Effects of botulinum toxin in two indicators of loss of domain and hernia size among patients with large ventral hernias.

BACKGROUND: In patients with large ventral hernias, botulinum toxin to external and internal oblique muscles decreases thickness and increases length. We examined the impact of botulinum toxin in the amount of loss of domain according to two ratios and in hernia size. METHODS: Between October 2021 and November 2023, 20 patients with ventral hernias measuring 10 cm or more on the horizontal size underwent the administration of 50 units of botulinum toxin to each external and each internal oblique muscle 4 weeks before their surgery. Incisional hernia volume to peritoneal volume ratio, volume ratio, and hernia size were compared before and 4 weeks after the injection of botulinum toxin. Comparisons between all variables obtained before and after the administration of botulinum toxin were performed using either the paired t-test or the Wilcoxon signed-rank test. Pearson correlation coefficient was used to analyze associations between initial conditions and further changes observed after botulinum toxin injection. RESULTS: We observed a 42% reduction in muscle amplitude, 16% increase in intra-abdominal volume, 28% decrease in herniated volume, decreases of 6% in IHV/PV ratio and of 11% in V ratio, 11% reduction of hernia width, and decrease of 10% in rectangular and elliptical hernia areas. CONCLUSIONS: In patients with large ventral hernias, botulinum toxin is associated with reduction of hernia size and decrease in loss of domain, the latter not being significant when less than 10% of the visceral block is herniated.

Comparison of open anterior component and open transversus abdominus release in repair of large subcostal hernias.

BACKGROUND: Large subcostal incisional hernias are considered as complex defects, and a few different approaches have been described for repair. The purpose of this comparative cross-sectional study is to evaluate the outcomes of patients with large subcostal incisional hernias treated with either the open anterior components separation technique (ACS) or with the open transversus abdominis release technique (TAR). METHODS: From the database of patients with large complex incisional hernias who underwent abdominal wall reconstruction with open techniques between April 2007 and October 2022 at our institution, on May 25th, 2023 we identified those whose hernias were located in the subcostal areas and who underwent reconstruction with a components separation technique and mesh. Perioperative variables and outcomes were compared between the patients with large subcostal hernias who underwent abdominal wall reconstruction with either the ACS or the TAR techniques. RESULTS: Thirty-one patients with large subcostal hernias were included in the study. ACS and intra-abdominal mesh was used in 11 patients; TAR and retro-muscular mesh was performed in 20 patients. More postoperative local abdominal wall complications were seen in patients who had ACS as opposed to TAR (55% vs 15%, p = 0.02). Hernia recurrence was more common in patients who had ACS as opposed to TAR (55% vs 5%, p = 0.008). CONCLUSIONS: More post-operative complications and recurrences were seen in patients who had ACS as opposed to TAR.

Morphological Assessment of Concomitant Lesions Detected in Goat Herds Naturally Infected with Paratuberculosis (Johne's Disease).

Paratuberculosis (PTB), caused by Mycobacterium avium subspecies paratuberculosis (MAP), causes significant financial losses in the ruminant industry. The aim of this study is to describe the concomitant pathological findings as well as PTB-induced lesions in 39 naturally infected goats (15 vaccinated and 24 non-vaccinated). All animals exhibited MAP-induced microscopic lesions affecting target organs, although only 62% of those were detected grossly. Mainly concomitant inflammatory pathologies were recognized affecting the hemolymphatic, respiratory and gastrointestinal systems. Non-vaccinated animals exhibited both moderate and marked granulomatous enteritis in contrast with vaccinated ones which presented mild intestinal affection. Our results demonstrate that non-vaccinated animals presented pneumonia in all age groups studied (from 12 up to >48 months old). A significantly higher prevalence of ileocecal valve PTB lesions was detected in non-vaccinated animals with pneumonic lesions (p = 0.027). Furthermore, a reduction of gastrointestinal non-PTB processes was described in vaccinated goats. In conclusion, a PTB infected goat herd can be affected by a wide range of concomitant pathologies, mostly inflammatory in origin. Anatomic pathology is of crucial importance for correct herd diagnosis and histopathology is an indispensable tool for lesion detection. Additionally, anti-MAP vaccination could have a beneficial effect on the reduction of respiratory and gastrointestinal non-PTB diseases.

Methodology and Neuromarkers for Cetaceans' Brains.

Cetacean brain sampling may be an arduous task due to the difficulty of collecting and histologically preparing such rare and large specimens. Thus, one of the main challenges of working with cetaceans' brains is to establish a valid methodology for an optimal manipulation and fixation of the brain tissue, which allows the samples to be viable for neuroanatomical and neuropathological studies. With this in view, we validated a methodology in order to preserve the quality of such large brains (neuroanatomy/neuropathology) and at the same time to obtain fresh brain samples for toxicological, virological, and microbiological analysis (neuropathology). A fixation protocol adapted to brains, of equal or even three times the size of human brains, was studied and tested. Finally, we investigated the usefulness of a panel of 20 antibodies (neuromarkers) associated with the normal structure and function of the brain, pathogens, age-related, and/or functional variations. The sampling protocol and some of the 20 neuromarkers have been thought to explore neurodegenerative diseases in these long-lived animals. To conclude, many of the typical measures used to evaluate neuropathological changes do not tell us if meaningful cellular changes have occurred. Having a wide panel of antibodies and histochemical techniques available allows for delving into the specific behavior of the neuronal population of the brain nuclei and to get a "fingerprint" of their real status.

A text-mining based analysis of 100,000 tumours affecting dogs and cats in the United Kingdom.

Cancer is a major reason for veterinary consultation, especially in companion animals. Cancer surveillance plays a key role in prevention but opportunities for such surveillance in companion animals are limited by the lack of suitable veterinary population health infrastructures. In this paper we describe a pathology-based animal tumour registry (PTR) developed within the Small Animal Veterinary Surveillance Network (SAVSNET) built from electronic pathology records (EPR) submitted to this network. From an original collection of 180232 free text (non-structured) EPRs reported between April 2018 and June 2019, we used specific text-mining methodologies to identify 109895 neoplasias. These data were normalized to describe both the tumour (type and location) and the animal (breed, neutering status and veterinary practice postcode). The resulting PTR, the largest of its kind for companion animals to date, is an important research resource being able to facilitate a wide array of research in areas including surveillance, clinical decision making and comparative cancer biology.

Postoperative Abdominal Bulge and Hernia Rates in Patients Undergoing Abdominally Based Autologous Breast Reconstruction: Systematic Review and Meta-Analysis.

ABSTRACT: Bulge and hernia may occur after abdominally based breast reconstruction. The purpose of this study is to provide an estimate of the effects that the type of flap used for breast reconstruction (ie, transverse rectus abdominis muscle [TRAM] vs muscle-sparing [MS]-2 TRAM vs DIEP) has on the postoperative development of both abdominal bulge and abdominal hernia, taking into consideration the method of donor site closure (ie, with mesh vs without mesh), based on the available literature. Twenty-eight studies met the inclusion criteria and were included in the systematic review. From these, 9 studies were comparative and suitable for meta-analysis. The results showed that, for unilateral breast reconstructions, there was no statistically significant difference in hernia/bulge rates in the following techniques: MS-2 TRAM flap without mesh, MS-2 TRAM flap with mesh, and DIEP flap without mesh, and they showed significantly lower hernia/bulge rates compared with TRAM flap without mesh, and TRAM flap with mesh, whereas for bilateral reconstructions, there was no statistically significant difference in hernia/bulge rates in the following techniques: MS-2 TRAM flaps with mesh and DIEP flaps without mesh, and they showed significantly lower hernia/bulge rates compared with TRAM flaps without mesh, TRAM flaps with mesh, and MS-2 TRAM flaps without mesh.

Amyloid-beta peptide and phosphorylated tau in the frontopolar cerebral cortex and in the cerebellum of toothed whales: aging versus hypoxia.

Hypoxia could be a possible risk factor for neurodegenerative alterations in cetaceans' brain. Among toothed whales, the beaked whales are particularly cryptic and routinely dive deeper than 1000 m for about 1 h in order to hunt squids and fishes. Samples of frontal cerebral and cerebellar cortex were collected from nine animals, representing six different species of the suborder Odontoceti. Immunohistochemical analysis employed anti-ß-amyloid (Aß) and anti-neurofibrillary tangle (NFT) antibodies. Six of nine (67%) animals showed positive immunolabeling for Aß and/or NFT. The most striking findings were intranuclear Aß immunopositivity in cerebral cortical neurons and NFT immunopositivity in cerebellar Purkinje neurons with granulovacuolar degeneration. Aß plaques were also observed in one elderly animal. Herein, we present immunohistopathological findings classic of Alzheimer's and other neurodegenerative diseases in humans. Our findings could be linked to hypoxic phenomena, as they were more extensive in beaked whales. Despite their adaptations, cetaceans could be vulnerable to sustained and repetitive brain hypoxia.

Comparative morphology, histology, and cytology of odontocete cetaceans prostates.

The prostate is the only male accessory gland in cetaceans. However, little is known about this organ in these species. Anatomical and histological characteristics of the prostate have been described in only a few cetacean species, further, one study reported a high incidence of prostatic pathologies in cetaceans that may impair reproduction. The objective of this work was to describe and compare the morphological, histological, and cytological characteristics of the prostate in different odontocete cetaceans. To this end, the prostate glands of 47 animals from nine different species of cetaceans were macroscopically and microscopically studied. Members of the families Delphinidae, Ziphiidae, and Physeteridae were included. In general, the prostate appeared as a musculo-glandular organ with two distinct parts-the Corpus prostatae and the Pars disseminata prostatae. In the pygmy sperm whale (Kogia breviceps) and the Cuvier's beaked whale (Ziphius cavirostris), the prostate was a discrete gland with a small Corpus prostatae. Microscopically, the prostates of different delphinids species shared similarities; however, the prostate of the pygmy sperm whale revealed significant histological differences compared to those of the delphinids. Immunohistochemical analysis was performed using low- and high-molecular-weight cytokeratin, vimentin, and prostatic specific antigen commercial antibodies. Electron microscopy analysis was performed on the prostate of a bottlenose dolphin and the cytomorphological differences among the major epithelial components of the prostatic epithelium were described. Anat Rec, 2019. © 2019 American Association for Anatomy Anat Rec, 303:2036-2053, 2020. © 2019 American Association for Anatomy.

Stress cardiomyopathy in stranded cetaceans: a histological, histochemical and immunohistochemical study.

BACKGROUND: Free-living cetaceans are exposed to a wide variety of stressful situations, including live stranding and interaction with human beings (capture myopathy), vessel strikes, and fishing activities (bycatch), which affect their wellbeing and potentially lead to stress cardiomyopathy (SCMP). METHODS: Here, the authors aimed to characterise SCMP of stranded cetaceans as an injury resulting from extreme stress responses, based on pathological analyses (histological, histochemical and immunohistochemical). Specifically, the authors examined heart samples from 67 cetaceans found ashore (48 live strandings, seven dead from ship collision and 12 dead from bycatch) on the coast of Spain, more specifically in the Canary Islands from 2000 to 2016 and Andalusia from 2011 to 2014. RESULTS: The microscopic findings were characterised by vascular changes, acute or subacute cardiac degenerative necrotic lesions, interstitial myoglobin globules, and infiltration of inflammatory cells. Immunohistochemically, cardiac troponin I, cardiac troponin C and myoglobin were depleted, along with fibrinogen being expressed in the degenerated/necrotic cardiomyocytes. A perivascular pattern was also identified and described in the damaged cardiomyocytes. CONCLUSIONS: This study advances current knowledge about the pathologies of cetaceans and their implications on conserving this group of animals by reducing mortality and enhancing their treatment and subsequent rehabilitation to the marine environment.

Pulmonary carcinoma with metastasis in a long-finned pilot whale (Globicephala melas).

BACKGROUND: Lung cancer is the most commonly diagnosed neoplasm in humans, however this does not apply to other animal species. Living in an aquatic environment the respiratory system of cetaceans had to undergo unique adaptations in order to them to survive and cope with totally different respiratory pathogens and potentially carcinogens from those affecting humans. CASE PRESENTATION: This article discusses not only macroscopical, histopathological and immunohistochemical features of a pulmonary carcinoma with disseminated metastases in a long-finned pilot whale (Globicephala melas), as well as the immunohistochemical analysis performed on various tissues of cetaceans belonging to the genus Globicephala. On the necropsy examination of the carcass, multiple pulmonary nodules and generalised thoracic lymphadenomegaly were noted. Histologically, a malignant epithelial neoplasia was identified in the lung, thoracic lymph nodes, and adrenal gland. Immunohistochemical analysis revealed a pulmonary carcinoma. Vasculogenic mimicry and epithelial-to-mesenchymal transition phenotype, as suggested by cytomorphological and immunohistochemical characteristics, were observed. CONCLUSIONS: A diagnosis of metastatic pulmonary carcinoma was determined, which to the author's knowledge, appears to be not previously recorded in long-finned pilot whale species. This is also the first report of vasculogenic mimicry and epithelial-to-mesenchymal transition event in a spontaneous cancer from a cetacean species.

Abdominal Closure after TRAM Flap Breast Reconstruction with Transversus Abdominis Muscle Release and Mesh.

Breast reconstruction with a pedicled transverse rectus abdominis muscle (TRAM) flap can result in significant abdominal wall donor-site morbidity. Although the pedicled TRAM flap donor area reinforced with mesh results in decreased rates of postoperative abdominal bulging and hernias, the best technique to accomplish that is yet to be elucidated. We present our novel technique of posterior components separation with transversus abdominis muscle release and retromuscular mesh reinforcement for donor-area closure during pedicled TRAM flap breast reconstruction.

Anatomical Mapping and Density of Merkel Cells in Skin and Mucosae of the Dog.

Merkel cells (MCs) are specialized cutaneous receptor cells involved with tactile sense. Although the distribution of MCs has been extensively studied in humans and rodents, their precise distribution and density throughout skin in the dog has not previously been determined. Knowledge of their distribution could facilitate understanding of their functions. By using of immunohistochemistry, density, and anatomical mapping of the MCs population in the dog skin was determined. Assessment of the MCs innervation was also achieved. Different patterns were noted in epidermis, hair follicles, or mucosa, including variable-sized clusters, linear or horse-shaped arrangements, and scattered and individualized cells. MCs revealed great variations in density and distribution over the body surface, with the highest numbers in oral mucosa and facial skin. There was no correlation of MCs density with age, sex, type of breed, coat type or pigmentation. Between 41 and 65% of MCs in hairy and glabrous skin and 8-18% of MCs in oral mucosa were in intimate contact with intraepithelial axon terminals. These findings indicate that canine MCs are numerous in sensory receptive areas and may be associated with the tactile sense in the dog. The present article enhances the knowledge of the skin structure in this species. Anat Rec, 299:1157-1164, 2016. © 2016 Wiley Periodicals, Inc.

Total Abdominal Wall Reconstruction with Component Separation, Reinforcement, and Vertical Abdominoplasty in Patients with Complex Ventral Hernias.

UNLABELLED: Large complex ventral hernias act as tissue expanders for skin and subcutaneous fat. The purpose of this study is to evaluate outcomes of total abdominal wall reconstruction with component separation, posterior reinforcement, and vertical abdominoplasty in patients with large complex ventral hernias. Between 2010 and 2014, 58 patients underwent total abdominal wall reconstruction with component separation, intra-abdominal reinforcement, and vertical abdominoplasty. Between 2010 and 2012, patients underwent the conventional technique of component separation, while a perforator-preserving technique was performed during 2013 and 2014. Reinforcement material used was either synthetic mesh in clean cases or biologic mesh if contamination was present. All of the excessive skin and subcutaneous fat was removed in a vertical fashion. Data were analyzed with Mann-Whitney's U test or Fisher's exact test, as indicated. There were 27 moderately complex and 31 majorly complex hernias. Mean hernia size was 16 × 12 cm. The mean size of the removed skin island was 21 × 12 cm. Patients with contamination during the repair had longer in-hospital stays. Overall the local wound complication rate was 24 %, and was lower with the perforator-preserving technique compared to the conventional technique of component separation (11 vs. 48 %; OR 0.13, CI 0.03-0.5; p = 0.003). The overall postoperative morbidity rate was higher in the presence of contamination, and in patients with lower preoperative serum albumin levels. Mean total follow-up was 14 months with a 1-year recurrence-free survival of 96 %. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Myoepithelial cells in canine mammary tumours.

Mammary tumours are the most common neoplasms of female dogs. Compared to mammary tumours of humans and cats, myoepithelial (ME) cell involvement is common in canine mammary tumours (CMT) of any subtype. Since ME cell involvement in CMT influences both histogenetic tumour classification and prognosis, correct identification of ME cells is important. This review describes immunohistochemical methods for identification of canine mammary ME cells used in vivo. In addition, phenotypic and genotypic methods to isolate ME cells for in vitro studies to analyse tumour-suppressor protein production and gene expression are discussed. The contribution of ME cells to both histogenetic classifications and the prognosis of CMT is compared with other species and the potential use of ME cells as a method to identify carcinoma in situ is discussed.

Contralateral Component Separation Technique for Abdominal Wall Closure in Patients Undergoing Vertical Rectus Abdominis Myocutaneous Flap Transposition for Pelvic Exenteration Reconstruction.

Pelvic floor reconstruction with pedicled vertical rectus abdominis myocutaneous flap has been popularized in patients undergoing pelvic exenteration due to locally advanced rectal carcinoma. Abdominal wall fascial dehiscence and incisional hernia may occur as a result of large skin and fascia islands as well as muscle required to close these large defects. The purpose of this paper was to describe a novel technique, consisting of VRAM flap donor-site closure with component separation technique, performed on the contralateral side as the flap harvest, allowing for a lower tension closure between ipsilateral external oblique/internal oblique/transverse abdominis muscles complex and contralateral rectus abdominis muscle. In 10 patients undergoing this technique, no abdominal fascial dehiscence, incisional hernia, or parastomal hernia occurred during a mean follow-up of 15 months. Overall 3-year patient survival rate was 80% with abdominal hernia free-survival rate of 100%. The addition of this technique represents an advance in overall patient care to provide a more successful outcomes in this complex scenario.

Ultrastructural characterization of normal Merkel cells in the dog.

BACKGROUND: Involvement of Merkel cells (MKs) in different cutaneous diseases as well as in the growth, differentiation and homeostasis of the skin has been previously documented. HYPOTHESIS/OBJECTIVES: The aim was to assess the ultrastructural features of MKs in canine skin, including morphometrics, highlighting their similarities with and differences from those described for other mammals. ANIMALS: Hard palate, nasal planum, lower lip and whisker pad samples were taken from two healthy young dogs destined for academic purposes. METHODS: Ultrathin sections of samples fixed in osmium tetroxide and embedded in Epon 812 resin were stained with uranyl acetate and lead citrate and examined using a JEOL JEM 2010 transmission electron microscope. RESULTS: Ultrastructural characteristics included the following: (i) arrangement in clusters in the basal layer of the epidermis, oral mucosa and external follicular root sheath; (ii) inconstant link with nerve terminal; (iii) oval (10.27 ± 1.64 µm major axis) cell shape with large lobulated nuclei (5.98 ± 1.16 µm major axis); (iv) spine-like and thick cytoplasmic processes interdigitating with surrounding keratinocytes; (v) presence of desmosomes in the cell body or at the base of spine-like processes attaching to neighbouring keratinocytes; and (vi) cytoplasm containing loosely arranged intermediate filaments (10.04 ± 1.17 nm) and numerous dense-core granules (100.1 ± 17.12 nm) arranged in the basal portion of the cytoplasm. CONCLUSIONS AND CLINICAL IMPORTANCE: This study provides the first complete description of the ultrastructural characteristics of MKs in the dog, enhancing our knowledge of the skin structure in this species and providing a basis for future physiological and pathological studies of the role of these cells in normal and damaged canine tissues.

Expression of cell cycle regulators, 14-3-3σ and p53 proteins, and vimentin in canine transitional cell carcinoma of the urinary bladder.

OBJECTIVES: The study of the expression of 14-3-3σ, p53, and vimentin proteins in canine transitional cell carcinoma (TCC) evaluating differences with normal bladder tissues, and the association with clinicopathological variables. METHODS: We analyze by immunohistochemistry in 19 canine TCCs the expression of 14-3-3σ, p53, and vimentin using monoclonal antibodys. A semiquantitative scoring method was employed and statistical analysis was performed to display relationships between variables. RESULTS: In contrast to normal urinary bladder epithelium, which showed high levels of 14-3-3σ, its expression was decreased in 53% of the studied tumors (P = 0.0344). The 14-3-3σ protein was expressed by neoplastic emboli and by highly infiltrative neoplastic cells. The p53 protein was expressed in 26% of TCCs, but no significant association between 14-3-3σ and p53 was detected. Neoplastic epithelial cells displayed vimentin immunoreactivity in 21% of TCCs, and a positive correlation with mitotic index was observed (P = 0.042). Coexpression of vimentin and 14-3-3σ by highly infiltrative neoplastic cells was also observed. CONCLUSIONS: 14-3-3σ is deregulated in canine TCCs and its expression by highly infiltrative tumor cells may be related to the acquisition of aggressive behavior. Furthermore, this article reinforce the role of canine TCC as relevant model of human urothelial carcinoma and we suggest 14-3-3σ as a potential therapeutic target. Further studies are necessary to clarify the role of 14-3-3σ in canine TCC.

Histopathological muscle findings may be essential for a definitive diagnosis of suspected sharp trauma associated with ship strikes in stranded cetaceans.

Ship strikes are a major issue for the conservation of may cetacean species. Certain gross and microscopic criteria have been previously reported for establishing a diagnosis of death due to ship strikes in these animals. However, some ship-strike injuries may be masked by advanced carcass decomposition and may be undetectable due to restricted access to the animals. In this report we describe histopathological muscular findings in 13 cetaceans with sharp trauma from ship strikes as the cause of death. Skeletal muscle samples were taken from the incision site and from the main locomotor muscle, the longissimus dorsi, in areas not directly affected by the sharp injury. The microscopic findings in tissues from both sites mainly consisted of haemorrhages; oedema; flocculent, granular or/and hyalinised segmentary degeneration; contraction band necrosis; and discoid degeneration or fragmentation of myofibres. We propose that skeletal muscle histopathology provides evidence of ante-mortem injuries even if the sample was taken elsewhere in the carcass and not only within or adjacent to the sharp trauma site and despite the advanced decomposition of some of the carcasses. This method helps to establish the diagnosis of ship strike as the cause of death.