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Valles et al., 2003

Asymmetric Tendon reflexes: Reduced in arms Growth retardation: Some patients Mental retardation: Some patients Laboratory Lactic acidosis Serum CK: High (600) EMG Myopathic Complex repetitive discharges Positive sharp waves NCV: Normal Muscle Mitochondrial Ragged red fibers COX negative fibers Dystrophic Muscle fibers Internal nuclei Size: Varied Necrosis Endomysial connective tissue: Increased Brain MRI: Cortical atrophy C-spine MRI: Myelomalacia Myopathy with Episodic high Creatine Kinase (MIMECK) 140 mtRNA Lys (MTTK) : A8291G Epidemiology: Japanese patients Genetics Homoplasmic A8291G mutation reported in few healthy controls Patients all had other similar mtDNA polymorphisms Clinical Onset Age: Adult

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WHITENING RESULTS: Whitening effects STILL vary with skin type, lifestyle, and metabolism