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Performed by Kami Parsa M.D. Patient is a 55 year old with a history of previous upper eyelid blepharoplasty with excessive skin removed from both upper eyelids which resulted in bilateral lagophthalmos. Patient could not close her eyes and had problems with severe dry eyes.

Arthrocentesis involves both the puncture of a joint and the aspiration of its synovial fluid. It is typically used to make an accurate diagnosis of a painful, warm, swollen joint. Removal of excess fluid can be therapeutic. Analysis of the removed fluid helps to decipher its etiology. [1]

The procedure was performed under wrist block regional anesthesia with tourniquet control. A single Chinese finger trap was used on the thumb with 5 to 8 lb of ongitudinal traction. The arm was held down with wide tape around the tourniquet securing it to the hand table to serve as countertraction. A shoulder holder, rather than a traction tower, was used to facilitate fluoroscopic intervention more easily. The Trapeziometacarpal joint was detected by palpation. Joint distension was achieved by injecting 1 to 3 mL of normal saline (Fig. 1). It is important to distally direct the needle approximately 20 degrees to clear the dorsal flare of the metacarpal base and enter the joint capsule. This course should be reproduced upon entering with arthroscopic sleeve/ trocar assembly to minimize iatrogenic cartilage injury. Fluid distention is important to facilitate this. The incision for the 1-R (radial) portal, used for proper assessment of the dorsoradial ligament, posterior oblique ligament, and ulnar collateral ligament, was placed just volar to the abductor pollicis longus tendon. The incision for the 1-U (ulnar) portal, for better evaluation of the anterior oblique ligament and ulnar collateral ligament, was made just ulnar to the extensor pollicis brevis tendon. A short-barrel, 1.9-mm, 30- degree inclination arthroscope was used for complete visualization of the CMC joint surfaces, capsule, and ligaments, and then appropriate management was done, as dictated by the stage of the arthritis detected (Fig. 2A). A full-radius mechanical shaver with suction was used in all the cases, particularly for initial debridement and visualization. Most of the cases were augmented with radiofrequency ablation to perform a thorough synovectomy and radiofrequency was also used to perform chondroplasty in the cases with focal articular cartilage wear or fibrillation. Chondroplasty refers to thedebridement of the fibrillated cartilage to improve vascularity of the cartilage and enhance the growth of fibrocartilage. Ligamentous laxity and capsular attenu- ation were treated with thermal capsulorraphy using a radiofrequency shrinkage probe. We were careful to avoid thermal necrosis; hence, a striping technique was used to tighten the capsule of the lax joints. The striping technique refers to thermal shrinkage performed in longitudinal stripes on the lax capsule, so as to leave vascular zones between the stripes; hence, thermal necrosis is prevented. Arthroscopic stage I disease was characterized by synovitis without any cartilage wear, wherein a synovectomy coupled with thermal capsulor- raphy as described was performed.

A heart attack is a frightening experience. If you have had a heart attack, or are close with someone who has, you are not alone: tens of thousands of Americans survive. As you work toward recovery, please use the following questions and answers to better understand what has happened to you and how you can help your heart heal so you can live a healthier, longer life.

5 Minute Butt and Thigh Workout for a Bigger Butt - Exercises to Lift and Tone Your Butt and Thighs

Watching A Dentist Fix Tooth Decay Is Beyond Satisfying.

Master perfect plank form and you .ll strengthen your core in no time.

Balloon Sinuplasty for Sinus Infection

Wireless charger for medical devices that are implanted deep inside the body.

New treatment could wipe out tumors in two hours.

RLS can make it hard or impossible for you to get enough sleep. Try these home remedies:

Laparoscopic postoperative ventral hernial (POVT) repair Laparoscopic surgery, also called minimally invasive surgery (MIS), bandaid surgery,

Muscle Contraction Part 3 The Cross Bridge Cycle

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Dieta Alcalina Recetas, Listado De Alimentos Alcalinos, Que Es El Agua Alcalina, Menu Para Adelgazar-- http://dieta-alcalina-alimentos.good-info.co -- Entendiendo los Efectos del nivel de pH en el cuerpo El nivel de pH en el cuerpo tiene la habilidad de afectar cada célula del cuerpo. Cuando la sangre tiene un pH alcalino en vez de un pH ácido, ocurre un efecto positivo en cada función corporal del sistema. El cerebro, el sistema circulatorio, los nervios, los músculos, el sistema respiratorio, el sistema digestivo y reproductivo se pueden beneficiar de un nivel adecuado de pH. Por otro lado, cuando el pH del cuerpo es muy ácido, es susceptible a muchas enfermedades y problemas. Ganancia de peso, enfermedades del corazón, envejecimiento prematuro, fatiga, problemas nerviosos, alergias, enfermedades musculares y cáncer son las más probables a ocurrir cuando el pH del cuerpo no está al nivel óptimo. Ya que todos estos problemas son más probables a ocurrir cuando el pH del cuerpo está muy ácido, tiene sentido consumir una dieta rica en alimentos alcalinos. El objetivo principal es usualmente comer aproximadamente entre 75-80% de alimentos alcalinos junto con solamente entre 20-25% de alimentos ácidos. Si se mantiene este nivel en la dieta, el resultado final es un nivel de pH bajo en el cuerpo, el que se requiere para una salud óptima. Descubre como la dieta alcalina funciona & por qué los alimentos alcalinos son altamente recomendados para tu salud. Haz clic aquí http://dieta-alcalina-alimentos.good-info.co

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