Lung malignancies are illuminated by fuorescent molecules tagged to a ligand that binds to
malignant cells and excited by light in the near-infrared spectrum.
Optical imaging has bright
future for cancer surgery
BY ALICIA GALLEGOS
Frontline Medical News
In a decision that keeps the Afordable Care Act intact, the U.S. Supreme Court has upheld the use of federal subsi- dies under the health law in states that have not created
In a 6-3 vote in favor of the Obama administration, justices ruled that residents in states that rely on the federal
marketplace are eligible for tax credits to purchase insurance, based on the high court’s interpretation of ACA
In their opinion, justices said the context and structure of the act’s language compel the conclusion that
tax credits are available for insurance purchased on any
exchange created under the law. The credits are necessary for the federal exchanges to function like their
state exchange counterparts, the high court stated, and
to avoid calamitous results that Congress intended to
“When read in context, the phrase ‘an exchange established by the state’ [in the ACA], is properly viewed as ambiguous,” the majority justices said. “The phrase may be
limited in its reach to state exchanges. But it could also refer
to all exchanges – both state and federal – for purposes of
the tax credits. If a state chooses not to follow the directive
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Pre s orte d Sta n d ard
banon Jct. K Y
A C S Surgery N e ws C H A N G E SE R VIC E R E Q U ES T E D
151 Fairchild Ave.,
S uite 2,
Plainvie w, N Y 11803-1709
See Supreme Court Â page 6
3 l Commentary
Dr. Bridget Fahy gives an
update on fellowship training for
hospice and palliative care.
9 l General Surgery
Acute uncomplicated appendicitis may no
longer necessarily be a surgical emergency
but instead be treated with antibiotics.
15 l Endocrine Surgery
Dr. James Wu conducted a study
to evaluate gene expression
testing for thyroid nodules.
Notice Something New?
ACS Surgery News has a fresh
design! Check out the new look in
print and online.
Tyler G. Hughes, M.D., FACS
ACS Communities: Bringing us together
The Editor in Chief of the ACS Communities discusses how
this unique communications venue is being used and the
reasons behind its growing popularity among Fellows.
Â Page 2
BY KARI OAKES
Frontline Medical News
For cancer patients and the surgeons who treat them, tumor margins matter. The amount of malignant tissue left behind
after cancer surgery can make a profound difference in overall survival, but sparing healthy
tissue while removing as much tumor as
possible is limited by the surgeon’s ability to
diferentiate one from the other.
Now, new optical imaging techniques
that deliver fluorescing molecules specif-
ically to tumor targets show promise to
allow both surgeons and pathologists to
optimize cancer surgery.
These intraoperative techniques use fluorescent molecules tagged to a ligand that
binds to a target site on malignant cells.
Thus, uptake occurs only in the malignant
cells, highlighting them for the surgeon and
for pathologists assessing margin adequacy.
Dr. Sunil Singhal of the University of
Pennsylvania, Philadelphia, has coined the
term “optical biopsy” to describe what’s
See Optical Â page 8
Dissenters object to interpretation.