Ventral mandibulectomy for removal of oral tumours in the dog: Surgical technique and results in 19 cases.

The purpose of this retrospective study is to describe in detail a novel ventral approach for mandibulectomy and the results in 19 dogs. The medical records of 19 dogs that received a partial or total unilateral mandibulectomy with the new ventral approach were reviewed. Information obtained included signalment, tumour type, extent of mandibulectomy, removal of regional lymph nodes, intrasurgical complications, immediate postoperative complications, histopathological diagnosis and study of margins. Intrasurgical complication occurred in one dog (haemorrhage) and required a blood transfusion. Postoperative morbidity was minor and included transient ventral cervical swelling and self-limiting sublingual swelling (two dogs). All 19 animals were discharged between 24 and 48 hours of the procedure, and appetite was considered normal at discharge. Some perceived advantages of this procedure include easy identification of all the important anatomic structures in the area, including the inferior alveolar artery and temporo-mandibular joint, and the fact that osteotomy of the zygomatic arch is not necessary (in case of caudal mandibulectomy). In addition, dissection of both mandibular and retropharyngeal lymph nodes is easily achieved by caudal extension of the same skin incision.

Pubectomy and stereotactic radiotherapy for the treatment of a non-resectable sacral osteosarcoma causing pelvic canal obstruction in a dog.

A pubectomy was carried out to relieve obstruction of the pelvic canal in a 6-year-old dog diagnosed with sacral osteosarcoma. Two days after surgery, the dog was ambulatory with normal urination and defecation. Pubectomy is a viable option to relieve clinical signs in patients with pelvic canal obstruction due to a non-resectable tumor.

Pubectomie et radiothérapie stéréotactique pour le traitement d'un ostéosarcome sacral non réséquable causant un blocage du canal pelvien chez un chien. Une pubectomie a été réalisée afin de soulager un blocage du canal pelvien chez une chienne âgée de 6 ans avec un diagnostic d'ostéosarcome sacral. Deux jours après la chirurgie, la chienne était ambulatoire et avait une miction et une défécation normales. La pubectomie représente une option viable pour soulager les signes cliniques chez les patients ayant un blocage pelvien causé par une tumeur non réséquable.(Traduit par Isabelle Vallières).

Hypertrophic osteopathy associated with hepatocellular carcinoma in a dog.

A 9-year-old spayed female dog diagnosed with hepatocellular carcinoma and hypertrophic osteopathy was negative for additional lesions on computed tomography of the thorax and abdomen. Resection of the affected liver lobe resulted in resolution of clinical signs. This is the first case of hypertrophic osteopathy secondary to hepatocellular carcinoma.

Ostéopathie hypertrophique associée à un carcinome hépatocellulaire chez un chien. Un carcinome hépatocellulaire et de l'ostéopathie hypertrophique ont été diagnostiqués chez une chienne stérilisée âgée de 9 ans mais était négative par tomodensitométrie pour des lésions additionnelles au thorax et à l'abdomen. La résection du foie touché a produit une résolution des signes cliniques. C'est le premier cas d'ostéopathie hypertrophique secondaire à un carcinome hépatocellulaire.(Traduit par Isabelle Vallières).

Nurses' perceptions and experiences with end-of-life communication and care.

PURPOSE/OBJECTIVES: To characterize oncology nurses' attitudes toward care at the end of life (EOL) and their experiences in caring for terminally ill patients, hospice discussions with patients and families, and the use of palliative care practices. DESIGN: Descriptive correlational survey study. SETTING: A Magnet®-designated hospital in southern California with more than 500 beds. SAMPLE: 31 oncology nurses. METHODS: Nurses completed the adapted version of the Caring for Terminally Ill Patients Nurse Survey. MAIN RESEARCH VARIABLES: Attitudes toward care at EOL and care experiences with terminally ill patients. FINDINGS: Despite having fairly positive attitudes toward hospice and having discussions about prognosis with terminally ill patients, nurses reported missed opportunities for discussions and patient referrals to hospice. On average, nurses cared for more than seven terminally ill patients during a three-month period while only discussing hospice care with a third of these patients and their family members. Most nurses acknowledged that patients would benefit from earlier initiation of hospice care. Specific palliative care practices used by nurses in the past three months varied, with active and passive listening and requesting increased pain medications used most frequently and aromatherapy and guided imagery used least. CONCLUSIONS: Missed opportunities may reflect nurses' attitudes. However, lack of patient and family member acceptance was the most important barrier to discussion of hospice. IMPLICATIONS FOR NURSING: Strategies to enable nurses to have a stronger voice during this critical time for their patients are needed and, when developed, supported in practice to ensure that they are used.

Great vessel development requires biallelic expression of Chd7 and Tbx1 in pharyngeal ectoderm in mice.

Aortic arch artery patterning defects account for approximately 20% of congenital cardiovascular malformations and are observed frequently in velocardiofacial syndrome (VCFS). In the current study, we screened for chromosome rearrangements in patients suspected of VCFS, but who lacked a 22q11 deletion or TBX1 mutation. One individual displayed hemizygous CHD7, which encodes a chromodomain protein. CHD7 haploinsufficiency is the major cause of coloboma, heart defect, atresia choanae, retarded growth and development, genital hypoplasia, and ear anomalies/deafness (CHARGE) syndrome, but this patient lacked the major diagnostic features of coloboma and choanal atresia. Because a subset of CHARGE cases also display 22q11 deletions, we explored the embryological relationship between CHARGE and VCSF using mouse models. The hallmark of Tbx1 haploinsufficiency is hypo/aplasia of the fourth pharyngeal arch artery (PAA) at E10.5. Identical malformations were observed in Chd7 heterozygotes, with resulting aortic arch interruption at later stages. Other than Tbx1, Chd7 is the only gene reported to affect fourth PAA development by haploinsufficiency. Moreover, Tbx1+/-;Chd7+/- double heterozygotes demonstrated a synergistic interaction during fourth PAA, thymus, and ear morphogenesis. We could not rescue PAA morphogenesis by restoring neural crest Chd7 expression. Rather, biallelic expression of Chd7 and Tbx1 in the pharyngeal ectoderm was required for normal PAA development.

Expression of avian Groucho-related genes (Grgs) during embryonic development.

Groucho-related genes (Grgs) encode transcriptional co-repressors of Lef/Tcf and Hes proteins, which are mediators of Wnt and Notch signalling, respectively. Thus, they are important players in the developmental processes controlled by Wnt and Notch signalling, including lateral inhibition, segmentation and dorso-ventral patterning. We have cloned the avian homologues of Grg genes and examined their expression pattern by whole-mount in situ hybridisation between Hamburger-Hamilton (HH) stages 3 and 24. At HH stage 3, Grg gene expression is detected in the primitive streak and Hensen's node. Later, Grg genes are expressed at high levels in the developing head fold and by HH stage 11, throughout the anterior CNS and in the ventricular zone of the neural tube. In addition, Grg2, Grg4 and Grg5 are expressed in the notochord. In the paraxial mesoderm, Grg genes are activated as soon as somites form. As somites mature, Grg1 and Grg5/AES are expressed predominantly in the medial myotome and dermomyotome, whereas Grg2, Grg3 and Grg4 are expressed throughout the myotome. In HH stage 20 limbs, Grg1, Grg3 and Grg4 transcripts are more abundant in the posterior limb bud, whereas Grg2 and Grg5/AES are expressed throughout. By HH stage 24, Grg1, Grg2 and Grg3 become localized to the dorsal and ventral limb muscle masses, whereas Grg4 and Grg5/AES occupy a more central and ventro-proximal domain, respectively. Overall, our expression data are consistent with a role for Grg genes in Lef/Tcf and Wnt signalling during somitogenesis and with a role in Hes and Notch signalling in neurogenesis.