Nagoya University develops method to enable measurement of brain tumors with microRNA in urine
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According to the Center for Cancer Treatment, Tokushima University Hospital, brain tumors refer to tumors that occur in the skull, such as the brain parenchyma, meninges, and cranial nerves.
On the 9th, a research group at the Graduate School of Medicine, Nagoya University will measure single-strand short RNA and micro RNA contained in urine ... → Continue reading
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Brain tumorWhat is (Brain tumor)?brain OfdiseaseOne of theSkullNeoplasms that occur in internal tissues (tumor) Means.That is, brain tumors are not limited to brain cellsDura,Arachnoid, In the skullBlood vessel,Peripheral nerve, Origin from any other tissue present in the skull.The frequency of occurrence is estimated to be 100,000 out of 12 each year.The specific cause is not clear.
Brain tumors usually grow to a certain size by the time some symptoms appear, because the tumor has already grown to a certain size.Brain edemaIn most cases, it is causingIntracranial pressureHypertrophic symptoms, i.e.headache,nausea,VomitingAs well as causing visual field defects as local symptoms depending on the site of occurrenceDeafness, Motor paralysis, speech disorder, etc. may be accompanied.If there is a lesion in the cortex痉挛It is not uncommon to have seizures.Headaches are most painful as soon as you wake up in the morning and are called morning headaches.
In the case of women (sometimes even men), as an early sign妊娠Despite not doingBreastmilk(Milk leakage).This is a lactation hormone (Prolactin) Is due to dysfunction of the hypothalamus and pituitary gland.Sella turcicaCharacteristically found in nearby tumors (reference).
As mentioned above, brain tumors originate from a wide variety of tissues, so the classification was based on the place of origin.World Health Organization The histological typing of tumours of the central nervous system by (WHO) is used worldwide.2006In the degree version
- Neuroepithelial tissue tumors (astrocytoma, oligodendroglioma,GlioblastomaSuch asGlioma,Ependymoma, Choroid plexus tumors, other neuroepithelial tumors, neuronal tumors, pineal tumors, fetal tumors, etc.)
- Schwannoma (Schwannoma, Neurofibromatosis, etc.)
- Meningeal tumor (Meningioma, Other mesenchymal tumors, malignant melanoma, etc.)
- Lymphoma and hematopoietic neoplasms (Malignant lymphoma,Such)
- Germinoma (germinoma, yolk sac tumor, choriocarcinoma, teratoma, etc.)
- Turkish saddle tumor (craniopharyngioma, pituitary cell tumor, etc.)
- Metastatic tumor
Of about 130 types of brain tumorsOrganization typeIs defined.
Generally in brain tumorsHistopathologySimilar to the histological classification, the WHO classification method is used for the specific malignancy, and it is classified into 4 stages from Grade I with the lowest malignancy to Grade IV with the highest malignancy and compared with individual tumors. doing.There is a relationship between this malignancy and the site of occurrence, and in general, it is often relatively benign in the case of extra-axial, and conversely, it may be malignant in the case of intra-axial. It tends to be high. WHO Grade I is localized and benign, Grade II is invasive but low malignancy (cell atypia only), Grade III is anaplastic (cell atypia and mitotic figures), and Grade IV is malignant (cell atypia). , In addition to mitotic figures, microvascular hyperplasia, necrosis).This Grade is thought to correlate with prognosis and influences treatment choices.
However, due to the special condition that the place of occurrence of a brain tumor is the brain, which is an organ that controls human thinking and personality and each organ, and is surrounded by a strong skull, it is mentioned above.PathologyIt is not preferable to make a judgment based only on the specifics, and it is necessary to consider the malignancy from a clinical standpoint (for example, pathologically, even if the tumor is Grade I = benign tumor, the intracranial pressure is increased.Brain herniaCan be fatal).That is, it is necessary to consider the site of occurrence of the tumor, its size, whether it is infiltrating (described later), and its reactivity to radiation or a drug.Basically, there is no concept of (Stage) in brain tumors.
- Invasiveness is one of the ways in which a tumor grows, and it means that it breaks into the surrounding normal tissue and grows as if it replaces normal cells with tumor cells (the synonym is "expansive"). "Or" exclusion ", which means that it only grows while mechanically pushing away the surrounding tissue).That is, since the boundary between a tumor and a non-tumor is unclear, if a tumor having this characteristic is to be completely removed, the normal cell tissue surrounding the tumor must be removed at the same time.In other words, it means that total removal of the tumor is extremely difficult.
- What is anaplasia?DifferentiationIt shows that the degree is more undifferentiated.It is considered that the more undifferentiated, the faster the growth rate, and the lack of specific markers makes it difficult to treat.
Classification by age of onset
- Brain tumors common in children
- (cerebellum)Medulloblastoma, Ependymoma, choroid plexus papilloma, embryonic cell tumor, craniopharyngioma,
- (Brain stem)Pediatric brain stem glioma
That is, children usually suspect craniopharyngioma or germinoma if they complain of bitemporal hemianopia, and adults usually suspect pituitary adenomas if they complain of bitemporal hemianopia.Craniopharyngioma, germinoma, and pituitary adenoma all occur most often in the Turkish saddle and are often noticed in bitemporal hemianopia.This is because the tumor in this area is seriousBrain herniaThis is because it is difficult to cause chronic progressive headache and the like.
Classification by onset site
- Tumor on the tent
- Glioma, meningioma, ependymoma of the third ventricle, etc.Basically, it is common in adults.
- Subtent tumor
- Medulloblastoma, ependymoma, astrocytoma, schwannoma, etc.Basically, it is common in children.
These parts are also related to how to cause brain herniation.
Classification by radiation sensitivity
- Radiosensitive tumor
- Germinoma, medulloblastoma, ventricular ependymoma
- Tumors with low radiosensitivity
- Glioma, meningioma,Hemangioblastoma, Craniopharyngioma, etc.
Characteristic image findings
Craniopharyngioma is frequentCalcificationCan be seen.Meningiomas are also often associated with calcification and use contrast mediaCTorMRI(GdContrastT1-weighted image), A uniform enhancing effect is observed (characterized by "dural tail sign" -adhesion of dura mater and tumor-).Glioblastoma has a blurred border with the brain parenchyma, and contrast-enhanced images or ring enhancement are observed (glioblastoma).For other diseases with ring enhancementBrain abscessI can give you.Low-grade gliomas (etc.) generally have a low contrast effect.
The treatment used in the treatment of brain tumors is basically surgery, but othersRadiation therapy,chemical treatmentThere are such things, and each feature and current situation will be briefly described.
The principle of brain tumor treatment is手術It is possible removal by.Benign tumorIf so, the boundary between the tumor and normal brain tissue is often clear, and if it can be completely removed, a complete cure can be expected.On the other hand, malignant brain tumors infiltrate the surrounding normal brain tissue, so total removal is difficult or impossible in most cases.If the adjacent normal tissue is removed at the time of removal, serious sequelae such as hemiplegia and speech disorder may be left after the operation depending on the removal site.Therefore, during surgery, electrophysiological monitoring such as motor evoked potential (MEP) and sensory evoked potential (SEP), or the current surgical operation position can be known in real time.Neuronavigation, IntraoperativeCT,MRIAttempts are made to remove as many tumors as possible by making full use of such means.Also,Language fieldExists inGliomaFor such cases, awake surgery is also performed.
Radiation therapy uses radiation to destroy tumor cells, 50-60GyIt is common to irradiate (gray) in dozens of times.Tumors that are highly radiosensitive (prone to be effective) include germinoma, lymphoma, and medulloblastoma, among which germinoma is particularly sensitive and may be cured by irradiation alone.Also, for some tumorsGamma knife (γ-knife)Cyberknife Treatment is performed using a machine called (Cyber Knife) that irradiates the affected area with intensive radiation.
Chemotherapy is a method of using drugs to shrink a tumor, but in the brainBlood-brain barrier Since there is a mechanism called (BBB; blood-brain barrier) that blocks the entry of foreign substances, there is a problem that it is difficult for the drug to reach the target location.recentlyGliomaForTemozolomideIs generally used.Also, in the skullMalignant lymphomaHigh-dose MTX therapy is given to the patient.
For anti-edema therapy, 200 ml of glyceol twice a dayDexamethasone6.6 mg orPrednisoloneAnti-edema therapy at 20 mg twice daily may provide transient symptom improvement. Radiation therapy such as 30 Gy whole-brain irradiation may be used in combination.
Other treatments include boosting the body's immune system and inhibiting tumor growth.Immunotherapy(BRM; biological response modifiers)Gene therapy,FurthermoreHeavy particle beam,Proton beamOr something that usesHyperthermiaEtc. have been devised, but at this stage these are not very promising.
Basic treatment policy
As mentioned above, brain tumors are composed of a wide variety of tumors, and of course, the treatment method differs depending on the individual tumor.Therefore, the description of specific tumors is avoided here, and the description is limited to the level of basic treatment policies for benign and malignant cases.
Refers to Grade I and II tumors.If the tumor can be completely removed, it can be completely cured.On the other handBrainstemDepartmentSkullIn the case of a tumor that occurs on the bottom and requires extremely difficult surgical techniques, it is difficult to completely remove it, and it may not be possible to remove it without leaving any sequelae.Postoperative radiation therapy may be added depending on the tumor.
Refers to Grade III-IV tumors.The most common Grade IV glioma is incurable, and how "useful life or time to act as a human being" QOLThe ability to prolong the quality of life) is the main focus of treatment.Remove the tumor as much as possible if it is a surgical site.Radiation therapy,chemical treatment,Supportive therapyRecurrence / recurrenceTransitionIf so, chemotherapy and, in some cases, surgery are given.However, despite the development of medicine, the improvement of life prognosis is not good, especiallyGliomaIn the case of, no matter what measures are taken, the averageLife expectancyIs only about a year.
- ^ A record of the fight against illness by a brain surgeon who developed malignant glioma and his wife is left (Takanobu Iwata "What I learned when a doctor became a terminal cancer patient", Takanobu Iwata, Noriko Iwata "The doctor is in the terminal stage What I learned as a patient ”).
Works dealing with brain tumors
- "School wars』――The character Hiroshi Okudera (nickname: Aesop) is affected and dies.
- "Last strike--- Former, who died at the young age of 32 due to a brain tumorHiroshima Toyo Carp-Tsunemi TsudaA book in which the wife summarizes the pitcher's fight against illness.2000May 7ToFuji Television Network, IncBroadcast in series.
- "Life's Color Empitsu-The story of a girl with a brain tumor.Taichi Kokubun,Nanami FujimotoIt was made into a drama starring,TV AsahiIn series2008May 3Broadcast to.
- "Don't forget about us-An essay written by the mother about the fight against illness of her eldest son, who became ill at the age of 15 and died eight years later. "24-hour TV "Love Saves the Earth""so,2009May 8Broadcast to.
- "Miporin Dimple-A true story of a girl who just entered junior high school wrote a picture letter while fighting a brain tumor. "24-hour TV "Love Saves the Earth"In the drama special2010May 8Broadcast to.
- "Natural History of Death-Small Fight-"-Depicts the interaction between a boy with a brain tumor and a bad boyShintaro IshiharaThe story of the original.1964May 4Fuji TV series "Theater for XNUMX million peopleIn the frame, it was made into a drama as a "small fight".same yearMay 10As "things that cannot be defeated"NikkatsuMade into a movie.Both drama and movieYujiro IshiharaPlayed the role of a bad boy.
- "Brave and Noble Life" -AnnouncerShosaku TakewakiSecond son and later an actorTakewaki selflessA book that summarizes the diary of his brother, Mari Takewaki, who wrote about his Christian life and the days of fighting illness due to brain tumors.
- "Baibai, Fuhita" --A book that my wife wrote down until her husband suffered from a brain tumor immediately after marriage and died four months later. February 4, 1994Nippon TVOf the seriesKanebo Human SpecialBroadcast in the frame.
- "Mom, I'm fine-Ryohei Sasaki, who became the deputy captain of the soccer club.I was diagnosed with an acute brain tumor while working hard to break through the prefectural convention.A work about the bond between friends and family in the soccer club. "24-hour TV "Love Saves the Earth"In the drama special2015May 8Broadcast to.
- "The day before the wedding』――Hitomi Serizawa decided to get married.A mother who should have divorced and died after being diagnosed with a brain tumor appears.A story of a mother and daughter fighting illness.
- "If the cat disappears from the world』- Genki KawamuraNovel. A movie released on May 2016, 5.
- "Cinderella for the exam"
A person with a brain tumor
- Kenji Shibata(An actor）
- Takeichi Terasawa(manga artist) --I was caught in the examination, and after that, I repeated treatment and rehabilitation.
- Sachiya Yamasaki(Professional baseball player,Orix Buffaloes)- 2008, Discovered by health check before entering high school.Overcome after surgery.
- Kimie Kato(singer : Hibari MisoraReal mothermanager) --By metastatic brain tumor1981May 7Died. 68 years old.
- Tsunemi Tsuda(Professional baseball player, formerHiroshima Toyo Carp)- 1991Affected during the season.Temporary recovery but recurrence1993May 7Died. 32 years old.
- Kiyono Sachiko(Picture book writer)
- Katsuhiko Twentyyama (former)Grand SumoWrestlerKatsuhiko Kitaten, HighestOzeki) - 2006In 3 monthKidney cancerDiagnosed as malignant brain tumor due to metastasis.same yearMay 6Died. 45 years old died.The causative kidney cancer had already developed a year before death.
- Hiroko Nagata(Union Red ArmyhighestExecutive)- trialWhile suffering from illness and then fighting against illness in prison絵DrawArt therapyI trained in.2011No.
- Sakuma Masahide(Musician)-Late-termScirrhous gastric cancerSuffering from malignant brain tumor due to metastasis.Even though I have surgery to remove it2014May 1Died at 2:27 am.He died at the age of 61.
- Maruyama Natsuzu(Singer, talent) --Affected when he was in the second grade of elementary school. I have 2 removal surgeries,2015May 5Died of lung cancer.21 years old died.
- Kyo Hanaki(Comedian)- 2002A brain tumor was removed in August. 2015May 8Died of pneumonia.He died at the age of 78.
- Yuuki Morita(Professional baseball player, formerOsaka Kintetsu Buffaloes)- 1998Affected during the season.1999Although he recovered and made a comeback, he repeated recurrence and surgery after retirement, and due to metastatic malignant adenoma.2015May 10Died. 45 years old died.His younger brother also died of a brain tumor.
- Michiyuki Kawashima (BOOM BOOM SATELLITES) --First onset at age 28, 5 times since.2016He died in October at the age of 10.
- Kenichi Kurosawa(Musician,L⇔Rmember) - 2016May 10Announced on his official website that he was ill and under treatment, the same yearMay 12Died.He died at the age of 48.
- Kyosei Iwamoto(Impressionist) wife- 2008Sequelae remain and he becomes a wheelchair.2014May 2Died in.
- Shintaro Yokota(Pro baseball player,Hanshin Tigers)- 2017Affected during the spring camp.Symptoms after six months of hospitalizationRemissionHowever, he retired from active duty only in 2019 due to aftereffects such as "I can't see the ball I hit" and "I can see the pitcher's ball double".
- Koji Imato(soccer player)-I hit my head during the match and a post-match examination revealed illness.After that, I was enrolledGamba OsakaI left the group and concentrated on treatment2003May 4Died in.
- Tomoshino Yokoyama(soccer player)- 2018At the end, the illness was discovered and he underwent excision surgery.Then recoverFC GifuJoined the team.20202Retired to.
- George Gershwin(作曲家)- 1937With a brain tumor.The day after the surgery, he fell into a coma after the test.May 7,Brain herniaDied by. 38 years old.
- Richard Jordan(An actor)- 1993A brain tumor was discovered in April and died on August 4 of the same year.He died shortly before the release of his last movie, Gettysburg (8), so the end of the credit says, "Dedicate this movie to Richard Jordan."
- Chuck Schuldiner(Musician:deathEtc.)-Temporary recovery but recurrence2001May 12Died. 34 years old.
- Beau Biden(Lawyer) - Joe BidenEldest son.2013I had an operation on my stomach and recovered2015It recurred in spring and died in May of the same year.
- ボ ブ · マ ー リ ー(Musician)- MelanomaDied in 1981 due to metastasis to the brain and lungs.
- Richard Burns(Rally driver),2003, Fainting while driving to the rally venue.As a result of the examination, it is diagnosed as malignant astrocytoma.Temporary recovery but recurrence2005May 11Died in. 34 years old died.The day I died2001It was the day when he won the title of World Champion.
- Fukushima Takanori --Authority of brain tumor surgery
- ――Since the intracranial pressure increases in spite of the absence of a brain tumor, it is also known as a pseudo-brain tumor.
- Idiopathic intracranial hypertension and pseudobrain tumorsMinocyclineIt is known to occur by oral administration.
- Brain tumor (Japanese, illustrated)CureSearch Japan version
Tokushima University Hospital
Tokushima Prefectural Central HospitalIt is connected to and by a connecting bridge, and the Kuramoto district of Tokushima City forms a comprehensive medical zone in Tokushima Prefecture. The number of patients in 2019 is 362,991 medical outpatients, 106,447 dental outpatients, 207,642 medical inpatients, and 7,554 dental inpatients..
- April 1943-Tokushima Prefectural Tokushima Medical College Hospital established
- April 1945-Renamed to Tokushima Medical College Clinic
- February 1948-Renamed Tokushima Medical University Hospital
- May 1949-Renamed Tokushima University Hospital
- April 1979 (Showa 54) --Established Dental Hospital
- March 2003-Established Hospital for School of Medicine and School of Dentistry
- April 2010-Renamed to Tokushima University Hospital
- Internal medicine
- Respirator-Internal Medicine for Collagen Disease
- Endocrinology / Metabolism Internal Medicine
- Cardiovascular surgery
- Esophageal / Breast Thyroid Surgery
- Respiratory surgery
- Digestive organ・ Transplant surgery
- Pediatric surgery・ Pediatric endoscopic surgery
- Department of Sensory / Skin / Motor Function
- Brain / nerve / psychiatry
- Pediatric / Perinatal / Women's
- Dentistry (Periodontal Disease)
- Dentistry (chewing department)
- Dentistry (Engagement Prosthodontics）
- Dentistry (Department of Dental Radiology）
- 矯正 歯 科
- Pediatric dentistry
- Dental oral surgery(Oral medicine）
- Dental and Oral Surgery (Oral Surgery)
- Dental and Oral Surgery (Dental anesthesiology）
Designation of medical institutions
- Insurance medical institution
- Emergency notification medical institution
- Work injury insuranceDesignated medical institution
- Designated independence support medical institution (rehabilitation medical care, upbringing medical care, mental outpatient medical care)
- Welfare Act for the DisabledMedical institution where designated doctor is located
- Mental health designated doctorThe medical institution where is located
- Welfare ActDesignated medical institution
- Tuberculosis designated medical institution
- Designated parenting medical institution
- War Injury Special Assistance Law Designated Medical Institution
- Atomic bomb victims General illness medical treatment medical institution
- Second-class infectious disease designated medical institution
- Pollution medical institution
- Maternal protection law designated doctorThe medical institution where is located
- Special function hospital
- Clinical training designated hospital
- Cancer clinic cooperation base hospital
- AIDS treatment base hospital
- Liver disease medical treatment cooperation base hospital
- Specific disease treatment research businessOutsourced medical institution
- Hospital targeted for DPC
- Pediatric chronic specific disease treatment research projectOutsourced medical institution
- General Perinatal Medical Center
- Infertility specialist consultation center
- LawsonTokushima University Hospital
- Tully's coffeeTokushima University Hospital
- Restaurant Sora
- Tenkichi Udon
- Fruit shop
- Barber / dressing shop
- Patient Library Libro
- Inside Tokushima University Hospitalpost office
- Outpatients, general (outpatients have a discount service, and the parking ticket must be stamped at that time)
- Family members who requested a visit from the doctor due to symptoms, explanation of surgery, etc.
- 24 yen up to 100 hours (need to get a stamp on the parking ticket at the reception of the department)
- Inpatient family pass card
- Initially, a charge of 10,000 yen / 50 days is required, the charge is 200 yen / day (the charge is counted even on days when the parking lot is not used), and the balance is settled when the pass card is returned (1 days when using the pass card) If it exceeds, it can be recharged)
- Shikoku Passenger Railway(JR Shikoku)Tokushima StationAbout 15 minutes by car
- Tokushima ExpresswayTokushima Interchange-Aizumi interchangeAbout 30 minutes by car
- Takamatsu Expressway-Kobe Awaji Naruto ExpresswayNaruto InterchangeAbout 50 minutes by car
- Tokushima Awaodori AirportAbout 50 minutes by car
- From JR Tokushima StationTokushima LineKuramoto Station5 minutes on foot.
- From JR Tokushima Station Bus TerminalTokushima City BusAbout 1 minutes from Platforms 5 and 20 to "Chuo Circulation Line", "Kami Ayu Eating Line", "Jizoin Line" and "Myodo Line", get off at Prefectural Central Hospital / Tokushima University Hospital or General Medical Zone (weekdays only).
- From JR Tokushima Station Bus TerminalTokushima BusAbout 3 minutes from Platforms 4 and 20 toward Ishii / Kamojima, get off at Prefectural Central Hospital / Tokushima University Hospital or get off at Sogo Medical Zone.
- ^ a b c d e f g h i Tokushima University Hospital 2020 (issued in June 2nd year of Reiwa)
- ^ "AIDS Treatment Center Hospital-For General and Patients". 2018th of February 8Browse.
- ^ "Liver disease medical treatment cooperation base hospitals List of prefecture cooperation base hospitals". 2018th of February 8Browse.
- ^ "Lawson Tokushima University Hospital". Store search. Lawson. 2018th of February 8Browse.
- ^ "Post office in Tokushima University Hospital". Find Post Office/ATM. Japan Post. 2018th of February 8Browse.