Week 7 - Justin Levine

 It’s hard to believe that we only have one week left here for our immersion term, but week 7 has been productive and engaging, both in shadowing and in the lab. We got to check in on the head and neck cancer patient undergoing treatment for lost/damaged facial tissue, both in rounds and in a follow-up procedure in the OR, and in the lab I was able to significantly improve on my primary adipose IF staining with the use of a confocal microscope and the arrival of dialysis tubing I had ordered.


The patient that I introduced at the end of last week’s post, with extensive damage on the right half of their face from complications associated with head and neck cancer, a failed skin graft, and side effects of radiation therapy, spent a week in the hospital after their operation last Wednesday. Checking in on them on Monday, they had a good amount of energy and were in an upbeat mood, and Dr. Spector decided he would bring the patient back to the OR this week to check the progress of the DermiSphere he had applied, and, if necessary, add more DermiSphere or a skin graft. On Wednesday this procedure was performed, and we were all happily surprised to see that the DermiSphere was working better than even Dr. Spector expected. This patient’s tissue was extremely damaged, and their wound-healing capabilities substantially lowered from both the cancer and its treatment regiment, but their body appeared to be slowly regenerating into the dermal template. Instead of a skin graft, Dr. Spector added a second layer of DermiSphere in a few locations, and the patient was able to go home the next day to continue their recovery.


This case is going to stay with me more than most - from a strictly clinical standpoint, it was a unique challenge to Dr. Spector and his DermiSphere, with some facial tissue having eroded all the way to the bone and the body’s natural regeneration processes badly damaged, so it was extremely impressive to see any positive results at all. From a human perspective, I deeply respected the surgical team working to bolster this patient’s comfort and dignity as they face a terminal illness. This dedication is what I find most exemplary about the medical field, and it helps showcase the deeply held beliefs that drew all of the experts in that OR to their profession. It is this kind of OR experience that I will most take with me as I go back to my research in Ithaca - a dedication to the most human sides of medicine, from the bench to the point of care.


In lab, I was finally able to get time on the Surgery department’s confocal microscope (with the help of our lab manager, Dr. Xue Dong), which was able to capture some beautiful images of the primary adipocytes I stained, even showing the folds in their membranes. I also received dialysis tubing, which I plan on incorporating into my staining protocol to minimize sample loss, and performed a pilot stain; unfortunately, due to computer issues I was unable to capture images (those will have to wait until Monday).

Comments

Post a Comment

Popular posts from this blog

Week 3: Eddie Wei - Multimodal Endoscope

Image
Figure 1: Multimodal OCT and Confocal Setup Housed in moving cart connected to Endoscope for operations Endoscope Design           This week, I finalized the optical setup and handheld endoscopic probe design in SolidWorks CAD for multimodal imaging with Optical Coherence Tomography (OCT) and Confocal Microscopy in both 360° side-view scanning and forward-view orientations, as shown in the setup and endoscope CAD figures above. Figure 2: Current OCT-Red ( Freund et al.)  and Confocal Fluorescence Microscopy-Green ( Wang et al. ) images in comparison to Histology.           As a brief review of their demonstrated applications in urology, OCT uses backscattered near-infrared light to generate depth-resolved structural images and can delineate bladder layers up to the muscularis with limited cellular information [1], while confocal fluorescence endoscopy uses fluorescein-induced emission and optical sectioning to distinguish...
Read more

Week One: Eddie Wei

Over the first week of immersion, I had the opportunity to observe a couple standard urologic operating room procedures, each offering a different perspective on diagnosis, imaging, and operative care. On June 1, I observed two standard operating room procedures. The first involved the treatment of four urinary bladder stones using a cystoscope inserted through the male urethra. The cystoscope was first equipped with a specialized head capable of generating a stream of water to break down the stones. After fragmentation, the water head was replaced with a suction tube to remove the stone fragments and excessive water from the water jet. The procedure was performed under direct real time visualization with a  standard 3x magnification camera integrated into the cystoscope. This procedure lasted 2-3 hours, with 2 and a half hours allocated to breaking down these stones using the water jet.  The second procedure involved a female patient undergoing blue-light cystoscopy to evalua...
Read more

Week 1- iqra

This week started off pretty slow since I didn’t meet with my clinician until Wednesday, but things picked up quick ly after that. One thing that has made a big difference is that Dr. Cheung sent an email out to the department about me shadowing, which has allowed me to move around and observe a variety of electrophysiology procedures rather than being limited to a single physician or case type. This has given me exposure to many different aspects of the field and has helped me gain a broader understanding of cardiac electrophysiology. In addition to clinical observations, I also met with one of the medical students working on my research project. During our meeting, we discussed some of the technical details and logistics of the project and worked through a few questions regarding the overall direction of the research. We are still in the early stages of planning, so there are additional details that need to be worked out, and we plan to continue those discussions next week. On Wednes...
Read more