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Неврологічні аспекти оцінки ефективності трансплантації ембріональної нервової тканини у хворих із спастичними формами дитячого церебрального паралічу

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I?I?NOA?NOAI IOI?IIE CAeI?IA’ss OE?A?IE

EE?ANUeEA IAAeE*IA AEAAeAI?ss I?NEssAeEIEIIII? INA?OE

?I. I. E. OOIEEA

I?/eo? Iaoae?y Ieaenaiae??aia

OAeE 616.831-009.11-71:616-053.2/.5.

Iaa?ieia?/i? aniaeoe ioe?iee aoaeoeaiino? o?ainieaioaoe??

aia??iiaeueii? ia?aiai? oeaieie o oai?eo ?c nianoe/ieie

oi?iaie aeeoy/iai oea?aa?aeueiiai ia?ae?/a.

Niaoe?aeuei?noue 14.01.15 – Ia?aia? oai?iae

Aaoi?aoa?ao

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Ee?a – 1999

Aeena?oaoe??th ? ?oeiien

?iaioa aeeiiaia a ?inoeooo? iae?io??o?a?? ?i.aeaae.A.I.?iiiaeaiiaa AII
Oe?a?ie

Iaoeiaee ea??aiee: aeieoi? iaaee/ieo iaoe, , /eai-ei?aniiiaeaio
Aeaaeai?? iaaee/ieo iaoe Oe?a?ie, i?ioani? Oeeiaaethe A?oae?e ?aaiiae/,
?inoeooo? iae?io??o?a?? ?i.aeaae.A.I.?iiiaeaiiaa AII Oe?a?ie, caa?aeoaa/
ee?i?ee a?aeiiaethaaeueii? iae?io??o?a??, canooiiee aee?aeoi?a ii
iaoeia?e ?iaio?

Io?oe?ei? iiiiaioe: – aeieoi? iaaee/ieo iaoe, /eai-ei?aniiiaeaio
Aeaaeai?? iaaee/ieo iaoe Oe?a?ie, i?ioani? Ia/a?ao ?aaai?y
Eaii?ae?aia, Ee?anueea iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe ?i.
I.E. Ooieea IIC Oe?a?ie, eaoaae?a iaa?ieiai? oa ?aoeaenioa?ai??,
caa?aeoaa/ eaoaae?e.

– aeieoi? iaaee/ieo iaoe, i?ioani? ?aoooaiei Noai?neaa Einoyioeiiae/,
Aeiiaoeueeee iaaee/iee oi?aa?neoao ?i. I.Ai?ueeiai IIC Oe?a?ie, eaoaae?a
aeeoy/i? oa caaaeueii? iaa?ieia?? c eo?nii ?aoeaenioa?ai?? oaeoeueoaoo
i?neyaeeieiiii? ina?oe, caa?aeoaa/ eaoaae?e.

I?ia?aeia onoaiiaa: Oe?a?inueeee iaoeiai-aeine?aeiee ?inoeooo ee?i?/ii?
oa aenia?eiaioaeueii? iaa?ieia?? oa ineo?ao??? IIC Oe?a?ie, a?aeae?e
ooieoe?iiaeueii? ae?aaiinoeee ? eiii’thoa?ii? oiiia?ao???, i. Oa?e?a.

Caoeno a?aeaoaeaoueny “ 17 ” eenoiiaaea 1999 ?. i 11-00 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.613.01 i?e Ee?anuee?e
iaaee/i?e aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E. Ooieea IIC Oe?a?ie
ca aae?anith: 254112, Ee?a, aoe. Aei?iaiaeeoeueea, 9, aoae. ?3.

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? Ee?anueei? iaaee/ii?
aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E. Ooieea IIC Oe?a?ie ca
aae?anith: 254112, Ee?a, aoe. Aei?iaiaeeoeueea, 9.

Aaoi?aoa?ao ?ic?neaiee “ 13 ” aeiaoiy 1999 ?.

A/aiee nae?aoa? niaoe?ae?ciaaii?

a/aii? ?aaee, aeioeaio
?iiaiaiei I.?.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. Ca?aeii aeaieo iaaee/ii? noaoenoeee iioe?ai?noue
aeeoy/iai oea?aa?aeueiiai ia?ae?/o (AeOeI) ye ca ei?aeiiii, oae ? ia
Oe?a?i?, neeaaea? 22 – 25 aeiaaee?a ia 10000 aeeoy/iai ianaeaiiy (Aieaea
I.A., Ia?oeithe A.TH., 1994; Patel J., 1997; Thompson C.M.,1997). C
127000 ae?oae-?iaae?ae?a, ca?a?no?iaaieo ia Oe?a?i?, 27000 – ae?oe c
aeeoy/ei oea?aa?aeueiei ia?ae?/ai. Iiiaae 70% oai?eo ia AeOeI ?
?iaae?aeaie aaaeeiai nooiaith, ui iio?aao? cia/ieo eioo?a ia ?o iain?eia
caaacia/aiiy.

Iaoiaee e?eoaaiiy oe??? iaoieia??, ye? canoiniaothoueny ia
nueiaiaei?oi?e aeaiue, iathoue ?yae iaiaaeaiue aeey naiai aeei?enoaiiy,
aai oa?aeoa?ecothoueny ei?ioei/aniei e?eoaaeueiei aoaeoii, iniaeeai a
i?ci?e ?aceaeoaeuei?e noaae?? (Penn R.D., 1990; ?aoooaiei N.E., 1994).

A ?inoeooo? iae?io??o?a?? ?i.aeaae.A.I.?iiiaeaiiaa AII Oe?a?ie
?ic?iaeaii oa ai?iaaaeaeaii a ee?i?/io i?aeoeeo iaoiaaiaoe/ii
iaa?oioiaaiee iaoiae e?eoaaiiy AeOeI – o?ainieaioaoe?th aia??iiaeueii?
ia?aiai? oeaieie (?iiiaeaiia A.I., 1989; Cicoey TH.A., 1990., Oeeiaaethe
A.E., 1989 – 1999). Iaeiae, aeai? e?oa?aoo?e i?i aoaeoeai?noue iaoiaeo
i?ioe??/i?. Oea, ia?o ca ana, iia’ycaii c i?iaeaiith noa’?eoeaii?
ioe?iee aoaeoeaiino? ??cieo iaoiae?a e?eoaaiiy AeOeI, a oiio /ene? ?
iae?io?ainieaioaoe??, a?aenooi?noth /?oei noaiaea?oeciaaieo e?eoa???a
ioe?iee iaa?ieia?/iiai noaoono oai?eo ia oea?aa?aeueiee ia?ae?/. Oiio
aeieeea iaiao?aei?noue a i?iaaaeaii? aenia?oii? ioe?iee ?acoeueoao?a
o?ainieaioaoe?? aia??iiaeueii? ia?aiai? oeaieie (OAIO) o oai?eo ia AeOeI
c iiceoe?? aeeoy/i? iaa?ieia??, yea /ano?oa aeei?enoiao? ia?iaaceai?
iaoiaee e?eoaaiiy. Iio??aii ?ic?iaeoe ?aeeio iaoiaeieia?th, yea
aeicaieeoue c iaeneiaeueiith ia’?eoeai?noth ioe?ieoe ia ??cieo
ooieoe?iiaeueieo ??aiyo an? iiaeeea? aoaeoe, ye? aeieeathoue i?ae
aieeaii aia??iiaeueii? ia?aiai? oeaieie (AIO) o oai?eo c AeOeI.
Noai?aiiy iaaee/ii? aace aeaieo oai?eo ia AeOeI ? aaoiiaoeciaaii?
nenoaie oi?aae?iiy iath aeicaieeoue ia o?eueee nenoaiaoecoaaoe ee?i?/iee
iaoa??ae ? i?iaanoe noaoenoe/iee aiae?c, aea e ioe?ieoe aoaeoeai?noue
iae?io?ainieaioaoe?? ? c?iaeoe i?iaiic aoaeoeaiino? e?eoaaiiy. E??i
oiai, ?aeeia iaoiaeieia?y, yea eaaeeoue a iniia? noai?aii?
aaoiiaoeciaaii? nenoaie oi?aae?iiy aaieii aeaieo oai?eo ia AeOeI,
aeicaieeoue aeei?enoiaoaaoe ?? i?e aiae?c? aoaeoeaiino? ?ioeo iaoiae?a
e?eoaaiiy oe??? iaoieia??.

Oaeei /eiii, i?iaaaeaiiy aeine?aeaeaiue a caieaiiaaiiio ianyc? caeaoia
caaacia/eoe ?ica’ycaiiy i?iaeaie ioe?iee aoaeoeaiino? e?eoaaiiy oai?eo
ia AeOeI ca aeiiiiiaith OAIO, aecia/eoe e?eoa??? i?iaiico aoaeoeaiino?
e?eoaaiiy ? oei naiei ni?eyoe i?aeaeuaiith eiai yeino?.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeena?oaoe?y
aeeiiaia ca?aeii c ieaiii iaoeiai-aeine?aeii? ?iaioe ?inoeoooo
iae?io??o?a?? ?i. aeaae. A.I.?iiiaeaiiaa AII Oe?a?ie: “?ic?iaeoe
ooiaeaiaioaeuei? oa i?eeeaaei? aniaeoe o?ainieaioaoe?? aia??iiaeueii?
ia?aiai? oeaieie a iae?io??o?a??” –1995-1997??. Aea?ae?a?no?aoe?y N
01.95 O 010355.

Iaoa ? caaea/? aeine?aeaeaiiy. Iaoith aeine?aeaeaiiy ? ?ic?iaea
ia’?eoeaieo e?eoa???a ioe?iee iaa?ieia?/iiai noaoono oa aea/aiiy
aoaeoeaiino? iia?aoe?? iae?io?ainieaioaoe?? o oai?eo c nianoe/ieie
oi?iaie aeeoy/iai oea?aa?aeueiiai ia?ae?/a.

Aeey aeinyaiaiiy oe??? iaoe ae??ooaaee oae? caaea/?:

– noai?eoe iaaee/iee aaie aeaieo ? aaoiiaoeciaaio nenoaio
oi?aae?iiy iei aeey ioe?iee aoaeoeaiino? e?eoaaiiy oai?eo ia AeOeI;

– aeine?aeeoe ee?i?ei-iaa?ieia?/i?, aeaye? aeaeo?io?c?ieia?/i? oa
a?iiaoai?/i? iieacieee ?ooiaiai aia?aoo o oai?eo ?c nianoe/ieie oi?iaie
AeOeI oa aea/eoe ?o ci?ie i?ae aieeaii iae?io?ainieaioaoe??;

– ioe?ieoe aoaeoeai?noue o?ainieaioaoe?? aia??iiaeueii? ia?aiai?
oeaieie i?e nianoe/ieo oi?iao AeOeI ca aeiiiiiaith cai?iiiiiaaieo
iaoiae?a;

– ?ic?iaeoe ca aeiiiiiaith noai?aii? aaoiiaoeciaaii? nenoaie
oi?aae?iiy aaieii aeaieo oai?eo ia AeOeI ae?aaiinoe/i? e?eoa???
i?iaiico aoaeoeaiino? o?ainieaioaoe?? aia??iiaeueii? ia?aiai?
oeaieie o oai?eo ?c nianoe/ieie oi?iaie AeOeI. Iaoeiaa
iiaecia iaea?aeaieo ?acoeueoao?a. Aia?oa noai?aii iaaee/iee aaie
aeaieo oai?eo ia AeOeI.

Aia?oa ?ic?iaeaia oa ai?iaaaeaeaia “Nenoaia oi?aae?iiy aaieii aeaieo
oai?eo ia AeOeI”, yea aeicaiey? ia’?eoeaii ioe?ieoe ci?ie noaio oai?eo
ia AeOeI i?ae aieeaii iae?io?ainieaioaoe?? oa ?ioeo iaoiae?a e?eoaaiiy.

Aeyaeaii ciaioaiiy ?aoeaeoi?ii? aeoeaiino? i’yc?a oa iie?auaiiy
a?iiaoai?/ieo iieaciee?a o oai?eo ?c nianoe/ieie oi?iaie AeOeI i?ney
OAIO.

Aeiaaaeaia aoaeoeai?noue iae?io?ainieaioaoe?? o oai?eo ?c nianoe/ieie
oi?iaie AeOeI.

Aia?oa ?ic?iaeaii ae?aaiinoe/i? e?eoa???, ye? aeicaieythoue i?iaiicoaaoe
aoaeoeai?noue e?eoaaiiy iaoiaeii OAIO.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a. ?ic?iaeaiee aeai?eoi
i?iaiico aoaeoeaiino? iae?io?ainieaioaoe?? i?e AeOeI aeicaiey? aecia/eoe
iieace oa i?ioeiieace aeey i?iaaaeaiiy iae?io?ainieaioaoe??.

Cai?iiiiiaaia ea?oa ee?i?ei-?ino?oiaioaeueiiai ianoaaeaiiy oai?iai
aeicaieeea noai?eoe aaie ee?i?/ieo aeaieo aeey oai?eo ia AeOeI, yeee
ia?aoiao? iiiaae 350 niinoa?aaeaiue. Oaeee i?aeo?ae aea? iiaeeea?noue
noai?aiiy aaie?a ee?i?/ieo aeaieo oai?eo ia AeOeI a iaa?ieia?/ieo
a?aeae?eaiiyo ? ?aaa?e?oaoe?eieo oeaio?ao. Cai?iiiiiaaia iaoiaeieia?y
aeicaiey? i?iaanoe noaoenoe/iee oa iaoeiaee aiae?c aoaeoeaiino?
aeei?enoaieo iaoiae?a e?eoaaiiy o oe??? eaoaai??? oai?eo.

Ioi?ieaii ?ioi?iaoe?eiee eeno a IIC Oe?a?ie “Iaoiae ea/aiey aieueiuo
AeOeI”.

?ic?iaeaia aaoi?ii “Nenoaia oi?aae?iiy aaieii aeaieo oai?eo ia AeOeI”,
ai?iaaaeaeaia a i?aeoeeo a?aeae?eo a?aeiiaethaaeueii? iae?io??o?a??
?inoeoooo iae?io??o?a?? ?i.aeaae.A.I.?iiiaeaiiaa AII Oe?a?ie i?e
iia-?aoeaieo ao?o/aiiyo o oai?eo ia AeOeI, ?oai?/ieo o?aaeaiiyo iiceo,
aeei?enoiao?oueny a iaaeaaia?/iiio i?ioean? ia eaoaae?? iae?io??o?a??
Ia-oe?iiaeueii? iaaee/ii? aeaaeai?? ?i.aeaae.I.I.Aiaiiieueoey, eaoaae??
iae?io??o?a?? ? eaoaae?? iaa?ieia?? N2 Ee?anueei? iaaee/ii? aeaaeai??
i?neyaeeieiiii? ina?oe ?i. I.E.Ooieea, ui i?aeoaa?aeaeo?oueny aeoaie
ai?iaaaeaeaiiy.

Iniaenoee aianie caeiaoaa/a. Aeena?oaoe?eia ?iaioa ? naiino?eiei
iaoeiaei aeine?aeaeaiiyi aaoi?a. Aeena?oaio ia i?ioyc? aeaio ?ie?a
naiino?eii ianoaaeeea 200 oai?eo c ??cieie oi?iaie AeOeI, yeei
i?iaaaeaii OAIO, aei iia?aoeaiiai ao?o/aiiy oa a aeeiai?oe?
i?neyiia?aoe?eiiai ia??iaeo. A?aea o/anoue a aeaeo?ii?ia?ao?/iiio
ianoaaeaii? oai?eo, aiae?coaaea io?eiai? ?acoeueoaoe. Aeey ioe?iee
aoaeoeaiino? iae?io?ainieaioaoe?? caeiaoaa/, i?ae ea??aieoeoaii
/eaia-ei?aniiiaeaioa AII Oe?a?ie A.?.Oeeiaaethea, ?ic?iaeea
oi?iae?ciaaio ?noi??th oai?iae oa a?aaeaoe?? iieaciee?a ee?i?/iiai
ianoa-aeaiiy aeey noai?aiiy aace aeaieo oa ?o iiaeaeueoiai noaoenoe/iiai
aiae?co. Aaoi?ii i?iaaaeaii aiae?c ae?aaiinoe/ii? oe?iiino? iieaciee?a
iaa?ieia?/iiai noaoono, anoaiiaeaii oaeoi?e, ye? iaaaoeaii aieeaathoue
ia ?acoeueoao iae?io?ainieaioaoe??. Aeena?oaio ca aeiiiiiaith
iaoaiaoe/ieo i?ia?ai ia?iaee ia’?eoeaii ioe?ieea aoaeoeai?noue iaoiaeo
OAIO o oai?eo c nianoe/ieie oi?iaie AeOeI, noi?ioethaaea iieiaeaiiy oa
aeniiaee aeena?oaoe?eii? ?iaioe.

Aeaeo?ii?ia?ao?/i? ianoaaeaiiy oa aiae?c io?eiaieo ?acoeueoao?a
i?iaiaeeany ni?eueii c noa?oei iaoeiaei ni?a?ia?oieeii ?inoeoooo
o?c?ieia?? IAI ?i.aeaae. I.I.Aiaiiieueoey, e.a.i. ?. I. ssoieoeath.

I?ia?aiiee eiiieaen aeey noai?aiiy aace aeaieo i?iiia?iaaieo oai?eo aoa
?ic?iaeaiee aeena?oaioii noi?nii c ?iaeaia?aie-i?ia?ai?noaie ?inoeoooo
iae?io??o?a?? ?i.aeaae.A.I.?iiiaeaiiaa AII Oe?a?ie I.A.Aoaeianueeith oa
E.O.Neiyanueeith.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. ?acoeueoaoe aeine?aeaeaiue
aeiiia?aeaeenue ia tha?eaei?e eiioa?aioe?? ‘‘Aeooaeuei? ieoaiiy
e?eoaaiiy caoai-?thaaiue iii?ii-?ooiaiai aia?aoo, oeaio?aeueii? oa
ia?eoa?e/ii? ia?aiai? nenoaie, ?ani??aoi?ieo aea?aic?a o ae?oae’’
(?aiaoi??y, 1995); VI Eiia?an? Na?oiai? Oaaea?aoe?? oe?a?inueeeo
e?ea?nueeeo oiaa?enoa (Iaeana, 1996); Ia?o?e Ana?in?enuee?e eiioa?aioe??
ii o?aai? ia?aiai? nenoaie o ae?oae (N.-Iaoa?ao?a, 1997); ?? C’?cae?
iae?io??o?a?a ?in?enueei? Oaaea?aoe?? (Ieaei?e Iiaai?iae, 1998); ??
C’?cae? iae?io??o?a?a Oe?a?ie (Iaeana, 1998).

Aeena?oaoe?y ai?iaiaaia ia i?aeeaoaae?aeueiiio can?aeaii? 17 o?aaiy
1999?.

Ioae?eaoe??. Ia oaio aeena?oaoe?? iaae?oeiaaii 11 i?aoeue, c ieo 6
noaoae a iaoeiaeo aeo?iaeao, 1 noaooy a ca??ieeo iaoeiaeo i?aoeue, 4
?iaioe a iaoa??aeao neiiic?oi?a, eiioa?aioe?e, c’?cae?a.

Ianya oa no?oeoo?a aeena?oaoe??. Aeena?oaoe?eia ?iaioa neeaaea?oueny ?c
anooio, iaeyaeo e?oa?aoo?e, iieno iaoa??ae?a oa iaoiae?a aeine?aeaeaiiy,
?icae?eo aeanieo aeine?aeaeaiue, aiae?co oa ocaaaeueiaiiy ?acoeueoao?a
aeine?aeaeaiue, aeniiae?a, nieneo e?oa?aoo?e. Iaoa??ae ?ethno?iaaiee 7
oaaeeoeyie, 39 ?enoieaie. Iiaiee ianya aeena?oaoe?? noaiiaeoue 150
noi??iie, ?ethno?aoe?? oa oaaeeoe? caeiathoue 19 noi??iie. Nienie
aeei?enoaieo e?oa?aoo?ieo aeaea?ae i?noeoue 138 iaeiaioaaiue, ui
aeeth/a? 71 ee?eeeoeath ? 67 eaoeiith.

INIIAIEE CI?NO AeENA?OAOe??

Iaoa??aee oa iaoiaee aeine?aeaeaiue. A iniiao ?iaioe iieeaaeai?
?acoeueoaoe ee?i?ei-iae?io?c?ieia?/iiai aeine?aeaeaiiy 145 oai?eo ?c
nianoe/ieie oi?iaie AeOeI, a?eii a?ae 3 aei 15 ?ie?a., ye? e?eoaaeenue a
?inoeooo? iae?io??o?a?? ?i. aeaae. A.I.?iiiaeaiiaa AII Oe?a?ie c 1992 ?.
ii 1997 ?..

O an?o oai?eo ia aeiiia?aoe?eiiio aoai? eiina?aaoeaia e?eoaaiiy oa
o?aaeeoe?ei? ?aaa?e?oaoe?ei? iaoiaee aoee iaei aoaeoeaieie. I?ciy
?aceaeoaeueia noaae?y oai?iae ae?aaiinoiaaia ca iayai?noth inoaoi/ii
noi?iiaaiiai ?ooiaiai aeaoaeoo.

Ca?aeii c eeaneo?eaoe??th aeeoy/eo oea?aa?aeueieo ia?ae?/?a
E.I.Aaaeaeyia, an? oai?? ?c nianoe/iith oi?iith AeOeI aoee ?iciiae?eai?
ia oae? a?oie: iiaea?eia aai?ieaa?y aai nianoe/iee oao?aia?ac (91
aeeoeia), nianoe/ia aeeieaa?y (32 oai?eo) oa aai?ia?aoe/ia oi?ia (22
ae?oae). An? oai?? aoee iiae?eai? ia aea? a?eia? a?oie: a?ae 3 aei 7
?ie?a – 85 oai?eo (59%), a?ae 7 aei 15 ?ie?a – 60 ae?oae (41%).

Aiae?c ao?ieia?/ieo oaeoi??a iieacaa, ui iciaee aioo??oiueioo?iaii?
a?iien?? oa ano?en?? i?ae /an iieia?a iaee i?noea o 86% aeiaaee?a,
iieiaiaa /a?aiii-iiceiaa o?aaia – o 73% oai?eo. 10 ae?oae ia?iaeeeiny c
aaaith o?ea iaioith ca 1500a. Noai ee?i?/ii? nia?o? i?e ia?iaeaeaii?
niinoa??aaany o 11% oai?eo.

An?i oai?ei aoea i?iaaaeaia o?ainieaioaoe?y aia??iiaeueii? ia?aiai?
oeaieie a i?aoeaio?aeueio caeaeio e?ai? oa i?aai? i?aeoeue aieiaiiai
iiceo.

Ee?i?/ia ianoaaeaiiy aeeth/aei eeane/ia aeine?aeaeaiiy ia?aiai? nenoaie.
Iniaeeaa oaaaa i?eae?eyeanue noaio ?ooiai? noa?e aeeoeie, iaae/eai
noaoeee oa eieiiioe??, iic? oai?iai oa ?? ci?i? a caeaaeiino? a?ae
iieiaeaiiy o?ea, iiaeeeaino? oiaeeoe, iiacaoe, iayaiino? eiio?aeoo? oa
iaoieia?/ieo iic, iii?? i?e oiaeuea?, iniaeeaino? ia?aai?ioo c nieie ia
aeea?o. Iioi?eeo a ?oeao ioe?ithaaee ca aeiiiiiaith oanoa iiiceoe?? ?
iaeueoey, iiaeeeaino? a?aoe i?aaeiao, oo?eioaaoe eiai, ii
noi?iaoi?ii-i?iiaoi?i?e iiceoe?? a ea?ii-?aae?aeueiiio noaeia?. Ie??i
?ooiai? noa?e ioe?ithaaee nioe?aeueii-iiaooia? iaae/ee oai?eo:
iiaeeea?noue naiiianeoaiaoaaiiy i?e i?eeiaii? ?ae?, iaae/-ee ioaeiino?.
I?iaiaeeee aea/aiiy iieaciee?a ?ioaeaeooaeueii? noa?e: ni?eeiyooy,
iai’youe, e?eoeea, ieneaiiy, ?iioe?eii-aieueiaa noa?a. Aea/aany nooi?iue
iiaiiai ?icaeoeo: iayai?noue o?aciai? iiae oa iiae neeaaeaie, ianya
ianeaiiai oa aeoeaiiai neiaieeiaiai caiano, ??ciiaeaee aeae?? oa
aeeca?o???. Aecia/aee iayai?noue noiooi?o neae?ii?a: ai?eaioe/iiai oa
a?ia?e?iaoe/iiai. Aiae?c ai?neiae?iio aeeth/aa oa?aeoa? ia?ieneci?a, ?o
/anoioo, iayai?noue noaoon?a oa ee?i?/ieo ?ai?n?e. A?ia?e?iaoe/iee
neiae?ii aiae?coaaee ca oa?aeoa?ii a?ia?e?iaco, eiai iioe?ai?noth oa
iino?ei?noth i?iyao.

Oaeei /eiii, iie?neiae?iiiee oa?aeoa? AeOeI aeiaaa? i?iaaaeaiiy aaeeeiai
ianyao aeine?aeaeaiue an?o nenoai i?aai?cio. C oe??th iaoith iaie
?ic?iaeaii oi?iae?ciaaio ?noi??th oai?iae (O?O). ?ioi?iaoe?y, eio?a
aiineoueny a O?O, neeaaea?oueny c ye?nieo oa e?euee?nieo iieaciee?a.
sse?ni? iieacieee o aeaeyae? /eneiaeo eiae?a oa?aeoa?ecothoue neiioiie ?
nooi?iue ?o i?iyao. E?euee?ni? iieacieee a?aeia?aaeathoue ?acoeueoaoe
aeiaeaoeiaeo iaoiae?a ianoaaeaiiy.

Aeai? i?i noai oai?eo aei iae?io?ainieaioaoe?? oa a aeeiai?oe?
i?neyiia?aoe?eiiai ia??iaeo (6-8 i?nyoe?a, 1,5-2 ?iee) aiineee a
noai?aio aaco aeaieo .

I?ia?aiia caaacia/aiiy aeicaieyei aeeiiaoe noaoenoe/i? caaaeaiiy ca
ie?aieie iieacieeaie o aeaeyae? /anoioe oa a?aenioeo aeyaeaiiy
a?aaeaoe?e iieacieea. Aeey io?eiaiiy noaoenoe/ieo caaaeaiue aoei
aeei?enoaii oae caai? ‘‘o?eueo?e’’.

I?e ioe?ioe? a??ia?aeiino? ??cieoe? i?ae io?eiaieie /anoioaie
aeei?enoiaoaaee iaoiae ?iciiae?eo ??cieoe? a?aeiinieo /anoio (I?ioea?
I.I. oa ni?aaao., 1991) c ?ic?aooieii na?aaeiueieaaae?aoe/ii? iiieeee;
i?e ?

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