Imaging for local recurrence of breast cancer.

PURPOSE: Isolated locoregional recurrence of breast cancer (ILRR) and contralateral breast cancer (CBC) affect up to 20% of all breast cancer (BC) patients in the first 20 years after primary diagnosis. Treatment options comprise surgical interventions and further systemic therapies depending on the histological subtype. Patients with hereditary breast or ovarian cancer (HBOC) undergo MRI, mammography, and ultrasound in the aftercare of BC, while non-HBOC (nHBOC) patients do not regularly receive MRI. Since early detection is crucial for morbidity and mortality, the evaluation and constant improvement of imaging methods of the breast is necessary. METHODS: We retrospectively analyzed the data of 1499 former BC patients that received imaging of the breast at a tertiary-care university hospital between 2015 and 2020. The analysis comprised various patient characteristics, such as breast density, age, tumor size and subtype, and their influence on BC detection rates by the different imaging methods. RESULTS: Within the patient sample, 176 individuals (11.7% of former BC patients) were diagnosed with either ILRR or CBC. CBC was observed in 32.4% of patients, while both ILRR and secondary breast cancer occurred in 20.5% and 23.9% of all patients. Sensitivity of MRI, mammography, and ultrasound for recurrent malignancy was 97.9%, 66.3%, and 67.8%, respectively. ILRR and CBC detection rates were similar for patients with and without HBOC history. Lower breast density and larger tumor size increased the detection rates of all imaging modalities. CONCLUSION: In breast cancer survivors, MRI might improve the early detection of ILRR and CBC in both HBOC and nHBOC patients.

Bacteraemia before, during and after tooth extraction in horses in the absence of antimicrobial administration.

BACKGROUND: Transient bacteraemia can occur during tooth extraction in humans, and dogs and can lead to severe infectious sequelae. Several case reports describe distant site infections following equine tooth extraction, but the occurrence of bacteraemia during dental surgery has not been evaluated in the horse. OBJECTIVES: To determine if transient bacteraemia occurs during tooth extraction in horses, describe isolated organisms and compare these with those found in the diseased teeth. STUDY DESIGN: Prospective, observational study. METHODS: Blood was collected aseptically for blood culture before, during and after oral extraction of incisor, canine or cheek teeth from 20 adult horses undergoing dental extraction that had not received antimicrobial agents for at least 4 weeks prior to surgery. Bacteria found in blood cultures were compared with those found in swab samples obtained from the extracted teeth. RESULTS: Eighteen of 20 horses had positive blood cultures at one or more time points. Streptococcus spp., Actinomyces spp., Fusobacterium spp. and Prevotella spp. were most commonly found. Bacterial genera isolated from swab samples of extracted teeth largely corresponded with those identified in blood cultures. MAIN LIMITATIONS: This study was limited by its use of only conventional bacterial culture, the lack of statistical analysis to explore associations between gingiva score and the occurrence of bacteraemia, and the lack of an age-matched control group of horses not undergoing exodontia. CONCLUSIONS: Transient bacteraemia of oral origin commonly occurs during dental extraction in horses. As none of the horses developed complications associated with bacteraemia during the observation period after surgery, the significance of this bacteraemia remains uncertain. The Summary is available in Chinese - see Supporting Information.

The cytoskeletal protein LASP-1 differentially regulates migratory activities of choriocarcinoma cells.

PURPOSE: During healthy pregnancy, a distinct but limited invasion of trophoblast cells into the uterus occurs. In contrast, excessive trophoblast invasion is associated with placental choriocarcinoma (CC). Overexpression of the cytoskeletal protein LASP-1 was shown to contribute to cancer aggressiveness. Here, the yet unknown role of LASP-1 in CC cells is analysed. METHODS: Expression of LASP-1 in human primary carcinoma was assessed by immunohistochemistry and confirmed in CC-derived cell lines by immunocytochemistry, RT-PCR and Western blot. After down-regulation of LASP-1 expression with specific si-RNA in CC-derived cell lines, migratory and proliferative activities were analysed by matrigel migration assay and WST-8 test. RESULTS: LASP-1 expression was detected in human primary choriocarcinoma and in JEG-3, JAR and BeWo cells. Knock down of LASP-1 resulted in a decreased expression of LASP-1 protein in JEG-3 and JAR cells accompanied by a diminished migration and a decreased proliferative activity of these two cell lines. Knockdown of LASP-1 in BeWo cells failed. In consequence, migratory function and proliferation was unaffected. CONCLUSION: This is the first study describing LASP-1 expression in CC cells. Detecting an affection of migratory processes after LASP-1 silencing, we propose that LASP-1 could impact on metastasis of CC cells.

Effects of an anabolic steroid (Durateston) on testicular angiogenesis in peripubertal stallions.

The aim of this study was to determine the effect of the anabolic steroid testosterone on the testicular vascularization, angiogenesis and expression of angiogenic factors, and their receptors in testes of peripubertal stallions. Seven peripubertal stallions were treated with Durateston and castrated either 4 (treatment group 1 [TG1]) or 12 weeks (TG2) after the last injection. The castration of seven untreated control stallions (control group [CG]) took place within the same time. In the testicular specimens, volume density (VD), numerical density (ND), and area of vessels were determined morphometrically. Immunohistochemically, the expression of vascular endothelial growth factor (VEGF) and its receptor VEGF-R2; angiopoietin 2 (Ang2) and its receptor Tie2 as well as of transforming growth factor α (TGF-α) was investigated. Morphometrically, the VD of TG1 (P = 0.000) and TG2 (P = 0.001) vessels and the ND of arterioles and venules and capillaries were higher (TG1, TG2: P < 0.05), and the area of capillary cross sections was smaller (TG1, TG2: P < 0.05) than that in the CG. Compared to TG2 horses, TG1 animals showed a higher (P < 0.05) VD and ND of vascular structures and a smaller (P < 0.05) area of capillary cross sections. In numerous vascular structures, especially of TG1, the TGF-α and, to a less extent, the Ang2 and VEGF-R2 expression was significantly higher (P < 0.05) than that in the CG. Sertoli cells in TG2 were characterized by a significantly higher expression (P < 0.05) of VEGF-R2 than in the CG. In summary, the most and smallest vessels could be detected in the testes of TG1. Most likely this is explainable by the highest expression of some angiogenic factors (TGF-α, Ang2) and receptors (VEGF-R2) investigated. This expression behavior may be stimulated by testosterone. As a significant decrease of morphometric parameters could be detected in TG2 compared to TG1, the stimulatory effect of testosterone seems to be temporary.

[Clinical relevant procedures for early pregnancy diagnosis in the mare]. / Klinisch relevante Vorgehensweisen zur frühzeitigen Überprüfung der Konzeption bei der Stute.

This review describes stepwise the recto-manual and transrectal ultrasonographic evidence of early pregnancy detection in the horse. The morphological and physiological conditions in the individual phases of early pregnancy are presented in correlation to the potential clinical findings. The importance of embryonic and early foetal losses is presented. Communication and documentation of findings are also addressed. The final section is devoted to the evaluation of the examination effort. In this regard, it is emphasized that the gynaecological examination for the evaluation of the pregnancy status represents a service contract.

Histomorphological and immunohistochemical characterization of equine granulosa cell tumours.

Benign (n=33) and malignant metastasizing (n=1) granulosa cell tumours (GCTs) from 34 mares aged 3-21 years, and normal (control) ovaries from nine mares aged 3-10 years, were examined histologically and immunohistochemically (for inhibin alpha, glutathione S-transferase alpha [GSTalpha], c-erbB-2 oncoprotein [cerb], cytokeratin, vimentin, desmin and alpha-actin), the results being related where appropriate to clinical signs and endocrinological data. Availability permitting, serum samples from GCT-affected mares before and several weeks after ovariectomy were examined for the following hormones: oestradiol, progesterone and testosterone (by radioimmunoassay); and inhibin B (by a cross-reactive ELISA). Histological examination revealed that the GCTs were predominantly well differentiated neoplasms. The metastasizing GCT differed immunohistochemically from the benign GCTs in respect of the expression patterns of vimentin, cerb and GSTalpha in the granulosa cells. A notable feature was the presence of Leydig-like cells in mares with stallion-like behaviour or elevated serum testosterone, or both. GSTalpha immunolabelling indicated that the Leydig-like cells were potential producers of steroid hormone. From the immunohistochemical and endocrinological findings it was concluded that GCTs produce abnormally high concentrations of inhibin, which reduce the release of follicle-stimulating hormone, leading to atrophy of the contralateral ovary-a finding in 27 of the mares.

[Bacteriological findings for endodontical and apical molar dental diseases in the horse]. / Bakteriologische Befunde bei endodontischen und apikalen Erkrankungen der Backenzähne des Pferdes.

In most cases the diagnosis of any molar dental disease in horses is made at an advanced stage, so that permanent restoration of the diseased teeth is not feasible. Complications such as bacteraemia and septicaemia due to infections as a result of dentogenous sinusitis and following dentosurgical procedures have been described in human medicine and in veterinary medicine. Twenty patients were available for examination from the Clinic for Horses of the School of Veterinary Medicine Hannover with molar dental disease in upper or lower jaw. As a result of this disease the infected tooth had to be removed surgically. The aim of this study was to determine the presence of and to identify microbes in 20 patients. Swab samples were taken from infected pulpa, from dental abscesses and from involved nasal sinuses. The samples were examined microbiologically and tested for aerobes and anaerobes at the same time. Infectious agents were found in 19 of 20 horses. In all, 27 different species of infectious agents were isolated, including both aerobic and anaerobic microbes. Fifteen patients (75%) showed a mixed flora. Further differentiation indicated a preponderance of the group of gram-negative obligatory anaerobic agents isolated from a total of 17 horses. In all these samples there was a high concentration of infectious agents of these genera, the most common of which were Prevotella spp (n = 16) and Fusobacterium spp. (n = 15). Pre-surgical antibacterial therapy is recommended to reduce the risk of intra- and/or post-surgical bacteraemia and its serious consequences. In light of these microbiological results and considering the high degree of resistance among all anaerobic microbes, all patients in this study were treated with Amoxicillin.

[Thermal injury and wound healing of the endometrium subsequent to minimally invasive transendoscopic use of Nd:YAG-laser-and electrosurgery in horses]. / Thermische Verletzung und Wundheilung des Endometriums nach minimal invasiver transendoskopischer Anwendung von Nd:YAG-Laser- und Hochfrequenzchirurgie beim Pferd.

Transendoscopic thermal preparation techniques like laser- or electrosurgery have proved to be most reliable for minimal invasive intrauterine surgery during operative hysteroscopy in mares. To determine the effect of Nd:YAG laser surgery on the endometrium and the complete uterine wall compared with electrosurgery, standard lesions were obtained by transendoscopic monopolar electrosurgery (loop electrode, cutting blade) and Nd:YAG laser surgery (contact, bare fibre, 25 Watt, exposure time four seconds, non contact, 80 Watt, exposure time four seconds) in five healthy mares on days d 0, 7, 14, 18 and 21. The gross effects were controlled endoscopically before the consecutive lesions were set. Following the last diathermic endometrial irritation, hysterectomy was performed under general anaesthesia. Recovery of the mares was uneventful. Specimens from the lesions were collected after dis-section of the uterus, fixed in formalin, routinely embedded and stained with H. E. for histological evaluation. The different energy forms caused tissue alterations of comparable quality but differing in degree. Most intensive peripheral hyperemia and tissue edema occurred on postoperative days three to seven. Non contact laser irradiation initiated maximal amount of fibrinous exudate. Lesions created with a loop electrode were superficial only and did only affect the endometrium. Preparation with an electrosurgical cutting blade or a laser bare fibre resulted in craterlike lesions lined by carbonisation and did involve deeper layers of the myometrium. The lesions caused by non contact laser irradiation affected all layers of the uterine wall. Three weeks postoperatively, reepithelization of the luminal epithelium was completed. The depth of thermal injury and coagulative necrosis, inflammatory reactions and scar formation was greater in lesions created by laser application compared with those set with a loop electrode at power densities comparable to those usually achieved at hysteroscopic surgery. The results suggest that an electrosurgical loop designed for operative hysteroscopy may be a reliable tool for diathermic resection of pathological endometrial structures like uterine cysts characterized by minimal thermal injuries and a short period of reconvalescence. Non contact laser irradiation may result in deep thermal injuries with the risk of delayed uterine perforation but may be profitable for treatment of partly intramural structures like an intramural leiomyoma.

[Standing behavior in horses after inhalation anesthesia with isoflurane (Isoflo) and postanesthetic sedation with romifidine (Sedivet) or xylazine (Rompun)]. / Aufstehverhalten bei Pferden nach Inhalationsnarkose mit Isofluran (Isoflo) und postanästhetischer Sedierung mit Romifidin (Sedivet) bzw. Xylazin (Rompun).

Isofluorane is a modern, only slightly depressive inhalation anaesthetic with excellent pharmacologic characteristics in use in equine medicine. In contrast to halothane, isofluorane is hardly broken down in the liver, but is eliminated by the lung. It low solubility in blood permits excellent control of anaesthesia. However, due to its swift elimination from the organism there is heightened risk of premature recovery from isofluorane anaesthesia. In this study the recovery phases of 96 horses were monitored for its duration and the animals' physical coordination. The horses were divided into four groups. Two groups were sedated with xylazine, one of which received postanaesthetic sedation with xylazine, the other saline solution only. The other two groups were sedated with romifidine, either with or without postanaesthetic sedation after general anaesthesia. In this study the horses of Group 4, sedated with 0.02 mg/kg BW romifidine at the moment of extubation, showed the best recovery phase. The number of attempts to arise was reduced and coordination was better. Similar results were obtained by postanaesthetic sedation with 0.2 mg/kg BW xylazine (Group 2). Premedication with 0.08 mg/kg BW romifidine without postanaesthetic sedation (Group 3) could be carried out at mean duration of anaesthesia of 85 minutes with no negative effects observed during the recovery period. Premedication with xylazine without postanaesthetic sedation (Group 1) is not to be recommended, as the number of attemps to stand up was significantly higher and coordination was either weak or significantly poorer than in the other three groups. The results of this study show that post-anaesthetic sedation of horses with an alpha 2-adrenoceptor agonist can improve the recovery phase after inhalant anaesthesia with isofluorane in regard to the number of attempts to arise and the animals' physical coordination.

[Development of an intrauterine distension pressure for hysteroscopy in the horse]. / Untersuchungen zur Entwicklung eines intrauterinen Distensionsdruckes für die Hysteroskopie beim Pferd.

Diagnostic and operative hysteroscopy have offered an advance in equine fertility diagnostic and equine fertility surgery. A distension of the uterine cavity and an establishment of a continuous intrauterine pressure are basic requirements for complete visualisation of intrauterine structures and safe and efficient surgical procedures. Superelevated pressure and resorption of distension media may result in fatal complications. Intrauterine pressure was monitored in 28 healthy di- or anestrus mares during hysteroscopy via a transcervically inserted catheter. Mares were sedated with xylazine and levornethadon and fixed in a stock. The pressure which was elementary for complete visualisation Parb, the pressure with onset of transcervical efflux of distension medium Pcerv and the maximum intrauterine pressure Pmax that could be obtained were determined. Complete visualisation of intrauterine structures could be achieved with a mean pressure of 17.8 +/- 5.5 mm Hg (mean +/- s) and a range of 12.8 to 28.6 mm Hg. Spontaneous efflux of distension media was registered in mares following further insufflation at a significantly higher (p < 0.001) intracavitary pressure of 62.5 +/- 10.0 mm Hg (mean +/- s). Maximum pressure Pmax that could be obtained was found to be significantly higher (p < 0.001) than Parb but also significantly higher than Pcerv with 101.6 +/- 24.4 mm Hg (mean +/- s). Clinical or cardiological signs of discomfort or affection on the circulatory system were only registered while Pmax was applicated. The results indicate, that a safe and efficient hysteroscopy can be performed with a mean pressure of 17.8 mm Hg and an upper pressure limit of 30 mm Hg.

[Injuries caused by outside violence with forensic importance in horses]. / Verletzungen durch äussere Gewalteinwirkung mit forensischer Bedeutung beim Pferd.

Traumatic injuries are common in horses and may be caused by self-infliction, accident or in an increasing number by an act of violence. Over a four year period, 193 horses with injuries caused by self-infliction or accident were referred to the clinic. In addition, ten horses with injuries associated with an act of violence had to be treated. Those injuries were caused by gunshots, or were stab wounds caused by spear like instruments or knives. Furthermore, cases of zoophilism and zoosadism were observed. Penetrating injuries were potentially life-threatening and in particular injuries with soft tissue damage extending over the limits of visible injury required a special approach. Of the ten horses, seven survived by surgical or medical treatment. Beside of medical aspects, forensic aspects should be considered in such cases.

Functional disturbances in the endometrium of barren mares: a histological and immunohistological study.

Different types of endometrial maldifferentiation were investigated by histopathological (haematoxylin-eosin (HE), periodic acid Schiff-alcian blue and picro-sirius red staining) and immunohistological (oestrogen and progesterone receptors, Ki-67 antigen, intermediate filaments and laminin) analysis of endometrial biopsy specimens from mares (n=34), most of which had been barren for at least 1 year. Two major features were observed: (i) unequal differentiation, in which two functional stages are visible within a single biopsy sample: areas which are differentiated in accordance with the stage of the ovarian cycle and multiple glandular nonfibrotic foci deviating from the dominant physiological pattern; and (ii) irregular endometrial differentiation, in which there are diffuse abnormalities of functional glandular morphology that cannot be appointed to any physiological endometrial stage. The basic diagnosis was made in HE-stained slides. Special stains and immunohistological analysis confirmed endometrial maldifferentiation concerning at least one, but mostly all, of the parameters investigated. Endometrial maldifferentiation was not related to the age or parity of mares, or to the annual season. The aetiopathogenesis and prognosis of endometrial maldifferentiation are not known. However, the findings of the present study indicate that endometrial maldifferentiation should be included in the routine assessment of endometrial biopsy specimens.

[Ascites as a result of peritoneal mesotheliomas in a horse]. / Aszites infolge eines peritonealen Mesothelioms bei einem Pferd.

An abdominal tumor was suspected after clinical evaluation in an eight-year-old, bay-coloured hannoveranian gelding. The diagnosis was based on the symptoms of ascites, on the results of the transcutaneous abdominal ultrasound examination and on the characteristic changes in the serum-electrophoresis. Postmortem a peritoneal mesothelioma was diagnosed. This primary tumor of the peritoneum is rarely described in horses.

[Topography of the organs of the pelvic cavity and macroscopic and histologic findings of the sex organs of a male giant anteater (Myrmecophaga tridactyla) with regard to fertility]. / Topographie der Beckenhöhlenorgane sowie Befunde zur Makroskopie und Histologie der Geschlechtsorgane eines männlichen Grossen Ameisenbären (Myrmecophaga tridactyla) im Hinblick auf seine Fertilität.

A study was conducted on the reproductive organs of a male Giant Anteater. Discussed is the specific anatomy with its effect on fertility. The ovoid testicles are characterized by an intraabdominal position throughout life. Histologically documented is the active spermiogenesis. The accessory sexual glands consist of a glandula prostatica, glandula vesiculares and glandulae bulbourethrales. The short penis is situated immediately ventral to the anus. The existing anatomic individualities in comparison to other mammalia result in special reproductive aspects and should be taken into consideration for successful breeding.