• Title/Summary/Keyword: storage disorder

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A Case of an 18-month-old Boy with Type 3 Gaucher Disease Presenting with Hepatosplenomegaly and Growth Retardation: The Clinical Course after Enzyme Replacement Therapy (18개월 남아에서 간비장비대, 성장 부진을 동반한 3형 고셔병 증례: 효소 대체 요법 후 임상 경과)

  • Lim, Young Shin;Hwang, Jeongyun;Kim, Jinsup;Yang, Aram;Park, Hyung Doo;Jeon, Tae Yeon;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.2
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    • pp.55-62
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    • 2017
  • Gaucher disease (GD) is an autosomal recessive lysosomal storage disorder caused by beta-glucosidase deficiency. An 18 month-old male with hepatosplenomegaly, anemia, thrombocytopenia, and growth retardation referred to our hospital. The patient showed neurological symptoms, such as supranuclear gaze palsy and developmental delay. Bone marrow biopsy performed to rule out malignancy and the results revealed no malignant cell; however, abnormal histiocytes suggesting storage disease was noted. Based on hepatosplenomegaly, bicytopenia and unexplained neurologic manifestations, enzyme activity and genetic analysis were conducted emergently with a strong suspicion of GD. Beta-glucosidase activity in leukocyte was decreased. GBA sequencing to confirm the diagnosis revealed compound heterozygous pathogenic variants (i.e., c.754T>A, c.887G>A), both previously reported as the cause of neuronopathic GD. Under the diagnosis of type 3 GD, the patient immediately received enzyme replacement therapy (ERT). After 17 months of ERT, the size of spleen decreased, and hemoglobin and platelet count returned to normal. In addition, the activity of chitotriosidase and angiotensin converting enzyme decreased. However, myoclonic movement and generalized seizure occurred at the age of 19 months and antiepileptic drug was started. Other neurological deterioration including supranuclear gaze palsy and developmental delay also persisted. A new therapy to overcome neurologic problems should be developed for patients with type 3 GD.

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Heterogenous Clinical Manifestations in Adult Patients with Late Diagnosis of Glycogen Storage Disease type Ia (성인기에 진단된 당원병 제 Ia형의 다양한 임상 양상)

  • Kim, Yoo-Mi;Cheon, Chong Kun;Kim, Gu-Hwan;Yoo, Han-Wook
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.1
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    • pp.9-17
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    • 2015
  • Glycogen storage disease (GSD) type Ia is rare inborn metabolic disorder, caused by glucose-6-phosphatase deficiency. It characterized by hepatomegaly, hypoglycemia, lactic acidosis, hypertriglyceridemia, and hyperuricemia and it is usually manifested in the infantile period. In addition, it is also associated with growth failure, pubertal delay, anemia, platelet dysfunction, osteopenia, and pulmonary hypertension. Hepatocellular adenoma and renal dysfunction are frequent late complications. Delayed diagnosis and inappropriate therapy lead to many complications such as growth failure, osteoporosis, refractory gout, renal failure, hepatocellular carcinoma (HCC), and pulmonary hypertension. Here, two Korean sisters diagnosed with GSD Ia, aged 33 and 36 respectively, were described and compared to recent articles about four adults with late diagnosis of GSD Ia. One sister had typical manifestations of GSD Ia including short stature (height, 145 cm), multiple hepatic adenoma, chronic kidney disease stage IV, and severe osteoporosis, whereas the older sister had normal stature (162 cm), one tiny hepatic nodule, and normal renal function. Direct sequencing of G6PC in two sisters identified a homozygous splicing mutation, c.645G>T, which is a prevalent mutation in Korea. Interestingly, our cases and four adults from recent reports had asymptomatic mild hypoglycemia and various manifestations including renal failure, HCC, fatty liver, or uncontrolled hyperlipidemia. These adult cases represent not only heterogenous phenotype to genotype within family members with GSD Ia but also long-term complications such as gouty arthritis, renal failure, and osteoporosis in untreated adult GSD Ia patients. In addition, lactic academia and hypertriglyceridemia are good markers of GSD Ia to distinguish from metabolic disease.

Bio-Green' Functional Water Supply Influences Mineral Uptake and Fruit Quality In Tsugaru Apples (‘바이오 그린’ 기능수 처리가 사과 쓰가루 품종의 무기성분 흡수와 과실품질에 미치는 영향)

  • Kim, Wol-Soo;Chung, Soon-Ju
    • Journal of Bio-Environment Control
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    • v.6 no.2
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    • pp.71-79
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    • 1997
  • Commercial Bio- Green(B.G.) functional water was manufactured through a series of processes : water - ultra-purification - adding catalysts - energy imprinting fermenting with energized water + zeolite and others + photosynthetic bacteria in fermenter longrightarrow filtering. Control(0), 5 or 10 liters per plant of B.G. functional water were supplied to the orchard soil under canopy of 10 year- old ‘Tsugaru’/M26 apple trees on March 20, May 20 and June 20, 1995, respectively. pH and content of Ca and Mg of orchard soil were increased by supply with B.G. functional water. However, P$_2$ $O_{5}$, K, and B contents were not influenced by the treatment. At harvest time soluble solid content of flesh tissue and anthocyanin of fruit skin were increased by the treatment. B.G functional water treatment showed higher root activities, and photosynthesis of leaves than that of control. Also B.G. functional water treatment enhanced Ca content in fruit skin and flesh tissues, whereas not affected N, K, and Mg contents. During storage at 4$^{\circ}C$ cold room, the more volume of B.G. functional water supply showed lower bitter pit symptom. Respiration and ethylene evolution in fruit decreased, while fruit firmness increased by the treatment during storage.

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Genetic classification and confirmation of inherited platelet disorders: current status in Korea

  • Shim, Ye Jee
    • Clinical and Experimental Pediatrics
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    • v.63 no.3
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    • pp.79-87
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    • 2020
  • Inherited platelet disorders (IPDs), which manifest as primary hemostasis defects, often underlie abnormal bleeding and a family history of thrombocytopenia, bone marrow failure, hematologic malignancies, undefined mucocutaneous bleeding disorder, or congenital bony defects. Wide heterogeneity in IPD types with regard to the presence or absence of thrombocytopenia, platelet dysfunction, bone marrow failure, and dysmegakaryopoiesis is observed in patients. The individual processes involved in platelet production and hemostasis are genetically controlled; to date, mutations of more than 50 genes involved in various platelet biogenesis steps have been implicated in IPDs. Representative IPDs resulting from defects in specific pathways, such as thrombopoietin/MPL signaling; transcriptional regulation; granule formation, trafficking, and secretion; proplatelet formation; cytoskeleton regulation; and transmembrane glycoprotein signaling are reviewed, and the underlying gene mutations are discussed based on the National Center for Biotechnology Information database and Online Mendelian Inheritance in Man accession number. Further, the status and prevalence of genetically confirmed IPDs in Korea are explored based on searches of the PubMed and KoreaMed databases. IPDs are congenital bleeding disorders that can be dangerous due to unexpected bleeding and require genetic counseling for family members and descendants. Therefore, the pediatrician should be suspicious and aware of IPDs and perform the appropriate tests if the patient has unexpected bleeding. However, all IPDs are extremely rare; thus, the domestic incidences of IPDs are unclear and their diagnosis is difficult. Diagnostic confirmation or differential diagnoses of IPDs are challenging, time-consuming, and expensive, and patients are frequently misdiagnosed. Comprehensive molecular characterization and classification of these disorders should enable accurate and precise diagnosis and facilitate improved patient management.

Cytologic Features of Gaucher's Disease in the Spleen - A Cese Report - (Gaucher병의 세포학적 소견 - 1예 보고 -)

  • Lee, Hun-Kyung;Park, Gyeong-Shin;Kim, Young-Shin;Lee, Kyo-Young;Kang, Chang-Suk;Shim, Sang-In
    • The Korean Journal of Cytopathology
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    • v.7 no.1
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    • pp.79-83
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    • 1996
  • Gaucher's disease is an autosomal recessive disorder resulting from mutation at the glucocerebrosidase locus on chromosome 1q21. As a result, glucocerebroside accumulates principally in the phagocytic cells known as Gaucher cells. In our case, a five-year old girl was admitted with seven days' history of fever and abdominal distension. At physical examination the patient had hepatosplenomegaly. Laboratory tests revealed a hemoglobin concentration of 2.8g/L: platelet counts of $23,000/{\mu}l$: normal range of white cell and differential counts, and negative Coombs' test. Liver enzymes were normal. For the evaluation of hepatosplenomegaly, fine needle aspiration was performed blindly against the palpable spleen. Wet-fixed hematoxylin and eosin-stained smears are made. The smears from the spleen showed predominantly macrophages with abundant cytoplasm and rather small, uniform, often eccentric nuclei with small nucleoli. The multinucleated cells were often found. The cytoplasm was pale, with more or less distinct fibrillarity. The cells had the characteristic appearance of Gaucher cells. Gaucher cells were also found in the tissue section from the liver, spleen and lymph node and the bone marrow aspirate. The diagnosis was later confirmed by determination of bela-glucosidase activity in peripheral blood leucocytes. Fine needle aspiration of the spleen is considered as a convenient procedure with a low complication rate for the diagnosis of lysosomal storage disease.

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Implementation of Augmentative and Alternative Communication System Using Image Dictionary and Verbal based Sentence Generation Rule (이미지 사전과 동사기반 문장 생성 규칙을 활용한 보완대체 의사소통 시스템 구현)

  • Ryu, Je;Han, Kwang-Rok
    • The KIPS Transactions:PartB
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    • v.13B no.5 s.108
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    • pp.569-578
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    • 2006
  • The present study implemented AAC(Augmentative and Alternative Communication) system using images that speech defectives can easily understand. In particular, the implementation was focused on the portability and mobility of the AAC system as well as communication system of a more flexible form. For mobility and portability, we implemented a system operable in mobile devices such as PDA so that speech defectives can communicate as food as ordinary People at any Place using the system Moreover, in order to overcome the limitation of storage space for a large volume of image data, we implemented the AAC system in client/server structure in mobile environment. What is more, for more flexible communication, we built an image dictionary by taking verbs as the base and sub-categorizing nouns according to their corresponding verbs, and regularized the types of sentences generated according to the type of verb, centering on verbs that play the most important role in composing a sentence.

Two Patients with Atypical Infantile Pompe Disease Presenting with Hypertrophic Cardiomyopathy (비후성 심근병증으로 발현된 비전형적 영아형 폼페병 2례)

  • Kim, Eun-Hee;Ko, Jung-Min;Lee, Beom-Hee;Kim, Gu-Hwan;Choi, Jin-Ho;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.6 no.2
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    • pp.161-165
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    • 2009
  • Pompe disease (glycogen storage disease type II) is an autosomal recessive disorder caused by deficiency of acid-${\alpha}$-glucosidase (GAA) resulting in lysosomal glycogen accumulation in multiple tissue, particularly cardiac and skeletal muscle. The classic infantile form of Pompe disease is characterized by marked cardiomegaly, respiratory failure and severe generalized hypotonia. Most patients die from cardiorespiratory failure or respiratory infection within the first year or two of life without treatment. A "non-classic" phenotype presents with less severe clinical feature and slow progression of disease. We report two patients with non-classic infantile Pompe disease from one family manifested hypertrophic cardiomyopathy and progressive proximal weakness.

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Research on Utilizing Method of CCTV System for Crime Prevention and Safety Accident Reduction (범죄예방 및 안전사고 감소를 위한 CCTV시스템의 활용방안에 관한 연구)

  • Kim, Tae-Hwan
    • Journal of the Society of Disaster Information
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    • v.3 no.1
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    • pp.55-68
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    • 2007
  • Recently, people in cities of developed countries are exposed to unfortified damages of crime and disaster due to urbanization, industrialization and information-oriented era caused by congestion of population in terms of hardware and various social pathology phenomena and frequent and large scale of disaster caused by crime and disorder, which occur in the course of going through nuclear family, a gap between rich and poor and aging society in terms of software. In this regard, demand for security upon individual life and property has been increased but the police that are responsible for the public security does not effectively reduce damage in life and property because their activities are mainly oriented in coping with security accidents more than prevention. Shortage of manpower and budget, retarded equipment, and heavy overwork are the reasons. In order to confront with this kind of situation, we should utilize CCTV system with the purpose of declining possible chances of crime, not for eliminating cause of crime as crime prevention activities to predict danger in advance as a way of prevention and we may expect a role of damage prevention by installing CCTV in places where security accident may possibly happen. In conclusion, there are invasion of privacy, misuse of the system, insufficiency of overall monitoring office management, lack of citizens' understanding and economical allotment of the system installation costs in installation of CCTV system. However. it is necessary to install the CCTV system for effective prevention of crime and prevention activities of security accidents and accurate PR of purposes of installing CCTV to local residents, establishing relevant laws about system misuse, allotment of equipment costs and fees by R&D of the system machinery, cost reduction method of storage, management and replacement, saving costs from co-operative attitude of government, and local autonomous entities and local residents should be involved.

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Korean Children with Infantile Pompe Disease Presenting with Hypertrophic Cardiomyopathy: Experiences in a Single Institution (단일 기관에서 경험한 비후성 심근병증으로 발현된 영아형 폼페병)

  • Ko, Jung Min;Lee, Young Ah;Kim, Gi Beom;Park, Sung Sup;Song, Jung-Han
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.12 no.1
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    • pp.42-48
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    • 2012
  • Pompe disease is a rare lysosomal glycogen storage disorder caused by a total or partial deficiency of the acid ${\alpha}$-glucosidase (GAA) enzyme due to the GAA gene mutations. The classic infantile form of Pompe disease is a rapidly progressive multi-organ disease with hypotonia, generalized muscle weakness, and hypertrophic cardiomyopathy, usually leading to death in the first 2 years of life. Enzyme replacement therapy with recombinant human GAA has been shown to be effective and subsequently yielded promising results. Here, we present clinical and genetic characteristics of three Korean non-classic infantile Pompe patients, and the short term efficacy of enzyme replacement therapy. Considering that enzyme replacement therapy can change the natural course of infantile Pompe disease, early diagnosis and early initiation of treatment is critical to improving patient outcomes.

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Genome-Wide Association Study of Metabolic Syndrome in Koreans

  • Jeong, Seok Won;Chung, Myungguen;Park, Soo-Jung;Cho, Seong Beom;Hong, Kyung-Won
    • Genomics & Informatics
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    • v.12 no.4
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    • pp.187-194
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    • 2014
  • Metabolic syndrome (METS) is a disorder of energy utilization and storage and increases the risk of developing cardiovascular disease and diabetes. To identify the genetic risk factors of METS, we carried out a genome-wide association study (GWAS) for 2,657 cases and 5,917 controls in Korean populations. As a result, we could identify 2 single nucleotide polymorphisms (SNPs) with genome-wide significance level p-values (< $5{\times}10^{-8}$), 8 SNPs with genome-wide suggestive p-values ($5{\times}10^{-8}{\leq}$ p < $1{\times}10^{-5}$), and 2 SNPs of more functional variants with borderline p-values ($5{\times}10^{-5}{\leq}$ p < $1{\times}10^{-4}$). On the other hand, the multiple correction criteria of conventional GWASs exclude false-positive loci, but simultaneously, they discard many true-positive loci. To reconsider the discarded true-positive loci, we attempted to include the functional variants (nonsynonymous SNPs [nsSNPs] and expression quantitative trait loci [eQTL]) among the top 5,000 SNPs based on the proportion of phenotypic variance explained by genotypic variance. In total, 159 eQTLs and 18 nsSNPs were presented in the top 5,000 SNPs. Although they should be replicated in other independent populations, 6 eQTLs and 2 nsSNP loci were located in the molecular pathways of LPL, APOA5, and CHRM2, which were the significant or suggestive loci in the METS GWAS. Conclusively, our approach using the conventional GWAS, reconsidering functional variants and pathway-based interpretation, suggests a useful method to understand the GWAS results of complex traits and can be expanded in other genomewide association studies.