Week 5 - Julie

This week I progressed significantly in my research project and observed patient procedures. I also got to attend patient rounds with my mentor and learn about each of their afflictions. These are interesting because many patients are post-operational and appear very normal to the untrained eye. I learned to not take their small concerns lightly, because they know their body better than anyone and often know when something is really wrong. The pre-operation appointments are unique because I get to learn how the surgeon explains the different treatment options, and how many doctors the patient is working with. I learn how the patient synthesizes the different options each doctor presents and then comes to a final operation decision.

The surgeries I observed this week both dealt with vascular reconstruction. The first was a breast reconstruction and free flap, where the oncologic surgeon removes the breast tissue due to cancer. Then they search with a tool to find the sentinel nodes and make sure those are removed so no metastasis could occur if any cancerous cells were missed. Plastic surgery then performs a free flap, where the pectoris muscle is removed from the abdomen and used as healthy tissue to reconstruct the breasts. Microsurgery was needed to connect the arteries and veins in the flap to the underlying breast tissue, which was done using a microscope setup. I learned that is it’s vital to place new healthy tissue in an area of distress to supply blood and nutrients.

The other vascular surgery was very complex and lasted the whole day. This patient had had a failed vascular graft with a synthetic PTFE vessel because it got infected. Therefore, in this revision surgery they had to remove the PTFE graft and replace it with a vein from farther down the leg. It was disappointing to learn that the engineered tissue often got infected and there is much room to improve these vascular constructs. I learned that as a BME, our products have real affects on patients, such as this man who had to be opened up again due to this failed product. Also, he had so few choices of blood vessels left that they used a femoral vein, which now I know, can hold up to arterial pressures. Vascular tissue engineers may want to look into reconstructing veins and how they are able to survive these pressures. They will actually transform into an artery-like tissue!

I had the opportunity to participate in my colleague’s MRI research project. I was dehydrated for 6 hours and then my pelvic region was imaged by MRI. Then I rehydrated and I was imaged again. She will measure my femoral artery diameter to see if it expands when I am hydrated. This was a great opportunity because I learned about diagnostic procedures first-hand as the patient would. I provided critique to my colleague so she will know how to best approach other volunteers who may be nervous about the MRI. Overall, I am very impressed with the quality and ease of obtaining the images, considering the complexity of the technology.

I worked a lot on my research project this week. With the help of the lab resident I seeded vascular cells into collagen and poured this into a mold. Now we have cells embedded into the collagen bulk with a vascular channel in the center of the construct to represent a small blood vessel. We hypothesize that the cells will migrate over the course of one week towards the vessel lumen and act like real vascular cells. Therefore, I am culturing this construct and feed it every day with fresh media. I have also setup collaboration between my PI in Ithaca and my mentor here in NYC. Hopefully we can have a mutual relationship where we use their constructs up in Ithaca, while they take advantage of our imaging resources. We all spoke to each other about the partnership on the phone, and I am excited for this to continue. Next week I will sacrifice the channel, fix the tissue and prepare it for histological analysis and imaging.