Scandinavian journal of gastroenterology. Supplement最新文献

{"title":"Role of mesalazine in acute and long-term treatment of ulcerative colitis and its complications.","authors":"K W Schroeder","doi":"10.1080/003655202320621445","DOIUrl":"https://doi.org/10.1080/003655202320621445","url":null,"abstract":"<p><strong>Background: </strong>Sulfasalazine, consisting of 5-aminosalicylic acid bound to sulfapyridine by a diazo bond, was first used for treatment of ulcerative colitis in the early 1940s and later found effective in placebo-controlled trials for acute disease and for long-term maintenance of remission. Later studies found that the active moiety is 5-ASA (mesalazine, mesalamine) and the sulfapyridine moiety acts as a carrier molecule but causes many of the symptomatic adverse reactions.</p><p><strong>Methods: </strong>Review of the literature.</p><p><strong>Results: </strong>The finding that 5-ASA in the active motility led to the development of mesalazine prodrugs, olsalazine (Dipentum) and balsalazide (Colazide, Colazal), and targeted release mesalazine preparations, such as Asacol, Pentasa, and Salofalk, as well as enemas and suppository preparations for distal disease. Most patients with adverse effects from sulfasalazine will tolerate mesalazine. Mesalazine has been shown equivalent or superior to sulfasalazine, and superior to placebo, with a dose-response benefit, in inducing remission of acute disease. and comparable to sulfasalazine and superior to placebo for long-term maintenance of remission. Better tolerance of mesalazine and the ability to use higher doses favor its use in patients intolerant of sulfasalazine and in patients failing to respond to usual doses of sulfasalazine. Adverse effects from mesalazine are uncommon, but include idiosyncratic worsening of the colitis symptoms and renal toxicity. Mesalazine is safe to use during pregnancy and for nursing mothers. As maintenance therapy, mesalazine may reduce the risk of developing colorectal carcinoma.</p><p><strong>Conclusion: </strong>Mesalazine represents effective and well-tolerated first-line therapy for mildly to moderately acute disease as well as for the long-term maintenance treatment in the patient with ulcerative colitis.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 236","pages":"42-7"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/003655202320621445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22090480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignancies in inflammatory bowel disease: fact or fiction?","authors":"R A van Hogezand,&nbsp;R F Eichhorn,&nbsp;A Choudry,&nbsp;R A Veenendaal,&nbsp;C B H W Lamers","doi":"10.1080/003655202320621454","DOIUrl":"https://doi.org/10.1080/003655202320621454","url":null,"abstract":"<p><strong>Background: </strong>The association between ulcerative colitis (UC), Crohn disease (CD) and colorectal cancer (CRC) has been confirmed in several studies. The aim of this study was critical analysis of the relation between IBD and malignancy.</p><p><strong>Methods: </strong>Review of the literature.</p><p><strong>Results: </strong>In UC, the extent of the disease, its duration and start at a young age are risk factors for the development of CRC. Primary sclerosing cholangitis and colonic strictures are additional risk factors for development of CRC. The relation between azathioprine or 6-MP and the development of lymphomas is a subject of debate. The administration of anti-TNF-alpha has produced some concern about the development of lymphomas in CD. However, at present there is no evidence of lymphomas caused by anti-TNF-alpha in CD. On the contrary, some drugs seem to have a preventive effect on CRC development in UC. 5-aminosalicylic acid in particular and to a lesser extent sulphasalazine have prevented the development of CRC significantly in retrospective studies. In CD, there is no strong relationship between the disease and the development of CRC or other malignancies. Only the development of small-bowel carcinoma is reported with a much higher frequency.</p><p><strong>Conclusions: </strong>There is a correlation with UC and the development of CRC. For CD, this correlation is less firmly established. There is a possible, but not proven, relation between AZA/6-MP use and the development of lymphoma in IBD. There is also a probable relationship between CD and the development of small-bowel carcinoma. In some retrospective studies, the use of 5-aminosalicylic or sulphasalazine has been shown to prevent the development of CRC in UC.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 236","pages":"48-53"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/003655202320621454","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22090481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second-line treatment for faecal incontinence.","authors":"C G M I Baeten,&nbsp;O Uludag","doi":"10.1080/003655202320621490","DOIUrl":"https://doi.org/10.1080/003655202320621490","url":null,"abstract":"<p><strong>Background: </strong>In the treatment of faecal incontinence, more than 30% of patients experience continuation of their problem. We discuss new therapeutic procedures for dealing with faecal incontinence.</p><p><strong>Methods: </strong>Discussion of authors' own work in relation to the literature.</p><p><strong>Results: </strong>First-line care includes diets, constipating drugs, biofeedback therapy, anal repair and operations for prolapse and fistulas. For the failures of these first-line treatments there is hope with second-line therapies. Creation of a neosphincter is possible with a dynamic graciloplasty (DGP) or an artificial bowel sphincter (ABS). A DGP is a conventional graciloplasty with the addition of implanted electrodes and a stimulator that transforms the muscle into an automatic contracting sphincter. ABS comprises an inflatable cuff around the anus that is filled from a pressure-regulating balloon. The cuff can be emptied with an implanted pump.</p><p><strong>Conclusions: </strong>DGP and ABS give good results in 56%-88% of cases. For patients with an anatomical intact but nonfunctioning sphincter there is a new treatment: sacral nerve stimulation. This gives continence in a high percentage of cases, but experience is rather limited. Second-line treatment for faecal incontinence is successful and should be considered in cases where initial therapies fail.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 236","pages":"72-5"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/003655202320621490","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22091016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surveillance in Barrett's oesophagus: a critical reappraisal.","authors":"M E Craanen,&nbsp;P Blok,&nbsp;G A Meijer,&nbsp;S G M Meuwissen","doi":"10.1080/003655202320621373","DOIUrl":"https://doi.org/10.1080/003655202320621373","url":null,"abstract":"<p><strong>Background: </strong>Current recommendations are for endoscopic surveillance of patients with Barrett's oesophagus to detect dysplasia and to diagnose carcinoma at an early and possibly treatable stage. However, observations suggest that these current practice guidelines are thwarted by many factors often not taken into account. These observations stem from general surveillance aspects as well from specific data on Barrett's oesophagus. This review therefore aims at discussing data on the current surveillance strategy in conjunction with general surveillance aspects relevant for their interpretation.</p><p><strong>Methods: </strong>Literature survey of published articles.</p><p><strong>Results: </strong>A critical reappraisal of the literature shows that the current surveillance strategy is hampered by multiple problems with the marker dysplasia, cost-ineffectiveness, an overrated cancer risk and an astonishing lack of prospective, randomized data showing a clear benefit in terms of a greater life expectancy. Moreover, the decisive study is unlikely ever to be performed because of the large number of patients needed and the required length of follow-up. As a result, protocols are being carried out that have never been critically tested prior to large-scale clinical implementation.</p><p><strong>Conclusions: </strong>Although these findings should not lead to therapeutic nihilism, the data raise the issue of whether or not surveillance protocols should be restricted to specialized referral centres with particular research efforts aimed at improving existing and developing new techniques that lack most of the described pitfalls and problems. Since it is foreseen that matters will not change rapidly in the (near) future, the clinician has no other choice than to rely on individually tailored arguments to survey taking into account for example family history, age and anxiety about potential long-term effects.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 236","pages":"4-8"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/003655202320621373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22090473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carcinoid heart disease: an update.","authors":"P F H J Quaedvlieg,&nbsp;C B H W Lamers,&nbsp;B G Taal","doi":"10.1080/003655202320621481","DOIUrl":"https://doi.org/10.1080/003655202320621481","url":null,"abstract":"<p><strong>Background: </strong>Carcinoid tumours are a poorly defined collection of lesions, histopathologically indistinguishable from gastroentero-pancreatic neuroendocrine tumours. In this report, we discuss epidemiology and survival, clinical presentation, carcinoid valvular heart disease (CVHD), histopathological considerations and treatment options.</p><p><strong>Methods: </strong>Review and update of the literature.</p><p><strong>Results: </strong>The term carcinoid suggests a disease entity, but with increasing knowledge it becomes progressively confusing. To avoid further confusion, it is advisable to define these tumours using differentiation, stage, primary site, known tumour products and an associated clinical syndrome. Incidence varies between 0.8 and 1.9/100,000 population. About 20% present with metastases, with a 5-year survival varying between 15% and 35%. Metastatic disease frequently accompanies the carcinoid syndrome (flushing, diarrhoea, wheezing and CVHD). CVHD incidence is about 50%, and seems unrelated to disease duration and tumour mass. An aetiological relation of CVHD with urinary 5-HIAA remains to be confirmed. Resection is the only curative option. Surgery can also offer prolonged palliation and is needed to restore bowel transit in obstructive/ischaemic bowel problems. Adequate palliation of hormone-related symptoms can also be achieved by somatostatin analogues, meta-iodo-benzyl-guanidine preparations and interferon-alpha formulations, all with a 70% response rate. Embolization of liver metastases has led to objective responses in about 50% of patients, but is accompanied by significant side effects.</p><p><strong>Conclusions: </strong>Most patients are cured by surgery. Symptom relief is the main target in metastatic disease and can be achieved by a range of equally potent biologically active medications, debulking surgery and hepatic embolization.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 236","pages":"66-71"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/003655202320621481","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22091015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barrett's oesophagus: new diagnostic and therapeutic techniques.","authors":"J Haringsma","doi":"10.1080/003655202320621382","DOIUrl":"https://doi.org/10.1080/003655202320621382","url":null,"abstract":"<p><strong>Background: </strong>Barrett's oesophagus is associated with an increased risk of developing adenocarcinoma. Cancer development is preceded by dysplastic changes. Yet, detection of these microscopic changes has remained beyond the reach of routine endoscopy. Endoscopic screening in Barrett's therefore relies mainly on extensive random biopsy sampling.</p><p><strong>Methods: </strong>Update on new endoscopic diagnostics techniques for Barrett's oesophagus.</p><p><strong>Results: </strong>Application of new optical techniques has the potential to enhance our ability to detect dysplasia during endoscopic procedures and take targeted biopsies. Spectral information can be obtained either by point measurements using an optical fibre ('spectral biopsy') or by imaging a broad tissue field. Light-induced fluorescence techniques are based on the observation that tissue when excited by light of shorter wavelength will emit fluorescent light of a longer wavelength. This concept can be used to image tissue in vivo, based on minimal biochemical and structural changes of the (sub)mucosa. Elastic scattering spectroscopy is a spectral biopsy technique that can be exploited even to detect low-grade dysplasia, based on structural information of the mucosa, in which the size and crowding of nuclei in the epithelial layer play a key role. Optical coherence tomography uses reflection of light at optically scattering structures for cross-sectional tissue imaging. Compared to B-scan ultrasonography, optical coherence tomography offers a much higher resolution (10-20 micron), without the need for tissue contact or acoustic coupling. These spectral techniques, although still in their infancy, have already shown the ability to detect early cancer, high-grade dysplasia and in some cases even low-grade dysplasia with a promising degree of sensitivity. As the instruments and the techniques will be further refined, they are likely to become an important part of endoscopic screening. Advances in endoscopic treatment techniques make early malignancies, for which surgical resection is the only accepted therapy, amenable for minimally invasive endoscopic treatment. Endoscopic mucosal resection is a minimally invasive endoscopic technique that can be used in patients with circumscribed mucosal carcinomas. The technique is also useful as a diagnostic procedure by obtaining a full-thickness mucosal specimen for histologic examination. Photodynamic therapy using the prodrug 5-aminolevulinic acid is an ablative therapy that destroys the oesophageal mucosa, leaving the deeper layers of the oesophageal wall intact. Cell damage is achieved by the action of light on the photosensitizing agent protoporphyrin IX in the mucosa, with skin photosensitivity of less than 48 h. Such mucosal ablation, however, can also be accomplished with more common thermal techniques like argon plasma coagulation. In all these ablative procedures, squamous regeneration is obtained by rigorous antacid ","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 236","pages":"9-14"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/003655202320621382","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22090474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic basis of chronic pancreatitis.","authors":"J B M J Jansen,&nbsp;R te Morsche,&nbsp;H van Goor,&nbsp;J P H Drenth","doi":"10.1080/003655202320621535","DOIUrl":"https://doi.org/10.1080/003655202320621535","url":null,"abstract":"<p><strong>Background: </strong>Pancreatitis has a proven genetic basis in a minority of patients.</p><p><strong>Methods: </strong>Review of the literature on genetics of pancreatitis.</p><p><strong>Results: </strong>Ever since the discovery that in most patients with hereditary pancreatitis a mutation in the gene encoding for cationic trypsinogen (R122H) was found that results in a gain of trypsin function', many other mutations in the cationic trypsinogen gene, as well as in the gene encoding for pancreatic secretory trypsin inhibitor, have been found in patients with chronic pancreatitis. Furthermore, mutations in other genes, like the mucoviscoidosis-gene encoding for a chloride channel, and in genes encoding for enzymes involved in the metabolism of ethanol, have been linked to chronic pancreatitis. This article reviews the highlights that have been achieved in this field of pancreatic research.</p><p><strong>Conclusions: </strong>Recent data suggest that genetics may play a role in the pathogenesis of pancreatitis.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 236","pages":"91-4"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/003655202320621535","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22091020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicobacter pylori and gastro-oesophageal reflux disease: association and clinical implications. To treat or not to treat with anti-H. pylori therapy?","authors":"R J L F Loffeld,&nbsp;R W M van der Hulst","doi":"10.1080/003655202320621391","DOIUrl":"https://doi.org/10.1080/003655202320621391","url":null,"abstract":"<p><strong>Background: </strong>It has been reported that patients are at risk of developing reflux oesophagitis after successful anti-Helicobacter pylori therapy, and the presence of the bacterium might be protective against the development of reflux oesophagitis.</p><p><strong>Methods: </strong>Review of the literature.</p><p><strong>Results: </strong>H. pylori is relevant to the management of oesophagitis because it increases the pH-elevating effect of proton-pump inhibitors. which increase the tendency of H. pylori gastritis to progress to atrophic gastritis, and because eradication of H. pylori increases the likelihood of oesophagitis. H. pylori increases basal gastrin levels, basal acid output, meal-stimulated maximal acid output and 24-h intragastric acidity. The effects on gastric acid production depend on the distribution of gastritis in the stomach.</p><p><strong>Conclusion: </strong>H. pylori eradication may induce or exacerbate gastro-oesophageal reflux by its influence on gastric acidity and the antisecretory action of proton-pump inhibitors.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 236","pages":"15-8"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/003655202320621391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22090475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic surgery for inflammatory bowel disease: current concepts.","authors":"W A Bemelman,&nbsp;M S Dunker,&nbsp;J F M Slors,&nbsp;D J Gouma","doi":"10.1080/003655202320621463","DOIUrl":"https://doi.org/10.1080/003655202320621463","url":null,"abstract":"<p><strong>Background: </strong>The aim of a laparoscopic approach is reduced pain scores, early mobilization, virtual absence of wound sepsis, rapid return of gastrointestinal function, early discharge from hospital and return to normal activity and improved cosmetics. Potential advantages are fewer complications due to adhesion formation, viz. small-bowel obstruction, infertility and chronic abdominal pain-advantages that are of particular importance to patients with inflammatory bowel disease (IBD) since they are young and in the middle of building up their socio-economic life. This review highlights the current status of laparoscopic surgery for patients with IBD.</p><p><strong>Methods: </strong>Virtually all abdominal procedures carried out in patients with IBD can be done laparoscopically, and vary from stoma formation to restorative proctocolectomy.</p><p><strong>Results: </strong>Conversion rates and operating times depend on the surgical expertise and patient-related factors, viz. prior laparotomy, the presence of intestinal fistula or inflammatory masses. Morbidity rates are similar to those of open surgery provided that the procedures are done by expert laparoscopic surgeons. The observed earlier recovery contributed to laparoscopic surgery has not been proved in well-conducted trials; however, an advantage can be expected. A very obvious feature of laparoscopic surgery is the improved cosmetics, which might turn out to be the most important advantage of the laparoscopic approach in this relatively young patient group.</p><p><strong>Conclusion: </strong>The laparoscopic approach can be considered the procedure of first choice in patients with IBD provided the surgery is done by expert laparoscopists ensuring low conversion rates, acceptable operating times and low morbidity.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 236","pages":"54-9"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/003655202320621463","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22091013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotics in laparoscopic surgery: current status and future perspectives.","authors":"I A M J Broeders,&nbsp;J P Ruurda","doi":"10.1080/003655202320621508","DOIUrl":"https://doi.org/10.1080/003655202320621508","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic surgery has been introduced to limit the burden of surgical damage to the abdominal wall and peritoneum.</p><p><strong>Methods: </strong>Description of procedure and results of robotic laparoscopic surgery.</p><p><strong>Results: </strong>Laparoscopic surgery has resulted in reduction of postoperative pain, surgery-related complications and scarring. Laparoscopic techniques, however, are challenging for the surgeon owing to the disadvantages of inverted and restricted manipulation and the indirect two-dimensional view. In order to solve these problems, robotic telemanipulation systems were developed and introduced to the market at the end of the past decade. This article describes and discusses the current status and future perspectives of robotic systems in endoscopic surgery.</p><p><strong>Conclusion: </strong>Robotic laparoscopic surgery overcomes some of the disadvantages of conventional laparoscopic surgery.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 236","pages":"76-80"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/003655202320621508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22091017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}