Sonographic and pathological features of metaplastic squamous cell carcinoma of the breast: a case series

OBJECTIVE

The aim of this study was to evaluate the sonographic features and to compare the sonographic findings with the pathologic features.

METHODS

The sonographic and pathological features of all patients were retrospectively reviewed.

RESULTS

All these 9 patients presented with a palpable breast mass first found by the patient before presentation. The median diameters were 3.67 cm. On two-dimensional imaging, 8 masses showed mixed echogenicity with both solid and cystic components, and only 1 mass showed hypoechoic. All the masses had irregular shapes. 1 mass had indistinct margin and 8 masses had microlobulated margins. Calcifications was seen in 1 mass. On color Doppler flow imaging, 8 masses had high vascularity with high resistance index; 5 masses had grade III blood flow signal; 3 masses had grade II blood flow signal. On histopathological examination, 5 masses were adenocarcinoma with squamous metaplasia, and 4 masses were pure SCC. On immunohistochemical staining, estrogen receptors (ER), progesterone receptors (PR) and human epidermal growth factor receptor (HER2) were negative in 5 masses. There were 2 patients with lymph node metastasis.

CONCLUSIONS

Most of the sonographic features of MSCC were mixed echogenicity with central cystic components, posterior echo enhancement, abundant vascularity with high resistance.

[Single-stage combined anterior-posterior stabilization and fusion for superior and distant cervical spine fractures]

OBJECTIVE

To evaluate the applicability and safety of single-stage combined anterior-posterior stabilization and fusion for superior and distant cervical spine fracture.

METHODS

Ten patients with superior and distant cervical spine fracture and/or dislocation aged 30 approximately 68, 8 males and 2 females, underwent single-stage combined anterior-posterior stabilization and fusion. For most cases, especially those whose inferior cervical fracture was without complete bilateral lock of small joints, anterior procedures were performed, including subtotal corpectomy or diskectomy and allograft iliac crest and plates placement, prior to the posterior procedures. For those cases with unstable superior cervical fracture and inferior cervical fracture with bilateral lock of small joints, posterior procedures, including the application of Apofix or Atlas instruments to reposition the atlanto-axial joint, were performed prior to anterior procedures. A hard cervical collar was used postoperatively in all patients. All patients were followed up for 29 months on average.

RESULTS

Satisfying fusion and reduction was obtained in all 10 patients (100%). There were no cases of nerve root injury, strut graft extrusion, or plate or screw looseness or fracture.

CONCLUSION

The combined single-stage anterior-posterior stabilization, reconstruction, and instrumentation procedure represents a viable option in the treatment of a group of patients with superior and distant cervical spine fracture. The technique provides immediate rigid stabilization of the cervical spine, eliminates the need for Halo immobilization or skull distraction and helps begin functional exercise dirigation earlier.

The role of ultrasound combined with water bath in the establishment of animal models of rat urethral stricture

Urinary tract injuries represent a significant clinical challenge, necessitating precise diagnosis and effective treatment strategies. Rat models are preferred for studying urinary tract injuries due to their size, visibility of external genitalia, and robust reproductive and growth capabilities. However, there is a lack of standardized methodologies for evaluating the endpoints of rat urinary tract injury models. This study aimed to investigate the methodology of model establishment, imaging evaluation techniques, and endpoint effectiveness. Twenty-four male Sprague-Dawley rats were randomly assigned to groups, including a blank control group and surgical groups. The surgical groups underwent urethral injury induced by recombinant transforming growth factor-β1 (TGF-β1) solution, followed by the random selection of one surgical group (n = 6) to receive treatment with mesenchymal stem cell (MSC) exosomes. High-frequency ultrasonography using a GE E10 device combined with a water bath method was employed to evaluate the urethral conditions of all rats. Ultrasonographic characteristics were scored for all surgical group rats, and an intergroup analysis was conducted between the surgical group and the control group rats. Statistical analysis was conducted using SPSS 22.0 software. Ultrasonographic assessment revealed significant differences in urethral echogenicity between the normal group and the surgical group, with noticeable changes in urethral morphology post-injury. Histopathological examination confirmed more severe urethral stenosis in the TGF group compared to the MSC group. High-frequency ultrasound could effectively differentiate between the two groups of rats. Additionally, there were significant differences in the scoring of ultrasonographic characteristics between the two groups. Urethral stricture presents a complex challenge in urology, often requiring invasive treatment modalities. The establishment of animal models plays a crucial role in understanding and addressing this condition. TGF-β1 induced fibrosis and MSC therapy represent promising avenues for urethral stricture management. High-frequency ultrasound combined with the immersion method offers a non-invasive and cost-effective approach for evaluating rat urethral stricture models. This study highlights the practicality of high-frequency ultrasound combined with the water bath method in evaluating rat urethral stricture models, as it can effectively differentiate between rats in the pure TGF-β1 induced group and those in the MSC treatment group based on urethral changes. The results underscore the importance of standardized methodologies for model assessment and the potential of non-invasive imaging techniques in preclinical research. Overall, this study contributes to advancing our understanding of urinary system injuries and holds implications for future therapeutic interventions in urology.

[High-frequency ultrasonography for evaluation of the urethral stricture model in rats]

OBJECTIVE

To explore the methodology for the establishment of the urethral stricture model in rats, the methods of end-point imaging evaluation of the model establishment and their efficiency.

METHODS

Twenty-four adult male rats were randomly divided into a blank control (n = 6) and a model group (n = 18), and the model was established by cutting the penile segment of the urethra to induce incomplete urethral rupture. Then the model rats were treated by injection of transforming growth factor-β1 (the TGF group, n = 6) or mesenchymal stem cells (the MSC group, n = 12) into the urethral cavernosum. At 4 weeks after modeling, the urethral condition of all the rats was evaluated blindly using high-frequency ultrasound combined with water bath, followed by comparison among different groups.

RESULTS

Compared with the blank controls, the model rats showed evident urethral stricture, with more significant urethral fibrous tissue hyperplasia in the TGF than in the MSC group. Ultrasonography revealed significantly narrowed echo strips (P < 0.01), decreased echo intensity and blurred echoes in some strips. The grouping of the model rats according to the assigned values to the ultrasonographic changes was consistent with the actual condition. The area under the ROC curve for distinguishing between the TGF and MSC groups was 0.972, with a sensitivity of 100.0% and a specificity of 83.3% when ultrasound assignment score was 7.5.

CONCLUSIONS

High-frequency ultrasonography combined with water bath is effective for evaluating urethral stricture in rats and may give some guidance in the establishment of the urethral stricture model.

[Effect of neurotoxin on spinal cord injury in rats]

OBJECTIVE

To elucidate the effect of neurotoxin, excitatory amino acid and neuropeptide on spinal cord injury post trauma.

METHODS

We detected the changes of concentration of EAA, glutamate(Glu) and aspartate(Asp) at injured segment tissue after spinal cord injury. Changes in dynorphin DynA1-13, an endogenous opioid, immnoreactivity following traumatic spinal cord injury in the rat were examined. We observed the effects of Glu and dynorphin DynA1-13 administered intrathecally on function of spinal cord in rats and the effects of 3-(2-carboxypiperazin-4-yl)propyl-1-phosphonic acid (CPP), an antagonist of EAA receptor, and antisera against dynorphin administered intrathecally on secondary spinal cord injury.

RESULTS

The concentrations of EAA and dynorphin DynA1-13 increased progressively along with the severity of injury, and were related to injury time. Glu exacerbated the extent of spinal cord injury. Dynorphin DynA1-13 administered intrathecally caused dose-related hindlimb paraplysis in rats, whereas CPP and antisera against dynorphin DynA1-13 were found to have protective effect on spinal cord injury.

CONCLUSION

These findings further support the potential pathophysiological role of EAA and dynorphin DynA1-13 as neurotoxin in spinal cord injury.

[Changes of N-methyl-D-aspartate receptor in spinal cord after trauma]

N-methyl-D-aspartate (NMDA) receptor-mediated events have implicated in the pathophysiology of posttraumatic spinal cord injury. In the present study, [3H] CPP was used as ligand to analyse the changes in NMDA receptor-binding sites in synaptic plasma membranes (SPM) isolated from rat spinal cord after impact trauma at T10. Radio-binding assays of [3H] CPP showed a specific and saturable binding site for [3H] CPP in spinal cord tissue. Scatchard analysis revealed the binding of [3H] CPP has one site with low affinity (Kd = 3.51 < or = 0.26 nM) and binding density (Bmax = 662.82 < or = 47.59 fmol/mg protein). [3H] CPP binding to NMDA receptor at the thoracic segment was significantly (P < 0.01) decreased posttrauma. Time-course studies demonstrated significantly decrease in the binding of [3H] CPP at 4 h after spinal cord injury with recovery by 24 h. Scatchard analysis results indicate that the posttrauma decrease of [3H] CPP-binding resulted from alteration in receptor binding density The data from the present study provided further evidence for a role for NMDA receptor-mediated mechanisms in the pathological consequences of spinal cord injury. The acute reduction in [3H] CPP-binding after trauma may reflect down-regulation of NMDA receptor as a consequence of posttraumatic glutamate release and may serve to limit excitotoxin-induced injury.