Factors influencing complications following mastectomy procedures in dogs with mammary gland tumors: 140 cases (2009-2015).

OBJECTIVE: To evaluate complication rates for various types of mastectomy procedures, identify factors associated with an increased risk of complications, and determine the consequences of such complications. ANIMALS: 140 female dogs that underwent 154 separate mastectomy procedures to treat mammary gland tumors. PROCEDURES: Medical records of dogs in the Penn Vet Shelter Canine Mammary Tumor Program from July 2009 to March 2015 were reviewed. Data regarding signalment, tumor characteristics (ie, number and size, benign or malignant, and bilateral or unilateral), mastectomy type, anesthesia time, concurrent ovariohysterectomy or ovariectomy, surgeons' qualifications, antimicrobial administration after surgery, postoperative placement of surgical drains, and complications (seroma, abscess, dehiscence, or infection) were collected. Complications that required hospitalization were recorded. Fisher exact tests were used to evaluate associations between variables of interest and complications. Multivariable analysis was used to identify factors independently associated with an increased risk of complications. RESULTS: Complication rate following all mastectomy procedures was 16.9% (26/154); of these, 9 (34.6%) required hospitalization. High body weight, undergoing bilateral mastectomy, and postoperative antimicrobial administration were associated with significantly increased odds of complications. The odds of complications associated with postoperative antimicrobial administration, however, varied according to mastectomy type; dogs undergoing chain mastectomy that did not receive antimicrobials postoperatively had the highest odds of developing complications. Dogs undergoing concurrent ovariohysterectomy or ovariectomy had significantly decreased odds of complications. CONCLUSIONS AND CLINICAL RELEVANCE: Previously spayed dogs with a large body size that underwent the most extensive mastectomy procedures had increased odds of having postoperative complications.

Prophylactic instillation therapy of superficial bladder cancer. A randomized study comparing mitomycin C and adriamycin with special reference to DNA ploidy.

Sixty patients with Ta and T1 bladder cancer were randomized between treatment with resection only and resection and instillations with either Adriamycin or Mitomycin C. Treatment lasted for one year and patients were evaluated after a mean follow-up of 35 to 47 months if progression had not occurred. Mitomycin C was superior in reducing the recurrence rate. Progressive disease was observed in 17 patients regardless of therapy but in all patients DNA aneuploidy could be identified at a risk factor.

Microassays for androgen and progesterone receptor quantitation as compared with standard saturation analyses in human prostatic tissues.

Simultaneous measurement of androgen and progesterone receptor content in cytosol and salt extractable nuclear subcompartments of benign hyperplastic prostatic tissue was carried out with various microassay techniques and compared to the results from analyses on bulky tissue from the same tissue specimens. The microassays were carried out as modified saturation analyses or as single concentration assays at various degrees of dilution with tris-EDTA-glycerol (TEG) buffer. Tissue samples for the standard assay weighed between 1.76 and 3.22 g, whereas the microassay samples weighted between 0.14 and 0.47 g. When considering the results of the standard assay as the "true" value, the microassays on the same tissue samples tended to underestimate both the androgen and progesterone receptor contents. Data from the microassays showed a wide variation of the androgen and progesterone receptor content in cytosol and nuclei. With the standard assay technique no detectable amount of progesterone receptor was found in the nuclei, whereas the microassays often indicated false-positive progesterone receptor content in this subcompartment. Therefore, the measurements of steroid receptors using biochemical microassays in prostatic tissue are unreliable and not suitable for clinical use, at least with the techniques available today. Reports in the literature based on such assays should therefore be interpreted with great caution.

Steroid receptor profile in human prostate cancer metastases as compared with primary prostatic carcinoma.

The steroid receptor profile in seven prostate cancer metastases was compared with the profile in seven primary prostate cancers. The secondaries were all lymph node metastases, obtained during pelvic lymphadenectomy, preceding radical prostatectomy or irradiation. Cytosol androgen receptor content was higher in metastases, whereas the nuclear androgen receptor content was only one-fourth that in primary cancer. Cytosol progesterone as well as estrogen receptor contents were markedly lower in metastases compared with primary cancer. The steroid receptor profile differed very little between primary cancer and normal tissue. Primary prostatic carcinoma is usually obtained at early stages of the disease, whereas metastases represent a dedifferentiated, more aggressive cell population. This may explain the low amounts of progesterone, estrogen, and nuclear androgen receptor levels. The total androgen receptor content was similar in metastatic and primary disease, however, with a shift towards a cytosolic predominance in metastases. Possibly androgen receptors in metastatic disease are "deactivated."

Steroid receptor profile and receptor stability in subfractions of human prostatic tissues. Critical aspects on microassays.

Androgen (AR), progesterone (PR), and estrogen (ER) receptor contents in cytosol and salt-extractable nuclear subcompartments from 6 normal, 39 benign hyperplastic (BPH), and 7 malignant prostatic tissue specimens were analyzed by radioligand-binding assay techniques. In addition, the temperature stability of AR and PR was measured in another three BPH specimens. Five punch-needle biopsy samples from prostate cancers were also analyzed for AR and PR content. All receptor data were calculated from saturation analyses. The highest AR content was found in the cytosol and nucleic from malignant prostatic tissues. The highest PR concentrations were found in BPH cytosol, whereas nuclei of all types of tissues were negative with regard to this receptor. Markedly lower concentrations of ER were found in cytosol and nuclei from BPH as compared with malignant and normal tissues. PR was the most temperature-stable receptor; a marked receptor loss at room temperature was not registered until after 12 h. AR was stable for 4-5 h in cytosol and for 8-9 h in nuclei. Needle-biopsy specimens from prostate cancer showed highly variable and confusing results for AR and PR content, indicating that microassay studies using biochemical techniques on small tissue samples are unreliable and should not be recommended.

Immunocytochemical detection of the androgen receptor in fine needle aspirates from benign and malignant human prostate.

A monoclonal antibody to the androgen receptor was applied to fine needle aspirates from patients with benign and malignant prostatic disease. The series includes six patients with benign hyperplasia and 24 patients with prostatic carcinomas. The androgen receptor was detected in most nuclei of both benign and malignant epithelial cells. The intensity of immunostaining varied. No obvious relation was observed between the intensity of the staining in benign versus malignant cells. In addition no clear differences were found in the proportion of androgen receptor positive cells in benign aspirates as compared with aspirates from well differentiated or moderately well differentiated prostatic carcinomas. The relative number of androgen receptor positive cells was highest in smears from poorly differentiated prostatic carcinomas.

Immunohistochemistry and biochemistry in detection of androgen, progesterone, and estrogen receptors in benign and malignant human prostatic tissue.

The relative distribution of androgen (AR), progesterone (PR), and estrogen receptors (ER) was localized and estimated in human prostate tissue by immunohistochemistry in five normal tissue samples, in eight benign hyperplastic (BPH) samples, in nine primary cancers, and in seven prostate cancer metastases. Moreover, three prostatic cancer cell lines (LNCaP, DU 145, and PC 3) were analyzed. A comparison between the results obtained by radioligand binding assays and immunohistochemistry was performed for the AR and PR. Using immunohistochemistry, the AR was exclusively detected in the nuclei of both benign and malignant prostatic epithelial cells. The highest proportion of AR-positive cells was found in BPH and in prostate cancer metastases as compared with normal prostatic tissue. In a majority of the cases, the PR was only present in the nuclei of stromal cells. Benign hyperplastic prostates contained higher proportions of PR-positive cells as compared with primary carcinoma. PR was sparse in epithelial cells. ER-positive stromal cell nuclei were only detected in carcinomatous prostates. A few ER-positive epithelial cell nuclei were found in one sample each of a BPH and normal prostate. All cells from the androgen-dependent, LNCaP, cell line and a majority of the cells from the androgen-independent, DU 145, cell line were AR-positive. In contrast, the cells from the androgen-independent, PC 3, cell line were all AR-negative. All three cell lines were PR- and ER-negative. The radioligand binding technique detected the AR in extracts from both the cytosol and the nucleus. Again BPH contained higher amounts of AR as compared with normal prostatic tissue. The LNCaP cells contained high amounts of cytosolic AR while cells from the DU 145 and PC 3 cell lines lacked detectable AR as estimated by biochemical techniques. There seemed to be a discrepancy between biochemically measured and immunohistochemically estimated receptor content.

A comparison between netilmicin with metronidazole and doxycycline as prophylaxis in elective colorectal surgery.

The aim of this study was to compare the prophylactic effects of netilmicin plus metronidazole administered for one day and of doxycycline administered for five days on the incidence of postoperative sepsis in patients undergoing elective colorectal surgery. One hundred patients were studied, 50 men and 50 women, with a mean age of 66.6 years. The patients were randomized into the two groups. Wound infections occurred in a total of 9 patients, 5 in the doxycycline group and 4 in the group given netilmicin plus metronidazole, i.e. the overall infection rate was 9%. It is concluded that there is no statistically significant difference on the incidence of postoperative wound sepsis in patients undergoing elective colorectal surgery between the group given doxycycline for five days and the group given netilmicin plus metronidazole for one day.

The effect of one prophylactic dosage of antibiotics on experimentally induced lethal intraabdominal sepsis.

In order to study the effect of one preoperative dosage of antibiotic on the mortality rate, incidence of abscesses, adhesions and intraperitoneal fluid, a previously described reproducible experimental model of intraabdominal infections in rats has been used. Preoperatively, the rats were fed with lean ground beef for two weeks in order to change the intestinal microflora into a microflora similar to humans. The antibiotics tested were: doxycycline (1 mg), cefoxitin (40 mg), tinidazole (8 mg) + netilmicin (5 mg), clindamycin (150 mg) + netilmicin (5 mg) and trimethoprimsulfa (76.8 mg) + tinidazole (8 mg). The results indicate that one preoperative dosage of the antibiotic(s) significantly reduces the mortality rate in rats with intraabdominal sepsis. Intraperitoneal fluid was observed in all non-surviving rats, whereas in the surviving animals no fluid was present regardless of the type of antibiotic. The rate of intraabdominal abscesses was significantly higher in the doxycycline group compared with the other treated groups, indicating an inadequate anaerobic cover of doxycycline. The incidence of intraabdominal postoperative adhesions was similar in all groups except the trimethoprimsulfa + tinidazole group, which had a significantly lower number of rats with adhesions.

The role of sensory nerves in catheter-induced urethral inflammation.

We have studied the contribution of the nervous system on experimentally induced urethral inflammation in the rat. Urethral inflammation was produced by inserting latex strips into the urethra. The effects of different experimental procedures were assessed by using a 4-grade inflammation scale based on histological findings. Attenuation of urethral inflammation was produced by administration of capsaicin at birth. A more complete attenuation was produced by infusion of capsaicin prior to application of the latex strip. These data taken together indicate that sensory innervation of the urethral mucosa is involved in the inflammatory reaction and that infusion of the urethra with capsaicin may be tried to prevent catheter-induced urethral inflammation.