Week 3 – June 20 to 24th.

Week 3 – June 20 to 24th. 

This week Dr. Altorki was out of town, but I was able to shadow two new doctors: Dr. Lee and Dr. Shostak in the OR and I also shadowed Dr. Port in clinic.

I shadowed Dr. Shostak in a case where he did a bronchoscopy to determine how the tumor was positioned and which surgery was best. He put a video camera down the airway, which was extremely interesting to watch. Dr. Shostak used cautery and cyro techniques to prevent the tumor from bleeding and then freezing the tumor to remove part of it. This tumor was specifically blocking an air passageway. As Dr. Shostak continued to remove the tumor you could see the passageway it was blocking. The surgery was not a treatment surgery, but rather a diagnostic surgery to help the surgeon determine what surgery is best suited. In the end, Dr. Shostak decided that based on the positioning of the tumor, it would be best to do a sleeve lobectomy as opposed to the normal lobectomy. One main difference is that surgeon will have to hand suture as opposed to using staples. 

While shadowing Dr. Lee, I watched him do a very complex surgery. The goal was to do a lobectomy on the left lower lobe, but the patient had many adhesions. This exponentially complicated the surgery. The doctors were not sure what caused the adhesions, as the patient had not had previous thoracic operations that they knew of. The hypothesized it could have been a previous infection, but of course were not sure. The adhesions were all over the pleura (both the visceral and the parietal pleura). The adhesions even caused the lung to be “attached” to the heart and aorta. The surgeon had to peel away each adhesion slowly and carefully. In total, it took around 1 to 1 and a half hours. The doctors also had to be careful not to puncture the lung when cutting away the adhesions. Once the adhesions were clear the surgeons had to cut and staple the sources of airway and blood (ex. Vein). This was also complicated as there were quite a few airways and veins in the region and the doctors had to determine which ones were correct.


I also started my research project. I was given scRNASeq data of NK cells. The first step was to clean the dataset. Although I have used R in the past, this was my first time handling scRNASeq data. I used a Seurat object and Seurat library to support my work. The main cells I cleaned were CD8 T cells as well as epithelial cells. CD8 T cells can be frequently mixed up with NK cells in initial sorting because they are both cytotoxic. However, there are a few markers you can use to distinguish the two. For example,  CD8 and CD3. I found these markers through a literature search.

This experience has been extremely excited and I have learned a lot. Thank you to everyone who has supported me in the experience.


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