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Ochotorena MJ. [Ocular findings associated with hypertelorism]. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2000; 75:627-31. [PMID: 11151235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
PURPOSE To show that in hypertelorism (a horizontal orbital dystopia in which interorbital distance is increased) there are various ophthalmologic abnormalities associated: strabismus, nystagmus, amblyopia, refractive errors, palpebral malpositions, lacrimal system imperforation, fundoscopic and anterior segment lesions. We want to show that the frequence and severity of ophthalmic findings are associated to the severity of hypertelorism. But the evolution and treatment of ocular findings is independent from the treatment of this orbital dystopia. METHODS We have studied 12 cases of hypertelorism. We made a previous ophthalmologic examination which included: visual acuity, ocular motility, cycloplegic refraction, palpebral statics, lacrimal system, slit lamp and fundoscopic examination. All four walls of each orbit are osteotomized to free them from the frontal, zygomatic, maxillary, nasal and sphenoid bones in surgical correction of hypertelorism. RESULTS Amblyopia and strabismus appeared in 58.3% of patients each of them, being exotropias the most common. The most frequent refractive error was hypermetropia (40%). Other ocular findings were: ptosis, lacrimal system impermeability, heterochromic iris, optic disk hypoplasia and enophthalmos. None of the deffects was modified after surgical correction of hypertelorism. CONCLUSIONS Ophthalmologic findings associated with hypertelorism are not caused by the deformity. They are more frequent as higher the severity of the hypertelorism is. The ocular findings do not modify after surgical treatment of hypertelorism, except if we treat them specifically.
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JAMES FE. Hypertelorism associated with poor frontal development of skull and bilateral Sprengel's shoulders. BRITISH MEDICAL JOURNAL 2000; 1:1019-20. [PMID: 13638618 PMCID: PMC1993184 DOI: 10.1136/bmj.1.5128.1019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Arcand P, Abela A, Al-Ammar A, Quintal MC. Laryngeal manifestations in Opitz BBB/G syndrome. THE JOURNAL OF OTOLARYNGOLOGY 2000; 29:179-82. [PMID: 10883834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Shimizu T, Kitamura S, Kinouchi K, Fukumitsu K. A rare case of upper airway obstruction in an infant caused by basal encephalocele complicating facial midline deformity. Paediatr Anaesth 2000; 9:73-6. [PMID: 10712719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
A four-month-old male infant with basal encephalocele of the transsphenoidal type presented with upper airway obstruction and facial midline deformity, including cleft lip, cleft palate, hypertelorism and exophthalmos. Basal encephalocele is a rare disease, and usually not detectable from the outside. In this case, initially the cause of an upper airway obstruction was considered to be posterior rhinostenosis, and posterior rhinoplasty with inferior nasal conchectomy was scheduled. However, in preoperative examination, computed tomography (CT) and magnetic resonance imaging (MRI) revealed a bony defect in the sphenoidal bone and a cystic mass in communication with cerebrospinal fluid, herniating into the nasal cavity through the bony defect. The mass was diagnosed as a transsphenoidal encephalocele, the scheduled operation cancelled, and tracheostomy performed for airway management. The possibility of basal encephalocele should be considered in the case of upper airway obstruction with facial midline deformity.
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Abbas IS, Hilal MA. Cystic fibrosis and hypertelorism: a case report. ANNALS OF TROPICAL PAEDIATRICS 2000; 20:67-9. [PMID: 10824217 DOI: 10.1080/02724930092101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This is a report of cystic fibrosis in association with multiple skeletal defects, including hypertelorism, in a consanguineous family in Sudan.
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Blustajn J, Netchine I, Frédy D, Bakouche P, Piekarski JD, Meder JF. Dysgenesis of the internal carotid artery associated with transsphenoidal encephalocele: a neural crest syndrome? AJNR Am J Neuroradiol 1999; 20:1154-7. [PMID: 10445462 PMCID: PMC7056245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
We describe two original cases of internal carotid artery dysgenesis associated with a malformative spectrum, which includes transsphenoidal encephalocele, optic nerve coloboma, hypopituitarism, and hypertelorism. Cephalic neural crest cells migrate to various regions in the head and neck where they contribute to the development of structures as diverse as the anterior skull base, the walls of the craniofacial arteries, the forebrain, and the face. Data suggest that the link between these rare malformations is abnormal neural crest development.
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Goga D, Fassio E, Bonin B, Durand JL, Sirinelli D. [Congenital stenosis of the piriform aperture: a cause of respiratory distress in newborn infants. Review of the literature, from 2 cases]. REVUE DE STOMATOLOGIE ET DE CHIRURGIE MAXILLO-FACIALE 1998; 99:203-6. [PMID: 10088192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Congenital nasal pyriform aperture stenosis is a rare cause of neonatal airway obstruction. Computed tomography confirms the diagnosis and delineates the anomaly. This abnormality can be isolated or associated with abnormalities of the midface. The two options are surgical or medical treatment. The surgical treatment usually used is a surgical enlargement of the nasal pyriform aperture via a sublabial approach. We report 2 cases of congenital nasal stenosis treated successfully by an inter-maxillary disjunction followed by an expandable palatal plate. This simple and low morbidity technique allowed a durable transversal augmentation of the pyriform apertures.
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Picichè M, Castriota Scanderbeg A, Chiariello L, Levato ME, Tomai F, Pellegrino A. Atrial septal defect associated with Albright's hereditary osteodystrophy and other anomalies: a clinical case. GIORNALE ITALIANO DI CARDIOLOGIA 1998; 28:1012-6. [PMID: 9788040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
A 36 year-old woman with a history of asthenia and palpitations was admitted to the Cardiac Surgery Department of Tor Vergata University, in Rome. Physical examination revealed short stature, depressed nasal bridge, hypertelorism, hypoacusia, pectus excavatum, diffuse brachydactyly, clinodactyly of the second digit of both the right hand and left foot. A 3/6 holosystolic increasing-decreasing murmur on the pulmonary focus was present at cardiac auscultation. Echocardiogram and cardiac catheterization revealed an ostium secundum atrial septal defect. X-ray examination of the hands exhibited shortening of the third, fourth and fifth metacarpals, shortening of the distal phalanges, shortening of the proximal and middle phalanges of the fifth digits and cone epiphysis of the middle phalanx of the second digits. Radiograph of the feet revealed shortening of the third and fourth and metatarsals on the left side, bilateral shortening of the first metatarsals and of the distal phalanges, cone epiphyses at the proximal base of the first toes. Additional radiographic findings included pectus excavatum and narrowing of the spinal canal. Laboratory investigations disclosed increased plasma levels of parathormone and hypocalcemia. The patient underwent primary closure of the atrial septal defect on cardiopulmonary bypass. Radiographic findings supported the diagnosis of Albright's hereditary osteodystrophy. This is a skeletal malformation involving type I-A pseudohypoparathyroidism and so-called pseudo-pseudohypoparathyroidism. Coexistence of hypocalcemia and high levels of parathormone indicated that our patient was affected with type I-A. About one-fourth of congenital heart diseases are associated with extracardiac anomalies. Although skeletal malformations appear to be the most frequent, the association of a congenital heart defect with Albright's hereditary osteodystrophy has never been described before.
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Woywodt A, Welzel J, Haase H, Duerholz A, Wiegand U, Potratz J, Sheikhzadeh A. Cardiomyopathic lentiginosis/LEOPARD syndrome presenting as sudden cardiac arrest. Chest 1998; 113:1415-7. [PMID: 9596329 DOI: 10.1378/chest.113.5.1415] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
A 26-year-old apparently healthy man with numerous pigmented skin lesions collapsed during an evening party and was resuscitated from ventricular fibrillation. Hypertrophic cardiomyopathy and subaortic tunnel were disclosed by angiocardiography. A diagnosis of cardiomyopathic lentiginosis/lentigines (multiple), electrocardiographic abnormalities, ocular hypertelorism, pulmonary stenosis, abnormalities of the genitalia, retardation of growth, and deafness (sensorineural) syndrome was made. The patient then underwent treatment with an implantable pacer-cardioverter-defibrillator device. Further evaluation revealed several well-established features of the disorder. This is the first reported case of survival from ventricular fibrillation associated with this rare and little known multifaceted syndrome. Disseminated lentiginosis must prompt clinicians to evaluate such cases further since underlying disorders may be associated with considerable morbidity and, apparently, sudden death.
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Abstract
Ten mild signs of midline closure defect and three anthropometric parameters characterizing the distance of paired organs ("hypertelorism") were investigated in 35 boys with isolated hypospadias and in 70 control children admitted for acute infections. No significant differences between the two groups were obtained. The findings suggest that isolated, nonsyndromic hypospadias is not associated with latent midline closure anomalies.
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Rovati LC, Pricca M, Caronni EP, Granata G, Donati R, Gaini SM. A delayed complication with steel wire osteosynthesis. J Craniofac Surg 1997; 8:323-5. [PMID: 9482058 DOI: 10.1097/00001665-199707000-00016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We treated a 6-year-old child for hyperteleorbitism. We performed a facial bipartition steel wire osteosynthesis of the frontal bone. After 7 years we observed two episodes of pneumococcal meningitis, which were treated with intravenous antibiotic, resulting in a prompt recovery. The computed tomographic scan and nuclear magnetic resonance image showed the steel wire included in the frontal sinus and in contact with the dura mater. Removal of the wire and suture of the dura allowed prompt recovery.
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Abstract
A staphyloma is an uncommon ocular lesion consisting of an attenuation in the sclera, which, along with the underlying uveal tissue, bulges to form a raised pigmented area on the eye. The scleral defect predisposes the globe to rupture under conditions of increased intraocular pressure, which might occur while retracting the eye during cranio-orbital surgery. We report a case of a staphyloma in a child with bilateral facial clefts. Before hypertelorism correction, she underwent scleral repair with a cadaveric graft. Her orbital repositioning was performed without incident 10 months later. The significance of a possible association between facial clefting and staphyloma is discussed.
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Abstract
We report a case of an extremely rare craniofacial condition, which, to our knowledge, has previously been reported once only. A male infant presented with a giant congenital bone defect of the skull, in the vertex region (10 x 20 cm) and without scalp deficiency. Minimal turricephaly and moderate orbital hypertelorism were associated with slight limb abnormalities, but psychometrical assessments appeared normal. Nonsurgical treatment was initially decided upon, but spontaneous reossification was so moderate that skull reconstruction was carried out at 28 months of age because of the risk of trauma. A full-size resin cephalic skeletal reconstruction was obtained according to three-dimensional computed tomography using stereolithographic techniques. A titanium plate was customized on the resin model for ideal adaptation to the convex skull defect (8 x 16 cm). Surgery was simply performed, consisting of a preliminary undermining between the dura mater and the scalp and screwing of the custom titanium plate. The initial follow-up was uneventful.
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De Ponte FS, Fadda T, Rinna C, Brunelli A, Iannetti G. Early and late surgical treatment of orbital dystopia in craniofacial malformation. J Craniofac Surg 1997; 8:17-22. [PMID: 10332293 DOI: 10.1097/00001665-199701000-00008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Orbital dystopia is one of the most frequent clinical signs of craniofacial malformation. The term dystopia indicates the mono- and bilateral asymmetry of the orbits at least in one of the three-dimensional planes. The diagnosis is based on the clinical test of the patient with the support of diagnostic instruments such as teleradiography in both standard projections, axial computed tomographic (CT) scans at a rate of 1:1 through the neuro-orbital plan, and the three-dimensional CT. Good results of the surgical treatment depend on the patient's age and on adequate programming, which should consider the anomalies in the three spatial planes. The VTO is obtained through a protocol of analysis on cephalometric graphics of the teleradiographics on the CT at a rate of 1:1. The surgical treatment of orbital dystopia is different depending on the age of the patient and the cause of the orbital anomaly. In the case of growing patients, it is preferable to use the fronto-orbital bandeau technique so as not to damage the dental buds, whereas in grown patients Tessier's orbital quadrant technique is used. Even the fixation is quite different between patients who are growing and those who are already grown. In still-growing patients, rigid internal fixation is used only in some cases to avoid the interference with the growth mechanisms.
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Bielanska MM, Khalifa MM, Duncan AM. Pallister-Killian syndrome: a mild case diagnosed by fluorescence in situ hybridization. Review of the literature and expansion of the phenotype. AMERICAN JOURNAL OF MEDICAL GENETICS 1996; 65:104-8. [PMID: 8911599 DOI: 10.1002/(sici)1096-8628(19961016)65:2<104::aid-ajmg4>3.0.co;2-s] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Pallister-Killian syndrome (PKS) is a rare disorder characterized by a specific combination of anomalies, mental retardation and mosaic presence of a supernumerary isochromosome 12p which is tissue-limited. We report an atypical case of PKS with a mild phenotype. Flourescence in situ hybridization (FISH) was used to demonstrate that the supernumerary marker chromosome identified in the patient's fibroblasts was an isochromosome 12p. This study broadens the spectrum of PKS phenotype. It also illustrates the usefulness of fluorescence in situ hybridization in diagnosis of patients with chromosomal abnormalities and mild or atypical clinical findings.
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Gorlin RJ, Zellweger H, Curtis MW, Wiedemann HR, Warburg M, Majewski F, Gillessen-Kaesbach G, Prahl-Andersen B, Zackai E. Blepharo-cheilo-dontic (BCD) syndrome. AMERICAN JOURNAL OF MEDICAL GENETICS 1996; 65:109-12. [PMID: 8911600 DOI: 10.1002/(sici)1096-8628(19961016)65:2<109::aid-ajmg5>3.0.co;2-n] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Patients with the autosomal dominant ble-pharo-cheilo-dontic (BCD) syndrome have ectropion of lower eyelids, distichiasis of upper eyelids, euryblepharon, bilaterally cleft lip/palate, oligodontia, and conical crown form. Initially known under the eponym "Elschnig syndrome" (1912), BCD syndrome has been described in binary, ternary, and quaternary combination. There is overlap with the syndrome reported by Martínez et al. [1987], postaxial acrofacial dysostosis (Miller syndrome, Genée-Wiedemann syndrome), and a syndrome reported briefly by Warburg.
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Robin NH, Opitz JM, Muenke M. Opitz G/BBB syndrome: clinical comparisons of families linked to Xp22 and 22q, and a review of the literature. AMERICAN JOURNAL OF MEDICAL GENETICS 1996; 62:305-17. [PMID: 8882794 DOI: 10.1002/(sici)1096-8628(19960329)62:3<305::aid-ajmg20>3.0.co;2-n] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Abstract
This is a case report of multiple lentigines (Leopard Syndrome) with Chiari malformation, i.e. a herniation of the cerebellum into the foramen magnum. This male patient had generalized multiple lentigines since birth, and the lesions spread steadily, involving the scalp but sparing all mucous membranes. Organ system involvements included heart murmur, ocular hypertelorism, and retardation of growth.
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Tardio Torio E, Sánchez Sánchez E, Pérez Prado C. [Larsen syndrome and idiopathic hypercalciuria]. ANALES ESPANOLES DE PEDIATRIA 1993; 39:467-9. [PMID: 8285473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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de Toni T, Arioni C, Traverso A, Gastaldi R, Vianello MG. [Nosologic evaluation of Noonan syndrome and description of nine cases]. Minerva Pediatr 1993; 45:347-56. [PMID: 8302230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Noonan syndrome was first described over 20 years ago by Noonan and Ehmke. They defined a specific group of nine patients with valvular pulmonary stenosis who, in addition, had short stature, mild mental retardation, hypertelorism and unusual facies. The incidence of Noonan syndrome has been estimated to be between 1 in 1000 and 1 in 2500 live births. The primary biochemical defect in Noonan's syndrome is unknown. We analyzed 9 patients (5 males and 4 females) in an age range of 6 months to 10 years and 3 months with Noonan syndrome. Patients were diagnosed as having the syndrome if they had characteristic facies and a normal karyotype, plus one of the following signs: cardiac defects, short stature or undescended testes. All patients have ocular anomalies (epicanthal folds, ptosis of eyelids, hypertelorism, downslanting palpebral fissures and ocular proptosis). Congenital heart malformations are present in 8 patients and the more frequent cardiopath is pulmonary valve stenosis due to a dysplastic or thickened valve. Short stature is present in 6 patients and 3 of them are actually on treatment with rhGH. A moderate-mild mental retardation is present in 6 patients. Case n. 9 had a syringomyelia and tethered cord. These malformations are rarely reported in Noonan's syndrome.
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Dorittke P. [Multiple lentigines syndrome (LEOPARD syndrome)]. KINDERKRANKENSCHWESTER : ORGAN DER SEKTION KINDERKRANKENPFLEGE 1992; 11:226. [PMID: 1627486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Heney D, Lockwood L, Allibone EB, Bailey CC. Nasopharyngeal rhabdomyosarcoma and multiple lentigines syndrome: a case report. MEDICAL AND PEDIATRIC ONCOLOGY 1992; 20:227-8. [PMID: 1574034 DOI: 10.1002/mpo.2950200309] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
An 8-year-old boy with multiple lentigines syndrome presented with a nasopharyngeal rhabdomyosarcoma. The tumour failed to respond to chemotherapy. This is a further association of rhabdomyosarcoma with a congenital syndrome.
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Temple IK, Brunner H, Jones B, Burn J, Baraitser M. Midline facial defects with ocular colobomata. AMERICAN JOURNAL OF MEDICAL GENETICS 1990; 37:23-7. [PMID: 1700608 DOI: 10.1002/ajmg.1320370107] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We describe 5 children with midline facial anomalies and iris colobomata reminiscent of frontonasal "dysplasia." Two patients have, in addition, abnormalities of the eyelids and one of them probably has the rare autosomal recessive condition frontofacionasal "dysplasia." The patients may have a new syndrome of midline facial defects, iris colobomata, and mental retardation.
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Ros Pérez P, Pareja Grande J, Nieto Soriano I, Alonso Blanco M, Visa Zurras M, Yturriaga Matarranz R, Barrio Castellanos R. [Trans-sphenoidal encephalocele associated with hypopituitarism and arteriovenous malformations]. ANALES ESPANOLES DE PEDIATRIA 1990; 32:547-50. [PMID: 2221634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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