Regulation of lithium and boron levels in normal human blood: environmental and genetic considerations.

Blood lithium levels may be both genetically and environmentally regulated. The genetic component is evidenced mainly from studies in twins who were either normal or had a manic-depressive disorder. An environmental contribution is adduced from the relationship between the blood lithium level and the amount of the element ingested. No such information is available for boron, another element present in ultra trace amounts in human blood. Unusually high levels of lithium and boron in the waters of northern Chile offer an opportunity to study the genetic and environmental regulation of these elements in the blood of healthy subjects. Samples of blood (n = 40) and water (n = 47) were collected at seven locations in the province of Tarapaca. Most of the healthy subjects were Aymara who had been resident in the respective communities for at least 3 years. The samples were transported to Canada and then freeze-dried. Neutron irradiation was performed in a highly thermalized flux to induce the reactions 6Li (n, alpha) t and 10B (n,7Li) alpha. Assays of 6Li and 10B were conducted in a static mass spectrometer by measurement, respectively, of 3He, produced from decay of tritium, and 4He from alpha-particles. Lithium concentrations in water and blood exhibited a linear relationship, as did the boron concentrations in these fluids. Because some of the individual subjects (n = 15) were first-degree relatives, a genetic component to the regulation of blood levels was explored. The variance in blood levels of lithium and boron was significantly greater between than within families (p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Neonatal cytomegalovirus infections: the relative role of neonatal blood transfusion and maternal exposure.

A prospective study of premature infants admitted to an intensive care neonatal unit was undertaken to evaluate the relative role of blood transfusions and maternal exposure in infections caused by cytomegalovirus (CMV), varicella zoster virus (VZV) and herpes simplex virus (HSV). During the first year of life, 13.7%, 4.8% and 4% of the infants became infected with CMV, VZV and HSV, respectively, as determined by virus isolation or seroconversion. Transfusion in the newborn period did not influence the rates of VZV or HSV infections. A higher rate of CMV infections occurred in transfused (18.8%) than in non-transfused (11%) infants but the difference was not statistically significant. A significant correlation was found between maternal antibody titers and the rate of CMV infection in infants whether or not transfusion occurred. An even stronger association was found between breast feeding and CMV infections. The risk of alloimmunization to erythrocyte and leucocyte antigens was also assessed; no evidence of increased alloimmunization to these antigens was associated with transfusion.

Chronic myeloid leukemia. A possible new variant in a child.

A case of Philadelphia (Ph') chromosome negative chronic myeloid leukemia (CML) in a child is reported. The age of onset (7 years) and duration of survival (40 months) are not typical of juvenile CML and the relatively low leukocyte and hemoglobin F concentrations are more akin to the findings in Ph' negative CML in adults. There was refractoriness to chemotherapy with the exception of a dramatic response to a combination of prednisone and vincristine, despite the absence of terminal transferase activity in circulating blood cells. Splenic irradiation, splenectomy, and leukapheresis were ineffective. Transition to a terminal aggressive phase caused a marked change in the growth characteristics of peripheral blood cells in vitro. This patient may represent a new variant in the spectrum of childhood CML.