Cancer prevalence in the subcategories of the indeterminate class III (AUS/FLUS) of the Bethesda system for thyroid cytology: a meta-analysis

PURPOSE

The indeterminate cytologic report represents a major challenge in the field of thyroid nodule. The indeterminate class III of the Bethesda classification system (i.e., AUS/FLUS) includes a heterogeneous group of subcategories characterized by doubtful nuclear and/or architectural atypia. The study aim was to  conduct a systematic review and meta-analysis to evaluate the rate of malignancy in each subcategory of Bethesda III.

METHODS

PubMed, CENTRAL, and Scopus databases were searched until April 2020. Original articles reporting data on the subcategories of Bethesda III were included. The histological diagnosis was the reference standard to classify true/false negative and true/false positive cases.

RESULTS

The pooled cancer prevalence in each subcategory of Bethesda III was estimated using a random-effects model. Twenty-three papers with 4241 nodules were included. Overall, 1163 (27.4%) were malignant. The cancer rate observed in the subcategories ranged from 15%, in "Hürthle cell aspirates with low risk pattern", to 44%, in "Focal cytologic atypia".

CONCLUSIONS

The overall cancer rate found in the Bethesda III ranged more largely than that originally estimated (10-30%) and varied among any scenarios. These evidence-based data represent a reference for the clinical management of these patients.

Differences between ATA, AACE/ACE/AME and ACR TI-RADS ultrasound classifications performance in identifying cytological high-risk thyroid nodules

OBJECTIVE

Thyroid ultrasound is crucial for clinical decision in the management of thyroid nodules. In this study, we aimed to estimate and compare the performance of ATA, AACE/ACE/AME and ACR TI-RADS ultrasound classifications in discriminating nodules with high-risk cytology.

DESIGN

Cross-sectional study.

METHODS

1077 thyroid nodules undergoing fine-needle aspiration were classified according to ATA, AACE/ACE/AME and ACR TI-RADS ultrasound classifications by an automated algorithm. Odds ratios (ORs) and receiver operating characteristic (ROC) curves for high-risk cytology categories (TIR3b, TIR4 and TIR5) were calculated for the different US categories and compared.

RESULTS

Cytological categories of risk increased together with all US classifications' sonographic patterns (P < 0.001). The diagnostic performance (C-index) of ACR TI-RADS and AACE/ACE/AME significantly improved when adding clinical data as gender and age in the regression model (P < 0.001). A significant difference in the final model C-index between the three US classification systems was found (P < 0.029), with the ACR TI-RADS showing the highest nominal C-index value, significantly superior to ATA (P = 0.008), but similar to AACE/ACE/AME (P = 0.287). ATA classification was not able to classify 54 nodules, which showed a significant 7 times higher risk of high-risk cytology than the 'very low suspicion' nodules (OR: 7.20 (95% confidence interval: 2.44-21.24), P < 0.001).

CONCLUSIONS

The ACR TI-RADS classification system has the highest area under the ROC curve for the identification of cytological high-risk nodules. ATA classification leaves 'unclassified' nodules at relatively high risk of malignancy.

PD-1 /PD-L1 checkpoint in hematological malignancies

Programmed cell death protein 1 (PD-1), is a cell surface receptor with an important role in down-regulating the immune system and promoting self-tolerance by suppressing T cell inflammatory activity. PD-1/PDL1 axis represents a checkpoint to control immune responses and it is often used as a mechanism of immune escaping by cancers and infectious diseases. Many data demonstrate its important role in solid tumors and report emerging evidences in lymphoproliferative disorders. In this review, we summarized the available data on the role of PD-1/PD-L1 checkpoint in lymphoproliferative diseases and the therapeutics use of monoclonal blocking antibodies.

Detecting N-RAS Q61R Mutated Thyroid Neoplasias by Immunohistochemistry

Recently, the immunohistochemistry (IHC) for N-RAS Q61R has been developed and commercialized for clinical practice. Here, we investigated the reliability of IHC to identify N-RAS Q61R mutated thyroid neoplasia. A series of 24 consecutive thyroid lesions undergone surgery following indeterminate cytology were enrolled. Paraffin sections were stained for IHC using the rabbit monoclonal anti-human N-RAS Q61R, clone SP174. N-RAS mutations in codon 61 were also investigated by automated sequencing. At histology, 12 cases of follicular carcinoma, cytologically defined as follicular lesions, 1 papillary cancer, 7 follicular adenomas, and 4 hyperplastic nodules were found. Of these, 4 showed a positive IHC for anti N-RAS antibody where N-RAS expression was detected mainly at cytoplasmic level with similar intensity of reaction. The remaining cases had negative IHC. A 100% concordance between IHC and molecular analysis for N-RAS Q61R was observed. In conclusion, this study shows high reliability of IHC to identify N-RAS Q61R mutated thyroid lesions with high cost-effectiveness. These data indicate the reliability of IHC to identify N-RAS Q61R mutated thyroid neoplasia and suggest to adopt this approach for a more accurate management of patients, when indicated.

Preoperative Assessment of TERT Promoter Mutation on Thyroid Core Needle Biopsies Supports Diagnosis of Malignancy and Addresses Surgical Strategy

In the last decade, several molecular markers have been proposed to improve the diagnosis of thyroid nodules. Among these, mutations in the telomerase reverse transcriptase (TERT) promoter have been correlated to malignant tumors, characterized by highest recurrence and decreased patients' survival. This suggests an important role of TERT mutational analysis in the clinical diagnosis and management of thyroid cancer patients. The aim of the study was to demonstrate the adequacy of core needle biopsy (CNB) for the preoperative assessment of TERT mutational status, to reach a more accurate definition of malignancy and a more appropriate surgical planning. Indeed, CNB is gaining momentum for improving diagnosis of thyroid nodules deemed inconclusive by fine needle aspirate (FNA). The study included 50 patients submitted to CNB due to inconclusive FNA report. TERT mutational status was correlated with BRAF mutation, definitive histology, and post-operative TNM staging of the neoplasia. C228T mutation of the TERT promoter was reported in 10% of the papillary carcinomas (PTC) series. When compared with final histology, all cases harboring TERT mutation resulted as locally invasive PTCs. The prevalence of TERT mutated cases was 17.6% among locally advanced PTCs. TERT analysis on CNB allows the assessment of the pathological population on paraffin sections before DNA isolation, minimizing the risk of false negatives due to poor sampling that affects FNA, and gathering aggregate information about morphology and TERT mutational status. Data indicating a worse outcome of the tumor might be used to individualize treatment decision, surgical option, and follow-up design.

First Report of the Southern Root-Knot Nematode Meloidogyne incognita on the Invasive Weed Araujia sericifera in Italy

Moth plant, Araujia sericifera, is native to South America and was exported to many other countries as an ornamental plant. However, it is now considered an invasive, perennial, noxious weed in Italy. Because of the ability of this plant to spread rapidly and invade natural ecosystems, A. sericifera has been included on the Alert list by the European and Mediterranean Plant Protection Organization (EPPO). In September 2013, numerous plants of A. sericifera with chlorotic leaves and large root-galls were observed in agricultural fields, gardens, and uncultivated locations in Nocera Inferiore, Salerno Province, Italy. Ten samples were collected from a vegetable farm (40°45'40.8″ N, 14°38'18.4″ E) and nematodes were extracted from soil and root samples using standard procedures (1). Meloidogyne sp. was found in all soil and root samples, with nematode population densities ranging from 420 to 1,270 eggs and J2s/10 cm³ of soil and 84 to 2,200 eggs and J2s/5 g of fresh roots. The morphological identification of the nematode was based on characterization of second-stage juveniles (J2s), males, eggs, and females (2). Measurements of J2s (n = 30) include: mean body length (L) = 403 ± 3.7 μm; L/maximum body width = 27.5 ± 0.3; L/esophageal length = 6.2 ± 0.1; stylet length = 12.8 ± 0.1 μm; L/tail length = 9.5 ± 0.1; tail length = 42.5 ± 0.3 μm. Males (n = 10): L = 1,491 ± 0.04 μm; L/maximum body width = 44.4 ± 0.8; L/esophageal length = 16.1 ± 0.3; stylet length = 22.1 ± 0.7 μm; spicules length = 30.1 ± 0.8 μm. Eggs (n = 30): length = 96.6 ± 1 μm; width = 45.1 ± 0.5 μm; length/width ratio = 2.1. Females (n = 20): L = 909.5 ± 38.4 μm; body width = 588.3 ± 19.3 μm; stylet length = 17.0 ± 0.2 μm. Perineal patterns of females had a high dorsal arch with wavy striae bending toward the lateral lines and the absence of distinct lateral line incisures. All measurements conformed to the description of Meloidogyne incognita (Kofoid & White, 1919) Chitwood 1949. DNA was extracted from five individual adult females from each sample and morphological identification was confirmed by a sequence-characterized amplified region (SCAR)-PCR technique using species-specific primers. The amplified product obtained was 1.2 kb in length, demonstrating proper amplification of the species-specific, length variant SCAR marker (3). Weeds are known to serve as hosts for nematodes in the absence of crop plants and to affect the success of nematode management programs. Meloidogyne spp. have been reported to survive and even thrive on weeds; among them, M. incognita is considered the most economically important agricultural nematode pest worldwide as it causes severe yield losses on many hosts. Thus, the invasive plant A. sericifera can be a potential reservoir for M. incognita in Italy and elsewhere. To our knowledge, this is the first report of M. incognita parasitizing A. sericifera. References: (1) K. R. Barker. Page 19 in: An Advanced Treatise on Meloidogyne. Vol. II, Methodology. K. R. Barker et al., eds. North Carolina State University Graphics, Raleigh, 1985. (2) J. D. Eisenback et al. A Guide to the Four Most Common Species of Root-Knot Nematodes (Meloidogyne spp.), with a Pictorial Key. North Carolina State University, Raleigh, 1981. (3) C. Zijlstra et al. Nematology 2:847, 2000.

Immunohistochemistry for BRAF(V600E) antibody VE1 performed in core needle biopsy samples identifies mutated papillary thyroid cancers

BRAF(V600E) is the most frequent genetic mutation in papillary thyroid cancer (PTC) and has been reported as an independent predictor of poor prognosis of these patients. Current guidelines do not recommend the use of BRAF(V600E) mutational analysis on cytologic specimens from fine needle aspiration due to several reasons. Recently, immunohistochemistry using VE1, a mouse anti-human BRAF(V600E) antibody, has been reported as a highly reliable technique in detecting BRAF-mutated thyroid and nonthyroid cancers. The aim of this study was to test the reliability of VE1 immunohistochemistry on microhistologic samples from core needle biopsy (CNB) in identifying BRAF-mutated PTC. A series of 30 nodules (size ranging from 7 to 22 mm) from 30 patients who underwent surgery following CNB were included in the study. All these lesions had had inconclusive cytology. In all cases, both VE1 and BRAF(V600E) genotypes were evaluated. After surgery, final histology demonstrated 21 cancers and 9 benign lesions. CNB correctly diagnosed 20/20 PTC and 5/5 adenomatous nodules. One follicular thyroid cancer and 4 benign lesions were assessed at CNB as uncertain follicular neoplasm. VE1 immunohistochemistry revealed 8 mutated PTC and 22 negative cases. A 100% agreement was found when positive and negative VE1 results were compared with BRAF mutational status. These data are the first demonstration that VE1 immunohistochemistry performed on thyroid CNB samples perfectly matches with genetic analysis of BRAF status. Thus, VE1 antibody can be used on thyroid microhistologic specimens to detect BRAF(V600E)-mutated PTC before surgery.

CONTROL OF VIRAL DISEASES TRANSMITTED IN A PERSISTENT MANNER BY THRIPS IN PEPPER (TOMATO SPOTTED WILT VIRUS)

Tomato spotted wilt disease is caused by Tomato Spotted Wilt Virus (TSWV) (Tospovirus, Bunyaviridae), a virus that severely damages and reduces the yield of many economically important plants worldwide and actually it is a major disease affecting the production of tomato and pepper in Italy. Due to the non-predictive nature of its outbreaks combined with the lack of forecasting, adoption of preventive measures have not always been practical, in fact the disease cycle has proven to be extremely difficult to break because of the wide and often overlapping host range of both the virus and the thrips vectors, which transmit the virus in a persistent, circulative, and propagative manner. Moreover recently, resistance breaking (RB) isolates of TSWV that overcome the resistance conferred by the Tsw gene in different pepper hybrids have been recovered in different locations in Italy and also in Brazil, USA, Spain and Australia, and this occurrence raises the question on the importance of a new approach of integrated pest management for TSWV management, including both control of its insect vector and the induction of the plant's resistance against viral infection. In this perspective, a study was performed in 2012 and 2013 with the purpose of evaluating the efficacy of the insecticide Cyantraniliprole alone or combined with Acibenzolar-S-Methyl (ASM), inducer of systemic acquired resistance, in the control of tomato spotted wilt disease in pepper. The experiment was performed in laboratory, in a thermo-conditioned greenhouse, into separate insect-proof cages and consisted of 5 treatments and 2 applications (plus a pre-transplant application for treatments were ASM was used. Variables were the mode of application of ASM in pre-transplant (by foliar or by drench) and the duration of the exposure time of the treated plants to viruliferous insects. Pepper cv. Corno di Toro, devoid of any resistance to TSWV, was used. Plants were observed daily to record any symptom induced by TSWV and/or of phytotoxicity. The possible TSWV infection was verified by DAS-ELISA using antisera supplied by Agdia Biofords. It was shown that the combination of ASM and Cyantraniliprole allowed the best control of TSWV transmission by thrips and of the development of the infection in treated pepper plants, regardless of the exposure time to thrips infestation. The application via drench of the combination seems to be the most effective. The efficacy of Cyantraniliprole used alone was comparable to that obtained with its combination with ASM only when plants were exposed to viruliferous insects for 24 h after product application, and the effectiveness of protection decreased with increasing time of exposure to viruliferous thrips. Treatment with ASM alone determined a good protection to plants regardless of the length of the exposure timing to viruliferous insects, with a smaller number of infected plants and milder symptoms compared to the check. Results of our current experiments raise the interesting possibility to combine in one product an insecticide and a non-specific (to various biotic and abiotic stresses) resistance inducer, particularly against diseases caused by viruses, and offer great opportunity for the integrated pest management (IPM) strategy for the control of pepper diseases.

New report of Phoma glomerata on Coriandrum sativum L

In 2011, coriander plants (Coriandrum sativum L.), showing symptoms of greyish to hell brown lesions with dark brown border between discoloured and asymptomatic tissues, were observed in Bulgaria. Pycnidia with small unicellular conidia appeared in the pale centre of the lesions. In this work, the identification of the causal agent of this disease was made applying Koch's postulates. Moreover, for a rapid and unambiguous identification of the fungal species, the internal transcribed spacers and the 5.8 rDNA gene (ITS1-5.8-ITS2) were amplified by PCR from DNA extracted from the isolated colonies. The amplicon was sequenced and analyzed using BLASTn, and showed a homology of 100% with a corresponding sequence of Phoma glomerata (accession number DQ093699). The fungus isolated, after the morphological and molecular characterization, was ascribed to the species Phoma glomerata (Corda) Wollenweber and Hochapfel. This is the first report of P. glomerata as agent of stem rot of coriander in Bulgaria and elsewhere.

Resistance breaking tomato spotted wilt virus isolates on resistant pepper varieties in Italy

In spring 2012, resistance breaking (RB) isolates of tomato spotted wilt virus (TSWV) that overcome the resistance conferred by the Tsw gene in different pepper hybrids have been recovered in different locations in southern Italy (Campania and Apulia regions) in protected cultivation, about one month after transplant. The percentage of symptomatic plants was 5-10% and, only in particular cases of advanced stage of cultivation, it reached 30-50% at the end of cycle. All TSWV isolates induced similar systemic symptoms in all resistant infected pepper hybrids: yellowing or browning of apical leaves, which later become necrotic, long necrotic streakson stems, extending to the terminal shoots, complete necrosis of younger fruits and large necrotic streaks and spots on fruits formed after infection. On ripe fruits, yellow spots with concentric rings or necrotic streaks could be observed. Leaf extracts of these samples were tested in ELISA for the detection of TSWV, Cucumber mosaic virus (CMV), Tobacco mosaic virus (TMV), Tomato mosaic virus (ToMV), Impatiens necrotic spot virus (INSV), Potato virus Y (PVY), Alfalfa mosaic virus (AMV), Pepper mild mottle virus (PMMoV) and Pepper Mottle Virus (PepMoV). Only TSWV was detected in all the field samples tested. The correspondent virus isolates were inoculated mechanically and by Frankliniella occidentalis on to a set of different pepper and tomato hybrids, as well as on some herbaceous test plants, in order to investigate for their ability to overcome the resistance genes Tsw and Sw5, respectively. Tomato hybrids carrying the Sw5 gene were uninfected by all RB isolates, whereas all resistant pepper hybrids became systemically infected. RB isolates did not differ noticeably in transmission efficiency when they were tested with the thrips F. occidentalis. Obtained results demonstrate that evolved strains of TSWV have emerged, that they are able to overcome the Tsw resistance gene in pepper plants experimentally inoculated both by mechanical infection and by the vector F. accidentalis. Moreover, evolved strains, here indicated as TSWV-RB-PI (Pepper, Italy), are not able to infect tomato plants carrying the Sw5 gene, confirming that distinct viral gene products control the outcome of infection in plants carrying Sw5 and Tsw. The simultaneous presence of evolved TSWV strains, showing the same biological characteristics (such as host range and symptomatology on different hosts) in two geographic areas of southern Italy, very far each other, let us hypothesize a unique focus of infection. Only subsequently, infected plants, through trade of plant material, have been diffused in locations so far apart. Further molecular studies are underway to assess the possible correlation between the different isolates in different geographical areas.

Medullary thyroid nodules by measurement of calcitonin (Ct) in aspiration needle washout in patients with multinodular goiter and moderately elevated serum Ct

The accuracy of fine needle aspiration cytology (FNAC) is low in medullary thyroid carcinomas (MTC). Recently, a few papers analyzed the measurement of calcitonin (Ct) in washout of the needle after aspiration (WO-Ct) suggesting that this approach may be useful in patients with high serum Ct. Here we reported, for the first time in our best knowledge, 3 patients with multinodular goiter, moderately elevated serum Ct, high value of WO-Ct, and medullary outcome. These findings suggest that in presence of high serum Ct, FNAC should be performed in all nodules, and it should be combined with WO-Ct in all cases.

Chlorantraniliprole/lambda-cyhalothrin, a new insecticide mixture to control Tuta absoluta and Spodoptera littoralis in tomato

A study was performed in the period May-July 2011 by Bioagritest test facility according to EPPO guidelines and Principles of Good Experimental Practice (GEP), in the land of Eboli (SA), southern Italy, with the purpose to test a new insecticide mixture in the defense strategies of processing tomato against Tuta absoluta and Spodoptera littoralis. The insecticide mixture Chlorantraniliprole 100 g/lambda-Cyhalothrin 50 g/l 0,4 It/ha was applied in a tomato field in four (A-B-C-D) application timings (a.t.) alone (treatment 2) and in two a.t. (A-B) combined with emamectin benzoate 0.5%, 1,5 Kg/ha (a.t. C-D) (treatment 3). Its effect in containing insect populations was compared with that exerted by emamectin benzoate 0.5%, 1,5 Kg/ha (a.t. A-B-C-D) (treatment 4) and the combination of chlorantraniliprole 35%, 0.115 Kg/ha (a.t. A-B) and indoxacarb 30% 0.125 Kg/ha (a.t. C-D) (treatment 5). Application of treatments (trt.) and mode of assessment (2 assessments), recording and measurements followed the guidelines foreseen by EPPO Standards PP1/150 and PP1/275. The lepidoptera infestation in the tomato crop was very high on both the leaves and fruits, and this enabled us to evaluate the efficacy of the tested products in conditions of severe pests infestation. If we consider the leaf damage, either as number of mines by T. absoluta or as % of leaf erosion by S. litteralis, all the treatments values were statistically lower than control, but with no difference among them. But when using as an infestation threshold the percentage of damaged fruits (much more relevant in economic terms), we observed statistically significant differences among treatments. Actually, treatment with chlorantraniliprole-lambda-cyhalothrin mixture was significantly more effective than the one with emamectin benzoate in reducing the attack of T. absoluta on tomato fruits, in both dates of assessments. As concerns damage by S. littoralis on the fruits, at the first assessment, trt. 2 and trt. 5 significantly reduced the percentage of infested berries in comparison with the control, whereas the infestation was not significantly reduced by trt. 3 and trt. 4. At the second assessment, no statistically significant difference between the four different treatments was observed. Since the infestation of tomato fruits by S. littoralis was much lower than the one caused by T. obsoluta, the overall performance of the four insecticide treatments was mainly due to the control effects towards T. obsoluta.

Morphological and molecular characterisation of fungal populations possibly involved in the biological alteration of stones in historical buildings

The deterioration process of historical building is progressive and irreversible, and the timing and mode of impact are different depending on the characteristics of building materials used, local microclimate, air pollution, presence of specific flora and fauna. The chemical and microbiological characterisation of building materials is mandatory in preventing and eventually recovering degradation effects. Ideally, the analysis of structural stones should be complete, efficient, rapid, and non destructive when dealing with a precious or unique construction. The investigation has been performed on a private historical building made using calcarenite stones and sited between the archaeological site of Lavello, a little town located in the Basilicata Region (South Italy), and the industrial area surrounding this town. To study in progress the degradation of stone materials, a new building sample (ca. 1 m3) was constructed by using the same stones (33 x 15cm), collected from a local quarry. The intact calcarenite stone was characterised by using different methods of surface analysis (XRD, XPS, SEM), and exposed to outdoor conditions. The analyses of the stone material were repeated after three and six months to early evaluate the progression of alterations and the forward modifications of calcarenite structure. After only three months of the new building sample exposure, the adopted analytical methods were able to provide a series of data, which allowed the assessment of the incipient modification of the stone surfaces. The degradation appeared worsened performing the same observations on sixth month replicates, suggesting that environmental conditions modified the structure and the compactness of stones and favoured the biological colonization of surfaces especially in the South-East direction of prevailing winds. For this reason the presence of fungi on the stones' surface was investigated and a morphological and molecular characterization of sampled fungi was performed. Several genera and species of fungi, possibly, involved in degradation were found. The most frequent colonies belonged to Alternaria (A. infectoria, A. citri and Alternaria sp.), Coprinopsis sp., Penicillium piceum, Fusatrium equiseti and Scytalidium termophilus.

Evaluation of efficacy and effect of application timing of a new herbicide, a.i. propoxy-carbazone + iodosulfuron + mefenpyr on Triticum durum

A study was performed from February to May 2010 by Bioagritest according to EPPO guidelines and Principles of Good Experimental Practice (GEP), in the land of Altamura (BA), in the core of Murgia, Apulia Region (Italy). The purpose of the study was to evaluate the efficacy and effect of two different application times of the herbicide SIT90 (propoxycarbazone + iodosulfuron + mefenpyr) on Triticum durum for weeds' control. Sit90 was applied alone or in combination with the herbicide Dicuran (a.i. chlortolorun) in early post-emergence, and in late post emergence once more alone or in combination with the adjuvant Biopower or with the commercial formulate Atlantis WG (mesosulfuron+ iodosulfuron+ mefenpyr) + Biopower. T. durum cultivar was "Iride". The study has given sufficient results on the use of SIT90, in the conditions foreseen by the protocol and in consideration of the present weeds, which represented the species mostly diffused in the Murgia, mainly Avena ludoviciana and Papaver rhoaes. Treatments with the SIT90 alone (even in combination with Chortoluron), applied in early or in late post-emergence, were very ineffective on grass weeds and dicotyledonous, highlighting the importance of the adjuvant Biopower to enhance the expression of the herbicide. In fact, the presence of the adjuvant allowed the expression of a clear and good overall herbicide activity of SIT90 for the control of P. rhoaes and other dicotyledonous, but also a discrete activity against grasses. More reliable was the treatment with SIT90 mixed with Atlantis, against the entire community of grass weeds and on F. officinalis. The performance of all the treatments was insufficient on P. rhoaes, because of the clear resistance shown by the weed.

Phenotypic changes of the thyrocyte membrane in papillary thyroid carcinoma. A three-dimensional study

Aim of the study was to assess the presence of structural changes in the complex carbohydrate chains of thyroid epithelia undergoing neoplastic transformation. We investigated thyroid cells from neoplastic lesions using a panel of lectins with specific affinity for distinct carbohydrate residues. Sixty samples of thyroid tissue, including normal, hyperplastic and neoplastic lesions were obtained from surgical specimens and blindly evaluated with lectin stains. Confocal microscopy was used to obtain three-dimensional (3-D) images of the samples with a positive reaction. Wheat germ agglutinin (WGA) was consistently positive on the apical membrane of papillary thyroid carcinomas (PTC), was weakly expressed in follicular carcinomas (FC) and resulted negative in normal thyrocytes and in benign conditions. The 3-D microscopy model showed that the WGA staining pattern in light microscopy corresponds to a continuous layer on the luminal surface of both papillary and tubular structures of PTC cells. The other lectins under evaluation did not provide any significant result. In conclusion, in PTC the apical border of thyrocytes showed a strong, specific and consistent staining with WGA. These findings may be related to a modified interaction of thyroglobulin molecule with thyroid cell membrane and with the expression of molecules that are involved in the process of tumorigenesis and tumor progression.

Evaluation of the efficacy and selectivity of Oberon (Spiromesifen) for the control of Tetranychus urticae on strawberry

A study was performed in the period June to July 2009 by Bioagritest test facility according to EPPO guidelines and Principles of Good Experimental Practice (GEP), in the campaign of Tursi (MT), southern Italy, in order to evaluate the efficacy and selectivity of Spiromesifen on strawberry for the control of Tetranyichus urticae. Two different dosages of OBERON (a.i. Spiromesifen)--45 and 60 ml/hl--were compared with a unique dosage of two commercial formulates: VERTIMEC (a.i. Abamectine, Syngenta Crop Protection), 60 ml/hl, and MAGISTER (a.i. Fenazaquin, Dow AgroSciences), 60 ml/hl. The study has achieved the purpose of evaluating/measuring with a single application the activity of Spiromesifen (Oberon) to control T. urticae on strawberry and its selectivity on phytoseiids. All the treatments differed significantly from the checks and showed high ability to control mites, on all stages of the population. About selectivity on phytoseiids, only Spiromesifen (at both doses) has demonstrated a good selectivity, while Abamectine (in part) and Fenazaquin (totally), have limited the population of the predator. The study confirmed the usefulness, indeed the need for the new compounds, to get confirmation of their selectivity against the useful entomofauna. The experiment has allowed to demonstrate the suitability of Spiromesifen to be included in strategies for strawberry integrated pest management.

Evaluation of the efficacy of Oberon (Spiromesifen), to contain infestations of mites and whiteflies on Capsicum annuum L

Following the EPPO guidelines and Principles of Good Experimental Practice (GEP), an experiment was realised in autumn 2008 for evaluating the efficacy of Oberon applied by foliar treatments to contain infestations of mites and whiteflies on Capsicum annuum L.. Two different dosages of OBERON (a.i. Spiromesifen)--45 and 60 g/hl--were compared with a unique dosage of two commercial formulates: VERTIMEC (a.i. Abamectine, Syngenta Crop Protection), 60 g/hl, and MAGISTER (a.i. Fenazaquin, Dow AgroSciences), 110 g/hl. Oberon resulted very effective in the control of phytopathogenic mites at both doses of 45 and 60 g/hl. Its effectiveness demonstrated to be remarkable for approximately one month after application. By contrast, Vertimec and Magister have proven their effectiveness for a much lower period of time (about the first 15 days post application). About the efficacy against whiteflies, even 36 days after the foliar application Oberon showed a strong containment of the populations of aleurodides. There were no phenomena of phytotoxicity nor on leaves nor on flowers and fruits, in none of the treatments. About the phytotoxicity on the useful entomofauna, the assessments made on the different treatments have highlighted the lack of harmful effects on predators and on parasitoids of insects and mites.

Borderline HER‐2 breast cancer cases: Histochemical versus real‐time PCR analysis and impact of different cut‐off values

Seventy-one cases that had resulted borderline for HER-2 protein expression at conventional immunohistochemical assay (2+) were assessed for HER-2 gene amplification by real-time PCR and by FISH in accordance with the manufacturer's recommendations (gene amplification with ratio >or=2 in both methods). Thirty-three out of 71 cases (47%) resulted amplified at real-time PCR analysis, whereas 15 cases resulted positive at FISH (21%). Apparently, PCR was more sensitive than FISH in HER-2 determination, only 10 cases resulting amplified in both tests. When the mean ratio value obtained in all PCR experiments was adopted as threshold in determining HER-2 gene amplification, the apparent sensitivity of PCR was reduced but correlation between PCR and FISH results was dramatically increased. Furthermore, when the mean PCR ratio value observed in the FISH-positive group was chosen as threshold, the best agreement between PCR and FISH results was achieved. Therefore, we found that the proposed threshold ratio value of >or=2 is not accurate in separating HER-2 amplified and non-amplified cases. We suggest that the threshold ratio value in PCR tests should be determined in each laboratory using FISH controlled cases. Finally, above certain in-lab generated threshold values, PCR might be proposed as a highly predictive positive test in HER-2 assessment.

Integrated approach to TYLCD management in Sardinia (Italy)

In Sardinia (Italy) Tomato yellow leaf curl disease (TYLCD) re-emerged in 2003, after a period of decline, producing severe yield losses in protected tomato crops. This epidemic outbreak highlighted the inadequacy of the approach to TYLCD management based chiefly on the chemical control of its vector, the whitefly Bemisia tabaci, and the use of 40-mesh nets for greenhouse screening. To evaluate the reliability of alternative practices for implementation within IP&DM programmes, in 2007 and 2008 we carried out two field experiments on greenhouse tomato crops planted in summer. In both trials we tested the use of UV-reflective mulches (UVRM) or floating row covers (NWRC), against an uncovered control on clear mulch. Furthermore, we assessed the effectiveness of acibenzolar-S-methyl, a SAR elicitor, as subplot factor in a split plot design. In 2007 because of the low incidence of the disease it was not possible to assess differences among the treatments. However a significant increase in plant growth, and production was observed in UVRM plots. By contrast, in 2008 the study crop was seriously affected by TYLCD. In the plots not treated with acibenzolar-S-methyl, the disease progression was initially slowed down in NWRC and, to a lesser extent, in UVRM plots compared to control plots but, during the second month of the cropping period, the differences among treatments became statistically not significant. In the plots treated with acibenzolar-S-methyl the dynamics of TYLCD infection during the first five weeks exhibited the same trend as in the untreated plots. Thereafter, the combination of UVRM and, to a lesser extent, of NWRC with the SAR elicitor resulted in a reduction of disease incidence with respect to the control. In conclusion, all the control measures tested in the present work showed the potential for TYLCD management in greenhouse tomatoes. However, the most promising results were achieved using UV-reflective mulch and non-woven row cover in combination with acibenzolar-S-methyl. In view of its positive impact on plant growth and yield in summer planted tomato crops, as well as on TYLCD infection, the use of UV-reflective mulch warrants further investigation.

First record of tomato yellow leaf curl Sardinia virus (TYLCSV) on pepper in Italy

During a survey in summer 2007, a disease of pepper (Capsicum annuum) under plastic tunnels was observed in Policoro (Matera), on the Ionic coast of Basilicata Region, with a disease incidence in some cases of more than 50%. Affected cultivars were Eppo and Almund (S Et G). The diseased plants exhibited light mosaic or mottling, leaf distortion, interveinal and marginal leaf chlorosis, upward curling of leaf margins of older leaves. The causal pathogen was suspected to be a begomovirus due to the large population of the whitefly Bemisia tabaci observed on the crop. Detection assays for Tomato yellow leaf curl Sardinia virus (TYLCSV) and Tomato yellow leaf curl virus (TYLCV) were used. In DAS-ELISA, positive results (178 plants resulted positive over 200 symptomatic plants assayed) were obtained using a "broad-spectrum" reagent combination (distributed by Bioreba AG) detecting TYLCV, TYLCSV, and other begamoviruses. A couple of synthetic oligonucleotides allowing the amplification of the whole coat protein (CP) gene of TYLCSV and TYLCV was used for PCR of ELISA positive samples in order to perform the molecular characterisation of the viral isolate responsible of the disease. RFLP analysis performed on the PCR product, 1008 bp long, showed the presence of only TYLCSV in the infected pepper plants. The same couple of primers allowed the detection of the virus also in symptomless pepper plants. To test whitefly transmission, adults of B. tabaci allowed to feed on naturally infected pepper plants were transferred on 10 healthy Eppo pepper seedlings (15 whiteflies/plant). Insects were killed 2 days later using an insecticide. Twenty days post exposition 10 plants/10 resulted positive in ELISA, and showed the same symptoms observed in natural infection. TYLCSV was not reported before on pepper in the surveyed area, but it was recorded with severe outbreaks on tomato, both in protected and in open field crops. This species was probably the primary source of infection from which subsequent diffusion by way of the vector B. tabaci followed on pepper. To our knowledge this is the first time that a natural infection of TYLCSV on pepper is recorded in Italy, with serious implications for the epidemiology of TYLCSV in our country.

Potato virus Y CFH, a putative recombinant isolate from Capsicum chinense cv. Habanero

Ornamental plants of Chili pepper, Capsicum chinense cv. Habanero, with symptoms of leaf mosaic, necrotic rings on fruits and necrotic stems were observed in June 2003 in a private garden in the province of Naples (Italy). Preliminary serological characterisation allowed the association of these symptoms with infections by Potato virus Y (PVY). The virus was isolated on Nicotiana tabacum cv. Xanthi and characterised by mechanical inoculation on herbaceous hosts and molecular characterisation of the P1 and the coat protein (CP) genes. Symptoms produced on indicator plants were generally consistent with those described for PVY. The identity of PVY was further confirmed by reaction with PVYN, PVYC and PVYO specific monoclonal antibodies: the isolate reacted only with the PVYC specific Mab. Immuno capture reverse transcription polymerase chain reaction (IC-RT-PCR) was performed on extracts of PVY-CFH infected N. tabacum cv. Xanthi plants, using two couples of primers specifically designed out of the P1 and the CP coding regions of the so far fully sequenced PVY isolates. PCR products were then cloned into pCRII-TOPO vector using TOPO-TA cloning kit (Invitrogen) and sequenced. Sequence analysis suggests that PVY-CFH originated from a recombination event involving a virus of the PVYO type and another parental virus, maybe resembling the PVYNP isolates, given the reasonably high similarity shared by PVY-CFH and, respectively, non potato PVY isolates in the CP coding region, PVYO isolates in the P1 coding region. Evidence for the existence of such a recombination comes, apart from similarity analysis, by the different locations of CFH within phylogenetic trees constructed from P1 and CP genomic regions.

Integrated management of TYLCV/TYLCSV on greenhouse hydroponic tomatoes in Southern Italy

Tomato yellow leaf curl (TYLC) caused by Tomato yellow leaf curl virus (TYLCV) and Tomato yellow leaf curl Sardinia virus (TYLCSV), vectored by the whitefly Bemisia tabaci, is a major disease of tomato in Sardinia and Sicily, and is becoming a serious threat in Southern Italy too. TYLCSV was first reported in Calabria region in 1991, but apparently it was an occasional outbreak, and B. tabaci was not detected. Later, during the 2003-2004 winter, a serious epidemic was observed in protected tomato crops in Castrovillari, Cosenza province. TYLCV was first described in Sicily in 2003 and during 2004 in continental Italy. Both viruses were detected in winter 2005-2006 on the Basilicata Ionic coast, in the Metapontum area, both in protected and in open field tomato crops. Experiments were conducted in Calabria Region, Southern Italy, under controlled conditions in a group of greenhouses where several tomato crops were grown hydroponically to determine the separate and integrated effects of UV-reflective mulch (UVRM), Acibenzolar-S-methyl (Actigard) and the two insecticides Imidacloprid (ADMIRE 2F) and Thiamethoxam (ACTARA 25WG). Highly UV-reflective mulch covered plots were treated with Actigard and insecticides, both alone or in combination. TYLC disease incidence was determined from late August 2005 to late January 2006. The highly UVRM alone was effective in reducing disease incidence of about 28.6% at the end of October, and of 31.7% at the end of January. However, Actigard with UVRM significantly reduced TYLC disease incidence to 70% and 48.5%, in 2 months and 5 months after the first treatment, respectively. The insecticides with UVRM, resulted in a moderate reduction of disease incidence (22.5%) at the end of October. At the end of January a reduction in disease incidence due to insecticide applications was not significant. The use of Actigard combined with the insecticides on UVRM reduced the disease incidence (63.4% with Admire and 56.1% with Actara) at the end of January. Actigard alone or with insecticides on UVRM was effective in reducing disease incidences. Highly UVRM and Actigard were effective in reducing the primary spread of TYLCV/TYLCSV in greenhouse hydroponic tomatoes. Comparative analysis of their effects at different periods post-treatment suggests that multiple applications of Actigard may be necessary to reduce progress of this disease.

Typing of tomato yellow leaf curl viruses and their vector in Italy

A molecular survey of TYLCV/TYLCSV and their associated vector Bemisia tabaci, was performed during 2004-2005 in five regions of Southern Italy: i.e. Sardinia (one locations), Sicily (one location), Calabria (three locations), Campania (two locations) and Basilicata (one location). A total of 71 tomato samples were checked for virus infection and for the presence of the vector. Degenerate primers allowing the amplification of the coat protein gene of both TYLCSV and TYLCV isolates were designed. PCR fragments were then digested with restriction endonuclease Ava II, which was expected to cut TYLCSV differently from TYLCV. Results clearly suggested that in all the inspected Italian regions the two viruses are widespread and present in single plant both alone and in mixed infections. The identity of the two viruses was confirmed by total or partial sequencing of field isolates. Concerning the populations of the B. tabaci associated with TYLCD epidemics, the molecular characterization of COI gene (citocrome oxidase I) indicated that Q biotype was the most prevalent biotype. This fact might be the result of the large use of some insecticides against which Q biotype populations easily develop resistances, as already confirmed in some countries of Mediterranean basin.

Characterisation of Potato virus Y nnp strain inducing veinal necrosis in pepper: a naturally occurring recombinant strain of PVY

The full-length genome of Potato virus Y (PVY) nnp strain, recovered from pepper showing veinal necrosis of leaves, was cloned and sequenced, finding an organisation typical for PVY species. It consists of 9699 nucleotides (nt) excluding the 3' terminal poly(A) tail and contains an open reading frame of 9186 nt, encoding the putative polyprotein of 3061 amino acids. In ELISA, the isolate reacted with a monoclonal antibody specific for PVY(C) but not with antibodies against PVY(N) or PVY(O). Sequence analysis strongly suggests that PVY-nnp originated from a recombination event involving a virus of the PVY(O) type and another parental virus, maybe resembling the PVY(NP) isolates, given the reasonably high similarity shared by PVY-nnp and Lye84.2 and Son41 isolates. The recombination event involved a breakpoint near the middle of the P1 gene, around position 603 of the viral genome. Proof for the existence of such a recombination comes from several lines of evidence, including similarity analysis, recombination analysis using six different methods and the different locations of nnp within phylogenetic trees constructed from genomic regions on either side of the identified recombination breakpoint.

Severe outbreaks of tomato yellow leaf curl Sardinia virus in Calabria, Southern Italy

During the winter 2003--2004 a serious disease was observed in protected tomato crops in Castrovillari, Reggio Calabria province, Southern Italy. Symptoms consisted in marginal leaf yellowing, leaf curling, plant stunting, flower abortion. The disease was detected in a group of greenhouses (about 10ha) where several tomato cultivars were grown hydroponically. The highest incidence of infection (60-100%) was observed in tomatoes grafted on Beaufort DRS tomato rootstock. Since the symptoms were similar to those described for Tomato yellow leaf curl Sardinia virus (TYLCSV) and Tomato yellow leaf curl virus (TYLCV), detection assays for these viruses were used. In DAS-ELISA positive results were obtained with a abroad-spectrums reagent combination (distributed by Bioreba AG) detecting TYLCV, TYLCSV, and other begomoviruses. When DNA probes were used in tissue print assays, positive reactions were obtained for TYLCSV, but not for TYLCV. The two probes consisted of digoxigenin-labelled DNAs representing the coat protein gene of either TYLCSV or TYLCV. Attempts to isolate the viral agent by mechanical inoculation failed, except in few cases where Potato virus Y and Tobacco mosaic virus were identified following transmission from symptomatic plants to herbaceous indicatorpplants. By contrast, grafting onto tomato seedlings always successfully transmitted the disease. In the Castrovillari area TYLCSV was not reported before. The rootstocks that nurseries used for grafting were obtained from Sicily, where the disease is endemic and both TYLCSV and TYLCV are widespread. Probably the grafted plantlets represented the primary source of infection from which subsequent diffusion by way of the vector Bemisia tabaci followed. In fact the vector had previously been detected in both the glasshouse-grown and open field tomato crops in Calabria region. TYLCV was previously reported in a different area of Calabria in 1991, but apparently it was an occasional outbreak, and B. tabaci was not detected. Since in the Castrovillari area surveyed in the present study tomato is grown throughtout the year in protected crops, the whitefly vector of the virus is present, and some natural hosts of the virus are found, it is feared that TYLCSV may become endemic, as already happened in Sicily, Sardinia, and Spain several years ago. In Spain and Sicily TYLCV, together with TYLCSV, was reported as the causal agent of very severe tomato crop losses. Therefore the danger exists that also TYLCV will reach this area, furthermore complicating the management of tomato crops.

The complete nucleotide sequence of Plum pox virus isolates from sweet (PPV-SwC) and sour (PPV-SoC) cherry and their taxonomic relationships within the species

Plum pox virus (PPV) sweet (SwC) and sour (SoC) cherry isolates were the first PPV isolates to be recovered from natural infection in sweet and sour cherry plants, respectively. Their complete nucleotide sequences have been determined finding a deduced genome organisation typical for PPV species. Both genomes are 9795 nucleotides long, excluding the 3' terminal poly(A) tail, and contain an open reading frame of 9432 nt, encoding a polyprotein of 3143 amino acids. The nucleotide and predicted amino acid sequences of PPV-SwC and SoC have been pairwise compared with available sequences of different PPV strains. Although a very high similarity exists between the whole genomes and polyproteins of the two cherry isolates, high levels of divergence have been calculated with sequences of PPV-M, D and EA isolates. In particular, the most considerable divergence has been found in part of 5' non coding region, in regions encoding P1, P3 + 6K1, 6K2 and NIa-VPg proteins as well as in the N-terminal domain of the coat protein. Phylogenetic analysis have been undertaken in order to establish the taxonomic localisation of SwC and SoC isolates within PPV species, showing that they are always clustered together and separated from the rest of PPV strains, being clearly the most distant.

Localization and expression of thyroid hormone receptors normal and neoplastic human thyroid

The aim of this study was to investigate the regional expression of thyroid hormone nuclear receptor forms (TR(alpha) and TR(beta)) and isoform (TR(alpha1) and TR(beta2)) mRNAs in normal and neoplastic (benignant and malignant) human thyroid tissue. Tumor specimens from patients with thyroid carcinomas (papillary: 5 cases; follicular: 5 cases; anaplastic: 2 cases), thyroid follicular adenomas (7 cases) and tissue from normal thyroid glands (12 cases) were analyzed by in situ hybridization and semiquantitative RT-PCR for the expression of TR(alpha1) and beta, as well as for the isoform alpha2 that does not bind the hormone. In normal tissues, TR(alpha2) was expressed at lower levels compared to TR(alpha1) (alpha1/alpha2 = 4.3). In papillary and follicular carcinomas, the expression of TR(alpha1) and TR(beta) did not change as compared with normal thyroid tissue and adenomas (0.87 +/- 0.15 SD vs 0.89 +/- 0.17 densitometric units, DU, and 0.15 +/- 0.02 vs 0.14 +/- 0.03 DU, respectively). However, the expression of TR(alpha2) was significantly higher in differentiated carcinomas compared to normal thyroid tissue and adenomas (0.47 +/- 0.05 vs 0.20 +/- 0.05 DU, p < 0.05) with alpha1/alpha2 = 1.4. In anaplastic carcinoma all TRs were absent. We concluded that both normal and pathological thyroid tissues, with the exception of anaplastic carcinoma, express all TRs in thyreocites and that differentiated thyroid carcinomas are associated in enhancing the expression of TR(alpha2) mRNA.

A new mathematical model based on clinical and laboratory variables for the diagnosis of Sjögren's syndrome

Sjögren's syndrome (SS) is a systemic autoimmune disease that mainly affects exocrine glands. A diagnosis of SS in its early stages has a potential clinical relevance, but it is difficult and cannot be made solely on clinical grounds. Several sets of diagnostic criteria have been proposed, but none has met with a general consensus. Minor salivary gland has been judged to be the "gold standard" for the diagnosis of SS. However, it is a painful procedure and has a small but significant proportion of both false positive and false negative results. The aim of our study was to develop a simple mathematical score that uses clinical and laboratory variables for diagnosing SS, thereby reducing the need of minor salivary gland. The following variables were included in the model: ANA, SS-A/SS-B, Schirmer's Test/BUT, C3/C4, serum gammaglobulin levels. One hundred consecutive individuals reporting clinical syndromes consistent with a sicca syndrome were included in the study. The application of our multifactorial mathematical model has shown a high predictive value for SS vs controls or vs patients with other autoimmune disorders (Sensitivity 93%, Specificity 100%), with an estimated minor salivary gland reduction of 77%. We conclude that our mathematical model can be considered a useful non-invasive approach for diagnosing Sjogren's Syndrome and recommend its validation on a larger scale.

Mucosal changes in ileal pouches after restorative proctocolectomy for ulcerative and Crohn's colitis

PURPOSE

Inflammation and dysplasia may affect the ileal pouch after restorative proctocolectomy and ileal pouch-anal anastomosis. The aim of this prospective study was to evaluate the morphologic changes and the risk of dysplasia within the pouch after ileal pouch-anal anastomosis.

METHODS

Thirty-seven patients with ileal pouch-anal anastomosis underwent endoscopies and biopsies of the pouch: 21 patients were affected by ulcerative colitis and 16 by Crohn's colitis. The mucosal biopsy specimens were studied to investigate the degree of acute and chronic inflammation and the occurrence of dysplasia. A score system was calculated for each patient and correlated with the histologic diagnosis of ulcerative colitis or Crohn's colitis.

RESULTS

After a median follow-up of 85 (range, 7-198) months, the inflammation histologic score evaluated was 3.8 (95 percent confidence interval, 2.4-5.1) and 3.5 (95 percent confidence interval, 2.6-4.3), respectively, in patients with Crohn's colitis and ulcerative colitis (mean and 95 percent confidence interval; P = 0.74, not significant), and no patient developed mucosal dysplasia. Fifteen patients (40.5 percent) developed clinical pouchitis that occurred in Crohn's colitis (9/16 patients or 56 percent) and in ulcerative colitis (6/21 patients or 28 percent; P not significant). The score was 4.1 (95 percent confidence interval, 3.2-5) in patients with pouchitis and 3.2 (95 percent confidence interval, 2.1-4.3) in patients without clinical pouchitis (P = 0.012) and was 4.1 (95 percent confidence interval, 2.6-5.5) and 4 (95 percent confidence interval, 2.9-5.3), respectively, in pouchitis patients with Crohn's colitis and ulcerative colitis.

CONCLUSION

No difference in the inflammation histologic score was observed in ileal pouches after restorative proctocolectomy for ulcerative and Crohn's colitis. In our series, which includes those patients with longer follow-up (>5 years) or with chronic unremitting pouchitis, no case of dysplasia was found. The occurrence of pouchitis was higher in the case of ileal pouch-anal anastomosis for Crohn's disease than for ulcerative colitis, but no difference in the severity of the histologic score was noted.

Thyroid tissue: US-guided percutaneous interstitial laser ablation-a feasibility study

PURPOSE

To evaluate percutaneous interstitial laser photocoagulation (ILP) as a palliative treatment of recurrent thyroid carcinoma untreatable with surgery or radioiodine administration.

MATERIALS AND METHODS

By using 18 resected thyroid glands, the volume and histologic pattern of ILP-induced thyroid damage were assessed. In vivo treatment feasibility was evaluated by using a low-energy laser in two volunteers before thyroidectomy for huge autonomously functioning nodules. With ultrasonographic (US) monitoring, a 21-gauge spinal needle was inserted into the thyroid nodules. A 300-microm quartz fiberoptic guide was inserted through the needle lumen, and the fiber tip was placed in direct contact with the tissue. Laser irradiation was performed with a 1.064-nm Nd:YAG laser in surgically resected glands, which were treated with 2, 3, 5, or 7 W.

RESULTS

Tissue ablation was well-defined histologically, and its area was related to laser irradiation parameters (range, 0-26 mm). No correlation was found between US images and the actual extent of laser-induced lesions. Large colloid or fluid collections did not permit regular heat diffusion within the tissue. In vivo low-energy ILP was performed without technical difficulties or complications.

CONCLUSION

ILP induces well-defined tissue ablation correlated with energy parameters in thyroid glands devoid of cystic areas. ILP could be a therapeutic tool for highly selected problems in thyroid tumor treatment.

Ontogenetic pattern of thyroid hormone receptor expression in the human testis

We studied the spatiotemporal distribution of thyroid hormone nuclear receptors (TRs) alpha1 and alpha2 and beta messenger RNA (mRNA) levels in normal human testicular tissue during development and in adulthood. Nonpathological specimens from five aborted fetuses (17 and 23 weeks of gestation, three and two cases, respectively) and from four patients undergoing orchiectomy (18 months old and 38-, 42-, and 52-yr-old, respectively) were analyzed by Northern blot, semiquantitative RT-PCR amplification using DNA sequences or specifically designed primers for the TR isoforms, and in situ hybridization. By using PCR amplification, we found that TRalpha1 and TRalpha2 are both expressed at different levels in fetal and adult testis. At all ages TRalpha2 is found at higher levels. Northern analysis showed hybridization signals corresponding to the expression of TRalpha2 and TRalpha in a ratio that increased from 2.6 at 17 weeks of gestation to 12.0 in adulthood. In fact, the expression of TRalpha1 dramatically decreased throughout development, being faintly detectable in the adult testis. Expression of TRbeta was not detected at any age studied. This finding was further confirmed by PCR, which did not amplify TRbeta either in fetal or in adult testis mRNAs. In situ hybridization studies showed the absence of TRbeta and that TRalpha1 and TRalpha2 colocalized in Sertoli cells of prepubertal testis, whereas germ and interstitial cells appeared devoid of TR mRNA signals. From these results it can be concluded that the human testis exclusively expresses TRalpha, which is localized in Sertoli cells, TRbeta being always undetectable. Fetal and prepubertal ages represent the period of maximal expression of TRalpha1 and TRalpha2. The alpha2/alpha1 ratio rises dramatically after development. These results confirm a critical window for the action of thyroid hormone in human testis, in the period of maximal expression of T3 binding isoform TRalpha1, and may account for the macroorchidism without virilization occurring when hyposecretion of thyroid hormones occurs before puberty.

Evidence of UCP1-independent regulation of norepinephrine-induced thermogenesis in brown fat

To study the thermal response of interscapular brown fat (IBF) to norepinephrine (NE), urethan-anesthetized rats (1.2 g/kg ip) maintained at 28-30 degrees C received a constant venous infusion of NE (0-2 x 10(4) pmol/min) over a period of 60 min. IBF temperatures (T(IBF)) were recorded with a small thermistor fixed under the IBF pad. Data were plotted against time and expressed as maximal variation (Deltat degrees C). Saline-injected rats showed a decrease in T(IBF) of approximately 0.6 degrees C. NE infusion increased T(IBF) by a maximum of approximately 3.0 degrees C at a dose of 10(4) pmol x min(-1) x 100 g body wt(-1). Surgically thyroidectomized (Tx) rats kept on 0.05% methimazole showed a flat response to NE. Treatment with thyroxine (T(4), 0.8 microg x 100 g(-1) x day(-1)) for 2-15 days normalized mitochondrial UCP1 (Western blotting) and IBF thermal response to NE, whereas iopanoic acid (5 mg x 100 g body wt(-1) x day(-1)) blocked the effects of T(4). Treatment with 3,5, 3'-triiodothyronine (T(3), 0.6 microg x 100 g body wt(-1) x day(-1)) for up to 15 days did not normalize UCP1 levels. However, these animals showed a normal IBF thermal response to NE. Cold exposure for 5 days or feeding a cafeteria diet for 20 days increased UCP1 levels by approximately 3.5-fold. Nevertheless, the IBF thermal response was only greater than that of controls when maximal doses of NE (2 x 10(4) pmol/min and higher) were used.

CONCLUSIONS

1) hypothyroidism is associated with a blunted IBF thermal response to NE; 2) two- to fourfold changes in mitochondrial UCP1 concentration are not necessarily translated into heat production during NE infusion.

Screening of thyrotropin receptor mutations by fine-needle aspiration biopsy in autonomous functioning thyroid nodules in multinodular goiters

Multinodular goiter (MNG) is characterized by nodules of different size and function. Areas of increased function may emerge, appearing as single, or more frequently, multiple autonomously functioning thyroid nodules (AFTN). The molecular mechanism for the autonomous growth and function of these nodules has been related to mutations in the thyrotropin receptor (TSHR) that constitutively activate the adenylyl cyclase. We searched for mutations in a limited area of the TSHR gene, covering the major mutational hotspot, in 38 AFTNs found in 37 patients with MNGs. We used reverse transcriptase-polymerase chain reaction (RT-PCR) and restriction enzyme analysis of fine-needle aspiration biopsy (FNAB) samples to rapidly identify 4 of the more frequently occurring TSHR mutations: D619G, F631C, T632I and D633E. Mutations were identified in 5 nodules (1 D619G mutation and 4 T632I mutations). Subsequently, the entire transmembrane portion of the TSHR gene was sequenced in a random sample of 12 AFTN samples that were free of mutations by RT-PCR and restriction enzyme analysis. By direct sequencing we identified a new mutation, F666L, in the seventh transmembrane domain in a sample from 1 nodule. Analysis of FMA samples of AFTN is an effective approach to identify TSHR gene mutations because individual mutations may be associated with different growth and function in vitro, our approach might, allow correlation of a given mutation with the clinical behavior in vivo.

Circular dichroism studies of CMV-D and CMV-S: two strains of cucumber mosaic cucumovirus with a different biological behaviour

Cucumber mosaic cucumovirus is a plant virus in which a typical satellite RNA system is present, displaying a dualistic biological behaviour. In fact, it has been shown that satRNA is able either to aggravate or attenuate the viral disease symptomatology with a modulating capability going from death of the host plant to a surprising absence of symptoms. D-satRNA and S-satRNA have been considered the prototype necrogenic and non necrogenic satRNAs respectively. On the basis of circular dichroism spectroscopy, it is suggested that the different biological behaviours can be explained by taking into account the different capabilities exerted by S- and D-satRNAs in inducing structuring effects onto CMV-S and CMV-D genomic RNAs.

Severe thyrotoxicosis due to hyperfunctioning liver metastasis from follicular carcinoma: treatment with (131)I and interstitial laser ablation

Liver metastases from differentiated thyroid tumors are unusual clinical findings, and are only rarely hyperfunctioning. We report a case of thyrotoxicosis caused by a huge and surgically unresectable liver metastasis from follicular thyroid cancer, unresponsive to treatment with large doses of thionamides. To avoid the hazardous side effects of (131)I treatment in a severely thyrotoxic patient, a preliminary debulking of the liver mass was performed by means of percutaneous interstitial laser photocoagulation. Three treatments (total energy delivery: 7200 J) were performed under ultrasound guidance, with no serious complications, during a 2-week period. One month later, serum thyroid hormones had decreased, general condition was improved, and magnetic resonance evaluation revealed large and well-defined areas of necrosis of metastatic tissue. During the following 10 months, the patient underwent 3 radioiodine treatments. Eighteen months after diagnosis, thyroid hormones were within normal levels, liver mass decreased, and the clinical condition markedly improved. The combination of percutaneous interstitial laser photocoagulation treatment and radioiodine therapy made possible the effective management of a hyperfunctioning and surgically untreatable liver metastasis from thyroid follicular carcinoma, avoiding the side effects of (131)I therapy in a thyrotoxic patient and increasing the effectiveness of radioiodine-induced neoplastic tissue ablation.

Cytospray fixation of frozen intraoperative sections

Preservation of cellular morphologic features is well known to be a limit of intraoperative frozen sections. Various techniques have been proposed to improve tissue details, the most common being ethanol immersion of cryostatic slide. We tested fixation with spray formulation for cytology smears on intraoperative frozen section from different organs to obtain a quick alcoholic fixation and a ready-to-use method. Our results of comparative study showed that cytospray fixation of frozen sections provide a significant improvement of cellular details, that it is quick, simple, economic, and that it does not require preorganization.

Long-term changes in nodular goiter: a 5-year prospective randomized trial of levothyroxine suppressive therapy for benign cold thyroid nodules

We studied for 5 yr a homogeneous group of 83 patients randomly assigned to a levothyroxine (L-T4) suppressive therapy or to a control group to evaluate changes in nodule or thyroid size, appearance of new nodules, and correlations with clinical parameters. In the control group, mean nodule volume increased significantly after 5 yr (2.12 +/- 1.46 vs. 1.46 +/- 0.77 mL), whereas in the treatment group it decreased, although not significantly (1.45 +/- 1.17 mL vs. 1.53 +/- 0.61 mL). Baseline nodule volume was not different in the two groups, but a significant difference was observed at 5 yr. After 5 yr, sonograms detected 12 new nodules in the control group (28.5%) and 3 (7.5%) in the treatment group. Nodule shrinkage was more frequent in patients with complete TSH suppression, but no correlation was found with other parameters. A significant increase in thyroid size was observed in the control group. In conclusion, long term TSH suppression induced volume reduction in only a subgroup of thyroid nodules, but effectively prevented the appearance of new lesions and increases in nodule and thyroid volume. As the changes in the natural history of nodular goiter are related to prolonged TSH suppression, which can induce unfavorable side-effects, L-T4 suppressive therapy should be reserved for small nodules in younger patients.

Production of strain specific antibodies against a synthetic polypeptide corresponding to the N-terminal region of the plum pox potyvirus coat protein

Comparison of the predicted coat protein amino acid sequence of the 'sweet cherry' strain of plum pox potyvirus (PPV-SwC) with the corresponding regions of several other PPV strains indicated that the main differences are in the N-terminal region. Polyclonal antibodies were produced against a synthetic peptide corresponding to the 1-14 sequence of the N-terminal region of PPV-SwC coat protein. They specifically detected PPV-SwC in different immunochemical tests.

Characterization of the Sweet Cherry Isolate of Plum Pox Potyvirus

An isolate of plum pox potyvirus from sweet cherry (PPV-SwC) in southern Italy was investigated. The isolate was mechanically or graft transmissible to different Prunus and Nicotiana spp. but not to Chenopodium spp. It was transmitted also by Aphis fabae and Myzus persicae in a nonpersistent manner. Restriction fragment length polymorphism analysis indicated and nucleotide sequencing confirmed that the isolate lacks AluI and RsaI sites in the C-terminal region of the coat protein (CP) gene. Western immunoblot results showed that the PPV-SwC CP has an electrophoretic mobility similar to that of strain PPV-D and faster than that of strain PPV-M. Double-antibody sandwich indirect enzyme-linked immunosorbent assay of the CP showed that PPV-SwC, although reacting with universal monoclonal antibodies to PPV, failed to react with antibodies specific to strains M and D. Results indicate that PPV-SwC is different from conventional strains of PPV but closely related to the sour cherry isolate of PPV from Moldova.