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A patient with vitamin D dependent rickets with decreased sensitivity to 1,25-Dihydroxyvitamin D was observed. She suffered from bone pain of two years duration beginning at 12 years of age and was found to be suffering from hypocalcemia, secondary hyperparathyroidism and osteomalacia. Laboratory findings revealed normal serum 25-hydroxyvitamin D (27 ng/ml) and markedly elevated serum 1,25-dihydroxy-vitamin D (131.9 pg/ml). The hypocalcemia was refractory in spite of administration of 25,000 units of vitamin D2, but therapy with high doses of oral la-hydroxyvitamin D3 resulted in significant elevation of the serum calcium level. The clinical findings and course of the patient's disease were quite different from those of other patients with vitamin D dependent rickets reported by other authors.

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Antigenic variations of respiratory syncytial virus (RSV) strains were analyzed using a collection of nine, seven, two, and one monoclonal antibodies (MAbs), respectively, raised against the fusion protein (F), large glycoprotein (G), nucleoprotein (NP), and phosphoprotein (P) components of the Long strain of RSV. Competitive binding assay by these MAbs demonstrated eight, four, and two distinct epitopes on F, G, and NP components, respectively. Comparison of prototype Long with ten field strains isolated in Sapporo, Japan, during a 9-year period from 1980 to 1988 by radioimmunoprecipitation (RIP), immunofluorescence (IF), and enzyme-linked immunosorbent assay (ELISA) test revealed four different patterns of reaction to these MAbs. Thus, prototype Long reacted to all 19 MAbs. Six field strains have shown a different reactivity to one of nine anti-F and to one of seven anti-G antibodies (subgroup A). Three of the remaining isolates failed to react with three of nine anti-F and with all of seven anti-G antibodies (subgroup B). One strain (58-104) isolated in 1983 was similar to subgroup A except for a lack of reaction with two anti-G antibodies. All field strains reacted with two anti-NP and one anti-P antibodies. The numbers of altered epitopes in subgroup A were 1/8 and 1/4; in subgroup B, 3/8 and 4/4; and in 58-104, 1/8 and 2/4 on the F and G components, respectively. No other variations have been observed among field isolates tested.

Abstract.[Purpose] The present study aimed to estimate the reliability of two protocols for measuring chest wall dimensions in the transverse plane in individuals (18 males, 12 females) aged 2 years 6 months to 58 years (mean age 34.7 ± 17.6) with Severe Motor and Intellectual Disabilities (SMID). [Subjects and Methods] For diagnosing pneumonia in individuals with SMID, 30 X-ray computed tomograms were taken at the level of the xiphisternal junction, scanned, and saved on a personal computer. Five therapists examined these images. Anteroposterior (AP) and laterolateral (LL) diameters were measured using two protocols. The largest AP and LL diameters were measured along the gravity line (protocol 1) and along the line where the middle point of the sternum connects with the spinous process of the vertebra (protocol 2). Intraclass correlation coefficients (ICCs) were calculated to estimate the intrarater and interrater reliability of each protocol.[Results] ICCs were >0.85 in protocols 1 and 2 for all measurements, showing these protocols are highly reliable for measuring chest wall dimensions in the transverse plane. [Conclusions] Measurements using these protocols are easy and cheap, and can be performed retrospectively, providing an effective way for evaluating chest wall deformity in individuals with SMID.