• 대한간호학회지
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• 제42권5호
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• pp.609-621
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• 2012

Purpose: The purpose of this study was to explore the experiences of Korean mothers in parenting children with Hunter's syndrome, an X linked recessive genetically inherited disease usually affecting boys. Methods: Data were collected from 14 mothers having children with Hunter's syndrome, through two focus group interviews and individual in-depth interviews. Qualitative data from the field notes and transcribed notes were analyzed using the grounded theory methodology developed by Strauss & Corbin (1998). Results: The core category about the process of rearing children with Hunter's syndrome was identified as "navigating in the maze". The process of rearing children with Hunter's syndrome passed through three phases; 'entering an unknown region', 'struggling to escape from the unknown region', 'settling down in the unknown region'. Conclusion: In this study "navigating in the maze", as the core category deeply showed joys and sorrows of mothers in the process of rearing their children with Hunter's syndrome. In this rearing process they gradually adjusted themselves to their given condition. Also they gained initiatively coping strategies to care for, and protect their children. Therefore health care providers can establish supportive programs in the clinical field to empower these mothers by reflecting their proactive coping strategies.

• 대한한방소아과학회지
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• 제21권2호
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• pp.145-152
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• 2007

Objectives The purpose of this study is to report a case that has an important meaning as a result of treating. Hunter syndrome patient with oriental medicine for elevation of quality of life and continuous health care. Methods The patient had abdominal dropsy, abdominal pain, constipation, frequent gases and the common cold, so we treated him with herbal medicine, acupuncture, infra red, laser, CEP nebulizer, aroma massage and cupping. Results After the treatment, the girth of abdomen didn't Increase any more, and abdominal pain, constipation, frequent gases and common cold were improved. Conclusions This study shows that oriental medicine can elevate the Hunter syndrome patient's quality of life with continuous heath care and treatment for major problem. For more accurate studies, further studies would be needed with more cases.

• 동국한의학연구소논문집
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• 제10권
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• pp.77-85
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• 2008

목적 : 이 연구의 목적은 Hunter 증후군 환아의 삶의 질 향상과 지속적인 건강관리를 위해 한방치료를 시행하여 유의한 결과를 얻은 증례를 보고하는 것이다. 방법 : 환아는 복부창만, 복통, 잦은 가스 배출, 변비, 번번한 감기 증상을 호소하였고 이러한 증상의 완화와 지속적인 건강상태 관리를 위해 한약치료, 침치료, IR, 비강레이저, CEP nebulizer, 아로마마사지, 건식부항을 시행하였다. 결과 : 복부둘레는 더 이상 증가하지 않았으며, 복통과 변비는 호전되었고, 가스 배출의 빈도, 감기의 빈도와 정도가 감소하였다. 결론 : 이 연구는 한방치료가 hunter 증후군 환아의 건강상태 관리와 대증 치료로 삶의 질을 향상시킬 수 있다는 것을 보여준다. 향후 더 많은 증례로 심도깊은 임상연구가 필요하다.

• 대한유전성대사질환학회지
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• 제15권3호
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• pp.160-164
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• 2015

Hunter syndrome(Mucopolysaccharidosis type II, MPS type II) is an X-linked disorder of glycosaminoglycans (GAGs) metabolism caused by an iduronate-2-sulfatase (IDS2) deficiency. A 24-month-old boy visited the department of pediatrics with the chief compliant of chronic purulent rhinorrhea beginning at age one. He had a history of repeated acute otitis media and chronic rhinitis. On physical examination he had a coarse face, enlarged tongue, distended abdomen, joint stiffness, and Mongolian spots at his first visit. The urine GAGs level was elevated at 66.10 mg/mmolCr (reference range, <11.1) and iduronate-2-sulfatase activity in leukocyte was decreased at 0.21 nmol/mg protein/hr (reference range, 18.7-57). Finally with an IDS gene mutational analysis, recombinant known mutation between intron 7 and distal of exon 3 in IDS2 was detected. Recombinant iduronate-2-sulfatase therapy was started without any infusion related reactions. The author highlights the importance of suspecting Hunter syndrome when pediatric patients visit with chronic purulent rhinorrhea which is a common cause of hospital visits for infants and children.

• Journal of Korean Neurosurgical Society
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• 제54권3호
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• pp.243-245
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• 2013

Bow hunter's syndrome (BHS) is rare cause of vertebrobasilar insufficiency that arises from mechanical compression of the vertebral artery by head rotation. There is no standardized diagnostic regimen or treatment of BHS. Recently, we experienced 2 cases resisted continues medication and treated by surgical approach. In both cases, there were no complications after surgery and there were improvements in clinical symptoms. Thus, we describe our cases with surgical decompression with a review of the relevant medical literature.

• 대한유전성대사질환학회지
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• 제14권2호
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• pp.156-162
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• 2014

A 25-month-old boy was referred to the hospital due to large head detected on routine physical examination. At visit, dysmorphic facial appearances, including broad nose, prominent forehead, and coarse face, were noted. Nasal obstruction with nasal voice, prominent adenoids, and bilateral middle ear effusions were detected. His abdomen was distended, and liver and spleen were palpated about 3 finger and 2 finger breadths, respectively. He was operated for bilateral inguinal hernias. The motion of both elbow joints was mildly limited on supination and pronation. Urinary level of glycosaminoglycan was elevated and the enzyme activity of iduronate sulfatase in leukocytes was decreased. The mutational analysis of the gene iduronate 2-sulfatase (IDS) revealed c.263G>A (p.Arg88His) mutation. His developmental scale showed delayed development and there was cardiac valvular involvement (tricuspid regurgitation and mitral valve prolapse). After the diagnosis of Hunter syndrome, enzyme replacement therapy started on a weekly basis without progression of any clinical features. Here we report a case of early diagnosed Hunter syndrome detected by large head on routine examination. Thus, it is important to associate Hunter syndrome in the patient with large head especially, if there is the history of bilateral inguinal hernia and prominent adenoids to increase the possibility of early diagnosis and treatment.

• 대한유전성대사질환학회지
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• 제14권2호
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• pp.178-181
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• 2014

헌터증후군(뮤코다당증 II형)은 글리코사미노글리칸의 분해를 촉매하는 효소인 iduronate-2-sulfatase 결핍에 의해 조직이나 기관의 세포 내 리소좀에 heparin sulfate와 dermatan sulfate 등의 전구물질이 축적되어 퇴행성 병변을 일으키는 유전 질환이다. 현재 효소보충요법을 통해 증상의 호전 및 질병의 진행을 지연시키는 치료가 가능하나, 중추신경계 증상이 발현된 경우 치료가 어려운 한계가 있어, 무엇보다 조기에 의심하고 진단하여 치료를 시작하는 것이 중요하다. 따라서 어린연령에 진단된 환아들의 임상적 특징에 대해 이해하는 것이 필요하며, 이에 저자들은 2.5세의 어린 연령에 진단된 환아를 경험하여 이를 보고하는 바이다.

• 대한청각학회지
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• 제25권1호
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• pp.49-54
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• 2021

Type II mucopolysaccharidosis (MPS II) commonly known as Hunter syndrome, is a rare X-linked lysosomal storage disorder caused by iduronate-2-sulfatase deficiency, which in turn causes otorhinolaryngological manifestations, including sensorineural hearing loss (SNHL). Previously, the median survival age of patients with MPS was approximately 13.4 years. However, in the era of enzyme replacement therapy and other multidisciplinary care modalities, the life expectancy has increased. Herein, we report a rare case of an adolescent with MPS II who underwent SNHL treatment with cochlear implantation (CI). Based on unexpected findings of mastoid emissary veins and overgrowth of the vessels around the temporal bone, CI was performed using the transmeatal approach instead of the conventional transmastoid method, to avoid damage to the vessels. The average hearing threshold after CI was 35 dB and no surgical complications were encountered. Adolescent MPS II may present vessel abnormalities, which can reduce the success rate of surgery. In patients with MPS II with SNHL, CI should be performed under careful monitoring of vessel overgrowth. Moreover, with regard to feasibility of CI in adolescent patients with MPS II with SNHL, surgical techniques such as the transmeatal approach should be selected based on adequate assessment of the case.

• Journal of Audiology & Otology
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• 제25권1호
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• pp.49-54
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• 2021

Type II mucopolysaccharidosis (MPS II) commonly known as Hunter syndrome, is a rare X-linked lysosomal storage disorder caused by iduronate-2-sulfatase deficiency, which in turn causes otorhinolaryngological manifestations, including sensorineural hearing loss (SNHL). Previously, the median survival age of patients with MPS was approximately 13.4 years. However, in the era of enzyme replacement therapy and other multidisciplinary care modalities, the life expectancy has increased. Herein, we report a rare case of an adolescent with MPS II who underwent SNHL treatment with cochlear implantation (CI). Based on unexpected findings of mastoid emissary veins and overgrowth of the vessels around the temporal bone, CI was performed using the transmeatal approach instead of the conventional transmastoid method, to avoid damage to the vessels. The average hearing threshold after CI was 35 dB and no surgical complications were encountered. Adolescent MPS II may present vessel abnormalities, which can reduce the success rate of surgery. In patients with MPS II with SNHL, CI should be performed under careful monitoring of vessel overgrowth. Moreover, with regard to feasibility of CI in adolescent patients with MPS II with SNHL, surgical techniques such as the transmeatal approach should be selected based on adequate assessment of the case.

• Journal of mucopolysaccharidosis and rare diseases
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• 제5권1호
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• pp.12-16
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• 2021

Mucopolysaccharidosis type II (MPS II, Hunter syndrome) is an X-linked lysosomal storage disorder caused by deficiency of the enzyme iduronate-2-sulfatase, leading to the accumulation of glycosaminoglycans (GAGs), which affects multiple organs and systems. Current treatments for MPS II include enzyme replacement therapy (ERT) and hematopoietic cell transplantation (HCT) to reduce the accumulation of GAGs. HCT has the potential advantage that donor-derived enzyme-competent cells can provide a continuous secreting source of the enzyme. However, HCT as a treatment for MPS II remains controversial because its effectiveness is unclear, particularly in terms of neurological symptoms. To date, several clinical experiences with HCT in MPS II have been reported. In this paper, we review post-HCT outcomes in the previously published literature and discuss the effects of HCT on each of the clinical signs and symptoms of MPS II.