• Journal of Genetic Medicine
• /
• 제7권2호
• /
• pp.111-118
• /
• 2010

염색체 microarray 검사는 유전체 전체를 한번에 검색하여 초현미경적인 염색체 이상을 매우 정밀하고 정확하게 검출할 수 있다. 외국에서는 현재 자주 활용되는 임상 진단 검사로 자리잡았고, 염색체 검사 또는 표적 부위를 검출하는 FISH 검사나 PCR 기반의 분자유전학적 방법을 대체하고 있다. 최근 발표된 consensus 들은 염색체 microarray 검사를 비특이적인 다발성 기형, 발달지연 또는 정신지체, 자폐증상질환의 환자에서는 염색체 검사보다 먼저 시행할 수 있는 검사로 제안하였다. 염색체 microarray 검사는 핵형 분석에서 검출된 염색체 불균형을 검증하기 위해 염색체 검사에 보조적으로 활용할 수 있고, 염색체 이상에 대한 보다 정확하고 종합적인 분석이 가능하다. 그러나 염색체 microarray 검사는 균형재배열의 염색체 이상과 low-level 모자이시즘을 검출하기 어렵고, 임상적 중요성이 불명확한 CNV에 대한 해석과 검사비용이 고가라는 한계점이 있다. 이러한 이유로 인해 현재로서는 염색체 microarray 검사가 산전 진단 목적으로는 고식적인 염색체 검사를 대신할 수는 없다는 의견이다. 임상검사실에서 염색체 microarray 검사 시행 시, 유전학적 및 세포유전학적 지식과 경험이 결과 분석과 해석 과정에서 요구되며, 적절한 검증 과정 단계와 유전상담이 동반되어야 한다.

• Journal of Genetic Medicine
• /
• 제19권1호
• /
• pp.14-21
• /
• 2022

Complex chromosome rearrangements (CCRs) are structural chromosomal rearrangements involving at least three chromosomes and more than two breakpoints. CCR carriers are generally phenotypically normal but related to higher risk of recurrent miscarriage and having abnormal offspring with congenital anomalies. However, most of CCR carriers are not aware of their condition until genetic analysis of either abortus or affected baby or parental karyotyping is performed. Herein, we present the case that CCR carrier patients can be identified by preimplantation genetic testing of preimplantation embryos. An infertile male patient with severe oligoasthenoteratozoospermia was diagnosed balanced reciprocal translocation, 46,XY,t(3;11) (p26;p14) at first. After attempting the first preimplantation genetic testing for structural rearrangement (PGT-SR) cycle, we found the recurrent segmental gain or loss on 21q21.3-q22.3 of five out of nine embryos. As a result of karyotype re-analysis, the patient's karyotype showed a balanced CCR involving chromosomes 3, 11, and 21 with three breakpoints 3p26, 11p14, and 21q21. The patient underwent two PGT-SR cycles, and a pregnancy was established after the transfer of an euploid embryo in the second cycle. Amniocentesis confirmed that the baby carried normal karyotype without mosaicism. At 37 weeks gestation, a healthy girl weighting 3,050 g was born.

• Clinical and Experimental Reproductive Medicine
• /
• 제50권3호
• /
• pp.192-199
• /
• 2023

Objective: This study was conducted to investigate chromosomal abnormalities and their correlations with clinical and radiological findings in females with primary amenorrhea (PA). Methods: Detailed forms were recorded for 470 females, including the construction of three-generation pedigrees. Peripheral venous blood was drawn, with informed consent, for cytogenetic analysis. Results: An abnormal karyotype was found in 16.38% of participants. The incidence of structural abnormalities (6.8%) exceeded that of numerical abnormalities (6.15%). Turner syndrome represented 45% of all numerical abnormalities. Furthermore, the Y chromosome was detected in 5% of females with PA. Among the structural chromosomal abnormalities detected (n=32) were mosaicism (25%), deletions (12.5%), isochromosomes (18.75%), fragile sites (3.12%), derivatives (3.12%), marker chromosomes (3.12%), and normal variants (29.125%). An examination of secondary sexual characteristics revealed that 29.6% of females had a complete absence of breast development, 29.78% lacked pubic hair, and 36.88% exhibited no axillary hair development. Radiological findings revealed that 51.22% of females had a hypoplastic uterus and 26.66% had a completely absent uterus. Abnormal ovarian development, such as the complete absence of both ovaries, absence of one ovary, one absent and other streak, or both streak ovaries, was observed in 69.47% of females with PA. Additionally 43.1%, 36.1%, 67.4%, and 8% of females had elevated levels of serum follicle-stimulating hormone, luteinizing hormone, thyroid-stimulating hormone, and prolactin, respectively. Conclusion: This study underscores the importance of karyotyping as a fundamental diagnostic tool for assessing PA. The cytogenetic correlation with these profiles will aid in genetic counseling and further management of the condition.

• Clinical and Experimental Reproductive Medicine
• /
• 제31권4호
• /
• pp.253-260
• /
• 2004

Objectives: Klinefelter syndrome is the most common genetic cause of male infertility and presents with 47, XXY mainly or 46, XX/47, XXY mosaicism. It is characterized by hypogonadism and azoospermia due to testicular failure, however, sporadic cases of natural pregnancies have been reported. With the development of testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI), sperm can be retrieved successfully and ART is applied in these patients for pregnancy. It has been suggested that the risk of chromosome aneuploidy for both sex chromosome and autosome is increased in the sperms from 47, XXY germ cells. Considering the risk for chromosomal aneuploidy in the offspring, preimplantation genetic diagnosis (PGD) could be applied as a safe and more effective treatment option in Klinefelter syndrome. The aim of this study is to assess the outcome of PGD cycles by using FISH for sex chromosome and autosome in patients with Klinefelter syndrome. Materials and Methods: From Jan. 2001 to Dec. 2003, PGD was attempted in 8 cases of Klinefelter syndrome but TESE was failed to retrieve sperm in the 3 cases, therefore PGD was performed in 8 cycles of 5 cases (four 47, XXY and one 46, XY/47, XXY mosaicism). In one case, ejaculated sperm was used and in 4 cases, TESE sperm was used for ICSI. After fertilization, blastomere biopsy was performed in $6{\sim}7$ cell stage embryo and the chromosome aneuploidy was diagnosed by using FISH with CEP probes for chromosome X, Y and 17 or 18. Results: A total of 127 oocytes were retrieved and ICSI was performed in 113 mature oocytes. The fertilization rate was $65.3{\pm}6.0%$ (mean$\pm$SEM) and 76 embryos were obtained. Blastomere biopsy was performed in 61 developing embryos and FISH analysis was successful in 95.1% of the biopsied blastomeres (58/61). The rate of balanced embryos for chromosome X, Y and 17 or 18 was $39.7{\pm}6.9%$. The rate of aneuploidy for sex chromosome (X and Y) was $45.9{\pm}5.3%$ and $43.2{\pm}5.8%$ for chromosome 17 or 18, respectively. Embryo transfer was performed in all 8 cycles and mean number of transferred embryos was $2.5{\pm}0.5$. In 2 cases, clinical pregnancies were obtained and normal 46, XX and 46, XY karyotypes were confirmed by amniocentesis, respectively. Healthy male and female babies were delivered uneventfully at term. Conclusion: The patients with Klinefelter syndrome can benefit from ART with TESE and ICSI. Considering the risk of aneuploidy for both sex chromosome and autosome in the sperms and embryos of Klinefelter syndrome, PGD could be offered as safe and more effective treatment option.

• Journal of Microbiology
• /
• 제44권6호
• /
• pp.660-664
• /
• 2006

The relationship between H. pylori clarithromycin resistance and genetic pattern distribution has been differently explained from different geographic areas. Therefore, we aimed to assess the clarithromycin resistance rate, to evaluate the bacterial genetic pattern, and to search for a possible association between clarithromycin resistance and cagA or vacA genes. This prospective study enrolled 62 consecutive H. pylori infected patients. The infection was established by histology and rapid urease test. Clarithromycin resistance, cagA and vacA status, including s/m subtypes, were assessed on paraffin-embedded antral biopsy specimens by TaqMan real time polymerase chain reaction (PCR). Primary clarithromycin resistance was detected in 24.1 % of cases. The prevalence of cagA was 69.3%, and a single vacA mosaicism was observed in 95.1 % cases. In detail, the s1m1 was observed in 23 (38.9%) patients, the s1m2 in 22 (37.2%), and the s2m2 in 14 (23.7%), whereas the s2m1 combination was never found. The prevalence of cagA and the vacA alleles distribution did not significantly differ between susceptible and resistant strains. Primary clarithromycin resistance is high in our area. The s1m1 and s1m2 are the most frequent vacA mosaicisms. There is no a relationship between clarithromycin resistance and bacterial genotypic pattern and/or cagA positivity.

• 한국가축번식학회지
• /
• 제26권3호
• /
• pp.205-214
• /
• 2002

현재까지 외래 유전자를 도입하여 형질전환 동물을 생산하는 방법이 다방면으로 연구되어 왔다. 그 중에서 본 연구에서는 정자를 EGFP 유전자와 공배양한 후 이를 난모 세포내에 미세 주입한 다음, 수정란의 발달과 ECFP 유전자의 발현을 조사하였다. 즉, 동결후 융해나 Triton X-100 처리 등으로 세포막을 파괴하여, 이들 정자를 EGFP 유전자와 다분간 공배양함으로써 정자와 EGFP 유전자와의 결합을 유도하였다. 정자나 정자두부의 미세주입에 의해 수정된 난자는 0.3%의 BSA가 첨가된 CR1aa 배양액에서 배양하였으며, EGFP 유전자의 발현은 형광현미경 하에서 관찰하였다. 통결 후 융해로 처리된 정자와 Triton X-100 처리 한 정자를 미세주입한 결과 난할율은 85.7과 80.1%였고, 배반포 발생율은 32.4 과 35.0%로서 유의차가 없었다. 동결 후 융해와 Triton X-100 으로 처리된 정자를 각각 미세주입한 수정란의 EGFP 유전자 발현율은 각각 19.1과 13.9%로서 전자가 유의하게 높았다. 또 정자 배양액에 첨가된 EGFP유전자의 농도가 54 ng/${\mu}\ell$일 때 EGFP 발현율은 15.4% 로서, 27 ng/${\mu}\ell$일 때의 9.0%와 63.5 ng/${\mu}\ell$일 때의 5.1% 보다 유의하게 높았다. 발현율을 높히기 위한 방법중 하나로써 electric shock의 방법을 이용해 보았으나 기존의 공배양 방법으로 얻은 최고 발현율인 19.1%에 못 미치는 2%를 보였다. EGFP 유전자가 발현된 수정란의 배반포 발생율은 0%로서 비발현 수정란의 29.5%보다 유의하게 낮았으며, EGFP 유전자의 발현은 mosaicism 형태를 보였다. 본 연구에서는 비록 낮은 외래 유전자 도입율을 보이기는 하나 (19.0%), 정자를 매개로 한 형질전환 동물의 생산은 그 방법이 간단하고 비용이 적게 든다는 장점이 있다. 기존 보고들의 효율성을 재고하여 볼 때, 난자내 정자 직접 주입술에 의한 형질전환 동물 생산의 연구는 향후 밝은 전망을 시사하고 있다.

• Journal of Genetic Medicine
• /
• 제2권1호
• /
• pp.11-15
• /
• 1998

This paper reports 3 cases with 46,XX sex reversed male. Three 46,XX hypogonadal subjects showed complete sex reversal and had normal phallus and azoospermia. We studied them under clinical, cytogenetic and molecular aspects to find out the origin of the sex reversal. Patients had markedly elevated serum follicle-stimulating hormone (FSH) and lutenizing hormone (LH) and decreased or normal range of serum testosterone. The testicular volumes were small (3-8ml). Testicular biopsy showed Leydig cell hyperplasia and atrophy of seminiferous tubules. We obtained the results of normal 46,XX, and the presence of Y chromosome mosaicism was ruled out through XY dual fluorescent in situ hybridization (FISH). By using polymerase chain reaction (PCR), we amplified short arm (SRY, PABY, ZFY and DYS14), centromere (DYZ3), and heterochromatin (DYZ1) region of the Y chromosome. PCR amplification of DNA from these patients showed the presence of the sex-determining region of the Y chromosome (SRY) but didn't show the centromere and heterochromatin region sequence. The SRY gene was detected in all the three patients. Amplification patterns of the other regions were different in these patients; one had four amplified loci (PABY+, SRY+, ZFY+, DYS14+), another had two loci (SRY+, ZFY+) and the other had two loci (PABY+, SRY+). We have found that each patient's translocation elements had different breakpoints at upstream and downstream of the SRY gene region. We conclude that the testicular development in 46,XX male patients were due to insertion or translocation of SRY gene into X chromosome or autosomes.

• 한국가축번식학회지
• /
• 제20권1호
• /
• pp.19-26
• /
• 1996

본 연구는 체외에서 생산된 돼지수정란에 외래유전자를 미세주입후 체외 배 발달과 유전자 발현을 조사하기 위하여 실시하였다. 체외수정후 18∼20 시간 사이에 LacZ 유전자와 산양 성장호르몬 유전자를 미세주입하였으며, 체외 배 발달율과 유전자 발현은 미세주입후 9일간 체외배양을 실시한 다음 조사하였다. 돼지수정란을 원심분리하여 전핵을 관찰한 결과 60.3%의 난자에서 전핵이 가시화되었다. 또한 유전자가 미세주입된 수정란중 상실배와 배반포까지 발달한 비율은 각각 8.6, 9.1%로 대조구의 발달율 19.0, 20.8%보다 유의하게 낮았다. 그러나, NCSU23 배양액에 4일간 배양후 EMEM 배양액으로 교체하여 배양한 결과, 배반포 및 부화배반포까지 높은 발달율(19.4%)을 나타내었다. X-gal 염색의 결과로서, LacZ의 발현을 나타낸 수정란의 비율은 상살배, 배반포 단계에서 40.0, 42.9%로 나타났으나, 이들 형질전환 수정란의 대부분은 mosaic 현상이 관찰되었다. 또한 PCR 부분에서, gGH 유전자가 도입된 수정란의 비율은 상실배, 배반포단계에서 45.0, 44.4%로 X-gal 염색의 결과와 유의한 차이가 없었다. 따라서 본 실험에서 얻어진 결과들은 체외에서 생산된 돼지수정란은 미세주입후에도 배반포 및 부화배반포까지 성공적으로 발달할 수 있다는 것을 입증하였다. 또한 체외성숙, 수정된 돼지수정란을 이용하여 형질전환 돼지 생산의 가능성을 시사하고 있다.

• Clinical and Experimental Reproductive Medicine
• /
• 제30권3호
• /
• pp.223-231
• /
• 2003

Objective: The aim of the present study was to evaluate the clinical efficiency of fluorescent in situ hybridization (FISH) in the prenatal diagnosis of chromosomal aneuploidy. Methods: We reviewed data of 268 cases to identify women undergoing genetic amniocentesis at cytogenetic laboratory, from January 2000 to December 2002. Amniotic fluid was submitted for both rapid FISH on uncultured interphase amniocytes using a commercially available DNA probe for chromosome 13, 18, 21, X, Y and standard karyotyping on cultured metaphase amniocytes. Results from FISH and full karyotype were compared. Results: There were 251 cases (84%) normal and 17 cases (16%) abnormal in FISH results. All 17 cases of trisomy 13, 18, 21 including two cases of mosaicism and sex chromosome aneuploidies which are detected by FISH were confirmed with conventional cytogenetics and there was no false positive result. Twenty two cases had karyotypically proven abnormalities that could not have been detected by the targeted FISH. Conclusion: Interphase FISH analysis of uncultured amniotic fluid cells has been shown to be an effective and reliable technique for rapid fetal aneuploidy screening during pregnancy as an adjunctive test to conventional cytogenetics.

• Clinical and Experimental Pediatrics
• /
• 제52권2호
• /
• pp.242-246
• /
• 2009

13번 환염색체 증후군은 정신발달의 지체, 성장 장애, 안면부 기형, 중추신경계 기형, 심장기형, 손발의 기형, 골격계 기형 및 항문기형의 특징을 가진다. 많은 수의 13번 환염색체 증후군에 대한 보고가 있었지만 국내에서는 오직 6예의 임상증례 고가 있다. 이들 보고는 모두 순수한 13번 환염색체 증후군을 보고한 것으로 본 저자들은 13번 환염색체 모자이크 현상의 증례를 경험하였다. 산전진찰 상 자궁내 발육지연이 의심되었던 남아에서 안면부기형이 관찰되었으나 이 외에 이학적 검사상 심장 기형, 골격계 및 외부 생식기 기형은 특별히 관찰되지 않았다. 시행한 세포 유전학 검사상 13번 염색체의 ring/monosomy/dicentric 모자이크 현상이 나타났다. 이후에도 근력저하, 성장과 발달지연을 보이고 있다. 저자들은 안면부 기형, 소두증과 대칭성 자궁내 발육지연을 보인 남아에서 13번 환염색체의 모자이크 증후군을 경험하여 기존에 보고된 다른 증례들과 임상 양상을 비교하여 보고하는 바이다.