Week 3 - Gram Stain of the Week!

This week, I was able to enjoy the holiday, but quickly got back into the swing of things. On Tuesday, I was able to observe a buccal fat tumor removal in the OR. This procedure was relatively short, and the tumor itself was very small. Post- excision, we had about 15 minutes of downtime for lab specimen processing to ensure that no more tissue had to be removed to completely isolate the growth. The surgery itself was successful, required no additional fine-tuning and took no more than three hours, so I was able to peek into the Spector lab afterwards. There, I shadowed a student in the lab and learned about T-cell proliferation in vitro. The cells are isolated from clinical tissues Dr. Spector obtains from his surgeries. Once they are isolated from the sample, they must be worked up until enough cells are present and can be used for construct seeding. In order to increase this proliferation rate, some T-cells were activated. Beads that present anti-CD3/CD28 antibodies were used to activate the cells, and IL-2 was added to the media (DMEM) to enhance their expansion as well. Once the cells were isolated and activated, the unstimulated and stimulated cells were imaged to ensure their presence. After it was determined that they were present in the culture media, they were incubated and would be checked on the following day. 

Next, I was in the OR again, and this time I was able to observe a lipoma removal. This time, we were able to get a bit more up close and personal- the attending surgeon was able to clearly indicate to us to the veins and vascular structures he was trying to avoid while removing the lipoma. Once it was removed, we were also able to see the true size of the benign mass - which was almost the width of a ping-pong ball but the thickness of a post-it note pad. It was impressive to think that the patient had walking normally despite the fact that this growth was on his inner thigh. After the hour-long surgery, we followed Dr. Spector to rounds as he checked in on a patient he'd operated on the week before. This time around, it was definitely a bit more difficult to see patients in mild discomfort. However, the surgery itself was necessary- a tongue carcinoma was the root cause. 

Then, on Thursday and Friday, I was back in the Westblade lab. First, I started at the wounds bench. There, fluid from injuries or drainages can be analyzed for the presence of pathogenic bacteria, indicative of infection. In these cases, dangerous bacterial strains were isolated and subcultured from selective and nonselective plate cultures generated from the injury fluid. Also, the location of injury and its severity play a large role in determining what is pathogenic vs. normal flora. For instance, a few vaginal samples were submitted- which meant that growths like yeast or Gardnerella bacteria would be alarming to see, whereas lactobacilli would not be. I was also able to see more biochemical tests, such as the Indol and Oxidase tests. These tests indicate which bacteria are able to breakdown tryptophan, and are aerobic. These observations allow us to classify bacteria in some cultures and in the case of PYR testing, differentiate between some Group A Streptococci or Enterroccocus species. 

Finally, to wrap everything up, I was able to participate in Gram stain of the week! I'll find out tomorrow if that my guess was correct..!

- Taylor