37 research outputs found
Neurosurgical anatomy of the insula and Sylvian fissure in gliomas: literature data and own experience. The first report. Arteries
Insular gliomas account for 25Β % of all low-grade and 10Β % of all high-grade gliomas. This complex neural and vascular anatomy of the insula and subinsular areas and the attendant risk of postoperative neurological deficit render resection of insular gliomas challenging. Postoperative morbidity can result from injury to these arteries. The cortex and adjacent subcortical structures of the insula are supplied with blood from the cortical insular perforating arteries and lenticulostriate arteries. The source of both types of arteries is the middle cerebral artery. To preserve these vessels, it is necessary to take into account their location while performing approach and tumor debulking.The presurgical planning is extremely important for insular glioma surgery, which allows predicting the extent of removal and to assess the risk of postoperative morbidity. The digital subtractive angiography, CT angiography, MRI angiography make a full picture of the tumor relationship with the lenticulostriate arteries while it is almost impossible to identify the tumor involvement of the insular arteries.The aim of insular glioma surgery is to achieve total removal while preserving critical arteries. This goal is complicated both by a small diameter of lenticulostriate and insular arteries, which intraoperatively complicates their identification and their involvement in tumor tissue. The intraoperative neuroimaging, neuronavigation, intraoperative neuromonitoring can help guide the extent of resection and prevent or minimize postoperative morbidity. However, these advanced technologies are often insufficient without a comprehensive understanding of the insular functional and vascular anatomy
Use of algorithm of the prevention complex of inflammatory processes in the oral cavity in metabolic syndrome
The aim of the work was to evaluate in the experiment the effectiveness of the developed treatment-and-prophylactic
complex for the prevention of periodontal tissue disorders under metabolic syndrome simulation.
Materials and methods. The study of biochemical and immunological changes in the blood serum, liver and gingival
tissue was performed during simulation on the metabolic syndrome of alimentary genesis on Wistar rats, all animals
were divided into 5 groups: 1) intact; 2) with simulated metabolic syndrome; 3) in a week after the start of MS simulation
5 times a week in the morning perorally administered a βCapillaroprotectβ aqueous solution (bioflavonoid, antioxidant)
produced by βEkosvit Oilβ (Ukraine) at a rate of 135 mg/kg; 4) under similar conditions receiving the preparation based
on the dihydroquercetin were locally applied on gums a new dental elixir based on bee products and adaptogens of plant
origin by 0,5 ml/rat with a tampon, which has held for 5β7 minutes; 5) during MS simulation from the second week were
used the preparation based on the dihydroquercetin, the dental elixir topically on gums and physiotherapy.
Results. Under conditions of experimental MS simulation with a diet rich in saturated fats and carbohydrate there are
systemic disorders in the body: reduced nonspecific antimicrobial protection, increased microbial contamination, intensification of lipid peroxidation, the development of inflammation and hepatotoxicity. Prophylactic administration of the
proposed dihydroquercetin preparation to animals in the process of simulation of MS significantly inhibits the established disorders, positively affecting the biochemical parameters of the blood serum, liver tissue, periodontium, reducing
triglycerides, total cholesterol, glucose level, restoring the state of non-specific resistance, lipid metabolism, preventing
inflammation and hepatosis, as well as contamination with pathogenic microflora.
Conclusion. The proposed treatment-and-prophylactic complex, which includes the dihydroquercetin preparation, used
per os in combination with local therapy of periodontal tissues with a tooth elixir based on propolis and biologically
active substances of plant origin adaptogens with ultraphonophoresis under induced metabolic syndrome significantly
removed the negative effects of its most important component
ΠΠ°ΡΡΠΎΡΡΠ²Π°Π½Π½Ρ ΠΌΡΠ»ΡΡΠΈΠΌΠΎΠ΄Π°Π»ΡΠ½ΠΎΡ Π½Π΅ΠΉΡΠΎΠ½Π°Π²ΡΠ³Π°ΡΡΡ Π² Ρ ΡΡΡΡΠ³ΡΡ ΠΏΡΡ Π»ΠΈΠ½ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·ΠΊΡ
The experience of multimodal neuronavigation using at patients with brain tumors surgical treatment is presented. Multimodal neuronavigation allows simultaneous using of different neuroiradiological methodsβ data for surgical intervention planning before operation and intraoperative orientation at brain tumors resection. The use of neuronavigation in neurooncology allows to improve tumor resection, to avoid damage of functionally important brain areas, and to reduce the risk of postoperative neurological deficit.ΠΡΠΈΠ²Π΅Π΄Π΅Π½ ΠΎΠΏΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΌΡΠ»ΡΡΠΈΠΌΠΎΠ΄Π°Π»ΡΠ½ΠΎΠΉ Π½Π΅ΠΉΡΠΎΠ½Π°Π²ΠΈΠ³Π°ΡΠΈΠΈ ΠΏΡΠΈ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΠΎΠΏΡΡ
ΠΎΠ»ΡΠΌΠΈ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°. ΠΡΠ»ΡΡΠΈΠΌΠΎΠ΄Π°Π»ΡΠ½Π°Ρ Π½Π΅ΠΉΡΠΎΠ½Π°Π²ΠΈΠ³Π°ΡΠΈΡ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΎΠ΄Π½ΠΎΠΌΠΎΠΌΠ΅Π½ΡΠ½ΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡ Π΄Π°Π½Π½ΡΠ΅ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π½Π΅ΠΉΡΠΎΠ²ΠΈΠ·ΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ Π΄Π»Ρ Π΄ΠΎΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΠΏΠ»Π°Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π° ΠΈ ΠΈΠ½ΡΡΠ°ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΎΡΠΈΠ΅Π½ΡΠ°ΡΠΈΠΈ ΠΏΡΠΈ ΡΠ΄Π°Π»Π΅Π½ΠΈΠΈ ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π½Π΅ΠΉΡΠΎΠ½Π°Π²ΠΈΠ³Π°ΡΠΈΠΈ Π² Π½Π΅ΠΉΡΠΎΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΠΈ ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΡΠ΅Ρ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΡΡΠΈ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°, ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΈΠ·Π±Π΅ΠΆΠ°ΡΡ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎ Π²Π°ΠΆΠ½ΡΡ
ΡΡΡΡΠΊΡΡΡ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°, ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ²Π°Π΅Ρ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠΈΡΠΊΠ° Π²ΠΎΠ·Π½ΠΈΠΊΠ½ΠΎΠ²Π΅Π½ΠΈΡ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π΄Π΅ΡΠΈΡΠΈΡΠ°.ΠΠ°Π²Π΅Π΄Π΅Π½ΠΈΠΉ Π΄ΠΎΡΠ²ΡΠ΄ Π·Π°ΡΡΠΎΡΡΠ²Π°Π½Π½Ρ ΠΌΡΠ»ΡΡΠΈΠΌΠΎΠ΄Π°Π»ΡΠ½ΠΎΡ Π½Π΅ΠΉΡΠΎΠ½Π°Π²ΡΠ³Π°ΡΡΡ ΠΏΡΠΈ Ρ
ΡΡΡΡΠ³ΡΡΠ½ΠΎΠΌΡ Π»ΡΠΊΡΠ²Π°Π½Π½Ρ Ρ
Π²ΠΎΡΠΈΡ
Π· ΠΏΡΡ
Π»ΠΈΠ½Π°ΠΌΠΈ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·ΠΊΡ. ΠΡΠ»ΡΡΠΈΠΌΠΎΠ΄Π°Π»ΡΠ½Π° Π½Π΅ΠΉΡΠΎΠ½Π°Π²ΡΠ³Π°ΡΡΡ Π΄ΠΎΠ·Π²ΠΎΠ»ΡΡ ΠΎΠ΄Π½ΠΎΠΌΠΎΠΌΠ΅Π½ΡΠ½ΠΎ Π²ΠΈΠΊΠΎΡΠΈΡΡΠΎΠ²ΡΠ²Π°ΡΠΈ Π΄Π°Π½Ρ ΡΡΠ·Π½ΠΈΡ
ΠΌΠ΅ΡΠΎΠ΄ΡΠ² Π½Π΅ΠΉΡΠΎΠ²ΡΠ·ΡΠ°Π»ΡΠ·Π°ΡΡΡ Π΄Π»Ρ Π΄ΠΎΠΎΠΏΠ΅ΡΠ°ΡΡΠΉΠ½ΠΎΠ³ΠΎ ΠΏΠ»Π°Π½ΡΠ²Π°Π½Π½Ρ Ρ
ΡΡΡΡΠ³ΡΡΠ½ΠΎΠ³ΠΎ Π²ΡΡΡΡΠ°Π½Π½Ρ ΡΠ° ΡΠ½ΡΡΠ°ΠΎΠΏΠ΅ΡΠ°ΡΡΠΉΠ½ΠΎΡ ΠΎΡΡΡΠ½ΡΠ°ΡΡΡ ΠΏΡΠ΄ ΡΠ°Ρ Π²ΠΈΠ΄Π°Π»Π΅Π½Π½Ρ ΠΏΡΡ
Π»ΠΈΠ½ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·ΠΊΡ. ΠΠ°ΡΡΠΎΡΡΠ²Π°Π½Π½Ρ Π½Π΅ΠΉΡΠΎΠ½Π°Π²ΡΠ³Π°ΡΡΡ Π² Π½Π΅ΠΉΡΠΎΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΡΡ ΡΠΏΡΠΈΡΡ ΠΏΡΠ΄Π²ΠΈΡΠ΅Π½Π½Ρ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΡΡΡ Ρ
ΡΡΡΡΠ³ΡΡΠ½ΠΎΠ³ΠΎ Π²ΡΡΡΡΠ°Π½Π½Ρ, Π΄ΠΎΠ·Π²ΠΎΠ»ΡΡ ΡΠ½ΠΈΠΊΠ½ΡΡΠΈ ΠΏΠΎΡΠΊΠΎΠ΄ΠΆΠ΅Π½Π½Ρ ΡΡΠ½ΠΊΡΡΠΎΠ½Π°Π»ΡΠ½ΠΎ Π²Π°ΠΆΠ»ΠΈΠ²ΠΈΡ
ΡΡΡΡΠΊΡΡΡ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·ΠΊΡ, Π·Π°Π±Π΅Π·ΠΏΠ΅ΡΡΡ Π·Π½ΠΈΠΆΠ΅Π½Π½Ρ ΡΠΈΠ·ΠΈΠΊΡ Π²ΠΈΠ½ΠΈΠΊΠ½Π΅Π½Π½Ρ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΡΡΠ½ΠΎΠ³ΠΎ Π΄Π΅ΡΡΡΠΈΡΡ
Time factor role estimation in combined treatment of primary malignant brain tumours
The effectiveness of postoperative radiotherapy in patients with primary malignant brain tumours treatment was analysed. The dependence of life duration and quality, radio reactions frequency and severity on the terms of postoperative irradiation
Substantiation of indications for the third molarβ follicle removing, taking into account violations of occlusal relations
Π¦Π΅Π»ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π±ΡΠ»ΠΎ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ ΠΎΠΊΠΊΠ»ΡΠ·ΠΈΠΎΠ½Π½ΡΡ
ΡΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΉ ΠΏΡΡΠ΅ΠΌ ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΠΉ ΠΏΠΎ ΡΠ΄Π°Π»Π΅Π½ΠΈΡ ΡΡΠ΅ΡΡΠΈΡ
ΠΌΠΎΠ»ΡΡΠΎΠ². ΠΠ·ΡΡΠ΅Π½Ρ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ ΠΎΠΊΠΊΠ»ΡΠ·ΠΈΠΎΠ½Π½ΡΡ
Π²Π·Π°ΠΈΠΌΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΉ (ΠΌΠ΅Π·ΠΈΠ°Π»ΡΠ½Π°Ρ, Π΄ΠΈΡΡΠ°Π»ΡΠ½Π°Ρ ΠΎΠΊΠΊΠ»ΡΠ·ΠΈΠΈ) ΠΏΡΠΈ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ ΠΈ ΠΏΡΠΎΡΠ΅Π·ΡΠ²Π°Π½ΠΈΠΈ ΠΈΠΌΠΏΠ°ΠΊΡΠ½ΡΡ
ΡΡΠ΅ΡΡΠΈΡ
ΠΌΠΎΠ»ΡΡΠΎΠ², Π° ΡΠ°ΠΊΠΆΠ΅ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΠ° ΡΠΎΠ»Π»ΠΈΠΊΡΠ»ΠΎΠ² ΡΡΠ΅ΡΡΠΈΡ
ΠΌΠΎΠ»ΡΡΠΎΠ². ΠΠ·ΡΡΠ΅Π½Ρ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ Π² Π²ΠΈΡΠΎΡΠ½ΠΎ-Π½ΠΈΠΆΠ½Π΅ΡΠ΅Π»ΡΡΡΠ½ΠΎΠΌ ΡΡΡΡΠ°Π²Π΅ ΠΏΡΠΈ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ ΠΎΠΊΠΊΠ»ΡΠ·ΠΈΠΎΠ½Π½ΡΡ
Π²Π·Π°ΠΈΠΌΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΉ ΠΏΡΠΈ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ ΠΈ
ΠΏΡΠΎΡΠ΅Π·ΡΠ²Π°Π½ΠΈΠΈ ΡΡΠ΅ΡΡΠΈΡ
ΠΌΠΎΠ»ΡΡΠΎΠ². ΠΠ·ΡΡΠ΅Π½Ρ ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΡΠΊΠ°Π½Π΅ΠΉ, ΠΎΠΊΡΡΠΆΠ°ΡΡΠΈΡ
ΠΈΠΌΠΏΠ°ΠΊΡΠ½ΡΠ΅ ΡΡΠ΅ΡΡΠΈ ΠΌΠΎΠ»ΡΡΡ Π½Π° ΠΌΠΎΠΌΠ΅Π½Ρ ΠΈΡ
ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΈ ΠΏΡΠΎΡΠ΅Π·ΡΠ²Π°Π½ΠΈΡ. Π£ΡΠΎΡΠ½Π΅Π½Ρ ΡΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΎ ΡΠ°ΠΊΡΠΎΡΠ°Ρ
, Π²Π»ΠΈΡΡΡΠΈΡ
Π½Π° ΠΏΡΠΎΡΠ΅ΡΡ
ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ ΠΎΠΊΠΊΠ»ΡΠ·ΠΈΠΎΠ½Π½ΡΡ
Π²Π·Π°ΠΈΠΌΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΉ ΠΏΡΠΈ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ ΠΈ ΠΏΡΠΎΡΠ΅Π·ΡΠ²Π°Π½ΠΈΠΈ ΠΈΠΌΠΏΠ°ΠΊΡΠ½ΡΡ
ΡΡΠ΅ΡΡΠΈΡ
ΠΌΠΎΠ»ΡΡΠΎΠ². Π£ΡΠΎΡΠ½Π΅Π½Ρ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΡΠ΅ΡΠΌΠ΅Π½ΡΠ°ΡΠΈΠ²Π½ΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ ΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ Π±ΠΈΠΎΡΠ΅Π½ΠΎΠ·Π° Π² ΠΏΠΎΠ»ΠΎΡΡΠΈ ΡΡΠ° ΠΏΡΠΈ
ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ ΠΈ ΠΏΡΠΎΡΠ΅Π·ΡΠ²Π°Π½ΠΈΠΈ ΠΈΠΌΠΏΠ°ΠΊΡΠ½ΡΡ
ΡΡΠ΅ΡΡΠΈΡ
ΠΌΠΎΠ»ΡΡΠΎΠ².The aim of the investigation was to increase the effectiveness of prevention of violations of occlusal relations by substantiating the indications for the removal of third molars. The mechanisms of formation of occlusal relationships (mesial, distal occlusion) during the formation and eruption of impacted third molars, as well as the shell of third molar follicles have been studied. Changes in the temporomandibular joint in the formation of occlusal relationships in the creation and eruption of third molars have been studied. The morphological features of the tissues surrounding the impacted third molars at the time of their formation and eruption have been studied. Updated information on the factors influencing the process of formation of violations of occlusal relationships in the formation and eruption of impact third molars. The indicators of enzymatic changes and indicators of biocenosis in the oral cavity during the formation and eruption of impact third molars have been specified
ΠΠΎΠΊΠ°Π·Π½ΠΈΠΊΠΈ ΡΠΊΠΎΡΡΡ ΠΆΠΈΡΡΡ Π² ΠΎΡΡΠ½ΡΡ Π΅ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π»ΡΠΊΡΠ²Π°Π½Π½Ρ Ρ Π²ΠΎΡΠΈΡ Π· Π³Π»ΡΠ°Π»ΡΠ½ΠΈΠΌΠΈ ΠΏΡΡ Π»ΠΈΠ½Π°ΠΌΠΈ ΠΏΡΠ²ΠΊΡΠ»Ρ Π²Π΅Π»ΠΈΠΊΠΎΠ³ΠΎ ΠΌΠΎΠ·ΠΊΡ
In the process of patients with gliomas complex treatment their quality of life was researched. It was found that before treatment the life quality was estimated as low and medium, it depended on localization, gystobiology, preoperative neurological deficit severity, age and gender. After postoperative treatment patients quantity with Karnofsky scale index 70 scores and more grew up to 37,2%, with medium and high levels of life quality by the social-psychology adaptation scale increased to 39%.ΠΠ·ΡΡΠ΅Π½Ρ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΆΠΈΠ·Π½ΠΈ (ΠΠ) Ρ 532 Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ Π³Π»ΠΈΠΎΠΌΠΎΠΉ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° (ΠΠΠ) Π² ΠΏΡΠΎΡΠ΅ΡΡΠ΅ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ. Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ ΠΠ Π·Π°Π²ΠΈΡΠΈΡ ΠΎΡ Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ, Π³ΠΈΡΡΠΎΠ±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ²ΠΎΠΉΡΡΠ² ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ, Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΠΈ Π΄ΠΎΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π΄Π΅ΡΠΈΡΠΈΡΠ°, Π²ΠΎΠ·ΡΠ°ΡΡΠ° ΠΈ ΠΏΠΎΠ»Π°. ΠΠΎΡΠ»Π΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΡΠ΅Π°Π±ΠΈΠ»ΠΈΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΠΉ ΡΠΈΡΠ»ΠΎ Π±ΠΎΠ»ΡΠ½ΡΡ
, Ρ ΠΊΠΎΡΠΎΡΡΡ
ΠΈΠ½Π΄Π΅ΠΊΡ Karnofsky ΠΏΡΠ΅Π²ΡΡΠ°Π» 70 Π±Π°Π»Π»ΠΎΠ², ΡΠ²Π΅Π»ΠΈΡΠΈΠ»ΠΎΡΡ Π½Π° 37,2%, ΡΠΈΡΠ»ΠΎ Π±ΠΎΠ»ΡΠ½ΡΡ
, Ρ ΠΊΠΎΡΠΎΡΡΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΠΠ ΠΏΠΎ ΡΠΊΠ°Π»Π΅ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π°Π΄Π°ΠΏΡΠ°ΡΠΈΠΈ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΎΠ²Π°Π»ΠΈ Β«ΡΡΠ΅Π΄Π½Π΅ΠΌΡΒ» ΠΈ Β«Π²ΡΡΠΎΠΊΠΎΠΌΡΒ» ΡΡΠΎΠ²Π½Ρ β Π½Π° 39%.ΠΠΈΠ²ΡΠ΅Π½Ρ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠΈ ΡΠΊΠΎΡΡΡ ΠΆΠΈΡΡΡ (Π―Π) Ρ 532 Ρ
Π²ΠΎΡΠΈΡ
Π· Π³Π»ΡΠΎΠΌΠΎΡ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·ΠΊΡ Ρ ΠΏΡΠΎΡΠ΅ΡΡ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ³ΠΎ Π»ΡΠΊΡΠ²Π°Π½Π½Ρ. ΠΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΠΎ Π―Π Π·Π°Π»Π΅ΠΆΠΈΡΡ Π²ΡΠ΄ Π»ΠΎΠΊΠ°Π»ΡΠ·Π°ΡΡΡ, Π³ΡΡΡΠΎΠ±ΡΠΎΠ»ΠΎΠ³ΡΡΠ½ΠΈΡ
Π²Π»Π°ΡΡΠΈΠ²ΠΎΡΡΠ΅ΠΉ ΠΏΡΡ
Π»ΠΈΠ½ΠΈ, Π²ΠΈΡΠ°ΠΆΠ΅Π½ΠΎΡΡΡ Π΄ΠΎΠΎΠΏΠ΅ΡΠ°ΡΡΠΉΠ½ΠΎΠ³ΠΎ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΡΡΠ½ΠΎΠ³ΠΎ Π΄Π΅ΡΡΡΠΈΡΡ, Π²ΡΠΊΡ Ρ ΡΡΠ°ΡΡ. ΠΡΡΠ»Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½Ρ ΡΠ΅Π°Π±ΡΠ»ΡΡΠ°ΡΡΠΉΠ½ΠΈΡ
Π·Π°Ρ
ΠΎΠ΄ΡΠ² ΠΊΡΠ»ΡΠΊΡΡΡΡ Ρ
Π²ΠΎΡΠΈΡ
, Ρ ΡΠΊΠΈΡ
ΡΠ½Π΄Π΅ΠΊΡ Karnofsky ΠΏΠ΅ΡΠ΅Π²ΠΈΡΡΠ²Π°Π² 70 Π±Π°Π»ΡΠ², Π·Π±ΡΠ»ΡΡΠΈΠ»Π°ΡΡ Π½Π° 37,2%, Π· ΡΠ΅ΡΠ΅Π΄Π½ΡΠΌ Ρ Π²ΠΈΡΠΎΠΊΠΈΠΌ ΡΡΠ²Π½Π΅ΠΌ Π―Π Π·Π° ΡΠΊΠ°Π»ΠΎΡ ΡΠΎΡΡΠ°Π»ΡΠ½ΠΎ-ΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΡΡΠ½ΠΎΡ Π°Π΄Π°ΠΏΡΠ°ΡΡΡ Π·ΡΠΎΡΠ»Π° β 39%
Changes in the structure of synaptic intercellular contacts in focal brain lesions
Purpose: to evaluate changes in the structure of synaptic contacts in various types of focal brain pathology.
Materials and methods. The results of treatment of 40 cases of supratentorial focal lesions of the brain (FLB) were retrospectively evaluated. The cases are divided into groups: 30 gliomas of various degrees of malignancy and 5 consequences of TBI, 5 epilepsy. All patients underwent surgical interventions. The synaptic plasticity of axo-dendritic and axo-spiny asymmetric synapses of neurons of the VI-VII layers of the frontotemporal cortex was studied by electron microscopy. Morphometric analysis was carried out on a computer image analyzer Π‘ΠΠ-01ΠΠΠ using the software "Kappa opto-electronics GmbH" using the STATISTICA 7 program package.
The results. It was established that the density of synapses decreased in glioblastomas (GB) and craniocerebral injury (Π‘Π‘Π). Qualitative changes demonstrate the plasticity of architectonics of synapse, in particular due to the increase in the number of perforated synaptic contacts. Maximum thickening and diffuse stratification of the postsynaptic seal indicates a violation of the functional capacity of the postsynaptic component of the contacts. A decrease in the number of synaptic vesicles was revealed in Π‘Π‘Π and GB, with their rearrangement, which is probably a manifestation of synaptic dysfunction. The latter proves the irreversibility of destructive local changes and is unfavorable criterion. The risk of the formation of destructive-degenerative changes in the synaptic apparatus is 7.64 times higher in DA, 3.17 times higher in GB, and 17.31 times higher in Π‘Π‘Π compared to cases of epilepsy, with GB significantly increases by 13.5 times compared to DA. Therefore, the assessment of the structural features of neuroplasticity should take into account the morphogenesis of the BM in comparison with clinical data
Conclusions. In the zones of invasive growth of gliomas of various degrees of malignancy and in Π‘Π‘Π and epilepsy, the indicators of synaptic plasticity differ statistically significantly. The density of placement of synapses is lower in GB and Π‘Π‘Π. The probability of non-reversibility of destructive-degenerative changes of synapses according to the number of SVs in FLB correlates with the degree of glioma differentiation with a sensitivity of 81.0% and a specificity of 76.0%. According to the structural changes of synaptic connections in tumors, probable differences between the variants have been proven: GB and DA, the sensitivity of the discriminant model is 85.0%, the specificity is 74.0%, which is an indirect evidence of the growth rate of the tumor mass and its destructive effect on the surrounding brain matter. The obtained results are important in assessing the prognosis of the further course of the disease
Neurosurgical anatomy of the insula and Sylvian fissure in gliomas: literature review and personal experience. The second report. Veins
Insular gliomas account for 25% of all low-grade and 10% of high-grade gliomas. Neurosurgical treatment of insular gliomas involves achieving the maximum possible volume of tumor removal while ensuring high quality of life.
The anatomical proximity of functionally important brain structures and the involvement of important insular arteries and veins limits the possibility of radical removal of tumors.
The key to the effectiveness of surgical intervention in insular gliomas is the selection and implementation of adequate surgical access surgical access. The most commonly used approach to insular gliomas is transsylvian-transinsular. The implementation of this approach is largely determined by the individual characteristics of the venous system of the sylvian fissure, since it is characterized by extreme anatomical variability in particular, the type of outflow direction dominance, the number of veins, their size, type of branching, drainage, collateral connections.
The review presents data on the informativeness of modern methods of instrumental research in the assessment of the venous system of the sylvian fissure and insula with the aim of planning surgery for insular gliomas.
Methods of preserving venous collectors of the sylvian fissure and possible complications associated with the exclusion of draining veins from the circulation are described