Brain and nerve = Shinkei kenkyū no shinpo
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Transient ischemic attack (TIA) is a medical emergency, which has been newly termed as "acute cerebrovascular syndrome" (ACVS). TIA is often ignored or unrecognized by patients or their families since its symptoms are naturally subsided without any treatment. TIA is also usually underestimated or nonprioritized by physicians because it is regarded merely as a minor stroke. ⋯ A large international, multicenter cooperative, observational study (TIA Registry. Org.) on 5,000 patients with TIA or minor stroke within 7 days of onset is being initiated. Now, we should say "Time is TIA".
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Endovascular therapy for cerebral aneurysms has been possible since the advent of Guglielmi detachable coils. The International Subarachnoid Aneurysm Trial (ISAT) showed that the 1-year outcome of endovascular coiling for ruptured aneurysms was significantly better than that of neurosurgical clipping. After the ISAT study, remarkably high numbers of aneurysms have been treated using coils across the world. ⋯ Bioactive coils allow the healing of aneurysm by promoting tissue reaction. However, it is difficult to cure very large and giant aneurysms even with the new coils. Hence flow-diverting stents and Onyx are being clinically tested for the treatment of such cases.
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Duchenne muscular dystrophy (DMD) is the most common form of inherited muscle disease and is characterized by progressive muscle wasting ultimately resulting in death of the patients in their twenties. DMD is characterized by a deficiency of the muscle dystrophin as a result of mutations in the dystrophin gene. Currently, no effective treatment for DMD is available. ⋯ Induction of the read-through effect using gentamycin or PTC124 is expected to produce dystrophin in DMD patients with nonsense mutation. The treatment with PTC124 is currently under clinical trial. In this review, these treatments strategies have been summarized.
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Despite remarkable advancements in brain tumor surgery after the introduction of operating microscopes and neuronavigation systems, precise removal of infiltrative brain tumors such as gliomas remains difficult. In many cases, the margins of these tumors are unclear even under the microscope. Neuronavigation based on preoperative images also is unreliable after the "brain shift" phonomenon following cerebrospinal fluid (CSF) withdrawal and/or tumor removal. ⋯ Various lay-outs of the operating room and iMRI units with different magnetic field strengths ranging from 0.12T to 3.0T are currently in use. In 2006, we introduced 2 operation theaters with iMRI units, a 0.4T, relatively low (0.4T) and high (1.5T) magnetic-field strengths were installed at the Nagoya University Hospital and the Nagoya Central Hospital, one of our affiliated hospitals, respectively. In this paper, we discuss the, effectiveness of iMRI, as well as several problems associated with its application on the basis of the relevant literatures and our experience of more than 400 operations performed at the 2 different iMRI operation theaters, Brain THEATER and BrainSUITE.
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Oncolytic viruses are genetically engineered, recombinant viruses or naturally occurring, attenuated viruses that infect, replicate selectively within, and destroy tumor cells. These viruses are nontoxic to normal tissues, and progeny viruses released from destroyed tumor cells can spread and infect surrounding tumor cells. In addition, most oncolytic viruses can elicit specific antitumor immunity in the course of tumor cell destruction. ⋯ Thus far, oncolytic viruses that are inoculated intratumorally, are shown to be safe; adverse events typically observed are usually transient and include local inflammation and flu-like symptoms. Oncolytic viruses can be used in combination with chemotherapy or other conventional therapies, which, in some cases, can lead to synergistic effects. This review summarizes the recent advances in clinical and preclinical research on oncolytic virus therapy for malignant brain tumors.