Medical Student Research Symposium 2022

[Chris Childers]: The project that I'm working on is a focused ultrasound to basically treat biofilms off of catheter based medical devices. Anytime we put these devices inside the human body, they can grow biofilms, and that bacteria can harbor there and cause infection in the body. So what we want to do is be able to remove and kill those biofilms on those medical devices non-invasively by using ultrasound.

We didn't have a whole lot of literature on whether or not this was actually feasible. And so kind of the first part of my project was really kind of that proof of concept of determining is this feasible? Is it possible? Can we get a cavitation cloud or an ultrasound histotripsy cloud inside the lumen of a catheter? Can we remove a biofilm and can we, you know, kill bacteria? The kind of the three just general big questions that we had at the beginning of the project.

[Eli Vlaisavjevich]: Chris really started this entire project, which was a completely new direction for our lab. So histotripsy is the core technology that our group works on is a focused ultrasound technology that we're currently developing for a lot of applications, but mostly in oncology. So noninvasive treatment of tumors, liver tumors. We have some work on pancreatic cancer. So Chris came in and was very interested in developing the technology, a version of this that we could actually use for the treatment of biomaterial associated infections.

[Chris Childers]: What we found in my project was that, one, we could use focused ultrasound to treat the inside of a catheter. We also found that focused ultrasound when we applied to this catheter will remove a biofilm from the catheter. And lastly, we found focused ultrasound will also kill bacteria in suspension. The future of medicine is starting to do things through smaller incisions, through completely potentially, in our case, noninvasive procedures. And if we could do that with this technology, you know, it means the world to the patient because then they don't have to have, you know, a needle stick. They don't have to go under the scalpel or anything. It's just an ultrasound device. Like you would go and have your baby ultrasound.

I originally wanted to go into emergency medicine. But this project exposed me to radiology and interventional radiology, kind of learning about the minimally invasive and noninvasive ablation methods. And from that, I started to become more interested in it, did more research, and now I've just applied to interventional and diagnostic radiology for my residency choice.

[Eli Vlaisavjevich]: I work with a lot of the leading interventional radiologists in the world, and I think Chris is the next in line to take over for that. He has that same attitude and that's not only caring about the patients, but is thinking ahead to what's next and how can we have more noninvasive technologies that can, you know, not only improve the outcomes of patients, but the quality of life going through these therapies. He really has that approach.

[Chris Childers]: If this becomes the next technology that we use to make sure that we keep medical devices sterile and keep patients from becoming septic from a implanted medical device, I mean, that's that's massive.

[Ariel Badger]: When I came to medical school, I knew I wanted a clinical research project, one that I could see the effects somewhat immediately, of course, relatively speaking. So when I met with Dr. Apel and I saw he was answering this question that patients really want to know the answer to, I immediately wanted to come on board.

[Peter Apel]: It's unknown after different types of surgery, whether it be on the wrist or the shoulder or the knee when a patient's safe to go back to driving. And these are everyday common questions from patients. Ariel's study was intended to answer a question of when can I go back to driving after having my carpal tunnel surgery?

[Ariel Badger]: We didn't know if we could really even measure driving fitness. And so when we began this it was really kind of see what happens. Let's see if it's possible. We came up VTTI, we looked at their instrument vehicles, They collect all sorts of information from different camera views to all the kinematic metrics. Yaw, acceleration, speed. It will have GPS coordinates. It looks at even steering wheel angle. After we found that we could effectively and objectively measure driving fitness, it was great to be able to take kind of this proof of concept that was done on just healthy volunteers into an actual patient population.

In the enclave, That's where we take the data collected in the from the hard drives in the car, which include, again, all the kinematic metrics as well as the camera views. And what we got to do was go through each video and determine the timestamps at which certain maneuvers were occurring. So I would kind of go frame by frame write down the start point and end point of those maneuvers so that we could ultimately extract the kinematic data.

[Peter Apel]: We want to do this in bigger surgeries. This project started out asking simply a question about carpal tunnel release. And with our methods and the skills that we gained, we're able to answer the same question about rotator cuff release. So what we found out, surprisingly, was that patients can drive pretty soon after surgery. She found in her research that the traditional way of looking at this problem by simply measuring patients in a simulator doesn't capture who they are with their adaptive abilities. And in that way, she's changed the way that we think about this problem.

[Ariel Badger]: I think the research curriculum is very important. It's a wonderful feeling to be able to really answer the question patients want to know the answer to. I feel like that's something that has been said quite often for this project. It has far exceeded my expectations. So it's truly been such an enjoyable experience, and I'm really glad to have been a part of it.