Recurrent copy number variations as risk factors for autism spectrum disorders: analysis of the clinical implications.

Chromosomal microarray analysis (CMA) is currently considered a first-tier diagnostic assay for the investigation of autism spectrum disorders (ASD), developmental delay and intellectual disability of unknown etiology. High-resolution arrays were utilized for the identification of copy number variations (CNVs) in 195 ASD patients of Greek origin (126 males, 69 females). CMA resulted in the detection of 65 CNVs, excluding the known polymorphic copy number polymorphisms also found in the Database of Genomic Variants, for 51/195 patients (26.1%). Parental DNA testing in 20/51 patients revealed that 17 CNVs were de novo, 6 paternal and 3 of maternal origin. The majority of the 65 CNVs were deletions (66.1%), of which 5 on the X-chromosome while the duplications, of which 7 on the X-chromosome, were rarer (22/65, 33.8%). Fifty-one CNVs from a total of 65, reported for our cohort of ASD patients, were of diagnostic significance and well described in the literature while 14 CNVs (8 losses, 6 gains) were characterized as variants of unknown significance and need further investigation. Among the 51 patients, 39 carried one CNV, 10 carried two CNVs and 2 carried three CNVs. The use of CMA, its clinical validity and utility was assessed.

Chitotriosidase plasma activity in nephropathic cystinosis.

Chitotriosidase is a fully active chitinase produced and secreted by activated phagocytes. Plasma chitotriosidase activity is a well-established marker of total disease burden in Gaucher disease that has proved useful in monitoring the response to both enzyme replacement and substrate reduction therapies in patients with Gaucher disease. Increased chitotriosidase plasma activity has also been observed in several other lysosomal and non lysosomal disorders. Cystinosis, a rare multisystemic lysosomal storage disease, is characterized by the intralysosomal accumulation of free cystine in many cell types including phagocytes. We here report on plasma chitotriosidase activity in a child with nephropathic cystinosis. Increased plasma chitotriosidase activity (481 nmol/h per ml; normal range 0-150 units) was found on diagnosis and prior to the initiation of oral cysteamine (Cystagon) treatment. Serial estimations of plasma chitotriosidase activity showed that it correlated with leukocyte cystine content and decreased to 100 nmol/h per ml following 14 months' treatment. This novel observation suggests that cystinosis should be included in the differential diagnosis of disorders associated with increased plasma chitotriosidase activity. Furthermore, it suggests that serial estimations of plasma chitotriosidase activity could be of value in monitoring the response to oral cysteamine treatment in cystinosis.

Cyclohexadiene ring opening observed with 13 fs resolution: coherent oscillations confirm the reaction path.

The third harmonic (270 nm, 11 fs), produced in a short argon cell from Ti-sapphire laser pulses (810 nm, 12 fs), was used to excite 1,3-cyclohexadiene to its lowest pipi* state (1B). Probing was done by transient ionization by the 810 nm pulses, measuring the yields of the parent and a fragment ion. As previously found with 10 times longer pulses, the molecule leaves in two steps (time constants tau(1), tau(2)) from the spectroscopic (1B) to a dark (2A) state and from there (within tau(3)) to the ground-state surface. In addition to slightly improved values for tau(1)-tau(3), we found in all three locations (L(1)-L(3)) on the potentials coherent oscillations, which can be assigned to vibrations. They are stimulated by slopes (driving forces) of the potentials, and the vibrational coordinates indicate the slope directions. From them we can infer the path following the initial excitation: the molecule is first not only accelerated towards CC stretching in the pi system but also along a symmetric C[double bond, length as m-dash]C twist. The latter motion-after some excursion-also erects and stretches the CH(2)-CH(2) bond, so that Woodward-Hoffmann interactions are activated after this delay (in L(2)). On leaving L(2) (the 1B minimum) around the lower cone of the 1B/2A conical intersection, the wave packet is rapidly accelerated along an antisymmetric coordinate, which breaks the C(2) symmetry of the molecule and eventually leads in a ballistic path to (and through) the last (2A/1A) conical intersection. The ring opening begins already on the 1B surface; near the 2A minimum it is already far advanced, but is only completed on the ground-state surface.

Ultrafast dynamics and coherent oscillations in ethylene and ethylene-d4 excited at 162 nm.

The fifth harmonic (162 nm, 11 fs), generated in a short argon cell from 12 fs Ti-sapphire laser pulses, was used to excite C2H4 and C2D4 in the maximum of the first pi pi* transition. Around 10% of the molecules were excited to the pi3s Rydberg state instead. The subsequent motion of the wave packet, moving over the potentials from the Franck-Condon region down to the ground state, was monitored by nonresonant ionization at 810 nm with mass-selective detection of the ion yield. Five time constants (from approximately 20 fs in excited states to 0.6-11 ps in the hot ground state) and four coherent oscillations (CC stretch and torsion vibrations or hindered free rotation) were determined for each isotopomer. The initial relaxation follows a superposition of CC twist and stretch coordinates; this explains a surprisingly small deuterium isotope effect of the initial time constant (21 versus 24 fs). Also the vibrations in the Franck-Condon region have such a mixed character and a correspondingly small isotope shift. From the perpendicular minimum the wave packet reaches (within 17 or 21 fs for the two isotopomers) a conical intersection via a direction that also involves partial hydrogen migration. This is concluded from the detection of ethylidene (CH3CH), formed simultaneously with ground-state ethylene. This carbene isomerizes in the ground state within 0.6 ps (1.6 ps for CD3CD) to ethylene. Two time constants for dissociation (4.5 and 11 ps) in the hot ground state were also identified. The small yields of bimolecular reactions (photodimerization, addition reactions involving a "suddenly polarized" excited state, carbene reactions) are interpreted in terms of the short lifetimes. It is pointed out that the relaxation path starting from the Rydberg state merges into that from the pi pi* state; nevertheless, there is a wavelength dependence in the photochemistry of olefins, because due to a momentum effect the wave packet remembers from which state it came.

[Neuroleptic Malignant Syndrome after whithdrawal of anticholinergic agents].

Neuroleptic Malignant Syndrome (NMS) is a rare but a potential lethal condition therefore it always represents a neurological emergency. Although NMS is considered mainly as idiosyncratic complication of antipsychotic medication, isolated reports show that the syndrome can rarely occur due to other causes such as, after abrupt withdrawal of anticholinergics and this was the case that is presented here. The syndrome continious to carry a high mortality rate and its basic management remains risk reduction, early diagnosis and supportive care. Thus, familiarity and vigilance to all known risk factors is considered essential for early diagnosis and intervention, and concequently for the reduction of morbidity and mortality of NMS.

Working memory deficits in multiple sclerosis: a controlled study with auditory P600 correlates.

BACKGROUND: Recently, the P600 component of event related potentials, a waveform that is conceived to be generated and/or modulated by basal ganglia and cingulate area has been considered an index of the completion of any synchronised operation after target detection, having much in common with working memory operation. Moreover, dysfunction of these brain structures as well as working memory deficits have been implicated in the pathophysiology of multiple sclerosis. The aim of this study was to investigate the patterns of P600 elicited during a working memory test in multiple sclerosis patients compared with healthy controls. METHODS: Twenty two definite, chronic progressive multiple sclerosis patients, with recent exacerbation of their illness, and 20 normal subjects matched for age, sex, and educational level, were studied with a computerised version of the digit span test of Wechsler batteries. Auditory P600 were measured during the anticipatory period of this test. RESULTS: The patient group, as compared with healthy controls, showed significantly reduced latencies of P600 at left frontal areas and reduced P600 amplitudes at left temporoparietal region. Moreover, memory performance of patients was significantly more impaired when compared with healthy controls. CONCLUSIONS: These findings may indicate that multiple sclerosis is associated with abnormal features of the completion of synchronised operation after target detection, as they are reflected by P600 amplitudes and latencies. Dysfunction of this mechanism may contribute to the identification of basic cognitive processes that could account for the cognitive deficits in multiple sclerosis.