From YSP to Hanging Out at Stanford: Michelle Cheung

Hello! My name is Michelle Cheung and I am a rising 2nd year student at the University of Toronto. I was one of the Youth Summer Program (YSP) students in Dr. Pascal Tyrrell’s lab in the summer of 2016. During the program, I helped with the Medical Imaging Network Enterprise Project by surveying patients at Sunnybrooks hospital for their perspectives on sharing medical images for research.
Before entering Pascal’s lab in 2016, I took part in YSP the summer before in 2015. It was my two years in the summer program that made me aware of U of T. Being able to live in the dorms, attend classes and labs, and explore the city made me fall in love with the campus, especially the fast-paced metropolitan city life in contrast to the suburban life back home in California. More importantly, through the program, I was exposed to the lab environment. Of course, it was more than the allure of lab coats and micropipettes, but my time in the labs sparked my interest in research, hence am now pursuing genomics and hoping to learn more about hereditary diseases. Thus, when it came down to deciding which college to attend, all these factors placed U of T high up on the list.
Near the beginning of second semester of my first year, I started thinking about what to do over the summer. I couldn’t waste the 4 months and knew I needed the exposure and experience in professional labs if I plan on becoming a genetics researcher, hence started looking for research internships.
I was offered an internship position at the biopharmaceutical company, AbbVie, back in California, and it was quite an interesting experience applying for the position. I thought the first phone interview went decent but I was aware that I didn’t express enough interest in a particular aspect of research associated with the position. A month later, I interviewed a second time. It went really well until the interviewer said, “Let me ask you a challenging question.” I was expecting a deep theoretical question, and it ended up being, “Introduce yourself and your career goals in Cantonese.” In all fairness, my auditory skills are on point and I can understand conversational Cantonese, however, truthfully, my speaking skills had grown too rusty after not speaking it at home anymore. Hence, in my response, I managed to fluently get out my name, age, and school. I tried talking about my hobbies; trying to say “hiking with friends” turned out in me saying “taking walks with friends”, and “baking” turned out to me saying “cooking”. I was stumped when trying to describe my career goals as I blanked on how to say genetics and research and complicated bio words. Least to say, the awkward silence as I tried to come up with the right thing to say was mortifying. Little did I know that the interviewer would become my current manager (great guy), but hey, he hasn’t brought up the mortifying experience and I now have an embarrassing interview story to tell and a lesson learned.
Meanwhile, my parents connected with a family friend who was a scientist at Stanford. She was looking for a student research trainee to help her with her research project studying pulmonary disease, working with mice, and it was a fitting role for me.
I found out I was accepted to the research internship at AbbVie and luckily, the timing works out with my shadowing at Stanford. One internship would give me more practical lab experience while the other would give me a taste of the bio corporate industry. Hence, it’s the best of both worlds this summer – getting to experience both academic and industry research.
All in all, I am here today, about 1.5 months into the research internships, and having a blast. I had a wonderful first year of undergrad, and as I reflect, am very grateful for my time in YSP for bringing me to U of T and exposing me to the medical research world.     
 
-Michelle Cheung

My Past and Future at U of T: Helena Lan’s Perspective

 



Hey everyone, it’s been a while since I posted here. In case you don’t remember me – my name is Helena Lan, and I started in Professor Pascal Tyrrell’s group as a ROP299 student. Fast forward to the present, I have finished my specialist program in pharmacology, and will be graduating with an Honours Bachelor of Science degree later this month! But if you think that I am finally leaving U of T – nope, my journey is not over yet. This August, I will be living my dream of many years as I start my MD training at U of T! As I prepare to begin the next chapter of my life, I wanted to share with you how my involvement in Prof. Tyrrell’s group paved the way for me achieving my goal today.

At the end of my first year of undergrad, I connected with Prof. Tyrrell and took on a project investigating how the choice of non-invasive imaging modality for diagnosing carotid stenosis impacts patient care (check out my experience here https://www.tyrrell4innovation.ca/2014/08/helena-lan-summer-2014-rop.html).
Afterwards, I continued on as a research assistant, where I ­explored the need for statistics and research methodology training in the medical imaging department.  My early research endeavours showed me that research was not just pipetting; there is a diversity of research that can drive innovations and improve patient care. 
That being said, I also wanted to experience working in a wet lab setting. So upon completing my second year of undergrad, I ventured to the Karolinska Institute in Sweden to investigate the tumour killing mechanism of Natural Killer cells (find out more about my project here https://www.tyrrell4innovation.ca/2015/02/who-is-going-to-karolinska-institute.html). After a summer in basic science research, I decided to switch gears into translational research, where I worked on strategies to augment the therapeutic utility of stem cells and enhance the drug delivery platforms at Prof. Jeff Karp’s lab at Brigham and Women’s Hospital, Harvard Medical School. After I returned from Boston, my passion for discovering ways to improve existing treatments for diseases led me to my current work at Dr. Albert Wong’s lab at CAMH, where I am assisting with the characterization of a novel animal model for schizophrenia with the ultimate goal of using it as a screening platform for new anti-psychotics.
In my experiences as a researcher, I’ve always been very excited at the prospect that what I am working on right now may be brought into the clinic sometime down the road and offer benefits to patients. Then one day, I thought to myself, “How rewarding would it be if I can get involved in patient care, where I can directly impact the life of the person sitting in front of me?” With this idea planted in my mind, I decided to shadow a physician. As I observed how a doctor applies their scientific knowledge and the findings from medical research to figure out ways to best help their patients, my attraction to medicine gradually evolved. For a long time, my goal in life has been to make a positive impact on other people’s lives. But after that shadowing experience, I realized that I wanted to do so through taking on the role of a clinician.
I am incredibly grateful to the U of T medical school for giving me the opportunity to pursue my dream, as well as the pharmacology department and New College for their recognition of my undergrad academic achievements with the Dr. Walter Roschlau Memorial award and the Tricia L. Carroll Memorial Prize in the Life Sciences. But more importantly, thank you to U of T for the unforgettable undergrad experience. Not only was I able to immerse myself in fascinating science and interesting research, I was also connected with mentors who provided unconditional support to me along my journey. Even though the ROP project I worked on under the supervision of Prof. Pascal Tyrrell and Dr. Eli Lechtman ended years ago, the two of them have provided invaluable mentoring to me even to this day.
University can seem arduous at times, and it is almost inevitable that we run into obstacles here and there. But no matter how difficult the circumstances may be, never, ever, lose sight of your goal. Surround yourself with people who cheer you on, and invest the work that is necessary to reach your ambition. And one day, your dream will come true!  
All the best,
Helena Lan

Walk Like an Egyptian!

So, in my last post I talked a little about Mesopotamian medicine (see here). I am certain many of you were thinking: “What? Should he not be talking about ancient Egypt?”. Well, of course, you are right – kind of… 


Egypt rose under the pharaohs during the same period as the Mesopotamian kingdoms (from about 3000 BC). They were known for their crazy ambition and technological prowess. Their medicine was very similar to that of the Mesopotamians in that it was influenced strongly by superstition  and religious beliefs. They too had three types of healers: the swnu who practiced medicine, and, of course, the priests and the sorcerers…




One of the reasons that ancient Egyptian medicine had a greater influence on modern medicine was that they were very good at documenting and archiving their work. The Ebers papyrus (c. 1550 BC) was their principal medical document that measured over 20 meters long (it is a scroll after all) and is the oldest surviving medical book. 




The Egyptians believed we were all born healthy but were susceptible to disorders caused by demons or by intestinal putrefaction. So the importance of eating your fruits and veggies was started way long ago! They also compared our vascular network to that of the River Nile and its canals and, therefore, it was important to keep the flow free from obstructions (see here for another interesting comparison!). Though they did not appreciate vascular plaques (atheroma) at the time they had already started to  figure out the importance of a healthy vasculature. Cool! 










As with Mesopotamia, Egypt’s powerful governance created a good environment for organized medical practice. However, because both regimes were highly codified (implying many strict rules based on religion and superstition that did not allow for discussion and experimentation) it will not be until ancient Greece that the roots of modern medicine will take hold.




Dance around your living room (in private if you must) to Walk Like an Egyptian by The Bangles in order to decompress and…


… I’ll see you in the blogosphere.




Pascal Tyrrell

Who is Going to the Karolinska Institute this Summer? Helena Lan Is, That’s Who!!!!










The Karolinska Institutet is one of the world’s leading medical universities and is located in Stockholm, Sweden. Did you know that in 1895 Alfred Nobel appointed the Karolinska Institutet to annually award the Nobel Prize in medicine or physiology? Now you do.

So, you may have read my previous post about “Connectory”. Well today I want to talk to you about one of my Research Opportunity Program students at the University of Toronto, Helena Lan. Not only was she a star student with me last summer (see her timeline post here) but she has continued on with our MiVIP group contributing to a systematic review on research methodology and biostatistics in medical imaging (stop rolling your eyes, it IS an interesting topic!).


Well she just found out that that she has been invited to work at the Karolinska Institute this summer as part of the Summer Research Abroad Program at the University of Toronto which is sponsored by the the Centre for International Experience. WOW!!!







Her supervisor will be Dr. Sofia Johansson, an assistant professor at Karolinska Institutet. Her research is focused on natural killer cell biology. You can find her research interests here.

Want to know about what natural killer cells do as part of our innate immune system? Watch this cool video.












Cool right? Well, I enjoyed it anyway. Maybe you need to watch Mr Brightside by The Killers to recover and…

… I’ll see you in the blogosphere.
PS: Congratulations Helena!!!

Pascal Tyrrell

The story behind Connectory…

So, you are reading our blog thinking Pascal is a nut – that much is clear – but what of all the students plugged into his group? Are they nuts too?


Well maybe, but today I am going to talk to you about the group of four (not the group of seven) who started small and grew to be Connectory. John, Maria, Natasha, and Roger met in a graduate course at the University of Toronto and decided to work together on a project about innovation. That’s when they met me, joined “the program”, and got busy! Starting any endeavour from scratch is no easy task. All four had never met before, all came from very different academic backgrounds, and though their initial project was for “credit” the rest was on their own time.


There were some rough times at first but with perseverance comes success and Connectory was born and is just finishing up its first project as a new start-up business. Wow! 


Essentially Connectory is a data management solutions software development consulting group that operates in the healthcare space. Check out their webpage here.


Ok, so what? Well this post is not only to congratulate these four on a job well done but also to encourage you to do the same. One thing is for sure: if you don’t try you will not succeed – ever. My programs are all about learning, trying new stuff, benefiting from your successes as well as your failures, and wait for it… giving back. Yup as Uncle Ben said in Spiderman: “With great power comes great responsibility“. 


Just wanted to share a good story from our group with you today.




Listen to Bulletproof by La Roux to get pumped and…


… I’ll see you in the blogosphere!




Pascal Tyrrell

MiWord of the Day Is… Cinemaradiology!

Yes, it is Halloween today and my kids could barely contain themselves getting ready for school. I suspect today will not be very productive as they count down the minutes before heading out to terrorize my neighbors.


Anyway, how about this for a scary thought: cinemaradiology! In the late 1800’s John MacIntyre at the Gasgow Royal Infirmary experimented with producing X-ray motion pictures. What!!!? He tried exposing film by passing it between the screen of the fluoroscope and the x-ray tube and by simply filming the fluoroscopic screen. This latter method was very difficult because, as all of you budding radiologists know, the images viewed on the fluoroscope screen were dim and of poor resolution at the time.


For years researchers worked on perfecting cinemaradiology. However, during those early years of discovery they lost interest when they realized that sharper images were possible when BOTH patients and investigators were exposed together AND that excessive radiation was a bad thing – duh! 


It would only be many many years later that fluoroscope screen technology would be improved to allow for brighter and higher resolution images (and without frying the patient and everyone around!). 

Fluoroscopy is a study of moving body structures – similar to an x-ray “movie.”  A continuous x-ray beam is passed through the body part being examined, and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail. As an imaging tool, Fluoroscopy is used in many types of examinations and procedures.

To my knowledge, no actors from the cinemaradiology era ever became successful stars in Hollywood…


No need to use the MiWord of the day in a sentence today (see rules here) as I realize you are busy getting ready for Halloween and need a break!


Decompress listening to the classic song Thriller by the King of Pop Michael Jackson and I’ll see you in the blogosphere…






Pascal Tyrrell

 

MiWord of the Day Is… Cuckoo!

One of my favorite more serious films is One Flew Over the Cuckoo’s Nest. What does Jack Nicholson’s portrayal of a bad guy hoping for easy served time in a mental institution have to do with medical imaging? Well it all starts with the lobotomy. Not to spoil the story, suffice it to say that the movie broaches the topic of lobotomies and how ridiculous they were. Lobotomy was a form of neurosurgery that involved damaging the prefrontal cortex in order to “calm” certain mentally ill patients. Needless to say the procedure was controversial from the beginning (1935 to the early 1970’s) but the author of the discovery, Egas Moniz, was awarded the Nobel Prize in 1949. Maybe not the most sound of decisions by the committee. However, for the time, it was considered progress in a very challenging area of medicine – mental illness. 


OK, medical imaging? Well as it turns out Moniz (do not confuse with St-Moriz, ahhh skiing…) is also known for developing cerebral angiography – a technique allowing the visualization of blood vessels in and around the brain. 



Moniz was interested in finding a non-toxic substance that would be eliminated from the body, but would not be diluted by the flow of blood before the x-ray could be taken. Another requirement is that the substance could not cause an emboli or clot as this would be a bad thing. Moniz played with salts of iodine and bromine and settled on iodine because of its greater radiographic density. And voila, birth of iodinated radiocontrast agents still in use today. Cool.




Supposedly it took him 9 patients to perfect his angiogram technique. Don’t ask about the first 8…

Moral of the story is: lobotomy bad and cerebral angiography good.



Now for the fun part (see the rules here), using Cuckoo in a sentence by the end of the day:

 
Serious: Hey Bob, when I was visiting my aunt in Australia I spied a little bronze cuckoo in her backyard! This could be my “big year“…


Less serious: Someone won a Nobel Prize for developing the lobotomy? Are you cuckoo?
 
 
Listen to Los Lobos (not short for lobotomy but “the wolves” in Spanish) singing La Bamba to decompress and…
 
… I’ll see you in the blogosphere,
 
 
Pascal Tyrrell

MiWord of the Day Is… Fluoroscope!

It is hard to believe that the fluoroscope (essentially an x-ray machine used to produce real-time moving images viewed on a screen of the internal structures of a patient) was used to “help” better fit shoes to your feet! From the 1920 to about 1970 you were able to irradiate your feet with x-rays in order to see if you had enough “wiggle-room” in your new shoes! Crazy. 
 
So, the whole concept of Fluroscopy dates back to you know who, Wilhelm Röntgen. We chatted about him here in our blog. He is also responsible for discovering the interesting phenomenon of barium salts fluorescing when exposed to x-rays (see here in our blog). 
 
Basic function of a fluoroscope
Soon after Rontgen’s discovery was announced, Thomas Edison (the light bulb guy) decided he could improve on this whole x-ray thing as these rays were produced by a “glass tube apparatus” – something he knew a lot about. After setting his team to work – he had a team as he was a very successful man in those days following his 1879 patent of the light bulb – they soon discovered the risks of working with x-rays. Edison decided to remove himself (literally!) from x-ray research. But before he did he developed one of the first (and arguably the most advanced in it’s time ) fluoroscopes along with a full line of x-ray kits. He also coined the term “Fluoroscope”. Interesting man…
Fluoroscopes have come a long way over the years and are still used today in areas such as orthopedic surgery, gastrointestinal investigations, and angiography but, of course, the dose of x-rays a patient receives is minimized and closely monitored. Have a look at this machine from Siemen’s. “Beam me up Scotty!”. 
So how did all of these machines suddenly flood the shoe retail industry? Good question. As it happens, following the development of the high vacuum, hot cathode, tungsten-target x-ray tube by William Coolidge in 1913 the interest for a portable and reliable machine increased dramatically with the advent of the First World War. The successful deployment of numerous machines during the war to aid army physicians spurred the manufacturing industry to mass produce them. After the war, the impact the fluoroscope had on army medicine flowed into community practice. 
 
Due to the enormous supply of portable x-ray machines at the time following the end of the war, Dr Jacob Lowe introduced the idea of using a modified portable x-ray machine in the shoe retail industry. Voila, fried feet fricassee for the next 50 years!

Now If were to be interested in using a fluoroscope to look at my feet I may be inclined to use a suit like this gentleman below is sporting…

WW I x-ray protection suit

Now for the fun part, using Fluoroscope in a sentence by the end of the day:


Serious: Bob, did you know that the foot-o-scope was a modified fluoroscope used to view ones feet when fitting new shoes which delivered on average 13 Roentgens for every 20 second exposure?


Less serious: I heard grampa grumbling he can never find shoes that fit right anymore since they banned fluoroscopes in shoe stores. What is a fluoroscope mommy?




Listen to High Heels to decompress and I’ll see you in the blogosphere.




Pascal Tyrrell

MiWord of the Day Is… Radio!

Easy one today! I thought I would give everyone a break as you have all been working very hard on the MiWord of the day in the past weeks. 


So, what does radio have to do with medical imaging? What a great question! The origin of the root word “Radio” is radiant energy. The radio you immediately think of is the one that is attached to your ear most of the time and has a DJ who selects music to play for your entertainment – along with ads to pay for the station’s bills! The use of “radio” to describe this form of wireless communication comes from the word radiotelegraphy


How about if we were simply interested in a medical picture produced by radiant energy? Well you would end up with a radiograph AKA an x-ray! We talked about that word here. Do you see the trend? How about a picture produced by radiant energy in the visible light range of the electromagnetic spectrum? A photograph. Cool.


OK now suppose you are an MD working in the emergency department and someone presents with a lung disorder. What do you do? Generally, you order a chest radiograph. As you zap your patient with x-rays you expect that most of them will pass through the chest area – that is mostly filled with air – unchecked and will proceed to expose the film (or trigger the detector) resulting in a dark area. However, if the lungs become filled with abnormal substances more of the x-rays are blocked and result in a lighter (whiter) radiograph. What would you be looking for?





1- Pus – a combination of bacteria and white blood cells as seen with pneumonia.
2- Edema – fluid that leaks into the lungs as seen with heart failure.
3- Hemorrhage – bleeding into the lung cavity as seen with trauma.
4- a solid mass – as seen in lung cancer.



Today, we have to use “Radio” in a sentence (see rules here). Easy! Here are two examples to help you along:


Serious: Bob, you will need to remove your radio from your person before entering the MRI. No metal objects are permissible in the room.


Less serious: I went for a radiograph today and all they did was have me stand in a room by myself and that was it! What a relief. I thought for a moment I was scheduled for a radio-graft…!



Have a listen to my favorite Radiohead to decompress and…


… I’ll see you in the blogosphere,




Pascal Tyrrell

MiWord of the Day Is… Ionizing!

So what the heck is ionizing radiation? Well consider the following conundrum about x-rays. They can:


1- cause cancer
2- be used to detect cancer.
3- be used to treat cancer.


Whaaat? How does that work?  We use the term ionizing  when the radiation has sufficient energy to detach electrons from molecules causing them to become chemically reactive ions




The name atom means “indivisable” and are incredibly small. They are made up of protons, neutrons, and electrons with about 99.9% of its mass concentrated in the nucleus that holds a positive charge. A surrounding negatively charged cloud of electrons makes up the difference and the atom stays together due to the attraction between the two. 


OK, so here is the rub: if an atom gains or loses an electron it becomes an ion and generally results in a very chemically reactive substance. This process to produce an ion can be achieved by many ways but one of the most important is electromagnetic radiation (we’ve talked about this already here). Radioactive materials such as radium emit ionizing radiation as does x-ray tubes. There is even such a thing as cosmic radiation (Yup, we talked about that here!). 


Now x-rays produce photons which are the same particles that make up visible light but at a much shorter wavelength and higher energy. When they penetrate through a solid object they will most often simply pass through. However, if they pass by close enough to an electron they can transfer their energy and in the process knock it out orbit producing an ion. Also, the more dense the object the more often the photons are blocked from travelling through resulting in a differential effect on a film or sensor placed on the opposite side. This is how we are able to see inside the body using x-rays.


The problem about ionizing radiation is that the resulting chemically reactive ions can result in DNA damage. Often the cell can repair itself resulting in no permanent damage. Other times, however, permanent damage occurs and can result in cell death (a good thing if they are cancerous cells) or DNA mutations that can in turn lead to the promotion of cancer – bummer.


Now on to using ionizing in a sentence today (not sure about the rules? See here):
Serious example – Bob, don’t stand too close to the x-ray machine. You wouldn’t want to be exposed to ionizing radiation that could damage the DNA in your cells…


Less serious – You wouldn’t believe what happened to me at work today! I was at the photocopy machine getting ready to change the toner cartridge and Bill from sales said:”Let me do that for you, Honey”. He is so ionizing or patronizing or whatever. He makes me mad… 




Listen to Just Because by Raygun to get ready for the weekend and I’ll see you back in the blogosphere soon.




Pascal Tyrrell