The placement of a percutaneous expandable biliary endoprosthesis was first reported in 1985 by Carrasco et al. in a canine model,[1] and the endoscopic placement of expandable metal stents to relieve biliary strictures in patients was first described in 1989.[2,3] Over the past two decades, the endoscopic approach to biliary endoprosthesis placement has largely supplanted the percutaneous approach. Self-expanding metal stents (SEMS) have traditionally been used for palliation of obstructive jaundice in patients with unresectable pancreaticobiliary tumors. However, SEMS are increasingly being used in patients with resectable cancers[4] and benign biliary strictures.[5] Uncovered SEMS (uSEMS) have been shown to have longer patency periods than plastic stents when used for malignant biliary obstruction and to be cost effective if the patient's life expectancy is greater than 4–6 months.[6–8] The common causes of malignant biliary obstruction are pancreatic cancer and cholangiocarcinoma.[9–11] Biliary drainage prior to surgical resection is controversial; several investigators have reported it to be beneficial owing to the improved tissue healing with reduced bilirubin levels,[12,13] but others have also reported its deleterious effects secondary to the additional intervention..

Mastitis is an infection of the breast tissue that results in breast pain, swelling, warmth and redness. You also might have fever and chills. Mastitis most commonly affects women who are breast-feeding (lactation mastitis), although sometimes this condition can occur in women who aren't breast-feeding. In most cases, lactation mastitis occurs within the first six to 12 weeks after giving birth (postpartum), but it can happen later during breast-feeding. The condition can cause you to feel run down, making it difficult to care for your baby. Sometimes mastitis leads a mother to wean her baby before she intends to, but continuing to breast-feed, even while taking an antibiotic for the mastitis, is better for you and your baby.

Ovarian cancer warning signs include ongoing pain or cramps in the belly or back, abnormal vaginal bleeding, nausea, and bloating. Depending on the cancer stage, ovarian cancer treatment includes surgery and chemotherapy.

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Pregnancy ultrasounds are performed mainly using transabdominal ultrasound. For many women, especially after 8 weeks gestation, sufficient information about the baby may be obtained with transabdominal ultrasound only. However, in the early pregnancy, the developing embryo is very small (at 6 weeks gestation, the baby is only 5-9mm long) and a transvaginal ultrasound may be required to get a better image of the baby. Transvaginal ultrasound is safe and commonly performed during all stages of pregnancy, including the first trimester. It will not harm you or your baby.

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There are several reasons that your doctor may recommend that you have your spleen removed. These include having: a spleen that’s damaged from injury an enlarged spleen or ruptured spleen, which can occur from trauma certain rare blood disorders cancer or large cysts of the spleen infection

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Scar revision includes techniques that improve the appearance of an unsightly scar, regardless of its size, type or age. This is typically not covered by insurance carriers and is treated as a cosmetic procedure. Though scars can never be completely removed, the appearance of scarring can be greatly diminished. Who Should Get Scar Revision? The best candidates for scar revision are in good health and have realistic expectations. Scar revision may be used to treat: Hyperpigmented scars Large or plainly visible scars Keloid scarring Raised scars Deep depression scars After scar revision, the appearance of your scar should be greatly reduced. Scar revision can improve the size, shape and color of your scar. Multiple procedures may be needed to achieve optimal results. There are several different techniques that can be used during your scar revision. During a consultation, we can discuss the best techniques and determine if you are a suitable candidate. What to Expect During Your Scar Revision Your scar revision may involve one or more of the following techniques: Topical treatments (gels, creams, external compression) can treat mild scarring or changes in pigmentation. Injectable treatments like dermal fillers are best for filling in scar depressions. These treatment options can provide long-lasting improvements, however, they are not always permanent. Surface treatments like chemical peels, dermabrasion, laser therapy and skin bleaching can improve skin tone and texture. More than one treatment may be needed to achieve optimal results. Surgical scar revision is only used in more severe cases. Reconstructive techniques like Z-plasty, tissue expansion, or skin grafting replace a prominent scar with a less noticeable scar. After Your Surgery Scar revision recovery varies depending on the procedure you have elected. Topical and injectable treatments rarely require downtime. Surface treatments and surgical removal can require several days of recovery. You may experience some temporary bruising, swelling, or discomfort. Over-the-counter or prescription medication can be used to manage pain. Topical and injectable treatments are likely to require sustained application to maintain results. The final results of surface treatments and surgical removal may not be visible for several weeks to months. It is important to protect the treatment area from direct sun exposure for several weeks. Additional details about your specific recovery will be discussed during your consultation.

The eustachian tube drains fluid from your ears to the back of your throat. If it clogs, otitis media with effusion (OME) can occur. If you have OME, the middle part of your ear fills with fluid, which can increase the risk of ear infection. OME is very common. According to the Agency of Healthcare Research and Quality, about 90 percent of children will have OME at least once by the age of 10.

Learn one of the hidden reasons why you still have a thyroid symptoms. If your lab results are "normal"--then why do you still have thyroid symptoms like: * Tired, sluggish * Can't lose weight even with exercise * Feel cold—hands, feet, or all over * Require excessive amounts of sleep to function properly * Increase in weight gain even with low-calorie diet * Gain weight easily * Difficult, infrequent bowel movements * Depression, lack of motivation * Morning headaches that wear off as the day progresses * Outer third of eyebrow thins * Thinning of hair on scalp, face or genitals or hair loss * Dryness of skin and/or scalp * Mental sluggishness * Nervousness and emotional * Insomnia * Night sweats

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Pancreatic Auto Islet Transplantation is a procedure used to maintain insulin production and secretion in patients with chronic pancreatitis that are undergoing a total pancreatectomy, or removal of the entire pancreas. When all other medical therapies fail to control the pain, removal of the pancreas may be an option; however it can leave a person diabetic, which means that the body can no longer control blood sugar levels, and will require intensive testing of blood sugar and injections of insulin. The pancreas is an organ, located in the upper abdominal cavity, behind the stomach, liver and colon. Within the pancreas, specialized clusters of cells known as islets produce insulin, which maintain healthy blood sugar levels. The pancreas also produces enzymes to help digest food. In order to alleviate pain and maintain insulin production, the pancreas is removed from the body, processed and the islets are harvested. Once the pancreas is removed, it is placed in a solution and put into a machine where the pancreas is digested. The islets are then infused into the patient’s liver. Within a short time, the islets are expected to start producing insulin. In 80% of patients, the pain from pancreatitis is relieved by a total pancreatectomy. Over time, some patients may be diabetic and will need to take insulin to maintain healthy blood sugar levels. All patients will take pancreatic enzymes to help digest food after surgery.

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If you have been diagnosed with a bulging disc, you are not alone. Bulging discs, also known as a disc protrusion, are a very common occurrence. They usually remain asymptomatic; however, they can cause discomfort and disability in various parts of the body if the disc compresses an adjacent nerve root or the spinal cord. As we age, the outer fibrous portion of our discs can weaken. Pressure from the central core of the disc can then stretch to the outer rim, causing the disc to bulge. If left untreated, the disc can continue to bulge until it tears, which is classified as a herniated disc. Because a bulging disc does not always show symptoms, many people have bulging discs without realizing it. As long as the bulging area does not press against a nearby nerve, no symptoms occur. When the bulging disc does cause a pinched nerve, however, you may begin to experience symptoms. In the lower back, the damaged disc can cause pain to travel to the hips, buttocks, legs and feet. In the cervical spine, pain can radiate from the neck, down the arm and to the fingers.

A peritonsillar abscess forms in the tissues of the throat next to one of the tonsils. An abscess is a collection of pus that forms near an area of infected skin or other soft tissue. The abscess can cause pain, swelling, and, if severe, blockage of the throat. If the throat is blocked, swallowing, speaking, and even breathing become difficult. When an infection of the tonsils (known as tonsillitis) spreads and causes infection in the soft tissues, a peritonsillar abscess may result. Peritonsillar abscesses are generally uncommon. When they do occur they are more likely among young adults, adolescents, and older children.

Hyperparathyroidism is an excess of parathyroid hormone in the bloodstream due to overactivity of one or more of the body's four parathyroid glands. These glands are about the size of a grain of rice and are located in your neck. The parathyroid glands produce parathyroid hormone, which helps maintain an appropriate balance of calcium in the bloodstream and in tissues that depend on calcium for proper functioning. Two types of hyperparathyroidism exist. In primary hyperparathyroidism, an enlargement of one or more of the parathyroid glands causes overproduction of the hormone, resulting in high levels of calcium in the blood (hypercalcemia), which can cause a variety of health problems. Surgery is the most common treatment for primary hyperparathyroidism. Secondary hyperparathyroidism occurs as a result of another disease that initially causes low levels of calcium in the body and over time, increased parathyroid hormone levels occur.

The vast majority of glucocorticoid activity in most mammals is from cortisol, also known as hydrocortisone. Corticosterone, the major glucocorticoid in rodents, is another glucocorticoid. Cortisol binds to the glucocorticoid receptor in the cytoplasm and the hormone-receptor complex is then translocated into the nucleus, where it binds to its DNA response element and modulates transcription from a battery of genes, leading to changes in the cell's phenotype. Only about 10% of circulating cortisol is free. The remaining majority circulates bound to plasma proteins, particularly corticosteroid-binding globulin (transcortin). This protein binding likely decreases the metabolic clearance rate of glucocorticoids and, because the bound steroid is not biologically active, tends to act as a buffer and blunt wild fluctuations in cortisol concentration.