Affiliation(s)
| | | | | | | | | | | | - Yi Luo
- Department of Ophthalmology, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China; (X.L.); (H.L.); (T.Y.); (X.L.); (F.F.); (X.Z.)
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6
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Kapczuk K, Kędzia W. Primary Amenorrhea Due to Anatomical Abnormalities of the Reproductive Tract: Molecular Insight. Int J Mol Sci 2021; 22:ijms222111495. [PMID: 34768925 PMCID: PMC8584168 DOI: 10.3390/ijms222111495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 10/17/2021] [Accepted: 10/20/2021] [Indexed: 12/14/2022] Open
Abstract
Congenital anomalies of the female reproductive tract that present with primary amenorrhea involve Müllerian aplasia, also known as Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS), and cervical and vaginal anomalies that completely obstruct the reproductive tract. Karyotype abnormalities do not exclude the diagnosis of MRKHS. Familial cases of Müllerian anomalies and associated malformations of the urinary and skeletal systems strongly suggest a complex genetic etiology, but so far, the molecular mechanism in the vast majority of cases remains unknown. Primary amenorrhea may also be the first presentation of complete androgen insensitivity syndrome, steroid 5α-reductase type 2 deficiency, 17β-hydroxysteroid dehydrogenase type 3 deficiency, and Leydig cells hypoplasia type 1; therefore, these disorders should be considered in the differential diagnosis of the congenital absence of the uterus and vagina. The molecular diagnosis in the majority of these cases can be established.
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7
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Levy MR, Thors V, Elínardottir SH, Moller AD, Haraldsson A. Decreasing death rates and causes of death in Icelandic children-A longitudinal analysis. PLoS One 2021; 16:e0257536. [PMID: 34591867 PMCID: PMC8483359 DOI: 10.1371/journal.pone.0257536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 09/06/2021] [Indexed: 12/05/2022] Open
Abstract
Background Global death rate in children has been declining during the last decades worldwide, especially in high income countries. This has been attributed to several factors, including improved prenatal and perinatal care, immunisations, infection management as well as progress in diagnosis and treatment of most diseases. However, there is certainly room for further progress. The aim of the current study was to describe the changes in death rates and causes of death in Iceland, a high-income country during almost half a century. Methods The Causes of Death Register at The Directorate of Health was used to identify all children under the age of 18 years in Iceland that died during the study period from January 1st, 1971 until December 31st, 2018. Using Icelandic national identification numbers, individuals could be identified for further information. Hospital records, laboratory results and post-mortem diagnosis could be accessed if cause of death was unclear. Findings Results showed a distinct decrease in death rates in children during the study period that was continuous over the whole period. This was established for almost all causes of death and in all age groups. This reduction was primarily attributed to a decrease in fatal accidents and fewer deaths due to infections, perinatal or congenital disease as well as malignancies, the reduction in death rates from other causes was less distinct. Childhood suicide rates remained constant. Interpretation Our results are encouraging for further prevention of childhood deaths. In addition, our results emphasise the need to improve measures to detect and treat mental and behavioural disorders leading to childhood suicide.
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Affiliation(s)
- Marina Ros Levy
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Valtyr Thors
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Children’s Hospital Iceland, Landspítali University Hospital Iceland, Reykjavík, Iceland
| | | | | | - Asgeir Haraldsson
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Children’s Hospital Iceland, Landspítali University Hospital Iceland, Reykjavík, Iceland
- * E-mail:
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Loane M, Given JE, Tan J, Reid A, Akhmedzhanova D, Astolfi G, Barišić I, Bertille N, Bonet LB, Carbonell CC, Carollo OM, Coi A, Densem J, Draper E, Garne E, Gatt M, Glinianaia SV, Heino A, Hond ED, Jordan S, Khoshnood B, Kiuru-Kuhlefelt S, Klungsøyr K, Lelong N, Lutke LR, Neville AJ, Ostapchuk L, Puccini A, Rissmann A, Santoro M, Scanlon I, Thys G, Tucker D, Urhoj SK, de Walle HEK, Wellesley D, Zurriaga O, Morris JK. Linking a European cohort of children born with congenital anomalies to vital statistics and mortality records: A EUROlinkCAT study. PLoS One 2021; 16:e0256535. [PMID: 34449798 PMCID: PMC8396745 DOI: 10.1371/journal.pone.0256535] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/09/2021] [Indexed: 11/19/2022] Open
Abstract
EUROCAT is a European network of population-based congenital anomaly (CA) registries. Twenty-one registries agreed to participate in the EUROlinkCAT study to determine if reliable information on the survival of children born with a major CA between 1995 and 2014 can be obtained through linkage to national vital statistics or mortality records. Live birth children with a CA could be linked using personal identifiers to either their national vital statistics (including birth records, death records, hospital records) or to mortality records only, depending on the data available within each region. In total, 18 of 21 registries with data on 192,862 children born with congenital anomalies participated in the study. One registry was unable to get ethical approval to participate and linkage was not possible for two registries due to local reasons. Eleven registries linked to vital statistics and seven registries linked to mortality records only; one of the latter only had identification numbers for 78% of cases, hence it was excluded from further analysis. For registries linking to vital statistics: six linked over 95% of their cases for all years and five were unable to link at least 85% of all live born CA children in the earlier years of the study. No estimate of linkage success could be calculated for registries linking to mortality records. Irrespective of linkage method, deaths that occurred during the first week of life were over three times less likely to be linked compared to deaths occurring after the first week of life. Linkage to vital statistics can provide accurate estimates of survival of children with CAs in some European countries. Bias arises when linkage is not successful, as early neonatal deaths were less likely to be linked. Linkage to mortality records only cannot be recommended, as linkage quality, and hence bias, cannot be assessed.
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Affiliation(s)
- M. Loane
- Faculty of Life and Health Sciences, Ulster University, Northern Ireland, United Kingdom
| | - J. E. Given
- Faculty of Life and Health Sciences, Ulster University, Northern Ireland, United Kingdom
| | - J. Tan
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - A. Reid
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - D. Akhmedzhanova
- OMNI-Net for Children International Charitable Fund, Rivne Regional Medical Diagnostic Center, Rivne, Ukraine
| | - G. Astolfi
- Emilia Romagna Registry of Birth Defects, University Hospital of Ferrara, Ferrara, Italy
| | - I. Barišić
- Klinika za dječje bolesti, Zagreb, Croatia
| | - N. Bertille
- Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - L. B. Bonet
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - C. C. Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | | | - A. Coi
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - J. Densem
- Biomedical Computing Limited, Battle, United Kingdom
| | - E. Draper
- East Midlands & South Yorkshire Congenital Anomaly Registry, University of Leicester, Leicester, United Kingdom
| | - E. Garne
- Hospital Lillebaelt, Region Syddanmark, Denmark
| | - M. Gatt
- Directorate for Health Information and Research, G’Mangia, Malta
| | - S. V. Glinianaia
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - A. Heino
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - E. Den Hond
- Provinciaal Instituut voor Hygiëne (PIH), Antwerpen, Belgium
| | - S. Jordan
- Swansea University, Wales, United Kingdom
| | - B. Khoshnood
- Institut National de la Santé et de la Recherche Médicale, Paris, France
| | | | - K. Klungsøyr
- Division of Mental and Physical Health, Department of Global Public Health and Primary Care, Norwegian Institute of Public Health, University of Bergen, Bergen, Norway
| | - N. Lelong
- Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - L. R. Lutke
- Department of Genetics, University Medical Center, University of Groningen, Groningen, The Netherlands
| | - A. J. Neville
- Emilia Romagna Registry of Birth Defects, University Hospital of Ferrara, Ferrara, Italy
| | - L. Ostapchuk
- OMNI-Net for Children International Charitable Fund, Rivne Regional Medical Diagnostic Center, Rivne, Ukraine
| | - A. Puccini
- Territorial Care Service, Emilia Romagna Health Authority, Bologna, Italy
| | - A. Rissmann
- Medical Faculty Otto-von-Guericke, Malformation Monitoring Centre Saxony-Anhalt, University Magdeburg, Magdeburg, Germany
| | - M. Santoro
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - I. Scanlon
- Swansea University, Wales, United Kingdom
| | - G. Thys
- Provinciaal Instituut voor Hygiëne (PIH), Antwerpen, Belgium
| | - D. Tucker
- Public Health Wales, Wales, United Kingdom
| | - S. K. Urhoj
- Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - H. E. K. de Walle
- Department of Genetics, University Medical Center, University of Groningen, Groningen, The Netherlands
| | - D. Wellesley
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, United Kingdom
| | - O. Zurriaga
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - J. K. Morris
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
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Wang G, Ma XY, Cheng X, Luo CH, Wang H, Xu X, Lee KKH, Yang X. The effects of long-term extracurricular scientific research on the medical students: Insight from Jinan University Medical School. Biochem Mol Biol Educ 2021; 49:535-545. [PMID: 33682343 DOI: 10.1002/bmb.21499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 12/30/2020] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
The benefits and long-term effects of extracurricular scientific research on undergraduate students in many countries have been intensively investigated, but it remains obscure for Chinese medical students. In this study, we investigated the outcome of 60 medical students who have participated in extracurricular scientific research at Jinan University Medical School over a period of 7 years (2011-2018). The results revealed that these students have contributed to 31 biomedical science articles in reputable academic journals, as first- or co-authors. Furthermore, they also independently procured various funding based on their research achievements, and smaller awards for achievements in conferences and competitions. Assessment of the grade point average score of these students revealed that conducting extracurricular scientific research did not affect their routine medical study and exam grades (P>0.05). The students benefited from participating in extracurricular research, by acquiring the ability to think scientifically and enhancing their communication skills. In addition, the medical students were motivated to enlist for postgraduate studies so that they could further embark in scientific research. In sum, Chinese medical students are capable of participating in scientific research and make a significant contribution to science.
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Affiliation(s)
- Guang Wang
- Division of Histology and Embryology, International Joint Laboratory for Embryonic Development & Prenatal Medicine, Medical College, Jinan University, Guangzhou, China
- Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, China
- Morphology experimental teaching center, Medical College, Jinan University, Guangzhou, China
| | - Xin-Yue Ma
- Department of Epidemiology, Medical School, Jinan University, Guangzhou, China
| | - Xin Cheng
- Division of Histology and Embryology, International Joint Laboratory for Embryonic Development & Prenatal Medicine, Medical College, Jinan University, Guangzhou, China
- Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, China
| | - Chao-Hua Luo
- College office, Medical College, Jinan University, Guangzhou, China
| | - Heng Wang
- College office, Medical College, Jinan University, Guangzhou, China
| | - Xu Xu
- College office, Medical College, Jinan University, Guangzhou, China
| | - Kenneth Ka Ho Lee
- Joint CUHK-UoS Laboratory for Stem Cells and Regeneration Medicine, School of Biomedical Sciences, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Xuesong Yang
- Division of Histology and Embryology, International Joint Laboratory for Embryonic Development & Prenatal Medicine, Medical College, Jinan University, Guangzhou, China
- Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, China
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Meunier J, Villar-Quiles RN, Duband-Goulet I, Ferreiro A. Inherited Defects of the ASC-1 Complex in Congenital Neuromuscular Diseases. Int J Mol Sci 2021; 22:ijms22116039. [PMID: 34204919 PMCID: PMC8199739 DOI: 10.3390/ijms22116039] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/19/2021] [Accepted: 05/27/2021] [Indexed: 12/12/2022] Open
Abstract
Defects in transcriptional and cell cycle regulation have emerged as novel pathophysiological mechanisms in congenital neuromuscular disease with the recent identification of mutations in the TRIP4 and ASCC1 genes, encoding, respectively, ASC-1 and ASCC1, two subunits of the ASC-1 (Activating Signal Cointegrator-1) complex. This complex is a poorly known transcriptional coregulator involved in transcriptional, post-transcriptional or translational activities. Inherited defects in components of the ASC-1 complex have been associated with several autosomal recessive phenotypes, including severe and mild forms of striated muscle disease (congenital myopathy with or without myocardial involvement), but also cases diagnosed of motor neuron disease (spinal muscular atrophy). Additionally, antenatal bone fractures were present in the reported patients with ASCC1 mutations. Functional studies revealed that the ASC-1 subunit is a novel regulator of cell cycle, proliferation and growth in muscle and non-muscular cells. In this review, we summarize and discuss the available data on the clinical and histopathological phenotypes associated with inherited defects of the ASC-1 complex proteins, the known genotype–phenotype correlations, the ASC-1 pathophysiological role, the puzzling question of motoneuron versus primary muscle involvement and potential future research avenues, illustrating the study of rare monogenic disorders as an interesting model paradigm to understand major physiological processes.
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Affiliation(s)
- Justine Meunier
- Basic and Translational Myology Laboratory, UMR8251, University of Paris/National Center for Scientific Research, 75013 Paris, France; (J.M.); (R.-N.V.-Q.)
| | - Rocio-Nur Villar-Quiles
- Basic and Translational Myology Laboratory, UMR8251, University of Paris/National Center for Scientific Research, 75013 Paris, France; (J.M.); (R.-N.V.-Q.)
- Reference Center for Neuromuscular Disorders, Pitié-Salpêtrière Hospital, APHP, Institute of Myology, 75013 Paris, France
| | - Isabelle Duband-Goulet
- Basic and Translational Myology Laboratory, UMR8251, University of Paris/National Center for Scientific Research, 75013 Paris, France; (J.M.); (R.-N.V.-Q.)
- Correspondence: (I.D.-G.); (A.F.); Tel.: +33-1-5727-7965 (I.D.-G.); +33-1-5727-7959 (A.F.)
| | - Ana Ferreiro
- Basic and Translational Myology Laboratory, UMR8251, University of Paris/National Center for Scientific Research, 75013 Paris, France; (J.M.); (R.-N.V.-Q.)
- Reference Center for Neuromuscular Disorders, Pitié-Salpêtrière Hospital, APHP, Institute of Myology, 75013 Paris, France
- Correspondence: (I.D.-G.); (A.F.); Tel.: +33-1-5727-7965 (I.D.-G.); +33-1-5727-7959 (A.F.)
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11
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Davidson JR, Uus A, Matthew J, Egloff AM, Deprez M, Yardley I, De Coppi P, David A, Carmichael J, Rutherford MA. Fetal body MRI and its application to fetal and neonatal treatment: an illustrative review. Lancet Child Adolesc Health 2021; 5:447-458. [PMID: 33721554 PMCID: PMC7614154 DOI: 10.1016/s2352-4642(20)30313-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/28/2020] [Accepted: 09/08/2020] [Indexed: 12/14/2022]
Abstract
This Review depicts the evolving role of MRI in the diagnosis and prognostication of anomalies of the fetal body, here including head and neck, thorax, abdomen and spine. A review of the current literature on the latest developments in antenatal imaging for diagnosis and prognostication of congenital anomalies is coupled with illustrative cases in true radiological planes with viewable three-dimensional video models that show the potential of post-acquisition reconstruction protocols. We discuss the benefits and limitations of fetal MRI, from anomaly detection, to classification and prognostication, and defines the role of imaging in the decision to proceed to fetal intervention, across the breadth of included conditions. We also consider the current capabilities of ultrasound and explore how MRI and ultrasound can complement each other in the future of fetal imaging.
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Affiliation(s)
- Joseph R Davidson
- Prenatal Cell and Gene Therapy, Elizabeth Garrett Anderson Institute of Women's Health, University College London, London, UK; UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
| | - Alena Uus
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Jacqueline Matthew
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Alexia M Egloff
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Maria Deprez
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Iain Yardley
- Paediatric Surgery, Evelina London Children's Hospital, London, UK
| | - Paolo De Coppi
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK; Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children, London, UK; Katholieke Universiteit Leuven, Leuven, Belgium
| | - Anna David
- Prenatal Cell and Gene Therapy, Elizabeth Garrett Anderson Institute of Women's Health, University College London, London, UK; Fetal Medicine Unit, University College London, London, UK
| | - Jim Carmichael
- Paediatric Radiology, Evelina London Children's Hospital, London, UK
| | - Mary A Rutherford
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
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Hur YJ, Lee BL, Chung WY, Yu S, Jun KR, Oh SH. Compound Heterozygous PIGT Mutations in Multiple Congenital Anomalies-Hypotonia-Seizures Syndrome: First Case in Korea and Characterization by Persistent Hypophosphatasia. Ann Clin Lab Sci 2021; 51:422-425. [PMID: 34162574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Mutations of phosphatidylinositol glycan biosynthesis class T (PIGT), which encodes a subunit of the glycosylphosphatidylinositol (GPI) transamidase complex, can lead to multiple anomalies, including seizures, intellectual disabilities, facial dysmorphism, and various congenital malformations. We performed whole-exome sequencing in a patient with seizures, intellectual disabilities, truncal ataxia, facial dysmorphism, and persistent hypophosphatasia without rickets or bone mineralization defects, and identified two heterozygous mutations in PIGT, c.250G>T (p.Glu84*) and c.1582G>A (p.Val528Met). GPI-linked protein analyses found no abnormalities. Although the patient's hypophosphatasia persists, no skeletal, urological, or dental abnormalities were found. The seizures disappeared after administering antiepileptic drugs. PIGT mutations should be considered in patients with multiple congenital symptoms and persistent hypophosphatasia.
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Affiliation(s)
- Yun Jung Hur
- Department of Pediatrics, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Bo Lyun Lee
- Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Woo Yeong Chung
- Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Shinae Yu
- Department of Laboratory Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Kyung Ran Jun
- Department of Laboratory Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Seung Hwan Oh
- Department of Laboratory Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
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13
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Luke B, Brown MB, Wantman E, Forestieri NE, Browne ML, Fisher SC, Yazdy MM, Ethen MK, Canfield MA, Nichols HB, Oehninger S, Doody KJ, Sutcliffe AG, Williams C, Eisenberg ML, Baker VL, Sacha CR, Lupo PJ. Risks of nonchromosomal birth defects, small-for-gestational age birthweight, and prematurity with in vitro fertilization: effect of number of embryos transferred and plurality at conception versus at birth. J Assist Reprod Genet 2021; 38:835-846. [PMID: 33547526 PMCID: PMC8079460 DOI: 10.1007/s10815-021-02095-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/27/2021] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Excess embryos transferred (ET) (> plurality at birth) and fetal heartbeats (FHB) at 6 weeks' gestation are associated with reductions in birthweight and gestation, but prior studies have been limited by small sample sizes and limited IVF data. This analysis evaluated associations between excess ET, excess FHB, and adverse perinatal outcomes, including the risk of nonchromosomal birth defects. METHODS Live births conceived via IVF from Massachusetts, New York, North Carolina, and Texas included 138,435 children born 2004-2013 (Texas), 2004-2016 (Massachusetts and North Carolina), and 2004-2017 (New York) were classified by ET and FHB. Major birth defects were reported by statewide registries within the first year of life. Logistic regression was used to estimate adjusted odds ratios (AORs) and 95% CIs of the risks of a major nonchromosomal birth defect, small-for-gestational age birthweight (SGA), low birthweight (LBW), and preterm birth (≤36 weeks), by excess ET, and excess ET + excess FHB, by plurality at birth (singletons and twins). RESULTS In singletons with [2 ET, FHB =1] and [≥3 ET, FHB=1], risks [AOR (95% CI)] were increased, respectively, for major nonchromosomal birth defects [1.13 (1.00-1.27) and 1.18 (1.00-1.38)], SGA [1.10 (1.03-1.17) and 1.15 (1.05-1.26)], LBW [1.09 (1.02-1.13) and 1.17 (1.07-1.27)], and preterm birth [1.06 (1.00-1.12) and 1.14 (1.06-1.23)]. With excess ET + excess FHB, risks of all adverse outcomes except major nonchromosomal birth defects increased further for both singletons and twins. CONCLUSION Excess embryos transferred are associated with increased risks for nonchromosomal birth defects, reduced birthweight, and prematurity in IVF-conceived births.
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Affiliation(s)
- Barbara Luke
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, 965 Wilson Road, East Fee Hall, Room 628, East Lansing, MI, 48824, USA.
| | - Morton B Brown
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Nina E Forestieri
- Birth Defects Monitoring Program, State Center for Health Statistics, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Marilyn L Browne
- Birth Defects Research Section, New York State Department of Health, Albany, NY, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY, USA
| | - Sarah C Fisher
- Birth Defects Research Section, New York State Department of Health, Albany, NY, USA
| | - Mahsa M Yazdy
- Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA, USA
| | - Mary K Ethen
- Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA, USA
| | - Mark A Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, USA
| | - Hazel B Nichols
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | | | | | - Alastair G Sutcliffe
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Carrie Williams
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Michael L Eisenberg
- Division of Male Reproductive Medicine and Surgery, Department of Urology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Valerie L Baker
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Caitlin R Sacha
- Massachusetts General Hospital Fertility Center and Harvard Medical School, Boston, MA, USA
| | - Philip J Lupo
- Epidemiology Program, Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TX, USA
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Bhale CP, Vare A, Gupta A. Fetal Autopsy-Categories and Causes of Death at a Tertiary Care Center. Am J Forensic Med Pathol 2021; 42:12-15. [PMID: 32868499 DOI: 10.1097/paf.0000000000000608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A fetus is defined from 8 weeks after conception until term while in the uterus. Fetal death is defined as death of the fetus before the complete expulsion or extraction from the mother, irrespective of the duration of pregnancy that is not an induced termination of pregnancy. The causes of fetal death determined after fetal autopsy can be categorized according to the classification proposed by Cunningham and Hollier as fetal, placental, and maternal. METHODS All fetuses dying in utero, that is, prior to birth, regardless of the gestational age, to the mothers admitted in the Department of Obstetrics and Gynecology along with the respective placentas were received in the Department of Pathology, MGM Medical College, Aurangabad, after an informed and written consent from October 26, 2017, to October 30, 2019, and were included in this study. Clinical details along with obstetric history and antenatal ultrasonographic findings were also recorded. Anthropometric examination of the fetus was performed and evisceration was then done using the Rokitansky technique. Representative sections from each of the organs were taken and kept in tissue cassettes and processed for routine hematoxylin and eosin staining. RESULTS This study was done on 33 cases of fetal death. Most fetal deaths occurred in the gestational age between 15 and 19 weeks (14 cases [42.42%]) and the least amount during 35 to 39 weeks (2 cases [6.06%]). The cause of death could not be ascertained in 6 cases (18.18%), whereas the maximum cases had fetal factor as the cause of death (15 cases [45.45%]). Maternal causes were seen in only 4 cases (12.12%). Gestational hypertension was seen to be the most common maternal factor associated with fetal death, which comprised 24.24% of cases (8 of 33). Thirteen of the total 33 cases did not have any associated obstetric complication. Of the total 33 fetal deaths, only 7 had associated placental defects on gross examination. Twenty-six placentas did not show any gross abnormality. Of these 7 cases, 5 were seen to have placental infarction. CONCLUSIONS Fetal autopsy is a valuable and cost-effective modality for the confirmation of cause of fetal death. Fetal autopsy can also prove beneficial to the parents in planning for future pregnancies. Fetal autopsy can serve as the ultimate tool in diagnosing cause of fetal death in cases where no other diagnostic clue is available. Therefore, it should be encouraged and couples to be counseled regarding its importance and clinical utility.
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15
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16
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Brabbing-Goldstein D, Yaron Y, Reches A. Familial Beckwith-Wiedemann syndrome: Prenatal manifestation and a possible expansion of the phenotype. Eur J Med Genet 2021; 64:104137. [PMID: 33421606 DOI: 10.1016/j.ejmg.2021.104137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 10/19/2020] [Accepted: 01/02/2021] [Indexed: 11/19/2022]
Abstract
We describe a case of Beckwith-Wiedemann syndrome (BWS) demonstrating pre- and post-natal intra-familial variability. Our first encounter with the family occurred in the 1990s following the birth of 3 affected offspring. The first two pregnancies presented with exomphalos and elevated second trimester maternal serum alpha-fetoprotein (msAFP, 3.43 and 4.01 MOM, respectively) as well as elevated maternal human chorionic gonadotrophin (mhCG, 4.33 and 8.8 MOM, respectively). The diagnosis of BWS was confirmed postnatally in both cases. The third ongoing pregnancy presented only with elevated mhCG (7.09 MOM) and no malformation. Nonetheless BWS was suspected. The diagnosis was confirmed postnatally with clinical manifestations including macroglossia and cleft palate. Two affected female siblings were also diagnosed with Mullerian agenesis in adulthood. Suspecting a common genetic etiology, sequencing of the CDKN1C gene revealed a maternally inherited, likely pathogenic variant (NM_000076.2: c.367_385del; p.(Ala123Serfs*143)) causative of BWS. Chromosomal microarray and whole exome sequencing did not reveal any other pathogenic variant that would explain the Mullerian agenesis. One of the affected females underwent successful preimplantation genetic testing (PGT) with a surrogate and gave birth to a healthy female. To the best of our knowledge, this is the first report of Mullerian agenesis as a possible rare expansion of the BWS phenotype. In addition, this case highlights the potential role of abnormal second trimester biochemical markers (msAFP, mHCG) as possible indicators of BWS, especially in familial cases.
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Affiliation(s)
- Dana Brabbing-Goldstein
- Genetic Institute at Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv, Israel.
| | - Yuval Yaron
- Genetic Institute at Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Reches
- Genetic Institute at Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv, Israel
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17
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Guo M, Xu Q, Yu X, Yang Q, Shao S. Association of Agenesis of the Dorsal Pancreas With HNF1B Heterozygote Mutation: A Case Report. Front Endocrinol (Lausanne) 2021; 12:640006. [PMID: 34721285 PMCID: PMC8554068 DOI: 10.3389/fendo.2021.640006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 09/30/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Agenesis of the dorsal pancreas (ADP) is a rare disease, the pathogenic mechanism of which is partially related to variants of hepatocyte nuclear factor 1B (HNF1B) gene. CASE PRESENTATION We report a case of ADP, which presented with acute ketoacidosis, hyperuricemia, and liver dysfunction. In this case, the HNF1B score was estimated as 16 and a heterozygous variant of HNF1B in exon 2 (c.513G>A-p.W171X) was identified through gene sequencing. CONCLUSIONS A good understanding of the clinical comorbidities of ADP is essential for avoiding missed diagnosis to a great extent. Moreover, estimation of HNF1B score is recommended before genetic testing.
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Affiliation(s)
- Mei Guo
- Division of Endocrinology, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, China
- Division of Endocrinology, Qianjiang Central Hospital of Hubei Province, Qianjiang Hospital Affiliated to Renmin Hospital of Wuhan University, Qianjiang Clinical Medical College, Health Science Center, Yangtze University, Qianjiang, China
| | - Qinqin Xu
- Division of Endocrinology, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, China
| | - Xuefeng Yu
- Division of Endocrinology, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, China
| | - Qin Yang
- Division of Pathology, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, China
- *Correspondence: Shiying Shao, ; Qin Yang,
| | - Shiying Shao
- Division of Endocrinology, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, China
- *Correspondence: Shiying Shao, ; Qin Yang,
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Son SL, Allshouse AA, Page JM, Debbink MP, Pinar H, Reddy U, Gibbins KJ, Stoll BJ, Parker CB, Dudley DJ, Varner MW, Silver RM. Stillbirth and fetal anomalies: secondary analysis of a case-control study. BJOG 2021; 128:252-258. [PMID: 32946651 PMCID: PMC7902300 DOI: 10.1111/1471-0528.16517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Approximately 10% of stillbirths are attributed to fetal anomalies, but anomalies are also common in live births. We aimed to assess the relationship between anomalies, by system and stillbirth. DESIGN Secondary analysis of a prospective, case-control study. SETTING Multicentre, 59 hospitals in five regional catchment areas in the USA. POPULATION OR SAMPLE All stillbirths and representative live birth controls. METHODS Standardised postmortem examinations performed in stillbirths, medical record abstraction for stillbirths and live births. MAIN OUTCOME MEASURES Incidence of major anomalies, by type, compared between stillbirths and live births with univariable and multivariable analyses using weighted analysis to account for study design and differential consent. RESULTS Of 465 singleton stillbirths included, 23.4% had one or more major anomalies compared with 4.3% of 1871 live births. Having an anomaly increased the odds of stillbirth; an increasing number of anomalies was more highly associated with stillbirth. Regardless of organ system affected, the presence of an anomaly increased the odds of stillbirth. These relationships remained significant if stillbirths with known genetic abnormalities were excluded. After multivariable analyses, the adjusted odds ratio (aOR) of stillbirth for any anomaly was 4.33 (95% CI 2.80-6.70) and the systems most strongly associated with stillbirth were cystic hygroma (aOR 29.97, 95% CI 5.85-153.57), and thoracic (aOR16.18, 95% CI 4.30-60.94) and craniofacial (aOR 35.25, 95% CI 9.22-134.68) systems. CONCLUSIONS In pregnancies affected by anomalies, the odds of stillbirth are higher with increasing numbers of anomalies. Anomalies of nearly any organ system increased the odds of stillbirth even when adjusting for gestational age and maternal race. TWEETABLE ABSTRACT Stillbirth risk increases with anomalies of nearly any organ system and with number of anomalies seen.
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Affiliation(s)
- S L Son
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
- Division of Maternal-Fetal Medicine, Intermountain Healthcare, Salt Lake City, UT, USA
| | - A A Allshouse
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
| | - J M Page
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
- Division of Maternal-Fetal Medicine, Intermountain Healthcare, Salt Lake City, UT, USA
| | - M P Debbink
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
- Division of Maternal-Fetal Medicine, Intermountain Healthcare, Salt Lake City, UT, USA
| | - H Pinar
- Division of Perinatal Pathology, Alpert Medical School of Brown University, Providence, RI, USA
| | - U Reddy
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Yale School of Medicine, New Haven, CT, USA
| | - K J Gibbins
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
| | - B J Stoll
- Department of Pediatrics, University of Texas Health McGovern Medical School, Houston, TX, USA
| | - C B Parker
- RTI International, Research Triangle Park, NC, USA
| | - D J Dudley
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - M W Varner
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
- Division of Maternal-Fetal Medicine, Intermountain Healthcare, Salt Lake City, UT, USA
| | - R M Silver
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
- Division of Maternal-Fetal Medicine, Intermountain Healthcare, Salt Lake City, UT, USA
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Fan C, An H, Sharif M, Kim D, Park Y. Functional mechanisms of MYRF DNA-binding domain mutations implicated in birth defects. J Biol Chem 2021; 296:100612. [PMID: 33798553 PMCID: PMC8094900 DOI: 10.1016/j.jbc.2021.100612] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 11/17/2022] Open
Abstract
Myrf is a pleiotropic membrane-bound transcription factor that plays critical roles in diverse organisms, including in oligodendrocyte differentiation, embryonic development, molting, and synaptic plasticity. Upon autolytic cleavage, the Myrf N-terminal fragment enters the nucleus as a homo-trimer and functions as a transcription factor. Homo-trimerization is essential for this function because it imparts DNA-binding specificity and affinity. Recent exome sequencing studies have implicated four de novo MYRF DNA-binding domain (DBD) mutations (F387S, Q403H, G435R, and L479V) in novel syndromic birth defects involving the diaphragm, heart, and the urogenital tract. It remains unknown whether and how these four mutations alter the transcription factor function of MYRF. Here, we studied them by introducing homologous mutations to the mouse Myrf protein. We found that the four DBD mutations abolish the transcriptional activity of the Myrf N-terminal fragment by interfering with its homo-trimerization ability by perturbing the DBD structure. Since the Myrf N-terminal fragment strictly functions as a homo-trimer, any loss-of-function mutation has the potential to act as a dominant negative. We observed that one copy of Myrf-F387S, Myrf-Q403H, or Myrf-L479V, but not Myrf-G435R, was tolerated by the Myrf N-terminal homo-trimer for structural and functional integrity. These data suggest that F387S, Q403H, and L479V cause birth defects by haploinsufficiency, while G435R does so via dominant negative functionality.
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Affiliation(s)
- Chuandong Fan
- Hunter James Kelly Research Institute, Department of Biochemistry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA
| | - Hongjoo An
- Hunter James Kelly Research Institute, Department of Biochemistry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA
| | - Mohamed Sharif
- Hunter James Kelly Research Institute, Department of Biochemistry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA
| | - Dongkyeong Kim
- Hunter James Kelly Research Institute, Department of Biochemistry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA
| | - Yungki Park
- Hunter James Kelly Research Institute, Department of Biochemistry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA.
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Yesodharan D, Krishnan V, Nair IR, Ganapathy A, Mannan AU, Nampoothiri S. Lethal Cenani Lenz syndrome in two consecutive pregnancies: Further extension of phenotype from Maldives. Am J Med Genet A 2020; 185:620-624. [PMID: 33179409 DOI: 10.1002/ajmg.a.61971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/16/2020] [Accepted: 10/17/2020] [Indexed: 11/07/2022]
Abstract
Cenani Lenz syndrome is a rare autosomal recessive disorder associated with variable degree of limb malformations, dysmorphism, and renal agenesis. It is caused due to pathogenic variants in the LRP4 gene, which plays an important role in limb and renal development. Mutations in the APC gene have also been occasionally associated with CLS. The phenotypic spectrum ranges from mild to very severe perinatal lethal type depending on the type of variant. We report a pathogenic variant, c.2710 del T (p.Trp904GlyfsTer5) in theLRP4 gene, in a fetus with lethal Cenani Lenz syndrome with antenatal presentation of tetraphocomelia and symmetrical involvement of hands and feet.
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Affiliation(s)
- Dhanya Yesodharan
- Department of Pediatric Genetics, Amrita Institute of Medical Sciences and Research Center, Cochin, India
| | - Vivek Krishnan
- Department of Perinatology, Amrita Institute of Medical Sciences and Research Center, Cochin, India
| | - Indu R Nair
- Department of Pathology, Amrita Institute of Medical Sciences and Research Center, Cochin, India
| | | | | | - Sheela Nampoothiri
- Department of Pediatric Genetics, Amrita Institute of Medical Sciences and Research Center, Cochin, India
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21
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Cheng D, Yuan S, Hu L, Yi D, Luo K, Gong F, Lu C, Lu G, Lin G, Tan YQ. The genetic cause of intellectual deficiency and/or congenital malformations in two parental reciprocal translocation carriers and implications for assisted reproduction. J Assist Reprod Genet 2020; 38:243-250. [PMID: 33094427 DOI: 10.1007/s10815-020-01986-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/15/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To elucidate the genetic cause of intellectual deficiency and/or congenital malformations in two parental reciprocal translocation carriers and provide appropriate strategies of assisted reproductive therapy (ART). MATERIALS AND METHODS Two similar couples having a child with global developmental delay/intellectual disability symptoms attended the Reproductive and Genetic Hospital of CITIC-Xiangya (Changsha, China) in 2017 and 2019, respectively, in order to determine the cause(s) of the conditions affecting their child and to seek ART to have a healthy baby. Both of the healthy couples were not of consanguineous marriage, denied exposure to toxicants, and had no adverse life history. This study was approved by the Institutional Ethics Committee of the Reproductive & Genetic Hospital of CITIC-Xiangya, and written informed consent was obtained from the parents. Genetic diagnoses were performed by karyotype analysis, breakpoint mapping analysis of chromosomal translocation(s), single-nucleotide polymorphism (SNP) microarray analysis, and whole-exome sequencing (WES) for the two children and different appropriate reproductive strategies were performed in the two families. RESULTS Karyotype analysis revealed that both patients carried parental reciprocal translocations [46,XY,t(7;16)(p13;q24)pat and 46,XY,t(13;17)(q12.3;p11.2)pat, respectively]. Follow-up breakpoint mapping analysis showed no interruption of associated genes, and SNP microarray analysis identified no significant copy number variations (CNVs) in the two patients. Moreover, WES results revealed that patients 1 and 2 harbored candidate compound heterozygous mutations of MCOLN1 [c.195G>C (p.K65N) and c.1061G>A (p.W354*)] and MCPH1 [c.877A>G (p.S293G) and c.1869_1870delAT (p.C624*)], respectively, that were inherited from their parents and not previously reported. Furthermore, the parents of patient 1 obtained 10 embryos during ART cycle, and an embryo of normal karyotype and non-carrier of observed MCOLN1 mutations according to preimplantation genetic testing for structural rearrangement and monogenic defect was successfully transferred, resulting in the birth of a healthy boy. The parents of patient 2 chose to undergo ART with donor sperm to reduce the risk of recurrence. CONCLUSIONS Systematic genetic diagnosis of two carriers of inherited chromosomal translocations accompanied by clinical phenotypes revealed their cause of disease, which was critical for genetic counseling and further ART for these families.
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Affiliation(s)
- Dehua Cheng
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
| | - Shimin Yuan
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
| | - Liang Hu
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
- Institute of Reproduction and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, 410078, Hunan, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Central South University, Changsha, 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha, 410013, China
| | - Duo Yi
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
| | - Keli Luo
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
| | - Fei Gong
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
- Institute of Reproduction and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, 410078, Hunan, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Central South University, Changsha, 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha, 410013, China
| | - Changfu Lu
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
- Institute of Reproduction and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, 410078, Hunan, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Central South University, Changsha, 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha, 410013, China
| | - Guangxiu Lu
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
- Institute of Reproduction and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, 410078, Hunan, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Central South University, Changsha, 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha, 410013, China
| | - Ge Lin
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
- Institute of Reproduction and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, 410078, Hunan, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Central South University, Changsha, 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha, 410013, China
| | - Yue-Qiu Tan
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China.
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China.
- Institute of Reproduction and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, 410078, Hunan, China.
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Central South University, Changsha, 410008, China.
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22
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Roubos J, Maliko N, van der Wilden GM. [A man with swollen abdomen, abdominal pain and nausea]. Ned Tijdschr Geneeskd 2020; 164:D5119. [PMID: 33201639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 45-year-old man presented with acute intestinal obstruction, due to congenital peritoneal encapsulation. This rare malformation leads to an accessory peritoneal sac around all or part of the small bowel. Torsion of this sac can lead to acute bowel obstruction and therefore ischaemia. In this case, detorsion and adhesiolysis resulted in a positive outcome.
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Affiliation(s)
- J Roubos
- Alrijne Ziekenhuis, afd. Heelkunde, Leiderdorp
- Contact: J. Roubos
| | - N Maliko
- Alrijne Ziekenhuis, afd. Heelkunde, Leiderdorp
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23
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Zhang X, Qiu J, Ding Y, Sun L, Hua K. Single port laparoscopy combined with vaginal cervicovaginal reconstruction in a patient with congenital atresia of the cervix. Fertil Steril 2020; 113:681-682. [PMID: 32192600 DOI: 10.1016/j.fertnstert.2019.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/07/2019] [Accepted: 11/11/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To introduce an innovation that combines single port laparoscopic and Wharton-Sheares-George cervicovaginal reconstruction using a small intestinal submucosa (SIS) graft in a patient with congenital cervical atresia, absence of vagina, and incomplete uterine septum (U2aC4V4). DESIGN Video article introducing a new surgical technique. SETTING University hospital. PATIENT(S) A 15-year-old patient with congenital cervical atresia, absence of vagina, and incomplete uterine septum had primary amenorrhea and cyclic lower abdominal pain. The magnetic resonance imaging did not show hematometra and the endometrium was 6 mm when she had lower abdominal pain. INTERVENTION(S) A neovagina (depth, 7 cm; width, 2.5 cm) was created using the Wharton-Sheares-George neovaginoplasty. By single laparoscopy, the bladder was separated from the anterior surface of the uterus. With the mold in the neovagina created by the assistant, the apex of neovagina was opened. Then the lower uterine segment was exposed and incised. A T-shaped intrauterine device was connected to an 8-cm-long catheter scissored from a 14-F Foley catheter and was inserted into the uterus to prevent cervical or vaginal stenosis. The upper end of the graft was applied onto the lower uterine segment with delayed absorbable sutures. The lower end was sutured to the high vaginal or vestibular mucosa. MAIN OUTCOME MEASURE(S) The feasibility and effect of combination single port laparoscopic with vaginal cervicovaginal reconstruction in the congenital atresia of cervix. RESULT(S) The operation was successful. The operating time was 90 minutes. Hospitalization was 3 days. There were no intraoperative and postoperative complications. The patient had resumption of menses at three cycles postoperatively, and she had no dysmenorrhea. No cervical or vaginal stenosis occurred because of the Foley catheter. CONCLUSION(S) Single port laparoscopic combined with vaginal cervicovaginal reconstruction provided a minimally invasive, safe, and effective surgical option for the young patient with congenital atresia of cervix. It was successful and without complications or cervical or vaginal stenosis.
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Affiliation(s)
- Xuyin Zhang
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Junjun Qiu
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yan Ding
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Li Sun
- Department of Ultrasound, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Keqin Hua
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China.
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24
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Ogliari KCM, Rios SDS, Chen ACR, Chen JR, Resende CN, Araujo Júnior E. An alternative approach to vaginal dilation in patients with Meyer-Rokitanski-Küster-Hauser syndrome: two case reports. Gynecol Endocrinol 2020; 36:746-748. [PMID: 31994956 DOI: 10.1080/09513590.2020.1719061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Vaginal dilation, currently considered as the first-line therapy for vaginal aplasia in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, is a safe and effective treatment that aims to create a functional neovagina. However, rigid vaginal dilators classically described in the literature usually cause physical discomfort and side effects that can lead to vaginal necrosis. Here, we present two cases of MRKH syndrome patients with vaginal agenesis whose main complaint was the inability to have sexual intercourse with their partners. Considering unavailability of acrylic dilators and previous studies reporting good responses with the use of silicone dilators in women with post-radiotherapy vaginal stenosis, the medical team and patients opted for creation of a neovagina through the daily use of silicone vaginal dilators. Patient 1 developed an 8-cm vagina after 6 months of treatment and had a satisfactory sex life with her partner. Patient 2 developed a 7-cm vagina and reported significant symptom improvement. None of the patients developed side effects after the treatment. The use of inexpensive and easily accessible silicone vaginal dilators may be an effective and noninvasive alternative with few side effects for women with vaginal agenesis, particularly in the developing countries.
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Affiliation(s)
| | - Salete da Silva Rios
- Department of Gynecology and Obstetrics, University of Brasília (UnB), Brasília-DF, Brazil
| | - Ana Carolina Rios Chen
- Department of Gynecology and Obstetrics, University of Brasília (UnB), Brasília-DF, Brazil
| | - Juliana Rios Chen
- Department of Gynecology and Obstetrics, University of Brasília (UnB), Brasília-DF, Brazil
| | - Ceres Nunes Resende
- Department of Gynecology and Obstetrics, University of Brasília (UnB), Brasília-DF, Brazil
| | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil
- Medical Course, Bela Vista Campus, Municipal University of São Caetano do Sul (USCS), São Paulo-SP, Brazil
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25
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Titelbaum AR. Developmental anomalies and South American paleopathology: A comparison of block vertebrae and co-occurring axial anomalies among three skeletal samples from the El Brujo archaeological complex of northern coastal Peru. Int J Paleopathol 2020; 29:76-93. [PMID: 31353289 DOI: 10.1016/j.ijpp.2019.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 06/10/2023]
Abstract
Though developmental anomalies have been noted for over a century in South American paleopathology, they have received less attention than other pathological conditions. When anomalies are reported, they tend to be unusual case studies or incidental findings. Paleopathological research should also consider anomalies from a population perspective, to broaden our understanding about the frequency of specific anomalies, and potentially offer insight into genetic relationships, cultural behavior, or environmental factors. This investigation compared block vertebrae and co-occurring postcranial axial anomalies among three skeletal samples reflecting an occupational sequence at the El Brujo Archaeological Complex of Peru. Block vertebrae demonstrate both considerable antiquity and persistence through time, though frequencies, vertebral level, and co-occurring anomalies varied by sex and cultural period. Among the Late Preceramic sample, the frequency of C2-C3 block vertebrae was highest and only seen among females, which may suggest familial influence, genetic isolation, and potentially matrilocality. The Moche sample demonstrated a moderate frequency of blocks, which in combination with the frequencies of other developmental anomalies, may suggest population continuity paired with an influx of new genes, demographic expansion, and possible cultural change with regard to postmarital residence. The Lambayeque sample demonstrated the lowest frequency of blocks and the highest frequency and greatest diversity of anomalies, which may suggest genetic continuity from the Moche, an expanded gene pool, broader opportunities for mate choice, and cultural change. It is hoped that this investigation will provide data for future comparisons and call attention to the need for the broader study of developmental anomalies in South America.
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Affiliation(s)
- Anne R Titelbaum
- Basic Medical Sciences, University of Arizona College of Medicine - Phoenix, Phoenix, AZ 85004, USA.
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26
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Arts P, Garland J, Byrne AB, Hardy TS, Babic M, Feng J, Wang P, Ha T, King‐Smith SL, Schreiber AW, Crawford A, Manton N, Moore L, Barnett CP, Scott HS. Paternal mosaicism for a novel PBX1 mutation associated with recurrent perinatal death: Phenotypic expansion of the PBX1-related syndrome. Am J Med Genet A 2020; 182:1273-1277. [PMID: 32141698 PMCID: PMC7217179 DOI: 10.1002/ajmg.a.61541] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/09/2020] [Accepted: 02/13/2020] [Indexed: 11/11/2022]
Abstract
Autosomal dominant (de novo) mutations in PBX1 are known to cause congenital abnormalities of the kidney and urinary tract (CAKUT), with or without extra-renal abnormalities. Using trio exome sequencing, we identified a PBX1 p.(Arg107Trp) mutation in a deceased one-day-old neonate presenting with CAKUT, asplenia, and severe bilateral diaphragmatic thinning and eventration. Further investigation by droplet digital PCR revealed that the mutation had occurred post-zygotically in the father, with different variant allele frequencies of the mosaic PBX1 mutation in blood (10%) and sperm (20%). Interestingly, the father had subclinical hydronephrosis in childhood. With an expected recurrence risk of one in five, chorionic villus sampling and prenatal diagnosis for the PBX1 mutation identified recurrence in a subsequent pregnancy. The family opted to continue the pregnancy and the second affected sibling was stillborn at 35 weeks, presenting with similar severe bilateral diaphragmatic eventration, microsplenia, and complete sex reversal (46, XY female). This study highlights the importance of follow-up studies for presumed de novo and low-level mosaic variants and broadens the phenotypic spectrum of developmental abnormalities caused by PBX1 mutations.
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Affiliation(s)
- Peer Arts
- Genetics and Molecular Pathology Research Laboratory, Centre for Cancer BiologyAn Alliance Between SA Pathology and the University of South AustraliaAdelaideSouth AustraliaAustralia
| | - Jessica Garland
- Paediatric and Reproductive Genetics UnitWomen's and Children's HospitalAdelaideSouth AustraliaAustralia
| | - Alicia B. Byrne
- Genetics and Molecular Pathology Research Laboratory, Centre for Cancer BiologyAn Alliance Between SA Pathology and the University of South AustraliaAdelaideSouth AustraliaAustralia
- School of Pharmacy and Medical SciencesUniversity of South AustraliaAdelaideSouth AustraliaAustralia
- Australian Genomics Health AllianceMelbourneVictoriaAustralia
| | - Tristan S.E. Hardy
- Genetics and Molecular Pathology Research Laboratory, Centre for Cancer BiologyAn Alliance Between SA Pathology and the University of South AustraliaAdelaideSouth AustraliaAustralia
- RepromedDulwichAustralia
- School of MedicineUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Milena Babic
- Genetics and Molecular Pathology Research Laboratory, Centre for Cancer BiologyAn Alliance Between SA Pathology and the University of South AustraliaAdelaideSouth AustraliaAustralia
| | - Jinghua Feng
- School of Pharmacy and Medical SciencesUniversity of South AustraliaAdelaideSouth AustraliaAustralia
- ACRF Cancer Genomics Facility, Centre for Cancer BiologyAn Alliance Between SA Pathology and the University of South AustraliaAdelaideSouth AustraliaAustralia
| | - Paul Wang
- ACRF Cancer Genomics Facility, Centre for Cancer BiologyAn Alliance Between SA Pathology and the University of South AustraliaAdelaideSouth AustraliaAustralia
| | - Thuong Ha
- Genetics and Molecular Pathology Research Laboratory, Centre for Cancer BiologyAn Alliance Between SA Pathology and the University of South AustraliaAdelaideSouth AustraliaAustralia
| | - Sarah L. King‐Smith
- Genetics and Molecular Pathology Research Laboratory, Centre for Cancer BiologyAn Alliance Between SA Pathology and the University of South AustraliaAdelaideSouth AustraliaAustralia
- Australian Genomics Health AllianceMelbourneVictoriaAustralia
| | - Andreas W. Schreiber
- School of Pharmacy and Medical SciencesUniversity of South AustraliaAdelaideSouth AustraliaAustralia
- ACRF Cancer Genomics Facility, Centre for Cancer BiologyAn Alliance Between SA Pathology and the University of South AustraliaAdelaideSouth AustraliaAustralia
- School of Biological SciencesUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - April Crawford
- Department of Anatomical PathologySA Pathology, Women's and Children's HospitalNorth AdelaideSouth AustraliaAustralia
| | - Nick Manton
- Department of Anatomical PathologySA Pathology, Women's and Children's HospitalNorth AdelaideSouth AustraliaAustralia
| | - Lynette Moore
- School of MedicineUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Department of Anatomical PathologySA Pathology, Women's and Children's HospitalNorth AdelaideSouth AustraliaAustralia
| | - Christopher P. Barnett
- Paediatric and Reproductive Genetics UnitWomen's and Children's HospitalAdelaideSouth AustraliaAustralia
- School of MedicineUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Hamish S. Scott
- Genetics and Molecular Pathology Research Laboratory, Centre for Cancer BiologyAn Alliance Between SA Pathology and the University of South AustraliaAdelaideSouth AustraliaAustralia
- School of Pharmacy and Medical SciencesUniversity of South AustraliaAdelaideSouth AustraliaAustralia
- School of MedicineUniversity of AdelaideAdelaideSouth AustraliaAustralia
- ACRF Cancer Genomics Facility, Centre for Cancer BiologyAn Alliance Between SA Pathology and the University of South AustraliaAdelaideSouth AustraliaAustralia
- Australian Genomics Health AllianceMelbourneVictoriaAustralia
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27
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Brzački V, Mladenović B, Jeremić L, Živanović D, Govedarović N, Dimić D, Golubović M, Stoičkov V. Congenital esophageal stenosis: a rare malformation of the foregut. Nagoya J Med Sci 2019; 81:535-547. [PMID: 31849372 PMCID: PMC6892676 DOI: 10.18999/nagjms.81.4.535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 01/17/2019] [Indexed: 12/30/2022]
Abstract
Congenital esophageal stenosis (CES) is a type of esophageal stenosis, and three histological subtypes (tracheobronchial remnants, fibromuscular thickening or fibromuscular stenosis, and membranous webbing or esophageal membrane) are described. Symptoms of CES usually appears with the introduction of the semisolid alimentation. Dysphagia is the most common symptom, but esophageal food impaction, respiratory distress or failure to thrive can be clinical manifestations of CES. Wide spectrum of differential diagnoses leads to delayed definitive diagnosis and appropriate treatment. Depends on hystological subtype of CES, some treatment procedures (dilation or segmental esophageal resection) are recommended, but individually approach is still important in terms of frequency and type of dilation procedures or type of the surgical treatment. Dysphagia can persist after the treatment and a long follow-up period is recommended. In 33% of patients with CES, a different malformations in the digestive system, but also in the other systems, are described.
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Affiliation(s)
- Vesna Brzački
- Gastroenterology and Hepatology Clinic, Clinical Center Niš, Niš, Serbia
- Department of Internal Medicine, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Bojan Mladenović
- Gastroenterology and Hepatology Clinic, Clinical Center Niš, Niš, Serbia
- Department of Internal Medicine, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Ljiljana Jeremić
- General Surgery Clinic, Clinical Center Niš, Niš, Serbia
- Department of Surgery, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Dragoljub Živanović
- Department of Surgery, Faculty of Medicine, University of Niš, Niš, Serbia
- Pediatric Surgery and Orthopedic Clinic, Clinical Center Niš, Niš, Serbia
| | - Nenad Govedarović
- Department of Internal Medicine, Faculty of Medicine, University of Niš, Niš, Serbia
- Hematology and Clinical Immunology Clinic, Clinical Center Niš, Niš, Serbia
| | - Dragan Dimić
- Department of Internal Medicine, Faculty of Medicine, University of Niš, Niš, Serbia
- Endocrinology Clinic, Clinical Center Niš, Niš, Serbia
| | - Mladjan Golubović
- Anesthesiology and Reanimation Center, Clinical Center Niš, Niš, Serbia
| | - Viktor Stoičkov
- Department of Internal Medicine, Faculty of Medicine, University of Niš, Niš, Serbia
- Institute for Treatment and Rehabilitation "Niška Banja," Niš, Serbia
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28
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Mittal A, Garg PK, Sureka B. Ask-Upmark Kidney, Imaging Features. Iran J Kidney Dis 2019; 13:362-371. [PMID: 31880582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/19/2019] [Indexed: 06/10/2023]
Abstract
Renovascular hypertension is known to occur due to varied causes. Absence of Renal artery stenosis or changes in renal vascular flow make it tough to establish a diagnosis of renovascular hypertension in the absence of invasive investigations. Segmental renal hypoplasia is not only a rare cause for renin mediated hypertension but also requires expertise and high index of suspicion while evaluating children with hypertension. We describe the classical imaging findings of a child with secondary hypertension which was due to hypoplasia of a renal segment.
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Affiliation(s)
- Aliza Mittal
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
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29
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Wen Y, Xiang G, Zhou L, Tong X. Left juxtaposition of atrial appendages with anatomically corrected malposition of great arteries: a challenging fetal diagnosis. Ultrasound Obstet Gynecol 2019; 54:560-562. [PMID: 31180602 DOI: 10.1002/uog.20369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/27/2019] [Accepted: 05/31/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Y Wen
- Department of Ultrasound, The Fifth People's Hospital of Chengdu, Chengdu, China
| | - G Xiang
- Department of Ultrasound, The Fifth People's Hospital of Chengdu, Chengdu, China
| | - L Zhou
- Department of Ultrasound, The Children and Women's Hospital of Chengdu, Chengdu, China
| | - X Tong
- Department of Ultrasound, The Fifth People's Hospital of Chengdu, Chengdu, China
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30
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Pooh RK, Machida M, Nakamura T, Uenishi K, Chiyo H, Itoh K, Yoshimatsu J, Ueda H, Ogo K, Chaemsaithong P, Poon LC. Increased Sylvian fissure angle as early sonographic sign of malformation of cortical development. Ultrasound Obstet Gynecol 2019; 54:199-206. [PMID: 30381845 PMCID: PMC6772089 DOI: 10.1002/uog.20171] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 10/17/2018] [Accepted: 10/19/2018] [Indexed: 05/20/2023]
Abstract
OBJECTIVE To evaluate Sylvian fissure development by assessing Sylvian fissure angles in fetuses with malformation of cortical development (MCD). METHODS This was a retrospective study of 22 fetuses with MCD. Cases with a stored three-dimensional (3D) brain volume acquired at 18 + 0 to 30 + 6 weeks of gestation at an ultrasound-based research clinic between January 2010 and December 2017 were identified through a database. Of the 22 fetuses, seven had an extracranial abnormality, such as cardiac, renal, gastrointestinal and/or digital anomalies, and five had a minor abnormality such as micrognathia, low-set ears and/or single umbilical artery. To confirm the final clinical diagnosis of brain abnormality, postmortem histological findings or prenatal or postnatal magnetic resonance images were used. For measurement of Sylvian fissure angle, an anterior coronal plane of the fetal brain on transvaginal 3D volume multiplanar imaging was visualized as a single image from the three orthogonal views. The right and left Sylvian fissure angles were measured between a horizontal reference line (0°) and a line drawn along the upper side of the respective Sylvian fissure. The Sylvian fissure angle on both sides was plotted on the graphs of the reference ranges for gestational age in weeks. RESULTS In 21 (95.5%; 95% CI, 86.8-100.0%) of 22 fetuses with MCD, the Sylvian fissure angle on one or both sides was larger than the 90th percentile of the normal reference. There was one case with apparent focal MCD in the parietal lobe, but the Sylvian fissure angles were normal. A case with apparent unilateral cortical dysplasia and one with apparent unilateral schizencephaly had conspicuous discrepancies between the left and right Sylvian fissure angles. Abnormal genetic test results were obtained in six cases, including four cases with a mutation in a single gene. CONCLUSIONS This study has shown that the Sylvian fissures, as defined by the Sylvian fissure angle, have delayed development in most MCD cases prior to the diagnosis of the condition. The Sylvian fissure angle may potentially be a strong indicator for the subsequent development of cortical malformation, before the time point at which the gyri and sulci become obvious on the fetal brain surface. Further research is required to validate these findings. © 2018 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- R. K. Pooh
- CRIFM Clinical Research Institute of Fetal Medicine Pooh Maternity ClinicOsakaJapan
| | - M. Machida
- CRIFM Clinical Research Institute of Fetal Medicine Pooh Maternity ClinicOsakaJapan
| | - T. Nakamura
- CRIFM Clinical Research Institute of Fetal Medicine Pooh Maternity ClinicOsakaJapan
| | - K. Uenishi
- CRIFM Clinical Research Institute of Fetal Medicine Pooh Maternity ClinicOsakaJapan
| | - H. Chiyo
- CRIFM Clinical Research Institute of Fetal Medicine Pooh Maternity ClinicOsakaJapan
| | - K. Itoh
- Department of Pathology and Applied Neurobiology, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - J. Yoshimatsu
- Department of Obstetrics and GynecologyNational Cerebral and Cardiovascular CenterOsakaJapan
| | - H. Ueda
- Department of PathologyNational Cerebral and Cardiovascular CenterOsakaJapan
| | - K. Ogo
- Department of PathologyNational Cerebral and Cardiovascular CenterOsakaJapan
| | - P. Chaemsaithong
- Department of Obstetrics and GynaecologyPrince of Wales Hospital, The Chinese University of Hong KongShatinHong Kong SAR
| | - L. C. Poon
- Department of Obstetrics and GynaecologyPrince of Wales Hospital, The Chinese University of Hong KongShatinHong Kong SAR
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Oosterhof N, Chang IJ, Karimiani EG, Kuil LE, Jensen DM, Daza R, Young E, Astle L, van der Linde HC, Shivaram GM, Demmers J, Latimer CS, Keene CD, Loter E, Maroofian R, van Ham TJ, Hevner RF, Bennett JT. Homozygous Mutations in CSF1R Cause a Pediatric-Onset Leukoencephalopathy and Can Result in Congenital Absence of Microglia. Am J Hum Genet 2019; 104:936-947. [PMID: 30982608 DOI: 10.1016/j.ajhg.2019.03.010] [Citation(s) in RCA: 133] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 03/08/2019] [Indexed: 01/30/2023] Open
Abstract
Microglia are CNS-resident macrophages that scavenge debris and regulate immune responses. Proliferation and development of macrophages, including microglia, requires Colony Stimulating Factor 1 Receptor (CSF1R), a gene previously associated with a dominant adult-onset neurological condition (adult-onset leukoencephalopathy with axonal spheroids and pigmented glia). Here, we report two unrelated individuals with homozygous CSF1R mutations whose presentation was distinct from ALSP. Post-mortem examination of an individual with a homozygous splice mutation (c.1754-1G>C) demonstrated several structural brain anomalies, including agenesis of corpus callosum. Immunostaining demonstrated almost complete absence of microglia within this brain, suggesting that it developed in the absence of microglia. The second individual had a homozygous missense mutation (c.1929C>A [p.His643Gln]) and presented with developmental delay and epilepsy in childhood. We analyzed a zebrafish model (csf1rDM) lacking Csf1r function and found that their brains also lacked microglia and had reduced levels of CUX1, a neuronal transcription factor. CUX1+ neurons were also reduced in sections of homozygous CSF1R mutant human brain, identifying an evolutionarily conserved role for CSF1R signaling in production or maintenance of CUX1+ neurons. Since a large fraction of CUX1+ neurons project callosal axons, we speculate that microglia deficiency may contribute to agenesis of the corpus callosum via reduction in CUX1+ neurons. Our results suggest that CSF1R is required for human brain development and establish the csf1rDM fish as a model for microgliopathies. In addition, our results exemplify an under-recognized form of phenotypic expansion, in which genes associated with well-recognized, dominant conditions produce different phenotypes when biallelically mutated.
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Affiliation(s)
- Nynke Oosterhof
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
| | - Irene J Chang
- Department of Pediatrics, Division of Genetic Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Ehsan Ghayoor Karimiani
- Genetics Research Centre, Molecular and Clinical Sciences Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Laura E Kuil
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
| | - Dana M Jensen
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA 98101, USA
| | - Ray Daza
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA 98101, USA
| | - Erica Young
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA 98101, USA
| | - Lee Astle
- Department of Laboratory and Pathology, Alaska Native Medical Center, Anchorage, AK 99508, USA
| | - Herma C van der Linde
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
| | | | - Jeroen Demmers
- Proteomics Center, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
| | - Caitlin S Latimer
- Department of Pathology, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - C Dirk Keene
- Department of Pathology, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Emily Loter
- Department of Laboratories, Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Reza Maroofian
- Genetics Research Centre, Molecular and Clinical Sciences Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK; Department of Neuromuscular Disorders and Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Tjakko J van Ham
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands.
| | - Robert F Hevner
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA 98101, USA; Department of Pathology, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - James T Bennett
- Department of Pediatrics, Division of Genetic Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA; Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA 98101, USA.
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Marsh M. Improving the uptake of post-mortem after pregnancy loss. BJOG 2019; 126:679-680. [PMID: 30972926 DOI: 10.1111/1471-0528.15364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jalowska A, Krzeszowiak J, Stembalska A, Szmyd K, Zimmer M, Jagielska G, Raś M, Pasławska A, Szafrańska A, Paluszyńska D, Fuchs T, Pesz K, Sąsiadek M, Królak-Olejnik B, Śmigiel R. [Perinatal palliative care performed in obstetrics and neonatology wards and hospices for children - own experience]. Dev Period Med 2019; 23:253-262. [PMID: 31913141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Lethal defects lead to the intrauterine death of the fetus or the passing away of the child immediately after birth or in early infancy, regardless of the treatment used. In the case of lethal defects, it is not possible to effectively help the child, despite using the most modern equipment or medicines in the treatment or the progress made by medicine. Parents, who decide to continue the pregnancy, although the fetus has a lethal defect that cannot be cured, may be covered by perinatal hospice care, which is comprehensive and consists in supporting the pregnant woman during the prenatal time, during delivery and after delivery and support of her family, giving full information to the parents about their child's illness. Childcare after birth is focused on protecting the infant from persistent therapy and providing him with appropriate conditions. Aim: To demonstrate the role of perinatal palliative care for pregnant women in whom the results of prenatal tests pointed to a severe developmental disorder in the fetus with a potentially lethal prognosis, and to present a pattern of behavior for their hospitalization in the perinatal hospice. PATIENTS AND METHODS Materials and methods: The retrospective analysis included documentation of 67 patients referred to the RAZEM (TOGETHER) Program in Wrocław in 2014-2018 due to abnormal results of (ultrasound and / or genetic) prenatal tests, which indicated a serious developmental disorder in the fetus with potentially lethal prognosis. Analysis was conducted of sociodemographic data, clinical data on fetal diagnosis, pregnancy and delivery, the procedure for prenatal delivery and postnatal birth. RESULTS Results: 67 women aged 20-43 years (mean 31.2) were referred to the RAZEM Program. Out of these, 57 women were enrolled for palliative care, which accounted for 85% of those referred to the program. Palliative care was continued in 51 patients, because 6 women decided to terminate their pregnancy during the diagnostic process (10.5%). The most common abnormalities in the fetuses were chromosomal aberrations, CNS defects and kidney defects. In 95% of the cases, intrauterine fetal death or neonatal death occurred. CONCLUSION Conclusions: Perinatal palliative care is an indispensable form of care for pregnant women in whom the results of prenatal tests indicate a serious developmental disorder in the fetus with potentially lethal prognosis. The in-hospital model of a perinatal hospice is a beneficial form of care, as it ensures consistency and good communication in the team, which favourably affects its quality.
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Affiliation(s)
- Agnieszka Jalowska
- Katedra i Klinika Neonatologii, Uniwersytet Medyczny we Wrocławiu, Polska
| | - Joanna Krzeszowiak
- Katedra Pediatrii, Zakład Propedeutyki Pediatrii i Chorób Rzadkich, Uniwersytet Medyczny we Wrocławiu, Polska
| | | | - Krzysztof Szmyd
- Stowarzyszenie Hospicjum dla Dzieci Dolnego Śląska " Formuła Dobra", Wrocław, Polska
| | - Mariusz Zimmer
- Katedra i Klinika Ginekologii i Położnictwa, Uniwersytet Medyczny we Wrocławiu, Polska
| | - Gizela Jagielska
- Oddział Ginekologii i Położnictwa, Powiatowy Zespół Szpitali w Oleśnicy, Polska
| | - Małgorzata Raś
- Oddział Kardiologii Dziecięcej, Wojewódzki Szpital Specjalistyczny we Wrocławiu, Polska
| | - Agnieszka Pasławska
- Stowarzyszenie Hospicjum dla Dzieci Dolnego Śląska " Formuła Dobra", Wrocław, Polska
| | | | - Dorota Paluszyńska
- Katedra i Klinika Neonatologii, Uniwersytet Medyczny we Wrocławiu, Polska
| | - Tomasz Fuchs
- Katedra i Klinika Ginekologii i Położnictwa, Uniwersytet Medyczny we Wrocławiu, Polska
| | - Karolina Pesz
- Katedra Genetyki, Uniwersytet Medyczny we Wrocławiu, Polska
| | - Maria Sąsiadek
- Katedra Genetyki, Uniwersytet Medyczny we Wrocławiu, Polska
| | | | - Robert Śmigiel
- Katedra Pediatrii, Zakład Propedeutyki Pediatrii i Chorób Rzadkich, Uniwersytet Medyczny we Wrocławiu, Polska
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Moreira-Soto A, Cabral R, Pedroso C, Eschbach-Bludau M, Rockstroh A, Vargas LA, Postigo-Hidalgo I, Luz E, Sampaio GS, Drosten C, Netto EM, Jaenisch T, Ulbert S, Sarno M, Brites C, Drexler JF. Exhaustive TORCH Pathogen Diagnostics Corroborate Zika Virus Etiology of Congenital Malformations in Northeastern Brazil. mSphere 2018; 3:e00278-18. [PMID: 30089647 PMCID: PMC6083096 DOI: 10.1128/msphere.00278-18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/19/2018] [Indexed: 12/30/2022] Open
Abstract
The Latin American 2015-2016 Zika virus (ZIKV) outbreak was associated with an increase in microcephaly predominantly in northeastern Brazil. To comparatively investigate infectious causes of congenital malformations, we performed a nested case-control study in 32 mothers of cases of suspected congenital Zika syndrome (CZS) and 160 age-matched controls from Bahia, northeastern Brazil. We collected clinical and imaging data and assessed past exposure to ZIKV, Chikungunya virus (CHIKV), dengue virus, and 8 established TORCH (Toxoplasma gondii, Treponema pallidum, rubella virus, cytomegalovirus, herpes simplex virus 1 [HSV-1] and HSV-2, varicella-zoster virus, parvovirus B19) pathogens using multiple serological tests. Heterogeneous symptoms prevented unequivocal diagnosis of CZS on clinical grounds. Only ZIKV and CHIKV seroprevalence rates differed significantly between cases and controls (93.8% versus 67.8% for ZIKV [Fisher's exact text, P = 0.002] and 20.7% versus 8.2% for CHIKV [χ2, P = 0.039]). High ZIKV seroprevalence rates in cases could not be explained by previous dengue virus infections potentially eliciting cross-reactive antibody responses affecting ZIKV serological tests. In conditional logistic regression analyses, only ZIKV was significantly associated with congenital malformations (P = 0.030; odds ratio, 4.0 [95% confidence interval, 1.1 to 14.1]). Our data support an association between maternal ZIKV exposure and congenital malformations. Parallels between the discrepant ZIKV and CHIKV seroprevalence rates between cases and controls and similar seroprevalence rates between cases and controls for the sexually transmitted T. pallidum and HSV-2 may suggest the occurrence of predominantly vector-borne transmission in our study population. High seroprevalence of TORCH pathogens suggests that exhaustive diagnostics will be necessary in the aftermath of the ZIKV outbreak and provides baseline data for longitudinal studies on ZIKV pathogenesis.IMPORTANCE The Latin American Zika virus (ZIKV) outbreak had a major impact on reproductive health worldwide. The reasons for the massively increased reports of neonatal microcephaly in northeastern Brazil are still unclear. Beyond the technical limitations of laboratory diagnostics, unambiguous diagnosis of ZIKV as the cause of congenital malformations is hampered by similar clinical pictures elicited by other pathogens known as TORCH pathogens. We performed a case-control study comparing mothers of children with congenital malformations to age-matched controls from Salvador, Brazil, one of the areas most extensively affected by the ZIKV outbreak. The ZIKV and Chikungunya virus seroprevalence rates differed significantly, whereas the levels of maternal exposure to TORCH pathogens were similar between cases and controls. Our data support a link between maternal ZIKV infection and congenital malformations and suggest the occurrence of predominantly vector-borne ZIKV transmission in these cases. In addition, some highly prevalent TORCH pathogens may be misinterpreted as representative of ongoing ZIKV activity in the absence of exhaustive diagnostics in northeastern Brazil.
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Affiliation(s)
- Andres Moreira-Soto
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
| | - Renata Cabral
- Maternidade Climério de Oliveira, Universidade Federal da Bahia, Salvador, Brazil
| | - Celia Pedroso
- Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
| | | | - Alexandra Rockstroh
- Department of Immunology, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - Ludy Alexandra Vargas
- Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
| | - Ignacio Postigo-Hidalgo
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
| | - Estela Luz
- Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
| | - Gilmara Souza Sampaio
- Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
| | - Christian Drosten
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
- German Centre for Infection Research (DZIF)‡
| | - Eduardo Martins Netto
- Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
| | - Thomas Jaenisch
- German Centre for Infection Research (DZIF)‡
- Department for Infectious Diseases (Section Clinical Tropical Medicine), Heidelberg University Hospital, Heidelberg, Germany
| | - Sebastian Ulbert
- Department of Immunology, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - Manoel Sarno
- Maternidade Climério de Oliveira, Universidade Federal da Bahia, Salvador, Brazil
- Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
| | - Carlos Brites
- Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
| | - Jan Felix Drexler
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
- German Centre for Infection Research (DZIF)‡
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Shruthi M, Gupta N, Jana M, Mridha AR, Kumar A, Agarwal R, Sharma R, Deka D, Gupta AK, Kabra M. Conventional vs virtual autopsy with postmortem MRI in phenotypic characterization of stillbirths and fetal malformations. Ultrasound Obstet Gynecol 2018; 51:236-245. [PMID: 28295775 DOI: 10.1002/uog.17468] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/25/2017] [Accepted: 02/28/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To compare virtual autopsy using postmortem magnetic resonance imaging (MRI) with conventional autopsy with respect to phenotypic characterization of stillbirths and malformed fetuses, and acceptability to parents. METHODS This was a prospective diagnostic evaluation study, conducted from June 2013 to June 2015, including stillbirths and pregnancies terminated owing to fetal malformation at ≥ 20 weeks' gestation, for which parental consent to both conventional autopsy and postmortem MRI was obtained. Cases of maternal and obstetric cause of fetal demise were excluded. Whole-body postmortem MRI (at 1.5 T) was performed prior to conventional autopsy. Taking conventional autopsy as the diagnostic gold standard, postmortem MRI findings alone, or in conjunction with other minimally invasive prenatal and postmortem investigations, were assessed and compared for diagnostic accuracy. RESULTS Parental consent for both conventional autopsy and postmortem MRI was obtained in 52 cases of which 43 were included in the analysis. In 35 (81.4%) cases, the final diagnosis based on virtual autopsy with postmortem MRI was in agreement with that of conventional autopsy. With conventional autopsy as the reference standard, sensitivity, specificity, positive and negative predictive values of postmortem MRI were, respectively: 77.7%, 99.8%, 97.4% and 98.0% for whole-body assessment; 93.1%, 99.0%, 87.1% and 99.5% for the nervous system; 61.0%, 100.0%, 100.0% and 96.7% for the cardiovascular system; 91.1%, 100.0%, 100.0% and 98.0% for the pulmonary system; 80.6%, 99.8%, 96.7% and 98.7% for the abdomen; 96.2%, 99.7%, 96.2% and 99.7% for the renal system; and 66.7%, 100.0%, 100.0% and 97.2% for the musculoskeletal system. Virtual autopsy was acceptable to 96.8% of families as compared with conventional autopsy to 82.5%. CONCLUSIONS Virtual autopsy using postmortem MRI and other minimally invasive investigations can be an acceptable alternative to conventional autopsy when the latter is refused by the parents. Postmortem MRI is more acceptable to parents and can provide additional diagnostic information on brain and spinal cord malformations. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M Shruthi
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - N Gupta
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - M Jana
- Department of Radio Diagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - A R Mridha
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - A Kumar
- Department of Radio Diagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - R Agarwal
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - R Sharma
- Department of Radio Diagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - D Deka
- Fetal Medicine Division, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - A K Gupta
- Department of Radio Diagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - M Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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Jianu DC, Jianu SN, Miclăuş GD, Munteanu G, Dan TF, Bârsan C, Munteanu M, Stanca HT, Motoc AGM, Creţu OM. Multiple congenital anomalies of carotid and vertebral arteries in a patient with an ischemic stroke in the vertebrobasilar territory. Case report and review of the literature. Rom J Morphol Embryol 2018; 59:1279-1285. [PMID: 30845313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The congenital anomalies of the supra-aortic arteries and their branches as potential risk factors for cerebrovascular insufficiency are not yet fully investigated and clarified. This report describes the case of a 68-year-old man who was admitted in our Clinic for an acute ischemic stroke in the vertebrobasilar territory. Extracranial color-coded duplex sonography (CCDS) and computed tomography angiography revealed a combination of congenital anomalies of the neck arteries: left internal carotid artery hypoplasia, left common carotid artery hypoplasia, right vertebral artery hypoplasia and the emergence of the left vertebral artery directly from the aortic arch. The aim of this article is to emphasize the value of CCDS as an accurate, non-invasive method of assessing the neck arteries and, also, the importance of the morphological anomalies of the carotid and vertebral arteries in the cerebral hemodynamics.
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Affiliation(s)
- Dragoş Cătălin Jianu
- Department of Anatomy and Embryology, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania; ; First Department of Neurology, "Pius Brînzeu" Emergency County Hospital, Timişoara, Romania;
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Singh AJ, Ramsey SA, Filtz TM, Kioussi C. Differential gene regulatory networks in development and disease. Cell Mol Life Sci 2017; 75:1013-1025. [PMID: 29018868 DOI: 10.1007/s00018-017-2679-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/19/2017] [Accepted: 10/04/2017] [Indexed: 02/02/2023]
Abstract
Gene regulatory networks, in which differential expression of regulator genes induce differential expression of their target genes, underlie diverse biological processes such as embryonic development, organ formation and disease pathogenesis. An archetypical systems biology approach to mapping these networks involves the combined application of (1) high-throughput sequencing-based transcriptome profiling (RNA-seq) of biopsies under diverse network perturbations and (2) network inference based on gene-gene expression correlation analysis. The comparative analysis of such correlation networks across cell types or states, differential correlation network analysis, can identify specific molecular signatures and functional modules that underlie the state transition or have context-specific function. Here, we review the basic concepts of network biology and correlation network inference, and the prevailing methods for differential analysis of correlation networks. We discuss applications of gene expression network analysis in the context of embryonic development, cancer, and congenital diseases.
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Affiliation(s)
- Arun J Singh
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Corvallis, OR, 97331, USA
| | - Stephen A Ramsey
- Department of Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, 97331, USA
- School of Electrical Engineering and Computer Science, College of Engineering, Oregon State University, Corvallis, OR, 97331, USA
| | - Theresa M Filtz
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Corvallis, OR, 97331, USA
| | - Chrissa Kioussi
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Corvallis, OR, 97331, USA.
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Zhang Y, Fang S, Dai J, Zhu L, Fan H, Tang W, Fan Y, Dai H, Zhang P, Wang Y, Xing X, Yang C. Experimental study of ASCs combined with POC-PLA patch for the reconstruction of full-thickness chest wall defects. PLoS One 2017; 12:e0182971. [PMID: 28800620 PMCID: PMC5553644 DOI: 10.1371/journal.pone.0182971] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/27/2017] [Indexed: 12/30/2022] Open
Abstract
To explore the repairing effect of combination of adipose stem cells (ASCs) and composite scaffolds on CWR, the electrospun Poly 1, 8-octanediol-co-citric acid (POC)-poly-L-lactide acid (PLA) composite scaffolds were prepared, followed by in vitro and in vivo biocompatibility evaluation of the scaffolds. Afterwards, ASCs were seeded on POC-PLA to construct the POC-PLA-ASCs scaffolds, and the POC-PLA, POC-PLA-ASCs, and traditional materials expanded polytetrafluoroethylene (ePTFE) were adopt for CWR in New Zealand white (NZW) rabbit models. As results, the POC-PLA-ASCs patches possessed good biocompatibility as the high proliferation ability of cells surrounding the patches. Rabbits in POC-PLA-ASCs groups showed better pulmonary function, less pleural adhesion, higher degradation rate and more neovascularization when compared with that in other two groups. The results of western blot indicated that POC-PLA-ASCs patches accelerated the expression of VEGF and Collagen I in rabbit models. From the above, our present study demonstrated that POC-PLA material was applied for CWR successfully, and ASCs seeded on the sheets could improve the pleural adhesions and promote the reparation of chest wall defects.
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Affiliation(s)
- Yuanzheng Zhang
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Shuo Fang
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Jiezhi Dai
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, PR China
| | - Lei Zhu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai, PR China
| | - Hao Fan
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Weiya Tang
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Yongjie Fan
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Haiying Dai
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Peipei Zhang
- Department of Plastic Surgery, the 455th hospital of Chinese People's Liberation Army, Shanghai, PR China
| | - Ying Wang
- Department of Plastic Surgery, the 455th hospital of Chinese People's Liberation Army, Shanghai, PR China
| | - Xin Xing
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
- * E-mail: (XX); (CY)
| | - Chao Yang
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
- * E-mail: (XX); (CY)
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Ho YK, Turley M, Marc-Aurele KL, Jones MC, Housman E, Engelkemier D, Romine LE, Khanna PC, Pretorius DH. Enlarged Cavum Septi Pellucidi and Vergae in the Fetus: A Cause for Concern. J Ultrasound Med 2017; 36:1657-1668. [PMID: 28417514 DOI: 10.7863/ultra.16.06081] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 11/07/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To investigate fetal cases identified at our institution to determine whether an enlarged cavum septi pellucidi or cavum vergae is associated with other fetal abnormalities and whether its presence warrants more detailed investigation of the fetus. METHODS In a retrospective study, 15 high- and low-risk patients undergoing prenatal sonography who had an enlarged cavum septi pellucidi or cavum vergae identified were reviewed. Data were collected for the sonographic study indication, gestation age at diagnosis of a prominent cavum, and associated anomalies. Follow-up outcome data regarding further imaging, karyotype, diagnosis of brain anomaly, and associated congenital abnormalities were obtained. RESULTS Fifteen patients met the inclusion criteria. Nine patients were identified as having a prominent cavum septi pellucidi, and 6 were identified as having a prominent cavum vergae. The mean gestational age ± SD was 22.7 ± 5.9 weeks. Eleven patients made it to delivery. Of the 15 patients, 4 were thought to have trisomy 21, and 13 had congenital anomalies. Outcomes included 10 major adverse outcomes, 4 cases with normal development or minor abnormalities, and 1 lost to follow-up. An isolated dilated cavum on prenatal sonography was seen in 5 cases: 1 with lissencephaly on a neonatal examination, 3 premature deliveries (1 demise, 1 hospice, and 1 normal), and 1 unknown. CONCLUSIONS Our cohort had many associated clinical anomalies: 3 confirmed trisomy 21 and 1 probable trisomy 21, 2 genetic disorders, and 10 major adverse outcomes, 5 of which were grave. Although we studied a small cohort, we conclude that an enlarged cavum septi pellucidi or cavum vergae warrants consideration of genetic counseling, which may include noninvasive prenatal testing (cell-free DNA), amniocentesis with microarray testing, or both.
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Affiliation(s)
- Yoona K Ho
- Maternal-Fetal Care and Genetics Center, University of California, San Diego, California, USA
- Departments of Radiology, University of California, San Diego, California, USA
| | - Michelle Turley
- Maternal-Fetal Care and Genetics Center, University of California, San Diego, California, USA
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | | | - Marilyn C Jones
- Maternal-Fetal Care and Genetics Center, University of California, San Diego, California, USA
- Genetics, University of California, San Diego, California, USA
- Departments of Genetics, Rady Children's Hospital, San Diego, California, USA
| | - Elise Housman
- Departments of Radiology, University of California, San Diego, California, USA
| | | | - Lorene E Romine
- Department of Radiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | | | - Dolores H Pretorius
- Maternal-Fetal Care and Genetics Center, University of California, San Diego, California, USA
- Departments of Radiology, University of California, San Diego, California, USA
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40
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Johnson KJ, Lee JM, Ahsan K, Padda H, Feng Q, Partap S, Fowler SA, Druley TE. Pediatric cancer risk in association with birth defects: A systematic review. PLoS One 2017; 12:e0181246. [PMID: 28749971 PMCID: PMC5716403 DOI: 10.1371/journal.pone.0181246] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/28/2017] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Many epidemiological studies have examined associations between birth defects (BDs) and pediatric malignancy over the past several decades. Our objective was to conduct a systematic literature review of studies reporting on this association. METHODS We used librarian-designed searches of the PubMed Medline and Embase databases to identify primary research articles on pediatric neoplasms and BDs. English language articles from PubMed and Embase up to 10/12/2015, and in PubMed up to 5/12/2017 following an updated search, were eligible for inclusion if they reported primary epidemiological research results on associations between BDs and pediatric malignancies. Two reviewers coded each article based on the title and abstract to identify eligible articles that were abstracted using a structured form. Additional articles were identified through reference lists and other sources. Results were synthesized for pediatric cancers overall and for nine major pediatric cancer subtypes. RESULTS A total of 14,778 article citations were identified, of which 80 met inclusion criteria. Pediatric cancer risk was increased in most studies in association with BDs overall with some notable specific findings, including increased risks for CNS tumors in association with CNS abnormalities and positive associations between rib anomalies and several pediatric cancer types. CONCLUSIONS Some children born with BDs may be at increased risk for specific pediatric malignancy types. This work provides a foundation for future investigations that are needed to clarify specific BD types predisposing toward malignancy and possible underlying causes of both BDs and malignancy.
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Affiliation(s)
- Kimberly J. Johnson
- Brown School, Washington University in St. Louis, St. Louis, Missouri,
United States of America
- Department of Pediatrics, Washington University School of Medicine,
Washington University in St. Louis, St. Louis, Missouri, United States of
America
- * E-mail:
| | - Jong Min Lee
- Brown School, Washington University in St. Louis, St. Louis, Missouri,
United States of America
| | - Kazi Ahsan
- Brown School, Washington University in St. Louis, St. Louis, Missouri,
United States of America
| | - Hannah Padda
- Brown School, Washington University in St. Louis, St. Louis, Missouri,
United States of America
| | - Qianxi Feng
- Brown School, Washington University in St. Louis, St. Louis, Missouri,
United States of America
| | - Sonia Partap
- Department of Neurology, Stanford University, Palo Alto, California,
United States of America
| | - Susan A. Fowler
- Brown School, Washington University in St. Louis, St. Louis, Missouri,
United States of America
| | - Todd E. Druley
- Department of Pediatrics, Washington University School of Medicine,
Washington University in St. Louis, St. Louis, Missouri, United States of
America
- Division of Pediatric Hematology and Oncology, Washington University
School of Medicine, Washington University in St. Louis, St. Louis, Missouri,
United States of America
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41
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Santos M, Cruz S, Casimiro C, Biscoito M, Costa M. [Vertebral artery dissection associated with MURCS syndrome]. Rev Neurol 2017; 64:190-192. [PMID: 28169416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- M Santos
- Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
| | - S Cruz
- Hospital Prof. Doutor Fernando da Fonseca, Amadora, Portugal
| | - C Casimiro
- Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
| | - M Biscoito
- Hospital Cuf Infante Santo, Lisboa, Portugal
| | - M Costa
- Hospital Prof. Doutor Fernando da Fonseca, Amadora, Portugal
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Simon MT, Ng BG, Friederich MW, Wang RY, Boyer M, Kircher M, Collard R, Buckingham KJ, Chang R, Shendure J, Nickerson DA, Bamshad MJ, Van Hove JLK, Freeze HH, Abdenur JE. Activation of a cryptic splice site in the mitochondrial elongation factor GFM1 causes combined OXPHOS deficiency. Mitochondrion 2017; 34:84-90. [PMID: 28216230 DOI: 10.1016/j.mito.2017.02.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 01/11/2017] [Accepted: 02/10/2017] [Indexed: 11/17/2022]
Abstract
We report the clinical, biochemical, and molecular findings in two brothers with encephalopathy and multi-systemic disease. Abnormal transferrin glycoforms were suggestive of a type I congenital disorder of glycosylation (CDG). While exome sequencing was negative for CDG related candidate genes, the testing revealed compound heterozygous mutations in the mitochondrial elongation factor G gene (GFM1). One of the mutations had been reported previously while the second, novel variant was found deep in intron 6, activating a cryptic splice site. Functional studies demonstrated decreased GFM1 protein levels, suggested disrupted assembly of mitochondrial complexes III and V and decreased activities of mitochondrial complexes I and IV, all indicating combined OXPHOS deficiency.
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Affiliation(s)
- Mariella T Simon
- Division of Metabolic Disorders, CHOC Children's, Orange, CA, USA; Department of Developmental and Cell Biology, University of California Irvine, Irvine, CA, USA
| | - Bobby G Ng
- Human Genetics Program, Sanford Children's Health Research Center, Sanford-Burnham-Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Marisa W Friederich
- Department of Pediatrics, Section of Clinical Genetics and Metabolism, University of Colorado, Aurora, CO, USA
| | - Raymond Y Wang
- Division of Metabolic Disorders, CHOC Children's, Orange, CA, USA; Department of Pediatrics, University of California Irvine, Irvine, CA, USA
| | - Monica Boyer
- Division of Metabolic Disorders, CHOC Children's, Orange, CA, USA
| | - Martin Kircher
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Renata Collard
- Department of Pediatrics, Section of Clinical Genetics and Metabolism, University of Colorado, Aurora, CO, USA
| | - Kati J Buckingham
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Richard Chang
- Division of Metabolic Disorders, CHOC Children's, Orange, CA, USA; Department of Pediatrics, University of California Irvine, Irvine, CA, USA
| | - Jay Shendure
- Department of Genome Sciences, University of Washington, Seattle, WA, USA; Howard Hughes Medical Institute, University of Washington, Seattle, WA, USA
| | | | - Michael J Bamshad
- Department of Genome Sciences, University of Washington, Seattle, WA, USA; Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Johan L K Van Hove
- Department of Pediatrics, Section of Clinical Genetics and Metabolism, University of Colorado, Aurora, CO, USA
| | - Hudson H Freeze
- Human Genetics Program, Sanford Children's Health Research Center, Sanford-Burnham-Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Jose E Abdenur
- Division of Metabolic Disorders, CHOC Children's, Orange, CA, USA; Department of Pediatrics, University of California Irvine, Irvine, CA, USA.
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Boer L, Radziun AB, Oostra R. Frederik Ruysch (1638-1731): Historical perspective and contemporary analysis of his teratological legacy. Am J Med Genet A 2017; 173:16-41. [PMID: 27126916 PMCID: PMC5215407 DOI: 10.1002/ajmg.a.37663] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 03/28/2016] [Indexed: 11/07/2022]
Abstract
The Peter the Great Museum of Anthropology and Ethnography (Kunstkamera) in Saint Petersburg is the oldest museum in Russia. It keeps the remains of the anatomical collection of the world-famous 17th century Dutch anatomist Frederik Ruysch. This unique collection was bought and shipped in 1717 by Czar Peter the Great, and presently still comprises more than 900 specimens, a modest number of which concerns specimens with congenital anomalies. We searched for teratological clues in the existing collection and in all his descriptions and correspondence regarding specimens and cases he encountered during his career as doctor anatomiae and chief instructor of the surgeons and midwives in Amsterdam. A total of 63 teratological specimens and case descriptions were identified in this legacy, including some exceedingly rare anomalies. As it turns out, Ruysch was the first to describe several of the conditions we encountered, including intracranial teratoma, enchondromatosis, and Majewski syndrome. Although his comments pose an interesting view on how congenital anomalies were scientifically perceived in early 18th century Europe, Ruysch mostly refrained from explaining the causes of the conditions he encountered. Instead, he dedicated himself to careful descriptions of his specimens. Almost 300 years after his demise, Ruysch's legacy still impresses and inspires both scientists and lay men. © 2016 The Authors. American Journal of Medical Genetics Part A Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Lucas Boer
- Department of Anatomy and Museum for Anatomy and PathologyRadboud University Medical CentreNijmegenThe Netherlands
| | - Anna B. Radziun
- Peter the Great Museum of Anthropology and EthnographyRussian Academy of SciencesSaint PetersburgRussia
| | - Roelof‐Jan Oostra
- Department of AnatomyEmbryology and PhysiologyAcademic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
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44
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Pridjian G, Sirois PA, McRae S, Hinckley AF, Rasmussen SA, Kissinger P, Buekens P, Hayes EB, O’Leary D, Kuhn S, Swan KF, Xiong X, Wesson DM. Prospective study of pregnancy and newborn outcomes in mothers with West nile illness during pregnancy. Birth Defects Res A Clin Mol Teratol 2016; 106:716-23. [PMID: 27223334 PMCID: PMC5008687 DOI: 10.1002/bdra.23523] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/11/2016] [Accepted: 04/20/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND A previous case report of West Nile virus (WNV) illness during pregnancy suggested that WNV could be a cause of congenital defects. We performed a prospective, longitudinal cohort study of pregnant women with WNV illness to increase our knowledge of the effects of WNV illness during pregnancy. METHODS Participants were enrolled in 2005 to 2008 from pregnant women with serologically confirmed WNV illness reported to the Centers for Disease Control and Prevention. Comparison was made to WNV-uninfected women, matched on maternal age and enrollment month. Pregnancy and newborn data were collected; cord blood WNV serology was obtained. Pediatric exams and the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) were performed. RESULTS Twenty-eight WNV-infected mothers and 25 WNV-uninfected mothers participated. Maternal demographics were similar except for a higher rate of planned pregnancies, education, and household income in the WNV-uninfected mothers. There were no differences in pregnancy and delivery characteristics except that infected mothers had a higher incidence of febrile illnesses and used more medications. Birth weight, length, head circumference, and rate of congenital malformations were similar in babies born to WNV-infected and -uninfected mothers. Follow-up physical exams were generally normal. The Bayley-III assessments, available for 17 children born to mothers with WNV illness, showed performance at or above age level across domains. CONCLUSION The risk for adverse pregnancy and newborn outcomes in women experiencing WNV illness in pregnancy appears to be low, but future studies with larger numbers are needed to rule out a small risk. Birth Defects Research (Part A) 106:716-723, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | | | | | | | | | | | | | - Edward B. Hayes
- Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Dan O’Leary
- Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Stephanie Kuhn
- Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | - Xu Xiong
- Tulane University, New Orleans, Louisiana
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Tangviriyapaiboon T. Complete Spontaneous Regression of the Intraspinal Synovial Cyst at the C1-C2 Junction Following with Atlantoaxial Fusion of Non-Union Odontoid Fracture: A Case Report. J Med Assoc Thai 2016; 99 Suppl 3:S120-S125. [PMID: 29901356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The author reported an extremely rare case of intraspinal synovial cyst at C1-C2 junction, located posteriorly to the odontoid process, compressing the upper cervical spinal cord. The patient had a history of spinal trauma 40 years ago without prior definitive treatment, presenting with two months of left leg and arm numbness with neck pain. Imaging studies including plain radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) of the cervical spine showed a large synovial cyst associated with atlantoaxial instability from non-union fracture of the odontoid process. The atlantoaxial fusion was performed without a direct excision of the synovial cyst, the patient showed significant improvement of neck pain and numbness of all extremities. In addition to the fracture stabilization, the follow-up post operative MRI revealed spontaneous regression of the intraspinal synovial cyst after atlantoaxial fusion alone
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46
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Vorobtsova IE. [Before and after Chernobyl Accident (Memoirs, Researches Hypotheses)]. Radiats Biol Radioecol 2016; 56:231-236. [PMID: 30629870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In the first part of the article the results of studies performed in the 1970-1980s on the progeny of irradiated animals (drosophila, mouse, rat) are presented. It was found that except severe disorders in this progeny named non target genetic radiation effects were observed (genome instability, increased cancer risk, impaired fitness) which were similar to the late somatic radiation effects. The hypothesis on the likeness of pathogenic nature of somatic and genetic effects of ionizing radiation was proposed. Comparison of effects of parental irradiation in humans and animals gave reason to propose that the frequency of severe disorders observed in the progeny (stillbirth, birth defects etc.) depends on the reproductive potential of a species. In the second part of the article the reminiscences on the author's work in Chernobyl in 1987 are presented. The last part is devoted to description of the main results, obtained in the post Chernobyl period in the frames of various national and international projects.
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Chen K, Yin D, Lyu H, Yang L, Zhang T, Dai P. Anatomic measurements of the posterior tympanum related to the round window vibroplasty in congenital aural atresia and stenosis patients. Acta Otolaryngol 2016; 136:470-4. [PMID: 27052964 DOI: 10.3109/00016489.2015.1122228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS With the aggravation of the external auditory canal malformation, the size of extra-niche fossa became smaller, providing concrete data and valuable information for the better design, selecting and safer implantation of the transducer in the area of round window niche. Three-dimensional measurements and assessments before surgery might be helpful for a safer surgical approach and implantation of a vibrant soundbridge. OBJECTIVES The aim of this study was to investigate whether differences exist in the morphology of the posterior tympanum related to the round window vibroplasty among congenital aural atresia (CAA), congenital aural stenosis (CAS), and a normal control group, and to analyze its effect on the round window implantation of vibrant soundbridge. METHODS CT images of 10 normal subjects (20 ears), 27 CAS patients (30 ears), and 25 CAA patients (30 ears) were analyzed. The depth and the size of outside fossa of round window niche related to the round window vibroplasty (extra-niche fossa)and the distances between the center of round window niche and extra-niche fossa were calculated based on three-dimensional reconstruction using mimics software. Finally, the data were analyzed statistically. RESULTS The size of extra-niche fossa in the atresia group was smaller than in the stenosis group (p < 0.05); furthermore, the size of extra-niche fossa in the stenosis group was smaller than that of the control group (p < 0.05). There was no statistically significant difference of the depth of extra-niche fossa among different groups.
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Affiliation(s)
- Keguang Chen
- a Department of Otorhinolaryngology Head & Neck Surgery , Eye & ENT Hospital, Fudan University , Shanghai , PR China
| | - Dongming Yin
- a Department of Otorhinolaryngology Head & Neck Surgery , Eye & ENT Hospital, Fudan University , Shanghai , PR China
| | - Huiying Lyu
- a Department of Otorhinolaryngology Head & Neck Surgery , Eye & ENT Hospital, Fudan University , Shanghai , PR China
| | - Lin Yang
- b Hearing Medicine Key Laboratory , National Ministry of Public Health, Research Center, Eye & ENT Hospital, Fudan University , Shanghai , PR China
| | - Tianyu Zhang
- a Department of Otorhinolaryngology Head & Neck Surgery , Eye & ENT Hospital, Fudan University , Shanghai , PR China
| | - Peidong Dai
- b Hearing Medicine Key Laboratory , National Ministry of Public Health, Research Center, Eye & ENT Hospital, Fudan University , Shanghai , PR China
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Kasap E, Gene M, Sahin N, Sivrikoz ON. Mayer-Rokitansky-Kuster-Hauser syndrome accompanied by invasive ductal carcinoma: a case report. EUR J GYNAECOL ONCOL 2016; 37:744-746. [PMID: 29787025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Milllerian agenesis and the absence of organs of Millerian canal origin are referred to as Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Invasive ductal carcinoma constitutes 47-75% of all breast carcinomas and is the most common type. The authors report the first case of invasive ductal carcinoma associated with MRKH syndrome in the literature to their knowledge. A 25-year-old woman with a palpable mass in her right breast for three months presented to the presented clinic. On physical examination a mobile, firm mass measuring 2x2 cm was detected in right breast, at a region close to axilla. A fine needle aspiration biopsy from the lesion revealed malignant cells and thus a segmental mastectomy operation was performed. All genital tract and endocrinological system should be thoroughly examined before administering hormone replacement therapy to patients presenting with primary amenorrhea.The co-occurrence MRKH syndrome of with invasive ductal carcinoma is regarded as coincidental. Confirming the absence of a common etiology, however, requires further genetic studies.
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Sirakov M, Tomova E. [CONSERVATIVE TREATMENT OF MAYER-ROKITANSKY-KÜSTER-HAUSER SYNDROME. REVIEW OF LITERATURE AND OUR EXPERIENCE]. Akush Ginekol (Sofiia) 2016; 55:51-58. [PMID: 27514132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Mayer-Rokitansky-Küster-Hauser syndrome is a part of the group of abnormalities known as "Anomalies of the fusion of the Müllerian ducts". It is characterized by normal development of breasts and hairs, normal appearance of external genitalia, normal feminine genotype (46XX), normal FSH, LH, E₂ and Test. levels, normal ovaries and congenital absence of uterus and the whole or the upper two thirds of the vagina. It is observed in about 15% of the cases with primary amenorrhea and the incidence is about 1:4500-6000. Etiologycal factors such as lack of estrogen/gestagen receptors, deletions or mutations of genes that stop the fusion, as well as the activation of anti-Müllerian hormone (AMH), are considered. The etiology is being explored but there is no consensus yet. The diagnosis is confirmed during a clinical examination, which takes place because of a primary amenorrhea (often happening at the age of 16), and the absence of a uterus and vagina is proved. The therapy should be handled by a multidisciplinary team including obstetrician, trained midwife, psychologist, specialist in imaging and psycho-sexual counseling. The idea for surgical creation of vagina (neovagina) dates many years ago. The first known documents date back to 1817 and over the years a variety of methods are offered usage of amnion, dura mater, peritoneum, skin grafts, different parts of the intestine, cellulose, etc. The first method of non-surgical treatment is offered by the Czech gynecologist Frank. His ambition was to build a vagina by gradual dilatation of the tissue while applying dilatators with successively increasing length and thickness. The method was further developed by Ingram (1981) and nowadays by Edmonds (2012). He reported about 245 patients treated during the last 12 years by his team. 232 of them had a success in anatomic aspect (95%), 13 did not complete the treatment due to psychological or cultural problems. The experts from American College of Obstetricians and Gynecologists include in their "Committee Opinion" from May 2013 the following lines: "Non-surgical creation of the vagina is the appropriate first line approach in most patients". Briefly is presented our experience in this field--14 girls at the age of 16-18, successfully treated with dilatation in the III Gynecology Clinic in University hospital "Maichin dom", Sofia, Bulgaria.
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50
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Dietrich JE. The female reproductive tract: congenital concerns. Horm Metab Res 2015; 47:329-34. [PMID: 25706288 DOI: 10.1055/s-0034-1398563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The incidence and prevalence of conditions of the reproductive tract varies. This is related to both the complexity and spectrum of underlying and associated conditions. In some cases, only retrospective or case data are available, and likely under-reporting occurs, contributing to a lower than expected prevalence. Given the complex nature in which the reproductive tract develops in the fetus, it is important to understand the embryology, especially in situations of congenital anatomic differences. It is interesting to note not only patterns of conditions, but patterns of concurrent conditions or anomalies such as those occurring with isolated Müllerian anomalies, in conjunction with disorders of sexual differentiation or with cloacal malformations. This review will address typical presentation of these conditions, highlights of management and point to areas of research need, including clinical outcomes and genetic implications.
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Affiliation(s)
- J E Dietrich
- Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
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