Peritumor Mucosa in Advanced Laryngeal Carcinoma Exhibits an Aberrant Proangiogenic Signature Distinctive from the Expression Pattern in Adjacent Tumor Tissue

The field cancerization theory is an important paradigm in head and neck carcinoma as its oncological repercussions affect treatment outcomes in diverse ways. The aim of this study is to assess the possible interconnection between peritumor mucosa and the process of tumor neoangiogenesis. Sixty patients with advanced laryngeal carcinoma were enrolled in this study. The majority of patients express a canonical HIF-upregulated proangiogenic signature with almost complete predominancy of HIF-1α overexpression and normal expression levels of the HIF-2α isoform. Remarkably, more than 60% of the whole cohort also exhibited an HIF-upregulated proangiogenic signature in the peritumoral benign mucosa. Additionally, the latter subgroup had a distinctly shifted phenotype towards HIF-2α upregulation compared to the one in tumor tissue, i.e., a tendency towards an HIF switch is observed in contrast to the dominated by HIF-1α tumor phenotype. ETS-1 displays stable and identical significant overexpression in both the proangiogenic phenotypes present in tumor and peritumoral mucosa. In the current study, we report for the first time the existence of an abnormal proangiogenic expression profile present in the peritumoral mucosa in advanced laryngeal carcinoma when compared to paired distant laryngeal mucosa. Moreover, we describe a specific phenotype of this proangiogenic signature that is significantly different from the one present in tumor tissue as we delineate both phenotypes, quantitively and qualitatively. This finding is cancer heterogeneity, per se, which extends beyond the "classical" borders of the malignancy, and it is proof of a strong interconnection between field cancerization and one of the classical hallmarks of cancer-the process of tumor neoangiogenesis.

EPIDEMIOLOGICAL REGISTRY OF NEUROENDOCRINE TUMORS IN BULGARIA--A PILOT SURVEY

The National registry of patients with neuroendocrine tumors (NET) in Bulgaria was established in 2013 as a joint initiative of the Bulgarian Surgical Society and the Institute for Rare Diseases. The register aims to explore the epidemiology of NET in Bulgaria, as well as the different diagnostic and treatment approaches for the disease throughout the country. This the first of its kind retrospective study of NET in the country is covering the period January 2012 - January 2013. A total of 127 patients with NET were identified. At the time of the survey the average age of patients with NET was 58.61 ± 15.59 years. The data show almost equal distribution between the genders with a slight predominance of women. The largest relative part of NET is those of NET located in the gastrointestinal tract (54.10 ± 4.51%), followed by those located in the pancreas (12.30 ± 2.97%) and in the lungs (10.66 ± 2.79%). In 72.44 ± 3.96% of the patients a immunohistochemical diagnosis was performed. The study confirmed the leading role of the surgery method of the NET management. In 65.83 ± 4.33% of the patients a radical removal of the tumor was conducted, while the relative part of the undertaken partial resection was 7.50 ± 2.40%. A statistically significant association between the type of surgical treatment and during the follow-up of patients was found. An update of the information in the register will allow a more precise determining of the distribution and management of NET in Bulgaria.

Surgical treatment of chronic pancreatitis and its complications. Comparative analysis of results in 91 patients

There is a large variety of proposed conservative, invasive, endoscopic and surgical methods for treatment of chronic pancreatitis and its complications. This study presents a comparative analysis of the results from each group of patients subjected to drainage, resection, denervation and other operative techniques for a total of 91 patients with chronic pancreatitis and its complications. Drainage and resection operative techniques yield comparable results in terms of postoperative pain control 93.1% and 100%, perioperative mortality--3.17% and 5.8%, perioperative morbidity--7.9% and 11.7%, respectively. There is a significant increase in the instances of diabetes in the resection group. Right-side semilunar ganglionectomy is a good method for pain control as an accompanying procedure in the course of another main operative technique.

Some aspects of the etiology and the pathogenesis of chronic pancreatitis

The development of modern technology and advances in medical science make possible understanding of etiology of chronic pancreatitis. From a century ago, the ethanol is connected to chronic pancreatitis. In the last decades medical science made a big footstep in understanding of so called "idiopathic pancreatitis". Factors as autoimmune disturbances, toxins, gene mutations, geographic characteristics are already known as cornerstones in etiology and pathogenesis of the disease.

[Not Available]

In the work submitted, the author makes a brief historical review of Bulgarian ethnographic literature, related, among other things, also to popular medicine investigations. Reference is made to authors as Dr. Yuri Ivanovich Venelin (1825), G.S. Rakovsky (1859), and after the liberation of Bulgaria: Tzani Ginchev Shkeparnev, one of the outstanding protagonists for collecting facts and materials in the field of popular medicine in this country, M. Georgiev, Hr. Popstoilov, K. Irechek, Iv. D. Shishmanov and others. A description is made of the traditional methods of treatment with herbs, charms, healers and the like. Due attention is given also to the popular conceptions and explanation of the contributing factors of diseases, looking for the rationale in them and giving special consideration to the superstitious traces, inherited from the ancient Thracians. It is stressed that the items published heretofore in the "Comopilation of national folklore and literature", covering the field of popular medicine, constitute a great, unique in its significance, national wealth which is seldom found in other countries and which might be utilized by modern medicine as well as for drawing important ethnogenetic inferences.

[Electron microscopic study of the liver after experimentally resecting it and covering its surface with BAPP and BAPK]

An analysis of data of electron microscopic investigations of liver preparations within the terms of from 7 to 425 days after resection of the liver in which the liver wound was covered by the antimicrobial polycaproamid gauze made in Bulgaria has shown that the polymer material does not cause alterations in the liver structure and cell organelles of hepatocytes not preventing regeneration of the liver.