تناسق القوام مطلب كل أنسان سواء رجل أو أمرأة ولذلك يجب تحديد معدل تراكم الدهون بالجسم و تحديد نوع تناسق القوام و كيفيته
د. محمد الروبي
استشارى جراحات التجميل بجامعة عين شمس

ENDOSCOPIC (NON-SURGICAL) REMOVAL OF MULTIPLE LARGE TUMORS FROM STOMACH IN A PATIENT WITH PEUTZ-JEGHERS SYNDROME
PEUTZ-JEGHERS SYNDROME: Peutz-Jeghers syndrome (PJS) is a familial syndrome consisting of mucocutaneous pigmentation, gastrointestinal polyposis and cancers of gut & other sites like breast, ovary, and testes. PJS has an autosomal dominant inheritance with variable and incomplete penetrance. Germline mutations of STK11/LKB1 gene on 19p cause this syndrome. Mucocutaneous pigmentation may be noted in early infancy. These deposits of melanin are most commonly found around the mouth, nose, lips, buccal mucosa, hands, and feet, and may also be present in perianal and genital areas. PJS polyps may be found in stomach, small intestine, or colon, but they tend to be prominent in the small intestine. These polyps may increase in size and cause small intestinal obstruction or intussusceptions that may occur in early infancy. Acute upper gastrointestinal bleeding and chronic faecal blood may complicate the disease.
PATIENT: The patient was a 25 yr male who had mucocutaneous pigmentation and multiple polyps in the stomach and duodenum. He presented with bleeding from gastric polyps. As the polyps in stomach were numerous, (more than 20 in number) and were large in size (some equal to small egg size), he had been advised to undergo surgery. Surgery planned was total gastrectomy.
PROCEDURE: The patient underwent video-endoscopy of the esophagus, stomach and duodenum. All polyps were examined for size and presence or absence of stalk. A plan to remove all the gastric polyps at endoscopy was made in the same sitting. He received light conscious sedation. Flat polyps were raised form the gastric wall by injection of saline in to polyp base to let these lesions have a stalk. This was done by needle injector. Each polyp was engaged in a snare and the polyp stalk was cut by coagulation cutting current. The cuts were clean without any bleeding. All polyps were recovered for histology. The histology revealed all polyps to be hamartomous lesions. None of the polyps were cancerous. Patient has been followed up for over one year and is doing fine without any further bleeding or pain.
Video shows the procedure of videoendoscpy and endoscopic removal of polyps.

Loyola Full Thorax Exam Part 2 A video from Loyola Medical School, Chicago showing the medical and clinical examination of the respiratory system.

are you a medical student, a resident, a primary care physician or you practice in an emergency department, you can improve your suture skills with this detailed instruction. As you practice towards a cosmetically perfect technique, your confidence will increase, especially when dealing with complex wounds. Areas of study include: methods of closure, closure materials, anesthetics, suture removal, infection, prophylaxis, when to call in a plastic surgeon, recapping techniques and more

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.

Cholecystectomy

This task requires streching a rubber band around 16 nails on a wooden board. A penalty is calculated when the rubber band is not streched around a nail at the end of the task. Score = time (seconds) + number of missed nails x 10. Performance standard: Score = 62 sec [Kolkman 2008]

NTI Tension Suppression System

Arestin Antibiotic for Periodontal Disease

Anatomy of the Prostate

The endoscopic removal of a large intramaxillary sinus cyst which contained serous like fluid and many shiny flat white cholesterol crystals.

Baby CPR

Doctors at the Detroit Medical Center pioneer laparoscopy procedures and other minimally invasive techniques that result in less pain, fewer risks, and quicker recovery time for surgical patients. ~ Detroit Medical Center

DMC Interventional Radiologist Doctor Bruce Wolf uses minimally invasive surgery called Balloon Kyphoplasty to bring relief to a patient suffering from severe back pain caused by spinal compression fractures. This new procedure is especially beneficial to patients suffering from osteoporosis. ~ Detroit Medical Center

The Miracle in the Human Brain

Views of the Brain

This podcast, intended for the general public, demonstrates how to put on and take off disposable respirators that are to be used in areas affected by the influenza outbreak.

A revision knee replacement operation is shown in four parts. In this first part, an account of the patient is given on why he wanted a revision. This patient was dissatisfied with the range of movement that he got after a primary TKR. The first part shows the exposure and removal of the old implants. From www.kneeindia.com

The video will describe what is oxygen saturation? What is Oxygen content and what is oxygen capacity. Please see my web site for disclaimer.

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