urgical management of proximal humerus fractures may be categorized either according to fracture type (eg, Neer type, anatomic type, greater tuberosity, surgical neck, anatomic neck, articular surface, lesser tuberosity fragments) or according to method of fixation (eg, closed reduction with no fixation, percutaneous fixation, open reduction with internal fixation [ORIF], humeral head replacement associated with tuberosity fixation

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Histology of Dense Bone

A subdural hematoma is most often the result of a severe head injury. This type of subdural hematoma is among the deadliest of all head injuries. The bleeding fills the brain area very rapidly, compressing brain tissue. This often results in brain injury and may lead to death. Subdural hematomas can also occur after a minor head injury. The amount of bleeding is smaller and occurs more slowly. This type of subdural hematoma is often seen in older adults. These may go unnoticed for many days to weeks, and are called chronic subdural hematomas. With any subdural hematoma, tiny veins between the surface of the brain and its outer covering (the dura) stretch and tear, allowing blood to collect. In older adults, the veins are often already stretched because of brain shrinkage (atrophy) and are more easily injured.

Histology of Endochondral Ossification

Histology of Urinary Bladder

Bacterial meningitis is very serious and can be deadly. Death can occur in as little as a few hours. While most people with meningitis recover, permanent disabilities such as brain damage, hearing loss, and learning disabilities can result from the infection. There are several types of bacteria that can cause meningitis. Some of the leading causes of bacterial meningitis in the United States include Streptococcus pneumoniae, group B Streptococcus, Neisseria meningitidis, Haemophilus influenzae, and Listeria monocytogenes.

Throat Endoscopy: This video shows the vocal cords while singing

How to Get Rid of Acne Overnight

Shaken baby syndrome usually occurs when a parent or caregiver severely shakes a child in frustration or anger, often because the child won't stop crying. Permanent brain damage or death may result. Symptoms include irritability, difficulty staying awake, seizures, abnormal breathing, poor eating, bruises, and vomiting. Treatment will vary depending on complications related to shaken baby syndrome. In rare instances, breathing support or surgery may be needed to stop bleeding in the brain.

Breast reconstruction 3D Animation
on Friday, December 17, 2010




The primary part of the procedure can often be carried out immediately following the mastectomy. As with many other surgeries, patients with significant medical comorbidities (high blood pressure, obesity, diabetes) and smokers are higher-risk candidates. Surgeons may choose to perform delayed reconstruction to decrease this risk. Patients expected to receive external beam radiation as part of their adjuvant treatment are also commonly considered for delayed autologous reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients. Breast reconstruction is a large undertaking that usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revisional surgeries. Outcomes based research on quality of life improvements and psychosocial benefits associated with breast reconstruction served as the stimulus in the United States for the 1998 Women's Health and Cancer Rights Act which mandated health care payer coverage for breast and nipple reconstruction, contralateral procedures to achieve symmetry, and treatment for the sequelae of mastectomy. This was followed in 2001 by additional legislation imposing penalties on noncompliant insurers. Similar provisions for coverage exist in most countries worldwide through national health care programs. There are many methods for breast reconstruction. The two most common are: * Tissue Expander - Breast implants This is the most common technique used in worldwide. The surgeon inserts a tissue expander, a temporary silastic implant, beneath a pocket under the pectoralis major muscle of the chest wall. The pectoral muscles may be released along its inferior edge to allow a larger, more supple pocket for the expander at the expense of thinner lower pole soft tissue coverage. The use of acellular human or animal dermal grafts have been described as an onlay patch to increase coverage of the implant when the pectoral muscle is released, which purports to improve both functional and aesthtic outcomes of implant-expander breast reconstruction. o In a process that can take weeks or months, saline solution is percutaneously injected to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a more permanent implant. Reconstruction of the areola and nipple are usually performed in a separate operation after the skin has stretched to its final size. * Flap reconstruction The second most common procedure uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen. This procedure may be performed by leaving the donor tissue connected to the original site to retain its blood supply (the vessels are tunnelled beneath the skin surface to the new site) or it may be cut off and new blood supply may be connected. o The latissimus dorsi muscle flap is the donor tissue available on the back. It is a large flat muscle which can be employed without significant loss of function. It can be moved into the breast defect still attached to its blood supply under the arm pit (axilla). A latissimus flap is usually used to recruit soft-tissue coverage over an underlying implant. Enough volume can be recruited occasionally to reconstruct small breasts without an implant. o Abdominal flaps The abdominal flap for breast reconstruction is the TRAM flap or its technically distinct variants of microvascular "perforator flaps" like the DIEP/SIEP flaps. Both use the abdominal tissue between the umbilicus and the

A breech birth is the birth of a baby from a breech presentation. In the breech presentation the baby enters the birth canal with the buttocks or feet first as opposed to the normal head first presentation.

There are either three or four main categories of breech births, depending upon the source:

* Frank breech - the baby's bottom comes first, and his or her legs are flexed at the hip and extended at the knees (with feet near the ears). 65-70% of breech babies are in the frank breech position.

* Complete breech - the baby's hips and knees are flexed so that the baby is sitting crosslegged, with feet beside the bottom.

* Footling breech - one or both feet come first, with the bottom at a higher position. This is rare at term but relatively common with premature fetuses.

* Kneeling breech - the baby is in a kneeling position, with one or both legs extended at the hips and flexed at the knees. This is extremely rare, and is excluded from many classifications.

As in labour with a baby in a normal head-down position, uterine contractions typically occur at regular intervals and gradually cause the cervix to become thinner and to open. In the more common breech presentations, the baby’s bottom (rather than feet or knees) is what is first to descend through the maternal pelvis and emerge from the vagina.

At the beginning of labour, the baby is generally in an oblique position, facing either the right or left side of the mother's back. As the baby's bottom is the same size in the term baby as the baby's head. Descent is thus as for the presenting fetal head and delay in descent is a cardinal sign of possible problems with the delivery of the head.

In order to begin the birth, internal rotation needs to occur. This happens when the mother's pelvic floor muscles cause the baby to turn so that it can be born with one hip directly in front of the other. At this point the baby is facing one of the mother's inner thighs. Then, the shoulders follow the same path as the hips did. At this time the baby usually turns to face the mother's back. Next occurs external rotation, which is when the shoulders emerge as the baby’s head enters the maternal pelvis. The combination of maternal muscle tone and uterine contractions cause the baby’s head to flex, chin to chest. Then the back of the baby's head emerges and finally the face.

Due to the increased pressure during labour and birth, it is normal for the baby's leading hip to be bruised and genitalia to be swollen. Babies who assumed the frank breech position in utero may continue to hold their legs in this position for some days after birth.

In this video, Professor Dan Reinstein performs a bilateral LASIK procedure filmed in real-time to demonstrate the full 8 and-a-half minute procedure from multiple angles. The superior design and experience of the Carl Zeiss Meditec Visumax femtosecond Laser for flap creation is seen, where the patient is only in contact with the device for about 30 seconds with extremely low contract force such that the patient feels effectively nothing, there are no red splodges (subconjunctival haemorages) left behind. From the surgeons' standpoint there is no device that is easier to use or faster for LASIK flap creation. The Carl Zeiss Meditec MEL80 excimer laser portion of the procedure is seamlessly integrated and incorporates all the features that make clinical outcomes so reproducible including the unique cone-for-controlled-atmosphere (CCA) and high efficiency, high sensitivity calibration test which can be performed for each individual patient to compensate for minor changes in energy that occur with excimer laser devices during the course of a day.

For reference to the clinical outcomes for LASIK with the MEL80 in presbyopia using PRESBYOND Laser Blended Vision see:

Reading glasses presbyopia (ageing eyes) only:
LASIK for presbyopia correction in emmetropic patients using aspheric ablation profiles and a micro-monovision protocol with the Carl Zeiss Meditec MEL 80 and VisuMax.
J Refract Surg. 2012 Aug;28(8):531-41. Reinstein DZ, Carp GI, Archer TJ, Gobbe M.
http://www.ncbi.nlm.nih.gov/pubmed/22869232

Short sighted, astigmatism and presbyopia (ageing eyes)
LASIK for Myopic Astigmatism and Presbyopia Using Non-Linear Aspheric Micro-Monovision with the Carl Zeiss Meditec MEL 80 Platform.
J Refract Surg. 2011 Jan;27(1):23-37. Epub 2010 Mar 1.
Reinstein DZ, Archer TJ, Gobbe M.
http://www.ncbi.nlm.nih.gov/pubmed/20205360

Long-sighted, astigmatism and presbyopia (ageing eyes)
LASIK for hyperopic astigmatism and presbyopia using micro-monovision with the Carl Zeiss Meditec MEL80 platform.
J Refract Surg. 2009 Jan;25(1):37-58. Reinstein DZ, Couch DG, Archer TJ.
http://www.ncbi.nlm.nih.gov/pubmed/19244952

For more information about laser eye surgery and PRESBYOND Laser Blended Vision, please contact the London Vision Clinic on 020 7224 1005.

Can a Vaccine Give Me the Disease It’s Supposed to Protect Me Against?

Watch that video of Creation and Pathway of Sperm During Ejaculation

Histology of Brain

Dr. Christian Reutter of the Pelvic Rehabilitation Manhattan location discuss sport hernia groin pain and how it can be treated.

Dr. T. R. Christian Reutter received his BA from The Johns Hopkins University, attended medical school at the University of Health Sciences College of Osteopathic Medicine in Kansas City Missouri, and then completed his residency in Physical Medicine and Rehabilitation at the University of Texas Health Science Center in San Antonio, Texas. He practiced for almost 17 years as a sports medicine and spine specialist in San Francisco, California before joining the Pelvic Rehabilitation Medicine team in New York.

At Pelvic Rehabilitation Medicine, our pelvic pain specialists provide a functional, rehab approach to pelvic pain. When you visit one of our offices, you spend an hour with your doctor reviewing in detail your medical history and symptoms. Then, we perform an internal exam (no speculum) to evaluate your nerves and muscles. Together, we'll discuss an individual treatment plan that gets to the root cause of your pain and helps you to feel better. The best part: you can begin treatment the same day!

At PRM, our mission is to decrease the time patients are suffering from pelvic pain symptoms.

LEARN MORE: https://www.pelvicrehabilitation.com/

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In this video, learn how to suture like a plastic surgeon! We'll go over the different types of sutures, appropriate needle sizes, and the correct technique for suturing different types of wounds. Whether you're a medical student or just interested in improving your suturing skills, this video is for you! Join us and start mastering this essential surgical skill.

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