European Journal of Pediatric Surgery Reports最新文献

{"title":"Cardiac Tamponade Secondary to a Giant Pleuropericardial Cyst in a Child: A Surgical Case Report from Sub-Saharan Africa.","authors":"Abdel Kémal Bori Bata, Yacoubou Imorou-Souaibou, Ahmad Ibrahim, Désiré Nékoua, Joseph Adoco, Arnaud Sonou","doi":"10.1055/a-2655-3348","DOIUrl":"10.1055/a-2655-3348","url":null,"abstract":"<p><p>Pleuropericardial cysts are rare mediastinal tumors with variable, often severe, clinical presentations in children, occasionally requiring urgent intervention. We report the case of a previously healthy 14-year-old male who was admitted with signs of severe congestive heart failure and clinical evidence of cardiac tamponade. Transthoracic echocardiography and thoracic CT scan confirmed the presence of a compressive mediastinal cystic mass. The patient underwent emergency surgical resection via median sternotomy. Histopathological examination confirmed a benign pericardial cyst. Postoperative recovery was uneventful, and no recurrence was observed after 2 years of follow-up.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"13 1","pages":"e31-e34"},"PeriodicalIF":0.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Neuroblastoma Surgery through the Clinical Integration of Virtual Reality and Indocyanine Green Fluorescence-Guided Imaging: A Case Report.","authors":"Irene Paraboschi, Ugo M Pierucci, Elena Di Blasi, Paola Collini, Marta Podda, Giovanna Gattuso, Roberto Luksch, Francescco Rizzetto, Alice M Munari, Cristina Gallotta, Tommaso Santaniello, Maurizio Vertemati, Paolo Milani, Gloria Pelizzo","doi":"10.1055/a-2646-8880","DOIUrl":"10.1055/a-2646-8880","url":null,"abstract":"<p><strong>Background: </strong>Neuroblastoma, the most common extracranial solid tumor in children, requires meticulous surgical interventions due to its complex anatomical location and proximity to vital structures. Emerging technologies, such as virtual reality (VR) and indocyanine green (ICG) fluorescence-guided imaging, offer promising solutions to enhance surgical precision and outcomes. Despite their potential, their use in pediatric oncology remains underexplored. This case report highlights the integration of VR and ICG fluorescence imaging in the surgical treatment of neuroblastoma, emphasizing their benefits, limitations, and the need for further advancements.</p><p><strong>Case description: </strong>A 12-month-old female with a prenatal diagnosis of cloacal malformation, Müllerian anomalies, and a horseshoe kidney was under care at our center for the management of her complex urogenital anomalies. During preoperative imaging to plan her reconstructive surgery, an abdominal MRI revealed a solid retroperitoneal mass, later confirmed as a right adrenal neuroblastoma. After six cycles of chemotherapy, metaiodobenzylguanidine (mIBG) scans indicated persistent uptake, suggesting the possible presence of tumor viability. Consequently, a definitive surgical resection was scheduled. The procedure incorporated VR for navigation and ICG fluorescence for real-time vascular mapping, facilitating precise dissection and preservation of critical structures. The patient's postoperative recovery was uneventful, and she was discharged in stable condition. Follow-up evaluations (i.e., MRI, mIBG) showed no evidence of residual macroscopic disease.</p><p><strong>Conclusion: </strong>VR and ICG fluorescence imaging hold promise for enhancing surgical precision and safety in pediatric neuroblastoma. While current limitations include the lack of real-time image overlay and inadequate visualization of tumor margins, future advancements in navigation systems and targeted probes may overcome these barriers and significantly improve oncologic outcomes.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"13 1","pages":"e23-e30"},"PeriodicalIF":0.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesenteric Shearing in a Pediatric Patient, Successfully Managed Conservatively: A Case Report.","authors":"Karim Sabeh-Ayoun, Nour Bakhos, Mustafa Natout, Ahmad Zaghal","doi":"10.1055/a-2642-0650","DOIUrl":"10.1055/a-2642-0650","url":null,"abstract":"<p><p>Mesenteric shear, injury due to sudden stretch of the mesentery, is a rare condition that remains poorly studied, especially in the pediatric population. Often resulting from trauma, its presentation can vary from nonspecific and vague abdominal symptoms to an acute abdomen and peritonitis requiring urgent surgical intervention. Unified management strategies are not yet in place. We describe the case of a 10-year-old boy who presented to the emergency department with diffuse abdominal pain of 1 day duration, 2 days after he sustained blunt abdominal trauma with an elbow during a soccer match. He was hemodynamically and clinically stable. Computed tomography scan revealed soft tissue thickening in the left upper quadrant at the root of the mesentery with mild surrounding inflammatory mesenteric fat stranding, suggesting mesenteric shearing. With stable vitals, a soft abdomen on physical exam, and no drop in hemoglobin, the decision was made to treat the patient conservatively. The patient was admitted for observation, and after frequent abdominal exams, stable laboratory results, and abdominal imaging, he was discharged home without any surgical intervention. Conservative management can be successful in the case of a stable patient without alarming physical, laboratory, or imaging findings. Observation and close monitoring remain essential to detect complicated cases that require surgical intervention.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"13 1","pages":"e19-e22"},"PeriodicalIF":0.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-Assisted Laparoscopic Endorectal Pull-Through Combined with Deloyers Turnover in Long-Segment Hirschsprung Disease: A Case Report.","authors":"Maria Stella Cipriani, Maria G Faticato, Federica Fanti, Michela C Y Wong, Girolamo Mattioli","doi":"10.1055/a-2640-4118","DOIUrl":"10.1055/a-2640-4118","url":null,"abstract":"<p><p>We report the first documented pediatric case of the Deloyers procedure performed using robotic surgery to treat a female patient with long-segment Hirschsprung disease. A 9-month-old child was diagnosed with long-segment Hirschsprung disease. Despite rectal irrigations, the patient experienced refractory constipation and enterocolitis, necessitating exploratory surgery and ileostomy. A transition zone was identified at the proximal transverse colon, with mapping biopsies confirming aganglionosis up to the splenic flexure. At 16 months of age, the child underwent a robot-assisted endorectal pull-through with ileostomy closure. Four 8-mm trocars were placed in the epigastric, left subcostal, right subcostal, and right flank regions. Dissection and mobilization extended distally beyond the peritoneal reflection and proximally to the hepatic flexure, preserving the marginal vascular arcades. The middle and right colic arteries were ligated, while the ileocolic artery was preserved. Indocyanine green fluorescence imaging confirmed adequate vascularization of the hepatic flexure. A counterclockwise 180-degree rotation of the right colon was performed. In the perineal phase, a mucosal incision above the dentate line was followed by progressive mucosectomy to reach the isolated rectum. The colon was pulled through, and a tension-free coloanal anastomosis was performed. The postoperative period was uneventful at the 6-month follow-up. Robot-assisted laparoscopic endorectal pull-through with the Deloyers procedure is a feasible and safe technique for long-segment Hirschsprung disease. Larger case series are required to assess its long-term outcomes and potential advantages. An explanatory video of the surgery is available.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"13 1","pages":"e14-e18"},"PeriodicalIF":0.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of Concurrent Cholangiohydatidosis with Obstructive Jaundice and Hepatothoracic Transit in a Pediatric Patient.","authors":"Narcis Flavius Tepeneu, Călin Marius Popoiu, Emil Radu Iacob, Simona Cerbu, Oana Belei, Rodica Heredea","doi":"10.1055/a-2590-5917","DOIUrl":"https://doi.org/10.1055/a-2590-5917","url":null,"abstract":"<p><p>Concurrent rupture of hepatic hydatid cysts into the biliary tree and into the pleural cavity is a very rare complication in echinococcosis and can pose diagnostic and treatment challenges. We present the case of a 15-year-old female patient with recurrent abdominal pain, chest pain, fever, vomiting, jaundice, and cholangitis. Ultrasound, X-rays, computed tomography of the abdomen and thorax and cholangio-magnetic resonance imaging revealed a hepatic hydatid cyst with rupture into the main biliary duct causing obstruction, gallbladder microlithiasis, rupture of the right hemidiaphragm, and pleural hydatidosis. Echinococcus serology tests were positive. Endoscopic retrograde cholangiopancreatography (ERCP) could not resolve the obstructive jaundice. A laparotomy with choledochotomy, removal of hydatid structures, choledochal drainage with Kehr tube, cholecystectomy, Lagrot partial pericystectomy, partial pleural resection, suturing of the diaphragm, and triple drainage (right pleural cavity, cystic cavity, and Douglas pouch) was performed. Perioperative albendazole and antibiotic therapy was administered. The patient had an uneventful postoperative course. Follow-up at 1, 6, 12, and 24 months showed a favorable evolution without relapse of the hydatidosis. The very rare complications of cholangiohydatidosis and concomitant hepatothoracic transit lead to a severe condition, which needs adequate surgical treatment. Clinical presentation and laboratory findings are not specific and may simulate an obstructive jaundice and acute cholangitis of other etiology. ERCP with endoscopic papillotomy offers the advantage of a minimally invasive surgery, but it does not allow a definitive treatment of the whole problem and may be useful as a bridge procedure to drain the bile duct while awaiting definitive surgery.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"13 1","pages":"e9-e13"},"PeriodicalIF":0.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Case of OHVIRA with Ectopic Inguinal Hemiuterus and Ovary.","authors":"Stefanie Welke, Ferdinand Kosch, Andreas Müller, Amelie Hufnagel-Schmude, Leonie Rother, Verena Ellerkamp","doi":"10.1055/a-2590-6030","DOIUrl":"https://doi.org/10.1055/a-2590-6030","url":null,"abstract":"<p><p>A 12-year-old girl presented with inguinal swelling and recurrent groin pain since menarche. Ultrasound showed an inguinally located ovary with normal perfusion. Herniorrhaphy revealed an ectopic inguinal left ovary with fallopian tube and atretic hemiuterus and a closed internal inguinal ring. Laparoscopy revealed a right-sided hemiuterus and vaginally palpable cervix, leading to the diagnosis of ectopic OHVIRA syndrome type 1.2. The left hemiuterus was resected and the left ovary was pulled through the inguinal canal into the abdomen. During 12 months of follow-up, the left ovary showed normal perfusion and sonomorphologic appearance, menstrual periods were uneventful.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"13 1","pages":"e4-e8"},"PeriodicalIF":0.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cloacal Exstrophy Associated with a Hindgut Duplication Anomaly: A Case Report of Challenges in Hindgut Preservation.","authors":"Suliaman Alaqeel, Jamila Almaary, Fatmah Alrabodh, Fayez AlModhen","doi":"10.1055/a-2544-3341","DOIUrl":"10.1055/a-2544-3341","url":null,"abstract":"<p><p>Cloacal exstrophy (CE) is a rare condition, and the preservation of a short hindgut is crucial for growth, fluid-electrolyte balance, and bowel management. Herein, we present the case of an infant with concurrent anomalies and the challenges faced during the preservation of both hindguts. A preterm male infant, born at 34 weeks weighing 2 kg, was diagnosed with CE. The first stage of CE repair was performed at 3 months of age, involving the separation and tubularization of the cecal plate and the joining of the two hemi-bladders. During the procedure, hindgut duplication was noted. Each hindgut had a short mesentery with far-separated, tiny blind ends (7 and 10 cm in length), each directed toward opposite sides of the pelvis and measuring 8 Fr in caliber. Due to the risk of compromising the blood supply during rotation and mobilization of one hindgut, the decision was made to exteriorize each hindgut as end stomas. Both stomas began functioning as expected. However, a colo-cutaneous fistula (connecting the cecum to the midline surgical wound) developed and was managed conservatively for 8 weeks. During this period, despite the functioning left stoma, the right stoma was stenosed, and the fistula persisted. The infant underwent a second laparotomy for fistula repair and reconstruction of both hindguts. This was successfully managed by creating a single-lumen end stoma, preserving the entire length of the hindguts with a wider caliber. In conclusion, complex cases of CE are uncommon, and unexpected operative findings should always be anticipated. Reconstructing both hindguts into a single lumen during the initial procedure can be challenging but is achievable with time and careful effort. Preservation of both hindgut ends should be prioritized. However, long-term outcomes remain uncertain due to the rarity of this presentation.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"13 1","pages":"e1-e3"},"PeriodicalIF":0.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterio-Ureteral Fistula as a Long-term Complication Following Retroperitoneal Presacral Ganglioneuroma Resection: Case Report in an Adolescent and Review of the Literature.","authors":"Theresa S Haecker, Thomas F Krebs, Regula von Allmen, Frank-Martin Haecker","doi":"10.1055/a-2496-5087","DOIUrl":"10.1055/a-2496-5087","url":null,"abstract":"<p><p>Arterio-ureteral fistula (AUF) is a rare condition affecting nearby adult-only patients. Patients usually present with hematuria, often starting as intermittent hematuria which frequently increases, and may lead to hemorrhagic shock. Without rapid diagnosis and prompt treatment, AUF can be lethal. Risk factors for developing an AUF include a history of pelvic surgery mainly due to cancer, a history of pelvic radiation, a history of vascular surgery, or chronic indwelling ureteral stents (CIUS). Imaging to confirm diagnosis includes angiography, computed tomography (CT) scan, or retrograde pyelography, although AUF may be missed. Therefore, even if imaging is negative, the presence of hematuria of unexplained origin in combination with mentioned risk factors is highly suspicious for AUF and must be excluded. We report the case of a 16-year-old male patient who presented with a new onset of intermittent hematuria to our emergency room. The patient's history included previous pelvic surgery for resection of ganglioneuroma 6 years ago with bilateral replacement of the iliac artery and postoperative acute kidney failure with reconstruction of both ureters and CIUS. After the initial uneventful postoperative follow-up over 5 years, another Double J (DJ) catheter had to be placed into the right ureter due to hydronephrosis. Six weeks later, the patient presented with intermittent hematuria. Despite negative imaging, we performed immediate surgical exploration confirming the diagnosis of AUF. To the best of our knowledge, this is the first case of AUF under the age of 18 years reported in the literature. In conclusion, in patients with macrohematuria and a history of the abovementioned risk factors, AUF has to be kept in mind and must be reliably excluded.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"12 1","pages":"e95-e98"},"PeriodicalIF":0.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anal Sphincter Reconstruction Using the Posterior Sagittal Approach for Pediatric Perineal Trauma.","authors":"Julia Ann Ryan, Thomas O Xu, Christina Ho, Briony K Varda, Veronica Gomez-Lobo, Allison Mayhew, Erin Teeple, Andrea Badillo, Christina Feng, Marc A Levitt","doi":"10.1055/a-2487-5249","DOIUrl":"10.1055/a-2487-5249","url":null,"abstract":"<p><p>Traumatic perineal injuries are rare but can result in significant morbidity, particularly when the anal sphincter is injured. The management of such injuries in the pediatric population is rarely noted in the literature. We aimed to describe reconstruction in such patients using lessons learned in reoperative anorectal malformation surgery. This is a single-institution retrospective case series of three pediatric patients who were referred to our institution with pelvic trauma who underwent anal sphincter reconstruction. Three patients aged 5 (female), 12 (male), and 13 (female) years were referred for reconstruction following pelvic trauma involving the anal sphincter, perineal body, and genitourinary system. All three underwent multidisciplinary evaluation with urology and gynecology (for females) and a subsequent repair with anal sphincter reconstruction utilizing a posterior sagittal approach. Two patients had ostomy reversal with appendicostomy for antegrade continence enemas and regained voluntary fecal control. The third patient is awaiting colostomy reversal but has regained volitional urinary control after urethral reconstruction. The experience gained from using the posterior sagittal anorectoplasty approach in reoperations for patients with anorectal malformations can be applied to cases of rectal trauma. Key aspects include mobilizing the rectum, repairing the sphincters, and placing them around the anus, and in females, reconstructing the perineal body. Pediatric pelvic trauma can cause devastating disruptions of physiology and are difficult to treat. Experience from reoperations for anorectal malformations can be applied to these cases, including the use of a multidisciplinary team and posterior sagittal approach.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"12 1","pages":"e90-e94"},"PeriodicalIF":0.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enigma of Gastric Teratoma in Infants: A Case Series.","authors":"Soumitra Saha, Mayank Tripathi, Kumar Vineet, Ajinkya Kale, Pooja Pande, Zachariah Chowdhury, Raghwesh Ranjan","doi":"10.1055/s-0044-1800885","DOIUrl":"10.1055/s-0044-1800885","url":null,"abstract":"<p><p>Gastric teratomas are an extremely rare variety of teratomas in children. The aim of our series is to present the natural history and progression of the disease. Retrospective analysis of prospectively maintained data of all the gastric teratoma patients treated at our center was done from their electronic medical records. A total of four cases of gastric teratoma were found to have been treated, all of them being less than 1 year old with three-fourths being male. Typical imaging features of teratoma along with normal germ cell tumor markers helped in making a diagnosis. Surgery is the main form of treatment. In final histopathology, there was equal distribution of mature and immature teratomas. On long-term follow-up, there has been no incidence of recurrence. There needs to be reporting of more cases to verify its natural history.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"12 1","pages":"e85-e89"},"PeriodicalIF":0.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}