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Clinical case discussion for exams.
Useful for medical students and others.
A 54 year old man with a left leg tumor, a vascular malformation, undergoes resection (removal) of the tumor.
This 40 yr male had upper abdominal pain for 3 months. A video-endoscopic examination of esophagus, stomach and duodenum was performed. A large 2.5x2.5 cm chronic ulcer was detected in the first part (bulb) of duodenum. A gastric biopsy was taken for diagnosis of Helicobacter infection and a rapid urease test done which was positive. He received triple therapy (2 antibiotics and acid suppressive drug for one week) to eradicate Helicobacter pylori infection. Ulcer disease showed rapid clinical and endoscopic healing. Eradication of Helicobacter pylori infection led to permanent ulcer cure.
Burying The Knot
This endoscopy shows a patient with cancer of the larynx, Laryngeal cancer is the most common cancer of the upper respiratory tract. The incidence of laryngeal tumors is closely correlated with smoking, as head and neck tumors occur 6 times more often among cigarette smokers than among nonsmokers. The age-standardized risk of mortality from laryngeal cancer appears to have a linear relationship with increasing cigarette consumption. Death from laryngeal cancer is 20 times more likely for the heaviest smokers than for nonsmokers. It should be suspected in any patient with hoarseness of the voice for three weeks or longer until proven otherwise.
Aortic Valve-Sparing Operation in a Patient with Aortic Root Aneurysm using a new Prosthesis for Anatomical Reconstruction of the Sinuses of Valsalva
Rhumatic fever has almost been eraicated in the developed world, however it remains prevelent in many under developed countries and causes devastating damage to heart valves. Up till recently valve replacement was the treatment of choice. The long term results and sequelae of valve replacement are...
common knowledge. Mitral and tricuspid valve replacement results are on the whole far worse than for example Aortic valve. Mitral valve replacement should be the last resort and patients with very severe valvular and sub valvular mitral disease can nowadays be helped by mitral valve repair. NO MITRAL OR TRICUSPID VALVE SHOULD BE REPLACED IF IT CAN BE REPAIRED
Importance of Regular Dental Exams
Laparoscopy in acute bowel obstruction following previous surgery is a difficult procedure and avoided by most of the surgeons due to the difficulty in obtaining pneumoperitoneum, port placement, lack of working space, adhesions and risk of bowel injury.
Here is a patient who had a previous laparotomy for trauma with a midline incision from xyphysternum to pubis; after unsuccessful conservative management he underwent a laparoscopy; a prior CT scan showed adhesions in the left side and a distal-mid small bowel obstruction. The pneumoperitoneum was obtained with the Visiport placed in the right lower quadrant; although the abdomen was grossly distended, under significant tension and distended loops of small bowel were occupying most the peritoneal cavity, with muscle relaxation there is usually enough space to perform a thorough inspection of the abdominal cavity. Port placement has to be done with special care as there is no room to push and usually a blunt trocar directed away from the bowel is employed in my practice. The collapsed loops of small bowel point quickly to the site of obstruction -- it is better to avoid manipulating the distended bowel as it is heavy, oedematous and prone to be lacerated with the instruments; once the pathology is identified, in this case the obstructive band, light packing is performed in order to expose the working space and protect the bowel from instruments like scissors or diathermy. In this case the band adhesion was slightly more difficult to separate from the bowel and required a combination of sharp and gentle blunt dissection.
Once the obstruction is release and the transit of contents is confirmed in the collapsed bowel the procedure is terminated. No abdominal drainage is usually necessary.
Herniated or Ruptured Disc: Between each of the vertebre of the spine is a disc which is filled with a gel type material to cushion the connection between the vertebre. With age or injury these intervertebral discs can rupture or herniate. This herniation causes them to push against the adjacent nerves which come from the spinal cord. This can frequently cause pain, numbenss and tingling. This animated video reviews herniated disc.
Infant CPR Video Demonstration
The BMHR uses the same socket (hydroxyapatite-coated metal uncemented cup) and bearing(metal on metal) as the BHR. The modular head component fits onto a hydroxyapatite proximal porous coated cobalt chrome stem. It is an uncemented short stemmed prosthesis. It was invented by Prof. Dereck Mc.Minn a year ago and is performed by very few surgeons the world over. In India it is being done only at the Asian Regional Center for Hip Resurfacing in Chennai.
Laparoscopic Appendectomy for Acute Appendicitis Post-illeal Appendix
Cosmetic surgery-mammoplasty-breast surgery-tummy
After losing control of his entire right side from a massive stroke, a teenager overcomes a long, difficult, and uncertain recovery with courage, grit, and determination. ~ Detroit Medical Center
DMC Orthopaedic Specialists are the state leaders in a unique new procedure to resurface the knee joint, preserving more bone for the patient. ~ Detroit Medical Center
A teenager's ability to perform the most basic tasks is threatened by a disorder that requires the replacement of both hip joints by a DMC pediatric orthopedic specialist. ~ Detroit Medical Center
Kathleen Carr, MD performs a full shoulder exam for the musculoskeletal program at the University of Wisconsin Department of Family Medicine.
