Download Eben Oil On My Head ((TOP))
Everardo Marquez
Trained in facial plastic and reconstructive surgery, Rosenthal specializes in the treatment and reconstruction of head and neck cancer. His research interests involve the use of optical imaging techniques to better detect cancer during surgical procedures, and he has initiated multiple clinical trials in improving cancer surgery and assessing drug delivery. A mentor and frequently invited speaker, Rosenthal has authored or co-authored more than 250 peer-reviewed publications.
OHNS and the Vanderbilt Bill Wilkerson Center, which also includes the Department of Hearing and Speech Science, are recognized as international leaders in research for new treatments and cures for voice, cancer, hearing, and other diseases of the head and neck. As a result, OHNS is currently ranked No. 2 in the nation in total National Institutes of Health funding among departments of otolaryngology.
Although surgical resection has been the primary treatment modality of solid tumors for decades, surgeons still rely on visual cues and palpation to delineate healthy from cancerous tissue. This may contribute to the high rate (up to 30%) of positive margins in head and neck cancer resections. Margin status in these patients is the most important prognostic factor for overall survival. In addition, second primary lesions may be present at the time of surgery. Although often unnoticed by the medical team, these lesions can have significant survival ramifications. We hypothesize that real-time fluorescence imaging can enhance intraoperative decision making by aiding the surgeon in detecting close or positive margins and visualizing unanticipated regions of primary disease. The purpose of this study was to assess the clinical utility of real-time fluorescence imaging for intraoperative decision making. Methods: Head and neck cancer patients (n = 14) scheduled for curative resection were enrolled in a clinical trial evaluating panitumumab-IRDye800CW for surgical guidance (NCT02415881). Open-field fluorescence imaging was performed throughout the surgical procedure. The fluorescence signal was quantified as signal-to-background ratios to characterize the fluorescence contrast of regions of interest relative to background. Results: Fluorescence imaging was able to improve surgical decision making in 3 cases (21.4%): identification of a close margin (n = 1) and unanticipated regions of primary disease (n = 2). Conclusion: This study demonstrates the clinical applications of fluorescence imaging on intraoperative decision making. This information is required for designing phase III clinical trials using this technique. Furthermore, this study is the first to demonstrate this application for intraoperative decision making during resection of primary tumors.
Purpose: Positive margins dominate clinical outcomes after surgical resections in most solid cancer types, including head and neck squamous cell carcinoma. Unfortunately, surgeons remove cancer in the same manner they have for a century with complete dependence on subjective tissue changes to identify cancer in the operating room. To effect change, we hypothesize that EGFR can be targeted for safe and specific real-time localization of cancer.
Experimental design: A dose escalation study of cetuximab conjugated to IRDye800 was performed in patients (n = 12) undergoing surgical resection of squamous cell carcinoma arising in the head and neck. Safety and pharmacokinetic data were obtained out to 30 days after infusion. Multi-instrument fluorescence imaging was performed in the operating room and in surgical pathology.
Knowing we had a long hike ahead of us, we left as early as we could and started hiking the road to the trailhead. Not surprisingly, the road is not an interesting hike. Fortunately for us, when we were approaching the main road, a pick-up truck pulled up beside us. It was two of our park ranger buddies, who asked if we wanted a ride to the trailhead! K and I looked at each other, unsure if we should skip the experience of hiking the road. Thankfully, we said yes, and piled into the back of the pick-up. It was great luck, and we saved a lot of time.
The opening view from the trailhead is pretty spectacular, with a great cove next to it. As we started hiking, we left the ocean behind and starting hiking inland, through the middle of the peninsula. There were downed trees everywhere, and the existing trees struggle to get very tall due to the wind. Compared to other places we went on the island, Eastern Head is more exposed with some wide open spaces. It made for a nice change of pace.
Objective: To assess the effect of combining a synthetic matrix metalloprotease inhibitor and chemoradiation therapy on tumor growth in a murine model of head and neck squamous-cell carcinoma (SCC). Methods: Athymic, nude mice bearing SCC-1 xenografts were used to comprise 4 treatment groups: (1) control receiving vehicle alone, (2) marimastat alone, (3) cisplatin + radiation in combination and (4) marimastat + cisplatin + radiation in combination. The marimastat was administered at a dose of 8.7 mg/kg/day over a 14-day period via a subcutaneous osmotic pump. The control group received vehicle only via a subcutaneous osmotic pump. Radiotherapy was given in 4 fractions of 8 Gy divided over days 8, 12, 16 and 20 with 4 intraperitoneal doses of cisplatin (3 mg/kg) 1 h before each fraction of radiation. Results: Animals receiving triple treatment had delayed growth, measured as lengthened tumor doubling time, compared to the cisplatin + radiation combination (p = 0.03). Also, compared to control, the triple-treatment group (p = 0.005) had delayed growth in terms of doubling time. Factor VIII immunohistochemistry to assess microvessel density did not demonstrate a reduction in neovascularization between the triple-treatment and cisplatin + radiation combination groups. Statistical analysis failed to demonstrate any significant difference among groups. Conclusions: Chemoradiation + marimastat therapy had delayed tumor growth, compared to the chemoradiation alone. Based on these results, marimastat may work in combination with chemotherapy and radiation to inhibit tumor growth.
Cylinder head design is a highly challenging task for modern engines, especially for the proliferation of boosted, gasoline direct injection engines (branded EcoBoost engines by Ford Motor Company). The high power density of these engines results in higher cylinder firing pressures and higher operating temperatures throughout the engine. In addition to the high operating stresses, cylinder heads are normally heat treated to optimize their mechanical properties; residual stresses are generated during heat treatment, which can be detrimental for high-cycle fatigue performance. In this paper, a complete cylinder head high cycle fatigue CAE analysis procedure is demonstrated. First, the heat treatment process is simulated. The transient temperature histories during the quenching process are used to calculate the distribution of the residual stresses, followed by machining simulation, which results in a redistribution of stress. After the heat treatment, the cylinder head is assembled to the engine and subjected to the engine operation loads. The engine assembly and operation stresses are employed for the high cycle fatigue calculation. In addition to the fatigue safety factors, the finite life of the aluminum material is considered, and the high cycle fatigue damage is also calculated. Initial calculations are performed in the nominal condition of the part, but due to manufacturing process variations, high cycle fatigue properties vary from part to part. A method to calculate the effects of high cycle fatigue properties variation and the prediction of the range of high cycle fatigue life/damage is also investigated. The developed analysis method has been successfully used for cylinder head design to improve high cycle fatigue performance.
While some students rigged up the likes of suped-up motion sensor ghosts, others opted for more practical devices with a twist, like a device to let a disabled person control a toy car with motions of their head, and a man cave beverage fridge. (A hand clap is all it takes to open it.)
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