Entry - #258860 - OROFACIODIGITAL SYNDROME IV; OFD4 - OMIM - (OMIM.ORG)
# 258860

OROFACIODIGITAL SYNDROME IV; OFD4


Alternative titles; symbols

OFDS IV
ORAL-FACIAL-DIGITAL SYNDROME, TYPE IV
OFD SYNDROME WITH TIBIAL DEFECTS
MOHR-MAJEWSKI SYNDROME
OFD SYNDROME, BARAITSER-BURN TYPE
BARAITSER-BURN SYNDROME


Phenotype-Gene Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
Gene/Locus Gene/Locus
MIM number
10q24.1 Orofaciodigital syndrome IV 258860 AR 3 TCTN3 613847
Clinical Synopsis
 
Phenotypic Series
 

INHERITANCE - Autosomal recessive [SNOMEDCT: 258211005] [UMLS: C0441748 HPO: HP:0000007] [HPO: HP:0000007] GROWTH Height - Short stature [SNOMEDCT: 422065006, 237837007, 237836003] [ICD10CM: E34. 31, R62. 52] [ICD9CM: 783. 43] [UMLS: C0013336, C0349588 HPO: HP:0004322, HP:0003510] [HPO: HP:0004322] HEAD & NECK Face - Micrognathia [SNOMEDCT: 32958008] [ICD10CM: M26. 04] [ICD9CM: 524. 04] [UMLS: C0025990 HPO: HP:0000347] [HPO: HP:0000347] Ears - Low-set ears [SNOMEDCT: 95515009] [ICD10CM: Q17. 4] [UMLS: C0239234 HPO: HP:0000369] [HPO: HP:0000369] Eyes - Hypertelorism [SNOMEDCT: 22006008] [ICD10CM: Q75. 2] [ICD9CM: 376. 41] [UMLS: C0020534 HPO: HP:0000316] [HPO: HP:0000316] - Epicanthal folds [SNOMEDCT: 74824007] [UMLS: C0678230, C0229249 HPO: HP:0000286] [HPO: HP:0000286] Mouth - High-arched palate [SNOMEDCT: 27272007] [ICD10CM: Q38. 5] [UMLS: C0240635 HPO: HP:0000218] [HPO: HP:0000218] - Cleft palate [SNOMEDCT: 87979003, 63567004] [ICD10CM: Q35. 9, Q35, Q35 V体育官网. 5] [ICD9CM: 749. 00, 749. 0] [UMLS: C2981150, C1837218, C0008925, C2240378 HPO: HP:0000175] [HPO: HP:0000175] - Lobulated tongue [SNOMEDCT: 253752000] [UMLS: C0431564 HPO: HP:0000180] [HPO: HP:0000180] - Tongue nodules [SNOMEDCT: 1144643009] [UMLS: C0241438 HPO: HP:0000199] [HPO: HP:0000199] - Oral frenula [UMLS: C1850258] CHEST External Features - Pectus excavatum [SNOMEDCT: 391982004, 391987005] [ICD10CM: Q67. 6] [ICD9CM: 754. 81] [UMLS: C0016842, C2051831 HPO: HP:0000767] [HPO: HP:0000767] SKELETAL Limbs - Short tibiae [UMLS: C1850259 HPO: HP:0005736] [HPO: HP:0005736] Hands - Preaxial and/or postaxial polydactyly [UMLS: C1850264] - Brachydactyly [SNOMEDCT: 43476002] [UMLS: C0221357 HPO: HP:0001156] [HPO: HP:0001156] - Clinodactyly [SNOMEDCT: 17268007] [UMLS: C4551485 HPO: HP:0030084] [HPO: HP:0030084] - Syndactyly [SNOMEDCT: 373413006] [ICD10CM: Q70, Q70. 9] [ICD9CM: 755. 1] [UMLS: C0039075, C2117411 HPO: HP:0001159] [HPO: HP:0001159] Feet - Preaxial and/or postaxial polydactyly [UMLS: C1850264] - Syndactyly [SNOMEDCT: 373413006] [ICD10CM: Q70, Q70. 9] [ICD9CM: 755. 1] [UMLS: C0039075, C2117411 HPO: HP:0001159] [HPO: HP:0001159] NEUROLOGIC Central Nervous System - Cerebral atrophy [SNOMEDCT: 278849000] [UMLS: C0235946 HPO: HP:0002059] [HPO: HP:0002059] - Porencephaly [SNOMEDCT: 38353004, 38837006] [ICD10CM: Q04. 6] [UMLS: C4082173, C0302892, C0151860] MOLECULAR BASIS - Caused by mutation in the tectonic family, member 3 gene (TCTN3, 613847. 0001) ▲ Close Orofaciodigital syndrome - PS311200 - 19 Entries Location Phenotype Inheritance Phenotypemapping key PhenotypeMIM number Gene/Locus Gene/LocusMIM number 1q21. 3 Orofaciodigital syndrome XIX AR 3 620107 SCNM1 608095 1q32. 1 Orofaciodigital syndrome V AR 3 174300 DDX59 615464 3q13. 12-q13. 13 . Orofaciodigital syndrome XVIII AR 3 617927 IFT57 606621 4q28. 1 . Orofaciodigital syndrome XVII AR 3 617926 INTU 610621 4q33 . Orofaciodigital syndrome II AR 3 252100 NEK1 604588 5p13. 2 Orofaciodigital syndrome VI AR 3 277170 CPLANE1 614571 6q22. 31 Orofaciodigital syndrome IX AR 3 258865 TBC1D32 615867 10q24. 1 Orofaciodigital syndrome IV AR 3 258860 TCTN3 613847 11q13. 4 Orofaciodigital syndrome XIV AR 3 615948 C2CD3 615944 17p13. 1 . Orofaciodigital syndrome XV AR 3 617127 KIAA0753 617112 17p13. 1 Orofaciodigital syndrome XVI AR 3 617563 TMEM107 616183 17q11. 2 Orofaciodigital syndrome XX AR 3 620718 RAB34 610917 Xp22. 2 Orofaciodigital syndrome I XLD 3 311200 OFD1 300170 Xp22. 2 Orofaciodigital syndrome XXI XLR 3 301132 ZRSR2 300028 Chr. X Orofaciodigital syndrome VIII XLR 2 300484 OFD8 300484 Not Mapped Orofaciodigital syndrome X AD 165590 OFD10 165590 Not Mapped Orofaciodigital syndrome III AR 258850 OFD3 258850 Not Mapped Orofaciodigital syndrome VII AD 608518 OFD7 608518 Not Mapped Orofaciodigital syndrome XI IC 612913 OFD11 612913 ▲ Close ▼ TEXT A number sign (#) is used with this entry because of evidence that orofaciodigital syndrome IV (OFD4) can be caused by homozygous or compound heterozygous mutation in the TCTN3 gene (613847) on chromosome 10q24.

Mutation in TCTN3 can also cause a form of Joubert syndrome (JBTS18; 614815).


Clinical Features

Baraitser (1986) suggested the existence of a fourth type of orofaciodigital syndrome but recognized that considerable overlap of the features of the various forms gives rise to difficulties in precise clinical differentiation V体育安卓版. The autosomal recessive mode of inheritance and the presence of severe tibial dysplasia differentiated type IV from type I (311200). .

Burn et al. (1984) described 2 sisters, the children of first-cousin Pakistani Moslem parents, who had unusual facies, tongue hamartomata, pre- and postaxial polydactyly, severe talipes, and mesomelic limb shortening associated with tibial dysplasia. Many of the features resembled those of the Majewski type of short rib-polydactyly syndrome (263520). Indeed, the older of the 2 sibs reported by Burn et al. (1984) had been reported as having either that syndrome (Cooper and Hall, 1982) or the Mohr-Majewski compound (Baraitser et al. , 1983) V体育ios版. Temtamy and McKusick (1978) had described a patient who they thought showed features of both syndromes. .

Nevin and Thomas (1989) reported a fifth patient with OFD IV VSports最新版本. The clinical characteristics included lobulated tongue, pseudo-cleft of the lip, pre- and postaxial polydactyly of the hands and feet, severe talipes equinovarus, mesomelic limb shortness associated with tibial hypoplasia, and severe bilateral deafness. Nevin et al. (1992) added to the genetic understanding of this disorder by describing an affected second cousin of the patient reported by Nevin and Thomas (1989). .

Meinecke and Hayek (1990) described a severely affected infant. V体育平台登录.

Ades et al. (1994) entertained a severe form of OFD IV as the diagnosis in a child of first-cousin Lebanese parents who was spontaneously delivered stillborn at 27 weeks' gestation. The fetus showed occipitoschisis, polydactyly, campomelia, cleft palate, laryngeal dysplasia, ocular colobomata, hepatic fibrosis with intrahepatic cyst, ambiguous genitalia, cystic dysplastic kidneys, and brain malformation. VSports注册入口.

Digilio et al V体育官网入口. (1995) described a female patient with OFD IV who, in addition to typical manifestations of the syndrome, had previously undescribed malformations and deformations, including cerebral and renal anomalies, anal atresia, and dislocation of elbows and knees. They stated that this was the tenth reported patient. .

Toriello et al. (1997) described 6 children diagnosed as having OFD syndrome with tibial defects. They concluded that the patients probably had different conditions, although all had oral, facial, digital, and tibial defects. VSports在线直播.

Thomas et al. (2012) examined a male fetus from a consanguineous Senegalese family; the pregnancy was terminated at 19 weeks due to brain anomalies, cystic kidneys, and severe skeletal dysplasia. He had facial dysmorphism with a lobulated tongue, polydactyly of all 4 limbs, severe cystic kidney disease, ductal plate proliferation in the liver, and occipital encephalocele. Neuropathologic assessment disclosed absent olfactory system, corpus callosum agenesis, and vermian hypoplasia. X-rays showed bowing of long bones with severe tibial hypoplasia. The acetabular margin had a trident appearance, but there were no short ribs. Thomas et al. (2012) concluded that the fetus fulfilled the diagnostic criteria for OFD4. V体育2025版.


Inheritance

Consanguinity in several reported families segregating OFD IV (e. g VSports. , Burn et al. , 1984; Ades et al. , 1994) supported autosomal recessive inheritance. .


Molecular Genetics

In a fetus from a consanguineous Senegalese family that fulfilled diagnostic criteria for OFD4, 22883145, images] [Full Text]" pmid="22883145">Thomas et al. (2012) performed genomewide homozygosity mapping and identified 14 regions of homozygosity. Targeted capture strategy combined with next-generation sequencing and filtering yielded a single nonsense mutation in the TCTN3 gene (E408X; 613847.0001) that was present in homozygosity in the fetus. Homozygosity mapping analysis in 18 additional cases presenting with lethal ciliopathies with various combinations of brain, renal, skeletal, and orofacial abnormalities and polydactyly revealed 6 with regions of homozygosity at the TCTN3 locus; direct sequencing of the TCTN3 gene identified 2 different homozygous truncating mutations in 3 of the fetuses (613847.0002 and 613847.0003). Sequencing of TCTN3 in an additional 82 nonconsanguineous fetal cases with a severe ciliopathy revealed compound heterozygosity for frameshift mutations in 2 affected French sibs (613847.0004-613847.0005). 22883145, images] [Full Text]" pmid="22883145">Thomas et al. (2012) noted that some of the affected fetuses did not display orofacial anomalies, thus confirming the variable phenotypic spectrum of OFD4.


REFERENCES

  1. Ades, L. C., Clapton, W. K., Morphett, A., Morris, L. L., Haan, E. A. Polydactyly, campomelia, ambiguous genitalia, cystic dysplastic kidneys, and cerebral malformation in a fetus of consanguineous parents: a new multiple malformation syndrome, or a severe form of oral-facial-digital syndrome type IV? Am. J. Med. Genet. 49: 211-217, 1994. [PubMed: 8116671, related citations] [Full Text]

  2. Baraitser, M. The orofaciodigital (OFD) syndromes. J. Med. Genet. 23: 116-119, 1986. [PubMed: 3712388, related citations] [Full Text]

  3. Baraitser, M., Burn, J., Fixsen, J. A female infant with features of Mohr and Majewski syndromes: variable expression, a genetic compound, or a distinct entity? J. Med. Genet. 20: 65-67, 1983. [PubMed: 6842538, related citations] [Full Text]

  4. Burn, J., Dezateux, C., Hall, C. M., Baraitser, M. Orofaciodigital syndrome with mesomelic limb shortening. J. Med. Genet. 21: 189-192, 1984. [PubMed: 6748015, related citations] [Full Text]

  5. Cooper, C. P., Hall, C. M. Lethal short-rib polydactyly syndrome of the Majewski type: a report of three cases. Radiology 144: 513-517, 1982. [PubMed: 7100463, related citations] [Full Text]

  6. Digilio, M. C., Giannotti, A., Pagnotta, G., Mingarelli, R., Dallapiccola, B. Joint dislocation and cerebral anomalies are consistently associated with oral-facial-digital syndrome type IV. Clin. Genet. 48: 156-159, 1995. [PubMed: 8556824, related citations] [Full Text]

  7. Meinecke, P., Hayek, H. Orofaciodigital syndrome type IV (Mohr-Majewski syndrome) with severe expression expanding the known spectrum of anomalies. J. Med. Genet. 27: 200-202, 1990. [PubMed: 2325097, related citations] [Full Text]

  8. Nevin, N. C., Magee, A. C., Mudenda, V., Thomas, P. S. Orofaciodigital syndrome type IV: report of a patient. (Letter) Am. J. Med. Genet. 43: 902-904, 1992. [PubMed: 1642284, related citations] [Full Text]

  9. Nevin, N. C., Thomas, P. S. Orofaciodigital syndrome type IV: report of a patient. Am. J. Med. Genet. 32: 151-154, 1989. [PubMed: 2929654, related citations] [Full Text]

  10. Temtamy, S. A., McKusick, V. A. The Genetics of Hand Malformations. New York: Alan R. Liss (pub.) 1978.

  11. Thomas, S., Legendre, M., Saunier, S., Bessieres, B., Alby, C., Bonniere, M., Toutain, A., Loeuillet, L., Szymanska, K., Jossic, F., Gaillard, D., Yacoubi, M. T., and 14 others. TCTN3 mutations cause Mohr-Majewski syndrome. Am. J. Hum. Genet. 91: 372-378, 2012. [PubMed: 22883145, images, related citations] [Full Text]

  12. Toriello, H. V., Carey, J. C., Suslak, E., Desposito, F. R., Leonard, B., Lipson, M., Friedman, B. D., Hoyme, H. E. Six patients with oral-facial-digital syndrome IV: the case for heterogeneity. Am. J. Med. Genet. 69: 250-260, 1997. [PubMed: 9096753, related citations]


Marla J. F. O'Neill - updated : 9/7/2012
Victor A. McKusick - updated : 5/13/1997
Creation Date:
Victor A. McKusick : 7/9/1987
carol : 09/11/2012
carol : 9/10/2012
terry : 9/7/2012
carol : 7/17/2009
terry : 8/26/2008
terry : 8/26/2008
joanna : 4/13/2005
alopez : 6/30/2004
alopez : 6/30/2004
alopez : 6/11/1997
mark : 5/13/1997
mark : 5/6/1997
terry : 11/13/1995
mark : 10/2/1995
mimadm : 3/11/1994
carol : 1/28/1994
carol : 8/24/1992
supermim : 3/17/1992

# 258860

OROFACIODIGITAL SYNDROME IV; OFD4


Alternative titles; symbols

OFDS IV
ORAL-FACIAL-DIGITAL SYNDROME, TYPE IV
OFD SYNDROME WITH TIBIAL DEFECTS
MOHR-MAJEWSKI SYNDROME
OFD SYNDROME, BARAITSER-BURN TYPE
BARAITSER-BURN SYNDROME


SNOMEDCT: 239031000;   ORPHA: 2753;   DO: 0060374;   MONDO: 0009794;  


Phenotype-Gene Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
Gene/Locus Gene/Locus
MIM number
10q24.1 Orofaciodigital syndrome IV 258860 Autosomal recessive 3 TCTN3 613847

TEXT

A number sign (#) is used with this entry because of evidence that orofaciodigital syndrome IV (OFD4) can be caused by homozygous or compound heterozygous mutation in the TCTN3 gene (613847) on chromosome 10q24.

Mutation in TCTN3 can also cause a form of Joubert syndrome (JBTS18; 614815).


Clinical Features

Baraitser (1986) suggested the existence of a fourth type of orofaciodigital syndrome but recognized that considerable overlap of the features of the various forms gives rise to difficulties in precise clinical differentiation. The autosomal recessive mode of inheritance and the presence of severe tibial dysplasia differentiated type IV from type I (311200).

Burn et al. (1984) described 2 sisters, the children of first-cousin Pakistani Moslem parents, who had unusual facies, tongue hamartomata, pre- and postaxial polydactyly, severe talipes, and mesomelic limb shortening associated with tibial dysplasia. Many of the features resembled those of the Majewski type of short rib-polydactyly syndrome (263520). Indeed, the older of the 2 sibs reported by Burn et al. (1984) had been reported as having either that syndrome (Cooper and Hall, 1982) or the Mohr-Majewski compound (Baraitser et al., 1983). Temtamy and McKusick (1978) had described a patient who they thought showed features of both syndromes.

Nevin and Thomas (1989) reported a fifth patient with OFD IV. The clinical characteristics included lobulated tongue, pseudo-cleft of the lip, pre- and postaxial polydactyly of the hands and feet, severe talipes equinovarus, mesomelic limb shortness associated with tibial hypoplasia, and severe bilateral deafness. Nevin et al. (1992) added to the genetic understanding of this disorder by describing an affected second cousin of the patient reported by Nevin and Thomas (1989).

Meinecke and Hayek (1990) described a severely affected infant.

Ades et al. (1994) entertained a severe form of OFD IV as the diagnosis in a child of first-cousin Lebanese parents who was spontaneously delivered stillborn at 27 weeks' gestation. The fetus showed occipitoschisis, polydactyly, campomelia, cleft palate, laryngeal dysplasia, ocular colobomata, hepatic fibrosis with intrahepatic cyst, ambiguous genitalia, cystic dysplastic kidneys, and brain malformation.

Digilio et al. (1995) described a female patient with OFD IV who, in addition to typical manifestations of the syndrome, had previously undescribed malformations and deformations, including cerebral and renal anomalies, anal atresia, and dislocation of elbows and knees. They stated that this was the tenth reported patient.

Toriello et al. (1997) described 6 children diagnosed as having OFD syndrome with tibial defects. They concluded that the patients probably had different conditions, although all had oral, facial, digital, and tibial defects.

Thomas et al. (2012) examined a male fetus from a consanguineous Senegalese family; the pregnancy was terminated at 19 weeks due to brain anomalies, cystic kidneys, and severe skeletal dysplasia. He had facial dysmorphism with a lobulated tongue, polydactyly of all 4 limbs, severe cystic kidney disease, ductal plate proliferation in the liver, and occipital encephalocele. Neuropathologic assessment disclosed absent olfactory system, corpus callosum agenesis, and vermian hypoplasia. X-rays showed bowing of long bones with severe tibial hypoplasia. The acetabular margin had a trident appearance, but there were no short ribs. Thomas et al. (2012) concluded that the fetus fulfilled the diagnostic criteria for OFD4.


Inheritance

Consanguinity in several reported families segregating OFD IV (e.g., Burn et al., 1984; Ades et al., 1994) supported autosomal recessive inheritance.


Molecular Genetics

In a fetus from a consanguineous Senegalese family that fulfilled diagnostic criteria for OFD4, Thomas et al. (2012) performed genomewide homozygosity mapping and identified 14 regions of homozygosity. Targeted capture strategy combined with next-generation sequencing and filtering yielded a single nonsense mutation in the TCTN3 gene (E408X; 613847.0001) that was present in homozygosity in the fetus. Homozygosity mapping analysis in 18 additional cases presenting with lethal ciliopathies with various combinations of brain, renal, skeletal, and orofacial abnormalities and polydactyly revealed 6 with regions of homozygosity at the TCTN3 locus; direct sequencing of the TCTN3 gene identified 2 different homozygous truncating mutations in 3 of the fetuses (613847.0002 and 613847.0003). Sequencing of TCTN3 in an additional 82 nonconsanguineous fetal cases with a severe ciliopathy revealed compound heterozygosity for frameshift mutations in 2 affected French sibs (613847.0004-613847.0005). Thomas et al. (2012) noted that some of the affected fetuses did not display orofacial anomalies, thus confirming the variable phenotypic spectrum of OFD4.


REFERENCES

  1. Ades, L. C., Clapton, W. K., Morphett, A., Morris, L. L., Haan, E. A. Polydactyly, campomelia, ambiguous genitalia, cystic dysplastic kidneys, and cerebral malformation in a fetus of consanguineous parents: a new multiple malformation syndrome, or a severe form of oral-facial-digital syndrome type IV? Am. J. Med. Genet. 49: 211-217, 1994. [PubMed: 8116671] [Full Text: https://doi.org/10.1002/ajmg.1320490211]

  2. Baraitser, M. The orofaciodigital (OFD) syndromes. J. Med. Genet. 23: 116-119, 1986. [PubMed: 3712388] [Full Text: https://doi.org/10.1136/jmg.23.2.116]

  3. Baraitser, M., Burn, J., Fixsen, J. A female infant with features of Mohr and Majewski syndromes: variable expression, a genetic compound, or a distinct entity? J. Med. Genet. 20: 65-67, 1983. [PubMed: 6842538] [Full Text: https://doi.org/10.1136/jmg.20.1.65]

  4. Burn, J., Dezateux, C., Hall, C. M., Baraitser, M. Orofaciodigital syndrome with mesomelic limb shortening. J. Med. Genet. 21: 189-192, 1984. [PubMed: 6748015] [Full Text: https://doi.org/10.1136/jmg.21.3.189]

  5. Cooper, C. P., Hall, C. M. Lethal short-rib polydactyly syndrome of the Majewski type: a report of three cases. Radiology 144: 513-517, 1982. [PubMed: 7100463] [Full Text: https://doi.org/10.1148/radiology.144.3.7100463]

  6. Digilio, M. C., Giannotti, A., Pagnotta, G., Mingarelli, R., Dallapiccola, B. Joint dislocation and cerebral anomalies are consistently associated with oral-facial-digital syndrome type IV. Clin. Genet. 48: 156-159, 1995. [PubMed: 8556824] [Full Text: https://doi.org/10.1111/j.1399-0004.1995.tb04077.x]

  7. Meinecke, P., Hayek, H. Orofaciodigital syndrome type IV (Mohr-Majewski syndrome) with severe expression expanding the known spectrum of anomalies. J. Med. Genet. 27: 200-202, 1990. [PubMed: 2325097] [Full Text: https://doi.org/10.1136/jmg.27.3.200]

  8. Nevin, N. C., Magee, A. C., Mudenda, V., Thomas, P. S. Orofaciodigital syndrome type IV: report of a patient. (Letter) Am. J. Med. Genet. 43: 902-904, 1992. [PubMed: 1642284] [Full Text: https://doi.org/10.1002/ajmg.1320430534]

  9. Nevin, N. C., Thomas, P. S. Orofaciodigital syndrome type IV: report of a patient. Am. J. Med. Genet. 32: 151-154, 1989. [PubMed: 2929654] [Full Text: https://doi.org/10.1002/ajmg.1320320202]

  10. Temtamy, S. A., McKusick, V. A. The Genetics of Hand Malformations. New York: Alan R. Liss (pub.) 1978.

  11. Thomas, S., Legendre, M., Saunier, S., Bessieres, B., Alby, C., Bonniere, M., Toutain, A., Loeuillet, L., Szymanska, K., Jossic, F., Gaillard, D., Yacoubi, M. T., and 14 others. TCTN3 mutations cause Mohr-Majewski syndrome. Am. J. Hum. Genet. 91: 372-378, 2012. [PubMed: 22883145] [Full Text: https://doi.org/10.1016/j.ajhg.2012.06.017]

  12. Toriello, H. V., Carey, J. C., Suslak, E., Desposito, F. R., Leonard, B., Lipson, M., Friedman, B. D., Hoyme, H. E. Six patients with oral-facial-digital syndrome IV: the case for heterogeneity. Am. J. Med. Genet. 69: 250-260, 1997. [PubMed: 9096753]


Contributors:
Marla J. F. O'Neill - updated : 9/7/2012
Victor A. McKusick - updated : 5/13/1997

Creation Date:
Victor A. McKusick : 7/9/1987

Edit History:
carol : 09/11/2012
carol : 9/10/2012
terry : 9/7/2012
carol : 7/17/2009
terry : 8/26/2008
terry : 8/26/2008
joanna : 4/13/2005
alopez : 6/30/2004
alopez : 6/30/2004
alopez : 6/11/1997
mark : 5/13/1997
mark : 5/6/1997
terry : 11/13/1995
mark : 10/2/1995
mimadm : 3/11/1994
carol : 1/28/1994
carol : 8/24/1992
supermim : 3/17/1992