Saturday, June 19, 2010

Mancuso: Summer Immersion Week I

For the duration of my time at Weill Cornell Medical University I’ll be based out of the pathology department under the direction of Doctor Cesarman and Doctor Lavi. With Dr. Cesarman I’ll be learning about current efforts to understand and detect disease using standard microbiology techniques. With Doctor Lavi I’ll be learning about clinical neuropathology and how diagnosis can be made using histology and a number of other tools. My research focuses on nanotechnology and applications to the diagnosis of disease, especially outside of a hospital or clinic and in resource limited locations. The information I learn here will be useful to my research and allow me to design tools more fit for use by medical personal.

During my first week I spent a large portion of my time with doctor Cesarman and her group. Here I’ve already started making significant strides to identifying and advancing my research project. I’ve already began growing two cell lines positive for Kaposi’s Sarcoma causing Herpes virus (KSHV) and learned to extract DNA, run Polymerase Chain Reactions, and run Agarose Gel’s to detect the presence of gene markers specific to the virus. Further, I’ve accompanied Dr. Cesarman and Dr. Giulino while they examined clinical histology samples and learned a great deal about how clinicians classify different tissue samples.

With Dr. Lavi I’ve looked at samples from muscle and nervous tissue and learned what sort of discrepancies he looked for in histological samples and how different stains could be employed to gain more information. Further, Dr. Lavi provided an excellent teacher actually demonstrating to me how to make the diagnosis he had made and walking me through his logic. Over the course of around twenty different slides he showed me how different types of cancer form from different cell lines and how to identify what sort of tissue brain tumors originate from. Eventually he presented me with a set of slides of muscle and asked me to determine what was wrong with the tissue. With his guidance I was able to determine that some of the muscle tissue was atrophying. He pushed me further, showing me new slides with different stains which allowed me to differentiate between Type I and Type II muscle and it immediately became clearer what was wrong; Type II muscle was atrophying. He then explained to me how this sort of atrophy could be the result of treatment with steroids, and that he’d have the check the patient’s medical record to determine if this was the case. We then discussed how it’s often the case in medicine that we need to recognize how powerful the side effects of treatment can be, and that it’s important to weigh them against the damage caused by the illness itself. Further, Dr. Lavi explained that this sort of atrophy could also me the result of paraneoplastic syndrome, a side effect of cancer not actually caused by the local cells but mediated by hormones or cytokines. He said he’d need more information on the patient before he could complete his diagnosis.

Later on Dr. Lavi showed me a set of slides of containing parasite infections on the brain. Specifically, worms had made their way into patient’s brains and triggered inflammation responses. I couldn’t believe how large these parasites could be in vivo; in their brains! From the slides I could make out the digestive track and “mouths” of these worms, it looked surreal.

In terms of a Summer Immersion Project it seems like I’ll be working with Dr. Cesarman and her group in order to create a system for the diagnosis of Kaposi’s sarcoma using the most self-contained system possible. I have considerable experience working on detection systems from my own research and Dr. Cesarman’s expertise has already proven useful in quickly identifying both gene sequences and protein targets which could be used for bioimmobilization. My thesis advisor and I have already discussed possible detection methods and believe we’ve come up with a good first candidate for this situation. With a little luck I’ll begin ordering some reagents next week to begin running preliminary experiments.

In summary I’ve already learned numerous important lessons from my time at Weill, including how histology is used in the diagnosis of disease and how molecular pathology labs work to determine the presence of viruses using genetic techniques. I’ve seen the sort of effects treatment, in this case steroids, can have on cellular function and just how scary some parasites can be. I’ve begun investigating some methods of current clinical diagnosis and have started determining methods of creating new ones. So far my time here has been thrilling and I look forward to future experiences, especially seeing doctor patient interactions.

No comments:

Post a Comment