Klinefelter syndrome associated with atrial septal defect and prolapse of the mitral valve.
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Biomedical subjects
Publications and source records attributed to A B Miller.
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In a study of the World Health Organization classification of the histologic typing of lung tumors, sections from a total of 740 patients in the Medical Research Council Study of Cytotoxic Chemotherapy, 182 of whom also had positive preoperativebronchial biopsies and 231 involved lymph nodes in the resected specimens, and from 30 patients in the Medical Research Council Trial of Surgery and Radiotherapy in Small or Oat-celled Carcinoma of the Bronchus have been assessed. Of the 740 primary tumors from the Study of Cytotoxic Chemotherapy, 71% were placed in Type I, 12% in Type II, 9% in Type III, and 7% in Type IV. Only 2 primary tumors could not be typed. A blind comparison of the type of primary tumor and bronchial biopsy showed that the biopsy was a good indicator of the type of the primary tumor. A bind comparison of the primary tumor and involved lymph node also showed a close degree of agreement. However, when the type of the primary tumor was assessed in the presence of the involved node. Tumors were placed in Type IV far less frequently than when assessed blind. It is concluded that the World Health Organization classification is applicable to primary tumor, bronchial biopsy, and involved node, that the biopsy is a valuable indicator of the type of the primary tumor, and that the apparent type of the involved node should not be allowed to over-influence the pathologist in deciding on the type of the primary tumor when both are assessed together.
The association of hypoplastic thumb and atrial septal defect, (Holt-Oram syndrome) with a prolapsed mitrial valve is described. Recognition of this association adds further support to the concept that the prolapsed mitrial valve syndrome is not necessarily an isolated cardiac disorder but may be part of a more generalized heritable disorder of connective tissue.
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As part of a large-scale international cooperative investigation into the side effects of thioacetazone-containing regimens in the treatment of tuberculosis, an evaluation has been made of the variation in the frequency of side effects between different countries and between different centres in the same country and of the likely reasons for this variation. In 3 countries patients of different racial origin were under observation in the same hospital. Over a 12-week period of treatment there was considerable variation between the countries and centres in the overall frequency of side effects and of those leading to a major departure from prescribed treatment, the variation being similar for the two thioacetazone-containing regimens and for the streptomycin plus isoniazid control regimen, though at a lower level for the latter. In Malaysia, Singapore, and Trinidad, where different racial groups were under treatment, there was no clear indication that race was an important factor in explaining the differences between countries, except for cutaneous side effects in Trinidad and possibly in Malaysia.It is concluded that the differences in the frequency of side effects to thioacetazone-containing regimens probably result from variation in the closeness of supervision of patients, in the recording and interpretation of side effects, and in environmental factors including the previous use of other medicaments or exposure to sensitizing substances.
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