Most corneal transplants performed in the U.S. involve replacing the entire thickness of the diseased cornea with a healthy donor cornea (called penetrating keratoplasty or PK). In partial-thickness corneal transplants (LK), only the anterior (surface) layers of the cornea are removed. The donor cornea is then attached to the host corneal bed, containing only posterior (deeper) layers. LK is less risky, but tends to result in somewhat inferior vision vs. PK and cannot be performed if the disease process (e.g. scar) involves the deeper layers of the cornea.

Nystagmus is a condition of involuntary (or voluntary, in rare cases) eye movement, acquired in infancy or later in life, that may result in reduced or limited vision. Due to the involuntary movement of the eye, it has been called "dancing eyes"

here may be no symptoms of stomach cancer early on. Later, symptoms include feeling bloated after eating, feeling full after eating small amounts of food, nausea, heartburn, or indigestion.

The major elements of the cardiac exam include observation, palpation and, most importantly, auscultation (percussion is omitted). As with all other areas of the physical exam, establishing adequate exposure and a quiet environment are critical. Initially, the patient should rest supine with the upper body elevated 30 to 45 degrees. Most exam tables have an adjustable top. If not, use 2 or 3 pillows. Remember that although assessment of pulse and blood pressure are discussed in the vital signs section they are actually important elements of the cardiac exam.

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What is Esophageal Dilation?
Esophageal dilation is a procedure that allows your doctor to dilate, or stretch, a narrowed area of your esophagus [swallowing tube]. Doctors can use various techniques for this procedure. Your doctor might perform the procedure as part of a sedated endoscopy. Alternatively, your doctor might apply a local anesthetic spray to the back of your throat and then pass a weighted dilator through your mouth and into your esophagus.
Why is it Done?
The most common cause of narrowing of the esophagus, or stricture, is scarring of the esophagus from reflux of acid occurring in patients with heartburn. Patients with a narrowed portion of the esophagus often have trouble swallowing; food feels like it is "stuck" in the chest region, causing discomfort or pain. Less common causes of esophageal narrowing are webs or rings (which are thin layers of excess tissue), cancer of the esophagus, scarring after radiation treatment or a disorder of the way the esophagus moves [motility disorder].
How Should I Prepare for the Procedure?
An empty stomach allows for the best and safest examination, so you should have nothing to drink, including water, for at least six hours before the examination. Your doctor will tell you when to start fasting.
Tell your doctor in advance about any medications you take, particularly aspirin products or anticoagulants (blood thinners). Most medications can be continued as usual, but you might need to adjust your usual dose before the examination. Your doctor will give you specific guidance. Tell your doctor if you have any allergies to medications as well as medical conditions such as heart or lung disease. Also, tell your doctor if you require antibiotics prior to dental procedures, because you might need antibiotics prior to esophageal dilation as well.
What Can I Expect during Esophageal Dilation?
Your doctor might perform esophageal dilation with sedation along with an upper endoscopy. Your doctor may spray your throat with a local anesthetic spray, and then give you sedatives to help you relax. Your doctor then will pass the endoscope through your mouth and into the esophagus, stomach and duodenum. The endoscope does not interfere with your breathing. At this point your doctor will determine whether to use a dilating balloon or plastic dilators over a guiding wire to stretch your esophagus. You might experience mild pressure in the back of your throat or in your chest during the procedure. Alternatively, your doctor might start by spraying your throat with a local anesthetic. Your doctor will then pass a tapered dilating instrument through your mouth and guide it into the esophagus.
What Can I Expect after Esophageal Dilation?
After the dilation is done, you will probably be observed for a short period of time and then allowed to return to your normal activities. You may resume drinking when the anesthetic no longer causes numbness to your throat, unless your doctor instructs you otherwise. Most patients experience no symptoms after this procedure and can resume eating the next day, but you might experience a mild sore throat for the remainder of the day.
If you received sedatives, you probably will be monitored in a recovery area until you are ready to leave. You will not be allowed to drive after the procedure even though you might not feel tired. You should arrange for someone to accompany you home, because the sedatives might affect your judgment and reflexes for the rest of the day.
What are the Potential Complications of Esophageal Dilation?
Although complications can occur even when the procedure is performed correctly, they are rare when performed by doctors who are specially trained. A perforation, or hole, of the esophagus lining occurs in a small percentage of cases and may require surgery. A tear of the esophagus lining may occur and bleeding may result. Complications from heart or lung diseases are potential risks

Female Sexual Dysfunction (FSD) is also known as female impotence. Women at some point of time in their lifetime can suffer from FSD. Frequent issues with sexual desire, pain during intercourse or relationship issues with the partner can contribute to female impotence. Ladygra, is a female version of generic Viagra that is used in the treatment of female impotency. For more details visit: http://www.buy-genericviagra.com/ladygra.aspx

ormal sperm densities range from 15 million to greater than 200 million sperm per milliliter of semen. You are considered to have a low sperm count if you have fewer than 15 million sperm per milliliter or less than 39 million sperm total per ejaculate.

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abdominal cavity

Microsurgical varicocelectomy is performed for patients with a varicocele and impaired semen parameters, testicular atrophy or pain due to the varicocele.

Splenectomy is a surgical procedure to remove your spleen. The spleen is an organ that sits under your rib cage on the upper left side of your abdomen. It helps fight infection and filters unneeded material, such as old or damaged blood cells. With the da Vinci Surgical System, Dr. Olson operates through just a few small incisions. The da Vinci System features a magnified 3D high-definition vision system and tiny wristed instruments that bend and rotate far greater than the human hand. As a result, da Vinci enables surgeons to operate with enhanced vision, precision and control.

Apprehension-Relocation Test

DMC Eye specialist restores a woman's vision by removing cataracts and installing an artificial lens. ~ Detroit Medical Center

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Otto Placik MD. a board certified Chicago based plastic surgeon presents Vulvar Vaginal Genital anatomy lesson reviewing the Vulva, Mons Pubis, clitoral hood, prepuce, frenulum, labia minora & majora, vagina, urethra and fourchette with surgical implications and techniques. Photos pictures and video of anatomic models are reviewed in detail on different models. Great for patients thinking about or planning before labiaplasty or vaginal cosmetic surgery

The exam should be performed in an orderly fashion as follows: 1. Have the patient stick out their tongue so that you can examine the posterior pharynx (i.e. the back of the throat). Ask the patient to say "Ah", which elevates the soft palate, giving you a better view. If you are still unable to see, place the tongue blade � way back on the tongue and press down while the patient again says "Ah," hopefully improving your view. This causes some people to gag, particularly when the blade is pushed onto the more proximal aspects of the tongue. It may occasionally be important to determine whether the gag reflex is functional (e.g. after a stroke that impairs CNs 9 or 10; or to determine if a patient with depressed level of consciousness is able to protect their airway from aspiration). This is done by touching a q-tip against the posterior pharynx, uvula or tongue. It is not necessary to do this during your routine exam as it can be quite noxious!
2. Note that the uvula hangs down from the roof of the mouth, directly in the mid-line. With an "Ah," the uvula rises up. Deviation to one side may be caused by CN 9 palsy (the uvula deviates away from the affected side), a tumor or an infection. CN9 Pasly Cranial Nerve 9 Dysfunction: Patient has suffered stroke, causing loss of function of left CN 9. As a result, uvula is pulled towards the normally functioning (ie right) side. 3. The normal pharynx has a dull red color. In the setting of infection, it can become quite red, frequently covered with a yellow or white exudate (e.g. with Strep. Throat or other types of pharyngitis).
4. The tonsils lie in an alcove created by arches on either side of the mouth. The apex of these arches are located lateral to and on a line with the uvula. Normal tonsils range from barely apparent to quite prominent. When infected, they become red, are frequently covered by whitish/yellow discharge. In the setting of a peritonsilar abscess, the tonsils appear asymmetric and the uvula may be pushed away from the affected side. When this occurs, the tonsil may actually compromise the size of the oral cavity, making breathing quite difficult.
5. Look carefully along the upper and lower gum lines and at the mucosa in general, which can appear quite dry if the patient is dehydrated.
6. Examine the teeth to get a sense of general dentition, particularly if the patient has a dental complaint. Pain produced by tapping on a tooth is commonly caused by a root abscess. Tooth Abscess: Tooth abscess involving left molar region. Associated inflammation of left face can clearly be seen. 7. Have the patient stick their tongue outside their mouth, which allows evaluation of CN 12. If there is nerve impairment, the tongue will deviate towards the affected side. Any obvious growths or abnormalities? Ask them to flip their tongue up so that you can look at the underside. If you see something abnormal, grasp the tongue with gauze so that you can get a better look. Left CN 12 Dysfunction: Stroke has resulted in L CN 12 Palsy. Tongue therefore deviates to the left.
8. Make note of any growths along the cheeks, hard palate (the roof of the mouth between the teeth), soft palate, or anywhere else. In particular, patients who smoke or chew tobacco are at risk for oral squamous cell cancer. Any areas which are painful or appear abnormal should also be palpated. Put on a pair of gloves to better explore these regions. What do they feel like? Are they hard? To what extent does a growth involve deeper structures? If the patient feels something that you cannot see, try to get someone else to hold the light source, freeing both your hands to explore the oral cavity with two tongue depressors.