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1Complications of radiofrequency ablation of hepatic tumors:Frequency and risk factors显示文摘Radiofrequency ablation(RFA)has become an important option in the therapy of primary and secondary hepatic tumors.Surgical resection is still the best treatment option,but only a few of these patients are candidates for surgery:multilobar disease,insufficient liver reserve that will lead to liver failure after resection,extra-hepatic disease,proximity to major bile ducts and vessels,and co-morbidities.RFA has a low mortality and morbidity rate and is considered to be safe.Thus,complications occur and vary widely in the literature.Complications are caused by thermal damage,direct needle injury,infection and the patient’s co-morbidities.Tumor type,type of approach,number of lesions,tumor localization,underlying hepatic disease,the physician’s experience,associated hepatic resection and lesion size have been described as factors significantly associated with complications.The physician in charge should promptly recognize high-risk patients more susceptible to complications,perform a close post procedure follow-up and manage them early and adequately if they occur.We aim to describe complications from RFA of hepatic tumors and their risk factors,as well as a few techniques to avoid them.This way,others can decrease their morbidity rates with better outcomes.Alexandre Zanchenko Fonseca Stephanie Santin Luiz Guilherme Lisboa Gomes Jaques Waisberg Marcelo Augusto Fontenelle Ribeiro Jr. 2014World Journal of Hepatology2014,6,3:24
2Laparoscopic liver resection:Experience based guidelines显示文摘Laparoscopic liver resection(LLR) has been progressively developed along the past two decades. Despite initial skepticism, improved operative results made laparoscopic approach incorporated to surgical practice and operations increased in frequency and complexity. Evidence supporting LLR comes from case-series, comparative studies and meta-analysis. Despite lack of level 1 evidence, the body of literature is stronger and existing data confirms the safety, feasibility and benefits of laparoscopic approach when compared to open resection. Indications for LLR do not differ from those for open surgery. They include benign and malignant(both primary and metastatic) tumors and living donor liver harvesting. Currently, resection of lesions located on anterolateral segments and left lateral sectionectomy are performed systematically by laparoscopy in hepatobiliary specialized centers. Resection of lesions located on posterosuperior segments(1, 4a, 7, 8) and major liver resections were shown to be feasible but remain technically demanding procedures, which should be reserved to experienced surgeons. Hand-assisted and laparoscopy-assisted procedures appeared to increase the indications of minimally invasive liver surgery and are useful strategies applied to difficult and major resections. LLR proved to be safe for malignant lesions and offers some short-term advantages over open resection. Oncological results including resection margin status and long-term survival were not inferior to open resection. At present, surgical community expects high quality studies to base the already perceived better outcomes achieved by laparoscopy in major centers' practice. Continuous surgical training, as well as new technologies should augment the application of lap-aroscopic liver surgery. Future applicability of new technologies such as robot assistance and image-guided surgery is still under investigation.fabricio ferreira coelho jaime arthur pirola kruger gilton marques fonseca raphael leonardo cunha araújo vagner birk jeismann marcos vinícius perini renato micelli lupinacci ivan cecconello paulo herman 2016World Journal of Gastrointestinal Surgery2016,8,1:22
32型糖尿病与肝胆疾病显示文摘Tolman KG Fonseca V Daipiaz A 马晓伟 2006中国糖尿病杂志2006,14,5:11
4Biliary tract schwannoma:A rare cause of obstructive jaundice in a young patient显示文摘Schwannoma is a tumor derived from Schwann cells which usually arises in the upper extremities, trunk, head and neck, retroperitoneum, mediastinum, pelvis, and peritoneum. However, it can arise in the gastro-intestinal tract, including biliary tract. We present a 24-year-old male patient with obstructive jaundice, whose investigation with computed tomography abdomen showed focal wall thickening in the common hepatic duct, difficult to differentiate with hilar adenocarcinoma. He was diagnosed intraoperatively schwannoma of common bile duct and treated with local resection. The patient recovered well without signs of recurrence of the lesion after 12 mo. We also reviewed the common bile duct schwannoma related in the literature and evaluated the difficulty in pre and intraoperative differential diagnosis with adenocarcinoma hilar. Resection is the treatment of choice for such cases and the tumordid not recur in any of the resected cases.Gilton Marques Fonseca André Luis Montagnini Manoel de Souza Rocha Rosely Antunes Patzina Mário Vinícius Angelete Alvarez Bernardes Ivan Cecconello José Jukemura 2012World Journal of Gastroenterology2012,18,37:10
5Open abdomen in gastrointestinal surgery:Which technique is the best for temporary closure during damage control?显示文摘AIM To compare the 3 main techniques of temporary closure of the abdominal cavity,vacuum assisted closure(vacuum-assisted closure therapy- VAC),Bogota bag and Barker technique,in damage control surgery.METHODS After systematic review of the literature,33 articles were selected to compare the efficiency of the three procedures.Criteria such as cost,infections,capacity of reconstruction of the abdominal wall,diseases associated with the technique,among others were analyzed.RESULTS The Bogota bag and Barker techniques present as advantage the availability of material and low cost,what is not observed in the VAC procedure.The VAC technique is the most efficient,not only because it reduces the tension on the boarders of the lesion,but also removes stagnant fluids and debris and acts at cellular level increasing cell proliferation and division.Bogota bag presents the higher rates of skin laceration and evisceration,greater need for a stent for draining fluids and wash-ups,higher rates of intestinal adhesion to the abdominal wall.The Barker technique presents lack of efficiency in closing the abdominal wall and difficulty on maintaining pressure on the dressing.The VAC dressing can generate irritation and dermatitis when the drape is applied,in addition to pain,infection and bleeding,as well as toxic shock syndrome,anaerobic sepsis and thrombosis.CONCLUSION The VAC technique,showed to be superior allowing a better control of liquid on the third space,avoiding complications such as fistula with small mortality,low infection rate,and easier capability on primary closure of the abdominal cavity.Marcelo A F Ribeiro Junior Emily Alves Barros Sabrina Marques de Carvalho Vinicius Pereira Nascimento José Cruvinel Neto Alexandre Zanchenko Fonseca 2016World Journal of Gastrointestinal Surgery2016,8,8:9
6Novel genetic markers in inflammatory bowel disease显示文摘Genetic factors play a significant role in determining inflammatory bowel disease(IBD)susceptibility.Epidemiologic data support genetic contribution to the pathogenesis of IBD,which include familial aggregation,twin studies,racial and ethnic differences in disease prevalence.Linkage studies have identified several susceptibility genes contained in different genomic regions named IBD1 to IBD9.Nucleotide oligomerization domain(NOD2)and human leukocyte antigen(HLA)genes are the most extensively studied genetic regions(IBD1 and IBD3 respectively)in IBD.Mutations of the NOD2 gene are associated with Crohn's disease(CD)and several HLA genes are associated with ulcerative colitis(UC)and CD.Toll like receptors(TLRs)have an important role in the innate immune response against infections by mediating recognition of pathogen-associated microbial patterns.Studying single-nucleotide polymorphisms(SNPs)in molecules involved in bacterial recognition seems to be essential to define genetic backgrounds at risk of IBD.Recently,numerous new genes have been identified to be involved in the genetic susceptibility to IBD:NOD1/Caspase-activation recruitment domains 4(CARD4),Chemokine ligand 20(CCL20),IL-11,and IL-18 among others.The characterization of these novel genes potentially will lead to the identification of therapeutic agents and clinical assessment of phenotype and prognosis in patients with IBD.Lorena Rodríguez-Bores Gabriela C Fonseca Marco A Villeda Jesús K Yamamoto-Furusho 2007World Journal of Gastroenterology2007,13,42:8
7Assessment of vascular invasion in gastric cancer: A comparative study显示文摘AIM: To evaluate and compare detection of lymphatic and blood vessel invasion (LVI and BVI) by hematox-ylin-eosin (HE) and immunohistochemistry (IHC) in gastric cancer specimens, and to correlate with lymph node status. METHODS: IHC using D2-40 (a lymphatic endothelial marker) and CD34 (a pan-endothelial marker) was performed to study LVI and BVI in surgical specimens froma consecutive series of 95 primary gastric cancer cases. The results of the IHC study were compared with the detection by HE using McNemar test and kappa index. The morphologic features of the tumors and the presence of LVI and BVI were related to the presence of lymph node metastasis. A χ2 test was performed to obtain associations between LVI and BVI and other prognostic factors for gastric cancer. RESULTS: The detection rate of LVI was considerably higher than that of BVI. The IHC study identified eight false-positive cases and 13 false-negative cases for LVI, and 24 false-positive cases and 10 false-negative cases for BVI. The average Kappa value determined was moderate for LVI (k=0.50) and low for BVI (k=0.20). Both LVI and BVI were statistically associated with the presence of lymph node metastasis (HE: P=0.001, P=0.013, and IHC: P=0.001, P=0.019). The mor-phologic features associated with LVI were location of the tumor in the distal third of the stomach (P=0.039), Borrmann's macroscopic type (P=0.001), organ inva-sion (P=0.03) and the depth of tumor invasion (P=0.001). The presence of BVI was related only to the depth of tumor invasion (P=0.003). CONCLUSION: The immunohistochemical identification of lymphatic and blood vessels is useful for increasing the accuracy of the diagnosis of vessel invasion and for predicting lymph node metastasis.Letícia Trivellato Gresta Ismael Alves Rodrigues-Júnior Lúcia Porto Fonseca de Castro Geovanni Dantas Cassali Mnica Maria Demas lva-res Cabral 2013World Journal of Gastroenterology2013,19,24:8
8Loss of oral mucosal stem cell markers in oral submucous fibrosis and their reactivation in malignant transformation显示文摘The integrity of the basal stem cell layer is critical for epithelial homoeostasis.In this paper,we review the expression of oral mucosal stem cell markers(OM-SCMs)in oral submucous fibrosis(OSF),oral potentially malignant disorders(OPMDs)and oral squamous cell carcinoma(OSCC)to understand the role of basal cells in potentiating cancer stem cell behaviour in OSF.While the loss of basal cell clonogenicity triggers epithelial atrophy in OSF,the transition of the epithelium from atrophic to hyperplastic and eventually neoplastic involves the reactivation of basal stemness.The vacillating expression patterns of OM-SCMs confirm the role of keratins 5,14,19,CD44,β1-integrin,p63,sex-determining region Y box(SOX2),octamer-binding transcription factor 4(Oct-4),c-MYC,B-cell-specific Moloney murine leukaemia virus integration site 1(Bmi-1)and aldehyde dehydrogenase 1(ALDH1)in OSF,OPMDs and OSCC.The downregulation of OM-SCMs in the atrophic epithelium of OSF and their upregulation during malignant transformation are illustrated with relevant literature in this review.Mohit Sharma Felipe Paiva Fonseca Keith D.Hunter Raghu Radhakrishnan 2020International Journal of Oral Science2020,12,3:7
9Perioperative blood transfusion decreases long-term survival in pediatric living donor liver transplantation显示文摘BACKGROUND The impact of perioperative blood transfusion on short-and long-term outcomes in pediatric living donor liver transplantation(PLDLT)must still be ascertained,mainly among young children.Clinical and surgical postoperative complications related to perioperative blood transfusion are well described up to three months after adult liver transplantation.AIM To determine whether transfusion is associated with early and late postoperative complications and mortality in small patients undergoing PLDLT.METHODS We evaluated the effects of perioperative transfusion on postoperative complications in recipients up to 20 kg of body weight,submitted to PLDLT.A total of 240 patients were retrospectively allocated into two groups according to postoperative complications:Minor complications(n=109)and major complications(n=131).Multiple logistic regression analysis identified the volume of perioperative packed red blood cells(RBC)transfusion as the only independent risk factor for major postoperative complications.The receiver operating characteristic curve was drawn to identify the optimal volume of the perioperative RBC transfusion related to the presence of major postoperative complications,defining a cutoff point of 27.5 mL/kg.Subsequently,patients were reallocated to a low-volume transfusion group(LTr;n=103,RBC≤27.5 mL/kg)and a high-volume transfusion group(HTr;n=137,RBC>27.5 mL/kg)so that the outcome could be analyzed.RESULTS High-volume transfusion was associated with an increased number of major complications and mortality during hospitalization up to a 10-year follow-up period.During a short-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and bleeding complications,with a decrease in rejection complications compared to the LTr.Over a long-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and minor neoplastic complications,with a decrease in rejection complications.Additionally,Cox hazard regression found that high-volume RBC transfusion increased the mortality risk by 3.031-fold compared to low-volume transfusion.The Kaplan-Meier survival curves of the studied groups were compared using log-rank tests and the analysis showed significantly decreased graft survival,but with no impact in patient survival related to major complications.On the other hand,there was a significant decrease in both graft and patient survival,with high-volume RBC transfusion.CONCLUSION Transfusion of RBC volume higher than 27.5 mL/kg during the perioperative period is associated with a significant increase in short-and long-term postoperative morbidity and mortality after PLDLT.Karina Gordon Estela Regina Ramos Figueira Joel Avancini Rocha-Filho Luiz Antonio Mondadori Eduardo Henrique Giroud Joaquim Joao Seda-Neto Eduardo Antunes da Fonseca Renata Pereira Sustovitch Pugliese Agustin Moscoso Vintimilla Jose Otavio Costa Auler Jr Maria Jose Carvalho Carmona Luiz Augusto Carneiro D'Alburquerque 2021World Journal of Gastroenterology2021,27,12:6
10Biliary complications after pediatric liver transplantation: Risk factors, diagnosis and management显示文摘The expanded indications of partial grafts in pediatric liver transplantation have reduced waiting list mortality. However, a higher morbidity is observed, including an increased rate of biliary complications(BCs). Factors such as the type of graft, the preservation methods applied, the donor characteristics, the type of biliary reconstruction, and the number of bile ducts in the liver graft influences the occurrence of these complications. Bile leaks and strictures comprise the majority of posttransplant BCs. Biliary strictures require a high grade of suspicion, and because most children have a bileoenteric anastomosis, its diagnosis and management rely on percutaneous hepatic cholangiography and percutaneous biliary interventions(PBI). The success rates with PBI range from 70% to 90%. Surgery is reserved for patients who have failed PBI. BCs in children after liver transplantation have a prolonged treatment and are associated with a longer length of stay and higher hospital costs. However, with early diagnosis and aggressive treatment, patient and graft survival are not significantly compromised.Flavia H Feier Eduardo A da Fonseca Joao Seda-Neto Paulo Chapchap 2015World Journal of Hepatology2015,7,18:4
11Duration and intensity of rainfall events with the same erosivity change sediment yield and runoff rates显示文摘The effect of different rainfall patterns on surface runoff,infiltration and thus soil losses and sediment concentrations are still in the focus of current research.In most simulated rainfall experiments,pre-cipitation is applied at a fixed intensity for a fixed time.However,the impact of rainfall patterns on soil erosion processes may be different varying the rainfall duration and intensity that produces an event with similar rainfall erosivity values.Twenty-five rainfall events were applied on micro-scale runoff plots in a soil covered with corn straw to evaluate the sediment yield and runoff rates.The different rainfall types were composed by association of duration(Dur)and intensity(IP)with the same erosivity value.The Dur varied from 38 to 106 min and the IP varied from 75.0 to 44.6 mm h^(-1).The sediment yield varied from 1.89±1.26 g m^(-2) to 4.02±2.66 g m^(-2) and runoff ranged from 16.9±8.74 mm to 32.63±10.67 mm with highest rates occurring with high intensity and low duration.The highest rainfall intensity provides the maximum sediment yield(0.138 g m^(-2) min^(-1))and runoff rates(0.87 mm min^(-1)).The time to start surface runoff varied from 14 to 19.2 min and it was longer in treatments with longer durations and low precipitation intensity.No difference was found in the amount of sediments applying rain with the same erosivity and different associations of duration and intensity.However,the intensity and duration of the rain,with the same erosivity,altered the amount and time of runoff.In rainfall experiments with con-stant intensity and fixed time,the erosion rates depend on the duration of the applied rain.Therefore,the results of this study can contribute to the development of new perspectives in the design of water erosion experiments with simulated rain considering the duration,intensity and also the association of these variables to produce rainfall that delivery the same soil erosion capacity.Wilk Sampaio de Almeida Steffen Seitz Luiz Fernando Coutinho de Oliveira Daniel Fonseca de Carvalho 2021International Soil and Water Conservation Research2021,9,1:4
12Spleen preserving distal pancreatectomy in an isolated blunt pancreatic trauma显示文摘Blunt isolated pancreatic trauma is uncommon,accounting for 1%-4% of high impact abdominal injuries.In addition,its diagnosis can be difficult;physical signs may be poor and laboratory findings nonspecific,resulting in delayed treatment.Preserving the spleen during distal pancreatectomy (DP) is controversial.One of the spleen's functions regards immunity;complications following splenectomy include leukocytosis,thrombocytosis,overwhelming post splenectomy sepsis and some degree of immunodeficiency.This is why many authors favor its preservation.We describe a case of a young man with an isolated pancreatic trauma due to a blunt abdominal trauma with a delayed presentation who was treated with spleen-preserving DP and we discuss the value of this procedure with reference to the literature.Alexandre Zanchenko Fonseca Marcelo Augusto Fontenelle Ribeiro Jr Orlando Contrucci Alexandre Pompeo Adriana Orsetti Herico Arsie Neto 2011World Journal of Gastrointestinal Surgery2011,3,9:3
13Idiopathic sudden sensorineural hearing loss:Effectiveness of salvage treatment with low-dose intratympanic dexamethasone显示文摘Objectives:To evaluate hearing outcome of salvage treatment with intratympanic steroids(ITS)in idiopathic sudden sensorineural hearing loss(ISSNHL)refractory to initial systemic steroid(SS)therapy.Material and methods:A retrospective medical chart review was conducted on 54 consecutive patients with ISSNHL refractory to SS.Salvage treatment with a low dose intratympanic dexamethasone(4 mg/ml)was offered after one week of primary treatment.Patients were divided into two groups:25 patients accepted ITS(treatment group)and 29 patients did not undergo additional treatment(control group).A pure tone average(PTA)gain of at least 10 dB was considered hearing improvement.Results:Hearing improvement rate was higher in ITS group compared to control group(40%vs.13.8%,p=0.035).A mean PTA improvement of 8.6±9.8 dB was observed in the ITS group and,whereas the control group had an average hearing gain of 0.7±2 dB(p<0.001).Audiometric analysis revealed a significant hearing gain in ITS group at all tested frequencies compared to control group(p<0.05).Analysis of the selected variables,identified intratympanic steroid treatment as the only independent prognostic factor for hearing improvement(OR=4.2,95%CI:1.1e15.7;p=0.04).Conclusion:Intratympanic low dose dexamethasone is effective in patients with incomplete hearing recovery after primary systemic steroid treatment.Pedro Salvador Francisco Moreira da Silva Rui Fonseca 2021Journal of Otology2021,16,1:3
14二甲双胍和罗格列酮联合用药治疗2型糖尿病的效果随机对照试验显示文摘Vivian Fonseca 尹士男 2001美国医学会杂志(中文版)2001,20,2:3
15Current status and future perspectives of radiomics in hepatocellular carcinoma显示文摘Given the frequent co-existence of an aggressive tumor and underlying chronic liver disease,the management of hepatocellular carcinoma(HCC)patients requires experienced multidisciplinary team discussion.Moreover,imaging plays a key role in the diagnosis,staging,restaging,and surveillance of HCC.Currently,imaging assessment of HCC entails the assessment of qualitative characteristics which are prone to inter-reader variability.Radiomics is an emerging field that extracts high-dimensional mineable quantitative features that cannot be assessed visually with the naked eye from medical imaging.The main potential applications of radiomic models in HCC are to predict histology,response to treatment,genetic signature,recurrence,and survival.Despite the encouraging results to date,there are challenges and limitations that need to be overcome before radiomics implementation in clinical practice.The purpose of this article is to review the main concepts and challenges pertaining to radiomics,and to review recent studies and potential applications of radiomics in HCC.Joao Miranda Natally Horvat Gilton Marques Fonseca Jose de Arimateia Batista Araujo-Filho Maria ClaraFernandes Charlotte Charbel Jayasree Chakraborty Fabricio Ferreira Coelho Cesar Higa Nomura Paulo Herman 2023World Journal of Gastroenterology2023,29,1:3
16Rheumatoid arthritis: Nuclear medicine state-of-the-art imaging显示文摘Rheumatoid arthritis(RA)is an autoimmune disease,which is associated with systemic and chronic inflammation of the joints,resulting in synovitis and pannus formation.For several decades,the assessment of RA has been limited to conventional radiography,assisting in the diagnosis and monitoring of disease.Nevertheless,conventional radiography has poor sensitivity in the detection of the inflammatory process that happens in the initial stages of RA.In the past years,new drugs that significantly decrease the progression of RA have allowed a more efficient treatment.Nuclear Medicine provides functional assessment of physiological processes and therefore has significant potential for timely diagnosis and adequate follow-up of RA.Several single photon emission computed tomography(SPECT)and positron emission tomography(PET)radiopharmaceuti-cals have been developed and applied in this field.The use of hybrid imaging,which permits computed tomography(CT)and nuclear medicine data to be acquired and fused,has increased even more the diagnostic accuracy of Nuclear Medicine by providing anatomical localization in SPECT/CT and PET/CT studies.More recently,fusion of PET with magnetic resonance imaging(PET/MRI)was introduced in some centers and demonstrated great potential.In this article,we will review studies that have been published using Nuclear Medicine for RA and examine key topics in the area.Paulo Henrique Rosado-de-Castro Sergio Augusto Lopes de Souza Dangelo Alexandre Lea Mirian Barbosa da Fonseca Bianca Gutfilen 2014World Journal of Orthopedics2014,5,3:3
17Systematic review:glucose control and cardiovascular disease in type 2 diabetes显示文摘Kelly TN Bazzano LA Fonseca VA Annals of Internal Medicine0,,:2
18Using ontologies for integrated geographic information systems显示文摘FONSECA F EGENHOFER M AGOURIS P 2002Transactions in GIS2002,6,3:2
19Search for naive human pluripotent stem cells显示文摘Normal mouse pluripotent stem cells were originally derived from the inner cell mass(ICM) of blastocysts and shown to be the in vitro equivalent of those pre-implantation embryonic cells, and thus were called embryonic stem cells(ESCs). More than a decade later, pluripotent cells were isolated from the ICM of human blastocysts. Despite being called human ESCs, these cells differ significantly from mouse ESCs, including different morphology and mechanisms of control of pluripotency, suggesting distinct embryonic origins of ESCs from the two species. Subsequently, mouse pluripotent stem cells were established from the ICMderived epiblast of post-implantation embryos. These mouse epiblast stem cells(Epi SCs) are morphological and epigenetically more similar to human ESCs. This raised the question of whether cells from the human ICM are in a more advanced differentiation stage than their murine counterpart, or whether the available culture conditions were not adequate to maintain those human cells in their in vivo state, leading to a transition into Epi SC-like cells in vitro. More recently, novel culture conditions allowed the conversion of human ESCs into mouse ESC-like cells called nave(or ground state) human ESCs, and the derivation of nave human ESCs from blastocysts. Here we will review the characteristics of each type of pluripotent stem cells, how(and whether) these relate to different stages of embryonic development, and discuss the potential implications of nave human ESCs in research and therapy.Simone Aparecida Siqueira Fonseca Roberta Montero Costas Lygia Veiga Pereira 2015World Journal of Stem Cells2015,7,3:2
20Children in Disaster Risk Reduction in Portugal: Policies,Education,and (Non) Participation显示文摘International agencies and scientific research have been calling for the inclusion of children in disaster preparedness and risk reduction, to hear their voices in order to address their specific needs and vulnerabilities and harness their capabilities in terms of building community resilience. This article assesses the roles ascribed to children in policy and education for disaster risk reduction in Portugal. The approach is based on a scoping methodology that encompasses document analysis and interviews with national and local stakeholders and policymakers in the disaster risk reduction field. The research is carried out within the scope of a European funded project, CUIDAR Cultures of Disaster Resilience among Children and Young People. More specifically, the article provides an overview of the discourses on the roles ascribed to children in urban disaster risk reduction(DRR). The authors maintain that although children are often taken as a target group in urban disaster prevention and management, they are seldom considered in terms of active participation in disaster risk reduction programs in the Portuguese context. Nevertheless, our analysis shows that there is a growing awareness of the relevance of active participation by children in order to create successful DRR.Ana Delicado ussara Rowland Susana Fonseca Ana Nunes de Almeida Luísa Schmidt Ana Sofia Ribeiro 2017International Journal of Disaster Risk Science2017,8,3:2
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