Diabetic encephalopathy is a major complication with cognitive impairment and neurodegeneration in patients with type 1 or type 2 diabetes mellitus (DM). DM-induced glucolipotoxicity is a risk factor for Alzheimer’s disease–like phenotype, including amyloidogenesis, tau hyperphosphorylation, and neuronal apoptosis. Although the detailed mechanism underlying the pathogenesis of diabetic encephalopathy remains unclear, mitochondrial oxidative stress is emerging as a key factor for diabetic complications and neurodegeneration. A deeper understanding of the regulatory mechanism of mitochondrial oxidative stress under hyperglycemic conditions will provide insights into the development of therapeutic strategies for diabetic encephalopathy. Here, we review the role of mitochondrial oxidative stress in diabetic encephalopathy and the regulatory mechanisms by which high glucose induces the generation of mitochondrial reactive species oxygen species in neuronal cells. This review also summarizes the mitochondrial-dependent and -independent pathways (O-linked-N-acetylglucosaminylation, calcium, and glycogen synthase kinase 3β signaling) that regulate mitochondrial oxidative stress in a DM model.

Infected walled-off pancreatic necrosis (WOPN) is dangerous complication of acute pancreatitis. Open necrosectomy and post-operative irrigation of necrotic cavity have been conventional treatment for infected pancreatic necrosis, however, recently minimally invasive techniques such as endoscopic necrosectomy has been regarded as preferred treatment method for infected WOPN. Endoscopic necrosectomy provides a targeted approach with a reduction in the systemic inflammatory response and avoidance of wound complications. Non alcohol related Wernicke encephalopathy is rare disease caused by thiamine deficiency due to intravenous feeding, and presented an encephalopathy, oculomotor dysfunction, gait ataxia. We report herein a case of Wernicke encephalopathy after successful endoscopic necrosectomy for infected WOPN.

내시경역행담췌관조영술은 췌담도질환의 진단과 치료에 있어서 널리 사용되는 방법으로 췌장염이나 출혈과 같은 합병증이 많이 발생한다. EPBD는 출혈의 합병증 측면에 있어서 내시경 괄약근 절개술과 비교하여 장점을 가지고 있어서 응고장애가 있는 환자들에서 사용되곤 하며 대량 출혈이 발생하는 경우는 드물다고 알려져 있다. 우상복부 통증으로 내원한 68세 여자가 원위부 양성 담관 협착에 대해 EPBD를 시행한 이후의 출혈이 확인되었고 혈관조영술을 통한 색전술 로 지혈하였으나 대량 출혈로 인한 대사성 뇌병증이 발생하 였다가 지지적 치료로 호전되었다. EPBD를 시행한 이후 대사성 뇌병증을 유발하는 대량 출혈이 발생된 증례는 이전에 보고된 적이 없기에 저자들은 이를 문헌고찰과 함께 보고한다.

The sensitivities of PrP Sc detection methods, western blotting (WB), immunohistochemistry (IHC) and protein mis-folding cyclic amplification (PMCA) techniques were compared from brains, spleens and blood of mice challenged with PrP Sc of murine-adapted BSE strain 301C. PrP Sc was detected in the spleen from 30 dpi by IHC and at 60 dpi by WB. At 30 dpi, disease-specific signals of PrP Sc was observed in only two follicles of a single spleen. PrP Sc was detected in spleen at 10 dpi with PMCA after 5 rounds of amplification. Clinical signs were obviously shown from 240 dpi, and coincided with first detection of PrP Sc in brains by WB, IHC and PMCA after one round amplification. In addition, PrP Sc was also detected in blood at 60, 180 and 240 dpi with PMCA after 5 rounds of amplification. The FDC-M1 epitope, which appears in immature FDCs, and PrP Sc were detected in follicles first at 30 dpi, whilst the FDC-M2 epitope of mature FDCs was detected at 60 dpi. More FDC-M2 epitope and PrP Sc were detected in follicles as disease progressed. The CD21/35 epitope is expressed on both FDCs and germinal center B cells. The pattern of CD21/35 expressing cells was similar to but less dominant than that of FDCs.

Severe maternal morbidity is frequently associated with catastrophic complications of pregnancy such as amniotic fluid embolism (AFE) or sepsis due to chorioamnionitis. The authors report a case of postpartum maternal hypoxic encephalopathy that might be attributed to AFE or sepsis due to chorioamnionitis with Escherichia coli bacteremia, and review the relevant literature. The patient presented with preterm labor, underwent Cesarean section for intrauterine fetal demise, and experienced postpartum cardiopulmonary collapse and disseminated intravascular coagulation, which led to catastrophic postpartum maternal encephalopathy.

Polyethylene glycol (PEG) solution is currently used to prepare the colon before colonoscopy. Hyponatremic encephalopathy is a condition with neurologic symptoms such as headache, vomiting, confusion, seizure, and sometimes respiratory arrest. A 55-year-old woman presented to our emergency department with generalized tonic-clonic seizure and mental change after ingestion of PEG solution 2 L with water. Serum sodium concentrations was 115 mmol/L. After correction with hypertonic saline for 12hrs, serum sodium concentration reached 129 mmol/L and mental status recovered. We experienced a case of acute hyponatremic encephalopathy resulting from ingestion of PEG solution 2 L for colonoscopy.

Capecitabine is a prodrug of a 5-fluorouracil (5-FU) that is converted to 5-FU inside the tumor cells. Here, we report a case of 5-FU induced encephalopathy which was subsequently treated with capecitabine without any neurologic complication. A 76-year-old man with rectal adenocarcinoma received chemotherapy, which consisted of 5-FU, leucovorin and oxaliplatin after resection of the primary and metastatic masses. Confusion and agitation were observed during the 2nd cycle of chemotherapy and reappeared during 4th cycle. Both events were completely disappeared within a few days. Capecitabine was administered for 4 cycles without any neurologic toxicity. Capecitabine could be an alternative in patients experiencing 5-FU induced encephalopathy.