BME Summer Immersion 2021

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...

 Lab-wise, I have really enjoyed the techniques I have been learning in lab. I have done many qpcr's sectioning and staining, and other helpful skills that I will use in Ithaca. We continued working on the beta cell mass project int he Pitt Lab. I sectioned and staining some samples to image and quantify using a software. The beta cell mass has been directly linked the the beta cell function.  We continued exploring New York City and I must say my favorite day last week was when we went to hot pot followed by a walk to Little Italy where I had spectacular gelato. I'll have that gelato on my mind for quite some time. Next week I look forward to wrapping up my projects and leaving Maiko in a good spot to continue after I leave. I will greatly miss the food and the hospital, clinical shadowing has been one of the my favorite experiences. 

 Wow has this been such a great summer.  A huge thank you to all those involved, especially those in the radiology department. This week I made good progress with the post doc I have been working with in the Pitt Lab. We were able to collect blood serum samples from mouse models that recapitulate Timothy Syndrome via a gain of function mutation in calcium channel 1.2 , the purpose of this is to simulate TS2 patients. This finding was really helpful for our studies this summer since we were able to eliminate the pancreas as the cause for hypoglycemia in TS2 patients. From here we move forward with this information to investigate if it potentially be the liver breaking down glucagon or if it is miscommunication between the brain and insulin secretion.  Additionally, this week, Dr. Pitt had rounds all week and I got to spend his morning and afternoon rounds with him. This proved to be a really exciting experience since I was able to see the MD side of his dual degree. The pa...

 Clinical: I was able to shadow Dr. Kaplitt for the final week again during a focused ultrasound case in which he ablated a specific region of the patient's brain using using MRI. The patient had essential tremors and showed significant improvement by the end of the session. I was also able to shadow in the OR and saw Dr. Kaplitt replace a battery pack for Deep Brain Stimulation. Research: My research finally began in the last week as I was able to perform the cannula implant surgeries on 8 experimental mice. I performed bilateral cannula implantations of optical cannula into the dorsal striatum, and in two weeks will return to Weill Cornell to conduct the fiber photometry imaging while the mice are exhibiting the freezing of gait phenotype due to exposure to magnetic field change brought on by MRI. My research mentor Dr. Santiago Unda has been an incredible hep during my time here and I wish I could have been more productive with my research with him, however have been able to due...

 I can't believe 6 weeks in NYC have already come and gone!  This week, I wrapped up shadowing in radiology, as well as continued to work on my shoulder impingement research project.  In this short period of time, I've gone from knowing almost nothing about radiology to really understanding how images are interpreted by physicians.  It's amazing how much information you can get about a patient's health (besides just their bone health) from a simple x-ray.  For example, I saw a teaching case where we were able to determine that the patient had lung cancer just by looking at a bilateral knee x-ray. Overall, I've had the opportunity to shadow in tons of different specialties throughout the summer: Musculoskeletal Radiology, Pediatric Radiology, Interventional Radiology, Plastic Surgery, Neurosurgery, Orthopaedic Surgery, and Physical Medicine & Rehabilitation.  Thank you to all the clinicians who have graciously taken the time to have me shadow and to answ...

Last week of immersion! This week was extra chaotic as I volunteered to assist with a virtual camp that my PI back in Ithaca is putting on for high schoolers. I was still able to attend office hours in the clinic and finish up a few things in the lab but I was unable to make it into the OR this week. In the clinic we saw two different acoustic neuroma patients this week which was very interesting as I had seen another acoustic neuroma patient in the OR a few weeks earlier. Acoustic neuromas are rare benign tumors that form on the cochlear nerves. Often when they are removed the cranial nerves, which animate the face, are severed causing varying degree's of facial paralysis. Dr. Spector then comes in and attempts to reconnect the nerves to restore some movement. It was really interesting to see the three different patients, as they had undergone different surgeries, had different degrees of paralysis, and were at different stages post op.  The original acoustic neuroma patient I saw...

      My final week of immersion largely served as a continuation of last week. I wrapped up (what I can) of my paper, amending figures and re-running outliers, and setting up instructions for conducting the reproducibility study. I continued to attend image readings alongside the cardiac imaging fellows, adding to my introduction on clinical cardiac magnetic resonance (CMR). I also got the chance to attend one of Dr. Weinsaft's lectures on basics of CMR readings, which served as a great summary and addendum to the last six weeks.      This week I attended a testing of coils for Magnetic Resonance-guided Focused Ultrasound (MRgFUS). MRgFUS utilizes ultrasound to ablate neural targets to treat cancer, Parkinson's, Essential Tremor, and other pathologies linked to specific areas of the brain. MRI is used to monitor the patient's brain in real time to monitor ablation progress, tissue heating, and the focus of the ultrasound transducers. Insightec's ExAblate N...