Factors involved in the stability of trinucleotide repeats during
transmission were studied in 139 families in which a full mutation,
premutation or intermediate allele at either FRAXA or FRAXE was
segregating. The transmission of alleles at FRAXA, FRAXE and four
microsatellite loci were recorded for all individuals. Instability within
the minimal and common ranges (0-40 repeats for FRAXA, 0-30 repeats for
FRAXE) was extremely rare; only one example was observed, an increased in
size at FRAXA from 29 to 39 repeats. Four FRAXA and three FRAXE alleles in
the intermediate range (41-60) repeats for FRAXA, 31-60 for FRAXE) were
unstably transmitted. Instability was more frequent for FRAXA intermediate
alleles that had a tract of pure CGG greater than 37 although instability
only occurred in two of 13 such transmissions: the changes observed were
limited to only one or two repeats. Premutation FRAXA alleles over 100
repeats expanded to a full mutation during female transmission in 100% of
cases, in agreement with other published series. There was no clear
correlation between haplotype and probability of expansion of FRAXA
premutations. Instability at FRAXA or FRAXE was more often observed in
conjunction with a second instability at an independent locus suggesting
genomic instability as a possible mechanism by which at least some FRAXA
and FRAXE mutations arise.
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Lipomas are common benign tumours that can occur in most parts of the body. Lipomas arising from the deep temporal fat pad, found between the two layers of the deep temporal fascia, are rare, however; there has been only one documented case report to our knowledge. We describe a second case arising from the temporal fat pad in a patient treated at our unit, having previously reported the first one, and discuss the relevant anatomy and management. 相似文献
Oral ulcerations associated with disseminated cytomegalovirus (CMV) infection were observed in four patients with AIDS manifestations showing low CD4 counts. Virus cultures of urine and saliva samples were positive for CMV in all cases. The lesions were characterized by a punched-out appearance, non-indurated borders, low bleeding tendency and lack of inflammatory wall. Light microscopy revealed granulation tissue containing "owl's eye" like cells in all specimens. Presence of CMV was confirmed by immunohistochemistry and in situ hybridization. The ulcerations were infiltrated with T-lymphocytes of the helper, suppressor and cytotoxic subset, most were positive for HLA DR. Despite the local invasion with immunocytes and high serum titers of serum antibodies the patients experienced progressive CMV disease. 相似文献
Background. The objective of this study was to evaluate long-term survival, valve-related complications as well as prognostic factors for early and late outcome after open and closed mitral commissurotomy covering a follow-up period of 35 years.
Methods. From 1955 to 1977, 183 patients with mitral stenosis underwent mitral commissurotomy at our institution. Closed valvotomy was performed on 143 patients (group A) and open valvotomy on 40 patients (group B).
Results. Survival rates after 10, 20, and 30 years were 89%, 67.8%, and 49.1% in group A and 91.7%, 66.7%, and 45.9% in group B (p = not significant). The risk of late death increased significantly with an advanced preoperative New York Heart Association functional class, atrial fibrillation, higher age at operation, pre- or postoperative mitral regurgitation, and leaflet calcification. Forty-four patients in group A and 5 patients in group B required reoperation (p < 0.05). Independent predictors for reoperation in a multivariate analysis were a remaining postoperative mitral stenosis or regurgitation. A total of 68 patients showed valve-related complications. The linearized rate of valve-related morbidity and mortality was 2.1% per patient-years in group A versus 1.1% per patient-years in B (p < 0.01).
Conclusions. Long-term survival for open and closed commissurotomy are excellent, showing no difference between the groups. However, both the incidence of reoperation as well as valve-related morbidity and mortality were significantly lower after open commissurotomy. In well-selected patients with pure mitral stenosis and no leaflet calcification, open commissurotomy still remains a valid surgical option. 相似文献
Zusammenfassung Präkanzeröse Konditionen (Zustände) umfassen Erkrankungen, die mit einem signifikant erhöhten Krebsrisiko verbunden sind. Dazu gehören die sideropenische Dysphagie, der orale Lichen planus (OLP), die orale submuköse Fibrose (OSF), die Syphilis, der diskoide Lupus erythematodes (DLE), das Xeroderma pigmentosum sowie die Epidermolysis bullosa. Die Zahl publizierter Fälle von oralen oder perioralen Transformationen zu Karzinomen ist für einige dieser Erkrankungen klein. Auch sind Zungenkarzinome oder Karzinome der Mundhöhle bei Spätsyphilis eher von historischem Interesse, obwohl in den 90er Jahren immer noch auf eine mögliche Assoziation einer positiven Syphilisserologie und dem Auftreten eines Zungenkarzinoms hingewiesen wurde. Der OLP ist eine nach wie vor kontrovers diskutierte präkanzeröse Kondition. Transformationsraten werden zwischen 0 und 5,6% angegeben. Neuere Untersuchungen, v. a. prospektive Studien, weisen darauf hin, dass möglicherweise die orale lichenoide Reaktion (OLR) Ausgangszustand einer Transformation ist und nicht der klassische OLP. Die Differenzierung zwischen OLP und OLR ist sowohl vom klinischen als auch vom histopathologischen Aspekt nach wie vor schwierig. Zweitwichtigste präkanzeröse Kondition ist die OSF, die durch das Kauen von Betel in Süd- und Südostasien bedingt wird. Mit 7,6% liegt für die OSF die höchste Transformationsrate aller präkanzerösen Konditionen vor.相似文献
Ultraviolet (UV) light has been associated with the development of human
non-melanoma skin cancers (NMSC). Such cancers often exhibit mutations in
the p53 tumour suppressor gene. In order to determine the UV-induced p53
mutation spectrum, a yeast expression vector that harbours a human
wild-type p53 cDNA was UV-irradiated in vitro and transfected into a yeast
strain that contained the ADE2 gene regulated by a p53-responsive promoter.
Forty-five mutant clones contained 51 mutations. Seven mutations were
tandem base pair substitutions, four of which being CC-->TT, hallmark
mutations of UV mutagenesis. Eighty percent (41/51) of the mutations were
single or non-tandem base pair substitutions, the majority of which (27/41)
were C-->T transitions. Ninety-five percent of such mutations occurred
at dipyrimidine sites. Through a rigorous statistical test, the UV-induced
p53 mutation spectrum appears to differ significantly (P < 0.008) from
the one induced by the antineoplastic drug
chloroethyl-cyclohexyl-nitrosourea, and to be indistinguishable from the
one observed in NMSC (P = 0.4). These results demonstrate that the assay
allows the determination of carcinogen-specific p53 mutation fingerprints
and represents a new tool for molecular epidemiology.
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The role of cardiac sympathetic nerves in the regulation of myocardial metabolism is not well defined. Owing to the presence of incomplete reinnervation, heart transplant recipients provide a unique model to study the effects of efferent sympathetic innervation. Using this model, we sought to determine the influence of cardiac sympathetic signals on substrate utilisation and overall oxidative metabolism. In 21 transplant recipients, positron emission tomography was applied to determine sympathetic innervation with the noradrenaline analogue carbon11 hydroxyephedrine, oxidative metabolism with carbon11 acetate (n=14), and glucose utilisation with fluorine-18 fluorodeoxyglucose (n=7). The reinnervated area comprised 22% +/- 20% of the left ventricle. Oxidative metabolism was similar in denervated and reinnervated myocardium [0.06 +/- 0.01 vs 0.06 +/- 0.01/min for k(mono)], while glucose uptake was significantly higher in denervated myocardium (6.9 +/- 6.6 vs 6.0 +/- 6.2 micromol/min/100 g; P=0.03). Reinnervation mainly occurred in the territory of the left anterior descending artery, where retention of 11C-hydroxyephedrine (6.8 +/- 2.7%/min) was higher compared with territories of the left circumflex (4.1 +/- 1.7%/min; P<0.01) and right coronary (3.8 +/- 1.1%/min; P<0.01) arteries. Oxidative metabolism was similar in all three territories, but compared with the reinnervated territory of the left anterior descending artery (53% +/- 16% of maximum), relative FDG uptake was higher in territories of the left circumflex (76% +/- 6%, P<0.01) and right coronary (67% +/- 10%, P<0.05) arteries. Similar degrees of regional heterogeneity were not observed in normals. Thus, while overall energy production through oxidative metabolism remains unaffected, cardiac utilisation of glucose in the fasting state is increased in the absence of catecholamine uptake sites. Innervated myocardium, however, may preferentially utilise free fatty acids, suggesting a role for sympathetic tone in substrate utilisation. 相似文献