• Title/Summary/Keyword: PWS

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Growth Hormone Therapy in Adults with Prader-Willi Syndrome

  • Cho, Sung Yoon
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.1 no.2
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    • pp.49-53
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    • 2015
  • Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder characterized by hypothalamic-pituitary dysfunction. Many features of PWS indicate a deficiency in growth hormone (GH) production, and these findings provide a rationale for GH therapy in PWS. It is possible that rhGH therapy could have beneficial effects in adults with PWS, similar to those in adults with GH deficiency (GHD) of non-syndromic cause. However, there is a paucity of data on the use of GH in adults with PWS. Here, the previous studies about efficacy and safety of rhGH therapy in PWS adults are summarized. Briefly, rhGH therapy in PWS adults may improve body composition, leading to increased lean body mass and decreased fat mass, as well as decreased subcutaneous and visceral adiposity without overall changes in body mass index. There may be at least transient deterioration in glucose homoeostasis in some PWS patients on rhGH therapy, which requires further study. In addition, clinical care guidelines for rhGH therapy in adults with PWS were suggested.

An Update on Prader-Willi Syndrome with Diabetes Mellitus

  • Lee, Ji-Eun
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.2 no.2
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    • pp.35-37
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    • 2016
  • Prader-Willi syndrome (PWS) often develops type 2 diabetes mellitus (T2DM) related to severe obesity. The prevalence of T2DM in adults with PWS (7-20%) exceeds greatly the prevalence in the general population (5-7%). It is uncommon for pre-pubertal children with PWS to develop overt diabetes or glucose intolerance. GH therapy and genotype did not influence the development of altered glucose metabolism. It has been assumed that T2DM in PWS develops as a consequence of morbid obesity and concomitant insulin resistance. However recent studies suggest the relationship between morbid obesity and T2DM development is more complex and appears to differ in PWS subjects compared to non-PWS subjects. PWS patients had relatively lower fasting insulin levels and increased adiponectin levels compared with BMI-matched obese control despite of similar levels of leptin. So PWS children may be protected to some extent form of obesity-associated insulin resistance. Although there's no data, it seems logical to approach diabetes management including weight loss and increased exercise, using similar pharmacological agents as with non-PWS obesity-related diabetes such as metformin or thiazolidinedione, with the introduction of insulin as required. On the other hand, several recent T2DM in PWS case reports suggest favorable outcomes using Glucagon-like peptide 1 (GLP-1) analog with regard to ghrelin reduction, control of glucose and appetite, weight loss and pre-prandial insulin secretion. The role of GLP-1 agonist therapy is promising, but has not yet been fully elucidated.

Genetics of Prader-Willi Syndrome

  • Yoon, Ju Young
    • Journal of Interdisciplinary Genomics
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    • v.3 no.2
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    • pp.35-40
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    • 2021
  • Prader-Willi syndrome (PWS) is a rare genetic disorder which lead to severe neurodevelopmental, endocrine, and metabolic impairment. PWS is genetic disorder related to genomic errors which lead to inactivation of paternally-inherited genes on chromosome 15q11-q13. Epigenetic mechanisms are also involved in PWS, and epigenetic therapies are under investigation. Here we provide review about genetics of PWS, focused on genes involved in pathophysiology of PWS. We will also summarize epigenetics and genetic counseling of PWS.

Evaluating the Efficacy of Pharmacological Therapy for Prader-Willi Syndrome: A Systematic Review and Meta-analysis

  • Alim Yoo;Sohyeon Park;Heeyoung Lee
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.4
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    • pp.336-351
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    • 2022
  • Background: Prader-Willi Syndrome (PWS) is a rare genetic disorder. To improve the health deterioration of PWS, investigating optimal treatment options for PWS is required. Thus, we aimed to evaluate the efficacy of pharmacotherapies compared with supportive care or placebos in patients with PWS. Methods: PubMed and EMBASE databases were used to search for randomized controlled trials (RCTs) evaluating the efficacy of pharmacotherapy in PWS patients. Only RCTs that evaluating the efficacy of pharmacotherapy in PWS patients were retrieved. Results: A total of 26 studies were included to evaluate body composition, hormones, glucose levels and hyperphagia behavioral status. Pharmacological treatment group showed a significant decrease of body fat (mean difference (MD): -6.32, 95% confidence interval (CI): -10.58 to -2.06, p=0.004), a significant increase of lean body mass (LBM) (MD: 1.86, 95% CI: 1.43 to 2.30, p<0.00001) and insulin-like growth factor 1 (IGF-1) levels (MD: 241.62, 95% CI: 68.59 to 414.64, p=0.006) compared with the control group. Nevertheless, based on other outcomes evaluated by the current systematic review, pharmacological options showed different efficacy in treating PWS. Conclusion: Pharmacological therapies were effective to decrease significantly in body fat and increase significantly on LBM and IGF-1 levels in patients with PWS. However, still, individualized therapies should be considered in real-world practice in PWS treatment.

A putative prolyl tRNA synthetase is involved in pheromone induction in Schizosaccharomyces pombe (Schizosaccharomyces pombe의 pheromone 유도와 연관된 prolyl tRNA synthetase)

  • Kim, Daemyung
    • Korean Journal of Microbiology
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    • v.54 no.4
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    • pp.309-319
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    • 2018
  • Previously, six Schizosaccharomyce pombe mutants that induce pheromone even in the presence of nitrogen source were isolated from a bank of temperature sensitive mutants. In this report, one of these mutants, pws6 was further characterized. The pheromone induction in pws6 mutant cells was specific to nutrient: the M-factor pheromone was induced without nitrogen starvation but not without glucose starvation. This result suggests that the pws6 mutant might have a specific defect in the pathway for nitrogen starvation. The pws6 mutant induces P-factor pheromone as well as M-factor without starvation of nitrogen in temperature sensitive mode, suggesting that the pheromone induction phenotype of pws6 mutation is not cell-type specific. From cloning of the $pws6^+$ gene by complementation of the temperature sensitive growth defect, three plasmids containing 8.1 kb, 3.3 kb, and 4.8 kb yeast DNA were recovered. These plasmids complement the growth defect of the pws6 mutant by 100%, 70%, and 10~20%, respectively. The abilities of these plasmids to complement pheromone induction phenotype of pws6 mutant cells were correlated well with the efficiencies of complementation of the growth defect. With comparison of their open reading frames to the complementation efficiencies, it is concluded that the open reading frame, SPBC19C7.06 is responsible for the complementation of temperature sensitive phenotype of the pws6 mutant. This open reading frame, named prs1, contains one long exon with no intron and encodes a putative prolyl tRNA synthetase. The putative Prs1 protein exhibits significant similarities to the prolyl tRNA synthetases of other species.

Introduction to the New Version of PWS Application and It's Use in Medical Practice

  • Kim, Jinsup;Yang, Aram;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.2 no.2
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    • pp.41-42
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    • 2016
  • Today's mobile phones and tablet PCs offer a considerably wider range of functionalities than before. Mobile applications (apps) are increasingly used for managing various daily health tasks. Currently, more than 165,000 health-related apps are offered on all the stores of different platforms. Pf Jin and the Association for Research on MPS and Rare Diseases (AMARD) have helped Prader-Willi syndrome (PWS) families through medical information and family support since 2015. AMARD developed the first mobile application for Korean patients with PWS, which was released to a limited number of patients under the age of 3 and only provided to Android users. The first version of the PWS application focused on growth hormone therapy and the assessment of growth and development by parents in infant and early-childhood PWS patients. The 2016 version of the PWS application has been improved in many different ways. We have expanded the subjects of the application to late childhood and adolescent groups, changed the user interface accordingly, and made the application available for iOS users. We will show the specialized growth curves of older children with PWS. Therefore, patients with PWS over the age of 3 and their parents can assess the patients' growth. Additionally, we have upgraded the growth hormone therapy menu by improving the input system for the growth hormone therapy injection schedule and the daily growth profile (height and weight). We expect that the new version of the PWS application will help many PWS families cope with growth hormone therapy and evaluate the effects of growth hormones in better ways. Additionally, we are making a constant effort to provide more useful information about patients with PWS in many aspects.

Aerodynamic Stability Assessment of PWS and CFRC Hanger Ropes for Suspension Bridge by Experiments (현수교 PWS 및 CFRC 행어로프의 내풍안정성 실험 평가)

  • Park, Hyung-Ghee;Kang, Seon-Jin
    • Journal of the Korean Society of Hazard Mitigation
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    • v.8 no.6
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    • pp.21-30
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    • 2008
  • In this study, to evaluate the aerodynamic stability of suspension bridge hanger ropes, the wind tunnel tests are carried out. It is found that the vortex induced vibration is detected only in single PE-coated PWS cable case. And the wake galloping is occurred in twin cables spaced $3\sim6$ cable diameters of cable center to center when the incidence angle of wind is only zero degree. In case of other incidence angles of wind except zero degree, the wake galloping or the wake flutter are showed in twin cables even outside range of the bounds of $3\sim6$ cable diameters. CFRC cable shows very stable for the twin cables regardless of the distance between two cables, and also for various incidence angles of wind. Thus the characteristic of CFRC rope overwhelms one of PWS cable in aerodynamic stability.

Development and validation of Pediatric Weakness Scale (PWS) (소아 허약 검사의 개발과 타당화 연구)

  • Chae, Han;Han, Sang Yun;Cheon, Jin Hong;Kim, Kibong
    • The Journal of Pediatrics of Korean Medicine
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    • v.33 no.3
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    • pp.30-41
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    • 2019
  • Objectives Development of objective clinical measure for analyzing pediatric weakness has been studied. However, there is no gold standard clinical measures with acceptable validity and reliability were not provided yet and these has been major issue for clinics. Methods Some Korean medicine hospital outpatients (n=324) were recruited as participants, and 55 preliminary questions were given. Pediatric Weakness Scale (PWS) with five subscales and thirty questions were developed using factor analysis and item analysis. The internal consistency of PWS subscales were examined with using Cronbach's alpha. The correlations between PWS subscales and physical characteristics of Body Mass Index (BMI) and Ponderal Index (PI) were attested using Pearson's correlation. The differences between PWS subscale scores and profiles among 3 to 13 years old children were examined using profile analysis and ANOVA by gender. Results PWS five subscales explained 49.1% of total variance, and the range of Cronbach's alpha was from 0.700 to 0.803. The range of correlation coefficient between PWS total score and five subscales was from 0.643 to 0.748, and the PWS total score was significantly (p<0.001) correlated positively with BMI (r=-0.237) and negatively with PI (r=-0.280). The scores and profiles of PWS five subscales, BMI and PI were found to be significantly different among the all age groups. Conclusions Objective and validated clinical measure for analyzing pediatric weakness with five subscales was developed in current study, and foundations for screening, managing and treating pediatric weakness during the development were established as well. This study would contribute to the integrative education and clinical practice of the Eastern and Western medicine.

Polarization Spectral Imaging System for Quantitative Evaluation of Port Wine Stain Blanching Following Laser Treatment

  • Jung, Byung-Jo
    • Journal of the Optical Society of Korea
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    • v.7 no.4
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    • pp.234-239
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    • 2003
  • Objective methods to assess quantitatively port wine stain (PWS) blanching in response to laser therapy are needed to improve laser therapeutic outcome. Previous studies have attempted to assess objectively PWS color based on point measurement devices. To date, these approaches have typically been limited by a number of factors such as small test area and need for contact. To address these issues, a polarization spectral imaging system and an image analysis method have been developed to evaluate quantitatively erythema and melanin content distribution in skin. The developed polarization spectral imaging system minimizes artifacts such as glaring, shadowing, and non-uniform illumination that interfere with image fidelity. Furthermore, the image analysis method has been employed to get images of skin melanin and erythema indices from the acquired color images for quantitative analysis. Finally, using PWS patient color image, the effectiveness in laser treatment of PWS was evaluated by calculating relative erythema index image that is the relative erythema index of PWS region to the normal region. The developed device and analysis method appears to be a simple and effective method for quantitative analysis of PWS blanching.

Issues in Adults Prader-Willi Syndrome

  • Park, Sung Won
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.1 no.2
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    • pp.40-43
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    • 2015
  • Prader-Willi syndrome (PWS), a complex genetic disorder, arises from suppressed expression of paternally inherited imprinted genes on chromosome 15q11-q13. Characteristics include short stature, intellectual disability, behavioral problems, hypogonadism, obesity, and reduced bone and muscle. The life expectancy of persons with PWS has increased in recent years. Cardiovascular diseases, diabetes, dermatological, and orthopedic problems are common physical complaints in older people with PWS. Behavioral problems are major concerns in adults with PWS into old age. And aging is also associated with significant social and economic changes. Age-related physical morbidity, physical appearance, behavioral and psychiatric problems, functional decline and economic problems can be combined in older PWS. The care for older people with PWS requires a life span approach that recognizes the presence, progression, and consequences of specific morbidity.