Cell-based therapy has been viewed as a promising alternative to organ transplantation, but cell transplantation aimed at organ repair is not always possible. Here, we show that the mouse lymph node can support the engraftment and growth of healthy cells from multiple tissues. Direct injection of hepatocytes into a single mouse lymph node generated enough ectopic liver mass to rescue survival of mice with lethal metabolic disease. Furthermore, thymuses transplanted into a lymph node of athymic nude mice generate a functional immune system capable of rejecting allogeneic and xenogeneic grafts. Finally, pancreatic islets injected into the lymph node of diabetic mice restore normal glucose control. Collectively, these results suggest the practical approach of targeting lymph nodes to restore, maintain or improve tissue and organ functions.

Objective To compare the bursting strength and failure mode of ventral midline celiotomy closed with a simple continuous suture pattern with 1 of 2 knot combinations, a novel self‐locking knot combination of a forwarder start with an Aberdeen end knot (F‐A) and a traditional combination of a surgeon's start with a surgeon's end knot (S‐S). Study design Ex vivo experimental. Sample population Equine cadavers (n = 14). Methods A 20‐cm ventral midline celiotomy was created in 14 equine cadavers. Horses were assigned to celiotomy closure with an F‐A or S‐S knot combination. Prior to closure, a 200‐L inflatable bladder was placed in the abdomen and then insufflated until failure of the celiotomy closure. The horses’ signalment, weight, breed, and age, as well as knot combination type, mode of failure, closure time, and bursting strength (mm Hg) were recorded. Results The median bursting strength was significantly greater when incisions were closed with the F‐A knot combination (388 mm Hg) compared with the S‐S knot combination (290 mm Hg) (P = .035). Most incisions failed along the fascia when closed with F‐A combinations and at the knot when closed with S‐S combinations. Conclusion The bursting strength of ventral midline incisions in equine cadavers was increased by an average of 25% when closed with the self‐locking F‐A knot combination. Clinical significance Closing ventral midline celiotomies with an F‐A knot combination may provide a more secure closure than the traditional S‐S knot combination. Additional in vivo investigation is required prior to recommending this closure in clinical cases.

Acute repeat celiotomy through a RVM incision results in similar incisional healing and tensile strength compared with repeat celiotomy through a RVP incision.

Autologous conditioned serum (ACS) and autologous protein solution (APS) are newer therapeutic options for osteoarthritis (OA). Co-culture of cartilage and synovium stimulated with IL-1β produces a similar physiologic response to tissues from naturally-ocurring OA. The study objective was to investigate the effects of ACS, APS, and triamcinolone (TA) on inflammatory and catabolic gene expression of inflamed joint tissues in co-culture. Blood was collected and processed for ACS and APS from six horses. Cartilage and synovial explants were harvested from the stifle, placed in co-culture, and treated as: (1) unstimulated control (2) stimulated control (3) ACS at 25% v/v (4) ACS at 50% v/v (5) APS at 25% v/v (6) APS at 50% v/v, (7) TA (10 −6 M). Treatment groups 2-7 were stimulated with IL-1β (10 ng/ml). Cultures were maintained for 96 hours, and then both media and explants were harvested for measurement of gene expression and protein. IL-1β stimulation significantly increased IL-1β (p = 0.029), IL-8 (p = 0.011) and MMP-3 (p = 0.043) expression in synovium and IL-1β (p = 0.003) and TNF-α (p = 0.001) expression in cartilage. Treatment with 50% ACS and APS v/v downregulated IL-1β expression in cartilage more than TA treatment (p = 0.001 and p = 0.0004) and APS downregulated MMP-1 expression in synovial membrane (p = 0.025). Treatment with ACS and APS caused a trend in upregulation of IL-10 expression in synovium and type II collagen and aggrecan expression in cartilage. PGE 2 media concentrations were significantly reduced following treatment with APS (13.7-fold decrease, p = 0.0001) and ACS (4.13-fold decrease, p = 0.024); while TA did not reduce PGE 2 significantly (2.3-fold decreased p = 0.406). As disease-modifying therapies, ACS and APS modified the cellular response from synovial membrane and articular cartilage. ACS and APS may offer an improved strategy to improve clinical signs of horses with naturally occurring OA, compared to TA treatment.

Conidiobolus coronatus is one of the most commonly identified upper respiratory fungal pathogens in horses. This article includes a review of clinical signs, diagnostics, treatment and outcomes in previously reported cases of equine conidiobolomycosis, as well as six additional cases seen at our hospital. Each of the six horses presented with a complaint of serosanguinous or haemorrhagic nasal discharge and conidiobolomycosis was confirmed by histopathology and fungal culture. Five horses recovered after administration of antifungal drugs alone (n = 4) or in combination with extensive nasal septum resection (n = 1). Surgical treatment alone was ineffective. One horse was euthanised without treatment because of the extent of the disease.

Summary During the course of a lameness examination, intra‐articular or perineural administration of a local anaesthetic is often necessary to isolate the source of pain causing lameness. Local anaesthetics are useful for intraoperative and post‐operative pain relief and may allow for elimination of, or a decrease in, general anaesthesia. Within recent years, new information has become available concerning the use of local anaesthetics for localisation of pain and for palliation of pain. New information indicates that Lidocaine is less efficacious than mepivacaine or ropivacaine in ameliorating lameness caused by pain. After administering a nerve block, loss of skin sensation may not correlate with loss of pain causing lameness. Local anaesthetic solution must be deposited within the sheath of the neurovascular bundle to be effective. The dose of a local anaesthetic, which is a factor of volume and concentration, affects potency and duration of a nerve block. Local anaesthetics are toxic to chondrocytes and synoviocytes. Lidocaine and bupivacaine appear to be more toxic than mepivacaine or ropivacaine. The clinical significance of the toxic effect of a single intra‐articular injection of local anaesthetic is yet to be determined. Sodium bicarbonate can be added to a local anaesthetic solution to increase its potency and speed of onset. Epinephrine added to local anaesthetic solution prolongs and intensifies its analgesic effect. Mixing quick‐acting, short‐duration and slow‐acting, long‐duration local anaesthetics will not result in a quick‐acting, long‐duration drug combination.

There are several non-steroidal intra-articular therapeutics (NSIATs) available for use by equine practitioners for the treatment of performance-limiting joint-related pathology. Information is limited on perceived clinical efficacy, recommended treatment protocols, and associated complications. Our objective with this cross-sectional survey was to investigate the current clinical usage of NSIATs by equine practitioners. An electronic cross-sectional convenience survey inquiring about the use of steroidal and NSIATS (platelet-rich plasma, autologous conditioned serum, autologous protein solution, cellular therapies, and polyacrylamide hydrogel) was distributed internationally to equine practitioners. A total of 353 surveys were completed. NSIATs were used by 87.5% of the participants. Corticosteroids and hyaluronic acid remain the intra-articular therapeutic of choice among practitioners, followed by autologous conditioned serum, platelet-rich plasma and autologous conditioned protein. Polyacrylamide hydrogel was the least used. Practitioners were more likely to use NSIATs if their caseload was > 50% equine (P < 0.001), they treated more than 10 horses intra-articularly per month (P < 0.001), and horses treated were considered English sport horses (P = 0.02). Years in practice and practice location did not influence the use of NSIATs. One of the most common reasons why NSIATs were chosen was to treat acute articular pathologies. As survey limitations, answers to questions regarding clinical response and complication rates were based on subjective estimation and practitioners recall, not clinical records. In conclusion, corticosteroids remain the most widely used intra-articular therapeutic. Among the NSIATs, blood-based products are more commonly used by practitioners, followed by cellular and synthetic products. Equine practitioners frequently use NSIATs, choosing to treat acute joint pathology more than previously reported.

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