Chromosomal mosaicism: Origins and clinical implications in preimplantation and prenatal diagnosis

The diagnosis of chromosomal mosaicism in the preimplantation and prenatal stage is fraught with uncertainty and multiple factors need to be considered in order to gauge the likely impact. The clinical effects of chromosomal mosaicism are directly linked to the type of the imbalance (size, gene content, and copy number), the timing of the initial event leading to mosaicism during embryogenesis/fetal development, the distribution of the abnormal cells throughout the various tissues within the body as well as the ratio of normal/abnormal cells within each of those tissues. Additional factors such as assay noise and culture artifacts also have an impact on the significance and management of mosaic cases. Genetic counseling is an important part of educating patients about the likelihood of having a liveborn with a chromosome abnormality and these risks differ according to the time of ascertainment and the tissue where the mosaic cells were initially discovered. Each situation needs to be assessed on a case-by-case basis and counseled accordingly. This review will discuss the clinical impact of finding mosaicism through: embryo biopsy, chorionic villus sampling, amniocentesis, and noninvasive prenatal testing using cell-free DNA.     

Frequency and clinical consequences of extremely high maternal serum PAPP-A levels

A multicentre study was carried out to determine the frequency and clinical consequences of extremely high maternal serum pregnancy-associated plasma protein (PAPP)-A. There was a total of 79 pregnancies with PAPP-A exceeding 5.0 multiples of the gestation-specific median in a series of 46 776 pregnancies tested (0.2%) at the 7 collaborating centres. Five pregnancies were lost to follow-up, one miscarried and one with Noonan's syndrome was terminated. Of the remaining 72 that ended in a live birth, one infant had gastroschisis and five pregnancies had obstetric complications: pre-eclampsia, pregnancy-induced hypertension, gestational diabetes and two with growth retardation. Among women with high PAPP-A and no complications or adverse outcomes, there was no evidence of a substantial change in the levels of other Down syndrome markers or the extent of nuchal translucency. Three analytical methods were used to assay PAPP-A and yielded different frequencies of extremely high levels (0.05%, 0.4% and 0.6%) possibly owing to cross-reaction with another substance. We conclude that women with high PAPP-A can be reassured that there is no reason to suppose that the outcome of pregnancy will differ from those with normal levels, provided other markers are normal. If, as more centres move their Down syndrome screening practice to the first trimester, additional cases emerge with Noonan's syndrome or gastroschisis and raised PAPP-A, this advice will need to be modified. Copyright © 2003 John Wiley & Sons, Ltd.     

Trisomy 18 in chorionic villus sampling: Problems and consequences

Among 1547 patients undergoing first-trimester prenatal diagnosis, 100 fetal chromosome aberrations were detected. Thirteen of these involved chromosome 18. In two structural abnormalities of chromosome 18, the aberration could be excluded in amniotic fluid cells and two healthy infants were born. Trisomy 18 was not confirmed in amniotic fluid cells in three trisomy 18 mosaics. In eight non-mosaic trisomy 18 first-trimester diagnoses, the diagnosis was excluded by amniotic fluid cells or fetal cultures in four, and confirmed in the remaining four. Diagnosis of chromosome 18 aberrations in the direct preparation should be confirmed in the long-term culture of the chorionic villus sample or by amniotic fluid cultures.     

Origins and mechanisms leading to aneuploidy in human eggs

The gain or loss of a chromosome—or aneuploidy—acts as one of the major triggers for infertility and pregnancy loss in humans. These chromosomal abnormalities affect more than 40% of eggs in women at both ends of the age spectrum, that is, young girls as well as women of advancing maternal age. Recent studies in human oocytes and embryos using genomics, cytogenetics, and in silico modeling all provide new insight into the rates and potential genetic and cellular factors associated with aneuploidy at varying stages of development. Here, we review recent studies that are shedding light on potential molecular mechanisms of chromosome missegregation in oocytes and embryos across the entire female reproductive life span.     

Landscape fragmentation by urbanization in the Netherlands:optionsand ecological consequences

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Hyperechoic fetal bowel: The perinatal consequences

A number of publications have reported an association between the finding of hyperechoic fetal bowel on prenatal sonogram and disorders such as aneuploidy and cystic fibrosis. To define more precisely the significance of this finding, we systematically reviewed the published material on the subject. Based on a total of 357 reported cases, we documented a high prevalence of cystic fibrosis (25·6 per cent) and chromosome abnormality (12·4 per cent) associated with increased bowel echogenicity in the fetus. High rates of intrauterine growth retardation (14·9 per cent), fetal demise (9·0 per cent), and prematurity (15·3 per cent) were also found. The data were obtained from a population at high a priori risk for aneuploidy and included fetuses at 1 in 4 risk for cystic fibrosis reported in two studies. This increased the bias towards an adverse outcome. The rate of complications when a hyperechoic abdomen is noted in a low-risk fetal population has so far not been delineated. Although the high frequency of complications found is of concern and warrants investigation, extrapolation of these risk figures to a fetal population at low a priori risk may not be appropriate.     

云南省地表水水化学特征及成因

对云南省主要河流、湖泊、水库等地表水的水化学特征及其分布规律进行了分析,简要分析了基本成因和影响因素.     

Urbanization, environmental consequences and management in China

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Aphid soldier differentiation: density acts on both embryos and newborn nymphs

The mechanism of caste differentiation in a social aphid Tuberaphis styraci, which has a sterile soldier caste in the 2nd instar, was investigated using an artificial diet rearing system. High aphid density induced soldier production. Combinatorial prenatal and postnatal density treatments revealed that (1) either prenatal high density or postnatal high density is sufficient for soldier induction; (2) thus, embryos in the maternal body and newborn 1st instar nymphs are both responsive to high density; (3) the combination of prenatal high density and postnatal high density enhances soldier differentiation in a synergistic manner; and (4) the final determination of soldier differentiation occurs postnatally, probably at a late 1st instar stage. This study first throws light on the developmental aspects of caste differentiation in a social aphid.     

Fetal blood sampling and cytogenetic abnormalities

From September 1984 to April 1991, we performed cytogenetic analysis on fetal blood samples from 214 second-and third-trimester pregnancies. One hundred and thirty-four cases were referred to consider the possibility of chromosomal mosaicism following amniocyte studies. The confirmation rate of mosaicism is at 0 per cent (0/9), 1·4 per cent (1/70), and 40 per cent (22/55) for cases of level I, level II, and level III mosaicism, respectively. Four out of 17 cases were positive for the diagnosis of fragile X syndrome. Of 63 cases with abnormal ultrasound findings, blood disorders, or other genetically related clinical conditions, 11 were found to have a chromosome abnormality. Fetal blood sampling is a valuable adjunct to other methods in the prenatal diagnosis of chromosomal mosaicism or pseudomosaicism. It is also useful when rapid cytogenetic diagnosis is desired because of malformations detected in pregnancies at a late gestational age.     

雷州半岛胀缩土地裂缝及其成因机理

本文简述了雷州半岛胀缩土地裂缝的特征及分布发育规律；分析了胀缩土地裂缝的成因。认为雷州半岛胀缩土地裂缝的形成发育是胀缩土以及气候、植被、地形地貌、水文地质作用等因素综合作用的结果。其中胀缩土含大量的亲水矿物和失水产生向心收缩的特性从而成为地裂缝成生发展的内因。而特定的气候、植被、地形地貌、水文地质作用等外部环境条件则是导致胀缩土失水和发展形成地裂缝的重要外因。桉树是一种吸水-蒸腾能力极强的树种，树根的干燥作用是导致了林区土体干燥-收缩和形成收缩应力场及在林地边缘产生地下暗裂缝的关键因子，而极端的干旱气候环境和久旱后第一场大暴雨则是暗裂牵动式胀缩土地裂缝发育形成不可或缺的因素。胀缩土地裂缝灾害应重在预防，有关的策略包括防水保湿、科学植树、建筑设计和地基处理、科学选址。     

Fetal cardiac abnormalities: Genetic etiologies to be considered

Congenital heart diseases are a common prenatal finding. The prenatal identification of an associated genetic syndrome or a major extracardiac anomaly helps to understand the etiopathogenic diagnosis. Besides, it also assesses the prognosis, management, and familial recurrence risk while strongly influences parental decision to choose termination of pregnancy or postnatal care. This review article describes the most common genetic diagnoses associated with a prenatal finding of a congenital heart disease and a suggested diagnostic process.     

Amniotic fluid-AFP in Down syndrome and other chromosome abnormalities

80·2 Per cent of 111 Down syndrome pregnancies had amniotic fluid (AF) alpha fetoprotein (AFP) levels on or below the median and 10·8 per cent at or below 0·5 MoM compared with 41·9 and 1·4 per cent of controls. These differences were even more striking when the gestational age was < 18 weeks compared with ⩾ 18 weeks. No such association was seen for other chromosome abnormalities including trisomy 18,45,X and mosaics, 47,XXY, 47,XXX, and other structural abnormalities and triploidy, even when high levels due to defects such as omphalocele and cystic hygroma were excluded. All cases of trisomy 13 and 80 per cent with 47,XYY had AF-AFP levels above the median. Selection of cases for karyotyping by a low level of AF-AFP would clearly fail to detect aneuploidies other than Down syndrome and is not recommended. A possible weak association between low maternal serum (MS) and AF-AFPs in Down syndrome was most evident at < 18 weeks, suggesting that MS screening between 16 and 18 weeks may be the most informative time.     

渔洞水库pH值碱化成因分析及控制

分析了渔洞水库水体pH值变化成因,藻类的生长与pH之间的关系,认为水体pH值变化与水库中营养盐存在密切关系。针对渔洞水库治理的实际,提出治理措施及管理建议。     

中国典型湖泊沉积物中脂肪烃的分布特征及来源

以我国13个典型湖泊的表层沉积物为研究对象,对沉积物的w(TOC)和w(TN)的分布特征进行了报道.结果显示,西南、华南地区湖泊沉积物的w(TOC)和w(TN)要高于西北地区,华东地区湖泊沉积物最低.结合多个脂肪烃来源参数,初步探讨了13个典型湖泊表层沉积物中脂肪烃的分布特征及来源. 结果表明:湛江玛珥湖、四海龙湾、洱海、红枫湖和程海受脂肪烃污染严重,鄱阳湖和双塔水库受脂肪烃污染程度最轻;受水体高矿化度的影响,双塔水库沉积物中有机质的δ13C值明显偏正;湛江玛珥湖中来自自身固氮藻类的脂肪烃含量明显高,致使湛江玛珥湖沉积物的δ15N值明显低;由于四海龙湾特殊的地理环境,四海龙湾沉积物中来自陆源木本植物的w(C_27+C29)明显高.      

Preimplantation genetic diagnosis for aneuploidy screening in early human embryos: a review

Embryonic aneuploidies may be responsible for pregnancy failure in many IVF patients. In recent years, fluorescent in situ hybridisation (FISH) for multiple chromosomes has been used to document a high frequency of chromosomal errors and aneuploidy in human preimplantation embryos and, after embryo biopsy, to select embryos that are more likely to implant. Such studies suggest that women with recurrent miscarriage and advanced maternal age may benefit most from preimplantation genetic diagnosis with aneuploidy screening (PGD-AS). The success of PGD-AS is likely to be enhanced by new technologies, such as comparative genomic hybridisation, which enable full karyotyping of single cells. Copyright © 2002 John Wiley & Sons, Ltd.