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Finally, a number of inherited mutations in genes involved in carnitine shuttling and fatty acid oxidation pathways do not systematically result in carnitine depletion (such that carnitine supplementation may not help mitigate the symptoms) but lead to abnormal profiles of acylcarnitine esters in blood (35, 40)

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After 72 h, the sites of the brown area were assessed using a chromameter (CR-400, Konica Minolta, Japan), and the degree of discoloration with the sample applied twice a day was measured every day