Oh My Melanoma! – Day 4

*Alarm blaring at 5am* – That is how I started my morning. Dr. Ingraffea normally starts his day at 7:30, but on Fridays he starts at 6:30, which unfortunately for my sleep pattern, means I too had to start at 6:30. He starts early on Fridays because that is the day he does surgery on melanomas. He told me I could come in at 7:30 if I wanted, but I figured I should go through what an actual doctor does on a regular basis, and besides, I would never pass up the opportunity to see surgery on a melanoma!

For basal and squamous cell carcinomas, it takes the lab about 30 minutes to stain the mohs layers, but for a melanoma, the layers go through a specific staining process to contrast the melanocytes from the background tissue. This process takes an extra 45 minutes, so Dr. Ingraffea really hopes he can get out the melanoma in one layer, or at the most two. Thankfully both melanomas were cleared in 2 layers at the most.

One of the patients was quite the bleeder, due to a specific known medical reason, so we were expecting it and had extra gauze ready. This patient’s reconstruction took much longer than others because we had to continue cauterizing the blood vessels to minimize bleeding. Dr. Ingraffea let me put on some surgical gloves and retract the skin as he cauterized the bleeders. It was so cool to be up close and actually getting to be a part of the surgical process!

Most cases were finished fairly quickly, which is exactly what I liked to hear on a half day! We did have one case that seemed like nothing but ended up taking 6 layers to clear and that is why mohs surgery is so important and useful!!

After work was done, I was able to make it to Cary Dermatology again and hang out with Hannah and Oyinlola for a drug rep hosted lunch. (We had Boston Market and it was delicious!!)

WEP Day 3 @ Lindy Biosciences

This morning a pipette vender came and talked about the benefits of the pipette tips he was selling.  It was very interesting to hear about all the technology that goes into the basic lab equipment that scientists use every day.  Later today I rehydrated the ovalbumin I previously microglass-ified and analyzed it with UV spectroscopy and prepared it for size-exclusion chromatography.  Although I did not do much today, at least compared to yesterday, I enjoyed being able to practice UV spectroscopy and learning about size-exclusion chromatography.

Day 2– Duke Work Experience

Today, I started my morning in the Stem Cell Laboratory. I was shown how scientists prepped donor cord blood cells to give to the patient. The cells were stored in a specially designed freezer, shown below. they were then diluted, centrifuged and then attached to IV cords. I learned that contamination was one of the main concerns when prepping cells, so after the centrifuging, the supernatant was kept to be tested for contamination. After the cells were prepped, I then rode with them to the Children’s Health Center.

In the Children’s Health Center, I shadowed another doctor and watched the cells that were prepped earlier be injected into the patient. In total, I was able to watch three of these infusions during the day. These infusions of cord blood cells are part of a clinical trial dealing with the brain that Duke is working on right now. Watching the whole process from the prepping of the cells to the infusion gave me a well-rounded experience in the medical world.

WEP Day 1 @ Lindy Biosciences

Today was the first day of the work experience program.  I went to Lindy Biosciences, a development-stage protein therapeutic formulations company, located in the Research Triangle Park.  This company is a two year old start up with novel Microglassification^TM technology.

While Microglassification is a very long and complex word, their technology involves dehydrating proteins into a stable bead shaped solid.  Proteins normally contain a large quantality of water which increases their weight. Microglassification removes much of this water resulting in a fine power.

Normally during drug delivery large amounts of proteins require delivery through an IV; however, Microglassification allows solid protein “balls” to be injected with a needle subcutaneously (under the skin).  This would allow patients to receive medicine as a quick shot instead of a long IV treatment.

After only two years, Lindy Biosciences have an impressive list of clients, containing some of the top pharmaceutical companies.  I can’t wait to continue my internship and get to help in their lab tomorrow.

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WEP Day 2 @ Lindy Biosciences

I was thrilled to work in the Lindy Biosciences lab for the first time.  Today I learned how to use a UV spectrometer.  I found the standard curve of ovalbumin.  I had been recommended before the start of this program, by actual biological researchers, that I should get experience working in a lab.  After working in a lab all day, I can say with some measure of confidence that I do not hate lab work.

The spectroscopy was very repetitive (I had 17 samples I needed to analyze), but it was also quite exciting.  After lunch, I was able to see the results of the analysis and it was very gratifying.  Adam was able to find the extinction coefficient of the samples of ovalbumin at a particular wavelength based off of my results.  I was very happy to hear that I did not have to redo the analysis and the results were helpful.

All About the Nurses!!

Today I got to work a bit before Dr. Ingraffea and I got to hang out with all of the nurses for a bit and ask them some questions about their job. I got to follow one into the room as she prepped the patient for the doctor to come in and understand the hard work that goes into a doctors visit. I must day, nurses don’t get enough credit for all they do to keep the office running so smoothly! Once the doctor got in, we had a well paced day with a lot of interesting cases! Of course I cannot really disclose the information about the cases, but there were a lot of long cases and I got to look in the microscope and see where the cancerous cells were on the skin. Some of the patients were brand new and this was their first skin cancer, some past patients came for another removal, and there were a few there for a post-op check up, so I got to see all aspects of the job in just one morning!

Day One is Done!

Having to get up at 6am was quite the change after getting to sleep in for almost a week. I had bought some scrubs to wear as I shadowed at the Cary Skin Center, and let me tell you, they’re quite comfortable!! I made sure to bring my hydroflask to stay hydrated throughout the day, but it was definitely difficult because of the fast paced environment. I was brought to the lab and was taken through the process of preparing, slicing, and staining the slides for the doctors. It was quite an interesting process and it was crazy how thin they could slice an already thin layer of skin. Dr. Flynn used a different technique from the other doctors to remove layers. He uses a thin double edged razor which creates thin layers. I saw a lot of basic reconstructions on the face.  My feet sure did hurt by the end of the day, but I absolutely loved it!

ILS Day 1

If you drove past Integrated Laboratory Solutions, you wouldn’t be able to tell that the unassuming facade in quiet Southern Pines was actually a state-of-the-art testing facility. So color me a shade of suprised when our guide for the day, Dr. Sean Zhong, whisked us through rooms brimming with humming and whirring machines that I still can’t probably pronounce the names of.

After, of course, donning personal protective equipment–lab coats and glasses–we embarked on our first adventure for the day: a high performance liquid chromatogarphy (HPLC) machine. Dr. Zhong explained that this fine invention is utilized to process urine samples from patients, separating the constituent parts and checking them with a list of common prescription medications. This process is twofold: one, it can make sure that complex compounds are being metabolized and excreted correctly; two, it can ensure that certain addictive medications like opiates aren’t being abused, leading to patient accountability. At the same time, we stared in awe at the fully automated process–the robot arm of the HPLC could even close the drawer filled with patient samples!

Our second quest involved scrutinizing the mass spectrometer (MS), which was a big box with tubes entering and exiting like the veins and arteries of the heart, along with a dashboard of blinking lights. It really seemed like something out of Star Wars. Dr. Zhong performed a demonstration some hemp samples on hand–ILS also works in conjunction with Integrated Hemp Solutions to create medical hemp products–and pointed out how the MS calculates the proportion of compounds within a given hemp oil sample.

After a quick lunch at a local bakery, courtesy of the Dr. Zhong and the other great folks at ILS, we headed back to our workstations as the mass spectrometer was finishing up. Fortunately, the sample we saw being tested was legal because the MS detected a less than 0.3%–the legal threshold–of THC, or the part of the cannabis plant that leads to the “high.” Dr. Zhong pulled up some linear regression curves to model the compound concentrations, which I understod thanks to what I learned this year in ADV Stats (shoutout to Mr. Lazarski)!

I had a great first day and I’m looking forward to what will unfold in the next 3 days! Dr. Zhong had to leave today for a conference in California, but I’m sure we’ll meet some more awesome scientists over the coming few days.

Day 8 – Great Experiences and Sad Goodbyes

Even though it was the last day of my WEP, I still learned so much. Dr. Bermek and I had our usual morning meeting to discuss our plans for the day. We briefly talked about our gel from yesterday that unfortunately didn’t work, but that was what we were expecting. We decided to run an EtBr experiment that had been successful again because we wanted a better direct comparison. The samples we compared last time on the EM and on a gel were from different experiments, so this time, we prepared a larger amount of each sample so we could split them in half. We planned to analyze half the sample in the EM and half the sample on an Agarose gel to get the most accurate results. I was familiar with this experiment, and we already knew it worked, so it seemed to run very smoothly. I was also nice to have 7 days of experience under my belt. While Dr. Bermek was getting other things started, she had me add all the necessary ingredients to microfuge tubes. I added 50uL of Tris, 10uL of BSA, 25uL of NaCl, and varying amounts of water to each sample.

During the middle of the day, I presented what I had learned over my past two weeks the UNC Lineberger Cancer Center to four other people in the lab. It was a nice end to my wonderful two-week experience. I was happy to get feedback from Dr. Berkmek’s other collaborators.

After my presentation, there were still 30 minutes left before the end of the day. Dr. Bermek is a very hard worker, and she likes to take advantage of every minute she has, so we got right back to work. I started getting the grids ready so they could be drop spreaded and put into the EM. Once I was finished with that, I prepared my last Agarose gel with success! And just like that my work experience was over. It finished on a high note with a good presentation and a successful gel. I cannot even explain how much I learned by immersing myself in a lab setting. Although the experience was a little daunting at first, I am really glad I got this unique opportunity. I would like to thank Dr. Bermek for her continued patience as I was learning and making mistakes. Her warm personality is really what made this experience so enjoyable. I’m really thankful for all the lessons I got to learn, and I’m ready for summer!

The facinating -80 degree freezer

The EtBr samples I prepared

Our calculations and plans

The grids I prepared for the EM

Day 7 – Parlodion Magic

Today was full of learning new techniques and exciting experiments. Dr. Bermek and I spent the first half of the morning discussing the experiments she still had to complete before her paper about the Herpes Simplex virus could be written. We decided to perform an experiment that could potentially lead to never seen before results. There is a shape of DNA that people have not been able to get, but with the protein UL8 we have been working with, Dr. Bermek wondered if this protein could help make the DNA shape because UL8 relaxes DNA and creates a nicked structure. Dr. Bermek wasn’t super optimistic we would get results but she wanted to try anyway. A large experiment like the one we were about to do calls for a lot of controls because, if it works, we want to make sure we know exactly what helped create the desired DNA shape. We set up 7 reactions that each included or didn’t include a specific ingredient. For example, one sample didn’t have UL8 but had UL30. The reason is because there has been speculation that UL30 might cause DNA to become nicked, so we wanted to have it as an option, but if it worked, we wanted to make sure that it was the UL30 protein that caused the DNA shape not the UL8.

Dr. Bermek had me make the master mix which is basically a large volume of ingredients that needed to be added to each reaction. It is used to save time and eliminate unwanted errors. I was happy she trusted me enough to make it. The timing of the preparation of the samples was overwhelming and difficult. We had four different timers going all for different things. We had to add specific ingredients to some of the seven samples but not others in addition to making sure the timing was perfect. Some samples had to be heated for five minutes others had to be heated for 30, and there were other parts of the experiment that required keeping a close eye on the time. Dr. Bermek and I had a good system going to help everything run smoothly. She would take the samples out the hot water bath and give them to me so I could pipette the ingredients in. She would then put the samples back in the hot water bath to continue heating them. While she was working with radioactive materials, I prepared two Agarose gels. I measured out the Agarose, added the TAE or TBE buffer, dissolved the Agarose for 2 minutes and 15 seconds, let the mixture cool, and then poured the gel liquid into the apparatus to let it settle. This time, Dr. Bermek loaded the samples into the gel because some of them were radioactive and required special precautions. I didn’t trust myself enough to load after we had spent about 3 hours preparing the samples.

While the gel was running we prepared grids for the EM that we would use tomorrow. When I first used grids last week, they were already prepared so I was glad I got to see the full process today. There was a special solution we poured over the mesh where our grids would be housed. Once the mesh was completely submerged in the liquid, we carefully placed the grids one by one on the mesh making sure they stuck. I got to help Dr. Bermek with this step, and I really liked the precise nature of it. Then came the coolest part: adding the Parlodion. Parlodion is used to coat the gel grids so they can be used in the EM. The coolest thing was when we added a few drops of it to the solution that the mesh was in, it created a rainbow colored layer over the grids. I was really fascinated.

By the time we had finished the UL8 experiment and set up the grids, they day was just about over. Even though we may not get the results that weren’t likely to happen, I’m excited to see what the gel image and EM show us tomorrow on my last day working with Dr. Bermek.

The gel that contains radioactive material getting run behind a protective shield.

Getting ready to add the Parlodion.

The cool rainbow effect of the Parlodion.

The Agarose gel I set up.

Our designed experiment plans for the day.

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