Primary malignant tumors of the spine are relatively rare, less than 5% of all spinal column tumors. However, these lesions are often among the most difficult to treat and encompass challenging pathologies such as cho...Primary malignant tumors of the spine are relatively rare, less than 5% of all spinal column tumors. However, these lesions are often among the most difficult to treat and encompass challenging pathologies such as chordoma and a variety of invasive sarcomas. The mechanisms of tumor recurrence after surgical intervention, as well as resistance to radiation and chemotherapy, remain a pervasive and costly problem. Recent evidence has emerged supporting the hypothesis that solid tumors contain a sub-population of cancer cells that possess characteristics normally associated with stem cells. Particularly, the potential for long-term proliferation appears to be restricted to subpopulations of cancer stem cells(CSCs) functionally defined by their capacity to self-renew and give rise to differentiated cells that phenotypically recapitulate the original tumor, thereby causing relapse and patient death. These cancer stem cells present a unique opportunity to better understand the biology of solid tumors in general, as well as targets for future therapeutics. The general objective of the current study is to discuss the fundamental concepts for understanding the role of CSCs with respect to chemoresistance, radioresistance, special cell surface markers, cancer recurrence and metastasis intumors of the osseous spine. This discussion is followed by a specific review of what is known about the role of CSCs in chordoma, the most common primary malignant osseous tumor of the spine.展开更多
Purpose:The median time from the event leading to the spinal cord injury(SCI)to the time of decompressive surgery is estimated to be 6.9 days in Iran,which is much longer than the proposed ideal time(less than 24 h)in...Purpose:The median time from the event leading to the spinal cord injury(SCI)to the time of decompressive surgery is estimated to be 6.9 days in Iran,which is much longer than the proposed ideal time(less than 24 h)in published guidelines.The current qualitative study aimed to determine the reasons for the observed decompression surgery delay in Iran from the perspective of neurosurgeons.Methods:This qualitative study is designed to perform content analysis on the gathered data from face-to-face semi-structured interviews with 12 Iranian neurosurgeons.Results:The findings of the current study suggest that patient-related factors constitute more than half of the codes extracted from the interviews.Overall,the type of injury,presence of polytrauma,and surgeons’’wrong attitude are the main factors causing delayed spinal cord decompression in Iranian patients from the perspective of neurosurgeons.Other notable factors include delay in transferring patients to the trauma center,delay in availability of necessary equipment,and scarce medical personnel.Conclusion:In the perspective of neurosurgeons,the type of injury,presence of polytrauma,and surgeons’’wrong attitude are the leading reasons for delayed decompressive surgery of individuals with SCI in Iran.展开更多
文摘Primary malignant tumors of the spine are relatively rare, less than 5% of all spinal column tumors. However, these lesions are often among the most difficult to treat and encompass challenging pathologies such as chordoma and a variety of invasive sarcomas. The mechanisms of tumor recurrence after surgical intervention, as well as resistance to radiation and chemotherapy, remain a pervasive and costly problem. Recent evidence has emerged supporting the hypothesis that solid tumors contain a sub-population of cancer cells that possess characteristics normally associated with stem cells. Particularly, the potential for long-term proliferation appears to be restricted to subpopulations of cancer stem cells(CSCs) functionally defined by their capacity to self-renew and give rise to differentiated cells that phenotypically recapitulate the original tumor, thereby causing relapse and patient death. These cancer stem cells present a unique opportunity to better understand the biology of solid tumors in general, as well as targets for future therapeutics. The general objective of the current study is to discuss the fundamental concepts for understanding the role of CSCs with respect to chemoresistance, radioresistance, special cell surface markers, cancer recurrence and metastasis intumors of the osseous spine. This discussion is followed by a specific review of what is known about the role of CSCs in chordoma, the most common primary malignant osseous tumor of the spine.
基金funded by Sina Trauma and Surgery Research Center,Tehran University of Medical Sciences(grant number 98-01-38-41413)。
文摘Purpose:The median time from the event leading to the spinal cord injury(SCI)to the time of decompressive surgery is estimated to be 6.9 days in Iran,which is much longer than the proposed ideal time(less than 24 h)in published guidelines.The current qualitative study aimed to determine the reasons for the observed decompression surgery delay in Iran from the perspective of neurosurgeons.Methods:This qualitative study is designed to perform content analysis on the gathered data from face-to-face semi-structured interviews with 12 Iranian neurosurgeons.Results:The findings of the current study suggest that patient-related factors constitute more than half of the codes extracted from the interviews.Overall,the type of injury,presence of polytrauma,and surgeons’’wrong attitude are the main factors causing delayed spinal cord decompression in Iranian patients from the perspective of neurosurgeons.Other notable factors include delay in transferring patients to the trauma center,delay in availability of necessary equipment,and scarce medical personnel.Conclusion:In the perspective of neurosurgeons,the type of injury,presence of polytrauma,and surgeons’’wrong attitude are the leading reasons for delayed decompressive surgery of individuals with SCI in Iran.
