Miyoshi myopathy associated with spine rigidity and multiple contractures: a case report.

BACKGROUND: Dysferlinopathy is a phenotypically heterogeneous group of hereditary diseases caused by mutations in the DYSF gene. Early contractures are considered rare, and rigid spine syndrome in dysferlinopathy has been previously reported only once. CASE PRESENTATION: We describe a 23-year-old patient with Miyoshi myopathy with a rigid spine and multiple contractures, a rare phenotypic variant. The disease first manifested when the patient was 13 years old, with fatigue of the gastrocnemius muscles and the development of pronounced contractures of the Achilles tendons, flexors of the fingers, and extensors of the toes, followed by the involvement of large joints and the spine. Magnetic resonance imaging revealed signs of connective tissue and fatty replacement of the posterior muscles of the thighs and lower legs. Edema was noted in the anterior and medial muscle groups of the thighs, lower legs, and the multifidus muscle of the back. Whole genome sequencing revealed previously described mutations in the DYSF gene in exon 39 (c.4282 C > T) and intron 51 (c.5785-824 C > T). An immunohistochemical analysis and Western blot showed the complete absence of dysferlin protein expression in the muscle fibers. CONCLUSIONS: This case expands the range of clinical and phenotypic correlations of dysferlinopathy and complements the diagnostic search for spine rigidity.

The effect of temperature and oxygen partial pressure on the concentration of iron and manganese ions in La1/3Sr2/3Fe1-xMnxO3-δ.

The oxygen content was measured in cubic perovskite-type La1/3Sr2/3Fe1-xMnxO3-δ (x = 0.1, 0.17, 0.25, and 1/3) in the range of oxygen partial pressure from 10-22 to 0.5 atm at 750-950 °C with a step of 50 °C by coulometric titration. Gradual removal of oxygen from the oxides during the measurements was carried out until the stability limit was achieved and the reductive decomposition began. An increase in manganese content was shown to lead to a decrease in the stability of La1/3Sr2/3Fe1-xMnxO3-δ under reducing conditions. The obtained data on oxygen content were used for defect chemistry modeling in the oxides. The enthalpy of the Fe3+ to Fe4+ and Mn3+ to Mn4+ oxidation reactions (ΔHox0) was determined to be -103.2 ± 0.3 and -250 ± 2 kJ mol-1, respectively, for the x = 0.1 composition, and increased slightly with increasing manganese content. The large difference in ΔHox0 determines a strong distinction between the behavior of iron and manganese in perovskite-type oxides. An increase in manganese content in La1/3Sr2/3Fe1-xMnxO3-δ was found to lead to a decrease in the concentration of Fe4+ ions, but did not affect the concentration of Fe2+ ions. The impact of La/Sr ratio was evaluated by comparison of the obtained data with that for La0.5Sr0.5Fe1-xMnxO3-δ, and found to be different for iron and manganese. An increase in lanthanum fraction causes a decrease in the concentration of Fe2+ ions and an increase in the concentration of Mn2+ under reducing conditions.

Structural Features and Defect Equilibrium in Cubic PrBa1-xSrxFe2O6-δ.

The structure, oxygen non-stoichiometry, and defect equilibrium in perovskite-type PrBa1-xSrxFe2O6-δ (x = 0, 0.25, 0.50) synthesized at 1350 °C were studied. For all compositions, X-ray diffraction testifies to the formation of a cubic structure (S.G. Pm3¯m), but an electron diffraction study reveals additional diffuse satellites around each Bragg spot, indicating the primary incommensurate modulation with wave vectors about ±0.43a*. The results were interpreted as a sign of the short-order in both A-cation and anion sublattices in the areas of a few nanometers in size, and of an intermediate state before the formation of an ordered superstructure. An increase in oxygen deficiency was found to promote the ordering, whereas partial substitution of barium by strontium caused the opposite effect. The oxygen content in oxides as a function of oxygen partial pressure and temperature was measured by coulometric titration, and the data were used for the modeling of defect equilibrium in oxides. The simulation results implied oxygen vacancy ordering in PrBa1-xSrxFe2O6-δ that is in agreement with the electron diffraction study. Besides oxidation and charge disproportionation reactions, the reactions of oxygen vacancy distribution between non-equivalent anion positions, and their trapping in clusters with Pr3+ ions were taken into account by the model. It was demonstrated that an increase in the strontium content in Pr0.5Ba0.5-xSrxFeO3-δ suppressed ordering of oxygen vacancies, increased the binding energy of oxygen ions in the oxides, and resulted in an increase in the concentration of p-type carriers.

Impact of oxygen content on preferred localization of p- and n-type carriers in La0.5Sr0.5Fe1-xMnxO3-δ.

The oxygen content in La0.5Sr0.5Fe1-xMnxO3-δ, measured by coulometric titration in a wide range of oxygen partial pressure at various temperatures, was used for defect chemistry analysis. The obtained data were well approximated by a model assuming defect formation in La0.5Sr0.5Fe1-xMnxO3-δvia Fe3+ and Mn3+ oxidation reactions and charge disproportionation on Fe3+ and Mn3+ ions. The partial molar enthalpy and entropy of oxygen in La0.5Sr0.5Fe1-xMnxO3-δ obtained by statistical thermodynamic calculations were found to be in satisfactory agreement with those obtained using the Gibbs-Helmholtz equations, thus further confirming the adequacy of the model. The impact of manganese substitution on defect equilibrium in La0.5Sr0.5Fe1-xMnxO3-δ was shown to be attributed to a lower enthalpy of Mn3+ oxidation reaction (vs. for the oxidation of Fe3+) and the charge disproportionation reaction on Mn3+ (vs. for that on Fe3+). The former makes Mn4+ ions more resistant to reduction than Fe4+. The latter favors the presence of Mn2+, Mn3+, and Mn4+ ions in oxides in comparable concentrations. The distribution of charge carriers over iron and manganese ions was determined as a function of oxygen content in La0.5Sr0.5Fe1-xMnxO3-δ.

Magnetic resonance imaging pattern variability in dysferlinopathy.

The widespread use of magnetic resonance imaging (MRI) in the diagnosis of myopathies has made it possible to clarify the typical MRI pattern of dysferlinopathy. However, sufficient attention has not been given to the variability of MRI patterns in dysferlinopathy. MATERIALS AND METHODS: Twenty-five patients with the clinical manifestations of dysferlinopathy were examined. For all patients, creatine phosphokinase levels were measured and molecular genetics were examined. In two patients, immunohistochemical examinations of muscle biopsies were performed. MRI scanning was included T2 multi-slice multi-echo, T1 weighted, T2 weighted and Short Tau Inversion Recovery T2 weighted sequences. Quantitative and semi-quantitative evaluations of fatty replacement and swelling of the muscles were undertaken. RESULTS: Variability in the MRI patterns was lowest in the pelvis and leg muscles and highest in the thigh muscles. Three main types of MRI patterns were distinguished: posterior-dominant (80%), anterior-dominant (16%), and diffuse (4%). Among patients with the anterior-dominant pattern, the collagen-like variant (4%), proximal variant (4%) and pseudo-myositis (8%) were separately distinguished. CONCLUSIONS: Awareness of atypical MRI patterns in dysferlinopathy is important for increasing the efficiency of routine diagnostics and optimizing the search for causative gene mutations.