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Novel expression pattern of cytosolic Gln synthetase in nitrogen-fixing root nodules of the actinorhizal host, Datisca glomerata.

Gln synthetase (GS) is the key enzyme of primary ammonia assimilation in nitrogen-fixing root nodules of legumes and actinorhizal (Frankia-nodulated) plants. In root nodules of Datisca glomerata (Datiscaceae), transcripts hybridizing to a conserved coding region of the abundant nodule isoform, DgGS1-1, are abundant in uninfected nodule cortical tissue, but expression was not detectable in the infected zone or in the nodule meristem. Similarly, the GS holoprotein is immunolocalized exclusively to the uninfected nodule tissue. Phylogenetic analysis of the full-length cDNA of DgGS1-1 indicates affinities with cytosolic GS genes from legumes, the actinorhizal species Alnus glutinosa, and nonnodulating species, Vitis vinifera and Hevea brasilensis. The D. glomerata nodule GS expression pattern is a new variant among reported root nodule symbioses and may reflect an unusual nitrogen transfer pathway from the Frankia nodule microsymbiont to the plant infected tissue, coupled to a distinctive nitrogen cycle in the uninfected cortical tissue. Arg, Gln, and Glu are the major amino acids present in D. glomerata nodules, but Arg was not detected at high levels in leaves or roots. Arg as a major nodule nitrogen storage form is not found in other root nodule types except in the phylogenetically related Coriaria. Catabolism of Arg through the urea cycle could generate free ammonium in the uninfected tissue where GS is expressed.

Base Sequence↗

Drought Stress, Permeability to O2 Diffusion, and the Respiratory Kinetics of Soybean Root Nodules.

In legume nodules, treatments such as detopping or nitrate fertilization inhibit nodule metabolism and N2 fixation by decreasing the nodule's permeability to O2 diffusion, thereby decreasing the infected cell O2 concentration (Oi) and increasing the degree to which nodule metabolism is limited by O2 availability. In the present study we used nodule oximetry to assess and compare the role of O2 limitation in soybean (Glycine max L. Merr) nodules inhibited by either drought or detopping. Compared to detopping, drought caused only minor decreases in Oi, and when the external O2 concentration was increased to raise Oi, the infected cell respiration rate in the drought-stressed plants was not stimulated as much as it was in the nodules of the detopped plants. Unlike those in detopped plants, nodules exposed to moderate drought stress displayed an O2-sufficient respiration rate that was significantly lower than that in control nodules. Despite possible side effects of oximetry in altering nodule metabolism, these results provided direct evidence that, compared to detopping, O2 limitation plays a minor role in the inhibition of nodule metabolism during drought stress and changes in nodule permeability are the effect, not the cause, of a drought-induced inhibition of nodule metabolism and the O2-suffiecient rate of respiration.

Journal Article↗

Glutathione and homoglutathione synthesis in legume root nodules.

High-performance liquid chromatography (HPLC) with fluorescence detection was used to study thiol metabolism in legume nodules. Glutathione (GSH) was the major non-protein thiol in all indeterminate nodules examined, as well as in the determinate nodules of cowpea (Vigna unguiculata), whereas homoglutathione (hGSH) predominated in soybean (Glycine max), bean (Phaseolus vulgaris), and mungbean (Vigna radiata) nodules. All nodules had greater thiol concentrations than the leaves and roots of the same plants because of active thiol synthesis in nodule tissue. The correlation between thiol tripeptides and the activities of glutathione synthetase (GSHS) and homoglutathione synthetase (hGSHS) in the nodules of eight legumes, and the contrasting thiol contents and activities in alfalfa (Medicago sativa) leaves (98% hGSH, 100% hGSHS) and nodules (72% GSH, 80% GSHS) indicated that the distribution of GSH and hGSH is determined by specific synthetases. Thiol contents and synthesis decreased with both natural and induced nodule senescence, and were also reduced in the senescent zone of indeterminate nodules. Thiols and GSHS were especially abundant in the meristematic and infected zones of pea (Pisum sativum) nodules. Thiols and gamma-glutamylcysteinyl synthetase were also more abundant in the infected zone of bean nodules, but hGSHS was predominant in the cortex. Isolation of full-length cDNA sequences coding for gamma-glutamylcysteinyl synthetase from legume nodules revealed that they are highly homologous to those from other higher plants.

Amino Acid Sequence↗

Nitrogen Fixation, Nodule Development, and Vegetative Regrowth of Alfalfa (Medicago sativa L.) following Harvest.

Nitrogenase-dependent acetylene reduction, nodule function, and nodule regrowth were studied during vegetative regrowth of harvested (detopped) alfalfa (Medicago sativa L.) seedlings grown in the glasshouse. Compared with controls, harvesting caused an 88% decline in acetylene reduction capacity of detached root systems within 24 hours. Acetylene reduction in harvested plants remained low for 13 days, then increased to a level comparable to the controls by day 18.Protease activity increased in nodules from harvested plants, reached a maximum at day 7 after harvest, and then declined to a level almost equal to the control by day 22 after harvest. Soluble protein and leghemoglobin decreased in nodules from harvested plants in an inverse relationship to protease activity.Nitrate reductase activity of nodules from harvested plants increased significantly within 24 hours and was inversely associated with acetylene reduction. The difference in nitrate reductase between nodules from harvested plants and control plants became less evident as shoot regrowth occurred and as acetylene reduction increased in the harvested plants.No massive loss of nodules occurred after harvest as evidenced by little net change in nodule fresh weight. There was, however, a rapid localized senescence which occurred in nodules of harvested plants. Histology of nodules from harvested plants showed that they degenerated at the proximal end after harvest. Starch in the nodule was depleted by 10 days after harvest. The meristem and vascular bundles of nodules from harvested plants remained intact. The senescent nodules began to regrow and fix nitrogen after shoot growth resumed.

Journal Article↗

Distribution of N within Pea, Lupin, and Soybean Nodules.

The (15)N abundance of some, but not all, legume root nodules is significantly elevated compared to that of the whole plant. It seems probable that differences in (15)N enrichment reflect differences in the assimilatory pathway of fixed N. In that context, we have determined the distribution of naturally occurring (15)N in structural fractions of nodules from soybean (Glycine max L. Merr.), yellow lupin (Lupinus luteus), and pea (Pisum sativum) nodules and in chemical components from soybean nodules and to a lesser extent, pea and lupin nodules. None of the fractions of pea nodules (cortex, bacteriod, or host plant cytoplasm) was enriched in (15)N. The differences among bacteriods, cortex, and plant cytoplasm were smaller in lupin than in soybean nodules, but in both, bacteriods had the highest (15)N enrichment. In soybean nodules, the (15)N abundance of bacteriods and cortex was higher than plant cytoplasm, but all three fractions were more enriched in (15)N than the entire plant. Plant cytoplasm from soybean nodules was fractionated into protein-rich material, nonprotein alcohol precipitable material (NA), and a low molecular weight fraction. The N of the latter was further separated into N of ureides, nucleotides and free amino acids. Most of these components were either similar to or lower in (15)N abundance than the plant cytoplasm as a whole, but the NA fraction showed unusual (15)N enrichment. However, the percentage of nodule N in this fraction was small. NA fractions from yellow lupin and pea nodules and from soybean leaves were not enriched in (15)N. Nor was the NA fraction in ruptured bacteriods and cortical tissue of soybean nodules. Variation among soybean nodule fractions in the preponderance in protein of different amino acids was not large enough to explain the differences in (15)N abundances among them. A hypothesis, consistent with all known data, concerning the mechanism leading to the observed excess (15)N of lupin and soybean bacteriods is offered.

Journal Article↗

Nitrogen Assimilating Enzyme Activities and Enzyme Protein during Development and Senescence of Effective and Plant Gene-Controlled Ineffective Alfalfa Nodules.

Effective (N(2)-fixing) alfalfa (Medicago sativa L.) and plant-controlled ineffective (non-N(2)-fixing) alfalfa recessive for the in(1) gene were compared to determine the effects of the in(1) gene on nodule development, acetylene reduction activity (ARA), and nodule enzymes associated with N assimilation and disease resistance. Effective nodule ARA reached a maximum before activities of glutamine synthetase (GS), glutamate synthase (GOGAT), aspartate aminotransferase (AAT), asparagine synthetase (AS), and phosphoenolpyruvate carboxylase (PEPC) peaked. Ineffective nodule ARA was only 5% of effective nodule ARA. Developmental profiles of GS, GOGAT, AAT, and PEPC activities were similar for effective and ineffective nodules, but activities in ineffective nodules were lower and declined earlier. Little AS activity was detected in developing ineffective nodules. Changes in GS, GOGAT, AAT, and PEPC activities in developing and senescent effective and ineffective nodules generally paralleled amounts of immunologically detectable enzyme polypeptides. Effective nodule GS, GOGAT, AAT, AS, and PEPC activities declined after defoliation. Activities of glutamate dehydrogenase, malate dehydrogenase, phenylalanine ammonia lyase, and caffeic acid-o-methyltransferase were unrelated to nodule effectiveness. Maximum expression of nodule N-assimilating enzymes appeared to require the continued presence of a product associated with effective bacteroids that was lacking in in(1) effective nodules.

Journal Article↗

Alfalfa Controls Nodulation during the Onset of Rhizobium-induced Cortical Cell Division.

The formation of first nodules inhibits subsequent nodulation in younger regions of alfalfa (Medicago sativa L.) roots by a feedback regulatory mechanism that controls nodule number systemically (G Caetano-Anollés, WD Bauer [1988] Planta 175: 546-557). Following inoculation with wild-type Rhizobium meliloti, almost all infections associated with cortical cell division developed into mature nodules. While the distribution of Rhizobium- induced cell divisions closely paralleled the distribution of first emergent nodules, only 9 to 15% of total cell division foci failed to become functional nodules. Nodule formation was restricted to the primary root when plants were inoculated before lateral root emergence. Excision of these primary root nodules allowed nodules to reappear in lateral roots clustered around the location of the root tip at the time of nodule removal. Apparently, this region regained susceptibility to infection within the first hours after excision of primary nodules and suppression of nodulation was restored a day later probably due to the development of new infection foci. Our results suggest that alfalfa controls nodulation during the onset of cell division in the root cortex and not during infection development as in soybean.

Journal Article↗

The risk of hepatocellular carcinoma in cirrhotic patients with small liver nodules on MRI.

BACKGROUND AND AIM: The presence of hepatocellular carcinoma (HCC) has important implications for patients with cirrhosis. Studies have not compared the risk of cancer in cirrhotic patients with small liver nodules to cirrhotic patients without nodules. Our aim was to determine the risk of HCC in cirrhotic patients with small liver nodules on MRI compared to those without nodules. METHODS: We conducted a prospective study to determine the rate of HCC in cirrhotic patients with and without liver nodules. Cases were patients with liver nodule(s) less than 2 cm on MRI and controls were cirrhotic patients without nodules. Kaplan-Meier estimates and multivariate analysis were performed to estimate the risk of HCC in the two groups. RESULTS: A total of 310 liver transplant candidates with a mean follow-up of 663 days were included in the study and 133 underwent liver transplant during follow-up. The 1-yr incidence of HCC in the liver nodule group and control group was 11% and 0.5%, respectively, p < 0.001. The adjusted risk for HCC in the liver nodule group was 25 times higher compared to the control group, HR = 25.1 [95% CI 8.0, 78.9]. In 133 candidates who underwent transplant with and without liver nodules the rate of HCC was 11 (50%) and 4 (3.6%), respectively, p < 0.001. CONCLUSION: The incidence of HCC in patients with small liver nodules is significantly higher compared to patients with cirrhosis without liver nodules. The presence of small liver nodules warrants increased imaging surveillance for HCC.

Adult↗

Cowpea rhizobia producing dark nodules: use in competition studies.

During a program of screening rhizobia from West Africa, it was found that some strains produced nodules of unusually dark appearance on cowpeas, but not on peanuts, soybeans, pigeon peas, or mung beans. The dark pigmentation was in the bacteroid zone, was not correlated with nodule effectiveness, and was additional to the leghemoglobin pigment. Only rhizobial strains with a nongummy ("dry") colony morphology produced dark nodules. Visually distinguishable pink and dark nodules formed on the same root when a mixture of pink and dark strains was applied as inoculum. The dark-nodule phenotype was therefore appraised as a marker and found to be useful for studying nodulation competition with strains of the orthodox pink-nodule type. The competitiveness of 10 pink-nodule strains was examined relative to a black-nodule strain, IRc 256; a range of competitiveness was obtained of less competitive than, equally competitive to, or more competitive than IRc 256. Patterns of primary (early) nodulation were generally the same as patterns of secondary (later) nodulation. Mixed infections by dark and pink strains produced piebald nodules, the frequency of occurrence of which was much greater among primary than among secondary nodules.

Journal Article↗

Localization of Bacteria and Hemoglobin in Root Nodules of Parasponia andersonii Containing Both Bradyrhizobium Strains and Rhizobium leguminosarum biovar trifolii.

Dual occupancy of Parasponia andersonii nodules with different Bradyrhizobium strains and Rhizobium leguminosarum biovar trifolii was frequently obtained when two strains were inoculated into plants grown aseptically in tubes. Since reisolates of Bradyrhizobium strains from dually occupied nodules acquired the ability to nodulate Trifolium repens, the spatial relationship of the two species of bacteria during nodule initiation and development was investigated and their proximity was demonstrated. By using light microscopy and electron microscopy and immunogold labeling, R. leguminosarum biovar trifolii NGR66 inoculated alone onto P. andersonii produced small ineffective nodules, with bacteria embedded in matrix material in intercellular spaces and in a few nonliving host cells rather than in infection threads (CP299). In dual infections, the two bacterial species were shown to be adjacent to one another in the matrix of nodule intercellular spaces and in some host nodule cells. However, when two different Bradyrhizobium strains occupied a single nodule, they were located in different lobes of the same nodule. Immunogold labeling showed that Parasponia hemoglobin was localized in the cytoplasm of young infected nodule cells. This suggests that the nitrogen-fixing phase of Parasponia nodule cells is short-lived and correlates with previous acetylene reduction data from nodule slices. Hemoglobin was associated only with areas of nodule tissue infected with the effective nitrogen-fixing strain CP299 and absent from areas infected with R. leguminosarum biovar trifolii.

Journal Article↗

Symbiotic Characteristics of Rhizobium leguminosarum bv. trifolii Isolates Which Represent Major and Minor Nodule-Occupying Chromosomal Types of Field-Grown Subclover (Trifolium subterraneum L.).

The symbiotic effectiveness and nodulation competitiveness of Rhizobium leguminosarum bv. trifolii soil isolates were evaluated under nonsoil greenhouse conditions. The isolates which we used represented both major and minor nodule-occupying chromosomal types (electrophoretic types [ETs]) recovered from field-grown subclover (Trifolium subterraneum L.). Isolates representing four ETs (ETs 2, 3, 7, and 8) that were highly successful field nodule occupants fixed between 2- and 10-fold less nitrogen and produced lower herbage dry weights and first-harvest herbage protein concentrations than isolates that were minor nodule occupants of field-grown plants. Despite their equivalent levels of abundance in nodules on field-grown subclover plants, ET 2 and 3 isolates exhibited different competitive nodulation potentials under nonsoil greenhouse conditions. ET 3 isolates generally occupied more subclover nodules than isolates belonging to other ETs when the isolates were mixed in 1:1 inoculant ratios and inoculated onto seedlings. In contrast, ET 2 isolates were less successful at nodulating under these conditions. In many cases, ET 2 isolates required a numerical advantage of at least 6:1 to 11:1 to occupy significantly more nodules than their competitors. We identified highly effective isolates that were as competitive as the ET 3 isolates despite representing serotypes that were rarely recovered from nodules of field-grown plants. When one of the suboptimally effective isolates (ET2-1) competed with an effective and competitive isolate (ET31-5) at several different inoculant ratios, the percentages of nodules occupied by the former increased as its numerical advantage increased. Although subclover yields declined as nodule occupancy by ET2-1 increased, surprisingly, this occurred at inoculant ratios at which large percentages of nodules were still occupied by ET31-5.

Journal Article↗

Effect of inoculation and leaf litter amendment on establishment of nodule-forming Frankia populations in soil.

High-N(2)-fixing activities of Frankia populations in root nodules on Alnus glutinosa improve growth performance of the host plant. Therefore, the establishment of active, nodule-forming populations of Frankia in soil is desirable. In this study, we inoculated Frankia strains of Alnus host infection groups I, IIIa, and IV into soil already harboring indigenous populations of infection groups (IIIa, IIIb, and IV). Then we amended parts of the inoculated soil with leaf litter of A. glutinosa and kept these parts of soil without host plants for several weeks until they were spiked with [(15)N]NO(3) and planted with seedlings of A. glutinosa. After 4 months of growth, we analyzed plants for growth performance, nodule formation, specific Frankia populations in root nodules, and N(2) fixation rates. The results revealed that introduced Frankia strains incubated in soil for several weeks in the absence of plants remained infective and competitive for nodulation with the indigenous Frankia populations of the soil. Inoculation into and incubation in soil without host plants generally supported subsequent plant growth performance and increased the percentage of nitrogen acquired by the host plants through N(2) fixation from 33% on noninoculated, nonamended soils to 78% on inoculated, amended soils. Introduced Frankia strains representing Alnus host infection groups IIIa and IV competed with indigenous Frankia populations, whereas frankiae of group I were not found in any nodules. When grown in noninoculated, nonamended soil, A. glutinosa plants harbored Frankia populations of only group IIIa in root nodules. This group was reduced to 32% +/- 23% (standard deviation) of the Frankia nodule populations when plants were grown in inoculated, nonamended soil. Under these conditions, the introduced Frankia strain of group IV was established in 51% +/- 20% of the nodules. Leaf litter amendment during the initial incubation in soil without plants promoted nodulation by frankiae of group IV in both inoculated and noninoculated treatments. Grown in inoculated, amended soils, plants had significantly lower numbers of nodules infected by group IIIa (8% +/- 6%) than by group IV (81% +/- 11%). On plants grown in noninoculated, amended soil, the original Frankia root nodule population represented by group IIIa of the noninoculated, nonamended soil was entirely exchanged by a Frankia population belonging to group IV. The quantification of N(2) fixation rates by (15)N dilution revealed that both the indigenous and the inoculated Frankia populations of group IV had a higher specific N(2)-fixing capacity than populations belonging to group IIIa under the conditions applied. These results show that through inoculation or leaf litter amendment, Frankia populations with high specific N(2)-fixing capacities can be established in soils. These populations remain infective on their host plants, successfully compete for nodule formation with other indigenous or inoculated Frankia populations, and thereby increase plant growth performance.

Actinomycetales↗

Malignant versus benign nodules at CT screening for lung cancer: comparison of thin-section CT findings.

PURPOSE: To evaluate thin-section computed tomographic (CT) characteristics of malignant nodules on the basis of overall appearance (pure ground-glass opacity [GGO], mixed GGO, or solid opacity) in comparison with the appearance of benign nodules. MATERIALS AND METHODS: Institutional review board approval and patient consent were obtained. Follow-up diagnostic CT was performed in 747 suspicious pulmonary nodules detected at low-dose CT screening (17 892 examinations). Of 747 nodules, 222 were evaluated at thin-section CT (1-mm collimation), which included 59 cancers and 163 benign nodules (3-20 mm). Thin-section CT findings of malignant versus benign nodules with pure GGO (17 vs 12 lesions), mixed GGO (27 vs 29 lesions), or solid opacity (15 vs 122 lesions) were analyzed. Fisher exact test for independence was used to compare differences in shape, margin, and internal features between benign and malignant nodules. Positive predictive value (PPV) was analyzed when a category was significantly different from the others. RESULTS: Among nodules with pure GGO, a round shape was found more frequently in malignant lesions (11 of 17, 65%) than in benign lesions (two of 12, 17%; P = .02; PPV, 85%); mixed GGO, a subtype with GGO in the periphery and a high-attenuation zone in the center, was seen much more often in malignant lesions (11 of 27, 41%) than in benign lesions (two of 29, 7%; P = .004; PPV, 85%). Among solid nodules, a polygonal shape or a smooth or somewhat smooth margin was present less frequently in malignant than in benign lesions (polygonal shape: 7% vs 38%, P = .02; smooth or somewhat smooth margin: 0% vs 63%, P < .001), and 98% (46 of 47) of polygonal nodules and 100% (77 of 77) of nodules with a smooth or somewhat smooth margin were benign. CONCLUSION: Recognition of certain characteristics at thin-section CT can be helpful in differentiating small malignant nodules from benign nodules.

Adenocarcinoma↗

Pulmonary nodules: automated detection on CT images with morphologic matching algorithm--preliminary results.

Institutional review board approval was obtained. Informed patient consent was not required for this retrospective study, which involved review of previously obtained image data. Patient confidentiality was protected; the study was compliant with the Health Insurance Portability and Accountability Act. An automated pulmonary nodule detection program that takes advantage of three-dimensional volumetric data was developed and tested with multi-detector row computed tomographic (CT) images from 20 patients (13 men, seven women; age range, 40-75 years) with pulmonary nodules. A total of 164 nodules 3 mm in diameter and larger were detected by two radiologists in consensus and were used as a reference standard to evaluate the computer-aided detection (CAD) program. The CAD algorithm was structured to process nodules that were categorized into three types: isolated, juxtapleural, and juxtavascular. Overall sensitivity for nodule detection with the CAD program was 95.1% (156 of 164 nodules). The sensitivity according to nodule size was 91.2% (52 of 57 nodules) for nodules 3 mm to less than 5 mm and 97.2% (104 of 107 nodules) for nodules 5 mm and larger. The number of false-positive detections per patient was 6.9 for false nodule structures 3 mm and larger and 4.0 for false nodule structures 5 mm and larger.

Adult↗

Effect of CT image compression on computer-assisted lung nodule volume measurement.

PURPOSE: To evaluate the effect of two-dimensional wavelet-based computed tomographic (CT) image compression according to the Joint Photographic Experts Group (JPEG) 2000 standard on computer-assisted assessment of nodule volume. MATERIALS AND METHODS: This HIPAA-compliant study was approved by the research board at the authors' institution; patients' informed consent was not required. Fifty-one nodules in 23 patients (seven men, 16 women; mean age, 59 years; age range, 39-75 years) were selected on low-dose CT scans that were compressed to levels of 10:1, 20:1, 30:1, and 40:1 by using a two-dimensional JPEG 2000 wavelet-based image compression method. Nodules were classified according to size (< or = 5 mm or > 5 mm in diameter), location (central, peripheral, or abutting pleura or fissures), and attenuation (solid, calcified, or subsolid). Regions of interest were placed on the original images and transposed onto compressed images. Nodule volumes on original (noncompressed) and compressed images were measured by using a computer-assisted method. A mixed-model analysis of variance was conducted for statistical evaluation. RESULTS: Nodule volumes averaged 388.1 mm3 (range, 34-3474 mm3). There were three calcified, 33 solid noncalcified, and 15 subsolid nodules (13 with ground-glass attenuation). Average volume decreased with increasing compression level, to 383 mm3 (10:1), 370 mm3 (20:1), 360 mm3 (30:1), and 354 mm3 (40:1). No significant difference was identified between measurements obtained on original images and those compressed to a level of 10:1. Significant differences were noted, however, between original images and those compressed to a level of 20:1 or greater (P < .05). Compression level significantly interacted with nodule size, location, and attenuation (P < .001). The effect of compression was greater for nodules with ground-glass attenuation than for those with higher attenuation values. The difference in mean volumes between original images and those compressed to a level of 20:1 was 34.9 mm3 for nodules with ground-glass attenuation, compared with 8.3 mm3 for higher-attenuation nodules, a 4.2-fold difference. CONCLUSION: Nodule volumes measured on images compressed to a level of 20:1 differed significantly from those measured on noncompressed images, especially for nodules with ground-glass attenuation. This difference could affect the assessment of nodule change in size as measured with computer-assisted methods.

Adult↗

Simulation of subtle lung nodules in projection chest radiography.

PURPOSE: To measure the radiologic characteristics of subtle lung nodules and develop nodule phantoms that simulate these characteristics. MATERIALS AND METHODS: From a database of chest radiographs, 16 radiographs that showed confirmed subtle lung nodules were selected. The optical density values surrounding each nodule were obtained, and the radiologic characteristic of the nodules were evaluated. A set of Teflon nodule phantoms with similar x-ray transmission and variability was designed and fabricated. The contrast characteristics of the images of the nodule phantoms were measured. RESULTS: Most of the subtle nodules appeared to have diffuse edges with Gaussian-like contrast profiles. The contrast and size characteristics of the nodule phantom images fulfilled the design criteria within a 4% deviation. CONCLUSION: The radiologic pattern of subtle lung nodules is poorly simulated by nodule phantoms with simple spherical or disk shapes. The nodule phantoms in this study produce realistic radiographic patterns with an energy-dependent attenuation equivalent to that of tissue. The nodule phantoms are intended for use in experiments involving human subjects.

Humans↗

Ultrasound-guided fine-needle aspiration biopsy and ultrasonographic features of infracentimetric nodules in patients with nodular goiter: correlation with pathological findings.

We evaluated the usefulness of ultrasound-guided fine-needle-aspiration biopsy (US-FNAB) for infracentimetric nodules. In addition, we used sonography to assess the risk of malignancy of thyroid nodules, and we evaluated the extent of disease in infracentimetric cancers. The cytopathological results of 472 US-FNABs from 207 nodular goiter patients (170 women, 37 men; mean age, 51.5 +/- 13.1 yr) seen between 1999 and 2004 were categorized into five groups: inadequate, benign, suspicious, follicular neoplasm, and malignant. There were 145 infracentimetric nodules and 327 supracentimetric nodules. All patients underwent surgery. Final histopathological results correlated with cytologic results. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of US-FNAB for infracentrimetric nodules were 96.3%, 71.2%, 44.8%, 98.8%, and 76.1%; and for supracentimetric nodules, these values were 98.1%, 63.1%, 35.6%, 99.4, and 69.1%, respectively. There were no significant differences between infracentimetric and supracentimetric nodules. More thyroid cancer could be detected in infracentimetric nodules that were hypoechoic or had fine calcification on ultrasonography (which may be helpful in discriminating which nodules are appropriate for FNAB) than in supracentimetric nodules. However, logistic regression analyses showed that no single variable was predictive of malignancy in infracentimetric nodules. The malignancy rate in infracentimetric nodules was 21.4%. In this subgroup, 4 of 31 patients (12.9%) had multifocal tumors at surgery, 3 of 31 had extrathyroidal invasion, and 1 had a metastasis to the lung. In addition, at surgery, 11 of 55 tumors (20%) larger than 1 cm were multifocal. In conclusion, small tumor size does not guarantee a low risk of thyroid cancer, and US-FNAB may be useful tool for diagnosing malignant infracentimetric nodules.

Biopsy, Fine-Needle↗

Analytical histopathological diagnosis of small hepatocellular nodules in chronic liver disease.

Due to the recent progress in radiology and increased clinical and pathological interest, small hepatocellular nodules about 1 cm in size are frequently being detected in patients with chronic liver disease, particularly liver cirrhosis. Two new types of small hepatocellular nodules are now known: low-grade hepatocellular carcinomas (HCC) and dysplastic nodules, in addition to the previously known HCC (classical) and regenerative nodules. Ultrasound-guided needle biopsies from these nodules are routinely used for the differential diagnosis. For comparison, a simultaneous needle biopsy from the liver remote from the nodule is strongly recommended. Low-grade HCC, which are different from classical HCC in their morphological atypia and also biological behaviors, show local invasion into the portal tracts and surrounding hepatic parenchyma, but not intrahepatic or extrahepatic metastasis. Dysplastic nodules show mild cellular and structural atypia, a finding which is not sufficient for making a diagnosis of malignancy. An increased nuclear/cytoplasmic (N/C) ratio and nuclear crowding, small cell-dysplasia, increased cytoplasmic staining, clear cell change, pseudogland formation, and fatty change of hepatocytes are variably seen in these nodules. Nuclear changes, local invasion to the portal tract and surrounding liver, and loss of the reticulum fibers along the hepatocytes are useful markers favoring low-grade HCC rather than dysplastic nodules. These low-grade HCC and dysplastic nodules should also be distinguished from classical HCC as well as large-sized regenerative nodules. A comparative analysis of the histological findings observed in individual nodules is a reasonable approach to differential diagnosis at present. The recognition and analysis of these two new hepatocellular nodules may augur a new horizon in the study of hepatocellular neoplasm.

Adenoma↗