The Evaluation of Integrated Test as an Antenatal Screening Test for Down's Syndrome in Korea

BACKGROUND: Antenatal screening for Down's syndrome has been developed and improved over the past 20 yr. Recently, integrated test, which combines the first and second trimester markers has shown the highest detection rate (DR) and lowest false positive rate (FPR) among Down's syndrome screening tests currently in use. The purposes of this study were to evaluate the screening performance of integrated test and to compare the results with triple test studies in Korea. METHODS: The study population consisted of Korean pregnant women who underwent triple or integrated test between April 2005 and December 2008. Triple test was performed using measurements of alpha-fetoprotein (AFP), unconjugated estriol (uE3), and human chorionic gonadotropin (hCG) in the second trimester. Integrated test was performed using nuchal translucency (NT) by ultrasonography and pregnancy-associated plasma protein A (PAPP-A) from maternal serum in the first trimester, and AFP, uE3, hCG, and inhibin-A in the second trimester. The screening performance of each test was evaluated by DR and FPR. RESULTS: Twenty-seven Down's syndrome pregnancies were confirmed in women screened by triple (N=6,736) or integrated test (N=7,688). At 1:100, 1:270, and 1:300 of risk cutoff, triple test showed 45%, 73%, and 73% of DR and 4.7%, 11.2%, and 12.4% of FPR, respectively. At 1:100, 1:150, and 1:300 of risk cutoff, integrated test showed 63%, 69%, and 75% of DR and 1.5%, 1.9%, and 3.0% of FPR, respectively. CONCLUSIONS: Integrated test showed higher DR and lower FPR, demonstrating better screening performance than triple test.

Efficacy and Safety of Autologous Bone Marrow-derived Mesenchymal Stem Cell Treatment in Patients With Amyotrophic Lateral Sclerosis

BACKGROUND: This study was performed to investigate the efficacy and safety of intrathecal autologous bone marrowderived mesenchymal stem cells (MSCs) treatment for patients with ALS. METHODS: After a lead-in period for 3 months, 22 patients were treated with MSCs twice at an interval of 1 month. After initial MSCs injection, all patients were followed up for 3 months and their disease course, clinical characteristics were assessed. Disease status of patients were analyzed with ALS functional rating scale-revised (ALSFRS-R) for primary outcome measure, and additional clinical findings after treatment were all collected for secondary outcome measure and safety. Age and disease-duration matched patients with ALS were selected as a control group. RESULTS: During the follow-up period, MSCs treatment yielded a significant lesser change of ALSFRS-R score, compared to control group (1.54 vs 3.56, p<0.01). Moreover, the slop of decline of ALSFRS-R was significantly lower during the follow-up period, compared to the lead-in period in MSCs treatment group (2.68 vs 1.54, p=0.04), whereas the slopes during the two periods were not different in the control group (3.15 vs 3.56, p=0.37). MSCs treatment was well tolerated except for occurrences of transient headache, low back pain, and myalgia. CONCLUSIONS: Our results show that intrathecal MSCs injection can slow disease progression and might be used as a disease modifying modality as an alternative treatment choice in patients with ALS.

Cord Blood Processing with Automated and Closed "Sepax(R) System" and Manual Technique / 대한수혈학회지

BACKGROUND: Cord blood has been established as an alternative source of hematopoietic reconstituting cells for allogeneic transplantation. CHA cord blood bank, I-CORD has been followed the 'Rubinstein method', which is manual method for collecting mononuclear cells (MNCs). The problem of these manual methods are the risk of bacterial contamination and poor reliability. Recently, an automated method running on the Sepax(R) system (Biosafe S.A., Eysins, Switzerland) has been developed and we compared the results of automated system and manual technique. METHODS: For the total 40 cord blood donations to CHA cord blood bank I-CORD, we processed with manual method using Rubinstein protocol or automated method using "Sepax(R)" (Biosafe S.A.). The recovery rate of total leukocytes and mononuclear cells and hematocrit ratio were compared after processing. RESULTS: The mean ratio of hematocrit after/before processing was significantly lower in samples processed by using manual method (0.96+/-0.42) than "Sepax(R)" (1.4+/-0.4). The WBC recoveries were comparable between two groups (82.8+/-12.8% with manual method and 83.9+/-8.9% with "Sepax(R)"). The recoveries of mononuclear cells were more efficient in samples processed by "Sepax(R)" (100.8+/-31.8%) than those by manual method (74.2+/-13.8%). CONCLUSION: The automated technique using "Sepax(R)" achieved a comparable recovery rate to conventional manual method and has advantages because these systems are more standardized and closed system. The processing effectiveness could be improved through more practices.

The Measurement of Gastric Emptying Time with 3-D Ultrasonography / 대한소화기학회지

BACKGROUND/AIMS: Three dimensional (3-D) ultrasonography is definitely more accurate than conventional 2-D ultrasonography in volume measurement of intra-abdominal organs. However, its application in measuring gastric emptying time has been limited. Thus, we tried to measure gastric antral emptying time by using 3-D ultrasonography and compare with that by radio-scintigraphy. METHODS: We performed both 3-D ultrasonography and radio-scintigraphy on the same day in 23 healthy subjects. After overnight fast, the subjects ingested 500 mL of soup meal (84 Kcal) that had been pre-mixed with 1 mCi of technetium(99m). The half emptying time (T(1/2)) measured by 3-D ultrasonography was defined by the time when the gastric antral volume decreased to half. RESUTLS: The mean T(1/2) of 23 healthy subjects measured by 3-D ultrasonography was 23.4 +/- 10.5 min, while that measured by scintigraphy was 28.4 +/- 14.4 min. The difference (p=0.11 by paired t-test) between the two methods was not significant. Moreover, no significant correlation of T1/2 between the two methods (r=0.361, p=0.09) was observed. CONCLUSIONS: Measuring gastric antral emptying time with 3-D ultrasonography may be useful but require further validation studies and advance in technology.