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Alan HY, ALMisned G, Yilmaz A, Susam LA, Ilik E, Kilic G, Ozturk G, Tuysuz B, Akkus B, Tekin HO. An investigation on protection properties of Tantalum (V) oxide reinforced glass screens on unexposed breast tissue for mammography examinations. Radiography (Lond) 2024; 30:282-287. [PMID: 38041916 DOI: 10.1016/j.radi.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 12/04/2023]
Abstract
INTRODUCTION The utilization of radiation shielding material positioned between the both breasts are crucial for the reduction of glandular dose and the safeguarding of the contralateral breast during mammographic procedures. This study proposes an alternative substance for shielding the contralateral breast from radiation exposure during mammography screening. METHODS In this study, we present an analysis of the shielding effectiveness of transparent glass that has been doped with Tantalum (V) oxide encoded as BTZT6. The evaluation of this shielding material was conducted using the MCNPX code, specifically for the ipsilateral and contralateral breasts. The design of the left and right breast phantoms involved the creation of three-layer heterogeneous breast phantoms, consisting of varying proportions of glandular tissue (25%, 50%, and 75%). The design of BTZT6 and lead-acrylic shielding screens is implemented using the MCNPX code. The comparative analysis of dose outcomes is conducted to assess the protective efficacy of BTZT6 and lead-acrylic shielding screens. RESULTS The utilization of BTZT6 shielding material resulted in a reduction in both breast dose and skin dose exposure when compared to the lead-acrylic shield. CONCLUSION Based on the findings acquired, the utilization of BTZT6 shielding material screens during mammography procedures involving X-rays with energy levels ranging from 26 to 30 keV is associated with a decrease in radiation dose. IMPLICATIONS FOR PRACTICE It can be inferred that the utilization of BTZT6 demonstrates potential efficacy in mitigating excessive radiation exposure to the breasts and facilitating the quantification of glandular doses in mammography procedures.
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Affiliation(s)
- H Y Alan
- Institute of Nuclear Sciences, Ankara University, 06100, Ankara, Türkey
| | - G ALMisned
- Department of Physics, College of Science, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - A Yilmaz
- Department of Physics, Faculty of Science, Istanbul University, 34134, Istanbul, Türkey
| | - L A Susam
- Department of Physics, Faculty of Science, Istanbul University, 34134, Istanbul, Türkey
| | - E Ilik
- Eskisehir Osmangazi University, Faculty of Science, Department of Physics, TR-26040 Eskisehir, Türkey
| | - G Kilic
- Eskisehir Osmangazi University, Faculty of Science, Department of Physics, TR-26040 Eskisehir, Türkey
| | - G Ozturk
- Department of Physics, Faculty of Science, Istanbul University, 34134, Istanbul, Türkey
| | - B Tuysuz
- Department of Physics, Faculty of Science, Istanbul University, 34134, Istanbul, Türkey
| | - B Akkus
- Department of Physics, Faculty of Science, Istanbul University, 34134, Istanbul, Türkey
| | - H O Tekin
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, 27272, Sharjah, United Arab Emirates; Istinye University, Faculty of Engineering and Natural Sciences, Computer Engineering Department, Istanbul 34396, Türkey.
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Ozkinay F, Emecen DA, Kose M, Isik E, Bozaci AE, Canda E, Tuysuz B, Zubarioglu T, Atik T, Onay H. Clinical and genetic features of 13 patients with mucopolysaccarhidosis type IIIB: Description of two novel NAGLU gene mutations. Mol Genet Metab Rep 2021; 27:100732. [PMID: 33747789 PMCID: PMC7966861 DOI: 10.1016/j.ymgmr.2021.100732] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 11/25/2022] Open
Abstract
Aim Mucopolysaccharidosis type III B (MPS IIIB) is an autosomal recessive lysosomal storage disease caused by mutations in the NAGLU gene which codes the lysosomal enzyme alpha-N-acetylglucosaminidase. The major symptoms of the disease are cognitive and neurological defects. In this study, the molecular spectrums of 13 MPS IIIB patients were evaluated. Material and methods Thirteen MPS IIIB patients from 11 families were included in this study. All patients were both clinically and molecularly diagnosed. NAGLU gene sequencing was performed using a next generation sequencing platform (Illumina MiSeq). Demographic, clinical and laboratory findings of the patients were obtained via the hospital records. Results Ten different mutations from the 13 MPS IIIB patients were identified. Eight of the 10 mutations were missense, one was splice site, and one large deletion was also observed. Two mutations c.509G>T (p.Gly170Val) and c.700C>G (p.Arg234Gly) have been defined for the first time in this study. Conclusion Our study expanded the mutation spectrum of the NAGLU gene thereby contributing to the improved genetic counselling of MPS IIIB patients. Confirming the literature, missense mutations were also found to be the most common NAGLU mutations in our study.
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Affiliation(s)
- F Ozkinay
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - D A Emecen
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - M Kose
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - E Isik
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - A E Bozaci
- Subdivision of Pediatric Metabolism, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - E Canda
- Subdivision of Pediatric Metabolism, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - B Tuysuz
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Cerrahpasa University, Izmir, Turkey
| | - T Zubarioglu
- Subdivision of Pediatric Metabolism, Department of Pediatrics, Faculty of Medicine, Cerrahpasa University, Izmir, Turkey
| | - T Atik
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - H Onay
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, Turkey
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Ranza E, Huber C, Levin N, Baujat G, Bole-Feysot C, Nitschke P, Masson C, Alanay Y, Al-Gazali L, Bitoun P, Boute O, Campeau P, Coubes C, McEntagart M, Elcioglu N, Faivre L, Gezdirici A, Johnson D, Mihci E, Nur BG, Perrin L, Quelin C, Terhal P, Tuysuz B, Cormier-Daire V. Chondrodysplasia with multiple dislocations: comprehensive study of a series of 30 cases. Clin Genet 2017; 91:868-880. [PMID: 28229453 DOI: 10.1111/cge.12885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 10/05/2016] [Accepted: 10/08/2016] [Indexed: 11/28/2022]
Abstract
The group of chondrodysplasia with multiple dislocations includes several entities, characterized by short stature, dislocation of large joints, hand and/or vertebral anomalies. Other features, such as epiphyseal or metaphyseal changes, cleft palate, intellectual disability are also often part of the phenotype. In addition, several conditions with overlapping features are related to this group and broaden the spectrum. The majority of these disorders have been linked to pathogenic variants in genes encoding proteins implicated in the synthesis or sulfation of proteoglycans (PG). In a series of 30 patients with multiple dislocations, we have performed exome sequencing and subsequent targeted analysis of 15 genes, implicated in chondrodysplasia with multiple dislocations, and related conditions. We have identified causative pathogenic variants in 60% of patients (18/30); when a clinical diagnosis was suspected, this was molecularly confirmed in 53% of cases. Forty percent of patients remain without molecular etiology. Pathogenic variants in genes implicated in PG synthesis are of major importance in chondrodysplasia with multiple dislocations and related conditions. The combination of hand features, growth failure severity, radiological aspects of long bones and of vertebrae allowed discrimination among the different conditions. We propose key diagnostic clues to the clinician.
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Affiliation(s)
- E Ranza
- Department of Genetics, INSERM UMR1163, Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Hôpital Necker Enfants Malades (AP-HP), Paris, France.,Service of Genetic Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - C Huber
- Department of Genetics, INSERM UMR1163, Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Hôpital Necker Enfants Malades (AP-HP), Paris, France
| | - N Levin
- Department of Genetics, INSERM UMR1163, Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Hôpital Necker Enfants Malades (AP-HP), Paris, France
| | - G Baujat
- Department of Genetics, INSERM UMR1163, Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Hôpital Necker Enfants Malades (AP-HP), Paris, France
| | - C Bole-Feysot
- Plateforme de génomique, Fondation IMAGINE, Paris, France
| | - P Nitschke
- Plateforme de Bioinformatique, Université Paris Descartes, Paris, France
| | - C Masson
- Plateforme de Bioinformatique, Université Paris Descartes, Paris, France
| | - Y Alanay
- School of Medicine, Department of Pediatrics, Pediatric Genetics Unit, Acibadem University, Istanbul, Turkey
| | - L Al-Gazali
- Department of Pediatrics, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
| | - P Bitoun
- Génétique Médicale, Hôpital Jean Verdier, Bondy, France
| | - O Boute
- Génétique Clinique, Hôpital Jeanne de Flandre, Lille, France
| | - P Campeau
- Division of Medical genetics, Department of Pediatrics, CHU Sainte Justine and University of Montreal, Montreal, Quebec, Canada
| | - C Coubes
- Département de Génétique Médicale, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - M McEntagart
- Medical Genetics, St George's Healthcare NHS Trust, London, UK
| | - N Elcioglu
- Department of Pediatric Genetics, Marmara University Medical School, Istanbul, Turkey
| | - L Faivre
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs et FHU TRANSLAD, CHU de Dijon et Université de Bourgogne, Dijon, France
| | - A Gezdirici
- Department of Medical Genetics, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - D Johnson
- Sheffield Clinical Genetics Service, Sheffield Children's Hospital, Sheffield, UK
| | - E Mihci
- Akdeniz University School of Medicine, Division of Pediatric Genetics, Antalya, Turkey
| | - B G Nur
- Akdeniz University School of Medicine, Division of Pediatric Genetics, Antalya, Turkey
| | - L Perrin
- Unité de Génétique Clinique, Hopital Robert Debré, Paris, France
| | - C Quelin
- Génétique Médicale, Hôpital Sud, Rennes, France
| | - P Terhal
- University Medical Center, Wilhelmina Childrens Hospital, Utrecht, the Netherlands
| | - B Tuysuz
- Cerrahpasa Medical Faculty, Department of Pediatric Genetics, Istanbul University, Istanbul, Turkey
| | - V Cormier-Daire
- Department of Genetics, INSERM UMR1163, Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Hôpital Necker Enfants Malades (AP-HP), Paris, France
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Bachmann-Gagescu R, Dempsey JC, Phelps IG, O'Roak BJ, Knutzen DM, Rue TC, Ishak GE, Isabella CR, Gorden N, Adkins J, Boyle EA, de Lacy N, O'Day D, Alswaid A, Ramadevi A R, Lingappa L, Lourenço C, Martorell L, Garcia-Cazorla À, Ozyürek H, Haliloğlu G, Tuysuz B, Topçu M, Chance P, Parisi MA, Glass IA, Shendure J, Doherty D. Joubert syndrome: a model for untangling recessive disorders with extreme genetic heterogeneity. J Med Genet 2015; 52:514-22. [PMID: 26092869 PMCID: PMC5082428 DOI: 10.1136/jmedgenet-2015-103087] [Citation(s) in RCA: 190] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 06/01/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND Joubert syndrome (JS) is a recessive neurodevelopmental disorder characterised by hypotonia, ataxia, cognitive impairment, abnormal eye movements, respiratory control disturbances and a distinctive mid-hindbrain malformation. JS demonstrates substantial phenotypic variability and genetic heterogeneity. This study provides a comprehensive view of the current genetic basis, phenotypic range and gene-phenotype associations in JS. METHODS We sequenced 27 JS-associated genes in 440 affected individuals (375 families) from a cohort of 532 individuals (440 families) with JS, using molecular inversion probe-based targeted capture and next-generation sequencing. Variant pathogenicity was defined using the Combined Annotation Dependent Depletion algorithm with an optimised score cut-off. RESULTS We identified presumed causal variants in 62% of pedigrees, including the first B9D2 mutations associated with JS. 253 different mutations in 23 genes highlight the extreme genetic heterogeneity of JS. Phenotypic analysis revealed that only 34% of individuals have a 'pure JS' phenotype. Retinal disease is present in 30% of individuals, renal disease in 25%, coloboma in 17%, polydactyly in 15%, liver fibrosis in 14% and encephalocele in 8%. Loss of CEP290 function is associated with retinal dystrophy, while loss of TMEM67 function is associated with liver fibrosis and coloboma, but we observe no clear-cut distinction between JS subtypes. CONCLUSIONS This work illustrates how combining advanced sequencing techniques with phenotypic data addresses extreme genetic heterogeneity to provide diagnostic and carrier testing, guide medical monitoring for progressive complications, facilitate interpretation of genome-wide sequencing results in individuals with a variety of phenotypes and enable gene-specific treatments in the future.
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Affiliation(s)
- R Bachmann-Gagescu
- Institute for Molecular Life Sciences and Institute of Medical Genetics, University of Zurich, Zurich, Switzerland
| | - J C Dempsey
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - I G Phelps
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - B J O'Roak
- Molecular and Medical Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - D M Knutzen
- Department of Oncology, Franciscan Health System, Tacoma, Washington, USA
| | - T C Rue
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - G E Ishak
- Department of Radiology, University of Washington, Seattle Children's Hospital, Seattle, Washington, USA
| | - C R Isabella
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - N Gorden
- Department of Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - J Adkins
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - E A Boyle
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - N de Lacy
- Department of Psychiatry, University of Washington, Seattle, Washington, USA
| | - D O'Day
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - A Alswaid
- Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | | | - L Lingappa
- Department of Child Neurology, Rainbow Children Hospital, Hyderabad, India
| | - C Lourenço
- Department of Neurosciences and Behavior Neurosciences, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - L Martorell
- Department of Genetica Molecular, Hospital Sant Joan de Deu, Barcelona, Spain
| | - À Garcia-Cazorla
- Department of Neurology, Neurometabolic Unit, Hospital Sant Joan de Déu and CIBERER, ISCIII, Barcelona, Spain
| | - H Ozyürek
- Department of Pediatric Neurology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - G Haliloğlu
- Department of Pediatric Neurology, Hacettepe University Children's Hospital, Ankara, Turkey
| | - B Tuysuz
- Department of Pediatric Genetics, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
| | - M Topçu
- Department of Pediatric Neurology, Hacettepe University Children's Hospital, Ankara, Turkey
| | - P Chance
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - M A Parisi
- National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA
| | - I A Glass
- Department of Pediatrics, University of Washington, Seattle, Washington, USA Seattle Children's Research Institute, Seattle, Washington, USA
| | - J Shendure
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - D Doherty
- Department of Pediatrics, University of Washington, Seattle, Washington, USA Seattle Children's Research Institute, Seattle, Washington, USA
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Tuysuz B, Yavuz A, Ozdil M, Caferler J, Ozon H. Atypical Down syndrome phenotype in a girl with 21;21 translocation trisomy. Genet Couns 2010; 21:61-67. [PMID: 20420031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We describe a girl with microcephaly, short stature, coarse face, severe growth and developmental delay, seizures, hypertonia, bilateral flexion contractures of the knees, and a de novo 21;21 translocation trisomy 21 in peripheral blood lymphocytes. Fluorescence in situ hybridization (FISH) analysis confirmed the trisomy 21 translocation using whole chromosome painting probe 21 (WCP21). Chromosome analysis which was also performed on skin fibroblasts and revealed mosaicism for a translocation trisomy 21 cell line (22.3%) as well as a second cell line consisting of one normal chromosome 21 and a small ring chromosome 21 derived from the translocation 21q21q (61%) and a third line consisting of monosomy 21 (16.7%). FISH analyses by LS121 probe for the critical (21q22.2-22.3) region of Down syndrome (DS) on interphase blood cells resulted with 30% two signals and 70% three signals, skin fibroblasts showed 84% single signal, 9% two signals and 7% three signals. The size of ring chromosome 21 in skin fibroblasts was very small and probably there was a large, more proximally located deletion including chromosome 21q22 band. We consider that the atypical DS phenotype of the patient originated from the small ring chromosome 21 and the monosomy 21 in the skin fibroblasts and other tissues not available for analysis. Therefore, the clinical findings of the patient were most similar to monosomy 21 mosaicism syndrome.
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Affiliation(s)
- B Tuysuz
- Division of Genetics, Department of Pediatrics, Istanbul University, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
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Basaran SY, Sensoy V, Kiroglu K, Messiaen L, Tuysuz B. Coexistence of neurofibromatosis type 1 and mosaic trisomy 8 in the same patient. Genet Couns 2010; 21:307-316. [PMID: 20964122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We described trisomy 8 mosaicism in a 6-month-old boy with left corneal leukoma, strabismus, posterior urethral valve, tibial bowing and congenital pseudarthrosis of the tibia (CPT) on graphic of left tibia. The patient also had some minor anomalies such as short philtrum, full everted lower lip, microretrognathia, flexion contracture on his left thumb, deep palmar and plantar creases and three cafe-au-lait macules (CALM) larger than 1 cm on the abdomen. Peripheral blood karyotype analysis of the patient showed 46,XY(10%)/47,XY,+8 (90%)). Mosaic trisomy 8 is a rare syndrome characterized by renal, cardiac, ophthalmologic anomalies, dysmorphic facial features and some skeletal manifestations. When re-evaluated at 2 years of age, his gross motor development was delayed and he also had 12 CALM larger than 1 cm, hence the patient fulfilled NIH diagnostic criteria for Neurofibromatosis type 1 (NF 1) based on the CALM and CPT. A truncating mutation was found through comprehensive NF1 mutation analysis, i.e., c.1019_1020delCT (p.Ser340CysfsX12). Here we report a patient with both mosaic trisomy 8 and NF1, which was not described previously.
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Affiliation(s)
- S Y Basaran
- Department of Medical Genetics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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Tuysuz B, Mizumoto S, Sugahara K, Celebi A, Mundlos S, Turkmen S. Omani-type spondyloepiphyseal dysplasia with cardiac involvement caused by a missense mutation in CHST3. Clin Genet 2009; 75:375-83. [PMID: 19320654 DOI: 10.1111/j.1399-0004.2009.01167.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
We describe a family with progressive skeletal dysplasia and severe spinal involvement, short stature, premature arthrosis and joint contractures diagnosed as spondyloepiphyseal dysplasia Omani type. Mutation analysis in CHST3, the gene encoding for the chondroitin 6-O-sulfotransferase-1 (C6ST-1), revealed a homozygous missense mutation (T141M) in exon 3 in all three affected members of the family. Using recombinant C6ST-1, we showed that the identified missense mutation results in a reduction of C6ST-1 activity to 24-29% of the wild type protein. In addition to the previously noted skeletal features, affected members of this family also had cardiac involvement including mitral, tricuspid and/or aortic regurgitations and type E brachydactyly.
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Affiliation(s)
- B Tuysuz
- Department of Pediatric Genetics, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.
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Schulz AL, Albrecht B, Arici C, van der Burgt I, Buske A, Gillessen-Kaesbach G, Heller R, Horn D, Hübner CA, Korenke GC, König R, Kress W, Krüger G, Meinecke P, Mücke J, Plecko B, Rossier E, Schinzel A, Schulze A, Seemanova E, Seidel H, Spranger S, Tuysuz B, Uhrig S, Wieczorek D, Kutsche K, Zenker M. Mutation and phenotypic spectrum in patients with cardio-facio-cutaneous and Costello syndrome. Clin Genet 2007; 73:62-70. [PMID: 18042262 DOI: 10.1111/j.1399-0004.2007.00931.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cardio-facio-cutaneous (CFC) and Costello syndrome (CS) are congenital disorders with a significant clinical overlap. The recent discovery of heterozygous mutations in genes encoding components of the RAS-RAF-MAPK pathway in both CFC and CS suggested a similar underlying pathogenesis of these two disorders. While CFC is heterogeneous with mutations in BRAF, MAP2K1, MAP2K2 and KRAS, HRAS alterations are almost exclusively associated with CS. We carried out a comprehensive mutation analysis in 51 CFC-affected patients and 31 individuals with CS. Twelve different BRAF alterations were found in twenty-four patients with CFC (47.0%), two MAP2K1 mutations in five (9.8%) and two MAP2K2 sequence variations in three CFC-affected individuals (5.9%), whereas three patients had a KRAS alteration (5.9%). We identified four different missense mutations of HRAS in twenty-eight cases with CS (90.3%), while KRAS mutations were detected in two infants with a phenotype meeting criteria for CS (6.5%). In 14 informative families, we traced the parental origin of HRAS alterations and demonstrated inheritance of the mutated allele exclusively from the father, further confirming a paternal bias in the parental origin of HRAS mutations in CS. Careful clinical evaluation of patients with BRAF and MAP2K1/2 alterations revealed the presence of slight phenotypic differences regarding craniofacial features in MAP2K1- and MAP2K2-mutation positive individuals, suggesting possible genotype-phenotype correlations.
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Affiliation(s)
- A L Schulz
- Institut für Humangenetik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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9
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Affiliation(s)
- M Haktan
- Department of Pediatrics, Cerrahpasa, Turkey
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