• Clinical and Experimental Reproductive Medicine
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• 제21권2호
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• pp.201-206
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• 1994

Down syndrome is one of the major chromosomal anomalies in Korea. To decrease incidence of Down syndrome, antenatal diagnosis is essential. At present, antenatal diagnosis of Down syndrome is done by karyotyping from chorionic villus sampling, amniocentesis, and cordocentsis. All these methods have some problems such as a risk of abortion, a long waiting time, difficulties in sampling, and so on. The aim of study was to confirm that PCR(Polymerase Chain Reaction) using D21S11 primer could be a diagnostic tool for Down syndrome. PCR using D21S11 primers with $^{32}P$ labeling at 5' end was done in 21 cases of DNA from 21 Trisomy and 20 cases of DNA from normal karyotype. PCR product was running for 10 hours on the 6% polyacrylamide gel under 1,000 V or for 8 hours under 1,500 V. After X-ray film exposure, it was read by densitometry. Normal group showed 1: 1 band or single band. 21 Trisomy group showed 1.3-2: 1 band or 2.3 times of density compared to normal single band or 3 bands. This method gave the result within 24 hours. It can be an useful diagnostic tool to detect 21 Trisomy antenatally, especially in late pregnancy, and in preimplantation diagnosis.

• Journal of Genetic Medicine
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• 제8권1호
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• pp.44-52
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• 2011

목적: 자연 유산에 대한 세포유전학적 분석은 유산의 원인을 규명하여 부모에게 정확한 유전상담을 위한 귀중한 정보를 제공한다. 또한 그 분석결과를 통해 염색체 이상의 빈도와 유형을 알 수 있으며 그에 따른 재발 위험도를 산정할 수 있다. 하지만 아직까지 한국인에서는 자연유산에서 관찰되는 염색체 이상에 대해 몇몇의 보고들이 있으나 그 대상군의 수가 적다. 이에 저자들은 자연유산에 의한 수태산물 470예에서 관찰되는 염색체 이상의 발생 빈도와 종류에 대해 보고하고자 한다. 대상 및 방법: 2005년부터 2010년까지 국내 병원이나 개인 산부인과에서 서울의과학연구소에 염색체 분석이 의뢰된 자연유산에 의한 수태산물 470예를 대상으로 염색체 핵형 결과와 함께 유산시 임신 주수와 산모나이에 따른 염색체 이상의 종류와 발생빈도를 분석하였다. 결과: 총 470예의 자연 유산에 의한 수태산물의 염색체 핵형을 분석한 결과 염색체 이상 빈도는 54.3% (255/470)였다. 그 중 수적 이상이 89.3% (228/470)로 대부분을 차지하였는데, 수적 이상 중에는 상염색체의 삼염색체가 67.0%였고, 단일염색체 X가 12.5%, 다배수성은 8.2%, 삼염색체X가 0.8%, 상염색체의 단일염색체가 0.8%였다. 구조적 이상은 10.7% (27/470)으로 균형전좌가 3예, 불균형전좌는 24예이었다. 남녀 성비는 정상핵형과 비정상핵형 모두 0.58과 0.65으로 여아에서 높게 나타났다. 상염색체의 삼염색체는 1번, 3번, 19번 염색체를 제외하고 모두 관찰되었는데, 16번 삼염색체가 19.9%로 가장 많았으며, 22번 염색체가 13.5%, 21번 염색체가 12.3%, 15번 염색체가 9.9%, 13번과 18번 염색체가 각각5.3% 순으로 관찰되었다. 염색체 이상의 빈도는 임신 주수가 낮을수록, 산모나이가 많을수록 높았는데, 산모나이가 많을수록 삼염색체와 수적이상과 구조적 이상이 같이 있는 염색체 이상의 빈도가 높았다. 결론: 본 연구는 최근 6년간의 자연유산에 의한 수태산물 470예에 대해 세포유전학적 결과를 분석하였고, 이는 국내 자연유산 환자에게 적절한 산전유전상담을 위한 기초자료로서 유용할 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제52권5호
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• pp.603-606
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• 2009

Pierre Robin sequence (PRS)는 소악증, 구개열, 설하수 및 고궁구개 등의 기형을 합병한 선천성 질환으로, 수유 장애 및 호흡 곤란 소견을 보이는 증후군이다. PRS과 관련된 염색체 핵형 분석 결과가 보고되면서, 유전학적 관련성이 제시되어 왔으나, 아직까지 명확히 규명되지 않은 상태이다. 이에 저자들은 PRS 환아에서 처음으로 핵형 46, XX, dup(8)(p21.3p23.1)를 보인 환아를 경험하고, 전염색체탐색자 분석을 통해 중복된 물질이 8번 염색체임을 확인하였으며, PRS와 8번 삼염색체성과의 관련성을 보고하는 바이다.

• Clinical and Experimental Reproductive Medicine
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• 제24권2호
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• pp.199-210
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• 1997

A study has been carried out to elucidate the cytogenetic characteristics of Down's syndrome in Korea. This study includes 877 cases which were diagnosed as Down's syndrome by the chromosomal analyses at the Cytogenetic Laboratory, Institute of Reproductive Medicine and Population, Seoul National University for 13 years from January, 1984 to December, 1996. 1. 83.6% of cases were diagnosed under 1 year of age and 10.9% were between 1 and 4 years old. The overall sex ratio was 3 to 2 (male to female). 2. The most frequent indication for cytogenetic analyses was suspicion of Down's syndrome. The next were growth retardation, congenital heart diseases, congenital anomalies. 3. 88.4% of cases had free trisomy 21. In 6.5%, there was translocation, mostly Robertsonian t(14;21) or t(21;21). 3.9% of cases were mosaics mostly with one normal cell line. 4. Karyotyping was also performed in 204 parents of patients. 6 parents (2.9%) were seen to be translocation carriers of Down's syndrome. We find the unique features of Down's syndrome in Korea that the incidences of free trisomy 21 is relatively lower and that translocation is higher than western countries.

• Journal of Genetic Medicine
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• 제11권2호
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• pp.56-62
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• 2014

Purpose: To assess the outcomes of increased fetal nuchal translucency (NT), to aid in prenatal counseling and management in our practice. Materials and Methods: We retrospectively reviewed the medical records of patients who underwent first trimester fetal karyotyping using chorionic villi sampling (CVS) and second trimester level II sonography for a fetal NT thickness ${\geq}3.0mm$ between 11 weeks and 13 weeks 6 days' gestation, at Gyeongsang National University Hospital. Pediatric medical records and a telephone interview were used to follow-up live-born children. Exclusion criteria included incomplete data and CVS for other indications. Results: Seventy cases met the inclusion criteria (median NT thickness, 4.7 mm; range, 3.0-16.1 mm). Twenty-nine cases (41.4%) were aneuploid. The prevalence of chromosomal defects increased with NT thickness: NT 3.0-3.4 mm, 16.7%; NT 3.5-4.4 mm, 27.3%; NT 4.5-5.4 mm, 66.7%; NT 5.5-6.4 mm, 37.5%; NT ${\geq}6.5mm$, 62.5%. The most common karyotype abnormality was trisomy 18 (n=12), followed by trisomy 21 (n=9). In chromosomally normal fetuses (n=41), fetal death occurred in 2 cases (4.9%), and structural malformations were found in 11 cases (26.8%). In chromosomally and anatomically normal fetuses (n=28), one child had neurodevelopmental delay (3.6%). Twenty-eight infants who had a prenatal increased NT were alive and well at follow-up (40%). Conclusion: Outcomes of increased fetal NT might help inform prenatal counseling and management. The high prevalence of chromosomal defects associated with increased fetal NT implies that CVS should be performed in the first trimester, particularly considering the stress associated with an uncertain diagnosis.

• Journal of Genetic Medicine
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• 제5권2호
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• pp.125-130
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• 2008

목 적: 양수 천자를 이용한 세포 유전학적 결과와 산전 유전 진단의 적응증의 변화를 알아보고자 하였다. 대상 및 방법: 지난 2000년부터 2007년까지 8년간 미즈메디 병원 산부인과에 내원한 산모 중 산전 유전 진단의 적응증에 해당되어 양수 천자를 시행한 2,523예에 대하여 세포 유전학적 검사 결과를 종합 분석하였다. 결 과: 양수 천자를 시행한 2,523예의 적응증은 고령의 산모가 1159예(45.9%)로 가장 많았으며, 다음으로 양성 산모혈청 표지자가 755예(29.9%)로 많았다. 염색체 핵형 분석 결과로는 정상 핵형이 2,413예(95.6%)였으며, 염색체 이상을 보인 경우가 110예(4.4%)였다. 염색체 이상을 보인 110예에서는 수적 이상이 38예(34.5%), 구조적 이상이 65예(59.1%), 모자이시즘이 7예(6.4%)로 나타났다. 위의 110예의 염색체 이상을 적응증에 따라 분석한 결과에는 고령의 산모로 의뢰된 경우가 40예(36.4%)로 가장 많았으며, 양성 산모 혈청 표지자가 36예(32.7%)로 많았다. 결 론: 양수 천자는 산전 진단에 있어서 효과적인 방법이다. 이에 고령 산모, 산모 혈청 표지자 검사 그리고 초음파 소견과 같은 적응증은 태아의 염색체 이상 등을 예측하기 위한 산전 세포 유전학적 진단에 효과적인 요인이 된다. 이에 지난 8년간의 미즈메디에서 시행한 산전 세포 유전학 분석 결과는 산전 진찰 및 유전 상담의 중요한 자료로 활용될 수 있을 것이라 사료된다.

• Journal of Genetic Medicine
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• 제15권2호
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• pp.72-78
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• 2018

Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

• Archives of Plastic Surgery
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• 제46권5호
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• pp.470-474
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• 2019

Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood C-reactive protein levels declined to ${\leq}2mg/L$, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh.

• Journal of Genetic Medicine
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• 제2권2호
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• pp.59-63
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• 1998

Between 1988-1998, cytogenetic analyses were performed for 1,476 couples and 162 women with recurrent abortions. We applied GTG-banding, high resolution-banding and FISH (fluorescent in situ hybridization) techniques in this study. The frequency of balanced translocations was 3.6% (112/3114). Of them, 74 cases (2.38%) were reciprocal translocations and 38 (1.22%) were robertsonian translocations. Chromosome aberrations were more frequent in women (80 cases) than in men (32 cases). No phenotypical abnormalities were found in all carriers who had experienced recurrent spontaneous abortions or experienced giving birth to malformed offsprings. Prenatal cytogenetic analyses were carried out on 40 subsequent pregnancies for carrier couples with balanced translocation. The fetal karyotypes showed that 13 cases (32.5%) were normal, 25 (62.5%) were balanced translocations, and two (6%) were unbalanced translocations. It is believed that the frequency of chromosomal abnormalities in patients with recurrent spontaneous abortion is higher than that of the normal population. Most of the fetal samples showed normal karyotypes or balanced translocations matching that of one of their parents. Although the incidence of chromosomal imbalance in the fetuses was relatively low in prenatal cytogenetic analysis, individuals with balanced translocations are predisposed to giving birth to malformed offsprings with partial trisomy or monosomy. Therefore, we recommend the cytogenetic and the prenatal cytogenetic analysis for those who experiences recurrent abortion as well as in case they become pregnant, to prevent the birth of offsprings with chromosomal abnormalities.

• Journal of Genetic Medicine
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• 제16권1호
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• pp.10-14
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• 2019

Purpose: The aim of this study was to investigate the clinicopathological features of premature ovarian insufficiency (POI) associated with chromosomal abnormalities. Materials and Methods: This was a retrospective study of POI patients with chromosomal abnormalities diagnosed between January 2009 and December 2017. The definition of POI is based on hypergonadotropinism of 40 or greater in follicle stimulating hormone (FSH) measurements at age 40 years or less. FSH was measured twice at least 4 weeks apart. Karyotyping using peripheral blood for chromosomal testing was conducted in all patients diagnosed with POI. We analyzed the clinical characteristics and genetic causes of patients who were diagnosed with POI. Results: Forty patients were diagnosed with POI including 9 (22.5%) with identified chromosomal abnormalities. The mean age at diagnosis was $23.1{\pm}7.8years$ (ranging between 14 and 39). Three patients did not experience menarche. The presenting complaints were short stature in one case, one case of amenorrhea with ambiguous external genitals, one case of infertility, and six related to menstruation such as oligomenorrhea or irregular rhythm. Turner syndrome was diagnosed in four cases, Xq deletion in one case, trisomy X in two cases, and 46,XY disorder of sexual development in two other patients. Conclusion: Patients diagnosed with POI carrying the same type of chromosomal abnormality manifest different phenotypes. The management protocol also needs to be changed depending on the diagnosis. A karyotype is indicated for accurate diagnosis and proper management of POI in patients, with or without stigmata of chromosomal abnormalities.