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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 magna rx pill penis elargement result penis enlagement herb herbal natural penile enlargement best penis enlargment penis enargement forum does vigrx really work herbal natural penis elargement

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The terms, AIDS and HIV, have been common currency for over twenty years and in many parts of the world it can seem as if the threatened crisis never happened. We do not see the drama anticipated from a mass epidemic, but you may not be aware that more than one million adults and children are living with HIV/AIDS in the United States alone. That figure is alarming but it pales in comparison with sub-Saharan Africa, where the number affected is more than 25 million adults and children. Here are some facts on AIDS and HIV that everyone needs to understand. AIDS stands for Acquired Immunodeficiency Syndrome: • Acquired means you can get infected with it • Immune Deficiency means a weakness in the body’s fight against disease. • Syndrome means the symptoms that make up a disease. AIDS is caused by a virus called Human Immunodeficiency Virus (HIV). If you get infected with HIV, your body tries to fight the infection by producing “antibodies”. When you have a blood test for HIV, it looks for the presence and concentration of these antibodies. As the HIV disease continues, the immune system becomes weaker and, normally harmless viruses, bacteria and fungal infections can cause more sickness than if you had been healthy. You can get infected with the virus in a number of ways: • Having sex with an infected person • Sharing a needle with an infected person • Being born from an infected mother • Drinking human milk from an infected woman • Blood transfusion with infected blood The symptoms of HIV start with fever and headache, similar to influenza. The virus can meanwhile multiply in the body, damaging your immune system and making the recovery longer and longer. HIV later becomes AIDS, when the immune system is severely diminished with serious weight loss, brain tumours and other infections. There is no cure for AIDS. The drugs that are currently available simply slow the HIV damage to the Immune System. SAFER SEX HIV infection can be transmitted during sex via blood or sexual fluids from one infected person to another. Unsafe sex has a high risk of spreading HIV. When blood or sexual fluids touch the soft, moist mucous membranes inside the rectum, vagina, mouth, nose or at the tip of the penis, the HIV can enter the body. The use of condoms is vital to stop the spread of the HIV. Cuts, sores or bleeding gums increase the risk of being infected. Lubricants can increase sexual stimulation; but oil based lubricants like petroleum jelly, oils or creams can damage condoms and other latex barriers and make them ineffective as a barrier to infection. Oral sex has a high risk of transmitting HIV, especially if sexual fluids get in the mouth and there is bleeding, sores or mouth ulcers. Condoms without lubricants are best for oral sex. If you are not infected, sex with just one partner, who is also uninfected, is the safest way to stay healthy! penis elargement before and after natural pennis enlargement technique top penis enhancement pills penis enlagement tip penis enlargment surgeon cheapest penis enlargement pills penile enlargment fact penis enlargement surgeries cheapest penis enlagement pills

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