A female with Coffin-Lowry syndrome and "cataplexy"

Coffin-Lowry syndrome (CLS) is an X-linked semidominant condition, caused by mutations in the gene encoding the ribosomal protein S6 kinase-2 (RSK-2), a growth factor regulating protein kinase, which is mapped to Xp 22.2. The syndrome is mainly seen in males. It is manifested by moderate to severe mental retardation and characteristic facial, hand and skeletal malformations. We present a female patient with fully manifested CLS, confirmed by molecular analysis, who experienced daily drop episodes, diagnosed as "cataplexy". The episodes were precipitated by emotional or auditory stimuli and were significantly reduced, by selective serotonine re-uptake inhibitors.     

Sinus bradycardia in chronic neuroglycopenic syndrome. A case of "short intestine" syndrome

The clinical pattern of the chronic hypoglycemic disorders is different from that of the acute disorders. While in acute hypoglycemic syndromes tachycardia usually occurs, in chronic hypoglycemic disorders there is, even if seldom, sinusal bradycardia. The bradycardia occurs after months with glycemia under 60 mg/dl and may be correlated to the neuroglycopenic state. It is easily reversible when plasma glucose concentration approaches the normal range again. Recently we observed sinusal bradycardia set up during the chronic hypoglycemia state, lasting from more than 5 months, in a man submitted to subtotal intestinal resection, owing to wide extensive eosinophilic granuloma. The bradycardia disappeared quickly after the correction of the hypoglycemia, when the patient was submitted to parenteral hyperalimentation with a silicone rubber catheter in the superior vena cava. We suggest to set the bradycardia among the markers of undernutritional syndromes beside the known anthropometric, biochemical and immunological signs.     

The "lazy" NK cells of Chediak-Higashi syndrome

Natural killer (NK) function, measured in a short-term (4-hr) 51Cr-release assay, is profoundly depressed in circulating PBL of donors with Chediak-Higashi syndrome (CHS). In this study, we demonstrate that CHS NK cells can express relatively normal lytic function after prolonged exposure in vitro to high levels of activating as well as cytotoxic stimuli. After activation with the human cloned interferon (B1) for 24 hr, CHS NK cells have lytic activity comparable to unactivated normals in a 4-hr 51Cr-release assay. In addition, after 5 days of activation with mitomycin C-treated B cell lines, CHS NK cells have levels of activity similar to those of activated normals but are defective in generating cytotoxic cells capable of lysing the stimulator B cell. Even though CHS NK cells are defective in a 4-hr 51Cr-release assay, after 16 hr they enhance their killing capability 200 to 400-fold. In fact, after 16 hr of interaction with K562 target cells, CHS NK cells are capable of releasing NK soluble cytotoxic factors. These results are consistent with the hypothesis that CHS NK cells have all the necessary cellular structures and molecules required for them to function as lytic effector cells, but their lack of cytotoxic function is due to a relative refractoriness in initiating the post-binding lytic mechanism.     

A brainstem "mini-discharge" syndrome (anesthesia dolorosa)

Chronic pain consisting of anesthesia dolorosa secondary to bilateral interruption of the trigeminal nerves is presented as a brain stem reticular denervation syndrome. Electrothalamograms revealed fast frequency discharges in the mesothalamic prerubral and centermedian reticular formation. Mesothalamic electrical stimulation attenuated the discharges. Pain and other symptoms presumably of brainstem origin also were attenuated or abolished by therapeutic electrical stimulation twice daily. It is postulated that brain stem-represented behavioral generators are implicated by the reticular discharges in order to produce the complex symptomatology. Consequently the symptom complex is collectively identified as a brainstem "mini-discharge" syndrome. A theoretical discussion is presented to defend the thesis that reticular denervation-induced low threshold discharge system accounts for the episodic states of pain, dyskinesia, mood, and memory disturbances.     

The "falcifolia" syndrome of Oenothera. First communication

Summary Reciprocal crosses between Oe. lamarckiana and Oe. suaveolens lead to an off-spring, part of which is crippled. According to Harte 1948 this characteristic malformation is called falcifolia (sickle-shaped leaf). It is restricted to certain sectors of the plant and appears in various plants at different stages of their development. For this reason the percentage of falcifolia-plants increases gradually during the vegetative period. Reciprocal crosses show a clear quantitative difference in regard to the percentage of crippled plants as well as to the degree of crippling. At maturity the percentage of falcifolia-plants is approximately as follows: Oe. lamarckianaxOe. suaveolens: 90–100% Oe. suaveolensxOe. lamarckiana: 20–40% Selfing of normal and crippled hybrids leads to an F₂ which consists of both types; the percentage varies. In general a crippled plant produces more falcifolia-progeny than a normal plant. Backcrossing with Oe. lamarckiana leads to an offspring with less than 20% falcifolia whilst backcrossing with Oe. suaveolens produces more than 50% crippled plants. This large difference appears in every backcross, regardless whether the F₁-plant is normal or crippled, and whether it functions as seed-parent or pollen-parent. Furthermore it does not matter whether the F₁ has been obtained with Oe. lamarckiana or with Oe. suaveolens as seed-parent. The peculiar inheritance appears to be independent of nuclear and plastid genes (genome and plastome), but is in fact a non-mendelian one. Falcifolia cannot be produced by grafting Oe. lamarckiana and Oe. suaveolens reciprocally. It seems to be caused by the interaction of different plasmotypes.

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Herrn Professor Dr. Dr. h. c. Friedrich Oehlkers zum 80. Geburtstag gewidmet.     

Ecology and evolution of the diaspore "burial syndrome"

Hygroscopically active awns or "bristles" have long intrigued scientists. Experimental evidence shows that they are important for diaspore burial in the correct orientation, thereby increasing successful seed germination and seedling survival. Despite these ecological advantages, 38 of the 280 species of grasses in Danthonioideae lack awns. We provide the first study of awns in a phylogenetic context and show that although the awnless state has arisen ca. 25 times independently, the ecological disadvantage of not having an awn also applies in an evolutionary context. Only in Tribolium and Schismus have awnless ancestors diversified to form a clade of primarily awnless descendents. Several of the awnless species in these genera are annual and we find a significant correlation between the evolution of awns and the evolution of life history. A suite of other diaspore traits accompany the awned or awnless states. We interpret the awn as being the visible constituent of a compound "burial syndrome," the two ecological extremes of which may explain the correlation between awns and life history and provide an explanation why awnless species in Tribolium and Schismus persist.     

Unilateral absent scaphoid in a patient with "Holt-Oram" syndrome

The absence of the scaphold in a patient with Holt-Oram syndrome is reported. Only a few similar cases have been published.     

A novel Fryns "Anophthalmia-plus" syndrome associated with primary hypothyroidism

A novel Fryns "anophthalmla-plus" syndrome associated with primary hypothyroidism: Here, we report a newborn male with "anophthalmia-plus" syndrome and primary congenital hypothyroidism. To our knowledge this is the first case of 'anophthalmia-plus' syndrome associated with congenital hypothyroidism in the literature up to date.     

Characterisation of a 19-year-old "long-term survivor" with Edwards syndrome

Trisomy 18 is the second most frequent autosomal aneuploidy affecting about 1 in 8,000 new-borns. Similar to trisomy 13 more than 90% of the patients die within the first year. Main causes of death are failure of vital organ function, in most cases of brain, heart, kidney, and gut, sometimes combined with severe infections. The degree to which essential organs are affected at birth and the clinical course differ considerably. Unknown genetic factors and various environmental effects are most likely involved. A less severe course of Edwards syndrome can be caused by a partial trisomy due to a deletion of the extra chromosome 18 or somatic mosaicism with a trisomic and a normal cell-line in the patient. In this report conventional chromosome analysis, FISH, and QF-PCR have been performed on a 19-year-old female patient with trisomy 18 to investigate a large number of cells including non-mitotic cells from various different tissues. This study supports evidence for an apparently pure form of trisomy 18 in this "long-living" patient with Edwards syndrome.     

New "pre-diabetes" category and the metabolic syndrome in Japanese.

BACKGROUND: Recently, impaired fasting glucose (IFG) was redefined as fasting plasma glucose of 100-125 mg/dl, and individuals with IFG and/or impaired glucose tolerance (IGT) were referred to as having "pre-diabetes". However, there is a lack of data using the new definition of IFG and "pre-diabetes". OBJECTIVE: The aim of this study was to examine associations of the metabolic syndrome components with the new "pre-diabetes" category in relatively lean Japanese. METHODS: Six hundred and sixty-one Japanese study participants underwent a 75 g oral glucose tolerance test. They were classified into three groups-normal (n=225), pre-diabetes (n=308), and diabetes (n=128). The metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III, as modified for waist circumference criteria by the Regional Office for the Western Pacific Region of WHO. RESULTS: Prevalence of the metabolic syndrome in each group was 10.7%, 27.9%, and 53.9%, respectively. Of the metabolic syndrome components, the OR for prevalent pre-diabetes was 2.00 (95% CI, 1.73-2.31, p<0.001) for fasting glucose, 1.93 (95% CI, 1.54-2.42, p<0.001) for waist circumference, and 1.36 (95% CI, 1.10-1.68, p=0.005) for triglycerides. Similar associations were found in prevalent diabetes. Insulin resistance assessed using Stumvoll's index was significantly associated with both pre-diabetes and diabetes. CONCLUSION: Pre-diabetes and the metabolic syndrome frequently coexist in relatively lean Japanese. This association seems to link with abdominal adiposity and insulin resistance.