Recent Progress In Diagnosis Research Articles

Recent progress in diagnosis and treatment of osteogenesis imperfecta.

Osteogenesis imperfecta (OI) is an inheritable disorder characterized by bone fragility with various symptoms of connective tissue disorders. OI is commonly classified by Sillence's classification into four types according to the clinical features. The cardinal symptom is pathologic fracture, which is often recognized before birth, is frequent during infancy and childhood, then decreases at puberty. Bone mineral density is markedly decreased in OI, especially of the lumbar spine. Bone deformities are frequently observed in the long bones of the extremities, and spinal deformities and compression fractures are also common. Growth retardation is extremely severe, especially in type III. Calcitonin has been the most common therapy for OI. Recently, bisphosphonates have been found to be potent drugs that increase bone mass in OI patients. To prevent further fracture or bone deformity, appropriate orthopedic managements, including intramedullary rodding, are critically important. Growth hormone is effective in stimulating bone growth during childhood. The pathogenesis of OI is quantitative or qualitative abnormalities of type I collagen. The clinical features of each type usually correspond to the type of mutation. Several possibilities for gene therapy have been proposed.

The Zollinger-Ellison syndrome: Review of recent progress in diagnosis and treatment

The Zollinger-Ellison syndrome: Review of recent progress in diagnosis and treatment

Nerve transfer in brachial plexus traction injuries

Brachial plexus palsy due to traction injury, especially spinal nerve-root avulsion, represents a severe handicap for the patient. Despite recent progress in diagnosis and microsurgical repair, the prognosis in such cases remains unfavorable. Nerve transfer is the only possibility for repair in cases of spinal nerve-root avulsion. This technique was analyzed in 37 patients with 64 reinnervation procedures of the musculocutaneous and/or axillary nerve using upper intercostal, spinal accessory, and regional nerves as donors. The most favorable results, with an 83.8% overall rate of useful functional recovery, were obtained in patients with upper brachial plexus palsy in which regional donor nerves, such as the medial pectoral, thoracodorsal, long thoracic, and subscapular nerves, had been used. The overall rates of recovery for the spinal accessory and upper intercostal nerves were 64.3% and 55.5%, respectively, which are significantly lower. The authors evaluate the results of nerve transfer and analyze different donor nerves as factors influencing the prognosis of surgical repair.

Recent progress in diagnosis of pulmonary diseases

Recent progress in diagnosis of pulmonary diseases

Recent progress in diagnosis and treatment of digestive diseases. I. Chronic gastritis and peptic ulcer. 2. Medical endoscopic treatment of massive bleeding due to peptic ulcer

Recent progress in diagnosis and treatment of digestive diseases. I. Chronic gastritis and peptic ulcer. 2. Medical endoscopic treatment of massive bleeding due to peptic ulcer

Recent progress in diagnosis and treatment of gastrointestinal diseases. V. Present status and problems of other treatments. 12. Enteral nutrition

Recent progress in diagnosis and treatment of gastrointestinal diseases. V. Present status and problems of other treatments. 12. Enteral nutrition

Japanese Staging System for Gastric Cancer: Evaluation and Documentation of Tumor Extension

A staging system was proposed in the ‘General Rules for Gastric Cancer Study’ published by the Japanese Research Society for Stomach Cancer in 1962. On the basis of the general rules, high-quality data on 132,379 patients with gastric cancer were collected. Statistical analysis of these data (10,812 resected cases in 1969–1973) showed several contradictions between stagings and survival rates, both in the Japanese staging and the present TNM staging of the UICC and the American Joint Committee (AJC). A new and unified staging system was completed by the UICC, the AJC, and the Japanese Joint Committee (JJC) to remove such contradictions, eliminate confusion caused by different systems, and introduce the most recent progress in diagnosis and treatment of gastric cancer. The most remarkable progress was ultrasound examination in the evaluation of tumor extension and the use of computer in the documentation and analysis of the data.

Surgery of Cancer of the Large Bowel

Remarks are first made on various items necessary for surgery of cancer of the large bowel. Detection of early cancer is only around 10% in the case of cancer in the large bowel. But recent progress in diagnosis especially of endoscopic biopsy, has revealed that majority of cancer in the large bowel originates from adenoma. Further, most of the early cancer take polypoid appearance and can now be cured easily by endoscopic polypectomy.In the surgery of colon cancer, it has become relatively easy to carry out wide resection of the colon and complete dissection of the lymph nodes. The rate of curative operation is as high as 80 %, and non-touch isolation technique (Turnbull) is also carried out to prevent hematogenic spread of cancer cells. For reconstruction of the intestine, end-to-end anasto-mosis is employed exclusively.For cancer in the lower rectum, abdomino-perineal amputation is used. For the prevention of local recurrence, which occurs in a relatively large number, wide removal of the rectum and anus, and complete dissection of regional lymph nodes are being carried out in recent years. Although it is somewhat complex, dissection of lymph nodes along the internal iliac vessels should not be overlooked. In spite of extended surgical technique, operative wound undergoes rapid primary healing.For cancer in the upper rectum, sphincter-peserving operation is carried out. This operation has become safe by the progress in surgical technique, and radicality can be fully satisfied. In cancer of the upper rectum, the low anterior resection is better. If the lower margin of the tumor is a little low and within 4-5 cm above the dentate line, the pull-through operation will be indicated. This sphincter-preserving technique is now used in 40 % of operated rectal cancer cases together with progress in the diagnosis of rectal cancer.Thus, the treatment of rectal cancer is being developed, with prevention of local recurrence by extended surgery in cancer of the lower rectum and by preservation of anal functions without loss of radicality in cancer of the upper rectum.Majority of cancer of the large bowel are localized type, the rate of metastasis to lymph nodes is low, and the end results are generally favorable. Five-year survival rates in cases undergoing curative operation have been 69% for colon carcinoma and 58% for rectal carcinoma.