Pilot study to determine the feasibility of radiation therapy for dogs with right atrial masses and hemorrhagic pericardial effusion.

OBJECTIVES: To determine the short-term safety and biologic activity of radiation therapy (RT) for presumptive cardiac hemangiosarcoma in pet dogs. ANIMALS: Six dogs with echocardiographic evidence of a right atrial/auricular mass, and hemorrhagic pericardial effusion, were enrolled in a prospective, single-arm clinical trial. METHODS: A single fraction of 12 Gy was delivered using conformal external beam irradiation. Serum cardiac troponin I and plasma concentrations of vascular endothelial growth factor were quantified before, 4 and 24 h after RT. The frequency of required pericardiocenteses (quantified as the number of pericardiocenteses per week) before RT was compared to that after treatment. Overall survival time was determined. RESULTS: No treatment-related complications were observed. Pericardiocentesis was performed an average of 0.91 times per week before RT, and an average of 0.21 times per week after RT; this difference was statistically significant (p=0.03, as compared using a Wilcoxon signed-rank test of paired data). Pre- and post-treatment plasma vascular endothelial growth factor concentrations were not significantly different at any time point; there was a statistically significant (p=0.04; Friedman's test for non-parametric repeated measures) increase in cardiac troponin concentrations 4 h after irradiation. Median overall survival time was 79 days. CONCLUSIONS: In this population of dogs, RT was delivered without complication, and appears to have reduced the frequency of periacardial tamponade that necessitated pericardiocentesis. Serum cardiac troponin levels are altered after RT. RT alone, or in combination with chemotherapy, may provide clinical benefit to dogs with presumptive diagnoses of cardiac hemangiosarcoma.

Permeability of latex gloves after contact with dental materials.

The use of latex examination gloves in the dental office has become the standard of care. However, the effectiveness of gloves as a barrier after coming into contact with specific dental materials is still uncertain. To examine the effects of dental materials is still uncertain. To examine the effects of dental materials on latex, 100 latex examination glove finger tips were divided into 10 groups. Each group was manipulated in a different dental material for 15 minutes. Permeability was detected by the passage of herpes virus across the latex membrane, rinsed from the inner glove surface and titrated onto Vero cells. Significant virus leakage was discovered in gloves treated with acrylic monomer, chloroform, and orange solvent. Little virus leakage was noted in bleach, soap, and 30% phosphoric acid etchant treated gloves, and no virus leakage was found with composite resin, ethanol, formocresol, and water treated gloves. These data were supported with scanning electron micrographs taken of the treated glove samples and comparing with the controls. When certain dental materials are manipulated while wearing gloves, irreversible damage to the material occurs and may increase the practitioner's exposure to pathogens.

Saline inflatable prostheses: 14 years' experience.

This article presents the author's experience with saline implants from 1977 through 1991. One thousand ninety-one women underwent cosmetic breast augmentation during that period. The accumulated surgical data represents the collective practice of the author during that period. From 1977 through 1981 all implants were placed in the submammary position. From 1982 through 1991 all implants were placed in the subpectoral position. The author reviews his experience including complications and results. The data supports the conclusion that saline implants are an effective, viable alternative to gel-filled implants for cosmetic breast augmentation.

Angioscopy in endovascular surgery: recent technical advances to enhance intervention selection and failure analysis.

Recent technical and procedural modifications have greatly enhanced the usefulness of angioscopy during angioplasty. A pulsed irrigation system, proximal and distal blood flow control by pressure, and attention to sheath/vessel diameter ratio were incorporated into a study in which angioscopy was used for pretreatment assessment in 23 patients with symptomatic peripheral vascular disease presenting for initial (8 patients) evaluation or repeat treatment (15 patients) following a previous vascular procedure. Twenty-five lesions were examined with a 2.3 mm flexible angioscope equipped with an irrigating lumen; there were no complications attributable to angioscopy. The angioscope was useful in the characterization of lesions for selection of the recanalization technique. Lesions more amenable to initial atherectomy were visualized in 12 patients; 7 occlusions were successfully treated with laser/balloon angioplasty, with angioscopy assisting in probe and/or wire passage in 4 cases. Three late reocclusions were identified angioscopically as due solely to thrombosis, indicating the need for thrombolytic therapy. Angioscopy also identified 4 cases of incomplete recanalization despite a satisfactory arteriographic image. Angioscopy was also used to evaluate stenotic lesions unaccompanied by thrombus formation in patients previously treated with laser-assisted angioplasty. Histologic evaluation of the biopsied plaques identified intimal hyperplasia as the etiology, matching identically similar specimens harvested from a lesion treated with balloon dilation only.

Nine-year experience with subpectoral breast reconstruction after subcutaneous mastectomy in 98 patients utilizing saline-inflatable prostheses.

Over the past nine years, the saline-inflatable breast prosthesis has been used exclusively for submuscular reconstruction after subcutaneous mastectomy in 98 patients. Its expansion capability offers greater versatility in addressing various reconstructive situation. Acting as an immediate tissue expander, it accommodates a larger residual skin envelope or expands a smaller one for better cosmetic results. A low percentage of capsular contracture results in significant softness of the reconstructed breast. Indications, complications, technical considerations, and interesting findings are included for readers' consideration. The saline-inflatable breast prosthesis offers a unique alternative to the silicone and foam-covered prosthesis for subcutaneous mastectomy breast reconstruction.

Is the lacrimal apparatus injured following cosmetic rhinoplasty?

A study was undertaken to test the validity of the belief that lacrimal apparatus injury is common in patients who undergo a cosmetic rhinoplasty. Dacryocystography was done in 15 patients immediately following the lateral osteotomy, and there was no evidence of lacrimal sac injury or extravasation of the dye in any patient.

Congenital scalp defect with thrombosis of the sagittal sinus. Case report.

A case report of a congenital scalp defect, associated with thrombosis of the superior sagittal sinus, is presented. A thrombectomy of the sinus, followed by skin grafting, was successful in achieving wound closure and a healthy, normal child. We propose that thrombectomy be considered for future similar situations.

The failure to survive of autogenous free grafts of whole gracilis muscles in dogs.

An experimental study was undertaken to define the limits in size (if any) of successful free autogenous grafts of skeletal muscle. In 8 dogs, 16 gracilis muscle grafts were transplanted to the contralateral hind limb. The left hind limb served as a control for the right side, which contained paralyzed muscle. Macroscopic, microscopic, and EMG analyses demonstrated a complete failure of the free muscle grafts to take and survive. We have shown that one can exceed the limitations to the size of a successful muscle graft. Perhaps future investigators will define exactly what the maximum viable size is.