mitral valve replacement surgery

A dermatologist explains how this skin condition is recognised and treated and the challenging effects it can have on an individual.

The Knee Exam
Observation:
1. Make sure that both knees are fully exposed. The patient should be in either a gown or shorts. Rolled up pant legs do not provide good exposure!
2. Watch the patient walk. Do they limp or appear to be in pain? When standing, is there evidence of bowing (varus) or knock-kneed (valgus) deformity? There is a predilection for degenerative joint disease to affect the medical aspect of the knee, a common cause of bowing. Varus Knee Deformity, more marked on the left leg. 3. Make note of any scars or asymmetry. Chronic/progressive damage, as in degenerative joint disease, may lead to abnormal contours and appearance. Is there obvious swelling as would occur in an effusion? Redness suggesting inflammation? 4. Is there evidence of atrophy of the quadriceps, hamstring, or calf muscle groups? Knee problems/pain can limit the use of the affected leg, leading to wasting of the muscles.

While both legs have well developed musculature,
the left calf and hamstring are bulkier than the right. 5. Look at the external anatomy, noting structures above and below the knee itself: 1. Patella 2. Patellar tendon 3. Quadriceps/Hamstring/Calf muscles 4. Medial and lateral joint lines. 5. Femur and Tibia 6. Tibial tuberosity


Ballotment (helpful if the effusion is large) 1. Slightly flex the knee which is to be examined.
2. Place one hand on the supra-pateallar pouch, which is above the patella and communicates with the joint space. Gently push down and towards the patella, forcing any fluid to accumulate in the central part of the joint.
3. Gently push down on the patella with your thumb.
4. If there is a sizable effusion, the patella will feel as if it's floating and "bounce" back up when pushed down.

The device has as great advantage that the accessibility increases in the hand, it maximizes the surgical area free of obstacles, it increases its functional versatility, for the material with the one that this made a maximum of durability is guaranteed, so that it can be sterilized in any team and it facilitates that the thumb is supported in relaxation state.
The considerable reduction of the surgical time of each intervention is inside the advantages that it provides this valuable instrument, also facilitating that they are executed with more security. For the stability that provide, it can also be used in bony fabrics of the hand. The instrument is both handle, of very easy use and great comfort in its handling. The standardization of most of its pieces makes it very simple. The solutions that are offered in this device for the subjection of the fingers and other parts of the hand are a novelty, but they also have the advantage that it commits very little surgical area and it guarantees a maximum of subjection staying the totally stable hand facilitating in great measure the surgeon's work. These pieces adapt to any diameter of fingers.

The complex circuitry interconnecting different areas in the brain, known collectively as white matter, is composed of millions of axons organized into fascicles and bundles. Upon macroscopic examination of sections of the brain, it is difficult to discern the orientation of the fibers. The same is true for conventional imaging modalities. However, recent advancements in magnetic resonance imaging (MRI) make such task possible in a live subject. By sensitizing an otherwise typical MRI sequence to the diffusion of water molecules it is possible to measure their diffusion coefficient in a given direction1. Normally, the axonal membrane and myelin sheaths pose barriers to the movement of water molecules and, thus, they diffuse preferentially along the axon2. Therefore, the direction of white matter bundles can be elucidated by determining the principal diffusivity of water. The three-dimensional representation of the diffusion coefficient can be given by a tensor and its mathematical decomposition provides the direction of the tracts3; this MRI technique is known as diffusion tensor imaging (DTI). By connecting the information acquired with DTI, three-dimensional depictions of white matter fascicles are obtained4. The virtual dissection of white matter bundles is rapidly becoming a valuable tool in clinical research.

Our journey begins with a transverse section of tightly packed axons as seen through light microscopy. Although represented as a two-dimensional "slice", we see that these axons in fact resemble tubes. A simulation of water molecules diffusing randomly inside the axons demonstrates how the membranes and myelin hinder their movement across them and shows the preferred diffusion direction --along the axons. The tracts depicted through DTI slowly blend in and we ride along with them. As we zoom out even more, we realize that it is a portion of the corpus callosum connecting the two sides of the brain we were traveling on and the great difference in relative scale of the individual axons becomes evident. The surface of the brain is then shown, as well as the rest of the white matter bundles--a big, apparently chaotic tangle of wires. Finally, the skin covers the brain.

With the exception of the simulated water molecules, all the data presented in the animation is obtained through microscopy and MRI. Computer algorithms for the extraction of the cerebral structures and a custom-built graphics engine make our journey through the brain's anatomy possible in a living person.

Micrograph courtesy of Dr. Christian Beaulieu, University of Alberta.
Music by Mario Mattioli.

References:
1. Stejskal, E.O., et al., J. Chem. Phys., 1965. 42:
2. Beaulieu, C., NMR Biomed., 2002. 15:435-55.
3. Basser, P.J., et al., J. Magn. Reson. B, 1994. 103:247-54.
4. Mori, S., et al., NMR Biomed., 2002. 15:468-80.

How to use a clamp?!

Use of Skin Stapler Remover

Removal of pregnancy within the fallopain tube using laparoscopic keyhole surgery. A segment of the tube together with the pregnancy within is removed video.

Next to esophagojejunostomy stapling for the reconstruction following total gastrectomy, several silk stitches anchoring the jejunum to endoabdominal fascia are made to restore the function of phrenoesophageal ligament.
anchoring suture reduces the impairment of the anastomotic blood flow that is caused by gravitational tension and so is useful to protect the esophagojejunostomy after total gastrectomy.

Diabetes contributes to Perio Disease

a great video showing the various techniques of stitches and suturing

Radial Artery Catheterization

A music video describing the life of a medical student

Dr. Rutledge and Dr. Berendes talk about severe infections seen in patients going to other countries to get less expensive surgical procedures.

DMC Specialists use minimally invasive surgery to remove an extremely large uterine fibroid from a patient. ~ Detroit Medical Center

This video demonstrates the Retrograde Wire Intubation

Migraine patients and who have any kinds of vascular headaches as (tension, cluster, travel, computer, headaches) can stop the headache within only one minute if he does Dr. Sultaneh pressure points procedure in the correct way.
If migraine headache in the front he must close the artery in place # 1 as you can see. If the headaches in the back of the head he must close the artery in places # 3. When the artery is closed all the headache will stop. After this you have to see my video (How to do migraine devices): www.alisultaneh.8m.com or www.migrainesurgery.4t.com

WORLD'S FIRST TRUE ANATOMIC ZIRCONIA DENTAL IMPLANT SOLUTION dentistry

أ.د/ سمير عبد الغفار في برنامج الصحة و الجمال يتحدث عن الطرق العلاجية المختلفة لعلاج الأورام الليفية في الرحم و خاصة بالطرق التي تتفادى استئصال الرحم.
أ.د/ سمير عبد الغفار هو استشاري العمليات التداخلية بدون جراحة في كلية الطب بجامعة عين شمس

للمزيد من المعلومات عن الأورام الليفية في الرحم:
http://www.Fibroidstoday.com

Associate Professor Dr. Samir Abd Elghaffar spekaing in the famous TV show "Health and Beauty" discussing various non invasive techniques of curing fibroids and leiomyomas stressing on the interventional radiology techniques.

Dr. Samir Abd Elghaffar is the consultant of interventional radiology and non invasive procedures in Ain Shams Faculty of medicine.

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