• Annals of Clinical Neurophysiology
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• 제16권2호
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• pp.81-85
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• 2014

Primary metabolic myopathy as a type of congenital myopathies was first described by McArdle in 1951. Glycogen storage disease is a disease caused by genetic mutations involved in glycogen synthesis, glycogenolysis or glycolysis. Several types of glycogen storage disease are known to cause metabolic myopathies. We report a case of adult onset metabolic myopathy with glycogen storage.

• Investigative Magnetic Resonance Imaging
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• 제2권1호
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• pp.89-95
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• 1998

목적 : 인($^{31}P$) 자기공명분광법을 사용하여 사립체 근병(mitochondria myopathy) 환자의 대퇴부 근조직의 대사물질의 변화를 정상인과 비교조사하였다. 대상 및 방법 : 사립체 근병환자 10명과 정상인 10명을 대상으로 1.5T MRI/MRS 장비를 사용하여 인($^{31}P$) 자기공명분광법을 적용하였다. 오른쪽 대퇴부위의 근조직에 $4{\;}{\times}{\;}4{\;}{\times}4{\;}cm^{3}$ 의 관심부위 (volume of interest ; VOI)를 선정하여 image selected in vivo spectroscopy (ISIS)를 저용하였다. 인대사불질의 정\ulcorner분석은 Marquart algorithm을 사용하였다. 결과 : 사립체 근병환자의 특징은 정상인과 비교하여 Pe/PCr 대사비율이 상당히 증가하고 (P=0.003), ATP/PCr 대사비율은 상당히 감소하였다(p=0.004). 특히 ATP 중 ${\beta}-ATP/PCr$ 비율의 변화가 가장 심하게 나타났다. 환자군과 정상군의 pH 차이는 통계학적으로 큰 의의는 없었다. 결론 : 인($^{31}P$) 자기 공명분광법은 사립체 근병환자의 대퇴부 근조직의 ATP/PCr 과 Pi/PCr 대사비율을 토대로 유용한 임상 평가 자료를 제공하고, 따라서 근대사물질의 질병을 이해하는데 도움을 줄 것으로 사료된다.

• 대한유전성대사질환학회지
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• 제14권2호
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• pp.191-194
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• 2014

사립체 근병증은 사립체 호흡 사슬의 장애로 인한 것으로 내분비계 관련 증상이 흔히 동반되고 그 중 당뇨병이 상대적으로 높은 빈도를 보인다고 알려져 있다. 사립체 근병증에서의 당뇨병은 사립체 기능 장애로 인한 인슐린 분비의 결함으로 발생하고, 대개 인슐린 의존성이나 당뇨병성 케톤산증으로 발현하거나 자가 항체가 검출되는 경우는 드물다. 저자들은 사립체 근병증 환자에서 당뇨병성 케톤산증으로 발현하고 Anti-GAD antibody와 Anti-insulin auto-antibody가 모두 양성으로 확인된 인슐린 의존성 당뇨병을 진단하였기에 이를 기존의 문헌과 비교하여 보고하는 바이다.

• Annals of Clinical Neurophysiology
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• 제3권1호
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• pp.50-52
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• 2001

Licorice is widely used as a Chinese(herbal) medicine. The glycyrrhizin, a main ingredient of the natural licorice, has a potent mineralocorticoid effect which may cause severe hypokalemia and muscle paralysis. We present a 60-year-old woman, who had been ingesting one or two spoonful of licorice powder daily for about one year, developed acute flaccid quadriparesis with high levels of serum muscle enzymes and the typical features of mineralocorticoid excess such as severe hypokalemia and metabolic alkalosis. Both plasma renin activity and serum aldosterone level were below the normal values. This case indicates that licorice-induced hypokalemic myopathy should be considered in the differential diagnosis of a patient with acute quadriparesis and hypokalemia.

• Clinical and Experimental Pediatrics
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• 제57권7호
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• pp.329-332
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• 2014

3-methylcrotonyl-coenzyme A carboxylase (3MCC) deficiency is an autosomal recessive disorder in which leucine catabolism is hampered, leading to increased urinary excretion of 3-methylcrotonylglycine. In addition, 3-hydroxyisovalerylcarnitine levels increase in the blood, and the elevated levels form the basis of neonatal screening. 3MCC deficiency symptoms are variable, ranging from neonatal onset with severe neurological abnormality to a normal, asymptomatic phenotype. Although 3MCC deficiency was previously considered to be rare, it has been found to be one of the most common metabolic disorders in newborns after the neonatal screening test using tandem mass spectrometry was introduced. Additionally, asymptomatic 3MCC deficient mothers have been identified due to abnormal results of unaffected baby's neonatal screening test. Some of the 3MCC-deficient mothers show symptoms such as fatigue, myopathy, or metabolic crisis with febrile illnesses. In the current study, we identified an asymptomatic 3MCC deficient mother when she showed abnormal results during a neonatal screening test of a healthy infant.

• 대한유전성대사질환학회지
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• 제22권1호
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• pp.21-27
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• 2022

Very long-chain acyl-coenzyme A dehydrogenase (VLCAD) deficiency (VLCADD) leads to a defective 𝛽-oxidation, specifically during prolonged fasting, infection, or exercise. Patients with VLCADD usually suffer from cardiomyopathy, hypoketotic hypoglycemia, hepatic dysfunction, exercise intolerance, muscle pain, and rhabdomyolysis, and sometimes succumb to sudden death. VLCADD is generally classified into three phenotypes: severe early-onset cardiac and multiorgan failure, hypoketotic hypoglycemia, and later-onset episodic myopathy. Diagnostic evaluation comprises acylcarnitine analysis, genetic analysis, and VLCAD activity assay. In the acylcarnitine analysis, the key metabolites are C14:1, C14:2, C14, and C12:1. A C14:1 level >1 mmol/L strongly suggests VLCADD. Various treatment recommendations are available for this condition. Dietary management includes decreasing fat content, increasing medium-chain triglyceride levels, and decreasing fasting periods. Supplementation with L-carnitine is controversial. Triheptanoin (a seven-carbon fatty acid triglyceride) treatment demonstrates improvement of cardiac functions. Bezafibrate may improve the quality of life of patients with VLCAD.

• 대한유전성대사질환학회지
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• 제22권1호
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• pp.1-8
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• 2022

Long-chain fatty acid oxidation disorders (LC-FAOD) are an autosomal recessive inherited rare disease group that result in an acute metabolic crisis and chronic energy deficiency owing to the deficiency in an enzyme that converts long-chain fatty acids into energy. LC-FAOD includes carnitine palmitoyltransferase type 1 (CPT1), carnitine-acylcarnitine translocase (CACT), carnitine palmitoyltransferase type 2 (CPT2), very long-chain acyl-CoA dehydrogenase (VLCAD), long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD), and trifunctional protein (TFP) deficiencies. Common symptoms of LC-FAOD are hypoketotic hypoglycemia, cardiomyopathy, and myopathy. Depending on symptom onset, the disease can be divided as neonatal period, late infancy and early childhood, adolescence, or adult onset, but symptoms can appear at any time. The neonatal screening test (NBS) can be used to identify the characteristic plasma acylcarnitine profiles for each disease and confirmed by deficient enzyme analysis or molecular testing. Before introduction of NBS, the mortality rate of LC-FAOD was very high. With NBS implementation as routine neonatal care, the mortality rate was dramatically decreased, but severe symptoms such as rhabdomyolysis recur frequently and affect the quality of life. Triheptanoin (Dojolvi^®), the first drug for pediatric and adult patients with molecularly confirmed LC-FAOD, has recently been approved by the US Food and Drug Administration in 2020. In this review, the diagnosis of LC-FAOD and treatment including triheptanoin are summarized.

• 생명과학회지
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• 제31권5호
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• pp.464-474
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• 2021

대사성질환, 암, 손상, 및 패혈증 등에 의해 유도되는 염증은 산화스트레스를 통해 세포의 미토콘드리아의 기능을 감퇴시켜 신경증과 근육위축증 등을 야기한다. 본 연구에서는 lipopolysaccharide (LPS)에 의해 유도된 미토콘 드리아의 기능감퇴와 근육위측증에 대한 butyrate의 억제효과를 확인하고자 하였다. LPS의 처리는 C2C12세포에서 MAPK의 활성을 통해 미토콘드리아 분열을 촉진하는 DRP1 (Ser616) 인산화와 Atrogin-1의 발현을 증가시켰다. 그러나 butyrate를 처리한 C2C12세포에서는 LPS 처리에 의한 염증 효과가 유의적으로 감소하며, 미토콘드리아 분열을 억제하는 DRP1 (Ser637)의 인산화와 mitofugin2 (Mfn2)의 발현을 증가를 유도하는 것을 확인하였다. 또한 butyrate를 처리한 세포에서 대사성질환을 유발하는 pyruvate dehydrogenase kinase 4 (PDK4)의 발현을 억제함이 관찰되었다. 이는 butyrate가 포도당 대사에서 염증에 의해 유도되는 Warburg 효과를 억제하여 산화스트레스를 개선함으로써, JNK의 활성을 억제하는 것으로 확인되었다. 이러한 결과들은 butyrate가 항산화효과를 통해 패혈증과 대사성질환과 같은 염증에 의해 유도되는 미토콘드리아의 기능 감퇴와 이에 따른 근육위축증을 개선할 수 있는 후보물질로 활용될 가능성이 있을 것으로 기대된다.

• Biomolecules & Therapeutics
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• 제22권2호
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• pp.83-92
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• 2014

Fatty acids (FAs) are highly diverse in terms of carbon (C) chain-length and number of double bonds. FAs with C>20 are called very long-chain fatty acids (VLCFAs). VLCFAs are found not only as constituents of cellular lipids such as sphingolipids and glycerophospholipids but also as precursors of lipid mediators. Our understanding on the function of VLCFAs is growing in parallel with the identification of enzymes involved in VLCFA synthesis or degradation. A variety of inherited diseases, such as ichthyosis, macular degeneration, myopathy, mental retardation, and demyelination, are caused by mutations in the genes encoding VLCFA metabolizing enzymes. In this review, we describe mammalian VLCFAs by highlighting their tissue distribution and metabolic pathways, and we discuss responsible genes and enzymes with reference to their roles in pathophysiology.

• The Korean Journal of Physiology and Pharmacology
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• 제25권1호
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• pp.69-77
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• 2021

Propofol infusion syndrome characterized by rhabdomyolysis, metabolic acidosis, kidney, and heart failure has been reported in long-term propofol use for sedation. It has been reported that intracellular adenosine triphosphate (ATP) is reduced in rhabdomyolysis. The study aims to investigate the protective effect of ATP against possible skeletal muscle damage of propofol in albino Wistar male rats biochemically and histopathologically. PA-50 (n = 6) and PA-100 (n = 6) groups of animals was injected intraperitoneally to 4 mg/kg ATP. An equal volume (0.5 ml) of distilled water was administered intraperitoneally to the P-50, P-100, and HG groups. One hour after the administration of ATP and distilled water, 50 mg/kg propofol was injected intraperitoneally to the P-50 and PA-50 groups. This procedure was repeated once a day for 30 days. The dose of 100 mg/kg propofol was injected intraperitoneally to the P-100 and PA-100 groups. This procedure was performed three times with an interval of 1 days. Our experimental results showed that propofol increased serum CK, CK-MB, creatinine, BUN, TP I, ALT, AST levels, and muscle tissue MDA levels at 100 mg/kg compared to 50 mg/kg and decreased tGSH levels. At a dose of 100 mg/kg, propofol caused more severe histopathological damage compared to 50 mg/kg. It was found that ATP prevented propofol-induced muscle damage and organ dysfunction at a dose of 50 mg/kg at a higher level compared to 100 mg/kg. ATP may be useful in the treatment of propofol-induced rhabdomyolysis and multiple organ damage.