Week 1: Diving in 

I used this week at WCMC to get acquainted with my lab and start the clinical shadowing process. For the research component of my immersion term, I will be working with Ethel Cesarman in Experimental Pathology. Her research interests lie in lymphoma and Kaposi's sarcoma (KS). KS is a cancer that you have probably seen in movies and never fully recognized what it truly was. KS's is caused by the human herpes virus 8 (HHV8/KSHV), a virus that many of us are already infected with but show no symptoms, similar to the Epstein Barr virus. KSHV can usually be controlled by the immune system but in immunodeficient patients, malignant transformation occurs and sarcomas appear on the skin as dark, red, or white growths or patches. You have probably seen these in movies about the AIDS epidemic such as the photo of Matthew McConaughey below from the movie Dallas Buyers Club, although there are much more extreme cases in real life (picture from imbd.com) .

My role in this KSHV lab is to bring tissue engineering technology into research of KSHV viral infection models. Traditionally this research has been done with primary and immortalized cell lines, but that doesn't accurately represent the body. Therefore, my research project will be to engineer endothelial cell organoids that better recapitulate KSHV infection in the lymph nodes than cells in a dish. I will start by using my Cornell lab's lymphoma and lymph node organoids and tailor parameters for the primary human vein endothelial cells we plan to infect with KSHV. 


In other news, this week I began shadowing Dr. Lisa Roth in the pediatric hematology and oncology clinic at NYP. She treats children with hematological malignancies including lymphoma and leukemia. I was able to see her interact with patients ranging in age from 3-19 years of age. The most interesting case that I saw was of a 18 year old male recovering from primary mediastinal B-cell lymphoma. This patient initially presented with an asymmetrical chest, with one side protruding much farther than the other. It turned out that he had a large lymphoma in the mediastinal region that showed invasion in the lungs, but he surprisingly didn't have any associated breathing problems. After treatment with combination chemotherapy (EPOCH) his mass had considerably reduced in size, although still showed activity on his most recent PET scan. Dr. Roth said that sometimes after chemotherapy, the immune system needs to reboot and produce all of the immune cells that were wiped out during treatment so the metabolic activity in the chest could just be the thymus doing its job and not cancer. I found it really interesting that there were no other follow up imaging studies to be done to further tell what was going on in this young man's chest. The doctor plans to watch this patient and have a followup PET scan in a couple of months to monitor the positive result, although she is hopeful that he is in the clear. I look forward to more shadowing with Dr. Roth, and hope that she can introduce me to some of her colleagues so that I can get some exposure to the treatment and monitoring of hematological malignancies in adults. 

Comments

Post a Comment

Popular posts from this blog

Week7

With the end of our summer immersion approaching, I feel sad to say goodbye to all the persons I've met in the hospital during this summer. The past 7 weeks has been very fulfilling and exciting to me, and I will never forget my experience here. As a student will electrical engineering background, I never thought that I can be able to go to a real operation room in the hospital and observe doctors operating on surgeries. But in the past 7 weeks, I was able to go to OR every week, and there's always surgery techniques that are impressing to me. Beside clinical experience, I also had a research project, automatic segmentation of zebra fish neuron images. As I have presented in my previous bloggers, for my project, I have tried several different algorithms. The first is simple thresholding. It is usually used as a preprocessing step in image analysis. The second method is watershed algorithm. It works pretty well, but, it's very sensitive to noise, resulting in over segmenta...
Read more

Week 5: Prostates & Autopsies

Image
This was a fun and interesting week! The prostate biopsy chip slides from last week were evaluated, and more testing was done. On Wednesday and Thursday, two people from the company were here to do some trials with the new chips. This time, real prostate biopsies were taken, and sections were used to evaluate the quality of the tissue. Each chip holds up to 6 biopsies inside the little grooves. The color of the dividers (blue, yellow, and black) orient each sample to distinguish where in the prostate each biopsy came from. It also allows six biopsy cores to be placed on one slide which saves space and resources [1]: Instead of all 12 of the slides on the left (although that is a little excessive), you just need two with the BxChip. It also seems to keep the cores flat and aligned. This is what a magnified core might look like [2]: The tissue fits right inside the little grooves (although it can be slightly difficult to get them in there), and then the whole chip can be ...
Read more

Week 5: Spine Surgeries and Excel Files

Image
On the context of my clinical research project, I continue extracting the different demographic and skeletal specific factors for the patients of our study. I was also able to attend an additional spinal fusion surgery under the supervision of Dr. Kim at HSS. During this week, I was particularly interested in the surgical equipment that he uses for the procedure. Dr. Kim uses the Zimmer Biomet Vitality Spinal Fixation System for his spine surgeries. The components of the system are made from medical grade titanium alloy and medical grade cobalt chromium alloy. In summary, these were the main steps of the process for installing the screws into the patient spine which, personally, was the most interesting part of the procedure.  Initially, the pedicle area of the vertebrae is localized, and an insertion is made in the cortical shell. Then, a probe, included with the system, creates a pathway for the polyaxial pedicle screw to be inserted into the pedicle and the vertebral body. ...
Read more