Cindy Tung / Dr. Susan Gauthier - Week 2

 This week, I gained both research and clinical experience. After watching a cardiac MRI taken of a patient, I shadowed cardiology fellows as they performed post-processes on the images to determine irregularities of the heart. In aorta imaging, they track T1/T2 values, hematocrit (volume percentage of red blood cells), myocardium (pre- and post-contrast), as well as extracellular volume (EVC). Additionally, they perform what's known as flow analysis by doing frame-by-frame adjustments to observe pulmonary vs aortic flow and compare stroke volume (SV) against a normal range. Afterward, the fellows will do a cross-examination/review with the attending to affirm their observations and clarify any indeterminate factors from the images. 

On Thursday, I was able to observe an AVNRT (atrioventricular nodal reentrant tachycardia) procedure on a patient who suffered from a re-entry circuit. This particular non-invasive procedure used femoral catheterization to thread an ultrasound-detectable catheter through the femoral artery into the inferior vena cava. By implanting in the femur, this non-invasive procedure allows physicians to operate away from the heart. There are special sensors at the tip of these catheters that use radiofrequency to scar an area of heart tissue in order to block any electrical signal triggering an arrhythmia. Once the catheters have been set up, the physicians spent a good amount of time in the reading room sending electrical impulses through the catheter to induce tachycardia and bradycardia to diagnose which region of the heart is producing arrhythmias. Most notably, the equipment and software used were able to 3D map a model of the heart, including force exerted from the catheter during the ablation procedure. After ablation, the physicians return to the reading room and re-conduct electrical signals to confirm the elimination of irregularities.

For research, I spoke to Dr. Gene Kim and his students about their research projects. This summer, I'll be working with Sawwal to help them examine histology slides to measure their density. I'll also be learning how to perform PET processing on tumor-induced tissue. Laura, a research assistant in the lab, is working with the NMR spectrometer to measure T1 and diffusion in cell cultures to validate cell properties. This week, I shadowed Laura in her training for the spectrometer. The output of the equipment is a hydrogen spectrum recovery of the sample over time. There is one big magnet in liquid helium sitting in liquid nitrogen. Room temperature shims adjust fields to be uniform across the sample, making the signals sharp. The advantage to using an NMR spectrometer over MRI is that they can use small samples of cells in solution while keeping them alive instead of doing a big setup for MRI. 

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