- Email: [email protected]
BLEEDING BEFORE AND AFTER
136
karyotypes The
extra
analysed. 19 cells contained 47 chromosomes. chromosome is identical with chromosome 3 (see
were
accompanying figure). Department of Obstetrics and Gynæcology, University of Edinburgh.
M. N. RASHAD M. G. KERR.
A MONGOL CHILD WITHOUT TRISOMY G more probable interprefindings presented in Dr. Cowie and Dr. Khan’s paper (July 10), on a patient with Down’s syndrome without trisomy 21, is that the patient did have a simple G/G interchange and that the father’s chromosomes are within the
SIR,-An alternative and perhaps
tation of the
normal range of variation. Karyotype of patient
with no.
partial deletion of the short
arm
of
a
C. O. CARTER D. Cox.
5 chromosome.
Apart from the equivalent of a transverse flexion crease in the right hand, the dermal configurations of the patient’s hands do not appear unusual. The maximal a.t.d. angles are 45° in both hands. The modal chromosome number is 46. In all cells a partial deleted no. 5 chromosome is found (see accompanying figure). The parents of our patient have normal chromosomes. A detailed report will be
Institute of Child Health, London, W.C.1.
published elsewhere.
University Genetics Laboratory, Niimegen. "’t-Honk " Institute for Mentally Retarded Children, Veldhoven, The Netherlands.
T. W.
J. HUSTINX.
J. C. H. M. WIJFFELS.
TRISOMY OF CHROMOSOME 3 IN AN ABORTION SiR,-Trisomy of a group-A chromosome is virtually unknown in live infants or adults-in adult life it is found only as a mosaic condition in the peripheral blood of some cases of macroglobulineemia.1 But trisomy of chromosome no. 2 has been reported in two early spontaneous abortions,2 and a monosomic condition for chromosome 1 has also been described in a nine-week spontaneous abortion.3 We here describe a case with trisomy of chromosome 3. The mother was aged 36 years. She had previously delivered five normal children, one of whom died at 8 months of an un-
BLEEDING BEFORE AND AFTER a tentative finger at the truth of the matter when you say in your annotation (July 10) that " mere size of an ulcer does not satisfactorily explain why some ulcer patients are more prone to bleed than others ". In fact, 20% of bleeding stomachs have no ulcer visible to the naked eye. But all such stomachs whether they have ulcers or not are the site of chronic gastroduodenitis, and bleeding arises from microscopic erosions of such a mucosa as often as it does from an ulcer. This would be more generally recognised had not the wide prevalence of radiography focused attention on the visible ulcer to a degree out of proportion to its clinical importance. The fact that a partial gastrectomy, carried to above the point at which the left gastric artery joins the lesser curvature, stops the majority of haemorrhages not due to gross ulcers is related to the fact that above this level the gastritis is minimal and probably reversible. One is tempted to think that persistent bleeding after such an operation is from severe gastritis at an unusually high level which has not been eliminated by the gastrectomy. Edgware General Hospital, FRANK FORTY. Edgware.
SiR,ŇYou point
WORLD TUBERCULOSIS interested to read your leading article on the SIR,-I in Great Britain.1 of tuberculosis persistence I feel that experience in this country has proved beyond any shadow of doubt the value of compulsory chest X-ray surveys in the detection of infectious cases of pulmonary tuberculosis. Without this method of case detection the fight against tuberculosis will be lost, and all the expenditure of effort and money will be wasted. If the Australian citizen is happy to submit himself to regular chest X-rays in the attempt to eradicate tuberculosis, surely there is no reason why his British counterpart should not also be happy to play his part in such an essential public-health was
measure.
In the earlier years of the compulsory surveys the odd voice raised against " this infringement of the personal right of the individual ", but the results were so dramatic that gradually all States of the Commonwealth of Australia fell into line with Tasmania and Western Australia, who had pioneered this type of examination. Surely an individual should not have the freedom to infect others with the disease, even if he is unaware of his infectivity. The obstacles to compulsory chest X-ray examination can be overcome.2 Even though the population of Western Australia is not great, experience has now proved the method satisfactory in the more heavily populated States of Australia. The finding and treatment of the infectious cases is one aspect of the problem, but record keeping3 is another important facet of tuberculosis control.
was
Karyotype showing trisomy of chromosome 3.
known cause. Her early pregnancy was uneventful until the 8th week when she began to bleed intermittently, and 2 weeks later she aborted spontaneously. The conceptus consisted of an intact amniotic sac containing no fcetal remnant-a " blighted ovum ". Primary cultures of amnion were established, and chromosome preparations were made from subcultures, using the method described by Harnden.4 28 cells were counted, and 7 1. 2. 3. 4.
Elves, M. W., Israels, M. C. G. Br. med. J. 1964, ii, 1024. Hall, B., Kallén, B. Lancet, 1964, i, 110. Kelly, S., Almy, R., Jakovic, L., Buckner, L. ibid. 1965, i, 166. Harnden, D. G. Br. J. exp. Path. 1960, 41, 31.
South Perth, Western Australia. 1. 2. 3.
ALAN KING.
Lancet, 1965, i, 689. King, A. Med. J. Aust. 1961, ii, 173. King, A. ibid. 1963, ii, 523.
karyotypes The
extra
analysed. 19 cells contained 47 chromosomes. chromosome is identical with chromosome 3 (see
were
accompanying figure). Department of Obstetrics and Gynæcology, University of Edinburgh.
M. N. RASHAD M. G. KERR.
A MONGOL CHILD WITHOUT TRISOMY G more probable interprefindings presented in Dr. Cowie and Dr. Khan’s paper (July 10), on a patient with Down’s syndrome without trisomy 21, is that the patient did have a simple G/G interchange and that the father’s chromosomes are within the
SIR,-An alternative and perhaps
tation of the
normal range of variation. Karyotype of patient
with no.
partial deletion of the short
arm
of
a
C. O. CARTER D. Cox.
5 chromosome.
Apart from the equivalent of a transverse flexion crease in the right hand, the dermal configurations of the patient’s hands do not appear unusual. The maximal a.t.d. angles are 45° in both hands. The modal chromosome number is 46. In all cells a partial deleted no. 5 chromosome is found (see accompanying figure). The parents of our patient have normal chromosomes. A detailed report will be
Institute of Child Health, London, W.C.1.
published elsewhere.
University Genetics Laboratory, Niimegen. "’t-Honk " Institute for Mentally Retarded Children, Veldhoven, The Netherlands.
T. W.
J. HUSTINX.
J. C. H. M. WIJFFELS.
TRISOMY OF CHROMOSOME 3 IN AN ABORTION SiR,-Trisomy of a group-A chromosome is virtually unknown in live infants or adults-in adult life it is found only as a mosaic condition in the peripheral blood of some cases of macroglobulineemia.1 But trisomy of chromosome no. 2 has been reported in two early spontaneous abortions,2 and a monosomic condition for chromosome 1 has also been described in a nine-week spontaneous abortion.3 We here describe a case with trisomy of chromosome 3. The mother was aged 36 years. She had previously delivered five normal children, one of whom died at 8 months of an un-
BLEEDING BEFORE AND AFTER a tentative finger at the truth of the matter when you say in your annotation (July 10) that " mere size of an ulcer does not satisfactorily explain why some ulcer patients are more prone to bleed than others ". In fact, 20% of bleeding stomachs have no ulcer visible to the naked eye. But all such stomachs whether they have ulcers or not are the site of chronic gastroduodenitis, and bleeding arises from microscopic erosions of such a mucosa as often as it does from an ulcer. This would be more generally recognised had not the wide prevalence of radiography focused attention on the visible ulcer to a degree out of proportion to its clinical importance. The fact that a partial gastrectomy, carried to above the point at which the left gastric artery joins the lesser curvature, stops the majority of haemorrhages not due to gross ulcers is related to the fact that above this level the gastritis is minimal and probably reversible. One is tempted to think that persistent bleeding after such an operation is from severe gastritis at an unusually high level which has not been eliminated by the gastrectomy. Edgware General Hospital, FRANK FORTY. Edgware.
SiR,ŇYou point
WORLD TUBERCULOSIS interested to read your leading article on the SIR,-I in Great Britain.1 of tuberculosis persistence I feel that experience in this country has proved beyond any shadow of doubt the value of compulsory chest X-ray surveys in the detection of infectious cases of pulmonary tuberculosis. Without this method of case detection the fight against tuberculosis will be lost, and all the expenditure of effort and money will be wasted. If the Australian citizen is happy to submit himself to regular chest X-rays in the attempt to eradicate tuberculosis, surely there is no reason why his British counterpart should not also be happy to play his part in such an essential public-health was
measure.
In the earlier years of the compulsory surveys the odd voice raised against " this infringement of the personal right of the individual ", but the results were so dramatic that gradually all States of the Commonwealth of Australia fell into line with Tasmania and Western Australia, who had pioneered this type of examination. Surely an individual should not have the freedom to infect others with the disease, even if he is unaware of his infectivity. The obstacles to compulsory chest X-ray examination can be overcome.2 Even though the population of Western Australia is not great, experience has now proved the method satisfactory in the more heavily populated States of Australia. The finding and treatment of the infectious cases is one aspect of the problem, but record keeping3 is another important facet of tuberculosis control.
was
Karyotype showing trisomy of chromosome 3.
known cause. Her early pregnancy was uneventful until the 8th week when she began to bleed intermittently, and 2 weeks later she aborted spontaneously. The conceptus consisted of an intact amniotic sac containing no fcetal remnant-a " blighted ovum ". Primary cultures of amnion were established, and chromosome preparations were made from subcultures, using the method described by Harnden.4 28 cells were counted, and 7 1. 2. 3. 4.
Elves, M. W., Israels, M. C. G. Br. med. J. 1964, ii, 1024. Hall, B., Kallén, B. Lancet, 1964, i, 110. Kelly, S., Almy, R., Jakovic, L., Buckner, L. ibid. 1965, i, 166. Harnden, D. G. Br. J. exp. Path. 1960, 41, 31.
South Perth, Western Australia. 1. 2. 3.
ALAN KING.
Lancet, 1965, i, 689. King, A. Med. J. Aust. 1961, ii, 173. King, A. ibid. 1963, ii, 523.