Cushing's disease is best treated with the surgical removal of the pituitary tumor, usually with a technique called transsphenoidal resection (behind the nose) by a neurosurgeon. Occasionally, the entire pituitary gland will need to be removed or injured in order to cure the Cushing's disease, leaving the person with a deficiency of ACTH and the other pituitary hormones. This can be treated by giving replacement hormones for cortisol, thyroid and gonadal (sex) hormones.

The diagnosis is made through a comprehensive evaluation by an endocrinologist. This includes taking a detailed medical history, performing a physical examination, and obtaining laboratory and radiologic tests. These might include measurement of cortisol levels in the blood, urine, and/or saliva, blood ACTH levels, dexamethasone suppression testing and/or CRH stimulation testing. Imaging studies of the pituitary, such as head MRIs, will sometimes, but not always, show a pituitary tumor.

The best treatment is almost always transsphenoidal surgery performed by a surgeon with extensive experience in pituitary tumor removal.

The surgery is at our offices or at the New York Eye and Ear Infirmary, at 2nd Avenue and 14th St. in Manhattan.

Adrenal disease is the most common disease that ferrets get - more than 80% of ferrets in the US will develop adrenal disease at some point in their lives. Adrenal disease occurs when a tumor or lesion on the adrenal glands causes an overproduction of hormones. It most often affects ferrets over the age of 3, but recently has been seen in ferrets as young as 10 or 11 months.

Cushing's disease is the common name for a disease called hyperadrenocorticism that most commonly affects people, dogs, cats, and ferrets. It's caused by a hyperactive adrenal gland that pumps too many steroids and other hormones into the bloodstream. It can be caused by a growth in the adrenal gland or the pituitary gland. The adrenal gland produces a wide range of hormones, and Cushing's disease can cause the overproduction of any one or more of them.

The chance of recurrence is small: only 5-10%. You should see an endocrinologist on a regular basis and more frequently if you have any concerns that the Cushing's disease might be returning.

Autopsy reports and radiologic and MRI evidence from around the globe indicate that one out of every five people worldwide has a pituitary tumor. The earliest study took place in 1936, when Dr. R.T. Costello of the Mayo Foundation conducted a cadaver study and found pituitary tumors in 22.4 % of the population (Costello R.T. Subclinical adenoma of the pituitary gland. Am. J. Pathol. 1936; 12:205-214). Statistics have not changed much ever since.

Before surgery, a small tube called an intravenous line will be inserted into your arm to administer antibiotics and other medication. In the operating room, you will be given anesthesia. Once the anesthesia takes effect, your knee will be scrubbed and sterilized. Your surgery will begin with an incision over the knee to expose the joint. The surgeon then uses precision guides and special instruments to remove any damaged surfaces and shape the ends of the bones.

Dr. Rick Schram of Southwest Orthopaedic Group in Austin, Texas, with assistance from Dr. Nick Tsourmas. Unfortunately Dr. Schram is no longer in practice; he switched professions, going back to school to study law. I was 28 years old when I had my first TKR (born in 1969), and my knees were in such bad shape that there was really no question of waiting. I have rheumatoid arthritis, and there was no cartilage left in either knee.

There are two ways of performing surgery on the vocal cords: the open surgery approach and endoscopic approach. The open surgery approach involves making an incision in the neck and performing the surgery through the opening. This approach is often performed after trauma or fracture of the larynx (upper front of neck) has occurred. The endoscopic approach requires a tube to be inserted through the mouth into the throat. This approach seems to be more successful in restoring normal voice sound.

Instead of accessing the brain through incision(s), surgeons irradiate the brain abnormality with beams of gamma radiation that pass through the skull and brain tissue and treat only the designated area.

On the day of surgery, an intravenous tube will be inserted into your arm to administer necessary medications and fluids during surgery. You will then be taken to the operating room and given anesthesia. The surgery usually takes two to four hours, depending on the condition of your hip. While you are in the operating room, a urinary catheter will be inserted. Compression stockings and pneumatic sleeves will be put on both legs.

Laser surgery for macular degeneration is an office procedure, performed under local anesthesia. The patient is sat in a comfortable chair opposite the laser machine. The eye is anesthetized with eye drops. A special contact lens covered with a thick gel is placed over the surface of the eye. Laser beam is directed through the contact lens to the retina and the CNV. The laser beam consists of about 100 bright flashes of light, each lasting between one tenth to one half of a second.

It is best to wait for the pain and swelling to subside and to allow associated injuries to heal before performing surgery for the ACL. If surgery is done too soon after injury, rehabilitation is difficult. The knee may get stiff and have permanent loss of motion. The athlete will usually get back to sports much more quickly if the knee is allowed to recover from initial injury and to regain its full painless range of motion (usually at least six weeks) before performing surgery.

Adrenal disease, or hyperadrenocorticism, is one of the most common ferret diseases, and it affects thousands of ferrets every year. It is most often seen in ferrets over three years of age, but younger and younger ferrets are being diagnosed every year. Adrenal disease is very treatable, but the effectiveness of the treatment does depend on how quickly the disease is diagnosed. This is why it is very important for every ferret owner to know the signs of adrenal disease.

Depending on how far your periodontal disease has progressed, treatment can vary widely. If the disease is caught early, simple procedures can be done that will remove the plaque and calculus from below the gum line and eliminate the infection-causing bacteria. If the disease has advanced to the point where the periodontal pockets are deep and the supporting bone is lost, surgery might be necessary. You may have heard about new products on the market that claim to cure periodontal disease.

No, this procedure in not done in our office. Dr. Paley performs all his surgeries at Brotman Medical Center.

It is not unusual for a cat that has a ruptured cruciate ligament to become sound (will no longer limp) even if surgery is not performed. This generally occurs within one month of the injury. However, arthritis will usually begin and result in lameness a few months later. That lameness cannot be corrected so we strongly urge you to have surgery performed.

Before any surgery for pelvic prolapse the following evaluation is very important. This evaluation should be performed by a physician who is experienced in the treatment of pelvic prolapse and knowledgeable about the effects of prolapse on the urinary tract. Pre-treatment evaluation usually includes the following: Special testing of the bladder function called Urodynamics. This testing should be performed with and without reduction (i.e. pushing in) of the pelvic prolapse.

A week or two before surgery, your ophthalmologist will measure the curvature of the cornea and the size and shape of the eye. For patients who will receive an IOL, this information helps your doctor to choose the right type of IOL.

Yes. The laparoscopic technique uses a number of small incisions and long instruments to reach deep inside the abdominal cavity. When BMI exceeds 50 (or in patients with a large distribution of body fat in the upper abdomen), the instruments may not be long enough to perform laparoscopic surgery. The surgeon will discuss surgical approaches with you at your initial consultation.

echocardiogram is essential for all patients prior to a Maze procedure. The echocardiogram is an ultrasound study of the heart that helps physicians to evaluate the structure and the function of the heart and the valves. In addition, all patients over the age of 40 will need to have a cardiac catheterization to assess the coronary arteries for evidence of blockage.