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Noninvasive Prenatal Diagnosis using Cell-Free Fetal DNA in Maternal Plasma: Clinical Applications

  • Yang, Young-Ho;Han, Sung-Hee;Lee, Kyoung-Ryul
    • Journal of Genetic Medicine
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    • v.8 no.1
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    • pp.1-16
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    • 2011
  • Owing to the risk of fetal loss associated with prenatal diagnostic procedures (amniocentesis, chorionic villus sampling), noninvasive prenatal diagnosis (NIPD) is ultimate goal of prenatal diagnosis. The discovery of circulating cell-free fetal DNA (cffDNA) in maternal plasma in 1997 has opened up new probabilities for NIPD by Dr. Lo et al. The last decade has seen great development in NIPD. Fetal sex and fetal RhD status determination by cffDNA analysis is already in clinical use in certain countries. For routine use, this test is limited by the amount of cell-free maternal DNA in blood sample, the lack of universal fetal markers, and appropriate reference materials. To improve the accuracy of detection of fetal specific sequences in maternal plasma, internal positive controls to confirm to presence of fetal DNA should be analyzed. We have developed strategies for noninvasive determination of fetal gender, and fetal RhD genotyping using cffDNA in maternal plasma, using real-time quantitative polymerase chain reaction (RT-PCR) including RASSF1A epigenetic fetal DNA marker (gender-independent) as internal positive controls, which is to be first successful study of this kind in Korea. In our study, accurate detection of fetal gender through gestational age, and fetal RhD genotyping in RhD-negative pregnant women was achieved. In this assay, we show that the assay is sensitive, easy, fast, and reliable. These developments improve the reliability of the applications of circulating fetal DNA when used in clinical practice to manage sex-linked disorders (e.g., hemophilia, Duchenne muscular dystrophy), congenital adrenal hyperplasia (CAH), RhD incompatibility, and the other noninvasive pregnant diagnostic tests on the coming soon. The study was the first successful case in Korea using cffDNA in maternal plasma, which has created a new avenue for clinical applications of NIPD.

Quality Characteristics and Antioxidant Activity of Spirulina added Yogurt (스피루리나 첨가 요구르트의 품질 특성 및 항산화능)

  • Shin, Yu-Mi;Son, Chan-Wok;Sim, Hyun-Jung;Kim, Min-Hee;Kim, Mi-Yeon;Kwon, Oh-Yun;Kim, Mee-Ree
    • Korean journal of food and cookery science
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    • v.24 no.1
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    • pp.68-75
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    • 2008
  • The aim of this study was to evaluate the quality characteristics and antioxidant activity of yogurt containing spirulina. Yogurt base was prepared from skim milk added with $0.25{\sim}1%(w/v)$ spirulina powder and fermented with lactic acid bacteria (S. thermophilus : L. bulgaricus = 1 : 1) at $40^{\circ}C$ for 12 hr. Kiwi puree and oligosaccharides were then added. The addition of 1% spirulina powder stimulated the growth of lactic acid bacteria, which showed the highest viable cell count ($3.4{\times}10^9$ CFU/mL), and increased the titratable acidity (1.10%). The viscosity range of the yogurt was 6,000 to 9,000 cP, and the sugar content of the yogurt was around 18 $^{\circ}Brix$. The antioxidant activities were determined using the DPPH method, and the hydroxyl radical scavenging activity of the yogurt containing spirulina was higher than that of the control. The sensory evaluation scores for appearance, odor, taste, overall acceptability and buying intention were higher in the yogurt containing 0.25% spirulina than in the other groups. The amount of macronutrients in the yogurt containing spirulina was higher than that in the control. In addition, the amounts of micronutrients in the yogurt containing spirulina was significantly increased. According to these results, the optimum concentration of spirulina powder is around 0.25%.

Evaluation of Autonomic Neuropathy in Patients with Sleep Apnea Syndrome (수면 무호흡 증후군 환자에서 자율 신경 장애의 평가)

  • Lee, Hak-Jun;Park, Hye-Jung;Shin, Chang-Jin;Kim, Ki-Beom;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.404-415
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    • 1998
  • Background: Sleep apnea syndrome, which occurs in 1~4 % of the adult population, frequently has different cardiovascular complications such as hypertension, ischemic heart disease, cardiac arrythmia as well as sleep-wake disorder such as excessive daytime hypersomnolence or insomnia. Mortality and vascular morbidity are reported to be significantly higher in sleep apnea syndrome patients than in normal population. According to the recent studies, autonomic dysfunction as well as hypoxemia, hypercapneic acidosis, and increased respiratory effort, may playa role in the high prevalence of cardiovascular complications in patients with sleep apnea syndrome. However the cause and mechanism of autonomic neuropathy in patients with sleep apnea syndrome are not well understood. We studied the existence of autonomic neuropathy in patients with sleep apnea syndrome and factors which influence the pathogenesis of autonomic neuropathy. Method: We used the cardiovascular autonomic neuropathy(CAN) test as a method for evaluation of autonomic neuropathy. The subjects of this study were 20 patients who diagnosed sleep apnea syndrome by polysomnography and 15 persons who were normal by polysomnography. Results: Body mass index and resting systolic blood pressure were higher in sleep apnea group than control group. Apnea index(Al), respiratory disturbance index(RDI) and snoring time percentage were significantly higher in sleep apnea group compared with control group. But there were no significant differences in saturation of oxygen and sleep efficiency in two groups. In the cardiac autonomic neuropathy test, the valsalva ratio was significantly low in sleep apnea group compared with control group but other tests had no differences between two groups. The CAN scores and corrected QT(QTc) interval were calculated significantly higher in sleep apnea group, but there were no significant correlations between CAN scores and QTc interval. There were no significant data of polysomnography to correlate to the CAN score. It meant that the autonomic neuropathy in patients with sleep apnea was affected by other multiple factors. Conclusion: The cardiovascular autonomic neuropathy test was a useful method for the evaluation of autonomic neuropathy in patients with sleep apnea syndrome and abnormalities of cardiovascular autonomic neuropathy were observed in patients with sleep apnea syndrome. However, we failed to define the factors that influence the pathogenesis of autonomic neuropathy of sleep apnea syndrome. This study warrants futher investigations in order to define the pathogenesis of autonomic neuropathy in patients with sleep apnea syndrome.

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Radiographic change of grafted sinus floor after maxillary sinus floor elevation and placement of dental implant (상악동저 거상술과 임플란트 식립 후 상악동저 변화에 대한 연구)

  • Cho, Sang-Ho;Kim, Ok-Su
    • Journal of Periodontal and Implant Science
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    • v.36 no.2
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    • pp.345-359
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    • 2006
  • Loss of maxillary molar teeth leads to rapid loss of crestal bone and inferior expansion of the maxillary sinus floor (secondary pneumatization). Rehabilitation of the site with osseointegrated dental implants often represents a clinical challenge because of the insufficient bone volume resulted from this phenomenon. Boyne & James proposed the classic procedure for maxillary sinus floor elevation entails preparation of a trap door including the Schneiderian membrane in the lateral sinus wall. Summers proposed another non-invasive method using a set of osteotome and the osteotome sinus floor elevation (OSFE) was proposed for implant sites with at least 5-6mm of bone between the alveolar crest and the maxillary sinus floor. The change of grafted material in maxillary sinus is important for implant survival and the evaluation of graft height after maxillary sinus floor elevation is composed of histologic evaluation and radiomorphometric evaluation. The aim of the present study was radiographically evaluate the graft height change after maxillary sinus floor elevation and the influence of the graft material type in height change and the bone remodeling of grafts in sinus. A total of 59 patients (28 in lateral approach and 31 in crestal approach) who underwent maxillary sinus floor elevation composed of lateral approach and crestal approach were radiographically followed for up to about 48 months. Change in sinusgraft height were calculated with respect to implant length (IL) and grafted sinus height(BL). It was evaluated the change of the graft height according to time, the influence of the approach technique (staged approach and simultaneous approach) in lateral approach to change of the graft height, and the influence of the type of graft materials to change of the graft height. Patients were divided into three class based on the height of the grafted sinus floor relative to the implant apex and evaluated the proportion change of that class (Class I, in which the grafted sinus floor was above the implant apex; Class II, in which the implant apex was level with the grafted sinus floor; and Class III, in which the grafted sinus floor was below the implant apex). And it was evaluated th bone remodeling in sinus during 12 months using SGRl(by $Br\ddot{a}gger$ et al). The result was like that; Sinus graft height decreased significantly in both lateral approach and crestal approach in first 12 months (p$MBCP^{TM}$ had minimum height loss. Class III and Class II was increased by time in both lateral and crestal approach and Class I was decreased by time. SGRI was increased statistically significantly from baseline to 3 months and 3 months(p<0.05) to 12 months(p$ICB^{(R)}$ single use, more reduction of sinusgraft height was appeared. Therefore we speculated that the mixture of graft materials is preferable as a reduction of graft materials. Increasing of the SGRI as time goes by explains the stability of implant, but additional histologic or computed tomographic study will be needed for accurate conclusion. From the radiographic evaluation, we come to know that placement of dental implant with sinus floor elevation is an effective procedure in atrophic maxillary reconstruction.

Change in Potential Productivity of Rice around Lake Juam Due to Construction of Dam by SIMRIW (벼 생장모형 SIMRIW를 이용한 주암호 건설에 따른 주변지역의 벼 잠재생산성 변이 추정)

  • 임준택;윤진일;권병선
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.42 no.6
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    • pp.729-738
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    • 1997
  • To estimate the change in rice productivity around lake Juam due to construction of artificial lake, growth, yield components and yield of rice were measured at different locations around lake Juam for three years from 1994 to 1996. Automated weather stations(AWS) were installed nearby the experimental paddy fields, and daily maximum, average and minimum temperature, solar radiation, relative humidity, and precipitation were measured for the whole growing period of rice. Plant height, number of tillers, leaf area and shoot dry weight per hill were observed from 8 to 10 times in the interval of 7 days after transplanting. Yield and yield components of rice were observed at the harvest time. Simulation model of rice productivity used in the study was SIMRIW developed by Horie. The observed data of rice at 5 locations in 1994, 3 locations in 1995 and 4 locations in 1996 were inputted in the model to estimate the unknown parameters. Comparisons between observed and predicted values of shoot dry weights, leaf area indices, and rough rice yield were fairly well, so that SIMRIW appeared to predict relatively well the variations in productivity due to variations of climatic factors in the habitat. Climatic elements prior to as well as posterior to dam construction were generated at six locatons around lake Juam for thirty years by the method of Pickering et al. Climatic elements simulated in the study were daily maximum and minimum temperature, and amount of daily solar radiation. The change in rice productivity around lake Juam due to dam construction were estimated by inputting the generated climatic elements into SIMRIW. Average daily maximum temperature after dam construction appeared to be more or less lower than that before dam construction, while average daily minimum temperature became higher after dam construction. Average amount of daily solar radiation became lower with 0.9 MJ $d^{-1}$ after dam construction. As a result of simulation, the average productivity of habitats around lake Juam decreased about 5.6% by the construction of dam.

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The Sr and Pb Isotopic and Geochemical Properties of the Atmospheric Bulk Deposition of Jeonju, Gunsan, and Namweon Areas (전주, 군산, 남원지역 강수의 Sr, Pb동위원소 지화학)

  • Jeon Seo-Ryeong;Chung Jae-il
    • Economic and Environmental Geology
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    • v.38 no.4 s.173
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    • pp.463-479
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    • 2005
  • The Sr and Pb isotopic ratios and chemical composition were measured for atmospheric bulk deposition samples collected in the Jeonju, Gunsan and Namweon areas over a period of one year. Acidity of deposition ranged pH $4\~7$ with little higher in dry season, and around pH 5.0 in rainy season. The EC and TDS of rainy season was low showing dilution effect, and increased during dry season. Sulfate $(SO_4)\;and\;NO_3$ are atmospheric aerosols largely of anthropogenic origin in winter. Sodium was concentrated in winter deposition, Ca was concentrated in spring to summer deposition. Namweon has lower EC and TDS than those of other, and Jeonju has higher. Namweon was concentrated in $HCO_3$ and Cunsan was concentrated in Cl. Aluminium, Cu, and Zn show good correlation index with TDS, indicating of their origin atmospheric. $^{87}Sr/^{86}Sr$ ratios of bulk deposition ranged from 0.7109 to 0.7128. The isotopic variations are correlated with mixing of isotopic compositions of local soils, road deposit and biogenic aerosol. In order to constrain further the origin of aerosols in rainwater, it will be necessary to collect additional Sr isotopic data for aerosols. Lead isotope ratios for all areas were similar and belonged to Pb isotope ratios of Seoul's aerosols, but little different with Beijing's aerosols. It showing that Pb in the Korea mainly derived from the gasoline combustion, not exclusively from the Beijing.

The Effect of the Addition of Carbohydrate Sources on the Concentration of Odorous Compounds for Recycling of Pig Slurry to Grassland (발효탄수화물 첨가 비육돈사료가 초지환원용 슬러리의 악취물질 농도에 미치는 영향)

  • Cho, Sung Back;Hwang, Ok Hwa;Park, Kyu Hyeun;Choi, Dong Yun;Yang, Seung Bong;Kim, Do Hwan;Park, Sung Kwon
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.33 no.4
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    • pp.257-262
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    • 2013
  • This study investigates the effect of fermentable carbohydrate on the concentration of odorous compounds in pig slurry. Four types of pig diet were studied: control, peanut hull (crude fiber 29.87, NDF 44.02%), golden fiber (crude fiber 48.77, NDF 65.88%), and almond hull (crude fiber 44.30, NDF 64.44%). Pigs (average BW 37.0 kg) were fed diets that met the Korean Feeding Standard (2012) and their excreta samples were collected from the slurry pits. Levels of volatile organic compounds (phenols and indoles) and volatile fatty acids were analyzed by gas chromatography. Phenol level was the lowest (p<0.05) in golden fiber (33.26 ppm) group and the highest in control (97.29 ppm). The concentration of indoles in the peanut hull (1.27 ppm), almond hull (1.20 ppm), and golden fiber (1.02 ppm) groups was lower (p < 0.05) than that of control (1.79 ppm). Levels of short chain fatty acid (SCFA) were lower (p < 0.05) in golden fiber (1,319 ppm) and almond hull (1,433 ppm) groups than in control (1,893 ppm). Concentration of branched chain fatty acid (BCFA) in the golden fiber group (74 ppm) was lower (p < 0.05) than that of control (98 ppm). Taken together, the concentration levels of phenols, indoles, and VFAs decreased on addition of peanut hull, golden fiber or almond hull to the diet, suggesting that fermentable carbohydrate may contribute to reducing odorous compounds in pig slurry.

Arthroscopic Treatment using Bioabsorbable Knotless Anchor for Anterior Instability of Shoulder (관절경하 생체흡수형 Knotless Anchor를 이용한 견관절 전방 불안정성의 치료)

  • Lee, Yong-Jae;Lee, Tong-Joo;Lim, Kwang-Yul;Kim, Myung-Ku
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.103-108
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    • 2004
  • Purpose: This study reported the outcomes following the use of bioabsorbable knotless anchor in patients with anterior instability of shoulder. Methods: We studied fifteen cases with traumatic anterior shoulder instability underwent arthroscopic Bankart repair with bioabsorbable knotless suture anchor between January 2003 and June 2003. Among fifteen patients, fourteen were male and one was female, with a mean patient age of 24 years (range 16-42). The mean follow-up was 14 months (range 12-18 months). We compared with operation time of twenty cases of arthroscopic Bankart repair by the suture anchor technique between January 2002 and October 2002. Results: Neither recurrent dislocation nor subluxation was happened in postoperative follow-up. Mean score for functional evaluation by Rowe et al. was 89.4 and that for patient subjective satisfaction was 87,5. At last follow-up period, average shoulder range of motion for flexion and external rotation was 171$^{\circ}$ and 54$^{\circ}$ respectively. All patients were satisfied except three who had an apprehension at the follow up. During Bankart repair, it took an average of 25.5 minutes for one knot with the use of suture anchor technique whereas an average of 16.5 minutes for one knot with the use of bioabsorbable knotless anchor. Significantly, we saved operation time with the use of bioabsorbable knotless anchor (P<0.05).Conclusion: Repairing the Bankart lesion with the use of knotless anchor technique has the advantage of obtaining good capsular tensioning and saving operation time. And it is considered to be very successful in treating shoulder instability without recurrent dislocation or subluxation.

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Role accomplishment and job satisfaction of hospice nurse (호스피스간호사의 역할수행 정도와 직무만족도)

  • Han, Hyoung-Suk;Choe, Wha-Sook
    • Korean Journal of Hospice Care
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    • v.8 no.1
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    • pp.29-48
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    • 2008
  • Purpose: The purpose of this study was to provide the basic information on the improvement plan by identifying the role accomplishment and job satisfaction of the hospice nurses and analyzing the factors that impact such role accomplishment and job satisfaction. Methods: The data was collected of 189 hospice nurses who have been working more than 6 months in 56 hospice programs registered in Korea Hospice Association and Korean Catholic Hospice Association from October to November, 2007 by structured questionnaire which was developed by Ryu(1979), based on the Riehl's nursing role and the research of Choe(2005) on the role of hospice nurse. Results: The role accomplishment and job satisfaction of the study subject were 3.53 point and 3.39 point, respectively. The roles of hospice nurses were accomplished by the order of advocator, nursing care provider, coordinator (cooperation), educator, quality manager, counsellor, administrator, and researcher. The job satisfaction of the hospice nurses was shown highest in the satisfaction of professional status, followed by the satisfaction of the interaction, satisfaction of the task itself, satisfaction of the administrative aspect, satisfaction of the autonomous, and the lowest in the satisfaction of the pay. The role accomplishment of the subjects according to their socio-demographic and job characteristics was found to have a significant difference by their age, marriage status, academic background, and position. It also has a significant difference by whether they play role of coordinator, whether they took whole responsibility as hospice, working experience as hospice/palliative nurse, and the level of hospice/palliative nursing training(p<.05). In the study of job satisfaction of the subjects according to their socio-demographic and job characteristics, the job satisfaction was found to have a significant difference by the increase of age, the number of duties consisting the hospice team, whether they play role of coordinator, whether they take whole responsibility as hospice, the level of hospice/palliative nursing training, and whether they wish to work for as long as possible(p<.05). The role accomplishment and the job satisfaction of the subjects showed a statistically significant positive correlation. (r=.541, p<.01) Conclusion: Raised saiary will be increased hospice nurse's job satisfaction. And we suggest a repetitive study using the identical tool to the equally extracted subjects with same representativeness of each hospice/palliative institute type. For the expanded role and enhanced professional standard of hospice nurses, we also suggest a study on the improvement plan to enhance the roles of researcher and administrator.

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Views of Public Dental Hygienist about Oral Health Hub Center - In the Area Not Implemented (구강보건센터 미설치 보건소 치과위생사의 구강보건센터 설치 및 운영에 관한 견해)

  • Kim, Kyung-Mi;Yoo, Eun-Mi;Heo, Sun-Soo;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.12 no.6
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    • pp.675-681
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    • 2012
  • Korean Ministry of Health and Welfare started to implement oral health hub center to provide oral health preventive program and dental treatment to public, especially dental vulnerable class in 2006. But, there is no applicant area to implement it regardless of national budget arrangement in 2012. This study is aimed to investigate the reason not to be implemented and requirements of implementation. 293 among 1,000 public dental hygienists in the area where have not implemented oral health hub center were surveyed in Korea from April to July in 2012 through convenience sampling. The questionnaire consisted of the reason why oral health hub center have not been implemented, the requirement of implementation, duty area and duty position et al. After removal of insufficient responses, 217 questionnaires were analyzed by t-test and ANOVA using SPSS 20.0. The reason why oral health hub center have not been implemented were deficiency of the priority list as compared with other health program (72.4%), space insufficiency (71.4%), regional budget insufficiency (70.5%), will insufficiency of oral health promotion (70.5%) and manpower insufficiency (62.7%). The first requirement of implementation were space expansion and regional budget expansion, followed by reduction of record-originated and administrative tasks, understanding on oral health program of higher ranking public officials in health center, manpower expansion, reduction of other tasks than oral health program and volunteer source expansion. Budget insufficiency and manpower insufficiency in Metropolis were ranked higher than other area (p<0.05). The group not to discuss oral health hub center graded each reason not to be implemented significantly higher than the other group (p<0.05). We suggested that to promote the importance of public oral health program be needed to public and higher ranking public officials to implement oral health hub center. In addition, we insisted that more dental manpower and budget be needed for reduction of oral health inequity in metropolis.