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It can be surprising to realize that an organ as high-powered and sophisticated as the brain also has a plumbing system. And, as the case with a house's plumbing, the drainage side of the system can get gummed up. But the symptoms are different. When a home's drainage backs up, well...I won't go there. When the brain's drainage system backs up, the brain's owner can become confused, incontinent of urine and unsteady on his or her feet. The plumbing system in question is that which produces and drains the cerebrospinal fluid (CSF). Normal CSF looks the same as water from a faucet, but is created from the bloodstream in the choroid plexus tissue within three of the brain's four inner chambers -- the right and left "lateral" ventricles and the midline "fourth" ventricle, but not the interposed, midline "third" ventricle. The CSF percolates through passageways from one ventricle to another, finally emerging through openings at the base of the brain to bathe the outer surfaces of the brain and spinal cord before getting reabsorbed into the bloodstream again. This re-absorption occurs in special collection-nodes in the membranes surrounding the brain. The entire CSF volume of about 150 milliliters or five ounces (about as much as a glass of wine) is produced and reabsorbed four times a day, so the fluid is constantly turning over. But blockages along the way can interfere with the normal flow of the CSF. For example, when the passageway between the third and fourth ventricles becomes narrowed or choked with sludge, the CSF backs into the lateral and third ventricles. Those ventricles react to the increased pressure by becoming physically dilated or enlarged. In this case, a CT or MRI scan could reveal the location of the blockage by showing expansion of the two lateral and the single third ventricles, but a normal-sized fourth ventricle. Another example of a blockage and its consequences is when the collection-nodes responsible for CSF re-absorption in the brain's overlying membranes (meninges) become clogged. In this case, all four ventricles are upstream from the blockage, and all four of them expand. This, too, is visible on brain scans. Both cases are examples of hydrocephalus, or water on the brain. The first case is one of "internal" or high-pressure hydrocephalus. The second is called "external" or normal-pressure hydrocephalus (NPH). In NPH the pressure is inexplicably normal much of the time, but the term is somewhat misleading because prolonged recordings with pressure-monitors do show intermittent periods of increased pressure. Hydrocephalus of one kind or another is especially prevalent at the two extremes of the life cycle -- in the very young and the very old -- but can occur at any age. In infancy, hydrocephalus can be caused by malformed brain-tissue. In contrast, adults with hydrocephalus were usually born with normal brain anatomy, but acquired a blockage due to a tumor, injury, bleed or infection. However, many cases of hydrocephalus in adults occur without a history of these preceding illnesses. CT and MRI scans are sensitive tools in detecting hydrocephalus, particularly when it's striking enough not be confused with ventricular enlargement due to gradual loss of surrounding brain tissue from aging. The main treatment of hydrocephalus is for a surgeon to insert a tube (shunt) into one of the swollen lateral ventricles and provide an alternative pathway for the backed-up CSF to drain. Once the shunt equipment is in place, a piece of hardware about the size of a large button sits outside the hole made in the skull (but inside the skin of the scalp) and redirects the excess CSF through another tube into either a jugular vein in the neck or into the abdominal cavity (peritoneum). Thus, the patient can receive either a "VJ" shunt or a "VP" shunt, with the letters designating the locations of the two ends of the shunt. The success or failure of shunting depends not just on the skill of the surgeon, but also on the selection of appropriate patients. Sometimes hydrocephalus turns up unexpectedly on scans when doctors are looking for something else entirely. Although an unexpected finding like this should always cause the doctors to re-think the case, the point is that hydrocephalus doesn't always cause problems. Sometimes the hydrocephalus has been there for years and the brain has adjusted to it in a way that produces no symptoms. This is an example of a case that should not be shunted, though it would still be appropriate to monitor the patient and his or her scans over subsequent months and years. Who, then, should receive a shunt? The answer, in short, is people for whom the benefits of the operation exceed its risks. Identifying them, however, is the tough part. And the task is made even more difficult by the lack of randomized, controlled trials in which a group of patients receiving treatment is compared to an equivalent group of patients not receiving treatment. Although similar reasoning applies to adults thought to have internal (high-pressure) hydrocephalus, I'll lay out the decision-tree as it applies to external (normal-pressure) hydrocephalus. Published observations imply that shunts are most likely to help NPH patients who have the following features:substantial enlargement of all four ventricles a full "triad" of symptoms, including confusion, urinary incontinence and altered walking poor walking as the first of the three symptoms temporary improvement of symptoms after drainage of 50-60 milliliters (2 ounces) of CSF by lumbar puncture (spinal tap) The elderly patients most at risk for NPH are also at increased risk for other diseases, and the shunting operation doesn't help symptoms produced by other causes. For example, confusion can be caused by Alzheimer's disease and strokes. Urinary incontinence can be due to prostate disease in men and sagging pelvic tissue in women. Walking can be disrupted by arthritis, fractured bones, low vision, inner-ear disease, Parkinson's disease and many other unrelated processes. So it's important for the doctor to determine if other diseases might be to blame for the very symptoms that seem, at first glance, to be from NPH. Assuming that NPH still seems likely, the next round of decision-making concerns the possibility that an operation will cause harm. Even a patient whose brain scan and symptoms are classic for NPH can develop serious complications from the operation. A particularly feared complication is bleeding into the space outside the brain, called a subdural hematoma. Older patients are also more likely to have other medical conditions that could compromise the safety of an operation, like coronary artery disease or emphysema. Cases in which expected benefits of the operation are much greater than risks, or in which the risks are much greater than the expected benefits, are easy to make decisions about. But many other cases are in the gray zone in which potential benefits and risks are more evenly matched and the chances of doing harm with an operation come close to canceling out the chances of doing good. (C) 2006 by Gary Cordingley free exercise tip for penis enlarement natural penis elargement and lengthening penis enlargment tip truth about penis enlarement pills surgical penis enlagement surgical penis enlagement penis enhancement program vimax medical penis enlargement

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Nobody likes surprises, so it's always nice to know what to expect when you take you're pet to the veterinarian. A good physical exam usually begins by weighing and recording so that a continuing record can be formed. An increase or decrease in weight can indicate a problem. Next, the temperature is taken, usually rectally with a normal temperature of 101 to 102.5 degrees for both dogs and cats. Coat and skin are examined next as poor hair coat or skin can indicate a poor diet or dermatological infection. Coat should be shiny, not brittle and coarse, and the skin, clean and not greasy. While handling your pet, the bones, muscles, and joints, nails, feet, and lymph nodes are checked for any abnormalities. The chest, heart, and lungs are examined with a stethoscope, along with the rate and nature of respiration. At the head, both ears are examined deep into the ear canal for infections. The visible eye structure and lids are examined and the interior of the eye is checked for cataract formation, and an examination of the mouth and throat for infected gums, loose teeth, tartar buildup on the teeth and any damage or swelling in the throat. Lastly, at the rear, the anus, anal glands, prepuce/penis or vcalva are checked for any abnormalities, and the anal glands cleaned if they are compacted. During the examination the vet will usually ask the name of your pet's food and any other treats or vitamin supplements, along with any medication you may have given your pet. A fecal sample will be taken for examination to check for intestinal parasites, such as hookworm and roundworm, and a blood test may be recommended if heartworm is suspected. No checkup would be complete without a flea and tick prevention/treatment with a choice as to who will administer the treatment, you or the vet. While the exam may sound involved and complicated, the entire process usually only takes about 30 minutes and guarantees your pet a healthier happier life. penis enargement technique magna rx review top rated pnis enlargement pills easy enlargement free pennis surgery way magnarx vimax free penis enlargement technique free penis elargement tip enlargment manhattan penis pennis enlargement without pills

Genital wart signs vary from men and women, this article will explain the different genital wart signs on each person and where they appear. Genital wart signs in men tend to be more outright and seen as their genitals are completely outside the body. Genital wart signs in women seem to be more internal and not as easily seen. On women the most notable wart signs are hard dots on the outer edges of the genitals as well as on the cervix and between the vaginal opening and the anal cavity. These are the genital warts and they may not show up for a long time after contraction occurs. Men may notice that genital warts seem to show up on the head of the penis and around the anus as well as the scrotum. They may be gray or pink in color and will grow bigger over time. Another sign that a person has contracted genital warts is burning or bleeding in the genital area, especially during sexual intercourse. Genital warts may seem to appear as small white lumps which many say resemble cauliflower and can be as small as 2 millimeters. Women who have genital wart infections will notice that the warts are small, sometimes too small to see. Genital warts appear in the cervix in some cases where they cannot be seen and there are no real symptoms or signs. Except for genital warts that are internal but may bleed during sex as the warts are being torn open. Doctor’s tests will readily tell a person if she has genital warts inside her cervix. In most cases genital warts will cause no symptoms and not be noticed unless the outbreak of genital warts is big enough that a person sees or feels them. People really have to reply on the signs that genital warts gives. These are for the most part the bumps and cauliflower shapes as well as where the warts appear and how long ago a person thinks they may have gotten them. Genital warts are considered a sexually transmitted disease because they are spread during unprotected sex and in some cases protected sex. The only dangerous thing about having genital warts and not doing anything about them is if there is no discomfort, and someone chooses not to pay attention to the bumps they can lead to some cancers. penis enlagement pills product pro fitness health solution pnis enlargement surgery cost safe penile enlargment best penis enlargement pill penile girth enlargement penis enlarement surgeries prosolutionpills pennis enlargement without pills

Boxers are very popular today, considering they have only been used during the last century. There is an unofficial debate over which is better, boxers and briefs, and so far, boxers seem to be winning. Read on to see why many men are switching to this comfortable underwear. Boxers are said to present a more adventurous choice of design in today’s market, where personalization of items is a good marketing tool. It pervades even the world of art – the artist/ photographer Storm Thorgerson once featured a Boxer dog in designer boxers on a beach as part of his exhibit (which featured many other parodies of men and animals). Many people regarded wearing boxers as taboo for a long time before they were finally accepted as definite alternative to briefs in the latter part of the twentieth century. The popularity of boxer shorts has transcended more than the local tailor shop. As we have seen over the past few years, sports apparel companies that release underwear lines are already featuring boxer shorts, as it said to aid in the rigors of many sports ordeals. It seems that the era of jockstraps and supporters, which were prevalent only years ago, is gone. (Back then, men were advised to wear supporters that hug the genitals to provide protection.) Results medical experiments also recommended boxer shorts, since they aid in airflow, avoiding the arrest of spermatogenesis. Brief-style underwear allegedly causes scrotal hyperthermia and can lead to clinical sub-fertility. How practical can wearing boxers get? Strong brief fans may argue otherwise, as these boxers may not be very helpful in hiding an erection or may cause uneasiness due to too much movement of the penis. penis elargement exercise penis elargement system guide to penile enlargment top penis enlagement pills medical penis enlarement natural pennis enlargement pills best pnis enlargement free penis elargement exercise pennis enlargement without pills

Men’s sexual health is as important a topic of discussion as any other health related issue. Sexual awareness in men is on the increase and more and more men world wide are becoming aware of their sexual health. Specific medical research and clinical trials are being conducted to understand the effects of new drugs in treating various sexual conditions in men. Erectile dysfunction (ED) or impotence is one such sexual condition that most men are scared off and its onset is considered with dread. This medical condition has multiple causes ranging from age, drug side effect, nervous disorder, injury or trauma. In the earlier stages it is generally considered trivial and ignored. But as the symptoms appear repeatedly the patient begins to suffer physically (lack of sexual activity) and psychologically (partners begin to ignore them). This is the stage when the panic sets in and if the condition is left untreated, it may turn disastrous for the victim. Nowadays your doctor or a sexual health specialist will be able to diagnose this condition using a combination of verbal and physical examination methods. Once there is a confirmed diagnosis, treatment can begin depending on the patient’s medical and physical condition. Viagra, containing sildenafil citrate, is used to effectively treat ED in men. It has a high success rate and its mild and short lived side effects make it a popular choice amongst doctors and patients. Viagra is sold as blue pills in dosage of 25mg to 100mg and can be taken once a day between 30 minutes to 4 hours before sexual intercourse. Viagra’s mechanism of action is based on relaxing the smooth muscles of the penis resulting in increased blood flow causing an erection. Without sexual stimulation Viagra by itself should not cause an erection. The compound sildenafil citrate, is also sold as a drug named Revatio which is used for treating pulmonary arterial hypertention (PAH). In this rare medical condition the right side walls of the heart tense up and may lead to heart failure. When Revatio is administered to the patient, it relaxes the tense right walls of the heart reducing the resistance and pressure, thus preventing a right-side heart failure. In fact sildenafil was initially synthesized for treating PAH. It was only later that its effect in treatment of ED was discovered. Revatio is sold as white round pills to distinguish it from Viagra sold as blue diamond pills. Like all medications these must be stored away from children in a cool place protected from direct sunlight and moisture. Remember never to share your prescription with others as your needs are unique. You should always use the medicines in the prescribed dosage and duration provided by your doctor. Overdose and off-label use of drugs can cause serious complications. Always use all medicines under qualified medical supervision.