A case of Wernicke encephalopathy arising in the early stage after the start of hemodialysis.

Wernicke encephalopathy (WE) resulting from vitamin B1 (VB1) deficiency is commonly regarded as being associated with a high alcohol intake; however, recently many non-alcohol-related cases have been reported. Herein, we report a case of WE due to VB1 deficiency in the early stage after the start of hemodialysis. The patient was a 79-year-old male recommended for hemodialysis due to chronic renal failure. He was admitted to our hospital due to a hemorrhagic duodenal ulcer, but hemodialysis was started as the result of exacerbation of renal function. After the start of 3-times-weekly hemodialysis, the patient's general condition was settled and he was able to consume about half his usual dietary intake. Seventeen days after the start of hemodialysis, impaired consciousness and involuntary movements appeared, and subsequent head magnetic resonance imaging showed increased signal intensity around the cerebral aqueduct. VB1 administration based on a suspicion of WE resulted in a significant improvement in neurological symptoms and no sequelae were observed. Hemodialysis may be a risk factor for VB1 deficiency. When a dialysis patient presents with psychiatric symptoms or impaired consciousness, in particular, it is important to always keep the possibility of VB1 deficiency in mind.

Renal primitive neuroectodermal tumor with elevated plasma adrenocorticotropic hormone levels: A case report.

INTRODUCTION: Primitive neuroectodermal tumors are small round-cell tumors - Ewing sarcoma family, frequently occurring in the extremities, but rarely in the kidney. CASE PRESENTATION: A 58-year-old woman presented with whole-body edema and weakness of lower limb muscles. Computed tomography revealed a left renal tumor, and the plasma adrenocorticotropic hormone level was elevated. The tumor was surgically removed without complications, her plasma adrenocorticotropic hormone reverted to normal levels, and symptoms disappeared after surgery. Histopathological examination revealed a primitive neuroectodermal tumor arising in her kidney. The patient was alive without metastasis 3 years after the surgery. CONCLUSION: We report the first case of renal primitive neuroectodermal tumor accompanying elevated plasma adrenocorticotropic hormone levels which are thought to be produced and secreted in an ectopic fashion.

Association of SNP rs1447295 and microsatellite marker DG8S737 with familial prostate cancer and high grade disease.

PURPOSE: Several prior studies show a relationship between genetic markers at chromosome 8q24 and an increased prostate cancer risk. We confirmed the association of 8q24 markers with prostate cancer in the Japanese population and the association of these genetic variants with clinical characteristics. MATERIALS AND METHODS: Included in this study were 134 patients with familial prostate cancer, 158 with sporadic prostate cancer and 119 controls. All were Japanese. We genotyped the 2, 8q24 markers SNP rs1447295 and microsatellite marker DG8S737 using real-time polymerase chain reaction and polymerase chain reaction based assay with fluorescence labeled primers. RESULTS: There was a significant positive association between the DG8S737 -12 allele and familial prostate cancer risk (OR 1.86, 95% CI 1.11-3.00, p = 0.02) and a significant association of risk with the rs1447295 A allele (OR 2.36, 95% CI 1.41-3.94, p = 0.002). Significant associations were noted for each marker in men with a high Gleason score. CONCLUSIONS: Two alleles at 8q24 are genetic risk factors for familial prostate cancer and high grade disease.

[Reiter's syndrome following intravesical instillation of Bacillus Calmette-Guerin].

A 54-year-old man who had received intravesical instillation of bacillus Calmette-Guerin(BCG) after transurethral resection for bladder cancer suffered from multiple arthritis, bilateral conjunctivitis, miction pain and high fever. Under the diagnosis of Reiter's syndrome, a nonsteroidal anti-inflammatory drug, histamine antagonists, anti-tubercular agent and corticosteroid were administered. The symptoms were improved within one month. It is important in early diagnosis and treatment of Reiter's syndrome to observe carefully the complications following intravesical instillation of BCG.