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Thyroid cancer lymph nodes survival,organic food bar one,survival acres food storage utah,ford kuga kullan?c? yorumlar? forum - Review

Figure 1: Plain chest radiograph demonstrating right-tracheal deviation and esophageal foreign body. On arrival to the Emergency Department the patient is in mild discomfort but is breathing comfortably and able to control her secretions. Thyroid ultrasound reveals a markedly enlarged thyroid with a diffusely infiltrative process occupying the entire left lobe. PTC is a tumor that arises from the follicular cells of the thyroid, the cells responsive to thyroid stimulating hormone (TSH) and capable of transporting iodide into their cytoplasm for the production of thyroid hormone (T4 and T3). At the time of diagnosis 60 percent of patients have lymph node metastasis and up to 15 percent have pulmonary metastasis.
Because PTC displays an indolent rate of growth and maintains a differentiated state, disease-specific mortality is low with survival over 30 or more years estimated at 95 percent.
After preoperative staging with neck ultrasound and axial imaging, the patient described underwent a total thyroidectomy with central and bilateral, lateral neck dissection; 29 of 47 lymph nodes were positive for metastasis. Targeted surgical resection of the two cervical regions was performed using radio-guided dissection.
Thyroid cancer in pediatrics has a favorable outcome, even for patients who present with significant metastasis. Cervical lymph nodes are part of you lymphatic system which also includes other organs, tissues, and vessels.
These are situated just beneath your jaw bone referred to as the mandible and are responsible for draining the posterior, or back, of your pharynx and your tonsils.
The other two groups are posterior and anterior cervical lymph nodes that will be discussed later. These particular lymph nodes are responsible for filtering and draining your lymphatic fluid from the areas in your neck and head.
Back of your neck near your skull also known as occipital—this would be a localized infection of your head or scalp. Behind your ears known as postauricular – this is a contained infection of your scalp or ears. The front of your ears known as preauricular – this is an infection in your eyelids also referred to as the mucus membrane, ear infections, or infection in your temporal region.
These particular cervical lymph nodes are responsible for the drainage of your tonsils, pharynx, and your thyroid gland.. Because of their location it is very common for the swelling to be noticed and may be more noticeable when you turn your neck to the right or left.
If your physician thinks that the cause of your posterior cervical lymph node swelling is cancer to ensure it is cancer and what type it is the physician will usually request a biopsy to be done.
If the cervical lymph nodes are painful, mobile, and soft with any signs of inflammation on the overlying skin the swelling is usually due to an infection. If the cervical lymph nodes are not painful, fixed and not mobile, and hard it is usually due to cancer. If the cervical lymph nodes seem to be connected to each other, also referred to as matted lymph nodes, it could be due to a malignancy, tuberculosis, or Sarcoidosis. If you are also experiencing night sweats, weight loss, running a fever, or feeling fatigued these could also help give a diagnosis as to why they are swollen.
You should make an appointment to see your physician if your lymph nodes are swollen longer than fourteen days, become more swollen, or you are seeing more swollen lymph nodes. If your posterior cervical lymph node is swollen because of cancer it will need to be treated. You can also apply simultaneously hot and cold compresses to the swollen cervical lymph nodes. These treatments, while an important part of treating the cancer, can bring on a painful and debilitating condition called oral mucositis (OM) or stomatitis. More than 40% of all patients undergoing conventional chemotherapy and 97% to 100% of patients undergoing conventional radiation or bone marrow transplant therapy are affected. NeutraSal comes in single-use packets of dissolving powder, which, when mixed with water, creates an oral rinse supersaturated with calcium and phosphate ions.
When NeutraSal is used at the start of chemotherapy or RADIATION THERAPY, it can help maintain the correct oral environment and initiate healing of the oral mucosa.
I appreciate that there is a direct access program that provides products for all patients experiencing oral mucositis or xerostomia who require NeutraSal treatment, regardless of their insurance or financial situation. With each prescription, the patient is shipped either the complementary Sjogren’s support kit or the oral mucositis support kit. With the incidence of HEAD AND NECK CANCERS  still rising, the importance of external head and neck exams cannot be overstated.
With the incidence of HEAD AND NECK CANCERS still rising, the importance of external head and neck exams cannot be overstated.
Despite the fact that we all learned how to do these exams in school, I find that very few hygienists and dentists are actually providing a comprehensive head and neck exam. Science, Technology and Medicine open access publisher.Publish, read and share novel research.
Local Metastasis in Head and Neck Cancer - an OverviewSuwarna Dangore–Khasbage1[1] Oral Medicine and Radiology, SPDC, Datta Meghe Institute of Medical Sciences, Wardha, India1.
N2Bilateral metastasis in lymph node(s), 6 cm or less in greatest dimension, above the supraclavicular fossa.
ABSTRACT: Selective neck dissection is a procedure that is primarily indicated in patients with clinically negative nodal disease in which there is a high risk of occult metastases.
Selective neck dissections are typically performed for occult or early metastases for which the removal of nonlymphatic structures (eg, sternocleidomastoid muscle, internal jugular vein, spinal accessory nerve) is thought not to be necessary.
Following Lindberg’s paper describing skip metastases that develop in level II and III nodes without affecting level I, suprahyoid neck dissection fell into disfavor and was replaced by supraomohyoid neck dissection.[3] Suarez[4] and Bocca et al[5] described a modification of radical neck dissection for patients with laryngeal and hypopharyngeal cancers and clinically negative nodal disease. Among the first to report the efficacy of limited neck surgery in a large series of patients, Jesse et al[6] independently developed neck dissection modifications for cancers of the oral cavity and pharynx. The general rationale for using selective neck dissections is based on the topographic distribution of lymph node metastases. In 1972, a clinical study by Lindberg[3] demonstrated that the lymph node groups most frequently involved in patients with carcinoma of the oral cavity are the jugulodigastric and midjugular nodes (levels II and III).
The Lindberg study demonstrated that in the absence of metastases to the first echelon nodes, tumors of the oral cavity and oropharynx rarely involve the inferior jugular and posterior triangle nodes. Further evidence supporting the concept that lymph node metastases follow predictable patterns of spread was provided by Shah[13] in a retrospective study of radical neck dissection specimens taken from patients with metastases from cancers of the oral cavity, larynx, and laryngopharynx. As a general rule, selective neck dissection is performed in patients with cancer arising in the head and neck region who are considered at risk for metastatic disease in the regional cervical lymph nodes.
Additional indications include situations in which surgical access to the primary cancer extends to lymph node groups at risk for metastases and, more controversially, clinical evidence of nodal metastases confined to the first echelon nodes (usually N1 disease) when the primary is to be treated by surgical removal. Previous reports on selective neck dissection have typically approached the subject based on the specific type of neck dissection performed; eg, supraomohyoid vs lateral.
A neck lump is any lump, bump, or swelling in the neck. Considerations There are many causes of lumps in the neck.
A CXR confirms the location of the missing retainer piece, but is also significant for right-tracheal deviation (Figure 1).
Within pediatrics the highest incidence of PTC is found in Caucasian girls, 15 to 19 years of age, where thyroid cancer is the second most common malignancy following Hodgkin’s lymphoma.
Complete surgical resection, to include total thyroidectomy with compartmental lymph node dissection, is the most critical initial step of management. Disease-specific morbidity, however, is not as favorable secondary to a high-recurrence rate. The creation of pediatric-specific guidelines for the evaluation and management of thyroid cancer, as well as the creation of regional referral centers with a multidisciplinary approach to care, is necessary to optimize evaluation and management and to decrease disease-specific morbidity. Your lymphatic system is what helps to fight infections and regulates your body’s fluid balance. In this area there are two different types which are your deep anterior cervical lymph nodes and your superficial anterior cervical lymph nodes. If you are experiencing other symptoms like pain, a sore throat, earache, running a fever, weakness, chills, etc you should see your physician to see what the cause is and if treatment is necessary.
If the cancer has already spread to your lymph nodes it will change how the cancer will be treated. To use this treatment you would place one clean washcloth in a bowl of hot water and one in a bowl of cold water.
Ulceroproliferative growth with rolled edges, involving buccal and lingual vestibule and alveolar ridge in a 62-year-old male.
Showing an enlarged (4 ? 4 cm), hard and fixed submandibular lymph node in a patient with a malignancy of bucco- lingual vestibule and alveolar ridge (extra oral photograph of the same 62-year-old male, shown in Figure 1)4. A CT scan of a skull with contrast reveals: homogenously enhancing lesion present in the left buccinator space, left submandibular and left jugulodigastric region lymphadenopathy. MRI reveals intense enhancing soft tissue mass involving gingiva, alveolus, submandibular gland and mandible suggestive of malignant lesion.


MRI reveals intense enhancing soft tissue mass involving gingiva, alveolus, submandibular gland and mandible, suggestive of a malignant lesion.
IntroductionHead and neck cancer refers to epithelial malignancies of various parts of the orofacial region, which include paranasal sinuses, nasal cavity, pharynx and larynx, etc. Decision Analysis and Treatment Threshold in a Management for the N0 Neck of the Oral Cavity Carcinoma.
Magnetic Resonance Imaging Versus Clinical Palpation in Evaluating Cervical Metastasis from Head and Neck Carcinoma.
Morphological Changes of Regional Lymph Node in Squamous Cell Carcinoma of the Oral Cavity. Squamous Cell Carcinoma of the Oral Cavity: A Clinicopathologic Scoring System for Evaluating Risk of Cervical Lymph Node Metastasis. Differentiation of Benign from Malignant Superficial Lymphadenopathy: The Role of High-resolution US.
Utility of Color Doppler Ultrasound in Evaluating the Status of Cervical Lymph Nodes in Oral Cancer. Evaluation of the Efficacy of Colour Doppler Ultrasound in Diagnosis of Cervical Lymphadenopathy. Evaluation of Cervical Lymph Nodes in Head and Neck Cancer with CT and MRI: Tips, Traps, and a Systematic Approach. Clinical Evaluation of Lymphoscintigraphy with a New Technetium Compound for Metastatic Cervical Lymphadenopathy.
Others have advocated its use for patients with positive nodes, although under very specific circumstances and in combination with postoperative radiation therapy. The procedure consists of compartmental removal of one or more levels containing lymph node groups determined to be at risk for metastatic cancer.
Head and neck surgeons likely used this approach for several decades without describing the technique in a formal manner. The procedure attracted much attention because it preserved the spinal accessory nerve, internal jugular vein, and sternocleidomastoid muscle.
This distribution appears to be predictable in patients with previously untreated squamous cell carcinoma of the head and neck, particularly in early disease.
In patients with carcinoma of the floor of the mouth, anterior oral tongue, and buccal mucosa, the nodes most frequently involved are in the submandibular triangle (level I).
They concluded that cancers of the oral cavity metastasize most frequently to neck nodes in levels I, II, and III, whereas cancers of the oropharynx, hypopharynx, and larynx metastasize most frequently to the nodes in levels II, III, and IV. The procedure is indicated primarily in patients who have no evidence of clinical metastases, who have a 15% to 20% risk of harboring occult metastatic disease, and for whom surgery is the preferred treatment of the primary lesion. In this setting, the patient will most likely receive postoperative radiation therapy, and the purpose of the selective neck dissection is to eradicate all gross disease. For this article, I have chosen to review the issues based on the site of origin of the cancer. She reports no prodrome of symptoms, only that she awoke with a sharp pain in  her neck and then noted that a corner of her orthodontic retainer was missing.
Fine needle aspiration biopsy of the thyroid and lymph nodes confirms the suspect diagnosis of papillary thyroid carcinoma (PTC).
The majority of patients are asymptomatic at the time of diagnosis, with the lesion incidentally discovered during unrelated physical exam or non-thyroid head and neck imaging. Efforts to improve the diagnostic testing for tumors with indeterminate cytology and pathology, to ensure the optimal stratification of surgical resection, and to define the appropriate dose and timing for radioiodine are critical to decrease morbidity.
The job of your lymphatic system is to drain excess fluid from the tissues and then return it to the blood that is circulating around in your body. This excess fluid will drain out of your lymph capillaries which are thin-walled blood vessels.
If they become swollen it is usually due to dental infections, toxoplasmosis, inflammation, also known as periodontitis, herpes also known as cytomegalovirus, or mononucleosis.
If these lymph nodes become swollen it could be due to infections of your neck, ears, pharynx, eyes, head, and sinuses.
If they become swollen it can be due to Hodgkin’s lymphoma, lung infection or cancer, or gastrointestinal cancer.
The anterior cervical lymph nodes are found along your muscles referred to as the sternocleidomastoid muscle that enables you to swivel and flex your head. Many times when a person has swollen cervical lymph nodes it is hard to diagnose the cause of the swelling.
Usually when you have swollen cervical lymph nodes they will return to normal within fourteen days without any treatment. Place the damp hot washcloth on your swollen cervical lymph nodes for ten minutes and then replace it with the cold washcloth for another ten minutes. It also reveals well-defined enhancing soft tissue lesion suggestive of lymphadenopathy (Axial view - T2-weighted image). It also reveals a well-defined enhancing soft tissue lesion, suggestive of lymphadenopathy (coronal view - T1-weighted image).6. These represent about 6% of all cancer cases and account for a number of new cancer cases and cancer-related deaths worldwide every year [1, 2]. The type of selective neck dissection performed varies according to the site of the primary, because the pattern of metastases is unique in each case. For example, at the end of the 19th century, Kocher used limited neck surgery when resecting cancer of the oral cavity without clinically evident neck nodes.[2] Later, a limited procedure known as suprahyoid neck dissection became popular as a means of removing occult lymphadenopathy associated with cancers of the oral cavity, particularly cancer of the lip.
It became known as functional neck dissection, with the major emphasis being preservation of function. Indeed, anatomic studies by Rouviere[10] and Fisch and Sigel[11] demonstrated that lymphatic drainage of the mucosal surfaces of the head and neck follows relatively constant and predictable routes.
Lindberg also noted that cancers frequently metastasize to both sides of the neck and can skip the submandibular and jugulodigastric nodes, metastasizing first to the midjugular region. With this approach, an analysis can be made that is applicable to patients presenting with the full spectrum of the disease. These can be caused by bacterial or viral infections, cancer (malignancy), or other rare causes. Enlargement of the salivary glands under the jaw may be caused by infection or cancer. Sporadic disease is most common, however risk factors include exposure to ionizing radiation, most commonly secondary to treatment of an unrelated malignancy, and others (Table 1). Post-operative staging is used to determine which patients may or may not benefit from I131-radioiodine therapy. Fifteen months after the initial treatment, an undetectable TSH-stimulated Tg and negative I123-DxWBS confirmed remission. All lymph nodes filter debris like cancer cells, viruses, bacteria, and anything else that should not be circulating throughout the body. These types of blood vessels are located in the spaces between the cells throughout your body and are closed at one end. The characteristics of having swollen cervical lymph nodes can also help to diagnose the cause of why they are swollen.
If you are running a fever or having pain your physician will recommend the standard treatment of taking over-the-counter pain relievers like ibuprofen or acetaminophen. This review presents the author’s philosophy on when, how, and why to employ the procedure, based on the location of primary cancers at oral, pharyngeal, laryngeal, cutaneous, thyroid, and salivary gland sites. Within each of the sites in the head and neck, the indications for selective neck dissection vary. Lumps in the muscles of the neck -- almost always in the front of the neck -- are caused by injury or torticollis.
She is currently maintained on TSH-suppressive therapy and is followed with serial surveillance labs and imaging. Your cervical lymph nodes are a great indicator of an illness, especially when they are swollen. If they become swollen it could because of retroperitoneal or thoracic cancer, an infection that could be fungal or bacterial, breast cancer, or lymphoma. You may also have to take a prescription medication if you have an immune disorder in order to reduce the swollen cervical lymph node.
Another home remedy to help ease the pain and swelling of your cervical lymph nodes is to dissolve a teaspoon of honey in a cup of warm, not hot, tea or water.
Squamous cell carcinoma is the most frequent single entity, constituting 95% of all oral malignancies [3].Oral squamous cell carcinoma is an invasive lesion with the presence of perineural growth. Levels II, III, and IV, respectively, include the superior, middle, and inferior jugular groups. Thus, the compartments removed depend on the location of the primary lesion and its known pattern of spread. Lumps in the skin or just below the skin are often caused by cysts, including sebaceous cysts. The thyroid gland may also produce a lump, multiple lumps, or swelling in the neck as a result of thyroid disease or cancer. Most of the lymph nodes, including your cervical lymph nodes, are glands that are small and bean-shaped.


When your lymph nodes become swollen it is called lymphadenopathy and is more common in children than in adults. A swollen lymph node on the left could be the first sign of stomach cancer even before any other symptoms of cancer appear. Drink this a few times during the day and in a few days you will see improvements on your swollen cervical lymph nodes. Level V defines the posterior triangle nodes, and level VI contains the anterior compartment group (Figure 1). Most cancers of the thyroid gland are extremely slow-growing and often curable by surgery, even if they have been present for several years. All neck lumps in children and adults should be checked immediately. Since squamous cell carcinoma constitutes the preponderance of primary malignancies of the head and neck, it is by far the most common tumour that spreads to the cervical nodes [4].
Reports from the American Cancer Society indicate that, at the time of initial diagnosis, over 40% of patients with squamous cell carcinomas of the oral cavity and pharynx present with regional dissemination of the disease [5].In oral cancer, tumour dissemination occurs via regional lymphatic to cervical lymph node in a predictable and sequential fashion. However, treatment should start quickly to prevent complications or the spread of infection. As adults age, the likelihood of the lump being a cancer increases, particularly for people who smoke or drink significant amounts of alcohol. Oral cancer occurring in the posterior aspect of the oral cavity, oropharynx and inferior of the mouth tends to be associated with a higher incidence of spread to the lymph nodes at the time of diagnosis. However, its spreading to contralateral nodes is more common with midline and posterior lesions [6].The incidence of spread is influenced by the size of the tumour.
Lesions classed as T1 may show a regional spread in 10 to 20% of cases, T2 lesions in 25 to 30% of cases and T3 to T4 tumours in 50 to 75% [6].The determination of the presence or absence of metastases in the neck nodes is mandatory for cancer-bearing patients.
This is because the therapeutic rational and prognosis depend on the staging of the cancer.
Moreover, the presence of another metastatic node on the contralateral side further reduces the survival rate by 25% [7].
Therefore, it is important to assess as reliably as possible whether or not a patient has regional lymph node metastases.The common cause of metastatic cervical lymphadenopathy is the spread from primary tumours in the head and neck region.
However, in unusual cases, they represent secondary tumours from primary sites below the clavicles [3]. The diagnosis of such cervical neck tumours can be decided after a complete clinical and radiological examination, focusing on the organs or areas where there is a high chance of an existing primary tumour.2. Mechanism of metastases in head and neck cancerThe most deadly aspect of any cancer is its ability to spread or metastasize. Metastasis is a complex process involving the detachment of cells from the tumour tissue, the regulation of cell motility and invasion, and the proliferation and evasion through the lymphatic system or blood vessels.There are different views regarding the involvement of regional lymph nodes in metastasis. The nearby lymph nodes in tumour-bearing hosts are considered as anatomic barriers to the spread of tumour cells. On the contrary, another concept is that the lymphatic and lymphaticovenous shunts bypass the regional lymph nodes and allow both the lymphatic and haematogenous dissemination of malignant cells.
Lymphatic drainage in head and neck cancerSeveral important groups of lymph nodes act as first echelon nodes of the oral cavity. The first lymph node encountered in the channel, which drains a particular submucosal or subepidermal lymph capillary plexus, is called the first echelon node.
This is because it is here that pathogenic organisms or free tumour cells within the lymph fluid meet their first resistance to travel. A sentinel lymph node is defined as the first lymph node in a regional lymphatic basin that receives lymph flow from the primary tumour. However, it does not provide information regarding the presence or absence of cancer cells in those nodes.Sometimes, lymphatic metastases do not first develop in the lymph nodes nearest to the tumour. The reason for this phenomenon could be venous lymphatic anastomoses or obliteration of lymphatics by inflammation or radiation. Due to the obstruction of the lymphatics by tumour cells, the lymph flow is disturbed and the tumour cells spread against the flow of the lymph. This causes retrograde metastases at unusual sites, for example, metastases of carcinoma prostrate to the supraclavicular nodes.
It is believed that lymph nodes in the vicinity of the tumour perform multiple roles – first, acting as an initial barrier filter and destructing tumour cells, while later providing fertile soil for the growth of tumour cells [9].Cervical lymph nodes include the submental, prevascular facial and submandibular group of lymph nodes.
Deep jugular lymph nodes include the jugulodigastric, juguloomohyoid and supraclavicular group of lymph nodes. Lymph nodes in the posterior triangle of the neck include the accessory chain of lymph nodes. The mucosa of the upper aerodigestive tract drains to the cervical lymph nodes in the lateral aspect of the neck.
Tumours of the pharynx may drain to the parapharyngeal and retropharyngeal lymph nodes.The Delphian lymph node is present in the central compartment of the neck and drains the larynx and perithyroid lymph nodes adjacent to the thyroid gland.
Lymph nodes in the tracheoesophageal groove provide primary drainage to the thyroid gland, as well as the hypopharynx, subglottic larynx and cervical oesophagus. Lymph nodes in the anterior superior mediastinum provide drainage to the thyroid gland and the oesophagus. Furthermore, they serve as a secondary lymphatic basin for anatomic structures in the central compartment of the neck. Each anatomic subgroup of lymph nodes described above specifically serve as primary echelon lymph nodes, draining a specific site in the head and neck region.
Assumptions about the mechanism of metastasesLymph node metastasis occurs by haematogenous or by lymphatic routes.
Similarly, the lymphatic system has channels throughout the body, like the circulatory system, through which a malignant cell can travel and metastasize.If the cells travel through the lymph system, they may end up in nearby lymph nodes or spread to other organs. In circulation, the cancer cells may reach to any part of the body where they begin to grow and form a secondary tumour mass.
The dimension of lymphatic vessels is significantly greater in the tumour tissue than in the tumour-free tissue.
This means that the function of lymphatic vessels appear to have increased in the tumour tissue, compared to the tumour-free tissue. This results in regional metastasis [11].Reviews of literature recommend that there are multiple and diverse reasons for cervical lymph node metastases in head and neck cancer. However, by any means, the careful evaluation of these metastatic regional nodes is essential for appropriate treatment and to achieve the best outcome of the treatment. Certainly, a careful clinical examination must be carried out at the beginning of the journey regarding the evaluation of the status of cervical lymph nodes in head and neck cancer.3.
Clinical examination of lymph nodes in head and neck cancerCustomarily, all of the palpable cervical lymph nodes are considered as positive for regional metastasis in oral cancer.
Thus, to treat all necks by considering the significant risk of having occult lymph node metastases is a traditional approach for the treatment of oral cancer. However, this approach often involves the unnecessary treatment of necks that ultimately prove to be pathologically free of cancer. However, size is not a reliable marker of malignancy as small nodes can harbour small metastases that do not expand the node and conversely, benign nodes can be enlarged due to hyperplasia or inflammation. Thus, the nodes of less than 1 cm should also be carefully evaluated, particularly if they are in expected drainage sites of the primary tumour. In clinical practice, the size of the lymph node is only considered useful when there is an increase in nodal size on serial examinations in a patient with a known primary tumour, which is highly suggestive of metastasis.Metastatic disease can change the shape of the node by infiltrating nodal tissue and expanding the nodal capsule.
As the disease progresses, ill-defined irregular margins in a lymph node are a sign of malignancy and may represent an extracapsular spread of tumour.Metastatic lymph nodes are usually painless and thus, remain undetected by the patient until they reach considerable dimensions.
Characteristically, these nodes are stony-hard and freely movable until the tumour cells penetrate the node capsule and invade the surrounding tissue. Then, they become fixed and the expanding tumour may amalgamate surrounding nodes into one larger, stony-hard and fixed mass. Sometimes, the small tumours in the nasal cavities, nasopharynx and larynx may go undetected.
The only evidence of their presence is the metastatic tumour.Oral cavity tumours usually cause metastasis in the submandibular and upper cervical regions. Clinical staging of cervical lymph nodes in head and neck cancerIn the 1940s, the tumour-node-metastasis (TNM) staging system was reported by Pierre Denoix. In current practice, information obtained from the clinical examination and radiologic imaging is used to assign a clinical stage (cTNM). This is then used to stratify patients for a selection of therapy and to report outcomes of the treatment.For many decades, the AJCC-UICC TNM staging system has been used worldwide for staging head and neck cancer [12, 13]. According to this, the cervical lymph nodes are divided into seven levels or groups, which are based on the extent and level of cervical nodal involvement by metastatic tumour. Although this classification of cervical lymph nodes is commonly used, especially by surgeons and oncologists, some important lymph nodes, such as parotid and retropharyngeal nodes, are not included in this classification.



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