Biomedical subjects
Publications and source records attributed to B Roland.
A child with Kostmann syndrome, or severe congenital neutropenia, developed myelodysplastic syndrome after 6 years of treatment with rhG-CSF. The bone marrow karyotype showed acquired trisomy 21, and in some cells pentasomy 21 due to two isodicentric chromosomes 21. This is the second report of a patient with Kostmann syndrome and acquired trisomy 21.
STUDY OBJECTIVE: To report long-term follow-up of 300 patients undergoing extraperitoneal retropubic bladder suspension using balloon distention and mesh suspension. DESIGN: Observational study (Canadian Task Force classification II-2). SETTING: Private practice. PATIENTS: Three hundred women with urinary incontinence. INTERVENTION: Extraperitoneal retropubic bladder neck suspension with mesh, after balloon distention of the space of Retzius performed under general anesthesia in 162 (54%) and epidural anesthesia in 138 (46%). MEASUREMENTS AND MAIN RESULTS: Eight procedures were converted to open urethropexy, resulting in 259 laparoscopic urethropexies. Spontaneous voiding resumed within 24 hours in 235 patients (90.4%). Follow-up was available for 267 patients and ranged from 1.5 to 5.5 years (mean 3.28 yrs). Of these, 173 women (67%) reported that they were cured and 64 (24.5%) were satisfied with the result; 22 (8.5%) were considered failures. CONCLUSION: Extraperitoneal retropubic bladder neck suspension with mesh results in a durable repair and is associated with relatively short operating time, low morbidity, and excellent patient satisfaction. (J Am Assoc Gynecol Laparosc 8(1):107-110, 2001)
Multiple factors, including efficacy, toxicity and cost, may influence the decision to treat immune thrombocytopenic purpura (ITP) with intravenous immune globulin (IVIG) or intravenous Rho (D) immune globulin (IV RhIG). We conducted a survey of 50 hospitals in 31 states to determine the costs for treating ITP using conventional doses for IVIG or IV RhIG, based on package insert recommendations. The average cost for a dose of IVIG ($2,771) was 71.7% ($1,157) more than that for a dose of IV RhIG ($1,614). In the absence of clearly defined differences in clinical outcomes when treating ITP with IVIG or IV RhIG, the difference in cost may be an important factor in selecting the treatment.
A 61-year-old woman with chronic myelogenous leukemia (CML) in accelerated phase had a near-triploid bone-marrow karyotype. This karyotype is an unusual finding in CML, as we review 12 previously published similar cases. These patients do not differ clinically from other patients with CML in blast crisis. The cytogenetic features of near-diploid and near-triploid CML are similar, except that relative loss of chromosomes is more common and that isochromosome 17q has not been reported in near-triploid CML.
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We report on a 16-week-old male fetus with partial trisomy 16 and partial monosomy 22 resulting from 3:3 adjacent-2 segregation of a maternal balanced complex chromosome translocation involving chromosomes 5, 16, and 22. The karyotype of the 29-year-old phenotypically normal mother was 46,XX,t(5;16;22)(q31.3;q12.1;q11.2). The karyotype of the fetus was 46,XY,der (5)t(5;16;22)(q31.3;q12.1;q11.2),+der(16) t(5;16;22)mat,-22. The fetus had multiple congenital anomalies, including bilateral cleft lip and palate.
One hundred and one DNA markers previously assigned to the short arm of the human X chromosome were localized on a hybrid mapping panel consisting of ten radiation-reduced, and four classical somatic cell hybrids. Of the 101 DNA markers, 16 are genes, two are pseudogenes, 13 are expressed sequence tags, 32 are simple tandem repeats (STRs), four are restriction fragment length polymorphisms, one is a variable number of tandem repeats, and 33 are sequence tagged sites (STSs). Three of these markers, two STSs and one STR, were generated from the products of an inter-Alu PCR library of a radiation-reduced hybrid containing Xp11.4-->p11.22 as its only human DNA content. A second STR was isolated from a region-specific cosmid containing the gene ZNF21. The 101 DNA markers fell into 22 bins based on their retention on the hybrids of this panel, which, in combination with YAC contig data, could be further resolved into 24 bins. This hybrid map of Xp11 has an average resolution of approximately 0.8 Mb.
A choroid plexus papilloma from a 23-month-old child was found to have a hyperdiploid karyotype. This karyotype is compared with that of other choroid plexus papillomas. Our results are also compared with flow cytometry results and the karyotypes of choroid plexus carcinomas.
The perinatal outcome of 26 patients with confined placental mosaicism (CPM) detected in chorionic villus sampling (CVS) who wished to continue their pregnancies was compared with that of two controls per patient matched for age and parity (n = 52). There were no significant differences in birth weight or gestational age at delivery between patients with CPM and controls. There were no cases of intrauterine growth retardation (IUGR) in the CPM patients as compared with two (2/52, 3.8 per cent) in the control group (P > 0.05). There was no significant increase in fetal loss between the study group (1/26, 3.6 per cent) and the controls (1/52, 1.9 per cent) (P > 0.05).
The diffuse-variant tenosynovial giant cell tumor is rare. Although it shares histologic features with the exclusively intra-articular pigmented villonodular synovitis and local tenosynovial giant cell tumor, its behavior differs dramatically, being locally very aggressive. We report a case of a diffuse-variant aggressive tenosynovial giant cell tumor that, although diploid by flow cytometry, demonstrated trisomy 7 and 5 as well as clonal rearrangements involving chromosomes 1, 3, and 15. These cytogenetic abnormalities may be markers for aggressive behavior and useful for directing treatment.
Fluorescence in-situ hybridization studies using a whole chromosome 9 painting probe were performed on three individuals from two different families, who carry a chromosome 9 variant with an extra band within the elongated 9qh region. The results confirm the euchromatic nature of the extra band, and provide evidence that it is of chromosome 9 origin. This variant band, which may not be very rare, thus possibly results from a duplication of a segment of 9qh plus band p12 or part of band q21.
A familial complex chromosomal rearrangement (CCR) was ascertained through a mentally retarded, dysmorphic individual. Carriers of the CCR have the karyotype 46,XX or XY, t(6;15)(q16;q21), ins(3;6)(q12;q14q16), and malsegregation of the CCR resulted in loss of the segment 6q14 to 6q16 in the proband, and in an additional copy of the same segment in three members of the extended family. The proband has features similar to other reported cases with deletion of 6q1. The individuals with duplication of 6q14 to 6q16 have moderate mental retardation, short stature, obesity, microcephaly, brachycephaly, a short smooth philtrum, central hair whorl, simian creases, 5th finger brachydactyly and skeletal disproportion. In the 4-generation family, CCR carriers have a 20% empiric risk of phenotypically abnormal livebirths.
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Male rats given lateral hypothalamic (LH) lesions exhibit an acute increase in gastric acid secretion and develop erosions of the glandular portion of the stomach within 24 h. Since this process has been examined predominantly in male rats, the present experiments were devised to study the effects of LH lesions on the gastric mucosa of female rats. In Experiment 1, 1-year-old Sprague-Dawley female rats given LH lesions exhibited erosions in the rumenal portion of the stomach, a pattern unlike that found in both young and old male rats. Although the glandular mucosa lacked evidence of gross defects, the mucosa appeared blanched and covered with a mucus-like secretion. Experiment 2 demonstrated that, like male rats, LH lesions produced gastric hypersecretion in 1-year-old females. The results of the first two experiments indicate that the dissimilar patterns of gastric mucosal injury between males and older females cannot be accounted for on the basis of differences in gastric acid secretion. Experiment 3 demonstrated that, unlike older females but like males, 4-month-old female rats given LH lesions developed gastric erosions in the glandular mucosa only. Additionally, ovariectomy had no significant effect in altering the extent of gastric pathology. Taken together, these results suggests that (1) age and gender are important variables in neurogenic gastric mucosal injury, (2) differences in the type of gastric ulceration cannot be accounted for by differences in acid secretion, (3) ovarian hormones do not appear to play a significant role in gastric ulceration following brain damage.
Amniocentesis was performed because of a fetal abdominal wall defect, and a 45,X karyotype was obtained. A near-normal male infant with no features of Turner syndrome was delivered. The karyotype of the infant was 45,X/46,X,dic(Y)(q11), with each of the cell lines present in approximately 50 per cent of the lymphocytes and fibroblasts examined.
The effects of lesions in the centromedial and basolateral amygdala were examined using three different tests sensitive to the following stress-related responses: exploratory behavior, pain reactivity, and immune responses. The most clear-cut results were found with exploratory behavior. Rats with lesions of the centromedial amygdala tended to explore a radial-arm maze more quickly and entered more novel arms of the maze than controls. Those with lesions of the basolateral amygdala were generally too hesitant to explore at all. No significant differences were found between groups on measurements of natural killer cell activity. In tests of pain perception, rats in the control group displayed an analgesic response on the hot plate following an injection of the anxiogenic drug, RO 15-1788, whereas rats with centromedial lesions tended to exhibit a blunted response. These findings provide modest support for the view that the central and lateral regions of the amygdala play complementary roles in aversively motivated behaviors and in stress-related response patterns.
A mother and daughter with an interstitial deletion of the chromosome segment 21q11 to 21q21.3 have similar minor dysmorphism and mild mental retardation. These two patients are compared to others in the literature with deletion of the same region of chromosome 21. Molecular analysis of DNA from our patients localizes the DNA segments D21S1, D21S11, D21S8, and D21S22 within the deleted region.
Responses to several thermogenic stimuli were measured in rats maintaining stable but reduced body weights following lateral hypothalamic (LH) lesions. Oxygen consumption was monitored in open-circuit respirometers before and after exposure to cold (16.5 degrees C), intubation of a meal, and isoproterenol injection (40 micrograms/kg 0.75). Observations were made in both warm- (28 degrees C) and cold-acclimated (9 degrees C) LH-lesioned rats. Cold exposure, intubation, and drug injection each caused marked increases in heat production in sham- and LH-lesioned rats. This thermogenic response was similar in magnitude and form for both groups. Acclimation to 9 degrees C caused increased baseline levels of heat production when measured at 28 degrees C. Subsequent exposure to thermogenic stimuli revealed an exaggerated response to isoproterenol but not intubation in cold-acclimated groups. The LH-lesioned cold-acclimated rats responded in the same manner as sham-lesioned cold-acclimated rats. These findings are in contrast to the immediate postlesion period when rats show enhanced thermogenic activity. At reduced body weights LH-lesioned rats show normal rates of heat production and make normal responses to thermogenic stimuli. Enhanced thermogenesis does not appear to play a role in the maintenance of chronically reduced body mass in LH-lesioned rats.