Fetal heart rate monitoring by telephone. II. Clinical experience in four centres with a commercially produced system

A commercially produced domiciliary fetal monitoring (DFM) system was assessed in four centres in the UK (Bristol, Glasgow, London and Nottingham) chosen to allow for comprehensive assessment in various settings in many different women. Overall, 825 recordings were made from 368 women (2.24 per woman). There were 56 unsuccessful attempts at transmission (6.8%), most were due to problems with telephone equipment. The system worked most efficiently when a dedicated direct line was used. The data transmission time varied between 40 and 60 s. The median telephone time (including data transmission and conversation) with a dedicated direct line was 7 min. Mean acceptance times from the four centres were between 70 and 80%. All recordings with acceptance times of 40% or more were interpretable. Ten recordings were abnormal. The women and mid-wives were equally proficient at using the DFM system. The DFM system represents an important addition to current methods of fetal assessment. Specific guidelines are outlined.

Double supernumerary isochromosome 9p in myeloproliferative syndrome

The presence of supernumerary isochromosome 9p in duplicate in about 50% of bone marrow cells of an elderly female patient with myeloproliferative syndrome is reported.

Successful medical management of neutropenic enterocolitis in adults with acute leukemia

Seven adults with acute leukemia had a clinical and radiologic diagnosis of neutropenic enterocolitis. Six of the seven patients had granulocyte counts less than 500/microliter. All seven patients responded to intensive medical therapy, including bowel rest, broad spectrum antibiotics, and white blood cell transfusions, and recovered from the neutropenic enterocolitis without surgical intervention. We discuss the clinical spectrum of neutropenic enterocolitis and the favorable results of medical therapy.

Chromosomal localization of the met proto-oncogene in the mouse and cat genome

The met proto-oncogene was mapped in the mouse and cat genomes with the use of mouse X hamster and cat X rodent somatic cell hybrid DNA panels. Based on these analyses we assigned the met gene to mouse chromosome 6 and to cat chromosome A2. We also assigned the cat raf-1 proto-oncogene to the A2 chromosome; met and raf-1 are the first cloned DNAs mapped to this linkage group. Using an interspecies backcross we further localized met on mouse chromosome 6 to a position proximal to the beta chain of the T-cell receptor. This places met near the obese locus in a region of mouse chromosome 6 that appears to be homologous with the long arm of human chromosome 7. The close linkage of met to the gene responsible for cystic fibrosis in humans suggests that further genetic analysis of mouse chromosome 6 may be useful in developing a mouse model for the disease.

The human myelin-basic-protein gene: chromosomal localization and RFLP analysis

With a human myelin-basic-protein (MBP) cDNA used as a probe, the human MBP gene has been mapped to chromosome region 18q22-q23 by a combination of Southern hybridization to a panel of somatic-cell hybrid DNAs and in situ hybridization to metaphase chromosomes. Restriction-fragment-length polymorphisms (RFLPs) have also been identified with this probe in human DNA, by means of the restriction enzymes BamHI, PvuII, and PstI. In studies of informative families, the alleles of the BamHI and PvuII polymorphisms have been shown to segregate as Mendelian traits.

A new moderately repetitive DNA sequence family of novel organization

In cloning adenovirus homologous sequences, from a human cosmid library, we identified a moderately repetitive DNA sequence family consisting of tandem arrays of 2.5 kb members. A member was sequenced and several non-adjacent, 15-20 bp G-C rich segments with homology to the left side of adenovirus were discovered. The copy number of 400 members is highly conserved among humans. Southern blots of partial digests of human DNA have verified the tandem array of the sequence family. The chromosomal location was defined by somatic cell genetics and in situ hybridization. Tandem arrays are found only on chromosomes 4 (4q31) and 19 (q13.1-q13.5). Homologous repetitive sequences are found in DNA of other primates but not in cat or mouse. Thus we have identified a new family of moderately repetitive DNA sequences, unique because of its organization in clustered tandem arrays, its length, its chromosomal location, and its lack of homology to other moderately repetitive sequence families.

Calcium, vitamin D and parathyroid hormone relationships in pregnant Caucasian and Asian women and their neonates

Plasma calcium, serum 25 hydroxyvitamin D [25(OH)D], 1,25 dihydroxyvitamin D[1,25(OH)2D] and parathyroid hormone (PTH) have been measured in pregnant and newborn Caucasians and Asians. Calcium and 25(OH)D concentrations were lower in Caucasian than in Asian women at all four stages (three trimesters and during labour) of pregnancy. PTH concentrations were greater in Asian than in Caucasian women during the three trimesters, but not at labour, and increased in both groups through pregnancy, without a concomitant change in plasma calcium concentrations. There was a significant inverse correlation between calcium and PTH, as well as 25(OH)D and PTH, concentrations. These data demonstrate the presence of progressive 'hyperparathyroidism' during pregnancy in Caucasian and Asian women. The higher PTH concentrations in Asian women may reflect the necessity of maintaining adequate plasma calcium concentrations through PTH-induced osteolysis in the face of vitamin D deficiency. Relative hyperparathyroidism in Asians may contribute to net loss of calcium from the skeleton and osteopenia in Asian women. Calcium, 25(OH)D and 1,25(OH)2D concentrations were lower, and those of PTH higher, in Asian newborns compared with Caucasian newborns. Serum 1,25(OH)2D concentrations in the Asian newborn, though lower than respective maternal levels, were comparable with normal adult levels, indicating that 1,25(OH)2D biosynthesis is stimulated in the Asian newborn to compensate for the low serum 25(OH)D concentrations.

Cloning, characterization, expression, and chromosomal localization of a human ferritin heavy-chain gene

A genomic phage clone containing a full-length copy of a functional human gene for ferritin heavy chain has been isolated. The gene consists of four exons spanning approximately 3 kilobases and has been localized to chromosome 11. The functionality of the gene was demonstrated by the fact that both transient transfectants and stable transformants of murine fibroblasts actively transcribe human ferritin heavy-chain mRNA.

Parathyroid hormone and neonatal calcium homeostasis: evidence for secondary hyperparathyroidism in the Asian neonate

Calcium, 25-hydroxyvitamin D (25 OHD), and parathyroid hormone (PTH) concentrations were measured in 11 Asian and ten Caucasian pregnant women at parturition and in their respective newborns following a full term normal delivery. Maternal calcium and 25 OHD concentrations were significantly lower while PTH concentrations were significantly greater in Asians than those in Caucasians. There was a significant inverse relationship between calcium and PTH and the relationship between 25 OHD and PTH concentrations. Neonatal calcium and 25 OHD concentrations were also significantly lower and PTH concentrations significantly higher in Asians than those in Caucasians. There was a highly significant inverse correlation between neonatal calcium and PTH concentrations. Three of the 11 Asian babies had supranormal concentrations of PTH in their cord blood. We conclude that PTH participates in neonatal calcium homeostasis and Asian newborns have frequent secondary hyperparathyroidism.

Varied citrus treatment of ruminant gagging in a teenager with Batten's disease

Chronic ruminant gagging was substantially reduced in a severely retarded 13-year-old girl with Batten's disease through the use of contingent citrus juice in an ABAB design. Previous literature suggests that citrus juice may not be effective for treatment of rumination in older and/or handicapped children due to habituation. In this study, habituation may have been prevented by alternating lime juice and lemon juice when ruminative gagging reached a predetermined rate. The lemon/lime variation offers an effective, practical, and acceptable alternative to other response suppression procedures for rumination.

Effectiveness of brief time-out with and without contingent delay: a comparative analysis

We evaluated a commonly used component of brief time-out, in which release from time-out is delayed contingent on the occurrence of disruption. Data were collected for one normal and two mentally retarded children on time-out-producing behaviors (aggression and disruption) as well as delay-producing behaviors during time-out (loud vocalizations, out-of-chair, aggression, and disruption). The results of a combination ABAC reversal and multiple-baseline design indicated that, under the conditions used in this investigation, both delay and no delay variations were effective in reducing the frequency of the target behaviors. Implications for the use of time-out to reduce aberrant behaviors are discussed.

Primary encopresis: evaluation and treatment

Cathartic and behavioral treatment procedures for eliminating diurnal and nocturnal primary encopresis were investigated using a multiple-baseline design across four children. The dependent and independent variables measured were appropriate bowel movements, soiling accidents, independent toiletings, and cathartic use. Over 177 reliability observations (home visits) were conducted. For two of the children, treatment with cathartics and child-time remedied their soiling accidents and increased their independent toiletings in 8 to 11 weeks. While the cathartics and child-time increased the rate of appropriate bowel movements, they did not eliminate the soiling accidents with the other two children. Independent toiletings for these two children were achieved after 32 to 39 weeks of treatment when punishment procedures (positive practice, time-out, and hourly toilet sits) were incorporated and the suppositories were faded systematically.

Analysis of environmental determinants of aggression and disruption in mentally retarded children

This study evaluated methods for empirically identifying environmental determinants of aggressive and disruptive behavior in three developmentally delayed children. A variety of sessions conducted on an inpatient treatment unit were designed to stimulate contingencies maintaining aggression and disruption in the subjects' natural environments. The basic analog conditions included: instructional demands, contingent social disapproval, and structured play. In addition, variations of the three basic conditions were developed based on informal observation and parental reports of naturally occurring contingencies. Results showed considerable variability both between and within subjects. However, for each subject a specific analog condition was shown to produce relatively higher rates of aberrant behavior. Subsequently, behavioral treatments based on assessment results were successfully implemented with two of the subjects. Results are discussed in terms of the importance and practical limitations of conducting systematic assessment of aberrant repertoires in developmentally delayed clients.

Social validation of heterosexual social behavior in community settings: a comparison of mentally retarded and non-mentally retarded adults

Adaptive heterosexual social interaction in community settings is an age-appropriate social skill. Subjective evaluation methodology was used as a social validation procedure to establish the appropriateness and optimal rate of occurrence of heterosexual social behaviors in bar and restaurant settings. Professionals working with mentally retarded persons and college students completed rating scales for hypothetical mentally retarded as well as non-mentally retarded subjects, respectively. The results show congruity between the behavioral expectations for mentally retarded and non-mentally retarded people in community settings. The findings suggest appropriate behaviors for training mentally retarded clients who lack adequate heterosexual community social skills.

Organization and chromosomal specificity of autosomal homologs of human Y chromosome repeated DNA

The human Y chromosome contains a group of repeated DNA elements, identified as 3.4-kilobase pair (kb) fragments in Hae III digests of male genomic DNA, which contain both Y-specific and non-Y-specific sequences. We have used these 3.4-kb Hae III Y fragments to explore the organizational properties and chromosomal distribution of the autosomal homologs of the non-Y-specific (NYS) 3.4-kb Hae III Y elements. Three distinct organizations, termed domains, have been identified and shown to have major concentrations on separate chromosomes. We have established that domain K is located on chromosome 15 and domain D on chromosome 16 and suggested that domain R is on chromosome 1. Our findings suggest that each domain is composed of a tandemly arrayed cluster of a regularly repeating unit containing two sets of repeated sequences: one that is homologous to the NYS 3.4-kb Hae III Y sequences and one that does not cross-react with the 3.4-kb Hae III Y repeats. Thus, these autosomal repeated DNA domains, like their Y chromosome counterparts, consist of a complex mixture of repeated DNA elements interspersed among each other in ways that lead to defined periodicities. Although each of the three identified autosomal domains cross-reacts with 3.4-kb Hae III Y fragments purified from genomic DNA, the length periodicities and sequence content of the autosomal domains are chromosome specific. The organizational properties and chromosomal distribution of these NYS 3.4-kb Hae III homologs seem inconsistent with stochastic mechanisms of sequence diffusion between chromosomes.

ERV3, a full-length human endogenous provirus: chromosomal localization and evolutionary relationships

A full-length human endogenous provirus termed ERV3 was isolated from a human fetal recombinant DNA library by low stringency hybridization with two probes: baboon endogenous virus LTR; and a pol-env subclone from the endogenous chimpanzee provirus, CH2. DNA sequencing within the clone and comparisons with other retroviruses revealed that ERV3 contains gag and pol gene sequences that are significantly related to those of mammalian type C retroviruses and previously described human endogenous proviruses. The ERV3 genome was determined to reside at a single locus on human chromosome 7 using a panel of rodent X human somatic cell hybrids.