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DECIMALS AND THE DAMNED SPOT
730
capped children, what evidence is there that the sheltered environment of special schools enables the child to learn these techniques effectively? Furthermore, might it not be that normal children react in this way because they themselves must learn to adapt to handicapped persons in their midst? Surely one function of a teacher attempting to provide truly comprehensive education would be to try to instil ideas of tolerance, understanding, and adaptability in all pupils. Finally, as your annotation indirectly suggests, the educational standards of special schools have not, in the past, been satisfactory, let alone superior as they ought to be if these children are to receive a genuine scholastic advantage to compensate for their physical disabilities. Clearly, if special education is to mean something more than merely separate education, it must be based on local units staffed by people who are well-trained teachers, gifted in the ability to adapt education to individual needs. Headmasters and school medical officers must look again at their responsibilities to these children to see whether their future development as responsible, self-sufficient adults is not best assured by creating flexible provisions within the framework of normal schooling. The Survey of Deaf Children and the work of Douglas and Ross which you cite cannot be accepted as evidence in support of the argument you present. These studies merely highlight isolated areas, and in doing so reaffirm the need for continued reassessment of special education, in social as well as educational terms, before further steps are taken to expand existing facilities. Department of Child Development, Institute of Education, I. B. PLESS. Malet Street, London W.C.1.
BLOOD-SEROTONIN IN DOWN’S SYNDROME
SIR,-Several studies 1-6 have shown a decrease of wholeblood-serotonin in patients with Down’s syndrome (D.s.). Rosner et al.4 have reported that 7 patients with the transTABLE I—BLOOD-SEROTONIN VALUES IN PATIENTS WITH TRANSLOCATION AND TRISOMIC D.S., NORMAL CONTROLS, AND MENTALLY RETARDED
CONTROLS
TABLE IIłCASE NUMBERS, BLOOD-SEROTONIN VALUES, AGE, COUNTRY OF ORIGIN, AND KARYOTYPE IN PATIENTS WITH TRANSLOCATION D.S.
reported.13 Although there was a significant difference between the patients with D.s. and the retarded controls, there was no significant difference between the patients with trisomic and translocation D.S. The findings of no differences between normal controls and patients with DIG and GIG translocations could be explained by the unusually high blood-serotonin level of 1 patient (case 114, table 11). If this determination (415 ng. per ml.) is omitted from the study the mean becomes 82.1 +- 31.7 and the P value less than 0’01. (P values for the other categories are
unaffected.) We wish to thank Dr. Lars Bordus, Dr. Karl-Henrik Gustavson, Dr. Henry Nadler, and Professor David Hsia for their help. This work was supported by grants Tl-AM-5186, IF3 HD-33178-01, 5-S01-FR-5370, and 1-SOl-FR-5475. Genetic Clinic, Children’s Memorial Hospital and Department of Pediatrics, Northwestern University Medical School, Chicago, Illinois.
JULIAN BERMAN.
Department of Endocrinology and Metabolism, Karolinska Sjukhuset, Stockholm, Sweden.
MAJ HULTÉN JAN LINDSTEN.
DECIMALS AND THE DAMNED SPOT SIR,-Dr. Massey Dawkins’ letter on errors (March 4, p. 510) is itself in error. The Romans did not invent the decimal system-the Hindus did, most probably between the first and third centuries A.D., and possibly by the mathematician Agastya. The system came to the West through the Arabs. Addiscombe, Surrey.
location form had whole-blood-serotonin levels significantly higher than in patients with the trisomic form, which approached the low-normal values for controls. We report here findings at variance with those of Rosner et al. Whole-blood-serotonin was determined by the method of Contractorwithin 24 hours of collection in 4 patients with G/G translocation D.S., 5 with D/G translocation D.S., 14 with trisomic D.s., 19 controls with normal mentality, and 19 controls who are mentally retarded but with normal karyotypes. None of the patients included in this study were on drug therapy known to affect blood-serotonin levels. As shown in table i, the retarded controls had much higher whole-blood-serotonin levels than the normal controls, as has previously been 1.
2. 3. 4. 5. 6. 7.
Pare, C. M. B., Sandier, M., Stacey, R. S. Proceedings of London Conference on the Scientific Study of Mental Deficiency; vol. I, p. 113, London. 1960. Tu, J., Zellweger, H. Lancet, 1965, ii, 715. Berman, J. L., Justice, P., Hsia, D. Y. Y. J. Pediat. 1965, 67, 603. Rosner, F., Ong, B. H., Paine, R. S., Mahanand, D. Lancet, 1965, i, 1191; New Engl. J. Med. 1965, 273, 1356. Ong, B. H., Jacobson, C. B., Paine, R. S., Mahanand, D. Lancet, Jan. 7, 1967, p. 51. Tissot, R., Guggisberg, S., Constaninois, S., Bettschart, W. Path. Biol. 1966, 14, 312. Contractor, S. F. Biochem. Pharmac. 1964, 13, 1351.
ANANDA NAYAKA.
CADMIUM AND PROSTATIC CARCINOMA SIR,-Evidence was quoted in a press report of an inquest on a cadmium-pigment worker that exposure to the dust of cadmium salts could not be excluded as a cause of carcinoma of the lung. In addition, Pottsgives a table of causes of death in workers exposed to cadmium oxide which suggests a possibly increased risk of carcinoma. With these facts in mind, we have surveyed a group of 248 workers who have been exposed for a minimum period of one year to cadmium oxide. 30 of these workers were still in this employment in December, 1966. The duration of his employment in this work was available for each man, and of those who had died the causes of death were ascertained. From annual incidence-rates supplied by the Birmingham Regional Cancer Registry, it was possible to compute the numbers of cases of cancer at certain sites which would be expected to occur in such a group of men of known age, assessing their duration of exposure either by taking the time from first employment to the end of December, 1966, or to death, or by excluding the time spent in other jobs or in retirement. The latter methods yielded slightly lower expected rates, but judging from work in similar fields fairly short exposure may be Gustavson, K.-H. in Down’s Syndrome: Investigation. Uppsala, 1964. 9. Potts, C. L. Ann. occup. Hyg. 1965, 8, 55. 8.
a
Clinical and
Cytogenetical
capped children, what evidence is there that the sheltered environment of special schools enables the child to learn these techniques effectively? Furthermore, might it not be that normal children react in this way because they themselves must learn to adapt to handicapped persons in their midst? Surely one function of a teacher attempting to provide truly comprehensive education would be to try to instil ideas of tolerance, understanding, and adaptability in all pupils. Finally, as your annotation indirectly suggests, the educational standards of special schools have not, in the past, been satisfactory, let alone superior as they ought to be if these children are to receive a genuine scholastic advantage to compensate for their physical disabilities. Clearly, if special education is to mean something more than merely separate education, it must be based on local units staffed by people who are well-trained teachers, gifted in the ability to adapt education to individual needs. Headmasters and school medical officers must look again at their responsibilities to these children to see whether their future development as responsible, self-sufficient adults is not best assured by creating flexible provisions within the framework of normal schooling. The Survey of Deaf Children and the work of Douglas and Ross which you cite cannot be accepted as evidence in support of the argument you present. These studies merely highlight isolated areas, and in doing so reaffirm the need for continued reassessment of special education, in social as well as educational terms, before further steps are taken to expand existing facilities. Department of Child Development, Institute of Education, I. B. PLESS. Malet Street, London W.C.1.
BLOOD-SEROTONIN IN DOWN’S SYNDROME
SIR,-Several studies 1-6 have shown a decrease of wholeblood-serotonin in patients with Down’s syndrome (D.s.). Rosner et al.4 have reported that 7 patients with the transTABLE I—BLOOD-SEROTONIN VALUES IN PATIENTS WITH TRANSLOCATION AND TRISOMIC D.S., NORMAL CONTROLS, AND MENTALLY RETARDED
CONTROLS
TABLE IIłCASE NUMBERS, BLOOD-SEROTONIN VALUES, AGE, COUNTRY OF ORIGIN, AND KARYOTYPE IN PATIENTS WITH TRANSLOCATION D.S.
reported.13 Although there was a significant difference between the patients with D.s. and the retarded controls, there was no significant difference between the patients with trisomic and translocation D.S. The findings of no differences between normal controls and patients with DIG and GIG translocations could be explained by the unusually high blood-serotonin level of 1 patient (case 114, table 11). If this determination (415 ng. per ml.) is omitted from the study the mean becomes 82.1 +- 31.7 and the P value less than 0’01. (P values for the other categories are
unaffected.) We wish to thank Dr. Lars Bordus, Dr. Karl-Henrik Gustavson, Dr. Henry Nadler, and Professor David Hsia for their help. This work was supported by grants Tl-AM-5186, IF3 HD-33178-01, 5-S01-FR-5370, and 1-SOl-FR-5475. Genetic Clinic, Children’s Memorial Hospital and Department of Pediatrics, Northwestern University Medical School, Chicago, Illinois.
JULIAN BERMAN.
Department of Endocrinology and Metabolism, Karolinska Sjukhuset, Stockholm, Sweden.
MAJ HULTÉN JAN LINDSTEN.
DECIMALS AND THE DAMNED SPOT SIR,-Dr. Massey Dawkins’ letter on errors (March 4, p. 510) is itself in error. The Romans did not invent the decimal system-the Hindus did, most probably between the first and third centuries A.D., and possibly by the mathematician Agastya. The system came to the West through the Arabs. Addiscombe, Surrey.
location form had whole-blood-serotonin levels significantly higher than in patients with the trisomic form, which approached the low-normal values for controls. We report here findings at variance with those of Rosner et al. Whole-blood-serotonin was determined by the method of Contractorwithin 24 hours of collection in 4 patients with G/G translocation D.S., 5 with D/G translocation D.S., 14 with trisomic D.s., 19 controls with normal mentality, and 19 controls who are mentally retarded but with normal karyotypes. None of the patients included in this study were on drug therapy known to affect blood-serotonin levels. As shown in table i, the retarded controls had much higher whole-blood-serotonin levels than the normal controls, as has previously been 1.
2. 3. 4. 5. 6. 7.
Pare, C. M. B., Sandier, M., Stacey, R. S. Proceedings of London Conference on the Scientific Study of Mental Deficiency; vol. I, p. 113, London. 1960. Tu, J., Zellweger, H. Lancet, 1965, ii, 715. Berman, J. L., Justice, P., Hsia, D. Y. Y. J. Pediat. 1965, 67, 603. Rosner, F., Ong, B. H., Paine, R. S., Mahanand, D. Lancet, 1965, i, 1191; New Engl. J. Med. 1965, 273, 1356. Ong, B. H., Jacobson, C. B., Paine, R. S., Mahanand, D. Lancet, Jan. 7, 1967, p. 51. Tissot, R., Guggisberg, S., Constaninois, S., Bettschart, W. Path. Biol. 1966, 14, 312. Contractor, S. F. Biochem. Pharmac. 1964, 13, 1351.
ANANDA NAYAKA.
CADMIUM AND PROSTATIC CARCINOMA SIR,-Evidence was quoted in a press report of an inquest on a cadmium-pigment worker that exposure to the dust of cadmium salts could not be excluded as a cause of carcinoma of the lung. In addition, Pottsgives a table of causes of death in workers exposed to cadmium oxide which suggests a possibly increased risk of carcinoma. With these facts in mind, we have surveyed a group of 248 workers who have been exposed for a minimum period of one year to cadmium oxide. 30 of these workers were still in this employment in December, 1966. The duration of his employment in this work was available for each man, and of those who had died the causes of death were ascertained. From annual incidence-rates supplied by the Birmingham Regional Cancer Registry, it was possible to compute the numbers of cases of cancer at certain sites which would be expected to occur in such a group of men of known age, assessing their duration of exposure either by taking the time from first employment to the end of December, 1966, or to death, or by excluding the time spent in other jobs or in retirement. The latter methods yielded slightly lower expected rates, but judging from work in similar fields fairly short exposure may be Gustavson, K.-H. in Down’s Syndrome: Investigation. Uppsala, 1964. 9. Potts, C. L. Ann. occup. Hyg. 1965, 8, 55. 8.
a
Clinical and
Cytogenetical