Biomedical subjects
Publications and source records attributed to N C Nevin.
Two male infants with almost complete trisomy 16q due to a maternal translocation, are reported. The phenotypic similarities of these patients who had trisomy 16q11 leads 16qter and of the eight previously published reports of partial trisomy 16q, were compared.
An ultrasonic examination revealed a grossly distended fetal abdomen. Amniocentesis at 19 weeks' gestation showed raised amniotic fluid alphafetoprotein, a second band of specific acetylcholinesterase, and a fetal karyotype 47,XY,+18. The pregnancy was terminated and the necropsy examination showed absence of the urethra, grossly distended bladder, hydroureters, and congenital heart anomalies.
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In Northern Ireland, with a population of 1.5 million, thirteen cases of Letterer-Siwe disease have been diagnosed over the past 21 years. The average age of onset was 10.5 months. There was a 69% mortality with an average survival time from diagnosis to death of 3.3 months. Four children survived with no morbidity. All deaths were from pulmonary complications, but two cases with pulmonary infiltration responded to treatment with quadruple chemotherapy. There were no familial cases in this study.
Temporalis fascia which is used to graft the tympanic membrane has been shown to be viable in tissue culture by a previous pilot study. This present study reports the effect on the viability of the fascia by scraping loose connective tissue from it and allowing it to dry. Pieces of fascia from 30 patients were each divided in 4 and prepared to give explants, fresh, fresh and scraped, dried, and dried and scraped. The fascia grew from 17 patients when cultured fresh, 5 when fresh and scraped, 1 when dried, and none when dried and scraped. These results are significantly different and show that the fascia is devitilized when prepared by the normal method for use in tympanoplasty.
This study concerned 74 patients with uncomplicated congenital hydrocephalus who were born in Northern Ireland between 1974 and 1977. Three of their 159 sibs (1.89 per cent) were also themselves hydrocephalic, which represents a recurrence risk of 26 times the population incidence. There was a smaller but significant increase of congenital hydrocephalus among first-cousins; three of 846 (0.35 per cent) first-cousins were affected, five times the population frequency. The occurrence of neural-tube defects among sibs and cousins was similar to that for the general population. For the purpose of genetic counselling, this study indicates that once X-linked inheritance has been excluded in uncomplicated congenital hydrocephalus, the over-all empirical risk of recurrence is approximately one in 50; or one in 40 after an affected male and one in 80 after a female index patient.
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This study suggests that social class has an effect on the incidence of anencephalus and spina bifida, the malformations being more frequent in the lower socio-economic groups. A family study of 226 patients with a CNS malformation suggests that social class also may be important in determining the recurrence risk of such malformations: there are higher risks in social classes III, IV and V than in social classes I and II.
An earlier preliminary paper is expanded. Women who had given birth to one or more infants with a neural tube defect were recruited into a trial of per conceptional vitamin supplementation. Two hundred mothers attending five centres were fully supplemented (FS), 50 were partially supplemented (PS), and 300 were unsupplemented (US). Neural tube defect recurrences in the study pregnancies were 1 (0.5%), in FS, none in PS, and 13 (4%) in US mothers. The difference in outcome between FS and US mothers is significant. The most likely explanation is that supplementation has prevented some neural tube defects, but further studies are needed.
A female with the orocraniodigital (Juberg-Hayward) syndrome is described in whom, in addition to bilateral cleft lip and palate, mild microcephaly, and anomalous thumbs and toes, there was absence of the pituitary fossa and a more widespread skeletal dysplasia.
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Women who had previously given birth to one or more infants with a neural-tube defect (NTD) were recruited into a trial of periconceptional multivitamin supplementation. 1 of 178 infants/fetuses of fully supplemented mothers (0.6%) had an NTD, compared with 13 of 260 infants/fetuses of unsupplemented mothers (5.0%).