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Biomedical subjects

C L Chang

Publications and source records attributed to C L Chang.

At least 91 records · Page 5Linked to original sources

Expression of human MutS homolog 2 (hMSH2) protein in resting and proliferating cells.

The hMSH2 protein plays an important role in the DNA mismatch repair system. Since this system is involved in the correction of errors that occur during DNA replication, we studied the expression of hMSH2 protein in resting and DNA-replicating cells, as well as through the cell cycle in cell types with different growth characteristics. Using Western blot analysis, we showed that hMSH2 protein was detectable in resting peripheral blood lymphocytes and thymocytes. However, when these cells were induced to proliferate, the protein level increased at least 12-fold. In cell-cycle dependent expression studies we chose two DNA mismatch repair proficient cell lines (HEL and HeLa-S3), and flow cytometry was used to monitor cell-cycle progression. At every phase in the cell cycle, the steady-state level of hMSH2 was higher than in resting lymphocytes or thymocytes, and only minor variations of expression level were observed through the cell cycle. In particular, a two to fourfold decrease in hMSH2 expression occurred at G1 in HEL and at early S phase in HeLa-S3, but higher expression levels resumed during the replicative and postreplicative phases of the cell cycle. Interestingly, hMSH2 protein expression decreased fourfold when HEL cells were induced to differentiate along the megakaryocyte lineage, when continuous DNA replication occurs without mitosis. These results suggest that a basal level of hMSH2 protein expression is necessary for resting and differentiated cells, and that increased hMSH2 protein expression is required when DNA replication is activated and followed by mitosis.

Cell Cycle↗

A nucleoside diphosphate kinase A (nm23-H1) serine 120-->glycine substitution in advanced stage neuroblastoma affects enzyme stability and alters protein-protein interaction.

A high level of nucleoside diphosphate kinase A (NDPK A/nm23-H1) in neuroblastoma is associated with advanced stage disease. We have also found a serine 120-->glycine substitution in NDPK A and/or amplification of the nm23-H1 gene in advanced stage neuroblastomas. Serine 120, a highly conserved residue, is located in proximity to histidine 118 which forms a phosphorylated intermediate essential for NDPK activity. The effect of Ser120-->Gly substitution on the biochemical properties of NDPK A was investigated. Phosphate-transferase activity was lower in the recombinant mutant NDPK A and in the immunoprecipitated complex consisting of NDPK A and NDPK B prepared from a neuroblastoma tumor containing the mutation, relative to the wild-type. There was a significant decrease in the enzyme stability toward urea- or temperature-induced denaturation for the recombinant mutant NDPK A and in an immunoprecipitate from a tumor containing the mutation. Recombinant NDPK A containing the Ser120-->Gly mutation exhibited reduced hexameric and increased dimeric oligomerization relative to the wild-type. Moreover a 28 kDa cellular protein was detected, that co-precipitated with the mutant but not wild-type NDPK A. The altered properties of the mutant protein may have relevance to a role for NDPK A in neuroblastoma progression.

Base Sequence↗

Capillary liquid chromatography coupled with an ion trap storage/reflectron time-of-flight mass spectrometer for structural confirmation of three recombinant protein isoforms.

Packed-capillary high-performance liquid chromatography (HPLC) was successfully coupled with an ion trap storage/reflectron time-of-flight mass spectrometer (LC/IT/reTOFMS) through an electrospray ionization interface for protein structural elucidation. Using the total-ion storage capabilities of the trap over a broad mass range and the high sensitivity from the packed capillary column with i.d. as small as 250 microns, high sensitivity peptide mapping in the low picomole range was demonstrated for the structural confirmation of three recombinant human nucleoside diphosphate kinase isoforms (NDPK, E.C. 2.7.4.6). A strategy combining chemical/enzymatic digestions as well as collisionally-induced dissociation (CID) in the electrospray source was successfully employed to infer the minor primary structural differences among the three recombinant proteins. This high sensitivity was achieved while also maintaining a resolution of nearly 1500 for mass identification using the capabilities of the IT/reTOF device. A point mutation of serine 120 to glycine was verified between the wild-type NDPK A and its mutant (delta m = 30 u) by both selected-ion monitoring and ion-source CID of the protein fragment containing the mutation site. For the structural confirmation of the sequence of NDPK A and B (88% homology), two sets of chemical/proteolytic digests were generated independently and followed by LC/MS analysis of the molecular weight of each protein-generated fragment. The complementary information from the two chromatographic analyses allowed for sequence verification of the two protein isoforms. The experiments clearly demonstrated that the high concentration sensitivity of the capillary high-performance liquid chromatographic separation together with the advantages of the IT/reTOF mass spectrometer could provide a low-cost, high-performance facility for protein analysis.

Amino Acid Sequence↗

Inhibitory effect of propofol on sympathetic neurotransmission results in changes of plasma neuropeptide Y in rats.

1. The effects of propofol on sympathetic neurotransmission and changes of plasma level of neuropeptide Y-like immunoreactivity (NPY-ir) were investigated in rats. 2. Intraperitoneal injection of propofol into rats lowered the systemic blood pressure and plasma NPY-ir in a dose-dependent manner. 3. Decrease of plasma NPY-ir induced by propofol was not modified in adrenalectomized rats. In the activation of adrenergic neurotransmission by a ganglionic nicotinic agonist, elevation of plasma NPY-ir was also reduced by propofol indicating the direct effect on peripheral adrenergic nerve terminals. 4. Plasma level of NPY-ir reversed in parallel with the recovery of anaesthesia induced by propofol. After an intracerebroventricular injection of propofol into the rats, both the lowering of plasma NPY-ir and the induction of anaesthesia were observed. Thus, a central nervous system effect of propofol can also be considered in its effect on plasma NPY-ir. 5. The data suggest that propofol has the ability to lower plasma NPY-ir in rats through an inhibition of adrenergic neurotransmission via central nervous pathway and/or peripheral nerve terminal blockade.

Adrenalectomy↗

Reliability of data from proxy respondents in an international case-control study of cardiovascular disease and oral contraceptives. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception.

STUDY OBJECTIVES: To evaluate the reliability of data supplied in a case-control study by proxy respondents for cases who were too ill to do so themselves. DESIGN: A hospital based, case-control study of the current use of oral contraceptives (OC) and cardiovascular diseases. Data from "true" controls matched to a subset of cases were compared with those supplied by proxy respondents about the true controls. SETTING: Hospitals in 21 centres from Africa, Asia, Europe, and Latin America. PATIENTS AND PARTICIPANTS: For a subset of cases, 403 pairs of controls-one "true" and one proxy-were interviewed. "True" controls were matched by age, place, and time of admission and were admitted with 1 of 27 permissible diagnoses not associated with OC use. Proxy controls were either relatives or friends of true controls. MAIN RESULTS: Levels of concordance between data from proxy and true controls were high for most variables regarding recent events, including current OC use, but were greatly diminished when detailed information, particularly from the past, was required. Husbands were usually the best proxy, although this was question-specific. The sensitivity and specificity of proxy responses were 93% (95% confidence intervals: 77%, 99%) and 100% (98%, 100%) respectively, for current use of OC. Assuming the misclassification of current OC use by proxy cases is similar to that produced by proxy controls, the estimated impact of using proxy data on risk estimates associated with current OC use was to bias the overall estimate of risk of stroke by less than 3% and the risks of both acute myocardial infarction and venous thromboembolism by less than 1%. CONCLUSIONS: Friends or relatives, and particularly husbands, provided reliable information when used as proxy respondents for young women. The estimated impact of misclassification by proxy respondents on overall risk estimates in the WHO collaborative study was less than that which would have arisen if information from proxy respondents had not been used.

Adult↗

Heterogeneous responses to the long-term treatment of active acromegaly with octreotide.

To study GH response to the long-acting somatostatin analogue, we treated 11 actively acromegalic patients with octreotide (Sandostatin), 100 micrograms, sc, tid, for six months. Their endocrinological outcomes and clinical improvements varied. The 11-h GH secretory profiles on pretreatment day confirmed the hypersecretion of GH in all patients. Three hours after the first dose of octreotide, serum GH declined rapidly to levels below 5 ng/ml in all but two patients who failed to normalize their serum GH. In spite of the subsequent doses, there was no further suppression in serum GH. Drug resistance with GH rebound developed in some patients after three months of continued treatment. The paradoxical serum GH rises in response to oral glucose or iv TRH detected before the treatment in all patients attenuated or disappeared after the 6-month octreotide therapy; an exceptional case was one of the above-mentioned two patients, whose serum GH was stimulated more than before by glucose and TRH at the end of therapy. Serum insulin-like growth factor I (IGF-I) levels of all patients showed a significant reduction after 6-month treatment, but their mean values remained abnormally high. There were no intolerable adverse side effects; some patients, however, experienced pain at the injection site, passage of loose stool, and incidence of new gall stone or intrahepatic lesions on octreotide therapy. We concluded that octreotide was a useful long-term adjunctive therapeutic agent for patients with active acromegaly, but that a high degree of response heterogeneity including total refractoriness would be expected.

Acromegaly↗

Prognostic factors of primary aldosteronism.

BACKGROUND: Primary aldosteronism (PA) is a rare but potentially curable cause of hypertension. Between October 1982 and November 1994, 30 patients of PA received unilateral adrenalectomy with a long-term follow up (mean:60.3 months). Nineteen (63.3%) cases were cured (Group 1); 11(36.7%) cases were improved (Group 2). The purpose of this study was to determine prognostic factors after surgery in patients with PA. METHODS: A retrospective analysis was performed regarding age and sex of the patients, duration of hypertension, family history of hypertension, preoperative blood pressure, plasma aldosterone concentration (PAC), plasma renin activity (PRA) and efficacy of spironolactone on blood pressure between both groups. End-organs (including kidney, heart, retina and brain) involvement was evaluated and compared. Adrenalectomy and renal biopsy specimen for pathology were similarly evaluated. RESULTS: The duration of hypertension was longer in Group 2 than in Group 1 (8.18 +/- 4.94 vs 5.21 +/- 4.24 years). The efficacy of spironolactone on blood pressure (BP) was positive in 81.8% of Group 1 and 16.7% of Group 2. Adrenal cortical adenoma in 24 cases with a cure rate of 70.8% (17/24) and adrenal cortical macronodular hyperplasia in 6 cases with a cure rate of 33.3% (2/6) were noted. Group 2 had more end-organs involvement than Group 1. The severity of histopathological change of the renal biopsy was similar. CONCLUSIONS: This study suggests that preoperative response of blood pressure to spironolactone administration predicts the postoperative prognosis of hypertension in patient with PA. Long duration of hypertension and involvement of two or more end-organs were poor prognostic factors. Excellent results can be achieved by unilateral adrenalectomy in adrenal cortical adenoma and fair results, in adrenal cortical macronodular hyperplasia.

Adolescent↗

The effects of hemodilution with polyethylene glycol bovine hemoglobin (PEG-Hb) in a conscious porcine model.

BACKGROUND: Severe hemodilution in large mammals has been used rigorously for the safety and efficacy testing of hemoglobin-based red blood cell substitutes. The effects of hemodilution with polyethylene glycol-modified bovine hemoglobin (PEG-Hb) were investigated in an unanesthetized porcine model. METHODS: Immature Yorkshire cross barrow pigs were subjected to exchange transfusion with PEG-Hb (n = 6) or dextran 70 (n = 4) until an 80% reduction in hematocrit was achieved. RESULTS: All six (100%) PEG-Hb-infused pigs and only one (25%) dextran 70 control pig survived the resultant reduction in erythrocytes. Heart rates and mean arterial pressure were not significantly affected by PEG-Hb infusion. Pigs infused with PEG-Hb maintained normal levels of blood pH, PO2, and PCO2 while dextran 70 controls showed low PvO2, PaCO2, and the development of acidosis. Histological evaluation revealed that the surviving dextran 70 control animal exhibited possible anoxia-induced hepatic centrilobular necrosis. PEG-Hb-treated pigs demonstrated the presence of renal tubular cell cytoplasmic vacuoles and vacuolated macrophages in spleens. CONCLUSIONS: The results indicate that PEG-Hb effectively supports life close to lethal levels of anemia.

Animals↗

Lovastatin lowers serum cholesterol levels in non-insulin-dependent diabetes mellitus patients without altering their insulin sensitivity.

BACKGROUND: Lovastatin, a potent 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, has been widely used in the treatment of hypercholesterolemia. It is also applied to dyslipidemia in patients with diabetes mellitus. The influence of lovastatin on insulin sensitivity was evaluated in twelve Chinese non-insulin-dependent diabetes mellitus (NIDDM) patients with hypercholesterolemia. METHODS: This double-blind, randomized, placebo-controlled, and two-period cross-over experiment enrolled 12 patients. After a run-in period of two months, the patients were randomized into 2 groups to receive either lovastatin (20 mg once daily) or placebo treatment. Eight weeks later, two groups of patients exchanged their treatment for another 8 weeks. Blood samples were collected at the end of the run-in period and at 4-week intervals during the study to observe serum lipid profiles. A modified insulin suppression test was made to assess insulin sensitivity three times: at the end of run-in period, in week 8 and week 16, respectively. Wilcoxon signed rank test was used for analysis of statistical significance of the difference between lovastatin and placebo treatments. RESULTS: As compared with the placebo, lovastatin reduced serum total cholesterol (TC) levels significantly. Serum total triglyceride (TG) concentrations decreased slightly by lovastatin. The ratio of TC to high density lipoprotein-cholesterol (HDL-C) also decreased significantly in lovastatin period. No difference was found in serum apolipoprotein A1 levels. A significant reduction of serum apolipoprotein B concentrations was also noted in lovastatin period. No difference in glycemic indices and insulin sensitivity was observed in the base-line, placebo or lovastatin periods. CONCLUSIONS: The results demonstrated that lovastatin significantly lowered the serum TC levels without perturbation of insulin sensitivity in hypercholesterolemic NIDDM patients.

Aged↗

Changes of propofol levels in isolated cardiopulmonary bypass circuit.

BACKGROUND: High dose fentanyl anesthesia in cardiac surgery has been supplemented with propofol to prevent patient's awareness and recall. It has been known that during cardiopulmonary bypass (CPB), fentanyl or midazolam concentration decreases, except for propofol where it remains unknown. This study evaluated the interaction between propofol and the CPB circuit in vitro. METHODS: Three identical experiments were conducted. In each experiment we used a set of CPB circuit composed of a standard 3/8 inch PVC tubing trap, a reservoir and a pump. The reservoir was primed with 2,000 ml solution of 2.5% dextrose and 0.45% NaCl in which 20 mg propofol was added. The solution was circulated in the circuit at a flow rate of 2 L/min. The experimental period was 30 min. A 5 ml sample of the solution was taken from the venous sampling site of the circuit immediately prior to the experiment, and thereafter each from the arterial and venous sampling sites at 1, 3, 5, 10, 20 and 30 min after the start of the experiment. The samples were kept at 4 degrees C and assayed by HPLC. RESULTS: The propofol concentrations decreased exponentially with the increase of experimental time. There were no significant differences in the concentrations and the rates of decrease between the arterial sampling site and the venous sampling site. The decrease was 20% at 1 min, 68% at 10 min, 83% at 20 min, and 92% at 30 min after the beginning of the experiment. CONCLUSIONS: The results demonstrate the presence of propofol sequestration by the CPB circuit. Evaporation in the bubble oxygenator, absorption by and/or adherence to the circuit are suspected as the possible causative factors.

Anesthetics, Intravenous↗

[Post-obstructive pulmonary edema following extubation--report of two cases].

Pulmonary edema may develop in healthy patients after anesthesia. It usually results from upper airway obstruction which may be caused by laryngospasm or aspiration. Increased inspiratory effort following airway obstruction significantly produces negative intrathoracic pressure that may lead to pulmonary edema. We reported two cases of post-obstructive pulmonary edema following extubation. They were essentially healthy young males, one of whom received urethroplasty and the other received pulmonary blebectomy. Their hemodynamic and ventilatory conditions had been kept stable during surgery. Upper airway obstruction followed by pulmonary edema developed immediately after extubation, which was successfully treated without any sequelae.

Adult↗

Shortening and superlon-wrapping the downstream tube can increase the useful range of the blood warmer.

BACKGROUND: Hypothermia occurs frequently in clinical anesthesia. Many apparatus were introduced to keep intravenous fluid warm. But at low to medium flow rates little effects have been achieved because of heat lost along the tube. Superlon, an industrial heat-preserving material widely used in air conditioning to prevent temperature change, has never been used in the blood warmer. METHODS: The study was performed in three groups group I using standard (120 cm) unwrapped tube (Animac AM-4 set), group II using a shortened downstream tube (60 cm), and group III using the downstream tube which was further wrapped with superlon (Super LTD). The blood warmer used was identical in all 3 groups. We recorded the fluid temperatures at different points downstream at various flow rates. The values were then compared among groups. RESULTS: The fluid temperatures before entering the warmer were around 20 degrees C and 37 degrees C at the 2 cm post-warmer points at various flow rates. The end point temperatures rose with flow rates and were the highest in group III and lowest in group I at each flow rate (p < 0.01). In group III the temperature could be kept above 32 degrees C at a very low flow rate (150 ml/h) and above 35 degrees C at 300 ml/h. In group I, 1,000 to 2,000 ml/h were needed to keep the same temperature. CONCLUSIONS: These refinements increase the useful range of the Animac AM-4 warmer and make it useful in pediatric rapid fluid resuscitation and current fluid management. Moreover, they are easy to set up, inexpensive, and can be applied to any kind of blood warmers.

Anesthesia↗

Acquired tracheomalacia--a case report.

Tracheomalacia is a condition characterized by weakness of the tracheal walls and supporting cartilage. It may be congenital, occurring in association with other lesions, such as vascular ring, tracheoesophageal fistula, dyschondroplasia, congenital cysts or tumors, or it may be acquired, most commonly as a result of protracted endotracheal intubation and less often of irradiation, trauma or neoplasm. We present a case of acquired tracheomalacia in a 15-year-old boy, a victim of Proteus syndrome (hemihypertrophy, subcutaneous tumors, and macrodactyly), who had congenital scoliosis with secondary chronic restrictive pulmonary disease, for which he was admitted to our hospital for surgical correction of the spine. Unfortunately, his conditions, particularly of respiratory, worsened after the operation, which called for an emergent tracheostomy. During the procedure, high airway pressure and CO2 retention developed, and an extreme narrowing of the tracheal lumen was revealed by fiberoptic bronchoscopy. Acquired tracheomalacia was diagnosed. The probable mechanisms, diagnostic tests, and treatments of tracheomalacia are hereunder discussed.

Adolescent↗

Decrease of anesthetics activity by electroacupuncture on Jen-Chung point in rabbits.

The effect of acupuncture at life-saving point on the central nervous depressive action of anesthetics was investigated in rabbits. Stimulation with electroacupuncture (EA) inserted in Jen-Chung point, which is located at the mid-point on the upper lip, decreased the sleeping time induced by pentobarbital or propofol. However, this action of acupuncture was not modified by naloxone at the doses sufficient to block opiate receptors. Plasma beta-endorphin detected by radioimmunoassay was also not markedly changed in rabbits which received similar electrostimulation. Moreover, pretreatment with para-chlorophenylalanine at a dose sufficient to deplete endogenous 5-hydroxytryptamine (5-HT) failed to influence the action of EA. Mediation of endogenous opioids and/or 5-HT in this action of EA was then ruled out. Prazosin reversed the sleeping time decreasing action of acupuncture in a dose-dependent manner. Also, the action of acupuncture was eliminated in rabbits which received intracerebroventricular injection of guanethidine at a dose which could block noradrenergic nerve terminals. It is suggested that stimulation of Jen-Chung point through EA can activate noradrenergic neurotransmission in the brain, which in turn reduces the central nervous depressive activity of anesthetics.

Acupuncture Analgesia↗

Novel galactose single point method as a measure of residual liver function: example of cefoperazone kinetics in patients with liver cirrhosis.

A novel, simple, clinically useful quantitative liver function test, called the galactose single point (GSP) method, was developed to assess residual liver function by measuring galactose blood concentration 1 hour after galactose was administered (0.5 g/kg). This method was applied to the study of cefoperazone kinetics in patients with hepatic cirrhosis. To study the influence of hepatic cirrhosis on the residual liver function and the correlation between the residual liver function and the pharmacokinetics of cefoperazone, a dose of 1 g of cefoperazone was administered to 11 healthy volunteers and 12 patients with liver cirrhosis. The GSP method, the galactose elimination capacity (GEC) test, and the modified galactose elimination capacity (MGEC) test were done for each volunteer and patient to measure residual liver function. The galactose concentrations were determined enzymatically. Cefoperazone was administered intravenously, and blood and urine samples were collected at appropriate intervals after drug administration. All blood and urine samples were stored at -30 degrees C until high-performance liquid chromatography analysis. Cefoperazone plasma concentrations were much higher in cirrhosis patients than in normal subjects at all times. The elimination half-life, hepatic clearance, mean residence time, and renal clearance of cirrhosis patients differed significantly from those of healthy volunteers. The plasma protein binding was unaltered in both groups. Urinary excretion of cefoperazone was significantly increased in cirrhosis patients (23.95 +/- 5.06% for normal men and 51.09 +/- 11.50% in cirrhosis patients). Hepatic clearance, fraction excreted in urine, and total clearance significantly correlated with GSP, GEC, and MGEC (P < .001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Cerebral microvascular reactivity to carbon dioxide during isoflurane anesthesia as assessed by laser-Doppler flowmetry.

BACKGROUND: To determine the effects of carbon dioxide on the cerebral microcirculation during isoflurane anesthesia. METHODS: We studied 10 rabbits using laser Doppler flowmetry on the parietal cortex. After surgical preparation, the end-tidal concentration of isoflurane was maintained at one MAC (2.05%). Mean arterial pressure, rectal temperature and hematocrit were kept constant. The arterial carbon dioxide tension (PaCO2) was randomly adjusted to three levels: 20-25 mmHg (hypocapnia); 35-40 mmHg (normocapnia); and 45-50 mmHg (hypercapnia). Cerebral blood flow (CBF) was measured after target PaCO2 had been achieved. RESULTS: CBF at normocapnia was 27.4 +/- 13.5 (mean +/- SD) ml/100 gm/min, which increased to 42.4 +/- 14.3 ml/100 g/min (p < 0.01) and decreased to 15.3 +/- 7.5 ml/100 g/min (p < 0.05) at hypercapnia and hypocapnia respectively. The slopes of CBF versus PaCO2 were 1.60 +/- 0.63 ml/100 g/min/mmHg from normocapnia to hypercapnia and -0.79 +/- 0.51 ml/100 g/min/mmHg from normocapnia to hypocapnia. The corresponding percentage of alteration in CBF on the respective change of PaCO2 was 7.2 +/- 5.1 and -3.0 +/- 1.2%/mmHg. CONCLUSIONS: These data indicate that the changes of the cerebral microvascular blood flow reflect the CO2 effects during isoflurane anesthesia.

Anesthesia↗

[The effect of needleless electroacupuncture in general anesthesia during laparoscopic surgery].

BACKGROUND: Three kinds of pain-relieving substances, namely, endorphins, enkephalins and dynorphins, can be released by stimulating the relevant acupoints with the dense-disperse mode of nerve stimulator. The neurochemical mechanisms of pain relief by acupoint stimulation have been widely studied and proved. In the present study, we investigated the modulatory effect of needleless electroacupuncture on the inhaled general anesthesia during laparoscopic surgery. METHODS: Forty gynecologic patients of ASA class I-II status, scheduled for elective laparoscopic surgery, were randomly allocated to study and control groups. Induction and intubation were performed in the same fashion and anesthesia was maintained with inhaled general anesthetics: 50% N2O in oxygen and isoflurane, which was adjusted to keep the hemodynamic changes within +/- 10% of their preoperated level. HANS (LY 257), a special nerve stimulator with 2 Hz and 100 Hz dense-disperse wave, was used to stimulate the bilateral Yang Ling Chuan (G34), Zusanli (S36) acupoints in patients of the study group during the surgery. RESULTS: We found that needleless electroacupuncture significantly lowered the volume concentration of isoflurane from 1.0 +/- 0.33% to 0.74 +/- 0.19% (p < 0.05) at 30 min after the start of operation. Furthermore, it also significantly shortened the recovery time from 11.4 +/- 3.3 min to 8.8 +/- 3.2 min (p < 0.05). CONCLUSIONS: Under general anesthesia, the application of needleless electroacupuncture can reduce the volume concentration of isoflurane and shorten the post-anesthetic recovery time during laparoscopic surgery.

Adult↗