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1.
Artículo en Ruso | MEDLINE | ID: mdl-38881016

RESUMEN

BACKGROUND: Contrast enhancement of intracranial aneurysm wall during MRI with targeted visualization of vascular wall correlates with previous aneurysm rupture and, according to some data, may be a predictor of further rupture of unruptured aneurysms. OBJECTIVE: To analyze possible causes of aneurysm contrast enhancement considering morphological data of aneurysm walls. MATERIAL AND METHODS: The study included 44 patients with intracranial aneurysms who underwent preoperative MRI between November 2020 and September 2022. Each aneurysm was assessed regarding contrast enhancement pattern. Microsurgical treatment of aneurysm was accompanied by resection of its wall for subsequent histological and immunohistochemical analysis regarding thrombosis, inflammation and neovascularization. Specimens were subjected to histological and immunochemical analysis. Immunohistochemical analysis was valuable to estimate inflammatory markers CD68 and CD3, as well as neurovascularization marker SD31. RESULTS: Aneurysms with contrast-enhanced walls were characterized by higher number of CD3+, CD68+, CD31+ cells and parietal clots. Intensity of contrast enhancement correlated with aneurysm wall abnormalities. CONCLUSION: Contrast enhancement of aneurysm wall can characterize various morphological abnormalities.


Asunto(s)
Aneurisma Intracraneal , Imagen por Resonancia Magnética , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/cirugía , Aneurisma Intracraneal/patología , Masculino , Femenino , Persona de Mediana Edad , Imagen por Resonancia Magnética/métodos , Neuroimagen/métodos , Antígenos de Diferenciación Mielomonocítica/análisis , Antígenos de Diferenciación Mielomonocítica/metabolismo , Adulto , Medios de Contraste , Antígenos CD/análisis , Antígenos CD/metabolismo , Anciano , Aneurisma Roto/diagnóstico por imagen , Aneurisma Roto/cirugía , Aneurisma Roto/patología , Molécula-1 de Adhesión Celular Endotelial de Plaqueta/análisis , Molécula-1 de Adhesión Celular Endotelial de Plaqueta/metabolismo , Complejo CD3/análisis , Complejo CD3/metabolismo , Molécula CD68
2.
Artículo en Ruso | MEDLINE | ID: mdl-38881020

RESUMEN

BACKGROUND: Treatment of patients with prolonged and permanent disturbance of consciousness is still an extremely difficult problem. Nowadays, management is based on pathophysiological and molecular mechanisms of impaired consciousness. Several electrophysiological and pharmacological methods were proposed to restore consciousness in appropriate patients. OBJECTIVE: We present recovery of clear consciousness under therapy with phenazepam and literature review devoted to therapy of these disorders. RESULTS AND CONCLUSION: This case confirms available data on drug neuromodulation in complex treatment of patients with prolonged impairment of consciousness and substantiates the need for individual multimodal assessment of structural and functional disorders in prolonged and chronic impairment of consciousness for adequate therapy.


Asunto(s)
Benzodiazepinas , Humanos , Benzodiazepinas/uso terapéutico , Benzodiazepinas/administración & dosificación , Estado de Conciencia/efectos de los fármacos , Estado de Conciencia/fisiología , Trastornos de la Conciencia/fisiopatología , Trastornos de la Conciencia/tratamiento farmacológico , Trastornos de la Conciencia/terapia , Masculino
3.
Artículo en Ruso | MEDLINE | ID: mdl-38549416

RESUMEN

Primary brainstem gliomas are still poorly studied in neurooncology. This concept includes tumors with different histological and genetic features, as well as variable clinical course and outcomes. Nevertheless, treatment implies radiotherapy without a clear idea of morphological substrate of disease in 80% of cases. Small number of studies and insufficient data on histological and genetic nature of brainstem tumors complicate clear diagnostic and treatment algorithms. This review provides current information regarding primary glial brainstem tumors. Appropriate problems and objectives are highlighted. The purpose of the review is to provide a comprehensive and updated understanding of the current state of brainstem glial tumors and to identify areas requiring further study for improvement of diagnosis and treatment of these diseases. Brainstem tumors are an understudied problem with small amount of data that complicates optimal treatment strategies. Further researches and histological verification are required to develop new methods of therapy, especially for diffuse forms of neoplasms.


Asunto(s)
Neoplasias del Tronco Encefálico , Glioma , Humanos , Glioma/terapia , Neoplasias del Tronco Encefálico/terapia , Neoplasias del Tronco Encefálico/patología
4.
Artículo en Inglés, Ruso | MEDLINE | ID: mdl-38054223

RESUMEN

BACKGROUND: Chordoid glioma is a rare slow-growing tumor of the central nervous system. Available world experience includes no more than 200 cases (lesion of the third ventricle in absolute majority of cases). Recognition and treatment of chordoid glioma are currently difficult problems due to small incidence of this disease. OBJECTIVE: To describe clinical manifestations and surgical treatment of chordoid glioma of the third ventricle considering literature data and own experience. MATERIAL AND METHODS: There were 12 patients (6 men and 6 women) with chordoid glioma between 2004 and 2023 (10 patients with lesion of the third ventricle, 1 - lateral ventricle, 1 - pineal region). Only patients with tumors of the third ventricle were analyzed. RESULTS: Total and subtotal resection was performed in 1 and 3 cases, respectively. Five patients underwent partial resection, 1 patient underwent biopsy. The follow-up data were available in 7 out of 10 patients (mean 25 months). Radiotherapy was performed in 4 patients (continued tumor growth in 2 cases). One patient died. CONCLUSION: Chordoid glioma is a benign tumor predominantly localized in the third ventricle. Preoperative MRI and CT in some cases make it possible to suspect chordoid glioma and differentiate this tumor from craniopharyngioma, meningioma and pituitary adenoma by such signs as isointense signal in T1WI, hyper- or isointense signal in T2WI, homogeneous contrast enhancement and edema of basal ganglia in T2 FLAIR images. The only effective treatment for chordoid glioma is surgery. Total resection is often impossible or extremely dangerous due to location of tumor, large size and invasion of the third ventricle. Postoperative mental disorders and diabetes insipidus, including severe hypernatremia, are common that requires mandatory monitoring of water and electrolyte balance.


Asunto(s)
Neoplasias del Ventrículo Cerebral , Glioma , Neoplasias Hipofisarias , Tercer Ventrículo , Masculino , Humanos , Femenino , Tercer Ventrículo/diagnóstico por imagen , Tercer Ventrículo/cirugía , Glioma/diagnóstico por imagen , Glioma/cirugía , Neoplasias del Ventrículo Cerebral/diagnóstico por imagen , Neoplasias del Ventrículo Cerebral/cirugía , Ventrículos Laterales , Neoplasias Hipofisarias/patología , Imagen por Resonancia Magnética
5.
Phys Rev Lett ; 131(22): 221801, 2023 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-38101357

RESUMEN

Using an 185-kg NaI[Tl] array, COHERENT has measured the inclusive electron-neutrino charged-current cross section on ^{127}I with pion decay-at-rest neutrinos produced by the Spallation Neutron Source at Oak Ridge National Laboratory. Iodine is one the heaviest targets for which low-energy (≤50 MeV) inelastic neutrino-nucleus processes have been measured, and this is the first measurement of its inclusive cross section. After a five-year detector exposure, COHERENT reports a flux-averaged cross section for electron neutrinos of 9.2_{-1.8}^{+2.1}×10^{-40} cm^{2}. This corresponds to a value that is ∼41% lower than predicted using the MARLEY event generator with a measured Gamow-Teller strength distribution. In addition, the observed visible spectrum from charged-current scattering on ^{127}I has been measured between 10 and 55 MeV, and the exclusive zero-neutron and one-or-more-neutron emission cross sections are measured to be 5.2_{-3.1}^{+3.4}×10^{-40} and 2.2_{-0.5}^{+0.4}×10^{-40} cm^{2}, respectively.

6.
Probl Endokrinol (Mosk) ; 69(5): 65-72, 2023 Nov 11.
Artículo en Ruso | MEDLINE | ID: mdl-37968953

RESUMEN

Reset osmostat syndrome (ROS) is characterized by a change of normal plasma osmolality threshold (decrease or increase), which leads to chronic dysnatremia (hypo- or hypernatremia). We have described a clinical case of ROS and chronic hyponatremia in a patient with chordoid glioma of the III ventricle. It is known that the patient had previously been diagnosed with hyponatremia (131-134 mmol/l). She has not hypothyroidism and hypocorticism. There is normal filtration function of the kidneys was (CKD-EPI 91.7 ml/mi/1,73m2). Urine osmolality and sodium level were studied to exclude of concentration kidney function disorder. During first three days after removal of the tumor of the third ventricle (chordoid glioma, WHO Grade II), the sodium level decreased to 119 mmol/l. Repeated infusions of 200-300 ml hypertonic 3% sodium chloride solution, gluco- and mineralocorticoid therapy was ineffective, increasing plasma sodium levels by 2-3 mmol/l with the return to the initial level during 6-8 hours. Hypopituitary disorders did not develop after surgery. With further observation, the sodium level remained within 126-129 mmol/l for 6 months after surgery. The water load test make exclude the classic syndrome of inappropriate secretion of antidiuretic hormone, and confirmed the diagnosis of RSO. Because of absence of clinical symptoms associated with hyponatremia, no medical correction was required, patient was recommended to clinical follow-up.


Asunto(s)
Glioma , Hiponatremia , Síndrome de Secreción Inadecuada de ADH , Enfermedades Renales , Femenino , Humanos , Hiponatremia/diagnóstico , Hiponatremia/etiología , Hiponatremia/tratamiento farmacológico , Síndrome de Secreción Inadecuada de ADH/diagnóstico , Síndrome de Secreción Inadecuada de ADH/complicaciones , Especies Reactivas de Oxígeno/uso terapéutico , Enfermedades Renales/complicaciones , Sodio , Glioma/complicaciones
7.
Artículo en Inglés, Ruso | MEDLINE | ID: mdl-37830469

RESUMEN

BACKGROUND: Hemorrhage from intracranial aneurysms is associated with high risk of adverse outcomes. In this regard, surgical treatment of unruptured asymptomatic aneurysms has been actively developed in recent decades. One of the objectives is searching for predictors of aneurysm rupture to clarify the indications for surgery. Non-invasive analysis of vascular wall is actively discussed in last years. OBJECTIVE: To evaluate the possibilities of MRI of ruptured and unruptured intracranial aneurysm walls and determine clinical significance of certain morphological patterns. MATERIAL AND METHODS: The study included 111 patients with 158 ruptured and unruptured saccular aneurysms who underwent MRI according to a special protocol between November 2020 and September 2023. We analyzed each aneurysm regarding features of contrast enhancement and changes in SWAN images. After that, we compared these data with ruptures. RESULTS: Wall of ruptured and unruptured aneurysms can accumulate contrast agent. We found 5 types of contrast enhancement. Thick-layer contrast enhancement was accompanied by 9.6-fold higher risk of aneurysm rupture compared to aneurysms without contrast enhancement. Dark MR signal from intracranial aneurysm wall in SWAN imaging is a significant sign of rupture. CONCLUSION: MRI of the vascular wall is valuable to verify ruptured aneurysms. Unruptured aneurysms can accumulate contrast agent inside the wall, and pattern of accumulation differs from ruptured aneurysms. Morphological analysis is needed to confirm contrast enhancement as a marker of aneurysm rupture.


Asunto(s)
Aneurisma Roto , Aneurisma Intracraneal , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/cirugía , Aneurisma Intracraneal/patología , Medios de Contraste , Imagen por Resonancia Magnética/métodos , Aneurisma Roto/diagnóstico por imagen , Aneurisma Roto/cirugía
8.
Phys Rev Lett ; 130(5): 051803, 2023 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-36800477

RESUMEN

The COHERENT Collaboration searched for scalar dark matter particles produced at the Spallation Neutron Source with masses between 1 and 220 MeV/c^{2} using a CsI[Na] scintillation detector sensitive to nuclear recoils above 9 keV_{nr}. No evidence for dark matter is found and we thus place limits on allowed parameter space. With this low-threshold detector, we are sensitive to coherent elastic scattering between dark matter and nuclei. The cross section for this process is orders of magnitude higher than for other processes historically used for accelerator-based direct-detection searches so that our small, 14.6 kg detector significantly improves on past constraints. At peak sensitivity, we reject the flux consistent with the cosmologically observed dark-matter concentration for all coupling constants α_{D}<0.64, assuming a scalar dark-matter particle. We also calculate the sensitivity of future COHERENT detectors to dark-matter signals which will ambitiously test multiple dark-matter spin scenarios.

9.
Artículo en Inglés, Ruso | MEDLINE | ID: mdl-36534620

RESUMEN

Difficult total resection of supratentorial gliomas adjacent to the corticospinal tract (CST) is due to the high risk of its injury and disability of patients. The main methods for preventing intraoperative CST damage are preoperative MR tractography and intraoperative electrophysiological monitoring. The problem of total resection of gliomas adjacent to the CST with preservation of high functional status is difficult due to immaturity and plasticity of brain structures in children. Moreover, the advantages of MR tractography combined with intraoperative monitoring have not been described. The authors present surgical treatment of supratentorial gliomas adjacent to the CST at different anatomical levels. Patients underwent preoperative and postoperative MR tractography and intraoperative electrophysiological monitoring. MR tractography provided preoperative data on CST lesion. Intraoperative monitoring made it possible to identify and preserve CST in the depth of surgical wound. MR tractography and intraoperative electrophysiological monitoring increase resection quality in patients with hemispheric and subcortical gliomas without postoperative functional deterioration.


Asunto(s)
Neoplasias Encefálicas , Glioma , Humanos , Niño , Tractos Piramidales , Neoplasias Encefálicas/cirugía , Mapeo Encefálico/métodos , Glioma/cirugía , Monitoreo Intraoperatorio/métodos
10.
Phys Rev Lett ; 129(8): 081801, 2022 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-36053683

RESUMEN

We measured the cross section of coherent elastic neutrino-nucleus scattering (CEvNS) using a CsI[Na] scintillating crystal in a high flux of neutrinos produced at the Spallation Neutron Source at Oak Ridge National Laboratory. New data collected before detector decommissioning have more than doubled the dataset since the first observation of CEvNS, achieved with this detector. Systematic uncertainties have also been reduced with an updated quenching model, allowing for improved precision. With these analysis improvements, the COHERENT Collaboration determined the cross section to be (165_{-25}^{+30})×10^{-40} cm^{2}, consistent with the standard model, giving the most precise measurement of CEvNS yet. The timing structure of the neutrino beam has been exploited to compare the CEvNS cross section from scattering of different neutrino flavors. This result places leading constraints on neutrino nonstandard interactions while testing lepton flavor universality and measures the weak mixing angle as sin^{2}θ_{W}=0.220_{-0.026}^{+0.028} at Q^{2}≈(50 MeV)^{2}.

11.
Artículo en Inglés | MEDLINE | ID: mdl-35960283

RESUMEN

The article is devoted to conceptualization of current scientific experience of studying disorders associated with information technologies. Over the past decades, prevalence of information technologies in world modern society occurs with such intensity that detailed study of influence of this factor on health is significantly lagged behind. In the last decade, a number of pathological conditions associated with application of modern information technologies, in particular psychological and psychiatric profile, was described. The new concepts of Internet addiction, gambling, problematic use of technologies, etc., describing individual response of patients, are introduced. At that, lack of fundamental understanding of both etiology and pathogenesis of described conditions due to multiform specifics, high comorbidity and active evolution of digital society. The article attempts to fill this gap and to approach issue on population scale, namely to evaluate from perspective of epidemiological method characteristics of occurrence, spread and termination of pathogenic effects. The analysis of existing studies suggests that causation of emerging disorders is related not only to addictive behavior and prolonged exposure to information flow, but also to different pathogenicity of its particular components, causing various clinical forms of health disorders in individual with different levels of susceptibility. The pattern of new unique pathogen with specific propagation in human population is described - indirectly through digital environment - and capable of replication within specific ecological niche, i.e. digital pathogen tropic to bio-substrates of higher nervous activity. At that, the duration of contact with digital environment is considered as necessary but insufficient cause of development of pathological process that corresponds to empirical data. The most important property of digital pathogen propagation is its ability to replicate in anthropogenic abiotic digital environment, which is conditioned by its nature, mechanisms of accumulation and distribution. It is also noteworthy that basic principles of dissemination of information flows in social networks largely repeat principles of propagation of infectious pathogens in nature and are characterized by unique mechanism and ways of its transmission. It is concluded that in modern conditions there is a need to study problem of pathology associated with digital environment at population level from position of epidemiological method. The important aspects are joint efforts in studying and classifying new pathogen at interdisciplinary level and developing preventive measures.


Asunto(s)
Conducta Adictiva , Juego de Azar , Conducta Adictiva/epidemiología , Conducta Adictiva/psicología , Juego de Azar/epidemiología , Juego de Azar/psicología , Humanos , Tecnología de la Información
12.
Artículo en Ruso | MEDLINE | ID: mdl-35170272

RESUMEN

Analysis of historical and modern approaches to teaching neurosurgery by professional communities and public authorities in the United States, the European Union and the Russian Federation makes it possible to develop a modern training program regarding content and duration. High-tech and dynamically developing specialty has acquired several large sub-specializations over the past decades. Each direction requires a long-term training and a special program. Training in neurosurgery in the modern world takes 5-7 years and involves acquisition of clinical and scientific knowledge. Some issues are brought up for discussion by professional community. Solution of these problems will provide an opportunity for international integration of the Russian training program for neurosurgeons. High level of neurosurgery in our country and a single educational space with the European community will allow exchanging students, adopting foreign experience and sharing our own experience.


Asunto(s)
Neurocirujanos , Neurocirugia , Humanos , Federación de Rusia , Estados Unidos
13.
Dalton Trans ; 51(3): 1206-1215, 2022 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-34951437

RESUMEN

Moving towards a hydrogen economy raises the demand for affordable and efficient catalysts for the oxygen reduction reaction. Cu-bmpa (bmpa = bis(2-picolyl)amine) is shown to have moderate activity, but poor selectivity for the 4-electron reduction of oxygen to water. To enhance the selectivity towards water formation, the cooperative effect of three Cu-bmpa binding sites in a single trinuclear complex is investigated. The catalytic currents in the presence of the trinuclear sites are lower, possibly due to the more rigid structure and therefore higher reorganization energies and/or slower diffusion rates of the catalytic species. Although the oxygen reduction activity of the trinuclear complexes is lower than that of mononuclear Cu-bmpa, the selectivity of the copper mediated oxygen reduction was significantly enhanced towards the 4-electron process due to a cooperative effect between three copper centers that have been positioned in close proximity. These results indicate that the cooperativity between metal ions within biomimetic sites can greatly enhance the ORR selectivity.

14.
Probl Endokrinol (Mosk) ; 67(5): 58-66, 2021 10 03.
Artículo en Ruso | MEDLINE | ID: mdl-34766492

RESUMEN

We describe a 15-year girl, who developed panhypopituitarism and diencephalic obesity after surgical excision of craniopharyngioma, followed by nonalcoholic fatty liver disease and cirrhosis 5 years after surgery. Cirrhosis in this case manifested by hypoxia due to hepatopulmonary syndrome, and despite cure of craniopharyngioma by surgery and radiosurgery treatment and adequate hormonal substitution therapy patient died 9 years after surgery. Growth hormone substitutional therapy in patients with hypopituitarism, and steatohepatitis may decrease liver triglyceride accumulation and prevent end-stage liver disease.


Asunto(s)
Craneofaringioma , Síndrome Hepatopulmonar , Enfermedad del Hígado Graso no Alcohólico , Neoplasias Hipofisarias , Craneofaringioma/complicaciones , Craneofaringioma/cirugía , Femenino , Síndrome Hepatopulmonar/complicaciones , Síndrome Hepatopulmonar/cirugía , Humanos , Cirrosis Hepática/complicaciones , Cirrosis Hepática/cirugía , Enfermedad del Hígado Graso no Alcohólico/complicaciones , Enfermedad del Hígado Graso no Alcohólico/cirugía , Obesidad/complicaciones , Neoplasias Hipofisarias/complicaciones , Neoplasias Hipofisarias/cirugía
15.
Artículo en Ruso | MEDLINE | ID: mdl-34714001

RESUMEN

Surgery is an effective approach for drug-resistant temporal lobe epilepsy following hippocampal sclerosis. There is still no clear and unanimous opinion about advantages and disadvantages of certain surgical technique. MATERIAL AND METHODS: There were 103 surgical interventions in 101 patients. Females prevailed (1.45:1). Age of patients ranged from 16 to 56 years (median 28). Anteromedial temporal lobectomy and selective amygdaloghippocampectomy were performed in 49 (47.6%) and 54 (52.4%) patients, respectively. In the latter group, 30 patients were operated via a 14-mm burr hole-subtemporal approach. Postoperative outcomes were assessed using the Engel grading system. The follow-up period ranged from 2 to 8 years (median 4 years). RESULTS: By the 2nd year, Engel class I was observed in 74 (72%) patients, Engel II, III and IV - in 20 (19.4%), 6 (5.8%) and 3 (2.9%) patients, respectively. Engel class I was achieved after anteromedial temporal lobectomy in 68% of cases, selective amygdaloghippocampectomy via standard approaches in 75% of cases, amygdaloghippocampectomy via subtemporal burr hole approach - in 80% of cases. Neurocognitive impairments after anteromedial lobectomy and selective amygdaloghippocampectomy were similar. At the same time, mental disorders de novo prevailed in the group of anteromedial lobectomy (p<0.05). There were no severe visual field disorders after subtemporal burr-hole access. In other cases, these disorders occurred in 36.2% of patients (p<0.05). There were 8 (7.8%) postoperative complications: 5 (10.2%) - after anterior temporal lobectomy, 3 (5.5%) - after selective surgeries via standard approaches. There were no complications after burr-hole surgery. CONCLUSION: Selective amygdaloghippocampectomy is not inferior to anteromedial lobectomy. Moreover, this procedure is associated with a lower risk of complications and adverse events.


Asunto(s)
Epilepsia del Lóbulo Temporal , Preparaciones Farmacéuticas , Adolescente , Adulto , Epilepsia del Lóbulo Temporal/etiología , Epilepsia del Lóbulo Temporal/cirugía , Femenino , Hipocampo/cirugía , Humanos , Persona de Mediana Edad , Esclerosis/patología , Esclerosis/cirugía , Resultado del Tratamiento , Adulto Joven
16.
Artículo en Ruso | MEDLINE | ID: mdl-34714008

RESUMEN

There are no literature data on brainstem arachnoid cysts in humans. OBJECTIVE: To describe the clinical case of brainstem (pontomesencephalic) arachnoid cyst and to analyze classification, pathogenesis, differential diagnosis and treatment of this pathology considering literature data and own experience. MATERIAL AND METHODS: A 29-year-old patient with pontomesencephalic arachnoid cyst is reported. The disease manifested in childhood with a headache aggravated by bending and pushing. Later, syncope, vegetative-visceral paroxysms, mild oculomotor disturbances, transient paresthesia and numbness of the left half of the face occurred. Headaches became significantly more severe and resulted nausea and vomiting. Magnetic resonance imaging (MRI) revealed a two-chambered arachnoid cyst. A smaller chamber was localized in interpeduncular cistern, a larger one - in brainstem. RESULTS AND DISCUSSION: Differential diagnosis included cystic glioma and Virchow-Robin space enlargement. Fenestration of the cyst wall within interpeduncular cistern was performed via right-sided pterional approach. The diagnosis was verified by histological examination. The follow-up period was 14 months. We observed postoperative cyst reduction confirmed by MR data and regression of all symptoms except for minimal signs of medial longitudinal fasciculus dysfunction. CONCLUSION: Correct surgical approach for brainstem arachnoid cyst complicated by progressive neurological deterioration is confirmed by postoperative regression of cyst and symptoms.


Asunto(s)
Quistes Aracnoideos , Adulto , Quistes Aracnoideos/diagnóstico por imagen , Quistes Aracnoideos/cirugía , Tronco Encefálico/diagnóstico por imagen , Tronco Encefálico/cirugía , Diagnóstico Diferencial , Humanos , Hipoestesia , Imagen por Resonancia Magnética
17.
Artículo en Ruso | MEDLINE | ID: mdl-33864664

RESUMEN

Central neurocytoma is a rare benign brain tumor. These tumors may be giant and accompanied by compression of ventricular system and surrounding structures. Modern treatment of brain neurocytoma includes extended resection and restoration of normal CSF circulation. Surgical treatment does not often lead to total resection of these tumors. Redo resection was preferred in patients with tumor progression for a long time. In the last decade, various authors report stereotactic irradiation for continued tumor growth to ensure local growth control. This study was aimed at evaluation of postoperative outcomes in patients with brain neurocytomas, as well as treatment of tumor progression in long-term period. OBJECTIVE: To analyze recurrence-free survival in patients with brain neurocytomas, risk factors of recurrence-free survival, effectiveness of various treatments for tumor progression and delayed complications. MATERIAL AND METHODS: Long-term postoperative follow-up data of patients with brain neurocytomas are reported in the manuscript. We analyzed recurrence-free survival and risk factors of recurrence-free survival, treatment outcomes in patients with progression of brain neurocytomas, long-term complications and their prevention. RESULTS: Follow-up included 84 out of 115 patients with brain neurocytoma after surgical treatment in 2008-2017. Follow-up period ranged from 2 to 10 years (mean 6 years) after resection. Most patients had regression of neurological symptoms after surgery. Continued tumor growth within 12-96 months after surgery occurred in 26 (30.19%) out of 84 patients (19 cases after partial resection and 7 cases after total resection according to MRI data). Two-year recurrence-free survival was 94%, 5-year survival - 83%. Risk factors of continued tumor growth were resection quality and Ki-67 index. Redo resection was performed in 7 cases. Eleven patients underwent stereotactic irradiation for tumor progression. Indications for stereotactic irradiation of central neurocytoma are MR data on continued growth of lateral ventricle tumor without signs of ICH and CSF flow impairment. There were no cases of hemorrhage inside the residual tumor and CSF flow impairment in early postoperative period after redo resection. In all cases (n=11), stereotactic irradiation (mean follow-up 2.5 years) ensured satisfactory control of tumor growth with reduction of the neoplasm in 4 cases and no tumor growth in 7 cases. CONCLUSION: Resection of central neurocytoma ensures long-term recurrence-free period. The main causes of tumor recurrence are partial resection and high proliferative activity (Ki-67 index over 5%). Redo resection is advisable for tumor progression followed by CSF flow impairment. In case of continued growth of neurocytoma without signs of intracranial hypertension, stereotactic irradiation with various fractionation modes ensures effective and safe control of tumor growth.


Asunto(s)
Neoplasias Encefálicas , Neurocitoma , Radiocirugia , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/cirugía , Estudios de Seguimiento , Humanos , Recurrencia Local de Neoplasia/cirugía , Neurocitoma/diagnóstico por imagen , Neurocitoma/cirugía , Resultado del Tratamiento
18.
Artículo en Ruso | MEDLINE | ID: mdl-33864667

RESUMEN

Complex management of patients with intracranial pilocytic astrocytoma (PA) consists of surgical treatment, drug therapy (mainly in young children) and radiotherapy. For many years, radiotherapy (RT) has been a standard for residual tumors, recurrence or continued growth of PA. Currently, stereotactic radiosurgery and radiotherapy are preferred for PA, because these procedures are characterized by high conformity and selectivity, precise irradiation of tumor with minimal damage to surrounding intact tissues. Stereotaxic approach is very important since PAs are localized near functionally significant and radiosensitive brain structures in most cases. There is significant experience of single-center studies devoted to radiotherapy of patients with PA at the Department of Neuroradiosurgery of the Burdenko Neurosurgery Center. In this research, the authors analyzed the results of stereotactic irradiation of 430 patients with PA for the period from 2005 to 2018.


Asunto(s)
Astrocitoma , Neoplasias Encefálicas , Radiocirugia , Astrocitoma/diagnóstico por imagen , Astrocitoma/cirugía , Encéfalo , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/cirugía , Niño , Preescolar , Humanos
19.
Artículo en Ruso | MEDLINE | ID: mdl-33560625

RESUMEN

The combination of intracranial tumors and asymptomatic brain aneurysms is an urgent problem, since it can significantly affect surgical intervention. Aneurysms are common in patients with meningioma, glioma and pituitary adenoma. According to certain authors, combination of aneurysms with pituitary adenomas is 7 times more common than with other tumors. In these cases, a comprehensive examination of the patient and decision-making on surgical strategy are required. This review is devoted to epidemiology, diagnosis and treatment of patients with a combination of pituitary adenomas and intracranial aneurysms detected intraoperatively or at the preoperative stage. The manuscript is illustrated by cases observed at the Burdenko Neurosurgery Center.


Asunto(s)
Adenoma , Aneurisma Intracraneal , Neoplasias Meníngeas , Neoplasias Hipofisarias , Adenoma/epidemiología , Adenoma/cirugía , Humanos , Aneurisma Intracraneal/epidemiología , Aneurisma Intracraneal/cirugía , Procedimientos Neuroquirúrgicos , Neoplasias Hipofisarias/cirugía
20.
Phys Rev Lett ; 126(1): 012002, 2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33480779

RESUMEN

We report the first measurement of coherent elastic neutrino-nucleus scattering (CEvNS) on argon using a liquid argon detector at the Oak Ridge National Laboratory Spallation Neutron Source. Two independent analyses prefer CEvNS over the background-only null hypothesis with greater than 3σ significance. The measured cross section, averaged over the incident neutrino flux, is (2.2±0.7)×10^{-39} cm^{2}-consistent with the standard model prediction. The neutron-number dependence of this result, together with that from our previous measurement on CsI, confirms the existence of the CEvNS process and provides improved constraints on nonstandard neutrino interactions.

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