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Santa Clara Valley
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CY 2002 PRESENTATIONS
January 16, 2002
Molecular Imaging with Optical,
Magnetic Resonance, and Radioisotope Techniques:
Potentials and Relative Limitations
Jonathon Maltz
Lawrence Berkeley National Laboratory
Advances in optical techniques of fluorescence and bioluminescence;
molecular engineering of tracers or probes for magnetic resonance,
ultrasound, and emission tomography have lead to new directions in
research and new strategies for the diagnosis and treatment of diseases.
In the last 10 years the resolution, speed, volume of coverage and
commercial availability of non-invasive imaging methods have improved
many fold. At the same time the contrast resolution for metabolic and
functional imaging of the body has shifted the thrust of medical imaging
from anatomy to function and identification of specific molecules and
genes by in vivo imaging.
The technology advances include photodiode arrays for optical methods,
high field magnets proposed to 12 Tesla for functional imaging and
multinuclear spectroscopy, 3D ultrasound and positron tomography systems
with 2mm resolution for animals and people. The engineered molecular
probes have the potential to image specific enzyme expression and
protein receptor patterns specific to diseases such as breast cancer,
congestive heart failure, drug addiction and progressive stroke. This
presentation will highlight current and future technological advances in
the context of major diseases such as Alzheimer's disease, manic
depressive diseases, heart failure, spinal vertebrae diseases, breast
cancer, and prostate cancer.
February 20, 2002
The BioX Project
A New Approach to Collaborative Research and Teaching Programs at
Stanford
Channing R. Robertson
Ruth G. and William K. Bowes Professor in the School of Engineering
Department of Chemical Engineering
Stanford University
In the summer of 2003, 50 faculty will move into the new Clark Center
for Biomedical Engineering and Sciences. From that time on, Stanford
will be forever changed in how it approaches and conducts teaching and
research across multitudes of departments within the Schools of
Medicine, Engineering and Humanities & Sciences. A new
institutional structure will be born and from it will emerge discoveries
in science and technology spanning the breadth of molecules to man. For
the first time in an academic setting, professors and their students
will inhabit a facility designed for the sole purpose of creating and
sustaining intellectual interactions among the residents to enhance the
potential for discovery beyond what we can now imagine. Investigators
will study the smallest details of life itself - the molecules that make
up the building blocks of larger biological structures. They will
examine the interactions of these molecules as they come together to
form coherent cellular structures and beyond that cellular systems and
tissues. At an even higher level of organization they will address the
complex systems formed by these structures and the functions they
perform including high level neurological connections. Linking all these
activities will be some of the most advanced computing resources in the
world. Referred to as the BioX Programs, these endeavors reach far
beyond the walls of the Clark Center and serve to galvanize the
Stanford community in an enterprise that initiates the coalescence of
engineering, the physical, chemical and biological sciences and
medicine. Professor Robertson, a founder of the BioX Programs will give
a first hand view of the present status of the project and its vision
for the emergence of new discoveries we can only begin to contemplate.
March 20, 2002
Development of Endoscopic Cardiovascular Surgical Techniques
Albert K. Chin, M.D.
Vice President of Research, Guidant Corporation
Conventional surgical therapy utilizes the elements of surgical
exposure, tissue retraction, direct visualization, tissue resection, and
wound closure. Large skin incisions required for adequate anatomical
exposure result in considerable morbidity associated with traditional
surgery. Minimally invasive surgical techniques employ endoscopes and
endoscopic instrumentation to perform surgery via small incisions.
Endoscopic techniques as applied to cardiovascular surgery will be
reviewed. Specialized instruments provide access to the heart and
peripheral vessels, and allow cardiovascular exposure and repair to be
performed through minimal incisions. New applications of endoscopic
technology to cardiac disease will be presented. Research in these new
areas may provide therapy for previously inadequately treated disease
entities. The ability to apply novel therapeutic modalities in a
minimally invasive manner has large implications for patient care and
satisfaction.
April 17, 2002
Image-guided Stereotactic
Radiosurgery
Mohan Bodduluri, Ph.D.
Accuray Inc.
Mohan Bodduluri will describe the CyberKnife(r) Stereotactic
Radiosurgery System, which combines image guidance, robotics,
computerized treatment planning, and a compact x-band linear accelerator
(linac) to accomplish non-invasive surgery for destruction of solid
tumors and certain other conditions.
The CyberKnife technology was developed by Accuray Incorporated
(Sunnyvale, CA) in cooperation with Stanford University and was cleared
by the FDA in August 2001 to provide radiosurgery for lesions anywhere
in the body when radiation treatment is indicated. Over 2,000 patients
have been treated worldwide.
The CyberKnife treatment is planned using CT (and, in some cases, MR)
images that relate the position of the target to skeletal features or
implanted radiopaque fiducial markers. During radiosurgical treatment,
a proprietary x-ray image-guidance system tracks the position of the
skeletal features or fiducials, and thus the tumor. Information about
tumor position is communicated to the robotic arm, which can re-position
the radiation-generating linac to compensate for changes in patient
position. Up to more than one hundred pencil beams of 6 MeV radiation
are cross-fired along trajectories and in doses dictated by the
treatment plan. Because of the system's high level of accuracy, high
doses of radiation can be used while minimizing damage to normal
tissues. Thus, the technique is surgery-like.
Dr. Bodduluri also will describe an accessory to the CyberKnife that
allows the robotic arm to follow the motion of tumors during
respiration. This minimizes the "margin" of normal tissue that must be
irradiated in order to assure that the treatment dose is given to the
target.
May 15, 2002
Startup 101
William New MD, Ph.D.
Natus Medical Inc.
All successful business satisfies customer need. Understanding that
need is where to start. The second leg on the stool is developing a
product to serve that need. The third critical leg is creating a
sustainably profitable method to deliver that product. Three simple
concepts are the zen of building a successful startup company.
Identifying markets, creating products, finding financing, gathering the
right people, organizing properly, focusing on core competence, getting
useful advice -- a few of the fundamentals to be covered with levity and
insight by a engineer-doctor-entrepreneur now venture capitalist sharing
wisdom from 25 years of successful startups aimed at healthcare
improvement.
June 19, 2002
Noise Reduction in Hearing Aids
Dr. Harry Levitt
Methods of noise reduction for hearing aids can be subdivided into two
broad groups, single-microphone and multi-microphone techniques. Much of
the research in this area has focused on single microphone techniques
because of the convenience and cosmetic appeal of small
single-microphone instruments. This approach has been moderately
successful in reducing noise levels and improving ease of listening, but
has not been successful in improving speech intelligibility to any
significant degree. Multi-microphone hearing aids, although larger and
less convenient to use, are now receiving more attention. The methods of
noise reduction vary from innovative implementations of adaptive noise
cancellation to wearable directional microphone arrays. The improvements
in signal-to-noise ratio obtained with experimental multi-microphone
hearing aids can exceed 10 dB under ideal conditions, such as a
reverberant-free environment. In practice, however, improvements are
much smaller, depending on factors such as the acceptable size of the
microphone array, the number of noise sources and amount of
reverberation.
Dr. Levitt will present both theory and practical applications
pertaining to improving speech intelligibility in hearing aids.
July 2002 (no
program)
August 2002 (no
program)
September 18, 2002
GeneScene
A Web-Enabled Medical Informatics System for Clinical Genetics
Carl Taswell, MD, PhD
Global TeleGenetics, Inc.
Computerized medical records are neither new nor revolutionary with a
history dating back many decades. However, web-enabled medical
informatics systems built recently over the past few years can truly be
considered both.
They do permit a significant change in the fundamental paradigm from
one in which medical records have been created and accessed solely by
health care providers under time and space restrictions to one in which
these records can now be created and accessed by both providers and
consumers anywhere anytime. Of course, these systems require all of the
necessary safeguards for security and confidentiality with both role-
and rule-based access to different parts of the medical record.
GeneScene (www.GeneScene.com) with its specialty focus on
clinical genetics is one example of this new paradigm. The design and
development of GeneScene will be discussed from the perspective of the
integration not only of different modes of use, and different components
of the medical record, but also of different tools ranging from symbolic
to numeric.
October 16, 2002
Advances in Vascular Tissue
Characterization and Imaging
Brian Courtney, MSEE
Stanford University
Cardiovascular disease remains the leading cause of death in North
America and is a substantial health issue for patients and caregivers
alike. Over 1 million people experience acute myocardial infarctions
each year, causing over 450,000 deaths. Advances in the understanding
of biological mechanisms of acute coronary syndromes, such as plaque
rupture and plaque erosion, coupled with new interventional techniques
and pharmacological agents, have greatly improved the likelihood of
survival for such patients in recent years.
A significant clinical challenge is developing sufficiently advanced
techniques to identify foci of pathological changes in coronary arteries
that present a high-risk for causing clinical events. These foci would
include lesions that are increasingly being referred to as "vulnerable
plaques." Methods to identify vulnerable plaques and other pathological
changes in vascular tissue with greater resolution and certainty would
have the potential to further enable physicians to effectively treat
their patients. Furthermore, such methods would become important
research tools in furthering an understanding of the progression and
regression of vascular disease while providing improved ability to
evaluate the efficacy of various treatment modalities.
Relevant technologies with significant potential in the field of
vascular tissue characterization and imaging include Radiofrequency
Intravascular Ultrasound (IVUS-RF), Optical Coherence Tomography (OCT),
Magnetic Resonance Imaging and Thermography. IVUS-RF, OCT and
Thermography are catheter-based diagnostic technologies at various
stages of development, each with unique sets of properties. MRI
techniques currently under investigation include both intravascular and
non-invasive techniques. The principles, capabilities and limitations
of each of these modalities will be discussed and representative images
will be presented.
November 20, 2002
Identification of Bio-Threat Agents
using DNA Sequence Detection Technology
Kurt Petersen, PhD
President and Co-Founder, Cepheid
Recent Advances in genomic discovery have made it possible to
definitively distinguish not only the identity of an infectious organism
but also its virulence and its antibiotic resistance characteristics.
Such identification and characterization routinely employ DNA sequence
detection technologies such as the Polymerase Chain Reaction (PCR).
Traditional methods for such analysis, based on culturing, typically
require a skilled scientist and take several days to accomplish. Only
very recently have miniaturized fluidic systems become available which
perform this complex biochemical processing automatically, in less than
30 minutes, even by an unskilled operator. In this talk I will describe
the difficulties of finding and analyzing the bio-threat "needle in a
haystack". Microfluidic-based solutions to this problem will be
presented, including a totally automated PCR system which is currently
being evaluated by the US Postal Service for detecting bio-threat agents
in the US mail. Additionally, I will describe how the DoD application
is also transforming numerous other areas of human health, safety and
diagnostics.
December, 2002 (no
program)
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