Surgery

Intraoperative identification of metastatic lesions is challenging due to unpredictable locations and coverage by normal tissue. Intraoperative molecular imaging (IMI) uses targeted radioisotopes and/or fluorophores to guide surgeons to cancer tissue and distinguish tumor margins from normal surrounding tissue. Radioactive isotopes and near-infrared (NIR) fluorophores complement each other in dual-labeled probes by providing both depth of detection (radioisotope) and visual delineation of tumor borders (fluorophore) with common clinically used handheld detectors.

Rationale: Vascular composite Allograft (VCA) transplantation (Tx) involves the Tx of a functional unit of multiple tissues, such as skin, muscle, tendon, nerve, and bone. This approved clinical procedure can restore function, sensation, and appearance for Wounded Warriors suffering serve wounds to their hands, limbs, and face.

Alcohol-related liver disease (ALD) is a prevalent clinical problem, with many knowledge gaps in the pathogenesis of ALD, including the role and regulation of inflammatory and tissue reactions. Our overarching goal is to identify key new players in alcohol-mediated effects on development and progression of liver damage and fibrosis that could translate to targeted therapies. The extracellular matrix (ECM) and ECM dyshomeostasis are known to be important in ALD.

Esophageal adenocarcinoma (EAC) incidence is increasing rapidly and endoscopy-based screening has not reduced mortality despite targeting patients with known risk factors [GERD, obesity, smoking and Barrett’s esophagus (BE)]. This proposal describes a five-year training and research plan to develop expertise in the control and prevention of EAC through a K07 career-development award. The long-term research goal is to develop clinical prediction models that enable timely utilization of health resources in the detection of curable EAC.

Trauma is the leading cause of death in young people worldwide and has an estimated annual healthcare cost of 400 billion dollars per year in the United States alone. Survivors of trauma suffer from severe morbidity in the form of organ failure and thromboembolic complications, which are driven, in large part, by excessive inflammation and a vicious cascade of coagulation abnormalities.

Hemorrhage following traumatic injury is estimated to be responsible for over 40% of all trauma-related deaths. Ongoing traumatic blood loss is complicated by the well-known ‘lethal triad’ of coagulopathy, hypothermia and acidosis which results in further unbridled hemorrhage. Uncontrolled bleeding, resultant shock and organ dysfunction remain the leading causes of early in-hospital mortality.