Chimeric plant calcium/calmodulin-dependent protein kinase gene with a neural visinin-like calcium-binding domain

Calcium, a universal second messenger, regulates diverse cellular processes in eukaryotes. Ca2+ and Ca2+/calmodulin-regulated protein phosphorylation play a pivotal role in amplifying and diversifying the action of Ca(2+)-binding domain was cloned and characterized from lily. The cDNA clone contains an open reading frame coding for a protein of 520 amino acids. The predicted structure of CCaMK contains a catalytic domain followed by two regulatory domains, a calmodulin-binding domain and a visinin-like Ca(2+)-binding domain. The amino-terminal region of CCaMK contains all 11 conserved subdomains characteristic of serine/threonine protein kinases. The calmodulin-binding region of CCaMK has high homology (79%) to alpha subunit of mammalian Ca2+/calmodulin-dependent protein kinase. The calmodulin-binding region is fused to a neural visinin-like domain that contains three Ca(2+)-binding EF-hand motifs and a biotin-binding site. The Escherichia coli-expressed protein (approximately 56 kDa) binds calmodulin in a Ca(2+)-dependent manner. Furthermore, 45Ca-binding assays revealed that CCaMK directly binds Ca2+. The CCaMK gene is preferentially expressed in developing anthers. Southern blot analysis revealed that CCaMK is encoded by a single gene. The structural features of the gene suggest that it has multiple regulatory controls and could play a unique role in Ca2+ signaling in plants.

Cholesterol mediated changes in beta-glucuronidase activities of rat theca interstitial cells and granulosa cells

Effects of steroid hormones on beta-glucuronidase activities of granulosa cells and theca interstitial cells were studied in vitro in the presence and absence of cholesterol in minimum essential medium (MEM with Hank's salts). Conspicuous fall in the enzyme activities of both these cells were noticed during first 10 min of incubation in MEM without cholesterol and remained lower throughout the experiment. Addition of cholesterol to incubation medium maintained beta-glucuronidase activities of both the cells as observed in the cells of immature ovary immediately after isolation. 17 beta-estradiol did not affect beta-glucuronidase activities of these cells, while testosterone and progesterone suppressed the enzyme activities of these cells in the presence of cholesterol.

Psyllium for the reduction of cholestyramine-associated gastrointestinal symptoms in the treatment of primary hypercholesterolemia

OBJECTIVE

To determine if the bulk-forming laxative, psyllium hydrophilic mucilloid (PHM), reduces the gastrointestinal side effects and enhances the cholesterol-lowering efficacy of cholestyramine resin in patients with primary hypercholesterolemia.

DESIGN

After a dietary lead-in period and 6 weeks of treatment with cholestyramine, the study followed a double-blinded, placebo-controlled, crossover format.

SETTING

Lipid clinic affiliated with a large metropolitan community hospital.

PARTICIPANTS

Twenty-seven randomly selected male and female patients with a diagnosis of primary hypercholesterolemia. Entry criteria required a fasting low-density lipoprotein cholesterol (LDL-C) concentration of 4.91 mmol/L (190 mg/dL) or greater and a triglyceride concentration of less than 2.26 mmol/L. Patients using steroids, beta-blockers, thiazide diuretics, and lipid-lowering agents, or having a history of allergy to psyllium or aspartame were excluded.

INTERVENTION

The study consisted of four interventional phases of 6 weeks' duration that included (1) dietary stabilization (National Cholesterol Education Program Step I Diet); (2) cholestyramine therapy (4 g twice daily); (3) cholestyramine with study medication (PHM [5.1 g twice daily] or placebo); and (4) cholestyramine with crossover to alternate study medication.

MAIN RESULTS

Following the 6-week dietary lead-in phase, four patients were eliminated from the study because their fasting LDL-C concentrations fell below 4.14 mmol/L (160 mg/dL), and one patient was eliminated because testosterone therapy was initiated by his internist. The remaining 22 patients entered the cholestyramine treatment phase. Four left the study within 2 weeks because of intolerable gastrointestinal tract symptoms. The 18 patients who completed this phase demonstrated significant reductions in their plasma total cholesterol (7.27 vs 6.67 mmol/L [281 vs 258 mg/dL]) and LDL-C (5.38 vs 4.63 mmol/L [208 vs 179 mg/dL]) concentrations compared with baseline levels. The addition of PHM to the cholestyramine regimen provided a tendency toward further reductions in total cholesterol and LDL-C levels (6.67 vs 6.46 mmol/L [258 vs 250 mg/dL] and 4.63 vs 4.29 mmol/L [179 vs 166 mg/dL], respectively), although statistical significance was not achieved. Psyllium hydrophilic mucilloid significantly reduced the frequency and severity of constipation, abdominal discomfort, and heartburn. No reports of new gastrointestinal tract symptoms or untoward effects were noted with the addition of PHM.

CONCLUSION

These data suggest that the addition of PHM to cholestyramine therapy may improve a patient's compliance by reducing the associated gastrointestinal tract side effects.

Perceived exertion and muscle efficiency in Parkinson's disease: L-DOPA effects

Weakness, easy fatiguing, and lack of endurance are commonly perceived by patients with Parkinson's disease (PD). Although the slowed motor repertoire in PD may underlie these experiences, other abnormalities in skeletal muscle utilization also may be involved. We investigated whether an index of metabolic efficiency during a continuous exercise task, the latency until anaerobic threshold (AT), is altered by L-DOPA (LD). While pedalling a bicycle ergometer against a uniform workload, subjects were monitored for expired O2 and CO2. As compared to an unmedicated state, LD treatment delayed AT by a mean (+/-SE) of 5.67 +/- 0.89 to 6.62 +/- 1.23 min (p < 0.05), paired t test). Subjects did not differ in their perceived exertion upon reaching AT. With relief of parkinsonism by LD, the efficiency of energy utilization is also increased in exercised skeletal muscle.

Effect of hepatoprotective ayurvedic drugs on lysosomal enzymes during hepatic injury induced by single dose of CCl4

Effects of single doses of kumari asav, kumari kalp, arogyavardhini and tamra bhasma on lysosomal enzymes (acid phosphatase and beta-glucuronidase) of rat liver and kidney were studied during hepatitis induced by single 0.3 ml/kg body wt dose of CCl4. Histologically all the drugs showed significant hepatoprotection. While acid phosphatase activities of liver and kidney were suppressed, activities of beta-glucuronidase were enhanced by these drugs. The results indicate that acid phosphatase and beta-glucuronidase behave differently, although they are lysosomal in nature.

Effect of age and sex on the elicitation of irritant contact dermatitis

Irritant contact dermatitis causes significant disability to numerous consumers and individuals in industry. Knowledge of the prevalence of this disease remains inadequate. Irritant contact dermatitis occurs in workers engaged in occupations where the subjects are exposed to different types and doses of irritants. The intensity of the reaction depends on the quality and the quantity of exposure. Irritant thresholds and dose responses depend on many different factors. This article reviews the clinical and physiological parameters that affect the age and sex related differences in irritant contact dermatitis.

Neural network in the clinical diagnosis of acute pulmonary embolism

The purpose of this investigation was to test the hypothesis that computer-based pattern recognition can accurately assess the likelihood of acute pulmonary embolism (PE) based on readily obtainable clinical characteristics. Data were obtained from 1,213 patients who participated in the collaborative study of the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED). Characteristics of the history, physical examination, electrocardiograph, chest radiograph, and arterial blood gases of patients with suspected acute PE were presented to a back propagation neural network. The 1,213 patients were divided into training set A (n = 606) and test set B (n = 607). These groups were then reversed into training set B (n = 607) and test set A (n = 606). A receiver operating characteristic (ROC) curve was constructed from PIOPED clinical assessment, and from neural network clinical assessment in groups A and B. Areas under the respective ROC curves were 0.7450, 0.7477, and 0.7324. All differences were not significant. Areas under ROC curves for PIOPED clinical assessment combined with ventilation/perfusion (V/Q) scan results were compared with neural network clinical assessment combined with V/Q scan results in groups A and B. The respective ROC areas were 0.8324, 0.8203, 0.8496 (all differences not significant). These data show that neural networks were able to predict the clinical likelihood of PE with an accuracy comparable to experienced clinicians.

Multiple neural inductions in area opaca by grafts of the Hensen's node do not retard host chick embryo development

Four hundred and forty four full primitive streak stage chick embryos were cultured in vitro and 261 were transplanted with 1, 3 or 5 Hensen's nodes in the area opaca. Irrespective of the number of grafts, neural induction was observed in 90% cases. The development of control and grafted embryos and the size of blastoderm area were monitored at the time of grafting and after 20 hr. We find that the induced neural tissue and differentiated tissue of graft-origin neither fuse with the host embryonic axis, nor retard its development.

Proficiency testing in clinical cytogenetics. A 6-year experience with photographs, fixed cells, and fresh blood

The College of American Pathologists and the American Society of Human Genetics offer a proficiency testing program in clinical cytogenetics. Two hundred twenty-five laboratories now provide data for this survey, which was begun in 1986. Challenges have consisted of photographed metaphases, fixed lymphoblastoid cell suspensions, fresh peripheral blood, and disarranged karyotypes. The "correct" response was based on 80% or greater consensus among either the referees or the participants. Referee laboratories performed better than participants. More laboratories were able to report accurate recognition of abnormalities by using a coded list than could write the interpretation in standardized nomenclature. Deletions, unbalanced translocations, and inversions were more difficult challenges than balanced translocations or trisomies. Prenatal and lymphocyte challenges were more likely to result in consensus than were bone marrow challenges. Participants performed best on whole-blood challenges. Fixed cell suspensions were less satisfactory. Excellent quality case material is essential for a successful challenge. A grading system has been devised to separate artifacts of the survey process from proficiency variables.

Effect of hepatoprotective ayurvedic drugs on lipolytic activities during CCl4 induced acute hepatic injury in albino rats

Daily treatment of CCl4(3 ml/kg body wt) for 7 days induced acute hepatic necrosis in albino rats. Treatment of CCl4 caused significant alterations in the activities of acid lipase, alkaline lipase, lipoprotein lipase of liver, kidney and adipose tissue and hormone sensitive lipase of adipose tissue of albino rat. Administration of hepatoprotective ayurvedic drugs (kumari asav, kumari kalp, arogyavardhini and tamra bhasma) concomitant with CCl4 counteracted the action of CCl4 on lipolytic enzymes exhibiting hepatoprotection. The possible physiological significance of alterations in lipolytic enzymes during hepatic necrosis induced by CCl4 and hepatoprotection by the above ayurvedic drugs is discussed.

Epidermal water permeation in vertebrates: an in vitro study using tritiated water

Structural lipids play an important role in the water holding property of the skin. beta emitters are known to pass through the skin barrier. A permeability cell was constructed and tritiated water was used to determine the rate of in vitro water permeation through the epidermis. The epidermal sheets from different classes of vertebrates were compared for water permeation. Some of the samples were treated with solvents, surfactants and conditioners, to fathom permeability changes of the epidermis after these treatments, at various time intervals. Solvent treated epidermal sheets show very high degree of permeation, both in rat pup skin and pigeon skin. Glycerol, Brij 99 and beewax treated skin shows negligible permeation; or rather, helps in retention of water compared to normal and solvent treated skin. Comparison of water permeation in rat, pigeon and lizard skin shows that the reptilian integument is more efficient, as it allows very less permeation of water compared to the avian and mammalian epidermis. These observations suggest that tritiated water could be used for determining in vitro water permeation through the epidermis.

Cysteine proteinase inhibitor in cultured human medullary thyroid carcinoma cells

The TT cell line of human medullary thyroid carcinoma, that retains some of the differentiated functions of thyroid C cells including the synthesis and secretion of calcitonin, was found to contain and release into the culture medium cysteine proteinase inhibitor(s), cystatin(s). The major inhibitor, which is similar to, if not identical with, cystatin C, is constitutively released, or secreted, by TT cells. The rate of secretion of cystatin, quantified by titration of inhibition of papain, was stimulated by dibutyryladenosine 3':5'-cyclic monophosphate, forskolin, the calcium ionophore A 23187, and by the tumor promoter, 12-O-tetradecanoylphorbol-13-acetate (TPA). Neither forskolin nor TPA had, however, an effect on the level of the inhibitor in TT cells. Treatment with n-butyrate strongly inhibited the proliferation of TT cells, and led, in 4 to 7 days, to a doubling of the intracellular concentration of cystatins. Northern blot hybridizations to a 32P-labeled riboprobe complementary to human cystatin C cDNA indicated that cAMP, forskolin, and TPA had no effect on the steady-state levels of cystatin C mRNA. These data indicate that release of cystatin(s) from TT cells is regulated by cAMP-calcium-protein kinase C mechanisms that appear to be similar to those that regulate the secretion of calcitonin from these cells. However, in contrast to the calcitonin gene, the expression of the cystatin C gene in these cells is not regulated by cAMP or TPA. By a combination of acetone fractionation, affinity chromatography on Cm-papain-Sepharose, and gel exclusion chromatography a protein of approximately 14 kilodaltons was isolated from TT cells that reacted with antibodies against human cystatin C, and strongly inhibited papain. Cystain secreted by TT cells also had a molecular weight of 14 kilodaltons, and reacted with anti-human cystatin C antibodies. The physiologic and pathologic roles of cystatins in different cell types remain to be established. The TT cells provide a suitable cell type to study the regulation of the expression of the cystatin gene and the mechanism of cystatin release.

Effect of Plumbago zeylanica root powder induced preimplantationary loss and abortion on uterine luminal proteins in albino rats

P. zeylanica treatment during first 7 days of pregnancy abolished uterine proteins of 13,000, 19,000 and 26,000 and 75,000 Da molecular weights resulting in preimplantationary loss. Proteins having molecular weights 55,000 and 65,000 Da were absent in aborted rats, that were given P. zeylanica root powder since day 6 to day 17 of pregnancy. The results suggest that proteins having molecular weights 13,000, 19,000, 26,000 and 75,000 Da influence the implantation and proteins of 55,000 and 65,000 Da are required for the maintenance of the pregnancy.

Autistic disorder associated with an iso-dicentric Y chromosome

The relationship between a fragile site on the X chromosome and autism has been well documented. The authors report a three-year-old child with partial duplication of the short arm of chromosome Y, who had an autistic disorder. He was microcephalic, but otherwise had a normal phenotype. There was a history of preterm birth and maternal diabetes. This is the sixth case of sex chromosome Y aneuploidy associated with autism, but the first with an isodicentric Y. In well-substantiated cases of autism, clinicians should now consider abnormalities of the Y as well as the X chromosome.

Cytochalasin-B-induced immunosuppression of murine allogeneic anti-tumor response and the effect of recombinant human interleukin-2

Cytochalasin B (CB), administered i.p. to C57B1/6 mice in a single dose as a suspension in carboxymethylcellulose 2%/Tween 20 1%, inhibits in a dose-dependent and time-dependent manner the ability of spleen cells to respond to allogeneic P815 mastocytoma tumor cells in vitro. Spleen cells from CB-treated animals sensitized to X-irradiated P815 cells in 4-day cultures at a 50:1 responder:stimulator ratio and tested for specific cytotoxicity against 51Cr-labelled P815 target cells showed strong inhibition 3 h after CB treatment at a dose of 50 mg/kg. A dose of 25 mg/kg showed measureable but not statistically significant inhibition at 3 h, whereas 10 mg/kg produced only slight inhibition, and 5 mg/kg and 2 mg/kg were noninhibitory. None of the doses produced significant suppression 19 h or 72 h after CB treatment. Addition to the sensitization cultures of human recombinant interleukin-2 (rhIL-2) at 350 BRMP units/ml completely restored tumor lytic capacity. C57B1/1 mice treated with CB 50 mg/kg, i.p. and challenged i.p. with 3 x 10(7) allogeneic P815 mastocytoma cells showed a brief, time-dependent, statistically significant abrogation of allogeneic responsiveness consistent with transient reversible immunosuppression within 3-12 h following CB treatment. No such inhibition of host allogeneic responsiveness in vivo was observed when CB was administered 24 h prior to, simultaneously with, or 1, 2, or 4 days after tumor challenge. Thus CB at the highest tolerated i.p. dose in vivo causes only a transient inhibition of anti-allo-responsiveness measured in culture, and rhIL-2 used in vitro restores lytic capacity. The anti-allo effect of CB is also seen to be transient directly in vivo since allogeneic tumor outgrowth is permitted for only a brief period following administration of CB. These results indicate that the use of CB in vivo in anti-tumor chemotherapy protocols will not be complicated by profound or prolonged immunosuppressive effects.

Molecular characterization of Beckwith-Wiedemann syndrome (BWS) patients with partial duplication of chromosome 11p excludes the gene MYOD1 from the BWS region

The molecular characterization of two patients with features of Beckwith-Wiedemann syndrome (BWS) and chromosome abnormalities is consistent with the association of this phenotype with a duplication of a portion of chromosome 11. Quantitative Southern blot analysis of DNA from patient A defines a large inherited duplicated segment of chromosome 11. For patient B, a de novo duplication of unknown origin has been shown to contain a segment of 11p15. This chromosome segment includes the genes for insulin-like growth factor 2, beta-hemoglobin, calcitonin A (CALCA), and parathyroid hormone (PTH). However, the myogenic differentiation factor, MYOD1, is not included in the duplicated segment. This demonstrates that MYOD1 is proximal to CALCA and PTH and excludes MYOD1 as the BWS gene. These data place the BWS gene distal to MYOD1 on 11p15.

Evidence for melanin concentrating hormone (MCH) receptors mediating melanosome aggregation in Labeo melanophores

Melanin concentrating hormone (MCH: 5 x 10(-12)-5 x 10(-8) M) induced a concentration related, rapid and reversible pigment aggregation in innervated melanophores of Labeo rohita. In inducing melanosome aggregation MCH was found to be 10(4) times more potent than norepinephrine. Experiments employing phentolamine and propranolol suggest that MCH acts through its own specific receptors on the melanophores unrelated to adrenoceptors. MCH was able to aggregate the melanosomes even in the absence of extracellular Ca2+.

Effect of hepatoprotective ayurvedic drugs on lipases following CCl4 induced hepatic injury in rats

Effects of kumari asav, kumari kalp, arogyavardhini and tamra bhasma used in Ayurved and Siddha medicine for the treatment of liver disorders have been studied on acid, alkaline and lipoprotein lipase activities of liver, adipose tissue and kidney and hormone sensitive lipase activity of adipose tissue following CCl4 induced liver injury in albino rats. The treatments of CCl4 and the above drugs show significant alterations in the lipolytic activities of liver, adipose tissue and kidney. Role of these enzymes during hepatoprotection by above drugs has been discussed.

Duchenne muscular dystrophy in monozygotic twins: deletion of 5' fragments of the gene

A recombinant DNA study for deletion evaluation was performed in a 4 generation family with Duchenne muscular dystrophy (DMD) in twins. The patients were 6 years old, had a history of progressive difficulty in walking since age 4, and showed weak gluteals, iliopsoas, latissimus dorsi, rhomboids, lower trapezius, sternocleidomastoids, pseudohypertrophic calves, and tight heelcords. Both patients had high serum creatine kinase of 19,000 and 11,000 IU, respectively, and the muscle biopsy of the left vastus lateralis showed dystrophic alterations. Both twins had the same red cell types for ABO, Rh, CDE, MNSs, Kelly, Lewis, Duffy, and Kidd. HLA typing also detected the same antigens in both twins: A2, B44, DR4, and DR5. Cytogenetic studies were consistent with 46, XY male individuals with normal banding pattern. By cDNA probes the entire DMD gene was surveyed for missing or abnormal-sized restriction fragments. Both twin boys showed absence of 8.5, 8.0, 4.6, 4.2, and 3.1 kb fragments on Hind III blots and absence of 13.5, 3.7, 2.9, and 1.4 kb fragments on Bgl II blots both hybridized with cDNA 1-2a corresponding to most 5' region of the DMD gene. The mother and other relatives of the patient did not show deletion. These findings strongly suggest that the deletion in the DMD monozygotic twins represents a new mutation.

Fetal karyotype following ascertainment of fetal anomalies by ultrasound

Data pooled from contributors to a Registry for Cytogenetic Abnormalities and PKU (ReCAP) shows an unbalanced chromosome abnormality rate of 27 per cent (29 fetuses) for 107 fetuses with ultrasonically diagnosed fetal anomalies. Of the abnormal, 12 were trisomic, 6 were monosomy X and 6 were structural abnormalities, 4 were mosaics and one triploid.

Infants with Down's syndrome. Use of cytogenetic studies and in vitro colony assay for granulocyte progenitor to distinguish acute nonlymphocytic leukemia from a transient myeloproliferative disorder

Infants with Down's syndrome have an increased incidence of acute nonlymphocytic leukemia (ANLL). They are also at risk of developing a transient myeloproliferative syndrome indistinguishable from ANLL except by its eventual clinical recovery. The authors studied five infants with Down's syndrome and leukocytosis with circulating blast forms in their peripheral blood with in vitro cultures of bone marrow colony forming units-granulocyte macrophage (CFU-GM), cytogenetics and peripheral blood neutrophil alkaline phosphatase (NAP) score. Three children developed ANLL, the other two had a transient myeloproliferative syndrome. The in vitro assay for CFU-GM showed abnormal results consistent with ANLL in the children who develop this disorder. Serial cytogenetic studies disclosed the appearance of an abnormal clone in one patient. A combination of clinical parameter in vitro colony studies and cytogenetic studies in these children was helpful in distinguishing ANLL from a myeloproliferative disorder. The NAP scores were not helpful.

High resolution gene mapping of the human alpha globin locus

A combination of polymorphic DNA markers, cytogenetic analysis, and in situ hybridisation has been used for the high resolution assignment of the human alpha globin gene cluster on chromosome 16. Multiallelic DNA probes from within the alpha globin cluster were used to determine the number of copies of this locus in three cell lines containing trisomies of the short arm of chromosome 16 and one with a familial inversion, inv(16). The breakpoints in these rearrangements flank the alpha globin locus and locate a shortest region of overlap to 16p13.1. A meiotic crossover was also localised to this band. In situ hybridisation of biotinylated DNA probes to normal and inverted chromosomes 16 [inv(16)(p13.1;q22)] showed hybridisation sites at opposite ends of the chromosomes, consistent with this regional localisation.

Abnormal pregnancy sonogram: selective indication for fetal karyotype

The inability to make a definitive diagnosis in the fetus with a sonographically identified abnormality often results in parental and physician uncertainty. An antenatal chromosome evaluation could resolve this uncertainty. Forty-one fetuses with an abnormal ultrasound examination were tested for karyotypic abnormality using a variety of specimens. Nearly one-third (13 of 41) of these fetuses had various chromosome abnormalities. There were only seven survivors in this series, underscoring the often poor prognosis when a significant ultrasound defect is detected antenatally. Knowledge of the fetal chromosome constitution in the setting of an abnormal ultrasound has important epidemiologic, cost-benefit, counseling, and pregnancy management implications.

Multiple congenital anomalies syndrome with myopathy in chromosome 16 abnormality

An abnormality of chromosome 16 in an eight year-old male was associated with a multiple congenital anomalies syndrome characterized by myopathy, cataracts, blepharophimosis, microcephaly, failure to grow, profound mental retardation, moderate sensorineural hearing loss, grand mal seizures, bilateral inguinal hernia, and thoracolumbar kyphoscoliosis. Magnetic resonance imaging of the head demonstrated absence of the corpus callosum and extensive loss of brain parenchyma in the occipital regions. Chromosome analysis from peripheral blood of the patient showed a recombinant chromosome 16 [46, XY, rec (16), dup (p13.1----p13.3) del (q22----q24)]. The mother had a pericentric inversion of chromosome 16 [46, XX, inv(16) (p13.1;q22)]. Independent recombinant DNA studies have shown that the breakpoints of these chromosomal rearrangements flank the alpha-globin gene cluster locus.

Duchenne muscular dystrophy, glycerol kinase deficiency, and adrenal insufficiency associated with Xp21 interstitial deletion

We report an interstitial deletion in the short arm of the X chromosome in a 6-year-old boy with Duchenne muscular dystrophy, glycerol kinase deficiency, adrenal insufficiency, intermittent hypoglycemia, spasticity, psychomotor retardation, and growth delay. His mother also has this deletion in an X chromosome. From our findings, we propose that the human glycerol kinase locus and the human X-linked adrenal hypoplasia locus are in the Xp21 band.

A new X-linked mental retardation syndrome

We have studied a three-generation family with 11 moderately to severely retarded males and three mildly retarded females (presumably manifesting carriers). The patients have a phenotype different from that of all other previously described types of X-linked MR (XLMR). These include short stature, macrocephaly, "coarse" facial appearance including prominent forehead and supraorbital ridges, hypertelorism, broad nasal tip with anteverted nostrils, and thick lips. All postpubertal males had macroorchidism (volume greater than 25 ml). Chromosomes were normal including fragile X analysis. X-ray findings of skull, spine, and hands were normal. The intellectually normal relatives do not resemble their affected relatives except for increased head size and testicular size. These findings suggest a new variant of XLMR different from fragile X-linked MR, the Coffin-Lowry syndrome, and other XLMR conditions.

[Projection of hospitalization rates based on VESKA diagnostic statistics 1982]

A method is presented for extrapolating the hospitalization rates for all Switzerland, using both VESKA diagnostic statistics and hospital administration data. The method is applied to chronic and obstructive lung diseases for the year 1982. A total of 33,430 hospitalizations is estimated with this diagnosis.

Postleukemic dysmyelopoiesis

The morphologic and clinical features of four patients who developed significant bone marrow and blood dyspoiesis after successful chemotherapy for acute nonlymphocytic leukemia (ANLL) are described. This postleukemic dyspoiesis developed 1-6 months after leukemia induction therapy and persisted for 5-20 months in a relatively stable state. This period of prolonged dyspoiesis was not associated with rising myeloblast counts or clinical evidence of relapse. Dyspoietic abnormalities developed while two patients were receiving maintenance chemotherapy; the other two patients received no maintenance therapy. The dyspoietic changes in these four patients greatly exceeded those noted in a control group of ANLL patients on maintenance chemotherapy. The morphologic features of postleukemic dysmyelopoiesis were similar to those described in preleukemic dysmyelopoietic disorders. Erythroid abnormalities included hyperplasia with ring sideroblasts, megaloblastic changes, and cytoplasmic PAS reactivity. Myeloid abnormalities consisted of left-shifted granulopoiesis with hyper- and hyposegmentation; megakaryocytic abnormalities included hyperplasia with a predominance of hypolobulated forms. Three of the four patients eventually suffered relapse and have died. The fourth patient died of sepsis after 20 months of pancytopenia and dysmyelopoiesis. Theories to explain the development of postleukemic dysmyelopoiesis are presented which emphasize the possibility of drug-induced leukemia cell differentiation. Cytogenetic studies will be necessary to establish any relationship between ANLL and the subsequent postleukemic dysmyelopoiesis.

Duplication of the distal segment of 14q

We describe a child with duplication of the distal segment of 14q. Her father carries a balanced translocation between chromosomes 14 and 15. A detailed table compares her clinical findings with those of the seven previously published cases and an additional three new cases in an effort to define a recognizable syndrome. Serum alpha-1 antitrypsin levels and PI typing did not help to localize the alpha-1 antitrypsin gene locus.