Terminal deletion of the long arm of chromosome 4. Report of a case of 46, XY, del(4)(q31) and review of 4q- syndrome.

Using Q banding technique we recently identified a terminal deletion of the distal segment of the long arm of chromosome 4 in a male infant with multiple long arm of chromosome 4 in a male infant with multiple congenital anomalies. The breakpoint is at 4q31. The infant had hypertelorism, epicanthal folds, depressed nasal bridge, short nasal septum with upturned nose, bilateral open cleft lip and palate, retro- and micrognathia, low set, malformed ear, short neck, distally placed nipples, a sacral dimple, hypospadias, dysplastic nails, overriding toes, simian creases, patterns on interdigital and hypothenar areas, hypoplasia of gallbladder, and cardiac defects consisting of tricuspid atresia, left sided vena cava and anomalous aortic arch.

Response of children with cardiac disease to the bivalent influenza A vaccines.

During the recent nationwide trials of influenza vaccine, 121 children with cardiac disease, aged three to 18 years, were evaluated with respect to their immune response and reaction rate after administration of a whole-virus or split-virus bivalent influenza A/New Jersey/76-A/Victoria/75 vaccine given as a single dose or two divided doses. The serologic response of the cardiac children did not differ significantly from that of the total group of high-risk children or normal children who recived the same vaccine. The major reaction to the vaccines was fever, which occurred in one-fourth to one-half of children receiving the whole-virus vaccines.

Pulmonary valve fluttering in subpulmonic ventricular septal defect.

Three patients with subpulmonic ventricular septal defect and pulmonary valve fluttering by echocardiography are presented. The echographic changes appear identical to that reported with infundibular pulmonic stenosis and the mechanism causing this fluttering is probably similar.