Brain and nerve = Shinkei kenkyū no shinpo
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Irritable bowel syndrome (IBS) is defined as a representative functional gastrointestinal disorder which is characterized by chronic or recurrent abdominal pain and/or abdominal discomfort associated with abnormal bowel movement. Gut microbiota are related to the pathophysiology of IBS. In the field of IBS, post-infectious etiology, stress-induced alteration of microbiota, increased mucosal permeability, bacterial overgrowth, disease-specific microbiota, microbial products, and brain-gut interactions are being investigated. ⋯ Gut microbiota in IBS patients differ from those in healthy individuals, and the profiles of gut microbiota in IBS patients also vary among IBS patients with constipation, diarrhea, and mixed subtypes. In Japan, gut microbiota in IBS patients also differ from those observed in healthy individuals, and organic acid by-products observed in the patients correlated with symptoms, quality of life, and alexithymia. Further research on gut microbiota in IBS patients is warranted.
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The treatment of Guillain-Barre syndromé (GBS) was mainly symptomatic until the 1950s, followed by corticosteroid treatment in the 1950s through 1960s. Plasma exchange (PE) was then performed during 1970s through the 1980s, after which intravenous immunoglobulin (IVIg) was performed in 1990s through the 2000s. ⋯ Recently, new treatments using biological products have been explored. In this paper, we summarize the development of the treatment of GBS.
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Cerebral small vessel disease (SVD), including subcortical lacunar infarcts (lacunes) and white matter hyperintensities (WMH), is commonly observed on MRI of elderly individuals with and without dementia. SVD is frequently observed in patients with Alzheimer's disease (AD). ⋯ Our recent studies suggest that cerebral SVD observed on CT/MRI of patients with AD is associated with delusions and delirium as well as depression. Mechanisms underlying these psychiatric symptoms in patients with AD remain unclear.
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Several studies have demonstrated the serious impact of surgeries on patients with Parkinson's disease (PD). In addition, PD is a risk factor for postoperative complications and prolonged hospital stays. Discontinuation of anti-Parkinsonian drugs due to surgery causes an exacerbation of Parkinsonism and sometimes Parkinsonism-hyperpyrexia syndrome (PHS). ⋯ During the postoperative phase, postoperative pain, aspiration pneumonia, ileus, and psychotic symptoms should be managed, taking into consideration the interactions between anti-Parkinsonian drugs and therapeutic agents. Currently, new anti-Parkinsonian drugs, such as rotigotine and apomorphine are available for patients with PD requiring parenteral treatment. It is important that medical experts share awareness about perioperative problems and their management in patients with PD.
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Spontaneous anterior or posterior interosseous nerve palsy is usually treated as a part of neuralgic amyotrophy. However, recent studies have shown that many of these cases involved fascicular constriction in the affected nerves, and interfascicular neurolysis may be a better option than conservative treatment in cases that do not show spontaneous recovery within several months. Here, we review recent studies on these palsies.