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PURPOSE: Laparoscopic partial nephrectomy (LPN) is an alternative modality of treatment for small sized renal cell carcinoma. Robot assisted laparoscopic partial nephrectomy (RLPN) has also been performed with an advantage in repairing resected surface after tumor resection. We compare the periopera...

tive data of patients treated with laparoscopic partial nephrectomy with those of RLPN undertaken patients. MATERIAL AND METHOD: From September 2006 to April 2008, 22 patients were treated with LPN and 22 were RLPN. 3 arms were used for RLPN; camera was inserted through the 12mm, umbilical trocar port. The laparoscopic Bulldog clamp was used for the clamping of renal hilum. We retrospectively compared each group about tumor size, operation time, estimated blood loss, warm ischemic time and hospital stay. RESULT: Operation time of LPN was shorter than that of RLPN (p=0.033). Tumor size, estimated blood loss and hospital stay was not significant different in each group. No case had conversion to open surgery. 1 patient of RLPN group, however, had conversion to radical nephrectomy due to severe bleeding. CONCLUSION: RLPN was safe and feasible in small sized renal cell carcinoma. Warm ischemic time was reasonable and morbidity associated with RLPN was also low. RLPN LPN p-value Tumor Size (cm) 2.5 2.1 0.605 Op time (min) 169.3 140.8 0.033 EBL (ml) 243.2 213.2 0.878 Warm Ischemic Time (min) 29.2 26.4 0.237 Transfusion (%) 4.5 4.5 0.756 Hospital stay (day) 4.4 5.5 0.053

Dr. Debbie Song at Gillette Children's describes in detail selective rhizotomy surgery.

A selective dorsal rhizotomy is an operation performed to treat spasticity. It is thought that high tone and spasticity arise from abnormal signals that are transmitted through sensory or dorsal nerve roots to the spinal cord. In a selective dorsal rhizotomy we identify and cut portions of the dorsal nerve roots that carry abnormal signals thereby disrupting the mechanisms that lead to spasticity. Potential patients go through a rigorous assessment that includes an in-depth gait and motion analysis as well as a physical therapy evaluation.

They are evaluated by a multidisciplinary team that includes a pediatric rehabilitation doctor, a neurosurgeon, and an orthopedist, Appropriate patient selection is vital. Ideal candidates for selective dorsal rhizotomy are children who are between four and ten years of age, have a history of being born prematurely, and have a diagnosis of diplegia cerebral palsy. These patients usually walk independently or with the assistance of crutches or a walker. They typically function at a level one, two, or three in the gross motor function classification system or gmfcs. A selective dorsal rhizotomy involves the coordinated efforts of the neurosurgery, physiatry, anesthesia and nursing teams. The operation entails making an incision in the lower back that is approximately six to eight inches long. We perform what we call a laminoplasty in which we remove the back part of the spinal elements from the lumbar one or l1 to l5 levels. At the end of the procedure the bone is put back on. We identify and open up the Dural sac that contain the spinal fluid spinal cord and nerve roots. Once the Dural sac is opened ,we expose the lumbar and upper sacral nerve roots that transmit information to and from the muscles of the lower extremities.

At each level we isolate the dorsal nerve root, which in turn is separated into as many as 30 smaller thread light fruitlets.

Each rootlet is then electrically stimulated. Specialized members of the physiatry team look for abnormal responses in the muscles of the legs as each rootless is being stimulated. If an abnormal response is observed then the rootlet is cut.

If a normal response is observed, then the rootlet is not cut. We usually end up cutting approximately 20 to 40 percent of the rootlets. The Dural sac is sutured closed and the l1 through l5 spinal elements are put back into anatomic position, thus restoring normal spinal alignment. The overlying tissues and skin are then closed and the patient is awoken from surgery. The entire operation takes between four and five hours. A crucial component to the success of our rhizotomy program is the extensive rehabilitation course following surgery. With their tone significantly reduced after a rhizotomy, patients relearn how to use their muscles to walk more efficiently through stretching, strengthening, and gait training. Approximately one to two years after a rhizotomy patients undergo repeat gait and motion analysis. The orthopedic surgeons assess the need for interventions to correct bone deformities, muscle contractures, poor motor control, impaired balance, or other problems related to cerebral palsy.

At Gillette we work closely with patients and families to ensure that our selective dorsal rhizotomy program meets their goals for enhancing their function and improving their quality of life.

VISIT https://www.gillettechildrens.org/ to learn more

0:00 Why choose selective dorsal rhizotomy?
0:56 Who is a good candidate for selective dorsal rhizotomy?
1:31 What does a selective dorsal rhizotomy entail?
3:26 What is recovery from selective dorsal rhizotomy like?

Acute kidney failure occurs when your kidneys suddenly become unable to filter waste products from your blood. When your kidneys lose their filtering ability, dangerous levels of wastes may accumulate, and your blood's chemical makeup may get out of balance. Acute kidney failure — also called acute renal failure or acute kidney injury — develops rapidly over a few hours or a few days. Acute kidney failure is most common in people who are already hospitalized, particularly in critically ill people who need intensive care. Acute kidney failure can be fatal and requires intensive treatment. However, acute kidney failure may be reversible. If you're otherwise in good health, you may recover normal or nearly normal kidney function.

This video demonstrates the management of a large abscess in the emergency department. This abscess probably began as a sebaceous cyst that became infected.

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Fillings are a way for dentists to restore a partially decayed tooth. While many people fear the dentist, this procedure is typically quick, effective, and inexpensive. Without fillings, cavities can rapidly worsen. Seeing a dentist regularly can help you to monitor the condition of your teeth and plan for corrective procedures. According to the National Institute of Dental and Craniofacial Research, nearly 93 percent of adults between the ages of 20 and 64 have cavities, and at least 29 percent have decay that is untreated. Dentists can quickly identify tooth decay and then come up with a plan of action that involves filling teeth and restoring adverse conditions. You can do your part by sticking to a solid at-home oral hygiene routine. By simply brushing twice a day with a fluoride-treated toothpaste and flossing regularly, you can prevent the build up of bacteria-rich plaque and eliminate cavity-causing conditions.

Watch that video to learn how to stop arterial bleeding

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Oral sex is a commonly performed act of foreplay involving the kissing or licking of the genital area to pleasure a partner. However, it is sometimes stated that the act alone can increase the risk of throat cancer. Is this really the case?

Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. The virus is one of several types of hepatitis viruses that cause inflammation and affect your liver's ability to function. You're most likely to contract hepatitis A from contaminated food or water or from close contact with someone who's infected. Mild cases of hepatitis A don't require treatment, and most people who are infected recover completely with no permanent liver damage. Practicing good hygiene, including washing hands frequently, is one of the best ways to protect against hepatitis A. Vaccines are available for people most at risk.

"The act of cutting off the prepuce or foreskin of males, or the internal labia of females." Webster's Revised Unabridged Dictionary (1913)

http://tmj-pain-relief.good-info.co What Is Tmj, Grinding Teeth While Sleeping, Tmj Disorder Treatment, Tmj Help, Tmj Night Guard. What is TMJ? The temporomandibular joint is the hinge joint of the jaw that connects the lower jaw (mandible) to the temporal bone of the skull. This joint is an articular disc composed of fibrocartilagenous tissue. It comprises, all in all, of six parts: mandibular condyles, articular surface of the temporal bone, capsule, articular disc, ligaments and lateral pterygoid. The TM Joint facilitates movement of the jaws, thereby allowing essential functions like talking, eating and swallowing. Needless to say, the slightest afflictions caused to this joint, disrupt a great deal of its basic functions. The most common affliction that occurs is the TMJ Disorder. So, what is TMJ Disorder? The TMJ Disorder is a term used to describe an acute inflammation of the TM Joint. It is categorized in three ways: 1.By myofascial pain: The fascia is the tissue that connects the different parts of your body. Fascia around the muscles is called myofascial. Thus, any injury to the myofascial, will automatically adversely affect the muscles. The most common TMJ disorder is associated with myofascial pain in the jaw muscles and neck. 2.By internal injury: Any dislocation, injury, or indeed, any derangement in the joint results in TMJ disorder.

Full examination of the female from head to toe by Loyola Medical School, Chicago. Part 3

Loyola Full Male Exam Part 1 A video from Loyola medical school, Chicago showing the full examination of the male

Polycystic ovary syndrome is a common endocrine system disorder among women of reproductive age. Women with PCOS may have enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary as seen during an ultrasound exam. Infrequent or prolonged menstrual periods, excess hair growth, acne, and obesity can all occur in women with polycystic ovary syndrome. In adolescents, infrequent or absent menstruation may raise suspicion for the condition. The exact cause of polycystic ovary syndrome is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications, such as type 2 diabetes and heart disease.