brain tumors

脑肿瘤
  • 文章类型: Case Reports
    室管膜下巨细胞星形细胞瘤(SEGA)是良性的,生长缓慢,经常与结节性硬化症(TSC)相关的非侵袭性肿瘤。诊断前应仔细考虑肿瘤的位置和患者的年龄。考虑SEGA作为鉴别诊断,即使在没有TSC的成年患者中,是必不可少的。在目前的情况下,一名22岁男性出现进行性头痛,头晕,和模糊的视野。放射学检查证实了肿瘤的部位,甲状腺转录因子1在神经节细胞成分中呈阳性表达,随着TSC1和TSC2中缺乏种系突变,导致SEGA的最终诊断没有TSC。
    Subependymal giant cell astrocytomas (SEGAs) are benign, slow-growing, noninvasive tumors frequently associated with the tuberous sclerosis complex (TSC). The tumor\'s location and the patient\'s age should be considered carefully before diagnosis. Considering SEGA as a differential diagnosis, even in adult patients without TSC, is essential. In the present case, a 22-year-old male presented with a progressive headache, dizziness, and blurring of vision. Radiological investigations confirmed the site of the tumor, and a positive expression of thyroid transcription factor 1 in the ganglion cell component, along with the absence of germline mutation in TSC1 and TSC2, led to the final diagnosis of SEGA without TSC.
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  • 文章类型: Journal Article
    胶质母细胞瘤(GBM)是一种严重的脑肿瘤,致死率高。它生长迅速,大多数时候导致对传统治疗如化疗和放疗和手术的抵抗。生物多样性,除了代表人类福祉的重要资源之外,提供了几种天然化合物,显示出作为抗癌药物的巨大潜力。其中许多正在被广泛研究,并通过降低增殖率显着减慢GBM的进展,迁移,和炎症,也通过调节氧化应激。这里,一些天然化合物的使用,比如葱葱,succisapratensis,还有Dianthus超级巴士,被探索以解决GBM;他们展示了他们对细胞数量减少的影响,部分由细胞周期静止给出。此外,据报道,细胞迁移能力降低,通过形态细胞骨架的变化来完成,这甚至突出了间质-上皮转化。此外,代谢研究显示诱导的细胞氧化应激调节和大量的代谢重排。因此,研究人员提出了一种新的治疗选择,以克服常规治疗的局限性,从而改善患者的预后.
    Glioblastoma (GBM) is a severe form of brain tumor that has a high fatality rate. It grows aggressively and most of the time results in resistance to traditional treatments like chemo- and radiotherapy and surgery. Biodiversity, beyond representing a big resource for human well-being, provides several natural compounds that have shown great potential as anticancer drugs. Many of them are being extensively researched and significantly slow GBM progression by reducing the proliferation rate, migration, and inflammation and also by modulating oxidative stress. Here, the use of some natural compounds, such as Allium lusitanicum, Succisa pratensis, and Dianthus superbus, was explored to tackle GBM; they showed their impact on cell number reduction, which was partially given by cell cycle quiescence. Furthermore, a reduced cell migration ability was reported, accomplished by morphological cytoskeleton changes, which even highlighted a mesenchymal-epithelial transition. Furthermore, metabolic studies showed an induced cell oxidative stress modulation and a massive metabolic rearrangement. Therefore, a new therapeutic option was suggested to overcome the limitations of conventional treatments and thereby improve patient outcomes.
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  • 文章类型: Journal Article
    接受脑肿瘤手术切除的患者经常表现出一系列的血液动力学波动,需要仔细的液体管理。本研究旨在评估流体反应性动态预测因子的可行性,例如deltadown(DD),主动脉流速时间积分变异性(VTIAoV),上腔静脉塌陷指数(SVCCI),接受脑肿瘤神经外科手术的患者。
    在这项前瞻性研究中,纳入了30例计划接受选择性神经外科手术切除脑肿瘤的患者。生命体征的基线测量,麻醉参数,和研究变量在诱导后记录。随后,患者在20分钟内接受了10mL/kg胶体的液体推注,并在加载后重复测量。数据表示为平均值±标准偏差。正态分布的连续变量使用学生t检验进行比较,P<0.05被认为具有统计学意义。使用Pearson系数分析(r)评估变量对液体反应性的预测能力。
    在30名患者中,22人被确定为体积响应者(R),8人是无应答者(NR)。DD>5mmHg有效区分R和NR(P<0.001),具有良好的预测能力(r=0.759)。SVCCI>38%的R与NR(P<0.001),具有良好的可预测性(r=0.994)。同样,VTIAov>20%也是一个很好的预测因子(P<0.05;r=0.746)。
    我们的研究表明,大多数接受脑肿瘤手术切除的患者表现出液体反应性。在评估的变量中,SVCCI>38%是一个很好的预测指标,其次是VTIAoV>20%和DD>5mmHg,用于评估该人群的体液状态。
    UNASSIGNED: Patients undergoing surgical resection of brain tumors frequently exhibit a spectrum of hemodynamic fluctuations necessitating careful fluid management. This study aimed to evaluate the feasibility of dynamic predictors of fluid responsiveness, such as delta down (DD), aortic velocity time integral variability (VTIAoV), and superior vena cava collapsibility index (SVCCI), in patients undergoing neurosurgery for brain tumors.
    UNASSIGNED: In this prospective study, 30 patients scheduled to undergo elective neurosurgery for brain tumor resection were enrolled. Baseline measurements of vitals, anesthetic parameters, and study variables were recorded post-induction. Subsequently, patients received a fluid bolus of 10 mL/kg of colloid over 20 min, and measurements were repeated post-loading. Data were presented as mean ± standard deviation. The normally distributed continuous variables were compared using Student\'s t-test, with P < 0.05 considered statistically significant. The predictive capability of variables for fluid responsiveness was assessed using Pearson\'s coefficient analysis (r).
    UNASSIGNED: Of the 30 patients, 22 were identified as volume responders (R), while eight were non-responders (NR). DD >5 mmHg effectively distinguished between R and NR (P < 0.001), with a good predictive ability (r = 0.759). SVCCI >38% differentiated R from NR (P < 0.001), with excellent predictability (r = 0.994). Similarly, VTIAoV >20% was also a good predictor (P < 0.05; r = 0.746).
    UNASSIGNED: Our study revealed that most patients undergoing surgical resection of brain tumors exhibited fluid responsiveness. Among the variables assessed, SVCCI >38% emerged as an excellent predictor, followed by VTIAoV >20% and DD >5 mm Hg, for evaluating fluid status in this population.
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  • 文章类型: Journal Article
    目前用于脑肿瘤治疗的常规化疗方法在靶向药物递送中具有低效率并且通常具有非靶标毒性。开发针对大多数无法治愈的疾病的稳定有效的药物递送载体是紧迫的生物医学挑战之一。我们已经开发了聚合物纳米颗粒(NPs)与改进的替莫唑胺(TMZ)递送用于有前途的脑肿瘤治疗,对阳离子壳聚糖和阴离子果胶的带相反电荷的多糖的聚电解质复合物进行合理设计。NPs的直径(30至330nm)和ζ电位(-29至73mV)根据生物聚合物的初始质量比而变化。对天然NP的纳米力学参数的评估表明,杨氏模量从58到234kPa变化,附着力从-0.3到-3.57pN变化。通过红外光谱和动态流变学提出了基于离子官能团之间离子相互作用的NPs形成的可能机理。对TMZ吸附的参数和动力学的研究使得有可能鉴定出在模拟身体内部环境的模型液体中最有效地固定和释放活性物质的化合物。在一系列获得的NP中,选择基于相等比例的果胶-壳聚糖(0.1重量%)的聚电解质载体作为最有效的TMZ递送。这表明了治疗脑肿瘤的一种有希望的方法。
    Conventional chemotherapeutic approaches currently used for brain tumor treatment have low efficiency in targeted drug delivery and often have non-target toxicity. Development of stable and effective drug delivery vehicles for the most incurable diseases is one of the urgent biomedical challenges. We have developed polymer nanoparticles (NPs) with improved temozolomide (TMZ) delivery for promising brain tumor therapy, performing a rational design of polyelectrolyte complexes of oppositely charged polysaccharides of cationic chitosan and anionic pectin. The NPs\' diameter (30 to 330 nm) and zeta-potential (-29 to 73 mV) varied according to the initial mass ratios of the biopolymers. The evaluation of nanomechanical parameters of native NPs demonstrated changes in Young\'s modulus from 58 to 234 kPa and adhesion from -0.3 to -3.57 pN. Possible mechanisms of NPs\' formation preliminary based on ionic interactions between ionogenic functional groups were proposed by IR spectroscopy and dynamic rheology. The study of the parameters and kinetics of TMZ sorption made it possible to identify compounds that most effectively immobilize and release the active substance in model liquids that simulate the internal environment of the body. A polyelectrolyte carrier based on an equal ratio of pectin-chitosan (0.1% by weight) was selected as the most effective for the delivery of TMZ among a series of obtained NPs, which indicates a promising approach to the treatment of brain tumors.
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  • 文章类型: Journal Article
    磁共振成像(MRI)在脑肿瘤分类中的应用受到传统诊断程序复杂、耗时的制约,主要是因为需要对几个地区进行全面评估。然而,深度学习(DL)的进步促进了自动化系统的开发,该系统可以改善医学图像的识别和评估,有效应对这些困难。卷积神经网络(CNN)已经成为图像分类和视觉感知的坚定工具。这项研究引入了一种创新的方法,将CNN与混合注意力机制相结合,对原发性脑肿瘤进行分类,包括神经胶质瘤,脑膜瘤,垂体,和无肿瘤病例。所提出的算法经过了来自文献中有据可查的基准数据的严格测试。它与建立的预训练模型如Xception、ResNet50V2、Densenet201、ResNet101V2和DenseNet169。该方法的性能指标显著,分类准确率为98.33%,准确率和召回率为98.30%,F1评分为98.20%。实验发现强调了新方法在识别最常见类型的脑肿瘤方面的优越性。此外,该方法表现出良好的泛化能力,使其成为医疗保健准确有效地诊断大脑状况的宝贵工具。
    The application of magnetic resonance imaging (MRI) in the classification of brain tumors is constrained by the complex and time-consuming characteristics of traditional diagnostics procedures, mainly because of the need for a thorough assessment across several regions. Nevertheless, advancements in deep learning (DL) have facilitated the development of an automated system that improves the identification and assessment of medical images, effectively addressing these difficulties. Convolutional neural networks (CNNs) have emerged as steadfast tools for image classification and visual perception. This study introduces an innovative approach that combines CNNs with a hybrid attention mechanism to classify primary brain tumors, including glioma, meningioma, pituitary, and no-tumor cases. The proposed algorithm was rigorously tested with benchmark data from well-documented sources in the literature. It was evaluated alongside established pre-trained models such as Xception, ResNet50V2, Densenet201, ResNet101V2, and DenseNet169. The performance metrics of the proposed method were remarkable, demonstrating classification accuracy of 98.33%, precision and recall of 98.30%, and F1-score of 98.20%. The experimental finding highlights the superior performance of the new approach in identifying the most frequent types of brain tumors. Furthermore, the method shows excellent generalization capabilities, making it an invaluable tool for healthcare in diagnosing brain conditions accurately and efficiently.
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  • 文章类型: Journal Article
    转移RNA(tRNA)在蛋白质合成中的基本功能是众所周知的。最近的研究揭示了tRNA经历的各种化学修饰,这对各种细胞过程至关重要。这些修饰对于蛋白质的精确和有效翻译是必需的,并且在基因表达调控和细胞应激反应中也起着重要作用。这篇综述探讨了tRNA修饰和失调在各种脑疾病的病理生理学中的作用。包括癫痫,中风,神经发育障碍,脑肿瘤,老年痴呆症,和帕金森病。通过对现有研究的综合分析,我们的研究旨在阐明tRNA失调与脑部疾病之间的复杂关系.这强调了在这一领域进行持续探索的迫切需要,并提供了宝贵的见解,可以促进创新的诊断工具和治疗方法的发展。最终改善应对复杂神经系统疾病的个体的预后。
    Transfer RNAs (tRNAs) are well-known for their essential function in protein synthesis. Recent research has revealed a diverse range of chemical modifications that tRNAs undergo, which are crucial for various cellular processes. These modifications are necessary for the precise and efficient translation of proteins and also play important roles in gene expression regulation and cellular stress response. This review examines the role of tRNA modifications and dysregulation in the pathophysiology of various brain diseases, including epilepsy, stroke, neurodevelopmental disorders, brain tumors, Alzheimer\'s disease, and Parkinson\'s disease. Through a comprehensive analysis of existing research, our study aims to elucidate the intricate relationship between tRNA dysregulation and brain diseases. This underscores the critical need for ongoing exploration in this field and provides valuable insights that could facilitate the development of innovative diagnostic tools and therapeutic approaches, ultimately improving outcomes for individuals grappling with complex neurological conditions.
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  • 文章类型: Case Reports
    脑膜瘤是常见的脑肿瘤,被归类为良性,非典型的,或恶性。该病例涉及一名75岁女性,有缺血性心脏病病史,高血压,和糖尿病。在接受与中风有关的症状评估时,她被诊断出患有非典型脑膜瘤。她在医院的演讲中,患者表现出身体右侧运动功能丧失等症状,弱点,吞咽困难,失语症,表示可能的行程。影像学检查证实了中风症状和非典型脑膜瘤的存在。她治疗的主要重点是解决中风症状。尽管脑膜瘤没有症状,患者选择保守治疗,拒绝侵入性治疗.她的决定得到了尊重,并制定了有关脑膜瘤的定期监测和咨询计划。此案例强调了在涉及偶然脑肿瘤的复杂临床情况下,量身定制的治疗决策的重要性。
    Meningiomas are common brain tumors that are classified as either benign, atypical, or malignant. This case involves a 75-year-old woman with a medical history of ischemic heart disease, hypertension, and diabetes. She was diagnosed with an atypical meningioma while being evaluated for symptoms related to a stroke. Upon her presentation at the hospital, the patient displayed symptoms such as loss of motor function on the right side of her body, weakness, dysphagia, and aphasia, indicating a possible stroke. Imaging tests confirmed both the stroke symptoms and the presence of an atypical meningioma. The primary focus of her treatment was addressing the stroke symptoms. Despite being asymptomatic for the meningioma, the patient opted for conservative treatment and declined invasive procedures. Her decision was respected, and a plan was put in place for regular monitoring and counseling regarding the meningioma. This case emphasizes the significance of tailored treatment decisions in complicated clinical situations involving incidental brain tumors.
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  • 文章类型: Case Reports
    关于神经外科的头部固定实践,二次固定骨折是罕见的,强调精确的销定位和三点夹具中足够的力以实现足够的固定的重要性。应注意骨代谢变化等因素。
    Regarding head immobilization practices in neurosurgery, secondary fixation fractures are rare, underscoring the importance of precise pin positioning and an adequate force in the three-point clamp to achieve adequate fixation. Attention should be given to factors such as changes in bone metabolism.
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  • 文章类型: Journal Article
    放射治疗(RT)在恶性和良性脑肿瘤的治疗中起着基本作用。当前最先进的基于光子和质子的RT结合了目标体积的更共形剂量分布和准确的剂量递送,同时限制了不利的辐射效应。从2000年到2023年10月,对PubMed进行了系统搜索,以确定报告与成人PT治疗中枢神经系统(CNS)/颅底肿瘤相关结果的研究。几项研究表明,与基于光子的(xRT)辐射技术相比,质子疗法(PT)对健康的脑实质提供了减少的剂量。然而,对于不同的成人脑肿瘤,剂量学优势是否转化为优异的临床结局仍是一个悬而未决的问题.这篇综述旨在批判性地回顾成人脑肿瘤患者PT的最新研究,包括神经胶质瘤,脑膜瘤,和脊索瘤,探索其与xRT相比的潜在优势。
    Radiation therapy (RT) plays a fundamental role in the treatment of malignant and benign brain tumors. Current state-of-the-art photon- and proton-based RT combines more conformal dose distribution of target volumes and accurate dose delivery while limiting the adverse radiation effects. PubMed was systematically searched from from 2000 to October 2023 to identify studies reporting outcomes related to treatment of central nervous system (CNS)/skull base tumors with PT in adults. Several studies have demonstrated that proton therapy (PT) provides a reduced dose to healthy brain parenchyma compared with photon-based (xRT) radiation techniques. However, whether dosimetric advantages translate into superior clinical outcomes for different adult brain tumors remains an open question. This review aims at critically reviewing the recent studies on PT in adult patients with brain tumors, including glioma, meningiomas, and chordomas, to explore its potential benefits compared with xRT.
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  • 文章类型: Journal Article
    很少有T细胞渗入原发性脑肿瘤,从根本上阻碍了免疫疗法的有效性。我们假设弓形虫,一种在大脑中自然引发Th1反应的微生物,尽管它们具有免疫抑制的微环境,但可以促进T细胞浸润到脑肿瘤中。使用髓母细胞瘤的小鼠遗传模型,我们发现弓形虫感染诱导可激活的T细胞浸润到肿瘤块中,并导致骨髓细胞向T细胞支持状态重编程,不会对老鼠造成严重的健康问题。该研究为未来的研究提供了具体的基础,以利用弓形虫的免疫调节能力来促进脑肿瘤的免疫治疗。
    Few T cells infiltrate into primary brain tumors, fundamentally hampering the effectiveness of immunotherapy. We hypothesized that Toxoplasma gondii, a microorganism that naturally elicits a Th1 response in the brain, can promote T cell infiltration into brain tumors despite their immune suppressive microenvironment. Using a mouse genetic model for medulloblastoma, we found that T. gondii infection induced the infiltration of activatable T cells into the tumor mass and led to myeloid cell reprogramming toward a T cell-supportive state, without causing severe health issues in mice. The study provides a concrete foundation for future studies to take advantage of the immune modulatory capacity of T. gondii to facilitate brain tumor immunotherapy.
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