Structural Organization of Perisomatic Inhibition in the Mouse Medial Prefrontal Cortex.

Perisomatic inhibition profoundly controls neural function. However, the structural organization of inhibitory circuits giving rise to the perisomatic inhibition in the higher-order cortices is not completely known. Here, we performed a comprehensive analysis of those GABAergic cells in the medial prefrontal cortex (mPFC) that provide inputs onto the somata and proximal dendrites of pyramidal neurons. Our results show that most GABAergic axonal varicosities contacting the perisomatic region of superficial (layer 2/3) and deep (layer 5) pyramidal cells express parvalbumin (PV) or cannabinoid receptor type 1 (CB1). Further, we found that the ratio of PV/CB1 GABAergic inputs is larger on the somatic membrane surface of pyramidal tract neurons in comparison with those projecting to the contralateral hemisphere. Our morphologic analysis of in vitro labeled PV+ basket cells (PVBC) and CCK/CB1+ basket cells (CCKBC) revealed differences in many features. PVBC dendrites and axons arborized preferentially within the layer where their soma was located. In contrast, the axons of CCKBCs expanded throughout layers, although their dendrites were found preferentially either in superficial or deep layers. Finally, using anterograde trans-synaptic tracing we observed that PVBCs are preferentially innervated by thalamic and basal amygdala afferents in layers 5a and 5b, respectively. Thus, our results suggest that PVBCs can control the local circuit operation in a layer-specific manner via their characteristic arborization, whereas CCKBCs rather provide cross-layer inhibition in the mPFC.SIGNIFICANCE STATEMENT Inhibitory cells in cortical circuits are crucial for the precise control of local network activity. Nevertheless, in higher-order cortical areas that are involved in cognitive functions like decision-making, working memory, and cognitive flexibility, the structural organization of inhibitory cell circuits is not completely understood. In this study we show that perisomatic inhibitory control of excitatory cells in the medial prefrontal cortex is performed by two types of basket cells endowed with different morphologic properties that provide inhibitory inputs with distinct layer specificity on cells projecting to disparate areas. Revealing this difference in innervation strategy of the two basket cell types is a key step toward understanding how they fulfill their distinct roles in cortical network operations.

Vasoactive Intestinal Polypeptide-Immunoreactive Interneurons within Circuits of the Mouse Basolateral Amygdala.

In cortical structures, principal cell activity is tightly regulated by different GABAergic interneurons (INs). Among these INs are vasoactive intestinal polypeptide-expressing (VIP+) INs, which innervate preferentially other INs, providing a structural basis for temporal disinhibition of principal cells. However, relatively little is known about VIP+ INs in the amygdaloid basolateral complex (BLA). In this study, we report that VIP+ INs have a variable density in the distinct subdivisions of the mouse BLA. Based on different anatomical, neurochemical, and electrophysiological criteria, VIP+ INs could be identified as IN-selective INs (IS-INs) and basket cells expressing CB1 cannabinoid receptors. Whole-cell recordings of VIP+ IS-INs revealed three different spiking patterns, none of which was associated with the expression of calretinin. Genetic targeting combined with optogenetics and in vitro recordings enabled us to identify several types of BLA INs innervated by VIP+ INs, including other IS-INs, basket and neurogliaform cells. Moreover, light stimulation of VIP+ basket cell axon terminals, characterized by CB1 sensitivity, evoked IPSPs in ∼20% of principal neurons. Finally, we show that VIP+ INs receive a dense innervation from both GABAergic inputs (although only 10% from other VIP+ INs) and distinct glutamatergic inputs, identified by their expression of different vesicular glutamate transporters.In conclusion, our study provides a wide-range analysis of single-cell properties of VIP+ INs in the mouse BLA and of their intrinsic and extrinsic connectivity. Our results reinforce the evidence that VIP+ INs are structurally and functionally heterogeneous and that this heterogeneity could mediate different roles in amygdala-dependent functions.SIGNIFICANCE STATEMENT We provide the first comprehensive analysis of the distribution of vasoactive intestinal polypeptide-expressing (VIP+) interneurons (INs) across the entire mouse amygdaloid basolateral complex (BLA), as well as of their morphological and physiological properties. VIP+ INs in the neocortex preferentially target other INs to form a disinhibitory network that facilitates principal cell firing. Our study is the first to demonstrate the presence of such a disinhibitory circuitry in the BLA. We observed structural and functional heterogeneity of these INs and characterized their input/output connectivity. We also identified several types of BLA INs that, when inhibited, may provide a temporal window for principal cell firing and facilitate associative plasticity, e.g., in fear learning.

[Evaluation of the efficacy of powered and manual toothbrushes in preventing oral diseases (Systematic review with meta-analysis)]. / Elektromos és kézi fogkefék hatékonyságának összehasonlítása az orális prevencióban. Irodalmi áttekintés, systematic review, meta-analízis.

BACKGROUND: The removal of dental plaque plays an essential role in the maintenance of oral health. Numerous powered and manual toothbrushes were manufactured to achieve this goal, but even up to this day different opinions and research results have been revealed to assess the priority of the mentioned devices. AIM: Comparison of powered and manual toothbrushes on the basis of periodontal parameters and safety. MATERIALS AND METHODS: Electronic search of the databases of MEDLINE and EMBASE (until May 2014) was carried out with the help of keywords in order to find relevant trials. The inclusion criteria were as follows: randomised controlled clinical trials, adult population, the presence of at least 15 permanent teeth. Split-mouth trials and interventions carried out by dental professionals, were excluded. Primary outcomes were the changes of plaque and gingival indices, while secondary outcomes were probing pocket depth (PPD), safety and quality assessment. The effect-size of the interventions was expressed by the standardised mean difference (SMD) with 95% confidence interval (CI). Random-effects models were performed. RESULTS: Electronic search resulted in 173 hits. 21 trials with the total number of 1500 subjects were then eligible for the meta-analysis. Both toothbrushes were safe, without considerable side effects on soft or hard tissues. Powered toothbrushes seemed to be generally more effective in removing plaque (-9%), reducing gingivitis (-6%) and preventing calculus formation. The SMDs for plaque and gingival indices were -0,40 (95% Cl: -0,95 to -0,16) and -0,29 (95% Cl: -0,56 to -0,03) respectively, in favour of the powered devices. There was no significant difference in changes of PPD. By further dividing the powered toothbrushes according to their mode of action, the plaque removal effect of the rotation oscillation (plus three dimensional), side to side sonic and ultrasonic toothbrushes seemed to be significantly better, than their manual ones, while the counter oscillation and the ionic toothbrushes did not perform better. Quality assessment and sensitivity analysis revealed various types of bias up to a certain extent. Consequently, no trial was found to be eligible for the highest quality criteria. CONCLUSIONS: The investigated rotation oscillation and vibrating toothbrushes appeared to be statistically more effective than their manual counterparts, although there is little known about its clinical relevance. The advantage of the electric toothbrushes disappears in case of adequately instructed and motivated patients that highlights the importance of individualised oral hygiene education. The design of the trials shows high heterogeneity, therefore their clinical implications should be handled carefully.

[Small bowel obstruction with an unusual background]. / Egy szokatlan hátteru vékonybél ileus.

Bevezetés: Kompressziós vékonybél ileus esetét ismertetjük, amelyet a bélfodor nem gyakori, inflammatorikus természetu betegsége, mesenterialis panniculitis idézett elo. A magyar szakirodalomban ilyen közléssel nem találkoztunk. Esetismertetés: A 91 éves férfi akut hasi panaszokkal került kórházba. A vizsgálatokkal vékonybél ileus derült ki. Ennek hátterében mutétkor malignitásra gyanús, bélfodri multinodularis elváltozást fedtünk föl. A biopsziából mesenterialis panniculitist diagnosztizáltunk. A ritka, több nyitott kérdéssel terhelt entitást mutatjuk be az irodalom és a saját észleleteink tükrében. Következtetések: Számos differenciáldiagnosztikai eshetoség figyelembevételével a kórkép szövettanilag igazolható. A diagnózis felállítása után a további teendoket az egyéb leletek és az adott klinikai kontextus gondos elemzése fogja meghatározni.

Histologic evaluation of edentulous alveolar ridge horizontal bone augmentations using a xenogeneic bone substitute and autologous platelet concentrates: a case series.

OBJECTIVES: This case series aimed to assess the efficacy of a novel horizontal ridge augmentation modality using histology. Combinations of "sticky bone" and tenting screws without autologous bone were used as augmentative materials. METHOD AND MATERIALS: Five individuals presenting healed, atrophic, partially edentulous sites that required horizontal bone augmentation before implant placement were enrolled. Patients underwent the same augmentation type and 5 months of postoperative reentry procedures. The first surgery served as implant site development, whereas the biopsy and corresponding implant placement were performed during reentry. The bone was qualitatively analyzed using histology and histomorphometry and quantitatively evaluated using CBCT. RESULTS: Four individuals healed uneventfully. Early wound dehiscence occurred in one case. Histology showed favorable bone substitute incorporation into the newly formed bone and intimate contact between de novo bone and graft material in most cases. Histomorphometry revealed an average of 48 ± 28% newly formed bone, 19 ± 13% graft material, and 33 ± 26% soft tissue components. The CBCT-based mean alveolar ridge horizontal increase was 3.9 ± 0.6 mm at 5 months postoperatively. CONCLUSIONS: The described augmentation method appears suitable for implant site development resulting in favorable bone quality according to histology. However, clinicians must accommodate 1 to 2 mm of resorption in augmentative material width at the buccal aspect.

ACTH-secreting Crooke cell carcinoma of the pituitary.

PURPOSE: While pituitary adenomas are common, pituitary carcinomas are rare. It is unclear whether pituitary carcinomas arise de novo or evolve from adenomas. METHODS: We studied the clinical characteristics and tissue samples from eight pituitary surgeries and the autopsy from a patient with pituitary carcinoma. A 16-year-old female patient was diagnosed with an aggressive Crooke cell macroadenoma. Following transsphenoidal surgery, clinical signs of Cushing disease quickly reappeared. During the 14-year course of the illness, eight pituitary surgeries, three courses of extracranial irradiation and two (90) Yttrium-DOTATOC treatments were undertaken. A bilateral adrenalectomy was performed. The patient died of metastatic disease and uncontrolled hypercortisolism due to an adrenal remnant. A systematic morphologic study (histologic staining, electron microscopy) of all available surgical and autopsy specimens was undertaken. RESULTS: Brisk mitotic activity, high Ki-67 and p53 immunolabelling were present in the pituitary samples from the onset. High proportion of tumour cells showed irregular nuclei and large nucleoli, and gradual increase in MGMT staining was observed. The tumour remained of Crooke cell type throughout the course. Autopsy disclosed a postirradiation sarcoma in the pituitary area. CONCLUSIONS: The question whether pituitary carcinomas arise de novo or transform from an adenoma cannot be answered at present with certainty.

Presentation of a novel surgical technique in periodontally accelerated osteogenic orthodontics. CBCT assessment of the buccal alveolar dimensional changes: a proof-of-concept report of four cases.

OBJECTIVES: The aim of this report was to present the effectiveness of a novel augmented corticotomy performed before orthodontic treatments in the prevention of buccal alveolar dehiscence and gingival recession. METHOD AND MATERIALS: Four periodontally healthy individuals presenting crowding and thin bone morphotype in the mandibular anterior area were treated with a double-layer tunnel flap, piezotomy, and hard and soft-tissue augmentation. Patients were divided into two groups according to the utilized graft material. The exclusive use of demineralized bovine bone minerals (group 2) was compared to the use of autologous concentrated growth factor-enriched bone graft matrix, "sticky bone" (group 1). CBCT measurements were performed before and 6 months after surgery. Orthodontic treatment was initialized 1 week after surgery. RESULTS: Postoperative wound healing was uneventful, and tooth alignments were successful in all cases. Postoperative buccal hard tissue dimensions were favorable in both groups, with no occurring bone dehiscence or gingival recession. The seemingly better results of group 2, in terms of quantitative hard tissue changes, did not have any clinical significance according to the objective to be achieved. In contrast, qualitative radiographic analysis showed a more homogenous tissue formation around teeth in group 1. CONCLUSION: It can be concluded that the presented preorthodontic treatment approach seems to be successful in preventing alveolar dehiscence and gingival recession around buccally inclined mandibular anterior teeth.

Preliminary Assessment of In Vivo Raman Spectroscopy Technique for Bone Quality Evaluation of Augmented Maxillary Sinus Floor.

(1) Background: In oral surgery, bone regeneration is achieved through various types of bone grafts or bone substitutes and its success is usually analyzed by micro-computed tomography and histomorphometry. The aim of this study was to evaluate the usefulness of Raman spectroscopy as an alternative to other techniques for bone quality evaluation during a standard oral surgery procedure. (2) Methods: The preliminary evaluation of bone augmentation during maxillary sinus floor elevation oral surgery was performed by Raman spectroscopy for several (five) patients during and after the surgery and the results were compared with postoperative data from histomorphometry, EDX and SEM analysis. (3) Results: After analyzing all the results for the bone samples according to the four methods (Raman, EDX, SEM and Histology) that were used in our study, the obtained result of the investigation provided a good augmentation process for three of the patients and partly successful augmentation process for two of the patients. The primary evaluation using Raman spectroscopy (in vivo and ex vivo investigation) was confirmed by histological results, thus having a first step for validation of Raman as a new method of imaging for dentistry. (4) Conclusions: Our results show that Raman spectroscopy could provide fast and reliable insight on bone condition during augmentation of the maxillary sinus floor. We emphasize the advantages and drawbacks of the proposed techniques as its accuracy could increase by performing larger size clinical trials. Using the Raman mapping, the method can serve as an alternative to histology.

Periodontal Disease Monitoring by Raman Spectroscopy of Phosphates: New Insights into Pyrophosphate Activity.

(1) Background: The intent of this survey was to investigate the quality of the alveolar bone by revealing the different phases for calcified tissues independent of the medical history of the patient in relation to periodontal disease by means of Raman spectroscopy and then to correlate the results by suggesting a possible mechanism for the medical impairment; (2) Methods: The investigation was mainly based on Raman spectroscopy that was performed in vivo during surgery for the selected group of patients. The targeted peaks for the Raman spectra were according to the reference compounds (e.g., calcium phosphates, other phosphates); (3) Results: The variation in the intensity of the spectrum correlated to the specific bone constituents' concentrations highlights the bone quality, while some compounds (such as pyrophosphate, PPi) are strongly related to the patient's medical status, and they provide information regarding a physiological process that occurred in the calcified tissues. Moreover, bone sample fluorescence is related to the collagen (Col) content, enabling a complete evaluation of bone quality, revealing the importance of collagen matrix acting as a load-bearing element for Calcium phosphate (CaP) deposition during the complex bone mineralization process; (4) Conclusions: We highlight that Raman spectroscopy can be considered a viable investigative method for in vivo and rapid bone quality valuation through oral health monitoring.

CaMKIIα Promoter-Controlled Circuit Manipulations Target Both Pyramidal Cells and Inhibitory Interneurons in Cortical Networks.

A key assumption in studies of cortical functions is that excitatory principal neurons, but not inhibitory cells express calcium/calmodulin-dependent protein kinase II subunit α (CaMKIIα) resulting in a widespread use of CaMKIIα promoter-driven protein expression for principal cell manipulation and monitoring their activities. Using neuroanatomical and electrophysiological methods we demonstrate that in addition to pyramidal neurons, multiple types of cortical GABAegic cells are targeted by adeno-associated viral vectors (AAV) driven by the CaMKIIα promoter in both male and female mice. We tested the AAV5 and AAV9 serotype of viruses with either Channelrhodopsin 2 (ChR2)-mCherry or Archaerhodopsin-T-green fluorescent protein (GFP) constructs, with different dilutions. We show that in all cases, the reporter proteins can visualize a large fraction of different interneuron types, including parvalbumin (PV), somatostatin (SST), neuronal nitric oxide synthase (nNOS), neuropeptide Y (NPY), and cholecystokinin (CCK)-containing GABAergic cells, which altogether cover around 60% of the whole inhibitory cell population in cortical structures. Importantly, the expression of the excitatory opsin Channelrhodopsin 2 in the interneurons effectively drive spiking of infected GABAergic cells even if the immunodetectability of reporter proteins is ambiguous. Thus, our results challenge the use of CaMKIIα promoter-driven protein expression as a selective tool in targeting cortical glutamatergic neurons using viral vectors.

Raman Spectroscopy: In Vivo Application for Bone Evaluation in Oral Reconstructive (Regenerative) Surgery.

The aim of this study was to evaluate the quality of the bone, revealing the different phases for calcified tissues independent of the medical history of the patient in relation to periodontitis by means of in vivo Raman spectroscopy. Raman spectroscopy measurements were performed in vivo during surgery and then ex vivo for the harvested bone samples for the whole group of patients (ten patients). The specific peaks for the Raman spectrum were traced for reference compounds (e.g., calcium phosphates) and bone samples. The variation in the intensity of the spectrum in relation to the specific bone constituents' concentrations reflects the bone quality and can be strongly related with patient medical status (before dental surgery and after a healing period). Moreover, bone sample fluorescence is related to collagen content, enabling a complete evaluation of bone quality including a "quasi-quantification" of the healing process similar to the bone augmentation procedure. A complete evaluation of the processed spectra offers quantitative/qualitative information on the condition of the bone tissue. We conclude that Raman spectroscopy can be considered a viable investigation method for an in vivo and quick bone quality assessment during oral and periodontal surgery.

[From project-based sample collection to biobank]. / Projektalapú mintagyujtéstol a biobankig.

The research group takes samples for molecular genetical examinations from tumors removed during operations within ischemic time interval. Samples are stored in liquid nitrogen. Clinical data of these patients are recorded in an informatics system developed by the group. Patients are followed in an out-patient clinic set up for this purpose not financed by the National Health Insurance Fund. Tissue samples and follow up data are used to cooperate with molecular genetical laboratories.

Male and female noctuid moths attracted to synthetic lures in Europe.

In field tests in Europe, traps baited with a blend of isoamyl alcohol, acetic acid, and isobutanol (compounds previously found attractive to a number of noctuids in North America) caught the following noctuid moths: Agrotis segetum Schiff., Agrotis crassa Hbn., Agrotis exclamationis L., Amathes (Xestia) c-nigrum L., Apatele rumicis L., Amphipyra pyramidea L., Dipterygia scabriuscula L., Discestra trifolii Hfn., Euxoa aquilina Schiff., Euclidia glyphica L., Mamestra brassicae L., Mamestra oleracea L., Mamestra suasa Schiff., Mythimna albipuncta Den. & Schiff., Mythimna l-album L., Noctua pronuba L., and Trachea atriplicis L. A substantial percentage of the catch of each species of moths was females. The presence of isobutanol in the mixture was important for catching A. rumicis, D. trifolii, and E. glyphica. The addition of 3-methyl-1-pentanol to the ternary mixture did not increase trap captures of any of the moths. Traps baited with the floral attractant phenylacetaldehyde alone caught several species of noctuid moths. However, when phenylacetaldehyde was added to the isoamyl-alcohol ternary blend, no increases in catches of any of the species, relative to the ternary blend or phenyacetaldehyde alone, were observed, with catches of most species being depressed. Comparing the noctuid species attracted to the phenylacetaldehyde- and isoamyl alcohol-based lures showed that phenylacetaldehyde attracted predominantly Plusiinae and Melicleptriinae spp., while isoamyl alcohol-based lures attracted species mostly from the Noctuinae or Hadeninae subfamilies.

Histologic Evaluation of Human Intrabony Periodontal Defects Treated with Deproteinized Bovine Bone Mineral in Combination with Orthodontic Tooth Movement: A Case Series.

The aim of this case series was the histologic evaluation of guided tissue regeneration utilizing deproteinized bovine bone mineral (DBBM) when regenerative surgery was combined with (test) or without (control) early orthodontic tooth movement. Core biopsy samples were harvested from previously defected sites after 9 months. The histologic section showed integration of DBBM particles in newly formed bone in the apical and middle thirds of the defect, while in the coronal part, graft materials were mainly embedded in connective tissues in the control patient. DBBM particles showed partial resorption with more de novo bone formation in test samples.

Morphological changes in the lower esophageal sphincter influencing the result of antireflux surgical interventions in chronic gastroesophageal reflux disease.

BACKGROUND/AIMS: It is still unclear whether long-term reflux episodes result in morphological changes in the lower esophageal sphincter or not. If the answer is supposedly yes, do these changes influence the postoperative functional results following antireflux surgery? METHODOLOGY: Between 1 January 2002 and 2004, we performed antireflux surgery on 85 patients. Muscle samples were taken from the lower esophageal sphincter (LES) in 57 patients on operation. Patients with endoscopic findings of moderate or severe reflux esophagitis--Los Angeles B, C, D--were excluded. Control samples were obtained from muscle tissue at the gastroesophageal junction that had been removed from 16 patients undergoing gastric or esophageal resection. Histologic (hematoxylin and eosin and Giemsa), and immunohistologic (S-100 Protein, NCL-SERCA2, alpha-SMA) and electronmicroscopic analysis were used to evaluate the specimens. The number of smooth muscle cell nuclei in these intraoperative biopsies was used to compare the results of antireflux operations (Visick I and II-III). RESULTS: In 19% (11/57) of the reflux-type LES muscle samples perivascular inflammatory infiltration has been noted and in 6 of these cases (6/57 = 11%) this has incorporated marked intramuscular and adventitial granulocyte infiltration. In one patient (1/57 = 2%) eosinophil infiltration of the myenteric plexus and the ganglion has been revealed. Significantly lower Schwann and smooth muscle cell count could be detected in LES muscle samples taken from patients with GERD (p < 0.05). The analysis of the values of the 9 patients in Visick groups II and III at two months after surgery, has shown a significant decrease in the number of smooth muscle cell nuclei as compared to those patients in Visick group I (p < 0.01). CONCLUSIONS: Our results draw attention to the morphological changes occurring in the LES muscles of reflux patients. The enteric ganglionitis induced by GERD may result in various functional esophageal diseases. The histologic changes--that very much resemble hypertrophy--developing in LES muscles may serve as a reason for symptoms after antireflux surgery, presumably for the most common complaint of dysphagia.

[Significance of endoscopic biopsy and cytology in the diagnosis of esophageal squamous cell carcinoma]. / Az endoszkópos biopszia és citológia jelentôsége a nyelôcsô laphámrákos daganatainak diagnosztikájában.

We have tested the role and significance of histology combined with cytology in the diagnosis of esophageal squamous cell carcinomas. Biopsy specimens and samples for cytological smear were taken by a fiberoptic flexible endoscope. In order to minimise the loss of biological sample, the residue from the brush was removed with rinsing fluid. From 1973 to 2005 we examined 820 patients with squamous cell carcinoma of the esophagus. Endoscopic biopsy yielded positive result in 97.2%. Cytology performed in 724 patients turned out to be positive in 90.3%. Both examinations were conducted in 648 patients (79%), and yielded positive result in 572 patients (88.3%). Negative biopsy result was obtained in 22 patients, however, 14 of them had positive cytological diagnosis. Both biopsy and cytology were negative in 8 cancer patients (1%). No complication was observed with either diagnostic technique. In our material cancer was diagnosed in 776 patients by histology. However, in a further 14 of 22 patients with negative histology, cancer was detected by cytology. This means that the presence of cancer was also confirmed on the basis of morphological features in 790 cases, i.e. in 96.3% of the patients. Our results show that the combined use of biopsy and cytology in malignant tumours yields high diagnostic accuracy. Since abrasion exfoliate cytology is a quick and useful diagnostic measure it should be a routine examination in the evaluation of abnormal changes in the esophageal mucosa. The examination of the rinsing fluid of the sampling brush, introduced by us, yielded additional diagnostic information.

Claudin expression in Barrett's esophagus and adenocarcinoma.

Claudins (CLDNs) are key molecules in cell adhesion, polarity, and control of paracellular solute transport. Several studies suggested that changes in claudin pattern have a role in cancer development. This study aimed to detect alterations in CLDN 1, 2, 3, 4, and 7 expression patterns in Barrett's esophagus (BE) and adenocarcinoma (ACC) compared with that in foveolar epithelium (FOV), normal squamous epithelium (SQ), and squamous cell carcinoma (SQCC). One hundred twenty five surgically or endoscopically removed, paraffin-embedded cases were studied by immunohistochemistry and analyzed statistically. BE, ACC, and FOV were dissected from 30 paraffin-embedded samples for further mRNA expression analysis. CLDN 7 was the dominating type in all epithelia and carcinomas, but its expression did not differ in normal and altered tissues. CLDN 1 expression was significantly increased in SQCC compared with that in SQ. CLDNs 3 and 4 were significantly elevated both in BE and ACC compared with that in FOV. CLDN 2 expression increased significantly in ACCs compared with that in BE. This is the first report proving similarities and differences regarding claudin expression pattern in BE and ACC compared with that in FOV and SQ. Our data prove a close link in CLDN pattern between BE and ACC, adding further evidence that BE is an alteration preceding esophageal ACC.

[Gastrointestinal stromal tumors (GISTs): clinical and pathological features]. / Gastrointestinalis stroma tumorok (GISTs): klinikai és patológiai jellemzok.

Gastrointestinal stromal tumors (GISTs): clinical and pathological features. The gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. With immunohistochemical, electron microscope and molecular examinations they can be clearly distinguished in both their genotype and phenotype from other mesenchymal tumors. GIST tumors express the CD 117 receptor in more than 90% independent of histopathological features and clinical behaviour. This is why it is considered as the most important characteristic. The incidence is 10-20 new cases per 1 million annually. The number of incidents is expected to increase by the establishment of CD117 and other new markers (protein kinase C theta, DOG1). Nowadays the establishment of the expected biological behavior and malignancy can be difficult. The best prognostic factors are the tumor size and the mitotic index. Dominantly, due to the mutation of the c-kit proto-oncogene and PGDFRA gene that the high level tyrosine kinase activity generates resulting uncontrolled proliferation and cell growth. The imatinib mesylate is a selective inhibitor of the KIT tyrosine kinase receptor and it also blocks the activity of the PDGFRA kinase. The therapeutic consequence of this is that the majority of advanced GIST tumors which do not react to conventional radio- and chemotherapy respond well to tyrosine kinase inhibitor treatment. As a result, survival and patient's quality of life can significantly improve.