WD患者ATP7B基因exon8 DNA突变检测方法的研究

目的对肝豆状核变性(又称Wilson病,WD)ATP7B基因的突变热点外显子8进行PCR扩增产物Msp I酶切和电泳分析及DNA直接双向测序,进而对实验中的方法进行优化研究。方法对102例患者和20例健康人提取基因组DNA,PCR扩增ATP7B基因第8号外显子,扩增产物进行Msp I酶切反应,并进行DNA直接双向测序;讨论分析改进PCR扩增、Msp I酶切的方法学,并对测序结果与临床表型做相关性研究。结果102例WD患者,用反复多次改进的实验方法研究分析后,发现35例存在Msp I酶切结果异常并经测序证实,8号外显子Arg778Leu纯合突变占所有WD病人的34.31%,其中1例伴Leu770Leu多态性同义突变;对照组未检出突变。结论改进实验方法后发现PCR扩增良好,适宜测序;WD突变热点8号外显子中Arg778Leu为主要突变形式,PCR-Msp I酶切反应可作为WD病人ATP7B8号外显子Arg778Leu突变的筛选方法,直接双向测序是确定8号外显子突变位点的可靠方法之一。     

A patient homozygous for the SCA6 gene with retinitis pigmentosa

The present authors studied a 55-year-old-patient homozygous for the SCA6 gene who experienced frequent attacks of positional vertigo at 37 years of age with subsequent staggering gait and night blindness. Retinitis pigmentosa (RP), as well as cerebellar ataxia and vertical antidirectional nystagmus, were detected. The subject's parents were first cousins, and two of his three male cousins, whose parents were also first cousins, had RP without ataxia or nystagmus. The numbers of CAG repeats in the expanded alleles of the SCA6 gene found by molecular analysis were 21 and 21. The genetic results were negative for SCA1, SCA2, SCA3, SCA7 and dentatorubral pallidoluysian atrophy. The retinal degeneration in this patient is most likely to be secondary to a genetic disorder of autosomal or X-linked recessive inheritance rather than SCA6. Other reported cases of patients homozygous for the SCA6 gene are also reviewed.     

Long‐term observation of a Japanese mucolipidosis IV patient with a novel homozygous p.F313del variant of MCOLN1

Mucolipidosis type IV (MLIV) is an autosomal recessively inherited lysosomal storage disorder characterized by progressive psychomotor delay and retinal degeneration that is associated with biallelic variants in the MCOLN1 gene. The gene, which is expressed in late endosomes and lysosomes of various tissue cells, encodes the transient receptor potential channel mucolipin 1 consisting of six transmembrane domains. Here, we described 14‐year follow‐up observation of a 4‐year‐old Japanese male MLIV patient with a novel homozygous in‐frame deletion variant p.(F313del), which was identified by whole‐exome sequencing analysis. Neurological examination revealed progressive psychomotor delay, and atrophy of the corpus callosum and cerebellum was observed on brain magnetic resonance images. Ophthalmologically, corneal clouding has remained unchanged during the follow‐up period, whereas optic nerve pallor and retinal degenerative changes exhibited progressive disease courses. Light‐adapted electroretinography was non‐recordable. Transmission electron microscopy of granulocytes revealed characteristic concentric multiple lamellar structures and an electron‐dense inclusion in lysosomes. The in‐frame deletion variant was located within the second transmembrane domain, which is of putative functional importance for channel properties.     

Alterations in short-term retention, conditioned avoidance response acquisition and motivation following aluminum induced neurofibrillary degeneration

Aluminum chloride induced neurofibrillary degeneration may provide a useful model for the study of a human dementia process. This possibility was assessed in cats trained to perform on a delayed-response task, a conditioned avoidance task, visual and temporal discrimination tasks and a motivational task involving rewarding intracranial electrical stimulation. After an initial asymptomatic period short term retention and acquisition of a conditioned avoidance response were selectively impaired. The associated ultrastructural abnormalities plausibly implicate the cytoplasmic streaming mechanism in the cellular substrate for some retention and acquisition phenomena.     

Non-functional adrenocortical adenoma with extensive degeneration

We report a case of non-functional adrenocortical adenoma of 5.5 x 5.5 x 3.2 cm in size that had an unusual histopathological appearance in two respects. First, the tumor contained small adipose foci with osteogenesis and was suspected of being a myelolipoma based on its appearance on computerized tomography (CT) and magnetic resonance imaging. However, pathologically, the fat element was seen focally and was not accompanied by hematopoietic cells, and the diagnosis of myelolipoma was abandoned. Second, the tumor was suspected of being an adrenal carcinoma based on its appearance on CT scans and showed extensive degeneration: fibrosis, hemorrhage, loss of parenchyma and moderate atypism of the tumor cells. However, as the architecture of the tumor cells was non-diffuse and there were no necrotic foci or mitoses, and vascular or capsular invasion were not present, the tumor was concluded to be an adrenocortical adenoma rather than a carcinoma. We diagnosed the tumor as a non-functional adrenocortical adenoma with extensive degeneration as the extensive areas of fibrosis were particularly remarkable. Furthermore, the extensive areas of degeneration might have been caused not only by an ischemic effect but also by low hormone levels.     

Age-dependent occurrence of an ascending axon on the omega neuron of the cricket, Teleogryllus oceanicus

The omega neurons (ON1s) are a mirror-symmetrical pair of identified prothoracic auditory interneurons of crickets which have been previously described as intraganglionic. Using intracellular techniques we stained ON1s of female Teleogryllus oceanicus and found that many ON1s have axons which project anteriorly out of the prothoracic ganglion. The ascending axon arises contralateral to the soma at the most anteriolateral bend of the bow-shaped process of an otherwise "archetypical" ON1 and travels up the neck connective in a ventral position just inside the connective tissue sheath. The occurrence of the ascending axon is age-dependent. Seventy-five percent of ON1s stained in late nymphal stages and in young adults had an ascending axon while only 30% of ON1s in older adults had an ascending axon. Evidence is presented to show that ON1s having ascending axons are developmental variants of the "archetypical" ON1 and do not represent a separate neuron type. The two morphological types of ON1s are not distinguishable on the basis of their responses to sound stimuli having carrier frequencies of 3.5-60 kHz. Although we know that the ascending axon conducts action potentials, its target and terminal morphology are not yet known.     

The topography of expanded uncrossed retinal projections following neonatal enucleation of one eye: differing effects in dorsal lateral geniculate nucleus and superior colliculus

The topographic organization of the uncrossed retinal projections to the dorsal lateral geniculate nucleus (dLGN) and superior colliculus (SC) was studied in normal adult hooded rats and in rats subjected to unilateral ocular enucleation on the day of birth. Sections were stained for anterograde degeneration products following discrete retinal lesions at various locations. The projection from the temporal crescent to the dLGN in neonatally enucleated rats had an expanded but topographically normal organization, with the nasotemporal and dorsoventral retinal axes displaying polarities identical to those in normal adults. Neonatal enucleation permits the remaining uncrossed retinogeniculate projection to extend primarily along the "lines of projection" into neuropil normally recipient of binocularly conjugate crossed projections. In the SC, the dorsoventral axis of the temporal crescent showed a normal polarity, but the nasotemporal axis failed to display any topographic organization. Retinal loci in the temporal crescent projected throughout the rostrocaudal extent of the ipsilateral SC. Retinal lesions placed outside the temporal crescent failed to produce any substantial degeneration in ipsilateral dLGN or SC. These topographically distinct effects in dLGN and SC following unilateral eye removal on the day of birth are discussed in the context of differing constraints upon axonal ingrowth and connectivity during early development, which may normally bring about the characteristically distinct features of retinogeniculate and retinocollicular organization.     

Electromyography and nerve conduction study in autosomal dominant olivopontocerebellar atrophy

Summary Electromyographic examination and studies of motor and sensory conduction velocities were performed in 11 patients with a presumptive diagnosis of olivopontocerebellar atrophy with autosomal dominant transmission. Peripheral nervous system involvement was shown in eight. In two patients with early onset of disease, electrophysiological alterations clearly pointed to severe axonal degeneration, whereas in six they were compatible with slight demyelination.

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Zusammenfassung Bei elf Patienten, bei welchen eine olivopontocerebelläre Atrophie mit autosomal dominanter Übertragung angenommen wurde, führten wir eine elektromyographische Untersuchung und eine Bestimmung der motorischen und sensiblen Erregungsleitungsgeschwindigkeit durch. Bei acht dieser Patienten wurde eine Mitbeteiligung des peripheren Nervensystems nachgewiesen. In zwei Fällen mit frühem Krankheitsbeginn wiesen die elektrophysiologischen Veränderungen eindeutig auf eine schwere axonale Degeneration hin, während bei sechs die Befunde mit einer leichten Demyelinisation vereinbar waren.

     

A Randomized Study of Nutritional Supplementation in Patients with Unilateral Wet Age-Related Macular Degeneration

The purpose of this study is evaluate the efficacy and safety of medicinal products containing the original Age-Related Eye Disease group (AREDS) formulation at doses approved in Europe (EU, control group; n = 59) with a product that adds DHA, lutein, zeaxanthin, resveratrol and hydroxytyrosol to the formula (intervention group; n = 50). This was a multicenter, randomized, observer-blinded trial conducted in patients aged 50 years or older diagnosed with unilateral exudative Age related Macular Degeneration AMD. At month 12, the intervention did not have a significant differential effect on visual acuity compared with the control group, with an estimated treatment difference in Early Treatment Diabetic Retinopathy Study (ETDRS) of −1.63 (95% CI −0.83 to 4.09; p = 0.192). The intervention exhibited a significant and, in most cases, relevant effect in terms of a reduction in some inflammatory cytokines and a greater improvement in the fatty acid profile and serum lutein and zeaxantin concentration. In patients with unilateral wet AMD, the addition of lutein, zeaxanthin, resveratrol, hydroxytyrosol and DHA to the AREDS EU recommended doses in the short-term did not have a differential effect on visual acuity compared to a standard AREDS EU formula but, in addition to improving the fatty acid profile and increasing carotenoid serum levels, may provide a beneficial effect in improving the proinflammatory and proangiogenic profile of patients with AMD.     

脑血流SPECT断层显像对糖尿病脑血管病的早期检测

目的 评价脑血流SPECT断层显像对糖尿病脑血管病（DCD）的早期诊断价值。方法 用^99mTc-ECD对30例临床确诊2型糖尿病患者进行了脑血流SPECT断层显像,按脑正常解剖和脑SPECT图像应用解剖关系将有每侧大脑灰质分为11个区域,用目测法对每个区域的核素分布进行判定。结果 糖尿病组检出22人共60处有脑血流灌注异常减低,低灌注以颞叶发生率最高（33．33％）,提示脑缺血以大脑中动脉受累为主。糖尿病＜5年的异常影像主要表现为脑皮层限局性楔形样稀疏／缺损,随病程延长,尤其是＞10年者,主要表现为一叶皮层大范围核素分布稀疏,甚至还可伴有楔形病性,说明糖尿病病程也是影响DCD的主要因素。该法对诊断糖尿病缺血性脑血管病的灵敏度,特异性,准确性分别为73．33％,90．00％和80．00％。结论 脑血流SPECT断层显像能直观显示脑皮层缺血部位,范围及程度,有助于临床早期发现DCD,以达到积极治疗目的。