Demonstration of subcuticular or intradermal suturing technique for wound closure in the operating room.

Hydatid Cyst Removal from the brain

Highlights of a fetal laser surgery for twin-to-twin transfusion syndrome (TTTS) will be shown from Tampa General Hospital

TTTS affects 10 to 15 percent of identical-twin pregnancies and is the result of abnormal blood exchange between identical twins through a common placenta. The larger of the twins, or recipient, is surrounded by too much amniotic fluid and in danger of heart failure as its body tries to pump the overwhelming volume of blood intended for both. The smaller, or donor twin, is encased in a shrinking amniotic sac deprived of blood. Without treatment, both will likely die.

Rubén Quintero, M.D., Medical Director of Maternal Fetal Medicine/Fetal Surgery at Tampa General Hospital and Professor and Director of the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida College of Medicine will narrate the procedure and answer e-mail questions live as taped highlights of the procedure are shown.

Most intact aortic aneurysms do not produce symptoms. As they enlarge, symptoms such as abdominal pain and back pain may develop. Compression of nerve roots may cause leg pain or numbness. Untreated, aneurysms tend to become progressively larger, although the rate of enlargement is unpredictable for any individual. Rarely, clotted blood which lines most aortic aneurysms can break off and result in an embolus. They may be found on physical examination. Medical imaging is necessary to confirm the diagnosis. Symptoms may include: anxiety or feeling of stress; nausea and vomiting; clammy skin; rapid heart rate. In patients presenting with aneurysm of the arch of the aorta, a common symptom is a hoarse voice as the left recurrent laryngeal nerve (a branch of the vagus nerve) is stretched. This is due to the recurrent laryngeal nerve winding around the arch of the aorta. If an aneurysm occurs in this location, the arch of the aorta will swell, hence stretching the left recurrent laryngeal nerve. The patient therefore has a hoarse voice as the recurrent laryngeal nerve allows function and sensation in the voicebox. Abdominal aortic aneurysms, hereafter referred to as AAAs, are the most common type of aortic aneurysm. One reason for this is that elastin, the principal load-bearing protein present in the wall of the aorta, is reduced in the abdominal aorta as compared to the thoracic aorta (nearer the heart). Another is that the abdominal aorta does not possess vasa vasorum, hindering repair. Most are true aneurysms that involve all three layers (tunica intima, tunica media and tunica adventitia), and are generally asymptomatic before rupture. The most common sign for the aortic aneuysm is the Erythema nodosum also known as leg lesions typically found near the ankle area. The prevalence of AAAs increases with age, with an average age of 65–70 at the time of diagnosis. AAAs have been attributed to atherosclerosis, though other factors are involved in their formation. An AAA may remain asymptomatic indefinitely. There is a large risk of rupture once the size has reached 5 cm, though some AAAs may swell to over 15 cm in diameter before rupturing. Before rupture, an AAA may present as a large, pulsatile mass above the umbilicus. A bruit may be heard from the turbulent flow in a severe atherosclerotic aneurysm or if thrombosis occurs. Unfortunately, however, rupture is usually the first hint of AAA. Once an aneurysm has ruptured, it presents with a classic pain-hypotension-mass triad. The pain is classically reported in the abdomen, back or flank. It is usually acute, severe and constant, and may radiate through the abdomen to the back. The diagnosis of an abdominal aortic aneurysm can be confirmed at the bedside by the use of ultrasound. Rupture could be indicated by the presence of free fluid in potential abdominal spaces, such as Morison's pouch, the splenorenal space (between the spleen and left kidney), subdiaphragmatic spaces (underneath the diaphragm) and peri-vesical spaces. A contrast-enhanced abdominal CT scan is needed for confirmation. Only 10–25% of patients survive rupture due to large pre- and post-operative mortality. Annual mortality from ruptured abdominal aneurysms in the United States alone is about 15,000. Another important complication of AAA is formation of a thrombus in the aneurysm.

Nearly 300 million people experience the world without certain colors every day. ‘Color For the Colorblind’ is a short documentary about what happened when we partnered with EnChroma, maker of color blindness-correcting glasses, to help people experience colors for the first time.

This animation describes what anti-TNF-alpha therapies are, how they work, and how patients with inflammatory bowel disease (IBD) can benefit.

Endoscopic crushing of a bladder stone

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MEDICAL ANIMATION TRANSCRIPT:

Laparoscopic Ovarian Drilling (LOD)

A surgical treatment for women with PCOS
Women with PCOS usually have ovaries with a thick outer layer.
Ovarian drilling works by breaking through the thick outer surface and lowering the amount of testosterone made by the ovaries

A small incision is made in the abdomen.
Carbon dioxide gas is used to inflate the abdomen.
Very small holes are made in the ovaries.
Ovarian drilling can help restore ovulation and improve the chances of becoming pregnant.
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*TimeStamps*
0:00 Introduction
0:15 Procedure of Laparoscopic Ovarian Drilling (LOD)
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Let us watch this 3D video to understand what is Laparoscopic Ovarian Drilling for PCOS, why it is done, how well it works, and what to expect.
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#pcos #pcostreatment #laparascopicovariandrilling

Implantation of a long-lasting implant for diabetic macular edema (DME)- steroidal implants

A little boy with a mystifying eye condition finally found an answer on the other side of the globe with the help of Dr. Harry Chugani at Children's Hospital of Michigan. ~ Detroit Medical Center

Ovarian cancer warning signs include ongoing pain or cramps in the belly or back, abnormal vaginal bleeding, nausea, and bloating. Depending on the cancer stage, ovarian cancer treatment includes surgery and chemotherapy.

Histology of Uterus

Laparoscopy Gunshot Wound to Abdomen

Rapid cycling is a pattern of frequent, distinct episodes in bipolar disorder. In rapid cycling, a person with the disorder experiences four or more episodes of mania or depression in one year

Appendectomy (midline caecum)

Gowers' sign is a medical sign that indicates weakness of the proximal muscles, namely those of the lower limb. The sign describes a patient that has to use his hands and arms to "walk" up his own body from a squatting position due to lack of hip and thigh muscle strength. It is named for William Richard Gowers. Gowers' sign is classically seen in Duchenne muscular dystrophy, but also presents itself in centronuclear myopathy, myotonic dystrophy and various other conditions associated with proximal muscle weakness. For this maneuver, the patient is placed on the floor away from any objects that could otherwise be used to pull oneself to a standing position. It is also used in testing paraplegia.

The best way to prepare yourself for your small group exercises is to first watch the cardiac exam video from beginning to end, then proceed through all the explanations of cardiac anatomy and physiology that follow. To go through the material in the recommended sequence, just click the "Next" button in the upper right corner of the screen. But you may also jump to any section using the menu to the left.

A 55-year-old man presented with recurrent epistaxis. After endoscopic sphenopalatine artery cauterization, the bleeding stopped. The patient was doing well at last follow up.