A cytogenetic survey of 14,069 newborn infants. III. an analysis of the significance and cytologic behavior of the Robertsonian and reciprocal translocations

A study of the chromosomes of 14,069 consecutive liveborn infants revealed 11 infants with balanced reciprocal and 13 with balanced Robertsonian translocations. A detailed physical assessment revealed no increase in major or minor malformations over control infants except for an increase in frequency of upslanting palpebral fissures and some possible minor dermatoglyphic changes. A preliminary psychologic assessment of six heterozygotes and 11 controls at 6 years of age revealed no detectable differences. The results of detailed family studies revealed only one child with an unbalanced karyotype, suggesting that where families are ascertained at random through balanced translocation heterozygotes, the frequency of children with unbalanced karyotypes is low in both the t(DqDq) and reciprocal translocation families. Fetal wastage was shown to be slightly increased in reciprocal but not in Robertsonian translocation families. In both the reciprocal and Robertsonian translocation families the segregation ratio for the translocation was not significantly different from 1:1. A significant excess of males was found among reciprocal but not among Robertsonian translocation heterozygotes. A study of the chromosomes involved in 60 reciprocal translocations ascertained at random by conventional staining in the present and two other series suggested that chromosome 11 and perhaps 13 were involved significantly more frequently than might have been expected by chance. However, with the possible exception of band ll(ql3), no “hot” spots for chromosome breakage were observed in these series. Breaks were, however, found to occur significantly more frequently in pale fluorescent, light-staining than in bright fluorescent, dark-staining bands. The importance of these findings in genetic counselling is discussed.

Phenotypic correlations in patients with ring chromosome 22

This paper reports two patients with a ring 22 chromosome which has been confirmed by Q-banding. The literature contains 19 patients with a ring G-group chromosome which has been shown by chromosome banding to be a ring 22. The most commonly reported features in affected patients have included: retardation with disproportionate verbal delay, reduced head circumference, hypotonia, unsteady gait, large ears with abnormal configuration, and epicanthic folds. The importance of these, as well as other, less often noted findings, is discussed in relation to a possible r(22) syndrome.

Cebocephaly in an infant with trisomy 18

An infant who died in the perinatal period with the unusual association of trisomy 18 and cebocephaly is described. It is suggested that this association may be more common than is generally recognised because the majority of such infants are stillborn or live only briefly and often do not have chromosome studies performed.

Favorable effects of hyaluronidase on electrocardiographic evidence of necrosis in patients with acute myocardial infarction

To evaluate hyaluronidase's effect in reducing post-infarction myocardial necrosis, we randomized 91 patients with anterior infarction to control (45) or to hyaluronidase-treatment (46) groups. A 35-lead precordial electrocardiogram was recorded on admission and seven days later. Hyaluronidase was administered intravenously after the first electrocardiogram and every six hours for 48 hours. QRS-complex changes were analyzed to assess the drug's effect. Precordial sites with ST-segment elevation (larger than or equal to 0.15 mV) on the initial electrocardiogram that retained an R wave were considered vulnerable for the development of electrocardiographic signs of necrosis. The sum of R-wave voltages of vulnerable sites fell more in the control group than in the hyaluronidase group (70.9 +/- 3.6 per cent [+/- 1 S.E.M.] vs 54.2 +/- 5.0 per cent P less than 0.01). Q waves appeared in 59.3 +/- 4.9 per cent of the vulnerable sites in control versus 46.4 +/- 4.9 per cent in hyaluronidase-treated patients (P less than 0.05). Thus, hyaluronidase reduced the frequency of electrocardiographic signs of myocardial necrosis.

Uridine-diphosphate-glucose 4-epimerase from Saccharomyces fragilis. Inactivation by heat and reconstitution of the inactive enzyme

UDP-glucose 4-epimerase from Saccharomyces fragilis is rapidly inactivated by heating at 42 degrees C for 7 min and at 45 degrees C for 4 min. The effector site, specific for sugar phosphates, is destroyed still earlier. The enzyme is inactivated by the dissocation of NAD from it leaving the dimeric structure unaffected. It can be reactivated by mercaptoethanol and NAD, both of which are essential for reactivation, and NAD becomes associated with the dimeric protein moiety.

Sudden death in patients evaluated for ischemic heart disease

Data from 981 patients evaluated for ischemic heart disease with coronary angiography were reviewed to identify variables predictive of sudden death and duration from onset of symptoms to death. During the period of follow-up, 113 patients died. Of these deaths, 99 were classified as cardiovascular. Forty percent occurred within 1 hour of onset of symptoms, 34% within 24 hours, and 25% in greater than 24 hours. Patients prone to sudden death were characterized as having severe multiple-vessel disease in combination with left ventricular dysfunction and disturbances in intraventricular conduction and rhythm. The best five-variable model to predict sudden death in these patients included the following variables: number of vessels greater than or equal to 70% obstructed (P less than .001); therapeutic requirement of inotropic (P less than .003) and diuretic (P less than .006) drugs; premature beats (P less than .006); and ventricular conduction defects (P less than .008). Additional variables were related significantly to the duration of the terminal episode. These data are preliminary, but indicate the possibility of identifying patients prone to sudden death.

A cytogenetic survey of 14,069 newborn infants. I. Incidence of chromosome abnormalities

Data from a chromosome examination of 14,069 consecutive newborn infants is presented. Successful karyotypes were obtained on 13,939 babies using short-term blood cultures and conventional staining methods. Of those, 13,645 babies had normal chromosomes; 64 (0.46%) had a major chromosome abnormality; and 230 (1.65%) had a marker chromosome; giving a total of 294 (2.11%) babies with a major chromosome abnormality or distinctive marker chromosomes. Six male babies with sex chromosome abnormalities had a 47,XXY and four a 47,XYY karyotype, and three were mixoploids. Five female babies had a 47,XXX karytotype and two were mixoploids. There were three babies with ambiguous external genitalia, all with normal karyotypes. Fourteen babies had 21-trisomy; there were three 18-trisomics and one 13-trisomic. The mother of one 18-trisomy baby had a balanced (18;21) translocation. Twenty-four infants had a balanced chromosome rearrangement. Eleven of these were reciprocal and thirteen were Robertsonian translocations. One baby had an unbalanced derivative chromosome resulting from an 18;11 insertion. Two infants with additional unidentified fragments were detected. Two hundred and thirty babies (1:60) carying distinctive chromosome variants were detected. The commonest variant was the Yq+ among males (0.89%). Other common variants involved the short arms of the D and G groups (0.32% and 0.57%, respectively) 16q+ (0.09%), and 1q+ (0.04%). The results of the present study when combined with five other comparable studies, thus comprising a total of 46,150 newborn infants, indicates that the frequency of major chromosome abnormalities is between 1:150 and 1:200 live-born babies. This represents a small proportion of all conceptuses with chromosome abnormalities, which has been estimated as being approximately 1:20. It is thus clear that chromosome abnormalities form a major part of the genetic load carried by the human population. The development of chromosome banding techniques already has increased, and with further increase, the complexities of human cytogenetics and may reveal many additional rearrangements undetectable by conventional methods.

The human complement after trypsin pretreatment as compared to the Paris standard

A composite G-banding diagram after trypsin pretreatment of metaphase chromosomes from 5 different individuals (2 males and 3 females) is presented and compared with the Paris diagram. The patterns obtained by the present technique were very similar to those previously reported. It was found that the darkly staining bands were much more consistent in appearance than the lightly staining bands and that there was little individual variation.

Studies on the prevention of respiratory distress syndrome of infants due to hyaline membrane disease with plasminogen

Hyaline membrane disease (HMD) is leading single cause of death of newborn, premature infants. The "hyaline membranes" consist chiefly of fibrin. The clinical manifestation of HMD is the respiratory distress syndrome (RDS). Infants with RDS were treated with urokinase-activated human plasmin in a previous clinical trial. Survival rate was increased in the plasmin treated group as compared to the placebo recipients. However, cost and difficulty in the preparation of the enzyme made this treatment impractical. We, as well as others, have shown the premature infants lack serum plasminogen; thus they are unable to develop effective fibrinolysis and are defenseless against pulmonary fibrin deposition. Therefore, plamsinogen was tested as a possible preventive agent in RDS due to HMD. In a double blind, randomized study, infants between 1 and 2.5 kg birth weight received plasminogen or placebo shortly after birth, and were then followed for development of RDS. After 100 infants were entered into the study, the code was broken and results were evaluated to assure safety of the procedure. Among the 100 infants, 51 received placebo, 49 received plasminogen. Among the infants who received placebo, seven developed mild, and ten developed severe respiratory distress; of these ten, five died with histopathologically documented HMD. Two infants died from causes other than HMD. Among the 49 infants treated with plasminogen, 13 developed mild and three developed severe respiratory distress. There was no death due to HMD. Two deaths were due to other causes. Factors placing the infant at risk from HMD (degree of prematurity, sex, cesarean section, bleeding episodes during pregnancy, maternal diabetes) were found to be evenly distributed between control and treated groups. Since completing the first phase of the study, data of an additional 277 infants has become available. Although the code was not broken in this series, a preliminary look at mortality data in comparison with mortality data of the first series of 100 (in which the code was broken) suggests that preventive activity of plasminogen has been maintained in the second phase of the study.

Galactose-6-phosphate dehydrogenase. Purification and partial characterization

A new enzyme, galactose-6-phosphate dehydrogenase has been purified about 50-fold from goat liver. The enzyme can be distinguished from the nonspecific hexose-6-phosphate dehydrogenase and glucose-6-phosphate dehydrogenase by its high substrate specificity and absolute pyridine nucleotide requirement. In contrast to the hexose-6-phosphate dehydrogenase, this enzyme is located exclusively in the cytoplasmic fraction of the cell. The enzyme is a metalloprotein and is highly sensitive to mercurials. The product of the reaction is possibly a ketoaldose, phosphorylated at the primary alcoholic group.

Tumor antigens in hamsters with sarcomas associated with herpesvirus type 2

Tumor-associated antigens (TTA) were demonstrated in preparations of hamster sarcomas associated with Herpes simplex virus type 2, as well as in the sera of tumor-bearing hamsters. An immunoadsorption-in-gel method was employed to demonstrate and purify the TAA and anti-TAA. These results suggest the potential use of this technique for the demonstration of TAA or of anti-TAA in humans or animals with cancer.