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Noninvasive localized measurement of extracellular pH in cancer tissues can have a significant impact on the management of cancer. Despite its significance, there are limited approaches for rapid and noninvasive measurement of local pH in a clinical environment. In this study, we demonstrate the potential of noninvasive topical delivery of Alexa-647 labeled pHLIP (pH responsive peptide conjugated with Alexa Fluor(®) 647) to image changes in extracellular pH associated with head and neck squamous cell carcinoma using widefield and high resolution imaging. We report a series of preclinical analyses to evaluate the optical contrast achieved after topical delivery of Alexa-647 labeled pHLIP in intact fresh human tissue specimens using widefield and high-resolution fluorescence imaging. Using topical delivery, Alexa-647 labeled pHLIP can be rapidly delivered throughout the epithelium of intact tissues with a depth exceeding 700 µm. Following labeling with Alexa-647 labeled pHLIP, the mean fluorescent contrast increased four to eight fold higher in clinically abnormal tissues as compared to paired clinically normal biopsies. Furthermore, the imaging approach showed significant differences in fluorescence contrast between the cancer and the normal biopsies across diverse patients and different anatomical sites (unpaired comparison). The fluorescence contrast differences between clinically abnormal and normal tissues were in agreement with the pathologic evaluation. Topical application of fluorescently labeled pHLIP can detect and differentiate normal from cancerous tissues using both widefield and high resolution imaging. This technology will provide an effective tool to assess tumor margins during surgery and improve detection and prognosis of head and neck cancer.

Objectives:1) Determine the patient characteristics, presentation, location, and rates of associated injury in pediatric foreign body ingestion and aspiration. 2) Analyze the types of intervention and rates of postoperative complications.Methods:Retrospective analysis of all patients under the age of 18 who were evaluated for foreign body (FB) ingestion and aspiration at a tertiary care center between January 1, 2003, and December 31, 2012.Results:We identified 315 patients. 61% were male and 39% female, with an average age of 3.9 years (SD 3.9). 55.6% of FBs were found to in the esophagus, 22.2% in the airway, and 22% in the oropharynx or GI tract. The most common signs and symptoms at presentation were emesis (30.9%), choking/gagging (27.4%), coughing (24.0%), drooling (23.4%), and dysphagia (23.4%) with an esophageal FB and increased work of breathing (50.0%), cough (48.6%), choking/gagging (44.3%), wheezing (40.0%), and stridor (20.0%) with an airway FB. The most common FBs were coins (88.6%) and nuts...

Objective: Isolated lateral pterygoid plate fractures on head CT imaging can serendipitously be associated with mandible fractures on subsequent maxillofacial imaging. Our objective is to understand the mechanism and to establish a protocol for the radiographic evaluation for this phenomenon.Method: We performed a retrospective case series of 7 maxillofacial trauma patients with evidence of isolated lateral pterygoid fractures noted on CT images between 2006 and 2012 at our tertiary care institution. Subsequent maxillofacial CT images with coronal, axial, and sagittal views allowed for complete evaluation of maxillofacial trauma.Results: Seven patients between 2006 and 2012 who sustained facial trauma were found to have isolated lateral pterygoid plate fractures. Subsequent evaluation via maxillofacial CT showed associated mandible fractures. All the patients were men with an average age of 37 years. Seven patients had an ipsilateral subcondylar fracture, 2 had a symphyseal fracture, 2 had a body fracture...