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The bilateral sagittal split osteotomy is an indispensable tool in the correction of dentofacial abnormalities. The technique has been in practice since the late 1800s, but did not reach widespread acceptance and use until several modifications were described in the 1960s and 1970s. Those modifications came from a desire to make the procedure safer, more reliable, and more predictable with less relapse. Those goals continue to stimulate innovation in the field today and have helped the procedure evolve to be a very dependable, consistent method of correction of many types of malocclusion. The operative surgeon should be well versed in the history, anatomy, technical aspects, and complications of the bilateral sagittal split osteotomy to fully understand the procedure and to counsel the patient.
The cause of pectus excavatum is not known however it can run in families, with up to 25 percent of affected patients reporting chest wall abnormalities in other family members. Pectus excavatum occurs in approximately 1 out of 400–1000 children and is three to five times more common in males than females.
Magnetic Resonance Imaging (MRI) "sees" inside the body by mapping the position of water molecules, which exist at different densities in different types of tissue. Watch the video above for a sample of some impressive MRI images of the human body in action.
Impaired awareness of illness (anosognosia) is a major problem because it is the single largest reason why individuals with schizophrenia and bipolar disorder do not take their medications. It is caused by damage to specific parts of the brain, especially the right hemisphere.
Suspect that a patient has a subphrenic abscess if he deteriorates, or recovers and then deteriorates, between the 14th and the 21st day after a laparotomy, with a low, slowly increasing, swinging fever, sweating, and a tachycardia. This, and a leucocytosis, show that he has ''pus somewhere', which is making him anorexic, wasted, and ultimately cachectic. If he has no sign of a wound infection, a rectal examination is negative, and his abdomen is soft and relaxed, the pus is probably under his diaphragm. The pus might be between his diaphragm and his liver, in (1) his right or (2) his left subphrenic space, or under his liver in (3) his right or (4) his left subhepatic space in his lesser sac. He may have pus in more than one of these spaces. Explore him on the suspicion that he might have a subphrenic abscess. Exploration is not a major operation; the difficulty is knowing where to explore, so refer him if you can. If you cannot refer him, explore him yourself. If you fail to find pus, you have done him no harm; missing a subphrenic abscess is far worse. If it is anterior, you can drain it by going under his costal margin anteriorly. If it is posterior, you can go through the bed of his 12th rib posteriorly.
This video shows the technique of suprapatellar tibial nailing as used for a segmental tibia fracture. The broken leg was treated with the nail to allow immediate mobility and range of motion; no cast was needed for this injury.
Pernicious anemia Email this page to a friend Print Facebook Twitter Google+ Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are many types of anemia. Pernicious anemia is a decrease in red blood cells that occurs when the intestines cannot properly absorb vitamin B12.