Syndrome of multiple pterygia, camptodactyly, facial anomalies, hypoplastic lungs and heart, cystic hygroma, and skeletal anomalies: delineation of a new entity and review of lethal forms of multiple pterygium syndrome

Three unrelated stillborn infants (cases 1-3) are presented here with a distinct constellation of multiple anomalies: namely, multiple pterygia involving chin-to-sternum, cervical, axillary, antecubital, crural and/or popliteal areas, flexion contractures of multiple joints, small chest, hydrops, characteristic abnormal facial appearance with hypertelorism, markedly flattened nasal bridge with hypoplastic nasal alae, cleft palate, micrognathia, apparently low-set malformed ears, short neck with a cystic hygroma at the back of the neck and head, and pulmonary and cardiac hypoplasia. Radiographic studies, in addition, showed scalp edema, microbrachycephaly, flattened mandibular angle, lack of normal curvature at the cervico-thoracic junction, marked bony fusion of posterior spinous processes of older fetuses (cases 1, 2), thin crowded ribs, markedly hypoplastic scapulae, hypoplastic iliac wings, ischia and pubic bones, undermodeling of tubular bones, and radio-ulnar synostosis. Histologic studies of the skeletal system showed cartilaginous and bony fusion of the spinous processes (cases 1, 2), fusion of epiphyseal cartilages of distal humerus and proximal ulna, a poorly developed joint space, an abnormal growth plate, and weak safranin staining of the resting cartilages (cases 1, 2). To the best of our knowledge, this pattern of anomalies constitutes a previously undescribed syndrome. Prenatal diagnosis of this entity is possible by ultrasonographic studies on the basis of nonimmune fetal hydrops, a cystic hygroma at the back of the head and neck, diminished fetal activity, short and fixed limbs, and/or maternal hydramnios. Three additional cases (cases 4-6) are also presented to show a possible heterogeneity of this syndrome.

Cardiotoxicity of Forssman antibodies in in vitro perfusion experiments

Guinea pig heart was perfused in vitro by xenogeneic sera. Sera from both Forssman-positive and Forssman-negative animals exerted strong cardiotoxicity. The toxic effect of rabbit sera could be very significantly decreased by absorption or neutralization of the naturally occurring Forssman antibodies, pointing to the significant role played by these antibodies in the "rejection" of a Forssman-positive organ.

Total lipid and cholesterol content in the blue crab, Callinectes sapidus Rathbun

Total lipid and cholesterol concentrations in hepatopancreas, gonad and muscle were analyzed for 70 blue crabs. The concentrations were highest in hepatopancreas, then gonad, and muscle was the lowest. In male crabs, the concentrations decreased from the immature stage (feeding and growth stage) to the mature stage (breeding stage), and from August to September (breeding period) in mature males. In female crabs, the concentrations were comparatively high for peelers (pre-molting stage) and mature females in October (pre-spawning migration period). The total lipid and cholesterol concentrations were significantly, positively correlated in both sexes. The total lipid and cholesterol concentrations were independent of both body weight and tissue weight. Exceptions were the immature females whose concentrations in hepatopancreas were negatively correlated with both body weight and hepatopancreas weight, and the mature females whose concentrations in gonads were positively correlated with gonad weight.

Immunological studies of autoimmune thyroid disorders: abnormalities in the inducer T cell subset and proliferative responses to autologous and allogeneic stimulation

Various immunological parameters were investigated in patients with Hashimoto's thyroiditis (HT) and Graves' disease (GD). The total T cell numbers were significantly decreased in both diseases whether they were enumerated by E rosetting or by pan-T cell monoclonal antibodies (OKT3 and anti-Leu 1). This diminution was due to a loss in the inducer T cell subset (OKT4+/Leu 3a+) whereas the cytotoxic/suppressor T cells (OKT8+/Leu 2a+) were present at normal levels in both diseases. The B cells were significantly higher in GD patients than in controls but were not modified in HT patients. Monocyte percentages remained unchanged and DR+ cells were slightly increased in the two diseases. On the other hand, T lymphocyte responses to stimulation by autologous or allogeneic cells were significantly impaired in GD but not in HT whether cultures were performed in autologous plasma or AB serum. In addition, lymphocytes from normal subjects were unable to proliferate in auto- or allo-MLR in the presence of plasma from GD patients but they were reactive in the presence of HT plasma or AB serum. Taken together, these results suggest that the patients with autoimmune thyroid disorders exhibit a T cell imbalance within the OKT4+/Leu 3a+ subset. Moreover, this abnormality is correlated with the observation that autoreactive and alloreactive cells are defective in GD.

The Pena-Shokeir syndrome: report of five cases and further delineation of the syndrome

We report on five cases of lethal Pena-Shokeir syndrome from three families with affected sibs. In addition to multiple anklyoses, camptodactyly, facial anomalies, and pulmonary hypoplasia, one fetus had pterygia of the neck and axillae and cardiac hypoplasia. Radiographic changes are nonspecific and probably are related to a lack of intrauterine movement. Our data and review of the literature suggest that pterygium formation is one of the manifestations of the Pena-Shokeir syndrome. A recently described lethal form of the recessively inherited multiple pterygium syndrome may represent a severe form of the Pena-Shokeir syndrome.

Fabrication of a 360 degrees astigmatic rainbow hologram

A 360 degrees astigmatic rainbow holographic recording scheme is proposed. The experimental result is also included.

Serum high density lipoprotein cholesterol and factors influencing its level in healthy Chinese

Serum HDL-cholesterol (HDLc) levels were studied on 2399 healthy urban inhabitants, from newborn to 78 years of age, in Shanghai. The results were as follows. (1) Frequency distribution of serum HDLc levels in most groups was approximately normal after age 20. (2) The serum HDLc levels and HDLc/total cholesterol ratio varied with age and sex among healthy subjects. The mean values of HDLc for people over 30 years of age were 58.7 +/- 11.2 mg/100 ml for males and 62.5 +/- 12.2 mg/100 ml for females. The difference was of statistical significance (P less than 0.01). (3) The mean values of serum HDLc were found to be 40.9 +/- 6.0 mg/100 ml and 40.7 +/- 7.9 mg/100 in male and female neonates respectively. These figures are quite similar to those reported from Western countries and Japan. The serum HDLc level rose steadily with age and such elevation was more marked in females than males before age 30. However, the values became closer at age 60, then began to decrease in both sexes. (4) Serum HDLc levels varied markedly with body weight; they correlated negatively with the weight/height index. (5) No statistically significant relationship was found in Chinese between smoking or drinking and serum HDLc levels. The high level of HDLc seemed a result of environmental factors and is, possibly, related to the lower incidence of coronary heart disease in China.

Specific terminal DNA replication sequence of X chromosomes in different tissues of a live-born triploid infant

Using the thymidine pulse method, DNA replication kinetics were studied on cells derived from cartilage, gonad, lymphocytes, and skin of a live-born triploid (69,XXY) infant with typical clinical findings. Replication studies showed that 3% of the lymphocytes had one early and one late replicating X, and 97% of the lymphocytes, and cartilage, gonad, and skin cells had two early replicating X's. Asynchronous DNA replication between the two early replicating X's was observed in all tissues (range 25-40%). The predominant terminal replication sequence of X chromosomes from chondrocytes, gonad, and skin fibroblast differed from that of the lymphocytes. Thus, a tissue-specific DNA replication pattern of the early-replicating X chromosome may be present. In every tissue, the last band to complete DNA replication was Xq21. Polymorphisms of metaphase chromosomes of parents and the patient were studied by Q-banding. The possible origin of the extra haploid set of chromosomes is discussed.

A lethal, Larsen-like multiple joint dislocation syndrome

We describe here two isolated cases of lethal, Larsen-like multiple joint dislocation syndrome. Death occurred shortly after birth with pulmonary insufficiency due to tracheomalacia and/or lung hypoplasia. Both had abnormal dermal collagen bundles. In one case, histochemical studies showed abnormal cartilagenous matrix and striking deficiency in the dense collagen bundles of joint capsules; electronmicroscopic studies of the hyaline cartilage of the trachea documented a relative increase of the small, short fibers with decrease of the matrix collagen fibers. This study confirms that this Larsen-like syndrome is a disorder of connective tissue, possibly involving dysmaturity of the collagen fibers, with a predilection for joint capsules and tracheal cartilage. This lethal condition is characterized by pulmonary insufficiency, tracheomalacia, and collagen fiber dysmaturity.

Evaluation of a method for estimating cardiac output from a single breath in humans

We have modified the single-breath method of Kim et al. (J. Appl. Physiol. 21: 1338-1344, 1966) for estimating cardiac output and arterial and mixed venous carbon dioxide tensions (PCO2). We assessed this using 30 normal subjects and 23 cardiac patients. The procedure was performed satisfactorily in all but two patients. The random errors, from 60 pairs of estimates of cardiac output in normal subjects and 50 pairs in patients, were +/- 12.8 and +/- 19.6% (95% tolerance limits; i.e., coefficient of variation multiplied by 2 for n greater than 50). The systematic error was assessed in 15 patients from comparisons with results obtained by the direct Fick method. There was no significant difference except in two patients with large intracardiac shunts. Mean values of cardiac output by single-breath and direct Fick estimates were 3.80 and 3.83 l/min. Arterial and mixed venous PCO2 were estimated by the single-breath method with random errors of +/- 1.5 and +/- 1.4 Torr, respectively, and no significant systematic errors. We conclude that our modification of the single-breath method is reliable in humans at rest, although the procedures for delivering the breath and processing the data are of critical importance.

Limb pterygium syndromes: a review and report of eleven patients

Conditions with limb pterygia and congenital contractures were reviewed as part of a study of over 350 infants with arthrogryposis. Emphasis was placed on inheritance and variability of distinct pterygium conditions. Eleven patients with limb pterygia were recognized in our study and are described here. Seven of the 350 patients with congenital contractures had the autosomal recessively inherited multiple pterygium syndrome (Patients 1-7). Three of the seven are sibs, a fourth was born to consanguineous parents, and three were chance isolated cases. These seven had multiple joint webs, unusual finger contractures, syndactyly, rocker bottom feet, ptosis, antimongoloid slant of palpebral fissures, epicanthal folds, highly arched palate, scoliosis, and short stature. There is intrafamilial variability. Three patients from one family had a lethal multiple pterygium syndrome. Two were monozygotic twins. They had webbing and contractures of the elbows, knees, neck, and fingers, calcaneovalgus deformity of the feet, and an unusual facial appearance: hypertelorism, flat nose, antimongoloid slant of palpebral fissures, apparently low-set ears. One had a cleft palate. Internal malformations included: bilateral pulmonary hypoplasia, small heart, absence of the appendix, and attenuation of the ascending and transverse colon. One sporadic case of lethal popliteal pterygium with facial clefts was studied. Multiple anomalies included: ankyloblepharon filiforme adnatum, upslanting palpebral fissures, hypoplasia of nasal cartilages, frenula, clefts into the oropharynx lateral to the mouth, apparently low-set ears with slit-like canals, large popliteal pterygia, syndactyly with fusion of all digits in hands and feet, and hypoplastic labia.

Diffraction-limited recording scheme in astigmatic rainbow holography

A lensless single-slit imaging system is employed in the recording scheme of the astigmatic rainbow holographic process. The resulting hologram forms an acceptable deep bright image under white-light illumination.

Aperture conjugation technique in astigmatic rainbow holography

A slit image conjugation technique using an astigmatic reference beam in astigmatic rainbow holography is developed. When the primary image is reconstructed with a white light point source, a wide-view orthoscope quasi-monochromatic holographic image will be revealed. Experimental results are also included.

Psychosocial aspects of patients with the Ullrich-Turner syndrome

Family and social background and psychosexual and psychomotor development were studied on 24 patients with the Ullrich-Turner syndrome ranging in age from 9 months to 18 years. Infancy is often characterized by mild feeding problems and sleeping difficulty. Early motor development is normal or mildly delayed but acquisition of speech and toilet training appear to be appropriate for age. Social skills are excellent. Psychopathology is not a significant aspect of the Ullrich-Turner syndrome. Psychological tests support the findings of verbal IQ exceeding performance IQ, space-form perceptual deficits, and visual motor deficit. No difference of intelligence was found between apparently nonmosaic and mosaic types of Ullrich-Turner syndrome. The degree of parental understanding and appropriate attitudes toward the patient and the syndrome largely depend on good family relationships, the socioeconomic level of the family, parents' personalities and their ability to cope with the implications of the syndrome, and appropriate physician's counseling.

Diffraction-limited imaging through a phase-distorting medium

An achromatic method of seeing through a phase-distorting medium, such as a turbulent atmosphere, utilizes a grating interferometer. Measurements are made at sample points throughout the region of fringe formation. A set of nonlinear simultaneous equations is generated and then solved by computer.

Achondrogenesis: a review with special consideration of achondrogenesis type II (Langer-Saldino)

We describe two dwarfed infants with large head, short neck and chest, prominent abdomen, and short limbs. Both died neonatally. Radiographic and morphologic characteristics identified the Langer-Saldino form of achondrogenesis (type II). Review of type II achondrogenesis documented distinctive clinical and anthropometric manifestations (fewer stillbirths, longer survival time and gestation period, larger size of the baby, longer limbs, and characteristic craniofacial features) as compared with type I achondrogenesis (Parenti-Fraccaro).

Interferometric construction of circular gratings

Low noise diffraction gratings are constructed with the aid of a circular grating interferometer illuminated with a polychromatic or extended source.

Kinetics of DNA replication in a dicentric X chromosome formed by long arm to long arm fusion

Utilizing the 5-bromo-deoxyuridine (BrdU) incorporation technique, we have recently studied the DNA replication kinetics in a dicentric X chromosome, formed by long arm-to-long arm fusion at band q23, for a 16-year-old black female with primary amenorrhea. The patient has a karyotype 45,X/46,X,dic(X)(q23). In the buccal smear the presence of X chromatin was found in 33% of the cells examined. The Barr bodies are large and 21% of them are bipartite. DNA replication studies were performed on the patient's lymphocytes by the thymidine pulse (T-pulse) method and confirmed comparatively by the BrdU pulse (B-pulse) method. The results indicate that the dicentric X chromosome is always late-replicating. The replication pattern is symmetric on both sides of the breakpoint and the replication sequence is, in order, p11, p22, q1(1-3), q22, q23, p21, and q21. This finding is comparable to those of other investigators and supports the theory that there exist two inactivation centers in the dicentric X chromosome, located on or near the q21 band.

Spondyloepiphyseal dysplasia congenita. A comparative study of chondrocytic inclusions

Spondyloepiphyseal dysplasia congenita is a short-trunk chondrodysplasia trait. The abnormalities are present at birth and involve primarily the spine, the epiphyses of long bones, and the pelvis. Postmortem examinations of two patients with this disease who died shortly after birth showed a mild disorganization of chondrocytic columnization in the physeal growth zone. The chondrocytes contained PAS-positive cytoplasmic inclusions after diastase digestion to eliminate glycogen. Ultrastructural examination of the inclusions in one patient showed them to be accumulations of finely granular material in dilated cisterns of rough endoplasmic reticulum. To our knowledge, similar findings have been seen only in three other types of chondrodysplasia. The inclusions, which therefore are of diagnostic importance, may be of importance also in reflecting the primary metabolic abnormality.

Multiple pterygium syndrome

We describe a sporadic case and four sibs from a consanguineous Nicaraguan family affected with the multiple pterygium syndrome. Clinical manifestations included normal intelligence; short stature; pterygia of neck, axillary, antecubital, popliteal, digital, and intercrural areas; multiple joint contractures with a crouched stance; a flat, sad, motionless facial appearance; and cleft palate. Males had small penis and scrotum and cryptorchidism; females had apparent aplasia of labia majora and small clitoris. Skeletal anomalies included fusion of cervical vertebrae, scoliosis, flexion contractures of fingers and "rocker-bottom" feet with vertical talus. This review documents genetic heterogeneity: Autosomal recessive inheritance in many cases, autosomal dominant determination in others, and sporadic occurrence.

Kniest dysplasia: neonatal death with necropsy

We describe a premature female infant with Kniest dysplasia, who died shortly after birth. This appears to be the first autopsy performed in this condition. Manifestations included neonatal respiratory distress, large head, midface hypoplasia, flat nasal bridge, short nose, micrognathia, cleft palate, short neck, micromelia, and mildly bowed limbs. Roentgenologic findings included short, slightly bowed tubular bones with metaphyseal flare; mild platyspondyly, with vertical clefts of vertebral bodies; small iliac bones with increased acetabular angles; and inadequate ossification of pubic rami. Histopathologic findings of cartilage included focal "Swiss-cheese" pattern; disorganized physeal growth zone; and PAS-positive, diastase-resistant intracytoplasmic inclusions, which corresponded to finely granular material accumulated in dilated cisterns of rough endoplasmic reticulum.

Short rib-polydactyly syndrome, Majewski type

A term infant had dwarfism with characteristic skeletal and extraskeletal changes of the short rib-polydactyly syndrome type 2 (Majewski). The skeletal changes included extremely short horizontal ribs, extreme micromelia with disproportionately short ovoid tibiae, and pre- and post-axial polydactyly. Microscopically, cartilage showed markedly stunted and disorganized endochondral ossification. Extraskeletal manifestations were hydrops, cleft lip, malformed larynx with hypoplastic epiglottis, pulmonary hypoplasia, glomerular and renal tubular cysts, ambiguous genitalia, pachygyria and small cerebellar vermis. Parental consanguinity supports the hypothesis of autosomal recessive inheritance of the condition.

Multiwavelength rainbow holographic interferometry

Although the two-step rainbow holographic process of Benton [S. A. Benton, J. Opt. Soc. Am. 50, (1969)] offers a significant improvement in holographic displays, its scientific applications are somewhat limited. It is primarily due to the awkardness of the two-step process. We have demonstrated [H. and F. T. S. Yu, Opt. Lett. 2, 85 (1978)] a one-step process which greatly simplifies the procedure in making rainbow holograms. In this paper, the applications of the one-step process to holographic interferometry is demonstrated. A unique multiwavelength holographic interferometric technique is also introduced. This multiwavelength process enables the study and comparison of more than one physical effect. The holographic interference fringe patterns due to different effects can be displayed individually, or together different colors. This capability further extends the usefulness and versatility of holographic interferometry.

H-Y antigen-positive male pseudohermaphroditism with 45,X/46,XYq-mosaicism

A 42-year-old male had short stature, microphallus, hypospadias, a bifid scrotum, abdominal undifferentiated testes, a uterus, bilateral fallopian tubes, and 45,X/46,XYq-mosaicism in his blood, skin, and germinal tissue and tissue surrounding the tests as determined by means of G-, Q-, and C-banding. An H-Y antigen assay on skin fibroblasts was positive, indicating that the locus for this antigen is not located in the brightly fluorescent region of the Y chromosome.

Omphalocele and partial trisomy 1q syndrome

A male infant with partial trisomy 1q syndrome (46,XY,der(21),t(1;21)(q25;q22)pat) is described. Clinical findings include small for gestational age, hypoglycemia, ocular hypertelorism, microphthalmia, coloboma of the iris, low-set ears, beak nose, micrognathia, micropenis, cryptorchidism, presacral dimple, flexion contractures of the fingers, bifid thumb, Simian crease, and overriding toes. In addition, he had a large omphalocele not previously seen in trisomy 1q. Postmortem findings include underdeveloped cerebellum, a thymus with moderate depletion of thymocytes, a large PDA, ASD, small adrenal, and fatty change of the liver. The grandfather, father, and a male sibling have translocation t(1;21)(q25;q22). A family history of repeated spontaneous abortions is present.

Development of a laboratory EXAFS facility

The EXAFS technique is a powerful new structural tool, particularly useful for studies of disordered or otherwise complex materials for which x-ray diffraction techniques are difficult or unfeasible. At the present time, most EXAFS experiments are carried out at a synchrotron facility because of the larger fluxes available. We have developed an in-laboratory apparatus utilizing a focusing crystal technique which increases available fluxes two to three orders of magnitude over previous laboratory facilities, so that EXAFS measurements can be carried out quickly and accurately in the laboratory. We will discuss the principles of the focusing monochromator and we will also illustrate the experimental method with examples, including studies of chemical solutions, defect crystalline solids, and high-temperature superconductors.

White-light pseudocolor density encoder

A simple technique utilizing a white-light processing system for the pseudocolor encoding of photographic materials by density is presented. Pseudocolored output of many different color codes is obtained by selectively spatial filtering the dispersed colors of the various high-diffraction orders of a halftone input. Besides permitting a large variety of color codes, this white-light technique would also eliminate all coherent artifact noises that plague coherent systems. Experimental results are presented, and comparison with the coherent technique is provided.

Color blur of the rainbow hologram

The color blur of the rainbow hologram is calculated from first-order holographic theory. The result is applicable to most of the rainbow holographic processes, including the one-step recording technique. Horizontal color blur approaches zero if the rainbow hologram image is near the optical axis of the hologram aperture.