RELATIONSHIPS BETWEEN BITTER TASTE SENSITIVITY AND CONSUMPTION OF BITTER SUBSTANCES

The effect of consumption of bitter taste substances (caffeine and beer) to bitter taste sensitivity was examined by 19 healthy adults. For individual taste sensitivity, detection thresholds were used on 6 bitter substances (caffeine, iso-alpha-acids: beer bittering agents, quinine sulfate, L-tryptophan, L-phenylalanine and glycyl-L-phenylalanyl-L-phenylalanine) and 3 non-bitter substances (L-aspartic acid, aspartame and NaCl). Nonusers of caffeine had significantly higher sensitivity (lower threshold) for caffeine compared to moderate and heavy users. Slight consumers of beer had significantly higher sensitivity for iso-alpha-acids relative to heavy users of beer, Iso-alpha-acids were not detected in saliva in acute dosing test by using 6 subjects. The correlations between thresholds of 6 bitter substances were calculated. Significant correlations (p < 0.01) were noted in 2 cases between caffeine and quinine, and iso-alpha-acids and L-trypothan. These data suggest the significant relation between individual bitter taste sensitivity and the consumption of caffeine and beer (iso-alpha-acids).     

Effects of linoleic acid on sweet, sour, salty, and bitter taste thresholds and intensity ratings of adults

Evidence supporting a taste component for dietary fat has prompted study of plausible transduction mechanisms. One hypothesizes that long-chain, unsaturated fatty acids block selected delayed-rectifying potassium channels, resulting in a sensitization of taste receptor cells to stimulation by other taste compounds. This was tested in 17 male and 17 female adult (mean +/- SE age = 23.4 +/- 0.7 yr) propylthiouracil tasters with normal resting triglyceride concentrations (87.3 +/- 5.6 mg/day) and body mass index (23.3 +/- 0.4 kg/m(2)). Participants were tested during two approximately 30-min test sessions per week for 8 wk. Eight stimuli were assessed in duplicate via an ascending, three-alternative, forced-choice procedure. Qualities were randomized over weeks. Stimuli were presented as room-temperature, 5-ml portions. They included 1% solutions of linoleic acid with added sodium chloride (salty), sucrose (sweet), citric acid (sour), and caffeine (bitter) as well as solutions of these taste compounds alone. Participants also rated the intensity of the five strongest concentrations using the general labeled magnitude scale. The suprathreshold samples were presented in random order with a rinse between each. Subjects made the ratings self-paced while wearing nose clips. It was hypothesized that taste thresholds would be lower and absolute intensity ratings or slopes of intensity functions would be higher for the stimuli mixed with the linoleic acid. Thresholds were compared by paired t-tests and intensity ratings by repeated measures analysis of variance. Thresholds were significantly higher (i.e., lower sensitivity) for the sodium chloride, citric acid, and caffeine solutions with added fatty acid. Sweet, sour, and salty intensity ratings were lower or unchanged by the addition of a fatty acid. The two highest concentrations of caffeine were rated as weaker in the presence of linoleic acid. These data do not support a mechanism for detecting dietary fats whereby fatty acids sensitize taste receptor cells to stimulation by taste compounds.     

Exercise endurance 1, 3, and 6 h after caffeine ingestion in caffeine users and nonusers.

The purpose of the present study was to examine the duration of caffeine's ergogenic effect and whether it differs between users and nonusers of the drug. Twenty-one subjects (13 caffeine users and 8 nonusers) completed six randomized exercise rides to exhaustion at 80% of maximal oxygen consumption after ingesting either a placebo or 5 mg/kg of caffeine. Exercise to exhaustion was completed once per week at either 1, 3, or 6 h after placebo or drug ingestion. Exercise time to exhaustion differed between users and nonusers with the ergogenic effect being greater and lasting longer in nonusers. For the nonusers, exercise times 1, 3, and 6 h after caffeine ingestion were 32.7 +/- 8.4, 32.1 +/- 8.6, and 31.7 +/- 12.0 min, respectively, and these values were each significantly greater than the corresponding placebo values of 24.2 +/- 6.4, 25.8 +/- 9.0, and 23.2 +/- 7.1 min. For caffeine users, exercise times 1, 3, and 6 h after caffeine ingestion were 27.4 +/- 7.2, 28.1 +/- 7.8, and 24.5 +/- 7.6 min, respectively. Only exercise times 1 and 3 h after drug ingestion were significantly greater than the respective placebo trials of 23.3 +/- 6.5, 23.2 +/- 7.1, and 23.5 +/- 5.7 min. In conclusion, both the duration and magnitude of the ergogenic effect that followed a 5 mg/kg dose of caffeine were greater in the nonusers compared with the users.     

Association of the -514C-->T polymorphism in the hepatic lipase gene (LIPC) promoter with elevated fasting insulin concentrations, but not insulin resistance, in non-diabetic Germans.

Hepatic lipase hydrolyses triglycerides and phospholipids in all major classes of lipoproteins. The -514C-->T genetic variation in the hepatic lipase gene promoter was found to be associated with diminished lipase activity, dyslipidemia, and atherosclerosis. We investigated whether this polymorphism associates with hyperinsulinemia and insulin resistance in 535 normal glucose-tolerant Germans. Only in homozygous individuals (22 subjects), the T allele (frequency: 18.1 %) was significantly associated with elevated glucose concentrations after 120 min of oral glucose tolerance test (p = 0.05) and with elevated fasting concentrations of insulin (p = 0.03), triglycerides (p < 0.01), total and HDL-cholesterol (p = 0.02), as determined by multivariate linear regression analysis. In a recessive model (C/C+C/T vs. T/T), T/T was associated with decreased insulin sensitivity index (p = 0.03) as calculated from oral glucose tolerance test data (n = 535), but not with the glucose infusion rate during hyperinsulinemic euglycemic clamp (n = 218). In conclusion, we have provided evidence that, among the metabolic parameters tested, the hepatic lipase -514C-->T gene polymorphism correlates with elevated fasting insulin concentrations in a German population. Since no corresponding difference in insulin sensitivity was seen in the clamp-subgroup, an effect of this polymorphism on insulin clearance has to be considered.     

Challenges in assessing associations between hormonal contraceptive use and the risks of HIV-1 acquisition and transmission

Prior observational studies produced inconsistent findings regarding hormonal contraception (HC) and risks of HIV acquisition and transmission. Heffron et al. conducted secondary data analyses on 3790 HIV discordant couples enrolled in two studies (a randomized trial of HSV-2 suppression and a study of immune correlates of HIV-1 protection) to assess HIV-1 acquisition and transmission in relation to HC use in females. HIV incidence among female HC nonusers was 3.8/100 person years (py), compared to 6.9/100 py among injectable users (p = 0.04) and 5.9/100 py in oral contraceptive users (p = 0.33). Among men, HIV incidence was 1.5/100 py in partners of HIV-positive HC nonusers, compared to 2.6/100 py in partners of injectable users (p < 0.05) and 2.5/100 py in men whose HIV-infected partners used oral contraceptives (p = 0.31). Study strengths included frequent follow up, excellent retention, known HIV exposure and viral load in the index infected partner, genetic linkage of virus from both partners and sexual behavior information. However, confounding by factors that cannot be controlled, including misreporting of condom use, is likely, given participants' high pregnancy rates. Clinicians and clients need to balance potential HC risks with the known risks of unwanted pregnancies. Condom use remains essential for HIV prevention regardless of other contraceptive usage.     

Olfactory and gustatory sensitivity in adults with attention-deficit/hyperactivity disorder

Recently, research on olfactory functions in attention-deficit/hyperactivity disorder (ADHD) has become prominent, whereas gustation has never been investigated. Increased odor sensitivity was found in medication-na?ve children with ADHD, but not in adult ADHD, which might be due to a dopaminergic dysregulation presumed to underlie this disorder. Taste sensitivity, in particular bitter sensitivity as a hereditary trait, also might be altered in ADHD. To examine olfactory and gustatory functions in adult ADHD patients, we assessed odor sensitivity by Sniffin' Sticks, taste sensitivity by taste strips, and bitter sensitivity by the one-solution test in women with ADHD (n = 12), Bulimia Nervosa (n = 12), and healthy control women (n = 12). Bulimia Nervosa as second patient group was included to control for effects of impulsivity. Preliminary results indicate that ADHD patients were significantly more often classified as tasters, i.e. perceived the bitter taste as more intense, compared to both bulimic patients and healthy controls. No group differences were found with regard to general odor and taste sensitivity. It is proposed that the higher frequency of tasters in ADHD patients might underlie a genetic variation of the bitter receptor-dependent signaling pathway associated with ADHD.     

EFFECTS OF WHOLE BODY VIBRATION ON STRENGTH AND JUMPING PERFORMANCE IN VOLLEYBALL AND BEACH VOLLEYBALL PLAYERS

The primary aim of this study was to examine the effects of 6-week strength training with whole body vibration (WBV) on leg strength and jumping performance in volleyball and beach volleyball players. Twenty-three sub-elite male volleyball (VB; n=12) and beach volleyball players (BVB; n=11) aged 21.2±3.0 years were divided into two groups and subjected to 6 weeks of strength training (three one-hour sessions per week): (I) 12 players (6 VB and 6 BVB players) underwent training with WBV (30-40 Hz, 1.7-2.5 mm, 3.0-5.7 g), and (II) 11 players (6 VB and 5 BVB players) underwent traditional strength training. Squat jump (SJ) and countermovement squat jump (CMJ) measurements by the Ergo Tester contact platform and maximum leg press test (1RM) were conducted. Three-factor (2 time x 2 WBV use x 2 discipline) analysis of variance for SJ, CMJ and 1RM revealed a significant time main effect (p<0.001), a WBV use effect (p<0.001) and a discipline effect (p<0.001). Significantly greater improvements in the SJ (p<0.001) and CMJ (p<0.001) and in 1RM (p<0.001) were found in the WBV training groups than in traditional training groups. Significant 3-way interaction effects (training, WBV use, discipline kind) were also found for SJ, CMJ and 1RM (p=0.001, p<0.001, p=0.001, respectively). It can be concluded that implementation of 6-week WBV training in routine practice in volleyball and beach volleyball players increases leg strength more and leads to greater improvement in jump performance than traditional strength training, but greater improvements can be expected in beach volleyball players than in volleyball players.     

The Relationship Between Fat Distribution and Coronary Risk Factors in Sedentary Postmenopausal Women On and Off Hormone Replacement Therapy

The purpose of this study was to examine the relationship between fat distribution and coronary risk factors (CRF) in sedentary overweight postmenopausal women both on and off hormone replacement therapy (HRT). Medical records and information were abstracted from nonsmoking women entering a weight loss program. A total of 33 women on HRT (mean age=50.12 ± 5.2) and 51 nonusers (mean age=52.52 ± 7.8) fulfilled subject eligibility requirements and were included in the data analysis. Results showed a significantly lower waist-to-hip ratio (WHR) (p=0.009) and waist (p=0.010) and greater levels of high-density lipoprotein cholesterol (HDL-C) (p=0.035) in HRT users than in nonusers. After converting correlations to standard Z-scores and performing z-tests, the correlation between total cholesterol (T-Chol) and WHR was significantly greater in nonusers than in HRT users (p=0.038). A multiple regression analysis showed differences between groups in the ability of age and anthropometric variables to predict CRF. Although T-Chol could be predicted in nonusers(r²=0.24; ^p=0.011), very low-density lipoprotein cholesterol (VLDL-C) and systolic blood pressure (SBP) could be significantly predicted in HRT users only (r²=0.28, P=0.055 and r²=0.40, p=0.005 for VLDL-C and SBP, respectively). These data suggest that there are differences between HRT users and nonusers in predictors of CRF, central adiposity, HDL-C, and the relationship between WHR and T-Chol. It is concluded that the significantly lower levels of central adiposity observed in HRT users may have clinical benefits with regard to CRF.     

Baroreflex sensitivity during operant blood pressure conditioning

Baroreflex sensitivity was measured in baboons operantly conditioned to increase their diastolic blood pressure in daily, 12-hr sessions, by using the extent of increases in interpulse interval per unit of increase in systolic pressure after intravenous phenylephrine injection as an index of baroreflex sensitivity. Following training, baroreflex sensitivity increases averaging 32% were observed before and after the 12-hr conditioning sessions. During the conditioning sessions, however, consistent diastolic blood pressure elevations averaging 17% (14 mmHg) were accompanied by significant decreases in baroreflex sensitivity averaging 44% relative to the increased before and after sensitivity levels. The results suggest that changes in baroreflex sensitivity participate in operantly conditioned blood pressure changes.     

TASTE PERCEPTIONS AND DIETARY INTAKES OF SMOKELESS TOBACCO USERS AND NONTOBACCO USERS†

Smokeless tobacco and nontobacco users differed for certain concentrations of perceived intensities of the four solutions – significantly for sweet (P ≤ 0.008) and salty (P = 0.001). Sensitivity to salty (P = 0.02) and bitter (P = 0.11) solutions decreased with increasing hours of exposure to smokeless tobacco. Smokeless tobacco and nontobacco users rated fruits and vegetables for preference and the four taste senses differently, with a decreasing trend for sweet tastes in smokeless tobacco users with increasing hours of exposure to smokeless tobacco. Smokeless tobacco users consumed more total fat (P = 0.06) and fat per 1000 kcal (P = 0.13) than nontobacco users. Higher intakes of total fat (P = 0.005), total fat per 1000 kcal (P = 0.18), total sodium (P = 0.03) and total Vitamin E (P = 0.06) were found with increasing hours of exposure to smokeless tobacco. Although fruit and vegetable intakes did not differ between smokeless tobacco and nontobacco users, both groups should increase their consumption of fruits and vegetables.     

Fat Distribution and Insulin Sensitivity in Postmenopausal Women: Influence of Hormone Replacement

Objective: To examine cross‐sectionally the influence of hormone replacement therapy (HRT) on the relationship between body composition and insulin sensitivity (Si). Research Methods and Procedures: Subjects were 57 early postmenopausal white women, 33 receiving HRT and 24 controls. Body composition was estimated using DXA and computed tomography scans at the abdomen and mid‐thigh. Si was assessed by a frequently sampled intravenous glucose tolerance test with minimal model analysis. Results: Compared with nonusers, HRT users had lower visceral adipose tissue, fasting serum glucose, and fasting insulin. Total body fat and unadjusted Si did not differ between groups. Visceral adipose tissue mass (VATM) was the only body‐fat compartment significantly associated with Si (r² = 0.43, p < 0.0001) in a model including total‐body fat, upper‐trunk fat, subcutaneous abdominal fat mass, leg fat, and mid‐thigh low‐density lean tissue. Lean body mass was positively correlated with Si among HRT users and tended to be negatively correlated among nonusers. HRT status also affected the relationship between VATM and Si such that, relative to nonusers, HRT users had lower Si across lower VATM levels, but higher Si across higher VATM. Discussion: These results suggest that in postmenopausal women, VATM is uniquely related to Si. HRT affects the relationship between VATM and Si and between lean body mass and Si. These interactions should be considered in future studies.     

Effect of Metformin Use on Survival in Resectable Pancreatic Cancer: A Single-Institution Experience and Review of the Literature

Observational studies have demonstrated that metformin use in diabetic patients is associated with reduced cancer incidence and mortality. Here, we aimed to determine whether metformin use was associated with improved survival in patients with resected pancreatic cancer. All patients with diabetes who underwent resection for pancreatic adenocarcinoma between 12/1/1986 and 4/30/2013 at our institution were categorized by metformin use. Survival analysis was done using the Kaplan-Meier method, with log-rank test and Cox proportional hazards multivariable regression models. For analyses of our data and the only other published study, we used Meta-Analysis version 2.2. We identified 44 pancreatic cancer patients with diabetes who underwent resection of the primary tumor (19 with ongoing metformin use, 25 never used metformin). There were no significant differences in major clinical and demographic characteristics between metformin and non-metformin users. Metformin users had a better median survival than nonusers, but the difference was not statistically significant (35.3 versus 20.2 months; P = 0.3875). The estimated 2-, 3-, and 5-year survival rates for non-metformin users were 42%, 28%, and 14%, respectively. Metformin users fared better with corresponding rates of 68%, 34%, and 34%, respectively. In our literature review, which included 111 patients from the two studies (46 metformin users and 65 non-users), overall hazard ratio was 0.668 (95% CI 0.397–1.125), with P = 0.129. Metformin use was associated with improved survival outcomes in patients with resected pancreatic cancer, but the difference was not statistically significant. The potential benefit of metformin should be investigated in adequately powered prospective studies.     

Extensive Gustatory Cortex Lesions Significantly Impair Taste Sensitivity to KCl and Quinine but Not to Sucrose in Rats

Recently, we reported that large bilateral gustatory cortex (GC) lesions significantly impair taste sensitivity to salts in rats. Here we extended the tastants examined to include sucrose and quinine in rats with ibotenic acid-induced lesions in GC (GCX) and in sham-operated controls (SHAM). Presurgically, immediately after drinking NaCl, rats received a LiCl or saline injection (i.p.), but postsurgical tests indicated a weak conditioned taste aversion (CTA) even in controls. The rats were then trained and tested in gustometers to discriminate a tastant from water in a two-response operant taste detection task. Psychometric functions were derived for sucrose, KCl, and quinine. Our mapping system was used to determine placement, size, and symmetry of the lesions (~91% GC damage on average). For KCl, there was a significant rightward shift (ΔEC₅₀ = 0.57 log₁₀ units; p<0.001) in the GCX psychometric function relative to SHAM, replicating our prior work. There was also a significant lesion-induced impairment (ΔEC₅₀ = 0.41 log₁₀ units; p = 0.006) in quinine sensitivity. Surprisingly, taste sensitivity to sucrose was unaffected by the extensive lesions and was comparable between GCX and SHAM rats. The fact that such large bilateral GC lesions did not shift sucrose psychometric functions relative to SHAM, but did significantly compromise quinine and KCl sensitivity suggests that the neural circuits responsible for the detection of specific taste stimuli are partially dissociable. Lesion-induced impairments were observed in expression of a postsurgical CTA to a maltodextrin solution as assessed in a taste-oriented brief-access test, but were not reflected in a longer term 46-h two-bottle test. Thus, deficits observed in rats after extensive damage to the GC are also dependent on the test used to assess taste function. In conclusion, the degree to which the GC is necessary for the maintenance of normal taste detectability apparently depends on the chemical and/or perceptual features of the stimulus.     

Effects of 1 vs. 2 sessions per week of equal-volume sprint training on explosive,high-intensity and endurance-intensive performances in young soccer players

The study aimed to evaluate the effects of 1 vs. 2 sessions per week of equal-volume sprint training on explosive, high-intensity and endurance-intensive performances among young soccer players. Thirty-six young male soccer players were randomly divided into 2 experimental groups that performed either a single weekly sprint training session (ST1, n = 18, age: 17.2 ± 0.8 years) or two weekly sprint training sessions (ST2, n = 18; age: 17.1 ± 0.9 years) of equal weekly and total volume, in addition to their regular soccer training regimen. Linear sprinting (10 m, 20 m, 30 m, and flying 10 m), T-test agility, countermovement jump (CMJ) and maximal oxygen consumption were assessed one week before (T1), in the middle (T2) and immediately after the 10 weeks of training (T3). A large magnitude and statistically significant main effect for time was found in all the assessed variables after both training interventions (all p < 0.001; ES ≥ 0.80). No main effect was observed between the 2 groups at any time in linear sprinting, T-test or CMJ test (p > 0.05; ES < 0.20). A significant interaction effect (F = 4.05; p = 0.04, ES = 0.21) was found for maximal oxygen consumption with ST2 inducing better performance than ST1 (p = 0.001; ES = 1.11). Our findings suggested that the two sprint training frequencies were effective in enhancing explosive, high-intensity and endurance-intensive performances. However, it is recommended for coaches and fitness coaches to use a biweekly sprint training modality as it was found to be more effective in improving endurance-intensive performance.     

Testosterone and sexual behavior in oral contraceptive users and nonusers: a prospective study

The relationship between plasma testosterone (T) secretion and patterns of sexual behavior was examined in 18 women using oral contraceptives (OCs) and 13 nonusers matched for partner availability. Retrospective assessments of perimenstrual symptoms, sexual attitudes, and sexual experience were obtained and women completed daily ratings of the frequency of sexual activities and the level of well-being for 1 month. Plasma levels of sex hormone binding globulin (SHBG), progesterone, Total T, Free T, and non-SHBG bound T were determined by radioimmunoassay at four phases of the pill or menstrual cycle. Overall, women not using OCs had higher plasma levels of Total, Free, and non-SHBG bound T and lower plasma levels of SHBG than those of OC users. Further, only nonusers had perimenstrual decreases in plasma levels of Total and Free T. The two groups were comparable on most retrospective measures. However, OC users reported more satisfaction with their sexual partners than did nonusers and prospective monitoring revealed that they engaged in sexual interactions more frequently than did nonusers across the cycle. In contrast, both groups reported a similar frequency of autosexual activities across the cycle. There were no correlations between average levels of T and levels of sexual desire, sexual interactions, or autosexuality. Moreover, only nonusers reported a decrease in levels of sexual desire during the perimenstrual period that was associated with the changes in Free T over the menstrual cycle.     

EFFECTIVENESS OF CATEGORY AND LINE SCALES TO CHARACTERIZE CONSUMER PERCEPTION OF FRUITY FERMENTED FLAVOR IN PEANUTS

Fruity fermented (FF) flavor is a common off‐flavor in peanuts resulting from high‐temperature curing. The 9‐point hedonic scale is the most widely used scale to determine consumer acceptance; however, research has indicated that line scales may provide equal reliability and greater sensitivity. The objectives of this study were to characterize consumer perception of FF flavor in peanuts and to compare the effectiveness of the two scale types. Consumers (n = 208) evaluated control (no FF), low‐intensity (1.0) FF and high‐intensity (3.0) FF peanut pastes for the strength/intensity of roasted peanut flavor (RPF), sweet taste (ST), fresh peanut flavor (FPF) and overall liking (OV) using randomly assigned ballots. Sensitivity in defining consumer perception of off‐flavor in peanuts was greater with use of line scales than with the hedonic scale. The line scale indicated that FF flavor in peanuts, even at low intensity, negatively impacted OV and further identified significantly lower RPF and FPF perception by consumers. The hedonic scale identified only a difference in FPF and was not sensitive enough to show a difference in OV.     

Genetic variation of umami taste genes in Koreans

Umami is a pleasant savoury taste imparted by glutamate, a type of amino acid, and ribonucleotides, including inosinate and guanylate, which occur naturally in many foods including meat, fish, vegetables and dairy products. A heterodimer of TAS1R1 and TAS1R3 is known to function as umami taste receptor in humans. To address the association between genetic polymorphism of TAS1R1 / TAS1R3 genes and individual difference in umami taste sensitivity, we have examined the entire coding region of these genes using PCR-mediated direct sequencing analysis. A total of 11 SNPs were identified from 98 unrelated Korean individuals and were in Hardy-Weinberg Equilibrium. Four out of 11 SNPs were found in the exons and two of them were nonsynonymous ones. These coding SNPs (cSNPs), p.A372T in TAS1R1 and p.C757R in TAS1R3 genes, were common in Koreans, so these will be useful resource for further studies to find a functional allele for individual variation to umami taste sensitivity in our population.     

Effect of concurrent endurance and circuit resistance training sequence on muscular strength and power development

The purpose of this study was to examine the influence of the sequence order of high-intensity endurance training and circuit training on changes in muscular strength and anaerobic power. Forty-eight physical education students (ages, 21.4 +/- 1.3 years) were assigned to 1 of 5 groups: no training controls (C, n = 9), endurance training (E, n = 10), circuit training (S, n = 9), endurance before circuit training in the same session, (E+S, n = 10), and circuit before endurance training in the same session (S+E, n = 10). Subjects performed 2 sessions per week for 12 weeks. Resistance-type circuit training targeted strength endurance (weeks 1-6) and explosive strength and power (weeks 7-12). Endurance training sessions included 5 repetitions run at the velocity associated with Vo2max (Vo2max) for a duration equal to 50% of the time to exhaustion at Vo2max; recovery was for an equal period at 60% Vo2max. Maximal strength in the half squat, strength endurance in the 1-leg half squat and hip extension, and explosive strength and power in a 5-jump test and countermovement jump were measured pre- and post-testing. No significant differences were shown following training between the S+E and E+S groups for all exercise tests. However, both S+E and E+S groups improved less than the S group in 1 repetition maximum (p < 0.01), right and left 1-leg half squat (p < 0.02), 5-jump test (p < 0.01), peak jumping force (p < 0.05), peak jumping power (p < 0.02), and peak jumping height (p < 0.05). The intrasession sequence did not influence the adaptive response of muscular strength and explosive strength and power. Circuit training alone induced strength and power improvements that were significantly greater than when resistance and endurance training were combined, irrespective of the intrasession sequencing.     

Ultrasound Assesment of Degrees of Extrathyroidal Extension in Papillary Thyroid Microcarcinoma

ObjectiveThis study aimed to assess the diagnostic accuracy of ultrasound (US)-based T staging of papillary thyroid microcarcinoma (PTMC).MethodsFrom January to June 2013, a total of 185 patients underwent preoperative thyroid US for the treatment of thyroid malignancy. A single radiologist immediately determined sonographic T staging for PTMC during real-time US examination. Based on histopathologic results, the diagnostic accuracy of sonographic T staging for PTMC and the difference in the frequency of level VI node metastasis according to the T stage of PTMC were evaluated.ResultsOf 105 PTMC cases, the preoperative sonographic diagnoses included intraglandular location (n = 35), subcapsular location (n = 30), mild capsule abutment (n = 7), moderate capsule abutment (n = 19), and perithyroidal invasion without adjacent strap muscle invasion (n = 14). When the sonographic T stages were compared with histopathologic results, all the sonographic categories showed high specificity and low sensitivity. The intraglandular and subcapsular location cases in preoperative US diagnosis showed a low rate of extrathyroidal tumor invasion (6.2%, 4/65). The extrathyroidal tumor invasion cases in preoperative US diagnosis only included 26 extrathyroidal fat invasion cases, and 12 (46.2%, 12/26) true positives. There was a significant correlation between multifocality and histopathologic T stage, but no significant relationship between level VI node metastasis and histopathologic T stage was found.ConclusionThe sonographic T staging categorization described here may be helpful for the preoperative evaluation of PTMC patients. (Endocr Pract. 2014;20: 1037-1043)