1. 20180316(Fri): Neurosurgery Department @ Amerikai utca.
   1. Spinal surgery: Disectomy. Microscopic surgery.
      Lumbar disk hernia, L5/S1. Left side. 31 male.
   2. Spinal Surgery: Disectomy. Microscopic surgery.
      Lumbar disk hernia, L5/S1. Right side. Assisted by me. nucleus pulposus extracted as a bulk. (a big chunk.)
   3. VP shunt tube replacement: (hydrocephalus). previous
   4. VP shunt tube replacement: to Atrium (Originally in Peritoneum)
   5. Explantation! (of kidney, liver, heart). Brain dead. 40s lady.

Neurosurgery. 
Trigeminal Neuralgia. 
  Needle Ablation. 
  Needle was inserted from orbit!
  Fluroscope guided to trigeminal ganglia.
  Radiofrequency ablation.

20180323(Fri): Traumatology. Fiumei utca.
 1. Cullen Fracture.

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20180323(Fri): Obstetrics. 
Neonetal Care. 
A. The 3rd day of the life:
  1. BCG. Every baby. in the upper arm.
     **intracutaneously.** make a swelling on the skin.

  2. Serum Bilirubin, if jaundice is suspected.
     physiologic jaundice usually happens in day 3 or 4.
     So earlier jaundice could be pathologic.

     ** Blood taken from veins on the sculp **

  3. Antibiotics: Oral. Amoxicilin and gentamycin.
     if infectious risk is higher.
       eg. mother is GBS+.
           earlier Rupture of membrane. 12 hours earlier than delivary.

B. Day 2
  1. Hearing. ABR: Auditory Brainstem Response.

C. Day 1.
  1. Eye. congenital cataract, retinoblastoma. by Red Reflex
  2. monitor general condition. 
  2. body temp.
  3. glucose.

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20180322(Thu): Traumatology. Fiumei utca.
Operating Theater:
  1. Hip Replacement Complication. Abscess. Assisted by me.
  2. SupraCondylar Fracture. Pediatrics.
     Fixated by K-Wire.
  3. Femoral Neck Fracture. Non-displaced. X-ray negative.
     34 male, prizoner.
     Fixed by plate; two long screws go to neck. 5 screws go to shaft.
  4. fiblotibial syndesmosis rupture.
     fixated by two long screw. 3 cortex: two fibla, one tibia.
     15 mins operation. general anesthesia.
Shock room:
  1. 2 year old child. head trauma. dropped in the Boiler?

Amblance:
  1. facial minor trauma. middle-aged man.
     complex wrist fractures by X-ray.
  2. femoral neck fracture. old lady.

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20180308(Thu): Iridotomy by laser for close angle glaucoma.
  1. 1st pt. make a hole at 11 oclock. 
  2. 2nd pt. 1 oclock
  anesthesia. (eye drop). dark room.
  slitlamp-like machine with laser function.

20180314(Wed): Research MRI anslysis for ADHD,  schizophrenia.
 motion recoginition: sup temporal sulcus
   dots motion recognition: human joints or random.
 inhibition: anterior cyngulate gyrus.
   press button on view of pictures. some are disgustinng.
   if the same picutre are shown consecutively you will not push the botton.
   Otherwise push button. Inhibitory test!

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20180317(Sat): Ophthalmology Out-Patient. 
1. Foreign Body. Left eye. Metal Piece <1mm on the cornea.
   Ocupational injury. Tearing a lot.
   Removed assisted by slit-lamp

2. Acute glaucoma: Unilateral Right.
   Red injection. 
   Slit lamp: narrow anterior chamber.

3. Hyphema. Trauma patient. somebody hits him on the right eye.
   Big bruise. Other wise normal.

4. endoophthalmitis. 83 years old female.
   sent from Gery(famous for wine) by ambulance car.
   Pus flowing down from her right eye.
   Left had been enuculated.
   Swollen and Red.
   endoophthalmitis+scleramalasia+cornea malasia.
   Ultrasound shows vitrous body is filled with pus.

5. Chlamydia suspected. 2 months long conjuctivitis.

6. Uveitis (anterior)
   DDx criteria: 
    1. cell in anterior chamber. missed it! Gabor said he found it! sepecific!
    2. photophobia.
    3. injection: non-specific

Others: good to know.
Adenovirus conjuctivitis: caruncle also becomes red. specific!

Conjuctivitis: Pharmacotherapy.
1. Tobramycin(aminoglycoside)
2. levoflaxicin, moxiflaxicin, ciproflaxicin(fluroquinolones)

SF6(Sulfo-hexo-fluoride) Vitrous body: Gas filling by 

Gleek use is much more common in ophthalmology than other specialty.
 Genio: angle in gleek. genu! 
 Rubiosis: Redness = neovascularization.
 Genio-Rubiosis: 1 type of glaucoma. iris neovasculization(DM) -> schlemm cannal close->glaucoma. 
 keratitis: <-> cornea(latin)
 irido-cyclitis.

3 types of Retinal Detachment.
 1. Rhegatatogen: retina tear <- fluid in sub retinal space. 
 2. Traction <- DM. retracted via direct connection.
 3. Inflammation.(edema)

Injection=red eyes.: can be caused by 3 layers.
 1. conjuctiva   e.g conjuctivitis.
 2. episclera
 3. sclera.

Opthalmologic Emergency.
1. Acute glaucoma
2. keratitis
3. CRAO/CRVO: central retinal artery/vein Occlusion.
4. 

aphakia: no lens.
anisometropia: VA diff in eyes.
applation tonomety: measure ICP. on slitlamp.
cycloplegics: cyclopetolate.

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20180318(Sun) Neurosurgery, Traumatology
1. Epidural hematoma: assisted by me.

2. Subdural hematoma: turned out to be pus, abscess: assisted by me.

3. vertebro-platy: compression fracture.
    local anasthesia. Patient feels pain during the operation.
   bone cement injection to vertebral body.
   aimed by metal tube (similar way with Stdinger techniquie).
   Fluoroscope. 
   Vertebral body was reached through the pedincle(neck of transverse process).