• Title/Summary/Keyword: Emaciation disease

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Clinical Observation on Hyperthyroidism (갑상선기능항진증(甲狀腺機能亢進症)의 임상적(臨床的) 관찰(觀察))

  • Lee, Kyu-Bo;Kang, Bann;Song, Suk-Ho;Park, Hi-Myung;Whang, Kee-Suk
    • The Korean Journal of Nuclear Medicine
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    • v.3 no.2
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    • pp.39-47
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    • 1969
  • A clinical analysis was made on 161 cases of hyperthyroidism seen at the Radioisotope Laboratory of Kyungpook National University Hospital. This series consisted of 144 cases of diffuse goiter and 17 cases of nodular goiter. 1) Hyperthyroidism was most prevalent in the 4th decade and male to female ratio was 1:4.6. 2) Cardinal symptoms in the order of frequency were weakness, easy fatigability, palpitation, weight loss, nervousness, perspiration, heat intolerance, increased appetite, insomnia and dysmenorrhea. 3) Major physical findings in the order of frequency were goiter, fine tremor, tachycardia, wide pulse pressure, emaciation, warm moist skin, exophthalmos, systolic hypertension and atrial fibrillation. 4) The complications were ophthalmopathy (34.2%), thyrotoxic heart disease (5.6%), thyroid crisis (1 case), pretibial myxedema (1 case) and thyrotoxic myopathy (1 case). 5) Mean values of the six hour and twenty-four hour $^{131}I$ uptakes by the thyroid glands were 67.5% and 71.6%, respectively, in diffuse goiter and 64.5% and 65.0%, respectively, in nodular goiter. 6) Mean values of twenty-four hour $PB^{131}I$ conversion ratio were 76.3% in diffuse goiter and 70.2% in nodular goiter and those of the basal metabolic rate was +51% in the former and +41% in the latter. Mean serum cholesterol level was 152mg% in diffuse goiter and that in nodular goiter was 175mg%. 7) Among the 134 cases treated with $^{131}I$, 66 cases (49.3%) were successful1y controlled with single dose and in the majority of the cases the initial therapeutic dose required was $4.1{\sim}5.0mC$ in diffuse goiter and $5.1{\sim}6.0mC$ in nodular goiter. 8) With $^{131}I$ treatment the symptoms improved in the following order: heat intolerance, emaciation, nervousness, insomnia, easy fatigability, weakness, fine tremor, goiter, perspiration, exertional dyspnea and palpitation. And in a few cases improvement of even exophthalmos was seen. 9) Following $^{131}I$ treatment myxedema occurred in 4 cases (3%) and reccurrence in 9 cases (6.8%).

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10 year follow up of a boy with Lesch Nyhan Syndrome

  • Kim, Sook Za;Song, Wung Ju
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.11 no.1
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    • pp.88-98
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    • 2011
  • Lesch-Nyhan syndrome is a X-linked recessive disorder caused by a deficiency of the enzyme hypoxanthine-guanidine phosphoribosyltransferase (HPRT), enzyme to recycle purines. Case history: born induced vaginal delivery at 40 weeks complicated by premature membrane ruputure, body weight 2.820 gm. He showed failure to thrive showing severe protein aversion like milk products and pink daper. Developmental delay revealing rolling over at 10.5 month, followed by regression. Seizure at 2 months, His poor oral feeding was lifelong problem. Weak crying, spastic, choreoathetoid movement. Self mutilating behavior noted and diagnosed at age 3 years. No family history of consanguinity and neurological disorders. Method: Laboratory test, physical exam, imaging study and molecular. Clinical follow up Treat ment with allopurinol. Result: uric acid 10.5 mg/dL (N 3.5-7.9), APRT 151.1uM/ min/ml pro(25.7-101), HPRT 7.6 (N 233.5-701) and c.151C>T hemizygote (p,Arg51X). Abdominal sonogram showed staghorn calculi in both kidneys, brain MRI brain atrophy. Clinical follow up showed, seizure at 2 mo, developmental delay (head control and, rolling over at at 11mo, pointing body part at 2 yr 7 mo, eye hand coordination at 2 y 11mo,creeping at 3 y 7 mo, speaking words at 6 y 6 mo ),and developmental regression at 3 yr of age. Sleeping problem including insomnia and severe constipation. Self mutilating behavior (lip bite) started at 2.5 yr, neurologic sx including intermittent upward gaze accompanied by swallowing difficulty at 3 y 7 mo grand mal seizure at 4.5 yr and spastic extremity and trunchal hypotonia and choleoathetoid movement and ataxia at 6.5 yr. Scoliosis with severe spasticity at 9 yr 9 mo. Acute life threatening episode with irregular breathing at 9 yr and 9 mo, Emaciation and nephrolithiasis and recurrent pneumonia. Died suddenly at 10 yr 3 mo. Conclusion: life long feeding problem, chronic gut motility dysfunction, sleeping difficulty and progressing neurologic deterioration and nephrolithiasis despite normal serum uric acid maintence by allopurinol treatment.

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Study on the 'Diagnosis and Treatment of Terror and Palpitation due to Fright and the Several Hemorrhagic Diseases' in Synopsis of Golden Chamber (금궤요략${\cdot}$경계토뉵하혈흉만어혈병맥증병치 제십육(第十六)에 대(對)한 연구(硏究))

  • Yun, Ju-Heon;Park, Kum-Sook;Kwon, Mi-Ja;Lim, Dong-Kook;Jeong, Heon-Young
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.1
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    • pp.13-24
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    • 2008
  • This Chapter mentioned Terror and Palpitation due to Fright(驚悸) and Hemorrhagic disease(血證). Terror and Palpitation due to FrightAcctually Terror(驚) is different from Palpitation(悸). Terror(驚) is one of the seven emotions. But in this case, It refer to the Palpitation and the uneasiness of mind due to one's hearing a strange sound of seeing a strange. Tremulous Pulse can be appear. So Terror(驚) is caused by Exopathic Factors(外因) and belongs to Excess syndrome(實證). Palpitaion(悸) is the sensation of plamus, palpitation and unrest not because of being frightened. It is usurally caused by the deficiency of Ki(氣) and blood(血). So Deep, Thready and weak pulse can be appear. So Palpitaion(悸) is caused by Endopathic Factors and belongs to Deficiency Syndrome. In this Chapter, Terror and Palpitation due to Fright(驚悸) treat with the Kyeji-ke-jakyak-ka-chokchil-moryu-yongkol-kuyuk-tang(桂枝去芍藥加蜀漆牡蠣龍骨救逆湯) and Banha-mahwang-hwan(半夏麻黃丸). There are two type in Hemorrhagic disease(血證). One is bleeding(出血) and another is blood stasis(瘀血). The contents which relate with the Hemorrhagic disease(血證) are Hematemisis(吐血), Rhinorrhagia, Hemafecia(下血). In hemorrhage pathological mechanisms, there are two mechanisms. One is that Fire and Heat(火熱) pressure blood. Another is that cold and deficiency(虛寒) disable Ki(氣) from keeping blood flowing within vessels. Blood stasis(瘀血) can be called Extravasated Blood(惡血), Coagulated Blood, Blood retention(蓄血,積血), Dead Blood(死血) and Emaciation due to Blood disorder(乾血). It refer to a morbid state of unsmooth circulation and blood stagnancy often resulting from Ki(氣) stagnation, Ki(氣) deficiency and accumulation of pathogenic coldness. The symptom of Blood stasis are 'Fullness sensation in the chest, Lip Flaccidity, Cyonotic Tongue and Dryness of Mouth'. And the man who have Blood stasis, want to rinse his mouth with the water, but he can't drink the water because there isn't interior Heat of Excess Type. The symptom of Cyonotic Tongue(舌靑) had influence on diagnosing Blood stasis(瘀血) in offspring.

The Review on the Study of Diabetes Mellitus in Oriental Medicine Journals (당뇨병의 연구 경향에 대한 고찰 -한의 학술 논문 검색을 중심으로-)

  • Lee Eun-Bang;Na Gun-Ho;Ryu Chung-Ryul;Cho Myung-Rae
    • The Journal of Korean Medicine
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    • v.25 no.3
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    • pp.169-179
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    • 2004
  • Objectives : The purpose of this study is to research trends in the study of diabetes mellitus and to establish the future direction for its study. Methods : We reviewed oriental medicine papers published in the last twenty-three years(1980-2002). Results : 1. We researched 94 papers in 14 journals and the patterns of study were as follows: experimental studies were 53 (56.3%), reviewed studies were 20 (21.2%), clinical studies were 12 (12.7%) and case reports were 9 (9.8%). 2. The experimental studies (53) were divided into papers on efficiency testing of herbal medications (40) and acupuncture & moxibustion (13). 3. The reviewed studies showed that research has been carried out in the fields of cause, pathogenesis, principles for treating disease, acupuncture and moxibustion, herbal medication, exercise, and relation of sasang (사상) to diabetes mellitus. 4. The clinical studies showed that the research was carried out in the fields of follow up surveys for herbal medication efficiency testing, the relativity of diabetes mellitus to other diseases and sasang (사상). 5. In consequence of researching the case reports, there was no common prescription used meaningfully. Conclusions : We need more studies of diabetes mellitus by reaching for specific therapy.

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Etiological Studies on the Acute Fatal Disease of Angora Rabbits : The So-Called Rabbit Viral Sudden Death (앙고라 토끼의 급성폐사성질병(急性斃死性疾病)의 병인학적(病因學的) 연구(硏究) : 소위(所謂) 토끼의 바이러스성(性) 급사병(急死病))

  • Lee, Cha-soo;Park, Cheong-kyu
    • Korean Journal of Veterinary Research
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    • v.27 no.2
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    • pp.277-290
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    • 1987
  • This paper dealt with etiological studies on the acute fatal disease of Angora rabbits occurring as a group in Korea. The disease was confirmed as an acute infectious disease caused by virus. The results obtained were summarized as follows: The disease produced a high morbidity in the rearing Angora rabbits and a high mortality in the infected rabbits, and was acute. The infected rabbits died soon without premonitory signs after inappetence. The body temperature of the affected rabbits rose to $40^{\circ}C$ and nearly all deaths occurred within 48 hours after inoculation. In many cases a bloody foam was visible from the nostrils after death. According to the progress of the disease the nervous signs, such as ataxia, paralysis of the legs, and torticollis could be recognized in the some cases. Rabbits that had recovered from the disease were severe emaciation, and bristly and sparse hairs. In macroscopical findings, there were hemorrhage and edema of the lung, hemorrhage or hyperemia of the tracheal and broncheal mucosae, appearance of blood-tinged effusion in the respiratory tract. The principal lesions were found in the liver. Usually the lobular necrosis of the liver cells was progressed, and focal necrosis and hemorrhagic spots of various sizes were often observed in the liver. Liver was as a whole pale. In chronic cases, however, there was a slight liver cirrhosis with the atrophy of the parenchymal cells. The other lesions encountered grossly consisted of swelling and petechiae of the kidney, hyperemia and hemorrhage of the spleen, catarrh of the small intestine, and hyperemia of the brain. The urinary bladder contained a lot of turbid urine or bloody urine and urinary cast, and was distended with the urine. In microscopical findings, the most striking lesions occurred in the liver and may be classified as viral hepatitis. The hepatic lesions were initially characterized by progression from periportal to peripheral necrosis of the lobules with the infiltration of mononuclear cells. Focal necrosis of various sizes, hemorrhage and hyperemia were often observed in the hepatic lobules. In chronic cases, there were intensive infiltration of lymphocytes, proliferation of fibroblasts, appearance of plasmal cells, and atrophy of parenchymal cells in the hepatic tissue. Perivascular lymphocytic infiltration and meningitis were seen in the brain and spinal cord. In the kidney, there were acute glomerulonephritis, hemorrhage, necrosis of the uriniferous tubules, and retention of eosinophilic substance within the renal tubules. Proliferation of fibroblasts and infiltration of mono-nuclear cells were found in the interstitial stroma of the kidney in chronic case. There were also hemorrhage and edema in the lung, hyperemia and hemorrhage in the trachea and bronchus, perivascular lymphocytic infiltration and focal myocardial necrosis in the heart, hyperemia and hemorrhage in the spleen, vacuolization and desquamation of mucous epithelia in the urinary bladder, catarrhal inflammation of the small intestine, hemorrhage in the adrenal cortex and hyperemia in the other organs. In the electron microscopical findings of the hepatic tissue, crystals of viral particles appeared in the cytoplasm of the hepatocytes and the sinusoidal endothelial cells, and the viral particles, were small in size and polygonal. The authors suppose the virus may belong to picornaviridae family of RNA viruses. Also immature virus-like particles, dilated rough endoplasmic reticulum and destruction of nuclear membrane were seen in the hepatocytes. From these results, it is concluded that the sudden death is an acute viral disease characterized by hepatitis and the affected rabbits may be died of viremia.

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Prophylactic and therapeutic studies on intestinal giant-cystic disease of the Israel carp caused by yhelohunellus kitauei I. Course of formation and vanishment of the cyst (향어의 장포자충(Thelohanellus kitauei)증의 예방 및 치료에 관한 기초적 연구 I . 종유의 소장 과정)

  • 이재구;김종오
    • Parasites, Hosts and Diseases
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    • v.28 no.3
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    • pp.183-194
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    • 1990
  • In an attempt to develop prophylactic and therapeutic measures of the intestinal giant-cystic disease caused by Thelohanellus kitauei in the Israel carp, Cyprinus carpio nodus, pathological observations were conducted upon the carps which were hatched in May 1988 and raised in a net cage fish farm at the Soyang lake, managed by Horim Fisheries for the period of 21 months with 1~2 months interval. After a gross inspection of the carps, necropsy was carried out periodically in order to clarify the pathological changes in various internal organs and muscular tissues. Also. the prevalence of the disease was checked during the period from 1988 to 1990. Gross inspections revealed that the infected carps showed some degree of fading in body and gill color, back-emaciation symptoms, reddish anus accompanying erosion and relaxation and pot-belly, as well as discharge of yellowish white mucoid material from the anus. However, most carps died eventually of intestinal obstruction. Other significant necropsy fadings included cyst formation of various size in the intestinal mucosa, ascites, anemic condition through internal organs and muscular tissues, hyperemia and dilation of intestines with decreased tension, thinness and fragility, and full contents of semi-fluid or yellowish white mucoid material in the intestinal canals. Based on the morphological characteristics of the spores found in the cysts, parasitic location in the intestines, macro- and microscopic findings of the lesions, the parasites were identised as Thelohanellus kitauei Egusa os Nakajima, 1981. Although monthly changes of water temperature were distinct, the extrusion rates of the polar filaments of the spores stayed constant throughout the year with an exception of a lower rate in July, The lesions initiated from mucosa and submucosa in early July became large swellings and then complete mature (orms following the peracute course. From late August the upper cysts were gradually opened and most of the spores were dispersed from anus into the surrounding water through December but only a few lasted until next April. The cysts were completely recovered until next September. Comparing the incidence and prevalence of the disease by year tremendous infection and death rates were checked in the first prevalent year, 1988, but the rates were significantly decreased in the second year, and showed an almost normal status in the third year, 1990. As the above summarized results showed, the disease entity might come to an end in three years after the first prevalent year, however, the spores must be strictly prevented because they could be infective in the water for one year.

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Study on the Development of a Standard Instrument of Diagnosis and Assessment for Spleen Qi Deficiency Pattern (脾氣虛證(비기허증) 진단평가도구 개발 연구)

  • Oh, Hye-Won;Lee, Ji-Won;Kim, Je-Shin;Song, Eun-Young;Shin, Seung-Won;Han, Ga-Jin;Lu, Huanyu;Lee, Jun-Hee
    • The Journal of Korean Medicine
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    • v.35 no.1
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    • pp.157-170
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    • 2014
  • Objectives: The purpose of this study was to develop a standard instrument of diagnosis and assessment for spleen qi deficiency pattern. Methods: Reports published in Korea and China related to spleen qi deficiency pattern were selected. Assessments of selected references were performed to select major symptoms of spleen qi deficiency pattern. Korean translation and review by a Korean linguist were performed to create a draft of [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)]. The final [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)] was completed after assessment on inclusion or exclusion, on importance of items and on validity of translation by an expert committee, consisting of professors from the National College of Korean Medicine. Results & Conclusions: 1. 14 major symptoms were selected by frequency from 45 references which were related to standard identification of spleen qi deficiency pattern, translated into Korean and reviewed by a Korean linguist. 2. 11 symptoms were selected after assessment on inclusion yes or no by the expert group. Items were listed in order of importance: tiredness of extremities (肢体倦怠), sallow complexion (面色萎黃), reduced appetite (食欲减退), abdominal distension after eating (腹胀食後尤甚), inability to eat (納少), pale tongue and white fur (舌淡苔白), lethargy (神疲), emaciation (消瘦), loose stool (大便溏薄), shortness of breath and reluctance to speak (少氣懶言), and weak pulse (脈緩弱). 3. Final [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)] was completed after assessment of translation validity, reflection of individual opinions by the expert committee, and application of weighted value computed from assessment on importance of items.

A Case of Systemic Lupus Erythematosus in a Dog (개에 있어서 전신성 홍반성 낭창 일례)

  • 김주향;김기홍;고인경;이금종;나기정;양만표
    • Journal of Veterinary Clinics
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    • v.17 no.2
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    • pp.443-449
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    • 2000
  • A three-year-old male jindo with generalized skin lesions (including seborrhea, hyperk- eratosis, alopecia, papules, and ecchymoses), pruritus lymph node enlargement, and fever was brought to Veterinary Teaching Hospital, College of Veterinary Medicine, Chungbuk National Uni- versity. There were no laboratory findings for parasites and fungi in the hair and skin But, the com- plete blood counts (CBC) showed leukocytosis and severe cosinophilia, It was suspected to be an inflammatory and allergic dermatitis. Thus, prednisoIone (0.5 mg/kg PO, BID for 1 week) and ampi- cillin (10 mg/kg PO, BID for 1 week given. One week later, pruritus and ecchymoses were reduced. These treatments were repeated for 7 day again. Three months later, the dog was presented again due to the relapse and exacerbation of the clinical signs. The signs were as follows; severe pru- ritus, vesicobullous skin lesions, anorexia, emaciation, lameness, and welling of carpal joints that showed inflammatory skin lesion and draining of synovia-like fluid. The values of WBC counts were returned to normal ranges. In contrast, eosinophilia was still observed. Coombs test for patient RBC and serum were negative. Hypoalbuminemia (2.5g/dl) was shown by serum chemistry. The uri- nalysis revealed and presence of leukocytes. Luxation finding of right radial carpal joint by polyarthritis was shown in radiography of affected joints.Lupus eryhematosus(LE) cells also appeared in peripheral blood and synovial fluid of affected joints. Definitely, antinuclear antibody (ANA) of patient serum using feline peripheral blood mononuclear cells was detected by all immu- nofluorescence. Based on these findings such as sedum ANA-Positive. major signs (skin disease, non- erosive polyarthritis with soft tissue swelling. and proteinuria), minor signs (fever), and LE cell-pos- itive, a diagnosis of systemic lupus crythematosus (SLE) was mad\ulcorner in this dog. The dog with SLE was administered with Pre(2.0 mg/kg PO, BID for first 4 week and then QOD) to inhibit the production of autoantibodies and with ampicillin (10 mg/kg PO, BID for first 4 weeks and then QOD) to prevent the secondary infection. The condition of this dog was monitored every 2 weeks by physical examinations, radiography, CBC, serum chemistry and urinalyais. At 8th week of treat- ment, the state of SLE evaluated by physical examinations and laboratory findings was markedly improved except for proteinura.

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A Long Term Follow Up Two Cases of Lesch-Nyhan Syndrome Pink Diaper (Lesch-Nyhan 증후군 장기 추적관찰: 분홍 기저귀)

  • Jae Young Kim;Wung Joo Song;Bong-Ok Kim;Harvey L. Levy;Sook Za Kim
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.24 no.1
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    • pp.26-36
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    • 2024
  • Lesch-Nyhan syndrome (LNS) is an Clinical symptoms can range from mild to severe depending on residual enzyme activity and genetic mutations. In Korea, 27 cases of LNS have been reported. We report the results of an 11-year comparative follow-up of two cases of children who visited because of pink diapers, one who died from LNS with no residual enzymes and one case with partial residual enzymes. Case 1: During follow-up, seizures, developmental delay, and regression were observed. The boy experienced insomnia and severe constipation. He exhibited self-mutilating behavior, a grand mal seizure, scoliosis with severe spasticity, truncal hypotonia, choreoathetoid movement, and ataxia. After prolonged emaciation, staghorn calculi, and recurrent pneumonia, the patient died suddenly at the age of 11 years. Genetic testing revealed a hemizygous HPRT1 variant (c.151C>T (p.Arg51Ter)). Uric acid level was 10.5 mg/dL (normal range: ~3.5-7.9) and HPRT activity 0.02 nmol/hr/spot (10-23.8 nmol/hr/spot). Case 2: During follow-up, the patient remained underweight. He has normal intelligence attending primary school. Self-mutilation symptoms were not observed. Regular renal ultrasonography did not reveal urolithiasis. The patient had a hemizygous HPRT1 variant (c.35A>C (p.Asp12Ala)). Uric acid level and HPRT activity were 11 mg/dL and 0.56 nmol/hr/spot. Pink diapers after the neonatal period and severe protein aversion, neurological problems, and kidney stones, differentiation for LNS is necessary. When suspected, serum uric acid levels, HPRT enzyme activity, and molecular biological tests may be helpful in predicting the prognosis of LNS.

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