Biomedical subjects
Publications and source records attributed to P A Gilman.
A 72-item questionnaire regarding attitudes toward euthanasia was administered to 240 residents of Humboldt County, California, who ranged from 18 to 86 years of age. The relationships between their attitudes and their demographic characteristics including age, religion, and education were examined.
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Hypertrichosis is an unusual but well-recognized genetic condition. Hypertrichosis may be generalized or limited to specific body areas, in which case it is usually not associated with other anomalies. Five previous cases of hypertrichosis cubiti have been reported, with short stature in 2 sibs being the only other associated abnormalities. We report on a child with hairy elbows, developmental delay, facial asymmetry, and delayed speech with normal parents. Our patient may represent severe expression of the hairy elbow syndrome or constitute a previously unrecognized syndrome.
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Two prepubertal sisters of American Indian origin developed osteosarcoma at 8 and 12 years of age. This familial occurrence, tumor onset prior to puberty, unusual tumor location in one who also had short stature, and ethnic background all suggest an inborn predisposition to bone cancer rather than a chance occurrence. Rearrangements involving chromosomes #13 and #14 were found in both the surviving proband and mother. Comparison of the arm ratio and prometaphase G-banding patterns of the rearranged chromosomes suggests either deletion of band 14q11.2 or pericentric inversion (with breakpoints at 13q12 and 14q11.2) in the proband's rearranged chromosome, but not in her mother's. Her mother, who had no malignancy, had a typical Robertsonian translocation [t(13;14)(p11;q11)]. Three previously reported children with chromosomal abnormalities developed osteosarcoma at unusually young ages, younger even than in reported sibships with osteosarcoma. The most frequently detected cytogenetic abnormalities in sarcoma tumor cells involve chromosomes #13 and #14. In addition, some cases of bilateral retinoblastoma and familial unilateral retinoblastoma, which are known to be at increased risk for osteosarcoma, are associated with tiny deletions on chromosome #13. Thus, there may be a causal relationship between constitutional loss or rearrangement of genetic material at these breakpoints on chromosomes #13 or #14 and development of osteosarcoma in this family that is similar to that seen in patients with small constitutional chromosomal deletions who develop Wilms' tumor and retinoblastoma.
The relevance of occupational exposure to electrical and magnetic fields (EMF) in the etiology of leukemia has been raised in several studies. Underground coal miners represent an occupational group with situationally determined EMF exposure, as high-voltage power distribution lines are strung overhead in the mines and converters and step-down transformers provide power to mining equipment. Risk in occupational exposure to EMF was examined in a case-control study of 40 leukemia decedents and 160 control subjects who died of causes other than cancer or accident and who were matched on age at death. The control subjects were selected from a group of 6,066 persons whose deaths were reported in four National Institute for Occupational Safety and Health cohort mortality follow-up studies. Based on these data, 25 or more years of underground mining, a surrogate of EMF exposure, was found to pose a statistically significant risk for leukemia (International Classification of Diseases [ICD] codes 204 through 207, eighth revision), myelogenous leukemia (ICD 205), and chronic lymphocytic leukemia (CLL) (ICD 204.1). Accumulative exposure to chemical agents probably poses a risk for acute myelogenous leukemia, although this relationship fell short of being statistically significant. Although CLL has not previously been attributed to environmental agents, these data suggest a possible CLL risk from prolonged exposure to EMF.
Linkage analysis of 28 genetic markers was undertaken in 108 subjects from 11 families with well-documented, classic, peripheral neurofibromatosis. Fifty-four persons were affected in one four-generation family, seven three-generation families, and three two-generation families. Lod scores were calculated using the standard LIPED programme for 49 combinations of theta male and theta female from 0.01 to 0.50. Lod scores excluded close linkage with 16 markers, including most tested on chromosome 1 and HLA on chromosome 6, and were inconclusive for 12 markers, including the secretor locus, closely linked to myotonic dystrophy. Analysis of five informative families resulted in a lod score of +2.2 for close linkage with GC on chromosome 4. However, the lod score for GC in the one additional informative family was negative, so that the final interpolated maximum was Z = 0.89 for theta male = 0.03, theta female = 0.28. Further studies are needed to evaluate this suggestion of linkage and possible genetic heterogeneity.
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To determine whether exercise responses are different from normal in children with sickle cell anemia (SCA), we performed dynamic cycle ergometer exercise testing in 47 patients with SCA, aged 5 to 18 years, and 170 healthy, black age-matched control subjects. Seven (15%) of the patients with SCA had definitely ischemic, 16 (34%) had equivocally ischemic, and 24 (51%) had nonischemic ECG responses. Resting heart rate in the three groups of patients with SCA was higher than control values. Maximum exercise heart rate attained was lowest in the definitely ischemic group. All patients with SCA had decreased blood pressure responses and maximum working capacity when compared with control subjects. Hemoglobin concentration was lowest in the definitely ischemic group and correlated with maximum workload. Long-term myocardial ischemia may lead to fibrosis and the decreased myocardial contractility seen in adult patients with SCA.
A white girl with sickle O-Arab disease (Hb S/O-Arab) had three separate episodes of acute splenic sequestration at 8, 12, and 15 months of age with hemoglobin levels falling to 3.9, 2.8, and 4.2 g/dl, respectively. Functional hyposplenism was suggested by the radionucleotide spleen scan. Following splenectomy her hemoglobin stabilized in the range of 0.7--8.5 g/dl. Life-threatening episodes of splenic sequestration, pneumococcal infections and osteomyelitis may occur in both Hb S/O-Arab and homozygous sickle cell diseases.
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