Intraoperative versus Early Postoperative Intraperitoneal Chemotherapy after Cytoreduction for Colorectal Peritoneal Carcinomatosis: an Experimental Study
Background Perioperative intraperitoneal chemotherapy is used as an adjunct to cytoreductive surgery (CS) for peritoneal carcinomatosis (PC) in order to prolong survival. Worldwide, hyperthermic intraperitoneal chemotherapy (HIPEC), early postoperative intraperitoneal chemotherapy (EPIC), and combin...
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| Veröffentlicht in: | Annals of surgical oncology 2012-07, Vol.19 (Suppl 3), p.475-482 |
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| container_issue | Suppl 3 |
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| container_title | Annals of surgical oncology |
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| creator | Klaver, Yvonne L. B. Hendriks, Thijs Lomme, Roger M. L. M. Rutten, Harm J. T. Bleichrodt, Robert P. de Hingh, Ignace H. J. T. |
| description | Background
Perioperative intraperitoneal chemotherapy is used as an adjunct to cytoreductive surgery (CS) for peritoneal carcinomatosis (PC) in order to prolong survival. Worldwide, hyperthermic intraperitoneal chemotherapy (HIPEC), early postoperative intraperitoneal chemotherapy (EPIC), and combinations of the two are used. It remains unclear which regimen is most beneficial.
Methods
The rat colon carcinoma cell line CC-531 was injected into the peritoneal cavity of 80 WAG/Rij rats to induce PC. Animals were randomized into four treatment groups (
n
= 20): CS only, CS followed by HIPEC (mitomycin 35 mg/m
2
at 41.5°C), CS followed by EPIC during 5 days (i.p. injection of mitomycin on day 1 and 5-fluorouracil on days 2–5), and CS followed by HIPEC plus EPIC. Primary outcome was survival.
Results
In rats treated with CS only, median survival was 53 days (95% confidence interval (CI) 49–57 days). In rats treated with CS followed by HIPEC, survival was significantly (
P
= 0.001) increased (median survival 94 days, 95% CI 51–137 days). In the group treated with EPIC after CS, 12 out of 20 rats were still alive at the end of the experiment (
P
|
| doi_str_mv | 10.1245/s10434-011-1984-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_1030189955</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2724354411</sourcerecordid><originalsourceid>FETCH-LOGICAL-c415t-c74fdc67905c147cf147f18b1a901186471d55fac6627c3981ece3033964765d3</originalsourceid><addsrcrecordid>eNp1kctOwzAQRS0E4v0BbJAl1gFPbCc2O1SVh4QEErCOXMeBoDYutlORX-FrmdLy2LCxPXPP3LFmCDkCdgq5kGcRmOAiYwAZaCUyvUF2QWJGFAo28c0Klem8kDtkL8ZXxqDkTG6TnRwUL2WudsnHTZeC8XMXTGoXji5ciH2kYxOmA733Mf1KXyRGbfKdM1M6enEzn15Qng_UNMkFOhqSD67ubWp9RxuPGT_FjE3I3_8pNcG2nZ-Z5GMbz6np6Ph9aT1z3RJ9SH09HJCtxkyjO1zf--Tpcvw4us5u765uRhe3mRUgU2ZL0dS2KDWTFkRpGzwaUBMwGgejClFCLWVjbFHkpeVagbOOM841SoWs-T45WfnOg3_rXUzVq-9Dhy0rYJyB0lpKpGBF2eBjDK6p5vhdEwaEquU2qtU2KmxaLbdRaaw5Xjv3k5mrfyq-x49AvgIiSt2zC39b_-f6CXAwmMs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1030189955</pqid></control><display><type>article</type><title>Intraoperative versus Early Postoperative Intraperitoneal Chemotherapy after Cytoreduction for Colorectal Peritoneal Carcinomatosis: an Experimental Study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Klaver, Yvonne L. B. ; Hendriks, Thijs ; Lomme, Roger M. L. M. ; Rutten, Harm J. T. ; Bleichrodt, Robert P. ; de Hingh, Ignace H. J. T.</creator><creatorcontrib>Klaver, Yvonne L. B. ; Hendriks, Thijs ; Lomme, Roger M. L. M. ; Rutten, Harm J. T. ; Bleichrodt, Robert P. ; de Hingh, Ignace H. J. T.</creatorcontrib><description>Background
Perioperative intraperitoneal chemotherapy is used as an adjunct to cytoreductive surgery (CS) for peritoneal carcinomatosis (PC) in order to prolong survival. Worldwide, hyperthermic intraperitoneal chemotherapy (HIPEC), early postoperative intraperitoneal chemotherapy (EPIC), and combinations of the two are used. It remains unclear which regimen is most beneficial.
Methods
The rat colon carcinoma cell line CC-531 was injected into the peritoneal cavity of 80 WAG/Rij rats to induce PC. Animals were randomized into four treatment groups (
n
= 20): CS only, CS followed by HIPEC (mitomycin 35 mg/m
2
at 41.5°C), CS followed by EPIC during 5 days (i.p. injection of mitomycin on day 1 and 5-fluorouracil on days 2–5), and CS followed by HIPEC plus EPIC. Primary outcome was survival.
Results
In rats treated with CS only, median survival was 53 days (95% confidence interval (CI) 49–57 days). In rats treated with CS followed by HIPEC, survival was significantly (
P
= 0.001) increased (median survival 94 days, 95% CI 51–137 days). In the group treated with EPIC after CS, 12 out of 20 rats were still alive at the end of the experiment (
P
< 0.001 as compared with CS only). In the group receiving both treatments, 11 rats died of toxicity, and therefore this group was not included in the survival analysis.
Conclusions
Both EPIC and HIPEC were effective in prolonging survival. The beneficial effect of EPIC on survival seemed to be more pronounced than that of HIPEC. Further research is indicated to evaluate and compare the possible benefits and adverse effects associated with both treatments.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-011-1984-9</identifier><identifier>PMID: 21837528</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Animals ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Carcinoma - drug therapy ; Carcinoma - secondary ; Carcinoma - therapy ; Chemotherapy, Adjuvant ; Colonic Neoplasms - pathology ; Confidence Intervals ; Fluorouracil - administration & dosage ; Hyperthermia, Induced ; Intraoperative Care ; Kaplan-Meier Estimate ; Male ; Medicine ; Medicine & Public Health ; Mitomycin - administration & dosage ; Oncology ; Peritoneal Neoplasms - drug therapy ; Peritoneal Neoplasms - secondary ; Peritoneal Neoplasms - therapy ; Postoperative Care ; Proportional Hazards Models ; Rats ; Surgery ; Surgical Oncology ; Translational Research and Biomarkers</subject><ispartof>Annals of surgical oncology, 2012-07, Vol.19 (Suppl 3), p.475-482</ispartof><rights>The Author(s) 2011</rights><rights>Society of Surgical Oncology 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-c74fdc67905c147cf147f18b1a901186471d55fac6627c3981ece3033964765d3</citedby><cites>FETCH-LOGICAL-c415t-c74fdc67905c147cf147f18b1a901186471d55fac6627c3981ece3033964765d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-011-1984-9$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-011-1984-9$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21837528$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Klaver, Yvonne L. B.</creatorcontrib><creatorcontrib>Hendriks, Thijs</creatorcontrib><creatorcontrib>Lomme, Roger M. L. M.</creatorcontrib><creatorcontrib>Rutten, Harm J. T.</creatorcontrib><creatorcontrib>Bleichrodt, Robert P.</creatorcontrib><creatorcontrib>de Hingh, Ignace H. J. T.</creatorcontrib><title>Intraoperative versus Early Postoperative Intraperitoneal Chemotherapy after Cytoreduction for Colorectal Peritoneal Carcinomatosis: an Experimental Study</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Perioperative intraperitoneal chemotherapy is used as an adjunct to cytoreductive surgery (CS) for peritoneal carcinomatosis (PC) in order to prolong survival. Worldwide, hyperthermic intraperitoneal chemotherapy (HIPEC), early postoperative intraperitoneal chemotherapy (EPIC), and combinations of the two are used. It remains unclear which regimen is most beneficial.
Methods
The rat colon carcinoma cell line CC-531 was injected into the peritoneal cavity of 80 WAG/Rij rats to induce PC. Animals were randomized into four treatment groups (
n
= 20): CS only, CS followed by HIPEC (mitomycin 35 mg/m
2
at 41.5°C), CS followed by EPIC during 5 days (i.p. injection of mitomycin on day 1 and 5-fluorouracil on days 2–5), and CS followed by HIPEC plus EPIC. Primary outcome was survival.
Results
In rats treated with CS only, median survival was 53 days (95% confidence interval (CI) 49–57 days). In rats treated with CS followed by HIPEC, survival was significantly (
P
= 0.001) increased (median survival 94 days, 95% CI 51–137 days). In the group treated with EPIC after CS, 12 out of 20 rats were still alive at the end of the experiment (
P
< 0.001 as compared with CS only). In the group receiving both treatments, 11 rats died of toxicity, and therefore this group was not included in the survival analysis.
Conclusions
Both EPIC and HIPEC were effective in prolonging survival. The beneficial effect of EPIC on survival seemed to be more pronounced than that of HIPEC. Further research is indicated to evaluate and compare the possible benefits and adverse effects associated with both treatments.</description><subject>Animals</subject><subject>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Carcinoma - drug therapy</subject><subject>Carcinoma - secondary</subject><subject>Carcinoma - therapy</subject><subject>Chemotherapy, Adjuvant</subject><subject>Colonic Neoplasms - pathology</subject><subject>Confidence Intervals</subject><subject>Fluorouracil - administration & dosage</subject><subject>Hyperthermia, Induced</subject><subject>Intraoperative Care</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mitomycin - administration & dosage</subject><subject>Oncology</subject><subject>Peritoneal Neoplasms - drug therapy</subject><subject>Peritoneal Neoplasms - secondary</subject><subject>Peritoneal Neoplasms - therapy</subject><subject>Postoperative Care</subject><subject>Proportional Hazards Models</subject><subject>Rats</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Translational Research and Biomarkers</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kctOwzAQRS0E4v0BbJAl1gFPbCc2O1SVh4QEErCOXMeBoDYutlORX-FrmdLy2LCxPXPP3LFmCDkCdgq5kGcRmOAiYwAZaCUyvUF2QWJGFAo28c0Klem8kDtkL8ZXxqDkTG6TnRwUL2WudsnHTZeC8XMXTGoXji5ciH2kYxOmA733Mf1KXyRGbfKdM1M6enEzn15Qng_UNMkFOhqSD67ubWp9RxuPGT_FjE3I3_8pNcG2nZ-Z5GMbz6np6Ph9aT1z3RJ9SH09HJCtxkyjO1zf--Tpcvw4us5u765uRhe3mRUgU2ZL0dS2KDWTFkRpGzwaUBMwGgejClFCLWVjbFHkpeVagbOOM841SoWs-T45WfnOg3_rXUzVq-9Dhy0rYJyB0lpKpGBF2eBjDK6p5vhdEwaEquU2qtU2KmxaLbdRaaw5Xjv3k5mrfyq-x49AvgIiSt2zC39b_-f6CXAwmMs</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Klaver, Yvonne L. B.</creator><creator>Hendriks, Thijs</creator><creator>Lomme, Roger M. L. M.</creator><creator>Rutten, Harm J. T.</creator><creator>Bleichrodt, Robert P.</creator><creator>de Hingh, Ignace H. J. T.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>C6C</scope><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>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20120701</creationdate><title>Intraoperative versus Early Postoperative Intraperitoneal Chemotherapy after Cytoreduction for Colorectal Peritoneal Carcinomatosis: an Experimental Study</title><author>Klaver, Yvonne L. B. ; Hendriks, Thijs ; Lomme, Roger M. L. M. ; Rutten, Harm J. T. ; Bleichrodt, Robert P. ; de Hingh, Ignace H. J. T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-c74fdc67905c147cf147f18b1a901186471d55fac6627c3981ece3033964765d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Animals</topic><topic>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</topic><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Carcinoma - drug therapy</topic><topic>Carcinoma - secondary</topic><topic>Carcinoma - therapy</topic><topic>Chemotherapy, Adjuvant</topic><topic>Colonic Neoplasms - pathology</topic><topic>Confidence Intervals</topic><topic>Fluorouracil - administration & dosage</topic><topic>Hyperthermia, Induced</topic><topic>Intraoperative Care</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mitomycin - administration & dosage</topic><topic>Oncology</topic><topic>Peritoneal Neoplasms - drug therapy</topic><topic>Peritoneal Neoplasms - secondary</topic><topic>Peritoneal Neoplasms - therapy</topic><topic>Postoperative Care</topic><topic>Proportional Hazards Models</topic><topic>Rats</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Translational Research and Biomarkers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Klaver, Yvonne L. B.</creatorcontrib><creatorcontrib>Hendriks, Thijs</creatorcontrib><creatorcontrib>Lomme, Roger M. L. M.</creatorcontrib><creatorcontrib>Rutten, Harm J. T.</creatorcontrib><creatorcontrib>Bleichrodt, Robert P.</creatorcontrib><creatorcontrib>de Hingh, Ignace H. J. T.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><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>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma 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</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical 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 China</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Klaver, Yvonne L. B.</au><au>Hendriks, Thijs</au><au>Lomme, Roger M. L. M.</au><au>Rutten, Harm J. T.</au><au>Bleichrodt, Robert P.</au><au>de Hingh, Ignace H. J. T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intraoperative versus Early Postoperative Intraperitoneal Chemotherapy after Cytoreduction for Colorectal Peritoneal Carcinomatosis: an Experimental Study</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>19</volume><issue>Suppl 3</issue><spage>475</spage><epage>482</epage><pages>475-482</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Perioperative intraperitoneal chemotherapy is used as an adjunct to cytoreductive surgery (CS) for peritoneal carcinomatosis (PC) in order to prolong survival. Worldwide, hyperthermic intraperitoneal chemotherapy (HIPEC), early postoperative intraperitoneal chemotherapy (EPIC), and combinations of the two are used. It remains unclear which regimen is most beneficial.
Methods
The rat colon carcinoma cell line CC-531 was injected into the peritoneal cavity of 80 WAG/Rij rats to induce PC. Animals were randomized into four treatment groups (
n
= 20): CS only, CS followed by HIPEC (mitomycin 35 mg/m
2
at 41.5°C), CS followed by EPIC during 5 days (i.p. injection of mitomycin on day 1 and 5-fluorouracil on days 2–5), and CS followed by HIPEC plus EPIC. Primary outcome was survival.
Results
In rats treated with CS only, median survival was 53 days (95% confidence interval (CI) 49–57 days). In rats treated with CS followed by HIPEC, survival was significantly (
P
= 0.001) increased (median survival 94 days, 95% CI 51–137 days). In the group treated with EPIC after CS, 12 out of 20 rats were still alive at the end of the experiment (
P
< 0.001 as compared with CS only). In the group receiving both treatments, 11 rats died of toxicity, and therefore this group was not included in the survival analysis.
Conclusions
Both EPIC and HIPEC were effective in prolonging survival. The beneficial effect of EPIC on survival seemed to be more pronounced than that of HIPEC. Further research is indicated to evaluate and compare the possible benefits and adverse effects associated with both treatments.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>21837528</pmid><doi>10.1245/s10434-011-1984-9</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Annals of surgical oncology, 2012-07, Vol.19 (Suppl 3), p.475-482 |
| issn | 1068-9265 1534-4681 |
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| subjects | Animals Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - adverse effects Carcinoma - drug therapy Carcinoma - secondary Carcinoma - therapy Chemotherapy, Adjuvant Colonic Neoplasms - pathology Confidence Intervals Fluorouracil - administration & dosage Hyperthermia, Induced Intraoperative Care Kaplan-Meier Estimate Male Medicine Medicine & Public Health Mitomycin - administration & dosage Oncology Peritoneal Neoplasms - drug therapy Peritoneal Neoplasms - secondary Peritoneal Neoplasms - therapy Postoperative Care Proportional Hazards Models Rats Surgery Surgical Oncology Translational Research and Biomarkers |
| title | Intraoperative versus Early Postoperative Intraperitoneal Chemotherapy after Cytoreduction for Colorectal Peritoneal Carcinomatosis: an Experimental Study |
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