Loading…
The metastatic behavior of osteosarcoma by gene expression and cytogenetic analyses
Summary Osteosarcoma is a malignant bone tumor with high metastatic potential. Metastasis at diagnosis is the most significant prognostic factor in predicting the clinical outcome of osteosarcoma. We compared the gene expression of metastases that were present at the time of initial diagnosis to tho...
Saved in:
Published in: | Human pathology 2013-10, Vol.44 (10), p.2188-2198 |
---|---|
Main Authors: | , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | cdi_FETCH-LOGICAL-c481t-2fc37b33499ee48339be2e761d703aa1088be3a2e047d638f5d61c4c09096103 |
---|---|
cites | cdi_FETCH-LOGICAL-c481t-2fc37b33499ee48339be2e761d703aa1088be3a2e047d638f5d61c4c09096103 |
container_end_page | 2198 |
container_issue | 10 |
container_start_page | 2188 |
container_title | Human pathology |
container_volume | 44 |
creator | Salinas-Souza, Carolina, PhD De Oliveira, Renato, MD Alves, Maria Teresa De Seixas, MD, PhD Garcia Filho, Reynaldo Jesus, MD, PhD Petrilli, Antonio Sergio, MD, PhD Toledo, Silvia Regina Caminada, PhD |
description | Summary Osteosarcoma is a malignant bone tumor with high metastatic potential. Metastasis at diagnosis is the most significant prognostic factor in predicting the clinical outcome of osteosarcoma. We compared the gene expression of metastases that were present at the time of initial diagnosis to those developed later in the course of the disease. We used quantitative real-time polymerase chain reaction to evaluate the gene expression of MDM2 , CXCR4, RANKL , RB1 , and OSTERIX in 98 samples of osteosarcoma taken from 47 patients (74 metastases and 24 primary tumors) and 30 nonmalignant lung tissues surrounding osteosarcoma metastases. In addition, we investigated the copy number changes of RB1 and MDM2 genes in 12 primary cultures of pulmonary metastases of osteosarcoma, using interphase fluorescence in situ hybridization. Metastases from metastatic patients at diagnosis were characterized by low expression of RB1 and RANKL ( P = .0009 and P = .0109, respectively) and overexpression of CXCR4 and MDM2 ( P = .0389 and P = .0325, respectively). The loss of RANKL and gain of CXCR4 could also be detected in the primary tumors of metastatic patients at diagnosis ( P = .0121 and P = .0264, respectively). Thus, some early genetic events such as the loss of RANKL and the gain of CXCR4 expressions probably facilitate the metastatic progression concomitant with the primary tumor establishment, supporting the role of the CXCR4 receptor in directing osteosarcoma metastases to the lung. On the other hand, late events such as the loss of RB1 and gain of MDM2 , crucial regulators of cell cycle, appear to be related to the final mechanisms contributing to the metastatic establishment of osteosarcoma. |
doi_str_mv | 10.1016/j.humpath.2013.04.013 |
format | article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1534844145</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0046817713001834</els_id><sourcerecordid>3076052881</sourcerecordid><originalsourceid>FETCH-LOGICAL-c481t-2fc37b33499ee48339be2e761d703aa1088be3a2e047d638f5d61c4c09096103</originalsourceid><addsrcrecordid>eNqFkktv1DAUhS0EotPHTwBFYsMmqR_XibMBoQpKpUosOnvLcW4YD0k82ElF_j0OM4DUTVdHsr57rHvPIeQNowWjrLzeF7t5OJhpV3DKREGhSPKCbJgUPFei5i_JhlIoc8Wq6oycx7inlDEJ8jU540KBhFJuyMN2h9mAk4mTmZzNGtyZR-dD5rvMxwl9NMH6wWTNkn3HETP8dQgYo_NjZsY2s8vk1_d11oymXyLGS_KqM33Eq5NekO2Xz9ubr_n9t9u7m0_3uQXFppx3VlSNEFDXiKCEqBvkWJWsragwhlGlGhSGI4WqLYXqZFsyC5bWtC4ZFRfk_dH2EPzPGeOkBxct9r0Z0c9Rp0uAAmAgn0dBSAU1K1lC3z1B934OabM_lFAcKlkmSh4pG3yMATt9CG4wYdGM6jUfvdenfPSaj6agk6S5tyf3uRmw_Tf1N5AEfDwCmA736DDoaB2OFlsX0E669e7ZLz48cbC9G501_Q9cMP7fRkeuqX5YS7J2hInUDyVA_AZ0Cbd7</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1433824756</pqid></control><display><type>article</type><title>The metastatic behavior of osteosarcoma by gene expression and cytogenetic analyses</title><source>Elsevier</source><creator>Salinas-Souza, Carolina, PhD ; De Oliveira, Renato, MD ; Alves, Maria Teresa De Seixas, MD, PhD ; Garcia Filho, Reynaldo Jesus, MD, PhD ; Petrilli, Antonio Sergio, MD, PhD ; Toledo, Silvia Regina Caminada, PhD</creator><creatorcontrib>Salinas-Souza, Carolina, PhD ; De Oliveira, Renato, MD ; Alves, Maria Teresa De Seixas, MD, PhD ; Garcia Filho, Reynaldo Jesus, MD, PhD ; Petrilli, Antonio Sergio, MD, PhD ; Toledo, Silvia Regina Caminada, PhD</creatorcontrib><description>Summary Osteosarcoma is a malignant bone tumor with high metastatic potential. Metastasis at diagnosis is the most significant prognostic factor in predicting the clinical outcome of osteosarcoma. We compared the gene expression of metastases that were present at the time of initial diagnosis to those developed later in the course of the disease. We used quantitative real-time polymerase chain reaction to evaluate the gene expression of MDM2 , CXCR4, RANKL , RB1 , and OSTERIX in 98 samples of osteosarcoma taken from 47 patients (74 metastases and 24 primary tumors) and 30 nonmalignant lung tissues surrounding osteosarcoma metastases. In addition, we investigated the copy number changes of RB1 and MDM2 genes in 12 primary cultures of pulmonary metastases of osteosarcoma, using interphase fluorescence in situ hybridization. Metastases from metastatic patients at diagnosis were characterized by low expression of RB1 and RANKL ( P = .0009 and P = .0109, respectively) and overexpression of CXCR4 and MDM2 ( P = .0389 and P = .0325, respectively). The loss of RANKL and gain of CXCR4 could also be detected in the primary tumors of metastatic patients at diagnosis ( P = .0121 and P = .0264, respectively). Thus, some early genetic events such as the loss of RANKL and the gain of CXCR4 expressions probably facilitate the metastatic progression concomitant with the primary tumor establishment, supporting the role of the CXCR4 receptor in directing osteosarcoma metastases to the lung. On the other hand, late events such as the loss of RB1 and gain of MDM2 , crucial regulators of cell cycle, appear to be related to the final mechanisms contributing to the metastatic establishment of osteosarcoma.</description><identifier>ISSN: 0046-8177</identifier><identifier>EISSN: 1532-8392</identifier><identifier>DOI: 10.1016/j.humpath.2013.04.013</identifier><identifier>PMID: 23845465</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Biomarkers, Tumor - genetics ; Bone Neoplasms - genetics ; Bone Neoplasms - pathology ; Bone surgery ; Brazil - epidemiology ; Cell culture ; Cell cycle ; Cell division ; CXCR4 ; Cytogenetic Analysis ; Disease ; Female ; Fluorescence in situ hybridization ; Gene amplification ; Gene Dosage ; Gene expression ; Gene Expression Regulation, Neoplastic - genetics ; Humans ; Kaplan-Meier Estimate ; Lung metastasis ; Lung Neoplasms - genetics ; Lung Neoplasms - secondary ; Male ; MDM2 ; Osteosarcoma ; Osteosarcoma - genetics ; Osteosarcoma - secondary ; Pathology ; Patients ; Prognosis ; Proto-Oncogene Proteins c-mdm2 - genetics ; RANK Ligand - genetics ; Real-Time Polymerase Chain Reaction ; Receptors, CXCR4 - genetics ; Retinoblastoma Protein - genetics ; Survival Rate ; Thoracic surgery ; Tumor Cells, Cultured ; Tumors</subject><ispartof>Human pathology, 2013-10, Vol.44 (10), p.2188-2198</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Oct 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c481t-2fc37b33499ee48339be2e761d703aa1088be3a2e047d638f5d61c4c09096103</citedby><cites>FETCH-LOGICAL-c481t-2fc37b33499ee48339be2e761d703aa1088be3a2e047d638f5d61c4c09096103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23845465$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Salinas-Souza, Carolina, PhD</creatorcontrib><creatorcontrib>De Oliveira, Renato, MD</creatorcontrib><creatorcontrib>Alves, Maria Teresa De Seixas, MD, PhD</creatorcontrib><creatorcontrib>Garcia Filho, Reynaldo Jesus, MD, PhD</creatorcontrib><creatorcontrib>Petrilli, Antonio Sergio, MD, PhD</creatorcontrib><creatorcontrib>Toledo, Silvia Regina Caminada, PhD</creatorcontrib><title>The metastatic behavior of osteosarcoma by gene expression and cytogenetic analyses</title><title>Human pathology</title><addtitle>Hum Pathol</addtitle><description>Summary Osteosarcoma is a malignant bone tumor with high metastatic potential. Metastasis at diagnosis is the most significant prognostic factor in predicting the clinical outcome of osteosarcoma. We compared the gene expression of metastases that were present at the time of initial diagnosis to those developed later in the course of the disease. We used quantitative real-time polymerase chain reaction to evaluate the gene expression of MDM2 , CXCR4, RANKL , RB1 , and OSTERIX in 98 samples of osteosarcoma taken from 47 patients (74 metastases and 24 primary tumors) and 30 nonmalignant lung tissues surrounding osteosarcoma metastases. In addition, we investigated the copy number changes of RB1 and MDM2 genes in 12 primary cultures of pulmonary metastases of osteosarcoma, using interphase fluorescence in situ hybridization. Metastases from metastatic patients at diagnosis were characterized by low expression of RB1 and RANKL ( P = .0009 and P = .0109, respectively) and overexpression of CXCR4 and MDM2 ( P = .0389 and P = .0325, respectively). The loss of RANKL and gain of CXCR4 could also be detected in the primary tumors of metastatic patients at diagnosis ( P = .0121 and P = .0264, respectively). Thus, some early genetic events such as the loss of RANKL and the gain of CXCR4 expressions probably facilitate the metastatic progression concomitant with the primary tumor establishment, supporting the role of the CXCR4 receptor in directing osteosarcoma metastases to the lung. On the other hand, late events such as the loss of RB1 and gain of MDM2 , crucial regulators of cell cycle, appear to be related to the final mechanisms contributing to the metastatic establishment of osteosarcoma.</description><subject>Adolescent</subject><subject>Biomarkers, Tumor - genetics</subject><subject>Bone Neoplasms - genetics</subject><subject>Bone Neoplasms - pathology</subject><subject>Bone surgery</subject><subject>Brazil - epidemiology</subject><subject>Cell culture</subject><subject>Cell cycle</subject><subject>Cell division</subject><subject>CXCR4</subject><subject>Cytogenetic Analysis</subject><subject>Disease</subject><subject>Female</subject><subject>Fluorescence in situ hybridization</subject><subject>Gene amplification</subject><subject>Gene Dosage</subject><subject>Gene expression</subject><subject>Gene Expression Regulation, Neoplastic - genetics</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Lung metastasis</subject><subject>Lung Neoplasms - genetics</subject><subject>Lung Neoplasms - secondary</subject><subject>Male</subject><subject>MDM2</subject><subject>Osteosarcoma</subject><subject>Osteosarcoma - genetics</subject><subject>Osteosarcoma - secondary</subject><subject>Pathology</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Proto-Oncogene Proteins c-mdm2 - genetics</subject><subject>RANK Ligand - genetics</subject><subject>Real-Time Polymerase Chain Reaction</subject><subject>Receptors, CXCR4 - genetics</subject><subject>Retinoblastoma Protein - genetics</subject><subject>Survival Rate</subject><subject>Thoracic surgery</subject><subject>Tumor Cells, Cultured</subject><subject>Tumors</subject><issn>0046-8177</issn><issn>1532-8392</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNqFkktv1DAUhS0EotPHTwBFYsMmqR_XibMBoQpKpUosOnvLcW4YD0k82ElF_j0OM4DUTVdHsr57rHvPIeQNowWjrLzeF7t5OJhpV3DKREGhSPKCbJgUPFei5i_JhlIoc8Wq6oycx7inlDEJ8jU540KBhFJuyMN2h9mAk4mTmZzNGtyZR-dD5rvMxwl9NMH6wWTNkn3HETP8dQgYo_NjZsY2s8vk1_d11oymXyLGS_KqM33Eq5NekO2Xz9ubr_n9t9u7m0_3uQXFppx3VlSNEFDXiKCEqBvkWJWsragwhlGlGhSGI4WqLYXqZFsyC5bWtC4ZFRfk_dH2EPzPGeOkBxct9r0Z0c9Rp0uAAmAgn0dBSAU1K1lC3z1B934OabM_lFAcKlkmSh4pG3yMATt9CG4wYdGM6jUfvdenfPSaj6agk6S5tyf3uRmw_Tf1N5AEfDwCmA736DDoaB2OFlsX0E669e7ZLz48cbC9G501_Q9cMP7fRkeuqX5YS7J2hInUDyVA_AZ0Cbd7</recordid><startdate>20131001</startdate><enddate>20131001</enddate><creator>Salinas-Souza, Carolina, PhD</creator><creator>De Oliveira, Renato, MD</creator><creator>Alves, Maria Teresa De Seixas, MD, PhD</creator><creator>Garcia Filho, Reynaldo Jesus, MD, PhD</creator><creator>Petrilli, Antonio Sergio, MD, PhD</creator><creator>Toledo, Silvia Regina Caminada, PhD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>7QP</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>RC3</scope></search><sort><creationdate>20131001</creationdate><title>The metastatic behavior of osteosarcoma by gene expression and cytogenetic analyses</title><author>Salinas-Souza, Carolina, PhD ; De Oliveira, Renato, MD ; Alves, Maria Teresa De Seixas, MD, PhD ; Garcia Filho, Reynaldo Jesus, MD, PhD ; Petrilli, Antonio Sergio, MD, PhD ; Toledo, Silvia Regina Caminada, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c481t-2fc37b33499ee48339be2e761d703aa1088be3a2e047d638f5d61c4c09096103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Biomarkers, Tumor - genetics</topic><topic>Bone Neoplasms - genetics</topic><topic>Bone Neoplasms - pathology</topic><topic>Bone surgery</topic><topic>Brazil - epidemiology</topic><topic>Cell culture</topic><topic>Cell cycle</topic><topic>Cell division</topic><topic>CXCR4</topic><topic>Cytogenetic Analysis</topic><topic>Disease</topic><topic>Female</topic><topic>Fluorescence in situ hybridization</topic><topic>Gene amplification</topic><topic>Gene Dosage</topic><topic>Gene expression</topic><topic>Gene Expression Regulation, Neoplastic - genetics</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Lung metastasis</topic><topic>Lung Neoplasms - genetics</topic><topic>Lung Neoplasms - secondary</topic><topic>Male</topic><topic>MDM2</topic><topic>Osteosarcoma</topic><topic>Osteosarcoma - genetics</topic><topic>Osteosarcoma - secondary</topic><topic>Pathology</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Proto-Oncogene Proteins c-mdm2 - genetics</topic><topic>RANK Ligand - genetics</topic><topic>Real-Time Polymerase Chain Reaction</topic><topic>Receptors, CXCR4 - genetics</topic><topic>Retinoblastoma Protein - genetics</topic><topic>Survival Rate</topic><topic>Thoracic surgery</topic><topic>Tumor Cells, Cultured</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Salinas-Souza, Carolina, PhD</creatorcontrib><creatorcontrib>De Oliveira, Renato, MD</creatorcontrib><creatorcontrib>Alves, Maria Teresa De Seixas, MD, PhD</creatorcontrib><creatorcontrib>Garcia Filho, Reynaldo Jesus, MD, PhD</creatorcontrib><creatorcontrib>Petrilli, Antonio Sergio, MD, PhD</creatorcontrib><creatorcontrib>Toledo, Silvia Regina Caminada, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><jtitle>Human pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Salinas-Souza, Carolina, PhD</au><au>De Oliveira, Renato, MD</au><au>Alves, Maria Teresa De Seixas, MD, PhD</au><au>Garcia Filho, Reynaldo Jesus, MD, PhD</au><au>Petrilli, Antonio Sergio, MD, PhD</au><au>Toledo, Silvia Regina Caminada, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The metastatic behavior of osteosarcoma by gene expression and cytogenetic analyses</atitle><jtitle>Human pathology</jtitle><addtitle>Hum Pathol</addtitle><date>2013-10-01</date><risdate>2013</risdate><volume>44</volume><issue>10</issue><spage>2188</spage><epage>2198</epage><pages>2188-2198</pages><issn>0046-8177</issn><eissn>1532-8392</eissn><abstract>Summary Osteosarcoma is a malignant bone tumor with high metastatic potential. Metastasis at diagnosis is the most significant prognostic factor in predicting the clinical outcome of osteosarcoma. We compared the gene expression of metastases that were present at the time of initial diagnosis to those developed later in the course of the disease. We used quantitative real-time polymerase chain reaction to evaluate the gene expression of MDM2 , CXCR4, RANKL , RB1 , and OSTERIX in 98 samples of osteosarcoma taken from 47 patients (74 metastases and 24 primary tumors) and 30 nonmalignant lung tissues surrounding osteosarcoma metastases. In addition, we investigated the copy number changes of RB1 and MDM2 genes in 12 primary cultures of pulmonary metastases of osteosarcoma, using interphase fluorescence in situ hybridization. Metastases from metastatic patients at diagnosis were characterized by low expression of RB1 and RANKL ( P = .0009 and P = .0109, respectively) and overexpression of CXCR4 and MDM2 ( P = .0389 and P = .0325, respectively). The loss of RANKL and gain of CXCR4 could also be detected in the primary tumors of metastatic patients at diagnosis ( P = .0121 and P = .0264, respectively). Thus, some early genetic events such as the loss of RANKL and the gain of CXCR4 expressions probably facilitate the metastatic progression concomitant with the primary tumor establishment, supporting the role of the CXCR4 receptor in directing osteosarcoma metastases to the lung. On the other hand, late events such as the loss of RB1 and gain of MDM2 , crucial regulators of cell cycle, appear to be related to the final mechanisms contributing to the metastatic establishment of osteosarcoma.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23845465</pmid><doi>10.1016/j.humpath.2013.04.013</doi><tpages>11</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0046-8177 |
ispartof | Human pathology, 2013-10, Vol.44 (10), p.2188-2198 |
issn | 0046-8177 1532-8392 |
language | eng |
recordid | cdi_proquest_miscellaneous_1534844145 |
source | Elsevier |
subjects | Adolescent Biomarkers, Tumor - genetics Bone Neoplasms - genetics Bone Neoplasms - pathology Bone surgery Brazil - epidemiology Cell culture Cell cycle Cell division CXCR4 Cytogenetic Analysis Disease Female Fluorescence in situ hybridization Gene amplification Gene Dosage Gene expression Gene Expression Regulation, Neoplastic - genetics Humans Kaplan-Meier Estimate Lung metastasis Lung Neoplasms - genetics Lung Neoplasms - secondary Male MDM2 Osteosarcoma Osteosarcoma - genetics Osteosarcoma - secondary Pathology Patients Prognosis Proto-Oncogene Proteins c-mdm2 - genetics RANK Ligand - genetics Real-Time Polymerase Chain Reaction Receptors, CXCR4 - genetics Retinoblastoma Protein - genetics Survival Rate Thoracic surgery Tumor Cells, Cultured Tumors |
title | The metastatic behavior of osteosarcoma by gene expression and cytogenetic analyses |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-11T08%3A48%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20metastatic%20behavior%20of%20osteosarcoma%20by%20gene%20expression%20and%20cytogenetic%20analyses&rft.jtitle=Human%20pathology&rft.au=Salinas-Souza,%20Carolina,%20PhD&rft.date=2013-10-01&rft.volume=44&rft.issue=10&rft.spage=2188&rft.epage=2198&rft.pages=2188-2198&rft.issn=0046-8177&rft.eissn=1532-8392&rft_id=info:doi/10.1016/j.humpath.2013.04.013&rft_dat=%3Cproquest_cross%3E3076052881%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c481t-2fc37b33499ee48339be2e761d703aa1088be3a2e047d638f5d61c4c09096103%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1433824756&rft_id=info:pmid/23845465&rfr_iscdi=true |