Biomedical subjects
Publications and source records attributed to A Matsunobu.
We report on twins of unlike sex who shared a 45,X/46,X,+mar karyotype. The mar chromosome was found to be Yq- by DNA analysis. Marker studies, including 8 VNTR loci, yielded a probability of monozygosity of 0.99999996.
The results of chromosome studies on cultured umbilical cord blood lymphocytes from a consecutive series of 14,835 liveborn infants (7,608 males and 7,227 females) are described. Ninety-three infants (6.27 per 1,000) had a major chromosome abnormality. Of these, thirty-one infants (2.09 per 1,000) had sex chromosome abnormalities. Seven male infants had a 47,XXY karyotype, five had a 47,XYY karyotype, and three were mosaics. One male had a ring Y chromosome in all cells examined. A pericentric inversion of the Y chromosome was found in one case. Seven female infants had a 47,XXX karyotype, one had a 45,X karyotype and six were mosaics. Sixty-two infants (4.18 per 1,000) had autosomal abnormalities. There were twenty-one infants with trisomy 21 including one mosaic, six infants with trisomy 18, and two infants with trisomy 13 of a Robertsonian translocation type. Three infants had an unbalanced derivative chromosome resulting from a parental reciprocal translocation. Two infants with a partial monosomy of chromosome 13 were detected. There were four infants carrying an additional small marker chromosome. Twenty-four infants (1.62 per 1,000) had a balanced structural rearrangement of the autosomes; eleven with a Robertsonian translocation, eleven with a reciprocal translocation, and two with a pericentric inversion. The incidence of each type of major chromosome abnormality in this study was quite similar to that obtained from previous newborn surveys.
The karyotypes of 144 spontaneous abortuses were determined using direct chromosome preparations from chorionic villi. The frequency of chromosome abnormality was 69.4%, which is considerably higher than figures cited in most previous cytogenetic surveys using the conventional method of cell culturing. Autosomal trisomy was the predominant abnormality (64%), followed by polyploidy (9%), monosomy X (7%), structural rearrangements (6%), mosaicism (6%), double trisomy (4%), and double chromosome anomaly (3%). Direct preparations have advantages in that results can be obtained rapidly, the success rate of karyotyping is satisfactory, and maternal-cell contamination is minimal.
Chromosome studies were carried out on both partners of 509 couples with a history of two or more spontaneous abortions. 1) Twenty-six individuals (2.6%) were carriers of a major chromosome abnormality. This incidence is at least six to seven times higher than that in the general adult population. 2) Of these, 10 were reciprocal translocations, 10 robertsonian translocations and 6 numerical aberrations of gonosomes. None of the carriers showed abnormal phenotypes. 3) Chromosome aberrations were more frequent in the women than in their husbands. There were 19 abnormalities in females and 7 in males. 4) The use of banding techniques in chromosome analysis improves the detection of balanced reciprocal translocations. 5) Prenatal diagnosis was performed in 5 subsequent pregnancies of 4 balanced translocation carriers. The fetal karyotypes were 2 normal and 3 balanced translocations. It would seem reasonable to recommend chromosome analysis for couples with repeated spontaneous abortions.
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A Robertsonian translocation involving homologous D chromosomes was found in two cases with a history of recurrent abortions. In the first case the propositus was a 37-year-old phenotypically normal man who had a balanced t(14q14q) translocation. In the second case, a 27-year-old phenotypically normal woman was found to be a balanced t(15q15q) translocation carrier. The recurrent abortions in both cases were probably owing to this translocation.
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A case of hydatidiform mole with a coexistent live fetus--an extremely rare condition--is reported. This is the only known case with delivery of a surviving fetus in which the diagnosis was made antepartum, and the grounds for it are discussed. The rationale for allowing the pregnancy to continue after this diagnosis at the 20th week of pregnancy is also discussed. The values for numerous blood and urinary measurements of fetal and placental status are presented, and the mechanisms of some of these are discussed. Spontaneous labor occurred at the 32d week of pregnancy, and a 1435-g living female infant was delivered. The uterus was evacuated manually and the recovered contents are illustrated, described, and discussed. The infant showed no physical or mental abnormalities at the age of 12 months. Her weight and height were 7170 g and 67.7 cm, respectively, and she had good development.