Dislocation of the hip in birth defects

Several heritable disorders--although rare--are reviewed that are directly or indirectly related to dislocation of the hip. With the ever increasing list of clinical syndromes and our growing understanding of genetics, the physician who first sees these patients should broaden his views to identify these conditions and establish the diagnosis. The effectiveness of treatment often depends upon such knowledge.

Defects in the biochemistry of collagen in diseases of connective tissue

The collagens are the major structural glycoproteins of connective tissues. A unique primary structure and a multiplicity of post-translational modification reactions are required for normal fibrillogenesis. The post-translational modifications include hydroxylation of prolyl and lysyl residues, glycosylation, folding of the molecule into triple-helical conformation, proteolytic conversion of precursor procollagen to collagen, and oxidative deamination of certain lysyl and hydroxylysyl residues. Any defect in the normal mechanisms responsible for the synthesis and secretion of collagen molecules or the deposition of these molecules into extracellular fibers could result in abnormal fibrillogenesis; such defects could result in a connective tissue disease. Recently, defects in the regulation of the types of collagen synthesized and in the enzymes involved in the post-translational modifications have been found in heritable diseases of connective tissue. Thus far, the primary heritable disorders of collagen metabolism in man include lysyl hydroxylase deficiency in Ehlers-Danlos syndrome type VI, p-collagen peptidase deficency in Ehlers-Danlos syndrome type VII, decreased synthesis of type III collagen in Ehlers-Danlos syndrome type IV, lysyl oxidase deficency in S-linked cutis laxa and Ehlers-Danlos syndrome type V, and decreased synthesis of type I collagen in osteogenesis imperfecta.

[Epidemiological findings in the study of congenital malformations]

Experience with thalidomide and German measles contracted during pregnancy has focused attention on the question of birth defects. It is suggested that good reasons exist for the carrying out epidemiological investigations to establish the true incidence and geographical and social distribution of such deformities, and hence their possibly "environmental" origin at least in some instances. Such investigations would supplement research into experimental teratology. The advantages, disadvantages and limitations of retrospective and prospective investigations are discussed. A detailed account is given of a prospective survey in progress in Israel. Reference is also made to a similar survey being launched in some Italian cities with the aid of the CNR.

Syndrome of pigmentary retinal degeneration, cataract, microcephaly, and severe mental retardation

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Unusual facies, joint hypermobility, genital anomaly and short stature: a new dysmorphic syndrome

Three brothers with a previously unrecognized pattern of malformations are presented. The syndrome is characterized by short stature; a broad, prominent forehead, hypertelorism, congenital ptosis, a broad, short nose with anteverted nostrils, a long, broad upper lip, low-set, abnormally shaped and posteriorly rotated ears; simian palmar creases; brachyclinodactyly; short fingers; ligamentous laxity allowing for hyperextensibility of the fingers, genu recurvatum, flat feet; and an anomalous penoscrotal configuration resulting in "saddle" deformity with scrotal folds incircling the base of the penis. This disorder is apparently transmitted as an X-linked recessive trait. It is important to recognize this syndrome because of its heritability and for prevention of neurologic problems consequent to ligamentous laxity and malformation of cervical vertebras.

Inheritance of multiple epiphyseal dysplasia, tarda

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Arthrogryposis multiplex congenita

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