Acquired Zinc Deficiency Mimicking Acrodermatitis Enteropathica in a Breast-Fed Premature Infant

We present a case of a transient acquired zinc deficiency in a breast-fed, 4-month-old-male prematurely born infant, with acrodermatitis enteropathica-like symptoms such as crusted, eroded, erythemato-squamous eruption in periorificial and acral patterns. The laboratory investigations showed low zinc levels in the infant's and the mother's serum and in the mother's milk; genetic analysis did not show any mutation in the SLC39A4 gene, involved in acrodermatitis enteropathica. Acquired zinc deficiency is often found in premature infants because of their increased requirement, the low serum and milk zinc levels in breastfeeding women being also an important risk factor, as in this case. A prompt zinc supplementation is essential for the good prognosis of the disease.

Digestive involvement in a severe form of Snyder-Robinson syndrome: Possible expansion of the phenotype

Snyder-Robinson syndrome (OMIM #309583) is a rare X-linked condition, caused by mutation in the SMS gene (MIM *300105), characterized by a wide spectrum of clinical signs including developmental delay, epilepsy, asthenic habitus, dysmorphism, osteopenia, and renal or genital anomalies. Here we describe two maternal half-brothers who both presented with severe neurodevelopmental delay, seizures, hearing loss, facial dysmorphism, renal and ophthalmologic anomalies, failure to thrive and premature death. A novel p.(Gly203Asp) variant was found at the hemizygous state in the two boys, and an elevated Spermidine/Spermine ratio confirmed the diagnosis of Snyder-Robinson syndrome. One of the brothers presented with gastrointestinal symptoms, with jejunal stenosis, enteral feeding intolerance, failure to thrive due to a dysfunctional gastrointestinal system, cholestasis and exocrine pancreatic insufficiency. Although more studies will be needed to understand its mechanisms, this observation lends further support to the possibility of severe digestive involvement in Snyder Robinson syndrome.

Proposition for the biochemical mechanism occurring in the sucrose isomerase active site

Sucrose conversion by sucrose isomerase from Protaminobacter rubrum, Serratia plymuthica and Erwinia rhapontici was investigated in the presence of different monosaccharides in the reaction mixture. These conditions led to inhibitory effects and to glucosyl transfer of the glucose moiety of sucrose to the exogen monosaccharide. Comparison of the structure of the different inhibitors and acceptors has allowed us to suppose the binding of the sucrose molecule into the active site, and thereafter, to propose the possible biochemical reactions leading to the formation of different products from sucrose. This study also underlines the close homologies between these enzymes.

[Uni- or biventricular circulatory assist devices. Selection criteria and patients' follow-up, choice of device]

Therapy of patients presenting with cardiogenic shock refractory to medical treatment can be undertaken with uni or biventricular circulatory assist devices. Pre implantation evaluation of patients is aimed at defining the etiology as well as the extent of uni versus biventricular heart failure, the possibility of recovery of myocardial function improvement of vital organ function and the possibility of cardiac transplantation. Circulatory assist devices must provide efficient support of the failing ventricles, allow recovery of myocardial function or cardiac transplantation under optimal circumstances. The choice of uni-biventricular support of total artificial heart is discussed as well as criteria useful in defining a therapeutic strategy.

[Influence of gender and size on parameters measured by signal-averaged electrocardiography in healthy subjects: preliminary study]

The aim of this study was to determine the influence of electrocardiographic and biomorphometric factors on the parameters measured by signal averaged electrocardiography (SA-ECG) in normal subjects. The study population comprised 40 Caucasian students (20 men, 20 women). The SA-ECG measured 6 parameters: total duration of the averaged QRS, the root mean square of the voltage of the last 40 ms of the QRS (RMS 40) and the length duration of the terminal signal of under 40 microV (LAS), each parameter being measured with a band pass filter of 25 and 40 Hz. The echocardiographic recording included measurement of 12 parameters including left ventricular mass and ventricular volumes. Five morphological parameters were measured, including height, weight and body surface area. The duration of QRS measured with a 25 Hz band pass filter was significantly longer by 9.7 ms in men than in women (102.9 +/- 8.5 ms versus 93.2 +/- 8.1 ms; p < 0.001). Similarly, QRS duration measured with the 40 Hz band pass filter was longer in men by 11.4 ms than in women (102.1 +/- 9.6 ms versus 90.7 +/- 7.5 ms; p < 0.001). Multiple linear regression analyses showed that in both men and women, the duration of the QRS measured with either a 25 or 40 Hz band pass filter was correlated to size: the taller the subject, the longer the QRS duration. A negative correlation was observed between size and RMS 40 measured with both 25 and 40 Hz band pass filters: the taller the subject, the smaller the value of RMS 40.(ABSTRACT TRUNCATED AT 250 WORDS)