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Baset GY, Katawazai S. Primary Umbilical Endometriosis (Villar's Nodule): A Case Report. Int Med Case Rep J 2024; 17:1021-1023. [PMID: 39678152 PMCID: PMC11646424 DOI: 10.2147/imcrj.s500922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Accepted: 12/05/2024] [Indexed: 12/17/2024] Open
Abstract
Primary umbilical endometriosis is a rare condition in which there is endometrial glands and stroma in the umbilicus. Primary umbilical endometriosis is also called villar's nodule. This condition is a diagnostic challenge, the pathophysiology of the disease is not well defined and should be considered in all other pathologies of the umbilicus. Surgery is the treatment of choice. Here we present a case of villar's nodule in a 33-years-old multiparous woman that was successfully treated with surgery.
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Li Y, Wang M, Chen P, Luo K, Lin P, Fu Z, Pu T, Wang X, Yong T, Yang W. Simulation of Defoliation Effects on Relay Strip Intercropping Soybean: Elucidating Foliar Shedding and Leaf-to- Nodule Growth Plasticity. PLANT, CELL & ENVIRONMENT 2024. [PMID: 39526422 DOI: 10.1111/pce.15251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 09/10/2024] [Accepted: 10/20/2024] [Indexed: 11/16/2024]
Abstract
Extensive foliar shedding in monoculture soybeans post-anthesis negatively impacts yield, whereas relay strip intercropping prolongs leaf area duration, enhancing productivity. However, little is known about the causes of leaf shedding in monoculture and its impact on physiological functions and plasticity of source and sink organs, we conducted a 4-year field experiment and leaf-removal simulations in relay intercropped soybeans. Results revealed that monoculture soybeans experienced severe self-shading and defoliation, while relay intercropping maintained better light conditions, supporting higher leaf area, nodule numbers, and carbon allocation. Increasing leaf removal initially increased leaf area but eventually reduced it. Extensive leaf-removal reduced Rubisco and sucrose phosphate synthase (SPS) activity, as well as sucrose, malate, ATP, and energy charge (EC) in nodules, revealing a trade-off between leaf growth and nodule development. Moderate leaf-removal (L30), however, balanced compensation and consumption, increasing total non-structural carbohydrates (TNC) in roots and N and ureide in leaves and pods. Network analysis showed that L30 improved the synergies of functional traits in leaves and nodules, ultimately benefiting overall plant growth and nutrient accumulation in pods. This study elucidates a mechanism of foliar shedding and highlights how relay strip intercropping optimizes source-sink coordination to enhance photosynthesis and nitrogen fixation.
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Jin AF, Luo ZH, Qi WL, Liu Q. Pre-procedure 18F-FDG PET/CT imaging improves the performance of CT-guided transthoracic biopsy. Diagn Interv Radiol 2024; 30:380-384. [PMID: 38293844 PMCID: PMC11589520 DOI: 10.4274/dir.2023.232364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 12/11/2023] [Indexed: 02/01/2024]
Abstract
PURPOSE To compare computed tomography (CT)-guided transthoracic lung biopsies (CTLB) with and without pre-procedure 18F-fludeoxyglucose positron emission tomography (18F-FDG PET)/CT images in the diagnosis of pulmonary nodules/masses. METHODS This is a case-control study in a single center. The data of patients with a transthoracic lung biopsy guided by CT and pre-procedure 18F-FDG PET/CT (group 2, here called the “PETCTLB” group), including demographics, clinical characteristics, and biopsy-related parameters, were collected. The PET/CT scan was performed within 15 days before the biopsy. The data from patients with CTLB were used as controls (group 1). Biopsies for all patients were performed by the same physician between January 2019 and December 2021. The final diagnosis was based on surgical outcomes, or imaging findings, and the results of at least one 6-month follow-up. The demographics and clinical characteristics of patients, lesions and biopsy-related variables, diagnostic yields, and incidence of complications were compared between the two groups. Two-tailed t-tests were used to compare the mean values in the two independent groups, while categorical variables were compared using the Pearson chi-squared test, and P values < 0.05 were considered to be significant. RESULTS A total of 84 patients were included, and 84 biopsies of 84 lung nodules/masses were analyzed. The demographics and clinical characteristics of group 2 (n = 39; 21 men; mean age, 63.2 ± 9.29 years) and group 1 (n = 45; 30 men; mean age, 61.2 ± 12.3 years) had no significant difference (P = 0.230 and 0.397, respectively). The procedure duration (11.1 ± 3.0 vs. 12.9 ± 3.3 minutes, P = 0.008), the number of samples (2.6 ± 0.5 vs. 3.1 ± 0.4, P < 0.001), diagnostic accuracy (97.4% vs. 82.2%, P = 0.033), and bleeding complication (25.6% vs. 42.2%, P = 0.034) of group 2 and group 1 were statistically different. CONCLUSION A biopsy guided by CT plus pre-procedure 18F-FDG PET/CT (PETCTLB) is a safe procedure that can provide a precise diagnosis in the majority of lung nodules/masses. It has better diagnostic performance than CTLB.
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Voloch L, Icht M, Ben-David BM, Carmel Neiderman NN, Levenberg G, Manor Y, Shpunt D, Oestreicher-Kedem Y. Seven Days of Voice Rest Post-phonosurgery Is Not Better than 3 days: A Prospective Randomized Short-term Outcome Study. Laryngoscope 2024; 134:4661-4666. [PMID: 38837365 DOI: 10.1002/lary.31556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/20/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE The aim of the study is to compare the short-term effect of 7 versus 3 days of voice rest (VR) on objective vocal (acoustic) parameters following phonosurgery. METHODS A prospective randomized study conducted at a tertiary referral medical center. Patients with vocal fold nodules, polyps, or cysts and scheduled for phonosurgery were recruited from the Voice Clinic. They were randomized into groups of 7- or 3-day postoperative VR periods and their voices were recorded preoperatively and at 4-week postoperatively. A mixed linear model statistical analysis (MLMSA) was used to compare pre- and postoperative jitter, shimmer, harmonic-to-noise ratio, and maximum phonation time between the two groups. RESULTS Sixty-five patients were recruited, but only 34 fully complied with the study protocol, and their data were included in the final analysis (19 males, 20 females; mean age: 40.6 years; 17 patients in the 7-day VR group and 16 in the 3-day VR group). The groups were comparable in age, sex, and type of vocal lesion distribution. The preoperative MLMSA showed no significant group differences in the tested vocal parameters. Both groups exhibited significant (p < 0.05) and comparable improvement in all vocal parameters at postoperative week 4. CONCLUSIONS A VR duration of 7 days showed no greater benefit on the examined vocal parameters than the 3-day protocol 4-week postoperatively. Our results suggest that a 3-day VR regimen can be followed by patients who undergo phonosurgery without compromising the vocal results. Larger-scale and longer-duration studies are needed to confirm our findings. LEVEL OF EVIDENCE 2 Laryngoscope, 134:4661-4666, 2024.
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Santone A, Mercaldo F, Brunese L. A Method for Real-Time Lung Nodule Instance Segmentation Using Deep Learning. Life (Basel) 2024; 14:1192. [PMID: 39337974 PMCID: PMC11433569 DOI: 10.3390/life14091192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 09/16/2024] [Accepted: 09/19/2024] [Indexed: 09/30/2024] Open
Abstract
Lung screening is really crucial in the early detection and management of masses, with particular regard to cancer. Studies have shown that lung cancer screening, can reduce lung cancer mortality by 20-30% in high-risk populations. In recent times, the advent of deep learning, with particular regard to computer vision, demonstrated the ability to effectively detect and locate objects from video streams and also (medical) images. Considering these aspects, in this paper, we propose a method aimed to perform instance segmentation, i.e., by providing a mask for each lung mass instance detected, allowing for the identification of individual masses even if they overlap or are close to each other by classifying the detected masses into (generic) nodules, cancer or adenocarcinoma. In this paper, we considered the you-only-look-once model for lung nodule segmentation. An experimental analysis, performed on a set of real-world lung computed tomography images, demonstrated the effectiveness of the proposed method not only in the detection of lung masses but also in lung mass segmentation, thus providing a helpful way not only for radiologist to conduct automatic lung screening but also for discovering very small masses not easily recognizable to the naked eye and that may deserve attention. As a matter of fact, in the evaluation of a dataset composed of 3654 lung scans, the proposed method obtains an average precision of 0.757 and an average recall of 0.738 in the classification task. Additionally, it reaches an average mask precision of 0.75 and an average mask recall of 0.733. These results indicate that the proposed method is capable of not only classifying masses as nodules, cancer, and adenocarcinoma, but also effectively segmenting the areas, thereby performing instance segmentation.
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Ashindoitiang JA, Canice Nwagbara VI, Ugbem TI, Ukam JS, Asuquo ME. Umbilical nodule, a rare presentation of primary cutaneous endometriosis: Case report and literature review. Rare Tumors 2024; 16:20363613241285148. [PMID: 39290294 PMCID: PMC11406645 DOI: 10.1177/20363613241285148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 07/31/2024] [Accepted: 09/03/2024] [Indexed: 09/19/2024] Open
Abstract
Umbilical endometriosis or Villar's nodule is defined as the presence of endometrial tissue within the umbilicus and represent 0.5%-1% cases of endometriosis ectopia. It is classified as primary or secondary based on the surgical history. The important symptoms that characterize primary umbilical endometriosis were cyclical pain and a palpable mass that may be associated with bleeding. These features have temporal association with catamenia. Presented is a 30 year old woman with clinical features that suggested primary umbilical endometriosis in the past 5 years. It was confirmed by histology and coexisted with uterine fibroid. In the absence of previous surgery, primary umbilical endometriosis should be considered in the differential diagnosis in females of reproductive age with umbilical pain and nodule related to catamenia. Surgery is the treatment of choice and this should be individualized as some lesions can be managed by local excision with satisfactory outcome regarding the cessation of the presenting symptoms with good cosmetic outcome.
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Takeda K, Kikuchi Y, Sawada YU, Kumamoto T, Watanabe J, Woo T, Kunisaki C, Endo I. Simultaneously Detected Liver and Lung Metastases from Colorectal Carcinoma: A Potential Treatment Strategy. Anticancer Res 2024; 44:3945-3954. [PMID: 39197895 DOI: 10.21873/anticanres.17223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 07/06/2024] [Accepted: 07/09/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND/AIM No clear treatment strategy for simultaneously detected liver and lung metastases (SLLM) of colorectal carcinoma has been established, to date. We aimed to identify the prognostic factors for SLLM and propose an appropriate treatment option. PATIENTS AND METHODS This retrospective study included 64 patients with SLLM: 32 underwent pulmonary resection after hepatectomy in 32, while the other 32 underwent hepatectomy alone in 32. Poor prognostic factors and a suitable strategy for SLLM were assessed. RESULTS Multivariate analysis showed that preoperative carcinoembryonic antigen (CEA) level ≥20 ng/ml (p=0.001) and unresected lung metastases (p=0.001) were independent prognostic factors for poor overall survival. Compared with the non-pulmonary resection group, the rate of R1 resection of liver tumors (46.8% vs. 15.6%; p=0.007), incidence of complications after hepatectomy (Clavien-Dindo grade ≥III: 21.8% vs. 0%; p=0.005) and having four or more metastatic lung nodules (40.6% vs. 3.2%; p=0.001) were significantly higher in the group that underwent hepatectomy only. CONCLUSION Preoperative CEA ≥20 ng/ml and unresectable pulmonary nodules were prognostic factors for poor survival of patients with SLLM. Furthermore, the presence of more than four pulmonary nodules was a preoperative predictive factor for unresectable pulmonary nodules. R1 resection and the occurrence of complications after hepatectomy should be avoided; a smooth transition from hepatectomy to pulmonary resection is important.
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Xiong TW, Gan H, Lv FJ, Zhang XC, Fu BJ, Chu ZG. Artificial intelligence-measured nodule mass for determining the invasiveness of neoplastic ground glass nodules. Quant Imaging Med Surg 2024; 14:6698-6710. [PMID: 39281163 PMCID: PMC11400670 DOI: 10.21037/qims-24-665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 08/12/2024] [Indexed: 09/18/2024]
Abstract
Background The nodule mass is an important indicator for evaluating the invasiveness of neoplastic ground-glass nodules (GGNs); however, the efficacy of nodule mass acquired by artificial intelligence (AI) has not been validated. This study thus aimed to determine the efficacy of nodule mass measured by AI in predicting the invasiveness of neoplastic GGNs. Methods From May 2019 to September 2023, a retrospective study was conducted on 755 consecutive patients comprising 788 pathologically confirmed neoplastic GGNs, among which 259 were adenocarcinoma in situ (AIS), 282 minimally invasive adenocarcinoma (MIA), and 247 invasive adenocarcinoma (IAC). Nodule mass was quantified using AI software, and other computed tomography (CT) features were concurrently evaluated. Clinical data and CT features were compared using the Kruskal-Wallis test or Pearson chi-square test. The predictive efficacy of mass and CT features for evaluating invasive lesions (ILs) (MIAs and IACs) and IACs was analyzed and compared via receiver operating characteristic (ROC) analysis and the Delong test. Results ROC curve analysis revealed that the optimal cutoff value of mass for distinguishing ILs and AISs was 225.25 mg [area under the curve (AUC) 0.821; 95% confidence interval 0.792-0.847; sensitivity 64.27%; specificity 89.19%; P<0.001], and for differentiating IACs from AISs and MIAs, it was 390.4 mg (AUC 0.883; 95% confidence interval 0.858-0.904; sensitivity 80.57%; specificity 86.32%; P<0.001). The efficacy of nodule mass in distinguishing ILs and AISs was comparable to that of size (P=0.2162) and significantly superior to other CT features (each P value <0.001). Additionally, the ability of nodule mass to differentiate IACs from AISs and MIAs was significantly better than that of CT features (each P value <0.001). Conclusions AI-based nodule mass analysis is an effective indicator for determining the invasiveness of neoplastic GGNs.
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Cervantes-Pérez SA, Zogli P, Amini S, Thibivilliers S, Tennant S, Hossain MS, Xu H, Meyer I, Nooka A, Ma P, Yao Q, Naldrett MJ, Farmer A, Martin O, Bhattacharya S, Kläver J, Libault M. Single-cell transcriptome atlases of soybean root and mature nodule reveal new regulatory programs that control the nodulation process. PLANT COMMUNICATIONS 2024; 5:100984. [PMID: 38845198 PMCID: PMC11369782 DOI: 10.1016/j.xplc.2024.100984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/21/2024] [Accepted: 06/03/2024] [Indexed: 07/14/2024]
Abstract
The soybean root system is complex. In addition to being composed of various cell types, the soybean root system includes the primary root, the lateral roots, and the nodule, an organ in which mutualistic symbiosis with N-fixing rhizobia occurs. A mature soybean root nodule is characterized by a central infection zone where atmospheric nitrogen is fixed and assimilated by the symbiont, resulting from the close cooperation between the plant cell and the bacteria. To date, the transcriptome of individual cells isolated from developing soybean nodules has been established, but the transcriptomic signatures of cells from the mature soybean nodule have not yet been characterized. Using single-nucleus RNA-seq and Molecular Cartography technologies, we precisely characterized the transcriptomic signature of soybean root and mature nodule cell types and revealed the co-existence of different sub-populations of B. diazoefficiens-infected cells in the mature soybean nodule, including those actively involved in nitrogen fixation and those engaged in senescence. Mining of the single-cell-resolution nodule transcriptome atlas and the associated gene co-expression network confirmed the role of known nodulation-related genes and identified new genes that control the nodulation process. For instance, we functionally characterized the role of GmFWL3, a plasma membrane microdomain-associated protein that controls rhizobial infection. Our study reveals the unique cellular complexity of the mature soybean nodule and helps redefine the concept of cell types when considering the infection zone of the soybean nodule.
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Sandoval-Mussi AY, Armenta-Quiroga AS, Padilla-Correa AM, Hernandez Peña RE. Nodular Mucinosis of the Breast: A Case Report. Cureus 2024; 16:e66396. [PMID: 39246959 PMCID: PMC11379412 DOI: 10.7759/cureus.66396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2024] [Indexed: 09/10/2024] Open
Abstract
This article presents a rare case of nodular mucinosis of the breast, typically manifested as a painless subcutaneous mass in young women. We describe the clinical scenario of a 48-year-old woman who previously underwent benign nodule resection in her 20s at the identical site where nodular mucinosis subsequently developed. This recurrence at the previous resection site underscores the unusual nature of the condition and emphasizes the need for continued vigilance in monitoring patients with a history of such lesions.
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Kim C, Lee HJ, Jang KY, Park JH, Jeong JS, Lee YC. Isolated recurrent metastatic pulmonary nodule from the kidney: An extraordinarily long interval. Respirol Case Rep 2024; 12:e70005. [PMID: 39188575 PMCID: PMC11345631 DOI: 10.1002/rcr2.70005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Accepted: 08/07/2024] [Indexed: 08/28/2024] Open
Abstract
Our case highlights the importance of follow-up. Previous meta-analysis has shown that patients with sub-centimetre nodules may have extended follow-up intervals before requiring intervention, unlike those with larger nodules exceeding 1 cm. However, referring to our case, we can see the importance of regular and dense follow-up.
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Bash GN, Chung J, Fett N. An Isolated Cutaneous Nodule: Dupilumab-Induced Sarcoid-Like Reaction. Cureus 2024; 16:e68061. [PMID: 39347285 PMCID: PMC11438517 DOI: 10.7759/cureus.68061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2024] [Indexed: 10/01/2024] Open
Abstract
Dupilumab has recently been recognized as a potential trigger for drug-induced sarcoid-like reactions (DISR). This phenomenon may become more prevalent with increased utilization of this drug for a multitude of skin and atopic conditions. We present a unique case of a patient developing a solitary cutaneous nodule on her left forearm following dupilumab initiation. Histopathology and MRI studies confirmed that this nodule had features of a sarcoid granuloma. Six months following dupilumab discontinuation, the patient's granuloma resolved. This case demonstrates that dupilumab can induce cutaneous-limited autoimmune disease and stresses the importance of prompt recognition of dupilumab-induced sarcoid-like reactions for appropriate diagnosis and treatment.
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Tiwari P, Srivastava M, Sehgal R, Kumar S, Selvapandiyan A, Kumari A, Gupta JC, Talwar GP. Prevention of nodules and enhancement of antibody response to genetically engineered recombinant vaccine against Human Chorionic Gonadotropin (hCG) for contraception. EUR J CONTRACEP REPR 2024; 29:182-187. [PMID: 38904162 DOI: 10.1080/13625187.2024.2359127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/14/2024] [Indexed: 06/22/2024]
Abstract
OBJECTIVE Human Chorionic Gonadotropin (hCG) plays a crucial role in embryo implantation and in maintenance of pregnancy. An immuno-contraceptive approach involves the use of a recombinant hCGβ-LTB vaccine formulated with adjuvant Mycobacterium indicus pranii (MIP), to prevent pregnancy without disturbing ovulation, hormonal profiles, and menstrual cycles in women. The present work in mice was designed to address issues encountered in clinical trials conducted with hCGβ-LTB vaccine, with focus on two primary concerns. Firstly, it aimed to determine the optimal vaccine dosage required to induce a high level of anti-hCG antibodies. Secondly, it aimed to assess the safety profile of the vaccine, specifically injection site reactions in the form of nodules, observed in some of the subjects. METHODS AND RESULTS Studies undertaken indicate that a 2 µg dose of the protein version of the vaccine, administered in mice through the intramuscular route, can induce high anti-hCG titres. Furthermore, administering a booster dose enhances the antibody response. Our findings suggest that the concentration and frequency of administration of the adjuvant MIP can also be reduced without compromising vaccine efficacy. CONCLUSION The issue of nodule formation at the injection site can be mitigated either by administering the vaccine along with MIP intramuscularly or injecting hCG vaccine and MIP at separate intradermal sites. Thus, protein vaccine administered at a 2µg dose via the intramuscular route addresses both efficacy and safety concerns.
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Sarkis LM, Higgins K, Enepekides D, Eskander A. A novel guided approach to radiofrequency ablation of thyroid nodules: the Toronto Sunnybrook experience. Front Endocrinol (Lausanne) 2024; 15:1402605. [PMID: 39114289 PMCID: PMC11303206 DOI: 10.3389/fendo.2024.1402605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Thyroid nodules are extremely common being detected by ultrasonography in up to 67% of the population, with current surgical tenet maintaining that lobectomy is required for large symptomatic benign nodules or autonomously functionally nodules resulting in a risk of hypothyroidism or recurrent laryngeal nerve injury even in high volume centres. The introduction of radiofrequency ablation (RFA) has allowed thermal ablation of both benign and autonomously functioning thyroid nodules with minimal morbidity. The moving shot technique is the most well-established technique in performing RFA of thyroid nodules, and has proven to be safe, efficacious, accurate and successful amongst experienced clinicians. The purpose of this article to propose the use of a novel guide when performing RFA of thyroid nodules in clinical practice utilizing the moving shot technique. Methods The technique proposed of RFA involves the use of a 10MHz linear ultrasound probe attached to an 18G guide which provides robust in line visualisation of a 7cm or 10cm radiofrequency probe tip (STARmed, Seoul, Korea) utilizing the trans isthmic moving shot technique. A geometric analysis of the guide has been illustrated diagrammatically. Results The use of an 18G radiofrequency probe guide (CIVCO Infiniti Plus™ Needle Guide) maintains in line visualisation of the radiofrequency probe over a cross-sectional area up to 28cm2, facilitating efficient and complete ablation of conceptual subunits during RFA of thyroid nodules. Discussion Radiofrequency ablation of thyroid nodules can be performed safely and effectively using the novel radiofrequency probe guide proposed which we believe potentially improves both accuracy and overall efficiency, along with operator confidence in maintaining visualisation of the probe tip, and hence we believe provides a valuable addition to the armamentarium of clinicians wishing to embark on performing RFA of thyroid nodules.
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Zhang C, Zhou H, Li M, Yang X, Liu J, Dai Z, Ma H, Wang P. The diagnostic value of CT-based radiomics nomogram for solitary indeterminate smoothly marginated solid pulmonary nodules. Front Oncol 2024; 14:1427404. [PMID: 39015490 PMCID: PMC11250261 DOI: 10.3389/fonc.2024.1427404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 06/21/2024] [Indexed: 07/18/2024] Open
Abstract
Objectives This study aimed to explore the value of radiomics nomogram based on computed tomography (CT) on the diagnosis of benign and malignant solitary indeterminate smoothly marginated solid pulmonary nodules (SMSPNs). Methods This study retrospectively reviewed 205 cases with solitary indeterminate SMSPNs on CT, including 112 cases of benign nodules and 93 cases of malignant nodules. They were divided into training (n=143) and validation (n=62) cohorts based on different CT scanners. Radiomics features of the nodules were extracted from the lung window CT images. The variance threshold method, SelectKBest, and least absolute shrinkage and selection operator were used to select the key radiomics features to construct the rad-score. Through multivariate logistic regression analysis, a nomogram was built by combining rad-score, clinical factors, and CT features. The nomogram performance was evaluated by the area under the receiver operating characteristic curve (AUC). Results A total of 19 radiomics features were selected to construct the rad-score, and the nomogram was constructed by the rad-score, one clinical factor (history of malignant tumor), and three CT features (including calcification, pleural retraction, and lobulation). The nomogram performed better than the radiomics model, clinical model, and experienced radiologists who specialized in thoracic radiology for nodule diagnosis. The AUC values of the nomogram were 0.942 in the training cohort and 0.933 in the validation cohort. The calibration curve and decision curve showed that the nomogram demonstrated good consistency and clinical applicability. Conclusion The CT-based radiomics nomogram achieved high efficiency in the preoperative diagnosis of solitary indeterminate SMSPNs, and it is of great significance in guiding clinical decision-making.
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Pokhriyal SC, Sapkota N, Al-Ghuraibawi MMH, Pasha MN, Khan AA, Idris H, Panigrahi K. A Rare Case of Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia: A Case Report. Cureus 2024; 16:e62527. [PMID: 39022484 PMCID: PMC11253604 DOI: 10.7759/cureus.62527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2024] [Indexed: 07/20/2024] Open
Abstract
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare pulmonary disease characterized by the diffuse proliferation of neuroendocrine cells in the bronchial epithelium. It is considered a preinvasive precursor to carcinoid tumors and usually presents with obstructive symptoms. We present the case of a 71-year-old female, non-smoker, with a past medical history of asthma, osteoarthritis, allergic rhinitis, and hyperlipidemia who was referred to the pulmonology clinic in view of incidental chest CT findings of multiple pulmonary nodules. Physical examination and labs were unremarkable. CT of the chest showed scattered multiple noncalcified pulmonary nodules with a 10 mm dominant nodule in the inferior right middle lobe and several subcentimeter hypodensities in the left and right lobes of the lung. A PET scan confirmed the CT findings along with no abnormal hypermetabolic activity to suggest malignancy. The patient was followed up in the pulmonology clinic at six months, 12 months, and then 18 months. At 18 months owing to a slight increase in the size of the largest lung nodule, a CT-guided biopsy done was conclusive of a carcinoid. The tumor cells were positive for synaptophysin, chromogranin, insulinoma-associated protein 1 (INSM-1), and thyroid transcription factor 1 (TTF-1). The Ki-67 (Keil) index was <1%. A video-assisted thoracic surgery with right middle lobectomy along with mediastinal lymph node dissection was then done, and the patient was found to have stage pT1aN0 typical carcinoid tumor (1.0 cm), with multiple carcinoid tumors and neuroendocrine hyperplasia, consistent with DIPNECH. She has been under clinical follow-up for over three years at present and continues to be asymptomatic with complete remission following surgery. DIPNECH primarily affects middle-aged, non-smoking females who present with cough and dyspnea, and diagnosis is often delayed due to clinical features overlapping with those of obstructive lung disease. Imaging shows lung nodules, ground-glass opacities, and/or mosaic attenuation. Due to the rarity of the conditions, there are no established clinical trials, and therefore, there is a need to establish guidelines.
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Yandong H, Shiqi Z, Lanting J, Wenxin H, Leyao C, Hejing H. Establishment and preliminary application of personalized three-dimensional reconstruction of thyroid gland with automatic detection of thyroid nodules based on ultrasound videos. J Appl Clin Med Phys 2024; 25:e14332. [PMID: 38528686 PMCID: PMC11163481 DOI: 10.1002/acm2.14332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/22/2024] [Accepted: 02/28/2024] [Indexed: 03/27/2024] Open
Abstract
PURPOSE A well display of the spatial location of thyroid nodules in the thyroid is important for surgical path planning and surgeon-patient communication. The aim of this study was to establish a three-dimensional (3D) reconstruction method of the thyroid gland, thyroid nodule, and carotid artery with automatic detection based on two-dimensional (2D) ultrasound videos, and to evaluate its clinical value. METHODS Ultrasound videos, including the thyroid gland with nodule, isthmus of thyroid gland, and ipsilateral carotid artery, were recorded. BC-UNet, MTN-Net, and RDPA-U-Net network models were innovatively employed for segmentation of the thyroid glands, the thyroid nodules, and the carotid artery respectively. Marching Cubes algorithm was used for reconstruction, while Laplacian smoothing algorithm was employed to smooth the 3D model surface. Using this model, 20 patients and 15 surgeons completed surveys on the effectiveness of this model for the pre-surgery demonstration of nodule location as well as surgeon-patient communication. RESULTS The thyroid gland with nodule, isthmus of gland, and carotid artery were reconstructed and displayed. With the 3D model, the understanding of the spatial location of thyroid nodules improved in all three surgeon groups, eliminating the influence of professional levels. In the patient survey, the patients' understanding of the thyroid nodule location and procedure for surgery were significantly improved. In addition, with the 3D model, the time for doctors to explain to patients was significantly reduced (16.75 vs. 8.85 min, p = 0.001). CONCLUSION To our knowledge, this is the first report of constructing a 3D thyroid model using a deep learning technique for personalized thyroid segmentation based on 2D ultrasound videos. The preliminary clinical application showed that it was conducive to the comprehension of the location of thyroid nodules for surgeons and patients, with significant improvement on the efficiency of surgeon-patient communication.
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Corwin MT, Caoili EM, Elsayes KM, Garratt J, Hackett CE, Hudson E, Mohd Z, Navin PJ, Sharbidre K, Shehata M, Wang MX, Wilson MD, Yalon M, Remer EM. Performance of CT With Adrenal-Washout Protocol in Heterogeneous Adrenal Nodules: A Multiinstitutional Study. AJR Am J Roentgenol 2024; 222:e2330769. [PMID: 38415578 DOI: 10.2214/ajr.23.30769] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND. CT with adrenal-washout protocol (hereafter, adrenal-protocol CT) is commonly performed to distinguish adrenal adenomas from other adrenal tumors. However, the technique's utility among heterogeneous nodules is not well established, and the optimal method for placing ROIs in heterogeneous nodules is not clearly defined. OBJECTIVE. The purpose of our study was to determine the diagnostic performance of adrenal-protocol CT to distinguish adenomas from nonadenomas among heterogeneous adrenal nodules and to compare this performance among different methods for ROI placement. METHODS. This retrospective study included 164 patients (mean age, 59.1 years; 61 men, 103 women) with a total of 164 heterogeneous adrenal nodules evaluated using adrenal-protocol CT at seven institutions. All nodules had an available pathologic reference standard. A single investigator at each institution evaluated the CT images. ROIs were placed on portal venous phase images using four ROI methods: standard ROI, which refers to a single large ROI in the nodule's center; high ROI, a single ROI on the nodule's highest-attenuation area; low ROI, a single ROI the on nodule's lowest-attenuation area; and average ROI, the mean of the three ROIs on the nodule's superior, middle, and inferior thirds using the approach for the standard ROI. ROIs were then placed in identical locations on unenhanced and delayed phase images. Absolute washout was determined for all methods. RESULTS. The nodules comprised 82 adenomas and 82 nonadenomas (36 pheochromocytomas, 20 metastases, 12 adrenocortical carcinomas, and 14 nodules with other pathologies). The mean nodule size was 4.5 ± 2.8 (SD) cm (range, 1.6-23.0 cm). Unenhanced CT attenuation of 10 HU or less exhibited sensitivity and specificity for adenoma of 22.0% and 96.3% for standard-ROI, 11.0% and 98.8% for high-ROI, 58.5% and 84.1% for low-ROI, and 30.5% and 97.6% for average-ROI methods. Adrenal-protocol CT overall (unenhanced attenuation ≤ 10 HU or absolute washout of ≥ 60%) exhibited sensitivity and specificity for adenoma of 57.3% and 84.1% for the standard-ROI method, 63.4% and 51.2% for the high-ROI method, 68.3% and 62.2% for the low-ROI method, and 59.8% and 85.4% for the average-ROI method. CONCLUSION. Adrenal-protocol CT has poor diagnostic performance for distinguishing adenomas from nonadenomas among heterogeneous adrenal nodules regardless of the method used for ROI placement. CLINICAL IMPACT. Adrenal-protocol CT has limited utility in the evaluation of heterogeneous adrenal nodules.
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Li Y, Liu Q, Zhang DX, Zhang ZY, Xu A, Jiang YL, Chen ZC. Metal nutrition and transport in the process of symbiotic nitrogen fixation. PLANT COMMUNICATIONS 2024; 5:100829. [PMID: 38303509 PMCID: PMC11009365 DOI: 10.1016/j.xplc.2024.100829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/14/2024] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Abstract
Symbiotic nitrogen fixation (SNF) facilitated by the interaction between legumes and rhizobia is a well-documented and eco-friendly alternative to chemical nitrogen fertilizers. Host plants obtain fixed nitrogen from rhizobia by providing carbon and mineral nutrients. These mineral nutrients, which are mostly in the form of metal ions, are implicated in various stages of the SNF process. This review describes the functional roles played by metal ions in nodule formation and nitrogen fixation and specifically addresses their transport mechanisms and associated transporters within root nodules. Future research directions and potential strategies for enhancing SNF efficiency are also discussed.
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Tokuchi K, Yanagi T, Kurosawa S, Kitamura S, Maeda T, Hsu CY, Miyamoto K, Nishihara H, Ujiie H. Clinical-histopathological features and cancer gene analysis of cutaneous epithelioid angiosarcoma: A report of 4 cases. JAAD Case Rep 2024; 46:45-48. [PMID: 38510840 PMCID: PMC10951464 DOI: 10.1016/j.jdcr.2023.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
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Piticchio T, Russ G, Radzina M, Frasca F, Durante C, Trimboli P. Head-to-head comparison of American, European, and Asian TIRADSs in thyroid nodule assessment: systematic review and meta-analysis. Eur Thyroid J 2024; 13:e230242. [PMID: 38417254 PMCID: PMC10959032 DOI: 10.1530/etj-23-0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/27/2024] [Indexed: 03/01/2024] Open
Abstract
Context Ultrasound-based risk stratification systems (Thyroid Imaging Reporting and Data Systems (TIRADSs)) of thyroid nodules (TNs) have been implemented in clinical practice worldwide based on their high performance. However, it remains unexplored whether different TIRADSs perform uniformly across a range of TNs in routine practice. This issue is highly relevant today, given the ongoing international effort to establish a unified TIRADS (i.e. I-TIRADS), supported by the leading societies specializing in TNs. The study aimed to conduct a direct comparison among ACR-, EU-, and K-TIRADS in the distribution of TNs: (1) across the TIRADS categories, and (2) based on their estimated cancer risk. Methods A search was conducted on PubMed and Embase until June 2023. Original studies that sequentially assessed TNs using TIRADSs, regardless of FNAC indication, were selected. General study characteristics and data on the distribution of TNs across TIRADSs were extracted. Results Seven studies, reporting a total of 41,332 TNs, were included in the analysis. The prevalence of ACR-TIRADS 1-2 was significantly higher than that of EU-TIRADS 2 and K-TIRADS 2, with no significant difference observed among intermediate- and high-risk categories of TIRADSs. According to malignancy risk estimation, K-TIRADS often classified TNs as having more severe risk, ACR-TIRADS as having moderate risk, and EU-TIRADS classified TNs as having lower risk. Conclusion ACR-, EU-, and K-TIRADS assess TNs similarly across their categories, with slight differences in low-risk classifications. Despite this, focusing on cancer risk estimation, the three TIRADSs assess TNs differently. These findings should be considered as a prerequisite for developing the I-TIRADS.
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Sinharoy S, Tian CF, Montiel J. Editorial: Plant-rhizobia symbiosis and nitrogen fixation in legumes. FRONTIERS IN PLANT SCIENCE 2024; 15:1392006. [PMID: 38529060 PMCID: PMC10961434 DOI: 10.3389/fpls.2024.1392006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/27/2024]
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Liu P, Zhang X, Lin L, Cao Y, Lin X, Ye L, Yan J, Gao H, Wen J, Mysore KS, Liu J. Nodulation Signaling Pathway 1 and 2 Modulate Vanadium Accumulation and Tolerance of Legumes. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2306389. [PMID: 38225717 DOI: 10.1002/advs.202306389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/14/2023] [Indexed: 01/17/2024]
Abstract
Vanadium (V) pollution potentially threatens human health. Here, it is found that nsp1 and nsp2, Rhizobium symbiosis defective mutants of Medicago truncatula, are sensitive to V. Concentrations of phosphorus (P), iron (Fe), and sulfur (S) with V are negatively correlated in the shoots of wild-type R108, but not in mutant nsp1 and nsp2 shoots. Mutations in the P transporter PHT1, PHO1, and VPT families, Fe transporter IRT1, and S transporter SULTR1/3/4 family confer varying degrees of V tolerance on plants. Among these gene families, MtPT1, MtZIP6, MtZIP9, and MtSULTR1; 1 in R108 roots are significantly inhibited by V stress, while MtPHO1; 2, MtVPT2, and MtVPT3 are significantly induced. Overexpression of Arabidopsis thaliana VPT1 or M. truncatula MtVPT3 increases plant V tolerance. However, the response of these genes to V is weakened in nsp1 or nsp2 and influenced by soil microorganisms. Mutations in NSPs reduce rhizobacterial diversity under V stress and simplify the V-responsive operational taxonomic unit modules in co-occurrence networks. Furthermore, R108 recruits more beneficial rhizobacteria related to V, P, Fe, and S than does nsp1 or nsp2. Thus, NSPs can modulate the accumulation and tolerance of legumes to V through P, Fe, and S transporters, ion homeostasis, and rhizobacterial community responses.
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Li D, Wang W, Peng Y, Qiu X, Yang J, Zhang C, Wang E, Wang X, Yuan H. Soluble humic acid suppresses plant immunity and ethylene to promote soybean nodulation. PLANT, CELL & ENVIRONMENT 2024; 47:871-884. [PMID: 38164043 DOI: 10.1111/pce.14801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/23/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024]
Abstract
Symbiotic nitrogen fixation (SNF) is a crucial process for nitrogen geochemical cycling and plant-microbe interactions. Water-soluble humic acid (WSHM), an active component of soil humus, has been shown to promote SNF in the legume-rhizobial symbiosis, but its molecular mechanism remains largely unknown. To reveal the SNF-promoting mechanism, we conducted transcriptomic analysis on soybean treated with WSHM. Our findings revealed that up- and downregulated differentially expressed genes (DEGs) were mainly involved in plant cell-wall/membrane formation and plant defence/immunity in the early stage, while the late stage was marked by the flavonoid synthesis and ethylene biosynthetic process. Further study on representative DEGs showed that WSHM could inhibit GmBAK1d-mediated immunity and BR signalling, thereby promoting rhizobial colonisation, infection, and nodulation, while not favoring pathogenic bacteria colonisation on the host plant. Additionally, we also found that the ethylene pathway is necessary for promoting the soybean nodulation by WSHM. This study not only provides a significant advance in our understanding of the molecular mechanism of WSHM in promoting SNF, but also provides evidence of the beneficial interactions among the biostimulator, host plant, and soil microbes, which have not been previously reported.
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Tan AJ, Su KA, Deng A, Belazarian L. A solitary polypoid papulo nodule on the knee of a 13-year-old girl. Pediatr Dermatol 2024; 41:334-335. [PMID: 38044548 DOI: 10.1111/pde.15476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/03/2023] [Indexed: 12/05/2023]
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