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[Oculo-cerebro-renal Lowe syndrome: clinical, biochemical and molecular studies in a Moroccan patient].

The oculo-cerebro-renal syndrome of Lowe is a rare X-linked disorder, caused by the inositol biphosphate 5-phosphatase deficiency, localized to the Golgi complex. Several mutations were reported in patient's OCRL gene leading to enzyme deficiency. We report a Moroccan case of OCRL syndrome of Lowe with a neo mutation in exon 10. The patient aged of 19 months was referred to our medical centre because of a psychomotor retardation. He had a medical history of eye abnormalities including cataract and bilateral glaucoma, diagnosed when he was 5 weeks old. Cataract has been treated after chirurgical therapy but ocular hypertonia persisted. Physical examination revealed an axial hypotonia and walking difficulties. Laboratory tests revealed a moderate acidosis (20 mmol/L), a slight decrease of serum phosphate level (24 mg/L) and an increased serum phosphatase activity. Further studies showed mild proteinuria, urinary bicarbonates loosing and generalised hyperaminoaciduria. Based on both clinical and biological data, Lowe syndrome has been suggested. In this context, molecular investigation has been performed using dHPLC/sequencing techniques which allow identifying an original mutation c.776T>C (p.Phe259Ser), localized on the exon 10 of the OCRL gene. The mutation was not found in the probant's mother suggesting a neo mutation. Lowe syndrome is a rare hereditary X-linked disorder resulting from a variety of heterogeneous mutations of OCRL gene. Indeed, numerous mutations have been reported, variations were noted concerning their localization as well as their type. To our knowledge, this is the first report of the neo mutation c.776T>C of OCRL gene and the first published case report of the Lowe syndrome in a Moroccan patient.

Amino Acid Sequence↗

Eye health and adolescence.

Complete development of eyes occurs between 8 and 11 years, though longitudinal growth of axial length may occur up to 13 years (approximately). Except a few, most of the eye diseases affecting adolescence age group are similar to adult type. Diseases like myopia, keratoconus, vernal keratoconjunctivitis, juvenile diabetic retinopathy and injuries to eye are exclusively diseases of adolescence that are commonly encountered. Psychologically, impact of eye disease on adolescent mind may be profound, thinking they might lose their eyesight. Early detection of diseases, prevention of injuries, health education and frequent eye check-up are essential.

Adolescent↗

[Problems in surgical management of persistent hyperplastic primary vitreous in children].

PURPOSE: To evaluate the surgical techniques that allows safe, effective removal of lens and retrolenticular fibrotic membranes in eyes with PHPV in children. MATERIAL AND METHODS: A total of 31 children (18 boys and 13 girls) with PHPV and cataract in one eye were divided into 2 groups, according to treatment modality. High frequency ultrasonography were used to identify anatomic correlates in the eyes--before operation. Limbal cataract extraction combined with vitrectomy and removalof embryonic remnants was carried out in 17 eyes, and a posterior pars plana approach in 14 eyes. RESULTS: In group with anterior approach, the most serious complication was corneal decompensation, in the next group--retinal detachement. CONCLUSIONS: The anterior and the posterior surgical technique to remove cataract and tenacious retrolenticular membranes was effective but associated with high risk of intraoperative and postoperative complications. Although the surgical intervention is necessary to prevent progressive pathologic changes and to obtain the best possible visualresults in some cases.

Cataract↗

The nasal fundus ectasia.

The object of this work has been to describe an eye anomaly consisting of a series of individual characteristics. As a name for the disorder "the nasal fundus ectasia" has been selected. Special attention has been paid to the bitemporal visual field defects which can easily lead to a suspicion of tumour in the region of the optic chiasm.

Adult↗

Embryotoxicity and teratogenicity of cadmium chloride in Xenopus laevis, assayed by the FETAX procedure.

The embryotoxicity and teratogenicity of cadmium chloride (CdCl2) were tested by the FETAX (Frog Embryo Teratogenesis Assay: Xenopus) procedure in the South African frog, Xenopus laevis. In five assays, groups of Xenopus embryos were grown in media that contained CdCl2 at concentrations ranging from 0.75 to 56 mumol per L; control groups were incubated in the same medium without added CdCl2. The exposures to CdCl2 were begun at the blastula stage (five hours post-fertilization) and were terminated 96 hours later (101 hours post-fertilization). The embryos were counted, fixed in formalin, and examined by microscopy to score malformations and measure head-to-tail lengths. In control groups, greater than or equal to 95 percent of the embryos survived at 101 hours post-fertilization, and the incidence of malformations was less than or equal to 7 percent. In Cd(2+)-exposed groups, there was concentration-dependent mortality, and the embryos showed a concentration-related pattern of malformations, including gut malrotation, ocular anomalies, bent notochord, misshapen dorsal fin, facial dysplasia, cardiac deformities, and dermal blisters. Other abnormalities, not categorized as malformations, included stunted growth and hypopigmentation. The minimum concentration of CdCl2 that inhibited growth (MCIG) was 18 mumol per L. The median embryolethal concentration (LC50) of CdCl2 was 32 (SE +/- 4) mumol per L; the median teratogenic concentration (EC50) was 3.7 (SE +/- 1) mumol per L; the teratogenic index (TI = LC50/EC50) was 8.6. This study demonstrates that CdCl2 is teratogenic for Xenopus laevis and provides a standardized experimental model for studies of the molecular mechanisms of cadmium teratogenesis.

Animals↗

Prenatal diagnosis of chondrodysplasia punctata by sonography.

The rhizomelic form of chondrodysplasia punctata is a lethal autosomal recessive disorder of unknown cause. It is characterized by marked shortening and bowing of the proximal limbs, vertebral column abnormalities, eye and skin defects, severe mental retardation, and recurrent infection. Previously, antenatal diagnosis of this condition was made by radiography. We describe ultrasonographic findings, specifically stippling of the proximal humerus, which permitted us to identify the condition in a fetus at 28 weeks' gestation.

Adolescent↗

Opsoclonus in malaria: the first report in the literature.

The first report in the literature of opsoclonus in malaria was presented. A 24-year-old woman had a two week history of high fever and lassitude. Physical examination revealed no specific neurological sign on admission. Ring form and gametocytes of Plasmodium falciparum were found in blood smear. Combined treatment of quinine and tetracycline were prescribed. She developed classical abnormal eye movement of opsoclonus and hand tremor on the following day, which gradually subsided on the tenth hospital day. Computed brain tomography and cerebrospinal fluid study were normal. She was discharged home after 3 weeks of admission with some occasional minimal opsoclonus without hand tremor.

Adult↗

[Congenital developmental anomalies of the visual system in children in our 13-year observations].

Cases of congenital anomalies of the visual system in children hospitalized in the period 1974-1986 were analyzed. Together 305 cases were analyzed. The most frequently seen congenital anomaly was an unilateral or bilateral cataract (107 cases), further glaucoma (50 cases) and pathological changes caused by Toxoplasma Gondii (33 cases). Among principal causes of these anomalies the author ++ is citing the rubella and toxoplasmosis.

Cataract↗

Postimplantation whole embryo culture: a new method for studying ocular development.

The molecular events involved in normal and abnormal eye development are of pivotal importance, but the living mammalian embryo during organogenesis is virtually inaccessible to the investigator. We describe a method of whole embryo culture applicable both to rat and to mouse. With these techniques, embryos in vitro develop normally through the crucial period of organogenesis, which includes early eye development. This method will enable us to manipulate the milieu in which the embryo develops, and so enable us to study the role of growth factors and other molecules in this important but hitherto inaccessible stage of ocular ontogeny.

Animals↗

[Ultrasound diagnosis in ophthalmology].

In this review the indications for ophthalmic sonography are presented along with the variety of diseases of the eye, orbit, its bony walls, and the lacrimal system that can be differentiated and diagnosed by ultrasound. The predictive value, and thus the clinical significance, of sonography are compared with those of other imaging procedures for sensitivity, specificity, radiation exposure, and expense in terms of time and financial resources. The use of prenatal sonography in the detection of ocular and orbital malformations is discussed. Acoustomicroscopy and angiodynography are presented as recent advances in diagnostic sonography, along with examples of application.

Eye Abnormalities↗

[Ocular hypotony].

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Aged↗

Neuropathological background of oculomotor disturbances in olivopontocerebellar atrophy with special reference to slow saccade.

Neuropathological findings responsible for abnormal eye movements in olivopontocerebellar atrophy (OPCA) are reported. The material consists of eight sporadic cases and two hereditary cases. The sporadic cases showed impaired smooth pursuit without exception. The hereditary cases showed slow saccade (slow eye movement). Two important neuropathological findings are noted: The first is a systemic degeneration of cerebellifugal oculomotor control (cerebello-fastigio-vestibulo-MLF (medial longitudinal fasiculus) and perihypoglossal nuclei) in both types. Furthermore, neuronal loss of the oculomotor nuclei (oculomotor, trochlear and abducens nuclei) was found only in the hereditary cases. The second is that the hereditary type had a combined degeneration of the zona reticulata of the substantia nigra, the superior colliculus and the pontomedullary reticular formation. A review of the literature showed that all the cases of spino-cerebellar degeneration with slow saccade were hereditary OPCA, and that almost all cases had primary nigral degeneration. The neuropathological background of the oculomotor disturbances in OPCA is discussed.

Aged↗

Potential hazards of diagnostic radiation.

There are no precise data for determining the extent of somatic damage from small doses of radiation used in diagnostic radiology. Diagnostic radiation given to pregnant women, knowingly or unknowingly, should rarely reach teratogenic levels causing brain and eye abnormalities. Evidence suggests that it does increase the risk of childhood malignancy, especially leukemia. Although rapidly growing tissues seem most susceptible, all radiation probably carries a very small risk of carcinogenesis. Genetic damage is equally difficult to estimate. Diagnostic radiation of females, even in childhood, may be related to an increased incidence of Down's syndrome in older mothers. Radiation also causes point mutations, which may explain the increase of some genetic abnormalities in progeny of older fathers. Whenever an abdominal or pelvic radiograph is ordered before the end of the reproductive period, there must be a potential benefit to balance the small risk involved.

Animals↗

[Cutaneous signs of Noonan's syndrome. Apropos of a case with ulerythema ophyogenes, disseminated pilar and sudoral keratosis and progressive alopecia].

A case of typical Noonan syndrome (NS) with eye abnormalities, pterygium colli, cryptorchid testes, lymphoedema and asymmetrical cardiac septal hypertrophy is reported in a 8-month old infant. This case was particularly interesting since it included skin manifestations which enabled an early diagnosis to be made. Ulerythema ophryogenes has already been proposed as a cutaneous marker of NS, but the keratinization disorders in our patient also included disseminated keratosis of both hair follicles and sweat glands orifices. Abnormally brittle short curly hair has already been reported, but our patient exhibited progressive alopecia which is very rare in NS. Biochemical hair analysis did not show any abnormalities of aminoacids. All these features were suggestive of keratosis follicularis spinulosa decalvans. It therefore seems very likely that NS is associated with keratinization disorders but ulerythema ophryogenes might only be the limited form of these disorders. The other skin manifestations of NS are reviewed. Since the patient had 4 "café au lait" spots, the relation of NS with Von Recklinghausen syndrome, and neurofibromatosis-Noonan syndrome is discussed. Watson's Leopard and cardio-facial syndromes overlap with, and may represent subsets of NS.

Abnormalities, Multiple↗

Head injuries in children--special features.

Head injury in children is very common. Mostly the trauma is slight and the child improves without defects. Even after severe injuries, which can be fatal for an adult, many children will survive in a good condition. Prediction of survival and of quality of life after severe head injuries can be difficult. Predictors of a bad outcome are: low age, initial low grade of coma, abnormal motor responses, fixed pupils, abnormal eye movements, very high ICP, presence of diffuse cerebral edema or intracranial hematoma and obliteration of basal cisters on CT scans. Many children surviving a severe diffuse head injury will be mentally retarded or show behavioural changes.

Brain Injuries↗