An odd looking man

No abstract available.     

An asian man with recurrent abdominal pain

Recurrent pyogenic cholangitis (RPC), or oriental cholangiohepatitis, is characterized by intrabiliary pigment stone formation, whose main manifestation consists of recurrent episodes of cholangitis, although other biliopancreatic complications can also occur. RPC develops mainly in Asian patients, in whom this entity is one of the main causes of acute abdominal pain. The differential diagnosis should be established with all other entities associated with intrahepatic stone formation, which is more common in Asian countries compared with the predominance of gallstone formation in the West. The diagnostic and therapeutic approach requires collaboration among gastroenterologists, radiologists and gastrointestinal surgeons. We review the most important clinical, diagnostic and therapeutic features of this entity, which, although clearly predominant in Asia, is increasingly diagnosed in our setting.     

An aggressive neuroendocrine tumour in a man with AIDS

Pancreatic neuroendocrine tumours (PETs), though rare, are usually slow growing tumours with a relatively good prognosis. We describe a case of an aggressive malignant neuroendocrine tumour of the pancreas occurring in an AIDS patient, which has not been reported previously.     

An unusual cause of breathlessness in a young man

Amphetamine abuse is a common problem in the developed world. Cardiomyopathy secondary to amphetamine abuse is rare in the general population. The present report describes a 34-year-old man who presented with shortness of breath. Following further investigations, the cause of his breathlessness was determined to be amphetamine abuse. The incidence of amphetamine abuse and its cardiac sequelae are reviewed. The mechanism of amphetamine-induced dilated cardiomyopathy is analyzed, with further review of its complications and treatment.     

Left atrial rhythm in man: An experimental study

Ten patients with atrial septal defect of the secondum variety undergoing diagnostic haemodynamic study were subjected to electrical stimulation of the endocardium of the left atrium using a bipolar pacing electrode catheter. The polarity, frontal plane P wave axis and P wave configuration were analysed from ten scalar 12 lead electrocardiogram (ECG), recorded at 25–50 mm/sec during sinus rhythm and left atrial stimulation. While four patients demonstrated the “dome and dart” appearance of P waves in V₁, nine out of ten patients revealed upright P waves in V₁ during left atrial pacing; one patient showed inverted P waves in V₁–V₆. Four patients had negative ‘P’ waves in L₁ and only five of ten patients had inverted ‘P’ waves in L₁ and V₆. All the criteria of left atrial rhythm were present in only one patient. It appears that the ‘P’ wave changes during left atrial pacing are variable and that the typical findings of left atrial rhythm are not obtained in all cases. This study was planned because trans-septal left atrial stimulation in the genesis of left atrial rhythm has not been widely reported.     

An evaluation of hormonal changes at puberty in man

The pulsatile nature of the secretion of gonadotrophins, sex steroids and growth hormone are important in both the onset and maintenance of sexual maturation. The night-time is intimately related to the endocrine events which result in puberty, such that hormone measurements during the daytime have little meaning. This relationship between the night-time and gonadal function is not restricted to puberty but continues in adult life; the onset of the preovulatory LH surge occurs in the early hours of the morning. Girls seem more sensitive to small changes in GnRH concentrations than boys, which is why the physical signs of puberty appear slightly earlier in them. Low levels of oestradiol appear to assist growth hormone secretion, whereas higher levels of testosterone are required for the same effect. This probably explains the sex differences in the timing of the pubertal growth spurts.     

1例85岁男性甲状腺癌广泛转移

1 病历摘要 患者,男性,85岁。主诉因进食梗噎、食欲减退半月于1998年8月19日入院。患者既往有高血压病、冠心病、心肌梗死,曾行右侧甲状腺乳头状癌切除术。入院查体发现甲状腺右叶区可扪及2cm质硬包块。胸部CT:双肺可见结节状、点状、斑片状高密度影。腹部CT:右肾内侧缘实质可见突向外