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1.
Rev Sci Instrum ; 94(5)2023 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-37227195

RESUMEN

We present the detailed metrology of a superconducting Transition-Edge Sensor (TES) absorber-coupled bolometer array bonded to a variable-delay backshort to form an integral field unit. The backshort is shaped as a wedge to continuously vary the electrical phase delay of the bolometer absorber reflective termination across the array. This resonant absorber termination structure is used to define a spectral response over a 4:1 bandwidth in the far-infrared, from ∼30 to 120 µm. The metrology of the backshort-bolometer array hybrid was achieved with a laser confocal microscope and a compact cryogenic system that provides a well-defined thermal (radiative and conductive) environment for the hybrid when cooled to ∼10 K. The results show the backshort free-space delays do not change with cooling. The estimated backshort slope is 1.58 milli-radians and within 0.3% of the targeted value. The sources of error in the free-space delay of the hybrid and optical cryogenic metrology implementations are discussed in detail. We also present measurements of the bolometer's single-crystal silicon membrane topography. The membranes deform and deflect out-of-plane under both warm and cold conditions. Intriguingly, the optically active area of the membranes tends to flatten when cold and repeatably achieve the same mechanical state over many thermal cycles; hence, no evidence for thermally-induced mechanical instability is observed. Most of the cold deformation is sourced from thermally-induced stress in the metallic layers comprising the TES element of the bolometer pixels. These results provide important considerations for the design of ultra-low-noise TES bolometers.

2.
Ultrasound Obstet Gynecol ; 60(6): 805-811, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-35943828

RESUMEN

Pathogenic variants of collagen type IV alpha 1 and 2 (COL4A1/COL4A2) genes cause various phenotypic anomalies, including intracerebral hemorrhage and a wide spectrum of developmental anomalies. Only 20% of fetuses referred for COL4A1/COL4A2 molecular screening (fetuses with a suspected intracerebral hemorrhage) carry a pathogenic variant in these genes, raising questions regarding the causative anomaly in the remaining 80% of these fetuses. We examined, following termination of pregnancy or in-utero fetal death, a series of 113 unrelated fetuses referred for COL4A1/COL4A2 molecular screening, in which targeted sequencing was negative. Using exome sequencing data and a gene-based collapsing test, we searched for enrichment of rare qualifying variants in our fetal cohort in comparison to the Genome Aggregation Database (gnomAD) control cohort (n = 71 702). Qualifying variants in pyruvate dehydrogenase E1 subunit alpha 1 (PDHA1) were overrepresented in our cohort, reaching genome-wide significance (P = 2.11 × 10-7 ). Heterozygous PDHA1 loss-of-function variants were identified in three female fetuses. Among these three cases, we observed microcephaly, ventriculomegaly, germinolytic pseudocysts, agenesis/dysgenesis of the corpus callosum and white-matter anomalies that initially suggested cerebral hypoxic-ischemic and hemorrhagic lesions. However, a careful a-posteriori reanalysis of imaging and postmortem data showed that the observed lesions were also consistent with those observed in fetuses carrying PDHA1 pathogenic variants, strongly suggesting that these two phenotypes may overlap. Exome sequencing should therefore be performed in fetuses referred for COL4A1/COL4A2 molecular screening which are screen-negative, with particular attention paid to the PDHA1 gene. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.


Asunto(s)
Enfermedades Metabólicas , Malformaciones del Sistema Nervioso , Embarazo , Femenino , Humanos , Colágeno Tipo IV/genética , Mutación , Fenotipo , Hemorragia Cerebral , Cuerpo Calloso
3.
Genet Med ; 23(12): 2433-2442, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34385668

RESUMEN

PURPOSE: PIK3CA pathogenic variants in the PIK3CA-related overgrowth spectrum (PROS) activate phosphoinositide 3-kinase signaling, providing a rationale for targeted therapy, but no drug has proven efficacy and safety in this population. Our aim was to establish the six-month tolerability and efficacy of low-dose taselisib, a selective class I PI3K inhibitor, in PROS patients. METHODS: Patients over 16 years with PROS and PIK3CA pathogenic variants were included in a phase IB/IIA multicenter, open-label single-arm trial (six patients at 1 mg/day of taselisib, then 24 at 2 mg/day). The primary outcome was the occurrence of dose limiting toxicity (DLT). Efficacy outcomes were the relative changes after treatment of (1) tissue volume at affected and unaffected sites, both clinically and on imaging; (2) cutaneous vascular outcomes when relevant; (3) biologic parameters; (4) quality of life; and (5) patient-reported outcomes. RESULTS: Among 19 enrolled patients, 2 experienced a DLT (enteritis and pachymeningitis) leading to early trial termination (17 treated, 10 completed the study). No serious adverse reaction occurred in the 1 mg cohort (n = 6). No significant reduction in affected tissue volume was observed (mean -4.2%; p = 0.81; SD 14.01). Thirteen (76.4%) participants reported clinical improvement (pain reduction, chronic bleeding resolution, functional improvement). CONCLUSION: Despite functional improvement, the safety profile of low-dose taselisib precludes its long-term use.


Asunto(s)
Síndrome de Klippel-Trenaunay-Weber , Syzygium , Adulto , Humanos , Imidazoles , Mutación , Oxazepinas , Fosfatidilinositol 3-Quinasas/genética , Calidad de Vida
4.
Artículo en Inglés | MEDLINE | ID: mdl-33967568

RESUMEN

Excess heat capacity in a bolometric detector has the consequence of increasing or leading to multiple device time constants. The Mo/Au bilayer transition edge sensor (TES) bolometric detectors initially fabricated for the high resolution mid-infrared spectrometer (HIRMES) exhibited two response thermalization scales, one of which is a few times longer than estimates based upon the properties of the bulk materials employed in the design. The relative contribution of this settling time to the overall time response of the detectors is roughly proportional to the pixel area, which ranges between ~0.3 and 2.6 mm2. Use of laser ablation to remove sections of the silicon membranes comprising the pixels results in a detector response with a smaller contribution from the secondary time constant. Additional information about the nature of this excess heat capacity is gleaned from glancing incidence x-ray diffraction, which reveals the presence of molybdenum silicides near the silicon surface which is a consequence of the bi-layer deposition. Quantitative analysis of the concentration of excess molybdenum, estimated with secondary ion mass spectroscopy, is commensurate to the additional heat capacity needed to explain the anomalous time response of the detectors.

5.
Astron Astrophys ; 6152018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30185990

RESUMEN

CONTEXT: In bright photodissociation regions (PDRs) associated to massive star formation, the presence of dense "clumps" that are immersed in a less dense interclump medium is often proposed to explain the difficulty of models to account for the observed gas emission in high-excitation lines. AIMS: We aim at presenting a comprehensive view of the modeling of the CO rotational ladder in PDRs, including the high-J lines that trace warm molecular gas at PDR interfaces. METHODS: We observed the 12CO and 13CO ladders in two prototypical PDRs, the Orion Bar and NGC 7023 NW using the instruments onboard Herschel. We also considered line emission from key species in the gas cooling of PDRs (C+, O, H2) and other tracers of PDR edges such as OH and CH+. All the intensities are collected from Herschel observations, the literature and the Spitzer archive and are analyzed using the Meudon PDR code. RESULTS: A grid of models was run to explore the parameter space of only two parameters: thermal gas pressure and a global scaling factor that corrects for approximations in the assumed geometry. We conclude that the emission in the high-J CO lines, which were observed up to J up =23 in the Orion Bar (J up =19 in NGC 7023), can only originate from small structures of typical thickness of a few 10-3 pc and at high thermal pressures (Pth ~ 108 K cm-3). CONCLUSIONS: Compiling data from the literature, we found that the gas thermal pressure increases with the intensity of the UV radiation field given by G0, following a trend in line with recent simulations of the photoevaporation of illuminated edges of molecular clouds. This relation can help rationalising the analysis of high-J CO emission in massive star formation and provides an observational constraint for models that study stellar feedback on molecular clouds.

6.
Acta Neurol Scand ; 138(4): 301-307, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29749052

RESUMEN

OBJECTIVE: As exercise intolerance and exercise-induced myalgia are commonly encountered in metabolic myopathies, functional screening tests are commonly used during the diagnostic work-up. Our objective was to evaluate the accuracy of isometric handgrip test (IHT) and progressive cycle ergometer test (PCET) to identify McArdle disease and myoadenylate deaminase (MAD) deficiency and to propose diagnostic algorithms using exercise-induced lactate and ammonia variations. METHODS: A prospective sample of 46 patients underwent an IHT and a PCET as part of their exercise-induced myalgia and intolerance evaluation. The two diagnostics tests were compared against the results of muscle biopsy and/or the presence of mutations in PYGM. A total of 6 patients had McArdle disease, 5 a complete MAD deficiency (MAD absent), 12 a partial MAD deficiency, and 23 patients had normal muscle biopsy and acylcarnitine profile (disease control). RESULTS: The two functional tests could diagnose all McArdle patients with statistical significance, combining a low lactate variation (IHT: <1 mmol/L, AUC = 0.963, P < .0001; PCET: <1 mmol/L, AUC = 0.990, P < .0001) and a large ammonia variation (IHT: >100 µmol/L, AUC = 0.944, P = .0005; PCET: >20 µmol/L, AUC = 1). PCET was superior to IHT for MAD absent diagnosis, combining very low ammonia variation (<10 µmol/L, AUC = 0.910, P < .0001) and moderate lactate variation (>1 mmol/L). CONCLUSIONS: PCET-based decision tree was more accurate than IHT, with respective generalized squared correlations of 0.796 vs 0.668. IHT and PCET are both interesting diagnostic tools to identify McArdle disease, whereas cycle ergometer exercise is more efficient to diagnose complete MAD deficiency.


Asunto(s)
AMP Desaminasa/deficiencia , Algoritmos , Prueba de Esfuerzo/métodos , Enfermedad del Almacenamiento de Glucógeno Tipo V/diagnóstico , Fuerza de la Mano/fisiología , AMP Desaminasa/genética , Adolescente , Adulto , Ejercicio Físico/fisiología , Femenino , Enfermedad del Almacenamiento de Glucógeno Tipo V/genética , Enfermedad del Almacenamiento de Glucógeno Tipo V/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Mutación/genética , Estudios Prospectivos , Adulto Joven
7.
Neurogenetics ; 19(2): 93-103, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29511999

RESUMEN

Molecular anomalies in MED13L, leading to haploinsufficiency, have been reported in patients with moderate to severe intellectual disability (ID) and distinct facial features, with or without congenital heart defects. Phenotype of the patients was referred to "MED13L haploinsufficiency syndrome." Missense variants in MED13L were already previously described to cause the MED13L-related syndrome, but only in a limited number of patients. Here we report 36 patients with MED13L molecular anomaly, recruited through an international collaboration between centers of expertise for developmental anomalies. All patients presented with intellectual disability and severe language impairment. Hypotonia, ataxia, and recognizable facial gestalt were frequent findings, but not congenital heart defects. We identified seven de novo missense variations, in addition to protein-truncating variants and intragenic deletions. Missense variants clustered in two mutation hot-spots, i.e., exons 15-17 and 25-31. We found that patients carrying missense mutations had more frequently epilepsy and showed a more severe phenotype. This study ascertains missense variations in MED13L as a cause for MED13L-related intellectual disability and improves the clinical delineation of the condition.


Asunto(s)
Discapacidad Intelectual/genética , Complejo Mediador/genética , Niño , Preescolar , Femenino , Humanos , Discapacidad Intelectual/diagnóstico , Masculino , Mutación Missense , Fenotipo
8.
Clin Genet ; 94(1): 43-53, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29322497

RESUMEN

The patella is a sesamoid bone, crucial for knee stability. When absent or hypoplastic, recurrent knee subluxations, patellofemoral dysfunction and early gonarthrosis may occur. Patella hypoplasia/agenesis may be isolated or observed in syndromic conditions, either as the main clinical feature (Nail-patella syndrome, small patella syndrome), as a clue feature which can help diagnosis assessment, or as a background feature that may be disregarded. Even in the latter, the identification of patella anomalies is important for an appropriate patient management. We review the clinical characteristics of these rare diseases, provide guidance to facilitate the diagnosis and discuss how the genes involved could affect patella development.


Asunto(s)
Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Anomalías Musculoesqueléticas/diagnóstico , Anomalías Musculoesqueléticas/genética , Rótula/anomalías , Alelos , Enfermedades del Desarrollo Óseo/diagnóstico , Enfermedades del Desarrollo Óseo/genética , Diagnóstico Diferencial , Estudios de Asociación Genética/métodos , Cadera/anomalías , Humanos , Isquion/anomalías , Imagen Multimodal/métodos , Rótula/diagnóstico por imagen , Fenotipo , Síndrome
9.
Astron Astrophys ; 6042017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29093599

RESUMEN

CONTEXT: Protoplanetary disks undergo substantial mass-loss by photoevaporation, a mechanism which is crucial to their dynamical evolution. However, the processes regulating the gas energetics have not been well constrained by observations so far. AIMS: We aim at studying the processes involved in disk photoevaporation when it is driven by far-UV photons (i.e. 6 < E < 13.6 eV). METHODS: We present a unique Herschel survey and new ALMA observations of four externally-illuminated photoevaporating disks (a.k.a. proplyds). For the analysis of these data, we developed a 1D model of the photodissociation region (PDR) of a proplyd, based on the Meudon PDR code and we computed the far infrared line emission. RESULTS: With this model, we successfully reproduce most of the observations and derive key physical parameters, i.e. densities at the disk surface of about 106 cm-3 and local gas temperatures of about 1000 K. Our modelling suggests that all studied disks are found in a transitional regime resulting from the interplay between several heating and cooling processes that we identify. These differ from those dominating in classical PDRs i.e. grain photo-electric effect and cooling by [OI] and [CII] FIR lines. This specific energetic regime is associated to an equilibrium dynamical point of the photoevaporation flow: the mass-loss rate is self-regulated to keep the envelope column density at a value that maintains the temperature at the disk surface around 1000 K. From the physical parameters derived from our best-fit models, we estimate mass-loss rates - of the order of 10-7 M⊙/yr - that are in agreement with earlier spectroscopic observation of ionised gas tracers. This holds only if we assume photoevaporation in the supercritical regime where the evaporation flow is launched from the disk surface at sound speed. CONCLUSIONS: We have identified the energetic regime regulating FUV-photoevaporation in proplyds. This regime could be implemented into models of the dynamical evolution of protoplanetary disks.

11.
Astron Astrophys ; 6062017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28989177

RESUMEN

CONTEXT: L1630 in the Orion B molecular cloud, which includes the iconic Horsehead Nebula, illuminated by the star system σ Ori, is an example of a photodissociation region (PDR). In PDRs, stellar radiation impinges on the surface of dense material, often a molecular cloud, thereby inducing a complex network of chemical reactions and physical processes. AIMS: Observations toward L1630 allow us to study the interplay between stellar radiation and a molecular cloud under relatively benign conditions, that is, intermediate densities and an intermediate UV radiation field. Contrary to the well-studied Orion Molecular Cloud 1 (OMC1), which hosts much harsher conditions, L1630 has little star formation. Our goal is to relate the [Cii] fine-structure line emission to the physical conditions predominant in L1630 and compare it to studies of OMC1. METHODS: The [Cii] 158 µm line emission of L1630 around the Horsehead Nebula, an area of 12' × 17', was observed using the upgraded German Receiver for Astronomy at Terahertz Frequencies (upGREAT) onboard the Stratospheric Observatory for Infrared Astronomy (SOFIA). RESULTS: Of the [Cii] emission from the mapped area 95%, 13 L⊙, originates from the molecular cloud; the adjacent Hii region contributes only 5%, that is, 1 L⊙. From comparison with other data (CO(1-0)-line emission, far-infrared (FIR) continuum studies, emission from polycyclic aromatic hydrocarbons (PAHs)), we infer a gas density of the molecular cloud of nH ∼ 3 · 103 cm-3, with surface layers, including the Horsehead Nebula, having a density of up to nH ∼ 4 · 104 cm-3. The temperature of the surface gas is T ∼ 100 K. The average [Cii] cooling efficiency within the molecular cloud is 1.3 · 10-2. The fraction of the mass of the molecular cloud within the studied area that is traced by [Cii] is only 8%. Our PDR models are able to reproduce the FIR-[Cii] correlations and also the CO(1-0)-[Cii] correlations. Finally, we compare our results on the heating efficiency of the gas with theoretical studies of photoelectric heating by PAHs, clusters of PAHs, and very small grains, and find the heating efficiency to be lower than theoretically predicted, a continuation of the trend set by other observations. CONCLUSIONS: In L1630 only a small fraction of the gas mass is traced by [Cii]. Most of the [Cii] emission in the mapped area stems from PDR surfaces. The layered edge-on structure of the molecular cloud and limitations in spatial resolution put constraints on our ability to relate different tracers to each other and to the physical conditions. From our study, we conclude that the relation between [Cii] emission and physical conditions is likely to be more complicated than often assumed. The theoretical heating efficiency is higher than the one we calculate from the observed [Cii] emission in the L1630 molecular cloud.

12.
Clin Genet ; 91(6): 908-912, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27861764

RESUMEN

Proximal 16p11.2 microdeletions are recurrent microdeletions with an overall prevalence of 0.03%. In patients with segmentation defects of the vertebra (SDV), a burden of this microdeletion was observed with TBX6 as a candidate gene for SDV. In a published cohort of patients with congenital scoliosis (CS), TBX6 haploinsufficiency was compound heterozygous with a common haplotype. Besides, a single three-generation family with spondylocostal dysostosis (SCD) was reported with a heterozygous stop-loss of TBX6. These observations questioned both on the inheritance mode and on the variable expressivity associated with TBX6-associated SDV. Based on a national recruitment of 56 patients with SDV, we describe four patients with variable SDV ranging from CS to SCD associated with biallelic variations of TBX6. Two patients with CS were carrying a proximal 16p11.2 microdeletion associated with the previously reported haplotype. One patient with extensive SDV was carrying a proximal 16p11.2 microdeletion associated with a TBX6 rare missense change. One patient with a clinical diagnosis of SCD was compound heterozygous for two TBX6 rare missense changes. The three rare variants were affecting the chromatin-binding domain. Our data illustrate the variable expressivity of recessive TBX6 ranging from CS to SCD.


Asunto(s)
Anomalías Múltiples/genética , Predisposición Genética a la Enfermedad , Hernia Diafragmática/genética , Escoliosis/genética , Proteínas de Dominio T Box/genética , Anomalías Múltiples/diagnóstico por imagen , Anomalías Múltiples/fisiopatología , Niño , Preescolar , Femenino , Genotipo , Haplotipos , Hernia Diafragmática/diagnóstico por imagen , Hernia Diafragmática/fisiopatología , Humanos , Lactante , Masculino , Mutación , Linaje , Escoliosis/diagnóstico por imagen , Escoliosis/fisiopatología , Columna Vertebral/diagnóstico por imagen , Columna Vertebral/fisiopatología
13.
Br J Dermatol ; 175(4): 721-7, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27062385

RESUMEN

BACKGROUND: We have encountered repeated cases of recessive lethal generalized severe (Herlitz-type) junctional epidermolysis bullosa (JEB gen sev) in infants born to Hungarian Roma parents residing in a small region of Hungary. OBJECTIVES: To identify the disease-causing mutation and to investigate the genetic background of its unique carrier group. METHODS: The LAMB3 gene was analysed in peripheral-blood genomic DNA samples, and the pathological consequences of the lethal defect were confirmed by cutaneous LAMB3cDNA sequencing. A median joining haplotype network within the Y chromosome H1a-M82 haplogroup of individuals from the community was constructed, and LAMB3 single-nucleotide polymorphism (SNP) patterns were also determined. RESULTS: An unconventional intronic splice-site mutation (LAMB3, c.1133-22G>A) was identified. Thirty of 64 voluntarily screened Roma from the closed community carried the mutation, but none of the 306 Roma from other regions of the country did. The age of the mutation was estimated to be 548 ± 222 years. Within the last year, more patients with JEB gen sev carrying the same unusual mutation have been identified in three unrelated families, all immigrants from the Balkans. Two were compound heterozygous newborns, in Germany and Italy, and one homozygous newborn died in France. Only the French family recognized their Roma background. LAMB3SNP haplotyping confirmed the link between the apparently unrelated Hungarian, German and Italian male cases, but could not verify the same background in the female newborn from France. CONCLUSIONS: The estimated age of the mutation corresponds to the time period when Roma were wandering in the Balkans.


Asunto(s)
Moléculas de Adhesión Celular/genética , Epidermólisis Ampollosa de la Unión/genética , Efecto Fundador , Mutación/genética , Romaní/genética , Sustitución de Aminoácidos/genética , ADN Complementario/genética , Emigración e Inmigración , Epidermólisis Ampollosa de la Unión/etnología , Femenino , Francia/etnología , Genoma Humano , Alemania/etnología , Haplotipos/genética , Humanos , Hungría/etnología , Lactante , Italia/etnología , Masculino , Filogeografía , Polimorfismo de Nucleótido Simple/genética , ARN/genética , Sitios de Empalme de ARN/genética , Kalinina
14.
Clin Genet ; 89(5): 630-5, 2016 05.
Artículo en Inglés | MEDLINE | ID: mdl-26582393

RESUMEN

Microarray-based comparative genomic hybridization (aCGH) is commonly used in diagnosing patients with intellectual disability (ID) with or without congenital malformation. Because aCGH interrogates with the whole genome, there is a risk of being confronted with incidental findings (IF). In order to anticipate the ethical issues of IF with the generalization of new genome-wide analysis technologies, we questioned French clinicians and cytogeneticists about the situations they have faced regarding IF from aCGH. Sixty-five IF were reported. Forty corresponded to autosomal dominant diseases with incomplete penetrance, 7 to autosomal dominant diseases with complete penetrance, 14 to X-linked diseases, and 4 were heterozygotes for autosomal recessive diseases with a high prevalence of heterozygotes in the population. Therapeutic/preventive measures or genetic counselling could be argued for all cases except four. These four IF were intentionally not returned to the patients. Clinicians reported difficulties in returning the results in 29% of the cases, mainly when the question of IF had not been anticipated. Indeed, at the time of the investigation, only 48% of the clinicians used consents mentioning the risk of IF. With the emergence of new technologies, there is a need to report such national experiences; they show the importance of pre-test information on IF.


Asunto(s)
Hibridación Genómica Comparativa/métodos , Asesoramiento Genético/ética , Asesoramiento Genético/métodos , Hallazgos Incidentales , Revelación/ética , Femenino , Francia , Genes Dominantes/genética , Genes Recesivos/genética , Enfermedades Genéticas Congénitas/diagnóstico , Enfermedades Genéticas Congénitas/genética , Enfermedades Genéticas Ligadas al Cromosoma X/diagnóstico , Enfermedades Genéticas Ligadas al Cromosoma X/genética , Humanos , Masculino , Análisis por Micromatrices/métodos , Relaciones Médico-Paciente/ética , Estudios Retrospectivos , Encuestas y Cuestionarios
15.
Eur J Neurol ; 22(6): 933-40, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25740218

RESUMEN

BACKGROUND AND PURPOSE: This was a retrospective study to assess the diagnostic value of the non-ischaemic forearm exercise test in detecting McArdle's disease. METHODS: The study is a retrospective diagnostic study over 15 years (1999-2013) on a referred sample of patients suffering from exercise intolerance and various muscle complaints, generally with elevated creatine kinase (CK). In all, 1226 patients underwent the non-ischaemic forearm exercise test. Blood lactate, ammonia and CK levels were analyzed. DNA analyses and/or muscle biopsies were assessed to confirm the diagnosis of McArdle's disease. The results of 60 volunteers were used to compare with the results of study subjects. RESULTS: In this cohort, 40 patients were finally diagnosed with McArdle's disease. Absolute values of lactate and ammonia rise were used to discriminate all McArdle patients from healthy patients. A sensitivity and specificity of respectively 100% and 99.7% were calculated. The 24-h CK level showed no significant difference from the CK level at the day of the test and confirms the safety of the test. CONCLUSIONS: This study has formally assessed the diagnostic value of the non-ischaemic forearm exercise test in the detection of McArdle's disease. Very high sensitivity and specificity were observed. Furthermore, the test is easy to set up and to perform, it is non-traumatic and cost effective. It may circumvent a muscle biopsy in McArdle patients presenting the most common mutations. Hence, it is a perfect and safe screening instrument to detect patients with McArdle's disease. Glycogen storage disease type III patients, however, may show similar patterns to McArdle patients.


Asunto(s)
Prueba de Esfuerzo/normas , Antebrazo , Enfermedad del Almacenamiento de Glucógeno Tipo V/diagnóstico , Adolescente , Adulto , Anciano , Niño , Femenino , Enfermedad del Almacenamiento de Glucógeno Tipo V/metabolismo , Enfermedad del Almacenamiento de Glucógeno Tipo V/patología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Sensibilidad y Especificidad , Adulto Joven
16.
Clin Genet ; 88(5): 479-83, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25382487

RESUMEN

During limb development, the spatio-temporal expression of sonic hedgehog (SHH) is driven by the Zone of polarizing activity Regulatory Sequence (ZRS), located 1 megabase upstream from SHH. Gain-of-function mutations of this enhancer, which cause ectopic expression of SHH, are known to be responsible for congenital limb malformations with variable expressivity, ranging from preaxial polydactyly or triphalangeal thumbs to polysyndactyly, which may also be associated with mesomelic deficiency. In this report, we describe a patient affected with mirror-image polydactyly of the four extremities and bilateral tibial deficiency. The proband's father had isolated preaxial polydactyly type II (PPD2). Using Sanger sequencing, a ZRS point mutation (NC_000007.14, g.156584153A>G, UCSC, Build hg.19) was only identified in the patient. However, pyrosequencing analysis enabled the detection of a 10% somatic mosaic in the blood and saliva from the father. To our knowledge, this is the first description of a ZRS mosaic mutation. This report highlights the complexity of genotype-phenotype correlation in ZRS-associated syndromes and the importance of detecting somatic mosaicism for accurate genetic counselling.


Asunto(s)
Anomalías Múltiples/genética , Anomalías Congénitas/genética , Ectromelia/genética , Deformidades Congénitas del Pie/genética , Deformidades Congénitas de la Mano/genética , Proteínas Hedgehog/genética , Disostosis Mandibulofacial/genética , Mosaicismo , Nariz/anomalías , Mutación Puntual , Anomalías Múltiples/metabolismo , Adulto , Anomalías Congénitas/metabolismo , Análisis Mutacional de ADN , Ectromelia/metabolismo , Deformidades Congénitas del Pie/metabolismo , Deformidades Congénitas de la Mano/metabolismo , Humanos , Lactante , Recién Nacido , Masculino , Disostosis Mandibulofacial/metabolismo , Mucosa Nasal/metabolismo , Linaje
17.
J Gynecol Obstet Biol Reprod (Paris) ; 44(4): 387-90, 2015 Apr.
Artículo en Francés | MEDLINE | ID: mdl-24842646

RESUMEN

Congenital diaphragmatic hernia has a physiopathology unfully understood, and is the cause of an important morbimortality. We report the case of a fetus suffering from a diaphragmatic hernia associated with a EDNRA gene triplication, coding for the endothelin 1 receptor. High-resolution genetic techniques were able to find the possible origin of this pathology, and showed that it was an isolated form with a good prognostic. ET-A receptor over-expression in lung vessels may cause a vascular remodeling and a lung arterial high blood pressure. This lung abnormality would have occurred before the diaphragmatic defect.


Asunto(s)
Endotelina-1/genética , Hernias Diafragmáticas Congénitas/diagnóstico por imagen , Hernias Diafragmáticas Congénitas/genética , Receptor de Endotelina A/metabolismo , Cromosomas Humanos Par 4 , Femenino , Humanos , Hipertensión/etiología , Pulmón/anomalías , Pulmón/diagnóstico por imagen , Embarazo , Trisomía , Ultrasonografía Prenatal
18.
Eur J Phys Rehabil Med ; 51(3): 345-9, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24980632

RESUMEN

In a 12-year old girl suffering from autosomal recessive axonal Charcot-Marie-Tooth (CMT) neuropathy, pes cavovarus was treated with botulinum toxin injection in the tibialis posterior. The patient underwent a clinical evaluation, video analysis of spatiotemporal gait parameters and dynamic foot plantar pressure assessment before treatment and then two weeks, three months and six months thereafter. The video gait analysis revealed a decrease in varus during the swing phase of gait. The dynamic foot plantar pressure decreased by 50% in the excessive pressure at the side of the foot six months after the injection (maximal pressure=42.6N/cm2 before treatment and 18.9 N/cm2 after 6 month). Botulinum toxin injection appears to be an efficacious means of correcting pes cavovarus in CMT disease. A larger-scale clinical trial is now required to evaluate the putative longer-term preventive effect of this treatment on the pes cavus deformity.


Asunto(s)
Toxinas Botulínicas/uso terapéutico , Enfermedad de Charcot-Marie-Tooth/complicaciones , Deformidades del Pie/tratamiento farmacológico , Marcha/fisiología , Enfermedad de Charcot-Marie-Tooth/tratamiento farmacológico , Preescolar , Femenino , Deformidades del Pie/etiología , Deformidades del Pie/fisiopatología , Humanos , Neurotoxinas/uso terapéutico
19.
Eur J Nucl Med Mol Imaging ; 42(3): 478-94, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25488184

RESUMEN

PURPOSE: We aimed to characterize pharmacologically the TSPO- radioligand [(18)F]DPA-714 in the brain of healthy cynomolgus monkeys and evaluate the cellular origin of its binding in a model of neurodegeneration induced by intrastriatal injection of quinolinic acid (QA). METHODS: [(18)F]DPA-714 PET images were acquired before and at 2, 7, 14, 21, 49, 70, 91 days after putaminal lesioning. Blocking and displacement studies were carried out (PK11195). Different modelling approaches estimated rate constants and V T (total distribution volume) which was used to measure longitudinal changes in the lesioned putamen. Sections for immunohistochemical labelling were prepared at the same time-points to evaluate correlations between in vivo [(18)F]DPA-714 binding and microglial/astrocytic activation. RESULTS: [(18)F]DPA-714 showed a widespread distribution with a higher signal in the thalamus and occipital cortex and lower binding in the cerebellum. TSPO was expressed throughout the whole brain and about 73 % of [(18)F]DPA-714 binding was specific for TSPO in vivo. The one-tissue compartment model (1-TCM) provided good and reproducible estimates of V T and rate constants, and V T values from the 1-TCM and the Logan approach were highly correlated (r (2) = 0.85). QA lesioning induced an increase in V T, which was +17 %, +54 %, +157 % and +39 % higher than baseline on days 7, 14, 21 and 91 after QA injection, respectively. Immunohistochemistry revealed an early microglial and a delayed astrocytic activation after QA injection. [(18)F]DPA-714 binding matched TSPO immunopositive areas and showed a stronger colocalization with CD68 microglia than with GFAP-activated astrocytes. CONCLUSION: [(18)F]DPA-714 binds to TSPO with high specificity in the primate brain under normal conditions and in the QA model. This tracer provides a sensitive tool for assessing neuroinflammation in the human brain.


Asunto(s)
Encéfalo/diagnóstico por imagen , Tomografía de Emisión de Positrones , Pirazoles/farmacocinética , Pirimidinas/farmacocinética , Radiofármacos/farmacocinética , Animales , Radioisótopos de Flúor/farmacocinética , Macaca fascicularis , Masculino , Receptores de GABA-A/metabolismo , Distribución Tisular
20.
Clin Genet ; 85(5): 464-9, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-23790188

RESUMEN

Split hand/foot malformation (SHFM) with long-bone deficiency (SHFLD, MIM#119100) is a rare condition characterized by SHFM associated with long-bone malformation usually involving the tibia. Previous published data reported several unrelated patients with 17p13.3 duplication and SHFLD. Recently, the minimal critical region had been reduced, suggesting that BHLHA9 copy number gains are associated with this limb defect. Here, we report on 13 new families presenting with ectrodactyly and harboring a BHLHA9 duplication.


Asunto(s)
Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/genética , Genes Duplicados , Deformidades Congénitas de las Extremidades/genética , Tibia/anomalías , Cromosomas Humanos Par 17/genética , Femenino , Humanos , Deformidades Congénitas de las Extremidades/fisiopatología , Masculino , Linaje , Fenotipo , Tibia/fisiopatología
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