Human Anatomy at Colby

Yvette Qu: My Overall Experience This Semester

February 22nd, 2015 · Comments Off on Yvette Qu: My Overall Experience This Semester

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Taking Human Physiology and anatomy as a freshman, I have found the course to be appropriately challenging and a great introduction into biology major. In the first few days of the course, the materials were somehow overwhelming to me. Everything needed to be memorized, and preview and review are required to do well on the quiz. However, the stress level was what I was expecting. I was hoping to learn more about biology and to decide if I can major in biology. Therefore, though I was a little terrified at first, I continued to work hard in the course, and I did gain more than I expected. Dr. Klepach had quiz after almost each lecture, and this stressed me out at first because I did not have the habit of reviewing things after each class. Being a procrastinator, I was more prone to leave everything before the finals despite the fact that I knew it was a bad habit. This course helped to reform my study methods. I have developed the habit of previewing and reviewing for each class, and the new method works perfectly. Another issue, which remained to be challenging, was the huge amount of terms of the labs. It was extremely difficult to remember hundreds of terms of minor body parts and to avoid forgetting them before the lab tests. For many time during the tests, I knew I had memorized the name of the model but could not remember how to spell it or the complete name. I did poorly on the first lab tests, but I had to admit that I did not work hard on the labs as I did for the lectures because I procrastinated the memorizing task to the last night. Despite the laziness, I forced myself to review for each lab, and as a result I did improve a lot from the first lab test to the second one. I am sure the reason is the amount of effort I put in for the second lab test. By the end of Jan Plan, I have been much more familiarized with human body than I was. The mysterious and complex human body amazed me so much that I cannot wait to learn more. My goal of learning more about biology and deciding if I want to major it was achieved, I have found myself interested in biology. Overall, I enjoyed the course of Human Physiology and Anatomy a lot and gained more than I have expected. Most significantly, this experience solidifies my decision of majoring in biology. Moreover, I have developed a better study method. Avoiding procrastination and just simply finishing preview and review for each lesson, I arrived at the score I am satisfied with, and I believe this method will help me to do better in any future courses. One more thing, with the time sheet, I did lead a healthier lifestyle in January, sleeping enough and eating regularly, than I did last semester. I would absolutely recommend this course to anyone interested in biology and ready to be appropriately challenged.

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A specific activity that I particularly enjoyed:

I had a mixed feeling toward the quiz after each lecture. I really hated them at first because they forced me to study after each lecture and challenged my bad habit of procrastination. Also, I was panic when Dr. Klepach said that the average grade for the quiz was a C or D for the past years. In order to get a score higher than a C, I reviewed with extreme attention everyday. At first, it was very difficult to fight against my laziness and painful to avoid procrastination. I was frustrated when my friends taking easy Jan Plan courses had nothing to do while I had tons of things to review. However, my efforts did pay off. I did pretty well on the quiz and I was very satisfied. I begin to enjoy the result coming with the painful procedure of fighting against procrastination. Though I did know working hard and stay on top of everything could bring much better result than procrastination and laziness do, but knowing something and actually experiencing something was very different. Knowing working hard would help did not motivate me to actually do so, while when the quiz forced me to work hard and I did experience the result of the effort, I was motivated. My feeling toward the quiz changed from hatred to enjoyment and thankfulness. After well preparation, the quiz became a great ways to examine my mastery of knowledge instead of a frustrating torture. Moreover, the quiz helped to reform my study method to a better one. Even though the beginning of the forcing from the quiz was painful, the change it brings will benefit me in an unpredictable way in the future. The habit of previewing and reviewing can make me understand and memorize things better through the repetition of content from each lesson, which is much lesser amount of things than whole semester. Another thing to mention, this daily study habit not only brings better grade, it also improves efficiency and helps me to lead a healthier lifestyle. By procrastination, I left a huge amount of work to do the few days before exams; while I stayed late in those days before exam, I just wasted time irrationally on other days. Staying up late means low efficiency and unhealthy lifestyle. However, with the newly formed study habits, previewing and reviewing for each lesson, I put a reasonable amount of work for each day; the reasonable amount of work can be done without staying up late, and thus efficiently. The quiz offered was a boon, for the change it brought to me will benefit me in any courses in the future. Knowing how procrastinated I was, I did not anticipate the course to change my study habits so radically, but it does and I really enjoyed the change. Just as Dr. Klepach said, the course not only helps the students to learn biological knowledge, it also helps the students to from a better and healthier learning method and even lifestyle.

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Grand Rounds: Oligoastrocytoma

January 28th, 2015 · Comments Off on Grand Rounds: Oligoastrocytoma

Grand Rounds: Oligoastrocytoma

Alex Lucas, Yvette Qu, Rachel Bird

 

Grand Rounds_Oligoastrocytoma_powerpoint pdf

Oligoastrocytoma

Oligoastrocytomas are brain tumors that consist of oligodendrocytes and astrocytes, the two cell types in the brain that support and insulate nerve cells. Unlike many brain tumors, which typically present initially with headaches, seizures are a common initial symptom of oligoastrocytomas.

The patient presented with episodes of “a feeling of walking through a cloud,” receptive, or Wernicke’s aphasia (the inability to understand spoken words), Aphasia (inability to speak), and vertigo. She also suffered from brief seizures, which worsened in severity over the course of the next eight years, and began to involve loss of consciousness and muscle tone, occasional incontinence, and overwhelming confusion. Three months prior to admittance, the patient struck her head during an episode, but MRI, ECG, echocardiography, Holter monitoring, EEG and multiple blood tests all appeared normal. The patient did not respond to triptans or beta-blockers, but the frequency of her seizures increased to at least one per day.

An MRI was performed on the patient, which showed a mass in the left occipitotemporal region of the brain. A biopsy helped to determine the grade of the tumor – grade II, which is a low grade tumor – and also presents the pathology which helps to determine the growth patterns of the tumor cells. Fluorescence in situ hybridization (FISH), which allows for reliable and accurate detection of chromosomal deletions, showed deletions in 1p and 19q tumors.

Similar to most tumors, the exact cause of an oligoastrocytoma is unknown. It is understood that normal cells become abnormal in the sense that they may produce the wrong number of proteins or enzymes or be lacking certain genetic material. In the case of an oligoastrocytoma, deletions of genetic information in chromosomes 1p and 19q are the reason for the tumor cell’s abnormalities. This certain type of tumor is a result of a mixture of oligodendrocytes and astrocytes. Genetic material losses in 19q occur in 60-80% of oligodendrogliomas and 30-40% in astrocytomas, which demonstrate that there may be a shared variation in the formation of gliomas. Losses in the 1p chromosome are frequent with oligodendrogliomas at about 50-80%, however are less apparent with astrocytomas, which is detected only 10-18% of the time. However, the combination of genetic material losses of the 1p and 19q chromosomes is detected in 60-80% of oligoastrocytoma cases.

A gross resection was performed to remove the patient’s low-grade oligoastrocytoma tumor. Standard radiotherapy and antiepileptic medications were given after the resection. Lifelong MRI was suggested instead of permanent pacemaker due to the low-grade of the tumor. Following MRI shows only postsurgical changes, implying good prognosis. During the 24-month following the resection, no seizure has occurred with reduction in medication, indicating great possibility of freedom from seizure in 10 years and absence of intractability.

The patient’s case is complicated by ictal asystole (stopping of the heart during her epileptic seizures, which is very rare) in a patient with a predisposition to neurocardiogenic syncope (fainting, loss of consciousness, loss of muscle tone due to an abnormal control mechanism of the brain over the heart) due to a genetic disorder, and with the asystole being triggered by the seizures caused by her oligoastrocytoma make this case very interesting and unique. The important information the case conveys is that a patient’s symptoms are not always indications of a single disease, and sometimes the symptoms need to be closely examined and can suggest more than one disease. Perhaps screening for relationships between cardiac dysfunction and neurologic mechanisms could help identify rare cases such as this one, which would allow for earlier diagnosis and treatment.

References:

(1) Paleologos, N A, ed. Oligodendroglioma and Oligoastrocytoma. Am Br Tum Assoc 2014: 3-8.

(2) Oligoastrocytoma. Univ CO Sch of Med Neusrgy 2015.

(3) Meenakshi G, MD, Azita Djalilvand, MD, Daniel J. Brat, MD, PhD. Clarifying the Diffuse Gliomas. Am J Clin Pathol. 2005;124(5):755-768.

(4) Cole, AJ, M.D., Eskandar, E. M.D., Mela, T, M.D., Noebels, J.L. M.D., Ph.D., Gonzalez, R.G. M.D., Ph.D., McGuone, D, M.B., Ch.B. Case 18-2013 — A 32-Year-Old Woman with Recurrent Episodes of Altered Consciousness. N Engl J Med 2013; 368:2304-2312.

(5) Ucdenver.edu. Department of Neurosurgery [Internet]. 2015 [cited 2015 Jan 15]; Available from:http://www.ucdenver.edu/academics/colleges/medicalschool/departments/Neurosurgery/patientcare/multi-disciplinaryprograms/AdultBrainTumorProgram/Pages/Oligoastrocytoma.aspx

 

 

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