Three sisters who developed recurrent uterine myomata from a very young age are presented. Despite repeated attempts at myomectomy, all three cases had hysterectomies ultimately. Complications encountered during surgery were severe hemorrhage, inadvertent injury to bladder and bowel in two patients and a rare complication of colonic-uteric-cutaneous fistula occurring post-operatively in one patient. Histology of the final hysterectomy specimens in two cases showed low grade leiomyosarcoma and cellular myoma, respectively.
The mosquito, Aedes albopictus, has recently become established in a number of cities throughout the United States. An initial survey of allozyme and genotypic frequencies in U.S. populations (Black et al., 1988) revealed an extensive amount of local differentiation of populations and suggested that much genetic drift may have accompanied colonization. A study of gene flow was initiated in native habitats of Ae. albopictus in Malaysia to determine if the result observed in the U.S. was a consequence of colonization or simply followed the natural breeding structure of the species. Allelic and genotypic frequencies were monitored at ten enzymatic loci in 11 populations from peninsular Malaysia and Borneo. Multiple populations were sampled within the districts of Kuala Lumpur and Kuala Trengganu. Peninsular Malaysian and Borneo populations were strongly genetically differentiated. Allele frequencies were significantly different among and within districts in both regions. Variance in allele frequencies among all collections was partitioned into the variance among regions, districts within regions and collections within districts. Almost all of the variance within regions was attributable to local differentiation suggesting that genetic drift is an important component of the natural breeding structure of this species. This indicates that the large amounts of local differentiation found in U.S. populations was not a consequence of recent colonization.
Starch-gel electrophoretic studies on nine gene-enzyme systems comprising 14 loci revealed a fair level of genetic variation in two population samples of Anopheles maculatus from Peninsular Malaysia. The proportion of polymorphic loci was 0.36 for the Fort Bertau sample and 0.29 for the Gua Musang sample, while the mean heterozygosity value was 0.09 for Fort Bertau and 0.07 for Gua Musang. The values of genetic similarity (I = 0.98) and genetic distance (D = 0.02) were of the rank of geographical populations.
Until recently, very little was known of Anopheles species complexes and their relationships to epidemiology and malaria transmission in Southeast Asia. During the past eight years, extensive studies on the genetics of natural populations of anopheline mosquitoes in this region, involving the interdisciplinary efforts of taxonomists, operational entomologists and biologists, have revealed groups of cryptic species of Anopheles vectors, particularly the An. leucos phyrus group. This species group comprise seventeen species and two subspecies widely distributed in the forested areas of Southeast Asia. Among these species. An. dirus Peyton and Harrison, has been shown by cytogenetic and morphological studies to be a complex of at least seven isomorphic species, provisionally designated species A, B, C, D, E, F and takasagoensis, on the Southeast Asian mainland. Cytological identification of these species is based on distinct banding patterns of salivary gland polytene chromosomes as well as heterochromatin differences in mitotic karyotypes. The five species found in Thailand (A-D, F) exhibit distinct geographic distributions. Species A is widespread throughout Thailand except in the south. Species B had been found in sympatry with species C in southern Thailand and both seem to show north-south clinal geographic variation. Species D is common on the west side of southern Thailand and along the Thai-Burmese border in sympatry with species A. Species F, An. nemophilous Peyton and Ramalingam, has been found in a population at the Thai-Malaysian border in this study although it was known to be common in southern and western Thailand and Peninsular Malaysia. Species E is known only from western India. The five species found in Thailand also exhibit seasonal variation in relative abundance and different nocturnal biting cycles. Chromosomal polymorphisms have been observed in mitotic and polytene chromosomes of An. dirus A and D. Species B and C also show heterochromatin variation in the sex chromosomes, but are monomorphic for the standard sequence in polytene chromosomes. These biological characteristics of the An. dirus complex may have implications for understanding the epidemiology of malaria in Southeast Asia. Recent cytogenetic studies of wild-caught samples of An. leucosphyrus from Sumatra, Kalimantan and southern Thailand have revealed the presence of two distinct species within this taxon. Species A is widely distributed in southern Thailand, East Malaysia and Kalimantan, while species B is confined to Sumatra. The two isomorphic species are vectors of human malaria within their range of distribution.(ABSTRACT TRUNCATED AT 400 WORDS)
Two separate observations from recent electrophoretic studies of the systematics and population genetics of laboratory-reared populations which had a long history of colonization in various laboratories, were found to be inconsistent with the present study which used wild-caught populations from East Malaysia. Reanalysis of the two data sets generally indicated a low amount of genetic variation in laboratory colonies. The latter is characterized by higher frequency of monomorphic loci, low average heterozygosity values and, in one extreme case, no variability at two loci. However, natural populations of An. balabacensis and An. leucosphyrus showed more protein variability by the use of polyacrylamide gel electrophoresis. Since laboratory-maintained mosquitoes are genetically and phenotypically different from those in the field, results of laboratory studies on the systematics and population genetics of Anopheles species complexes may be biased.
Genetic polymorphism of the 'X'-protein in red cells from Malaysian Katjang goats was demonstrated by starch gel electrophoresis at pH 7.3. Two new phenotypes were observed, suggesting that one new allele is involved. A new nomenclature for the 'X'-protein system in goats is proposed.
Thirteen strains of dengue type 1 were isolated from the lymphocyte fractions of 69 acute phase blood samples collected at Thursday Island Hospital during 1981 and 1982. One further strain of type 1 was isolated from 7 blood samples despatched by air from Cairns Base Hospital during 1982. Four of these Australian isolates representing the beginning, middle, and end of the epidemic were examined by restriction enzyme mapping and were found to be identical for the nine restriction enzymes used. The maps differed from those derived from two Malaysian dengue type 1 strains isolated during the epidemic of 1981-82 in that country. This suggests reliance on serological typing to establish global circulation patterns of epidemic dengue is insufficient and that more specific methods such as genome mapping are useful.
Clinical studies were carried out on mild Indian sickle cell anaemia in Malaysia, and genetic and fertility studies were carried out on 101 families with and without sickle-cell haemoglobin (Hb S). The Indian sickle cell anaemia patients reached adulthood, and pregnancies and deliveries were uneventful without blood transfusion. There was no foetal wastage and the number of children produced was not significantly different from that in families without Hb S. 28 Indian patients hospitalized with Plasmodium falciparum malaria infection were also examined for their beta S genotype. P. falciparum malaria infection occurred much more frequently in individuals without Hb S than in Hb S carriers.
The activities of membrane marker enzymes in normal (3T3) and simian virus transformed mouse cells (SV3T3) are affected not only by densities of cultures but also by the sera types used in the growth media. We have assayed the levels of 5'nucleotidase, monoamine oxidase and rotenone insensitive NADH ferricyanide reductase in these cells grown to sparse and confluent cultures in medium supplemented with 10% newborn calf serum (n.c.s.) or in medium supplemented with 10% foetal bovine serum (f.b.s.). It was found that in 3T3 cells grown in 10% f.b.s. the transition from sparse to confluent cultures was associated with a reduction in the activities of the marker enzymes while in those grown in 10% n.c.s., the activities of these enzymes increased. In the SV3T3 cells, the activities of all the enzymes except for monoamine oxidase decreased from sparse to confluent culture densities in cells grown in 10% n.c.s. whereas in those grown in 10% f.b.s. there were no significant change in the activities of the enzymes over the same culture densities. The results suggest that the marker enzymes are affected by sera types and culture densities.
The clinical spectrum of HbH disease varies from a benign disorder to a severe anemia which is blood-transfusion dependent. Heterogeneity at the clinical level is now being understood in terms of the underlying molecular defects. In this study a mild phenotype found in a group of patients with HbH disease is associated with two types of alpha-thalassemia. These are: alpha+-thalassemia (-alpha 3.7/) and alpha 0-thalassemia (--SEA/). In contrast, a second group with more severe HbH disease has a non-deletional alpha-thalassemia defect instead of alpha+-thalassemia (genotype alpha alpha T/--SEA). In the majority of cases, the basis for non-deletional alpha-thalassemia is Hb Constant Spring.
The distribution of group-specific component (Gc) subtypes was determined by isoelectric focussing in thin layer polyacrylamide gels of pH range 4 to 6.5, in a group of 2412 individuals from 10 Mongoloid populations of East Asia. The sample comprised 959 Chinese from different localities (Singapore, 249; Malaysia, 347; Taiwan, 246; Hong Kong, 57; Fuzhou mainland, 60), 338 Koreans, 277 Filipinos, 484 Thais, 330 Malays and 24 Indonesians. The Filipinos and Malays had lower frequencies of Gc2 (0.15 and 0.18) compared to other Mongoloid populations (0.23 to 0.32) and the Chinese (0.24 to 0.32). The frequencies of Gc1F varied from 0.39 to 0.49 in the Chinese and 0.35 to 0.52 in other Mongoloid populations. Low frequency of rarer variants was observed in most of the populations. The average frequency of Gc2 was higher in the Japanese (0.26 +/- 0.01) than in the Chinese (0.24 +/- 0.02), and in Mongoloids of East Asia (0.23 +/- 0.01) and South-East Asia (0.17 +/- 0.01). The average frequencies of Gc1F and Gc1S were similar in the Chinese and Japanese, whereas the Mongoloids of South-East Asia had a much higher frequency of Gc1F and a lower frequency of Gc1S than the Chinese, Japanese and East Asian Mongoloid populations.
Glutathione S-transferases (GST; E.C.2.5.1.18) were phenotyped by starch gel electrophoresis in post-mortem liver samples from 683 unrelated subjects of both sexes. 305 were Chinese, 185 Indians, 147 Malays and 46 from other racial groups of South-East Asia. GST1 and GST2 were found to be polymorphic in these populations. Additional alleles (GST1*3 and GST2*O) were observed at low frequency in all the ethnic groups. The frequency of GST1*1 was lower and that of GST1*2 was higher in Indians and Malays as compared to Chinese. GST1*0 and GST1*3 frequencies were similar in all these ethnic groups. The gene frequencies of the alleles of the GST2 locus varied significantly in the population studied. GST2*0 frequency was significantly higher in Indians than in Chinese and Malays, while the lowest frequency of GST2*1 was found in the Indians. GST2*2 frequency was higher in the Malays than in Chinese and Indians. GST1 and GST2 phenotype distributions were in agreement with Hardy-Weinberg equilibrium in all the ethnic groups studied. Sex made no significant difference in the phenotype distribution.
An analysis of rotavirus electropherotypes circulating in Kuala Lumpur, Malaysia, over 7 years showed that all except 1 of the 360 electropherotypes encountered were characteristic of group A rotaviruses. The long electropherotype predominated annually, and there was a rarity of short electropherotypes. Extensive genome variability and cocirculation of different electropherotypes were observed annually. A sequential appearance of the predominant electropherotype was observed in all years of the study, except for 1985 and 1988, when one electropherotype predominated throughout the study periods. There was no shift in the predominant electropherotype over a 6-year period.
This study concerned the identification of the beta-thalassaemia mutations that were present in 27 Malay patients with Hb E-beta-thalassaemia and seven Malay patients with thalassaemia major who were from West Malaysia. Nearly 50% of all beta-thalassaemia chromosomes carried the G----C substitution at nucleotide 5 of IVS-I; the commonly occurring Chinese anomalies such as the frameshift at codons 41 and 42, the nonsense mutation A----T at codon 17, the A----G substitution at position -28 of the promoter region, and the C----T substitution at position 654 of the second intron, were rare or absent. Two new thalassaemia mutations were discovered. The first involves a frameshift at codon 35 (-C) that was found in two patients with Hb E-beta zero-thalassaemia and causes a beta zero-thalassaemia because a stop codon is present at codon 60. The second is an AAC----AGC mutation in codon 19 that was present on six chromosomes. This substitution results in the production of an abnormal beta chain (beta-Malay) that has an Asn----Ser substitution at position beta 19. Hb Malay is a 'Hb Knossos-like' beta +-thalassaemia abnormality; the A----G mutation at codon 19 likely creates an alternate splicing site between codons 17 and 18, reducing the efficiency of the normal donor splice site at IVS-I to about 60%.
Forty-six Malaysian patients with chronic granulocytic leukaemia were found to be rearranged in the breakpoint cluster region (BCR) of chromosome 22, molecular evidence of Philadelphia chromosome (t9.22) translocation. Through the use of a 1.2 kb 3' BCR probe and two restriction enzyme digests, patients' breakpoints could be localized either to 5' or 3' regions of the BCR. Breakpoint site localization at the time of DNA sampling did not show any positive statistical association to clinical status defined as chronic phase, chronic phase with less than 6 months to blast crisis, accelerated phase and blast crisis. This was in contrast to earlier reports which indicated that patients with breakpoint at 3' site were at a higher biologic risk for entering blast crisis.
In this paper, urolithiasis is remarked from the standpoint of descriptive epidemiology, which examines the frequency distribution of a given disease in a population in terms of time, place and personal characteristics with an aim of identifying risk factors or some clues to the etiology. Some descriptive epidemiological features of urolithiasis are summarized. Prevalence rate is around 4% (4-15% in males and 4-8% in females), and incidence rate varies from area to area: 53.2 per 100,000 population in 1975 in Japan, 364 in 1976 in Malaysia, and 540 in 1979 in West Germany. Prevalence and/or incidence rates have, in general, increased in the developed countries since World War II and in the developing countries as well, where upward trends are quite analogous to the trends observed in the nineteenth century in Europe. Recurrence rate, which is much higher in males than in females, ranges from 31% to 75%, depending on the follow-up periods. In the industrialized countries, upper urinary (renal and ureteral) stones account for more than 90% of total stones, which are ordinarily calcium complexes in composition. More common in the developing countries are lower urinary (bladder and urethral) stones, frequently composed of magnesium ammonium phosphate, which indicates a close association with urinary tract infections. Variations in frequency are evident by season and by region within a country. Age and sex differentials in urinary stone formers are substantial: more common in males 30-40 years old in the industrialized countries and in children under 10 years old in the developing countries. Racial differentials are also noted; blacks appear to suffer less frequently than whites. Stone formers experience more frequent episodes of stone formation in their family members, particularly father and brothers, than non-stone formers. These findings on racial differentials and family preponderance suggest the possible relevance of genetic factors in stone formation. Stone formers are more likely to be occupationally sedentary and socially affluent. This observation and differentials by age and sex suggest the probable relevance of lifestyle and environmental factors in stone formation. Epidemiological factors incriminated for stone formation will be discussed in a separate paper.