Enhanced Expression of Podoplanin in Oral Carcinomas in situ and Squamous Cell Carcinomas
Objective: Podoplanin, a known lymphatic endothelial cell marker, has been reported to be expressed in various types of cancer. To elucidate the expression of podoplanin in precancerous lesions, we examined the immunohistochemical profiles of podoplanin in oral squamous epithelial lesions. Method: W...
Gespeichert in:
| Veröffentlicht in: | Pathobiology (Basel) 2011-01, Vol.78 (3), p.171-180 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 180 |
|---|---|
| container_issue | 3 |
| container_start_page | 171 |
| container_title | Pathobiology (Basel) |
| container_volume | 78 |
| creator | Funayama, Akinori Cheng, Jun Maruyama, Satoshi Yamazaki, Manabu Kobayashi, Takanori Syafriadi, Mei Kundu, Sukalyan Shingaki, Susumu Saito, Chikara Saku, Takashi |
| description | Objective: Podoplanin, a known lymphatic endothelial cell marker, has been reported to be expressed in various types of cancer. To elucidate the expression of podoplanin in precancerous lesions, we examined the immunohistochemical profiles of podoplanin in oral squamous epithelial lesions. Method: We studied a total of 298 foci of squamous cell carcinoma (SCC), carcinoma in situ (CIS), epithelial dysplasia, and hyperplastic and/or normal epithelial lesions by immunohistochemistry using D2-40. Results: There was no positivity for podoplanin in normal or hyperplastic epithelia, while all of the CIS and SCC foci stained positive. Approximately one third of the mild dysplasia foci (10 of 36 foci, 28%) and 80% of moderate dysplasia foci (78/98) showed grade 1 positive reactions (positive only in the 1st layer). Grade 2 reactions (up to 4th layer) were seen in 4 of 98 moderate dysplasia foci (4%), 29 of 74 CIS foci (39%), and 3 of 30 SCC foci (10%). Grade 3 reactions (to more than 5th layer) were found in 35 (47%) CIS foci and 26 (87%) SCC foci. Conclusions: The relationship between the present histological categorization and podoplanin grade was statistically significant. D2-40 expression is considered to be related to the severity of oral precancerous lesions. |
| doi_str_mv | 10.1159/000324926 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1159_000324926</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>873705018</sourcerecordid><originalsourceid>FETCH-LOGICAL-c398t-460090d9d3428b3e414a6a1ddbd2efa4b6cf98508b83d931134fac4234154b7a3</originalsourceid><addsrcrecordid>eNpd0M1LwzAYBvAgipvTg3eR4EU8VN98tEuOUuYHDCaoB08lbVLtbJMtWUH_ezM2hwiBhPDLy5MHoVMC14Sk8gYAGOWSZntoSDhlCVBJ9uMZSJpQADFARyHMIxOQwSEaUJIRJoAP0dvEfihbGY0nXwtvQmicxa7GT067RatsY3FcM69anCtfNdZ1KqyvQrPqsbIaPy971bk-4Ny0f9ExOqhVG8zJdh-h17vJS_6QTGf3j_ntNKmYFKuEZwAStNSMU1EywwlXmSJal5qaWvEyq2opUhClYFoyQhivVRU_yUnKy7FiI3S5mbvwbtmbsCq6JlQxi7ImxirEmI0hBSKivPgn5673NoaLKKMSCIOIrjao8i4Eb-pi4ZtO-e-CQLFuu9i1He35dmBfdkbv5G-9EZxtwKfy78bvwPb9DwaVgRg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>876290130</pqid></control><display><type>article</type><title>Enhanced Expression of Podoplanin in Oral Carcinomas in situ and Squamous Cell Carcinomas</title><source>MEDLINE</source><source>Karger Journals Complete</source><source>Alma/SFX Local Collection</source><creator>Funayama, Akinori ; Cheng, Jun ; Maruyama, Satoshi ; Yamazaki, Manabu ; Kobayashi, Takanori ; Syafriadi, Mei ; Kundu, Sukalyan ; Shingaki, Susumu ; Saito, Chikara ; Saku, Takashi</creator><creatorcontrib>Funayama, Akinori ; Cheng, Jun ; Maruyama, Satoshi ; Yamazaki, Manabu ; Kobayashi, Takanori ; Syafriadi, Mei ; Kundu, Sukalyan ; Shingaki, Susumu ; Saito, Chikara ; Saku, Takashi</creatorcontrib><description>Objective: Podoplanin, a known lymphatic endothelial cell marker, has been reported to be expressed in various types of cancer. To elucidate the expression of podoplanin in precancerous lesions, we examined the immunohistochemical profiles of podoplanin in oral squamous epithelial lesions. Method: We studied a total of 298 foci of squamous cell carcinoma (SCC), carcinoma in situ (CIS), epithelial dysplasia, and hyperplastic and/or normal epithelial lesions by immunohistochemistry using D2-40. Results: There was no positivity for podoplanin in normal or hyperplastic epithelia, while all of the CIS and SCC foci stained positive. Approximately one third of the mild dysplasia foci (10 of 36 foci, 28%) and 80% of moderate dysplasia foci (78/98) showed grade 1 positive reactions (positive only in the 1st layer). Grade 2 reactions (up to 4th layer) were seen in 4 of 98 moderate dysplasia foci (4%), 29 of 74 CIS foci (39%), and 3 of 30 SCC foci (10%). Grade 3 reactions (to more than 5th layer) were found in 35 (47%) CIS foci and 26 (87%) SCC foci. Conclusions: The relationship between the present histological categorization and podoplanin grade was statistically significant. D2-40 expression is considered to be related to the severity of oral precancerous lesions.</description><identifier>ISSN: 1015-2008</identifier><identifier>EISSN: 1423-0291</identifier><identifier>DOI: 10.1159/000324926</identifier><identifier>PMID: 21613804</identifier><identifier>CODEN: PATHEF</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Antibodies, Monoclonal, Murine-Derived ; Biomarkers ; Biomarkers, Tumor - metabolism ; Cancer ; Carcinoma in Situ - metabolism ; Carcinoma in Situ - pathology ; Carcinoma, Squamous Cell - metabolism ; Carcinoma, Squamous Cell - pathology ; Gene Expression Regulation, Neoplastic ; Humans ; Hyperplasia - metabolism ; Hyperplasia - pathology ; Immunohistochemistry ; Lesions ; Membrane Glycoproteins - metabolism ; Mouth Mucosa - metabolism ; Mouth Mucosa - pathology ; Mouth Neoplasms - metabolism ; Mouth Neoplasms - pathology ; Neoplasm Staging ; Oral cancer ; Original Paper ; Precancerous Conditions - metabolism ; Precancerous Conditions - pathology</subject><ispartof>Pathobiology (Basel), 2011-01, Vol.78 (3), p.171-180</ispartof><rights>2011 S. Karger AG, Basel</rights><rights>Copyright © 2011 S. Karger AG, Basel.</rights><rights>Copyright (c) 2011 S. Karger AG, Basel</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c398t-460090d9d3428b3e414a6a1ddbd2efa4b6cf98508b83d931134fac4234154b7a3</citedby><cites>FETCH-LOGICAL-c398t-460090d9d3428b3e414a6a1ddbd2efa4b6cf98508b83d931134fac4234154b7a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2429,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21613804$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Funayama, Akinori</creatorcontrib><creatorcontrib>Cheng, Jun</creatorcontrib><creatorcontrib>Maruyama, Satoshi</creatorcontrib><creatorcontrib>Yamazaki, Manabu</creatorcontrib><creatorcontrib>Kobayashi, Takanori</creatorcontrib><creatorcontrib>Syafriadi, Mei</creatorcontrib><creatorcontrib>Kundu, Sukalyan</creatorcontrib><creatorcontrib>Shingaki, Susumu</creatorcontrib><creatorcontrib>Saito, Chikara</creatorcontrib><creatorcontrib>Saku, Takashi</creatorcontrib><title>Enhanced Expression of Podoplanin in Oral Carcinomas in situ and Squamous Cell Carcinomas</title><title>Pathobiology (Basel)</title><addtitle>Pathobiology</addtitle><description>Objective: Podoplanin, a known lymphatic endothelial cell marker, has been reported to be expressed in various types of cancer. To elucidate the expression of podoplanin in precancerous lesions, we examined the immunohistochemical profiles of podoplanin in oral squamous epithelial lesions. Method: We studied a total of 298 foci of squamous cell carcinoma (SCC), carcinoma in situ (CIS), epithelial dysplasia, and hyperplastic and/or normal epithelial lesions by immunohistochemistry using D2-40. Results: There was no positivity for podoplanin in normal or hyperplastic epithelia, while all of the CIS and SCC foci stained positive. Approximately one third of the mild dysplasia foci (10 of 36 foci, 28%) and 80% of moderate dysplasia foci (78/98) showed grade 1 positive reactions (positive only in the 1st layer). Grade 2 reactions (up to 4th layer) were seen in 4 of 98 moderate dysplasia foci (4%), 29 of 74 CIS foci (39%), and 3 of 30 SCC foci (10%). Grade 3 reactions (to more than 5th layer) were found in 35 (47%) CIS foci and 26 (87%) SCC foci. Conclusions: The relationship between the present histological categorization and podoplanin grade was statistically significant. D2-40 expression is considered to be related to the severity of oral precancerous lesions.</description><subject>Antibodies, Monoclonal, Murine-Derived</subject><subject>Biomarkers</subject><subject>Biomarkers, Tumor - metabolism</subject><subject>Cancer</subject><subject>Carcinoma in Situ - metabolism</subject><subject>Carcinoma in Situ - pathology</subject><subject>Carcinoma, Squamous Cell - metabolism</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Gene Expression Regulation, Neoplastic</subject><subject>Humans</subject><subject>Hyperplasia - metabolism</subject><subject>Hyperplasia - pathology</subject><subject>Immunohistochemistry</subject><subject>Lesions</subject><subject>Membrane Glycoproteins - metabolism</subject><subject>Mouth Mucosa - metabolism</subject><subject>Mouth Mucosa - pathology</subject><subject>Mouth Neoplasms - metabolism</subject><subject>Mouth Neoplasms - pathology</subject><subject>Neoplasm Staging</subject><subject>Oral cancer</subject><subject>Original Paper</subject><subject>Precancerous Conditions - metabolism</subject><subject>Precancerous Conditions - pathology</subject><issn>1015-2008</issn><issn>1423-0291</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpd0M1LwzAYBvAgipvTg3eR4EU8VN98tEuOUuYHDCaoB08lbVLtbJMtWUH_ezM2hwiBhPDLy5MHoVMC14Sk8gYAGOWSZntoSDhlCVBJ9uMZSJpQADFARyHMIxOQwSEaUJIRJoAP0dvEfihbGY0nXwtvQmicxa7GT067RatsY3FcM69anCtfNdZ1KqyvQrPqsbIaPy971bk-4Ny0f9ExOqhVG8zJdh-h17vJS_6QTGf3j_ntNKmYFKuEZwAStNSMU1EywwlXmSJal5qaWvEyq2opUhClYFoyQhivVRU_yUnKy7FiI3S5mbvwbtmbsCq6JlQxi7ImxirEmI0hBSKivPgn5673NoaLKKMSCIOIrjao8i4Eb-pi4ZtO-e-CQLFuu9i1He35dmBfdkbv5G-9EZxtwKfy78bvwPb9DwaVgRg</recordid><startdate>20110101</startdate><enddate>20110101</enddate><creator>Funayama, Akinori</creator><creator>Cheng, Jun</creator><creator>Maruyama, Satoshi</creator><creator>Yamazaki, Manabu</creator><creator>Kobayashi, Takanori</creator><creator>Syafriadi, Mei</creator><creator>Kundu, Sukalyan</creator><creator>Shingaki, Susumu</creator><creator>Saito, Chikara</creator><creator>Saku, Takashi</creator><general>S. Karger AG</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BKSAR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PCBAR</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20110101</creationdate><title>Enhanced Expression of Podoplanin in Oral Carcinomas in situ and Squamous Cell Carcinomas</title><author>Funayama, Akinori ; Cheng, Jun ; Maruyama, Satoshi ; Yamazaki, Manabu ; Kobayashi, Takanori ; Syafriadi, Mei ; Kundu, Sukalyan ; Shingaki, Susumu ; Saito, Chikara ; Saku, Takashi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c398t-460090d9d3428b3e414a6a1ddbd2efa4b6cf98508b83d931134fac4234154b7a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Antibodies, Monoclonal, Murine-Derived</topic><topic>Biomarkers</topic><topic>Biomarkers, Tumor - metabolism</topic><topic>Cancer</topic><topic>Carcinoma in Situ - metabolism</topic><topic>Carcinoma in Situ - pathology</topic><topic>Carcinoma, Squamous Cell - metabolism</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Gene Expression Regulation, Neoplastic</topic><topic>Humans</topic><topic>Hyperplasia - metabolism</topic><topic>Hyperplasia - pathology</topic><topic>Immunohistochemistry</topic><topic>Lesions</topic><topic>Membrane Glycoproteins - metabolism</topic><topic>Mouth Mucosa - metabolism</topic><topic>Mouth Mucosa - pathology</topic><topic>Mouth Neoplasms - metabolism</topic><topic>Mouth Neoplasms - pathology</topic><topic>Neoplasm Staging</topic><topic>Oral cancer</topic><topic>Original Paper</topic><topic>Precancerous Conditions - metabolism</topic><topic>Precancerous Conditions - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Funayama, Akinori</creatorcontrib><creatorcontrib>Cheng, Jun</creatorcontrib><creatorcontrib>Maruyama, Satoshi</creatorcontrib><creatorcontrib>Yamazaki, Manabu</creatorcontrib><creatorcontrib>Kobayashi, Takanori</creatorcontrib><creatorcontrib>Syafriadi, Mei</creatorcontrib><creatorcontrib>Kundu, Sukalyan</creatorcontrib><creatorcontrib>Shingaki, Susumu</creatorcontrib><creatorcontrib>Saito, Chikara</creatorcontrib><creatorcontrib>Saku, Takashi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Earth, Atmospheric & Aquatic Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Earth, Atmospheric & Aquatic Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Pathobiology (Basel)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Funayama, Akinori</au><au>Cheng, Jun</au><au>Maruyama, Satoshi</au><au>Yamazaki, Manabu</au><au>Kobayashi, Takanori</au><au>Syafriadi, Mei</au><au>Kundu, Sukalyan</au><au>Shingaki, Susumu</au><au>Saito, Chikara</au><au>Saku, Takashi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Enhanced Expression of Podoplanin in Oral Carcinomas in situ and Squamous Cell Carcinomas</atitle><jtitle>Pathobiology (Basel)</jtitle><addtitle>Pathobiology</addtitle><date>2011-01-01</date><risdate>2011</risdate><volume>78</volume><issue>3</issue><spage>171</spage><epage>180</epage><pages>171-180</pages><issn>1015-2008</issn><eissn>1423-0291</eissn><coden>PATHEF</coden><abstract>Objective: Podoplanin, a known lymphatic endothelial cell marker, has been reported to be expressed in various types of cancer. To elucidate the expression of podoplanin in precancerous lesions, we examined the immunohistochemical profiles of podoplanin in oral squamous epithelial lesions. Method: We studied a total of 298 foci of squamous cell carcinoma (SCC), carcinoma in situ (CIS), epithelial dysplasia, and hyperplastic and/or normal epithelial lesions by immunohistochemistry using D2-40. Results: There was no positivity for podoplanin in normal or hyperplastic epithelia, while all of the CIS and SCC foci stained positive. Approximately one third of the mild dysplasia foci (10 of 36 foci, 28%) and 80% of moderate dysplasia foci (78/98) showed grade 1 positive reactions (positive only in the 1st layer). Grade 2 reactions (up to 4th layer) were seen in 4 of 98 moderate dysplasia foci (4%), 29 of 74 CIS foci (39%), and 3 of 30 SCC foci (10%). Grade 3 reactions (to more than 5th layer) were found in 35 (47%) CIS foci and 26 (87%) SCC foci. Conclusions: The relationship between the present histological categorization and podoplanin grade was statistically significant. D2-40 expression is considered to be related to the severity of oral precancerous lesions.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>21613804</pmid><doi>10.1159/000324926</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1015-2008 |
| ispartof | Pathobiology (Basel), 2011-01, Vol.78 (3), p.171-180 |
| issn | 1015-2008 1423-0291 |
| language | eng |
| recordid | cdi_crossref_primary_10_1159_000324926 |
| source | MEDLINE; Karger Journals Complete; Alma/SFX Local Collection |
| subjects | Antibodies, Monoclonal, Murine-Derived Biomarkers Biomarkers, Tumor - metabolism Cancer Carcinoma in Situ - metabolism Carcinoma in Situ - pathology Carcinoma, Squamous Cell - metabolism Carcinoma, Squamous Cell - pathology Gene Expression Regulation, Neoplastic Humans Hyperplasia - metabolism Hyperplasia - pathology Immunohistochemistry Lesions Membrane Glycoproteins - metabolism Mouth Mucosa - metabolism Mouth Mucosa - pathology Mouth Neoplasms - metabolism Mouth Neoplasms - pathology Neoplasm Staging Oral cancer Original Paper Precancerous Conditions - metabolism Precancerous Conditions - pathology |
| title | Enhanced Expression of Podoplanin in Oral Carcinomas in situ and Squamous Cell Carcinomas |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T01%3A47%3A52IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Enhanced%20Expression%20of%20Podoplanin%20in%20Oral%20Carcinomas%20in%20situ%20and%20Squamous%20Cell%20Carcinomas&rft.jtitle=Pathobiology%20(Basel)&rft.au=Funayama,%20Akinori&rft.date=2011-01-01&rft.volume=78&rft.issue=3&rft.spage=171&rft.epage=180&rft.pages=171-180&rft.issn=1015-2008&rft.eissn=1423-0291&rft.coden=PATHEF&rft_id=info:doi/10.1159/000324926&rft_dat=%3Cproquest_cross%3E873705018%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=876290130&rft_id=info:pmid/21613804&rfr_iscdi=true |