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Rascanu C, Duran M, Grabitz K, Weis-Müller B, Sandmann W. Successful surgical management of a recurrent leiomyosarcoma of the inferior vena cava. VASA 2011; 40:69-72. [PMID: 21283976 DOI: 10.1024/0301-1526/a000072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The leiomyosarcoma of the inferior vena cava (IVC) is a rare malignant tumour of the venous system. The recurrence of the tumour after previous initial surgical resection is common and occurs in more than half of the patients. Surgical resection of a local recurrence is poorly described in the literature and the available data are restricted to a small number of cases. We report the case of a 62 year old woman, who was referred to our vascular surgical unit for recurrence of a leiomyosarcoma of the inferior vena cava, 35 months after diagnosis and initial surgical treatment. We performed an extensive local resection and circumferencial replacement of the IVC. 18 months after the second operation and adjuvant radiotherapy, the patient is in a very good physical condition and CT-scans show no evidence of tumour recurrence.
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Kosus N, Kosus A, Yildirim M, Duran M, Turhan NO. Mean platelet volume as a marker of thrombosis in patients with missed abortion. Acta Haematol 2011; 125:208-9. [PMID: 21252498 DOI: 10.1159/000322943] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Accepted: 11/22/2010] [Indexed: 11/19/2022]
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Grotemeyer D, Duran M, Grabitz K, Reinecke P, Sandmann W, Antakyali M. Segmentäre inkomplette Thrombose der Vena poplitea durch Kompression eines Osteochondroms am distalen Femur. PHLEBOLOGIE 2011. [DOI: 10.1055/s-0037-1621782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungVenöse Thrombosen der unteren Extremitäten bei Kindern und in der Adoleszenz sind selten (0,07/10 000 Kindern) (1) und können verschiedene Ursachen haben. Ein ätiologischer Faktor ist die Kompression von außen. Vorgestellt wird ein 16-jähriger Junge der durch Kompression eines Osteochondroms des Femurs eine Phlebothrombose der V. poplitea erlitten hatte und durch operative Exostosenabtragung und Thrombektomie geheilt wurde.Ergänzend stellen wir die aktuelle Literatur bezüglich arterieller und venöser Gefäßkomplikation durch gleichzeitiges Vorliegen einer Exostose vor.
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van der Kolk JH, Wijnberg ID, Westermann CM, Dorland L, de Sain-van der Velden MGM, Kranenburg LC, Duran M, Dijkstra JA, van der Lugt JJ, Wanders RJA, Gruys E. Equine acquired multiple acyl-CoA dehydrogenase deficiency (MADD) in 14 horses associated with ingestion of Maple leaves (Acer pseudoplatanus) covered with European tar spot (Rhytisma acerinum). Mol Genet Metab 2010; 101:289-91. [PMID: 20655779 DOI: 10.1016/j.ymgme.2010.06.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 06/27/2010] [Accepted: 06/27/2010] [Indexed: 11/30/2022]
Abstract
This case-series describes fourteen horses suspected of equine acquired multiple acyl-CoA dehydrogenase deficiency (MADD) also known as atypical myopathy of which seven cases were confirmed biochemically with all horses having had access to leaves of the Maple tree (Acer pseudoplatanus) covered with European tar spot (Rhytisma acerinum). Assessment of organic acids, glycine conjugates, and acylcarnitines in urine was regarded as gold standard in the biochemical diagnosis of equine acquired multiple acyl-CoA dehydrogenase deficiency.
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Sagban A, Grotemeyer D, Rehbein H, Sandmann W, Duran M, Balzer K, Grabitz K. Der stenosierende Aortenprozess als Coral Reef Aorta – Erfahrungen in 80 Patienten. Zentralbl Chir 2010; 135:438-44. [DOI: 10.1055/s-0030-1247382] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Calé R, Guedes-De-Pinho P, Aragão I, Martins H, Cardoso G, Duran M, Wanders R, Silva M, Ferreira L, Branco P, Bastos M. Identification of potential biomarkers of PRIS (Propofol Infusion Syndrome): A prospective study. Toxicol Lett 2010. [DOI: 10.1016/j.toxlet.2010.03.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Michailova P, Atanasov N, Ilkova J, Chassovnikarova T, Duran M, Karadurmus E. Genome Response of Model Invertebrates and Vertebrates Species to Stress Agents in the Environment. BIOTECHNOL BIOTEC EQ 2010. [DOI: 10.1080/13102818.2010.10817870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Park C, Bega A, Unlu C, Chadderton RA, McKean WR, Kohl PM, Hunt JA, Keaney J, Willis JL, Duran M. Acetoclastic methanogens in an anaerobic digester could be susceptible to trace metal supplementation. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2010; 62:2905-2911. [PMID: 21123921 DOI: 10.2166/wst.2010.161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The objective of this study was to investigate the effects of nutrient supplementation on anaerobic biomass. While many studies emphasized the importance of supplementing trace metals such as iron, cobalt, and nickel for maximum methanogenic activity, there is no evidence whether such supplements, even at relatively low concentration, could perturb anaerobic biomass. Effects of supplementing nutrients, including yeast extract, on anaerobic biomass from two full-scale mesophilic digesters, operating under different conditions, at the North East Water Pollution Control Plant in Philadelphia, Pennsylvania, USA, were assessed using biochemical methane potential tests. The results show that acetoclastic methanogens from a recently cleaned digester was not stimulated by nutrient supplementation at relatively low concentrations and a slight perturbation was observed when supplementation was at a relatively high concentration. Furthermore, greater degree of susceptibility to the trace metal supplementation was observed for biomass from another digester that had not been cleaned for over 10 years, thus it had reduced active volume due to grit accumulation. For instance, supplementation of 200 mg/L of iron as FeCl(2)·4H(2)O to the biomass from the reduced-active-volume digester caused 17% reduction in CH(4) production, as compared to a control which did not receive any supplements, while the same concentration had no effect on the biomass from full-active-volume digester. Results strongly suggest that acetoclastic methanogens stressed due to reduced hydraulic/solids retention time may be susceptible to trace metal addition. Therefore, trace metal supplementation for anaerobic digesters should be considered on a case by case basis.
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Castelo-Branco C, Duran M, Puig M, Vanrell JA. Gynaecological short communication: Compliance with hormone replacement therapy at the menopause. J OBSTET GYNAECOL 2009. [DOI: 10.3109/01443619509015501] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Peters BD, Duran M, Vlieger EJ, Majoie CB, den Heeten GJ, Linszen DH, de Haan L. Polyunsaturated fatty acids and brain white matter anisotropy in recent-onset schizophrenia: a preliminary study. Prostaglandins Leukot Essent Fatty Acids 2009; 81:61-3. [PMID: 19477108 DOI: 10.1016/j.plefa.2009.04.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2009] [Revised: 03/27/2009] [Accepted: 04/24/2009] [Indexed: 01/22/2023]
Abstract
Brain white matter myelin abnormalities and cell membrane fatty acid abnormalities have been implicated in schizophrenia and other psychiatric disorders. We investigated in young adults with a psychotic disorder (n=12) whether (poly)unsaturated fatty acid concentrations in erythrocyte membranes are related to an MRI measure of brain white matter, which depends on the degree of myelination. A significant correlation was found between total (poly)unsaturated fatty acid concentration and fractional anisotropy of a fronto-temporal white matter tract (r=0.503, P=0.048). Unsaturated fatty acids may be necessary for the myelinating activity of oligodendrocytes or for myelin maintenance. These results warrant further investigation.
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Domingo E, Suriñach JM, Murillo J, Duran M, Suriñach J, Baselga J, de Sevilla TF. Prognostic factors in the diagnostic work-up of cancer patients in an internal medicine department: does age matter? Int J Clin Pract 2008; 62:1723-9. [PMID: 19143858 DOI: 10.1111/j.1742-1241.2008.01886.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Increasing life expectancy in the general population has led to a rise in the incidence of cancer and new challenges with regard to the diagnosis, therapy and prognosis of this disease. AIM To assess prognostic factors in the initial work-up of patients ultimately diagnosed with cancer in an Internal Medicine Service, particularly those related with age. PATIENTS AND METHODS A prospective study was undertaken with 224 patients ultimately diagnosed with cancer, as confirmed by histological or cytological study. The neoplasms included respiratory, gastrointestinal, genitourinary, metastatic adenocarcinoma of unknown origin, gynaecological, hepatobiliary and others. Before reaching the diagnosis, the following factors were investigated in all patients: functional status [Karnofsky Performance Status (KPS)], comorbidity (Charlson scale), body mass index (BMI), serum cholesterol and albumin concentrations, cognitive level (Mini-mental test), quality of life (Short Form 36 questionnaire), and extension of the disease according to established criteria. Survival at 1 year was analysed. Statistical analyses were done with spss 11.0 for Windows, using a forward stepwise (likelihood ratio) method to construct the model and a Cox multivariate model for the survival analysis. RESULTS A total of 224 patients, 167 men (74.5%) and 57 women (25.5%), with a mean age of 66.1 +/- 12.3 years were studied. KPS was >or= 70 in 84% and comorbidity was zero or one in 74%. BMI was 24.25 +/- 4.3, cholesterol 180.7 +/- 4.3, albumin 3.32 +/- 0.5 and Mini-mental score 25.4 +/- 3.7. Metastasis was seen in 131 patients (58.5%) and local disease in 93 cases (41.5%). One-year survival was 38.8% (87 patients) with a mean of 203.8 +/- 143 days. In the Cox analysis, the independent predictive factors for survival were KPS [hazard ratio (HR) = 0.951; 95% CI = 0.930-0.974; p < 0.01], metastatic dissemination (HR = 2.422; 95% CI = 1.643-3.571; p < 0.01), physical quality of life (HR = 0.978; 95% CI = 0.962-0.995; p < 0.01) and albumin (HR = 0.653; 95% CI = 0.455-0.936; p < 0.01). CONCLUSIONS In the initial work-up of patients ultimately diagnosed with cancer in an Internal Medicine Service, functional status, dissemination, the physical component in the quality of life scale and serum albumin levels were independent prognostic factors for survival. Age was not an independent prognostic factor and should not be used as a basis for adopting diagnostic or therapeutic decisions in these patients.
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van Kuilenburg ABP, Stroomer AEM, Bosch AM, Duran M. Beta-alanine and beta-aminoisobutyric acid levels in two siblings with dihydropyrimidinase deficiency. NUCLEOSIDES NUCLEOTIDES & NUCLEIC ACIDS 2008; 27:825-9. [PMID: 18600547 DOI: 10.1080/15257770802146445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Dihydropyrimidinase (DHP) deficiency is an inborn error of the pyrimidine degradation pathway, affecting the hydrolytic ring opening of the dihydropyrimidines. In two siblings with a complete DHP deficiency and a variable clinical presentation, a normal concentration of beta-alanine and strongly decreased levels of beta-aminoisobutyric acid were observed in plasma, urine and CSF. No major differences were observed for the concentrations of the beta-amino acids in plasma and urine between the symptomatic and asymptomatic sibling. Thus, the relevance of the shortage of beta-aminoisobutyric acid for the onset of a clinical phenotype in patients with DHP deficiency remains to be established.
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van Kuilenburg ABP, Meijer J, Dobritzsch D, Lohkamp B, Ruitenbeek W, Roelofsen J, Abeling NGGM, Duran M, Buzing C. Identification of two novel mutations C79X and R235Q in the dihydropyrimidine dehydrogenase gene in a patient presenting with hematuria. NUCLEOSIDES NUCLEOTIDES & NUCLEIC ACIDS 2008; 27:809-15. [PMID: 18600544 DOI: 10.1080/15257770802146247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A patient with hematuria was shown to have thymine-uraciluria. The dihydropyrimidine dehydrogenase (DPD) activity in peripheral blood mononuclear cells was 0.16 nmol/mg/h; controls: 9.9 +/- 2.8 nmol/mg/h. Analysis of DPYD showed that the patient was compound heterozygous for the novel mutations 237C > A (C79X) in exon 4 and 704G > A (R235Q) in exon 7. The nonsense mutation (C79X) leads to premature termination of translation and thus to a non-functional protein. Analysis of the crystal structure of pig DPD suggested that the R235Q mutation might interfere with the binding of FAD and the electron flow between the NADPH and the pyrimidine substrate site of DPD.
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van Maldegem BT, Duran M, Wanders RJA, Niezen-Koning KE, Hogeveen M, Ijlst L, Waterham HR, Wijburg FA. [Short-chain acyl-CoA dehydrogenase deficiency (SCADD): relatively high prevalence in the Netherlands and strongly variable fenotype; neonatal screening not indicated]. NEDERLANDS TIJDSCHRIFT VOOR GENEESKUNDE 2008; 152:1678-1685. [PMID: 18714522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To describe the clinical, genetic, and biochemical characteristics of short-chain acyl-CoA dehydrogenase deficiency (SCADD), a clinically heterogeneous metabolic disorder for which neonates are screened for in parts of the United States and Australia. To explore the genotype-phenotype relation and to discuss neonatal screening for SCADD. DESIGN Retrospective study of 31 Dutch SCADD patients and 8 SCADD relatives. METHOD Patients and relatives were included ifbiochemical SCADD characteristics (increased C4-carnitine and/or ethylmalonic acid) were present in combination with a mutation and/or the c.511C>T or c.625G>A variant on each SCAD-encoding (ACADS) allele. The patients were subdivided into 3 genotype groups: mutation/mutation, mutation/variant and variant/variant group. RESULTS A birth prevalence for SCADD of at least 1:50,000 was calculated. Most patients presented before the age of 3 years, mainly with developmental delay, epilepsy, behavioural disturbances and/or hypoglycaemia. The ACADS genotype showed a statistically significant association with biochemical, but not with clinical characteristics. In total 7 out of 8 SCADD relatives were free of symptoms. In 5 of the 31 patients, of whom 2 had severe symptoms, a second diagnosis was made which might explain the symptoms. CONCLUSION SCADD was far more common than had previously been assumed and clinical symptoms in SCADD were non-specific, often transient or absent and not correlated with specific ACADS genotypes. SCADD does not meet major neonatal screening criteria and is therefore not suited for inclusion in neonatal screening programmes.
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Wadman SK, Duran M, Kamerling JP. Organic acidurias: approach, results and clinical relevance. CIBA FOUNDATION SYMPOSIUM 2008; 87:324-39. [PMID: 6918293 DOI: 10.1002/9780470720691.ch18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
More than twenty-five inherited organic acidurias have been identified during the last fifteen years. This remarkable development is due mainly to the introduction of gas chromatography, and gas chromatography combined with mass spectrometry, in paediatric laboratories for metabolic disease. The chemical approach is determined mainly by physical properties of the acid, such as their extractability and volatility. Most progress has been made with extractable acids. The techniques used for derivatization are mentioned, such as trimethylsilylation, methylation and the preparation of asymmetric derivatives for the separation of optical enantiomers. Metabolite patterns may be so characteristic that the underlying enzyme defect can be deduced. Examples are the leucine degradation defects, all encountered in the authors' laboratory: branched-chain ketoaciduria; isovaleric acidaemia; 3-methylcrotonylglycinuria; 3-methylglutaconic aciduria; and 3-hydroxy-3-methylglutaric aciduria. These abnormalities are discussed. D-glyceric aciduria is shown as an example of a not yet fully understood organic aciduria. The clinical approach varies. Metabolic acidosis is an indication for organic acid analysis in urine and plasma, but in many defects there is no acidosis, or only a transient one caused by secondary metabolites, such as lactic and 3-hydroxybutyric acids. Gas chromatography is an obligatory routine investigation in screening programmes for inborn errors of metabolism, especially for the examination of acutely ill neonates and premature babies.
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Silva MFB, Aires CCP, Luis PBM, Ruiter JPN, IJlst L, Duran M, Wanders RJA, Tavares de Almeida I. Valproic acid metabolism and its effects on mitochondrial fatty acid oxidation: a review. J Inherit Metab Dis 2008; 31:205-16. [PMID: 18392741 DOI: 10.1007/s10545-008-0841-x] [Citation(s) in RCA: 253] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2007] [Revised: 02/12/2008] [Accepted: 02/15/2008] [Indexed: 12/25/2022]
Abstract
Valproic acid (VPA; 2-n-propylpentanoic acid) is widely used as a major drug in the treatment of epilepsy and in the control of several types of seizures. Being a simple fatty acid, VPA is a substrate for the fatty acid beta-oxidation (FAO) pathway, which takes place primarily in mitochondria. The toxicity of valproate has long been considered to be due primarily to its interference with mitochondrial beta-oxidation. The metabolism of the drug, its effects on enzymes of FAO and their cofactors such as CoA and/or carnitine will be reviewed. The cumulative consequences of VPA therapy in inborn errors of metabolism (IEMs) and the importance of recognizing an underlying IEM in cases of VPA-induced steatosis and acute liver toxicity are two different concepts that will be emphasized.
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Dunaev T, Alanya S, Duran M. Use of RNA-based genotypic approaches for quantification of viable but non-culturable Salmonella sp. in biosolids. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2008; 58:1823-1828. [PMID: 19029724 DOI: 10.2166/wst.2008.555] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Recent research efforts demonstrated an increase in fecal coliform counts in anaerobically digested biosolids after dewatering. Variety of bacteria enters viable but nonculturable (VNC) state as a survival response when exposed to environmental stress. Increase in coliform concentration after digestion and dewatering processes have been attributed to cells going into a viable but non-culturable state implying that traditional coliform enumeration methods are not sufficient to determine number of viable cells. Therefore, this research has been undertaken to develop a method for rapid and accurate quantification of viable but non-culturable pathogens in biosolids via monitoring and quantifying stress-related genes in Salmonella sp. The proposed method has the potential to allow accurate detection of pathogens in biosolids even when the cells are non-culturable due to environmental stress. The research proposed identification of stress related genes in Salmonella when cells are exposed to heat for different durations by using available Salmonella microarrays. In the context of this study the identified stress genes can be quantified through reverse transcription, complementary DNA (cDNA) synthesis, and amplification of cDNA via quantitative reverse transcription polymerase chain reaction (qRT-PCR). Then quantity of mRNA can be correlated to cell viability and cells ability to grow, i.e., their culturability. Development of a novel approach to understand the pathogen behaviour in biosolids is key to ensure low public health risks from biosolids. Nevertheless, the initial results suggest that intact RNA isolation from biosolids is still challenging task.
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Tepe N, Yurtsever D, Mehta RJ, Bruno C, Punzi VL, Duran M. Odor control during post-digestion processing of biosolids through bioaugmentation of anaerobic digestion. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2008; 57:589-594. [PMID: 18360000 DOI: 10.2166/wst.2008.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The effects of bioaugmenting anaerobic biosolids digestion with a commercial product that contained selected strains of bacteria from genera Bacillus, Pseudomonas, and Actinomycetes, along with ancillary organic compounds containing various micronutrients were evaluated. The main objective of the study was to investigate the effects of bioaugmentation specifically on the performance of methanogenesis during anaerobic digestion, as well as on the generation and fate of odor-causing compounds during the storage of the digested biosolids. The bench-scale digester with 5 g/L bioaugment generated 29% more net CH4 than a control during the eight weeks of operation. In addition, the average residual propionic acid concentration in the bioaugmented digester was 46% lower than that in the control. The biosolids digested in the bioaugmented digester generated a negligible amount of methyl mercaptan (CH3SH) during 10 days of post-digestion storage, while CH3SH concentration in the control reached nearly 300 ppmv during the same period. Similarly peak dimethyl sulfide (CH3SCH3) generated by stored biosolids from the bioaugmented digester was only 37% of that from the control. Similar results were obtained in a subsequent short term study designed to confirm the repeatability of the findings.
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ten Hoedt AE, van Kempen AA, Boelen A, Duran M, Kemper-Proper EA, Oey-Spauwen MJW, Wijburg FA, Bosch AM. High incidence of hypermethioninaemia in a single neonatal intensive care unit detected by a newly introduced neonatal screening programme. J Inherit Metab Dis 2007; 30:978. [PMID: 17876719 DOI: 10.1007/s10545-007-0701-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Revised: 08/13/2007] [Accepted: 08/16/2007] [Indexed: 11/27/2022]
Abstract
From 1 January 2007 an expanded neonatal screening programme was initiated in the Netherlands, including homocystinuria with methionine as the primary marker. During the first 2 months hypermethioninaemia was detected in 14 newborns who, after proper evaluation, were demonstrated not to have classical homocystinuria. Remarkably, all these children were admitted to a single neonatal intensive care unit (Academic Medical Center, Amsterdam (AMC-NICU)). We evaluated the possible causes for this finding. The cohort of newborns with hypermethioninaemia (group 1) was compared with the cohort of newborns with normal screening results admitted to the AMC-NICU in the same time period (group 2). In addition, parenteral nutrition protocols from all NICUs in the Netherlands were compared. Mean birth weight and gestational age were significantly lower in group 1 than in group 2. All patients in group 1 received parenteral feeding (TPN) at the time of screening and received a higher mean amino acid intake per kilogram body weight than patients receiving TPN in group 2. Also, the AMC-NICU uses a different amino acid mixture for TPN than the other Dutch NICUs, containing more than twice the amount of methionine per gram of amino acids compared with other mixtures. The high incidence of hypermethioninaemia in the AMC-NICU is explained by a combination of low birth weight, low gestational age, and high protein intake supplied by a specific parenteral amino acid mixture containing large amounts of methionine. To prevent hypermethioninaemia, the use of high-methionine containing solutions for TPN should be reconsidered.
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Pourhassan S, Duran M, Engers R, Sandmann W. [Do we have to remove a painless collar swelling along the carotid artery?]. Laryngorhinootologie 2007; 87:341-4. [PMID: 17960522 DOI: 10.1055/s-2007-966970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Schwannoma are rare. We describe the clinical presentation, diagnostic workup and therapy in sympathetic chain schwannoma in a 54 year old patient. Besides the operative management the differential diagnosis of painless swelling at the carotid bifurcation are discussed.
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Ng BG, Kranz C, Hagebeuk EEO, Duran M, Abeling NGGM, Wuyts B, Ungar D, Lupashin V, Hartdorff CM, Poll-The BT, Freeze HH. Molecular and clinical characterization of a Moroccan Cog7 deficient patient. Mol Genet Metab 2007; 91:201-4. [PMID: 17395513 PMCID: PMC1941618 DOI: 10.1016/j.ymgme.2007.02.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2006] [Revised: 02/10/2007] [Accepted: 02/10/2007] [Indexed: 10/23/2022]
Abstract
Mutations in the N-linked glycosylation pathway cause rare autosomal recessive defects known as Congenital Disorders of Glycosylation (CDG). A previously reported mutation in the Conserved Oligomeric Golgi complex gene, COG7, defined a new subtype of CDG in a Tunisian family. The mutation disrupted the hetero-octomeric COG complex and altered both N- and O-linked glycosylation. Here we present clinical and biochemical data from a second family with the same mutation.
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Benninga MA, Lilien M, de Koning TJ, Duran M, Versteegh FGA, Goldschmeding R, Poll-The BT. Renal Fanconi syndrome with ultrastructural defects in lysinuric protein intolerance. J Inherit Metab Dis 2007; 30:402-3. [PMID: 17530437 DOI: 10.1007/s10545-007-0446-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Revised: 03/06/2007] [Accepted: 03/07/2007] [Indexed: 10/23/2022]
Abstract
Renal Fanconi syndrome developed rapidly in a 3-year-old Moroccan girl with established lysinuric protein intolerance. She was hospitalized because of lowered consciousness, uncoordinated movements and hepatosplenomegaly after a febrile period. Laboratory investigations revealed plasma ammonia 270 micromol/L (normal <70 micromol/L), ferritin 159 micromol/L (normal 2-59 micromol/L), LDH 1180 U/L (normal 26-534 U/L). LPI was diagnosed based on the findings of reduced plasma ornithine, arginine and lysine, and an increased level of glutamine. Urinary orotic acid (645 micromol/mmol creatinine; normal <3.6) was strongly increased. A defect in the SLC7A7 amino acid transporter was established (homozygous c.726G > A mutation). Detailed renal function tests including an acid challenge test, bicarbonate loading, and tubular maximal reabsorption of glucose showed complex tubular dysfunction. No evidence of respiratory chain defects was found in muscle or kidney tissue. No morphological abnormalities were demonstrated in the mitochondria. Ultrastructural analysis of proximal tubular cells showed vacuolization and sloughing of the apical brush border (Fig. 1). Renal involvement in LPI has only been described in a few reports; however, no detailed studies of the renal acidification mechanism were performed. Our patient had evidence of a full-blown Fanconi syndrome. Surprisingly, a metabolic acidosis was found with a moderately increased serum anion gap combined with repeatedly normal plasma organic acid values. This finding is in contrast with the diagnosis of renal tubular acidosis. Patients with hyperlysinaemia have a similar heavy load on the renal tubules; they never develop a renal Fanconi syndrome. Therefore, we consider the intratubular accumulation of lysine an unlikely candidate for the development of the renal Fanconi syndrome.
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Williams M, Huijmans JGM, Duran M, de Klerk JBC, van Maldegem BT, Poll-The BT. [Lactic acidosis and accumulation of glutamate in the blood of neonates following treatment with calcium levulinate for hypocalcaemia]. NEDERLANDS TIJDSCHRIFT VOOR GENEESKUNDE 2007; 151:1191-6. [PMID: 17557760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The data from 5 clinics concerning 8 infants, who had developed severe lactic acidosis and hyperglutamic acidaemia were reviewed. Blood-lactate levels were up to 15 mmol/l (reference level: < 2) and plasma-glutamate levels up to 1632 pmol/l (reference level: 14-78), and there was no concomitant hyperglutaminaemia (levels up to 1032 micromol/l (reference level: 333-809)). A positive correlation between the amount of calcium levulinate administered and the degree of hyperglutamic acidaemia was found. Replacement of the calcium levulinate by another calcium salt caused a reversal of the biochemical abnormalities of the patients. Two of the infants had a 22q11 microdeletion. This development of severe acidosis in infants who had been given a calcium supplement in the form of calcium levulinate may be related to genetic predisposition. The paradoxal hyperketonaemia and generalized aminoaciduria in 4 other patients suggested disturbed function ofthe mitochondrial respiratory chain. The hypothesis of the occurrence of an underlying defect of the mitochondrial respiratory chain was tested in the muscle tissue of one 22q11 patient, but this showed no abnormalities. Excessive accumulation of glutamate because of dysfunction ofglutamine synthetase, which forms glutamate from glutamine seems unlikely because of the relatively low values of plasma glutamate compared to the glutamine plasma levels. Calcium levulinate should no longer be used in neonates as it may lead to lactic acidosis.
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Duran M, Kara Y, Akyildiz GK, Ozdemir A. Antimony and heavy metals accumulation in some macroinvertebrates in the Yesilirmak River (N Turkey) near the Sb-mining area. BULLETIN OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2007; 78:395-9. [PMID: 17618389 DOI: 10.1007/s00128-007-9183-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Accepted: 06/01/2007] [Indexed: 05/16/2023]
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