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Hoffman E, Dang U, Clemens P, Gordish-Dressman H, Schwartz B, Mengle-Gaw L, Leinonen M, Smith E, Castro D, Kuntz N, Finkel R, Tulinius M, Nevo Y, Ryan M, Webster R, van den Anker J, Ward L, Damsker J, McDonald C, Guglieri M, Mah J. CLINICAL TRIAL HIGHLIGHTS. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ben-Yaacov A, Laks S, Goldenshluger M, Nevo Y, Mor E, Schtrechman G, Margalit O, Boursi B, Shacham-Shmueli E, Halpern N, Purim O, Hazzan D, Segev L, Zippel D, Adileh M, Nissan A. Impact of "critical lesions" on outcomes following cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy. Eur J Surg Oncol 2021; 47:2933-2938. [PMID: 34088586 DOI: 10.1016/j.ejso.2021.05.022] [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: 03/17/2021] [Revised: 04/19/2021] [Accepted: 05/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Peritoneal Cancer Index (PCI) and complete cytoreduction are the best outcome predictors following cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). Lesions in critical areas, regardless of PCI, complicate surgery and impact oncological outcomes. We prospectively defined "Critical lesions" (CL) as penetrating the hepatic hilum, diaphragm at hepatic outflow, major blood vessels, pancreas, or urinary tract. METHODS Retrospective analysis of a prospective database of 352 CRS + HIPEC patients from 2015 to 2019. Excluded patients with aborted/redo operation (n = 112), or incomplete data (n = 19). Patients categorized by CL status and compared: operative time, estimated blood loss (EBL), PCI, transfusions, hospital stay, post-operative complications and mortality, overall survival (OS) and disease-free survival (DFS). RESULTS Included 221 patients (78 CL; 143 no-CL). No difference in patients' characteristics: age, BMI, gender or co-morbidities noted. Operative time longer (5.3 h vs 4.3 h, p < 0.01), EBL higher (769 ml vs 405 ml, p < 0.01), transfusions higher (1.9 vs 0.7 Units, p < 0.001) and PCI higher (15.5 vs 9.5, p < 0.01) in CL. No difference in major complications. Postoperative complications, CL, OR-time and transfusions were predictive of OS in univariate analysis, while only complications remained on multivariate analysis. Median follow up of 21.4 months, 3-year DFS/OS was 22% vs 30% (p < 0.037) and 73% vs 87% (p < 0.014) in CL and non-CL, respectively. Despite CL complete resection, 17/38 patients (44.7%) that recurred had recurrence at previous CL site. CONCLUSIONS Critical lesions complicate surgery and may be associated with poor oncological outcomes with high local recurrence rate, despite no significant difference in complications. Utilizing adjuvant or intra-operative radiation may be beneficial.
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Affiliation(s)
- A Ben-Yaacov
- Department of General and Oncological Surgery- Surgery C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Israel.
| | - S Laks
- Department of General and Oncological Surgery- Surgery C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Israel
| | - M Goldenshluger
- Department of General and Oncological Surgery- Surgery C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Israel
| | - Y Nevo
- Department of General and Oncological Surgery- Surgery C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Israel
| | - E Mor
- Department of General and Oncological Surgery- Surgery C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Israel
| | - G Schtrechman
- Department of General and Oncological Surgery- Surgery C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Israel
| | - O Margalit
- Sackler School of Medicine, Tel-Aviv University, Israel; Gastrointestinal Malignancies Unit at the Institution of Oncology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - B Boursi
- Sackler School of Medicine, Tel-Aviv University, Israel; Gastrointestinal Malignancies Unit at the Institution of Oncology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - E Shacham-Shmueli
- Sackler School of Medicine, Tel-Aviv University, Israel; Gastrointestinal Malignancies Unit at the Institution of Oncology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - N Halpern
- Sackler School of Medicine, Tel-Aviv University, Israel; Gastrointestinal Malignancies Unit at the Institution of Oncology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - O Purim
- Gastrointestinal Malignancy Service at Assuta Samson Hospital, Ashdod, Israel
| | - D Hazzan
- Department of General and Oncological Surgery- Surgery C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Israel
| | - L Segev
- Department of General and Oncological Surgery- Surgery C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Israel
| | - D Zippel
- Department of General and Oncological Surgery- Surgery C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Israel
| | - M Adileh
- Department of General and Oncological Surgery- Surgery C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Israel
| | - A Nissan
- Department of General and Oncological Surgery- Surgery C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Israel
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Kuzminsky A, Nevo Y, Aharoni S, Rabie M. MYASTHENIA & RELATED DISORDERS. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Guglieri M, Clemens P, Haberlova J, Horrocks I, Selby K, Webster R, Smith E, Straub V, McMillan H, Yang M, Harper A, Tulinius M, Mah J, Childs A, Finkel R, Nevo Y, McDonald C, Morgenroth L, Bendixon R, Hoffman E. P.336Vision DMD: a phase IIb randomized, double-blind, parallel group, placebo- and active-controlled study to assess the efficacy and safety of vamorolone in boys with Duchenne muscular dystrophy. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Clemens P, Mengle-Gaw L, Smith E, Castro D, Mah J, McDonald C, Kuntz N, Finkel R, Guglieri M, Tulinius M, Nevo Y, Ryan M, Webster R, Morgenroth L, Siener C, Shale P, Nagaraju K, Gordish-Dressman H, Damsker J, Hoffman E. P.338Vamorolone trial in Duchenne muscular dystrophy shows dose-related improvement of muscle function. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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McDonald CM, Gordish-Dressman H, Henricson EK, Duong T, Joyce NC, Jhawar S, Leinonen M, Hsu F, Connolly AM, Cnaan A, Abresch RT, Dubrovsky A, Kornberg A, Ryan M, Webster R, Biggar W, McAdam L, Mah J, Kolski H, Vishwanathan V, Chidambaranathan S, Nevo Y, Gorni K, Carlo J, Tulinius M, Lotze T, Bertorini T, Day J, Karachunski P, Clemens P, Abdel-Hamid H, Teasley J, Kuntz N, Driscoll S, Bodensteiner J, Connolly A, Pestronk A, Abresch R, Henricson E, Joyce N, McDonald C, Cnaan A, Morgenroth L, Leshner R, Tesi-Rocha C, Thangarajh M, Duong T. Longitudinal pulmonary function testing outcome measures in Duchenne muscular dystrophy: Long-term natural history with and without glucocorticoids. Neuromuscul Disord 2018; 28:897-909. [DOI: 10.1016/j.nmd.2018.07.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 06/24/2018] [Accepted: 07/17/2018] [Indexed: 10/28/2022]
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Konikov-Rozenman J, Yanay N, Rabie M, Nevo Y. DMD TREATMENT: ANIMAL MODELS. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Guedj A, Geiger-Maor A, Galun E, Benyamini H, Nevo Y, Elgavish S, Amsalem H, Rachmilewitz J. Early age decline in DNA repair capacity in the liver: in depth profile of differential gene expression. Aging (Albany NY) 2017; 8:3131-3146. [PMID: 27922819 PMCID: PMC5191890 DOI: 10.18632/aging.101120] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 11/16/2016] [Indexed: 02/02/2023]
Abstract
Aging is associated with progressive decline in cell function and with increased
damage to macromolecular components. DNA damage, in the form of double-strand breaks
(DSBs), increases with age and in turn, contributes to the aging process and
age-related diseases. DNA strand breaks triggers a set of highly orchestrated
signaling events known as the DNA damage response (DDR), which coordinates DNA
repair. However, whether the accumulation of DNA damage with age is a result of
decreased repair capacity, remains to be determined. In our study we showed that with
age there is a decline in the resolution of foci containing γH2AX and pKAP-1
in diethylnitrosamine (DEN)-treated mouse livers, already evident at a remarkably
early age of 6-months. Considerable age-dependent differences in global gene
expression profiles in mice livers after exposure to DEN, further affirmed these age
related differences in the response to DNA damage. Functional analysis identified p53
as the most overrepresented pathway that is specifically enhanced and prolonged in
6-month-old mice. Collectively, our results demonstrated an early decline in DNA
damage repair that precedes ‘old age’, suggesting this may be a driving
force contributing to the aging process rather than a phenotypic consequence of old
age.
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Affiliation(s)
- Avital Guedj
- Goldyne Savad Institute of Gene Therapy, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Anat Geiger-Maor
- Goldyne Savad Institute of Gene Therapy, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Eithan Galun
- Goldyne Savad Institute of Gene Therapy, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Hadar Benyamini
- Bioinformatics Unit, of the I-CORE Computation Center, the Hebrew University and Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Yaval Nevo
- Bioinformatics Unit, of the I-CORE Computation Center, the Hebrew University and Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Sharona Elgavish
- Bioinformatics Unit, of the I-CORE Computation Center, the Hebrew University and Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Hagai Amsalem
- Department of Obstetrics and Gynecology, Hadassah University Hospital-Mount Scopus, Jerusalem, Israel
| | - Jacob Rachmilewitz
- Goldyne Savad Institute of Gene Therapy, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Yanay N, Elbaz M, Konikov J, Elgavish S, Rabie M, Mitrani-Rosenbaum S, Nevo Y. Characterization of molecular pathophysiology in muscular dystrophy by next generation RNA sequencing using DMD and CMD mouse models. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Aharoni S, Nevo Y, Orenstein N, Basel-Vanagaite L, Mussaffi H, Singer A. The impact of the national population carrier screening program on reducing birth rates of patients with spinal muscular atrophy. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Yanay N, Turgeman K, Elbaz M, Issa B, Rabie M, Barenholz Y, Nevo Y. Improved efficacy and reduced osteoporosis following methylprednisolone – Nano liposomes treatment in mdx mice. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Aharoni S, Sadeh M, Sagi L, Rabie M, Daana M, Argov Z, Edvardson S, Shapira Y, Dor T, Bloch A, Engel A, Nevo Y. Congenital myasthenic syndromes in Israel: Genetic and clinical characterization. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Elbaz M, Yanay N, Laban S, Rabie M, Mitrani-Rosenbaum S, Nevo Y. Life or death by NFκB, Losartan promotes survival in dy2J/dy2J mouse of MDC1A. Cell Death Dis 2015; 6:e1690. [PMID: 25766329 PMCID: PMC4385938 DOI: 10.1038/cddis.2015.60] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 01/26/2015] [Accepted: 01/27/2015] [Indexed: 02/06/2023]
Abstract
Inflammation and fibrosis are well-defined mechanisms involved in the pathogenesis of the incurable Laminin α2-deficient congenital muscular dystrophy (MDC1A), while apoptosis mechanism is barely discussed. Our previous study showed treatment with Losartan, an angiotensin II type I receptor antagonist, improved muscle strength and reduced fibrosis through transforming growth factor beta (TGF-β) and mitogen-activated protein kinases (MAPK) signaling inhibition in the dy2J/dy2J mouse model of MDC1A. Here we show for the first time that Losartan treatment up-regulates and shifts the nuclear factor kappa B (NFκB) signaling pathway to favor survival versus apoptosis/damage in this animal model. Losartan treatment was associated with significantly increased serum tumor necrosis factor alpha (TNF-α) level, p65 nuclei accumulation, and decreased muscle IκB-β protein level, indicating NFκB activation. Moreover, NFκB anti-apoptotic target genes TNF receptor-associated factor 1 (TRAF1), TNF receptor-associated factor 2 (TRAF2), cellular inhibitor of apoptosis (cIAP2), and Ferritin heavy chain (FTH1) were increased following Losartan treatment. Losartan induced protein expression toward a pro-survival profile as BCL-2 expression levels were increased and Caspase-3 expression levels were decreased. Muscle apoptosis reduction was further confirmed using terminal deoxynucleotidyltransferase-mediated dUTP nick end labeling (TUNEL) assay. Thus, along with TGF-β and MAPK signaling, NFκB serves as an important regulatory pathway which following Losartan treatment promotes survival in the dy2J/dy2J mouse model of MDC1A.
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Affiliation(s)
- M Elbaz
- Pediatric Neuromuscular Laboratory and Neuropediatric Unit, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - N Yanay
- Pediatric Neuromuscular Laboratory and Neuropediatric Unit, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - S Laban
- Pediatric Neuromuscular Laboratory and Neuropediatric Unit, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - M Rabie
- Pediatric Neuromuscular Laboratory and Neuropediatric Unit, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - S Mitrani-Rosenbaum
- Goldyne Savad Institute of Gene Therapy, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - Y Nevo
- 1] Pediatric Neuromuscular Laboratory and Neuropediatric Unit, Hadassah - Hebrew University Medical Center, Jerusalem, Israel [2] Institute of Neurology, Schneider Children's Medical Center of Israel, 14 Kaplan St., Petach Tikva, Israel
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Nevo Y, Peer N, Yochelis S, Igbaria M, Meirovitch S, Shoseyov O, Paltiel Y. Nano bio optically tunable composite nanocrystalline cellulose films. RSC Adv 2015. [DOI: 10.1039/c4ra11840e] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We utilize nanocellulose and semiconductor nanocrystals to reinforce and functionalize a biodegradable transparent film to create a transparent, strong and optically tunable plastic film.
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Affiliation(s)
- Y. Nevo
- The Robert H. Smith Institute of Plant Sciences and Genetics in Agriculture
- The Hebrew University of Jerusalem
- Rehovot 7610001
- Israel
| | - N. Peer
- Department of Applied Physics
- The Hebrew University of Jerusalem
- Jerusalem 9190401
- Israel
| | - S. Yochelis
- Department of Applied Physics
- The Hebrew University of Jerusalem
- Jerusalem 9190401
- Israel
| | - M. Igbaria
- Valentis Nanotech Ltd
- Industrial Zone, Misgav 2017900
- Israel
| | - S. Meirovitch
- Valentis Nanotech Ltd
- Industrial Zone, Misgav 2017900
- Israel
| | - O. Shoseyov
- The Robert H. Smith Institute of Plant Sciences and Genetics in Agriculture
- The Hebrew University of Jerusalem
- Rehovot 7610001
- Israel
| | - Y. Paltiel
- Department of Applied Physics
- The Hebrew University of Jerusalem
- Jerusalem 9190401
- Israel
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Elbaz M, Yanay N, Gelb S, Rabie M, Rosenbaum SM, Nevo Y. P.8.10 Losartan up-regulates NFκB signaling pathway and favors survival versus apoptosis in the dy2J/dy2J mouse model of Congenital Muscular Dystrophy. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nevo Y, Ben-Zeev B, Tabib A, Straussberg R, Anikster Y, Shorer Z, Fattal-Valevski A, Ta-Shma A, Aharoni S, Rabie M, Zenvrit S, Goldshmidt H, Felig Y, Shaag A, Mevorach D, Elpeleg O. P.6.9 Childhood relapsing immune-mediated polyneuropathy and hemolysis is associated with CD59 deficiency. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Escolar DM, Zimmerman A, Bertorini T, Clemens PR, Connolly AM, Mesa L, Gorni K, Kornberg A, Kolski H, Kuntz N, Nevo Y, Tesi-Rocha C, Nagaraju K, Rayavarapu S, Hache LP, Mayhew JE, Florence J, Hu F, Arrieta A, Henricson E, Leshner RT, Mah JK. Pentoxifylline as a rescue treatment for DMD: a randomized double-blind clinical trial. Neurology 2012; 78:904-13. [PMID: 22402864 DOI: 10.1212/wnl.0b013e31824c46be] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether pentoxifylline (PTX) slows the decline of muscle strength and function in ambulatory boys with Duchenne muscular dystrophy (DMD). METHODS This was a multicenter, randomized, double-blinded, controlled trial comparing 12 months of daily treatment with PTX or placebo in corticosteroid-treated boys with DMD using a slow-release PTX formulation (~20 mg/kg/day). The primary outcome was the change in mean total quantitative muscle testing (QMT) score. Secondary outcomes included changes in QMT subscales, manual muscle strength, pulmonary function, and timed function tests. Outcomes were compared using Student t tests and a linear mixed-effects model. Adverse events (AEs) were compared using the Fisher exact test. RESULTS A total of 64 boys with DMD with a mean age of 9.9 ± 2.9 years were randomly assigned to PTX or placebo in 11 participating Cooperative International Neuromuscular Research Group centers. There was no significant difference between PTX and the placebo group in total QMT scores (p = 0.14) or in most of the secondary outcomes after a 12-month treatment. The use of PTX was associated with mild to moderate gastrointestinal or hematologic AEs. CONCLUSION The addition of PTX to corticosteroid-treated boys with DMD at a moderate to late ambulatory stage of disease did not improve or halt the deterioration of muscle strength and function over a 12-month study period. CLASSIFICATION OF EVIDENCE This study provides Class I evidence that treatment with PTX does not prevent deterioration in muscle function or strength in corticosteroid-treated boys with DMD.
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Affiliation(s)
- D M Escolar
- Children’s National Medical Center, Washington, DC, USA.
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Brunschwig Z, Yanay N, Aga-Mizrachi S, Ettinger K, Elbaz M, Kassis I, Felig Y, Rabbie M, Nevo Y. P4.24 Glatiramer acetate (Copaxone) decreases macrophage infiltration and increases muscle strength in mdx mouse model of Duchenne muscular dystrophy. Neuromuscul Disord 2011. [DOI: 10.1016/j.nmd.2011.06.989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Escolar DM, Hache LP, Clemens PR, Cnaan A, McDonald CM, Viswanathan V, Kornberg AJ, Bertorini TE, Nevo Y, Lotze T, Pestronk A, Ryan MM, Monasterio E, Day JW, Zimmerman A, Arrieta A, Henricson E, Mayhew J, Florence J, Hu F, Connolly AM. Randomized, blinded trial of weekend vs daily prednisone in Duchenne muscular dystrophy. Neurology 2011; 77:444-52. [PMID: 21753160 DOI: 10.1212/wnl.0b013e318227b164] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To perform a double-blind, randomized study comparing efficacy and safety of daily and weekend prednisone in boys with Duchenne muscular dystrophy (DMD). METHODS A total of 64 boys with DMD who were between 4 and 10 years of age were randomized at 1 of 12 centers of the Cooperative International Neuromuscular Research Group. Efficacy and safety of 2 prednisone schedules (daily 0.75 mg/kg/day and weekend 10 mg/kg/wk) were evaluated over 12 months. RESULTS Equivalence was met for weekend and daily dosing of prednisone for the primary outcomes of quantitative muscle testing (QMT) arm score and QMT leg score. Secondary strength scores for QMT elbow flexors also showed equivalence between the 2 treatment groups. Overall side effect profiles of height and weight, bone density, cataract formation, blood pressure, and behavior, analyzed at 12 months, did not differ between weekend and daily dosing of prednisone. CONCLUSIONS Weekend dosing of prednisone is equally beneficial to the standard daily dosing of prednisone. Analysis of side effect profiles demonstrated overall tolerability of both dosing regimens. CLASSIFICATION OF EVIDENCE This study provides Class I evidence that weekend prednisone dosing is as safe and effective as daily prednisone in preserving muscle strength and preventing body mass index increases in boys with DMD over a 12-month period.
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Affiliation(s)
- D M Escolar
- Children's National Medical Center, Washington, DC, USA.
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Elbaz M, Aga-Mizrachi S, Yanay N, Dadush O, Ettinger K, Brunschwig Z, Rabie M, Barak V, Nevo Y. P3.48 Losartan improves muscle strength and ameliorates fibrosis in the dy2J/dy2J mouse model of merosin deficient congenital muscular dystrophy. Neuromuscul Disord 2010. [DOI: 10.1016/j.nmd.2010.07.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Dadush O, Aga-Mizrachi S, Ettinger K, Tabakman R, Elbaz M, Fellig J, Barak V, Nevo Y. T.P.5.12 Regeneration is up-regulated in Glatiramer acetate treated dy2J/dy2J mice with congenital muscular dystrophy. Neuromuscul Disord 2009. [DOI: 10.1016/j.nmd.2009.06.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cohen-Sadan S, Kramer U, Ben-Zeev B, Lahat E, Sahar E, Nevo Y, Eidlitz T, Zeharia A, Kivity S, Goldberg-Stern H. Multicenter long-term follow-up of children with idiopathic West syndrome: ACTH versus vigabatrin. Eur J Neurol 2009; 16:482-7. [PMID: 19348622 DOI: 10.1111/j.1468-1331.2008.02498.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Long-term follow-up of children with idiopathic West syndrome (WS) treated with adrenocorticotropic hormone (ACTH) or vigabatrin. METHODS Records of 28 normal magnetic resonance imaging (MRI) WS cases were reviewed for seizure development and cognitive outcome in relation to treatment type and lag. RESULTS Average age at disease onset was 5.5 months, and average lag time to treatment was 25 days. Fourteen patients were treated with ACTH (eight early and six late), and 14 with vigabatrin (without delay). Response rates were 88% for ACTH and 80% for vigabatrin. Short-term outcomes for seizure cessation and electroencephalography normalization were identical between the groups. In the long-term, early ACTH treatment was better than the rest combined. Average follow-up time was 9 years. A normal cognitive outcome was achieved in 100% of the early-ACTH group, 67% of the late-ACTH group and 54% of the vigabatrin group (P = 0.03). Seizures subsequently developed in 54% of the vigabatrin group, in 33% of the late ACTH group, and 0% of the early ACTH group (P < 0.05). CONCLUSIONS Idiopathic WS with normal MRI is associated with a good cognitive outcome. Early ACTH treatment, administered within 1 month, yields a better cognitive and seizure outcome than vigabatrin or late ACTH.
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Affiliation(s)
- S Cohen-Sadan
- Pediatric Neurology Unit, Dana Children's Hospital, Tel Aviv, Israel
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23
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Attali R, Warwar N, Israel A, Gurt I, McNally E, Puckelwartz M, Glick B, Nevo Y, Ben-Neriah Z, Melki J. Mutation of SYNE-1, encoding an essential component of the nuclear lamina, is responsible for autosomal recessive arthrogryposis. Hum Mol Genet 2009; 18:3462-9. [DOI: 10.1093/hmg/ddp290] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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24
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Cohen-Sadan S, Kramer U, Ben-Zeev B, Lahat E, Sahar E, Nevo Y, Eidlitz T, Zeharia A, Kivity S, Goldberg-Stern H. Multicenter long-term follow-up of children with idiopathic West syndrome: ACTH versus vigabatrin - CME questions. Eur J Neurol 2009. [DOI: 10.1111/j.1468-1331.2009.02644.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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Lamont PJ, Thorburn DR, Fabian V, Vajsar J, Hawkins C, Saada Reisch A, Durling H, Laing NG, Nevo Y. Nemaline rods and complex I deficiency in three infants with hypotonia, motor delay and failure to thrive. Neuropediatrics 2004; 35:302-6. [PMID: 15534765 DOI: 10.1055/s-2004-821243] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Three infants are described who had nemaline rods on muscle biopsy and isolated deficiency of complex I of the respiratory chain on biochemical analysis. They all manifested failure to thrive from birth, and hypotonia and muscle weakness within the first three months of life. Different genetic defects leading to isolated complex I deficiency have been described associated with a variety of morphological changes on muscle biopsy, but rods have not been described. Nemaline rods have been secondary phenomena in a number of conditions, as well as being the primary abnormality in nemaline myopathy. However, the combination of nemaline rods and complex I deficiency is an association not previously reported.
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Affiliation(s)
- P J Lamont
- Neurogenetic Unit, Department of Neurology, Royal Perth Hospital, Perth, Western Australia.
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26
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Abstract
We have studied changes in energy expenditure and body composition in adult males with Emery-Dreifuss muscular dystrophy, age-matched males with hyperCKemia and age-matched healthy controls. All participants were studied twice, 2-3 years apart. Resting energy expenditure was studied by indirect calorimetry, lean body mass and body fat by dual X-ray absorptiometry, and muscle mass was estimated based on 24-h urinary creatinine excretion. At baseline and 2-3 years later, body fat was significantly higher (P < 0.011 and P < 0.003, respectively) and lean body mass significantly lower (P < 0.024 and P < 0.012, respectively) in patients with Emery-Dreifuss muscular dystrophy as compared to subjects with hyperCKemia and healthy controls. Resting energy expenditure, over the study period, increased significantly in patients with Emery-Dreifuss muscular dystrophy (P < 0.031), but not in patients with hyperCKemia nor in healthy controls. Our study suggests that patients with Emery-Dreifuss muscular dystrophy may have increased energy expenditure relative to healthy subjects. If not met by increased caloric intake, this greater energy expenditure may partially contribute to a further deterioration in their muscle performance.
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Affiliation(s)
- N Vaisman
- Unit of Clinical Nutrition, Tel-Aviv Sourasky Medical Centre, 6 Weizmann Street, Tel-Aviv 64239, Israel.
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27
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Vaisman N, Nevo Y. Increased resting energy expenditure in subjects with emery-dreifuss muscular dystrophy. Clin Nutr 2003. [DOI: 10.1016/s0261-5614(03)80038-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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28
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Abstract
The mitochondrial deoxyribonucleotide (dNTP) pool is separated from the cytosolic pool because the mitochondria inner membrane is impermeable to charged molecules. The mitochondrial pool is maintained by either import of cytosolic dNTPs through dedicated transporters or by salvaging deoxynucleosides within the mitochondria; apparently, enzymes of the de novo dNTP synthesis pathway are not present in the mitochondria. In non-replicating cells, where cytosolic dNTP synthesis is down-regulated, mtDNA synthesis depends solely on the mitochondrial salvage pathway enzymes, the deoxyribonucleosides kinases. Two of the four human deoxyribonucleoside kinases, deoxyguanosine kinase (dGK) and thymidine kinase-2 (TK2), are expressed in mitochondria. Human dGK efficiently phosphorylates deoxyguanosine and deoxyadenosine, whereas TK2 phosphorylates deoxythymidine, deoxycytidine and deoxyuridine. Here we identify two mutations in TK2, histidine 90 to asparagine and isoleucine 181 to asparagine, in four individuals who developed devastating myopathy and depletion of muscular mitochondrial DNA in infancy. In these individuals, the activity of TK2 in muscle mitochondria is reduced to 14-45% of the mean value in healthy control individuals. Mutations in TK2 represent a new etiology for mitochondrial DNA depletion, underscoring the importance of the mitochondrial dNTP pool in the pathogenesis of mitochondrial depletion.
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Affiliation(s)
- A Saada
- The Metabolic Disease Unit, Shaare-Zedek Medical Center, Faculty of Medicine, the Hebrew University, Jerusalem 91031, Israel
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29
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Landau M, Mesterman R, Ophir J, Mevorah B, Alcalay J, Harel A, Nevo Y. Clinical significance of markedly elevated serum creatine kinase levels in patients with acne on isotretinoin. Acta Derm Venereol 2001; 81:350-2. [PMID: 11800143 DOI: 10.1080/000155501317140070] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [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: 10/16/2022] Open
Abstract
Muscle-related complaints and high creatine kinase (CK) blood levels have been reported in 16-51% of patients with acne treated with isotretinoin. It has been suggested that this retinoid and exercise have a synergistic effect on muscle. The presence of marked hyperCKemia during the treatment raises concern about rhabdomyolysis. The objective of this report was to evaluate the incidence, course and clinical significance of severe hyperCKemia in isotretinoin therapy for acne. Out of 442 patients on isotretinoin, we reviewed 7 patients (1.58%) with CK values above 5,000 IU/l. Only two of them had myalgia. Physical activity or intramuscular injection prior to blood testing was reported in 6 patients. CK values returned to normal within 2 weeks and all subjects except 2, completed treatment. In conclusion, marked hyperCKemia with or without muscle-related complaints in isotretinoin-treated patients with acne is a benign phenomenon.
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Affiliation(s)
- M Landau
- Dermatology Unit, Edith Wolfson Medical Center, Holon, Israel.
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30
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Abstract
Emery-Dreifuss Muscular Dystrophy (EMD or EDMD) is a rare X-linked recessive disorder, characterized by progressive muscle wasting and weakness, contractures, and cardiomyopathy, manifesting as heart block. Mutation analysis at the EMD gene locus was performed in 4 unrelated Israeli families with X-linked EMD and in one sporadic case. In the 4 families 4 different mutations were found, 3 of which were novel. These included two frame shift mutations in exon 2 (333delT and 412insA) and one base pair substitution at the consensus +1 donor splice in intron 5 (1429G-->A). The fourth mutation in exon 6 (1675-1678delTCCG) has been previously described. No mutations were identified in the one sporadic case. Two of the three novel mutations were found in exon 2. A summary of the previously published mutations described in the EMD Mutation Database (http://www.path.cam.ac.uk/emd/) as well as the mutations described in our study suggest that the distribution of mutations in EMD gene is not entirely random and that exon 2 is prone to mutations. Hum Mutat 17:522, 2001.
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Affiliation(s)
- Y Nevo
- Pediatric Neuromuscular Service, Dana Hospital, Tel Aviv Sourasky Medical Center, Israel.
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31
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Abstract
A 5-year-old female was evaluated because of severe speech and expressive language delay. On examination, she could hardly speak and communicated through gestures. She manifested severe dysarthria and difficulty in protruding and moving her tongue laterally. She lacked coordination of the swallowing process, with drooling and an increased mental reflex. Her cognitive development was normal, and no associated neurologic dysfunction of the limbs was noted. On follow-up, the child experienced two episodes of seizures at 6 years of age. Magnetic resonance imaging of the brain demonstrated perisylvian and frontal polymicrogyria. Clinical and radiologic findings demonstrated a similarity and continuum between congenital suprabulbar paresis (Worster-Drought syndrome) and perisylvian syndrome.
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Affiliation(s)
- Y Nevo
- Institute for Child Development and the Pediatric Neurology Unit, Division of Pediatrics, Dana Children's Hospital, Tel Aviv, Israel
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32
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Fishel B, Zhukovsky G, Legum C, Jossiphov J, Alon M, Peer G, Iaina A, Nevo Y. A case of Bartter's syndrome, gout and Becker's muscular dystrophy. Clin Exp Rheumatol 2000; 18:426-7. [PMID: 10895394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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33
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Abstract
We present the family of two girls affected with alternating hemiplegia of childhood who were born to the same mother and different fathers. Previous reports suggested mitochondrial dysfunction as an etiologic mechanism for this disorder. Muscle biopsy, including a measurement of the respiratory chain enzymes, performed in one of the sisters showed no mitochondrial abnormalities. The mode of inheritance is not certain, but an autosomal-dominant gene is most likely.
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Affiliation(s)
- U Kramer
- Pediatric Neurology, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
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34
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Abstract
Whether seizures are the direct cause of cognitive deterioration in epileptic children is undetermined. This retrospective study aimed to delineate a subgroup of pediatric patients with cognitive deterioration and refractory seizures in the absence of recognized causes for mental retardation. Of the 80 children identified as having mental retardation and refractory seizure disorder, seven (8.7%) had normal cognitive development until at least 1 year of age. Their metabolic status was normal. Five of them suffered repeated frequent partial seizures with onset in the first year of life and two had repeated episodes of status epilepticus. All seven had similar characteristics of early onset partial seizures, six of them had partial seizures secondarily generalized and one had complex partial seizures. The time of peak cognitive deterioration correlated with increases in seizure frequency during that period. Evaluation revealed a well-defined epileptic focus in the absence of neuroimaging abnormality except for hippocampal atrophy in the two children with complex partial seizures and a small vascular malformation in one child. Uncontrolled partial seizures in the first months of life may result in cognitive deterioration.
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Affiliation(s)
- U Kramer
- Pediatric Neurology Unit and Child Development Center, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
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35
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Abstract
Duchenne muscular dystrophy (DMD) is a relentless progressive disorder, leading to severe disability during childhood and death in adolescence or early adulthood. In most families, prenatal diagnosis is readily achieved by molecular detection of DNA deletions using chorionic villi or amniocytes, or by linkage analysis. In some cases, however, molecular methods fail to provide a definitive diagnosis and in such cases in utero fetal muscle biopsy may serve as a diagnostic option. We describe three families in whom fetal muscle biopsy was performed, focusing on the prenatal diagnostic dilemmas, the indications and timing for in utero fetal muscle biopsy, and the difficulties encountered.
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Affiliation(s)
- Y Nevo
- Institute for Child Development and Pediatric Neurology Unit, Dana Children's Hospital, Tel-Aviv, Israel.
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36
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Abstract
The purpose of this study was to search for STA gene defects in three families with clinically typical Emery-Dreifuss muscular dystrophy. Emery-Dreifuss is an X-linked muscular dystrophy with humeroperoneal weakness and life-threatening, but treatable, cardiac abnormalities in male patients and in female carriers. The defect is in the gene coding for emerin, a 254 amino acid protein of unknown function. Complementary and genomic DNA from T lymphocytes from the reported patients and their family members were amplified, cloned, and sequenced. A novel mutation, a 26 base-pair deletion in three brothers and a carrier mother, was detected in one family. A splicing mutation with one base pair insertion and a five base-pair deletion, which have been described previously, were found in the second and third families, respectively. The additional novel mutation detected and the findings of three different mutations in these three families support the idea of genetic heterogeneity of Emery-Dreifuss muscular dystrophy with different mutations in different families.
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Affiliation(s)
- Y Nevo
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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37
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Nevo Y, Yaron Y. [Update on diagnosis of limb girdle muscular dystrophy]. Harefuah 1999; 136:720-5. [PMID: 10955098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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38
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Fattal-Valevski A, Kramer U, Leitner Y, Nevo Y, Greenstein Y, Harel S. Characterization and comparison of autistic subgroups: 10 years' experience with autistic children. Dev Med Child Neurol 1999; 41:21-5. [PMID: 10068046 DOI: 10.1017/s0012162299000055] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To summarize our 10-year experience with autistic children at the Tel Aviv Child Development Center, the files of all 55 children with autism treated at our center over a 10-year period were retrospectively reviewed. Particular attention was addressed to the value of the medical work-up in detecting the etiology of autism and to factors differentiating infantile autism (IA) from autistic-like behavior (ALB). Twenty-four subjects (44%) had IA and 31 (56%) had ALB. These subgroups were compared for demographic, perinatal, familial, neurological, and psychological findings, and outcome at discharge. Associated medical conditions and the yield of metabolic work-up and neuroimaging and electroencephalography studies are discussed. The two subgroups differed only in severity of autistic symptoms and cognitive function (P<0.05), but not in demographic or neurobiological findings. It was concluded that IA and ALB are similar conditions, and autism has a wide continuum of clinical expressions.
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Affiliation(s)
- A Fattal-Valevski
- The Institute for Child Development and Pediatric Neurology Unit, Division of Pediatrics, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Israel
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39
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Abstract
In a retrospective analysis of all our patients with seizure onset prior to age 16 years, 25 patients with primary generalized tonic (n = 10) or tonic-clonic (n = 15) seizures were identified. These patients constituted 5.7% of the total seizure patient population in our institute between the ages of 1 month and 16 years. The natural history of generalized tonic-clonic seizures is known to be benign; however, that of isolated primary generalized tonic seizures is not clear. Therefore, an attempt was made to characterize the patients suffering from primary generalized tonic seizures and determine their outcome. Analysis of our patient population shows that both seizure types are characterized by early onset of generalized seizures that appear in normally developed children with a normal electroencephalographic background. The children usually respond quickly to antiepileptic drugs. A long-term follow-up (mean period of 7.6 years) was possible in 84% of the patients, and showed that 95% of them were seizure free at the end of the follow-up period. There was no significant difference between the two groups in regard to age of onset, family history, and seizures at follow-up. In conclusion, the natural history of patients with generalized tonic seizures is similar to the benign course of those with generalized tonic-clonic seizures.
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Affiliation(s)
- U Kramer
- Institute for Child Development and Pediatric Neurology Unit, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
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40
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Ben-Amitay G, Nevo Y, Lieberman D, Mester R, Harel S. [Cyclic vomiting syndrome in children]. Harefuah 1998; 134:611-3, 671. [PMID: 10911424] [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: 02/17/2023]
Abstract
Cyclic vomiting syndrome in children is a manifestation of various etiologies, including gastroenterological and renal disorders, central and autonomic nervous system abnormalities, as well as metabolic and endocrine dysfunction. Frequently no organic cause is found. Personality profiles of children with cyclic vomiting reveal perfectionism, competitiveness, and aggressive behavior. Vomiting attacks have been induced by anxiety and excitement in patients with cyclic vomiting. We describe an 8-year-old girl with cyclic vomiting, frequently associated with occipital headaches, photophobia or dizziness. Psychiatric evaluation indicated a generalized anxiety disorder.
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Affiliation(s)
- G Ben-Amitay
- Ness Ziona Mental Health Center, Institute for Child Development Tel Aviv-Sourasky Medical Center
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41
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Abstract
The predictive value of abnormal neurological findings on neuroimaging (NI) of children with partial seizures (PS) was studied. The sample comprised 143 children and adolescents with PS from 1979 to 1996. Fifty patients had the following abnormal NI findings: diffuse atrophy and porencephalic cyst (5.6% each), hemiatrophy, tumors, neurocutaneous syndrome brain lesions, and dysgenesis (4.2% each), and arachnoid cyst and hydrocephalus (2.1% each). There were significantly more NI abnormalities among those with simple PS than among the other groups of complex PS or PS with secondary generalization. All cases of porencephalic cyst (n = 8), and hemiatrophy (n = 6) were in the hemiparetic group, all cases of tumor (n = 6) were in the normal group, while most cases of diffuse atrophy were in the mentally retarded group. Patients with abnormal NIs had a significantly earlier age of seizure onset than the others. The chance of finding a treatable abnormality in neuroimaging was 5% for tumors and 2% for arachnoid cysts in the group of patients with PS and normal neurological findings. Neither an abnormality detected in a neurological examination nor the type of seizure are predictive parameters for suggesting the presence of a resectable brain tumor. All patients with newly diagnosed PS should undergo an MRI.
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Affiliation(s)
- U Kramer
- Pediatric Neurology Unit, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
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42
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Nevo Y, Kramer U. [Emery-Dreyfuss dystrophy--update]. Harefuah 1998; 134:486-8. [PMID: 10909584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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43
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Nevo Y, Kramer U, Legum C, Shomrat R, Fatal A, Soffer D, Harel S, Shapira Y. SMA type 2 unrelated to chromosome 5q13. Am J Med Genet 1998; 75:193-5. [PMID: 9450884] [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: 02/05/2023]
Abstract
We describe two brothers with clinical and histological findings of type 2 spinal muscular atrophy (SMA) associated with small head circumference (<2%) and normal cognitive development. No survival motor neuron (SMN) or neuronal apoptosis-inhibitory protein (NAIP) deletions were detected in these sibs, and they were discordant for the haplotypes determined by DNA markers flanking the 5q13 SMA locus. These findings support the presence of a distinct anterior horn disease unrelated to 5q13. This entity may have either autosomal recessive or X-linked inheritance.
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Affiliation(s)
- Y Nevo
- Institute for Child Development, Division of Pediatrics, Dana Children's Hospital, Tel-Aviv, Israel.
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44
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Abstract
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic disorder of the peripheral nervous system with sensory and motor involvement, and insidious onset over a period of months. In children and adults, both proximal and distal muscles are affected. Muscle stretch reflexes are absent or depressed. Laboratory findings include elevated cerebrospinal fluid protein with no increase of mononuclear cells. Electrophysiological and pathological studies show evidence of demyelination. No control studies of the efficacy of immunomodulating therapy in childhood CIDP are available. However, several studies have indicated clinical improvement after treatment with prednisolone, plasmapheresis and intravenous immunoglobulin, but disappointing results with other immunosuppressive agents. While some children have a monophasic course, with complete recovery, others have a protracted course, with either a slowly progressive or a relapsing-remitting course, resulting in prolonged morbidity and disability.
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Affiliation(s)
- Y Nevo
- The Institute for Child Development, Division of Pediatrics, Dana Children's Hospital, Sackler School of Medicine, Tel Aviv University, Israel
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45
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Abstract
This study analyzes the relative frequency and age of onset of the different seizure types in a 20-year cohort of a pediatric neurology outpatient clinic of an urban hospital that serves the majority of the city's population (Tel Aviv Medical Center). Only patients with two or more unprovoked seizures were included. Neonatal seizures were excluded from the analysis. The different seizure types in descending order of frequency were: partial seizures secondarily generalized (20.6%), complex partial seizures (12.5%), West syndrome (9%), simple partial seizures (8.6%), benign rolandic epilepsy of childhood (8%), absence seizures (7%), generalized tonic-clonic seizures (6.6%), generalized tonic seizures (5%), myoclonic seizures (2.2%), benign occipital epilepsy of childhood (2%), mixed type seizures (1.8%), Lennox-Gastaut syndrome (1.5%), juvenile myoclonic epilepsy (0.9%), atypical absence (0.6%), Landau-Kleffner syndrome, Ohtahara syndrome, myoclonic astatic epilepsy, electrical status epilepticus in sleep and startle epilepsy (0.2% each), and unclassified seizures (12%). The findings of this study confirm that there are more pediatric patients with partial seizures (52%) than primary generalized seizures (33%) and that partial seizures secondarily generalized is the most frequent seizure type in this age group.
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Affiliation(s)
- U Kramer
- Pediatric Neurology Unit, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
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46
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Kramer U, Nevo Y, Harel S. Electroencephalography in the evaluation of headache patients: a review. Isr J Med Sci 1997; 33:816-820. [PMID: 9464351] [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: 05/22/2023]
Abstract
The intention of this paper was to review the literature on the use of EEG in headache evaluation and recommend clinical applications of this technique. The consensus of published findings was that EEG can differentiate migraineurs from controls but that it is not justified for routine diagnosis of headache etiology. We conclude that neuroimaging is a superior technique for detecting underlying structural lesions.
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Affiliation(s)
- U Kramer
- Institute for Child Development, Beit Habriut Strauss, Tel Aviv, Israel
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47
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Nevo Y, Pestronk A. Acute immune polyneuropathies: correlations of serum antibodies to Campylobacter jejuni and Helicobacter pylori with anti-GM1 antibodies and clinical patterns of disease. J Infect Dis 1997; 176 Suppl 2:S154-6. [PMID: 9396701 DOI: 10.1086/513784] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 02/05/2023] Open
Abstract
Antecedent Campylobacter jejuni infection, detected by serologic tests, has been implicated in some acute immune polyneuropathies (AIP). Antibodies to Helicobacter pylori, C. jejuni, and GM1 ganglioside were measured in sera from 35 Chinese patients with AIP. Anti-GM1 antibodies were found in 54% of C. jejuni-seropositive, H. pylori-seronegative patients. In contrast, anti-GM1 antibodies were rare in sera that were either seropositive for both C. jejuni and H. pylori (P = .04) or seronegative for C. jejuni (P = .01). Motor axonal AIP was more common in the C. jejuni-seropositive, H. pylori-seronegative patients (82%) than in the bacterial antibody-negative group (38%). It was concluded that in AIP patients, C. jejuni-positive sera may be polyreactive, in that it may also react with H. pylori. In this situation, the specificity for either infection requires further validation. In contrast, sera with specific C. jejuni seropositivity are associated with both motor axonal AIP and selective serum IgG anti-GM1 antibodies.
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Affiliation(s)
- Y Nevo
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
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48
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Harel S, Greenstein Y, Kramer U, Yifat R, Samuel E, Nevo Y, Leitner Y, Kutai M, Fattal A, Shinnar S. Clinical characteristics of children referred to a child development center for evaluation of speech, language, and communication disorders. Pediatr Neurol 1996; 15:305-11. [PMID: 8972529 DOI: 10.1016/s0887-8994(96)00222-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Speech, language, and communication disorders are prominent reasons for referrals to a child development center. From 1984 to 1988, 1,090 preschool children were referred to our child development center, which serves the Tel Aviv metropolitan area. Of all referrals, 432 (41%) were primarily due to speech, language, and communication problems. After exclusion of those with IQ < 50 and those with non-language-related disabilities, 323 children remained. The children were classified into different subtypes of developmental language disorders and autistic spectrum disorders. The main developmental language disorder subtypes were combined expressive-receptive (49%) and expressive (44%). Central processing deficits were less common, occurring in 20 (7%) of the children. Parents of children with developmental language disorders had educational levels similar to those of parents of children referred to the child development center for other causes. However, parents of children with infantile autism had higher educational levels than parents of children with developmental language disorder or parents of children referred for other causes (P < .001). Our results reflect the distribution of language and related problems in an unselected population of preschool children referred to a child development center.
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Affiliation(s)
- S Harel
- Institute of Child Development and Pediatric Neurology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
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49
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Abstract
A 4-year-old child with metachromatic leukodystrophy was initially diagnosed with chronic immune demyelinating polyneuropathy and treated with immunosuppressive therapy. Physical examination revealed diffuse, distal > proximal weakness and areflexia. Electro-diagnostic studies revealed nerve conduction velocities that were slowed to variable degrees in different nerves. In the 18 months after institution of immunomodulating therapy, she had functionally significant improvement and a quantitative increase in her strength. Treatment was discontinued at age 6 years when the patient developed urinary incontinence, followed by loss of motor and cognitive skills. We conclude that immunomodulation early in the course of metachromatic leukodystrophy presenting as a neuropathy may result in temporary functional improvement. Whether the immunomodulation altered the disease progression or had direct effects on the function of the dysmyelinated axons is not known.
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Affiliation(s)
- Y Nevo
- Department of Neurology, Barnes and St. Louis Children's Hospital, Washington University School of Medicine, USA
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50
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Abstract
Perifascicular atrophy of muscle fibers is generally considered to be a specific feature of autoimmune myopathies, dermatomyositis in particular. We describe a neonate presenting with hypotonia and weakness. A biopsy revealed atrophic and regenerating muscle fibers in a perifascicular distribution, and abnormal alkaline phosphatase activity in neighboring perimysial connective tissue. The weakness was nonprogressive and improved on follow-up even though no long-term treatment was administered. We conclude that the presence of perifascicular myopathic changes and muscle fiber atrophy in infants presenting with hypotonia and weakness is neither diagnostic of progressive dermatomyositis, nor a necessary indication for immunosuppressive therapy.
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Affiliation(s)
- Y Nevo
- Department of Neurology, Barnes and St. Louis Children's Hospitals, Washington University School of Medicine, MO 63110, USA
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