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This is the first mutation described in the short, antiparallel beta-sheet domain of the prion protein. This report highlights the importance of genetic analysis of patients with atypical dementia even in the absence of a family history.

The clinical and myopathological features of 13 patients with a myopathy occurring in association with hypothyroidism are presented. Seven patients had hypothyroid myopathy, including two with the Hoffmann syndrome and one with the Kocher-Debre-Semelaigne syndrome. Five patients had an inflammatory myopathy and one had polymyalgia rheumatica. Serum CK activity was elevated up to 12-fold in the patients with hypothyroid myopathy and returned to normal after treatment with thyroxine. Pathological changes in these cases included type 1 or type 2 fibre atrophy or hypertrophy, myofibre necrosis and regeneration in four cases and, in one case, prominent core-like areas containing amorphous granulo-filamentous material. The findings in this series of cases illustrate the clinical and histopathological heterogeneity of patients with hypothyroid myopathy and the need to consider other myopathies in hypothyroid patients who present with muscular symptoms.

Summary The lipids of muscle and adipose tissue from normal males and of muscle from males with Duchenne muscular dystrophy were investigated. Triglyceride, the major neutral lipid, showed similar fatty acid compositions in all tissues examined. When the phospholipids of dystrophic muscle and of normal adipose tissue were compared with those of normal muscle, it was found that there was an increase in the proportion of sphingomyelin in dystrophic muscle, while adipose tissue had higher proportions of sphingomyelin and lysophosphatidylcholine but lower choline phosphoglyceride. In dystrophic muscle only small alterations from normal were observed in the fatty acid compositions of the individual phospholipids, whereas the phospholipids of adipose tissue had quite distinctive fatty acid compositions. An atrophic muscle sample resulting from poliomyelitis consisted almost entirely of connective tissue and fat and had a phospholipid composition similar to that of adipose tissue. From a comparison of the results for all the types of tissue studied, it is evident that the increase in sphingomyelin in dystrophic muscle biopsies and the changes in the fatty acid compositions of individual phospholipids may be accounted for by the increased amounts of fat and connective tissue which are present in dystrophic muscle samples. In a case each of polymyositis, limb girdle muscular dystrophy and an autosomal recessive form of muscular dystrophy, the results obtained for the phospholipid composition of the muscle sample were also normal or consistent with some contamination from fat and connective tissue.

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