Search

Convection-enhanced delivery for central nervous system gene therapy is an emerging treatment strategy to modify the course of previously untreatable or inadequately treated neurologic conditions, including brain tumors, metabolic disorders, epilepsy, and neurodegenerative disorders. Ongoing nervous system gene therapy clinical trials highlight advantages and ongoing challenges to this therapeutic paradigm., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Brain metastases are the most common intracranial tumor and a leading cause of morbidity and mortality for patients with systemic cancer. En bloc surgical resection of brain metastases improves survival, local recurrence rates, and functional independence in patients with up to three metastases and controlled extracranial disease. Modern techniques and technologies provide the neurosurgeon with minimally invasive approaches, such as keyhole craniotomies and tubular retractors. Preoperative planning for tumors located in eloquent regions includes mapping with functional MRI and diffusion tensor imaging, and intraoperative mapping and monitoring with electrophysiologic techniques under general or awake anesthesia to preserve normal neurologic function., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2020 Elsevier Inc. All rights reserved.)

The resolution and real-time navigation of intraoperative MRI (iMRI) has been leveraged in neurosurgery. We review frameless stereotactic biopsy platforms and focus on emerging technology integrating intraoperative MRI with frameless stereotaxy. Brain biopsy with iMRI allows for an accurate tissue sample with the ability to correct cannula trajectory during surgery, eliminating misdiagnosis secondary to faulty targeting. This technology allows for a percutaneous approach avoiding large incisions, obviates the need for frozen tissue evaluation, has the potential to reduce unnecessary specimen harvesting and operating room time, and optimizes safety of targeting deep brain lesions., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background/aims: Low serum levels of pepsinogen A are indicative of chronic atrophy, a risk factor for gastric cancer. This study investigated the relationships between low pepsinogen A levels, Helicobacter pylori seropositivity, and gastric cancer rates in 17 populations worldwide., Methods: In each center, about 200 randomly selected subjects (50 male and 50 female, aged 25-34 and 55-64 years) provided serum samples for pepsinogen analysis and H. pylori serology., Results: Cumulative gastric cancer rates were associated with the prevalence of low pepsinogen A levels in men (coefficient, 0.15 [P = 0.06] for mortality; coefficient, 0.36 [P = 0.01] for incidence) but not women. The prevalence of low pepsinogen A levels was also correlated with H. pylori seropositivity in the older age group (r = 0.55; P = 0.02). Low pepsinogen A levels were significantly more common in the older group (7.5% vs. 2.1% in the younger group; P < 0.001), among women (5.5% vs. 4.1% in men; P = 0.04), and among nonsmokers (5.8% vs. 2.9% in current smokers; P = 0.001)., Conclusions: Low pepsinogen A levels are more common in areas with a high seroprevalence of H. pylori and in men in areas with high rates of gastric cancer. The prevalence of low pepsinogen A levels increases with age, but the excess in women and nonsmokers could reflect factors other than gastric pathology.