Author |
Message |
Herckleperckle
Member
11-20-2003
| Tuesday, April 04, 2006 - 9:58 pm
Source: Ivanhoe.com Reported April 3, 2006 Predicting Outcome for Breast Cancer Patients (Ivanhoe Newswire) -- New research may help give doctors a better idea of which women with breast cancer are most likely to experience a recurrence of their disease. Two specific genes, HOXB13 and IL-17BR, when expressed together, may mean a woman is at greater risk for recurrence and potentially early death, say researchers publishing in Clinical Cancer Research. Doctors have known that, in certain women with estrogen receptor positive cancer, the drug tamoxifen can reduce the risk of recurrence and death. Still, many women with ER-positive cancer tend to not respond or build up a resistance to tamoxifen, leading researchers to look for additional markers to help identify women at risk for recurrence. Additional recent research has suggested gene expression could be one tool to do this. In the current study, researchers from the Mayo Clinic, Harvard Medical School and Arcturus Bioscience examined the association between HOXB13 and Il-17BR in more than 200 women with ER-positive cancer. The women were then tracked for relapse and survival. Results showed the expression of these two genes is associated with breast cancer recurrence and reduced survival, regardless of standard clinical markers. They also note the findings hold especially true among women in whom the cancer has not spread to the lymph nodes. This, say researchers, "Suggests that this biomarker may be a marker of early invasion and metastatic potential." Women with a high HOXB13/IL-17BR ratio were also more likely to experience a recurrence within the first four years of starting treatment with tamoxifen. Lead study author, Matthew Goetz, M.D., says, "We believe these findings are critically important and corroborate the accumulating laboratory data which suggests that the HOXB13 gene is critically involved in breast cancer metastases." He adds, "Further research is needed to determine whether more aggressive or additional treatments will improve the outcomes of women identified to be at high risk by means of this marker." SOURCE: Clinical Cancer Research, 2006;12
|
Karen
Member
09-07-2004
| Sunday, April 23, 2006 - 4:14 pm
After about six months of on-and-off tenderness, I finally went and saw a doctor last week, who sent me for an ultrasound. The technician found something she was concerned by, and has scheduled me for a fine needle aspiration on Tuesday. Does anyone know anything about this? Is this something I should be concerned about yet? I know it's just a needle into the 'questionable' area to find whether it's cancerous or not, I guess I'm concerned that 1)it's a needle into my boob -- is it painful?? and 2) the ultrasound was on Thursday, the needle is on Tuesday, and the tech was irked with the staff that they couldn't get me in for the needle test sooner. Why the urgency?? I'm under 30 and the only history of breast cancer in my family is my maternal grandmother's sister. Please tell me not to panic just yet??
|
Nancy
Member
08-01-2000
| Sunday, April 23, 2006 - 4:56 pm
HI karen. I had the same thing with my first baseline mammo. It ended up just being a fibroid cyst. Its really not all that painful having the biopsy, they numb it up pretty good, although its a weird sensation. good luck!
|
Herckleperckle
Member
11-20-2003
| Sunday, April 23, 2006 - 5:15 pm
Is the tenderness you feel in sync with your periods? If so, that might be a reasonable explanation for that symptom. And dear, do NOT wait that long to talk to your physician when you have a problem like this. <HP smacks Karen's hand.> Let us know what the tests reveal, Sweetie. I hope you get the same news as Nancy! Oh, and I think (somebody who knows for sure confirm or not) that IF they are able to withdraw fluid, then that is a good thing (as it probably means a cyst). If not, still doesn't mean trouble. That's when the mammogram information will be needed.
|
Herckleperckle
Member
11-20-2003
| Wednesday, April 26, 2006 - 5:34 pm
READ THIS RIGHT NOW. Source: Ivanhoe.com Reported April 26, 2006 New Imaging May Reduce Repeat Breast Cancer Surgeries (Ivanhoe Newswire) -- Light waves in a newly explored region of the electromagnetic spectrum -- the terahertz region -- may help ensure complete tumor removal during breast cancer surgery. A new study reveals this new technology could potentially eliminate the need for multiple surgeries and additional tissue samples. "We found that terahertz light could reliably distinguish between normal breast tissue, tumor and even early-stage 'in situ' cancers in excised tissue samples," says Vincent P. Wallace, Ph.D., lead investigator at TeraView, who worked with Addenbrooke's Hospital in Cambridge, England, to conduct the study. "This technology could aid the surgeon in immediately identifying residual cancer after the main tumor has been removed, thus minimizing the need for additional surgical procedures." It currently takes several days to get results back after tissue samples are surgically removed. Since surgeons do not know right away if the entire tumor has been removed, repeat surgeries often have to be scheduled. Terahertz imaging could allow surgeons to analyze tissue samples during the first procedure and potentially eliminate additional surgeries. The study reveals when a slice of the surgically removed breast tissue is put on a special quartz plate and exposed to terahertz light, the light waves reflected from the tissue contain unique information about it. Researchers could then distinguish both invasive and noninvasive breast cancers from healthy tissue. Terahertz light is located between the infrared and microwave sections of the electromagnetic spectrum. This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/. SOURCE: Radiology, 2006;239;533-540
|
Herckleperckle
Member
11-20-2003
| Wednesday, April 26, 2006 - 5:43 pm
Source: Ivanhoe.com Notice the old date on this article, but still interesting. Reported November 25, 2003 New Technique to Diagnose Breast Cancer (Ivanhoe Newswire) -- Researchers from the University of Minnesota are working on a new way to diagnose breast cancer without having to perform a biopsy on suspected tissue. The technique uses high-level magnetic resonance imaging, or MRI, along with a method developed by the investigators called spectroscopy that measures levels of key compounds known to be present in breast cancers. These choline (tCho) compounds are found in normal breast tissue as well, but are significantly elevated in women with breast cancer. The combined technique, known as magnetic resonance spectroscopy, or MRS, is currently being tested in about 100 women, and the researchers are looking for additional women to add to the study. To be eligible, women must enroll before having a biopsy or surgery so that levels of tCho may be measured and then compared against results of a subsequent biopsy. Study authors are confident the new method may eventually lead to a noninvasive way to diagnose breast cancer and measure its progress. Michael Garwood, Ph.D., says, “We found tCho concentrations to be significantly higher in malignancies than in benign lumps and normal breast tissues using this quantitative method. Using high magnetic fields and this spectroscopic technique may produce a powerful way to diagnose breast cancer and to monitor its response to treatment. We hope this technique will eventually be used to avoid unnecessary biopsy.” For women interested in learning more about the study, call (612) 273-1944. SOURCE: Magnetic Resonance in Medicine, 2003;50;1134-1143
|
Herckleperckle
Member
11-20-2003
| Wednesday, April 26, 2006 - 8:41 pm
Source: Ivanhoe.com Reported October 18, 2004 Breast Cancer 2004 Executive Summary: Risks, Preventives and Detection The American Cancer Society estimates that a woman in the United States has a one in seven chance of developing invasive breast cancer during her lifetime -- the risk was one in 11 in 1975. While recognizing the incidence is increasing among American women, it is hopeful to look at all of the research that has gone on in 2004 to reduce incidence and mortality from the most commonly diagnosed cancer among women in America and worldwide. As 2004 comes to a close, here is a summary of all of the breast cancer research we've reported on including information on risk, detection, preventives and outcomes of the disease. RISKS Aborted Pregnancy: Investigators from the Collaborative Group on Hormonal Factors in Breast Cancer say evidence does not suggest any increase in the risk of developing breast cancer for women who have had a spontaneous or induced abortion. The number of abortions was also not associated with any change in breast cancer risk. Growth Rate as a Kid: Dutch researchers link a high birth weight, reaching peak growth at an early age, being tall for one’s age at age 14, having a low body mass index (BMI) at age 14, and having a high growth rate during childhood with greater likelihood of the disease. Antibiotics: Researchers from the University of Washington, Seattle, found women who had more prescriptions for antibiotics and took the medications for longer periods of time were more likely to develop breast cancer. They say all classes of antibiotics were associated with an increased risk. Childhood Cancer's Ties to Breast Cancer: Doctors have long known women who survive a bout with cancer in childhood are at increased risk of developing breast cancer when they get older. Most of the increased risk has been linked to exposure to chest radiation therapy during childhood cancer treatment. A new study is helping identify other factors involved in increasing the risk including a diagnosis of bone or soft tissue cancer, a family history of breast cancer, and a history of thyroid disease to the list. PREVENTIVES Exercise: Renowned exercise expert Walter Bortz, M.D., an internist at Stanford University in Stanford, Calif., studies the effects of exercise on cancer. His research shows exercise can improve quality of life, spirit and health among survivors. Research also shows women who routinely exercise, whether it's walking, rowing, lifting weights, have a 20-percent lower risk of ever getting breast cancer. Food: Elaine Magee, M.P.H., a registered dietician and author of several books including "Tell me What to eat to Help Prevent Breast Cancer," says there are 10 foods you can eat today to help reduce the risk of breast cancer tomorrow. (I'll post this article in a moment.) Aspirin: Aspirin is best known for its painkilling effects, but according to a study published in The Journal of the American Medical Association, regular use may also offer protection against breast cancer. DETECTION Electrical Breast Test: Mammograms miss about 10 percent of cancers and are especially ineffective in young women. A new device is being studied as an alternative screening method. It sends electricity through the breast and measures the speed it travels because breasts with cancer conduct electricity differently. (I'll post this article momentarily, too.) Earlier Detection for High-risk Women: Women who inherit the BRCA1 or BRCA2 genes are at significantly higher risk for breast cancer than other women. Currently, many of these women undergo prophylactic mastectomies to avoid the disease. But a study from the California Breast Cancer Research Foundation and the NIH shows new screening techniques, breast magnetic resonance imaging and ductal lavage, may also be beneficial. HELP FOR SIDE EFFECTS Cranial micro-current electrical stimulation: Researchers at the University of Virginia School of Nursing say stimulating the brain may help relieve the side effects of chemotherapy. For one hour a day, women attach ear clips that send a micro-current to the brain. They activate pathways that relieve symptoms. Exercise: Breast cancer survivors who exercised, particularly older women, reported higher body esteem and better mood than sedentary breast cancer survivors in a study from Brown Medical School. EFFECTS ON OUTCOME Weight: Your weight could make you more likely to die from breast cancer found researchers at Fox Chase Center in Philadelphia. They found that despite being diagnosed with early-stage disease, which is more commonly cured, obese women more often developed metastatic disease and more often died. In another study, researchers found patients with early-stage breast cancer in the highest weight category of 175 pounds and over experienced a 2.5-fold increased risk of dying from breast cancer compared to women in the lowest weight category of less than 133 pounds. They also found women with estrogen receptor-negative cancer had a two-fold increased risk of dying from breast cancer compared to women with ER-positive cancer, regardless of their stage at diagnosis. A study from the American Cancer Society shows weight gain after age 18 can be a significant predictor of breast cancer risk for postmenopausal women who are not taking hormone replacement therapy. (I'll post this article in a bit, too.) Who is Most Likely to die From the Disease? Researchers found women with more advanced stages of disease at diagnosis and those who are diagnosed at a younger age, even with less advanced stages, are the most likely to die from the disease. Black women are also more likely to die of breast cancer than white women, as are those whose tumors are negative for the estrogen receptor. (I'll post this one, too) Too few Surgeries: A new study from the Medical College of Wisconsin in Milwaukee shows doctors are not performing enough breast cancer surgeries, which may impact patient survival rates. (I'll post this one, too) Prognosis in White vs. Black Women: New research from the Harbor-UCLA Research and Education Institute in Torrance, Calif., provides more explanation as to why more black women die of breast cancer than white women, despite the incidence of breast cancer being higher in white women. (I'll post this one, too) Age: A new study from Germany shows young breast cancer survivors may suffer from more long-term effects than older patients. Consequently, patients may not be getting the appropriate therapy needed for coping with the aftermath of the disease. (I'll post this one, too.)
|
Herckleperckle
Member
11-20-2003
| Wednesday, April 26, 2006 - 8:56 pm
Source: Ivanhoe.com on air: Smart Woman Reported: April 26, 2006 Foods Fight Breast Cancer ORLANDO, Fla. (Ivanhoe Broadcast News) -- More and more research suggests a healthy diet can lower our risk of breast cancer. But what does 'healthy' really mean? This dietician sifts through all of the medical jargon and whips up a healthy menu that’s easy to digest. We know there are plenty of foods we shouldn't eat … foods that increase our risk of disease, but dietician Elaine Magee says there are also foods that can help prevent disease if we eat them. Spinach, broccoli and carrots top the list. Garlic and onions are close behind, and oranges are Magee’s fruit of choice. And don’t forget oatmeal, whole grain breads, beans, tuna and flaxseed for good measure -- the 'oat bran' of the new millennium. All of these foods are loaded with plant chemicals, vitamins, minerals and fiber. Research suggests they stimulate the immune system and protect cells from DNA damage. "It would be ideal if we had a 10- or 20-year clinical study with women, but frankly, we don’t have that kind of time," says Magee, author of Tell Me What To Eat To Prevent Breast Cancer. Working these foods into your daily diet is as easy as Magee’s vegetable bean salad: Add onions and a can of kidney beans to cooked carrots and broccoli. Top it off with vinaigrette made with canola or olive oil, and you’ve worked five of the top 10 foods into one dish. Or you can blend vanilla yogurt, apricots, orange juice, ice and flaxseed, and you've got yourself a power-packed smoothie. A half cup of fruits and vegetables is one serving. If we put away 10 a day, eat fish twice a week, and add flaxseed to our food, Magee is convinced we’d give our bodies a fighting chance. You can find flaxseed in health food stores. Magee says grind it up and sprinkle a teaspoon on soups, cereals and smoothies a few times a week. If you would like more information, please contact: Elaine Magee http://www.recipedoctor.com
|
Herckleperckle
Member
11-20-2003
| Wednesday, April 26, 2006 - 9:12 pm
Source: Ivanhoe.com Reported February 25, 2004 Electrical Breast Test FARMINGTON, Conn. (Ivanhoe Broadcast News) -- Each year, more than 200,000 women are diagnosed with breast cancer in the United States. Mammograms are still the standard test for detecting breast cancer, but the test misses about 10 percent of cancers and is especially ineffective in young women. Now, a new test may help those who don’t benefit from a mammogram.
Like many people, Janet Gemmiti has been touched by breast cancer. "My mother is a breast cancer survivor, and I have a couple of close girlfriends that also are breast cancer survivors," she tells Ivanhoe. Because of that, Gemmiti is diligent when it comes to her own health. "I have two other sisters, and we do go for our mammograms on a regular basis." Now, Gemmiti is doing her part to help with future methods to find breast cancer. She’s taking part in a study of a new device that sends electricity through the breast and measures the speed it travels. While doctors can’t explain why, they know breasts with cancer conduct electricity differently. "It doesn’t try to give us a picture of the breast, so much as it tells us if the conduction of electricity is different between the two breasts," Scott H. Kurtzman, M.D., a surgical oncologist at University of Connecticut Health Center in Farmington, tells Ivanhoe.
Dr. Kurtzman is one of the researchers involved in the ongoing study. They hope to confirm the results of an early study in 400 women. "It showed one important thing," Dr. Kurtzman says. "That is, if this test said there was no cancer, there was only one person who actually had a cancer that this missed." Gemmiti says the test was simple. "I didn’t feel any electrical charge or really any sensation at all," she says. And in the future, that simple test could be all it takes to reduce the number of people whose lives are affected by breast cancer.
For now, experts recommend women aged 40 and over get a mammogram every year. Dr. Kurtzman points out that the new test could also be used as a screening tool for women in rural areas who don’t have access to mammograms. If you would like more information, please contact: Jane Shaskan Office of Communications University of Connecticut Health Center shaskan@nso.uchc.edu
|
Herckleperckle
Member
11-20-2003
| Wednesday, April 26, 2006 - 9:17 pm
Source: Ivanhoe.com Reported February 26, 2004 Weight Gain Leads to Breast Cancer (Ivanhoe Newswire) -- A new study shows weight gain after age 18 can be a significant predictor of breast cancer risk for postmenopausal women who are not taking hormone replacement therapy. In 1992, researchers from the American Cancer Society sampled nearly 62,000 women, ages 50 to 74, by asking them about their weight at age 18 and their current weight. Since then, the women have been periodically asked to provide updates on their weight, in addition to any diagnosis of cancer. The research shows women who gained 20 to 30 pounds since age 18 were 40-percent more likely to develop breast cancer than those who had not gained more than five pounds. Women who gained more than 70 pounds doubled their risk. This supports the theory that more body fat yields higher estrogenic levels, increasing the risk of breast cancer in women. Women with less body fat are reported to have lower estrogenic levels and lower risks of breast cancer. Heather Spencer Feigleson, Ph.D., lead author of the study, says even modest weight gain should motivate women to take precautionary measures. "Avoiding weight gain is one of the few ways we know of to reduce the risk of breast cancer among postmenopausal women," she concludes. SOURCE: Cancer Epidemiology Biomarkers and Prevention, 2004;13:224-234
|
Herckleperckle
Member
11-20-2003
| Wednesday, April 26, 2006 - 9:28 pm
Source: Ivanhoe.com Reported September 3, 2004 Who Dies From Breast Cancer? (Ivanhoe Newswire) -- With advances in treatment, a growing number of women are surviving breast cancer, especially when it’s caught in its early stages. But the disease is still fatal in many cases. Is there any way to tell who will succumb to the disease and who won’t? Yes, report researchers who analyzed nearly 30 years worth of data on breast cancer patients. They find women with more advanced stages of disease at diagnosis and those who are diagnosed at a younger age, even with less advanced stages, are the most likely to die from the disease. Black women are also more likely to die of breast cancer than white women, as are those whose tumors are negative for the estrogen receptor. The study, published in this month’s Journal of the National Cancer Institute, is the first to evaluate which women diagnosed with breast cancer actually die of the disease as opposed to dying of other causes. More than 400,000 women who developed breast cancer between 1973 and 2000 were included in the study. Researchers looked at the stage of their disease at diagnosis, their age at diagnosis, and their race. An additional 11-year follow-up also gauged the effect of tumor size and ER status. The investigators note, "Although death from other causes became increasingly important with advancing age, death from breast cancer remained substantial within the first five years after diagnosis, particularly with advancing stage." This was true even among women who were 70 years old or older at the time of diagnosis. The reason black women are more likely to die of breast cancer than white women was not entirely clear in the study, but the investigators speculate treatment and other differences may come into play. SOURCE: Journal of the National Cancer Institute, 2004;96:1311-1321
|
Herckleperckle
Member
11-20-2003
| Wednesday, April 26, 2006 - 9:36 pm
Source: Ivanhoe.com Reported August 11, 2004 Too Few Breast Cancer Surgeries (Ivanhoe Newswire) -- A new study shows doctors are not performing enough breast cancer surgeries, which may impact patient survival rates. Researchers from the Medical College of Wisconsin in Milwaukee studied nearly 1,000 surgeons. They found fewer than 20 percent of surgeons in the United States performed 15 or more surgeries for breast cancer over two years. Breast cancer is one of the most common cancers in the United States, and nearly all patients will have to undergo surgery. Previous studies have shown patients of surgeons who performed at least 15 operations per year for breast cancer were more likely to live longer. Researchers also found the average surgeon only performed six operations on Medicare patients over two years. Nearly 30 percent of surgeons did not perform any breast cancer operations on Medicare patients during the study. Surgeons who performed more operations were also more likely to offer their patients hormone receptor testing, breast conserving surgery, and lymph node dissection. Study authors conclude, "Despite the growing evidence that low surgical volumes are associated with worse outcomes in many types of cancer care, our study shows that U.S. breast cancer surgeons, on average, perform surprisingly few annual operations for primary breast cancer." SOURCE: CANCER, published online Aug. 9, 2004
|
Herckleperckle
Member
11-20-2003
| Wednesday, April 26, 2006 - 9:53 pm
Source: Ivanhoe.com Reported June 8, 2004 Ethnic Breast Cancer? By Stacie Overton, Ivanhoe Health Correspondent NEW ORLEANS (Ivanhoe Newswire) -- New research provides more explanation as to why more black women die of breast cancer than white women, despite the incidence of breast cancer being higher in white women. Researchers from across the country collaborated on the study to determine why blacks have a higher mortality rate when it comes to breast cancer. More than 156,500 women were included in the study. They were gathered from current clinical trials and the ongoing Observational Study of the Women’s Health Initiative. Researchers found about 98 percent of the women had medical insurance, indicating a higher socio-economic status, thus minimizing the idea that different socio-economic status among some blacks and whites plays a role in the mortality rate. Also, black women in this study were less likely to use alcohol and were younger than the white women. Black women were heavier, but Rowan Chlebowski, M.D., Ph.D., from the Harbor-UCLA Research and Education Institute in Torrance, Calif., who presented the research, points out that body mass index (BMI) had only a modest and insignificant effect on the prognosis among these women. Results show a significantly lower breast cancer incidence among black women. However, while they were less likely to develop the illness, they were also less likely to survive it. After about three years, nearly 9 percent of black women had died, while 5.5 percent of whites had died. Dr. Chlebowski says: "Ethnicity had a major effect on poor prognosis cancer risk. In [black women], a higher proportion of breast cancers are diagnosed with unfavorable characteristics." In short, the types of cancer blacks develop are much harder to treat successfully. Specifically, blacks were more likely to develop poor/anaplastic grade plus estrogen receptor-negative cancers (33 percent vs. just 10 percent among whites. Dr. Chlebowski points out that genetic and biochemical factors may be the source for these high-grade receptor-negative cancers. He points out that, "[Black women] might have a genetic profile that puts them at lower risk of getting breast cancer, but higher risk of this one specific high-grade tumor." SOURCE: Stacie Overton at the 40th Annual Meeting of the American Society of Clinical Oncology in New Orleans, June 5-8, 2004
|
Herckleperckle
Member
11-20-2003
| Wednesday, April 26, 2006 - 10:02 pm
Source: Ivanhoe.com Reported March 19, 2004 Better Care for Young Breast Cancer Survivors (Ivanhoe Newswire) -- A new study from Germany shows young breast cancer survivors may suffer from more long-term effects than older patients. Consequently, patients may not be getting the appropriate therapy needed for coping with the aftermath of the disease. Researchers sampled nearly 200 breast cancer patients who had been diagnosed 10 years ago and asked about their physical symptoms and current therapy treatments. Results showed that 65 percent of the respondents were still under a physician's care. Over half of them had physical complaints that included arm problems and fatigue. Interestingly enough, the age of respondents also made a significant difference. Seventy-one percent of women younger than age 50 reported far greater problems than the older patients. Researchers are considering attributing lower energy levels of younger patients to the fact that many of them are working and running households, whereas older patients are focusing on taking care of themselves and not necessarily working. "Nowadays all kinds of care programs exist to deal with the physical and emotional problems associated with a new diagnosis of breast cancer. It is important that we make the same kind of facilities available to breast cancer survivors, who despite being free of disease, can still suffer greatly with both physical and psychosocial problems," researchers concluded. SOURCE: European Breast Cancer Conference
|
Herckleperckle
Member
11-20-2003
| Saturday, May 13, 2006 - 8:56 am
Source: SLATE (article: Your health this month) Tamoxifen and Raloxifene Date: May 2, 2006 Tamoxifen and raloxifene: There is good news in another large study that's soon to be formally reported. The National Cancer Institute's "Study of Tamoxifen and Raloxifene," in which almost 20,000 women participated, compared the value of two medications in preventing the development of breast cancer in high-risk postmenopausal women. Some were treated with a placebo, others took tamoxifen, a medication used to treat some breast cancers, and a third group took raloxifene, a drug used to help prevent elderly women from developing osteoporosis (the weakening and loss of calcium from bones that often comes with aging). Previous research had shown that tamoxifen decreases the risk for developing breast cancer. But many doctors were reluctant to prescribe it because of side effects: an increased likelihood of uterine cancer and increased probability of developing serious blood clots in the lungs or the deep veins. Key finding: The STAR study showed that the two drugs were equally good at preventing the development of breast cancer. But raloxifine carried less risk: In the study, women who took it had a markedly lower rate of blood clot formation and a lower rate of developing uterine cancer. Other studies, too, suggest that raloxifene doesn't increase the risk of uterine cancer. And—perhaps most remarkably—raloxifene is less expensive than tamoxifen. Conclusion: What to make of all this? It's tremendously exciting to have a new, safer drug that can help prevent breast cancer and strengthen women's bones at the same time. The first wave of the fight against cancer involved learning from epidemiological studies how to help prevent the disease—by avoiding cigarette smoke and diesel emissions, for instance. We can all hope that medications like raloxifene represent the second wave of assault. And the third wave is following close behind: the imminent arrival of the vaccines that prevent cervical cancer. Finally, progress.
|
|