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Itagaki Y, Fukunaga A, Takano H, Yamamoto K, Nishigami K, Ichimura T, Manase H, Obata M, Kato T, Hirano S. Dedifferentiated liposarcoma primary to the chest wall with spontaneous shrinking: report of a case. Surg Case Rep 2023; 9:26. [PMID: 36788154 PMCID: PMC9929008 DOI: 10.1186/s40792-023-01606-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
An 80-year-old man presented to our emergency department complaining of a mass on the right side of his chest and pain in the right flank of his back. A chest computed tomography (CT) scan showed a relatively heterogenous oval-shaped tumor measuring 7.5 × 6.0 cm eroded to the 8th rib, with slightly dense fluid accumulation inside and calcification of the tumor wall. A 1-month follow-up CT scan showed spontaneous shrinkage of the tumor. The tumor was completely excised from the thoracic wall and the wall was reconstructed with a polytetrafluoroethylene mesh. Pathological examination showed coagulation necrosis in the chest wall tumor, but immunohistochemical staining revealed murine double minute 2- and Cyclin-dependent kinase 4-positive cells with irregular nuclear size and bizarre morphology. Therefore, dedifferentiated liposarcoma (DDLPS) was the final pathological diagnosis. Remarkable infiltration of CD8+ lymphocytes into the tumor was observed, along with a 90% positive ratio for programmed cell death-ligand 1. The patient has been followed-up for 1 year without any recurrence, despite not receiving any additional treatment. Liposarcoma is one of the most common types of soft tissue sarcomas; however, spontaneous regression of primary DDLPS arising from the chest wall is extremely rare. Herein, we report a case of DDLPS primary to the chest wall with spontaneous regression, probably due to a spontaneously induced T cell response.
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Affiliation(s)
- Yuki Itagaki
- grid.413965.c0000 0004 1764 8479Department of Surgery, Japanese Red Cross Asahikawa Hospital, 1-1, Akebono 1-1, Hokkaido, Asahikawa, 070-8530 Japan ,grid.39158.360000 0001 2173 7691Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, North 15 West 7, Kita-Ku, Hokkaido, Sapporo, 060-8638 Japan
| | - Akira Fukunaga
- Department of Thoracic Surgery, Japanese Red Cross Asahikawa Hospital, 1-1, Akebono 1Joh, 1Choume, Hokkaido, Asahikawa, , 070-8530, Japan.
| | - Hironobu Takano
- grid.413965.c0000 0004 1764 8479Department of Surgery, Japanese Red Cross Asahikawa Hospital, 1-1, Akebono 1-1, Hokkaido, Asahikawa, 070-8530 Japan ,grid.39158.360000 0001 2173 7691Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, North 15 West 7, Kita-Ku, Hokkaido, Sapporo, 060-8638 Japan
| | - Kazuyuki Yamamoto
- grid.413965.c0000 0004 1764 8479Department of Surgery, Japanese Red Cross Asahikawa Hospital, 1-1, Akebono 1-1, Hokkaido, Asahikawa, 070-8530 Japan
| | - Kohei Nishigami
- grid.413965.c0000 0004 1764 8479Department of Surgery, Japanese Red Cross Asahikawa Hospital, 1-1, Akebono 1-1, Hokkaido, Asahikawa, 070-8530 Japan
| | - Tatsunosuke Ichimura
- grid.413965.c0000 0004 1764 8479Department of Surgery, Japanese Red Cross Asahikawa Hospital, 1-1, Akebono 1-1, Hokkaido, Asahikawa, 070-8530 Japan
| | - Hiroto Manase
- grid.413965.c0000 0004 1764 8479Department of Surgery, Japanese Red Cross Asahikawa Hospital, 1-1, Akebono 1-1, Hokkaido, Asahikawa, 070-8530 Japan
| | - Masahiko Obata
- grid.413965.c0000 0004 1764 8479Department of Surgical Pathology, Japanese Red Cross Asahikawa Hospital, 1-1, Akebono 1Joh, 1Choume, Hokkaido, Asahikawa, 070-8530 Japan
| | - Tatsuya Kato
- grid.412167.70000 0004 0378 6088Department of Thoracic Surgery, Hokkaido University Hospital, North 14 West 5, Kita-Ku, Hokkaido, Sapporo, 060-8648 Japan
| | - Satoshi Hirano
- grid.39158.360000 0001 2173 7691Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, North 15 West 7, Kita-Ku, Hokkaido, Sapporo, 060-8638 Japan
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Itagaki Y, Yamamoto K, Kikuchi T, Takano H, Nishigami K, Fukunaga A, Ichimura T, Manase H, Hirano S. Laparoscopic cholecystectomy after transcatheter arterial embolisation for haemobilia due to a pseudoaneurysm in the gallbladder: A case report. SAGE Open Med Case Rep 2023; 11:2050313X231166777. [PMID: 37122424 PMCID: PMC10134114 DOI: 10.1177/2050313x231166777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/14/2023] [Indexed: 05/02/2023] Open
Abstract
Pseudoaneurysms of the cystic artery are a rare but significant complication of acute cholecystitis. Laparoscopic cholecystectomy may be a safe alternative to open cholecystectomy in such cases. We report the case of a female patient in her seventies, who presented with anaemia, jaundice, and hepatic dysfunction during hospitalisation for right knee pyogenic arthritis. The patient had no pain in the right upper quadrant. Her serum haemoglobin level was 6.5 g/dL, and upper gastrointestinal endoscopy revealed no abnormalities. Six days later, jaundice worsened, and endoscopic retrograde cholangiopancreatography revealed bloody bile. An endoscopic biliary drainage tube was inserted at the discretion of the gastroenterology department. Contrast-enhanced computed tomography revealed a haematoma in the gallbladder and a pseudoaneurysm in the lateral wall of the gallbladder. On the same day, the endoscopic biliary drainage tube was replaced with an endoscopic nasobiliary drainage tube, which indicated the degree of haemorrhage and enabled lavage of the lumen in cases of obstruction. The next day, angiography revealed a pseudoaneurysm of the deep branch of the cystic artery and coil embolisation was performed at the periphery of the cystic artery. Uninterrupted laparoscopic cholecystectomy was performed. Although laparoscopic cholecystectomy is difficult when bleeding is uncontrolled, it was safely performed following haemostasis using transcatheter arterial embolisation. Laparoscopic cholecystectomy is feasible in haemodynamically stable patients with cystic artery pseudoaneurysms after transcatheter arterial embolisation.
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Affiliation(s)
- Yuki Itagaki
- Department of Surgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
- Yuki Itagaki, Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, North 15 West 7, Kita-ku, Sapporo 0608638, Hokkaido, Japan.
| | - Kazuyuki Yamamoto
- Department of Surgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | - Tomoki Kikuchi
- Department of Surgical Pathology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | - Hironobu Takano
- Department of Surgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Kohei Nishigami
- Department of Surgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | - Akira Fukunaga
- Department of Thoracic Surgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | | | - Hiroto Manase
- Department of Surgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
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Nishigami K, Kawami H, Yamaguchi T, Yamaguchi K, Kato S. [A case of liver metastasis of rectal cancer, refractory to previous chemotherapy(5-FU/LV, irinotecan, oxaliplatin) responding to bevacizumab combined with FOLFIRI chemotherapy]. Gan To Kagaku Ryoho 2009; 36:1765-1768. [PMID: 19838045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The case was a 69-year-old man with liver metastasis who had relapsed after the resection of rectal cancer. We treated the patient with FOLFIRI+bevacizumab(BV)after the failure of S-1+CPT-11, radiation, UFT/LV, FOLFOX and FOLFIRI regimen. The tumor marker level and accumulation of FDG-PET were rapidly decreased after initiating FOLFIRI+BV. There was no serious adverse event, and a remarkable improvement of QOL was observed. This case suggests that the BV combination regimen is useful even after the failure of FOLFOX and FOLFIRI regimen.
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Nakamura S, Yoshihara F, Kamide K, Nakahama H, Nishigami K, Fukuchi K, Ogino H, Kawano Y. Microalbuminuria and deterioration of renal function after elective repair of infrarenal abdominal aortic aneurysm. Clin Nephrol 2006; 65:165-72. [PMID: 16550747 DOI: 10.5414/cnp65165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
AIMS Renal dysfunction affects the prognosis of patients after aortic surgery. However, the factors associated with the postoperative deterioration of renal function has not been clarified precisely. METHOD We prospectively examined renal function in 80 patients (age: 73 +/- 7 years, 66 males) who required the elective repair of infrarenal abdominal aortic aneurysm (AAA). Serum creatinine (Scr) was measured. 24-h-creatinine clearance (Ccr) and urinary albumin excretion (UAE) were determined. Renal volume and mean renal length were calculated using the data obtained by ultrasonography. 48 patients showed normal UAE (< 30 mg/day), and 24 had microalbuminuria (30-300 mg/day) and 8 had overt proteinuria (> 300 mg/day). Scr were 0.9 +/- 0.4, 1.0 +/- 0.3 and 2.1 +/- 1.3 mg/dl, respectively. RESULTS On Day 5 after surgery, 12 patients (15%) showed deterioration of renal function as defined either by an increase in Scr (> or = 0.5 mg/dl) or by a decrease in Ccr > or =20%). The acute deterioration of renal function was related to mean renal volume, mean renal length, duration of operation and the use of antibiotics. At Month 12 after surgery, Scr increased in the overt proteinuria group. The deterioration of renal function at Month 12 was found in 8 patients (10%) with microalbuminuria or overt proteinuria, and related to preoperative Ccr, UAE, mean renal volume, mean renal length, smoking status and blood pressure. CONCLUSION We conclude that the deterioration of renal function occurred in considerable number of patients with AAA after elective operation on acute and chronic phase, although the development of end-stage renal failure is rare. Factors related to the acute and late deterioration appears to be different. UAE and renal size should be measured, even if Scr is in normal range at preoperative observation.
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Affiliation(s)
- S Nakamura
- Division of Hypertension and Nephrology, National Cardiovascular Center, Osaka, Japan.
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Abstract
BACKGROUND An aortic intramural hematoma (IMH) is a form of aortic dissection (AD). IMHs regress with time or completely disappear in some patients, whereas they progress to overt AD in other patients. The purpose of the present study was to investigate how IMHs change serially during a follow-up period. METHODS AND RESULTS We analyzed 44 consecutive medically treated patients with IMHs, in whom transesophageal echocardiography (TEE) was performed serially at both 1 and 6 months after the onset. After TEE, the patients were followed with interviews (mean follow-up 1552+/-539 days). IMHs disappeared at 6 months in 21 patients (48%) (disappearance group), whereas IMHs were still demonstrated at 6 months in 20 patients (45%) (persistent group); in the disappearance group, IMHs disappeared at 1 month in 8 patients (18%). In 3 patients (7%) in whom an IMH was demonstrated at 1 month, overt AD occurred until 6 months. The disappearance group was younger than the persistent group (64+/-11 versus 72+/-8 years, P:<0.01), and the maximum diameter of the aorta was smaller in the disappearance group than in the persistent group (33+/-5 versus 42+/-7 mm, P:<0.01). During the long-term follow-up, overt AD occurred at 7 and 11 months in 2 patients, and progressive aortic dilatation that required surgical treatment occurred at 12 and 24 months in 2 of the persistent group patients, whereas neither overt AD nor progressive aortic dilatation occurred in the disappearance group. In the patients in whom overt AD occurred, the maximal aortic diameter was >45 mm and an IMH was demonstrated at 1 month. On the other hand, those with a maximal aortic diameter of <45 mm or a disappeared IMH did not have overt AD. CONCLUSIONS IMHs disappeared until 1 month in 18% and until 6 months in 48% of patients with IMHs. The disappearance of IMHs was related to the maximum diameter of the aorta and age. Both a disappeared IMH and a maximal aortic diameter of <45 mm suggest a good prognosis.
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Affiliation(s)
- K Nishigami
- Cardiovascular Center, Saiseikai Kumamoto Hospital, Kumamoto, Japan.
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Kaji S, Nishigami K, Akasaka T, Hozumi T, Takagi T, Kawamoto T, Okura H, Shono H, Horibata Y, Honda T, Yoshida K. Prediction of progression or regression of type A aortic intramural hematoma by computed tomography. Circulation 1999; 100:II281-6. [PMID: 10567317 DOI: 10.1161/01.cir.100.suppl_2.ii-281] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND It has been reported that early surgery should be required for patients with type A aortic intramural hematoma (IMH) because it tends to develop classic aortic dissection or rupture. However, the anatomic features of type A IMH that develops dissection or rupture are unknown. The purpose of this study was to investigate the predictors of progression or regression of type A IMH by computed tomography (CT). METHODS AND RESULTS Twenty-two consecutive patients with type A IMH were studied by serial CT images. Aortic diameter and aortic wall thickness of the ascending aorta were estimated in CT images at 3 levels on admission and at follow-up (mean 37 days). We defined patients who showed increased maximum aortic wall thickness in the follow-up CT (n=9) or died of rupture (n=1) as the progression group (n=10). The other 12 patients, who all showed decreased maximum wall thickness, were categorized as the regression group. In the progression group, the maximum aortic diameter in the initial CT was significantly greater than that in the regression group (55+/-6 vs 47+/-3 mm, P=0.001). A Cox regression analysis revealed that the maximum aortic diameter was the strongest predictor for progression of type A IMH. We considered the optimal cutoff value to be 50 mm for the maximum aortic diameter to predict progression (positive predictive value 83%, negative predictive value 100%). CONCLUSIONS Maximum aortic diameter estimated by the initial CT images is predictive for progression of type A IMH.
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Affiliation(s)
- S Kaji
- Division of Cardiology, Kobe General Hospital, Kobe, Japan
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Nishigami K, Honda T, Shono H, Ohdo T, Horibata Y. [Usefulness and safety of the early rehabilitation program for patients with acute aortic dissection]. J Cardiol 1999; 34:19-24. [PMID: 10422622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
The usefulness and safety of the early rehabilitation program (2- and 3-week courses) were validated for patients with acute aortic dissection. This program undergone by 42 consecutive patients between 1996 and 1997 was compared to the conventional program undergone by 66 patients between 1993 and 1995, using the prognosis and complications for elderly patients. Mortality rate and morbidity rate were not significantly different between the early and conventional programs. The incidence of intensive care unit (ICU) syndrome in elderly patients was 16% (3 of 19 cases) vs 50% (15 of 30 cases), respectively (p < 0.05). The duration of hospital stays was 26 +/- 7 vs 37 +/- 13 days, respectively (p < 0.05). The early rehabilitation program for patients with acute aortic dissection was safe and useful to prevent complications in elderly patients, and was cost effective.
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Affiliation(s)
- K Nishigami
- Cardiovascular Center, Saiseikai Kumamoto Hospital
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Abstract
We evaluated the effects of antecedent anginal episodes and coronary artery stenosis on left ventricular function during coronary occlusion and the role of collateral filling in 33 patients with angina pectoris who underwent angioplasty. Wall motion abnormalities were investigated by echocardiography and classified into hypokinesia and akinesia. Collateral filling during angioplasty was evaluated by using a second artery catheter. Akinesia was observed as follows: 24% of the patients had > 30 anginal episodes, 38% had 5 to 30, and 87% of the patients had < 5 (p < 0.01); 12% of patients had a lesion of 99%, 47% had a lesion of 90%, and 83% had a lesion of 75% (p < 0.05). Akinesia was observed in none of the patients with grade 3 collaterals, 57% with grade 2, and 67% with grade 1 or 0 (p < 0.01). These observations suggest that the patients with antecedent frequent anginal episodes and severe coronary stenosis have less left ventricular dysfunction during coronary occlusion. This finding may be the result of more extensive collateral development.
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Affiliation(s)
- K Nishigami
- Division of Cardiology, Saiseikai Kumamoto Hospital, School of Medicine, Kumamoto University, Japan
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Yoshida K, Yoshikawa J, Akasaka T, Nishigami K, Minagoe S. Value of acceleration flow signals proximal to the leaking orifice in assessing the severity of prosthetic mitral valve regurgitation. J Am Coll Cardiol 1992; 19:333-8. [PMID: 1732360 DOI: 10.1016/0735-1097(92)90487-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
To test the value of acceleration flow signals proximal to the leaking orifice in assessing the severity of prosthetic mitral valve regurgitation, 39 consecutive patients undergoing left ventriculography were examined by Doppler color flow imaging. Acceleration flow signals proximal to the regurgitant orifice were detected in 27 of the 31 patients who had prosthetic mitral regurgitation by left ventriculography (sensitivity 87%). All four patients without acceleration flow signals had mild prosthetic mitral regurgitation by angiography. No acceleration flow signals were detected in any patient without prosthetic regurgitation by left ventriculography (specificity 100%). Individual values of the maximal area of acceleration flow signals obtained from three orthogonal planes in seven patients with mild prosthetic mitral regurgitation by angiography ranged from 0 to 17 mm2 (mean 4 +/- 6). In 8 patients with moderate prosthetic mitral regurgitation by angiography, the maximal area of acceleration flow signals ranged from 21 to 58 mm2 (mean 33 +/- 15), whereas the maximal area of acceleration flow signals in 16 patients with severe prosthetic regurgitation ranged from 20 to 173 mm2 (mean 102 +/- 41). The maximal area of the acceleration flow signals from three planes correlated well with the angiographic grade of prosthetic mitral regurgitation. There was a significant difference in the maximal area of acceleration flow signals between mild and moderate (p less than 0.001), moderate and severe (p less than 0.001) and mild and severe (p less than 0.001) prosthetic mitral regurgitation. Thus, measurement of acceleration flow signals by Doppler color flow imaging is useful in assessing the severity of prosthetic mitral regurgitation.
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Affiliation(s)
- K Yoshida
- Department of Cardiology, Kobe General Hospital, Japan
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Affiliation(s)
- K Okumura
- Division of Cardiology, Kumamoto University Medical School, Japan
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Onoda T, Morikawa S, Harada T, Suzuki Y, Inoue K, Nishigami K. Antitumor activity of D-mannosamine in vitro: different sensitivities among human leukemia cell lines possessing T-cell properties. Cancer Res 1982; 42:2867-71. [PMID: 6979385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
D-Mannosamine is toxic to human malignant T-lymphoid cell lines derived from patients with T-cell leukemia. We observed heterogeneity of mannosamine susceptibility among those cell lines. The leukemic T-cell lines, subgrouped according to the degree of mannosamine inhibition on nucleic acid biosyntheses, were: Subgroup 1, HPB-MLT cells; Subgroup 2, CCRF-HSB-2 and HPB-ALL cells; and Subgroup 3, MOLT-4 cells. The most sensitive line, HPB-MLT, originated from the patient with adult T-cell leukemia. The cytotoxicity of mannosamine was potentiated by a fatty acid, sodium oleate, at concentrations that were noncytolytic, and the interaction between the two drugs was synergistic. These results would suggest that mannosamine induces changes in the membrane structure of the leukemia cells. Thus, the primary target of the tumoricidal activity of mannosamine may also be the cellular membranes.
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Onoda T, Nishigami K. Effects of N-acetylglucosamine on cell surface glycoprotein and cell behavior of glucosamine requiring mutant derived from Chinese hamster lung cells. Hiroshima J Med Sci 1981; 30:29-34. [PMID: 7275686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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