A mixed autoregressive-moving average exponential sequence and point process (EARMA 1,1)

A stationary sequence of random variables with exponential marginal distributions and the correlation structure of an ARMA (1, 1) process is defined. The process is formed as a random linear combination of i.i.d. exponential random variables and is very simple to generate on a computer. Moments and joint distributions for the sequence are obtained, as well as limiting properties of sums of the random variables and of the point process whose intervals have the EARMA (1, 1) structure.

Functionals of an infinite particle system with independent motions, creation, and annihilation

Particles enter a state space at random times. Each particle travels in the space independent of the other particles until its death. Functionals of the particle system are studied with strong laws and central limit theorems being obtained.

Finite birth-and-death models in randomly changing environments

An efficient computational approach to the analysis of finite birth-and-death models in a Markovian environment is given. The emphasis is upon obtaining numerical methods for evaluating stationary distributions and moments of first-passage times.

Male breast cancer, age and sex chromosome aneuploidy

Background:

In cultured, dividing transformed T lymphocytes and in dividing bone marrow cells from normal men and those with a haematological malignancy, sex chromosome aneuploidy has been found to increase in prevalence and degree with age. This has rarely been investigated in non-dividing uncultured blood samples. The loss and gain of the X chromosome in dividing transformed lymphocytes in women with age is much more frequent than that of the Y chromosome in males. However, paradoxically X chromosome aneuploidy is rarely seen in the dividing cells of bone marrow of females.

Methods:

In blood samples from 565 men with breast cancer and 54 control men from the England and Wales general population, 80 cell nuclei per sample were scored for presence of X and Y chromosomes using fluorescent centromeric probes.

Results:

Sex chromosome aneuploidy, largely Y chromosome loss, was present in 63% of cases and 57% of controls, with the prevalence and degree of aneuploidy increasingly sharply and highly significantly with age. At ages 65–80 years, 71% of cases and 85% of controls showed aneuploidy and 15% and 25%, respectively, had ⩾10% of cells aneuploid. Allowing for age, aneuploidy was less prevalent (P=0.03) in cases than controls.

Conclusion:

Sex chromosome aneuploidy in non-dividing nuclei of peripheral blood cells is frequent in adult men, the prevalence and degree increasing sharply with age. The possible relation of sex chromosome aneuploidy to breast cancer risk in men, and to cancer risk generally, needs further investigation, ideally in cohort studies.

Self-mixing flow sensor using a monolithic VCSEL array with parallel readout

The self-mixing sensing technique is a compact, interferometric sensing technique that can be used for measuring fluid flows. In this work, we demonstrate a parallel readout self-mixing flow velocity sensing system based on a monolithic Vertical-Cavity Surface-Emitting Laser (VCSEL) array. The parallel sensing scheme enables high-resolution full-field imaging systems employing electronic scanning with faster acquisition rates than mechanical scanning systems. The self-mixing signal is acquired from the variation in VCSEL junction voltage, thus markedly reducing the system complexity. The system was validated by measuring velocity distribution of fluid in a custom built diverging-converging planar flow channel. The results obtained agree well with simulation and demonstrate the feasibility of high frame-rate and resolution parallel self-mixing sensors.

Closely linked cis-acting modifier of expansion of the CGG repeat in high risk FMR1 haplotypes

In its expanded form, the fragile X triplet repeat at Xq27.3 gives rise to the most common form of inherited mental retardation, fragile X syndrome. This high population frequency persists despite strong selective pressure against mutation-bearing chromosomes. Males carrying the full mutation rarely reproduce and females heterozygous for the premutation allele are at risk of premature ovarian failure. Our diagnostic facility and previous research have provided a large databank of X chromosomes that have been tested for the FRAXA allele. Using this resource, we have conducted a detailed genetic association study of the FRAXA region to determine any cis-acting factors that predispose to expansion of the CGG triplet repeat. We have genotyped SNP variants across a 650-kb tract centered on FRAXA in a sample of 877 expanded and normal X chromosomes. These chromosomes were selected to be representative of the haplotypic diversity encountered in our population. We found expansion status to be strongly associated with a ∼50-kb region proximal to the fragile site. Subsequent detailed analyses of this region revealed no specific genetic determinants for the whole population. However, stratification of chromosomes by risk subgroups enabled us to identify a common SNP variant which cosegregates with the subset of D group haplotypes at highest risk of expansion (, p=0.00002). We have verified that this SNP acts as a marker of repeat expansion in three independent samples. Hum Mutat 28(12), 1216–1224, 2007. © 2007 Wiley-Liss, Inc.

X chromosome loss and ageing

The detection of a low level 45,X cell line during routine cytogenetic analysis in an adult female can be difficult to interpret. In the absence of recent information regarding loss of the X chromosome and ageing, we undertook a prospective study. A total of 19,650 cells from 655 females aged from birth to 80 years were screened cytogenetically. The frequency of X chromosome loss ranged from 0.07% at age <16 years to 7.3% at >65 years of age and showed a highly significant quadratic relationship between X chromosome loss and ageing (P < or = 0.00001). We have produced a graphic representation that provides a minimum baseline age-related rate of X chromosome loss. This should assist diagnostic cytogenetics laboratories to determine the significance of 45,X cell lines detected in women of all ages. We also compared the frequency of 45,X cells in women referred with at least one spontaneous abortion with those referred for other reasons and found no significant difference. Thus, in our population, an excess of 45,X cells is not associated with pregnancy loss.

An investigation of FRAXA intermediate allele phenotype in a longitudinal sample

The FRAXA trinucleotide repeat at Xq27.3 gives rise to fragile X syndrome when fully expanded, and both premature ovarian failure (POF) and fragile X tremor and ataxia syndrome (FXTAS) when in the premutation range. Reports of phenotypic effects extending into the intermediate repeat range are inconsistent but some studies suggest that these smaller expansions predispose to special educational needs (SEN). This study utilises the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort to investigate cognitive and behavioural variables that might be associated with FRAXA intermediate alleles. The current study failed to find any strong evidence of association of FRAXA intermediate alleles with SEN, behavioural problems or cognitive difficulties. However, our findings illustrate some of the difficulties encountered in identifying individuals with SEN. The power to identify specific components of cognitive and behavioural difficulties was reduced due to elective drop-out, which is characteristic of longitudinal studies. Our findings demonstrate the non-random loss of participants from this cohort and highlight problems that may arise when such data are used in genetic association studies.

Polysulfone−ZrO2 Surface Interactions. The Influence on Formation, Morphology and Properties of Zirfon-Membranes

The interaction between polysulfone and ZrO(2) particles is studied as a function of the particle sintering temperature in order to understand the role of ZrO(2) on the formation, morphology, and properties of organo-mineral composite membranes. The adsorption between the sintered ZrO(2) and the constituents of polysulfone, 2,2-diphenylpropane and diphenyl sulfone, is investigated using high-pressure liquid chromatography. The influence of the polymer-ZrO(2) interaction on the flow behavior of the casting suspension is registered via viscoelastic measurements. The organo-mineral composite membranes are formed by immersion precipitation in water, and the resulting membrane morphology is analyzed using high-resolution SEM. The zirconia concentration in the top-layer of the composite structure is determined by XPS. Finally, the link between the polymer-filler interactions, the membrane formation process, and the resulting membrane structure and properties is established.

The complex nature of constitutional de novo apparently balanced translocations in patients presenting with abnormal phenotypes

OBJECTIVE

To describe the systematic analysis of constitutional de novo apparently balanced translocations in patients presenting with abnormal phenotypes, characterise the structural chromosome rearrangements, map the translocation breakpoints, and report detectable genomic imbalances.

METHODS

DNA microarrays were used with a resolution of 1 Mb for the detailed genome-wide analysis of the patients. Array CGH was used to screen for genomic imbalance and array painting to map chromosome breakpoints rapidly. These two methods facilitate rapid analysis of translocation breakpoints and screening for cryptic chromosome imbalance. Breakpoints of rearrangements were further refined (to the level of spanning clones) using fluorescence in situ hybridisation where appropriate.

RESULTS

Unexpected additional complexity or genome imbalance was found in six of 10 patients studied. The patients could be grouped according to the general nature of the karyotype rearrangement as follows: (A) three cases with complex multiple rearrangements including deletions, inversions, and insertions at or near one or both breakpoints; (B) three cases in which, while the translocations appeared to be balanced, microarray analysis identified previously unrecognised imbalance on chromosomes unrelated to the translocation; (C) four cases in which the translocation breakpoints appeared simple and balanced at the resolution used.

CONCLUSIONS

This high level of unexpected rearrangement complexity, if generally confirmed in the study of further patients, will have an impact on current diagnostic investigations of this type and provides an argument for the more widespread adoption of microarray analysis or other high resolution genome-wide screens for chromosome imbalance and rearrangement.

A clinical and molecular study of 26 females with Xp deletions with special emphasis on inherited deletions

We have undertaken a clinical study of 26 females with deletions of Xp including five mother-daughter pairs. Cytogenetic and molecular analyses have mapped the breakpoints of the deletions. We determined the parental origin of each abnormality and studied the X-inactivation patterns. We describe the clinical features and compare them with the amount of Xp material lost. We discuss the putative loci for features of Turner syndrome and describe how our series contributes further to their delineation. We conclude that (1) fertility can be retained even with the loss of two-thirds of Xp, thus, if there are genes on Xp for ovarian development, they must be at Xp11-Xp11.2; (2) in our sample of patients there is no evidence to support the existence of a single lymphogenic gene on Xp; (3) there is no evidence for a second stature locus in proximal Xp; (4) there is no evidence to support the existence of a single gene for naevi; (5) we suggest that the interval in Xp21.1-Xp11.4 between DXS997 and DXS1368 may contain a gene conferring a predisposition to hypothyroidism.

Nondisjunction of chromosome 21

Chromosome heteromorphisms and restriction fragment length polymorphisms were used to study the origin of the extra chromosome in 54 trisomy 21 conceptuses. The parental origin was determined in 43 cases, with 39 (91%) being maternally and 4 (9%) parentally derived. Analysis of recombination demonstrated the presence of one or two cross-overs in most cases for which sufficient information was available, suggesting that failure to pair/exchange at meiosis I is relatively unimportant in the genesis of trisomy 21.

Complete hydatidiform mole in Hawaii: An epidemiological study

An analysis of hydatidiform moles occurring in Hawaii over a 14-year period (1968-1981) was undertaken. The pathology of all 278 reported molar pregnancies was reviewed and showed 69.4% to be complete, 24.5% to be partial, and 6.1% to be nonmolar. A case-control epidemiological investigation of the complete moles showed maternal age and race to be important, moles being significantly more prevalent in women under 20 and over 40 yr of age and also in women of Japanese, Filipino, and other Oriental ancestry. However no difference was seen in the prevalence of moles between Oriental women born in the Orient and those born and raised in Hawaii. No significant difference was found in paternal age, paternal race, socioeconomic status, or reproductive history, suggesting that these factors do not play an important role in the etiology of complete hydatidiform mole. Incidence rates for complete moles were calculated taking age and race into consideration and ranged from a high of 1 in 150 to a low of 1 in 2,000 naturally terminating pregnancies.

Acid Zeolites as Alcohol Racemization Catalysts: Screening and Application in Biphasic Dynamic Kinetic Resolution

Acid zeolites were screened as heterogeneous catalysts for racemization of benzylic alcohols. The most promising zeolites appeared to be H-Beta zeolites, for which the optimal reaction conditions were studied in further detail. The zeolite performance was compared to that of homogeneous acids and acid resins under similar reaction conditions. In a second part of the research, H-Beta zeolites were applied in dynamic kinetic resolution (DKR) of 1-phenylethanol, which was conducted by means of a two-phase approach and which resulted in yields smoothly crossing the 50% border up to 90%, with an enantiomeric excess of >99%. To explore the applicability of this biphasic methodology, several other substrates were examined in the standard racemization reaction and in the biphasic dynamic kinetic resolution.

A laboratory comparison of the life cycles of the dog ticks Haemaphysalis leachi and Rhipicephalus sanguineus

Engorged female Haemaphysalis leachi and Rhipicephalus sanguineus as well as their eggs, flat and engorged larvae and nymphs were incubated at combinations of five temperatures and three relative humidities. Mean pre-oviposition periods for H. leachi varied between 4.3 days and 12.1 days and for R. sanguineus between 4.8 days and 21.0 days. Haemaphysalis leachi converted up to 65.7% of their body mass into eggs and produced up to 16.3 eggs/mg body mass, with 4801 eggs the maximum number deposited by a single female. Peak egg production of 520 eggs/day was recorded 3 days after the commencement of oviposition. Rhipicephalus sanguineus converted up to 68.1% of their body mass into eggs and produced up to 17.2 eggs/mg body mass, with a maximum of 3,232 eggs, and peak egg production of 400 eggs/day 4 days after the commencement of oviposition. Mean incubation periods for eggs of H. leachi varied between 15.5 days and 66.7 days, and for R. sanguineus between 19.0 days and 72.0 days. Mean pre-moult periods for engorged larvae and nymphs of H. leachi varied between 14.0 days and 192.0 days, and 13.0 days and 41.0 days respectively, and for R. sanguineus between 9.5 days and 36.5 days, and 15.0 days and 44.5 days respectively. Allowing 7 days for female engorgement and 7 days for hardening of the exoskeletons and mouthparts of each of the three parasitic stages before they attach to a host, the life cycle of H. leachi would require 97-190 days and that of R. sanguineus 99-236 days to complete at the various regimes of temperature and relative humidity. The greatest proportion of H. leachi larvae engorging on mice detached between 18:00 and 19:00 on the first day of detachment and between 06:00 and 08:00 in the morning and 14:00 and 18:00 in the afternoon of the following day, while the greatest proportion of nymphs engorging on dogs detached around 19:00 on the first day of detachment and between 13:00 and 17:00 on the following day. The greatest proportion of R. sanguineus larvae engorging on dogs detached between 11:00 and 21:00 on the second day of detachment, and the greatest proportion of nymphs detached between 03:00 and 5:00 on the second and third days of detachment.

Recycling of the homogeneous Co-Jacobsen catalyst through solvent-resistent nanofiltration (SRNF)

The Co-Jacobsen complex, catalysing a hydrolytic kinetic resolution, was recycled in a semi-continuous operation using a laboratory prepared polymeric SRNF-membrane.

Molecular and fluorescence in situ hybridization characterization of the breakpoints in 46 large supernumerary marker 15 chromosomes reveals an unexpected level of complexity

Supernumerary marker chromosomes (SMCs) of chromosome 15, designated "SMC(15)s," are the most common SMC in humans, accounting for as much as 60% of all those observed. We report the characterization of 46 large SMC(15)s, using both fluorescence in situ hybridization and polymerase chain reaction analysis within and distal to the Prader-Willi/Angelman syndrome critical region (PWACR). Our aim was to establish detailed information on origin, content, and breakpoints, to address the formation of SMC(15)s, and to facilitate genotype-phenotype correlations. For all patients in whom we were able to establish the parental origin, the SMC(15)s were maternally derived. Two patients were observed who had familial SMC(15)s, both inherited from the mother; however, in all remaining patients for whom parental samples were available, the SMC(15)s were shown to have arisen de novo. With one exception, all the SMC(15)s were shown to include the entire PWACR. Detailed investigations of the distal breakpoints categorized the SMC(15)s into two groups. Group A, representing approximately two-thirds of the SMC(15)s, had a breakpoint beyond the standard distal PWS/AS deletion breakpoint BP3, at a position close to the microsatellite marker D15S1010 and the bacterial artificial chromosome 10I10. The group B SMC(15)s were shorter, with more variable breakpoints located around BP3. The majority of the SMC(15)s were shown to have asymmetrical breakpoints, with the two inverted arms of the SMC being unequal in length. Our study revealed an unexpected level of complexity and heterogeneity among SMC(15)s that is not seen in other chromosome 15 rearrangements, such as deletions and duplications. This suggests that multiple mechanisms are involved in the formation of large SMC(15)s.

Cross-cultural differences in GPs' attitudes towards complementary and alternative medicine: a survey comparing regions of the UK and Germany

OBJECTIVE

To investigate whether there is a difference in general practitioners' attitudes towards CAM in the UK and Germany.

STUDY DESIGN

A descriptive questionnaire was developed and sent to 97 GPs in the UK and 99 GPs in Germany.

RESULTS

The overall response rate was 68%. German GPs showed a (non-significant) overall more positive attitude towards CAM than did British GPs. British GPs made more referrals to complementary practitioners. The most popular CAM therapies that UK GPs referred their patients to were chiropractic treatment, acupuncture and osteopathy. German GPs referred their patients mainly to acupuncture treatment, chiropractic treatment and herbal medicine. A significantly higher number of German GPs reported having practised as a CAM practitioner before and having personally used CAM themselves. Seventy percent of British GPs and 76% of German GPs thought it is safe to prescribe complementary medicine and therapies to patients.

CONCLUSION

There are small national differences in referring patients to various CAM modalities. Both nations have an overall positive attitude toward and a high interest in CAM. Lack of scientific evidence and information on training opportunities were important points that were continuously raised by GPs in both countries.

Mass spectrometric methods prove the use of beeswax and ruminant fat in late Roman cooking pots

Lipid extracts of sherds of archaeological late Roman cooking pots were analysed using high temperature-gas chromatography coupled to a mass spectrometer and liquid chromatography with atmospheric pressure chemical ionization mass spectrometer detection (LC-APCI-MS). With these advanced techniques the use of beeswax was shown through identification of the constituting alkanes, mono and diesters. The detection of high amounts of saturated triacylglycerols (TAGs) further indicated that animal fat was processed in these pots. Part of the animal fat was characterised as originating from ruminants due to the presence of trans-fatty acids. The distribution of saturated TAGs and the higher concentration of stearic acid compared to palmitic acid in the transesterified lipid extract indicated that this was sheep fat. The results illustrate how complex mixtures can be unravelled and original contents of ancient ceramic vessels can be determined using specialised analytical equipment.

Analysis of oil used in late Roman oil lamps with different mass spectrometric techniques revealed the presence of predominantly olive oil together with traces of animal fat

The lipid fraction of residues in ancient oil lamps found at the archaeological site of Sagalassos (south-west Turkey) was analysed by gas chromatography (GC) coupled to mass spectrometry (MS). The identification of plant sterols and long chain alcohols suggested that a vegetable oil was used in these lamps. The lipid sample was also analysed with reversed-phase liquid chromatography (LC) coupled to MS with atmospheric pressure chemical ionization (APCI). The identification of TAG's detected with LC-APCI-MS showed that predominantly olive oil was used as a fuel for the antique oil lamps. The presence of large quantities of multiply unsaturated triacylglycerol (TAG) and traces of saturated TAG indicated that also other oils and animal fat were added. Summarizing, the analysis of TAG's with LC-APCI-MS in lipid extracts of ancient ceramics proved to be a valuable method to reconstitute the original contents.

Diversity, seasonality and sites of attachment of adult ixodid ticks on dogs in the central region of the Free State Province, South Africa

Several surveys of ticks infesting dogs belonging to owners in resource-limited and more affluent communities have been conducted in South Africa, but no such investigation has been carried out in the Free State Province of this country. The present study was initiated to meet this shortcoming. Ticks were collected from dogs at six localities in, and to the east of the city of Bloemfontein in the central region of the province. Three of these localities could be classed as resource-limited and two as affluent, while the sixth locality was an animal shelter serving all members of the public. Adult ticks belonging to nine ixodid tick species were collected, of which Rhipicephalus sanguineus was the most numerous. Significantly more R. sanguineus was collected from dogs at resource-limited than at more affluent localities. The greatest proportions of these ticks attached to the backs and necks of the dogs, with the proportions being larger in long-haired than in short-haired dogs. Most R. sanguineus were collected during the warmer months particularly from January to April. The greatest proportions of Haemaphysalis leachi, the next most numerous species, were also collected from the backs and the necks of the dogs. Most of these were present during the period September to November.

Use of WO(4)(2-) on layered double hydroxides for mild oxidative bromination and bromide-assisted epoxidation with H(2)O(2)

Tungstate, exchanged on a (Ni,Al) layered double hydroxide, is applied as a heterogeneous catalyst in the oxidation of bromide with H(2)O(2) and the ensuing electrophilic bromination of olefins. The high halogenation activity of the catalyst in essentially neutral conditions mimicks the activity of V-bromoperoxidase enzymes. In water, aromatic and aliphatic olefins are selectively converted to bromohydrins; in methanol, methoxybromides are produced. In appropriate solvent conditions, the bromohydroxylation of geminally di-, tri-, and tetrasubstituted olefins proceeds via dehydrobromination to the epoxide. Evidence for this mechanism is provided by kinetic and labeling experiments. This one-pot alternative for the two-step halohydrin epoxidation process is enabled by the mild pH conditions; bromide is effective in substoichiometric, catalytic amounts. All new catalytic procedures are characterized by a high oxidative stability of the catalyst, high productivity of the catalyst on weight basis, high W turnover frequencies in ambient conditions (up to 50 mol of product per W per h), and high chemo-, regio-, and stereoselectivities.

Maternal folate polymorphisms and the etiology of human nondisjunction

Attempts to identify genetic contributors to human meiotic nondisjunction have met with little, if any, success. Thus, recent reports linking Down syndrome to maternal polymorphisms at either of two folate metabolism enzymes, methylenetetrahydrofolate reductase (MTHFR) and methionine synthase reductase (MTRR), have generated considerable interest. In the present report, we asked whether variation at MTHFR (677C-->T) or MTRR (66A-->G) might be associated with human trisomies other than trisomy 21. We analyzed maternal polymorphisms at MTHFR and MTRR in 93 cases of sex-chromosome trisomy, 44 cases of trisomy 18, and 158 cases of autosomal trisomies 2, 7, 10, 13, 14, 15, 16, 18, or 22, and compared the distributions of genotypes to those of control populations. We observed a significant increase in the MTHFR polymorphism in mothers of trisomy 18 conceptuses but were unable to identify any other significant associations. Overall, our observations suggest that, at least for the sex chromosomes and for a combined set of autosomal trisomies, polymorphisms in the folate pathway are not a significant contributor to human meiotic nondisjunction.

Kinetic and spectroscopic study of 1O2 generation from H2O2 catalyzed by LDH-MoO4(2-) (LDH=layered double hydroxide)

Layered double hydroxides (LDHs), exchanged with molybdate, decompose H2O2 to form one molecule of singlet-state dioxygen (1O2) from two molecules of H2O2. The dependence of the kinetics of H2O2 decomposition on Mo and H2O2 concentrations and on temperature has been related to structural characteristics of the material (X-ray diffraction (XRD), scanning electron microscopy (SEM), IR spectroscopy, N2 adsorption, thermogravimetry) and to molybdate speciation as revealed by in-situ studies in the presence of peroxide (FT Raman, diffuse reflectance UV/visible spectroscopy). The H2O2 decomposition rate is linearly correlated with the amount of LDH-exchanged molybdate, except when a considerable fraction of the molybdate occupies less accessible interlayer positions. A maximum in the H2O2 decomposition rate as the H2O2 concentration is increased is due to the successive formation of mono-, di-, tri-, and tetraperoxomolybdates. This behavior was modeled successfully by using the equilibrium constants for formation of the Mo-peroxo complexes, and the rate constants for decay of the peroxomolybdates with 1O2 liberation. Time-resolved diffuse reflectance and Raman observations of the various MoO4(2-)-peroxide adducts are in line with the proposed kinetic scheme. Of all the Mo-peroxo species on the LDH, the triperoxomolybdate has the highest rate for decay to 1O2. Comparison with the kinetics of dissolved molybdate shows that the monomolecular decay of all peroxomolybdate species proceeds much faster at the LDH surface than in solution. Consequently, maximal rates per Mo atom are at least twice as high for the heterogeneous LDH catalyst as for the homogeneous systems.

The closed cryosurgical treatment of giant cell tumor

Twelve patients with giant cell tumor (GCT) treated by the closed method of cryotherapy along with curettage and bone grafting were reviewed retrospectively. Follow-up examinations ranged from two years and two months to 11 years. There was one osseous and one soft-tissue recurrence. There were no thermally related soft-tissue complications. Five patients suffered six postoperative pathologic fractures. Joint function was well preserved in ten of 12 patients, although five patients have varying degrees of joint pain or instability. Closed cryotherapy, curettage, and bone grafting are effective in the treatment of GCT. Special attention to surgical approach, controlled freezing, bone grafting technique, and a supervised rehabilitation program will minimize the incidence of postoperative pathologic fracture and maximize joint function.

Mortality and cancer incidence in persons with numerical sex chromosome abnormalities: a cohort study

Mortality and cancer incidence were assessed in a cohort of 1373 patients with numerical sex chromosome abnormalities diagnosed at three cytogenetics centres in Britain during 1959-90, and were compared with expectations from national rates. Four hundred patients with Turner's syndrome were followed, of whom 62 died, with a relative risk (RR) of death of 4.16 (95% confidence interval (CI) 3.22-5.39). Turner's syndrome patients had greatly raised risks of death from diseases of the nervous, cardiovascular, respiratory, digestive and genitourinary systems. One hundred and sixty three deaths occurred among 646 patients with Klinefelter's syndrome with a 47,XXY constitution, giving an RR of 1.63 (1.40-1.91). Mortality in these patients was significantly raised from diabetes and diseases of the cardiovascular, respiratory and digestive systems. There was also significantly increased mortality for patients with X polysomy (RR = 2.11 (1.43-3.02)) and Y polysomy (RR = 1.90 (1.20-2.85)), the former with significantly increased mortality from cardiovascular disease and the latter from respiratory disease. The only significantly raised risks of cancer incidence or mortality in the cohort were for lung cancer and breast cancer in patients with Klinefelter's syndrome with a 47,XXY constitution, and non-Hodgkin's lymphoma in men with more than three sex chromosomes.