|Elizabeth Lehner – YSP 2015
Maybe not all rest and relaxation but certainly radiology and rheumatology! Here is a great example of why collaboration between disciplines is so important in medicine. Elizabeth recently graduated from Iroquois Ridge High School and will be a new University of Toronto student this fall. See her post below.
Great job Elizabeth!!!
Many people are familiar with the word arthritis. This is probably because one in six Canadians aged 15 years and older report having arthritis. Rheumatoid Arthritis is a specific form of arthritis that unfortunately can lead to severe disability and joint replacement.
Over the past several weeks, I participated in the 2015 YSP research program with the Division of Teaching Laboratories within the Faculty of Medicine at the University of Toronto and had the opportunity to look more closely at Rheumatoid Arthritis and ways to better diagnose this debilitating disease.
Under the supervision of Prof. Pascal Tyrrell and the Department of Medical Imaging at U of T, I was introduced to various imaging modalities including MRI machines, CT scanners and ultrasound machines. The work by Dr. Tyrrell was of particular interest given his studies on inflammation and the use of the various imaging modalities.
As part of this program I also participated in specific lab tasks including dissections and micropipetting and was exposed to clinical work such as suturing and operating an ultrasound machine. In addition, the program provided me with the opportunity to participate in daily workshops led by two instructors from the Division of Teaching Laboratories, Jastaran Singh and Jabir Mohamed. These workshops provided important overviews on a variety of topics relating to research that were very interesting.
The things I learned in this program provided me with a much better understanding of various research and medical issues that I think will be of use to me as I begin my studies at the University of Toronto this fall.
I would very much like to thank Prof. Pascal Tyrrell, Jastaran Singh and Jabir Mohamed for allowing me to be exposed to the various projects and for answering the many questions that I had during the program. Thank you!
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.
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!
|The Moody Tree
Ok, so I may have taken a longer break than I should have. Where was I you ask? I was enjoying some R&R with my family. My kids are at great ages – 15, 11, and 6. Then, of course, when I got back to my desk – whammo! The deluge of work. This morning, as I sat on the GoTrain on the way into Toronto, I thought of you and happily sat down to write my first post of 2015.
First, a thank you for your readership. We are soon approaching our first anniversary (next month) and my programs (MiVIP and MiB) and this blog are chugging along famously… all because of you!
Next, a funny story to explain the picture above. When I attended the RSNA last December (see my post here on this event) I brought along my old film camera for fun as I enjoy photography and decided to reminisce a little. To your right is a picture of the Chicago skyline reflected on the “Bean“. See me?
I hadn’t developed film in so long that I almost ruined it – in my laundry room between all of my family’s clothes, the ironing board, buckets, detergents… Anyway, I also had with me my trusted digital for snaps and one evening I was invited to a function at my boss’ hotel and he said to me:”Let me know what you think of the Christmas lights on the trees in front the hotel on your way in”. Alan Moody is an uber-radiologist, the chair of our department, and loves imaging the carotid arteries. As our minds often operate on the same wave lengths, I took the picture and voila – the Moody Tree was born!
There is no end to the fun we have here in the Department of Medical Imaging…
Even though this is not a “MiWORD” post how about you wish a belated Happy New Year to someone you have not been in touch with yet? Send them a quick text or better yet, send them the link to this post and tell them to visit the Moody Tree next time they are in Chicago during the holidays…
See you in the blogosphere,
MiWord, a post on Sunday?!!! Well, I have been very busy lately and fell behind on my blog so I am now playing a little catch-up…
I was waiting in Logan airport for my flight back from a presentation in Boston – what unbelievably crazy traffic in that city – and I was texting my kids with my laptop open and my tablet next to me on the seat when I thought: I feel a little like Jimmy Neutron! I enjoyed watching that show with my kids. Lots of fun. Anyway, that idea of crazy science and the internal structure of the atom as displayed on Jimmy’s t-shirt may be the premise for a great kids show but it also led to the development of MRI. What?!!! You say.
MRI is an imaging technique. Maybe so, but it is particular in that it does not use any classic photographic equipment (film or lenses) or use x-rays as Roentgen did. It simply numerically measures how hydrogen nuclei absorb and release energy in response to particular frequencies. Need a refresher on the structure of an atom? See this post.
Don’t get it? OK, how about you think of this process as a crazy huge tuning fork. If you were to flick a tuning fork of a certain frequency (pitch) other tuning forks of the same frequency close by will pick up energy from the humming tuning fork and emit a sound in turn. Cool.
The nucleus of an atom can absorb energy and then relax by emitting energy in a similar way. Different atoms (or the same atom in different environments) will have different relaxation rates allowing for the identification of the composition of molecules. Ya, maybe a little complicated.
MRI measures how hydrogen nuclei absorb and release energy. Dependent on the location and the environment of the hydrogen atoms the MRI process is able to provide knowledge about the placement of hydrogen atoms in the body and in turn knowledge about the anatomy.
Now for the fun part (see the rules here), using Atom in a sentence by the end of the day:
Serious: Hey Bob, did you know that the atom is the smallest unit that defines the chemical elements and their isotopes?
Less serious: I thought that splitting atoms would produce a large explosion but when I tried using my mom’s perfume “atomizer” it just produced a fine spray and nice smell…
Ok that was a little intense for a Sunday. Watch and listen to Symphony of Science (very cool BBC production) to decompress and I’ll see you in the blogosphere…
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…
This week and I had the pleasure of presenting to the Division of Rheumatology Research Rounds – University of Toronto. They were a fantastic audience who asked questions and appeared to be very engaged. Shout out to the Rheumatology gang!
So, I was asked to talk about a statistical methodology called Cluster Analysis. I thought I would start a short series on the topic for you guys. Don’t worry I will keep the stats to a minimum as I always do!
Complex information can always be best recognized as patterns. The first picture below on the left certainly helps you realize that it is not a simple task to know someone at a glance.
Now, I guess it doesn’t help that many of you have never met me either! However, you can appreciate that things get a little easier when the same portrait is presented in the usual manner – upright!
This is an interesting example where the information is identical, however, our ability to intuitively recognize a pattern (me!) appears to be restricted to situations that we are familiar with.
This intuition often fails miserably when abstract magnitudes (numbers!) are involved. I am certain most of us can relate to that.
The good news is that with the advent of crazy powerful personal computers we can benefit from complex and resource intensive mathematical procedures to help us make sense of large scary looking data sets.
So, when would you use this kind of methodology you ask? I’ll tell you…
1 – Detection of subgroups/ clusters of entities (ie: items, subjects, users…) within your data set.
2 – Discovery of useful, possibly unexpected, patterns in data.
OK, time for some homework. Try to think of times when you could apply this kind of analysis.
I’ll start you off with an example that you can relate to. Every time you go to YouTube and search for your favorite movie trailer you get a long list of other items on the right that YouTube thinks may be of interest to you. How do you think they do that? By taking into account things like keywords, popularity, and user browser history (and many, many more variables) and using cluster analysis of course! You and your interests belong to a cluster. Cool!
In this series, we will delve into this fun world of working with patterns in data.
Now that you have peace of mind, listen to The Grapes of Wrath…
See you in the blogosphere,
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,
Happy Canadian Thanksgiving!!!
A traditional holiday – originating from the native peoples of the Americas – to celebrate the completion and bounty of the harvest. Well, no harvest for me but I will take the time to appreciate some of the successes of our MiVIP program and this blog over the long weekend.
Thanks for being a part of it!
See you in the blogosphere,