An asymptomatic enlargement of the medial clavicle is a condition that is often both missed and misdiagnosed. We review the most common causes of an isolated and asymptomatic enlargement of the medial clavicle. Underlying aetiologies... more
An asymptomatic enlargement of the medial clavicle is a condition that is often both missed and misdiagnosed. We review the most common causes of an isolated and asymptomatic enlargement of the medial clavicle. Underlying aetiologies include osteoarthritis of the sternoclavicular joint, condensing osteitis, spontaneous dislocation of the sternoclavicular joint, and sternocostoclavicular hyperostosis. Key points in the history and physical examination as well as characteristic radiographic findings are sufficient for correct diagnoses. Treatment is conservative.
Nasal obstruction due to chronic enlargement of the inferior turbinate is a common problem for the ENT surgeon. This review will discuss the pathology of 'bilateral' and 'unilateral' turbinate enlargement associated with... more
Nasal obstruction due to chronic enlargement of the inferior turbinate is a common problem for the ENT surgeon. This review will discuss the pathology of 'bilateral' and 'unilateral' turbinate enlargement associated with chronic rhinitis and nasal septal deviation, and focus on the structural changes in the turbinates. Cellular hyperplasia, tissue oedema and vascular congestion all contribute to turbinate enlargement, but there is some evidence that bony enlargement is associated with unilateral turbinate enlargement. There is no evidence for cellular hypertrophy despite the common use of the term 'turbinate hypertrophy' and this term should be replaced with the more correct term of 'turbinate enlargement'. The underlying pathology of turbinate enlargement has important implications for the surgical management of nasal obstruction.
The present study aimed at comparing the effects of traditional resistance training (TRT) and power training (PT) in inducing muscle hypertrophy in older men. Twenty older men (aged between 69 and 76 years) were divided in two groups: TRT... more
The present study aimed at comparing the effects of traditional resistance training (TRT) and power training (PT) in inducing muscle hypertrophy in older men. Twenty older men (aged between 69 and 76 years) were divided in two groups: TRT training (n=9) and PT training (n=11). The volunteers trained twice a week, during 10 weeks. Both groups performed an equal work output and the same exercises with loads between 40% and 60% of 1 RM. Three sets of eight repetitions of each exercise were performed with rest intervals of 90 s between sets. Muscle thickness was measured by ultrasound at the biceps brachii (BIC) and rectus femoris (RF), using a 12 MHz high resolution scanning probe. An ANCOVA was used to compare post training muscle thickness values between TRT and PT, using baseline values as covariates. According to the results, RF muscle thickness increased only in PT, while BIC muscle thickness increased in both groups, but with larger increases in PT. In conclusion, ten weeks of PT...
To present a radiculopathy case due to unilateral facet hypertrophy developing three years after a lumbar disc hernia operation. A fifty two-year-old female patient, who had been operated on for a left L5-S1 herniated lumbar disc three... more
To present a radiculopathy case due to unilateral facet hypertrophy developing three years after a lumbar disc hernia operation. A fifty two-year-old female patient, who had been operated on for a left L5-S1 herniated lumbar disc three years ago, was hospitalized and re-operated with a diagnosis of unilateral facet hypertrophy. She had complaints of left leg pain and walking restrictions for the last six months. Left Straight Leg Raising test was positive at 40 degrees , left ankle dorsiflexion muscle strength was 4/5, left Extensor Hallucis Longus muscle strength was 3/5, and left Achilles reflex was hypoactive. Lumbar spinal Magnetic Resonance Imaging revealed left L5-S1 facet hypertrophy. Lumbar radiculopathy due to lumbar facet hypertrophy is a well-known neurological condition. Radicular pain develops during the late postoperative period following lumbar disc hernia operations that are often related to recurrent disc herniation or to formation of post-operative scar tissue. In ...
Objective: To compare the effects of different resistance training programs on measures of muscle strength and hypertrophy. Methods: Sixty-seven untrained subjects were randomized to one of two groups: Split Workout Routine (n=35), in... more
Objective: To compare the effects of different resistance training programs on measures of muscle strength and hypertrophy. Methods: Sixty-seven untrained subjects were randomized to one of two groups: Split Workout Routine (n=35), in which muscle groups were trained twice per week in an A/B split consisting of eight sets per session, or Full-Body Workout Routine (n=32), in which muscle groups were trained four times per week with four and eight sets per session. Both groups performed eight to 12 repetition maximum per set, with 60 seconds of rest between sets. Maximal strength and muscle thickness were assessed at baseline and after eight weeks of training. Results: A significant main effect of time (pre versus post) was observed for maximal strength in the bench press and squat exercises and thickness of the elbow extensor, elbow flexor and quadriceps femoris muscles. Selected variables did not differ significantly between groups. Conclusion: Resistance training twice or four times per week has similar effects on neuromuscular adaptation, provided weekly set volume is equal.
We sought to reintroduce a historical procedure-intracapsular tonsillar reduction (partial tonsillectomy or tonsillotomy)-for tonsillar hypertrophy causing obstructive sleep disordered breathing (OSDB) in children, as well as to determine... more
We sought to reintroduce a historical procedure-intracapsular tonsillar reduction (partial tonsillectomy or tonsillotomy)-for tonsillar hypertrophy causing obstructive sleep disordered breathing (OSDB) in children, as well as to determine whether partial tonsillectomy, compared with conventional (total) tonsillectomy when performed by more than one surgeon, is equally effective for the relief of OSDB while resulting in less pain and more rapid recovery. We conducted a retrospective case series at a tertiary children's hospital. The charts of children who underwent partial tonsillectomy and total tonsillectomy (1998 through 2002) for postoperative complications were reviewed. The caregivers were surveyed to assess postoperative pain, rapidity of recovery, and effectiveness of surgery for relieving symptoms of OSDB. Two hundred forty-three children underwent partial tonsillectomy and 107 children underwent total tonsillectomy. There were no significant differences in immediate and delayed complications between the groups. Both operations were equally effective in relieving OSDB. Children who had partial tonsillectomy had significantly less postoperative pain and significantly more rapid recovery. Intracapsular tonsillar reduction with an endoscopic microdebrider relieves OSDB as effectively as conventional tonsillectomy, but results in less postoperative pain and a more rapid recovery.
Needle biopsy samples were taken from vastus lateralis muscle (VL) of five male body builders (BB, age 27.4+/-0.93 years; mean+/-s.e.m.), who had being performing hypertrophic heavy resistance exercise (HHRE) for at least 2 years, and... more
Needle biopsy samples were taken from vastus lateralis muscle (VL) of five male body builders (BB, age 27.4+/-0.93 years; mean+/-s.e.m.), who had being performing hypertrophic heavy resistance exercise (HHRE) for at least 2 years, and from five male active, but untrained control subjects (CTRL, age 29.9+/-2.01 years). The following determinations were performed: anatomical cross-sectional area and volume of the quadriceps and VL muscles in vivo by magnetic resonance imaging (MRI); myosin heavy chain isoform (MHC) distribution of the whole biopsy samples by SDS-PAGE; cross-sectional area (CSA), force (Po), specific force (Po/CSA) and maximum shortening velocity (Vo) of a large population (n=524) of single skinned muscle fibres classified on the basis of MHC isoform composition by SDS-PAGE; actin sliding velocity (Vf) on pure myosin isoforms by in vitro motility assays. In BB a preferential hypertrophy of fast and especially type 2X fibres was observed. The very large hypertrophy of V...
Synopsis: Adolescent and pre-menarchal patients with symptomatic unilateral labial hypertrophy should be counselled extensively prior to surgical management regarding risks of recurrence or contralateral occurrence. Purpose: Present the... more
Synopsis: Adolescent and pre-menarchal patients with symptomatic unilateral labial hypertrophy should be counselled extensively prior to surgical management regarding risks of recurrence or contralateral occurrence. Purpose: Present the management of two unique cases of adolescent girls with unilateral labial hypertrophy. Case 1: 9 year-old pre-menarchal patient with a five-month history of unilateral labial hypertrophy causing discomfort that limited daily activities. External pelvic examination revealed grossly asymmetric labia minora. The left labia minora measured 5 cm in length. After counseling, the patient underwent unilateral labioplasty with resolution of symptoms. Patient returned after two years complaining of contralateral labial hypertrophy.The patient again underwent surgical management due to discomfort and interference with normal daily activities. Case 2: 12 year-old post-menarchal patient with a history of unilateral labial hypertrophy causing irritation and discomfort starting prior to menarche. External pelvic exam revealed grossly asymmetric labia minora. The right labia minora measured 4.5cm in length. The patient underwent unilateral labioplasty with resolution of her symptoms. After 2 years of follow up, patient remained asymptomatic. Conclusion: Adolescence unilateral labial hypertrophy may represent a normal variant and surgery should be delayed until achieving full puberty. However, when it causes significant discomfort or interferes with normal daily activities, surgical management should be considered after counseling regarding recurrence or contralateral occurrence. Keywords: Adolescence; Unilateral labial Hypertrophy; Premenarchal; Labioplasty.
Sports nutrition is a constantly evolving field with hundreds of research papers published annually. In the year 2017 alone, 2082 articles were published under the key words 'sport nutrition'. Consequently, staying current with... more
Sports nutrition is a constantly evolving field with hundreds of research papers published annually. In the year 2017 alone, 2082 articles were published under the key words 'sport nutrition'. Consequently, staying current with the relevant literature is often difficult. This paper is an ongoing update of the sports nutrition review article originally published as the lead paper to launch the Journal of the International Society of Sports Nutrition in 2004 and updated in 2010. It presents a well-referenced overview of the current state of the science related to optimization of training and performance enhancement through exercise training and nutrition. Notably, due to the accelerated pace and size at which the literature base in this research area grows, the topics discussed will focus on muscle hypertrophy and performance enhancement. As such, this paper provides an overview of: 1.) How ergogenic aids and dietary supplements are defined in terms of governmental regulation ...
Priapism is a common complication of sickle cell anemia. We report a little known sequela of priapism: painless megalophallus, with significant penile enlargement. The patient had had an intense episode of priapism 9 years previously and... more
Priapism is a common complication of sickle cell anemia. We report a little known sequela of priapism: painless megalophallus, with significant penile enlargement. The patient had had an intense episode of priapism 9 years previously and his penis remained enlarged. Blood oxygen level-dependent magnetic resonance imaging revealed enlarged, hypoxic corpora cavernosa. Megalophallus probably resulted from permanent loss of elasticity of the tunica albuginea due to severe engorgement during the episode of priapism. This sequela needs to be recognized by physicians because no intervention is necessary and sexual function seems to remain intact.
Functional data suggest that the kinetics of force production and relaxation are slowed in hypertrophied skeletal muscle because of chronic overload. The purpose of this study was to determine whether gene expression of the slow/cardiac... more
Functional data suggest that the kinetics of force production and relaxation are slowed in hypertrophied skeletal muscle because of chronic overload. The purpose of this study was to determine whether gene expression of the slow/cardiac isoform of the sarcoplasmic reticulum (SR) Ca(2+)-adenosinetriphosphatase (ATPase) pump is upregulated in overloaded fast-twitch plantaris muscles. Increased active muscle loading was induced in rat plantaris muscles bilaterally by surgical removal of gastrocnemius and soleus muscles. Mass of the plantaris muscle was 80% greater 5 wk after surgery than in age-matched unoperated control rats (P < 0.05). Expression of the slow pump mRNA was 135% greater in hypertrophied muscles, as determined from autoradiograms of Northern blots with use of a cDNA probe specific for the slow/cardiac isoform. A monoclonal antibody (7E6) was used to quantify slow Ca2+ pump in SR vesicles with use of Western blot analysis. Densitometry of blots showed that the relativ...
Juvenile hypertrophy of the breast (JHB) is an uncommon, benign disorder and typically occurs in peri-pubertal females. The etiology ofJHB is uncertain. It may represent an end-organ hypersensitivity of the breast to normal levels of sex... more
Juvenile hypertrophy of the breast (JHB) is an uncommon, benign disorder and typically occurs in peri-pubertal females. The etiology ofJHB is uncertain. It may represent an end-organ hypersensitivity of the breast to normal levels of sex steroids. Clinically, it is characterized by rapid enlargement of breasts, either unilateral or bilateral. The definitive diagnosis is made by histopathologic examination. Treatment recommendations include surgery and hormonal therapy, although hormonal manipulation is still controversial in pediatric patients. Here we report a 13-year-old girl with unilateral JHB who did not require surgery or medical treatment.
