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Educational Paper Ciliopathies
Eur J Pediatr (2012) 171:1285–1300 DOI 10.1007/s00431-011-1553-z REVIEW Educational paper Ciliopathies Carsten Bergmann Received: 11 June 2011 /Accepted: 3 August 2011 /Published online: 7 September 2011 # The Author(s) 2011. This article is published with open access at Springerlink.com Abstract Cilia are antenna-like organelles found on the (NPHP) . Ivemark syndrome . Meckel syndrome (MKS) . surface of most cells. They transduce molecular signals Joubert syndrome (JBTS) . Bardet–Biedl syndrome (BBS) . and facilitate interactions between cells and their Alstrom syndrome . Short-rib polydactyly syndromes . environment. Ciliary dysfunction has been shown to Jeune syndrome (ATD) . Ellis-van Crefeld syndrome (EVC) . underlie a broad range of overlapping, clinically and Sensenbrenner syndrome . Primary ciliary dyskinesia genetically heterogeneous phenotypes, collectively (Kartagener syndrome) . von Hippel-Lindau (VHL) . termed ciliopathies. Literally, all organs can be affected. Tuberous sclerosis (TSC) . Oligogenic inheritance . Modifier. Frequent cilia-related manifestations are (poly)cystic Mutational load kidney disease, retinal degeneration, situs inversus, cardiac defects, polydactyly, other skeletal abnormalities, and defects of the central and peripheral nervous Introduction system, occurring either isolated or as part of syn- dromes. Characterization of ciliopathies and the decisive Defective cellular organelles such as mitochondria, perox- role of primary cilia in signal transduction and cell isomes, and lysosomes are well-known -
Glossary for Narrative Writing
Periodontal Assessment and Treatment Planning Gingival description Color: o pink o erythematous o cyanotic o racial pigmentation o metallic pigmentation o uniformity Contour: o recession o clefts o enlarged papillae o cratered papillae o blunted papillae o highly rolled o bulbous o knife-edged o scalloped o stippled Consistency: o firm o edematous o hyperplastic o fibrotic Band of gingiva: o amount o quality o location o treatability Bleeding tendency: o sulcus base, lining o gingival margins Suppuration Sinus tract formation Pocket depths Pseudopockets Frena Pain Other pathology Dental Description Defective restorations: o overhangs o open contacts o poor contours Fractured cusps 1 ww.links2success.biz [email protected] 914-303-6464 Caries Deposits: o Type . plaque . calculus . stain . matera alba o Location . supragingival . subgingival o Severity . mild . moderate . severe Wear facets Percussion sensitivity Tooth vitality Attrition, erosion, abrasion Occlusal plane level Occlusion findings Furcations Mobility Fremitus Radiographic findings Film dates Crown:root ratio Amount of bone loss o horizontal; vertical o localized; generalized Root length and shape Overhangs Bulbous crowns Fenestrations Dehiscences Tooth resorption Retained root tips Impacted teeth Root proximities Tilted teeth Radiolucencies/opacities Etiologic factors Local: o plaque o calculus o overhangs 2 ww.links2success.biz [email protected] 914-303-6464 o orthodontic apparatus o open margins o open contacts o improper -
Clinical Classification of Caroli's Disease: an Analysis of 30 Patients
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector DOI:10.1111/hpb.12330 HPB ORIGINAL ARTICLE Clinical classification of Caroli's disease: an analysis of 30 patients Zhong-Xia Wang1,2*, Yong-Gang Li2*, Rui-Lin Wang2, Yong-Wu Li3, Zhi-Yan Li3, Li-Fu Wang2, Hui-Ying Yang2, Yun Zhu2, Yao Wang2, Yun-Feng Bai2, Ting-Ting He2, Xiao-Feng Zhang2 & Xiao-He Xiao1,2 1Department of Graduate School, 301 Hospital, 2Integrative Medical Centre, and 3Imaging Centre, 302 Hospital, Beijing, China Abstract Background: Caroli's disease (CD) is a rare congenital disorder. The early diagnosis of the disease and differentiation of types I and II are of extreme importance to patient survival. This study was designed to review and discuss observations in 30 patients with CD and to clarify the clinical characteristics of the disease. Methods: The demographic and clinical features, laboratory indicators, imaging findings and pathology results for 30 patients with CD were reviewed retrospectively. Results: Caroli's disease can occur at any age. The average age of onset in the study cohort was 24 years. Patients who presented with symptoms before the age of 40 years were more likely to develop type II CD. Approximately one-third of patients presented without positive signs at original diagnosis and most of these patients were found to have type I CD on pathology. Anaemia, leucopoenia and thrombocytopoenia were more frequent in patients with type II than type I CD. Magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT) examinations were most useful in diagnosing CD. -
Biliary Tract
2016-06-16 The role of cytology in management of diseases of hepatobiliary ducts • Diagnosis in patients with radiologically/clinically detected lesions • Screening of dysplasia/CIS/cancer in risk groups biliary tract cytology • Preoperative evaluation of the candidates for liver transplantation (Patients with cytological low-grade and high-grade Mehmet Akif Demir, MD dysplasia/adenocarcinoma are currently referred for liver transplantation Sahlgrenska University Hospital in some institutions). Gothenburg Sweden Sarajevo 18th June 2016 • Diagnosis of the benign lesions and infestations False positive findings • majority of false positive cases have a Low sensitivity but high specificity! background of primary sclerosing cholangitis. – lymphoplasmacytic sclerosing pancreatitis and cholangitis, – primary sclerosing cholangitis, – granulomatous disease, – non-specific fibrosis/inflammation – stone disease. False negative findings • Repeat brushing increases the diagnostic yield and should be performed when sampling • Poor sampling biliary strictures with a cytology brush at ERCP. • Lack of diagnostic criteria for dysplasia-carcinoma in situ • Difficulties in recognition of special tumour types – well-differentiated cholangiocarcinoma with tubular architecture • Predictors of positive yield include – gastric foveolar type cholangiocarcinoma with mucin-producing – tumour cells. older age, •Underestimating the significance of the smear background – mass size >1 cm, and – stricture length of >1 cm. •The causes of false negative cytology –sampling -
Diseases of Salivary Glands: Review
ISSN: 1812–1217 Diseases of Salivary Glands: Review Alhan D Al-Moula Department of Dental Basic Science BDS, MSc (Assist Lect) College of Dentistry, University of Mosul اخلﻻضة امخجوًف امفموي تُئة رطبة، حتخوي ػىل طبلة ركِلة من امسائل ثدغى انوؼاب ثغطي امسطوح ادلاخوَة و متﻷ امفراغات تني ااطَة امفموًة و اﻷس نان. انوؼاب سائل مؼلد، ًنذج من امغدد انوؼاتَة، اذلي ًوؼة دورا" ىاما" يف اﶈافظة ػىل سﻻمة امفم. املرىض اذلٍن ؼًاهون من هلص يف اﻷفراز انوؼايب حكون دلهيم مشبلك يف اﻷلك، امخحدث، و امبوع و ًطبحون غرضة مﻷههتاابت يف اﻷغش َة ااطَة و امنخر املندرش يف اﻷس نان. ًوخد ثﻻثة أزواج من امغدد انوؼاتَة ام ئرُسة – امغدة امنكفِة، امغدة حتت امفكِة، و حتت انوساهَة، موضؼيا ٍكون خارج امخجوًف امفموي، يف حمفظة و ميخد هظاهما املنَوي مَفرغ افرازاهتا. وًوخد أًضا" امؼدًد من امغدد انوؼاتَة امطغرية ، انوساهَة، اتحنكِة، ادلىوزيًة، انوساهَة احلنكِة وما كبل امرخوًة، ٍكون موضؼيا مﻷسفل و مضن امغشاء ااطي، غري حماطة مبحفظة مع هجاز كنَوي كطري. افرازات امغدد انوؼاتَة ام ئرُسة مُست مدشاهبة. امغدة امفكِة ثفرز مؼاب مطيل غين ابﻷمِﻻز، وامغدة حتت امفكِة ثنذج مؼاب غين اباط، أما امغدة حتت انوساهَة ثنذج مؼااب" مزخا". ثبؼا" ميذه اﻷخذﻻفات، انوؼاب املوحود يق امفم ٌشار امَو مكزجي. ح كرَة املزجي انوؼايب مُس ثس َطا" واملادة اﻷضافِة اموػة من لك املفرزات انوؼاتَة، اكمؼدًد من امربوثُنات ثنذلل ثرسػة وثوخطق هبدروكس َل اﻷتُذاًت مﻷس نان و سطوح ااطَة امفموًة. ثبدأ أمراض امغدد انوؼاتَة ػادة تخغريات اندرة يف املفرزات و ام كرتَة، وىذه امخغريات ثؤثر اثهواي" من خﻻل جشلك انووحية اجلرثومِة و املوح، اميت تدورىا ثؤدي اىل خنور مذفش َة وأمراض وس َج دامعة. ىذه اﻷمراض ميكن أن ثطبح شدًدة تؼد املؼاجلة امشؼاغَة ﻷن امؼدًد من احلاﻻت اجليازًة )مثل امسكري، امخوَف اهكُيس( ثؤثر يف اجلراين انوؼايب، و ٌش خيك املرض من حفاف يف امفم. -
Unraveling the Genetics of Joubert and Meckel-Gruber Syndromes
Journal of Pediatric Genetics 3 (2014) 65–78 65 DOI 10.3233/PGE-14090 IOS Press Unraveling the genetics of Joubert and Meckel-Gruber syndromes Katarzyna Szymanska, Verity L. Hartill and Colin A. Johnson∗ Department of Ophthalmology and Neuroscience, University of Leeds, Leeds, UK Received 27 May 2014 Revised 11 July 2014 Accepted 14 July 2014 Abstract. Joubert syndrome (JBTS) and Meckel-Gruber syndrome (MKS) are recessive neurodevelopmental conditions caused by mutations in proteins that are structural or functional components of the primary cilium. In this review, we provide an overview of their clinical diagnosis, management and molecular genetics. Both have variable phenotypes, extreme genetic heterogeneity, and display allelism both with each other and other ciliopathies. Recent advances in genetic technology have significantly improved diagnosis and clinical management of ciliopathy patients, with the delineation of some general genotype-phenotype correlations. We highlight those that are most relevant for clinical practice, including the correlation between TMEM67 mutations and the JBTS variant phenotype of COACH syndrome. The subcellular localization of the known MKS and JBTS proteins is now well-described, and we discuss some of the contemporary ideas about ciliopathy disease pathogenesis. Most JBTS and MKS proteins localize to a discrete ciliary compartment called the transition zone, and act as structural components of the so-called “ciliary gate” to regulate the ciliary trafficking of cargo proteins or lipids. Cargo proteins include enzymes and transmembrane proteins that mediate intracellular signaling. The disruption of transition zone function may contribute to the ciliopathy phenotype by altering the composition of the ciliary membrane or axoneme, with impacts on essential developmental signaling including the Wnt and Shh pathways as well as the regulation of secondary messengers such as inositol-1,4,5-trisphosphate (InsP3) and cyclic adenosine monophosphate (cAMP). -
Germline and Mosaic Mutations Causing Pituitary Tumours: Genetic and Molecular Aspects
240 2 Journal of S Pepe et al. Germline and mosaic 240:2 R21–R45 Endocrinology mutations in pituitary tumours REVIEW Germline and mosaic mutations causing pituitary tumours: genetic and molecular aspects Sara Pepe1,2, Márta Korbonits1 and Donato Iacovazzo1 1Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London, UK 2Department of Medical Biotechnologies, University of Siena, Siena, Italy Correspondence should be addressed to M Korbonits: [email protected] Abstract While 95% of pituitary adenomas arise sporadically without a known inheritable Key Words predisposing mutation, in about 5% of the cases they can arise in a familial setting, either f genetics isolated (familial isolated pituitary adenoma or FIPA) or as part of a syndrome. FIPA is f pituitary caused, in 15–30% of all kindreds, by inactivating mutations in the AIP gene, encoding f pituitary adenoma a co-chaperone with a vast array of interacting partners and causing most commonly f mutation growth hormone excess. While the mechanisms linking AIP with pituitary tumorigenesis have not been fully understood, they are likely to involve several pathways, including the cAMP-dependent protein kinase A pathway via defective G inhibitory protein signalling or altered interaction with phosphodiesterases. The cAMP pathway is also affected by other conditions predisposing to pituitary tumours, including X-linked acrogigantism caused by duplications of the GPR101 gene, encoding an orphan G stimulatory protein- coupled receptor. Activating mosaic mutations in the GNAS gene, coding for the Gα stimulatory protein, cause McCune–Albright syndrome, while inactivating mutations in the regulatory type 1α subunit of protein kinase A represent the most frequent genetic cause of Carney complex, a syndromic condition with multi-organ manifestations also involving the pituitary gland. -
Germinoma of the Pineal Its Identity with Gcrminoma ( Scminoma") of the Testis
Germinoma of the Pineal Its Identity with Gcrminoma ( Scminoma") of the Testis Major Nathan B. Friedman, MC, AUS (From the Army Institute ot Pathology, \X/ashillgto~L D. C.) (Received for publication December 10, 1946) In 1944 Dorothy Russell (15) published the re- gcrminonmtous elements. Only 2 tulnors in this suits of a study of pineal tumors. She presented a group of 8 appeared to bc of neural origin; one, rational explanation for the well known similarity which had the pattern of a classic pinealoma, was in histologic appearance of "pinealomas" and "semi- TABLE l: DATA IN T\VENTY-THREt CASES OF PlNEAL nomas." She suggested that in'any "pincalomas" NEOPI.ASM ucre in truth teratoid tumors. The present report Case Age, Type of proposes to confirln h er.~obscrvations and to extend No. Sex years npoplasm s features her interpretations in accord with the teratologic CRovP 1 concepts gained through study of nearly 1,000 tu- 1 M 29 Neural mors of the testis at the Army Institute of Patho- 2 XI 22 Germinoma Extrapineal. Pitui- logy (6). tary involved. Dia- The files of the Institute contain pathologic ma- betes insipidus. Hypogonadism. terial from 23 patients with tumors of the pineal or ectopic "pinealomas." Fifteen tumors were submit- 3 1~i 17 Neural ted by military installations ~ (Group 1), and 8 were 4 1~I 18 Germinoma Pituitary involved. obtained from civilian sources e (Group 2). The Diabetes insipidus. _~I 21 essential data in all 23 cases arc listed in Table I. Puhnonary metas- tases. Radiosensi- Seven of the 15 tumors in group 1 were identical tMty. -
Pearls and Forget-Me-Nots in the Management of Retinoblastoma
POSTERIOR SEGMENT ONCOLOGY FEATURE STORY Pearls and Forget-Me-Nots in the Management of Retinoblastoma Retinoblastoma represents approximately 4% of all pediatric malignancies and is the most common intraocular malignancy in children. BY CAROL L. SHIELDS, MD he management of retinoblastoma has gradu- ular malignancy in children.1-3 It is estimated that 250 to ally evolved over the years from enucleation to 300 new cases of retinoblastoma are diagnosed in the radiotherapy to current techniques of United States each year, and 5,000 cases are found world- chemotherapy. Eyes with massive retinoblas- Ttoma filling the globe are still managed with enucleation, TABLE 1. INTERNATIONAL CLASSIFICATION OF whereas those with small, medium, or even large tumors RETINOBLASTOMA (ICRB) can be managed with chemoreduction followed by Group Quick Reference Specific Features tumor consolidation with thermotherapy or cryotherapy. A Small tumor Rb <3 mm* Despite multiple or large tumors, visual acuity can reach B Larger tumor Rb >3 mm* or ≥20/40 in many cases, particularly in eyes with extrafoveal retinopathy, and facial deformities that have Macula Macular Rb location been found following external beam radiotherapy are not (<3 mm to foveola) anticipated following chemoreduction. Recurrence from Juxtapapillary Juxtapapillary Rb location subretinal and vitreous seeds can be problematic. Long- (<1.5 mm to disc) term follow-up for second cancers is advised. Subretinal fluid Rb with subretinal fluid Most of us can only remember a few interesting points C Focal seeds Rb with: from a lecture, even if was delivered by an outstanding, Subretinal seeds <3 mm from Rb colorful speaker. Likewise, we generally retain only a small and/or percentage of the information that we read, even if writ- Vitreous seeds <3 mm ten by the most descriptive or lucent author. -
Practice Parameter for the Diagnosis and Management of Primary Immunodeficiency
Practice parameter Practice parameter for the diagnosis and management of primary immunodeficiency Francisco A. Bonilla, MD, PhD, David A. Khan, MD, Zuhair K. Ballas, MD, Javier Chinen, MD, PhD, Michael M. Frank, MD, Joyce T. Hsu, MD, Michael Keller, MD, Lisa J. Kobrynski, MD, Hirsh D. Komarow, MD, Bruce Mazer, MD, Robert P. Nelson, Jr, MD, Jordan S. Orange, MD, PhD, John M. Routes, MD, William T. Shearer, MD, PhD, Ricardo U. Sorensen, MD, James W. Verbsky, MD, PhD, David I. Bernstein, MD, Joann Blessing-Moore, MD, David Lang, MD, Richard A. Nicklas, MD, John Oppenheimer, MD, Jay M. Portnoy, MD, Christopher R. Randolph, MD, Diane Schuller, MD, Sheldon L. Spector, MD, Stephen Tilles, MD, Dana Wallace, MD Chief Editor: Francisco A. Bonilla, MD, PhD Co-Editor: David A. Khan, MD Members of the Joint Task Force on Practice Parameters: David I. Bernstein, MD, Joann Blessing-Moore, MD, David Khan, MD, David Lang, MD, Richard A. Nicklas, MD, John Oppenheimer, MD, Jay M. Portnoy, MD, Christopher R. Randolph, MD, Diane Schuller, MD, Sheldon L. Spector, MD, Stephen Tilles, MD, Dana Wallace, MD Primary Immunodeficiency Workgroup: Chairman: Francisco A. Bonilla, MD, PhD Members: Zuhair K. Ballas, MD, Javier Chinen, MD, PhD, Michael M. Frank, MD, Joyce T. Hsu, MD, Michael Keller, MD, Lisa J. Kobrynski, MD, Hirsh D. Komarow, MD, Bruce Mazer, MD, Robert P. Nelson, Jr, MD, Jordan S. Orange, MD, PhD, John M. Routes, MD, William T. Shearer, MD, PhD, Ricardo U. Sorensen, MD, James W. Verbsky, MD, PhD GlaxoSmithKline, Merck, and Aerocrine; has received payment for lectures from Genentech/ These parameters were developed by the Joint Task Force on Practice Parameters, representing Novartis, GlaxoSmithKline, and Merck; and has received research support from Genentech/ the American Academy of Allergy, Asthma & Immunology; the American College of Novartis and Merck. -
Classification of Salivary Gland Disorders
Salivary Gland Diseases and Disorders Dr. Mahmoud E. Khalifa Prof of OMFS Lecture ILOs At the end of this chapter you should be able to: 1. Distinguish the clinical features of infections of the salivary glands from those in other structures 2. Differentiate on clinical grounds between infection, obstruction, benign and malignant neoplasms of the salivary glands 3. Plan and evaluate the results of the investigation of disorders of the salivary glands 4. List the important/relevant information to be elicited from patients with salivary gland disorders 5. Select cases which require referral for a specialist opinion 6. Describe the causes of a dry mouth and be able to distinguish between organic and functional causes. Anatomy Major glands Minor glands 3 pairs Situated mostly 800 to 1000 in the oral cavity Parotid Submandibular The majority atAlso found in the the junction of pharynx, larynx, the hard and soft trachea, and palates sinuses sublingual Functions These glands function to produce saliva, which serves as Lubricant for speech & swallowing Assists taste Immunologic (antibacterial) Digestive Cleansing properties Based on the type of secretion, the salivary glands may be grouped as: (i) Serous, (ii) Mucous and (iii) Mixed. Parotid gland secretion is serous in nature. The sublingual gland secretes mixed, but predominantly mucous. The submandibular gland secretion is also mixed, but is predominantly serous. The minor glands secrete mucous saliva. Parotid Gland The parotid gland is the largest salivary gland, the secretion of which is serous in nature. It is pyramidal in shape; The base located superficial and apex medially The base is triangular in shape its apex is towards the angle of the mandible, the base at the external acoustic meatus The parotid duct (Stenson‘s duct) Emerges at the anterior part of the gland. -
Evolving Concepts in Human Renal Dysplasia
DISEASE OF THE MONTH J Am Soc Nephrol 15: 998–1007, 2004 EBERHARD RITZ, FEATURE EDITOR Evolving Concepts in Human Renal Dysplasia ADRIAN S. WOOLF, KAREN L. PRICE, PETER J. SCAMBLER, and PAUL J.D. WINYARD Nephro-Urology and Molecular Medicine Units, Institute of Child Health, University College London, London, United Kingdom Abstract. Human renal dysplasia is a collection of disorders in correlating with perturbed cell turnover and maturation. Mu- which kidneys begin to form but then fail to differentiate into tations of nephrogenesis genes have been defined in multiorgan normal nephrons and collecting ducts. Dysplasia is the princi- dysmorphic disorders in which renal dysplasia can feature, pal cause of childhood end-stage renal failure. Two main including Fraser, renal cysts and diabetes, and Kallmann syn- theories have been considered in its pathogenesis: A primary dromes. Here, it is possible to begin to understand the normal failure of ureteric bud activity and a disruption produced by nephrogenic function of the wild-type proteins and understand fetal urinary flow impairment. Recent studies have docu- how mutations might cause aberrant organogenesis. mented deregulation of gene expression in human dysplasia, Congenital anomalies of the kidney and urinary tract and the main renal pathology is renal dysplasia (RD). In her (CAKUT) account for one third of all anomalies detected by landmark book Normal and Abnormal Development of the routine fetal ultrasonography (1). A recent UK audit of child- Kidney published in 1972 (7), Edith Potter emphasized that one hood end-stage renal failure reported that CAKUT was the must understand normal development to generate realistic hy- cause in ~40% of 882 individuals (2).