TAVI-in-homograft (TiH): open transcatheter aortic valve replacement in calcified aortic homograft case reports

Background Redo surgery in patient who underwent aortic valve replacement with an aortic homograft can result technically challenging because of the massive calcification of the conduit. Case presentation We present a case of a patient who underwent open surgery on cardiopulmonary bypass assistance to implant a standard transcatheter aortic bioprosthesis through aortotomy in an off-label procedure and we discuss its safety and feasibility. Conclusions The combination of open cardiac surgery and open trans-aortic implant of a transcatheter prosthesis may reduce the surgical risk shrinking the technical difficulties that the implantation of a standard surgical prosthesis would have given.

Convolution Index based Unsupervised Label Procedure for Efficient Medical Image Exploration

Medical imaging is a forceful idea of various medicinal ideas i.e. malignant growth and other related infections, present days; various kinds of therapeutic pictures are caught and saved in computerized position in medicinal research focuses. Confronting this kind of huge volume of picture information with various sorts of picture modalities, it is critical to execute effective content based image retrieval (CBIR) for restorative research focuses. Picture mark ordering is another actualized strategy for medicinal picture recovery. Traditionally various kinds of CBIR methodologies are proposed to give unsatisfied therapeutic picture recovery results. So that in this paper, propose a Convolution Index based Unsupervised Label (CIUL) way to deal with recover marks of pictures utilizing AI wording. We characterize AI as matrix convex optimization with cluster-based matrix representation which can be utilized to improve the productivity in picture recovery framework.

A tale of two LAMS: a report of benign tissue ingrowth resulting in recurrent gastric outlet obstruction

Background and study aims Endoscopic ultrasound (EUS)-guided gastroenterostomy is a novel, off-label, procedure that has been facilitated by availability of a novel lumen apposing metal stent (LAMS) (Axios, Boston Scientific, Marlbourough Massachusetts, United States). The literature suggests its efficacy to be comparable to surgical gastrojejunostomy. In theory, this procedure overcomes the issues associated with woven enteral stents, which are subject to continuous, straightening, axial forces. We report the adverse event of tissue ingrowth in an Axios stent placed as an EUS-guided gastroduodenostomy, resulting in recurrence of gastric outlet obstruction, treated by a stent-inside-stent technique.

Ultrastructural identification of noradrenergic nerve terminals and vasopressin-containing neurons of the paraventricular nucleus in the same thin section.

Since many peptidergic cell groups receive a diverse and complex monoaminergic innervation, we have developed a double-label procedure to visualize a peptide and a catecholamine in the same ultrathin section. Radiolabeled norepinephrine (NE) is applied locally and its reuptake into NE terminals is demonstrated by ultrastructural radioautography. Controls in this and other studies demonstrate that the NE labels only NE (and possibly epinephrine) terminals and not dopaminergic or serotonergic terminals. In the same tissue, vasopressin is localized by immunocytochemistry on unembedded sections that are subsequently embedded in epoxy resins for thin sectioning. The procedure as described here shows that NE terminals in the periventricular zone of the paraventricular nucleus of the hypothalamus innervate both vasopressin-positive and vasopressin-negative structures. This technique is useful in determining the chemical connectivity of the hypothalamus.