Kathrin Müller-Wielsch  Foto Kathrin Müller-Wielsch

Home Institution
Charité - Universitätsmedizin Berlin

Host Institution
Albert Einstein College of Medicine, Yeshiva University, New York
Mentor: Cedric S. Raine, Ph.D., D.Sc.

E-Mail: kamuewi@web.de
Research Topic
see Abstract
Personal Reactions to the U.S. Experience
The months I spent in New York with the BMEP were a very unique and unforgettable experience for me. I had a warm welcome and was seen as a full member of my lab team immediately. While having the opportunity of working quite independently on my project, I received helpful advice from all lab members whenever I needed it. Looking back, I think I learned a lot from my team, both with regards to science and beyond.
In my clinical rotations, teaching was regarded as a part of their job by most residents and attendings, which I appreciated a lot. Although the level of responsibility for students was generally lower than during the final year in German medical education, I was still very involved and got a lot of valuable theoretical and practical training. Besides, realizing the large impact that tuition fees have on students and their families also made me feel grateful for having received my education almost for free.
Living in Manhattan and working in the Bronx, I saw very different facets of New York, which I found very interesting. Multiethnicity is an omnipresent feature that enriches life in the city a lot, but it sometimes also leads to conflicts, unfortunately. The inequality that is still present was striking to me, seen e.g. in the fact that service jobs are still held predominantly by non-whites. Yet, thinking about reasons for and solutions to this is a task too complex to fit into these few lines.
New York is indeed a “city that never sleeps”; it is amazing (and sometimes nerve-racking, too) to see how that flow of cars and people never stops. Greater New York on its own can keep you busy exploring for a long time, so I went to see other cities on the East Coast only a few times. And I do not even feel that I am done with New York itself, which means that I will have to come back…
Greatest Difficulties Encountered
Looking back to my experience here I do not remember any “real” difficulties, but getting the DS-2019 form for my visa was definitely a hard thing. I had been prepared to provide all kinds of forms, certifications and proofs, and finally got everything together. Shortly before my visa interview I finally received the fearfully awaited DS-2019 – only to realize that it was valid for only 4 months. Someone at AECOM had decided that my fundings would last for only that amount of time, and I had to put in some effort to convince them that without a new DS-2019 I would not be able to get my visa for my whole time of stay. In the end everything went well, and after that the rest of the visa procedure seemed like nothing to me…
Most humorous incident
Incidents that made me laugh were often simply misunderstandings on my behalf, such as the following one: Early in my stay during a lecture held by a company salesman, the lecturer mentioned several fluorescent markers, one of which she pronounced like “ugst”. I did not have any idea what this was supposed to mean, and, as usually when I hear a word I do not know or recognize, I gave it a guessed spelling in my notes. She mentioned the word several times in her lecture, and I kept wondering what it might mean. How surprised was I when in the end of her talk I finally found out what she was referring to: a marker by the German company “Hoechst”.
Helpful Hints for Future Students
  • If you are interested in classical music, Carnegie Hall offers student tickets for $ 10 14 days prior to the event. Other concert halls and most museums offer student discounts as well. Both ISIC and your US student ID should be accepted in most cases; with a German student ID only you may be denied the discount.
  • If housing is not supplied by your host institution, try to find a room in a shared apartment at one of the housing facilities of the universities. They are a lot cheaper than regular NY apartments and you make friends easily.
  • For calls to Germany I used Skype or www.peterzahlt.de (international calls for free).
  • Talk to former BMEP students and ask them about all those practical things – so if you have any questions, feel free to contact me.

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  table of contents

 

Abstract on Research Topic
Neuronal Changes in the Spinal Cord in Multiple Sclerosis

Authors: Kathrin Müller-Wielsch, Kakuri M Omari, Cedric S Raine

Institution:
Albert Einstein College of Medicine of Yeshiva University, Department of Pathology, 1300 Morris Park Avenue, Bronx, NY 10461

Introduction:
Multiple Sclerosis (MS) is a putative autoimmune disease of the central nervous system (CNS) and the leading cause of disability among young adults in Western countries. It has traditionally been regarded to be a disease affecting white matter only, yet in recent years, gray matter damage, known to occur in MS but never emphasized, has become a topical subject 1)2)3). The latter findings focused mainly on neuronal damage in the brain. The present study explored neuronal damage of the spinal cord in MS. A reduction of motor neuron counts in spinal cord has already been shown in MS and its mouse model (experimental autoimmune encephalomyelitis, EAE) in a previous study by Vogt et al. (in preparation).

Methods:
Material: Human tissue: 10 μm transverse sections of fresh frozen spinal cord of 14 MS cases, 3 cases of OND and 3 healthy control persons were examined.
Animal tissue: 10 μm transverse sections of fresh frozen spinal cord of 15 EAE cases and 3 healthy control animals were used.
Induction of EAE: EAE was induced with myelin oligodendrocyte glycoprotein in mice 8-12 weeks old. Animals were clinically graded for neurological status and sacrificed 15d, 20d, 40d, 63d after sensitization for EAE. 3 healthy animals were sacrificed at 8-14 weeks to serve as controls.
Immunohistochemistry: Sections were stained with markers for neurofilament (NF) phosphorylation state (SMI-31 for phosphorylated NF, SMI-32 for unphosphorylated NF). A change in NF phosphorylation has been shown in various studies to be associated with neuronal damage4). The reaction was developed with diaminobenzidine (DAB). In murine spinal cord a Mouse-on-Mouse Kit was used, as primary antibodies had been produced in mouse.
Evaluation: Sections were examined qualitatively under light microscope at a maximum magnification of 20x (human) and 40x (murine). Quantitative evaluation will take place at my home university.

Preliminary Results and Discussion:
MS cases showed a significant increase in SMI-31 reaction of anterior horn cells compared to healthy controls, particularly in lumbar spinal cord. This finding already suggests that there is indeed neuronal cell damage in the anterior horn in MS, but the number of controls needs to be increased to strengthen the results. In addition, SMI-32 staining needs to be evaluated to examine the tissue for axonal damage.
In the murine study, the difference between EAE cases and controls was very slight compared to that seen in the human tissue, differences were only apparent in older animals. This observation might support the hypothesis that irreversible neuronal damage in MS occurs only years after disease onset5). An alternative explanation may also be that the antibodies reacted differently with mouse tissue.
1) Ferguson et al., Axonal damage in acute multiple sclerosis lesions, Brain 1997
2) Trapp et al., Axonal transection in the lesions of Multiple Sclerosis, N Engl J Med 1998
3) Peterson et al., Transected neurites, apoptotic neurons, and reduced inflammation in cortical Multiple Sclerosis lesions, Ann Neurol 2001
4) e.g. Hedreen et Koliatsos, Phosphorylated neurofilaments in neuronal perikarya and dendrites in human brain following axonal damage, J Neuropathol Exp Neurol 1994
5) Bjartmar et al., Axonal loss in the pathology of MS: consequences for understanding the progressive phase of the disease, J Neurol Sci 2003