Search

Objectives— To determine the incidence of postoperative ileus (POI) in a population of horses after small intestinal surgery and the effect of multiple variables on development of POI. Study Design— Case series. Animals— Horses (n=233) aged ≥1 year that had exploratory celiotomy for small intestinal disease that recovered from surgery from 1995 to 2005. Methods— Sixty-eight variables were collected from medical records (1995–2005) for each horse. POI was defined as nasogastric reflux volume >20 L over 24 hours or >8 L at any single time after surgery. Results— Twenty-seven percent (64/233) of horses developed POI; 29 of 64 (46%) horses with POI had duodenitis proximal jejunitis (DPJ). When no intestinal resection was required at surgery, excluding horses with DPJ, 15% of horses had POI; 30% horses had POI after intestinal resection. Ten percent of horses had POI for >24 hours. When horses with DPJ were excluded, factors associated with increased risk of POI included high packed cell volume at hospital admission (P=.024), increasing age (P=.0004), and length of intestinal resection (P=.05). Conclusions— Risk factors for POI in this study were nonspecific although horses with intestinal resection are at higher risk compared with horses without intestinal resection. Clinical Relevance— Predicting with certainty which cases will develop POI remains elusive.

The purpose of this study was to determine changes in the expression of regulatory molecules in normal equine articular cartilage throughout development up to 18 months of age. The hypothesis was that expression of these regulatory molecules would decrease from birth to postpubescence. Cartilage was harvested from normal femoropatellar or scapulohumeral joints from 34 fresh horse cadavers. Horses were placed in four age groups (prenatal (n ¼ 5); prepubertal, 0- 6 months (n ¼ 11); pubertal, 7-14 months (n ¼ 13); and postpubertal, 15-18 months (n ¼ 5)). Indian hedgehog (Ihh), Gli1, Gli3, Patched1 (Ptc1), Smoothened (Smo), Noggin, bone morphogenetic protein-6 (BMP-6), BMP-2, parathyroid hormone-related peptide (PTHrP), and PTH/PTHrP receptor mRNA expression levels were evaluated by real-time quantitative PCR. Spatial tissue mRNA and protein expression was determined by in situ hybridization and immunohistochemistry. The expression of PTHrP decreased (p ¼ 0.002) in the pubertal group, while PTH/PTHrP receptor expression significantly increased (p ¼ 0.001). No significant difference was found between groups for Ihh (p ¼ 0.6) or Smo (p ¼ 0.3) expression. In contrast, there was significantly increased expression of Ptc1 (p ¼ 0.006), Gli1 (p ¼ 0.04), and Gli3 (p ¼ 0.007) in the pubertal group, and Gli3 (p ¼ 0.007) remained elevated in the postpubertal group. The expression of BMP-6 significantly increased from prenatal to postnatal groups (p ¼ 0.03) while BMP-2 expression increased during puberty and postpuberty (p ¼ 0.03). The changes in expression of hedgehog and BMP signaling molecules in articular cartilage during postnatal development have not been shown previously. The increased expression of hedgehog receptor and transcription factors during puberty may indicate maturation of the deep articular layer during this time period. 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 24:1773-1781, 2006

Hypertrophic differentiation and endochondral ossification of growth cartilage are regulated by a complex array of signaling peptides, including parathyroid hormone-related protein (PTH-rP), Indian hedgehog (Ihh), and bone morphogenetic proteins (BMPs). This study investigated the expression of Ihh, Patched1 and 2 (Ptc1, Ptc2), Smoothened (Smo), Gli1, and Gli3, in naturally acquired articular osteochondrosis, using an equine model. Cartilage was harvested from osteochondrosis (OC) affected femoropatellar or scapulohumeral joints from immature horses and normal control horses of similar age. Ihh, Ptc1, Smo, Gli1, and Gli3 mRNA expression levels were evaluated by real-time quantitative PCR. Spatial tissue expression was determined by in situ hybridization for Ihh and Smo and immunohistochemistry for Ptc1 and Ptc2. The expression of Ihh was significantly increased in OC cartilage compared to normal control cartilage and was localized mainly to the deep layer of articular cartilage, just above the calcified zone, with some mild expression also present in the middle cartilage layer. The expression of Gli1 was significantly decreased in OC samples, but there was no significant difference in expression of Gli3, Ptc1 and Smo in OC cartilage compared to normal cartilage. The expression of Ptc1 protein was present at the junction of deep and calcified layers, while Ptc2 protein was expressed throughout the middle, deep, and calcified cartilage layers. Spatial expression of Smo was variable between animals and confined mainly to the middle and deep layers when present. Half of the OC samples displayed areas of moderate to strong Smo expression compared to mild or minimal expression in normal controls. The increased Ihh expression in OC suggests a role of Ihh in diseased cartilage, although it is not known if a PTH-rP/Ihh feedback cycle exists in articular cartilage. The disparity between increased Ihh expression and decreased Gli1 expression in OC cartilage suggests a different primary transcription factor for Ihh or the presence of an elevated Ihh inhibitor in these tissues.

This study evaluated the potential of gene induced synoviocyte expression of a combination of insulin-like growth factor-I (AdIGF-I) and interleukin-1 receptor antagonist protein (AdIL-1Ra) to control articular cartilage degradation in vitro. Cartilage explants and synovial membrane were harvested from young mature horses. Synovial monolayers were established and either (1) maintained as untransduced controls; (2) transduced with AdIGF-I at 200 MOI in 500 μl serum-free medium; (3) transduced with AdIL-1Ra at 100 MOI; or (4) transduced with a combination of AdIGF-I (200 MOI) and AdIL-1Ra (100 MOI). Following transduction, cartilage explants were exposed to the synovial monolayer medium using co-culture inserts. Cultures were maintained for 6 days in either serum-free medium or medium containing 10 ng/ml recombinant human interleukin-1β. At termination, synovial cell RNA was isolated for real-time PCR analysis, and cartilage explants were collected for H&E and toluidine blue staining, immunohistochemistry for type II collagen and IGF-I, in situ localization of IGF-I and type II collagen gene expression, and biochemical assays. Synovial monolayers were readily transduced with both AdIGF-I and AdIL-1Ra. IGF-I and IL-1Ra protein were secreted at beneficial levels throughout the experiment, having peak concentrations of 94.6 ng/ml and 33.0 ng/ml, respectively. Transduction with IGF-I promoted cartilage production of proteoglycan and type II collagen, suggesting a beneficial role for healing injured cartilage. Transduction with IL-1Ra decreased the synovial expression of IL-1α and IL-1β and matrix metalloproteinases, indicating a mechanism for prevention of matrix degradation. The beneficial effects of the combination of anabolic growth factors and catabolic blockers were evident in improved preservation of proteoglycan content of cartilage explants exposed to the depleting effects of IL-1. These results show that gene therapy combining anabolic growth factors to stimulate matrix synthesis and catabolic blockers to prevent matrix degradation by IL-1, protects and causes partial restoration of cartilage matrix, and suggest a potential benefit of combination gene therapy for cartilage healing.

Objectives: To compare the proportion of the proximal recess of the navicular bursa that could be examined through a single endoscopic portal and the severity of iatrogenic lesions between conventional and modified approaches. Design: Descriptive study. Sample Population: Equine cadaver forelimbs (n=16). Methods: Arthroscopic access to the navicular bursa in 1 limb of each pair was by a conventional approach and in the other limb, by a modified approach using sharp dissection through the distal digital flexor sheath, immediately palmar to the T ligament. The time required to access the bursa and the estimated proportion of the navicular bone that could be seen with each approach were recorded. Iatrogenic damage to the navicular bone and the deep digital flexor tendon (DDFT) were quantified. Results: The mean access time to the navicular bursa using the conventional approach was 1.21±0.41 minutes compared with 2.09±0.86 minutes using the modified technique. The estimated proportions of the bursa visible through a single endoscopic portal using the conventional and modified approaches were 60% and 80%, respectively. Scores for navicular bone (P=.003) and DDFT (P=.012) damage using the conventional approach were significantly higher than those using the modified approach. Conclusions: A modified, transthecal approach to the navicular bursa under direct observation resulted in significantly less iatrogenic damage than the conventional approach. Clinical Relevance: With experience, the modified approach is straightforward, reasonably rapid, and allows near-complete examination of the navicular bursa through a single portal, with minimal iatrogenic damage to the intrabursal structures.