Molecular Genetic Testing

Given the ever-growing list of CFTR defects, molecular genetic testing has evolved from relatively simple assays directed only at the predominant AF508 mutation[10] to increasingly complex multiplex mutation detection systems. Not all of these are on micro- or miniarray platforms, although the first practical assays for detecting more than a few mutations at a time utilized allele-specific DNA probes bound to solid supports in the form of nylon strips or membranes.[11,12] Originally all such assays were in-house-developed tests (''home brews''), but as the commercial potential of CF testing has exploded with the advent of nationwide population carrier screening,[5] several vendors have come forward with manufactured systems.

The systems available and in use at this time include reverse dot blots (Inno-LiPA CFTR33 Probe Array, Innogenetics; Linear Array CF Gold 1.0, Roche), amplification refractory mutation detection system (ARMS; Elucigene CF29, Orchid), and the oligonucleotide ligation assay (OLA; CF V3.0, Abbott/Celera). More recent additions to the CFTR testing arena include the invader assay (Third Wave Technologies) and various microarray platforms (e.g., Nanochip CFTR, Nanogen). Other emerging technologies include matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (Sequenom) and real-time PCR (Light-Typer, Roche). In addition, a handful of research and clinical laboratories offer complete sequencing of the CFTR gene, which can be used to identify rare mutations and polymorphisms and resolve ambiguities not defined by the allele-specific methods.[13] Several of the more popular (and more established) technologies are described in the American College of Medical Genetics (ACMG) Standards and Guidelines for Clinical Genetics Laboratories.[14] While these systems include both array-based and nonarray technologies, the remainder of our discussion here will focus on the array-based platforms that are now commercially available.

Getting Started With Dumbbells

Getting Started With Dumbbells

The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.

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