Pleurisy is a condition in which the pleura — a membrane consisting of a layer of tissue that lines the inner side of the chest cavity and a layer of tissue that surrounds the lungs — becomes inflamed. Also called pleuritis, pleurisy causes sharp chest pain (pleuritic pain) that worsens during breathing. A variety of underlying conditions can cause pleurisy. Treatment of pleurisy involves pain control and treating the underlying condition.

This video, Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition also can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.

During normal sleep, you cycle through REM and four stages of non-REM (NREM) sleep numerous times a night. Stage 1 of NREM sleep is the lightest, while stage 4 is the deepest. When you're repeatedly interrupted and can't cycle normally through these types and stages of sleep, you may feel tired, fatigued, and have trouble concentrating and paying attention while you're awake. Sleepiness puts you at greater risk for car wrecks and other accidents.

Endoscopic finding in a patient with a typical rectal cancer (adenocarcinoma)

Breast reconstruction 3D Animation
on Friday, December 17, 2010




The primary part of the procedure can often be carried out immediately following the mastectomy. As with many other surgeries, patients with significant medical comorbidities (high blood pressure, obesity, diabetes) and smokers are higher-risk candidates. Surgeons may choose to perform delayed reconstruction to decrease this risk. Patients expected to receive external beam radiation as part of their adjuvant treatment are also commonly considered for delayed autologous reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients. Breast reconstruction is a large undertaking that usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revisional surgeries. Outcomes based research on quality of life improvements and psychosocial benefits associated with breast reconstruction served as the stimulus in the United States for the 1998 Women's Health and Cancer Rights Act which mandated health care payer coverage for breast and nipple reconstruction, contralateral procedures to achieve symmetry, and treatment for the sequelae of mastectomy. This was followed in 2001 by additional legislation imposing penalties on noncompliant insurers. Similar provisions for coverage exist in most countries worldwide through national health care programs. There are many methods for breast reconstruction. The two most common are: * Tissue Expander - Breast implants This is the most common technique used in worldwide. The surgeon inserts a tissue expander, a temporary silastic implant, beneath a pocket under the pectoralis major muscle of the chest wall. The pectoral muscles may be released along its inferior edge to allow a larger, more supple pocket for the expander at the expense of thinner lower pole soft tissue coverage. The use of acellular human or animal dermal grafts have been described as an onlay patch to increase coverage of the implant when the pectoral muscle is released, which purports to improve both functional and aesthtic outcomes of implant-expander breast reconstruction. o In a process that can take weeks or months, saline solution is percutaneously injected to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a more permanent implant. Reconstruction of the areola and nipple are usually performed in a separate operation after the skin has stretched to its final size. * Flap reconstruction The second most common procedure uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen. This procedure may be performed by leaving the donor tissue connected to the original site to retain its blood supply (the vessels are tunnelled beneath the skin surface to the new site) or it may be cut off and new blood supply may be connected. o The latissimus dorsi muscle flap is the donor tissue available on the back. It is a large flat muscle which can be employed without significant loss of function. It can be moved into the breast defect still attached to its blood supply under the arm pit (axilla). A latissimus flap is usually used to recruit soft-tissue coverage over an underlying implant. Enough volume can be recruited occasionally to reconstruct small breasts without an implant. o Abdominal flaps The abdominal flap for breast reconstruction is the TRAM flap or its technically distinct variants of microvascular "perforator flaps" like the DIEP/SIEP flaps. Both use the abdominal tissue between the umbilicus and the

Acute aortic dissection can be treated surgically or medically. In surgical treatment, the area of the aorta with the intimal tear is usually resected and replaced with a Dacron graft. Emergency surgical correction is the preferred treatment for Stanford type A (DeBakey type I and II) ascending aortic dissection. It is also preferred for complicated Stanford type B (DeBakey type III) aortic dissections with clinical or radiologic evidence of the following conditions: Propagation (increasing aortic diameter) Increasing size of hematoma Compromise of major branches of the aorta Impending rupture Persistent pain despite adequate pain management Bleeding into the pleural cavity Development of saccular aneurysm

Drs. Moore and Miklos are very excited to be one of the first centers in the US to offer the next step in minimally invasive treatment for Stress Urinary Incontinence, the single incision Mini-sling. The procedure utilizes the same concepts of the tension-free tape mid-urethral slings, however only one incision is needed and the procedure can be completed in as little as 5-10 minutes under local anesthesia.

The procedure was initially released in September of 2006 by Gynecare with a procedure called the TVT-Secure and Dr Miklos and Moore were some of the first surgeons to evaluate and study the procedure. They liked the concept of a single incision sling, however were not enthused by the engineering and design of the Secure sling. In early 2007, with development input from Dr Moore and Miklos, American Medical Systems made several improvements to the procedure and in April, Dr Moore was the first surgeon in the United States to place the Mini-Arc mini-sling. Dr Moore’s and Miklos’s center in Atlanta, because of their reputation of being world leader’s in treatment for Stress Urinary Incontinence, was chosen as the lead center in the USA to evaluate and study the Mini-Arc procedure. Dr Moore was chosen as principal investigator, leading 5 centers in the USA and the world, to study and present the initial results in the USA, which have been excellent and very exciting!

We present a cases of child of age 4 yrs with open safety pin (SP) impacted in the U/3 esophagus and description of the techniques used for their removal

The key difference between monophasic and biphasic defibrillator is that the monophasic defibrillator is a type of defibrillation waveform where a shock is delivered to the heart from one vector as shown below. Whereas, in biphasic defibrillation, shock is delivered to the heart via two vectors.

Diabetic Foot Surgical Debridement

Continuous Lumbar Epidural

LASIK, which stands for laser in-situ keratomileusis, is a popular surgery used to correct vision in people who are nearsighted, farsighted, or have astigmatism. All laser vision correction surgeries work by reshaping the cornea, the clear front part of the eye, so that light traveling through it is properly focused onto the retina located in the back of the eye. LASIK is one of a number of different surgical techniques used to reshape the cornea.

Dr. Thomas Haas, MD, Board Certified plastic surgeon, performed breast augmentation on his patient in November, 2007. The surgery was performed in his JCAHO accredited in-office Surgery Suite (Imaage) located in Louisville, Kentucky. With so many women interested in this surgery, this video can answer many of their questions. Dr. Haas specializes in cosmetic and aesthetic surgery and has been in practice over 15 years

Handal Plastic Surgery at the Sanctuary Surgery Center is the leading cosmetic surgery center of the Southeast Florida region, providing excellent consultation, surgery, and post operative services. Headed by Doctor Arthur G. Handal, top plastic & cosmetic surgeon in Boca Raton, the professional staff of the Sanctuary Surgery Center offers the best in patient care.

DMC Neurosurgeon Sandeep Mittal maps the brain and performs delicate surgery to remove epileptic tissue, and stop a patient's seizures. ~ Detroit Medical Center

A ventricular septal defect (VSD), a hole in the heart, is a common heart defect that's present at birth (congenital). The hole occurs in the wall that separates the heart's lower chambers (septum) and allows blood to pass from the left to the right side of the heart. The oxygen-rich blood then gets pumped back to the lungs instead of out to the body, causing the heart to work harder. A small ventricular septal defect may cause no problems, and many small VSDs close on their own. Larger VSDs need surgical repair early in life to prevent complications.

A video showing the phases of normal wound healing

What is a Cataract

Dr. David Rivadeneira from Stony Brook University in Stony Brook, NY will host a panel discussion on how to obtain improved outcomes during open surgery through the application of advanced techniques and technologies, including the new LigaSure Impact™ instrument. "It provides excellent and reliable hemostasis on major blood vessels, but the big advancement is that it is faster than traditional techniques and leaves no foreign material behind."

The program will begin with a brief introduction of the topic, followed by video presentation of two procedures, a right hemicolectomy and a sigmoid colectomy. Dr. Rivadeneira will discuss the techniques that he uses. "You'll be able to see the impact of applying multifunctional energy-based instruments to enable rapid and reliable dissection of the mesentery and ligation of colonic blood supply. This is particularly evident on tough diverticular cases, where it works very well with complicated tissue." Joining Dr. Rivadeneira, to review and discuss the cases, will be Dr. Sang Lee from Weill Cornell Medical College, NY.

Histology of GastroDuodenal Junction