A Solid Mass in the Head of the Pancreas with Intense 18FDG Uptake: Intraductal Tubulopapillary Neoplasm

Context 18FDG-PET/CT has emerged as a useful diagnostic modality for the staging of different malignancies. Its role in the characterization of both cystic and solid pancreatic tumors is debated, especially in the differential diagnosis between malignant and benign/borderline tumors. Case report A 66-year-old man complained of abdominal discomfort with no other symptoms. An abdominal US showed a solid mass in the head of the pancreas. He underwent contrast medium CT scan and MRI that showed a pseudonodular mass of 35x40 mm in the pancreatic head without dilatation of the common bile duct/main pancreatic duct. There was no infiltration of the surrounding pancreatic parenchyma, duodenum and peripancreatic vessels. Serum CA 19.9 was 795 U/mL. A 18FDG PET/CT scan showed an intense uptake by the mass. He underwent pylorus-preserving pancreaticoduodenectomy. Macroscopic examination of the specimen revealed a 4 cm tumor with endocystic growth without infiltration of surrounding structures, including common bile duct and main pancreatic duct. Histologically the tumor was composed of cubic to cylindrical well-differentiated cells, with low/intermediate grade atypia. Tumor cells formed tubulopapillae and contained little cytoplasmic mucin. Immunohistochemical profile showed positivity only for cytokeratin 7 and cytokeratin 19. Ki67 index was 25-30%. 37 lymph nodes were removed without metastases. A diagnosis of intraductal tubulopapillary neoplasm (ITPN) with low-grade/intermediate dysplasia was made. Conclusion ITPN is a rare primary pancreatic neoplasm accounting for less than 1% of all pancreatic exocrine neoplasms. ITPN can show a different biological behavior, from low-grade to high-grade dysplasia and invasive carcinoma. Presence of high proliferative index, high-grade atypia, and, obviously, infiltration of surrounding structures/lymph node metastases, indicate malignancy. Differential diagnosis include mainly solid-pseudopapillary tumor and acinar cell carcinoma. In this case intense 18FDG uptake and high CA 19.9 level prompted for resection, although only low-grade/intermediate dysplasia was present

Anterior insula stimulation suppresses appetitive behavior while inducing forebrain activation in alcohol-preferring rats

The anterior insular cortex plays a key role in the representation of interoceptive effects of drug and natural rewards and their integration with attention, executive function, and emotions, making it a potential target region for intervention to control appetitive behaviors. Here, we investigated the effects of chemogenetic stimulation or inhibition of the anterior insula on alcohol and sucrose consumption. Excitatory or inhibitory designer receptors (DREADDs) were expressed in the anterior insula of alcohol-preferring rats by means of adenovirus-mediated gene transfer. Rats had access to either alcohol or sucrose solution during intermittent sessions. To characterize the brain network recruited by chemogenetic insula stimulation we measured brain-wide activation patterns using pharmacological magnetic resonance imaging (phMRI) and c-Fos immunohistochemistry. Anterior insula stimulation by the excitatory Gq-DREADDs significantly attenuated both alcohol and sucrose consumption, whereas the inhibitory Gi-DREADDs had no effects. In contrast, anterior insula stimulation failed to alter locomotor activity or deprivation-induced water drinking. phMRI and c-Fos immunohistochemistry revealed downstream activation of the posterior insula and medial prefrontal cortex, as well as of the mediodorsal thalamus and amygdala. Our results show the critical role of the anterior insula in regulating reward-directed behavior and delineate an insula-centered functional network associated with the effects of insula stimulation. From a translational perspective, our data demonstrate the therapeutic potential of circuit-based interventions and suggest that potentiation of insula excitability with neuromodulatory methods, such as repetitive transcranial magnetic stimulation (rTMS), could be useful in the treatment of alcohol use disorders.Peer reviewe

Characterisation of refined marc distillates with alternative oak products using different analytical approaches

The use of oak barrel alternatives, including oak chips, oak staves and oak powder, is quite common in the production of spirits obtained from the distillation of vegetal fermented products such as grape pomace. This work explored the use of unconventional wood formats such as peeled and sliced wood. The use of poplar wood was also evaluated to verify its technological uses to produce aged spirits. To this aim, GC-MS analyses were carried out to obtain an aromatic characterisation of experimental distillates treated with these products. Moreover, the same spirits were studied for classification purposes using NMR, NIR and e-nose. A significant change in the original composition of grape pomace distillate due to sorption phenomena was observed; the intensity of this effect was greater for poplar wood. The release of aroma compounds from wood depended both on the toasting level and wood assortment. Higher levels of xylovolatiles, namely, whisky lactone, were measured in samples aged using sliced woods. Both the NIR and NMR analyses highlighted similarities among samples refined with oak tablets, differentiating them from the other wood types. Finally, E-nose seemed to be a promising alternative to spectroscopic methods both for the simplicity of sample preparation and method portability

Large excited state two photon absorptions in the near infrared region of surprisingly stable radical cations of (ferrocenyl)indenes

Multiphoton absorptions are important non-linear optical processes which allow us to explore excited states with low energy photons giving rise to new possibilities for photoinduced processes. Among these processes, multiphoton absorptions from excited states are particularly interesting because of the large susceptibilities characteristic of excited states. Here we explore the nonlinear transmission measurements recorded with 9 ns laser pulses at 1064 nm of the radical cations of (2-ferrocenyl)indene and of (2-ferrocenyl)-hexamethylindene, two interesting very stable molecules. The non-linear transmission data can be interpreted with a multiphoton sequence of three photon absorptions, the first being a one photon absorption related to the intramolecular charge transfer and the second a two photon absorption from the excited state created with the first process. The two photon absorption cross section is found to be several orders of magnitude larger than those usually found for two photon absorbing systems excited from the ground state

Characterisation of Refined Marc Distillates with Alternative Oak Products Using Different Analytical Approaches

The use of oak barrel alternatives, including oak chips, oak staves and oak powder, is quite common in the production of spirits obtained from the distillation of vegetal fermented products such as grape pomace. This work explored the use of unconventional wood formats such as peeled and sliced wood. The use of poplar wood was also evaluated to verify its technological uses to produce aged spirits. To this aim, GC-MS analyses were carried out to obtain an aromatic characterisation of experimental distillates treated with these products. Moreover, the same spirits were studied for classification purposes using NMR, NIR and e-nose. A significant change in the original composition of grape pomace distillate due to sorption phenomena was observed; the intensity of this effect was greater for poplar wood. The release of aroma compounds from wood depended both on the toasting level and wood assortment. Higher levels of xylovolatiles, namely, whisky lactone, were measured in samples aged using sliced woods. Both the NIR and NMR analyses highlighted similarities among samples refined with oak tablets, differentiating them from the other wood types. Finally, E-nose seemed to be a promising alternative to spectroscopic methods both for the simplicity of sample preparation and method portability

Long-access heroin self-administration induces region specific reduction of grey matter volume and microglia reactivity in the rat

In opioid use disorder (OUD) patients, a decrease in brain grey matter volume (GMV) has been reported. It is unclear whether this is the consequence of prolonged exposure to opioids or is a predisposing causal factor in OUD development. To investigate this, we conducted a structural MRI longitudinal study in NIH Heterogeneous Stock rats exposed to heroin self-administration and age-matched naïve controls housed in the same controlled environment. Structural MRI scans were acquired before (MRI ) and after (MRI ) a prolonged period of long access heroin self-administration resulting in escalation of drug intake. Heroin intake resulted in reduced GMV in various cortical and sub-cortical brain regions. In drug-naïve controls no difference was found between MRI and MRI . Notably, the degree of GMV reduction in the medial prefrontal cortex (mPFC) and the insula positively correlated with the amount of heroin consumed and the escalation of heroin use. In a preliminary gene expression analysis, we identified a number of transcripts linked to immune response and neuroinflammation. This prompted us to hypothesize a link between changes in microglia homeostasis and loss of GMV. For this reason, we analyzed the number and morphology of microglial cells in the mPFC and insula. The number of neurons and their morphology was also evaluated. The primary motor cortex, where no GMV change was observed, was used as negative control. We found no differences in the number of neurons and microglia cells following heroin. However, in the same regions where reduced GMV was detected, we observed a shift towards a rounder shape and size reduction in microglia, suggestive of their homeostatic change towards a reactive state. Altogether these findings suggest that escalation of heroin intake correlates with loss of GMV in specific brain regions and that this phenomenon is linked to changes in microglial morphology