1/21. An uncommon association of H-type tracheoesophageal fistula with infantile hypertrophic pyloric stenosis.Although infantile hypertrophic pyloric stenosis following esophageal atresia repair is known, infantile hypertrophic pyloric stenosis following H-type tracheoesophageal fistula has not been encountered previously. A case of H-type tracheoesophageal fistula and infantile hypertrophic pyloric stenosis is presented. The patient, operated on for H-type fistula, a rare congenital anomaly of the esophagus, on the tenth day of life was readmitted 19 days later because of continuous vomiting after every feeding. The clinical findings and physical and radiological examinations revealed infantile hypertrophic pyloric stenosis which required surgical treatment. It is suggested that the association of H-type tracheoesophageal fistula with infantile hypertrophic pyloric stenosis is coincidental, given the estimated incidence of one in every 84,375,000 males and 337,500,000 females.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/21. Infantile hypertrophic pyloric stenosis in a 5-month-old baby: case report.Hypertrophic pyloric stenosis is commonly seen in infants 2 to 4 weeks old. We report a case of pyloric stenosis diagnosed in a boy 5 months and 11 days old suffering from the sudden onset of vomiting. Gastric volvulus was initially diagnosed at another hospital. Abdominal ultrasonography at first using an Acuson 5-MHz transducer revealed a negative diagnosis. However, a tubular pyloric mass measuring 5.5 mm in thickness, 15 mm in the transverse diameter, and 2.0 cm in length was detected by a 7-MHz transducer immediately after the infant vomited. On physical examination, no abdominal mass was palpable. This suggested that this might have been a case of hypertrophic pyloric stenosis which was missed until the infant was older than 5 months. We believe this is the oldest reported case of infantile hypertrophic pyloric stenosis in taiwan.- - - - - - - - - - ranking = 6.6027197118122keywords = physical examination, physical (Clic here for more details about this article) |
3/21. scoliosis in proteus syndrome: case report.STUDY DESIGN: The case of patient with scoliosis based on a rare hamartomatous, proteus syndrome, is reported. OBJECTIVES: To present the characteristics of scoliosis associated with proteus syndrome, and to investigate the mechanisms that cause it. SUMMARY OF BACKGROUND DATA: proteus syndrome, a rare hamartomatous disorder first coined by Wiedemann, manifests many clinical morphologic abnormalities including scoliosis. The characteristics and cause of scoliosis in this syndrome are fully unknown. methods: A patient with proteus syndrome was followed from the age of 3 months to the age of 21 years. This patient received spinal corrective surgery for severe scoliosis. Detailed investigations of the scoliosis as well as the physical and imaging examinations were performed to characterize the scoliosis. RESULTS: Computed tomography showed exclusive asymmetric appearance of lumbar spine, hypertrophy of the only right facet joints, and pedicles at L1-L4, which accorded with the right-side hemihypertrophy of the patient's extremities. CONCLUSIONS: scoliosis with proteus syndrome seems to be based on hemihypertrophy, with no influence of mechanical stress.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/21. Lumbar canal stenosis caused by hypertrophy of the posterior longitudinal ligament: case report.STUDY DESIGN: This is a case report of a patient with hypertrophy of the posterior longitudinal ligament (HPLL) in the lumbar spine, with assessment of operative treatment and a 10-year follow-up using magnetic resonance imaging. OBJECTIVES: To report on the long-term outcome of a case of lumbar HPLL, to review the literature on case reports of HPLL, and to outline the pathology of HPLL in the lumbar spine. SUMMARY OF BACKGROUND DATA: There have been several reports of HPLL in the cervical spine and thoracic spine. However, the authors found no reports of this condition in the lumbar spine and no reports of long-term follow-up. Two types of pathology are associated with HPLL: primary hypertrophy of the ligament and secondary hypertrophy associated with intervertebral disc herniation. methods: A 10-year follow-up evaluation of a 56-year-old man with HPLL at L2 is reported. The patient was observed using serial physical examinations, radiographs, and MRIs over 10 years. Because he did not respond to conservative management, surgical treatment was applied. After complete decompression by hemilaminectomy and resection of hypertrophied ligament, the nerve roots were freed of constriction through the neural foramens at L2 and L3. RESULTS: One year after the operation the patient was asymptomatic without evidence of recurrence of the disease. CONCLUSIONS: HPLL is a very rare disease. This appears to be the first report of the disease in the lumbar spine.- - - - - - - - - - ranking = 6.6027197118122keywords = physical examination, physical (Clic here for more details about this article) |
5/21. maintenance of breast size reduction after mastoplasty and switch to a protease inhibitor-sparing regimen in an hiv-positive woman with highly active antiretroviral therapy-associated massive breast enlargement.Fat distribution disorders are among the most frequent side effects of antiretroviral treatment. The pathophysiologic mechanism(s) for these events remains unclear, and a casual link to a specific drug or class of drugs is uncertain. The physical changes associated with the lipodystrophy syndrome can be divided into three major types: lipoatrophy or fat wasting; lipohypertrophy or fat accumulation; and mixed forms with atrophy and hypertrophy coexisting in different body regions. Fat accumulation can occur in one or more of several areas including dorsal-cervical and abdominal regions and breasts. Withdrawal of antiretroviral therapy does not seem to influence the stabilized lesions significantly, and no one of the therapeutic strategies adopted so far was capable to achieve substantial improvements. Here we describe the successful and lasting treatment of a massive and movement/posture-hampering breast hypertrophy with reductive mastoplasty.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/21. sciatica caused by piriformis muscle syndrome: report of two cases.The diagnosis of piriformis muscle syndrome, an unusual cause of sciatica, is difficult. However, with the advancement of imaging techniques, it has become clear that the condition is not just clinical speculation, but is a definite entity. We report on two cases with piriformis muscle syndrome, diagnosed on the basis of: a history of sciatica; physical findings, such as a tender point at the sciatic notch and around the piriformis muscle by palpation of the gluteal region, and by a digital pelvic examination; and computed tomography (CT) to demonstrate hypertrophy of the piriformis muscle. In both cases, a tenotomy of the piriformis muscle at the greater trochanter relieved entrapment of the sciatic nerve and gave satisfactory results. Since local tenderness at the piriformis muscle is the most reliable physical finding, a pelvic examination is recommended in the evaluation of suspected cases of piriformis muscle syndrome. CT is helpful in showing hypertrophy of the piriformis muscle. Detailed history taking, a careful physical examination, and versatile use of CT or magnetic resonance imaging can lead to an early, accurate diagnosis and proper treatment.- - - - - - - - - - ranking = 8.6027197118122keywords = physical examination, physical (Clic here for more details about this article) |
7/21. inclusion bodies in cerebral cortical astrocytes: a new change of astrocytes.A unique pathological finding of astrocytes was observed in the brain of a 20-year-old man who had severe physical and mental retardation. The brain was malformed showing micropolygyria in several cortical areas. A large number of hypertrophic astrocytes with eosinophilic granular substances in their cytoplasm were found throughout the cerebral cortex. Several staining procedures and electron microscopical examinations were carried out on these intracytoplasmic inclusion. It was found that the appearance and staining character of these inclusions were different from other astrocytic changes, especially the Rosenthal fiber, described so far. The authors consider that these inclusion bodies in cerebral cortical astrocytes represent new pathological changes of astrocytes that appear to be associated with malformation of the brain.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/21. Multiple congenital malformations including generalized hypertrichosis with gum hypertrophy in a child exposed to valproic acid in utero.Fetal valproate syndrome results from in utero exposure to valproic acid. It is characterized by a distinctive facial appearence, a cluster of minor and major anomalies, and central nervous system dysfunction. We report on a child exposed prenatally to valproic acid with unusual anomalies. This patient was the first child of young parents. Mother had several generalized seizures one year before this pregnancy, and since than she took valproic acid. pregnancy was otherwise uneventful. At birth physical examination showed generalized hypertrichosis sparing palms and soles, coarse face, gum hypertrophy, hypotonia, club feet and club hands, two annular constrictions of the right lower leg, and abnormal dermatoglyphics. Skeletal x-rays were normal. Gum hypertrophy and hypertrichosis may be part of a broader pattern of altered morphogenesis in fetus exposed to valproic acid or this patient had two conditions, fetal valproate syndrome and hypertrichosis with gum fibromatosis.- - - - - - - - - - ranking = 6.6027197118122keywords = physical examination, physical (Clic here for more details about this article) |
9/21. Familial juvenile hypertrophy of the breast.OBJECTIVE: Juvenile (virginal) hypertrophy of the breast (JHB) is a relatively rare condition leading to gigantomastia in peripubertal females. The pathology is limited usually to the breast, with otherwise normal growth and development and without any other deformities. The rapid growth of the breast (bilateral or unilateral) in adolescent girls leads to significant physical and psychological difficulties. This gigantomastia is treated surgically by breast reduction or mastectomy and its modification. Familial JHB was described only once in the literature, and its etiology is unknown. RESULTS: We report here on a familial pattern of juvenile hypertrophy of the breast accompanied by congenital anonychia. To the best of our knowledge, this is the first report of such a presentation. Our study dealt with four members of the same family, related through their fathers, enduring congenital anonychia of hands and feet with no functional limitation and who showed rapid uncontrolled breast enlargement in prepubertal age. This was severe enough to cause the curtailment of their social activity and cessation of schooling. The mothers of all four patients had normal breasts and nails, whereas their fathers had anonychia. The genetic basis for the association between the two clinical findings is yet to be determined. CONCLUSION: The four girls underwent breast reduction surgery.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/21. Unilateral breast enlargement 5 years after reduction mammaplasty.A 26-year-old woman presented with unilateral breast enlargement 5 years after bilateral reduction mammaplasty. After careful physical examination combined with a clinical assessment, mammogram, and histologic tissue examination, the patient underwent bilateral reduction mammaplasty using an inferior wedge resection technique. Histologic examination confirmed the diagnosis of a fibrocystic breast disease in both breasts. The most common differential diagnoses are juvenile fibroadenoma, virginal hypertrophy, fibrocystic disease, and cystosarcoma phylloides.- - - - - - - - - - ranking = 6.6027197118122keywords = physical examination, physical (Clic here for more details about this article) |
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