Pancreatic neuroendocrine tumor with abundant mitochondria.

ABSTRACT: A 40-year-old woman presented with dull, boring periumbilical region pain radiating to the back and vomiting for 1 year. Magnetic resonance cholangiopancreatography detected a polypoid growth in the ampullary region. The patient underwent Whipple's procedure. The specimen revealed a 4.9 × 4.5 × 3.7 cm tumor arising from the pancreas, abutting the posterior pancreatic surface and infiltrating the terminal common bile duct and the ampulla. Microscopic examination showed a pancreatic tumor composed of neuroendocrine cells. In addition, many large foci showing solid sheets of oncocytic cells with abundant granular eosinophilic cytoplasm were observed. Immunohistochemistry studies revealed positivity for synaptophysin, chromogranin, and Ki67 index above 70%. A diagnosis of oncocytic neuroendocrine tumor of Grade 3 was made. In electron microscopy, oncocytic cells showed abundant mitochondria dispersed throughout the cytoplasm. Oncocytic pancreatic neuroendocrine neoplasms are uncommon and can be diagnosed only on histopathological examination. These tumors tend to show a malignant behavior.

Efficacy of sucrose application in minimizing pain perception related to dental injection in children aged 3 to 9 years: a randomized control trial.

Background: Dental fear and anxiety are significant challenges in managing behavior in children. Oral administration of sucrose or sweet-tasting solutions has shown effectiveness in reducing procedural pain in infants and neonates. This study aimed to investigate whether pre-application of sucrose solution had an effect on minimizing pain perception during injection and to assess the potential impact of the child's age and sweet preference. Methods: A randomized control clinical trial was conducted on 60 children aged 3-9 years requiring buccal infiltration injections. Following parental consent, demographic data of the children were recorded. Sweet preferences was assessed using a modified forced-choice test. Children were equally and randomly allocated into study (sucrose) and control groups using a lottery method. Sucrose solution or distilled water, respectively, was applied to the lateral surface of the tongue for 2 min. Topical anesthetic was applied at the site of injection, followed by local anesthesia administration. The children rinsed their mouths thrice with water immediately after anesthetic injection. A video was recorded during injection which was then scored by three blinded examiners on the Sound Eye Motor (SEM) scale. The children also self-evaluated using Wong-Baker Faces Pain Rating Scale (WBFPS). Results: The mean SEM scores and WBFPS scores were analyzed using the Kruskall-Wallis test. The mean SEM score in the study group was 1.37 ± 0.61, compared to 3.17 ± 0.87 in the control group, showing a statistically significant difference (P < 0.001). Mean pain scores assessed by WBFPS in the study group were 0.60 ± 1.4, while in the control group, they were 6.27 ± 2.33, also showing a statistically significant difference (P < 0.001). Children with a sweet preference demonstrated a subjective reduction in pain perception. Conclusion: Application of sucrose before dental injections in children helps to minimize pain upon injection across all age groups.

Air-Abrasion in Dentistry: A Short Review of the Materials and Performance Parameters.

The selection of abrasive material and parameters of the Air-Abrasion device for a particular application is a crucial detail. However, there are no standard recommendations or manuals for choosing these details; the operator must depend on his experience and knowledge of the procedure to select the best possible material and set of parameters. This short review attempts to identify some of the effects that the selection of material and parameters could have on the performance of the Air-Abrasion procedure for a particular application. The material and parameter data are collected from various studies and categorized according to the most popular materials in use right now. These studies are then analyzed to arrive at some inferences on the performance of Air-Abrasion materials and parameters. This review arrives at a few conclusions on the effectiveness of a material and parameter set, and that there is potential for developments in the area of standardizing parameter selection; also, there is scope for further studies on Bio-Active Glass as an alternative to the materials currently used in Air-Abrasion.