Multipath correlations in underwater acoustic communication channels

Uncorrelated scattering (US), which assumes that multipath arrivals undergo uncorrelated scattering and are thus uncorrelated, has been the standard model for digital communications including underwater acoustic communications. This paper examines the cross-correlation of multipath arrivals based on at-sea data with different temporal coherence time, assuming quasi-stationary statistics. It is found that multipath arrivals are highly cross-correlated when the channel is temporally coherent, and are uncorrelated when the channel is temporally incoherent. A theoretical model based on the path phase rates and relative-phase fluctuations is used to explain experimentally observed phenomena, assuming the path amplitudes vary slowly compared with the phases. The implications of correlated scattering for underwater acoustic communication channel tracking are discussed.

Transgenic expression of haem oxygenase-1 in pancreatic beta cells protects non-obese mice used as a model of diabetes from autoimmune destruction and prolongs graft survival following islet transplantation

AIMS/HYPOTHESIS

Haem oxygenase 1 (HO-1) has strong anti-apoptotic, anti-inflammatory and antioxidative effects that help protect cells against various forms of immune attack. We investigated whether transgenic expression of Ho-1 (also known as Hmox1) in pancreatic beta cells would protect NOD mice from autoimmune damage and prolong graft survival following islet transplantation.

METHODS

To evaluate the protective effect of beta cell-specific HO-1 in autoimmune diabetes, we used an insulin promoter-driven murine Ho-1 construct (pIns-mHo-1) to generate a transgenic NOD mouse. Transgene expression, insulitis and the incidence of diabetes in mice were characterised. Lymphocyte composition, the development of T helper (Th)1, Th2 and T regulatory (Treg) cells, T cell proliferation and lymphocyte-mediated disease transfer were analysed. The potential effects of transgenic islets and islet transplantation on apoptosis, inflammation and the generation of reactive oxygen species (ROS) and reactive nitrogen species (RNS) were evaluated.

RESULTS

Transgenic mice showed less severe insulitis and a lower incidence of diabetes than non-transgenic control littermates. Lymphocyte composition and functions were not affected. Islets from transgenic mice expressed lower levels of proinflammatory cytokines/chemokines, proapoptotic gene expression and amounts of ROS/RNS, and were more resistant to TNF-α- and IFN-γ-induced apoptosis. Islet grafts from transgenic mice also survived longer in diabetic recipients than control islets.

CONCLUSIONS/INTERPRETATION

Transgenic overexpression of Ho-1 in beta cells protected NOD mice from diabetes and delayed the autoimmune destruction of islet grafts, providing valuable insight into the development of better strategies for clinical islet transplantation in patients with type 1 diabetes.

Structural Analysis of Highly Relaxed GaSb Grown on GaAs Substrates with Periodic Interfacial Array of 90° Misfit Dislocations

We report structural analysis of completely relaxed GaSb epitaxial layers deposited monolithically on GaAs substrates using interfacial misfit (IMF) array growth mode. Unlike the traditional tetragonal distortion approach, strain due to the lattice mismatch is spontaneously relieved at the heterointerface in this growth. The complete and instantaneous strain relief at the GaSb/GaAs interface is achieved by the formation of a two-dimensional Lomer dislocation network comprising of pure-edge (90°) dislocations along both [110] and [1-10]. In the present analysis, structural properties of GaSb deposited using both IMF and non-IMF growths are compared. Moiré fringe patterns along with X-ray diffraction measure the long-range uniformity and strain relaxation of the IMF samples. The proof for the existence of the IMF array and low threading dislocation density is provided with the help of transmission electron micrographs for the GaSb epitaxial layer. Our results indicate that the IMF-grown GaSb is completely (98.5%) relaxed with very low density of threading dislocations (105 cm-2), while GaSb deposited using non-IMF growth is compressively strained and has a higher average density of threading dislocations (>109 cm-2).

Sodium trimer ordering on a NaxCoO2 surface

Sodium ion ordering on an in situ cleaved NaxCoO2 (x=0.84) surface has been studied by ultrahigh vacuum scanning tunneling microscopy at room temperature. Three main phases, with p(3 x 3), ( radical7 x radical7), and (2 radical3 x 2 radical3) hexagonal unit cells and a surface Na concentration of 1/3, 3/7, 1/2, respectively, were identified. One surprising finding is that Na trimers act as the basic building blocks that order in long range. The stability of Na trimers is attributed to the increased Na coordination with oxygen as indicated by ab initio calculations, and possibly at finite temperature by configuration entropy.

A comparison study of cerebral protection using Ginkgo biloba extract and Losartan on stroked rats

It has been well documented that oxidative stress is involved in stroke. Currently, many neuroprotective strategies have been targeted at molecules that are able to act as an oxidant to intervene with free-radical mediated apoptosis in the ischemic penumbra. In particular, natural products which contain antioxidant properties have undoubtedly efficacious for stroke treatment. In the current study, therapeutic effects of Ginkgo biloba extract (EGb) against cerebral protection in Wistar rats underwent middle cerebral artery occlusion (MCAO) was evaluated. A comparison study was conducted by using Losartan, an antihypertensive drug. Gene expression levels of pro-apoptotic genes (AT2 receptor, Fas, Bax and Bcl-xS) have shown to have significant reduction by EGb- and Losartan-treated groups as compared to vehicle group. Significant reduction of immunoreactivity of protein production of these genes, together with least nuclear green fluorescence observed in TUNEL, EGb, as an antioxidant drug, is concluded to have potent and promising therapeutic effect for stroke treatment.

Mixed antagonistic effects of bilobalide at ρ1 GABAC receptor

Bilobalide was found to be a moderately potent antagonist with a weak use-dependent effect at recombinant human rho(1) GABA(C) receptors expressed in Xenopus oocytes using two-electrode voltage clamp methodology. Antagonism of bilobalide at homomeric rho(1) GABA(C) receptors appeared to be mixed. At low concentration, bilobalide (3 microM) caused a parallel right shift and surmountable GABA maximal response of the GABA dose-response curve characteristic of a competitive antagonist. At high concentrations, bilobalide (10-100 microM) caused nonparallel right shifts and reduced maximal GABA responses of GABA dose-response curves characteristic of a noncompetitive antagonist. The potency of bilobalide appears to be dependent on the concentrations of GABA and was more potent at lower GABA concentrations. The mechanism of action of bilobalide at rho(1) GABA(C) receptors appears to be similar to that of the chloride channel blocker picrotoxinin.

TAP 2 Gene Msp-I Polymorphism Might Be Associated with Calcium Oxalate Stone Disease

INTRODUCTION

Inflammation might be one of the causes of stone disease. The function of the transporter associated with antigen-processing protein (TAP) is related to immune response and inflammation. Our aim was to investigate the relationship between stone disease and 5 polymorphic sites of the TAP gene (TAP1-1, 1-2, 2-1, 2-2, 2-3).

MATERIALS AND METHODS

We compared the frequencies of 5 polymorphisms in the TAP gene between 208 patients with recurrent calcium oxalate stone and 210 healthy controls. The polymorphism was detected by polymerase chain reaction-based restriction analysis.

RESULTS

Significant differences in the frequency of the polymorphism at the TAP2-2 site were detected between normal individuals and calcium stone disease patients (p<0.0001). The distribution of the genotype AA homozygote was higher in stone patients (33.3%) than in the control group (16.3%). The odds ratio for the A allele compared with the G allele was 2.097 (95% CI 1.571-2.802).

CONCLUSIONS

We conclude that the TAP2-2 MspI polymorphism might be associated with calcium stone disease.

Antioxidants in Chinese herbal medicines: a biochemical perspective

Recently, intense interest has focused on the antioxidant properties of natural products. In particular, Chinese herbal medicines (CHM) have become hot topics for life science researchers since many are reported to possess cardioprotective compounds, many of which remain to be identified. Indeed, the exact mechanisms by which CHM work remain unknown. Although many of these herbal remedies are undoubtedly efficacious, few have been scientifically investigated for their active chemical constituents and biological activities. We have previously reported higher activities of antioxidant defence enzymes such as superoxide dismutase, catalase, glutathione peroxidase and glutathione S-transferases in the liver of rats treated with the herb Salvia miltiorrhiza in a model of acute myocardial infarction. Using well established in vitro antioxidant assays employing 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS) and diphenyl-l-picrylhydrazyl (DPPH) we have shown that in addition to elevating endogenous antioxidant enzyme activity, Salvia miltiorrhiza and other CHM traditionally used for cardiovascular disorders (such as Rhizoma ligustici, Herba leonuri, Radix achyranthis bidentatae, and Camellia sinensis) contain potent antioxidant moieties in addition to their phenolic constituents. Furthermore, these novel non-phenolic components are effective inhibitors of oxidative reactions mediated by the inflammatory oxidants, peroxynitrite,hypochlorous acid and hydroxyl radical as well as iron-dependent lipid peroxidation. In this review, we discuss the various antioxidant properties of CHM in the context of their biochemical mechanisms.

Efficacy of ultrasonic tissue dissector and tissue glue for laparoscopic partial nephrectomy in a porcine model

The purpose of this study was to evaluate the efficacy and long-term tissue effects of ultrasonic dissector and cyanoacrylate glue during laparoscopic partial nephrectomy in a porcine model. Nine domestic pigs underwent laparoscopic left lower pole partial nephrectomy without vascular control. An ultrasonic tissue dissector was used to assist in the parenchymal incision, and the raw surfaces of the kidneys, including the exposed urinary system, were sealed with cyanoacrylate glue. No internal stents or additional sutures were placed. Intraoperative hemorrhages and urinary extravasation were recorded. The animals were humanely killed 28 days after undergoing the operations. The long-term effects of ultrasonic dissector and cyanoacrylate glue on the healing process of urothelium and renal parenchyma were determined histologically. All pigs survived the laparoscopic partial nephrectomy, and the blood loss ranged from 0 to 120 ml (mean, 60 ml). The average operative time was 89 +/- 10 min. The severity of the bleeding was minimal in six animals and moderate in three animals. No urinary extravasation was found using intravenous urography at the 28th postoperative day. No urinary fistula or renal abscess formation was found histologically. Cyanoacrylate glue infiltrated into the tissue defects and did not dissolve. The glue was encased by fibrotic tissue with minimal foreign body inflammatory reaction. Ultrasonic dissector was effective in achieving hemostasis during laparoscopic partial nephrectomy without the need of vascular control in pigs. Cyanoacrylate glue achieved good long-term adhesive power. The sealing effects provided by cyanoacrylate glue were adequate to prevent urinary extravasation from urothelial defects at least for 1 month.

[Inflammation, bronchial hyperreactivity, and progression of asthma: a 5-year follow-up in grass sensitized farmers]

We studied in a group of 53 asthmatic farmers the influence of various treatment regimens on progression of disease, during five years follow-up. Specific immuno-therapy (SIT) and steroid treated patients showed significantly lower ECP levels and higher methacholine PD20 FEV1 than untreated patients, during all years of the study. During the first two years, spring ECP increase was higher in SIT treated patients than in steroid ones, however no significant differences were found during the following years. Bronchial hyperreactivity showed same course, except for a significant higher PD20 FEV1 in steroid and SIT treated asthmatics, in respect to the steroid or SIT alone. We may conclude that ECP and bronchial reactivity are useful for asthma monitoring and SIT and inhalant steroids have additional effects on asthma.

[Serum tryptase: marker of occupational anaphylaxis]

Tryptase is a protein released by mast cells, which is involved in the enhancement of inflammatory sequences in immune-mediated reactions. According with our experience, some patients having a reaction clinically classified as anaphylaxis, showed high levels of tryptase (> 20 ng/l) but also of serum specific IgE, showing the immune-mediated nature of the reactions. On the other hand workers without specific IgE and with low levels of tryptase probably had developed pseudoallergic (anaphylactoid) reactions. So, tryptase can be used as biomarker of occupational anaphylaxis and appear to be able to make out immune and nonimmune mediated reactions.

beta-Phenylethyl isothiocyanate-mediated apoptosis in hepatoma HepG2 cells

beta-Phenylethyl isothiocyanate (PEITC) is a promising chemoprotective compound that is routinely consumed in the diet as its glucosinolate precursor. Previous studies have shown that PEITC can inhibit phase I enzymes and induce phase II detoxification enzymes along with apoptosis in vitro. The detailed mechanisms involved in the apoptotic cascade, however, have not been elucidated. In the present study, we demonstrate that PEITC can induce apoptosis in hepatoma HepG2 cells in a concentration- and time-dependant manner as determined by TUNEL positive and SubG1 population analysis. Caspase-3-like activity and poly(ADP-ribosyl)polymerase cleavage increased during treatment with 20 microM PEITC; high concentrations, however, induced necrosis. Pre-treatment with Z-VAD-FMK and the caspase-3-specific inhibitor Ac-DEVD-CHO prevented PEITC-induced apoptosis, as determined by caspase-3-like activity and DNA fragmentation. Additional investigations also showed that at concentrations of 5-10 microM PEITC, DNA synthesis was inhibited and G2/M phase cell cycle arrest occurred, correlating with an alteration in cyclin B1 and p34(cdc2) protein levels. Furthermore, we also demonstrate a concentration- and time-dependant burst of superoxide (O2*-) in PEITC-treated cells. However, pre- and co-treatment with the free radical scavengers Trolox, ascorbate, mannitol, uric acid and the superoxide mimetic manganese (III) tetrakis (N-methyl-2-pyridyl) porphyrin failed to prevent PEITC-mediated apoptosis. Taken together, these results suggest that PEITC potently induces apoptosis and cell cycle arrest in HepG2 cells and that the generation of reactive oxygen species appears to be a secondary effect.

Creation of ureteropelvic junction obstruction and its correction by chemical glue-assisted laparoscopic dismembered pyeloplasty

PURPOSE

We established a porcine model of ureteropelvic junction (UPJ) obstruction using a laparoscopic technique and assessed the outcome of standard suture-assisted and chemical glue-assisted laparoscopic pyeloplasty.

MATERIALS AND METHODS

Female domestic pigs (N = 20) underwent laparoscopic suture-ligature to create UPJ obstruction. One month later, laparoscopic end-to-end anastomosis was performed to correct the obstruction: with standard suturing techniques in 10 animals and with chemical (cyanoacrylate) glue in the other 10. Postoperative ureteral stents were not used. Four weeks postoperatively, intravenous urography was performed to evaluate the patency of the anastomoses. The UPJ was procured by laparotomy to assess the anastomoses and periureteral fibrosis histologically.

RESULTS

The UPJ obstruction was created in an average of 15 +/- 6 minutes. There was no early postoperative mortality. Eighteen pigs survived for at least 1 month, and UPJ obstruction developed in 17 (95%). Microscopically, the lumen of the UPJ was partially occluded, measuring an average of 40% +/- 5% of normal. After laparoscopic correction, a patent UPJ was found in seven of nine animals treated with traditional sutures. Among the eight animals with chemically glued anastomoses, none had a patent UPJ, and severe periureteral adhesions and intraluminal fibrosis were noted at the pyeloplasty site. Marked ureteral tortuosity was present in six of the eight pigs receiving glue-assisted pyeloplasty but in none of the animals having suture-assisted pyeloplasty.

CONCLUSIONS

Ureteropelvic junction obstruction was established by laparoscopic suture-ligature in a porcine model with a 95% success rate. Chemical glue-assisted anastomosis was inferior to standard laparoscopic sutures for pyeloplasty to correct the obstruction.

Comparison study on two different accessing methods for retroperitoneoscopic adrenalectomy

OBJECTIVES

To compare, in a retrospective nonrandomized study, two retroperitoneal laparoscopic access methods for treatment of adrenal tumors: direct needle insufflation with balloon dissection and finger-assisted dissection without balloon dissection.

METHODS

The operative data from 120 consecutive patients undergoing retroperitoneoscopic adrenalectomy (RA) for benign adrenal tumors were reviewed. The operative outcomes of 70 RAs accessed by direct needle insufflation and balloon dissection were compared with another 50 RAs accessed by finger dissection without balloon dissection. The RA surgical parameters for tumors with different laterality, pathologic features, and size were also analyzed.

RESULTS

The operative time in the finger dissection group was shorter (118 +/- 11 minutes) compared with that in the balloon dissection group (143 +/- 21 minutes; P = 0.03). The surgical parameters, including incidence of peritoneal perforation, intraoperative blood loss, time to oral intake, analgesic requirement, postoperative hospital stay, and convalescence, did not differ between the groups. For tumors greater than 5 cm, the operative time increased to 220 +/- 30 minutes compared with 132 +/- 31 minutes for tumors 5 cm or less (P = 0.02). The finger and balloon dissection methods had similar operative times for tumors larger than 5 cm (218 +/- 10 versus 224 +/- 15 minutes). No additional morbidity regarding the recovery time was noted in the finger dissection group compared with the balloon dissection group.

CONCLUSIONS

Finger dissection appears to be a more efficient and equally effective access method for RA compared with balloon dissection. We suggest that balloon dissection may not be required for RA in patients not excessively obese.

Three-dimensional cytomorphology in fine needle aspiration biopsy of medullary thyroid carcinoma

OBJECTIVE

To elucidate three-dimensional (3-D) cytomorphology in fine needle aspiration biopsy (FNAB) of medullary thyroid carcinoma (MTC).

STUDY DESIGN

ENAB was performed on tumors from five patients with MTC. The aspirate was stained and observed under a light microscope (LM). The aspirate was also fixed, dehydrated, critical point dried, spattered with gold ions and observed with a scanning electron microscope (SEM). For transmission electron microscopy (TEM), the specimen was fixed, dehydrated, embedded in an Epon mixture, cut with an ultramicrotome, mounted on copper grids, electron doubly stained with uranium acetate and lead citrate, and observed with TEM. Findings under SEM were correlated with those under LM and TEM.

RESULTS

Under SEM, 3-D cytomorphology of MTC displayed a disorganized cellular arrangement with indistinct cell borders in three cases. The cell surface was uneven and had granular protrusions that corresponded to secretory granules observed under TEM. In one case with multiple endocrine neoplasia type IIB, there were abundant granules on the cell surface. In one case of sporadic MTC with multinucleated tumor giant cells and small cells, granular protrusions also were noted on the cell surface.

CONCLUSION

Granular protrusion was a characteristic finding in FNAB of MTC tinder SEM and might be helpful in the differential diagnosis.

IgG subclass responses in experimental silicosis

Silicosis is a crippling fibrotic lung disease induced by inhaling crystalline silica. In addition to fibrosis, silica inhalation by humans is associated with a number of immunological effects including increased levels of serum immunoglobulins (in particular IgG), increased prevalence of autoantibodies, and autoimmune disease. Recent studies using rodent models have shown that experimental silicosis is associated with a T-helper (TH)1 pattern of T-cell activation in the lungs and lung-associated lymph nodes after silica inhalation, which are also the sites of increased IgG production. We therefore hypothesized that the subclass distribution of IgG production occurring in experimental silicosis would suggest TH1 activation as the primary stimulus for IgG production. Using an ELISPOT assay, we found increased IgG-secreting spot-forming cells of all IgG subclasses in lung-associated lymph nodes taken from silica-exposed rats 3 to 4 months after aerosol exposure to silica. Neither TH1- nor TH2-dependent IgG subclass-secreting cells were selectively enhanced. Our findings suggest that TH1 activation alone does not account for increased production of IgG in experimental silicosis.

A novel genetic island of meningitic Escherichia coli K1 containing the ibeA invasion gene (GimA): functional annotation and carbon-source-regulated invasion of human brain microvascular endothelial cells

The IbeA (ibe10) gene is an invasion determinant contributing to E. coli K1 invasion of the blood-brain barrier. This gene has been cloned and characterized from the chromosome of an invasive cerebrospinal fluid isolate of E. coli K1, strain RS218 (018:K1: H7). In the present study, a genetic island of meningitic E. coli containing ibeA (GimA) has been identified. A 20.3-kb genomic DNA island unique to E. coli K1 strains has been cloned and sequenced from an RS218 E. coli K1 genomic DNA library. Fourteen new genes have been identified in addition to the ibeA. The DNA sequence analysis indicated that the ibeA gene cluster was localized to the 98 min region and consisted of four operons, ptnIPKC, cglDTEC, gcxKRCI and ibeRAT. The G+C content (46.2%) of unique regions of the island is substantially different from that (50.8%) of the rest of the E. coli chromosome. By computer-assisted analysis of the sequences with DNA and protein databases (GenBank and PROSITE databases), the functions of the gene products could be anticipated, and were assigned to the functional categories of proteins relating to carbon source metabolism and substrate transportation. Glucose was shown to enhance E. coli penetration of human brain microvascular endothelial cells and exogenous cAMP was able to block the stimulating effect of glucose, suggesting that catabolic regulation may play a role in control of E. coli K1 invasion gene expression. Our data suggest that this genetic island may contribute to E. coli invasion of the blood-brain barrier through a carbon-source-regulated process.

Role of laparoscopic cholecystectomy in the management of polypoid lesions of the gallbladder

This retrospective clinicohistopathologic study was performed to delineate the role of laparoscopic cholecystectomy in the management of polypoid lesions of the gallbladder. One hundred forty-three consecutive patients who had a preoperative sonographic diagnosis of polypoid lesions of the gallbladder with a diameter less than 1.5 cm and who underwent laparoscopic cholecystectomy at Cathay General Hospital were included in the analysis. Histopathologic study showed that 22 (15.4%) patients had true tumors, including adenoma (16), adenoma with focal adenocarcinoma (2), adenocarcinoma (3), and carcinoid tumor (1). Tumorlike lesions were found in 121 (84.6%) patients and included cholesterol polyp (106), adenomyomatous hyperplasia (10), inflammatory polyp (3), and papillary hyperplasia (2). The mean diameter of malignant polypoid lesions of the gallbladder was 1.35 +/- 0.42 cm, which was significantly larger than that of cholesterol polyps (0.66 +/- 0.40 cm, P = 0.0001) but not significantly larger than that of adenomyomatous hyperplasias (1.12 +/- 0.42 cm) and adenomas (1.08 +/- 0.47 cm). The mean age of patients with malignant polypoid lesions of the gallbladder (61.2 +/- 13.3 years old) was significantly older than that of patients with adenomyomatous hyperplasia (46.6 +/- 13.4 years, P = 0.03), cholesterol polyps (44.5 +/- 10.5 years, P = 0.0003), and adenomas (41.4 +/- 9.4 years, P = 0.0008). Clinical follow-up showed that most (98.6%) patients benefited from the minimal invasiveness of laparoscopic cholecystectomy with satisfactory surgical results. We conclude that laparoscopic cholecystectomy is a reliable, safe, and minimally invasive biopsy procedure and definite management of polypoid lesions of the gallbladder with a diameter less than 1.5 cm.

Optimal treatment for distal ureteral calculi: extracorporeal shockwave lithotripsy versus ureteroscopy

BACKGROUND

The optimal treatment for distal ureteral calculi remains controversial. We present data from our institution to compare the efficacy of extracorporeal shockwave lithotripsy (SWL) and ureteroscopy with different lithotripsy modalities (URSL).

METHODS

From January 1994 to September 1997, 954 distal ureteral calculi were treated at our institution using in situ SWL (Siemens Lithostar) in 524 patients and ureteroscopy (Wolf 8.0F instrument and Swiss Lithoclast) in 430 patients. Stone sizes and patient ages were similar in these two groups.

RESULTS

In the SWL group, the 3-month stone-free rate was 87%, and the effectiveness quotient (EQ) was 68.7%. In the URSL group, there was a 96% stone-free rate with an EQ of 92.1%. The SWL treatment was more expensive than URSL.

CONCLUSION

At our institution, ureteroscopy is more efficacious than SWL for the treatment of distal ureteral calculi. In selected patients who had stones >10 mm with evidence of impaction and severe colic pain, we strongly suggest that URSL is the best choice.

Thyroidectomy or radioiodine? The value of ultrasonography and cytology in the assessment of nodular lesions in Graves' hyperthyroidism

Although diffuse toxic goiter is a classical feature of Graves' disease (GD) nodular goiters are occasionally found in some patients. The aim of the present study was to investigate the ultrasonographic and corresponding cytological manifestations in GD patients with nodular lesions to decide on a therapeutic strategy. Twenty-seven consecutive GD patients with nodular goiter were included in this study (21 women and six men, mean age 41.2 years, range 22-77 years). All underwent thyroid ultrasonography and fine-needle aspiration cytology. Of the 27 patients eight underwent surgical intervention because papillary thyroid carcinoma or follicular neoplasm was diagnosed by cytology; five of these were shown to have papillary thyroid carcinomas. Ultrasonography revealed the malignant nodules to be hypoechogenic, heterogeneous, and with ill-defined margins in four of these five thyroid cancers, whereas the remaining sonogram showed a cystic change and cauliflower-like tumor formation with microcalcification. The volume and maximal diameter of cancerous nodules were significantly larger than those of benign nodules. In conclusion our results reveal that ultrasonography and fine-needle aspiration cytology are reliable and quick methods for diagnosing nodular goiters in GD patients. If thyroid neoplasms are found ablative therapy with thyroidectomy is indicated instead of radioactive iodine.