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Camurcu Y, Sofu H, Ucpunar H, Kockara N, Cobden A, Duman S. Single-dose intra-articular corticosteroid injection prior to platelet-rich plasma injection resulted in better clinical outcomes in patients with knee osteoarthritis: A pilot study. J Back Musculoskelet Rehabil 2018; 31:603-610. [PMID: 29710676 DOI: 10.3233/bmr-171066] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The synergistic and protective effect of platelet-rich plasma (PRP) added to methlyprednisolone (MP) has been demonstrated via in-vitro studies. However, there is no report in the literature about this issue. OBJECTIVE The aim of this study was to evaluate clinical outcomes of intra-articular (IA) MP injection prior to PRP injection in comparison with single-dose MP and PRP injections alone in patients with knee osteoarthritis (OA). METHODS The treatment groups were "PRP group" (n= 37) who underwent single-dose IA PRP injection, "PRP + MP group" (n= 40) who underwent MP injection one week prior to single-dose PRP injection, and "MP group" (n= 38) who underwent single-dose MP injection. Visual Analog Scale (VAS) and The Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were applied at first admission and at 1st, 3rd, 6th, and 12th month follow-ups. RESULTS At the end of the 1st month, WOMAC score in PRP + MP group was significantly lower than PRP group. At the 3rd month, WOMAC score in PRP + MP group was significantly lower than PRP and MP groups. At the 6th month, VAS and WOMAC score in PRP + MP group was significantly lower than MP group. At the end of the 12th month, no significant difference was observed among three groups in VAS and WOMAC scores. CONCLUSION According to our results, IA MP injection prior to PRP injection resulted in significantly better clinical outcomes compared to PRP and MP injections alone in patients who had mild to moderate knee OA.
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Affiliation(s)
- Yalkin Camurcu
- Department of Orthopedics and Traumatology, Faculty of Medicine, Erzincan University, Erzincan, Turkey
| | - Hakan Sofu
- Department of Orthopedics and Traumatology, Faculty of Medicine, Erzincan University, Erzincan, Turkey
| | - Hanifi Ucpunar
- Department of Orthopedics and Traumatology, Faculty of Medicine, Erzincan University, Erzincan, Turkey
| | - Nizamettin Kockara
- Department of Orthopedics and Traumatology, Faculty of Medicine, Erzincan University, Erzincan, Turkey
| | - Adem Cobden
- Department of Orthopedics and Traumatology, Sivas Numune Hospital, Sivas, Turkey
| | - Serda Duman
- Department of Orthopedics and Traumatology, Selahaddin Eyyubi State Hospital, Diyarbakir, Turkey
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Camurcu Y, Sofu H, Issin A, Kockara N, Saygili H. Operative Treatment of the Ingrown Toenail With a Less-Invasive Technique: Flashback to the Original Winograd Technique. Foot Ankle Spec 2018; 11:138-141. [PMID: 28587478 DOI: 10.1177/1938640017713615] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the results of the partial nail plate excision and curettage of nail bed and matrix (the original Winograd technique) in patients with ingrown toenail. MATERIALS AND METHODS Patients with ingrown toenail who were treated surgically from May 2014 to June 2015, with a minimum follow-up of 1 year were included in this study. Those who had previous ingrown toenail surgery were excluded. Partial nail plate excision with curettage of nail bed and nail matrix was performed for all patients. Rifampicin soaked sterile gauze was placed onto the wounds after the procedure. RESULTS The study population included 100 males and 89 females with a mean age of 30 years. Eight patients (4.2%) had stage 1, 71 patients (37.6%) had stage 2, and 110 patients (58.2%) had stage 3 ingrown toenails. The mean operation time was 4.8 minutes. No complication occurred during the procedure. It was found that 15 patients (7.9%) had recurrence during the follow-up. CONCLUSION The original Winograd technique is an efficient and less-invasive technique for the treatment of ingrown toenail, with lower rates of recurrence and complications. LEVELS OF EVIDENCE Therapeutic Case Series Study, Level IV.
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Affiliation(s)
- Yalkin Camurcu
- Department of Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan, Turkey (YC, HS, AI, NK)
- Department of Orthopaedics and Traumatology, Kozan State Hospital, Adana, Turkey (HS)
| | - Hakan Sofu
- Department of Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan, Turkey (YC, HS, AI, NK)
- Department of Orthopaedics and Traumatology, Kozan State Hospital, Adana, Turkey (HS)
| | - Ahmet Issin
- Department of Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan, Turkey (YC, HS, AI, NK)
- Department of Orthopaedics and Traumatology, Kozan State Hospital, Adana, Turkey (HS)
| | - Nizamettin Kockara
- Department of Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan, Turkey (YC, HS, AI, NK)
- Department of Orthopaedics and Traumatology, Kozan State Hospital, Adana, Turkey (HS)
| | - Hakan Saygili
- Department of Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan, Turkey (YC, HS, AI, NK)
- Department of Orthopaedics and Traumatology, Kozan State Hospital, Adana, Turkey (HS)
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Kockara N, Sofu H, Issin A, Çamurcu Y, Bursali A. Predictors of the clinical outcome and survival without degenerative arthritis after surgical treatment of femoroacetabular impingement. J Orthop Sci 2018; 23:117-121. [PMID: 29021102 DOI: 10.1016/j.jos.2017.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/04/2017] [Accepted: 09/05/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND The main purposes of the present study were to evaluate the functional improvement, to identify the predictors of the clinical outcome after open surgical management of femoroacetabular impingement (FAI) in mid-term, and to determine 5-year survival rate. METHODS In this retrospective study, the clinical data of 33 patients (34 hips) were evaluated. Sex, age, body mass index (BMI), type of FAI, duration of symptoms up to surgical treatment, internal rotation of the affected hip, improvement of the Harris hip score (HHS) in the first 2 years, joint space narrowing evaluated radiographically and classified according to Kellgren-Lawrence classification, and any labral tear were the independent variables. Harris hip score and degenerative arthritic changes at the latest follow-up were identified as outcome measures. Univariate and multivariate analyses were performed. The mean post-operative follow-up was 6 years. RESULTS Harris hip scores at the latest follow-up were significantly worse in patients with a pre-operative age >35 years, BMI ≥25 kg/m2, internal rotation of the hip ≤10°, grade 1 or 2 joint space narrowing, labral tear, and <15 points improvement of the HHS at the first 2 years follow-up. According to multivariate analysis; major predictors of the outcome were BMI, labral tear, and improvement of the HHS at the first 2 years. CONCLUSIONS A pre-operative BMI ≥25 kg/m2, labral tear, and <20 points improvement of the HHS in the first 2 years of surgery should be considered as the major predictors of the clinical outcome after open surgical management of idiopathic FAI.
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Affiliation(s)
| | - Hakan Sofu
- Erzincan University Faculty of Medicine, Erzincan, Turkey.
| | - Ahmet Issin
- Erzincan University Faculty of Medicine, Erzincan, Turkey.
| | - Yalkın Çamurcu
- Erzincan University Faculty of Medicine, Erzincan, Turkey.
| | - Aysegul Bursali
- Private Office, Yıldız Posta Caddesi, Emekli Subay Evleri 34. Blok, 34349, Istanbul, Turkey.
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Demirel D, Yu A, Cooper-Baer S, Dendukuri A, Halic T, Kockara S, Kockara N, Ahmadi S. A hierarchical task analysis of shoulder arthroscopy for a virtual arthroscopic tear diagnosis and evaluation platform (VATDEP). Int J Med Robot 2017; 13. [PMID: 28026107 DOI: 10.1002/rcs.1799] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 10/05/2016] [Accepted: 11/15/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Shoulder arthroscopy is a minimally invasive surgical procedure for diagnosis and treatment of a shoulder pathology. The procedure is performed with a fiber optic camera, called arthroscope, and instruments inserted through very tiny incisions made around the shoulder. The confined shoulder space, unintuitive camera orientation and constrained instrument motions complicates the procedure. Therefore, surgical competence in arthroscopy entails extensive training especially for psychomotor skills development. Conventional arthroscopy training methods such as mannequins, cadavers or apprenticeship model have limited use attributed to their low-fidelity in realism, cost inefficiency or incurring high risk. However, virtual reality (VR) based surgical simulators offer a realistic, low cost, risk-free training and assessment platform where the trainees can repeatedly perform arthroscopy and receive quantitative feedback on their performances. Therefore, we are developing a VR based shoulder arthroscopy simulation specifically for the rotator cuff ailments that can quantify the surgery performance. Development of such a VR simulation requires a through task analysis that describes the steps and goals of the procedure, comprehensive metrics for quantitative and objective skills and surgical technique assessment. METHODS We analyzed shoulder arthroscopic rotator cuff surgeries and created a hierarchical task tree. We introduced a novel surgery metrics to reduce the subjectivity of the existing grading metrics and performed video analysis of 14 surgery recordings in the operating room (OR). We also analyzed our video analysis results with respect to the existing proposed metrics in the literature. RESULTS We used Pearson's correlation tests to find any correlations among the task times, scores and surgery specific information. We determined strong positive correlation between cleaning time vs difficulty in tying suture, cleaning time vs difficulty in passing suture, cleaning time vs scar tissue size, difficulty passing vs difficulty in tying suture, total time and difficulty of the surgery. CONCLUSION We have established a hierarchical task analysis and analyzed our performance metrics. We will further use our metrics in our VR simulator for quantitative assessment.
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Affiliation(s)
- Doga Demirel
- Computer Science Department, University of Central Arkansas, Conway, Arkansas, USA.,Computer Science Department, University of Arkansas, Little Rock, Arkansas, USA
| | - Alexander Yu
- Computer Science Department, University of Central Arkansas, Conway, Arkansas, USA
| | - Seth Cooper-Baer
- Computer Science Department, University of Central Arkansas, Conway, Arkansas, USA
| | - Aditya Dendukuri
- Computer Science Department, University of Central Arkansas, Conway, Arkansas, USA
| | - Tansel Halic
- Computer Science Department, University of Central Arkansas, Conway, Arkansas, USA
| | - Sinan Kockara
- Computer Science Department, University of Central Arkansas, Conway, Arkansas, USA
| | - Nizamettin Kockara
- Department of Orthopedics and Traumatology, Erzincan University Medical School, Erzincan, Turkey
| | - Shahryar Ahmadi
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Sofu H, Kockara N, Oner A, Camurcu Y, Issın A, Sahin V. Results of Hyaluronic Acid-Based Cell-Free Scaffold Application in Combination With Microfracture for the Treatment of Osteochondral Lesions of the Knee: 2-Year Comparative Study. Arthroscopy 2017; 33:209-216. [PMID: 27614391 DOI: 10.1016/j.arthro.2016.06.035] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 06/16/2016] [Accepted: 06/20/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the clinical and radiographic efficacy of hyaluronic acid-based cell-free scaffold applied in combination with microfracture versus microfracture alone in patients with focal osteochondral lesion of the knee joint. METHODS Clinical data of 43 patients between 24 and 55 years of age were evaluated. Hyaluronic acid-based cell-free scaffold was applied in combination with microfracture for 19 knees (group 1), whereas microfracture alone was the surgical intervention for 24 knees (group 2). All lesions were Outerbridge grade III or IV with a mean size of 3.6 ± 1.3 cm2. The mean follow-up time was 25.7 months. Visual analog scale (VAS), Lysholm knee score, and Tegner activity scale were the instruments used to evaluate the clinical status. Magnetic resonance observation of cartilage repair tissue (MOCART) system was used to analyze the characteristics of repair tissue. RESULTS Better VAS and Lysholm scores were detected in group 1 at 12 and 24 months (P = .019 and P = .025). According to the Tegner activity scale, group 1 had also better activity level at the end of 24 months after surgery (P = .020). The mean time from surgery to return to nonimpact sports activities was 7.8 months in group 1, whereas it was 9.2 months in group 2 (P = .013). Complete repair with the filling of the defect was achieved in 7 (36.8%) of the knees in group 1, whereas it was 4 (16.6%) of the knees in group 2 according to the MOCART system at 24 months. CONCLUSIONS Single-stage regenerative cartilage surgery using hyaluronic acid-based cell-free scaffold in combination with microfracture for focal osteochondral lesions of the knee revealed promising clinical outcomes at 24 months of follow-up, but the clinical significance of the differences seen is simply not known. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Hakan Sofu
- Department of Orthopedics, Erzincan University Faculty of Medicine, Erzincan, Turkey.
| | - Nizamettin Kockara
- Department of Orthopedics, Erzincan University Faculty of Medicine, Erzincan, Turkey
| | - Ali Oner
- Erzincan Mengucekgazi Education and Research Hospital, Erzincan, Turkey
| | - Yalkin Camurcu
- Department of Orthopedics, Erzincan University Faculty of Medicine, Erzincan, Turkey
| | - Ahmet Issın
- Department of Orthopedics, Erzincan University Faculty of Medicine, Erzincan, Turkey
| | - Vedat Sahin
- Department of Orthopedics, Erzincan University Faculty of Medicine, Erzincan, Turkey
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Sofu H, Kockara N, Aydin BK, Suleyman B, Tayfur M, Malkoc I. Should orthopedic surgeons consider the effects of gabapentin administration on bone healing while treating a long bone fracture: experimental study in a rat model. SICOT J 2016; 2:36. [PMID: 27801642 PMCID: PMC5088749 DOI: 10.1051/sicotj/2016028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/17/2016] [Indexed: 12/18/2022] Open
Abstract
Objective: The main purpose of the present study was to assess the radiographic, histological, and mechanical effects of gabapentin on fracture healing in a rat model of femur fracture. Materials and methods: A standard transverse fracture of the mid-diaphysis was created. A total of 60 female Wistar-Albino rats with the mean age of 13.5 ± 1.2 weeks were used for this experimental trial. The rats were randomized into four groups with 15 animals included in each group. Group A and B were the control groups whereas C and D were the treatment groups. Drugs were delivered by oral gavage twice a day with the daily dosage calculated according to body surface area conversion to the human equivalent dosing regimen of 1200 mg/day. Radiographic, histological, and biomechanical evaluation was performed. Results: We could not detect any statistically significant difference between the control and gabapentin treatment groups according to the comparative assessment of radiographic scores on the 15th and 30th days. Although no significant differences were found between the groups on the 15th day, histological scores were better in the control group on the 30th day. According to the results of biomechanical testing, the fractured femurs resected from the control group exhibited significantly more strength on the 30th day. Conclusions: According to the data we acquired during the present study, administration of gabapentin negatively affects the fracture healing process especially in the aspects of histological progression as well as the biomechanical strength of the callus in a rat model.
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Affiliation(s)
- Hakan Sofu
- Faculty of Medicine, Erzincan University, Erzincan 24030, Turkey
| | | | | | - Bahadir Suleyman
- Faculty of Medicine, Erzincan University, Erzincan 24030, Turkey
| | - Mahir Tayfur
- Faculty of Medicine, Erzincan University, Erzincan 24030, Turkey
| | - Ismail Malkoc
- Faculty of Medicine, Atatürk University, Erzincan 25030, Turkey
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Abstract
Occurrence of fractures is highly dependent on lifestyle. Domestic data should be used when needed. In this cross-sectional study, the authors aim to find the most recent distribution of pediatric fracture types and the attributes of fracture occurrence within a large sample size in a metropolitan area of Turkey.This study consists of 4879 pediatric age patients with a fracture who took advantage of the emergency service of a trauma center in a metropolitan area between March 2010 and December 2013 (1397 days). Date, hour, age, sex, fracture type, and social security status of the patients were studied.A total of 65% of the patients were men and 35% were women. A total of 81% of the fractures were in the upper extremities, whereas 19% of them were in the lower extremities. In 22 patients (0.5%), there were open fractures. Fractures showed some seasonal, daily, and circadian variations. Different types of fractures showed some specific patterns in different age groups. Ankle, elbow, and shoulder fractures were more common in girls, whereas wrist and forearm fractures were more in boys and the difference was statistically significant (P < 0.05).Fractures in pediatric ages vary depending on the age, sex, season, and the hour of the day. Types of fractures show some obvious patterns especially depending on the age. This data can be useful in making optimizations in fracture care units. Considering these specific patterns would enable more effective planning of providing preventive measures for pediatric injuries.
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Affiliation(s)
- Ahmet Issin
- From the Mengucek Gazi Education and Research Hospital Orthopedics and Traumatology Department, Erzincan University, Erzincan (AI, NK); Orthopedics and Traumatology Department, Metin Sabanci Bone and Joint Diseases Education and Research Hospital, Istanbul (AO); and Mengucek Gazi Education and Research Hospital Orthopedics and Traumatology Department, Erzincan University, Erzincan, Turkey (VS)
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Sofu H, Kockara N, Gursu S, Issin A, Oner A, Sahin V. Transverse Subtrochanteric Shortening Osteotomy During Cementless Total Hip Arthroplasty in Crowe Type-III or IV Developmental Dysplasia. J Arthroplasty 2015; 30:1019-23. [PMID: 25707993 DOI: 10.1016/j.arth.2015.01.045] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 01/23/2015] [Accepted: 01/26/2015] [Indexed: 02/01/2023] Open
Abstract
The purpose of this study was to review the outcomes of transverse subtrochanteric shortening osteotomy during cementless total hip arthroplasty in Crowe Type-III or IV developmental dysplasia. Seventy-three osteotomies were included in our study. Mean follow-up was 61 months. Harris hip score, leg length discrepancy, neurological status, union status of the osteotomy, and femoral component stability were the criteria for evaluation. All complications were noted. The mean Harris hip score improved from 38.6 points to 83.7 points. The mean leg length discrepancy decreased from 56.5 mm to 10.7 at the latest follow-up. The mean union time was 5.2 months. We observed 4 non-unions. Transverse subtrochanteric shortening osteotomy is an effective and reliable method in restoration of a more normal limb.
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Affiliation(s)
- Hakan Sofu
- Erzincan University Faculty of Medicine, Erzincan, Turkey
| | | | - Sarper Gursu
- Baltalimani Bone and Joint Diseases Hospital, Istanbul, Turkey
| | - Ahmet Issin
- Erzincan University Faculty of Medicine, Erzincan, Turkey
| | - Ali Oner
- Mengucekgazi Education and Research Hospital, Erzincan, Turkey
| | - Vedat Sahin
- Erzincan University Faculty of Medicine, Erzincan, Turkey
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Abstract
The present study is an observational cross-sectional study. The main purpose of this research was to analyze the perception and behaviors of parents in a series of pediatric upper extremity fracture cases. Hundred and seventeen patients younger than 12 years who were conservatively treated for the upper extremity fracture were included in our study. Parents of the patients were requested to answer a family-centered questionnaire related to their child's fracture and its treatment. When the parents were asked whether they believe casting would be sufficient or not as the treatment of their child's fracture, 84.6% answered 'yes', 13.7% answered 'I am not sure,' and 1.7% answered 'no.' Sixty-four of the parents were not worried about any residual defect in joint or extremity functions related to fracture, whereas 21 were worried and 32 were not sure on this. The rate of searching further information about the child's fracture was 34.2% and the mostly used source was the Internet. Twenty-eight of the 117 respondents (23.9%) emphasized that they would reduce the time their child spend outside the home at least for a while after the removal of cast. When conservatively treating a child's fracture, physicians dealing with traumatology should always consider the parents' perception and behaviors as critically important.
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Affiliation(s)
- Hakan Sofu
- From the Erzincan Department of Orthopedics and Traumatology, University Faculty of Medicine, Erzincan, Turkey (HS); Department of Orthopedics and Traumatology, Baltalimani Bone and Joint Diseases Education and Research Hospital, Istanbul, Department of Orthopedics and Traumatology (NK); Department of Orthopedics and Traumatology, Erzincan University Faculty of Medicine (AI); Department of Orthopedics and Traumatology, Mengücekgazi Education and Research Hospital, Erzincan (AO); Department of Orthopedics and Traumatology, Devrek State Hospital, Zonguldak, Turkey (YC)
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