Wernicke’s encephalopathy, an acute neuropsychiatric syndrome caused by thiamine (vitamin B1 ) deficiency, is associated with serious clinical disease and can be fatal. It has rarely been reported in infants and children. We report a case of a 3-year-old girl with Wernicke’s encephalopathy. The patient’s diet had been severely unbalanced since the age of 2 years, and for about a month prior to admission to our hospital had consisted almost exclusively of polished white rice and noodles. Her clinical symptoms supported thiamine deficiency-related neuropathy. Brain MRI findings revealed abnormalities consistent with pediatric Wernicke’s encephalopathy with involvement of the putamen. The diagnosis prompted thiamine replacement therapy, to which the patient showed an excellent response.
Central Nervous System

BACKGROUND: This study was done to evaluate the validity and reliability of the Kaigo-Yobo (K-Y) checklist in the Korean elderly population. METHODS: The study population included 283 men and women over 65 years who visited the three community senior's welfare centers located in Seoul and Gyeonggi province from March 29, 2011 to May 26, 2011. The Korean frailty index (FI), Japanese K-Y checklist, Cardiovascular Health Study frailty index (CHSFI), activities of daily living, and Korean Mini-Mental Status Examination were completed for each participant. Reliability was tested by internal consistency (Cronbach's alpha), as was the test-retest reliability, at a 2-week interval. Validity was tested by the area under the curve (AUC) from the receiver operating characteristics curve as a predictor of frailty according to the CHS criteria and the validity index estimated by the reliability index. RESULTS: The correlation coefficients between Korean FI and K-Y checklist, Korean FI and CHSFI, and K-Y checklist and CHSFI were 0.61, 0.43, and 0.44 respectively. The range of Kappa value for each item on the Korean FI was 0.28 to 0.60 and 0.19 to 0.65 for the K-Y checklist. Cronbach's alpha for the Korean FI was 0.58 and 0.64 for the K-Y checklist. The AUC for the Korean FI was 0.79, and 0.64 for the K-Y checklist. The validity index for the items on the Korean FI ranged from 0.28-0.53 to 0.60-0.78 and 0.19-0.44 to 0.65-0.81 for the K-Y checklist. CONCLUSION: The K-Y checklist is a valid and reliable instrument to measure frailty in the Korean elderly population. Follow-up studies are needed.
Activities of Daily Living ; Aged ; Area Under Curve ; Asian Continental Ancestry Group ; Checklist ; Female ; Humans ; Male ; Reproducibility of Results ; ROC Curve

Physical performance measures, such as gait speed, one-legged stance and hand-grip strength, are known as assessment measures of motor function and predictors for adverse health outcomes, and widely used for assessing motor function in preventive programs for long-term care or screening of frail elderly. However, there is no standard assessment sheet for feedback of the results. In the present study, an assessment sheet on physical performance measures for community-dwelling older adults was developed. A pooled analysis of data from six cohort studies, including urban and rural areas was conducted as part of the Tokyo Metropolitan Institute of Gerontology Longitudinal Interdisciplinary Study on Aging. The pooled analysis included cross-sectional data from 4683 nondisabled, community-dwelling adults aged 65 years or older. Quintiles were derived according to age and sex group for six physical performance measures, i.e., hand-grip strength, one-legged stance, and gait speed and step length at both usual and maximum paces. The assessment sheets, which indicated the physical performance level according to age and sex, were developed by fitting third order polynomial curves to the data. The reference values in the present assessment sheet were considered to be derived from better represented community-dwelling older adults by using more large-scale population-based cohort data than that in the previous study. The assessment sheet should be useful for feeding back results on physical performance measures to elderly individuals and help them better understand their own physical performance levels.

PURPOSE: To introduce a new simple technique using suture anchors and ceramic spacers to stabilize the elevated laminae in open-door cervical laminoplasty. Although ceramic spacers were placed in the opened laminae and fixed with nylon threads in this series, it was occasionally difficult to fix the nylon threads to the lateral mass. MATERIALS AND METHODS: Study 1: A preliminary study was conducted using a suture anchor system. Sixteen consecutive patients who underwent surgery for cervical myelopathy were prospectively examined. Study 2: The second study was performed prospectively to evaluate the feasibility of this new technique based on the result of the preliminary study. Clinical outcomes were examined in 45 consecutive patients [cervical spondylotic myelopathy (CSM)] and 43 consecutive patients (OPLL). The Japanese Orthopedic Association scoring system (JOA score), axial neck pain, and radiological findings were analyzed. RESULTS: 1) In one case, re-operation was necessary due to dislodgement of the ceramic spacer following rupture of the thread. 2) In all patients, postoperative CT scans showed that the anchors were securely inserted into the bone. In the CSM group, the average JOA score improved from 9.5 points preoperatively to 13.3 at follow-up (recovery 51%). In the OPLL group, the average JOA score improved from 10.1 (5-14) points preoperatively to 14.4 (11-16) at follow-up (recovery 62%). There were no serious complications. CONCLUSION: The use of the suture anchor system made it unnecessary to create a hole in the lateral mass and enabled reliable and faster fixation of the HA spacers in open-door laminoplasty.
Adult ; Aged ; *Ceramics ; Cervical Vertebrae/radiography ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Laminoplasty/*methods ; Male ; Middle Aged ; Postoperative Period ; Prospective Studies ; Spinal Cord Diseases/*surgery ; Suture Anchors ; *Sutures ; Tomography, X-Ray Computed ; Treatment Outcome