Fistula Ani

 

OMO H PEIFMDUAUMI Dmbphr Dmb phr sebum sebum jhstea jhstea perhmi perhmima ma mtmu mtmu jhstea jhstea prm-mim prm-mima, a, fhseom fhseomolmi olmi caed caed perjcr perjcrmsh msh mtmu mtmu  peiymahrmi moses micreltub, sedhiggm leomiymlmi jhstea bebpuiymh smtu bumrm fh lrhptm fhperomtmsmi mius fmi rektub fmi acomig amhi fh perhieub fh luaht perhmima. Lmfmig jhstea fhseomolmi caed kcahths ymig fhsertmh prclthths, seperth VOK, mbuohmshs, mtmu bcrous Krcdi.

=,?,;

Jhsteaa fmpmt teraetml fhsuoluths, Jhste fhsuoluths, suobulcsm, suobulcsm, mitmr sjhigter, sjhigter, mtmu beiebous beiebous sjhigter, sjhigter, buiglhi jhstea teraetml miterhcr, amterma, mtmu pcsterhcr. Oeituliym buiglhi aurus, oeiglcl, mtmu bhrhp sepmtu lufm. Ububiym sjhigter oershjmt tuiggma, lmfmig fhtebulmi ymig lcbpaels. Jhstea feigmi auomig lrhptm fh seoeamd miterhcr ububiym oeroeitul aurus, jhstea feigmi acomig ymig  oermsma fmrh lrhptm fh seoeamd fcrsma ububiym thfml aurus, tetmph oeiglcl le fepmi lmreim rmfmig fmi pus terfcrcig le miterhcr fh selhtmr b.puocreltmahs fmi fmpmt beboeitul smtu acomig  perjcrmsh mtmu aeohd fh seoeamd miterhcr, sesumh Dulub Dccfsmaa.?,; Peimtmamlsm Peimtm amlsmimmi immi jhstuam jhstuam perhmima perhmima oertunumi oertunumi uitul ermfhlmsh ermfhlmsh sepshs tmipm beiyeomolmi beiyeomolmi hilcisthiei hilcis thieishm. shm. Vermph Vermph fmrh jhstuam tergmituig tergmituig fmrh neihs jhstuamiym jhstuamiym seifhrh. seifhrh. Vermph lciservmthj  lciservmthj  befhlm bef hlmbei beitcs tcsmm feigmi feigmi peboer peboerhmi hmi mimaget mimagethl, hl, mithph mithphret rethl hl sertm sertm prcjha prcjhamls mlshs hs mithoh mithohcth cthl l nmiglm nmiglm  pminmig uitul beikegmd jhstuam relurei.=,?,; Jhstuam perhmima mfmamd duouigmi moicrbma mitmrm ephtea fmrh lmimahs mima fmi ephferbhs fmrh luaht perhmima. Ohmsmiym berupmlmi leaminutmi fmrh moses micreltma, sedhiggm jhstuam mih berupmlmi berup mlmi oeitul lrcihs fmrh moses micreltma. micreltma. Fmamb bumrm hiterim (prhber) dmbphr seamau  oermfm fmamb lrhptm, jhstuam ohmsmiym tuiggma fmi dmiym beahomtlmi omghmi busluaus sjhigter< jhstuam bmnebul mtmu jhstuam-jhstuam ymig beahomtlmi seaurud busluaus sjhigter elsterim lurmig amzhb fhtebulmi. ?,; Jhstuam fmpmt teraetml fh suoluths, suobulcsm, mitmr spdhigter mtmu beiebous sjhigter. Jhstuam buiglhi teraetml fh miterhcr, amterma mtmu pcsterhcr. Oeituliym buiglhi aurus, oeiglcl, mtmu bhrhp sepmtu lufm. Ububiym jhigter oershjmt tuiggma, lmfmig fhtebulmi ymig lcbpaels. ?,; 

 

OMO HH EBO_HCACGH Eborhcacgh Eborh cacgh smaurmi gmstrchite gmstrchitesthima sthima teroeitul pmfm bhiggu le-6 jmse eborhc, fhbmim fhbmim  perhcfe pertuboudmi buamh fmrh eborhc sepminmig 6 bb smbpmh feigmi ?00 bb. Usus teroeitul teroe itul pmfm mwma ledhfupmi fhseout fhseout  prhbhthve gut , ymig ter terfhr fhrhh mtms ; omghmi omghmi ymhtu ymhtu  jcrgut, bhfg bhfgut ut,, fmi dhfgut .  Jcrgut   mlmi mlmi oerfhj oerfhjere ereish ishmsh msh beinmf beinmfhh escjmg escjmgus, us, trmlem trmlem fmi tuims tuims pmru, pmru, ambo am boui uig, g, fu fucfe cfeiu iub b fh se seoea oeamd md prcls prclshb hbma ma bumr bumrmm sm smau aurm rmi i ebpe ebpefu. fu.  Bhfgut   mlm mlmi i beinmf beinmfhh fucfeiub fh seoeamd fhstma bumrm smaurmi ebpefu, persmbouigmi ?/; omghmi prclshbma lcaci trmi trmisv sver ersu sub b fm fmi i =/; =/; om omgh ghmi mi fhst fhstma maiym iym se sefm fmig iglmi lmi dh dhif ifgu gutt ml mlmi mi bein beinmfh mfh =/ =/; ; fh fhst stma ma lc lcac aci i trmisversub, lcaci feseifeis, shgbchf, reltub, omghmi mtms lmimahs mimahs, lmifuig lebhd fmi uretrm. Dhifgut  uretrm.  Dhifgut  berupmlmi   berupmlmi leaminutmi bhfgut  smbpmh   smbpmh bebormie lacmlm, fhbmim bebormie hih terfhrh fmrh eifcferb eifcferb lacmlm  lacmlm fmi ektcferb mima pht.=,;,5 Pmfm perhcfe ushm gestmsh : bhiggu, omghmi mldhr pmahig fhstma fmrh dhifgut  ymhtu   ymhtu kacmkm kacmkm,, sumt sumtu u rcig rciggm gm ym ymig ig fham fhamph phsh sh ei eifc fcfe ferb rb fm fmi i ek ektc tcfe ferb rb bebo beboei eitu tul l bebo beborm rmim im la lacm cmlm lm.. Perlebomigmi Perleb omigmi seaminutiym, seaminutiym, thboua thboua sumtu rhgh beahitmig, beahitmig, ymhtu septub septub urcreltma, urcreltma, pmfm sufut maamit maamitchs chs fmi usus usus oeamlm oeamlmig. ig. [elmt [elmt hih tuboud tuboud le mrmd mrmd lmufma lmufma,, lmr lmreim eim htu bebomgh bebomgh lacmlm lacmlm beinmfh omghmi fepmi (shius urcgeihtmahs prhbhthve) fmi omghmi pcsterhcr (lmimahs micreltmahs). Lethlm bufhgmd oerubur 7 bhiggu, septub urcreltma beikmpmh bebormie lacmlm fmi fmermd hih teroeitul lcrpus perhiemahs. Bebormim lacmlmahs lebufhmi teromgh beinmfh bebormie mimahs fh  oeamlmig fmi bebormie urcgeihtmahs fh fepmi.=,? [ebeitmrm htu, bebormi mimahs fhleahahigh caed tcinca-tcinca beseilhb, fmi pmfm bhiggu le-4 le4 seamp seamput ut hih teraet teraetml ml fh fmsmr fmsmr keluigm keluigmi i eltcfer eltcferb, b, ymig fhleima fhleima seomgmh seomgmh keamd mius mius mtmu mtmu  prcltcferb. Pmfm bhiggu le-8, bebormi mimahs lcyml, lc yml, fmi teroulmamd nmami mitmrm reltub fmi fuihm aumr. Omghmi mtms lmimahs mimahs oermsma fmrh eifcferb fmi fhperfmrmdh caed pebouaud imfh usus oeamlmig, ymhtu mrterh beseitrhlm hijerhcr. Mlmi tetmph, seperthgm omghmi omwmd lmimahs mimahss oermsma mimah oermsma fmrh eltcferb eltcferb fmi fhperfmrmdh fhperfmrmdh caed mm. _eltmaes, _eltmaes, ymig berupmlmi berupmlmi kmomig fmrh mrterhh pufeifm hiterim. Vebpmt persmbouigmi mrter persmbouigmi mitmrm mitmrm omghmi eifcferb fmi eltcferb eltcferb fhoeitul  fhoeitul  caed ahiem pelthimtm, ymig terfmpmt tepmt fh omwmd lcaubim mimahs. Pmfm gmrhs hih, ephtea oeruomd fmrh ephtea tcrml beinmfh ephtea oeramphs gepeig. 6

 

 

Gmbomr =. Eborhc

 

OMO HHH MIMVCBH

Gmbomr

?. Mimtcbh Kmimahs Mimahs

Lmimahs mimahs oermsma fmrh prcltcferb ymig berupmlmi hivmghimsh eltcferb, sefmiglmi reltub oermsma fmrh eifcferb. Lmreim peroefmmi msma mius fmi reltub hih, bmlm peifmrmdmi,  persmrmjmi, sertm peiymahrmi veim fmi ahbjeiym oeroefm nugm, febhlhmi puam ephtea ymig beiutu bei utuphi phiym. ym. _eltub _eltub fhamph fhamphsh sh caed caed bulcsm bulcsm gamifu gamifuaer aer usus usus sefmigl sefmiglmi mi lmimah lmimahss mimahs mimahs caed caed micferb ymig berupmlmi aminutmi ephtea oeramphs gepeig luaht aumr. Vhfml mfm ymig fhseout bulcsm mius. Fmermd omtms rektub fmi lmimahs mimahs fhtmifmh feigmi peruomdmi neihs ephtea. Lmimah Lmi mahss mimahs mimahs fmi luaht luaht aumr aumr fhselh fhselhtmr tmriym iym lmym lmym mlmi mlmi persmr persmrmjm mjmi i seiscr seiscrhs hs scbmth scbmthl l fmi pelm terdmfmp rmigsmigmi iyerh, sefmiglmi bulcsm rektub bebpuiymh persmrmjmi ctcicb fmi thfml  ;

 pelm terdmfmp iyerh.

 

Lmimahs mimahs oerulurmi pminmig ?,5 kb smbpmh 6 kb, buamh fmrh jaexurm perhiemahs rekth. Ohmsmiym kmimahs mimahs fmamb lemfmmi tertutup fmi omru teroulm pmfm wmltu fejelmsh. [eamput aeifhrr kmimahs aeifh kmimahs bebpuiymh bebpuiymh senubamd senubamd 5-=0 ahpmtmi-ahpmtm ahpmtmi-ahpmtmi i verthlma verthlma ymig tetmp tetmp fmi fhimbmlmi fhimbmlmi kcaubime rektmaes (kcaubim mimaes) Bcrgmgih. Ohmsmiym kcaubim mimaes Bcrgmgih oerulurmi  pminmig 4 bb ‛ =? bb, aeomr ; bb ‛ : bb fmi beboeitmig smbpmh =? bb ‛ ?0 bb fh fmamb f mamb crhjhshub mimahs. Fhmitmrm kcaubim mimaes bcrgmgih terfmpmt aelulmi-aelulmi ymig beiyerupmh lmitcig-lmitcig lekha ymig fhimbmlmi shius rektmahs (shius mimahs, kryptm mimahs). Ahpmtmi ymig terfmpmt terfm pmt pmfm unuig kcaubim mimahs fmi bebomtmsh bebomtmsh shius rektmahs beboeitul beboeitul sumtu lmtup ymig fhimbm fhi mbmlmi lmi vmavua vmavuamm mimahs mimahs Bcrgmg Bcrgmgih. ih. Kcaubi Kcaubimm mimaes mimaes bebpuiy bebpuiymm puikml puikml ymig serhig serhig lmah lmah beinua bei nuamig mig le mtms mtms teph teph omwmd omwmd kcaubi kcaubimm rektma rektmahs hs fmi oeroeit oeroeitul ul sepert seperthh tcinca tcincami mi lekha lekha ymig ymig fhimbm fhi mbmlmi lmi pmphaa pmphaame me mimaes. mimaes. Oersmb Oersmbm-s m-smbm mbm teph teph mtms mtms vmavua vmavuamm mimaes mimaes beboei beboeitul tul sumtu sumtu gmrhs gmrhs  oergerhgh ymig fhimbmlmi ahiem pekthiem (ahiem feitmtm). [eamput aeifhr fh mtms ahiem pekthiem bebpuiymh ephtea shahifrhs sefmiglmi fhomwmdiym ephtea gepeig. Fhfmermd hih terfmpmt lrhptm mi mius us fm fmi i le leae aein inmr mr bu bumr mrmm mi mius us mi mitm tmrm rm lcaub lcaubim im re relt ltub ub.. Hi Hije jels lshh ym ymig ig te tern rnmfh mfh fh fhsh shih ih fm fmpmt pmt beihboualmi moses micreltub ymig fmpmt beboeitul jhstea. Aelulmi mitmr sjhigter shrluaer  fmpmt fhrmom fh fmamb lmimahs mimahs sewmltu beamlulmi kcacl fuour, fmi beiuinullmi omtms mitmrm sjhigter hiterim fmi sjhigter elsterim ( gmrhs Dhatci ) ?,; Khikhi Khi khi sjh sjhigt igter er mius beahig beahiglmr lmrhh lmimahs lmimahs mimahs mimahs fmi ter terfhr fhrhh fmrh fmrh sjh sjhigt igter er hiterim hiterim fmi elsterim. [hsh pcsterhcr fmi amterma khikhi hih teroeitul fmrh jush sjhigter hiterim, ctct acightufhima,  omghmi teigmd fmrh ctct aevmtcr ( puocreltmahs ), fmi lcbpciei b. sjhigter elsterius. Busluaus sjhigter sjhi gter mih hiterius hiterius terfhrh mtms sermout sermout ctct pcacs, sefmiglmi b usluaus usluaus sjhigter sjhigter mih elsterius elsterius ?,;

terfhrh mtms sermout ctct aurhl.

 

Gmbomr ;. Mimtcbh Lmimahs Mimahs Mimahs Letermigmi (=). _eltub fhamphsh bulcsm usus (?). Amphsmi ctct shrluaer fhifhig rektub (;). Amphsmi ctct acightufhima acightufh ima fhifhig reltub( 6). Vuamig pmiggua (5). b.coturmtcr b.coturmtcr hiterius (:). b.aevmtcr b.aevmtcr mius (7). b.puoc-reltma b.puoc-reltma (4). b.sjhigter hiterius (8). b.sjhigter exterius (=0). Gmrhs mtms-sjhigter (fmrh dhatci ) berupmlmi peromtmsmi mitmrm sjh sjhigte igterr hiteri hiteri fmi elsteri elsteri ymig fmpmt fhrmom fhrmom (==). (==). Vcincami Vcincami reltub mtmu lcaubim lcaubim bcrgmgih bcrgmgih feigmi bumrm bumrm leaeinmr le aeinmr relt reltub ub fhmitmrmiym fh fmamb lrhptm (=?). Gmrhs bclclultmi bclclultmi mtmu ahiem pelthimtm pelthimtm berupmlmi peromtmsmi peromtmsmi mitmrm seamput aeifhr aeifhr (2bulcsm) reltub reltub fmi luths (2luaht) mius (=;). Lmimahs mimahs mimahs feigmi ephtea gepeig.?,; ;.=

Peifmrmdmi Mrterh

_ektub fmi kmimahs mimahs beifmpmt perfmrmdmi fmrh > =.

Mr Mrte terh rh deb debcr crch chfm fmae aess supe superh rhcr cr mfma mfmamd md leam leamin inut utmi mi ami amigs gsuig uig m. m. bese beseit iter erhl hlmm hijer hijerhc hcr. r.

?.

Mr Mrte terh rh deb debcr crch chfm fmah ahss befh befhma mahs hs ber berupm upmlm lmi i perkm perkmom omigm igmi i miter miterhc hcrr m.hah m.hahmlm mlm hit hiter erim. im.

;.

Mr Mrte terh rh de debc bcrc rchf hfma mahs hs hije hijerh rhcr cr mfm mfmam amd d kmom kmomig ig fmr fmrhh mmrt rter erhh pufe pufeif ifmm hit hiter erim im..

Mrterh debcrchfmaes superhcr berupmlmi imfh utmbm uitul rektub. Mimstcbmshs terseout lepebo lep ebouau uaud d lcamte lcamterma rma debcrc debcrchf hf hijerh hijerhcr cr fmpmt fmpmt beinmb beinmbhi hi peifmrm peifmrmdmi dmi fh lefum lefum elstre elstrebht bhtms ms  omwmd.Peifmrmdmi fh paelsus debcrchfmahs berupmlmi lcamterma aums fmi lmym selmah fmrmd.5

Gmbomr 6. Peifmrmdmi Mrterh-mrterh reltub

 

Letermigmi >(=). m.debcrchfmahs m.debcrchfmahs hijerh hijerhcr cr (?). m. pufeifm (;). m.debcrchfmahs befhm (6). m. hahmlm hiterim(5). m. debcrchfmahs debcrchfmahs superhcr (:). Kmomig mrterh mrterh shgbchfem shgbchfem (7). m. hahmlm lcbuihs lcbuihs fextrm (4). m.beseiterhlm m.beseiterhlm hijerhcr hijerhcr (8). Mcrtm (=0). v.lmvm hijerhcr hijerhcr (==). m.smlrmahs m.smlrmahs

;.?

Peifmrmdmi Zeim

Zeim debcrchfmahs superhcr oermsma fmrh paelsus debcrchfmahs hiterius fmi oernmami le mrmd krmihma le fmamb veim beseiterhlm hijerhcr fmi seterusiym beamauh veim aheimahs le veim  pcrtm. Zeim hih thfml terlmtup sedhiggm telmimi rciggm perut beieitulmi telmimi fhfmambiym. Zeim debcrchfmahs hijerhcr beigmahrlmi fmrmd le fmamb veim pufeifm hiterim fmi le fmamb veim hahmlm hiterim fmi shsteb lmvm. 5

;.;

Mahrmi Ahbje

Pebouaud ahbje fmrh lmimahs beboeitul paelsus dmaus ymig beiymahrlmi hshiym beiunu le leaeinmr ahbje higuhima, seaminutiym fmrh shih kmhrmi ahbje terus beigmahr smbpmh le leaeinmr  ahbje hamlm. Hijelsh fmi tubcr gmims fh fmermd mius fmpmt beigmlhomtlmi ahbjmfeicpmth higuhima. Pebouaud Peboua ud ahbje ahbje fmrh rektub fhmtms fhmtms gmrhs micreltub micreltub oernmami oernmami sehruig sehruig feigmi v.debcrch v.debcrchfmahs fmahs superhcr fmi beaminut le leaeinmr ahbje beseiterhlm hijerhcr fmi mcrtm. Cpermsh rmfhlma uitul  ermfhlmsh lmrshicbm rektub fmi mius fhfmsmrlmi pmfm mimtcbh smaurmi ahbje hih.5

Gmbomr 5. Mahrmi Ahbje

 

Letermigmi >(=). Le leaeinmr higuhima higuhima (?). Leaeinmr hahmlm hahmlm hiterim (;). Leaeinmr pmrmlcahl pmrmlcahl (6). Leaeinmr fhbeseiterhub fhbeseiterhub (5). Leaeinmr pmrm mcrtm ;.6

Persmrmjmi

Persmrmjmi reltub terfhrh mtms shsteb shbpmthl fmi pmrmshbpmthl. [ermout shbpmthl oerms oermsma ma fmrhh paelsu fmr paelsuss beseit beseiterh erhlus lus hijerh hijerhcr cr fmi fmrh fmrh sh shste steb b pmrmsm pmrmsmlrm lrmaa ymig ymig ter teroei oeitul tul fmrh fmrh gmigahc gmigahci i shbpmths auboma rums lefum, lethgm, fmi leebpmt. Uisur shbpmths paeslsus hih beiunu le mrmd str strult ultur ur geihtm geihtmaa fmi sermou sermoutt ctct ctct pcacs pcacs ymig beigeif beigeifmah mahlmi lmi ebhsh ebhsh mhr bmih bmih fmi enmlua enmluamsh msh.. Persmrmjmi pmrmshbpmths (iervh ergeites) oermsma fmrh smrmj smkrma lefum, lethgm, leebpmt fmi leahbm. [ermout smrmj hih beiunu le nmrhigmi ereltha peihs fmi lahtcrhs sertm beigeifmahlmi erelsh feigmi kmrm beigmtur mahrmi fmrmd le fmamb nmrhigmi hih.?,; Busluaus Buslua us puocreltma puocreltma bebpertmdmilmi bebpertmdmilmi sufut micrektub< micrektub< ctct hih bebpertmnmb bebpertmnmb sufut terseout oham beregmig fmi beauruslmi usus oham beigeifur. ?,;

 

OMO HZ JH[VUAM PE_HMIMA

6.=

Fejhihsh

Jhstuam perhmima mfmamd duouigmi moicrbma mitmrm ephtea fmrh lmimahs mima fmi ephferbhs fmrh luaht perhmima. 6.?

Hishfei & Ephfebhcacgh

Jhstuam perhmima serhig ternmfh pmfm amlh amlh oerubur ?0 ‛ 60 tmdui, oerlhsmr =-; lmsus thmp =0.000 crmig. [eomghmi oesmr jhstuam teroeitul fmrh seoumd moses (tmph thfml sebum moses beinmfh jhstuam). [elhtmr 60% pmshei feigmi moses mlmi teroeitul jhstuam. =,; Jhstuam perhmima ububiym buikua buikua pmfm hifhvhfu ymig sedmt, sedmt, imbui fmpmt nugm buikua  pmfm pmshei feigmi peiymlht hijambmsh, seperth Krcdi fhsemse. Hishfeish jhstuam perhmima fh Mberhlm [erhlmt fhperlhrmlmi seomiyml :4.000 dhiggm 8:.000 lmsus per tmduiiym. Moses  perhmima fmpmt buikua pmfm =?,; per =00.000 pcpuamsh prhm fmi 5,: per =00.000 pmfm wmihtm, feigmi rmtm-rmtm ushm ymhtu 60 tmdui pmfm lefum neihs neihs leambhi. 6.;

Ethcacgh

Leomiymlmi jhstuam oermwma fmrh leaeinmr fmamb fh fhifhig mius mtmu reltub. Lmfmiglmfmig jhstuam berupmlmi mlhomt fmrh peigeaumrmi imimd pmfm moses micreltma. Verfmpmt selhtmr  7-60% 7-6 0% pmfm lmsus lmsus moses moses micrelt micreltma ma oerami oeraminut nut beinmf beinmfhh jh jhste steaa perhmi perhmima. ma. Imb Imbui ui aeo aeohd hd serhig serhig  peiyeomoiym thfml fmpmt fhletmduh. Crgmihsbe ymig ohmsmiym terahomt fmamb peboeitulmi moses mfmamd Eskderhkdhm kcah, Eiterckckkus sp fmi Omkterchfes sp. Jhstuam nugm serhig fhtebulmi pmfm  peiferhtm feigmi peiymlht Krcdi, tuoerluacshs, feverthluahths, lmiler mtmu keferm mius bmupui reltub, mlthicbhlcshs fmi hijelsh lambhfhm. Jhstuam pmfm miml-miml ohmsmiym berupmlmi kmkmt  omwmmi. Jhstuam ymig beigduouiglmi beigdu ouiglmi reltub fmi vmghim ohsm berupmlmi mlhomt fmrh termph shimt x, lmiler, peiymlht Krcdi fmi keferm pmfm hou seambm prcses persmahimi. ; Ohmsmiym berupmlmi leaminutmi fmrh moses micreltma, sedhiggm jhstuam mih berupmlmi  oeitul lrcihs fmrh moses micreltma. Fmamb bumrm hiterim (prhber) dmbphr seamau oermfm fmamb lrhptm, jhstuam ohmsmiym tuiggma fmi dmiym beahomtlmi omghmi busluaus sjhigter< jhstuam bmnebul 

 

mtmu jhstuam-jhstuam ymig beahomtlmi seaurud busluaus sjhigter elsterim lurmig amzhb fhtebulmi. ?,;

Dmbphr Dmb phr sebum sebum jhstua jhstuamm fhseomo fhseomolmi lmi caed caed perjcr perjcrmsh msh mtmu mtmu peiymah peiymahrmi rmi moses moses micrelt micreltub, ub, sedhiggm leomiymlmi jhstuam bebpuiymh smtu bumrm fh lrhptm fh peromtmsmi mius fmi rektub fmi auomig amhi fh perhieub fh luaht perhmima. Lmfmig, jhstuam fhseomolmi caed kcahths fhsertmh prclthths seperth seper th VOK, mbcohmshs mbcohmshs fmi bcrous bcrous Krcdi. Oham genmam genmam fhmre beiyertmh jhstuam jhstuam micreltma micreltma ymig  oeruamig, perau fhphlhrlmi peiymlht Krcdi, lmreim 50 % peiferhtm peiymlht Krcdi beigmambh jhstuam mius.?,; Jhstuam fmpmt teraetml fh suoluths, suobulcsm, mitmr spdhigter mtmu beiebous sjhigter. Jhstuam buiglhi teraetml fh miterhcr, amterma mtmu pcsterhcr. Oeituliym buiglhi aurus, oeiglcl, mtmu bhrhp sepmtu lufm. Ububiym jhigter oershjmt tuiggma, lmfmig fhtebulmi ymig lcbpaels. ?,;

6.6

Pmtcjhshcacgh

Pmfm lmimahs mima terfmpmt leaeinmr lrhptcgamifur ymig beigmahr beiunu lrhptm pmfm ahiem feitmtm. Oham leaeinmr beigmambh hijelsh fmi smaurmiiym tersubomt mlmi beiyeomolmi moses micreltma. Fmpmt oermfm pmfm perhmima, hskdhcrektma spmke, hiterspdhikterhk spmke, fmi peavhrektma spmke.;  Ohamm lemfmmi Oha lemfmmi hih terus terus oerami oeraminut nut mlmi mlmi oerami oeraminut nut beinmf beinmfhh jhs jhstua tuamm fhbmim fhbmim moses moses mlmi mlmi  oerusmdm beikmrh nmami leaumr le aumr fmi fmpmt thboua nugm seteamd frmhimse, lmfmig nmrhigmi grmiuamsh  oeramphs fmpmt terthiggma fmi beiyeomolmi genmam oeruamig.; 

 

 Icrbmaiym, leaeinmr reltub ymig terfmpmt fh lrhptm mitmr lcaubim reltub oerjuigsh seomgmh omrrher  terdmfmp   terdmfmp aewmtiym bhlrccrgmihsbe peiyeomo hijelsh ymig oermsma fmrh aubei usus le fmermd  perhreltma. Leaeinmr hih beigeaumrlmi sebmkmb aeifhr, oerguim seomgmh peahkhi/ auorhlmsh. [maurmi hih bebhahlh laep smtu mrmd mgmr prcfulsh ohsm leaumr tmph jeses thfml ohsm bmsul. Verdmamigiym nmami leaumr   prcfulsh fmrh leaeinmr hih mlhomt stmshs beiyeomolmi lubmi fmi kmhrmi jeses bmsul le fmamb leaeinmr. Jeses ymig omiyml omiyml lubmi lubmiiym iym oerlebomig oerlebomig ohml le fmamb fmamb leaeinmr, leaeinmr, beboeitul permfmigmi permfmigmi ymig nmfh mo mose ses. s. Mose Mosess ml mlmi mi beik beikmr mrhh nm nmam ami i le leau aumr mr fm fmi i be bebo boei eitu tul l se sebmk bmkmb mb phpm phpm ym ymig ig bei beieb ebou ouss luah luaht. t. Mlhomtiym, luaht nmfh tmbpml seperth ohsua amau pekmd. Pekmdmi hih thfml ohsm beiutup lmreim imimd seamau leaumr fmi thfml ohsm lerhig lmreim oerduouigmi feigmi jeses. Lcifhsh hih ohsm oeramigsuig oerouami ouami dhiggm oertmdui-tmdui. oertmdui-tmdui.=,;

Lamshjhlmsh=,?,;

6.5

Jhstua Jhs tuamm fhlams fhlamshj hjhlm hlmshl shlmi mi oerfms oerfmsmrl mrlmi mi duouigm duouigmiiym iiym feigmi feigmi lcbpae lcbpaels ls mima mima spdhik spdhikter  ter  seomgmh oerhlut> 

Jhstuam hiterspdhikterhk  oermwma fmamb rumig fhmitmrm B. [jhigter Elsterim fmi Hiterim fmi oerbumrm oerfelmtmi feigmi auomig mius.

Kcaci mif _ektma [urgery, ?005



Jhstuam trmisspdhikterhk  oermwma fmab rumig fhmitmrm B. [jhigter Elsterim fmi Hiterim, lebufhmi beaewmth B. [jhigter Elsterim fmi oerbumrm sepminmig ² hikdh fh aumr auomig mius.

 

Kcaci mif _ektma [urgery, ?005 

Jhstuam suprmspdhikterhk  oermwma fmrh rumig fhmitmrm B. [jhigter Elsterim fmi Hiterim fmi beboeamd le mtms B. Puocreltmahs amau turui fhmitmrm puocreltma fmi B. Aevmtcr mih amau buikua ² hikdh fh aumr mius.

Kcaci mif _ektma [urgery, ?005



Jhstuam extrmspdhikterhk  oermwma fmrh reltub/kcaci shgbchf fmi bebminmig le omwmd, ,eaewm ,eaewmth th B. Aevmtc Aevmtcrr mih fmi oermld oermldhr hr fh selhtm selhtmrr mius. mius. Ohmsmi Ohmsmiym ym mlhomt mlhomt fmrh fmrh trmubm trmubm,, Kdrci‘s Fhsemse, PHF, fmi moses suprmaevmtcr.

 

Kcaci mif _ektma [urgery, ?005

[kdwmrtz‘s Prhikhpaes cj [urgery, ?006

 

Dulub Gccfsmaa

Jhstuam mih terfhrh auomig hiterim fmi elsterim. Feigmi beahdmt mfmiym auomig exterim fmpmt fmp mt fhperl fhperlhr hrmlmi mlmi aetml aetml auomig auomig hiteri hiterimiym miym fmi smaurm smaurmiiym iiym feigmi feigmi Gccfsma Gccfsmaa‘s a‘s ruae. ruae. [ek [ekmrm mrm ubub, nhlm auomig elsterim oermfm fh seoeamd miterhcr fmrh mima trmiversma ahie bmlm smaurmiiym  oernmami rmfher beboeitul gmrhs aurus. [eomahliym oham auomig elsterim oermfm fh seoeamd  pcsterhcr fmrh mima trmisversma ahie bmlm smaurmi mlmi beaeigluig beiunu pcsterhcr bhfahie.;

  Gccfsmaa _uae (e (ebe befh fhkh khie ie.b .bef efsk skmp mpe. e.kc kcb) b) ef efht hthc hci) i)

Gccfsmaa _uae ([mohstci Vextoccl cj [urgery, =7 td efhthci)

 

6.:

Peiegmlmi Fhmgicsm  

Mimbieshs

Fmrhh mimbie Fmr mimbieshs shs ohmsmi ohmsmiym ym mfm rhw rhwmym mymtt lmb lmboud oudmi mi moses moses perhmi perhmima ma feigm feigmi i seamig seamig wml wmltu tu fhmitmrmiym, fhsertmh peigeaumrmi imimd sefhlht-sefhlht. sefhlht-sefhlht. [erhig beboerhlmi senmrmd ymig fmpmt fhmifmalmi iyerh seoeaubiym, oeiglml, fmi spcitmi mtmu frmhimse oefmd fhreikmimlmi fmrh moses micreltma.?,5 Vmifm fmi genmam seomgmh oerhlut; > oergerml, fejelmsh fmi omtul    Iyerh pmfm smmt oergerml, 

Ualus



Leaumr kmhrmi puruaei



Oeincami (Bmssm jaultumsh)



Prurhtus mih



Febmb



Lebermdmi fmi hrhtmsh luaht fh selhtmr mius



Geierma bmamhse

Jhstuam lcbpaels mfmamd seomgmh oerhlut>

 



_mfmig usus



Fhverthluahths



[eoeaubiym termph rmfhmsh uitul lmiler prcstmt mtmu fuour 



Vuoerluacshs



Vermph sterchf



Hijelsh DHZ

Peberhlsmmi Jhshl

Vebumi peberhlsmmi peberhlsmmi jhshl tetmp beinmfh beinmfh mifma mifmami mi fhmg fhmgicsh icshs. s. Pmfm peberhlsmm peberhlsmmi i jhshl fh fmermd fmerm d mius (feigmi (feigmi peberhlsmm peberhlsmmi i fhghtma/ fhghtma/rektm rektmaa tcuk tcukder) der) fhtebulmi fhtebulmi smtu mtmu aeoh aeohd d elsterima elsterima cpeihig jhstuam mtmu termom mfmiym jhstuam jhstuam fh omwmd perbulmmi luaht. luaht. Elsterima cpeihig jhstuam jhstuam tmbpml seomgmh ohsua (oham moses moses oeaub pekmd) mtmu tmbpml seomgmh smaurmi ymig ymig fhleahahigh caed  nmrhigmi grmiuamsh. Hiterima cpeihig jhstuam fmpmt fhrmsmlmi seomgmh fmermd hifurmsh/ icfua fh

 

fhifhig mius sethiggh gmrhs feitmtm. Veraepms fmrh nubamd elsterima cpeihig, terfmpmt dmbphr  seamau dmiym smtu hiterima cpeihig. 5,: Pmfm kcacl fuour ububiym jhstea fmpmt fhrmom mitmrm teauinul fhmius (oulmi fh rektub) fmi hou nmrh fhluaht perhieub seomgmh tmah seteoma lhrm-lhrm ;bb (kcacl fuour ohfhghtma). Nhlm jhstea mgml mgm l aurus aurus fmpmt fmpmt fh fhsci scife fe smbpmh smbpmh scife scife leaumr leaumr fh lrhptm lrhptm msmaiy msmaiym. m. Jhstea Jhstea perhie perhieub ub nmrmig nmrmig beiyeomolmi gmiggumi shstebhl, jhstea lrcihl ymig ambm selmah fmpmt beigmambh fegeiermsh bmahgim beinmfh lmrshicbm pamicseauaer luaht. 

Peberhlsmmi Peiuinmig=,?,;  

Peberhlsmmi Amocrmtcrhub

Vhfml mfm stufh stufh amocrmtcr amocrmtcrhub hub ldusus ldusus ymig fhperaulmi< fhperaulmi< stufh prm cpermsh cpermsh icrbm icrbmaa fhamlulmi oerfmsmrlmi ushm fmi lcbcrohfhtms.  

Peberhlsmmi _mfhcacgh

-

inelsh lcitrms beamauh peboulmmi hiterima, fhhluth feigmi mitercpcsterhcr, Jhstuacgrmjh > HHinelsh amterma fmi gmbomrmi T-rmy coahl uitul beahdmt nmaur jhstuam.

-

-

Uatrmscuif eifcmima / eifcreltma  > Beigguimlmi trmisfuser 7 mtmu =0 BDz le fmamb

lmimah lmi mahss mih uitul uitul bebomi bebomitu tu beahdm beahdmtt fhjjer fhjjereis eishms hmshh buslu busluaus aus hiters hitersjhi jhigte gterr fmr fmrhh aes aeshh trmisjhig trmis jhigter. ter. Vrmisfuse Vrmisfuserr wmter-jha wmter-jhaaef aef omaac omaaci i bebom bebomitu itu evmau evmaumsh msh fhifhig fhifhig rektma rektma fmrh  oeoermpm elsteish suprmsjhigter. suprmsjhigter.

 

-

B_H > B_H fhphahd mpmoham highi beigevmaumsh jhstuam lcbpaels, uitul bebperomhlh

relureish.

6.7

Peimtmamlsmimmi

Vunumi termph fmrh jhstuam mih mfmamd ermfhlmsh sepshs tmipm beiyeomolmi hilcisthieishm. Vermph fmrh jhstuam tergmituig fmrh neihs jhstuamiym seifhrh. 

[hbpae hiterspdhikterhk jhstuam serhig fhtermph feigmi jhstuactcby (beboulm trmkt jhstuam), luretmse, fmi peiyeboudmi seluifer.

 

Kcaci mif _ektma [urgery, ?005



Pmfm jhstu jhstuam am trmis trmisspdh spdhite iterh rhkk termph termph tergmit tergmituig uig fmrh fmrh aclmsh aclmsh lcbpae lcbpaels ls spdhik spdhikter ter ymig terlei terleim. m. Oham Oham jhstu jhstuam am lurmig lurmig fmrh fmrh ;0% ctct ctct spdhik spdhikter ter ymig ter terlei leimm fmpmt fmpmt fhamlul fhamlulmi mi spdhikterct spdhik terctcby cby tmipm beihboualmi beihboualmi hilcisthieishm hilcisthieishm ymig oermrth. oermrth. Oham jhstuamiym jhstuamiym dhgd ;,:



trmisspdhikterhk fmpmt fhamlulmi feigmi pebmsmigmi setci.   Pmfm jhstuam suprmspdeiterhk ohmsmiym fhtermph nugm feigmi pebmsmigmi setci.;,: 



Pmfm jhstuam extrmspdhikterhk termph tergmituig fmrh mimtcbh fmrh jhstuam, ohmsmiym oham jhstuam fhaumr spdhikter fhoulm fmi fhfrmhimse. ;,:  [etci fhguimlmi uitul hfeithjhlmsh trmkt, seomgmh frmhimse, fmi bermigsmig ternmfhiym

jhorcshs feigmi tetmp beinmgm beinmgm juigsh fmrh spdhikter. Kutthig setci teroumt fmrh lmret ymig fhaetml   pmfm jhstuam uitul bermigsmig jhorcshs. Icikutthig setci teroumt fmrh pamsthk ymig fhguimlmi seomgmh frmhimse.;,:  Oeoermpm betcfe teamd fhperleimalmi uitul beighfeithjhlmsh trmkt jhstuam smmt oermfm fh lmbmr cpermsh?,:> 

Bebmsullmi prcoe beamauh auomig elsterima smbpmh le oulmmi hiterima, mtmu seomahliym.



Beighinelsh kmhrmi wmrim seperth betdyaeie oaue, susu, mtmu dhfrcgei perclshfm, fmi bebperdmthlmi ththl leaumriym fh ahiem feitmtm.



Beighluth nmrhigmi grmiuamsh pmfm trmltus jhstuam.



Bebper Beb perdmt dmthlm hlmi i ahpmt ahpmtmi mi lrhptm lrhptm mima smmt smmt trmls trmlshh fhamlu fhamlulmi lmi pmfm trmltu trmltus. s. Dma hih fmpmt fmpmt  oerguim pmfm jhstuam seferdmim imbui lurmig oerdmsha pmfm vmrhmi ymig lcbpaels Vermph Ver mph Lciser Lciservmt vmthj hj Befhlm Befhlmbei beitcs tcsmm feigmi feigmi peboer peboerhmi hmi mimaget mimagethl, hl, mithph mithphret rethl hl sertm sertm  prcjhamlshs mithohcthl nmiglm pminmig uitul beikegmd jhstuam relurei.

 

Vermph peboefmdmi?,;,6>

-

[etci >

[etci fmpmt fhguimlmi seomgmh setci pctcig mtmu ici pctcig (aepms). [etci aciggmr  mfmamdo mfma mdoern ernmam mami i beamauh beamauh smaurm smaurmi i stuam. stuam. [etci [etci ohsm ohsm beinmf beinmfhh nebomt nebomtmi mi omg omghh fejhih fejhihthv thvee  prcsefur. [etci pebctcigmi fhrmikmig uitul bebctcig sjhigter fmi beigmrmd le ctct. Hih seomifhig feigmi jhstuactcbh, tetmph setci phifmd sekmrm peramdmi beamauh sjhigter. Mamsmiiym mfmamd omdwm ctct teromgh smigmt ambomt fmi puiym wmltu uitul seboud. [etci smmt hih terutmbm fhguimlmi uitul sebeitmrm mtmu frmhimse nmiglm pminmig fmrh smaurmi jhstuam perhmima

Oeimig mtmu lmret fhhlmtlmi fhhlmtlmi bmamauh bmamauh smaurmi smaurmi jhstuam. jhstuam. Verfmpmt fum bmkmb [etci, kutthig [etci, fhbmim oeimig [etci fhtmrhl sekmrm grmfuma uitul bebctcig ctct spdhikter sekmrm  oertmdmp, fmi accse [etci, fhbmim oeimig [etci fhthiggmalmi supmym teroeitul grmiuamsh fmi oeimig mlmi fhtcaml caed tuoud fmi teraepms seifhrh seteamd oeoermpm ouami.

 

-

Mfvmikebeit Jamp > Beiutup auomig feigmi fhifhig usus, tetmph leoerdmshamiiym thfml 

teramau oesmr. Jamp Jamp mf mfvm vmik ikeb ebei eitt bulc bulcsm sm sm smmt mt hih hih beru berupm pmlm lmi i st stmi mifm fmrr ebms ebms ui uitu tul l jh jhst stua uamm trmisspdhikterhk thiggh . Mamsmi fh omahl jamp mfvmikebeit mfmamd omdwm peboulmmi hiterima ymig teroul teroulmm mfmamd mfmamd peiyeom peiyeomo o fmrh fmrh smaurm smaurmi i jhstu jhstuam am ymig beietm beietmp. p. Feig Feigmi mi bebmnu bebmnulmi lmi  nmrhigmi fh mtms auomig omghmi fmamb, thfml buiglhi jeses bmsul smaurmi jhstuam smmt oumig mhr oesmr. Jamp mfvmikebeit fhamlulmi sesumh feigmi telihl oerhlut. 

Peboulm Peb oulmmi mi hiteri hiterima ma fhpctc fhpctcig ig fhhlut fhhluthh feigmi feigmi bcoha bcohahsm hsmsh sh bulcsm bulcsm,, suobul suobulcsm csm,, fmi senubamd lekha sermt ctct fmrh lcbpaels sjhigter hiterima. [eoumd reltma jamt feigmi fmsmr  aeomr fum smbpmh thgm seithbeter fhgermllmi.



Jamp reltma kulup fhbcohahsmsh uitul beiutuph oulmmi hiterima.



Debcstmshs fhamlulmi uitul beikegmd debmtcbm fh omwmd jamp. [maurmi jhstuam mfmamd luret fmi oulmmi hiterima fhtutup seteamd jamp beaewmth hiterima peboulmmi. Mldhriym, jamp fhnmdht fh smaurmi mius fhstma feigmi Zhkrya terputus Nmdhtmi ?-0 (Etdhkci Eifc[urgery, Khikhiimth, CD). Lebui Leb uiglh glhimi imi lcbpa lcbpahl hlms mshh fm fmrh rh mf mfvm vmik ikeb ebei eitt ja jamp mp bulc bulcsm sm mfmam mfmamd d re retr trml mlsh sh,, debmtcbm, fmi ielrcshs jamp. Fmamb dma thiglmt lelmboudmi uitul jamp mfvmikebeit bulcsm ymig fhampcrlmi fmamb ahtermtur oervmrhmsh fmi fhampcrlmi oerlhsmr mitmrm 0-:8% .

 

-

Jhorhi Gaue> Feigmi beiyuithllmi beiyuithllmi aeb jhorhi jhorhi pmfm smaurmi smaurmi jhstuam fmi oulmmi hiterima hiterima  oershjmt tertutup sebeitmrm. Lethlm aeb oeruomd seteamd oeoermpm bhiggu, jhorcoamst

fhmlthjlmi caed bmtrhx pmfm aeb jhorhi, sedhiggm ternmfh peiutupmi smaurmi jhstuam. Beslhpui dmsha pertmbm omgus, peieahthmi seaminutiym beigekewmlmi. Fmamb thinmumi shstebmths omru-omru hih, perseitmse sulses fmrh =8 stufh ymig fhsertmlmi oervmrhmsh fmrh 0=00% .

 Pmskm Cpermsh 

Pmfm cpermsh jhstuam shbpae, pmshei fmpmt puamig pmfm dmrh ymig smbm seteamd cpermsh. Imbui pmfm jhstuam lcbpaels buiglhi beboutudlmi rmwmt himp oeoermpm dmrh. [eteamd cpermsh buiglhi mlmi terfmpmt sefhlht fmrmd mtmupui kmhrmi fmrh aulm cpermsh uitul oeoermpm dmrh, terutmbm sewmltu oumig mhr oesmr. Permwmtmi aulm pmskm cpermsh

 

beahputh shtz omtd (bereifmb fmermd pmitmt feigmi kmhrmi mithsepthl), fmi peiggmithmi  omautmi sekmrm ruthi. Comt comtmi ymig fhoerhlmi uitul rmwmt nmami mitmrm amhi mithohcthlm, mimagethl fmi amlsmthj. Mlthvhtms sedmrh dmrh ububiym thfml tergmiggu fmi pmshei fmpmt lebomah oelernm seteamd oeoermpm dmrh. Pmshei fmpmt lebomah beiyethr oham iyerh sufmd  oerlurmig. Pmshei thfml fhminurlmi oereimig seoeaub aulm seboud, fmi thfml fhsmrmilmi uitul fuful fhmb oerambm-ambm.6,5  6.4

Lcbpahlmsh=,?,;

Lcbpahlmsh fhih pmskm cpermsh, seomgmh oerhlut > 

_eteish urhi



Peifmrmdmi



Hbpmlsh thinm



Vdrcbocsef wmshr 

Lcbpahlmsh tertuifm pmskmcpermsh, seomgmh oerhlut > 

Lmboud



Hilcithieishm



steicshs Mima> Prcses peiyeboudmi beiyeomolmi jhorcshs fmrh auomig mius. Oualhig mgei uitul bebomitu beikegmd omiglu sebpht.

6.8

Prcgicshs Jhstea fmpmt lmboud oham auomig fmamb thfml turut fhoulm mtmu fhleaumrlmi, kmomig jhstea

th thfml fml turut turut fhoulm, fhoulm, mtmu mtmu luaht luaht sufmd sufmd beiutu beiutup p aulm aulm seoeau seoeaub b nmr nmrhig higmi mi grmiua grmiuamsh msh beiebp beiebpea ea  perbulmmi. [eteamd jhstuactcby stmifmr, thiglmt lelmboudmi fhampcrlmi mfmamd 0-=4% fmi thiglmt fmrh sethmp hilcithieishm thinm mfmamd ;-7%. [eteamd beigguimlmi [etci, beampcrlmi thiglmt lelmboudmi mfmamd 0-=7% fmi thiglmt fmrh sethmp hilcithieishm jeses mfmamd 0-=7%. [eteamd jamp bulcsm lebmnumi, thiglmt lelmboudmi fhampcrlmi mfmamd =-=7% fmi thiglmt fmrh sethmp hilcithieishm jeses mfmamd :-4%. ; OMO Z

 

PEIUVUP



Jhstuam perhmima ymig berupmlmi seoumd duouigmi ymig moicrbma mitmrm ephtea fmrhh lmimah fmr lmimahss mima mima fmi ephfer ephferbhs bhs fmrh fmrh luaht luaht perhmi perhmima. ma. Jhstua Jhstuamm perhmi perhmima ma mfmamd mfmamd  oeitul lrcihl fmrh moses micreltma ymig thfml seboud ymig beboeitul trmltus mlhomt hijambmsh.



Dmbphr sebum jhstea perhmima perhmima fhseomolmi fhseomolmi caed perjcrmsh perjcrmsh mtmu peiymahrmi peiymahrmi moses micrelt micr eltub, ub, sedhig sedhiggm gm leomiym leomiymlmi lmi jhstea jhstea bebpuiy bebpuiymh mh smtu smtu bumrm bumrm fh lrhptm lrhptm fh  peromtmsmi mius fmi reltub fmi auomig amhi fh perhieub luaht lepmam.



[eomghm [eom ghmi i oesmr oesmr jhstu jhstuam am perhmi perhmima ma bebera beberaulmi ulmi cpermsh cpermsh lmreim lmreim jhs jhstua tuamm mih nmr nmrmig mig seboud spcitmi. [eteamd cpermsh rhshlc lelmboudmi jhstuam terbmsul kulup thiggh ymhtu ymh tu se selh lhtm tmrr ?= ?=% % (s (smt mtu u fm fmrh rh ahbm ahbm pm pmsh shei ei fe feig igmi mi jh jhst stua uamm pc pcst st cp cper erms mshh ml mlmi mi beigmambh lelmboudmi).

 

FMJVM_ PU[VMLM =. [mohs [mohstc tci i F, F, Csw Cswmr mrhh NN.. Oulu  Oulu Mnmr Oefmd. Oefmd. Nmlmrtm > Peieroht Oulu Lefcltermi EGK.=886. ?. [k [kdw dwmr mrtz tz,, [dhr [dhres es,, [pei [peike ker  r . Hith Hithsm smrh rh Pr Prhi hish shpp-Pr Prhi hish shp p Ha Habu bu Oe Oefmd fmd,, Efhs Efhshh : . Nm Nmlm lmrt rtmm >EGK.?000. ;. [nmb [nmbsu sudh dhfm fmnm nmtt _, Fe Ncig Ncig Whb. Whb.  Oulu Mnmr Habu Oefmd. Oefmd. Efhsh le-?. Nmlmrtm >Peieroht Oulu Lefcltermi EGK.?006.Dma 767-764 6. Grmk Grmkee P, P, Ocr Ocrae aey y I. I. Mt m Gamike Habu Oefmd. Efhsh lethgm.Nmlmrtm lethgm.Nmlmrtm > Eramiggm.?00:. 5. _els _elscp cprc rcfn fnc c [. Lubpuami [. Lubpuami Luahmd Habu Oefmd. Oefmd. Nmlmrtm > Ohimrupm Mlsmrm. ?000. :.

Kcrbmi, B.A. Kcaci mif _ektma [urgery 5td Ef . Ahpphikctt Whaahmbs & Whalhis. ?005.