Tay Js

Use of interlocking detachable coils in embolization of coronary arteriovenous fistulas

Thirteen patients underwent transcatheter closure of coronary artery fistulas using interlocking detachable coils alone or combined with fibered coils. Complete occlusion was achieved in 92% of patients; although inadvertent embolization of coils occurred in 23% of patients, all these coils were easily retrieved using snares.

Association of factor VII genotype with plasma factor VII activity and antigen levels in healthy Indian adults and interaction with triglycerides.

Plasma factor VII activity (factor VIIc) is one of the independent risk factors for coronary artery disease and is controlled by both genetic and environmental factors. Several studies in healthy Caucasian subjects have revealed an association of a common genetic polymorphism at residue 353 (Arg-->Gln) of the factor VII gene with plasma factor VIIc. We have investigated the influence of this polymorphism (factor VII Arg/Gln353) on fasting plasma factor VIIc and antigen (factor VIIag) levels and its interaction with triglyceride levels in 185 healthy Dravidian Indians of both sexes (128 men, 57 women). The frequency of Gln353 has been found to be significantly higher in Dravidian Indians (0.29; confidence interval, 0.27 to 0.30) than in Caucasians (0.10). The distribution of factor VII Arg/Gln353 genotypes was at Hardy-Weinberg equilibrium. The carriers of the Gln353 allele had significantly lower plasma factor VIIc and factor VIIag in men (P < .05). The factor VII Arg/Gln353 polymorphism explained 13% and 11% of the total variance of plasma factor VIIc and factor VIIag, respectively, in men (P < .001) and 6% and 9% in women (P > .1). The genotype-specific correlation of factor VIIc and factor VIIag with triglyceride levels was stronger in carriers of the Gln353 allele (r = .38 and .41; P < .001) than in Arg353 homozygotes (r = .09 and .27; P = .19 and .005, respectively).

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<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<0.001). The majority of non-apartment dwellers had homes in runal 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.

Influence of apolipoprotein B signal peptide insertion/deletion polymorphism on serum lipids and apolipoproteins in a Chinese population

Saha N, Tay JSH, Chew LS. Influence of apolipoprotein B signal peptide insertion/deletion polymorphism on serum lipids and apolipoproteins in a Chinese population. Clin Genet 1992:41: 152–156.

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).

Racial Variation of Cord Plasma Lipoprotein(a) Levels in Relation to Coronary Risk Level: A Study in Three Ethnic Groups in Singapore

Lipoprotein(a) [Lp(a)] is recognized as an independent risk factor for atherosclerosis. Studies have also shown that there are racial differences in the Lp(a) profile. The multiracial population of Singapore has demonstrated a differential prevalence of coronary artery disease, which is concordant with the plasma Lp(a) profile in the adult populations of Singapore. The level of Lp(a) is under strict genetic control, and its plasma concentration is determined significantly by inheritance. Expression of the racial profile of Lp(a) at birth was studied in the cord blood of 542 male and 468 female newborns from three ethnic groups of Singapore using the sandwich-ELISA. The Lp(a) levels were then related to the coronary risk levels of their respective adult populations. Lp(a) levels in Singapore newborns were found to be independent of the infants birth weight and sex but were significantly influenced by race. Indian newborns had significantly higher plasma levels of Lp(a). Chinese newborns had the lowest Lp(a) levels at birth. The ranking of Lp(a) levels at birth was concordant with the relative coronary mortality rates for the respective adult populations of Singapore. Racial differences in plasma Lp(a) levels are present and expressed at birth.

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.

Interrelationships of Serum Paraoxonase, Serum Lipids and Apolipoproteins in Normal Pregnancy

Serum paraoxonase (EC 3.1.1.2) may be implicated in the lipid metabolism. In order to substantiate this view we conducted a longitudinal study of interrelationships of serum paraxonase, lipids and apolipoproteins during pregnancy. Fasting serum levels of paraoxonase, serum lipids (total, HDL and LDL cholesterols, triglycerides) and apolipoproteins (AI, AII and B) were estimated in 91 pregnant women at 28 and 32 weeks of gestation and 6 weeks after delivery, and 40 nonpregnant women. Serum paraoxonase, total HDL and LDL cholesterol levels were significantly higher during pregnancy along with corresponding apolipoprotein (p < 0.001). The most striking increase was seen in serum triglycerides and paraoxonase levels (p < 0.001). Serum paraoxonase levels had a significant correlation with triglycerides (r: 0.45-0.60) and Apo-AII (r: 0.32-0.41) in both pregnant and nonpregnant states (p < 0.001). Moreover, both serum paraoxonase and triglyceride levels at 28 weeks of pregnancy were negatively correlated with birth weight (r: 0.3, p < 0.05), suggesting a possible role of paraoxonase in energy delivery for fetal development derived from maternal hypertriglyceridemia.

Association of haptoglobin types with serum lipids and apolipoproteins in a Chinese population

Association of haptoglobin types with serum lipids and apolipoprotein levels was investigated in a healthy Chinese population of both sexes (n= 679) in Singapore. The frequency of Hp1 and Hp2 was found to be 0.30 and 0.70, respectively. The distribution of haptoglobin phenotypes was at Hardy‐Weinberg equilibrium in this population. There was an excess of Hp2 in individuals with the upper two quartiles of serum total cholesterol levels compared to those with the lower two quartiles in both sexes (X12: 11.84; P < 0.001). Subjects with Hp 2–2 had significantly higher serum total and LDL cholesterol levels (243.8 ± 2.83 and 165.9 ± 2.48 mg/dl) compared to those in other haptoglobin types (230.7 ± 2.58 and 154.9 ± 2.49 mg/dl), respectively (P < 0.001 and 0.002) after adjustments for age, sex and BMI. No other lipid (HDL cholesterol and triglyceride) and apolipoprotein (apo A‐I, A‐II and B) traits were associated with haptoglobin types. ANOVA statistics using age, sex and BMI as covariates showed that 1.8% of total variability of serum total cholesterol and 2.1% of serum LDL cholesterol could be explained by haptoglobin types (P 0.008 and 0.003, respectively). It is concluded that haptoglobin polymorphism is significantly associated with serum total and LDL cholesterol levels in this Chinese population.

Transcatheter embolization of coronary artery fistula with controlled release coils

ABSTRACT The treatment for large congenital coronary cameral fistulas has been surgical but with advances in interventional catheterization techniques transcatheter embolization of these fistulas with coils or detachable balloons is now possible. This report describes occlusion of a congenital coronary arteriovenous fistula in a 6‐year‐old girl.