A Reappraisal of Lymphadenectomy in Common Gynecological Cancers

Objectives: Lymph node dissection (LND) in gynecological malignancies has always been a cornerstone in the diagnosis of metastasis, it is also considered an important prognostic factor, and a reliable guide to management strategies. However, its incidence of complications, namely lymphedema, vascular injuries and other lesions, has led to a reconsideration of its efficacy and a comparison of the role of systematic vs. sentinel lymph node (SLN) dissection. Mechanism: Review of the literature using keywords such as “lymph nodes”, “sentinel lymph nodes”, “morbidity and mortality”, “gynecological cancers”, “endometrial cancer”, “ovarian cancer”, and “cervical cancer”. Findings in Brief: In the case of endometrial cancer, several studies have investigated the efficacy of SLN compared with systematic LND. Most of the results demonstrated the efficacy of SLN dissection in endometrial cancer, with the added benefit of lower morbidity. In patients with ovarian cancer, the mainstay of treatment is debulking with optimal cytoreductive surgery. Recent studies have compared systematic lymphadenectomy to non-lymphadenectomy, with an additional advantage in the cases of lymphadenectomy. However, since its publication, the lymphadenectomy in ovarian cancers (LIONS) trial, has revolutionized the standard of care for patients with advanced ovarian cancer and has called into question the increased morbidity and mortality in systematic lymphadenectomy. In cervical cancers, lymph node status is considered to be the most important prognostic factor. In this case, limiting lymphadenectomy to the borders of the inferior mesenteric artery seems promising, and studies are currently being carried out to investigate the feasibility of SLN dissection instead of systematic lymph node dissection. Conclusions: SLN dissection is associated with lower morbidity and mortality, and has been shown to be superior to systematic lymphadenectomy in several studies. However, more research and specific guidelines are needed to better select either one or the other method in the management of gynecological cancers. Copyright: © 2023 The Author(s)

Distance disintegration characterizes node-level topological dysfunctions in cocaine addiction

Previous investigations have used global graph theory measures in order to disentangle the complexity of the neural reorganizations occurring in cocaine use disorder (CUD). However, how these global topological alterations map into individual brain network areas remains unknown. In this study, we used resting state functional magnetic resonance imaging (fMRI) data to investigate node-level topological dysfunctions in CUD. The sample was composed of 32 individuals with CUD and 32 healthy controls, matched in age, years of education and intellectual functioning. Graph theory measures of optimal connectivity distance, node strength, nodal efficiency and clustering coefficient were estimated in each participant using voxel-wise functional connectivity connectomes. CUD individuals as compared with healthy controls showed higher optimal connectivity distances in ventral striatum, insula, cerebellum, temporal cortex, lateral orbitofrontal cortex, middle frontal cortex and left hippocampus. Furthermore, clinical measures quantifying severity of dependence were positively related with optimal connectivity distances in the right rolandic operculum and the right lateral orbitofrontal cortex, whereas length of abstinence was negatively associated with optimal connectivity distances in the right temporal pole and the left insula. Our results reveal a topological distancing of cognitive and affective related areas in addiction, suggesting an overall reduction in the communication capacity of these regions. © 2021 The Authors. Addiction Biology published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction

Whole-genome analysis of histone H3 lysine 27 trimethylation in Arabidopsis

Trimethylation of histone H3 lysine 27 (H3K27me3) plays critical roles in regulating animal development, and in several cases, H3K27me3 is also required for the proper expression of developmentally important genes in plants. However, the extent to which H3K27me3 regulates plant genes on a genome-wide scale remains unknown. In addition, it is not clear whether the establishment and spreading of H3K27me3 occur through the same mechanisms in plants and animals. We identified regions containing H3K27me3 in the genome of the flowering plant Arabidopsis thaliana using a high-density whole-genome tiling microarray. The results suggest that H3K27me3 is a major silencing mechanism in plants that regulates an unexpectedly large number of genes in Arabidopsis (~4,400), and that the maintenance of H3K27me3 is largely independent of other epigenetic pathways, such as DNA methylation or RNA interference. Unlike in animals, where H3K27m3 occupies large genomic regions, in Arabidopsis, we found that H3K27m3 domains were largely restricted to the transcribed regions of single genes. Furthermore, unlike in animals systems, H3K27m3 domains were not preferentially associated with low-nucleosome density regions. The results suggest that different mechanisms may underlie the establishment and spreading of H3K27me3 in plants and animals