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1.
Vet Comp Orthop Traumatol ; 28(3): 179-85, 2015.
Article in English | MEDLINE | ID: mdl-25899684

ABSTRACT

OBJECTIVE: To evaluate the technical feasibility and efficacy of a joint distraction technique to increase the stifle joint space and assess potential soft tissue damage due to the distraction. METHODS: Twenty stifle joints of twelve canine cadavers without evidence of disease were radiographically evaluated by medio-lateral, cranio-caudal and varus-valgus stressed projections. Joint distraction was applied with loads from 40 N up to 200 N, and the joint space achieved was measured on radiographic images. Distraction plus distension with saline was subsequently applied and measured. Varus-valgus stressed projections were repeated after distraction to evaluate a potential increase in joint laxity. RESULTS: Distraction produced a significant increase of the joint space for most of the evaluated loads. Distraction plus distension produced a significant increase for most of the loads compared to the distraction alone. No ensuing joint laxity could be inferred from the post-distraction radiographic evaluation. CLINICAL SIGNIFICANCE: Stifle distraction produces an increase of the joint space, which is wider when intra-articular saline is injected. This may be potentially useful for improving joint structure visualization and facilitating arthroscopic procedures, thus reducing the potential for iatrogenic damage to intra-articular structures. No soft tissue damage could be inferred by radiographic pre- and post-procedure comparison. Further clinical studies are required to evaluate potential neurovascular complications.


Subject(s)
Arthroscopy/veterinary , Stifle/anatomy & histology , Animals , Arthroscopy/instrumentation , Arthroscopy/methods , Dogs , Joint Diseases/diagnosis , Joint Diseases/pathology , Joint Diseases/veterinary , Joint Instability/diagnosis , Joint Instability/pathology , Joint Instability/veterinary , Patient Positioning/veterinary , Radiography , Stifle/diagnostic imaging , Stress, Mechanical
2.
Vet Comp Orthop Traumatol ; 28(2): 116-23, 2015.
Article in English | MEDLINE | ID: mdl-25650590

ABSTRACT

OBJECTIVE: To retrospectively identify factors that predispose to tibial tuberosity (TT) fracture after tibial tuberosity advancement (TTA) in dogs. METHODS: The medical records and radiographs of a group of control dogs (n = 212) that had TTA surgery (n = 241 procedures) and did not sustain a fracture between 2008 and 2013, and those of 12 dogs that did sustain a fracture (n = 13 procedures) between 2008 and 2013 at two veterinary teaching hospitals were evaluated to determine the effect of signalment, body weight and surgical inaccuracies on TT fracture. Multivariable logistic regression was performed with the occurrence of TT fracture as the outcome variable of interest. RESULTS: Signalment and body weight were not found to be associated with TT fracture. Of the surgical inaccuracies, osteotomy shape (p = 0.003), plate position (p = 0.009), and cage position (p = 0.039) were factors significantly associated with TT fracture. CLINICAL SIGNIFICANCE: This study provides data to support the hypothesis that poor plate position, poor cage position, and narrow distal osteotomy width are associated with TT fracture after TTA. We conclude that it is of paramount importance to pay careful attention to surgical technique in order to reduce this risk.


Subject(s)
Dog Diseases/etiology , Orthopedic Procedures/veterinary , Postoperative Complications/veterinary , Tibial Fractures/veterinary , Animals , Body Weight , Dog Diseases/surgery , Dogs , Medical Errors/veterinary , Orthopedic Procedures/adverse effects , Orthopedic Procedures/standards , Retrospective Studies , Risk Factors , Tibial Fractures/surgery
3.
Ground Water ; 53(5): 819-24, 2015.
Article in English | MEDLINE | ID: mdl-25269423

ABSTRACT

A hydrochemical facies evolution diagram (HFE-D) is a multirectangular diagram, which is a useful tool in the interpretation of sea water intrusion processes. This method note describes a simple method for generating an HFE-D plot using the spreadsheet software package, Microsoft Excel. The code was applied to groundwater from the alluvial coastal plain of Grosseto (Tuscany, Italy), which is characterized by a complex salinization process in which sea water mixes with sulfate or bicarbonate recharge water.


Subject(s)
Groundwater/chemistry , Seawater/chemistry , Water Movements , Bicarbonates/chemistry , Hydrology/methods , Italy , Software , Sulfates/chemistry
4.
J Small Anim Pract ; 55(12): 603-8, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25369986

ABSTRACT

OBJECTIVE: To evaluate the technical feasibility and efficacy of a hip joint distraction technique, any potential ligamentous damage linked to the procedure, and the effect of joint venting on the maximum distraction achieved. METHODS: Twenty hip joints from 11 canine cadavers were evaluated radiographically by standard and stressed projections. Joint distraction was applied with loads from 40 up to 200 N, in 40 N increments, and fluoroscopic images were obtained at each load. At 200 N, a needle was inserted into the joint to achieve a venting effect, and the space was measured again. Standard and stressed radiographs were performed to evaluate potential laxity changes. RESULTS: Distraction caused a significant increase in joint space at each load of distraction, although there were some variations. Joint venting produced a significant increase in joint space. A statistically significant difference in joint laxity evaluated radiographically before and after the procedure was recorded. CLINICAL SIGNIFICANCE: Use of the distraction apparatus resulted in an increase in joint space. This could be useful for clinical situations where a larger joint space is required such as for arthroscopic procedures. However, loads in excess of 200 N may induce significant increases in joint laxity.


Subject(s)
Arthroscopy/veterinary , Dogs/surgery , Hip Joint/surgery , Animals , Arthroscopy/methods , Femur Head/diagnostic imaging , Femur Head/surgery , Hip Joint/diagnostic imaging , Radiography
5.
Vet Comp Orthop Traumatol ; 27(2): 148-54, 2014.
Article in English | MEDLINE | ID: mdl-24441572

ABSTRACT

OBJECTIVES: To retrospectively compare two clinical subsets of dogs suffering tibial tuberosity (TT) fracture (incidental finding or sudden onset severe lameness) as a complication of tibial tuberosity advancement (TTA) and to report the surgical management and outcome of TT fracture as a complication of TTA. MATERIAL AND METHODS: The medical records of 10 dogs with eleven TT fractures or crest fractures after TTA were reviewed. The outcome and complications were determined from clinical and radiographic follow-up examinations. Limb function was evaluated between six and 12 weeks postoperatively. Owners were contacted by phone for long-term follow-up at least six months after the last examination. RESULTS: Four dogs required surgical stabilization and six dogs had conservative management. In the surgical group, every case experienced a sudden non-weight-bearing lameness after the initial TTA surgery. In three of the four cases an attempt was made to stabilize the TT and crest fracture while maintaining the TT advancement. Postoperative complications were encountered in three of the four surgically treated cases. Functional outcome was considered excellent in seven cases and good in the other three. CLINICAL SIGNIFICANCE: Tibial tuberosity fracture is a complication of TTA that seems to have a favourable prognosis, although it can result in significant morbidity and in some cases revision surgery may be required.


Subject(s)
Dogs/injuries , Tibia/surgery , Tibial Fractures/veterinary , Animals , Fracture Fixation/methods , Fracture Fixation/veterinary , Lameness, Animal/etiology , Lameness, Animal/surgery , Postoperative Complications/veterinary , Retrospective Studies , Tibial Fractures/etiology , Tibial Fractures/surgery , Treatment Outcome
6.
Vet Rec ; 173(23): 581, 2013 Dec 14.
Article in English | MEDLINE | ID: mdl-24296357

ABSTRACT

Dental disease is now recognised as a major but often unrecognised disorder of equids, including horses and donkeys. However, very few large clinical studies have documented the prevalence and type of dental disease present in different equid populations and no dental studies have been reported in Zamorano-Leonés or Mirandês donkeys, two endangered donkey breeds. Clinical and detailed oral examinations were performed in 400 Mirandês and 400 Zamorano-Leonés donkeys in Portugal and Spain. It was found that just 4.5 per cent had ever received any previous dental care. Cheek teeth (CT) disorders were present in 82.8 per cent of these donkeys, ranging from a prevalence of 29.6 per cent in the <2.5-year-old group to 100 per cent in the >25-year-old group. These CT disorders included enamel overgrowths (73.1 per cent prevalence but with just 6.3 per cent having associated soft tissue injuries), focal overgrowths (37.3 per cent), periodontal disease (23.5 per cent) and diastemata (19.9 per cent). Peripheral caries was present in 5.9 per cent of cases, but inexplicably, infundibular caries was very rare (1.3 per cent prevalence); this may have been due to their almost fully foraged diet. The high prevalence of enamel overgrowths in these donkeys, most which never received concentrates, also raises questions about the aetiology of this disorder. This very high prevalence of CT disorders, especially in older donkeys, was of great welfare concern in some cases and emphasises the need for routine dental care in these cases on welfare grounds and in order to help preserve these unique breeds.


Subject(s)
Equidae , Tooth Diseases/veterinary , Age Factors , Animals , Data Collection , Portugal/epidemiology , Prevalence , Prospective Studies , Spain/epidemiology , Tooth Diseases/epidemiology
7.
J Anim Sci ; 91(10): 4765-71, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23965395

ABSTRACT

The influence of dental correction on nociceptive (pressure) test responses, fecal appearance, BCS, and apparent digestibility coefficient for DM was studied in 18 Zamorano-Leonés donkeys, an endangered local breed from the Zamora province in Spain. For this purpose, donkeys were divided into 2 homogeneous control and treatment groups, based on age, BCS, and dental findings. On d 1, 45, 90, and 135, BCS and nociceptive test responses were evaluated in all donkeys. Feed and fecal samples were collected from all donkeys for 3 consecutive days, starting at each of the aforementioned days. Apparent digestibility coefficient for DM was estimated, using ADL as an internal marker. A progressive decrease of positive nociceptive test responses was observed from d 1 up to 90 (P < 0.01) in the treatment group. No difference between groups was observed for BCS. However, BCS at d 90 was greater (P = 0.018) than observed on d 1 or 45, indicating a time influence. Concerning apparent digestibility coefficient for DM, there were differences among collection days in apparent digestibility coefficient for DM (P < 0.05). No differences in fecal appearance were observed between treatments or collection days. This study highlighted the importance of regular dental care for not only Zamorano-Leonés donkeys but also the equid population, in general, to improve their welfare.


Subject(s)
Body Constitution/physiology , Dental Prophylaxis/veterinary , Digestion/physiology , Equidae , Feces , Pain Measurement/veterinary , Animal Feed/analysis , Animal Nutritional Physiological Phenomena , Animals , Diet/veterinary , Female , Male
8.
Equine Vet J ; 45(2): 187-92, 2013 Mar.
Article in English | MEDLINE | ID: mdl-22943362

ABSTRACT

REASONS FOR PERFORMING STUDY: Noncontrast magnetic resonance angiography (MRA) is widely used in human and small animal medicine. However, this technique has not yet been described in the horse, and compared to other angiographic techniques MRA could be more cost efficient and potentially safer. OBJECTIVES: The aim of this study was to provide a comprehensive anatomical reference of the normal equine head vasculature using a noncontrast MRA technique, on both low- and high-field MRI. METHODS: Five healthy adult horses were examined, 4 with a low-field magnet (0.23T) and the remaining one with a high-field magnet (1.5T). The magnetic resonance angiography sequence used was TOF (time-of-flight) 2D-MRA and CT images of a vascular corrosion cast were subsequently used as anatomical references. RESULTS: The MRA imaging protocol provided good visualisation of all major intra- and extracranial vessels down to a size of approximately 2 mm in diameter on both low- and high-field systems. This resulted in identification of vessels to the order of 3rd-4th branches of ramification. The visibility of the arteries was higher than of the veins, which showed lower signal intensity. Overall, MRA obtained with the high-field protocol provided better visualisation of the arteries, showing all the small arterial branches with a superior resolution. CONCLUSIONS: The use of a specific vascular sequence such as TOF 2D-MRA allows good visualisation of the equine head vasculature and eliminates the need for contrast media for MRA. POTENTIAL RELEVANCE: Magnetic resonance angiography allows for visualisation of the vasculature of the equine head. Vessel morphology, symmetry and size can be evaluated and this may possibly play a role in preoperative planning or characterisation of diseases of the head, such as neoplasia or guttural pouch mycosis.


Subject(s)
Head/blood supply , Horses/anatomy & histology , Magnetic Resonance Angiography/veterinary , Animals , Magnetic Resonance Angiography/methods
9.
J Small Anim Pract ; 49(12): 641-6, 2008 Dec.
Article in English | MEDLINE | ID: mdl-18684138

ABSTRACT

OBJECTIVES: To determine the reliability of early passive hip laxity examination in predicting moderate and severe hip dysplasia. METHODS: The passive hip laxity of 104 Estrela Mountain dogs was evaluated using the Ortolani method, conventional hip-extended radiography and the PennHIP method, when the animals were between four and 12 months of age. After the age of one, dogs were re-examined for hip dysplasia using the Fédération Cynologique Internationale scoring system. The passive hip laxity results were subsequently compared with the Fédération Cynologique Internationale scores for sensitivity, specificity, positive predictive value, negative predictive value and accuracy. RESULTS: The PennHIP method achieved the best results in specificity (93 per cent), positive predictive value (91 per cent) and accuracy (88 per cent), and the Ortolani method was the best in sensitivity (92 per cent) and negative predictive value (92 per cent). CLINICAL SIGNIFICANCE: The Fédération Cynologique Internationale grades D and E can be predicted with confidence even before animals are one year old.


Subject(s)
Hip Dysplasia, Canine/epidemiology , Hip Dysplasia, Canine/pathology , Hip Joint/diagnostic imaging , Joint Instability/veterinary , Age Factors , Animals , Breeding , Dogs , Female , Hip Dysplasia, Canine/diagnosis , Hip Dysplasia, Canine/diagnostic imaging , Joint Instability/diagnosis , Joint Instability/epidemiology , Joint Instability/pathology , Male , Predictive Value of Tests , Radiography , Reproducibility of Results , Sensitivity and Specificity , Severity of Illness Index
12.
Vet Pathol ; 44(1): 84-7, 2007 Jan.
Article in English | MEDLINE | ID: mdl-17197628

ABSTRACT

A 3-year-old female Alaskan Malamute was submitted to the Veterinary Teaching Hospital of Madrid with a mass in the right maxilla. It was ulcerated, covered by a yellowish infected membrane, and painful. The histologic examination showed a neoplastic proliferation of palisading cells distributed irregularly in cords. The tumor was diagnosed as an ameloblastic carcinoma because of the histologic signs of malignancy, the aggressive behavior, and the absence of distal metastasis. This is the first description of an ameloblastic carcinoma in a dog.


Subject(s)
Dog Diseases/pathology , Maxillary Neoplasms/veterinary , Odontogenic Tumors/veterinary , Animals , Biopsy/veterinary , Dog Diseases/surgery , Dogs , Female , Histocytochemistry/veterinary , Maxillary Neoplasms/pathology , Maxillary Neoplasms/surgery , Odontogenic Tumors/pathology , Odontogenic Tumors/surgery
13.
Rehabilitación (Madr., Ed. impr.) ; 40(4): 180-187, jul. 2006. tab
Article in Es | IBECS | ID: ibc-046538

ABSTRACT

Introducción. El objetivo de este trabajo fue elaborar un sistema de clasificación de pacientes en rehabilitación ambulatoria, común para Atención Primaria (AP) y Atención Especializada (AE). Métodos. La elaboración siguió dos etapas:1. Estudio descriptivo de las patologías atendidas a nivel ambulatorio durante el año 2002 en los Centros de Especialidades y un Centro Hospitalario y en las Unidades de Fisioterapia de AP del área sanitaria 1 de la Comunidad de Madrid. Se revisó una muestra aleatoria de 945 historias clínicas de un total de 47.204. 2. Revisión bibliográfica de publicaciones en MEDLINE de sistemas de clasificación de patologías en rehabilitación. Las patologías atendidas en AE se clasificaron en función del diagnóstico principal y en AP en función del motivo de derivación de la consulta del médico de familia a la Unidad de Fisioterapia. Se reagruparon en función de la prevalencia y se codificaron siguiendo los criterios de la Clasificación Internacional de Enfermedades, 9.ª revisión Modificación Clínica (CIE-9-MC) y criterios de la Clasificación Internacional de Atención Primaria (CIAP). Se constituyó un grupo de trabajo con profesionales que participan en el proceso de rehabilitación ambulatoria en el área sanitaria 1 de la Comunidad de Madrid, para consensuar el sistema de clasificación de patologías. Resultados. Elaboración de un sistema de clasificación de patologías en pacientes ambulatorios en rehabilitación, común para AP y AE. Conclusiones. Establecer un único sistema de clasificación de pacientes en el proceso de rehabilitación ambulatoria permite describir el tipo de pacientes que demanda atención y comparar las patologías atendidas en los diferentes centros de los dos niveles asistenciales


Introduction. The objective of the study has been to develop a classification system of patients for use in out-patient rehabilitation for Primary Care (PC) and Specialized Care (SC). Methods. It was developed in two phases:1. Descriptive study of diseases attended in out-patient care during the year 2002 in the speciality centers, hospital center and physiotherapy units of health district 1 primary care of the Community of Madrid. A random sample of 945 clinical records out of a total of 47204 were reviewed. 2. Review of the available literature in MEDLINE in order to find patient classification systems in rehabilitation and to analyze its possible application in our setting. The classification was performed using the principal diagnosis of the patient according to International Classification of Diseases 9th revision Clinical Modification (ICD-9-MC) for patients treated in speciality centers and hospitals centers or International Classification of Primary Care (ICPC) for patients treated in primary care. Secondly, the diseases were grouped based on the prevalence. A workgroup reviewed the patients classification system. The workgroup was constituted by health professionals involved in the process of rehabilitation in out-patient care in health district 1 of the Community of Madrid. Results. Development of a patients classification system in out-patient rehabilitation, common for PC and SC. Conclusions. To establish an unique patients classification system in the process of out-patient rehabilitation makes it possible to describe the type of patients that demands health services and to compare the diseases attended in different centers


Subject(s)
Male , Female , Humans , Rehabilitation Centers/statistics & numerical data , Wounds and Injuries/classification , Wounds and Injuries/rehabilitation , Ambulatory Care/statistics & numerical data , Triage , Physical Therapy Department, Hospital/statistics & numerical data , International Classification of Functioning, Disability and Health
17.
J Vet Dent ; 19(1): 19-21, 2002 Mar.
Article in English | MEDLINE | ID: mdl-11985121

ABSTRACT

Calcinosis circumscripta occurs rarely in dogs and cats, especially in the oral cavity. This case report describes the diagnosis and management of lingual calcinosis circumscripta in an eight-month-old, intact/male German shepherd-cross dog. An excellent prognosis for this disease may be achieved when the patient is managed as described in this report.


Subject(s)
Calcinosis/veterinary , Dog Diseases/diagnosis , Tongue Diseases/veterinary , Animals , Calcinosis/diagnosis , Diagnosis, Differential , Dog Diseases/pathology , Dog Diseases/surgery , Dogs , Male , Tongue Diseases/diagnosis
18.
J Chromatogr A ; 869(1-2): 471-80, 2000 Feb 11.
Article in English | MEDLINE | ID: mdl-10720260

ABSTRACT

The pollution of agricultural land due to herbicides was assessed in the Guareña and Almar river basins, situated in the provinces of Zamora and Salamanca (Spain). A set of fifteen herbicides, including triazines, ureas, amides and others, was selected owing to their frequency of use, the amounts used, their toxicity and their persistence in the environment. Solid-phase extraction with polymeric cartridges, followed by HPLC with diode-array detection, were used to monitor the herbicides. This technique was chosen owing to the wide range of functionality and polarity of the analytes under study. The detection limits obtained were in the 0.004-0.025 microg/l range (lambda=220 nm). Surface and ground waters, taken from different locations in the basins, were analyzed over a 6-month period. The presence of six out of the fifteen herbicides monitored--chlortoluron, atrazine, terbutryn, alachlor, diflufenican and fluazifop-butyl--was detected in several samples at levels ranging from the detection limit to 1.2 microg/l. The relationship of these herbicides to the agricultural activities of the zone is discussed.


Subject(s)
Herbicides/analysis , Water Pollutants, Chemical/analysis , Chromatography, High Pressure Liquid/methods , Spain , Spectrophotometry, Ultraviolet
19.
Vet Surg ; 27(4): 384-91, 1998.
Article in English | MEDLINE | ID: mdl-9662784

ABSTRACT

OBJECTIVE: To determine the analgesic, sedative, and cardiopulmonary effects of epidural ketamine in the horse. ANIMAL POPULATION: Six healthy horses (three males and three females) weighing between 350 and 450 kg. METHODS: Three doses of ketamine were selected (0.5, 1, 2 mg/kg). Two months before the beginning of experiments, the carotid artery was exteriorized, and 1 week before experiments began, an epidural catheter was placed percutaneously in all animals with the tip located 12 cm cranially in the midsacrum. One week later, either saline (control) or one of three doses of ketamine was injected epidurally. Each animal received each ketamine dose and saline in random order at 1-week intervals. Ketamine was diluted in saline 0.9% before the experiment, and the volume used was adjusted to horse size and correlated to clinically used volumes. All the animals received a standard noxious stimulus consisting of needle insertion into the skin and deep muscle using a 3-point scale for scoring the response. A second scale was used to score the degree of sedation. The response to a noxious stimulus, the degree of sedation, and arterial blood pressure were assessed at previously determined intervals: before drug and 2, 5, 10, and 15 minutes and every 15 minutes to 210 minutes after ketamine or saline administration. Arterial blood samples were drawn for blood gas analysis before drug and at 15, 30, 60, and 90 minutes. RESULTS: All the tested doses of ketamine were effective in producing analgesia of the tail, perineum, and upper hindlimb. Total tail and perineal analgesia times were similar depending on dosage (30 minutes for 0.5 and 1.0 mg/kg and 75 minutes for 2.0 mg/kg). A sedative effect of ketamine was also observed in a dose-response manner with a peak effect between 15 and 30 minutes postadministration. No cardiopulmonary effects were observed with any dose of ketamine. CONCLUSIONS: Results indicate that epidurally administered ketamine in the horse produces local spinal and central nervous system effects with analgesia and sedation but minimal cardiopulmonary effects. CLINICAL RELEVANCE: Further studies are required to determine whether the analgesia is sufficient for surgery.


Subject(s)
Analgesia, Epidural/veterinary , Anesthetics, Dissociative , Horses/physiology , Ketamine , Anesthetics, Dissociative/administration & dosage , Anesthetics, Dissociative/adverse effects , Animals , Ataxia/chemically induced , Ataxia/veterinary , Blood Pressure/drug effects , Cross-Over Studies , Dose-Response Relationship, Drug , Female , Heart Rate/drug effects , Injections, Epidural/veterinary , Ketamine/administration & dosage , Ketamine/adverse effects , Male , Perineum , Pulmonary Gas Exchange/drug effects , Single-Blind Method , Tail , Time Factors
20.
Burns ; 24(7): 621-30, 1998 Nov.
Article in English | MEDLINE | ID: mdl-9882060

ABSTRACT

The aim of this study was to develop a new keratinocyte culture system on a dermal equivalent suitable for skin wound closure. Our dermal matrix is based on a fibrin gel from plasma cryoprecipitate containing live human fibroblast (from human foreskin). Keratinocytes obtained from primary culture according to the Rheinwald and Green method, were seeded on the gel at different seeding ratios. In all cases, the keratinocytes plated on the dermal equivalent grew to confluence and stratified epithelium was obtained within 10-15 days in culture. Early expression of basal membrane proteins was detected by immunostaining with laminin and type IV collagen antibodies. Cell proliferation was detected both in the epidermal layer and in the fibroblast embedded in the gel as assessed by BrdU incorporation. Detachment of composite cultures from dishes or flasks is a simple and quick procedure without the need for dispase treatment. Grafting of composite cultures to nude mice gave rise to an orderly stratified, orthokeratinized epithelium resembling human epidermis. A number of advantages including a large expansion factor without the need of 3T3 feeder layer, the availability of fibrin/plasma cryoprecipitate from blood banks and the versatile manipulation of composite cultures suggest that this system could be suitable for the definitive coverage of severely burned patients.


Subject(s)
Fibrin/pharmacology , Fibroblasts/cytology , Keratinocytes/cytology , Skin/cytology , Adult , Animals , Basement Membrane/metabolism , Cell Division , Cells, Cultured , Coculture Techniques , Collagen/biosynthesis , Fibroblasts/metabolism , Follow-Up Studies , Gels , Humans , Infant , Keratinocytes/metabolism , Keratinocytes/transplantation , Keratins/biosynthesis , Laminin/biosynthesis , Mice , Mice, Nude , Skin/drug effects , Skin/metabolism , Skin Transplantation , Wound Healing/physiology
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