BACKGROUND Squamous cell carcinoma of head and neck(SCCHN) is the fifth most common cancer worldwide. Inhibition of epidermal growth factor receptor signaling has been shown to be a critical component of therapeutic o...BACKGROUND Squamous cell carcinoma of head and neck(SCCHN) is the fifth most common cancer worldwide. Inhibition of epidermal growth factor receptor signaling has been shown to be a critical component of therapeutic option. Herein, we report a case of durable complete response to erlotinib.CASE SUMMARY An 81-year-old Caucasian male who presented with metastatic poorly differentiated squamous cell carcinoma of right cervical lymph nodes(levels 2 and 3). Imaging studies including(18)F-fluorodeoxyglucose positron emission tomography/computed tomography(CT) and contrast-enhanced CT scan of neck and chest did not reveal any other disease elsewhere. Panendoscopic examination with random biopsy did not reveal malignant lesion in nasopharynx,oropharynx, and larynx. He underwent modified neck dissection and postoperative radiation. Within 2 mo after completion of radiation, he developed local recurrence at right neck, which was surgically removed. Two mo after the salvage surgery, he developed a second recurrence at right neck. Due to suboptimal performance status and his preference, he started erlotinib treatment.He achieved partial response after first 2 mo of erlotinib treatment, then complete response after total 6 mo of erlotinib treatment. He developed sever skin rash and diarrhea including Clostridium difficile infection during the course of erlotinib treatment requiring dose reduction and eventual discontinuation. He remained in complete remission for more than two years after discontinuation of erlotinib.CONCLUSION We report a case of metastatic SCCHN achieving durable complete response from erlotinib. Patient experienced skin rash and diarrhea toxicities which were likely predictors of his treatment response.展开更多
This paper presents the current knowledge about the reconstruction of dinosaur heads. To reconstruct the dinosaur head, several features and functions of the head must be studied, namely osteology, musculature and sof...This paper presents the current knowledge about the reconstruction of dinosaur heads. To reconstruct the dinosaur head, several features and functions of the head must be studied, namely osteology, musculature and soft tissue of the head, cranial kinesis, craniodental biomechanical characteristics, posterior part of the cranium, skin, and others. The main steps and points resulting from the study are the following. Firstly, the osteological remains of the head are studied for reconstruction according to the correct size and form in comparison with known remains belonging to the same family in case the remains were not complete. As the dinosaurs did not have facial muscles, their skin was pressed directly to the skull. The skin covering the large openings in front of the orbits of many dinosaurs probably bulged gently outward, and similarly, the jaw muscles bulged gently from the skull openings. Also, an investigation is performed to decide if sauropods were terrestrial or aquatic animals. Then, the individual characteristics of the head are examined in detail. These concern: 1) endocranial cast and nerves, 2) nostrils position, 3) the existence and kind of cheeks and lips, 4) Teeth types and function, 5) the palate shape and skin covering, 6) hyoid apparatus and tongues, 7) the details of the ear, 8) sclerotic rings and eyes, 9) skin and color. With the knowledge gathered about the various parts of the head in mind, decisions are made about the Amargasaurus (a sauropod) head in order to reconstruct a 3D, actual size head, as a worked example. Finally, the reconstruction procedure is described in detail.展开更多
文摘BACKGROUND Squamous cell carcinoma of head and neck(SCCHN) is the fifth most common cancer worldwide. Inhibition of epidermal growth factor receptor signaling has been shown to be a critical component of therapeutic option. Herein, we report a case of durable complete response to erlotinib.CASE SUMMARY An 81-year-old Caucasian male who presented with metastatic poorly differentiated squamous cell carcinoma of right cervical lymph nodes(levels 2 and 3). Imaging studies including(18)F-fluorodeoxyglucose positron emission tomography/computed tomography(CT) and contrast-enhanced CT scan of neck and chest did not reveal any other disease elsewhere. Panendoscopic examination with random biopsy did not reveal malignant lesion in nasopharynx,oropharynx, and larynx. He underwent modified neck dissection and postoperative radiation. Within 2 mo after completion of radiation, he developed local recurrence at right neck, which was surgically removed. Two mo after the salvage surgery, he developed a second recurrence at right neck. Due to suboptimal performance status and his preference, he started erlotinib treatment.He achieved partial response after first 2 mo of erlotinib treatment, then complete response after total 6 mo of erlotinib treatment. He developed sever skin rash and diarrhea including Clostridium difficile infection during the course of erlotinib treatment requiring dose reduction and eventual discontinuation. He remained in complete remission for more than two years after discontinuation of erlotinib.CONCLUSION We report a case of metastatic SCCHN achieving durable complete response from erlotinib. Patient experienced skin rash and diarrhea toxicities which were likely predictors of his treatment response.
文摘This paper presents the current knowledge about the reconstruction of dinosaur heads. To reconstruct the dinosaur head, several features and functions of the head must be studied, namely osteology, musculature and soft tissue of the head, cranial kinesis, craniodental biomechanical characteristics, posterior part of the cranium, skin, and others. The main steps and points resulting from the study are the following. Firstly, the osteological remains of the head are studied for reconstruction according to the correct size and form in comparison with known remains belonging to the same family in case the remains were not complete. As the dinosaurs did not have facial muscles, their skin was pressed directly to the skull. The skin covering the large openings in front of the orbits of many dinosaurs probably bulged gently outward, and similarly, the jaw muscles bulged gently from the skull openings. Also, an investigation is performed to decide if sauropods were terrestrial or aquatic animals. Then, the individual characteristics of the head are examined in detail. These concern: 1) endocranial cast and nerves, 2) nostrils position, 3) the existence and kind of cheeks and lips, 4) Teeth types and function, 5) the palate shape and skin covering, 6) hyoid apparatus and tongues, 7) the details of the ear, 8) sclerotic rings and eyes, 9) skin and color. With the knowledge gathered about the various parts of the head in mind, decisions are made about the Amargasaurus (a sauropod) head in order to reconstruct a 3D, actual size head, as a worked example. Finally, the reconstruction procedure is described in detail.
