Brain iron deposits have been reported consistently in imaging and histologic examinations of patients with neurodegenerative disorders. While the origins of this finding have not been clarified yet, it is speculated that impaired iron homeostasis or deficient transport mechanisms result in the accumulation of this highly toxic metal ultimately leading to formation of reactive oxygen species and cell death. On the other hand, there are also those who support that iron is just an incidental finding, a by product of neuronal loss. A literature review has been performed in order to present the key findings in support of the iron hypothesis of neurodegeneration, as well as to identify conditions causing or resulting from iron overload and compare and contrast their features with the most prominent neurodegenerative disorders. There is an abundance of experimental and observational findings in support of the hypothesis in question; however, as neurodegeneration is a rare incident of commonly encountered iron-associated disorders of the nervous system, and this metal is found in non-neurodegenerative disorders as well, it is possible that iron is the result or even an incidental finding in neurodegeneration. Understanding the underlying processes of iron metabolism in the brain and particularly its release during cell damage is expected to provide a deeper understanding of the origins of neurodegeneration in the years to come.
Οncological outcomes in patients with primary rectal cancer have markedly improved over the last few years, mainly due to the widespread application of the total mesorectal excision technique. This improvement should also be largely attributed to multiple specialties, other than colorectal surgery, such as radiology, oncology and pathology. Therefore, a multimodal approach is key to efficient and appropriate rectal cancer management. Multidisciplinary tumor (MDT) boards have become an important asset for the management and treatment of patients with rectal cancer, and a number of studies published to date suggest the beneficial effect of the multidisciplinary approach on the management of such patients. The available evidence demonstrates a modification of the treatment plan, attributed to the MDT implementation, in a non-negligible proportion of these patients. However, more studies are required in order to assess the exact impact of MDT boards on disease-free and overall survival of patients with primary rectal cancer.
Sclerosing mesenteritis is primarily diagnosed through histologic and radiologic evaluation; however, only a few works provide a systematic description using MRI. This work presents the case of a 68-year-old male, who was admitted for a routine cholecystectomy. Intraoperativly, a large mass was identified dislocating the abdominal viscera. The microscopic examination revealed vascular congestion of the omentum. The contrast-enhanced CT and MRI scans revealed the presence of a heterogenous, lipomatous mass with lesions visible only in T2W and contrast-enhanced T1W MRI. Based on these findings, the diagnosis of sclerosing mesenteritis was made. According to the available literature, depending on the stage of sclerosing mesenteritis, different radiologic features are encountered; however, it is possible that features from more than one form of the condition coexist in the same lesion. We therefore suggest that a combination of MRI sequences should be acquired for a more accurate staging of the condition.
27 January 2024 in Spine Surgery and Related Research
BackgroundThe emergence of novel minimally invasive techniques has opened new horizons for the management of degenerative diseases of the spine. Platelet-rich plasma (PRP) has gained considerable attention through its applications in various pathologies. In the present review, an overview of the science behind the application of PRP is provided, ultimately focusing on the clinical trials that may render it a useful tool in the hands of spine surgeons in the future.MethodsA review of the available literature is conducted, focusing on its existing clinical and experimental applications with a particular interest in the degenerative diseases of the spine.ResultsIn terms of the degenerative diseases of the spine, initial studies suggest that it is a safe and effective method that could change the practice of spinal cord medicine in the years to come. The available studies demonstrate that besides being minimally invasive, causing less discomfort than that of surgery, it provides longer lasting improvement than standard pharmaceutical interventions.ConclusionsPRP is an emerging and promising biodrug for the treatment of patients with spinal pain. PRP has demonstrated some promising qualities; however, careful consideration of its indications of use and strict protocols of application need to be established before widespread clinical induction.
1 January 2018 in Surgical Neurology International
Cavernomas of the cauda equina are extramedullary, arise on the inner aspect of the dura, and may be tightly adhered to the nerve roots. To attain gross total excision, the involved nerve may have to be sacrificed; in some cases, this may result in a permanent neurological deficit. Of interest, half of the cauda equina lesions were previously found in patients who had prior radiotherapy; this was not the case in this patient.