Patients with multiple intracranial aneurysms present a great challenge to neurosurgical practice. The presence of one or more additional aneurysms, whether recognized or unrecognized, along with the source of the haemorrhage profoundly changes the outcome. It also alters the timing and strategy of surgery. In this study the experiences gained from 138 cases with a total of 317 aneurysms are discussed. The analysis of the clinical data, our results and the factors influencing the outcome suggest that the risk of clipping all aneurysms simultaneously are less than the risk of a rebleed from an untreated, previously silent sac even in the early postoperative period.

Abstract. Background In Europe, according to the age-standardized rates per 100,000 population, Hungary had the highest estimated incidence, mortality and prevalence in lip, oral cavity and pharyngeal cancers for both sexes. Based on the cancer registerty held by the National Institute of Oncology, in 2010 and 2011 meso-and hypopharyngeal carcinomas counted more than 1,200 cases. The number of diagnosed mesopharyngeal carcinomas in our clinical site has doubled, while hypopharyngeal carcinoma cases have tripled since 1983 (Figures 1 and 2). Incidence of meso-and hypopharyngeal carcinomas is constantly growing, while the rate of mortality is above 50% due to late-stage recognition. In our clinical practice, malignant cancers of the meso-and hypopharyngeal regions are most specific in the 55-60 age range population, although the appearance of the different pharyngeal carcinomas has been observed in a growing number at younger ages in the past few years. It is important to note that the cancers affecting only one region, having good operability options and a better prognosis are disappearing, while the ones involving more than one region, with aggressive spreading and progressive prognosis are becoming more frequent. Our goal was to find and study a molecular marker that could be used as a predictive and a prognostic tool to complete clinical diagnostics.In recent years micro-RNAs (miRNA) have been excessively studied. These small, 19-25 base-pair-long RNAs are transcribed from an intra-or intergenic segment of DNA and are not translated into proteins. Matured miRNA binds to a ribonucleotid complex, called RISC (RNA induced silencing complex), and drives the regulation of mRNA translation, either by binding to the target mRNA's 3' UTR (untranslated region) segment, or to 5' UTR or just directly to the ORF (open reading frame). This way translation is blocked or endonucleases are activated causing the degradation of mRNA target (1, 2). An estimated 50-60% of the human genome is regulated by miRNAs. A specific mRNA can be regulated by multiple miRNAs, and a miRNA can modulate translation of more then hundred mRNAs (1). This RNA interference mechanism establishes precise modulation of gene expression, harmonic regulation of cellular functions as cell division, differentiation, apoptosis and intermediary metabolism (3). miRNAs can behave either as oncogenes (oncomirs) or tumor suppressors according to which target mRNA is regulated by them (1). miRNAs can be detected in blood serum, saliva and other body fluids (4-285

Aneurysms of the middle cerebral bifurcation represent an interesting entity among intracranial saccular aneurysms. Their shape, size, situation, and in particular their relation to the middle cerebral trunk and its branches show wide variations. Topographical analysis of the angiograms offers a great deal of interest in planning surgery. Our experience with 289 patients with middle cerebral artery aneurysms operated on since 1977 are presented. Factors such as number of previous haemorrhages, timing of surgery, preoperative condition, major intraoperative bleeding or brain oedema and delayed postoperative deterioration play a major role in the outcome. Others such as severity of the subarachnoid bleed, age, size of the sac seem to have much less influence.

The aim of this study was to visualize the tumor propagation and surrounding mucosal field in radiography-based 3D model for advanced stage HNSCC and combine it with HPV genotyping and miRNA expression characterization of the visualized area. 25 patients with T1-3 clinical stage HNSCC were enrolled in mapping biopsy sampling. Biopsy samples were evaluated for HPV positivity and miR-21-5p, miR-143, miR-155, miR-221-5p expression in Digital Droplet PCR system. Significant miRNA expression differences of HPV positive tumor tissue biopsies were found for miR-21-5p, miR-143 and miR-221-5p compared to the HPV negative tumor biopsy series. Peritumoral mucosa showed patchy pattern alterations of miR-21-5p and miR-155 in HPV positive cases, while gradual change of miR-21-5p and miR-221-5p was seen in HPV negative tumors. In our study we found differences of the miRNA expression patterns among the HPV positive and negative tumorous tissues as well as the surrounding mucosal fields. The CT based 3D models of the cancer field and surrounding mucosal surface can be utilized to improve proper preoperative planning. Complex evaluation of HNSCC tissue organization field can elucidate the clinical and molecular differentiation of HPV positive and negative cases, and enhance effective organ saving therapeutic strategies.

Squamous cell carcinoma (SCC) of the head and neck region is the sixth most frequent malignancy with high mortality rate. Due to its poor prognosis it is considered a growing public health problem worldwide inspite of existing treatment modalities. Thus, early diagnosis of new diseases and recurrences is emerging on one hand, but on the other hand troublesome in the lack of reliable tumor markers in this field. The rapid development of proteomics has opened new perspectives in tumor marker discovery. Liquid chromatography/mass spectrometry (LC/MS) as the gold standard in proteomics enables the semi-quantitative analysis of proteins within various tissues. Abundance differences between tumor and normal tissue also can be interpreted as tumor specific changes. The aim of this study was to identify potential tumor markers of laryngeal/hypopharyngeal SCC by revealing abundance changes between cancerous and the surrounding phenotypically healthy tissue. After separating the phenotypically cancerous and healthy parts of formalin-fixed paraffin-embedded tissues, each sample underwent protein recovery process and tryptic digestion for label-free semi-quantitative LC/MS analysis. Eight proteins showed significantly higher abundance in tumor including tenascin, transmembrane emp24 domain-containing protein 2, cytoplasmic dynein light chain 1, coactosin-like protein, small proline-rich protein 2D, nucleolin, U5 small nuclear RNP 200-kDa helicase and fatty aldehyde dehydrogenase. Desmoglein-1 and keratin type I cytoskeletal 9 were down-regulated in tumor. Using Ingenuity Pathway Analysis we mapped the signaling pathways these proteins play role in regarding other tumors. Based on these findings these proteins may serve as promising biomarkers in the fight against laryngeal/hypopharyngeal SCCs.