The phenotypic and cytogenetic spectrum of partial trisomy 9

A new patient with trisomy for the chromosome segment 9pter----q22 is compared to 19 previously reported cases of partial trisomy 9. Manifestations such as microcephaly, prominent nasal root, bulbous nose, and down-turned corners of the mouth are common to patients with trisomic segments extending from 9p21 to 9q13, while intra-uterine growth retardation, cleft lip/palate, skeletal anomalies, and heart defects are more common with trisomic segments extending through 9q22-9q32. A graphic method illustrates this progression in the partial trisomy 9 malformation spectrum as the triplicated chromosome region extends from bands 9p21 to 9q32. More severe and random defects are observed with complete trisomy 9 or tetrasomy 9p, suggesting an extreme excess of material greatly increases developmental variability.

Correlation of postcoital evaluation with in vitro sperm cervical mucus determinations and ureaplasma cultures

Fifteen trials were completed in 14 couples during an infertility evaluation. The postcoital test (PCT) was accomplished in a standardized manner. Also, standardized determinations of the sperm-cervical mucus penetration test (SCMPT) with the addition of cross-testing (X-test) utilizing bovine cervical mucus (BCM) and normal donor semen (NDS) were done. Male and female samples were also cultured for Ureaplasma urealyticum using U9-B indicator broth and A-7 agar. The PCT and SCMPT agreed in 87% (13/15) of the cases. Utilizing BCM and NDS, where possible, the causative factor was the cervical mucus in 54% (7/13); semen factor in 15% (2/13); both factors in 8% (1/13); and undetermined in 23% (3/13). U. urealyticum cultures were positive in 40% (6/15) of the cases. Analysis of the results revealed: (1) significant correlation between PCT and SCMPT (P less than 0.01); (2) no significant difference among the PCT, SCMPT, and X-test, indicating that the cervical mucus was the causative factor; and (3) no U. urealyticum correlation with the PCT or the SCMPT. Thus, laboratory SCMPT and X-test correlated with the PCT, providing additional information concerning the causative factor in infertility. The U. urealyticum status in cervical mucus and semen cannot be determined from the PCT nor the SCMPT.

Renal pathology of prenatally diagnosed nephrosis

Congenital Finnish nephrosis is a rare autosomal-recessive disorder, usually fatal at an early age. The disease is prenatally detected through elevation of alpha fetoprotein in the amniotic fluid of pregnancies at risk. This originates from fetal proteinuria. Maternal serum alpha fetoprotein reflects amniotic fluid levels. We describe a case of congenital nephrosis diagnosed through maternal serum screening in a low-risk population. The characteristic histology of congenital nephrosis is demonstrated, and evidence of proteinuria by electron microscopy, light microscopy, and immunofluorescence is presented.

Absorption of labeled triethanolamine salicylate in human and canine knee joints. II

The transdermal absorption by tissues of salicylate from triethanolamine salicylate (TEA/S) ointment applied to canine and human skin was shown to be consistent, significant, and reproducible. Salicylate levels were measured using thin-layer chromatography, nuclear magnetic resonance, and radiochemistry. Absorption was directly proportional to the concentrations of the active ingredient in the ointment up to the 10 per cent preparation. Tissue salicylate levels were not influenced by the sex of the canine subjects. In humans, the activity of the patients affected both tissue levels and urinary excretion. Autoradiographic and doubly labeled studies suggest that during transdermal absorption of TEA/S, the salt may disassociate; this could permit the salicylate to have a longer transit time in the area of application.

The influence of infused calcium on the postischemic myocardium

Despite evidence for calcium-induced damage in the postischemic myocardium, calcium remains a frequently used inotropic agent following cardiopulmonary bypass surgery with cardioplegic arrest. The purpose of this study was (1) to challenge the postischemic myocardium with incremental doses of ionized calcium, and (2) to relate postischemic calcium reperfusion concentration to final recovery of left ventricular contractile function. Rabbit hearts (N = 38) were perfused and equipped with a ventricular balloon to monitor developed pressure (DP) +/- dp/dt, and left ventricular end diastolic pressure (LVEDP). Hearts underwent 40 min of global ischemia. Hearts were then assigned to one of four groups to receive a variable calcium concentration (0.6, 1.2, 2.5, 5.0 mM) for the initial 5 min of reperfusion followed by 55 min of reperfusion (Ca+2 = 1.25 mM). No differences were found between groups for final recovery of DP +/- dp/dt, or final LVEDP. It was concluded that: (1) within the physiologic range, variable calcium infusions during the first 5 min of postischemic reperfusion do not impair final recovery of LV contractile function, (2) irreversible partial recovery of left ventricular function appears due to mechanisms other than mitochondrial or myofibrillar calcium loading during reperfusion, and (3) infused calcium is a safe inotropic agent even in the postischemic myocardium.

The natural history of spondylolysis and spondylolisthesis

We performed a prospective roentgenographic study to determine the incidence of spondylolysis, spondylolisthesis, or both, in 500 unselected first-grade children from 1955 through 1957. The families of the children with spondylolysis were followed in a similar manner. The incidence of spondylolysis at the age of six years was 4.4 per cent and increased to 6 per cent in adulthood. The degree of spondylolisthesis was as much as 28 per cent, and progression of the olisthesis was unusual. The data support the hypothesis that the spondylolytic defect is the result of a defect in the cartilaginous anlage of a vertebra. There is a hereditary pre-disposition to the defect and a strong association with spina bifida occulta. Progression of a slip was unlikely after adolescence and the slip was never symptomatic in the population that we studied.

Eyelid and orbital treatment following radical maxillectomy

Malignant lesions of the nasopharynx and paranasal sinuses often encroach upon the orbit. A series of nineteen patients who underwent partial or radical maxillectomy is presented to summarize the eyelid and orbital findings that required further treatment. Fifteen of these patients were left with an intact globe and a visually useful eye, but the defects of epiphora, eyelid malposition, dacryocystitis, and diplopia were visually threatening and required treatment. The cosmetic deformities and diplopia following maxillectomy and radiation are partially amenable to treatment with late bone grafting. Lacrimal outflow deficiencies were successfully treated with dacryocystorhinostomy. Only patients with ocular complications following maxillectomy are included in this series; therefore, the range of problems and their treatment confronting the ophthalmologist is summarized.

Response of previously irradiated skin to combinations of x radiation, hyperthermia, and cis-diamminedichloroplatinum

Mouse legs were irradiated to a dose of 30 Gy. After 50 days, when the acute reaction had regressed to a steady state, they were retreated with either various doses of x rays (15 to 30 Gy), hyperthermia, 45 min at 42.7 degrees C, cis-DDP, or a combination of these agents. The maximum skin reactions and the skin reactions integrated over 50 days were determined. Statistical analysis of these data indicated the thermal enhancement ratio for the previously irradiated skin was approximately 1.20. The combination of x irradiation, hyperthermia, and cis-DDP treatments to the previously irradiated skin did not enhance the radiation damage beyond that produced by x irradiation and hyperthermia.

A new technique in quantitative immunohematology: solid-phase kinetic enzyme-linked immunosorbent assay

A solid-phase kinetic enzyme-linked immunosorbent assay has been developed to measure binding of antibodies to purified or synthetic blood group antigens and tested in the Lewis blood group system. Chemically synthesized Lewis a antigen is used as the target for the binding of serum antibody in this sandwich-type assay. Kinetic, rather than endpoint, determinations are used to calculate the amount of specific antibody. Data are presented showing the assay to be quantitative, sensitive, and specific. It can separately quantitate the amount of IgG or IgM anti-Lewis a present in patient sera. The assay uses commercially available reagents and is semiautomated. Thus, it will be useful for studies in quantitative immunohematology as other blood group antigens become available in purified form.

The effect of ultrasound-induced hyperthermia and X irradiation on skin

Local hyperthermia for up to 60 min at 42.5-43.0 degrees C was induced in the skin of the mouse leg using ultrasound (780 kHz, 0.5-2.0 W/cm2). X radiation at doses of 10 to 30 Gy was delivered either before, during, or after the hyperthermia and the skin reactions were followed for 50 days. The thermal enhancement factor (TEF) was estimated using three criteria: (1) the maximum skin reaction; (2) the skin reaction integrated over the 50-day experimental period; (3) the skin reaction integrated over Days 8 to 32, which have a larger estimate. The TEF was independent of the sequence of heat and X radiation for intervals up to 1 hr. For 1 hr of hyperthermia, the TEF as measured by the maximum skin reaction did not change with radiation doses of 10 to 20 Gy. When the skin reaction integrated over 50 days or Days 8 to 32 was used as the criterion of response, the TEF varied with radiation dose from 4.7 at 10 Gy to 1.6 at 20 Gy. For a fixed radiation dose of 20 Gy, the TEF was not increased significantly by extending the duration of the hyperthermia from 30 to 60 min. The TEF for a radiation dose of 20 Gy delivered in three fractions over 5 days was smaller than that for a single 10-Gy fraction.

The neurite-promoting effect of fibroblast growth factor on PC12 cells

Treatment of PC12 cells with fibroblast growth factor(s) from either brain or pituitary caused neurite outgrowth comparable to that produced by nerve growth factor. The neurite outgrowth was preceded by a substantial rise in the activity of ornithine decarboxylase.

Mortality and early retirement

This article examines and compares the survival rates of persons claiming retired-worker benefits at age 62 with those who did not. The study is based on a sample of Social Security insured workers who reached age 62 during the period 1962-72. The proportion of men dying in the initial years after age 62 was higher among those who claimed benefits at age 62 than among those who did not. The same pattern held for women but the difference was very small. To the extent that survival after age 62 can be taken as an indication of health status at age 62, these data suggest that the age-62 claimants were somewhat more likely than others to have had health problems. The difference in survival rates between the two groups, however, was not as great as the difference in the incidence of health problems reported in surveys. Past surveys have shown that men receiving early retirement benefits were twice as likely as other men to report health problems. According to this study, survival rates for men claiming benefits at age 62 were only 3-5 percentage points lower by age 68 than those for other insured men. Within any given age cohort, the difference between survival rates of age-62 claimants and other insured men widened over time. Survival rates improved across the age cohorts. Among the men, survival rates improved somewhat more for the age-62 claimants than for others.

Hepatotoxicity of bile acids in rabbits: ursodeoxycholic acid is less toxic than chenodeoxycholic acid

The hepatotoxic effects of cholelitholytic bile acids, ursodeoxycholic and chenodeoxycholic acids, were compared with each other and with those of lithocholic acid, a known hepatotoxic bile acid, in the rabbit. Male New Zealand white rabbits were fed regular laboratory chow containing ursodeoxycholic, chenodeoxycholic, or lithocholic acid at a concentration of 0.5 per cent (w/w) for 14 days. The control group was fed the chow without added bile acids. The mortality rate was highest (six of 12) in the lithocholate group, intermediate (two of eight) in the chenodeoxycholate group, and lowest (none of six) in the ursodeoxycholate group. Light microscopy of the liver revealed fibrosis, inflammation, and bile duct proliferation in the portal regions in the three experimental groups; however, the lesions in the lithocholate and chenodeoxycholate groups were more severe and often associated with periportal extension of fibrosis and focal necrosis of the parenchyma. In addition, electron microscopy revealed distortion of bile canaliculi, conspicuous bundles of intermediate-sized filaments, expansion of pericanalicular cytoplasmic matrix due to apparent accumulation of microfilaments, prominence of lysosomes, and fragmentation of cisternae of the rough endoplasmic reticulum. These ultrastructural changes were less marked and often absent in the ursodeoxycholate group. The serum L-alanine aminotransferase activity increased 5- to 6-fold in the lithocholate and chenodeoxycholate groups, whereas it remained less than 2-fold of the control level in the ursodeoxycholate group on day 14. The serum lithocholate concentration was markedly elevated to comparable levels in all three groups, whereas ursodeoxycholate was highly increased in the ursodeoxycholate group but undetectable in the other groups at the time of sacrifice. It is concluded that (1) although the oral administration of three bile acids induces hepatic injuries in the rabbit, ursodeoxycholate causes less severe injury than do the other two, (2) the advantage of ursodeoxycholate versus chenodeoxycholate is probably relative rather than absolute, (3) lithocholate formed through metabolic conversion from ursodeoxycholate may be responsible for the most part for hepatotoxicity, and (4) it is possible that the concurrent presence of ursodeoxycholate may mitigate lithocholate's hepatotoxicity.

The influence of warfarin of levamisole on the incidence of metastases following local irradiation of a solid tumor

KHT sarcomas were implanted in the right rear legs of C3H mice. An x-ray dose of 6000 rad, delivered in ten equal fractions over 12 days, resulted in 60% local tumor control, but 83% of these mice developed metastases. Three strategies to use the tumoricidal effect of x-radiation and reduce the incidence of metastases were compared. A modification of the fractionation scheme to deliver an initial large fraction of 1800 rad followed by seven 600-rad fractions resulted in a decreased incidence of metastases compared with the same dose delivered in ten equal fractions. The use of warfarin anticoagulation during the ten-fraction course of radiation resulted in a small decrease in the incidence of metastases. Immune stimulation with levamisole, injected subcutaneously every second day during the irradiation, also resulted in a decrease in the incidence of metastases. However, when warfarin or levamisole were combined with the eight-fraction radiation scheme there were fewer metastases than following the ten-fraction scheme. The combination of the eight-fraction radiation course with levamisole also produced a significant increase in primary tumor control. In this treatment regimen, therefore, levamisole appears to act as a radiation sensitizer. An hypothesis to explain this action is proposed.

Dose local x-irradiation of a tumor increase the incidence of metastases?

KHT sarcomas were implanted into the right rear legs of C3H mice. Animals receiving no treatment died at 32 days with a 67% incidence of metastatic tumors. A dose of 6000 rads in ten fractions over 12 days, starting ten days after implant, delivered to the primary tumor (with the remainder of the body shielded) produced 55% local tumor control. However, 83% of the mice with local tumor control, subsequently developed metastatic lesions. Amputation of the tumor-bearing leg either prior to the start of radiation treatment, at the end of treatment or at intervals during treatment or sham treatment, indicated that 1) metastases occurred predominantly during the initial three radiation fractions and 2) the increased incidence of metastases following irradiation was a result of the manipulations associated with the irradiation and not the irradiation per se. Irradiation did not change the distribution of organ sites involved with metastatic tumors compared to untreated or sham-treated tumors.

The influence of ICRF-159 and levamisole on the incidence of metastases following local irradiation of a solid tumor

Courses of irradiation consisting of 6000 rad in ten equal fractions over 12 days delivered to KHT sarcomas in mice controlled 55% of the local tumors but 83% of the mice died from metastases. Three strategies to reduce the risk of metastatic spread were tested. The fractionation scheme was changed to deliver the same total dose using a large initial fraction followed by seven equal portions with the same overall time. ICRF-159 was used with the intention of partially synchronizing the tumor growth fraction in a radiosensitive state of the growth cycle and of promoting normalization of the tumor vasculature. Levamisole was used to stimulate the immune system. The combination of ICRF-159 with the eight-fraction radiation course proved to be effective for both increasing local control and decreasing the incidence of metastases. The addition of levamisole did not improve the results obtained with a combination of ICRF-159 and irradiation.

Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men

The association between specific job characteristics and subsequent cardiovascular disease was tested using a large random sample of the male working Swedish population. The prospective development of coronary heart disease (CHD) symptoms and signs was analyzed using a multivariate logistic regression technique. Additionally, a case-controlled study was used to analyze all cardiovascular-cerebrovascular (CHD-CVD) deaths during a six-year follow-up. The indicator of CHD symptoms and signs was validated in a six-year prospective study of CHD deaths (standardized mortality ratio 5.0; p less than or equal to .001). A hectic and psychologically demanding job increases the risk of developing CHD symptoms and signs (standardized odds ratio 1.29, p less than 0.25) and premature CHD-CVD death (relative risk 4.0, p less than .01). Low decision latitude-expressed as low intellectual discretion and low personal schedule freedom-is also associated with increased risk of cardiovascular disease. Low intellectual discretion predicts the development of CHD symptoms and signs (SOR 1.44, p less than .01), while low personal schedule freedom among the majority of workers with the minimum statutory education increases the risk of CHD-CVD death (RR 6.6, p less than .0002). The associations exist after controlling for age, education, smoking, and overweight.

Development of infrared interferometry for upper atmospheric emission studies

This paper is a review of the historical development of the Michelson interferometer into modern-day Fourier transform spectrometry (FTS) used for upper atmospheric emission studies in the near IR. For the period of the last decade, the focus of the review is upon USAF/USU interferometric instruments. Michelson invented the "cross beam" interferometer in 1880; however, the first interferogram was not reported until that of Wood in 1911. Fellgett deduced the multiplex advantage in 1949. By the early 1950s, both Jacqui-not and Rupert had pointed out the throughput advantage, and Fellgett and Strong had each obtained Fourier transforms of interferograms. In 1959, J. Connes and Gush obtained a spectrum of the nighttime IR airglow in 30 min using a Michelson interferometer. In 1962 Gush and Buijs flew an interferometer aboard a balloon to obtain spectra from the airglow. Mertz and M. Block developed a commercial Michelson interferometer in about 1959. L. Block of AFCRL flew a Michelson interferometer aboard a satellite in 1962. In 1965, Connes and Connes obtained high-resolution spectra of planets using cat's-eye retroreflectors coupled with an interferometrically controlled step and integrate method. NASA successfully flew an interferometer aboard a satellite in 1969, which led to including FTS experiments on the planetary probes. In 1965 Tukey and Cooley published their FFT computer program based upon the algorithm of Good. AFGL/USU applied the FFT algorithm to FTS that same year. Stair launched a rocketborne liquid-He cooled interferometer in 1976 which obtained spectra of earth limb emissions. Mertz in 1959 approached field-of-view widening of an interferometer using variable thickness glass compensator plates. Baker and his USU staff used the Connes-Bouchareine compensation method to develop a series of wide-angle Michelson interferometers (WAMIs) for airglow and auroral studies. In 1973, they created a cryogenic WAMI to obtain an IR airglow spectrum in only 10 sec. A rocketborne version was successfully flown to obtain airglow spectra in 1979. This instrument took a 2-cm(-1) interferogram in 1 sec., used a liquid-He cooled detector to cover the 2-8-microm range, and the NESR was 3 x 10(-13) W cm(-2) sr(-1)/cm(-1) at 5 microm.

Characterization of an effective actinorhizal microsymbiont, Frankia sp. AvcI1 (Actinomycetales)

The actinomycete, Frankia sp. AvcI1, isolated from root nodules of Alnus viridis ssp. crispa was grown in axenic culture and used to inoculate host seedlings. This bacterium has been shown to be an infective and effective nitrogen-fixing microsymbiont which can be distinguished from other frankiae, in vitro, on the basis of size, distinctive morphology, and growth characteristics. Cross-inoculation studies indicated that the host range of this symbiont encompasses all of the members of the genera Alnus, Myrica, and Comptonia tested. In all cases, the symbioses developed were effective in fixing atmospheric dinitrogen.

Characterization of an ineffective actinorhizal microsymbiont, Frankia sp. EuI1 (Actinomycetales)

The actinomycete, Frankia sp. EuI1, isolated from root nodules of Elaeagnus umbellata is an infective endophyte but which lacks the ability to form an effective nitrogen-fixing symbiosis with its host. This ineffective organism can be distinguished easily from other frankiae, in vitro, on the basis of size, morphology, and the elaboration of a diffusible pigment. Cross-inoculation studies indicated that the host range of this symbiont is narrow and probably restricted to the Elaeagnaceae. In all cases of nodulation the symbiosis never developed nitrogenase activity and the microsymbiont never produced endophytic vesicles within the infected host cells. Sporangia were produced in vivo and in vitro so the morphogenetic block is apparently restricted to vesicle formation.

The use and health consequences of shift work

The amount of shift work has increased dramatically in all industrialized nations during the past 30 years. In the United States, more than one-quarter of workers do shift work. The proportion of shift workers is highest in service and large-scale, capital-intensive industries. Shift work has spread subsequent to the rise of industrialization and the development of large corporations. It is used primarily to maximize the profits of the owners of these industries. On the other hand, it has substantial social and economic costs in terms of the ill health of shift workers. They suffer significantly more sleeping disturbances, nervous troubles, and disturbances of the alimentary tract. They also report disruptions in their family and social lives. The adverse consequences of shift work could be decreased by designing physiologically and socially appropriate shift schedules and by providing necessary additional services for shift workers. Unfortunately, these changes will be inadequate unless they are accompanied by efforts on the national level to restrict the use of shift work. Workers must push for laws restricting shift work to industries where it is technically necessary. Since shift work is really only one manifestation of the increasingly complex social and technical organization of work forced on workers in the drive to maximize profits, they must ultimately act together to gain control over their working conditions.

Differentiating minimal brain dysfunction and temperament

After referral to a pediatric neurologist for problems in behavior and learning, 61 children aged from three to seven years were assigned to one of four diagnostic groups: (1) minimal brain dysfunction (MBD); (2) hyperactivity; (3) learning disability; and (4) other criteria. Their temperament profiles were determined by the Behavioral Style Questionnaire. The disproportionately large number of children with more difficult temperament diagnoses in the referred population indicates that teachers and physicians may have mininterpreted a less adaptive behavioral style as evidence of neurological dysfunction. Those diagnosed clinically as having MBD were less adaptable, less persistent, more active and more negative than the control population. This suggests that MBD overlaps with difficult temperament. Children in the other three groups were temperamentally similar to the MBD group, which raises doubt about the advisability of diagnosing MBD on the basis of behavior alone. A comprehensive neurobehavioral profile is necessary to separate clearly the various factors contributing to problems in school performance.

A new device to support handicapped patients during venography or myelography

The authors describe a seating device which holds the patient in position when the x-ray table is tilted and permits non-weight-bearing venograms to be obtained in handicapped as well as normal patients. Simultaneous bilateral venography reduces the study time considerably. The device is also helpful in lumbar myelography in paraplegics.

Doppler echocardiography. Use of a graphical display system

Pulsed Doppler echocardiography (PDE) is a technique for evaluating blood flow characteristics at specific locations within the heart and great vessels. Because this method assesses blood flow rather than cardiac structures, PDE complements the findings of M-mode echocardiography. A new on-line graphical method for displaying pulsed Doppler information provides 1) a printed, permanent record of flow information, 2) precise timing of blood flow events, and 3) information on the direction of flow in the heart and great vessels.