30 research outputs found

    Sliding Luttinger liquid phases

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    We study systems of coupled spin-gapped and gapless Luttinger liquids. First, we establish the existence of a sliding Luttinger liquid phase for a system of weakly coupled parallel quantum wires, with and without disorder. It is shown that the coupling can {\it stabilize} a Luttinger liquid phase in the presence of disorder. We then extend our analysis to a system of crossed Luttinger liquids and establish the stability of a non-Fermi liquid state: the crossed sliding Luttinger liquid phase (CSLL). In this phase the system exhibits a finite-temperature, long-wavelength, isotropic electric conductivity that diverges as a power law in temperature TT as T→0T \to 0. This two-dimensional system has many properties of a true isotropic Luttinger liquid, though at zero temperature it becomes anisotropic. An extension of this model to a three-dimensional stack exhibits a much higher in-plane conductivity than the conductivity in a perpendicular direction.Comment: Revtex, 18 pages, 8 figure

    ВаргСтная тСрапия Ρ…Π΅Ρ€ΡƒΠ²ΠΈΠ·ΠΌΠ° Ρƒ Ρ€Π΅Π±Π΅Π½ΠΊΠ° 9 Π»Π΅Ρ‚

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    Reparative giant cell granulomas (RGCG) is a rare benign lesion of the skull bones in children, which is 1.7% of all recorded cases of RGCG. Despite the benign nature of the disease, RGCG often recurs after surgical treatment and can metastasize. One of the rare forms of RGCG is cherubism, characterized by total defeat of the upper and lower jaw, in connection with which it is impossible to carry out radical surgical treatment, especially in children in the period before puberty. In the department of maxillofacial surgery of the Russian Childrens’ Clinical Hospital under ambulatory supervision for 3 years was a child diagnosed with cherubism. During this time, progressive growth of the upper and lower jaw persisted, leading to exorbitalism. After the histological verification of the diagnosis and the approval of the ethical committee, a course of therapy with the drug denosumab was conducted. Histological examination of the tumor denosumab treatment showed a significant response which resulted in disappearance of giant cells. CT before and after the therapy showed an increase in bone density from 65 to 385 HU. The size of tumor nodes reduced, allowing to made contour resection of the mandible. The structure and volume of the upper jaw reached the average value and did not require surgical correction. After the course of the denosumab, there was no growth retardation according to the control X-ray examination of the wrist. inoperable forms of RGCG and cherubism, a complex approach is needed, including a course of denosumab therapy followed by transfer to therapy with alendronic acid. After the therapy, contour resection of excess bone tissue is possible with the purpose of medical and social rehabilitation of such patients.ГигантоклСточная рСпаративная Π³Ρ€Π°Π½ΡƒΠ»Π΅ΠΌΠ° (Π“ΠšΠ Π“) – Ρ€Π΅Π΄ΠΊΠΎΠ΅ доброкачСствСнноС ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ костСй Ρ‡Π΅Ρ€Π΅ΠΏΠ° Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ, ΠΊΠΎΡ‚ΠΎΡ€ΠΎΠ΅ составляСт 1,7% всСх рСгистрируСмых случаСв Π“ΠšΠ Π“. НСсмотря Π½Π° доброкачСствСнный Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€, Π“ΠšΠ Π“ часто Ρ€Π΅Ρ†ΠΈΠ΄ΠΈΠ²ΠΈΡ€ΡƒΠ΅Ρ‚ послС ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ лСчСния ΠΈ ΠΌΠΎΠΆΠ΅Ρ‚ ΠΌΠ΅Ρ‚Π°ΡΡ‚Π°Π·ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ. Одна ΠΈΠ· Ρ€Π΅Π΄ΠΊΠΈΡ… Ρ„ΠΎΡ€ΠΌ Π“ΠšΠ Π“ – Ρ…Π΅Ρ€ΡƒΠ²ΠΈΠ·ΠΌ, Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€Π½Ρ‹ΠΉ Ρ‚ΠΎΡ‚Π°Π»ΡŒΠ½Ρ‹ΠΌ ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ Π²Π΅Ρ€Ρ…Π½Π΅ΠΉ ΠΈ Π½ΠΈΠΆΠ½Π΅ΠΉ Ρ‡Π΅Π»ΡŽΡΡ‚Π΅ΠΉ, Π² связи с Ρ‡Π΅ΠΌ Π½Π΅Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ Ρ€Π°Π΄ΠΈΠΊΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ лСчСния, особСнно Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ Π² ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ Π΄ΠΎ ΠΏΠΎΠ»ΠΎΠ²ΠΎΠ³ΠΎ созрСвания. Π’ ΠΎΡ‚Π΄Π΅Π»Π΅Π½ΠΈΠΈ Ρ‡Π΅Π»ΡŽΡΡ‚Π½ΠΎ-Π»ΠΈΡ†Π΅Π²ΠΎΠΉ Ρ…ΠΈΡ€ΡƒΡ€Π³ΠΈΠΈ Российской дСтской клиничСской Π±ΠΎΠ»ΡŒΠ½ΠΈΡ†Ρ‹ ΠœΠΈΠ½Π·Π΄Ρ€Π°Π²Π° России ΠΏΠΎΠ΄ Π°ΠΌΠ±ΡƒΠ»Π°Ρ‚ΠΎΡ€Π½Ρ‹ΠΌ наблюдСниСм Π² Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ 3 Π»Π΅Ρ‚ находился Ρ€Π΅Π±Π΅Π½ΠΎΠΊ с Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ Β«Ρ…Π΅Ρ€ΡƒΠ²ΠΈΠ·ΠΌΒ»: наблюдался прогрСссивный рост Π²Π΅Ρ€Ρ…Π½Π΅ΠΉ ΠΈ Π½ΠΈΠΆΠ½Π΅ΠΉ Ρ‡Π΅Π»ΡŽΡΡ‚Π΅ΠΉ, приводящий ΠΊ экзоорбитизму. ПослС гистологичСской Π²Π΅Ρ€ΠΈΡ„ΠΈΠΊΠ°Ρ†ΠΈΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° ΠΈ получСния одобрСния этичСского ΠΊΠΎΠΌΠΈΡ‚Π΅Ρ‚Π° ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ курс Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚ΠΎΠΌ Π΄Π΅Π½ΠΎΠ·ΡƒΠΌΠ°Π±. ГистологичСскоС исслСдованиС ΠΎΠΏΡƒΡ…ΠΎΠ»ΠΈ послС лСчСния ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚ΠΎΠΌ Π΄Π΅Π½ΠΎΠ·ΡƒΠΌΠ°Π± продСмонстрировало Π²Ρ‹Ρ€Π°ΠΆΠ΅Π½Π½Ρ‹ΠΉ ΠΏΠ°Ρ‚ΠΎΠΌΠΎΡ€Ρ„ΠΎΠ·, ΠΎ Ρ‡Π΅ΠΌ ΡΠ²ΠΈΠ΄Π΅Ρ‚Π΅Π»ΡŒΡΡ‚Π²ΠΎΠ²Π°Π»ΠΈ ΠΌΠ°Π»ΠΎΡ‡ΠΈΡΠ»Π΅Π½Π½ΠΎΡΡ‚ΡŒ ΠΈΠ»ΠΈ исчСзновСниС гигантских ΠΊΠ»Π΅Ρ‚ΠΎΠΊ, ΠΎΠ±Ρ€Π°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ костной ΠΈ волокнистой Ρ‚ΠΊΠ°Π½Π΅ΠΉ. По Π΄Π°Π½Π½Ρ‹ΠΌ ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½ΠΎΠΉ Ρ‚ΠΎΠΌΠΎΠ³Ρ€Π°Ρ„ΠΈΠΈ Π΄ΠΎ ΠΈ послС Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ, ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½ΠΎ ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΠ΅ костной плотности с 65 Π΄ΠΎ 385 HU. ПослС курса Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚ΠΎΠΌ Π΄Π΅Π½ΠΎΠ·ΡƒΠΌΠ°Π± замСдлСния роста, ΠΏΠΎ Π΄Π°Π½Π½Ρ‹ΠΌ ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»ΡŒΠ½ΠΎΠ³ΠΎ рСнтгСнологичСского исслСдования кистСй, Π½Π΅ ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½ΠΎ. ОбъСм ΠΎΠΏΡƒΡ…ΠΎΠ»Π΅Π²Ρ‹Ρ… ΡƒΠ·Π»ΠΎΠ² ΡƒΠΌΠ΅Π½ΡŒΡˆΠΈΠ»ΡΡ, Ρ‡Ρ‚ΠΎ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΎ бСзопасно провСсти ΠΊΠΎΠ½Ρ‚ΡƒΡ€Π½ΡƒΡŽ Ρ€Π΅Π·Π΅ΠΊΡ†ΠΈΡŽ Π½ΠΈΠΆΠ½Π΅ΠΉ Ρ‡Π΅Π»ΡŽΡΡ‚ΠΈ. ΠŸΡ€ΠΈ Π½Π΅ΠΎΠΏΠ΅Ρ€Π°Π±Π΅Π»ΡŒΠ½Ρ‹Ρ… Ρ„ΠΎΡ€ΠΌΠ°Ρ… Π“ΠšΠ Π“ ΠΈ Ρ…Π΅Ρ€ΡƒΠ²ΠΈΠ·ΠΌΠ΅ Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌ комплСксный ΠΏΠΎΠ΄Ρ…ΠΎΠ΄: курс Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Π΄Π΅Π½ΠΎΠ·ΡƒΠΌΠ°Π±ΠΎΠΌ с ΠΏΠΎΡΠ»Π΅Π΄ΡƒΡŽΡ‰ΠΈΠΌ ΠΏΠ΅Ρ€Π΅Ρ…ΠΎΠ΄ΠΎΠΌ Π½Π° Ρ‚Π΅Ρ€Π°ΠΏΠΈΡŽ Π°Π»Π΅Π½Π΄Ρ€ΠΎΠ½ΠΎΠ²ΠΎΠΉ кислотой. ПослС ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ΠΈΠ΅ ΠΊΠΎΠ½Ρ‚ΡƒΡ€Π½ΠΎΠΉ Ρ€Π΅Π·Π΅ΠΊΡ†ΠΈΠΈ ΠΈΠ·Π±Ρ‹Ρ‚ΠΎΡ‡Π½ΠΎΠΉ костной Ρ‚ΠΊΠ°Π½ΠΈ с Ρ†Π΅Π»ΡŒΡŽ ΠΌΠ΅Π΄ΠΈΠΊΠΎ-ΡΠΎΡ†ΠΈΠ°Π»ΡŒΠ½ΠΎΠΉ Ρ€Π΅Π°Π±ΠΈΠ»ΠΈΡ‚Π°Ρ†ΠΈΠΈ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°

    Involute Helical-bevel Gearing

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    AbstractThis paper describes helical-bevel gearing (HBG). The helical-bevel gearing commonly includes a cylindrical and a bevel gear. The tooth profiles can be either spur or helical. The involute HBG provides an opportunity to design a broad variety of gear trains, unobtainable by the use of conventional types of gears. The article defines methods of their generation, a contact shape and points out advantages of various arrangements of gears, diagrams of an external helical-bevel gearing skew axis, hypoid gearing, intersecting axes, parallel axes. The expediency of the use of such gear in a machine drive is justified

    10-Π»Π΅Ρ‚Π½ΠΈΠΉ ΠΎΠΏΡ‹Ρ‚ лСчСния Ρ„ΠΈΠ±Ρ€ΠΎΠ·Π½ΠΎΠΉ дисплазии Ρ‡Π΅Π»ΡŽΡΡ‚Π½ΠΎ-Π»ΠΈΡ†Π΅Π²ΠΎΠΉ области ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Π°ΠΌΠΈ Π°Π»Π΅Π½Π΄Ρ€ΠΎΠ½ΠΎΠ²ΠΎΠΉ кислоты

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    Fibrous dysplasia is a benign rare hamartom disease of bones, characterized by a combination of fibrous tissue elements in the focis. At the present time surgical treatment is the most preferable, however, in the case of small foci or subtotal skull bone affected this approach is not rational or impossible. The accumulated foreign and our experience of conservative treatment of patients with bisphosphonate series increases the possibilities for choosing the tactics of treating patients with this congenital pathology. When using this drug, there was no development of serious adverse effects and in a number of cases, surgical treatment was avoided.Ѐиброзная дисплазия (Π€Π”) – Ρ€Π΅Π΄ΠΊΠΎΠ΅ доброкачСствСнноС Π³Π°ΠΌΠ°Ρ€Ρ‚ΠΎΠΌΠ½ΠΎΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ костСй, Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€ΠΈΠ·ΡƒΡŽΡ‰Π΅Π΅ΡΡ соСдинСниСм Ρ„ΠΈΠ±Ρ€ΠΎΠ·Π½Ρ‹Ρ… костных элСмСнтов Π² ΠΎΡ‡Π°Π³Π΅. Π’ связи с отсутствиСм общСпринятого ΡƒΠ½ΠΈΠ²Π΅Ρ€ΡΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ…ΠΎΠ΄Π° ΠΊ Π»Π΅Ρ‡Π΅Π½ΠΈΡŽ Π€Π” хирургичСскоС Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ остаСтся ΠΏΡ€Π΅Π΄ΠΏΠΎΡ‡Ρ‚ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹ΠΌ, ΠΎΠ΄Π½Π°ΠΊΠΎ Π² случаС ΠΌΠ°Π»Ρ‹Ρ… ΠΎΡ‡Π°Π³ΠΎΠ² ΠΈΠ»ΠΈ ΡΡƒΠ±Ρ‚ΠΎΡ‚Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ пораТСния костСй хирургичСский ΠΌΠ΅Ρ‚ΠΎΠ΄ Π½Π΅Ρ€Π°Ρ†ΠΈΠΎΠ½Π°Π»Π΅Π½ ΠΈΠ»ΠΈ Π½Π΅Π²ΠΎΠ·ΠΌΠΎΠΆΠ΅Π½. НакоплСнный Π·Π°Ρ€ΡƒΠ±Π΅ΠΆΠ½Ρ‹ΠΉ ΠΈ наш собствСнный ΠΎΠΏΡ‹Ρ‚ консСрвативного лСчСния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Π°ΠΌΠΈ бисфосфонатного ряда Ρ€Π°ΡΡˆΠΈΡ€ΡΠ΅Ρ‚ возмоТности Π²Ρ‹Π±ΠΎΡ€Π° Ρ‚Π°ΠΊΡ‚ΠΈΠΊΠΈ лСчСния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π΄Π°Π½Π½ΠΎΠΉ Π²Ρ€ΠΎΠΆΠ΄Π΅Π½Π½ΠΎΠΉ ΠΏΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΠ΅ΠΉ. ΠŸΡ€ΠΈ использовании бисфосфонатных ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚ΠΎΠ² Π½Π΅ ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½ΠΎ развития ΡΠ΅Ρ€ΡŒΠ΅Π·Π½Ρ‹Ρ… ΠΏΠΎΠ±ΠΎΡ‡Π½Ρ‹Ρ… Ρ€Π΅Π°ΠΊΡ†ΠΈΠΉ, Π° Π² рядС случаСв ΡƒΠ΄Π°Π»ΠΎΡΡŒ ΠΈΠ·Π±Π΅ΠΆΠ°Ρ‚ΡŒ ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ лСчСния

    Π‘Π˜ΠΠ”Π ΠžΠœ Π“Π˜ΠŸΠžΠ“Π›ΠžΠ‘Π‘Π˜Π˜: ΠžΠ‘Π—ΠžΠ  Π›Π˜Π’Π•Π ΠΠ’Π£Π Π« И ΠšΠ›Π˜ΠΠ˜Π§Π•Π‘ΠšΠ˜Π• Π‘Π›Π£Π§ΠΠ˜

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    Introduction. Aglossia / hypoglossia is a rare condition combined with underdeveled lower jaw, lack of mandibular incisors and various degrees of limb anomalies. In domestic and foreign literature, one can find only few such observations in pediatric and adult populations. This malformation is met in the syndrome of limb and oromandibular hypogynesia or aglossia-adactylia syndrome. The incidence of aglossia / hypoglossia is very low (1 / 175,000-1 / 1,000,000 live births, ) and in most cases it is represented by hypoglosia, and not true aglossia. The isolated aglossia without limb malformations is an even more rare condition. The etiology of aglossia / hypoglosia is unknown, since all known cases are sporadic and by present moment no more than 100 observations have been published. Material and methods. In 2015, a girl (1 year 10 mon old ) and a 3- year old boy were examined in hospital and outpatiently because of complaints for the reduction of lower jaw. The children were examined by an orthodontist; additional examinations were prescribed to the girl because of revealed comorbidities. Results. The girl also had vertebrae malformation. Such a pathological combination had not been seen previously in the available literature. The second child was a boy of 3 y.o.; his parents decided to consult an orthodontist for correcting the bite. In both cases, children were well adapted, although there were some deficiencies in verbal activity and difficulties in feeding; after speech therapy and spoon-feeding trainings these problems were solved. Conclusion. Even with a significant degree of tongue underdevelopment, there are practically no functional limitations in patients with aglossia-adactyl syndrome, which is important for determining prognosis as well as for consulting patients and their parents and for making decision about the need for corrective surgery.Π’Π²Π΅Π΄Π΅Π½ΠΈΠ΅: Аглоссия / гипоглоссия - Ρ€Π΅Π΄ΠΊΠΎΠ΅ состояниС, ΡΠΎΡ‡Π΅Ρ‚Π°ΡŽΡ‰Π΅Π΅ΡΡ с Π½Π΅Π΄ΠΎΡ€Π°Π·Π²ΠΈΡ‚ΠΈΠ΅ΠΌ Π½ΠΈΠΆΠ½Π΅ΠΉ Ρ‡Π΅Π»ΡŽΡΡ‚ΠΈ, отсутствиСм Π½ΠΈΠΆΠ½ΠΈΡ… Ρ€Π΅Π·Ρ†ΠΎΠ² ΠΈ Ρ€Π°Π·Π»ΠΈΡ‡Π½ΠΎΠΉ ΡΡ‚Π΅ΠΏΠ΅Π½ΡŒΡŽ Π°Π½ΠΎΠΌΠ°Π»ΠΈΠΉ конСчностСй. Π’ отСчСствСнной ΠΈ Π·Π°Ρ€ΡƒΠ±Π΅ΠΆΠ½ΠΎΠΉ Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Π΅ прСдставлСны Π΅Π΄ΠΈΠ½ΠΈΡ‡Π½Ρ‹Π΅ наблюдСния Π΄Π΅Ρ‚Π΅ΠΉ ΠΈ взрослых с Π΄Π°Π½Π½Ρ‹ΠΌ ΠΏΠΎΡ€ΠΎΠΊΠΎΠΌ развития, входящим Π² состав синдрома Π³ΠΈΠΏΠΎΠ³Π΅Π½Π΅Π·ΠΈΠΈ конСчностСй ΠΈ оромандибулярной области (Π“ΠšΠžΠž) ΠΈΠ»ΠΈ синдром аглосии-Π°Π΄Π°ΠΊΡ‚ΠΈΠ»ΠΈΠΈ. Π—Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡ‚ΡŒ Π“ΠšΠžΠž ΠΎΡ‡Π΅Π½ΡŒ низкая (1 / 175 000-1 / 1 000 000 ΠΆΠΈΠ²ΠΎΡ€ΠΎΠΆΠ΄Π΅Π½Π½Ρ‹Ρ…) ΠΈ Π² Π±ΠΎΠ»ΡŒΡˆΠΈΠ½ΡΡ‚Π²Π΅ случаСв прСдставлСна гипоглосиСй, Π° Π½Π΅ истинной аглоссиСй. Π˜Π·ΠΎΠ»ΠΈΡ€ΠΎΠ²Π°Π½Π½Π°Ρ аглоссия Π±Π΅Π· ΠΏΠΎΡ€ΠΎΠΊΠΎΠ² развития конСчностСй Π΅Ρ‰Π΅ Π±ΠΎΠ»Π΅Π΅ Ρ€Π΅Π΄ΠΊΠΎΠ΅ состояниС. Этиология аглоссии / гипоглосии нСизвСстна, Ρ‚Π°ΠΊ ΠΊΠ°ΠΊ всС извСстныС случаи Π΅Π΄ΠΈΠ½ΠΈΡ‡Π½Ρ‹ ΠΈ Π½Π° Π΄Π°Π½Π½Ρ‹ΠΉ ΠΌΠΎΠΌΠ΅Π½Ρ‚ ΠΎΠΏΡƒΠ±Π»ΠΈΠΊΠΎΠ²Π°Π½ΠΎ Π½Π΅ Π±ΠΎΠ»Π΅Π΅ 100 наблюдСний. ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π» ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. Π’ 2015 Π³. стационарно ΠΈ Π°ΠΌΠ±ΡƒΠ»Π°Ρ‚ΠΎΡ€Π½ΠΎ наблюдались ΠΈ обслСдовались Π΄Π΅Π²ΠΎΡ‡ΠΊΠ° 1 Π³. 10 мСс ΠΈ ΠΌΠ°Π»ΡŒΡ‡ΠΈΠΊ 3 Π»Π΅Ρ‚ с ΠΆΠ°Π»ΠΎΠ±Π°ΠΌΠΈ Π½Π° ΡƒΠΌΠ΅Π½ΡŒΡˆΠ΅Π½ΠΈΠ΅ Π½ΠΈΠΆΠ½Π΅ΠΉ Ρ‡Π΅Π»ΡŽΡΡ‚ΠΈ. Π”Π΅Ρ‚ΠΈ осмотрСны ΠΎΡ€Ρ‚ΠΎΠ΄ΠΎΠ½Ρ‚ΠΎΠΌ, ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Ρ‹ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹Π΅ обслСдования Π² связи с Π½Π°Π»ΠΈΡ‡ΠΈΠ΅ΠΌ ΡΠΎΠΏΡƒΡ‚ΡΡ‚Π²ΡƒΡŽΡ‰Π΅ΠΉ ΠΏΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΠΈ Ρƒ Π΄Π΅Π²ΠΎΡ‡ΠΊΠΈ . Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. Π’ ΠΎΠ΄Π½ΠΎΠΌ случаС Ρƒ Π΄Π΅Π²ΠΎΡ‡ΠΊΠΈ, ΠΊΡ€ΠΎΠΌΠ΅ Π°Π½ΠΎΠΌΠ°Π»ΠΈΠΈ развития языка ΠΈ Π½ΠΈΠΆΠ½Π΅ΠΉ Ρ‡Π΅Π»ΡŽΡΡ‚ΠΈ, Π±Ρ‹Π» ΠΏΠΎΡ€ΠΎΠΊ развития ΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ². Π’Π°ΠΊΠΎΠ΅ сочСтаниС Ρ€Π°Π½Π΅Π΅ Π½Π΅ Π²ΡΡ‚Ρ€Π΅Ρ‡Π°Π»ΠΎΡΡŒ Π½Π°ΠΌ Π² доступной Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Π΅. Π’Ρ‚ΠΎΡ€Ρ‹ΠΌ Ρ€Π΅Π±Π΅Π½ΠΊΠΎΠΌ Π±Ρ‹Π» ΠΌΠ°Π»ΡŒΡ‡ΠΈΠΊ 3 Π»Π΅Ρ‚, с ΠΊΠΎΡ‚ΠΎΡ€Ρ‹ΠΌ Ρ€ΠΎΠ΄ΠΈΡ‚Π΅Π»ΠΈ ΠΎΠ±Ρ€Π°Ρ‚ΠΈΠ»ΠΈΡΡŒ ΠΊ ΠΎΡ€Ρ‚ΠΎΠ΄ΠΎΠ½Ρ‚Ρƒ для исправлСния прикуса. Π’ ΠΎΠ±ΠΎΠΈΡ… случаях Π΄Π΅Ρ‚ΠΈ Π±Ρ‹Π»ΠΈ Ρ…ΠΎΡ€ΠΎΡˆΠΎ Π°Π΄Π°ΠΏΡ‚ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹, хотя отмСчался Π½Π΅ΠΊΠΎΡ‚ΠΎΡ€Ρ‹ΠΉ Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ Π²Π΅Ρ€Π±Π°Π»ΡŒΠ½ΠΎΠΉ активности ΠΈ трудности ΠΏΡ€ΠΈ ΠΊΠΎΡ€ΠΌΠ»Π΅Π½ΠΈΠΈ, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Π΅ послС логопСдичСской ΠΊΠΎΡ€Ρ€Π΅ΠΊΡ†ΠΈΠΈ ΠΈ обучСния кормлСния с Π»ΠΎΠΆΠΊΠΈ Π±Ρ‹Π»ΠΈ Ρ€Π΅ΡˆΠ΅Π½Ρ‹. Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. Π”Π°ΠΆΠ΅ ΠΏΡ€ΠΈ Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ стСпСни нСдоразвития языка, Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½Ρ‹Π΅ ограничСния Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с синдромом аглоссии-Π°Π΄Π°ΠΊΡ‚ΠΈΠ»ΠΈΠΈ практичСски ΠΎΡ‚ΡΡƒΡ‚ΡΡ‚Π²ΡƒΡŽΡ‚, Ρ‡Ρ‚ΠΎ Π²Π°ΠΆΠ½ΠΎ для опрСдСлСния ΠΏΡ€ΠΎΠ³Π½ΠΎΠ·Π°, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΠΏΡ€ΠΈ ΠΊΠΎΠ½ΡΡƒΠ»ΡŒΡ‚Π°Ρ†ΠΈΠΈ с ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°ΠΌΠΈ ΠΈ ΠΈΡ… родитСлями ΠΈ принятия Ρ€Π΅ΡˆΠ΅Π½ΠΈΠΉ ΠΎ нСобходимости ΠΊΠΎΡ€Ρ€Π΅ΠΊΡ‚ΠΈΡ€ΡƒΡŽΡ‰ΠΈΡ… ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΉ

    ВаргСтная тСрапия Ρ…Π΅Ρ€ΡƒΠ²ΠΈΠ·ΠΌΠ° Ρƒ Ρ€Π΅Π±Π΅Π½ΠΊΠ° 9 Π»Π΅Ρ‚

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    Reparative giant cell granulomas (RGCG) is a rare benign lesion of the skull bones in children, which is 1.7% of all recorded cases of RGCG. Despite the benign nature of the disease, RGCG often recurs after surgical treatment and can metastasize. One of the rare forms of RGCG is cherubism, characterized by total defeat of the upper and lower jaw, in connection with which it is impossible to carry out radical surgical treatment, especially in children in the period before puberty. In the department of maxillofacial surgery of the Russian Childrens’ Clinical Hospital under ambulatory supervision for 3 years was a child diagnosed with cherubism. During this time, progressive growth of the upper and lower jaw persisted, leading to exorbitalism. After the histological verification of the diagnosis and the approval of the ethical committee, a course of therapy with the drug denosumab was conducted. Histological examination of the tumor denosumab treatment showed a significant response which resulted in disappearance of giant cells. CT before and after the therapy showed an increase in bone density from 65 to 385 HU. The size of tumor nodes reduced, allowing to made contour resection of the mandible. The structure and volume of the upper jaw reached the average value and did not require surgical correction. After the course of the denosumab, there was no growth retardation according to the control X-ray examination of the wrist. inoperable forms of RGCG and cherubism, a complex approach is needed, including a course of denosumab therapy followed by transfer to therapy with alendronic acid. After the therapy, contour resection of excess bone tissue is possible with the purpose of medical and social rehabilitation of such patients.ГигантоклСточная рСпаративная Π³Ρ€Π°Π½ΡƒΠ»Π΅ΠΌΠ° (Π“ΠšΠ Π“) – Ρ€Π΅Π΄ΠΊΠΎΠ΅ доброкачСствСнноС ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ костСй Ρ‡Π΅Ρ€Π΅ΠΏΠ° Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ, ΠΊΠΎΡ‚ΠΎΡ€ΠΎΠ΅ составляСт 1,7% всСх рСгистрируСмых случаСв Π“ΠšΠ Π“. НСсмотря Π½Π° доброкачСствСнный Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€, Π“ΠšΠ Π“ часто Ρ€Π΅Ρ†ΠΈΠ΄ΠΈΠ²ΠΈΡ€ΡƒΠ΅Ρ‚ послС ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ лСчСния ΠΈ ΠΌΠΎΠΆΠ΅Ρ‚ ΠΌΠ΅Ρ‚Π°ΡΡ‚Π°Π·ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ. Одна ΠΈΠ· Ρ€Π΅Π΄ΠΊΠΈΡ… Ρ„ΠΎΡ€ΠΌ Π“ΠšΠ Π“ – Ρ…Π΅Ρ€ΡƒΠ²ΠΈΠ·ΠΌ, Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€Π½Ρ‹ΠΉ Ρ‚ΠΎΡ‚Π°Π»ΡŒΠ½Ρ‹ΠΌ ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ Π²Π΅Ρ€Ρ…Π½Π΅ΠΉ ΠΈ Π½ΠΈΠΆΠ½Π΅ΠΉ Ρ‡Π΅Π»ΡŽΡΡ‚Π΅ΠΉ, Π² связи с Ρ‡Π΅ΠΌ Π½Π΅Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ Ρ€Π°Π΄ΠΈΠΊΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ лСчСния, особСнно Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ Π² ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ Π΄ΠΎ ΠΏΠΎΠ»ΠΎΠ²ΠΎΠ³ΠΎ созрСвания. Π’ ΠΎΡ‚Π΄Π΅Π»Π΅Π½ΠΈΠΈ Ρ‡Π΅Π»ΡŽΡΡ‚Π½ΠΎ-Π»ΠΈΡ†Π΅Π²ΠΎΠΉ Ρ…ΠΈΡ€ΡƒΡ€Π³ΠΈΠΈ Российской дСтской клиничСской Π±ΠΎΠ»ΡŒΠ½ΠΈΡ†Ρ‹ ΠœΠΈΠ½Π·Π΄Ρ€Π°Π²Π° России ΠΏΠΎΠ΄ Π°ΠΌΠ±ΡƒΠ»Π°Ρ‚ΠΎΡ€Π½Ρ‹ΠΌ наблюдСниСм Π² Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ 3 Π»Π΅Ρ‚ находился Ρ€Π΅Π±Π΅Π½ΠΎΠΊ с Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ Β«Ρ…Π΅Ρ€ΡƒΠ²ΠΈΠ·ΠΌΒ»: наблюдался прогрСссивный рост Π²Π΅Ρ€Ρ…Π½Π΅ΠΉ ΠΈ Π½ΠΈΠΆΠ½Π΅ΠΉ Ρ‡Π΅Π»ΡŽΡΡ‚Π΅ΠΉ, приводящий ΠΊ экзоорбитизму. ПослС гистологичСской Π²Π΅Ρ€ΠΈΡ„ΠΈΠΊΠ°Ρ†ΠΈΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° ΠΈ получСния одобрСния этичСского ΠΊΠΎΠΌΠΈΡ‚Π΅Ρ‚Π° ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ курс Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚ΠΎΠΌ Π΄Π΅Π½ΠΎΠ·ΡƒΠΌΠ°Π±. ГистологичСскоС исслСдованиС ΠΎΠΏΡƒΡ…ΠΎΠ»ΠΈ послС лСчСния ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚ΠΎΠΌ Π΄Π΅Π½ΠΎΠ·ΡƒΠΌΠ°Π± продСмонстрировало Π²Ρ‹Ρ€Π°ΠΆΠ΅Π½Π½Ρ‹ΠΉ ΠΏΠ°Ρ‚ΠΎΠΌΠΎΡ€Ρ„ΠΎΠ·, ΠΎ Ρ‡Π΅ΠΌ ΡΠ²ΠΈΠ΄Π΅Ρ‚Π΅Π»ΡŒΡΡ‚Π²ΠΎΠ²Π°Π»ΠΈ ΠΌΠ°Π»ΠΎΡ‡ΠΈΡΠ»Π΅Π½Π½ΠΎΡΡ‚ΡŒ ΠΈΠ»ΠΈ исчСзновСниС гигантских ΠΊΠ»Π΅Ρ‚ΠΎΠΊ, ΠΎΠ±Ρ€Π°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ костной ΠΈ волокнистой Ρ‚ΠΊΠ°Π½Π΅ΠΉ. По Π΄Π°Π½Π½Ρ‹ΠΌ ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½ΠΎΠΉ Ρ‚ΠΎΠΌΠΎΠ³Ρ€Π°Ρ„ΠΈΠΈ Π΄ΠΎ ΠΈ послС Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ, ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½ΠΎ ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΠ΅ костной плотности с 65 Π΄ΠΎ 385 HU. ПослС курса Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚ΠΎΠΌ Π΄Π΅Π½ΠΎΠ·ΡƒΠΌΠ°Π± замСдлСния роста, ΠΏΠΎ Π΄Π°Π½Π½Ρ‹ΠΌ ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»ΡŒΠ½ΠΎΠ³ΠΎ рСнтгСнологичСского исслСдования кистСй, Π½Π΅ ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½ΠΎ. ОбъСм ΠΎΠΏΡƒΡ…ΠΎΠ»Π΅Π²Ρ‹Ρ… ΡƒΠ·Π»ΠΎΠ² ΡƒΠΌΠ΅Π½ΡŒΡˆΠΈΠ»ΡΡ, Ρ‡Ρ‚ΠΎ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΎ бСзопасно провСсти ΠΊΠΎΠ½Ρ‚ΡƒΡ€Π½ΡƒΡŽ Ρ€Π΅Π·Π΅ΠΊΡ†ΠΈΡŽ Π½ΠΈΠΆΠ½Π΅ΠΉ Ρ‡Π΅Π»ΡŽΡΡ‚ΠΈ. ΠŸΡ€ΠΈ Π½Π΅ΠΎΠΏΠ΅Ρ€Π°Π±Π΅Π»ΡŒΠ½Ρ‹Ρ… Ρ„ΠΎΡ€ΠΌΠ°Ρ… Π“ΠšΠ Π“ ΠΈ Ρ…Π΅Ρ€ΡƒΠ²ΠΈΠ·ΠΌΠ΅ Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌ комплСксный ΠΏΠΎΠ΄Ρ…ΠΎΠ΄: курс Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Π΄Π΅Π½ΠΎΠ·ΡƒΠΌΠ°Π±ΠΎΠΌ с ΠΏΠΎΡΠ»Π΅Π΄ΡƒΡŽΡ‰ΠΈΠΌ ΠΏΠ΅Ρ€Π΅Ρ…ΠΎΠ΄ΠΎΠΌ Π½Π° Ρ‚Π΅Ρ€Π°ΠΏΠΈΡŽ Π°Π»Π΅Π½Π΄Ρ€ΠΎΠ½ΠΎΠ²ΠΎΠΉ кислотой. ПослС ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ΠΈΠ΅ ΠΊΠΎΠ½Ρ‚ΡƒΡ€Π½ΠΎΠΉ Ρ€Π΅Π·Π΅ΠΊΡ†ΠΈΠΈ ΠΈΠ·Π±Ρ‹Ρ‚ΠΎΡ‡Π½ΠΎΠΉ костной Ρ‚ΠΊΠ°Π½ΠΈ с Ρ†Π΅Π»ΡŒΡŽ ΠΌΠ΅Π΄ΠΈΠΊΠΎ-ΡΠΎΡ†ΠΈΠ°Π»ΡŒΠ½ΠΎΠΉ Ρ€Π΅Π°Π±ΠΈΠ»ΠΈΡ‚Π°Ρ†ΠΈΠΈ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°

    ΠŸΡ€Π΅Π΄ΡƒΡˆΠ½Ρ‹Π΅ свищи: клиничСскиС Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Ρ‹ ΠΈ ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΈΠ²Π½ΠΎΠ΅ Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅

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    Introduction. Preauricular sinuses and cysts are a frequent congenital head and neck organs anomaly in children, which appears in the form of a small hole near the anterior limb of the ascending helix. Despite a seemingly easy surgical treatment for these cysts, the relapse rate stays high. The purpose of this article is to analyze the value of diagnostic methods in planning surgical treatment of preauricular sinuses. Material and methods. A retrospective study was conducted based on data obtained from the Craniomaxillofacial Surgery Department of the Russian Children's Clinical Hospital, Moscow, from 2012 to 2019. Medical records were checked for the facts of postoperative complications and relapse rates. The fistulous canal was visualized using preoperative fistulography with computed tomography, as well as intraoperative instillation of the dye and installation of the catheter. The skin near the sinus was excised elliptically, and the sinus was removed throughout the dyed area. Results. 17 patients aged from 9 months to 14.5 years were included in the study. A unilateral preauricular sinus tract was right-sided in 7 patients and left-sided in 10 patients). None of the patients had problems with the wound in the postoperative period. However, in 1 case there was relapse after 1 year. Conclusion. Using fistulography, a combination of dye instillation, insertion of a catheter and modified dissection, it is possible to achieve a relapse-free series of excision of the preauricular fistula among a heterogeneous group of patients.Π’Π²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠŸΡ€Π΅Π°ΡƒΡ€ΠΈΠΊΡƒΠ»ΡΡ€Π½Ρ‹Π΅ свищи ΠΈ кисты - ΠΎΠ΄Π½Π° ΠΈΠ· частых Π²Ρ€ΠΎΠΆΠ΄Π΅Π½Π½Ρ‹Ρ… Π°Π½ΠΎΠΌΠ°Π»ΠΈΠΉ Π³ΠΎΠ»ΠΎΠ²Ρ‹ ΠΈ шСи Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ, ΠΏΡ€ΠΎΡΠ²Π»ΡΡŽΡ‰Π°ΡΡΡ Π² Π²ΠΈΠ΄Π΅ нСбольшого отвСрстия Π²Π±Π»ΠΈΠ·ΠΈ ΠΏΠ΅Ρ€Π΅Π΄Π½Π΅ΠΉ Π½ΠΎΠΆΠΊΠΈ Π·Π°Π²ΠΈΡ‚ΠΊΠ°. НСсмотря Π½Π° ΠΊΠ°ΠΆΡƒΡ‰Π΅ΡŽΡΡ простоту хирургичСского лСчСния этих кист, частота развития Ρ€Π΅Ρ†ΠΈΠ΄ΠΈΠ²ΠΎΠ² остаСтся высокой. ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π» ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎ рСтроспСктивноС исслСдованиС Π½Π° Π±Π°Π·Π΅ отдСлСния Ρ‡Π΅Π»ΡŽΡΡ‚Π½ΠΎ-Π»ΠΈΡ†Π΅Π²ΠΎΠΉ Ρ…ΠΈΡ€ΡƒΡ€Π³ΠΈΠΈ Российской дСтской клиничСской Π±ΠΎΠ»ΡŒΠ½ΠΈΡ†Ρ‹ (Π Π”ΠšΠ‘) ΠœΠΎΡΠΊΠ²Ρ‹ с 2012 ΠΏΠΎ 2019 Π³. ΠœΠ΅Π΄ΠΈΡ†ΠΈΠ½ΡΠΊΠΈΠ΅ записи Π±Ρ‹Π»ΠΈ ΠΏΡ€ΠΎΠ²Π΅Ρ€Π΅Π½Ρ‹ Π½Π° ΠΏΡ€Π΅Π΄ΠΌΠ΅Ρ‚ послСопСрационных ослоТнСний ΠΈ частоты Ρ€Π΅Ρ†ΠΈΠ΄ΠΈΠ²ΠΎΠ². Π‘Π²ΠΈΡ‰Π΅Π²ΠΎΠΉ ΠΊΠ°Π½Π°Π» Π²ΠΈΠ·ΡƒΠ°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π»ΠΈ с ΠΏΠΎΠΌΠΎΡ‰ΡŒΡŽ ΠΏΡ€Π΅Π΄ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΎΠ½Π½ΠΎΠΉ фистулографии с ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ΠΌ ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½ΠΎΠΉ Ρ‚ΠΎΠΌΠΎΠ³Ρ€Π°Ρ„ΠΈΠΈ, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΠΈΠ½Ρ‚Ρ€Π°ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΎΠ½Π½ΠΎ Π·Π°ΠΊΠ°ΠΏΡ‹Π²Π°Π»ΠΈ ΠΊΡ€Π°ΡΠΈΡ‚Π΅Π»ΡŒ ΠΈ устанавливали Π·ΠΎΠ½Π΄. КоТа рядом с отвСрстиСм ΠΏΠ°Π·ΡƒΡ…ΠΈ Ρ€Π°ΡΡΠ΅ΠΊΠ°Π»Π°ΡΡŒ эллиптичСски, Π° сам свищСвой Ρ…ΠΎΠ΄ иссСкался Π½Π° всСм протяТСнии ΠΏΡ€ΠΎΠΊΡ€Π°ΡˆΠΈΠ²Π°Π½ΠΈΡ. Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. Π’ исслСдованиС Π±Ρ‹Π»ΠΈ ΠΎΡ‚ΠΎΠ±Ρ€Π°Π½Ρ‹ 17 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π² возрастС ΠΎΡ‚ 9 мСсяцСв Π΄ΠΎ 14,5 Π³ΠΎΠ΄Π°. ΠžΠ΄Π½ΠΎΡΡ‚ΠΎΡ€ΠΎΠ½Π½ΠΈΠΉ прСаурикулярный синусовый Ρ‚Ρ€Π°ΠΊΡ‚ присутствовал Ρƒ 7 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² справа ΠΈ Ρƒ 10 слСва. Ни Ρƒ ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΈΠ· ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π½Π΅ Π±Ρ‹Π»ΠΎ ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌ с Ρ€Π°Π½ΠΎΠΉ Π² послСопСрационном ΠΏΠ΅Ρ€ΠΈΠΎΠ΄Π΅, ΠΎΠ΄Π½Π°ΠΊΠΎ Π² 1 случаС развился Ρ€Π΅Ρ†ΠΈΠ΄ΠΈΠ² Ρ‡Π΅Ρ€Π΅Π· 1 Π³ΠΎΠ΄. Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. Π˜ΡΠΏΠΎΠ»ΡŒΠ·ΡƒΡ Ρ„ΠΈΡΡ‚ΡƒΠ»ΠΎΠ³Ρ€Π°Ρ„ΠΈΡŽ, ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Ρ†ΠΈΡŽ инстилляции краситСля, ввСдСния Π·ΠΎΠ½Π΄Π° ΠΈ ΠΌΠΎΠ΄ΠΈΡ„ΠΈΡ†ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠΉ диссСкции, Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ Π΄ΠΎΠ±ΠΈΡ‚ΡŒΡΡ Π±Π΅Π·Ρ€Π΅Ρ†ΠΈΠ΄ΠΈΠ²Π½ΠΎΠΉ сСрии иссСчСния прСаурикулярного свища срСди Ρ€Π°Π·Π½ΠΎΡ€ΠΎΠ΄Π½ΠΎΠΉ Π³Ρ€ΡƒΠΏΠΏΡ‹ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ²

    Unique Experience of Cherubism Targeted Therapy

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    The family form of giant cell reparative granuloma or cherubism is a rare benign lesion of the jaws which causes face deformation reminiscent of the cherubs portrayed in Renaissance art. Radical surgery, especially in children before puberty, is impossible or irrational, because it leads to disablement. For four years, a child with cherubism was undergoing an outpatient supervision in the Department of Maxillofacial Surgery in Russian Children Clinical Hospital. During the observation period it was noted that tumor masses were slowly progressing leading to exoorbitism. The child had a diagnosis histological verification; a treatment using human monoclonal antibodies to RANKL was developed, adapted and approved by the ethical committee. The clinical effect was observed from the third month of therapy - jaws corners sharpened, the volume reduced. The control biopsy material taken at the end of the 6-month course did not reveal any giant cells which meant complete pathomorphism. Computed tomography showed that at the end of the therapy bone density increased by 6-7 times in the affected zones and was additionally growing over the next 6 months of observation. Such dynamics allowed making effective contouring surgery of excessive bone tissues. Inoperable and early stages of cherubism require a combined treatment which includes a course of monoclonal antibodies followed by alendronic acid therapy that increases osteoblasts survival. After the treatment, if it is necessary to improve the appearance, contouring surgery of excessive bone tissue is performed

    10-Π»Π΅Ρ‚Π½ΠΈΠΉ ΠΎΠΏΡ‹Ρ‚ лСчСния Ρ„ΠΈΠ±Ρ€ΠΎΠ·Π½ΠΎΠΉ дисплазии Ρ‡Π΅Π»ΡŽΡΡ‚Π½ΠΎ-Π»ΠΈΡ†Π΅Π²ΠΎΠΉ области ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Π°ΠΌΠΈ Π°Π»Π΅Π½Π΄Ρ€ΠΎΠ½ΠΎΠ²ΠΎΠΉ кислоты

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    Fibrous dysplasia is a benign rare hamartom disease of bones, characterized by a combination of fibrous tissue elements in the focis. At the present time surgical treatment is the most preferable, however, in the case of small foci or subtotal skull bone affected this approach is not rational or impossible. The accumulated foreign and our experience of conservative treatment of patients with bisphosphonate series increases the possibilities for choosing the tactics of treating patients with this congenital pathology. When using this drug, there was no development of serious adverse effects and in a number of cases, surgical treatment was avoided.Ѐиброзная дисплазия (Π€Π”) – Ρ€Π΅Π΄ΠΊΠΎΠ΅ доброкачСствСнноС Π³Π°ΠΌΠ°Ρ€Ρ‚ΠΎΠΌΠ½ΠΎΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ костСй, Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€ΠΈΠ·ΡƒΡŽΡ‰Π΅Π΅ΡΡ соСдинСниСм Ρ„ΠΈΠ±Ρ€ΠΎΠ·Π½Ρ‹Ρ… костных элСмСнтов Π² ΠΎΡ‡Π°Π³Π΅. Π’ связи с отсутствиСм общСпринятого ΡƒΠ½ΠΈΠ²Π΅Ρ€ΡΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ…ΠΎΠ΄Π° ΠΊ Π»Π΅Ρ‡Π΅Π½ΠΈΡŽ Π€Π” хирургичСскоС Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ остаСтся ΠΏΡ€Π΅Π΄ΠΏΠΎΡ‡Ρ‚ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹ΠΌ, ΠΎΠ΄Π½Π°ΠΊΠΎ Π² случаС ΠΌΠ°Π»Ρ‹Ρ… ΠΎΡ‡Π°Π³ΠΎΠ² ΠΈΠ»ΠΈ ΡΡƒΠ±Ρ‚ΠΎΡ‚Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ пораТСния костСй хирургичСский ΠΌΠ΅Ρ‚ΠΎΠ΄ Π½Π΅Ρ€Π°Ρ†ΠΈΠΎΠ½Π°Π»Π΅Π½ ΠΈΠ»ΠΈ Π½Π΅Π²ΠΎΠ·ΠΌΠΎΠΆΠ΅Π½. НакоплСнный Π·Π°Ρ€ΡƒΠ±Π΅ΠΆΠ½Ρ‹ΠΉ ΠΈ наш собствСнный ΠΎΠΏΡ‹Ρ‚ консСрвативного лСчСния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Π°ΠΌΠΈ бисфосфонатного ряда Ρ€Π°ΡΡˆΠΈΡ€ΡΠ΅Ρ‚ возмоТности Π²Ρ‹Π±ΠΎΡ€Π° Ρ‚Π°ΠΊΡ‚ΠΈΠΊΠΈ лСчСния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π΄Π°Π½Π½ΠΎΠΉ Π²Ρ€ΠΎΠΆΠ΄Π΅Π½Π½ΠΎΠΉ ΠΏΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΠ΅ΠΉ. ΠŸΡ€ΠΈ использовании бисфосфонатных ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚ΠΎΠ² Π½Π΅ ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½ΠΎ развития ΡΠ΅Ρ€ΡŒΠ΅Π·Π½Ρ‹Ρ… ΠΏΠΎΠ±ΠΎΡ‡Π½Ρ‹Ρ… Ρ€Π΅Π°ΠΊΡ†ΠΈΠΉ, Π° Π² рядС случаСв ΡƒΠ΄Π°Π»ΠΎΡΡŒ ΠΈΠ·Π±Π΅ΠΆΠ°Ρ‚ΡŒ ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ лСчСния

    Craniomaxillofacial anomalies in gorlin–goltz syndrome: A description of clinical cases

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    Gorlin–Goltz syndrome is an autosomal dominant rare phacomatosis characterized by multiple odontogenic keratocysts, rib splitting, multiple basal cell carcinomas and other anomalies. The most frequent early manifestation of this disease is multiple keratocysts, therefore the task of it often falls with dentists, maxillofacial and pediatric surgeons. Materials and methods: authors performed a retrospective analysis of treated patients to assess a correlation between the presence of large odontogenic cysts and Gorlin–Goltz syndrome. All children underwent computed tomography at the preoperative stage, followed by surgical treatment that included cystectomy. Results: multiple or large odontogenic cysts in young patients require a complete examination with computed tomography of the entire skull to detect a calcification falx cerebri, which was found in 4 out of 7 patients with Gorlin-Goltz syndrome. In all the cases, the lower jaw was affected by keratocysts prior to foci appearing on the posterior parts of the upper jaw. The surgical treatment must include cysts resection with the embedded teeth and placement of the xeroform turunda into the tumor bed to reduce the risk of relapse. Conclusion: an early diagnosis of Gorlin-Goltz syndrome plays a crucial role in avoiding severe complications such as maxillofacial deformities associated with jaw cysts. Β© 2020, Pediatria Ltd.. All rights reserved
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