Patient description: A 54-year-old obese woman admitted to the emergency department with abdominal pain that started 4 days ago with nausea and vomiting. The epigastric pain radiates to the right upper quadrant, getting worse after eating fatty food. The patient experienced similar pain twice in the past year. Her past medical history is remarkable for hypercholesterolemia and 2 NVDs. She has 2 children, and she is menopausal. She does not smoke, drink alcohol, or use illicit drugs. She is mildly febrile. Her BP is 150/85, HR 115, RR 15, T 38.2, SpO2 98% on RA. She is an obese woman with no acute distress. On palpation, she experiences epigastric tenderness and tenderness in the right upper quadrant without rebound. Bowel sounds are normal. Laboratory analysis is remarkable for elevated ESR and leukocytosis with a left shift. The ultrasound revealed several gallstones, biliary sludge and CBD stones. The smallest stone is 14mm.

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Cancer of Head and Neck Neoplasms, Head and Neck Participants with premalignant lesions (mild dysplasia, moderate dysplasia, severe dysplasia, or carcinoma in situ) of the head and neck, as confirmed by biopsy within the 4 months prior to study entry or a treated primary T1N0 or T2N0 squamous cell carcinoma will be eligible For patients with T1N0 or T2N0 treated squamous cell carcinoma, they must have been free of disease for a minimum period of 8 weeks, up to a maximum of 3 years following completion of surgery and/or radiotherapy Eligible tumor and premalignant lesion sites oral cavity (buccal mucosal, gingival, floor of mouth, dorsal/ventral tongue, pharyngeal wall), oropharynx, larynx (glottis, supraglottis, subglottis, epiglottis), hypopharynx paranasal sinus and nasal cavity Patients with a treated tumor 1-node 0 (T1N0) or tumor 2-node 0 (T2N0) squamous cell carcinoma may have oral premalignant lesions (i.e., hyperplasia, dysplasia, carcinoma in situ) at the time of study entry (provided their Stage I or II disease has been definitively treated) Lesion sites oral cavity (buccal mucosa, gingival, floor of mouth, dorsal/ventral tongue, pharyngeal wall), oropharynx, hypopharynx,larynx (glottis, supraglottis, subglottis, epiglottis), nasopharynx and paranasal sinuses Eastern Cooperative Oncology Group (ECOG)/Zubrod performance status of 0-1 No medical contraindications for flexible laryngoscopy using topical anesthesia, and in the setting of a contraindication to topical anesthesia, general anesthesia may not be used as a substitute General anesthesia, if indicated, is acceptable in patients whose lesions would require general anesthesia for laryngoscopy and biopsy according to routine standard of care Blood counts: total neutrophil count > 1,500/mm³; platelet count > 100,000/mm³ Adequate liver function  Because no dosing or adverse event data are currently available on the use of Polyphenon E in participants < 18 years of age, children are excluded from this study Participants with hyperplasia, in absence of dysplasia or carcinoma in situ, will be excluded because there is possibly no benefit Participants with acute intercurrent illness or those who had surgery within the preceding 4 weeks unless they have fully recovered History of previous malignancies unless the cancer was stage I or II and rendered free of disease more than 1 year Participants who are pregnant or breast feeding. Pregnant women are excluded from this study because Polyphenon E is an investigational agent with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with Polyphenon E, breastfeeding should be discontinued if the mother is treated with Polyphenon E Not practicing adequate contraception if the participants are of child bearing potential Uncontrolled intercurrent illness including, but not limited to, severe active infection, symptomatic congestive heart failure, myocardial infarction within the past six months, unstable angina pectoris, serious cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements are excluded Documented history of coagulopathy such as hemophilia or Von Willebrand's disease or inherited thrombophilia Hypertension not adequately controlled by medication (i.e. systolic blood pressure ≥ 150 and/or diastolic blood pressure ≥ 90 on at least two separate readings) History of congestive heart failure (CHF) greater than New York Heart Association (NYHA) Grade II