Nihon rinsho. Japanese journal of clinical medicine
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Review
[Clinical diagnosis and treatment of anti-NMDA (N-methyl-D-aspartate) receptor encephalitis].
Recent clinical management of anti-NMDA receptor encephalitis is reviewed. This illness is required the management of the neurological emergency. Typical symptoms of anti-NMDA receptor encephalitis develop in several stages that progresses from psychosis, memory deficits, seizures, and language disintegration into a state of unresponsiveness with catatonic features often associated with abnormal movements, and autonomic and respiratory instability. ⋯ The disorder predominantly affects children and young adults, occurs with or without tumor association. The presence of a tumor (usually an ovarian teratoma) is dependent on age and sex, being more frequent in women older than 18 years. Anti-NMDA receptor encephalitis should be treated with tumor resection and immunotherapy (corticosteroids, intravenous immunoglobulin, or plasma exchange) responded faster to treatment and less frequently needed second-line immunotherapy (cyclophosphamide or rituximab, or both).
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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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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 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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Obesity is a heterogeneous pathologic condition that is driven by interactions between multiple genetic and environmental factors. The discovery of leptin has provided the useful clue to the molecular dissection of central pathways involved in the regulation of food intake and body weight. ⋯ The patients who have a mutation of such genes developed early onset of obesity and distinct metabolic abnormalities. Also, several gene mutations have been identified in some syndromes presenting hereditary symptomatic obesity.