Pompe disease diagnosis and management guideline

ACMG standards and guidelines are designed primarily as an educational resource for physicians and other health care providers to help them provide quality medical genetic services. Adherence to these standards and guidelines does not necessarily ensure a successful medical outcome. These standards and guidelines should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed to obtaining the same results. in determining the propriety of any specific procedure or test, the geneticist should apply his or her own professional judgment to the specific clinical circumstances presented by the individual patient or specimen. It may be prudent, however, to document in the patient's record the rationale for any significant deviation from these standards and guidelines.Duke Univ, Med Ctr, Durham, NC 27706 USAOregon Hlth Sci Univ, Portland, OR 97201 USANYU, Sch Med, New York, NY USAUniv Florida, Coll Med, Powell Gene Therapy Ctr, Gainesville, FL 32611 USAIndiana Univ, Bloomington, in 47405 USAUniv Miami, Miller Sch Med, Coral Gables, FL 33124 USAHarvard Univ, Childrens Hosp, Sch Med, Cambridge, MA 02138 USAUniversidade Federal de São Paulo, São Paulo, BrazilColumbia Univ, New York, NY 10027 USANYU, Bellevue Hosp, Sch Med, New York, NY USAColumbia Univ, Med Ctr, New York, NY 10027 USAUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Biogeochemical and isotopic gradients in a BTEX/PAH contaminant plume: Model-based interpretation of a high-resolution field data set

A high spatial resolution data set documenting carbon and sulfur isotope fractionation at a tar oil-contaminated, sulfate-reducing field site was analyzed with a reactive transport model. Within a comprehensive numerical model, the study links the distinctive observed isotope depth profiles with the degradation of various monoaromatic and polycyclic aromatic hydrocarbon compounds (BTEX/PAHs) under sulfate-reducing conditions. In the numerical model, microbial dynamics were simulated explicitly and isotope fractionation was directly linked to the differential microbial uptake of lighter and heavier carbon isotopes during microbial growth. Measured depth profiles from a multilevel sampling well with high spatial resolution served as key constraints for the parametrization of the model simulations. The results of the numerical simulations illustrate particularly well the evolution of the isotope signature of toluene, which is the most rapidly degrading compound and the most important reductant at the site. The resulting depth profiles at the observation well show distinct differences between the small isotopic enrichment in the contaminant plume core and the much stronger enrichment of up to 3.3‰ at the plume fringes

Depth-resolved quantification of anaerobic toluene degraders and aquifer microbial community patterns in distinct redox zones of a tar oil contaminant plume.

Microbial degradation is the only sustainable component of natural attenuation in contaminated groundwater environments, yet its controls, especially in anaerobic aquifers, are still poorly understood. Hence, putative spatial correlations between specific populations of key microbial players and the occurrence of respective degradation processes remain to be unraveled. We therefore characterized microbial community distribution across a high-resolution depth profile of a tar oil-impacted aquifer where benzene, toluene, ethylbenzene, and xylene (BTEX) degradation depends mainly on sulfate reduction. We conducted depth-resolved terminal restriction fragment length polymorphism fingerprinting and quantitative PCR of bacterial 16S rRNA and benzylsuccinate synthase genes (bssA) to quantify the distribution of total microbiota and specific anaerobic toluene degraders. We show that a highly specialized degrader community of microbes related to known deltaproteobacterial iron and sulfate reducers (Geobacter and Desulfocapsa spp.), as well as clostridial fermenters (Sedimentibacter spp.), resides within the biogeochemical gradient zone underneath the highly contaminated plume core. This zone, where BTEX compounds and sulfate--an important electron acceptor--meet, also harbors a surprisingly high abundance of the yet-unidentified anaerobic toluene degraders carrying the previously detected F1-cluster bssA genes (C. Winderl, S. Schaefer, and T. Lueders, Environ. Microbiol. 9:1035-1046, 2007). Our data suggest that this biogeochemical gradient zone is a hot spot of anaerobic toluene degradation. These findings show that the distribution of specific aquifer microbiota and degradation processes in contaminated aquifers are tightly coupled, which may be of value for the assessment and prediction of natural attenuation based on intrinsic aquifer microbiota

Spatial distributions of sulphur species and sulphate-reducing bacteria provide insights into sulphur redox cycling and biodegradation hot-spots in a hydrocarbon-contaminated aquifer.

Dissimilatory sulphate reduction (DSR) has been proven to be one of the most relevant redox reactions in the biodegradation of contaminants in groundwater. However, the possible role of sulphur species of intermediate oxidation state, as well as the role of potential re-oxidative sulphur cycling in biodegradation particularly at the groundwater table are still poorly understood. Here we used a combination of stable isotope measurements of SO42−, H2S, and S0 as well as geochemical profiling of sulphur intermediates with special emphasis on SO32−, S2O32−, and S0 to unravel possible sulphur cycling in the biodegradation of aromatics in a hydrocarbon-contaminated porous aquifer. By linking these results to the quantification of total bacterial rRNA genes and respiratory genes of sulphate reducers, as well as pyrotag sequencing of bacterial communities over depth, light is shed on possible key-organisms involved. Our results substantiate the role of DSR in biodegradation of hydrocarbons (mainly toluene) in the highly active plume fringes above and beneath the plume core. In both zones the concentration of sulphur intermediates (S0, SO32− and S2O32−) was almost twice that of other sampling-depths, indicating intense sulphur redox cycling. The dual isotopic fingerprint of oxygen and sulphur in dissolved sulphate suggested a re-oxidation of reduced sulphur compounds to sulphate especially at the upper fringe zone. An isotopic shift in δ34S of S0 of nearly +4‰ compared to the δ34S values of H2S from the same depth linked to a high abundance (∼10%) of sequence reads related to Sulphuricurvum spp. (Epsilonproteobacteria) in the same depth were indicative of intensive oxidation of S0 to sulphate in this zone. At the lower plume fringe S0 constituted the main inorganic sulphur species, possibly formed by abiotic re-oxidation of H2S with Fe(III)oxides subsequent to sulphate reduction. These results provide first insights into intense sulphur redox cycling in a hydrocarbon contaminant plume, which widens the perspective of redox processes and microbial interactions ongoing in contaminated aquifers