No abstract available.
Brain* ; Cerebral Infarction ; Hyperhomocysteinemia* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

Adult ; Aged ; Alcohol Drinking ; epidemiology ; China ; epidemiology ; Cities ; epidemiology ; Female ; Folic Acid Deficiency ; epidemiology ; Humans ; Hyperhomocysteinemia ; epidemiology ; Male ; Middle Aged ; Prevalence ; Smoking ; epidemiology ; Vitamin B 12 Deficiency ; epidemiology

Bilateral vestibulopathy (BV) is a clinical entity with impaired function of bilateral peripheral vestibular system, which is characterized by movement-induced vertigo, oscillopsia and gait unsteadiness. Among various etiologies of BV, alcohol and vitamin B deficiency has rarely been reported. We experienced a case of BV with vitamin B deficiency in a 24-year-old man who was previously exposed to alcohol. He had osillopsia and gait unsteadiness as a primary symptom, and was treated successfully with vestibular rehabilitation and vitamin supplement. Bithermal caloric test, rotatory chair test and head impulse test showed the result compatible with BV.
Alcoholism ; Alcohols ; Avitaminosis ; Caloric Tests ; Gait ; Head Impulse Test ; Humans ; Rehabilitation ; Vertigo ; Vitamin B Deficiency ; Vitamins ; Young Adult

Subclinical vitamin B12 deficiency is common in the elderly worldwide. We investigated the change of serum vitamin B12 concentration with aging and compared anthropometric data and clinical health indicators between normal (> or = 340 pg/mL) and low (< 340 pg/mL) serum vitamin B12 groups in 470 Korean women aged 65 years and over living in a rural area. Serum vitamin B12 concentration showed inverse correlation with age (r = -0.0992, p < 0.05). The normal B12 group showed significantly (p < 0.05) higher red blood cell count, hemoglobin, and hematocrit compared to the low B12 group, however, no difference in mean corpuscular volume was observed between the two groups. The normal B12 group showed significantly lower serum homocysteine concentration (p < 0.01) and prevalence of vitamin D (p < 0.01) or folate deficiency (p < 0.001). Bone mineral density (T-score) was significantly higher (p < 0.05) in the normal B12 group, compared with that in the low B12 group, and showed positive correlation (r = 0.1490, p < 0.01) with serum vitamin B12 concentration after adjusting for age, body weight, and body mass index. No differences in anthropometric data, physical activity, and smoking and drinking habits were observed between the two groups. In conclusion, it could be suggested that older female adults with normal serum vitamin B12 level would be less anemic and osteoporotic and more resistant to hyperhomocysteinemia associated chronic diseases than those with low serum vitamin B12 level.
Adult ; Aged ; Aging ; Body Mass Index ; Body Weight ; Bone Density ; Chronic Disease ; Drinking ; Erythrocyte Count ; Erythrocyte Indices ; Female ; Folic Acid ; Hematocrit ; Hemoglobins ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Korea ; Motor Activity ; Prevalence ; Smoke ; Smoking ; Vitamin B 12 ; Vitamin B 12 Deficiency ; Vitamin D ; Vitamins

Vitamin B12 deficiency in exclusively breastfed infants is an important problem in developing countries. Vitamin B12 deficiency is associated with a wide spectrum of clinical manifestations. Few cases of vitamin B12 deficiency have been reported as the cause of infantile spasms. We report the case of a 6-month-old boy diagnosed with infantile spasms associated with vitamin B12 deficiency caused by nutritional inadequacy in the mother. He was observed to have head nods and flexor limbs spasms which appeared in clusters. Psychomotor development was normal. The serum vitamin B12 level was low and results of electroencephalography (EEG) indicated modified hypsarrhythmia. His symptoms resolved after synthetic adrenocorticotropic hormone (ACTH) and vitamin B12 treatment. The EEG was completely normal after the first month and sixth month of treatment. In addition to ACTH and vitamin B12 treatment, following antiepileptic drug treatment was not initiated. During 21 months’ follow up he is seizure-free and his neurological development is age-appropriate. This case of a 6 month-old infant with infantile spasms due to vitamin B12 deficiency seems to be a striking because of only with vitamin B12 and ACTH treatment the patient became seizure-free. Vitamin B12 deficiency may be a treatable cause of infantile spasms and should be considered in the associated cause of infantile spasms especially if nutritional inadequacy in the mother.
Vitamin B 12 Deficiency ; Infants

Folate and vitamin B12 are essential cofactors for homocysteine (Hcy) metabolism. Homocysteinemia has been related with cardiovascular and neurodegenerative disease. We examined the effect of folate and/or vitamin B12 deficiency on biomarkers of one carbon metabolism in blood, liver and brain, and analyzed the correlation between vitamin biomarkers in mild and moderate homocysteinemia. In this study, Sprague-Dawley male rats (5 groups, n = 10) were fed folate-sufficient diet (FS), folate-deficient diet (FD) with 0 or 3 g homocystine (FSH and FDH), and folate-/vitamin B12-deficient diet with 3 g homocystine (FDHCD) for 8 weeks. The FDH diet induced mild homocysteinemia (plasma Hcy 17.41 +/- 1.94 nmol/mL) and the FDHCD diet induced moderate homocysteinemia (plasma Hcy 44.13 +/- 2.65 nmol/mL), respectively. Although liver and brain folate levels were significantly lower compared with those values of rats fed FS or FSH (p < 0.001, p < 0.01 respectively), there were no significant differences in folate levels in liver and brain among the rats fed FD, FDH and FDHCD diet. However, rats fed FDHCD showed higher plasma folate levels (126.5 +/- 9.6 nmol/L) compared with rats fed FD and FDH (21.1 +/- 1.4 nmol/L, 22.0 +/- 2.2 nmol/L)(p < 0.001), which is the feature of "ethyl-folate trap"by vitamin B12 deficiency. Plasma Hcy was correlated with hepatic folate (r = -0.641, p < 0.01) but not with plasma folate or brain folate in this experimental condition. However, as we eliminated FDHCD group during correlation test, plasma Hcy was correlated with plasma folate (r = -0.581, p < 0.01), hepatic folate (r = -0.684, p < 0.01) and brain folate (r = -0.321, p < 0.05). Hepatic S-adenosylmethionine (SAM) level was lower in rats fed FD, FDH and FDHCD than in rats fed FS and FSH (p < 0.001, p < 0.001 respectively) and hepatic S-adenosylhomocysteine (SAH) level was significantly higher in those groups. The SAH level in brain was also significantly increased in rats fed FDHCD (p < 0.05). However, brain SAM level was not affected by folate and/or vitamin B12 deficiency. This result suggests that dietary folate- and vitamin B12-deficiency may inhibit methylation in brain by increasing SAH rather than decreasing SAM level, which may be closely associated with impaired cognitive function in nutritional homocysteinemia.
Animals ; Biomarkers ; Brain ; Carbon ; Diet ; DNA Methylation ; Folic Acid ; Homocysteine ; Homocystine ; Humans ; Hyperhomocysteinemia ; Liver ; Male ; Methylation ; Neurodegenerative Diseases ; Plasma ; Rats ; S-Adenosylhomocysteine ; S-Adenosylmethionine ; Vitamin B 12 ; Vitamin B 12 Deficiency ; Vitamins

No abstract available.
Hand* ; Hyperpigmentation* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

No abstract available.
Anemia* ; Gastrectomy* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

BACKGROUND: Neutrophil hypersegmentation (NH) in peripheral blood is known to be usually associated with deficiency of vitamin B12 or folate. Iron deficiency anemia (IDA) is another suggested cause of NH based on a limited number of studies, but the mechanism is uncertain. There was no such study in Korea. METHODS: The study groups were 41 patients with IDA (four males, 37 females ; mean age, 43.63+/-15.71) and 39 hematologically normal patients (five males, 34 females ; mean age, 46.64+/-19.12). We counted the number of nuclear lobes for 100 neutrophils on Wright-stained peripheral blood smear. Two lobes were regarded as separate only if there was a clear filament or the isthmus between them contained no nuclear material. The neutrophils with uncertainty in nuclear lobe count were classified as 'folded'. RESULTS: NH was observed in 14.6% (6/41) of patients with IDA and 7.6% (3/39) of normal controls. Mean neutrophil lobe counts were 2.48+/-0.28 and 2.43+/-0.27, respectively. There was no statistical significance in these differences. CONCLUSION: We could not find significant relation between NH and IDA in Korean, which is different from studies performed in other countries. This result may suggest the possibility of racial differences in the mechanism connecting IDA and NH, if there is any.
Anemia, Iron-Deficiency* ; Female ; Folic Acid ; Humans ; Iron* ; Korea ; Male ; Neutrophils* ; Uncertainty ; Vitamin B 12

BACKGROUND: The traditional treatment of cobalamin deficiency anemia is performed by intramuscular injections. However, it has been suggested that oral replacement of cobalamin is also effective as an intramuscular injection. We studied the effectiveness of oral mecobalamin treatment in patients with cobalamin deficiency. METHODS: Patients with newly diagnosed cobalamin deficiency (<200 pg/mL) or who were previously maintained on intramuscular injection were given 2,000 microgram of oral mecobalamin daily. RESULTS: Sixteen patients were enrolled. The common causes of cobalamin deficiency were total gastrectomy (75%) and pernicious anemia (12.5%). Twelve patients received oral mecobalamin, except for four patients who were lost from follow-up after initial diagnosis. The mean pretreatment values of serum cobalamin and hemoglobin level were 58.3+/-21.9pg/mL and 8.1+/-1.9g/dL, respectively. After one, two, and six months of oral therapy, the respective mean values were 1,691.8+/-260.4pg/mL, 1,085.8+/-1,110.3pg/mL and 990.2+/-249.8pg/mL of serum cobalamin, and 10.4+/-1.3g/dL, 11.3+/-2.2g/dL and 12.1+/-2.3g/dL of hemoglobin. Initially elevated serum homocysteine were normalized after one month of oral therapy. Symptoms such as glossitis were relieved rapidly by oral treatment. CONCLUSION: High-dose oral mecobalamin supplement was a simple and effective treatment in patients with cobalamin deficiency, especially in total gastrectomized patients.
Anemia ; Anemia, Pernicious ; Diagnosis ; Follow-Up Studies ; Gastrectomy ; Glossitis ; Homocysteine ; Humans ; Injections, Intramuscular ; Vitamin B 12 Deficiency ; Vitamin B 12*