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At least 19 recordsLinked to original sources

Dual Aberrant Splicing Caused by an Apparently Missense CHD7 Variant, c.5273A>G (p.Asp1758Gly), in CHARGE Syndrome.

CHARGE syndrome is a rare congenital disorder primarily attributed to heterozygous pathogenic variants of the CHD7 gene. Most pathogenic CHD7 variants are loss-of-function (LoF) variants, whereas the interpretation of missense variants remains challenging in the absence of functional evidence for their pathogenicity. We report a female infant presenting with clinical features characteristic of CHARGE syndrome. Targeted sequencing identified a heterozygous CHD7 variant (NM_017780.4:c.5273A>G), initially annotated as a missense substitution p.Asp1758Gly. This variant has been previously reported and registered with conflicting pathogenicity classifications; however, its transcript-level consequences remain unclear. Long-PCR-based RNA sequencing of total RNA from peripheral blood mononuclear cells revealed two aberrant splicing patterns associated with the variant: a predominant transcript carrying a 28-bp deletion due to cryptic donor splice-site activation, and a minor transcript with partial intron 24 retention. Both transcripts were predicted to result in premature termination codons. These findings demonstrate that c.5273A>G functions as a LoF variant through dual aberrant splicing rather than a simple missense substitution. This case underscores the importance of RNA-level splicing analysis for the accurate interpretation and classification of CHD7 missense variants.

CHD7

[Suicide risk and care of suicide attempters].

Starting from the notion of suicidal risk and a critique of its usage, it is possible to distinguish groups whose suicidal risk is particularly high. The suicidal group-composed of persons who have already attempted to commit suicide once-is in this paper the subject of general considerations as well as personal research. The latter shows that it is still difficult to detect those persons who are about to commit suicide and that tell-tale signs-be they clinical or resulting from tests-are still not very reliable. The difficulties encountered by secondary prevention are made obvious by two pieces of research done on the taking in charge of suicide-prone persons in a university general hospital. the timely recognition of the pre-suicidal syndrome and of the self-denial syndrome is very important for suicide prevention. Self-depreciation, and consequently the narcissistic blow is, as are the aggression phenomena, one of the psychological cores which lead to an act of suicide. Medical attitudes concerning the suicidal person are analyzed, and the difficulty in the psychotherapeutic relationship is stressed. Pratical considerations on the psychotherapeutic approach to the suicidal person close up the article.

Adolescent

[Nasosinusal polyposis and aspirin intolerance. Fernand Widal-Lermoyez syndrome].

The authors describe the clinical picture of the aspirin idiosyncrasy and propose to call this peculiar entity: syndrom of Widal and Lermoyez. They compare 25 cases of aspirin nasal polyposis with 26 other cases of various etiologies. Other substances than aspirin seem to be charged. The complications are regular with severe asthma and infection. The pathogenesis is discussed, excluding an allergic mechanism; it remain not quite clear. Essentially prophylactic, the treatment is poor and difficult.

Adult

Effects of levamisole on normal and abnormal leukocyte locomotion.

The anti-helminthic drug levamisole hydrochloride has been reported to stimulate immune responses in humans and experimental animals. We have investigated levamisole effects on human leukocyte locomotion in vitro in studies of neutrophils and mononuclear cells from normal adults, from patients with Chediak-Higashi disease and from patients with the syndrome of hyperimmunoglobulin E, recurrent pyogenic infections, and defective leukocyte chemotaxis. Directed migration (chemotaxis) of neutrophils and mononuclear cells from normal adults and from the hyperimmunoglobulin E syndrome patients, but not from Chediak-Higashi patients, were stimulated by levamisole at concentrations of 0.01-1.0 micronM, with stimulation observed most consistently at 0.1 micronM. These concentrations of drug also increased cyclic GMP levels in mononuclear cells and enhanced hexose monophosphate shunt activity in neutrophils, but did not alter chemotactic factor-induced changes in the surface charge of neutrophils. Other concentrations of levamisole did not affect leukocyte locomotion except for a high concentration (5.0 mM) which stimulated both random and directed leukocyte migration. When patients with the hyperimmunoglobulin E syndrome took levamisole by mouth, the abnormal chemotactic responses of their neutrophils were significantly improved towards normal. These studies are the first to show pharmacologic improvement of in vitro leukocyte locomotion in patients in whom recurrent infections have been attributed to a defect of this leukocyte function.

Adolescent

Mechanisms of headache.

It is thus evident that the mechanisms of headache differ widely from one syndrome or symptom complex to another. Both intracranial and extracranial structures may be involved. Knowledge of headache mechanisms is indispensable to the clinician charged with the management of his patient's complaints. Such knowledge should guide the investigations which may be required, and the treatment program to be instituted. As knowledge of headache mechanisms is broadened and our current concepts are altered, we can expect to learn more, not only about the complicated nature of the subject, but also about patients. Future research on headache will almost certainly concentrate on headache mechanisms and will be concerned with molecular mechanisms, immunity and the biochemistry of vascular mediators. That is as it should be, as the pursuits become increasingly focused and scientific. Yet it must also be emphasized that headaches occur, so far as we know, only in man, that they are unique to the human situation, and they cannot be understood without considering the personality, environment, and hopes and aspirations of the individual. In the end, many headaches will be seen to be a problem of inappropriate life adjustment, of poor tempo, a type of conditioned response evoked by the individual's attempts to deal with the vicissitudes of life. This "headache mechanism," so frequently a part of the human condition, will be understood by the perceptive physician as a symptom of his patient's dysfunction, and treated accordingly.

Arteritis

Pathology of structured water and associated cations in cells (ther tissue damage syndrome) and its medical treatment.

Modern experimental evidence indicates that the cell should be regarded as analogous to an ion exchanger resin granule with structured water in the interstices and with potassium and sodium ions associated with fixed negative charges on the protein matrix. In tissues damaged by disease or trauma, a similar set of changes in properties of cell cations and water is to be expected, for which a similar set of therapies is appropriate. Tissue damage causes a configurational change of the protein matrix from the normal to the damaged state. This leads to loss of association preference for potassium vs. sodium ions and to loss of water structuring, resulting in replacement of cell potassium by sodium and abnormal uptake of water by the cell. Appropriate therapies for reestablishment of the normal configurational state of the proteins of the cell are reestablishment of normal cell ATP production, for which prostaglandin PGBx is the rational approach, plus diets or drugs that decrease sodium and/or increase potassium concentrations in the body. Partial normalization of cell protein configuration by digitalis compounds may also be possible.

Adenosine Triphosphate

Mucopolysaccharidosis III A (Sanfilippo disease type A). Histochemical, electron microscopical and biochemical findings.

This is a report of two brothers iwth mucopolysaccharidosis. The 8- and 10-year-old boys presented the characteristic clinical symptoms of the syndrome in their entirety. Both had a highly increased excretion of heparan sulfate in urine. The elder boy died and was autopsied and diagnosed as having Sanfilippo disease Typ A by a drastic reduction of heparan sulfate sulfamidase activity in organ extracts. Histochemically, highly water-soluble, sulfate acid mucopolysaccharides were demonstrated in liver, spleen, and cerebrum of the deceased child. Chemical analyses revealed a 12-fold increase of sulfated mucopolysaccharide in the patients liver and a 4.5-fold increase in the cerebrum when compared with normal controls. The sulfated polysaccharide consisted mainly of heparan sulfate, which was of low molecular size, heterogeneous in charge, and rich in its sulfamino hexose content. In addition, the gangliocytes of cerebrum and cerebellum had accumulated glycolipids. Electron microscopically the storage cells were overloaded with lysosomal residual bodies. The mitral valve was also involved in the storage process, which is a rare manifestation of the Sanfilippo syndrome. Acid mucopolysaccharides were deposited intracellularly as well as extracellularly in the mitral valve tissue. Polarisation microscopically there was found a change from normally positive to negative birefringence in the connective tissue ground substance of the mitral valve when containing stored mucopolysaccharides.

Autopsy

Human triclonal anti-IgG gammopathy. I. Iso-electric focusing characteristics of the IgG, IgA and IgM anti-IgG and their heavy and light chains.

Human IgG, IgA and IgM anti-IgG autoantibodies have been isolated from the serum of an individual with Felty's syndrome. These were initially noted as soluble circulating serum complexes by analytical ultracentrifugation. Isolation was accomplished by solid phase immunoadsorption and each of the three antibody populations obtained was shown to be of restricted heterogeneity by liquid and polyacrylamide gel electrofocussing methods. Type kappa light chains were obtained from each protein. Co-isoelectric focusing experiments of all possible pairs of these light chains showed them to have identical net charge characteristics. Heavy chains obtained from each protein were also monoclonal and of differing isoelectric point. The availability of this serum provides a human model with which to study the changes which may occur in autoantibodies during the autoimmune response.

Antibodies, Anti-Idiotypic

[Freud and neurology].

The author describes sequentially the neurological work of Sigmund Freud, emphasizing this little known phase of "the researcher of laboratory and microscope". It seems that Freud's writings on psychoanalysis left behind other very important scientific research, such as descriptions about protoplasmic movements of carb's neurons, giving the bases for Waldeyer's neural theory. He described cocaine's influence of the psyche, its possible use in the treatment of melancholy and as a substitute for morphine. Freud studies polyneuritis, the brain effects of scurvy and syringomyelia. His description of aphasias follow Hughlings Jackson. He became interested in the study of cerebral palsy in children and assumed that the convulsive crises were manifestations and not its etiology; he classified them, emphasizing that Friedreich's syndrome has to do with heredity and asphyxia of the newborn is acquired. In 1895 he wrote his classic: "A project for a scientific psychology for neurologists" where he writes about the cathexis concept, related to local neuronal charges and graded excitability of the CNS, upon which modern neurophysiology concentrates great attention. After this time, he went on to work on psychopatology.

Austria

A new biochemical subtype of the Sanfilippo syndrome: characterization of the storage material in cultured fibroblasts of Sanfilippo C patients.

Fibroblasts cultured from the skin of three unrelated patients with the clinical symptoms of the Sanfilippo syndrome (mucopolysaccharidosis III) accumulated intracellularly excessive amounts of heparan sulfate and showed a lengthened turnover time for this mucopolysaccharide. They exhibited, however, neither a deficiency of heparan sulfate sulfamidase or alpha-N-acetylglucosaminidase nor of any other known glycosaminoglycan-degrading hydrolase. This new mucopolysaccharidosis was therefore designated as type C of the Sanfilippo syndrome. The abnormal heparan sulfate metabolism of Sanfilippo C fibroblasts could not be normalized by addition of crude urinary proteins or concentrated secretions from normal fibroblasts to the culture medium or by cocultivation with normal fibroblasts. The accumulated heparan sulfate was characterized by a reduced negative net charge. A small proportion of it could be adsorbed onto a cation exchange resin. It was sensitive to nitrous acid degradation under conditions where glucosamine residues with free amino groups are attacked. It is therefore suggested that the primary defect in this new mucopolysaccharidosis concerns the step which follows the hydrolysis of N-sulfonate groups in heparan sulfate degradation.

Adolescent

Multiple forms of corticotropin (adrenocorticotropic hormone, ACTH) and their significance.

Big corticotropin (adrenocroticotropic hormone, ACTH), an immunoreactive form of ACTH with low biological activity and which elutes in the void volume on Sephadex G-50 gel filtration, is found in plasma and extracts of human pituitary and tumour. Controlled tryptic digestion of big ACTH releases a product with full corticotropic activity which is indistinguishable from the (1-39) ACTH with respect to size, charge and susceptibility to tryptic digestion. Immunoreactive ACTH, predominantly in the big form, is found in virtually all tissue extracts of carcinoma primary to or metastatic from the lung, but not of carcinoma metastatic to the lung, and even in precancerous lung lesions. The absence of clinical Cushing syndrome in patients with carcinoma of the lung and moderate elevation of plasma concentrations of ACTH is due to the low biological activity of big ACTH. Prolonged survival (for more than two years) of patients with lung carcinoma has been observed only in those whose plasma ACTH is low before therapy or after resection of the lung tumour. Rabbit, rat and mouse pituitaries contain an intermediate sized ACTH but the usual 1-39 peptide predominates in the pituitaries of monkey, sheep, dog, cat and guinea pig, as well as man. The hormonal form of ACTH appears to be an important factor regulating the cortisol/corticosterone ratio in mammalian adrenal corticoid secretion because administration of porcine ACTH to rabbits alters the adrenal secretory pattern so as to decrease corticosterone production and increase cortisol production.

Addison Disease

Changes in chemical composition of chick embryos treated with a beta-xyloside and a lathyrogen.

Nine-day chick embryos were treated with 4-methylumbelliferyl beta-D-xyloside or beta-aminopropionitrile fumarate, and their gross chemical composition was examined one week later. Total DNA was 10--20% less in embryos treated with either drug than it was in control embryos. Xyloside-treated embryos showed marked increases in percent wet weight and in sodium/DNA and chloride/DNA ratios, and small decreases in protein/DNA, hydroxyproline/DNA and sulfate/DNA. None of these parameters was affected in embryos treated with beta-aminopropionitrile. Approximately 85% of the uronic acid of control embryos was present as chondroitin sulfate, with a degree of sulfation of 80% and charge density of 1.8; all of this chondroitin sulfate was covalently linked to peptide and had a number-average molecular weight of 29,300. In embryos treated with beta-xyloside, 90% of the uronic acid was present as chondroitin sulfate, with a degree of sulfation of 40% and charge density ranging from 1 to 2; 27% of this chondroitin sulfate, with an average molecular weight of 25,400, was peptide linked, while 73% was linked to 4-methylumbelliferone and had an average molecular weight of 22,900. The chemical differences between embryos treated with the xyloside and embryos treated with the lathyrogen reinforce the conclusion on morphological grounds that these are distinct syndromes involving different aspects of the extracellular matrix.

Abnormalities, Drug-Induced

Glomerular permselectivity: barrier function based on discrimination of molecular size and charge.

The formation of glomerular ultrafiltrate is dependent on the interplay of glomerular pressures and flows as well as the intrinsic permselectivity properties of the glomerular capillary wall. These intrinsic permeability properties serve to exclude macromolecules from the urinary space, based on size as well as net molecular charge discrimination. Neutral dextrans with molecular radii less than 20 A cross the glomerular wall without measurable restriction, whereas dextrans with radii greater than 42 A are almost completely barred. For any given size, negatively charged macromolecules are restricted to a greater extent than neutral molecules. Additionally, positively charged molecules are enhanced in their ability to cross the glomerular wall compared to similarly sized neutral polymers. The concept of a charge barrier, due to fixed negative charges within the glomerular wall, is also supported by morphological studies. Glomerular injury, leading to proteinuria, has been associated with loss of the charge-selective properties of these capillaries. Loss of glomerular fixed negative charges may also result in the foot process fusion and mesangial cell dysfunction often observed in proteinuric states.

Animals

Complexes between the LKB1 tumor suppressor, STRAD alpha/beta and MO25 alpha/beta are upstream kinases in the AMP-activated protein kinase cascade.

BACKGROUND: The AMP-activated protein kinase (AMPK) cascade is a sensor of cellular energy charge that acts as a 'metabolic master switch' and inhibits cell proliferation. Activation requires phosphorylation of Thr172 of AMPK within the activation loop by upstream kinases (AMPKKs) that have not been identified. Recently, we identified three related protein kinases acting upstream of the yeast homolog of AMPK. Although they do not have obvious mammalian homologs, they are related to LKB1, a tumor suppressor that is mutated in the human Peutz-Jeghers cancer syndrome. We recently showed that LKB1 exists as a complex with two accessory subunits, STRAD alpha/beta and MO25 alpha/beta. RESULTS: We report the following observations. First, two AMPKK activities purified from rat liver contain LKB1, STRAD alpha and MO25 alpha, and can be immunoprecipitated using anti-LKB1 antibodies. Second, both endogenous and recombinant complexes of LKB1, STRAD alpha/beta and MO25 alpha/beta activate AMPK via phosphorylation of Thr172. Third, catalytically active LKB1, STRAD alpha or STRAD beta and MO25 alpha or MO25 beta are required for full activity. Fourth, the AMPK-activating drugs AICA riboside and phenformin do not activate AMPK in HeLa cells (which lack LKB1), but activation can be restored by stably expressing wild-type, but not catalytically inactive, LKB1. Fifth, AICA riboside and phenformin fail to activate AMPK in immortalized fibroblasts from LKB1-knockout mouse embryos. CONCLUSIONS: These results provide the first description of a physiological substrate for the LKB1 tumor suppressor and suggest that it functions as an upstream regulator of AMPK. Our findings indicate that the tumors in Peutz-Jeghers syndrome could result from deficient activation of AMPK as a consequence of LKB1 inactivation.

AMP-Activated Protein Kinase Kinases

In vitro of adenosine on lymphocytes and erythrocytes from horses with combined immunodeficiency.

The effect of adenosine on the mitogenic response of peripheral blood lymphocytes (PBL) and on the nucleotide pools of erythrocytes from normal horses, horses heterozygous for the combined immunodeficiency (CID) trait (carriers), and foals with CID was studied. When PBL from normal, carrier, and CID horses were stimulated by phytohemagglutinin (PHA), concanavalin A, or pokeweed mitogen, [3H]thymidine uptake was inhibited by adenosine (0.1 microM) to 1.0 mM) in a dose-dependent manner. Adenosine (100 microM) mediated inhibition of [3H]thymidine uptake was prevented in both normal and carrier horse PBL by incubation with uridine. Uridine had no sparing effect on PBL from horses with CID. Differences were detected between human and horse PBL in response to adenosine and erythro-9(2-hydroxy-3-nonyl) adenine (EHNA), a competitive inhibitor of adenosine deaminase. In the first assay, mitogen-stimulated PBL from horses were more sensitive to adenosine. In the second assay, adenosine was added to PBL cultures at various times after PHA addition. Adenosine inhibited mitogenesis in horse PBL if added within the first 24 h. In human PBL cultures, adenosine inhibited mitogenesis only if added within the first 4 h. The third assay measured capacity of PHA-stimulated human and horse lymphocytes to escape inhibition by adenosine or EHNA. At the end of a 72-h culture period, horse PBL were still inhibited of mitogenesis in both human and horse PBL. With prolonged incubation (72 h), synergistic inhibition was detected only in horse PB. With high-pressure liquid chromatography, nucleotide levels in erythrocytes of normal, carrier, and CID horses were found to be similar. Incubation with adenosine produced a 1.5- to 2-fold increase in total adenine nucleotide pools in erythrocytes from all horses. However, these increases were accompanied by alterations in the relative amounts of the nucleotide components. This was seen as a significant decrease in the ATP:(AMP plus ADP plus ATP) ratio and energy charge in erythrocytes from normal horses. In contrast, the ATP:(AMP plus ADP plus ATP) ratio decreased only slightly in erythrocytes from CID horses, whereas no change in the energy charge was detected. The data from these studies indicate a difference in adenosine metabolism exists between human and horse lymphoyctes, and an abnormality may exist in purine metabolism or in an interconnecting pathway in horses with CID.

Adenine

Therapeutic and economic implications of emergency department evaluation for venous thrombosis.

Records of 160 emergency department patients with lower extremity complaints were reviewed to determine the economic and therapeutic impact of noninvasive venous impedance testing. Venograms obtained in 86 extremities were used to determine diagnostic accuracy. The incidence of pulmonary thromboembolic events, postphlebitic syndrome and complications of anticoagulation was ascertained. Outflow impedance testing correctly identified all patients with deep venous thrombosis and overall diagnostic accuracy was 95% (41/43 patients). In 123 patients (33 positive results, 90 negative) therapeutic decisions were based solely on impedance test results. Examination required 20 to 30 minutres at a cost of $35. Follow-up ranging from 4 to 60 weeks failed to reveal documented thromboembolic complications or recurrence of lower extremity symptoms. In 37 patients (six positive results, 31 negative) impedance test results were ignored and inpatient workup, including invasive venography, was undertaken. Hospital charges for these patients averaged $1,500. In addition to its ease of performance and high degree of accuracy, comparison with inpatient evaluation documents its cost effectiveness. Impedance testing for emergency department evaluation of suspected deep vein thrombosis appears appropriate.

Cost-Benefit Analysis

The effects of ristocetin and von Willebrand factor on platelet electrophoretic mobility.

Ristocetin will induce the agglutination of platelets in the presence of von Willebrand factor. In previous studies, an electrostatic mechanism was proposed for this phenomenon wherein first the platelet's surface charge is reduced by the binding of ristocetin and then the von Willebrand factor acts as a bridge between platelets. To test this hypothesis, the effects of ristocetin and von Willebrand factor, singly and together, on the electrophoretic mobility of normal, trypsinized, and Bernard-Soulier platelets was measured. Ristocetin alone, at concentrations of 0.5 mg/ml or more, produced a statistically significant reduction in the electrophoretic mobility of fresh or fixed platelets. Control experiments showed that the reduction was not due to changes in the ionic milieu of the solution. Therefore, the decrease in platelet mobility is evidence for binding of ristocetin to the platelet surface. Bernard-Soulier and trypsinized platelets also had reductions in mobility with ristocetin, suggesting that ristocetin binds to the platelet at sites other than the binding site for von Willebrand factor. The presence of plasma from a patient with von Willebrand's disease did not alter the reduction in mobility of normal platelets by ristocetin. However, the reduction was markedly enhanced in the presence of normal plasma. This enhancement did not occur with Bernard-Soulier platelets and was inhibited by anti-Factor VIII/von Willebrand factor antiserum or trypsinization of the platelets. Thus, the enhanced reduction appears to be associated with the binding of von Willebrand factor to the platelet surface. These studies indicate that platelets undergo two changes with ristocetin and von Willebrand factor, both of which facilitate agglutination: reduction in net surface charge and binding of von Willebrand factor, a large molecule which can serve as a bridge between platelets. In parallel studies, bovine von Willebrand factor, without ristocetin, agglutinated and reduced the electrophoretic mobility of normal but not Bernard-Soulier or trypsinized platelets; this indicates a similar mechanism of agglutination.

Antibodies

The proteogenomic landscape of the human kidney and implications for cardio-kidney-metabolic health.

Nearly one-third of the global population is affected by cardio-kidney-metabolic (CKM) diseases; however, the molecular mechanisms underlying CKM diseases are poorly understood. Here we show that tissue proteomics provide critical insights not captured by tissue gene expression or blood proteomics information by performing whole-genome and RNA sequencing and proteomics analysis of human kidney samples (n = 337), and we generated a publicly available database. Via Bayesian co-localization and Mendelian randomization analyses of kidney protein quantitative trait loci and 36 CKM genome-wide association studies, we prioritized 89 proteins for CKM traits. We prioritized relationships that could underlie the interconnectedness of CKM traits and discovered multiple and targetable mechanisms for CKM diseases, including the potential role of kidney angiopoietin-like protein 3 (ANGPTL3) in serum lipid levels and kidney function as well as the role of charged multivesicular body protein 1A in kidney function and hypertension. Notably, we identify pathways with confluence of evidence from genetic loci, tissue gene expression and protein levels for CKM traits. In summary, our large-scale kidney proteomics study uncovers proteins and targetable mechanisms prioritized for CKM diseases.

Humans