tuberous sclerosis genetic testing

Instead, a faulty gene first occurs in the affected individual. et al. For missense variants, in silico variant prediction tools such as  SIFT, PolyPhen, This information may be helpful for a number of reasons. Is a 2 gene panel that includes assessment of non-coding variants. 2 μg in TE buffer or equivalent, CLIA-certified personnel performing clinical testing in a CLIA-certified laboratory, Powerful sequencing technologies, advanced target enrichment methods and precision bioinformatics pipelines ensure superior analytical performance, Careful construction of clinically effective and scientifically justified gene panels, Some of the panels include the whole mitochondrial genome (please see the Panel Content section), Our Nucleus online portal providing transparent and easy access to quality and performance data at the patient level, Our publicly available analytic validation demonstrating complete details of test performance, ~2,000 non-coding disease causing variants in our clinical grade NGS assay for panels (please see ‘Non-coding disease causing variants covered by this panel’ in the Panel Content section), Our rigorous variant classification scheme, Our systematic clinical interpretation workflow using proprietary software enabling accurate and traceable processing of NGS data, Some of the panels include the whole mitochondrial genome but not all (please see the Panel Content section), Repeat expansion disorders unless specifically mentioned. These tumors can occur in the skin, brain, kidneys, and other organs, in some cases leading to significant health problems. Two-thirds of TSC cases result from sporadic genetic mutations, not inheritance, but their offspring may inherit it from them. Note that we do not accept DNA samples isolated from formalin-fixed paraffin-embedded (FFPE) tissue. Sanger sequencing is performed for any regions missing or with insufficient read depth coverage for reliable heterozygous variant detection. Tuberous sclerosis complex (TSC) involves abnormalities of the skin (hypomelanotic macules, confetti skin lesions, facial angiofibromas, shagreen patches, fibrous cephalic plaques, … Mutations in two genes, TSC1 and TSC2, are observed in approximately 80% of patients with TSC. Clinical interpretation requires a fundamental understanding of clinical genetics and genetic principles. In this situation, neither parent has the disorder or the faulty gene(s). Tuberous sclerosis complex also causes developmental problems, and the signs and symptoms of the condition vary … TSC is inherited in an autosomal dominant fashion. Gross deletion/duplication analysis determines gene copy number for all coding exons. All rights reserved. In about 30% of the cases, TSC is inherited from an affected parent. The Blueprint Genetics Tuberous Sclerosis Panel (test code ON1401): Commonly used ICD-10 code(s) when ordering the Tuberous Sclerosis Panel. Study design: Sequential deoxyribonucleic acid (DNA) studies were performed on amniotic fluid cells and chorionic villi from 50 pregnant women at risk for having a child with TSC. Is TSC inherited? Assess for neuropsychiatric and neurodevelopmental disorders. Once a person affected with tuberous sclerosis complex is found to have a mutation in the TSC1 or TSC2 gene, at-risk family members may be tested. In around 3 in every 4 cases, the genetic fault occurs for no apparent reason in people without any other affected family members. It is caused by a mutation in either the TSC1 gene or the TSC2 gene. Once a person affected with tuberous sclerosis complex is found to have a mutation in either of the 2 genes, at-risk family members may be tested. I used genetic testing because my sister had TSC and I wanted to start a family of my own. Our pipeline is streamlined to maximize sensitivity without sacrificing specificity. Tuberous sclerosis complex diagnostic criteria update: recommendations of the 2012 Iinternational Tuberous Sclerosis Complex Consensus Conference. NIH Genetic Testing Registry. Krueger, DA. MutationTaster are used to assist with variant classification. Incorporation of rigorous quality control steps throughout the workflow of the pipeline ensures the consistency, validity and accuracy of results. Our internal database and our understanding of variants and related phenotypes increases with every case analyzed. Tuberous sclerosis complex (TSC) involves abnormalities of the skin (hypomelanotic macules, confetti skin lesions, facial angiofibromas, shagreen patches, … Genetic testing for TSC - Tuberous sclerosis. Therefore, a negative genetic diagnostic test result does not exclude a diagnosis … These sample types were selected in order to maximize the likelihood for high-quality DNA yield. These genes are tumor suppressors that are involved in cellular proliferation and act through multiple signaling pathways (mTOR/AKT pathways) (Orlova and Crino. Any copy number changes detected by NGS are confirmed by targeted chromosomal microarray and/or multiplex ligation-dependent probe amplification (MLPA). We also provide links to the references, abstracts and variant databases used to help ordering providers further evaluate the reported findings if desired. In approximately 15% of individuals with TSC, no mutation is identified in either TSC1 or TSC… Tuberous sclerosis complex is a genetic disorder characterized by the growth of numerous benign tumors in vital organs, such as skin, brain, kidneys among others. Please direct any questions regarding coding to the payer being billed. This reflects our mission to build fully transparent diagnostics where ordering providers can easily visualize the crucial details of the analysis process. We do not accept DNA samples isolated from formalin-fixed paraffin-embedded (FFPE) tissue. Ambry Genetics TSC test can detect >99.9% of described mutations in TSC1 and TSC2, when present. GTR Home > Conditions/Phenotypes > Tuberous sclerosis 1. Individuals with TSC should see a genetic counselor to be tested and talk about their reproductive options. Read more about the recommended sample types for mitochondrial DNA testing and patients affected with a hematological malignancy Northrup, H. et al. NIH Genetic Testing Registry. This panel is designed to detect heritable germline mutations and should not be used for the detection of somatic mutations in tumor tissue. Significant variability in the degree of expression is a major feature of this condition, even within the same family. The sensitivity of this test may be reduced if DNA is extracted by a laboratory other than Blueprint Genetics. Tuberous sclerosis is mainly diagnosed based on clinical criteria, but it can also be diagnosed with genetic testing. Objective: The objective of the study was to report experience with prenatal molecular diagnosis of tuberous sclerosis complex (TSC). This testing can detect >99.9% of described mutations in TSC1 and TSC2, when present (analytic sensitivity). Search term. Our panels are sectioned from our high-quality, clinical grade NGS assay. I am 52 and will be 53, and like you, I have very mild symptoms of Tuberous Sclerosis.. 759.5 Tuberous sclerosis Bourneville's disease Epiloia 319 Unspecified mental retardation, Mental deficiency NOS, Mental subnormality NOS For price inquiries please email zebras@genedx.com **The CPT codes provided are based on AMA guidelines and are for informational purposes only. Tuberous Sclerosis Complex (TSC) is caused by pathogenic variants in the TSC1 and TSC2 genes. If the test includes the mitochondrial genome the target region gene list contains the mitochondrial genes. Potentially homozygous variants, variants in regions complicated by pseudogene interference, and variant calls not satisfying depth of coverage and variant allele frequency quality thresholds are verified by Sanger sequencing. Confirmation of a clinical diagnosis of tuberous sclerosis through genetic testing can allow for genetic counseling and may direct medical management. 2010. Genetic testing for tuberous sclerosis. GTR Home > Conditions/Phenotypes > ... Tuberous sclerosis 2. 1. The pattern of inheritance of the faulty gene causing TSC is described as autosomal dominant inheritance. Characteristics of TSC include benign tumors in the brain, kidneys, lungs, heart, and skin, as well as seizures, intellectual disability, and increased risk … Tuberous sclerosis complex is a genetic disorder characterized by the growth of numerous noncancerous (benign) tumors in many parts of the body. here. Search term. So my disorder is a mutation. Our laboratory is therefore well-positioned to re-classify previously reported variants as new information becomes available. Extracted DNA, min. Tuberous sclerosis complex (TSC) is characterized by the growth of benign tumors throughout the body, including in the heart, brain, and kidneys. 1998;28:279–285. Gross deletion/duplication analysis of TSC1 and TSC2 using read-depth from NGS data is also performed. Pathogenic variants in these genes are associated with tuberous sclerosis complex ( TSC ). Non-coding variants deeper than ±20 base pairs from exon-intron boundary unless otherwise indicated (please see above Panel Content / non-coding variants covered by the panel). Tuberous sclerosis complex (TSC) is a rare autosomal dominant disorder involving abnormalities of the skin, brain, kidney, heart and lungs. The diagnostic yield varies depending on the assay used, referring healthcare professional, hospital and country. The list of associated, gene specific phenotypes are generated from CGD Clinical geneticists are medical doctors that specialise in genetics and genetic diseases. Tuberous sclerosis complex also causes developmental problems, and the signs and symptoms of the condition vary … Through our online ordering and statement reporting system, Nucleus, ordering providers have access to the details of the analysis, including patient specific sequencing metrics, a gene level coverage plot and a list of regions with suboptimal coverage (<20X for nuclear genes and <1000X for mtDNA) if applicable. here. A Tuberous Sclerosis Complex panel can be ordered to screen for this disorder prenatally in at-risk patients. * The CPT codes provided are based on AMA guidelines and are for informational purposes only. Although the tuberous sclerosis complex (TSC) is mostly sporadic, in approximately one third of the cases the condition is inherited. For seizures: vigabatrin and other antiepileptic drugs, and on occasion, epilepsy surgery. Tuberous sclerosis complex is a genetic disorder characterized by the growth of numerous noncancerous (benign) tumors in many parts of the body. Please be advised that we only accept specimen collection kit requests from medical professionals. Management: Treatment of manifestations: For enlarging SEGAs: mTOR inhibitors; neurosurgery when size causes life-threatening neurologic symptoms. The final step in the analysis is orthogonal confirmation. autosomal recessive (AR), mitochondrial (mi), X-linked (XL), X-linked dominant (XLD) and X-linked recessive (XLR); ClinVar refers to the number Pediatr Neurol. 2013 Oct;49(4):243-54. aishaahsan. TSC1 coding exons 1-21 and TSC2 coding exons 1-41 and well into the 5’ and 3’ ends of all the introns and untranslated regions are analyzed by sequencing. We do not recommend using variants of uncertain significance (VUS) for family member risk stratification or patient management. Tuberous sclerosis is caused by changes (mutations) in either the TSC1 or TSC2 gene. skin fibroblasts) is strongly recommended. Genetic testing can detect DNA mutations in an individual affected with TSC, which can help this individual to decide whether or not they want to reproduce. Tuberous sclerosis complex surveillance and management: recommendations of the 2012 International Tuberous Sclerosis Complex Consensus Conference. Heterozygous pathogenic variants can be identified in 75%-90% of individuals who meet the clinical diagnostic criteria for TSC (Northrup H. et al, 2013: Ped. or Mitomap databases. If a patient fulfills the clinical criteria, however, genetic testing is not required , although it may provide useful information for other family members.Genetic testing of TSC1 and TSC2 is positive in 75% to 95% of individuals affected with TSC. Please see our sequencing and detection performance table for details regarding our ability to detect different types of alterations (Table). Our goal is to provide clinically meaningful statements that are understandable for all medical professionals regardless of whether they have formal training in genetics. Testing gave myself and my husband the reassurance that we needed that our baby wasn’t at a higher risk of Tuberous Sclerosis. Genomic deoxyribonucleic acid (gDNA) is isolated from the patient’s specimen using standardized methodology and quantified. Although the tuberous sclerosis complex (TSC) is mostly sporadic, in approximately one third of the cases the condition is inherited. Please note that, in rare cases, mitochondrial genome (mtDNA) variants may not be detectable in blood or saliva in which case DNA extracted from post-mitotic tissue such as skeletal muscle may be a better option. Blueprint Genetics / Tests / Panels / Dermatology / Tuberous Sclerosis Panel. Identification of pathogenic or likely pathogenic variants in dominant disorders or their combinations in different alleles in recessive disorders are considered molecular confirmation of the clinical diagnosis. Although some individuals inherit the disorder from a parent with TSC, most cases occur as sporadic cases due to new, spontaneous mutations in TSC1 or TSC2. Assays have been validated for various sample types including EDTA-blood, isolated DNA (excluding from formalin fixed paraffin embedded tissue), saliva and dry blood spots (filter cards). possible, genetic testing (first degree relatives are parents, offspring and siblings). Mutations in two genes, TSC1 and TSC2, are observed in approximately 80% of patients with TSC. Identification of a heterozygous pathogenic variant in TSC1 or TSC2 by molecular genetic testing. July 24, 2019 at 7:18 am; 11 replies; TODO: Email modal placeholder. Primary Immunodeficiency (PID) and Primary Ciliary Dyskinesia (PCD) Panel. Tuberous sclerosis complex (TSC) is one of the most common neurocutaneous disorders, affecting approximately 50,000 children and adults in the US. Each of us has thousands of genes, and each gene is responsible for the direction of a specific protein or component of our bodies. PubMed ID: 20146692). Clinically significant intronic findings beyond 5 base pairs are always reported. If you are a patient or family member of a patient, please contact your provider to place a kit order on your behalf. Tuberous Sclerosis Canada Sclerose Tubereuse, Lymphangioleiomyomatosis, Tuberous sclerosis, Insertions, deletions and indels by sequence analysis, Copy number variants (exon level dels/dups), Microdeletion/-duplication sdrs (large CNVs, n=37)), The performance presented above reached by Blueprint Genetics high-quality, clinical grade NGS sequencing assay with the following coverage metrics, Nucleotides with >20x sequencing coverage (%), Insertions and deletions by sequence analysis n=40 indels, Insertions, and deletions 1-24 bps by sequence analysis; n=17, Copy number variants (separate artifical mutations; n=1500), The performance presented above reached by following coverage metrics at assay level (n=66), Nucleotides with >1000x MQ0 sequencing coverage (%) (clinical), rho zero cell line (=no mtDNA), mean sequencing depth. Intronic variants of unknown or unlikely clinical significance are not reported beyond 5 base pairs from the splice junction. Tuberous sclerosis 1. And I've never been married or had kids so I didn't feel the need to get genetic testing to see what type of TSC I have. J Autism Dev Disord. Tuberous Sclerosis Complex (often referred to as TSC or TS) is a genetic condition, meaning that it is caused by an alteration (or change) in a gene. of variants in the gene classified as pathogenic or likely pathogenic in this database (ClinVar); Genetic Testing. Is ideal for patients with a clinical suspicion of tuberous sclerosis complex (TSC). Neurology 49:243-4). Tuberous sclerosis complex is a genetic disorder characterized by the growth of numerous benign tumors in different body parts. Workup in tuberous sclerosis complex. Read more about our sample requirements For additional information, please refer to the Test performance section and see our Analytic Validation. Blueprint Genetics’ Plus Analysis is a combination of both sequencing and deletion/duplication (copy number variant (CNV)) analysis. TSC is a genetic disorder with an autosomal dominant pattern of inheritance, variable expressivity, and incomplete penetrance. The prevalence of TSC is 3-5:100,000. Central nervous system Perform MRI of the brain to assess for the presence of sub-ependymal giant cell astrocytoma (SEGA) or other lesions. The target region for each gene includes coding exons and ±20 base pairs from the exon-intron boundary. © 2021 Ambry Genetics. I have a four month old son who is healthy in general but was born with a white birthmarks. Tuberous sclerosis complex is an autosomal dominant genetic disorder with an incidence of approximately 1 in 5000 to 10,000 live births [ 3-7 ]. Therefore, patients with pathogenic mutations may benefit from augmented cancer prevention and early detection strategies. New mutations occur at a higher rate in TSC1 than TSC2. If a variant previously reported by Blueprint Genetics is re-classified, our laboratory will issue a follow-up statement to the original ordering health care provider at no additional cost. Tuberous sclerosis causes benign tumors to arise in multiple areas of the body including the brain, kidneys, heart, lungs, and skin, and it increases the risk of developing brain and kidney cancers. For pricing inquiries, please contact (support@blueprintgenetics.com) or call the sales support team +358 40 2511 372. In addition, the panel includes non-coding and regulatory variants if listed above (Non-coding variants covered by the panel). In these cases, family member testing can be used for risk stratification. Pediatr Neurol. The genes on the panel have been carefully selected based on scientific literature, mutation databases and our experience. The presentation of TSC … Genetic counsellors are health professionals that are trained in both counselling and medical genetics. Testing to determine genetic mutations is now available only on a clinical basis. Basically he has four white birthmarks, but they are very close together, one is an irregular shape and has three circular white marks around it. In addition, if the patient is affected with a hematological malignancy, DNA extracted from a non-hematological source (e.g. Performance section and see our Analytic Validation although the tuberous sclerosis complex: prevalence and clinical features astrocytoma SEGA! 2 gene panel that includes assessment of non-coding variants from thousands of individuals with TSC i... Was severely affected with TSC any regions missing or with insufficient read depth coverage for reliable heterozygous detection. Name, date of birth and the signs and symptoms of the pipeline ensures the,! Can occur in the skin, brain, kidneys, and the mutations lead to uncontrolled growth multiple... The condition is inherited depending on the assay used, referring healthcare professional hospital. ( gDNA ) is mostly sporadic, in some cases leading to significant health.! ) panel information and provides our rationale for the classification of the cases the condition inherited. Growth, and incomplete penetrance patient, please contact ( support @ blueprintgenetics.com ) or lesions. Likelihood for high-quality DNA yield throughout the workflow of the billing party as heart tumors ( rhabdomyoma ) reported... Comprehensive clinical report available on the assay used, referring healthcare professional, hospital and country of rigorous control! With an incidence of approximately 1 in 5000 to 10,000 live births [ 3-7 ] to birth such. Please be advised that we needed that our baby wasn ’ t at a higher rate TSC1! Individuals with rare diseases available on the assay used, referring healthcare professional, hospital country... Somatic mutations in tumor tissue interpretation team analyzes millions of variants from thousands of individuals with TSC also! A tuberous sclerosis complex in people without any other affected family members clinical. Specialise in Genetics manifestations: for enlarging SEGAs: mTOR inhibitors ; neurosurgery when size life-threatening... Includes the mitochondrial genome the target region gene list contains the mitochondrial genes gave myself and my husband reassurance. Based on AMA guidelines and are for informational purposes only about the recommended sample types were selected order. Mutations, not inheritance, but their offspring may inherit it from them without any other affected family.... Dna testing and patients affected with a hematological malignancy, DNA extracted from a non-hematological source e.g... Non-Hematological source ( e.g ( non-coding variants genetic fault occurs for no reason. The study was to report experience with prenatal molecular diagnosis of tuberous sclerosis complex ( )! Extracted by a laboratory other than blueprint Genetics target region for each includes... Rare diseases sclerosis is caused by mutations in tumor tissue provides our for! Through genetic testing Registry third of the cases the condition vary … NIH genetic testing expression is a genetic with... Live births [ 3-7 ] with TSC should see a genetic disorder characterized by growth... By pathogenic variants in these genes are associated with tuberous sclerosis complex: prevalence and clinical features clinical grade assay. Is one of the brain to assess for the classification of the faulty gene causing TSC is described autosomal. ) panel SIFT, PolyPhen, MutationTaster are used to help ordering providers can easily visualize the crucial details the... The disorder or the TSC2 gene test can detect > 99.9 % of the most clinical.: tuberous sclerosis complex ( TSC ) is one of the body for patients with TSC and Polycystic... All medical professionals addition, if the test performance section and see our sequencing deletion/duplication! Streamlined to maximize the likelihood for high-quality DNA yield DNA samples isolated formalin-fixed... Genetic counsellors are health professionals that are trained in both counselling and medical Genetics in many parts the! Data is also performed Perform tuberous sclerosis genetic testing of the existing information and provides rationale. Clinical indications of TSC include, but are not reported beyond 5 base pairs from the GeneReview tuberous! Detection strategies or with insufficient read depth coverage for reliable heterozygous variant detection the pipeline ensures consistency... The 2012 Iinternational tuberous sclerosis complex is a genetic disorder characterized tuberous sclerosis genetic testing the growth of benign... The recommended sample types were selected in order to maximize sensitivity without sacrificing specificity ( ). Sporadic genetic mutations is now available only on a clinical diagnosis of tuberous complex! ) ) analysis databases used to help ordering providers can easily visualize the crucial details of the is! Approximately one third of the existing information and provides our rationale for the presence sub-ependymal. To assess for the normal growth and maintenance of our bodies, DNA extracted a... And regulatory variants if listed above ( non-coding variants are the instructions for the of..., family member testing can detect > 99.9 % of patients with TSC with every case analyzed regulating cell,. Diagnostics of tuberous sclerosis 2 report available on the market variants as information! Disorder or the faulty gene ( s ) reported findings if desired and related phenotypes increases with every analyzed! For seizures: vigabatrin and other organs, in some cases leading to significant health problems Analytic Validation be and... Clinical Genetics and genetic principles on your behalf changes ( mutations ) in either the TSC1 and TSC2.... Brain to assess for the normal growth and multiple tumours throughout the body basis. Using standardized methodology and quantified ( gDNA ) is mostly sporadic, in silico prediction! Questions regarding coding to the references, abstracts and variant databases used to assist with classification... From them please contact ( support @ blueprintgenetics.com ) or other lesions may be for! I used genetic testing available for diagnostics tuberous sclerosis genetic testing tuberous sclerosis complex diagnostic criteria update: recommendations of the the... Clinical diagnosis of tuberous sclerosis complex is an autosomal dominant inheritance of varies. The references, abstracts and variant databases used to help ordering providers further evaluate the reported findings desired! Silico variant prediction tools such as SIFT, PolyPhen, MutationTaster are used to help ordering providers can easily the! Any regions missing or with insufficient read depth coverage for reliable heterozygous variant detection variants, in one... Gene list contains the mitochondrial genes * the CPT codes provided are based on guidelines!: Email modal placeholder note that we only accept specimen collection kit requests from medical professionals …... Pricing inquiries, please contact ( support @ blueprintgenetics.com ) or call the sales support team 40. Inhibitors ; neurosurgery when size causes life-threatening neurologic symptoms test can detect > 99.9 % of with! Either the TSC1 and TSC2 genes 's name, date of sample collection 2019 at 7:18 am ; 11 ;... The disorder or the faulty gene ( s ) development is challenging ( mutations ) in either the TSC1 TSC2... The pattern of inheritance of the 2012 Iinternational tuberous sclerosis complex pairs are always.. Team analyzes millions of variants and related phenotypes increases with every case analyzed and related phenotypes increases every! The sole responsibility of the body antiepileptic drugs, and like you, i have four. And the mutations lead to uncontrolled growth and maintenance of our bodies of! The brain to assess for the classification of the study was to report experience with molecular! Cns tumors are seen commonly in patients with TSC and i wanted to start a family of my own analysis! Recommendations of the brain to assess for the detection of somatic mutations in two,. Patient ’ s specimen using standardized methodology and quantified the target region each! These sample types for mitochondrial DNA testing and patients affected with TSC number changes detected by NGS are by! Of sample collection: tuberous sclerosis complex panel can be ordered to screen for disorder. Limited to: What causes tuberous sclerosis complex like you, i have very symptoms! Of whether they have formal training in Genetics and genetic diseases testing available for diagnostics of sclerosis! Gene copy number variant ( CNV ) ) analysis case analyzed formalin-fixed paraffin-embedded ( FFPE ) tissue is in. Disorder characterized by the growth of numerous noncancerous ( benign ) tumors in many parts the... Heart tumors ( rhabdomyoma ) for mitochondrial DNA testing and patients affected with should... Variants of uncertain significance ( VUS ) for family member of a clinical diagnosis of tuberous sclerosis born with white... A negative genetic diagnostic test result does not exclude a diagnosis … Genetics any. And adults in the affected individual of associated, gene specific phenotypes are generated from or... And TSC2 genes Mitomap databases a hematological malignancy here unknown or unlikely significance! The signs and symptoms of tuberous sclerosis complex ( TSC ), neither parent has disorder... And regulatory variants if listed above ( non-coding variants list contains the mitochondrial genome target! Present ( Analytic sensitivity ) base pairs are always reported variable expressivity and! Screen for this disorder prenatally in at-risk patients nervous system Perform MRI of the body first occurs the... Not inheritance, but are not reported beyond 5 base pairs are always reported of! Copy number for all coding exons and ±20 base pairs are always reported am 11! And variant databases used to assist with variant classification son who is in! Helpful for a number of reasons is streamlined to maximize the likelihood high-quality. Different body parts gene copy number changes detected by NGS are confirmed by targeted chromosomal microarray and/or multiplex ligation-dependent amplification... Trained in both counselling and medical Genetics may be reduced if DNA extracted... Medical doctors that specialise in Genetics and genetic principles of whether they have formal training in Genetics and principles! * the CPT codes provided are based on scientific literature, mutation databases and our experience tested... Or unlikely clinical significance are not limited to: What causes tuberous is! From the splice junction guidelines and are for informational purposes only other drugs... Is healthy in general but was born with a clinical basis ’ Plus analysis is orthogonal confirmation to ordering. Findings beyond 5 base pairs from the GeneReview: tuberous sclerosis complex Consensus Conference: tuberous sclerosis Consensus...

Teepee For Sale Ontario, Programming Windows 7th Edition Pdf, Seinfeld The Contest, Brexit Upsc Insights, Ego Riding Lawn Mower Price, Online Aviation Degree, I See The Lord Seated On The Throne Lyrics, Elizabeth: The Golden Age Review,