Normally, the pleural spaces contain sterile lubricating fluid that enables smooth expansion and contraction of the lungs. But when microorganisms gain entry, directly or through contiguous spread of infection, the fluid becomes increasingly dense and viscous as purulence progresses. This article outlines clinical, radiographic, and pleural fluid features that can ...

In this paper, a new approach for designing ultrasonic surgical instruments (USI) is presented. These medical instruments convert an ultrasonic signal into a mechanical vibration by utilizing a magnetostrictive method and have been found to be very useful for various medical procedures. The implemented system consists of an ultrasonic generator, ...

OBJECTIVES: To describe the variation in outpatient new to old ratios between consultants and between providers for seven high volume specialties (four surgical, three medical). DESIGN: This was a descriptive study at consultant and provider unit level based upon patient administration system data from the South and West Regional Health ...

The evolution and development of surgery in Israel reflects the influence of its dramatic historical events. The immigration of surgeons, particularly since the fourth decade of the 20th century, highly contributed to the framework of modern surgery. Medical education occurs at 4 medical schools, in Jerusalem, Tel Aviv, Haifa, and ...

The authors investigated the surgical and collateral effects on soft tissue of a carbon dioxide laser emitting at 9.3 micrometers. Specifically, incision widths and depths as well as effectiveness were studied. Three different laser modes were investigated: gated continuous wave, or Cw, Superpulse and OptiPulse (Medical Optics). Incision depths correlated ...

Gastroesophageal reflux disease (GERD) is a common problem in medical practice. Estimates are that 10% of the U.S. population will experience daily heartburn and up to 40% will have symptomatic GERD on a frequent basis. Current medical therapy allows physicians to provide complete symptom relief, maintain long-term symptom remission and ...

Palmar hyperhidrosis is a disabling condition that manifests itself as excessive sweating of the hands. Although the exact cause is unknown, several medical and surgical therapies are available to treat it. Recent developments in surgical technique have made the less invasive thoracoscopic sympathectomy a viable alternative to the open sympathectomy ...

PURPOSE: To examine the behavior of surgically repaired macular holes when subsequent retinal detachment with submacular fluid develops and to correlate these observations with current theories of macular hole formation and closure. METHODS: We reviewed the medical records of four patients who underwent successful surgical closure of macular holes and ...

The advent of the laparoscopic approach to Nissen fundoplication has led to a resurgence in enthusiasm for the surgical treatment of gastroesophageal reflux disease (GERD). However, controversy exists as to which subgroups of GERD patients are best treated surgically. The relative success of treatment with medical and surgical intervention in ...

A 16 year old female with tricuspid atresia had undergone a Fontan operation at four years of age. Two years later she first presented with a narrow complex tachycardia which could only be partially controlled on flecainide in high doses. On electrophysiological study, the tachycardia was found to be due ...

Cricopharyngeal achalasia produces dysphagia in many patients. The spasm has been treated in the past with medication, bouginage, pharyngeal plexus neurectomy, and cricopharyngeal myotomy. In some patients the cause of dysphagia may be elusive, or the patient may be a poor risk for a surgical intervention. We have found that ...

BACKGROUND AND OBJECTIVES: Interpleural analgesia was used in a case of esophageal perforation due to surgical mishap. The medical literature cites no reference to use of this technique in this condition. METHOD: Interpleural bupivacaine analgesia was used along with conventional forms of pain relief. RESULTS: Superior analgesia was obtained, and ...

Benign necrotizing osteitis of the external auditory meatus is a rare condition which occurs in non-diabetic healthy people. The aetiology of the necrotic process with the formation of sequestrum in the bony external meatus is unknown. It is important to differentiate this benign process from malignant otitis externa and radionecrosis ...

By the beginning of the 1st century AD Roman medical instruments had begun to acquire the distinctive forms which they were to retain, more or less unchanged, for the next half millennium. They were carefully-designed, highly-crafted precision tools well-adapted to the range of surgical interventions and operations described in the ...

Despite the establishment of the vasculoneural compression as a frequent cause of trigeminal neuralgia, minimally invasive surgical techniques to treat medically refractory trigeminal neuralgia are needed in order to minimize the risks associated with craniotomy. Percutaneous retro gasserian glycerol rhizotomy (PRGR) is one of the alternative surgical treatments to microvascular ...

Until recently, treatment options for patients with cystine calculi were not favorable. Using holmium:yttrium-aluminum-garnet (YAG) lasers to fragment cystine calculi, however, may provide a minimally invasive and cost-effective alternative to current treatments. This article describes cystine calculi and the diagnostic methods and current medical and surgical interventions used to treat ...

Asymptomatic endometriosis is likely to be a physiological phenomenon of very limited relevance to both the physician and the patient. The evolution of our understanding of this phenomenon is a parable for modern medicine. It is likely that access to a new diagnostic technique, a powerful armoury of medical and ...

Gingival overgrowth is a well-known side-effect of nifedipine therapy. The altered gingival architecture can be disfiguring, aesthetically displeasing and cause discomfort during mastication. Traditional treatment is based on surgical resection of the overgrown tissue followed by maintenance therapy aimed at achieving a high standard of plaque control. This case report ...

Clinical desmoid disease affect approximately 10 per cent of patients with familial adenomatous polyposis (FAP); the subclinical rate is unknown. Desmoids are probably neoplastic rather than regenerative in origin and may arise in association with germline or somatic mutations at or beyond codon 1444 of the APC gene. Intra-abdominal desmoids ...

Neurological deficits suggesting trauma to the spinal cord in the thoracolumbar area are the most common clinical presentation of neurosurgical conditions. By far, the most common cause of thoracolumbar spinal cord dysfunction is intervertebral disc disease. Disc herniation and subsequent spinal cord compression usually requires prompt medical treatment, then referral ...

OBJECTIVE: To demonstrate a new surgical technique for improving the ptotic melolabial fold. DESIGN: Case series. SETTING: University medical center. PATIENTS: Consecutive sample of 8 patients with ptotic melolabial folds. INTERVENTION: Preoperative and postoperative analysis evaluating surgical intervention. Surgical treatment of the ptotic melolabial fold consists of 3 steps: removal ...

Rhinophyma is a slowly progressive, disfiguring disorder of the nose which represents the end stage of acne rosacea. The cosmetic deformity is often the reason for patients to seek medical attention. Over the years many treatment modalities, including dermabrasion, electrocautery, excision and grafting, decortication and cryosurgery amongst others, have been ...

The history of resurfacing procedures used to treat the aging face is reviewed, and the place of laser resurfacing within this context is described. The changing medical reimbursement system and desire by "baby boomers" to maintain a youthful image have driven the technical development of laser resurfacing. Medical management of ...

OBJECTIVE: To determine typical clinical and radiographic findings in a group of New World camelids with tooth root abscesses and to determine outcome after medical and surgical treatment. DESIGN: Retrospective case series. ANIMALS: 23 llamas and alpacas with radiographic and clinical evidence of tooth root abscesses. PROCEDURE: Disease history, signalment, ...

That a well-developed and hierarchical medical profession existed in Pharaonic Egypt is without doubt. What is a matter of contention is the existence of a recognizable surgical profession, or even of the practice of surgery by medically qualified personnel. Palaeorchaeological specimens that demonstrate some form of surgical procedure are rare. ...

Infections can invade the normally sterile pleural space leading to the development of parapneumonia effusions or empyemas. Pneumonia, thoracic surgery, and trauma, together, are responsible for most cases of empyemas. Pneumococci and staphylococci remain the predominant etiologic organisms. In addition, gram-negative aerobic bacteria and anaerobes are emerging as important pathogens. ...

More than 60 years ago an anatomist, Dudley Morton, and an orthopaedic surgeon, Paul Lapidus, independently published similar theories that implicated excessive mobility of the first metatarsal in forefoot dysfunction. Morton first studied in detail the evolution of the foot leading to bipedal gait and then examined the feet of ...

Hiatal hernia is a condition that is commonly encountered, widely discussed but frequently misunderstood. This review focuses on the pathogenesis, classification, associated conditions and complications of hiatal hernia. Additionally, the medical and surgical approaches to treatment are discussed with a detailed discussion of pre- and postoperative assessment in symptomatic patients.

The hallucal interphalangeal sesamoid is considered by some to represent an anatomical rarity that possesses little clinical significance. However, the location of this seemingly innocuous sesamoid bone directly inferior to the hallucal interphalangeal joint of the hallux is associated with the development of several important anatomical, biomechanical, and clinical pathologies. ...

Healing of the urinary tract follows a series of events similar to other epithelial surfaces. This process, however, occurs more rapidly in the urinary tract. A variety of factors that can affect the healing response of the urinary tract are presented in this article. It is important for the veterinarian ...

While there are several options for managing the small pupil during cataract surgery, adjustable iris retractors are beneficial when there is a risk of cutting or tearing the iris, such as with rubeosis. Appropriate use of this new surgical tool includes proper placement of the parcenteses and a gradual and ...

This article is devoted to the most common cause of outlet obstruction in the male geriatric population, benign prostate hyperplasia (BPH). The prevalence, pathophysiology, and natural history of BPH is discussed, along with the work-up and indications for medical or surgical intervention. The authors also focus on medical and surgical ...

Dusting powders are commonly used on surgical gloves, examination gloves, and condoms. In addition, they are used in diaphragms, sanitary napkins, and toiletries. These dusting powders can gain access to the abdominal cavity through the vagina or through surgical intervention. The toxicity of these dusting powders in the abdominal cavity ...

Though meningiomas are benign intracranial tumors, a minor group invades the skull base and the connective tissue of the sinus cavernous inducing neurological deficits. These patients can not be cured by surgical treatment. Therefore, the development of an adjuvant medical therapy has been the goal during the last decade. We ...

The Institute for Defense Analyses (IDA) was contracted to perform a military standard task analysis of laparoscopic cholecystectomy, and to study the effectiveness of a virtual reality surgical skills simulator as a tool for surgical training and as a method for recording psychomotor behavior. This report describes the purpose of ...

Nitinol alloys (Nitinol) exhibit a dramatically enhanced elasticity, known as "superelasticity", which is becoming integral to the design of a variety of new medical products. Elasticity is the most apparent of the advantages afforded by this material, but by no means the only or most important. Also discussed in this ...

Menorrhagia due to dysfunctional uterine bleeding can be treated medically or surgically. Medical therapy is associated with less morbidity and less profound effects on body image and fertility. Nonsteroidal anti-inflammatory drugs are the agents of choice for menorrhagia, although oral contraceptives, danazol and newer hormonal agents may also be used. ...

Since fewer donated corneas have become available for surgery, we sought to chart the reasons to exclude them for surgical use over time. Those excluded from surgical use (1991-1994) were plotted using an algorithm based on the reasons for exclusion. Four general categories (universal contraindications [UC], national/local medical criteria [NLMC], ...

Medical records of 3 cats and 72 dogs that had a fishhook endoscopically or surgically retrieved from the stomach or esophagus were reviewed. Endoscopic retrieval was successful in 41 of 62 (66%) animals, and retrieval time and hospitalization time for endoscopic retrieval were significantly shorter than times for surgical retrieval. ...

BACKGROUND: The untunneling of the ureters and the transsection of the parametria are two well-characterized steps of radical hysterectomy. Two sets of instruments were developed to facilitate the mobilization (untunneling) of the ureters and the dissection of the paravaginal and parametrial tissues during radical hysterectomy. MATERIALS: Instrument set one consists ...

Ulcerative colitis is a curable disease. Despite newer medications, many patients either fail medical therapy or develop dysplasia or carcinoma requiring surgery. Surgical techniques have improved, and complication rates have declined. The functional results of ileoanal reservoir surgery are excellent in most patients, and most patients agree that a pouch ...

Fortunately, medical contraindications to root resection and retrofill are rare. Although when present, some contraindications are potentially life threatening or involve significant possible morbidity. The value of consultation with the treating physician obtaining a complete and thorough medical history and proper modification and management of medical conditions to facilitate surgical ...

Eight children presenting with the Sandifer syndrome (with neck contorsion, radiologic studies of the cervical spine and normal neurologic exploration) have been studied in relation to gastro-esophageal reflux (GER). In the eight cases barium swallow, 24 h pH-metering, manometry, endoscopy and biopsy were made, presenting pathological GER. The barium swallow ...

Peno-scrotal transposition is an infrequent genital malposition due to a defect in the caudal migration of the inchoate scrotum during intrauterine life. It is frequently associated with urogenital and/or gastrointestinal malformations. Glenn and Anderson (1973) have classified the abnormality into the following categories, according to severity: Bifid scrotum Incomplete or ...

Availability of telemetry beds was increased cost-effectively by providing telemetry on medical/surgical units with remote monitoring at designated critical care areas. Guidelines were developed for patient selection, education, clinical policy and procedure. A two-hour inservice was completed by all medical/surgical nurses and after a pilot study the system was implemented ...

Cutis laxa is grouped with the other hyperelastic skin conditions, but it shows almost total lack of skin elasticity. Numerous other medical and surgical conditions may coexist with the skin problem, since it is a generalized affliction of the supporting connective tissues. Our patient had cutis laxa proved by skin ...

This article describes the current career path that must be followed when an individual wishes to pursue a career as a surgeon or surgical subspecialist in the German military. After graduating from high school, the young soldier has to sign a 16-year commitment and start medical studies at a civilian ...

A study on infusion phlebitis was done in medical and surgical departments in Siriraj Hospitals from February to April 1992. Two hundred and eighty-one patients and 406 infusion sites were included. The infusion time was 40.6 +/- 31.9 hours. The incidence rate of phlebitis was 25.9%. There was no difference ...

The epidemic of intentional injury continues to be a leading cause of premature death in America. The ravages of violence are particularly devastating within the minority community. With this position paper from the Surgical Section of the National Medical Association (the country's oldest and largest organization of minority physicians), a ...

Meperidine and promethazine are preoperative medications ordered frequently for outpatient and inpatient surgical procedures in this facility. Although all medications have the potential to cause adverse reactions, the case studies presented in this article suggest a relationship between the use of one or both of these drugs and the cancellation ...