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Alagille syndrome (AS) is an autosomal dominant disorder (OMIM 118450) associated with abnormalities of the liver, heart, skeleton, eye, and kidneys and a characteristic facial appearance. In 1973, Watson and Miller reported 9 cases of neonatal liver disease with familial pulmonary valvular stenosis.

A man's age matters. As men get older, the chances of conceiving and having a healthy child decline. Male fertility starts to decline after 40 when sperm quality decreases. This means it takes longer for their partners to conceive and when they do, there's an increased risk of miscarriage.

TV interview with Adina Nack, Ph.D. about her own cervical HPV experiences, STD research, her new book (Damaged Goods? Women Living with Incurable Sexually Transmitted Diseases), and women's lives after genital warts, HPV and herpes infections. More info is available on STDdatings.com, which is the official STD dating & support site.

A video showing how to do Spinal Anaesthesia

Stop Nose Bleeds by Cautery

Facial Tenderness
1. Ask the patient to tell you if these maneuvers causes excessive discomfort or pain. ++
2. Press upward under both eyebrows with your thumbs.
3. Press upward under both maxilla with your thumbs.
4. Excessive discomfort on one side or significant pain suggests sinusitis.

Sinus Trans illumination 1. Darken the room as much as possible. ++
2. Place a bright otoscope or other point light source on the maxilla.
3. Ask the patient to open their mouth and look for an orange glow on the hard palate.
4. A decreased or absent glow suggests that the sinus is filled with something other than air.

Temporomandibular Joint 1. Place the tips of your index fingers directly in front of the tragus of each ear. ++
2. Ask the patient to open and close their mouth.
3. Note any decreased range of motion, tenderness, or swelling.

Normal Heart Sounds With the aid of a stethoscope you can hear the characteristic sounds of the normal heartbeat, typically described as a "lub-dub." These sounds are produced by the closure of the heart valves. The first heart sound or "lub" results from closure of the tricuspid and mitral valves. It is a rather low-pitched and a relatively long sound which, as indicated in, represents the beginning of ventricular systole. The second heart sound, or "dub," marks the beginning of ventricular diastole. It is produced by closure of the aortic and pulmonary (pulmonic) semilunar vanes when the intraventricular pressure begins to fall. This "dub" sound is typically heard as a sharp snap because the semilunar valves tend to close much more rapidly than the AV valves. Because diastole occupies more time than systole, a brief pause occurs after the second heart sound when the heart is beating at a normal rate. Therefore, the pattern that one hears is one of: "lub-dub" pause, "lub-dub" pause, and so on. Sometimes, especially in young normal individuals, a third heart sound can be heard. This sound is produced by the very rapid influx of blood into the partially filled ventricle. It is typically very faint and as such difficult to hear.

This operation can be performed as an open or laparoscopic (keyhole procedure). During the operation the sigmoid colon is removed. This involves taking away the blood vessels and lymph nodes to that part of the bowel. The surgeon then re-makes the join (anastomosis) between the remaining left side of the colon and the top of the rectum. The surgeon may use either sutures or special staples to make this join.

Rhomboid muscle strain and spasm causes upper back pain between the shoulder blades. Some patients describe the muscle spasms and discomfort as knots in the back. Early treatment is important to speed healing and recovery. Ice therapy for the first few days followed by moist heat can help relieve symptoms.Oct 12, 2015

The purpose of an ELISA is to determine if a particular protein is present in a sample and if so, how much. There are two main variations on this method: you can determine how much antibody is in a sample, or you can determine how much protein is bound by an antibody. The distinction is whether you are trying to quantify an antibody or some other protein. In this example, we will use an ELISA to determine how much of a particular antibody is present in an individuals blood.

ELISAs are performed in 96-well plates which permits high throughput results. The bottom of each well is coated with a protein to which will bind the antibody you want to measure. Whole blood is allowed to clot and the cells are centrifuged out to obtain the clear serum with antibodies (called primary antibodies). The serum is incubated in a well, and each well contains a different serum (see figure below). A positive control serum and a negative control serum would be included among the 96 samples being tested.

Tongue and lip-tie are common causes of nipple pain, uneven breast drainage, slow weight gain and low milk supply. Many physicians do not properly assess for tongue or lip-tie or recognize their impact on the breastfeeding relationship, leaving babies vulnerable to early weaning. Ultrasound studies have shown that the tongue movements used by tongue-tied babies are qualitatively different from those used by by babies who are not tongue-tied. These movements are not as effective at removing milk from the breast and can cause significant pain and nipple damage. In these studies, tongue-tied babies also did not draw the nipple as deeply into the mouth as babies who were not tongue-tied.

Carpal Tunnel Syndrome Information

Appendectomy operation

Graphic images focusing on the reconstruction of an ear after the removal of a long-standing skin cancer that this patient allowed to slowly grow over many years because he was afraid of what the surgery to remove might entail. Go to www.skincancercentre.com to learn more about the importance of the early diagnosis of skin cancer. BTW, when you put on your sunscreen, don't forget your ears, and wear a broad brimmed hat to cover this very vulnerable area of your anatomy. www.skincancercentre.com

Cardiac Catheterization Video

A laparoscope is a small, thin tube that is put into your body through a tiny cut made just below your navel. Your surgeon can then see your gallbladder on a television screen and do the surgery with tools inserted in three other small cuts made in the right upper part of your abdomen. Your gallbladder is then taken out through one of the incisions.

Stop suffering alone and get relief from vaginal atrophy symptoms

A parasitic twin (also known as an asymmetrical or unequal conjoined twin) is the result of the processes that produce vanishing twins and conjoined twins, and may represent a continuum between the two. Parasitic twins occur when a twin embryo begins developing in utero, but the pair does not fully separate, and one embryo maintains dominant development at the expense of the other. Unlike conjoined twins, one ceases development during gestation and is vestigial to a mostly fully-formed, otherwise healthy individual twin. The undeveloped twin is defined as parasitic, rather than conjoined, because it is incompletely formed or wholly dependent on the body functions of the complete fetus. The independent twin is called the autosite.

“People need to realize this is imminently preventable,” he said. Lyme disease develops following an infection with the bacteria Borrelia burgdorferi. It's transmitted to humans through the bite of infected blacklegged ticks. The tick must be attached to its host for 36 to 48 hours to transmit the bacteria.