Summary Reasons for performing study: Equine melanomas occur most commonly in grey horses at age 5 years or more. Generally, benign and malignant melanomas are distinguished by microscopy, but a more distinct classification would be helpful. Objectives: The objectives of this study were to gain further evidence concerning the occurrence of melanotic tumours, and to evaluate the impact of heredity on melanoma development. Methods: A clinical study was conducted on a defined population of 296 grey horses of Lipizzaner breed. Individuals were classified according to theirstage of disease using a 0–5 scale. Heritability was estimated on a sample of 296 grey horses with pedigrees traced back as far as 32 generations. Results: Of the 296 horses, dermal melanomas were present in 148 horses (50%), 68 of which were more than age 15 years; 51 of these were melanoma‐bearing. In 75.6% of cases, melanotic tumours were detected underneath the tail. Although melanoma‐bearing grey horses were encountered up to stage 4, none of the affected individuals suffered any severe clinical effect or was handicapped in performance. Statistical analysis revealed highly significant effects of stud and age (P<0.0001), explaining 28% of the total variability. Conclusions: In contrast to melanomas in solid‐coloured horses characterised by early metastases, melanomas in grey horses showed less malignancy. Affected individuals often had encapsulated nodules or structures similar to human blue nevi. Grey horse‐specific genetic factors inhibiting metastatic processes may be responsible for this phenomenon. Potential clinical relevance: Although the obtained heritability estimate of 0.36 with a standard error of 0.11 indicates a strong genetic impact on the development of melanoma in ageing grey horses, a possible influence of the genes with large effects was also suggested. Therefore, further analysis is required of melanoma development in the ageing grey horse.

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For improved control of the degree of arytenoid cartilage abduction during laryngoplasty, use of a nylon suture system with metal crimps should be considered.

Background: The Edwards Intuity Valve System is a bioprosthesis with a balloon-expandable stent frame which enables rapid-deployment (RD). We aimed to analyze our single-center long-term experience with a follow-up until 9 years after aortic valve replacement (AVR) with this bioprosthesis. Methods: Between May 2010 and May 2019, 700 consecutive patients with severe aortic stenosis or combined aortic valve disease, implanted with a RD valve at our institution, were included in a prospective database. Median follow-up was 19 months and the total accumulated follow-up was 2,140 patient-years. Pre-operative characteristics, operative parameters, survival rates, valve-related adverse events and valve hemodynamics were assessed. Results: Mean age was 74±8 years, 45% female. Concomitant procedures were performed in 339 (48.4%) patients. In case of isolated AVR (361/700), a minimally invasive surgical (MIS) approach was conducted in 283 patients (78.4%). Cardio-pulmonary bypass (CPB) and cross-clamp times for isolated AVR were 107.7±28.2 and 73.8±21.3 minutes for MIS approaches and 92.8±28.8 and 57.5±20.6 minutes for full sternotomy (P<0.001), respectively. Mean gradients at discharge, 1, 3 and 5 years were 13±5, 11±4, 12±5 and 13±8 mmHg. New early pacemaker implantation was required in 8.9% of patients. Re-intervention or reoperation with valve explantation for structural degeneration, non-structural dysfunction or endocarditis, occurred in 21 cases (3%). Thirty-day mortality was 0.7% (5/700) and overall survival at 1, 3 and 5 years was 98%, 91% and 76%. Conclusions: We report excellent long-term results in this updated single center experience for RD aortic valves regarding durability, safety and hemodynamic performance.

Of these patients, 122 were available for follow-up examinations, on average 5.9 years (range 2.2-12.3 years) after the original injury. The operative procedure was carried out as described by Kirchmayr in 19176 utilizing non-resorbable suture material in all instances. This group consisted of 15 women and 107 men with an average age of 41.1 years (range 22.0-74.0 years).Postoperatively, the affected extremity was immobilized for 2 weeks in an long-leg cast in 300 of plantar flexion in the ankle, which was then reduced to 150 for the second two week period. For the final 2 weeks of a 6 week immobilization period a short-leg walking cast in neutral position was applied. For the following 3 months a heel elevation of 1.5 cm was prescribed. A programme of physical therapy was only necessary in isolated instances.Of the 122 patients available for follow-up examinations, 50 also completed a questionnaire concerning the subjective results. An ultrasound examination using the Siemens Sonolinee model with a 5.0 Mhz linear transducer was carried out on 71 patients (9 women, 62 men; average age 44 years). The examination was performed with the ankle in a neutral position. The classification of the internal structure of the Achilles tendon was carried out using a modification of the Thermann model3 and the 121