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1.
Front Cell Dev Biol ; 10: 947430, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36105352

RESUMO

Epithelial cells of human breast glands are exposed to various mechanical ECM stresses that regulate tissue development and homeostasis. Mechanoadaptation of breast gland tissue to ECM-transmitted shear stress remained poorly investigated due to the lack of valid experimental approaches. Therefore, we created a magnetic shear strain device that enabled, for the first time, to analyze the instant shear strain response of human breast gland cells. MCF10A-derived breast acini with basement membranes (BM) of defined maturation state and basoapical polarization were used to resemble breast gland morphogenesis in vitro. The novel biophysical tool was used to apply cyclic shear strain with defined amplitudes (≤15%, 0.2 Hz) over 22 h on living spheroids embedded in an ultrasoft matrix (<60 Pa). We demonstrated that breast spheroids gain resistance to shear strain, which increased with BM maturation and basoapical polarization. Most intriguingly, poorly developed spheroids were prone to cyclic strain-induced extrusion of apoptotic cells from the spheroid body. In contrast, matured spheroids were insensitive to this mechanoresponse-indicating changing mechanosensing or mechanotransduction mechanisms during breast tissue morphogenesis. Together, we introduced a versatile tool to study cyclic shear stress responses of 3D cell culture models. It can be used to strain, in principle, all kinds of cell clusters, even those that grow only in ultrasoft hydrogels. We believe that this approach opens new doors to gain new insights into dynamic shear strain-induced mechanobiological regulation circuits between cells and their ECM.

2.
J Dent Res ; 101(3): 323-330, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34528480

RESUMO

Nonsyndromic cleft lip with or without palate (nsCL/P) ranks among the most common human birth defects and has a multifactorial etiology. Human neural crest cells (hNCC) make a substantial contribution to the formation of facial bone and cartilage and are a key cell type in terms of nsCL/P etiology. Based on increasing evidence for the role of noncoding regulatory mechanisms in nsCL/P, we investigated the role of hNCC-expressed microRNAs (miRNA) in cleft development. First, we conducted a systematic analysis of miRNAs expressed in human-induced pluripotent stem cell-derived hNCC using Affymetrix microarrays on cell lines established from 4 unaffected donors. These analyses identified 152 candidate miRNAs. Based on the hypothesis that candidate miRNA loci harbor genetic variation associated with nsCL/P risk, the genomic locations of these candidates were cross-referenced with data from a previous genome-wide association study of nsCL/P. Associated variants were reanalyzed in independent nsCL/P study populations. Jointly, the results suggest that miR-149 is implicated in nsCL/P etiology. Second, functional follow-up included in vitro overexpression and inhibition of miR-149 in hNCC and subsequent analyses at the molecular and phenotypic level. Using 3'RNA-Seq, we identified 604 differentially expressed (DE) genes in hNCC overexpressing miR-149 compared with untreated cells. These included TLR4 and JUNB, which are established targets of miR-149, and NOG, BMP4, and PAX6, which are reported nsCL/P candidate genes. Pathway analyses revealed that DE genes were enriched in pathways including regulation of cartilage development and NCC differentiation. At the cellular level, distinct hNCC migration patterns were observed in response to miR-149 overexpression. Our data suggest that miR-149 is involved in the etiology of nsCL/P via its role in hNCC migration.


Assuntos
Fenda Labial , Fissura Palatina , MicroRNAs , Estudos de Casos e Controles , Fenda Labial/genética , Fissura Palatina/genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , MicroRNAs/genética , Crista Neural , Polimorfismo de Nucleotídeo Único
3.
Sci Rep ; 10(1): 19836, 2020 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-33199768

RESUMO

The efforts to improve the treatment efficacy in blind patients with retinal degenerative diseases would greatly benefit from retinal activity feedback, which is lacking in current retinal implants. While the door for a bidirectional communication device that stimulates and records intraretinally has been opened by the recent use of silicon-based penetrating probes, the biological impact induced by the insertion of such rigid devices is still unknown. Here, we developed for the first time, flexible intraretinal probes and validated in vitro the acute biological insertion impact in mouse retinae compared to standard silicon-based probes. Our results show that probes based on flexible materials, such as polyimide and parylene-C, in combination with a narrow shank design 50 µm wide and 7 µm thick, and the use of insertion speeds as high as 187.5 µm/s will successfully penetrate the retina, reduce the footprint of the insertion to roughly 2 times the cross-section of the probe, and induce low dead cell counts, while keeping the vitality of the tissue and recording the neural activity at different depths.


Assuntos
Retina/fisiologia , Retina/cirurgia , Animais , Eletrodos Implantados , Desenho de Equipamento , Retroalimentação Fisiológica , Teste de Materiais , Camundongos , Microeletrodos , Imagens de Fantasmas , Maleabilidade , Silício/química
4.
Vasc Endovascular Surg ; 45(8): 681-7, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22262112

RESUMO

Visceral artery aneurysms (VAAs) are a rare condition, in case of a rupture they have a high mortality rate up to 70%. Visceral artery aneurysms are seen more often these days with the more widespread use of computed tomography and angiography. There are various options for treating VAAs; open surgical repair, endovascular treatment, and laparoscopic surgery. We report 5 cases of visceral aneurysms, all treated differently--ligation, aneurysmectomy (with splenectomy), emergency and elective coil embolization, and conservatively. We will further give a review of the literature on etiology, diagnosis, and treatment options.


Assuntos
Aneurisma Roto , Aneurisma , Vísceras/irrigação sanguínea , Idoso , Idoso de 80 Anos ou mais , Aneurisma/diagnóstico por imagem , Aneurisma/etiologia , Aneurisma/terapia , Aneurisma Roto/diagnóstico por imagem , Aneurisma Roto/etiologia , Aneurisma Roto/terapia , Implante de Prótese Vascular , Embolização Terapêutica , Procedimentos Endovasculares , Evolução Fatal , Feminino , Humanos , Ligadura , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Esplenectomia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
5.
Eur J Trauma Emerg Surg ; 36(5): 491-3, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21841956

RESUMO

A case of femoral neck fracture is reported after electrical shock injury with 300 V direct current in a 41-year old male. He had two small full thickness burns on his left heel, probably the exit wounds. A fracture after electrical shock due to musculoskeletal contractions is a very rare condition. Surgeons caring for patients with electrical injury should be aware of the possibility of skeletal injuries. Without vigilance for these injuries, delay in diagnosis may occur.

6.
Tech Coloproctol ; 11(2): 158-60, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17510736

RESUMO

Proteus syndrome was originally described by Cohen and Hayden in 1979. The disorder was named Proteus syndrome by Wiedmann and colleagues in 1983 after Proteus, the giant Greek god of the sea. Proteus syndrome is a rare, sporadic, congenital polymorphic condition. Approximately 200 cases have been reported in the literature, but none has been associated with anal bleeding from hemorrhoids. We describe the case of a 21-year-old man with Proteus syndrome with severe anal bleeding. A hemorrhoidectomy was assumed to be too risky because of the massive venous abnormalities seen on CT. The patient was successfully treated by Doppler-guided haemorrhoidal artery ligation (DG-HAL). Six months after surgery, the patient has had no further episodes of anal bleeding.


Assuntos
Hemorragia Gastrointestinal/etiologia , Hemorroidas/etiologia , Síndrome de Proteu/complicações , Adulto , Hemorroidas/diagnóstico por imagem , Humanos , Masculino , Síndrome de Proteu/diagnóstico por imagem , Tomografia Computadorizada por Raios X
7.
Ned Tijdschr Geneeskd ; 147(15): 681-5, 2003 Apr 12.
Artigo em Holandês | MEDLINE | ID: mdl-12722528

RESUMO

In two adult patients, a 74-year-old woman and a 84-year-old man, who suffered from vague abdominal complaints, an intussusception was diagnosed by CT. Surgical resection of the affected bowel parts was successful. Intussusception is usually seen in children; in adults it is a rare condition. Adult patients mostly complain about vague abdominal pain only. Physical examination, laboratory investigations and plain abdominal X-rays often don't give any additional information. In such patients it is advised to perform CT of the abdomen at an early stage. CT may show a so-called 'target sign' which is characteristic of an intussusception. In addition it can provide information about the possible causes of the intussusception, most commonly a malignant tumour in adults. During laparotomy one should not attempt to reduce the intussusception because of the risk of tumour spill. In this clinical review, we present two adult patients with unexplained abdominal complaints due to intussusception, caused by malignancy.


Assuntos
Intussuscepção/diagnóstico por imagem , Dor Abdominal/etiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Intussuscepção/diagnóstico , Intussuscepção/cirurgia , Laparotomia , Masculino , Tomografia Computadorizada por Raios X
8.
Ned Tijdschr Geneeskd ; 146(14): 663, 2002 Apr 06.
Artigo em Holandês | MEDLINE | ID: mdl-11969034

RESUMO

A subfebrile girl with ascites.--A 16-year-old Ethiopian girl who had been living in the Netherlands for 4 years had ascites and echogenic spots in the abdomen. Laparoscopy revealed peritonitis tuberculosa.


Assuntos
Antituberculosos/uso terapêutico , Peritonite Tuberculosa/diagnóstico , Adolescente , Ascite/etiologia , Ascite/microbiologia , Diagnóstico Diferencial , Feminino , Febre/etiologia , Humanos , Peritonite Tuberculosa/tratamento farmacológico
9.
Eur J Obstet Gynecol Reprod Biol ; 86(1): 35-41, 1999 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10471140

RESUMO

OBJECTIVE: The purpose of the present study was to evaluate the clinical significance of tumour necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) for endothelial cell activation in pre-eclampsia. Therefore, we determined and compared the correlations between these cytokines and circulating adhesion molecules in the sera of pre-eclamptic pregnant women, normotensive pregnant women and nonpregnant women. METHODS: The soluble adhesion molecules VCAM-1, ICAM-1, E-selectin, and P-selectin were determined in the serum of 38 pre-eclamptic pregnant women and 40 normotensive pregnant and nonpregnant controls using ELISA-techniques. We correlated these serum concentrations with the serum levels of TNF-alpha and IL-1beta, respectively, also determined by ELISA. RESULTS: Elevated serum levels of VCAM-1 and E-selectin could be detected in pre-eclamptic patients, with and without HELLP-syndrome. In contrast, no increased serum concentration of ICAM-1, P-selectin, TNF-alpha and IL-1beta were found in these patients. While significant correlation between VCAM-1 and E-selectin could be determined (r=0.604; p<0.001) no unambiguous correlations, however, were found between TNF-alpha or between IL-1beta and the examined adhesion molecules or the selectins. CONCLUSIONS: In contrast to in vitro investigations on cultured umbilical vein endothelium, our experimental results indicate that the cytokines TNF-alpha and IL-1beta can not explain endothelial cell activation, and that their measurement in serum is not useful for the detection of pre-eclampsia.


Assuntos
Moléculas de Adesão Celular/sangue , Endotélio Vascular/fisiopatologia , Interleucina-1/fisiologia , Pré-Eclâmpsia/sangue , Fator de Necrose Tumoral alfa/fisiologia , Adulto , Selectina E/sangue , Feminino , Síndrome HELLP/sangue , Humanos , Molécula 1 de Adesão Intercelular/sangue , Interleucina-1/análise , Selectina-P/sangue , Gravidez , Fator de Necrose Tumoral alfa/análise , Molécula 1 de Adesão de Célula Vascular/sangue
10.
Am J Obstet Gynecol ; 180(1 Pt 1): 68-72, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9914581

RESUMO

OBJECTIVE: Adhesion molecules, such as vascular cell adhesion molecule 1, are known to be increased in the serum of patients with preeclampsia, indicating that these molecules are possible markers of endothelial cell activation. We investigated the influence of serum from women with preeclampsia on the expression of adhesion molecules by cultured endothelial cells. STUDY DESIGN: Human umbilical vein endothelial cells were cultured in Ham/Iscove modified Dulbecco's medium containing 20% pooled human serum, l -glutamine (200 mmol/L), penicillin, and streptomycin. We stimulated these cells for 24 hours with sera from patients with preeclampsia and then determined the levels of vascular cell adhesion molecule 1, intercellular cell adhesion molecule 1, E-selectin, and P-selectin in the supernatant and in the maternal serum by means of enzyme-linked immunosorbent assay. These results were compared with those of sera obtained from normotensive pregnant and nonpregnant women. In addition, the expressions of these adhesion molecules on the endothelial surface were determined by immunofluo-rescence microscopy. RESULTS: Only for vascular cell adhesion molecule 1 and E-selectin were elevated plasma levels found in hypertensive patients, whereas intercellular cell adhesion molecule 1 and P-selectin showed similar plasma levels in all the patients. No differences in the levels of the adhesion molecules were found between the supernatants of endothelial cell cultures after stimulation with sera from patients with preeclampsia and those after stimulation with normotensive control sera. In contrast, with immunofluorescence microscopy we could detect higher amounts of vascular cell adhesion molecule 1, intercellular cell adhesion molecule 1, and E-selectin on the endothelial surface after stimulation with sera from women with preeclampsia. CONCLUSION: Although vascular cell adhesion molecule 1 and E-selectin were elevated in maternal serum samples from women with preeclampsia and on the endothelial surface after stimulation with such sera, there were no detectable increases in the levels of both of these adhesion molecules in the supernatant of cultured endothelial cells. We therefore assume that sera from women with preeclampsia may cause endothelial cell activation. Because we could not detect elevated concentrations of any of the investigated adhesion molecules in the supernatant of endothelial cells, we believe that factors other than sera from women with preeclampsia seem to play a major role in the release of soluble forms of adhesion molecules from the endothelial membrane.


Assuntos
Moléculas de Adesão Celular/fisiologia , Endotélio Vascular/fisiopatologia , Pré-Eclâmpsia/fisiopatologia , Adulto , Fenômenos Fisiológicos Sanguíneos , Moléculas de Adesão Celular/metabolismo , Membrana Celular/metabolismo , Células Cultivadas , Selectina E/metabolismo , Endotélio Vascular/metabolismo , Endotélio Vascular/patologia , Feminino , Humanos , Molécula 1 de Adesão Intercelular/metabolismo , Pré-Eclâmpsia/sangue , Pré-Eclâmpsia/metabolismo , Pré-Eclâmpsia/patologia , Gravidez , Solubilidade , Molécula 1 de Adesão de Célula Vascular/metabolismo
11.
Thromb Haemost ; 79(2): 362-70, 1998 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-9493592

RESUMO

A decreased fibrinolytic activity of serosal surfaces appears to be a major factor in the development of peritoneal fibrous adhesions. Serosal fibrinolysis is regulated by mesothelial release of tissue type plasminogen activator (t-PA) and plasminogen activator inhibitor types 1 and 2 (PAI-1 and PAI-2). We investigated the influence of tumor necrosis factor alpha (TNF-alpha), transforming growth factor beta (TGF-beta1) and interleukin 1beta (IL-1beta) on pro- and antifibrinolytic properties of mesothelial cells (HOMC) using a cell/fibrin clot assay. TGF-beta1, TNF-alpha and IL-1beta induced a dose dependent 2.9, 2.3 and 1.9-fold increase of PAI-1 antigen, respectively, whereas t-PA concentrations decreased to one third of the control values. This modified PAI-1/t-PA secretion pattern leads to a significant delay of fibrinolysis. Analysis of m-RNA levels revealed increased PAI-1 m-RNA concentrations after 12 h and decreased m-RNA concentrations for t-PA after 6 h. Serosal hypofibrinolysis during peritonitis may be explained at least in part by cytokine effects which thus may favor adhesion formation.


Assuntos
Fibrinólise/fisiologia , Interleucina-1/farmacologia , Peritônio/citologia , Peritônio/fisiologia , Fator de Crescimento Transformador beta/farmacologia , Fator de Necrose Tumoral alfa/farmacologia , Adesão Celular/efeitos dos fármacos , Células Cultivadas , Epitélio/efeitos dos fármacos , Epitélio/fisiologia , Fibrinólise/efeitos dos fármacos , Humanos , Inibidor 1 de Ativador de Plasminogênio/biossíntese
12.
Am J Pathol ; 150(5): 1537-46, 1997 May.
Artigo em Inglês | MEDLINE | ID: mdl-9137080

RESUMO

Four different DNA extraction methods were compared to determine their ability to provide DNA for amplification of viral sequences from paraffin-embedded human tissue samples by polymerase chain reaction (PCR). The suitability of extraction methods was assessed using parameters like DNA yield, length of recovered DNA fragments, and duration. Furthermore, the efficiency of amplifying a human single-copy gene, the beta-globin gene, from DNA samples was tested. The best preservation of DNA molecules could be achieved by binding the DNA onto a silica column before further purification. Viral DNA sequences could be amplified by PCR in DNA extracted from routinely processed paraffin blocks from cases with clinically or morphologically suspected cytomegalovirus or Epstein-Barr virus infections. The PCR products were specified by a novel liquid hybridization assay called PCR-enzyme-linked immunosorbent assay. Using this assay, the time-consuming Southern hybridization could be replaced and the time requirement for the detection of PCR products could be reduced from 1 day to 4 hours. The assay system described here represents a reliable, sensitive, and specific method for the detection of viral DNA from paraffin-embedded tissue samples.


Assuntos
DNA Viral/isolamento & purificação , Ensaio de Imunoadsorção Enzimática/métodos , Reação em Cadeia da Polimerase/métodos , Citomegalovirus/genética , Infecções por Citomegalovirus/genética , Infecções por Citomegalovirus/patologia , DNA Viral/química , Ensaio de Imunoadsorção Enzimática/normas , Fixadores , Infecções por Herpesviridae/genética , Infecções por Herpesviridae/patologia , Herpesvirus Humano 4/genética , Humanos , Hibridização de Ácido Nucleico , Inclusão em Parafina , Reação em Cadeia da Polimerase/normas , Sensibilidade e Especificidade , Infecções Tumorais por Vírus/genética , Infecções Tumorais por Vírus/patologia
13.
Plant Mol Biol ; 32(5): 831-48, 1996 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8980535

RESUMO

Phosphoenolpyruvate carboxylase (PEPC) genes from Corynebacterium glutamicum (cppc), Escherichia coli (eppc) or Flaveria trinervia (fppc) were transferred to Solanum tuberosum. Plant regenerants producing foreign PEPC were identified by Western blot analysis. Maximum PEPC activities measured in eppc and fppc plants grown in the greenhouse were doubled compared to control plants. For cppc a transgenic plant line could be selected which exhibited a fourfold increase in PEPC activity. In the presence of acetyl-CoA, a known activator of the procaryotic PEPC, a sixfold higher activity level was observed. In cppc plants grown in axenic culture PEPC activities were even higher. There was a 6-fold or 12-fold increase in the PEPC activities compared to the controls measured in the absence or presence of acetyl-CoA, respectively. Comparable results were obtained by transient expression in Nicotiana tabacum protoplasts. PEPC of C. glutamicum (PEPC C.g.) in S. tuberosum leaf extracts displays its characteristic K(m) (PEP) value. Plant growth was examined with plants showing high expression of PEPC and, moreover, with a plant cell line expressing an antisense S. tuberosum (anti-sppc) gene. In axenic culture the growth rate of a cppc plant cell line was appreciably diminished, whereas growth rates of an anti-sppc line were similar or slightly higher than in controls. Malate levels were increased in cppc plants and decreased in antisense plants. There were no significant differences in photosynthetic electron transport or steady state CO2 assimilation between control plants and transformants overexpressing PEPC C.g. or anti-sppc plants. However, a prolonged dark treatment resulted in a delayed induction of photosynthetic electron transport in plants with less PEPC. Rates of CO2 release in the dark determined after a 45 min illumination period at a high proton flux density were considerably enhanced in cppc plants and slightly diminished in anti-sppc plants. When CO2 assimilation rates were corrected for estimated rates of mitochondrial respiration in the light, the electron requirement for CO2 assimilation determined in low CO2 was slightly lower in transformants with higher PEPC, whereas transformants with decreased PEPC exhibited an appreciably elevated electron requirement. The CO2 compensation point remained unchanged in plants (cppc) with high PEPC activity, but might be increased in an antisense plant cell line. Stomatal opening was delayed in antisense plants, but was accelerated in plants overexpressing PEPC C.g. compared to the controls.


Assuntos
Fosfoenolpiruvato Carboxilase/genética , Solanum tuberosum/genética , Aminoácidos/metabolismo , Dióxido de Carbono/metabolismo , Corynebacterium/enzimologia , DNA Antissenso/genética , Escuridão , Transporte de Elétrons , Escherichia coli/enzimologia , Vetores Genéticos , Malatos/metabolismo , Fosfoenolpiruvato Carboxilase/metabolismo , Fotossíntese , Folhas de Planta/metabolismo , Plantas/enzimologia , Plantas Geneticamente Modificadas , Plantas Tóxicas , Ácido Pirúvico/metabolismo , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Solanum tuberosum/crescimento & desenvolvimento , Nicotiana
14.
Science ; 263(5146): 499-502, 1994 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-17754881

RESUMO

Analysis of a 60-picosecond molecular dynamics trajectory of the reaction center of Rhodopseudomonas viridis provides an understanding of observations concerning vibrational coherence and the nonexponential kinetics of the primary charge transfer in photosynthesis. Complex kinetics arises from energy gap correlations that persist beyond 1 picosecond.

15.
Plant Mol Biol ; 23(4): 881-8, 1993 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-8251640

RESUMO

A cDNA coding for phosphoenolpyruvate carboxylase (PEPC) was isolated from a cDNA library from Solanum tuberosum and the sequence of the cDNA was determined. It was inserted into a bacterial expression vector and a PEPC- Escherichia coli mutant could be complemented by the cDNA construct. A functional fusion protein could be synthesized in E. coli. The properties of this PEPC protein clearly resembled those of typical C3 plant enzymes.


Assuntos
Fosfoenolpiruvato Carboxilase/genética , Solanum tuberosum/genética , Sequência de Aminoácidos , Sequência de Bases , Clonagem Molecular , DNA Complementar/genética , Regulação da Expressão Gênica , Dados de Sequência Molecular , Peso Molecular , Fosfoenolpiruvato Carboxilase/metabolismo , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , RNA Mensageiro/genética , Proteínas Recombinantes/química , Proteínas Recombinantes/metabolismo
16.
Anal Biochem ; 211(1): 113-6, 1993 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-8323022

RESUMO

Four different promoters--the 35S, a double 35S promoter, and two different promoter fragments of the ribulose-bisphosphate carboxylase small subunit (rbcS)--were fused to the reporter gene chloramphenicol acetyltransferase (CAT) and transient expression studies were performed in potato protoplasts. Promoter strength was evaluated by using a nonradioactive CAT immunoassay not previously tested with plant cells. The activities of the rbcS promoters were 10-fold less than those of the 35S promoters. Unspecific reactions due to the immunoassay adopted were very low, and the sensitivity was in the range of that of other radioactive and nonradioactive reporter gene assays. The CAT-enzyme-linked immunosorbent assay test is a suitable nonradioactive alternative to test relatively weak promoters in plant systems.


Assuntos
Cloranfenicol O-Acetiltransferase/genética , Genes de Plantas , Regiões Promotoras Genéticas , Protoplastos/fisiologia , Solanum tuberosum/genética , Clonagem Molecular , Ensaio de Imunoadsorção Enzimática , Plasmídeos/genética , Sensibilidade e Especificidade , Transformação Genética
17.
Phys Rev Lett ; 58(13): 1296-1299, 1987 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-10034395
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