Medical hypotheses
-
Degenerative disc disease (DDD) is a major health problem worldwide. Both Modic lesions and Schmorl's nodes are considered to correlate with DDD such as low back pain. Modic lesions are the changes of degenerative vertebral endplate and adjacent bone marrow observed on magnetic resonance imaging and are divided into three types. Modic type III lesions are thought to represent extensive subchondral bone sclerosis within the bone marrow of adjacent endplate. The pathological performance of Schmorl's nodes is cystic lesions around indistinct sclerotic margins and beneath the cartilaginous endplate. Coincidently, there are many similarities between Modic type III lesions and Schmorl's nodes including pathological appearances, pathogenetic location and related diseases. ⋯ This hypothesis explains the possible pathologic process of Modic type III lesions and Schmorl's nodes. If the hypothesis were conformed, Modic type III lesions and Schmorl's nodes will be rediscovered, which provides the new basis for the clinical treatment of DDD. In additions, this hypothesis also has crucial significances for the classification of Modic lesions.
-
In a recent series of polemical editorials in this journal, a scathing and much needed criticism is made of many aspects of current scientific mores, detecting some worrying dysfunctions which threaten the integrity of the whole scientific enterprise. Although the tone is a bit hyperbolic, many important issues are addressed, such as honesty in research, the centrality of truth in science, the role of creativity, just to cite a few. Though agreeing with the overall diagnosis, the discussion still suffers from a lack of a clear and systemic view of science, from which a more precise analysis could be carried out. ⋯ In this paper we address these shortcomings with the aim of contributing to a better understanding of this timely discussion. Though conceding that major structural, historical and cultural shifts might have caused irreversible changes on the way science now evolves, we make some suggestions to counter this trend. These include, among others, the need for an honest and careful dealing with the media and public, to prize and abide by the ethos of science and its underlying values, to cultivate an exact philosophy and to insist that disinterested curiosity and the desire to understand the world are the vital motivations of science.