1/10. Focal myopathy induced by chronic heroin injection is reversible.We report a patient who developed a focal myopathy with prominent contractures of his thigh muscles induced by chronic heroin injection. Muscle biopsy and magnetic resonance imaging (MRI) were indicative of a fibrotic and inflammatory process. Treatment with steroids, D-penicillamine, and physical therapy led to full functional recovery within 6 months. Sequential electromyographic (EMG) studies and muscle biopsies showed evidence of regenerating muscle fibers and absence of inflammatory cells. We conclude that heroin-induced focal myopathy is reversible and that combination therapy with D-penicillamine and steroids may be useful.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/10. male inflammatory breast cancer.A case of a 48-year-old male with an inflammatory breast cancer is used to illustrate this uncommon malignancy. The physical examination of thickening and erythema made the clinical diagnosis. Mammographic findings of increased density in the right breast with coarsened stroma and an underlying mass confirmed the clinical findings. The sonographic evaluation revealed a 2-cm ill-defined hypoechoic mass. The pathologic examination of the mastectomy specimen showed an infiltrating duct cell carcinoma with lobular features. male breast cancer afflicts 1500 men each year. Clinically it must be differentiated from gynecomastia, a much more common and benign condition.- - - - - - - - - - ranking = 9.1912976745873keywords = physical examination, physical (Clic here for more details about this article) |
3/10. Feminizing sertoli cell tumor associated with peutz-jeghers syndrome.peutz-jeghers syndrome (PJS) is an autosomal dominant disorder characterized by the association of mucocutaneous pigmentation and multiple gastrointestinal hamartomatous polyps and with an increased risk of developing gonadal sex tumors besides other malignancies. We describe a 7 1/2 year-old boy with PJS and bilateral gynecomastia. He has had buccal pigmentation since 1.5 years and had been operated for rectal polyp excision at 3.5 years. On physical examination, his height was at the 90th percentile, and his height age and bone age were 9 and 10 1/2 years, respectively. Increased melanotic buccal pigmentation of the lips and bilateral gynecomastia were noticed. Both of the testes were firm, non-tender and smooth on the surface, and each measured 8 ml. Hormonal measurements were all in the prepubertal range. testis ultrasonography showed bilateral hyperechogenic areas within the glands. When he was operated for invagination and an ileum segment full of polyps was resected, bilateral testicular biopsies were also performed. Histopathological evaluation of the testes revealed bilateral multicentric benign Sertoli cell tumors. The aromatase inhibitor testolactone was started to slow skeletal maturation. On the basis of this and previous reports, PJS associated with sex-cord tumors is increasingly recognized in males as well as in females.- - - - - - - - - - ranking = 9.1912976745873keywords = physical examination, physical (Clic here for more details about this article) |
4/10. Gynaecomastia: is one cause enough?Gynaecomastia can be detected in between one-third and two-thirds of men. A wide variety of causes of gynaecomastia, some physiological, some very serious, have been identified. We present a case in which the cause of the gynaecomastia seemed obvious after history taking and physical examination but we finally ended up with a more complex combination of diagnoses. This case stresses the importance of combining history taking and physical examination with additional laboratory testing for the assessment of gynaecomastia.- - - - - - - - - - ranking = 18.382595349175keywords = physical examination, physical (Clic here for more details about this article) |
5/10. New X-linked syndrome of mental retardation, gynecomastia, and obesity is linked to DXS255.We describe 14 males from 3 successive generations in a family who have X-linked mental retardation (XLMR), obesity, gynecomastia, speech difficulties, emotional lability, tapering fingers, and small feet. Linkage analysis using markers spread along the X chromosome demonstrated a gene localisation close to the centromere. Maximum lod scores for markers near the centromere, all at theta = 0.00, were 1.36 for DXS72, and 1.46 for DXYS1. The closest flanking markers which showed recombination were DXS84 and DXS94, defining the physical localisation within Xp21.1-q22. DXS255 was fully informative with lod-1 confidence interval for theta of 0.00-0.12. Clinical findings and linkage data in this family distinguish it from the Borjeson-Forssman-Lehmann syndrome and other previously described XLMR syndromes.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/10. gynecomastia. A bothersome but readily treatable problem.Although breast enlargement in boys and men can cause both psychological and physical distress, the disorder is rarely serious and is readily treatable. Several factors can lead to the estrogenic excess that causes growth of breast tissue. Dr Jacobs describes a patient with gynecomastia related to cirrhosis of the liver who responded promptly to a brief course of tamoxifen citrate therapy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/10. prevalence of Klinefelter's syndrome (47,XXY) in a general male population.In a representative sample of 3,840 males examined for military service chromosome examination was made in those with testes equal to or less than 12 ml and those with a stature equal to or greater than 181 cm, as well as in males not recruited because of physical or mental disability. Testes equal to or less than 12 ml were found in 59 patients (1.45%). Three of these males had a 47,XXY karyotype (5.1%), the prevalence among the total sample of 3,840 being 0.78 per 1,000. Hypogonadal signs, except for gynaecomastia, which was only present in one patient, were found in the saem proportion as in 47,XXY males ascertained in institutions and clinics. The results of EEG investigations were alos similar to those found in psychiatric institutions. The intelligence level was comparatively low; none had an IQ above 100. The personality traits corresponded to those found in institutionalized Klinefelter males.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/10. Pectoralis major ruptures postsuction lipectomy for surgical management of gynecomastia.Over the last decade, suction-assisted lipoplasty has been shown to be a safe and reliable procedure in the hands of trained individuals. A large number of plastic surgeons employ liposuction as an adjunct to surgery for gynecomastia with excellent results and low morbidity. An unusual problem, traumatic rupture of the pectoralis major muscle, has been observed by us in a patient who had undergone the procedure. The physical deficit arising from the injury may go unnoticed in all but the most physically active people, and surgeons should be wary of the possibility of this previously unreported complication.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
9/10. Combined surgical correction of bilateral congenital lower limb lymphedema with associated anomalies.An unusual combination of congenital malformations in a 16-year-old emotionally disturbed man is described. The anomalies included severe congenital bilateral leg lymphedema, bilateral gynecomastia, unilateral cataract, and malformed external genitalia. Genetic and hormonal investigations were unremarkable. Multiple concomitant operations (vascular and plastic surgeons) to correct the deformities and restore physical well-being and self-esteem were undertaken.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/10. An adult with 49,XYYYY karyotype: case report and endocrine studies.Sex chromosome abnormalities, such as 47,XXX, 47,XXY, 47,XYY, and 45,X, are relatively common and occur in approximately 1 of 400 births. Sex chromosome tetrasomy and pentasomy are much rarer events. The somatic and developmental consequences of supernumerary sex chromosomes have not been studied adequately. This is especially true of individuals with only supernumerary Y chromosomes. Based on available case reports, the effects of extra Y chromosomes appear not as severe as those of supernumerary X chromosomes. Only two case reports of nonmosaic tetrasomy of the y chromosome have been published. We evaluated a 30-year-old man with a 49,XYYYY karyotype and assessed his severe physical and mental handicaps (particularly the endocrine abnormalities) and attempted to clarify the effects of extra Y chromosomes on growth, development, and behavior.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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