Topographic Distribution Pattern Research Articles

Topographic, pachymetric and epithelial thickness distribution patterns in clinically unaffected fellow eyes of patients with asymmetric keratoconus

PurposeTo compare topographic, pachymetric and epithelial distribution patterns of clinically unaffected fellow eyes of patients with asymmetric keratoconus (AKC) with those of normal controls and keratoconic fellow eyes. MethodsA prospective, observational study was conducted at a tertiary care center, in which twenty-five clinically unaffected fellow eyes in patients with AKC were compared to 25 keratoconic fellow eyes and 67 normal controls. Pachymetric and epithelial thicknesses in the central 2 mm and 8 octants in the 2–5 mm and 5–7 mm zones were compared using Spectral Domain Optical Coherence Tomography (SDOCT). Scheimpflug derived topography was also compared. ResultsMean simulated keratometry of fellow eyes (43.6D ± 1.34 D) was comparable to that of control eyes (43.85D ± 1.57 D) (p > 0.99) and less than that of keratoconic eyes (47.08D ± 4.62 D) (p = 0.004). Central corneal and epithelial thicknesses of fellow eyes (474.28 ± 40.27 μm, 52.76 ± 7.45 μm, respectively) were less than in control eyes (505.97 ± 30.12 μm, 60.48 ± 8.37 μm) (p < 0.001 and p = 0.006, respectively) but comparable to those of keratoconic eyes (470.48 ± 44.19 μm, 52.48 ± 8.00 μm) (p > 0.99). Pachymetric differences of radially opposite octants in the 2–5 mm zone demonstrated thinning in the inferior and inferotemporal octants of fellow eyes which was greater than that seen in control eyes (p = 0.017 and 0.04, respectively) ConclusionReduced central epithelial thickness and greater pachymetric differences in radially opposite octants of the mid-peripheral cornea may be suggestive of susceptibility to ectasia despite normal topography.

Morphological Characteristics of Retinal Ganglion Cells in the Retinas of Giant Pandas (Ailuropoda melanoleuca).

Vision plays a crucial role in the survival of animals, and the visual system has particularly selectively evolved in response to the visual environment, ecological niche, and species habitats in vertebrate species. To date, a horizontal streak of retinal ganglion cell (RGC) distribution pattern is observed across mammal species. Here, we report that the giant panda's vertically oriented visual streak, combined with current evidence of the animal's forward-placed eyes, ocular structure, and retinal neural topographic distribution patterns, presents the emergence of a well-adapted binocular visual system. Our results suggest that the giant panda may use a unique way to processing binocular visual information. Results of mathematical simulation are in favor of this hypothesis. The topographic distribution properties of RGCs reported here could be essential for understanding the visual adaptation and evolution of this living fossil.

Environmental DNA Reveals Geographic Distributions of Two eel Species, Anguilla japonica and A. marmorata, in Western Kyushu, Japan.

Some anguillid eels migrate thousands of kilometers from their spawning grounds, dispersing across vast geographic areas to fresh and brackish water habitats, where they settle and grow. Japanese eels (Anguilla japonica) and giant mottled eels (A. marmorata) are both found in Japan, although their distributions differ, and their exact distributions are poorly known. We assumed that topographic distribution patterns of Japanese and giant mottled eels must differ among and within rivers along the northwest coast of Kyushu, Japan. Environmental DNA (eDNA) analysis was conducted at 87 sites in 23 rivers. Japanese eel eDNA was detected in 19 rivers (82.6%) and that of giant mottled eels was detected in eight (34.8%). We detected giant mottled eel eDNA in five rivers where they were previously unknown. eDNA for Japanese eels was detected at six of nine sites in the north (66.7%), 13 of 23 sites in Omura (56.5%), and 37 of 55 sites in the south (67.3%). In contrast, giant mottled eel eDNA was detected at one of nine sites in the north (11.1%), no sites in Omura, and 15 of 55 sites in the south (27.3%). There was no correlation between eDNA concentrations of the two species at 10 sites in the five rivers where eDNA of both species was detected. These findings suggest differences in the distribution of the two eel species and the northern distributional limit of giant mottled eels in the area facing the East China Sea.

Anatomical characteristics and significance of the metopism and Wormian bones in dry adult-Chinese skulls.

This study aimed to investigate the incidence, topographical distribution, morphology, and interrelationship of the metopism and Wormian bones (WBs) in dry adult-Chinese skulls. In this study, 285 dried adult-Chinese skull specimens from the Department of Anatomy at the Southern Medical University were examined. The incidence of different types of metopism and WBs were recorded. The length of the metopic suture was measured using a flexible ruler. Additionally, the lengths and widths of the WBs were measured using a vernier calliper. The incidence of metopism and WBs in Chinese adults were estimated at 10.18% (29/285) and 63.86% (182/285), respectively. The metopism always accompanied WBs (26/29, 89.66%), but the WBs did not necessarily accompany metopism (26/182, 14.29%). The locations of the WBs in the order of decreasing incidence were the lambdoid suture (78.57%, 143/182), pterion (34.62%, 63/182), asterion (12.09%, 22/182), lambda (8.24%, 15/182), sagittal suture (4.95%, 9/182), and Inca bone (3.85%, 7/182). These locations differed in topographical distribution and morphological patterns. Chinese adults differ in incidence of metopism and WBs from adults of other races, indicating racial differences. The characteristics of WBs vary depending on the cranial site of occurrence. The metopism always accompanies WBs, but the WBs do not necessarily accompany metopism.

Study on the penetration and diffusion of chloride ions in interface transition zone of recycled concrete prepared by modified recycled coarse aggregates

This work aims at exploring the penetration and diffusion behavior of chloride ions in interfacial transition zones (ITZs) of modified recycled aggregate concrete (RAC). For this purpose, RAC were prepared by using nano-SiO2 and carbonation treated recycled coarse aggregates (RCA, with different strength grades of C30 and C60) and immersed in 3.5% NaCl solution for 45 days and 90 days. The mechanical properties and free chloride ion content of the modified RAC were investigated and the topographic characteristics and element distribution patterns of Ca, Si, and Cl in ITZs of RAC were detailed characterized. The results show that the chloride ion will permeate into the interface in ITZs of RAC in the first instance, and then intrude into mortar matrix through the pores and fractures. In contrast, the internal microscopic structure of ITZs become more compact and the number of the cracks are decreased obviously after nano-SiO2 treatment, which can provide effective barrier and significantly reduce the penetration depth of chloride ions. In addition, the high strength RCA can also effectively reduce the penetration and diffusion of chloride ions to concrete matrix due to the compact and uniform microstructure. This work provides a certain theoretical guidance for further improving the chloride erosion resistance of RAC.

Coordinated State Analysis and Differential Regulation of Territorial Spatial Functions in Underdeveloped Regions: A Case Study of Gansu Province, China

The coordinated development of territorial spatial functions is the main manifestation of the sustainable utilization of territorial resources. Identifying spatial functions and their coordinated relationship has become an important guarantee for regional coordinated development, and is of great significance to the construction of a sustainable land development and protection pattern. This study constructs a classification and function scoring system for Production-Living-Ecological Spaces (PLES) by using land-use data from Gansu Province in 2000 and 2020, and revises the spatial functions of the land to supplement the deficiencies of existing related researches by combining socio-economic data (GDP, population density) and ecosystem service value data. In the aforementioned works, the Mechanical Equilibrium Model in physics is referenced to explore the coordinated state among territorial spatial functions. The results show that the high-value areas of production function are mainly distributed in the eastern and central areas of the Loess Plateau, with a strip-like distribution in the Hexi Corridor. The high-value areas of living function are consistent with that in the center of the city. The distribution of high-value areas of ecological function is in line with the topographic distribution pattern of mountainous areas in Gansu Province. The distribution pattern of the coordinated state of land space function in Gansu Province is relatively stable from 2000 to 2020. Simultaneously, the functional dominant area and the promotion area are identified according to the deviation of the coordinated degree of production-living-ecological function. After clarifying the functional characteristics of each county, the author proposes a differentiated regulation strategy of territorial spatial function.

Study of extra-nodal lymphoma with special reference to histomorphology, immunohistochemistry, and topographical distribution

Background: Primary extra-nodal lymphomas (ENLs) are rare neoplasm but can affect many organ systems of body. Proper and timely diagnosis and justified treatment of primary ENL are often affected due to variety of lymphoma types and the relative rarity of many of these tumor types. They are mainly of Non-Hodgkin lymphoma which further consists of many subtypes having variation of epidemiology and clinical presentation along with geographic distribution. Aim and Objectives: Aim and objectives of the study were to find out topographical distribution and histological patterns of ENL along with their immunohistochemical character in a tertiary care hospital of Eastern India. Materials and Methods: All the cases from April 2015 to March 2018 diagnosed as ENL by histopathological examination were included in this descriptive cross-sectional study for further immunohistochemical analysis for CD45 Life-cycle assessment (LCA), CD3 and CD 20 to identify the cell of origin (B cell vs. T cell). Results: Out of total 31 cases, 67.74% were male and the most common age group was 51–60 years. Gastrointestinal tract was the most common organ system (61.29% of cases) affected and stomach (29.03%) followed by Ileum (9.67%) were the most common sites affected by ENL. Histomorphologically diffuse large cell lymphoma was the most common pattern while immunohistochemistry study revealed all the cases were B cell type with LCA and CD 20 positive and CD3 negative. Conclusion: This study revealed the topographical pattern along with predominant histomorphological and immunohistochemical character of ENL in study population. However, further studies with meta- analysis can enlighten these characters more comprehensively.

Topographical distribution and radiographic pattern of lung lesions in canine eosinophilic bronchopneumopathy.

To evaluate the radiographic lung pattern and topographical distribution in canine eosinophilic bronchopneumopathy. Medical records were retrospectively reviewed for dogs diagnosed with eosinophilic bronchopneumopathy. Lateral thoracic radiographs were examined for the presence of increased radiopacity, classification of pattern, topography of lung changes (cranioventral, perihilar, caudodorsal, caudoventral) and severity of pulmonary lesions. Forty-four cases were identified with the Labrador retriever being the most commonly affected breed; there was a mean age of 5 years and an equal gender distribution. Coughing was the most common clinical sign. Circulating eosinophilia was present in 39% of dogs, with a mean peripheral eosinophilia of 5.1×109 cells/L and a mean bronchoalveolar lavage fluid eosinophilia of 40%. Eighty percent of dogs had an abnormal lung pattern in at least one of the four lung fields; the remaining had normal thoracic radiographs. The most common patterns were a bronchial and a bronchointerstitial pattern, with 41 and 89% distribution to the caudodorsal lung field, respectively. A bronchial and bronchointerstitial pattern are the most common radiographic lung patterns seen in canine eosinophilic bronchopneumopathy with these patterns most frequently topographically distributed to at least the caudodorsal lung field. Furthermore, within the caudodorsal lung field, a bronchointerstitial pattern predominates. This radiographic and topographical finding may allow eosinophilic bronchopneumopathy to take precedence on a differential diagnoses list before confirmatory bronchoalveolar lavage fluid sampling.

Inner structural organization of the mandibular corpus in the late Early Pleistocene human specimens Tighenif 1 and Tighenif 2

The present study investigates the inner structural organization of the two mandible specimens Tighenif 1 and Tighenif 2 from the late early Pleistocene site of Tighenif, Algeria. Using (micro)tomographic scans, we built a new protocol to investigate the cortical bone topography at the post-canine level. We selected two cross-sectional slices placed between the P3/P4 and M1/M2 on the right and left sides and assessed the cortical bone thickness topography (CBT) on each slice. Our analyses demonstrate that the mandibles from Tighenif exhibit higher CBT and a different topographic distribution pattern at the molar level than in modern humans, resulting in a proportionally more robust inner structure, while a similar signal is observed between the fossil and extant specimens at the premolar level. Further studies need to be done in order to determine if this feature is related to functional constraints during mastication or paramasticatory activities; or if it is related to any independent evolutionary process.

Unraveling the relationship between the topographic distribution patterns of skin temperature and perspiration response in dromedary camels

The question of how skin temperature (Tsk), measured at different regions of the skin, can affect sudomotor activity and thus show a pattern in topographic distribution for the perspiration response (PR) rate in dromedary camels was approached and examined in this experiment. Under natural summer conditions, four healthy dromedary bulls, with a mean body mass of 420 kg and age of three years, were measured for Tsk and PR in seven skin regions (i.e. head, neck, shoulder, axillary, hump, flank, and hip) twice daily [between 04:00-05:00 h with a mean ambient temperature (Ta) of 26·78 °C and relative humidity (RH) of 18·25% as well as between 13:00-14:00 h with Ta of 44·78 °C and RH of 5·90%] for two successive days. The experiment has clearly demonstrated some novel findings. In fact, results pointed out that Tsk (P < 0·05) exhibited a distinct topographic pattern that faded almost completely at a higher Ta. Meanwhile, PR unexpectedly manifested a uniform (P ≥ 0·05) distribution throughout the experiment, which appears to serve an eco-teleological purpose in dromedaries. Moreover, the obtained findings indicated that the hump and hip regions in particular can work as thermal windows, yet all seven skin regions can predict whole-skin PR fairly accurately (R2 ≥ 0·90; P < 0·000). Above all, analysis indicated that Tsk in many regions can affect perspiration in camels (R2 < 0·82; P < 0·000), but it failed to demonstrate a topographic pattern in perspiration response at higher or lower Ta; therefore, the data attests that no specific relationship may exist between the topography of a perspiration pattern and the level of regional Tsk. Some shortcomings were noted herein, but research dealing with this subject may very well improve our understanding of the basic functional mechanisms of the thermoregulatory system in this species.

Chronic Traumatic Encephalopathy in Professional American Football Players: Where Are We Now?

Repetitive head trauma provides a favorable milieu for the onset of inflammatory and neurodegenerative processes. The result of long-lasting head trauma is chronic traumatic encephalopathy (CTE), a disease process well-recognized in boxers, military personnel, and more recently, in American football players. CTE is a chronic neurodegenerative disease with hallmarks of hyperphosphorylated tau (p-tau) aggregates and intercellular lesions of neurofibrillary tangles. The criteria for CTE diagnosis requires at least 1–2 focal perivascular lesions of p-tau in the cerebral cortex, at the depth of the sulci. These pathognomonic lesions aggregate within neurons and glial cells such as astrocytes, and cell processes within the vicinity of small blood vessels. CTE presents in a distinct topographical distribution pattern compared to other tauopathies such as AD and other age-related astrogliopathies. CTE also has an insidious onset, years after repetitive head trauma. The disease course of CTE is characterized by cognitive dysfunction, behavioral changes, and can progress to altered motor function with parkinsonian-like manifestations in later stages. This short review aims to summarize CTE in professional football, epidemiology, diagnosis based on neuroanatomical abnormalities, cognitive degeneration, and adverse mental health effects, as well as gaps in the literature and future directions in diagnostics, therapeutics, and preventive measures.

Emotion-Related Consciousness Detection in Patients With Disorders of Consciousness Through an EEG-Based BCI System.

For patients with disorders of consciousness (DOC), such as vegetative state (VS) and minimally conscious state (MCS), detecting and assessing the residual cognitive functions of the brain remain challenging. Emotion-related cognitive functions are difficult to detect in patients with DOC using motor response-based clinical assessment scales such as the Coma Recovery Scale-Revised (CRS-R) because DOC patients have motor impairments and are unable to provide sufficient motor responses for emotion-related communication. In this study, we proposed an EEG-based brain-computer interface (BCI) system for emotion recognition in patients with DOC. Eight patients with DOC (5 VS and 3 MCS) and eight healthy controls participated in the BCI-based experiment. During the experiment, two movie clips flashed (appearing and disappearing) eight times with a random interstimulus interval between flashes to evoke P300 potentials. The subjects were instructed to focus on the crying or laughing movie clip and to count the flashes of the corresponding movie clip cued by instruction. The BCI system performed online P300 detection to determine which movie clip the patients responsed to and presented the result as feedback. Three of the eight patients and all eight healthy controls achieved online accuracies based on P300 detection that were significantly greater than chance level. P300 potentials were observed in the EEG signals from the three patients. These results indicated the three patients had abilities of emotion recognition and command following. Through spectral analysis, common spatial pattern (CSP) and differential entropy (DE) features in the delta, theta, alpha, beta, and gamma frequency bands were employed to classify the EEG signals during the crying and laughing movie clips. Two patients and all eight healthy controls achieved offline accuracies significantly greater than chance levels in the spectral analysis. Furthermore, stable topographic distribution patterns of CSP and DE features were observed in both the healthy subjects and these two patients. Our results suggest that cognitive experiments may be conducted using BCI systems in patients with DOC despite the inability of such patients to provide sufficient behavioral responses.

Topographic distribution pattern of morphologically different G cells in the murine antral mucosa.

Gastrin-secreting enteroendocrine cells (G cells) in the antrum play an important role in the regulation of gastric secretion, gastric motility and mucosal cell proliferation. Recently we have uncovered the existence of two subpopulations of G cells with pivotally different morphology and a distinct localization in the antral invaginations; the functional implications of the different G cell types are still elusive. In this study a transgenic mouse line in which EGFP is expressed under the control of a gastrin promoter was used to elucidate the distribution pattern of the two G cell types throughout the different regions of the antrum. The results of immunohistochemical analyses revealed that G cells were not equally distributed along the anterior/posterior axis of the antrum. The “typical” pyramidal- or roundish-shaped G cells, which are located in the basal region of the antral invaginations, were more abundant in the proximal antrum bordering the corpus region but less frequent in the distal antrum bordering the pylorus. In contrast, the “atypical” G cells, which are located in the upper part of the antral invaginations and have a spindle-like contour with long processes, were evenly distributed along the anterior/posterior axis. This characteristic topographic segregation supports the notion that the two G cell types may serve different functions. A comparison of the antrum specific G cells with the two pan-gastrointestinal enteroendocrine cell types, somatostatin-secreting D cells and serotonin-secreting enterochromaffin (EC) cells, revealed a rather similar distribution pattern of G and D cells, but a fundamentally different distribution of EC cells. These observations suggest that distinct mechanisms govern the spatial segregation of enteroendocrine cells in the antrum mucosa.

Experimental Infection of Cattle With a Novel Prion Derived From Atypical H-Type Bovine Spongiform Encephalopathy.

H-type bovine spongiform encephalopathy (H-BSE) is an atypical form of BSE in cattle. During passaging of H-BSE in transgenic bovinized (TgBoPrP) mice, a novel phenotype of BSE, termed BSE-SW emerged and was characterized by a short incubation time and host weight loss. To investigate the biological and biochemical properties of the BSE-SW prion, a transmission study was conducted in cattle, which were inoculated intracerebrally with brain homogenate from BSE-SW-infected TgBoPrP mice. The disease incubation period was approximately 15 months. The animals showed characteristic neurological signs of dullness, and severe spongiform changes and a widespread, uniform distribution of disease-associated prion protein (PrPSc) were observed throughout the brain of infected cattle. Immunohistochemical PrPSc staining of the brain revealed the presence of intraglial accumulations and plaque-like deposits. No remarkable differences were identified in vacuolar lesion scores, topographical distribution patterns, and staining types of PrPSc in the brains of BSE-SW- vs H-BSE-infected cattle. PrPSc deposition was detected in the ganglia, vagus nerve, spinal nerve, cauda equina, adrenal medulla, and ocular muscle. Western blot analysis revealed that the specific biochemical properties of the BSE-SW prion, with an additional 10- to 12-kDa fragment, were well maintained after transmission. These findings indicated that the BSE-SW prion has biochemical properties distinct from those of H-BSE in cattle, although clinical and pathologic features of BSW-SW in cattle are indistinguishable from those of H-BSE. The results suggest that the 2 infectious agents, BSE-SW and H-BSE, are closely related strains.

Periprostatic innervation: New issues based on segmental analysis of 10 human cadaver pelvic blocs.

The exact paths of periprostatic nerves have been under debate over the last decades. In the present study, the topographic distribution of nerves around the prostate and their relative distances from the prostatic capsule were analyzed in male cadaver visceral blocs. The pelvic organs from ten fresh male cadavers were removed and serial sectioned en bloc for histological investigation. The macroslices was divided into four sectors. Each sector was centrally covered with a raster dividing each sector in three subsectors numbered clockwise. The prostatic capsule was identified, and distances of 2.5 and 5 mm from the prostate were demarked with lines. We quantified the number of nerve fibers present in each subsector of each slide and recorded their position relative to the prostatic capsule. In general, the topographic analysis revealed that the majority of nerves were identified in sectors 4 through 9, corresponding to the posterolateral and posterior surfaces of the prostate gland. At the prostate base, the majority of nerves were found at the posterolateral and posterior surfaces of the gland. Within the mid-region of the prostate, the same topographic distribution pattern was observed, but the nerve fibers were closer to the prostatic capsule. At the apical region, the percentage of nerve fibers identified in the anterior region was higher, despite their major concetration in the posterior surface. The nerves identified at the apex were mainly located up to 2.5 mm from the prostate. This proximity to the prostate was specifically observed in the anterolateral and anterior sectors. In the craniocaudal sense, the percentage of nerves identified between 2.5 and 5 mm from the prostatic capsule remained constant. A significant number of nerve fibers were present in the anterior and anterolateral positions, especially at the apex. The anterior nerves were closer to the prostate. This proximity suggests that the anterior nerves may participate in local physiology and that the cavernous nerves are probably formed by the posterior nerve fibers. It is likely that the safe distance of 2.5 mm from all surfaces of the prostate may be related to cavernous fiber preservation.

A comparison of the anatomical structure of the pancreas in experimental animals.

As basic knowledge for evaluation of pancreatic toxicity, anatomical structures were compared among experimental animal species, including rats, dogs, monkeys, and minipigs. In terms of gross anatomy, the pancreases of dogs, monkeys, and minipigs are compact and similar to that of humans. The rat pancreas is relatively compact at the splenic segment, but the duodenal segment is dispersed within the mesentery. In terms of histology, the islet of each animal is characterized by a topographic distribution pattern of α- versus β-cells. β-cells occupy the large central part of the rat islet, and α-cells are located in the periphery and occasionally exhibit cuffing. In dog islets, β-cells are distributed in all parts and α-cells are scattered in the center or periphery of the islet (at body and left lobe); whereas β-cells occupy all parts of the islet and no α-cells are present in the islet (at right lobe). Monkey islets show two distinct patterns, that is, α-cell-rich or β-cell-rich islets, and the former represent peripheral β-cells forming an irregular ring. Minipig islets show an irregular outline, and both α- and β-cells are present in all parts of the islet, intermingling with each other. According to morphometry, the endocrine tissue accounts for <2% of the pancreas roughly in rats and minipigs, and that of monkeys accounts for >7% of the pancreas (at tail). The endocrine tissue proportion tends to increase as the position changes from right to left in the pancreas in each species.

Evaluating Preoperative Models: A Methodologic Contribution

Three-dimensional (3D) printed models of the human skull and parts of it are being increasingly used for surgical education and customized preoperative planning. This study, using the calvaria as a model, provides a methodologic analysis with regard to future investigations aimed at evaluating patient-specific skull replicas. Postmortem computed tomography was used for 3D reconstruction of a skull. The digital model obtained was converted to a physical replica by 3D printing. This copy was compared qualitatively and quantitatively with the original, using both a classical anthropometric and a 3D surface scanning approach. Qualitatively, the replica and the original displayed good qualitative concordance. The quantitative deviations, as measured by osteometric tools, lay partly in the submillimetric area, partly between 1 and 2 mm. The maximum difference was 3.7 mm. On the basis of the surface scans, a mean deviation of 0.2930 mm (±0.2677 mm) and a median difference of 0.2125 mm (0.0000-1.5509 mm) were observed for the inner surface. For the whole object, corresponding figures amounted to 0.9101 mm (±0.5390 mm) and 0.8851 mm (0.000-3.2647 mm). Qualitatively flawless replicas of the skull region investigated are feasible, subject to extensive manual CT image editing. However, neurosurgeons should be aware that models of one and the same patient will vary according to the production chain used by the 3D printing laboratory in charge. Methodologically, both classic anthropological and light-stripe-based comparisons are justified for use in future studies. For trials aimed at assessing mean deviations and topographic distribution patterns, optical 3D scanning technologies can be recommended.

Could the extent of lymphadenectomy be modified by neoadjuvant chemotherapy in cervical cancer? A large-scale retrospective study.

BackgroundThe effect of neoadjuvant chemotherapy (NACT) on topographical distribution patterns of lymph node metastasis in cervical cancer was unknown.MethodsPatients with FIGO stage IB1-IIB who underwent radical surgery with or without NACT were enrolled (3527 patients). A matched-case comparison design was used to compare the effects of NACT on lymph node metastasis.ResultsWe analyzed groups of 167 and 140 patients who were diagnosed with lymph node metastasis in the matched primary surgery group and NACT group, respectively, and no significant difference was observed (p = 0.081). The incidence of lymph node metastasis was significantly decreased in the NACT-responsive group compared to the non-responsive group (18.4% vs. 38.6%, P<0.001). The metastatic rates for every lymph node group also declined in the NACT-responsive group except for the deep inguinal and the para-aortic lymph node groups. Clinical response, deep stromal, parametrial and lymph vascular invasions were independent risk factors for lymph node metastasis in the NACT group. Furthermore, deep stromal invasion and lymph vascular invasion, but not the response to NACT, were independently associated with upper LNM. The number of lymph nodes involved, response to NACT, tumor histology and a positive vaginal margin were independent prognostic factors affecting DFS or OS rates in node-positive patients treated with NACT plus radical surgery.ConclusionThe frequency and topographic distribution of LNM are not modified by NACT, and clinical non-responders showed more involved LNs. A systemic and extensive lymphadenectomy should be performed in patients treated with NACT plus surgery regardless of the response to NACT.

Peripheral nerve injury activates convergent nociceptive input to dorsal horn neurons from neighboring intact nerve

Previous studies demonstrated that peripheral nerve injury induced excessive nociceptive response of spinal cord dorsal horn neurons and such change has been proposed to reflect the development of neuropathic pain state. The aim of this study was to examine the spinal dorsal horn for convergence of nociceptive input to second-order neurons deafferented by peripheral nerve injury. Double immunofluorescence labeling for c-Fos and phosphorylated extracellular signal-regulated kinase (p-ERK) was performed to detect convergent synaptic input to spinal dorsal horn neurons after the saphenous nerve injury. c-Fos expression and the phosphorylation of ERK were induced by noxious heat stimulation of the hindpaw and by electrical stimulation of the injured or uninjured saphenous nerve, respectively. Within the central terminal field of the saphenous nerve, the number of c-Fos protein-like immunoreactive (c-Fos-IR) cell profiles was significantly decreased at 3 days and returned to the control level by 14 days after the injury. p-ERK immunoreactive (p-ERK-IR) cell profiles were distributed in the central terminal field of the saphenous nerve, and the topographic distribution pattern and number of such p-ERK-IR cell profiles remained unchanged after the nerve injury. The time course of changes in the number of double-labeled cell profiles was similar to that of c-Fos-IR cell profiles after the injury. These results indicate that convergent primary nociceptive input through neighboring intact nerves contributes to increased responsiveness of spinal dorsal horn nociceptive neurons.

13. Cortical modularity breakdown in the epileptic brain

Sleep and deprivation of it are known methods to increase the yield of epileptic abnormalities. Whereas neurophysiological mechanisms underlying discharges increase were suggested, less is known of the topographical distribution patterns in wake and sleep. We compared interictal epileptic discharges (IEDs) scalp distribution using 256-channels EEG recordings in wake and sleep in people with pharmaco-resistant temporal lobe epilepsy (TLE). 14 adults with Right TLE, identified through clinical data, 3T-MRI, PET and electrical source imaging, recorded during a daytime-nap were included. IEDs were identified in wake and S2. A mean of 21 IEDs in wake and 39 in sleep were selected ( p =0.024) and processed to obtain the averaged spike. Digital signals from the averaged wake traces were then subtracted to the sleep ones (Geodesic-EGI, Oregon, USA) and a t -test between the two conditions run. Single subjects traces localized IEDs over the right temporal regions (rare zygomatic projection), topographically more circumscribed in sleep. EEG digital subtraction showed higher amplitude IEDs limited to the temporal mesio-posterior right areas, with a dipole inversion over the contralateral zygomatic leads. Student t -test confirmed a statistically significant signal increase over the same topographic region, with a slight posterior shift on temporal leads ( p =0.039). This is the first report of a progressive breaking up of cortical modularity during sleep, even S2 stage, in a pathologically hyperactive brain. A similar phenomenon has been previously described (Massimini et al., 2005) using TMS during sleep in healthy subjects. Our data exploit naturally occurring interfering stimuli (IEDs) in a naturally sleeping epileptic brain, demonstrating how they reverberate differently in sleep and in wake, with a sleep related amplitude increase. Interestingly, such phenomenon tends to be constrained to a cortical area partially overlapping with the waking one, as to point to the progressive disconnection of integrated areas.