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The typical radiograph is of a well-defined, rounded, retrocardiac opacity with an air-fluid level. In this image, the radiolucent gas is highlighted in blue, while the gastric contents are highlighted in the green. In many cases of hiatal hernia, there will not be an air bubble below the left hemidiaphragm. This is a relatively expected finding considering that the stomach is no longer in its usual position. The anatomical position of the herniated organ can be further elucidated on the lateral radiograph. Here we can see that the stomach is in the middle mediastinum posterior to the heart and above the diaphragm. Hiatal hernias can look similar to a retrocardiac lung abscess or another cavitary lesion, but it will change in size and shape between radiographs. Large hernias can shift the mediastinum to the right and result in a widening of the carinal angle. They can even give the appearance of cardiomegaly. In this radiograph, the cardiac silhouette is distinctly visible within the confines of the hiatal hernia. To review, a hiatal hernia on an AP chest radiograph typically appears as a round retrocardiac opacity with an air-fluid level.
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Disclaimer: All the information provided by Medical Education for Visual Learners and associated videos are strictly for informational purposes only. It is not intended as a substitute for medical advice from your health care provider or physician. It should not be used to overrule the advice of a qualified healthcare provider, nor to provide advice for emergency medical treatment. If you think that you or someone that you know may be suffering from a medical condition, then please consult your physician or seek immediate medical attention.
Purpose: To evaluate the results of LASIK and IntraLASIK treatment in myopic patients with nystagmus. Methods: Eight patients with congenital nystagmus (16 eyes), from 23 to 49 years of age, underwent LASIK surgery. Corneal flaps were created using either the Hansatome microkeratome or the Intral...ase femtosecond laser. The ablations were performed with the Bausch & Lomb excimer laser with an active tracking system. In some patients, the eyes were fixated with forceps or a fixation ring during the laser ablation. Results: The refractive errors were corrected in all cases. There was no decentration or loss of best corrected visual acuity greater than 1 line. In 56% of the eyes, the post-operative uncorrected visual acuity was better than the best spectacle corrected-visual acuity (BSCVA). 62.5% of the eyes improved their BSCVA. The overall visual performance was improved in all the patients. One patient that did not not drive before become eligible to get a driver license after the surgery. Conclusions: Selected patients with myopia and congenital nystagmus may benefit from laser refractive surgery. Laser refractive surgery may be safely and accurately performed by using either the Hansatome microkeratome or the Intralase femtosecond laser and an active tracking system with or without mechanical fixation. Certain patients improve their BSCVA post-operatively.
Since the first replant more than 50 years ago, thousands of severed body parts have been reattached, preserving the quality of life for thousands of patients through improved function and appearance that the void remaining after amputation cannot provide. Ronald Malt performed the first replantation on May 23, 1962 at Massachusetts General Hospital on a 12-year-old boy who had his right arm amputated in a train accident. [1, 2] This amputation occurred at the level of the humeral neck.
A computed tomography (CT) scan uses a special X-ray machine to take detailed pictures of the body’s organs and tissues. In a biopsy, a small piece of tissue is removed from your body. This tissue sample is then examined in the lab. A needle biopsy is the safest and easiest way to remove this tissue safely from the body. To do a needle biopsy, the radiologist will insert a needle through your skin and into your tissue. A syringe or an automated needle may be used to take the tissue sample.
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Microsurgical bipolar cautery tonsillectomy compares favorably with traditional techniques in terms of intraoperative bleeding, postoperative pain, otalgia, and hemorrhage. This technique combines the hemostatic advantage of cautery dissection, the excellent visualization achieved by a microscope, and, with the use of a video, greatly improves the physician's ability to teach how to perform a tonsillectomy.
Here Drs Oetting and Shriver of the University of Iowa demonstrate the McCannel technique of fixing an IOL to the iris. In this video both the standard McCannel suture retrieval technique and the Siepser/Chang modifed technique are demonstrated. A 10-O prolene with a long curved ctc-6 needle is u...sed to place a suture through the iris and under an 3 piece IOL haptic. Using the standard technique the two ends of the suture are retrieved through a common paracentesis near the fixation site and tied externally. The other haptic is tied using the Siepser sliding knot technique as described by Chang for this indication with an internal knot. The standard technique is a bit easier but does not allow as thight a knot for fixation of the iris to the haptic.