Whole genome sequencing (WGS)-based noninvasive prenatal test (NIPT) is the first method applied in the clinical setting out of various NIPT techniques. Several companies, such as Sequenom, BGI, and Illumina offer WGS-based NIPT, each with different technical and bioinformatic approaches. Sequenom, BGI, and Illumina utilize z-, t-, and L-scores, as well as normalized chromosome values, respectively, for trisomy detection. Their outstanding performance has been demonstrated in clinical studies of more than 100,000 pregnancies. The sensitivity and specificity for detection of trisomies 13, 18, and 21 were above 98%, as reported by all three companies. Unlike other techniques, WGS-based NIPT can detect other trisomies as well as clinically significant segmental duplications/deletions within a chromosome, which could expand the scope of NIPT. Incorrect results could be due to low fetal fraction, fetoplacental mosaicism, confined placental mosaicism or maternal copy number variation (CNV). Among those, maternal CNV is a significant contributor of false positive results and therefore genome wide scanning plays an important role in preventing the occurrence of false positives. In this article, the bioinformatic techniques and clinical performance of three major companies are comprehensively reviewed.
Down Syndrome ; Genome* ; Mosaicism ; Pregnancy ; Sensitivity and Specificity ; Trisomy

No abstract available.
Child* ; Humans ; Lymphangioma*

To investigate the NS4 region of JEV, NS4 cDNA of K94P05 (JEV strain isolated from Korea in 1994) was amplified by RT-PCR and analyzed by sequencing PCR product. Genomic size of NS4 was 1212bp and nucleotide sequence was compared with that of other JEV strains. Nucleotide homology between JaOAr582 and K94P05 was 91.1% and that between Beijing and K94P05 was 89.8%, respectively. But the nucleotide sequence of I region of JaOAr582 and K94P05 showed 97.0% homology and that of Beijing and K94P05 did 95.8% homology. NS4 protein was expressed as a form of fusion protein by a prokaryotic expression system. The induced fusion product showed a lower molecular weight than predicted size and remained insoluble. The NS4 protein might be cleavages by E. coli protease. Concluding above results, high hydrophobicity of the NS4 protein supported the fact that this protein played a role as a membrane component and the poor nucleotide sequence conservativity among JEV strains suggested that this region might be important to adapt each viral growth environment.
Asian Continental Ancestry Group* ; Base Sequence ; DNA, Complementary ; Encephalitis Virus, Japanese* ; Encephalitis, Japanese* ; Humans ; Hydrophobic and Hydrophilic Interactions ; Korea* ; Membranes ; Molecular Weight ; Polymerase Chain Reaction

No abstract available.
Infection Control*

Intrathecal administration of methotrexate(IT-MTX) has constituted the standard approach to prophylaxis and treatment of central nevous system(CNS) leukemia. We experienced a quadriplegia and motor aphasia in a 14-year-old boy following repeated IT-MTX for the prophylaxis of meningeal leukemia. He was diagnosed as ALL without CNS involvement and treated by CCG- 1882 protocol. IT-MTX was administered for CNS prophylaxis. The patient began complaining of urinary incontinence, motor aphasia and weakness in his right leg from 12 days after the 5th dose of the IT-MTX therapy. Even though the IT-MTX was discontinued, loss of muscle power progressed upward resulting in quadriplegia. The patient showed slow and partial recovery on right extremities over 3 months. We report this case with brief review of literature.
Adolescent ; Aphasia, Broca* ; Extremities ; Humans ; Leg ; Leukemia ; Male ; Methotrexate* ; Quadriplegia* ; Urinary Incontinence

No abstract available.
Child* ; Humans

Terminal or interstitial deletions of Xp (Xp22.2-->Xpter) in males have been recognized as a cause of contiguous gene syndromes showing variable association of apparently unrelated clinical manifestations such as Leri-Weill dyschondrosteosis (SHOX), chondrodysplasia punctata (CDPX1), mental retardation (NLGN4), ichthyosis (STS), Kallmann syndrome (KAL1), and ocular albinism (GPR143). Here we present a case of a 13.5 yr old boy and sister with a same terminal deletion of Xp22.2 resulting in the absence of genes from the telomere of Xp to GPR143 of Xp22. The boy manifested the findings of all of the disorders mentioned above. We began a testosterone enanthate monthly replacement therapy. His sister, 11 yr old, manifested only Leri-Weill dyschondrosteosis, and had engaged in growth hormone therapy for 3 yr. To the best of our knowledge, this is the first report of a male with a 9.7 Mb terminal Xp deletion including the OA1 locus in Korea.
Abnormalities, Multiple/*genetics ; Adolescent ; Child ; Chromosome Deletion ; *Chromosomes, Human, X ; Eye Proteins/genetics ; Female ; Genetic Loci ; Growth Hormone/therapeutic use ; Humans ; Male ; Membrane Glycoproteins/genetics ; Telomere/genetics ; WAGR Syndrome/*diagnosis/genetics/therapy

We managed three cases of anesthesia for living related liver transplantation from December 1994 to July 1995. Donors were recipient's parents and two of them were 35-year old man, the other was 25-year-old woman. The recipients were suffered from congenital liver diseases (two of them were diagnosed as biliary atresia and the other Byler's disease). They had presented severe jaundice and cholangitis and their mean age & body weight were 15 +/- 4.9 months and 8.6 +/- 1.22 kg, respectively. Average duration of anesthesia was about 15 hours, and anhepatic time was 140 minutes, 80 m inutes and 50 minutes, respectively. Careful attention was paid to body temperature, serum potassium, ionized calcium, blood coagulation function, as well as to general condition and respiratory function. Hemodynamic value was relatively stable through out the operation and postoperative mechanical ventilatory support was required for about 3 days.
Adult ; Anesthesia ; Biliary Atresia ; Blood Coagulation ; Body Temperature ; Body Weight ; Calcium ; Child* ; Cholangitis ; Female ; Hemodynamics ; Humans ; Jaundice ; Liver Diseases ; Liver Transplantation* ; Liver* ; Parents ; Potassium ; Tissue Donors*

Reports of constitutional ring chromosome 22, r(22) are rare. Individuals with r(22) present similar features as those with the 22q13 deletion syndrome. The instability in the ring chromosome contributes to the development of variable phenotypes. Central nervous system (CNS) atypical teratoid rhabdoid tumors (ATRTs) are rare, highly malignant tumors, primarily occurring in young children below 3 years of age. The majority of ATRT cases display genetic alterations of SMARCB1 (INI1/hSNF5), a tumor suppressor gene located on 22q11.2. The coexistence of a CNS ATRT in a child with a r(22) is rare. We present a case of a 4-month-old boy with 46,XY,r(22)(p13q13.3), generalized hypotonia and delayed development. High-resolution microarray analysis revealed a 3.5-Mb deletion at 22q13.31q13.33. At 11 months, the patient had an ATRT (5.6 cmx5.0 cmx7.6 cm) in the cerebellar vermis, which was detected in the brain via magnetic resonance imaging.
Brain ; Brain Neoplasms* ; Central Nervous System ; Child ; Genes, Tumor Suppressor ; Humans ; Infant* ; Magnetic Resonance Imaging ; Male ; Microarray Analysis ; Muscle Hypotonia ; Phenotype ; Rhabdoid Tumor ; Ring Chromosomes*

Testicular feminization syndrome (TFS) is a genetic disorder due to androgen insensitivity of the target organs. The most common clinical presentation of complete TFS is inguinal hernia in the infant or primary amenorrhea in the adolescence. A 7-year old phenotypically female patient was seen with a complaint of a right inguinal mass. Under the diagnosis of right inguinal hernia, high ligation was performed. Six months later, the patient showed a left inguinal mass. On operation, the mass looked like a testis. The external genitalia were normal female, but a uterus and ovary were not identified. Chromosome study showed a 46, XY karyotype and the levels of serum testosterone and dihydrotestosterone were increased after HCG stimulation. The patient was diagnosed as complete TFS and underwent bilateral gonadectomy 6 months later.
Adolescent ; Amenorrhea ; Androgen-Insensitivity Syndrome* ; Child ; Diagnosis ; Dihydrotestosterone ; Female ; Genitalia ; Hernia, Inguinal ; Humans ; Infant ; Karyotype ; Ligation ; Male ; Ovary ; Testis ; Testosterone ; Uterus