Transoral Access in Endoscopic Thyroid Surgery Background: The number of patients demanding endoscopic neck surgery is rising. The access trauma of the axillary, breast and chest approaches is bigger than in open or video assisted surgery. We tested the feasibility of he sublingual transoral access which is in our opinion the only real minimally...-invasive extracollar endoscopic access to the thyroid gland Methods: We performed an experimental investigation in a porcine model. In 10 pigs we made 10 endoscopic transoral thyroidectomys with a modified axilloscope with the help of ultrasonic scissors and a neuro-monitoring system for identification of the recurrent laryngeal nerve. Results: The average operation time from the introduction to the removal of the obturator just above the larynx was 57 seconds. The mean operation time was 43 minutes. With the help of the neuro-monitoring system we proved in all cases the function of the recurrent laryngeal nerve on both sides. The pigs were observed for another two hours after operation. During and after the operation no complications appeared. Conclusions: We could show that the endoscopic transoral thyroid resection in pigs is possible and save. Our results might be useful for using this access for endoscopic thyroid resection in humans.

Can bile duct injuries be prevented? A new technique in laparoscopic cholecystectomy

Over the last decade, laparoscopic cholecystectomy has gained worldwide acceptance and considered to be as "gold standard" in the surgical management of symptomatic cholecystolithiasis. However, the incidence of bile duct injury in laparoscopic cholecystectomy is still two times greater ...compared to classic open surgery. The development of bile duct injury may result in biliary cirrhosis and increase in mortality rates. The mostly blamed causitive factor is the misidentification of the anatomy, especially by a surgeon who is at the beginning of his learning curve. Biliary tree injuries may be decreased by direct coloration of the cystic duct, ductus choledochus and even the gall bladder. Methods gall bladder fundus was punctured by Veress needle and all the bile was aspirated. The same amount of fifty percent methylene blue diluted by saline solution was injected into the gall bladder for coloration of biliary tree. The dissection of Calot triangle was much more safely performed after obtention of coloration of the gall bladder, cystic duct and choledocus. Results Between October 2003 and December 2004, overall 46 patients (of which 9 males) with a mean age of 47 (between 24 and 74) underwent laparoscopic cholecystectomy with methylene blue injection technique. The diagnosis of chronic cholecystitis (the thickness of the gall bladder wall was normal) confirmed by pre-operative abdominal ultrasonography in all patients. The diameters of the stones were greater than 1 centimeter in 32 patients and calcula of various sizes being smaller than 1 cm. were documented in 13 cases. One patient was operated for gall bladder polyp (our first case). Successful coloration of the gall bladder, cystic duct and ductus choledochus was possible in 43 patients, whereas only the gall bladder and proximal cystic duct were visualised in 3 cases. In these cases, ductus choledochus visibility was not possible. None of the patients developed bile duct injury. Conclusion The number of bile duct injuries related to anatomic misidentification can be decreased and even vanished by using intraoperative methylene blue injection technique into the gall bladder fundus intraoperatively.

A video showing how to draw blood for sampling

As one of the first pediatric centers in the United States to use a new state-of-the-art MRI machine designed especially for kids, Children's Hospital of Michigan continues to deliver world-class, patient-friendly health care. ~ Detroit Medical Center

Bat Ears Correction Plastic Surgery

USMLE Step 2 CS - Numbness Weakness This is just preview video. To get full access please visit our website : www.usmletutoring.com

A video showing the procedure of lipoma excision

A high definition HD video of Laparoscopic Cholecystectomy surgery

Skin cancer is the most common of all cancer types, accounting for an estimated one third of all new cases. It’s important to take the right steps to ensure proper protection and adopt good sun care habits no matter what your age or stage in life.

Laparoscopic Liver Surgery 3D Animation

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TV interview with Dr. Mostafa Yakoot, MD discussing latest researches on herbal drugs

An InterActive Medical Technologies Training Video

QuikRead CRP is a quantitative assay of CRP (C-reactive protein) in whole blood, serum or plasma, using the QuikRead® 101 Instrument and is FDA cleared.

Measurement of CRP helps to evaluate the acute inflammatory processes induced by infectious microbial agents or non-infectious inflammatory stimuli. For in vitro diagnostic use.

QuikRead CRP is not intended for measurement of CRP as a risk marker for coronary heart disease.

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A very funny song made by the staff of the Ob/Gyn Gangnam style

This video shows the heart transplant surgery

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---Sintomas Del Autismo Cura Autismo. Más de la mitad de los niños del país que padecen autismo tienen sobrepeso, lo que los pone además en riesgo de sufrir diabetes, enfermedades cardiovasculares y problemas en los huesos y articulaciones. Esta estadística alarmante motivó a la experta en fitness Suzanne M. Gray a desarrollar una rutina de ejercicios que los padres pueden hacer con los pequeños con autismo. Gray ha pasado alrededor de 30 años desarrollando diferentes programas de acondicionamiento físico para niños con necesidades especiales y nos ofrece algunos valiosos consejos.

http://www.youtube.com/watch?v=RprDE2jxLeE
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¿Qué Es Y Cómo Se Trata La Queilitis Angular?

Perleche, queilosis, estomatitis, boqueras, son otras denominaciones con las que se conoce a la queilitis angular. Las comisuras de los labios presentan lesiones inflamatorias. Las grietas verticales a nivel de la piel pueden profundizarse y provocar ulceraciones, llagas, sangrados, infecciones, descamaciones, costras. Con ello, sobrevendrán las dificultades para hablar, para sonreír, para ingerir los alimentos y las bebidas.

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Para Más Información

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https://www.youtube.com/watch?v=i89z59Oi7Bg

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What is Myelomeningocele and how does it affect my baby? Myelomeningocele (MMC), one of the most severe forms of spina bifida, is a condition where the fetus’ spinal cord fails to close during development. This happens between 20 and 28 days of gestation, often before a woman knows she is pregnant. Because the spinal cord does not close, many of the nerves are exposed, resulting in damage to the cord as the pregnancy continues. Spina bifida can impact the nervous system, bones and muscles, kidneys and bladder. The location on the spine where the undeveloped area occurs is called the level of the spina bifida. Because nerve damage at this site prevents function below that level, the higher the level, the greater the impact on normal development and function. The opening in the spinal cord also results in loss of the fluid surrounding the nervous system. This causes the brain to be positioned further down into the upper spinal column than normal, which is called an Arnold Chiari II malformation. When this happens, the normal flow of fluid out of the brain is obstructed, causing Hydrocephalus, an excess of cerebrospinal fluid within the brain. After birth, most children with Hydrocephalus need to have the extra fluid shunted out of the brain into the abdomen via a ventriculoperitoneal shunt. MMC affects about 1 in every 1,000 babies, and it ranges in severity. Some children, with mild cases very low on the spinal cord, can function nearly normally. More severe cases can cause leg weakness and paralysis, as well as Hydrocephalus, and the Arnold Chiari malformation. People with MMC often live long lives, especially if the condition is diagnosed and treated early. How is Myelomeningocele diagnosed? At about 15 weeks gestation, a blood test measuring the levels of alpha-fetoprotein can show the physician that there might be a problem. After that, an ultrasound is performed to detect the MMC, but also to detect the conditions that can result from it, such as Hydrocephalus, the Chiari malformation, and any problems with the lower extremities. In all cases, we perform a fetal MRI to gain more detailed information and we perform a fetal echocardiogram (echo) to rule out any problem with the heart. What is the prenatal surgery for Myelomeningocele, and how does it differ from postnatal surgery? Until recently, the only way to treat MMC was surgery after birth. But, now that the nine-year long Management of Myelomeningocele (MOMS) trial has been completed, we know that repairing the MMC before birth, in the womb, can be beneficial to the baby’s outcome. The SSM Health St. Louis Fetal Care Institute has one of the fastest growing fetal MMC repair programs in the country. The results of the trial found that prenatal treatment helps reduce, or even eliminate, the major complications of MMC—the Hydrocephalus, the Chiari malformation, and the lack of movement in the lower extremities. Diagnosis and repair of the MMC before birth can make a big difference in the way the baby develops. The MOMS trial showed that babies treated in the womb need half the VP shunts, often have reversal of the Arnold-Chiari malformation, and are more likely to walk, at least until 30 months. Long-term follow up data of children treated with prenatal surgery is still being collected, so the benefit beyond 30 months is not fully known. The operation for open fetal surgery for MMC repair involves making a small opening in the uterus, then closing the spinal cord opening just like after birth. The womb is repaired and the mother is in the hospital for four to five days. The surgery is performed between 19 and 26 weeks of the pregnancy. Mothers usually stay locally for about two weeks so that we can monitor the pregnancy. After this, they can return home for delivery. Because of the scar caused by the surgery on the uterus, the baby and all future babies have to be delivered by Cesarean birth. The benefit to the fetal repair is several fold. First, the spine is protected after the fetal repair. The spine can no longer be damaged during the pregnancy and after. Second, the leakage of CSF is stopped. We think that this causes the brain to rise back into the skull, allowing the fluid within the brain to drain normally and preventing the development of Hydrocephalus. As with any prenatal surgery, there are risks to both the mother and the baby. Our team at the Fetal Care Institute will discuss all of the risks and benefits of the surgery with you and your family, so you can make the best decision for your baby. The standard care for babies with spina bifida is to repair the defect after birth. The neurosurgeon closes the opening of the spinal cord, and restores the muscle, skin, and tissue to cover it. Unfortunately, postnatal surgery cannot restore any of the function that has been lost during the pregnancy, and the damage from Hydrocephalus, the Chiari malformation, and/or loss of movement are then permanent. How will Myelomeningocele impact my baby after birth? MMC is a disease affecting many parts of the body. There can be a major impact on a baby’s leg and hip movement, depending on the level of the defect. Problems with Hydrocephalus and the Arnold-Chiari malformation need to be followed carefully. Because the spinal cord also affects urine and bowel function, these bodily functions often need to be managed to prevent complications. Optimally, babies need to be followed in a spina bifida clinic, where a team of specialists work together to help determine the best course of treatment. At SSM Health Cardinal Glennon Children’s Hospital, a long established spina bifida clinic is available for follow up care after birth. This is a very specialized clinic in which many doctors of different specialties and nurses are dedicated to the care of these babies.

Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear in their mid-60s. Estimates vary, but experts suggest that more than 5 million Americans may have Alzheimer’s. Alzheimer's disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people. Alzheimer’s is the most common cause of dementia among older adults. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living. The causes of dementia can vary, depending on the types of brain changes that may be taking place. Other dementias include Lewy body dementia, frontotemporal disorders, and vascular dementia. It is common for people to have mixed dementia—a combination of two or more disorders, at least one of which is dementia. For example, some people have both Alzheimer's disease and vascular dementia. Alzheimer’s disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles). These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body.