Nihon rinsho. Japanese journal of clinical medicine
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Fibromyalgia syndrome (FMS) is recognizable syndrome characterized by chronic, diffuse pain, an absence of inflammatory or structural muscloskeletal abnormalities, and a range of symptoms that include fatigue, and sleep and mood disturbances. Physical examination and laboratory testing are unrevealing, except for the presence of pain on palpation of characteristic soft-tissue sites, the tender points. Despite the recognition of FMS by the World Health Organization, it remains a controversial condition and its existence as a distinct entity remains uncertain. ⋯ Many patients with chronic fatigue syndrome(CFS) fulfill the criteria of FMS and represent one end of a spectrum of presentation. Evidence for triggering viral infection and the lower level of serum acylcarnitine, observed in CFS patients, is lacking in the majority of patients with FMS. These findings are suggestive to be distinctively another disorders between FMS and CFS.
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Recent evidence suggests that most of the rheumatic diseases are complex or multifactorial diseases with contributions from HLA and multiple non-HLA genes. Studies using candidate gene approach suggested that early components of the complement pathway, Fc receptor IIa, IIIa, mannose-binding lectin, IL-10 and TNFR2 might be potential non-HLA susceptibility genes to systemic lupus erythematosus, although substantial difference among populations are reported. ⋯ A recently completed genome-wide linkage analysis of rheumatoid arthritis revealed a number of possible candidate regions in addition to HLA. Identification of the susceptibility genes will be accelerated along with technological advances and the accomplishment of human genome project, and will deepen our understanding of rheumatic diseases.
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Many classifications of vasculitis syndrome have been proposed. The American College of Rheumatology (ACR) proposed criteria for classification of vasculitis in 1990. In 1994, the nomenclature of systemic vasculitides was proposed by Chapel Hill International Consensus Conference. ⋯ In Japan, Research committee of intractable vasculitis syndrome, Survey and Research on Specific Diseases, the Ministry of Health and Welfare of Japan proposed diagnostic criteria for vasculitis syndrome. The criteria for ANCA related vasculitis syndrome, temporal arteritis and antiphospholipid syndrome were proposed and a nation-wide survey has been undertaken in this committee (Chairman: Hiroshi Hashimoto). In this review, we describe a recent classification of vasculitides and recent topics on Takayasu arteritis, temporal arteritis, Wegener's granulomatosis and Churg-Strauss syndrome.
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Review Comparative Study
[Eradication rate and side effect from a point of view of Helicobacter pylori eradication of peptic ulcer disease in dual therapy or new triple therapy].
Eradication rate of Helicobacter pylori in dual therapy (omeprazole/amoxicillin) are reported in the range of 28-91%, side effect such as loose stool and skin reaction are reported 3.9-16.8%. In our study, eradication rate in dual therapy is 69.6% (lansoprazole/amoxicillin) and 74.0% (lansoprazole/clarithromycin). ⋯ In general, eradication rate of new triple therapy is effective in the range of 80-100%, and side effect are reported in 1.7-49%. However, Suzuki et al reported side effect decreased in new triple therapy adding mucosal protective agent.
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A 6-month regimen consisting of isoniazid (INH. 0.3-0.5 g).rifampicin (RFP. 0.3-0.45 g).pyrazinamide (PZA. 1.2-2.0 g) and streptomycin (SM. 0.75 g) or ethambutol (EB. 0.75-1.0 g) given for 2 month followed by isoniazid and rifampicin for 4 month is the preferred treatment for patients with fully susceptible organism, who adhere to treatment. Consideration should be given to treating all patients with directly observed treatment.