Germplasm cryopreservation in bulls: Effects of gonadal tissue type, cryoprotectant agent, and freezing-thawing rates on sperm quality parameters.

Germplasm preservation is crucial for reproductive programs involving farm and endangered species. This study describes the effects of slow-uncontrolled cryopreservation protocols on bovine sperm associated with testicular or epididymal tissues. Samples from the testis or epididymis (cauda) were cut into ∼0.5 or 1 cm3 fragments and cryopreserved using Me2SO (Dimethyl Sulfoxide) or glycerol-based cryoprotectants. Sperm were collected from testicular or epididymal tissue before and after freezing-thawing (38 °C or 40 °C) and kept at room temperature (RT) or 4 °C during handling. The parameters studied were viability, membrane integrity (HOS), motility, acrosome integrity, chromatin, and morphology. Pre-freezing parameters were lower in testicular sperm than epididymal: HOS+ and DNA integrity (P < 0.05). Normal-% pre-freezing testicular sperm morphology was lower than epididymal (43.3 ± 1.8% vs. 65.3 ± 14.8%). All testicular RT-kept sperm parameters decreased post-freezing, except for acrosome integrity, which remained constant (P > 0.05). There were no differences in Me2SO-frozen tissue sizes (P > 0.05). All epididymal RT-kept sperm parameters dropped post-freezing except for the constant DNA integrity (P > 0.05). 4oC-kept sperm were fitter than those at RT (P < 0.05). 4oC-kept testicular sperm viability, DNA, and membrane integrities declined after 38 °C or 40 °C thawing (P < 0.05). Acrosome integrity and motility remained unchanged after freezing (P > 0.05). 4oC-kept epididymal sperm acrosome integrity, motility, and HOS+% severely dropped post-thawing (P < 0.05). Viability and DNA integrity were unchanged (38 °C vs. 40 °C; P > 0.05). Overall, post-freezing sperm morphology was unaffected (P > 0.05), but Dag defect was significantly lower in testicular samples (P < 0.05). Whole-epididymis parameters were maintained up to 24h at 4 °C (P > 0.05). In conclusion, testis-epididymis freezing protocols should use small tissue pieces, Me2SO-based cryoprotectants, and 4°C-kept samples to reduce sperm damage.

Active immunization against GnRH in pre-pubertal domestic mammals: testicular morphometry, histopathology and endocrine responses in rabbits, guinea pigs and ram lambs.

Effective tools for male contraception are important in the control of reproduction in animal populations. The aim of the present study was to evaluate the effects of active immunization against gonadotropin-releasing hormone (GnRH) on male reproductive function assessing testicular morphological changes and serum-gonadotropin levels in pre-pubertal rabbits, guinea pigs and ram lambs. An anti-GnRH vaccine was developed by linking a GnRH-homologous molecule to a tetanus clostridial toxoid (Al(OH)3 coadjuvant). After vaccination protocols testicular morphometry, histopathological alterations and endocrine responses (FSH, LH, testosterone and cortisol serum levels) were evaluated. Testicular volume was significantly reduced in vaccinated animals with respect to the control group in rabbits, guinea pigs and ram lambs (P<0.05 to P<0.001). The anti-GnRH vaccine generated a reduction in testicular volume of 15-, 27- and 11-fold, respectively. Tubule diameters decreased in the vaccinated group with respect to the control ~2.0-, 1.2- and 3.5-fold, respectively (P<0.001). Tubule, intertubular and lumen volumes significantly decreased in vaccinated rabbits (P<0.05), guinea pigs and ram lambs (P<0.01). Vaccinated animals of the three species showed significant reductions in spermatogonial numbers (10- to 40-fold; P<0.01). Sperm was absent in all seminiferous tubules of all rabbits, and most individuals of guinea pigs (80%) and ram lambs (60%). No significant differences were observed between vaccinated and control groups regarding FSH and LH during the experiments in the three experimental species/models used. Testosterone, however, was only significantly lower (~22-fold, P<0.01) in vaccinated rabbits. In conclusion, the present study demonstrated that pre-pubertal active immunization against GnRH leads to endocrine disruption and marked differences on testicular morphometry, development and activity among lagomorphs, hystricomorphs and ovine species with species-specific sensitivity regarding the anti-GnRH immune response.

Sperm volumetric dynamics during in vitro capacitation process in bovine spermatozoa.

Previous studies have demonstrated that sperm head morphometry can be used as a potential diagnostic tool for detecting biophysical changes associated with sperm viability in bovine spermatozoa. In this study, sperm head morphometry was used to investigate its value as a biophysical marker for detecting volumetric changes in bovine spermatozoa under in vitro capacitating and non-capacitating incubation conditions. To further test this hypotesis, aliquots of pooled, washed bovine sperm were incubated in either Tyrode's complete medium with heparin (TCMH; a capacitating medium containing Ca2+, NaHCO3 and heparin), Tyrode's complete medium heparin-free (TCM; a medium containing just Ca2+ and NaHCO3) or Tyrode's basal medium (TBM; a non-capacitating medium free of Ca2+, NaHCO3 and heparin, used as control). Aliquots of sperm were processed for morphometric analysis at different incubation-time intervals (0, 3 and 6 h at 38°C), and the chlortetracycline assay was used simultaneously to confirm the ability of the sperm to undergo capacitation (B pattern) and the acrosome reaction (AR pattern) status in each medium. After 3 h of incubation under TCMH conditions, a significant increase was observed in the percentage of B and AR patterns and a significant decrease was found in all sperm morphometric parameters (P<0.01). Interestingly, after 6 h of incubation in TCMH, the percentage of B and AR patterns increased drastically over time and marked differences were found in the dimensional and shape parameters, which were significantly smaller compared with TBM or TCM media (P<0.001). Significant correlations were observed between sperm size and AR pattern (r=-0.875, P<0.01). In conclusion, sperm head morphometry can be used as a potential biophysical marker for detecting volumetric changes during capacitation process in bovine spermatozoa.

Sperm morphometry: a tool for detecting biophysical changes associated with viability in cryopreserved bovine spermatozoa.

The aim of this study was to determine whether computerised sperm head morphometric analysis can be used as a diagnostic tool for detecting biophysical changes associated with sperm viability in frozen-thawed bovine spermatozoa. Ejaculates from five bulls (4 ejaculates/bull) were pooled and processed for computerised morphometric analysis, and SYBR-14 green/ethidium homodimer-1 fluorescence-based live/dead viability assay was used simultaneously to confirm the viability index of frozen-thawed spermatozoa. Sperm samples were assigned to three experimental groups. The first group was enriched in live spermatozoa (after a double Percoll selection), the second group was enriched in dead spermatozoa (after a refreeze-thaw procedure), and the last group was a 50 : 50 pool of live/dead spermatozoa (from first and second group samples). There were significant differences (P < 0.001) related to sperm morphometric dimensional parameters among the three groups analysed, being the lowest overall sperm head dimension found in the second (dead spermatozoa) group. In conclusion, sperm head morphometry can be used as a potential diagnostic tool for detecting biophysical changes associated with sperm viability in frozen-thawed bovine spermatozoa.

Differential distribution of sperm subpopulations and incidence of pleiomorphisms in ejaculates of captive howling monkeys (Alouatta caraya).

The aim of this study was to develop an objective method to determine the incidence of pleiomorphisms and its influence on the distribution of sperm morphometric subpopulations in ejaculates of howling monkeys (Alouatta caraya) by using a combination of computerized analysis system (ASMA) and principal component analysis (PCA) methods. Ejaculates were collected by electroejaculation methods on a regular basis from five individuals maintained under identical captive environmental, nutritional, and management conditions. Each sperm head was measured for dimensional parameters (Area [A, (square micrometers)], Perimeter [P, (micrometers)], Length [L, (micrometers)], and Width [W, (micrometers)]) and shape-derived parameters (Ellipticity [(L/W)], Elongation [(L - W)/(L + W)], and Rugosity [(4лA/P (2))]). PCA revealed two principal components explaining more than the 96 % of the variance. Clustering methods and discriminant analyzes were performed and seven separate subpopulations were identified. There were differences (P < 0.001) in the distribution of the seven subpopulations as well as in the incidence of abnormal pleiomorphisms (58.6 %, 49.8 %, 35.1 %, 66.4 %, and 55.1 %, P < 0.05) among the five donors tested. Our results indicated that differences among individuals related to the incidence of pleiomorphisms, and sperm subpopulational structure was not related to the captivity conditions or the sperm collection method, since all individuals were studied under identical conditions. In conclusion, the combination of ASMA and PCA is a useful clinical diagnostic resource for detecting deficiencies in sperm morphology and sperm subpopulations in A. caraya ejaculates that could be used in ex situ conservation programs of threatened species in Alouatta genus or even other endangered neotropical primate species.

Identification of sperm head subpopulations with defined pleiomorphic characteristics in ejaculates of captive Goeldi's monkeys (Callimico goeldii).

The aim of this study was to evaluate the incidence of pleiomorphisms and its influence on the distribution of sperm morphometric subpopulations in ejaculates from the vulnerable Goeldi's monkey (Callimico goeldii) by using a combination of computerized analysis system and Principal Component Analysis (PCA) methods. Each sperm head was measured for four primary spermatozoal head dimensional parameters (area [A (µm(2))], perimeter [P (µm)], length [L (µm)] and width [W (µm)]) and three head shape derived parameters (ellipticity [(L/W)], elongation [(L-W)/(L+W)] and rugosity [(4πA/P(2))]). Six separate subpopulations (SPs) were identified: SP1, constituted by very large, narrow and very elliptical spermatozoa (A=16.85±1.56µm(2), W=2.75±0.42µm and ellipticity=2.16±0.24); SP2, characterized by average sized, short, wide and round spermatozoa (A=15.00±1.92µm(2), L=5.06±0.49µm, W=3.51±0.31µm and ellipticity=1.44±0.15); SP3, represented by small, wide and slightly round spermatozoa (A=14.95±1.75µm(2), W=3.47±0.29µm and ellipticity=1.48±0.14); SP4 included very small, short and very round spermatozoa (A=14.15±2.38µm(2), L=4.90±0.57µm and elongation=0.18±0.05); SP5 consisted of average sized and slightly elliptical spermatozoa (A=15.14±1.72µm(2) and ellipticity=1.49±0.14); and SP6 included large and round spermatozoa (A=16.30±1.62µm(2) and elongation=0.19±0.04). There were differences in the sperm subpopulation distribution (P<0.001) among the five donors analyzed. In conclusion, the results of the current study confirmed that the use of computer sperm analysis methods combined with PCA cluster analyses are useful methods to identify, classify, and characterize different sperm head morphometric subpopulations in neotropical primates. Broadening our knowledge of C. goeldii sperm morphometric abnormalities as well as developing reliable techniques for sperm evaluation may be essential for ex situ conservation of this threatened species.

Sperm head morphometry in ejaculates of adult marmosets (Callithrix jacchus): a model for studying sperm subpopulations and among-donor variations.

In humans and other mammals, sperm morphology has been considered one of the most important predictive parameters of fertility. The objective was to determine the presence and distribution of sperm head morphometric subpopulations in a nonhuman primate model (Callithrix jacchus), using an objective computer analysis system and principal component analysis (PCA) methods to establish the relationship between the subpopulation distribution observed and among-donor variation. The PCA method revealed a stable number of principal components in all donors studied, that represented more than 85% of the cumulative variance in all cases. After cluster analysis, a variable number (from three to seven) sperm morphometric subpopulations were identified with defined sperm dimensions and shapes. There were differences in the distribution of the sperm morphometric subpopulations (P < 0.001) in all ejaculates among the four donors analyzed. In conclusion, in this study, computerized sperm analysis methods combined with PCA cluster analyses were useful to identify, classify, and characterize various head sperm morphometric subpopulations in nonhuman primates, yielding considerable biological information. In addition, because all individuals were kept in the same conditions, differences in the distribution of these subpopulations were not attributed to external or management factors. Finally, the substantial information derived from subpopulation analyses provided new and relevant biological knowledge which may have a practical use for future studies in human and nonhuman primate ejaculates, including identifying individuals more suitable for assisted reproductive technologies.

Anomalías cromosómicas en ambos padres de un niño con defectos congénitos múltiples: reporte de caso / Chromosomal abnormalities in both parents of a child with multiple congenital defects: case report

Se presenta el caso de una pareja con antecedente de hijo portador de defectos congénitos, fallecido a los 2 días. No se realizó cariotipo al niño fallecido, quien es el producto del 3º embarazo de madre de 35 años y padre de 45 años, ambos aparentemente sanos y no con sanguíneos. No refieren antecedentes familiares de defectos congénitos, no hay antecedentes patológicos ni de ingestión de medicamentos durante el embarazo. El estudio cromosómico de la pareja se realizó en linfocitos de sangre periférica. En todas las células analizadas de la madre se observó la heterocromatina del cromosoma 9 aumentada, en el 2% de las células, una translocación entre los cromosomas 2 y 22 y también en el 2% un isocromosoma para el brazo largo del cromosoma 1. En el padre, el 7,5% de las células analizadas, se observó la presencia de un cromosoma marcador. El cariotipo de la madre fue 46,XX,9qh+,t(2;22),i(1q); y del padre, XY/47,XY+mar.Si bien el 9qh+ es considerado variante cromosómica normal y sin repercusión clínica, esta condición ha sido hallada en parejas con problemas de esterilidad e infertilidad. La translocación y el isocromosoma hallados en la paciente, son alteraciones cromosómicas más severas, fueron observadas en muy bajo porcentaje,constituyen rearreglos cromosómicos que conducen a la formación de gametos desequilibrados. Sería más factible considerar al cromosoma marcador supernumerario como responsable de la malformación en el niño. Con estos antecedentes, se resalta la indicación médica del estudio citogenético en padres de pacientes portadores de malformaciones múltiples, para el asesoramiento genético familiar correspondiente.

This is the case of a couple with a child carrier of congenital defects, deceased at the second day after birth. The karyotype the deceased child was not made and the child was product of the third pregnancy of a mother of 35 years old and a father of 45 years old, both apparently healthy and non-consanguineous. Both parents did not refer any family history of birth defects, pathological background or medicines intake during pregnancy. The couples karyotype was performed on lymphocytes isolated from peripheral blood. All cells from the mother showed and increased heterochromatin on chromosome 9; 2% showed a translocation between chromosomes 2 and 22; and another 2% showed anisochromosome for the long arm of chromosome 1. In the father, 7.5% of the cells showed the presence of a marker chromosome. The mother´s kariotype was 46,XX,9hq+,t(2;22),i(1q) and the father´s was 46,XY/47,XY+mar. While 9qh+ chromosomal is considered normal with no clinical consequences, this condition has been found in couples with infertility and sterility problems. The translocation and the isochromosome found at a very low percentage are considered the most severe chromosomal abnormalities that lead to the production of unbalanced gametes. It would be more feasible to consider the supernumerary marker chromosome as responsible of the birth defects in the child. This background emphasizes the importance of the medical indication of cytogenetic studies in parents of children carriers of multiple malfomrations = for the corresponding genetic counseling.

Cromosoma 20 en anillo en gemelas monocigotas / Ring Chromosome 20 in Monozygotic Twins

El cromosoma en anillo es una infrecuente alteración cromosómica caracterizada por la delección del cromosoma en ambos extremos y su posterior ensamblaje en forma circular. El fenotipo y la clínica del paciente se hallan en relación directa con la cantidad de material genético perdido en los extremos así como el cromosoma involucado. El sx del cromosoma 20 en anillo se caracteriza a su vez, por retraso mental, trastornos de conducta, dismorfias y epilepsia refractaria con crisis polimorfas, siendo el tercer tipo de epilepsia conocido de base genética localizado en el cromosoma 20, en el locus 20q13. Caso dos lactantes, de 9 meses de edad, que consultan por retraso psicomotor y rasgos dismórficos. Producto de un embarazo gemelar monocorial-monoamniotico, parto por cesárea, ambas ingresadas en incubadora por 24 días por bajo peso, Gemela 1: Peso:1.600 grs, presenta un mamelón preauricular y en las extremidades inferiores se visualizan manchas café con leche. Sostén cefálico a los 7 meses y Gemela 2: Peso: 1.570 grs. Sostén cefálico a los 6 meses. En ella la madre refiere crisis de hiperextensibilidad, sin diagnostico etiológico. Por lo demás el fenotipo de ambas es superponible: dolicocefalia, hipertelorismo, fisuras palpebrales estrechas con pliegues epicánticos. TAC, ecocardiograma y examen oftálmico normales para la edad. Hipotonía generalizada. Antecedentes familiares: madre y padre, casados en segundas nupcias, ambos de 44 años de edad, no consanguíneos. La madre tiene ocho hijos de su primera pareja y el padre un hijo. En el estudio citogenético de ambas se observó la presencia en mosaico de un cromosoma 20 en anillo: 45,XX,-20/46,XX,r(20) en el 5 % y 95% respectivamente de las metafases analizadas. Se desconoce reportes previos de ocurrencia del cromosoma 20 en anillo en gemelos monocigotos. Se discuten las posibles implicancias clínicas, considerando que esta anormalidad podría comprometer a dos genes relacionados con canalopatías epilépticas (CHRNA4 y KCNQ2).

El Síndrome de Williams-Reporte de tres casos / Williams syndrome- Report of three cases

El síndrome de Williams, síndrome de Williams- Beuren, hipercalcemia idiopática osíndrome de estenosis aórtica supravalvular, es un desorden de etiología genéticacaracterizado por facies dismórfica con características típicas, retraso mental, deficiencia delcrecimiento, anomalías del tejido conectivo, anomalías cardiovasculares, una personalidadtípica y, a veces, hipercalcemia en la infancia. La frecuencia de este síndrome ha sidoestimada en 1 en 10000 a 20000 nacimientos. La causa del mismo, es una deleciónsubmicroscópica del cromosoma 7q11-13 que incluye el gen de la elastina (ELN) en 90 a95% de los casos. Este es un síndrome de genes contiguos (diferentes genes implicados,producen diferentes síntomas) y se conocen comprometidos los genes: ELN (implicado enlas anomalías del tejido conectivo), GTF21 (implicado en el retardo mental) y LIMK1(implicado en el fenotipo del síndrome). La deleción es de novo en la mayoría de los casos,aunque se ha documentado trasmisión de padres a hijos. Se puede realizar el diagnosticoprenatal por Fluorescente in situ hybridization (FISH). CASOS CLINICOS: Se describen loscasos de dos niños de 1 año y 9 meses y 1 año y 10 meses, y una niña de 6 años y 8 meses,los tres con diferentes características clínicas. En este trabajo se resalta la importancia delfenotipo sobre las otras características del síndrome, que pueden o no estar presentes

Monosomía 11 q compatible con síndrome de Jacobsen. Reporte de caso / 11 q monosomy compatible with Jacobson syndrome. Case report

Se reporta el caso de una niña de 13 días de vida, con una deleción distal del brazo largo del cromosoma 11, nacida de madre portadora de un cromosoma marcador y de una inversión pericéntrica de la heterocromatina del cromosoma 9, la cual también se hallaba presente en la propósita. El cariotipo de la niña resultó 46,XX, del(11)(q24 ­11qter), inv 9qh.La madre de la niña, con fenotipo normal, presentó un cariotipo 46,XX/47,XX+mar, inv9qh. El cariotipo del padre de la propósita fue normal. En este reporte destacamos la importancia de realizar el diagnóstico cromosómico en niños portadores de múltiples malformaciones y también la de efectuar el análisis cromosómico a los padres para el pronóstico del caso y asesoramiento genético de la pareja.

This is the case of a 13-day girl with a distal deletion of the long arm of chromosome 11 and a pericentric inversion of the heterochromatin of chromosome 9. Her mother also had a pericentric inversion of the heterochromatin of chromosome 9 and a chromosome marker. The cariotype of the affected girl was 46, XX, del (11) (q24 ­11qter), inv 9qh and the cariotype of the mother, with normal phenotype, was 46,XX,/47,XX+mar, inv 9qh. The mother of the proband had a normal phenotype. This paper highlights the importance of making an accurate chromosomal diagnosis in a child with multiple malformations as well as the importance of making a chromosomal analysis of the parents to make the case prognosis and proper genetic counselling.

Retardo mental y cardiopatía en una portadora de una translocación balanceada / Mental retardation and cardiopathy in a carrier of a balanced translocation

Las translocaciones reciprocas balanceadas ocurren con una incidencia de 1 por cada 500 nacimientos. Un porcentaje de ellas es diagnosticado en adultos que consultan por problemas reproductivos, otras descubiertas de manera fortuita y muchas pasan desapercibidas porque los portadores no tienen sintomatología, ni problemas al concebir y tienen descendencia normal. Solo un 5%, cursa con anomalías fenotípicas, con o sin retardo mental, atribuible a una inactivación o pérdida de genes. Se reporta el caso de una niña de 3 años y 6 meses de edad, portadora de una translocación balanceada reciproca entre los cromosomas 2 y 11, que consulta al servicio de Genética por retardo del desarrollo sicomotor y convulsiones. Al examen físico la paciente presentaba: CC: 46,5cm. (­2DS), talla de 87 cm. percentil 3, clinodactilia de ambos quintos dedos, hipertricosis y un soplo sistólico debido a una insuficiencia tricúspides y una válvula aórtica bicúspide. La niña es el producto del tercer embarazo de un matrimonio joven, no consanguíneo, tiene dos hermanos varones, el mayor de 8 años, con la misma cardiopatía y en el otro hermano de 6 años se ausculta un soplo sistólico, de etiología a confirmar. El estudio cromosómico de la propósita, ambos padres y los dos hermanos, se llevó a cabo a través de las técnicas de cultivo de sangre periférica. Las láminas se analizaron con coloración convencional y Bandas G y C. Se examinaron treinta células por individuo. En la paciente se encontró una translocación reciproca balanceada, no así en los padres y hermanos, por lo cual se la considero de novo. Cariotipo: 46, XX,rcp (2;11)(p11;p11). Se reporta este caso por ser de interés ya que las características clínicas de la niña son atribuibles a la anomalía cromosómica pero no así la cardiopatía y también porque el número de portadores de translocaciones reciprocas balanceadas afectados es bajo.

The incidence of balanced reciprocal translocations is 1 for every 500 births. A percentage of them is diagnosed in adults consulting for reproductive problems, other are discovered fortuitously and many pass unnoticed because the carriers do not have either symptomatology or problems on conception and have normal descents. Only 5% of them deal with phenotypic anomalies, with or without mental retardation, attributable to an inactivation or loss of genes. Here we report the case of a 3­year­old girl and 6 months of age, carrier of a balanced reciprocal translocation between chromosomes 2 and 11, who consulted the service of Genetics for retardation of the psychomotor development and convulsion. To the physical examination the patient presented: CC: 46.5cm.(­2DS), size of 87 cm, percentile 3, clinodactyly of both fifth fingers, hypertrichosis and a systolic breath due to an tricuspid insufficiency and bicuspid aortic valves. The girl is the product of the third pregnancy of a young, non­consanguineous couple. She has and older brother who was 8 years old and presented the same cardiopathy and a 6­year­old brother with a systolic breath of unknown aetiology detected by auscultation. The chromosomal study of the patient, both parents and both brothers, was made by culture of peripheral blood. The slides were analyzed by conventional coloration and G and C bands. Thirty cells were examined per patient and a balanced reciprocal translocation balanced was found in the girl but not in the parents and brothers. Due to this, it was considered a de novo translocation. Karyotype: 46, XX, rcp (2; 11) (p11; p11). This case is reported for being of interest since the clinical characteristics of the girl are attributable to the chromosomal anomaly but not the cardiopathy and because the number of carriers of balanced reciprocal translocations affected is low.

El síndrome de masa - reporte de una familia / The masa syndrome - a case report family

El síndrome de Masa, Síndrome de Bianchine­Lewis, Síndrome de Gareis­Masson, Síndrome de retardo mental ligado al X y pulgar incluido, retardo mental con pulgar en aducción o retardo mental con pulgar incluido congénito, Síndrome de CRASH; es una forma de retardo mental raro, de etiología recesiva ligada al X. Los criterios mayores de diagnóstico son: retardo mental, afasia, marcha arrastrando los pies y aducción de los pulgares, de donde viene su nombre por las siglas en ingles (Mental retardation, Aphasia, Shuffling gait, Adducted thumbs­MASA). El gen mutado es L1CAM que codifica la Molécula de Adhesión Celular L1, y mapea en Xq28. Este gen es el mismo de la hidrocefalia ligada al X y de la Paraplejía Espástica Complicada tipo 1. La mayoría de los pacientes son varones, sin embargo existen familias con mujeres afectadas, pero en general las mujeres portadoras son asintomáticas. La variabilidad clínica inter e intra familiar de los afectados es amplia. Reportamos el caso de un paciente del sexo masculino de 10 meses de edad, producto del primer embarazo de una pareja joven, no consanguínea, que consulta por retraso del desarrollo sicomotor y aducción de ambos pulgares. En la Tomografía computarizada del cráneo se observa: ventrículos laterales muy agrandados y disgenesia del cuerpo calloso. Su estudio cromosómico es normal. Se trata de una familia en la cual dos hermanos de la madre y un hermano de la abuela materna también están afectados por retardo mental, pulgares en aducción y marcha arrastrada. En estos pacientes no se realizó el estudio cromosómico y no tenían diagnóstico hasta este momento. En este trabajo se resalta la importancia del diagnóstico certero de patologías genéticas en países subdesarrollados a través del conocimiento de las manifestaciones clínicas de las patologías, aunque no dispongamos de medios de diagnóstico más avanzados. En esta familia el diagnóstico recién fue realizado en el propósito y por lo tanto la misma no pudo beneficiarse de un correcto asesoramiento genético.

The MASA syndrome, Bianchine Lewis Syndrome, Gareis Masson Syndrome, Mental Retardation and adducted thumbs syndrome, Mental Retardation with adducted thumbs, Mental Retardation with congenital adducted thumbs or CRASH syndrome, is a rare form of X linked mental retardation. The main features are: mental retardation, aphasia, shuffling gait, adducted thumbs and its name comes from the first letters of these characteristics (MASA). The locus is Xq28 and the mutated gene is L1 CAM, which encodes for the neural cell adhesion molecule 1. This is the same gene of the X­Linked Hydrocephalus Spectrum and the Complicated Cerebral Palsy type 1. The majority of the patients are men although there are families with affected girls but, in general, female carriers are asymptomatic. There is a wide intra and inter clinical variety of the affected patients. Here we report the case of a 10­month old boy that was the first child of young, apparently healthy, non­consanguineous parents. He consulted with us because of psychomotor retardation and adducted thumbs. The CAT scan of the brain showed enlarged lateral ventricles and dysgenesia of the corpus callosum. The high­resolution chromosomal analysis was normal. Two maternal uncles and one brother of the maternal grandmother also had mental retardation, adducted thumbs and shuffling gait. These patients did not have either chromosomal analysis or diagnosis until now. In this paper, we highlight the importance of the accurate diagnosis of genetic syndromes, even in countries with few and not very advanced genetic analysis. Our patient was the first member of the family diagnosed and therefore the have not received the benefits of Genetic Counselling until now.

Diagnóstico prenatal de ectrodactilia, por ecografía, en dos hermanos / Prenatal diagnosis of ectrodactyly in two siblings

La Ectrodactilia una malformación congénita rara caracterizada por la ausencia de dígitos y tiene una amplia variedad de expresión. Esta anomalía puede ser esporádica o asociada a síndromes genéticos y no genéticos, como la Ectrodactilia autosómica dominante y el Síndrome de Ectrodactília y displasia ectodérmica y paladar hendido. En este trabajo presentamos los casos de dos hermanos con el diagnóstico prenatal de ectrodactilía por ecografía del 2° trimestre, en ambos casos. El primer embarazo resultó en un feto muerto con ectrodactilia de ambas manos y ambos pies y estenosis de cordón umbilical. El segundo embarazo, en el nacimiento de un niño de sexo masculino con agenesia de mano izquierda y ectrodactília de mano derecha y ambos pies. Se resalta la importancia de un examen exhaustivo de manos y pies fetales, en la ecografía del segundo trimestre para así realizar más y mayores diagnósticos de malformaciones de manos y pies.

Ectrodactyly is a rare congenital malformation characterized by absence of digits and has a wide variety of expression. This anomaly can be sporadic or associated with various genetic and non­genetic syndromes such as the autosomal dominant Ectrodactyly and the Ectrodactyly and Ectodermal Dysplasia, Cleft Palate Syndrome (EEC). In this report, we present the cases of two brothers with a prenatal diagnosis of ectrodactyly by ultrasound in the second trimester of both pregnancies. The first pregnancy ended in the stillbirth of a male fetus with ectrodactyly of both hands and feet and stenosis of the umbilical cord. The second pregnancy resulted in the delivery of a boy with left hand agenesis and right hand and feet ectrodactyly. We highlight the importance of routine and thorough examination of fetal hands and feet during the second trimester ultrasound to make a better and more frequent diagnosis of hand and foot malformations.

Síndrome femoral facial en un hijo de madre con diabetes gestacional / Femoral facial syndrome in a child of a mother with gestational diabetes

El Síndrome Femoral Facial (SFF) o Síndrome de Hipoplasia Femoral, Facies Inusual (SHFFI), es una asociación rara de anomalías femorales y faciales. La diabetes materna ha sido implicada como agente causal. En este trabajo se describe a un niño con el síndrome de hipoplasia femoral, facies inusual. El mismo tiene las características faciales típicas, de fisuras palpebrales de inclinación mongoloide, filtrum largo con labio superior fino, alaenasi hipoplásicos y micrognatia. Presentaba también anomalias de miembros superiores, costillas, vértebras, y miembros inferiores. Insuficiencia de la válvula tricúspide y defecto de tubo neural. No hay antecedentes familiares. Se le diagnóstico diabetes gestacional a la madre, a las 20 semanas se reporta este caso para resaltar y reforzar la relación de la diabetes gestacional con el Síndrome Femoral Facial.

The Femoral Facial Syndrome (FFS) or Femoral Hypoplasia­Unusual Facies Syndrome (FHUFS) is a rare association of femoral and facial abnormalities. Maternal diabetes has been mainly involved as the causative agent. The case of a child with Femoral Hypoplasia, Unusual Facies Syndrome is described here. He had characteristic facial pattern of upslanted palpebral fissures, long philtrum with thin upper lip, hypoplastic alae nasi and micrognathia. He also had upper limb involvement, rib, vertebral and lower extremities abnormalities, tricuspid valve insufficiency and a neural tube defect. He did not have a positive family history. His mother had gestational diabetes detected at 32 weeks of gestation. We report this case to stress the relationship between Femoral Facial Syndrome and maternal gestational diabetes.

El síndrome de Prader Willi: revisión e importancia del diagnóstico precoz, reporte de 6 casos / Preder Willi syndrome: review and importance of early diagnosis, report of 6 cases

El Síndrome de Prader Willi (SPW) es un defecto del nacimiento asociado a una anormalidad del cromosoma 15, que puede ser delección, disomía uniparental u otra. Ocurre en 1 de cada 15000 personas, en ambos sexos y en cualquier raza. Es una de las diez condiciones más comunes que se ven en Genética Clínica y una de las causas de obesidad más común. Tiene dos etapas clínicas típicas y muy diferentes. En su primera etapa se caracteriza por: bajo peso al nacer, hipotomía y retraso del crecimiento. En la segunda etapa: los pacientes se desarrollan muy bien hasta que aparece la compulsión por la comida con un apetito voraz. También presentan retraso mental, que no suele ser severo. Talla baja, manos y pies pequeños e hipogenitalismo. Se describen los casos de 6 pacientes de 3a 2m, 5a, 5a 6m, 5a 11m, 10a 9m y 12a 2m, todos con el diagnóstico clínico de SPW. Tres del sexo masculino y tres del sexo femenino. Todos los pacientes presentaron obesidad, retraso mental e hipogenitalismo. Uno de los niños presentó daño neurológico atribuido a parálisis cerebral y una de las niñas falleció por complicaciones respiratorias, frecuentes en el SPW. Se resalta en este trabajo la importancia de realizar un diagnóstico temprano, para que la evolución del niño sea la mejor posible y con el menor número de complicaciones, ya que todos los pacientes presentados fueron diagnosticados en forma tardía y la evolución de los mismos no es considerada buena, así como tampoco el manejo familiar

Síndrome de Ellis Van Creveld: a propósito de 2 hermanos / Ellis Van Creveld Syndrome: 2 friends

El síndrome de Ellis Van Creveld es uan displasia condroectodérmica rara, de etiología autosómatica recesiva, que consiste en polidactilia postaxial bilateral de manos y fusión de huesos del carpo. La condrodisplasia en huesos largos, resulta en en enanismo acromesomélico. La displasia ectodérmica afecta uñas y dientes. En el 50-60 porciento de los casos se presentan malformaciones cardiacas congénitas. Un tercio de los pacientes masculinos tiene anomalías genitales. En general no se observa retraso mental. El diagnóstico es clínico-radiológico. Se presenta 2 hermanos, una niña y un niño de 9 y 8 años, respectivamente. La niña es el producto del primer embarazo de una pareja joven no consanguínea. El varón es producto del segundo embarazo de la misma pareja. No hay antecedentes familiares, ni de patologia materna o ingestión de medicamentos durante los embarzos. Ambos niños presentan características clínicas y radiológicas típicas de síndrome de Ellis Van Creveld. El niño presenta mayor afectación de huesos largos. Ninguno de ellos tiene retraso mental, ni malformaciones congénitas cardiacas. Al reportar estos casos se destaca la importancia de conocer este síndrome, ya que por ser una patología de etiología autosómica recesiva, el asesoramiento genético de la familia es muy importante. Se discute el tratamiento y manejo adecuado de los pacientes con síndrome de Ellis Van Creveld