• 제목/요약/키워드: late-onset type

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Pseudodeficiency 및 potential late onset Pompe disease 보인자로 확인된 cis형 dual variant 돌연변이 두 개를 가진 여아 1례 (A Case of Pseudodeficiency in a Potential Late Onset Pompe Disease Carrier, with Double Dual Variant, Each in cis Formation)

  • 김승호;김구련;장영표;이동환
    • 대한유전성대사질환학회지
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    • 제22권2호
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    • pp.58-62
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    • 2022
  • 폼페병(PD, Pompe disease), 2형 당원축적병(Glycogen storage disease type II)은 보통염색체 열성 질환으로 용해소체 효소인 acid maltase (acid α-glucosidase, GAA) 결핍으로 인한 대사근육병이다. 한 종류의 효소 결핍에 의한 질환이지만, GAA의 결핍정도와 유전자형에 따라 임상양상이 다르게 나타난다. 발병 시기에 따라 크게 영아형 폼페병(infantile onset Pompe disease, IOPD), 성인형 폼페병(late onset Pompe disease, LOPD)으로 나눌 수 있다. 저자들은 신생아기 때 호흡곤란증후군을 진단받고 치료받은 후 잠시 혈중 CK 증가가 확인되었으나 다른 임상증상 없이 경과 관찰 후 호전되었고, LSD 스크리닝 검사 결과 상 GAA 수치가 0.58 umol/h/L로 감소되어 있음을 확인한 1례에 대해 보고하고자 한다. 해당 환아를 PD 의증으로 고려하여 시행한 GAA enzyme essay 상 total GAA level은 16.2 nmol/2hr/mg protein, GAA with acarbose level은 2.0 nmol/2hr/mg protein, acarbose/total level의 비율은 12.0%로 낮은 수치를 확인하였다. 환아의 유전자 검사 상 exon #4에서 두개의 likely pathogenic heterozygous mutation인 c.752C>T (p.Ser251Leu), c.761C>T (p.Ser254Leu), exon #12에서 heterozygous mutation인 c.1726G>A (p.Gly576Ser), exon #15에서 heterozygous mutation인 c.2065G>A (p.Glu689 Lys)이 확인되었다. 환아의 7세 오빠는 유전자 검사에서 정상으로 확인되었고, 아버지는 환아에서 동일하게 확인된 exon #12에서 heterozygous mutation인 c.1726G>A(p.Gly576Ser), exon #15에서 heterozygous mutation인 c.2065G>A (p.Glu689Lys)이, 어머니에서는 exon #4에서 두 개의 likely pathogenic heterozygous mutation인 c.752C>T (p.Ser251Leu), c.761C>T (p.Ser254Leu)가 확인되었다. Pathogenic한 유전자 두개가 있으면 보통 환자로 인식될 수 있으나 이 환아에서처럼 pathogenic한 유전자 두 개가 있더라도 cis 형태로 하나처럼 움직인 경우 PD 환자가 아니라 carrier 일 수 있다는 것을 경험한 증례였다. 이에 PD 환아의 유전검사 결과를 해석할 시 pathogenic variant 유전자가 두 개일지라도 혹시 cis 형태로 하나의 유전자인지를 확인하여, pseudodeficiency나 potential LOPD carrier일 수 있는 점을 고려하며 여러 임상 양상을 취합하여 진료를 시행하는 것이 필요하다.

우측 경부에 발생한 제1 새열낭종(Type I)의 치험례 (TREATMENT OF FIRST BRANCHIAL CLEFT CYST (TYPE I);A CASE REPORT)

  • 김일규;이성준;하수용;주영채
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제12권1호
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    • pp.180-186
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    • 1990
  • This is a case report of first branchial cleft cyst in 56 year old male patient, which was tentatively diagnosed as acute right submandibular abscess resulted from the periapical lesion of the lower right second molar. The results are as follows, 1. The accompanying ipsilateral inflammatory swelling resulted from the periapical lesion of lower right second molar tooth makes the diagnosis difficult. 2. The onset of this case was very late in comparison to the mean discovering age of branchial cleft cysts. 3. The plain radiography using contrast media is helpful for the diagnosis of cystic lesions within soft tissues. 4. This case in a first branchial cleft cyst(Type I) which occurs less than 1% of all branchial cleft anomalies.

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쇄골하 정책 도관법 합병증이 발생한 후기 발병형 B군 연쇄상 구균 패혈증 1례 (A Case of Late Onset Group B Streptoccocal Sepsis with the Complication of Subclavian Vein Catheterization)

  • 김우경;김미란;김덕하;이혜란;박종영;황대현
    • Pediatric Infection and Vaccine
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    • 제5권2호
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    • pp.289-295
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    • 1998
  • Group B Streptococcal sepsis and/or meningitis is one of the most serious and common diseases in the neonatal period with high mortality and frequent complications. We have experienced a case of late onset type group B streptococcal sepsis and meningitis with a complication of subclavian vein catheterization catheterization. This 29-day-old male neonate was admitted to intensive care unit with the presentation of fever and septic shock. He was born with Cesarean delivery at 36 weeks and 3 days of gestational age. He showed multiple episodes of seizure after admission and group B streptococcus was isolated from blood. CSF profiles 10 days after admission showed the features of bacterial meningitis without organism isolated. Diffuse cerebral infarction was detected on brain CT 24 days after admission. In the 13th hospital day, the complication of subclavian vein catheterization occurred; Guide wire was cut during insertion and the distal portion of it(2.5cm) was retained in the left subclavian vein. We removed the retained guide wire with goose-neck snare catheter via right femoral vein. This case was presented with a brief review of the literatures.

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Plasma Levels of Hormones and Metabolites as Affected by the Forages Type in Two Different Types of Crossbred Holstein Cattle

  • Chaiyabutr, N.;Preuksagorn, S.;Komolvanich, S.;Chanpongsang, S.
    • Asian-Australasian Journal of Animal Sciences
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    • 제13권10호
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    • pp.1359-1366
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    • 2000
  • An experiment was carried out to study plasma levels of hormones and metabolites of crossbred Holstein cattle during late pregnancy (28 days pre partum), early lactation (30 days post partum), mid-lactation (120 days post partum) and late lactation (210 days post partum). Two breed types of Holstein $Friesian{\times}Red$ Sindhi (50:50 = 50%HF) and Holstein $Friesian{\times}Red$ Sindhi (87.5:12.5 = 87.5%HF) were divided into four groups of four animals each. Two groups of each breed were fed with either rice straw treated with 5% urea or pangola hay (Digitaria decumbens) as the source of roughage throughout the experiments. There were a substantial increases in the mean levels of total triiodothyronine ($T_3$), insulin and glucagon at the onset of lactation, and maintained in a high levels during lactation advance for all groups of experiments. The mean levels of prolactin and thyroxine ($T_4$) were not significantly different among groups of animals, but the plasma cortisol concentration was slightly higher in both groups of 50%HF in comparison with those of 87.5%HF animals. The mean levels of plasma growth hormone (GH) of both groups of 87.5%HF animals feeding on either hay or urea treated rice straw markedly rose in the early period of lactation and markedly reduced in mid- and late lactation. These changes were accompanied with changes of milk yield. In contrast to 50%HF animals, plasma GH levels were considerably higher in the late pregnant period than in the early period of lactation and it remained constant as its value at the early lactation throughout the experimental period. The high levels of both plasma progesterone and estradiol concentration significantly declined after parturition and remained low through lactating period. The plasma glucose level in the 50%HF animals feeding on either hay or urea treated rice straw was higher than the 87.5%HF animals in all periods of experiments. Changes in plasma FFA levels of both types of crossbred animals were depended on the endocrine status during late pregnancy and lactation. The levels of plasma FFA of 50%HF animals were significantly higher (p<0.05) than those of 87.5%HF animals during late pregnancy. Both plasma ${\beta}$-hydroxybutyrate and lactate concentrations were not affected by feeding on either hay or urea treated rice straw during late pregnancy and lactation. These data demonstrate that there were no differences in the physiological performances in the same crossbred animals fed either hay or urea treated rice straw. The 87.5%HF animal has the genetic potential for a high milk yield and homeorhetic adaptation for mammary function differed from 50%HF animals during periods of lactation. Altering lactation persistency in 87.5%HF is regulated mainly by chronically acting growth hormones through the period of lactation.

Transcriptional Onset of Lysozyme Genes during Early Development in Olive Flounder (Paralichthys olivaceus)

  • Lee, Jang-Wook;Lee, Jeong-Ho;Noh, Jae Koo;Kim, Hyun Chul;Park, Choul-Ji;Park, Jong-Won;Kim, Kyung-Kil
    • 한국발생생물학회지:발생과생식
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    • 제18권4호
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    • pp.267-274
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    • 2014
  • The immune system in teleost fish is not completely developed during embryonic and larval stages, therefore effective innate mechanisms is very important for survival in such an environment. However, the knowledge of the development of immune system assumed to be restricted. In many species, lysozymes have been considered as important genes of the first line immune defense. The early detection of lysozyme mRNA in previous reports, led to the investigation of its presence in oocytes. As a result, c-type lysozyme mRNA transcripts were detected in unfertilized oocytes indicating maternal transfer. Therefore, we investigated the expression patterns of lysozymes in flounder, including the matured oocyte. In our results, c-type lysozyme mRNA was first detected in unfertilized oocyte stage, observed the significantly decreased until hatching stage, and was significantly increased after hatching stage. On the other hand, g-type lysozyme mRNA transcripts were first detected at late neurula stage, and the mRNA level was significantly increased after 20 dph. It may be suggest that maternally supplied mRNAs are selectively degraded prior to the activation of embryonic transcription. This study will be help in understanding the maturation and onset of humoral immunity during development of olive flounder immune system.

Circadian Variation of Acute Stroke;Hospital Based Study

  • Yun, Sang-Pil;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • 대한한의학회지
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    • 제28권4호
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    • pp.8-12
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    • 2007
  • Objectives : This study aimed to investigate the circadian variation in stroke types, ischemic stroke subtypes, and Sasang constitutions. Methods : 295 patients with acute stroke within 14 days onset were included, who were admitted to Kyunghee Oriental Medical Center from October 2005 to May 2007. The stroke onset time was subdivided into four groups of 6-hour intervals in a day. Stroke types, ischemic stroke subtypes, and Sasang constitutions in four groups were examined. Results : Most ischemic stroke occurred between 6:01-12:00 hours (30.2%). For ischemic stroke subtypes, the peak period of small-vessel occlusion was between 6:01-12:00 hours (33.2%), large-artery atherosclerosis was most common between 12:01-18:00 hours (39.5%), and cardiac embolism was most frequent between 18:01-24:00 hours (50%). In terms of Sasang constitution, Soyeumin and Taeyeumin were most common between 6:01-12:00 hours (36.4% versus 41.5%, respectively), but the peak time of Soyangin was between 12:01-18:00 hours (35.2%). Conclusion :Most ischemic stroke events occurred in the mid-to-late morning hours in the present study and there was a circadian variation of onset in ischemic stroke subtypes and Sasang constitution.

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Role of Oxidative Stress and Mitochondria in Parkinson's Disease

  • Jin, Son-Hyeung
    • 한국응용약물학회:학술대회논문집
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    • 한국응용약물학회 2007년도 Proceedings of The Convention of The Korean Society of Applied Pharmacology
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    • pp.147-153
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    • 2007
  • Central to developing new treatment strategies for late onset sporadic Parkinson's disease (PD) and early onset familial PD is resolving the enigma of the specific vulnerability exhibited by substantia nigra dopamine (DA) neurons despite multiple risk factors. Neuropathological evidence from both human and experimental models of PD firmly supports a significant role for oxidative stress (OS) and mitochondrial dysfunction in the death of nigral DA neurons. Largely unknown are the genes underlying selective susceptibility of nigral DA neuron to OS and mitochondrial dysfunction and how they effect nigral DA cell death. To overcome the paucity of nigral DA neurons as well as the dilution effect of non-DA cells in brain tissues, we have developed wild type DA cell line model, SN4741 and mutant DJ-1 (-/-) DA cells, appropriate for microarray analysis and differential mitochondrial proteomics. Mutations in the DJ-1 gene (PARK7), localized in cytoplasm and mitochondria, cause autosomal recessive early onset PD. Through microarray analysis using SN4741 cells followed by validation tests, we have identified a novel phylogenically conserved neuroprotective gene, Oxi-a, which is specifically expressed in DA neurons. The knockdown of the gene dramatically increased vulnerability to as. Importantly as down-regulated the expression level of the gene and recovery of its expression via transient transfection exerted significant neuroprotection against as insult. We also have identified altered expression of mitochondrial proteins and other familial PD genes in DJ-1 (-/-) mutant cells by differential mitochondrial proteomics. In DJ-1 (-/-) cells the knockdown of the other familial PD genes (Parkin and PINK1) dramatically increased susceptibility to as. Thus, further functional characterization of the Oxi-$\alpha$ gene family and the mitochondrial alteration in the DJ-1 (-/-) cell model will provide the rationale for the neuroprotective therapy against both sporadic and familial PD.

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Isolation and characterization of Vitreoscilla mutant defective in catalase-peroxidase hydroperoxidase I

  • Kim, Hee-Jung;Moon, Ja-Young;Lee, John-Hwa;Park, Kie-In
    • 한국동물위생학회지
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    • 제30권3호
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    • pp.291-304
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    • 2007
  • Mutants of an obligate aerobic bacterium, Vitreoscilla, that have deficiency in heat-labile catalase-peroxidase hydroperoxidase I (HPI) were created by EMS treatment. The catalase-peroxidase HPI-deficient mutant showed substantially lower peroxidase activity in exponential and mid-stationary phase compared with the wild type strain. In late stationary phase, the mutant exhibited no peroxidase activity. Peroxidase deficiency in the mutant was revealed by polyacrylamide gels stained for peroxidase activity. Characteristically, catalase levels in the mutant increased about 14- and 8-fold during growth in the exponential and stationary phases, respectively, compared to those in the wild type, suggesting a compensatory effect for protection from $H_2O_2$ toxicity. The mutant showed differences in physiology from the wild type: retardation in growth rate and decrease in oxygen consumption. Both the wild type and the catalase-peroxidase HPI-deficient mutant of Vitreoscilla had lower growth rates in media containing increasing $H_2O_2$ concentrations. However, the mutant exhibited an additionally decreased growth rate after 6 to 8 h of growth compared to the wild type. The wild type was resistent up to 20 mM $H_2O_2$, whereas the mutant was very sensitive to high concentrations of exogenous $H_2O_2$. Although elevated catalase levels would provide protection of the bacteria from the deleterious effect of $H_2O_2$, it did not appear to be complete. Cell-free extracts of the mutant showed decreased NADH oxidation rates and higher accumulation of $H_2O_2$ during this oxidation. These results may account for the impaired growth and earlier onset of death phase by the catalase-peroxidase HPI-deficient mutant of Vitreoscilla.

효소 보충 치료로 호전을 보인 비전형적 영아형 Pompe 병 1례 (Clinical improvement in a case of atypical infantile onset Pompe disease with enzyme replacement therapy)

  • 전유훈;은백린;손창성;이동환
    • Clinical and Experimental Pediatrics
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    • 제50권2호
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    • pp.213-217
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    • 2007
  • Pompe 병(Glycogen storage disease type II)은 acid ${\alpha}$-glucosidase (GAA)의 결손에 의한 질환이며 열성으로 유전한다. 전신적인 근육약화와 비후성 심근병이 생긴 후 대개 1년 안에 사망하게 되는 영아기 발병형과 상대적으로 임상양상이 경한 후기 발병형이 있다. Pompe 병의 국내 보고는 드문 상태이나 최근 GAA 효소 보충 요법이 개발되어 임상적으로 시도 중이다. 저자들은 발병은 영아기에 있으나 비교적 임상증상이 심하지 않은 비전형적 영아형 Pompe 병을 진단받고 심한 간비대와 비후성 심근병증, 보행곤란의 증상을 보이던 4세 남아에게 재조합 인간 GAA 효소($Myozyme^{(R)}$, Genzyme Co., MA, USA) 치료를 하여 운동능력과 심기능의 현저한 호전을 경험하였기에 보고한다. 비전형적 영아형 Pompe 병에서는 ERT의 효과가 더욱 큰 것으로 생각되며 소아과의사들이 비전형적 Pompe 병 초기의 특징인 비음이나 동요성 보행같은 증상을 이해하고 있어 이를 빨리 진단하고 효소보충요법을 조기에 시행한다면 Pompe 병 환아의 예후를 호전시킬 수 있겠다.

Detection of Germline Mutations in Argentine Retinoblastoma Patients: Low and Full Penetrance Retinoblastoma Caused by the Same Germline Truncating Mutation

  • Dalamon, Viviana;Surace, Ezequiel;Giliberto, Florencia;Ferreiro, Veronica;Fernandez, Cecilia;Szijan, Irene
    • BMB Reports
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    • 제37권2호
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    • pp.246-253
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    • 2004
  • Constitutional RB1 gene mutations were studied in a series of 21 families with unilateral and bilateral retinoblastoma patients. Peripheral blood lymphocytes were analyzed by "exon by exon" PCR-heteroduplex and sequencing. Mutations were identified in 6 (29%) of the patients. One mutation corresponded to an intronic polymorphism in g.174351T > A. The other five mutations resulted C to T exonic transitions, four were CGA sequences (g.65386, g.150037 in two patients, and g.162237), creating stop codons and presumably truncated proteins. The fifth one was new and resulted in alanine to valine substitution (g.73774). Two patients had the same the germline truncated mutation (g.150037C > T), one with a familial bilateral early onset retinoblastoma and one with a sporadic unilateral late onset retinoblastoma. The later type has not been previously described. This finding is discussed in the genotype/phenotype correlation context. Additionally, a single nucleotide change was found in six studied samples, where a C to T homozygous transversion was identified in intron 26 (IVS26 + 28). It is worthy the non concordance of the nucleotide with the published sequence. This analysis proved to be a useful method for the detection of mutations in the RB1 gene, and contributed to the adequate genetic counseling to patients and relatives.