RESUMO
Inadvertent injury to important anatomic structures is a significant risk in minimally invasive surgery (MIS) that potentially requires conversion to an open procedure, which results in increased morbidity and mortality. Surgeons operating minimal-invasively currently do not have an easy-to-use, real-time device to aid in intraoperative identification of important anatomic structures that underlie tissue planes. We demonstrate freehand diffuse optical spectroscopy (DOS) imaging for intraoperatively identifying major underlying veins and arteries. An applicator probe that can be affixed to and detached from an 8-mm laparoscopic instrument has been developed. The 10-mm DOS source-detector separation renders sampling of tissue heterogeneities a few millimeters deep. DOS spectra acquired consecutively during freehand movement of the applicator probe on the tissue surface are displayed as a temporal and spectral image to assist in spatially resolved identification of the underlying structures. Open surgery identifications of the vena cava and aorta underlying peritoneal fat of â¼4 mm in thickness using the applicator probe under room light were demonstrated repeatedly in multiple pigs in vivo.
Assuntos
Tecido Adiposo/irrigação sanguínea , Tecido Adiposo/diagnóstico por imagem , Artérias/diagnóstico por imagem , Cavidade Peritoneal/irrigação sanguínea , Cavidade Peritoneal/diagnóstico por imagem , Análise Espectral/instrumentação , Veias/diagnóstico por imagem , Animais , Período Intraoperatório , Laparoscopia/instrumentação , SuínosRESUMO
OBJECTIVE To determine rate of recurrence of disk herniation in dogs that underwent percutaneous laser disk ablation (PLDA) because of a previous episode of suspected or confirmed thoracolumbar intervertebral disk herniation (IVDH). DESIGN Retrospective case series. ANIMALS 303 dogs that underwent PLDA and for which a minimum of 3 years of follow-up information was available (n = 294) or for which recurrence was documented within 3 years after the procedure (9). PROCEDURES Information on signalment, previous episodes of IVDH, specifics of the PLDA procedure, and recurrence was obtained from the medical records. Owners were contacted to complete a questionnaire regarding outcome and recurrence. RESULTS 60 of the 303 (19.8%) dogs had an episode of suspected or confirmed IVDH after undergoing PLDA, but only 11 of the 303 (3.6%) dogs had a recurrence of IVDH confirmed by means of CT or MRI and hemilaminectomy. Recurrence rate following PLDA was not significantly different between dogs that had been treated medically for previous episodes of IVDH and dogs that had been treated surgically. Overall, 270 of 286 (94.4%) owners reported that their dog was the same (109 [38.1%]) or improved (161 [56.3%]) immediately after PLDA, and 265 (92.7%) owners rated their satisfaction with the procedure as ≥ 9 on a scale from 1 (completely dissatisfied) to 10 (completely satisfied). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that PLDA was a relatively safe, minimally invasive procedure associated with a low rate of recurrence of disk herniation when performed in dogs with a history of previous episodes of suspected or confirmed IVDH.
Assuntos
Discotomia Percutânea/veterinária , Doenças do Cão/cirurgia , Deslocamento do Disco Intervertebral/veterinária , Terapia a Laser/veterinária , Complicações Pós-Operatórias/veterinária , Animais , Discotomia Percutânea/métodos , Cães , Feminino , Terapia a Laser/métodos , Vértebras Lombares/cirurgia , Masculino , Recidiva , Estudos RetrospectivosRESUMO
This study explores percutaneous single-fiber spectroscopy (SfS) of rat livers undergoing fatty infiltration. Eight test rats were fed a methionine-choline-deficient (MCD) diet, and four control rats were fed a normal diet. Two test rats and one control rat were euthanized on days 12, 28, 49, and 77 following initiation of the diet, after percutaneous SfS of the liver under transabdominal ultrasound guidance. Histology of each set of the two euthanized test rats showed mild and mild hepatic lipid accumulations on day 12, moderate and severe on day 28, severe and mild on day 49, and moderate and mild on day 77. Livers with moderate or higher lipid accumulation generally presented higher spectral reflectance intensity when compared to lean livers. Livers of the eight test rats on day 12, two of which had mild lipid accumulation, revealed an average scattering power of 0.37±0.14 in comparison to 0.07±0.14 for the four control rats (p<0.01 ). When livers of the test rats with various levels of fatty infiltration were combined, the average scattering power was 0.36±0.15 0.36±0.15 in comparison to 0.14±0.24 of the control rats (0.05
Assuntos
Tecido Adiposo/fisiopatologia , Fígado Gorduroso/diagnóstico , Fígado Gorduroso/fisiopatologia , Tecnologia de Fibra Óptica/métodos , Fígado/fisiopatologia , Análise Espectral/métodos , Tecido Adiposo/patologia , Adiposidade , Animais , Deficiência de Vitaminas/complicações , Carboxiliases/deficiência , Deficiência de Colina/complicações , Fígado Gorduroso/etiologia , Luz , Fígado/patologia , Masculino , Ratos , Ratos Sprague-Dawley , Reprodutibilidade dos Testes , Espalhamento de Radiação , Sensibilidade e EspecificidadeRESUMO
Endurance exercise relies on transsarcolemmal flux of substrates in order to avoid depletion of intramuscular reserves. Previous studies of endurance trained sled dogs have shown a remarkable capacity of these dogs to adapt rapidly to endurance exercise by decreasing the utilization of intramuscular reserves. The current study tested the hypothesis that the dogs' glycogen-sparing phenotype is due to increased sarcolemmal transport of glucose and fatty acids. Basal and exercise-induced transport of glucose and fatty acids into sarcolemmal vesicles was evaluated in racing sled dogs prior to and after 7 months of exercise conditioning. Sarcolemmal substrate transport capacity was measured using sarcolemmal vesicles and radiolabelled substrates, and transporter abundance was measured using Western blot quantification in whole muscle homogenates and the sarcolemmal vesicle preparations. Conditioning resulted in increased basal and exercise-induced transport of both glucose and palmitate. Neither acute exercise nor conditioning resulted in changes in muscle content of GLUT4 or FAT/CD36, but conditioning did result in decreased abundance of both transporters in the sarcolemmal vesicles used for the basal transport assays, and this decrease was further amplified in the vesicles used for the exercise-induced transport assays. These results demonstrate conditioning-induced increases in sarcolemmal transport of oxidizable substrates, as well as increased gain of exercise-induced sarcolemmal transport of these substrates. These results further indicate that increased sarcolemmal transport of oxidizable substrates may be due to either an increased intrinsic capacity of the existing transporters or to a different population of transporters from those investigated.
Assuntos
Contração Muscular , Condicionamento Físico Animal , Resistência Física , Sarcolema/metabolismo , Animais , Transporte Biológico , Antígenos CD36/metabolismo , Cães , Glucose/metabolismo , Transportador de Glucose Tipo 4/metabolismo , Proteínas Musculares/metabolismo , Palmitatos/metabolismoRESUMO
BACKGROUND AND OBJECTIVES: Intervertebral disc herniation is a common disease in chondrodystrophic dogs, and a similar neurologic condition also occurs in humans. Percutaneous laser disc ablation (PLDA) is a minimally invasive procedure used increasingly for prevention of disc herniation. Currently, PLDA is performed on thoracolumbar discs with the same laser energy applied regardless of the differing extent of degeneration among mineralized discs. In a previous study performed on 15 normal and 6 degenerated intervertebral discs in chondrodystrophoid canine species, it was demonstrated that percutaneous single-fiber reflectance spectroscopy (SfRS) detected increased light scattering from mineralized intervertebral discs when comparing to normal discs. The objective of this study is to evaluate how SfRS evaluation of mineralized discs in situ fairs with X-ray radiography and computed tomography (CT) diagnoses and if SfRS sensing of the scattering changes correlates with the level of mineral degeneration in nucleus pulposus. MATERIALS AND METHODS: Percutaneous SfRS was performed on a total of 28 intervertebral discs of three dogs post-mortem, through a 20 gauge spinal needle standard to PLDA. The raw SfRS measurement was normalized to extract a dimension-less spectral intensity profile, from which the average over 600-900 nm was used as the SfRS intensity index to compare among the measured discs. The discs were imaged prior to percutaneous SfRS by radiography and CT, and harvested after percutaneous SfRS for histopathologic examinations. RESULTS: Five among 10 discs of dog #1, six among 9 discs of dog #2, and nine out of 9 discs of dog #3 were determined by histopathology to have central focal or multi-focal areas of mineralization occupying 5-75% of the examined area of nucleus pulposus. The overall numbers of discs with detectable and undetectable central mineralization were 20 and 8, respectively. CT resulted in one false positive (FP) and four false negative (FN) diagnoses for dog #1, three FP and zero FN diagnoses for dog #2, and zero FP and one FN diagnosis for dog #3. Of the total 28 discs the CT had an overall positive predictive value (PPV) of 78.8% and an overall negative predictive value (NPV) of 44.4%. X-ray radiography gave five FN diagnoses for dog #1, two FN diagnoses for dog #2, and eight FN diagnoses for dog #3. Of the total 28 discs the radiography had an overall PPV of 100% and an overall NPV of 30.4%. The receiver-operating-characteristic analysis of the SfRS measurement was performed on 24 discs that had a central mineralization not greater than 50%. An area-under-curve of 0.6758 infers that the SfRS intensity weakly indicates the level of mineralization. CONCLUSIONS: Percutaneous SfRS may be useful as an in situ sensing tool for assessing the level of mineral degeneration in intervertebral discs for the prospect of disc-specific dosage adjustment in PLDA.
Assuntos
Tecnologia de Fibra Óptica , Deslocamento do Disco Intervertebral/diagnóstico , Análise Espectral/métodos , Animais , Modelos Animais de Doenças , Cães , Técnicas In Vitro , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/metabolismo , Minerais/metabolismo , Valor Preditivo dos Testes , Tomografia Computadorizada por Raios XRESUMO
We demonstrate the feasibility of diffuse optical tomography (DOT) of the proximal pancreas by using optical applicator channels deployed longitudinally along the exterior surface of a duodenoscope. As the duodenum that nearly encircles the proximal pancreas forms a natural "C-loop" that is approximately three-quarters of a circle of 5-6 cm in diameter, a multichannel optical applicator attached to a duodenoscope has the potential to perform transduodenal DOT sampling of the bulk proximal pancreas wherein most cancers and many cystic lesions occur. The feasibility of transduodenal DOT is demonstrated on normal porcine pancreas tissues containing an introduced gelatinous inclusion of approximately 3 cm in diameter, by using nine source channels and six detector channels attached to a duodenoscope. Concurrent ultrasonography of the gelatinous inclusion in the porcine pancreas parenchyma provided a coarse, albeit indispensable, anatomic prior to transduodenal DOT in reconstructing a contrast of optical properties in the pancreas.
Assuntos
Duodeno , Pâncreas , Tomografia Óptica/métodos , Animais , Pancreatopatias/diagnóstico , SuínosRESUMO
The purpose of this randomized clinical trial was to compare the efficacy of three patient warming devices (i.e., circulating water blanket, forced-air, and warming panels) used either alone or in combination on patients undergoing surgeries lasting >60 min. In total, 238 dogs were included and divided into either the celiotomy or nonceliotomy group. Dogs in each group were further divided into one of three subgroups. Dogs in subgroup 1 (n=39) were placed on a circulating water blanket with a forced-air warming blanket placed over the trunk. Subgroup 2 dogs (n=40) were placed on a forced-air warming blanket only. Subgroup 3 dogs (n=40) were placed on warming panels. Significant temperature drops occurred from time of induction (38.1°C±0.64°C) to the start of surgical procedures (36.7°C±0.95°C). Although body temperature was maintained once the warming units were started in all groups, there were significant differences in temperatures for the type of surgical procedures (i.e., celiotomies versus nonceliotomies) performed over time except for subgroup 3. The warming panels and forced-air devices were equally effective in preserving body temperature in anesthetized patients.
Assuntos
Regulação da Temperatura Corporal/fisiologia , Cães/fisiologia , Calefação/instrumentação , Cuidados Intraoperatórios/veterinária , Laparoscopia/veterinária , Animais , Cães/cirurgia , Feminino , Homeostase/fisiologia , Cuidados Intraoperatórios/normas , Período Intraoperatório , Laparoscopia/efeitos adversos , MasculinoRESUMO
OBJECTIVE: To determine using light and scanning electron microscopy if treatment with CO2 photokeratotomy alters the corneal endothelium in healthy dogs. PROCEDURE: Eight surgery laboratory dogs were determined to be free of ocular abnormalities. Under general anesthesia, the left eye of each dog was treated in a quadrant from 12 to 3 o'clock with the CO(2) laser in a defocused mode. The right eye served as a control. There were four treatment groups, each with 2 dogs: group 1 (2 W, 0.1 J/s, 0.8 mm tip), group 2 (3 W, 0.3 J/s, 0.8 mm tip), group 3 (2 W, 0.04 J/s NovaScan), group 4 (3 W, 0.06 J/s, NovaScan). The 0.8 mm tip delivered a power density of 382 W/cm(2) or 573 W/cm(2), at 2 or 3 watts respectively. The NovaScan handpiece delivered a power density of 30 W/cm(2) or 40 W/cm(2), at 2 or 3 Watts respectively. Following euthanasia, right and left corneas including a 2-mm scleral rim were harvested and fixed in commercial grade Karnovsky's fixative. One piece of cornea was processed routinely, embedded in Embed 812 resin, sectioned at 1 um, stained with toluidine blue and evaluated with the light microscope. A separate piece of each cornea was routinely processed and examined with a JEOL 6400 scanning electron microscope (SEM) at 20 KV. RESULTS: No changes in endothelial cell morphology were detected by light microscopy in the sections examined. SEM indicated normal endothelial cell morphology in control eyes with presumed artifactual changes at the corneal free margin (4/8 eyes). Multiple punctate to linear regions of endothelial cell destruction were observed in 6/8 laser-treated corneas. A significant increase in corneal thickness ranging from 1.90 to 37.28% was observed in all laser treated corneas. This increase in thickness correlated linearly with the degree of endothelial damage. Ultrastructural findings also correlated with postoperative clinical findings. CONCLUSION: CO2 laser photokeratotomy alters corneal endothelial cell morphology and thickness.
Assuntos
Cirurgia da Córnea a Laser/veterinária , Cães , Endotélio Corneano/patologia , Lasers de Gás , Animais , Cirurgia da Córnea a Laser/efeitos adversos , Feminino , MicroscopiaRESUMO
In vivo trans-rectal near-infrared (NIR) optical tomography was performed concurrently with, albeit reconstructed without spatial a prior of, trans-rectal ultrasound (US) on transmissible venereal tumor (TVT) developed as a model in the canine pelvic canal. Studies were taken longitudinally at prior to, 14 days after, and 35 days after the TVT injection. As the tumor grew, the nodules became increasingly hyperabsorptive and moderately hyperscattering on NIR. The regions of strong NIR contrast, especially on absorption images, correlated well with those of US hypoechoic masses indicative of tumors. Combining the information of trans-rectal NIR and US detected the tumor more accurately than did the US alone at 14 days postinjection.
Assuntos
Doenças do Cão/diagnóstico por imagem , Tomografia Óptica/métodos , Ultrassom Focalizado Transretal de Alta Intensidade/métodos , Tumores Venéreos Veterinários/diagnóstico por imagem , Animais , Linhagem Celular Tumoral , Modelos Animais de Doenças , Cães , Raios Infravermelhos , Masculino , Transplante de Neoplasias , Neoplasias Pélvicas/diagnóstico por imagem , Pelve/diagnóstico por imagem , Próstata/diagnóstico por imagem , UltrassonografiaRESUMO
We demonstrate trans-rectal optical tomography of the prostate using an endo-rectal near-infrared (NIR) applicator integrated with a transrectal ultrasound (TRUS) probe. The endo-rectal NIR applicator incorporated a design presented in our previously reported work. A continuous-wave NIR optical tomography system is combined with a commercial US scanner to form the dual-modality imager. Sagittal transrectal imaging is performed concurrently by endo-rectal NIR and TRUS. The TRUS ensures accurate positioning of the NIR applicator as well as guides NIR image reconstruction using the spatial prior of the target. The use of a condom, which is standard for TRUS, is found to have minimal effect on trans-rectal NIR imaging. Tests on avian tissues validates that NIR imaging can recover the absorption contrast of a target, and its accuracy is improved when the TRUS spatial prior is incorporated. Trans-rectal NIR/US imaging of a healthy canine prostate in situ is reported.
Assuntos
Raios Infravermelhos , Próstata/diagnóstico por imagem , Reto/diagnóstico por imagem , Tomografia Óptica/instrumentação , Animais , Calibragem , Galinhas , Cães , Masculino , Imagens de Fantasmas , UltrassonografiaRESUMO
OBJECTIVE: Biomechanical analysis of acute load to failure (ALF) of 3 veterinary and 1 human suture anchor and cyclic load to failure with two suture material/suture anchor constructs in canine femoral condyles. STUDY DESIGN: Biomechanical in vitro study. SAMPLE POPULATION: Cadaveric femora from 20-30 kg dogs. METHODS: Three veterinary and 1 human suture anchor were placed in the cranial and caudal aspects of the femoral condyle and subjected to 0 degrees ALF. Anchors were loaded with 5 USP Fiberwire or 27 kg test nylon leader line (NLL) and subjected to 90 degrees cyclic testing for 10,000 cycles followed by ALF at 90 degrees. RESULTS: No significant difference in ALF for any anchor type was detected in the cranial aspect of the femoral condyle; however all veterinary anchors had higher ALF in the caudal aspect of the femoral condyle. In cyclic testing, the constructs in descending order (most cycles to least) were: (1) FlexiTwist/NLL, (2) Securos/Fiberwire, Securos/NLL, (3) IMEX/Fiberwire, IMEX/NLL, and (4) FlexiTwist/Fiberwire, Fastin/Fiberwire. Fiberwire was significantly stronger than NLL in post-cycling ALF testing. CONCLUSIONS: Veterinary anchors had higher ALF in the caudal versus cranial aspect of the femoral condyle. Except for the FlexiTwist in which NLL performed better, Fiberwire and NLL both had similar cyclic performance with each veterinary anchor type. The veterinary anchors exceeded the human anchor in ALF and cycles to failure. CLINICAL RELEVANCE: The tested veterinary suture anchors with Fiberwire or NLL may be used in the femoral condyle, preferably in the caudal aspect, and should withstand estimated loading conditions in appropriately confined postoperative canine patients.
Assuntos
Fêmur/cirurgia , Âncoras de Sutura/veterinária , Técnicas de Sutura/veterinária , Suturas/veterinária , Animais , Fenômenos Biomecânicos , Fios Ortopédicos , Cadáver , CãesRESUMO
Tissue surface temperature distribution on the treatment site can serve as an indicator for the effectiveness of a photothermal therapy. In this study, both infrared thermography and theoretical simulation were used to determine the surface temperature distribution during laser irradiation of both gel phantom and animal tumors. Selective photothermal interaction was attempted by using intratumoral indocyanine green enhancement and irradiation via a near-infrared laser. An immunoadjuvant was also used to enhance immunological responses during tumor treatment. Monte Carlo method for tissue absorption of light and finite difference method for heat diffusion in tissue were used to simulate the temperature distribution during the selective laser photothermal interaction. An infrared camera was used to capture the thermal images during the laser treatment and the surface temperature was determined. Our findings show that the theoretical and experimental results are in good agreement and that the surface temperature of irradiated tissue can be controlled with appropriate dye and adjuvant enhancement. These results can be used to control the laser tumor treatment parameters and to optimize the treatment outcome. More importantly, when used with immunotherapy as a precursor of immunological responses, the selective photothermal treatment can be guided by the tissue temperature profiles both in the tumor and on the surface.
Assuntos
Terapia a Laser , Neoplasias Mamárias Animais/cirurgia , Temperatura Cutânea , Animais , Galinhas , Feminino , Camundongos , Camundongos Endogâmicos BALB C , Método de Monte Carlo , Imagens de Fantasmas , Termografia/métodos , Resultado do TratamentoRESUMO
A chitosan derivative, glycated chitosan (GC), has been used as an immunostimulant for cancer treatment in laser immunotherapy. The function of GC is to enhance the host immune response after direct cancer cell destruction by a selective laser photothermal interaction. To further test its effects, laser immunotherapy was extended to include several different adjuvants for immunological stimulation and to include photodynamic therapy (PDT) as a different tumor-destruction mechanism. Complete Freund (CF) adjuvant, incomplete Freund (IF) adjuvant and Corynebacterium parvum (CP) were selected for treatment of metastatic mammary tumors in rats, in combination with a selective photothermal interaction. The solution of the immunoadjuvants admixed with indocyanine green (ICG), a light-absorbing dye, was injected directly into the tumors, followed by noninvasive irradiation of an 805 nm laser. Combined with PDT, in the treatment of tumors in mice, GC was administered peritumorally immediately after laser irradiation. The survivals of treated animals were compared with untreated control animals. In the treatment of rat tumors, CF, IF and CP raised the cure rates from 0% to 18%, 7% and 9%, respectively. In comparison, GC resulted in a 29% long-term survival. In the treatment of EMT6 mammary sarcoma in mice, GC of 0.5% and 1.5% concentrations increased the cure rates of Photofrin-based PDT treatment from 38% to 63% and 75%, respectively. In the treatment of Line 1 lung adenocarcinoma in mice, a 1.67% GC solution enabled a noncurative meso-substituted tetra(meta-hydroxy-phenyl)chlorin-based PDT to cure 37% of the tumor-bearing mice. The experimental results of this study confirmed our previous studies, showing that immunoadjuvants played an active role in laser-related cancer treatment and that GC significantly enhanced the efficacy of laser cancer treatment.
Assuntos
Adjuvantes Imunológicos/uso terapêutico , Quitosana/química , Lasers , Neoplasias Pulmonares/terapia , Neoplasias Mamárias Experimentais/terapia , Animais , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Neoplasias Mamárias Experimentais/tratamento farmacológico , Neoplasias Mamárias Experimentais/patologia , Metástase Neoplásica , RatosRESUMO
OBJECTIVE: To compare histologic artifacts caused by carbon dioxide (CO2) or 810-nm diode surgical lasers used to obtain small biopsy specimens of skin from healthy dogs. DESIGN: Prospective study. ANIMALS: 4 dogs. PROCEDURE: 21 skin biopsy specimens were collected from each dog. Three biopsy specimens were obtained with a CO2 or an 810-nm diode laser at 3 operating settings each, and 3 biopsy specimens were obtained with a 6-mm biopsy punch instrument (controls). After processing, biopsy specimens were examined for artifacts related to laser-tissue interactions. Microscopically visible char was measured from the lateral edge of each specimen obtained with a laser. RESULTS: There were no significant differences among mean char distances in biopsy specimens obtained with the CO2 laser at various settings. Mean char distance was significantly greater in all skin biopsy specimens obtained with the diode laser, compared with those obtained with the CO2 laser. Mean char distance was significantly greater in biopsy specimens obtained with the 810-nm diode laser at high power, compared with biopsy specimens obtained with the 810-nm diode laser at low power. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that the CO2 laser caused less thermal injury at margins of skin biopsy specimens; therefore, if a surgical laser is used for removal of cutaneous masses or to obtain skin biopsy specimens, use of the CO2 laser is recommended. Veterinarians performing a biopsy by using a surgical laser should be aware that laser-induced artifacts may render small biopsy specimens useless for providing accurate histologic diagnosis.
Assuntos
Cães/cirurgia , Terapia a Laser/veterinária , Lasers , Pele/patologia , Animais , Biópsia/instrumentação , Biópsia/métodos , Biópsia/veterinária , Dióxido de Carbono , Procedimentos Cirúrgicos Dermatológicos , Terapia a Laser/métodos , Lasers/efeitos adversos , Estudos ProspectivosRESUMO
OBJECTIVE: To confirm in vivo optimal laser energy settings previously determined in vitro for lithotripsy, to develop a technique for Ho:YAG laser lithotripsy, and to evaluate acute and chronic tissue effects of laser lithotripsy. STUDY DESIGN: Prospective, randomized preclinical trial. ANIMALS OR SAMPLE POPULATION: Nineteen intact, adult male dogs. METHODS: Via cystotomy, a single urolith was inserted into the urethra to the level of the base of the os penis to simulate obstruction. Uroliths (calcium oxalate, urate, or magnesium ammonium phosphate) were fragmented by Ho:YAG laser, in contact mode through a 320 micro optic fiber, passed through the operating channel of a 2.8 mm flexible endoscope. The time and total energy to fragmentation were recorded. Dogs were euthanatized immediately after lithotripsy (3 dogs) or at 3 days (7 dogs), and urethral lesions and any stone remnants were evaluated. Urethral integrity was also evaluated in 9 other dogs by endoscopy on day 10; these were also monitored clinically for 30 days. RESULTS: The mean time for adequate fragmentation was 166.7 seconds (range, 47-494.5 seconds). The mean+/-SD energy used was 1418+/-851.2 J. In part 1, 2 dogs were obstructed with urolith fragments at necropsy. Eight dogs had minimal (<30 mg) or no urolith material evident within the urethra. Four dogs had gross focal or circumferential erosion, ulceration, or hemorrhage of the urethral mucosa. Lesions were not associated with the site of laser irradiation in 2 dogs. In dogs observed for 30 days, hematuria, pollakiuria, and stranguria that were observed after lithotripsy, resolved in all affected dogs by day 5. No mucosal lesions were observed by endoscopy and none of the dogs became obstructed. CONCLUSION: Laser lithotripsy with the Ho:YAG laser in contact mode successfully fragmented obstructive uroliths in male dogs. CLINICAL RELEVANCE: Laser lithotripsy may be a clinically relevant technique for treatment of urolithiasis in male dogs; clinical studies to evaluate long-term effects on urethral mucosa and the role of repeat treatment for recurrence are indicated.
Assuntos
Doenças do Cão/terapia , Litotripsia a Laser/veterinária , Obstrução Uretral/veterinária , Cálculos Urinários/veterinária , Animais , Doenças do Cão/patologia , Cães , Masculino , Estudos Prospectivos , Resultado do Tratamento , Obstrução Uretral/terapia , Cálculos Urinários/terapiaRESUMO
BACKGROUND AND OBJECTIVES: To assess the effect of holmium laser energy on canine uroliths and porcine urethra. STUDY DESIGN/MATERIALS AND METHODS: Uroliths of known composition and fresh cadaveric urethra were exposed to holmium laser energy. Urolith fragmentation times and depth of urethral lesions were determined. RESULTS: Overall mean fragmentation time was 11.8 +/- 8.01 seconds. Magnesium ammonium phosphate (MAP) and urate uroliths had significantly shorter fragmentation times compared to other uroliths. Fragmentation time of MAP uroliths irradiated with 1.2 J/pulse was significantly longer than the fragmentation time of MAP uroliths irradiated with 0.3 J/pulse. Overall mean lesion depth for urethral specimens treated with 90 degrees contact mode irradiation was significantly greater than overall mean lesion depth for specimens treated with 30 degrees non-contact mode. CONCLUSIONS: Holmium laser energy effectively fragmented canine uroliths and caused minimal urethral damage in vitro. Dogs with urolithiasis may represent a useful animal model for developing human lithotripsy procedures.
Assuntos
Lasers , Uretra/patologia , Cálculos Urinários/patologia , Animais , Cães , Hólmio , Técnicas In Vitro , Litotripsia a Laser , Suínos , Uretra/efeitos da radiação , Cálculos Urinários/terapiaRESUMO
OBJECTIVE: To determine outcome of and complications associated with prophylactic percutaneous laser disk ablation in dogs with thoracolumbar disk disease. DESIGN: Retrospective study. ANIMALS: 277 dogs. PROCEDURE: Medical records of dogs with a history of thoracolumbar disk disease in which the 7 intervertebral disks from T10-11 through L3-4 were ablated with a holmium-yttrium-aluminum-garnet laser inserted through percutaneously placed needles were reviewed. Complications and episodes of a recurrence of neurologic signs (eg, paresis or paralysis) were recorded. Owners were contacted by telephone for follow-up information. RESULTS: Nine of 262 (3.4%) dogs for which follow-up information was available had a recurrence of paresis or paralysis. Follow-up time ranged from 1 to 85 months (mean, 15 months); signs recurred between 3 and 52 months (mean, 15.1 months) after laser disk ablation. Acute complications occurred in 5 dogs and included mild pneumothorax in 1 dog, an abscess at a needle insertion site in 1 dog, and proprioceptive deficits in 3 dogs, 1 of which required hemilaminectomy within 1 week because of progression and severity of neurologic signs. One dog developed diskospondylitis. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that prophylactic percutaneous laser disk ablation is associated with few complications and may reduce the risk of recurrence of signs of intervertebral disk disease in dogs.
Assuntos
Discotomia Percutânea/veterinária , Doenças do Cão/cirurgia , Disco Intervertebral , Terapia a Laser/veterinária , Doenças da Coluna Vertebral/veterinária , Animais , Discotomia Percutânea/métodos , Cães , Feminino , Seguimentos , Disco Intervertebral/cirurgia , Terapia a Laser/efeitos adversos , Terapia a Laser/métodos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Masculino , Paresia/etiologia , Paresia/veterinária , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/veterinária , Radiografia , Recidiva , Estudos Retrospectivos , Doenças da Coluna Vertebral/cirurgia , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/cirurgia , Resultado do TratamentoRESUMO
OBJECTIVE: To study the outcome of military working dogs (MWDs) diagnosed with degenerative lumbosacral stenosis (DLS) after surgical intervention and to determine what prognostic indicators affected outcome. STUDY DESIGN: Retrospective study. ANIMALS: Twenty-nine MWDs with DLS. METHODS: The medical records of dogs diagnosed and surgically treated for DLS at the Department of Defense Military Working Dog Veterinary Service Hospital were reviewed. Retrieved data were signalment, clinical signs, survey radiograph results, and surgical findings. RESULTS: Breed and sex were not found to have prognostic significance. Increasing age at surgery correlated with a poor surgical outcome. Twelve dogs (41%) returned to normal function, 11 (38%) improved, and 6 (20%) never returned to active duty. The average age at surgery was 74 months, 93 months, and 112 months for normal, improved, and dogs not returning to duty, respectively. Significant clinical findings associated with a poor prognosis were related to increasing neurologic severity. The only significant radiographic finding indicating a poor prognosis was foraminal narrowing. Surgical findings with negative prognostic significance were hypertrophic articular facets and interarcuate ligament. Recurrence rates were 16.7% and 54.5% for normal and improved dogs, respectively. CONCLUSIONS: MWDs with DLS have a good prognosis with surgical decompression if they are young dogs with mild clinical signs at the time of diagnosis. As age and severity of clinical signs increase, the prognosis for successful outcome decreases. Recurrence may be seen in some dogs. CLINICAL RELEVANCE: Information provided by this study should help military veterinarians determine the prognosis for working dogs with DLS after surgical treatment.
Assuntos
Doenças do Cão/epidemiologia , Doenças do Cão/cirurgia , Estenose Espinal/veterinária , Animais , Cruzamento , Doenças do Cão/diagnóstico por imagem , Cães , Feminino , Laminectomia/veterinária , Região Lombossacral , Masculino , Oklahoma/epidemiologia , Radiografia , Registros/veterinária , Estudos Retrospectivos , Estenose Espinal/epidemiologia , Estenose Espinal/cirurgia , Resultado do Tratamento , Estados Unidos , Serviço Veterinário MilitarRESUMO
Use of a neodymium:yttrium-aluminum-garnet laser to remove exuberant granulation tissue from the esophagus of a horse A 4-year-old Quarter Horse mare was evaluated because of recurrent esophageal obstruction. Endoscopic examination revealed a proliferative mass in the esophagus approximately 55 cm aborad to the nares. Histologic examination of biopsy specimens revealed diffuse suppurative esophagitis and granulation tissue with no evidence of neoplasia. The mass was excisedand ablated transendoscopically with a neodymium:yttrium-aluminum-garnet laser. During a follow-up examination 2 weeks after the final laser procedure, the mass was no longer apparent, and the esophagus appeared healed. Six months after the final examination, there had been no recurrence of the mass. In this horse, transendoscopic laser excision was efficacious and avoided problems associated with an esophagotomy.
Assuntos
Doenças do Esôfago/veterinária , Tecido de Granulação/cirurgia , Doenças dos Cavalos/cirurgia , Terapia a Laser/veterinária , Animais , Doenças do Esôfago/cirurgia , Feminino , Cavalos , Terapia a Laser/instrumentação , Terapia a Laser/métodos , Recidiva , Resultado do TratamentoRESUMO
Induction of a long-term tumor-specific immunity is the ultimate cure of metastatic cancers. Laser immunotherapy is a novel approach that aims at the tumor-directed stimulation of the immune system of the host. It involves an intratumor administration of a laser-absorbing dye and an immunoadjuvant, followed by noninvasive laser irradiation. Previous studies using glycated chitosan (GC) as immunoadjuvant and indocyanine green (ICG) as laser-absorbing dye have shown positive effects of the treatment on metastatic breast tumors in rats. In vivo experiments showed promising results such as: (a) eradication of treated primary tumors; (b) regression of untreated metastases; (c) induced antitumor immune response; and (d) long-term resistance to tumor rechallenge. In this study, rats bearing metastatic breast tumors and metastatic prostate tumors were treated with various combinations of the three components of laser immunotherapy. The rat survival rates and profiles of primary and metastatic tumors, after treatment by individual components and various combinations of the components, were analyzed. In the treatment of breast tumors, all of the experimental groups without immunoadjuvant showed little or no positive effect. The use of GC, either by itself or in combination with other components, had a noticeable impact on the survival rate of tumor-bearing rats. However, it was the combination of all of the three components that resulted in the highest cure rate. Three different concentrations of GC, 0.5, 1, and 2%, were also used to treat the metastatic breast tumors. The results showed that 1% GC was most effective in laser immunotherapy. In the treatment of metastatic prostate tumors, both the laser-ICG and laser-ICG-GC treatments significantly reduced the growth of primary tumors and lung metastases. Long-term survival of the rats bearing the prostate tumors was also observed after the laser immunotherapy treatment in our preliminary studies. These results revealed the important function of the immunoadjuvant in laser immunotherapy.