80 research outputs found
The wearing of Christian baptismal crosses
The text, accepted by the Director, reproduces the joint Conclusion by the Representation of the Russian Orthodox Church to the Council of Europe (Strasbourg, France) and the Institute for State-Confessional Relations and Law (Moscow, Russia)SUMMARY: 1. On the religious significance of baptismal crosses and grounds for the need for Orthodox Christian believers to wear them β 2. On the illegitimate nature of the ban imposed by the state on the wearing of baptismal symbols of Christian religious affiliation β 3. Absence of any grounds for assessing the religious rite of wearing Christian baptismal crosses as a threat to public safety, public order, health or morals or the rights and freedoms of others β 4. The groundless emasculation, denial and reduction of the religious meaning and importance of Christian baptismal crosses
ΠΠ°ΡΠΈΠ°Π½ΡΡ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π½Π΅ΡΠΎΠ²Π΅ΡΡΠ΅Π½Π½ΡΠΌ ΠΎΡΡΠ΅ΠΎΠ³Π΅Π½Π΅Π·ΠΎΠΌ: ΠΎΠ±Π·ΠΎΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ
Background. The scientific and clinical interest in the problems of osteogenesis imperfecta (OI) has grown in the last decade. However, the analysis of various variants of spinal pathologies in OI received insufficient attention.
The study aimed to analyze the current literature on various variants of the spinal pathology in patients with OI. OI is a phenotypically and genetically heterogeneous group of hereditary bone dysplasias. The spine pathology in OI is represented by scoliosis, kyphoscoliosis, anomalies of the craniovertebral junction, instability of the segments and fractures of the vertebral bodies, spondylolysis, and spondylolisthesis. Scoliosis and kyphoscoliosis are the most common forms of spinal pathology. In severe forms and at age 6 years, the prevalence of scoliosis can reach 89%. The exact mechanism of scoliosis formation in patients with OI is complex and incompletely defined. Anomalies of the craniovertebral junction are recorded in 37% of patients with OI and are determined in all four types of OI. Clinical manifestations of the craniocervical junction pathology can vary from asymptomatic to compression of the brainstem, restriction of cerebrospinal fluid circulation, leading to hydrocephalus, syringomyelia, and cranial nerve damage. The pathology of the lumbosacral spine is represented by spondylolysis and spondylolisthesis generally in the L5S1 segment in 5.3%10.9% of cases. The clinical significance and natural course of spondylolysis and spondylolisthesis in patients with OI are not fully defined in the literature, and the information on surgical indications and methods is available only in rare case reports. The changes in the axial skeleton in OI can lead to significant functional disability, pain, and potentially life-threatening complications, such as radicular neurological deficit, decrease in the ventilation capacity of the lungs, and cardiorespiratory complications. The overall severity of OI remains the best criterion for predicting the development of secondary spinal pathology. Given the generalization and heterogeneity of OI, an individual and multidisciplinary approach is necessary when diagnosing and planning the treatment strategy for this group of patients.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. Π ΠΏΠΎΡΠ»Π΅Π΄Π½Π΅Π΅ Π΄Π΅ΡΡΡΠΈΠ»Π΅ΡΠΈΠ΅ Π·Π°ΠΌΠ΅ΡΠ½ΠΎ Π²ΡΡΠΎΡ Π½Π°ΡΡΠ½ΡΠΉ ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΈΠ½ΡΠ΅ΡΠ΅Ρ ΠΊ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ°ΠΌ Π½Π΅ΡΠΎΠ²Π΅ΡΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΎΡΡΠ΅ΠΎΠ³Π΅Π½Π΅Π·Π° (ΠΠ). ΠΠ΄Π½Π°ΠΊΠΎ Π°Π½Π°Π»ΠΈΠ·Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π²Π°ΡΠΈΠ°Π½ΡΠΎΠ² ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° ΠΏΡΠΈ ΠΠ ΡΠ΄Π΅Π»Π΅Π½ΠΎ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎ Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ.
Π¦Π΅Π»Ρ Π°Π½Π°Π»ΠΈΠ· ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ ΠΏΠΎ Π²ΠΎΠΏΡΠΎΡΠ°ΠΌ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π²Π°ΡΠΈΠ°Π½ΡΠΎΠ² ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠ. ΠΠ΅ΡΠΎΠ²Π΅ΡΡΠ΅Π½Π½ΡΠΉ ΠΎΡΡΠ΅ΠΎΠ³Π΅Π½Π΅Π· ΡΠ΅Π½ΠΎΡΠΈΠΏΠΈΡΠ΅ΡΠΊΠΈ ΠΈ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈ Π³Π΅ΡΠ΅ΡΠΎΠ³Π΅Π½Π½Π°Ρ Π³ΡΡΠΏΠΏΠ° Π½Π°ΡΠ»Π΅Π΄ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΊΠΎΡΡΠ½ΡΡ
Π΄ΠΈΡΠΏΠ»Π°Π·ΠΈΠΉ. ΠΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° ΠΏΡΠΈ ΠΠ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π° ΡΠΊΠΎΠ»ΠΈΠΎΠ·ΠΎΠΌ, ΠΊΠΈΡΠΎΡΠΊΠΎΠ»ΠΈΠΎΠ·ΠΎΠΌ, Π°Π½ΠΎΠΌΠ°Π»ΠΈΡΠΌΠΈ ΠΊΡΠ°Π½ΠΈΠΎΠ²Π΅ΡΡΠ΅Π±ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΎΠ΅Π΄ΠΈΠ½Π΅Π½ΠΈΡ, Π½Π΅ΡΡΠ°Π±ΠΈΠ»ΡΠ½ΠΎΡΡΡΡ ΡΠ΅Π³ΠΌΠ΅Π½ΡΠΎΠ² ΠΈ ΠΏΠ΅ΡΠ΅Π»ΠΎΠΌΠ°ΠΌΠΈ ΡΠ΅Π» ΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ², ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ»ΠΈΠ·ΠΎΠΌ ΠΈ ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ»ΠΈΡΡΠ΅Π·ΠΎΠΌ. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΠΌΠΈ ΡΠΎΡΠΌΠ°ΠΌΠΈ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° ΡΠ²Π»ΡΡΡΡΡ ΡΠΊΠΎΠ»ΠΈΠΎΠ· ΠΈ ΠΊΠΈΡΠΎΡΠΊΠΎΠ»ΠΈΠΎΠ·. ΠΡΠΈ ΡΡΠΆΠ΅Π»ΡΡ
ΡΠΎΡΠΌΠ°Ρ
ΠΈ Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΡΡΠ°ΡΡΠ΅ 6 Π»Π΅Ρ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ ΡΠΊΠΎΠ»ΠΈΠΎΠ·Π° ΠΌΠΎΠΆΠ΅Ρ Π΄ΠΎΡΡΠΈΠ³Π°ΡΡ 89%. Π’ΠΎΡΠ½ΡΠΉ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠΊΠΎΠ»ΠΈΠΎΠ·Π° Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠ ΡΠ»ΠΎΠΆΠ΅Π½ ΠΈ ΠΎΡΡΠ°Π΅ΡΡΡ Π΄ΠΎ ΠΊΠΎΠ½ΡΠ° Π½Π΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΡΠΌ. ΠΠ½ΠΎΠΌΠ°Π»ΠΈΠΈ ΠΊΡΠ°Π½ΠΈΠΎΠ²Π΅ΡΡΠ΅Π±ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΠ΅ΡΠ΅Ρ
ΠΎΠ΄Π° ΡΠ΅Π³ΠΈΡΡΡΠΈΡΡΡΡΡΡ Ρ 37% ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠ, ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡΡΡ ΠΏΡΠΈ Π²ΡΠ΅Ρ
ΡΠ΅ΡΡΡΠ΅Ρ
ΡΠΈΠΏΠ°Ρ
ΠΠ. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΊΡΠ°Π½ΠΈΠΎΡΠ΅ΡΠ²ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΠ΅ΡΠ΅Ρ
ΠΎΠ΄Π° ΠΌΠΎΠ³ΡΡ Π²Π°ΡΡΠΈΡΠΎΠ²Π°ΡΡΡΡ ΠΎΡ ΠΎΡΡΡΡΡΡΠ²ΠΈΡ ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ² Π΄ΠΎ ΡΠ΄Π°Π²Π»Π΅Π½ΠΈΡ ΡΡΠ²ΠΎΠ»Π° ΠΌΠΎΠ·Π³Π°, ΠΎΠ³ΡΠ°Π½ΠΈΡΠ΅Π½ΠΈΡ ΡΠΈΡΠΊΡΠ»ΡΡΠΈΠΈ ΡΠΏΠΈΠ½Π½ΠΎΠΌΠΎΠ·Π³ΠΎΠ²ΠΎΠΉ ΠΆΠΈΠ΄ΠΊΠΎΡΡΠΈ, ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡΠΈΡ
ΠΊ Π³ΠΈΠ΄ΡΠΎΡΠ΅ΡΠ°Π»ΠΈΠΈ, ΡΠΈΡΠΈΠ½Π³ΠΎΠΌΠΈΠ΅Π»ΠΈΠΈ ΠΈ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΡ ΡΠ΅ΡΠ΅ΠΏΠ½ΡΡ
Π½Π΅ΡΠ²ΠΎΠ². ΠΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡ ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΠΎ-ΠΊΡΠ΅ΡΡΡΠΎΠ²ΠΎΠ³ΠΎ ΠΎΡΠ΄Π΅Π»Π° ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π° ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ»ΠΈΠ·ΠΎΠΌ ΠΈ ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ»ΠΈΡΡΠ΅Π·ΠΎΠΌ, ΠΊΠ°ΠΊ ΠΏΡΠ°Π²ΠΈΠ»ΠΎ, Π² ΡΠ΅Π³ΠΌΠ΅Π½ΡΠ΅ L5S1, Π² 5,310,9% ΡΠ»ΡΡΠ°Π΅Π². ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ ΠΈ Π΅ΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ΅ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ»ΠΈΠ·Π° ΠΈ ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ»ΠΈΡΡΠ΅Π·Π° Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠ Π² Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ΅ Π΄ΠΎ ΠΊΠΎΠ½ΡΠ° Π½Π΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Ρ, Π° ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΡ ΠΎ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡΡ
ΠΈ ΠΌΠ΅ΡΠΎΠ΄Π°Ρ
Π΄ΠΎΡΡΡΠΏΠ½Π° ΡΠΎΠ»ΡΠΊΠΎ Π² ΡΠ΅Π΄ΠΊΠΈΡ
ΠΎΡΡΠ΅ΡΠ°Ρ
ΠΎ ΡΠ»ΡΡΠ°ΡΡ
. ΠΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΎΡΠ΅Π²ΠΎΠ³ΠΎ ΡΠΊΠ΅Π»Π΅ΡΠ° ΠΏΡΠΈ ΠΠ ΠΌΠΎΠ³ΡΡ ΠΏΡΠΈΠ²Π΅ΡΡΠΈ ΠΊ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΠΈ, Π±ΠΎΠ»ΠΈ ΠΈ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΠΎ ΠΎΠΏΠ°ΡΠ½ΡΠΌ Π΄Π»Ρ ΠΆΠΈΠ·Π½ΠΈ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡΠΌ: ΠΊΠΎΡΠ΅ΡΠΊΠΎΠ²ΠΎΠΌΡ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌΡ Π΄Π΅ΡΠΈΡΠΈΡΡ, ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΌΠΎΡΠ½ΠΎΡΡΠΈ Π²Π΅Π½ΡΠΈΠ»ΡΡΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ
, ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΠΌ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡΠΌ. ΠΠ±ΡΠ°Ρ ΡΡΠΆΠ΅ΡΡΡ ΠΠ Π΄ΠΎ ΡΠΈΡ
ΠΏΠΎΡ ΠΎΡΡΠ°Π΅ΡΡΡ Π»ΡΡΡΠΈΠΌ ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅ΠΌ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° ΡΠ°Π·Π²ΠΈΡΠΈΡ Π²ΡΠΎΡΠΈΡΠ½ΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ°. Π ΡΠΈΠ»Ρ Π³Π΅Π½Π΅ΡΠ°Π»ΠΈΠ·ΠΎΠ²Π°Π½Π½ΠΎΡΡΠΈ ΠΈ Π³Π΅ΡΠ΅ΡΠΎΠ³Π΅Π½Π½ΠΎΡΡΠΈ ΠΠ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΠΏΡΠΈΠΌΠ΅Π½ΡΡΡ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΡΠΉ ΠΈ ΠΌΡΠ»ΡΡΠΈΠ΄ΠΈΡΡΠΈΠΏΠ»ΠΈΠ½Π°ΡΠ½ΡΠΉ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ ΠΏΡΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΈ ΠΏΠ»Π°Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ ΡΡΡΠ°ΡΠ΅Π³ΠΈΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ Π΄Π°Π½Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²
ΠΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΡ Π³ΡΡΠ΄Π½ΡΡ ΠΈ ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΡΡ ΠΏΠΎΠ»ΡΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ² ΠΈΠ· Π΄ΠΎΡΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π΄ΠΎΡΡΡΠΏΠ° Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ ΡΠΊΠ°Π»ΡΠΏΠ΅Π»Ρ Ρ Π΄Π΅ΡΠ΅ΠΉ: ΡΠ΅Π·ΡΠ»ΡΡΠ°Ρ ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΌΠ½ΠΎΠ³ΠΎΡΠ΅Π½ΡΡΠΎΠ²ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ
Background. The surgical treatment of congenital spinal deformity caused by hemivertebra is associated with high rate of complications. A research of a new surgery technique for operation time and blood loss decrease could potentially improve outcomes. The purpose β to evaluate the efficacy of ultrasonic bone scalpel in surgical treatment of pediatric congenital spinal deformities caused by monosegmental hemivertebra. Patients and Methods. Level of Evidence III. The study based on the data of 55 consecutively operated pediatric patients who underwent 59 posterior hemivertebra resection provided by ultrasonic bone scalpel from January 2015 to December 2019. The average age was 4 years and 4 months. 36 hemivertebra were located in thoracic spine and 23 were located in lumbar spine. Total duration of surgery, estimated blood loss (ml and % of circulated blood volume, CBV), complications rate and deformity correction were noted. The influence of posterior instrumentation length and patients age at time of surgery on evaluation parameters was analyzed. 5-year (2015β2019) systematic literature review was performed for compare with obtain results. Results. Total operation time was 131 min Β± 33 min for thoracic spine and 165 min Β± 50 min for lumbar spine (p = 0,005). Estimated blood loss was 105 ml Β± 74 ml (Me 80 ml) for thoracic resection and 123 ml Β± 59 ml (Me 120 ml) β for lumbar (p = 0,178). The length of posterior instrumentation were not influence on operation time and total blood loss (p = 0,957; p = 0,967), patients age at time of surgery were not influence on operation time (p = 0,458), but correlate with total blood loss (p = 0,023). Intraoperative complications was not observed. Four cases of transpedicular screw malposition without neurological deficit were noted (type C acc. Gertzbein-Robbins). Conclusions. Posterior hemivertebra resection with ultrasonic bone scalpel is safe and effective procedure provides decrease of operation time and estimated blood loss.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. Π₯ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΡΡ
Π΄Π΅ΡΠΎΡΠΌΠ°ΡΠΈΠΉ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° Ρ Π΄Π΅ΡΠ΅ΠΉ Π½Π° ΡΠΎΠ½Π΅ ΠΏΠΎΠ»ΡΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ² ΡΠΎΠΏΡΡΠΆΠ΅Π½ΠΎ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΡΠΎΠ²Π½Π΅ΠΌ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ. ΠΠΎΠΈΡΠΊ ΠΏΡΡΠ΅ΠΉ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΡΠ°Π²ΠΌΠ°ΡΠΈΡΠ½ΠΎΡΡΠΈ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΡ ΡΠ»ΡΡΡΠΈΡΡ ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π¦Π΅Π»Ρ β ΠΎΡΠ΅Π½ΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ ΡΠΊΠ°Π»ΡΠΏΠ΅Π»Ρ Π² Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΡΡ
Π΄Π΅ΡΠΎΡΠΌΠ°ΡΠΈΠΉ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° Ρ Π΄Π΅ΡΠ΅ΠΉ Π½Π° ΡΠΎΠ½Π΅ ΠΌΠΎΠ½ΠΎΡΠ΅Π³ΠΌΠ΅Π½ΡΠ°ΡΠ½ΡΡ
ΠΏΠΎΠ»ΡΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ². ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠΈΠ·Π°ΠΉΠ½ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΡΡΠ΅Ρ
ΡΠ΅Π½ΡΡΠΎΠ²ΠΎΠ΅ ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅. ΠΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎ ΠΎΠΏΠ΅ΡΠΈΡΠΎΠ²Π°Π½Ρ 55 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΠΎΡ 10 ΠΌΠ΅Ρ. Π΄ΠΎ 13 Π»Π΅Ρ (M = 4 Π³ΠΎΠ΄Π° 4 ΠΌΠ΅Ρ., Me β 3 Π³ΠΎΠ΄Π° 8 ΠΌΠ΅Ρ.), Π²ΡΠΏΠΎΠ»Π½Π΅Π½Ρ 59 ΡΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΠΉ ΠΏΠΎΠ»ΡΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ² (Π³ΡΡΠ΄Π½ΡΡ
β 36, ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΡΡ
β 23) Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ ΡΠΊΠ°Π»ΡΠΏΠ΅Π»Ρ ΠΈΠ· ΠΎΠ΄Π½ΠΎΠ³ΠΎ Π΄ΠΎΡΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π΄ΠΎΡΡΡΠΏΠ°. ΠΡΠ΅Π½ΠΈΠ²Π°Π΅ΠΌΡΠ΅ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΡ: Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ, ΠΎΠ±ΡΠ΅ΠΌ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ (Π°Π±ΡΠΎΠ»ΡΡΠ½ΡΠΉ ΠΈ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΡΠΉ), ΡΠ°ΡΡΠΎΡΠ° ΠΈ Ρ
Π°ΡΠ°ΠΊΡΠ΅Ρ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ, Π²Π΅Π»ΠΈΡΠΈΠ½Π° ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠΈ Π΄Π΅ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΈ Π΅Π΅ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ° Π² ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ ΡΠΈΡΡΠ΅ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΎΠ±Π·ΠΎΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ (ΠΏΠ΅ΡΠΈΠΎΠ΄ ΠΏΠΎΠΈΡΠΊΠ° ΠΏΡΠ±Π»ΠΈΠΊΠ°ΡΠΈΠΉ 2015β2019 Π³Π³.) ΠΏΠΎ Π΄ΠΎΡΡΠ°Π»ΡΠ½ΡΠΌ ΡΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΡΠΌ ΠΏΠΎΠ»ΡΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ² Ρ Π΄Π΅ΡΠ΅ΠΉ, Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π½ΡΡ
Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΠΎΠΉ ΡΠ΅Ρ
Π½ΠΈΠΊΠΈ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π²ΡΡΠΎΠΊΠΎΡΠΊΠΎΡΠΎΡΡΠ½ΠΎΠ³ΠΎ Π±ΡΡΠ°. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠ»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ Π² ΡΠ΅ΡΠΈΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 131Β±33 ΠΌΠΈΠ½. Π΄Π»Ρ Π³ΡΡΠ΄Π½ΡΡ
ΡΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΠΉ ΠΈ 165Β±50 ΠΌΠΈΠ½. Π΄Π»Ρ ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΡΡ
(p = 0,005). ΠΠ±ΡΠ΅ΠΌ Π°Π±ΡΠΎΠ»ΡΡΠ½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ: 105Β±74 ΠΌΠ» (Me 80 ΠΌΠ») Π΄Π»Ρ Π³ΡΡΠ΄Π½ΡΡ
ΡΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΠΉ ΠΈ 123Β±59 ΠΌΠ» (Me 120 ΠΌΠ») Π΄Π»Ρ ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΡΡ
(p = 0,178). ΠΠ±ΡΠ΅ΠΌ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ: 6,8Β±3,1% ΠΎΡ ΠΠ¦Π Π΄Π»Ρ Π³ΡΡΠ΄Π½ΡΡ
ΠΈ 11,5Β±5,5% ΠΎΡ ΠΠ¦Π Π΄Π»Ρ ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΡΡ
ΡΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΠΉ (p = 0,002). ΠΡΠΎΡΡΠΆΠ΅Π½Π½ΠΎΡΡΡ Π·Π°Π΄Π½Π΅ΠΉ ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΈΠΊΡΠ°ΡΠΈΠΈ Π½Π΅ ΠΎΠΊΠ°Π·ΡΠ²Π°Π΅Ρ Π·Π½Π°ΡΠΈΠΌΠΎΠ³ΠΎ Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΠΈ ΠΎΠ±ΡΠ΅ΠΌ Π°Π±ΡΠΎΠ»ΡΡΠ½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ (p = 0,957; p = 0,967). ΠΠΎΠ·ΡΠ°ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π½Π° ΠΌΠΎΠΌΠ΅Π½Ρ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ Π½Π΅ ΠΎΠΊΠ°Π·ΡΠ²Π°Π΅Ρ Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ (p = 0,458), ΠΏΡΠΈ ΡΡΠΎΠΌ Π²Π»ΠΈΡΠ΅Ρ Π½Π° ΠΎΠ±ΡΠ΅ΠΌ Π°Π±ΡΠΎΠ»ΡΡΠ½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ (p = 0,023). ΠΠ½ΡΡΠ°ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Π½Π΅ Π²ΡΡΠ²Π»Π΅Π½ΠΎ, Π·Π° ΠΈΡΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ΠΌ 4 ΡΠ»ΡΡΠ°Π΅Π² ΠΌΠ°Π»ΡΠΏΠΎΠ·ΠΈΡΠΈΠΈ Π’ΠΠ€, Π½Π΅ ΠΏΠΎΡΡΠ΅Π±ΠΎΠ²Π°Π²ΡΠΈΡ
ΡΠ΅Π²ΠΈΠ·ΠΈΠΈ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ ΡΠΊΠ°Π»ΡΠΏΠ΅Π»Ρ ΠΏΡΠΈ Π΄ΠΎΡΡΠ°Π»ΡΠ½ΡΡ
ΡΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΡΡ
ΠΏΠΎΠ»ΡΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ² Ρ Π΄Π΅ΡΠ΅ΠΉ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ²Π°Π΅Ρ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ, ΡΠ½ΠΈΠΆΠ°Π΅Ρ Π΅Π΅ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΈ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΡ
STRUCTURAL MODERNIZATION AS A FACTOR OF COMPETITIVENESS OF AICβS ENTERPRISES
This article is related to the scientific problems of competitiveness of enterprises and the individual segments of the regional AIC. The article presents the main results of the economic analysis of the market of elevator services in the Tambov region in terms of the separate entity's competitiveness. The authors substantiate the hypothesis that the content of the structural changes, as well as structural modernization in general, are determined by the stage of the life cycle of a business or the industry in general
ΠΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈ ΠΌΠΎΡΡΠΎΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ Π±Π΅Π΄ΡΠ΅Π½Π½ΠΎΠ³ΠΎ Π½Π΅ΡΠ²Π° ΠΏΡΠΈ ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ Π±ΠΎΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΌΠ΅ΠΆΡΠ΅Π»ΠΎΠ²ΠΎΠ³ΠΎ ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ΄Π΅Π·Π° ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ΄Π΅Π»Π° ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° Π² ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ΅
Background. Neuropathies of the lumbar plexus trunks, in particular those of the femoral nerve, are the most common complications of lateral interbody fusion of the lumbar spine. Modeling of this surgical intervention in normal animals experimentally makes it possible to assess the degree of its trauma to the nervous structures, and to understand what is the reason for the persistence or aggravation of neurological symptoms iatrogenic injuries or the existing pathology progression. Purpose to study histological and morphometric changes in the femoral nerve in the long-term periods after the lateral interbody fusion modeling of the canine lumbar spine. Study design an experimental prospective continuous uncontrolled study. Materials and Methods. Discectomy via lateral approach was performed in 18 mongrel dogs (aged 2-3 years, mass 13.2-17.6 kg) at the level of L4-5 ΠΈ L5-6, interbody titanium implants were mounted, the lumbar spine was stabilized with a wire device for external fixation within 30 days. Clinical and neurological evaluation was performed, as well as histological investigation of the femoral nerves from the side of surgical approach. Results. In the early postoperative period a temporary decrease in the femoral nerve function was observed, which was manifested by the disorder of the support function and muscle weakness of the pelvic limbs, decrease in the knee reflex, the foot support shift to the metatarsal pad. Later, until the end of the study (18 months), the general condition of all animals was satisfactory, there were no disorders of the limb support function and motor reflexes. After six months, in the femoral nerve there was 4-fold decrease in the proportion of large fast-conducting myelin fibers D10 m and 3-fold increase in that of the small ones. The mean axon diameter and myelin thickness were 62% and 53% of the norm. After 12-18 months, the dimensional characteristics of myelin fibers were restored. During the entire experiment, 4-6% of myelin fibers were reactively and destructively altered. Conclusions. The modeling of the lateral interbody fusion of the lumbar spine in normal animals experimentally demonstrated the absence of neurological symptoms after 6-18 months, which indicated low invasiveness of the surgical intervention. Nevertheless, the subclinical reactive and destructive changes in the myelin fibers of the femoral nerve revealed 6 months after the surgery indicated the need for preventive anti-neurotic therapy.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΡΠΌΠΈ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡΠΌΠΈ Π±ΠΎΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΌΠ΅ΠΆΡΠ΅Π»ΠΎΠ²ΠΎΠ³ΠΎ ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ΄Π΅Π·Π° ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ΄Π΅Π»Π° ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° ΡΠ²Π»ΡΡΡΡΡ Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΠΈ ΡΡΠ²ΠΎΠ»ΠΎΠ² ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΠΎΠ³ΠΎ ΡΠΏΠ»Π΅ΡΠ΅Π½ΠΈΡ, Π² ΡΠ°ΡΡΠ½ΠΎΡΡΠΈ Π±Π΅Π΄ΡΠ΅Π½Π½ΠΎΠ³ΠΎ Π½Π΅ΡΠ²Π°. ΠΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π΄Π°Π½Π½ΠΎΠ³ΠΎ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π° Π½Π° Π·Π΄ΠΎΡΠΎΠ²ΡΡ
ΠΆΠΈΠ²ΠΎΡΠ½ΡΡ
Π² ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ΅ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΎΡΠ΅Π½ΠΈΡΡ ΡΡΠ΅ΠΏΠ΅Π½Ρ Π΅Π³ΠΎ ΡΡΠ°Π²ΠΌΠ°ΡΠΈΡΠ½ΠΎΡΡΠΈ Π΄Π»Ρ Π½Π΅ΡΠ²Π½ΡΡ
ΡΡΡΡΠΊΡΡΡ ΠΈ ΠΏΠΎΠ½ΡΡΡ, Ρ ΡΠ΅ΠΌ ΡΠ²ΡΠ·Π°Π½ΠΎ ΡΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΠ΅ Π»ΠΈΠ±ΠΎ ΠΎΡΡΠ³ΠΎΡΠ΅Π½ΠΈΠ΅ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΡΠΈΠΊΠΈ: Ρ ΡΡΡΠΎΠ³Π΅Π½Π½ΡΠΌΠΈ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡΠΌΠΈ ΠΈΠ»ΠΈ Ρ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΈΠΌΠ΅ΡΡΠ΅ΠΉΡΡ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ. Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΈΠ·ΡΡΠΈΡΡ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈ ΠΌΠΎΡΡΠΎΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ Π±Π΅Π΄ΡΠ΅Π½Π½ΠΎΠ³ΠΎ Π½Π΅ΡΠ²Π° Π² ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΠ΅ ΠΏΠ΅ΡΠΈΠΎΠ΄Ρ ΠΏΠΎΡΠ»Π΅ ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π±ΠΎΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΌΠ΅ΠΆΡΠ΅Π»ΠΎΠ²ΠΎΠ³ΠΎ ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ΄Π΅Π·Π° ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ΄Π΅Π»Π° ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° Ρ ΡΠΎΠ±Π°ΠΊ. ΠΠΈΠ·Π°ΠΉΠ½ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎΠ΅ ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΡΠΏΠ»ΠΎΡΠ½ΠΎΠ΅ Π½Π΅ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΡΠ΅ΠΌΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅. ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. 18 Π±Π΅ΡΠΏΠΎΡΠΎΠ΄Π½ΡΠΌ ΡΠΎΠ±Π°ΠΊΠ°ΠΌ (Π²ΠΎΠ·ΡΠ°ΡΡ 23 Π³ΠΎΠ΄Π°, ΠΌΠ°ΡΡΠ° ΡΠ΅Π»Π° 13,217,6 ΠΊΠ³) ΡΠ΅ΡΠ΅Π· Π±ΠΎΠΊΠΎΠ²ΠΎΠΉ Π΄ΠΎΡΡΡΠΏ Π²ΡΠΏΠΎΠ»Π½ΡΠ»ΠΈ Π΄ΠΈΡΠΊΡΠΊΡΠΎΠΌΠΈΡ Π½Π° ΡΡΠΎΠ²Π½Π΅ L4-5 ΠΈ L5-6, ΡΡΡΠ°Π½Π°Π²Π»ΠΈΠ²Π°Π»ΠΈ ΠΌΠ΅ΠΆΡΠ΅Π»ΠΎΠ²ΡΠ΅ ΠΈΠΌΠΏΠ»Π°Π½ΡΠ°ΡΡ, ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΡΠΉ ΠΎΡΠ΄Π΅Π» ΡΡΠ°Π±ΠΈΠ»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π»ΠΈ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 30 ΡΡΡ. ΡΠΏΠΈΡΠ΅Π²ΡΠΌ Π°ΠΏΠΏΠ°ΡΠ°ΡΠΎΠΌ Π²Π½Π΅ΡΠ½Π΅ΠΉ ΡΠΈΠΊΡΠ°ΡΠΈΠΈ. ΠΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΡΡ ΠΎΡΠ΅Π½ΠΊΡ ΠΈ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π±Π΅Π΄ΡΠ΅Π½Π½ΡΡ
Π½Π΅ΡΠ²ΠΎΠ² ΡΠΎ ΡΡΠΎΡΠΎΠ½Ρ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π΄ΠΎΡΡΡΠΏΠ°. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π ΡΠ°Π½Π½Π΅ΠΌ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΈ Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΡΠ½ΠΊΡΠΈΠΈ Π±Π΅Π΄ΡΠ΅Π½Π½ΠΎΠ³ΠΎ Π½Π΅ΡΠ²Π°, ΠΊΠΎΡΠΎΡΠΎΠ΅ ΠΏΡΠΎΡΠ²Π»ΡΠ»ΠΎΡΡ Π½Π°ΡΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΎΠΏΠΎΡΠ½ΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠΈ ΠΈ ΠΌΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠ»Π°Π±ΠΎΡΡΡΡ ΡΠ°Π·ΠΎΠ²ΡΡ
ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΡΡΠ΅ΠΉ, ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΠΊΠΎΠ»Π΅Π½Π½ΠΎΠ³ΠΎ ΡΠ΅ΡΠ»Π΅ΠΊΡΠ°, ΠΏΠ΅ΡΠ΅Π½ΠΎΡΠΎΠΌ ΠΎΠΏΠΎΡΡ ΡΡΠΎΠΏΡ Π½Π° ΠΏΠ»ΡΡΠ½Π΅Π²ΡΠΉ ΠΌΡΠΊΠΈΡ. Π Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠ΅ΠΌ, ΡΠ΅ΡΠ΅Π· 18 ΠΌΠ΅Ρ., ΠΎΠ±ΡΠ΅Π΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ Π²ΡΠ΅Ρ
ΠΆΠΈΠ²ΠΎΡΠ½ΡΡ
Π±ΡΠ»ΠΎ ΡΠ΄ΠΎΠ²Π»Π΅ΡΠ²ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΡΠΌ, Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ ΠΎΠΏΠΎΡΠ½ΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠΈ ΠΈ Π΄Π²ΠΈΠ³Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΡΠ΅ΡΠ»Π΅ΠΊΡΠΎΠ² ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΡΡΠ΅ΠΉ Π½Π΅ ΠΎΡΠΌΠ΅ΡΠ°Π»ΠΎΡΡ. Π Π±Π΅Π΄ΡΠ΅Π½Π½ΠΎΠΌ Π½Π΅ΡΠ²Π΅ ΡΠ΅ΡΠ΅Π· 6 ΠΌΠ΅Ρ. Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΈ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ Π² 4 ΡΠ°Π·Π° Π΄ΠΎΠ»ΠΈ ΠΊΡΡΠΏΠ½ΡΡ
Π±ΡΡΡΡΠΎΠΏΡΠΎΠ²ΠΎΠ΄ΡΡΠΈΡ
ΠΌΠΈΠ΅Π»ΠΈΠ½ΠΎΠ²ΡΡ
Π²ΠΎΠ»ΠΎΠΊΠΎΠ½ D10 ΠΌΠΊΠΌ ΠΈ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ Π² 3 ΡΠ°Π·Π° Π΄ΠΎΠ»ΠΈ ΠΌΠ΅Π»ΠΊΠΈΡ
. Π‘ΡΠ΅Π΄Π½ΠΈΠΉ Π΄ΠΈΠ°ΠΌΠ΅ΡΡ Π°ΠΊΡΠΎΠ½Π° ΠΈ ΡΠΎΠ»ΡΠΈΠ½Π° ΠΌΠΈΠ΅Π»ΠΈΠ½Π° ΡΠΎΡΡΠ°Π²Π»ΡΠ»ΠΈ 62% ΠΈ 53% ΠΎΡ Π½ΠΎΡΠΌΡ. Π§Π΅ΡΠ΅Π· 1218 ΠΌΠ΅Ρ. ΡΠ°Π·ΠΌΠ΅ΡΠ½ΡΠ΅ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠΈ ΠΌΠΈΠ΅Π»ΠΈΠ½ΠΎΠ²ΡΡ
Π²ΠΎΠ»ΠΎΠΊΠΎΠ½ Π²ΠΎΡΡΡΠ°Π½Π°Π²Π»ΠΈΠ²Π°Π»ΠΈΡΡ. Π ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ Π²ΡΠ΅Π³ΠΎ ΠΎΠΏΡΡΠ° 46% ΠΌΠΈΠ΅Π»ΠΈΠ½ΠΎΠ²ΡΡ
Π²ΠΎΠ»ΠΎΠΊΠΎΠ½ Π±ΡΠ»ΠΈ ΡΠ΅Π°ΠΊΡΠΈΠ²Π½ΠΎ-Π΄Π΅ΡΡΡΡΠΊΡΠΈΠ²Π½ΠΎ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½Ρ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π±ΠΎΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΌΠ΅ΠΆΡΠ΅Π»ΠΎΠ²ΠΎΠ³ΠΎ ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ΄Π΅Π·Π° ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ΄Π΅Π»Π° ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° Ρ Π·Π΄ΠΎΡΠΎΠ²ΡΡ
ΠΆΠΈΠ²ΠΎΡΠ½ΡΡ
ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΎ ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΡΠΈΠΊΠΈ ΡΠ΅ΡΠ΅Π· 618 ΠΌΠ΅Ρ., ΡΡΠΎ ΡΠ²ΠΈΠ΄Π΅ΡΠ΅Π»ΡΡΡΠ²ΡΠ΅Ρ ΠΎ ΠΌΠ°Π»ΠΎΠΉ ΡΡΠ°Π²ΠΌΠ°ΡΠΈΡΠ½ΠΎΡΡΠΈ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°. Π’Π΅ΠΌ Π½Π΅ ΠΌΠ΅Π½Π΅Π΅, Π²ΡΡΠ²Π»Π΅Π½Π½ΡΠ΅ ΡΠ΅ΡΠ΅Π· 6 ΠΌΠ΅Ρ. ΠΏΠΎΡΠ»Π΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΡΡΠ±ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅Π°ΠΊΡΠΈΠ²Π½ΠΎ-Π΄Π΅ΡΡΡΡΠΊΡΠΈΠ²Π½ΡΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΌΠΈΠ΅Π»ΠΈΠ½ΠΎΠ²ΡΡ
Π²ΠΎΠ»ΠΎΠΊΠΎΠ½ Π±Π΅Π΄ΡΠ΅Π½Π½ΠΎΠ³ΠΎ Π½Π΅ΡΠ²Π° ΡΠΊΠ°Π·ΡΠ²Π°ΡΡ Π½Π° Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΏΡΠ΅Π²Π΅Π½ΡΠΈΠ²Π½ΠΎΠΉ Π°Π½ΡΠΈΠ½Π΅Π²ΡΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ
Comparative analysis of dynamics in thermal pain sensitivity after correction of severe and mild spine deformities in patients with idiopathic scoliosis
Introduction Despite a great number of researches on idiopathic scoliosis reported there is still no instrumentation assessment of sensitivity before and after surgical correction of the curve found in literature. The purpose of the work was to explore dynamics in thermal pain sensitivity following correction of severe and mild spinal curves in patients with idiopathic scoliosis. Material and methods The work included results of examination of 25 patients with idiopathic scoliosis. Sampling population was divided into two groups depending on the extent of preoperative curve in major
arch: Group I included patients with the curve of β€ 60ΒΊ (15 cases); Group II consisted of patients with the curve of > 60ΒΊ (10 patients). Preoperative neurological examination showed no motor, reflex and sensory impairments. Acute deformity correction and spine stabilization with transpedicular systems were produced in all the cases. Thermal pain sensitivity was explored preoperatively and postoperatively at Th1-S2 dermatomes using electric esthesiometer. Results Disturbed thermal pain sensitivity of various extent was observed preoperatively in the study dermatomes of all patients with idiopathic scoliosis and was not shown to be dependent on the amount of the curve. Positive dynamics in thermal pain sensitivity revealed itself in reduced pain and heat thresholds and restored heat sensitivity and was observed in 41.5 to 54.1 % of the cases Group I following spine deformity correction. Deterioration was seen in 29.2 to 34.7 % of the cases. Group II showed negative dynamics in thermal pain sensitivity in 35.4 to 50 % of the cases with either increased or decreased pain threshold, enhanced heat threshold and loss of heat sensitivity. Sensitivity improved in 29.4 to 31.8 % of the patients. No changes in neurological status were noted in both groups after surgical correction with subclinical changes in
thermal pain sensitivity to be considered. Conclusion Positive dynamics in thermal pain sensitivity prevailed in patients with idiopathic scoliosis following baseline curve correction of β€ 60ΒΊ. Negative dynamics in thermal pain sensitivity was seen in patients with baseline curve correction of > 60ΒΊ with a greater risk of neurological complications
Π₯ΠΠ Π£Π ΠΠΠ§ΠΠ‘ΠΠΠ ΠΠΠ§ΠΠΠΠ ΠΠΠ’ΠΠ Π‘ ΠΠΠ’Π ΠΠΠΠΠ’ΠΠ§ΠΠ‘ΠΠΠ ΠΠΠ‘Π’ΠΠ ΠΠΠ«Π ΠΠ’ΠΠΠΠ’Π-ΠΠΠ‘ΠΠΠΠ¬ΠΠ«Π Π ΠΠ’ΠΠ¦ΠΠΠΠΠ«Π ΠΠΠΠΠΠ ΠΠΠΠΠΠΠ
Atlanto-axial rotatory fixation (AORF) develops on the background of acute torticollis. Widely adopted terms such as C1 subluxation or atlantooccipital rotational subluxation do not reflect the core of this pathology and carry negative weight in the diagnostics and treatment of AORF. Retrospective analysis of the diagnostics and treatment outcome of 5 children with confirmed AORF diagnosis and literature review were performed. Clinical method, radiography and functional computer tomography were used to verify the diagnosis. De-rotational halo-traction and open correction with screw fixation were applied for treatment. Head position was managed to be improved in all patients. In one case the reduction was performed using correction in suboccipital segments and in other 4 cases the correction and fixation by Harms and de-rotational halo-traction allowed to correct torticollis. The pain syndrome had been arrested completely. Disease outcome resulted in formation of C1-C2 fibrous or bone fusion regardless the method of treatment. The patients with neglected AORF represent a great challenge for diagnostics and treatment. When conservative treatment fails it is necessary to involve de-rotational halo-traction with possible application of open reduction and posterior fusion. The purpose of treatment is to eliminate torticollis and pain using creation of proper C1-C2 alignment. The motions in atlantooccipital joint do not restore due to formation of the fibrous or bone fusion.ΠΡΠ»Π°Π½ΡΠΎ-Π°ΠΊΡΠΈΠ°Π»ΡΠ½ΠΎΠ΅ ΡΠΎΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ΅ Π±Π»ΠΎΠΊΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ (ΠΠΠ Π) ΡΠ°Π·Π²ΠΈΠ²Π°Π΅ΡΡΡ Π½Π° ΡΠΎΠ½Π΅ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΠΎΡΡΡΠΎΠΉ ΠΊΡΠΈΠ²ΠΎΡΠ΅ΠΈ. Π¨ΠΈΡΠΎΠΊΠΎ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ΅ΠΌΡΠ΅ Ρ Π½Π°Ρ ΡΠ΅ΡΠΌΠΈΠ½Ρ Β«ΠΏΠΎΠ΄Π²ΡΠ²ΠΈΡ
Π‘1Β» ΠΈΠ»ΠΈ Β«Π°ΡΠ»Π°Π½ΡΠΎ-Π°ΠΊΡΠΈΠ°Π»ΡΠ½ΡΠΉ ΡΠΎΡΠ°ΡΠΈΠΎΠ½Π½ΡΠΉ ΠΏΠΎΠ΄Π²ΡΠ²ΠΈΡ
Β» Π½Π΅ ΠΎΡΡΠ°ΠΆΠ°ΡΡ ΡΡΡΠΈ Π΄Π°Π½Π½ΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ Π²Π½ΠΎΡΡΡ ΡΠ²ΠΎΡ ΠΎΡΡΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΡΡ Π»Π΅ΠΏΡΡ Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΡ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΠΠ Π. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Π»Π΅ΡΠ΅Π½ΠΈΡ 5 Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½Π½ΡΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ ΠΠΠ Π, ΠΎΠ±Π·ΠΎΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ. ΠΠ»Ρ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½ΠΈΡ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΌΠ΅ΡΠΎΠ΄, ΡΠ΅Π½ΡΠ³Π΅Π½ΠΎΠ³ΡΠ°ΡΠΈΡ ΠΈ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½Π°Ρ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½Π°Ρ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΡ. Π ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ»ΠΎΡΡ Π΄Π΅ΡΠΎΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ΅ halo-Π²ΡΡΡΠΆΠ΅Π½ΠΈΠ΅, ΠΎΡΠΊΡΡΡΠ°Ρ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΡ Ρ Π²ΠΈΠ½ΡΠΎΠ²ΠΎΠΉ ΡΠΈΠΊΡΠ°ΡΠΈΠ΅ΠΉ. Π£ Π²ΡΠ΅Ρ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠ΄Π°Π»ΠΎΡΡ ΡΠ»ΡΡΡΠΈΡΡ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠ΅ Π³ΠΎΠ»ΠΎΠ²Ρ. Π ΠΎΠ΄Π½ΠΎΠΌ ΡΠ»ΡΡΠ°Π΅ ΡΠ΅ΠΏΠΎΠ·ΠΈΡΠΈΡ Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π° Π·Π° ΡΡΠ΅Ρ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠΈ Π² ΡΡΠ±Π°ΠΊΡΠΈΠ°Π»ΡΠ½ΡΡ
ΡΠ΅Π³ΠΌΠ΅Π½ΡΠ°Ρ
, Ρ ΠΎΡΡΠ°Π»ΡΠ½ΡΡ
4 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΡ ΠΈ ΡΠΈΠΊΡΠ°ΡΠΈΡ ΠΏΠΎ Harms ΠΈ Π΄Π΅ΡΠΎΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ΅ halo-Π²ΡΡΡΠΆΠ΅Π½ΠΈΠ΅ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΈ ΡΡΡΡΠ°Π½ΠΈΡΡ ΠΊΡΠΈΠ²ΠΎΡΠ΅Ρ. ΠΠΎΠ»Π΅Π²ΠΎΠΉ ΡΠΈΠ½Π΄ΡΠΎΠΌ ΠΊΡΠΏΠΈΡΠΎΠ²Π°Π½ ΠΏΠΎΠ»Π½ΠΎΡΡΡΡ. ΠΡΡ
ΠΎΠ΄ΠΎΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π²Π½Π΅ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΠΌΠ΅ΡΠΎΠ΄Π° Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ²Π»ΡΠ»ΠΎΡΡ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠΈΠ±ΡΠΎΠ·Π½ΠΎΠ³ΠΎ ΠΈΠ»ΠΈ ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ Π±Π»ΠΎΠΊΠ° Π‘1-Π‘2. ΠΠ°ΡΠΈΠ΅Π½ΡΡ Ρ Π·Π°ΡΡΠ°ΡΠ΅Π»ΡΠΌ ΠΠΠ Π ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΡΡ ΡΠ΅ΡΡΠ΅Π·Π½ΡΡ ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ Π΄Π»Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ. ΠΡΠΈ Π½Π΅ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΊΠΎΠ½ΡΠ΅ΡΠ²Π°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ, Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΠΏΠ΅ΡΠ΅ΠΉΡΠΈ ΠΊ Π΄Π΅ΡΠΎΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ halo-ΡΡΠ°ΠΊΡΠΈΠΈ Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΡΠΌ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΎΡΠΊΡΡΡΠΎΠΉ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠΈ ΠΈ Π·Π°Π΄Π½Π΅ΠΉ ΡΠΈΠΊΡΠ°ΡΠΈΠΈ. Π¦Π΅Π»ΡΡ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΡΡΡΠ°Π½Π΅Π½ΠΈΠ΅ ΠΊΡΠΈΠ²ΠΎΡΠ΅ΠΈ ΠΈ Π±ΠΎΠ»Π΅ΠΉ Π·Π° ΡΡΠ΅Ρ ΡΠΎΠ·Π΄Π°Π½ΠΈΡ ΠΏΡΠ°Π²ΠΈΠ»ΡΠ½ΠΎΠ³ΠΎ ΡΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ Π‘1-Π‘2. ΠΠ²ΠΈΠΆΠ΅Π½ΠΈΡ Π² Π°ΡΠ»Π°Π½ΡΠΎ-Π°ΠΊΡΠΈΠ°Π»ΡΠ½ΠΎΠΌ ΡΡΡΡΠ°Π²Π΅ Π½Π΅ Π²ΠΎΡΡΡΠ°Π½Π°Π²Π»ΠΈΠ²Π°ΡΡΡΡ ΠΈΠ·-Π·Π° ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΡΠΈΠ±ΡΠΎΠ·Π½ΠΎΠ³ΠΎ ΠΈΠ»ΠΈ ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ Π±Π»ΠΎΠΊΠ°
- β¦