Genetic diagnoses and associated anomalies in fetuses prenatally diagnosed with esophageal atresia

Esophageal atresia (EA) is a congenital anomaly occurring in 2.3 per 10,000 live births. Due to advances in prenatal imaging, EA is more readily diagnosed, but data on the associated genetic diagnoses, other anomalies, and postnatal outcome for fetuses diagnosed prenatally with EA are scarce. We collected data from two academic medical centers (n = 61). Our data included fetuses with suspected EA on prenatal imaging that was confirmed postnatally and had at least one genetic test. In our cohort of 61 cases, 29 (49%) were born prematurely and 19% of those born alive died in the first 9 years of life. The most commonly associated birth defects were cardiac anomalies (67%) and spine anomalies (50%). A diagnosis was made in 61% of the cases; the most common diagnoses were vertebral defects, anal atresia, cardiac anomalies, tracheoesophageal fistula with esophageal atresia, radial or renal dysplasia, and limb anomalies association (43%, although 12% met only 2 of the criteria), trisomy 21 (5%), and CHARGE syndrome (5%). Our findings suggest that most fetuses with prenatally diagnosed EA have one or more additional major anomaly that warrants a more comprehensive clinical genetics evaluation. Fetuses diagnosed prenatally appear to represent a cohort with a worse outcome.     

Human growth hormone 1 (GH1) gene expression: complex haplotype-dependent influence of polymorphic variation in the proximal promoter and locus control region

The proximal promoter region of the human pituitary expressed growth hormone (GH1) gene is highly polymorphic, containing at least 15 single nucleotide polymorphisms (SNPs). This variation is manifest in 40 different haplotypes, the high diversity being explicable in terms of gene conversion, recurrent mutation, and selection. Functional analysis showed that 12 haplotypes were associated with a significantly reduced level of reporter gene expression whereas 10 haplotypes were associated with a significantly increased level. The former tend to be more prevalent in the general population than the latter (p<0.01), possibly as a consequence of selection. Although individual SNPs contributed to promoter strength in a highly interactive and non-additive fashion, haplotype partitioning was successful in identifying six SNPs as major determinants of GH1 gene expression. The prediction and functional testing of hitherto unobserved super-maximal and sub-minimal promoter haplotypes was then used to test the efficacy of the haplotype partitioning approach. Electrophoretic mobility shift assays demonstrated that five SNP sites exhibit allele-specific protein binding. An association was noted between adult height and the mean in vitro expression value corresponding to an individual's GH1 promoter haplotype combination (p=0.028) although only 3.3% of the variance of adult height was found to be explicable by reference to this parameter. Three additional SNPs, identified within sites I and II of the upstream locus control region (LCR), were ascribed to three distinct LCR haplotypes. A series of LCR-GH1 proximal promoter constructs were used to demonstrate that 1) the LCR enhanced proximal promoter activity by up to 2.8-fold depending upon proximal promoter haplotype, and that 2) the activity of a given proximal promoter haplotype was also differentially enhanced by different LCR haplotypes. The genetic basis of inter-individual differences in GH1 gene expression thus appears to be extremely complex.     

用分子克隆技术构建D12S391基因座等位基因分型标准物及群体遗传学研究

目的 解决长期困扰短串联重复序列（short tandem repeat,STR）分型上存在的准确性和标准化问题。方法 先用PCR扩增出D12S391基因座的9个等位基因片段，将其插入pUC重组质粒中，经DNA测序分析证实插入片段的结构及大小，用国际标准将插入的等位基因片段进行命名，最后经转染、扩大培养、扩增及再鉴定后，制备出标准的D12S391等位基因分型标准物。结果 应用此法制备出大量的D12S391基因座等位基因分型标准物，并将其用于调查该基因座在德国Mainz地区、日本Miyazaki地区及中国成都汉族、北京汉族、新疆维吾尔族和甘肃回族6个群体中的基因型分布频率。D12S391基因座在各群体中均有较高的多态性，其非父排除概念及个人识别能力分别为0.609-0.786和0.940-0.952。结论 该法制备的STR基因座等位基因分型标准物在法医科学实践中应用价值极高，D12S391基因座是一个非常适合于群体遗传学研究和法医科学应用的遗传标记。     

下颌第一前磨牙根管系统和根尖孔解剖及临床意义

采用牙髓透明法对 347颗下颌第一前磨牙根管系统的数目和形态进行观察。下颌第一前磨牙根管可分为Ⅰ、Ⅱ、Ⅲ、Ⅳ型。其中Ⅰ型 (单根单管型 )占 83 86 % ,Ⅱ型 (单根双管型 )占 4 6 1% ,Ⅲ型 (单双管混合型 )占 11 2 4 % ,Ⅳ型 (双根双管型 )占 0 2 9%。应用XTT— 3A连续变倍体视显微镜对 347颗下颌第一前磨牙的根管系统形态进行观察 ,根尖分歧出现率 15 6 3% ,根尖分叉出现率 2 4 3% ,根管侧支出现率 1 0 8%。并对 347颗下颌第一前磨牙的根尖孔与根尖顶的位置关系进行观察 ,根尖孔位于根尖顶者占 88 14 % ,位于旁侧者占 11 86 %。并就上述内容的临床意义进行了讨论。     

鸡后根神经节多巴胺细胞在体及体外培养中的免疫细胞化学观察

应用免疫细胞化学PAP法,研究了鸡胚和雏鸡后根神经节细胞内多巴胺递质的表现与胚胎发育过程中的变化,并在细胞培养条件下研究了周围靶组织——皮肤对后根节细胞胚胎发育的影响。鸡后根节细胞内多巴胺的免疫反应最先出现于E_(10),只占后根节细胞的0.8%,E_(18)时达5.6%,出壳后雏鸡为8.6%。在鸡后根节内,多巴胺免疫反应阳性细胞主要为较大的A类细胞,和极少较小的B类细胞。免疫反应阳性的周围神经末梢位于皮肤和交感干内。当取自E_9的鸡胚后根节细胞经7天培养后,部分神经细胞出现多巴胺免疫反应阳性;而取自E_6的鸡胚后根节细胞虽经10天培养后仍为免疫反应阴性;然而,将取自E_6后根节细胞与皮肤组织联合培养10天后,少量神经细胞及轴突出现多巴胺免疫阳性反应。作者认为:鸡后根节多巴胺细胞在胚胎时期的发育有赖于周围靶组织的作用。     

Skeletal manifestations in Fryns syndrome

We report on a female baby with Fryns syndrome who died soon after birth. The patient had short limbs, coarse face, hypoplastic lungs, diaphragmatic hernia, and acral hypoplasia. Literature review disclosed varying degrees of skeletal manifestations in Fryns syndrome; short limbs may be a component of Fryns syndrome. © 1995 Wiley-Liss, Inc.     

Oligodontia, short stature and small head circumference with normal intelligence

Complete absence of third molars and mandibular permanent second molars is reported in a 19-year-old female, with occipito-frontal head circumference and height at the 3rd centile. The patient's intelligence, appearance and physical examination were normal. Direct count of the patient's sweat pores in different areas of the palms and digits was normal. Microcephaly, short stature and normal intelligence have been reported in two families as a distinct autosomal dominant syndrome. To the best of our knowledge, oligodontia, in addition to these findings, has not been previously reported.     

非悬滴开放式培养法在鸡胚背根节体外培养中的应用

本研究针对悬滴培养法在操作和应用上存在的问题和局限性，改用操作简便、适用范围广的非悬滴开放式培养法培养鸡胚背根节。将数个鸡胚背根节按一定间隔种植在内置生长基质盖玻片的35mm培养皿中，加人适量培养液，置于CO2。孵箱中进行培养。结果显示.从培养24h至60h各时期，培养皿中背根节生长状况均良好，神经突起明显增长，表明用非悬滴开放式培养法培养鸡胚背根节是可行且可靠的。     

骶骨骨折的动态冲击试验研究

目的:探讨骶骨在冲击载荷作用下发生骨折的机理。方法:采集人体新鲜骨盆标本10具,分别行动态冲击试验和静态破坏试验,测量动态骨折时的一系列动力学参数,确定骨折的动力学特性。结果:⑴骶骨受垂直冲击时按应力波的传递方向发生骨折,其动力学性质呈粘弹性,应力波呈周期性衰减,得到了骶骨的载荷响应曲线与应变响应曲线;骶骨骨折的平均冲击载荷为(9366±514) N,冲击时间为(2.78±1.02) s,动荷系数为1.21。⑵骶骨的动态破坏机制与静态破坏机制有很大的不同,不但极限载荷不同,而且前者随应变速率的提高而快速增加,冲击能量在25 J以上时呈脆性劈裂状通过骶孔或骶髂关节骨折,并累及神经根损伤,而静态大多为骶髂关节骨折。结论:骶骨骨折大都在高速冲击下发生,与其动力学特性、力的传导以及动载荷响应等诸多因素相关。     

Comparison of couples referred and not referred for genetic counseling in a genetic clinic after the birth of a child with a congenital anomaly: A study in a population in the northeastern Netherlands

After the birth of a child with a congenital anomaly, parents have many questions about cause, prognosis, and recurrence risk. An important means of transmitting such information is referral to a genetic clinic. We were interested in knowing what determines whether or not parents are referred for genetic counseling. Data from the local registration of congenital anomalies in the northeastern Netherlands (birth years 1981–1986; 1,217 children/fetuses) and data of the local genetic clinic were compared. The parents of 204 cases (16.8%) had been referred for genetic counseling. Of the couples referred, 76% were referred within one year after birth, usually by a pediatrician (48%). Parents of children with a single anomaly, recognized syndrome, or multiple anomalies not recognized as a syndrome were referred in 5%, 43%, and 26% of cases, respectively. Parents of liveborn children who died were referred in 38% of cases, parents of liveborn/still-alive and stillborn children in 13% and 22%, respectively. Previous affected sibs and absence of previous livebirths increased the likelihood of referral.