Alexandra J. Golby, MD, Director, Image-guided Neurosurgery at Brigham and Women’s Hospital, discusses technological advancements to improve the precision of surgery to remove brain tumors.

It’s estimated that each year nearly 80,000 people are diagnosed with primary brain tumors and 100,000 with metastatic brain tumors. Nearly everybody is at risk for developing a brain tumor. Brain tumors can affect people from childhood to the last years of their lives. Men are slightly more affected than women and the causes of most brain tumors are not known.

There are a number of unique challenges in treating brain tumors. One challenge is that primary tumors can have indistinct margins that are difficult to see. Another challenge is that the tissue around a brain tumor is uniquely important and may impact things like language, visual and motor function.

The AMIGO Suite, opened in 2011 at Brigham and Women’s Hospital, is the Advanced Multimodality Image Guided Operating Suite. It's an NIH-funded national center which was developed with the goal of translating technological advances into improvements in surgical and interventional care for patients. In the AMIGO Suite, there is an intraoperative MRI scanner which can be brought in and out of the operating room during surgery to help surgeons visualize a patient’s tumor better.

Image-guided surgery uses the information obtained from advanced imaging and translates that into the planning and execution of surgery by acquiring high resolution and specialty structural images of the brain and also functional images of the brain. These images can be registered to one another and then to the patient's head during surgery. This allows surgeons to pinpoint the location of the tumor as well as the areas that we would like to preserve, areas that serve critical brain functions are located.

One of the big challenges, even with image-guided surgery, is that as we perform the surgery, the configuration of the brain is changing, and we call that brain shift. And it's due to changes in the brain itself and also as we remove tissue, things are constantly shifting and moving. When we're talking about doing brain tumor surgery, a few millimeters of movement can be a big difference. How to measure and track brain shift is an important area of research and a number of technologies are being studied to understand how to measure brain shift during surgery.

The development of various intraoperative imaging technologies allows surgeons to provide the most accurate surgical treatment for each individual patient.

Learn more about precision brain surgery at Brigham and Women’s Hospital:
https://www.brighamandwomens.o....rg/neurosurgery/brai

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You may have heard that some positions, such as your partner on top (missionary position), are better than others for getting pregnant. In fact, there's no evidence to back these theories up. Experts just haven't done the research yet. What experts have done, though, is use scanning to show what's going on inside when you're doing the deed. The research looked at two positions: the missionary position and doggy style. (Doggy style being when you're on all fours, and your partner enters you from behind). Common sense tells us that these positions allow for deep penetration. This means that they're more likely to place sperm right next to your cervix (the opening of your uterus). The scans confirm that the tip of the penis reaches the areas between the cervix and vaginal walls in both of these positions. The missionary position allows the penis to reach the area at the front of the cervix. The rear entry position reaches the area at back of the cervix. It's amazing what some experts spend their time doing, isn't it! Other positions, such as standing up, or woman on top, may be just as good for getting sperm right next to the cervix. We just don't know yet. So, in the meantime, enjoy some variety in your sex life and keep it fun while you're trying for a baby. And talk to others who are hoping to get pregnant by joining our Actively trying group. Do I have to have an orgasm to conceive? Obviously, it's very important for your partner to reach orgasm if you are trying for a baby. There is no evidence, however, that you need to orgasm to conceive. The female orgasm is all about pleasure and satisfaction. It doesn't really help to get the sperm to the egg. Gentle contractions in your uterus can help the sperm along, but these happen without you having an orgasm. So, it's really not vital for you to reach orgasm after your partner, or even to reach orgasm at all, for you to conceive.

This video is really sad. You can literally watch this man dying. He was shot in the chest and rushed to the emergency room. His heart has stopped beating or has arrested. As a last resort, surgeons did an extreme procedure called an open thoracotomy which is that crazy tool you see there that basically splits the ribs open and allows easy open access to the heart. They did this so they could give him a cardiac massage. A cardiac massage is when surgeons are manually trying to pump the heart after it has stopped working on its own (cardiac arrest). Unfortunately he lost so much blood from his gun shot wound and he was pronounced dead. There are cases of patients surviving after having this kind of invasive resuscitation but it is rare.

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Ellis demonstrates how to perform a sterile wound dressing change. It would be appropriate to perform hand hygiene between glove changes.

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00:00 What to expect
00:51 Prepping for wound dressing change
1:15 Removing the old wound dressing
1:40 Assessing a wound
2:05 Setting up sterile field
2:49 Sterile gloving
4:02 Preparing equipment for wound dressing change
5:09 Cleaning a wound
6:13 Drying a wound
6:28 Packing a wound
7:19 Covering a wound
7:47 Labeling a wound dressing

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History, Examination and Management of Hernia
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This video shows the delivery of the placenta after delivery of the fetus

Olympus has extended the value of its award-winning combined surgical energy device, THUNDERBEAT, to open surgical procedures. Watch Dr. Francois Blaudeau master use of THUNDERBEAT Open Extended Jaw (OEJ) in a total abdominal hysterectomy.
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Female condoms are easy to use with a little practice. Here are the basics on how to insert, use, and remove a female condom.

Kendall Lee, M.D., describes deep brain stimulation surgery, and how it is is typically done with patients who remain awake, so neurological functions can be measured and maintained. For more information on deep brain stimulation, visit http://mayocl.in/2A09T80.

a video showing the process of child birth or delivery using forceps