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Biomedical subjects

V A Khil'ko

Publications and source records attributed to V A Khil'ko.

At least 19 recordsLinked to original sources
PubMed2005

[Combined treatment of brain stem tumors].

During the two recent decades the introduction of new technologies to neurosurgery resulted in certain progress in diagnosis and combined treatment of brain stem tumors which still remain the most complex problems of neurooncology. Using the present-day diagnostic complex including a thorough dynamic neurological examination, neurophysiological investigations, and visualization methods allowed not only to detect the primary forms of brain stem tumors and their sizes but also to reveal the topographoanatomical interrelationships with the stem structures that allowed to determine the chances of surgical, combined treatment or the radiation and chemotherapy treatment only. The article gives an analysis and the clinical course of the diagnosis and combined treatment of 333 children and adult patients with primary, secondary and peri-trunkal tumors of the brain stem.

Adolescent↗
PubMed2003

[Use of modern technologies in the diagnosis and combined treatment of brain stem tumors].

The latest technologies, introduced into neurosurgery during the last 2 decades of the 20th century, ensured progress in the diagnostics and treatment of brainstem tumors--pathologies that remain until now a most complicated problem in neurooncology. The modern diagnostic tools comprising profound dynamic neurological and neurophysiological examinations (AVP, EEG) visualization techniques (CT, MRT with contrasting, MRT, spectroscopy, PET) provide for detecting not only the initial signs of stem tumors and their sizes but also their topographic interaction with the stem structures; it, in its turn, opens up a possibility to choose between the combined surgical treatment and the radiotherapy or chemotherapy alone. The clinical course, diagnosis and combined treatment of 333 children and adults with tumors bordering on the brainstem are analyzed within the case study.

Adolescent↗
PubMed2000

[The comprehensive surgical treatment of patients with degenerative lesions of the lumbosacral spine].

On the basis of a complex analysis of surgical treatment of 52 patients with degenerative diseases of the lumbosacral part of the spine complicated by the formation of compressive reticulopathies main states were established responsible for the worse quality of life of this category of patients. Different forms of vertebrogenic radiculopathies were determined according to the morphological substrate of compression. The methods of diagnosing the spinal diseases at the lumbosacral level were estimated and the diagnostic algorithms for different variants of degenerative lesions were developed. Rational schemes of surgical correction are proposed according to the established groups of vertebrogenic lumbosacral radiculopathies. Special attention is given to prophylactics of recurrences of the pain syndrome and postoperative instability of the spine.

Humans↗
PubMed1999

[Monitoring of the auditory stem evoked potentials in removal of tumors of the posterior cranial fossa].

The material of intraoperative monitoring of the acoustic stem evoked potentials (ASEP) in 9 patients with tumors of the stem and in 28 patients with the parastem localization was analyzed. It was shown that changes in the amplitude of ASEP rather than latency were the decisive factor in the assessment of the functional state of the brain stem. It was found that even the pronounced changes of the bioelectrical activity recorded during the excision of the tumor could be reversible after a change of the strategy of the operative intervention and/or after performing the necessary therapeutic measures. An important test of favorable prognosis of the postoperative course is considered to be the normalization of brain activity, ASEP included, at the final stages of the operation.

Adolescent↗
PubMed1998

[Diagnosis and treatment of chronic cerebrovascular insufficiency in carotid atherosclerotic stenosis].

Examining the outcomes of surgical and medical treatments in 485 and 315 patients with brain ischemic disease, respectively, who were followed up for 13 years identified 3 stages of disease progression. Stage 1 included early signs of carotid and vertebrobasilar insufficiencies, Stage 2 involved transient ischemic attacks, minor stroke, extensive stroke, Stage 3 comprised sequelae of stroke and recurrent strokes, slowly progressive circulatory insufficiency. The early results of surgical and medical treatment for brain ischemic disease were positive in 89 and 72%, respectively. Analysis of late results (at 1 to 13 years) showed evident advantages of surgical treatment which yielded positive results in 92.1% of cases while medical treatment provided them only in 44.4% of cases. Surgical treatment was most effective in Stage 1 brain ischemic disease.

Adult↗
PubMed1997

[The diagnosis and treatment of chronic cerebrovascular insufficiency in atherosclerotic stenosis or occlusion of the carotid artery].

The methods of diagnosis and treatment of chronic cerebro-vascular insufficiency in atherosclerotic stenosis or occlusion of the carotid artery are described. Ambulatory examinations were performed in 62000 patients. Clinical and psychological tests were used in examining 123 patients with ischemic brain disease. The present-day diagnostic methods were used in treatment of 1100 patients (clinical tests, CT, MRT, EEG, Ag, TCD). Operations were performed on 546 patients (carotid endarterectomy, extracranial-intracranial bypass). Results of operations for making the extra-intracranial microvascular bypasses for revascularization of the ischemic hemisphere were estimated as positive. Direct correlations were found between the structural-functional state of the CNS and the degree of neurological deficiency. The 1-13 years follow-up allows a conclusion to be made that surgical treatment is more perspective than conservative methods.

Arteriosclerosis↗
PubMed1997

[Anesthesiological support, postoperative care and the results of the surgical treatment of patients with tumors of the base of the posterior cranial fossa].

Problems of anesthesiological maintenance, measures of the postoperative management and results of surgical treatment of 76 patients with an oncological process on the base of the posterior cranial fossa are discussed. An analysis of informative-regulatory and adaptational reactions of organism is made on the basis of the intervalogram in the course of operative interventions near by the cerebral trunk. The results are estimated.

Anesthesia↗
PubMed1996

[The characteristics of the biochemical reactions of the cerebrospinal fluid in victims with gunshot wounds of the skull and brain in relation to treatment outcome].

Biochemical reactions of the liquor were investigated in 68 patients with gunshot wounds of the skull and brain and in closed treatment of the brain wound. The reactivity of biochemical system plays a certain role in the development of infectious complications. In dead people the developing pathogenetical biochemical syndromes having a sanogenic role of clearance from antigens of the injured tissues turn pathogenesis into thanatogenesis.

Afghanistan↗
PubMed1995

[Cellular immune reactions in the victims of explosive injuries to the skull and brain].

Specific features in the immunological status of 49 wounded with explosion injuries of neurosurgical profile are as follows: in light injuries--it is hyperergic character of the immune system and its inadequacy to the injuries of a middle degree it is a distinct parallelism between the dynamics of the immune status indices and the functional state of the CNS depending on the severity of the injury-an extremely flabby with the inhibiting of main immunological indices at a low but permanent level.

Adolescent↗
PubMed1995

[The individual immunotherapy of the intracranial complications after neurosurgical operations].

A system of individual immunotherapy is proposed which is based on the selection of an immunomodulator maximally suitable for the patients' immune system which is the therapeutic measure directed to the stimulation of forming the functional adaptive CNS dominant adequate to the pathological focus--the main component of sanogenesis in neuroanimatologic patients representing a complex of psychoneuroimmunoendocrine connections of the organism. As a result of immunotherapy the adequate adaptive CNS dominant makes concrete effector adaptive functional systems, determines the rate and sequence of the course of the adaptive reactions.

Combined Modality Therapy↗
PubMed1995

[The diagnosis of arteriovenous malformations of the brain by transcranial dopplerography (the dopplerographic semeiotics of arteriovenous malformations)].

The work is devoted to investigation of possible use of transcranial dopplerography as a method of noninvasive diagnosing of arteriovenous malformations of the brain. An analysis of results of investigations in 89 patients with suspected arteriovenous malformations was made. A close correlation is confirmed between the parameters of the blood flow and the volume, diameter and type of the structure of the supplying arteries. Transcranial dopplerography was shown to allow the detection of arteriovenous shunts in the brain vessels which is one of main symptoms of the arteriovenous malformations.

Adolescent↗
PubMed1995

[The immunological and biochemical reactions of the cerebrospinal fluid in victims of blast injuries of the skull and brain].

An analysis of immunobiochemical indices of the cerebrospinal fluid has shown possibilities to establish objective mechanisms of injuries of the brain by explosions. Biochemical manifestations of the cytolysis syndrome can be taken as symptoms of primary injury of the brain under conditions of burst polytrauma since increased activity of cytoplasmic and mitochondrial enzymes in the liquor is directly proportional to the brain trauma degree. The primary injury of the brain is characterized by a specific immune response: increased concentration of IgG, IgA in the liquor with the increased circulation of immune complexes.

Acute Disease↗
PubMed1995

[The diagnosis of arteriovenous malformations of the brain by transcranial dopplerography (the potentials of complex noninvasive neurosonoradiological diagnosis)].

Under analysis were results of diagnostics in 89 patients with suspected arteriovenous malformations (AVM) obtained by the method of ROC-analysis. The examination included computed tomography (CT) and transcranial dopplerography (TCDG) performed by the standard method. The total sensitivity of TCDG in diagnosing AVMs as a nosological form was 89.5% which is considerably higher than the possibilities of CT. Malformation having a torpid course were diagnosed correctly reliably more often (100%) than those with hemorrhagic debut (78.6%). Most perspective is the principle of unity of "morphological" and functional methods of noninvasive diagnostics. Sensitivity of the complex diagnostics of AVMs was 92.9%, diagnostics of malformations with a torpid course being without errors.

Cerebral Angiography↗
PubMed1994

[Intrathecal synthesis of immunoglobulins G in patients with nervous system neoplasms].

Brain tumor development and their recurrence are accompanied by an increase in IgG levels in liquor as well as in the number of circulating immunocomplexes and by the presence of blockage factors in liquor. The data presented in the paper, on the whole, illustrate the development of autoimmune reactions, which happen to be mechanisms involved in the pathogenesis of brain tumor growth and recurrence. Surgical removal of tumor is followed by a reduction in the rates of IgG synthesis.

Brain Neoplasms↗
PubMed1994

[Changes in the immunobiochemical composition of the cerebrospinal fluid and the antitumor reactions of the local immune system in astrocytic brain tumors].

Pre- and postoperative immunochemical indices of cerebrospinal fluid (CSF) were investigated in 10 patients with fibrillary-protoplasmic astrocytoma and 10 patients with glioblastoma multiforme. Malignant neoplastic developments in the brain are associated with appearance of marked humoral reaction. Tumor-specific CSF changes observed comprise registration of ceruloplasmin immunomodulating proteins and alpha 2-macroglobulin. It is emphasized that biochemical antioxidant, antiprotease, energy-supplying systems are related directly to humoral immune reactions in the process of relevant postoperative rehabilitation.

Adolescent↗
PubMed1994

[Leakadin immunotherapy in the combined therapy of acoustic neurinomas].

The paper specifies the role of leacadin immunotherapy in combined treatment of acoustic nerve neurinomas. The antitumor immunomodulator leacadin contributes to establishment and consolidation of the tumor carrier's immunological adaptation which results in uneventful postoperative developments and recurrent-free survival.

Adjuvants, Immunologic↗