Hodgkin's disease after transplantation
Hodgkin's disease (HD) has seldom been reported after transplantation. Epstein-Barr virus (EBV) is present in about 50% of Reed-Sternberg cells in HD developing in immunocompetent individuals, but is more frequently found in HD of acquired immune deficiency syndrome patients. We report 7 cases...
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| Veröffentlicht in: | Transplantation 1996-01, Vol.61 (1), p.71-76 |
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| creator | GARNIER, J.-L LEBRANCHU, Y DELSOL, G BERGER, F TOURAINE, J.-L DANTAL, J BEDROSSIAN, J CAHEN, R ASSOULINE, D JACCARD, A FETISSOFF, F MOREAU, A MARTIN, X |
| description | Hodgkin's disease (HD) has seldom been reported after transplantation. Epstein-Barr virus (EBV) is present in about 50% of Reed-Sternberg cells in HD developing in immunocompetent individuals, but is more frequently found in HD of acquired immune deficiency syndrome patients. We report 7 cases of HD that occurred in transplant recipients. Clinical and pathological data and studies of EBV reveal specific features of HD after transplantation. Six patients received kidney transplants and 1 patient received combined kidney and pancreas transplantation. Immunosuppressive therapy consisted of cyclosporine, steroids, azathioprine, and antilymphocyte globulins. One patient received, in addition, anti-CD3 mAb therapy and an EBV+ B cell lymphoma developed. Retrospective EBV serological data from patients were collected. Tumors were classified according to pathology. EBV studies were conducted by immunohistochemical methods with monoclonal antibodies to EBV-latent membrane protein (LMP) or EBV-nuclear antigen 2 (EBNA2), and by in situ hybridization for latent nuclear EBV-early RNAs (EBERs). The mean lapse of time between transplantation and HD was 49 months. Six patients presented with enlarged lymph nodes and 1 patient presented with liver involvement. HD was classified as IA in 2 patients, IIA in 3 patients, IIIB in 1 patient, and IVB in 1 patient. Four patients had primary EBV infection after graft, before HD, and the others reactivated latent EBV infection. Histological subtypes were mixed cellularity in 6 cases and lymphocytic depletion in 1 case. Latent EBV infection was detected with EBERs in all tumors. Reed-Sternberg cells expressed LMP, and were negative for EBNA2 expression. Six patients were treated: 2 patients at stage I received radiotherapy, and relapsed within 1 year with a more advanced stage of HD; chemotherapy was indicated as primary therapy in 5 patients, and as salvage therapy in 2 patients; it was associated with radiotherapy in 4 patients. Immunosuppressive therapy was reduced in all patients. Four patients were alive and in complete remission 18, 25, 31, and 67 months after chemotherapy, with a functioning graft in 3 patients. Two patients died of infection. Mixed cellularity is the most frequent histological subtype observed in HD occurring in transplant patients. EBV is present in all Reed-Sternberg cells. Posttransplant HD shows similarities with human immunodeficiency virus-associated HD. These facts argue for a role of EBV infection and |
| doi_str_mv | 10.1097/00007890-199601150-00015 |
| format | Article |
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Epstein-Barr virus (EBV) is present in about 50% of Reed-Sternberg cells in HD developing in immunocompetent individuals, but is more frequently found in HD of acquired immune deficiency syndrome patients. We report 7 cases of HD that occurred in transplant recipients. Clinical and pathological data and studies of EBV reveal specific features of HD after transplantation. Six patients received kidney transplants and 1 patient received combined kidney and pancreas transplantation. Immunosuppressive therapy consisted of cyclosporine, steroids, azathioprine, and antilymphocyte globulins. One patient received, in addition, anti-CD3 mAb therapy and an EBV+ B cell lymphoma developed. Retrospective EBV serological data from patients were collected. Tumors were classified according to pathology. EBV studies were conducted by immunohistochemical methods with monoclonal antibodies to EBV-latent membrane protein (LMP) or EBV-nuclear antigen 2 (EBNA2), and by in situ hybridization for latent nuclear EBV-early RNAs (EBERs). The mean lapse of time between transplantation and HD was 49 months. Six patients presented with enlarged lymph nodes and 1 patient presented with liver involvement. HD was classified as IA in 2 patients, IIA in 3 patients, IIIB in 1 patient, and IVB in 1 patient. Four patients had primary EBV infection after graft, before HD, and the others reactivated latent EBV infection. Histological subtypes were mixed cellularity in 6 cases and lymphocytic depletion in 1 case. Latent EBV infection was detected with EBERs in all tumors. Reed-Sternberg cells expressed LMP, and were negative for EBNA2 expression. Six patients were treated: 2 patients at stage I received radiotherapy, and relapsed within 1 year with a more advanced stage of HD; chemotherapy was indicated as primary therapy in 5 patients, and as salvage therapy in 2 patients; it was associated with radiotherapy in 4 patients. Immunosuppressive therapy was reduced in all patients. Four patients were alive and in complete remission 18, 25, 31, and 67 months after chemotherapy, with a functioning graft in 3 patients. Two patients died of infection. Mixed cellularity is the most frequent histological subtype observed in HD occurring in transplant patients. EBV is present in all Reed-Sternberg cells. Posttransplant HD shows similarities with human immunodeficiency virus-associated HD. These facts argue for a role of EBV infection and immunosuppression in the progression of HD after transplantation.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/00007890-199601150-00015</identifier><identifier>PMID: 8560577</identifier><identifier>CODEN: TRPLAU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adolescent ; Adult ; AIDS/HIV ; Biological and medical sciences ; Epstein-Barr virus ; Graft Rejection - prevention & control ; Herpesvirus 4, Human - isolation & purification ; Hodgkin Disease - etiology ; Hodgkin Disease - physiopathology ; Hodgkin Disease - virology ; Humans ; Immunosuppressive Agents - adverse effects ; Kidney Transplantation - adverse effects ; Lymphoma, B-Cell - etiology ; Lymphoma, B-Cell - physiopathology ; Lymphoma, B-Cell - virology ; Male ; Medical sciences ; Middle Aged ; Pancreas Transplantation - adverse effects ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system</subject><ispartof>Transplantation, 1996-01, Vol.61 (1), p.71-76</ispartof><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2959281$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8560577$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GARNIER, J.-L</creatorcontrib><creatorcontrib>LEBRANCHU, Y</creatorcontrib><creatorcontrib>DELSOL, G</creatorcontrib><creatorcontrib>BERGER, F</creatorcontrib><creatorcontrib>TOURAINE, J.-L</creatorcontrib><creatorcontrib>DANTAL, J</creatorcontrib><creatorcontrib>BEDROSSIAN, J</creatorcontrib><creatorcontrib>CAHEN, R</creatorcontrib><creatorcontrib>ASSOULINE, D</creatorcontrib><creatorcontrib>JACCARD, A</creatorcontrib><creatorcontrib>FETISSOFF, F</creatorcontrib><creatorcontrib>MOREAU, A</creatorcontrib><creatorcontrib>MARTIN, X</creatorcontrib><title>Hodgkin's disease after transplantation</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>Hodgkin's disease (HD) has seldom been reported after transplantation. Epstein-Barr virus (EBV) is present in about 50% of Reed-Sternberg cells in HD developing in immunocompetent individuals, but is more frequently found in HD of acquired immune deficiency syndrome patients. We report 7 cases of HD that occurred in transplant recipients. Clinical and pathological data and studies of EBV reveal specific features of HD after transplantation. Six patients received kidney transplants and 1 patient received combined kidney and pancreas transplantation. Immunosuppressive therapy consisted of cyclosporine, steroids, azathioprine, and antilymphocyte globulins. One patient received, in addition, anti-CD3 mAb therapy and an EBV+ B cell lymphoma developed. Retrospective EBV serological data from patients were collected. Tumors were classified according to pathology. EBV studies were conducted by immunohistochemical methods with monoclonal antibodies to EBV-latent membrane protein (LMP) or EBV-nuclear antigen 2 (EBNA2), and by in situ hybridization for latent nuclear EBV-early RNAs (EBERs). The mean lapse of time between transplantation and HD was 49 months. Six patients presented with enlarged lymph nodes and 1 patient presented with liver involvement. HD was classified as IA in 2 patients, IIA in 3 patients, IIIB in 1 patient, and IVB in 1 patient. Four patients had primary EBV infection after graft, before HD, and the others reactivated latent EBV infection. Histological subtypes were mixed cellularity in 6 cases and lymphocytic depletion in 1 case. Latent EBV infection was detected with EBERs in all tumors. Reed-Sternberg cells expressed LMP, and were negative for EBNA2 expression. Six patients were treated: 2 patients at stage I received radiotherapy, and relapsed within 1 year with a more advanced stage of HD; chemotherapy was indicated as primary therapy in 5 patients, and as salvage therapy in 2 patients; it was associated with radiotherapy in 4 patients. Immunosuppressive therapy was reduced in all patients. Four patients were alive and in complete remission 18, 25, 31, and 67 months after chemotherapy, with a functioning graft in 3 patients. Two patients died of infection. Mixed cellularity is the most frequent histological subtype observed in HD occurring in transplant patients. EBV is present in all Reed-Sternberg cells. Posttransplant HD shows similarities with human immunodeficiency virus-associated HD. These facts argue for a role of EBV infection and immunosuppression in the progression of HD after transplantation.</description><subject>Adolescent</subject><subject>Adult</subject><subject>AIDS/HIV</subject><subject>Biological and medical sciences</subject><subject>Epstein-Barr virus</subject><subject>Graft Rejection - prevention & control</subject><subject>Herpesvirus 4, Human - isolation & purification</subject><subject>Hodgkin Disease - etiology</subject><subject>Hodgkin Disease - physiopathology</subject><subject>Hodgkin Disease - virology</subject><subject>Humans</subject><subject>Immunosuppressive Agents - adverse effects</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Lymphoma, B-Cell - etiology</subject><subject>Lymphoma, B-Cell - physiopathology</subject><subject>Lymphoma, B-Cell - virology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pancreas Transplantation - adverse effects</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE9LxDAQxYMo67r6EYQexD1FJ81O_hxlUVdY8KLnMtkkUu22teke_PZGLF6dy8C8H8N7j7FCwI0Aq28hjzYWuLBWgRAIPF8EHrG5QLniCgwcsznASnAhpT5lZym9ZwSl1jM2M6gAtZ6z5abzbx91u0yFr1OgFAqKYxiKcaA29Q21I411156zk0hNChfTXrDXh_uX9YZvnx-f1ndb3pdKjRwhOmVDdAEIPKAtTbDeooyKHEgwAVx2oFFHBc4776kUFgJ5vULvrVyw69-__dB9HkIaq32ddqHJRkJ3SJXWVlll_gcFoimhVBm8nMCD2wdf9UO9p-GrmirI-tWkU9pRE3PuXZ3-sNL-hBDyG90ras8</recordid><startdate>19960115</startdate><enddate>19960115</enddate><creator>GARNIER, J.-L</creator><creator>LEBRANCHU, Y</creator><creator>DELSOL, G</creator><creator>BERGER, F</creator><creator>TOURAINE, J.-L</creator><creator>DANTAL, J</creator><creator>BEDROSSIAN, J</creator><creator>CAHEN, R</creator><creator>ASSOULINE, D</creator><creator>JACCARD, A</creator><creator>FETISSOFF, F</creator><creator>MOREAU, A</creator><creator>MARTIN, X</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>19960115</creationdate><title>Hodgkin's disease after transplantation</title><author>GARNIER, J.-L ; LEBRANCHU, Y ; DELSOL, G ; BERGER, F ; TOURAINE, J.-L ; DANTAL, J ; BEDROSSIAN, J ; CAHEN, R ; ASSOULINE, D ; JACCARD, A ; FETISSOFF, F ; MOREAU, A ; MARTIN, X</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p266t-50fb69efbe0a0d05928e9d953f6ab0308e0b377757f60bdbdda2190ead745dd93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>AIDS/HIV</topic><topic>Biological and medical sciences</topic><topic>Epstein-Barr virus</topic><topic>Graft Rejection - prevention & control</topic><topic>Herpesvirus 4, Human - isolation & purification</topic><topic>Hodgkin Disease - etiology</topic><topic>Hodgkin Disease - physiopathology</topic><topic>Hodgkin Disease - virology</topic><topic>Humans</topic><topic>Immunosuppressive Agents - adverse effects</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Lymphoma, B-Cell - etiology</topic><topic>Lymphoma, B-Cell - physiopathology</topic><topic>Lymphoma, B-Cell - virology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pancreas Transplantation - adverse effects</topic><topic>Surgery (general aspects). 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Graft diseases</topic><topic>Surgery of the urinary system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GARNIER, J.-L</creatorcontrib><creatorcontrib>LEBRANCHU, Y</creatorcontrib><creatorcontrib>DELSOL, G</creatorcontrib><creatorcontrib>BERGER, F</creatorcontrib><creatorcontrib>TOURAINE, J.-L</creatorcontrib><creatorcontrib>DANTAL, J</creatorcontrib><creatorcontrib>BEDROSSIAN, J</creatorcontrib><creatorcontrib>CAHEN, R</creatorcontrib><creatorcontrib>ASSOULINE, D</creatorcontrib><creatorcontrib>JACCARD, A</creatorcontrib><creatorcontrib>FETISSOFF, F</creatorcontrib><creatorcontrib>MOREAU, A</creatorcontrib><creatorcontrib>MARTIN, X</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GARNIER, J.-L</au><au>LEBRANCHU, Y</au><au>DELSOL, G</au><au>BERGER, F</au><au>TOURAINE, J.-L</au><au>DANTAL, J</au><au>BEDROSSIAN, J</au><au>CAHEN, R</au><au>ASSOULINE, D</au><au>JACCARD, A</au><au>FETISSOFF, F</au><au>MOREAU, A</au><au>MARTIN, X</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hodgkin's disease after transplantation</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>1996-01-15</date><risdate>1996</risdate><volume>61</volume><issue>1</issue><spage>71</spage><epage>76</epage><pages>71-76</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>Hodgkin's disease (HD) has seldom been reported after transplantation. Epstein-Barr virus (EBV) is present in about 50% of Reed-Sternberg cells in HD developing in immunocompetent individuals, but is more frequently found in HD of acquired immune deficiency syndrome patients. We report 7 cases of HD that occurred in transplant recipients. Clinical and pathological data and studies of EBV reveal specific features of HD after transplantation. Six patients received kidney transplants and 1 patient received combined kidney and pancreas transplantation. Immunosuppressive therapy consisted of cyclosporine, steroids, azathioprine, and antilymphocyte globulins. One patient received, in addition, anti-CD3 mAb therapy and an EBV+ B cell lymphoma developed. Retrospective EBV serological data from patients were collected. Tumors were classified according to pathology. EBV studies were conducted by immunohistochemical methods with monoclonal antibodies to EBV-latent membrane protein (LMP) or EBV-nuclear antigen 2 (EBNA2), and by in situ hybridization for latent nuclear EBV-early RNAs (EBERs). The mean lapse of time between transplantation and HD was 49 months. Six patients presented with enlarged lymph nodes and 1 patient presented with liver involvement. HD was classified as IA in 2 patients, IIA in 3 patients, IIIB in 1 patient, and IVB in 1 patient. Four patients had primary EBV infection after graft, before HD, and the others reactivated latent EBV infection. Histological subtypes were mixed cellularity in 6 cases and lymphocytic depletion in 1 case. Latent EBV infection was detected with EBERs in all tumors. Reed-Sternberg cells expressed LMP, and were negative for EBNA2 expression. Six patients were treated: 2 patients at stage I received radiotherapy, and relapsed within 1 year with a more advanced stage of HD; chemotherapy was indicated as primary therapy in 5 patients, and as salvage therapy in 2 patients; it was associated with radiotherapy in 4 patients. Immunosuppressive therapy was reduced in all patients. Four patients were alive and in complete remission 18, 25, 31, and 67 months after chemotherapy, with a functioning graft in 3 patients. Two patients died of infection. Mixed cellularity is the most frequent histological subtype observed in HD occurring in transplant patients. EBV is present in all Reed-Sternberg cells. Posttransplant HD shows similarities with human immunodeficiency virus-associated HD. These facts argue for a role of EBV infection and immunosuppression in the progression of HD after transplantation.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>8560577</pmid><doi>10.1097/00007890-199601150-00015</doi><tpages>6</tpages></addata></record> |
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| ispartof | Transplantation, 1996-01, Vol.61 (1), p.71-76 |
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| subjects | Adolescent Adult AIDS/HIV Biological and medical sciences Epstein-Barr virus Graft Rejection - prevention & control Herpesvirus 4, Human - isolation & purification Hodgkin Disease - etiology Hodgkin Disease - physiopathology Hodgkin Disease - virology Humans Immunosuppressive Agents - adverse effects Kidney Transplantation - adverse effects Lymphoma, B-Cell - etiology Lymphoma, B-Cell - physiopathology Lymphoma, B-Cell - virology Male Medical sciences Middle Aged Pancreas Transplantation - adverse effects Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system |
| title | Hodgkin's disease after transplantation |
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