[Acute leukemia in the elderly patient. Forty case reports]

Between 1989 and 1996, 40 cases with acute leukemia (16 males and 24 females) were diagnosed in our institution. Median age was 65 years (range, 56-88 years). Leukocyte count was more than 30.109/l in 42% of cases. According to the French-American-British (FAB) criteria, 11 cases were classified lymphoblastic and 29 myeloblastic. Sixteen patients have received palliative treatment because of there age and there bad performance status. Only 24 patients have received curative treatment. Complete remission was achieved in 12 cases (50%), 5 cases (20%) failed to respond and 7 (30%) died during induction. Relapse was observed in 8 cases. The 2-year survival rate was 10% confirming the worse prognosis of the acute leukemia in elderly.

[Molecular analysis and prenatal diagnosis of beta-thalassemia: about our experience in central Tunisia]

Beta-thalassemia, by its high frequency and its heterogeneity, constitutes a real problem of health in Tunisia. Prenatal diagnosis by DNA analysis represents the only reality for couples at risk. The denaturant gradient (urea and formamide) on polyacrylamide gel electrophoresis has been performed in our laboratory, using psoralen as chemical clamps. This method is simple, reliable, safe, rapid, without radioactivity and has a reasonable cost (chemical clamps). Even if it needs an informatic modelization in other laboratories, this method seems to be adapted to our economic and work conditions and to the molecular heterogeneity of the Tunisian beta-thalassemia. We present the results of an epidemiological molecular study on 75 patients with beta-thalassemia and the results of ten prenatal diagnosis. The molecular lesions codon 39 (C-T) and IVS1 nt2 (T-G) are the most frequent in our study. This technical approach provides genetic counselling for at risk families by offering prenatal diagnosis (reducing as possible the cost and the delay of the result) after prealable family study and identification of the mutation(s).

The fate and persistence of zineb, maneb, and ethylenethiourea on fresh and processed tomatoes

Tomatoes grown under greenhouse conditions were sprayed with radiolabelled maneb and zineb to determine the extent of degradation of these fungicides to ethylenethiourea (ETU) and to study the persistence of ETU on the fruits. The total (14C) residues decreased from 0.082 mg/kg and 0.11 mg/kg at day 0 to 0.023 mg/kg and 0.05 mg/kg at day 20, on zineb- and maneb-treated fruits, respectively. This reduction was mainly due to the rapid growth of the fruits. ETU residues on tomato fruits were found to decline with time. A sharp reduction in ETU content was observed during the first 24 h after treatment, followed by a slow decline in the following 5 days. ETU content was reduced by about 80% by day 20 after the fungicide application, and the concentration of EU, the major degradation product of ETU, doubled during the same period. Studies with tomatoes fortified with (14C) ETU (0.006 mg/kg) prior to processing into tomato paste showed that 70% of the radioactivity was lost during washing of the tomatoes in water. Further losses of ETU occurred during boiling of the juice (6%) and during storage of the tomato paste for a period of 3 weeks (3%).

[Childhood acute myeloblastic leukemias. Report of 21 cases]

Between 1989 and 1996, 21 cases with acute non lymphoblastic leukemia (11 males and 10 females) were diagnosed in our institution. Median age was 9 years (range, 2-15 years). Leukocyte count was more than 50,109/l in 47% of cases. According to the French-American-British (FAB) criteria, 7 cases were classified M1, 10 cases were classified M2, 1 classified M4Eo and 3 classified M5. All patients were treated with "7 + 3" protocol and complete remission was achieved in 17 cases (80%), 2 cases (10%) failed to respond and 2 (10%) died during induction. Relapse was observed in 15 cases. The 3-year survival rate was 20% and the relapse-free-survival rate was 12% confirming the worse prognosis of this leukemia when treated with standard chemotherapy.

The epidemiology of schistosomiasis in Egypt: Ismailia governorate

A multi-stage stratified sample of 12,515 individuals from 1,941 households in 42 villages in the Ismailia governorate of Egypt were surveyed for schistosomal infection. A subset of 2,390 subjects were surveyed for morbidity by physical and ultrasonographic examination. The prevalence of Schistosoma mansoni infection in rural Ismailia was 42.9% and the geometric mean egg count (GMEC) was 93.3 eggs/gram of stool, with considerable variability between communities. Prevalence and intensity peaked in the 20-30-year-old age group and was higher in males than in females. Prevalence and intensity of S. haematobium was very low: 1.8% and 3.5 ova/10 ml of urine GMEC, respectively. Canal water exposure risk factors for S. mansoni infection were males bathing (odds ratio [OR] = 2.2), females washing clothes (OR = 1.9), and children playing or swimming (OR = 2.3). Presence of in-house piped water supply and latrine lowered infection rates (P < 0.001 and P = 0.002, respectively). Histories of S. mansoni infection (OR = 1.6) or treatment (OR = 1.5) and blood in feces (OR = 3.5) were associated with infection. Hepatomegaly (16.0%) was more frequently detected than splenomegaly (3.6%) by physical examination, with both being more frequent in older age groups. Splenomegaly, but not hepatomegaly, was associated with presence of S. mansoni ova in stools (OR = 1.4) and the community burden of infection (P = 0.02). Ultrasonographically detected hepatomegaly, splenomegaly, and periportal fibrosis (PPF) were detected in 43.0%, 17.4%, and 39.7% of the subjects, respectively. The higher grades of PPF were rare. Ultrasonographically detected splenomegaly, not hepatomegaly, was associated with S. mansoni infection, community burden of infection, and PPF. Risk factors for PPF were the same as for S. mansoni infection. There was a marginal association of PPF with infection and none (P = 0.33) with the intensity of infection in individuals or in the community. We conclude that in rural Ismailia, S. haematobium infection is rare but the prevalence and intensity of infection with S. mansoni is high. The risk of infection is associated with environmentally detected factors and behaviors. Hepatosplenic morbidity attributable to S. mansoni infection is low, presumably because of the favorable effect of wide application of praziquantel therapy.

[Acute lymphoblastic leukemia in adults. Apropos of 42 cases]

Between 1989 and 1995, 42 cases with acute lymphoblastic leukemia (18 males and 24 females) were diagnosed in our institution. Median age was 38.5 years (range, 16-88 years). Leukocyte count was more than 30.10(9)/l in 54% of cases. According to the French-American-British (FAB) criteria, 67% were classified L1 and 33% L2. Sixteen patients were treated with 12LA80 protocol, 14 patients with LALA 85 protocol, 6 patients with LALA 87 protocol and 6 patients with EORTC protocol. Complete remission was achieved in 22 cases (52%), 8 cases (20%) failed to respond and 12 (28%) died during induction. Relapse was observed in 10 cases. The 4-year survival rate was 28% confirming the worse prognosis of this leukemia when treated with standard chemotherapy.

Discriminant analysis of free fatty acids of some Egyptian snails as a step for schistosomiasis control: new trends

Schistosomiasis is still the most common occupational health problem of rural workers in Egypt. The use of molluscicides, either chemical or biological, and environmental changing are the most successful methods of snail control. The new trend in Schistosoma control programs is to study the ecological factors that attract miracidium Schistosoma specific snails, to emphasizing to find out new environmental safe control methods. Since Schistosoma worms do not make fatty acids de novo, they require host lipids for survival and to complete their life cycle. Discriminate analysis of the estimated free fatty acids was done in this study in Biomphalaria alexandrina, Biomphalaria glabrata, and Bulinus truncatus, viz. Lymnaea truncatula and Physa acuta (Schistosoma intermediate and non-intermediate respectively). With the objective of determination of the biochemical difference that attract the infestation of Schistosoma miracidium to the target snails, as a step of the new control trends. Caprylic acid (C8:0), and Oleic acid (C18:1) are significantly lower in the tissues of Schistosoma intermediate snails compared to the non-intermediate snails. While, Capric acid (C10:0), Margaric acid (C17:0), and Lenoleic acid (C18:2) of the intermediate snails are significantly higher than that of non-intermediate snails. The percent of correct medical classification of snails are more than 80% according to Caprylic acid, Margaric acid, and Lenoleic acid, the other 15 fatty acids are less than 80%. These three free fatty acids could be chemoattractive of Schistosoma miracidium, and could be used as safe environmental control compounds, which needs further research.

Roles of triplex and scaffolding proteins in herpes simplex virus type 1 capsid formation suggested by structures of recombinant particles

Typical herpes simplex virus (HSV) capsids contain seven proteins that form a T=16 icosahedron of 1,250-A diameter. Infection of cells with recombinant baculoviruses expressing two of these proteins, VP5 (which forms the pentons and hexons in typical HSV capsids) and VP19C (a component of the triplexes that connect adjacent capsomeres), results in the formation of spherical particles of 880-A diameter. Electron cryomicroscopy and computer reconstruction revealed that these particles possess a T=7 icosahedral symmetry, having 12 pentons and 60 hexons. Among the characteristic structural features of the particle are the skewed appearance of the hexons and the presence of intercapsomeric mass densities connecting the middle domain of one hexon subunit to the lower domain of a subunit in the adjacent hexon. We interpret these connecting masses as being formed by VP19C. Comparison of the connecting masses with the triplexes, which occupy equivalent positions in the T=16 capsid, reveals the probable locations of the single VP19C and two VP23 molecules that make up the triplex. Their arrangement suggests that the two triplex proteins have different roles in controlling intercapsomeric interactions and capsid stability. The nature of these particles and of other aberrant forms made in the absence of scaffold demonstrates the conformational adaptability of the capsid proteins and illustrates how VP23 and the scaffolding protein modulate the nature of the VP5-VP19C network to ensure assembly of the functional T=16 capsid.

Vaccination against Schistosoma mansoni infection using 74 kDa Schistosoma protein antigen

An IgG2a anti-Schistosoma mansoni mouse monoclonal antibody was shown to passively protect Swiss mice. The 74 kDa target antigen was isolated from antigenic extracts of S. mansoni adult worms. Swiss and C57 BL/6J mice were immunized with 30, 50, 100 and 200 microg antigen/mouse doses with and without Freund's adjuvant. Sera of immunized mice showed high reactivity against 74 kDa antigen. The highest protection level (76.6% in Swiss mice and 50.1% in C57 BL/6J mice) was obtained using the 50 microg antigen dose with and without Freund's adjuvant. A marked reduction in granuloma number and intensity of collagen and reticular granuloma fibers was observed. The 74 kDa antigen has the ability to protect mice of different strains and to modulate the host immune system.

Vaccination against Schistosoma mansoni infection using 74 kDa Schistosoma protein antigen

An IgG2a anti-Schistosoma mansoni mouse monoclonal antibody was shown to passively protect Swiss mice. The 74 kDa target antigen was isolated from antigenic extracts of S. mansoni adult worms. Swiss and C57 BL/6J mice were immunized with 30, 50, 100 and 200 microg antigen/mouse doses with and without Freund's adjuvant. Sera of immunized mice showed high reactivity against 74 kDa antigen. The highest protection level (76.6% in Swiss mice and 50.1% in C57 BL/6J mice) was obtained using the 50 microg antigen dose with and without Freund's adjuvant. A marked reduction in granuloma number and intensity of collagen and reticular granuloma fibers was observed. The 74 kDa antigen has the ability to protect mice of different strains and to modulate the host immune system.

[Fanconi disease: study of 43 cases in southern Tunisia]

BACKGROUND

To report the epidemiologic, clinical, biological features and course of Fanconi's anemia in southern Tunisia.

PATIENTS AND METHODS

During a period of 12 years we observed 43 cases. For each patient, careful clinical, biological (hemogram, myelogram, bone marrow biopsy, hemoglobin electrophoresis, karyotype) and radiological (skeleton X-rays, abdominal echography and intravenous urography) examinations were performed. All the patients who were at a pancytopenia stage were given androgens. None had a bone marrow allograft.

RESULTS

There were 24 girls and 19 boys. The mean age at diagnosis was 10 years and 9 months. The familial character was present in 53% of the cases. The most frequent initial complaint was anemic syndrome (69%). In ten cases (24%), the diagnosis has been established during a familial investigation. Malformations were present in all cases (abnormal pigmentation: 86%; skeletal maturation retardation: 83%; facial dysmorphy: 76%; statural hypotrophy: 65%; bone abnormalities: 53%; renal malformations: 44%). Anemia was present in 88% of the cases, thrombocytopenia and neutropenia in all cases. Bone marrow was hypoplastic or aplastic in all cases on biopsies. Spontaneous chromosomal breaks were found in 79% of the studied cases. Fetal hemoglobin was increased in 80% of the studied cases with a mean level of 20.5%. Actuarial survival rate at 5 years was 48%, but long survival durations were rare (eight out of 43 patients).

DISCUSSION

This disease, rare in the world, seems to be frequent in southern Tunisia. A normal karyotype (with classical techniques), found in five patients, could not discard the diagnosis; for this reason, the use of sensitizing agents should improve the sensitivity of the test. Besides, an increased level of fetal hemoglobin enabled us to suggest the diagnosis in some cases. Androgenotherapy increased the survival duration to more than 5 years in eight patients. However, bone marrow allograft remains the only possibility of cure.

Gluconeogenic activity in response to chronic administration of amphetamine sulphate and drug withdrawal

1. Chronic amphetamine administration (10 mg/kg) to young rats (Rattus norvegius) (40-90 g) produced an initial hyperglycemia following the initial drug administration. This was followed by progressive hypoglycemia with the continuous drug treatment. 2. The present data also demonstrate increases in levels of serum ACTH and corticosterone that were maintained after drug withdrawal, in the case of corticosterone. 3. The Analysis of the transaminase activity revealed the occurrence of significant increases in serum GOT level. Furthermore, progressive increase in the G-6-Pase activity was recorded, reaching its maximum level by the end of the experiment, which demonstrates that induced amphetamine toxicity is time-dependent.

Fetal faciocervical teratoma with anemia and thrombocytopenia. A case report

A massive teratoma in the faciocervical region was found in a fetus at 21 weeks, with laboratory evidence of anemia and thrombocytopenia. Vaginal delivery was achieved by cardiocentesis followed by Laminaria tent insertion, dilation and evacuation.

The reliability and validity of the proposed axis V (disabilities) of ICD-10

BACKGROUND

The purpose of this study was to examine the reliability and validity of the newly proposed axis V (disabilities) of ICD-10.

METHOD

Eighty-six acutely ill men and women were prospectively recruited from the Al Ain psychiatric units, UAE. Both versions of ICD-10, the Clinical Descriptions and Diagnostic Guidelines and the Diagnostic Criteria for Research (DCR) were used for coding axis I psychiatric diagnosis and its grade of severity; the WHO Disability Assessment Schedule was used to assess disabilities.

RESULTS

Inter-rater reliability of the DAS items ranged from moderate to good, and axis V ratings correctly predicted 84% of the observed classification on axis I.

CONCLUSION

Axis V is a valid measure of disabilities, but is limited by its modest reliability.

Expression of c-kit and kit ligand proteins in normal human tissues

The c-kit receptor and its cognate ligand, KL, play a critical role in melanogenesis, gametogenesis, and hematopoiesis. Studies on the expression of c-kit and KL have been primarily focused on mouse development. We undertook the present study to characterize the pattern of expression of these molecules in normal adult human tissues. Using immunohistochemistry and consecutive tissue sections from the same block, we evaluated a variety of well-preserved normal tissues for c-kit and KL microanatomic distribution. c-kit protein was identified in tissue mast cells, melanocytes, glandular epithelial cells of breast, parotid, dermal sweat, and esophageal glands. Scattered c-kit immunoreactivity was also observed for testicular and ovarian interstitial cells. A striking regional distribution of c-kit was detected in the central nervous system, particularly in the cerebellum, hippocampus, and dorsal horn of the spinal cord. KL protein was identified in cells complementary to staining for the receptor, such as glandular myoepithelium of breast and sweat glands. Intense KL immunoreactivity was observed in smooth muscle cells of the bladder, cervix, uterus, and gastrointestinal tract, as well as in striated and cardiac muscle. Strong KL staining was also detected in prostate fibromuscular stroma cells. In the central nervous system, KL expression was confined to Golgi and Purkinje cells in the cerebellum. These results suggest a role for this receptor and its ligand in the maintenance of a variety of fully differentiated tissues.

Frequency of arylsulphatase A pseudodeficiency associated mutations in a healthy population

Arylsulphatase A (ASA, EC 3.1.6.1) is a lysosomal enzyme that catalyses cerebroside sulphate degradation. ASA deficiency is associated with metachromatic leucodystrophy (MLD), a rare autosomal recessive disorder, which is characterised by the storage of cerebroside sulphate. Low ASA activities can be also observed in clinically healthy persons, a condition termed ASA pseudodeficiency. Two mutations responsible for the majority of pseudodeficiency alleles have been defined in the ASA gene. These are both A-->G transitions. One causes an asparagine to serine substitution (N350S). The second changes the first polyadenylation signal downstream of the stop codon (1524 + 95A-->G), which causes a severe deficiency of one ASA mRNA species. The incidence of the pseudodeficiency allele is estimated to be high in the general population and can be found in families carrying MLD associated mutations. We report a reliable stratagem for detecting the two PD associated mutations separately, which we have applied to a healthy population. Two homozygotes for the N350S and 1524 + 95A-->G mutations were detected, which gives a population frequency of 2.6%. The overall frequencies of the ASA-PD mutations were shown to be 17.5% for the N350S change and 13.0% for the 1524 + 95A-->G change, estimating each mutation separately. In addition, the frequency of both PD associated mutations occurring together on the same chromosome was found to be 12.3% in our population. The study has also allowed us to establish a new control ASA activity range, which was based on assay of blood from persons who had been shown at the DNA level not to carry ASA PD associated mutations.

Phenomenology of obsessive-compulsive disorder: a transcultural study

Ninety patients suffering from obsessive-compulsive disorder (OCD) and diagnosed according to International Classification of Diseases (10th edition [ICD-10]) criteria attending the outpatient clinic of the Institute of Psychiatry in Cairo in 1991-1992 were assessed by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) for symptomatology and severity of symptoms. Sixty-nine percent of the patients were males, and 32% were females. The mean age of the sample was 23.7 years, with a mean duration of OCD of 3.2 years. Twenty percent of patients had a positive family history for OCD. Forty percent of patients presented with a mixture of obsessions and compulsions, whereas 29% presented with obsessions and 31% with compulsions. The most commonly occurring obsessions were religious and contamination obsessions (60%) and somatic obsessions (49%), and the most commonly occurring compulsions were repeating rituals (68%), cleaning and washing compulsions (63%), and checking compulsions (58%). Seventy-one percent of patients were rated severe on the Y-BOCS, and all of them had impaired insight; 9% were insightless. The age of patients was found to correlate positively with the total compulsive score and the total Yale BOCS score, but it correlated negatively with the total obsessive score. One third of patients had a comorbid depressive disorder. Regarding premorbid personality disorders, 14% had obsessive personality disorder, 34% had paranoid, anxious, or emotionally labile personality disorder, and 52% had no premorbid personality disorder. The role of religious upbringing has been evident in the phenomenology of OCD in Egypt, which is similar to the outcomes of studies in Jerusalem and different from results in India and Britain.(ABSTRACT TRUNCATED AT 250 WORDS)

Echocardiographic evaluation of the five-chamber heart: a rare congenital coronary anomaly

Coronary artery fistulas are rare congenital anomalies that usually drain into one of the cardiac chambers or veins. The current patient was found to have a distinctly unusual anatomic picture, with a fifth cardiac chamber appearing at the cardiac apex. This proved to be the drainage site for a large coronary artery fistula originating in the left anterior descending coronary artery. The anatomic relations and blood flow patterns were demonstrated with transthoracic and transesophageal echocardiography.

Fertility estimates in the Tunisian all-acrocentric and Robertsonian populations of the house mouse and their chromosomal hybrids

The reproductive features of wild all-acrocentric and 2n = 22 Robertsonian (Rb) house mice (M. m. domesticus) from Tunisia were studied. The aim was to examine the possibility of a reproductive selective advantage associated with chromosomal change as well as to measure the effect of heterozygosity for a large number of Rb fusions on the fertility of hybrids. Results showed that litter sizes were significantly smaller in Rb than in all-acrocentric mice. This difference, which may represent a favourable demographic strategy related to the habitat segregation observed in the Tunisian mice, needs to be studied further. The F1 hybrids between the two chromosomal races showed a significantly reduced reproductive success and litter size (respectively, 53 per cent and 60 per cent less than either parental race). Analysis of the testicular histology of F1 and backcross males showed in some cases a breakdown of spermatogenesis. The degree of this disturbance was not related to the level of chromosomal heterozygosity suggesting that genetic incompatibilities between the two genomes might be involved. The strong reduction in fertility measured in these hybrids represents a reproductive isolating mechanism effectively reducing gene flow between the all-acrocentric and 22Rb mice populations of Tunisia.

Presentation of acute psychosis in an Egyptian sample: a transcultural comparison

The symptomatological and diagnostic differentiations and outcome of acute psychosis were studied in 50 Egyptian patients using the Schedule of Clinical Assessment of Acute Psychotic States (SCAAPS). The prevailing symptoms were delusions, worry, irritability, mood changes, and disturbed behavior. Sixty-four percent of the patients were symptom-free at 1-year follow-up assessment. Various factors that affect clinical and social outcome were discussed. The problem of diagnostic terms was also studied comparing SCAAPS terms with those of DSM-III-R and ICD-10. The most frequent diagnosis was psychogenic psychosis or brief reactive psychosis corresponding to the previously mentioned first and second systems, respectively. The inclusion of acute and transient polymorphic psychotic disorders with or without stress in ICD-10 will encompass those clinical syndromes in different cultures. A comparative study with a matched Indian sample was also conducted, the results of which are discussed in detail.

Pharmacokinetics and intramuscular bioavailability of amikacin in chickens following single and multiple dosing

The pharmacokinetics of amikacin were studied in healthy mature female chickens (n = 6). Single doses of amikacin were injected as an i.v. bolus (10 mg/kg) and i.m. (20 mg/kg) into the same birds with a 30-day rest period between treatments. Amikacin was determined by the fluorescence polarization immunoassay method. The i.v. pharmacokinetics could be described by a two-compartment model with a t1/2 alpha of 0.150 +/- 0.064 h and a t1/2 beta of 1.44 +/- 0.34 h. The total body clearance was 0.109 +/- 0.017 1/h/kg and the volume of distribution at steady-state was 0.193 +/- 0.060 l/kg. Following a single i.m. injection, the peak plasma concentration (Cmax) was 50.79 +/- 4.05 micrograms/ml and occurred at 0.50 +/- 0.26 h. The i.m. extent of absorption was 91.2 +/- 17.6%. Simultaneous modeling of i.v. and i.m. results provided estimates of an absorption half-life of 0.480 +/- 0.158 h. The i.m. pharmacokinetics after repeated administration were studied following the tenth dose (20 mg/kg, every 8 h). The Cssmax was 38.58 +/- 6.96 micrograms/ml and occurred at 0.79 +/- 0.37 h, and the biological half-life of amikacin was 1.86 +/- 0.47 h. The multiple dosing yielded peak concentrations of 39 micrograms/ml and trough concentrations of 3.26 micrograms/ml. Based on these data, the recommended amikacin dosage in chickens is 20 mg/kg body weight every 8 h.

Movement characteristics of human spermatozoa collected from different layers of a discontinuous Percoll gradient

In order to evaluate the functional state of human spermatozoa separated on discontinuous Percoll gradient, sperm provided by 15 healthy volunteers were recovered from different layers (60, 70, 80, 90, 100%) of the gradient, then submitted to a complete analysis of sperm movement characteristics. This one was performed using a computer assisted system (Cellsoft, Cryo Resources, Ltd., NY, USA). In all fractions sperm motility was highly maintained during 24 h and all movement characteristics, with the exception of ALH, were different from that observed in seminal plasma. Curvilinear velocity (VCL), linearity (LIN), and percentage of hyper-activated sperm (HA) increased in relation to the Percoll concentration. Nevertheless there was no dramatic difference, concerning motion parameters, between 100%, 90%, and 80% Percoll fractions, which can thereby be pooled in case of insufficient sperm recovering in 100% fraction. On the contrary there is some doubt about the fertilizing ability of spermatozoa recovered in 70% and 60% Percoll layers, since VCL, LIN, and especially HA are severely decreased.

[4p trisomy secondary to paternal translocation t(4p-;15q+)]

A new case of trisomy 4p is reported. The patient was a boy with dysmorphism, growth failure and developmental retardation. Craniofacial features included microcephaly with a flat forehead, a prominent glabella, hyperteleorism, a broad, concave nasal bridge, a bulb-shaped nose, a wide mouth with a prominent upper lip and a short philtrum, low-set ears, a low hairline, micrognathia, and a short neck. Abdominal muscles were normal. Cryptorchidism with a hypoplastic scrotum and a micropenis were found, as well as forced flexion of the fingers and talipes equinus. The intravenous urogram disclosed ptosis of the right kidney. Developmental retardation was severe with an IQ under 50. RHG banding techniques on peripheral lymphocytes disclosed 4p14 pter duplication. The karyotype was 46,XY inv dup(4-p) (p14----pter). The mother's karyotype was normal. The father had a translocation between the short arm of chromosome 4 and the long arm of chromosome 15; his karyotype was 46,XY, t(4;15) (p14;q26). Thus, the child had trisomy for a segment of the short arm of chromosome 4 (p14----pter) and monosomy for the terminal band of the long arm of chromosome 15 (15q26). The first case of trisomy 4p was reported in 1970 by Wilson et al. Since then, there have been 46 additional reports in the medical literature. Although children with trisomy 4p share a number of features, the phenotypic manifestations of this chromosomal abnormality are variable and nonspecific, making clinical diagnosis difficult.

Multielement determination in rice, wheat, and barley by instrumental neutron activation analysis

INAA has been used for the determination of Na, Mg, Al, Cl, K, Sc, Cr, Mn, Fe, Co, Cu, Zn, As, Se, Br, Rb, Sr, Mo, and W in grains of rice, wheat, and barley, which were collected from different plant fields in Iraq. Samples and standards were irradiated in the IRT-5000 reactor, at neutron fluxes of 2 x 10(13) cm-2.s-1 and 3.2 x 10(11) cm-2.s-1. Interferences of photopeaks with each other were considered, and reaction interferences were calculated and determined experimentally. Accuracy of our method was assessed by the analysis of IAEA standards Wheat Flour and Bovine liver. A good agreement has been achieved between the present results and recommended values. The precision and detection limit were determined for all elements in all types of grain.

HLA antigens and infertility with sperm autoantibodies in man

Vasectomized men with sperm auto-antibodies (S.A.A.) and high frequency of HLA-A20 antigen (Ag) were observed by Law et al. (1979); Hancock et al. (1983) observed the prevalence of HLA-A28 in infertile men with S.A.A. HLA-A, B and DR Ag were determined in a population of 80 Caucasian infertile men with (n = 22) or without (n = 58) agglutinating and/or cytotoxic S.A.A. in serum (S) and/or seminal plasma (SP), and the association between HLA-determinants and infertility with S.A.A. was investigated. The frequence of HLA-A28 Ag was found higher in the group with S.A.A. than without (18.2% vs 0.0%) but not statistically significant (chi 2 = 8.87; pc less than 0.15). The same result was obtained with HLA-B13 Ag (chi 2 = 8.87; pc less than 0.32). Lastly, there was no prevalence of HLA-DR Ag in men with S.A.A. In conclusion, no association was found between HLA-A, B and DR Ag and infertility with S.A.A. Nevertheless, two HLA-Ag were more frequently observed in the group with S.A.A.

The effects of metallic tin on background plaque-forming cells, immunoglobulins and the immune response

Inoculation of metallic tin powder into Lewis rats resulted in marked enlargement of the draining lymph nodes. Plasma cells were the major contributors to the increase in cell mass. Certain immunologic aspects of this plasma cell lymphadenopathy were investigated. Immunoglobulin isotypes were distinguished and quantitated by fluorescence immunocytochemistry and rocket electrophoresis of lymph node extracts. Background plaque-forming cells directed against sheep red blood cells were increased. Specific activity was highest 4 days after inoculation of tin. Lymph nodes and spleen continued to increase in cell number so that total background activity attained a maximum at 14 days after inoculation of tin. Tin was a good adjuvant for plaque-forming cells in lymph nodes and for serum agglutinins (primary and secondary responses) when the rats were immunized with sheep red blood cells, even when the antigen was injected at a remote site. The plasma cell response to tin may be due to local polyclonal activation.

Biology of the gametes of some teleost species

Our knowledge of the biology of fish gametes is still limited. Up to now research was short-term, aiming at solving practical questions connected with gamete storage and artificial insemination. More information on gamete biology is now available and has been summarized in this minireview.In vivo storage of gametes in the genital tract after ovulation or spermiation may be influenced by the osmotic environmentvia changes in the ionic composition of the companion fluid. There is great inter-individual variability in gamete survival bothin vivo andin vitro. Mechanisms involved in the initiation of trout sperm motility have been analysed; after dilution in water or NaCl solution (125 mM) at pH > 7, Ca(++) entry due to changes in membrane potential have been observed. The involvement of cAMP and protein phosphorylation has been reported. The morphological, physical and biochemical changes in eggs that have been studied after fertilization and the corticol reaction lead to a better understanding of the mechanisms of polyspermy blockage.

Human chorionic gonadotropin immunoreactivity in serum of patients with malignant neoplasms

The beta-human chorionic gonadotropin (HCG) radioimmunoassay was used to determine the presence of HCG immunoreactivity in serum of patients (n = 71) with diagnosis of cancer. Of patients with active neoplasia, 60.5% showed HCG immunoactivity above controls (greater than 5 mIU/ml). An apparent degree of correlation was observed with tumor activity in that a case with widespread metastases due to a colonic carcinoma exhibited the highest HCG levels while, in one patient, the level of HCG decreased progressively according to therapeutic response. A high frequency of immunoactive HCG was found in patients with carcinomas of the cervix, breast, gonad, and digestive system and in patients with melanoma. Trophoblastic cells were not evident in the tumors biopsied. Immunologic similarity of HCG secreted by tumors and that contained in serum of pregnant women, of patients with hydatidiform mole, and of males injected with exogenous HCG was shown by parallel inhibition curves in the radioimmunoassay. The positivity of HCG was predominant in cases of cervix carcinoma.

Serological studies in cholera. 2. The vibriocidal antibody response of cholera patients determined by a microtechnique

A microtechnique is described for the determination of vibriocidal antibodies to Vibrio cholerae, using 0.025 ml of fingertip blood or venous serum per test. This test could be used in epidemiological surveys, or as a routine test on patients admitted to hospital.Fourfold or greater rises in vibriocidal titre were noted for 96.5% of 370 bacteriologically confirmed cholera patients in an endemic area of East Pakistan (91.5% for the 94 children under 5 years in the study group). It is necessary to test sera against both Ogawa and Inaba serotypes of V. cholerae, as a significant titre rise was found against the homologous serotype only in 11% of the cases, and against the heterologous serotype only in 2%.Six serologically positive but bacteriologically negative persons were found to be household contacts of confirmed cholera patients (and 3 of the contacts had been vaccinated against cholera within 1 week before testing); 3 other cases (1.6%) were considered to be false positives.The vibriocidal test using fingertip blood was compared with daily rectal swabbing for the detection of cholera carriers among 153 household contacts of cholera patients, who had not received cholera vaccine within 2 weeks before testing; 16% gave a positive vibriocidal titre, while V. cholerae was isolated from 13% only.

Serological studies in cholera. 3. Serum toxin neutralization--rise in titre in response to infection with Vibrio cholerae, and the level in the "normal" population of East Pakistan

A method has been evaluated for the titration of antibodies to Vibrio cholerae, based on the ability of sera containing such antibodies to neutralize the inflammatory effect of a factor from V. cholerae cultures on the skin of test animals.Ninefold or greater rises in toxin-neutralization titre were found in 73% of 111 bacteriologically confirmed cholera patients in an endemic area of East Pakistan, and in 2.5% of bacteriologically negative patients. This method compares well with the microtechniques developed for the titration of vibrio-agglutinating and vibriocidal antibodies to V. cholerae.The toxin-neutralization method has the advantage that no titre rise is produced in response to vaccination with the whole-cell vaccine in current use in East Pakistan.Relatively high toxin-neutralization titres were noted among children under 15 years of age without vibriocidal or agglutinating antibodies, and without a history of prior infection with V. cholerae.