• Title/Summary/Keyword: Developmental delay

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Cytogenetic Study and Clinical Features in Patients with Klinefelter's Syndrome and Y Chromosomal Abnormalities (Klinefelter 증후군 및 Y염색체 이상으로 진단된 환자들의 염색체 결과 및 임상 양상)

  • Moon, Shin-Yong;Choi, Seok-Tae;Ko, Hee-Jung;Oh, Sun-Kyung;Han, Jung-Ho;Suh, Chang-Suk;Kim, Seok-Hyun;Choi, Young-Min;Kim, Jung-Gu;Lee, Jin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.1
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    • pp.43-54
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    • 1999
  • Klinefelter's syndrome is a very important disease in gynecologic endocrinologic fields, because the patients with this karyotype complain of infertility, azospermia and ambiguous genitalia. Y chromosome is an important chromosome which determine genetic sex and the structure of gonad and genitalia. In this study, to elucidate the cytogenetic characteristics and clinical features of Klinefelter's syndrome and Y chromosomal abnormalities in Korea, we studied 303 cases of Klinefelter's syndrome and 11 cases of Y chromosomal abnormalities which were diagnosed by chromosomal analysis at the Cytogenetic Laboratory, Institute of Reproductive Medicine and Population, Seoul National University for 12 years from January 1984 to December 1996. The results of this study showed as follows: 1. In a total of 9275 cases, there were 303 cases (3.3%) of Klinefelter's syndromes, 11 cases (0.1%) of Y chromosomal abnormalities. 2. In 102 cases of patients showed typical clinical features of Klinefelter's syndrome, 101 cases (99%) of them were diagnosed to Klinefelter's syndrome in karyotyping. 3. In 303 cases of Klinefelter's syndrome, there were 277 cases (91.4%) of 47,XXY complement, 16 cases (5.3%) of mosaicism, 2 cases (0.7%) of 48,XXXY, 5 cases (1.7%) of 48,XXYY and 3 cases (1.0%) of 49,XXXXY. 4. In 303 cases of Klinefelter's syndrome, 284 cases (93.7%) of them were diagnosed after puberty and only 19 cases (6.3%) of them were diagnosed before puberty. 5. In 303 cases of Klinefelter's syndrome, there were 146 cases (48.2%) of patients with infertility-associated chief complaints, 101 cases (33.3%) of patients with typical clinical features of Klinefelter's syndrome, 22 cases (7.3%) of patients with ambiguous genitalia. 6. In patients with Klinefelter's syndrome, 48,XXYY and 49,XXXXY had serious symptoms such as mental retardation, developmental delay, Down syndrome-like features, congenital anomalies, but 48,XXYY and other mosaicisms had infertility-associated symptoms or ambiguous genitalia. 7. The 8 cases of polysomy Y (XYY complement) showed several serious symptoms such as Down syndrome-like features, mental retardation, fragile X syndrome-like feature, congenital anomalies, ambiguous genitalia which could be detected before puberty.

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Phenotypic and Cytogenetic Delineation of Six Korean Children with Kabuki Syndrome (한국인 Kabuki 증후군 환아들의 임상적 표현형 및 세포유전학적 양상)

  • Ko, Jung-Min;Hwang, Jeong-Min;Kim, Hyon-Ju
    • Journal of Genetic Medicine
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    • v.7 no.1
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    • pp.37-44
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    • 2010
  • Purpose : Kabuki syndrome is a multiple congenital malformation syndrome with mental retardation. It was named after its characteristic appearance, a face resembling that of an actor in a Kabuki play. To date, six Korean cases of Kabuki syndrome have ever been reported. Here, we present the phenotypic and genetic characteristics of six patients with Kabuki syndrome. Materials and Methods : Between 2003 and 2009, six Korean girls have been diagnosed and followed up as Kabuki syndrome at Center for Genetic Diseases of Ajou University Hospital. Their clinical and laboratory data were collected and analyzed by the retrospective review of medical records. Results : All six patients showed the characteristic facial dysmorphism and developmental delay. Persistent fingertip pads were also found in all patients. Most patients showed postnatal growth retardation (83.3%) and hypotonia (83.3%). Opthalmologic problems were common, particularly for strabismus (83.3%). Congenital heart defects were present in three patients (50%). Skeletal abnormalities including 5th finger shortening (83.3%), clinodactyly (50%), joint hypermobility (50%) and hip dislocation (16.7%) were also observed. There was no patient who had positive family history for Kabuki syndrome. Cytogenetic and molecular cytogenetic analyses including karyotyping and array CGH could not reveal any underlying genetic cause of Kabuki syndrome. Conclusion : Korean patients with Kabuki syndrome showed a broad spectrum of clinical features affecting multiple organ systems. Although clinical manifestations of Kabuki syndrome have been well established, our results failed to detect recurrent chromosome aberrations which could cause Kabuki syndrome. Its natural history and genetic background remains to be further studied for providing appropriate management and genetic counseling.

Effects of Active Oral Play and Ayres Sensory Integration (ASI®) for Child With Oral Defensiveness: Single Subject Research (구강방어아동을 위한 능동적 구강놀이와 ASI적용효과 : 단일사례연구)

  • Sung, Ga-young;Choi, Jeong-Sil;Jung, Hyerim
    • The Journal of Korean Academy of Sensory Integration
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    • v.17 no.3
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    • pp.1-13
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    • 2019
  • Objective : The purpose of the present study is to investigate the effects of Ayres Sensory Integration (ASI®) with play-centered oral defensiveness reduction activities on the oral sensitivity of a child with oral defensiveness. Methods : The subject was a three-and-a-half year-old boy with a developmental delay. The study was performed from August to September, 2018. The research design used in this study is the design for single-subject research. The experimental period was divided into three phases: three sessions for the initial baseline phase (A), 15 sessions for the treatment phase (B), and three sessions for the final baseline phase (A'). Ayres Sensory Integration (ASI®) with active oral play was conducted in the treatment phase. The Measuring Oral Sensitivity in Practice was used to test changes in the oral sensitivity level. The Korean Children's Eating Behavior Inventory and Food Checklist were used to assess the difference in functions related to oral sensitivity before and after the intervention. Results : In comparison with the baseline phase, the Measuring Oral Sensitivity in Practice and Korean Children's Eating Behavior Inventory were improved during the treatment phase, but the Food Intake checklist score was not changed after the treatment phase. Conclusion : The use of Ayres Sensory Integration (ASI®) with active oral play produced positive results and reduced the child's oral sensitivity and eating problems.

Effects of Equilibration Time, Precooling and Straw Loading Method on Survival of Mouse Embryos Frozen by Vitrification (생쥐 수정란의 유리화 동결보존에 있어서 동결전 처리방법에 관한 연구)

  • Gong, Il-Geun;Lee, Eun-Bong;Gang, Dae-Jin;Park, Chung-Saeng
    • Korean Journal of Animal Reproduction
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    • v.15 no.1
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    • pp.49-57
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    • 1991
  • This study was carried out to investigate the effect of equilibration time, precooling and straw loading method on the post-thaw survival rates of mouse embryos cryopreserved by vitrification method. The effect of the vitrification procedure on the damage of the embryos was also examined by the straining of nuclei using Hoechst 33342. The results obtained were summarized as follows; 1. The equilibration in Medium-1 for 10 minutes was considered to be the optimum equilibration time. Embryos equilibrated in Medium-1 for 10 minutes(81.0%) showed significantly(P<0.05) higher survival rates than those equilibrated for 5 minutes(40.0%) or 15 minutes(74.1%). 2. The survival rate of embryos cryopreserved using the double Medium-2 column(81.0%) was significantly(P<0.01) higher than that using the single Medium-2 column, whish was considered to be due to the double Medium-2 column method being more reliable for preventing contamination of diluent solution of 1M sucrose. 3. The survival rate of compacted morula stage embryos cryopreserved with the precooled and non-precooled Medium-2 was not significantly(P<0.05) different. 4. The number of blastomeres of embryos at late blastocyst stage after culture of mouse morulae for 24 to 28hours was significantly(P<0.05) decreased by freezing embryos using vitrification(53.3${\pm}$1.6 vs 41.4${\pm}$1.5), which was considered to be due to the damage of embryos during vitrification and the delay of embryo development by handling in vitro. 5. The vitrification procedure is considered to be a very simple and efficient method for cryopreservation of embryos at early developmental stage.

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Tandem Mass Spectrometric Analysis for Disorders in Amino, Organic and Fatty Acid Metabolism : 2 Years of SCL Experience in Korea

  • Yoon, Hye-Ran;Lee, Kyung Ryul
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.3 no.1
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    • pp.86-93
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    • 2003
  • Background : The SCL began screening of newborns and high risk group blood spots with tandem mass spectrometry (MS/MS) in April 2001. Our goal was to determine approximate prevalence of metabolic disorders, optimization of decision criteria for estimation of preventive effect with early diagnosis. This report describes the ongoing effort to identify more than 30 metabolic disorders by MS/MS in South Korea. Methods : Blood spot was collected from day 2 to 30 (mostly from day 2 to 10) after birth for newborn. Blood spot of high risk group was from the pediatric patients in NICU, developmental delay, mental retardation, strong family history of metabolic disorders. One punch (3.2 mm ID) of dried blood spots was extracted with $150{\mu}L$ of methanol containing isotopically labelled amino acids (AA) and acylcarnitines (AC) internal standards. Butanolic HCl was added and incubated at $65^{\circ}C$ for 15 min. The butylated extract was introduced into the inlet of MS/MS. Neutral loss of m/z 102 and parent ion mode of m/z 85 were set for the analyses of AA and AC, respectively. Diagnosis was confirmed by repeating acylcarnitine profile, urine organic acid and plasma amino acid analysis, direct enzyme assay, or molecular testing. Results : Approximately 31,000 neonates and children were screened and the estimated prevalence (newborn/high risk group), sensitivity, specificity and recall rate amounted to 1:2384/1:2066, 96.55%, 99.98%, and 0.73%, respectively. Confirmed 28 (0.09%) multiple metabolic disorders (newborn/high risk) were as follows; 13 amino acid disorders [classical PKU (3/4), BH4 deficient-hyperphenylalaninemia (0/1), Citrullinemia (1/0), Homocystinuria (0/2), Hypermethioninemia (0/1), Tyrosinemia (1/0)], 8 organic acidurias [Propionic aciduria (2/1), Methylmalonic aciduria (0/1), Isovaleric aciduria (1/1), 3-methylcrotonylglycineuria (1/0), Glutaric aciduria type1 (1/0)], 7 fatty acid oxidation disorders [LCHAD def. (2/2), Mitochondrial TFP def. (0/1), VLCAD def. (1/0), LC3KT def. (0/1). Conclnsion : The relatively normal development of 10 patients with metabolic disorders among newborns (except for the expired) demonstrates the usefulness of newborn screening by MS/MS for early diagnosis and medical intervention. However, close coordination between the MS/MS screening laboratory and the metabolic clinic/biochmical geneticists is needed to determine proper decision of screening parameters, confirmation diagnosis, follow-up scheme and additional tests.

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A Study the effect of Cooking Activity as a Language Intervention on the Language Development of Language Delayed Infants. (요리활동을 통한 언어중재가 언어발달지연을 보이는 유아의 언어능력 향상에 대한 연구)

  • Seo, Eui-Jung;Kim, Yun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.10
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    • pp.109-118
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    • 2016
  • Language intervention through cooking activity programs is designed to provide an efficient teaching method and improved educational environment in the field of teaching. This program addresses the effects of this program on the language development of three three-year-old infants (M;2, F;1) in the Center in Seoul. A cooking topic suitable for the age of this group was selected. The language Intervention was conducted for 50 minutes per week for a total of 25 times, and made use of vocabulary, verbs and nouns related to cooking which were evenly distributed. In this study, the Peabody Picture Vocabulary Test-Revised (PPVT-R), receptive language age (RLA) and expressive language age (ELA), and Preschool Receptive-Expressive Language Scale (PRES) were used to analyze the collected data. After the study, the cooking activity was accomplished with normal development outcomes appearing in the ability of vocabulary, receptive language, expressive language, and integrated language. There is now a solid evidence base supporting the efficacy of cooking activity in producing positive outcomes in the language development of language delayed infants. Consequently, cooking can induce their active participation and interest and extend their language abilities through various experiences.

A Case of Ornithine Transcarbamylase Deficiency in a Boy with Neonatal Seizure and Altered Mentality (신생아기 경련 및 의식저하를 주소로 내원한 Ornithine Transcarbamylase Deficiency 남아 1례)

  • Im, Minji;Song, Ari;Lee, Soo-Youn;Park, Hyung-Doo;Cho, Sung Yoon;Jin, Dong-kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.18 no.2
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    • pp.55-61
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    • 2018
  • Orinithine transcarbamylase (OTC) deficiency is the most common inborn error of the urea cycle with resulting hyperammonemia, which is medical emergency in newborns.We recently had a case of a boy that presented with lethargy, seizure, hyperammonemia and hypocalcemia in neonatal period. He was diagnosed with OTC deficiency by two consequent ways which are initial biochemical phenotype including hyperammonemia and an increased orotic acid in his urine and genetic analysis of the OTC gene. The OTC gene showed a novel hemizygous mutation c.913C>T (p.Pro305Ser). He was treated by low protein intake, sodium benzoate, phenylbutyrate sodium, L-arginine, and continuous renal replacement therapy (CRRT). After discharge, he has a relatively good prognosis without notable developmental delay. For good prognosis, the duration of hyperammonemia should be shorten. And it can be reached by an early diagnosis. For early detection of OTC deficiency, targeted exome sequencing will be a important role as well as biochemical tests.

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DENTAL MANAGEMENT OF A PATIENT WITH MOYAMOYA DISEASE UNDER GENERAL ANESTHESIA: CASE REPORT (모야모야병(moyamoya disease) 환자의 전신마취 하 치과치료: 증례보고)

  • Chae, Jong Kyun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.40-44
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    • 2019
  • Moyamoya disease (MMD) is a chronic, occlusive cerebrovascular disease of unknown etiology characterized by progressive stenosis at the terminal portion of the internal carotid artery and an abnormal vascular network at the base of the brain. The clinical presentations of MMD include transient ischemic attacks (TIA), ischemic stroke, hemorrhagic stroke, seizures, headache, and cognitive impairment. MMD is the most important cause of stroke or TIA in children in East Asian countries. A 5-year-3-month old boy with MMD experienced cerebral infarctions five times. Cerebrovascular anastomosis surgery was performed on him four years ago. He had dysphagia, developmental delay, hemiplegia, and strabismus. Besides, a number of dental caries in primary dentition were identified during clinical oral examination. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation and underlying systemic disease. MMD is associated with various medical diseases requiring thoughtful consideration during dental treatment. Crying and hyperventilation in MMD patients may cause hypocapnia and have a cerebral vasoconstrictive effect. If dental treatment is required, control of pain and anxiety is very important. General anesthesia may be considered for dental treatment in uncooperative or very young patients with MMD.

Congenital Insensitivity to Pain with Anhidrosis: Five-Year-Old Girl with a Neglected Distal Femur Fracture (선천성 무통증과 무한증: 5세 여아에서 발생한 방치된 원위 대퇴골 골절)

  • Woo, Seung Hun;Kim, Tae Woo;Bae, Jung Yun;Kwak, Sang Ho
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.463-468
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    • 2019
  • Congenital insensitivity to pain with anhidrosis (CIPA) is a rare disease that affects the sensory and autonomic nervous system. The patients do not have the ability to sense different sensations, such as pain, which tends to lead to different injuries. In addition, the patients suffer from fluctuations in body temperature due to autonomic involvement. The present case was a five-year-old girl with a neglected distal femur fracture. X-rays taken during the follow-up showed marked callus formation and pseudarthrosis of the distal femur. She had biting injuries of the tongue, auto-amputation of the fingers, some developmental delay and a history of recurrent fever with an unknown origin. The electrodiagnostic study was normal. The quantitative sudomotor axon reflex test revealed markedly reduced postganglionic sudomotor axonal responses at all sites recorded on the left. She was diagnosed with CIPA. As the initial presentation of CIPA involves the musculoskeletal system, orthopedic surgeons should have a high index of suspicion.

Identifying Latent Classes in Adolescent's Self-Determination Motivation and Testing Determinants of Classes (자기결정성 이론에 따른 학습동기 변화의 잠재프로파일 분류 및 영향요인 검증)

  • Choi, Hyunju;Cho, Minhee
    • Korean Journal of School Psychology
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    • v.11 no.1
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    • pp.253-274
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    • 2014
  • The present study classified groups based on latent profile of self-determination motivation(amotivation, external motivation, intrinsic motivation), and examined the determinants for each group. The data was collected through panel data of Korea Education Longitudinal Study(KELS), total 5,459 participants who answered questionnaires of self-determination motivation of two times both second grade of middle school and second grade of high school. To identify the change motivational type, standardized residual was conducted using SPSS 17.0., and the latent classes for the change of motivational type was investigated using M-Plus in the frame work of Latent Profile Analysis(LPA). The results indicated that five groups(increase of self-determination, self-determination maintenance, self-determination developmental delay, elf-determination confusion, decrease of self-determination group) were classified based on latent profile. In addition, parental control, academic self-concept, teacher-student relationship, test anxiety, avoidance orientation, gender, father's education, and income were significantly related to each group. Lastly, the implications for directions of the adolescent counseling, limitations and future research are discussed.