One hundred and six triploids were ascertained during a study of 1500 consecutive spontaneous abortions. The mechanism of origin of the additional haploid complement was investigated by comparing parental and foetal cytogenetic heteromorphisms and a histopathological examination of each triploid was done in a subsequent blind study. The mechanism of origin of the additional haploid complement was found to be highly correlated with the development of partial hydatidiform mole and with gestational age. All 51 paternally derived triploids in which a pathologic diagnosis could be made were partial moles, whereas only 3 of 15 maternally derived triploids on which a diagnosis could be made were molar. The mean gestational age of the paternally derived triploids was 122 days while that of the maternally derived triploids was only 74 days. It was suggested that the development of partial mole was primarily associated with the presence of two paternal haploid chromosome complements, the association with relatively long gestational ages being a secondary one consequent upon retention of the molar placentae for many weeks after foetal demise.

The present communication describes the histological investigation by immunofluorescence of the distribution of blood group substances A and B in the tissues of various human organs, a question which heretofore has been investigated mainly by serologic tests on extracts of tissues. Previous workers have found relatively large amounts of water-soluble, mainly mucus-bound antigen in appropriate tissues of secretors, as contrasted with the small amounts found in those of non-secretors. On the other hand, antigen extractable by ethanol has been found in small amounts in practically all tissues from individuals of appropriate blood group, regardless of their secretor status.Immunofluorescence microscopy aims at cytological localization. The mapping out of the histological sites occupied by these two forms of antigen, and possibly others to be encountered in the future, and the investigation of their solubility and other properties, may allow further histochemical study of the various forms of the blood group substances in their native state. At the same time the differences in the distribution of these antigens in secretors and nonsecretors provide an opportunity to investigate histologically the modification imposed by one set of alleles (secretor:non-secretor, S, s) on the phenotypic expression of another independent set (ABO).Landsteiner's discovery of the ABO system of antigens in human erythrocytes initiated numerous further investigations of their occurrence and distribution in the body. The earlier workers investigated the various body fluids and secretions (30,31,17,27), free cells other than crythrocytes (e.g. spermatozoa) (16), and extracts of tissues and organs (29, 15), using hemagglutination inhibition or complement-fixation techniques. Among the numerous publications the most comprehensive are the monograph of Putkonen (23) on tissue fluids and secretions and that of Hartmann (11) on tissues and organs. The accumulation of such data led to the classification of

The ABH antigens have been mapped out in the tissues of embryos and fetuses, 18 to 125 mm crown to rump length, 6 to 14½ weeks ovulation age. Both the H and A,B antigens have the same distribution, and their spatial and temporal parallel obtains in intrauterine as well as extrauterine phases of life. The cell wall antigens are present in their maximal distribution in the youngest specimens available. They outline the endothelium of the cardiovascular system, and the cells of most of the epithelia throughout the body. The exceptions are the liver, the adrenal, and the nervous system, presumed to have lost the epithelial antigens at stages antedating the youngest specimens here described. The antigens of the stratified epithelia (and of the simple epithelia of the renal collecting tubules), together with the endothelial antigens, are permanent and persist into and throughout adult life. All other cell wall antigens disappear at a time characteristic for each organ. The antigenic recession coincides with recognizable steps of morphological advancement and often with assumption of function by the organ concerned; it is completed at about the end of the first trimester of pregnancy. The secretion-borne antigens first appear at the 35 to 40 mm stage (8 weeks ovulation age) in the salivary glands and in the stomach, to be followed in a constant sequence by the rest of the gastrointestinal tract, respiratory system, and pancreas. The secretion of these antigens persists throughout life. The early presence and wide distribution of the cell wall A,B antigens render them likely potential targets for maternal anti-A,B antibodies in heterologous pregnancies; the advent of the water-soluble substances at 8 weeks ovulation age may be providing a buffer shielding the fetal cell wall antigens by mopping up the maternal isoagglutinins.

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The H antigen was mapped out by immunofluorescence in human tissues (including those of fetuses from 15 cm crown-heel length) from individuals of the various groups within the ABO system, both secretors and non-secretors. The distribution of the antigen can be summarized under the following headings: Cell walls of endothelium: present throughout the cardiovascular system; Cell walls of stratified epithelia: in skin, non-cornifying squamous stratified membranes, transitional epithelia; Mucus: occurring wherever the latter is produced in secretor individuals and confined to a few special topographical areas in non-secretors; Secretions and excretions: the pancreatic and sudoriferous (independent of secretor status), and mammary and uterine (governed by the secretor makeup) all contain it. The distribution of the H antigen is most fully represented in tissues of group O. It follows an over-all universal pattern, characteristically modified in non-secretors, equally valid for antigens A and B described in a preceding study. Within this pattern, in tissues of the non-O groups, the complement of the H substance in its various forms wanes in a manner consistent with the hypothesis that it serves as a substrate for the A1, A2, B genes, exerting their action with different degrees of efficiency. The secretor:non-secretor phenomena can be most simply interpreted by viewing the non-secretor, recessive gene (in the homozygous, ss condition) as inhibiting the production of some of the water-soluble forms of the blood group substances. Since the gene was never found responsible for dissociation of the H and A, B antigens its inhibitory action is thought to be wrought at the point of formation of the basic H substance or its precursor.

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Summary. The results of a 5 year prospective cytogenetic and epidemiologic investigation of complete and partial hydatidiform mole are described. A total of 40 complete and 88 partial moles were identified by pathologic criteria in a population of 1602 spontaneous abortions. Cytogenetic observations confirmed the close correlation between chromosome constitution and histopathologic type, virtually all the complete moles were paternal parthenogenones and virtually all the partial moles were triploid. The distributions of maternal age, race, place of birth and socioeconomic status were the same in women with partial moles and in the control population of spontaneous abortions. However, the incidence of complete moles was significantly increased in women aged <20 years and also in Filipino women, these two effects being independent of one another.