Organ Of Origin Research Articles

Unexpected PAX8 Immunoreactivity in Metastatic High-grade Breast Cancer.

Immunohistochemistry (IHC) is often critical for distinction between metastatic carcinomas of Mullerian organ and breast origin. Paired box family protein 8 (PAX8) has been described as a transcription factor highly specific to neoplasms derived from Mullerian organs, thyroid, and kidney. PAX8 IHC with polyclonal and monoclonal antibody reagents was performed on 27 primary and 22 metastatic breast carcinomas. Eight of 27 primary breast carcinomas (30%) were positive for PAX8 with the monoclonal antibody reagent only; 0 of 22 were polyclonal anti-PAX8 immunoreactive. Substantial numbers of metastases had positive immunoreactivity for polyclonal anti-PAX8 (23%). Each of these metastases and additional cases (45% total) also had positive immunoreactivity for monoclonal anti-PAX8, including 5 of 7 brain metastases. IHC with monoclonal anti-PAX8 was positive on 6 of 7 primary breast carcinomas corresponding to PAX8-positive metastases. Together, these results indicate a significant fraction of breast carcinoma metastases and corresponding primary neoplasms have immunoreactivity for PAX8, and positivity rates depend on the antibody used. Diagnoses of metastatic breast carcinoma were achieved with the aid of clinical history and additional IHC in cases of PAX8 immunoreactivity. Contextual interpretation is imperative for PAX8 IHC, particularly when the differential diagnosis includes metastatic breast carcinoma with limited diagnostic material available.

The heterogeneity and complexity of Cannabis extracts as antitumor agents.

The Cannabis plant contains over 100 phytocannabinoids and hundreds of other components. The biological effects and interplay of these Cannabis compounds are not fully understood and yet influence the plant’s therapeutic effects. Here we assessed the antitumor effects of whole Cannabis extracts, which contained significant amounts of differing phytocannabinoids, on different cancer lines from various tumor origins. We first utilized our novel electrospray ionization liquid chromatography mass spectrometry method to analyze the phytocannabinoid contents of 124 Cannabis extracts. We then monitored the effects of 12 chosen different Cannabis extracts on 12 cancer cell lines. Our results show that specific Cannabis extracts impaired the survival and proliferation of cancer cell lines as well as induced apoptosis. Our findings showed that pure (-)-Δ9-trans-tetrahydrocannabinol (Δ9-THC) did not produce the same effects on these cell lines as the whole Cannabis extracts. Furthermore, Cannabis extracts with similar amounts of Δ9-THC produced significantly different effects on the survival of specific cancer cells. In addition, we demonstrated that specific Cannabis extracts may selectively and differentially affect cancer cells and differing cancer cell lines from the same organ origin. We also found that cannabimimetic receptors were differentially expressed among various cancer cell lines and suggest that this receptor diversity may contribute to the heterogeneous effects produced by the differing Cannabis extracts on each cell line. Our overall findings indicate that the effect of a Cannabis extract on a specific cancer cell line relies on the extract’s composition as well as on certain characteristics of the targeted cells.

Gboxin is an oxidative phosphorylation inhibitor that targets glioblastoma

Cancer specific inhibitors reflective of unique metabolic needs, are rare. We describe a novel small molecule, Gboxin, that specifically inhibits primary mouse and human glioblastoma (GBM) cell growth but not mouse embryo fibroblasts or neonatal astrocytes. Gboxin rapidly and irreversibly compromises GBM oxygen consumption. Reliant on its positive charge, Gboxin associates with mitochondrial oxidative phosphorylation complexes in a proton gradient dependent manner and inhibits F0F1 ATP synthase activity. Gboxin resistant cells require a functional mitochondrial permeability transition pore that regulates pH impeding matrix accumulation. Administration of a pharmacologically stable Gboxin analog inhibits GBM allografts and patient derived xenografts. Gboxin toxicity extends to established human cancer cell lines of diverse organ origin and exposes the elevated proton gradient pH in cancer cell mitochondria as a new mode of action for antitumor reagent development.

A multiomics comparison between endometrial cancer and serous ovarian cancer.

BackgroundEndometrial carcinoma (EC) and serous ovarian carcinoma (OvCa) are both among the common cancer types in women. EC can be divided into two subtypes, endometroid EC and serous-like EC, with distinct histological characterizations and molecular phenotypes. There is an increasing awareness that serous-like EC resembles serous OvCa in genetic landscape, but a clear relationship between them is still lacking.MethodsHere, we took advantage of the large-scale molecular profiling of The Cancer Genome Atlas(TCGA) to compare the two EC subtypes and serous OvCa. We used bioinformatics data analytic methods to systematically examine the somatic mutation (SM) and copy number alteration (SCNA), gene expression, pathway activities, survival gene signatures and immune infiltration. Based on these quantifiable molecular characterizations, we asked whether serous-like EC should be grouped more closely to serous OvCa, based on the context of being serous-like; or if should be grouped more closely to endometroid EC, based on the same organ origin.ResultsWe found that although serous-like EC and serous OvCa share some common genotypes, including mutation and copy number alteration, they differ in molecular phenotypes such as gene expression and signaling pathway activity. Moreover, no shared prognostic gene signature was found, indicating that they use unique genes governing tumor progression. Finally, although the endometrioid EC and serous OvCa are both highly immune infiltrated, the immune cell composition in serous OvCa is mostly immune suppressive, whereas endometrioid EC has a higher level of cytotoxic immune cells. Overall, our genetic aberration and molecular phenotype characterizations indicated that serous-like EC and serous OvCa cannot be simply treated as a simple “serous” cancer type. In particular, additional attention should be paid to their unique gene activities and tumor microenvironments for novel targeted therapy development.

Timeliness of Presentation and Referral Among Cancer Patients Who Presented With Abdominal Symptoms: Evidence to Inform Symptom Awareness Campaigns

Background: Abdominal symptoms at presentation are common among patients subsequently diagnosed with cancer. While public health education campaigns in England and other countries have traditionally focused on 'red flag' symptoms associated with a single common cancer (e.g., 'blood in poo' and colorectal cancer), there is increasing interest in raising awareness of symptoms grouped by body area or system (eg 'abdominal symptoms'). Evidence regarding the frequency and nature of abdominal symptoms at presentation among a representative cancer patient cohort could inform the design and evaluation of community based cancer symptom awareness campaigns. Aim: To describe the frequency of abdominal symptoms at presentation among an incident cohort of cancer patients, examine variation in diagnostic timeliness and subsequently diagnosed cancer sites by abdominal symptom. Methods: The presenting symptom(s) of 15,956 cancer patients from a national audit of primary care records in England was coded into symptom categories. Eight abdominal symptoms with a range of predictive values and specificity for cancer were studied: abdominal pain, change in bowel habit, bloating/distension, dyspepsia, rectal bleeding, dysphagia, reflux, and nausea/vomiting. We investigated the prevalence of abdominal symptoms among the cancer patient population, examined variation in the length of the patient interval (time from symptom onset to presentation to primary care) and primary care interval (time from presentation to specialist referral) by symptom, and described the associated spectrum of diagnosed cancer sites for each individual symptom. Results: Almost a quarter (23%) of the incident cancer patient population had abdominal symptom(s) at presentation (n=3,661/15,956). The relative lengths of the patient and primary care intervals varied greatly by abdominal symptom. One in two cancer patients who had dysphagia before diagnosis presented 30 days after symptom onset (median (IQR) patient interval: 30 (10-61) days), but were referred immediately (median (IQR) primary care interval: 0 (0-14) days). In comparison, cancer patients who presented with abdominal pain had longer intervals postpresentation (median (IQR) patient interval: 7 (0-28) days, median (IQR) primary care interval: 16 (2-43) days). The majority (88.6%) of cancer patients who presented with an abdominal symptom were diagnosed with an abdominal or adjacent cancer, including colorectal, esophageal, ovarian, and pancreatic cancers. However, the remainder of patients were diagnosed with solid tumors of nonabdominal organ origin (7.6%) or a hematologic cancer (3.8%). Conclusion: Cancer symptom awareness campaigns focusing on abdominal symptoms could contribute to the earlier diagnosis of numerous common and rarer cancers. Evidence regarding the relative lengths of the patient and primary care intervals could be used as a measure of relative need for raising awareness.

In Reply to the Letter to the Editor “Circumventricular Organ Origin of Hemangioblastoama; Hypothesis for Pathogenesis of Disease”

In Reply to the Letter to the Editor “Circumventricular Organ Origin of Hemangioblastoama; Hypothesis for Pathogenesis of Disease”

In Reply to the Letter to the Editor “Circumventricular Organ Origin of Hemangioblastoama; Hypothesis for Pathogenesis of Disease”

In Reply to the Letter to the Editor “Circumventricular Organ Origin of Hemangioblastoama; Hypothesis for Pathogenesis of Disease”

DNA damage in kidney transplant patients. Role of organ origin.

Chronic kidney disease (CKD) patients are characterized by elevated levels of genomic damage. This damage increases when kidney function decreases being maximum in hemodialysis patients. As kidney transplantation improves renal function, and it is related with better survival, the aim of our study was to evaluate potential changes in DNA damage levels after kidney transplantation, and comparing living donor recipients with cadaveric donor recipients. The alkaline comet assay was used to determine DNA breaks and oxidative damaged DNA; and the micronucleus assay was used to determine chromosomal breakage and/or aneuploidy. Fifty CKD patients were followed up after 6 and 12 months of their kidney transplantation. All patients increased their genomic damage levels after 6 and 12 months of renal transplantation, compared with those observed before transplantation, despite of the improvement of their metabolic functions. Donor advanced age correlated positively with higher DNA damage. Genomic damage was lower in living donor transplants with respect to cadaveric donor transplants. Our conclusion is that DNA damage increased in kidney transplantation patients, whereas their renal function improved. Higher levels of DNA damage were found in cadaveric donor transplants when compared to living donor transplants. Environ. Mol. Mutagen. 58:712-718, 2017. © 2017 Wiley Periodicals, Inc.

A Multivariate Evaluation of Factors Affecting the Quality of Freshly Frozen Tissue Specimens.

Well-prepared and preserved freshly frozen specimens are indispensable materials for clinical studies. To manage specimen quality and to understand the factors potentially affecting specimen quality during preservation processes, we analyzed the quality of RNA and genomic DNA of various tissues collected between 2002 and 2011 in Linkou Chang Gung Memorial Hospital, Taiwan. During this period, a total of 1059 freshly frozen specimens from eight major cancer categories were examined. It was found that preservation duration, organ origin, and tissue type could all influence the quality of RNA samples. The increased preservation period correlated with decreased RNA quality; the brain, breast, and stomach RNA specimens displayed faster degradation rates than those of other organs, and RNA specimens isolated from tumor tissues were apparently more stable than those of other tissues. These factors could all be used as quality predictors of RNA quality. In contrast, almost all analyses revealed that the genomic DNA samples had good quality, which was not influenced by the aforementioned factors. The results assisted us in determining preservation factors that affect specimen quality, which could provide evidence for improving processes of sample collection and preservation. Furthermore, the results are also useful for researchers to adopt as the evaluation criteria for choosing specimen collection and preservation strategies.

Variation in Phenolic Composition of Knautia arvensis in Correlation with Geographic Area and Plant Organ

Knautia arvensis (family Dipsacaceae) is usually found in grasslands of Europe, but can also be found in some parts of Africa and Asia, usually in dry meadows, pastures, dry hills, and open woods. The chemical composition of this species is relatively unknown. The aim of this study was to give a phenolic profile of this plant, and to show how its phenolic composition varies depending upon plant organ and geographic origin. The chemical analysis included quantification of free phenolics soluble in methanol, esters and glycosides, and phenolics that are insoluble in methanol. Fourteen different phenolic acids and eight flavonoids were quantified in total. According to this study, the chemical composition of individual plant parts can differ tremendously within one - population, which does not have to be in correspondence with chemical variability between populations. As shown in this study, the variation in chemical composition between plant parts can exceed that between different populations (from different climates, altitudes, with different environmental factors), which implies that microhabitat conditions can greatly affect the composition of some plant parts, which was shown also after PCA and HCA analysis.

A cell wall reference profile for Miscanthus bioenergy crops highlights compositional and structural variations associated withdevelopment and organ origin.

Summary Miscanthus spp. are promising lignocellulosic energy crops, but cell wall recalcitrance to deconstruction still hinders their widespread use as bioenergy and biomaterial feedstocks. Identification of cell wall characteristics desirable for biorefining applications is crucial for lignocellulosic biomass improvement. However, the task of scoring biomass quality is often complicated by the lack of a reference for a given feedstock.A multidimensional cell wall analysis was performed to generate a reference profile for leaf and stem biomass from several miscanthus genotypes harvested at three developmentally distinct time points. A comprehensive suite of 155 monoclonal antibodies was used to monitor changes in distribution, structure and extractability of noncellulosic cell wall matrix glycans.Glycan microarrays complemented with immunohistochemistry elucidated the nature of compositional variation, and in situ distribution of carbohydrate epitopes. Key observations demonstrated that there are crucial differences in miscanthus cell wall glycomes, which may impact biomass amenability to deconstruction.For the first time, variations in miscanthus cell wall glycan components were comprehensively characterized across different harvests, organs and genotypes, to generate a representative reference profile for miscanthus cell wall biomass. Ultimately, this portrait of the miscanthus cell wall will help to steer breeding and genetic engineering strategies for the development of superior energy crops.

Abstract B21: Establishment of a novel spontaneous prostate cancer liver metastasis model

Abstract Objective: Prostate cancer (PCa) preferentially spreads to bone with additional metastasis to regional lymph nodes, lung and liver in a subset of patients. Understanding the determining factors of this metastatic pattern and to elucidate the involved pathways and interplay between epithelial and the stromal niche, we established a patient-derived xenograft (PDX) model showing spontaneous metastatic spread to all relevant organs and metastatic lesions in liver. Methods: PDX of PCa were obtained from NMRI tumor-bearing mice and 3D cell cultures were established by collagenase treatment o/n in prostate growth medium (PGM) containing 2% fetal calf serum. 3D cultures of PDX PC339 were established (PC339C) that could be passaged and stored in liquid nitrogen. PC339C was transfected with a lentiviral construct containing luc2-GFP fused protein (M21) and upon FACS-sorting the PC339C-M21 was retrieved. PC339C-M21 cells were inoculated subcutaneously in NSG mice and when tumors were established mice underwent tumorectomy (700-1000 mm3) to extend the life span of the animal and allow metastastic outgrowth. Mice were monitored weekly for metastatic outgrowth using IVIS, microCT and MRI. At sacrifice, M21-positive organs, including liver, lymph nodes, lung and bone, were sampled. Part of the tissue was used for culturing, part was fresh frozen for RNA and protein isolation to allow qPCR and western blot analyses, and part was formalin-fixed and paraffin-embedded for histology and immunohistochemistry. Results: PC339C-M21 tumors were established in NSG mice and after tumorectomy a spontaneous liver metastasis was established. Culturing of this tumor resulted in the PC339C-M21-L cell line. This cell line was inoculated subcutaneously in NSG mice to result in tumor formation and spontaneous liver metastasis in all mice. Tumorectomy was performed at 25-30 days after inoculation. Luciferase-positive signals in liver were detected by IVIS as early as 7 days after tumorectomy with MRI showing first visible lesions at 21 days and microCT at 28 days. 3D reconstructed microCT images and MRI-detected lesions confirmed the signals and location as seen by IVIS. When inoculated orthotopically, liver metastatic lesions became visible by IVIS at 40 days, which was not different from the subcutaneous tumors. However, these mice could not be followed longer due to the orthotopic tumor burden. On top of the PC339C-M21-L cell line, culturing of luciferase-positive organs resulted in cell lines from lymph node (PC339C-M21-L-LN), lung (PC339C-M21-L-LU), and bone (PC339C-M21-L-B) together constituting a cell line panel of metastatic PCa. This cell line panel is being further characterized in vitro and in vivo for their unique properties and metastatic potential. Conclusion: A new spontaneous PCa liver metastasis xenograft model, PCL339-M21-L, was generated. This model was extended to yield a panel of metastatic sublines from different organ origin. Together, this platform may serve as a tool to study the biology of spontaneous metastatic outgrowth in liver and other organs. Furthermore, we demonstrated the feasibility of non-invasive imaging techniques to follow metastatic spread and outgrowth allowing to monitor responses to anti-cancer therapies. Citation Format: Hanneke J.A.A. van Zoggel, Sigrun E. Erkens-Schulze, Corrina M.A. De Ridder, Wilma Teubel, Hamza Saleem, Stefan J. Roobol, Sander A.H. Hoeben, Yanto R. Ridwan, Joost C. Haeck, Wytske M. van Weerden{Authors}. Establishment of a novel spontaneous prostate cancer liver metastasis model. [abstract]. In: Proceedings of the AACR Special Conference: Patient-Derived Cancer Models: Present and Future Applications from Basic Science to the Clinic; Feb 11-14, 2016; New Orleans, LA. Philadelphia (PA): AACR; Clin Cancer Res 2016;22(16_Suppl):Abstract nr B21.

Organization of the Mammalian Ionome According to Organ Origin, Lineage Specialization, and Longevity.

Trace elements are essential to all mammals, but their distribution and utilization across species and organs remains unclear. Here, we examined 18 elements in the brain, heart, kidney, and liver of 26 mammalian species and report the elemental composition of these organs, the patterns of utilization across the species, and their correlation with body mass and longevity. Across the organs, we observed distinct distribution patterns for abundant elements, transition metals, and toxic elements. Some elements showed lineage-specific patterns, including reduced selenium utilization in African mole rats, and positive correlation between the number of selenocysteine residues in selenoprotein P and the selenium levels in liver and kidney across mammals. Body mass was linked positively to zinc levels, whereas species lifespan correlated positively with cadmium and negatively with selenium. This study provides insights into the variation of mammalian ionome by organ physiology, lineage specialization, body mass, and longevity.

Concentrations and δ²H values of cuticular n-alkanes vary significantly among plant organs, species and habitats in grasses from an alpine and a temperate European grassland.

n-Alkanes are long-chained hydrocarbons contained in the cuticle of terrestrial plants. Their hydrogen isotope ratios (δ(2)H) have been used as a proxy for environmental and plant ecophysiological processes. Calibration studies designed to resolve the mechanisms that determine the δ(2)H values of n-alkanes have exclusively focused on n-alkanes derived from leaves. It is, however, unclear in which quantities n-alkanes are also produced by other plant organs such as roots or inflorescences, or whether different plant organs produce distinct n-alkane δ(2)H values. To resolve these open questions, we sampled leaves, sheaths, stems, inflorescences and roots from a total of 15 species of European C3 grasses in an alpine and a temperate grassland in Switzerland. Our data show slightly increased n-alkane concentrations and n-alkane δ(2)H values in the alpine compared to the temperate grassland. More importantly, inflorescences had typically much higher n-alkane concentrations than other organs while roots had very low n-alkane concentrations. Most interestingly, the δ(2)H values of the carbon autonomous plant organs leaves, sheaths and stems were in general depleted compared to the overall mean δ(2)H value of a species, while non-carbon autonomous organs such as roots and inflorescences show δ(2)H values that are higher compared to the overall mean δ(2)H value of a species. We attribute organ-specific δ(2)H values to differences in the H-NADPH biosynthetic origin in different plant organs as a function of their carbon relationships. Finally, we employed simple mass balance calculations to show that leaves are in fact the main source of n-alkanes in the sediment. As such, studies assessing the environmental and physiological drivers of n-alkanes that focus on leaves produce relationships that can be employed to interpret the δ(2)H values of n-alkanes derived from sediments. This is despite the significant differences that we found among the δ(2)H values in the different plant organs. Our study brings new insights into the natural variability of n-alkane δ(2)H values and has implications for the interpretation of n-alkane δ(2)H values in ecological and paleohydrological research.

Peripheral ameloblastoma of the upper gingiva: Report of a case and literature review

According to the 2005 histological classification of odontogenic neoplasms by the World Health Organization, ameloblastoma is a benign, locally invasive epithelial odontogenic tumor of putative enamel organ origin. There are four distinct subgroups in which this neoplasm can be gathered: the solid/multicystic type, the unicystic type, the desmoplastic and the peripheral type. Peripheral ameloblastoma is believed to be the rarest subgroup, making up for 2 to 10% of all ameloblastomas. From its first description by Kuru in 1911 to date, less than 200 cases of PA have been described in literature. PAs commonly affect the mandible, in the maxilla the most common location is the soft palatal tissue of the tuberosity area. The present report discusses a rare case of PA aroused in the gingiva of upper jaw in a 64-year-old woman. The treatment of the lesion and its immunohistochemical phenotype are described. A review of the literature is also performed, focusing on the epidemiological and pathological aspects of the lesions and their implications on the therapy. Key words:Peripheral ameloblastoma, upper gingiva, ameloblastoma.

Endothelial, epithelial, and fibroblast cells exhibit specific splicing programs independently of their tissue of origin

Alternative splicing is the main mechanism of increasing the proteome diversity coded by a limited number of genes. It is well established that different tissues or organs express different splicing variants. However, organs are composed of common major cell types, including fibroblasts, epithelial, and endothelial cells. By analyzing large-scale data sets generated by The ENCODE Project Consortium and after extensive RT-PCR validation, we demonstrate that each of the three major cell types expresses a specific splicing program independently of its organ origin. Furthermore, by analyzing splicing factor expression across samples, publicly available splicing factor binding site data sets (CLIP-seq), and exon array data sets after splicing factor depletion, we identified several splicing factors, including ESRP1 and 2, MBNL1, NOVA1, PTBP1, and RBFOX2, that contribute to establishing these cell type–specific splicing programs. All of the analyzed data sets are freely available in a user-friendly web interface named FasterDB, which describes all known splicing variants of human and mouse genes and their splicing patterns across several dozens of normal and cancer cells as well as across tissues. Information regarding splicing factors that potentially contribute to individual exon regulation is also provided via a dedicated CLIP-seq and exon array data visualization interface. To the best of our knowledge, FasterDB is the first database integrating such a variety of large-scale data sets to enable functional genomics analyses at exon-level resolution.

Urgent Lung Transplantation National Program: The Italian Experience

IntroductionAn urgent lung transplantation national program in Italy was developed over the past three years. Indispensable conditions that were included in the program were invasive respiratory support and/or extracorporeal vascular device (DECAP excluded). The aim of this study was to test the effectiveness of the program. Materials and MethodsWe analyzed urgent lung requests received between 2009 and 2011 taking into account primary pathology, request outcome, average waiting time, and organ origin. Taking as reference the same period of time, we also examined the ordinary waiting list, waiting list mortality, and number of transplantations performed and we have compared them with another three-year period prior to the activation of the program. ResultsThe total number of urgent requests was 43. Primary pathologies with the highest incidence proportion were cystic fibrosis (40%) and idiopathic pulmonary fibrosis (26.6%). A total of 34 requests (79%) were successfully dealt with and 9 of them were suspended because of worsening conditions. The average waiting time was 17.9 days. During the same period of time 340 lung transplantations were performed and there were 499, 524, and 564 wait-listed patients in 2009, 2010, and 2011, respectively. The mortality rate was 21.3%. Over the previous three-year period 295 transplantations were performed and there were 457, 476, and 464 wait-listed patients in 2006, 2007, and 2008, respectively. Also the mortality rate was 25.3%. DiscussionUrgent lung transplantations can provide patients in an imminent life-threatening situation with adequate care without affecting the mortality rate of patients on the ordinary waiting list.

Punção Aspirativa Por Agulha Fina De Lesões Da Cabeça E Pescoço Dirigida Por Ultrassonografia: Experiência De 15 Anos Em Uma Instituição

To evaluate the diagnostic potential of the fine needle aspiration biopsy tecnique on head and neck lesions with ultrasound guidance. Retrospective study based upon ultrasound guided fine needle aspiration cytology reports bettween july/1995 and july/2011. Cytologic findings were categorized in organ origin, neoplastic or non-neoplastic, their sub-categories, and non conclusive or indeterminate samples. There was also a evalution of possible local or sistemic complications of the procedures. The study reveals the main diagnosis among cervical nodes sent to be elucidated, with histopathologic correlation, as possible, when the initial situation required further investigative ou therapeutic procedure. Considers also some comments about the tecnique and specially the practice of a four handed work crew uniting radiologist and pathologist. Fine needle aspiration tecnique ultrasound guided is a highly safe and a highly efficacious method to diagnose head and neck lesions.

Carcinoid syndrome in neuroendocrine tumors - not easy to recognize

Neuroendocrine tumors (NET) are solid potentially malignant tumors originated from the diffuse neuroendocrine system. They could origin in many organs, with highest prevalence in lungs, small intestine and rectum. Characteristics of NET are slow growth, non-specific clinical presentation causing diagnostic problems. Thus, in majority of patients diagnosis is established in the metastatic phase of the disease. Hopefully, there are new and very potent treatment options capable to successfully control the disease. Clinical presentation cause local tumor growth or para-neoplastic syndrome. Secretory active tumors produce peptides or hormones causing different clinical syndromes. In most cases NET cause carcinoid syndrome. It is often misinterpreted, because similar symptoms are present in more prevalent disorders. Symptoms are not specific and include flashing, diarrhea, abdominal pain, right heart disease, bronchoconstriction ... and to establish the right diagnosis medical doctor have to think about NET as a possibility. Thus, it is very important to recognize symptoms and signs of the carcinoid syndrome, and distinguish them from other gastrointestinal disorders. Early diagnosis and treatment have significant impact in control of the disease, and overall treatment results.

Morphological and molecular characterization of Colletotrichum coccodes isolated from pepper cultivated in Bulgaria and Macedonia

Colletotrichum coccodes has been recognized as one of the causal agents of pepper fruit anthracnose in Bulgaria. Recently, this species has been recorded in pepper fruits in Macedonia. In Bulgaria, the fungus has also been isolated from roots of premature senescent pepper plants but in Macedonia it has not been isolated yet. The purpose of the investigation was to make comparative morphological, cultural and molecular characterization of C. coccodes isolates obtained from pepper fruits and roots in Bulgaria and Macedonia. Additionally, a technique was applied to differentiate among the C. coccodes isolates obtained from roots and other microsclerotia-producing fungi. On the host tissue, C. coccodes developed acervular conidiomata with cup-shaped fruiting bodies accompanied with dark-pigmented, unbranched, thick-walled sterile hyphae called setae. A slimy mass of hyaline, straight, unicellular, fusiform conidia appeared on nutrient media. In a short time, numerous small dark globose setose microsclerotia emerged in the colony starting from its centre and distributing proportionally throughout agar plates. Two PCR primer sets were used to sequences of the ribosomal internal transcribed spacer (ITS1 and ITS2) regions. Single products of ~450 bp and ~350 bp were amplified by the genus-specific (Cc1F1/Cc2R1) and the species-specific primers (Cc1NF1/Cc2NR1), respectively. Morphological, cultural and molecular characterization of the isolates from roots and fruits showed that root rot and fruit anthracnose of pepper were caused by one and the same causal agent determined as C. coccodes. The isolates from roots showed rapid mycelial growth, gave rise to numerous minute microsclerotia and produced conidia only on SSPA. SSPA supported significantly more mycelium growth and sporulation than all other media tested and could be recommended for production of large quantity of conidia. No pattern of genetic variation associated with the organ or geographic origin of the isolates was determined.