Flexible and Tunable 3D Gold Nanocups Platform as Plasmonic Biosensor for Specific Dual LSPR-SERS Immuno-Detection.

Early medical diagnostic in nanomedicine requires the implementation of innovative nanosensors with highly sensitive, selective, and reliable biomarker detection abilities. In this paper, a dual Localized Surface Plasmon Resonance - Surface Enhanced Raman Scattering (LSPR- SERS) immunosensor based on a flexible three-dimensional (3D) gold (Au) nanocups platform has been implemented for the first time to operate as a relevant "proof-of-concept" for the specific detection of antigen-antibody binding events, using the human IgG - anti-human IgG recognition interaction as a model. Specifically, polydimethylsilane (PDMS) elastomer mold coated with a thin Au film employed for pattern replication of hexagonally close-packed monolayer of polystyrene nanospheres configuration has been employed as plasmonic nanoplatform to convey both SERS and LSPR readout signals, exhibiting both well-defined LSPR response and enhanced 3D electromagnetic field. Synergistic LSPR and SERS sensing use the same reproducible and large-area plasmonic nanoplatform providing complimentary information not only on the presence of anti-human IgG (by LSPR) but also to identify its specific molecular signature by SERS. The development of such smart flexible healthcare nanosensor platforms holds promise for mass production, opening thereby the doors for the next generation of portable point-of-care devices.

Esotracheal Fistula in Esophageal Stenoses of Malignant Origin - Case Report.

BACKGROUND: Approximately 80% of acquired eso-tracheal or mediastinal fistulae are of malignant nature. The occurrence of an eso-respiratory malignant fistula is a devastating complication for both patient and doctor, and, if not treated, records a survival time of 1 to 6 weeks. MATHERIAL AND METHOD: We present a patient, aged 51, smoker,with progressive dysphagia, at first to solids, then to semi-solids and liquids, followed by manifestation of post-deglutition cough due to eso-tracheal fistula, incapability of feeding, and decline of the general condition. Surgical intervention consists of esophageal transstenotic endo-prosthesing by transtumoral drilling with prosthetic montage and the occlusion of the eso-tracheal fistulous orifice. RESULTS: The post-operatory evolution is favorable, the feeding per os resumes in 8 hours after surgery, good digestive tolerance. The radiologic examination using contrast medium, performed in 48 hours after surgery, reveals a permeable esophageal endo-prosthesis, without reflux of contrast substance in the tracheobronchial tree. CONCLUSIONS: The laparo-gastroscopic montage of prosthesis through transtumoral drilling, using siliconized semi-rigid prostheses, represents the only efficient palliative treatment of malignant eso-tracheal or eso-bronchial fistula.

[Particular aspects of endoprosthesis in malignant advanced pharingeal-esophageal stenosis]. / Aspecte particulare ale endoprotezarii în stenozele maligne faringoesofagiene avansate.

INTRODUCTION: The esophageal neoplasm is currently the seventh cause of death through cancer worlwide. In the developing countries it is situated on the fifth place and has one of the worst prognostics for a neoplasm. Due to the specifical intratoracical topography, clinically inaccesible and without symptoms, the disease is rather incurable when the disphagia appears. MATERIAL AND METHOD: The esophageal prosthesis procedure through laparogastroscopical approach, used by us, is an original one, noninvasive, acknowledged both nationally and internationally. The endoprosthesis esophageal cases belong to three Clinics of Surgery (Clinic Surgery 2 from Sibiu, Clinic Surgery 1 from Braila, Clinic of Surgery 4, Bucharest) on a period of 14 years (1996-2009), identically coordinated. RESULTS AND DISCUSSIONS: Out of the 68 patients, 18 cases have been cancers situated in the medial and inferior third and 28 have been eso-cardial-tuberositary neoplasms. In the cases of the high malignant pharingeal-esophageal stenosis, the placement of the prosthesis (different prosthesis adapted to this particular situation) in areas of aerial-digestive junction implies significant technical difficulties especially in the option with the conservation of the larinx as a fonatory and respiratory solution. CONCLUSIONS: Our original procedure, simple and efficient presents numerous advantages which allow the widening of the indications of stent gastroenterology: firm traction, the possibility of catheterism through narrow lumens of 1-2 mm, sometimes anfractuous, the distal visibility, the visual placement or expanding of the prosthesis, the evaluation of the intraoperatory visceral or parietal methastasis and eventually the avoidance of the gastrostomic invalidation.

Pathological evidence in support of total mesorectal excision in the management of rectal cancer.

BACKGROUND: Pelvic recurrence following conventional rectal resection for cancer is common. Preoperative iradiation has been shown in prospective randomized studies to halve this risk. AIM: This multiinstitutional study aimed to assess the necesity of total mesorectal excision in rectal cancer. PATIENTS AND METHOD: Pathological resections from 50 consecutive patients with adenocarcinoma of the rectum within 12 cm of the anal verge who underwent currative resection incorporating total mesorectal excision were examined. The resection specimen was examined by one of two pathologists. Some 50 total mesorectal excision specimens were examined following rectal excision for cancer. Some 38 had total mesorectal excision as a component of a low anterior resection and 12 with abdomino-perineal resection. "Cure" was defined as absence of metastatic disease and the excision of entire macroscopic tumor tissue with negative proximal and distal borders. TME was performed as described by Heald et al. The mesorectum was evaluated for lymph nodes and tumor deposists in three areas: deep to the tumor, in the proximal mesorectum and in the distal mesorectum. RESULTS: Six patients had Dukes A lesions. Of 21 patients with Dukes B tumors, five had discrete foci of adenocarcinoma in the mesorectum, with no evidence of lymph node metastasis. Dukes C lesions were more heterogeneous, but 12 out of 23 patients had distinct mesorectal deposists in addition to mesorectal node involvement. Circumferential margin involvement was rare, but mesorectal tumor deposits were present in 17 of 44 patients with pT3 tumors, and 23 of 44 had mesorectal nodal involvement. No patient with a pT2 tumor had mesorectal involvement. Failure to excise the mesorectum completely has the potential to leave gross or microscopic residual disease that may in theory predispose to local failure. CONCLUSION: Total mesorectal excision is necessary to avoid incomplete pathological evaluation of the mesorectum and understaging of rectal cancer.