Joshua B. Bederson, MD, with a 3D model and an interactive simulation of the skull of a patient with a large epidermoid tumor—tools he used in planning the patient’s surgery.
The Mount Sinai Health System recently launched the Medical Modeling Core, a collaboration led by the Department of Neurosurgery, where Mount Sinai clinicians can order 3D and virtual models that can be used to explain procedures to patients, plan surgeries, and even conduct trial runs.
“Our simulation, prototyping, and 3D printing resources developed here at Mount Sinai are rare for a medical institution,” says Joshua B. Bederson, MD, Professor and Chair of Neurosurgery for the Mount Sinai Health System, and Clinical Director of the Neurosurgery Simulation Core at the Icahn School of Medicine at Mount Sinai. “In conjunction with simulation, they also play an important role in the patient-consultation process.”
The team is led by Anthony B. Costa, PhD, Assistant Professor in the Department of Neurosurgery, Scientific Director of the Neurosurgery Simulation Core, and Director of the Medical Modeling Core. Dr. Costa has developed digital tools to expedite the process of turning radiological data into 3D models and interactive, virtual modeling. The work is done rapidly—“in days, as opposed to weeks,” Dr. Costa says—and at a significantly lower cost than outside vendors. Recent models include brain tumors with surrounding vasculature and cranial nerves, spine modeling for the correction of severe scoliosis, and pelvic models for the planning of total hip replacement.
“When patients come in and are told they require a surgical procedure, it is often difficult for them to have a clear picture of what is going on in their own body,” Dr. Costa says. And 3D printing enables patients to pick up a model of the area affected, as the physician explains their condition and how the surgical procedure will work. “This offers patients confidence about what is about to happen to them,” Dr. Costa says. “We have found this to be a very successful approach.”
A population of cells in early development may give rise to the ventricular chambers of the heart, but not the atria, according to a study led by researchers from the Mindich Child Health and Development Institute at the Icahn School of Medicine at Mount Sinai and published in Nature Communications.
Yasmin Hurd, PhD, a professor of psychiatry, neuroscience, and pharmacology and systems therapeutics at the Icahn School of Medicine at Mount Sinai, discusses her new report on marijuana, and its potential to curb opioid addiction.
Douglas Dieterich MD, Professor, Department of Medicine, Division of Liver Diseases, Director of the Institute for Liver Medicine, Mount Sinai Health System
Guest blog written by Douglas Dieterich MD, Professor, Department of Medicine, Division of Liver Diseases, Director of the Institute for Liver Medicine, Mount Sinai Health System
Viral hepatitis is liver inflammation caused by an infection with one of several different hepatitis viruses. According to Centers for Disease Control and Prevention (CDC), more than five million people in the United States live with some form of the disease—with the World Health Organization estimating 400 million affected worldwide. (more…)
Nimesh Nagarsheth, MD, an associate professor of obstetrics, gynecology, and reproductive science at the Icahn School of Medicine at Mount Sinai, reviews cervical cancer prevention and treatment, including HPV vaccination.
Manish Arora, PhD, MPH, is known for his work on biomarkers—using human teeth to reconstruct the timing of exposure to harmful chemicals and essential nutrients.
Manish Arora, PhD, MPH, Vice Chair of the Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai, has been named a recipient of the Presidential Early Career Award for Scientists and Engineers, the highest honor bestowed by the U.S. government on science and engineering professionals in the first 10 years of their independent research careers.
“Dr. Arora’s research is one of those rare paradigm shifts in science,” says Robert O. Wright, MD, MPH, Ethel H. Wise Professor of Community Medicine and Chair, Department of Environmental Medicine and Public Health, and Director, Senator Frank R. Lautenberg Environmental Health Sciences Laboratory at the Icahn School of Medicine. “I first met him 10 years ago when he was a trainee with a big idea. When he explained the concept of using teeth to measure exposure to lead in pregnancy—to assign a date to an event that happened years ago—it felt like science fiction, but he was able to make it happen, which is a testament to both his intellect and perseverance.”
Dr. Arora, an environmental epidemiologist and exposure biologist with a clinical background in dentistry, has long been passionate about the environment and inventing. He earned a PhD analytical chemistry, and nuclear beam methods from the University of Sydney in Australia. He had a joint appointment at that university and at Harvard University’s School of Public Health before being recruited by Dr. Wright to Mount Sinai in 2013. But he credits a source close to home for his current success: his late mother. “She was a big proponent of generating new knowledge,” Dr. Arora says, but as a young girl in India, her education ended in middle school. “So she always valued education, much more than most people do, because it was not easily attainable to many of her generation.”
Dr. Arora focuses his research, which is funded by the National Institute of Environmental Health Sciences, on the effects of prenatal and early childhood chemical exposures on lifelong health. In the same way that trees have growth rings, he says, “we have growth rings in teeth, and because those start forming before you are born, we can actually go back in time and figure out, for example, what you were exposed to in the second or third trimester.”
A baby tooth being prepared for analysis by a laser.
Dr. Arora and his team collect teeth donated by families and dentists all over the world. To study the teeth, they invented novel techniques and equipment, including a robot that cuts, or “micro-dissects,” samples the width of a human hair. The samples are then analyzed for thousands of chemicals the donors may have been exposed to at different times of their development.
“There are two big findings: One is that it’s not just how much you are exposed to, it’s also when you get exposed to it,” Dr. Arora says. “That is what we are finding for diseases like Lou Gehrig’s disease (ALS), in which you become symptomatic at age 50, 60, 70. But the initial exposure—what altered your trajectory—may have occurred early in life. We are also discovering this is true for autism and schizophrenia.” Dr. Arora says the second finding is that a single chemical is not always the key. “What happens when you get exposed to a mixture of chemicals is not the same as when you get any single component. Previously, the technology to study these mixtures of chemicals didn’t exist, but the methods we are developing allow measurement with novel precision. We now have an NIH laboratory hub for this new technology.”
For this work, Dr. Arora received a New Innovator Award in 2014, which included $2.2 million from the NIH. Dr. Arora is now seeing results in the search for metal and organic risk factors. “The next phase will be finding approaches to mitigate the risk, both at a clinical level, with the goal of personalized environmental medicine, and also at a population level, to support public health and policy development,” Dr. Arora says. “The idea is that as clinicians we can treat people one-on-one, but taking broader action like getting rid of lead in gasoline helps all of us.”
Yasmin Hurd, PhD, a professor of psychiatry, neuroscience, and pharmacology and systems therapeutics at the Icahn School of Medicine at Mount Sinai, discusses her new report on marijuana, and its potential to curb opioid addiction.
