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OCR for page 295
HEMOGLOBIN C DISEASES:IlANNEY 295 15. 1 3. Ranney, H. M.: Observations on the inheritance of sickle cell hemoglobin and hemoglobin C, i. Clin. Invest. 33: 1634, 1954. 14. Ranney, H. M., Larson, D. L.' and McCormacl<, G. H., Jr.: Some clinical, bio- chemical and genetic observations on hemoglobin C, J. Clin. Invest. 32: 1277, 1953. Ransone, J. W., and Lange, R. D.: Homozygous hemoglobin C disease in a 79 year old man with gout, Ann. Int Med. 46: 420, 1957. 16. Schwart%, S. O., and Hartz, W. H., Jr.: Mediterranean anemia in the Negro, Blood 10: 1256, 1955. 17. Singer, K., Chapman, A. Z., Goldberg, S. R., Rubinstein, H. M., and Rosenblum, S. A.: Studies on abnormal hemoglobins. IX. Pure (homozygous) hemoglobin C disease, Blood 9: 1023, 1954. 18. Singer, K., Kraus, A. P., Singer, L., Rubinstein, H. M., and Goldberg, S. R.: Studies on abnormal hemoglobins. X. A new syndrome: Hemoglobin C-thalas- semia disease, Blood 9: 1032, 1954. 19. Schneider, R. G.: Incidence of hemoglobin C trait in 505 normal Negroes: a family with homozygous hemoglobin C and sickle-cell trait union, J. Lab. and Clin. Med. 44: 133, 1954. 20. Smith, E. W., and Conley, C. L.: Filter paper electrophoresis of human hemo- globins, with special reference to the incidence and clinical significance of hemoglobin C, Bull. Johns Hopkins Hosp. 3: 94, 1953. 21. Spaet, T. H., Alway, :R. PI., and Ward, G.: Homozygous type 'C" hemoglobin, Pediatrics 12: 483, 1953. 22. Terry, D. W., Motulsky, A. G., and Rath, C. E.: Homozygous hemoglobin C, New Eng. l. Med. 251: 365, 1954. 23. Watson, R. J.: The hereditary anemias, Bull. N. Y. Acad. Med. ]0: 106, 1954. 24. Weinstein, I. M., Spurling, C. I., Klein, H., and Necheles, T. F.: Radioactive sodium chromate for the study of survival of red blood cells. III. The abnormal hemoglobin syndromes, Blood 9: 1155, 1954. 25. Wheby, M. S., Thorup, O. A., and Leavell, B. S.: Homozygous hemoglobin C disease in siblings: Further comment on intraerythrocytic crystals, Blood 1~1: 266, 1956. 26. Zuelzer, W. W., and Kaplan, E.: Thalassemia-hemoglobin C disease, Blood 9: 1047, 1954. DISCUSSION Dr. W. f. Zuelzer: The subjects on ~Thich I might have anything to say have been ~rery amply and nicely covered. The only comment I would like to make is in respect to Hb C combinations which, as Dr. Ranney has said, can vary quite a lot in their physiologic expressions. There again, we may have some evidence of the kind that Dr. Neel touched on this morning. Under certain conditions at least, we might 1O0JA; upon these variants as not neces- sarily abnormal. The cases which were described by Dr. Singer and his group showed a minimum of physiologic disturbance. The case we obser~red and some that Dr. Rarlney herself described, showed a great deal of severe anemia. The point is that in these interaction effects, or so-called interaction effects, we