[Methods of intraoperative control in resection of intraparenchymal brain tumors].

Primary CNS tumors represent 1.4% of all malignant neoplasias and 2.4% of total oncological mortality. The principal goal of tumor resection is maximally possible radical removal with minimal injury of normal brain tissue. This is due to correlation between intraoperative trauma of the brain and postoperative neurological deficit and quality of life. Recently intraoperative ultrasonic and fluorescent methods of guidance have been widely introduced in neurosurgical practice. In conditions of altered anatomy ultrasonographic guidance is intended to optimize approach to intracerebral tumors considering eloquent areas and main vessels. This allows decrease of neurological deficit in the postoperative period. Fluorescent guidance provides possibility of visual differentiation of tumor and normal tissue thus defining the borderline. Combination of these two techniques may lead to more radical resection of tumors and minimize injury of normal brain. We operated 70 patients with primary and metastatic intraparenchymal brain tumors. Intraoperative ultrasonographic guidance was applied in 58 cases, fluorescent guidance--in 21, both methods--in 9.

[Glial tumors of the brain: current aspects of the immunopathogenesis and immunogenodiagnosis].

Glioblastoma growth is a genetically regulated process. Loss or inactivation of genes - tumor suppressors may give rise to tumors and their progression. Glioblastoma multiforme is followed by a number of genetic breakages. Expression of a number of genes may affect the prognosis of the disease and tumor sensitivity to chemotherapy. Comprehensive studies of glioblastomas showed that there were at least two immunologic phenotypes: 1) that with a picture of pronounced immunodeficiency and 2) that without obvious immunodeficiency. This should be considered when elaborating present-day programs of geno- and immunodiagnosis, as well as clinicoimmunological criteria for the treatment of these tumors.

[Glial tumors of the brain: current aspects of their classification and bases for genetic predisposition].

Gliomas are the most common tumors of the central nervous system (CNS). Malignant astrocytic gliomas account for 50% of all primary brain tumors. Cells of origin are unknown for the majority of brain tumors: CNS tumors have frequently in their content many histological forms and their classification will depend on what the parts of neoplasm that will be clearly identified at the material taking and further investigation. Current immunohistochemical studies may determine the antigenic structure of a tumor cell, compare it with the antigens expressed by a certain cell type and, thus, classify the tumor by its origin, but there are no antibodies which would correctly identify different types of tumors. The lecture reflects the current classifications of glial tumors: the typical three-leveled classification, the Kernokhan classification, the Duma-Duport classification. A part of the lecture deals with the specific features of genetics and molecular biology of gliomas: recent studies cast any doubt on the existing data on the sources of growth of these tumors.