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Subcutaneous fat necrosis of the newborn is a self-limited disorder of the panniculus that arises in the first six weeks of life. Some differential diagnoses may be difficult such as bacterial cellulitis or erysipelas. The prognosis is usually favorable but there are serious complications for which the patient must be regularly monitored, especially hypercalcemia. We report a case of a full-term newborn with a liquidated area of subcutaneous fat necrosis. A surgical incision was performed because of the discomfort and the lack of regression. Hypercalcemia and nephrocalcinosis appeared afterward. A set of clinical, biological, and histological arguments allows the diagnosis of subcutaneous fat necrosis. Follow-up to early detection and to manage such complications is necessary.

Subcutaneous granuloma annulare (SGA) is a rare clinicopathologic subtype of granuloma annulare characterized by the presence of subcutaneous nodules. There are no present reviews synthesizing the clinical features and treatment modalities in SGA. We conducted a systematic review following PRISMA guidelines [CRD42022344672] on all peer‐reviewed English‐language studies that reported one or more cases of SGA. A total of 97 studies, comprising 26 case series and 71 case reports with 324 patients, were included for analysis. Most cases were predominantly pediatric, with 78.9% of the cases identified being age 16 or lower and a median age of diagnosis of 6. There was no overall gender predisposition. Although over two‐thirds of patients did not have any comorbidities, diabetes mellitus was the most common comorbidity present in 4% of cases. The most common feature of SGA was nodules, which were present in 99.6% of patients. Pain or tenderness was reported in 15.4%, and erythema of overlying skin in 11.0% of cases. Surgical excision was performed in 96/141 (68.1%) patients. Among the 27/141 (18.0%) patients who were conservatively managed, 87.0% spontaneously improved, including 60.0% who completely self‐resolved. Topical and intralesional steroids were used in 3.40% and 1.85% of patients, respectively, resulting in complete or partial resolution in 54.6% and 100%. Among patients who were followed up, 83/324 (25.6%) patients experienced recurrence after a median duration of 26 weeks. SGA is predominantly a pediatric disease that frequently occurs on the limbs and the head. Juxta‐articular lesions are more commonly observed in adults than in children. Surgical excision is common and effective in most patients. Spontaneous improvement occurs in most untreated cases, and intralesional steroids but not topical steroids may be beneficial for non‐resolving cases and to reduce time to resolution. [ABSTRACT FROM AUTHOR]

Ovariohysterectomy (OHE) is a common surgical procedure in small animals that causes significant postoperative pain. Tuning Element Relief Patches (TERPs) are silicone patches containing titanium salts, believed to relieve pain by resonating pain-related ion channels. In this experiment, 12 dogs undergoing OHE surgery received subcutaneous robenacoxib (group R, n = 6) injection or two sheets of TERPs (group T, n = 6) as postoperative analgesia to assess the analgesic effect of TERPs. The results demonstrated no significant differences in physiological parameters, pain scores and mechanical nociceptive thresholds (MNTs) between groups postoperatively, indicating that the TERPs provide comparable results to robenacoxib in managing postoperative pain in dogs undergoing OHE. While this study provides evidence of the pain-relieving effects of TERPs, further studies are required to evaluate their long-term safety and efficacy in various clinical conditions. [ABSTRACT FROM AUTHOR]

Background: Pilonidal disease has numerous management techniques available to surgeons worldwide. Because of the variety of clinical manifestations, several methods of intervention are needed; as a result, we hope for careful selection of the best technique for the patient's severity and recurrence. Aim: To prevent possible recurrence after bilateral subcutaneous fatty flap(BSF), a novel method for treating pilonidal sinus illness and Z-Plasty(ZP) with fasciocutaneous flap. Patients and methods: All prospective patients having recurrent pilonidal sinus and operated on at our institute, Surgical Department from Jan. 2022 to Dec. 2023. In total, 50 cases have sacrococcygeal disease ( SCD), and 25 patients in Group A had bilateral subcutaneous fatty flap surgery. In contrast, the 25 patients in Group B were treated by Z-Plasty(ZP) with fasciocutaneous flap surgery. We assessed the length of the procedure, the level of postoperative pain, the length of the hospital stay, the postoperative complications, and the likelihood of recurrence. Results: The wound size was in the bilateral Subcutaneous fatty flap (BSF) 28.11 ± 8.48 mm relative to the (ZP) 23.84 ± 8.44 mm). Also, the complete healing was comparatively prolonged in the BSF (13days) relative to the ZP group (30 days). The surgery duration differs significantly (P < 0.001) between the groups; it was lower in the BSF group (29.15 ± 7.69 mins) than in the ZP (23.03 ± 6.06 mins). In the BSF group, the hospitalization was four days. Still, ZP group (11days), The time for work recovery or activity was shorter in the BSF (11 days) relative to the ZP group (36 days). BSF had more reasonable satisfaction than the ZP group, duration of wound healing in BSF being 11 days but in ZP 30 days. Additionally, the duration of pain in the group was ZP (38 days but in the BSF group (11 days). Return to work in BSF 11 days and in ZP 36 days; The median satisfaction scores attained 8 (28.1%) in BSF and 9 (37%) in the ZP (P = 0.046). The median VAS scores attained 37.8% BSF and 44% for ZP (P = 0.934). The highest VAS score was equal to group B, which was 6. Conclusion: when treating pilonidal sinus disease, the bilateral subcutaneous fatty flap is superior to the ZP flap. [ABSTRACT FROM AUTHOR]

Subcutaneous incisionless surgery, also known as subcision, is a minimally invasive procedure that is commonly indicated for the treatment of atrophic acne scars. In recent years, many new techniques have been developed to maximize results from this procedure. This review article aims to identify an updated list of instruments and combinatorial treatments available for atrophic acne scar patients undergoing subcision. We constructed a comprehensive PubMed search term and performed triple-blinded screening on all resulting studies for mentions of subcision as indicated by acne scarring. Our results show that there are four main categories of subcision tools that are commonly employed to treat atrophic acne scars: needles, cannulas, wires, and blunt-blade instruments. Usage of these devices varies by scar depth, personal preference, and combinatorial treatment options. Overall, subcision is a particularly effective treatment for atrophic acne scars, and there is vast potential for further innovation with this technique. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the usefulness of gasless reduced-port laparoscopic myomectomy (GRP-LM) using a subcutaneous abdominal wall lifting method.In GRP-LM, after lifting the abdominal wall by a subcutaneous abdominal wall lifting method, a 1.5-cm incision is made in the lateral abdomen, Lap Protector® is placed. The operation is performed by two surgeons, one who inserts multiple forceps from the Lap Protector and performs the operation, and an assistant who operates the laparoscope and uterine manipulator. The surgical outcome of GRP-LM and the factors that affect it were investigated.GRP-LM was performed in 966 patients. Complications (0.5%) and blood transfusions (0.3%) were remarkably rare, and there were no cases of conversion to open surgery. With regard to the correlation between the number of fibroids extracted and each factor, the number of fibroids extracted correlated with fibroid weight and operation time, but not with blood loss. The average number of sutures per case was 21, and the average suture and ligation time per suture was 77 s. Comparing the cost of GRP-LM with that of the conventional insufflation LM, a saving of $875 was possible with GRP-LM.GRP-LM is a suitable for multiple fibroids, and is cosmetic and economical, because it allows rapid and reliable suture and ligation, despite having only one port for the procedure.Methods: To evaluate the usefulness of gasless reduced-port laparoscopic myomectomy (GRP-LM) using a subcutaneous abdominal wall lifting method.In GRP-LM, after lifting the abdominal wall by a subcutaneous abdominal wall lifting method, a 1.5-cm incision is made in the lateral abdomen, Lap Protector® is placed. The operation is performed by two surgeons, one who inserts multiple forceps from the Lap Protector and performs the operation, and an assistant who operates the laparoscope and uterine manipulator. The surgical outcome of GRP-LM and the factors that affect it were investigated.GRP-LM was performed in 966 patients. Complications (0.5%) and blood transfusions (0.3%) were remarkably rare, and there were no cases of conversion to open surgery. With regard to the correlation between the number of fibroids extracted and each factor, the number of fibroids extracted correlated with fibroid weight and operation time, but not with blood loss. The average number of sutures per case was 21, and the average suture and ligation time per suture was 77 s. Comparing the cost of GRP-LM with that of the conventional insufflation LM, a saving of $875 was possible with GRP-LM.GRP-LM is a suitable for multiple fibroids, and is cosmetic and economical, because it allows rapid and reliable suture and ligation, despite having only one port for the procedure.Results: To evaluate the usefulness of gasless reduced-port laparoscopic myomectomy (GRP-LM) using a subcutaneous abdominal wall lifting method.In GRP-LM, after lifting the abdominal wall by a subcutaneous abdominal wall lifting method, a 1.5-cm incision is made in the lateral abdomen, Lap Protector® is placed. The operation is performed by two surgeons, one who inserts multiple forceps from the Lap Protector and performs the operation, and an assistant who operates the laparoscope and uterine manipulator. The surgical outcome of GRP-LM and the factors that affect it were investigated.GRP-LM was performed in 966 patients. Complications (0.5%) and blood transfusions (0.3%) were remarkably rare, and there were no cases of conversion to open surgery. With regard to the correlation between the number of fibroids extracted and each factor, the number of fibroids extracted correlated with fibroid weight and operation time, but not with blood loss. The average number of sutures per case was 21, and the average suture and ligation time per suture was 77 s. Comparing the cost of GRP-LM with that of the conventional insufflation LM, a saving of $875 was possible with GRP-LM.GRP-LM is a suitable for multiple fibroids, and is cosmetic and economical, because it allows rapid and reliable suture and ligation, despite having only one port for the procedure.Conclusion: To evaluate the usefulness of gasless reduced-port laparoscopic myomectomy (GRP-LM) using a subcutaneous abdominal wall lifting method.In GRP-LM, after lifting the abdominal wall by a subcutaneous abdominal wall lifting method, a 1.5-cm incision is made in the lateral abdomen, Lap Protector® is placed. The operation is performed by two surgeons, one who inserts multiple forceps from the Lap Protector and performs the operation, and an assistant who operates the laparoscope and uterine manipulator. The surgical outcome of GRP-LM and the factors that affect it were investigated.GRP-LM was performed in 966 patients. Complications (0.5%) and blood transfusions (0.3%) were remarkably rare, and there were no cases of conversion to open surgery. With regard to the correlation between the number of fibroids extracted and each factor, the number of fibroids extracted correlated with fibroid weight and operation time, but not with blood loss. The average number of sutures per case was 21, and the average suture and ligation time per suture was 77 s. Comparing the cost of GRP-LM with that of the conventional insufflation LM, a saving of $875 was possible with GRP-LM.GRP-LM is a suitable for multiple fibroids, and is cosmetic and economical, because it allows rapid and reliable suture and ligation, despite having only one port for the procedure. [ABSTRACT FROM AUTHOR]

This study was concerned with the examination of patients who underwent surgery for subcutaneous endometriosis in our clinic and the relationship between subcutaneous endometriosis and inflammatory markers. Patient demographics and information on history and duration of previous surgery, lesion size, number of lesions, location, recurrence, symptoms, type and number of deliveries, recurrence status, and imaging method were recorded. Laboratory analysis recorded TSH, blood count (Hb), WBC, mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), monocyte/platelet ratio (MPR), lymphocyte/monocyte ratio (LMR), platelet/lymphocyte ratio (PLR) and CA -125 values of patients. The study included 28 patients and it was found that the mean age of the patients was 32.67±5.56 years. Five (17.9%) and 18 (64.3%) of the patients complained of a palpable mass and cyclic pain, respectively. Five patients (17.9%) were asymptomatic. Endometriosis associated with the scar line was localized in 18 (64.3%) of the patients. In three (10.7%) of the patients, the endometriosis was localized in the perineal line and in 7 (25%) of the patients in the rectus abdominis. No significant difference was found in the patients' routine laboratory results and inflammatory markers. In the present study, there was no significant association between the levels of inflammatory markers in patients who underwent surgery for subcutaneous endometriosis at different sites and with different symptoms. [ABSTRACT FROM AUTHOR]

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La phallopoièse antébrachiale est considérée comme la technique de référence en reconstruction pénienne totale. Cette technique permet la confection d'un phallus et d'un néo-urètre en un temps au prix de séquelles non négligeables du site donneur. Ainsi cette technique est dans certains centres remplacée par d'autres techniques comme le lambeau MSLD ou encore le lambeau ALT. Ces techniques nécessitent, néanmoins, dans les populations occidentales, l'adjonction d'une technique dédiée à la confection de l'urètre. Le lambeau scapulaire est une technique peu décrite dans la littérature permettant, comme le lambeau antébrachial, la création d'un phallus et d'un urètre en un temps selon la technique du « tube within tube ». Le but de l'étude était de détailler cette technique, étudier sa vascularisation et adapter les mensurations du lambeau à une population occidentale. Six dissections cadavériques ont été réalisées au laboratoire. L'injection intravasculaire de latex colorés a permis le repérage plus simple des vaisseaux d'intérêts et l'étude de l'arborescence vasculaire sous cutanée. Des lambeaux scapulaires de taille variable ont été levés afin d'adapter la taille à une population occidentale. Six dissections ont été réalisées chez des sujets caucasiens. L'artère circonflexe scapulaire était constante et avait un diamètre moyen de 3,5 mm (3,3mm–3,8 mm). La longueur moyenne du pédicule était de 7,3 cm (6,8cm–8,1 cm). La taille des lambeaux a été adaptée au tissu sous cutané et des lambeaux d'au moins 14 × 16 cm permettait la réalisation de la technique du « tube dans le tube ». Le lambeau scapulaire est une technique de phallopoièse peu connue. Cette technique a pour avantage de permettre la réalisation de phallopoièse avec urétroplastie dans le même temps. Le pédicule est constant et de bon diamètre. De plus, les séquelles du site donneur sont minimes. En revanche le pédicule utilisé est court et le lambeau ne peut être réinnervé chirurgicalement. Néanmoins la restauration d'une sensibilité protectrice permet l'implantation d'une prothèse pénienne. Antebrachial phalloplasty is considered as the standard technique in total penile reconstruction. This technique allows the creation of a phallus and a neourethra in one step at the cost of significant sequelae of the donor site. Thus, this technique has been replaced in some centers by other techniques such as the MSLD flap or the ALT flap. However, in Western populations, these techniques require the addition of a technique dedicated to the urethroplasty. The scapular flap is a technique that is not widely described in the literature and, like the antebrachial flap, allows the creation of a phallus and a urethra in one step according to the "tube within tube" technique. The aim of the study was to detail this technique, to study its vascularization and to adapt the measurements of the flap to a western population. Six cadaveric dissections were performed in the laboratory. Intravascular injection of colored latex allowed easier identification of the vessels of interest and study of the subcutaneous vascular tree. Scapular flaps of variable size were raised to adapt the size to a Western population. Six dissections were performed in Caucasian subjects. The scapular circumflex artery was constant and had a mean diameter of 3.5 mm (3.3mm–3.8 mm). The mean pedicle length was 7.3 cm (6.8cm–8.1 cm). The size of the flaps was adapted to the subcutaneous tissue and flaps of at least 14 × 16 cm allowed the "tube within tube" technique to be performed. The scapular flap has the advantage of allowing phalloplasty with urethroplasty to be performed at the same time. The pedicle is constant and of good diameter. In addition, the sequelae of the donor site are minimal. On the other hand, the pedicle used is short and the flap cannot be surgically reinnervated. Nevertheless, the restoration of a protective sensitivity allows the implantation of a penile prosthesis. [ABSTRACT FROM AUTHOR]

Improvements in the recently observed breast reconstruction surgery techniques have changed the clinical practice in patients with breast cancer. Nowadays, every patient diagnosed with breast cancer clinical stage I, II and III, except for inflammatory breast cancer, should have the opportunity to undergo breast reconstruction. Radiation therapy increases the risk of complications following reconstruction. The aim of this paper is to review the current literature in an attempt to select the safest and most convenient reconstruction technique in patients requiring radiation therapy. Immediate autologous breast reconstruction seems to be the best option, but everyday clinical practice seems to contradict the conclusions from these data. The choice of the reconstruction type depends not only on the rate of complications but on the surgeon's skills, the patient's preference and the hospital's equipment. [ABSTRACT FROM AUTHOR]

Background: In the aging society, many patients with movement disorders, pain syndromes, or psychiatric disorders who are candidates for deep brain stimulation (DBS) surgery suffer also from cardiovascular co-morbidities that require chronic antiplatelet or anticoagulation treatment. Because of a presumed increased risk of intracranial hemorrhage during or after surgery and limited knowledge about perioperative management, chronic antiplatelet or anticoagulation treatment often has been considered a relative contraindication for DBS. Here, we evaluate whether or not there is an increased risk for intracranial hemorrhage or thromboembolic complications in patients on chronic treatment (paused for surgery or bridged with subcutaneous heparin) as compared to those without. Methods: Out of a series of 465 patients undergoing functional stereotactic neurosurgery, 34 patients were identified who were on chronic treatment before and after receiving DBS. In patients with antiplatelet treatment, medication was stopped in the perioperative period. In patients with vitamin K antagonists or novel oral anticoagulants (NOACs), heparin was used for bridging. All patients had postoperative stereotactic CT scans, and were followed up for 1 year after surgery. Results: In patients on chronic antiplatelet or anticoagulation treatment, intracranial hemorrhage occurred in 2/34 (5.9%) DBS surgeries, whereas the rate of intracranial hemorrhage was 15/431 (3.5%) in those without, which was statistically not significant. Implantable pulse generator pocket hematomas were seen in 2/34 (5.9%) surgeries in patients on chronic treatment and in 4/426 (0.9%) without. There were only 2 instances of thromboembolic complications which both occurred in patients without chronic treatment. There were no hemorrhagic complications during follow-up for 1 year. Conclusions: DBS surgery in patients on chronic antiplatelet or anticoagulation treatment is feasible. Also, there was no increased risk of hemorrhage in the first year of follow-up after DBS surgery. Appropriate patient selection and standardized perioperative management are necessary to reduce the risk of intracranial hemorrhage and thromboembolic complications. [ABSTRACT FROM AUTHOR]

Background Scar visibility is a major deterrent to patients seeking reconstructive surgery. Endoscopic surgery can address a wide range of problems, from minimizing or concealing scars to improving access and outcomes in certain situations. This case series includes a wide range of reconstructive surgery problems addressed by subcutaneous endoscopic surgery. Having one or more trained assistants is a major deterrent to the performance of endoscopic surgery by the lone practitioner. The single (or two-port technique for muscle harvest) used in most cases simplifies subcutaneous endoscopic surgery. Methods A single-port endoscopy technique, with a 4-mm, 30-degree side viewing telescope and sheath, optical camera and cold light source, was used. Case records were reviewed for access incisions, procedure abandonment, postoperative pain, complications, and patient satisfaction. Results A total of 53 endoscopic surgical episodes between 2003 and 2013 were reviewed. Using a single port, most cases were done successfully. The access site was changed peroperatively in one case. Complications included transient nerve palsy in one case, which recovered completely. There was minimal intraoperative bleeding. Postoperative pain was low except in one case and managed with minimal analgesia. Patient satisfaction was high in all cases. Conclusions Subsurface endoscopy done on a wide range of reconstructive surgery procedures and resulted in minimal scars and high patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: Soft-tissue sarcomas (STS) are rare tumors of the soft tissue. Recent diagnostic studies on STS mainly dealt with only few cases of STS and did not investigate the post-therapeutic performance of MRI in a routine clinical setting. Therefore, we assessed the long-term diagnostic accuracy of MRI for detecting recurrent STS at a multidisciplinary sarcoma center.Methods: In all, 1055 postoperative follow-up MRIs of 204 patients were included in the study. MRI follow-up scans were systematically reviewed for diagnostic values (true-positive/-negative and false-positive/-negative results) in detecting recurrences. Pathological reports and follow-up MRIs were set as baseline references.Results: The median age of the patients was 55.3 ± 18.2 years. Of the patients, 34.8% presented with recurrences. Here, 65 follow-up scans were true positive, 23 false positive, 6 false negative, and 961 true negative. The overall sensitivity and specificity of MRI for detecting recurrences were 92 and 98%, respectively, with an accuracy of 97%. For intramuscular lesions and after surgery alone the sensitivity was higher (95 and 97%, respectively) than for subcutaneous lesions and surgery with additional radiation therapy (83 and 86%, respectively), at similarly high specificities (96-98%). The 6 false-negative results were found in streaky (n = 2) and small ovoid/nodular (n = 4) recurring lesions. The false-positive lesions imitated streaky (n = 14), ovoid/nodular (n = 8), and polycyclic/multilobulated recurring tumors (n = 1). All false-positive results were found in patients in whom the primary tumors were polycyclic/multilobulated in appearance.Conclusion: MRI shows a high diagnostic accuracy for detecting recurrent STS, with a high sensitivity and specificity. The diagnostic accuracy decreases in subcutaneous lesions and after surgery with radiation therapy, compared to intramuscular lesions and surgery alone. Radiologists should pay particular attention to streaky and small ovoid/nodular recurring lesions and patients with polycyclic/multilobulated primary tumors. [ABSTRACT FROM AUTHOR]

Background: Nipple-sparing mastectomy (NSM) has become widely adopted owing to its oncologic safety, aesthetic results and psychological benefits. Lack of sensation on the Nipple-areola complex (NAC) after reconstruction remains a common complaint that has been scarcely researched in the alloplastic reconstruction population. The aim of this report is to present a nipple neurotization technique suitable for patients undergoing implant-based breast reconstruction. Case Presentation: A 42-year-old female with ductal breast carcinoma underwent periareolar NSM with implant-based reconstruction and complained about lack of tactile sensation on mastectomy flaps and NAC. A year after the reconstruction surgery, she underwent late NAC neurotization by bridging the 4th intercostal nerve to the undersurface of the areola using a 15cm sural nerve autograft. Recovery of protective and pressure sensation was seen six months later over the NAC. Conclusion: This case confirms that late neurotization in alloplastic reconstruction by bridging the areolar dermis to a donor intercostal nerve provides sensory recovery at the NAC. [ABSTRACT FROM AUTHOR]

Background: Subcision, also known as subcutaneous incisionless surgery, is a surgical intervention used to treat a variety of skin conditions including atrophic acne scars, depressed scars, cellulite, and wrinkles. Aims: We plan to prepare a review article about the indications of subcision, its adverse reactions, and pearls. Patients/Methods: We searched the literature for the information about subcision and its applications from papers published up to March 2019. The search was performed through the databases of the National Library of Medicine. Results: After a thorough review of the published papers about subcision, we finally chose to review 40 articles that had proper sample size and design to prepare this review article. Twenty‐one papers were related to the application of subcision in the treatment of acne scar and other scars. Four articles were about the application of subcision to treat cellulite, and eight articles were related to other applications of subcision such as the treatment of striae or nasolabial fold. The remaining seven articles include published review papers about subcision or acne scar classification. Conclusion: Subcision seems to be effective on various skin conditions including acne scar, other depressed scars, and cellulite. It is easy to apply and inexpensive with short downtime and no significant complications. Subcision needs proper technique and adequate experience. [ABSTRACT FROM AUTHOR]

Teeth presenting external and internal resorption are uncommon, and affected teeth are often only discovered by chance. In most cases, these teeth are symptom-free. In rare cases, the differential diagnosis between external and internal resorption is very difficult, especially for teeth pretreated elsewhere with inadequate documentation of the clinical situation, as in the case presented. Resorption lacunae can also present a challenge for treatment. Invasive cervical resorption affecting the endodontium requires different therapeutic techniques in terms of position and timing. Presented is treatment of a case of pretreated, invasive cervical resorption with irreversible pulpitis. Root canal treatment was performed by filling the initial perforating resorption using MTA, and treatment of the cervical defect occurred later. Compared with incidents such as extrusion of H2O2 or NaOCl into the periradicular tissues during root canal irrigation, air inclusion in the tissue is comparatively less dramatic. However, this should be taken seriously. The present case report describes the treatment of a symptomatic invasive cervical resorption, with the occurrence of massive subcutaneous emphysema during the final cervical composite restoration. [ABSTRACT FROM AUTHOR]

Purpose: A major concern for implants that penetrate stratified epithelia is aggressive epithelial proliferation and migration. This epithelial down growth on the implant can be inhibited by a firm attachment between the underlying connective tissue and the implant. This study evaluates the connective tissue attachment to titanium implants with various well-defined surface topographies. Materials and Methods: Titanium-coated epoxy replicas of polished (PO; Ra = 0.06 μm), finely blasted (FB; Ra = 1.36 μm), coarsely blasted (CB; Ra = 5.09 μm), acid-etched (AE; Ra = 0.59 μm), coarsely blasted and acid-etched (SLA; Ra = 4.39 μm), titanium plasma-sprayed (TPS; Ra = 5.85 μm), machined-like (ML; Ra=2.15 μm), and micromachined grooved (GR; V-shaped grooves 30 μm deep) surfaces were implanted subcutaneously in 74 rats for 1 to 11 weeks. Animals were sacrificed weekly. Surfaces were processed for histomorphometric evaluation of connective tissue attachment, capsule thickness, and where applicable, the degree of separation between the tissue and implant. Results: A total of 153 test surfaces were analyzed. Statistical analysis revealed that textured and rough substrata, namely the GR, TPS, AE, CB, and SLA surfaces, exhibited significantly greater (P < .05) connective tissue attachment and thinner fibrous encapsulation when compared to the PO surface. Tissue separation from the implant interface was of significantly lower magnitude and frequency with the rough surfaces than with the PO surface. Conclusions: The results indicate that rough implant surfaces are associated with stable connective tissue attachment, which has implications for their use in percutaneous and permucosal applications. In addition, data from the AE surface may indicate that the geometry of the surface irregularities can also be a significant determinant of the connective tissue response. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the effects of breast-conserving surgery (BCS) and subcutaneous mastectomy with implant reconstruction (SMIR) in terms of postoperative psychosocial effects, sexuality, and quality of life. Methods: Demographic data and clinical breast cancer parameters of patients who underwent BCS (n=48) or SMIR (n=27) between January 2012 and December 2016 were reviewed retrospectively. The data were collected via face-to-face interview using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the breast cancer-specific submodule, EORTC QLQ-BR23. Results: In this study group, 23 (48%) patients who underwent BCS and 25 (92.6%) patients who underwent SMIR were premenopausal (p<0.01). More patients in the SIMR group underwent axillary dissection [BCS: 11 (22.9%); SMIR: 17 (63%)] and had adjuvant therapy [25 (52%) vs. 23 (85%)] (p<0.01). The number of women working outside the home was greater in the SMIR group [BCS: 13 (27%); SMIR: 18 (66.6%)] (p<0.01). The EORTCQLQ-C30 and QLQ-BR23 questionnaires revealed no significant difference between the groups in terms of functional scales (p>0.05). Fatigue scores on the QLQ-C30 were greater for SMIR patients, as well as arm symptoms in the QLQ-BR23 side effects scale (p<0.05). Conclusion: The results of BCS patients were better than those of SMIR patients on 3 scales, suggesting that BCS may be the first choice of treatment when feasible. For those who are not eligible, SMIR is an option to consider before a modified radical mastectomy. [ABSTRACT FROM AUTHOR]

Summary Introduction Rhinoplasty is frequently performed worldwide, and patients and surgeons both expect good cosmetic results without any deformity recurrence. We report a rare case of mucous cyst occurred after post-traumatic rhinoseptoplasty. Observation A 27-year old woman presented a median mass of the nose root 7 years after prior rhinoseptoplasty. Investigations showed a subcutaneous lesion of 10.5 × 24.5 mm. The surgery consisted on an external rhinoplasty allowing cyst removal, bilateral osteotomies and reconstruction of the nasal dorsum by deep temporal fascia graft. Histological examination confirmed the diagnosis of begnin mucous cyst. No recurrence was observed at 1-year follow-up. Discussion Mucous cyst post rhinoplasty is rare and is probably due to accidental mucosal material implantation into the subcutaneous plane during rhinoplasty. This complication can be avoided by adequate infiltration and hydrodissection, careful dissection, and avoidance of unnecessary trauma during osteotomies. [ABSTRACT FROM AUTHOR]

An approximately 42-year-old, wild-caught, red-crowned Amazon parrot (Amazona viridigenalis) was evaluated for a subcutaneous mass to the right of the keel. Cytologic examination of a fine needle aspirate of the mass were suggestive of granulomatous inflammation. The mass was surgically excised, and the parrot was treated with oral nonsteroidal anti-inflammatory drugs. Histologically, the mass was diagnosed as a teratoma with stratified squamous epithelial and neuroectodermal components. Tumor cells extended to surgical margins. Two years later, the neoplasm recurred, with regrowth of only the neuroectodermal component. The neoplasm was again removed surgically, but it recurred again 14 months later, necessitating a third surgery. Histopathologic examination confirmed recurrence of the original neoplasm in both instances, with incomplete margins on both excisions. [ABSTRACT FROM AUTHOR]

Background: Axillary osmidrosis is a distressing condition that can reduce quality of life and lead to personal and social problems. Fractional microneedling radiofrequency (FMR) treatment is a new minimally invasive procedure. Objective: We sought to assess retrospectively the efficacy and safety of FMR treatment for axillary osmidrosis compared with subcutaneous surgery in a Chinese population. Methods: In total, 48 and 42 patients receiving FMR treatment and subcutaneous surgery, respectively, were recruited. The treatments were assessed in terms of efficacy, complications, and malodor recurrence. Patient satisfaction and the Dermatology Life Quality Index (DLQI) were also evaluated. Results: In total, 93.75% of patients in the FMR group and all patients in the surgery group showed good‐to‐excellent improvement in osmidrosis (P > 0.05). The patients' satisfaction in the FMR group was significantly higher than that in the surgery group at 1 month after treatment, but there were no differences between the two groups at the 3rd and 6th months (P > 0.05). The DLQI score was significantly decreased after both treatments. Two patients in the surgery group experienced hemorrhage complications, and no patients in the FMR group showed severe adverse effects. There was no significant difference in the malodor recurrence rate between the groups. Conclusions: Fractional microneedling radiofrequency treatment offers a safe and effective method for treating axillary osmidrosis with minimal recovery time and no strict postoperative immobilization. [ABSTRACT FROM AUTHOR]

Painful tumors of the skin present as dermal or subcutaneous nodules. They can originate from several sources: adipose tissue, cartilage degeneration, deposition of bone or calcium, eccrine glands, fibrous tissue, infiltration of benign (endometrium) or malignant (metastatic neoplasm) tissue, muscle, nerve, or vascular structures. Although pathologic evaluation of the lesion is necessary to determine the diagnosis, it is possible to make a reasonable differential diagnosis based on knowledge of prior tumors that have appeared as tender lesions. Two women with painful skin tumors – either osteoma cutis or an organizing thrombus – are described. Based on our clinical experience and review of the literature, 25 painful skin tumors were identified: chondrodermatitis nodularis helicis, angioendotheliomatosis, leiomyoma, metastases, hidradenoma, osteoma cutis, glomus tumor, fibromyxoma, leiomyosarcoma, eccrine angiomatous hamartoma, Dercum's disease, peizogenic pedal papule, neurilemmoma, angiolipoma, neuroma, dermatofibroma, granular cell tumor, endometriosis, thrombus, scar, blue rubber bleb nevus, angioma, calcinosis cutis, and keloid. An acronym – inspired by Charlotte's Web, a book that many children have read – that can be used as a memory aid for recalling the list of painful skin tumors is introduced: "CALM HOG FLED PEN AND GETS BACK". [ABSTRACT FROM AUTHOR]

The aim of this study was to clarify the combined effects and dose-effect relationships of rhGH on tumor growth, nutrition status, and immune function in MKN-45 xenograft mice. In this study, animal models were induced in nude mice using the subcutaneous transplantation of MKN-45 cells, and rhGH was injected daily for 14 days. Three rhGH treatment dosages were set with reference to the equivalent dosage converted from human clinical dosage, including 2 IU (0.67 mg), 10 IU (3.35 mg) and 50 IU (16.75 mg) per kg body weight. The tumor volume, body weight and food intake were measured every two or three days. After 14 days of rhGH treatment, the tumors were isolated and weighed. The expression levels of Ki-67, vascular endothelial growth factor (VEGF) and CD31in tumor tissues were detected by immunohistochemistry (IHC). The protein expression levels of pJAK2, JAK2, pSTAT3, STAT3, pAKT, AKT, pERK and ERK were measured by western blotting. The percentage of active NK cells in peripheral blood mononuclear cells (PBMCs) was detected by fluorescence-activated cell sorting (FACS). The results showed that rhGH had improved the food intake, increased the body weight and strengthened the immune function of MKN-45 xenograft mice but had not promote tumor growth. MKN-45 xenograft mice treated with rhGH at a higher dosage gained more weight, while those treated with rhGH at a lower dosage showed stronger immune function and smaller tumor volume. [ABSTRACT FROM AUTHOR]

Background: This study assessed subcutaneous absorption kinetics of rapid-acting insulin administered as a bolus using bolus delivery speeds commonly employed in commercially available insulin pumps (i.e., 2 and 40 s for delivering 1 insulin unit).Materials and Methods: Twenty C-peptide-negative type 1 diabetic subjects were studied on two occasions, separated by at least 7 days, using the euglycemic clamp procedure. After an overnight fast, subjects were given, in random order, a subcutaneous insulin bolus (15 U of insulin lispro, Eli Lilly) either for 30 s using an Animas IR2020 pump (fast bolus delivery) or for 10 min using a Medtronic Minimed Paradigm 512 pump (slow bolus delivery).Results: Fast bolus delivery resulted in an earlier onset of insulin action as compared with slow bolus delivery (21.0 ± 2.5 vs. 34.3 ± 2.7 min; P < 0.002). Furthermore, time to reach maximum insulin effect was found to be 27 min earlier with fast bolus delivery as compared with slow bolus delivery (98 ± 11 vs. 125 ± 16 min; P < 0.005). In addition, the area under the plasma insulin curve from 0 to 60 min for fast bolus delivery was greater than the one for slow bolus delivery (10,307 ± 1291 vs. 8192 ± 865 min·pmol/L; P = 0.027).Conclusions: Results suggest that insulin bolus delivery with fast delivery speed may result in more rapid insulin absorption and, thus, may provide a better control of meal-related glucose excursions than that obtained with bolus delivery using slow delivery speeds. Our findings may have important implications for the future design of the bolus delivery unit of insulin pumps. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the effects of low-intensity pulsed ultrasound (LIPUS) on the osteogenic differentiation of dental follicle cells (DFCs) in vitro and on the regenerative effects of DFC-OsteoBoneTM complexes in vivo. DFCs were isolated and characterized. In the in vitro study, DFCs were cultured in an osteogenic medium in the presence or absence of LIPUS. The expression levels of ALP, Runx2, OSX, and COL-I mRNA were analyzed using real-time polymerase chain reaction (RT-PCR) on day 7. Alizarin red staining was performed on day 21. The state of the growth of the DFCs that were seeded on the scaffold at 3, 5, 7, and 9 days was detected by using a scanning electron microscope. In our in vivo study, 9 healthy nude mice randomly underwent subcutaneous transplantation surgery in one of three groups: group A, empty scaffold; group B, DFCs + scaffold; and group C, DFCs + scaffold + LIPUS. After 8 weeks of implantation, a histological analysis was performed by HE and Mason staining. Our results indicate that LIPUS promotes the osteogenic differentiation of DFCs by increasing the expression of the ALP, Runx2, OSX, and COL-I genes and the formation of mineralized nodules. The cells can adhere and grow on the scaffolds and grow best at 9 days. The HE and Mason staining results showed that more cells, fibrous tissue and blood vessels could be observed in the DFCs + scaffold + LIPUS group than in the other groups. LIPUS could promote the osteogenic differentiation of DFCs in vitro and promote tissue regeneration in a DFCs-scaffold complex in vivo. Further studies should be conducted to explore the underlying mechanisms of LIPUS. [ABSTRACT FROM AUTHOR]

Abstract Background There are various suture techniques used during laparoscopic gastrostomy to secure the stomach to the anterior abdominal wall. However, it remains unclear whether temporary fixation or subcutaneous absorbable sutures predispose pediatric patients to fewer postoperative complications. Our goal was to determine if a particular suture technique resulted in an increased risk for the development of postoperative complications. Materials and methods A retrospective cohort analysis was performed for patients less than 18 y of age who underwent laparoscopic gastrostomy at a tertiary Children's Hospital between 2012 and 2016. Children were grouped according to suture techniques for laparoscopic gastrostomy placement: temporary sutures or subcutaneous absorbable sutures. Postoperative outcomes at 30 d were defined as major complications (tube dislodgement, unplanned reoperation, readmission) and minor complications (stitch abscess, surgical site infection, emergency department visit). The chi squared test was used to determine if an association existed between the suture techniques and 30 d postoperative complications. Results We identified 682 pediatric patients who underwent laparoscopic gastrostomy. There were 301 (44%) patients with subcutaneous sutures placed and 381 (56%) with temporary sutures placed. The overall rate of major and minor complications was 8.3% and 22%, respectively. We observed a significant difference in the occurrence of major postoperative complications between the subcutaneous and temporary suture techniques (11% versus 6.3%, P = 0.029). There was no significant difference in the development of minor complications between subcutaneous and temporary suture techniques. Conclusions Children who receive subcutaneous sutures during laparoscopic gastrostomy are at an increased risk for developing a major postoperative complication. [ABSTRACT FROM AUTHOR]

Introduction: Allergic rhinitis (AR) is among the most common chronic conditions affecting both children and adults. It is the cause of significant morbidity from the symptoms and interference with sleep. It results in major impairment of performance both at school and at work. In the U.S. and certain parts of Europe, ragweed pollen is a major cause of seasonal AR. In 2014, the U.S. Food and Drug Administration (FDA) approved a sublingual ragweed tablet (MK-3641) for use in adults with ragweed-induced AR. Areas covered: This paper will review the impact of ragweed-induced AR and available treatments including subcutaneous immunotherapy and studies with MK-3641. The principal search method was PubMed. Expert commentary: One dosing finding, two 28-day safety and two 52-week safety and efficacy studies have been conducted with MK-3641. The 12-U (12μg Amb a 1) tablet was the most effective. Local application site reactions were common but usually not serious. Only one, non-serious systemic reaction was reported in four safety studies. MK-3641 is a safe and effective treatment for ragweed-pollen-induced AR when treatment is initiated ≥ 12 weeks prior to the onset of the ragweed pollen season. [ABSTRACT FROM AUTHOR]

Background Acellular dermal matrix (ADM) helps wound healing by stimulating angiogenesis, acting as a chemoattractant for endothelial cells, providing growth factors, and permitting a substrate for fibroblasts to attach. The current standard for using paste-type ADM (CG Paste) in wound healing is direct application over the wounds. The major concerns regarding this method are unpredictable separation from the wounds and absorption into negativepressure wound therapy devices. This study aimed to investigate the effects of subcutaneous injection of paste-type ADM on wound healing in rats. Methods Full-thickness skin defects were created on the dorsal skin of rats. Eighteen rats were randomly divided into three groups and treated using different wound coverage methods: group A, with a saline dressing; group B, standard application of CG Paste; and group C, injection of CG Paste. On postoperative days 3, 5, 7, 10, and 14, the wound areas were analyzed morphologically. Histological and immunohistochemical tissue analyses were performed on postoperative days 3 and 7. Results Groups B and C had significantly less raw surface than group A on postoperative days 10 and 14. Collagen fiber deposition and microvessel density were significantly higher in group C than in groups A and B on postoperative days 3 and 7. Conclusions This study showed comparable effectiveness between subcutaneous injection and the conventional dressing method of paste-type ADM. Moreover, the injection of CG Paste led to improved wound healing quality through the accumulation of collagen fibers and an increase in microvessel density. [ABSTRACT FROM AUTHOR]

CASE DESCRIPTION A 7-year-old female domestic shorthair cat was referred for evaluation of azotemia and unilateral hydronephrosis. CLINICAL FINDINGS Abdominal ultrasonography revealed right-sided hydronephrosis and dilation of the proximal aspect of the ureter; the left kidney was small with irregular margins. A highly vascular, irregular retroperitoneal mass, not clearly associated with the ureteral obstruction, was also visualized. Surgical exploration confirmed a retroperitoneal mass involving the caudal mesenteric artery and both ureters, with hydroureter on the right side. TREATMENT AND OUTCOME A subcutaneous ureteral bypass (SUB) device was surgically implanted to treat right ureteral obstruction, and the mass was biopsied. Shortly after surgery, progressive azotemia and hyperkalemia were detected; ultrasonographic examination revealed left-sided hydronephrosis and hydroureter, which was suspected secondary to inflammation of the mass causing a left-sided ureteral obstruction. A second surgery was performed to place an SUB device for the left kidney and remove the retroperitoneal mass; both ureters were ligated at the mid- and distal aspects and then transected and removed with the mass. A neuroendocrine paraganglioma was identified by histopathologic evaluation of the mass. Hydronephrosis improved (right kidney) or resolved (left kidney) after surgery, and azotemia improved. Chemotherapeutic intervention was declined. Markers of renal function were static during the 14-month follow-up period. At the last follow-up evaluation, the patient was reportedly doing well, and both SUB devices were patent. CLINICAL RELEVANCE This was the first report of retroperitoneal paraganglioma in a domestic cat causing bilateral ureteral obstruction. Bilateral SUB device placement enabled en bloc mass resection and provided long-term relief of ureteral obstruction. [ABSTRACT FROM AUTHOR]

Abstract The strategies for improving the in vitro maturation (IVM) of domestic animal oocytes focus on promoting nuclear and cytoplasmic maturation. The identification of paracrine factors and their supplementation in the culture medium represent effective approaches for oocyte maturation and embryo development. This study investigated the effects of paracrine factor supplementation including connective tissue growth factor (CTGF), nerve growth factor (NGF), hepatocyte growth factor (HGF), and stromal derived factor 1 (SDF1) on ovine oocytes and early parthenogenetic embryos using an in vitro culture system. First, we identified the optimal concentrations of CTGF (30 ng/mL), SDF1 (10 ng/mL), NGF (3 ng/mL), and HGF (100 ng/mL) for promoting oocyte maturation, which combined, induced nuclear maturation in 94.19% of oocytes. This combination also promoted cumulus cell expansion and inhibited oocyte/cumulus apoptosis, while enabling a larger proportion (33.04%) of embryos to develop into blastocysts than in the controls and prevented embryo apoptosis. These novel findings demonstrate that the paracrine factors CTGF, SDF1, NGF, and HGF facilitate ovine oocyte and early parthenogenetic embryo development in vitro. Thus, supplementation with these factors may help optimize the IVM of ovine oocytes and early parthenogenetic embryo development strategies. [ABSTRACT FROM AUTHOR]

Abstract MicroRNAs (miRNAs) are small noncoding 20–25 nt RNA molecules that regulate gene expression by posttranscriptional repression of messenger RNA. There have been few investigations on the profiles and functions of miRNAs in ovine subcutaneous fat; their roles in the metabolism and deposition of subcutaneous fat also remain unclear. In this study, small RNA libraries were constructed for 2 important Chinese local sheep breeds, Small-tailed Han Sheep, and Shanxi Meat Sheep Dam Line, and used for high-throughput sequencing. Differentially expressed miRNAs were identified, revealing the effect of miR-124-3p on adipogenic differentiation by targeting C/EBPα. Our results provide both a comprehensive understanding of miRNA expression patterns in sheep subcutaneous fat and an insight into the specific roles of miRNAs in adipogenesis. Highlights • Differentially expressed MicroRNAs in subcutaneous fat of small-tailed Han Sheep and Shanxi Meat Sheep Dam Line were identified. • C/EBPα is a target gene of miR-124-3p. • MiR-124-3p inhibits the adipogenic differentiation of stromal vascular fractions of sheep. [ABSTRACT FROM AUTHOR]

Abstract Bile acids (BAs) are synthesized in the liver via the oxidation of cholesterol and further metabolized by microbiota in the gut, where they simultaneously impact gut function. In the present study, 10 goats were randomly divided into 2 groups; 1 group was injected with dexamethasone (Dex; 0.2 mg/kg), and the other group was injected with saline as the control (Con) for 21 d. Expression levels of key genes and proteins in the liver and gut mucosa were analyzed and compared to investigate the impact of chronic stress on BA metabolism and related functions in ruminants. The results revealed that Dex decreased plasma total BAs (TBAs) concentration (P < 0.05) but increased TBA concentration in the cecal digesta (P < 0.05). Total cholesterol in the liver decreased moderately in response to Dex. The protein expression of cytochrome P450 family 7 subfamily A member 1 and cytochrome P450 family 27 subfamily A member 1, 2 enzymes that control BA synthesis in the liver, remained unchanged by Dex administration (P > 0.05). The expression of several genes in the cecal mucosa encoding epithelial tight junction proteins, including occludin (P < 0.05), tight junction protein 1 (P < 0.01), and claudin 1 (P < 0.05), increased significantly in response to Dex, and expression of defensin beta 1 , which can strengthen the innate immune system, was also upregulated (P < 0.05). In addition, BAs increased the expression of the Solute Carrier family 9 member A 2 (P < 0.01) that encodes a sodium hydrogen exchanger. These results suggest that the Dex-induced disruption of BA homeostasis might be mediated through a liver-independent pathway in goats, and the Dex-induced accumulation of TBAs in the cecal digesta may improve volatile fatty acid transportation and mucosal defense. Highlights • Dexamethasone-induced bile acid homeostasis disruption was mediated through liver-independent pathways. • Bile acids increased the expression of the cecal Solute carrier family 9 member A 2, which encodes a sodium hydrogen exchanger. • The expression of genes encoding tight junction proteins was increased in the cecum. [ABSTRACT FROM AUTHOR]

Object: The aim of this paper is to review the current knowledge on the management of local infections in posterior cranial fossa (PCF) and spinal surgery; the center of our paper will be the diagnosis and management of infections of the wound, the subcutaneous tissue, and muscle strata.Results and conclusions: Very few papers address the problem of local infections in posterior cranial fossa and spinal surgery. The largest amount of the literature data is indeed centered on how to deal with deep infections, CSF leak, and secondary meningitis or hardware infection. Concerning PCF surgery, a higher rate of local infections has been reported, compared with supratentorial surgery. To prevent such complications, prophylaxis remains the most important tool in dealing with local infections; a careful surgical planning and patient selection are also important. On the other hand, in dealing with local infection in spinal setting, there are several evidences that local vancomycin might help reducing them in adults as well as in children. The treatment protocol consists in antibiotic therapy and, whenever needed, wound revision to remove infectious material or to obtain a microbiological diagnosis. Prognosis has overall to be considered favorable both in the short term as well as in the long term. [ABSTRACT FROM AUTHOR]

BACKGROUND A bipolar fractional radiofrequency (RF) device was developed to generate cutaneous thermal injuries using a temperature-controlled microneedle electrode array. OBJECTIVE Evaluate safety and efficacy of a novel subcutaneous microneedle RF for treatment of posterolateral thigh cellulite. METHODS The study design was an institutional review board-approved multicenter clinical trial after a perprotocol analysis. Fifty subjects with Nurnberger-Muller Grade II or III cellulite were enrolled at 4 treatment centers and received 1 subcutaneous microneedle RF treatment (67°C/4-second duration). Efficacy was evaluated by blinded grading by 3 dermatologists using randomized, standardized photographs and investigator grading at baseline, 1-, 3-, and 6-month follow-up. As per the Food and Drug Administration, treatment success was defined by ≥1-point improvement on dimple number or severity of undulation irregularities scales by at least 2 of 3 blinded physicians. Study subjects' self-assessments and satisfaction questionnaires and procedural pain levels and adverse events were monitored. RESULTS Blinded physician evaluations revealed a procedural success rate of 93% at 6-month follow-up. Procedural pain level was 3.74 ± 1.96 on a 10-point scale. There were no adverse events. Seventy-five percent of subjects were satisfied with the results at 6-month follow-up. CONCLUSION The results indicate that subcutaneous microneedle RF treatment is safe and effective for long-term treatment of Type II and III cellulite in a single session. [ABSTRACT FROM AUTHOR]

Background: A retained medullary cord (RMC) is a rare closed spinal dysraphism with a robust elongated neural structure continuous from the conus and extending to the dural cul-de-sac. Four cases of RMC extending down to the base of an associated subcutaneous meningocele at the sacral level have been reported.Clinical presentation: We report an additional case of RMC, in whom serial MRI examination revealed an enlargement of the meningocele associated with RMC over a 3-month period between 8 and 11 months of age, when he began to stand. At the age of 12 months, untethering of the cord was performed. Histologically, the presence of ependyma-lined central canals in the dense neuroglial cores was noted in all cord-like structures in the intradural and intrameningocele sacs and at the attachment to the meningocele.Conclusion: It is conceivable that the hydrodynamic pressure with standing position and the check valve phenomenon were involved in meningocele enlargement. We should be mindful of these potential morphological changes. [ABSTRACT FROM AUTHOR]

The objective of this prospective study was to evaluate agreement and reliability of calliper‐based measurements of locally invasive subcutaneous malignant tumours in dogs. Four raters measured the longest diameter of 12 subcutaneous tumours (7 soft tissue sarcomas and 5 mast cell tumours) from 11 client‐owned dogs during 3 randomized, blinded measurement trials, both pre‐ and post‐sedation. Inter‐ and intra‐rater reliability was evaluated using intra‐class correlation coefficient (ICC) and agreement was evaluated using Bland‐Altman plots. Inter‐ and intra‐rater reliability was good (ICC range of 0.8694‐0.89520) and excellent (ICC range of 0.9720‐0.9966), respectively. For agreement calculations, an a priori clinically relevant limit of agreement of 10 mm was set. Inter‐ and intra‐rater agreement was unacceptable with inter‐rater limits of agreement ranging from 15.9 to 55.6 mm and intra‐rater limit of agreement ranging from 11.9 to 28.1 mm. Review of the measurement trial photographs revealed that calliper orientation changes were frequent, occurring in 9/12 (75%) and 8/12 (67%) pre‐ and post‐sedation cases. No significant correlation was found between inter‐rater measurement standard deviations and calliper orientation changes or dog body condition score. These findings suggest veterinarians may have poor agreement in determining the gross edge of tumours, which is expected to introduce bias and inconsistency in tumour staging, assessing response to therapy, and surgical margin planning. Due to the potential consequences for veterinary cancer patients, future studies are needed to validate the present findings. [ABSTRACT FROM AUTHOR]

Morel-Lavallée lesions are rare, closed degloving soft tissue injuries in which the skin and subcutaneous tissues are traumatic separated from the underlying fascia. There is lack of consensus regarding optimal management of these lesions. After failure of conservative management, operative intervention is imperative. The purpose of this manuscript is to describe a minimally invasive endoscopic method for treatment of Morel-Lavallée Lesions, which achieves the goal of an open surgical debridement. [ABSTRACT FROM AUTHOR]

Alopecia in dogs occurs secondary to a variety of underlying inflammatory and noninflammatory conditions. Hair cycle arrest (alopecia X) is a noninflammatory alopecia that is frustrating to diagnose and treat due to lack of understanding of disease pathogenesis. A variety of therapies for hair cycle arrest have been described with inconsistent efficacy in different dog breeds and sexes; no definitive treatment is available. This report describes the use of a deslorelin acetate implant in two sexually intact adult male keeshonden, both diagnosed with hair cycle arrest. The dogs had progressive alopecia of the trunk that spared the head and distal limbs present for at least 2 yr. Diagnosis of hair cycle arrest was made based on clinical features, dermatohistopathology, and lack of systemic abnormalities. Treatment with a single subcutaneous 4.7 mg deslorelin acetate implant resulted in profuse hair regrowth within 3.5 mo that endured for at least 14 mo. Deslorelin implantation is a management option that is safe, affordable, and appears effective for sexually intact male keeshonden with hair cycle arrest. [ABSTRACT FROM AUTHOR]

The objective of this study was to develop a 3D cell culture model of the human subcutaneous tissue, allowing the prediction of the immunogenicity of subcutaneously injected therapeutic proteins. Several hydrogels were evaluated as scaffolds to mimic the human subcutaneous tissue in vitro . Cytocompatibility of the hydrogels with the human myelomonocytic cell line (MUTZ-3) was investigated, as well as their influence on cellular phenotype changes. Elastic Young’s moduli in compression of the hydrogels were measured by a texture analyser and compared to ex vivo human samples. MUTZ-3 cells were differentiated into dendritic cells before embedding in hydrogels. Agarose at various concentrations (0.5%, 0.35% and 0.25% w/v), Geltrex® matrix and HyStem™ scaffold (1% w/v) displayed a wide range of elastic Young’s moduli from 560 kPa to 49 kPa, compared to the reference value of 23 kPa obtained for human tissue. With the exception of HyStem™, good cytocompatibility of hydrogels was shown at the concentrations tested. An optimal combination of MUTZ-3 cells with 0.25% agarose or Geltrex® is suggested. [ABSTRACT FROM AUTHOR]