The diagnostic significance of hyperfibrinogenemia and thrombocytosis in patients with ovarian tumors/adnexal masses

Background: We aim to study the correlation of thrombocytosis and hyperfibrinogenemia with ovarian tumors and its role in the diagnosis of ovarian malignancy. And to evaluate the platelet and fibrinogen levels in early and advanced stage ovarian disease. Methods: This is a single centre prospective study. We evaluated plasma fibrinogen levels and plasma platelet levels in 250 patients in women presenting in our OPD with adnexal masses/ovarian tumors. Thrombocytosis was defined as a platelet count greater than >410,000/uL. Hyperfibrinogenemia was defined as a fibrinogen level higher than 360 mg/dL. The association between plasma fibrinogen, platelet levels and clinico-pathological, histopathological parameters were investigated in regards to: 1. Malignant or benign ovarian tumor. 2. Early or advanced disease in malignant ovarian tumors. A multivariate logistic regression model was performed to identify an independent association. Results: Thrombocytosis and hyperfibrinogenemia are seen to be associated with malignant ovarian tumors. In a multivariate model, plasma fibrinogen and plasma platelet levels were identified to be independently associated with the malignant ovarian tumours. Within the EOC cohort, patients with advanced stage disease had higher plasma fibrinogen levels than patients with early stage. Conclusions: In this study, we demonstrated that both thrombocytosis and hyperfibrinogenemia were positively associated with malignant ovarian tumors. They were also associated with advanced disease stage, elevated CA125 level and other markers. These finding are in accordance with the previous published data from patients with ovarian cancer, indicating that the platelet and fibrinogen levels increase in parallel with tumor progression and metastasis. Thus confirming the role of elevated platelet and fibrinogen levels in diagnosis and prognosis of ovarian Malignancy

Effect of time interval from completion of neoadjuvant chemotherapy to starting of adjuvant chemotherapy after interval debulking surgery on survival of patients with advanced ovarian cancer

Background: To find the effect of time interval between completion of neo adjuvant chemotherapy to the starting of adjuvant chemotherapy on the RFS and OS of patients with advanced ovarian cancers. Methods: It is a retrospective study of 170 patients with histopathological proven epithelial ovarian cancers who received full treatment (NACT+IDS+POAC) at Gujarat cancer Research Institute, Ahmedabad between 2010- 2016. They were assessed and followed up for maximum 5 year. The time interval was defined as period from the completion of NACT including Interval de-bulking surgery to initiation of chemotherapy. Results: Out of 170 patients, 86 patients (50.5%) received adjuvant chemotherapy within 44 days after neoadjuvant chemotherapy while 84 patients (49.4%) received it after 44 days. There was no significant difference in patient characteristics between these two groups. The shorter and longer TI was having recurrence in 40 (53.48%) and47 (55.55%) patients respectively. Whereas overall survival was 67.44% and 47.61% respectively. Conclusions: Our analysis showed that patients with longer time interval >44 days had poorer recurrence free survival and overall survival in comparison to lesser TI group

Study of epidemiology, clinicopathological correlation, prognostic factors and management in squamous cell carcinoma of vulva

Background: Carcinoma of the vulva is rare cancer, pruritus is the most common and long-lasting reported symptom. It is found to be associated with HPV and HIV infection. Currently, a more individualized and less radical treatment is suggested. In this study we evaluated epidemiology, clinicopathological prognostic factors, HPV distribution and risk factors for metastases to lymph nodes. We also reviewed multidisciplinary clinical management carried out at our institute.Methods: It is a prospective study of 25 biopsy proven cases of Squamous Cell Carcinoma of Vulva, treated at our center from September 2014 to September 2016. We collected the data regarding the clinical presentation, histological details, treatment given, survival and complications. HPV 16 and 18 testing were done using PCR method. Median follow up of the patients are for 24 months.Results: The mean age of patients was 54.6 years. Commonest presentation was perineal itching (36%). HPV 16/18 were positive in 25% of the patients. Radical vulvectomy with bilateral groin dissection was done in 14/25 (56%) patients. Among these 14 patients, 35.7 % (5/14) has lymph node metastases, disease free survival was 63.6% and overall survival was 81.1% for median follow up of 24 months. About one third of the patient presented with locally advanced disease.  Six (24%) patients received only chemo radiation as a treatment.Conclusions: HPV and HIV infection increase the risk of vulvar cancer. Individualization of treatment is necessary. The use of preoperative chemoradiation in locally advanced disease might have promising results in future

The connectome of the adult Drosophila mushroom body provides insights into function.

Making inferences about the computations performed by neuronal circuits from synapse-level connectivity maps is an emerging opportunity in neuroscience. The mushroom body (MB) is well positioned for developing and testing such an approach due to its conserved neuronal architecture, recently completed dense connectome, and extensive prior experimental studies of its roles in learning, memory, and activity regulation. Here, we identify new components of the MB circuit in Drosophila, including extensive visual input and MB output neurons (MBONs) with direct connections to descending neurons. We find unexpected structure in sensory inputs, in the transfer of information about different sensory modalities to MBONs, and in the modulation of that transfer by dopaminergic neurons (DANs). We provide insights into the circuitry used to integrate MB outputs, connectivity between the MB and the central complex and inputs to DANs, including feedback from MBONs. Our results provide a foundation for further theoretical and experimental work

A connectome and analysis of the adult Drosophila central brain.

The neural circuits responsible for animal behavior remain largely unknown. We summarize new methods and present the circuitry of a large fraction of the brain of the fruit fly Drosophila melanogaster. Improved methods include new procedures to prepare, image, align, segment, find synapses in, and proofread such large data sets. We define cell types, refine computational compartments, and provide an exhaustive atlas of cell examples and types, many of them novel. We provide detailed circuits consisting of neurons and their chemical synapses for most of the central brain. We make the data public and simplify access, reducing the effort needed to answer circuit questions, and provide procedures linking the neurons defined by our analysis with genetic reagents. Biologically, we examine distributions of connection strengths, neural motifs on different scales, electrical consequences of compartmentalization, and evidence that maximizing packing density is an important criterion in the evolution of the fly's brain

Statistical analysis and data mining of digital reconstructions of dendritic morphologies

Neuronal morphology is diverse among animal species, developmental stages, brain regions, and cell types. The geometry of individual neurons also varies substantially even within the same cell class. Moreover, specific histological, imaging, and reconstruction methodologies can differentially affect morphometric measures. The quantitative characterization of neuronal arbors is necessary for in-depth understanding of the structure-function relationship in nervous systems. The large collection of community-contributed digitally reconstructed neurons available at NeuroMorpho.Org constitutes a big data research opportunity for neuroscience discovery beyond the approaches typically pursued in single laboratories. To illustrate these potential and related challenges, we present a database-wide statistical analysis of dendritic arbors enabling the quantification of major morphological similarities and differences across broadly adopted metadata categories. Furthermore, we adopt a complementary unsupervised approach based on clustering and dimensionality reduction to identify the main morphological parameters leading to the most statistically informative structural classification. We find that specific combinations of measures related to branching density, overall size, tortuosity, bifurcation angles, arbor flatness, and topological asymmetry can capture anatomically and functionally relevant features of dendritic trees. The reported results only represent a small fraction of the relationships available for data exploration and hypothesis testing enabled by digital sharing of morphological reconstructions

Neural circuitry linking mating and egg laying in Drosophila females

Mating and egg laying are tightly cooordinated events in the reproductive life of\ua0all oviparous females. Oviposition is typically rare in virgin females but is initiated after copulation. Here we identify the neural circuitry that links egg laying to mating status in Drosophila melanogaster. Activation of female-specific oviposition descending neurons (oviDNs) is necessary and sufficient for egg laying, and is equally potent in virgin and mated females. After mating, sex peptide—a protein from the male seminal fluid—triggers many behavioural and physiological changes in the female, including the onset of egg laying. Sex peptide is detected by sensory neurons in the uterus, and silences these neurons and their postsynaptic ascending neurons in the abdominal ganglion. We show that these\ua0abdominal ganglion neurons directly activate the female-specific pC1 neurons. GABAergic (γ-aminobutyric-acid-releasing) oviposition inhibitory neurons (oviINs) mediate feed-forward inhibition from pC1 neurons to both oviDNs and their major excitatory input, the oviposition excitatory neurons (oviENs). By attenuating the abdominal ganglion inputs to pC1 neurons and oviINs, sex peptide disinhibits oviDNs to enable egg laying after mating. This circuitry thus coordinates the two key events in female reproduction: mating and egg laying