• Title/Summary/Keyword: Neurological disorder

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Detergent Screening for NMR-Based Structural Study of the Integral Membrane Protein, Emopamil Binding Protein (Human Sterol Δ8-Δ7 Isomerase)

  • Won, Hyung-Sik
    • Journal of the Korean Magnetic Resonance Society
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    • v.21 no.1
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    • pp.13-19
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    • 2017
  • Human sterol ${\Delta}8-{\Delta}7$ isomerase, commonly known as emopamil binding protein (EBP), is an essential protein in the cholesterol-synthetic pathway, and mutations of this protein are critically associated with human diseases such as Conradi-Hunermann-Happle or male EBP disorder with neurological defects syndrome. Due to such a clinical importance, EBP has been intensively investigated and some important features have been reported. EBP is a tetra-spanning membrane protein, of which $2^{nd}$, $3^{rd}$, and $4^{th}$ membrane-spanning ${\alpha}$ helices play an important role in its enzymatic function. However, detailed structural feature at atomic resolution has not yet been elucidated, due to characteristic difficulties in dealing with membrane protein. Here, we over-expressed EBP using Escherichia coli and performed detergent screening to find suitable membrane mimetics for structural studies of the protein by NMR. As results, DPC and LMPG could be evaluated as the most favorable detergents to acquire promising NMR spectra for structural study of EBP.

A Case of Patient with Recurrent Vomiting and Abdominal pain due to Intestinal Pseudoobstruction (반복적 구토 및 복통으로 가성 장 폐쇄로 진단받은 환자 1례)

  • Cho, Hyung-Jun;Lee, Jin-Yong;Kim, Deog-Gon;Kim, Ki-Hoon
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.1
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    • pp.93-104
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    • 2004
  • Objectives: Transverse myelitis is a rare neurological disorder that is part of a spectrum of neuroimmunologic diseases of the central nervous system. A patient was hospitalized with intestinal pseudoobstruction(poor oral feeding, vomiting, abdominal pain, constipation) secondary to Transverse myelitis. We treated her with Oriental medical approach and obtained satisfactory result. Methods: The Herbal medicine(Bihwa-eum), Acupuncture, Moxibustion therapy were applied for improving the deficiency of energy of the spleen and stomach, regulate the flow of vital energy. Results: After treatments, Patient's vomiting frequency is decreased and abdominal pain is improved and oral feeding is available. She gains in weight continuously. Conclusion: The authors thought that Bihwa-eum is effective to vomiting and abdominal pain due to intestinal pseudoobstruction. The more study is needed.

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Recent Advances in Diagnosis and Treatment of Alzheimer's Disease (알츠하이머병의 최신지견)

  • Lee, Jung Jae;Lee, Seok Bum
    • Korean Journal of Biological Psychiatry
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    • v.23 no.2
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    • pp.48-56
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    • 2016
  • Alzheimer's disease (AD) is a neurodegenerative disorder in which neuronal loss causes cognitive decline and other neuropsychiatric problems. It can be diagnosed based on history, examination, and appropriate objective assessments, using standard criteria such as the Diagnostic and Statistical Manual of Mental Disorders or the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA). Brain imaging and biomarkers are making progress in the differential diagnoses among the different disorders. The cholinesterase inhibitors, donepezil, rivastigmine and galantamine and N-methyl-D-aspartate receptors antagonist memantine are approved by the US Food and Drug Administration for AD. Recently some acetylcholinesterase inhibitors gained approval for the treatment of severe AD and became available in a higher dose formulation or a patch formulation. Optimal care in AD is multifactorial and it should include early diagnosis and multidisciplinary care with pharmacological and nonpharmacological interventions including exercise interventions, cognitive interventions and maintenance of social networks.

Systematic review of the clinical and genetic aspects of Prader-Willi syndrome

  • Jin, Dong-Kyu
    • Clinical and Experimental Pediatrics
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    • v.54 no.2
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    • pp.55-63
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    • 2011
  • Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder that is caused by the lack of expression of paternally inherited imprinted genes on chromosome 15q11-q13. This syndrome has a characteristic phenotype including severe neonatal hypotonia, early-onset hyperphagia, development of morbid obesity, short stature, hypogonadism, learning disabilities, behavioral problems, and psychiatric problems. PWS is an example of a genetic condition caused by genomic imprinting. It can occur via 3 main mechanisms that lead to the absence of expression of paternally inherited genes in the 15q11.2-q13 region: paternal microdeletion, maternal uniparental disomy, and an imprinting defect. Over 99% of PWS cases can be diagnosed using DNA methylation analysis. Early diagnosis of PWS is important for effective long-term management. Growth hormone (GH) treatment improves the growth, physical phenotype, and body composition of patients with PWS. In recent years, GH treatment in infants has been shown to have beneficial effects on the growth and neurological development of patients diagnosed during infancy. There is a clear need for an integrated multidisciplinary approach to facilitate early diagnosis and optimize management to improve quality of life, prevent complications, and prolong life expectancy in patients with PWS.

Successful sulfonylurea treatment in a patient with permanent neonatal diabetes mellitus with a novel KCNJ11 mutation

  • Ahn, Sung Yeon;Kim, Gu-Hwan;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.58 no.8
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    • pp.309-312
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    • 2015
  • Permanent neonatal diabetes mellitus refers to diabetes that occurs before the age of 6 months and persists through life. It is a rare disorder affecting one in 0.2-0.5 million live births. Mutations in the gene KCNJ11, encoding the subunit Kir6.2, and ABCC8, encoding SUR1 of the ATP-sensitive potassium ($K_{ATP}$) channel, are the most common causes of permanent neonatal diabetes mellitus. Sulfonylureas close the $K_{ATP}$ channel and increase insulin secretion. KCNJ11 and ABCC8 mutations have important therapeutic implications because sulfonylurea therapy can be effective in treating patients with mutations in the potassium channel subunits. The mutation type, the presence of neurological features, and the duration of diabetes are known to be the major factors affecting the treatment outcome after switching to sulfonylurea therapy. More than 30 mutations in the KCNJ11 gene have been identified. Here, we present our experience with a patient carrying a novel p.H186D heterozygous mutation in the KCNJ11 gene who was successfully treated with oral sulfonylurea.

The Surgical Management of Traumatic C6-C7 Spondyloptosis

  • Keskin, Fatih;Kalkan, Erdal;Erdi, Fatih
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.49-51
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    • 2013
  • A case of traumatic spondyloptosis of the cervical spine at the C6-C7 level is reported. The patient was treated succesfully with a anterior-posterior combined approach and decompression. The patient had good neurological outcome after surgery. A-51-year-old female patient was transported to our hospital's emergency department after a vehicle accident. The patient was quadriparetic (Asia D, MRC power 4/5) with severe neck pain. Plain radiographs, computerize tomography and spinal magnetic resonance imaging (MRI) showed C6-7 spondyloptosis and C5, C6 posterior element fractures. Gardner-Wells skeleton traction was applied. Spinal alignment was reachived by traction and dislocation was decreased to a grade 1 spondylolisthesis. Then the patient was firstly operated by anterior approach. Anterior stabilization and fusion was firstly achieved. Seven days after first operation the patient was operated by a posterior approach. The posterior stabilization and fusion was achieved. Postoperative lateral X-rays and three-dimensional computed tomography showed the physiological realignment and the correct screw placements. The patient's quadriparesis was improved significantly. Subaxial cervical spondyloptosis is a relatively rare clinical entity. In this report we present a summary of the clinical presentation, the surgical technique and outcome of this rarely seen spinal disorder.

Decompressive Surgery in a Patient with Posttraumatic Syringomyelia

  • Byun, Min-Seok;Shin, Jun-Jae;Hwang, Yong-Soon;Park, Sang-Keun
    • Journal of Korean Neurosurgical Society
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    • v.47 no.3
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    • pp.228-231
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    • 2010
  • Posttraumatic syringomyelia may result from a variety of inherent conditions and traumatic events, or from some combination of these. Many hypotheses have arisen to explain this complex disorder, but no consensus has emerged. A 28-year-old man presented with progressive lower extremity weakness, spasticity, and decreased sensation below the T4 dermatome five years after an initial trauma. Magnetic resonance imaging (MRI) revealed a large, multi-septate syrinx cavity extending from C5 to L1, with a retropulsed bony fragment of L2. We performed an L2 corpectomy, L1-L3 interbody fusion using a mesh cage and screw fixation, and a wide decompression and release of the ventral portion of the spinal cord with an operating microscope. The patient showed complete resolution of his neurological symptoms, including the bilateral leg weakness and dysesthesia. Postoperative MRI confirmed the collapse of the syrinx and restoration of subarachnoid cerebrospinal fluid (CSF) flow. These findings indicate a good correlation between syrinx collapse and symptomatic improvement. This case showed that syringomyelia may develop through obstruction of the subarachnoid CSF space by a bony fracture and kyphotic deformity. Ventral decompression of the obstructed subarachnoid space, with restoration of spinal alignment, effectively treated the spinal canal encroachment and post-traumatic syringomyelia.

Ambulatory Anesthesia Management of the Patient with Adrenoleukodystrophy for Dental Treatment -A Case Report- (부신백질이영양증 환자의 치과치료를 위한 외래전신마취 -증례 보고-)

  • Seo, Kwang-Suk;Bak, So-Yeon;Shin, Teo-Jeon;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.10 no.1
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    • pp.45-49
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    • 2010
  • Adrenoleukodystrophy (ALD) is a rare X-linked genetic disorder associated with various central nervous system problems and adrenal insufficiency. It is common in childhood and symptoms include loss of previously acquired neurological abilities, seizures, ataxia, Addison's disease as well as degeneration of visual and auditory function. These children frequently require anesthesia during imagining procedure such as MRI or during some surgical procedures like gastrostomy. There is special need for careful management because of numerous anesthetic challenges like difficulty in cooperation, seizure disorders, life-threatening airway obstruction, copious oral secretion and possibility of aspiration. In addition, adrenal involvement and hypofunction must be considered for safe anesthesia management. We report a successful anesthetic management in a patient with ALD for dental procedures.

Neuro-Behcet's Disease Presented with Cerebral Venous Sinus Thrombosis -A Case Report- (뇌정맥동혈전증으로 발현된 신경계베체트병 1예)

  • Lee, Yun-Kyung;Park, Mee-Young;Lee, Seung-Hyun;Joo, Sung-Gyun;Cho, Yong-Kook
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.96-100
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    • 2004
  • Behcet's disease is a chronic, relapsing multisystem disorder, that may develop into variable neurological manifestations. They include vascular and parenchymal involvement. Vascular involvement is dominated by cerebral venous sinus thrombosis marked by benign intracranial hypertension. Cerebral venous sinus thrombosis can present with all the classical criteria for idiopathic intracranial hypertension, including normal brain CT findings with normal CSF content. But brain MRI is a useful diagnostic method in this situation to confirm the presence of cerebral venous sinus thrombosis. We experienced a case of raised intracranial pressure in a 21-year-old man, caused by cerebral venous sinus thrombosis. We disclosed his symptoms and signs thus fulfilling the diagnostic criteria for Behcet's disease.

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A pediatric case of idiopathic Harlequin syndrome

  • Kim, Ju Young;Lee, Moon Souk;Kim, Seung Yeon;Kim, Hyun Jung;Lee, Soo Jin;You, Chur Woo;Kim, Jon Soo;Kang, Ju Hyung
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.125-128
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    • 2016
  • Harlequin syndrome, which is a rare disorder caused by dysfunction of the autonomic system, manifests as asymmetric facial flushing and sweating in response to heat, exercise, or emotional factors. The syndrome may be primary (idiopathic) with a benign course, or can occur secondary to structural abnormalities or iatrogenic factors. The precise mechanism underlying idiopathic harlequin syndrome remains unclear. Here, we describe a case of a 6-year-old boy who reported left hemifacial flushing and sweating after exercise. He had an unremarkable birth history and no significant medical history. Complete ophthalmological and neurological examinations were performed, and no other abnormalities were identified. Magnetic resonance imaging was performed to exclude lesions of the cerebrum and cervicothoracic spinal cord, and no abnormalities were noted. His final diagnosis was classic idiopathic harlequin syndrome. Herein, we report the first pediatric case of idiopathic harlequin syndrome in Korea.