Primary presacral neuroendocrine tumor associated with imperforate anus

<p>Abstract</p> <p>Background</p> <p>Presacral masses are unusual growths that have a limited differential diagnosis, typically not including neuroendocrine tumors (NETs). Classically, NETs are well-differentiated gastroenteropancreatic tumors of probable benign behavior. These tumors are associated with a typical morphologic pattern and involve the distal colon, rectum, and genitourinary tract; they are considered less aggressive, frequently asymptomatic, and rarely cause carcinoid syndrome, even when metastatic. Neuroendocrine tumors of the presacral region are extremely rare and few have been described in the literature. They have not been previously reported as being associated with imperforate anus.</p> <p>Case presentation</p> <p>We present an interesting case of a woman with a history of imperforate anus that was found to have a primary neuroendocrine tumor of the presacral region with no rectal wall involvement.</p> <p>Conclusion</p> <p>We argue that this is a primary gastroenteropancreatic neuroendocrine tumor which likely originated from cells of hindgut origin that underwent an abnormal migration during embryonic development.</p

Multimodal nanoparticles for non-invasive bio-imaging

The present teachings provide multimodal nanoparticles that can act simultaneously as contrast agents for one or more of PAT, fluorescence imaging, x-ray imaging, and/or MRI. Exemplary multimodal nanoparticles can have a size between 50-100 nm and can be tunable to large sizes. In various embodiments, these nanoparticles can also be used for therapeutic purposes

Multi-dye theranostic nanoparticle platform for bioimaging and cancer therapy

Amit K Singh,1,2 Megan A Hahn,2 Luke G Gutwein,3 Michael C Rule,4 Jacquelyn A Knapik,5 Brij M Moudgil,1,2 Stephen R Grobmyer,3 Scott C Brown,2,61Department of Materials Science and Engineering, College of Engineering, 2Particle Engineering Research Center, College of Engineering, 3Division of Surgical Oncology, Department of Surgery, College of Medicine, 4Cell and Tissue Analysis Core, McKnight Brain Institute, 5Department of Pathology, College of Medicine, University of Florida, Gainesville, FL, USA; 6DuPont Central Research and Development, Corporate Center for Analytical Science, Wilmington, DE, USABackground: Theranostic nanomaterials composed of fluorescent and photothermal agents can both image and provide a method of disease treatment in clinical oncology. For in vivo use, the near-infrared (NIR) window has been the focus of the majority of studies, because of greater light penetration due to lower absorption and scatter of biological components. Therefore, having both fluorescent and photothermal agents with optical properties in the NIR provides the best chance of improved theranostic capabilities utilizing nanotechnology.Methods: We developed nonplasmonic multi-dye theranostic silica nanoparticles (MDT-NPs), combining NIR fluorescence visualization and photothermal therapy within a single nanoconstruct comprised of molecular components. A modified NIR fluorescent heptamethine cyanine dye was covalently incorporated into a mesoporous silica matrix and a hydrophobic metallo-naphthalocyanine dye with large molar absorptivity was loaded into the pores of these fluorescent particles. The imaging and therapeutic capabilities of these nanoparticles were demonstrated in vivo using a direct tumor injection model.Results: The fluorescent nanoparticles are bright probes (300-fold enhancement in quantum yield versus free dye) that have a large Stokes shift (&amp;gt;110 nm). Incorporation of the naphthalocyanine dye and exposure to NIR laser excitation results in a temperature increase of the surrounding environment of the MDT-NPs. Tumors injected with these NPs are easily visible with NIR imaging and produce significantly elevated levels of tumor necrosis (95%) upon photothermal ablation compared with controls, as evaluated by bioluminescence and histological analysis.Conclusion: MDT-NPs are novel, multifunctional nanomaterials that have optical properties dependent upon the unique incorporation of NIR fluorescent and NIR photothermal dyes within a mesoporous silica platform.Keywords: bioluminescence, in vivo imaging, mesoporous silica nanoparticles, NIR fluorescence, photothermal ablation, theranosti

Pain Control in Breast Surgery: Survey of Current Practice and Recommendations for Optimizing Management—American Society of Breast Surgeons Opioid/Pain Control Workgroup

Introduction: The opioid epidemic in the United States is a public health crisis. Breast surgeons are obligated to provide good pain control for their patients after surgery but also must minimize administration of narcotics to prevent a surgical episode of care from becoming a patient's gateway into opioid dependence. Methods: A survey to ascertain pain management practice patterns after breast surgery was performed. A review of currently available literature that was specific to breast surgery was performed to create recommendations regarding pain management strategies. Results: A total of 609 surgeons completed the survey and demonstrated significant variations in pain management practices, specifically within regards to utilization of regional anesthesia (e.g., nerve blocks), and quantity of prescribed narcotics. There is excellent data to guide the use of local and regional anesthesia. There are, however, fewer studies to guide narcotic recommendations; thus, these recommendations were guided by prevailing practice patterns. Conclusions: Pain management practices after breast surgery have significant variation and represent an opportunity to improve patient safety and quality of care. Multimodality approaches in conjunction with standardized quantities of narcotics are recommended