A new report of mesomelic camptomelia,polydactyly and Dandy–Walker complex in siblings

Two male siblings with several malformations are reported. The anomalies detected in both fetuses were mesomelic camptomelia, postaxial hexadactyly and Dandy–Walker complex. There was only one similar previous report in the literature. This combination could represent a specific pattern of malformation or a new syndrome, with different variants. The parents' consanguinity and the recurrence in a subsequent pregnancy suggest an autosomal recessive inheritance pattern. Copyright © 2003 John Wiley & Sons, Ltd.     

Evaluation of X,Y, 18, and 13/21 alpha satellite DNA probes for interphase cytogenetic analysis of uncultured amniocytes by fluorescence in situ hybridization

The major aneuploidies diagnosed prenatally involve the autosomes 13, 18, and 21, and sex chromosomes. Fluorescence in situ hybridization (FISH) allows rapid analysis of chromosome copy number in interphase cells. This prospective study evaluated the use of four commercially available centromeric DNA probes (DXZ1, DYZ1, D18Z1, and D13Z1/D21Z1) for direct analysis of uncultured amniocytes. One hundred and sixteen amniotic fluid samples were analysed by FISH and standard cytogenetics. This evaluation demonstrated that FISH with, X, Y, and 18 alpha satellite DNA probes could accurately and rapidly detect aneuploidies involving these chromosomes and could be used in any prenatal clinical laboratory. In contrast, the 13/21 alpha satellite DNA probe hybridizing both chromosomes 13 and 21 was unreliable for prenatal diagnosis in uncultured amniocytes.     

氟离子慢性暴露对中国林蛙蝌蚪生长发育的毒性效应研究

氟元素以不同的结合形式广泛存在于自然界中,适量氟的摄取有益于龋齿预防和骨骼发育,然而过量氟的摄取会对动物及人体健康造成危害。近年来,大量的人类活动导致水环境中氟含量持续升高。为探究水域氟污染对中国林蛙的毒性影响,本研究以中国林蛙(Rana chensinensis)胚胎为试验材料,对卵黄栓期(G12期)胚胎进行了0、0.7、4.2、19.4、42.8 mg·L~(-1)F-慢性水体暴露直至胚胎发育到变态高峰期(G42期)的研究。分别于暴露25 d和40 d后取样测定了蝌蚪全长、体长、体重和发育分期;此外,分析了F-慢性暴露对变态率、G42期蝌蚪的全长、体长、体重和后肢长以及G42期蝌蚪骨骼发育的影响。结果表明:暴露25 d时,4.2 mg·L~(-1)F-处理组促进了林蛙蝌蚪的生长发育,而42.8 mg·L~(-1)F-处理组显著抑制了蝌蚪的生长发育;暴露40 d时,19.4 mg·L~(-1)F-和42.8 mg·L~(-1)F-处理组蝌蚪的生长发育均受到显著抑制。持续进行慢性暴露78 d后,4.2 mg·L~(-1)F-处理组蝌蚪的变态率显著升高,而42.8 mg·L~(-1)F-处理组蝌蚪的变态率受到了显著抑制。此外,42.8 mg·L~(-1)F-处理组G42期蝌蚪形态指标(全长、体长和后肢长)以及骨骼发育均受到抑制。依据G42期中国林蛙蝌蚪的生长发育指标和变态率为观察指标,氟离子慢性暴露对中国林蛙蝌蚪的最低可观察效应浓度(LOEC)为0.7 mg·L~(-1)。研究表明,水环境中高浓度的氟污染会对中国林蛙蝌蚪的生长发育、变态和骨骼发育等造成潜在的不利影响,水体氟污染的生态毒性效应理应引起高度重视。     

Temporal changes in Ohio amniocentesis utilization during the first twelve years (1972–1983), and frequency of chromosome abnormalities observed

The history of amniocentesis utilization in the seventh largest state of the United States is documented from its inception in 1972 through the first half of 1984. Amniocentesis utilization ratios for Ohio residents aged ⩾35 have increased from 0.21 per cent (19/9091) in 1972 to 23.4 per cent (1655/7531) in 1983, representing an average annual growth rate of 43.1 per cent. Of the amniocenteses performed from January 1, 1978–July 1, 1984, 71 per cent were referred for advanced maternal age (⩾35), 15 per cent for maternal anxiety (30–34), 10 per cent for family history or previous child with a genetic defect, and 4 per cent for other reasons. Between 1978-1983 utilization by women 45 years of age was only 20 per cent higher than women 35 even though their risk of giving birth to a Down syndrome child was about one order of magnitude higher. In addition, various factors were tested as to whether they affected utilization of amniocentesis by women ⩾35 during 1978 1983. A strong correlation of +0.89 existed between county population size and utilization ratios. No difference in utilization was found between whites and nonwhites, regardless of county population size. When utilization ratios were compared separately between Protestants, Catholics and other religions in Ohio's most populated county, no statistical differences were found. From 1978–July 1, 1984, the frequency of all cytogenetically abnormal chromosome results observed in Ohio amniocenteses to women ⩾35 was 2.48 per cent (187/7536). Of these, 2.15 per cent (162/7536) had unbalanced karyotypes. Future maximum amniocentesis utilization for women ⩾35 is estimated at 60–70 per cent.     

The impact of prenatal diagnosis on the occurrence of chromosome abnormalities

From the public health point of view, several formal attempts have been made to measure the impact of prenatal diagnosis (PND) on the incidence of Down's Syndrome (DS), but the results have varied widely. The impact of PND (reduction in the birth rate of chromosomally abnormal neonates) is related to utilization rates but quantitative estimates of this have not been established. In a three-year (1981–1983) total population study from Queensland, Australia, we present results to measure the impact of a voluntary PND programme on the birth incidence of DS, and also other chromosomally abnormal births. Utilization rates for the PND service were 15·5 per cent in that population of mothers 35 years and over. Numbers and rates of all cases of chromosomal abnormalities are presented, subclassified by type of diagnosis–-either by PND or by clinical diagnosis after birth. For the total population, 7·3 per cent of cases of DS were detected prenatally, and 15·4 per cent of all chromosome abnormalities. (A method for measuring the impact of PND is described.) Using this in conjunction with our demographic data, we estimate that with a 15 per cent utilization rate of PND by older mothers, 14 per cent of DS births can be prevented in this age group, or a 5 per cent overall reduction can be achieved if mothers of all ages are considered. One index–-the ratio of the percentage of DS births which are preventable compared with the population utilization rates of PND–-has potential for widespread use. Queensland data for this ratio is 0·34, a figure consistent with that from other studies. Thus a 3·5 per cent drop in the overall DS birth rate may be expected for each 10 per cent increase in the utilization rates of PND for mothers of 35 years and over. A diagram is presented which may serve as a model for improved data collection and better impact estimates in the future.     

Fetal curarization for prenatal magnetic resonance imaging

Fetal magnetic resonance (MR) imaging was performed at 33 weeks of gestation for investigation of a posterior fossa abnormality found at ultrasound screening. Fetal movements were abolished by vecuronium injected under ultrasound guidance into the umbilical vein. MR images showed atrophy of the left cerebellar lobe with cisternal dilatation. These were confirmed postnatally by CT scan.     

Prenatal demonstration of a cervical myelocystocele

Myelocystocele is a rare spinal cord disorder and has not been described prenatally. We report a case in which prenatal ultrasound and magnetic resonance imaging (MRI) demonstrated a posterior cervical mass which was initially thought to be a meningocele or an atypical cystic hygroma. Surgery performed at 1 day of age showed this to be a myelocystocele. Therefore, the differential diagnosis of an extracranial cystic mass in the posterior cervical region should be expanded to include myelocystoceles.     

An incidence of skeletal fluorosis associated with groundwaters of the maritime carboniferous basin,Gaspé region,Quebec, Canada

Consumption of unusually high concentrations of F^– in groundwaters of the Maria area in the Gaspé peninsula of Quebec have resulted in symptoms of skeletal fluorosis in two members of the population. One of these individuals consumed approximately 50 mg of fluoride per day over a 6 year period before being hospitalized and later diagnosed with skeletal fluorosis. It is estimated that, until this case came to light, approximately 15–20% of the rural population (total approximately 1,600) in the area were consuming groundwaters with F^– levels between 5 and 28 mg L^–1 for at least 6 years. The high concentrations of F^– in well waters of the Maria area occur only in wells completed in Carboniferous sandstone-siltstone-conglomerate sediments that underlie a thick blanket of alluvial-colluvial-glacial overburden. These fluoriferous groundwaters exhibit high Na and HCO₃ ^– contents and low Ca and Mg concentrations compared to those associated with the overburden sediments. The high F levels greatly increase the risk for fluorotic diseases such as skeletal fluorosis and skeletal radiculomyopathy. Wells completed in overburden, although having suboptimal F^– levels are safer for the health of individuals in this region. Effective regulations for well drilling need to be formulated for regions underlain by Carboniferous formations in the Maritime provinces of Canada. In some regions, high F^– levels (10–25 mg L^–1) in groundwaters will seriously affect how, and to what extent, groundwater supplies can be developed for domestic use.To whom correspondence should be addressed.