Transmission of social attitudes

Data gathered in Australia and England on the social attitudes of spouses and twins are largely consistent with a genetic model for family resemblance in social attitudes. There is substantial assortative mating and little evidence of vertical cultural inheritance.

Genetic variation and plasma creatine kinase activity

The distribution of plasma creatine kinase (CK; E.C.2.7.3.2) is known to be skewed, and this has made it difficult to analyse the sources of variation. We have studied plasma CK in 206 pairs of twins and have analysed the results after separating them into what appear to be two Gaussian frequency distributions. The results in the main distribution (CK less than 300 iu/1) are apparently affected by genetic factors common to both men and women, and by environmental factors which are of much greater effect in men. The tendency for some men to have very high CK values may also have a genetic basis.

Symptoms of anxiety and depression in a volunteer twin population. The etiologic role of genetic and environmental factors

We examined the etiologic role of genetic and environmental factors in 14 symptoms of anxiety and depression reported by 3,798 pairs of adult twins from the Australian National Health and Medical Research Council Twin Register. Multifactorial multiple-threshold models fit the individual symptom scores well. For a substantial majority of the symptoms, the variance in liability was best explained by only genetic factors and environmental influences specific to the individual, where 33% to 46% of the variance was due to genetic factors. For four symptoms, it was not possible to choose definitively between models that, in addition to specific environment, included genetic vs familial environmental effects. These results provide strong evidence for the role of genetic factors in the etiology of symptoms of anxiety and depression as reported in a general population. Evidence for an etiologic role of familial environmental factors was much weaker. If familial environmental factors play any role in the production of these symptoms, they are more important in symptoms of depression than of anxiety, and the factors that predispose to these symptoms are only modestly correlated in males and females.

Anti-CALLA antibodies identify unique antigens on lymphoid cells and granulocytes

The common acute lymphoblastic leukemia antigen (CALLA) is a 100-kd surface glycoprotein that is present on normal and malignant lymphoid cells. It is a useful marker for distinguishing between clinically important types of acute leukemia. Anti-CALLA monoclonal antibodies (MoAb) also react with mature myeloid cells (granulocytes), where they identify an antigen having a similar molecular weight (mol wt). We now report that the antigens detected by anti-CALLA MoAb on human lymphoid and myeloid cells differ in their behavior and chemistry. Surface-labeling studies indicate that the antigen on lymphoid cells has a mol wt of approximately 100 kd v 110 kd for that on granulocytes. When cells are metabolically labeled with 35S-methionine, differences in the mol wt of these antigens are again observed. Unlike the lymphoid antigen, expression of that on purified granulocytes is not modulated by incubation with specific antibody. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of proteolytic digests of the two antigens fails to clarify their chemical relationship. Thus the antigens detected on these two cell types may share an epitope(s) but be chemically distinct, or CALLA may exist in distinct forms and behave differently on lymphoid cells and granulocytes.

[Bone metastases of bronchial carcinomas. 3 cases of subperiosteal cortical osteolysis]

The morphologic appearance of osseous metastasis may rarely suggest a specific site of origin. A subperiosteal location has recently been reported to be typical for metastatic lung carcinoma. We report three cases of such metastasis which destroyed the cortex so that it appears saucer shaped. The primary tumor was a bronchogenic carcinoma in every case. We conclude that in the cancer-age group cortical metastasis is a highly characteristic feature of lung carcinoma.

Pharmacokinetics of naproxen in elderly patients

The pharmacokinetics of naproxen have been examined in 13 elderly patients (mean age 84.2 years) and in 9 younger patients (mean age 53.9 years) at the end of a 21 day course of therapy with naproxen 500 mg b.d. The mean pre-dose concentration on days 19, 20 and 21 was significantly higher in the elderly patients than in the controls (60.1 vs. 43.3 micrograms X ml-1). The AUC (0-24) was significantly higher in the elderly subjects only when normalized for body weight (9.1 vs. 5.4 micrograms X ml-1 X h kg-1 p less than or equal to 0.02). The AUC was significantly higher in the elderly group compared to the control group also in the normalized form. The apparent clearance of naproxen was reduced in the elderly compared to the control patients (315 vs. 628 ml X h-1). The percentage protein binding of naproxen was the same in both groups (99.8%) but the free concentration of naproxen was significantly higher in the elderly patients than in the control patients (141 vs. 89.8 ng X ml-1). Although there was no excess of side effects in the elderly patients it is suggested that when naproxen is given to elderly patients, therapy should be started at the lower end of the dosage range.

The impact of prenatal diagnosis on the occurrence of chromosome abnormalities

From the public health point of view, several formal attempts have been made to measure the impact of prenatal diagnosis (PND) on the incidence of Down's Syndrome (DS), but the results have varied widely. The impact of PND (reduction in the birth rate of chromosomally abnormal neonates) is related to utilization rates but quantitative estimates of this have not been established. In a three-year (1981-1983) total population study from Queensland, Australia, we present results to measure the impact of a voluntary PND programme on the birth incidence of DS, and also other chromosomally abnormal births. Utilization rates for the PND service were 15.5 per cent in that population of mothers 35 years and over. Numbers and rates of all cases of chromosomal abnormalities are presented, subclassified by type of diagnosis--either by PND or by clinical diagnosis after birth. For the total population, 7.3 per cent of cases of DS were detected prenatally, and 15.4 per cent of all chromosome abnormalities. (A method for measuring the impact of PND is described.) Using this in conjunction with our demographic data, we estimate that with a 15 per cent utilization rate of PND by older mothers, 14 per cent of DS births can be prevented in this age group, or a 5 per cent overall reduction can be achieved if mothers of all ages are considered. One index--the ratio of the percentage of DS births which are preventable compared with the population utilization rates of PND--has potential for widespread use. Queensland data for this ratio is 0.34, a figure consistent with that from other studies. Thus a 3.5 per cent drop in the overall DS birth rate may be expected for each 10 per cent increase in the utilization rates of PND for mothers of 35 years and over. A diagram is presented which may serve as a model for improved data collection and better impact estimates in the future.

The Montreal Type A Intervention Project: Major findings

This article reports a comparison of three short-term treatments (aerobic exercise, cognitive-behavioral stress management, and weight training) in modifying behavioral and cardiovascular reactivity to laboratory psychosocial stressors in healthy Type A men. One hundred seven men completed the treatments and evaluations, 33 in the aerobic exercise group, and 37 each in the cognitive-behavioral stress management and weight-training groups. The stress management group showed significantly greater changes in behavioral reactivity (reductions of 13% to 23% below initial values) than the two physical exercise groups, which did not differ significantly from each other. For physiological reactivity, changes attributable to intervention were trivial for all three treatment groups. The positive finding of reduced behavioral reactivity as a result of the stress management intervention is of potential clinical significance and warrants further exploration. The lack of meaningful reductions in physiological reactivity also requires further exploration in that it raises questions concerning the ability of behavioral treatments in general to modify physiological reactivity, the ability of existing measures to assess accurately changes that are produced and, most fundamental of all, the relevance of physiological reactivity as an outcome measure for treatment efforts with Type As.

Genetic covariation between neuroticism and the symptoms of anxiety and depression

A genetic analysis of the trait of neuroticism and symptoms of anxiety and depression in 3,810 pairs of adult MZ and DZ twins is reported. Differences between people in these measures can be explained simply by differences in their genes and in their individual environmental experiences. There is no evidence that environmental experiences that are shared by cotwins, such as common family environment or social influences, are important. There are differences between the sexes in gene action affecting neuroticism, and genetic effects become more pronounced with age in females. The lack of evidence for dominance variance affecting neuroticism contrasts well with the detection of considerable genetical nonadditivity for extraversion in the same sample and reinforces the view that these two traits are not only statistically, but also genetically, quite independent. An analysis of the causes of covariation between anxiety, depression, and neuroticism shows that additive gene effects are more important causes of covariation than environmental factors. Genetic variation in symptoms of anxiety and depression is largely dependent on the same factors as effect the neuroticism trait. However, there is also evidence for genetic variation specific to depression.

Sense and nonsense in genetic epidemiology: a critique of the statistical model of Williams and Iyer

The statistical model for the analysis of twin-family data of Williams and Iyer is examined. The model uses a large number of redundant parameters. It does not lead to quantitative predictions for new relationships. It allows for epistasis but not dominance. It makes assumptions about assortative mating which are inconsistent with any biologically plausible mechanism. It assumes that the environmental correlation between parent and offspring is due to the direct effect of the parental genotypes, not phenotypes, on offspring environment. Other models which avoid these problems are more appropriate for the analysis of extended twin-family data.

Causes of variation in drinking habits in a large twin sample

A genetic analysis of alcohol consumption in 3810 pairs of adult twins is reported. When no correction was made for age, individual environmental variance, including non-repeatable errors of reporting, accounted for approximately 44% of variation in both sexes. In females, there was no evidence of shared environmental effects and 56% of the variance was genetic in origin. In males, only 36% of the variance was genetic and common environmental effects accounted for the remaining 20% of individual differences. For females, the results for younger (30 years and under) and older (over 30) twins were similar. For males, however, the effect of age was striking. In younger male twins over 60% of the variance was genetic in origin, with the remaining variance due to environmental influences unique to the individual. In older twins genetic differences do not appear to be important, with approximately 50% of the total variance due to individual environmental differences and the remaining 50% due to the effect of the common family environment. Our results suggest that both age and sex need to be considered when analysing the causes of variation in alcohol consumption.

Effects of the protease inhibitor (Pi) polymorphism on alpha-1-antitrypsin concentration and elastase inhibitory capacity in human serum

The concentration of alpha-1-antitrypsin (AAT) and its elastase inhibitory capacity (EIC) have been investigated in vitro in sera from 1688 healthy Canberra blood donors typed for electrophoretic variants of the protease inhibitor (Pi) locus. Nine Pi alleles were recorded in the sample, of which M1 was found at a frequency of nearly 70% and the other eight were each at frequencies below 15%. As a class, heterozygotes among the three Pi M subtype alleles, M1, M2 and M3, have higher means and lower variances for AAT and EiC than do the three M subtype homozygotes. Among the three homozygotes M1M1 has highest AAT and EIC and among the heterozygotes dominance in M1M2 and M1M3 is towards or beyond the high M1M1 values. Of the six other Pi alleles recorded, two (F and G) have similar values to the M subtypes but the other four (I, N, S and Z) have lower values. The patterns of means and variances in AAT and EIC for the different M subtype genotypes do not support the precise threshold function postulated by Martin and Oakeshott (1983) to relate activity to Darwinian fitness. Nevertheless, several aspects of the results are consistent with a general positive relationship between activity and fitness.

The psychological characteristics of infantile hypercalcaemia: a preliminary investigation

A sample of 23 children aged seven to 12 years with diagnoses of infantile hypercalcaemia was assessed on a battery of psychological tests and rating scales in an attempt to describe the psychological characteristics of this disorder. All children were found to have a mild or moderate degree of mental handicap. As a group, their expressive language skills were superior to their verbal comprehension. They displayed a high degree of behaviour and emotional disorders, most notably in terms of high levels of activity. Most children were reported as being highly sensitive to noise. This study clarifies some of the psychological correlates of infantile hypercalcaemia and some implications for management are suggested.

Utilization of prenatal cytogenetic diagnosis in women of advanced maternal age in Australia, 1979-1982

This paper reports the results of a complete national survey to measure utilization rates of prenatal cytogenetic diagnosis (P.C.D.) in women of advanced maternal age in Australia. P.C.D. has been available throughout Australia for the last decade. Every laboratory in Australia providing a P.C.D. service for the years 1979-1982 took part in this study. Utilization rates (both National and State rates) by ages of mothers, are presented. Big interstate differences exist. The 1982 National P.C.D. utilization rate for pregnant women who were 40 years of age and over was 38.8 per cent, and this rate has shown an average annual increase of 9 per cent. In those four States which offered P.C.D. to pregnant women of 35 years or over the median utilization rate was 20 per cent. These Australian rates indicate an under-utilization of P.C.D. services with (in 1982) 50-80 per cent of 'at risk' women not being tested. Factors which influence this are discussed.

Individual differences in plasma ALT, AST and GGT: contributions of genetic and environmental factors, including alcohol consumption

The causes of individuality of the plasma enzymes alanine aminotransferase (ALT; EC 2.6.1.2), aspartate aminotransferase (AST; EC 2.6.1.1) and gamma-glutamyl transferase (GGT; EC 2.3.2.2) were investigated in a study of 206 pairs of twins. Between-person variance was greater in men than women, while within-person variation was similar in both sexes. Plasma ALT and AST levels were affected by genetic factors, while GGT was affected by some environmental factor shared by co-twins. In the men, alcohol intake had a significant but small effect on all three enzyme levels, and since alcohol consumption was highly heritable, this appeared as a genetic influence on enzyme activities. The major factors involved in the observed correlations between these enzymes were a non-shared environmental factor other than alcohol affecting ALT, AST and GGT, and a genetic factor affecting only ALT and AST.

Survival in trisomy 18. Life tables for use in genetic counselling and clinical paediatrics

Clinical management of neonates with Trisomy 18 depends on a knowledge of life expectancy. True estimates of potential life span are required for genetic counselling purposes when parents interpret the genetic threat, not only in terms of the mathematical odds involved, but also in terms of the quality and length of life of an affected infant, should such be born. This paper reports the findings from a study to generate life tables for Trisomy 18. This study is a total population study over 10 years based on a primary population of 2.2 million. Forty-eight cases of Trisomy 18 were identified, five at amniocentesis. Four of the 43 clinical cases (9%) were mosaics. The median life expectancy for live-born infants was five days (range one hour to 18 months). Mean age at death was 48 days. Life tables, by sex and by sub-types (associated congenital abnormalities) are presented. The annual incidence is 14 per 100,000 total births, with a prevalence estimate of 0.06 per 100,000 total population.

Genetic and environmental influences on the size and number of cells in the blood

The heritabilities of human blood cell characteristics were estimated in a study of 206 pairs of young adult twins, male and female. White cell numbers, indices related to circulating red cell mass (haemoglobin, red cell count, and haematocrit), and platelet numbers and size all appeared to be accounted for by genetic and nonshared environmental influences only. Mean cell volume (of the erythrocytes) appeared to be influenced by environmental factors shared by siblings as well as the other two sources of variation. Correlation between red cell count and haemoglobin is modulated by both genetic and environmental factors, but the negative correlation between red cell numbers and size is due mainly to genetic factors independent of those influencing haemoglobin. A significant negative correlation also exists between platelet numbers and size. In males, alcohol consumption increased mean cell volume, and genetic factors influencing alcohol consumption are partly responsible for the correlation between them.