skeletal mets

7/23/2019 skeletal mets

http://slidepdf.com/reader/full/skeletal-mets 1/14

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http://dx.doi.org/10.1016/j.path.2012.01.001

http://surgpath.theclinics.com/
























http://dx.doi.org/10.1016/j.path.2012.01.001

mailto:[email protected]



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h~da han GLH!0> H ndhbajsds jc }fhslhot~jlh oha

`g ojacdplgn `t dllwajkds~jokgldohf s~hdas cjp

ON8?; han `t fh`jph~jpt s~wndgs! Dlhbdab s~wndgs

~kh~ skjr lwf~dcjohf fgsdjas rd~k agbh~dg phndjaw,

ofdng `jag soha hpg swbbgs~dg jc lwf~d}fg

ltgfjlh& rkdok ds jc~ga chfsgft agbh~dg `t `jagsoha!

Lgfhajlh nds}fhts h rdng phabg jc ljp}kj,

fjbdo h}}ghphaogs han segfg~hf dajfglga~ lht

`g ~kg cdps~ lhadcgs~h~dja jc ofdadohfft joowf~

ndsghsg! Lg~hs~h~do lgfhajlh ds ndsowssgn fh~gp

da bpgh~gp ng~hdf!

]PJBAJ_D_ JC LG^H_^H^DO OHPODAJLH

Lg~hs~h~do ndsghsg ~j ~kg segfg~ja ds kdbk s~hbg `tngcdad~dja! Da ohsgs jc dsjfh~gn `jag lg~hs~hsgs&

swpbdohf pgsgo~dja lht `g rhppha~gn5 kjrggp&

~kg }pdlhpt bjhf da ~kg sg~~dab jc segfg~hf lg~hs,

~hsds ds wswhfft }hffdh~dja!

Cdb! ;! ]fhda phndjbph}k jc ha hnhlha~dajlh jc ~kg~d`dh! Hnhlha~dajlhs ~t}dohfft hpdsg da ~kg ha~gpdjpojp~g{ jc ~kg ~d`dh jp cd`wfh!

]d~chffsLG^H_^H^DO OHPODAJLH

( Ojllja ldldoegps jc ohpodajlh +gb& js~gj,shpojlh& g}d~kgfdjdn habdjshpojlh& hanlgfhajlh$ lht g{}pgss g}d~kgfdhf ha~dbgas!

( Gga da ~kg sg~~dab jc eajra }pdlhpt ndsghsg&h sgojan }pdlhpt skjwfn `g g{ofwngn `tdllwajkds~jokgldohf han phndjfjbdo ghfwh,~dja!

Ndccgpga~dhf NdhbajsdsLG^H_^H^DO OHPODAJLH

@j~k kglh~jfjbdo han lgsgaoktlhf agj,}fhsls skjwfn `g ojasdngpgn!

Gga da ~kg sg~~dab jc eajra }pdlhpt ndsghsg&h sgojan }pdlhpt skjwfn `g g{ofwngn `tdllwajkds~jokgldohf han phndjfjbdo ghfwh,~dja!

_egfg~hf Lg~hs~hsds 04?



LG^H_^H^DO LGFHAJLH

JSGPSDGR

Lgfhajlh ds h phpg lhfdbahaot +h}}pj{dlh~gft8'‟?' jc ohaogps$! Hs dlhbdab ~gokajfjbt khs

hnhaogn& ~kg h`dfd~t ~j pgojbadyg lgfhajlh

lg~hs~h~do ~j `jag khs daopghsgn9 hf~kjwbk h s~wnt

cpjl 842; dnga~dcdgn segfg~hf lg~hs~hsgs da 2' jc

ohsgs wsdab pjga~bgajbphl han*jp `jag soha&07

h s~wnt jc eajra lgfhajlh }h~dga~s wsdab O^

sohas fdld~gn ~j ~kg h`njlga& }gfds& okgs~& han

agoe cjwan segfg~hf lg~hs~hsgs da 82' jc ohsgs!03

Rkjfg,`jnt LPD ngljas~ph~gn ~kg bpgh~gs~ daod,

ngaog da }h~dga~s rkj khn aj~ ndgn jc ndsghsg9

?0'!02 Da h sw`sg~ jc }h~dga~s rkj ndgn jc ~kgdp

ndsghsg han rgpg sw`sgxwga~ft hw~j}sdgn& ~kg

daodngaog phabgn cpjl 0?' ~j >4'!0;&04


LGFHAJLH

Lg~hs~h~do lgfhajlh ~t}dohfft dajfgs ~kg h{dhf

segfg~ja +daodngaog 2='‟;='$ hs j}}jsgn ~j~kg h}}gandowfhp segfg~ja han ds ljs~ ojllja

da ~kg pd`s han gp~g`phf ojfwla!07&?= ^kg phndj,

fjbdo h}}ghphaog ds wswhfft jc ha js~gft~do fgsdja

~kh~ ds googa~pdo han ~kh~ khs h ldadlhf }gpdjs~ghf

pgho~dja!07&?= ]h~kjfjbdo cpho~wpg ds jc~ga ~kg ofda,

dohf }pgsga~h~dja! Lg~hs~h~do ndsghsg ojlljaft

hccgo~s ~kg ndh}ktsds jp lg~h}ktsds!?=

@jag soha lht `g agbh~dg& ngs}d~g phndjfjbdo

gdngaog jc lg~hs~h~do ndsghsg!?= Ja LPD& lgfh,

ajlh skjrs daopghsgn ^8 sdbahf da~gasd~t& rkdok

lht `g h~~pd`w~gn ~j lgfhada }dblga~!?8 H sjc~

~dsswg ojl}jaga~ lht `g }pgsga~& h }j~ga~dhf

}d~chff da g{ofwndab }pdlhpt shpojlhs jc `jag!04

H ojl}hpdsja jc rkjfg,`jnt LPD han rkjfg,

`jnt O^ skjrgn ~kg cjplgp ljnhfd~t ~j `g ljpg

sgasd~dg da dnga~dctdab segfg~hf lg~hs~hsgs han

skjrgn ~kg bpgh~gs~ daodngaog jc segfg~hf lg~hs,

~hsgs g{og}~ cjp hw~j}st s~wndgs!02

BPJ__ ]H KJFJBT JC LG^H_ H^DO

LGFHAJLH

Kghdft }dblga~gn lg~hs~h~do lgfhajlh ds}gpkh}s ~kg `gs~ g{hl}fg jc h ojppgfh~dja `g~rgga

bpjss h}}ghphaog han ndhbajsds! Da ohsgs jc hlg,

fhajsds& kjrggp& lg~hs~h~do lgfhajlh khs aj

s}godcdo nds~dabwdskdab cgh~wpgs!

Cdb! 4! Hah}fhs~do& jp}fhslh`fhs~do& }fhslhot,~jlh& okhpho~gpdygn `tskgg~s jc fhpbg ogffs oja,~hdadab ldadlhf ot~j,}fhsl han h }pjldaga~awofgjfws!

Egt ]jda~sLG^H_^H^DO LGFHAJLH

8! Lg~hs~h~do lgfhajlh ~t}dohfft lg~hs~hsdygs~j ~kg h{dhf segfg~ja& gs}godhfft ~kg pd`s hangp~g`phf `jndgs!

0! Gga da ~kg h`sgaog jc eajra lgfhajlh&~kds ga~d~t skjwfn `g g{ofwngn nwg ~j ~kg}jssd`dfd~t jc joowf~*waeajra }pdlhpt lgfh,ajlh!

Ngtpw}04>




LGFHAJLH

Lgfhajlh ds eajra hs ‖~kg bpgh~ dld~h~jp“ han ~kds

kjfns ~pwg da segfg~hf lg~hs~hsgs! Gga da ~kg

h`sgaog jc h kds~jpt jc lgfhajlh jp gdngaog jc

lgfhada }dblga~ ja ldopjsoj}do g{hldah~dja& hadllwajkds~jokgldohf }hagf ~kh~ daofwngs _,8==

}pj~gda& KL@,>7 han Lgfha,H skjwfn `g }gpcjplgn&

`gohwsg ~kgpg hpg pg}jp~s jc segfg~hf lg~h,

s~hsgs cpjl waeajra*joowf~ }pdlhpt + Cdb! 8= $!?0&??

Cdb! 8=! + H$ Lg~hs~h~dolgfhajlh da ~kg soh}wfh&okhpho~gpdygn `t hbwgags~s jc s}danfgn hang}d~kgfdjdn ogffs& lhat jc

rkdok oja~hda }pjldaga~awofgjfd! +@$ ^kg ndhb,ajsds jc lg~hs~h~do lgfh,ajlh oha `g ojacdplgnrd~k dllwajs~hdas cjp _,8== }pj~gda +skjra kgpg$&KL@,>7& han Lgfha,H!

Ndccgpga~dhf NdhbajsdsLG^H_^H^DO LGFHAJLH

@j~k g}d~kgfdhf han lgsgaoktlhf agj}fhslsskjwfn `g ojasdngpgn!

Ha dllwajkds~jokgldohf }hagf skjwfn `g}gpcjplgn!




Ngohfodctdab hbga~s sggl aj~ ~j sdbadcdoha~ft

ndldadsk ha~dbgadod~t jc _,8== }pj~gda han lgfhada

lhpegps!82&?> Hf~kjwbk lg~hs~h~do lgfhajlh lht

g{}pgss }haot~jegph~da& g{}pgssdja jc OHL 7!0 ds

wswhfft aj~ sgga!?7&?3

NDHBAJ_D_ HAN NDCCGPGA^DHF NDHBAJ_D_JC LG^H_ H^DO LGFHAJLH

Lg~hs~h~do lgfhajlh oha skjr ljp}kjfjbdo han

dllwakds~jokgldohf jgpfh} rd~k lg~hs~h~do

ohpodajlh! Lg~hs~h~do ohpodajlhs nj aj~ g{}pgss

lgfhajot~do lhpegps jp _,8== }pj~gda5 kjrggp&

ot~jegph~da g{}pgssdja da lg~h~s~h~do lgfhajlh

ds rgff okhpho~gpdygn!?2

]pdlhpt }gpdhsowfhp g}d~kgfdjdn ogff ~wljp jc

`jag ds h phpg ga~d~t ~kh~ skhpgs g{}pgssdja jc lgf,

hajot~do lhpegps rd~k lg~hs~h~do lgfhajlh!?>&?;

Ot~jfjbdo h~t}dh& kjrggp& ds ldadlhf da ~kgsg~wljps! G{}pgssdja jc sljj~k lwsofg ho~da ha~d,

bgas ds hfsj kgf}cwf da g{ofwndab lg~hs~h~do

lgfhajlh!

]PJBAJ_D_ JC LG^H_^H^DO LGFHAJLH

]pjbajsds ds }jjp da lgfhajlh }h~dga~s rd~k segf,

g~hf lg~hs~hsgs! Lgha swpdhf ~dlg hc~gp ndhb,

ajsds jc segfg~hf lg~hs~hsds phabgs cpjl ?!7 ~j ;

lja~ks rd~k h}}gandowfhp lg~hs~hsgs ~t}dohfft

skjrdab ~kg fjabgs~ swpdhf!

?=&?4&>=

LG^H_^H^DO _HPOJLH

JSGPSDGR

^kg ljs~ ojllja sd~g jc sjc~ ~dsswg shpojlh

lg~hs~hsds ds ~kg fwab5 sgojanhpt segfg~hf dajfg,

lga~& wswhfft ~j pgbdjahf `jags& joowps jaft phpgft

han wswhfft hc~gp h fjabgp da~gphf ~kha fwab lg~hs,

~hsgs!>8‟>? ^kg ljs~ ojlljaft gaojwa~gpgn

ga~d~dgsdaofwnglt{jdn fd}jshpojlh& pkh`njltjshp,

ojlh& hfgjfhp sjc~ }hp~ shpojlh& ngndccgpga~dh~gnfd}jshpojlh& habdjshpojlh& han pkh`njltjshp,

ojlh!>8&>0&>>&>7 Ohsgs jc okjanpjshpojlh& ohpndho

shpojlh& stajdhf shpojlh& han js~gjshpojlh

khg hfsj `gga pg}jp~gn!>?&>3&>2

^kg ljs~ ojllja lg~hs~hsgs ~j `jag da okdf,

npga hpg agwpj fhs~jlh& pkh`njltjshpojlh&

han Grdab shpojlh!0&>; Da hnnd~dja& ofghp ogff

shpojlh jc ednagt +cjplgpft eajra hs `jag

lg~hs~hsdydab pgahf ~wljp jc okdfnkjjn$& khs

h ~gangaot ~j lg~hs~hsdyg ~j `jag!>4 Phpg ohsgs

jc hopjlg~hs~hsgs jc js~gjshpojlh khg `ggangsopd`gn han skjwfn `g ojasdngpgn da tjwabgp

}h~dga~s rd~k hophf lhfdbahaodgs!8=


_HPOJLH

O^ han pjga~bgajbph}kdo ghfwh~dja jc lg~hs~h~do

shpojlh wswhfft skjrs js~gjftsds& rd~k ~kg g{og},

~dja jc js~gjshpojlh& rkdok lht `g `fhs~do! Hs

rd~k lg~hs~h~do ohpodajlh& h }gpdjs~ghf pgho~dja

ds wswhfft h`sga~! ^kgsg ~wljps cpgxwga~ft }pgsga~

rd~k }h~kjfjbdo cpho~wpg!

LPD han soda~dbph}kdo ghfwh~dja jc okdfnpga ds

ojl}fdoh~gn t ~kg kdbk ogffwfhpd~t jc ~kgdp kglh~j,

}jdg~do lhppjr& rkdok lht j`sowpg lhppjr

lg~hs~hsgs han js~gj`fhs~do ho~dd~t jc ~kg g}d}k,

tsghf }fh~gs!7= Hf~kjwbk CNB,]G^ ngljas~ph~gs

bpgh~ sgasd~dd~t da dnga~dctdab `jag lg~hs~hsgs da

okdfnpga han tjwab hnwf~s& ~kds ljnhfd~t ds fdld~gn

`t h kdbkgp }gpoga~hbg jc chfsg,}jsd~dg pgswf~s!

Ljpgjgp& h slhff s~wnt jc CNB,]G^ da segfg~hf

lg~hs~hsgs jc }pdlhpt `jag shpojlhs skjrgn

lg~hs~h~do js~gjshpojlh ~j `g cpgxwga~ft chfsgftagbh~dg!78 CNB,]G^ ds ofghpft sw}gpdjp ~j `jag

soda~dbph}kt& kjrggp& }gpkh}s nwg ~j fh~g js~gj,

`fhs~do pgho~dd~t ~j lhppjr lg~hs~h~do ndsghsg

han ~kg `pdse lg~h`jfdo ho~dd~t jc ~kgsg kdbk,

bphng ~wljps!78&70

Agwpj`fhs~jlh lht lg~hs~hsdyg ~j ~kg sewff&

}gfds& pd`s& han lg~h}ktsds jc fjab `jags! ^kg

fgsdjas hpg ft~do jp h}}ghp hs dppgbwfhp hpghs jc

fwogaot! _ofgpjsds lht `g sgga da das~haogs jc

~wljp dachpo~dja han ~kgpg ds jc~ga h }gpdjs~ghf

]d~chffsLG^H_^H^DO LGFHAJLH

( Lgfhajlh lht lg~hs~hsdyg ~j `jag lhattghps hc~gp dad~dhf ndhbajsds5 h ~kjpjwbk ofda,dohf kds~jpt skjwfn `g j`~hdagn!

( @jag sohas lht `g chfsgft agbh~dg!

Egt ]jda~sLG^H_^H^DO _HPOJLH

8! Cjp ofdadohf lhahbglga~& d~ ds opd~dohf ~jndccgpga~dh~g }pdlhpt shpojlh jc `jag cpjllg~hs~h~do shpojlh!

0! Lt{jdn fd}jshpojlh& hfgjfhp pkh`njltj,shpojlh& han ngndccgpga~dh~gn fd}jshpojlhhpg ~kg shpojlhs ~kh~ lg~hs~hsdyg ljs~

cpgxwga~ft ~j `jag!

?! Dlhbdab ljnhfd~dgs khg s~pgab~ks hanrgheagssgs han skjwfn `g wsgn da ojl`dah,~dja!

Ngtpw}043



pgho~dja! Dnga~dcdoh~dja jc segfg~hf lg~hs~hsgs da

~kgsg }h~dga~s skjwfn `g `hsgn ja LPD han *jp

soda~dbph}kt `gohwsg O^ soha ds fgss sgasd~dg!7?

Da ~kg ohsg jc fd}jshpojlhs& da }hp~dowfhp lt{jdn

fd}jshpojlh& `jag sohas han ]G^ soha hpg jc~ga

agbh~dg& ngs}d~g ~kg }pgsgaog jc lg~hs~h~do

ndsghsg!>>&>7 Rkjfg,s}dag LPD sohaadab khs`gga swbbgs~gn& h~ fghs~ da hs ha dad~dhf s~hbdab

ljnhfd~t& da ~kds ojkjp~ jc }h~dga~s!7>

BPJ__ CGH^WPG_ JC LG^H_^H^DO _HPOJLH

Bpjss h}}ghphaog ds aj~ }hp~dowfhpft wsgcwf da }pg,

ndo~dab dc ~kg fgsdja ds }pdlhpt jp sgojanhpt! ^kg

kgljppkhbdo h}}ghphaog jc habdjshpojlh han

~kg ohp~dfhbdajws ajnwfgs jc lg~hs~h~do okjanpj,

shpojlh oha `g sgga da ~gfhabdgo~h~do js~gjshp,ojlh han okjanpj`fhs~do js~gjshpojlh*}pdlhpt

okjanpjshpojlh& pgs}go~dgft!

Cdb! 88! + H$ G}s~gda,@hppdpws sljj~k lwsofg ~wljpojl}jsgn jc chsodofgs jcs}danfgn ogffs skhp}ft sg}h,

ph~gn cpjl h ljpg ogffwfhpajnwfg rd~k pjwan ogffcgh~wpgs! +@$ Da sd~w kt`pdn,dyh~dja cjp G}s~gda,@hppghpft lPAHs& sw}}jp~dab~kg ndhbajsds jc haG}s~gda,@hpp dpws sljj~klwsofg ~wljp!





_HPOJLH

Hs rd~k ohpodajlhs& ~kg ldopjsoj}do h}}ghphaog

ojppgfh~gs rd~k ~kg fdag jc ndccgpga~dh~dja jc ~kg

}pdlhpt shpojlh! Dllwajkds~jokgldohf hahftsds

ds opd~dohf cjp ojacdpldab ~kg fdag jc ndccgpga~dh~djahan& ng}gandab ja ~kg ~wljp ljp}kjfjbt& segf,

g~hf lhpegps +ngslda& ltjbgada& LtjN8& han

sljj~k lwsofg ho~da$& ~phasfjoh~dja,s}godcdo

lhpegps +^CG? han ohp j{t,~gpldaws jc R^8$&

han agwphf lhpegps +_,8== }pj~gda$ skjwfn `g

ojasdngpgn!

NDCCGPGA DHF NDHBAJ_D_ JC LG^H_^H^DO

_HPOJLH

Jc ~kg }pdlhpt shpojlhs jc `jag ~kh~ lws~ `g

g{ofwngn& js~gjshpojlh khs ~kg kdbkgs~ daod,ngaog! J~kgp }pdlhpt shpojlhs jc `jag hpg phpg

han daofwng cd`pjshpojlh*lhfdbaha~ cd`pjws kds~dj,

ot~jlh jc `jag& habdjshpojlh& fgdjltjshpojlh&

han fd}jshpojlh! J~kgp shpojlhs ~kh~ ~t}dohfft

}pgsga~ da sjc~ ~dsswg khg `gga njowlga~gn da

dsjfh~gn ohsg pg}jp~s!77&73

Fgdjltjshpojlh jc `jag ds rgff ngsopd`gn han

~t}dohfft dajfgs ~kg fjab ~w`wfhp `jags jc ~kg

fjrgp g{~pgld~t! Ophadjchodhf fjoh~dja khs `gga

hssjodh~gn rd~k }pgdjws phndh~dja ~kgph}t!72‟74

^kgsg hpg phpg ~wljps& kjrggp& han ohpgcwfg{ofwsdja jc h lg~hs~h~do sjwpog ds opd~dohf& }hp~do,

wfhpft da cglhfg }h~dga~s!

G}s~gda,@hpp dpws‟hssjodh~gn sljj~k lwsofg

~wljps hpg phpg ~wljps ~kh~ hpdsg da ~kg sg~~dab jc

dllwajsw}}pgssdja! ^kgsg ~wljps hpg jc~ga

lwf~dcjohf han khg h nds~dao~ }pgndfgo~dja cjp

`jag han lht& ~kgpgcjpg& phdsg ~kg }jssd`dfd~t jc

lg~hs~h~do fgdjltjshpojlh + Cdb! 88 H$!3= Wafdeg

lg~hs~h~do fgdjltjshpojlh& kjrggp& G}s~gda,

@hpp dpws‟hssjodh~gn sljj~k lwsofg ~wljps hpg

aj~ ofdadohfft hbbpgssdg han phpgft hpg h ndpgo~

ohwsg jc ngh~k! Ofdadohf kds~jpt han da sd~w

kt`pdndyh~dja hsshts cjp G}s~gda,@hpp ghpft lPAHs

+sgg Cdb! 88@$ hpg kgf}cwf da hppddab h~ ~kg ojppgo~

ndhbajsds!Gga fgss ojllja hpg ~wljps ~kh~ hpg ojasdn,

gpgn `gadba +gb& fgdjltjlh& bdha~ ogff ~wljp jc

`jag& han }fgjljpkdo hngajlh$ ~kh~ lg~hs~hsdyg

~j `jag& gga da ohsgs rd~kjw~ gdngaog jc kds~j,

fjbdo }pjbpgssdja ~j ha hbbpgssdg fgsdja!38‟3?

^kgsg das~haogs hpg }pdlhpdft jc hohngldo da~gpgs~!

PGCGPGAOG_

8! @h~sja JS! ^kg Cwao~dja jc ~kg gp~g`phf gdas han

~kgdp pjfg da ~kg s}pghn jc lg~hs~hsgs! Haa _wpb

84>=588098?;‟>4!0! Epdskaha O& Bgjpbg ^D& Hp`gp NH! @jag lhppjr

lg~hs~hsgs9 h swpgt jc ajakglh~jfjbdo lg~hs~hsgs

rd~k dllwajkds~jokgldohf s~wnt jc lg~hs~h~do ohpod,

ajlhs! H}}f Dllwajkds~jokgl Ljf Ljp}kjf 0==25

8798‟2!

?! Pjwbphcc @ & Eagdsf I_& _dlja LH! _egfg~hf lg~hs,

~hsgs jc waeajra jpdbda! H }pjs}go~dg s~wnt jc

h ndhbajs~do s~ph~gbt! I @jag Ijda~ _wpb Hl 844?5

2798023‟;8!

>! Hshawlh K& Ahehd K& ^hegnh L& g~ hf! Pgahf ogff

ohpodajlh da okdfnpga9 g{}gpdgaog h~ h sdabfg das~d~w,

~dja da Ih}ha! I Wpjf 8444583098>=0‟7!

7! Ew~fwe L & Thfoda @& @wtwe}hlweow A& g~ hf! Cd`pjfh,

lgffhp kg}h~jogffwfhp ohpodajlh rd~k segfg~hf lg~hs,

~hsgs! ]gndh~p Kglh~jf Jaojf 0==858;902?‟;!

3! Fwohpdad _& Cjp~dgp L& Fghegp L& g~ hf! Kg}h~jogffwfhp

ohpodajlh `jag lg~hs~hsds da ha 88,tghp,jfn `jt!

]gndh~p Phndjf 0==;5?;9888‟>!

2! LoNgplj~~ L& Bhlds H_& gf,Ljc~t _& g~ hf! Hngaj,

ohpodajlh jc ldajp shfdhpt bfhan jpdbda rd~k segfg~hf

lg~hs~hsds da h okdfn! ]gndh~p ]h~kjf Fh` Lgn 84435

839;4‟4;!

;! Pjsga~khf ND! Phndjfjbdo ndhbajsds jc `jag lg~hs,~hsgs! Ohaogp 84425;=98747‟3=2!

4! Pjwfghw ]& Rgabgp N! Phndjfjbdo ghfwh~dja jc lg~h,

sh~do `jag ndsghsg! Pjsglja~ +DF$9 Hlgpdoha

Hohnglt jc Jp~kj}hgndo _wpbgjas5 0==0! }! ?8?‟00!

]d~chffsLG^H_^H^DO _HPOJLH

( Lwf~dcjohf segfg~hf sljj~k lwsofg ~wljpslht pg}pgsga~ G}s~gda,@hpp dpws‟hssjodh~gnsljj~k lwsofg ~wljps han aj~ lg~hs~h~dofgdjltjshpojlh!

( Dlhbdab ghfwh~dja jc ~kg }gndh~pdo }j}wfh,~dja ds ojl}fdoh~gn `t h hpdg~t jc cho~jps~kh~ lht pgswf~ da kdbkgp ph~gs jc chfsg,}jsd~dg han chfsg,agbh~dg pgswf~s!

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Lgn 844?5?>90848‟;!

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;;4‟47!

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8=922‟;0!

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