Clinical application of ACMG-AMP guidelines in HNF1A and GCK variants in a cohort of MODY families.

Maturity-onset diabetes of the young (MODY) is a form of monogenic diabetes with autosomal dominant inheritance. GCK -MODY and HNF1A -MODY are the prevalent subtypes. Currently, there is growing concern regarding the correct interpretation of molecular genetic findings. The American College of Medical Genetics and Genomics (ACMG) updated guidelines to interpret and classify molecular variants. This study aimed to determine the prevalence of MODY ( GCK / HNF1A ) in a large cohort of Brazilian families, to report variants related to phenotype, and to classify them according to ACMG guidelines. One hundred and nine probands were investigated, 45% with clinical suspicion of GCK -MODY and 55% with suspicion of HNF1A -MODY. Twenty-five different variants were identified in GCK gene (30 probands-61% of positivity), and 7 variants in HNF1A (10 probands-17% of positivity). Fourteen of them were novel (12- GCK /2- HNF1A ). ACMG guidelines were able to classify a large portion of variants as pathogenic (36%- GCK /86%- HNF1A ) and likely pathogenic (44%- GCK /14%- HNF1A ), with 16% (5/32) as uncertain significance. This allows us to determine the pathogenicity classification more efficiently, and also reinforces the suspected associations with the phenotype among novel variants.

Ability of 18-fludeoxyglucose positron emission tomography/CT to detect incidental cancer.

OBJECTIVE: To determine the prevalence and clinical features of pathologically proven incidental cancer (IC) detected by whole-body fluorine-18 fludeoxyglucose ((18)F-FDG) positron emission tomography (PET)/CT, as well as the incidence of false-positive and false-negative results. METHODS: We retrospectively reviewed reports derived from (18)F-FDG PET/CT images of 3079 consecutive patients with known or suspected malignancies for 3 years. Discrete focal uptake indicating IC was identified from reports as well as pathological or clinical diagnoses, and the clinical courses were investigated. The false-positive result was defined as uptake indicating IC but not pathologically confirmed as malignant during follow-up. The false-negative result was defined as pathologically proven IC detected by another modality at initial clinical work-up or diagnosed during the follow-up period. RESULTS: We found (18)F-FDG uptake indicating IC in 6.7% of all patients, and IC was pathologically proven in 2.2% of all patients. The most common sites were the colon, lung and stomach. The median survival duration of patients with IC was 42 months. The results were false positive in 4.5% of all patients, and the results were false negative in 2.3% of all patients. CONCLUSION: (18)F-FDG PET/CT is a valuable tool for detecting IC. The rates of false-positive and false-negative results are within acceptable range. ADVANCES IN KNOWLEDGE: This is the first report to describe the survival of patients with IC, and the detailed features of false-negative results at actual clinical settings.

Amorphous Ge15Te85: density functional, high-energy x-ray and neutron diffraction study.

The structure and electronic properties of amorphous Ge(15)Te(85) have been studied by combining density functional (DF) simulations with high-energy x-ray and neutron diffraction measurements. Three models with 560 atoms have been constructed using reverse Monte Carlo methods constrained to (1) agree with the experimental structure factors S(Q), and have (2) energies close to the DF minimum and (3) a semiconducting band structure. The best structure is based on the melt-quenched DF structure and has a small number of Ge-Ge bonds. It shows interlocking networks of Te and GeTe with a significant fraction (22-24%) of voids (cavities). Ge occurs with both tetrahedral and 3 + 3 defective octahedral configurations, and the coordination of Te is slightly higher than indicated by the '8 - N rule' (N is the number of valence electrons). The GeTe network includes clusters of ABAB squares (A = Ge, B = Te), and the bonding is characterized by the chemical bond orders.

Relationship between topological order and glass forming ability in densely packed enstatite and forsterite composition glasses.

The atomic structures of magnesium silicate melts are key to understanding processes related to the evolution of the Earth's mantle and represent precursors to the formation of most igneous rocks. Magnesium silicate compositions also represent a major component of many glass ceramics, and depending on their composition can span the entire fragility range of glass formation. The silica rich enstatite (MgSiO(3)) composition is a good glass former, whereas the forsterite (Mg(2)SiO(4)) composition is at the limit of glass formation. Here, the structure of MgSiO(3) and Mg(2)SiO(4) composition glasses obtained from levitated liquids have been modeled using Reverse Monte Carlo fits to diffraction data and by density functional theory. A ring statistics analysis suggests that the lower glass forming ability of the Mg(2)SiO(4) glass is associated with a topologically ordered and very narrow ring distribution. The MgO(x) polyhedra have a variety of irregular shapes in MgSiO(3) and Mg(2)SiO(4) glasses and a cavity analysis demonstrates that both glasses have almost no free volume due to a large contribution from edge sharing of MgO(x)-MgO(x) polyhedra. It is found that while the atomic volume of Mg cations in the glasses increases compared to that of the crystalline phases, the number of Mg-O contacts is reduced, although the effective chemical interaction of Mg(2+) remains similar. This unusual structure-property relation of Mg(2)SiO(4) glass demonstrates that by using containerless processing it may be possible to synthesize new families of dense glasses and glass ceramics with zero porosity.

Structural disorder in lithium lanthanum titanate: the basis of superionic conduction.

High-energy x-ray and neutron diffraction measurements on polycrystalline La(2/3-x)Li(3x)TiO(3) (0.075 < x < 0.165) were performed. The total scattering structure factors were analysed by the reverse Monte Carlo (RMC) modelling technique, resulting in three-dimensional particle configurations. These configurations were then used for revealing the distributions of La and Li ions and to understand the relationship between these distributions and ionic conduction. An alternating arrangement of La-rich and La-poor layers along the c-axis was found in the x = 0.075 composition. Intriguingly, this arrangement has gradually disappeared in samples with higher Li concentration. Furthermore, RMC models exhibit disordered distributions of Li ions, situated mainly on the La-rich layer, and there is a significant probability of Li ions occupying the interstitial sites (T site) between the O-3 triangle plane of the TiO(6) octahedron and an La ion or its vacancy site. It was also found on the basis of the RMC models that the bond valence sum (BVS) for Li ions behaves differently on La-rich and La-poor layers at low Li concentration compositions, but they are similar at high Li concentration compositions. This is consistent with the behaviour of the alternating arrangement of La-rich and La-poor layers. It is also suggested that the Li ions around the bottleneck at (1/2, 0, 0) (bottom layer) can jump to an adjacent bottleneck at (0, 1/2, 0) through the T site and not only Li ions in the La-poor layers but also Li ions in the La-rich layers contribute to the bottleneck-bottleneck Li conduction.

Nanometer range correlations between molecular orientations in liquids of molecules with perfect tetrahedral shape: CCl(4), SiCl(4), GeCl(4), and SnCl(4).

Neutron and x-ray weighted total scattering structure factors of liquid carbon, silicon, germanium, and tin tetrachlorides, CCl(4), SiCl(4), GeCl(4), and SnCl(4), have been interpreted by means of reverse Monte Carlo modeling. For each material the two sets of diffraction data were modeled simultaneously, thus providing sets of particle coordinates that were consistent with two experimental structure factors within errors. From these particle configurations, partial radial distribution functions, as well as correlation functions characterizing mutual orientations of molecules as a function of distance between molecular centers were calculated. Via comparison with reference systems, obtained by hard sphere Monte Carlo simulations, we demonstrate that orientational correlations characterizing these liquids are much longer ranged than expected, particularly in carbon tetrachloride.

Novel cynomolgus macaque MHC-DPB1 polymorphisms in three South-East Asian populations.

Cynomolgus macaques (Macaca fascicularis, Mafa), alias the crab-eating monkeys or long-tailed macaques, live across a vast range of South-East Asia. These non-human primates have emerged as important animal models in infectious and chronic diseases and transplantation studies, necessitating a more extensive characterization of their major histocompatibility complex polymorphic regions. The current information on the polymorphic variation or diversity of the Mafa-DPB1 locus is largely limited in comparison with the more commonly studied rhesus macaque DPB1 locus. In this article, to better elucidate the degree and types of polymorphisms and genetic differences of Mafa-DPB1 locus among three South-East Asian populations and to investigate how the allele differences between macaques and humans might affect their respective immune responses, we identified 40 alleles within exon 2 of the Mafa-DPB1 locus by DNA sequencing using 217 individuals. We also performed evolutionary and population analyses using these sequences to reveal some population-specific alleles and trans-species allelic conservation between the cynomolgus macaques and the rhesus macaques. Of the 40 new alleles, eight belong to a newly identified lineage group not previously found in the rhesus macaque species. This allele information will be useful for medical researchers using the cynomolgus macaques in disease and immunological studies.

Temperature dependence of isotopic quantum effects in water.

The technique of high energy x-ray diffraction has been used to measure the temperature variation of hydrogen versus deuterium isotopic quantum effects on the structure of water. The magnitude of the effect is found to be inversely proportional to the temperature, varying by a factor of 2.5 over the range 6 to 45 degrees C. In addition, the H216O versus H218O effect has been measured at 26 degrees C and the structural difference shown to be restricted to the nearest neighbor molecular interactions. The results are compared to recent simulations and previously measured isochoric temperature differentials; additionally, implications for H/D substitution experiments are considered.

Glass formation at the limit of insufficient network formers.

Inorganic glasses normally exhibit a network of interconnected, covalent-bonded, structural elements that has no long-range order. In silicate glasses, the network formers are based on SiO4 tetrahedra interconnected through oxygen atoms at the corners. Conventional wisdom implies that alkaline and alkaline-earth orthosilicate materials cannot be vitrified, because they do not contain sufficient network-forming SiO2 to establish the needed interconnectivity. We studied a bulk magnesium orthosilicate glass obtained by containerless melting and cooling. We found that the role of network former was largely taken on by corner and edge sharing of highly distorted, ionic Mg-O species that adopt 4-, 5-, and 6-coordination with oxygen. The results suggest that similar glassy phases may be found in the containerless environment of interstellar space.

Clonal analysis of nodular parathyroid hyperplasia in renal hyperparathyroidism.

Although it is well known that chronic renal failure induces parathyroid hyperplasia, the pathogenesis and development of this parathyroid lesion in this disease are poorly understood. Histopathologically, there is progression from diffuse to nodular hyperplasia, and each nodule consists of a single cell type with aggressive proliferative potential. Pathophysiologic and clinical investigations have suggested that neoplastic tumors may emerge from nodular hyperplasia. In this study the clonality of parathyroid tissue in nodular and diffuse hyperplasia in renal hyperparathyroidism was analyzed by a method based on restriction fragment length polymorphism of the X chromosome-linked phosphoglycerokinase gene and on random inactivation of the gene by methylation. DNA of peripheral lymphocytes was screened in 43 women undergoing parathyroidectomy for advanced renal hyperparathyroidism, and 10 of these patients appeared to be heterozygous. Fourteen specimens from these patients were available for clonal analysis. The analysis showed that all four specimens of diffuse hyperplasia were polyclonal, whereas all seven specimens from nodules in nodular hyperplasia and all three samples representing parathyroid tissue removed from forearm because of graft-dependent recurrence were revealed to be monoclonal. It is likely that the clonal origin of each nodule is independent. These results suggest that in renal hyperparathyroidism parathyroid glands initially grow diffusely and polyclonally, and then the cells in the nodules are later transformed monoclonally and proliferate aggressively. From the present study it can be concluded that nodular hyperplasia represents monoclonal parathyroid neoplasia, which might explain why patients with nodular hyperplasia in renal hyperparathyroidism are refractory to medical treatment, requiring parathyroidectomy. To prevent recurrences, nodular hyperplastic tissue should not be left at surgery.

[Anti-glomerular basement membrane antibody-mediated glomerulonephritis remarkably improved by pulse therapy with methylprednisolone, plasmapheresis and continuous heparin infusion].

The patient, a 28 year-old-man, was admitted to a hospital because of general fatigue and fever. He was pointed out renal dysfunction and was transferred to Nagasaki University Hospital. The laboratory data on admission showed moderate azotemia (BUN 43 mg/dl, Cr 5.4 mg/dl). A percutaneous renal biopsy on admission revealed a diffuse crescentic glomerulonephritis. A direct immunofluorescence of renal biopsy showed a linear pattern for IgG along the glomerular basement membrane. Radioimmunoassay of his serum for circulating anti-GBM antibody was strongly positive. Aggressive treatment with pulse therapy (methylprednisolone), plasmapheresis, and continuous heparin infusion was performed. He had markedly recovered from renal failure and escaped hemodialysis. The patient is making satisfactory process after 3 years.

Thyroid hormone directly induces hepatocyte competence for estrogen-dependent vitellogenin synthesis during the metamorphosis of Xenopus laevis.

Hepatocytes competent for estrogen-dependent vitellogenin synthesis appeared and increased in number in the liver at the metamorphic climax of Xenopus laevis (A. Kawahara, S. Kohara, Y. Sugimoto, and M. Amano, 1987, Dev. Biol. 122, 139-145). The present study was conducted to determine whether cells competent for vitellogenin synthesis could be induced by thyroid hormone in a primary culture of larval hepatocytes. The thyroid hormone, triiodothyronine (T3), directly induced the competent cells in a primary culture of premetamorphic larval hepatocytes in a dose- and duration-dependent manner. The competency acquired in response to T3 persisted after removal of the hormone. Aphidicholin, an inhibitor of DNA synthesis, failed to block this induction, suggesting the presence of a "precursor cell fraction." This cell fraction in the hepatocyte population increased with the progress of metamorphosis. The thyroid hormone is thus considered the cause of competent cell formation at metamorphic climax.

A change of the hepatocyte population is responsible for the progressive increase of vitellogenin synthetic capacity at and after metamorphosis of Xenopus laevis.

Synthesis of the egg yolk precursor protein, vitellogenin, can be induced in adult, but not in larval, amphibian hepatocytes by estrogen treatment. The transition process for this inducibility of hepatocytes during development of Xenopus laevis was examined, using primary cultures of hepatocytes. This was found to occur at about the metamorphic climax of stage 62, although the level of vitellogenin production was very limited at this stage. This low level seemed due neither to insufficient estradiol-17 beta nor to high estrogen-degrading activity. The level of synthesis gradually increased following metamorphosis. Immunohistochemical analysis showed that fewer than 5% of the hepatocytes at stage 62 could be stained with antivitellogenin antibody and that the stained cell fraction subsequently increased gradually for several months after metamorphosis. These findings indicate that adult-type cells capable of synthesizing vitellogenin appear at metamorphosis and then expand their population in the liver during postmetamorphic maturation.