(45,X)
Based on a number of cytogenetic studies, the incidence of TS is estimated to range from 25 to 210 per 100,000 women ( 13 ). According to study from 1999 to 2004, the incidence of TS in 119,158 births was 1/1,180 or 0.85% ( 14 ). The incidence rate of Chinese (0.90‰ or 1/1,111) is higher than that of Malays (0.72‰ or 1/1,389) and India (0.38‰ or 1/2,632). The incidence of TS has increased according to a study in Denmark ( 15 ), and the known number of surviving patients with TS steadily increased during that study. Mortality due to TS has also increased. In a UK cohort study, the relative risk of death increased to 4.2 due to an increased risk of diseases of the nervous system, digestive system, cardiovascular system, respiratory system, or genitourinary system ( 16 ).
3.1. cardiovascular abnormalities.
An epidemiological study indicated that the overall mortality rate for patients with TS was 3 times that for the normal population ( 17 ). Cardiovascular events are a major risk factor and occur in 41% of patients. Patients with TS have congenital cardiovascular abnormalities more often than normal people. Heart valve disease is a prevalent abnormality, and patients with TS have a significantly higher incidence of aortic bicuspid deformity. Patients with TS have a risk of dying mainly from an aortic dissection aneurysm, young people with TS have a significantly smaller aortic diameter than the general population, and aortic surgery is indicated for patients with TS over the age of 18 with an ascending aortic size index > 2.5 cm/m 2 to prevent aortic dissection ( 18 ). Due to the limited number of patients and ethnic differences, the exact incidence of cardiovascular disease in patients with TS is unclear and needs to be studied further.
Secondary autoimmune disease is one of the most prominent features of TS due to aneuploidy of the X chromosome ( 19 ). TS causes a variety of autoimmune diseases such as thyroiditis, colitis, celiac disease, type 1 diabetes, and psoriasis, though the most common is autoimmune thyroiditis ( 20 ). Follow-up studies have indicated that the incidence of autoimmune thyroiditis in patients with TS is 3.2% ( 21 ). Chinese (Han) patients with TS are prone to Hashimoto's thyroiditis ( 22 ); the prevalence of Hashimoto's thyroiditis in the general population in China is about 0.4-1.5%. The incidence of Hashimoto's thyroiditis in children with TS is significantly higher than that in other regions ( 23 ). Compared to the general population, patients with TS have an increased incidence of celiac disease; depending on the number of patients studied, its prevalence varies from 2.2 to 8.1%. Celiac disease may aggravate the manifestation of short stature, hypogonadism, and osteoporosis ( 24 , 25 ). The incidence of other autoimmune disease impacts the lives of patients with TS to an extent.
Fractures are considered to be one of the major complications of TS. However, there is currently no evidence of an increased risk of fracture in children and adolescents with TS, but there is evidence that women with TS have about a 25% increased risk of fracture, mainly in the form of forearm fractures ( 26 ). However, tomographic data from patients with TS are disputed, and especially those from studies of elderly patients who have never received estrogen or who have received delayed and suboptimal therapy, and the prevalence of fractures may be overestimated ( 15 ). Landin- Wilhelmsen et al . found that osteoporosis and fractures are related to age in patients with TS; of 70 patients with TS, 16% had suffered a fracture and 50% were over the age of 45 ( 27 ). Timely diagnosis and treatment can help to keep bone healthy in patients.
Prenatal counseling is important, and in some countries a fetus diagnosed with TS is electively aborted. An increasing number of patients are diagnosed with TS during a prenatal examination. Some babies are diagnosed with TS in the womb or at birth based on the results of an ultrasound examination or signs of lymphedema or congenital heart disease (such as aortic coarctation) ( 28 , 29 ). Next-generation sequencing technologies (such as genomes, whole exomes, and gene panel sequencing) are likely to identify more diseases during newborn screening than other methods ( 30 , 31 ). However, errors do occur during prenatal examinations, so a complete karyotype analysis needs to be performed to verify those results. The gold standard for diagnosis is karyotype analysis ( 32 ). Real-time polymerase chain reaction (PCR) gene quantification can be used to diagnose TS. CpG methylation sites specific to X-chromosome inactivation that are widely distributed on the X chromosome may be a marker of TS ( 33 ).
Attention should also be paid to other signs of TS: i ) conductive and sensorineural deafness; regular hearing tests should be conducted every 1-3 years; ii ) hyperopia; a regular eye examination should be performed at age 1.0-1.5; iii ) strabismus, a normal eye examination should be performed at 4 months to 5 years of age; iv ) abnormal kidney or liver function; a renal ultrasound should be performed, and at the age of 10 or so urea and creatinine levels, liver function, and the total blood cell count should be measured; v ) hip dislocation and feeding difficulties; these manifestations should be monitored until infancy; vi ) otitis media and delayed adolescence; these manifestations should be monitored throughout childhood; vii ) scoliosis/kyphosis; these manifestations should be monitored during adolescence; and viii ) dysplasia; this manifestation should be monitored during the entire growth process ( 34 ). Methods of diagnosing TS are listed in Table 2 .
Method of diagnosis | Characteristics | . |
---|---|---|
Next-generation sequencing technologies (such as genomes, whole exomes, and gene panel sequencing) | Noninvasive prenatal test; allows the identification of more diseases. | ( , ) |
Karyotype (gold standard) | Labor intensive, unrealistic for large-scale population or high-throughput testing. | ( ) |
Molecular methods (Southern blotting, polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP), fluorescent PCR genotyping, GeneScan-based genotyping, and real-time PCR) | Cannot effectively detect individuals with mosaic or partial X chromosome deletions. | ( ) |
Developmental process (hearing, vision, liver function, kidney function, and spine) | Can help with diagnosis. | ( ) |
In short, timely diagnosis is very important. In addition to genetic testing, manifestations of TS should be monitored during the entire developmental process so that TS can be treated in a timely manner.
5.1. growth hormone therapy.
A study has indicated that growth hormone therapy can increase the adult height of patients with TS ( 35 ). A study administered growth hormone to 16 girls with TS in India over a prolonged period; the patients' height SD score and body mass index indicated that patients with TS did benefit from growth hormone ( 36 ). A large number of studies have indicated that administration of high doses of biosynthetic human growth hormone can significantly increase the lifelong height of children with TS, so growth hormone therapy is currently the treatment of choice. The sensitivity of an individual to recombinant human growth hormone (r-hGH) is known to vary ( 37 ); it causes significantly accelerated growth in the first year, but the response gradually diminishes over time ( 38 , 39 ). The patient's lifelong height is related to the age at treatment, time, and dose ( 1 ) and the administration of growth hormone ( 40 ). Various combination therapies are better than therapy with growth hormone alone. Long-term growth hormone therapy has a positive effect on craniofacial development in girls with TS, and its greatest impact is on posterior facial height and the height of the mandibular ramus ( 41 ).
Retarded adolescent growth is related to a deficiency of estrogen in patients with TS, so estrogen is administered ( 42 ). In the past, estrogen replacement therapy started when the patient was 15 years old to avoid premature closure of the epiphysis, thus affecting the patient's lifelong height. The general recommendation is that patients be started on small doses of estrogen at age 12, enabling the patient to begin developing secondary sexual characteristics and the uterus and to improve liver function, cognitive function, and quality of life ( 43 ). A recent trial administered r-hGH and low-dose estrogen to patients with TS for 20 years ( 44 ). Results clearly indicated that administering very low doses of estradiol and r-hGH in adolescence produced estrogen levels close to those of healthy girls in puberty; as adolescent girls with TS mature, increasing the dose of estradiol greatly increases their final adult height. Many forms of estrogen can be used to treat patients, the most common of which is oral estrogen followed by transdermal patches. However, whether young patients with TS should take oral estrogen or use estradiol transdermal patches needs to be verified further ( 43 ).
In 1986, a trial administered r-hGH alone or in combination with androgen for the first time; once the trial was complete and patients with TS reached their final height, this combination therapy significantly increased growth and final adult height ( 45 ). However, the possibility of adverse reactions (such as masculinization ( e.g . an enlarged clitoris, deeper voice, hirsutism, and acne), a delay in breast development, and lower HDL cholesterol levels) has prompted caution in the clinical use of androgens ( 46 ). Currently, oxytocin is seldom used because hormone replacement has proven to be a more effective treatment when using estradiol in combination with r-hGH ( 47 ).
Liao et al . administered nandrolone phenylpropionate in the early stages of TS to promote the synthesis of protein, and they also administered a traditional Chinese medicine - Liuwei Dihuang pills - to aid the kidneys ( 48 ). This alleviated the lack of estrogen and it also prompted the patient's genital organs and secondary sexual characteristics to develop to an extent, resulting in limited menstruation. Fractures are one of the major complications of TS. The mechanism of bone injury in patients is not clear, but an estrogen deficiency and X chromosome abnormalities are key factors. Several studies have noted a low level of vitamin D in the serum of patients with TS, and this may lead to lower bone mineral density ( 27 , 49 ). Therefore, vitamin D supplementation and an active lifestyle including weight-bearing activities and regular sports are of great benefit to the health of bone in patients with TS ( 50 ). Forms of treatment are listed in Table 3 .
Treatment of Turner syndrome | Characteristics | . |
---|---|---|
Growth hormone therapy | Individual sensitivity is variable. Lifelong height is related to age, time, and dose of treatment. | ( , ) |
Estrogen therapy | The general recommendation is to start a low dose of estrogen replacement therapy at the age of 12. Increasing the dose of estradiol given to girls with TS will greatly promote final adult height. | ( , ) |
Oxymetholone treatment | Marked effect when used in combination with growth hormone. Adverse reactions may occur, so this treatment should be used with caution. | ( , ) |
Other methods | Traditional Chinese medicine treatment; vitamin D supplementation; active lifestyle. | ( , - ) |
TS is a rare disease in which all or part of the X chromosome is missing, and patients' growth and lives are heavily affected. Timely diagnosis and treatment is crucial. The incidence of cardiovascular diseases and bone abnormalities in TS is currently being studied. In addition to unusual physical phenotypes, patients with TS exhibit characteristic neurocognitive features that involve deficits in visual spatial processing. Cognitive deficits that have been found in TS seem to persist into adulthood. Whether this is caused by genetic mechanisms or only by hormones and other biological factors is unclear. Genetic and hormonal effects may need to be studied in the same patient. Further research is needed in this area to determine how genes, karyotypes, and the brain are linked to cognition ( 51 ). The latest structural and molecular biology techniques need to be used in post-mortem studies, modern genomic strategies need to be adopted, and medical histories need to be routinely reported ( 52 ).
Given trends in biomedical development, the next generation of treatment will be based on stem cells and regenerative medicine. Stem cell research has become an area of interest. Stem cells are cells that have the potential to proliferate, differentiate, and self-renew. Somatic cells are dedifferentiated into pluripotent stem cells by introducing foreign genes, and those stem cells are known as induced pluripotent stem (iPS) cells. The major advantage of iPS cells over embryonic stem (ES) cells is that iPS cells can be derived from a patient's own somatic cells, thus avoiding immunological rejection and ethical issues ( 53 ). For rare diseases such as TS, the somatic cells of patients can be extracted and their dedifferentiation into stem cells can be induced to create a model of the disease in order to study its pathogenesis and to develop new methods of studying and treating that disease.
Researching the White Paper:
The process of researching and composing a white paper shares some similarities with the kind of research and writing one does for a high school or college research paper. What’s important for writers of white papers to grasp, however, is how much this genre differs from a research paper. First, the author of a white paper already recognizes that there is a problem to be solved, a decision to be made, and the job of the author is to provide readers with substantive information to help them make some kind of decision--which may include a decision to do more research because major gaps remain.
Thus, a white paper author would not “brainstorm” a topic. Instead, the white paper author would get busy figuring out how the problem is defined by those who are experiencing it as a problem. Typically that research begins in popular culture--social media, surveys, interviews, newspapers. Once the author has a handle on how the problem is being defined and experienced, its history and its impact, what people in the trenches believe might be the best or worst ways of addressing it, the author then will turn to academic scholarship as well as “grey” literature (more about that later). Unlike a school research paper, the author does not set out to argue for or against a particular position, and then devote the majority of effort to finding sources to support the selected position. Instead, the author sets out in good faith to do as much fact-finding as possible, and thus research is likely to present multiple, conflicting, and overlapping perspectives. When people research out of a genuine desire to understand and solve a problem, they listen to every source that may offer helpful information. They will thus have to do much more analysis, synthesis, and sorting of that information, which will often not fall neatly into a “pro” or “con” camp: Solution A may, for example, solve one part of the problem but exacerbate another part of the problem. Solution C may sound like what everyone wants, but what if it’s built on a set of data that have been criticized by another reliable source? And so it goes.
For example, if you are trying to write a white paper on the opioid crisis, you may focus on the value of providing free, sterilized needles--which do indeed reduce disease, and also provide an opportunity for the health care provider distributing them to offer addiction treatment to the user. However, the free needles are sometimes discarded on the ground, posing a danger to others; or they may be shared; or they may encourage more drug usage. All of those things can be true at once; a reader will want to know about all of these considerations in order to make an informed decision. That is the challenging job of the white paper author. The research you do for your white paper will require that you identify a specific problem, seek popular culture sources to help define the problem, its history, its significance and impact for people affected by it. You will then delve into academic and grey literature to learn about the way scholars and others with professional expertise answer these same questions. In this way, you will create creating a layered, complex portrait that provides readers with a substantive exploration useful for deliberating and decision-making. You will also likely need to find or create images, including tables, figures, illustrations or photographs, and you will document all of your sources.
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Effective delegation is critical to managerial success : delegating properly can help empower employees , and those who delegate can increase their earnings . Delegation can also be a way for managers to give employees experience and control, especially when they delegate decision-making responsibilities, which allow employees to exhibit agency over important stakes. Yet, some of our recent research has shown that employees can view delegated decision-making as a burden that they would prefer to avoid.
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staining chromosomes with a dye or on assaying for a. particular function. The most common methods of dye-. based chromosome banding are G- (Giemsa), R- (reverse), C- (centromere) and Q ...
Chromosome microarray analysis combined with karyotype analysis is a powerful tool for the detection in pregnant women with high-risk indicators. Background Karyotype analysis and fluorescence in ...
Explore the latest full-text research PDFs, articles, conference papers, preprints and more on KARYOTYPE. Find methods information, sources, references or conduct a literature review on KARYOTYPE
Molecular karyotyping, also called "chromosomal microarray" (CMA) or "array-comparative genomic hybridization" (aCGH), is a cytogenomic approach (Liehr, 2021a, Liehr, 2021b), which historically developed from molecular cytogenetics (Liehr, 2021c).In 1992 it was published that it is possible and informative if one applies whole genomic DNA (WG-DNA) in fluorescence in-situ hybridization ...
Genetics, Cytogenetic Testing And Conventional Karyotype
Implications of mLOY in men. Normally, men's karyotype configuration is 46, XY (left); however, throughout life, ... this paper aims to review the molecular mechanisms that may be associated with Y chromosome loss in males, ... research was conducted on the ability to predict age using the percentage of mLOY through ddPCR, where 232 male ...
1 Department of Biology, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, USA. [email protected]; PMID: 21822875 DOI: 10.1007/978-1-61779-201-4_13 Abstract Classical cytogenetics by karyotyping has been utilized in clinical research laboratories for more than 50 years and remains the key method used in the stem cell ...
The karyotype is the characterization of number, size, and morphology of the set of chromosomes of a species, as seen under the microscope. Studying karyotype evolution of a group of organisms means initially being concerned with the information provided by karyotypic data, which are chromosome number, position of centromeres, and number and position of secondary constrictions and banding ...
1 Introduction. Karyotype data are the most common form of genetic data regularly employed in clinical medicine. They are stored in a text-based standard format with a syntax defined by the International System for human Cytogenetic Nomenclature or ISCN (McGowan-Jordan et al., 2016).This international standard is updated regularly and dictates how karyotypes should be written and stored.
Moreover, we introduced a novel thread by designing oligo-probes for karyotype detection. Funding. This work was supported the Fundamental Research Funds for the Central Universities (KYCXJC2023003, KYZZ2023002), a Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions.
There are three main steps for karyotype image analysis: image enhancement, image segmentation and chromosome classification. In this paper, we have proposed a novel chromosome segmentation algorithm to decompose overlapped chromosomes. We have also proposed a CNN-based classifier which outperforms all the existing classifiers.
When compared to BM, PB specimens had a similar rate of abnormal karyotype: 51% in PB vs 48% in BM. Our results unequivocally demonstrated that conventional cytogenetics of MF can be successfully obtained from unstimulated PB specimens in 96% of patients and that analysis of BM does not reveal additional cytogenetic abnormalities.
The karyotypes of C. striata and C. gachua are relatively asymmetrical compared to C. punctata and the chromosome points in the genomic diagram of C. striata and C. gachua are negatively skewed (Figures 2C Figures 3C). Thus, C. punctata's karyotype can be regarded as a relatively advanced/specialized one, in which many structural changes have ...
A Review of Recent Developments in Turner Syndrome ...
What Is Karyotyping? Methods and Their Significance
The increasing interest in and demand for the study of human genetics has led to the introduction on the market of a diverse array of systems for automated metaphase spread location and karyotyping.
The present work reports a comparative karyotype analysis of six H. marinum accessions representing all taxa and cytotypes. Karyotypes were determined by analysing the chromosomal distribution of several tandemly repeated sequences, including the Triticeae cloned probes pTa71, pTa794, pAs1 and pSc119·2 and the simple sequence repeats (SSRs ...
The iguanid lizards, Conolophus subscristatus, Tropidurus albemarlensis, T. delanonis, and T. dnncanensis have similar 2n = 36 karyotypes. C. subcristatus has a 12 metacentric macrochromosome and 24 microchromosome karyotype that is here shown to be primitive for the Ignanidae and probably for all lizards, while the three Galapagos Tropidurus have identical patterns to Tropidurus species from ...
The aim was to find out the most suitable method for Plumbago auriculata by comparing the effect of different pre-treatment and dissociation time on chromosome, and the results showed that the best pretreatment was 0.05% colchicine solution under 0℃ - 4℁ or 2 h and then 1 mol/L HCL under 60 t water for 6 min. In this study, the chromosome karyotype of Plumbago auriculata was analyzed by ...
PDF | As is known, the diploid number of human chromosomes is 46, while in other higher primates, such as chimpanzees and gorillas, this number is 48.... | Find, read and cite all the research you ...
Japanese eels can escape via the gill of the predatory fish after being captured. Hasegawa et al. examine the behavioral patterns and escape processes of eels within the predator's digestive tract using an X-ray video system and demonstrate that eels escape from the predator's stomach by going back up the digestive tract towards the gill.
Against this backdrop, green energy development has become a critical area of research, reflected in a more than 10-fold increase in related publications from 2010 (1,105) to 2023 (11,346 ...
A basic understanding of Turner syndrome: Incidence, ...
The research you do for your white paper will require that you identify a specific problem, seek popular culture sources to help define the problem, its history, its significance and impact for people affected by it. You will then delve into academic and grey literature to learn about the way scholars and others with professional expertise ...
The karyotype and C-banding analysis of somatic metaphase chromosomes were attempted on 3 species of Indian frogs (Rana curtipes, R. temporalis, R. malabarica) which are distributed in the Western ...
Yet, previous research has shown that delegating decision-making can cause employees to feel overly burdened. In a new paper, researchers examine the negative impact that handing over choice ...
Suicide is prevalent in all countries and is largely preventable. The causes of suicide are multiple and varied. Social determinants of suicide are crucial, but to date these have received insufficient policy attention. This paper, which is the first in a Series on taking a public health approach to suicide prevention, argues for a major change in the way we think about suicide and its prevention.
The chromosome complement of the duck A. platyrhynchos is composed of 78 autosomes (AA) and a. pair of s ex-chromoso mes (Z an d W), thus making the. total number of chromosomes, 2n=80 ( Table 2 ...