Acute abdominal pain due to atypical bilateral adrenal infarction in acute myeloid leukemia with alterations related to myelodysplasia: A case report.

Key Clinical Message: Acute myeloid leukemia (AML) can cause acute abdomen following adrenal insufficiency or adrenal infarction. Therefore, when diffusely enlarged adrenal glands and adrenal insufficiency of unknown cause are seen in a patient presenting with acute abdomen, adrenal infarction due to AML, or other hematologic diseases should be ruled out. Abstract: A 49-year-old man developed acute abdominal pain following adrenal insufficiency and was diagnosed with acute myeloid leukemia (AML) with myelodysplasia-related changes. Because AML can cause acute abdominal pain due to adrenal infarction following adrenal insufficiency, a patient with these conditions should be ruled out adrenal infarction due to AML or other hematologic diseases.

Late-Onset Ornithine Transcarbamylase Deficiency Complicated with Extremely High Serum Ammonia Level: Prompt Induction of Hemodialysis as the Key to Successful Treatment.

BACKGROUND Ornithine transcarbamylase deficiency (OTCD) is an X-linked semi-dominant disorder, causing possible fatal hyperammonemia. Late-onset OTCD can develop at any time from 2 months after birth to adulthood, accounting for 70% of all OTCDs. CASE REPORT A 35-year-old man with chronic headaches stated that since childhood he felt sick after eating meat. Fourteen days before hospital admission, he began receiving 60 mg/day of intravenous prednisolone for sudden deafness. The prednisolone was stopped 5 days before hospital admission. Four days later, he was transferred to our hospital because of confusion. On admission, he had hyperammonemia of 393 µmol/L. Because he became comatose 7 hours after admission, and his serum ammonia increased to 1071 µmol/L, we promptly started hemodialysis. Because his family history included 2 deceased infant boys, we suspected late-onset OTCD. On day 2 of hospitalization, we began administering ammonia-scavenging medications. Because he gradually regained consciousness, we stopped his hemodialysis on day 6. After his general condition improved, he was transferred to the previous hospital for rehabilitation on day 32. We definitively diagnosed him with late-onset OTCD due to the low plasma citrulline and high urinary orotic acid levels found during his hospitalization. CONCLUSIONS Clinicians should suspect urea cycle disorders, such as OTCD, when adult patients present with marked hyperammonemia without liver cirrhosis. Adult patients with marked hyperammonemia should immediately undergo hemodialysis to remove ammonia, regardless of causative diseases.

Influences of molar loss of rat on learning and memory.

PURPOSE: The maxillary unilateral or bilateral molars of rats were extracted, and the influences of the partial loss of occlusal support were evaluated using an 8-arm radial maze and a step-through type passive-avoidance apparatus. METHODS: Rats were randomly allocated to three groups not undergoing molar extraction or undergoing extraction of the maxillary unilateral or bilateral molars. Each group was further divided into two groups for maze or passive-avoidance experiments. Thus, a total of six groups were established. The maze experiment was conducted once daily for 10 days. The number of correct choices, number of errors, and the trial time were recorded. The passive-avoidance experiment consisted of an acquisition trial and retention trial. In the acquisition trial, rats were placed in a light room, and the response latency until their entry into a dark room was measured. After 24h, a similar procedure was performed as a retention trial. RESULTS: In the maze experiment, there was no significant difference by all the groups except on the day 1 in the number of correct choices. But bilateral molar loss group, the number of errors were significantly lower than no extraction group on days 1, 2, 3, 4, and 7. In the passive-avoidance experiment, though the response latency in the retention trial was longer than that in the acquisition trial in all three groups, according to the increase in the number of tooth extraction, it became significantly shorter between P1 and P3. CONCLUSION: These results suggested that molar loss may be a cause of learning/memory impairment.