Анатомическое исследование возможности прямого эндоскопического выключения решетчатых артерий для деваскуляризации структур передних отделов основания черепа
Background. Many tumors of different histologic structure originate from the anterior skull base. These lesions may be highly vascularized leading to limited resection and severe intraoperative blood loss. Midline tumors are primarily supplied by ethmoidal arteries, which are not subject to endovascular embolization. Aim of this study was comparative experimental analysis of different surgical approaches to the ethmoidal arteries.
Materials and methods. The anatomical study was performed on 12 fresh human cadavers without diseases involving the anterior skull base, orbits, and paranasal sinuses (24 sides). In all specimens internal and external carotid arteries were injected by silicone dye. Anatomical dissection was carried on investigating four different minimally invasive endoscopic approaches to the ethmoidal arteries: 1) transorbital approach to the ethmoidal arteries via bicoronal incision; 2) pre/trans/retrocaruncular approach to the ethmoidal arteries; 3) endoscopic endonasal transethmoidal approach to the canals of ethmoidal arteries; 4) endoscopic endonasal transethmoidal-transorbital approach to the ethmoidal arteries in the orbit.
Results. Surgical technique of the mentioned approaches was described, and their advantages and disadvantages were analyzed. We propose the algorithm for selection of direct endoscopic ligation of ethmoidal arteries based on selected surgical approach for tumor resection and its extracranial extension.
Conclusion. Decision making for tumor devascularization must be substantiated by visualization of vasculature (CT or MR angiography). The study has demonstrated advantages and disadvantages of different endoscopic approaches to the ethmoidal arteries for their ligation aiming at early devascularization of anterior skull base lesions. All four are minimally invasive and provide good functional outcome and cosmesis.
The article presents the literature data on the structural variability and age-related features of the midline anatomical structures of the anterior skull base (frontal sinus, ethmoid bone, anterior parasellar region, and medial orbital wall). This is the area of surgical interests of neurosurgeons and rhinosurgeons. The study objective is to analyze the literature data on the individual variability and age-related anatomy of these structures. The work is illustrated with original images from the authors’ personal archive. The individual anatomical features of eloquent structures in the surgical area (structures within the surgical corridor, key anatomical landmarks, optic tract, internal carotid and ethmoidal arteries, etc.) should be considered in planning surgery in patients of all age groups because they can limit the view and the amount of safe manipulations or increase the risk of complications. The presented data may be useful for neurosurgeons and otolaryngologists whose surgical interests are focused on the midline structures of the anterior skull base.
Objective. To identify the most frequently occurring symptoms resulting from the affection of internal and external skull base in patients with benign tumors of the anterior and middle cranial base. Material and methods. The authors analyzed a complex of history, clinical, and instrumental data as well as results of combined treatment of 642 patients with benign tumors of the anterior and middle cranial base operated Medical Research between 2007 and 2011. Results. Neurological signs and symptoms in patients with benign tumors of the anterior cranial base, parasellar region, and middle cranial fossa were studied. In the majority of cases, the tumor extended extracranially. The most common groups of symptoms were identified and described, the most important groups are presented in the diagrams. The proposed scheme is applicable also for malignant tumors or other mass lesions of the same localization. Conclusion. Effective treatment and selection of the best management of a patient depends on modern medical approaches and techniques including neuroimaging. Careful assessment of symptoms is crucial in detection of tumors in the early stage. Dynamic monitoring of the patient using the proposed scheme will contribute to early detection of tumor recurrence or progression.
Background. The aim of the project was to show the peculiarities of manipulations in two-dimensional (2D) visualization and to enlighten young neurosurgical residents for further independent training of their manual skills in the anatomic lab. The course followed a step-by-step training program starting with artificial models in a static 2D exoscopic view field with subsequent transition to cadaveric animal models and the use of dynamic four-hand techniques and endoscopy.
Materials and methods. Since 2015, two 2-day workshops and four 1-day workshops have been organized. All courses consisted of short theoretical and prevailing hands-on practical part and were designed mainly for manual skills training. For optimal practical training, each pair of trainees were engaged with a separate working place equipped with a video system, exoscope, drill, suction, and a set of microsurgical and endoscopic instruments. A total of 48 trainees, including residents of the Nikolay Nilovich (NN) Burdenko National Medical Research Center of Neurosurgery (NMRCN), the Russian Medical Academy of Continuous Postgraduate Education, and other institutions from different regions of Russia, completed the program. Analysis of evaluation sheets revealed that over 90% of trainees were under the age of 30.
Results. The key idea – accommodation to endoscopy through a series of microsurgical exercises in 2D visualization – has been successfully actualized and met with interest. After analyzing the questionnaires, we found that an overall satisfaction rate was high. The vast majority of trainees intended to gain further experience and apply new techniques in their clinical neurosurgical and microsurgical practice. The number of practiced techniques and the quality of the provided equipment were considered by the participants as good or very good. The highly individualized training course with a participant/tutor ratio of 4:1 and the use of tissue models (no sacrifice of living animals) was well appreciated.
Conclusion. The demand for a workshop indicates a lack of such training activities for young professionals, such as the one we presented herein. Evaluation of the courses by the trainees showed that the contents of workshops corresponded to their tasks and expectations, regardless of their previous experience. The workshop was not only the 'stepping stone' from which the path of practical self-development should begin but also initiated the development of a whole series of specially focused training workshops on microsurgery and endoscopy for neurosurgeons.
Proceedings of the conference "Molecular basis of epidemiology, diagnosis, prevention and treatment of current infections" 4-6 December 2018
Background: In this review we survey medical treatments and research strategies, and we discuss why they have failed to cure degenerative disc diseases or even slow down the degenerative process.
Objective: We seek to stimulate discussion with respect to changing the medical paradigm associated with treatments and research applied to degenerative disc diseases.
Method Proposal: We summarize a Biological Transformation therapy for curing chronic inflammations and degenerative disc diseases, as was previously described in the book Biological Transformations controlled by the Mind Volume 1.
Preliminary Studies: A single-patient case study is presented that documents complete recovery from an advanced lumbar bilateral discopathy and long-term hypertrophic chronic rhinitis by application of the method proposed.
Conclusion: Biological transformations controlled by the mind can be applied by men and women in order to improve their quality of life and cure degenerative disc diseases and chronic inflammations illnesses.
Unlike stroke, neurosurgical removal of left-hemisphere gliomas acts upon a reorganized language network and involves brain areas rarely damaged by stroke. We addressed whether this causes the profiles of neurosurgeryand stroke-induced language impairments to be distinct. K-means clustering of language assessment data (neurosurgery cohort: N = 88, stroke cohort: N = 95) identified similar profiles in both cohorts. But critically, a cluster of individuals with specific phonological deficits was only evident in the stroke but not in the neurosurgery cohort. Thus, phonological deficits are less clearly distinguished from other language deficits after glioma surgery compared to stroke. Furthermore, the correlations between language production and comprehension scores at different linguistic levels were more extensive in the neurosurgery than in the stroke cohort. Our findings suggest that neurosurgery-induced language impairments do not correspond to those caused by stroke, but rather manifest as a ‘moderate global aphasia’ – a generalized decline of language processing abilities.
The study of clinical terminology has always occupied a significant place in the discipline "Latin language and outlines of medical terminology." Undoubtedly, surgical terminology is one of the most voluminous terminology in the clinical block. Moreover, there are a lot of terms used in it in other departments of the clinical direction, so-called "common" terms.
Objective: Glioblastoma is a highly aggressive and invasive brain and Central Nervous System (CNS) tumor. Current treatment options do not prolong overall survival significantly because the disease is highly prone to relapse. Therefore, research to find new therapies is of paramount importance. It has been discovered that glioblastomas contain a population of cells with stem-like properties and that these cells are may be responsible for tumor recurrence.
Methods: A review of relevant papers and clinical trials in the field was conducted. A PubMed search with related keywords was used to gather the data. For example, “glioblastoma stem cells AND WNT signaling” is an example used to find information on clinical trials using the database ClinicalTrials.gov.
Results: Cancer stem cell research has several fundamental issues and uncertainties that should be taken into consideration. Theoretically, a number of treatment options that target glioblastoma stem cells are available for patients. However, only a few of them have obtained promising results in clinical trials. Several strategies are still under investigation.
Conclusion: The majority of treatments to target cancer stem cells have failed during clinical trials. Taking into account a number of biases in the field and the number of unsuccessful investigations, the application of the cancer stem cells concept is questionable in clinical settings, at least with respect to glioblastoma.
The series “Advances in Intelligent Systems and Computing” contains publications on theory, applications, and design methods of Intelligent Systems and Intelligent Computing. Virtually all disciplines such as engineering, natural sciences, computer and information science, ICT, economics, business, e-commerce, environment, healthcare, life science are covered. The list of topics spans all the areas of modern intelligent systems and computing such as: computational intelligence, soft computing including neural networks, fuzzy systems, evolutionary computing and the fusion of these paradigms, social intelligence, ambient intelligence, computational neuroscience, artificial life, virtual worlds and society, cognitive science and systems, Perception and Vision, DNA and immune based systems, self-organizing and adaptive systems, e-Learning and teaching, human-centered and human-centric computing, recommender systems, intelligent control, robotics and mechatronics including human-machine teaming, knowledge-based paradigms, learning paradigms, machine ethics, intelligent data analysis, knowledge management, intelligent agents, intelligent decision making and support, intelligent network security, trust management, interactive entertainment, Web intelligence and multimedia.
The publications within “Advances in Intelligent Systems and Computing” are primarily proceedings of important conferences, symposia and congresses. They cover significant recent developments in the field, both of a foundational and applicable character. An important characteristic feature of the series is the short publication time and world-wide distribution. This permits a rapid and broad dissemination of research results.
This book contains a selection of papers accepted for the presentation and discussion at the 2018 International Conference on Digital Science (DSIC’18). This Conference had the support of the Institute of Certified Specialists, Russia, AISTI (Iberian Association for Information Systems and Technologies), and Springer. It will take place at Convention Centre, Budva, Montenegro, October 19–21, 2018. DSIC’18 is an international forum for researchers and practitioners to present and discuss the most recent innovations, trends, results, experiences, and concerns in the several perspectives of Digital Science. The main idea of this Conference is that the world of science is unified and united allowing all scientists/practitioners to be able to think, analyze, and generalize their thoughts. DSIC aims efficiently to disseminate original research results in natural, social, art, and humanities sciences. An important characteristic feature of the Conference should be the short publication time and worldwide distribution. This Conference enables fast dissemination, so conference participants can publish their papers in print and electronic format, which is then made available worldwide and accessible by numerous researchers. The Scientific Committee of DSIC’18 was composed of a multidisciplinary group of 26 experts. One hundred and seven invited reviewers who are intimately concerned with Digital Science have had the responsibility for evaluating, in a “double-blind review” process, the papers received for each of the main themes proposed for the Conference: Digital Art and Humanities; Digital Economics; Digital Education; Digital Engineering; Digital Environmental Sciences; Digital Finance, Business and Banking; Digital Media; Digital Medicine, Pharma and Public Health; Digital Public Administration; Digital Technology and Applied Sciences.
DSIC’18 received 88 contributions from 16 countries around the world. The papers accepted for the presentation and discussion at the Conference are published by Springer (this book) and will be submitted for indexing by ISI, SCOPUS, among others.