A DMC Neurologist and Neurosurgeon install a nerve stimulator in a young patient to try and control his epileptic seizures. ~ Detroit Medical Center

Orthopedic surgeon Donald Polakoff, MD describes recovery time from knee replacement surgery.

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Recommended range without diabetes is 70 to 130mg/dL. (The standard for measuring blood glucose is "mg/dL" which means milligrams per deciliter.) If your blood glucose level is above 130mg/dL, that's fasting hyperglycemia. Fasting hyperglycemia is a common diabetes complication.

Watch that video to learn How to Know When You Are Ovulating

Three to five years after gastric bypass surgery, some patients start to regain weight because the size of their stoma (the opening at the bottom of the stomach pouch) or their stomach pouch itself has increased. This can keep you from feeling full after small meals.

To resolve this problem, our surgeons use new surgical tools to create and suture folds into the pouch, reducing its volume and at the stoma to decrease its diameter. The surgeon performs the procedure entirely through the mouth -- inserting an endoscope under heavy sedation -- so there are no external incisions into the body.

Emphysema gradually damages the air sacs (alveoli) in your lungs, making you progressively more short of breath. Emphysema is one of several diseases known collectively as chronic obstructive pulmonary disease Smoking is the leading cause of emphysema. Your lungs' alveoli are clustered like bunches of grapes. In emphysema, the inner walls of the air sacs weaken and eventually rupture — creating one larger air space instead of many small ones. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream. When you exhale, the damaged alveoli don't work properly and old air becomes trapped, leaving no room for fresh, oxygen-rich air to enter. Treatment may slow the progression of emphysema, but it can't reverse the damage.

Mohs surgery is a procedure used to remove skin cancers (most commonly basal and squamous cell carcinoma and melanoma) in a way that preserves a maximum amount of healthy tissue. It is useful for skin cancers when:

(1) the location of the cancer is near sensitive areas, like the fingers or face;
(2) earlier treatments have not worked;
(3) a skin cancer is large; and
(4) regular surgery is less likely to remove the cancer.

This procedure video illustrates the procedure on 2 patients with basal cell carcinoma. Click https://ja.ma/3b4scuY to learn more.

0:00 Disclaimer
0:07 Introduction
0:28 What this video will cover
0:43 Mohs "stage" steps
1:09 Marking surgical sites
1:27 Stage 1: skin layer resection (patient 1)
1:59 Maintaining skin layer orientation
2:55 Stage 1: processing layer onto slides (patient 1)
3:53 Stage 1: histology review for cancer (patient 1)
4:31 Discussion on wound closure
5:10 Wound closure (patient 1)
5:47 Stage 1: histology review for cancer (patient 2)
6:24 Stage 2: skin layer resection (patient 2)
6:38 Stage 2: histology review for cancer (patient 2)
6:56 Stage 3: skin layer resection (patient 2)
7:07 Stage 3: histology review for cancer (patient 2)
7:20 Wound closure (patient 2)
7:57 1-week follow-up before-and-after wound healing

Pancreatic Auto Islet Transplantation is a procedure used to maintain insulin production and secretion in patients with chronic pancreatitis that are undergoing a total pancreatectomy, or removal of the entire pancreas. When all other medical therapies fail to control the pain, removal of the pancreas may be an option; however it can leave a person diabetic, which means that the body can no longer control blood sugar levels, and will require intensive testing of blood sugar and injections of insulin. The pancreas is an organ, located in the upper abdominal cavity, behind the stomach, liver and colon. Within the pancreas, specialized clusters of cells known as islets produce insulin, which maintain healthy blood sugar levels. The pancreas also produces enzymes to help digest food. In order to alleviate pain and maintain insulin production, the pancreas is removed from the body, processed and the islets are harvested. Once the pancreas is removed, it is placed in a solution and put into a machine where the pancreas is digested. The islets are then infused into the patient’s liver. Within a short time, the islets are expected to start producing insulin. In 80% of patients, the pain from pancreatitis is relieved by a total pancreatectomy. Over time, some patients may be diabetic and will need to take insulin to maintain healthy blood sugar levels. All patients will take pancreatic enzymes to help digest food after surgery.

A video demonstrating the proper insertion of the Quicktrach emergency cricothyrotomy device.

Gastric bypass, also called Roux-en-Y gastric bypass surgery, is considered a “metabolic” procedure because it changes how your body absorbs fat, calories and nutrients. This metabolic change occurs because your gastrointestinal tract is altered when your gastric bypass surgeon attaches the smaller section of your stomach directly to your small intestine. As a result, your appetite changes and you feel full faster.

LIZ: The first time the doctor made my tip too narrow and I didnt look like myself. The second time the doctor made my tip too wide, and actually took out (removed) extra bone from the side of my nose. That didnt need to be taken out (removed)

My initial consultation with Dr. Nassif was fantastic! He treated me liker his own daughter, and was very caring and thorough. He went over everything!

DR. NASSIF: Liz came into me for a revision rhinoplasty. She told me that shes had two previous rhinoplasties. She was unhappy with the way her nose appeared on her face. She felt it was asymmetric, the tip was kind of bulbous, or large appearing, especially when she looked up, this view, it was very asymmetric. And so, her whole goal was to make it look better, hopefully make it her LAST surgery, and also to help with her breathing.

One of the things thats very important about revision rhinoplasty that you always have to consider is; What are you going to find in there? Even though you can feel the nose, you can palpate it, you can look at it, and you can guess what the other doctors have performed; your first up-hill battle is to see how much scar tissue youre going to be able to identify with. So when you have to open up the nose, you have to remove the scar tissue, identify it: whats there, whats present, whats been removed. Then after you do that, and you have cartilage now ready for grafting, or fascia, or perichondrium, you have to start rebuilding it. Rebuilding it (cartilage) is the second big stage after weve already carved everything; weve carved the cartilage. In that scenario when Im playing with the nose, in regards to staring at the profile, staring at the front of the nose, I go back and forth and look inside and outside of the nose to make sure its as symmetric as possible. That takes a long time One of Lizs main complaints was that on her profile, that her tip stuck out too far. And so one of the things I had to do in surgery is called a medial cura tuck-up, I had to push the tip back, by pushing the tip back, it can make the tip look a little bit wider. But in this situation, I was able to bring everything in as much as I can. After Im finished with everything, and Im happy, then we go ahead and we start to close the nose. Thats putting every little small stitch in perfectly, so that the scar will be minimally visible.

St. John's wort (Hypericum perforatum) is an over-the-counter herbal supplement used for its antidepressant, anti-inflammatory, and wound-healing properties. Although it has been prescribed in Europe for mild to moderate depression, negative clinical trials and multiple reports of adverse drug interactions have raised concern about its use. St. John's wort induces various P450 isozymes (CYP 1A2, 2C19, 2C9, and 3A4) and P-glycoprotein systems. Drug interactions with the herbal product can lead to treatment failures with many medications, including hormonal contraceptives, antiretrovirals, immunosuppressive agents, narcotics, anticoagulants, and antifungals. There is also a risk for serotonin syndrome when St. John's wort is used in combination with other serotonergic antidepressants. The lack of strict regulation of herbal products that results in variable quality and content (unknown toxic ingredients or inactive ingredients) is also a concern.

This is a surgical video demonstrating the release and skin grafting of the middle and ring fingers. It demonstrates the marking, dissection, and repair of the fingers.

Christopher J. Rapuano, MD, Director of the Cornea Service at Wills Eye Institute describes his surgical approach of a Combined Penetrating Keratoplasty (PK) and Cataract Surgery

The majority of epileptic seizures are controlled by medication, particularly anticonvulsant drugs. The type of treatment prescribed will depend on several factors, including the frequency and severity of the seizures and the person's age, overall health, and medical history. An accurate diagnosis of the type of epilepsy is also critical to choosing the best treatment. Drug Therapy Many drugs are available to treat epilepsy. Although generic drugs are safely used for most medications, anticonvulsants are one category where doctors proceed with caution. Most doctors prefer to use brand-name anticonvulsants, but realize that many insurance companies will not cover the cost. As a result, it is acceptable to start taking a generic anticonvulsant medication, but if the desired control is not achieved, the patient should be switched to the brand-name drug.

Cleft palate is among the most common birth defects affecting children in North America. The incomplete formation of the roof of the mouth can occur individually, or in addition to cleft lip. Cleft palate repair is a type of plastic surgery to correct this abnormal development both to restore function and a more normal appearance. This video explains what to expect for families scheduled for cleft palate surgery at the Craniofacial Anomalies Program at University of Michigan C.S. Mott Children's Hospital.

Learn more about our program at http://www.mottchildren.org/craniofacial

Female to Male gender confirming top surgery video : "Double Incision" Technique.

Large Leg Abscess

A detailed description of the causes and diagnosis of pleural effusion. The presentation includes a discussion of the causes and exudative and transudative pleural effusions. Light's criteria and its modification are described along with definition and clinical implication of pleural fluid acidosis, glucose, adenosine deaminase, hemorrhagic pleural effusion and protein and LDH as well.