Percutaneous transvenous coil embolization (PTCE) for treatment of single extrahepatic portosystemic shunt in dogs.

BACKGROUND: There is limited information regarding percutaneous transvenous coil embolization (PTCE) for single extrahepatic portosystemic shunt (PSS). This study aimed to describe the procedure and outcome of PTCE in dogs with a single extrahepatic PSS. Forty-two privately owned dogs were included in this study. All dogs were diagnosed with extrahepatic PSS by computed tomography (CT). Preoperative CT images were used to evaluate the diameter of the PSS for coil placement. A multipurpose balloon catheter was percutaneously inserted into the PSS via the jugular vein, and transvenous retrograde portography (TRP) and measurement of blood pressure in the PSS (pPSS) were performed during balloon inflation; one or more embolization coils were implanted via the catheter. RESULTS: In most cases, preoperative median fasting and postprandial serum total bile acid (TBA) concentrations were high (fasting, 86.5 µmol/L [ 3.7-250.0 µmol/L]; postprandial, 165.5 µmol/L [ 1.5-565.0 µmol/L]). CT revealed that 30 dogs had left gastrophrenic shunt; eight had left gastroazygos shunt; and one each had left gastrocaval, splenocaval, splenophrenic, and left colocaval shunt. TRP revealed that intrahepatic portal vascularity was clearly detectable in all dogs. The median values of pPSS before and during the balloon occlusion were 4.8 mmHg [2.0-13.0 mmHg] and 8.6 mmHg [5.0-18.0 mmHg], respectively. The median number and diameter of coils used were 2 coils [1 - 5 coils] and 8.0 mm [4.0 - 12.0 mm], respectively. The median times of irradiation and PTCE were 9 min [4-26 min] and 40 min [23-75 min], respectively. The median fasting and postprandial TBAs significantly decreased to 8.2 µmol/L [0.3-45.1 µmol/L, n = 38, p = 0.0028] and 19.8 µmol/L [0.3-106.7 µmol/L, n = 38, p = 0.0018], respectively, approximately 1 month after PTCE. The clinical success rate of PTCE without requirement for a second surgery was 95.2% (40/42 dogs). During revision surgery, one dog underwent surgical ligation and, in another dog, an ameroid constrictor was placed. CONCLUSIONS: PTCE was clinically effective in treating single extrahepatic PSS in dogs. Preoperative CT and TRP prior to PTCE might be clinically valuable for choosing the size of embolization coils, deciding the appropriate location of coil implantation, and estimating the number of coils to be implanted. PTCE is a promising alternative to conventional surgical procedures for single extrahepatic PSS in dogs.

Comparison of outcomes between medical and surgical treatment in dogs with prostatic adenocarcinoma: a retrospective study.

BACKGROUND: Prostatic cancer is uncommon in dogs. Dogs with prostatic carcinoma have been reported to have a poor prognosis. Information regarding prognosis with various surgery options as well as prognosis with surgical vs. medical treatment is lacking. This retrospective study compares the outcomes of medical management to surgical treatment in dogs with prostatic adenocarcinoma and assesses the surgical outcomes of patients who underwent total prostatectomy (TP) and prostatocystectomy (TPC). The medical records of 41 dogs with prostatic adenocarcinoma, between February 2008 and June 2019, were reviewed for information on signalment, clinical signs in the initial evaluation, preoperative diagnostic imaging findings, treatment type (non-surgical or surgical), surgery type, postoperative complications, adjunctive medical therapy, and survival time. The dogs were divided into non-surgical (n = 12) or surgical (n = 29) groups. The surgical group was subdivided into the TP (n = 20) and TPC (n = 9) subgroups. RESULTS: Age was not significantly different between the surgical (median 13.1 years [8.4-15.4] years) and the non-surgical groups (median 10.8 [7.7-15.3] years). Body weight (BW) was also not significantly different between the surgical (median 6.8 kg [2.4-34.5 kg]) and non-surgical groups (median 6.4 kg [3.7-9.12 kg]). The overall median survival time (MST) from the initial evaluation was significantly longer in the surgical than in the non-surgical group (337 vs. 90.5 days). The postoperative MST was significantly longer in the TP group than in the TPC subgroup (510 vs. 83 days). As TPC was performed in cases of tumor progression, its postoperative complications were severe, resulting in a shorter MST. Ten (50%) and 6 patients (30%) in the TP subgroup postoperatively showed mild and severe urinary incontinence, respectively, whereas all patients in TPC subgroup did show severe incontinence. CONCLUSION: Results of the study suggest that surgical treatment of prostatic carcinoma results in longer survival times over medical management alone. In particular, TP might be recommended for improving survival time and quality of life in canine prostatic adenocarcinoma that does not infiltrate the bladder. Early detection is key for a survival advantage with surgical treatment.

Clinical impact of near-infrared fluorescence imaging with indocyanine green on surgical treatment for hepatic masses in dogs.

BACKGROUND: Near-infrared fluorescence imaging using indocyanine green (ICG) is clinically applied to intraoperatively identify hepatic masses in humans. In addition, it is reported to be effective for assessing complete resection in human hepatocellular carcinoma (HCC). However, there is limited information on ICG fluorescence imaging for canine HCC, and its clinical usefulness is still unclear. Therefore, the purpose of this study was to evaluate the intraoperative identification and status of surgical margin for canine hepatic masses using near-infrared ICG fluorescence imaging. This clinical study included 104 dogs with hepatic masses. Between 12 and 24 h prior to surgery, ICG solution was injected intravenously at a dose of 0.5 mg/kg. The fluorescence intensity and pattern of each hepatic mass was investigated using an infrared camera before resection. After resection, the fluorescence intensity of the resection margin was also investigated. The resected masses were histopathologically diagnosed and compared using ICG fluorescence imaging. RESULTS: One hundred and twenty-two masses obtained from 104 dogs included 76 HCCs, 16 hepatocellular adenomas, 12 focal nodular hyperplasias, and 18 other lesions. Of the 122 masses, 106 (94 partial, 9 whole, and 3 ring fluorescence patterns), 7, and 9 masses showed increased, the same, or decreased fluorescence compared to the normal liver tissue, respectively. The fluorescence intensity and pattern were not significantly related to the histopathological diagnosis. The sensitivity and specificity of the margin evaluation in the 47 dogs were 100% and 77.3%, respectively. The median survival times in cases of HCC with complete and incomplete resection were 914 and 254 days, respectively. The median survival time of patients with a complete resection was significantly longer than that of patients with a incomplete resection (p = 0.043). CONCLUSION: ICG fluorescence imaging has potential clinical value for the identification and margin evaluation of canine hepatic masses. Although it is difficult to use fluorescence imaging for the differential diagnosis of liver tumours, it may be useful for assessing complete resection in cases of hepatic masses demonstrating increased fluorescence in dogs, and complete resection of HCC could have a survival benefit.

α-Xylosidase plays essential roles in xyloglucan remodelling, maintenance of cell wall integrity, and seed germination in Arabidopsis thaliana.

Regulation and maintenance of cell wall physical properties are crucial for plant growth and environmental response. In the germination process, hypocotyl cell expansion and endosperm weakening are prerequisites for dicot seeds to complete germination. We have identified the Arabidopsis mutant thermoinhibition-resistant germination 1 (trg1), which has reduced seed dormancy and insensitivity to unfavourable conditions for germination owing to a loss-of-function mutation of TRG1/XYL1, which encodes an α-xylosidase. Compared to those of wild type, the elongating stem of trg1 showed significantly lower viscoelasticity, and the fruit epidermal cells were longitudinally shorter and horizontally enlarged. Actively growing tissues of trg1 over-accumulated free xyloglucan oligosaccharides (XGOs), and the seed cell wall had xyloglucan with a greatly reduced molecular weight. These observations suggest that XGOs reduce xyloglucan size by serving as an acceptor in transglycosylation and eventually enhancing cell wall loosening. TRG1/XYL1 gene expression was abundant in growing wild-type organs and tissues but relatively low in cells at most actively elongating part of the tissues, suggesting that α-xylosidase contributes to maintaining the mechanical integrity of the primary cell wall in the growing and pre-growing tissues. In germinating seeds of trg1, expression of genes encoding specific abscisic acid and gibberellin metabolism enzymes was altered in accordance with the aberrant germination phenotype. Thus, cell wall integrity could affect seed germination not only directly through the physical properties of the cell wall but also indirectly through the regulation of hormone gene expression.

Fungal hemicellulose-degrading enzymes cause physical property changes concomitant with solubilization of cell wall polysaccharides.

MAIN CONCLUSION: Physical properties of wheat coleoptile segments decreased after treatment with hemicellulose-degrading enzymes, indicating that hemicellulosic polysaccharides function to control the strength of primary cell walls. Changes in the physical properties of plant cell walls, a viscoelastic structure, are thought to be one of the growth-limiting factors for plants and one of the infection-affecting factors for fungi. To study the significance of hemicellulosic polysaccharides that form cross-bridges between cellulose microfibrils in controlling cell wall strength in monocot plants, the effects of hemicellulose degradation by recombinant Magnaporthe oryzae xylanase and 1,3-1,4-ß-glucanase, and recombinant Aspergillus oryzae xyloglucanase on the physical properties and polysaccharide solubilization were investigated using wheat (Triticum aestivum L.) coleoptiles. Treatments with xylanase or 1,3-1,4-ß-glucanase significantly decreased the viscosity and elasticity of wheat coleoptile segments. In addition, xyloglucanase treatment slightly decreased the viscoelasticity. Furthermore, 1,3-1,4-ß-glucan polymer was solubilized during hydrolysis with xylanase and xyloglucanase, even though neither enzyme had hydrolytic activity towards 1,3-1,4-ß-glucan. These results suggest that xylan and xyloglucan interact with 1,3-1,4-ß-glucan and that the composites and hemicellulosic polysaccharides form inter-molecular bridges. Degradation of these bridges causes decreases in the physical properties, resulting in increased extensibility of the cell walls. These findings provide a testable model in which wheat coleoptile cell walls are loosened by the degradation of hemicellulosic polysaccharides and hemicellulose-degrading enzymes play a significant role in loosening the walls during fungal infection.

New Swallowing Evaluation Using Piezoelectricity in Normal Individuals.

This study aimed to elucidate the relationship between the piezoelectric waveform latency, hyoid bone movement, surface electromyogram (sEMG), and the pharyngeal transit time (PTT) during swallowing. Forty-one healthy subjects were divided into three age groups: younger (20-39 years, n = 8), middle-aged (40-59 years, n = 9), and older (60-79 years, n = 24). Motion analysis of the hyoid bone using videofluorography (VF), waveform analysis of the front neck using piezoelectric films, and sEMG of the suprahyoid muscle group were performed simultaneously. Latencies of the three movement phases were defined as upward (VFS1), forward (VFS2), and returning to starting position (VFS3). The three phases of the piezoelectric waveform-from wave initiation of the negative wave to the start of the second deep negative wave; from the start of the second deep negative wave to the start of the last positive wave (SLPW); and from the SLPW to the end of the last positive wave-were defined as PS1, PS2, and PS3, respectively. VFS1-3 and PS1-3 were significantly correlated. VFS1 and PS1 latencies were significantly longer with thick liquid than with thin liquid. VFS2, PS1, and PS2 latencies were longer in the older group than in the other two groups. The start of PS1 was nearly equal to those of sEMG and VFS1. Bolus arrival time in the valleculae was statistically equal to the end of the PS1 with both thin and thick liquids. To establish the swallowing screening using Piezoelectric film, further investigation is necessary in the dysphagia patients.

[A case of ampullary carcinoma progression-free for four years after treatment with TS-1].

A 63-year old man was referred to our hospital because of fever, appetite loss, and increased biliary enzyme levels. Upper gastrointestinal endoscopy revealed a tumor in the duodenal papilla, diagnosed as an adenocarcinoma via biopsy, and computed tomography (CT) revealed multiple tumors in the liver. Chemotherapy with TS-1 was initiated based on a diagnosis of ampullary cancer with multiple liver metastases. After TS-1 treatment, the multiple tumors were no longer detectable, and the primary tumor did not increase in size for 4 years. At this time, however, the patient experienced fever, jaundice, and appetite loss. The hepatic mass was not detected via CT or MRI. The primary tumor was determined to be resectable; therefore, we performed subtotal stomach preserving pancreatoduodenectomy. The patient was discharged 55 days after surgery and is alive without recurrence 2 years after surgery.

Reconstruction surgery using polypropylene mesh after extensive resection of a costal osteosarcoma in a dog.

Osteosarcoma is the most common tumour that develops in the chest wall of dogs; an extensive excision is the treatment of choice. Various methods have been reported for reconstruction of chest wall defects following extensive excision. The objective of this report was to describe the complete resection of an extensive costal osteosarcoma with an extended resection of the ribs and part of the diaphragm in a dog. An 11-year-old neutered, male, miniature pinscher was presented with dyspnoea: An extensive mass was observed, stretching from the right chest wall to the abdominal wall. On computed tomography, the mass originated from the right 9th rib and exceeded the 6th rib on the cranial side and the 13th rib on the caudal side; it was compressing the lungs, diaphragm, liver, stomach and duodenum. When the patient's condition was medically stabilized, the tumour was removed from the right 9th rib. In consideration of the surgical margin, the 5th-13th ribs were excised, and the tumour was resected with the thoracoabdominal wall and part of the diaphragm. The missing thoracoabdominal wall and section of the diaphragm were reconstructed using two sheets of a polypropylene mesh. Postoperatively, flail chest was observed, although dyspnoea was not observed in the patient. Histopathological examination confirmed the diagnosis of osteosarcoma with a clean margin. Although 60.6 months have passed post-surgery, no metastasis has reoccurred. In this case, complete resection and reconstruction of the chest wall and diaphragm were achieved using a polypropylene mesh without fatal postoperative complications, despite extensive osteosarcoma resection.

Impact of near-infrared fluorescence imaging with indocyanine green on the surgical treatment of pulmonary masses in dogs.

Objectives: To investigate the intraoperative identification and complete resection of pulmonary masses, and to evaluate lymph node metastasis of pulmonary malignant tumors in dogs using indocyanine green (ICG) fluorescence imaging. Methods: Forty dogs with pulmonary masses were included, all of which underwent surgical treatment. ICG fluorescence imaging was performed on pulmonary masses before lobectomy and the resection margins after lobectomy. In addition, ICG fluorescence of the excised masses and lymph nodes was evaluated in the shaded box. The fluorescence findings were compared with the histopathological diagnosis. Results: Of 44 nodules resected from 40 dogs, 32 nodules were histopathologically diagnosed as lung adenocarcinoma, five were histiocytic sarcoma, three were undifferentiated sarcoma, two were malignant epithelial tumor metastases, one was carcinosarcoma, and one was a non-neoplastic lesion. Fluorescence was observed in all nodules. In addition to the main lesion, other fluorescent nodules were found in four dogs. Regarding the diagnostic accuracy of complete resection based on ICG fluorescence, the sensitivity was 67.7% and the specificity was 60.0%. The sensitivity and specificity of ICG fluorescence for the diagnosis of lymph node metastasis were 100 and 75.0%, respectively. Conclusions: ICG fluorescence imaging might be a useful intraoperative diagnostic method to identify the location of tumors and lymph node metastasis, but not to evaluate complete tumor resection, in dogs with pulmonary malignant tumors.

Preemptively planned en bloc resection of an extensive right adrenal pheochromocytoma involving the right hepatic division, caval thrombus and segmental caudal vena cava in a dog with Budd-Chiari-like syndrome.

BACKGROUND: Surgical resection is the treatment of choice for canine adrenal pheochromocytomas (PHEOs). Information on en bloc resection of adrenal PHEO with tumour thrombus, right hepatic division and segmental caudal vena cava (CVC) running through the adrenal tumour and right hepatic division is limited. OBJECTIVE: To describe the preemptively planned en bloc resection of an extensive right adrenal PHEO involving the right hepatic division, the caval thrombus and the segmental CVC in a dog with Budd-Chiari-like syndrome (BCLS). METHODS: A 13-year-old castrated male miniature dachshund was referred for surgical treatment due to anorexia, lethargy and severe abdominal distension caused by abundant ascites. Preoperative computed tomography (CT) revealed a large mass in the right adrenal gland with a large caval thrombus obstructing the CVC and hepatic veins, which caused BCLS. Additionally, collateral vessels were formed between the CVC and azygos veins. No findings suggested obvious metastases. Based on CT findings, an en bloc resection of the adrenal tumour with caval thrombus, right hepatic division and segmental CVC was planned. RESULTS: The preoperatively planned resection was feasible; the tumour was completely resected grossly. The operation time and total Pringle manoeuvre time were 162 min and 16 min 56 s, respectively. There was no postoperative hindlimb oedema, renal dysfunction, ascites or abdominal distention. The patient's clinical signs, including appetite, fully improved. Hospitalization lasted 16 days. However, the patient died on the 130th postoperative day due to suspected metastases and cachexia. CONCLUSIONS: Even in case of an extensive infiltration of adrenal PHEO causing BCLS, an en bloc resection might be successfully achieved based on the preoperative CT findings speculating the collateral vessels formed for caudal venous return.

Proposal of nomograms to predict clinical outcomes in patients with ampulla of Vater cancer based on the Korea-Japan collaborative study.

BACKGROUND: In this study, we aimed to develop and validate a nomogram to predict overall survival (OS) and recurrence-free survival (RFS) in patients who underwent curative resection of ampulla of Vater (AOV) cancer. This is the first study for nomograms in AOV cancer patients using retrospective data based on an international multicenter study. METHODS: A total of 2007 patients with AOV adenocarcinoma who received operative therapy between 2002 January and 2015 December in Korea and Japan were retrospectively assessed to develop a prediction model. Nomograms for 5-year OS and 3-year RFS were constructed by dividing the patients who received and who did not receive adjuvant therapy after surgery, respectively. Significant risk factors were identified by univariate and multivariate Cox analyses. Performance assessment of the four prediction models was conducted by the Harrell's concordance index (C-index) and calibration curves using bootstrapping. RESULTS: A total of 2007 and 1873 patients were collected for nomogram construction to predict 5-year OS and 3-year RFS. We developed four types of nomograms, including models for 5-year OS and 3-year RFS in patients who did not receive postoperative adjuvant therapy, and 5-year OS and 3-year RFS in patients who received postoperative adjuvant therapy. The C-indices of these nomograms were 0.795 (95% confidence interval [CI]: 0.766-0.823), 0.712 (95% CI: 0.674-0.750), 0.804 (95% CI: 0.7778-0.829), and 0.703 (95% CI: 0.669-0.737), respectively. CONCLUSIONS: This predictive model could help clinicians to choose optimal treatment and precisely predict prognosis in AOV cancer patients.

Sequential analysis of head movement during mandibular open-close movements in TMD patients with disc displacement with reduction.

This study examined relationships between starting points of head and mandibular movements in 11 female control subjects and 10 TMD patients showing disc displacement with reduction during consecutive open-close movements, using a six-degree-of-freedom measuring device. During the first mandibular opening cycle, in the TMD group, head movement was significantly preceded in relation to mandibular movement when compared with the control group, and major differences in onset were seen between maximum and minimal values at the beginning of mandibular movements. After the second cycle, significant differences in starting points were not evident. In TMD patients showing disc displacement with reduction, in the first cycle, at the commencement of opening movements, it is proposed that the head precedes the mandible in order to compensate for irregular condylar movements, and the degree of the condylar movement irregularity might affect the onset relation between the head and the mandible.

[A case of curatively resected locally advanced cancer of the pancreatic body treated by distal pancreatectomy with en bloc celiac axis resection after neoadjuvant chemotherapy].

A 68-year-old man with locally advanced pancreatic body cancer invading the celiac axis(CA, including common hepatic artery)and in contact with the superior mesenteric artery(SMA)underwent 2 courses of neoadjuvant chemotherapy(NAC); gemcitabine hydrochloride(GEM 1,000 mg/m / / 2, on day 1 and 15)and S-1(100mg/m2day, 2-weeks of continuous administration followed by 1-week rest). The tumor volume and the contact area to SMA were greatly diminished. All tumor markers were reduced. He underwent R0 resection by distal pancreatectomy with en bloc celiac axis resection(DP-CAR). After the surgery, he could continue adjuvant chemotherapy; (GEM 1,000 mg/m2)only twice because of malnutrition. Nine months later CT revealed local recurrence and multiple lung metastases. The patient died 371 days after surgery. Appropriate NAC can contribute to R0 resection in locally advanced pancreatic cancer.

Triple-combination surgery with thoracic duct ligation, partial pericardiectomy, and cisterna chyli ablation for treatment of canine idiopathic chylothorax.

This study aimed to evaluate the outcomes and complications of triple-combination surgery consisting of thoracic duct ligation (TDL), partial pericardiectomy (PPC), and cisterna chyli ablation (CCA) for the treatment of idiopathic chylothorax in dogs. Eleven privately owned dogs with idiopathic chylothorax underwent the triple-combination surgery: TDL and PPC were performed in left recumbency, followed by CCA in dorsal recumbency. Of the 11 dogs, seven were Shiba, two were Afghan hounds, and one each was Borzoi and mixed-breed. TDL and PPC required two intercostal thoracotomies in five dogs, whereas they were performed through a single intercostal incision in the other dogs. None of the dogs showed major intraoperative complications. The median operation time was 190 min (range, 151-234 min). Nine dogs showed no pleural effusion after surgery without medical management. Another dog showed the disappearance of chylous effusion, followed by the pleural accumulation of modified transudate. However, the residual one dog in whom chylothorax did not improve postoperatively died 4 months after the combination surgery. The mortality rate at the conclusion of this study was 9.1%. Although the triple-combination surgery with TDL, PPC, and CCA was complex and required a prolonged operation time, the success rate of resolving chylothorax in our study was comparable to that of open surgery as previously reported. Therefore, this study suggests that such triple-combination surgery can become one of the therapeutic options for the management of canine idiopathic chylothorax.

Clinical, diagnostic, and pathologic features and surgical outcomes of combined hepatocellular-cholangiocarcinoma in dogs: 14 cases (2009-2021).

OBJECTIVE: To describe the clinical, diagnostic, and pathological features and postoperative prognosis of canine combined hepatocellular-cholangiocarcinoma (cHCC-CCA). ANIMALS: 14 privately owned dogs that underwent surgical treatment. PROCEDURES: The medical records, including signalment, clinical signs, blood test, urine analysis, computed tomography (CT) findings, intraoperative findings, and pathological findings, were retrospectively reviewed in the dogs with cHCC-CCA. RESULTS: Of 306 dogs that underwent surgical removal of hepatic masses, 14 dogs (4.6%) were pathologically confirmed to have cHCC-CCA. Median age and body weight were 11.3 years and 7.3 kg, respectively. There were no specific clinicopathological findings for cHCC-CCA. CT revealed a massive hepatic mass in all dogs and the inclusion of cyst-like lesions within the mass in 13 dogs. Intrahepatic metastases were found at time of surgery in 2 dogs (14.3%). Of the residual 12 dogs, 1 dog showed postoperative formation of intrahepatic nodules suggestive of metastases and another had intrahepatic and pulmonary nodules and a forelimb skin mass, suggesting postoperative metastases. The median survival time of the patients with cHCC-CCA was 700 days (range, 10 to 869 days) after surgery. CLINICAL RELEVANCE: To the authors' knowledge, this is the first study to describe the clinical, diagnostic, and pathological features and postoperative prognosis of canine cHCC-CCA. The clinical and diagnostic features of canine cHCC-CCA might be more similar to those of HCC rather than to those of CCA, but the preoperative diagnosis differentiating between HCC and cHCC-CCA was challenging. Our study suggests that the postoperative prognosis of canine patients with cHCC-CCA is similar to that of dogs with HCC.

Quantitative analysis of contrast-enhanced ultrasound estimates intrahepatic portal vascularity in dogs with single extrahepatic portosystemic shunt.

OBJECTIVE: To evaluate the clinical impact on quantitative analysis of contrast-enhanced ultrasound (CEUS) on single extrahepatic portosystemic shunt (PSS) in dogs. ANIMALS: 21 client-owned dogs with single extrahepatic PSS and 5 healthy Beagles. PROCEDURES: In all dogs, CEUS was performed to calculate the rising time (RT), rising rate (RR), and portal vein-to-hepatic parenchyma transit time (ΔHP-PV) from the time-intensity curve obtained in the hepatic parenchyma and portal vein. All dogs in the PSS group underwent preoperative CT angiography (CTA) and surgery. The CEUS variables in the PSS group were compared with those in the healthy dogs (control group) and were analyzed for shunt types and grades of intrahepatic portal venous branches based on CTA findings, intraoperative portal pressure, and surgical procedures. RESULTS: All 3 CEUS variables showed no significant differences between the PSS and control groups. The RT and ΔHP-PV in the left gastrophrenic shunt group were significantly longer than in the other shunt types. In the intrahepatic portal vascularity, the RT in grade 1 was significantly shorter than in grades 3 and 4, and the RR in grade 1 was significantly higher than in grade 4. The RT and ΔHP-PV were significantly correlated with portal pressure variables. The RT in dogs with partial ligation was significantly shorter than in dogs with complete ligation and percutaneous transvenous coil embolization. CLINICAL RELEVANCE: Quantitative assessments of CEUS may be useful for estimating intrahepatic portal vascularity in dogs with single extrahepatic PSS.

Glucoregulatory factors in canine hepatocellular carcinoma and leiomyosarcoma with non-islet cell tumour hypoglycaemia.

INTRODUCTION: Hypoglycaemia caused by malignant tumours other than insulinoma is referred to as non-islet cell tumour hypoglycaemia (NICTH), which may be caused by hepatocellular carcinoma (HCC) and leiomyosarcoma (LMS) in veterinary medicine. However, the pathogenetic mechanism of NICTH remains unclear. Therefore, this study aimed to evaluate the gene-expression levels of glucoregulatory factors in canine HCC and LMS accompanied by hypoglycaemia. MATERIALS & METHODS: Four patients (three with HCC and one with LMS) exhibiting hypoglycemia were included in the hypoglycemic (H) group, whereas ten patients not exhibiting hypoglycemia were in the non-hypoglycaemia (NH) group. The preoperative and postoperative blood glucose and serum insulin-like growth factor-2 (IGF-2) levels, as well as the expression of genes involved regulating blood glucose levels were analysed. RESULTS: Compared with the NH group, the H group exhibited significantly decreased blood-glucose levels, which increased to normal values after surgery. Compared with the NH group, the H group exhibited significantly increased gene expression of insulin-like growth factor 1, IGF-2, and insulin-like growth factor binding protein 3 in the tumours. Conversely, expression of genes encoding glucoregulatory factors including insulin, gastric inhibitory polypeptide and glucagon was not observed. Serum IGF-2 levels were significantly higher in the H group compared with that in the control group (healthy dogs) and NH group. In two cases in the H group, serum IGF-2 levels decreased after tumour resection. CONCLUSION: These results suggest that NICTH development in dogs with HCC and LMS is mechanistically associated with IGF-2 overexpression and elevated serum IGF-2 levels.

Serum vascular endothelial growth factor in dogs with various proliferative diseases.

Angiogenesis plays an important role in the proliferation and metastasis mechanisms of malignant tumors. Vascular endothelial growth factor (VEGF), a group of cytokines that contribute to angiogenesis and vasculogenesis. This study aimed to investigate the serum VEGF-A concentrations in dogs with various proliferative diseases. A total of 202 dogs that were histopathologically diagnosed with proliferative diseases were included in the study. Serum VEGF-A concentrations were measured using enzyme-linked immunosorbent assay. Median serum VEGF-A concentrations in dogs were as follows: healthy dogs, 4 pg/ml [0-21 pg/ml]; hepatocellular carcinoma, 30 pg/ml [0-158 pg/ml, P=<0.001]; hepatocellular adenoma, 32 pg/ml [0-49 pg/ml, P=0.003]; hepatic nodular hyperplasia, 18 pg/ml [0-51 pg/ml, P=0.595]; adrenal pheochromocytoma, 32 pg/ml [0-187 pg/ml, P=<0.001]; adrenocortical carcinoma, 32 pg/ml [3-161 pg/ml, P=0.002]; adrenocortical adenoma, 27 pg/ml [0-106 pg/ml, P=0.005]; colorectal adenocarcinoma, 36 pg/ml [0-75 pg/ml, P=0.002]; colorectal adenoma, 43 pg/ml [0-48 pg/ml, P=0.144]; inflammatory colorectal polyps, 37 pg/ml [0-111 pg/ml, P=<0.001]; pulmonary adenocarcinoma, 35 pg/ml [4-107 pg/ml, P=0.002]; pulmonary histiocytic sarcoma, 35 pg/ml [0-131 pg/ml, P=0.016]; and follicular thyroid carcinoma, 35 pg/ml [0-106 pg/ml, P=0.009]. The serum VEGF-A concentrations were significantly higher in dogs with neoplastic lesions compared to healthy dogs, except for colorectal adenoma. High serum VEGF-A concentrations were observed in dogs with proliferative diseases. The present study suggests that angiogenesis-inhibiting therapy, which targets VEGF-A, may be useful for canine neoplastic diseases.

Perineal herniorrhaphy with pedunculated tunica vaginalis communis in dogs: Description of the technique and clinical case series.

Background: Perineal hernia (PH) in dogs is caused by the separation of the anal septal muscles and the displacement of pelvic/abdominal organs under the perineal skin. Reconstruction of the pelvic septum by surgical repositioning is the only curative treatment. Objectives: To describe the procedure and outcomes of surgical repair using the pedunculated tunica vaginalis communis (TVC) for PH in dogs. Methods: Intact male dogs diagnosed with PH were included in this study. For surgery, each dog was positioned in the Trendelenburg position. Castration was performed with the open technique, followed by colopexy and cystopexy via laparotomy. The remaining bilateral TVCs transposed to the opening of PH were used for the perineal herniorrhaphy. Intraoperative findings, complications, and outcomes were evaluated and recorded. Results: Eight dogs [median age 10.5 years (range, 9-13 years); median body weight 4.9 kg (range, 1.6-12.3 kg)] were treated using the TVC surgical technique. Perineal herniorrhaphy with the TVC was feasible in all dogs. The median operation time was 105.5 min (range, 46-149 min) in unilateral PH, and 92 and 122 min in two dogs with bilateral PH. Short-term postoperative complications during hospitalization did not occur in six dogs, whereas the residual two dogs had a temporary local infection as a minor complication. Postoperative recurrence occurred in one dog (13%) on postoperative day 136. Conclusions: Our study suggests that the herniorrhaphy technique using the pedunculated TVC is an alternative option for the repair of PH in dogs.