BME Summer Immersion 2021

A beautiful view of the Queensboro Bridge, the East River, and Queens. Looking at this reminds me of the first few words form J. Cole's Change  - "My intuition is telling me there'll be better days." I'll just leave it at that. Six weeks is a lot of time. 42 days, or 1008 hours, or 60,480 minutes. In an almost cruel twist, it passes like no time at all. Of course, this is the duality of time; both lengthy and fleeting in a single experience. I look back and see that through this immersion, I've gotten to witness many cases, work day in and day out with physicians, and work through my project. Before I started, I was interested and enthusiastic about MRI - learning about T2 and other image weighting. Now, I have some of the basics of scanner operations down, and I was even able to perform a scan on a phantom just this week! I didn't really know what ablation was, and I got to watch two procedures in the past two weeks. I've learned a lot, and there is a...

As this is my final week, I find it just to reflect on my experiences during this immersion. From day 1 to day 42, there were a lot of ups and downs. However, I am glad I made the decision to come in the end When I started this term, I had no idea about what could be achieved in these six weeks. Thankfully, with the guidance of Dr. Dadhania, Dr. Westblade, and Dr. Chughtai, I was able to learn a lot about conditions and procedures that would be either foreign or hear say. Research wise, it is unfortunate not to have more time to continue working on the current projects while in proximity to the clinicians.  However, I hope to continue what I started in Ithaca. Although it took me a while to get the logistics and understand what I was to to, I am happy I got to do some actual data analysis.

The final week! This week I watched a kidney biopsy and ablation and a bone biopsy. Biopsy involves getting small cores of tissues from a tumor or mass. Ablation is a technique used to destroy tumors. This can be done with heat or cold. Thermal ablation can further be accomplished using radio frequency or microwaves. However, when heat is used, the doctor must also account for "burn back." Heat is difficult to control precisely and will diffuse to surrounding healthy tissues/organs back along the probe. Hydrodissection injects saline to push organs away from the burn area, protecting them. The craziest part, though, is that they do this with the patient awake (but sedated) and insert a long needle through the torso. The bone biopsy was similar, but a drill had to be used to go through the bone and cut a small cylinder out of the suspicious area. For my last weekend in NYC, I went to Luna Park and the Coney Island beach. Personally, the ticket price for Luna Park wasn't wo...

For clinical experience, I shadowed one flap surgery and two wound cleaning surgeries with Dr. Spector. The patient with flap surgery had a huge hold in her mouse due to tumor removal, and the plan was to harvest a muscle from the wrist to patch up that hole. Two fellows were making incisions on the patient's neck to access the oral cavity while Dr. Spector was harvesting the muscle flap. Then, microsurgery was performed to anastomose the arteries and veins of the muscle slap to that of the neck, and the muscular flap was sutured on top of the hold in the mouth. Meanwhile, a layer of skin was harvested using a dermatome to cover up the wound on the wrist. Overall, I was impressed by how efficiently the medical team worked together to perform multiple parts of the surgeries simultaneously. For the wound cleaning surgeries, one was for the back of a foot and another was for the spinal fusion metal implant. Both patients had serious infections that halted wound healing, therefore Dr. ...

Clinical:     As I wrapped up my time at Weill Cornell, I spent most of my time working on deliverables for our program.  I did get into surgery on Thursday though to watch a tumor removal.  The main reason I went in was so that Robert, another student in the  program, could come with me.  He had not seen a surgery at all yet so it was good that we were able to get in for one.  I know what to expect from tumor removal surgeries by now so it was mostly the same, but there are always some new things to pick up during every surgery.  Usually some new brain anatomy and how the surgery has to be individualized based on the certain location of the tumor.       Research:     I had finish up most of my research so that I could present on earlier today (07/31).  I have been done with my app for a few weeks now, so all I had to do with that was put what I did into a few slides for the presentation.  My secon...

 It's crazy to think that immersion is over and it's already been 6 weeks. It feels like just yesterday we were all debating how many clothes to bring and how many suitcases we'd be allowed to take on the bus. Although one suitcase was enough for my clothes, I'm glad I had an extra duffle bag to bring some bagels back with me. I came into this experience with very little expectations and not a clear path of what I wanted to learn and take away. I knew I wanted to make connections and meet different research labs in case we wanted to collaborate in the future, but other than that it was more or less an open slate. I chose to dive into learning about lymphoma and stem cell transplants since cancer research has always been interesting to me, but I've never worked anywhere where this was an option. Dr. Leonard and other lymphoma clinicians graciously took me under their wing and taught me an incredible amount about lymphoma and how patients are treated. I saw some patie...

It's hard to believe that the clinical immersion has come to an end! This has definitely been an incredible experience that I will carry with me for a long time. When I first arrived in NYC, I was excited to learn about the technical aspects of radiation oncology--the complex biology of solid tumors, the physics underlying the design of radiation treatment fields, and the engineering of the machines built to deliver these treatments. By shadowing Dr. Marciscano and the other clinicians in the department, I succeeded in learning about all of these things. Beyond the technical side of medicine, however, I was pleasantly surprised to find that a significant amount of my learning was also focused on the human side of medicine. How do you convince a patient with curable disease to undergo cancer treatment when they are clinically depressed and seemingly ready to give up? How do you make a patient feel confident about the team of surgeons, medical oncologists, and radiation oncologists w...

The last week of the clinical immersion term has been incredible and productive just as previous weeks. I continued to shadow Dr. Riew's surgeries and clinics. I saw the MRI for a Chordoma bone cancer patient on Tuesday. The young patient had a huge tumor in his brain. When the tumor was surgically removed, the patient was left with a large cranial cervical junction and required a cervical fusion all the way from the skull to the bottom of the neck. However, the cervical fusion he had done before was not very good. For a fusion all the way to the skull, the patient will not be able to move their neck at all, but in this chordoma patient, the bone plate at the back of his neck has a very bad skull to neck angle, so that he can only maintain a very flexed position, in which his chin is almost touching the chest. The patient and his family went to Dr. Riew for a cervical fusion revision. Dr. Riew plans to take out the bone plate from the back of his neck and replace it with a plate to...

 Week 6 In the last week of the summer immersion program, I tried to wrap of a few of my deliverables instead of continuing to shadow surgeries for the majority of time. Over the past weeks I have been working with Dr. Bradley Pua for a conjoined case study with Dr. Jeffrey Milsom who is in the colon and rectal surgery department. The case study was looking at a possibility to combine interventional radiologic techniques for treating some small bowel complications. This week I helped them with editing the texts and figures for this case report. We imagine there would be a few more rounds of edits in the next few weeks before finalizing the manuscript. In addition, on last Friday I gave a brief presentation on the topic of this case study to our fellow summer immersion students and our coordinators.  Overall the summer immersion has been an incredible experience for me. Not only has it given me the opportunity to witness medical practices on a daily basis, it has also prompted ...

During my final week of clinical immersion, I said my goodbyes to my clinical mentor and the lab I’ve been working in. I spent most of the week wrapping up experiments and selecting samples to bring back to Ithaca for further analysis. In Dr. Chen’s lab, I prepped samples for a glucose-stimulated insulin secretion (GSIS) assay using my stem cell (SC) derived pancreatic islets and the SC derived-islets encapsulated in microgel followed by an ELISA to measure the amount of insulin produced by the cells and their total insulin content. I also imaged the immunostained cerebral organoids, processed all the images, and cryosectioned a few microgel encapsulated SC derived islets. I will finish sectioning and immunostaining these samples back in Ithaca. Overall, the clinical immersion experience has been incredibly informative and motivating for my own research. Being in a lab dedicated to stem cell research, especially beta cell differentiations, will aid in my thesis work. Seeing surgeri...

Clinical - This past week was very interesting as I was able to observe the cognitive assessment of a person with moderate Alzheimer's disease and was also able to tag along with Austin to observe Dr. Schwartz remove a brain tumor. Seeing the patient with Alzheimer's disease was quite eye-opening as in addition to the memory problems that are most typically associated with Alzheimer's disease they were also very withdrawn, would often take a minute or more to answer a simple question, and would often only answer in one word replies. This was evidence of how Alzheimer's disease can affect all brain functions, not just memory, and was overall quite sad to see as it was evident that Alzheimer's disease had severely deteriorated this person's quality of life. Meanwhile, in the OR I was surprised by how calm and loose the atmosphere was and was impressed with the ease at which Dr. Schwartz was able to remove the tumor. It was also evident that a glaring clinical need...

 Immersion term is finally over! What an experience. Between the shadowing opportunities, research, and time able to be spent bonding with the cohort, my time here has been packed with excitement. I am quite tired of city life and ready to be back to Ithaca and with my birds.  This past week, I met with my clinical mentor's laboratory and updated everyone on the current status of the MBP/Fe3+ quantification project. In order to remove bias from the processing pipeline, consistent image thresholding must be achieved. There are 17 built-in thresholding algorithms in imageJ, and I found the max entropy algorithm best suits our data. I constructed another macro to analyze images with all 17 algorithms at once, and taught Ria (the high school student assigned to this project with me) how to implement the macro on her device back home. Further work that needs to be accomplished for this project involves collecting more ROIs from the raw histology images and running a larger scale an...

This week I worked on finishing up gathering data for my research project and sent it off to the statistician for analysis. I also started writing an abstract for this project so we can submit this data to the American Society of Hematology (ASH) meeting. If the abstract is accepted we will prepare a publication for this project, but either way, it has been great getting to experience clinical research. The clinical team is interested in our results and hopefully, this project can help them learn something/ answer some questions. Outside of clinic, I also spent time shadowing in Dr. Cubillos-Ruiz’s research lab. I was able to learn the protocol and analysis for RT-qPCR, as well as learn about some other databases and resources for data analysis that will be helpful in the future. I also observed the isolation and staining of immune cells from patient samples. Spending some time in an immunology lab has been great and will help my research back in Ithaca. Overall, the past 6 weeks have ...

 With the conclusion of the immersion experience, I find myself with a greater appreciation of the medical field and the technology that has advanced us to this point. I am looking forward to working closely with clinicians, surgeons, and their medical team in the future.  This week, Shoufei and I worked on optimizing the PCL dorsal nasal constructs using the new Ender 3 pro 3D printer. We went through many trials and ended up figuring out the printing parameters for the best scaffold using a 0.2mm nozzle. The scaffolds were replicated each time we used those parameters with similar indentions in the pores. This means that they can be tested using cells and should provide consistent results. The next steps for this project are to utilize a glass heated bed in place of using duct tape and further optimizing the porosity of the scaffolds. The image below shows a PLA scaffold on the left with two PCL scaffolds to its right. The PCL scaffolds were printed using two different types...

 This was our last week of the summer immersion program! This week was very busy as I tried to get the most out of it and wrap up everything that I have been working on. On Monday I shadowed Dr. Greenfield's surgeries where I was able to see a chiari malformation surgical procedure. The medical fellows and residents were super welcoming in the OR and they helped guide me through the anatomy involved and how to orient myself when looking at the microscope and the projected screen. On Tuesday I shadowed Dr. Schweitzer in the neuroradiology reading room where I also got to see different cases that had come into the emergency room. One of the cases had actually involved an interventional radiology procedure as well which was super cool to see as it was a successful intervention. I also watched the fellows conference where they presented interesting cases. Later in the week, I worked on wrapping up my image analysis of the in-vivo study we were conducting in lab. This was a challenge be...