• 대한유전성대사질환학회지
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• 제12권1호
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• pp.54-57
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• 2012

3세된 환아가 응급실에 혼수와 복통을 주소로 전원되었다. 응급실에서 시행한 신체 진찰에서 drowsy한 정신상태를 나타내었으나 다른 신경학적 검사에서 특별한 이상 소견을 보이지는 않았다. 시행한 혈액 및 소변 검사에서 고글리세롤혈증(hyperglycerolemia), 케톤혈증(ketonemia) 및 케톤요증(ketonuria)이 있었다. 아침 첫 소변으로 시행한 소변 유기산 검사에서 현저한 고글리세롤요증이 발견되었으며, 암모니아의 상승, 음이온차의 상승, 전해질의 이상 등의 소견이 없어 단독성 GKD를 의심하였다. GK 유전자 검사를 시행한 결과 exon 11 주위 인트론에서 4염기가 삽입된 새로운 돌연변이를 확인하여 문헌고찰과 함께 보고하는 바이다.

• 동의생리병리학회지
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• 제19권4호
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• pp.884-892
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• 2005

Seeing through the reference of literatures ${\ll}$Internal Classic${\gg}$, ${\ll}$Donguibogam${\gg}$ and Master Jisan's theory about Ki-Hyul and Hyul-Ki, the writer came to conclusions as follows. In ${\ll}$Internal Classic${\gg}$ Ki-Hyul is expressed into being orderly and ordinate, but Hyul-Ki is described differently into making Hyul-Ki or operating Hyul-Ki. In ${\ll}$Donguibogam${\gg}$ Ki-Hyul and Hyul-Ki are not distinguished between two things, but Ki-Hyul is mentioned as harmony of Ki-Hyul and Hyul-Ki, and Hyul-Ki as ascending and descending or as deficiency and excess. In Hyungsang medicine the special characters of Ki-Hyul is seized the essence of the meanings from the deflection between left and right, changes of skin, flesh, meridian, muscle and bones. And the distinctive marks of Hyul-Ki is got hold from changes of complexion, many or few hairs, ascending or descending spirits of ears, eyes, mouth and nose. Also Ki-Hyul is recognized by laying stress on rise and fall, after birth, breast, upper limbs, eight extra meridians. And Hyul-Ki is recognized by laying stress on going up and down, the inborn constitution, abdomen, lower limbs, and twelve meridians. Jisan distinguished Ki-Hyul from Hyul-Ki theoretically and he applied the theory to clinical examination proved the facts that the theory and the examination are in accord with each other. This attempts was for the first time in Oriental medicine history and the theory was set up. It is thought that the defects of the theory about Ki-Hyul and Hyul-Ki which Jisan insisted on need much more study from now on.

• 대한유전성대사질환학회지
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• 제14권2호
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• pp.174-177
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• 2014

단독 메틸말론산혈증은 상염색체 열성으로 유전되는 선천성 유전대사질환으로 methylmalonyl-coenzyme A mutase (MCM)의 결핍에 의해 야기된다. MCM를 코딩하는 MUT 유전자의 돌연변이가 단독 메틸말론산 혈증의 주된 원인이다. 저자들은 생후 15일 여아가 신생아 선별검사를 통하여 C3-acylcarnitine (C3)이 증가되어 있었던 증례를 경험하였다. 환아의 혈장 homocysteine은 정상이었고, 소변 methylmalonic acid는 증가되어 있어서 단독 메틸말론산혈증이 의심되었다. 환아는 단백제한식이와 함께 carnitine 보충요법을 시작하였고, 생후 3개월까지 특별한 증상없이 정상적인 성장을 하고 있다. MUT 유전자 검사를 시행하였으며, 환아는 c.323G>A와 c.1672+2T>C (IVS8 (+2)T>C 변이를 각각 이형접합자로 가지고 있었다. 이중 c.1672+2T>C (IVS8(+2)T>C)은 이전에 보고되지 않은 새로운 돌연변이로 이에 증례 보고하는 바이다.

• 대한유전성대사질환학회지
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• 제13권1호
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• pp.48-53
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• 2013

Tyrosinemia I (fumarylacetoacetate hydrolase deficiency) is an autosomal recessive inborn error of tyrosine metabolism that produces liver failure in infancy or a more chronic course of liver disease with cirrhosis, often complicated by hepatocellular carcinoma in childhood or early adolescence. We studied a 37-year-old woman with tyrosinemia I whose severe liver disease in infancy and rickets during childhood were resolved with dietary therapy. From 14 years of age, she resumed unrestricted diet with the continued presence of the biochemical features of tyrosinemia, yet maintained normal liver function. In adult years, she accumulated only a small amount of succinylacetone. Despite this evolution to a mild biochemical and clinical phenotype, she eventually developed hepatocellular carcinoma. Her fumarylacetoacetate hydrolase genotype consists of a splice mutation, IVS6-1G>T, and a novel missense mutation, p.Q279R. Studies of resected liver revealed the absence of hydrolytic activity and immunological expression of fumarylacetoacetate hydrolase in tumour. In the non-tumoral areas, however, 53% of normal hydrolytic activity and immunologically present fumarylacetoacetate hydrolase were found. This case demonstrates the high risk of liver cancer in tyrosinemia I even in a seemingly favorable biological environment. In this study of tyrosinemia I, Case 2 with negative succinylacetone accumulation and the recovery of acute liver failure was compared with Case 1. Diet restriction and NTBC treatment are crucial to prevent hepatocellular carcinoma until liver transplant can take place and cure the condition. Further studies are needed to examine cases where liver cancer did not result despite clinical symptoms/signs of tyrosinemia type I.

• 대한유전성대사질환학회지
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• 제12권2호
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• pp.104-107
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• 2012

본 연구는 신생아 대사 이상 질환에 대한 광범위 스크리닝으로 매우 희귀한 아미노산 대사 이상 질환 중 하나인 Alpha-methylacetoacetic aciduria의 국내 첫 증례를 경험했기에 이를 보고하는 바이다. 신생아 스크리닝의 광범위한 시행으로 인해 향후 우리나라에도 알려지지 않은 희귀 유전성 대사 질환의 보고가 증가할 것으로 예측된다. 이 환자들에 대한 적절한 관리를 통해 질환의 자연경과와 장기적 예후에 대한 관찰이 필요하다.

• 대한유전성대사질환학회지
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• 제12권2호
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• pp.99-103
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• 2012

I형 타이로신혈증은 타이로신의 분해 과정 중 최종단계에 관여하는 효소인 fumarylacetoacetate hydrolase(FAH)의 결핍에 의한 대사 이상질환이다. 급성 I형 타이로신혈증은 치명적인 간부전이나 혈액응고장애와 같은 급성 임상증상이 나타난 이후에는 예후가 불량하였으나 최근에는 신생아 대사이상 선별검사를 통해 조기 진단이 가능해졌고 2-(2-nitro-4-trifluoro-methylbenzyol)-1,3 cyclohexanedione nitisinone (NTBC) 약물 치료로 타이로신혈증의 치료 성적이 향상됨에 따라 신생아 대사이사 선별검사를 통한 조기 진단과 조기 치료가 더욱 중요해졌다고 할 수 있다. 이에 저자들은 심각한 출혈이나 간부전과 같은 급성 이상 증상이 나타나기 전 신생아 대사이상 선별검사로 조기 진단 및 조기 중재적 치료로 양호한 경과를 보이고 있는 I형 타이로신혈증 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한유전성대사질환학회지
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• 제12권2호
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• pp.94-98
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• 2012

Purpose: Developmental delay and mental retardation are frequently occurring disorders that present major socio-economic burden on the affected individual's family and society. Both can be congenital or acquired. However, a large number of people are institutionalized without exact diagnosis and, as a result, have not received proper care. Methods: 508 subjects with mental retardation or developmental delay from six institutions in Chung Buk Province were clinically evaluated and screened for metabolic and endocrinologic problems between 2000 and 2012. Results: Clinical genetic disorders were observed in 52 (10.2%) subjects. Cerebral palsy attributed to 21% of the institutionalized. 18 (3.5%) were diagnosed with metabolic disorders and 13 (2.6%) exhibited secondary endocrinologic dysfunction. Over 16% showed metabolic evidence of malnutrition. Conclusion: 21% and 3.5% of the population institutionalized due to mental retardation or developmental delay were afflicted by preventable cerebral palsy and metabolic disorders, respectively. Through early identification of the causes and early treatment, it may be possible to prevent, reduce, or alleviate the disability of many institutionalized individuals. Further research is imperative for establishing guidelines for diagnostic investigation for mental retardation.

• 대한유전성대사질환학회지
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• 제10권1호
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• pp.27-30
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• 2010

3-Methylcrotonylglycinuria (3-MCCD)는 상염색체 열성 질환으로 3-methylcrotonyl-CoA carboxylase(3-MCC)의 결핍에 의해 발생한다. 최근 신생아시기에 대사이상질환 선별검사의 도입과 더불어 본 질환의 유병률이 증가하고 있다. 본 질환의 환자 대부분이 무증상이나 일부에서 신경학적 이상이 동반되어 유전상담에 어려움을 겪고 있다. 본 보고에서는 신생아 선별검사를 통하여 발견되어 3-MCCD로 진단되어 4세까지 정상 발달을 보이는 증례를 보고한다. 환자는 MCCC2 유전자에 p.[D280Y]+[D280Y] 돌연변이를 가지고 있다. 향후 국내의 3-MCCD 환자들의 임상양상과 유전학적 특성에 대한 고찰이 필요하다.

• 사상체질의학회지
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• 제10권1호
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• pp.311-341
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• 1998

The objective of this article is to induce that the conception of 'Qi-jul(氣質) and Qi-pum(氣稟)' was introduced to the Sasang(四象) Constitutional Medicine from bibliographic study on the theory of 'Qi-pum(氣稟)'. The conclusions summerized as followings. 1. In the oriental medicine, qualitative difference of 'zheng-qi(正氣)' among the individuals, the opposing power against a disease, is regarded as constitution. Having been used as 'nature(素)', 'quality(質)' and 'character(氣質)' in the oriental medical book, the word of 'Che-Jil(體質)' was used in good earnest at the end of 'Qing(情)' dynasty. 2. The nature(性) is divided into two, original nature(本然之性) and charicteristic nature(氣質之性) in the 'New confucianism(新儒學)' and the former means a principle(理), is a pure and good thing and used as a conception of universality, the latter is a principle of character and a imperfect imitation of principle(理). 3. It was repeatedly confirmed that 'Qi-jil and Qi-pum' meant the difference among the individuals by the dispute of 'Li-Qi(理氣)' caused by Lee Hwang(李滉) and Lee Yi(李耳) and by that of 'Ho-Rak(湖洛)' in the Ch'o-son(朝鮮) dynasty. 4. Han Sok-Ji, based on Meng-Zi(孟子)'s doctrine that man's inborn nature is good, criticized the theory of 'Qi-pum' which was 'Zhu-Zi(朱子)'s opinion and his opinion about the life(命) was thought to clue to the classification of the 'Sasang(四象)' invented by Lee Je-Ma as Park Se-Dang's theory that everyone has common nature but has different life(命). 5. By introducing the theory of 'Qi-pum' and the conception of life(命) which was understood as a special character by Han Sok-Ji and Park Se-Dang to Sa-sang constitutional medicine, Lee Je-Ma explained the reason why each man who was classified four constitutions, 'Taiyang'(太陽), 'Taiyin'(太陰), 'Shaoyang'(少陽), 'Shaoyin'(少陰), had the different formation of the visceral department(臟局).

• Clinical and Experimental Pediatrics
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• 제55권8호
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• pp.301-305
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• 2012

Nonketotic hyperglycinemia (NKH) is a rare inborn error of amino acid metabolism. A defect in the glycine cleavage enzyme system results in highly elevated concentrations of glycine in the plasma, urine, cerebrospinal fluid, and brain, resulting in glycine-induced encephalopathy and neuropathy. The prevalence of NKH in Korea is very low, and no reports of surviving patients are available, given the scarcity and poor prognosis of this disease. In the current study, we present a patient with NKH diagnosed on the basis of clinical features, biochemical profiles, and genetic analysis. Magnetic resonance spectroscopy (MRS) allowed the measurement of absolute glycine concentrations in different parts of the brain that showed a significantly increased glycine peak, consolidating the diagnosis of NKH. In additional, serial MRS follow-up showed changes in the glycine/creatinine ratios in different parts of the brain. In conclusion, MRS is an effective, noninvasive diagnostic tool for NKH that can be used to distinguish this disease from other glycine metabolism disorders. It may also be useful for monitoring NKH treatment.