Nihon rinsho. Japanese journal of clinical medicine
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The author reviewed the epidemiological and clinical aspects of Bickerstaff brainstem encephalitis (BBE) based on the data from the nationwide survey, which was planned in Japanese population between 2006 and 2009. Annual BBE onset was roughly estimated as 100 cases in Japan, which accounted for 43% of brainstem encephalitis, and corresponded to 6.8% of Guillain-Barré syndrome incidence. BBE consisted of typical and atypical cases, and typical BBE had the similar neurological and serological features to Fisher syndrome as well as with good recovery, whereas atypical BBE was characterized by delayed recovery, negative anti-GQ1b antibodies, and abnormal CSF and brain MRI findings with possible other pathogeneses.
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Selective serotonin reuptake inhibitors (SSRI) are widely used antidepressants characterized by less-frequent adverse effects compared with classical anti-depressive agents. On the other hand, SSRI can cause hemorrhagic events more due to impaired platelet aggregation induced by a depletion of serotonin in the peripheral platelet. Epidemiological studies have indicated that patients taking SSRI are predisposed to gastrointestinal hemorrhage, especially in case that nonsteroidal anti-inflammatory drugs are prescribed concomitantly. Here we describe a risk of the gastrointestinal hemorrhage in patients taking SSRI.
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The cerebral small vessel disease (CSVD) refers to a group of pathological condition that affects the intracranial small vessels. CSVD causes lacunar infarction, white matter disease and hemorrhage, and may contribute to development of dementia and motor disability in the elderly. CSVD is a common aging phenomenon, however, little is known about its molecular pathogenesis. To understand the molecular pathogenesis for CSVD, here, we review the clinical spectrum, pathological findings and the molecular pathogenesis of CSVD caused by single gene defect: including cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy, COLAA1-related disorders, retinal vasculopathy with cerebral leukodystrophy, Fabry disease, and hereditary cerebral amyloid angiopathy.
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Since lung is a directly affected organ by cigarette smoking, various respiratory diseases including lung cancer, chronic obstructive pulmonary disease, interstitial lung diseases, bronchial asthma, are caused and worsen by cigarette smoking not only in case of active smoking but also in case of passive smoking. A lot of carcinogen in cigarette smoke causes lung cancer through the DNA damage. ⋯ Meanwhile, inflammation also induces lung fibrosis. Cigarette smoking is a risk factor for the development of asthmas and is associated with decreased asthma control and increased risk of mortality and exacerbations.
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The field of obesity surgery (bariatric surgery) expands as a consequence of the rapid increase of overweight and obesity not only in the western countries but also in Asia. Japan is still far behind the western progression but the problem of obesity is rising in our country so that necessity for bariatric surgery will also rise in Japan. A few statements of indication of bariatric surgery for Asian are published recently. According to the statements from IFSO-APC (International Federation of Surgery for Obesity and Metabolic Disorders, Asian Pacific Chapter) consensus 2011, bariatric surgery for Asian should be considered for the patient with BMI over 35 without co-morbidity and for the patient with BMI over 30 with co-morbidities.