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Smith-Magenis syndrome is characterized by multiple congenital anomalies and mental retardation caused by the heterozygous deletion of chromosomal region 17p11.2. We present a long-term follow-up study of a girl with Smith-Magenis syndrome and West syndrome. West syndrome became apparent at 7 months of age. Since then, mental retardation, particularly in terms of language development, became increasingly more obvious. The patient's spasms and hypsarrhythmia disappeared after a course of adrenocorticotropic hormone therapy, but focal seizures reappeared at the age of 3 years and 3 months. Her craniofacial dysmorphia and mental retardation became increasingly evident compared to her condition at the onset of West syndrome. Chromosome analysis detected the characteristic 17p deletion, which was then confirmed via fluorescent in situ hybridization analysis. This is the second report of a patient with Smith-Magenis syndrome and West syndrome; taken together, these results suggest that Smith-Magenis syndrome may be a further cause of West syndrome. [ABSTRACT FROM AUTHOR]

Abstract: Carnitine palmitoyl transferase І (CPT І) deficiency is a rare disorder of long-chain fatty acid oxidation. It is one of the metabolic diseases detectable by tandem mass spectrometry. We report herein a presymptomatic CPT І deficiency detected in a Japanese female newborn by tandem mass spectrometry newborn screening. A mutation analysis of the CPT1A gene revealed two novel mutations, p.R446X and p.G719D. [Copyright &y& Elsevier]

The aim of this study was to elucidate whether dietary zinc-deficiency and its recovery play a role in controlling autonomic thermoregulation. We investigated the effects of dietary zinc-deficiency and its recovery on autonomic thermoregulation by measuring the rectal temperature, an index of deep body temperature. The weaned male Sprague Dawley rats were randomly divided into the dietary zinc-deficient diet (0.6 mg zinc/kg diet) group and the control diet (35.2 mg zinc/kg diet) group, and were fed for 4 weeks. In the recovery period, the rats of two groups were fed with the control diet for 3 weeks. The rectal temperature was significantly decreased throughout the period of zinc-deficiency and the hypothermic responses during the experimental period were recovered to the control group levels at least within 1 week in the recovery process from dietary zinc-deficiency. These results suggest that the deep temperature in rats was clearly associated with the dietary zinc intake levels. [ABSTRACT FROM AUTHOR]

Not only increasing body carbohydrate (CHO) stores before exercise but also suppressing CHO oxidation during exercise is important for improving endurance performance. We tested the hypothesis that intensive high-fat ingestion in the early stage of recovery from exercise training (ET) for 2 d would suppress CHO oxidation during exercise by increasing whole body lipolysis and/or fat oxidation. In a randomized crossover design, on days 1 and 2, six male subjects performed cycle ET at 50% peak oxygen consumption (VO(2 peak)) for 60-90 min, and consumed a control diet (CON: 1,224 kcal, 55% carbohydrate, 30% fat) or the same diet supplemented with high fat (HF: 1,974 kcal, 34% carbohydrate, 56% fat) 1 h after ET, with the diet other than post-ET similar in both trials. On day 3, subjects performed cycle exercise at 65% VO(2 peak) until exhaustion. Exercise time to exhaustion was longer in the HF trial than in the CON trial (CON: 48.9 ± 6.7 vs. HF: 55.8 ± 7.7 min, p<0.05). In the HF trial, total fat oxidation until exhaustion was higher, accompanied by higher post-exercise plasma glycerol concentration, than in the CON trial (CON: 213 ± 54 vs. HF: 286 ± 63 kcal, p<0.05), whereas total carbohydrate oxidation until exhaustion was not different between trials. These results suggest that intensive high-fat ingestion in the early stage of recovery from ET for a few days until the day before exercise was an effective means of eliciting a CHO-sparing effect during exercise by enhancing fat metabolism.

Pulmonary involvement is a serious complication in Gaucher disease, as is neuronopathic involvement. Few reports are available, however, on the frequency, clinical course and therapy for pulmonary involvement in patients with Gaucher disease. We report a case of type 2 Gaucher disease with severe hepatosplenomegaly, anemia, hypertonia, and psychomotor retardation. The diagnosis of Gaucher disease was confirmed by the presence of Gaucher cells in bone marrow and low serum beta-glucocerebrosidase activity (patient, 0.8; control, 4.1-9.7 nmol/mg.protein/hr) at the age of 1 year. The patient's genotype is L444P/unknown. Enzyme replacement therapy (ERT) with intravenous imiglucerase at 78 U/kg/2weeks was started, and hepatosplenomegaly and laboratory abnormalities were markedly improved after 6 months of therapy. After 8 months of therapy, respiratory impairment appeared together with a decrease of tidal volume and low SpO2 during sleep. Serum acid phosphatase and angiotensin converting enzyme levels mildly increased, and radiological findings showed bilateral ground-glass appearance without signs of respiratory infection. With the diagnosis of progressive pulmonary involvement in Gaucher disease, we increased the dosage of imiglucerase from 50 to 75 U/kg/2 weeks. After a month, respiratory symptoms and CT findings of ground-glass appearance remarkably improved, but interlobular septal and intralobular interstitial thickening persisted. The maximum permitted dosage of imiglucerase in Japan is 60 U/kg/2 weeks. Based on our experience with this case, we propose that a higher ERT dosage would be uselul for serious pulmonary involvement.