\set{final}

\def\Author{Small} 
\def\author{small} 
\def\vol{5} 
\def\year{1999}
\def\page{38} 
\def\txt_title{North Carolina macular dystrophy (MCDR1) locus: A fine resolution genetic map and haplotype analysis}
\def\txt_authors{Kent W. Small, Nitin Udar, Svetlana Yelchits, Ronald Klein, Charlie Garcia, Guillermo Gallardo, Bernard Puech, Virginie Puech, David Saperstein, Jennifer Lim, Julia Haller, Christina Flaxel, Rosemary Kelsell, David Hunt, Kevin Evans, Felicia Lennon, Margaret Pericak-Vance}

\def\rcvd{26 February 1999} 
\def\accept{27 December 1999} 
\def\publ{29 December 1999} 
\def\pdfsize{} 
\def\PMID{}

\include{mvstyle.hsm}

\| External links

\def\medgen{http://www2.mc.duke.edu/depts/medicine/medgen/}
\def\sanger{http://www.sanger.ac.uk/HGP/Chr6/}
\def\marshmed{http://www.marshmed.org/genetics}
\def\homog{http://linkage.rockefeller.edu/index.html}

\| Internal defs

\article{

\title{North Carolina macular dystrophy (MCDR1) locus: A fine resolution
genetic map and haplotype analysis}

\authors{\mailto{small@jsei.ucla.edu}{Kent W. Small},\sup{1} Nitin
Udar,\sup{1} Svetlana Yelchits,\sup{1} Ronald Klein,\sup{2} Charlie
Garcia,\sup{3} Guillermo Gallardo,\sup{3} Bernard Puech,\sup{4} Virginie
Puech,\sup{4} David Saperstein,\sup{5} Jennifer Lim,\sup{5} Julia
Haller,\sup{6} Christina Flaxel,\sup{7} Rosemary Kelsell,\sup{8} David
Hunt,\sup{8} Kevin Evans,\sup{8} Felicia Lennon,\sup{9} Margaret
Pericak-Vance\sup{9}}

\institutions{\sup{1}Department of Ophthalmology, the Jules Stein Eye
Institute, University of California, Los Angeles, CA; \sup{2}University
of Wisconsin; \sup{3}University of Texas, Houston, TX; \sup{4}Centre
Hospitalier Regional Universitaire de Lille, France; \sup{5}Emory Eye
Center, Emory University, Atlanta, GA; \sup{6}Wilmer Eye Institute,
Johns Hopkins University, Baltimore, MD; \sup{7}University of West
Virginia, Morgantown, WV; \sup{8}Department of Molecular Genetics,
Institute of Ophthalmology, University College London, London, UK;
\sup{9}Section of Medical Genetics, Duke University Medical Center,
Durham, NC}

\correspondence{Kent W. Small, M.D., 200 Stein Plaza, UCLA, Los Angeles,
CA, 90095; Phone: (310) 206-7475; FAX: (310) 794-7904; email:
\mailto{small@jsei.ucla.edu}{small@jsei.ucla.edu}}

\abstract

\abs_purpose{We previously reported linkage of North Carolina macular
dystrophy in a single isolated family to a broad region on chromosome
6q16. In order to refine the localization of the MCDR1 gene (North
Carolina macular dystrophy), additional families with this disease and
new markers were studied.}

\abs_methods{We ascertained 10 families with the North Carolina macular
dystrophy phenotype (MCDR1). These families were of various ethnic and
geographic origins such as Caucasian, Mayan Indian, African-American,
French, British, German, and American of European decent. Two hundred
thirty-two individuals in these families underwent comprehensive
ophthalmic examinations and blood was collected for genotyping. One
hundred seventeen were found to be affected. Linkage simulation studies
were performed. Two-point linkage, haplotype analysis, and multipoint
linkage was performed using VITESSE and FASTLINK. HOMOG was used to test
for genetic heterogeneity.}

\abs_results{The clinical features were consistent with the diagnosis of
North Carolina macular dystrophy in all families. Multipoint linkage
analysis indicates that the MCDR1 gene is in the interval between D6D249
and D6S1671 with a maximum LOD score of 41.52. There was no evidence of
genetic heterogeneity among the families studied. Families 765, 768,
772, 1193, and 1292 shared the same chromosomal haplotype in this
region.}

\abs_conclusions{This is the largest single data set of families with
the MCDR1 phenotype. The single large family from North Carolina
continues to be informative for the closest flanking markers and alone
supports the minimal candidate region as suggested by previous studies.
There remains no evidence of genetic heterogeneity in this disease. Most
of the American families appear to have descended from the same
ancestral mutation. The remaining families could each represent
independent origins of the mutation in the MCDR1 gene.}

\introduction

\p{North Carolina macular dystrophy is an autosomal dominant inherited
trait consisting of congenital or infantile onset of a macular
degeneration that tends to not progress [1-11]. The fundus appearance
can vary considerably between individuals even within the same family.
Approximately a third of affected individuals have normal vision with
only drusen centrally (20/20 - 20/25). Approximately a third have the
appearance of confluent drusen moderate impairment of central vision
(20/20-20/40) and a third have colobomatous-appearing or
disciform-appearing lesions with moderate impairment if central vision
(20/40-20/800). The original report of this disease by Lefler,
Wadsworth, and Sidbury described the descendants of a large family that
had settled in the mountains of North Carolina in the 1800s [2]. This
report called the disease "dominant macular degeneration and
aminoaciduria." A subsequent report of the same family by Frank and
associates revealed that the aminoaciduria was in fact unrelated to the
macular degeneration and renamed the disease "dominant progressive
foveal dystrophy" [3]. Subsequently, families with "central areolar
pigment epithelial dystrophy" and "autosomal dominant central pigment
epithelial and choroidal degeneration" were shown to be descendents of
the original North Carolina family [5,6,8-10]. These early studies were
limited by the size of the ascertained families. The diverse names given
this one disease reflect in part, the wide phenotypic variability.}

\p{The disease-causing gene was linked to chromosome 6q16 by Small and
associates [12]. The Human Genome Organization named this disease locus
MCDR1 (MC = macular, D = dystrophy, R = retinal, 1 = first macular
degeneration genetically mapped). Originally, the markers linked to
MCDR1 were crudely localized, were all centromeric to the gene and were
in an area of the human genome where no other markers were available for
20 cM. The only subsequent report of linkage studies in the original
North Carolina family defined the telomeric cross at marker D6S283
[13].}

\p{Linkage studies in newly reported families have been reported by
Small et al. and others and have narrowed the interval [14-18]. A family
(1463) studied by Rabb and Small et al. from Belize, Central America,
showed linkage to the region flanked by D6S501 centromerically and
D6S475 telomerically [16]. Studies by Small et al. in a Texan family
(768) found linkage to the region flanked by D6S492 and D6S468 [14]. A
family from the United Kingdom with the MCDR1 phenotype defined the
critical region flanked by D6S251 and D6S468 [18]. In Germany 3 families
were reported with the MCDR1 phenotype and were found to share a common
haplotype flanked by the markers D6S249 and D6S475 [17]. Small et al.
studied a family with the MCDR1 phenotype from France (769) that defined
the minimal candidate region to D6S424-D6S1671 [15]. The marker D6S1671
remains the closest telomeric cross. No subsequent studies of the
original North Carolina family (765) have been reported. A graphical
summation of all previous and current MCDR1 reports is shown in
\figref{1}.}

\p{Herein, we report the accumulation of the genetic linkage data
obtained from 10 families with this disorder. Five of these families
have not been previously reported and in the remaining 5 families, new
genetic markers were studied.}

\methods

\p{We ascertained and examined 232 individuals from ten families with
the MCDR1 phenotype (\tabref{1}). Seven of these families were American
(families 765, 768, 1193, 1292, 771, 770, 772) and primarily located in
North Carolina, Texas, Illinois, Washington DC, West Virginia,
Wisconsin, and South Carolina respectively. One family was of Mayan
Indian decent living in Belize, Central America. Another family was from
northern France in the Flanders region. One family was from London. All
were Caucasian except for the family from Chicago, Illinois (1193) that
was African-American and the Mayan Indian family in Belize (1463). All
of these families were thought to be genealogically independent at the
time of ascertainment. Institutional review board approved signed
consents were obtained from all subjects. Blood samples were collected
in EDTA tubes. The DNA was extracted using a Purgene kit (Gentra
systems, Minneapolis, MN).}

\p{Genotyping was performed with modifications to the method described
by Weber and May [19]. Primers were end labeled with
\gamma\sup{33}P-dATP (NEN, Boston, MA). The DNA samples were
subjected to PCR for 18 to 20 cycles. The alleles were separated on a
denaturing 6% polyacrylamide gel (USB, Cleveland, OH), 7M Urea (USB)
and electrophoresed at constant power. The standard sequence ladder
(plasmid-PUC18) was prepared as recommended by the manufacturer using the
Thermo Sequenase Kit (Amersham, Piscataway, NJ). The PCR conditions
were as follows. Denaturation was at 94 \deg C for 2 min, followed by 18
cycles of 94 \deg C for 30 min, 57 \deg C for 30 min, 72 \deg C for 30
min. The reaction was allowed to extend for 72 \deg C for 10 min and
then maintained at 4 \deg C. Polymorphic markers in the chromosome
6q16.3 region were tested. The fragments were then separated on a
polyacrylamide gel by electrophoresis. Five microliters of formamide dye
solution (formamide 10 ml, xylene cyanol FF 10 mg, bromophenol blue 10
mg, 0.5 M EDTA (pH 8.0) 200 \mu l) were added to the PCR mix and
denatured at 94 \deg C for 4 min and immediately put on ice. Five
microliters of this were then loaded onto a 6% polyacrylamide (29:1
acrylamide:bisacrylamide) gel containing 7M Urea on a 38 x 50 cm
sequencing gel apparatus (BioRad, Hercules, CA) and run at 80W constant
power. A pUC18 plasmid and -40 M13 forward (23-mer) primer were used in
a separate sequencing reaction (Thermo Sequenase, USB) and run on the
same gel as a standard ladder. The gel was then transferred to a
blotting paper backing, dried, and exposed to autoradiograph film.
Allele sizes were determined by comparing it to the standard ladder.}

\p{MCDR1 was analyzed as a completely penetrant, autosomal dominant
trait with a disease allele frequency of 0.00001. The maximum possible
LOD score for each pedigree was obtained via computer simulation with
the SIMLINK program [20]. Simulation studies were performed using 5000
replicates. Allele frequencies for the polymorphic markers were
determined using a minimum of 70 unrelated spouses from the MCDR1
families (\hot{\medgen}{Duke Center for Human Genetics}). This genetic
map information was based on current genetic maps in the internet
databases (\hot{\sanger}{The Sanger Centre, Human Chromosome 6 Home} and
\hot{\marshmed}{Marshfield Center for Medical Genetics}) as well as from
our unpublished data from our physical map. The physical map data
consists of information from YACs, BACs, PACs and, Radiation Hybrid maps
(data not shown). VITESSE and FASTLINK computer packages were used
assuming equal recombination rates in males and females [21,22]. For
two-point LOD scores greater than 3.0, a 1-LOD unit down support
interval was calculated as an approximation to a 95% confidence limit
[20]. The family from the United Kingdom was not used in the multipoint
analysis but was used in the haplotype analysis. The entire family's DNA
was unobtainable for this study [18]. The reason for using the UK family
in this study was to search for shared haplotypes.}

\results

\p{The original description of the disease phenotype was in a single
family from North Carolina. With the additional families described
herein and by others, it is apparent that the disease is present in many
different locations throughout the world and ethnic groups. \tabref{1}
shows the ethnicity and the location of the various families that have
been ascertained.}

\p{The clinical findings were identical to that previously reported
[1-11]. Affected individuals in these families ranged in age from 2
months to 48 years. The family from Wisconsin was not large enough to
observe the most severe forms of the disease such as the grade 3 macular
coloboma-like lesion [8]. Therefore, there is a possibility that this
family represents a phenocopy such as dominant drusen.}

\p{Most of the subjects had good visual acuity, the range being from
20/20 to 20/100. All individuals with grade I findings had visual
acuities ranging from 20/20 to 20/25. Only those with grade 2-3 findings
had visual acuities of 20/40 or worse.}

\p{The order of the markers and the genetic distances between them are
shown in \figref{1}. A summary of the actual two-point LOD scores of
the analyzed markers in these families is shown in \tabref{2}. The
maximum two-point LOD scores actually achieved were for markers D6S249
and D6S1671 with LOD scores of 32.00 and 35.71 respectively. Multi-point
analysis in families 765, 768, 1463, 771, 769, 772, 1193, 1292 generated
a maximum LOD score of 41.52 when MCDR1 was placed between D6S249 and
D6S6171 (\figref{2}). There were no recombinations observed with
marker D6S1717.}

\p{Analysis for genetic heterogeneity in the multipoint analysis using
HOMOG (Copyright (C) Jurg Ott 1999, available at \hot{\homog}{Genetic Linkage Analysis
at Rockefeller University}) showed that there was no evidence of genetic
heterogeneity (Chi square = 28.68, p\lt 0.0001, likelihood odds = 14.33,
square difference = 1,700,000). Odds in favor of homogeneity versus
heterogeneity were 1689258:1.}

\p{Several recombination events in the families support the closest
flanking markers as shown with multipoint analysis. (\tabref{3}). The
closest telomeric crosses were with marker D6S1671 seen in family 765,
individual 8125, and family 1463, individual 9034. The closest
centromeric cross is observed in family 765, individual 8151, who
crosses with D6S249. Thus, both the closest centromeric and telomeric
crosses were observed in the original North Carolina family 765.}

\p{Haplotype analysis of the data (\figref{3}) suggests that families
765, 768, 772, 1292, and 1193 share the same haplotype. The affected
haplotype (1-1-1-4-1) was not observed in any unaffected individuals.
Each of the other families is most likely a separate haplotype and
therefore represents separate independent mutations.}

\discussion

\p{Our earlier reports had localized the MCDR1 gene to a broad area on
chromosome 6q16 [12,13]. Herein, we show the accumulation of the
largest single data set from multiple families with the MCDR1 phenotype
and have confirmed the genetic interval to be between D6S249 and
D6S1671. Previously, the closest telomeric cross was defined by the
French family (769) and the closest centromeric cross defined by the
North Carolina family [15]. Herein we show that the original North
Carolina family remained the most informative and provided the key
recombinant individuals that narrowed the genetic interval both
centromerically and telomerically. This is the only single MCDR1 family
to achieve this. All of the other families, in our data set as well as
in other's, provided no additional information that was useful for
narrowing the interval.}

\p{Haplotype analysis showed interesting potential ancestral
relationships among the different families (\figref{3}). Of the 10
families reported herein, 5 have not been previously reported. Most of
the American families appeared to have a single ancestral mutation in
their MCDR1 gene. These American families shared the rare
disease-associated allele #1 for D6S249 on the centromeric end and the
rarer allele #1 for D6S1671 on the telomeric end as well as the same
alleles of all markers in between. This suggests a common founder of the
disease causing gene and thus likely harbor the same mutation.
Initially, there was no known genealogical relationship between the
North Carolina, Texas, South Carolina, Washington D.C., and Chicago
families after obtaining extensive family history information. All of
these families were Caucasian except for the family from Chicago which
was African-American. Because racial admixture occurred in the Southern
United States before and after the Civil War, this racial difference
should not deter one from considering that these five families have a
common ancestor. Additionally, there was a period after the Civil War
when immigration did occur from the mountains of North Carolina to
Texas. This may account for the common ancestor between the North
Carolina and the Texas families. Family 772 lived in the foothills of
South Carolina about 100 miles from the North Carolina family.
Additionally, they shared the same last name as the original founding
brothers in the North Carolina family. While there was no direct
genealogical tie made between the South Carolina and the North Carolina
families, it was not surprising to find that they shared the common
disease associated haplotype.}

\p{The remaining families could each potentially represent independent
origins of mutations in the MCDR1 gene. The haplotype sharing in these
families was not so clear because in most instances the shared alleles
were commonly occurring in the general population. The potential
relationship of the Belize family with the British and West Virginia
families was obscure. It appeared that part of the disease associated
haplotype was shared among these three families. Because Belize was a
British colony from the mid-1800s until 1973, it is conceivable that
this shared haplotype could be due to a common founder. However, the
affected family in Belize is of Mayan Indian ancestry. The West Virginia
family had possible partial sharing of the disease associated haplotype
but this was more difficult to explain unless there was a common British
founder for both families from Belize and West Virginia. While this is
possible, the assumptions may be too excessive to rely on this apparent
haplotype sharing to base positional cloning strategies.}

\p{North Carolina macular dystrophy (MCDR1) was originally named because
of the founder effect that concentrated the mutated gene in the
mountains of North Carolina [4]. There was very little consanguinity in
the family. In the 1800s, families in this agricultural region typically
had many children as did the founders of our North Carolina family
(765). Therefore, the increased frequency of the disease allele in this
population is primarily because of the large and stable families there.
Because of the disease's name, many clinicians and researchers have
assumed that this was an extremely rare entity present in only one
family in the world. Small et al. demonstrated that the previously
published North American individuals affected with North Carolina
macular dystrophy did indeed emanate from the same family in North
Carolina [10]. Recently, Small et al. reported unrelated families in
France and Belize with the MCDR1 phenotype [15,16]. Others have reported
families in the UK and in Germany [11,17,18]. The name, MCDR1, as
established by the Human Genome Organization, seems more appropriate
than North Carolina macular dystrophy [12].}

\p{The MCDR1 gene is important to understand for several reasons. This
disease seems to be macula-specific, as evidenced by the funduscopic
examination as well as the lack of electroretinogram and
electro-oculograms abnormalities. Therefore, understanding this gene's
function will give insight into specific features of macular function
and dysfunction. Additionally, the MCDR1 phenotype appears in some
aspects similar to age-related macular degeneration, the most common
cause of blindness in the elderly American population. Therefore,
understanding the MCDR1 gene may shed light on our understanding and
possible management of age-related macular degeneration.}

\acknowledgements

\p{This work was supported in part by NIH/NEI RO1-EY12039 (Dr. Small),
and The McCone Endowment (Dr. Small). Parts of this manuscript were used
by Dr. Small in a thesis requisite for gaining membership into the American
Ophthalmological Society.}

\references

\p{1. Small KW. North Carolina macular dystrophy, revisited.
Ophthalmology 1989; 96:1747-54. \pubmed{2622620}}

\p{2. Lefler WH, Wadsworth JA, Sidbury JB Jr. Hereditary macular
degeneration and amino-aciduria. Am J Ophthalmol 1971; 41:224-30.
\pubmed{5100467}}

\p{3. Frank HR, Landers MB 3d, Williams RJ, Sidbury JB. A new dominant
progressive foveal dystrophy. Am J Ophthalmol 1974; 78:903-16.
\pubmed{4440724}}

\p{4. Gass JDM. Stereoscopic atlas of macular diseases: diagnosis and
treatment. St. Louis: Mosby; 1987.}

\p{5. Hermsen VM, Judisch GF. Central areolar pigment epithelial
dystrophy. Ophthalmologica 1984; 189:69-72. \pubmed{6472809}}

\p{6. Fetkenhour CL, Gurney N, Dobbie JG, Choromokos E. Central areolar
pigment epithelial dystrophy. Am J Ophthalmol 1976; 81:745-53.
\pubmed{937428}}

\p{7. Leveille AS, Morse PH, Kiernan JP. Autosomal dominant central
pigment epithelial and choroidal degeneration. Ophthalmology 1982;
89:1407-13. \pubmed{7162784}}

\p{8. Klein R, Bresnick G. An inherited central retinal pigment
epithelial dystrophy. Birth Defects Orig Artic Ser 1982; 18:281-96.
\pubmed{7171762}}

\p{9. Small KW, Killian J, McLean WC. North Carolina's dominant
progressive foveal dystrophy: how progressive is it? Br J Ophthalmol
1991; 75:401-6. \pubmed{1854692}}

\p{10. Small KW, Hermsen V, Gurney N, Fetkenhour CL, Folk JC. North
Carolina macular dystrophy and central areolar pigment epithelial
dystrophy. One family, one disease. Arch Ophthalmol 1991; 110:515-8.
\pubmed{1562260}}

\p{11. Rohrschneider K, Blankenagel A, Kruse FE, Fendrich T, Volcker HE.
Macular function testing in a German pedigree with North Carolina
macular dystrophy. Retina 1998; 18:453-9. \pubmed{9801043}}

\p{12. Small KW, Weber JL, Roses A, Lennon F, Vance JM, Pericak-Vance
MA. North Carolina macular dystrophy is assigned to chromosome 6.
Genomics 1992; 13:681-5. \pubmed{1639395}}

\p{13. Small KW, Weber JL, Pericak-Vance MA. North Carolina macular
dystrophy (MCDR1). A review and refined mapping to 6q14-q16.2.
Ophthalmic Paediatr Genet 1993; 14:143-50. \pubmed{8015785}}

\p{14. Small KW, Garcia CA, Gallardo G, Udar N, Yelchits S. North
Carolina macular dystrophy (MCDR1) in Texas. Retina 1998; 18:448-52.
\pubmed{9801042}}

\p{15. Small KW, Puech B, Mullen L, Yelchits L. North Carolina macular
dystrophy in France maps to the MCDR1 locus. Mol Vis 1997; 3:1.
\pubmed{9238090}}

\p{16. Rabb MF, Mullen L, Yelchits S, Udar N, Small KW. A North Carolina
macular dystrophy phenotype in a Belizean family maps to the MCDR1
locus. Am J Ophthalmol 1998; 125:502-8. \pubmed{9559736}}

\p{17. Sauer CG, Schworm HD, Ulbig M, Blankenagel A, Rohrschneider K,
Pauleikhoff D, Grimm T, Weber BH. An ancestral core haplotype defines
the critical region harbouring the North Carolina macular dystrophy gene
(MCDR1). J Med Genet 1997; 34:961-6. \pubmed{9429134}}

\p{18. Reichel MB, Kelsell RE, Fan J, Gregory CY, Evans K, Moore AT,
Hunt DM, Fitzke FW, Bird AC. Phenotype of a British North Carolina
macular dytrophy family linked to chromosome 6q. Br J Ophthalmol 1998;
82:1162-8. \pubmed{9924305}}

\p{19. Weber JL, May PE. Abundant class of human DNA polymorphisms which
can be typed using the polymerase chain reaction.  Am J Hum Genet 1989;
44:388-96. \pubmed{2916582}}

\p{20. Ott J. Computer-simulation methods in human linkage analysis.
Proc Natl Acad U S A 1989; 86:4175-8. \pubmed{2726769}}

\p{21. O'Connell JR, Weeks DE. The VITESSE algorithm for rapid exact
multilocus linkage analysis via genotype set-recoding and fuzzy
inheritance. Nat Genet 1995; 11:402-8. \pubmed{7493020}}

\p{22. Cottingham RW Jr, Idury RM, Schaffer AA. Faster sequential
genetic linkage computations. Am J Hum Genet 1993; 53:252-63.
\pubmed{8317490}}

\endreferences

}

\begintables

\tabfile{1}{
\tabtitle{1}{MCDR1 families, location, and ethnicity}

\box{\pre{
Family Number   Location                  Ethnicity
-------------   -----------------------   ----------------

765             USA, North Carolina       Caucasian

1292            USA, Washington, DC       Caucasian

768             USA, Texas                Caucasian

1193            USA, Chicago              African-American

771             USA, West Virginia        Caucasian

770             USA, Wisconsin            Caucasian

772             USA, South Carolina       Caucasian

1463            Belize, Central America   Mayan Indian

769             France                    Caucasian

BR1             UK, London                Caucasian
}}

}

\tabfile{2}{
\tabtitle{2}{Maximum 2-point LOD scores obtained from the
analysis of the most informative chromosome 6q16 markers}

\box{\pre{

         THETA
           0.0      0.1      0.2      0.3      0.4
centromeric
MARKER
    family number
D6S249     -inf     28.3     22.2     15.1     7.4
    765    -inf     22.1     17.6     12.26    6.17
    1292   2.3      2.06     1.61     1.05     0.46
    768    4.3      3.5      2.5      1.58     0.63
    1463   -0.00    -0.00    -0.00    -0.00    -0.00
    771    0.06     0.04     0.02     0.01     0.00
    770    0.12     0.06     0.03     0.00     0.00
    769    -0.00    0.01     0.01     0.00     0.00
    772    0.31     0.22     0.13     0.06     0.01
    1193   0.24     0.21     0.17     0.12     0.06
D6S1717    27.2     21.9     16.3     10.5     4.6
    765    18.6     15.2     11.5     7.6      3.5
    1292   0.00     0.00     0.00     0.00     0.00
    768    0.94     0.68     0.4      0.25     0.09
    1463   1.38     1.08     0.76     0.43     0.13
    771    0.17     0.12     0.07     0.03     0.00
    770    0.72     0.56     0.39     0.21     0.06
    769    4.12     3.25     2.33     1.38     0.49
    772    0.63     0.49     0.353    0.219    0.09
    1193   0.60     0.51     0.4      0.29     0.15
D6S1671    -inf     33.8     27.5     19.5     10.1
    765    -inf     23.8     19.0     13.4     7.12
    1292   0.00     0.00     0.00     0.00     0.00
    768    4.7      3.81     2.86     1.85     0.85
    1463   5.7      4.84     3.8      2.6      1.3
    771    0.58     0.44     0.30     0.16     0.04
    770    -0.17    -0.13    -0.09    -0.062   -0.03
    769    -inf     -0.70    0.30     0.51     0.371
    772    1.48     1.21     0.91     0.60     0.28
    1193   0.55     0.47     0.37     0.26     0.14
D6S468     -inf     13.0     10.1     6.9      3.3
    765    -inf     10.8     8.27     5.47     2.55
    1292   0.00     0.00     0.00     0.00     0.00
    768    -1.1     -1.2     -1.29     -0.80   -0.33
    1463   -inf     0.78     0.87     0.66     0.316
    771    0.38     0.28     0.18     0.09     0.024
    770    0.72     0.54     0.36     0.18     0.03
    769    -inf     0.81     0.94     0.77     0.45
    772    1.39     1.13     0.85     0.56     0.27
    1193   -0.008   -0.05    -0.08    -0.08    -0.052
D6S283     -inf     26.7     21.2     14.4     6.9
    765    -inf     19.6     15.65    10.75    5.231
    1292   -4.191   -0.15    -0.096   -0.08    -0.05
    768    3.02     2.67     2.03     1.25     0.50
    1463   -inf     2.24     1.95     1.46     0.81
    771    0.533    0.40     0.27     0.14     0.04
    770    0.727    0.54     0.36     0.18     0.03
    769    0.00     0.00     0.00     0.00     0.00
    772    1.09     0.87     0.65     0.41     0.19
    1193   0.60     0.51     0.40     0.29     0.15
}}

}

\tabfile{3}{
\tabtitle{3}{Summary of individual recombination events}

\box{\pre{
FAM-INDIV   D6S249   D6S1717   D6S1671   D6S283
---------   ------   -------   -------   ------

765-8207      NI       O          O        X
765-8125      NI       O          X        X
765-8083      NI       O          O        X
765-8151      X        O          O        O
1463-9028     NI       NI         O        X
1463-9034     NI       NI         X        X
769-4022      NI       NI         X        NI


FAM = family number

INDIV = individual number in the pedigree

NI = not informative

X = crossover individual

O = an informative individual who is not a crossover
}}

}

\beginfigures

\figfile{1}{
\figtitle{1}{Ideogram of chromosome 6 showing location of
markers and the distances between the markers in centiMorgans}

\p{The location of the MCDR1 gene as defined by different family studies
is shown with shaded bars.}

\ctr{\gifimage{1}{509}{601}{15}}

}

\figfile{2}{
\figtitle{2}{Multipoint plot of cumulative family data}

\p{The location of the most informative markers are shown in their respective relation.}

\ctr{\gifimage{2}{494}{320}{13}}

}

\figfile{3}{
\figtitle{3}{Haplotypes of the different families showing
common regions shared between the different families}

\p{The black, shaded, or striped bar represents the affected chromosome
with the respective marker allele.}

\ctr{\gifimage{3}{446}{427}{11}}

}

