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Breast Cancer spreads by 3 mechanisms- local spread, by lymph nodes, or through the blood. Dr. Lorraine Champion, and Dr. Lisa Bailey discuss how breast cancer spreads. They discuss the different methods of spread and how this will affect the treatment of breast cancer.
This procedure describes one of the most versatile approaches to the anterior skull base for large tumors of the sinonasal cavity. It may be used with or without a craniofacial resection. The benefits of this approach are: wide access around the tumor; good postoperative cosmesis; & decreased operative & postoperative morbidity. We have used this approach for many bilateral tumors of the nasal & sinus cavities that approach &/or invade the skull base & brain. This video show the resection of a large esthesioneuroblastoma.
Bronchiectasis is an abnormal dilation of the proximal and medium-sized bronchi (>2 mm in diameter) caused by weakening or destruction of the muscular and elastic components of the bronchial walls. Affected areas may show a variety of changes, including transmural inflammation, edema, scarring, and ulceration, among other findings. Distal lung parenchyma may also be damaged secondary to persistent microbial infection and frequent postobstructive pneumonia. Bronchiectasis can be congenital but is most often acquired.[9] Congenital bronchiectasis usually affects infants and children. These cases result from developmental arrest of the bronchial tree. Acquired forms occur in adults and older children and require an infectious insult, impairment of drainage, airway obstruction, and/or a defect in host defense. The tissue is also damaged in part by the host response of neutrophilic proteases, inflammatory cytokines, nitric oxide, and oxygen radicals. This results in damage to the muscular and elastic components of the bronchial wall. Additionally, peribronchial alveolar tissue may be damaged, resulting in diffuse peribronchial fibrosis.[12] The result is abnormal bronchial dilatation with bronchial wall destruction and transmural inflammation. The most important functional finding of altered airway anatomy is severely impaired clearance of secretions from the bronchial tree. Impaired clearance of secretions causes colonization and infection with pathogenic organisms, contributing to the purulent expectoration commonly observed in patients with bronchiectasis. The result is further bronchial damage and a vicious cycle of bronchial damage, bronchial dilation, impaired clearance of secretions, recurrent infection, and more bronchial damage
Massive bone defects (>8 cm) will not unite without an additional intervention. They require a predictable, durable, and efficient method to regrow bone. The Ilizarov method of tension stress, or distraction osteogenesis, first involves a low-energy osteotomy1 - 5. The bone segments are then pulled apart, most often using an external device at a specific rate and rhythm (distraction phase), after which the newly formed bone (the regenerate) requires time for consolidation. The consolidation phase is variable and usually requires a substantially greater amount of time before the external device can be removed. Our technique of tibial bone transport over an intramedullary nail using cable and pulleys combines internal and external fixation, allowing the external fixator to be removed at the end of the distraction phase. This increases the efficiency of limb reconstruction and decreases the external-fixator-associated complications.
A ventricular septal defect (VSD) is an opening or hole in the wall that separates the two lower chambers of the heart. This wall is called the ventricular septum. The hole causes oxygen-rich blood to leak from the left side of the heart to the right side. This causes extra work for the right side of the heart, since more blood than necessary is flowing through the right ventricle to the lungs.
Upper right quadrant: The right upper quadrant contains the liver and gallbladder, which are protected by the lower right part of the ribcage. The large intestine, or colon, also spends a little time in this section. Upper left quadrant: The left upper quadrant contains part of the stomach and the spleen.
In this medical video: This 72-year-old patient was unable to resist blinking when we tapped on the glabella. This is the glabellar reflex or Myerson's sign . It is often an early sign of Parkinson's disease, but can also be seen in early dementia as well as other progressive neurologic illness. Note the left (i.e., asymmetrical) hand resting tremor.
The digestive system is a group of organs working together to convert food into energy and basic nutrients to feed the entire body. Food passes through a long tube inside the body known as the alimentary canal or the gastrointestinal tract (GI tract).
Phlebitis may occur with or without a blood clot. It can affect surface or deep veins. When caused by a blood clot, it's called thrombophlebitis. Trauma to the vein, for instance from an IV catheter, is a possible cause. Symptoms include redness, warmth, and pain in the affected area. Treatments may include a warm compress, anti-inflammatory medication, compression stockings, and blood thinners.