54 research outputs found
Non-triggered auroral substorms and long-period (1β4 mHz) geomagnetic and auroral luminosity pulsations in the polar cap
A study is undertaken into parameters of the polar auroral and geomagnetic pulsations in the frequency range 1β4β―mHz (Pc5βPi3) during quiet geomagnetic intervals preceding auroral substorms and non-substorm background variations. Special attention is paid to substorms that occur under parameters of the interplanetary magnetic field (IMF) conditions typical for undisturbed days (βnon-triggered substormsβ). The spectral parameters of pulsations observed in auroral luminosity as measured by a meridian scanning photometer (Svalbard) in the polar cap and near the polar boundary of the auroral oval are studied and compared with those for the geomagnetic pulsations measured by the magnetometer network IMAGE in the same frequency range. It is found that Pc5βPi3 power spectral density (PSD) is higher during pre-substorm time intervals than for non-substorm days and that specific variations of pulsation parameters (βsubstorm precursorsβ) occur during the last 2β4 pre-substorm hours
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A Multicenter Retrospective Study on Clinical Characteristics, Treatment Patterns, and Outcome in Elderly Patients with Hepatocellular Carcinoma
Background. There is a paucity of information on the clinical presentation and outcome of elderly hepatocellular carcinoma (HCC) patients. We performed a multicenter retrospective comparative study to assess the impact of age on potential differences in clinical characteristics, treatment patterns, and outcome in HCC patients. Methods. We retrospectively analyzed HCC patients treated at two U.S. tertiary institutions from 1998 to 2008. Demographics, tumor parameters, etiology and severity of cirrhosis, treatment, and survival from diagnosis were collected and analyzed. After exclusion of transplanted patients, survival analyses were performed using the Kaplan-Meier method with log-rank tests and Cox proportional hazards models. Results. Three hundred thirty-five HCC patients were divided into two groups: βelderlyβ (95 patients, age β₯70 years) and βyoungerβ (240 patients, aged <70 years). The male/female (M/F) ratio was 5.8:1 and 1.7:1 in the younger and elderly groups, respectively (p < .0001). Hepatitis C virus (HCV) infection rate was 48.3% in younger and 21.1% in elderly patients (p < .0001); Child class B and C cirrhosis accounted for 35.8% in younger and 25.3% in elderly patients (p = .063). Compared with younger patients, the elderly received transplant less frequently (19.6% versus 5.3%, p = .0002) and were more likely to receive supportive care only (22.9% versus 36.8%, p = .01). No significant differences between the two age groups were seen in tumor parameters or other treatments received. Overall (p = .47) and HCC-specific survival rates (p = .38) were similar in both age groups. Conclusions. Characteristics that distinguish elderly from younger HCC patients include lower M/F ratio, worse performance status, lower rate of HCV infection, and less advanced underlying cirrhosis. Elderly patients were less likely to have a liver transplant and more likely to receive supportive care only. However, overall and HCC-specific survival were similar between the two groups
Improving milk quality to prevent microelement deficiencies: a socio-hygienic perspective on adding bioavailable trace elements
Based on the study of actual nutrition and the availability of macro- and microelements, it was found that the adult population of the North Caucasus Federal District (NCFD) of Russia belongs to the risk group for the development of micronutrient insufficiency associated with a low content in the diet of several essential elements (copper, zinc, calcium, selenium), which are a priority for correction. This is because 89% of the population in the NCFD has a diet that is significantly out of balance both quantitatively and qualitatively, negatively impacting nutritional status and the dispersion of trace elements. It was found that a significant part of the population of the NCFD is characterized by a lack of dairy products in the diet (59.8%), as well as insufficient intake of vitamins B2, B6, C, PP, folic acid, I, Se, Cu, Zn, Mg, Ca, fiber, polyunsaturated fatty acids, tryptophan. Volunteers were selected for the experiment β adult men living in the NCFD. The volunteers took 200 ml of βVoznesenovsky Ecoproduktβ milk (2.5% fatness) for 60 days, produced by a local enterprise using the technology proposed by the authors. Significant violations of mineral metabolism were found in 68.3% of the population at the start of the trial, according to the findings of screening examinations conducted on the hair of the experiment's volunteer participants. Among the priorities for the correction of essential elements are: Se (deficiency in 88.2% of the examined), J (82.2%), Cu (59.1%), Zn (66.7%), Ca (29.8%). The proportion of people with calcium deficiency decreased from 29.8 to 21.5%, copper from 59.1 to 36.2%, selenium from 88.2 to 72.4%, zinc from 66.7 to 38.4%, and iodine from 82.2 to 68.4% when "Voznsenovsky Ecoproduct" was added to the milk diet. At the end of the preventive course, an increase in the concentration in the hair was noted: calcium (by 26.6%), zinc (by 11.0%), copper (by 10.1%), iodine (by 32.5%) and selenium (by 38.9%). Regular consumption of βVoznesenovsky Ecoproduktβ milk allowed to increase the consumption of dairy products among the study participants, to receive a rapid physiological response of the body in the form of an increase in the content of the studied micro- and macroelements in the hair, reducing the number of people with calcium, zinc and selenium deficiency
5Ξ±-ReductaseType 3 Enzyme in Benign and Malignant Prostate
Currently available 5Ξ±-reductase inhibitors are not completely effective for treatment of benign prostate enlargement, prevention of prostate cancer (CaP), or treatment of advanced castration-recurrent (CR) CaP. We tested the hypothesis that a novel 5Ξ±-reductase, 5Ξ±-reductase-3, contributes to residual androgen metabolism, especially in CR-CaP
Common genetic polymorphisms affect the human requirement for the nutrient choline
Humans eating diets deficient in the essential nutrient choline can develop organ dysfunction. We hypothesized that common single nucleotide polymorphisms (SNPs) in genes involved in choline metabolism influence the dietary requirement of this nutrient. Fifty-seven humans were fed a low choline diet until they developed organ dysfunction or for up to 42 days. We tested DNA SNPs for allelic association with susceptibility to developing organ dysfunction associated with choline deficiency. We identified an SNP in the promoter region of the phosphatidylethanolamine N-methyltransferase gene (PEMT; β744 GβC; rs12325817) for which 18 of 23 carriers of the C allele (78%) developed organ dysfunction when fed a low choline diet (odds ratio 25, P=0.002). The first of two SNPs in the coding region of the choline dehydrogenase gene (CHDH; +318 AβC; rs9001) had a protective effect on susceptibility to choline deficiency, while a second CHDH variant (+432 GβT; rs12676) was associated with increased susceptibility to choline deficiency. A SNP in the PEMT coding region (+5465 GβA; rs7946) and a betaine:homocysteine methyl-transferase (BHMT) SNP (+742 GβA; rs3733890) were not associated with susceptibility to choline deficiency. Identification of common polymorphisms that affect dietary requirements for choline could enable us to identify individuals for whom we need to assure adequate dietary choline intake.βda Costa, K.-A., Kozyreva, O. G., Song, J., Galanko, J. A., Fischer, L. M., Zeisel, S. H. Common genetic polymorphisms affect the human requirement for the nutrient choline
Π‘ΠΠΠΠ ΠΠΠΠΠ’ΠΠ ΠΠΠ§ΠΠΠ‘Π’Π Π Π‘ΠΠ‘Π’ΠΠΠ ΠΠΠΠ ΠΠ Π«ΠΠΠΠΠ ΠΠΠ ΠΠΠΠΠΠΠΠ―
Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½Π°ΡΠΈΠΈ ΠΈ ΠΌΠΎΠ΄Π΅Π»ΠΈ ΠΏΠΎΠ½ΡΡΠΈΡ Β«ΡΠ°ΠΌΠΎΡΠ°Π·Π²ΠΈΡΠΈΠ΅ Π»ΠΈΡΠ½ΠΎΡΡΠΈΒ», ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Ρ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΡΠ»ΠΎΠ²ΠΈΡ ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π·Π°Π΄Π°Ρ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΊΡΠ»ΡΡΡΡΡ ΡΠ°ΠΌΠΎΡΡΠΎΡΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠ°Π±ΠΎΡΡ Π»ΠΈΡΠ½ΠΎΡΡΠΈ, ΠΏΡΠ΅Π΄ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡΠ΅ΠΉ ΡΡΠΏΠ΅ΡΠ½ΠΎΡΡΡ Π²ΡΠ±ΠΎΡΠ° Π»ΠΈΡΠ½ΠΎΡΡΡΡ ΡΠΈΡΡΠ΅ΠΌ ΠΈ ΡΠΎΡΠΌ ΡΠ°ΠΌΠΎΡΠ΅Π°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΈ ΡΠ°ΠΌΠΎΡΡΠ²Π΅ΡΠΆΠ΄Π΅Π½ΠΈΡ Π² ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠ°Ρ
ΠΈΠ½Π½ΠΎΠ²Π°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΠΊΠΈ. Π‘ΠΎΡΠΈΠ°Π»ΡΠ½Π°Ρ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΠΎΡΡΡ ΡΠ°ΠΌΠΎΡΠ°Π·Π²ΠΈΡΠΈΡ Π»ΠΈΡΠ½ΠΎΡΡΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅Ρ ΡΡΠΏΠ΅ΡΠ½ΠΎΡΡΡ Π²ΡΠ±ΠΎΡΠ° ΠΌΠΎΠ΄Π΅Π»ΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ, Π³Π°ΡΠ°Π½ΡΠΈΡΡΠ΅Ρ ΡΠ²ΠΎΠ΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΡ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΈ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½ΠΈΡΡΠ΅ΠΌΡΡ
ΡΡΠ»ΠΎΠ²ΠΈΠΉ ΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅ΠΌΡΡ
ΠΏΡΠΎΡΠΈΠ²ΠΎΡΠ΅ΡΠΈΠΉ Π² ΠΌΠΎΠ΄Π΅Π»ΠΈ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΈ ΠΎΠ±ΡΠ΅Π½ΠΈΡ. Π‘ΠΏΠ΅ΡΠΈΡΠΈΠΊΠ° Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½Π°ΡΠΈΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠ΅ΠΉ ΡΠ°ΠΌΠΎΡΠ°Π·Π²ΠΈΡΠΈΡ Π»ΠΈΡΠ½ΠΎΡΡΠΈ ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ Π²ΡΠ΄Π΅Π»Π΅Π½Π° Π² ΡΠΈΡΡΠ΅ΠΌΠ΅ ΠΏΡΠΈΠ½ΡΠΈΠΏΠΎΠ² ΠΈ Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½ΠΈΡΡΠ΅ΠΌΡΡ
ΡΡΠ»ΠΎΠ²ΠΈΠΉ ΠΎΠΏΡΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ Π»ΠΈΡΠ½ΠΎΡΡΠΈ, Π²ΠΊΠ»ΡΡΠ΅Π½Π½ΠΎΠΉ Π² ΡΠΈΡΡΠ΅ΠΌΡ Π½Π΅ΠΏΡΠ΅ΡΡΠ²Π½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ, Π³Π΄Π΅ ΡΠ°ΠΌΠΎΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠΎΠΌ ΡΠ°ΠΌΠΎΠΈΠ΄Π΅Π½ΡΠΈΡΠΈΠΊΠ°ΡΠΈΠΈ ΠΈ Π²Π΅ΡΠΈΡΠΈΠΊΠ°ΡΠΈΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° Π²ΡΡΠ²Π»ΡΠ΅ΠΌΡΡ
ΠΈ ΡΠ΅ΡΠ°Π΅ΠΌΡΡ
Π·Π°Π΄Π°Ρ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎ-ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΉ ΠΈ ΡΠΎΡΡΡΠ΄Π½ΠΈΡΠ΅ΡΡΠ²Π°. ΠΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅Ρ Π² Π½Π°ΡΠ΅ΠΉ ΡΠ°Π±ΠΎΡΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½Π°ΡΠΈΠΈ ΠΈ ΡΡΠΎΡΠ½Π΅Π½ΠΈΡ ΠΌΠΎΠ΄Π΅Π»Π΅ΠΉ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π΅ΠΌΠΎΠ³ΠΎ ΡΠ²Π»Π΅Π½ΠΈΡ Π² ΡΠΈΡΠΎΠΊΠΎΠΌ, ΡΠ·ΠΊΠΎΠΌ, Π»ΠΎΠΊΠ°Π»ΡΠ½ΠΎΠΌ ΠΈ ΡΠ½ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΡΠΌΡΡΠ»Π°Ρ
, ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡ ΡΡΠΏΠ΅ΡΠ½ΠΎΠ΅ ΡΠ΅Π»ΠΎΡΡΠ½ΠΎΠ΅ ΠΏΠΎΡΡΡΠΎΠ΅Π½ΠΈΠ΅ ΠΊΠ°ΡΡΠΈΠ½Ρ ΠΌΠΈΡΠ° ΠΈ Π½Π°ΡΡΠ½ΠΎΠ³ΠΎ ΠΏΠΎΠ½ΠΈΠΌΠ°Π½ΠΈΠ΅ Π²Π°ΠΆΠ½ΠΎΡΡΠΈ Π²ΡΠ΅Ρ
ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½ΠΈΡΡΠ΅ΠΌΡΡ
ΠΈ ΡΠ΅Π°Π»ΠΈΠ·ΡΠ΅ΠΌΡΡ
ΠΏΡΠΎΡΠ΅ΡΡΠΎΠ².Π Π΅Π·ΡΠΌΠ΅ ΡΡΠ°ΡΡΠΈ. ΠΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠΈ Π·Π°Π΄Π°Ρ Π½Π°ΡΡΠ½ΠΎΠ³ΠΎ ΠΏΠΎΠΈΡΠΊΠ° Π² ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΠΊΠ΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΈ ΡΡΠ»ΠΎΠ²ΠΈΡ Π²ΡΠ΄Π΅Π»Π΅Π½Π½ΠΎΠ³ΠΎ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΡ Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½Π°ΡΠΈΠΈ ΠΏΠΎΠ½ΡΡΠΈΠΉΠ½ΠΎΠ³ΠΎ Π°ΠΏΠΏΠ°ΡΠ°ΡΠ° ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π½Π°ΡΠΊΠΈ. Π‘Π°ΠΌΠΎΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΠΊΠ°ΠΊ ΠΊΠ°ΡΠ΅Π³ΠΎΡΠΈΡ β ΡΠ»ΠΎΠΆΠ½ΠΎΠ΅ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΡΠ°Π΄ΠΈΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΈ ΠΈΠ½Π½ΠΎΠ²Π°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΠΊΠΈ, ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡΠ΅Π΅ Π² Π΅Π΄ΠΈΠ½ΡΡΠ²Π΅ Π½Π°ΡΡΠ½ΠΎΠ³ΠΎ Π·Π½Π°Π½ΠΈΡ Π½ΡΠ°Π½ΡΡ ΡΡΠ°Π±ΠΈΠ»ΠΈΠ·ΠΈΡΡΡΡΠΈΡ
ΠΈ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΡΡΡΡΠΈΡ
ΡΠ΅ΡΡΡΡΠΎΠ² Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½Π°ΡΠΈΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠ΅ΠΉ ΠΊΠ°ΡΠ΅Π³ΠΎΡΠΈΠΈ ΠΊΠ°ΠΊ ΠΏΡΠΎΡΠ΅ΡΡΠ°, ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠ°, ΡΡΠ΅Π΄ΡΡΠ²Π°, ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΡΡΠ»ΠΎΠ²ΠΈΡ ΠΈ ΠΌΠΎΠ΄Π΅Π»ΠΈ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π·Π°Π΄Π°Ρ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ. Π‘Π°ΠΌΠΎΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΎ Π² ΡΠΈΡΠΎΠΊΠΎΠΌ, ΡΠ·ΠΊΠΎΠΌ, Π»ΠΎΠΊΠ°Π»ΡΠ½ΠΎΠΌ ΠΈ ΡΠ½ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΌ ΡΠΌΡΡΠ»Π°Ρ
, ΠΊΠ°ΠΆΠ΄ΡΠΉ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅ΠΌΡΠΉ ΡΠΌΡΡΠ» ΡΠ΅ΡΠ°Π΅Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΡΡ Π·Π°Π΄Π°ΡΡ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΈ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π½Π°ΡΠΊΠΈ Π² ΡΠ΅Π»ΠΎΠΌ. Π‘ΠΈΡΡΠ΅ΠΌΠ° Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½Π°Π½Ρ ΠΈ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΠ½ΠΊΡΠΈΠΉ, Π½Π΅ΠΏΠΎΡΡΠ΅Π΄ΡΡΠ²Π΅Π½Π½ΠΎ ΡΠ²ΡΠ·Π°Π½Π½ΡΡ
Ρ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎΠΌ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π»ΠΈΡΠ½ΠΎΡΡΠΈ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³Π°, ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ Π²ΡΡΠ²Π»Π΅Π½Π° ΠΈ ΠΎΠΏΡΠΈΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π° Π² ΠΌΠΎΠ΄Π΅Π»ΠΈ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ ΠΊΡΡΡΠΎΠ² ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉΒ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΠΊΠΈ, ΠΏΠΎΡΡΡΠΎΠ΅Π½Π½ΡΡ
Π² ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΈΠΈ Ρ Π½ΡΠ°Π½ΡΠ°ΠΌΠΈ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π·Π°Π΄Π°Ρ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π² ΠΌΠΎΠ΄Π΅Π»ΠΈΒ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ ΡΠΈΡΡΠ΅ΠΌΠ½ΠΎ-ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΡ. ΠΠ°ΡΠ΅ΡΡΠ²ΠΎ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡΒ ΠΊΡΡΡΠΎΠ² ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΠΊΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅ΡΡΡ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎΠΌ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΊΡΠ»ΡΡΡΡΡΒ ΡΠ°ΠΌΠΎΡΡΠΎΡΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠ°Π±ΠΎΡΡ Π»ΠΈΡΠ½ΠΎΡΡΠΈ, ΡΠ²Π»ΡΡΡΠ΅ΠΉΡΡ ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅ΠΌ ΠΈ ΡΠ΅ΡΡΡΡΠΎΠΌ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π΅ΠΌΠΎΠ³ΠΎ Π²Β ΡΠ°Π±ΠΎΡΠ΅ ΡΠ²Π»Π΅Π½ΠΈΡ. ΠΠ°Π΄Π΅ΠΆΠ½ΠΎΡΡΡ Π²ΡΠ±ΠΎΡΠ° ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΠ»ΠΎΠ²ΠΈΠΉ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡΒ Π»ΠΈΡΠ½ΠΎΡΡΠΈ Π² ΡΠΈΡΡΠ΅ΠΌΠ΅ Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½Π°Π½Ρ ΡΠ°ΠΌΠΎΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΌ ΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎΒ Π²ΡΠ±ΠΎΡΠ° ΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎΠΌ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ
ΠΠΠΠ‘Π’Π Π£ΠΠ’ΠΠ ΠΠ ΠΠΠ¦ΠΠΠΠ ΠΠΠΠΠΠΠΠΠ§ΠΠ‘ΠΠΠΠ ΠΠΠΠΠΠΠΠΠΠ‘Π’ΠΠΠ― Π Π‘Π’Π Π£ΠΠ’Π£Π Π ΠΠΠ£Π§ΠΠΠΠ― ΠΠ£Π Π‘Π Β«ΠΠΠΠΠΠΠΠΠΠΒ»
Π ΡΡΠ°ΡΡΠ΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡΡΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠΈ ΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΎΡΠ° ΠΏΡΠΈΠ½ΡΠΈΠΏΠΎΠ² ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΡ Π² ΡΡΡΡΠΊΡΡΡΠ΅ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ ΠΊΡΡΡΠ° Β«ΠΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΠΊΠ°Β». ΠΠ°ΡΠ΅ΡΡΠ²ΠΎ ΠΈ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠΎΠ΄Π΅Π»ΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅ΠΌΡΡ
ΡΠ΅ΡΡΡΡΠΎΠ² Π±ΡΠ΄ΡΡΠΈΡ
ΡΠΈΡΡΠ΅ΠΌ ΠΏΡΠΈΠ½ΡΠΈΠΏΠΎΠ² ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΡ Π²ΠΈΠ·ΡΠ°Π»ΡΠ½ΠΎ ΠΌΠΎΠ³ΡΡ Π±ΡΡΡ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Ρ Π±ΡΠ΄ΡΡΠΈΠΌΠΈ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³Π°ΠΌΠΈ Π² Π»ΠΈΠ½Π΅ΠΉΠ½ΠΎΠΉ ΠΈ Π½Π΅Π»ΠΈΠ½Π΅ΠΉΠ½ΠΎΠΉ ΡΡΡΡΠΊΡΡΡΠ΅. ΠΠ΅Π»ΠΈΠ½Π΅ΠΉΠ½ΠΎΡΡΡ Π²ΡΠ±ΠΎΡΠ° ΡΠΈΡΡΠ΅ΠΌΡ ΠΏΡΠΈΠ½ΡΠΈΠΏΠΎΠ² ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΡ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅Ρ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΠΉ ΠΈΠ»ΠΈ Π²ΡΡΠΎΠΊΠΈΠΉ ΡΡΠΎΠ²Π΅Π½Ρ ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ Π»ΠΈΡΠ½ΠΎΡΡΠΈ Π² ΡΠΈΡΡΠ΅ΠΌΠ΅ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ ΠΈ ΡΠ°ΠΌΠΎΡΠ΅Π°Π»ΠΈΠ·Π°ΡΠΈΠΈ. ΠΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠΈ Π·Π°Π΄Π°Ρ ΠΌΠΎΠ΄ΡΠ»Ρ Β«Π’Π΅ΠΎΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΠΊΠ°Β» ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΊΠΈ Π±ΡΠ΄ΡΡΠΈΡ
ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΎΠ² ΠΊ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΠΎΠΌΡ Π²ΡΠ±ΠΎΡΡ ΡΡΠ»ΠΎΠ²ΠΈΠΉ ΠΈ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΠ΅Π΄ΡΡΠ² ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ Π²ΠΎΡΠΏΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠΉ, ΡΡΠ΅Π±Π½ΠΎΠΉ, ΡΡΠ΅Π±Π½ΠΎ-ΡΡΠ΅Π½ΠΈΡΠΎΠ²ΠΎΡΠ½ΠΎΠΉ, Π·Π΄ΠΎΡΠΎΠ²ΡΠ΅ ΡΠ±Π΅ΡΠ΅Π³Π°ΡΡΠ΅ΠΉ, ΠΏΡΠΎΡΠ²Π΅ΡΠΈΡΠ΅Π»ΡΡΠΊΠΎΠΉ, Π½Π°ΡΡΠ½ΠΎ-ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΡΠΊΠΎΠΉ, ΠΊΡΠ»ΡΡΡΡΠ½ΠΎ-ΠΌΠ°ΡΡΠΎΠ²ΠΎΠΉ ΡΠ°Π±ΠΎΡΡ. ΠΠ½ΠΎΠ³ΠΎΠΌΠ΅ΡΠ½ΠΎΡΡΡ ΠΈ ΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠΈΠΊΠ°ΡΠΈΡ ΠΏΠΎΠΈΡΠΊΠ° ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡ Π²Π°ΡΠΈΠ°ΡΠΈΠ²Π½ΠΎΡΡΡ ΠΈ ΠΊΠΎΠ½ΠΊΡΡΠ΅Π½ΡΠΎΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΡ ΠΏΡΠΎΠ΄ΡΠΊΡΠΎΠ² Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΈ Π΄Π΅ΡΠ°Π»ΠΈΠ·ΠΈΡΡΠ΅ΠΌΡΡ
ΡΠ΅ΡΠ΅Π½ΠΈΠΉ ΠΏΠΎΡΡΠ°Π²Π»Π΅Π½Π½ΡΡ
Π·Π°Π΄Π°Ρ. Π‘ΠΈΡΡΠ΅ΠΌΡ ΠΏΡΠΈΠ½ΡΠΈΠΏΠΎΠ² ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΡ, ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅ΠΌΡΠ΅ ΡΠ΅ΡΠ΅Π· ΠΊΠΎΠ½ΡΡΡΡΠΊΡΡ ΠΏΡΠΈΠ½ΡΠΈΠΏΠΎΠ², ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΡΡΡΡ Π² ΡΡΡΡΠΊΡΡΡΠ΅ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ ΠΌΠΎΠ΄ΡΠ»Π΅ΠΉ Β«ΠΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΠΊΠ°Β» ΠΈ Β«ΠΠ΅ΡΠΎΠ΄ΠΈΠΊΠ° Π²ΠΎΡΠΏΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠ°Π±ΠΎΡΡΒ».Π Π΅Π·ΡΠΌΠ΅ ΡΡΠ°ΡΡΠΈ. ΠΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ ΠΎΡΠ½ΠΎΠ² ΠΊΡΡΡΠ° Β«ΠΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΠΊΠ°Β» Π² ΡΡΡΡΠΊΡΡΡΠ΅ Π²ΡΠ΄Π΅Π»ΡΠ΅ΠΌΡΡ
ΠΌΠΎΠ΄ΡΠ»Π΅ΠΉ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅Ρ Π·Π°Π΄Π°ΡΡ ΠΏΠΎΡΡΡΠΎΠ΅Π½ΠΈΡ ΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΎΡΠ° ΠΏΡΠΈΠ½ΡΠΈΠΏΠΎΠ² ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΡ ΠΎΠ΄Π½ΠΎΠΉ ΠΈΠ· Π²Π°ΠΆΠ½ΡΡ
Π·Π°Π΄Π°Ρ, ΡΠ²ΡΠ·ΡΡΡΠ΅ΠΉ ΡΠ΅ΠΎΡΠΈΡ ΠΈ ΠΏΡΠ°ΠΊΡΠΈΠΊΡ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΠΈ ΡΡΠ»ΠΎΠ²ΠΈΡ ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ ΠΌΠΎΠ΄ΡΠ»Ρ Β«Π’Π΅ΠΎΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΠΊΠ°Β» ΠΈ Β«ΠΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΠΊΠ°Β». Π ΡΠ°Π±ΠΎΡΠ΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Ρ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΈΠ½Π½ΠΎΠ²Π°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΈ ΡΡΠ°Π΄ΠΈΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΠΊΠΈ, Π³Π°ΡΠ°Π½ΡΠΈΡΡΡΡΠΈΠ΅ Π±ΡΠ΄ΡΡΠ΅ΠΌΡ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³Ρ ΡΡΠΏΠ΅ΡΠ½ΠΎΠ΅ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ Π·Π°Π΄Π°Ρ Π½Π°ΡΡΠ½ΠΎ-ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΠΈΡΠΊΠ° Π² ΡΠΈΡΡΠ΅ΠΌΠ΅ Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½Π°ΡΠΈΠΈ ΠΈ ΡΠ΅Π°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΎΡΠ½ΠΎΠ² ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Ρ ΠΎΠ±ΡΡΠ°ΡΡΠΈΠΌΠΈΡΡ, Π²ΠΊΠ»ΡΡΠ΅Π½Π½ΡΠΌΠΈ Π² ΡΠΈΡΡΠ΅ΠΌΡ Π½Π΅ΠΏΡΠ΅ΡΡΠ²Π½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ. ΠΠ°ΡΠ΅ΡΡΠ²ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎ-ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΡΠ΅ΠΌ Π²ΡΡΠ΅, ΡΠ΅ΠΌ Π»ΡΡΡΠ΅ ΡΡΡΠ΅Π½Ρ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ Π΅Π΅ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ ΠΈ ΠΎΠΏΡΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ Π² ΠΌΠΎΠ΄Π΅Π»ΠΈ Π½Π΅ΠΏΡΠ΅ΡΡΠ²Π½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ. Π Π²ΡΠ΄Π΅Π»Π΅Π½Π½ΠΎΠΌ Π°ΡΠΏΠ΅ΠΊΡΠ΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡΡΡ Π²ΡΠ΅ ΡΠΎΡΡΠ°Π²Π½ΡΠ΅ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈΒ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ, ΠΊΠΎΡΠΎΡΡΠ΅ ΠΌΠΎΠ³ΡΡ Π±ΡΡΡ ΠΏΠΎΠ»Π΅Π·Π½Ρ Π±ΡΠ΄ΡΡΠ΅ΠΌΡ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³Ρ Π² ΠΌΠΎΠ΄Π΅Π»ΠΈΒ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠΈ ΠΈ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ. ΠΠ½ΠΎΠ³ΠΎΠΌΠ΅ΡΠ½ΠΎΡΡΡΒ ΠΏΠΎΠΈΡΠΊΠ° ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΎΠ² ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊΠ°ΠΊ Π΄ΠΎΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΎΠ² ΠΈ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΎΡΠΎΠ² ΠΏΡΠΈΠ½ΡΠΈΠΏΠΎΠ²Β ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΡ, ΡΠ°ΠΊ ΠΈ ΡΠ΅ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠΈ ΡΠΈΡΡΠ΅ΠΌΡ ΠΏΡΠΈΠ½ΡΠΈΠΏΠΎΠ² ΠΏΠ΅Π΄Π°Π³ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎΠ²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΡ
Metastatic Syringocystadenocarcinoma Papilliferum: A Case Report, Tumor Genomic Profiling, and Literature Review
Syringocystadenocarcinoma papilliferum (SCACP) is an extremely rare cutaneous neoplasm of the apocrine or eccrine sweat glands. Solid and cystic glandular structures with cribriform and tubular architecture along with CK5/6, pankeratin and p63 immuno-profile set apart SCACP from other cutaneous malignancies. Wide local excision (WLE) has been the mainstay treatment for localized SCACP; however, no standard treatment has yet been established for unresectable or metastatic disease. Herein, we report a 74-year-old male with SCACP, who initially presented with a painful nodule on the upper back and later developed metastatic disease. He was treated with carboplatin and paclitaxel with concurrent intensity-modulated radiation therapy (IMRT), which resulted in disease stabilization for 12 months. Next generation sequencing (NGS) revealed a total of 18 genomic alterations associated with potential benefit from targeted therapeutics. PD-L1 expression was identified in 70% of tumor cells. These findings suggest that the opportunity of targeted therapeutics and immunotherapy exist as for metastatic SCACP. Reporting molecular profile of the rare tumors with no established standard treatment options should be encouraged
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