434 research outputs found

    EISCAT and Cluster observations in the vicinity of the dynamical polar cap boundary

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    The dynamics of the polar cap boundary and auroral oval in the nightside ionosphere are studied during late expansion and recovery of a substorm from the region between TromsΓΈ (66.6° cgmLat) and Longyearbyen (75.2° cgmLat) on 27 February 2004 by using the coordinated EISCAT incoherent scatter radar, MIRACLE magnetometer and Cluster satellite measurements. During the late substorm expansion/early recovery phase, the polar cap boundary (PCB) made zig-zag-type motion with amplitude of 2.5° cgmLat and period of about 30 min near magnetic midnight. We suggest that the poleward motions of the PCB were produced by bursts of enhanced reconnection at the near-Earth neutral line (NENL). The subsequent equatorward motions of the PCB would then represent the recovery of the merging line towards the equilibrium state (Cowley and Lockwood, 1992). The observed bursts of enhanced westward electrojet just equatorward of the polar cap boundary during poleward expansions were produced plausibly by particles accelerated in the vicinity of the neutral line and thus lend evidence to the Cowley-Lockwood paradigm. <br><br> During the substorm recovery phase, the footpoints of the Cluster satellites at a geocentric distance of 4.4 <I>R<sub>E</sub></I> mapped in the vicinity of EISCAT measurements. Cluster data indicate that outflow of H<sup>+</sup> and O<sup>+</sup> ions took place within the plasma sheet boundary layer (PSBL) as noted in some earlier studies as well. We show that in this case the PSBL corresponded to a region of enhanced electron temperature in the ionospheric F region. It is suggested that the ion outflow originates from the F region as a result of increased ambipolar diffusion. At higher altitudes, the ions could be further energized by waves, which at Cluster altitudes were observed as BBELF (broad band extra low frequency) fluctuations. <br><br> The four-satellite configuration of Cluster revealed a sudden poleward expansion of the PSBL by 2° during ~5 min. The beginning of the poleward motion of the PCB was associated with an intensification of the downward FAC at the boundary. We suggest that the downward FAC sheet at the PCB is the high-altitude counterpart of the Earthward flowing FAC produced in the vicinity of the magnetotail neutral line by the Hall effect (Sonnerup, 1979) during a short-lived reconnection pulse

    MANAGEMENT DECISION-MAKING AND RISK MANAGEMENT IN THE DIGITAL ECONOMY

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    This article reviews the aspects of management decision-making in the digital economy and as a consequence the possibility of timely and qualitative response to emerging risks in the process of management decision-making. This issue is considered from the position of influence on management decision-making both internal and external factors of the operation of the company has been considered. Therefore, the topic under consideration is relevant, since the issue of digitalization with a large coverage extends in all areas and spheres of our life and as a result should cover more the possibility of improving the quality of management decision-making, but is it so

    ΠŸΡ€ΠΎΡ‚ΠΈΠ²ΠΎΠΎΠΏΡƒΡ…ΠΎΠ»Π΅Π²Π°Ρ ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ ΠΊΠΎΠ½Ρ‚Π°ΠΊΡ‚Π½ΠΎΠΉ Π»ΡƒΡ‡Π΅Π²ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Π² ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Ρ†ΠΈΠΈ с фотосСнсибилизатором Ρ…Π»ΠΎΡ€ΠΈΠ½ΠΎΠ²ΠΎΠ³ΠΎ ряда Π² экспСримСнтС

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    Authors have studied the antitumor efficacy of contact radiation therapy (CRT) in combination with a chlorin-based photosensitizer (PS) in an experiment on laboratory animals with transplanted tumors. The experimental study was performed in 50 white outbred rats weighing 250Β±50 g. Subcutaneously transplanted Pliss lymphosarcoma (PLS) and alveolar liver cancer RS1 (RS1) were used as tumor models. Chlorinbased PS photolon (RUE Β«BelmedpreparatyΒ», Republic Belarus) was injected intravenously at a dose of 2.5 mg/kg. The radiation sessions were carried out 2.5–4 hours (depending on the tumor model) after the administration of the PS using the device Β«microSelectron HDR V3 DigitalΒ» (Β«NucletronΒ», Netherlands) with a 192-Ir radiation source in single focal doses 5 and 10 Gy. All laboratory animals (for PLS and RS1) were subdivided into 5 groups of 5 animals each: intact control, CRT 5 Gy, CRT 10 Gy, PS + CRT 5 Gy, PS + CRT 10 Gy. For the PLS tumor model – on the 14th day from the beginning of the experiment Vav. in groups were 26.31Β±5.81; 22.45Β±6.97; 18.99Β±4.86; 10.75Β±5.18 and 28.06Β±2.85 cm3, respectively (pΛ‚0.05). The coefficients of tumor growth inhibition in the experimental groups were 14.67%, 27.82%, 59.14% and 6.65%, respectively. The frequency of complete tumor regressions 60 days after the start of the experiment was 0%, 20%, 20%, 60%, and 20%, respectively. On RS1 tumor model – on the 14th day from the beginning of the experiment Vav. in groups were 4.48Β±1.03; 0.80Β±0.21; 0.29Β±0.09; 0.19Β±0.07 and 0.32Β±0.08 cm3, respectively (p=0.009). The coefficients of tumor growth inhibition in the experimental groups were 82.14%, 93.53%, 95.76% and 92.86%, respectively. The frequency of complete tumor regressions 60 days after the start of the experiment was 0%, 0%, 20%, 0%, and 0%, respectively. Systemic administration of chlorin-based PS before the CRT session increases the antitumor efficacy of radiation therapy in animals with transplantable tumors of different histological structure and growth patterns. The data obtained indicate that further studies of the radiosensitizing properties of PS are promising.Авторами ΠΈΠ·ΡƒΡ‡Π΅Π½Π° противоопухолСвая ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ ΠΊΠΎΠ½Ρ‚Π°ΠΊΡ‚Π½ΠΎΠΉ Π»ΡƒΡ‡Π΅Π²ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ (ΠšΠ›Π’) Π² ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Ρ†ΠΈΠΈ с фотосСнсибилизатором (Π€Π‘) Ρ…Π»ΠΎΡ€ΠΈΠ½ΠΎΠ²ΠΎΠ³ΠΎ ряда Π² экспСримСнтС Π½Π° Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½Ρ‹Ρ… ΠΆΠΈΠ²ΠΎΡ‚Π½Ρ‹Ρ… с ΠΏΠ΅Ρ€Π΅Π²ΠΈΠ²Π½Ρ‹ΠΌΠΈ опухолями. Π Π°Π±ΠΎΡ‚Π° Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Π° Π½Π° 50 Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½Ρ‹Ρ… ΠΆΠΈΠ²ΠΎΡ‚Π½Ρ‹Ρ… (Π±Π΅Π»Ρ‹Π΅ бСспородныС крысы) с массой Ρ‚Π΅Π»Π° 250Β±50 Π³. Π’ качСствС ΠΎΠΏΡƒΡ…ΠΎΠ»Π΅Π²Ρ‹Ρ… ΠΌΠΎΠ΄Π΅Π»Π΅ΠΉ использовали лимфосаркому Плисса (Π›Π‘ΠŸ) ΠΈ Π°Π»ΡŒΠ²Π΅ΠΎΠ»ΡΡ€Π½Ρ‹ΠΉ Ρ€Π°ΠΊ ΠΏΠ΅Ρ‡Π΅Π½ΠΈ Π Π‘ (Π Π‘1), ΠΏΠ΅Ρ€Π΅Π²ΠΈΡ‚Ρ‹Π΅ ΠΏΠΎΠ΄ΠΊΠΎΠΆΠ½ΠΎ. Π€Π‘ Ρ…Π»ΠΎΡ€ΠΈΠ½ΠΎΠ²ΠΎΠ³ΠΎ ряда Ρ„ΠΎΡ‚ΠΎΠ»ΠΎΠ½ (РУП Β«Π‘Π΅Π»ΠΌΠ΅Π΄ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Ρ‹Β», Π‘Π΅Π»Π°Ρ€ΡƒΡΡŒ) вводился Π²Π½ΡƒΡ‚Ρ€ΠΈΠ²Π΅Π½Π½ΠΎ капСльно Π² Π΄ΠΎΠ·Π΅ 2,5 ΠΌΠ³/ΠΊΠ³ массы Ρ‚Π΅Π»Π°. БСанс ΠšΠ›Π’ ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ Ρ‡Π΅Ρ€Π΅Π· 2,5 – 4 Ρ‡ (Π² зависимости ΠΎΡ‚ ΠΎΠΏΡƒΡ…ΠΎΠ»Π΅Π²ΠΎΠΉ ΠΌΠΎΠ΄Π΅Π»ΠΈ) послС ввСдСния Π€Π‘ с использованиСм Π°ΠΏΠΏΠ°Ρ€Π°Ρ‚Π° Β«microSelectron HDR V3 DigitalΒ» (Β«NucletronΒ», НидСрланды) с источником излучСния 192–Ir Π² Ρ€Π°Π·ΠΎΠ²Ρ‹Ρ… ΠΎΡ‡Π°Π³ΠΎΠ²Ρ‹Ρ… Π΄ΠΎΠ·Π°Ρ… (Π ΠžΠ”) 5 ΠΈ 10 Π“Ρ€. ВсС Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½Ρ‹Π΅ ΠΆΠΈΠ²ΠΎΡ‚Π½Ρ‹Π΅, ΠΊΠ°ΠΊ Π² ΠΏΠΎΠ΄Π³Ρ€ΡƒΠΏΠΏΠ΅ с Π›Π‘ΠŸ, Ρ‚Π°ΠΊ ΠΈ Π² ΠΏΠΎΠ΄Π³Ρ€ΡƒΠΏΠΏΠ΅ с Π Π‘1, Π±Ρ‹Π»ΠΈ Ρ€Π°Π·Π΄Π΅Π»Π΅Π½Ρ‹ Π½Π° 5 Π³Ρ€ΡƒΠΏΠΏ ΠΏΠΎ 5 особСй Π² ΠΊΠ°ΠΆΠ΄ΠΎΠΉ: ΠΈΠ½Ρ‚Π°ΠΊΡ‚Π½Ρ‹ΠΉ ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»ΡŒ, ΠšΠ›Π’ Π ΠžΠ” 5 Π“Ρ€, ΠšΠ›Π’ Π ΠžΠ” 10 Π“Ρ€, Π€Π‘ + ΠšΠ›Π’ Π ΠžΠ” 5Π“Ρ€, Π€Π‘ + ΠšΠ›Π’ Π ΠžΠ” 10 Π“Ρ€. На ΠΌΠΎΠ΄Π΅Π»ΠΈ Π›Π‘ΠŸ Π½Π° 14–С сутки ΠΎΡ‚ Π½Π°Ρ‡Π°Π»Π° воздСйствий срСдний объСм ΠΎΠΏΡƒΡ…ΠΎΠ»ΠΈ (Vср ) Π² Π³Ρ€ΡƒΠΏΠΏΠ°Ρ… составил 26,31Β±5,81; 22,45Β±6,97; 18,99Β±4,86; 10,75Β±5,18 ΠΈ 28,06Β±2,85 см3, соотвСтствСнно (Ρ€Λ‚0,05). ΠšΠΎΡΡ„Ρ„ΠΈΡ†ΠΈΠ΅Π½Ρ‚ тормоТСния роста ΠΎΠΏΡƒΡ…ΠΎΠ»ΠΈ (ВРО) Π² ΠΎΠΏΡ‹Ρ‚Π½Ρ‹Ρ… Π³Ρ€ΡƒΠΏΠΏΠ°Ρ… составил 14,67%; 27,82%; 59,14% ΠΈ - 6,65%, соотвСтствСнно. Частота ΠΏΠΎΠ»Π½Ρ‹Ρ… рСгрСссий ΠΎΠΏΡƒΡ…ΠΎΠ»Π΅ΠΉ Ρ‡Π΅Ρ€Π΅Π· 60 суток послС Π½Π°Ρ‡Π°Π»Π° экспСримСнта составила 0%, 20%, 20%, 60% ΠΈ 20%, соотвСтствСнно. На ΠΌΠΎΠ΄Π΅Π»ΠΈ Π Π‘1 Π½Π° 14–С сутки ΠΎΡ‚ Π½Π°Ρ‡Π°Π»Π° воздСйствий Vср . Π² Π³Ρ€ΡƒΠΏΠΏΠ°Ρ… составил 4,48Β±1,03; 0,80Β±0,21; 0,29Β±0,09; 0,19Β±0,07 ΠΈ 0,32Β±0,08 см3, соотвСтствСнно (Ρ€=0,009). ΠšΠΎΡΡ„Ρ„ΠΈΡ†ΠΈΠ΅Π½Ρ‚ ВРО Π² ΠΎΠΏΡ‹Ρ‚Π½Ρ‹Ρ… Π³Ρ€ΡƒΠΏΠΏΠ°Ρ… составил 82,14%; 93,53%; 95,76% ΠΈ 92,86%, соотвСтствСнно. Частота ΠΏΠΎΠ»Π½Ρ‹Ρ… рСгрСссий ΠΎΠΏΡƒΡ…ΠΎΠ»Π΅ΠΉ Ρ‡Π΅Ρ€Π΅Π· 60 суток послС Π½Π°Ρ‡Π°Π»Π° экспСримСнта составила 0%, 0%, 20%, 0% ΠΈ 0%, соотвСтствСнно. Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ исслСдования ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ, Ρ‡Ρ‚ΠΎ Π²Π²Π΅Π΄Π΅Π½ΠΈΠ΅ Π€Π‘ Ρ…Π»ΠΎΡ€ΠΈΠ½ΠΎΠ²ΠΎΠ³ΠΎ ряда ΠΏΠ΅Ρ€Π΅Π΄ сСансом ΠšΠ›Π’ ΡƒΠ²Π΅Π»ΠΈΡ‡ΠΈΠ²Π°Π΅Ρ‚ ΠΏΡ€ΠΎΡ‚ΠΈΠ²ΠΎΠΎΠΏΡƒΡ…ΠΎΠ»Π΅Π²ΡƒΡŽ ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ Π»ΡƒΡ‡Π΅Π²ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρƒ ΠΆΠΈΠ²ΠΎΡ‚Π½Ρ‹Ρ… с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ ΠΏΠΎ гистологичСской структурС ΠΈ Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€Ρƒ роста ΠΏΠ΅Ρ€Π΅Π²ΠΈΠ²Π½Ρ‹ΠΌΠΈ опухолями. ΠŸΠΎΠ»ΡƒΡ‡Π΅Π½Π½Ρ‹Π΅ Π΄Π°Π½Π½Ρ‹Π΅ ΡΠ²ΠΈΠ΄Π΅Ρ‚Π΅Π»ΡŒΡΡ‚Π²ΡƒΡŽΡ‚ ΠΎ пСрспСктивности Π΄Π°Π»ΡŒΠ½Π΅ΠΉΡˆΠΈΡ… исслСдований Ρ€Π°Π΄ΠΈΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·ΠΈΡ€ΡƒΡŽΡ‰ΠΈΡ… свойств Π€Π‘

    A reaction-diffusion model for the growth of avascular tumor

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    A nutrient-limited model for avascular cancer growth including cell proliferation, motility and death is presented. The model qualitatively reproduces commonly observed morphologies for primary tumors, and the simulated patterns are characterized by its gyration radius, total number of cancer cells, and number of cells on tumor periphery. These very distinct morphological patterns follow Gompertz growth curves, but exhibit different scaling laws for their surfaces. Also, the simulated tumors incorporate a spatial structure composed of a central necrotic core, an inner rim of quiescent cells and a narrow outer shell of proliferating cells in agreement with biological data. Finally, our results indicate that the competition for nutrients among normal and cancer cells may be a determinant factor in generating papillary tumor morphology.Comment: 9 pages, 6 figures, to appear in PR

    Light Element Evolution and Cosmic Ray Energetics

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    Using cosmic-ray energetics as a discriminator, we investigate evolutionary models of LiBeB. We employ a Monte Carlo code which incorporates the delayed mixing into the ISM both of the synthesized Fe, due to its incorporation into high velocity dust grains, and of the cosmic-ray produced LiBeB, due to the transport of the cosmic rays. We normalize the LiBeB production to the integral energy imparted to cosmic rays per supernova. Models in which the cosmic rays are accelerated mainly out of the average ISM significantly under predict the measured Be abundance of the early Galaxy, the increase in [O/Fe] with decreasing [Fe/H] notwithstanding. We suggest that this increase could be due to the delayed mixing of the Fe. But, if the cosmic-ray metals are accelerated out of supernova ejecta enriched superbubbles, the measured Be abundances are consistent with a cosmic-ray acceleration efficiency that is in very good agreement with the current epoch data. We also find that neither the above cosmic-ray origin models nor a model employing low energy cosmic rays originating from the supernovae of only very massive progenitors can account for the 6^6Li data at values of [Fe/H] below βˆ’-2.Comment: latex 19 pages, 2 tables, 10 eps figures, uses aastex.cls natbib.sty Submitted to the Astrophysical Journa

    ΠžΡ†Π΅Π½ΠΊΠ° эффСктивности ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ лСчСния Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… с хроничСской критичСской ишСмиСй Π½ΠΈΠΆΠ½ΠΈΡ… конСчностСй Π² стадии трофичСских ослоТнСний

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    Relevance. Chronic critical ischemia of the lower extremities (CCILE) in the stage of trophic complications is the final stage of diseases of the arteries of the lower extremities, leading to disability of patients and having a poor prognosis in terms of preservation of the lower extremities and mortality.Aim of study. Objective assessment of the efficacy of lower limb revascularization in trophic disorders.Material and methods. The analysis of treatment of 52 patients with stage IV CCILE (according to the classification of R. Fontaine and A.V. Pokrovsky) was carried out. Of these, 42 patients underwent three-phase scintigraphy combined with X-ray computed angiography on a hybrid apparatus. After the operation, this study was conducted in 37 patients.Results. Out of 52 patients, surgery for revascularization of the lower extremities was performed in 37 patients, 15 were not operated on. Out of 37 operated patients, improvement of blood circulation occurred in 32 (86.5%). Circulatory decompensation was observed in 5 patients (9.7%). Among non-operated patients, improvement of blood circulation occurred in 9 patients (17.3%), no effect or decompensation β€” in 5 (9.7%). Subjective improvement in the condition and decrease in the degree of ischemia corresponded to the improvement of microcirculation according to the data of three-phase scintigraphy.Conclusion.1. Revascularization of the lower extremities in patients with trophic disorders is an effective method of treating this pathology. Therefore, all patients with chronic ischemia threatening limb loss should be considered as candidates for revascularization.2. If the leg arteries or short occlusive or stenotic lesions of the main arteries are affected, such patients should be discussed together with specialists in endovascular surgery for endovascular treatment or joint intervention.3. Hybrid radiation method (three-phase scintigraphy and single-photon emission computed tomography, combined with X-ray computed angiography) is an objective method that reflects the state of peripheral circulation and microcirculation, and allows you to objectively assess the effectiveness of the treatment.ΠΠΊΡ‚ΡƒΠ°Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ. Π₯роничСская критичСская ишСмия Π½ΠΈΠΆΠ½ΠΈΡ… конСчностСй (Π₯КИНК) Π² стадии трофичСских ослоТнСний прСдставляСт собой ΠΊΠΎΠ½Π΅Ρ‡Π½ΡƒΡŽ ΡΡ‚Π°Π΄ΠΈΡŽ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ Π°Ρ€Ρ‚Π΅Ρ€ΠΈΠΉ Π½ΠΈΠΆΠ½ΠΈΡ… конСчностСй, ΠΏΡ€ΠΈΠ²ΠΎΠ΄ΡΡ‰ΡƒΡŽ ΠΊ ΠΈΠ½Π²Π°Π»ΠΈΠ΄ΠΈΠ·Π°Ρ†ΠΈΠΈ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… ΠΈ ΠΈΠΌΠ΅ΡŽΡ‰ΡƒΡŽ нСблагоприятный ΠΏΡ€ΠΎΠ³Π½ΠΎΠ· ΠΏΠΎ показатСлям сохранСния Π½ΠΈΠΆΠ½ΠΈΡ… конСчностСй ΠΈ Π»Π΅Ρ‚Π°Π»ΡŒΠ½ΠΎΡΡ‚ΠΈ.ЦСль исслСдования. ΠžΠ±ΡŠΠ΅ΠΊΡ‚ΠΈΠ²Π½Π°Ρ ΠΎΡ†Π΅Π½ΠΊΠ° эффСктивности рСваскуляризации Π½ΠΈΠΆΠ½ΠΈΡ… конСчностСй ΠΏΡ€ΠΈ трофичСских расстройствах.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π» ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· лСчСния 52 Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π₯КИНК IV стадии (ΠΏΠΎ классификации R. Fontaine ΠΈ А.Π’. ΠŸΠΎΠΊΡ€ΠΎΠ²ΡΠΊΠΎΠ³ΠΎ). Из Π½ΠΈΡ… 42 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°ΠΌ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Π° трСхфазная сцинтиграфия, совмСщСнная с рСнтгСновской ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½ΠΎΠΉ Π°Π½Π³ΠΈΠΎΠ³Ρ€Π°Ρ„ΠΈΠ΅ΠΉ Π½Π° Π³ΠΈΠ±Ρ€ΠΈΠ΄Π½ΠΎΠΌ Π°ΠΏΠΏΠ°Ρ€Π°Ρ‚Π΅. ПослС ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΈ Π΄Π°Π½Π½ΠΎΠ΅ исслСдованиС ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎ 37 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°ΠΌ.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. Из 52 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² опСрация ΠΏΠΎ рСваскуляризации Π½ΠΈΠΆΠ½ΠΈΡ… конСчностСй Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Π° 37 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°ΠΌ, Π½Π΅ ΠΎΠΏΠ΅Ρ€ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ 15. Из 37 ΠΎΠΏΠ΅Ρ€ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹Ρ… ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΠ΅ кровообращСния ΠΏΡ€ΠΎΠΈΠ·ΠΎΡˆΠ»ΠΎ Ρƒ 32 (86,5%). ДСкомпСнсация кровообращСния ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½Π° Ρƒ 5 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² (9,7%). Π‘Ρ€Π΅Π΄ΠΈ Π½Π΅ΠΎΠΏΠ΅Ρ€ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹Ρ… ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΠ΅ кровообращСния ΠΏΡ€ΠΎΠΈΠ·ΠΎΡˆΠ»ΠΎ Ρƒ 9 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² (17,3%), отсутствиС эффСкта ΠΈΠ»ΠΈ дСкомпСнсация β€” Ρƒ 5 (9,7%). Π‘ΡƒΠ±ΡŠΠ΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΠ΅ ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΠ΅ состояния ΠΈ сниТСниС стСпСни ишСмии соотвСтствовали ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΡŽ микроциркуляции ΠΏΠΎ Π΄Π°Π½Π½Ρ‹ΠΌ Ρ‚Ρ€Π΅Ρ…Ρ„Π°Π·Π½ΠΎΠΉ сцинтиграфии.Π’Ρ‹Π²ΠΎΠ΄Ρ‹.1. РСваскуляризация Π½ΠΈΠΆΠ½ΠΈΡ… конСчностСй Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с трофичСскими Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡΠΌΠΈ являСтся эффСктивным ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠΌ лСчСния Π΄Π°Π½Π½ΠΎΠΉ ΠΏΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΠΈ. ΠŸΠΎΡΡ‚ΠΎΠΌΡƒ всС ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ с хроничСской ишСмиСй, ΡƒΠ³Ρ€ΠΎΠΆΠ°ΡŽΡ‰Π΅ΠΉ ΠΏΠΎΡ‚Π΅Ρ€Π΅ΠΉ конСчности, Π΄ΠΎΠ»ΠΆΠ½Ρ‹ Π±Ρ‹Ρ‚ΡŒ рассмотрСны ΠΊΠ°ΠΊ ΠΊΠ°Π½Π΄ΠΈΠ΄Π°Ρ‚Ρ‹ для рСваскуляризации.2. ΠŸΡ€ΠΈ ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠΈ Π°Ρ€Ρ‚Π΅Ρ€ΠΈΠΉ Π³ΠΎΠ»Π΅Π½ΠΈ ΠΈΠ»ΠΈ ΠΊΠΎΡ€ΠΎΡ‚ΠΊΠΈΡ… ΠΎΠΊΠΊΠ»ΡŽΠ΄ΠΈΡ€ΡƒΡŽΡ‰ΠΈΡ… ΠΈΠ»ΠΈ стСнотичСских пораТСниях ΠΌΠ°Π³ΠΈΡΡ‚Ρ€Π°Π»ΡŒΠ½Ρ‹Ρ… Π°Ρ€Ρ‚Π΅Ρ€ΠΈΠΉ Ρ‚Π°ΠΊΠΈΠ΅ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ Π΄ΠΎΠ»ΠΆΠ½Ρ‹ Π±Ρ‹Ρ‚ΡŒ обсуТдСны совмСстно со спСциалистами ΠΏΠΎ рСнтгСнэндоваскулярной Ρ…ΠΈΡ€ΡƒΡ€Π³ΠΈΠΈ Π½Π° ΠΏΡ€Π΅Π΄ΠΌΠ΅Ρ‚ эндоваскулярного лСчСния ΠΈΠ»ΠΈ выполнСния Π²ΠΌΠ΅ΡˆΠ°Ρ‚Π΅Π»ΡŒΡΡ‚Π²Π° совмСстно.3. Π“ΠΈΠ±Ρ€ΠΈΠ΄Π½Ρ‹ΠΉ Π»ΡƒΡ‡Π΅Π²ΠΎΠΉ ΠΌΠ΅Ρ‚ΠΎΠ΄ (трСхфазная сцинтиграфия ΠΈ однофотонная эмиссионная ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½Π°Ρ томография, совмСщСнная с рСнтгСновской ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½ΠΎΠΉ Π°Π½Π³ΠΈΠΎΠ³Ρ€Π°Ρ„ΠΈΠ΅ΠΉ) являСтся ΠΎΠ±ΡŠΠ΅ΠΊΡ‚ΠΈΠ²Π½Ρ‹ΠΌ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠΌ, ΠΎΡ‚ΠΎΠ±Ρ€Π°ΠΆΠ°ΡŽΡ‰ΠΈΠΌ состояниС пСрифСричСского кровообращСния ΠΈ микроциркуляции, ΠΈ позволяСт ΠΎΠ±ΡŠΠ΅ΠΊΡ‚ΠΈΠ²Π½ΠΎ ΠΎΡ†Π΅Π½ΠΈΡ‚ΡŒ ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠ³ΠΎ лСчСния

    Π₯ирургичСскоС Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ Π²Π°Ρ€ΠΈΠΊΠΎΠ·Π½ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ Π½ΠΈΠΆΠ½ΠΈΡ… конСчностСй

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    The review presents an analysis of relevant literature on the surgical treatment of varicose veins of the lower extremities. Modern methods of surgical intervention for varicose veins are considered: open operations, methods of thermal ablation of the main veins, non-thermal non-tumescent methods, vein-preserving surgery (ASVAL), methods of treating reflux in perforating veins and recurrent varicose veins. The effectiveness of each of the surgical treatment methods used was analyzed. The frequency of relapses and the likelihood of complications of the described operations are considered. All surgical treatment methods presented in the review were developed on the basis of modern ideas about the pathogenesis of varicose veins, the mechanisms of formation of chronic venous insufficiency, and have an evidence base. These techniques are reflected in the latest clinical guidelines and are widely used in medical practice.Π’ ΠΎΠ±Π·ΠΎΡ€Π΅ прСдставлСн Π°Π½Π°Π»ΠΈΠ· тСматичСской Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Ρ‹, посвящСнный хирургичСскому Π»Π΅Ρ‡Π΅Π½ΠΈΡŽ Π²Π°Ρ€ΠΈΠΊΠΎΠ·Π½ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ Π½ΠΈΠΆΠ½ΠΈΡ… конСчностСй. РассмотрСны соврСмСнныС ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ хирургичСского Π²ΠΌΠ΅ΡˆΠ°Ρ‚Π΅Π»ΡŒΡΡ‚Π²Π° ΠΏΡ€ΠΈ Π²Π°Ρ€ΠΈΠΊΠΎΠ·Π½ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ: ΠΎΡ‚ΠΊΡ€Ρ‹Ρ‚Ρ‹Π΅ ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΈ, ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ Ρ‚Π΅Ρ€ΠΌΠΎΠΎΠ±Π»ΠΈΡ‚Π΅Ρ€Π°Ρ†ΠΈΠΈ ΠΌΠ°Π³ΠΈΡΡ‚Ρ€Π°Π»ΡŒΠ½Ρ‹Ρ… Π²Π΅Π½, нСтСрмичСскиС нСтумСсцСнтныС ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹, Π²Π΅Π½ΠΎΡΠΎΡ…Ρ€Π°Π½ΡΡŽΡ‰Π°Ρ хирургия (ASVAL), ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ лСчСния Ρ€Π΅Ρ„Π»ΡŽΠΊΡΠ° ΠΏΠΎ ΠΏΠ΅Ρ€Ρ„ΠΎΡ€Π°Π½Ρ‚Π½Ρ‹ΠΌ Π²Π΅Π½Π°ΠΌ ΠΈ Ρ€Π΅Ρ†ΠΈΠ΄ΠΈΠ²Π½ΠΎΠΉ Π²Π°Ρ€ΠΈΠΊΠΎΠ·Π½ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ. ΠŸΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Π° ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ ΠΊΠ°ΠΆΠ΄ΠΎΠ³ΠΎ ΠΈΠ· ΠΈΡΠΏΠΎΠ»ΡŒΠ·ΡƒΠ΅ΠΌΡ‹Ρ… ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠ² хирургичСского лСчСния. РассмотрСны частота Ρ€Π΅Ρ†ΠΈΠ΄ΠΈΠ²ΠΎΠ² ΠΈ Π²Π΅Ρ€ΠΎΡΡ‚Π½ΠΎΡΡ‚ΡŒ ослоТнСний описанных ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΉ. ВсС ΠΏΡ€ΠΈΠ²Π΅Π΄Π΅Π½Π½Ρ‹Π΅ Π² ΠΎΠ±Π·ΠΎΡ€Π΅ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ хирургичСского лСчСния Ρ€Π°Π·Ρ€Π°Π±ΠΎΡ‚Π°Π½Ρ‹ Π½Π° основании соврСмСнных прСдставлСний ΠΎ ΠΏΠ°Ρ‚ΠΎΠ³Π΅Π½Π΅Π·Π΅ Π²Π°Ρ€ΠΈΠΊΠΎΠ·Π½ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ, ΠΌΠ΅Ρ…Π°Π½ΠΈΠ·ΠΌΠ°Ρ… формирования хроничСской Π²Π΅Π½ΠΎΠ·Π½ΠΎΠΉ нСдостаточности, ΠΈΠΌΠ΅ΡŽΡ‚ Π΄ΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΡŒΠ½ΡƒΡŽ Π±Π°Π·Ρƒ. Π”Π°Π½Π½Ρ‹Π΅ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈΠΊΠΈ нашли ΠΎΡ‚Ρ€Π°ΠΆΠ΅Π½ΠΈΠ΅ Π² Π½ΠΎΠ²Π΅ΠΉΡˆΠΈΡ… клиничСских рСкомСндациях ΠΈ ΡˆΠΈΡ€ΠΎΠΊΠΎ ΠΏΡ€ΠΈΠΌΠ΅Π½ΡΡŽΡ‚ΡΡ Π² мСдицинской ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ΅
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