Saturday, June 26, 2010

Mancuso: Summer Immersion Week II

During my second week of summer immersion I continued shadowing doctors in Molecular Pathology and Surgical Pathology. So far the experience has been very satisfying. One of my most surprising discoveries has been how huge the knowledge gap between engineers and doctors is. Most of surgical pathology seems to revolve around histology slides in simple brightfield illumination. While it is certainly a useful and well understood technique it feels dated from the sort of technologies used in Biomedical Research.

With Dr. Lavi from Surgical Neuropathology I've continued seeing histology samples from different patients. The samples come in two different types; samples fixed in formalehyde which are then stained and sectioned and samples which are frozen and sectioned to help surgeons make quick decisions. I'm always surprised to see just how many samples are some form of cancer; I know the statistics for it are high but actually seeing it is so much different.

One of the most interesting set of opportunities I've had this week was the chance to observe both a full body pathological autopsy and a brain autopsy. While I've dissected my share of animals during my education I've never seen a human body opened like that and was amazed by what I saw. Everything looked very similar to I what I expected from books and the size and color of different organs amazed me. It was definitely a little more unnerving to see a human opened up then an animal, but the excitement for the chance to learn kept me focused.

During the brain autopsy I had more of a chance to ask questions because it was preceeding at a slower speed and the doctors were looking for specific parts of the brain. The patient had suffered from amyotrophic lateral sclerosis (ALS), or Lou Gehrig's disease, which progressed rapidly and eventually caused his death. The autopsy was being conducted to confirm the diagnosis and figure out exactly what had happened. ALS is a degenerative motor neuron disease in which the patient loses the use of their voluntary muscles. In general it can effect either or both the upper and lower motor neurons and in rare cases some other areas. During the autopsy we looked at both sets of motor neurons and took samples for later observation.We then fully sectioned the brain and upper spine and looked for other anomalies. All together we took around 20 samples to send to histology for staining which I'm hoping to get a chance to look at next week.

Along with Dr. Cesarman I've continued my research on Kaposi's Sarcoma causing Herpes Virus (KSHV) and the detection of it. A set of articles, starting with two papers from Chad Mirkin's group in 1995 and 1996 began a body of work around using transition metal nanoparticles for the aggregation and detection of different analytes. With Dr. Cesarman I'm trying to use some of this technology to create a system for the detection of KSHV DNA which would be operable with little infrastructure or equipment. Briefly, viral DNA would be used to crosslink nanoparticles and form an aggregate with different optical properties. In the presence of enough viral DNA a visible change in solution color could serve as an indication of positive detection. Over the course of this week I learned a little about how current detection can be carried out using PCR, Gel electrophoresis, and a number of other techniques. Further, I identified a nucleotide sequence which should be detectable using the a similar system and studied most of the chemistry I'll need.

This week has proven just as exciting as the previous has and I'm excited for all of the opportuniutes that are arising. Next week I hope to see another brain autopsy and the slides from this weeks. Further, I hope to continue my research project and order the reagents and parts neccesary. I've also began spending some time in the Neonatal ICU which I'd like to continue next week. It's fascinating to see how all sorts of technology and measurements can be used to get information from patients otherwise unable to communicate.

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