Development of a Deep Learning Algorithm for the Histopathologic Diagnosis and Gleason Grading of Prostate Cancer Biopsies: A Pilot Study.

Background: The pathologic diagnosis and Gleason grading of prostate cancer are time-consuming, error-prone, and subject to interobserver variability. Machine learning offers opportunities to improve the diagnosis, risk stratification, and prognostication of prostate cancer.

Objective: To develop a state-of-the-art deep learning algorithm for the histopathologic diagnosis and Gleason grading of prostate biopsy specimens.

Spontaneous perirenal hemorrhage in end-stage renal disease treated with selective embolization.

Spontaneous nontraumatic rupture of the kidney (Wunderlich syndrome) is an extremely uncommon condition on hemodialysis. We report a case of 44-year-old hemodialysis patient presented with hemorrhagic shock and a right quadrant abdominal pain to the emergency department. There was no history of trauma.

Combined endocardiectomy and bidirectional glenn shunt for right ventricular endomyocardial fibrosis.

We report the case of a young African woman with a history of right ventricular failure. Image studies suggested endomyocardial fibrosis affecting only the right side of the heart. The right ventricle was extremely small and restricted.

Scrotal distension after endoscopic harvesting of the saphenous vein in patients with inguinal hernia.

The great saphenous vein remains the most commonly used conduit for coronary artery bypass grafting. The endoscopic vein harvesting technique is widely used due to reduced postoperative complications. We present the case of 5 patients with a history of inguinal hernia undergoing coronary artery bypass grafting, which resulted in CO2 infiltration through the deep inguinal ring and into the scrotum leading to acute scrotal enlargement.

A case series of myectomy: a review of its current application as an adjunct procedure.

In this article, we review the role played by myectomy in cardiac surgery. For this purpose, we looked at three cases of different etiology where myectomy in conjunction with treatment of the primary condition proved invaluable in the outcome of these patients. The primary conditions requiring treatment were subaortic membrane, hypertrophic obstructive cardiomyopathy with mitral valve regurgitation, and aortic stenosis.

Successful graft patency after factor VIIa use for bleeding in coronary artery surgery: an unusual complication of a coronary artery bypass surgery.

There is a growing literature regarding the use of recombinant activated factor VII (rFVIIa) (NovoSeven, NovoNordisk, Copenhagen, Denmark) to control refractory hemorrhage after cardiopulmonary bypass in cardiac surgery. This supporting evidence is mostly documented as case reports on patients, of which only six involve coronary artery grafting. We present our experience of a patient undergoing coronary artery bypass grafting, who suffered an anaphylactic reaction to protamine preventing safe reversal of systemic heparinization.

Complex off-pump coronary artery bypass surgery can be safely taught to cardiothoracic trainees.

Objectives: Off-pump coronary revascularisation is demanding technically as the surgeon is faced with a beating heart and not a bloodless field. The potential clinical advantages of off-pump coronary revascularisation have made this procedure an essential part of a cardiothoracic training program. The aim of this study is to investigate the impact of teaching trainees complex off-pump coronary artery surgery (arterial grafting, 'Y' grafts, sequential grafting and minimally invasive direct coronary artery bypass) on clinical outcomes.

Effects of cell saver autologous blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing cardiac surgery on- versus off-cardiopulmonary bypass: a randomised trial.

Objective: Off-pump CABG is potentially associated with reduced intraoperative blood loss and homologous blood transfusion in comparison to on-pump CABG. In this randomised controlled study we investigated the effects of autologous cell saver blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing CABG on- versus off-CPB.

Methods: Eighty patients were randomised into one of four groups: (A) on-CPB with cell saver blood transfusion (CSBT), (B) on-CPB without CSBT, (C) off-pump with CSBT and (D) off-pump without CSBT.

How safe is it to train residents to perform off-pump coronary artery bypass surgery?

Background: The technique of off-pump coronary artery bypass graft (OPCABG) surgery differs considerably from on-pump CABG. This study investigates the impact of surgical training on clinical outcome in patients undergoing OPCABG.

Methods: All 251 OPCABG cases performed by one service over an 18-month period were analyzed.

Renal function after cardiac surgery off- versus on-pump coronary artery bypass: analysis using the Cockroft-Gault formula for estimating creatinine clearance.

Background: Cardiopulmonary bypass (CPB) is often associated with renal dysfunction, as measured by plasma creatinine levels and hemodialysis rates. This study compared creatinine clearance (CrCl), estimated with the Cockroft and Gault formula, between patients undergoing off-pump coronary artery bypass grafting (OPCAB) versus on-pump CABG (on-CAB).

Methods: Data of 704 consecutive patients were analyzed.

Pericardial abscess mimicking intracardiac neoplasm causing right heart failure.

Purulent pericarditis involves the whole pericardium and usually presents as an acute illness with high mortality without prompt diagnosis and treatment. Presentation as a mediastinal mass causing compression of the right ventricle (RV) and symptoms of heart failure in patients without previous cardiac surgery is very rare and only three cases have been reported up to now (English language medical literature). Clinicians should be aware of this unusual condition for prompt diagnosis and treatment to be instituted.

Myxoma of the free wall of the right ventricle: a case report.

We present a 30-year-old female patient with a myxoma of the right ventricle, which was attached to the free wall of the right ventricle and was moving in and out the pulmonary valve causing right ventricular outflow tract obstruction. Myxomas of the right ventricle are rare and their surgical excision can be challenging especially if they infiltrate into important structures of the myocardium. They can be part of a broader category of diseases known as Carney complex with a familial predisposition.

Management of patients undergoing coronary artery bypass graft surgery with mild to moderate aortic stenosis.

Background And Aim Of The Study: The management of patients undergoing coronary artery bypass graft (CABG) surgery with mild to moderate aortic stenosis (AS) remains controversial. The study aim was to examine the outcome in patients with mild to moderate AS undergoing CABG.

Methods: A retrospective analysis was carried out of 200 patients with coronary artery disease requiring CABG and with a peak AS gradient < 40 mmHg measured by Doppler echocardiography, between 1990 and 2000.