Next-generation sequencing testing in children with epilepsy reveals novel clinical, diagnostic and therapeutic implications

Introduction: Epilepsy is one of the commonest diseases in children, characterized by extensive phenotypic and genetic heterogeneity. This study was conducted to determine the diagnostic utility and to identify novel clinical and therapeutic implications of genetic testing in pediatric patients with epilepsy. Methods: Large multigene panel and/or exome sequencing was performed in 127 unrelated Polish and Ukrainian patients with suspected monogenic epilepsy. Diagnostic yields were presented for five phenotypic subgroups, distinguished by seizure type, electroencephalographic abnormalities, anti-seizure treatment response, and neurodevelopmental deficits. Results: A definite molecular diagnosis was established in 46 out of 127 cases (36%). Alterations in six genes were detected in more than one patient: SCN1A, MECP2, KCNT1, KCNA2, PCDH19, SLC6A1, STXBP1, and TPP1, accounting for 48% of positive cases. 4/46 cases (8.7%) were mosaic for the variant. Although the highest rates of positive diagnoses were identified in children with developmental delay and generalized seizures (17/41, 41%) and in developmental end epileptic encephalopathies (16/40, 40%), a monogenic etiology was also frequently detected in patients with solely focal seizures (10/28, 36%). Molecular diagnosis directly influenced anti-seizure management in 15/46 cases. Conclusion: This study demonstrates the high diagnostic and therapeutic utility of large panel testing in childhood epilepsies irrespective of seizure types. Copy number variations and somatic mosaic variants are important disease-causing factors, pointing the need for comprehensive genetic testing in all unexplained cases. Pleiotropy is a common phenomenon contributing to the growing phenotypic complexity of single-gene epilepsies.

Development of the 99mTc-Labelled SST2 Antagonist TECANT-1 for a First-in-Man Multicentre Clinical Study

Broad availability and cost-effectiveness of 99Mo/99mTc generators worldwide support the use, and thus the development, of novel 99mTc-labelled radiopharmaceuticals. In recent years, preclinical and clinical developments for neuroendocrine neoplasms patient management focused on somatostatin receptor subtype 2 (SST2) antagonists, mainly due to their superiority in SST2-tumour targeting and improved diagnostic sensitivity over agonists. The goal of this work was to provide a reliable method for facile preparation of a 99mTc-labelled SST2 antagonist, [99mTc]Tc-TECANT-1, in a hospital radiopharmacy setting, suitable for a multi-centre clinical trial. To ensure successful and reproducible on-site preparation of the radiopharmaceutical for human use shortly before administration, a freeze-dried three-vial kit was developed. The final composition of the kit was established based on the radiolabelling results obtained during the optimisation process, in which variables such as precursor content, pH and buffer, as well as kit formulations, were tested. Finally, the prepared GMP-grade batches met all predefined specification parameters together with long-term kit stability and stability of the product [99mTc]Tc-TECANT-1. Furthermore, the selected precursor content complies with micro-dosing, based on an extended single-dose toxicity study, where histopathology NOEL was established at 0.5 mg/kg BW, being more than 1000 times higher than the planned human dose of 20 µg. In conclusion, [99mTc]Tc-TECANT-1 is suitable to be advanced into a first-in-human clinical trial.

The PURPLE N study: objective and perceived nutritional status in children and adolescents with cerebral palsy

PURPOSE

To obtain information on characteristics, management, current objective nutritional status and perception of nutritional status of children with cerebral palsy (CP) from healthcare professionals (HCPs) and caregivers.

MATERIALS AND METHODS

A detailed survey of several items on eight main topics (general characteristics, motor function, comorbidities, therapies, anthropometry, feeding mode and problems and perceived nutritional status) was developed and tested for the study. Correlation between nutritional status and Gross Motor Function Classification System (GMFCS) levels was assessed using continuous variables (Z-scores for weight-for-age, height-for-age, weight-for-height, and body mass index-for-age), and categorical variables (being malnourished, stunted, or wasted). HCP and caregiver perceptions of the child's nutritional status as well as agreement between perceived and objective nutritional status and agreement between perceived nutritional status and concerns about the nutritional status were analyzed.

RESULTS

Data were available for 497 participants from eight European countries. Poorer nutritional status was associated with higher (more severe) GMFCS levels. There was minimal agreement between perceived and objective nutritional status, both for HCPs and caregivers. Agreement between HCP and caregiver perceptions of the child's nutritional status was weak (weighted kappa 0.56). However, the concerns about the nutritional status of the child were in line with the perceived nutritional status.

CONCLUSIONS

The risk of poor nutritional status is associated with more severe disability in children and adolescents with CP. There is a mismatch between HCP and caregiver perceptions of participants' nutritional status as well as between subjective and objective nutritional status. Our data warrant the use of a simple and objective screening tool in daily practice to determine nutritional status in children and adolescents with CP. Clinical trial registration: ClinicalTrials.gov Identifier: NCT03499288 (https://clinicaltrials.gov/ct2/show/NCT03499288). IMPLICATIONS FOR REHABILITATIONUse of the ESPGHAN recommendations and simple screening tools in daily practice is needed to improve nutritional care for individuals with CP.Attention should be paid to the differences in the perception of nutritional status of individuals with CP between professionals and caregivers to improve appropriate referral for nutritional support.Objective measures rather than the professional's perception need to be used to define the nutritional status of individuals with CP.

[99mTc]Tc-PSMA-T4-Novel SPECT Tracer for Metastatic PCa: From Bench to Clinic

Despite significant advances in nuclear medicine for diagnosing and treating prostate cancer (PCa), research into new ligands with increasingly better biological properties is still ongoing. Prostate-specific membrane antigen (PSMA) ligands show great potential as radioisotope carriers for the diagnosis and therapy of patients with metastatic PCa. PSMA is expressed in most types of prostate cancer, and its expression is increased in poorly differentiated, metastatic, and hormone-refractory cancers; therefore, it may be a valuable target for the development of radiopharmaceuticals and radioligands, such as urea PSMA inhibitors, for the precise diagnosis, staging, and treatment of prostate cancer. Four developed PSMA-HYNIC inhibitors for technetium-99m labeling and subsequent diagnosis were subjected to preclinical in vitro and in vivo studies to evaluate and compare their diagnostic properties. Among the studied compounds, the PSMA-T4 (Glu-CO-Lys-L-Trp-4-Amc-HYNIC) inhibitor showed the best biological properties for the diagnosis of PCa metastases. [99mTc]Tc-PSMA-T4 also showed effectiveness in single-photon emission computed tomography (SPECT) studies in humans, and soon, its usefulness will be extensively evaluated in phase 2/3 clinical trials.

Does the Number of Bifunctional Chelators Conjugated to a mAb Affect the Biological Activity of Its Radio-Labeled Counterpart? Discussion Using the Example of mAb against CD-20 Labeled with 90Y or 177Lu

There has been considerable interest in developing a monoclonal antibody (mAb) against-CD-20 (for example, Rituximab) modified by bifunctional chelating agents (BCA) for non-Hodgkin's lymphoma radioimmunotherapy. Therefore, many researchers have modified this monoclonal antibody by attaching different BCA moieties and evaluated their biological activities in terms of in vitro study and in vivo study in healthy and tumor xenografted rodents. This mini-perspective reviews the in vitro studies, the immunoreactivity and physiological distribution studies: organ-to-blood and the tumor-to-organ ratio of conjugates with different numbers of chelators per mAb. We set up a null hypothesis that states there is no statistical significance between the biological activity of monoclonal antibody (Rituximab) and the number of conjugated bifunctional chelators. Overall, we have concluded that there is no strong evidence for this hypothesis. However, the literature data should be questioned due to the potential lack of uniform study methodology.

Occurrence and Relevance of Mycoplasma spp. in Racing and Ornamental Pigeons in Poland

This report is one of the first studies describing the relationship between the occurrence of Mycoplasma spp. as regards the type of breed and health status of pigeons. The aim of the study was to evaluate the prevalence of Mycoplasma gallisepticum, Mycoplasma synoviae, Mycoplasma columbinum, Mycoplasma columborale, and Mycoplasma columbinasale in Polish populations of racing and ornamental pigeons in the context of their correlation with type of breed and health status. The study was conducted on 179 samples (100 racing and 79 ornamental pigeons) collected from pigeons in different regions of Poland. Tracheal swabs were examined for Mycoplasma spp. using genus-specific PCR. If Mycoplasma spp. were detected, the species were identified by species-specific PCR developed on the 16-23S rRNA intergenic spacer region. Ninety-two of 100 (92%) racing pigeons and 67 of 79 (85%) ornamental pigeons were Mycoplasma spp. positive. None of the tested pigeons were positive for M. gallisetpticum or M. synoviae. The average prevalence of M. columbinum was determined at 49%, M. columborale at 79%, and M. columbinasale at 23% in all birds tested. A single mycoplasma infection was found in 40% of pigeons whereas multiple infections were found in 49% of tested birds. Differences were found in the occurrence of mycoplasmas between racing and ornamental pigeons. Our results have shown a high prevalence of Mycoplasma species both as a single and as multiple infections.

Impact of DOTA-Chelators on the Antitumor Activity of 177Lu-DOTA-Rituximab Preparations in Lymphoma Tumor-Bearing Mice

Background: This work aimed to evaluate the influence of two chelators: DOTA(SCN) and DOTA(NHS) on radioimmunotherapy using ¹⁷⁷Lu-DOTA-Rituximab preparations in murine lymphoma xenograft models. Subsequently, based on animal data, the organ radiation-absorbed doses were extrapolated to humans (adult male). Materials and Methods: Therapeutic efficacy of ¹⁷⁷Lu-DOTA-Rituximab was evaluated in male nude mice bearing either Raji (B lymphocyte, CD20⁺) and Jurkat (T lymphocyte, CD20) xenografts, utilizing an anti-CD20 antibody-Rituximab conjugate with either DOTA(SCN) or DOTA(NHS). The DOTA-Rituximab conjugates were prepared in the form of freeze-dried kits. Results: All radioimmunoconjugates were obtained with high radiolabeling yield (radiochemical purity, RCP > 95%) and specific activity of ca. 0.5 GBq/mg. Therapeutic effects of ¹⁷⁷Lu-DOTA-Rituximab were observed in animals regardless whether DOTA(SCN) or DOTA(NHS) were used for conjugation. Importantly, therapy involving ¹⁷⁷Lu-DOTA-Rituximab was more effective than use of Rituximab alone. Conclusions: The degree of antitumor efficacy was dependent on the type of applied bifunctional chelators conjugated to mAb. However, this difference was not statistically significant. Dosimetry calculations showed that the absorbed radiation doses extrapolated to humans were very low for osteogenic cells regardless of the conjugates. Organs like the liver and spleen, treated with ¹⁷⁷Lu-DOTA(SCN)-Rituximab, showed similar radiation absorbed doses when compared with ¹⁷⁷Lu-DOTA(NHS)-Rituximab.

Impact of obesity and nitric oxide synthase gene G894T polymorphism on essential hypertension

Hypertension is a multifactorial disease caused by environmental, metabolic and genetic factors, but little is currently known on the complex interplay between these factors and blood pressure. The aim of the present study was to assess the potential impact of obesity, and angiotensin-converting enzyme (ACE) I/D polymorphism and endothelial nitric oxide synthase gene (NOS3) 4a/4b, G894T and -T786C variants on the essential hypertension. The study group consisted of 1,027 Caucasian adults of Polish nationality (45.5 ± 13.6 years old), of which 401 met the criteria for hypertension. Body weight, height and blood pressure were measured and data on self-reported smoking status were collected. Fasting blood glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides were determined by standard procedures. The ACE I/D polymorphism and three polymorphisms in NOS3 gene (4a/4b, G894T, -T786C) were detected by the PCR method. Multivariable logistic regression demonstrated that age above 45 years, diabetes, dyslipidemia, smoking and male sex are important risk factors for hypertension and no significant influence of variants in ACE and NOS3 genes on this risk was recognized. Obese subjects had a 3.27-times higher risk (OR = 3.27, 95% CI: 2.37 - 4.52) of hypertension than non-obese, and in obese the NOS3 894T allele was associated with 1.37 fold higher risk of hypertension (P = 0.031). The distribution of NOS3 G894T genotypes supported the co-dominant (OR = 1.35, P = 0.034, Pfit = 0.435) or recessive (OR = 2.00, P = 0.046, Pfit = 0.286), but not dominant model of inheritance (P = 0.100). The study indicates that in obese NOS3 G894T polymorphism may enhance hypertension risk. However, in the presence of such strong risk factors as age, diabetes and smoking, the impact of this genetic variant seems to be attenuated. Further studies are needed to reveal the usefulness of G894T polymorphism in hypertension risk assessment in obese.

Mindfulness-based cognitive therapy for adults with intellectual disabilities: an evaluation of the effectiveness of mindfulness in reducing symptoms of depression and anxiety

BACKGROUND

Mindfulness-based interventions have been shown to be effective in the treatment of a range of health and psychological disorders in adults and young people without intellectual disabilities (ID). Clinical studies are emerging reporting on the efficacy of mindfulness-based interventions as a stand-alone treatment for common clinical disorders in adults with ID.

METHOD

This paper aims to evaluate the efficacy of an innovative structured mindfulness-based cognitive therapy (MBCT) group programme adapted for adults with ID with a diagnosis of either recurrent depression, anxiety or both clinical conditions and a history of deliberate self-harm behaviour. Two groups ran consecutively consisting of a total of fifteen participants and seven carers. All participants were recorded as having either a borderline, mild, or moderate ID. The group programme ran over a period of 9 weeks with a follow-up session at 6 weeks post group intervention. Outcome measures included the Hospital Anxiety and Depression Scale and two sub-scales from the Self-Compassion Scale administered at baseline, post therapy and at 6-week follow-up.

RESULTS

The evaluation showed that participants reported an improvement in their experience of depression, anxiety, self-compassion and compassion for others. The most significant impact was in the reduced levels of anxiety reported. Improvements across all outcomes were maintained at 6-week follow-up.

CONCLUSION

The results of the evaluation suggest that people with intellectual disabilities benefit from a structured MBCT group intervention and the results are maintained at 6-week follow-up.

The influence of non-radioactive iodine (127I) on the outcome of radioiodine (131I) therapy in patients with Graves' disease and toxic nodular goitre

BACKGROUND

The aim of the study was to achieve an effective target dose in the thyroid by increasing the effective half-life (Teff) of (131)I by use of iodide ((127)I) two days after (131)I therapy in patients with hyperthyroidism with low Teff.

MATERIAL AND METHODS

The study was carried out in two groups. Group A - 41 patients, and Group B - 14 patients, all the patients were with hyperthyroidism with Teff less than 3 days qualified for (131)I therapy. Only group A patients received 600 μg of iodide a day for 3 days, two days after (131)I therapy. Radioiodine uptake (RAIU) after 24 and 48 hours, thyroid scintiscan and ultrasonography were done before and after 12 months of (131)I therapy.

RESULTS

In group A a significant increase was seen in the Teff (5 days on average) resulting in an increase in the energy target dose by 28% and 37%, in patients with Graves' disease (GD) and toxic nodular goitre (TNG), respectively. After one year of therapy 50% of GD and 93% of TNG patients achieved euthyroidism; 28% of GD and 3% of TNG patients were in hypothyroidism. In Group B, all the patients had radioiodine treatment failure and received a second therapeutic dose of (131)I.

CONCLUSIONS

Administration of (127)I after (131)I treatment can lead to an increase in its effective half-life. This will also increase the absorbed energy dose in thyroid tissue, thereby improving therapeutic outcome without administration of a higher or second dose of (131)I. This may minimize whole-body exposure to radiation and reduces the cost of treatment.

Chromosomal alterations in mini organ cultures of human oropharyngeal mucosa cells caused by hydrogen peroxide

BACKGROUND

Oxidative stress is a known exogenous risk factor for carcinogenesis in the head and neck. In addition to exogenous risk factors, the development of head and neck cancer is based on genetic alterations and individual mutagen sensitivity. DNA damage caused by reactive oxygen species (ROS) is not uniformly distributed over the DNA, as certain chromosomes and genes are more likely to be damaged than others. The ability to repair damaged DNA sufficiently is a necessity in order to prevent carcinogenesis. The DNA-damaging effect of ROS, the specific sites of chromosomal changes and DNA repair in those regions require further investigation.

MATERIALS AND METHODS

In order to evaluate DNA damage in macroscopically healthy mucosal tissue of 37 patients with (15) and without cancer (22) of the oropharynx, four different chromosomes (chromosomes 3, 5, 8 and 11) involved in carcinogenesis of the oropharynx were examined. After incubation with H(2)O(2), comet FISH was applied to assess DNA damage of these chromosomes. The extent of DNA repair was evaluated in the same samples after a 24-hour repair period.

RESULTS

H(2)O(2) caused significant DNA damage in oropharyngeal mucosal cells of patients with and without carcinoma. DNA fragmentation of all chromosomes investigated in the two groups was comparable. No differences were observed between mutagen sensitivity of patients suffering from cancer of the oropharynx and those without malignancy for any of the observed chromosomes. On the other hand, chromosomal DNA damage of these specific chromosomes was significantly higher than the average DNA fragmentation of the entire DNA in both groups. DNA repair led to a significant decrease in DNA damage in all groups. Controls tend to have a better DNA repair in all of the analysed chromosomes. However, these differences were not significant.

CONCLUSION

The increased chromosomal DNA fragmentation in comparison to that of the entire DNA indicates the contribution of the investigated chromosomes to carcinogenesis in the oropharynx. DNA repair in those chromosomes might play a role in carcinogenesis of the oropharynx, but further investigations are warranted.

Translocation form of Wolf-Hirschhorn syndrome --assessment of recurrence rate probability

PURPOSE

The families experienced by occurrence of child with Wolf-Hirschhorn syndrome (WHS: OMIM # 194190) and by other unfavourable pregnancy outcomes (miscarriages or stillbirths/early deaths and partial trisomy 4p imbalance leading to intellectual disability in live born progeny) are asking for genetic counseling. In order to obtain the recurrence probability rates for the particular forms of unfavourable pregnancy we collected the empirical data and evaluated pedigrees of reciprocal chromosome translocations (RCT) carriers involving 4p. Results were applied to family of carrier of t(4;11)(p16.1;q23.3) ascertained by four miscarriages, in which latter the girl with WHS was born.

MATERIAL AND METHODS

Total empirical data about 170 pregnancies of 46 carriers were collected from 25 pedigrees RCT at risk for single segment imbalance. Classification was based mostly on cytogenetic methods. The probability rates of particular type of pathology related to total number of pregnancies after ascertainment correction have been calculated according to the method of Stengel-Rutkowski and Stene.

RESULTS

The risk figures for unbalanced offspring after 2:2 disjunction and adjacent-1 segregation for whole group of pedigrees were calculated as 15.2 +/- 3.5% (16/105), for unbalanced fetuses at second trimester of prenatal diagnosis as 50 +/- 13.4% (7/14), for miscarriages about 19 +/- 3.8% (20/105) and for stillbirths/early death as 15.2 +/- 3.5% (16/105). The higher probability rate for RCT carriers at risk for distal 4p--shorter segment imbalance (28.6 +/- 12%, 4/14) in comparison to the rate for proximal (medium) one as 15.4 +/- 4.5% (10/65) and to more proximal (longer) one as 7.7 +/- 5.2% (2/26) were found.

CONCLUSIONS

Our results confirm that the recurrence probability rates are different for particular categories of unfavourable pregnancy outcomes and dependent on size and genetic content of unbalanced 4p segments.

Partial trisomy of long arm of chromosome 4 as a result of dir dup (4)(q27q31.3) de novo

The phenotype of a girl at age of 12 years with a partial trisomy 4q caused by unique direct duplication 4q27 --> q31.3 included the thick, broad and straight eyebrows, upward slanting palpebral fissures, a deep-set eyes, narrow bridge and long back of the nose, flattened philtrum columns, narrow of vermilion borders of both upper and lower lips, protrusion of maxillary alveolar processus and anterior teeth together with shortened and posteriorly situated mandible, malocclusion corresponding with II class of Angle and long fingers, narrowing towards distal phalanges has been described. Further investigations are needed to delineate the clinical spectrum of features essential for partial trisomy 4q.

Inverse Potassium Hydride: A Theoretical Study

Results of an experimental study on the unusual "inverse" charge state (H(+)Na(-)) in salts where the H(+) ion is sequestered, combined with our earlier theoretical calculations on an unsequestered model compound (Me(3)N-H(+)...Na(-)), prompted us to further investigate such systems. In particular, we examined Et(3)N-H(+)...K(-) because considerations of the proton affinity of the amine and of the metal-hydride bond strength suggested that this ion-pair complex might be more stable to proton abstraction than was Me(3)N-H(+)...Na(-). In the present work, the ground-state potential energy surface of the Et(3)N-H(+)...K(-) ion pair was examined using second-order Møller-Plesset perturbation theory and 6-311++G basis sets. We found Et(3)N-H(+)...K(-) to be metastable to dissociation with a barrier of 8 kcal mol(-1) (computed at the CCSD(T) level of theory). This barrier indeed is substantially larger than that found earlier for (Me(3)N-H(+)...Na(-)) and suggests that unsequestered inverse-charged H(+)M(-) ion-pair salts may offer a reasonable route to creating high-energy materials if a means for synthesizing them in the laboratory can be designed.

[Nephrology of love]

The article presents different aspects of the connection between human heart and kidneys. This connection is evident in the symbolism of the Old Testament of the Bible, organ donation as the manifestation of the love of our neighbor, endocrinological and sexual dysfunction, and finally in searching for biological determinants of finer feelings. In the Old Testament tradition kidneys were thought to be human spirit's dwelling. Moreover, the simultaneous studying of kidneys and heart meant profound understanding of the matter. Nowadays, it is also possible to find the Biblical love of our neighbor, for instance among kidney donors. What is more, every nephrologist should treat his patients with love and dedication, which makes it easier for him to understand their problems, especially these concerning sexual dysfunction. Sexual dysfunction occurs among men and women equally and specialists, apart from using many different methods, have to deal with the consequences of renal failure mainly by means of transplantation.

Coulomb-Assisted Dissociative Electron Attachment: Application to a Model Peptide

The fragmentation of positively charged gas-phase samples of peptides is used to infer the primary structure of such molecules. In electron capture dissociation (ECD) experiments, very low-energy electrons attach to the sample and rupture bonds to effect the fragmentation. It turns out that ECD fragmentation tends to produce cleavage of very specific types of bonds. In earlier works by this group, it has been suggested that the presence of positive charges produces stabilizing Coulomb potentials that allow low-energy electrons to exothermically attach to sigma orbitals of certain bonds and thus to cleave those bonds. In the present effort, the stabilizing effects of Coulomb potentials due to proximal positive charges are examined for a small model peptide molecule that contains a wide range of bond types. Direct attachment of an electron to the sigma orbitals of eight different bonds as well as indirect sigma bond cleavage, in which an electron first binds to a carbonyl C=O pi orbital, are examined using ab initio methods. It is found that direct attachment to and subsequent cleavage of any of the eight sigma bonds is not likely except for highly positively charged samples. It is also found that attachment to a C=O pi orbital followed by cleavage of the nitrogen-to-alpha-carbon bond is the most likely outcome. Interestingly, this bond cleavage is the one that is seen most commonly in ECD experiments. So, the results presented here seem to offer good insight into one aspect of the ECD process, and they provide a means by which one can estimate (on the basis of a simple Coulomb energy formula) which bonds may be susceptible to cleavage by low-energy electron attachment.

Inverse sodium hydride: a theoretical study

A recent experimental investigation in which a salt containing the unusual charge distribution H(+) and Na(-) was synthesized and characterized prompted us to undertake an ab initio theoretical investigation. In the salt synthesized, the H(+) is bound to the nitrogen center of an amine and the Na(-) alkalide is "blocked" from approaching the protonated amine site by steric constraints of a cage structure. Although one expects that the Na(-) would deprotonate an unprotected R(3)N-H(+) cation, we decided to further explore this issue. Using extended atomic orbital basis sets and Møller-Plesset and coupled-cluster treatments of electron correlation, we examined the relative stabilities of the prototype (Me)(3)N + NaH, (Me)(3)N + Na(+) + H(-), (Me)(3)N-H(+) + Na(-), and (Me)(3)N-Na(+) + H(-) as well as the ion pair complexes (Me)(3)N-H(+).Na(-) and (Me)(3)N-Na(+).H(-). The primary focus of this effort was to determine whether the high-energy (Me)(3)N-H(+).Na(-) ion pair, which is the analogue of what the earlier workers termed "inverse sodium hydride", might be stable with respect to proton abstraction under any reasonable solvation conditions (which we treated within the polarized continuum model). Indeed, we find that such ion pairs are metastable (i.e., locally geometrically stable with a barrier to dissociation) for solvents having dielectric constants below approximately 2 but spontaneously decompose into their constituent ions for solvents with higher dielectric constants. We suggest that amines with large proton affinities and/or metals with weaker MH bond strengths should be explored experimentally.

[Pedigree analysis of childless families of reciprocal chromosome translocation carriers]

OBJECTIVES

Pedigree analysis of childless families of unique reciprocal chromosome translocation (RCT) carriers may be useful for clinical prognosis and genetic counselling.

MATERIAL AND METHODS

The group 13 childless families of RCT carriers were detected. Cytogenetic analysis of RCT was performed on blood samples using GTG and RBG banding technique.

RESULTS

Thirteen pedigrees were constructed on basis of 64 cytogenetic results and anamnestic data of 62 spontaneous abortions and 7 stillbirths. Familial RCT were found in ten families. In addition fourteen relatives of the RCT carriers have had healthy children. Further observations showed other three healthy children among progeny of eight families. Low risk for unbalanced progeny at birth were estimate in most families.

CONCLUSION

Childless families of RCT carriers have possibility to have healthy offsprings. Spontaneous abortions are result of RCT carrierstrip.

[Familial complex chromosome translocation of t(1;4;10)(q21.3;q27;q26.1) verified by FISH]

The inheritance complex chromosome translocation is a rare. A familial complex chromosome rearrangement t(1;4;10)(q21.3;q27;q26.1) involving three chromosomes ascertained due to four spontaneous abortions in phenotypically normal childless woman there is presented. Cytogenetic analysis according to classic banding techniques were verified by fluorescent in situ hybridization (FISH) technique.

[Familial translocation t (9;16) in a patient with irregular menstrual cycles]

In this report we present a family with identified carriers of unique reciprocal translocation t (9; 16) (q31; q13) detected through karyotyping of the patient with irregularity of menstrual cycles. Genetic risk for birth of a child with congenital anomalies was estimated as low (0.6%). However, risk for abortion was high. We suggest introducing cytogenetic studies in such cases.

Familial occurrence of isodicentric X chromosomes with different breakpoints

We report two cases of an idic (X) chromosome found in relatives with Turner's syndrome. A 21-year-old female revealed a non-mosaic form of X isochromosome of the long arms with two C-band regions, i.e. dic(X)(qter----cen----p11::p11----cen----qter). Her 46-year-old aunt with Turner's syndrome had an X chromosome with long arm breakpoints at site q21 and chromosomal mosaicism, i.e. 45,X/46,X, dic(X)(pter----q21::q21----pter)(78/22). The relative rarity of reports about familial Turner's syndrome with structural abnormality may suggest a coincidence. However, it is difficult to exclude familial predisposition to X isochromosome formation in this family.

XYY syndrome and acute myeloblastic leukemia

A 69-year-old man with hypogonadism was found to have a 47,XYY karyotype. Clinical and laboratory data revealed acute nonlymphocytic leukemia (ANLL) of the M2 type. The association between the XYY and ANLL-M2 is most likely accidental coincidence.