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📊 | Nagoya University develops method to measure brain tumor with microRNA in urine


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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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Wikipedia related words

If there is no explanation, there is no corresponding item on Wikipedia.

Brain tumor

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.

symptom

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).

Sort

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.

Malignancy

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.

Infiltrative
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.
Anaplasia
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
Brain tumors common in adults
Meningioma,Pituitary adenoma,Glioma, Schwannoma

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.

Typical treatment

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.

surgery

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

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.

chemical treatment

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.

Anti-edema therapy

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

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.

Benign tumor

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.

Malignant 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[1].

Source

[How to use footnotes]
  1. ^ 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

A person with a brain tumor

Japan

Overseas

Related item

  • 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.

外部 リンク

Tokushima University Hospital

Tokushima University Hospital(Tokushima University Hospital)TokushimaTokushimaKuramotochoNational university corporation inTokushima UniversityOperated bySpecial function 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.[1].

History

  • April 1943-Tokushima Prefectural Tokushima Medical College Hospital established[1]
  • April 1945-Renamed to Tokushima Medical College Clinic[1]
  • February 1948-Renamed Tokushima Medical University Hospital[1]
  • May 1949-Renamed Tokushima University Hospital[1]
  • April 1979 (Showa 54) --Established Dental Hospital[1]
  • March 2003-Established Hospital for School of Medicine and School of Dentistry[1]
  • April 2010-Renamed to Tokushima University Hospital[1]

Department

Internal medicine
surgical
Department of Sensory / Skin / Motor Function
Brain / nerve / psychiatry
Pediatric / Perinatal / Women's
Radiology
Dentistry

Designation of medical institutions

Hospital facilities

In-hospital parking

  • 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)

Directions

Automobile

Public transport

  • 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.

footnote

[How to use footnotes]
  1. ^ a b c d e f g h i Tokushima University Hospital 2020 (issued in June 2nd year of Reiwa)
  2. ^ "AIDS Treatment Center Hospital-For General and Patients". 2018th of February 8Browse.
  3. ^ "Liver disease medical treatment cooperation base hospitals List of prefecture cooperation base hospitals". 2018th of February 8Browse.
  4. ^ "Lawson Tokushima University Hospital". Store search. Lawson. 2018th of February 8Browse.
  5. ^ "Post office in Tokushima University Hospital". Find Post Office/ATM. Japan Post. 2018th of February 8Browse.

外部 リンク


 

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