Artificial Intelligence Segmentation Model-Based Computed Tomography Angiography Image in the Diagnosis of Congenital Aortic Constriction

This study was to analyze the impacts of the image segmentation model and computed tomography angiography (CTA) on the clinical diagnosis of aortic constriction under the background of artificial intelligence. In this study, 126 patients with congenital aortic constriction (CAC) diagnosed by surgery were selected as the research objects and routine digital subtraction angiography (DSA) and CTA were performed. Then, the traditional active contour model (AC model) was optimized based on the local area information to construct a new image segmentation model for intelligent segmentation and reconstruction of the CTA images of patients. The results revealed that compared with the AC model and the image segmentation model based on region growth (RG model) obtained from angiography segmentation, the algorithm constructed in this study showed a smaller segmentation range for angiography images and more accurate segmentation results. The quantitative data results suggested that the evolution times and running time of the constructed model were less than those of the AC and RG models P < 0.05 . Based on the gold standard of DSA examination results, there were 122 correctly diagnosed cases, 3 missed diagnosed cases, and 1 misdiagnosed by CTA, so the diagnosis coincidence rate was 96.83%. Compared with DSA, the average inner diameter and average pressure difference of patients with precatheter, paracatheter, and postcatheter type were not greatly different in CTA P > 0.05 . The CTA examination suggested there were 154 cases with intracardiac structural abnormalities, with a detection rate of 86.52%; there were 32 cases of cardiac-vascular connection abnormalities, with a detection rate of 100%; and there were 79 extracardiac vascular abnormalities, with the detection rate of 95.18%. It indicated that the optimized image segmentation model based on local area information proposed in this paper has excellent segmentation performance for CT angiography images and has good segmentation effect and efficiency. The CTA based on the artificial intelligence image segmentation model showed a better diagnostic effect on abnormal heart-vascular connection and abnormal extracardiac blood vessels and can be used as an effective examination method for clinical diagnosis of CAC.

The corona mortis: is it a rare and dangerous anomaly in adolescents undergoing periacteabular osteotomy?

ABSTRACT The corona mortis (CM) is a vascular connection between the obturator and external iliac or internal epigastric vessels that has historically been identified as a source of hemorrhage in pelvic surgery. However, its frequency, location, proximity to the osteotomies performed, vascular contributions and impact on blood loss in patients undergoing periacetabular osteotomy (PAO) are unknown. We sought to identify the frequency, origin, location relative to osteotomies performed during surgery and impact on blood loss of the CM. Preoperative magnetic resonance imaging (MRI) of the hips of 28 adolescent patients (56 hips) undergoing PAO was retrospectively reviewed for the presence of a CM. When identifiable, the size, nature (arterial or venous), orientation, position relative to the iliopectineal eminence (IPE) and associated estimated blood loss (EBL) were recorded. 75% (21/28) of patients possessed an identifiable, ipsilateral CM to the site of PAO, 90% of which were venous and 10% arterial. The vessel was typically 8.3 ± 3.8 mm medial and 11.1 ± 5.3 mm caudal from the anterosuperomedial edge of the IPE. There was no significant difference in the amount of EBL (519 ± 260 versus 694 ± 369 ml) or need for post-op transfusions (1/21 versus 0/7) between patients who possessed a CM and those who did not, respectively (P = 0.21). CM was more prevalent in this study than previously reported. However, the presence of an ipsilateral CM was not associated with an increase in EBL or transfusion during routine PAO surgery using modern surgical techniques.

Cytological Studies on Graft Union Development with Perennial Chilli Rootstocks

Grafting technology in vegetable crops is becoming increasingly popular as an alternative tool to improve the biotic and abiotic resistance besides improvement in horticultural traits. By utilizing the right combination of resistant rootstock and scion, desired variability can be achieved to improve the yield and quality of vegetables. A study was conducted at the College orchard, Department of Vegetable science, Horticultural College and Research Institute, Tamil Nadu Agricultural University, Coimbatore during the year 2020-2021 to evaluate the graft compatibility with two chilli rootstocks. The experimental material consisted of two perennial rootstocks viz., CC-CBE-001 and CF-CBE-007 and three scion materials viz., TNAU Chilli Hybrid CO 1, Ranga hybrid and Bangaram hybrid. Wedge grafting was done using 60 days old rootstock and 45 days old scion seedlings with nine treatments. The adhesion line wall thickness of pith cells were determined at different stages after grafting. The wound healing of the scion-rootstock union was studied using microscopic examination of the grafting region on the 5th, 10th, 15th and 20th day after grafting. It was observed that ten days after grafting, vascular bundle was formed and a large amount of callus was produced to bridge the scion and rootstock. Despite interspecific grafting, callus formation, subsequent cell differentiation and vascular connection were established, resulting in effective graft compatibility, according to the anatomical and histological analysis.

Cranium of an Eocene/Oligocene pheasant-sized galliform bird from western North America, with the description of a vascular autapomorphy of the Galliformes

We describe the fossil cranium of a pheasant-sized galliform land bird from latest Eocene or earliest Oligocene marine rocks of the Jansen Creek Member, Makah Formation (Washington State, USA), which is the only three-dimensionally preserved cranium of a Paleogene representative of the Galliformes. The specimen was freed from a hard calcareous nodule with dilute formic acid. Micro-computed tomography provided further osteological details and a virtual cranial endocast. The fossil exhibits a plesiomorphic temporal morphology, lacking an ossified aponeurosis zygomatica, a feature characterizing some extant Cracidae and most Odontophoridae and Phasianidae. Overall, the fossil is most similar to the skull of the Asian phasianid taxon Arborophila, but this resemblance may well be plesiomorphic for a more inclusive clade. Still, we consider it possible that the fossil represents an archaic member of the Phasianoidea, in which case it would be the earliest record of this taxon from the New World. The fossil exhibits a previously unnoticed cranial autapomorphy of galliforms, a foramen in the temporal region that enables the vena profunda to enter the braincase, for which the name foramen temporale venosum is here introduced. Consistently present in all studied extant galliform taxa and absent in all other extant birds, this foramen enables a vascular connection between the brain and the ophthalmic rete, the latter playing an important role in thermoregulation of the avian brain.

Anatomical and Histological Studies of Grafted Tomato with Interspecific Solanaceous Rootstocks

A study was carried out at the Department of Vegetable Science, Horticultural College and Research Institute, Tamil Nadu Agricultural University, Coimbatore, Tamil Nadu,India during 2019-2020 to assess the anatomical and histological changes within the graft union of tomato and identify compatible rootstocks for improved propagation of the crop. This experiment involved rootstocks of three wild tomatoes including Solanum torvum, S. sisymbrifolium and S. capsicoides and scions of two tomato hybrids including TNAU tomato hybrid CO3 and Shivam. The grafting was done using the cleft grafting method. The anatomical and histological sections of six graft combinations and two tomato scion samples were viewed microscopically at 7, 14 and 21 days after grafting (DAG). Among the six tomato graft combinations, S. torvum rootstock showed complete development of vascular connection at 21 DAG followed by S. sisymbrifolium rootstock, whereas S. capsicoides rootstock showed only callus growth at 14 DAG. Scion growth dominated the rootstock growth in S. torvum rootstock leading to mismatch of scion-rootstock stem thickness and delayed epinasty symptom at the later stages of plant growth. Of the rootstocks of the three species studied, S. sisymbrifolium rootstock was compatible for tomato grafting though it exhibited delayed vascular connection between the scion and rootstock.

The impact of cirrhosis on the postoperative outcomes of patients undergoing splenectomy: Propensity score matched analysis of the 2011–2017 US hospital database

Background & objective: While splenectomy is performed for various trauma and non-trauma indications, there is little information about the impact of cirrhosis on the post-splenectomy outcomes, despite the intricate physiological and vascular connection between the liver and the spleen. Methods: 2011–2017 National Inpatient Sample was used to select patient cases who underwent the splenectomy procedure, who were further stratified using cirrhosis. The cirrhosis-absent controls were matched to the study cohort using propensity score matching with nearest neighbor matching method. Endpoints included mortality, length of stay, hospitalization costs, and postoperative complications. Results: There were 675 patients with cirrhosis and 675 matched controls identified from the database. Cirrhosis cohort had higher mortality (20.0 vs 7.26%, p < 0.001, OR = 3.19, 95% CI = 2.26–4.52) and hospitalization costs ($210,716 vs $186,673, p = 0.003), but shorter length of stay (11.8 vs 12.5d, p = 0.04). In terms of complications, cirrhosis cohorts had higher postoperative bleeding (7.26 vs 4.3%, p = 0.027, OR = 1.74, 95% CI = 1.09–2.80) and shock (3.7 vs 1.04%, p = 0.002, OR = 3.67, 95% CI = 1.58–8.54), and were more likely to be discharged to short-term hospitals and home with home health care. On multivariate analysis, presence of cirrhosis resulted in higher mortality (p < 0.001, aOR = 3.30, 95% CI = 2.33–4.69). Conclusions: Cirrhosis is an independent risk factor of postoperative mortality in patients undergoing splenectomy; given this finding, further precautious and multidisciplinary care should be rendered in these at-risk patients with cirrhosis in the setting of splenectomy.

CAROTID-CAVERNOUS FISTULA (CCF) - A REVIEW

A carotid-cavernous stula (CCF) is the result of an abnormal vascular connection between the carotid system (ICA/ECA) and the venous channels of the cavernous sinus. CCFs are classied based on the arterial system involved, hemodynamics, and etiology. The presentation can be varied and nonspecic; commonly presents with ophthalmic manifestations due to impairment of venous drainage of the orbit from the cavernous sinus. Early diagnosis and appropriate management is essential to avoid vision and life-threatening complications. Patients with CCF may initially present to an ophthalmologist with decreased vision, conjunctival chemosis, external ophthalmoplegia and proptosis. Ophthalmologist may be the rst physician to encounter a patient with clinical manifestations of CCF, and this review article should help in understanding the clinical features of CCF, current diagnostic approach, usefulness of the available imaging modalities, possible modes of treatment and expected outcome.

Pancreatic heterotopia: An overview of a lesion often mimicking neuroendocrine tumour

Pancreatic tissue that has no direct or vascular connection to the main body of the pancreas constitutes ectopic pancreas or heterotopic pancreas (HP). Majority are located in the upper gastrointestinal tract (GIT). HP may be mistaken for neoplasms like neuroendocrine tumour (NET) and adenocarcinoma on endoscopy as well as on histopathology. We report six cases of HP along with review of literature; three of them were misdiagnosed as NET. To the best of our knowledge, this is the first case series of HP from India, rest being case reports. Histopathological features of six cases of HP were analyzed. Variables examined were clinical presentation, age at diagnosis, location, histopathologic type and immunohistochemical profile. Two cases each were seen in duodenum and Meckel’s diverticulum while one case each was seen in stomach and an atretic segment of ileum, a site never reported previously. There were five males and one female with age ranging from one day to 48 years. Patients with gastric and duodenal HP were symptomatic. On histopathology, four cases were intramuscular and two were submucosal. Four cases were of Type I and two cases were of type II. HP should be considered in the differential diagnosis of submucosal upper GI lesions. Awareness, high degree of suspicion and thorough histopathological examination are necessary to arrive at a correct diagnosis. Immunohistochemistry for chromogranin and synaptophysin is useful for confirming the islets especially on small endoscopic biopsies. HP must be considered in the differential diagnosis of submucosal upper GI lesions. Knowledge about this entity, high degree of suspicion and thorough histopathological examination help in arriving at a correct diagnosis and excluding mimics.

The Application of an Omentum Graft or Flap in Spinal Cord Injury

Background: Spinal cord injury (SCI) causes a primary injury at the lesion site and triggers a secondary injury and prolonged inflammation. There has been no definitive treatment till now. Promoting angiogenesis is one of the most important strategies for functional recovery after SCI. The omentum, abundant in blood and lymph vessels, possesses the potent ability of tissue regeneration. Methods: The present work examines the efficacy of autologous omentum, either as a flap (with vascular connection intact) or graft (severed vascular connection), on spinal nerve regeneration. After contusive SCI in rats, a thin sheath of omentum was grafted to the injured spinal cord. Results: Omental graft improved behavior scores significantly from the 3rd to 6th week after injury (6th week, 5.5 ± 0.5 vs. 8.6 ± 1.3, p < 0.05). Furthermore, the reduction in cavity and the preservation of class III β-tubulin-positive nerve fibers in the injury area was noted. Next, the free omental flap was transposed to a completely transected SCI in rats through a pre-implanted tunnel. The flap remained vascularized and survived well several weeks after the operation. At 16 weeks post-treatment, SCI rats with omentum flap treatment displayed the preservation of significantly more nerve fibers (p < 0.05) and a reduced injured cavity, though locomotor scores were similar. Conclusions: Taken together, the findings of this study indicate that treatment with an omental graft or transposition of an omental flap on an injured spinal cord has a positive effect on nerve protection and tissue preservation in SCI rats. The current data highlight the importance of omentum in clinical applications.

Reconstruction of a Composite Defect of the Distal Index Finger Using a Chimeric Reverse Flow Second Dorsal Metacarpal Artery Flap: A Case Report

The reconstruction for mild tissue loss at the distal part of a finger is challenging. We report about a 29-year-old man presenting with traumatic tissue loss at the distal interphalangeal (DIP) joint of the index finger, including skin, bone, and nerve. Reconstruction using two types of flaps was performed. The dorsal skin flap, nourished by the second dorsal metacarpal artery (SDMA) perforator, was elevated. The vascularized second metacarpal bone, nourished by the SDMA, was also elevated. Using the vascular connection between the DMA and the palmar digital artery (PDA), both flaps were raised to the distal part of the finger, and the pivot point was set at the dorsal proximal phalanx. After arthrodesis of the DIP joint with the vascularized second metacarpal bone, the digital nerve was repaired using the cutaneous nerve in the skin flap, and the skin defect was covered using the perforator flap. The postoperative course, including flap survival and bone union, was uneventful. A good indication for the reconstruction of the distal part of a finger with this technique is when the defect sizes of the skin and bone differ and the vascular connection between the SDMA and dorsal branch of PDA is not injured.