Dr. 一位伯杰 is chair of the neurological surgery department at UCSF and director of the 脑瘤 Research Center. 伯杰在迈阿密长大, attended Harvard and turned to medicine after his first career choice – professional football – didn't pan out. 自1979年成为一名内科十大赌博平台排行榜以来，伯杰的专长是治疗 脑部肿瘤 在成人和 癫痫 与脑肿瘤有关. 他也是先驱 大脑映射 techniques used to identify speech, motor and sensory areas that should be avoided during surgery.
你为什么决定成为一名神经外科十大赌博平台排行榜?
可能有两个原因. 一个是在医学院, the subject matter that made the most sense to me was the nervous system. 我立刻明白了这一点. 第二，我一直喜欢建造东西. I built my mother a stool; I built my own dresser. 我真的很喜欢用我的双手工作. 所以我把这两件事放在一起，这就是神经外科.
在过去，被诊断出脑瘤就相当于被判了死刑. 这种情况正在改变吗??
It's important to remember that there are many different types of tumors with different prognoses. But in general, it's a much more encouraging field now for several reasons. We understand the genetics and the biology of these tumors so much better than we ever used to and have better ways of predicting how patients are going to do. We can do a molecular-based analysis of a tumor to look for various molecular signatures. If we see a certain chromosomal pattern or a certain gene that's not functioning well, 我们将知道病人是否对治疗有反应. 通过这些线索, we've learned how to deal with these tumors in different ways and we're much, 比以往任何时候都要成功.
即使是最具侵袭性的肿瘤也是如此吗?
A lot of tumors such as the very high-grade aggressive tumors can't be cured with surgery alone. But we can significantly prolong a person's life – good quality life. 在过去的20年里, we've essentially tripled the lifespan of patients with the most aggressive glioma, 胶质母细胞瘤.
你是怎么做到的?
我们做的手术更激进也更安全, 我们使用的放射疗法更有针对性, 更有效的, 一次又一次, 更安全的. And then we've got better chemotherapy with the drugs Temodar and 阿瓦斯丁. 阿瓦斯丁, 例如, 阻断肿瘤中新血管的形成, 所以它减缓了肿瘤的生长，这非常令人印象深刻.
该领域还有哪些令人兴奋的发展?
我们可以花几个星期讨论这个问题. 新的大脑绘图技术, 其中很多都是我们在加州大学旧金山分校开创的, 真的有影响吗. 我们现在可以知道大脑中语言中心的位置, 运动，感觉系统和视觉通路在哪里. That allows us to be more aggressive in surgery, but more importantly, we can be 更安全的. 这是巨大的. In the past many patients were injured by surgery and that decreased not just their quantity of life, 还有他们的生活质量. Brain mapping has made the biggest difference in treating the low-grade gliomas, the slower growing tumors that typically affect young people and where surgery has long been the most effective treatment. We did a study on low-grade gliomas and found that if post-operative imaging shows that we were successful in completely removing the tumor, 我们现在可以达到近100%的十年存活率. 在做这项研究之前，我们从来不知道这一点. 这改变了神经外科的面貌, because now we know that when we see those low-grade gliomas we have to do everything we can to remove them.
那么新型的成像系统呢?
Imaging has completely changed the field, allowing us to see things we could never see before. 我们有高分辨率 核磁共振成像 scanners that not only give us the anatomy of the tumor but they tell about the physiology of it – how many cells are infiltrating a given part of the brain, 在大脑的特定部位有多少血流量, 哪个更能说明肿瘤的恶性程度更高.
Have these advances made neurosurgery a happier, more hopeful specialty?
这从来都不是一个不愉快的职业——它只是充满挑战. But our goals of improving patient outcome are more reachable now than they never have been. 知道你能帮助病人让人非常兴奋.
Has the prevalence of 脑部肿瘤 changed – it seems like you hear about them a lot more often?
不，都是一样的. The incidence for children is around four to six people per 100,000 population. 对于成年人来说，每10万人中大约有10到12人. But the detection rates are higher because people do more imaging than they ever used to do.
我读到你最初想成为一名足球运动员.
I played football in high school and college and tried out for the Chicago Bears but didn't last there, 所以我去了医学院. Football was a big part of my life because it taught me how to work within a team environment.
这和你现在的工作有关吗?
我想是的. 没有人自己管理护理. 你在一个团队里做.
You are now serving on a committee advising the National Football League on how to reduce concussions and other injuries that can cause brain trauma. 这让你绕了一圈，不是吗?
I've always wanted to give back to the sport that allowed me to be a physician. I learned all that discipline and team management because I was in football. This is one of the ways I've decided to give back — to help them make it a 更安全的 game.
这意味着什么??
The game is intrinsically violent and that's not going to change unless we change the rules. 所以我们改变了规则. 我们已经禁止头盔间的接触. We've made the kickoffs different so there are fewer kick-off returns because that's where a lot of the bad injuries occur. The goal is to try to change the culture of the people who play the game and those who manage the game like coaches and team physicians to be much more aware of the possible consequences of these injuries.
在加州大学旧金山分校工作最好的部分是什么?
这是一个非凡的环境. We're steeped in talent at every level – it’s like playing on an all-star football team.
You have a reputation as being a physician who is very accessible to his patients.
我为此感到自豪. I've always had the basic philosophy that I treat my patients like they're my family. That's the way I have always been and that's the way I will always be. 所以我为什么不想把我的电话号码给家人呢? 我为什么不想让他们通过电子邮件联系我呢? 我想让他们觉得和我在一起很舒服. I want us to be as friendly as we can as we go though this process together. 我想让他们依靠我，指望我. 我想替他们担心. 我爱我的病人.
你们会长期保持联系吗?
是的. 今天我看了一个两年没见的病人. 我看见她从提款机里取钱, 轻轻地拍了拍她的肩膀, 给了她一个拥抱和吻. 我喜欢拥抱我的病人. 我从中得到了很多温暖. 这让我感觉很好.
这对神经外科十大赌博平台排行榜来说并不常见.
神经外科十大赌博平台排行榜可能以自我为中心，冷漠. 我理解. 有些人就是不能十大赌博靠谱网络平台. But many of my friends in life are patients that I socialize with and go out with. I think when you try to live dual lives – one as a physician, one as a person – it doesn't work. 我觉得这辈子应该只有一次.
女演员撞到头部——十大赌博平台排行榜发现她患有脑瘤
The story: When a tumor showed up on an 核磁共振成像 after an actress fell from a hammock, a UCSF brain-mapping technique and a special surgeon "saved" her brain.
