Charcot-Marie-Tooth Disease - A Bibliography and Dictionary for Physicians, Patients, and Genome Researchers

CHARCOT-MARIE-TOOTH DISEASE A 3-in-1 Medical Reference A Bibliography and Dictionary for Physicians, Patients, and ...

Author: Philip M. Parker

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CHARCOT-MARIE-TOOTH DISEASE

A

3-in-1

Medical

Reference

A Bibliography and Dictionary for Physicians, Patients, and Genome Researchers TO INTERNET REFERENCES

CHARCOT-MARIE-TOOTH DISEASE A BIBLIOGRAPHY AND DICTIONARY FOR PHYSICIANS, PATIENTS, AND GENOME RESEARCHERS

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 7404 Trade Street San Diego, CA 92121 USA Copyright ©2007 by ICON Group International, Inc. Copyright ©2007 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher’s note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Charcot-Marie-Tooth Disease: A Bibliography and Dictionary for Physicians, Patients, and Genome Researchers/ James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-11350-3 1. Charcot-Marie-Tooth Disease-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on Charcot-Marie-Tooth disease. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Chaired Professor of Management Science at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 7404 Trade Street San Diego, CA 92121 USA Fax: 858-635-9414 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON CHARCOT-MARIE-TOOTH DISEASE ......................................................... 3 Overview........................................................................................................................................ 3 Genetics Home Reference ............................................................................................................... 3 What Is Charcot-Marie-Tooth Disease?......................................................................................... 3 How Common Is Charcot-Marie-Tooth Disease? .......................................................................... 4 What Genes Are Related to Charcot-Marie-Tooth Disease?.......................................................... 4 How Do People Inherit Charcot-Marie-Tooth Disease? ................................................................ 5 Where Can I Find Additional Information about Charcot-Marie-Tooth Disease? ........................ 6 References....................................................................................................................................... 7 What Is the Official Name of the BSCL2 Gene? ............................................................................ 8 What Is the Normal Function of the BSCL2 Gene?....................................................................... 8 What Conditions Are Related to the BSCL2 Gene?....................................................................... 9 Where Is the BSCL2 Gene Located?............................................................................................... 9 References..................................................................................................................................... 10 What Is the Official Name of the DNM2 Gene?.......................................................................... 11 What Is the Normal Function of the DNM2 Gene? .................................................................... 11 What Conditions Are Related to the DNM2 Gene? .................................................................... 11 Where Is the DNM2 Gene Located? ............................................................................................ 12 References..................................................................................................................................... 12 What Is the Official Name of the EGR2 Gene?............................................................................ 13 What Is the Normal Function of the EGR2 Gene? ...................................................................... 13 What Conditions Are Related to the EGR2 Gene? ...................................................................... 13 Where Is the EGR2 Gene Located? .............................................................................................. 13 References..................................................................................................................................... 14 What Is the Official Name of the GARS Gene? ........................................................................... 14 What Is the Normal Function of the GARS Gene?...................................................................... 15 What Conditions Are Related to the GARS Gene?...................................................................... 15 Where Is the GARS Gene Located?.............................................................................................. 15 References..................................................................................................................................... 16 What Is the Official Name of the GDAP1 Gene?......................................................................... 16 What Is the Normal Function of the GDAP1 Gene? ................................................................... 16 What Conditions Are Related to the GDAP1 Gene? ................................................................... 17 Where Is the GDAP1 Gene Located?........................................................................................... 17 References..................................................................................................................................... 17 What Is the Official Name of the GJB1 Gene? ............................................................................. 18 What Is the Normal Function of the GJB1 Gene?........................................................................ 18 What Conditions Are Related to the GJB1 Gene?........................................................................ 19 Where Is the GJB1 Gene Located?................................................................................................ 19 References..................................................................................................................................... 20 What Is the Official Name of the HSPB1 Gene?.......................................................................... 20 What Is the Normal Function of the HSPB1 Gene? .................................................................... 20 What Conditions Are Related to the HSPB1 Gene? .................................................................... 21 Where Is the HSPB1 Gene Located? ............................................................................................ 21 References..................................................................................................................................... 22 What Is the Official Name of the KIF1B Gene? ........................................................................... 22 What Is the Normal Function of the KIF1B Gene?...................................................................... 22 What Conditions Are Related to the KIF1B Gene?...................................................................... 23 Where Is the KIF1B Gene Located?.............................................................................................. 23 References..................................................................................................................................... 24 What Is the Official Name of the LITAF Gene?........................................................................... 24

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What Is the Normal Function of the LITAF Gene? ..................................................................... 24 What Conditions Are Related to the LITAF Gene? ..................................................................... 24 Where Is the LITAF Gene Located? ............................................................................................. 25 References..................................................................................................................................... 25 What Is the Official Name of the LMNA Gene?.......................................................................... 26 What Is the Normal Function of the LMNA Gene? .................................................................... 26 What Conditions Are Related to the LMNA Gene? .................................................................... 26 Where Is the LMNA Gene Located? ............................................................................................ 27 References..................................................................................................................................... 28 What Is the Official Name of the MFN2 Gene?........................................................................... 29 What Is the Normal Function of the MFN2 Gene? ..................................................................... 30 What Conditions Are Related to the MFN2 Gene? ..................................................................... 30 Where Is the MFN2 Gene Located? ............................................................................................. 30 References..................................................................................................................................... 31 What Is the Official Name of the MPZ Gene? ............................................................................. 31 What Is the Normal Function of the MPZ Gene? ....................................................................... 31 What Conditions Are Related to the MPZ Gene? ....................................................................... 32 Where Is the MPZ Gene Located? ............................................................................................... 32 References..................................................................................................................................... 33 What Is the Official Name of the MTMR2 Gene? ....................................................................... 33 What Is the Normal Function of the MTMR2 Gene?.................................................................. 33 What Conditions Are Related to the MTMR2 Gene?.................................................................. 34 Where Is the MTMR2 Gene Located?.......................................................................................... 34 References..................................................................................................................................... 34 What Is the Official Name of the NDRG1 Gene? ........................................................................ 35 What Is the Normal Function of the NDRG1 Gene?................................................................... 35 What Conditions Are Related to the NDRG1 Gene?................................................................... 36 Where Is the NDRG1 Gene Located? .......................................................................................... 36 References..................................................................................................................................... 36 What Is the Official Name of the NEFL Gene?............................................................................ 37 What Is the Normal Function of the NEFL Gene? ...................................................................... 37 What Conditions Are Related to the NEFL Gene? ...................................................................... 37 Where Is the NEFL Gene Located? .............................................................................................. 37 References..................................................................................................................................... 38 What Is the Official Name of the PMP22 Gene? ......................................................................... 39 What Is the Normal Function of the PMP22 Gene?.................................................................... 39 What Conditions Are Related to the PMP22 Gene?.................................................................... 40 Where Is the PMP22 Gene Located?............................................................................................ 40 References..................................................................................................................................... 41 What Is the Official Name of the PRX Gene?.............................................................................. 41 What Is the Normal Function of the PRX Gene? ........................................................................ 41 What Conditions Are Related to the PRX Gene? ........................................................................ 42 Where Is the PRX Gene Located? ................................................................................................ 42 References..................................................................................................................................... 42 What Is the Official Name of the RAB7 Gene?............................................................................ 43 What Is the Normal Function of the RAB7 Gene? ...................................................................... 43 What Conditions Are Related to the RAB7 Gene? ...................................................................... 43 Where Is the RAB7 Gene Located? .............................................................................................. 44 References..................................................................................................................................... 44 What Is the Official Name of the SBF2 Gene? ............................................................................. 45 What Is the Normal Function of the SBF2 Gene? ....................................................................... 45 What Conditions Are Related to the SBF2 Gene? ....................................................................... 45 Where Is the SBF2 Gene Located? ............................................................................................... 45 References..................................................................................................................................... 46

Contents

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What Is the Official Name of the SH3TC2 Gene? ....................................................................... 47 What Is the Normal Function of the SH3TC2 Gene?.................................................................. 47 What Conditions Are Related to the SH3TC2 Gene?.................................................................. 47 Where Is the SH3TC2 Gene Located?.......................................................................................... 47 References..................................................................................................................................... 48 What Is the Official Name of the YARS Gene? ........................................................................... 48 What Is the Normal Function of the YARS Gene?...................................................................... 48 What Conditions Are Related to the YARS Gene?...................................................................... 49 Where Is the YARS Gene Located?.............................................................................................. 49 References..................................................................................................................................... 49 The National Library of Medicine: PubMed ................................................................................ 50 CHAPTER 2. ALTERNATIVE MEDICINE AND CHARCOT-MARIE-TOOTH DISEASE ......................... 96 Overview...................................................................................................................................... 96 National Center for Complementary and Alternative Medicine.................................................. 96 Additional Web Resources ......................................................................................................... 100 General References ..................................................................................................................... 101 CHAPTER 3. DISSERTATIONS ON CHARCOT-MARIE-TOOTH DISEASE ......................................... 102 Overview.................................................................................................................................... 102 Dissertations on Charcot-Marie-Tooth Disease......................................................................... 102 Keeping Current ........................................................................................................................ 102 CHAPTER 4. BOOKS ON CHARCOT-MARIE-TOOTH DISEASE ....................................................... 103 Overview.................................................................................................................................... 103 Book Summaries: Online Booksellers......................................................................................... 103 The National Library of Medicine Book Index ........................................................................... 104 CHAPTER 5. MULTIMEDIA ON CHARCOT-MARIE-TOOTH DISEASE ............................................. 105 Overview.................................................................................................................................... 105 Bibliography: Multimedia on Charcot-Marie-Tooth Disease..................................................... 105 APPENDIX A. HELP ME UNDERSTAND GENETICS ....................................................................... 107 Overview.................................................................................................................................... 107 The Basics: Genes and How They Work..................................................................................... 107 Genetic Mutations and Health................................................................................................... 118 Inheriting Genetic Conditions ................................................................................................... 124 Genetic Consultation ................................................................................................................. 132 Genetic Testing .......................................................................................................................... 134 Gene Therapy ............................................................................................................................. 140 The Human Genome Project and Genomic Research................................................................. 143 APPENDIX B. PHYSICIAN RESOURCES ........................................................................................... 146 Overview.................................................................................................................................... 146 NIH Guidelines.......................................................................................................................... 146 NIH Databases........................................................................................................................... 147 Other Commercial Databases..................................................................................................... 150 The Genome Project and Charcot-Marie-Tooth Disease ............................................................ 150 APPENDIX C. PATIENT RESOURCES .............................................................................................. 154 Overview.................................................................................................................................... 154 Patient Guideline Sources.......................................................................................................... 154 Finding Associations.................................................................................................................. 158 Resources for Patients and Families........................................................................................... 159 ONLINE GLOSSARIES................................................................................................................ 160 Online Dictionary Directories ................................................................................................... 161 CHARCOT-MARIE-TOOTH DISEASE DICTIONARY ........................................................ 163 INDEX .............................................................................................................................................. 205

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FORWARD In March 2001, the National Institutes of Health issued the following warning: “The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading.”1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with Charcot-Marie-Tooth disease is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about Charcot-Marie-Tooth disease, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to Charcot-Marie-Tooth disease, from the essentials to the most advanced areas of research. Special attention has been paid to present the genetic basis and pattern of inheritance of Charcot-Marie-Tooth disease. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on Charcot-Marie-Tooth disease. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to Charcot-Marie-Tooth disease, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. We hope these resources will prove useful to the widest possible audience seeking information on Charcot-Marie-Tooth disease. The Editors

1

From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/.

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CHAPTER 1. STUDIES ON CHARCOT-MARIE-TOOTH DISEASE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on Charcot-Marie-Tooth disease. For those interested in basic information about CharcotMarie-Tooth disease, we begin with a condition summary published by the National Library of Medicine.

Genetics Home Reference Genetics Home Reference (GHR) is the National Library of Medicine’s Web site for consumer information about genetic conditions and the genes or chromosomes responsible for those conditions. Here you can find a condition summary on Charcot-Marie-Tooth disease that describes the major features of the condition, provides information about the condition’s genetic basis, and explains its pattern of inheritance. In addition, a summary of the gene or chromosome related to Charcot-Marie-Tooth disease is provided.2 The Genetics Home Reference has recently published the following summary for CharcotMarie-Tooth disease:

What Is Charcot-Marie-Tooth Disease?3 Charcot-Marie-Tooth disease is a group of progressive disorders that affect the peripheral nerves. Peripheral nerves connect the brain and spinal cord to muscles as well as sensory cells that detect sensations such as touch, pain, heat, and sound. Symptoms of Charcot-Marie-Tooth disease usually begin in adolescence or early adulthood, but onset may occur anytime from early childhood to mid-adulthood. Symptoms vary in 2 3

This section has been adapted from the National Library of Medicine: http://ghr.nlm.nih.gov/.

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/condition=charcotmarietoothdisease.

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severity. Some people never realize they have the disorder, but most have a moderate amount of physical disability, and a small percentage of people experience severe weakness. Many people with this disorder lead active lives and have normal life expectancies. Typically, the earliest symptoms involve muscle weakness in the feet, which can cause foot abnormalities such as high arches (pes cavus) or curled toes (hammer toes). It may become difficult to hold up the foot or to walk on the heel of the foot. These difficulties may cause a higher than normal step (or gait) and can increase the chance of ankle injuries and tripping. As the disease progresses, muscles in the lower legs usually weaken, but leg and foot problems rarely require the use of a wheelchair. Later symptoms may include muscle weakness in the hands, causing difficulty with daily activities such as writing, fastening buttons, and turning doorknobs. Because signals to sensory cells can be disrupted in Charcot-Marie-Tooth disease, people with this disorder may also notice some numbness, feel pain in the feet and lower legs, or experience a decreased sensitivity to heat and cold. In rare cases, sensory loss can include gradual hearing impairment and deafness. Different types of Charcot-Marie-Tooth disease can be distinguished by the abnormality that disrupts nerve function and by the genetic cause. Type X Charcot-Marie-Tooth disease is caused by mutations in a gene on the X chromosome, one of the two sex chromosomes. Type 1 Charcot-Marie-Tooth disease is characterized by abnormalities in myelin, the protective substance that covers nerve cells. Type 2 Charcot-Marie-Tooth disease is characterized by abnormalities in the fiber, or axon, that extends from a nerve cell and transmits nerve impulses. In intermediate forms of Charcot-Marie-Tooth disease, abnormalities occur in axons and myelin. Type 4 Charcot-Marie-Tooth disease affects either the axon or myelin. Types 1, 2, 4, and intermediate forms are further categorized by subtypes (such as 1A, 2A, 4A). Subtypes are distinguished by the specific gene that is altered. No universal system is used to classify types of Charcot-Marie-Tooth disease, and sometimes other names are used to describe this disorder. For example, Roussy-Levy syndrome is a form of type 1 Charcot-Marie-Tooth disease (type 1B). Dejerine-Sottas syndrome is a severe, early childhood form of Charcot-Marie-Tooth disease that may be type 1 or type 4 (depending on the specific gene that is altered).

How Common Is Charcot-Marie-Tooth Disease? Charcot-Marie-Tooth disease is the most common inherited disorder that involves the peripheral nerves, affecting an estimated 150,000 people in the United States. It occurs in all races and ethnic groups. Worldwide, this disorder affects about 1 in 3,300 people.

What Genes Are Related to Charcot-Marie-Tooth Disease? Mutations in the BSCL2 (http://ghr.nlm.nih.gov/gene=bscl2), DNM2 (http://ghr.nlm.nih.gov/gene=dnm2), EGR2 (http://ghr.nlm.nih.gov/gene=egr2), GARS (http://ghr.nlm.nih.gov/gene=gars), GDAP1 (http://ghr.nlm.nih.gov/gene=gdap1), GJB1 (http://ghr.nlm.nih.gov/gene=gjb1), HSPB1 (http://ghr.nlm.nih.gov/gene=hspb1), KIF1B (http://ghr.nlm.nih.gov/gene=kif1b), LITAF (http://ghr.nlm.nih.gov/gene=litaf), LMNA (http://ghr.nlm.nih.gov/gene=lmna), MFN2 (http://ghr.nlm.nih.gov/gene=mfn2), MPZ (http://ghr.nlm.nih.gov/gene=mpz), MTMR2 (http://ghr.nlm.nih.gov/gene=mtmr2),

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NDRG1 (http://ghr.nlm.nih.gov/gene=ndrg1), NEFL (http://ghr.nlm.nih.gov/gene=nefl), PMP22 (http://ghr.nlm.nih.gov/gene=pmp22), PRX (http://ghr.nlm.nih.gov/gene=prx), RAB7 (http://ghr.nlm.nih.gov/gene=rab7), SBF2 (http://ghr.nlm.nih.gov/gene=sbf2), SH3TC2 (http://ghr.nlm.nih.gov/gene=sh3tc2), and YARS (http://ghr.nlm.nih.gov/gene=yars) genes cause Charcot-Marie-Tooth disease. Charcot-Marie-Tooth disease is caused by changes in one of several different genes that are essential to the function of nerves in the feet, legs, and hands. These changes impair axons that transmit nerve impulses or affect the specialized cells that produce myelin. As a result of these disrupted functions, nerve cells slowly lose the ability to stimulate the muscles and to transmit sensory signals. Increasingly, Charcot-Marie-Tooth disease is categorized by the specific gene that is altered. Type 1 is caused by mutations in the following genes: PMP22 (subtypes 1A and 1E), MPZ (subtype 1B), LITAF (subtype 1C), EGR2 (subtype 1D), and NEFL (subtype 1F). Alterations in the following genes cause type 2 Charcot-Marie-Tooth disease: KIF1B and MFN2 (subtype 2A), RAB7 (subtype 2B), LMNA (subtype 2B1), BSCL2 and GARS (subtype 2D), NEFL (subtype 2E), HSPB1 (subtype 2F), MPZ (subtypes 2I and 2J), and GDAP1 (subtype 2K). Type 4 Charcot-Marie Tooth disease is caused by mutations in the following genes: GDAP1 (subtype 4A), MTMR2 (subtype 4B1), SBF2 (subtype 4B2), SH3TC2 (subtype 4C), NDRG1 (subtype 4D), EGR2 (subtype 4E), and PRX (subtype 4F). Type X Charcot-Marie-Tooth disease is caused by a mutation in the GJB1 gene, and intermediate forms of the disorder are caused by an altered DNM2 or YARS gene.

How Do People Inherit Charcot-Marie-Tooth Disease? The pattern of inheritance varies with the type of Charcot-Marie-Tooth disease. Type 1, most cases of type 2, and intermediate forms of Charcot-Marie-Tooth disease are inherited in an autosomal dominant pattern. This pattern of inheritance means that one copy of the altered gene in each cell is sufficient to cause the disorder. In most cases, an affected person has one affected parent. Type 4 and subtypes 2B1 and 2K are inherited in an autosomal recessive pattern, which means two copies of the gene in each cell are altered. Most often, the parents of a child with an autosomal recessive disorder are not affected but are carriers of one copy of the altered gene. Type X is inherited in an X-linked dominant pattern. A condition is considered X-linked if the mutated gene that causes the disorder is located on the X chromosome. The inheritance is dominant if one copy of the altered gene is sufficient to cause the condition. In most cases, males experience more severe symptoms of the disorder than females. A striking characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons. Some cases of Charcot-Marie-Tooth disease result from a new mutation and occur in people with no history of the disorder in their family.

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Charcot-Marie-Tooth Disease

Where Can I Find Additional Information about Charcot-Marie-Tooth Disease? You may find the following resources about Charcot-Marie-Tooth disease helpful. These materials are written for the general public. NIH Publications - National Institutes of Health •

National Center for Biotechnology Information: Genes and Disease: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?tool=bookshelf&call=bv.View.Sho wSection&searchterm=Charcot&rid=gnd.section.197

•

National Human Genome Research Institute: http://www.genome.gov/11009201

•

National Institute of Neurological Disorders and Stroke: http://www.ninds.nih.gov/disorders/charcot_marie_tooth/detail_charcot_marie_tooth. htm MedlinePlus - Health Information

•

Encyclopedia: Charcot-Marie-Tooth disease: http://www.nlm.nih.gov/medlineplus/ency/article/000727.htm

•

Encyclopedia: Hammer toe: http://www.nlm.nih.gov/medlineplus/ency/article/001235.htm

•

Encyclopedia: High arch: http://www.nlm.nih.gov/medlineplus/ency/article/001261.htm

•

Health Topic: Charcot-Marie-Tooth Disease: http://www.nlm.nih.gov/medlineplus/charcotmarietoothdisease.html Educational Resources - Information Pages

•

Duke Center for Human Genetics: http://www.chg.duke.edu/diseases/cmt.html

•

Madisons Foundation: Charcot-Marie-Tooth disorder: http://www.madisonsfoundation.org/content/3/1/display.asp?did=428

•

Madisons Foundation: Dejerine-Sottas disease: http://www.madisonsfoundation.org/content/3/1/display.asp?did=364

•

Madisons Foundation: Roussy-Levy syndrome: http://www.madisonsfoundation.org/content/3/1/display.asp?did=524

•

New York Online Access to Health (NOAH): http://www.noah-health.org/en/bns/disorders/charcot/

•

University of Chicago: http://millercenter.uchicago.edu/learnaboutpn/typesofpn/hereditary/charcotmarietoot h.shtml

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Patient Support - for Patients and Families •

Charcot-Marie-Tooth Association: http://www.charcot-marie-tooth.org

•

Muscular Dystrophy Association: http://www.mdausa.org/disease/cmt.aspx

•

National Organization for Rare Disorders: http://www.rarediseases.org/search/rdbdetail_abstract.html?disname=Charcot+Marie +Tooth+Disease Professional Resources

You may also be interested in these resources, which are designed for healthcare professionals and researchers. •

Gene Reviews - Clinical summary: http://ghr.nlm.nih.gov/condition=charcotmarietoothdisease/show/Gene+Reviews;jses sionid=5290086C85533AC98E0875021E7B8222

•

Gene Tests - DNA tests ordered by healthcare professionals: http://ghr.nlm.nih.gov/condition=charcotmarietoothdisease/show/Gene+Tests;jsessio nid=5290086C85533AC98E0875021E7B8222

•

Genetic Tools - Teaching cases: http://www.genetests.org/servlet/access?fcn=y&filename=/tools/cases/cmt-7/

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ClinicalTrials.gov - Linking patients to medical research: http://clinicaltrials.gov/search/condition=%22charcot-marietooth+disease%22?recruiting=false

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PubMed - Recent literature: http://ghr.nlm.nih.gov/condition=charcotmarietoothdisease/show/PubMed;jsessionid =5290086C85533AC98E0875021E7B8222

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Online Books - Medical and science texts: http://books.mcgrawhill.com/getommbid.php?isbn=0071459960&template=ommbid&c=227

•

OMIM - Genetic disorder catalog: http://ghr.nlm.nih.gov/condition=charcotmarietoothdisease/show/OMIM;jsessionid= 5290086C85533AC98E0875021E7B8222

References These sources were used to develop the Genetics Home Reference condition summary on Charcot-Marie-Tooth disease. •

Benstead TJ, Grant IA. Progress in clinical neurosciences: Charcot-Marie-Tooth disease and related inherited peripheral neuropathies. Can J Neurol Sci. 2001 Aug;28(3):199-214. Review. PubMed citation

•

Bone LJ, Deschenes SM, Balice-Gordon RJ, Fischbeck KH, Scherer SS. Connexin32 and Xlinked Charcot-Marie-Tooth disease. Neurobiol Dis. 1997;4(3-4):221-30. Review. PubMed citation

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•

Carter GT, England JD, Chance PF. Charcot-Marie-Tooth disease: electrophysiology, molecular genetics and clinical management. IDrugs. 2004 Feb;7(2):151-9. Review. PubMed citation

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Chance PF. Genetic evaluation of inherited motor/sensory neuropathy. Suppl Clin Neurophysiol. 2004;57:228-42. Review. PubMed citation

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De Sandre-Giovannoli A, Chaouch M, Kozlov S, Vallat JM, Tazir M, Kassouri N, Szepetowski P, Hammadouche T, Vandenberghe A, Stewart CL, Grid D, Levy N. Homozygous defects in LMNA, encoding lamin A/C nuclear-envelope proteins, cause autosomal recessive axonal neuropathy in human (Charcot-Marie-Tooth disorder type 2) and mouse. Am J Hum Genet. 2002 Mar;70(3):726-36. Epub 2002 Jan 17. Erratum in: Am J Hum Genet 2002 Apr;70(4):1075. PubMed citation

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Gemignani F, Marbini A. Charcot-Marie-Tooth disease (CMT): distinctive phenotypic and genotypic features in CMT type 2. J Neurol Sci. 2001 Feb 15;184(1):1-9. Review. PubMed citation

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Gene Review: Charcot-Marie-Tooth Neuropathy Overview

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Kuhlenbaumer G, Young P, Hunermund G, Ringelstein B, Stogbauer F. Clinical features and molecular genetics of hereditary peripheral neuropathies. J Neurol. 2002 Dec;249(12):1629-50. Review. PubMed citation

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Reilly MM. Classification of the hereditary motor and sensory neuropathies. Curr Opin Neurol. 2000 Oct;13(5):561-4. Review. No abstract available. PubMed citation

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Vallat JM, Tazir M, Magdelaine C, Sturtz F, Grid D. Autosomal-recessive Charcot-MarieTooth diseases. J Neuropathol Exp Neurol. 2005 May;64(5):363-70. Review. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

A summary of the genes related to Charcot-Marie-Tooth disease is provided below:

What Is the Official Name of the BSCL2 Gene?4 The official name of this gene is “Bernardinelli-Seip congenital lipodystrophy 2 (seipin).” BSCL2 is the gene's official symbol. The BSCL2 gene is also known by other names, listed below.

What Is the Normal Function of the BSCL2 Gene? The BSCL2 gene provides instructions for making a protein called seipin, whose function is unknown. Within cells, seipin is found in the membrane of a tubelike structure called the endoplasmic reticulum. The endoplasmic reticulum modifies newly produced proteins and also helps transport proteins, fats, and other molecules to specific sites either inside or 4

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=bscl2;jsessionid=5290086C85533AC98E0875021E7B8222.

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outside the cell. The BSCL2 gene is active in cells throughout the body, particularly nerve cells that control muscle movement (motor neurons), brain cells, and cells in fat-storing (adipose) tissue.

What Conditions Are Related to the BSCL2 Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the BSCL2 Gene A BSCL2 mutation has been reported in a small number of people with signs and symptoms that are characteristic of Charcot-Marie-Tooth disease type 2. This mutation changes one of the protein building blocks (amino acids) used to make seipin. Specifically, the amino acid asparagine is replaced with the amino acid serine at protein position 88 (written as Asn88Ser or N88S). This mutation probably alters the structure of seipin. It is unclear, however, how the altered protein impairs motor neurons, which leads to weakened muscles in the arms and legs and disrupted signals to sensory cells that detect sensations such as touch, sound, and sight. Distal Hereditary Motor Neuropathy, Type V - Caused by Mutations in the BSCL2 Gene A BSCL2 mutation has been reported in a small number of people with signs and symptoms that are characteristic of Charcot-Marie-Tooth disease type 2. This mutation changes one of the protein building blocks (amino acids) used to make seipin. Specifically, the amino acid asparagine is replaced with the amino acid serine at protein position 88 (written as Asn88Ser or N88S). This mutation probably alters the structure of seipin. It is unclear, however, how the altered protein impairs motor neurons, which leads to weakened muscles in the arms and legs and disrupted signals to sensory cells that detect sensations such as touch, sound, and sight. Other Disorders - Caused by Mutations in the BSCL2 Gene Two BSCL2 mutations have been identified in people with distal hereditary motor neuropathy, type V. These mutations change one of the protein building blocks (amino acids) used to make seipin. Specifically, serine is replaced with leucine at position 90 (written as Ser90Leu or S90L), or asparagine is replaced by serine at position 88 (written as Asn88Ser or N88S). These mutations probably alter the structure of seipin. It is unclear, however, how the altered protein impairs motor neurons, which leads to weakened muscles in the hand.

Where Is the BSCL2 Gene Located? Cytogenetic Location: 11q12-q13.5 Molecular Location on chromosome 11: base pairs 62,214,322 to 62,231,394

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Charcot-Marie-Tooth Disease

The BSCL2 gene is located on the long (q) arm of chromosome 11 between positions 12 and 13.5. More precisely, the BSCL2 gene is located from base pair 62,214,322 to base pair 62,231,394 on chromosome 11.

References These sources were used to develop the Genetics Home Reference gene summary on the BSCL2 gene. •

Agarwal AK, Garg A. Seipin: a mysterious protein. Trends Mol Med. 2004 Sep;10(9):4404. Review. No abstract available. PubMed citation

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Auer-Grumbach M, Schlotter-Weigel B, Lochmuller H, Strobl-Wildemann G, AuerGrumbach P, Fischer R, Offenbacher H, Zwick EB, Robl T, Hartl G, Hartung HP, Wagner K, Windpassinger C; Austrian Peripheral Neuropathy Study Group. Phenotypes of the N88S Berardinelli-Seip congenital lipodystrophy 2 mutation. Ann Neurol. 2005 Mar;57(3):415-24. PubMed citation

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Gene Review: BSCL2-Related Neurologic Disorders

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Magre J, Delepine M, Khallouf E, Gedde-Dahl T Jr, Van Maldergem L, Sobel E, Papp J, Meier M, Megarbane A, Bachy A, Verloes A, d'Abronzo FH, Seemanova E, Assan R, Baudic N, Bourut C, Czernichow P, Huet F, Grigorescu F, de Kerdanet M, Lacombe D, Labrune P, Lanza M, Loret H, Matsuda F, Navarro J, Nivelon-Chevalier A, Polak M, Robert JJ, Tric P, Tubiana-Rufi N, Vigouroux C, Weissenbach J, Savasta S, Maassen JA, Trygstad O, Bogalho P, Freitas P, Medina JL, Bonnicci F, Joffe BI, Loyson G, Panz VR, Raal FJ, O'Rahilly S, Stephenson T, Kahn CR, Lathrop M, Capeau J; BSCL Working Group. Identification of the gene altered in Berardinelli-Seip congenital lipodystrophy on chromosome 11q13. Nat Genet. 2001 Aug;28(4):365-70. PubMed citation

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OMIM: BSCL2

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Windpassinger C, Auer-Grumbach M, Irobi J, Patel H, Petek E, Horl G, Malli R, Reed JA, Dierick I, Verpoorten N, Warner TT, Proukakis C, Van den Bergh P, Verellen C, Van Maldergem L, Merlini L, De Jonghe P, Timmerman V, Crosby AH, Wagner K. Heterozygous missense mutations in BSCL2 are associated with distal hereditary motor neuropathy and Silver syndrome. Nat Genet. 2004 Mar;36(3):271-6. Epub 2004 Feb 22. PubMed citation

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What Is the Official Name of the DNM2 Gene?5 The official name of this gene is “dynamin 2.” DNM2 is the gene's official symbol. The DNM2 gene is also known by other names, listed below.

What Is the Normal Function of the DNM2 Gene? The DNM2 gene provides instructions for making a protein called dynamin 2. Dynamin 2 is present in cells throughout the body and plays a role in several cell activities. One such activity is a process called endocytosis, by which cells transport materials from outside to inside the cell. Through this process, the cell membrane folds around a substance outside the cell and forms a saclike vesicle. The vesicle is drawn into the cell and is pinched off from the cell membrane. Dynamin 2 is thought to play a key role in altering the cell membrane to form these vesicles. This protein probably also participates in moving vesicles within the cell. Additionally, dynamin 2 associates with tubelike structures, called microtubules, which are part of the cell's structural framework (cytoskeleton). The cytoskeleton helps to define cell shape and organize cell contents, and aids in cell movement. Microtubules are also essential for cell division. In a related role, dynamin 2 appears to be important for the structure of a cell component called the centrosome, which is the organizing center for microtubules.

What Conditions Are Related to the DNM2 Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the DNM2 Gene Researchers have identified a few DNM2 mutations that cause a form of Charcot-MarieTooth disease known as dominant intermediate B. These mutations alter the number or types of protein building blocks (amino acids) used to make dynamin 2. One mutation replaces the amino acid lysine with the amino acid glutamic acid at protein position 558 (written as Lys558Glu). As a result of other mutations, dynamin 2 is missing one or more amino acids. Other Disorders - Caused by Mutations in the DNM2 Gene Researchers have identified a few DNM2 mutations that cause a form of Charcot-MarieTooth disease known as dominant intermediate B. These mutations alter the number or types of protein building blocks (amino acids) used to make dynamin 2. One mutation replaces the amino acid lysine with the amino acid glutamic acid at protein position 558 (written as Lys558Glu). As a result of other mutations, dynamin 2 is missing one or more amino acids.

5

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=dnm2.

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Charcot-Marie-Tooth Disease

Where Is the DNM2 Gene Located? Cytogenetic Location: 19p13.2 Molecular Location on chromosome 19: base pairs 10,689,754 to 10,803,578

The DNM2 gene is located on the short (p) arm of chromosome 19 at position 13.2. More precisely, the DNM2 gene is located from base pair 10,689,754 to base pair 10,803,578 on chromosome 19.

References These sources were used to develop the Genetics Home Reference gene summary on the DNM2 gene. •

Bitoun M, Maugenre S, Jeannet PY, Lacene E, Ferrer X, Laforet P, Martin JJ, Laporte J, Lochmuller H, Beggs AH, Fardeau M, Eymard B, Romero NB, Guicheney P. Mutations in dynamin 2 cause dominant centronuclear myopathy. Nat Genet. 2005 Nov;37(11):1207-9. Epub 2005 Oct 16. PubMed citation

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OMIM: DNM2

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Schafer DA. Regulating actin dynamics at membranes: a focus on dynamin. Traffic. 2004 Jul;5(7):463-9. Review. PubMed citation

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Thompson HM, Cao H, Chen J, Euteneuer U, McNiven MA. Dynamin 2 binds gammatubulin and participates in centrosome cohesion. Nat Cell Biol. 2004 Apr;6(4):335-42. Epub 2004 Mar 14. PubMed citation

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Zuchner S, Noureddine M, Kennerson M, Verhoeven K, Claeys K, De Jonghe P, Merory J, Oliveira SA, Speer MC, Stenger JE, Walizada G, Zhu D, Pericak-Vance MA, Nicholson G, Timmerman V, Vance JM. Mutations in the pleckstrin homology domain of dynamin 2 cause dominant intermediate Charcot-Marie-Tooth disease. Nat Genet. 2005 Mar;37(3):289-94. Epub 2005 Jan 30. PubMed citation

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What Is the Official Name of the EGR2 Gene?6 The official name of this gene is “early growth response 2 (Krox-20 homolog, Drosophila).” EGR2 is the gene's official symbol. The EGR2 gene is also known by other names, listed below.

What Is the Normal Function of the EGR2 Gene? The EGR2 gene provides instructions for making a protein called early growth response 2, which is part of the early growth response family of proteins. These proteins bind to specific areas of DNA and help control the activity of particular genes. On the basis of this action, the proteins are referred to as transcription factors. The early growth response 2 protein activates several genes that are involved in the formation and maintenance of myelin, the fatty substance that covers and protects nerve cells. Myelin promotes the efficient transmission of nerve impulses. If myelin is lost (demyelination) or its structure is disrupted, the transmission of nerve impulses is impaired.

What Conditions Are Related to the EGR2 Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the EGR2 Gene Mutations in the EGR2 gene can cause two forms of Charcot-Marie-Tooth disease, type 1D or type 4E (sometimes called congenital hypomyelinating neuropathy). These mutations change a protein building block (amino acid) used to make the early growth response 2 protein. As a result, the altered protein cannot bind effectively to DNA, which disrupts the control of genes involved in myelin formation and maintenance. This disruption impairs the transmission of nerve impulses, leading to the symptoms of Charcot-Marie-Tooth disease.

Where Is the EGR2 Gene Located? Cytogenetic Location: 10q21.1 Molecular Location on chromosome 10: base pairs 64,241,762 to 64,246,132

6

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=egr2;jsessionid=5290086C85533AC98E0875021E7B8222.

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Charcot-Marie-Tooth Disease

The EGR2 gene is located on the long (q) arm of chromosome 10 at position 21.1. More precisely, the EGR2 gene is located from base pair 64,241,762 to base pair 64,246,132 on chromosome 10.

References These sources were used to develop the Genetics Home Reference gene summary on the EGR2 gene. •

Leblanc SE, Srinivasan R, Ferri C, Mager GM, Gillian-Daniel AL, Wrabetz L, Svaren J. Regulation of cholesterol/lipid biosynthetic genes by Egr2/Krox20 during peripheral nerve myelination. J Neurochem. 2005 May;93(3):737-48. PubMed citation

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Musso M, Balestra P, Taroni F, Bellone E, Mandich P. Different consequences of EGR2 mutants on the transactivation of human Cx32 promoter. Neurobiol Dis. 2003 Feb;12(1):89-95. PubMed citation

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Warner LE, Svaren J, Milbrandt J, Lupski JR. Functional consequences of mutations in the early growth response 2 gene (EGR2) correlate with severity of human myelinopathies. Hum Mol Genet. 1999 Jul;8(7):1245-51. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

What Is the Official Name of the GARS Gene?7 The official name of this gene is “glycyl-tRNA synthetase.” GARS is the gene's official symbol. The GARS gene is also known by other names, listed below.

7

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=gars.

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What Is the Normal Function of the GARS Gene? The GARS gene provides instructions for making an enzyme called glycyl-tRNA synthetase. This enzyme is found in all cell types and plays an important role in the production (synthesis) of proteins. During protein synthesis, building blocks (amino acids) are connected together in a specific order, creating a chain of amino acids. Glycyl-tRNA synthetase plays a role in adding the amino acid glycine at the proper place in a protein's chain of amino acids.

What Conditions Are Related to the GARS Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the GARS Gene Two mutations in the GARS gene cause a form of Charcot-Marie-Tooth disease known as type 2D. These mutations change one of the amino acids used to make glycyl-tRNA synthetase. One mutation replaces the amino acid glycine with the amino acid arginine at protein position 240 (written as Gly240Arg). The other mutation replaces the amino acid glutamic acid with the amino acid glycine at position 71 (Glu71Gly). It remains unclear how GARS mutations lead to type 2D Charcot-Marie-Tooth disease. The mutations probably cause a decrease in the activity of glycyl-tRNA synthetase, which could affect the synthesis of every protein that contains glycine. Scientists suggest that nerve cells need glycine-rich proteins to function properly, and these functions would be disrupted by GARS mutations. Distal Hereditary Motor Neuropathy, Type V - Caused by Mutations in the GARS Gene Two mutations in the GARS gene cause a form of Charcot-Marie-Tooth disease known as type 2D. These mutations change one of the amino acids used to make glycyl-tRNA synthetase. One mutation replaces the amino acid glycine with the amino acid arginine at protein position 240 (written as Gly240Arg). The other mutation replaces the amino acid glutamic acid with the amino acid glycine at position 71 (Glu71Gly). It remains unclear how GARS mutations lead to type 2D Charcot-Marie-Tooth disease. The mutations probably cause a decrease in the activity of glycyl-tRNA synthetase, which could affect the synthesis of every protein that contains glycine. Scientists suggest that nerve cells need glycine-rich proteins to function properly, and these functions would be disrupted by GARS mutations.

Where Is the GARS Gene Located? Cytogenetic Location: 7p14 Molecular Location on chromosome 7: base pairs 30,600,705 to 30,640,168

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Charcot-Marie-Tooth Disease

The GARS gene is located on the short (p) arm of chromosome 7 at position 14. More precisely, the GARS gene is located from base pair 30,600,705 to base pair 30,640,168 on chromosome 7.

References These sources were used to develop the Genetics Home Reference gene summary on the GARS gene. •

Antonellis A, Ellsworth RE, Sambuughin N, Puls I, Abel A, Lee-Lin SQ, Jordanova A, Kremensky I, Christodoulou K, Middleton LT, Sivakumar K, Ionasescu V, Funalot B, Vance JM, Goldfarb LG, Fischbeck KH, Green ED. Glycyl tRNA Synthetase Mutations in Charcot-Marie-Tooth Disease Type 2D and Distal Spinal Muscular Atrophy Type V. Am J Hum Genet. 2003 May;72(5):1293-9. Epub 2003 Apr 10. PubMed citation

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OMIM

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Sivakumar K, Kyriakides T, Puls I, Nicholson GA, Funalot B, Antonellis A, Sambuughin N, Christodoulou K, Beggs JL, Zamba-Papanicolaou E, Ionasescu V, Dalakas MC, Green ED, Fischbeck KH, Goldfarb LG. Phenotypic spectrum of disorders associated with glycyl-tRNA synthetase mutations. Brain. 2005 Oct;128(Pt 10):2304-14. Epub 2005 Jul 13. PubMed citation

What Is the Official Name of the GDAP1 Gene?8 The official name of this gene is “ganglioside-induced differentiation-associated protein 1.” GDAP1 is the gene's official symbol. The GDAP1 gene is also known by other names, listed below.

What Is the Normal Function of the GDAP1 Gene? The GDAP1 gene provides instructions for making a protein called ganglioside-induced differentiation-associated protein 1. This protein is made in several different types of cells 8

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=gdap1;jsessionid=5290086C85533AC98E0875021E7B8222.

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throughout the body, particularly cells of the nervous system. Within cells, the GDAP1 protein is found in the outer envelope (membrane) of mitochondria, the structures that produce energy to power cell activities. Mitochondria are dynamic structures that change shape through processes called fission (splitting into smaller pieces) and fusion (combining pieces). Changes in shape are thought to be critical for mitochondria to work properly. Although its function is not well understood, the GDAP1 protein appears to play a role in controlling the shape of mitochondria by promoting fission.

What Conditions Are Related to the GDAP1 Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the GDAP1 Gene About 20 different mutations cause a form of Charcot-Marie-Tooth disease (type 4A) in which two copies of the GDAP1 gene in each cell are altered. Two GDAP1 mutations have been identified in cases of Charcot-Marie-Tooth disease in which just one copy of the GDAP1 gene in each cell is altered; these cases are called type 2K.

Where Is the GDAP1 Gene Located? Cytogenetic Location: 8q13.3-q21.1 Molecular Location on chromosome 8: base pairs 75,425,251 to 75,439,156

The GDAP1 gene is located on the long (q) arm of chromosome 8 between positions 13.3 and 21.1. More precisely, the GDAP1 gene is located from base pair 75,425,251 to base pair 75,439,156 on chromosome 8.

References These sources were used to develop the Genetics Home Reference gene summary on the GDAP1 gene. •

Ammar N, Nelis E, Merlini L, Barisic N, Amouri R, Ceuterick C, Martin JJ, Timmerman V, Hentati F, De Jonghe P. Identification of novel GDAP1 mutations causing autosomal

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Charcot-Marie-Tooth Disease

recessive Charcot-Marie-Tooth disease. Neuromuscul Disord. 2003 Nov;13(9):720-8. PubMed citation •

Boerkoel CF, Takashima H, Nakagawa M, Izumo S, Armstrong D, Butler I, Mancias P, Papasozomenos SC, Stern LZ, Lupski JR. CMT4A: identification of a Hispanic GDAP1 founder mutation. Ann Neurol. 2003 Mar;53(3):400-5. PubMed citation

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Claramunt R, Pedrola L, Sevilla T, Lopez de Munain A, Berciano J, Cuesta A, SanchezNavarro B, Millan JM, Saifi GM, Lupski JR, Vilchez JJ, Espinos C, Palau F. Genetics of Charcot-Marie-Tooth disease type 4A: mutations, inheritance, phenotypic variability, and founder effect. J Med Genet. 2005 Apr;42(4):358-65. No abstract available. PubMed citation

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Cuesta A, Pedrola L, Sevilla T, Garcia-Planells J, Chumillas MJ, Mayordomo F, LeGuern E, Marin I, Vilchez JJ, Palau F. The gene encoding ganglioside-induced differentiationassociated protein 1 is mutated in axonal Charcot-Marie-Tooth type 4A disease. Nat Genet. 2002 Jan;30(1):22-5. Epub 2001 Dec 17. PubMed citation

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Nelis E, Erdem S, Van Den Bergh PY, Belpaire-Dethiou MC, Ceuterick C, Van Gerwen V, Cuesta A, Pedrola L, Palau F, Gabreels-Festen AA, Verellen C, Tan E, Demirci M, Van Broeckhoven C, De Jonghe P, Topaloglu H, Timmerman V. Mutations in GDAP1: autosomal recessive CMT with demyelination and axonopathy. Neurology. 2002 Dec 24;59(12):1865-72. PubMed citation

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Niemann A, Ruegg M, La Padula V, Schenone A, Suter U. Ganglioside-induced differentiation associated protein 1 is a regulator of the mitochondrial network: new implications for Charcot-Marie-Tooth disease. J Cell Biol. 2005 Sep 26;170(7):1067-78. Epub 2005 Sep 19. PubMed citation

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Pedrola L, Espert A, Wu X, Claramunt R, Shy ME, Palau F. GDAP1, the protein causing Charcot-Marie-Tooth disease type 4A, is expressed in neurons and is associated with mitochondria. Hum Mol Genet. 2005 Apr 15;14(8):1087-94. Epub 2005 Mar 16. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

What Is the Official Name of the GJB1 Gene?9 The official name of this gene is “gap junction protein, beta 1, 32kDa (connexin 32, CharcotMarie-Tooth neuropathy, X-linked).” GJB1 is the gene's official symbol. The GJB1 gene is also known by other names, listed below.

What Is the Normal Function of the GJB1 Gene? The GJB1 gene provides instructions for making a protein called gap junction beta 1 (also known as connexin 32). This protein is a member of the gap junction connexin family, which 9

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=gjb1.

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plays a role in cell communication by forming channels (gap junctions) between cells. Gap junctions speed the transport of nutrients, charged particles (ions), and small molecules that carry communication signals between cells. The gap junction beta 1 protein is made in several tissues, including the liver, pancreas, kidney, and nervous system. In the nervous system, this protein is located in the cell membrane of specialized cells called Schwann cells. Schwann cells play an important role in protecting nerves by producing a fatty substance called myelin, which is also located in the cell membrane. The Schwann cell membrane wraps around a nerve in concentric layers, like a jelly roll, to form a protective myelin sheath. The gap junction beta 1 protein forms channels through the myelin layers, allowing efficient transport and communication between the outer myelin layers and the interior of the Schwann cell.

What Conditions Are Related to the GJB1 Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the GJB1 Gene Researchers have identified more than 250 GJB1 mutations in people with type X CharcotMarie-Tooth disease. Some mutations result in a protein with an abnormal length (too short or too long). Most mutations, however, change one of the building blocks (amino acids) used to make the gap junction beta 1 protein. A few of these changes in amino acids also cause hearing loss in individuals with type X Charcot-Marie-Tooth disease.

Where Is the GJB1 Gene Located? Cytogenetic Location: Xq13.1 Molecular Location on the X chromosome: base pairs 70,359,800 to 70,361,768

The GJB1 gene is located on the long (q) arm of the X chromosome at position 13.1. More precisely, the GJB1 gene is located from base pair 70,359,800 to base pair 70,361,768 on the X chromosome.

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Charcot-Marie-Tooth Disease

References These sources were used to develop the Genetics Home Reference gene summary on the GJB1 gene. •

Abrams CK, Oh S, Ri Y, Bargiello TA. Mutations in connexin 32: the molecular and biophysical bases for the X-linked form of Charcot-Marie-Tooth disease. Brain Res Brain Res Rev. 2000 Apr;32(1):203-14. Review. PubMed citation

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Kochanski A, Kabzinska D. Molecular genetic analysis of the GJB1 gene: a study of six mutations. J Appl Genet. 2004;45(1):95-100. PubMed citation

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Ressot C, Bruzzone R. Connexin channels in Schwann cells and the development of the X-linked form of Charcot-Marie-Tooth disease. Brain Res Brain Res Rev. 2000 Apr;32(1):192-202. Review. PubMed citation

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Wang HL, Chang WT, Yeh TH, Wu T, Chen MS, Wu CY. Functional analysis of connexin-32 mutants associated with X-linked dominant Charcot-Marie-Tooth disease. Neurobiol Dis. 2004 Mar;15(2):361-70. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

What Is the Official Name of the HSPB1 Gene?10 The official name of this gene is “heat shock 27kDa protein 1.” HSPB1 is the gene's official symbol. The HSPB1 gene is also known by other names, listed below.

What Is the Normal Function of the HSPB1 Gene? The HSPB1 gene provides instructions for making a protein called heat shock protein beta-1 (also called heat shock protein 27). This protein is a member of the heat shock protein family, which helps to protect cells under adverse conditions such as infection, inflammation, exposure to toxins, elevated temperature, injury, and disease. Heat shock proteins block signals that tell cells to self-destruct through a sequence of events known as programmed cell death (apoptosis). Heat shock proteins also appear to be involved in activities such as cell motility and muscle movement, stabilizing the cell's structural framework (cytoskeleton), assisting with folding and stabilizing newly produced proteins, and repairing damaged proteins. Heat shock protein beta-1 is found in cells throughout the body and is abundant in nerve cells. In nerve cells, this protein helps to organize the network of molecular threads (called neurofilaments) that maintain the diameter of the fiber, or axon, extending from these cells. Maintaining proper axon diameter is essential for the efficient transmission of nerve impulses.

10

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=hspb1;jsessionid=5290086C85533AC98E0875021E7B8222.

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What Conditions Are Related to the HSPB1 Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the HSPB1 Gene Three HSPB1 mutations have been reported in individuals with a form of Charcot-MarieTooth disease known as type 2F. Each mutation changes a single protein building block (amino acid) used to make heat shock protein beta-1. One mutation replaces the amino acid serine with the amino acid phenylalanine at protein position 135 (written as Ser135Phe). The other mutations replace arginine with tryptophan at position 136 (Arg136Trp) or at position 127 (Arg127Trp). These mutations alter a region of the protein that is critical for heat shock protein beta-1 to function properly. It not clear how these alterations produce axon abnormalities that are characteristic of type 2F Charcot-Marie-Tooth disease. Researchers suggest that HSPB1 mutations alter the assembly of neurofilaments or allow misfolded proteins to accumulate, which impairs nerve axons and disrupts the transmission of nerve impulses. Other Disorders - Caused by Mutations in the HSPB1 Gene Three HSPB1 mutations have been reported in individuals with a form of Charcot-MarieTooth disease known as type 2F. Each mutation changes a single protein building block (amino acid) used to make heat shock protein beta-1. One mutation replaces the amino acid serine with the amino acid phenylalanine at protein position 135 (written as Ser135Phe). The other mutations replace arginine with tryptophan at position 136 (Arg136Trp) or at position 127 (Arg127Trp). These mutations alter a region of the protein that is critical for heat shock protein beta-1 to function properly. It not clear how these alterations produce axon abnormalities that are characteristic of type 2F Charcot-Marie-Tooth disease. Researchers suggest that HSPB1 mutations alter the assembly of neurofilaments or allow misfolded proteins to accumulate, which impairs nerve axons and disrupts the transmission of nerve impulses.

Where Is the HSPB1 Gene Located? Cytogenetic Location: 7q11.23 Molecular Location on chromosome 7: base pairs 75,769,858 to 75,771,547

The HSPB1 gene is located on the long (q) arm of chromosome 7 at position 11.23.

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Charcot-Marie-Tooth Disease

More precisely, the HSPB1 gene is located from base pair 75,769,858 to base pair 75,771,547 on chromosome 7.

References These sources were used to develop the Genetics Home Reference gene summary on the HSPB1 gene. •

Benndorf R, Welsh MJ. Shocking degeneration. Nat Genet. 2004 Jun;36(6):547-8. No abstract available. PubMed citation

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Cooper, David N; Nature encyclopedia of the human genome; London; New York : Nature Pub. Group, 2003. p184-190. NLM Catalog

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Dierick I, Irobi J, De Jonghe P, Timmerman V. Small heat shock proteins in inherited peripheral neuropathies. Ann Med. 2005;37(6):413-22. PubMed citation

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Evgrafov OV, Mersiyanova I, Irobi J, Van Den Bosch L, Dierick I, Leung CL, Schagina O, Verpoorten N, Van Impe K, Fedotov V, Dadali E, Auer-Grumbach M, Windpassinger C, Wagner K, Mitrovic Z, Hilton-Jones D, Talbot K, Martin JJ, Vasserman N, Tverskaya S, Polyakov A, Liem RK, Gettemans J, Robberecht W, De Jonghe P, Timmerman V. Mutant small heat-shock protein 27 causes axonal Charcot-Marie-Tooth disease and distal hereditary motor neuropathy. Nat Genet. 2004 Jun;36(6):602-6. Epub 2004 May 02. PubMed citation

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Ismailov SM, Fedotov VP, Dadali EL, Polyakov AV, Van Broeckhoven C, Ivanov VI, De Jonghe P, Timmerman V, Evgrafov OV. A new locus for autosomal dominant CharcotMarie-Tooth disease type 2 (CMT2F) maps to chromosome 7q11-q21. Eur J Hum Genet. 2001 Aug;9(8):646-50. PubMed citation

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OMIM: HSPB1

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Tang B, Liu X, Zhao G, Luo W, Xia K, Pan Q, Cai F, Hu Z, Zhang C, Chen B, Zhang F, Shen L, Zhang R, Jiang H. Mutation analysis of the small heat shock protein 27 gene in chinese patients with Charcot-Marie-Tooth disease. Arch Neurol. 2005 Aug;62(8):1201-7. PubMed citation

What Is the Official Name of the KIF1B Gene?11 The official name of this gene is “kinesin family member 1B.” KIF1B is the gene's official symbol. The KIF1B gene is also known by other names, listed below.

What Is the Normal Function of the KIF1B Gene? The KIF1B gene provides instructions for making a protein called kinesin family member 1B, part of the kinesin family of proteins. These proteins are essential for the transport of 11

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=kif1b.

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materials within cells. Kinesin proteins function like freight trains that transport cargo, and their structure is suited for this cargo-carrying function. One part of the protein, called the motor domain, powers the protein and its cargo along a track-like system made from structures called microtubules. Another part of the kinesin protein, which varies among family members, binds to specific materials for transport. Research suggests that the kinesin family member 1B protein specializes in carrying two types of cargo. In nerve cells, this protein transports small, saclike structures called synaptic vesicles, which contain materials necessary for the transmission of nerve impulses. In other cell types, the kinesin family member 1B protein carries energy-producing structures called mitochondria.

What Conditions Are Related to the KIF1B Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the KIF1B Gene One KIF1B gene mutation has been detected in some patients with a form of Charcot-MarieTooth disease known as type 2A. The mutation changes one of the protein building blocks (amino acids) in the motor domain of kinesin family member 1B. Specifically, the amino acid glutamine is replaced by the amino acid leucine at protein position 98 (written as Gln98Leu). Although the effect of this mutation is not fully understood, the motor function of the protein and the transport of synaptic vesicles are probably disrupted. Lowered levels of synaptic vesicles at nerve endings could impair the transmission of nerve impulses, causing the symptoms of type 2A Charcot-Marie-Tooth disease.

Where Is the KIF1B Gene Located? Cytogenetic Location: 1p36.2 Molecular Location on chromosome 1: base pairs 10,193,417 to 10,364,241

The KIF1B gene is located on the short (p) arm of chromosome 1 at position 36.2. More precisely, the KIF1B gene is located from base pair 10,193,417 to base pair 10,364,241 on chromosome 1.

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Charcot-Marie-Tooth Disease

References These sources were used to develop the Genetics Home Reference gene summary on the KIF1B gene. •

Berger P, Young P, Suter U. Molecular cell biology of Charcot-Marie-Tooth disease. Neurogenetics. 2002 Mar;4(1):1-15. Review. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

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Zhao C, Takita J, Tanaka Y, Setou M, Nakagawa T, Takeda S, Yang HW, Terada S, Nakata T, Takei Y, Saito M, Tsuji S, Hayashi Y, Hirokawa N. Charcot-Marie-Tooth disease type 2A caused by mutation in a microtubule motor KIF1Bbeta. Cell. 2001 Jun 1;105(5):587-97. PubMed citation

What Is the Official Name of the LITAF Gene?12 The official name of this gene is “lipopolysaccharide-induced TNF factor.” LITAF is the gene's official symbol. The LITAF gene is also known by other names, listed below.

What Is the Normal Function of the LITAF Gene? The LITAF gene (sometimes referred to as SIMPLE) provides instructions for making a protein called lipopolysaccharide-induced tumor necrosis factor-alpha factor. The role of this protein is unclear, but two functions have been proposed. The LITAF protein probably plays a role in processes that fight infection and destroy unwanted cells. Specifically, this protein is thought to activate the production of an infection-fighting substance called tumor necrosis factor-alpha. Tumor necrosis factor-alpha may also participate in the destruction of cancer cells. Another function of the LITAF protein was proposed on the basis of its cellular location. It is found in the membrane surrounding lysosomes, the saclike compartments in cells that are filled with enzymes to break down toxic substances, digest bacteria that invade the cell, and recycle worn-out cell components. The LITAF protein may participate in the breakdown of proteins and other substances.

What Conditions Are Related to the LITAF Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the LITAF Gene A form of Charcot-Marie-Tooth disease known as type 1C is caused by one of several mutations in the LITAF gene. Each mutation changes a single DNA building block (base pair), which alters the instructions for making the LITAF protein. It is unclear how these mutations lead to type 1C Charcot-Marie-Tooth disease. The protein made by the altered instructions may mistakenly degrade proteins that are critical for nerve function. Another 12

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=litaf;jsessionid=5290086C85533AC98E0875021E7B8222.

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possibility is that the altered LITAF protein cannot destroy substances that are toxic to nerve cells.

Where Is the LITAF Gene Located? Cytogenetic Location: 16p13.3-p12 Molecular Location on chromosome 16: base pairs 11,549,356 to 11,587,729

The LITAF gene is located on the short (p) arm of chromosome 16 between positions 13.3 and 12. More precisely, the LITAF gene is located from base pair 11,549,356 to base pair 11,587,729 on chromosome 16.

References These sources were used to develop the Genetics Home Reference gene summary on the LITAF gene. •

Bennett CL, Shirk AJ, Huynh HM, Street VA, Nelis E, Van Maldergem L, De Jonghe P, Jordanova A, Guergueltcheva V, Tournev I, Van Den Bergh P, Seeman P, Mazanec R, Prochazka T, Kremensky I, Haberlova J, Weiss MD, Timmerman V, Bird TD, Chance PF. SIMPLE mutation in demyelinating neuropathy and distribution in sciatic nerve. Ann Neurol. 2004 May;55(5):713-20. PubMed citation

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Moriwaki Y, Begum NA, Kobayashi M, Matsumoto M, Toyoshima K, Seya T. Mycobacterium bovis Bacillus Calmette-Guerin and its cell wall complex induce a novel lysosomal membrane protein, SIMPLE, that bridges the missing link between lipopolysaccharide and p53-inducible gene, LITAF(PIG7), and estrogen-inducible gene, EET-1. J Biol Chem. 2001 Jun 22;276(25):23065-76. PubMed citation

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Saifi GM, Szigeti K, Wiszniewski W, Shy ME, Krajewski K, Hausmanowa-Petrusewicz I, Kochanski A, Reeser S, Mancias P, Butler I, Lupski JR. SIMPLE mutations in CharcotMarie-Tooth disease and the potential role of its protein product in protein degradation. Hum Mutat. 2005 Apr;25(4):372-83. PubMed citation

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Street VA, Bennett CL, Goldy JD, Shirk AJ, Kleopa KA, Tempel BL, Lipe HP, Scherer SS, Bird TD, Chance PF. Mutation of a putative protein degradation gene LITAF/SIMPLE in Charcot-Marie-Tooth disease 1C. Neurology. 2003 Jan 14;60(1):22-6. PubMed citation

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Tang X, Fenton MJ, Amar S. Identification and functional characterization of a novel binding site on TNF-alpha promoter. Proc Natl Acad Sci U S A. 2003 Apr 1;100(7):4096101. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

What Is the Official Name of the LMNA Gene?13 The official name of this gene is “lamin A/C.” LMNA is the gene's official symbol. The LMNA gene is also known by other names, listed below.

What Is the Normal Function of the LMNA Gene? The LMNA gene provides instructions for making several slightly different proteins. The two major proteins, lamin A and lamin C, are produced in most of the body's cells. These proteins have a nearly identical sequence of protein building blocks (amino acids). The small difference in the sequence makes lamin A longer than lamin C. Lamins A and C are a type of structural protein called an intermediate filament protein. Intermediate filaments provide stability and strength to cells. Lamins A and C are essential scaffolding (supporting) components of the nuclear envelope, which is a structure that surrounds the nucleus in cells. Specifically, these proteins are located in the nuclear lamina, a mesh-like layer of intermediate filaments that is attached to the inner membrane of the nuclear envelope. The nuclear envelope regulates the movement of molecules into and out of the nucleus, and researchers believe it may play a role in regulating the activity of certain genes. The lamin A protein must be processed within the cell before becoming part of the lamina. Its initial form, called prelamin A, undergoes a complex series of steps that are necessary for the protein to be inserted into the lamina. Lamin C does not have to undergo this processing before becoming part of the lamina.

What Conditions Are Related to the LMNA Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the LMNA Gene At least one LMNA mutation has been identified in people with a form of Charcot-MarieTooth disease known as type 2B1. The mutation changes a single amino acid in the LMNA proteins. Specifically, the amino acid arginine is replaced by the amino acid cysteine at protein position 298 (written as Arg298Cys or R298C). Although its effect is not fully understood, the Arg298Cys mutation alters a protein region important for interactions with

13

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=lmna.

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other molecules. It is unclear how the altered LMNA proteins contribute to the signs and symptoms of type 2B1 Charcot-Marie-Tooth disease. Emery-Dreifuss Muscular Dystrophy - Caused by Mutations in the LMNA Gene At least one LMNA mutation has been identified in people with a form of Charcot-MarieTooth disease known as type 2B1. The mutation changes a single amino acid in the LMNA proteins. Specifically, the amino acid arginine is replaced by the amino acid cysteine at protein position 298 (written as Arg298Cys or R298C). Although its effect is not fully understood, the Arg298Cys mutation alters a protein region important for interactions with other molecules. It is unclear how the altered LMNA proteins contribute to the signs and symptoms of type 2B1 Charcot-Marie-Tooth disease. Hutchinson-Gilford Progeria Syndrome - Caused by Mutations in the LMNA Gene More than 100 mutations in the LMNA gene have been identified in people with EmeryDreifuss muscular dystrophy. Most of these mutations change single amino acids in lamins A and C, which alters the structure of these proteins. The effects of LMNA mutations within cells remains unclear. Abnormal versions of lamins A and C may alter the activity of certain genes or weaken the structure of the nucleus, making cells more fragile. Researchers continue to investigate how LMNA mutations affect skeletal and heart (cardiac) muscle and lead to the characteristic features of Emery-Dreifuss muscular dystrophy. Other Disorders - Caused by Mutations in the LMNA Gene A specific mutation in the LMNA gene has been found in most patients with HutchinsonGilford progeria syndrome. This mutation changes a single DNA building block (nucleotide) in the gene. Specifically, the mutation replaces the nucleotide cytosine with the nucleotide thymine at position 1824 (written as C1824T). This mutation is also sometimes noted as Gly608Gly or G608G, which refers to the position in the lamin A protein affected by the mutation. The C1824T mutation leads to a lamin A protein that is missing 50 amino acids near one end. The location of the mutation in the LMNA gene does not affect the production of lamin C. Other mutations in the LMNA gene have been identified in a small number of people with Hutchinson-Gilford progeria syndrome.

Where Is the LMNA Gene Located? Cytogenetic Location: 1q21.2-q21.3 Molecular Location on chromosome 1: base pairs 154,351,121 to 154,376,494

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Charcot-Marie-Tooth Disease

The LMNA gene is located on the long (q) arm of chromosome 1 between positions 21.2 and 21.3. More precisely, the LMNA gene is located from base pair 154,351,121 to base pair 154,376,494 on chromosome 1.

References These sources were used to develop the Genetics Home Reference gene summary on the LMNA gene. •

Bonne G, Mercuri E, Muchir A, Urtizberea A, Becane HM, Recan D, Merlini L, Wehnert M, Boor R, Reuner U, Vorgerd M, Wicklein EM, Eymard B, Duboc D, Penisson-Besnier I, Cuisset JM, Ferrer X, Desguerre I, Lacombe D, Bushby K, Pollitt C, Toniolo D, Fardeau M, Schwartz K, Muntoni F. Clinical and molecular genetic spectrum of autosomal dominant Emery-Dreifuss muscular dystrophy due to mutations of the lamin A/C gene. Ann Neurol. 2000 Aug;48(2):170-80. PubMed citation

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Brown CA, Lanning RW, McKinney KQ, Salvino AR, Cherniske E, Crowe CA, Darras BT, Gominak S, Greenberg CR, Grosmann C, Heydemann P, Mendell JR, Pober BR, Sasaki T, Shapiro F, Simpson DA, Suchowersky O, Spence JE. Novel and recurrent mutations in lamin A/C in patients with Emery-Dreifuss muscular dystrophy. Am J Med Genet. 2001 Sep 1;102(4):359-67. PubMed citation

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De Sandre-Giovannoli A, Bernard R, Cau P, Navarro C, Amiel J, Boccaccio I, Lyonnet S, Stewart CL, Munnich A, Le Merrer M, Levy N. Lamin a truncation in HutchinsonGilford progeria. Science. 2003 Jun 27;300(5628):2055. Epub 2003 Apr 17. No abstract available. PubMed citation

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De Sandre-Giovannoli A, Chaouch M, Kozlov S, Vallat JM, Tazir M, Kassouri N, Szepetowski P, Hammadouche T, Vandenberghe A, Stewart CL, Grid D, Levy N. Homozygous defects in LMNA, encoding lamin A/C nuclear-envelope proteins, cause autosomal recessive axonal neuropathy in human (Charcot-Marie-Tooth disorder type 2) and mouse. Am J Hum Genet. 2002 Mar;70(3):726-36. Epub 2002 Jan 17. Erratum in: Am J Hum Genet 2002 Apr;70(4):1075. PubMed citation

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Eriksson M, Brown WT, Gordon LB, Glynn MW, Singer J, Scott L, Erdos MR, Robbins CM, Moses TY, Berglund P, Dutra A, Pak E, Durkin S, Csoka AB, Boehnke M, Glover TW, Collins FS. Recurrent de novo point mutations in lamin A cause HutchinsonGilford progeria syndrome. Nature. 2003 May 15;423(6937):293-8. Epub 2003 Apr 25. PubMed citation

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Goldman RD, Shumaker DK, Erdos MR, Eriksson M, Goldman AE, Gordon LB, Gruenbaum Y, Khuon S, Mendez M, Varga R, Collins FS. Accumulation of mutant lamin A causes progressive changes in nuclear architecture in Hutchinson-Gilford progeria syndrome. Proc Natl Acad Sci U S A. 2004 Jun 15;101(24):8963-8. Epub 2004 Jun 7. PubMed citation

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Hegele RA. Lamin mutations come of age. Nat Med. 2003 Jun;9(6):644-5. No abstract available. PubMed citation

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Helbling-Leclerc A, Bonne G, Schwartz K. Emery-Dreifuss muscular dystrophy. Eur J Hum Genet. 2002 Mar;10(3):157-61. Review. PubMed citation

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Mounkes L, Kozlov S, Burke B, Stewart CL. The laminopathies: nuclear structure meets disease. Curr Opin Genet Dev. 2003 Jun;13(3):223-30. Review. PubMed citation

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Muchir A, Worman HJ. The nuclear envelope and human disease. Physiology (Bethesda). 2004 Oct;19:309-14. Review. PubMed citation

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Novelli G, Muchir A, Sangiuolo F, Helbling-Leclerc A, D'Apice MR, Massart C, Capon F, Sbraccia P, Federici M, Lauro R, Tudisco C, Pallotta R, Scarano G, Dallapiccola B, Merlini L, Bonne G. Mandibuloacral dysplasia is caused by a mutation in LMNAencoding lamin A/C. Am J Hum Genet. 2002 Aug;71(2):426-31. Epub 2002 Jun 19. PubMed citation

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Pollex RL, Hegele RA. Hutchinson-Gilford progeria syndrome. Clin Genet. 2004 Nov;66(5):375-81. Review. PubMed citation

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Raffaele Di Barletta M, Ricci E, Galluzzi G, Tonali P, Mora M, Morandi L, Romorini A, Voit T, Orstavik KH, Merlini L, Trevisan C, Biancalana V, Housmanowa-Petrusewicz I, Bione S, Ricotti R, Schwartz K, Bonne G, Toniolo D. Different mutations in the LMNA gene cause autosomal dominant and autosomal recessive Emery-Dreifuss muscular dystrophy. Am J Hum Genet. 2000 Apr;66(4):1407-12. Epub 2000 Mar 16. PubMed citation

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Tazir M, Azzedine H, Assami S, Sindou P, Nouioua S, Zemmouri R, Hamadouche T, Chaouch M, Feingold J, Vallat JM, Leguern E, Grid D. Phenotypic variability in autosomal recessive axonal Charcot-Marie-Tooth disease due to the R298C mutation in lamin A/C. Brain. 2004 Jan;127(Pt 1):154-63. Epub 2003 Nov 07. PubMed citation

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Worman HJ, Courvalin JC. How do mutations in lamins A and C cause disease? J Clin Invest. 2004 Feb;113(3):349-51. Review. PubMed citation

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Worman HJ, Courvalin JC. The nuclear lamina and inherited disease. Trends Cell Biol. 2002 Dec;12(12):591-8. Review. PubMed citation

What Is the Official Name of the MFN2 Gene?14 The official name of this gene is “mitofusin 2.” MFN2 is the gene's official symbol. The MFN2 gene is also known by other names, listed below.

14

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=mfn2;jsessionid=5290086C85533AC98E0875021E7B8222.

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What Is the Normal Function of the MFN2 Gene? The MFN2 gene provides instructions for making a protein called mitofusin 2, which helps to determine the shape and structure (morphology) of mitochondria, the energy-producing centers within cells. Mitofusin 2 is made in many types of cells and tissues, including muscles, the spinal cord, and nerves that connect the brain and spinal cord to muscles (peripheral nerves). Within cells, mitofusin 2 is found in the outer envelope (membrane) that surrounds mitochondria. Mitochondria are dynamic structures that undergo changes in morphology through processes called fission (splitting into smaller pieces) and fusion (combining pieces). These changes in morphology are necessary for mitochondria to function properly. Mitofusin 2 helps to regulate the morphology of mitochondria by controlling the fusion process.

What Conditions Are Related to the MFN2 Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the MFN2 Gene Researchers have identified at least 15 MFN2 mutations that cause a form of Charcot-MarieTooth disease known as type 2A. Almost all these mutations change one of the protein building blocks (amino acids) used to make mitofusin 2. These changes in amino acids disrupt a region of the mitofusin 2 protein that is critical for proper function. One mutation creates a premature stop signal in the instructions for making mitofusin 2. As a result, no protein is produced, or an abnormally small protein is made.

Where Is the MFN2 Gene Located? Cytogenetic Location: 1p36.22 Molecular Location on chromosome 1: base pairs 11,962,955 to 11,996,151

The MFN2 gene is located on the short (p) arm of chromosome 1 at position 36.22. More precisely, the MFN2 gene is located from base pair 11,962,955 to base pair 11,996,151 on chromosome 1.

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References These sources were used to develop the Genetics Home Reference gene summary on the MFN2 gene. •

Ben-Asher E, Lancet D. A new gene for the Charcot-Marie-Tooth disorder. Isr Med Assoc J. 2004 Jun;6(6):376-7. No abstract available. PubMed citation

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Bradbury J. Mitochondrial fusion protein mutated in CMT2A. Lancet Neurol. 2004 Jun;3(6):326. No abstract available. PubMed citation

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Kijima K, Numakura C, Izumino H, Umetsu K, Nezu A, Shiiki T, Ogawa M, Ishizaki Y, Kitamura T, Shozawa Y, Hayasaka K. Mitochondrial GTPase mitofusin 2 mutation in Charcot-Marie-Tooth neuropathy type 2A. Hum Genet. 2005 Jan;116(1-2):23-7. Epub 2004 Nov 11. PubMed citation

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Neuspiel M, Zunino R, Gangaraju S, Rippstein P, McBride H. Activated mitofusin 2 signals mitochondrial fusion, interferes with Bax activation, and reduces susceptibility to radical induced depolarization. J Biol Chem. 2005 Jul 1;280(26):25060-70. Epub 2005 May 4. PubMed citation

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OMIM

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Zuchner S, Mersiyanova IV, Muglia M, Bissar-Tadmouri N, Rochelle J, Dadali EL, Zappia M, Nelis E, Patitucci A, Senderek J, Parman Y, Evgrafov O, Jonghe PD, Takahashi Y, Tsuji S, Pericak-Vance MA, Quattrone A, Battaloglu E, Polyakov AV, Timmerman V, Schroder JM, Vance JM, Battologlu E. Mutations in the mitochondrial GTPase mitofusin 2 cause Charcot-Marie-Tooth neuropathy type 2A. Nat Genet. 2004 May;36(5):449-51. Epub 2004 Apr 04. No abstract available. Erratum in: Nat Genet. 2004 Jun;36(6):660. Battologlu E [corrected to Battaloglu E]. PubMed citation

What Is the Official Name of the MPZ Gene?15 The official name of this gene is “myelin protein zero (Charcot-Marie-Tooth neuropathy 1B).” MPZ is the gene's official symbol. The MPZ gene is also known by other names, listed below.

What Is the Normal Function of the MPZ Gene? The MPZ gene provides instructions for making a protein called myelin protein zero. It is the most abundant protein in the myelin sheath, the covering that protects nerves and promotes the efficient transmission of nerve impulses. Specialized cells called Schwann cells are the only cells that make myelin protein zero. Schwann cells are part of the peripheral nervous system that connects the brain and spinal cord to muscles and to sensory cells that detect sensations such as touch, pain, heat, and sound. Myelin protein zero is required for

15

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=mpz.

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the proper formation and maintenance of myelin. This protein acts like a molecular glue (adhesion molecule) and plays a role in tightly packing the myelin (myelin compaction). From inside a Schwann cell, myelin protein zero is inserted through the cell membrane, the structure that encloses a cell. One end of the protein remains inside the cell and is called the intracellular domain. The other end of the protein pokes through the membrane to the outside of the cell; this part of the protein is called the extracellular domain. The extracellular domain interacts with other substances that make up the myelin sheath. The section of myelin protein zero that spans the cell membrane is called the transmembrane domain.

What Conditions Are Related to the MPZ Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the MPZ Gene Researchers have identified about 90 MPZ mutations that cause a form of Charcot-MarieTooth known as type 1B. Many of these mutations alter the extracellular domain by changing one of the building blocks (amino acids) used to make myelin protein zero. The altered extracellular domain probably impairs interactions with other myelin components, which may disrupt the formation and maintenance of the myelin sheath. Some MPZ mutations produce an abnormally small protein, which also affects interactions with other myelin components. If myelin's structure or its interactions are significantly altered, peripheral nerve cells cannot activate muscles used for movement or relay information from sensory cells back to the brain, causing the symptoms of type 1B Charcot-Marie-Tooth disease. Some MPZ mutations cause severe symptoms that begin during infancy or early childhood. (The early-onset forms are sometimes called Dejerine-Sottas syndrome, congenital hypomyelination, or Roussy-Levy syndrome.)

Where Is the MPZ Gene Located? Cytogenetic Location: 1q22 Molecular Location on chromosome 1: base pairs 159,541,148 to 159,546,367

The MPZ gene is located on the long (q) arm of chromosome 1 at position 22. More precisely, the MPZ gene is located from base pair 159,541,148 to base pair 159,546,367 on chromosome 1.

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References These sources were used to develop the Genetics Home Reference gene summary on the MPZ gene. •

Boerkoel CF, Takashima H, Garcia CA, Olney RK, Johnson J, Berry K, Russo P, Kennedy S, Teebi AS, Scavina M, Williams LL, Mancias P, Butler IJ, Krajewski K, Shy M, Lupski JR. Charcot-Marie-Tooth disease and related neuropathies: mutation distribution and genotype-phenotype correlation. Ann Neurol. 2002 Feb;51(2):190-201. PubMed citation

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Gene Review: Charcot-Marie-Tooth Neuropathy Type 2

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Kochanski A. Mutations in the Myelin Protein Zero result in a spectrum of CharcotMarie-Tooth phenotypes. Acta Myol. 2004 May;23(1):6-9. Review. PubMed citation

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Numakura C, Lin C, Ikegami T, Guldberg P, Hayasaka K. Molecular analysis in Japanese patients with Charcot-Marie-Tooth disease: DGGE analysis for PMP22, MPZ, and Cx32/GJB1 mutations. Hum Mutat. 2002 Nov;20(5):392-8. PubMed citation

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OMIM

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Warner LE, Hilz MJ, Appel SH, Killian JM, Kolodry EH, Karpati G, Carpenter S, Watters GV, Wheeler C, Witt D, Bodell A, Nelis E, Van Broeckhoven C, Lupski JR. Clinical phenotypes of different MPZ (P0) mutations may include Charcot-Marie-Tooth type 1B, Dejerine-Sottas, and congenital hypomyelination. Neuron. 1996 Sep;17(3):451-60. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

What Is the Official Name of the MTMR2 Gene?16 The official name of this gene is “myotubularin related protein 2.” MTMR2 is the gene's official symbol. The MTMR2 gene is also known by other names, listed below.

What Is the Normal Function of the MTMR2 Gene? The MTMR2 gene provides instructions for making a protein that is a member of the myotubularin family. Members of this family help remove a phosphate group, a cluster of one phosphorus and three oxygen atoms, from other substances. Removal of a phosphate group modifies the activity of a substance. Based on the action of removing phosphate groups, these proteins are called phosphatases. The MTMR2 protein modifies substances that act as chemical messengers. These messengers relay signals from receptors on the cell surface to specific compartments inside the cell, through a process called signal transduction. Signal transduction helps cells respond to their environment, for example, by dividing or maturing to take on specialized functions. The 16

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=mtmr2;jsessionid=5290086C85533AC98E0875021E7B8222.

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Charcot-Marie-Tooth Disease

MTMR2 protein modifies a chemical messenger that helps regulate processes such as the transport of fats (lipids) and proteins within the cell.

What Conditions Are Related to the MTMR2 Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the MTMR2 Gene Researchers have identified several MTMR2 mutations that cause a form of Charcot-MarieTooth disease known as type 4B1. These mutations alter the structure of the MTMR2 protein by producing a protein that is abnormally small or by changing one of the building blocks (amino acids) used to make the protein. The altered structure probably impairs the protein's ability to modify messenger molecules, which could disrupt the transport of lipids and proteins.

Where Is the MTMR2 Gene Located? Cytogenetic Location: 11q22 Molecular Location on chromosome 11: base pairs 95,205,693 to 95,296,919

The MTMR2 gene is located on the long (q) arm of chromosome 11 at position 22. More precisely, the MTMR2 gene is located from base pair 95,205,693 to base pair 95,296,919 on chromosome 11.

References These sources were used to develop the Genetics Home Reference gene summary on the MTMR2 gene. •

Berger P, Bonneick S, Willi S, Wymann M, Suter U. Loss of phosphatase activity in myotubularin-related protein 2 is associated with Charcot-Marie-Tooth disease type 4B1. Hum Mol Genet. 2002 Jun 15;11(13):1569-79. PubMed citation

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Bolino A, Muglia M, Conforti FL, LeGuern E, Salih MA, Georgiou DM, Christodoulou K, Hausmanowa-Petrusewicz I, Mandich P, Schenone A, Gambardella A, Bono F,

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Quattrone A, Devoto M, Monaco AP. Charcot-Marie-Tooth type 4B is caused by mutations in the gene encoding myotubularin-related protein-2. Nat Genet. 2000 May;25(1):17-9. PubMed citation •

Houlden H, King RH, Wood NW, Thomas PK, Reilly MM. Mutations in the 5' region of the myotubularin-related protein 2 (MTMR2) gene in autosomal recessive hereditary neuropathy with focally folded myelin. Brain. 2001 May;124(Pt 5):907-15. PubMed citation

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Kim SA, Vacratsis PO, Firestein R, Cleary ML, Dixon JE. Regulation of myotubularinrelated (MTMR)2 phosphatidylinositol phosphatase by MTMR5, a catalytically inactive phosphatase. Proc Natl Acad Sci U S A. 2003 Apr 15;100(8):4492-7. Epub 2003 Mar 31. PubMed citation

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Robinson FL, Dixon JE. The phosphoinositide-3-phosphatase MTMR2 associates with MTMR13, a membrane-associated pseudophosphatase also mutated in type 4B CharcotMarie-Tooth disease. J Biol Chem. 2005 Sep 9;280(36):31699-707. Epub 2005 Jul 5. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

What Is the Official Name of the NDRG1 Gene?17 The official name of this gene is “N-myc downstream regulated gene 1.” NDRG1 is the gene's official symbol. The NDRG1 gene is also known by other names, listed below.

What Is the Normal Function of the NDRG1 Gene? The NDRG1 gene provides instructions for making a protein whose function is not well understood. The NDRG1 protein may play a role in arresting cell growth and prompting cells to mature (differentiate) and assume specialized functions. It probably performs this role by shuttling signals between the nucleus and other parts of the cell. The NDRG1 gene is active in cells throughout the body, but its activity is particularly high in specialized cells called Schwann cells. Schwann cells nourish and protect nerves, especially the long fiber (axon) that transmits nerve impulses. Schwann cells also produce myelin, a substance that covers axons and promotes the efficient transmission of nerve impulses. Scientists speculate that the NDRG1 protein is involved in Schwann cell differentiation, myelin maintenance, and the signaling necessary for the survival of nerve axons.

17

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=ndrg1.

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Charcot-Marie-Tooth Disease

What Conditions Are Related to the NDRG1 Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the NDRG1 Gene Two NDRG1 mutations have been identified in patients with a form of Charcot-Marie-Tooth disease known as type 4D. Both mutations alter the structure of the NDRG1 protein by producing an abnormally small protein or a protein that is missing a critical segment. The altered structure probably causes a loss of the protein's function. Although it is unclear how the NDRG1 mutation leads to this disorder, the specialized functions of Schwann cells and interactions necessary for the survival of axons may be disrupted. Schwann cell dysfunction and axonal loss are signs of type 4D Charcot-Marie-Tooth disease.

Where Is the NDRG1 Gene Located? Cytogenetic Location: 8q24 Molecular Location on chromosome 8: base pairs 134,318,595 to 134,378,679

The NDRG1 gene is located on the long (q) arm of chromosome 8 at position 24. More precisely, the NDRG1 gene is located from base pair 134,318,595 to base pair 134,378,679 on chromosome 8.

References These sources were used to develop the Genetics Home Reference gene summary on the NDRG1 gene. •

Hirata K, Masuda K, Morikawa W, He JW, Kuraoka A, Kuwano M, Kawabuchi M. Nmyc downstream-regulated gene 1 expression in injured sciatic nerves. Glia. 2004 Sep;47(4):325-34. PubMed citation

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Hunter M, Bernard R, Freitas E, Boyer A, Morar B, Martins IJ, Tournev I, Jordanova A, Guergelcheva V, Ishpekova B, Kremensky I, Nicholson G, Schlotter B, Lochmuller H, Voit T, Colomer J, Thomas PK, Levy N, Kalaydjieva L. Mutation screening of the N-myc downstream-regulated gene 1 (NDRG1) in patients with Charcot-Marie-Tooth Disease. Hum Mutat. 2003 Aug;22(2):129-35. PubMed citation

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Kalaydjieva L, Gresham D, Gooding R, Heather L, Baas F, de Jonge R, Blechschmidt K, Angelicheva D, Chandler D, Worsley P, Rosenthal A, King RH, Thomas PK. N-myc downstream-regulated gene 1 is mutated in hereditary motor and sensory neuropathyLom. Am J Hum Genet. 2000 Jul;67(1):47-58. Epub 2000 May 30. PubMed citation

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Okuda T, Higashi Y, Kokame K, Tanaka C, Kondoh H, Miyata T. Ndrg1-deficient mice exhibit a progressive demyelinating disorder of peripheral nerves. Mol Cell Biol. 2004 May;24(9):3949-56. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

What Is the Official Name of the NEFL Gene?18 The official name of this gene is “neurofilament, light polypeptide 68kDa.” NEFL is the gene's official symbol. The NEFL gene is also known by other names, listed below.

What Is the Normal Function of the NEFL Gene? The NEFL gene provides instructions for making the smallest protein component (the light subunit) of neurofilaments. Neurofilaments, which are assembled from light, medium, and heavy subunits, are essential for normal nerve function. They form a structural framework that helps to define the shape and size of nerve cells. Cross-linking or bridging between neurofilaments maintains the diameter of the fiber, or axon, that extends from a nerve cell. Maintaining the proper axon diameter is essential for the transmission of nerve impulses.

What Conditions Are Related to the NEFL Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the NEFL Gene Researchers have identified several NEFL mutations that cause forms of Charcot-MarieTooth disease known as type 1F and type 2E. These mutations change one of the protein building blocks (amino acids) used to make the neurofilament light subunit. A change in amino acids probably disrupts the assembly of neurofilaments or their transport to the axon. These disruptions can alter the axon diameter and impair the transmission of nerve impulses. Abnormalities in the axon are a sign of type 2E Charcot-Marie-Tooth disease. In some cases, the speed of nerve transmission is reduced, which is a sign of type 1F CharcotMarie-Tooth disease.

Where Is the NEFL Gene Located? Cytogenetic Location: 8p21 Molecular Location on chromosome 8: base pairs 24,866,239 to 24,869,945 18

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=nefl;jsessionid=5290086C85533AC98E0875021E7B8222.

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Charcot-Marie-Tooth Disease

The NEFL gene is located on the short (p) arm of chromosome 8 at position 21. More precisely, the NEFL gene is located from base pair 24,866,239 to base pair 24,869,945 on chromosome 8.

References These sources were used to develop the Genetics Home Reference gene summary on the NEFL gene. •

Jordanova A, De Jonghe P, Boerkoel CF, Takashima H, De Vriendt E, Ceuterick C, Martin JJ, Butler IJ, Mancias P, Papasozomenos SCh, Terespolsky D, Potocki L, Brown CW, Shy M, Rita DA, Tournev I, Kremensky I, Lupski JR, Timmerman V. Mutations in the neurofilament light chain gene (NEFL) cause early onset severe Charcot-MarieTooth disease. Brain. 2003 Mar;126(Pt 3):590-7. PubMed citation

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Mersiyanova IV, Perepelov AV, Polyakov AV, Sitnikov VF, Dadali EL, Oparin RB, Petrin AN, Evgrafov OV. A new variant of Charcot-Marie-Tooth disease type 2 is probably the result of a mutation in the neurofilament-light gene. Am J Hum Genet. 2000 Jul;67(1):37-46. PubMed citation

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Omary MB, Coulombe PA, McLean WH. Intermediate filament proteins and their associated diseases. N Engl J Med. 2004 Nov 11;351(20):2087-100. No abstract available. PubMed citation

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Perez-Olle R, Lopez-Toledano MA, Goryunov D, Cabrera-Poch N, Stefanis L, Brown K, Liem RK. Mutations in the neurofilament light gene linked to Charcot-Marie-Tooth disease cause defects in transport. J Neurochem. 2005 May;93(4):861-74. PubMed citation

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Yoshihara T, Yamamoto M, Hattori N, Misu K, Mori K, Koike H, Sobue G. Identification of novel sequence variants in the neurofilament-light gene in a Japanese population: analysis of Charcot-Marie-Tooth disease patients and normal individuals. J Peripher Nerv Syst. 2002 Dec;7(4):221-4. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

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Zuchner S, Vorgerd M, Sindern E, Schroder JM. The novel neurofilament light (NEFL) mutation Glu397Lys is associated with a clinically and morphologically heterogeneous type of Charcot-Marie-Tooth neuropathy. Neuromuscul Disord. 2004 Feb;14(2):147-57. PubMed citation

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What Is the Official Name of the PMP22 Gene?19 The official name of this gene is “peripheral myelin protein 22.” PMP22 is the gene's official symbol. The PMP22 gene is also known by other names, listed below.

What Is the Normal Function of the PMP22 Gene? The PMP22 gene provides instructions for making a protein called peripheral myelin protein 22. This protein is a major component of myelin, a protective substance that covers nerves and promotes the efficient transmission of nerve impulses. Peripheral myelin protein 22 is produced primarily by specialized cells called Schwann cells, where the protein plays a crucial role in the development and maintenance of myelin. The PMP22 gene may also play a role in regulating cell division and maturation, cell shape, and cell death. Before it becomes part of myelin, newly produced peripheral myelin protein 22 goes through several processing and packaging steps in specialized structures known as the endoplasmic reticulum and the Golgi apparatus. Completion of these processing and packaging steps is critical for proper myelin function.

19

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=pmp22.

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Charcot-Marie-Tooth Disease

What Conditions Are Related to the PMP22 Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the PMP22 Gene An extra copy of the PMP22 gene in each cell is the most common mutation that causes a form of Charcot-Marie-Tooth disease known as type 1A. The extra gene leads to an overproduction of peripheral myelin protein 22, which clogs the Golgi apparatus in Schwann cells and prevents completion of the necessary processing steps. Myelin assembly is impaired due to the reduced availability of properly processed protein. The buildup of unprocessed peripheral myelin protein 22 probably also disrupts other Schwann cell activities, which leads to myelin instability and loss. The loss of myelin (demyelination) causes the signs and symptoms of type 1A Charcot-Marie-Tooth disease. Hereditary Neuropathy with Liability to Pressure Palsies - Caused by Mutations in the PMP22 Gene An extra copy of the PMP22 gene in each cell is the most common mutation that causes a form of Charcot-Marie-Tooth disease known as type 1A. The extra gene leads to an overproduction of peripheral myelin protein 22, which clogs the Golgi apparatus in Schwann cells and prevents completion of the necessary processing steps. Myelin assembly is impaired due to the reduced availability of properly processed protein. The buildup of unprocessed peripheral myelin protein 22 probably also disrupts other Schwann cell activities, which leads to myelin instability and loss. The loss of myelin (demyelination) causes the signs and symptoms of type 1A Charcot-Marie-Tooth disease.

Where Is the PMP22 Gene Located? Cytogenetic Location: 17p11.2 Molecular Location on chromosome 17: base pairs 15,073,820 to 15,109,368

The PMP22 gene is located on the short (p) arm of chromosome 17 at position 11.2. More precisely, the PMP22 gene is located from base pair 15,073,820 to base pair 15,109,368 on chromosome 17.

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References These sources were used to develop the Genetics Home Reference gene summary on the PMP22 gene. •

Berger P, Young P, Suter U. Molecular cell biology of Charcot-Marie-Tooth disease. Neurogenetics. 2002 Mar;4(1):1-15. Review. PubMed citation

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Jetten AM, Suter U. The peripheral myelin protein 22 and epithelial membrane protein family. Prog Nucleic Acid Res Mol Biol. 2000;64:97-129. Review. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

What Is the Official Name of the PRX Gene?20 The official name of this gene is “periaxin.” PRX is the gene's official symbol. The PRX gene is also known by other names, listed below.

What Is the Normal Function of the PRX Gene? The PRX gene provides instructions for making a protein called periaxin. Periaxin is required for the maintenance of myelin, the protective substance that covers nerves and promotes the efficient transmission of nerve impulses. The exact function of periaxin is unclear, but research suggests that it helps to stabilize the myelin. The PRX gene produces two forms of periaxin, called long (L) and short (S) because they differ in size. Research studies show that the short form (S-periaxin) is distributed throughout the cytoplasm, the fluid inside cells. The long form (L-periaxin) is concentrated initially in the cell nucleus, then relocates to the cell membrane during the formation of myelin. L- and S-periaxin probably have slightly different functions, based on their different cell locations.

20

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=prx;jsessionid=5290086C85533AC98E0875021E7B8222.

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Charcot-Marie-Tooth Disease

What Conditions Are Related to the PRX Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the PRX Gene Researchers have identified several PRX mutations that cause a form of Charcot-MarieTooth disease known as type 4F (sometimes called Dejerine-Sottas syndrome). One mutation affects both L- and S-periaxin, while the other mutations affect only L-periaxin. An abnormally short protein is produced as the result of PRX mutations. The shortened protein cannot perform its normal function, maintaining the myelin structure. Disrupted myelin structure can lead to the loss of myelin (demyelination), which can impair the transmission of nerve impulses and cause the signs and symptoms of type 4F Charcot-Marie-Tooth disease.

Where Is the PRX Gene Located? Cytogenetic Location: 19q13.1-13.2 Molecular Location on chromosome 19: base pairs 45,591,514 to 45,611,110

The PRX gene is located on the long (q) arm of chromosome 19 between positions 13.1 and 13.2. More precisely, the PRX gene is located from base pair 45,591,514 to base pair 45,611,110 on chromosome 19.

References These sources were used to develop the Genetics Home Reference gene summary on the PRX gene. •

Boerkoel CF, Takashima H, Stankiewicz P, Garcia CA, Leber SM, Rhee-Morris L, Lupski JR. Periaxin mutations cause recessive Dejerine-Sottas neuropathy. Am J Hum Genet. 2001 Feb;68(2):325-33. PubMed citation

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Guilbot A, Williams A, Ravise N, Verny C, Brice A, Sherman DL, Brophy PJ, LeGuern E, Delague V, Bareil C, Megarbane A, Claustres M. A mutation in periaxin is responsible

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for CMT4F, an autosomal recessive form of Charcot-Marie-Tooth disease. Hum Mol Genet. 2001 Feb 15;10(4):415-21. PubMed citation •

Kijima K, Numakura C, Shirahata E, Sawaishi Y, Shimohata M, Igarashi S, Tanaka T, Hayasaka K. Periaxin mutation causes early-onset but slow-progressive Charcot-MarieTooth disease. J Hum Genet. 2004;49(7):376-9. Epub 2004 Jun 12. PubMed citation

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Takashima H, Boerkoel CF, De Jonghe P, Ceuterick C, Martin JJ, Voit T, Schroder JM, Williams A, Brophy PJ, Timmerman V, Lupski JR. Periaxin mutations cause a broad spectrum of demyelinating neuropathies. Ann Neurol. 2002 Jun;51(6):709-15. PubMed citation

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Vallat JM, Tazir M, Magdelaine C, Sturtz F, Grid D. Autosomal-recessive Charcot-MarieTooth diseases. J Neuropathol Exp Neurol. 2005 May;64(5):363-70. Review. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

What Is the Official Name of the RAB7 Gene?21 The official name of this gene is “RAB7, member RAS oncogene family.” RAB7 is the gene's official symbol. The RAB7 gene is also known by other names, listed below.

What Is the Normal Function of the RAB7 Gene? Certain substances, such as proteins and fats, are moved around within cells by small saclike structures called transport vesicles. The RAB7 gene provides instructions for making a protein that helps regulate the traffic patterns of these vesicles. This protein is part of the RAB protein family. Each member of the RAB family appears to play a role in moving substances to specific compartments within the cell. The RAB7 protein regulates transport from the cell surface to cell compartments called lysosomes. Lysosomes are filled with enzymes that break down toxic substances, digest bacteria that invade the cell, and recycle worn-out cell components. The RAB7 protein is essential for the maintenance of functional lysosomes.

What Conditions Are Related to the RAB7 Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the RAB7 Gene Researchers have identified three RAB7 mutations that cause a form of Charcot-Marie-Tooth disease known as type 2B. These mutations change one of the building blocks (amino acids) used to make the RAB7 protein. In one such change, the amino acid leucine is replaced by the amino acid phenylalanine at protein position 129 (written as Leu129Phe). The other mutations replace asparagine with threonine at protein position 161 (Asn161Thr) or replace valine with methionine at protein position 162 (Val162Met). Research studies indicate that 21

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=rab7.

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Charcot-Marie-Tooth Disease

lysosomes break up and disperse if the RAB7 protein is missing or malfunctioning. Without lysosomes, cells cannot break down toxic substances or recycle cell components. It remains unclear, however, how the altered RAB7 gene produces the signs and symptoms of type 2B Charcot-Marie-Tooth disease.

Where Is the RAB7 Gene Located? Cytogenetic Location: 3q21.3 Molecular Location on chromosome 3: base pairs 129,927,668 to 130,016,330

The RAB7 gene is located on the long (q) arm of chromosome 3 at position 21.3. More precisely, the RAB7 gene is located from base pair 129,927,668 to base pair 130,016,330 on chromosome 3.

References These sources were used to develop the Genetics Home Reference gene summary on the RAB7 gene. •

Bucci C, Thomsen P, Nicoziani P, McCarthy J, van Deurs B. Rab7: a key to lysosome biogenesis. Mol Biol Cell. 2000 Feb;11(2):467-80. PubMed citation

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Entrez Gene

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Houlden H, King RH, Muddle JR, Warner TT, Reilly MM, Orrell RW, Ginsberg L. A novel RAB7 mutation associated with ulcero-mutilating neuropathy. Ann Neurol. 2004 Oct;56(4):586-90. PubMed citation

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OMIM

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Verhoeven K, De Jonghe P, Coen K, Verpoorten N, Auer-Grumbach M, Kwon JM, FitzPatrick D, Schmedding E, De Vriendt E, Jacobs A, Van Gerwen V, Wagner K, Hartung HP, Timmerman V. Mutations in the small GTP-ase late endosomal protein RAB7 cause Charcot-Marie-Tooth type 2B neuropathy. Am J Hum Genet. 2003 Mar;72(3):722-7. Epub 2003 Jan 21. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

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What Is the Official Name of the SBF2 Gene?22 The official name of this gene is “SET binding factor 2.” SBF2 is the gene's official symbol. The SBF2 gene is also known by other names, listed below.

What Is the Normal Function of the SBF2 Gene? The SBF2 gene (also called MTMR13) provides instructions for making a protein called SET binding factor 2. The function of this protein remains unknown, but it probably plays a role in cellular communication or the signaling network that is essential for the production of myelin. Myelin is the protective substance that covers nerve cells and promotes the rapid transmission of nerve impulses. SET binding factor 2 probably also plays a role in the development of meshlike drainage canals (trabecular meshwork) that surround the colored part of the eye (the iris).

What Conditions Are Related to the SBF2 Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the SBF2 Gene Several SBF2 mutations have been identified in patients with a form of Charcot-Marie-Tooth disease known as type 4B2. These mutations alter the structure of SET binding factor 2 by producing an abnormally small protein or a protein that is missing a critical segment. The altered structure probably causes a loss of the protein's function. Although it remains unclear how SBF2 mutations lead to this disorder, the signaling network necessary for myelin production is probably disrupted. Irregular myelin structure (called outfolding) is a characteristic sign of type 4B2 Charcot-Marie-Tooth disease.

Where Is the SBF2 Gene Located? Cytogenetic Location: 11p15.3 Molecular Location on chromosome 11: base pairs 9,756,789 to 10,272,295

22

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=sbf2;jsessionid=5290086C85533AC98E0875021E7B8222.

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Charcot-Marie-Tooth Disease

The SBF2 gene is located on the short (p) arm of chromosome 11 at position 15.3. More precisely, the SBF2 gene is located from base pair 9,756,789 to base pair 10,272,295 on chromosome 11.

References These sources were used to develop the Genetics Home Reference gene summary on the SBF2 gene. •

Azzedine H, Bolino A, Taieb T, Birouk N, Di Duca M, Bouhouche A, Benamou S, Mrabet A, Hammadouche T, Chkili T, Gouider R, Ravazzolo R, Brice A, Laporte J, LeGuern E. Mutations in MTMR13, a new pseudophosphatase homologue of MTMR2 and Sbf1, in two families with an autosomal recessive demyelinating form of Charcot-Marie-Tooth disease associated with early-onset glaucoma. Am J Hum Genet. 2003 May;72(5):114153. Epub 2003 Apr 08. PubMed citation

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Conforti FL, Muglia M, Mazzei R, Patitucci A, Valentino P, Magariello A, Sprovieri T, Bono F, Bergmann C, Gabriele AL, Peluso G, Nistico R, Senderek J, Quattrone A. A new SBF2 mutation in a family with recessive demyelinating Charcot-Marie-Tooth (CMT4B2). Neurology. 2004 Oct 12;63(7):1327-8. No abstract available. PubMed citation

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Hirano R, Takashima H, Umehara F, Arimura H, Michizono K, Okamoto Y, Nakagawa M, Boerkoel CF, Lupski JR, Osame M, Arimura K. SET binding factor 2 (SBF2) mutation causes CMT4B with juvenile onset glaucoma. Neurology. 2004 Aug 10;63(3):577-80. PubMed citation

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Senderek J, Bergmann C, Weber S, Ketelsen UP, Schorle H, Rudnik-Schoneborn S, Buttner R, Buchheim E, Zerres K. Mutation of the SBF2 gene, encoding a novel member of the myotubularin family, in Charcot-Marie-Tooth neuropathy type 4B2/11p15. Hum Mol Genet. 2003 Feb 1;12(3):349-56. Erratum in: Hum Mol Genet. 2004 Feb 1;13(3):363. PubMed citation

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Young P, Suter U. The causes of Charcot-Marie-Tooth disease. Cell Mol Life Sci. 2003 Dec;60(12):2547-60. Review. PubMed citation

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What Is the Official Name of the SH3TC2 Gene?23 The official name of this gene is “SH3 domain and tetratricopeptide repeats 2.” SH3TC2 is the gene's official symbol. The SH3TC2 gene is also known by other names, listed below.

What Is the Normal Function of the SH3TC2 Gene? The SH3TC2 gene is active in nervous tissue and provides instructions for making a protein whose function is unknown. Based on its structure, the SH3TC2 protein probably interacts with other proteins and may assist in assembling proteins into a group or complex.

What Conditions Are Related to the SH3TC2 Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the SH3TC2 Gene Researchers have identified more than 10 SH3TC2 mutations that cause a form of CharcotMarie-Tooth disease known as type 4C. Most of these mutations disrupt protein production, resulting in an abnormally small or unstable version of the SH3TC2 protein. Some mutations change one of the building blocks (amino acids) used to make the SH3TC2 protein, which alters the protein's structure. It is unclear how SH3TC2 mutations cause the signs and symptoms of type 4C Charcot-Marie-Tooth disease.

Where Is the SH3TC2 Gene Located? Cytogenetic Location: 5q32 Molecular Location on chromosome 5: base pairs 148,364,376 to 148,422,879

The SH3TC2 gene is located on the long (q) arm of chromosome 5 at position 32. More precisely, the SH3TC2 gene is located from base pair 148,364,376 to base pair 148,422,879 on chromosome 5. 23

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=sh3tc2.

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Charcot-Marie-Tooth Disease

References These sources were used to develop the Genetics Home Reference gene summary on the SH3TC2 gene. •

OMIM

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Senderek J, Bergmann C, Stendel C, Kirfel J, Verpoorten N, De Jonghe P, Timmerman V, Chrast R, Verheijen MH, Lemke G, Battaloglu E, Parman Y, Erdem S, Tan E, Topaloglu H, Hahn A, Muller-Felber W, Rizzuto N, Fabrizi GM, Stuhrmann M, RudnikSchoneborn S, Zuchner S, Michael Schroder J, Buchheim E, Straub V, Klepper J, Huehne K, Rautenstrauss B, Buttner R, Nelis E, Zerres K. Mutations in a gene encoding a novel SH3/TPR domain protein cause autosomal recessive Charcot-Marie-Tooth type 4C neuropathy. Am J Hum Genet. 2003 Nov;73(5):1106-19. Epub 2003 Oct 21. PubMed citation

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Vallat JM, Tazir M, Magdelaine C, Sturtz F, Grid D. Autosomal-recessive Charcot-MarieTooth diseases. J Neuropathol Exp Neurol. 2005 May;64(5):363-70. Review. PubMed citation

What Is the Official Name of the YARS Gene?24 The official name of this gene is “tyrosyl-tRNA synthetase.” YARS is the gene's official symbol. The YARS gene is also known by other names, listed below.

What Is the Normal Function of the YARS Gene? The YARS gene provides instructions for making an enzyme called tyrosyl-tRNA synthetase. This enzyme is found in all cells and plays an important role in the production (synthesis) of proteins. During protein synthesis, building blocks (amino acids) are connected together in a specific order, creating a chain of amino acids. Tyrosyl-tRNA synthetase plays a role in adding the amino acid tyrosine at the proper place in a protein's chain of amino acids. In addition to its role in protein synthesis, tyrosyl-tRNA synthetase appears to have other functions. Under certain conditions, such as inflammation, this enzyme is cleaved into two fragments called mini-tyrRS and C-tyrRS. Research findings indicate that mini-tyrRS promotes the growth of new blood vessels (angiogenesis). Both fragments appear to stimulate the movement of particular cells, such as white blood cells that help fight infection.

24

Adapted from the Genetics Home Reference of the National Library of Medicine: http://ghr.nlm.nih.gov/gene=yars;jsessionid=5290086C85533AC98E0875021E7B8222.

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What Conditions Are Related to the YARS Gene? Charcot-Marie-Tooth Disease - Caused by Mutations in the YARS Gene Mutations in the YARS gene cause a form of Charcot-Marie-Tooth disease known as dominant intermediate C. Two YARS mutations change one of the amino acids used to make tyrosyl-tRNA synthetase. One mutation replaces the amino acid glycine with the amino acid arginine at protein position 41 (written as Gly41Arg or G41R). The other mutation replaces the amino acid glutamic acid with the amino acid lysine at protein position 196 (written as Glu196Lys or E196K). A third YARS mutation results in an altered version of the tyrosyl-tRNA synthetase enzyme that is missing four amino acids. Mutations in the YARS gene probably cause a decrease in the activity of tyrosyl-tRNA synthetase, which could affect the synthesis of any protein that contains tyrosine. It is unclear how these mutations lead to the dominant intermediate C form of Charcot-Marie-Tooth disease.

Where Is the YARS Gene Located? Cytogenetic Location: 1p35.1 Molecular Location on chromosome 1: base pairs 33,013,426 to 33,056,219

The YARS gene is located on the short (p) arm of chromosome 1 at position 35.1. More precisely, the YARS gene is located from base pair 33,013,426 to base pair 33,056,219 on chromosome 1.

References These sources were used to develop the Genetics Home Reference gene summary on the YARS gene. •

Ewalt KL, Schimmel P. Activation of angiogenic signaling pathways by two human tRNA synthetases. Biochemistry. 2002 Nov 12;41(45):13344-9. Review. PubMed citation

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Jordanova A, Irobi J, Thomas FP, Van Dijck P, Meerschaert K, Dewil M, Dierick I, Jacobs A, De Vriendt E, Guergueltcheva V, Rao CV, Tournev I, Gondim FA, D'Hooghe M, Van Gerwen V, Callaerts P, Van Den Bosch L, Timmermans JP, Robberecht W, Gettemans J, Thevelein JM, De Jonghe P, Kremensky I, Timmerman V. Disrupted function and axonal distribution of mutant tyrosyl-tRNA synthetase in dominant intermediate Charcot-

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Marie-Tooth neuropathy. Nat Genet. 2006 Feb;38(2):197-202. Epub 2006 Jan 22. PubMed citation •

Wakasugi K, Slike BM, Hood J, Otani A, Ewalt KL, Friedlander M, Cheresh DA, Schimmel P. A human aminoacyl-tRNA synthetase as a regulator of angiogenesis. Proc Natl Acad Sci U S A. 2002 Jan 8;99(1):173-7. Epub 2002 Jan 2. PubMed citation

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Yang XL, Schimmel P, Ewalt KL. Relationship of two human tRNA synthetases used in cell signaling. Trends Biochem Sci. 2004 May;29(5):250-6. Review. PubMed citation

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.25 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with Charcot-Marie-Tooth disease, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type CharcotMarie-Tooth disease (or synonyms) into the search box, and click Go. The following is the type of output you can expect from PubMed for Charcot-Marie-Tooth disease (hyperlinks lead to article summaries): •

A distinct congenital motor and sensory neuropathy (neuronal type) with dysmorphic features in a father and two sons. A variant of Charcot-Marie-Tooth disease. Author(s): Ruiz C, Rivas F, Ramirez-Casillas G, Vazquez-Santana R, Mendoza-Chalita B, Feria-Velasco A, Tapia-Arizmendi G, Cantu JM. Source: Clinical Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3470161&query_hl=6&itool=pubmed_docsum

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A family with tomaculous neuropathy mimicking Charcot-Marie-Tooth disease. Author(s): Barbieri F, Santangelo R, Crisci C, Ragno M, Perretti A, Santoro L. Source: Clinical Neurology and Neurosurgery. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2171842&query_hl=6&itool=pubmed_docsum

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A linkage study of the locus for X-linked Charcot-Marie-Tooth disease. Author(s): Goonewardena P, Welihinda J, Anvret M, Gyftodimou J, Haegermark A, Iselius L, Lindsten J, Pettersson U. Source: Clinical Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2901924&query_hl=6&itool=pubmed_docsum

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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A long-term study of triple arthrodesis for correction of pes cavovarus in CharcotMarie-Tooth disease. Author(s): Wukich DK, Bowen JR. Source: Journal of Pediatric Orthopedics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2732324&query_hl=6&itool=pubmed_docsum

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A novel Cx32 mutation causes X-linked Charcot-Marie-Tooth disease with brainstem involvement and brain magnetic resonance spectroscopy abnormalities. Author(s): Murru MR, Vannelli A, Marrosu G, Cocco E, Corongiu D, Tranquilli S, Cherchi MV, Mura M, Barberini L, Mallarini G, Marrosu MG. Source: Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16688595&query_hl=6&itool=pubmed_docsum

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A novel duplication/insertion mutation of NEFL in a patient with Charcot-MarieTooth disease. Author(s): Leung CL, Nagan N, Graham TH, Liem RK. Source: Am J Med Genet A. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16619203&query_hl=6&itool=pubmed_docsum

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A novel mutation of GDAP1 associated with Charcot-Marie-Tooth disease in three Italian families: evidence for a founder effect. Author(s): Di Maria E, Gulli R, Balestra P, Cassandrini D, Pigullo S, Doria-Lamba L, Bado M, Schenone A, Ajmar F, Mandich P, Bellone E. Source: Journal of Neurology, Neurosurgery, and Psychiatry. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15377708&query_hl=6&itool=pubmed_docsum

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A novel out-of-frame mutation in the neurofilament light chain gene (NEFL) does not result in Charcot-Marie-Tooth disease type 2E. Author(s): Andrigo C, Boito C, Prandini P, Mostacciuolo ML, Siciliano G, Angelini C, Pegoraro E. Source: Neurogenetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15654615&query_hl=6&itool=pubmed_docsum

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Absence of genetic linkage of Charcot-Marie-Tooth disease (HMSN Ia) with chromosome 1 gene markers. Author(s): Raeymaekers P, De Jonghe P, Backhovens H, Wehnert A, De Winter G, Swerts L, Gheuens J, Martin JJ, Vandenberghe A, Van Broeckhoven C. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2725880&query_hl=6&itool=pubmed_docsum

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Activated T cells in type I Charcot-Marie-Tooth disease: evidence for immunologic heterogeneity. Author(s): Williams LL, Shannon BT, O'Dougherty M, Wright FS. Source: Journal of Neuroimmunology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2444625&query_hl=6&itool=pubmed_docsum

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An animal model for Charcot-Marie-Tooth disease type 4B1. Author(s): Bonneick S, Boentert M, Berger P, Atanasoski S, Mantei N, Wessig C, Toyka KV, Young P, Suter U. Source: Human Molecular Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16249189&query_hl=6&itool=pubmed_docsum

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Anaesthesia for abdominal hysterectomy in Charcot-Marie-Tooth disease. A case report. Author(s): Roelofse JA, Shipton EA. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3983744&query_hl=6&itool=pubmed_docsum

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Anesthetic management for cesarean section of a patient with Charcot-Marie-Tooth disease. Author(s): Brian JE Jr, Boyles GD, Quirk JG Jr, Clark RB. Source: Anesthesiology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3826702&query_hl=6&itool=pubmed_docsum

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Assessment and management of pes cavus in Charcot-Marie-tooth disease. Author(s): Alexander IJ, Johnson KA. Source: Clin Orthop Relat Res. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2766615&query_hl=6&itool=pubmed_docsum

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Audiologic evaluation in Charcot-Marie-Tooth disease. Author(s): Perez H, Vilchez J, Sevilla T, Martinez L. Source: Scand Audiol Suppl. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3227273&query_hl=6&itool=pubmed_docsum

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Auditory function in hereditary motor and sensory neuropathy (Charcot-Marie-Tooth disease). Author(s): Raglan E, Prasher DK, Trinder E, Rudge P. Source: Acta Oto-Laryngologica. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3471036&query_hl=6&itool=pubmed_docsum

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Autosomal recessive axonal form of Charcot-Marie-Tooth Disease caused by compound heterozygous 3'-splice site and Ser130Cys mutation in the GDAP1 gene. Author(s): Kabzinska D, Kochanski A, Drac H, Ryniewicz B, Rowinska-Marcinska K, Hausmanowa-Petrusewicz I. Source: Neuropediatrics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15944907&query_hl=6&itool=pubmed_docsum

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Autosomal recessive forms of Charcot-Marie-Tooth disease. Author(s): Vallat JM, Grid D, Magdelaine C, Sturtz F, Tazir M. Source: Curr Neurol Neurosci Rep. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15324608&query_hl=6&itool=pubmed_docsum

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Autosomal recessive inheritance of Charcot-Marie-Tooth disease associated with sensorineural deafness. Author(s): Cornell J, Sellars S, Beighton P. Source: Clinical Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=6705250&query_hl=6&itool=pubmed_docsum

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Axonal Charcot-Marie-Tooth disease: the fog is slowly lifting! Author(s): Reilly MM. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16043782&query_hl=6&itool=pubmed_docsum

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Behavioural profiling of a murine Charcot-Marie-Tooth disease type 1A model. Author(s): Norreel JC, Jamon M, Riviere G, Passage E, Fontes M, Clarac F. Source: The European Journal of Neuroscience. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11328356&query_hl=6&itool=pubmed_docsum

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Benign autosomal dominant syndrome of neuronal Charcot-Marie-Tooth disease, ptosis, parkinsonism, and dementia. Author(s): Tandan R, Taylor R, Adesina A, Sharma K, Fries T, Pendlebury W. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2184381&query_hl=6&itool=pubmed_docsum

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Bilateral abductor vocal cord paralysis in Charcot-Marie-Tooth disease. Author(s): Holinger PC, Vuckovich DM, Holinger LD, Holinger PH. Source: The Annals of Otology, Rhinology, and Laryngology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=443714&query_hl=6&itool=pubmed_docsum

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Bilateral sudden sensorineural hearing loss caused by Charcot-Marie-Tooth disease. Author(s): Papadakis CE, Hajiioannou JK, Kyrmizakis DE, Bizakis JG. Source: The Journal of Laryngology and Otology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12803792&query_hl=6&itool=pubmed_docsum

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Bilateral, localized orbital neurofibromas and Charcot-Marie-Tooth disease. Author(s): Ma'luf RN, Noureddin BN, Ghazi NG, Tawil AN, Allam SS. Source: Archives of Ophthalmology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16219741&query_hl=6&itool=pubmed_docsum

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Brace modification improves aerobic performance in Charcot-Marie-Tooth disease: a single-subject design. Author(s): Bean J, Walsh A, Frontera W. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11475477&query_hl=6&itool=pubmed_docsum

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Brain white matter lesions in an italian family with Charcot-Marie-Tooth disease. Author(s): Sacco S, Totaro R, Bastianello S, Marini C, Carolei A. Source: European Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15073442&query_hl=6&itool=pubmed_docsum

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Central neural blockade in Charcot-Marie-Tooth disease. Author(s): Schmitt HJ, Muenster T, Schmidt J. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15574563&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease and cardiac arrhythmias. Author(s): Battistella PA, Moreolo GS, Benetti E, Da Dalt L, Pellegrino PA. Source: Brain & Development. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3218708&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease and nephropathy in a mother and daughter with a review of the literature. Author(s): Paul MD, Fernandez D, Pryse-Phillips W, Gault MH. Source: Nephron. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2404215&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease and related hereditary polyneuropathies: molecular diagnostics determine aspects of medical management. Author(s): Szigeti K, Garcia CA, Lupski JR. Source: Genetics in Medicine : Official Journal of the American College of Medical Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16481890&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease and respiratory failure. Author(s): Dyer EL, Callahan AS 3rd. Source: Chest. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3335163&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease and respiratory failure. Author(s): Dyer EL, Callahan AS. Source: Chest. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3665622&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease due to a de novo mutation of the RAB7 gene. Author(s): Meggouh F, Bienfait HM, Weterman MA, de Visser M, Baas F. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=17060578&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease due to the Thr124Met mutation in the myelin protein zero gene associated with multiple sclerosis. Author(s): Rajabally YA, Abbott RJ. Source: Journal of the Peripheral Nervous System : Jpns. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16279991&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease impairs quality of life: why? And how do we improve it? Author(s): Shy ME, Rose MR. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16186514&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease in northern Finland. Author(s): Rantala H, Tolonen U, Myllyla V. Source: Ann Clin Res. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3740791&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease type 1A duplication with severe paresis of the proximal lower limb muscles: a long-term follow-up study. Author(s): Berciano J, Gallardo E, Garcia A, Infante J, Mateo I, Combarros O. Source: Journal of Neurology, Neurosurgery, and Psychiatry. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16788010&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease type 1A duplication: spectrum of clinical and magnetic resonance imaging features in leg and foot muscles. Author(s): Gallardo E, Garcia A, Combarros O, Berciano J. Source: Brain; a Journal of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16317020&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease type 1A: clinicopathological correlations in 24 patients. Author(s): Carvalho AA, Vital A, Ferrer X, Latour P, Lagueny A, Brechenmacher C, Vital C. Source: Journal of the Peripheral Nervous System : Jpns. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15703022&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease type 1A: molecular mechanisms of gene dosage and point mutation underlying a common inherited peripheral neuropathy. Author(s): Roa BB, Garcia CA, Lupski JR. Source: Int J Neurol. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11980069&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease: a case presenting with hyperreflexia. Author(s): Shieh CC, Wang PJ, Lin HJ, Lin MY, Hsieh HC, Shen YZ. Source: Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2275366&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth disease: study of a large kinship with an intermediate form. Author(s): Rossi A, Paradiso C, Cioni R, Rizzuto N, Guazzi G. Source: Journal of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=4020397&query_hl=6&itool=pubmed_docsum

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Class II antigen expression on human cultured Schwann cells from patients with Charcot-Marie-Tooth disease. Author(s): De Martini I, Bianchini D, Schenone A, Cadoni A, Zicca A, Zaccheo D, Mancardi GL. Source: Neuroscience Letters. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2761783&query_hl=6&itool=pubmed_docsum

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Cochlear implantation in a patient with deafness induced by Charcot-Marie-Tooth disease (hereditary motor and sensory neuropathies). Author(s): Postelmans JT, Stokroos RJ. Source: The Journal of Laryngology and Otology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16772060&query_hl=6&itool=pubmed_docsum

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Correction of cavovarus foot deformity in Charcot-Marie-Tooth disease. Author(s): Azmaipairashvili Z, Riddle EC, Scavina M, Kumar SJ. Source: Journal of Pediatric Orthopedics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15832156&query_hl=6&itool=pubmed_docsum

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Corticospinal tract MRI hyperintensity in X-linked Charcot-Marie-Tooth Disease. Author(s): Kassubek J, Bretschneider V, Sperfeld AD. Source: Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16051098&query_hl=6&itool=pubmed_docsum

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De novo mutation (Arg98-->Cys) of the myelin P0 gene and uncompaction of the major dense line of the myelin sheath in a severe variant of Charcot-Marie-Tooth disease type 1B. Author(s): Komiyama A, Ohnishi A, Izawa K, Yamamori S, Ohashi H, Hasegawa O. Source: Journal of the Neurological Sciences. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9168174&query_hl=6&itool=pubmed_docsum

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De novo mutation of Charcot-Marie-Tooth disease type 1A. Author(s): Tachi N, Kozuka N, Ohya K, Chiba S. Source: Pediatric Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9308980&query_hl=6&itool=pubmed_docsum

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De novo partial duplication of 17p associated with Charcot-Marie-Tooth disease type 1A. Author(s): Fernandez-Torre JL, Otero B, Alvarez V, Hernando I, Fernandez-Toral J. Source: Journal of Neurology, Neurosurgery, and Psychiatry. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11336036&query_hl=6&itool=pubmed_docsum

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De novo Ser72Leu mutation in the peripheral myelin protein 22 in two Polish patients with a severe form of Charcot-Marie-Tooth disease. Author(s): Kochanski A, Kabzinska D. Source: Acta Biochimica Polonica. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15625576&query_hl=6&itool=pubmed_docsum

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Degeneration of anterior horn cell in neuronal type of Charcot-Marie-Tooth disease (hereditary motor and sensory neuropathy type II): a Golgi study. Author(s): Ono S, Hara K, Sasaki H, Sugano I, Nagao K. Source: Acta Neuropathologica. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7687811&query_hl=6&itool=pubmed_docsum

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Delayed neurophysiologic abnormalities in Charcot-Marie-Tooth disease type 1A. Author(s): Ryan MM, Jones HR Jr. Source: Muscle & Nerve. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15221889&query_hl=6&itool=pubmed_docsum

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Deletion and nonsense mutations of the connexin 32 gene associated with CharcotMarie-Tooth disease. Author(s): Lin C, Numakura C, Ikegami T, Shizuka M, Shoji M, Nicholson G, Hayasaka K. Source: The Tohoku Journal of Experimental Medicine. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10587015&query_hl=6&itool=pubmed_docsum

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Deletion of the serine 34 codon from the major peripheral myelin protein P0 gene in Charcot-Marie-Tooth disease type 1B. Author(s): Kulkens T, Bolhuis PA, Wolterman RA, Kemp S, te Nijenhuis S, Valentijn LJ, Hensels GW, Jennekens FG, de Visser M, Hoogendijk JE, et al. Source: Nature Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7693130&query_hl=6&itool=pubmed_docsum

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Demyelinating and axonal features of Charcot-Marie-Tooth disease with mutations of myelin-related proteins (PMP22, MPZ and Cx32): a clinicopathological study of 205 Japanese patients. Author(s): Hattori N, Yamamoto M, Yoshihara T, Koike H, Nakagawa M, Yoshikawa H, Ohnishi A, Hayasaka K, Onodera O, Baba M, Yasuda H, Saito T, Nakashima K, Kira J, Kaji R, Oka N, Sobue G; Study Group for Hereditary Neuropathy in Japan. Source: Brain; a Journal of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12477701&query_hl=6&itool=pubmed_docsum

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Demyelinating X-linked Charcot-Marie-Tooth disease: unusual electrophysiological findings. Author(s): Tabaraud F, Lagrange E, Sindou P, Vandenberghe A, Levy N, Vallat JM. Source: Muscle & Nerve. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10487913&query_hl=6&itool=pubmed_docsum

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Denaturing high-performance liquid chromatography of the myotubularin-related 2 gene (MTMR2) in unrelated patients with Charcot-Marie-Tooth disease suggests a low frequency of mutation in inherited neuropathy. Author(s): Bolino A, Lonie LJ, Zimmer M, Boerkoel CF, Takashima H, Monaco AP, Lupski JR. Source: Neurogenetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11354824&query_hl=6&itool=pubmed_docsum

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Diaphragm weakness in Charcot-Marie-Tooth disease. Author(s): Laroche CM, Carroll N, Moxham J, Stanley NN, Evans RJ, Green M. Source: Thorax. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3420560&query_hl=6&itool=pubmed_docsum

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Diaphragmatic dysfunction in siblings with hereditary motor and sensory neuropathy (Charcot-Marie-Tooth disease). Author(s): Chan CK, Mohsenin V, Loke J, Virgulto J, Sipski ML, Ferranti R. Source: Chest. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3829750&query_hl=6&itool=pubmed_docsum

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Dietary essential fatty acids, vitamin E, and Charcot-Marie-Tooth disease. Author(s): Williams LL, O'Dougherty MM, Wright FS, Bobulski RJ, Horrocks LA. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3748386&query_hl=6&itool=pubmed_docsum

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Differential diagnosis of Charcot-Marie-Tooth disease and related neuropathies. Author(s): Pareyson D. Source: Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15221625&query_hl=6&itool=pubmed_docsum

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Disability and quality of life in Charcot-Marie-Tooth disease type 1. Author(s): Pfeiffer G, Wicklein EM, Ratusinski T, Schmitt L, Kunze K. Source: Journal of Neurology, Neurosurgery, and Psychiatry. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11254787&query_hl=6&itool=pubmed_docsum

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Disease course of Charcot-Marie-Tooth disease type 2 and comorbidity. Author(s): Gemignani F, Marbini A. Source: Archives of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15364699&query_hl=6&itool=pubmed_docsum

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Disease course of Charcot-Marie-Tooth disease type 2: a 5-year follow-up study. Author(s): Teunissen LL, Notermans NC, Franssen H, Van Engelen BG, Baas F, Wokke JH. Source: Archives of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12810486&query_hl=6&itool=pubmed_docsum

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Disease mechanisms and potential therapeutic strategies in Charcot-Marie-Tooth disease. Author(s): Young P, Suter U. Source: Brain Research. Brain Research Reviews. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11690618&query_hl=6&itool=pubmed_docsum

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DNA diagnostics for Charcot-Marie-Tooth disease and related inherited neuropathies. Author(s): Lupski JR. Source: Clinical Chemistry. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8674212&query_hl=6&itool=pubmed_docsum

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Early clinical and electrophysiologic features of the two most common autosomal recessive forms of Charcot-Marie-Tooth disease in the Roma (Gypsies). Author(s): Guergueltcheva V, Tournev I, Bojinova V, Hantke J, Litvinenko I, Ishpekova B, Shmarov A, Petrova J, Jordanova A, Kalaydjieva L. Source: Journal of Child Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16551448&query_hl=6&itool=pubmed_docsum

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Early onset Charcot-Marie-Tooth disease caused by a homozygous Leu239Phe mutation in the GDAP1 gene. Author(s): Kabzinska D, Drac H, Rowinska-Marcinska K, Fidzianska A, Kochanski A, Hausmanowa-Petrusewicz I. Source: Acta Myol. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=17039978&query_hl=6&itool=pubmed_docsum

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Early onset neuropathy in a compound form of Charcot-Marie-Tooth disease. Author(s): Meggouh F, de Visser M, Arts WF, De Coo RI, van Schaik IN, Baas F. Source: Annals of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15786462&query_hl=6&itool=pubmed_docsum

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Early onset severe and late-onset mild Charcot-Marie-Tooth disease with mitofusin 2 (MFN2) mutations. Author(s): Chung KW, Kim SB, Park KD, Choi KG, Lee JH, Eun HW, Suh JS, Hwang JH, Kim WK, Seo BC, Kim SH, Son IH, Kim SM, Sunwoo IN, Choi BO. Source: Brain; a Journal of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16835246&query_hl=6&itool=pubmed_docsum

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Edg-2 in myelin-forming cells: isoforms, genomic mapping, and exclusion in CharcotMarie-Tooth disease. Author(s): Allard J, Barron S, Trottier S, Cervera P, Daumas-Duport C, Leguern E, Brice A, Schwartz JC, Sokoloff P. Source: Glia. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10384882&query_hl=6&itool=pubmed_docsum

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Electrodiagnostic evidence of phrenic nerve demyelination in Charcot-Marie-Tooth disease 1A. Author(s): Sagliocco L, Orlandi G, Calabrese R, Pellegrinetti A, Baglini O, Castelli F, Baldinotti F, Sartucci F. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=14508405&query_hl=6&itool=pubmed_docsum

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Electrodiagnostic studies in a murine model of demyelinating Charcot-Marie-Tooth disease. Author(s): Meekins GD, Weiss MD. Source: Phys Med Rehabil Clin N Am. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16214054&query_hl=6&itool=pubmed_docsum

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Electrophysiological studies in the different genotypes of Charcot-Marie-Tooth disease. Author(s): England JD, Garcia CA. Source: Current Opinion in Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8894408&query_hl=6&itool=pubmed_docsum

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Elevated expression of messenger RNA for peripheral myelin protein 22 in biopsied peripheral nerves of patients with Charcot-Marie-Tooth disease type 1A. Author(s): Kamholz J, Shy M, Scherer S. Source: Annals of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8080259&query_hl=6&itool=pubmed_docsum

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Elevated expression of messenger RNA for peripheral myelin protein 22 in biopsied peripheral nerves of patients with Charcot-Marie-Tooth disease type 1A. Author(s): Yoshikawa H, Nishimura T, Nakatsuji Y, Fujimura H, Himoro M, Hayasaka K, Sakoda S, Yanagihara T. Source: Annals of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7512319&query_hl=6&itool=pubmed_docsum

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Epidural analgesia for labour in a patient with Charcot-Marie-Tooth disease. Author(s): Scull T, Weeks S. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8922772&query_hl=6&itool=pubmed_docsum

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Estimation of the mutation frequencies in Charcot-Marie-Tooth disease type 1 and hereditary neuropathy with liability to pressure palsies: a European collaborative study. Author(s): Nelis E, Van Broeckhoven C, De Jonghe P, Lofgren A, Vandenberghe A, Latour P, Le Guern E, Brice A, Mostacciuolo ML, Schiavon F, Palau F, Bort S, Upadhyaya M, Rocchi M, Archidiacono N, Mandich P, Bellone E, Silander K, Savontaus ML, Navon R, Goldberg-Stern H, Estivill X, Volpini V, Friedl W, Gal A, et al. Source: European Journal of Human Genetics : Ejhg. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8800924&query_hl=6&itool=pubmed_docsum

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Evaluation and treatment of hip dysplasia in Charcot-Marie-Tooth disease. Author(s): Chan G, Bowen JR, Kumar SJ. Source: The Orthopedic Clinics of North America. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16638451&query_hl=6&itool=pubmed_docsum

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Evidence for a recessive PMP22 point mutation in Charcot-Marie-Tooth disease type 1A. Author(s): Roa BB, Garcia CA, Pentao L, Killian JM, Trask BJ, Suter U, Snipes GJ, OrtizLopez R, Shooter EM, Patel PI, Lupski JR. Source: Nature Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8252046&query_hl=6&itool=pubmed_docsum

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Evidence that Charcot-Marie-tooth disease with tremor coincides with the RoussyLevy syndrome. Author(s): Barbieri F, Filla A, Ragno M, Crisci C, Santoro L, Corona M, Campanella G. Source: The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=6509399&query_hl=6&itool=pubmed_docsum

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Evoked potentials in Charcot-Marie-Tooth disease. Author(s): Penicaud A, Meunier S, Le Canuet P, Laffont F, Cathala HP. Source: Electroencephalogr Clin Neurophysiol Suppl. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2289435&query_hl=6&itool=pubmed_docsum

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Evolutionary and structural analyses of GDAP1, involved in Charcot-Marie-Tooth disease, characterize a novel class of glutathione transferase-related genes. Author(s): Marco A, Cuesta A, Pedrola L, Palau F, Marin I. Source: Molecular Biology and Evolution. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=14595091&query_hl=6&itool=pubmed_docsum

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Expression of IL-17B in neurons and evaluation of its possible role in the chromosome 5q-linked form of Charcot-Marie-Tooth disease. Author(s): Moore EE, Presnell S, Garrigues U, Guilbot A, LeGuern E, Smith D, Yao L, Whitmore TE, Gilbert T, Palmer TD, Horner PJ, Kuestner RE. Source: Neuromuscular Disorders : Nmd. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11738356&query_hl=6&itool=pubmed_docsum

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Expression of peripheral myelin protein zero in sural nerve of patients with CharcotMarie-Tooth disease 1B. Author(s): Tachi N, Kozuka N, Ohya K, Chiba S, Sasaki K, Uyemura K. Source: Pediatric Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11182278&query_hl=6&itool=pubmed_docsum

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Familial bilateral vocal cord paralysis and Charcot-Marie-tooth disease type II-C. Author(s): Lacy PD, Hartley BE, Rutter MJ, Cotton RT. Source: Archives of Otolaryngology--Head & Neck Surgery. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11255479&query_hl=6&itool=pubmed_docsum

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Familial periodic paralysis and Charcot-Marie-Tooth disease in a 7-generation family. Author(s): Hisama FM. Source: Archives of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15642860&query_hl=6&itool=pubmed_docsum

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Familial trigeminal neuralgia in Charcot-Marie-Tooth disease. Author(s): Testa D, Milanese C, La Mantia L, Mastrangelo M, Crenna P, Negri S. Source: Journal of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=6169808&query_hl=6&itool=pubmed_docsum

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Fibrillary glomerulonephritis and Charcot-Marie-Tooth disease. Author(s): Nadal MA, Lago NR, Olivieri LE, de Rosa G, Pierri T. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10074591&query_hl=6&itool=pubmed_docsum

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Fluorescence in situ hybridization (FISH) for identifying the genomic rearrangements associated with three myelinopathies. Charcot-Marie-Tooth disease, hereditary neuropathy with liability to pressure palsies, and Pelizaeus-Merzbacher disease. Author(s): Mohammed MS, Shaffer LG. Source: Methods in Molecular Biology (Clifton, N.J.). http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12491936&query_hl=6&itool=pubmed_docsum

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Focal glomerulosclerosis and Charcot-Marie-Tooth disease: not a chance association? Author(s): Lloveras JJ, Salles JP, Durand D, Suc JM, Rascol A. Source: Nephron. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3724932&query_hl=6&itool=pubmed_docsum

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Focal glomerulosclerosis associated with Charcot-Marie-Tooth disease. Author(s): Gherardi R, Belghiti-Deprez D, Hirbec G, Bouche P, Weil B, Lagrue G. Source: Nephron. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=4010852&query_hl=6&itool=pubmed_docsum

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Focal segmental glomerulosclerosis and Charcot-Marie-Tooth disease. Author(s): Martini A, Ravelli A, Burgio GR. Source: Int J Pediatr Nephrol. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=4030225&query_hl=6&itool=pubmed_docsum

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Foot and ankle fusions in Charcot-Marie-Tooth disease. Author(s): Santavirta S, Turunen V, Ylinen P, Konttinen YT, Tallroth K. Source: Archives of Orthopaedic and Trauma Surgery. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8357693&query_hl=6&itool=pubmed_docsum

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Foot and ankle manifestations of Charcot-Marie-Tooth disease. Author(s): Holmes JR, Hansen ST Jr. Source: Foot Ankle. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8253442&query_hl=6&itool=pubmed_docsum

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Foot surgery in Charcot-Marie-Tooth disease. Author(s): Cavuoto JW. Source: J Foot Surg. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7264217&query_hl=6&itool=pubmed_docsum

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Footdrop, foot rotation, and plantarflexor failure in Charcot-Marie-Tooth disease. Author(s): Vinci P, Perelli SL. Source: Archives of Physical Medicine and Rehabilitation. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11932853&query_hl=6&itool=pubmed_docsum

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Four novel connexin 32 mutations in X-linked Charcot-Marie-Tooth disease with phenotypic variability. Author(s): Karadima G, Panas M, Floroskufi P, Kalfakis N, Vassilopoulos D. Source: Journal of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16096811&query_hl=6&itool=pubmed_docsum

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Four novel mutations of the connexin 32 gene in four Japanese families with CharcotMarie-Tooth disease type 1. Author(s): Ikegami T, Lin C, Kato M, Itoh A, Nonaka I, Kurimura M, Hirayabashi H, Shinohara Y, Mochizuki A, Hayasaka K. Source: American Journal of Medical Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9856562&query_hl=6&itool=pubmed_docsum

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Frequency of duplication at 17p11.2 in families of northeast Italy with Charcot-MarieTooth disease type 1. Author(s): Mostacciuolo ML, Schiavon F, Angelini C, Miccoli B, Piccolo F, Danieli GA. Source: Neuroepidemiology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7891814&query_hl=6&itool=pubmed_docsum

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Functional alterations in gap junction channels formed by mutant forms of connexin 32: evidence for loss of function as a pathogenic mechanism in the X-linked form of Charcot-Marie-Tooth disease. Author(s): Abrams CK, Freidin MM, Verselis VK, Bennett MV, Bargiello TA. Source: Brain Research. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11325342&query_hl=6&itool=pubmed_docsum

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Functional analysis of connexin-32 mutants associated with X-linked dominant Charcot-Marie-Tooth disease. Author(s): Wang HL, Chang WT, Yeh TH, Wu T, Chen MS, Wu CY. Source: Neurobiology of Disease. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15006706&query_hl=6&itool=pubmed_docsum

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Further evidence that neurofilament light chain gene mutations can cause CharcotMarie-Tooth disease type 2E. Author(s): De Jonghe P, Mersivanova I, Nelis E, Del Favero J, Martin JJ, Van Broeckhoven C, Evgrafov O, Timmerman V. Source: Annals of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11220745&query_hl=6&itool=pubmed_docsum

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F-wave conduction velocity in the deep peroneal nerve: Charcot-Marie-Tooth disease and dystrophia myotonica. Author(s): Panayiotopoulos CP. Source: Muscle & Nerve. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=752107&query_hl=6&itool=pubmed_docsum

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F-wave velocity in the central segment of the median and ulnar nerves. A study in normal subjects and in patients with Charcot-Marie-Tooth disease. Author(s): Kimura J. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=4857549&query_hl=6&itool=pubmed_docsum

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Gait rehabilitation in a patient affected with Charcot-Marie-Tooth disease associated with pyramidal and cerebellar features and blindness. Author(s): Vinci P. Source: Archives of Physical Medicine and Rehabilitation. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12736893&query_hl=6&itool=pubmed_docsum

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Ganglioside-induced differentiation associated protein 1 is a regulator of the mitochondrial network: new implications for Charcot-Marie-Tooth disease. Author(s): Niemann A, Ruegg M, La Padula V, Schenone A, Suter U. Source: The Journal of Cell Biology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16172208&query_hl=6&itool=pubmed_docsum

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Ganglioside-induced differentiation-associated protein-1 is mutant in Charcot-MarieTooth disease type 4A/8q21. Author(s): Baxter RV, Ben Othmane K, Rochelle JM, Stajich JE, Hulette C, Dew-Knight S, Hentati F, Ben Hamida M, Bel S, Stenger JE, Gilbert JR, Pericak-Vance MA, Vance JM. Source: Nature Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11743579&query_hl=6&itool=pubmed_docsum

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Gap junction protein beta 1 (GJB1) mutations and central nervous system symptoms in X-linked Charcot-Marie-Tooth disease. Author(s): Takashima H, Nakagawa M, Umehara F, Hirata K, Suehara M, Mayumi H, Yoshishige K, Matsuyama W, Saito M, Jonosono M, Arimura K, Osame M. Source: Acta Neurologica Scandinavica. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12542510&query_hl=6&itool=pubmed_docsum

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GDAP1, the protein causing Charcot-Marie-Tooth disease type 4A, is expressed in neurons and is associated with mitochondria. Author(s): Pedrola L, Espert A, Wu X, Claramunt R, Shy ME, Palau F. Source: Human Molecular Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15772096&query_hl=6&itool=pubmed_docsum

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Gene dosage sensitivity of a novel mutation in the intracellular domain of P0 associated with Charcot-Marie-Tooth disease type 1B. Author(s): Fabrizi GM, Pellegrini M, Angiari C, Cavallaro T, Morini A, Taioli F, Cabrini I, Orrico D, Rizzuto N. Source: Neuromuscular Disorders : Nmd. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16488608&query_hl=6&itool=pubmed_docsum

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Gene symbol: MPZ. Disease: Charcot-Marie-Tooth disease type 1B. Author(s): Lee YC, Chang MH, Lin KP, Soong BW. Source: Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16521307&query_hl=6&itool=pubmed_docsum

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Genetic diagnosis of Charcot-Marie-Tooth disease. Author(s): Baas F. Source: Methods in Molecular Biology (Clifton, N.J.). http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12491932&query_hl=6&itool=pubmed_docsum

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Genetic linkage and heterogeneity in type I Charcot-Marie-Tooth disease (hereditary motor and sensory neuropathy type I). Author(s): Chance PF, Bird TD, O'Connell P, Lipe H, Lalouel JM, Leppert M. Source: American Journal of Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2239969&query_hl=6&itool=pubmed_docsum

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Genetic linkage of hereditary motor and sensory neuropathy type I (Charcot-MarieTooth disease) to markers of chromosomes 1 and 17. Author(s): Defesche JC, Hoogendijk JE, de Visser M, de Visser O, Bolhuis PA. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2392234&query_hl=6&itool=pubmed_docsum

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Genetic linkage relationships of Charcot-Marie-Tooth disease (HMSN-Ib) to chromosome 1 markers. Author(s): Chance PF, Murray JC, Bird TD, Kochin RS. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3468376&query_hl=6&itool=pubmed_docsum

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Genetic mapping of autosomal dominant Charcot-Marie-Tooth disease in a large French-Acadian kindred: identification of new linked markers on chromosome 17. Author(s): Patel PI, Franco B, Garcia C, Slaugenhaupt SA, Nakamura Y, Ledbetter DH, Chakravarti A, Lupski JR. Source: American Journal of Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2316525&query_hl=6&itool=pubmed_docsum

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Genetics of Charcot-Marie-Tooth disease type 4A: mutations, inheritance, phenotypic variability, and founder effect. Author(s): Claramunt R, Pedrola L, Sevilla T, Lopez de Munain A, Berciano J, Cuesta A, Sanchez-Navarro B, Millan JM, Saifi GM, Lupski JR, Vilchez JJ, Espinos C, Palau F. Source: Journal of Medical Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15805163&query_hl=6&itool=pubmed_docsum

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Genetics of Charcot-Marie-Tooth disease. Author(s): Pleasure DE. Source: Archives of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12707058&query_hl=6&itool=pubmed_docsum

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Genotype/phenotype correlations in X-linked dominant Charcot-Marie-Tooth disease. Author(s): Hahn AF, Bolton CF, White CM, Brown WF, Tuuha SE, Tan CC, Ainsworth PJ. Source: Annals of the New York Academy of Sciences. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10586261&query_hl=6&itool=pubmed_docsum

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Giant axon and neurofilament accumulation in Charcot-Marie-Tooth disease type 2E. Author(s): Fabrizi GM, Cavallaro T, Angiari C, Bertolasi L, Cabrini I, Ferrarini M, Rizzuto N. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15111691&query_hl=6&itool=pubmed_docsum

Studies

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Glu528del in NEFL is a polymorphic variant rather than a disease-causing mutation for Charcot-Marie-Tooth disease in Japan. Author(s): Yamamoto M, Yoshihara T, Hattori N, Sobue G. Source: Neurogenetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=14586770&query_hl=6&itool=pubmed_docsum

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Glycyl tRNA synthetase mutations in Charcot-Marie-Tooth disease type 2D and distal spinal muscular atrophy type V. Author(s): Antonellis A, Ellsworth RE, Sambuughin N, Puls I, Abel A, Lee-Lin SQ, Jordanova A, Kremensky I, Christodoulou K, Middleton LT, Sivakumar K, Ionasescu V, Funalot B, Vance JM, Goldfarb LG, Fischbeck KH, Green ED. Source: American Journal of Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12690580&query_hl=6&itool=pubmed_docsum

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Gm and Km allotypes in Charcot-Marie-Tooth disease. Author(s): Shannon BT, Williams LL, Fedrick JA, Pandey JP. Source: J Immunogenet. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=4093613&query_hl=6&itool=pubmed_docsum

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Guidelines for the diagnosis of Charcot-Marie-Tooth disease and related neuropathies. Ad hoc Working Group of the Peripheral Nervous System Study Group, Italian Neurological Society. Author(s): Pareyson D. Source: Italian Journal of Neurological Sciences. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10551906&query_hl=6&itool=pubmed_docsum

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Handgrip impairment in Charcot-Marie-Tooth disease. Author(s): Vinci P, Villa LM, Castagnoli L, Marconi C, Lattanzi A, Manini MP, Calicchio ML, Vitangeli L, Di Gianvito P, Perelli SL, Martini D. Source: Eura Medicophys. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16200028&query_hl=6&itool=pubmed_docsum

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Hemizygous mutation of the peripheral myelin protein 22 gene associated with Charcot-Marie-Tooth disease type 1. Author(s): Numakura C, Lin C, Oka N, Akiguchi I, Hayasaka K. Source: Annals of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10632107&query_hl=6&itool=pubmed_docsum

70

Charcot-Marie-Tooth Disease

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Hereditary angioneurotic edema and Charcot-Marie-Tooth disease in the same family. Author(s): Fernandez PG, Day JH, Simpson NE, Zachariah PK. Source: Can Med Assoc J. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=688147&query_hl=6&itool=pubmed_docsum

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Hereditary motor-sensory neuropathy (Charcot-Marie-Tooth disease) with nerve deafness: a new variant. Author(s): Hamiel OP, Raas-Rothschild A, Upadhyaya M, Frydman M, Sarova-Pinhas I, Brand N, Passwell JH. Source: The Journal of Pediatrics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8355122&query_hl=6&itool=pubmed_docsum

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Hereditary neuropathy with liability to pressure palsies with a partial deletion of the region often duplicated in Charcot-Marie-Tooth disease, type 1A. Author(s): Chapon F, Diraison P, Lechevalier B, Chazot G, Viader F, Bonnebouche C, Vandenberghe A, Timmerman V, Van Broeckhoven C, Vandenberghe A. Source: Journal of Neurology, Neurosurgery, and Psychiatry. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8937360&query_hl=6&itool=pubmed_docsum

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Heterogeneity evidence and linkage studies on Charcot-Marie-Tooth disease. Author(s): Griffiths LR, Zwi MB, McLeod JG, Ross DA, Nicholson GA. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2915802&query_hl=6&itool=pubmed_docsum

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Heterogeneity of Charcot-Marie-Tooth disease suggested by a linkage study. Author(s): Micaglio G, Fardin P, Battilana M, Lombardi A, Mostacciuolo ML, Danieli GA, Angelini C. Source: Adv Neurol. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3334783&query_hl=6&itool=pubmed_docsum

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Heterogeneity of hereditary motor and sensory neuropathy type I (HMSN I): electroneurographical findings, visual evoked potentials and blood group markers in a family with Charcot-Marie-Tooth disease (CMT). Author(s): Leblhuber F, Reisecker F, Mayr WR, Deisenhammer E. Source: Acta Neurologica Scandinavica. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3022527&query_hl=6&itool=pubmed_docsum

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Heterozygous null mutation in the P0 gene associated with mild Charcot-Marie-Tooth disease. Author(s): Pareyson D, Menichella D, Botti S, Sghirlanzoni A, Fallica E, Mora M, Ciano C, Shy ME, Taroni F. Source: Annals of the New York Academy of Sciences. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10586278&query_hl=6&itool=pubmed_docsum

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Hip abnormalities in children with Charcot-Marie-Tooth disease. Author(s): Walker JL, Nelson KR, Heavilon JA, Stevens DB, Lubicky JP, Ogden JA, VandenBrink KA. Source: Journal of Pediatric Orthopedics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8113373&query_hl=6&itool=pubmed_docsum

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Hip dysplasia associated with Charcot-Marie-Tooth disease in the older child and adolescent. Author(s): Kumar SJ, Marks HG, Bowen JR, MacEwen GD. Source: Journal of Pediatric Orthopedics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=4044807&query_hl=6&itool=pubmed_docsum

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Hip dysplasia in Charcot-Marie-Tooth disease: report of a family. Author(s): Ushiyama T, Tanaka C, Kawasaski T, Matsusue Y. Source: Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12898320&query_hl=6&itool=pubmed_docsum

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Histopathological features of X-linked Charcot-Marie-Tooth disease in 8 patients from 6 families with different connexin32 mutations. Author(s): Vital A, Ferrer X, Lagueny A, Vandenberghe A, Latour P, Goizet C, Canron MH, Louiset P, Petry KG, Vital C. Source: Journal of the Peripheral Nervous System : Jpns. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11446387&query_hl=6&itool=pubmed_docsum

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HLA in Charcot-Marie-Tooth disease. Author(s): Williams LL. Source: Annals of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7436389&query_hl=6&itool=pubmed_docsum

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Homozygosity mapping of an autosomal recessive form of demyelinating CharcotMarie-Tooth disease to chromosome 5q23-q33. Author(s): LeGuern E, Guilbot A, Kessali M, Ravise N, Tassin J, Maisonobe T, Grid D, Brice A. Source: Human Molecular Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8894708&query_hl=6&itool=pubmed_docsum

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How to assess the pathogenicity of mutations in Charcot-Marie-Tooth disease and other diseases? Author(s): Kochanski A. Source: Journal of Applied Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16877806&query_hl=6&itool=pubmed_docsum

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H-reflex studies in a family with possibly X-linked neuronal Charcot-Marie-Tooth disease. Author(s): Heimans JJ, Lindhout D, Huisman UW, Kwee ML, Visser SL, Whitton HW. Source: Clinical Neurology and Neurosurgery. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=6295678&query_hl=6&itool=pubmed_docsum

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Human Connexin 32, a gap junction protein altered in the X-linked form of CharcotMarie-Tooth disease, is directly regulated by the transcription factor SOX10. Author(s): Bondurand N, Girard M, Pingault V, Lemort N, Dubourg O, Goossens M. Source: Human Molecular Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11734543&query_hl=6&itool=pubmed_docsum

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Hypertrophic Charcot-Marie-Tooth disease: MR imaging findings. Author(s): Friedman DP, Flanders AE, Tartaglino LM. Source: Ajr. American Journal of Roentgenology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8079895&query_hl=6&itool=pubmed_docsum

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Hypertrophic motor and sensory neuropathy type I (Charcot-Marie-Tooth disease): ultrastructural study of sural nerve biopsy in members of a family. Author(s): Calore EE, Alonso Neto JL, Cavaliere MJ, Perez NM, Russo DH, Wakamatsu A, Maeda MY, Kitamura C. Source: Pathologica. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7808799&query_hl=6&itool=pubmed_docsum

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Identical point mutations of PMP-22 in Trembler-J mouse and Charcot-Marie-Tooth disease type 1A. Author(s): Valentijn LJ, Baas F, Wolterman RA, Hoogendijk JE, van den Bosch NH, Zorn I, Gabreels-Festen AW, de Visser M, Bolhuis PA. Source: Nature Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=1303281&query_hl=6&itool=pubmed_docsum

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Identification of a 4 bp deletion (1560del4) in po gene in a family with severe CharcotMarie-Tooth disease. Author(s): Bellone E, Mandich P, James R, Nelis E, Lamba LD, Van Broeckhoven C, Ajmar F. Source: Human Mutation. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8723697&query_hl=6&itool=pubmed_docsum

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Identification of a 5' splice site mutation in the PMP-22 gene in autosomal dominant Charcot-Marie-Tooth disease type 1. Author(s): Nelis E, Timmerman V, De Jonghe P, Van Broeckhoven C. Source: Human Molecular Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8012365&query_hl=6&itool=pubmed_docsum

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Identification of a new locus for autosomal recessive Charcot-Marie-Tooth disease with focally folded myelin on chromosome 11p15. Author(s): Othmane KB, Johnson E, Menold M, Graham FL, Hamida MB, Hasegawa O, Rogala AD, Ohnishi A, Pericak-Vance M, Hentati F, Vance JM. Source: Genomics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10644431&query_hl=6&itool=pubmed_docsum

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Identification of novel GDAP1 mutations causing autosomal recessive CharcotMarie-Tooth disease. Author(s): Ammar N, Nelis E, Merlini L, Barisic N, Amouri R, Ceuterick C, Martin JJ, Timmerman V, Hentati F, De Jonghe P. Source: Neuromuscular Disorders : Nmd. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=14561495&query_hl=6&itool=pubmed_docsum

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Identification of novel sequence variants in the neurofilament-light gene in a Japanese population: analysis of Charcot-Marie-Tooth disease patients and normal individuals. Author(s): Yoshihara T, Yamamoto M, Hattori N, Misu K, Mori K, Koike H, Sobue G. Source: Journal of the Peripheral Nervous System : Jpns. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12477167&query_hl=6&itool=pubmed_docsum

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Induced myelination and demyelination in a conditional mouse model of CharcotMarie-Tooth disease type 1A. Author(s): Perea J, Robertson A, Tolmachova T, Muddle J, King RH, Ponsford S, Thomas PK, Huxley C. Source: Human Molecular Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11331611&query_hl=6&itool=pubmed_docsum

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Inflammatory pathological changes in a 2-year-old boy with Charcot-Marie-Tooth disease. Author(s): Nakai Y, Okumura A, Takada H, Negoro T, Watanabe K, Hattori N, Sobue G. Source: Brain & Development. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11377008&query_hl=6&itool=pubmed_docsum

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Inherited neuropathies: Charcot-Marie-Tooth disease and related disorders. Author(s): Chance PF, Lupski JR. Source: Baillieres Clin Neurol. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7952853&query_hl=6&itool=pubmed_docsum

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Initial semeiology in children with Charcot-Marie-Tooth disease 1A duplication. Author(s): Berciano J, Garcia A, Combarros O. Source: Muscle & Nerve. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12508292&query_hl=6&itool=pubmed_docsum

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Is a novel I214M substitution in the NEFL gene a cause of Charcot-Marie-Tooth disease? Functional analysis using cell culture models. Author(s): Kabzinska D, Perez-Olle R, Goryunov D, Drac H, Ryniewicz B, Hausmanowa-Petrusewicz I, Kochanski A, Liem RK. Source: Journal of the Peripheral Nervous System : Jpns. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16930284&query_hl=6&itool=pubmed_docsum

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Isolation and use of chromosome 1 probes for linkage studies on Charcot-MarieTooth disease. Author(s): Griffiths LR, Zwi MB, Mesterovic N, Ross DA, Board PG, Callen DF, Mohandas T, Buckland R, Fletcher JM, Driesel AJ, et al. Source: Annals of Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2321912&query_hl=6&itool=pubmed_docsum

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Isolation of a marker linked to the Charcot-Marie-Tooth disease type IA gene by differential Alu-PCR of human chromosome 17-retaining hybrids. Author(s): Patel PI, Garcia C, Montes de Oca-Luna R, Malamut RI, Franco B, Slaugenhaupt S, Chakravarti A, Lupski JR. Source: American Journal of Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=1978559&query_hl=6&itool=pubmed_docsum

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Laryngeal electromyographic findings in Charcot-Marie-Tooth disease type II. Author(s): Dray TG, Robinson LR, Hillel AD. Source: Archives of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10404989&query_hl=6&itool=pubmed_docsum

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Leber's optic neuropathy and Charcot-Marie-Tooth disease. Report of a case. Author(s): McCluskey DJ, O'Connor PS, Sheehy JT. Source: J Clin Neuroophthalmol. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2942573&query_hl=6&itool=pubmed_docsum

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Left ventricular hypertrabeculation/noncompaction with PMP22 duplication-based Charcot-Marie-Tooth disease type 1A. Author(s): Corrado G, Checcarelli N, Santarone M, Stollberger C, Finsterer J. Source: Cardiology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16449811&query_hl=6&itool=pubmed_docsum

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Letter: Charcot-Marie-Tooth disease. Author(s): McLain LW Jr. Source: Jama : the Journal of the American Medical Association. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=4407819&query_hl=6&itool=pubmed_docsum

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Linkage analyses between dominant X-linked Charcot-Marie-Tooth disease, and 15 Xq11-Xq21 microsatellites in a new large family: three new markers are closely linked to the gene. Author(s): Le Guern E, Ravise N, Gugenheim M, Vignal A, Penet C, Bouche P, Weissenbach J, Agid Y, Brice A. Source: Neuromuscular Disorders : Nmd. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7881290&query_hl=6&itool=pubmed_docsum

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Linkage analysis of the Duffy blood group marker with several chromosome 1 genes in an extended pedigree with Charcot-Marie-Tooth disease. Author(s): Raeymaekers P, Van Broeckhoven C, Backhovens H, Wehnert A, Muylle L, De Jonghe P, Gheuens J, Martin JJ, Vandenberghe A. Source: Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2921030&query_hl=6&itool=pubmed_docsum

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Linkage and mutation analysis in an extended family with Charcot-Marie-Tooth disease type 1B. Author(s): Nelis E, Timmerman V, De Jonghe P, Muylle L, Martin JJ, Van Broeckhoven C. Source: Journal of Medical Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7530774&query_hl=6&itool=pubmed_docsum

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Linkage in a family with X-linked Charcot-Marie-Tooth disease. Author(s): Haites N, Fairweather N, Clark C, Kelly KF, Simpson S, Johnston AW. Source: Clinical Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2567643&query_hl=6&itool=pubmed_docsum

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Linkage localization of X-linked Charcot-Marie-Tooth disease. Author(s): Bergoffen J, Trofatter J, Pericak-Vance MA, Haines JL, Chance PF, Fischbeck KH. Source: American Journal of Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8430694&query_hl=6&itool=pubmed_docsum

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Linkage mapping of the gene for Charcot-Marie-Tooth disease type 2 to chromosome 1p (CMT2A) and the clinical features of CMT2A. Author(s): Saito M, Hayashi Y, Suzuki T, Tanaka H, Hozumi I, Tsuji S. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9409358&query_hl=6&itool=pubmed_docsum

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Linkage of a locus (CMT4A) for autosomal recessive Charcot-Marie-Tooth disease to chromosome 8q. Author(s): Ben Othmane K, Hentati F, Lennon F, Ben Hamida C, Blel S, Roses AD, Pericak-Vance MA, Ben Hamida M, Vance JM. Source: Human Molecular Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8268915&query_hl=6&itool=pubmed_docsum

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Linkage of a new locus for autosomal recessive axonal form of Charcot-Marie-Tooth disease to chromosome 8q21.3. Author(s): Barhoumi C, Amouri R, Ben Hamida C, Ben Hamida M, Machghoul S, Gueddiche M, Hentati F. Source: Neuromuscular Disorders : Nmd. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11166163&query_hl=6&itool=pubmed_docsum

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Linkage studies in Charcot-Marie-Tooth disease type 2: evidence that CMT types 1 and 2 are distinct genetic entities. Author(s): Loprest LJ, Pericak-Vance MA, Stajich J, Gaskell PC, Lucas AM, Lennon F, Yamaoka LH, Roses AD, Vance JM. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=1549221&query_hl=6&itool=pubmed_docsum

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Localization of a gene (CMT2A) for autosomal dominant Charcot-Marie-Tooth disease type 2 to chromosome 1p and evidence of genetic heterogeneity. Author(s): Ben Othmane K, Middleton LT, Loprest LJ, Wilkinson KM, Lennon F, Rozear MP, Stajich JM, Gaskell PC, Roses AD, Pericak-Vance MA, et al. Source: Genomics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8406488&query_hl=6&itool=pubmed_docsum

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Localization of Charcot-Marie-Tooth disease type 1a (CMT1A) to chromosome 17p11.2. Author(s): Vance JM, Barker D, Yamaoka LH, Stajich JM, Loprest L, Hung WY, Fischbeck K, Roses AD, Pericak-Vance MA. Source: Genomics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=1674726&query_hl=6&itool=pubmed_docsum

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Localization of PMP-22 gene (candidate gene for the Charcot-Marie-Tooth disease 1A) to band 17p11.2 by direct R-banding fluorescence in situ hybridization. Author(s): Takahashi E, Takeda O, Himoro M, Nanao K, Takada G, Hayasaka K. Source: Jpn J Hum Genet. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=1297450&query_hl=6&itool=pubmed_docsum

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Localization of X-linked dominant Charcot-Marie-Tooth disease (CMT 2) to Xq13. Author(s): Beckett J, Holden JJ, Simpson NE, White BN, MacLeod PM. Source: Journal of Neurogenetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3462379&query_hl=6&itool=pubmed_docsum

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Long-term results of triple arthrodesis in Charcot-Marie-Tooth disease. Author(s): Wetmore RS, Drennan JC. Source: The Journal of Bone and Joint Surgery. American Volume. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2925716&query_hl=6&itool=pubmed_docsum

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Marked improvement of glycaemic control with pioglitazone in a Type 2 diabetic patient associated with Charcot-Marie-Tooth disease. Author(s): Ota T, Osawa K. Source: Diabetic Medicine : a Journal of the British Diabetic Association. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12752495&query_hl=6&itool=pubmed_docsum

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Charcot-Marie-Tooth Disease

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Mild early onset axonal Charcot-Marie-Tooth disease not linked to other axonal Charcot-Marie-Tooth loci. Author(s): Kochanski A, Kennerson M, Kawulak M, Ryniewicz B, Rowinska-Marcinska K, Walizada G, Nowakowski A, Hausmanowa-Petrusewicz I, Nicholson GA. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15699389&query_hl=6&itool=pubmed_docsum

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Molecular analysis in Japanese patients with Charcot-Marie-Tooth disease: DGGE analysis for PMP22, MPZ, and Cx32/GJB1 mutations. Author(s): Numakura C, Lin C, Ikegami T, Guldberg P, Hayasaka K. Source: Human Mutation. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12402337&query_hl=6&itool=pubmed_docsum

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Molecular cell biology of Charcot-Marie-Tooth disease. Author(s): Berger P, Young P, Suter U. Source: Neurogenetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12030326&query_hl=6&itool=pubmed_docsum

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Molecular mechanisms, diagnosis, and rational approaches to management of and therapy for Charcot-Marie-Tooth disease and related peripheral neuropathies. Author(s): Saifi GM, Szigeti K, Snipes GJ, Garcia CA, Lupski JR. Source: Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=14577517&query_hl=6&itool=pubmed_docsum

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Motor unit number estimate of distal and proximal muscles in Charcot-Marie-Tooth disease. Author(s): Lewis RA, Li J, Fuerst DR, Shy ME, Krajewski K. Source: Muscle & Nerve. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12872319&query_hl=6&itool=pubmed_docsum

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Mutant small heat-shock protein 27 causes axonal Charcot-Marie-Tooth disease and distal hereditary motor neuropathy. Author(s): Evgrafov OV, Mersiyanova I, Irobi J, Van Den Bosch L, Dierick I, Leung CL, Schagina O, Verpoorten N, Van Impe K, Fedotov V, Dadali E, Auer-Grumbach M, Windpassinger C, Wagner K, Mitrovic Z, Hilton-Jones D, Talbot K, Martin JJ, Vasserman N, Tverskaya S, Polyakov A, Liem RK, Gettemans J, Robberecht W, De Jonghe P, Timmerman V. Source: Nature Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15122254&query_hl=6&itool=pubmed_docsum

Studies

79

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Mutation analysis of the small heat shock protein 27 gene in chinese patients with Charcot-Marie-Tooth disease. Author(s): Tang B, Liu X, Zhao G, Luo W, Xia K, Pan Q, Cai F, Hu Z, Zhang C, Chen B, Zhang F, Shen L, Zhang R, Jiang H. Source: Archives of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16087758&query_hl=6&itool=pubmed_docsum

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Mutation frequency for Charcot-Marie-Tooth disease type 1 in the Chinese population is similar to that in the global ethnic patients. Author(s): Song S, Zhang Y, Chen B, Zhang Y, Wang M, Wang Y, Yan M, Zou J, Huang Y, Zhong N. Source: Genetics in Medicine : Official Journal of the American College of Medical Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16912585&query_hl=6&itool=pubmed_docsum

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Mutation of a putative protein degradation gene LITAF/SIMPLE in Charcot-MarieTooth disease 1C. Author(s): Street VA, Bennett CL, Goldy JD, Shirk AJ, Kleopa KA, Tempel BL, Lipe HP, Scherer SS, Bird TD, Chance PF. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12525712&query_hl=6&itool=pubmed_docsum

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Mutation screening of Cx32 in Han Chinese patients with Charcot-Marie-Tooth disease. Author(s): Zhang RX, Luo W, Zi XH, Xia K, Cai F, Xiao JF, Zhao GH, Zhang FF, Shen L, Jiang H, Tang BS. Source: Beijing Da Xue Xue Bao. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15719046&query_hl=6&itool=pubmed_docsum

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Mutation screening of the N-myc downstream-regulated gene 1 (NDRG1) in patients with Charcot-Marie-Tooth Disease. Author(s): Hunter M, Bernard R, Freitas E, Boyer A, Morar B, Martins IJ, Tournev I, Jordanova A, Guergelcheva V, Ishpekova B, Kremensky I, Nicholson G, Schlotter B, Lochmuller H, Voit T, Colomer J, Thomas PK, Levy N, Kalaydjieva L. Source: Human Mutation. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12872253&query_hl=6&itool=pubmed_docsum

80

Charcot-Marie-Tooth Disease

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Mutations in MTMR13, a new pseudophosphatase homologue of MTMR2 and Sbf1, in two families with an autosomal recessive demyelinating form of Charcot-MarieTooth disease associated with early-onset glaucoma. Author(s): Azzedine H, Bolino A, Taieb T, Birouk N, Di Duca M, Bouhouche A, Benamou S, Mrabet A, Hammadouche T, Chkili T, Gouider R, Ravazzolo R, Brice A, Laporte J, LeGuern E. Source: American Journal of Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12687498&query_hl=6&itool=pubmed_docsum

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Mutations in the neurofilament light chain gene (NEFL) cause early onset severe Charcot-Marie-Tooth disease. Author(s): Jordanova A, De Jonghe P, Boerkoel CF, Takashima H, De Vriendt E, Ceuterick C, Martin JJ, Butler IJ, Mancias P, Papasozomenos SCh, Terespolsky D, Potocki L, Brown CW, Shy M, Rita DA, Tournev I, Kremensky I, Lupski JR, Timmerman V. Source: Brain; a Journal of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12566280&query_hl=6&itool=pubmed_docsum

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Mutations in the neurofilament light gene linked to Charcot-Marie-Tooth disease cause defects in transport. Author(s): Perez-Olle R, Lopez-Toledano MA, Goryunov D, Cabrera-Poch N, Stefanis L, Brown K, Liem RK. Source: Journal of Neurochemistry. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15857389&query_hl=6&itool=pubmed_docsum

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Mutations in the pleckstrin homology domain of dynamin 2 cause dominant intermediate Charcot-Marie-Tooth disease. Author(s): Zuchner S, Noureddine M, Kennerson M, Verhoeven K, Claeys K, De Jonghe P, Merory J, Oliveira SA, Speer MC, Stenger JE, Walizada G, Zhu D, Pericak-Vance MA, Nicholson G, Timmerman V, Vance JM. Source: Nature Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15731758&query_hl=6&itool=pubmed_docsum

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Myasthenia gravis and Charcot-Marie-Tooth disease. Author(s): Smith JL. Source: J Clin Neuroophthalmol. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2947919&query_hl=6&itool=pubmed_docsum

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Myasthenia gravis complicating Charcot-Marie-Tooth disease: report of a case. Author(s): Berger JR, Ayyar DR, Kimura I, Kovacs A. Source: J Clin Neuroophthalmol. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2947920&query_hl=6&itool=pubmed_docsum

Studies

81

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Myelin protein zero gene mutations in Taiwanese patients with Charcot-Marie-Tooth disease type 1. Author(s): Lee YC, Soong BW, Lin KP, Lee HY, Wu ZA, Kao KP. Source: Journal of the Neurological Sciences. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15050444&query_hl=6&itool=pubmed_docsum

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Myotubularin and MTMR2, phosphatidylinositol 3-phosphatases mutated in myotubular myopathy and type 4B Charcot-Marie-Tooth disease. Author(s): Kim SA, Taylor GS, Torgersen KM, Dixon JE. Source: The Journal of Biological Chemistry. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11733541&query_hl=6&itool=pubmed_docsum

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Nemaline rod myopathy and Charcot-Marie-Tooth disease. Report of a case in a 10year-old girl. Author(s): Danon MJ, Sarpel G, Manaligod JR. Source: Archives of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7356407&query_hl=6&itool=pubmed_docsum

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Nephropathy associated with Charcot-Marie-Tooth disease. Author(s): Hara M, Ichida F, Higuchi A, Tanizawa T, Okada T. Source: Int J Pediatr Nephrol. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=6490324&query_hl=6&itool=pubmed_docsum

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Nerve decompression at the wrist in patients with Charcot-Marie-Tooth disease. Author(s): Chalekson CP, Brown RE, Gelber DA, Haws MJ. Source: Plastic and Reconstructive Surgery. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10654739&query_hl=6&itool=pubmed_docsum

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Nerve excitability properties in Charcot-Marie-Tooth disease type 1A. Author(s): Nodera H, Bostock H, Kuwabara S, Sakamoto T, Asanuma K, Jia-Ying S, Ogawara K, Hattori N, Hirayama M, Sobue G, Kaji R. Source: Brain; a Journal of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=14607794&query_hl=6&itool=pubmed_docsum

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Nerve root enlargement in Charcot-Marie-Tooth disease: CT appearance. Author(s): Morano JU, Russell WF. Source: Radiology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3786733&query_hl=6&itool=pubmed_docsum

82

Charcot-Marie-Tooth Disease

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Neurofibromatosis, Charcot-Marie-Tooth disease, or both? Author(s): Roos KL, Pascuzzi RM, Dunn DW. Source: Neurofibromatosis. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2517818&query_hl=6&itool=pubmed_docsum

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Neurological dysfunction and axonal degeneration in Charcot-Marie-Tooth disease type 1A. Author(s): Krajewski KM, Lewis RA, Fuerst DR, Turansky C, Hinderer SR, Garbern J, Kamholz J, Shy ME. Source: Brain; a Journal of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10869062&query_hl=6&itool=pubmed_docsum

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Neuronal type of Charcot-Marie-Tooth disease with a syndrome of continuous motor unit activity. Author(s): Vasilescu C, Alexianu M, Dan A. Source: Journal of the Neurological Sciences. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=6699650&query_hl=6&itool=pubmed_docsum

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Neuropathic ankle joint in Charcot-Marie-Tooth disease after triple arthrodesis of the foot. Author(s): Medhat MA, Krantz H. Source: Orthop Rev. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3174227&query_hl=6&itool=pubmed_docsum

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Neuropathic pain in Charcot-Marie-Tooth disease. Author(s): Carter GT, Jensen MP, Galer BS, Kraft GH, Crabtree LD, Beardsley RM, Abresch RT, Bird TD. Source: Archives of Physical Medicine and Rehabilitation. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9862301&query_hl=6&itool=pubmed_docsum

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Neuropathic spinal arthropathy in Charcot-Marie-Tooth disease. A case report. Author(s): Anand N, Levine DB, Burke S, Bansal M. Source: The Journal of Bone and Joint Surgery. American Volume. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9278085&query_hl=6&itool=pubmed_docsum

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Neurotrophin-3 therapy for Charcot-Marie-Tooth disease type 1A. Author(s): Pleasure DE, Chance PF. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16157894&query_hl=6&itool=pubmed_docsum

Studies

83

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New connexin32 mutations associated with X-linked Charcot-Marie-Tooth disease. Author(s): Bone LJ, Dahl N, Lensch MW, Chance PF, Kelly T, Le Guern E, Magi S, Parry G, Shapiro H, Wang S, et al. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7477983&query_hl=6&itool=pubmed_docsum

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New mutations in the X-linked form of Charcot-Marie-Tooth disease. Author(s): Latour P, Fabreguette A, Ressot C, Blanquet-Grossard F, Antoine JC, Calvas P, Chapon F, Corbillon E, Ollagnon E, Sturtz F, Boucherat M, Chazot G, Dautigny A, Pham-Dinh D, Vandenberghe A. Source: European Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9018031&query_hl=6&itool=pubmed_docsum

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New polymorphic short tandem repeats for PCR-based Charcot-Marie-Tooth disease type 1A duplication diagnosis. Author(s): Badano JL, Inoue K, Katsanis N, Lupski JR. Source: Clinical Chemistry. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11325886&query_hl=6&itool=pubmed_docsum

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Night splinting does not increase ankle range of motion in people with CharcotMarie-Tooth disease: a randomised, cross-over trial. Author(s): Refshauge KM, Raymond J, Nicholson G, van den Dolder PA. Source: The Australian Journal of Physiotherapy. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16942454&query_hl=6&itool=pubmed_docsum

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Normal pyruvate oxidation in Friedreich ataxia and Charcot-Marie-Tooth disease fibroblasts. Author(s): Wilson WG. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=4075529&query_hl=6&itool=pubmed_docsum

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Novel mutation in X-linked Charcot-Marie-Tooth disease associated with CNS impairment. Author(s): Kawakami H, Inoue K, Sakakihara I, Nakamura S. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12297581&query_hl=6&itool=pubmed_docsum

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Novel mutation of the myelin Po gene in a pedigree with Charcot-Marie-Tooth disease type 1B. Author(s): Ikegami T, Ikeda H, Mitsui T, Hayasaka K, Ishii S. Source: American Journal of Medical Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9217235&query_hl=6&itool=pubmed_docsum

84

Charcot-Marie-Tooth Disease

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Novel mutations in the Charcot-Marie-Tooth disease genes PMP22, MPZ, and GJB1. Author(s): Huehne K, Benes V, Thiel C, Kraus C, Kress W, Hoeltzenbein M, Ploner CJ, Kotzian J, Reis A, Rott HD, Rautenstrauss BW. Source: Human Mutation. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12497641&query_hl=6&itool=pubmed_docsum

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On the pathogenesis of Charcot-Marie-Tooth disease. A study of the sensory and motor conduction velocity in the median nerve. Author(s): Nielsen VK, Pilgaard S. Source: Acta Orthopaedica Scandinavica. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=5080641&query_hl=6&itool=pubmed_docsum

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Onset and duration of mivacurium-induced neuromuscular blockade in children with Charcot-Marie-Tooth disease. A case series with five children. Author(s): Schmitt HJ, Wick S, Munster T. Source: Paediatric Anaesthesia. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16430417&query_hl=6&itool=pubmed_docsum

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Operative treatment of the foot deformity in Charcot-Marie-Tooth disease. Author(s): Karlholm S, Nilsonne U. Source: Acta Orthopaedica Scandinavica. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=5730102&query_hl=6&itool=pubmed_docsum

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Origin of the de novo duplication in Charcot-Marie-Tooth disease type 1A: unequal nonsister chromatid exchange during spermatogenesis. Author(s): Palau F, Lofgren A, De Jonghe P, Bort S, Nelis E, Sevilla T, Martin JJ, Vilchez J, Prieto F, Van Broeckhoven C. Source: Human Molecular Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8111370&query_hl=6&itool=pubmed_docsum

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Overexpression of ErbB2 and ErbB3 receptors in Schwann cells of patients with Charcot-Marie-tooth disease type 1A. Author(s): Massa R, Palumbo C, Cavallaro T, Panico MB, Bei R, Terracciano C, Rizzuto N, Bernardi G, Modesti A. Source: Muscle & Nerve. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16307437&query_hl=6&itool=pubmed_docsum

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Overview of Charcot-Marie-Tooth disease type 1A. Author(s): Thomas PK. Source: Annals of the New York Academy of Sciences. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10586223&query_hl=6&itool=pubmed_docsum

Studies

85

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Overwork weakness in Charcot-Marie-Tooth disease. Author(s): Vinci P, Esposito C, Perelli SL, Antenor JA, Thomas FP. Source: Archives of Physical Medicine and Rehabilitation. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12808533&query_hl=6&itool=pubmed_docsum

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Pathogenesis of Charcot-Marie-Tooth disease. Gait analysis and electrophysiologic, genetic, histopathologic, and enzyme studies in a kinship. Author(s): Sabir M, Lyttle D. Source: Clin Orthop Relat Res. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=6705352&query_hl=6&itool=pubmed_docsum

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Pathophysiology of Charcot-Marie-Tooth disease. Author(s): Mann RA, Missirian J. Source: Clin Orthop Relat Res. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3409580&query_hl=6&itool=pubmed_docsum

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Periaxin mutation causes early-onset but slow-progressive Charcot-Marie-Tooth disease. Author(s): Kijima K, Numakura C, Shirahata E, Sawaishi Y, Shimohata M, Igarashi S, Tanaka T, Hayasaka K. Source: Journal of Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15197604&query_hl=6&itool=pubmed_docsum

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Periaxin mutation in Japanese patients with Charcot-Marie-Tooth disease. Author(s): Otagiri T, Sugai K, Kijima K, Arai H, Sawaishi Y, Shimohata M, Hayasaka K. Source: Journal of Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16770524&query_hl=6&itool=pubmed_docsum

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Pes cavus pathogenesis in Charcot-Marie-Tooth disease type 1A. Author(s): Burns J, Ouvrier R. Source: Brain; a Journal of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16803835&query_hl=6&itool=pubmed_docsum

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Phenotypic analysis of neurofilament light gene mutations linked to Charcot-MarieTooth disease in cell culture models. Author(s): Perez-Olle R, Jones ST, Liem RK. Source: Human Molecular Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15282209&query_hl=6&itool=pubmed_docsum

86

Charcot-Marie-Tooth Disease

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Phrenic involvement in Charcot-Marie-Tooth disease. A pathologic documentation. Author(s): Gilchrist D, Chan CK, Deck JH. Source: Chest. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2553346&query_hl=6&itool=pubmed_docsum

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Phrenic nerve involvement in Charcot-Marie-Tooth disease. Author(s): Snyder RW, Mishel HS, Christensen GC 3rd. Source: Chest. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2209121&query_hl=6&itool=pubmed_docsum

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Phrenic nerve involvement in Charcot-Marie-Tooth disease. Author(s): Abboud L, El SF, Takubo T, Byrd RP Jr, Roy TM. Source: Tenn Med. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16294569&query_hl=6&itool=pubmed_docsum

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Pregnancies and deliveries in patients with Charcot-Marie-Tooth disease. Author(s): Hoff JM, Gilhus NE, Daltveit AK. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15699375&query_hl=6&itool=pubmed_docsum

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Pregnancy in Charcot-Marie-Tooth disease. Author(s): Basu A, Al-Shenar S, Ray S. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16753695&query_hl=6&itool=pubmed_docsum

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Prevalence of Charcot-Marie-Tooth disease in patients who have bilateral cavovarus feet. Author(s): Nagai MK, Chan G, Guille JT, Kumar SJ, Scavina M, Mackenzie WG. Source: Journal of Pediatric Orthopedics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16791058&query_hl=6&itool=pubmed_docsum

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Psychosocial issues that face patients with Charcot-Marie-Tooth disease: the role of genetic counseling. Author(s): Arnold A, McEntagart M, Younger DS. Source: Journal of Genetic Counseling. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16047093&query_hl=6&itool=pubmed_docsum

Studies

87

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Quadriceps strength and timed motor performances in myotonic dystrophy, CharcotMarie-Tooth disease, and healthy subjects. Author(s): Lindeman E, Leffers P, Reulen J, Spaans F, Drukker J. Source: Clinical Rehabilitation. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9619654&query_hl=6&itool=pubmed_docsum

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Quality of life in patients with Charcot-Marie-Tooth disease. Author(s): Vinci P, Serrao M, Millul A, Deidda A, De Santis F, Capici S, Martini D, Pierelli F, Santilli V. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16186535&query_hl=6&itool=pubmed_docsum

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Quantitation of Meissner's corpuscles in hereditary neurologic disorders. CharcotMarie-Tooth disease, Roussy-Levy syndrome, Dejerine-Sottas disease, hereditary sensory neuropathy, spinocerebellar degenerations, and hereditary spastic paraplegia. Author(s): Dyck PJ, Winkelmann RK, Bolton CF. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=5948001&query_hl=6&itool=pubmed_docsum

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Quantitative measurement of duplicated DNA as a diagnostic test for Charcot-MarieTooth disease type 1a. Author(s): Hensels GW, Janssen EA, Hoogendijk JE, Valentijn LJ, Baas F, Bolhuis PA. Source: Clinical Chemistry. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8375058&query_hl=6&itool=pubmed_docsum

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Radiological findings in a case of Charcot-Marie-Tooth disease. Author(s): Miura T, Hirabuki N, Imakita S, Harada K, Kawai R, Mitomo M, Takahashi M. Source: The British Journal of Radiology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3842305&query_hl=6&itool=pubmed_docsum

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Rapid detection of a recombinant hotspot associated with Charcot-Marie-Tooth disease type IA duplication by a PCR-based DNA test. Author(s): Chang JG, Jong YJ, Wang WP, Wang JC, Hu CJ, Lo MC, Chang CP. Source: Clinical Chemistry. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9474023&query_hl=6&itool=pubmed_docsum

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Rapid detection of duplication/deletion of the PMP22 gene in patients with CharcotMarie-Tooth disease Type 1A and hereditary neuropathy with liability to pressure palsy by real-time quantitative PCR using SYBR Green I dye. Author(s): Kim SW, Lee KS, Jin HS, Lee TM, Koo SK, Lee YJ, Jung SC. Source: Journal of Korean Medical Science. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=14555828&query_hl=6&itool=pubmed_docsum

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Recessive Charcot-Marie-tooth disease. Author(s): Lupski JR. Source: Annals of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10632095&query_hl=6&itool=pubmed_docsum

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Regional chromosomal assignment of human renin gene to 1q12----qter and use in linkage studies in Charcot-Marie-Tooth disease. Author(s): Griffiths LR, Nicholson GA, Ross DA, Zwi MB, McLeod JG, Mohandas T, Morris BJ. Source: Cytogenetics and Cell Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3319438&query_hl=6&itool=pubmed_docsum

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Resistance training effectiveness in patients with Charcot-Marie-Tooth disease: recommendations for exercise prescription. Author(s): Chetlin RD, Gutmann L, Tarnopolsky M, Ullrich IH, Yeater RA. Source: Archives of Physical Medicine and Rehabilitation. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15295743&query_hl=6&itool=pubmed_docsum

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Resistance training exercise and creatine in patients with Charcot-Marie-Tooth disease. Author(s): Chetlin RD, Gutmann L, Tarnopolsky MA, Ullrich IH, Yeater RA. Source: Muscle & Nerve. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15221881&query_hl=6&itool=pubmed_docsum

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Respiratory insufficiency in Charcot-Marie-Tooth disease. Author(s): Hirsch NP. Source: Anaesthesia. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9893560&query_hl=6&itool=pubmed_docsum

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Respiratory muscle weakness in Charcot-Marie-Tooth disease. A field study. Author(s): Nathanson BN, Yu DG, Chan CK. Source: Archives of Internal Medicine. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2730255&query_hl=6&itool=pubmed_docsum

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Response to cisatracurium in patient with Charcot-Marie-Tooth disease. Author(s): Garcia-Ferreira J, Hernandez-Palazon J. Source: European Journal of Anaesthesiology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15816600&query_hl=6&itool=pubmed_docsum

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Schwann cells and the pathogenesis of inherited motor and sensory neuropathies (Charcot-Marie-Tooth disease). Author(s): Berger P, Niemann A, Suter U. Source: Glia. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16856148&query_hl=6&itool=pubmed_docsum

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Selective defects in channel permeability associated with Cx32 mutations causing Xlinked Charcot-Marie-Tooth disease. Author(s): Bicego M, Morassutto S, Hernandez VH, Morgutti M, Mammano F, D'Andrea P, Bruzzone R. Source: Neurobiology of Disease. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16442804&query_hl=6&itool=pubmed_docsum

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Short latency somatosensory evoked potentials in Charcot-Marie-Tooth disease. A family with an intermediate form. Author(s): Rossi A, Paradiso C, Dell'Anna P, Mondelli M. Source: Acta Neurologica Scandinavica. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2984874&query_hl=6&itool=pubmed_docsum

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SIMPLE mutation analysis in dominant demyelinating Charcot-Marie-Tooth disease: three novel mutations. Author(s): Latour P, Gonnaud PM, Ollagnon E, Chan V, Perelman S, Stojkovic T, Stoll C, Vial C, Ziegler F, Vandenberghe A, Maire I. Source: Journal of the Peripheral Nervous System : Jpns. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16787513&query_hl=6&itool=pubmed_docsum

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Soft tissue surgery in Charcot-Marie-Tooth disease. Author(s): Roper BA, Tibrewal SB. Source: The Journal of Bone and Joint Surgery. British Volume. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2914996&query_hl=6&itool=pubmed_docsum

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Somatosensory evoked potentials in Charcot-Marie-Tooth disease. Author(s): Cosi V, Lombardi M, Zandrini C, Gerosa E, Callieco R. Source: Neurophysiologie Clinique = Clinical Neurophysiology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2615747&query_hl=6&itool=pubmed_docsum

90

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Spinal deformities in patients with Charcot-Marie-tooth disease. A review of 12 patients. Author(s): Daher YH, Lonstein JE, Winter RB, Bradford DS. Source: Clin Orthop Relat Res. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3955951&query_hl=6&itool=pubmed_docsum

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Surgery in advanced Charcot-Marie-Tooth disease. Author(s): Gould N. Source: Foot Ankle. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=6724453&query_hl=6&itool=pubmed_docsum

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Surgical considerations in the presence of Charcot-Marie-Tooth disease. Author(s): Fenton CF 3rd, Schlefman BS, McGlamry ED. Source: J Am Podiatry Assoc. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=6491142&query_hl=6&itool=pubmed_docsum

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The causes of Charcot-Marie-Tooth disease. Author(s): Young P, Suter U. Source: Cellular and Molecular Life Sciences : Cmls. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=14685682&query_hl=6&itool=pubmed_docsum

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The CNS phenotype of X-linked Charcot-Marie-Tooth disease: more than a peripheral problem. Author(s): Taylor RA, Simon EM, Marks HG, Scherer SS. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=14663027&query_hl=6&itool=pubmed_docsum

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The Duffy blood group is linked to the alpha-spectrin locus in a large pedigree with autosomal dominant inheritance of Charcot-Marie-Tooth disease type 1. Author(s): Raeymaekers P, Van Broeckhoven C, Backhovens H, Wehnert A, Muylle L, De Jonghe P, Gheuens J, Vandenberghe A. Source: Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2892777&query_hl=6&itool=pubmed_docsum

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The hypertrophic forms of hereditary motor and sensory neuropathy. A study of hypertrophic Charcot-Marie-Tooth disease (HMSN type I) and Dejerine-Sottas disease (HMSN type III) in childhood. Author(s): Ouvrier RA, McLeod JG, Conchin TE. Source: Brain; a Journal of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3467805&query_hl=6&itool=pubmed_docsum

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The phosphoinositide-3-phosphatase MTMR2 associates with MTMR13, a membrane-associated pseudophosphatase also mutated in type 4B Charcot-MarieTooth disease. Author(s): Robinson FL, Dixon JE. Source: The Journal of Biological Chemistry. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15998640&query_hl=6&itool=pubmed_docsum

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Therapeutic administration of progesterone antagonist in a model of Charcot-MarieTooth disease (CMT-1A). Author(s): Sereda MW, Meyer zu Horste G, Suter U, Uzma N, Nave KA. Source: Nature Medicine. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=14608378&query_hl=6&itool=pubmed_docsum

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Thr(118)Met amino acid substitution in the peripheral myelin protein 22 does not influence the clinical phenotype of Charcot-Marie-Tooth disease type 1A due to the 17p11.2-p12 duplication. Author(s): Marques W Jr, Sweeney MG, Wood NW. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=14502374&query_hl=6&itool=pubmed_docsum

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Three modality evoked potentials in Charcot-Marie-Tooth disease (HMSN-1). Author(s): Gadoth N, Gordon CR, Bleich N, Pratt H. Source: Brain & Development. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=1892226&query_hl=6&itool=pubmed_docsum

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Transient, recurrent, white matter lesions in X-linked Charcot-Marie-Tooth disease with novel connexin 32 mutation. Author(s): Hanemann CO, Bergmann C, Senderek J, Zerres K, Sperfeld AD. Source: Archives of Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12707076&query_hl=6&itool=pubmed_docsum

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Two missense mutations of EGR2 R359W and GJB1 V136A in a Charcot-Marie-Tooth disease family. Author(s): Chung KW, Sunwoo IN, Kim SM, Park KD, Kim WK, Kim TS, Koo H, Cho M, Lee J, Choi BO. Source: Neurogenetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15947997&query_hl=6&itool=pubmed_docsum

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Ultrastructural distribution of PMP22 in Charcot-Marie-Tooth disease type 1A. Author(s): Haney C, Snipes GJ, Shooter EM, Suter U, Garcia C, Griffin JW, Trapp BD. Source: Journal of Neuropathology and Experimental Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8786387&query_hl=6&itool=pubmed_docsum

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Ultrastructural findings in the peripheral nerve in a family with the intermediate form of Charcot-Marie-Tooth disease. Author(s): Malandrini A, Ceuterick C, Villanov M, Gambelli S, Berti G, Rossi A, Guazzi GC. Source: J Submicrosc Cytol Pathol. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11686409&query_hl=6&itool=pubmed_docsum

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Understanding Schwann cell-neurone interactions: the key to Charcot-Marie-Tooth disease? Author(s): Maier M, Berger P, Suter U. Source: Journal of Anatomy. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12090402&query_hl=6&itool=pubmed_docsum

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Unequal exchange at the Charcot-Marie-Tooth disease type 1A recombination hotspot is not elevated above the genome average rate. Author(s): Han LL, Keller MP, Navidi W, Chance PF, Arnheim N. Source: Human Molecular Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10915777&query_hl=6&itool=pubmed_docsum

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Uneventful administration of cisplatin to a man with X-linked Charcot-Marie-Tooth disease (CMT). Author(s): Cowie F, Barrett A. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11332159&query_hl=6&itool=pubmed_docsum

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Unrecognized Charcot-Marie-Tooth disease: diagnostic difficulties in the assessment of recovery from paralysis. Author(s): Fiacchino F, Grandi L, Ciano C, Sghirlanzoni A. Source: Anesthesia and Analgesia. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7598259&query_hl=6&itool=pubmed_docsum

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Unusual electrophysiological findings in X-linked dominant Charcot-Marie-Tooth disease. Author(s): Gutierrez A, England JD, Sumner AJ, Ferer S, Warner LE, Lupski JR, Garcia CA. Source: Muscle & Nerve. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10639608&query_hl=6&itool=pubmed_docsum

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Unusual motor conduction velocity values in Charcot-Marie-Tooth disease associated with essential tremor: report of a kinship. Author(s): Salisachs P. Source: European Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=1149757&query_hl=6&itool=pubmed_docsum

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Variability in nerve biopsy findings in a kinship with dominantly inherited CharcotMarie-Tooth disease. Author(s): Van Weerden TW, Houthoff HJ, Sie O, Minderhoud JM. Source: Muscle & Nerve. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7088015&query_hl=6&itool=pubmed_docsum

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Variation of phenotype in Charcot-Marie-Tooth disease. Author(s): Baker RS, Upton AR. Source: Neuropadiatrie. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=583067&query_hl=6&itool=pubmed_docsum

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Visual evoked potential abnormalities in Charcot-Marie-Tooth disease and comparison with Friedreich's ataxia. Author(s): Carroll WM, Jones SJ, Halliday AM. Source: Journal of the Neurological Sciences. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=6631447&query_hl=6&itool=pubmed_docsum

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Vocal cord and diaphragm paralysis, as clinical features of a French family with autosomal recessive Charcot-Marie-Tooth disease, associated with a new mutation in the GDAP1 gene. Author(s): Stojkovic T, Latour P, Viet G, de Seze J, Hurtevent JF, Vandenberghe A, Vermersch P. Source: Neuromuscular Disorders : Nmd. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15019704&query_hl=6&itool=pubmed_docsum

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Vocal fold paresis of Charcot-Marie-Tooth disease. Author(s): Sulica L, Blitzer A, Lovelace RE, Kaufmann P. Source: The Annals of Otology, Rhinology, and Laryngology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11713921&query_hl=6&itool=pubmed_docsum

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Voltage opens unopposed gap junction hemichannels formed by a connexin 32 mutant associated with X-linked Charcot-Marie-Tooth disease. Author(s): Abrams CK, Bennett MV, Verselis VK, Bargiello TA. Source: Proceedings of the National Academy of Sciences of the United States of America. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11891346&query_hl=6&itool=pubmed_docsum

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Wide spectrum of motor conduction velocity in Charcot-Marie-Tooth disease. An anatomico-physiological interpretation. Author(s): Salisachs P. Source: Journal of the Neurological Sciences. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=4855423&query_hl=6&itool=pubmed_docsum

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X-linked Charcot-Marie-Tooth disease and connexin32. Author(s): Ionasescu VV. Source: Cell Biology International. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10873293&query_hl=6&itool=pubmed_docsum

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X-linked Charcot-Marie-Tooth disease and connexin32. Author(s): Fischbeck KH, Abel A, Lin GS, Scherer SS. Source: Annals of the New York Academy of Sciences. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10586227&query_hl=6&itool=pubmed_docsum

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X-linked Charcot-Marie-Tooth disease and progressive-relapsing central demyelinating disease. Author(s): Isoardo G, Di Vito N, Nobile M, Benetton G, Fassio F. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16301507&query_hl=6&itool=pubmed_docsum

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X-linked Charcot-Marie-Tooth disease caused by a novel point mutation in the connexin-32 gene. Author(s): Ma W, Farrukh Nizam M, Grewal RP. Source: Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12536289&query_hl=6&itool=pubmed_docsum

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X-linked Charcot-Marie-Tooth disease with connexin 32 mutations: clinical and electrophysiologic study. Author(s): Birouk N, LeGuern E, Maisonobe T, Rouger H, Gouider R, Tardieu S, Gugenheim M, Routon MC, Leger JM, Agid Y, Brice A, Bouche P. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9566397&query_hl=6&itool=pubmed_docsum

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X-linked Charcot-Marie-Tooth disease with myokymia: report of a family. Author(s): Chakravarty A, Ghosh B, Sengupta S, Mukhopadhyay S. Source: Neurology India. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=14652447&query_hl=6&itool=pubmed_docsum

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X-linked Charcot-Marie-Tooth disease with transient splenium lesion on MRI. Author(s): Okada K, Fujiwara H, Tsuji S. Source: Intern Med. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16467604&query_hl=6&itool=pubmed_docsum

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X-linked Charcot-Marie-Tooth disease: phenotypic expression of a novel mutation Ile127Ser in the GJB1 (connexin 32) gene. Author(s): Vondracek P, Seeman P, Hermanova M, Fajkusova L. Source: Muscle & Nerve. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15468313&query_hl=6&itool=pubmed_docsum

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X-linked dominant Charcot-Marie-Tooth disease: nerve biopsies allow morphological evaluation and detection of connexin32 mutations (Arg15Trp, Arg22Gln). Author(s): Senderek J, Bergmann C, Quasthoff S, Ramaekers VT, Schroder JM. Source: Acta Neuropathologica. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9600589&query_hl=6&itool=pubmed_docsum

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X-linked dominant Charcot-Marie-Tooth disease: suggestion of linkage with a cloned DNA sequence from the proximal Xq. Author(s): Gal A, Mucke J, Theile H, Wieacker PF, Ropers HH, Wienker TF. Source: Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2987105&query_hl=6&itool=pubmed_docsum

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CHAPTER 2. ALTERNATIVE MEDICINE AND CHARCOT-MARIE-TOOTH DISEASE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to Charcot-Marie-Tooth disease. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to Charcot-Marie-Tooth disease and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select CAM on PubMed. Enter Charcot-Marie-Tooth disease (or synonyms) into the search box. Click Go. The following references provide information on particular aspects of complementary and alternative medicine that are related to Charcot-Marie-Tooth disease: •

Acute deterioration of Charcot-Marie-Tooth disease IA (CMT IA) following 2 mg of vincristine chemotherapy. Author(s): Hildebrandt G, Holler E, Woenkhaus M, Quarch G, Reichle A, Schalke B, Andreesen R. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10942065&query_hl=1&itool=pubmed_docsum

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Acute vincristine neurotoxicity in the presence of hereditary motor and sensory neuropathy type I. Author(s): McGuire SA, Gospe SM Jr, Dahl G.

Alternative Medicine 97

Source: Medical and Pediatric Oncology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=2685529&query_hl=1&itool=pubmed_docsum •

Auditory processing in patients with Charcot-Marie-Tooth disease type 1A. Author(s): Neijenhuis K, Beynon A, Snik A, van Engelen B, van den Broek P. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=14600466&query_hl=1&itool=pubmed_docsum

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Charcot-Marie-Tooth disease and vincristine. Author(s): Orejana-Garcia AM, Pascual-Huerta J, Perez-Melero A. Source: Journal of the American Podiatric Medical Association. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12756314&query_hl=1&itool=pubmed_docsum

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Charcot-Marie-Tooth disease type I diagnosed in a 5-year-old boy after vincristine neurotoxicity, resulting in maternal diagnosis. Author(s): Olek MJ, Bordeaux B, Leshner RT. Source: J Am Osteopath Assoc. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10217912&query_hl=1&itool=pubmed_docsum

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Charcot-Marie-Tooth disease. Author(s): Martel J, Mierau D, Donat J. Source: Journal of Manipulative and Physiological Therapeutics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7790797&query_hl=1&itool=pubmed_docsum

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Curcumin treatment abrogates endoplasmic reticulum retention and aggregationinduced apoptosis associated with neuropathy-causing myelin protein zerotruncating mutants. Author(s): Khajavi M, Inoue K, Wiszniewski W, Ohyama T, Snipes GJ, Lupski JR. Source: American Journal of Human Genetics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16252242&query_hl=1&itool=pubmed_docsum

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Current Therapy for Charcot-Marie-Tooth Disease. Author(s): Grandis M, Shy ME. Source: Current Treatment Options in Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15610704&query_hl=1&itool=pubmed_docsum

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Early recognition of hereditary motor and sensory neuropathy type 1 can avoid lifethreatening vincristine neurotoxicity.

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Author(s): Naumann R, Mohm J, Reuner U, Kroschinsky F, Rautenstrauss B, Ehninger G. Source: British Journal of Haematology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11703329&query_hl=1&itool=pubmed_docsum •

Effects of exercise and creatine on myosin heavy chain isoform composition in patients with Charcot-Marie-Tooth disease. Author(s): Smith CA, Chetlin RD, Gutmann L, Yeater RA, Alway SE. Source: Muscle & Nerve. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16881064&query_hl=1&itool=pubmed_docsum

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Enhancement of Schwann cell myelin formation by K252a in the Trembler-J mouse dorsal root ganglion explant culture. Author(s): Liu N, Varma S, Shooter EM, Tolwani RJ. Source: Journal of Neuroscience Research. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15605381&query_hl=1&itool=pubmed_docsum

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Fulminant peripheral neuropathy with severe quadriparesis associated with vincristine therapy. Author(s): Moudgil SS, Riggs JE. Source: The Annals of Pharmacotherapy. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=11054980&query_hl=1&itool=pubmed_docsum

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Hereditary neuropathy with liability to pressure palsies emerging during vincristine treatment. Author(s): Kalfakis N, Panas M, Karadima G, Floroskufi P, Kokolakis N, Vassilopoulos D. Source: Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12427913&query_hl=1&itool=pubmed_docsum

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Improvement of muscle function in Charcot-Marie-Tooth disease by transcutaneous electric nerve stimulation. Author(s): Hassel B. Source: Muscle & Nerve. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=9466615&query_hl=1&itool=pubmed_docsum

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Medication-induced exacerbation of neuropathy in Charcot Marie Tooth disease. Author(s): Weimer LH, Podwall D. Source: Journal of the Neurological Sciences. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=16386273&query_hl=1&itool=pubmed_docsum

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Molecular genetics of hereditary neuropathies. Author(s): Chance PF. Source: Journal of Child Neurology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10223854&query_hl=1&itool=pubmed_docsum

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Polyneuropathy following vincristine therapy in two patients with Charcot-MarieTooth syndrome. Author(s): Hogan-Dann CM, Fellmeth WG, McGuire SA, Kiley VA. Source: Jama : the Journal of the American Medical Association. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=6092732&query_hl=1&itool=pubmed_docsum

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Severe vincristine neuropathy in Charcot-Marie-Tooth disease type 1A. Author(s): Graf WD, Chance PF, Lensch MW, Eng LJ, Lipe HP, Bird TD. Source: Cancer. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8608515&query_hl=1&itool=pubmed_docsum

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Severe vincristine neurotoxicity in a patient with Charcot-Marie-Tooth disease. Author(s): Dickerhoff R, Lindner W, Scheiber W. Source: Pediatric Hematology and Oncology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=3152952&query_hl=1&itool=pubmed_docsum

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The administration of chemotherapy in a patient with Charcot-Marie-Tooth and ovarian cancer. Author(s): Martino MA, Miller E, Grendys EC Jr. Source: Gynecologic Oncology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15863189&query_hl=1&itool=pubmed_docsum

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Vincristine neuropathy in type I and type II Charcot-Marie-Tooth disease (hereditary motor sensory neuropathy). Author(s): Igarashi M, Thompson EI, Rivera GK. Source: Medical and Pediatric Oncology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=7603395&query_hl=1&itool=pubmed_docsum

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Vincristine neuropathy: neurophysiological and genetic studies in a case of Wilms tumor. Author(s): Schiavetti A, Frascarelli M, Uccini S, Novelli A. Source: Pediatric Blood & Cancer. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=15382281&query_hl=1&itool=pubmed_docsum

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Vincristine neurotoxicity in Charcot-Marie-Tooth syndrome. Author(s): Griffiths JD, Stark RJ, Ding JC, Cooper IA.

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Source: The Medical Journal of Australia. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=4046919&query_hl=1&itool=pubmed_docsum •

Vincristine neurotoxicity in the presence of hereditary neuropathy. Author(s): Trobaugh-Lotrario AD, Smith AA, Odom LF. Source: Medical and Pediatric Oncology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12426685&query_hl=1&itool=pubmed_docsum

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Vincristine neurotoxicity. Author(s): Chauncey TR, Showel JL, Fox JH. Source: Jama : the Journal of the American Medical Association. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=4009878&query_hl=1&itool=pubmed_docsum

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Vincristine treatment revealing asymptomatic hereditary motor sensory neuropathy type 1A. Author(s): Mercuri E, Poulton J, Buck J, Broadbent V, Bamford M, Jungbluth H, Manzur AY, Muntoni F. Source: Archives of Disease in Childhood. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=10519723&query_hl=1&itool=pubmed_docsum

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Vincristine treatment triggering the expression of asymptomatic Charcot-Marie-Tooth disease. Author(s): Neumann Y, Toren A, Rechavi G, Seifried B, Shoham NG, Mandel M, Kenet G, Sharon N, Sadeh M, Navon R. Source: Medical and Pediatric Oncology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=8600343&query_hl=1&itool=pubmed_docsum

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Vincristine-induced neuropathy as the initial presentation of Charcot-Marie-Tooth disease in acute lymphoblastic leukemia: a Pediatric Oncology Group study. Author(s): Chauvenet AR, Shashi V, Selsky C, Morgan E, Kurtzberg J, Bell B; Pediatric Oncology Group Study. Source: Journal of Pediatric Hematology/Oncology : Official Journal of the American Society of Pediatric Hematology/Oncology. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=A bstractPlus&list_uids=12679647&query_hl=1&itool=pubmed_docsum

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://health.aol.com/healthyliving/althealth

Alternative Medicine 101

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com®: http://www.drkoop.com/naturalmedicine.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Alternative/

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 3. DISSERTATIONS ON CHARCOT-MARIE-TOOTH DISEASE Overview In this chapter, we will give you a bibliography on recent dissertations relating to CharcotMarie-Tooth disease. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “Charcot-Marie-Tooth disease” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on Charcot-Marie-Tooth disease, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Charcot-Marie-Tooth Disease ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to CharcotMarie-Tooth disease. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

Glycyl-tRNA synthetase mutations cause Charcot-Marie-Tooth disease type 2D and distal spinal muscular atrophy type V: A potentially novel disease mechanism for human peripheral neuropathies Antonellis, Anthony from George Washington University, 2005, 143 pages http://wwwlib.umi.com/dissertations/fullcit/3167020

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 4. BOOKS ON CHARCOT-MARIE-TOOTH DISEASE Overview This chapter provides bibliographic book references relating to Charcot-Marie-Tooth disease. In addition to online booksellers such as www.amazon.com and www.bn.com, the National Library of Medicine is an excellent source for book titles on Charcot-Marie-Tooth disease. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for Charcot-Marie-Tooth disease at online booksellers’ Web sites, you may discover non-medical books that use the generic term “Charcot-Marie-Tooth disease” (or a synonym) in their titles. The following is indicative of the results you might find when searching for Charcot-Marie-Tooth disease (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

21st Century Complete Medical Guide to Charcot-Marie-Tooth Disease (CMT), Hereditary Motor and Sensory Neuropathy (HMSN), Peroneal Muscular Atrophy, Authoritative. for Patients and Physicians (CD-ROM) PM Medical Health News (2004); ISBN: 1592487149; http://www.amazon.com/exec/obidos/ASIN/1592487149/icongroupinterna

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Clinical and electrodiagnostic features of Charcot-Marie-Tooth syndrome (Acta neurologica Scandinavica : Supplementum) John Calvin Morrison Brust (1978); ISBN: 8716080491; http://www.amazon.com/exec/obidos/ASIN/8716080491/icongroupinterna

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Glycyl-tRNA synthetase mutations cause Charcot-Marie-Tooth disease type 2D and distal spinal muscular atrophy type V: A potentially novel disease mechanism for human peripheral neuropathies Anthony Antonellis (2006); ISBN: 0542024179; http://www.amazon.com/exec/obidos/ASIN/0542024179/icongroupinterna

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The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select LocatorPlus. Once you are in the search area, simply type Charcot-Marie-Tooth disease (or synonyms) into the search box, and select the Quick Limit Option for Keyword, Title, or Journal Title Search: Books. From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine26: •

26

Clinical and electrodiagnostic features of Charcot-Marie-Tooth Syndrome Author: Brust, John C. M. (John Calvin M.),; Year: 1978; Copenhagen: Munksgaard, 1978; ISBN: 9788716080 http://www.amazon.com/exec/obidos/ASIN/9788716080/icongroupinterna

In addition to LocatorPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a Books button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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CHAPTER 5. MULTIMEDIA ON CHARCOT-MARIE-TOOTH DISEASE Overview In this chapter, we show you how to find bibliographic information related to multimedia sources of information on Charcot-Marie-Tooth disease.

Bibliography: Multimedia on Charcot-Marie-Tooth Disease The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select LocatorPlus. Once you are in the search area, simply type Charcot-Marie-Tooth disease (or synonyms) into the search box, and select the Quick Limit Option for Keyword, Title, or Journal Title Search: Audiovisuals and Computer Files. From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on Charcot-Marie-Tooth disease: •

The Role of triple arthrodesis in the management of Charcot-Marie-Tooth disease [videorecording] Source: Pennsylvania College of Podiatric Medicine; Year: 1979; Format: Videorecording; Philadelphia, PA: Video Services, Annenberg Communication Center, Pennsylvania College of Podiatric Medicine, c1979

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APPENDICES

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APPENDIX A. HELP ME UNDERSTAND GENETICS Overview This appendix presents basic information about genetics in clear language and provides links to online resources.27

The Basics: Genes and How They Work This section gives you information on the basics of cells, DNA, genes, chromosomes, and proteins. What Is a Cell? Cells are the basic building blocks of all living things. The human body is composed of trillions of cells. They provide structure for the body, take in nutrients from food, convert those nutrients into energy, and carry out specialized functions. Cells also contain the body’s hereditary material and can make copies of themselves. Cells have many parts, each with a different function. Some of these parts, called organelles, are specialized structures that perform certain tasks within the cell. Human cells contain the following major parts, listed in alphabetical order: •

Cytoplasm: The cytoplasm is fluid inside the cell that surrounds the organelles.

•

Endoplasmic reticulum (ER): This organelle helps process molecules created by the cell and transport them to their specific destinations either inside or outside the cell.

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Golgi apparatus: The golgi apparatus packages molecules processed by the endoplasmic reticulum to be transported out of the cell.

•

Lysosomes and peroxisomes: These organelles are the recycling center of the cell. They digest foreign bacteria that invade the cell, rid the cell of toxic substances, and recycle worn-out cell components.

27 This appendix is an excerpt from the National Library of Medicine’s handbook, Help Me Understand Genetics. For the full text of the Help Me Understand Genetics handbook, see http://ghr.nlm.nih.gov/handbook.

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•

Mitochondria: Mitochondria are complex organelles that convert energy from food into a form that the cell can use. They have their own genetic material, separate from the DNA in the nucleus, and can make copies of themselves.

•

Nucleus: The nucleus serves as the cell’s command center, sending directions to the cell to grow, mature, divide, or die. It also houses DNA (deoxyribonucleic acid), the cell’s hereditary material. The nucleus is surrounded by a membrane called the nuclear envelope, which protects the DNA and separates the nucleus from the rest of the cell.

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Plasma membrane: The plasma membrane is the outer lining of the cell. It separates the cell from its environment and allows materials to enter and leave the cell.

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Ribosomes: Ribosomes are organelles that process the cell’s genetic instructions to create proteins. These organelles can float freely in the cytoplasm or be connected to the endoplasmic reticulum. What Is DNA?

DNA, or deoxyribonucleic acid, is the hereditary material in humans and almost all other organisms. Nearly every cell in a person’s body has the same DNA. Most DNA is located in the cell nucleus (where it is called nuclear DNA), but a small amount of DNA can also be found in the mitochondria (where it is called mitochondrial DNA or mtDNA). The information in DNA is stored as a code made up of four chemical bases: adenine (A), guanine (G), cytosine (C), and thymine (T). Human DNA consists of about 3 billion bases, and more than 99 percent of those bases are the same in all people. The order, or sequence, of these bases determines the information available for building and maintaining an organism, similar to the way in which letters of the alphabet appear in a certain order to form words and sentences. DNA bases pair up with each other, A with T and C with G, to form units called base pairs. Each base is also attached to a sugar molecule and a phosphate molecule. Together, a base, sugar, and phosphate are called a nucleotide. Nucleotides are arranged in two long strands that form a spiral called a double helix. The structure of the double helix is somewhat like a ladder, with the base pairs forming the ladder’s rungs and the sugar and phosphate molecules forming the vertical sidepieces of the ladder. An important property of DNA is that it can replicate, or make copies of itself. Each strand of DNA in the double helix can serve as a pattern for duplicating the sequence of bases. This is critical when cells divide because each new cell needs to have an exact copy of the DNA present in the old cell.

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DNA is a double helix formed by base pairs attached to a sugar-phosphate backbone. What Is Mitochondrial DNA? Although most DNA is packaged in chromosomes within the nucleus, mitochondria also have a small amount of their own DNA. This genetic material is known as mitochondrial DNA or mtDNA. Mitochondria are structures within cells that convert the energy from food into a form that cells can use. Each cell contains hundreds to thousands of mitochondria, which are located in the fluid that surrounds the nucleus (the cytoplasm). Mitochondria produce energy through a process called oxidative phosphorylation. This process uses oxygen and simple sugars to create adenosine triphosphate (ATP), the cell’s main energy source. A set of enzyme complexes, designated as complexes I-V, carry out oxidative phosphorylation within mitochondria. In addition to energy production, mitochondria play a role in several other cellular activities. For example, mitochondria help regulate the self-destruction of cells (apoptosis). They are also necessary for the production of substances such as cholesterol and heme (a component of hemoglobin, the molecule that carries oxygen in the blood). Mitochondrial DNA contains 37 genes, all of which are essential for normal mitochondrial function. Thirteen of these genes provide instructions for making enzymes involved in oxidative phosphorylation. The remaining genes provide instructions for making molecules called transfer RNAs (tRNAs) and ribosomal RNAs (rRNAs), which are chemical cousins of

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DNA. These types of RNA help assemble protein building blocks (amino acids) into functioning proteins. What Is a Gene? A gene is the basic physical and functional unit of heredity. Genes, which are made up of DNA, act as instructions to make molecules called proteins. In humans, genes vary in size from a few hundred DNA bases to more than 2 million bases. The Human Genome Project has estimated that humans have between 20,000 and 25,000 genes. Every person has two copies of each gene, one inherited from each parent. Most genes are the same in all people, but a small number of genes (less than 1 percent of the total) are slightly different between people. Alleles are forms of the same gene with small differences in their sequence of DNA bases. These small differences contribute to each person’s unique physical features.

Genes are made up of DNA. Each chromosome contains many genes. What Is a Chromosome? In the nucleus of each cell, the DNA molecule is packaged into thread-like structures called chromosomes. Each chromosome is made up of DNA tightly coiled many times around proteins called histones that support its structure. Chromosomes are not visible in the cell’s nucleus—not even under a microscope—when the cell is not dividing. However, the DNA that makes up chromosomes becomes more tightly packed during cell division and is then visible under a microscope. Most of what researchers know about chromosomes was learned by observing chromosomes during cell division. Each chromosome has a constriction point called the centromere, which divides the chromosome into two sections, or “arms.” The short arm of the chromosome is labeled the “p arm.” The long arm of the chromosome is labeled the “q arm.” The location of the centromere on each chromosome gives the chromosome its characteristic shape, and can be used to help describe the location of specific genes.

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DNA and histone proteins are packaged into structures called chromosomes. How Many Chromosomes Do People Have? In humans, each cell normally contains 23 pairs of chromosomes, for a total of 46. Twentytwo of these pairs, called autosomes, look the same in both males and females. The 23rd pair, the sex chromosomes, differ between males and females. Females have two copies of the X chromosome, while males have one X and one Y chromosome.

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The 22 autosomes are numbered by size. The other two chromosomes, X and Y, are the sex chromosomes. This picture of the human chromosomes lined up in pairs is called a karyotype. How Do Geneticists Indicate the Location of a Gene? Geneticists use maps to describe the location of a particular gene on a chromosome. One type of map uses the cytogenetic location to describe a gene’s position. The cytogenetic location is based on a distinctive pattern of bands created when chromosomes are stained with certain chemicals. Another type of map uses the molecular location, a precise description of a gene’s position on a chromosome. The molecular location is based on the sequence of DNA building blocks (base pairs) that make up the chromosome. Cytogenetic Location Geneticists use a standardized way of describing a gene’s cytogenetic location. In most cases, the location describes the position of a particular band on a stained chromosome: 17q12 It can also be written as a range of bands, if less is known about the exact location: 17q12-q21 The combination of numbers and letters provide a gene’s “address” on a chromosome. This address is made up of several parts: •

The chromosome on which the gene can be found. The first number or letter used to describe a gene’s location represents the chromosome. Chromosomes 1 through 22 (the autosomes) are designated by their chromosome number. The sex chromosomes are designated by X or Y.

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•

The arm of the chromosome. Each chromosome is divided into two sections (arms) based on the location of a narrowing (constriction) called the centromere. By convention, the shorter arm is called p, and the longer arm is called q. The chromosome arm is the second part of the gene’s address. For example, 5q is the long arm of chromosome 5, and Xp is the short arm of the X chromosome.

•

The position of the gene on the p or q arm. The position of a gene is based on a distinctive pattern of light and dark bands that appear when the chromosome is stained in a certain way. The position is usually designated by two digits (representing a region and a band), which are sometimes followed by a decimal point and one or more additional digits (representing sub-bands within a light or dark area). The number indicating the gene position increases with distance from the centromere. For example: 14q21 represents position 21 on the long arm of chromosome 14. 14q21 is closer to the centromere than 14q22.

Sometimes, the abbreviations “cen” or “ter” are also used to describe a gene’s cytogenetic location. “Cen” indicates that the gene is very close to the centromere. For example, 16pcen refers to the short arm of chromosome 16 near the centromere. “Ter” stands for terminus, which indicates that the gene is very close to the end of the p or q arm. For example, 14qter refers to the tip of the long arm of chromosome 14. (“Tel” is also sometimes used to describe a gene’s location. “Tel” stands for telomeres, which are at the ends of each chromosome. The abbreviations “tel” and “ter” refer to the same location.)

The CFTR gene is located on the long arm of chromosome 7 at position 7q31.2.

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Molecular Location The Human Genome Project, an international research effort completed in 2003, determined the sequence of base pairs for each human chromosome. This sequence information allows researchers to provide a more specific address than the cytogenetic location for many genes. A gene’s molecular address pinpoints the location of that gene in terms of base pairs. For example, the molecular location of the APOE gene on chromosome 19 begins with base pair 50,100,901 and ends with base pair 50,104,488. This range describes the gene’s precise position on chromosome 19 and indicates the size of the gene (3,588 base pairs). Knowing a gene’s molecular location also allows researchers to determine exactly how far the gene is from other genes on the same chromosome. Different groups of researchers often present slightly different values for a gene’s molecular location. Researchers interpret the sequence of the human genome using a variety of methods, which can result in small differences in a gene’s molecular address. For example, the National Center for Biotechnology Information (NCBI) identifies the molecular location of the APOE gene as base pair 50,100,901 to base pair 50,104,488 on chromosome 19. The Ensembl database identifies the location of this gene as base pair 50,100,879 to base pair 50,104,489 on chromosome 19. Neither of these addresses is incorrect; they represent different interpretations of the same data. For consistency, Genetics Home Reference presents data from NCBI for the molecular location of genes. What Are Proteins and What Do They Do? Proteins are large, complex molecules that play many critical roles in the body. They do most of the work in cells and are required for the structure, function, and regulation of the body’s tissues and organs. Proteins are made up of hundreds or thousands of smaller units called amino acids, which are attached to one another in long chains. There are 20 different types of amino acids that can be combined to make a protein. The sequence of amino acids determines each protein’s unique 3-dimensional structure and its specific function.

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Examples of Protein Functions Proteins can be described according to their large range of functions in the body, listed in alphabetical order: Function Antibody

Description Antibodies bind to specific foreign particles, such as viruses and bacteria, to help protect the body.

Example Immunoglobulin G (IgG)

Enzyme

Enzymes carry out almost all of the thousands of chemical reactions that take place in cells. They also assist with the formation of new molecules by reading the genetic information stored in DNA.

Phenylalanine hydroxylase

Messenger

Messenger proteins, such as some types of hormones, transmit signals to coordinate biological processes between different cells, tissues, and organs.

Growth hormone

Structural component

These proteins provide structure and support for cells. On a larger scale, they also allow the body to move. These proteins bind and carry atoms and small molecules within cells and throughout the body.

Actin

Transport/storage

Ferritin

How Does a Gene Make a Protein? Most genes contain the information needed to make functional molecules called proteins. (A few genes produce other molecules that help the cell assemble proteins.) The journey from gene to protein is complex and tightly controlled within each cell. It consists of two major steps: transcription and translation. Together, transcription and translation are known as gene expression. During the process of transcription, the information stored in a gene’s DNA is transferred to a similar molecule called RNA (ribonucleic acid) in the cell nucleus. Both RNA and DNA are made up of a chain of nucleotide bases, but they have slightly different chemical properties. The type of RNA that contains the information for making a protein is called messenger RNA (mRNA) because it carries the information, or message, from the DNA out of the nucleus into the cytoplasm. Translation, the second step in getting from a gene to a protein, takes place in the cytoplasm. The mRNA interacts with a specialized complex called a ribosome, which “reads” the sequence of mRNA bases. Each sequence of three bases, called a codon, usually codes for

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one particular amino acid. (Amino acids are the building blocks of proteins.) A type of RNA called transfer RNA (tRNA) assembles the protein, one amino acid at a time. Protein assembly continues until the ribosome encounters a “stop” codon (a sequence of three bases that does not code for an amino acid). The flow of information from DNA to RNA to proteins is one of the fundamental principles of molecular biology. It is so important that it is sometimes called the “central dogma.”

Through the processes of transcription and translation, information from genes is used to make proteins.

Can Genes Be Turned On and Off in Cells? Each cell expresses, or turns on, only a fraction of its genes. The rest of the genes are repressed, or turned off. The process of turning genes on and off is known as gene regulation. Gene regulation is an important part of normal development. Genes are turned on and off in different patterns during development to make a brain cell look and act different from a liver cell or a muscle cell, for example. Gene regulation also allows cells to react quickly to changes in their environments. Although we know that the regulation of genes is critical for life, this complex process is not yet fully understood. Gene regulation can occur at any point during gene expression, but most commonly occurs at the level of transcription (when the information in a gene’s DNA is transferred to mRNA). Signals from the environment or from other cells activate proteins called transcription factors. These proteins bind to regulatory regions of a gene and increase or decrease the level of transcription. By controlling the level of transcription, this process can determine the amount of protein product that is made by a gene at any given time.

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How Do Cells Divide? There are two types of cell division: mitosis and meiosis. Most of the time when people refer to “cell division,” they mean mitosis, the process of making new body cells. Meiosis is the type of cell division that creates egg and sperm cells. Mitosis is a fundamental process for life. During mitosis, a cell duplicates all of its contents, including its chromosomes, and splits to form two identical daughter cells. Because this process is so critical, the steps of mitosis are carefully controlled by a number of genes. When mitosis is not regulated correctly, health problems such as cancer can result. The other type of cell division, meiosis, ensures that humans have the same number of chromosomes in each generation. It is a two-step process that reduces the chromosome number by half—from 46 to 23—to form sperm and egg cells. When the sperm and egg cells unite at conception, each contributes 23 chromosomes so the resulting embryo will have the usual 46. Meiosis also allows genetic variation through a process of DNA shuffling while the cells are dividing.

Mitosis and meiosis, the two types of cell division. How Do Genes Control the Growth and Division of Cells? A variety of genes are involved in the control of cell growth and division. The cell cycle is the cell’s way of replicating itself in an organized, step-by-step fashion. Tight regulation of this process ensures that a dividing cell’s DNA is copied properly, any errors in the DNA are repaired, and each daughter cell receives a full set of chromosomes. The cycle has checkpoints (also called restriction points), which allow certain genes to check for mistakes and halt the cycle for repairs if something goes wrong.

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If a cell has an error in its DNA that cannot be repaired, it may undergo programmed cell death (apoptosis). Apoptosis is a common process throughout life that helps the body get rid of cells it doesn’t need. Cells that undergo apoptosis break apart and are recycled by a type of white blood cell called a macrophage. Apoptosis protects the body by removing genetically damaged cells that could lead to cancer, and it plays an important role in the development of the embryo and the maintenance of adult tissues. Cancer results from a disruption of the normal regulation of the cell cycle. When the cycle proceeds without control, cells can divide without order and accumulate genetic defects that can lead to a cancerous tumor.

Genetic Mutations and Health This section presents basic information about gene mutations, chromosomal changes, and conditions that run in families.28 What Is a Gene Mutation and How Do Mutations Occur? A gene mutation is a permanent change in the DNA sequence that makes up a gene. Mutations range in size from a single DNA building block (DNA base) to a large segment of a chromosome. Gene mutations occur in two ways: they can be inherited from a parent or acquired during a person’s lifetime. Mutations that are passed from parent to child are called hereditary mutations or germline mutations (because they are present in the egg and sperm cells, which are also called germ cells). This type of mutation is present throughout a person’s life in virtually every cell in the body. Mutations that occur only in an egg or sperm cell, or those that occur just after fertilization, are called new (de novo) mutations. De novo mutations may explain genetic disorders in which an affected child has a mutation in every cell, but has no family history of the disorder. Acquired (or somatic) mutations occur in the DNA of individual cells at some time during a person’s life. These changes can be caused by environmental factors such as ultraviolet radiation from the sun, or can occur if a mistake is made as DNA copies itself during cell division. Acquired mutations in somatic cells (cells other than sperm and egg cells) cannot be passed on to the next generation. Mutations may also occur in a single cell within an early embryo. As all the cells divide during growth and development, the individual will have some cells with the mutation and some cells without the genetic change. This situation is called mosaicism. Some genetic changes are very rare; others are common in the population. Genetic changes that occur in more than 1 percent of the population are called polymorphisms. They are common enough to be considered a normal variation in the DNA. Polymorphisms are 28

This section has been adapted from the National Library of Medicine’s handbook, Help Me Understand Genetics, which presents basic information about genetics in clear language and provides links to online resources: http://ghr.nlm.nih.gov/handbook.

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responsible for many of the normal differences between people such as eye color, hair color, and blood type. Although many polymorphisms have no negative effects on a person’s health, some of these variations may influence the risk of developing certain disorders. How Can Gene Mutations Affect Health and Development? To function correctly, each cell depends on thousands of proteins to do their jobs in the right places at the right times. Sometimes, gene mutations prevent one or more of these proteins from working properly. By changing a gene’s instructions for making a protein, a mutation can cause the protein to malfunction or to be missing entirely. When a mutation alters a protein that plays a critical role in the body, it can disrupt normal development or cause a medical condition. A condition caused by mutations in one or more genes is called a genetic disorder. In some cases, gene mutations are so severe that they prevent an embryo from surviving until birth. These changes occur in genes that are essential for development, and often disrupt the development of an embryo in its earliest stages. Because these mutations have very serious effects, they are incompatible with life. It is important to note that genes themselves do not cause disease—genetic disorders are caused by mutations that make a gene function improperly. For example, when people say that someone has “the cystic fibrosis gene,” they are usually referring to a mutated version of the CFTR gene, which causes the disease. All people, including those without cystic fibrosis, have a version of the CFTR gene. Do All Gene Mutations Affect Health and Development? No, only a small percentage of mutations cause genetic disorders—most have no impact on health or development. For example, some mutations alter a gene’s DNA base sequence but do not change the function of the protein made by the gene. Often, gene mutations that could cause a genetic disorder are repaired by certain enzymes before the gene is expressed (makes a protein). Each cell has a number of pathways through which enzymes recognize and repair mistakes in DNA. Because DNA can be damaged or mutated in many ways, DNA repair is an important process by which the body protects itself from disease. A very small percentage of all mutations actually have a positive effect. These mutations lead to new versions of proteins that help an organism and its future generations better adapt to changes in their environment. For example, a beneficial mutation could result in a protein that protects the organism from a new strain of bacteria. For More Information about DNA Repair and the Health Effects of Gene Mutations •

The University of Utah Genetic Science Learning Center provides information about genetic disorders that explains why some mutations cause disorders but others do not. (Refer to the questions in the far right column.) See http://learn.genetics.utah.edu/units/disorders/whataregd/.

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Additional information about DNA repair is available from the NCBI Science Primer. In the chapter called “What Is A Cell?”, scroll down to the heading “DNA Repair Mechanisms.” See http://www.ncbi.nlm.nih.gov/About/primer/genetics_cell.html. What Kinds of Gene Mutations Are Possible?

The DNA sequence of a gene can be altered in a number of ways. Gene mutations have varying effects on health, depending on where they occur and whether they alter the function of essential proteins. The types of mutations include: •

Missense mutation: This type of mutation is a change in one DNA base pair that results in the substitution of one amino acid for another in the protein made by a gene.

•

Nonsense mutation: A nonsense mutation is also a change in one DNA base pair. Instead of substituting one amino acid for another, however, the altered DNA sequence prematurely signals the cell to stop building a protein. This type of mutation results in a shortened protein that may function improperly or not at all.

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Insertion: An insertion changes the number of DNA bases in a gene by adding a piece of DNA. As a result, the protein made by the gene may not function properly.

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Deletion: A deletion changes the number of DNA bases by removing a piece of DNA. Small deletions may remove one or a few base pairs within a gene, while larger deletions can remove an entire gene or several neighboring genes. The deleted DNA may alter the function of the resulting protein(s).

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Duplication: A duplication consists of a piece of DNA that is abnormally copied one or more times. This type of mutation may alter the function of the resulting protein.

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Frameshift mutation: This type of mutation occurs when the addition or loss of DNA bases changes a gene’s reading frame. A reading frame consists of groups of 3 bases that each code for one amino acid. A frameshift mutation shifts the grouping of these bases and changes the code for amino acids. The resulting protein is usually nonfunctional. Insertions, deletions, and duplications can all be frameshift mutations.

•

Repeat expansion: Nucleotide repeats are short DNA sequences that are repeated a number of times in a row. For example, a trinucleotide repeat is made up of 3-base-pair sequences, and a tetranucleotide repeat is made up of 4-base-pair sequences. A repeat expansion is a mutation that increases the number of times that the short DNA sequence is repeated. This type of mutation can cause the resulting protein to function improperly. Can Changes in Chromosomes Affect Health and Development?

Changes that affect entire chromosomes or segments of chromosomes can cause problems with growth, development, and function of the body’s systems. These changes can affect many genes along the chromosome and alter the proteins made by those genes. Conditions caused by a change in the number or structure of chromosomes are known as chromosomal disorders. Human cells normally contain 23 pairs of chromosomes, for a total of 46 chromosomes in each cell. A change in the number of chromosomes leads to a chromosomal disorder. These changes can occur during the formation of reproductive cells (eggs and sperm) or in early fetal development. A gain or loss of chromosomes from the normal 46 is called aneuploidy.

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The most common form of aneuploidy is trisomy, or the presence of an extra chromosome in each cell. “Tri-” is Greek for “three”; people with trisomy have three copies of a particular chromosome in each cell instead of the normal two copies. Down syndrome is an example of a condition caused by trisomy—people with Down syndrome typically have three copies of chromosome 21 in each cell, for a total of 47 chromosomes per cell. Monosomy, or the loss of one chromosome from each cell, is another kind of aneuploidy. “Mono-” is Greek for “one”; people with monosomy have one copy of a particular chromosome in each cell instead of the normal two copies. Turner syndrome is a condition caused by monosomy. Women with Turner syndrome are often missing one copy of the X chromosome in every cell, for a total of 45 chromosomes per cell. Chromosomal disorders can also be caused by changes in chromosome structure. These changes are caused by the breakage and reunion of chromosome segments when an egg or sperm cell is formed or in early fetal development. Pieces of DNA can be rearranged within one chromosome, or transferred between two or more chromosomes. The effects of structural changes depend on their size and location. Many different structural changes are possible; some cause medical problems, while others may have no effect on a person’s health. Many cancer cells also have changes in their chromosome number or structure. These changes most often occur in somatic cells (cells other than eggs and sperm) during a person’s lifetime. Can Changes in Mitochondrial DNA Affect Health and Development? Mitochondria are structures within cells that convert the energy from food into a form that cells can use. Although most DNA is packaged in chromosomes within the nucleus, mitochondria also have a small amount of their own DNA (known as mitochondrial DNA or mtDNA). In some cases, inherited changes in mitochondrial DNA can cause problems with growth, development, and function of the body’s systems. These mutations disrupt the mitochondria’s ability to generate energy efficiently for the cell. Conditions caused by mutations in mitochondrial DNA often involve multiple organ systems. The effects of these conditions are most pronounced in organs and tissues that require a lot of energy (such as the heart, brain, and muscles). Although the health consequences of inherited mitochondrial DNA mutations vary widely, frequently observed features include muscle weakness and wasting, problems with movement, diabetes, kidney failure, heart disease, loss of intellectual functions (dementia), hearing loss, and abnormalities involving the eyes and vision. Mitochondrial DNA is also prone to noninherited (somatic) mutations. Somatic mutations occur in the DNA of certain cells during a person’s lifetime, and typically are not passed to future generations. Because mitochondrial DNA has a limited ability to repair itself when it is damaged, these mutations tend to build up over time. A buildup of somatic mutations in mitochondrial DNA has been associated with some forms of cancer and an increased risk of certain age-related disorders such as heart disease, Alzheimer disease, and Parkinson disease. Additionally, research suggests that the progressive accumulation of these mutations over a person’s lifetime may play a role in the normal process of aging.

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What Are Complex or Multifactorial Disorders? Researchers are learning that nearly all conditions and diseases have a genetic component. Some disorders, such as sickle cell anemia and cystic fibrosis, are caused by mutations in a single gene. The causes of many other disorders, however, are much more complex. Common medical problems such as heart disease, diabetes, and obesity do not have a single genetic cause—they are likely associated with the effects of multiple genes in combination with lifestyle and environmental factors. Conditions caused by many contributing factors are called complex or multifactorial disorders. Although complex disorders often cluster in families, they do not have a clear-cut pattern of inheritance. This makes it difficult to determine a person’s risk of inheriting or passing on these disorders. Complex disorders are also difficult to study and treat because the specific factors that cause most of these disorders have not yet been identified. By 2010, however, researchers predict they will have found the major contributing genes for many common complex disorders. What Information about a Genetic Condition Can Statistics Provide? Statistical data can provide general information about how common a condition is, how many people have the condition, or how likely it is that a person will develop the condition. Statistics are not personalized, however—they offer estimates based on groups of people. By taking into account a person’s family history, medical history, and other factors, a genetics professional can help interpret what statistics mean for a particular patient. Common Statistical Terms Some statistical terms are commonly used when describing genetic conditions and other disorders. These terms include: Statistical Term Incidence

Description The incidence of a gene mutation or a genetic disorder is the number of people who are born with the mutation or disorder in a specified group per year. Incidence is often written in the form “1 in [a number]” or as a total number of live births.

Examples About 1 in 200,000 people in the United States are born with syndrome A each year. An estimated 15,000 infants with syndrome B were born last year worldwide.

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Prevalence

The prevalence of a gene mutation or a genetic disorder is the total number of people in a specified group at a given time who have the mutation or disorder. This term includes both newly diagnosed and preexisting cases in people of any age. Prevalence is often written in the form “1 in [a number]” or as a total number of people who have a condition.

Approximately 1 in 100,000 people in the United States have syndrome A at the present time. About 100,000 children worldwide currently have syndrome B.

Mortality

Mortality is the number of deaths from a particular disorder occurring in a specified group per year. Mortality is usually expressed as a total number of deaths.

An estimated 12,000 people worldwide died from syndrome C in 2002.

Lifetime risk

Lifetime risk is the average risk of developing a particular disorder at some point during a lifetime. Lifetime risk is often written as a percentage or as “1 in [a number].” It is important to remember that the risk per year or per decade is much lower than the lifetime risk. In addition, other factors may increase or decrease a person’s risk as compared with the average.

Approximately 1 percent of people in the United States develop disorder D during their lifetimes. The lifetime risk of developing disorder D is 1 in 100.

Naming Genetic Conditions Genetic conditions are not named in one standard way (unlike genes, which are given an official name and symbol by a formal committee). Doctors who treat families with a particular disorder are often the first to propose a name for the condition. Expert working groups may later revise the name to improve its usefulness. Naming is important because it allows accurate and effective communication about particular conditions, which will ultimately help researchers find new approaches to treatment. Disorder names are often derived from one or a combination of sources: •

The basic genetic or biochemical defect that causes the condition (for example, alpha-1 antitrypsin deficiency)

•

One or more major signs or symptoms of the disorder (for example, sickle cell anemia)

•

The parts of the body affected by the condition (for example, retinoblastoma)

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•

The name of a physician or researcher, often the first person to describe the disorder (for example, Marfan syndrome, which was named after Dr. Antoine Bernard-Jean Marfan)

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A geographic area (for example, familial Mediterranean fever, which occurs mainly in populations bordering the Mediterranean Sea)

•

The name of a patient or family with the condition (for example, amyotrophic lateral sclerosis, which is also called Lou Gehrig disease after a famous baseball player who had the condition).

Disorders named after a specific person or place are called eponyms. There is debate as to whether the possessive form (e.g., Alzheimer’s disease) or the nonpossessive form (Alzheimer disease) of eponyms is preferred. As a rule, medical geneticists use the nonpossessive form, and this form may become the standard for doctors in all fields of medicine. Genetics Home Reference uses the nonpossessive form of eponyms. Genetics Home Reference consults with experts in the field of medical genetics to provide the current, most accurate name for each disorder. Alternate names are included as synonyms. Naming genes The HUGO Gene Nomenclature Committee (HGNC) designates an official name and symbol (an abbreviation of the name) for each known human gene. Some official gene names include additional information in parentheses, such as related genetic conditions, subtypes of a condition, or inheritance pattern. The HGNC is a non-profit organization funded by the U.K. Medical Research Council and the U.S. National Institutes of Health. The Committee has named more than 13,000 of the estimated 20,000 to 25,000 genes in the human genome. During the research process, genes often acquire several alternate names and symbols. Different researchers investigating the same gene may each give the gene a different name, which can cause confusion. The HGNC assigns a unique name and symbol to each human gene, which allows effective organization of genes in large databanks, aiding the advancement of research. For specific information about how genes are named, refer to the HGNC’s Guidelines for Human Gene Nomenclature. Genetics Home Reference describes genes using the HGNC’s official gene names and gene symbols. Genetics Home Reference frequently presents the symbol and name separated with a colon (for example, FGFR4: Fibroblast growth factor receptor 4).

Inheriting Genetic Conditions This section gives you information on inheritance patterns and understanding risk. What Does It Mean If a Disorder Seems to Run in My Family? A particular disorder might be described as “running in a family” if more than one person in the family has the condition. Some disorders that affect multiple family members are caused by gene mutations, which can be inherited (passed down from parent to child). Other conditions that appear to run in families are not inherited. Instead, environmental factors

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such as dietary habits or a combination of genetic and environmental factors are responsible for these disorders. It is not always easy to determine whether a condition in a family is inherited. A genetics professional can use a person’s family history (a record of health information about a person’s immediate and extended family) to help determine whether a disorder has a genetic component.

Some disorders are seen in more than one generation of a family. Why Is It Important to Know My Family Medical History? A family medical history is a record of health information about a person and his or her close relatives. A complete record includes information from three generations of relatives,

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including children, brothers and sisters, parents, aunts and uncles, nieces and nephews, grandparents, and cousins. Families have many factors in common, including their genes, environment, and lifestyle. Together, these factors can give clues to medical conditions that may run in a family. By noticing patterns of disorders among relatives, healthcare professionals can determine whether an individual, other family members, or future generations may be at an increased risk of developing a particular condition. A family medical history can identify people with a higher-than-usual chance of having common disorders, such as heart disease, high blood pressure, stroke, certain cancers, and diabetes. These complex disorders are influenced by a combination of genetic factors, environmental conditions, and lifestyle choices. A family history also can provide information about the risk of rarer conditions caused by mutations in a single gene, such as cystic fibrosis and sickle cell anemia. While a family medical history provides information about the risk of specific health concerns, having relatives with a medical condition does not mean that an individual will definitely develop that condition. On the other hand, a person with no family history of a disorder may still be at risk of developing that disorder. Knowing one’s family medical history allows a person to take steps to reduce his or her risk. For people at an increased risk of certain cancers, healthcare professionals may recommend more frequent screening (such as mammography or colonoscopy) starting at an earlier age. Healthcare providers may also encourage regular checkups or testing for people with a medical condition that runs in their family. Additionally, lifestyle changes such as adopting a healthier diet, getting regular exercise, and quitting smoking help many people lower their chances of developing heart disease and other common illnesses. The easiest way to get information about family medical history is to talk to relatives about their health. Have they had any medical problems, and when did they occur? A family gathering could be a good time to discuss these issues. Additionally, obtaining medical records and other documents (such as obituaries and death certificates) can help complete a family medical history. It is important to keep this information up-to-date and to share it with a healthcare professional regularly. What Are the Different Ways in which a Genetic Condition Can Be Inherited? Some genetic conditions are caused by mutations in a single gene. These conditions are usually inherited in one of several straightforward patterns, depending on the gene involved: Inheritance Pattern Autosomal dominant

Description One mutated copy of the gene in each cell is sufficient for a person to be affected by an autosomal dominant disorder. Each affected person usually has one affected parent. Autosomal dominant disorders tend to occur in every generation of an affected family.

Examples Huntington disease, neurofibromatosis type 1

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Autosomal recessive

Two mutated copies of the gene are present in each cell when a person has an autosomal recessive disorder. An affected person usually has unaffected parents who each carry a single copy of the mutated gene (and are referred to as carriers). Autosomal recessive disorders are typically not seen in every generation of an affected family.

cystic fibrosis, sickle cell anemia

X-linked dominant

X-linked dominant disorders are caused by mutations in genes on the X chromosome. Females are more frequently affected than males, and the chance of passing on an X-linked dominant disorder differs between men and women. Families with an X-linked dominant disorder often have both affected males and affected females in each generation. A striking characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons (no male-to-male transmission).

fragile X syndrome

X-linked recessive

X-linked recessive disorders are also caused by mutations in genes on the X chromosome. Males are more frequently affected than females, and the chance of passing on the disorder differs between men and women. Families with an X-linked recessive disorder often have affected males, but rarely affected females, in each generation. A striking characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons (no male-to-male transmission).

hemophilia, Fabry disease

Codominant

In codominant inheritance, two different versions (alleles) of a gene can be expressed, and each version makes a slightly different protein. Both alleles influence the genetic trait or determine the characteristics of the genetic condition.

ABO blood group, alpha-1 antitrypsin deficiency

Mitochondrial

This type of inheritance, also known as maternal inheritance, applies to genes in mitochondrial DNA. Mitochondria, which are structures in each cell that convert molecules into energy, each contain a small amount of DNA. Because only egg cells contribute mitochondria to the developing embryo, only females can pass on mitochondrial conditions to their children. Mitochondrial disorders can appear in every generation of a family and can affect both males and females, but fathers do not pass mitochondrial traits to their children.

Leber hereditary optic neuropathy (LHON)

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Many other disorders are caused by a combination of the effects of multiple genes or by interactions between genes and the environment. Such disorders are more difficult to analyze because their genetic causes are often unclear, and they do not follow the patterns of inheritance described above. Examples of conditions caused by multiple genes or gene/environment interactions include heart disease, diabetes, schizophrenia, and certain types of cancer. Disorders caused by changes in the number or structure of chromosomes do not follow the straightforward patterns of inheritance listed above. Other genetic factors can also influence how a disorder is inherited. If a Genetic Disorder Runs in My Family, What Are the Chances That My Children Will Have the Condition? When a genetic disorder is diagnosed in a family, family members often want to know the likelihood that they or their children will develop the condition. This can be difficult to predict in some cases because many factors influence a person’s chances of developing a genetic condition. One important factor is how the condition is inherited. For example: •

Autosomal dominant inheritance: A person affected by an autosomal dominant disorder has a 50 percent chance of passing the mutated gene to each child. The chance that a child will not inherit the mutated gene is also 50 percent.

•

Autosomal recessive inheritance: Two unaffected people who each carry one copy of the mutated gene for an autosomal recessive disorder (carriers) have a 25 percent chance with each pregnancy of having a child affected by the disorder. The chance with each pregnancy of having an unaffected child who is a carrier of the disorder is 50 percent, and the chance that a child will not have the disorder and will not be a carrier is 25 percent.

•

X-linked dominant inheritance: The chance of passing on an X-linked dominant condition differs between men and women because men have one X chromosome and one Y chromosome, while women have two X chromosomes. A man passes on his Y chromosome to all of his sons and his X chromosome to all of his daughters. Therefore, the sons of a man with an X-linked dominant disorder will not be affected, but all of his daughters will inherit the condition. A woman passes on one or the other of her X chromosomes to each child. Therefore, a woman with an X-linked dominant disorder has a 50 percent chance of having an affected daughter or son with each pregnancy.

•

X-linked recessive inheritance: Because of the difference in sex chromosomes, the probability of passing on an X-linked recessive disorder also differs between men and women. The sons of a man with an X-linked recessive disorder will not be affected, and his daughters will carry one copy of the mutated gene. With each pregnancy, a woman who carries an X-linked recessive disorder has a 50 percent chance of having sons who are affected and a 50 percent chance of having daughters who carry one copy of the mutated gene.

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Codominant inheritance: In codominant inheritance, each parent contributes a different version of a particular gene, and both versions influence the resulting genetic trait. The chance of developing a genetic condition with codominant inheritance, and the characteristic features of that condition, depend on which versions of the gene are passed from parents to their child.

•

Mitochondrial inheritance: Mitochondria, which are the energy-producing centers inside cells, each contain a small amount of DNA. Disorders with mitochondrial inheritance result from mutations in mitochondrial DNA. Although mitochondrial

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disorders can affect both males and females, only females can pass mutations in mitochondrial DNA to their children. A woman with a disorder caused by changes in mitochondrial DNA will pass the mutation to all of her daughters and sons, but the children of a man with such a disorder will not inherit the mutation. It is important to note that the chance of passing on a genetic condition applies equally to each pregnancy. For example, if a couple has a child with an autosomal recessive disorder, the chance of having another child with the disorder is still 25 percent (or 1 in 4). Having one child with a disorder does not “protect” future children from inheriting the condition. Conversely, having a child without the condition does not mean that future children will definitely be affected. Although the chances of inheriting a genetic condition appear straightforward, factors such as a person’s family history and the results of genetic testing can sometimes modify those chances. In addition, some people with a disease-causing mutation never develop any health problems or may experience only mild symptoms of the disorder. If a disease that runs in a family does not have a clear-cut inheritance pattern, predicting the likelihood that a person will develop the condition can be particularly difficult. Estimating the chance of developing or passing on a genetic disorder can be complex. Genetics professionals can help people understand these chances and help them make informed decisions about their health. Factors that Influence the Effects of Particular Genetic Changes Reduced penetrance and variable expressivity are factors that influence the effects of particular genetic changes. These factors usually affect disorders that have an autosomal dominant pattern of inheritance, although they are occasionally seen in disorders with an autosomal recessive inheritance pattern. Reduced Penetrance Penetrance refers to the proportion of people with a particular genetic change (such as a mutation in a specific gene) who exhibit signs and symptoms of a genetic disorder. If some people with the mutation do not develop features of the disorder, the condition is said to have reduced (or incomplete) penetrance. Reduced penetrance often occurs with familial cancer syndromes. For example, many people with a mutation in the BRCA1 or BRCA2 gene will develop cancer during their lifetime, but some people will not. Doctors cannot predict which people with these mutations will develop cancer or when the tumors will develop. Reduced penetrance probably results from a combination of genetic, environmental, and lifestyle factors, many of which are unknown. This phenomenon can make it challenging for genetics professionals to interpret a person’s family medical history and predict the risk of passing a genetic condition to future generations. Variable Expressivity Although some genetic disorders exhibit little variation, most have signs and symptoms that differ among affected individuals. Variable expressivity refers to the range of signs and

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symptoms that can occur in different people with the same genetic condition. For example, the features of Marfan syndrome vary widely— some people have only mild symptoms (such as being tall and thin with long, slender fingers), while others also experience lifethreatening complications involving the heart and blood vessels. Although the features are highly variable, most people with this disorder have a mutation in the same gene (FBN1). As with reduced penetrance, variable expressivity is probably caused by a combination of genetic, environmental, and lifestyle factors, most of which have not been identified. If a genetic condition has highly variable signs and symptoms, it may be challenging to diagnose. What Do Geneticists Mean by Anticipation? The signs and symptoms of some genetic conditions tend to become more severe and appear at an earlier age as the disorder is passed from one generation to the next. This phenomenon is called anticipation. Anticipation is most often seen with certain genetic disorders of the nervous system, such as Huntington disease, myotonic dystrophy, and fragile X syndrome. Anticipation typically occurs with disorders that are caused by an unusual type of mutation called a trinucleotide repeat expansion. A trinucleotide repeat is a sequence of three DNA building blocks (nucleotides) that is repeated a number of times in a row. DNA segments with an abnormal number of these repeats are unstable and prone to errors during cell division. The number of repeats can change as the gene is passed from parent to child. If the number of repeats increases, it is known as a trinucleotide repeat expansion. In some cases, the trinucleotide repeat may expand until the gene stops functioning normally. This expansion causes the features of some disorders to become more severe with each successive generation. Most genetic disorders have signs and symptoms that differ among affected individuals, including affected people in the same family. Not all of these differences can be explained by anticipation. A combination of genetic, environmental, and lifestyle factors is probably responsible for the variability, although many of these factors have not been identified. Researchers study multiple generations of affected family members and consider the genetic cause of a disorder before determining that it shows anticipation. What Is Genomic Imprinting? Genomic imprinting is a factor that influences how some genetic conditions are inherited. People inherit two copies of their genes—one from their mother and one from their father. Usually both copies of each gene are active, or “turned on,” in cells. In some cases, however, only one of the two copies is normally turned on. Which copy is active depends on the parent of origin: some genes are normally active only when they are inherited from a person’s father; others are active only when inherited from a person’s mother. This phenomenon is known as genomic imprinting. In genes that undergo genomic imprinting, the parent of origin is often marked, or “stamped,” on the gene during the formation of egg and sperm cells. This stamping process, called methylation, is a chemical reaction that attaches small molecules called methyl groups to certain segments of DNA. These molecules identify which copy of a gene was inherited

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from the mother and which was inherited from the father. The addition and removal of methyl groups can be used to control the activity of genes. Only a small percentage of all human genes undergo genomic imprinting. Researchers are not yet certain why some genes are imprinted and others are not. They do know that imprinted genes tend to cluster together in the same regions of chromosomes. Two major clusters of imprinted genes have been identified in humans, one on the short (p) arm of chromosome 11 (at position 11p15) and another on the long (q) arm of chromosome 15 (in the region 15q11 to 15q13). What Is Uniparental Disomy? Uniparental disomy is a factor that influences how some genetic conditions are inherited. Uniparental disomy (UPD) occurs when a person receives two copies of a chromosome, or part of a chromosome, from one parent and no copies from the other parent. UPD can occur as a random event during the formation of egg or sperm cells or may happen in early fetal development. In many cases, UPD likely has no effect on health or development. Because most genes are not imprinted, it doesn’t matter if a person inherits both copies from one parent instead of one copy from each parent. In some cases, however, it does make a difference whether a gene is inherited from a person’s mother or father. A person with UPD may lack any active copies of essential genes that undergo genomic imprinting. This loss of gene function can lead to delayed development, mental retardation, or other medical problems. Several genetic disorders can result from UPD or a disruption of normal genomic imprinting. The most well-known conditions include Prader-Willi syndrome, which is characterized by uncontrolled eating and obesity, and Angelman syndrome, which causes mental retardation and impaired speech. Both of these disorders can be caused by UPD or other errors in imprinting involving genes on the long arm of chromosome 15. Other conditions, such as Beckwith-Wiedemann syndrome (a disorder characterized by accelerated growth and an increased risk of cancerous tumors), are associated with abnormalities of imprinted genes on the short arm of chromosome 11. Are Chromosomal Disorders Inherited? Although it is possible to inherit some types of chromosomal abnormalities, most chromosomal disorders (such as Down syndrome and Turner syndrome) are not passed from one generation to the next. Some chromosomal conditions are caused by changes in the number of chromosomes. These changes are not inherited, but occur as random events during the formation of reproductive cells (eggs and sperm). An error in cell division called nondisjunction results in reproductive cells with an abnormal number of chromosomes. For example, a reproductive cell may accidentally gain or lose one copy of a chromosome. If one of these atypical reproductive cells contributes to the genetic makeup of a child, the child will have an extra or missing chromosome in each of the body’s cells.

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Changes in chromosome structure can also cause chromosomal disorders. Some changes in chromosome structure can be inherited, while others occur as random accidents during the formation of reproductive cells or in early fetal development. Because the inheritance of these changes can be complex, people concerned about this type of chromosomal abnormality may want to talk with a genetics professional. Some cancer cells also have changes in the number or structure of their chromosomes. Because these changes occur in somatic cells (cells other than eggs and sperm), they cannot be passed from one generation to the next. Why Are Some Genetic Conditions More Common in Particular Ethnic Groups? Some genetic disorders are more likely to occur among people who trace their ancestry to a particular geographic area. People in an ethnic group often share certain versions of their genes, which have been passed down from common ancestors. If one of these shared genes contains a disease-causing mutation, a particular genetic disorder may be more frequently seen in the group. Examples of genetic conditions that are more common in particular ethnic groups are sickle cell anemia, which is more common in people of African, African-American, or Mediterranean heritage; and Tay-Sachs disease, which is more likely to occur among people of Ashkenazi (eastern and central European) Jewish or French Canadian ancestry. It is important to note, however, that these disorders can occur in any ethnic group.

Genetic Consultation This section presents information on finding and visiting a genetic counselor or other genetics professional. What Is a Genetic Consultation? A genetic consultation is a health service that provides information and support to people who have, or may be at risk for, genetic disorders. During a consultation, a genetics professional meets with an individual or family to discuss genetic risks or to diagnose, confirm, or rule out a genetic condition. Genetics professionals include medical geneticists (doctors who specialize in genetics) and genetic counselors (certified healthcare workers with experience in medical genetics and counseling). Other healthcare professionals such as nurses, psychologists, and social workers trained in genetics can also provide genetic consultations. Consultations usually take place in a doctor’s office, hospital, genetics center, or other type of medical center. These meetings are most often in-person visits with individuals or families, but they are occasionally conducted in a group or over the telephone.

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Why Might Someone Have a Genetic Consultation? Individuals or families who are concerned about an inherited condition may benefit from a genetic consultation. The reasons that a person might be referred to a genetic counselor, medical geneticist, or other genetics professional include: •

A personal or family history of a genetic condition, birth defect, chromosomal disorder, or hereditary cancer.

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Two or more pregnancy losses (miscarriages), a stillbirth, or a baby who died.

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A child with a known inherited disorder, a birth defect, mental retardation, or developmental delay.

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A woman who is pregnant or plans to become pregnant at or after age 35. (Some chromosomal disorders occur more frequently in children born to older women.)

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Abnormal test results that suggest a genetic or chromosomal condition.

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An increased risk of developing or passing on a particular genetic disorder on the basis of a person’s ethnic background.

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People related by blood (for example, cousins) who plan to have children together. (A child whose parents are related may be at an increased risk of inheriting certain genetic disorders.)

A genetic consultation is also an important part of the decision-making process for genetic testing. A visit with a genetics professional may be helpful even if testing is not available for a specific condition, however. What Happens during a Genetic Consultation? A genetic consultation provides information, offers support, and addresses a patient’s specific questions and concerns. To help determine whether a condition has a genetic component, a genetics professional asks about a person’s medical history and takes a detailed family history (a record of health information about a person’s immediate and extended family). The genetics professional may also perform a physical examination and recommend appropriate tests. If a person is diagnosed with a genetic condition, the genetics professional provides information about the diagnosis, how the condition is inherited, the chance of passing the condition to future generations, and the options for testing and treatment. During a consultation, a genetics professional will: •

Interpret and communicate complex medical information.

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Help each person make informed, independent decisions about their health care and reproductive options.

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Respect each person’s individual beliefs, traditions, and feelings.

A genetics professional will NOT: •

Tell a person which decision to make.

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Advise a couple not to have children.

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Recommend that a woman continue or end a pregnancy.

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Tell someone whether to undergo testing for a genetic disorder. How Can I Find a Genetics Professional in My Area?

To find a genetics professional in your community, you may wish to ask your doctor for a referral. If you have health insurance, you can also contact your insurance company to find a medical geneticist or genetic counselor in your area who participates in your plan. Several resources for locating a genetics professional in your community are available online: •

GeneTests from the University of Washington provides a list of genetics clinics around the United States and international genetics clinics. You can also access the list by clicking on “Clinic Directory” at the top of the GeneTests home page. Clinics can be chosen by state or country, by service, and/or by specialty. State maps can help you locate a clinic in your area. See http://www.genetests.org/.

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The National Society of Genetic Counselors offers a searchable directory of genetic counselors in the United States. You can search by location, name, area of practice/specialization, and/or ZIP Code. See http://www.nsgc.org/resourcelink.cfm.

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The National Cancer Institute provides a Cancer Genetics Services Directory, which lists professionals who provide services related to cancer genetics. You can search by type of cancer or syndrome, location, and/or provider name at the following Web site: http://cancer.gov/search/genetics_services/.

Genetic Testing This section presents information on the benefits, costs, risks, and limitations of genetic testing. What Is Genetic Testing? Genetic testing is a type of medical test that identifies changes in chromosomes, genes, or proteins. Most of the time, testing is used to find changes that are associated with inherited disorders. The results of a genetic test can confirm or rule out a suspected genetic condition or help determine a person’s chance of developing or passing on a genetic disorder. Several hundred genetic tests are currently in use, and more are being developed. Genetic testing is voluntary. Because testing has both benefits and limitations, the decision about whether to be tested is a personal and complex one. A genetic counselor can help by providing information about the pros and cons of the test and discussing the social and emotional aspects of testing. What Are the Types of Genetic Tests? Genetic testing can provide information about a person’s genes and chromosomes. Available types of testing include:

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Newborn screening is used just after birth to identify genetic disorders that can be treated early in life. Millions of babies are tested each year in the United States. All states currently test infants for phenylketonuria (a genetic disorder that causes mental retardation if left untreated) and congenital hypothyroidism (a disorder of the thyroid gland). Most states also test for other genetic disorders.

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Diagnostic testing is used to identify or rule out a specific genetic or chromosomal condition. In many cases, genetic testing is used to confirm a diagnosis when a particular condition is suspected based on physical signs and symptoms. Diagnostic testing can be performed before birth or at any time during a person’s life, but is not available for all genes or all genetic conditions. The results of a diagnostic test can influence a person’s choices about health care and the management of the disorder.

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Carrier testing is used to identify people who carry one copy of a gene mutation that, when present in two copies, causes a genetic disorder. This type of testing is offered to individuals who have a family history of a genetic disorder and to people in certain ethnic groups with an increased risk of specific genetic conditions. If both parents are tested, the test can provide information about a couple’s risk of having a child with a genetic condition.

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Prenatal testing is used to detect changes in a fetus’s genes or chromosomes before birth. This type of testing is offered during pregnancy if there is an increased risk that the baby will have a genetic or chromosomal disorder. In some cases, prenatal testing can lessen a couple’s uncertainty or help them make decisions about a pregnancy. It cannot identify all possible inherited disorders and birth defects, however.

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Preimplantation testing, also called preimplantation genetic diagnosis (PGD), is a specialized technique that can reduce the risk of having a child with a particular genetic or chromosomal disorder. It is used to detect genetic changes in embryos that were created using assisted reproductive techniques such as in-vitro fertilization. In-vitro fertilization involves removing egg cells from a woman’s ovaries and fertilizing them with sperm cells outside the body. To perform preimplantation testing, a small number of cells are taken from these embryos and tested for certain genetic changes. Only embryos without these changes are implanted in the uterus to initiate a pregnancy.

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Predictive and presymptomatic types of testing are used to detect gene mutations associated with disorders that appear after birth, often later in life. These tests can be helpful to people who have a family member with a genetic disorder, but who have no features of the disorder themselves at the time of testing. Predictive testing can identify mutations that increase a person’s risk of developing disorders with a genetic basis, such as certain types of cancer. Presymptomatic testing can determine whether a person will develop a genetic disorder, such as hemochromatosis (an iron overload disorder), before any signs or symptoms appear. The results of predictive and presymptomatic testing can provide information about a person’s risk of developing a specific disorder and help with making decisions about medical care.

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Forensic testing uses DNA sequences to identify an individual for legal purposes. Unlike the tests described above, forensic testing is not used to detect gene mutations associated with disease. This type of testing can identify crime or catastrophe victims, rule out or implicate a crime suspect, or establish biological relationships between people (for example, paternity).

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How Is Genetic Testing Done? Once a person decides to proceed with genetic testing, a medical geneticist, primary care doctor, specialist, or nurse practitioner can order the test. Genetic testing is often done as part of a genetic consultation. Genetic tests are performed on a sample of blood, hair, skin, amniotic fluid (the fluid that surrounds a fetus during pregnancy), or other tissue. For example, a procedure called a buccal smear uses a small brush or cotton swab to collect a sample of cells from the inside surface of the cheek. The sample is sent to a laboratory where technicians look for specific changes in chromosomes, DNA, or proteins, depending on the suspected disorder. The laboratory reports the test results in writing to a person’s doctor or genetic counselor. Newborn screening tests are done on a small blood sample, which is taken by pricking the baby’s heel. Unlike other types of genetic testing, a parent will usually only receive the result if it is positive. If the test result is positive, additional testing is needed to determine whether the baby has a genetic disorder. Before a person has a genetic test, it is important that he or she understands the testing procedure, the benefits and limitations of the test, and the possible consequences of the test results. The process of educating a person about the test and obtaining permission is called informed consent. What Is Direct-to-Consumer Genetic Testing? Traditionally, genetic tests have been available only through healthcare providers such as physicians, nurse practitioners, and genetic counselors. Healthcare providers order the appropriate test from a laboratory, collect and send the samples, and interpret the test results. Direct-to-consumer genetic testing refers to genetic tests that are marketed directly to consumers via television, print advertisements, or the Internet. This form of testing, which is also known as at-home genetic testing, provides access to a person’s genetic information without necessarily involving a doctor or insurance company in the process. If a consumer chooses to purchase a genetic test directly, the test kit is mailed to the consumer instead of being ordered through a doctor’s office. The test typically involves collecting a DNA sample at home, often by swabbing the inside of the cheek, and mailing the sample back to the laboratory. In some cases, the person must visit a health clinic to have blood drawn. Consumers are notified of their results by mail or over the telephone, or the results are posted online. In some cases, a genetic counselor or other healthcare provider is available to explain the results and answer questions. The price for this type of at-home genetic testing ranges from several hundred dollars to more than a thousand dollars. The growing market for direct-to-consumer genetic testing may promote awareness of genetic diseases, allow consumers to take a more proactive role in their health care, and offer a means for people to learn about their ancestral origins. At-home genetic tests, however, have significant risks and limitations. Consumers are vulnerable to being misled by the results of unproven or invalid tests. Without guidance from a healthcare provider, they may make important decisions about treatment or prevention based on inaccurate, incomplete, or misunderstood information about their health. Consumers may also experience an invasion of genetic privacy if testing companies use their genetic information in an unauthorized way.

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Genetic testing provides only one piece of information about a person’s health—other genetic and environmental factors, lifestyle choices, and family medical history also affect a person’s risk of developing many disorders. These factors are discussed during a consultation with a doctor or genetic counselor, but in many cases are not addressed by athome genetic tests. More research is needed to fully understand the benefits and limitations of direct-to-consumer genetic testing. What Do the Results of Genetic Tests Mean? The results of genetic tests are not always straightforward, which often makes them challenging to interpret and explain. Therefore, it is important for patients and their families to ask questions about the potential meaning of genetic test results both before and after the test is performed. When interpreting test results, healthcare professionals consider a person’s medical history, family history, and the type of genetic test that was done. A positive test result means that the laboratory found a change in a particular gene, chromosome, or protein of interest. Depending on the purpose of the test, this result may confirm a diagnosis, indicate that a person is a carrier of a particular genetic mutation, identify an increased risk of developing a disease (such as cancer) in the future, or suggest a need for further testing. Because family members have some genetic material in common, a positive test result may also have implications for certain blood relatives of the person undergoing testing. It is important to note that a positive result of a predictive or presymptomatic genetic test usually cannot establish the exact risk of developing a disorder. Also, health professionals typically cannot use a positive test result to predict the course or severity of a condition. A negative test result means that the laboratory did not find a change in the gene, chromosome, or protein under consideration. This result can indicate that a person is not affected by a particular disorder, is not a carrier of a specific genetic mutation, or does not have an increased risk of developing a certain disease. It is possible, however, that the test missed a disease-causing genetic alteration because many tests cannot detect all genetic changes that can cause a particular disorder. Further testing may be required to confirm a negative result. In some cases, a negative result might not give any useful information. This type of result is called uninformative, indeterminate, inconclusive, or ambiguous. Uninformative test results sometimes occur because everyone has common, natural variations in their DNA, called polymorphisms, that do not affect health. If a genetic test finds a change in DNA that has not been associated with a disorder in other people, it can be difficult to tell whether it is a natural polymorphism or a disease-causing mutation. An uninformative result cannot confirm or rule out a specific diagnosis, and it cannot indicate whether a person has an increased risk of developing a disorder. In some cases, testing other affected and unaffected family members can help clarify this type of result. What Is the Cost of Genetic Testing, and How Long Does It Take to Get the Results? The cost of genetic testing can range from under $100 to more than $2,000, depending on the nature and complexity of the test. The cost increases if more than one test is necessary or if multiple family members must be tested to obtain a meaningful result. For newborn

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screening, costs vary by state. Some states cover part of the total cost, but most charge a fee of $15 to $60 per infant. From the date that a sample is taken, it may take a few weeks to several months to receive the test results. Results for prenatal testing are usually available more quickly because time is an important consideration in making decisions about a pregnancy. The doctor or genetic counselor who orders a particular test can provide specific information about the cost and time frame associated with that test. Will Health Insurance Cover the Costs of Genetic Testing? In many cases, health insurance plans will cover the costs of genetic testing when it is recommended by a person’s doctor. Health insurance providers have different policies about which tests are covered, however. A person interested in submitting the costs of testing may wish to contact his or her insurance company beforehand to ask about coverage. Some people may choose not to use their insurance to pay for testing because the results of a genetic test can affect a person’s health insurance coverage. Instead, they may opt to pay out-of-pocket for the test. People considering genetic testing may want to find out more about their state’s privacy protection laws before they ask their insurance company to cover the costs. What Are the Benefits of Genetic Testing? Genetic testing has potential benefits whether the results are positive or negative for a gene mutation. Test results can provide a sense of relief from uncertainty and help people make informed decisions about managing their health care. For example, a negative result can eliminate the need for unnecessary checkups and screening tests in some cases. A positive result can direct a person toward available prevention, monitoring, and treatment options. Some test results can also help people make decisions about having children. Newborn screening can identify genetic disorders early in life so treatment can be started as early as possible. What Are the Risks and Limitations of Genetic Testing? The physical risks associated with most genetic tests are very small, particularly for those tests that require only a blood sample or buccal smear (a procedure that samples cells from the inside surface of the cheek). The procedures used for prenatal testing carry a small but real risk of losing the pregnancy (miscarriage) because they require a sample of amniotic fluid or tissue from around the fetus. Many of the risks associated with genetic testing involve the emotional, social, or financial consequences of the test results. People may feel angry, depressed, anxious, or guilty about their results. In some cases, genetic testing creates tension within a family because the results can reveal information about other family members in addition to the person who is tested. The possibility of genetic discrimination in employment or insurance is also a concern.

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Genetic testing can provide only limited information about an inherited condition. The test often can’t determine if a person will show symptoms of a disorder, how severe the symptoms will be, or whether the disorder will progress over time. Another major limitation is the lack of treatment strategies for many genetic disorders once they are diagnosed. A genetics professional can explain in detail the benefits, risks, and limitations of a particular test. It is important that any person who is considering genetic testing understand and weigh these factors before making a decision. What Is Genetic Discrimination? Genetic discrimination occurs when people are treated differently by their employer or insurance company because they have a gene mutation that causes or increases the risk of an inherited disorder. People who undergo genetic testing may be at risk for genetic discrimination. The results of a genetic test are normally included in a person’s medical records. When a person applies for life, disability, or health insurance, the insurance company may ask to look at these records before making a decision about coverage. An employer may also have the right to look at an employee’s medical records. As a result, genetic test results could affect a person’s insurance coverage or employment. People making decisions about genetic testing should be aware that when test results are placed in their medical records, the results might not be kept private. Fear of discrimination is a common concern among people considering genetic testing. Several laws at the federal and state levels help protect people against genetic discrimination; however, genetic testing is a fast-growing field and these laws don’t cover every situation. How Does Genetic Testing in a Research Setting Differ from Clinical Genetic Testing? The main differences between clinical genetic testing and research testing are the purpose of the test and who receives the results. The goals of research testing include finding unknown genes, learning how genes work, and advancing our understanding of genetic conditions. The results of testing done as part of a research study are usually not available to patients or their healthcare providers. Clinical testing, on the other hand, is done to find out about an inherited disorder in an individual patient or family. People receive the results of a clinical test and can use them to help them make decisions about medical care or reproductive issues. It is important for people considering genetic testing to know whether the test is available on a clinical or research basis. Clinical and research testing both involve a process of informed consent in which patients learn about the testing procedure, the risks and benefits of the test, and the potential consequences of testing.

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Gene Therapy This section presents information on experimental techniques, safety, ethics, and availability of gene therapy. What Is Gene Therapy? Gene therapy is an experimental technique that uses genes to treat or prevent disease. In the future, this technique may allow doctors to treat a disorder by inserting a gene into a patient’s cells instead of using drugs or surgery. Researchers are testing several approaches to gene therapy, including: •

Replacing a mutated gene that causes disease with a healthy copy of the gene.

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Inactivating, or “knocking out,” a mutated gene that is functioning improperly.

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Introducing a new gene into the body to help fight a disease.

Although gene therapy is a promising treatment option for a number of diseases (including inherited disorders, some types of cancer, and certain viral infections), the technique remains risky and is still under study to make sure that it will be safe and effective. Gene therapy is currently only being tested for the treatment of diseases that have no other cures. How Does Gene Therapy Work? Gene therapy is designed to introduce genetic material into cells to compensate for abnormal genes or to make a beneficial protein. If a mutated gene causes a necessary protein to be faulty or missing, gene therapy may be able to introduce a normal copy of the gene to restore the function of the protein. A gene that is inserted directly into a cell usually does not function. Instead, a carrier called a vector is genetically engineered to deliver the gene. Certain viruses are often used as vectors because they can deliver the new gene by infecting the cell. The viruses are modified so they can’t cause disease when used in people. Some types of virus, such as retroviruses, integrate their genetic material (including the new gene) into a chromosome in the human cell. Other viruses, such as adenoviruses, introduce their DNA into the nucleus of the cell, but the DNA is not integrated into a chromosome. The vector can be injected or given intravenously (by IV) directly into a specific tissue in the body, where it is taken up by individual cells. Alternately, a sample of the patient’s cells can be removed and exposed to the vector in a laboratory setting. The cells containing the vector are then returned to the patient. If the treatment is successful, the new gene delivered by the vector will make a functioning protein. Researchers must overcome many technical challenges before gene therapy will be a practical approach to treating disease. For example, scientists must find better ways to deliver genes and target them to particular cells. They must also ensure that new genes are precisely controlled by the body.

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A new gene is injected into an adenovirus vector, which is used to introduce the modified DNA into a human cell. If the treatment is successful, the new gene will make a functional protein.

Is Gene Therapy Safe? Gene therapy is under study to determine whether it could be used to treat disease. Current research is evaluating the safety of gene therapy; future studies will test whether it is an effective treatment option. Several studies have already shown that this approach can have very serious health risks, such as toxicity, inflammation, and cancer. Because the techniques are relatively new, some of the risks may be unpredictable; however, medical researchers, institutions, and regulatory agencies are working to ensure that gene therapy research is as safe as possible. Comprehensive federal laws, regulations, and guidelines help protect people who participate in research studies (called clinical trials). The U.S. Food and Drug Administration (FDA) regulates all gene therapy products in the United States and oversees research in this area. Researchers who wish to test an approach in a clinical trial must first obtain permission from the FDA. The FDA has the authority to reject or suspend clinical trials that are suspected of being unsafe for participants. The National Institutes of Health (NIH) also plays an important role in ensuring the safety of gene therapy research. NIH provides guidelines for investigators and institutions (such as universities and hospitals) to follow when conducting clinical trials with gene therapy. These guidelines state that clinical trials at institutions receiving NIH funding for this type of research must be registered with the NIH Office of Biotechnology Activities. The protocol, or plan, for each clinical trial is then reviewed by the NIH Recombinant DNA Advisory Committee (RAC) to determine whether it raises medical, ethical, or safety issues that warrant further discussion at one of the RAC’s public meetings.

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An Institutional Review Board (IRB) and an Institutional Biosafety Committee (IBC) must approve each gene therapy clinical trial before it can be carried out. An IRB is a committee of scientific and medical advisors and consumers that reviews all research within an institution. An IBC is a group that reviews and approves an institution’s potentially hazardous research studies. Multiple levels of evaluation and oversight ensure that safety concerns are a top priority in the planning and carrying out of gene therapy research. What Are the Ethical Issues surrounding Gene Therapy? Because gene therapy involves making changes to the body’s set of basic instructions, it raises many unique ethical concerns. The ethical questions surrounding gene therapy include: •

How can “good” and “bad” uses of gene therapy be distinguished?

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Who decides which traits are normal and which constitute a disability or disorder?

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Will the high costs of gene therapy make it available only to the wealthy?

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Could the widespread use of gene therapy make society less accepting of people who are different?

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Should people be allowed to use gene therapy to enhance basic human traits such as height, intelligence, or athletic ability?

Current gene therapy research has focused on treating individuals by targeting the therapy to body cells such as bone marrow or blood cells. This type of gene therapy cannot be passed on to a person’s children. Gene therapy could be targeted to egg and sperm cells (germ cells), however, which would allow the inserted gene to be passed on to future generations. This approach is known as germline gene therapy. The idea of germline gene therapy is controversial. While it could spare future generations in a family from having a particular genetic disorder, it might affect the development of a fetus in unexpected ways or have long-term side effects that are not yet known. Because people who would be affected by germline gene therapy are not yet born, they can’t choose whether to have the treatment. Because of these ethical concerns, the U.S. Government does not allow federal funds to be used for research on germline gene therapy in people. Is Gene Therapy Available to Treat My Disorder? Gene therapy is currently available only in a research setting. The U.S. Food and Drug Administration (FDA) has not yet approved any gene therapy products for sale in the United States. Hundreds of research studies (clinical trials) are under way to test gene therapy as a treatment for genetic conditions, cancer, and HIV/AIDS. If you are interested in participating in a clinical trial, talk with your doctor or a genetics professional about how to participate. You can also search for clinical trials online. ClinicalTrials.gov, a service of the National Institutes of Health, provides easy access to information on clinical trials. You can search for specific trials or browse by condition or trial sponsor. You may wish to refer to a list of gene therapy trials that are accepting (or will accept) patients.

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The Human Genome Project and Genomic Research This section presents information on the goals, accomplishments, and next steps in understanding the human genome. What Is a Genome? A genome is an organism’s complete set of DNA, including all of its genes. Each genome contains all of the information needed to build and maintain that organism. In humans, a copy of the entire genome—more than 3 billion DNA base pairs—is contained in all cells that have a nucleus. What Was the Human Genome Project and Why Has It Been Important? The Human Genome Project was an international research effort to determine the sequence of the human genome and identify the genes that it contains. The Project was coordinated by the National Institutes of Health and the U.S. Department of Energy. Additional contributors included universities across the United States and international partners in the United Kingdom, France, Germany, Japan, and China. The Human Genome Project formally began in 1990 and was completed in 2003, 2 years ahead of its original schedule. The work of the Human Genome Project has allowed researchers to begin to understand the blueprint for building a person. As researchers learn more about the functions of genes and proteins, this knowledge will have a major impact in the fields of medicine, biotechnology, and the life sciences. What Were the Goals of the Human Genome Project? The main goals of the Human Genome Project were to provide a complete and accurate sequence of the 3 billion DNA base pairs that make up the human genome and to find all of the estimated 20,000 to 25,000 human genes. The Project also aimed to sequence the genomes of several other organisms that are important to medical research, such as the mouse and the fruit fly. In addition to sequencing DNA, the Human Genome Project sought to develop new tools to obtain and analyze the data and to make this information widely available. Also, because advances in genetics have consequences for individuals and society, the Human Genome Project committed to exploring the consequences of genomic research through its Ethical, Legal, and Social Implications (ELSI) program. What Did the Human Genome Project Accomplish? In April 2003, researchers announced that the Human Genome Project had completed a high-quality sequence of essentially the entire human genome. This sequence closed the gaps from a working draft of the genome, which was published in 2001. It also identified the locations of many human genes and provided information about their structure and

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organization. The Project made the sequence of the human genome and tools to analyze the data freely available via the Internet. In addition to the human genome, the Human Genome Project sequenced the genomes of several other organisms, including brewers’ yeast, the roundworm, and the fruit fly. In 2002, researchers announced that they had also completed a working draft of the mouse genome. By studying the similarities and differences between human genes and those of other organisms, researchers can discover the functions of particular genes and identify which genes are critical for life. The Project’s Ethical, Legal, and Social Implications (ELSI) program became the world’s largest bioethics program and a model for other ELSI programs worldwide. What Were Some of the Ethical, Legal, and Social Implications Addressed by the Human Genome Project? The Ethical, Legal, and Social Implications (ELSI) program was founded in 1990 as an integral part of the Human Genome Project. The mission of the ELSI program was to identify and address issues raised by genomic research that would affect individuals, families, and society. A percentage of the Human Genome Project budget at the National Institutes of Health and the U.S. Department of Energy was devoted to ELSI research. The ELSI program focused on the possible consequences of genomic research in four main areas: •

Privacy and fairness in the use of genetic information, including the potential for genetic discrimination in employment and insurance.

•

The integration of new genetic technologies, such as genetic testing, into the practice of clinical medicine.

•

Ethical issues surrounding the design and conduct of genetic research with people, including the process of informed consent.

•

The education of healthcare professionals, policy makers, students, and the public about genetics and the complex issues that result from genomic research. What Are the Next Steps in Genomic Research?

Discovering the sequence of the human genome was only the first step in understanding how the instructions coded in DNA lead to a functioning human being. The next stage of genomic research will begin to derive meaningful knowledge from the DNA sequence. Research studies that build on the work of the Human Genome Project are under way worldwide. The objectives of continued genomic research include the following: •

Determine the function of genes and the elements that regulate genes throughout the genome.

•

Find variations in the DNA sequence among people and determine their significance. These variations may one day provide information about a person’s disease risk and response to certain medications.

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•

Discover the 3-dimensional structures of proteins and identify their functions.

•

Explore how DNA and proteins interact with one another and with the environment to create complex living systems.

•

Develop and apply genome-based strategies for the early detection, diagnosis, and treatment of disease.

•

Sequence the genomes of other organisms, such as the rat, cow, and chimpanzee, in order to compare similar genes between species.

•

Develop new technologies to study genes and DNA on a large scale and store genomic data efficiently.

•

Continue to explore the ethical, legal, and social issues raised by genomic research. What Is Pharmacogenomics?

Pharmacogenomics is the study of how genes affect a person’s response to drugs. This relatively new field combines pharmacology (the science of drugs) and genomics (the study of genes and their functions) to develop effective, safe medications and doses that will be tailored to a person’s genetic makeup. Many drugs that are currently available are “one size fits all,” but they don’t work the same way for everyone. It can be difficult to predict who will benefit from a medication, who will not respond at all, and who will experience negative side effects (called adverse drug reactions). Adverse drug reactions are a significant cause of hospitalizations and deaths in the United States. With the knowledge gained from the Human Genome Project, researchers are learning how inherited differences in genes affect the body’s response to medications. These genetic differences will be used to predict whether a medication will be effective for a particular person and to help prevent adverse drug reactions. The field of pharmacogenomics is still in its infancy. Its use is currently quite limited, but new approaches are under study in clinical trials. In the future, pharmacogenomics will allow the development of tailored drugs to treat a wide range of health problems, including cardiovascular disease, Alzheimer disease, cancer, HIV/AIDS, and asthma.

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APPENDIX B. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute29: •

National Institutes of Health (NIH); guidelines consolidated across agencies available at http://health.nih.gov/

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/Publications/FactSheets.htm

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancertopics/pdq

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/health/

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/HealthInformation/Publications/

•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/Publications/

29

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidcr.nih.gov/HealthInformation/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/healthinformation/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

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National Institute of Biomedical Imaging and Bioengineering; general information at http://www.nibib.nih.gov/HealthEdu

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.30 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic

30

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html).

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citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine31: •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/index.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

31

See http://www.nlm.nih.gov/databases/index.html.

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The NLM Gateway32 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.33 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type Charcot-Marie-Tooth disease (or synonyms) into the search box and click Search. The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 2111 12 36 0 6 2165

HSTAT34 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.35 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.36 Simply search by Charcot-Marie-Tooth disease (or synonyms) at the following Web site: http://text.nlm.nih.gov. Coffee Break: Tutorials for Biologists37 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. 32

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

33

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 34 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 35 36

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force’s Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 37 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

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Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.38 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.39 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

MD Consult: Access to electronic clinical resources, see http://www.mdconsult.com/.

•

Medical Matrix: Lists over 6000 medical Web sites and links to over 1.5 million documents with clinical content, see http://www.medmatrix.org/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

The Genome Project and Charcot-Marie-Tooth Disease In the following section, we will discuss databases and references which relate to the Genome Project and Charcot-Marie-Tooth disease. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).40 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type Charcot-Marie-Tooth disease (or synonyms) into the search box, and click Go. If too many results appear, you can narrow the search by adding the word clinical. Each report will

38

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 39 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 40 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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have additional links to related research and databases. The following is an example of the results you can obtain from the OMIM for Charcot-Marie-Tooth disease: •

CHARCOT-MARIE-TOOTH DISEASE and DEAFNESS Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=118300

•

CHARCOT-MARIE-TOOTH DISEASE with PTOSIS and PARKINSONISM Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=118301

•

CHARCOT-MARIE-TOOTH PERONEAL MUSCULAR ATROPHY, X-LINKED, with APLASIA CUTIS CONGENITA Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=302803

•

CHARCOT-MARIE-TOOTH PERONEAL MUSCULAR ATROPHY FRIEDREICH ATAXIA, COMBINED Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=302900

•

HEREDITARY MOTOR and SENSORY NEUROPATHY V Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=600361

•

HEREDITARY MOTOR and SENSORY NEUROPATHY VI Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=601152

and

Genes and Disease (NCBI - Map) The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •

Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html

•

Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html

•

Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html

•

Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease,

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Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html •

Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html

•

Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez

Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •

Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books

•

Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome

•

GEO DataSets: Curated gene expression and molecular abundance data sets assembled from the Gene Expression Omnibus (GEO) repository, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

GEO Profiles: Individual gene expression and molecular abundance profiles assembled from the Gene Expression Omnibus (GEO) repository, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/

•

Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide

•

OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM

•

PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset

•

Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein

•

PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

•

Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure

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Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/gquery/gquery.fcgi, and then select the database that you would like to search. Or, to search across databases, you can enter Charcot-Marie-Tooth disease (or synonyms) into the search box and click Go. Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database41 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database42 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the GDB Human Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search All Biological Data by Name/GDB ID. Type Charcot-Marie-Tooth disease (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word and or or (using or might be useful when using synonyms).

41

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 42 Adapted from the Genome Database: http://www.gdb.org/gdb/aboutGDB.html#mission.

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APPENDIX C. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called Fact Sheets or Guidelines. They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on Charcot-Marie-Tooth disease can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources This section directs you to sources which either publish fact sheets or can help you find additional guidelines on topics related to Charcot-Marie-Tooth disease. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are health topic pages which list links to available materials relevant to Charcot-Marie-Tooth disease. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for Charcot-Marie-Tooth disease:

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Guides on Charcot-Marie-Tooth disease Charcot-Marie-Tooth Disease http://www.nlm.nih.gov/medlineplus/charcotmarietoothdisease.html

•

Other guides Dizziness and Vertigo http://www.nlm.nih.gov/medlineplus/dizzinessandvertigo.html Head and Brain Malformations http://www.nlm.nih.gov/medlineplus/headandbrainmalformations.html Muscle Disorders http://www.nlm.nih.gov/medlineplus/muscledisorders.html Neurologic Diseases http://www.nlm.nih.gov/medlineplus/neurologicdiseases.html Neuromuscular Disorders http://www.nlm.nih.gov/medlineplus/neuromusculardisorders.html Peripheral Nerve Disorders http://www.nlm.nih.gov/medlineplus/peripheralnervedisorders.html Spinal Muscular Atrophy http://www.nlm.nih.gov/medlineplus/spinalmuscularatrophy.html Tooth Disorders http://www.nlm.nih.gov/medlineplus/toothdisorders.html

Within the health topic page dedicated to Charcot-Marie-Tooth disease, the following was listed: •

Diagnosis/Symptoms Creatine Kinase Test Source: Muscular Dystrophy Association http://www.mda.org/publications/Quest/q71ss-cktest.html Electromyography and Nerve Conduction Velocities Source: Muscular Dystrophy Association http://www.mda.org/publications/Quest/q75ss.html Muscle Biopsies Source: Muscular Dystrophy Association http://www.mda.org/publications/Quest/q74ss.html

•

From the National Institutes of Health Charcot-Marie-Tooth Disease Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/disorders/charcot_marie_tooth/charcot_marie_tooth.h tm

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Charcot-Marie-Tooth Disease Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/disorders/charcot_marie_tooth/detail_charcot_marie_t ooth.htm •

Organizations Charcot-Marie-Tooth Association http://www.charcot-marie-tooth.org/ Muscular Dystrophy Association http://www.mda.org/ National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/

•

Research Charcot-Marie-Tooth Disease (CMT): MDA's Search For a Treatment or Cure Source: 11/01/2005, Muscular Dystrophy Association http://www.mda.org/publications/fa-cmt-tx.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click Search. This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

Auditory Neuropathy Source: www.nidcd.nih.gov http://www.nidcd.nih.gov/health/hearing/neuropathy.asp

•

Charcot-Marie-Tooth Disease Information Page: National Institute. Summary: CMT, also known as hereditary motor and sensory neuropathy (HMSN) or peroneal muscularatrophy, comprises a group of disorders caused by mutations in genes. Source: www.ninds.nih.gov http://www.ninds.nih.gov/disorders/charcot_marie_tooth/charcot_marie_tooth.htm

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geneticalliance.org Source: www.geneticalliance.org http://www.geneticalliance.org/ws_display.asp?filter=diseases_what_is&char=P &s_Diseases=

•

Genetics and Neuromuscular Diseases Source: www.mdausa.org http://www.mdausa.org/publications/gen_purp.html

•

MDA / Quest 4-2 / Get Outta Town Summary: All his life, Mora has loved hiking, and having to use a wheelchair full-time asa young man because of peroneal muscular atrophy didn't slow him down much. Source: www.mdausa.org http://www.mdausa.org/publications/Quest/q42outdo.html

•

MDA / Quest Vol 13 No 3 | Research Updates Summary: Known as hereditary motor and sensory neuropathy type 6, this condition causes a severe, early-onset peripheral nerve disorder, with vision impairment later on. Source: www.mdausa.org http://www.mdausa.org/publications/Quest/q133resup.html The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to Charcot-Marie-Tooth disease. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://health.nih.gov/index.asp. Under Search Health Topics, type Charcot-Marie-Tooth disease (or synonyms) into the search box, and click Search. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

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•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMD®Health: http://www.webmd.com/diseases_and_conditions/default.htm

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to Charcot-Marie-Tooth disease. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with Charcot-Marie-Tooth disease. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about Charcot-Marie-Tooth disease. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://sis.nlm.nih.gov/dirline.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. Simply type in Charcot-Marie-Tooth disease (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://healthhotlines.nlm.nih.gov/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type CharcotMarie-Tooth disease (or a synonym) into the search box, and click Submit Query.

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Resources for Patients and Families The following are organizations that provide support and advocacy for patient with genetic conditions and their families43: •

Genetic Alliance: http://geneticalliance.org

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Genetic and Rare Diseases Information Center: http://rarediseases.info.nih.gov/html/resources/info_cntr.html

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Madisons Foundation: http://www.madisonsfoundation.org/

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March of Dimes: http://www.marchofdimes.com

•

National Organization for Rare Disorders (NORD): http://www.rarediseases.org/ For More Information on Genetics

The following publications offer detailed information for patients about the science of genetics: •

What Is a Genome?: http://www.ncbi.nlm.nih.gov/About/primer/genetics_genome.html

•

A Science Called Genetics: http://publications.nigms.nih.gov/genetics/science.html

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Genetic Mapping: http://www.genome.gov/10000715

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Adapted from the National Library of Medicine: http://ghr.nlm.nih.gov/ghr/resource/patients.

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/archive//20040831/nichsr/ta101/ta10108.html

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on Charcot-Marie-Tooth disease: •

Basic Guidelines for Charcot-Marie-Tooth Disease Charcot-Marie-Tooth disease (hereditary) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000727.htm

•

Signs & Symptoms for Charcot-Marie-Tooth Disease Atrophy (loss of muscle mass) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003188.htm Decreased sensation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm Muscle Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Numbness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm

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Paresthesias Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm Sensory loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm Ulcers Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003228.htm Wasting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003188.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm •

Diagnostics and Tests for Charcot-Marie-Tooth Disease Biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003416.htm Muscle biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003924.htm Nerve biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003928.htm Nerve conduction tests Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003927.htm

•

Background Topics for Charcot-Marie-Tooth Disease Central Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002311.htm Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Myelin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002261.htm Palpation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002284.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

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•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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CHARCOT-MARIE-TOOTH DISEASE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 3-dimensional: 3-D. A graphic display of depth, width, and height. Three-dimensional radiation therapy uses computers to create a 3-dimensional picture of the tumor. This allows doctors to give the highest possible dose of radiation to the tumor, while sparing the normal tissue as much as possible. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abductor: A muscle that draws a part away from the median line. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Actin: Essential component of the cell skeleton. [NIH] Acupuncture Analgesia: Analgesia produced by the insertion of acupuncture needles at certain points in the body. These activate the small myelinated nerve fibers in the muscle which transmit impulses to the spinal cord and then activate three centers - the spinal cord, midbrain and pituitary hypothalamus - to produce analgesia. [NIH] Acute lymphoblastic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphocytic leukemia. [NIH] Acute lymphocytic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphoblastic leukemia. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenosine Triphosphate: Adenosine 5'-(tetrahydrogen triphosphate). An adenine nucleotide containing three phosphate groups esterified to the sugar moiety. In addition to its crucial roles in metabolism adenosine triphosphate is a neurotransmitter. [NIH] Adenovirus: A group of viruses that cause respiratory tract and eye infections. Adenoviruses used in gene therapy are altered to carry a specific tumor-fighting gene. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids,

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androgens, and glucocorticoids. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acid Substitution: The naturally occurring or experimentally induced replacement of one or more amino acids in a protein with another. If a functionally equivalent amino acid is substituted, the protein may retain wild-type activity. Substitution may also diminish or eliminate protein function. Experimentally induced substitution is often used to study enzyme activities and binding site properties. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amnion: The extraembryonic membrane which contains the embryo and amniotic fluid. [NIH]

Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneuploidy: The chromosomal constitution of cells which deviate from the normal by the addition or subtraction of chromosomes or chromosome pairs. In a normally diploid cell the loss of a chromosome pair is termed nullisomy (symbol: 2N-2), the loss of a single chromosome is monosomy (symbol: 2N-1), the addition of a chromosome pair is tetrasomy (symbol: 2N+2), the addition of a single chromosome is trisomy (symbol: 2N+1). [NIH] Angioedema: A vascular reaction involving the deep dermis or subcutaneous or submucal tissues, representing localized edema caused by dilatation and increased permeability of the

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capillaries, and characterized by development of giant wheals. [EU] Angioneurotic: Denoting a neuropathy affecting the vascular system; see angioedema. [EU] Angioneurotic Edema: Recurring attacks of transient edema suddenly appearing in areas of the skin or mucous membranes and occasionally of the viscera, often associated with dermatographism, urticaria, erythema, and purpura. [NIH] Angiotensinogen: An alpha-globulin of which a fragment of 14 amino acids is converted by renin to angiotensin I, the inactive precursor of angiotensin II. It is a member of the serpin superfamily. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Ankle Injuries: Harm or hurt to the ankle or ankle joint usually inflicted by an external source. [NIH] Ankle Joint: The joint that is formed by the inferior articular and malleolar articular surfaces of the tibia, the malleolar articular surface of the fibula, and the medial malleolar, lateral malleolar, and superior surfaces of the talus. [NIH] Anterior chamber: The space in front of the iris and behind the cornea. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is

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characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Aqueous humor: Clear, watery fluid that flows between and nourishes the lens and the cornea; secreted by the ciliary processes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arthropathy: Any joint disease. [EU] Articular: Of or pertaining to a joint. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary

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movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Base Sequence: The sequence of purines and pyrimidines in nucleic acids and polynucleotides. It is also called nucleotide or nucleoside sequence. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bewilderment: Impairment or loss of will power. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biogenesis: The origin of life. It includes studies of the potential basis for life in organic compounds but excludes studies of the development of altered forms of life through mutation and natural selection, which is evolution. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up

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of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. [NIH] Brain Diseases: Pathologic conditions affecting the brain, which is composed of the intracranial components of the central nervous system. This includes (but is not limited to) the cerebral cortex; intracranial white matter; basal ganglia; thalamus; hypothalamus; brain stem; and cerebellum. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Buffers: A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer. [NIH]

Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Carbohydrates: The largest class of organic compounds, including starches, glycogens, cellulose, gums, and simple sugars. Carbohydrates are composed of carbon, hydrogen, and oxygen in a ratio of Cn(H2O)n. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Cataracts: In medicine, an opacity of the crystalline lens of the eye obstructing partially or totally its transmission of light. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH]

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Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Communication: Any of several ways in which living cells of an organism communicate with one another, whether by direct contact between cells or by means of chemical signals carried by neurotransmitter substances, hormones, and cyclic AMP. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell motility: The ability of a cell to move. [NIH] Cell Movement: The movement of cells from one location to another. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Centrioles: Self-replicating, short, fibrous, rod-shaped organelles. Each centriole is a short cylinder containing nine pairs of peripheral microtubules, arranged so as to form the wall of the cylinder. [NIH] Centromere: The clear constricted portion of the chromosome at which the chromatids are joined and by which the chromosome is attached to the spindle during cell division. [NIH] Centrosome: The cell center, consisting of a pair of centrioles surrounded by a cloud of amorphous material called the pericentriolar region. During interphase, the centrosome nucleates microtubule outgrowth. The centrosome duplicates and, during mitosis, separates to form the two poles of the mitotic spindle (mitotic spindle apparatus). [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that

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develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervical Plexus: A network of nerve fibers originating in the upper four cervical spinal cord segments. The cervical plexus distributes cutaneous nerves to parts of the neck, shoulders, and back of the head, and motor fibers to muscles of the cervical spinal column, infrahyoid muscles, and the diaphragm. [NIH] Cesarean Section: Extraction of the fetus by means of abdominal hysterotomy. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chromosome Fragility: Susceptibility of chromosomes to breakage and translocation or other aberrations. Chromosome fragile sites are regions that show up in karyotypes as a gap (uncondensed stretch) on the chromatid arm. They are associated with chromosome break sites and other aberrations. A fragile site on the X chromosome is associated with fragile X syndrome. Fragile sites are designated by the letters "FRA" followed by the designation for the specific chromosome and a letter which refers to the different fragile sites on a chromosome (e.g. FRAXA). [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear

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to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Codon: A set of three nucleotides in a protein coding sequence that specifies individual amino acids or a termination signal (codon, terminator). Most codons are universal, but some organisms do not produce the transfer RNAs (RNA, transfer) complementary to all codons. These codons are referred to as unassigned codons (codons, nonsense). [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colchicine: A major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of gout, but it has been used also in the therapy of familial Mediterranean fever (periodic disease). [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colonoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the colon. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a

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bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concentric: Having a common center of curvature or symmetry. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connexins: A group of homologous proteins which form the intermembrane channels of gap junctions. The connexins are the products of an identified gene family which has both highly conserved and highly divergent regions. The variety contributes to the wide range of functional properties of gap junctions. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH]

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Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]

Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH]

Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of

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special organs. [NIH] De novo: In cancer, the first occurrence of cancer in the body. [NIH] Death Certificates: Official records of individual deaths including the cause of death certified by a physician, and any other required identifying information. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Demyelinating Diseases: Diseases characterized by loss or dysfunction of myelin in the central or peripheral nervous system. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Deoxyribonucleic: A polymer of subunits called deoxyribonucleotides which is the primary genetic material of a cell, the material equivalent to genetic information. [NIH] Deoxyribonucleic acid: A polymer of subunits called deoxyribonucleotides which is the primary genetic material of a cell, the material equivalent to genetic information. [NIH] Deoxyribonucleotides: A purine or pyrimidine base bonded to a deoxyribose containing a bond to a phosphate group. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU]

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Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrolytes: Substances that break up into ions (electrically charged particles) when they are dissolved in body fluids or water. Some examples are sodium, potassium, chloride, and calcium. Electrolytes are primarily responsible for the movement of nutrients into cells, and the movement of wastes out of cells. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryology: The study of the development of an organism during the embryonic and fetal stages of life. [NIH] Endocytosis: Cellular uptake of extracellular materials within membrane-limited vacuoles or microvesicles. Endosomes play a central role in endocytosis. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of

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the failed kidneys. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Estrogen: One of the two female sex hormones. [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Excrete: To get rid of waste from the body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exocytosis: Cellular release of material within membrane-limited vesicles by fusion of the vesicles with the cell membrane. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Eye Color: Color of the iris. [NIH]

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Eye Infections: Infection, moderate to severe, caused by bacteria, fungi, or viruses, which occurs either on the external surface of the eye or intraocularly with probable inflammation, visual impairment, or blindness. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fathers: Male parents, human or animal. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fibula: The bone of the lower leg lateral to and smaller than the tibia. In proportion to its length, it is the most slender of the long bones. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Founder Effect: The principle that when a small subgroup of a larger population establishes itself as a separate and isolated entity, its gene pool carries only a fraction of the genetic diversity of the parental population. This may result in an increased frequency of certain diseases in the subgroup, especially those diseases known to be autosomal recessive. [NIH] Frameshift: A type of mutation which causes out-of-phase transcription of the base sequence; such mutations arise from the addition or delection of nucleotide(s) in numbers other than 3 or multiples of 3. [NIH] Frameshift Mutation: A type of mutation in which a number of nucleotides not divisible by three is deleted from or inserted into a coding sequence, thereby causing an alteration in the reading frame of the entire sequence downstream of the mutation. These mutations may be induced by certain types of mutagens or may occur spontaneously. [NIH] Gait: Manner or style of walking. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Ganglioside: Protein kinase C's inhibitor which reduces ischemia-related brain damage. [NIH]

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Gap Junctions: Connections between cells which allow passage of small molecules and electric current. Gap junctions were first described anatomically as regions of close apposition between cells with a narrow (1-2 nm) gap between cell membranes. The variety in the properties of gap junctions is reflected in the number of connexins, the family of proteins which form the junctions. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Dosage: The number of copies of a given gene present in a cell or nucleus. An increase in gene dosage can result in the formation of higher levels of gene product, provided that the gene is not subject to autogenous regulation. [NIH] Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Products, rev: Trans-acting nuclear proteins whose functional expression are required for HIV viral replication. Specifically, the rev gene products are required for processing and translation of the HIV gag and env mRNAs, and thus rev regulates the expression of the viral structural proteins. rev can also regulate viral regulatory proteins. A cis-acting antirepression sequence (CAR) in env, also known as the rev-responsive element (RRE), is responsive to the rev gene product. rev is short for regulator of virion. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] Genes, env: DNA sequences that form the coding region for the viral envelope (env) proteins in retroviruses. The env genes contain a cis-acting RNA target sequence for the rev protein (= gene products, rev), termed the rev-responsive element (RRE). [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genomics: The systematic study of the complete DNA sequences (genome) of organisms. [NIH]

Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Germline mutation: A gene change in the body's reproductive cells (egg or sperm) that becomes incorporated into the DNA of every cell in the body of offspring; germline

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mutations are passed on from parents to offspring. Also called hereditary mutation. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glomerulosclerosis: Scarring of the glomeruli. It may result from diabetes mellitus (diabetic glomerulosclerosis) or from deposits in parts of the glomerulus (focal segmental glomerulosclerosis). The most common signs of glomerulosclerosis are proteinuria and kidney failure. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glutamine: A non-essential amino acid present abundantly throught the body and is involved in many metabolic processes. It is synthesized from glutamic acid and ammonia. It is the principal carrier of nitrogen in the body and is an important energy source for many cells. [NIH] Glutathione Transferase: A transferase that catalyzes the addition of aliphatic, aromatic, or heterocyclic radicals as well as epoxides and arene oxides to glutathione. Addition takes place at the sulfur atom. It also catalyzes the reduction of polyol nitrate by glutathione to polyol and nitrite. EC 2.5.1.18. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granule: A small pill made from sucrose. [EU] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Guanine: One of the four DNA bases. [NIH] Hair Color: Color of hair or fur. [NIH] Hammer: The largest of the three ossicles of the ear. [NIH]

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Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Hemochromatosis: A disease that occurs when the body absorbs too much iron. The body stores the excess iron in the liver, pancreas, and other organs. May cause cirrhosis of the liver. Also called iron overload disease. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemophilia: Refers to a group of hereditary disorders in which affected individuals fail to make enough of certain proteins needed to form blood clots. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Hereditary mutation: A gene change in the body's reproductive cells (egg or sperm) that becomes incorporated into the DNA of every cell in the body of offspring; hereditary mutations are passed on from parents to offspring. Also called germline mutation. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Heterogenous: Derived from a different source or species. Also called heterogenic. [NIH] Histones: Small chromosomal proteins (approx 12-20 kD) possessing an open, unfolded structure and attached to the DNA in cell nuclei by ionic linkages. Classification into the various types (designated histone I, histone II, etc.) is based on the relative amounts of arginine and lysine in each. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1

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isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hyperreflexia: Exaggeration of reflexes. [EU] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypokinesia: Slow or diminished movement of body musculature. It may be associated with basal ganglia diseases; mental disorders; prolonged inactivity due to illness; experimental protocols used to evaluate the physiologic effects of immobility; and other conditions. [NIH] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Hysterectomy: Excision of the uterus. [NIH] Hysterotomy: An incision in the uterus, performed through either the abdomen or the vagina. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infantile: Pertaining to an infant or to infancy. [EU] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

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Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Informed Consent: Voluntary authorization, given to the physician by the patient, with full comprehension of the risks involved, for diagnostic or investigative procedures and medical and surgical treatment. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Intermediate Filaments: Cytoplasmic filaments intermediate in diameter (about 10 nanometers) between the microfilaments and the microtubules. They may be composed of any of a number of different proteins and form a ring around the cell nucleus. [NIH] Interphase: The interval between two successive cell divisions during which the chromosomes are not individually distinguishable and DNA replication occurs. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Karyotype: The characteristic chromosome complement of an individual, race, or species as defined by their number, size, shape, etc. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney

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failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kinesin: A microtubule-associated mechanical adenosine triphosphatase, that uses the energy of ATP hydrolysis to move organelles along microtubules toward the plus end of the microtubule. The protein is found in squid axoplasm, optic lobes, and in bovine brain. Bovine kinesin is a heterotetramer composed of two heavy (120 kDa) and two light (62 kDa) chains. EC 3.6.1.-. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Leukemia: Cancer of blood-forming tissue. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipodystrophy: A collection of rare conditions resulting from defective fat metabolism and characterized by atrophy of the subcutaneous fat. They include total, congenital or acquired, partial, abdominal infantile, and localized lipodystrophy. [NIH] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph

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nodes, that produce and store cells that fight infection and disease. [NIH] Lymphoblastic: One of the most aggressive types of non-Hodgkin lymphoma. [NIH] Lymphoblasts: Interferon produced predominantly by leucocyte cells. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Lysosome: A sac-like compartment inside a cell that has enzymes that can break down cellular components that need to be destroyed. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malformation: A morphologic developmental process. [EU]

defect

resulting

from

an

intrinsically

abnormal

Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammography: Radiographic examination of the breast. [NIH] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. [NIH] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH]

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Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]

Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microfilaments: The smallest of the cytoskeletal filaments. They are composed chiefly of actin. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitotic: Cell resulting from mitosis. [NIH]

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Mitotic Spindle Apparatus: An organelle consisting of three components: (1) the astral microtubules, which form around each centrosome and extend to the periphery; (2) the polar microtubules which extend from one spindle pole to the equator; and (3) the kinetochore microtubules, which connect the centromeres of the various chromosomes to either centrosome. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monosomy: The condition in which one chromosome of a pair is missing. In a normally diploid cell it is represented symbolically as 2N-1. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Mosaicism: The occurrence in an individual of two or more cell populations of different chromosomal constitutions, derived from a single zygote, as opposed to chimerism in which the different cell populations are derived from more than one zygote. [NIH] Motility: The ability to move spontaneously. [EU] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]

Motor Neurons: Neurons which activate muscle cells. [NIH] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Diseases: Acquired, familial, and congenital disorders of skeletal muscle and smooth muscle. [NIH] Mutagens: Chemical agents that increase the rate of genetic mutation by interfering with the function of nucleic acids. A clastogen is a specific mutagen that causes breaks in

Dictionary 187

chromosomes. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myelin Sheath: The lipid-rich sheath investing many axons in both the central and peripheral nervous systems. The myelin sheath is an electrical insulator and allows faster and more energetically efficient conduction of impulses. The sheath is formed by the cell membranes of glial cells (Schwann cells in the peripheral and oligodendroglia in the central nervous system). Deterioration of the sheath in demyelinating diseases is a serious clinical problem. [NIH] Myopathy: Any disease of a muscle. [EU] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Natural selection: A part of the evolutionary process resulting in the survival and reproduction of the best adapted individuals. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Nephropathy: Disease of the kidneys. [EU] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH] Neuroeffector Junction: The synapse between a neuron (presynaptic) and an effector cell other than another neuron (postsynaptic). Neuroeffector junctions include synapses onto muscles and onto secretory cells. [NIH] Neurofilaments: Bundle of neuronal fibers. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neurologic Manifestations: Clinical signs and symptoms caused by nervous system injury or dysfunction. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular

Blockade:

The

intentional

interruption

of

transmission

at

the

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Charcot-Marie-Tooth Disease

neuromuscular junction by external agents, usually neuromuscular blocking agents. It is distinguished from nerve block in which nerve conduction is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce muscle relaxation as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here. [NIH] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neurosciences: The scientific disciplines concerned with the embryology, anatomy, physiology, biochemistry, pharmacology, etc., of the nervous sytem. [NIH] Neurosyphilis: A late form of syphilis that affects the brain and may lead to dementia and death. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]

Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Envelope: The membrane system of the cell nucleus that surrounds the nucleoplasm. It consists of two concentric membranes separated by the perinuclear space. The structures of the envelope where it opens to the cytoplasm are called the nuclear pores (nuclear pore). [NIH] Nuclear Pore: An opening through the nuclear envelope formed by the nuclear pore complex which transports nuclear proteins or RNA into or out of the cell nucleus and which, under some conditions, acts as an ion channel. [NIH] Nucleates: Bacteria-inducing ice nucleation at warm temperatures (between zero and minus ten degrees C.). [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the

Dictionary 189

chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nurse Practitioners: Nurses who are specially trained to assume an expanded role in providing medical care under the supervision of a physician. [NIH] Oligodendroglia: A class of neuroglial (macroglial) cells in the central nervous system. Oligodendroglia may be called interfascicular, perivascular, or perineuronal satellite cells according to their location. The most important recognized function of these cells is the formation of the insulating myelin sheaths of axons in the central nervous system. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Ossicles: The hammer, anvil and stirrup, the small bones of the middle ear, which transmit the vibrations from the tympanic membrane to the oval window. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidative Phosphorylation: Electron transfer through the cytochrome system liberating free energy which is transformed into high-energy phosphate bonds. [NIH] Oxides: Binary compounds of oxygen containing the anion O(2-). The anion combines with metals to form alkaline oxides and non-metals to form acidic oxides. [NIH] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is

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comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paraparesis: Mild to moderate loss of bilateral lower extremity motor function, which may be a manifestation of spinal cord diseases; peripheral nervous system diseases; muscular diseases; intracranial hypertension; parasagittal brain lesions; and other conditions. [NIH] Paraplegia: Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with spinal cord diseases, although brain diseases; peripheral nervous system diseases; neuromuscular diseases; and muscular diseases may also cause bilateral leg weakness. [NIH] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Particle: A tiny mass of material. [EU] Paternity: Establishing the father relationship of a man and a child. [NIH] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] PDQ: Physician Data Query. PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information is available on the CancerNet Web site, and more specific information about PDQ can be found at http://cancernet.nci.nih.gov/pdq.html. [NIH] Pedigree: A record of one's ancestors, offspring, siblings, and their offspring that may be used to determine the pattern of certain genes or disease inheritance within a family. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peripheral Nerves: The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. [NIH]

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Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Peroneal Nerve: The lateral of the two terminal branches of the sciatic nerve. The peroneal (or fibular) nerve provides motor and sensory innervation to parts of the leg and foot. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Phrenic Nerve: The motor nerve of the diaphragm. The phrenic nerve fibers originate in the cervical spinal column (mostly C4) and travel through the cervical plexus to the diaphragm. [NIH]

Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized

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by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plastids: Self-replicating cytoplasmic organelles of plant and algal cells that contain pigments and may synthesize and accumulate various substances. Plastids are used in phylogenetic studies. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Pneumonia: Inflammation of the lungs. [NIH] Point Mutation: A mutation caused by the substitution of one nucleotide for another. This results in the DNA molecule having a change in a single base pair. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polyneuropathies: Diseases of multiple peripheral nerves. The various forms are categorized by the type of nerve affected (e.g., sensory, motor, or autonomic), by the distribution of nerve injury (e.g., distal vs. proximal), by nerve component primarily affected (e.g., demyelinating vs. axonal), by etiology, or by pattern of inheritance. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or

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symptom that heralds another. [EU] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progeria: An abnormal congenital condition characterized by premature aging in children, where all the changes of cell senescence occur. It is manifested by premature greying, hair loss, hearing loss, cataracts, arthritis,osteoporosis, diabetes mellitus, atrophy of subcutaneous fat, skeletal hypoplasia, and accelerated atherosclerosis. Many affected individuals develop malignant tumors, especially sarcomas. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Protein Transport: The process of moving proteins from one cellular compartment (including extracellular) to another by various sorting and transport mechanisms such as gated transport, protein translocation, and vesicular transport. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with

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formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Ptosis: 1. Prolapse of an organ or part. 2. Drooping of the upper eyelid from paralysis of the third nerve or from sympathetic innervation. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Pyrimidines: A family of 6-membered heterocyclic compounds occurring in nature in a wide variety of forms. They include several nucleic acid constituents (cytosine, thymine, and uracil) and form the basic structure of the barbiturates. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together

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in either parent; usually applied to linked genes. [EU] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Reproductive cells: Egg and sperm cells. Each mature reproductive cell carries a single set of 23 chromosomes. [NIH] Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Ribonucleic acid: RNA. One of the two nucleic acids found in all cells. The other is deoxyribonucleic acid (DNA). Ribonucleic acid transfers genetic information from DNA to proteins produced by the cell. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Rod: A reception for vision, located in the retina. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Scatter: The extent to which relative success and failure are divergently manifested in qualitatively different tests. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the tibial nerve and the peroneal nerve. [NIH]

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Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sedimentation: The act of causing the deposit of sediment, especially by the use of a centrifugal machine. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senescence: The bodily and mental state associated with advancing age. [NIH] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Sequester: A portion of dead bone which has become detached from the healthy bone tissue, as occurs in necrosis. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the

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one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatic cells: All the body cells except the reproductive (germ) cells. [NIH] Somatic mutations: Alterations in DNA that occur after conception. Somatic mutations can occur in any of the cells of the body except the germ cells (sperm and egg) and therefore are not passed on to children. These alterations can (but do not always) cause cancer or other diseases. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU]

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Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrin: A high molecular weight (220-250 kDa) water-soluble protein which can be extracted from erythrocyte ghosts in low ionic strength buffers. The protein contains no lipids or carbohydrates, is the predominant species of peripheral erythrocyte membrane proteins, and exists as a fibrous coating on the inner, cytoplasmic surface of the membrane. [NIH]

Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spermatogenesis: Process of formation and development of spermatozoa, including spermatocytogenesis and spermiogenesis. [NIH] Spermatozoa: Mature male germ cells that develop in the seminiferous tubules of the testes. Each consists of a head, a body, and a tail that provides propulsion. The head consists mainly of chromatin. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Diseases: Pathologic conditions which feature spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. [NIH] Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included. [NIH] Spinocerebellar Degenerations: A heterogenous group of degenerative syndromes marked by progressive cerebellar dysfunction either in isolation or combined with other neurologic manifestations. Sporadic and inherited subtypes occur. Inheritance patterns include autosomal dominant, autosomal recessive, and X-linked. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH]

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Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stroma: The middle, thickest layer of tissue in the cornea. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the comfort and quality of life of people who have cancer. [NIH] Sural Nerve: A branch of the tibial nerve which supplies sensory innervation to parts of the lower leg and foot. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Vesicles: Membrane-bound compartments which contain transmitter molecules. Synaptic vesicles are concentrated at presynaptic terminals. They actively sequester transmitter molecules from the cytoplasm. In at least some synapses, transmitter release occurs by fusion of these vesicles with the presynaptic membrane, followed by exocytosis of their contents. [NIH] Systemic: Affecting the entire body. [NIH] Talus: The second largest of the tarsal bones and occupies the middle and upper part of the tarsus. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Terminator: A DNA sequence sited at the end of a transcriptional unit that signals the end of transcription. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH]

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Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thoracic: Having to do with the chest. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tibia: The second longest bone of the skeleton. It is located on the medial side of the lower leg, articulating with the fibula laterally, the talus distally, and the femur proximally. [NIH] Tibial Nerve: The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trabecular Meshwork: A porelike structure surrounding the entire circumference of the anterior chamber through which aqueous humor circulates to the canal of Schlemm. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and

Dictionary 201

branching into the right and left main bronchi. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transcutaneous: Transdermal. [EU] Transcutaneous Electric Nerve Stimulation: Electrical stimulation of nerves and/or muscles to relieve pain; it is used less frequently to produce anesthesia. The optimal placements of electrodes or "trigger points" may correspond with acupuncture analgesia points. TENS is sometimes referred to as acupuncture-like when using a low frequency stimulus. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transport Vesicles: Vesicles that are involved in shuttling cargo from the interior of the cell to the cell surface, from the cell surface to the interior, across the cell or around the cell to various locations. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Trinucleotide Repeat Expansion: DNA region comprised of a variable number of repetitive, contiguous trinucleotide sequences. The presence of these regions is associated with diseases such as Fragile X Syndrome and myotonic dystrophy. Many chromosome fragile sites (chromosome fragility) contain expanded trinucleotide repeats. [NIH] Trinucleotide Repeats: Microsatellite repeats consisting of three nucleotides dispersed in the euchromatic arms of chromosomes. [NIH] Trisomy: The possession of a third chromosome of any one type in an otherwise diploid cell. [NIH]

Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH]

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Tubulin: A microtubule subunit protein found in large quantities in mammalian brain. It has also been isolated from sperm flagella, cilia, and other sources. Structurally, the protein is a dimer with a molecular weight of approximately 120,000 and a sedimentation coefficient of 5.8S. It binds to colchicine, vincristine, and vinblastine. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulnar Nerve: A major nerve of the upper extremity. In humans, the fibers of the ulnar nerve originate in the lower cervical and upper thoracic spinal cord (usually C7 to T1), travel via the medial cord of the brachial plexus, and supply sensory and motor innervation to parts of the hand and forearm. [NIH] Ultraviolet radiation: Invisible rays that are part of the energy that comes from the sun. UV radiation can damage the skin and cause melanoma and other types of skin cancer. UV radiation that reaches the earth's surface is made up of two types of rays, called UVA and UVB rays. UVB rays are more likely than UVA rays to cause sunburn, but UVA rays pass deeper into the skin. Scientists have long thought that UVB radiation can cause melanoma and other types of skin cancer. They now think that UVA radiation also may add to skin damage that can lead to skin cancer and cause premature aging. For this reason, skin specialists recommend that people use sunscreens that reflect, absorb, or scatter both kinds of UV radiation. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vacuoles: Any spaces or cavities within a cell. They may function in digestion, storage, secretion, or excretion. [NIH] Valine: A branched-chain essential amino acid that has stimulant activity. It promotes muscle growth and tissue repair. It is a precursor in the penicillin biosynthetic pathway. [NIH]

Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in

Dictionary 203

nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vinblastine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. It is a mitotic inhibitor. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vocal cord: The vocal folds of the larynx. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

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Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zygote: The fertilized ovum. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

205

INDEX 3 3-dimensional, 114, 145, 163 A Abdomen, 163, 176, 181, 183, 190, 198, 203 Abdominal, 52, 163, 170, 174, 183, 189 Abductor, 53, 163 Acceptor, 163, 189 Actin, 12, 115, 163, 185, 187 Acupuncture Analgesia, 163, 201 Acute lymphoblastic leukemia, 163 Acute lymphocytic leukemia, 163 Adaptability, 163, 169 Adenine, 108, 163, 194 Adenosine, 109, 163, 183, 191 Adenosine Triphosphate, 109, 163, 191 Adenovirus, 141, 163 Adolescence, 3, 163 Adrenal Cortex, 163, 193 Adverse Effect, 164, 196 Aerobic, 54, 164, 185 Algorithms, 164, 167 Alleles, 110, 127, 164 Alpha-1, 123, 127, 164 Alternative medicine, 164 Amino Acid Substitution, 91, 164 Ammonia, 164, 179 Amnion, 164 Amniotic Fluid, 136, 138, 164 Anatomical, 164, 170, 181, 196 Anemia, 122, 123, 126, 127, 132, 152, 164 Anesthesia, 92, 164, 188, 201 Aneuploidy, 120, 121, 164 Angioedema, 164, 165 Angioneurotic, 70, 165 Angioneurotic Edema, 70, 165 Angiotensinogen, 165, 195 Animal model, 52, 165 Anions, 165, 182 Ankle, 4, 64, 82, 83, 90, 165 Ankle Injuries, 4, 165 Ankle Joint, 82, 165 Anterior chamber, 165, 182, 200 Antibacterial, 165, 198 Antibiotic, 165, 190, 198 Antibody, 115, 165, 171, 180, 181, 194 Anticoagulant, 165, 193 Antigen, 56, 165, 172, 180, 181 Anuria, 165, 182 Anus, 165, 171, 182

Aponeurosis, 165, 177 Apoptosis, 20, 109, 118, 165 Aqueous, 166, 167, 173, 200 Aqueous humor, 166, 200 Arginine, 15, 21, 26, 27, 49, 166, 180 Arterial, 166, 181, 193 Arteries, 166, 167, 173 Arterioles, 166, 167 Arthropathy, 82, 166 Articular, 165, 166 Asymptomatic, 166 Ataxia, 83, 93, 151, 152, 166, 169, 200 Atrophy, 151, 152, 160, 166, 183, 193 Atypical, 131, 166 Auditory, 52, 156, 166 Autoimmune disease, 166, 186 Autonomic Nervous System, 166, 191 Axons, 4, 5, 21, 35, 36, 166, 187, 189, 190, 193 B Bacteria, 24, 43, 107, 115, 119, 165, 166, 175, 177, 185, 188, 198, 201, 202 Basal Ganglia, 166, 168, 177, 181 Basal Ganglia Diseases, 166, 181 Base Sequence, 119, 167, 177 Benign, 53, 167, 177 Bewilderment, 167, 172 Bilateral, 53, 54, 63, 86, 167, 190 Bile, 167, 177, 183 Biochemical, 123, 164, 167, 183, 196 Biogenesis, 44, 167 Biopsy, 72, 93, 161, 167 Biosynthesis, 167, 196 Biotechnology, 6, 50, 104, 114, 141, 143, 148, 150, 151, 152, 153, 167 Bladder, 167, 186, 193, 202 Blastocyst, 167, 172, 191 Blood Glucose, 167, 180 Blood pressure, 126, 167, 168, 181, 186 Blood vessel, 48, 130, 167, 168, 170, 179, 182, 197, 199, 200, 202 Bone Marrow, 142, 163, 167, 178, 183 Brachial, 168, 184, 202 Brachial Plexus, 168, 184, 202 Brain Diseases, 168, 190 Buccal, 136, 138, 168 Buffers, 168, 198 C Calcium, 168, 171, 175, 197

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Carbohydrates, 168, 169, 198 Carcinogenic, 168, 182, 193 Carcinogens, 168, 189 Cardiac, 27, 54, 168, 176 Cardiovascular, 145, 168, 196 Cardiovascular disease, 145, 168 Case report, 52, 82, 168 Case series, 84, 168 Cataracts, 168, 193 Cations, 168, 182 Cause of Death, 169, 174 Cell Communication, 19, 169 Cell Cycle, 117, 118, 169, 171 Cell Death, 20, 39, 118, 165, 169, 187 Cell Differentiation, 35, 169, 197 Cell Division, 11, 39, 110, 117, 118, 130, 131, 166, 169, 182, 184, 185, 192, 193, 196 Cell membrane, 11, 19, 32, 41, 169, 174, 176, 178, 187, 191 Cell motility, 20, 169 Cell Movement, 11, 169 Cell proliferation, 169, 197 Cell Respiration, 169, 185 Central Nervous System, 67, 166, 168, 169, 177, 179, 186, 187, 189, 196 Centrioles, 169, 193 Centromere, 110, 113, 169 Centrosome, 11, 12, 169, 186 Cerebellar, 66, 166, 169, 195, 198, 201 Cerebellar Diseases, 166, 169, 201 Cerebellum, 168, 169, 195 Cerebral, 166, 168, 169, 170, 176, 197 Cerebral Cortex, 166, 168, 169 Cerebral Palsy, 170, 197 Cerebrovascular, 167, 168, 170, 200 Cerebrum, 169, 170, 201 Cervical, 168, 170, 184, 191, 202 Cervical Plexus, 170, 191 Cesarean Section, 52, 170 Chemotherapy, 170 Chin, 170, 185 Cholesterol, 14, 109, 167, 170, 173 Chromatin, 166, 170, 184, 198 Chromosomal, 88, 118, 120, 121, 131, 132, 133, 135, 164, 170, 180, 186 Chromosome, 3, 4, 5, 9, 10, 12, 13, 14, 15, 16, 17, 19, 21, 22, 23, 25, 27, 28, 30, 32, 34, 36, 37, 38, 40, 42, 44, 45, 46, 47, 49, 51, 63, 68, 72, 73, 74, 75, 76, 77, 110, 111, 112, 113, 114, 117, 118, 120, 121, 127, 128, 131, 132, 137, 140, 164, 169, 170, 182, 183, 186, 196, 201

Chromosome Fragility, 170, 201 Chronic, 170, 175, 181, 182, 183, 192, 199 Chronic renal, 170, 192 Cirrhosis, 170, 180 CIS, 170, 178 Cisplatin, 92, 170 Clinical Medicine, 144, 171, 192 Clinical trial, 141, 142, 145, 148, 171, 190, 194 Cloning, 167, 171 Codon, 58, 115, 171 Cofactor, 171, 193, 200 Colchicine, 171, 202 Collagen, 171, 177 Colon, 124, 171 Colonoscopy, 126, 171 Comorbidity, 59, 171 Complement, 171, 172, 182 Complementary medicine, 96, 172 Computational Biology, 148, 150, 172 Concentric, 19, 172, 188 Conception, 117, 172, 177, 197 Conduction, 66, 84, 93, 94, 155, 161, 172, 187, 188 Confusion, 124, 172, 175, 202 Conjunctiva, 172, 201 Connective Tissue, 168, 171, 172, 177, 190, 199 Connexins, 172, 178 Consciousness, 172, 174 Constriction, 110, 113, 172, 182 Consultation, 132, 133, 136, 137, 172 Contraindications, ii, 172 Coordination, 169, 173, 186 Coronary, 168, 173 Coronary heart disease, 168, 173 Corpus, 173, 193 Corpus Luteum, 173, 193 Cranial, 169, 173, 187, 190, 191, 201 Creatine, 88, 155, 173 Creatinine, 173, 183 Crossing-over, 173, 195 Cyclic, 169, 173 Cysteine, 26, 27, 173, 199 Cystine, 173 Cytochrome, 173, 189 Cytoplasm, 41, 107, 108, 109, 115, 166, 169, 173, 179, 184, 188, 195, 199 Cytosine, 27, 108, 173, 194 Cytoskeleton, 11, 20, 173, 185 Cytotoxic, 173, 197 Cytotoxicity, 171, 173

Index 207

D De novo, 28, 55, 57, 84, 118, 174 Death Certificates, 126, 174 Decompression, 81, 174 Decompression Sickness, 174 Degenerative, 174, 198 Deletion, 58, 70, 73, 88, 120, 165, 174 Dementia, 53, 121, 174, 188 Demyelinating Diseases, 174, 187 Dendrites, 174, 188 Deoxyribonucleic, 108, 174, 195 Deoxyribonucleic acid, 108, 174, 195 Deoxyribonucleotides, 174 Depolarization, 31, 174, 197 Diabetes Mellitus, 174, 179, 180, 193 Diagnostic procedure, 174 Diaphragm, 59, 93, 170, 174, 191 Digestion, 167, 174, 183, 198, 202 Diploid, 164, 174, 186, 192, 201 Direct, iii, 77, 136, 137, 138, 169, 171, 174, 175, 195, 199 Discrimination, 138, 139, 144, 175 Disorientation, 172, 174, 175 Distal, 9, 10, 15, 16, 22, 69, 78, 102, 103, 175, 191, 192, 193, 194 Dopamine, 175, 188, 191 Dorsal, 175, 192, 198 Dorsum, 175, 177 Dysplasia, 29, 62, 71, 152, 175 Dystrophy, 7, 27, 28, 29, 151, 155, 156, 175 E Edema, 164, 165, 175 Elective, 89, 175 Electrolytes, 167, 175, 182 Electrons, 167, 175, 182, 184, 189, 194 Elementary Particles, 175, 184, 194 Embryo, 117, 118, 119, 127, 164, 167, 169, 175 Embryology, 175, 188 Endocytosis, 11, 175 Endotoxin, 175, 202 End-stage renal, 170, 175, 192 Environmental Exposure, 176, 189 Environmental Health, 147, 148, 176 Enzyme, 15, 48, 49, 85, 109, 115, 164, 176, 178, 193, 195, 197, 200, 203, 204 Epigastric, 176, 189 Epinephrine, 175, 176, 188, 202 Epithelial, 41, 176 Epithelium, 176, 182 Erythema, 165, 176, 202 Erythrocytes, 164, 167, 176

Essential Tremor, 93, 151, 176 Estrogen, 25, 176 Ethnic Groups, 4, 132, 135, 176 Eukaryotic Cells, 176, 181, 189 Excitability, 81, 176 Excitatory, 176, 179 Excrete, 165, 176, 182 Exocrine, 176, 189 Exocytosis, 176, 199 Extracellular, 32, 172, 175, 176, 177, 193 Extracellular Matrix, 172, 176, 177 Extremity, 168, 176, 184, 190, 195, 202 Eye Color, 119, 176 Eye Infections, 163, 177 F Family Planning, 148, 177 Fat, 9, 167, 173, 177, 183, 186, 193, 197 Fathers, 5, 127, 177 Fatty acids, 59, 177 Fetus, 135, 136, 138, 142, 170, 177, 191, 193, 198, 202 Fibroblasts, 83, 177 Fibrosis, 119, 122, 126, 127, 152, 177, 196 Fibula, 165, 177, 200 Fluorescence, 64, 77, 177 Fold, 93, 177 Forearm, 167, 177, 184, 202 Founder Effect, 18, 51, 68, 177 Frameshift, 120, 177 Frameshift Mutation, 120, 177 G Gait, 4, 66, 85, 169, 177 Gallbladder, 163, 177 Ganglia, 166, 177, 187, 191 Ganglion, 177 Ganglioside, 16, 18, 66, 177 Gap Junctions, 19, 172, 178 Gas, 164, 174, 178, 180, 188, 195 Gas exchange, 178, 195 Gastrin, 178, 180 Gene Dosage, 56, 178 Gene Expression, 115, 116, 152, 178 Gene Products, rev, 178 Gene Therapy, 140, 141, 142, 163, 178 Genes, env, 126, 178 Genetic testing, 129, 133, 134, 135, 136, 137, 138, 139, 144, 178 Genomics, 73, 77, 145, 178 Genotype, 33, 68, 178, 191 Germ Cells, 118, 142, 178, 184, 197, 198 Germline mutation, 118, 178, 180 Gland, 163, 179, 189, 190, 193, 198, 200

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Glomerular, 179, 183 Glomeruli, 179 Glomerulonephritis, 64, 179 Glomerulosclerosis, 64, 179 Glomerulus, 179 Glucose, 151, 167, 174, 179, 180 Glutamate, 179 Glutamic Acid, 11, 15, 49, 179, 188 Glutamine, 23, 179 Glutathione Transferase, 63, 179 Glycine, 15, 49, 179, 188, 196 Glycoprotein, 179, 200, 202 Governing Board, 179, 192 Grafting, 179, 181 Granule, 179, 195 Granulocytes, 179, 183, 197, 203 Gravis, 80, 179 Guanine, 108, 179, 194 H Hair Color, 119, 179 Hammer, 4, 6, 179, 189 Heart attack, 168, 180 Hemochromatosis, 135, 180 Hemodialysis, 180, 183 Hemoglobin, 109, 164, 176, 180, 183 Hemoglobinopathies, 178, 180 Hemoglobinuria, 151, 180 Hemophilia, 127, 152, 180 Hemorrhage, 180, 194, 199 Hereditary mutation, 118, 179, 180 Heredity, 110, 178, 180 Heterogeneity, 52, 67, 70, 77, 180 Heterogenous, 180, 198 Histones, 110, 170, 180 Homologous, 164, 172, 173, 178, 180, 196, 199 Hormonal, 166, 180 Hormone, 115, 176, 178, 180, 185, 193, 197, 200 Hydrogen, 163, 167, 168, 180, 186, 189, 194 Hydrolysis, 170, 181, 183, 191, 192, 193 Hyperreflexia, 56, 181 Hypertension, 168, 181, 190 Hypokinesia, 181, 190 Hypoplasia, 181, 193 Hysterectomy, 52, 181 Hysterotomy, 170, 181 I Immune response, 165, 166, 181, 203 Immune system, 181, 184, 186, 202, 203 Immunodeficiency, 151, 181 Immunologic, 52, 181

Impairment, 4, 69, 83, 157, 166, 167, 177, 181, 185 Implantation, 57, 172, 181 In situ, 64, 77, 181 In Situ Hybridization, 64, 77, 181 In vitro, 178, 181 In vivo, 178, 181 Infancy, 32, 145, 181 Infantile, 181, 183 Infection, 20, 24, 48, 177, 181, 184, 188, 190, 199, 202, 203 Infiltration, 179, 182 Inflammation, 20, 48, 141, 177, 182, 192 Informed Consent, 136, 139, 144, 182 Initiation, 182, 201 Innervation, 168, 182, 184, 191, 194, 195, 199, 200, 202 Inorganic, 170, 182 Insulator, 182, 186, 187 Intermediate Filaments, 26, 182 Interphase, 169, 182 Intestinal, 182, 184 Intestines, 163, 182, 196 Intracellular, 32, 67, 181, 182, 185, 197 Invasive, 182, 184 Involuntary, 166, 176, 182, 195 Ions, 19, 167, 168, 175, 180, 182 Iris, 45, 165, 176, 182 Ischemia, 166, 177, 182 K Karyotype, 112, 182 Kidney Disease, 64, 147, 152, 182 Kidney Failure, 121, 175, 179, 182, 183 Kidney Failure, Acute, 182, 183 Kidney Failure, Chronic, 183 Kinesin, 22, 23, 183 L Larynx, 183, 200, 203 Latency, 89, 183 Lesion, 95, 183 Leucine, 9, 23, 43, 183 Leucocyte, 164, 183, 184 Leukemia, 178, 183 Ligament, 183, 193 Linkage, 50, 51, 67, 68, 70, 74, 75, 76, 77, 88, 95, 183 Lipid, 14, 183, 186, 187 Lipodystrophy, 8, 10, 183 Lipopolysaccharide, 24, 25, 183 Liver, 19, 116, 163, 167, 170, 177, 180, 183 Localization, 76, 77, 183 Localized, 54, 164, 181, 183, 192, 202

Index 209

Lumbar, 183, 195, 200 Lymphatic, 181, 183, 192 Lymphoblastic, 184 Lymphoblasts, 163, 184 Lymphocytes, 165, 183, 184, 203 Lymphoid, 183, 184 Lymphoma, 184 Lysine, 11, 49, 180, 184 Lysosome, 44, 184 M Macrophage, 118, 184 Magnetic Resonance Imaging, 56, 184 Magnetic Resonance Spectroscopy, 51, 184 Malabsorption, 151, 184 Malformation, 184 Malignant, 184, 193 Malignant tumor, 184, 193 Malnutrition, 166, 184, 186 Mammography, 126, 184 Mastication, 184, 201 Medial, 165, 184, 200, 202 Median Nerve, 84, 184 Medical Records, 126, 139, 184 MEDLINE, 148, 150, 152, 184 Meiosis, 117, 184, 199 Melanin, 182, 185, 191, 202 Melanocytes, 185 Melanoma, 185, 202 Membrane Proteins, 185, 198 Memory, 174, 185 Meninges, 169, 185, 198 Menstrual Cycle, 185, 193 Mental, iv, 131, 133, 135, 147, 149, 153, 170, 172, 174, 175, 181, 185, 194, 195, 196, 202 Mental Retardation, 131, 133, 135, 153, 185 Microbe, 185, 200 Microbiology, 166, 185 Microfilaments, 182, 185 Microorganism, 171, 185, 203 Microtubules, 11, 23, 169, 182, 183, 185, 186 Miscarriage, 138, 185 Mitochondria, 17, 18, 23, 30, 67, 108, 109, 121, 127, 128, 185, 189 Mitochondrial Swelling, 185, 187 Mitosis, 117, 166, 169, 185 Mitotic, 169, 185, 186, 203 Mitotic Spindle Apparatus, 169, 186 Modification, 54, 186, 194

Molecule, 31, 108, 109, 110, 115, 165, 167, 172, 180, 181, 186, 189, 192, 194, 197, 202 Monitor, 173, 186, 188 Mononuclear, 186, 202 Monosomy, 121, 164, 186 Morphological, 95, 175, 185, 186 Morphology, 30, 186 Mosaicism, 118, 186 Motility, 186, 196 Motor nerve, 186, 191 Motor Neurons, 9, 186 Mucinous, 177, 186 Multiple sclerosis, 55, 186 Muscle Fibers, 186, 187 Muscle Relaxation, 186, 188 Muscular Atrophy, 16, 69, 102, 103, 151, 155, 157, 186 Muscular Diseases, 186, 190 Mutagens, 177, 186 Myelin, 4, 5, 13, 19, 31, 32, 33, 35, 39, 40, 41, 42, 45, 55, 57, 58, 61, 62, 63, 69, 73, 81, 83, 91, 161, 174, 186, 187, 189, 196 Myelin Sheath, 19, 31, 32, 57, 187, 189 Myopathy, 12, 81, 187 Myosin, 187 Myotonic Dystrophy, 87, 130, 151, 187, 201 N Natural selection, 167, 187 NCI, 1, 146, 170, 187, 190 Necrosis, 24, 165, 187, 196 Neoplasia, 187 Nephropathy, 54, 81, 182, 187 Nerve Endings, 23, 187 Nervous System, 17, 19, 130, 151, 166, 169, 187, 188, 189, 191 Neural, 54, 187 Neuralgia, 63, 187 Neuroeffector Junction, 187 Neurofilaments, 20, 21, 37, 187 Neurologic, 10, 87, 155, 187, 198 Neurologic Manifestations, 187, 198 Neuromuscular, 63, 67, 73, 75, 76, 84, 93, 155, 157, 187, 188, 190 Neuromuscular Blockade, 84, 187 Neuromuscular Junction, 188 Neuronal, 50, 53, 58, 72, 82, 187, 188, 190 Neurons, 18, 63, 67, 174, 176, 177, 186, 187, 188, 199 Neurophysiology, 51, 59, 89, 94, 174, 188 Neurosciences, 7, 188 Neurosyphilis, 188, 190

210

Charcot-Marie-Tooth Disease

Neurotoxicity, 188 Neurotransmitter, 163, 169, 175, 179, 188, 197 Niacin, 188, 201 Nitrogen, 174, 179, 183, 188, 201 Nuclear, 8, 26, 28, 29, 108, 166, 175, 176, 177, 178, 187, 188 Nuclear Envelope, 26, 29, 108, 188 Nuclear Pore, 188 Nucleates, 169, 188 Nuclei, 175, 178, 180, 184, 185, 188, 194 Nucleic acid, 167, 173, 181, 186, 188, 189, 194, 195 Nurse Practitioners, 136, 189 O Oligodendroglia, 187, 189 Oliguria, 182, 183, 189 Oncogene, 43, 189 Orbit, 189 Orbital, 54, 189 Organelles, 107, 108, 169, 173, 183, 185, 189, 192 Ossicles, 179, 189 Osteoporosis, 189, 193 Ovaries, 135, 189, 196 Ovum, 173, 189, 193, 203, 204 Oxidation, 83, 163, 173, 189 Oxidative Phosphorylation, 109, 189 Oxides, 179, 189 P Palsy, 88, 189 Pancreas, 19, 163, 180, 189, 190 Pancreatic, 190 Pancreatic cancer, 190 Paralysis, 53, 63, 92, 93, 190, 194, 197 Paraparesis, 190 Paraplegia, 87, 190 Paresis, 56, 93, 190 Parkinsonism, 53, 190 Paroxysmal, 151, 190 Particle, 190, 197, 201 Paternity, 135, 190 Pathologic, 86, 166, 167, 168, 173, 190, 198 Pathologic Processes, 166, 190 PDQ, 146, 190 Pedigree, 75, 83, 90, 190 Pelvic, 190, 193 Pelvis, 163, 183, 189, 190, 202 Penicillin, 190, 202 Peptide, 190, 192, 193 Peripheral Nerves, 3, 4, 30, 37, 61, 62, 190, 191, 192, 198

Peripheral Nervous System, 31, 55, 56, 69, 71, 73, 74, 89, 174, 187, 188, 189, 190, 191, 193 Peripheral Nervous System Diseases, 190, 191 Peripheral Neuropathy, 10, 56, 191 Peroneal Nerve, 66, 191, 195 Pharmacologic, 164, 191, 200 Phenotype, 33, 68, 90, 91, 93, 191 Phenylalanine, 21, 43, 115, 191, 202 Phospholipases, 191, 197 Phospholipids, 177, 191 Phosphorus, 33, 168, 191 Phosphorylation, 109, 191 Phrenic Nerve, 61, 191 Physical Examination, 133, 191 Physiologic, 167, 181, 185, 191, 194, 201 Physiology, 29, 188, 191 Pigment, 185, 191 Placenta, 191, 193 Plants, 179, 186, 191, 200 Plasma, 108, 169, 180, 182, 192, 195, 196 Plastids, 189, 192 Platelet Activation, 192, 197 Plexus, 168, 170, 192, 195 Pneumonia, 172, 192 Point Mutation, 28, 56, 62, 73, 94, 192 Polycystic, 152, 192 Polymorphic, 69, 83, 192 Polymorphism, 137, 192 Polyneuropathies, 55, 192 Polypeptide, 37, 171, 192, 204 Polysaccharide, 165, 192 Posterior, 166, 169, 175, 182, 189, 192 Postsynaptic, 187, 192, 197 Potentiation, 192, 197 Practice Guidelines, 149, 192 Precursor, 165, 175, 191, 192, 201, 202 Prenatal, 135, 138, 175, 193 Presynaptic, 187, 188, 193, 199 Presynaptic Terminals, 187, 193, 199 Prevalence, 86, 123, 193 Progeria, 27, 28, 29, 193 Progesterone, 91, 193 Progression, 165, 193 Progressive, 3, 29, 37, 43, 85, 94, 121, 169, 170, 174, 183, 187, 192, 193, 198, 202 Promoter, 14, 26, 193 Prone, 121, 130, 193 Prophase, 193, 199 Prostate, 193 Protein Transport, 23, 193

Index 211

Proteinuria, 179, 193 Proteolytic, 164, 171, 193 Protocol, 141, 194 Protons, 180, 184, 194 Proximal, 56, 78, 95, 175, 192, 193, 194 Psychic, 185, 194, 196 Ptosis, 53, 194 Public Policy, 148, 194 Pulmonary, 167, 182, 194, 203 Pulmonary Artery, 167, 194, 203 Pulmonary Edema, 182, 194 Purines, 167, 194, 196 Purpura, 165, 194 Pyrimidines, 167, 194, 196 Q Quality of Life, 55, 59, 194, 199 R Race, 54, 182, 194 Radiation, 163, 175, 176, 177, 194, 202, 203 Radiation therapy, 163, 194 Radioactive, 181, 188, 194 Receptor, 124, 165, 175, 194, 196, 197 Recombinant, 87, 141, 194, 203 Recombination, 92, 178, 195 Rectum, 165, 171, 178, 193, 195 Red Nucleus, 166, 195 Refer, 1, 113, 117, 119, 124, 142, 168, 171, 183, 195 Reflex, 72, 195 Refraction, 195, 198 Renin, 88, 165, 195 Reproductive cells, 120, 131, 132, 178, 180, 195 Respiratory failure, 55, 195 Retina, 195 Retinoblastoma, 123, 195 Retroviral vector, 178, 195 Ribonucleic acid, 115, 195 Ribose, 163, 195 Ribosome, 115, 195, 201 Rigidity, 190, 192, 195 Rod, 81, 169, 195 S Salivary, 190, 195 Scatter, 195, 202 Schizophrenia, 128, 195 Sciatic Nerve, 25, 36, 191, 195, 200 Sclerosis, 124, 151, 186, 196 Screening, 36, 79, 126, 135, 136, 138, 171, 190, 196 Sedimentation, 196, 202 Segmental, 64, 179, 196

Segmentation, 196 Segregation, 195, 196 Seizures, 190, 196 Semen, 193, 196 Senescence, 193, 196 Sensory loss, 4, 161, 196, 200 Sequencing, 143, 196 Sequester, 196, 199 Serine, 9, 21, 58, 196 Serotonin, 188, 196, 201 Sex Characteristics, 163, 196 Sex Determination, 152, 196 Shock, 20, 21, 22, 78, 79, 196, 201 Side effect, 142, 145, 164, 196, 199, 200 Signal Transduction, 33, 197 Signs and Symptoms, 9, 27, 40, 42, 44, 47, 129, 130, 135, 187, 197 Skeletal, 27, 186, 193, 197 Skeleton, 163, 197, 200 Small intestine, 180, 182, 197 Social Environment, 194, 197 Social Work, 132, 197 Soft tissue, 89, 167, 197 Soma, 197 Somatic, 118, 121, 132, 163, 184, 185, 191, 197 Somatic cells, 118, 121, 132, 184, 185, 197 Somatic mutations, 121, 197 Sound wave, 172, 197 Spastic, 87, 197 Spasticity, 197 Specialist, 136, 158, 198 Species, 145, 171, 176, 180, 182, 184, 185, 194, 198, 199, 203 Spectrin, 90, 198 Spectrum, 16, 28, 33, 43, 56, 94, 198 Sperm, 117, 118, 120, 121, 130, 131, 132, 135, 142, 170, 178, 180, 195, 197, 198, 202 Spermatogenesis, 84, 198 Spermatozoa, 196, 198 Spinal cord, 3, 30, 31, 163, 168, 169, 170, 177, 184, 185, 187, 188, 190, 191, 195, 198, 202 Spinal Cord Diseases, 190, 198 Spinal Nerves, 190, 191, 198 Spinocerebellar Degenerations, 87, 198 Sporadic, 195, 198 Stillbirth, 133, 198 Stimulant, 198, 202 Stimulus, 182, 183, 195, 198, 200, 201 Stomach, 163, 178, 180, 182, 197, 198 Stool, 171, 198

212

Charcot-Marie-Tooth Disease

Strand, 108, 198 Stroke, 6, 126, 147, 155, 156, 168, 199 Stroma, 182, 199 Subacute, 181, 199 Subclinical, 181, 196, 199 Subcutaneous, 164, 175, 183, 193, 199 Subspecies, 198, 199 Sulfur, 179, 199 Supportive care, 190, 199 Sural Nerve, 63, 72, 199 Symphysis, 170, 193, 199 Synapse, 187, 188, 193, 199, 201 Synapsis, 199 Synaptic, 23, 188, 197, 199 Synaptic Vesicles, 23, 199 Systemic, 167, 176, 181, 194, 199 T Talus, 165, 199, 200 Telangiectasia, 152, 199 Tendon, 177, 197, 199 Terminator, 171, 199 Thalamic, 166, 199, 200 Thalamic Diseases, 166, 200 Thoracic, 168, 174, 184, 200, 202, 203 Threonine, 43, 196, 200 Threshold, 176, 181, 200 Thrombin, 193, 200 Thrombomodulin, 193, 200 Thrombosis, 193, 199, 200 Thyroid, 135, 200, 202 Thyroid Gland, 135, 200 Thyroid Hormones, 200, 202 Thyroxine, 191, 200 Tibia, 165, 177, 200 Tibial Nerve, 195, 199, 200 Toxic, iv, 24, 25, 43, 44, 107, 173, 176, 188, 200 Toxicity, 141, 200 Toxicology, 148, 200 Toxins, 20, 165, 181, 200 Trabecular Meshwork, 45, 200 Trachea, 183, 200 Transcription Factors, 13, 116, 201 Transcutaneous, 201 Transcutaneous Electric Nerve Stimulation, 201 Transduction, 33, 197, 201 Transfection, 167, 178, 201 Translation, 115, 116, 178, 201 Translocation, 170, 193, 201 Transmitter, 175, 199, 201 Transport Vesicles, 43, 201

Trauma, 64, 167, 187, 200, 201 Tremor, 62, 190, 201 Trigeminal, 63, 201 Trinucleotide Repeat Expansion, 130, 201 Trinucleotide Repeats, 201 Trisomy, 121, 164, 201 Tryptophan, 21, 171, 196, 201 Tuberous Sclerosis, 152, 201 Tubulin, 12, 185, 202 Tumor Necrosis Factor, 24, 202 Tumour, 177, 202 Tyrosine, 48, 49, 175, 202 U Ulnar Nerve, 66, 202 Ultraviolet radiation, 118, 202 Uremia, 182, 202 Urethra, 193, 202 Urine, 165, 167, 173, 180, 183, 189, 193, 202 Urticaria, 165, 202 Uterus, 135, 170, 173, 181, 189, 193, 202 V Vaccine, 194, 202 Vacuoles, 175, 189, 202 Valine, 43, 202 Vascular, 164, 165, 181, 191, 198, 200, 202 Vector, 140, 141, 201, 202 Vein, 188, 203 Venous, 193, 203 Ventricle, 194, 203 Ventricular, 75, 203 Venules, 167, 203 Vertebrae, 198, 203 Vesicular, 193, 203 Veterinary Medicine, 148, 203 Vinblastine, 202, 203 Vinca Alkaloids, 203 Vincristine, 202, 203 Viral, 140, 178, 201, 203 Virulence, 200, 203 Virus, 140, 195, 201, 203 Viscera, 165, 197, 203 Vitro, 135, 203 Vocal cord, 53, 63, 93, 203 W White blood cell, 48, 118, 163, 165, 184, 203 Windpipe, 200, 203 Womb, 202, 203 X Xenograft, 165, 203 X-ray, 177, 188, 194, 203

Index 213

Y Yeasts, 191, 204

Z Zygote, 172, 186, 204 Zymogen, 193, 204

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