[Frequency view on genome changes testing]. / Frekvencní pohled na vysetrení odchylek genomu.

Laboratories dealing with human genome, both inherited and acquired changes, dispose with similar methods and technology. The spectrum of genetic tests is relatively broad and the number of mutations or variants tested differs substantially. Also the number of examinations carried out in individual laboratories varies. Data presented in the tables come from the year 2004 and indicate the number of examinations requested and number of positive results. Many laboratories mentioned in the registry CZDDNAL (http://www.uhkt.cz/lab_a_vysetreni/nr lab_dna_diag/dna_lab_db) perform the same tests but there is also a great number of tests carried out by only one laboratory. Reasons of the request, cost-effectiveness and clinical utility of genetic testing is being discussed.

[Case reports of patients with a marker chromosome]. / Kazuistiky pacientu s marker chromozómy.

Small, usually supernumerary chromosomes, denoted as marker chromosomes or markers, can be represented by various phenotypic expression, that depends on their origin and extent. Our article presents results of molecular cytogenetic analysis (FISH) of 34 patients with identified marker chromosome. In 21 cases a marker derived from acrocentric chromosome was identified, in 9 cases markers of gonosomal origin [der(X), der(Y)], and in 4 patients markers of some other chromosomes (5, 17, 18) were proved. The most frequent marker was that originating from chromosome 15 (8 cases). Two patients with different phenotype, markedly influenced by the extent of pseudoizodicentric chromosome 15 are described. In accordance with hitherto presented data, presence of supernumerary copies of the critical region PWACR (it is the partial trisomy, resp. tetrasomy 15q11-q13) in majority of cases brings about serious affection described as syndrome of the inverted duplication of chromosome 15. The most typical symptoms are psychomotoric retardation, hypotony, neurological symptoms and autistic features. The article stresses the importance of FISH method in the prenatal examination of marker chromosomes.

[Detection of HER-2/neu in breast carcinoma]. / Prukaz HER-2/neu v karcinomu mlécné zlázy.

BACKGROUND: HER-2/neu protein overexpression has been shown to be an independently adverse prognostic and predictive factor in patients with breast cancer. Recently, HER-2/neu overexpression has gained therapeutic implications: It has been shown that in patients with breast cancer the use of trastuzumab/Herceptin TM, the recombinant humanized monoclonal antibody directed against extracellular domain of HER-2/neu molecule, can block the HER-2/neu protein activation and bring about a clinical remission. Following these developments, demand for pathologists to evaluating properly HER-2/neu in breast cancer specimens has been rapidly increasing. METHODS AND RESULTS: In our series of 449 cases of breast cancer, HER-2/neu protein and gene were examined by means of immunohistochemistry and fluorescence in situ hybridization respectively. Results of HER-2/neu study were compared with the hormonal status, cancer grade and proliferation activity as assessed using immunohistochemistry with MIB1 antibody. All seven cases of breast cancer with strong overexpression of HER-2/neu (score 3+) manifested a gene amplification. In contrast, among 11 cases of breast cancers with mild HER-2/neu overexpression (score 2+), the gene amplification was demonstrated in 5 cases only (45%). CONCLUSIONS: Immunohistochemical assessment and fluorescence in situ hybridization (FISH) are complementary methods for detection of HER-2/neu status in breast cancer. While immunohistochemistry is an excellent screening method, FISH should be used for the confirmation of positive results before the Herceptin treatment.

Cytogenetic analysis of chromosomal aberrations of peripheral lymphocytes in workers occupationally exposed to nickel.

The authors carried out a cytogenetic examination of chromosomal aberrations of peripheral lymphocytes (100 cells evaluated in each sample) with simultaneous monitoring of the level of exposure by means of determination of nickel in the urine, serum and hair. The series included 21 workers occupationally exposed to nickel at two workshops producing NiO (6 persons) and NiSO4 (15 persons) in a chemical plant. At the same time a comparable control group, i.e., 19 workers of the same chemical plant but without any direct occupational nickel exposure (clerks, service men, etc.), were examined in the same way. In the exposed group chromosomal aberrations of peripheral lymphocytes were detected with an average value of 6.41 +/- 1.9% (range 2-14%); in the group producing NiO it was, on the average, 9.5 +/- 3.2% (range 7-14%) whereas in the NiSO4 production workers it was only 5.2 +/- 1.9% (range 2-10%). There was a dependence of chromosomal aberrations of peripheral lymphocytes on the exposure time and on the nickel content of the biological material. Significantly increased values (in contrast to the normal value of chromosomal aberrations of peripheral lymphocytes, up to 2%) were detected in the control group as well (average value of 4.05 +/- 2.27%, range 1-10%). The authors explain this fact by the nickel-polluted environment of the whole observed chemical plant.

[Diagnosis of Turner's syndrome 1965-1989: karyotype, age at diagnosis and determining signs]. / Diagnostika Turnerova syndromu 1965-1989: karyotyp, vek pri diagnóze a rozhodující príznak.

Early diagnosis of Turner's syndrome makes possible optimal application of all procedures of substitution and symptomatic therapy and offers also psychological support to the parents and the patients. In 1965-1989 in two centres 135 girls with Turner's syndrome were detected, 72 with karyotype 45, X, 63 with a chromosomal mosaic and/or structural anomaly. Girls and women with karyotype 45, X are detected sooner (9.4 +/- 6.9 years, as compared with 14.2 +/- 8.1 years, p = 0.0003). Before the age of three 28% of the girls with karyotype 45, X were detected (by congenital lymphoedemas, coarctation of the aorta, poor progress), only 9% of the others. Growth impairment revealed the diagnosis in 27% of the affected girls. Girls with karyotype 45, X were diagnosed on account of impaired growth sooner (7.9 +/- 2.2 years as compared with 11.8 +/- 2.7 years, p = 0.00005). At a time when the diagnosis of girls with karyotype was practically completed, 16% of the spontaneously maturing and menstruating women with chromosomal mosaic where the syndrome was detected during examination of sterility or habitual abortion were still not diagnosed.

Freeman-Sheldon syndrome: a disorder of congenital myopathic origin?

Freeman-Sheldon syndrome was diagnosed in an unrelated adult man and woman, with severe abnormalities of the extremities but only slight anomalies of the face. Electromyography and muscle biopsy showed a myopathy which was classified as a congenital disproportion of fibre type and seemed to be the primary cause of the deformities. This allowed classification of the syndrome as a separate type of myopathic arthrogryposis.

Results of screening for phenylalanine and other amino acid disturbances among pregnant women.

Blood specimens were collected from 15000 pregnant women during the first 3 months of their pregnancy and screened for amino acid disturbances by means of paper chromatography. A high incidence of disturbances in the phenylalanine metabolism was discovered: three cases of mild hyperphenylalaninaemia without phenylpyruvicaciduria (incidence 1:5000); two cases of mild hyperphenylalaninaemia with phenylpyruvicaciduria (incidence 1:7550); four cases of mild phenylketonuria (incidence 1:3750). Disturbances in the metabolism of other amino acids were found to be rare. Metabolic and genealogical findings in some detected families are briefly described.