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Medicine: The art and science of studying, performing research on, preventing, diagnosing, and treating disease, as well as the maintenance of health.

Embryonic Stem Cells

JoVE 10811

Embryonic stem (ES) cells are undifferentiated pluripotent cells, meaning they can produce any cell type in the body. This gives them tremendous potential in science and medicine since they can generate specific cell types for use in research or to replace body cells lost due to damage or disease.

ES cells are present in the inner cell mass of an embryo at the blastocyst stage, which occurs at about 3–5 days after fertilization in humans before the embryo is implanted in the uterus. Human ES cells are usually derived from donated embryos left over from the in vitro fertilization (IVF) process. The cells are collected and grown in culture, where they can divide indefinitely—creating ES cell lines. Under certain conditions, ES cells can differentiate—either spontaneously into a variety of cell types, or in a directed fashion to produce desired cell types. Scientists can control which cell types are generated by manipulating the culture conditions—such as changing the surface of the culture dish or adding specific growth factors to the culture medium—as well as by genetically modifying the cells. Through these methods, researchers have been able to generate many specific cell types from ES cells, including blood, nerve, heart, bone, liver, and pancreas cells. Regenerative medicine concerns the creation of living, functio

 Core: Biotechnology

Peripheral Venous Cannulation

JoVE 10200

Source: Sharon Bord, MD, Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Maryland, USA


Placement of an intravenous (IV) catheter is one of the key procedures in medicine. The IV catheter allows patients to receive critical medications, including pain medicine, insulin, antibiotics, blood products, and…

 Emergency Medicine and Critical Care

Percussion

JoVE 10136

Source: Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


Simply stated, percussion refers to the striking of one object against another to produce sound. In the early 1700s, an Austrian inn-keeper's son, named Leopold Auenbrugger, discovered that he could take inventory …

 Physical Examinations I

Proper Adjustment of Patient Attire during the Physical Exam

JoVE 10147

Source: Jaideep S. Talwalkar, MD, and Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


In order to optimize the predictive value of the physical examination, the provider must perform maneuvers correctly. The proper use of drapes is an important component of correctly performing…

 Physical Examinations I

Observation and Inspection

JoVE 10119

Source: Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


Observation and inspection is fundamental to physical examination and begins at the first point of contact with a patient. While observation and inspection are often used interchangeably, observation is a general term …

 Physical Examinations I

General Approach to the Physical Exam

JoVE 10043

Source: Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


The examination of the body is fundamental to the practice of medicine. Since the Roman Empire, physicians have described the connection between alterations in function of specific parts of the body and specific…

 Physical Examinations I

Genetics of Organisms- Concept

JoVE 10557

Mendelian Genetics

Evolution is caused by changes in the genetic composition of populations. In the field of population genetics, scientists model this process as changes in the frequency of alleles at individual genetic loci. This simple representation of how evolution occurs dates to Gregor Mendel’s analysis of trait inheritance patterns in pea plants, first presented in 1865.…

 Lab Bio

Auscultation

JoVE 10153

Source: Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


Through auscultation, the clinician is able "to eavesdrop on the workings of the body" to gain important diagnostic information.1 Historically, the term "auscultation" was synonymous with…

 Physical Examinations I

Pelvic Exam III: Bimanual and Rectovaginal Exam

JoVE 10163

Source:


Alexandra Duncan, GTA, Praxis Clinical, New Haven, CT


Tiffany Cook, GTA, Praxis Clinical, New Haven, CT


Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


A bimanual exam is a…

 Physical Examinations II

Pelvic Exam I: Assessment of the External Genitalia

JoVE 10144

Source:
Alexandra Duncan, GTA, Praxis Clinical, New Haven, CT
Tiffany Cook, GTA, Praxis Clinical, New Haven, CT
Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


The pelvic exam can feel invasive to patients, so it is important to do everything possible to…

 Physical Examinations II

Pelvic Exam II: Speculum Exam

JoVE 10141

Source:


Alexandra Duncan, GTA, Praxis Clinical, New Haven, CT


Tiffany Cook, GTA, Praxis Clinical, New Haven, CT


Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


Providing…

 Physical Examinations II

Comprehensive Breast Exam

JoVE 10118

Source:
Alexandra Duncan, GTA, Praxis Clinical, New Haven, CT
Tiffany Cook, GTA, Praxis Clinical, New Haven, CT
Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


Breast exams are a key part of an annual gynecological exam and are important for all patients, …

 Physical Examinations II

Intraosseous Needle Placement

JoVE 10312

Source: Julianna Jung, MD, FACEP, Associate Professor of Emergency Medicine, The Johns Hopkins University School of Medicine, Maryland, USA


For unstable patients requiring urgent administration of medications, fluids, or blood products, establishing vascular access quickly is essential. However, there are many factors that can…

 Emergency Medicine and Critical Care

Basic Life Support: Cardiopulmonary Resuscitation and Defibrillation

JoVE 10199

Source: Julianna Jung, MD, FACEP, Associate Professor of Emergency Medicine, The Johns Hopkins University School of Medicine, Maryland, USA


High-quality cardiopulmonary resuscitation (CPR) is the single most important determinant of intact survival in cardiac arrest, and it is critical that all healthcare workers are able…

 Emergency Medicine and Critical Care

Eye Exam

JoVE 10149

Source: Richard Glickman-Simon, MD, Assistant Professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, MA


Proper evaluation of the eyes in a general practice setting involves vision testing, orbit inspection, and ophthalmoscopic examination. Before beginning the exam, it is crucial to be familiar…

 Physical Examinations II

Ear Exam

JoVE 10148

Source: Richard Glickman-Simon, MD, Assistant Professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, MA


This video describes the examination of the ear, beginning with a review of its surface and interior anatomy (Figure 1). The cartilaginous auricle consists of the helix,…

 Physical Examinations II

Ophthalmoscopic Examination

JoVE 10146

Source: Richard Glickman-Simon, MD, Assistant Professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, MA


The simplest ophthalmoscopes consist of an aperture to look through, a diopter indicator, and a disc for selecting lenses. The ophthalmoscope is primarily used to examine the fundus, or the…

 Physical Examinations II

Palpation

JoVE 10143

Source: Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


The physical examination requires the use of all of the provider's senses to gain information about the patient. The sense of touch is utilized to obtain diagnostic information through palpation.


 Physical Examinations I

Peripheral Vascular Exam Using a Continuous Wave Doppler

JoVE 10123

Source: Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


Peripheral vascular disease (PVD) is a common condition affecting older adults and includes disease of the peripheral arteries and veins. While the history and physical exam offer clues to its diagnosis, Doppler ultrasound has become a…

 Physical Examinations I

Peripheral Vascular Exam

JoVE 10122

Source: Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


The prevalence of peripheral vascular disease (PVD) increases with age and is a significant cause of morbidity in older patients, and peripheral artery disease (PAD) is associated with cardiovascular and cerebrovascular complications.…

 Physical Examinations I

Abdominal Exam IV: Acute Abdominal Pain Assessment

JoVE 10120

Source: Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


Abdominal pain is a frequent presenting concern in both the emergency department and the office setting. Acute abdominal pain is defined as pain lasting less than seven days, while an acute abdomen refers to …

 Physical Examinations II

Lymph Node Exam

JoVE 10061

Source: Richard Glickman-Simon, MD, Assistant Professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, MA


The lymphatic system has two main functions: to return extracellular fluid back to the venous circulation and to expose antigenic substances to the immune system. As the collected fluid passes …

 Physical Examinations II

Open Cricothyrotomy

JoVE 10284

Source: James W Bonz, MD, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA


Open cricothyrotomy is an emergent surgical procedure. It is performed to establish an airway access by passage of a tube through an incision in the cricothyroid membrane. This is a procedure of choice in the feared "can't intubate, can't…

 Emergency Medicine and Critical Care

Cancer

JoVE 10987

Cancers arise due to mutations in genes involved in the regulation of cell division, which leads to unrestricted cell proliferation. Modern science and medicine have made great strides in the understanding and treatment of cancer, including eradicating cancer in some patients. However, there is still no cure for cancer. This is largely due to the fact that cancer is a large group of many diseases. Tumors may result in a case where two people have the same mutations in an oncogene or tumor suppressor gene. Initially, the tumors may be very similar. However, the uncontrolled cell division results in new random mutations. As the tumor cells continue to divide, they become more varied. As a result, the two tumors will grow at different rates and undergo angiogenesis and metastasis at different times. The two cancers become so distinct from one another that they will not respond in the same way to the same therapy. This demonstrates why even a particular type of cancer, breast cancer, for example, can be a myriad of different cancers, each disease case with its unique properties, potentially requiring unique treatment approaches. As such, new cancer research and clinical trials focus on tailoring therapeutic approaches specifically for each patient’s genomic and molecular landscape. This is called personalized medicine. On the other hand, chemotherapy a

 Core: Cell Cycle and Division

Recombinant DNA

JoVE 10808

Scientists create recombinant DNA by combining DNA from different sources—often, other species—in the laboratory. DNA cloning allows researchers to study specific genes by inserting them into easily manipulated cells, such as bacteria. Organisms that contain recombinant DNA are known as genetically modified organisms (GMOs). Recombinant DNA technology produces organisms with new genes that can benefit science, medicine, and agriculture. Creation of recombinant DNA involves inserting a gene of interest into a vector—a vehicle that carries foreign DNA into host cells for DNA replication and protein expression. The most commonly used cloning vectors are plasmids, small circular pieces of DNA that replicate independently from the host’s chromosomal DNA. To create recombinant DNA, both the donor DNA, including the gene of interest, and the vector are cut at specific nucleotide sequences—called restriction sites—using restriction enzymes. The enzyme DNA ligase seals the sugar-phosphate backbone where the gene of interest and plasmid connect. The result is a recombinant DNA molecule consisting of a vector with an integrated piece of donor DNA—called an insert. A scientist may then introduce this hybrid DNA molecule into a host organism—typically bacteria or yeast—where it easily and rapidly replicat

 Core: Biotechnology

The Central Dogma

JoVE 10798

The central dogma of biology states that information encoded in the DNA is transferred to messenger RNA (mRNA), which then directs the synthesis of protein. The set of instructions that enable the mRNA nucleotide sequence to be decoded into amino acids is called the genetic code. The universal nature of this genetic code has spurred advances in scientific research, agriculture, and medicine. In the early 1900s, scientists discovered that DNA stores all the information needed for cellular functions and that proteins perform most of these functions. However, the mechanisms of converting genetic information into functional proteins remained unknown for many years. Initially, it was believed that a single gene is directly converted into its encoded protein. Two crucial discoveries in eukaryotic cells challenged this theory: First, protein production does not take place in the nucleus. Second, DNA is not present outside the nucleus. These findings sparked the search for an intermediary molecule that connects DNA with protein production. This intermediary molecule, found in both the nucleus and the cytoplasm, and associated with protein production, is RNA. During transcription, RNA is synthesized in the nucleus, using DNA as a template. The newly-synthesized RNA is similar in sequence to the DNA strand, except thymidine in DNA is replaced by uracil i

 Core: Gene Expression

DNA Isolation and Restriction Enzyme Analysis- Concept

JoVE 10628

The revelation of DNA as the hereditary molecule in all organisms has led to enormous scientific and medical breakthroughs and significantly enhanced our understanding of ourselves and other organisms. DNA isolation and profiling have been the fundamental first steps for many of the advancements in the past century; from identification of gene function, to revolutions of agriculture and…

 Lab Bio

Tube Thoracostomy

JoVE 10283

Source: Rachel Liu, BAO, MBBCh, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA


Tube thoracostomy (chest tube placement) is a procedure during which a hollow tube is inserted into the thoracic cavity for drainage of fluid or air. Emergency chest tube insertion is performed for definitive treatment of tension…

 Emergency Medicine and Critical Care

Intra-articular Shoulder Injection for Reduction Following Shoulder Dislocation

JoVE 10282

Source: Rachel Liu, BAO, MBBCh, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA


The anterior shoulder dislocation is one of the most common joint dislocations seen in emergency settings. In anterior shoulder dislocation, the humeral head is displaced out of the glenohumeral joint in front of the scapular glenoid,…

 Emergency Medicine and Critical Care

Lateral Canthotomy and Inferior Cantholysis

JoVE 10266

Source: James W Bonz, MD, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA


Lateral canthotomy is a potentially eyesight-saving procedure when performed emergently for an orbital compartment syndrome. An orbital compartment syndrome results from a buildup of pressure behind the eye; as pressure mounts, both the optic …

 Emergency Medicine and Critical Care

Central Venous Catheter Insertion: Subclavian Vein

JoVE 10241

Source: James W Bonz, MD, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA


Central venous access is necessary in a multitude of clinical situations for hemodynamic monitoring, medication delivery, and blood sampling. There are three veins in the body that are accessed for central venous cannulation: the internal…

 Emergency Medicine and Critical Care

Central Venous Catheter Insertion: Femoral Vein

JoVE 10240

Source: James W Bonz, MD, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA


Central venous access is necessary in a multitude of clinical situations, including vascular access, vasopressor and caustic medication delivery, central venous pressure monitoring, volume resuscitation, total parental nutrition,…

 Emergency Medicine and Critical Care

Percutaneous Cricothyrotomy

JoVE 10239

Source: James W Bonz, MD, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA


A surgical airway procedure is indicated when other forms of endotracheal intubation have failed and ventilation is worsening or not possible. This is the feared "can't intubate, can't ventilate" scenario, and in the emergency …

 Emergency Medicine and Critical Care

Central Venous Catheter Insertion: Internal Jugular

JoVE 10237

Source: James W Bonz, MD, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA


Central venous access is necessary in a multitude of clinical situations, including vascular access, vasopressor and caustic medication delivery, central venous pressure monitoring, intravascular device delivery (pacing wires, Swann-Ganz…

 Emergency Medicine and Critical Care

Pericardiocentesis

JoVE 10236

Source: Rachel Liu, BAO, MBBCh, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA


The heart lies within the pericardium, a relatively inelastic fibrous sac. The pericardium has some compliance to stretch when fluid is slowly introduced into the pericardial space. However, rapid accumulation overwhelms pericardial…

 Emergency Medicine and Critical Care

Needle Thoracostomy

JoVE 10233

Source: Rachel Liu, BAO, MBBCh, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA


A tension pneumothorax is a life-threatening situation in which excess air is introduced into the pleural space surrounding the lung, either through trauma to the chest cavity or as a spontaneous leak of air from the lung itself. Air…

 Emergency Medicine and Critical Care

Arterial Line Placement

JoVE 10178

Source: Sharon Bord, MD, Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Maryland, USA


When monitoring patients, it is important to obtain values that are accurate and reliable. Blood pressure monitoring is one of the essential vital signs, and for a majority of patients, measuring it utilizing…

 Emergency Medicine and Critical Care

Nose, Sinuses, Oral Cavity and Pharynx Exam

JoVE 10152

Source: Richard Glickman-Simon, MD, Assistant Professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, MA


This video provides an overview of sinus, nose, and throat examinations. The demonstration begins with a brief overview of the anatomy of the region. The upper third of the nose is bony, and…

 Physical Examinations II

Male Rectal Exam

JoVE 10102

Source: Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT


While its usefulness in cancer screening is debated, the male rectal examination remains an important part of the physical exam. The exam is indicated in selected patients with lower urinary tract symptoms, urinary and/or fecal incontinence…

 Physical Examinations II

Thyroid Exam

JoVE 10098

Source: Richard Glickman-Simon, MD, Assistant Professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, MA


The thyroid gland is located in the neck anterior trachea between the cricoid cartilage (above) and the suprasternal notch (below) (Figure 1). It consists of a right and left…

 Physical Examinations II

Safety Checks and Five Rights of Medication Administration

JoVE 10235

Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT



According to the 1999 Institution of Medicine (IOM) report titled To Err is Human: Building a Safer Health System, medication errors are significant contributors to avoidable patient deaths in the hospital…

 Nursing Skills

An Introduction to Stem Cell Biology

JoVE 5331

Cells that can differentiate into a variety of cell types, known as stem cells, are at the center of one of the most exciting fields of science today. Stem cell biologists are working to understand the basic mechanisms that regulate how these cells function. These researchers are also interested in harnessing the remarkable potential of stem cells to treat human diseases.


Here,…

 Developmental Biology

Induced Pluripotent Stem Cells

JoVE 10812

Stem cells are undifferentiated cells that divide and produce different types of cells. Ordinarily, cells that have differentiated into a specific cell type are post-mitotic—that is, they no longer divide. However, scientists have found a way to reprogram these mature cells so that they “de-differentiate” and return to an unspecialized, proliferative state. These cells are also pluripotent like embryonic stem cells—able to produce all cell types—and are therefore called induced pluripotent stem cells (iPSCs). iPSCs are potentially valuable in medicine, because a patient who needs a particular cell type—for instance, someone with a damaged retina due to macular degeneration—could receive a transplant of the required cells, generated from another cell type in their own body. This is called autologous transplantation, and it reduces the risk of transplant rejection that can occur when tissues are transplanted between individuals. To create iPSCs, mature cells such as skin fibroblasts or blood cells from a person are grown in culture. Then, genes for multiple transcription factors are delivered into the cells using a viral vector, and the transcription factor proteins are expressed using the cell’s machinery. The transcription factors then turn on many other genes that are expressed by embryonic stem cells, re

 Core: Biotechnology

16S rRNA Sequencing: A PCR-based Technique to Identify Bacterial Species

JoVE 10510

Source: Ewa Bukowska-Faniband1, Tilde Andersson1, Rolf Lood1
1 Department of Clinical Sciences Lund, Division of Infection Medicine, Biomedical Center, Lund University, 221 00 Lund, Sweden


Planet Earth is a habitat for millions of bacterial species, each of which has specific characteristics. Identification of bacterial species is…

 Microbiology
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