Efficacy and tolerance of ivermectin in human onchocerciasis

Initial clinical studies in 32 Senegalese subjects have demonstrated the efficacy of ivermectin in Onchocerca volvulus infection (river blindness). Although O. volvulus microfilariae in skin snips were not reduced in number after single oral doses of 5 micrograms or 10 micrograms/kg body-weight, they were greatly reduced in all subjects after single oral doses of 30 micrograms or 50 micrograms/kg and were eliminated completely in 6 of th 8 subjects who received the 50 micrograms/kg dose. All subjects tolerated the drug well. Transient pruritus which did not require treatment was observed on the day the dose was given in 2 of the 8 subjects after the 30 micrograms/kg dose and in 4 of the 8 who received the 50 micrograms/kg dose. Ivermectin produced no abnormal laboratory results.

Possible "atavistic" structures in human aneuploids

Comprehensive dissections of aneuploid (trisomy 18 and 13) neonates have revealed numerous supernumerary muscles that, although present in rare individuals, do not regularly occur in the human. These supernumerary muscles include: "platysma occipitalis," "rhomboideus occipitalis, "deltopectoral" complex, "latissimocondyloideus," "pectorodorsalis," "chondrohumeralis," and "peroneus digiti quinti"; a few muscles, e.g., palmaris longus and brevis are lacking altogether. One specimen exhibited a "linguofacial trunk" arising from the external carotid artery. The supernumerary muscles found in these aneuploid specimens are regularly found in monkeys and sometimes in the great apes. It is suggested that these supernumerary muscles may be "atavistic" structures. Problems in establishing homologies between these muscles among primates are discussed, and mechanisms leading to the development of these muscles in human aneuploids are proposed.

Muscular anomalies caused by delayed development in human aneuploidy

Comprehensive dissections of three infants with trisomy-13 and three with trisomy-18 have revealed several muscles which appear to be "abnormal" at the time of birth and shortly thereafter. Careful observations show that the peculiar morphology of these muscles results from delayed development rather than from anatomical malformation. The observations are compared with physiological, pathological and in vitro experimental studies of delayed embryonic development in human aneuploidy.

Anatomical defects in a case of trisomy 13 with a D/D translocation

Gross morphological defects and variations in a cytogenetically confirmed case of trisomy 13 with t (D/D) are described comprehensively for the first time. The subject, a female neonate, exhibited the following clinical features: microcephaly, sloping forehead, coloboma of the iris, bilateral cleft lip and palate, short neck, and postaxial extra digits on hands and feet. Visceral anomalies included: dextrocardia; hypertrophied right ventricle; common atrium; hypertrophied sinus venosus; persistent left superior vena cava; a large, patent ductus arteriosus interventricular septal defect; Meckel diverticulum; common mesentary; omphalocele; accessory renal arteries and veins; bicornuate uterus; bilateral agenesis of the olfactory bulb; partial holoprosencephaly; and the ulnar nerve passed anterior to the medial epicondyle, bilaterally. Supernumerary muscles included: pectorodorsalis ("achselbogen"); chondroepitrochlearis; sternochondroscapularis; accessory heads of biceps brachii; and radiocarpus. The following muscles were absent: stylohyoideus; pectoralis minor (left); subclavius; palmaris longus and brevis; plantaris; and peroneus tertius. The following muscles exhibited unusual variations: digastricus; mylohyoideus; pectoralis major; and extensor indicis. These findings are compared and contrasted with those recently reported in primary trisomy 13 and 18 and with a case of trisomy 13 with a D/G translocation.

Muscular and other abnormalities in a case of Edwards' syndrome (18-trisomy)

This paper describes the anatomical variations observed in a specimen exhibiting Edwards' Syndrome (18-trisomy). The clinical and autopsy data are compared with those reported in earlier literature. Aside from having a tracheoesophageal fistula, the viscera were characterized by abnormalities of the heart, lungs, liver and kidneys. The facial musculature was relatively undifferentiated. Only a few abnormalities were recorded in the otomandibular and suprahyoid structures. The infrahyoid region had three pairs of supernumerary muscles, including the "sternohyoideus azygos." The bluk of abnormalities were found in the muscles and nerves of the upper limb. These included the absence of the palmaris longus and brevis, the subclavius and the extensor digiti quinti proprius; the presence of supernumerary muscles, e.g., the "rhomboideus occipitalis," the "latissimocondyloideus," and the "subclavius posticus." The deltoid and the pectoralis major were fused to form the "deltopectoral" complex. A definitive musculocutaneous nerve was found in the right arm only. In the lower extremity supernumerary muscles included the "tenuissimus," "peroneus quinti digiti," and the "extensor primi internodii hallucis."