61 research outputs found

    Capture of carriers to screened charged centres and low temperature shallow impurity electric field break down in semiconductors

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    Free carrier capture by a screened Coulomb potential in semiconductors are considered. It is established that with decreasing screening radius the capture cross section decreases drastically, and it goes to zero when % r_s=a_B^{*}. On the basis of this result a new mechanism of shallow impurity electric field break down in semiconductors is suggested.Comment: 8 pages, latex, 1 figure in gif format, to be submitted to "Journal of Condensed Matter

    Unoccupied Topological States on Bismuth Chalcogenides

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    The unoccupied part of the band structure of topological insulators Bi2_2Tex_{x}Se3βˆ’x_{3-x} (x=0,2,3x=0,2,3) is studied by angle-resolved two-photon photoemission and density functional theory. For all surfaces linearly-dispersing surface states are found at the center of the surface Brillouin zone at energies around 1.3 eV above the Fermi level. Theoretical analysis shows that this feature appears in a spin-orbit-interaction induced and inverted local energy gap. This inversion is insensitive to variation of electronic and structural parameters in Bi2_2Se3_3 and Bi2_2Te2_2Se. In Bi2_2Te3_3 small structural variations can change the character of the local energy gap depending on which an unoccupied Dirac state does or does not exist. Circular dichroism measurements confirm the expected spin texture. From these findings we assign the observed state to an unoccupied topological surface state

    Revision Anterior Cruciate Ligament Reconstruction: Current Approaches to Preoperative Planning (Systematic Review)

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    Background. The number of primary anterior cruciate ligament (ACL) reconstructions increases every year, which causes an increase in revision interventions due to ACL graft failure. When studying the literature, we identify many factors that together influence the outcome of revision ACL reconstruction, but are not always taken into account by surgeons. Aim of the review β€” is to perform a systematic review of studies that evaluated the outcomes of revision anterior cruciate ligament reconstructions and to identify optimal solutions to the most common problems encountered in preoperative planning. Methods. Information search was performed in the eLIBRARY, PubMed, and Scopus databases for the period from 2013 to 2022. Studies describing the main aspects of revision ACL reconstruction were selected for analysis. Inclusion criteria were the following: mean patient follow-up period of no less than 12 months, number of observations of no less than 10 cases. After evaluation of 898 articles, 22 articles were included in the systematic review. Results. Five main factors that should be taken into account in preoperative planning of revision ACL reconstruction have been identified: choice of the graft, necessity of reconstruction of the anterolateral complex, correction of tibial plateau deformity in the sagittal plane, determination of indications for one- or two-stage intervention, method of bone defect replacement in two-stage surgical treatment. Conclusion. The patient’s autogenous tissues should be preferred when choosing a graft. Correction of excessive anteroposterior tibial plateau inclination angle is performed only at the second revision intervention if the inclination angle exceeds 12ΒΊ. Reconstruction of the anterolateral complex should be performed in young, active patients who are involved in pivot sports and in case of severe anterior instability. When determining the possibility of performing revision ACL reconstruction in one or two stages, the canal diameter is not a crucial parameter, as it is necessary to take into account the possibility of fusion of the canals from the previous surgery with the newly created ones. If the canals have correct entry points, one-stage revision reconstruction can be performed with the canal width not exceeding 10 mm and depending on the expected diameter and type of the prepared tendon graft. Bone grafting of the secondary dilated canals in two-stage intervention can be carried out using any material, but allogenous bone or synthetic grafts have certain advantages

    The influence of climatic factors on the course of pregnancy in women of the far north

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    The article describes the influence of climatic and geographic conditions on the course of pregnancy in women of the Tazovsky district in the far North (Yamalo-Nenets). After analyzing the course of pregnancy on individual cards found that the course of pregnancy has a significant effect on the change in photoperiodicity. In the years of high solar activity, the frequency of complications increases in indigenous and alien residents. In this regard, it is necessary to carry out preventive measures to identify and eliminate complications during pregnancy in all residents of the NorthΠ’ ΡΡ‚Π°Ρ‚ΡŒΠ΅ рассмотрСно влияниС ΠΊΠ»ΠΈΠΌΠ°Ρ‚ΠΎ-гСографичСских условий Π½Π° Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ бСрСмСнности Ρƒ ΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΠΈΡ† Вазовского Ρ€Π°ΠΉΠΎΠ½Π° ΠšΡ€Π°ΠΉΠ½Π΅Π³ΠΎ Π‘Π΅Π²Π΅Ρ€Π° (ЯНАО). ΠŸΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π² Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ бСрСмСнности ΠΏΠΎ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡƒΠ°Π»ΡŒΠ½Ρ‹ΠΌ ΠΊΠ°Ρ€Ρ‚Π°ΠΌ установлСно, Ρ‡Ρ‚ΠΎ Π½Π° Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ бСрСмСнности сущСствСнноС влияниС ΠΎΠΊΠ°Π·Ρ‹Π²Π°Π΅Ρ‚ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ фотопСриодичности. Π’ Π³ΠΎΠ΄Ρ‹ высокой солнСчной активности частота ослоТнСний возрастаСт Ρƒ ΠΊΠΎΡ€Π΅Π½Π½Ρ‹Ρ… ΠΈ ΠΏΡ€ΠΈΡˆΠ»Ρ‹Ρ… ΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΠΈΡ†. Π’ связи с этим Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠΎ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ профилактичСских мСроприятий ΠΏΠΎ Π²Ρ‹ΡΠ²Π»Π΅Π½ΠΈΡŽ ΠΈ ΡƒΡΡ‚Ρ€Π°Π½Π΅Π½ΠΈΡŽ ослоТнСний Π½Π° Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ бСрСмСнности Ρƒ всСх ΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΠΈΡ† Π‘Π΅Π²Π΅Ρ€

    The influence of climatic factors on the course of pregnancy in women of the far north

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    The article describes the influence of climatic and geographic conditions on the course of pregnancy in women of the Tazovsky district in the far North (Yamalo-Nenets). After analyzing the course of pregnancy on individual cards found that the course of pregnancy has a significant effect on the change in photoperiodicity. In the years of high solar activity, the frequency of complications increases in indigenous and alien residents. In this regard, it is necessary to carry out preventive measures to identify and eliminate complications during pregnancy in all residents of the NorthΠ’ ΡΡ‚Π°Ρ‚ΡŒΠ΅ рассмотрСно влияниС ΠΊΠ»ΠΈΠΌΠ°Ρ‚ΠΎ-гСографичСских условий Π½Π° Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ бСрСмСнности Ρƒ ΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΠΈΡ† Вазовского Ρ€Π°ΠΉΠΎΠ½Π° ΠšΡ€Π°ΠΉΠ½Π΅Π³ΠΎ Π‘Π΅Π²Π΅Ρ€Π° (ЯНАО). ΠŸΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π² Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ бСрСмСнности ΠΏΠΎ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡƒΠ°Π»ΡŒΠ½Ρ‹ΠΌ ΠΊΠ°Ρ€Ρ‚Π°ΠΌ установлСно, Ρ‡Ρ‚ΠΎ Π½Π° Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ бСрСмСнности сущСствСнноС влияниС ΠΎΠΊΠ°Π·Ρ‹Π²Π°Π΅Ρ‚ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ фотопСриодичности. Π’ Π³ΠΎΠ΄Ρ‹ высокой солнСчной активности частота ослоТнСний возрастаСт Ρƒ ΠΊΠΎΡ€Π΅Π½Π½Ρ‹Ρ… ΠΈ ΠΏΡ€ΠΈΡˆΠ»Ρ‹Ρ… ΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΠΈΡ†. Π’ связи с этим Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠΎ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ профилактичСских мСроприятий ΠΏΠΎ Π²Ρ‹ΡΠ²Π»Π΅Π½ΠΈΡŽ ΠΈ ΡƒΡΡ‚Ρ€Π°Π½Π΅Π½ΠΈΡŽ ослоТнСний Π½Π° Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ бСрСмСнности Ρƒ всСх ΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΠΈΡ† Π‘Π΅Π²Π΅Ρ€

    STUDY OF THE EFFICIENCY AND SAFETY OF MYCOPHENOLATE MOFETIL THERAPY IN PATIENTSWITH SYSTEMIC SCLERODERMA

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    Interstitial lung disease (ILD) is one of the major causes of death in systemic scleroderma (SSD). Treatment of these patients remains difficult and controversial. Mycophenolate mofetil (MPM) has been in vitro shown to inhibit overproduction of type I collagen and hence may be effective against SSD. Objective: to study the efficiency and safety of MPM therapy in patients with SSD and clinically relevant ILD in an open-label prospective study. Subjects and methods. Ten patients with SSD (7 and 3 with its diffuse and limited forms, respectively) and ILD were given MPM in combination with glucocorticoids (mean daily dose was 10+4 mg). The mean MPM therapy duration was 11.4+1.3 months. The Rodnan total skin thickness score, flexion index, forced vital capacity (FVC), diffusing capacity of the lung for carbon monoxide (DLCO), and European Scleroderma Study Group (EScSG) activity index were estimated and a 6-minute walk test (6MWT) was carried out before and after MPM therapy. Results. After therapy, the whole group showed a significant reduction in skin scores from 12.9+9.8 to 5.6+3.2 (p=0.036) and EScSG from 3.9+1.4 to 2.25+1.03 (p=0.015) and an increase in exercise tolerance from 446+155 to 535+78 m (p=0.03) as evidenced by 6MWT. The degree of flexion contractures decreased from 15+21 to 3.7+11.3 mm (p>0.05). FVC (77.8+18.7% versus 73.8+11.3%) and DLCO (45+14.4% versus 42+16.4%) were significantly unchanged. A 10% or more clinically significant fall was noted in FVC and DLCO in 3 and 1 patients, respectively. In the remaining patients, the lung functional test results remained stable. MPM tolerability was satisfactory. All the patients completed their course of treatment. Conclusion. Stabilization of lung function with higher exercise tolerance and significantly reduced skin density allow therapy with MPM in combination with low-dose glucocorticoids to be regarded as an effective and well-tolerated treatment in patients with ILD in the presence of SS

    БостояниС ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠΉ плотности кости Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с систСмной склСродСрмиСй

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    Objective: to assess the frequency of a reduction in bone mineral density (BMD) and its association with traditional risk factors and clinical parameters in patients with systemic scleroderma (SSD).Patients and methods. The investigation included 330people: 190 patients (median age 55 [41; 61.5] years) with SSD and 140 control individuals (median age 57 [40.5; 66] years without a history of inflammatory rheumatic diseases. The patients were interviewed using a uniform questionnaire; dual-energy X-ray absorptiometry was used to measure BMD in the lumbar spine (Li-iv), femoral neck (FN), entire proximal femur (PF), and distal third of the forearm (DTF). The concentration of 25(OH)D was measured in 155 examinees.Results and discussion. Decreased BMD was found in 69% of patients with SSD and in 58% of controls (p=0.0392), including osteoporosis (OP) in 38 and 31% of cases, respectively. BMD in the Li-iv and FN was significantly lower in the women with SSD than in the control exam-nees, regardless of age. There was a direct correlation between BMD and body mass index (BMi) and an inverse correlation between BMD and the duration of menopause, that of the disease, and cumulative dose of glucocorticoids (GCs). Among the analyzed clinical factors, there was an inverse correlation between Li-iv BMD and erythrocyte sedimentation rate (ESR), between BMD in both femoral areas (FN and PF) and C-reactive protein (CRP). The mean concentration of 25(OH)D was 19.83+11.06 ng/mL in the patients with SSD and 23.29+8.61 ng/mL in the controls; normal vitamin D levels were detected in 9% of the patients with SSD and 24% of the controls (p<0.05).Conclusion. Low BMD was found in 69% of patients with SSD, including in those with OP (38%). Most (91%) patients had vitamin D deficiency. BMD correlated with traditional risk factors: positively with BMi and negatively with age and menopause duration. The clinical factors were found to be association with disease duration and cumulative GC dose.ЦСль исслСдования β€” ΠΎΡ†Π΅Π½ΠΊΠ° частоты сниТСния ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠΉ плотности кости (МПК) ΠΈ Π΅Π΅ взаимосвязи с Ρ‚Ρ€Π°Π΄ΠΈΡ†ΠΈΠΎΠ½Π½Ρ‹ΠΌΠΈ Ρ„Π°ΠΊΡ‚ΠΎΡ€Π°ΠΌΠΈ риска ΠΈ клиничСскими ΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€Π°ΠΌΠΈ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с систСмной склСродСрмиСй (Π‘Π‘Π”).ΠŸΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. Π’ исслСдованиС Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΎ 330 Ρ‡Π΅Π»ΠΎΠ²Π΅ΠΊ: 190 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π‘Π‘Π” (ΠΌΠ΅Π΄ΠΈΠ°Π½Π° возраста 55 [41; 61,5] Π»Π΅Ρ‚) ΠΈ 140 Π»ΠΈΡ† ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»ΡŒΠ½ΠΎΠΉ Π³Ρ€ΡƒΠΏΠΏΡ‹ Π±Π΅Π· Π²ΠΎΡΠΏΠ°Π»ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… рСвматичСских Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ Π² Π°Π½Π°ΠΌΠ½Π΅Π·Π΅ (ΠΌΠ΅Π΄ΠΈΠ°Π½Π° возраста 57[40,5; 66] Π»Π΅Ρ‚). ΠŸΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ Π±Ρ‹Π»ΠΈ ΠΎΠΏΡ€ΠΎΡˆΠ΅Π½Ρ‹ с ΠΏΠΎΠΌΠΎΡ‰ΡŒΡŽ ΡƒΠ½ΠΈΡ„ΠΈΡ†ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠΉ Π°Π½ΠΊΠ΅Ρ‚Ρ‹, МПК измСряли с использованиСм двуэнСргСтичСской рСнтгСновской абсорб-Ρ†ΠΈΠΎΠΌΠ΅Ρ‚Ρ€ΠΈΠΈ Π² поясничном ΠΎΡ‚Π΄Π΅Π»Π΅ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡ‡Π½ΠΈΠΊΠ° (Li-rv), шСйкС Π±Π΅Π΄Ρ€Π° (Π¨Π‘), ΠΏΡ€ΠΎΠΊΡΠΈΠΌΠ°Π»ΡŒΠ½ΠΎΠΌ ΠΎΡ‚Π΄Π΅Π»Π΅ Π±Π΅Π΄Ρ€Π° Π² Ρ†Π΅Π»ΠΎΠΌ (ΠŸΠžΠ‘) ΠΈ Π² области Ρ‚Ρ€Π΅Ρ‚ΠΈ Π΄ΠΈΡΡ‚Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ ΠΎΡ‚Π΄Π΅Π»Π° ΠΏΡ€Π΅Π΄ΠΏΠ»Π΅Ρ‡ΡŒΡ (Π”ΠžΠŸ). ΠžΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΊΠΎΠ½Ρ†Π΅Π½Ρ‚Ρ€Π°Ρ†ΠΈΠΈ 25(OH)D ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Ρƒ 155 обслСдованных.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ ΠΈ обсуТдСниС. БниТСнная МПК выявлСна Ρƒ 69% ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π‘Π‘Π” ΠΈ 58% Π»ΠΈΡ† ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»ΡŒΠ½ΠΎΠΉ Π³Ρ€ΡƒΠΏΠΏΡ‹ (Ρ€=0,0392), Π² Ρ‚ΠΎΠΌ числС остСопороз (ОП) β€” Ρƒ 38 ΠΈ 31% соотвСтствСнно. Π’Π΅Π»ΠΈΡ‡ΠΈΠ½Π° МПК Ρƒ ΠΆΠ΅Π½Ρ‰ΠΈΠ½ с Π‘Π‘Π” Π² Li-ivu Π¨Π‘ Π±Ρ‹Π»Π° Π·Π½Π°Ρ‡ΠΈΠΌΠΎ мСньшС, Ρ‡Π΅ΠΌ Ρƒ обслСдованных ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»ΡŒΠ½ΠΎΠΉ Π³Ρ€ΡƒΠΏΠΏΡ‹, нСзависимо ΠΎΡ‚ возраста. УстановлСна прямая коррСляция ΠΌΠ΅ΠΆΠ΄Ρƒ Π²Π΅Π»ΠΈΡ‡ΠΈΠ½ΠΎΠΉ МПК ΠΈ индСксом массы Ρ‚Π΅Π»Π° (ИМВ) ΠΈ обратная β€” с ΠΏΡ€ΠΎΠ΄ΠΎΠ»ΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒΡŽ постмСнопаузы, Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒΡŽ заболСвания, кумулятивной Π΄ΠΎΠ·ΠΎΠΉ Π³Π»ΡŽΠΊΠΎΠΊΠΎΡ€Ρ‚ΠΈΠΊΠΎΠΈΠ΄ΠΎΠ² (Π“Πš). Π‘Ρ€Π΅Π΄ΠΈ ΠΏΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹Ρ… клиничСских Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΎΠ² ΠΎΠ±Π½Π°Ρ€ΡƒΠΆΠ΅Π½Π° обратная Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡ‚ΡŒ ΠΌΠ΅ΠΆΠ΄Ρƒ МПК Π² Li-vu БОЭ; ΠΌΠ΅ΠΆΠ΄Ρƒ МПК Π² ΠΎΠ±Π΅ΠΈΡ… областях ΠŸΠžΠ‘ (Π¨Π‘ ΠΈ ΠŸΠžΠ‘) ΠΈ Π‘Π Π‘. БрСдняя концСнтрация 25(OH)D составила 19,83+11,06Π½Π³/ΠΌΠ» Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π‘Π‘Π” ΠΈ 23,29+8,61 Π½Π³/ΠΌΠ» Ρƒ Π»ΠΈΡ† ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»ΡŒΠ½ΠΎΠΉ Π³Ρ€ΡƒΠΏΠΏΡ‹; Π½ΠΎΡ€ΠΌΠ°Π»ΡŒΠ½Ρ‹ΠΉ ΡƒΡ€ΠΎΠ²Π΅Π½ΡŒ Π²ΠΈΡ‚Π°ΠΌΠΈΠ½Π° D ΠΎΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½ Ρƒ 9 ΠΈ 24% обслСдованных соотвСтствСнно (p<0,05).Π’Ρ‹Π²ΠΎΠ΄Ρ‹. Низкая МПК выявлСна Ρƒ 69% ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π‘Π‘Π”, Π² Ρ‚ΠΎΠΌ числС ОП - Ρƒ 38%. ΠΠ΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒ ΠΈ Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ Π²ΠΈΡ‚Π°ΠΌΠΈΠ½Π° D имСлись Ρƒ 91% Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ…. Π’Π΅Π»ΠΈΡ‡ΠΈΠ½Π° МПК ΠΊΠΎΡ€Ρ€Π΅Π»ΠΈΡ€ΠΎΠ²Π°Π»Π° с Ρ‚Ρ€Π°Π΄ΠΈΡ†ΠΈΠΎΠ½Π½Ρ‹ΠΌΠΈ Ρ„Π°ΠΊΡ‚ΠΎΡ€Π°ΠΌΠΈ риска: ΠΏΠΎΠ·ΠΈΡ‚ΠΈΠ²Π½ΠΎ с ИМВ ΠΈ Π½Π΅Π³Π°Ρ‚ΠΈΠ²Π½ΠΎ с возрастом ΠΈ ΠΏΡ€ΠΎΠ΄ΠΎΠ»ΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒΡŽ постмСнопаузы. Π‘Ρ€Π΅Π΄ΠΈ клиничСских Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΎΠ² установлСна связь с Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒΡŽ заболСвания ΠΈ кумулятивной Π΄ΠΎΠ·ΠΎΠΉ Π“Πš

    Π˜Π·ΠΎΠ»ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠ΅ сниТСниС Π΄ΠΈΡ„Ρ„ΡƒΠ·ΠΈΠΎΠ½Π½ΠΎΠΉ способности Π»Π΅Π³ΠΊΠΈΡ… ΠΏΡ€ΠΈ систСмной склСродСрмии Π±Π΅Π· Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Π°Ρ€Ρ‚Π΅Ρ€ΠΈΠ°Π»ΡŒΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅Ρ€Ρ‚Π΅Π½Π·ΠΈΠΈ: Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠ΅ проспСктивноС наблюдСниС

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    The objective of this 5year prospective study was to investigate a clinical role of isolated decrease of DLCO in patients with systemic sclerosis (SS)Β without pulmonary arterial hypertension (PAH).Methods. We selected 48 out of 142 patients with SS: 35 (73%) with limited SS and 13 (27%) withΒ diffuse SS. The average length of the disease was 12.9 Β± 7.9 years. Inclusion criteria were DLCO < 80% pred., forced vital capacity (FVC) β‰₯ 80%Β pred. and systolic pulmonary artery pressure (PAP) ≀ 35 mm Hg according to echocardiographic examination (echoCG). High resolution computed tomography (HRCT), spirometry, DLCO measurement, and echoCG were obtained at baseline and after 4.7 Β± 1 year of follow up. All patientsΒ were treated with standard therapy.Results. CT signs of interstitial lung disease (ILD) were found in 43 (89.6%) patients at baseline and newly developed in 3 other patients during the followup. During the followup, lung CT improved in 5 (10.4%) patients and progressed in 15 (31.3%) patients.Β Over 5 years, FVC did not change significantly (97.6 Β± 10.7% and 100.8 Β± 18.9%; Ρ€ = 0.15), while DLCO significantly decreased both in limitedΒ and diffuse SS groups (59.8 Β± 13.5% and 56.3 Β± 12%; Ρ€ = 0.006). Mean PAP values remained within normal range in majority of patients. ClinicallyΒ significant FVC reduction (β‰₯ 10%) was found in 5 patients; of them, CT signs of ILD at baseline were seen in 3 patients and newly developed during the followup in 2 others. Clinically significant DLCO reduction (β‰₯ 10%) was documented in 11 (23%) patients, all had CT signs of ILD at baseline, although CT progression during the followup was noted only in six of them. Contemporary deterioration in FVC, DLCO and CT was found in 3 patients.Conclusion. Clinical course of ILD in SS patients with isolated DLCO reduction and without PAH was relatively benign, with respiratoryΒ volumes being preserved within normal range for long time. Comparison of radiological and functional changes in a prospective study has suggested that DLCO is a more sensitive tool to determine ILD progression compared to HRCT. Regular DLCO measurements could be used as a reliable toolΒ for monitoring of ILD associated with SS.Π˜Π½Ρ‚Π΅Ρ€ΡΡ‚ΠΈΡ†ΠΈΠ°Π»ΡŒΠ½ΠΎΠ΅ ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ Π»Π΅Π³ΠΊΠΈΡ… (Π˜ΠŸΠ›) ΠΏΡ€ΠΈ систСмной склСродСрмии (Π‘Π‘Π”), ΠΊΠ°ΠΊ ΠΏΡ€Π°Π²ΠΈΠ»ΠΎ, сопровоТдаСтся Ρ€Π΅ΡΡ‚Ρ€ΠΈΠΊΡ‚ΠΈΠ²Π½Ρ‹ΠΌΠΈΒ Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡΠΌΠΈ Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΈ, ΠΏΡ€ΠΈ этом сниТСниС Π΄Ρ‹Ρ…Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… объСмов ΠΈ Π΄ΠΈΡ„Ρ„ΡƒΠ·ΠΈΠΎΠ½Π½ΠΎΠΉ способности Π»Π΅Π³ΠΊΠΈΡ… (DLCO) ΠΏΡ€ΠΎΠΈΡΡ…ΠΎΠ΄ΠΈΡ‚Β ΠΏΠ°Ρ€Π°Π»Π»Π΅Π»ΡŒΠ½ΠΎ. Π’ рядС случаСв ΠΏΡ€ΠΈ Π˜ΠŸΠ› выявляСтся ΠΈΠ·ΠΎΠ»ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠ΅ сниТСниС DLCO, клиничСскоС Π·Π½Π°Ρ‡Π΅Π½ΠΈΠ΅ ΠΊΠΎΡ‚ΠΎΡ€ΠΎΠ³ΠΎ остаСтся Π΄ΠΎ конца нСясным.ЦСль. ΠšΠ»ΠΈΠ½ΠΈΡ‡Π΅ΡΠΊΠ°Ρ ΠΎΡ†Π΅Π½ΠΊΠ° ΠΈΠ·ΠΎΠ»ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ сниТСния DLCO Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π‘Π‘Π” Π±Π΅Π· Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Π°Ρ€Ρ‚Π΅Ρ€ΠΈΠ°Π»ΡŒΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅Ρ€Ρ‚Π΅Π½Π·ΠΈΠΈ (ЛАГ)Β Π² 5Π»Π΅Ρ‚Π½Π΅ΠΌ проспСктивном исслСдовании.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. Из Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… (n = 142), Π½Π°Π±Π»ΡŽΠ΄Π°Π²ΡˆΠΈΡ…ΡΡ Π² Π€Π΅Π΄Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠΌ Π³ΠΎΡΡƒΠ΄Π°Ρ€ΡΡ‚Π²Π΅Π½Π½ΠΎΠΌΒ Π±ΡŽΠ΄ΠΆΠ΅Ρ‚Π½ΠΎΠΌ Π½Π°ΡƒΡ‡Π½ΠΎΠΌ ΡƒΡ‡Ρ€Π΅ΠΆΠ΄Π΅Π½ΠΈΠΈ Β«ΠΠ°ΡƒΡ‡Π½ΠΎΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Ρ‚Π΅Π»ΡŒΡΠΊΠΈΠΉ институт Ρ€Π΅Π²ΠΌΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈΠΌΠ΅Π½ΠΈ Π’.А.Насоновой», ΠΎΡ‚ΠΎΠ±Ρ€Π°Π½Ρ‹ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹Β (n = 48) с Π»ΠΈΠΌΠΈΡ‚ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠΉ – 35 (73 %) ΠΈ Π΄ΠΈΡ„Ρ„ΡƒΠ·Π½ΠΎΠΉ – 13 (27 %) Ρ„ΠΎΡ€ΠΌΠ°ΠΌΠΈ Π‘Π‘Π” (Π΄Π°Π²Π½ΠΎΡΡ‚ΡŒ Π‘Π‘Π” – 12,9 Β± 7,9 Π³ΠΎΠ΄Π°; сниТСниС DLCO < 80 %; форсированная ТизнСнная Π΅ΠΌΠΊΠΎΡΡ‚ΡŒ Π»Π΅Π³ΠΊΠΈΡ… (Π€Π–Π•Π›) β‰₯ 80 %Π΄ΠΎΠ»ΠΆ., отсутствиС ЛАГ ΠΏΠΎ Π΄Π°Π½Π½Ρ‹ΠΌ эхокардиографии (Π­Ρ…ΠΎΠšΠ“); систоличСскоС давлСниС Π² Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Π°Ρ€Ρ‚Π΅Ρ€ΠΈΠΈ (БДЛА) ≀ 35 ΠΌΠΌ Ρ€Ρ‚. ст.). ΠšΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½Π°Ρ томография высокого Ρ€Π°Π·Ρ€Π΅ΡˆΠ΅Π½ΠΈΡ (ΠšΠ’Π’Π ), спиромСтрия,Β ΠΎΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ DLCO, Π­Ρ…ΠΎΠšΠ“ ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈΡΡŒ ΠΏΡ€ΠΈ Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠΈ Π² исслСдованиС ΠΈ Ρ‡Π΅Ρ€Π΅Π· 4,7 Β± 1,0 Π³ΠΎΠ΄Π°. ВсС ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ ΠΏΠΎΠ»ΡƒΡ‡Π°Π»ΠΈ ΡΡ‚Π°Π½Π΄Π°Ρ€Ρ‚Π½ΡƒΡŽΒ Ρ‚Π΅Ρ€Π°ΠΏΠΈΡŽ.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. ΠŸΡ€ΠΈ Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠΈ Π² исслСдованиС ΠšΠ’ΠΏΡ€ΠΈΠ·Π½Π°ΠΊΠΈ Π˜ΠŸΠ› ΠΎΠ±Π½Π°Ρ€ΡƒΠΆΠ΅Π½Ρ‹ Ρƒ 43 (89,6 %) Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… ΠΈ Ρ‡Π΅Ρ€Π΅Π· 5 Π»Π΅Ρ‚ появились Π΅Ρ‰Π΅Β Ρƒ 3; ΠΏΡ€ΠΈ этом ΠΏΠΎΠ»ΠΎΠΆΠΈΡ‚Π΅Π»ΡŒΠ½Π°Ρ КВдинамика ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½Π° Ρƒ 5 (10,4 %), прогрСссированиС – Ρƒ 15 (31,3 %) ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ². ΠŸΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ Π€Π–Π•Π›Β Π² срСднСм ΠΏΠΎ Π³Ρ€ΡƒΠΏΠΏΠ΅ Π·Π½Π°Ρ‡ΠΈΠΌΠΎ Π½Π΅ измСнились (97,6 Β± 10,7 ΠΈ 100,8 Β± 18,9 соотвСтствСнно; Ρ€ = 0,15), DLCO достовСрно снизилась (59,8 Β±Β 13,5 ΠΈ 56,3 Β± 12,0 % соотвСтствСнно; Ρ€ = 0,006). ΠŸΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ БДЛА ΠΎΡΡ‚Π°Π²Π°Π»ΠΈΡΡŒ Π² ΠΏΡ€Π΅Π΄Π΅Π»Π°Ρ… Π½ΠΎΡ€ΠΌΠ°Π»ΡŒΠ½Ρ‹Ρ… Π·Π½Π°Ρ‡Π΅Π½ΠΈΠΉ Ρƒ Π±ΠΎΠ»ΡŒΡˆΠΈΠ½ΡΡ‚Π²Π°Β ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ². ΠšΠ»ΠΈΠ½ΠΈΡ‡Π΅ΡΠΊΠΈ Π·Π½Π°Ρ‡ΠΈΠΌΠΎΠ΅ (β‰₯ 10 %) сниТСниС Π€Π–Π•Π› выявлСно Ρƒ 5 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², ΠΈΠ· Π½ΠΈΡ… Π² 3 случаях ΠšΠ’ΠΏΡ€ΠΈΠ·Π½Π°ΠΊΠΈ Π˜ΠŸΠ› ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½Ρ‹Β ΠΏΡ€ΠΈ Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠΈ Π² исслСдованиС, Π² 2 – появились Π² Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ΅. ΠšΠ»ΠΈΠ½ΠΈΡ‡Π΅ΡΠΊΠΈ Π·Π½Π°Ρ‡ΠΈΠΌΠΎΠ΅ сниТСниС DLCO (β‰₯ 10 %) ΠΎΠ±Π½Π°Ρ€ΡƒΠΆΠ΅Π½ΠΎ Ρƒ 11 (23 %)Β ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ². Π£ всСх ΠΏΡ€ΠΈ 1ΠΌ обслСдовании выявлСны ΠšΠ’ΠΏΡ€ΠΈΠ·Π½Π°ΠΊΠΈ Π˜ΠŸΠ›, ΠΎΠ΄Π½Π°ΠΊΠΎ Ρ‚ΠΎΠ»ΡŒΠΊΠΎ Π² 6 случаях Π² Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ΅ ΠΎΡ‚ΠΌΠ΅Ρ‡Π°Π»ΠΎΡΡŒ нарастаниС рСнтгСнологичСских ΠΏΡ€ΠΈΠ·Π½Π°ΠΊΠΎΠ² Π˜ΠŸΠ›. ΠŸΠ°Ρ€Π°Π»Π»Π΅Π»ΡŒΠ½ΠΎΠ΅ сниТСниС Π€Π–Π•Π› ΠΈ DLCO, ΡΠΎΠΏΡ€ΠΎΠ²ΠΎΠΆΠ΄Π°Π²ΡˆΠ΅Π΅ΡΡ прогрСссированиСм рСнтгСнологичСских ΠΏΡ€ΠΈΠ·Π½Π°ΠΊΠΎΠ² Π˜ΠŸΠ›, выявлСно Ρƒ 3 Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ….Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. Π’Π΅Ρ‡Π΅Π½ΠΈΠ΅ Π˜ΠŸΠ› Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π‘Π‘Π” с ΠΈΠ·ΠΎΠ»ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹ΠΌ сниТСниСм DLCO бСз ЛАГ Π±Ρ‹Π»ΠΎ ΠΎΡ‚Π½ΠΎΡΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ доброкачСствСнным с сохранСниСм Π»Π΅Π³ΠΎΡ‡Π½Ρ‹Ρ… объСмов Π² ΠΏΡ€Π΅Π΄Π΅Π»Π°Ρ… Π½ΠΎΡ€ΠΌΠ°Π»ΡŒΠ½Ρ‹Ρ… Π·Π½Π°Ρ‡Π΅Π½ΠΈΠΉ Π² Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠ³ΠΎΒ Π²Ρ€Π΅ΠΌΠ΅Π½ΠΈ. ΠŸΡ€ΠΈ сопоставлСнии рСнтгСнологичСской Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠΈ ΠΈ Π»Π΅Π³ΠΎΡ‡Π½Ρ‹Ρ… тСстов Π² проспСктивном наблюдСнии ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½ΠΎ, Ρ‡Ρ‚ΠΎ Π² ΠΎΡ‚Ρ€Π°ΠΆΠ΅Π½ΠΈΠΈ прогрСссирования Π˜ΠŸΠ› DLCO являСтся Π±ΠΎΠ»Π΅Π΅ Ρ‡ΡƒΠ²ΡΡ‚Π²ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹ΠΌ тСстом, Ρ‡Π΅ΠΌ ΠšΠ’Π’Π . РСгулярноС ΠΎΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ DLCO ΠΌΠΎΠΆΠ΅Ρ‚ Π±Ρ‹Ρ‚ΡŒΒ ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ‚ΠΈΠ²Π½Ρ‹ΠΌ инструмСнтом динамичСского наблюдСния Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π‘Π‘Π” ΠΏΡ€ΠΈ Π˜ΠŸΠ›

    Electronic properties and phase transitions in low-dimensional semiconductors

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    We present the first review of the current state of the literature on electronic properties and phase transitions in TlX and TlMX2 (M = Ga, In; X = Se, S, Te) compounds. These chalcogenides belong to a family of the low-dimensional semiconductors possessing chain or layered structure. They are of significant interest because of their highly anisotropic properties, semi- and photoconductivity, non-linear effects in their I-V characteristics (including a region of negative differential resistance), switching and memory effects, second harmonic optical generation, relaxor behavior and potential applications for optoelectronic devices. We review the crystal structure of TlX and TlMX2 compounds, their transport properties under ambient conditions, experimental and theoretical studies of the electronic structure, transport properties and semiconductor-metal phase transitions under high pressure, and sequences of temperature-induced structural phase transitions with intermediate incommensurate states. Electronic nature of the ferroelectric phase transitions in the above-mentioned compounds, as well as relaxor behavior, nanodomains and possible occurrence of quantum dots in doped and irradiated crystals is discussed.Comment: 70 pages, 38 figure
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