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3 Embryology and Development
BIOL 6505 − INTRODUCTION TO FETAL MEDICINE 3. EMBRYOLOGY AND DEVELOPMENT Arlet G. Kurkchubasche, M.D. INTRODUCTION Embryology – the field of study that pertains to the developing organism/human Basic embryology –usually taught in the chronologic sequence of events. These events are the basis for understanding the congenital anomalies that we encounter in the fetus, and help explain the relationships to other organ system concerns. Below is a synopsis of some of the critical steps in embryogenesis from the anatomic rather than molecular basis. These concepts will be more intuitive and evident in conjunction with diagrams and animated sequences. This text is a synopsis of material provided in Langman’s Medical Embryology, 9th ed. First week – ovulation to fertilization to implantation Fertilization restores 1) the diploid number of chromosomes, 2) determines the chromosomal sex and 3) initiates cleavage. Cleavage of the fertilized ovum results in mitotic divisions generating blastomeres that form a 16-cell morula. The dense morula develops a central cavity and now forms the blastocyst, which restructures into 2 components. The inner cell mass forms the embryoblast and outer cell mass the trophoblast. Consequences for fetal management: Variances in cleavage, i.e. splitting of the zygote at various stages/locations - leads to monozygotic twinning with various relationships of the fetal membranes. Cleavage at later weeks will lead to conjoined twinning. Second week: the week of twos – marked by bilaminar germ disc formation. Commences with blastocyst partially embedded in endometrial stroma Trophoblast forms – 1) cytotrophoblast – mitotic cells that coalesce to form 2) syncytiotrophoblast – erodes into maternal tissues, forms lacunae which are critical to development of the uteroplacental circulation. -
VATER/VACTERL Association in Palestinian Children: a Case Report
www.symbiosisonline.org Symbiosis www.symbiosisonlinepublishing.com Research Article International Journal of Pediatrics & Child Care Open Access VATER/VACTERL Association in Palestinian Children: A Case Report Basal A Ahmed1, Elessi Khamis2* 1Specialist and Head of Pediatrics, Shaheed Mohammed Al - Durra Hospital 2Assistant Professor, Faculty of medicine, Islamic university- Gaza Received:December 13, 2017; Accepted: February 3, 2018; Published: February 6, 2018 *Corresponding author: Elessi Khamis, MD Pediatrics, Assistant Professor, Faculty of medicine, Islamic university- Gaza, E-mail: khamis_essi@yahoo. com have reported a prevalence among infants of one in 10 000 to one Abstract of at least three of the following congenital malformations: vertebral however,in 40 000 live-bornchromosomal infants abnormalities (approximately have <1-9/100,000 also been described infants) VACTERL/VATER association is typically defined by the presence [2]. Most of the cases of VACTERL association occur sporadically; defects, anal atresia, cardiac defects, tracheo-esophageal fistula, stress and usage of oral contraceptives at the initial stages of by evidence linking all of the human disease genes for the VATER/ in a few cases [3]. Maternal diabetes, teratogenic drugs, physical renal anomalies, and limb abnormalities. This finding is supported pregnancy have been suggested as possible causes [4]. VACTERL is believed to result from an early embryonic insult, more VACTERL association identified to date, namely, FGF8, FOXF1, HOXD13, LPP, TRAP1, and ZIC3, with renal malformations. VATER association was first described in 1972 by Quan and Smith. We present here a specifically of blastogenic origin occurring during the first 4 75 days male boy with cardiac (VSD, PDA), esophageal atresia, anal weeks of embryogenesis, so the expected effects are primary, abnormalities (sacral dimple), and genitourinary (hypospadias and polytopic,This early developmental embryonic field event defects can [5]lead (Figure to different 1). -
FROGLOG Newsletter of the Declining Amphibian Populations Task Force
Salamandra salamandra by Franco Andreone ISSN 1026-0269 FROGLOG Newsletter of the Declining Amphibian Populations Task Force August 2004, Number 64. Meteyer et al. (2000) and Ouellet very low number of abnormalities. We (2000). only found one L. kuhlii, which may We examined a total of 4,331 have strayed from a nearby stream. frogs of 23 species and found 20 A third of abnormalities were types of deformities in 9 species of due to trauma; these included digit frogs. We divided deformities into two amputations (16% of all general types: developmental abnormalities), limb amputations (2%), abnormalities and trauma (injuries). fractured limbs (7%) and skin wounds Morphological Abnormalities in We distinguished trauma (4%). The most common Frogs of West Java, Indonesia abnormalities based on the developmental abnormalities were appearance of old scars or, if they digital (43%) and, of these, By Mirza D. Kusrini, Ross A. Alford, involved digits, the occurrence of brachydactyly (16.3%), syndactyly Anisa Fitri, Dede M. Nasir, Sumantri digital re-growth. Developmental (14.6%) and ectrodactyly (11.4%) Rahardyansah abnormalities occurred in limbs were the three most common. In recent decades, amphibian (amelia, micromelia, brachymelia, The oldest specimen of F. deformities have generated public hemimelia, ectromelia, taumelia, cuta- limnocharis stored in the MZB that interest as high incidences have been neous fusions), digits (ectrodactyly, exhibited abnormalities was a juvenile found in several locations, notably in brachydactyly, syndactyly, polydactyly, frog captured on 16 November 1921 North America (Helgen et al., 1998; clinodactyly), the back-bone (scoli- from Bogor without one leg (amelia) Ouellet, 2000). The only report on the osis), the eyes (anophthalmy) and the (ID057.10). -
Type II Familial Synpolydactyly: Report on Two Families with an Emphasis on Variations of Expression
European Journal of Human Genetics (2011) 19, 112–114 & 2011 Macmillan Publishers Limited All rights reserved 1018-4813/11 www.nature.com/ejhg SHORT REPORT Type II familial synpolydactyly: report on two families with an emphasis on variations of expression Mohammad M Al-Qattan*,1 Type II familial synpolydactyly is rare and is known to have variable expression. However, no previous papers have attempted to review these variations. The aim of this paper was to review these variations and show several of these variable expressions in two families. The classic features of type II familial synpolydactyly are bilateral synpolydactyly of the third web spaces of the hands and bilateral synpolydactyly of the fourth web spaces of the feet. Several members of the two families reported in this paper showed the following variations: the third web spaces of the hands showing syndactyly without the polydactyly, normal feet, concurrent polydactyly of the little finger, concurrent clinodactyly of the little finger and the ‘homozygous’ phenotype. It was concluded that variable expressions of type II familial synpolydactyly are common and awareness of such variations is important to clinicians. European Journal of Human Genetics (2011) 19, 112–114; doi:10.1038/ejhg.2010.127; published online 18 August 2010 Keywords: type II familial syndactyly; inherited synpolydactyly; variations of expression INTRODUCTION CASE REPORTS Type II familial synpolydactyly is rare and it has been reported in o30 The first family families.1–12 It is characterized by bilateral synpolydactyly of the third The family had a history of synpolydactyly type II for several web spaces of the hands and bilateral synpolydactyly of the fourth web generations on the mother’s side (Table 1). -
The Genetic Basis for Skeletal Diseases
insight review articles The genetic basis for skeletal diseases Elazar Zelzer & Bjorn R. Olsen Harvard Medical School, Department of Cell Biology, 240 Longwood Avenue, Boston, Massachusetts 02115, USA (e-mail: [email protected]) We walk, run, work and play, paying little attention to our bones, their joints and their muscle connections, because the system works. Evolution has refined robust genetic mechanisms for skeletal development and growth that are able to direct the formation of a complex, yet wonderfully adaptable organ system. How is it done? Recent studies of rare genetic diseases have identified many of the critical transcription factors and signalling pathways specifying the normal development of bones, confirming the wisdom of William Harvey when he said: “nature is nowhere accustomed more openly to display her secret mysteries than in cases where she shows traces of her workings apart from the beaten path”. enetic studies of diseases that affect skeletal differentiation to cartilage cells (chondrocytes) or bone cells development and growth are providing (osteoblasts) within the condensations. Subsequent growth invaluable insights into the roles not only of during the organogenesis phase generates cartilage models individual genes, but also of entire (anlagen) of future bones (as in limb bones) or membranous developmental pathways. Different mutations bones (as in the cranial vault) (Fig. 1). The cartilage anlagen Gin the same gene may result in a range of abnormalities, are replaced by bone and marrow in a process called endo- and disease ‘families’ are frequently caused by mutations in chondral ossification. Finally, a process of growth and components of the same pathway. -
Gastrulation
Embryology of the spine and spinal cord Andrea Rossi, MD Neuroradiology Unit Istituto Giannina Gaslini Hospital Genoa, Italy [email protected] LEARNING OBJECTIVES: LEARNING OBJECTIVES: 1) To understand the basics of spinal 1) To understand the basics of spinal cord development cord development 2) To understand the general rules of the 2) To understand the general rules of the development of the spine development of the spine 3) To understand the peculiar variations 3) To understand the peculiar variations to the normal spine plan that occur at to the normal spine plan that occur at the CVJ the CVJ Summary of week 1 Week 2-3 GASTRULATION "It is not birth, marriage, or death, but gastrulation, which is truly the most important time in your life." Lewis Wolpert (1986) Gastrulation Conversion of the embryonic disk from a bilaminar to a trilaminar arrangement and establishment of the notochord The three primary germ layers are established The basic body plan is established, including the physical construction of the rudimentary primary body axes As a result of the movements of gastrulation, cells are brought into new positions, allowing them to interact with cells that were initially not near them. This paves the way for inductive interactions, which are the hallmark of neurulation and organogenesis Day 16 H E Day 15 Dorsal view of a 0.4 mm embryo BILAMINAR DISK CRANIAL Epiblast faces the amniotic sac node Hypoblast Primitive pit (primitive endoderm) faces the yolk sac Primitive streak CAUDAL Prospective notochordal cells Dias Dias During -
Holt-Oram Syndrome: a Clinical Genetic Study J Med Genet: First Published As 10.1136/Jmg.33.4.300 on 1 April 1996
300_0fMed Genet 1996;33:300-307 Holt-Oram syndrome: a clinical genetic study J Med Genet: first published as 10.1136/jmg.33.4.300 on 1 April 1996. Downloaded from R A Newbury-Ecob, R Leanage, J A Raebum, I D Young Abstract to clarify the spectrum of abnormalities and to A clinical and genetic study of the Holt- delineate the HOS phenotype led us to review Oram syndrome (HOS) has been carried the clinical features in our patients, and dis- out in the United Kingdom involving 55 tinguish the clinical features most helpful for cases designated Holt-Oram syndrome, counselling purposes. together with their parents and sibs. Data This study was carried out in conjunction from the clinical assessment of both fa- with a genetic linkage study which has shown milial and isolated cases were used to de- genetic heterogeneity in the Holt-Oram syn- fine the HOS phenotype and to outline drome, with one gene (HOS1) being localised the spectrum of abnormalities, especially to chromosome 12 in five out ofseven families.7 factors affecting severity. Skeletal defects No phenotypic differences could be detected affected the upper limbs exclusively and between the linked and unlinked families. were bilateral and asymmetrical. They ranged from minor signs such as clino- dactyly, limited supination, and sloping Patients and methods shoulders to severe reduction deformities The study was carried out between March 1991 of the upper arm (4.5%). The radial ray and September 1993. Cases were ascertained was predominantly affected and the left by contacting clinical geneticists and paediatric side was more severely affected than the cardiologists and through the support group right. -
Characterization of SPECC1L Function in Palatogenesis
Characterization of SPECC1L Function in Palatogenesis By © 2019 Everett Gordon Hall B.A. Biology, Westminster College, Missouri, 2013 Submitted to the graduate degree program in Anatomy and Cell Biology and the Graduate Faculty of the University of Kansas in partial fulfillment of the requirements for the degree of Doctor of Philosophy. ________________________________________ Chair: Dr. Irfan Saadi ________________________________________ Dr. András Czirók ________________________________________ Dr. Brenda Rongish ________________________________________ Dr. Paul Trainor ________________________________________ Dr. Pamela Tran ________________________________________ Dr. Jinxi Wang Date Defended: April 26, 2019 The dissertation committee for Everett Gordon Hall certifies that this is the approved version of the following dissertation: Characterization of SPECC1L Function in Palatogenesis ________________________________________ Chair: Dr. Irfan Saadi Date Approved: May 16, 2019 ii Abstract Orofacial clefts are among the most common congenital birth defects, occurring in as many as 1 in 800 births worldwide. Genetic and environmental factors contribute to the complex etiology of these anomalies. SPECC1L encodes a cytoskeletal protein with roles in adhesion, migration, and cytoskeletal organization. SPECC1L mutations have been identified in patients with atypical clefts, Opitz G/BBB syndrome, and Teebi hypertelorism syndrome. Our lab has previously shown that knockout of Specc1l in mice with gene trap alleles results in early embryonic lethality with defects in neural tube closure and neural crest cell delamination, as well as reduced PI3K-AKT signaling. However, the early lethality phenotype rendered these models incapable of recapitulating the human anomalies. To validate a role for SPECC1L in palatogenesis, we generated additional gene trap and truncation mutant Specc1l alleles. Specc1lgenetrap/truncation compound heterozygote embryos survive to the perinatal period, allowing analysis at later developmental stages. -
Differential Diagnosis of Oromandibular Limb Hypogenesis Syndromes Ole Junga,B, Ralf Smeetsb, Henning Hankenb, Reinhard E
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2016 Jun; 160(2):310-315. A patient with Charlie M Syndrome: Differential diagnosis of Oromandibular Limb Hypogenesis Syndromes Ole Junga,b, Ralf Smeetsb, Henning Hankenb, Reinhard E. Friedrichb, Max Heilandb, Amir Tagnihaa, Brian Labowa Aim. In order to provide adequate treatment to a patient with a subtype of Oromandibular Limb Hypogenesis Syndromes (OLHS), this study aimed to review and to analyze the current literature and treatment options of OLHS. Methods. Literature review in PubMed and Sciencedirect. Due to the small number of results, all available references were analyzed precisely. Results. Cases of OLHS are formerly rare and often incomplete. There are various classifications available, which, however, often seem confusing and are of little practical relevance. Furthermore, we present a complete case report of a patient with Charlie M syndrome, a type IV (Chicarilli)/ V (Hall) OLHS malformation. We also describe embryologic pathogenesis and differential diagnoses. Conclusion. As a result of our literature review, we recommend an adjusted classification for OLHS. Key words: Oromandibular Limb Hypogenesis Syndromes (OLHS), Charlie M Syndrome, Oromandibular and limb hypogenesis malformations (OLHM) Received: August 1, 2015; Accepted with revision: April 8, 2016; Available online: April 27, 2016 http://dx.doi.org/10.5507/bp.2016.020 aDepartment of Plastic and Oral Surgery, Children´s Hospital Boston, Harvard Medical School, Boston, USA bDepartment of Oral and Maxillofacial Surgery, University Medical Center Hamburg, Hamburg, Germany Corresponding author: Ole Jung, e-mail: [email protected] INTRODUCTION CASE REPORT Oromandibular Limb Hypogenesis Syndromes A twenty-three-year-old male with severe oroman- (OLHS) describe a group of heterogeneous malforma- dibular and limb deformities presented for mandibular tions of the face and body. -
2018 Etiologies by Frequencies
2018 Etiologies in Order of Frequency by Category Hereditary Syndromes and Disorders Count CHARGE Syndrome 958 Down syndrome (Trisomy 21 syndrome) 308 Usher I syndrome 252 Stickler syndrome 130 Dandy Walker syndrome 119 Cornelia de Lange 102 Goldenhar syndrome 98 Usher II syndrome 83 Wolf-Hirschhorn syndrome (Trisomy 4p) 68 Trisomy 13 (Trisomy 13-15, Patau syndrome) 60 Pierre-Robin syndrome 57 Moebius syndrome 55 Trisomy 18 (Edwards syndrome) 52 Norrie disease 38 Leber congenital amaurosis 35 Chromosome 18, Ring 18 31 Aicardi syndrome 29 Alstrom syndrome 27 Pfieffer syndrome 27 Treacher Collins syndrome 27 Waardenburg syndrome 27 Marshall syndrome 25 Refsum syndrome 21 Cri du chat syndrome (Chromosome 5p- synd) 16 Bardet-Biedl syndrome (Laurence Moon-Biedl) 15 Hurler syndrome (MPS I-H) 15 Crouzon syndrome (Craniofacial Dysotosis) 13 NF1 - Neurofibromatosis (von Recklinghausen dis) 13 Kniest Dysplasia 12 Turner syndrome 11 Usher III syndrome 10 Cockayne syndrome 9 Apert syndrome/Acrocephalosyndactyly, Type 1 8 Leigh Disease 8 Alport syndrome 6 Monosomy 10p 6 NF2 - Bilateral Acoustic Neurofibromatosis 6 Batten disease 5 Kearns-Sayre syndrome 5 Klippel-Feil sequence 5 Hereditary Syndromes and Disorders Count Prader-Willi 5 Sturge-Weber syndrome 5 Marfan syndrome 3 Hand-Schuller-Christian (Histiocytosis X) 2 Hunter Syndrome (MPS II) 2 Maroteaux-Lamy syndrome (MPS VI) 2 Morquio syndrome (MPS IV-B) 2 Optico-Cochleo-Dentate Degeneration 2 Smith-Lemli-Opitz (SLO) syndrome 2 Wildervanck syndrome 2 Herpes-Zoster (or Hunt) 1 Vogt-Koyanagi-Harada -
CHARGE Syndrome
orphananesthesia Anaesthesia recommendations for CHARGE syndrome Disease name: CHARGE syndrome ICD 10: Q87.8 Synonyms: CHARGE association; Hall-Hittner syndrome Disease summary: CHARGE syndrome was initially defined as a non-random association of anomalies: - Coloboma - Heart defect - Atresia choanae (choanal atresia) - Retarded growth and development - Genital hypoplasia - Ear anomalies/deafness In 1998, an expert group defined the major (the classical 4C´s: Choanal atresia, Coloboma, Characteristic ear and Cranial nerve anomalies) and minor criteria of CHARGE syndrome [1]. In 2004, mutations in the CHD7 gene were identified as the major cause. The inheritance pattern is autosomal dominant with variable expressivity. Almost all mutations occurs de novo, but parent-to-child transmission has occasionally been reported [2]. Clinical criteria for CHARGE syndrome [1] Major criteria: • Coloboma • Choanal Atresia • Cranial nerve anomalies • Abnormalities of the inner, middle, or external ear Minor criteria: • Cardiaovascular malformations • Genital hypoplasia or delayed pubertal development • Cleft lip and/or palate • Tracheoesophageal defects • Distinctive CHARGE facies • Growth retardation • Developmental delay Occasional: • Renal anomalies: duplex system, vesicoureteric reflux • Spinal anomalies: scoliosis, osteoporosis • Hand anomalies 1 • Neck/shoulder anomalies • Immune system disorders Individuals with all four major characteristics or three major and three minor characteristics are highly likely to have CHARGE syndrome [1]. CHARGE syndrome -
Chest Wall Hypoplasia - Principles and Treatment
Paediatric Respiratory Reviews 16 (2015) 30–34 Contents lists available at ScienceDirect Paediatric Respiratory Reviews Mini-symposium: Chest Wall Disease Chest Wall Hypoplasia - Principles and Treatment Oscar Henry Mayer * Associate Professor of Clinical Pediatrics, Perelman School of Medicine at The University of Pennsylvania, Division of Pulmonary Medicine, The Children’s Hospital of Philadelphia, 3501 Civic Center Boulevard, Philadelphia, PA 19104 EDUCATIONAL AIMS Understand the significance of chest wall and spine growth on lung growth and respiration. Understand how abnormal spine growth can cause chest wall hypoplasia and the treatment options available. Understand how abnormal lateral chest wall growth can impact lung development and the options for therapy. A R T I C L E I N F O S U M M A R Y Keywords: The chest is a dynamic structure. For normal movement it relies on a coordinated movement of the Chest wall hypoplasia multiple bones, joints and muscles of the respiratory system. While muscle weakness can have clear Jeune Syndrome impact on respiration by decreasing respiratory motion, so can conditions that cause chest wall Jarcho-Levin Syndrome hypoplasia and produce an immobile chest wall. These conditions, such as Jarcho-Levin and Jeune Spondylocostal dysostosis syndrome, present significantly different challenges than those faced with early onset scoliosis in which Spondylothoracic dysplasia chest wall mechanics and thoracic volume may be much closer to normal. Because of this difference more aggressive approaches to clinical and surgical management are necessary. ß 2014 Elsevier Ltd. All rights reserved. abnormal or asymmetric growth in even a small number these can INTRODUCTION cause non-syndromic early onset scoliosis (EOS) [1].