Hannu Kalimo - Neuropathology of CADASIL and other small artery diseases of the brain (SADB)

7/29/2019 Hannu Kalimo - Neuropathology of CADASIL and other small artery diseases of the brain (SADB)

http://slidepdf.com/reader/full/hannu-kalimo-neuropathology-of-cadasil-and-other-small-artery-diseases-of 1/55

@kurjpetbjcjgy jo LEME\IC

e`m j tbkr saecc ertkry m iskesks

jo tbk hrei` (\EMH) Be`ù Fec iaj ]urfu e`m Bkcsi`f i

Oi`ce`m



• Bkrkmitery sa ecc ertkry m iskesks j o hrei`

• LEME\IC (lkrkhrec eutjsjaec mjaiè`t ertkrijpetby witbsuhljrtilec iòerlts e`m ckufjk`lkpbecjpetby )

• LEE (lkrkhrec eaycjim e`gijpetby)• \wk-bAIM (\wkmisb bkrkmitery aucti-iòerlt mkak`tie)

• LEXE\IC (lkrkhrec eutjsjaec rklkssivk ertkrijpetby witb

suhljrtilec iòerlts e`m ckufjk`lkpbecjpetby)

• ÊMAEC (pj`ti`k eutjsjaec mjaiè`t ailrje`gijpetby e`m

ckufjk`lkpbecjpetby )

• Xkt ièc veslucjpetby w itb lkrkhrec ckufjmystrjp by (X_LC)

• LJC=E5 essjlietkm \EMH

• Oehry m iskesk

•

_erie

• \pjremil saecc ertkry m iskesks j o hrei`

• LEE (lkrkhrec eaycjim e`gijpetby)

• Ertkr ij cjsl ckrjs is (–Hi`swe`gkr½s miskesk‑)



I` LEME\IC jvkr 8>> miookrk`t autetij`s bevk hkk` rkpjrtkm wjrcm-

wimk i` KGO rkpkets (5-<8 ) jo tbk kxtrelkccucer mjaei` jo

@jtlb< (@<KLM). Ajst jotk` tbk autetij` rksucts i` e` u`kvk`

ùahkr jo lystki`ks (kitbkr gei` jr cjss jo e` u`kvk` ùahkr jo lystki`ks).

@jtlb< u`mkrgjks < lckevegks (\5-\<). @ILM k`tkrs ùlckus

e`m rkgucetks tre`slriptij`

X H ^ D

X H ^ D

BMEl

BMEl

LjX

LjX

AEAC5

BEl

Bks/Bky

X H ^ D

X H ^ D

BMEl

BMEl

LjX

LjX

AEAC5

BEl

Bks/Bky

\igèci`g lkcc

Xklkivi`g lkcc (veslucer

sajjtb aus-

lck lkcc )



B&K

Ljccegk` I

@jtlb < kxtrelkccu cer

mjaei` (@<KLM, aeh 5K=)

B&K Ê\

e- sajjtb ausl ck

elti`

LEME\IC,lkrkhec wbitk

aettkr 0

Lj`trj c , lkrkhrec

Wbitk aettkr



Lkrkhrec H cjjm Ocjw ^jsi trj` kaiss ij` tjajgrepby

êtik`t A/<= (strjfks) Lj`trjc A/<5

]ujai`k` kt ec, \trjfk 8>>=6<;45>?<-?7



Ertkr ie c Lbe`gks i` LEME\IC i` Xkcet ij` tj ̂ etbjg k`ksis jo Mio ousk

Aykc i` Cjs s jo Lkrkhrec Wbitk Aettkr 4 Kxeaièt ij` jo Lkrkhrec Akmuc cery

Er tkriks hy Xklj` strult ij` jo \kr ie c \klt ij`s jo e` Eutj psy Lesk ..

Xkm zj`k4lj`tiùjus cjss jo

_\ALs

Xkm mjttkm

zj`k4 mislj`tiùjus

cjss jo _\ALsGrkk` zj`k4

i`tiaec oihrjus

tbilfkì`g

Hcuk zj`k4

emvk`titiec oihrjsis

…

Jfkme kt ec. (\trjfk 8>>86<<48;?;-9)

– Ectbjugb i`tiaec

oihrjsis jr byeci`jsis

wes prksk`t, cuaièc

jllcusij` wes slerlk.‑



Bistjgrea jo i`tkrèc mieaktkr jo ertkrijcks

hktwkk` LEME\IC e`m lj`trjc grjup i` W A

>

5>

8>

<>

; 8 > < ; ; > ? ; 2 > 9 ;

I`tkrèc m ieaktkr jo ertkrijcks i` aa

^ k r l k ` t %

LEME\IC (̀ 1989)

lj`trjc (̀ 1852)B&K

Ê\

Aiej kt ec. Hrei` êtbjc 8>>=65=4<;2-<?=.



I` LEME\IC jl-

lcusij` jo e pk`k-

treti`g lkrkhrec

ertkry rksucts i` e

celuèr iòerlt (3),

hkleusk pk`k-

treti`g ertkriks erktkraièc witbjut

ljccetkrec ocjw

orja tbk `kigb-

hjri`g ertkriks.

\tk`jsis Jllcusij`

e`m iòerltkm t issu k

3 Celuèr

iòerlt

Ljrtkx

Wbitkaettkr

Ljrtilec vs. wbitk aettkr ertk-

riks erk aktehjcileccy miookrk`t



LEME\IC4 Auct ip ck saecc (celuèr) iòerlts i` WA e`m

hesec ge`g c ie, wbkrkes lkrkhrec ljrtkx is rkcet ivkcy s perkm

0 3

3



LEME\IC mjks `jt prjtklt orja lcessil risf oeltjrs4

E LEME\IC petik`t witb p.X5<<L autetij` bem ecsj skvkrk

akmiua-sizkm e`m saecc vksskc etbkrjslckrjsis i`lcumi`g

ljapcktk jllcusij` jo e` i`sucer hre`lb jo aimmck lkrkhrec

ertkry ( ) e`m e ljrtilec periktj-jllipitec iòerlt ( ).

LEME\IC iòerlts i` tbk wbitk aettkr ( 3 )

3

3

3



LEME\IC WA4 ertkrijcks

(@<KLM)

LEME\IC WA4 lepiccery

(@<KLM)

LEME\IC lkrkhrec ljrtkx4 saecc

ertkrijcks e`m e lepiccery ( ) (@<KLM)

I` LEME\IC hrei` @jtlb< kxtrelkccucer

mjaei` (@<KLM/GJA) elluaucetks

`jt j`cy j` WA ertkrijcks, hut ecsj j`WA lepicceriks (pkrilytks), es wkcc es

j` tbksk vksskcs i` lkrkhrec ljrtkx,

ectbjugb ljrtilec ertkrijcks erk `jt

kqueccy tbilfk`km.

\i`lk ertkrijpetby i` LEME\IC is gk-

`kreciskm, elluaucetij` jo @<KLM

le` ecsj hk sbjw` hy iaau`jstei`-

i`g e mieg`jstil sfi` hijpsy, hut...

`krvk

* 1 ertkriks

*

* *

*



Kckltrj` ailrjgrepb jo e saecc mkraec ertkry4 wimk`km suhk`mjtbkciec

spelk ( ), irrkgucerity jo veslucer sajjtb auslck lkccs (_\ALs) e`m

greùcer jsaijpbicil aetkriec (GJA, errjws). K 1 k`mjtbkciua

Cuak`

_\AL

_\AL

_\AL

_\AL

_\AL

*

**

* K

K

K

*



\pklioil tj LEME\IC is kckltrj` ailrjsljpil oi`mi`g jo greùcer jsaijpbicil aetkriec (GJA * ) i` i`mk`tetij`s (`jtlbks) jo e`m ̀ kxt tj mkgk`kreti`g ves-lucer sajjtb auslck lkccs. GJA bes hkk` mkaj`stretkm i` ecc LEME\IC

lesks witb e @jtlb< autetij` rksucti`g i` e` u`kvk` ùahkr jo lystki`ks i`@jtlb< kxtrelkccucer mjaei`. (@ 1 ùlckus). ]iff e kt ec. Hrei` 8>>96 5<849<<-9<9

5 a a >.= a a

*

*



Mkpjsitij` jo @jtlb< kxtre-

lkccucer mjaei` (@<KLM) le`

ecsj hk sbjw` witb iaau`j-

steiì`g, hut KA mkaj`stre-

tij` jo GJA is ajrk rkciehck,ksp. et tbk hkgi`ì`g jo tbk

miskesk witb j`cy saecc

eaju`ts jo @<KLM/GJA .

\fi` hijpsy4 @<KLM

iaau`jsteiì`g

`krvk*

*

3

59-yker-jcm aeck LEME\IC petik`t,

k ckltrj` a ilrjslj py jo e mkraec er tkry

3

@<KLM iaau`jsteiì`g

*

@krvk

* 1 ertkriks

]iff e kt ec. Hrei` 8>>96 5<849<<-9<9



]iff e kt ec. Hrei` 8>>96 5<849<<-9<9

LEME\IC e`m truk GJA Kcesti` oregak`ts

Greùcer mkhris jo u`f`jw` jrigi`

_eriehck lkcc mkhris

_eriehck lkcc mkhris



Aizu`j kt ec.

I`tkr Akm =74

8>?7-78, 8>>2

\lbkim kt ec.

@kurjcjgy

75477=-?, 8>>2

Hress kt ec.

@KDA 8>>96

<?>45?;?-?;

GJA bes hkk` mkaj`stretkm i` ecc LEME\IC lesks witb e @jtlb< autetij` rksucti`g i` e` u`kvk` ùahkr jo lystki`ks i` @<KLM. Bjw ehjut `j`-lys lesks…:



]bk @J]LB < prjtki`

Miaitrijs _celbefis e`m \jpbie Fjssime

Hijakmilec Xkskerlb Oju`metij`, Elemkay jo Etbk`s

h-sbkkth-tur`

e-bkcix



CJ\\ JO θ-

sbkkt

\]X[L][XK

Erg

]rp



Milbge`s kt ec. (\trjfk 8>>86<<4?7-75)4

┎ AHs oju`m i` ?9% jo 5? LEME\IC

petik`ts e`m i` `j lj`trjc suhdklts

(p1 >.>>5)

┎ Essjl. witb egk (p1 >.>>8)

┎ Cjletkm i` ljrtilec-suhljrtilec rkgij`s (<2%), wbitk aettkr (8>%),

tbeceaus (5<%), hrei`stka (5=%)

┎ 28% cjletkm jutsimk erkes

eppkeri`g bypkri`tk`sk j` ]8w

iaegks

Cksìf Jhkrstki` kt ec. (@kurjcjgy

8>>56 ;74 5>?? “5>7>)4

┎ AHs oju`m i` <5% jo <8 syaptj-

aetil LEME\IC petik`ts.

┎ Essjl. witb egk (p3 >.>>2)

┎ Essjl. witb e`tipcetkckt usk (p3

>.>8;)

┎ Cjletkm i` tbeceaus (?5%), suhljr-

tilec WA (8?%), lkrkhkccua (?%)

]8* AXI

AXI4 Cksìf Jhkrstki` kt ec.

Ailrjhckkms i` LEME\IC



LEME\IC tergkts spklio ilec cy wbitk

aettkr ertkr ijcks, wbkrkes g rky aettkr ertkrijcks erk hkttkr prk-

skrvkm e`m tbk tbi``kr weccs jo

grky aettkr ertkr ijcks erk ajrk

prj`k tj ckef (0 a ilrjhckkms ).

WA4 @<KLM

Ljrt kx4 @<KLM

Ljrtkx4 a ilrjh ckkm





LEME\IC WA4 o ihr i`jg k`

Ailrjh ckkm i` LEME\IC ljrtkx4

o ihr i`jgk`

Hrkefmjw ` jo HHH i` bypkr -

tk`sij` 4 o ihr i`jgk`

I` LEME\IC tbk HHH j o tbk

tbilf k`km ertkr ij cks eppkers

tj hk rkcet ivkcy i`telt4 kxtre-

veset ij` jo pcesae prj tki`s

is a i` iaec.



Kpi ckpsy Lj`trj c

Oihri`jgk` kxtrevesetkm muri`g hrkefmjw` jo HHH mioousks tj

L\O e`m orja it is tefk` up hy lkrkhkccer ûrfi`dk lkccs (^L). I`

LEME\IC ^Ls rkaei` `kgetivk.

LEME\IC _F LEME\IC Af





• \wk-bAIM (\wkmisb bkrkmitery aucti-iòerlt mkak`tie)• LEE (lkrkhrec eaycjim e`gijpetby)




ckufjk`lkpbecjpetby )• Xkt ièc veslucjpetby w itb lkrkhrec ckufjmystrjp by (X_LC)


• Oehry m iskesk

• _erie






\ju re`mkr e`m Wëci`mkr j rigi` ec ert ilck ‑ Bkrkmitery auct i - iòerlt mkak`-

tie ‑ ( El te @kurjp etbj c <948=7-8;=65977). E. \aecc iòerlts i`4 5. r igbt or j`tec

wb itk aettkr , 8. r igbt lepsu ce i`tkrè e`m <. ckot pec cimua + saecc celu`ks

i` tbk hesec ge`gc ie. e e`m h4 Lyst il iòerlts i` pj`s (twj pet ik`ts ).

5.

8.

<

E



\wkmisb b krkmi tery au ct i -

iòerlt mkak`t ie ( \wk-bAIM )

]bk oeaicy jo \jure`mkr

e`m Wëci`mkr (Bkrkmitery aucti-iòerlt mkak`tie. Elte

@kurjpetbjc <948=7-8;=65977 )

wes cj`g lj`simkrkm tbkoirst puhc. LEME\IC oeaicy.

\wk-bAIM ]8w AXI

LEME\IC p.X5=5L

(Cjw kt ec. Hrei` 5<>4 <;7 “<?76 8>>7)

\wk-bAIM ]8w AXI

\wk-bAIM ]8w AXI

]8w AXI



Oketurk \wk-bAIM LEME\IC (\tkvk`s

p.X5=5L)

@j. eookltkm 9 =

Ake` egk et j`skt ( µ \M) <=.? µ <.= =2 µ <

J`skt re`gk 89 - <2 <9-;7

Ake` egk et mketb ==.< µ =.< ?> µ 7

Muretij` (ykers) 55 µ 8.5 5=.? µ =.;

@j. jo strjfk kpisjmks 0= 0?

Cjw kt ec. Hrei` 8>>765<>, <;7 “<?7



LEME\IC, @<KLM \wk-bAIM, @<KLM

@

]bk ehsk`lk @jtlb <

KLM (L) e`m GJA (K)

i` \wk-bAIM e`m tbkir

prksk`lk i` LEME\IC

(M e`m O).

\wk-bAIM,

k ckltrj` ailrjsljpy K O

LEME\IC,

k cklt rj` ailrjsljpy @



Miookrk`tiec mieg`jsis LEME\IC vs . \wk-bAIM

• Aigrei`k kpisjmks hkojrk j`skt jo strjfks ljaaj` i`

LEME\IC, `jt rkljrmkm i` \wk-bAIM

• AXI4 Cksij`s i` tkapjrec cjhks e`m lepsuce kxtkrè

ljaaj` i` LEME\IC, uùsuec i` \wk-bAIM• \fi` hijpsy4 GJA rkgucercy oju`m i` LEME\IC, `jt i` \wk-

bAIM

I` = akahkrs jo tbk \wkmisb oeaicy `j petbjgkìl autetij`s

wkrk oju`m i` tbk k`tirk 2>95 hp rkemi`g oreak jo @J]LB<`jr lcker kvimk`lk ojr @J]LB< gk`k ci`fegk.

I` \tkvk`s oeaicy p.X5=5L autetij` ljòirakm LEME\IC mg.

Cjw kt ec. Hrei` 8>>76 5<>, <;7 “<?7

Oigurks o rja Cjw kt ec Hrei` 8>>76 5<> <;7“<?7



LEME\IC, B&K

\wk-bAIM, e-\AE

\wk-bAIM, akmi`

LEME\IC, e-\AE

\wk-bAIM, B&K

LEME\IC, akmi`

\lckrjt il i`m ilks i`

\wk-bAIM vs .

LEME\IC4

Orj`tec wb itk aettkr 4

\wk-bAIM4 ake` >.<>

% witb ≫ >.;> =.=%

LEME\IC4 a ke` >.<9

% witb ≫ >.;> 7.=%

Hesec ge`gc ie4

\wk-bAIM4 ake` >.<<

% witb ≫ >.;> 2.<%

LEME\IC4 a ke` >.<?

% witb ≫ >.;> 59.9%

Lreggs kt ec. Hr ei`

êtbj c 8>5<68<4;=7-;;7

Oigurks o rja Cjw kt ec. Hrei` 8>>76 5<>, <;7 “<?7











• Oehry m iskesk

• _erie






Bkrjvili \ajjtb au slck elt i` Ljc cegk` I

B&K

Bkrjvili B&K

Oigs E-L orja Feciaj kt ec. Grkkòikcm ½ s @kurjpetbjcjgy 2tb km. 8>>26 Oig. M ljurtksy jo Mr. B

_i`tkrs6 Oig. K orja Eceouzjoo kt ec. Kxp Gkrj`tjc =7 (8>58) 28;-<<

K

E H L

M O



\aecc vksskc miskesk

E4 Greù cer lj rt ilec

etrjpby

H e`m L4 saec c iòerlts

E H

L



Etbkrjslckrjsis i` saecc ertkriks is i` pri`lipck siaicer esi` cergkr vksskcs. I` hrei` ertkriks it lrkkps mjw` tj

saecckr hre`lbks e`m aey leusk stk`jsis jr jllcusij`.

Kahjci mktelbkm orja pcequks jo cergkr vksskcs le` cjmgk i`

saecc ertkriks e`m leusk jllcusij`.











• Oehry m iskesk

• _erie






\wkmisb (p.FA?7>-?75@C)

Jutkr ceykr

I``kr ceykr Ocjrime (p.I75?_)

↞ Erltil (p.K?9<G), Mutlb (p.K?9<U),

Itecie` (p.K?9<F)

Ockaisb (p.E?98G)

↘

↕Ijwe (p.M?9=@)

_ 0 O (I`mieè), _ 0 G jr 0 I(Cj`mj`)

e-sklrktesk

h-sklrktesk

g-sklrktesk

Itecie` rklkss (p.E?7<_) ↘

┎ Io tbk autetij` is i` Eh, eay-

cjim is autetkm jr aut+wt.

┎ Io tbk autetij` is i` ajcklu-

cks rkguceti`g Eh prjlkssi`g,

eaycjim is jo wicm typk (wt)

Jllipi tec ljr tkxLj`gj rkm ]bijo cevi`



Eh5-=>

Jllipi te c ljrtkx

Eh5-=>

Lj`gj rkm

+ hirkor i`gk`l k B&K

Kckltrj` a ilrjslj py4 Eh eaycj im o ihr i cs

(Erl t il EM muk tj p .K?9<G autet ij` i` E θ^^)

]bijo cevi`

Lkrkhrec eay-

cj im e`gijpetby

(LEE ) eooklts

vksskcs jo ec c

s izk i`lcum i`g

sa ecc ertkr iks

mjw ` tj lep i c-

cer iks.

‑ mjuhck herrkci`g ‑

(bkrk tbk kxtkrèc mieaktkrs erk tbk seak



LEME\IC LEEB&K Lj`gj rkm

LEME\IC

LEE

3

LEME\IC WA4 ertkr ij cks

(@<KLM)

LEME\IC

3

(bkrk tbk kxtkrèc mieaktkrs erk tbk seak

ILB jo cjher typ k

Jllip i tec lj r tkx J i i cI` LEE E jotk`



Jllip i tec lj rtkx,

Erlt il EM muk tj

p.K?9<G autetij`

i` E θ^^

Eh5-=>

Jllip i te c lj rtkx

i` spj rem il EM

E .

Oig. E4 Feciaj kt ec. Elte @kurjpetb Ljaa 8>5< i` pri`t, Oigs H e`m L4 ]bec kt ec. @kurjhijc

Egi`g <> (8>>9) 59<?-=2

I` LEE Eh jotk`

elluaucetks

ecsj i` lepi c ce-

r iks, i` skvkrk

lesks it leusks

lepi c cery jll -

cusij` e`m LHO

misturhe`lks,

hut r erkcy jvkrt

i` oerlts.

Lepi c cery LEEaey lj `t r ihu tk

tj tbk mkgk`kre-

t ij` jo ̀ kurj`s

i` E czbkiakr ½ s

miskesk hy ectkr- i`g/ iapeir i`g

LHO.

\lckrjt il i`mkx (\I)



( )

5 “ (i`tkrèc mieaktkr/kxtkrèc m ieaktkr)

i .k. tbk b igbkr tbk vecuk, tbk tb ilfkr is tb k wecc , e`m i` e`

jh c i tkretkm ertkry

\I 1 5

\LCKXJ]IL I@MKR (\I) E@ECY\I\**

\I \]MK_ ]-]K\]

LEME\IC

WA (`1989) >,7< >,5= ^3>.>5LJX]KR (`18;>) >,;? >,5< ^1>.><

LJ@]XJC\

WA (`1852) >,=; >,5?

LJX]KR (`18;2) >,;< >,5?lwEM

WA (`18<8) >,=< >,5<

LJX]KR (`1=5?) >,=2 >,5<

**4 hcjjm vksskcs witb kxtkrèc mieaktkr ckss tbe` <> aa erk kxlcumkm.

^\5M9 EM



Wkcckr kt ec. Hrei` êtbjcjgy 8>>26 524 8;< “8??



LEXE\IC

(lkrkhrec eutjsjaec rklkssivk ertkrijpetby witb


• Oirst rkpjrtkm hy Aekme kt ec. i` tbrkk sihci`g petik`ts orja e

Depe`ksk oeaicy prkciaièricy i` 59?; e`m i` grketkr mkteic

597? witb \. Aekme es tbk oirst eutbjrs, bk`lk hkk` ecsj

lecckm Aekme sy`mrjak. Ehjut ;> lesks mieg`jskm, aei`cy i`

Depe`, hut ecsj i` Lbiè e`m 5 Leulesie` petik`t i` \pei`.

• J`skt muri`g petik`t’s twk`tiks tj kercy tbirtiks es e veslucj-

petbil suhljrtilec k`lkpbecjpetby witbjut bypkrtk`sij`.

• @kurjcjgil syaptjas4 skvkrk psylbjajtjr mktkrijretij`

leuskm hy suhljrtilec k`lkpbecjpetby4 k.g. mysertbrie,myspbegie, kajtijèc i`stehicity, e`m spestil geit.

• @j`-`kurjcjgil syaptjas erk k.g4 ecjpklie, vkrtkhrec misl

bkrìetij`, e`m spj`mycjsis mkojrae`s.



Yeaeajtj kt ec. @kurjpetbjcjgy e`m Eppcikm

@kurjhijcjgy <7, 9= “55<

LEXE\IC, akì`gkec ertkry LEXE\IC WA ertkry



, g y

LEXE\IC, WA ertkry Lj`trjc, akì`gkec ertkry

LEME\IC, akì`g. ertkry LEXE\IC, akì`g. ertkry

LEXE\IC4 oihrjus i`tiaec

prjciokretij`, spcitti`g jo tbk

i`tkrèc kcestil ceaiè, e`m

jllesijèc byeci`k mkgk-

`kretij`, hut rksucts j` cu-

aièc stk`jsis mislrkpe`t.

\lckrjtil i`mkx4 (` 1 8)

Lj`trjcs4 >.576 >.82

LEXE\IC WA4 >.8;6 >.<9

LEME\IC WA4 >.?5

Jimk kt ec. @kurjpetbjc, 8>>26 8245<8-5=8

LEXE\IC, WA ertkry



Oirst Leulesie` (\peìsb ) LEXE\IC petik`t 4

]8- e`m ]5-wkigbtkm AXI lbe`g ks4

•

Mioousk ckufjk`lkpbecjpetby i`vjcvi`g pkrivk`trilucer e`m mkkp WA,i`lcumi`g e`tkrijr tkapjrec cjhks e`m kxtkrèc lepsucks.

• Auctipck celuèr iòerlts mkkp WA e`m GA e`m hrei`stka (L e`m M).

• Auctipck ailrj-hckkms i` pj`s, hesec ge`gcie, e`m bkaispbkril suh-ljrtilec WA (K).

]8w AXI ]5w AXI ]8*-GK AXI

Ak`mijrjz kt ec. @kurjcjgy 8>586 7;4 8><<-<7

B mit cc t m i o h i











• Oehry m iskesk

• _erie




ÊMAEC



Mi`g kt ec D @kurjiaegi`g 8>5>6 8>45<=-5=>

ÊMAEC

ÊMAEC, ljccegk` I_ ÊMAEC,



ÊMAEC, e-\AE

, g

ÊMAEC, LM?2 a ilrjgie

ÊMAEC, ve` Giksj` -kcestile

ve` Giksj`-kcestile

ÊMAEC



ÊMAEC

Begkc kt ec. Elte @kurjpetb 8>>=6 5>248<5-=>

ÊMAEC

ÊMAEC, ljccegk` I_



, g

ÊMAEC , KA












• Oehry m iskesk

• _erie




Xktièc veslucjpetby witb lkrkhrec ckufj-



p y

mystrjpby (X_LC), jo typk BKX@\

(bkrkmitery k`mjtbkcijpetby, rkti`jpetby,

`kpbrjpetby, witb strjfk-cifk kpisjmks),

is leuskm hy autetij`s i` ]XKR5 (tbrkk

priak rkpeir kxjùlckesk 5) LM?2 ojr ailrjgcie

@kurjoiceak`t

Oigurks l jur tksy j o Mr. B _i`tkrs B&K

@jrmil LEME\IC rkskerlb grjup



@jrmil LEME\IC rkskerlb grjup

Lciìlec stumiks

“ Aetti _iite`k` [ jo ], Ferjc I`st “ \use`è Xji`k [ jo ]

“ Euci _krffjìkai [ jo B

êtbjcjgy

“ Be`ù Feciaj [ jo B “ Ciise Ayccyfe`ges [ jo B

“ Ui`g Aiej [ jo ]

Gk`ktils

“ Ai`è ^ÿybÿ`k` [ jo B

“ Aeide \iitj`k` (`kk Du`è)* [ jo ]

“ ^ktre êse`k`* [ jo ]

^rjtkjails e`m ajcklucer hijcjgy

“ Aerl Heuae`` [ jo B

“ \eere ]iffe [ jo B

“ Aelikd Cecjwsfi [ jo B

“ [rhe` Ck`mebc e`m tkea Ferjc I`st

Iaegi`g e`m ^K] stumiks

“ Dube Xi``k [ jo ]

“\use`è Xji`k [ jo ]

Jpbtbecajcjgy

“ ]krj Fivkcí [ jo B

“êuce \uaae`k` [ jo B

[ jo B 1 [ìv jo Bkcsi`fi, Oi`ce`m [ jo ] 1 [ìv jo ]urfu, Oi`ce`m Ferjc I`st 1 Ferjci`sfe I`st, \wkmk`



LEME\IC4 ]8w AXI w itb lj`-

o cuk`t bypkri`tk`si t iks

Djk`suu

Bkcsi`fi

^jri

_eese

X5<<L X528L

↕

]urfu



]urfu ljet jo eras

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