West syndrome (WS) is a generalized epileptic syndrome of infancy and early childhood with various etiologies, and consists of a triad of infantile spasm, arrest or regress of psychomotor development and specific electroencephalogram (EEG) pattern of hypsarrhythmia. WS had been believed to be refractory, but recent evidence supports effectiveness of adrenocorticotropic hormone (ACTH) treatment. The ACTH treatment, however, has a problem that it is often accompanied by adverse autonomic symptoms. We therefore examined heart rate variability (HRV) for assessing cardiac autonomic functions in WS and prospectively observed the changes during ACTH treatment. We studied 15 patients with WS and 9 age-matched controls during sleep (EEG stage 2). Compared with controls, the patients with WS were greater in the low-frequency component (LF) of HRV, an index reflecting sympatho-vagal interaction ( p = 0.02), but were comparable for high-frequency component (HF) and LF-to-HF ratio (LF/HF), indices reflecting cardiac vagal activity and sympathetic predominance, respectively. During ACTH treatment, heart rate decreased ( p < 0.01), LF and HF increased ( p < 0.01), and LF/HF did not differ significantly. These results indicate that West syndrome might be accompanied by autonomic changes and that ACTH treatment enhances parasympathetic function and causes bradycardia. West syndrome; ACTH; heart rate variability; bradycardia; autonomic function

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SummaryThe intestinal calcium transport activity and serum calcium and phosphorous concentrations of vitamin D-deficient rats were increased by irradiation with an ultraviolet (UV) lamp. The existence of 25-hydroxyvitamin D3(25-OH-D3) in their bloods and livers was physicochemically confirmed by high-performance liquid chromatography (HPLC), gas-liquid chromatography (GLC) and mass fragmentography, whereas the compound could not be detected in the tissues of non irradiated rats. The results strongly suggested that vitamin D3 in vivo generated in irradiated rat skin might be normally metabolized and utilized to prevent rickets. The level of 25-OH-D3 in the tissues was determined by a HPLC method.