• Journal of Genetic Medicine
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• 제1권1호
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• pp.39-43
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• 1997

The mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is inherited maternally, in which the MTTL1*MELAS 3243 mutation has been most commonly found as a heteroplasmy of A to G point mutation in the $tRNA^{Leu(UUR)}$ gene. The MTTL1*MELAS 3271 mutation is known to be the second common mutation, though clinical features of both mutations are not remarkably different. Recently, a variety of minor mutations have been reported in patients with MELAS. In this study, major efforts have been made to investigate the allele frequency of major three mutations including MTTL1*MELAS 3243, 3252, 3271 in 10 Korean families with MELAS probands. The PCR and subsequent direct sequencing of the PCR product in the regions spanning these three mutation sites were employed to identify the mutation in each proband. All family members have been screened for the presence of these three mutations by PCR-RFLP assay using Apa I, Acc I and Bfr I restriction enzymes. The MTTL1*MELAS 3243 mutation was most commonly found (7 out of 10 families tested) followed by the MTTL1*MELAS 3271 which was identified in 1 out of 10 families. In the remaining 2 families none of three mutations were found, indicating the presence of either nuclear mutation or yet unidentified mitochondrial DNA mutation in these families.

• 대한한방소아과학회지
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• 제13권2호
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• pp.225-235
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• 1999

MELAS is the condition associated with mutant mtDNA that most closely mimics thrombotic cerebrovascular disease. Characteristic abnormalities are two. first, 'ragged-red fibers' in muscle biopsy. second, point mutation in the mitochondrial DNA analyses. The characteristic clinical presentations of MELAS are short stature, recurrent stroke like episodes, migraine-like headache, sensorineural hearng loss, glucose intolerance and neuropathy. We now report a case of MELAS syndrome having mitochondrial DNA mutation with an A to G transition at the 3,243rd position diagnosed in Chung-ang Hospital.

• 생명과학회지
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• 제14권2호
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• pp.296-300
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• 2004

환자의 생조직, 얼린 조직 혹은 혈액이 없는 경우에, formalin으로 고정된 파라핀조직을 이용하여 미토콘드리아 돌연변이를 확인할 수 있는지를 조사하였다. MELAS 환자 4명의 파라핀조직을 택해 이들 조직으로부터 DNA를 추출하여 대부분의 MELAS 환자 미토콘드리아 DNA의 tRN $A^{Leu(UUR)}$ gene의 3243지역에서 발견되는 Adenine의 Cuanine으로의 염기치환을 확인하고자 하였다. 실험결과 3명의 환자에게서 이 점 돌연변이를 확인할 수 있어 이들 파라핀조직의 상태가 좋은 것으로 여겨져 미토콘드리아 DNA 돌연변이 연구에 파라핀조직을 활용할 수 있을 것으로 보인다.다.

• Journal of Genetic Medicine
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• 제16권1호
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• pp.31-38
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• 2019

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a maternally inherited mitochondrial disorder of which m.3243A>G is the most commonly associated mutation, resulting in an inability to meet the energy requirements of various organs. MELAS poses a diagnostic challenge owing to its multiple organ involvement and great clinical variability due to its heteroplasmic nature. We report three cases from a family who were initially misdiagnosed with myasthenia gravis or undiagnosed. Although there is no optimal consensus treatment approach for patients with MELAS because of the disease's heterogeneity, our 21-year-long therapy regimen of ${\text\tiny{L}}-arginine$, ${\text\tiny{L}}-carnitine$, and coenzyme Q10 supplementation combined with dietary management appeared to provide noticeable protection from the symptoms and complications. Prompt early diagnosis is important, as optimal multidisciplinary management and early intervention may improve outcomes.

• Annals of Clinical Neurophysiology
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• 제24권2호
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• pp.84-89
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• 2022

Vestibular dysfunction has rarely been reported in MELAS syndrome. A 40-year-old male with long-term diabetes and hearing loss experienced a stroke-like episode with hemisensory disturbance and lactic acidosis. Brain MRI showed temporo-parieto-occipital cortical lesions, and a final diagnosis was made of MELAS syndrome with the mitochondrial 3243A>G mutation. Neuro-otologic evaluations revealed anterior-canal-sparing bilateral impairments of the vestibulo-ocular reflex in the video head impulse test and no caloric paresis. This unique pattern of vestibular dysfunction may aid in diagnosing MELAS syndrome.

• 대한한의학방제학회지
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• 제18권2호
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• pp.267-277
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• 2010

Objective : Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke like episodes (MELAS) syndrome is a progressive neurodegenerative disorder. The typical presentation of patients with MELAS syndrome includes features such as mitochondrial encephalomyopathy, lactic acidosis, and stroke like episodes. Other features, such as seizures, diabetes mellitus, hearing loss, cardiac disease, short stature, endocrinopathies, exercise intolerance, and neuropsychiatric dysfunction are clearly part of the disorder. Approximately 80% of patients with the clinical characteristics of MELAS syndrome have a genetic mutation. This progressive disorder is reported to have a high morbidity and mortality. This case report is intended to estimate clinical effects of oriental meedicinal treatment of MELAS syndrome. Methods : A 44 year old female patient diagnosed as MELSA syndrome was treated with general oriental medicinal therapy including acupuncture, moxibustion, cupping, pharmacupunture and herbal medication in 20XX in Wonkwang Medical Center Gwangju. And the changes in symptoms and signs were evaluated as time dependently. Results : Although there is currently no curable treatment and MEALS syndrome is tend to progress, our treatment showed improvement in general weakness, gait disturbance and pain in the patient. Conclusion : Our case report suggests that various oriental medicinal treatment could be effective for improvement of MELAS syndrome and may represent a new potential therapeutic approach to control the disease. It could be applied to improve general condition, prevent relapse, enhance the quality of life and reduce complaints in the patient.

• 대한유전성대사질환학회지
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• 제16권2호
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• pp.102-108
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• 2016

멜라스 증후군은 사립체 질환 중의 하나로서, 증상발현 시기 및 임상 양상이 매우 다양하여 의심하지 않으면 진단이 늦어지는 경우가 있을 수 있다. 연구자들은 임상경과를 달리하는 두 증례를 경험하였기에 보고하는 바이다. 증례 1에서는 두통과 시야 흐림, 경련 등이, 증례 2에서는 성장장애, 난청, 시야 흐림, 경련 등이 초기 증상으로 나타났으며, 증례 1은 현재도 일상 생활이 가능한 정상적인 활동도를 보이는 반면에, 증례 2의 경우에는 심각한 뇌손상을 받은 후에 진단되어 예후가 불량하였다. 멜라스 증후군의 치료는 대증적으로 이루어지게 되며, 약물적인 치료 중 코엔자임 Q10, L-아르지닌 등을 사용하였을 때 성공적인 결과를 얻을 수 있다. 질환의 초기에는 비특이적인 경우가 많음으로 관심과 의심을 통하여 멜라스 증후군을 조기 진단하는 것이 매우 중요하다고 할 수 있으며, 조기 진단과 적절한 교육 및 지지적인 치료를 통해 임상경과를 좋게 만들 수 있도록 노력하는 것이 예후에 중요하다고 할 수 있겠다.

• 대한유전성대사질환학회지
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• 제23권1호
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• pp.17-24
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• 2023

목적: 과거에는 혈장 아미노산 및 소변 유기산의 대사 이상 검출이 멜라스 증후군과 같은 임상적인 미토콘드리아 질환을 진단하는 데 널리 사용되었다. 본 연구에서는 혈장 아미노산 및 소변 유기산의 진단적 가치를 고찰하고, 멜라스 증후군 진단에 있어 이들의 유효성을 후향적으로 살펴보았다. 방법: 임상적으로 진단된 모든 멜라스 증후군 환자(n=31)로부터, 진단 당시의 혈액 및 소변 검체를 채취하여 혈장 아미노산 및 소변 유기산 검사를 시행하였다. 모든 샘플은 결과의 인위적 오류를 최소화하기 위해 금식 상태에서 수집되었습니다. 유전자로 진단된 멜라스 증후군 환자(n=19, m.3243A>G 돌연변이)와 유전자로 진단되지 않은 멜라스 증후군 환자(n=12) 그룹 간에 초기 진단 시 혈장 아미노산 및 소변 유기산의 비정상 대사물질 비율의 차이를 통계적으로 비교하였다. 유전자로 진단되지 않은 멜라스 증후군 환자군을 대조군으로 사용하였다. 결과: 두 그룹 간의 혈장 아미노산과 소변 유기산을 비교한 결과, 유전자로 진단된 멜라스 증후군 환자와 유전자로 진단되지 않은 멜라스 증후군 환자 간에 특징적인 차이를 보이는 비정상적인 대사 산물이 없는 것으로 나타났다. 결론: 혈장 아미노산 또는 소변 유기산의 비정상적인 대사물질 값은 멜라스 증후군의 진단에 있어서 선별 검사로 유용할 수 있지만 진단하기에는 충분하지 않다.

• Annals of Clinical Neurophysiology
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• 제24권2호
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• pp.107-110
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• 2022

We describe the case of a 22-year-old female complaining of ophthalmoplegia, which deteriorated with seizure. Leigh syndrome (LS) was diagnosed by identifying the m.9176T>C mutation. She improved with vitamin cocktail therapy plus intravenous methylprednisolone, and had an excellent prognosis. This was the first case of an adult patient with LS presenting with the m.9176T>C mutation and reporting cortical symptoms, which in this case comprised cortical vision loss, and cortical, basal ganglia, and brainstem signal changes on magnetic resonance imaging.

• BMB Reports
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• 제38권6호
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• pp.690-694
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• 2005

Transcription termination of the human mitochondrial genome requires specific binding to termination factor mTERF. In this study, mTERF was produced in E. coli and purified by two-step chromatography. mTERF-binding DNA sequences were isolated from a pool of randomized sequences by the repeated selection of bound sequences by gel-mobility shift assay and polymerase chain reaction. Sequencing and comparison of the 23 isolated clones revealed a 16-bp consensus sequence of 5'-GTG$\b{TGGC}$AGANCCNGG-3' in the light-strand (underlined residues were absolutely conserved), which nicely matched the genomic 13-bp terminator sequence 5'-$\b{TGGC}$AGAGCCCGG-3'. Moreover, mTERF binding assays of heteroduplex and single-stranded DNAs showed mTERF recognized the light strand in preference to the heavy strand. The preferential binding of mTERF with the light-strand may explain its distinct orientation-dependent termination activity.