{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:17:31Z","timestamp":1780100251426,"version":"3.54.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2004,10,13]],"date-time":"2004-10-13T00:00:00Z","timestamp":1097625600000},"content-version":"vor","delay-in-days":9723,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[1978,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A patient with a long history of exercise\u2010induced pain developed myoglobinuria and respiratory failure following extensive exercise (football). Although muscle histochemistry was normal, tissue oxidation of <jats:sup>14<\/jats:sup>Clabeled palmitate was decreased, and muscle carnitine palmityltransferase (CPT) activity was one\u2010tenth of normal. During fasting, his creatine kinase (CK) rose from 127 mu\/ml to 278 mu\/ml and blood ketones failed to exhibit a normal rise. Triglycerides were normal, as was fatty\u2010acid mobilization. Prolonged exercise resulted in an inordinately increased CK with only moderate elevations in lactate. Treatment with medium\u2010chain triglycerides did not alter his symptoms or improve exercise performance. Pain on exercise is a common complaint, but the occurrence of myoglobinuria points to a defect of energy metabolism. Screening for defects of fat utilization may be accomplished by the prolonged\u2010exercise test, invitro oxidation of <jats:sup>14<\/jats:sup>C\u2010labeled substrates, and prolonged fasting.<\/jats:p>","DOI":"10.1002\/mus.880010203","type":"journal-article","created":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T07:49:40Z","timestamp":1104565780000},"page":"103-110","source":"Crossref","is-referenced-by-count":47,"title":["Biochemical and physiologic consequences of carnitine palmityltransferase deficiency"],"prefix":"10.1002","volume":"1","author":[{"given":"James E.","family":"Carroll","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael H.","family":"Brooke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darryl C.","family":"DeVivo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth K.","family":"Kaiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Hagberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,10,13]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI107645"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00313485"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197502272920902"},{"key":"e_1_2_1_5_2","first-page":"499","article-title":"The prolonged exercise test in patients with muscle pain and fatigue (abstract)","volume":"1","author":"Brooke MH","year":"1977","journal-title":"Ann Neurol"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1042\/bj1300697"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(76)90131-3"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.182.4115.929"},{"key":"e_1_2_1_9_2","first-page":"601","volume-title":"Exploratory Concepts in Muscular Dystrophy II","author":"Engel AG","year":"1973"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197003262821301"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI106017"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0026-0495(65)90151-4"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/path.1711060102"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(77)80821-4"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0033-0620(76)90011-6"},{"key":"e_1_2_1_16_2","first-page":"434","article-title":"A microfluorometric enzymatic assay for the determination of alanine and pyruvate in plasma and tissue","volume":"80","author":"Karl IE","year":"1972","journal-title":"J Lab Clin Med"},{"key":"e_1_2_1_17_2","first-page":"379","article-title":"Muscle carnitine palmityltransferase deficiency: a case with diabetes and ketonuria (abstract)","volume":"27","author":"Layzer RB","year":"1977","journal-title":"Neurology (Minneap)"},{"key":"e_1_2_1_18_2","volume-title":"A Flexible System of Enzymatic Analysis","author":"Lowry OH","year":"1972"},{"key":"e_1_2_1_19_2","first-page":"760","article-title":"Urinary excretion of carnitine in man","volume":"87","author":"Maebashi M","year":"1976","journal-title":"J Lab Clin Med"},{"key":"e_1_2_1_20_2","first-page":"13","article-title":"Myopathy due to a defect in muscle glycogen breakdown","volume":"10","author":"McArdle B","year":"1951","journal-title":"Clin Sci"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-2275(20)36985-6"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.137.4.495"},{"key":"e_1_2_1_23_2","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S0021-9258(17)41640-1","article-title":"The biuret reaction of proteins in the presence of ethylene glycol","volume":"157","author":"Mehl JW","year":"1945","journal-title":"J Biol Chem"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI106730"},{"key":"e_1_2_1_25_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.20.12.1171"},{"key":"e_1_2_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-2275(20)39315-9"},{"key":"e_1_2_1_27_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1971.31.3.416"},{"key":"e_1_2_1_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00423050"},{"key":"e_1_2_1_29_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI108057"},{"key":"e_1_2_1_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-4159.1970.tb03731.x"},{"key":"e_1_2_1_31_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1973.35.2.236"},{"key":"e_1_2_1_32_2","doi-asserted-by":"publisher","DOI":"10.1042\/bj0820090"}],"container-title":["Muscle &amp; 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