Week Two (Jason Chang)

This week, I focused on installing MATLAB onto my work computer and getting clearance to observe OR procedures at WCMC and the Hospital for Special Surgery (HSS). As far as clinical exposure this week, Carla, one of the stroke research coordinators, brought me with her to the emergency room on Monday after she was paged about an incoming stroke patient. However, the patient turned out to be a construction worker who had fallen and sustained several blunt force injuries, which meant that the patient fell under the jurisdiction of trauma, not neurology. It was very interesting to see the high-pressure and fast-paced environment that the emergency medicine clinicians work in. Additionally, Dr. Prince gave a lecture on Monday on interpreting imaging results, specifically with magnetic resonance imaging (MRI), computed tomography (CT), and x-ray scans. During his lecture, Dr. Prince emphasized the importance of always having multiple views for every scan to confirm any abnormalities in the patient. His lecture included case studies with various pathological condition areas. Although he had to guide a lot of our answers, I learned a lot and am now able to differentiate between these commonly used scanning techniques.

On Tuesday, Dr. Mangat and I met to discuss more details regarding my research project on patients who have suffered from subarachnoid hemorrhage (SAH) (Figure 1).


Figure 1. Subarachnoid hemorrhage caused by bleeding into the space surrounding the brain [1]

SAH is a serious, life-threatening condition that occurs from spontaneous bleeding often caused by a ruptured aneurysm or traumatic brain injury (TBI). When blood accumulates in the subarachnoid space surrounding the brain tissue, the patient is at risk of seizures, stroke, coma, losing consciousness and/or alertness, and even death in extreme situations. The long-term impact on a patient’s quality of life after SAH depends largely on early diagnosis and treatment. Therefore, initial critical care management and monitoring is crucial to the patient making a recovery.

Our research study in collaboration with Dr. Forgács focuses on analyzing EEG segments from SAH patients. The first step of my research project will be to remove physiologic artifacts, such as eye movement (low frequency) or muscle activity (high frequency) signals, present in continuous EEG signals collected from patients in the study. This artifact removal process is typically done by having the clinician manually identify and delete artifacts, but this manual cleaning process can be very time-consuming and subjective. Additionally, variability in clinical expertise can affect the results, so an automated protocol in MATLAB would be more efficient. On Thursday, I met with Dr. Forgács to get all the EEG data and discuss how to approach this first step of my project. However, I soon realized that there was no all-encompassing solution since each region of the brain would contain different degrees and types of artifacts, so Dr. Forgács recommended that we start off by narrowing the scope of the analysis.

In the meanwhile, I spent time reading about the syndrome of SAH, as well as familiarizing myself with MATLAB codes written by Dr. Forgács' lab members for the various types of analyses of EEG tracings. 

Dr. Mangat and I will meet early next week to discuss my project in further detail. Next week, I plan to start going through patient EEG files and learn how to identify artifacts in each of the channels. I also hope to begin observing orthopaedic surgery procedures in WCMC and HSS, but I am still waiting on my clearance.  

References
[1] https://s-media-cache-ak0.pinimg.com/736x/96/27/a3/9627a3d11d53248564e3ea3b68fdfb76--subarachnoid-hemorrhage-stroke-recovery.jpg

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