Origin of the Koreans: a population genetic study

A population genetic study was undertaken to investigate the origin of Koreans. Thirteen polymorphic and 7 monomorphic blood genetic markers (serum proteins and red cell enzymes) were studied in a group of 437 Koreans. Genetic distance analyses by both cluster and principal components models were performed between Koreans and eight other populations (Koreans in China, Japanese, Han Chinese, Mongolians, Zhuangs, Malays, Javanese, and Soviet Asians) on the basis of 47 alleles controlled by 15 polymorphic loci. A more detailed analysis using 65 alleles at 19 polymorphic loci was performed on six populations. Both analyses demonstrated genetic evidence of the origin of Koreans from the central Asian Mongolians. Further, the Koreans are more closely related to the Japanese and quite distant from the Chinese. The above evidence of the origin of Koreans fits well with the ethnohistoric account of the origin of Koreans and the Korean language. The minority Koreans in China also maintained their genetic identity.

Genetic study of five populations of Bihar, India

Four-hundred fifty-nine people, including 106 Santals, 43 Bhuiyas, 107 Sakaldipi Brahmins, 108 Chamars, and 95 Ansari Muslims, of the Giridhi district of Bihar have been tested for transferrin, group-specific component, phosphoglucomutase subtypes, and glyoxalase-I, 6-phosphogluconate dehydrogenase, and adenylate kinase types. Genetic distance estimates by both dendrogram and principal component methods for these 5 populations and the Oraons on the basis of 19 alleles at 6 polymorphic loci indicate 2 major clusters: Brahmins and Muslims, the latter of which is composed of two subclusters (Santals and Bhuiyas, and Oraons and Chamars). The Santal and Bhuiya tribes both speak Mundari, whereas the Oraons speak a Dravidian language. The Chamars, although low-caste Hindus, seem to have a non-Europoid origin, as do the Oraons.

Deletional types of alpha-thalassaemia in central Java

The frequency of deletional alpha-thalassaemia in a Javanese population sample (n = 103) was investigated at three restriction sites of the alpha-globin gene (BamHI, BglII and RsaI). The overall gene frequency of alpha+ deletional thalassaemia was found to be very low (0.03). Leftward (-alpha 4.2) and rightward (-alpha 3.7) deletions and triplicated genes were present in equal frequency (0.015 and 0.005, respectively).

Polymorphisms of alpha-1-acid (orosomucoid), alpha-2-HS-glycoproteins and alpha-1-B among the Parsis of India

Genetic polymorphisms of plasma alpha 1-acid glycoprotein (oro-somucoid, ORM), alpha 2-HS-glycoprotein (A2HS) and alpha 1-B-glycoprotein (alpha 1B) were studied in a group of Parsis in Bombay, India. The frequencies of ORM1*1, ORM1*2 and ORM1*3 were found to be 0.636, 0.356 and 0.008, respectively. A2HS*1, A2HS*2 and A2HS*3 frequencies were 0.855, 0.135 and 0.010, while the frequencies of A1B*1 and A1B*2 were 0.881 and 0.119, respectively. The phenotype distribution at all three loci was at Hardy-Weinberg equilibrium. The ORM2 locus was monomorphic in the Parsis.

MspI polymorphism of the apolipoprotein A-II gene, serum lipids and apolipoproteins in Chinese from Singapore

The effect of a DNA polymorphism (MspI) of the apolipoprotein (apo) A-II gene on serum lipid and apo levels was studied in a group of 125 healthy Chinese of both sexes. The frequency of the 3.7-kb rarer allele (M2) was found to be significantly higher in the Chinese (0.30) than in Caucasians (0.16; p < 0.025). The distribution of apo A-II genotypes was in Hardy-Weinberg equilibrium in the Chinese population. The presence of a polymorphic site (MspI) within an Alu sequence at the 3' end of the gene, the 3.0 kb (M1) allele, was associated with significantly higher levels of serum apo A-I and A-II (p < 0.05 and < 0.01, respectively). Serum high-density Lipoprotein cholesterol levels were also correspondingly higher in individuals with M1, but did not reach a significant level. Male heterozygotes of the apo A-II polymorphism had significantly higher levels of serum triglycerides compared to homozygotes (p < 0.05). Thus the MspI polymorphism of the apo A-II gene appears to be associated with altered levels of lipids and apos in the Chinese population.

Biochemical characteristics of glucose-6-phosphate dehydrogenase variants among the Malays of Singapore with report of a new non-deficient (GdSingapore) and three deficient variants

Biochemical characteristics of one non-deficient fast G6PD variant (GdSingapore) and six different deficient variants (three new, two Mahidol, one each of Indonesian and Mediterranean) were studied among the Malays of Singapore. The GdSingapore variant had normal enzyme activity (82%) and fast electrophoretic mobilities (140% in TEB buffer, 160% in phosphate and 140% in Tris-HCl buffer systems respectively). This variant is further characterized by normal Km for G6P; utilization of analogues (Gal6P, 2dG6P; dAmNADP), heat stability and pH optimum. The other six deficient G6PD variants had normal electrophoretic mobility in TEB buffer with enzyme activities ranging from 1 to 12% of GdB+. The biochemical characteristics identity them to be 2 Mahidol, 1 Indonesian and 1 Mediterranean variants and three new deficient variants.

Influence of serum paraoxonase polymorphism on serum lipids and apolipoproteins

One hundred and sixty-three healthy Chinese subjects of both sexes were studied for serum paraoxonase (PON) polymorphism, and levels of lipids and apolipoproteins in order to examine effects of PON alleles on these parameters. The level of serum triglyceride was significantly higher in high activity allele (PON*B) compared with that in low activity allele (PON*A) in both sexes (P less than 0.01). The subjects with PON A had significantly higher LDL cholesterol (P less than 0.05) and lower Apo A-II and ApoB levels. The influence of serum paraoxonase on serum lipids was estimated further by Spearman's rank correlation. In the males, there was a significant negative correlation of serum paraoxonase activity with total (P less than 0.05) and LDL (P less than 0.01) cholesterol levels, and positive correlation with HDL cholesterol and Apo A-II levels (P less than 0.05). Serum paraoxonase activity had a high positive correlation with serum triglyceride levels in both sexes (P less than 0.001). Serum ApoB level had a positive correlation with the enzyme activity only in females (P less than 0.01). The allelic effect of PON on these parameters was studied by multiple regression analysis. The high activity allele (PON*B) was associated with higher serum triglyceride level (P less than 0.001) and ApoB (P less than 0.001), while it had lowering influence on total cholesterol (P less than 0.05) and LDL cholesterol (P less than 0.005) in men. The average allelic effect of PON was found to be about 22% for serum triglycerides, 11% for LDL cholesterol, 14% for Apo A-II and 19% for Apo B in the present study. This study suggests a possible significant role of serum paraoxonase alleles in the metabolism of serum lipids and apolipoproteins.

Assessment of ventricular septal defect by colour flow mapping

The purpose of this study was to evaluate the usefulness of colour flow mapping (CFM) in the diagnosis and classification of congenital ventricular septal defect (VSD) and in the confirmation of spontaneous and surgical closure. Between August 1988 and March 1990, a total of 102 patients with isolated VSD (82 preoperative and 20 postoperative), age ranging from one day to 14 years, were subjected to 176 echocardiographic examinations. Sequential cross sectional imaging and CFM were the main modalities of assessment with conventional Doppler interrogation for quantitative measurements. In the preoperative group, there were 56 (68.3%) perimembranous (pm) VSD, 14 (17.1%) muscular (m) VSD and 12 (14.6%) doubly committed subarterial (dcsa) VSD. Ventricular septal defect was detected by CFM only in 88.9% of m/VSD, 57.6% of dcsa/VSD and 11.8% of pm/VSD (p less than 0.01). Spontaneous closure rate was highest in m/VSD (28.6%) followed by pm/VSD (8.9%) (p = 0.05). None of the dcsa/VSD closed as assessed by CFM. In the postoperative group, CFM served to quickly confirm complete closure without residual left to right shunt in 20 patients. In addition, CFM was useful in the assessment of haemodynamics and flow directed Doppler interrogation. Hence, CFM is a useful adjunct to cross sectional imaging in the assessment of children with isolated VSD.

Serum paraoxonase polymorphism in three populations of southeast Asia

Serum paraoxonase hydrolyzes paraoxon, the principal metabolite of the insecticide parathion. Serum paraoxonase is polymorphic and controlled by two codominant alleles - PON*A and PON*B representing low and high activity, respectively. Three populations of southeast Asia comprising 194 Chinese, 159 Filipinos and 73 Dravidian Indians were investigated for serum paraoxonase polymorphism. The frequency of PON*B was found to be 0.14 in the Chinese, 0.04 in the Filipinos and 0.18 in Dravidian Indians. The distribution of the PON phenotypes was at Hardy-Weinberg equilibrium in all the three populations studied.

Red cell glucose-6-phosphate dehydrogenase phenotypes in several Mongoloid populations of eastern India: existence of a non-deficient fast variant in two Australasian tribes

A total of 954 subjects of both sexes from nine Mongoloid tribes of eastern India were investigated for the distribution of red cell glucose-6-phosphate dehydrogenase (G6PD) phenotypes by starch-gel electrophoresis. The incidence of Gd- was found to be 8% in the Khasi, 6% in the Nishi, 5% in Apatani and 3% in Adi. The small group of Bodo and the mixed group of other Arunachal tribes had Gd- frequencies of 19% and 15%, respectively. Only one isolated incidence of Gd- was encountered in the Naga, while the Hmar lacked Gd-. The Khasi had a polymorphic frequency (about 4%) of a non-deficient fast variant (GdV) (105% mobility in TEB buffer of pH 8.6). Two heterozygotes of this allele with a combination of common GdB+ were detected in two females. Interestingly, the same allele was reported earlier in another Australasian tribe--the Korkus of central India.

Acute glomerulonephritis--changing patterns in Singapore children

This study compared the pattern of acute glomerulonephritis (AGN), a disease known to be influenced by socioeconomic and environmental factors, in children 12 years and under, for the years 1971 and 1985. All children admitted to the four major paediatric departments with haematuria and at least two of the following (oedema, hypertension or oliguria) had an initial diagnosis of AGN. A sample population from one unit from 1980 to 1984 showed that over 70% of these children had evidence of a post-streptococcal aetiology. In 1971, 411 children were admitted with AGN, as compared with only 58 in 1985. The age-sex-race standardized rates for 1971 and 1985 were 0.632 and 0.023/1,000 children 12 years and under, respectively (P less than 0.001). The mean age of presentation was lower in 1971. Over this period, Singapore saw a threefold rise in the gross national product, accompanied by rapid urbanization. On analysis of the housing pattern, only 31% of the children lived in high-rise apartments in 1971, in contrast with 86% in 1985 (P less than 0.001). The majority of non-apartment dwellers had homes in rural districts. From an epidemiological perspective, factors which could have led to the highly significant decline in prevalence of AGN in Singapore children included improvement in the socioeconomic status and health care system, and urbanization of the country.

The distribution of some serum protein and red cell enzyme polymorphisms in the Koch ethnic group of West Bengal, India

Three populations (Poliya, Deshi, and Tiyor) of the Koch ethnic group have been studied for the distribution of three serum protein and four red cell enzyme polymorphisms. There was no significant difference in the allelic frequencies of these systems in the three populations of the Koch ethnic group. The overall gene frequencies were as follows: Hp1, 0.21; Gc1F, 0.34; Gc1S, 0.36; Gc2, 0.30; TfC1, 0.66; TfC2, 0.26; TfC3, 0.001; TfD, 0.06; GLO1, 0.21; PGI2, 0.04; AK2, 0.01; PGM1+, 0.80; PGM1-, 0.06; PGM2+, 0.11 and PGM2-, 0.02. The phenotypic distribution at all the loci was at Hardy-Weinberg equilibrium.

Genetic studies among the Nagas and Hmars of eastern India

A total of 148 Nagas (65 urban and 83 rural) and 81 Hmars from northeastern India were tested for 15 blood genetic markers. Both the Nagas and Hmars lacked haemoglobin variants and G6PD deficiency and had a high frequency of PGDC. This may be attributed to selective pressures operating at these loci. Genetic distance estimates using 41 alleles at 11 polymorphic loci showed appreciable heterogeneity between the urban and rural Nagas that were in line with the differences in gene frequencies. Considerable genetic admixture of the urban Nagas from the Hmar and other neighbouring populations is evident. The Nagas were found to be quite distant from the mainland Han Chinese and Malays as well as from the Bengalis and Oraons. However, they appear to be related to the Hmar and Lepcha. Evidence supporting the ethnohistoric origin of the Nagas from China or the South Seas is lacking.

Restriction fragment length polymorphism (RFLP) at the DNF15S2 locus in three ethnic groups of Singapore

Three different ethnic groups from Singapore comprising 79 Chinese, 34 Malays and 23 Indians of Dravidian origin, were investigated for the HindIII RFLP at the DNF15S2 locus. The three populations had very similar allele frequencies and the frequency of rarer(S) allele was significantly (p less than 0.01) lower (0.21) in these ethnic groups compared to that in Caucasians (0.41). The phenotypic distributions were at Hardy-Weinberg equilibrium.

Percutaneous transluminal balloon valvuloplasty: the treatment of choice for congenital valvar pulmonary stenosis

Forty-eight children with suspected isolated pulmonary valvar stenosis were evaluated clinically and echocardiographically between January 1987 and December 1988. Fourteen patients with significant transpulmonary peak systolic pressure gradient greater than 30 mmHg on continuous-wave Doppler interrogation were subjected to right heart catheterisation. Percutaneous transluminal balloon valvuloplasty was performed in 11 of these patients with peak systolic pressure gradient than 40 mmHg across the pulmonary valve at cardiac catheterisation. Satisfactory reduction of systolic right ventricular pressure (110 +/- 43 to 46 +/- 17 mmHg, p less than 0.001) and peak systolic pressure gradient across pulmonary valve (92 +/- 44 to 27 +/- 16 mmHg, p less than 0.001), were achieved in all cases. The reduction of peak systolic pressure gradient (64 +/- 37 mmHg, range = 29-158 mmHg), was positively correlated with the initial right ventricular systolic pressure (r = 0.92, p less than 0.0002). There was no significant complication in this series and all patients were discharged the day after the procedure. Percutaneous transluminal balloon valvuloplasty is effective and safe. It should be the treatment of choice for significant valvar pulmonary stenosis in children.

Transferrin subtypes and spontaneous abortion in a Chinese population

A series of Chinese newborns of consecutive normal vaginal deliveries were investigated for the distribution of serum transferrin subtypes by polyacrylamide gel iso-electric focusing at pH 3.5-9.5. Newborns whose mothers had a history of previous spontaneous abortion (n = 189) had a significantly higher frequency of the C2 variant and the C2 gene compared to those (n = 864) without a history of spontaneous abortion. There was no significant difference in the frequency of transferrin alleles between newborns with normal and low birth weight (n = 147).

Detection of cardiac problems among school children by health screening

A study was undertaken to assess the types of cardiac diseases and dysrhythmias in a healthy population of 651,794 school children who underwent general health screening between January 1981 to December 1986. Congenital heart lesions were diagnosed in 1159 (0.18 per cent), the majority being mitral valve prolapse (MVP; 0.08 per cent), small ventricular septal defects (VSD; 0.04 per cent), mild pulmonary stenosis (PS; 0.03 per cent), and small atrial septal defects (ASD; 0.02 per cent). Other lesions detected were patent ductus arteriosus (PDA), coarctation of aorta (CoA), Fallot's Tetralogy (FT) and total anomalous pulmonary venous drainage (TAPVD). Of these, five had surgical closure of ASD, eight and ligation of PDA, and one had correction for TAPVD. Cardiac dysrhythmias were seen in 350 patients; consisting of premature ventricular contractions (PVC) in 186, right bundle branch block (RBBB) in 132, atrial ectopics (AE) in 17, sinus node dysfunction in five, atrioventricular (AV) block in seven, Wolff-Parkinson-White (WPW) syndrome in two, and paroxysmal atrial tachycardia (PAT) in one boy. Associated congenital heart lesions were found in 110 patients. The cardiac screening programme has resulted in a significant detection of cardiac abnormalities among apparently healthy school children. Early detection of cardiac disease has resulted in early remedial measures to be taken and thus improved cardiological care.

Kawasaki syndrome in Chinese children

A retrospective analysis of the clinical features and outcome of 39 Chinese children with Kawasaki syndrome was made. The mean age of onset was 2.7 years (range: 0.2-13 years). The male:female ratio was 2.9:1. One child presented with nephrotic syndrome. This renal manifestation has not been described in Kawasaki disease. Ten (32%) out of 31 patients were found to have coronary aneurysms by cross-sectional echocardiography. The only significant risk factor detected in this group of patients was anaemia (P less than 0.007). There was one (2.5%) death from acute myocardial infarction and the rest of the patients were clinically well with a mean follow-up period of 1 year (mean: 5-40 days). This study indicates that there is a high incidence of coronary aneurysm complicating Kawasaki syndrome in Chinese comparable with that reported in Japanese children.

Inbreeding effects on average heterozygosity in the Sudan

In the first series, the average heterozygosity based on ten polymorphic loci (Rhesus, MN, P, and Kell blood groups; haemoglobin; serum haptoglobin; transferrin; red cell acid phosphatase, phosphoglucomutase-1 and glyoxalase-1) was determined among the offspring of unrelated (n = 328) and related (first-cousin) matings (n = 466) in the Sudan. The estimated average heterozygosity was found to be the same in the offspring of the first-cousin and unrelated parents (0.3628 +/- 0.0584 and 0.3697 +/- 0.0581, respectively). In the second series, the average heterozygosity at five polymorphic loci (Rhesus blood group, haemoglobin, serum haptoglobin and transferrin and red cell acid phosphatase) was estimated in several tribes with variable levels of inbreeding coefficients. The estimated average heterozygosity varied from 0.14 +/- 0.09 to 0.37 +/- 0.08 in different tribes with varying degrees of inbreeding coefficients (alpha x 10(5) of 967-3,904). However there was no significant correlation between the level of parental inbreeding with either average heterozygosity or deviation from the Hardy-Weinberg equilibrium in the offspring.

Nephrotic syndrome in Kawasaki disease

Renal manifestations in Kawasaki disease are rare, and nephrotic syndrome in this disorder has not been described previously. We report a 3 month old infant with Kawasaki disease, presenting with nephrotic syndrome which responded to steroid therapy. The patient, however, developed coronary aneurysms and died of acute myocardial infarction.

Distribution of plasma alpha-1-B-glycoprotein phenotypes in several Mongoloid populations of East Asia

The distribution of plasma alpha 1B-glycoprotein (alpha 1B) phenotypes was determined by a simple method of two-dimensional electrophoresis followed by protein staining in a group of 1,154 individuals from 8 Mongoloid populations of East Asia. The sample comprised 581 Chinese from different localities (Singapore: 204; Taiwan: 150; Fujien and Hopeh provinces of eastern China: 146 and 81), 155 Koreans, 155 Filipinos, 152 Thais and 111 Malays. Altogether, 6 different alpha 1B phenotypes (1-1, 1-2, 2-2, 1-3, 2-3, and 1-6) were observed. The alpha 1B allele frequencies were very similar in all of the populations. The frequency of A1B*1 varied from 0.89 to 0.91 and that of A1B*2 from 0.08 to 0.10. The A1B*3 allele, reported previously only in American blacks, was observed with a frequency range of 0.003-0.01 in 3 of the Chinese populations, in Koreans and in Malays. A new alpha 1B allele (A1B*6) was observed in 2 Chinese individuals.

Pattern of glomerulonephritis in Singapore children--a renal biopsy perspective

This study was aimed at determining the pattern of glomerulonephritis (GN) in Singapore children from a histopathological perspective. Fifty-seven consecutive children, aged between 10 weeks to 16 years, who underwent a renal biopsy at the Departments of Paediatrics, National University of Singapore and Singapore General Hospital over an 8 year period were studied. The main indications for biopsy were nephrotic syndrome (67%), recurrent gross haematuria (16%), nephritic syndrome (7%), and renal failure (10%). Primary GN occurred in 81%, while secondary GN was seen in 19%, the most common being lupus nephritis. Of the primary GN, minor abnormalities was the most common (22%), followed by focal global sclerosis (20%), focal segmental glomerulosclerosis (17%), diffuse mesangial proliferative GN (11%), focal mesangial proliferative GN (9%), membranous GN (7%), diffuse endocapillary GN (4%), diffuse sclerosing GN (4%), diffuse mesangial sclerosis (4%), and diffuse crescentic GN (2%). Immunofluorescent examination was performed in 50 children. IgA nephropathy was diagnosed in 17% of the patients with primary GN. Of the children with primary nephrotic syndrome due to minimal change disease or focal global sclerosis, about half had IgM mesangial deposits. Of 47 patients who were followed up, 9 developed chronic renal failure, of which 7 reached end-stage disease (4 have died, while 3 are on chronic dialysis). Three other patients died of other complications. The histopathological findings influenced the therapeutic decision in 49% of our patients. In summary, the pattern of GN in our cohort of patients tended to reflect more severe glomerular lesions, mainly due to our criteria of selection for renal biopsy.