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Epidemiology of Staphylococcus aureus Bacteremia in Children at a Single Center from 2002 to 2016 2002 - 2016年某中心儿童金黄色葡萄球菌菌血症流行病学分析
Q3 Medicine Pub Date : 2019-04-01 DOI: 10.14776/PIV.2019.26.E2
Seonhee Lim, Seok Gyun Ha, H. Tchah, I. Jeon, E. Ryoo, D. Son, Hye Jung Cho, Yonghan Sun, Hyo Jung Kim, J. Ahn, H. Cho
목적: 본 연구를 통해 소아청소년에서 발생한 황색 포도알균혈증(Staphylococcus aureus bacteremia; SAB)의 역학적 특성을 알아보고자 하였다.방법: 2002년부터 2016년까지 15년 간 가천대 길병원에 입원한 18세 이하 소아청소년 중 SAB 환자의 의무기록을 후향적으로 분석하였다.결과: 총 212명의 소아청소년 SAB 환자가 분석에 포함되었다. 2002년부터 2016년까지 연간 SAB 발생률은 입원환자 1,000명당 0.77-1.95명이었다. 전체 SAB 중 신생아군(28일 미만)과 소아청소년군(28일-18세 이하)은 각각 51.4% (n=109), 48.6% (n=103)이었으며, 지역사회 관련 감염(community associated [CA])과 의료기관 관련 감염(healthcare associated [HA])은 각각 43.9% (n=93), 56.1% (n=119)였다. 소아청소년군(47.6%)보다 신생아군(64.2%)에서 HA-SAB의 비중이 더 높았다(P=0.015). CA-SAB와 HA-SAB에서 합병증 발생 여부는 차이가 없었으나, 사망률은 HA-SAB에서 더 높았다. 메티실린 내성 황색포도알균(methicillin-resistance S. aureus [MRSA])의 비율은 신생아군에서 가장 높았고(88.1%), 연령이 증가할수록 감소하여 5세 이상에서는 36.4-37.5%였다. MRSA 비율은 72.2%로 시간에 따른 일정한 추세는 보이지 않았다.결론: 지난 15년 간 소아청소년에서 SAB의 발생률 및 MRSA의 비율은 일정한 추세 없이 유지되었다. 소아청소년의 SAB에서 적절한 항생제를 선택하기 위해 환자의 연령 및 감염 기원에 대한 신중한 고려가 필요하다.
目的:通过本研究发生在少儿和青少年的金黄色葡萄球菌血症(Staphylococcus aureus bacteremia);SAB)的力学特性。方法:对2002年至2016年15年间在嘉泉大学吉医院住院的18岁以下少儿青少年中SAB患者的医务记录进行后向分析。结果:共212名少儿青少年SAB患者被纳入分析。从2002年到2016年,每年SAB的发生率为每1000名住院患者0.77-1.95人。在全体SAB中,新生我军(未满28天)和少儿青少年群(28日-18岁以下)分别为51.4% (n=109)和48.6% (n=103),地区社会相关感染(community associated [CA])和医疗机构相关感染(healthcare associated [HA])分别为43.9% (n=93)和56.1% (n=119)。与少儿青少年群(47.6%)相比,在新生我军(64.2%)中HA-SAB的比重更高(P=0.015)。CA-SAB和HA-SAB的并发症发生率没有差异,但死亡率在HA-SAB更高。耐甲氧西林金黄色葡萄球菌(methicillin-resistance S. aureus [MRSA])的比例在新生体内最高(88.1%),随着年龄的增长而下降,在5岁以上人群中为36.4-37.5%。MRSA的比率为72.2%,没有出现随时间的一定趋势。结论:在过去的15年里,在少儿和青少年中,SAB的发生率和MRSA的比例一直没有固定的趋势。为了在少儿和青少年的SAB中选择适当的抗生素,有必要慎重考虑患者的年龄及感染起源。
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引用次数: 1
Clinical Features of Staphylococcal Scalded Skin Syndrome Caused by Community-Associated Methicillin-Resistant Staphylococcus aureus in Changwon City, Korea, during 2006 and 2015 2006年至2015年韩国昌原市社区相关耐甲氧西林金黄色葡萄球菌引起的葡萄球菌烫伤皮肤综合征的临床特征
Q3 Medicine Pub Date : 2019-04-01 DOI: 10.14776/PIV.2019.26.E5
Jun Hyeong Park, Min Chae Kim, J. Kang, Jae Won Choi, Hak-Sung Lee, J. Shin, Je Chul Lee, S. Ma
Purpose: We investigated the clinical features and epidemiology of staphylococcal scalded skin syndrome (SSSS) from year 2006 to 2015 in Changwon city, Korea. Methods: We reviewed medical records of 69 patients diagnosed with SSSS from year 2006 to 2015. Antibiotic susceptibility testing was performed by agar dilution method. Methicillinresistant Staphylococcus aureus (MRSA) was phenotypically identified by oxacillin susceptibility testing and genotypically confirmed by the existence of the mecA gene. Results: The median age of patients was 2.0 years (range 0.2–6 years). Three (4.3%), 53 (76.8%), and 13 (18.9%) patients showed the generalized type, the intermediate type, and the abortive type, respectively. Patients occurred throughout the year, but most patients occurred between July and October. MRSA was isolated from 54 of the 60 patients regardless of the clinical types. All patients recovered without any complications. Pediatr Infect Vaccine. 2019 Apr;26(1):42-50 https://doi.org/10.14776/piv.2019.26.e5 pISSN 2384-1079·eISSN 2384-1087
目的:我们调查了2006年至2015年韩国昌原市葡萄球菌烫伤皮肤综合征(SSSS)的临床特征和流行病学。方法:我们回顾了2006年至2015年诊断为SSSS的69例患者的病历。采用琼脂稀释法进行药敏试验。耐甲氧西林金黄色葡萄球菌(MRSA)通过苯唑西林敏感性测试进行表型鉴定,并通过mecA基因的存在进行基因型证实。结果:患者的中位年龄为2.0岁(0.2-6岁)。3例(4.3%)、53例(76.8%)和13例(18.9%)患者分别表现为全身型、中间型和流产型。患者发生在全年,但大多数患者发生在7月至10月之间。MRSA是从60名患者中的54名中分离出来的,而不考虑临床类型。所有患者均痊愈,无任何并发症。小儿感染疫苗。2019年4月;26(1):42-50https://doi.org/10.14776/piv.2019.26.e5pISSN 2384-1079·eISSN 2384-1087
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引用次数: 0
The Case Report of Newborn Prenatally infected by Human Immunodeficiency Virus in Republic of Korea 韩国新生儿产前感染人类免疫缺陷病毒1例报告
Q3 Medicine Pub Date : 2019-04-01 DOI: 10.14776/PIV.2019.26.E8
Kyoung Eun Lee, Won Young Lee, Eui Kyung Choi, Jeonghee Shin, B. Choi, Y. Kim
신생아의 태반을 통한 사람면역결핍바이러스 감염은 아프리카에서 흔하지만, 대한민국에서는 아직 보고된 적이 없다. 대한민국에서 사람면역결핍바이러스 감염자의 수는 증가하는 추세이며, 특히 생식연령에서의 사람면역결핍바이러스 감염자의 수가 증가하고 있다. 이는 사람면역결핍바이러스 수직 감염의 위험성을 높인다. 저자들은 아직 국내에 보고되지 않은 자궁 내 전파를 통한 신생아의 사람면역결핍바이러스 감염을 경험하였기에 보고하는 바이다. 자궁 내 전파를 통한 사람면역결핍바이러스 감염의 예후는 좋지 않으나 본 증례의 남아는 생후 9개월 경까지 정상 성장과 발달을 보였으며 특별한 의학적 문제가 없었다.
通过新生儿胎盘感染人类免疫缺陷病毒在非洲很常见,但在大韩民国还没有报告过。在大韩民国,人免疫缺陷病毒感染者的数量呈增加趋势,特别是生殖年龄的人免疫缺陷病毒感染者的数量正在增加。这增加了人免疫缺陷病毒垂直感染的危险性。作者们报告说,他们经历了通过国内尚未报告的宫内传播的新生儿人免疫缺陷病毒感染。通过宫内传播的人免疫缺陷病毒感染的预后不好,但本病例的男婴到出生9个月左右仍正常生长发育,没有特别的医学问题。
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引用次数: 1
Brachial Artery Thrombosis in an 8-year-old Boy with Antiphospholipid Antibodies Induced by Mycoplasma pneumoniae Infection: a Case Report 肺炎支原体感染致抗磷脂抗体8岁男童臂动脉血栓1例
Q3 Medicine Pub Date : 2019-04-01 DOI: 10.14776/PIV.2019.26.E7
Junghee Woo, J. Kwon, Bo-Kyung Je, Jae Seoung Shin, W. H. Seo, G. Jang
Antiphospholipid antibodies may be produced in cases involving autoimmune diseases and can sometimes be caused by infections, such as Mycoplasma pneumoniae infection. However, antiphospholipid antibodies causing thrombosis associated with M. pneumoniae pneumonia in children have rarely been reported. We report a case of an 8-year-old boy with M. pneumoniae pneumonia with antiphospholipid antibodies, complicated by brachial artery thrombosis. He was found to have antiphospholipid antibodies and low protein S levels. The brachial artery thrombus was removed via thrombectomy. The titers of antiphospholipid antibodies turned normal within 5 months. This is a rare case of M. pneumoniae infection with brachial artery thrombosis associated with transient antiphospholipid antibodies.
抗磷脂抗体可能在涉及自身免疫性疾病的病例中产生,有时可能由感染引起,如肺炎支原体感染。然而,抗磷脂抗体导致儿童肺炎支原体肺炎血栓形成的报道很少。我们报告一例8岁男孩肺炎支原体肺炎伴抗磷脂抗体,并发肱动脉血栓形成。他被发现有抗磷脂抗体和低蛋白S水平。通过血栓切除术去除肱动脉血栓。抗磷脂抗体的滴度在5个月内恢复正常。这是一例罕见的肺炎支原体感染并伴有短暂抗磷脂抗体的肱动脉血栓形成的病例。
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引用次数: 2
Clinical Manifestations of PFAPA (Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis) Syndrome from a Single Center 来自单一中心的PFAPA(周期性发热、口疮性口炎、咽炎和腺炎)综合征的临床表现
Q3 Medicine Pub Date : 2019-01-01 DOI: 10.14776/piv.2019.26.e20
M. Shin, E. Choi, M. Han
Purpose: Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome is a leading cause of periodic fever in children. This study describes the clinical characteristics of PFAPA syndrome in patients from a single center. Methods: Thirteen children diagnosed with PFAPA syndrome at Seoul National University Children's Hospital were included in this study. Retrospective medical chart reviews were performed. Results: Among the 13 patients, 8 (61.5%) were male. The median follow-up duration was 3.3 years (range, 10 months–8.3 years). The median age of periodic fever onset was 3 years (range, 1–6 years). All patients had at least 5 episodes of periodic fever and pharyngitis, managed with oral antibiotics, before diagnosis. The median occurrence of fever was every 3.9 weeks and lasted for 4.2 days. All patients had pharyngitis and 12 (92.3%) had cervical lymphadenitis. Blood tests were performed for 12 patients, and no patients had neutropenia. Both the C-reactive protein and erythrocyte sedimentation rate were elevated at medians of 4.5 mg/ dL (range, 0.4–13.2 mg/dL) and 29 mm/hr (range, 16–49 mm/hr), respectively. Throat swab cultures and rapid streptococcal antigen tests were negative. Nine (69.2%) patients received oral prednisolone at a median dose of 0.8 mg/kg, and in 6 (66.7%) patients, fever resolved within a few hours. Three (23.1%) patients received tonsillectomy and adenoidectomy. Conclusions: PFAPA syndrome should be considered when a child presents with periodic fever along with aphthous stomatitis, pharyngitis, or cervical lymphadenitis. Glucocorticoid administration is effective for fever resolution and can reduce unnecessary use of antibiotics.
目的:周期性发热、口疮性口炎、咽炎和腺炎(PFAPA)综合征是儿童周期性发热的主要原因。本研究从单一中心描述了PFAPA综合征患者的临床特征。方法:在首尔国立大学儿童医院诊断为PFAPA综合征的13例儿童纳入本研究。进行回顾性病历回顾。结果:13例患者中,男性8例,占61.5%。中位随访时间为3.3年(10个月- 8.3年)。周期性发热发病的中位年龄为3岁(范围1-6岁)。所有患者在诊断前至少有5次周期性发热和咽炎发作,经口服抗生素治疗。发热的中位发生率为每3.9周,持续时间为4.2 d。所有患者均有咽炎,宫颈淋巴结炎12例(92.3%)。对12例患者进行了血液检查,没有患者出现中性粒细胞减少症。c反应蛋白和红细胞沉降率均升高,中位数分别为4.5 mg/dL(范围0.4-13.2 mg/dL)和29 mm/hr(范围16-49 mm/hr)。咽拭子培养和快速链球菌抗原试验均为阴性。9例(69.2%)患者口服强的松龙,中位剂量为0.8 mg/kg, 6例(66.7%)患者发热在数小时内消退。3例(23.1%)患者行扁桃体和腺样体切除术。结论:当儿童出现周期性发热并伴有口疮性口炎、咽炎或宫颈淋巴结炎时,应考虑PFAPA综合征。糖皮质激素对解热有效,可减少不必要的抗生素使用。
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引用次数: 0
Respiratory Microbiome in Children 儿童呼吸道微生物组
Q3 Medicine Pub Date : 2019-01-01 DOI: 10.14776/piv.2019.26.e24
Dong Hyun Kim
The human respiratory tract hosts both pathogenic and commensal bacteria. The development of well-conserved 16S rRNA sequencing and culture-independent techniques has enabled many achievements in the study of the human microbiome. Microbial composition of the respiratory tract in early childhood has been shown to correlate to respiratory health in later stages of life. This review highlights current understandings of respiratory microbiota development in healthy children, examples of microbial interactions, impacts on the host immune system, and the relationship between respiratory tract microbiome and respiratory health.
人的呼吸道是致病细菌和共生细菌的宿主。保守性良好的16S rRNA测序和非培养技术的发展使人类微生物组的研究取得了许多成果。幼儿呼吸道的微生物组成已被证明与生命后期的呼吸健康有关。这篇综述强调了目前对健康儿童呼吸道微生物群发育的理解,微生物相互作用的例子,对宿主免疫系统的影响,以及呼吸道微生物群与呼吸健康之间的关系。
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引用次数: 0
Childhood Tuberculosis Contact Investigation and Treatment of Latent Tuberculosis Infection: a Single Center Study, 2014–2017 2014-2017年儿童结核接触者调查与潜伏性结核感染治疗:单中心研究
Q3 Medicine Pub Date : 2019-01-01 DOI: 10.14776/piv.2019.26.e4
W. Hwang, G. Lee, So Hyun Kim, Eun Young Cho
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引用次数: 3
Neonatal Sepsis and Meningitis Caused by Neisseria meningitidis Serogroup B: a Case Report 乙型脑膜炎奈瑟菌引起的新生儿败血症和脑膜炎1例报告
Q3 Medicine Pub Date : 2018-12-01 DOI: 10.14776/PIV.2018.25.E13
Yoo Na Kim, Yong Sung Choi, S. Cha
수막구균 감염은 신생아에서 높은 사망률을 보이지만 매우 드물고, 단체 생활하는 연장아나 청소년에서 더 흔하다고 알려져 있다. 이 증례에서 소개된 생후 16일 신생아는 수막구균 B 혈청군 패혈증과 수막염이 진단되었지만 조기 항생제 치료를 통해 합병증 없이 건강하게 퇴원하였다. 이 증례 보고의 목적은 신생아에서 수막구균 감염의 발생률과 중요성을 상기시키고 노출된 가족들과 의료진에 대한 조사와 예방 요법의 필요성을 강조하기 위함이다. 한국에서는 많은 신생아가 출생 후 산후조리원 시설에서 지내내므로 감염 발생과 전파에 단체 생활이 영향을 미칠 수도 있음을 생각해 볼 필요가 있다. 질병의 조기 발견, 격리, 그리고 경험적 치료가 치명적인 질병의 전파를 예방하기 위해 매우 중요하다.
据悉,脑膜球菌感染在新生儿中死亡率很高,但非常罕见,在集体生活的老年人和青少年中更常见。在该病例中介绍的出生16日新生儿被诊断为水膜球菌B血清群败血症和水膜炎,但通过早期抗生素治疗,没有并发症,健康出院。该病例报告的目的是提醒新生儿脑膜球菌感染的发生率和重要性,并强调对暴露的家属和医疗人员进行调查和预防疗法的必要性。在韩国,很多新生儿出生后都在产后调理院设施中生活,因此有必要考虑集体生活可能会对感染的发生和传播产生影响。疾病的早期发现、隔离和经验性治疗对预防致命疾病的传播非常重要。
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引用次数: 2
Epidemiology and Clinical Characteristics of Parainfluenza Virus Type 4 in Korean Children: a Single Center Study, 2015–2017 2015-2017年韩国儿童4型副流感病毒流行病学及临床特征的单中心研究
Q3 Medicine Pub Date : 2018-12-01 DOI: 10.14776/PIV.2018.25.E12
Young Joo Sohn, Y. Choi, K. Yun, E. Choi, H. Lee
Purpose: We aimed to identify the epidemiology and the clinical characteristics of human parainfluenza virus type 4 (HPIV-4) infection compared to HPIVs 1–3 infections in Korean children. Methods: We reviewed medical records of children with HPIV infection who visited Seoul National University Children's Hospital from 2015 to 2017. Detection of respiratory viruses was performed using real time-polymerase chain reaction (rt-PCR), which could differentiate HPIVs 1–4. Diagnosis was classified as a febrile illness, upper respiratory tract infection (URI), croup, bronchiolitis, or pneumonia. The epidemiology, demographic features, and clinical characteristics among HPIV types were compared. The clinical data were analyzed only for the previously healthy children. Results: Of the 472 children diagnosed with HPIV infection, 108 (22.9%) were previously healthy: 24 (22.2%), 19 (17.6%), 39 (36.1%), and 26 (24.1%) in HPIV types 1, 2, 3, and 4, respectively. The median age of children with HPIV-4 infection was 11 (0–195) months: the proportion of children aged < 2 years and 2 to < 5 years were 65.4% and 19.2%, respectively. Clinical diagnoses of HPIV-4 infection were bronchiolitis (38.5%), pneumonia (30.8%), and URI (30.8%). Croup was the most prevalent in HPIV-2 (21.1%) and none in HPIV-4 infection (P=0.026). Hospital admission rates among HPIV types were not significantly different (P>0.05). Conclusions: We observed seasonal peak of HPIV-4 infection in 2015 and 2017. HPIV-4 was a common respiratory pathogen causing lower respiratory tract infection in hospitalized children.
目的:我们旨在确定韩国儿童人类副流感病毒4型(HPIV-4)感染与hpiv - 1-3感染的流行病学和临床特征。方法:回顾2015年至2017年在首尔国立大学儿童医院就诊的HPIV感染儿童的医疗记录。采用实时聚合酶链反应(rt-PCR)检测呼吸道病毒,可区分hpiv 1-4。诊断为发热性疾病,上呼吸道感染(URI),群,细支气管炎或肺炎。比较不同HPIV类型的流行病学、人口学特征和临床特征。临床数据仅针对先前健康的儿童进行分析。结果:在472例诊断为HPIV感染的儿童中,108例(22.9%)以前健康:HPIV 1、2、3和4型分别为24例(22.2%)、19例(17.6%)、39例(36.1%)和26例(24.1%)。HPIV-4感染儿童的中位年龄为11(0 ~ 195)个月,其中< 2岁和2 ~ < 5岁儿童所占比例分别为65.4%和19.2%。HPIV-4感染的临床诊断为毛细支气管炎(38.5%)、肺炎(30.8%)和URI(30.8%)。HPIV-2感染率最高(21.1%),HPIV-4感染率为零(P=0.026)。不同HPIV类型患者住院率差异无统计学意义(P>0.05)。结论:2015年和2017年是我国HPIV-4感染的季节性高峰。HPIV-4是引起住院儿童下呼吸道感染的常见呼吸道病原体。
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引用次数: 4
임신 중 Tdap 접종에 대한 임부들의 인식, 태도 및 행동 孕妇对孕期Tdap接种的认识、态度及行为
Q3 Medicine Pub Date : 2018-12-01 DOI: 10.14776/PIV.2018.25.E10
이 신혜, 진 보경, 백 경숙, 조 용선, 이 택진
목적: 임신 중 tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) 접종의 효과 및 안전성에도 불구하고, 아직 국내 임신 중 Tdap 접종률은 낮다. 이에 저자들은 임신 중 Tdap 접종에 대한 임부들의 인식, 태도 및 행동에 대한 조사를 하였다.방법: 본 연구는 서울 및 경기 소재 대학병원 산부인과를 방문한 임부를 대상으로 개별적인 설문지를 통해 임신 중 Tdap 접종에 대한 인식, 태도 및 행동을 수집한 단면 설문조사다.결과: 총 184명의 임부들이 설문지 작성을 완료하였다. 이 중 158명(86%)의 임부들은 의사로부터 백일해 및 Tdap 백신에 대한 정보를 안내 받지 못했고, 166명(90%)의 임부들은 임신 중 Tdap 접종의 필요성을 알지 못했다. 현 임신기간 중 Tdap 접종을 하지 않을 것이라고 답한 임부 중 7%만이 백일해 및 백신에 대한 이해를 묻는 5문항 중 3문항 이상 올바르게 답하였다. 로지스틱 회귀분석에서 의사의 추천(adjusted odds ratio [OR], 236.2; 95% confidence interval [CI], 12.6-4,432), 백신이 효과적이라는 믿음(adjusted OR, 40.21; 95% CI, 2.35-687.7), 백신이 안전하다는 믿음(adjusted OR, 19.83; 95% CI, 1.54-255.9) 등이 Tdap 접종을 결정하는데 유의하게 중요한 요인이었다.결론: 대부분의 임부들이 Tdap 접종에 대하여 적절하게 안내를 받지 못하거나, 추천받지 못하는 것으로 보인다. 임부들의 Tdap 접종률을 향상시키는 데에 의료기관 종사자에 의해 제공되는 정보가 매우 중요하다.
目的:尽管孕期tetanus toxoid、reduced diphtheria toxoid、and acellular pertussis (Tdap)接种的效果及安全性较好,但国内孕期Tdap接种率仍较低。为此,作者对孕妇在怀孕期间接种Tdap的认识、态度和行为进行了调查。方法:本研究是以访问首尔及京畿大学医院妇产科的孕妇为对象,通过个别问卷调查,收集怀孕期间对Tdap接种的认识、态度及行动的片面问卷调查。结果:共有184名孕妇完成了问卷调查。其中,158名(86%)孕妇没有从医生那里得到有关百日咳和Tdap疫苗的信息,166名(90%)孕妇在怀孕期间不知道接种Tdap疫苗的必要性。在回答孕期不接种Tdap的孕妇中,只有7%的孕妇正确回答了5个问题中的3个以上。adjusted odds ratio [OR], 236.2;95% confidence interval [CI], 12.6-4,432),相信疫苗有效(adjusted OR, 40.21;95% CI, 2.35-687.7),相信疫苗安全(adjusted OR, 19.83;95% CI, 1.54-255.9)等是决定Tdap接种的重要因素。结论:大部分孕妇对Tdap接种没有得到适当的指导或推荐。为提高孕妇的Tdap接种率,医疗机构工作人员提供的信息非常重要。
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Pediatric Infection and Vaccine
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