Professor Sebastian Brandner, we have a great discussion of brain diseases. We discussed how brain tumors benefit from the science of neuropathology and neurology. But it's interesting to know this. Dr. Anton Titov, MD. What drives you in life? What makes you tick? What makes you determined and successful in your research and clinical work? Dr. Sebastian Brandner, MD. First of all, it's a very interesting job that we're having here. It's a very major academic health science center. It's a major referral hospital with lots of specialists working around us. I have to say it becomes interesting because we are embedded in one of these centers of excellence for brain research. We do neurodegeneration research. Dr. Sebastian Brandner, MD. We do brain tumor research. Without a proper functioning of these associated and affiliated departments, all the success will be impossible. There's no point coming every day to work and having to deal with only small numbers of clinical cases. It’s boring to deal with only small quantities and repetitive diagnosis. What we want to see is interesting diseases and patients. We want to see diseases and patients that fascinate us every day. Dr. Sebastian Brandner, MD. We are having 5% of our work being new everyday. We are having 5% of problematic clinical cases and unsolvable cases. That drives us. The curiosity motivates us. Dr. Anton Titov, MD. How can we solve that medical problem? There is the molecular classification of brain tumors. We saw a lot of problems with the diagnosis. But now we realize we created a few more new problems. These problems are at the fringes of these clear-cut diagnoses. Because now we find new combinations of brain tumor markers that don't seem to make sense. Brain tumor markers sometimes don't fit into the diagnostic landscape of brain tumor. So that drives us. Dr. Anton Titov, MD. What's behind that brain tumor problem? That's why we use additional diagnostic tests. We find out more about a brain tumor. Other things that drive me, in particular, is leading the department. We have the financial challenges at the NHS. Dr. Sebastian Brandner, MD. At our hospital we have to make savings. But we have to be clever about how to make the savings. How we can make savings by attracting more referrals of brain tumor patients. This gives us the opportunity to develop economies of scale. It's an important factor that allows us to invest and cut down the prices. This is great for the NHS. It is very useful for patients. The charities like that. Brain tumor charities like that. One of the brain tumor charities is now called BTC, the Brain Tumor Charity. They funded a startup with 75,000 GBP 8 or 9 years ago. Startup set up this molecular diagnostics test. The aim was to make sure revenue from new brain tumor diagnostic test covers the expenditures. Expenditure for staff and equipment and everything costs a lot of money. Dr. Sebastian Brandner, MD. So this is now very economical. This is the sort of thing that drives me. So every year, twice a year, I will be summoned to my clinical director. I go to the managing director. He says this. Where are the savings? Can you demonstrate you can cut down costs 10% here and there? This can be challenging. I think a hospital director shouldn't be too much focused on savings. Because you have to keep center of excellence running. Dr. Sebastian Brandner, MD. But these are the challenges that keep me awake at night. The third challenge is getting research grants to continue the brain tumor research. We must ask the questions that I really am interested in. We must find new brain tumor biomarkers. Dr. Anton Titov, MD. How can we find the brain tumor marker that is predictive of a certain brain tumor survival? We must do neurodegeneration research. We have to find answers to the question that our recent publication has opened now. Is there another way of transmitting protein diseases? Are certain Alzheimer’s patients at risk? Is it a medical procedure that can transmit Alzheimer’s disease? Which other medical procedures can transmit Alzheimer’s disease? How can we actually find a way of discovering Alzheimer’s disease transmission? Dr. Sebastian Brandner, MD. So all these questions keep us awake at night. So yes, this is one of the things. These are the constellations that make me want to come here. I want to achieve something. I’d like to have a great team of colleagues around. We have trainees who deliver a great deal of work. They deliver fantastic brain tumor research results. I'm happy to promote trainees into lecturer positions. Dr. Sebastian Brandner, MD. So this sort of thing drives me. I see young physicians growing up. I see trainees growing up to become clinically excellent academics. This is the environment where this is possible. What I'm hearing is that. It is part of the challenge. Your interest is to be a medical detective on behalf of the patients. You investigate what it is that is not discovered. Dr. Anton Titov, MD. What it is that's not on a surface. What seems to be a large challenge? That is a part of your being a medical detective. Yes! Professor Sebastian Brandner, thank you very much for this conversation on brain tumors and larger aspects of neurology. I really appreciate it. I am sure it will be very interesting for viewers around the world. Thank you for the interview! Dr. Sebastian Brandner, MD. Thanks for coming here! “Having 5% of problematic clinical cases and unsolvable cases. How can we solve that problem? Now we find new combinations of diagnostic molecular markers. They don’t seem to fit into the brain tumor diagnostic landscape. So that drives us. What’s behind that problem?”.
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