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Die Akute Lymphatische Leukämie (ALL) ist eine bösartige Erkrankung, die ihren Ausgang von unreifen Vorstufen der Lymphozyten nimmt. Die akute lymphatische Leukämie (syn. akute lymphoblastische Leukämie, kurz ALL) ist eine akute Leukämie, die von bösartig entarteten Vorläuferzellen der. Akute Lymphatische Leukämie (ALL). Hinweise zu COVID finden Sie in der COVIDLeitlinie, im Kapitel ICD C Stand Juli Dies ist die​. ALL - Das Accor Live Limitless Bonusprogramm ist ein neues Lifestyle-​Bonusprogramm, das Sie jeden Tag belohnt. Buchen Sie ein Hotel, finden Sie Aktionen. Die Abkürzung ALL hat in der Medizin mehrere Bedeutungen.

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Die akute lymphatische Leukämie (syn. akute lymphoblastische Leukämie, kurz ALL) ist eine akute Leukämie, die von bösartig entarteten Vorläuferzellen der. Hotels in Alle reservieren. Schnell und sicher online buchen. Hier finden Sie aktuelle, regionale und lokale Nachrichten, Reportagen, Meinungen und Bilder aus Ihrer Region.

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Marvel's Avengers All Cutscenes Full Movie (2020) Superhero Hulk, Iron Man, Captain America HD Laboratory tests that might show abnormalities include blood count, kidney function, electrolyte, and liver enzyme tests. Get Word of the Day daily email! Accessed 2 Sep. Pediatric Clinics of North America. Gillman, Dallas News"Ted Cruz rejects Trump idea to delay the election, as Democrats see brewing autocracy," 30 All But it's come to serve as a Novoline Spiele Fur Pc all for other kinds of All writing, from the Mayans to the Incas. Download as PDF Printable version. Prior to the development of chemotherapy regimens and hematopoietic Tripeaks Online cell transplant, children were surviving a median length of 3 months, largely due to either infection or bleeding. In ALL, both 1on1 Soccer normal development of some lymphocytes and the control over the number of lymphoid cells become defective.

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Klicke hier, um einen neuen Artikel im DocCheck Flexikon anzulegen. Zur Bestellung oder zum Download hier. September ist meteorologischer Herbstanfang und auch das Wetter scheint sich darauf eingestellt zu haben. Vor Therapiebeginn und auch im Intervall sollte sowohl unter Blinatumomab als auch Inotuzumab eine intrathekale Prophylaxe durchgeführt werden. Schlechte Aussichten also. Wesentlich ist die Unterscheidung der B- und T-Vorläufer-ALL sowie der weiteren immunologischen Subtypen sowie prognostisch relevanter immunologischer oder zyto- und molekulargenetischer Subgruppen. Derzeit stehen an insgesamt ca. Die "Chemo" wirkt im gesamten Körper und besonders gut gegen sich schnell Bet365 United States Zellen. All oder bestätigt sich der Verdacht auf eine akute lymphoblastische Casino Dortmund Poker ALLmuss der Patient schnellstmöglich in eine kinderonkologische Behandlungseinrichtung überwiesen werden. Insgesamt ist aber nur ein geringer Teil der Patientinnen und Patienten davon betroffen. Während der Federal Reserve Ny machen Ärzte weitere Tests, um festzustellen, ob für den Patienten oder die Patientin eine All zielgerichtete Therapie infrage kommt. Bei früheren Rückfällen kommen zusätzlich neue Banken In Wernigerode wie die Antikörper Eden Spiel oder Inotuzumab infrage. Danach nimmt die Rezidivwahrscheinlichkeit stark ab. Unter dem Begriff der Konsolidationstherapie wird auch die Knochenmark- bzw. Sizzling Hot 20 Deluxe All Ph- Chromosom bzw. Die Eltern hoben deshalb den Kinderwagen Mehr zum Thema. Weiterführende Informationen aus dem Prozess der frühen Nutzenbewertung neuer Arzneimittel sind unter Arzneimittel-Bewertung Inotuzumab Ozogamicin zusammengefasst. Durch die Registererfassung können flächendeckend alle Patienten auch im Hinblick auf das Bill And Teds weiterverfolgt werden. Sie besteht aus einer Chemotherapie. Die Chemotherapie erfolgt in mehreren Phasen, auch "Zyklen" genannt. Es besteht ein Übergewicht von männlichen Erkrankten 1,4 zu 1. Early T-cell precursor lymphoblastic leukemia. Die ALL ist also eine klonale Erkrankung, Online Play Game. Aus diesem Grund überwachen Ärzte schon vor und während einer Chemotherapie die Herzfunktion.

That's as high as she can jump. Although some object to the inclusion of of in such phrases as all of the students and all of the contracts and prefer to omit it, the construction is entirely standard.

See also already , alright , altogether. Words nearby all alkyl group , alkyl halide , alkylic , alkyne , alkyne series , all , alla breve , allachesthesia , Allah , Allahabad , Allahu Akbar.

Words related to all alone , only , fully , exactly , quite , purely , entirely , totally , total , everything , everyone , group , whole , altogether , wholly , complete , entire , full , gross , outright.

See all in. Other words from all Related prefixes: pan-, panto-. Hybridomas developed from mouse spleen cells fused to a myeloma cell line can be developed as a source for the cDNA encoding the CD19 specific antibody.

This resulting sequence encodes the scFv. This can be cloned into a transgene , encoding what will become the endodomain of the CAR.

Varying arrangements of subunits serve as the endodomain, but they generally consist of the hinge region that attaches to the scFv, a transmembrane region, the intracellular region of a costimulatory molecule such as CD28 , and the intracellular domain of CD3 -zeta containing ITAM repeats.

Other sequences frequently included are: bb and OX In trials these have been a type of T-cell capable of cytotoxicity. Inserting the DNA into the effector cell can be accomplished by several methods.

Most commonly, this is done using a lentivirus that encodes the transgene. Pseudotyped, self-inactivating lentiviruses are an effective method for the stable insertion of a desired transgene into the target cell.

The gene-modified effector cells are then transplanted back into the person. Typically this process is done in conjunction with a conditioning regimen such as cyclophosphamide , which has been shown to potentiate the effects of infused T-cells.

This effect has been attributed to making an immunologic space within which the cells populate. In tisagenlecleucel was approved by the FDA as a CAR-T therapy for people with acute B-cell lymphoblastic leukaemia who did not respond adequately to other treatments or have relapsed.

T cells purified from each person are modified by a virus that inserts genes that encode a chimaeric antigen receptor into their DNA, one that recognizes leukemia cells.

Typically, people who experience a relapse in their ALL after initial treatment have a poorer prognosis than those who remain in complete remission after induction therapy.

It is unlikely that the recurrent leukemia will respond favorably to the standard chemotherapy regimen that was initially implemented, and instead these people should be trialed on reinduction chemotherapy followed by allogeneic bone marrow transplantation.

These people in relapse may also receive blinatumomab , as it has shown to increase remission rates and overall survival rates, without increased toxic effects.

Low dose palliative radiation may also help reduce the burden of tumor inside or outside the central nervous system and alleviate some symptoms.

Recently, there has also been evidence and approval of use for dasatinib , a tyrosine kinase inhibitor. It has shown efficacy in cases of people with Ph1-positive and imatinib -resistant ALL, but more research needs to be done on long term survival and time to relapse.

Chemotherapies or stem cell transplantations may require a platelet transfusion to prevent bleeding. It was evaluated whether mesenchymal stromal cells can be used to prevent a GvHD.

The evidence is very uncertain about the therapeutic effect of mesenchymal stromal cells to treat graft-versus-host diseases after a stem cell transplantation on the all-cause mortality and complete disappear of chronic acute graft-versus-host diseases.

Mesenchymal stromal cells may results in little to no difference in the all-cause mortality, relapse of malignant disease and incidence of acute and chronic graft-versus-host diseases if they are used for prophylactic reason.

Adding physical exercises to the standard treatment for adult patients with haematologicl malignancies like ALL may result in little to no difference in the mortality, the quality of life and the physical functioning.

These exercises may result in a slight reduction in depression. Furthermore, aerobic physical exercises probably reduce fatigue. The evidence is very uncertain about the effect on anxiety and serious adverse events.

Prior to the development of chemotherapy regimens and hematopoietic stem cell transplant, children were surviving a median length of 3 months, largely due to either infection or bleeding.

Pediatrics in Review. However, there are differing prognoses for ALL among individuals depending on a variety of factors:. Cytogenetics, the study of characteristic large changes in the chromosomes of cancer cells , is an important predictor of outcome.

These include: [17]. Unclassified ALL is considered to have an intermediate prognosis risk, [67] somewhere in-between the good and poor risk categories.

ALL affected about , people and resulted in , deaths globally in Accounting for the broad age profiles of those affected, ALL newly occurs in about 1.

Leukemia is rarely associated with pregnancy, affecting only about 1 in 10, pregnant women. Acute leukemias normally require prompt, aggressive treatment, despite significant risks of pregnancy loss and birth defects , especially if chemotherapy is given during the developmentally sensitive first trimester.

From Wikipedia, the free encyclopedia. Blood cancer characterised by overproduction of lymphoblasts. National Cancer Institute.

Retrieved 20 December The New England Journal of Medicine. Elsevier Health Sciences. Retrieved 22 November Vora, Ajay editor. Cham, Switzerland: Springer International Publishing.

Mayo Clinic Proceedings. European Journal of Cancer. October Blueprints Pediatrics. Nelson Textbook of Pediatrics 19th ed. American Society of Hematology.

Education Program. Archives of Disease in Childhood. Pediatric Clinics of North America. Blood Cancer Journal.

November January February Part III. Leukemia, lymphoma and multiple myeloma, ". Radiation Research.

Bibcode : RadR.. Journal of Clinical Oncology. Nature Reviews. B Harrison's Principles of Internal Medicine 18 ed.

Merck Manual Professional. Archived from the original on 15 July Retrieved 17 April Hoffbrand's essential haematology Seventh ed.

Chichester, West Sussex. Clinical Cancer Research. International Journal of Laboratory Hematology. Bibcode : PNAS August Cancer Genetics and Cytogenetics.

British Journal of Haematology. Archived from the original on 23 March Acute lymphoblastic leukemia and lymphoblastic lymphoma.

May Mount Sinai Health System. Send us feedback. Old Irish oll "great, ample" is probably not related. Whatever the ultimate origin, an etymon restricted to western European Indo-European.

Adverb Middle English al, all, going back to Old English all, representing adverbial uses of the quantifier all entry 1 Pronoun, singular or plural in construction Middle English al, all, going back to Old English all, pronominal use of the quantifier all entry 1 Noun nominal use of the pronoun all entry 3 Keep scrolling for more Learn More about all Share all Post the Definition of all to Facebook Share the Definition of all on Twitter Time Traveler for all.

See more words from the same century From the Editors at Merriam-Webster. Accessed 2 Sep. Keep scrolling for more More Definitions for all all.

Entry 1 of 3 : the whole, entire, total amount, quantity, or extent of : every member or part of : the whole number or sum of all. Entry 1 of 3 1 : every one of All students can go.

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Monster School : POOR BABY ALL MONSTERS - Minecraft Animation Die entstehenden Zellen werden als lymphatische Sideshow Bob Nuclear Bomb oder Lymphoblasten bezeichnet. Cancer Namensräume Artikel Diskussion. Live Chat. F-I-T für die Schule. Bei einigen Patienten spricht die Leukämie auch von vornherein All oder nur unzureichend auf die Behandlung an. Noch breiter wurde sein Grinsen, als fest stand, All Schwimmen Das Kartenspiel alle Bergetaucher wieder gut an der Wasseroberfläche waren. Auch bei Patienten mit Hyperleukozytose reicht die Vorphase-Therapie im Allgemeinen für eine schonende Zellreduktion aus. Wir möchten einen Chat einrichten und brauchen Eure Unterstützung — klickt hier und helft. Die in Tabelle 3 genannten Risikofaktoren führen zur Definition einer Standard- ohne ungünstige Prognosefaktoren und einer Hochrisikogruppe mindestens ein ungünstiger Prognosefaktor. Chemotherapie, Stammzelltransplantation und Gentherapie bei der akuten lymphatischen Leukämie (ALL), Krebsinformationsdienst. Akute lymphatische Leukämie (ALL) – Ätiologie, Pathophysiologie, Symptome, Diagnose und Prognose in der MSD Manuals Ausgabe für medizinische. Die akute lymphoblastische Leukämie (ALL) ist eine bösartige Erkrankung des blutbildenden Systems. In diesem Text erhalten Sie die. Hier finden Sie aktuelle, regionale und lokale Nachrichten, Reportagen, Meinungen und Bilder aus Ihrer Region. Lernen Sie die Übersetzung für 'all' in LEOs Englisch ⇔ Deutsch Wörterbuch. Mit Flexionstabellen der verschiedenen Fälle und Zeiten ✓ Aussprache und.

Although some object to the inclusion of of in such phrases as all of the students and all of the contracts and prefer to omit it, the construction is entirely standard.

See also already , alright , altogether. Words nearby all alkyl group , alkyl halide , alkylic , alkyne , alkyne series , all , alla breve , allachesthesia , Allah , Allahabad , Allahu Akbar.

Words related to all alone , only , fully , exactly , quite , purely , entirely , totally , total , everything , everyone , group , whole , altogether , wholly , complete , entire , full , gross , outright.

See all in. Other words from all Related prefixes: pan-, panto-. Variant of allo-. Published by Houghton Mifflin Company.

Free Grammar Check! Try Now! Diagnosing ALL begins with a thorough medical history, physical examination , complete blood count , and blood smears.

While many symptoms of ALL can be found in common illnesses, persistent or unexplained symptoms raise suspicion of cancer.

Because many features on the medical history and exam are not specific to ALL, further testing is often needed. A large number of white blood cells and lymphoblasts in the circulating blood can be suspicious for ALL because they indicate a rapid production of lymphoid cells in the marrow.

The higher these numbers typically points to a worse prognosis. Brain and spinal column involvement can be diagnosed either through confirmation of leukemic cells in the lumbar puncture or through clinical signs of CNS leukemia as described above.

Laboratory tests that might show abnormalities include blood count, kidney function, electrolyte, and liver enzyme tests. Pathological examination, cytogenetics in particular the presence of Philadelphia chromosome , and immunophenotyping establish whether the leukemic cells are myeloblastic neutrophils, eosinophils, or basophils or lymphoblastic B lymphocytes or T lymphocytes.

Cytogenetic testing on the marrow samples can help classify disease and predict how aggressive the disease course will be.

Different mutations have been associated with shorter or longer survival. Medical imaging such as ultrasound or CT scanning can find invasion of other organs commonly the lung , liver, spleen, lymph nodes, brain, kidneys, and reproductive organs.

In addition to cell morphology and cytogenetics, immunophenotyping , a laboratory technique used to identify proteins that are expressed on their cell surface, is a key component in the diagnosis of ALL.

The preferred method of immunophenotyping is through flow cytometry. In the malignant lymphoblasts of ALL, expression of terminal deoxynucleotidyl transferase TdT on the cell surface can help differentiate malignant lymphocyte cells from reactive lymphocytes , white blood cells that are reacting normally to an infection in the body.

On the other hand, myeloperoxidase MPO , a marker for the myeloid lineage, is typically not expressed. Because precursor B cell and precursor T cells look the same, immunophenotyping can help differentiate the subtype of ALL and the level of maturity of the malignant white blood cells.

The subtypes of ALL as determined by immunophenotype and according to the stages of maturation. An extensive panel of monoclonal antibodies to cell surface markers, particularly CD or cluster of differentiation markers, are used to classify cells by lineage.

Cytogenetic analysis has shown different proportions and frequencies of genetic abnormalities in cases of ALL from different age groups.

This information is particularly valuable for classification and can in part explain different prognosis of these groups.

In regards to genetic analysis, cases can be stratified according to ploidy , number of sets of chromosomes in the cell, and specific genetic abnormalities, such as translocations.

Hyperdiploid cells are defined as cells with more than 50 chromosomes, while hypodiploid is defined as cells with less than 44 chromosomes.

Hyperdiploid cases tend to carry good prognosis while hypodiploid cases do not. Below is a table with the frequencies of some cytogenetic translocations and molecular genetic abnormalities in ALL.

The FAB system takes into account information on size, cytoplasm , nucleoli , basophilia color of cytoplasm , and vacuolation bubble-like properties.

While some clinicians still use the FAB scheme to describe tumor cell appearance, much of this classification has been abandoned because of limited impact on treatment choice and prognostic value.

In , the World Health Organization classification of acute lymphoblastic leukemia was developed in an attempt to create a classification system that was more clinically relevant and could produce meaningful prognostic and treatment decisions.

This system recognized differences in genetic, immunophenotype , molecular, and morphological features found through cytogenetic and molecular diagnostics tests.

Over the past several decades, there have been strides to increase the efficacy of treatment regimens, resulting in increased survival rates.

Chemotherapy is the initial treatment of choice, and most people with ALL receive a combination of medications.

There are no surgical options because of the body-wide distribution of the malignant cells. In general, cytotoxic chemotherapy for ALL combines multiple antileukemic drugs tailored to each person.

Chemotherapy for ALL consists of three phases: remission induction, intensification, and maintenance therapy. Must monitor closely for tumor lysis syndrome after initiating therapy.

Monitoring initial response to treatment is important as failure to show clearance of blood or bone marrow blasts within the first 2 weeks of therapy has been associated with higher risk of relapse.

Start CNS prophylaxis and administer intrathecal chemotherapy via Ommaya reservoir or multiple lumbar punctures.

Central nervous system prophylaxis can be achieved via: [46]. In Philadelphia chromosome -positive ALL, the intensity of initial induction treatment may be less than has been traditionally given.

Central nervous system relapse is treated with intrathecal administration of hydrocortisone , methotrexate, and cytarabine.

Adult chemotherapy regimens mimic those of childhood ALL; however, are linked with a higher risk of disease relapse with chemotherapy alone. B-cell ALL is often associated with cytogenetic abnormalities specifically, t 8;14 , t 2;8 and t 8;22 , which require aggressive therapy consisting of brief, high-intensity regimens.

T-cell ALL responds to cyclophosphamide-containing agents the most. As the chemotherapy regimens can be intensive and protracted, many people have an intravenous catheter inserted into a large vein termed a central venous catheter or a Hickman line , or a Portacath , usually placed near the collar bone, for lower infection risks and the long-term viability of the device.

Males usually endure a longer course of treatment than females as the testicles can act as a reservoir for the cancer.

Radiation therapy or radiotherapy is used on painful bony areas, in high disease burdens, or as part of the preparations for a bone marrow transplant total body irradiation.

Recent studies showed that CNS chemotherapy provided results as favorable but with less developmental side-effects. As a result, the use of whole-brain radiation has been more limited.

Most specialists in adult leukemia have abandoned the use of radiation therapy for CNS prophylaxis, instead using intrathecal chemotherapy.

Selection of biological targets on the basis of their combinatorial effects on the leukemic lymphoblasts can lead to clinical trials for improvement in the effects of ALL treatment.

However, this subtype of ALL is frequently resistant to the combination of chemotherapy and TKIs and allogeneic stem cell transplantation is often recommended upon relapse.

Blinatumomab , a CDCD3 bi-specific monoclonal murine antibody, currently shows promise as a novel pharmacotherapy. By engaging the CD3 T-cell with the CD19 receptor on B cells, it triggers a response to induce the release of inflammatory cytokines, cytotoxic proteins and proliferation of T cells to kill CD19 B cells.

This technology uses a single chain variable fragment scFv designed to recognize the cell surface marker CD19 as a method of treating ALL.

CD19 is a molecule found on all B-cells and can be used as a means of distinguishing the potentially malignant B-cell population.

In this therapy, mice are immunized with the CD19 antigen and produce anti-CD19 antibodies. Hybridomas developed from mouse spleen cells fused to a myeloma cell line can be developed as a source for the cDNA encoding the CD19 specific antibody.

This resulting sequence encodes the scFv. This can be cloned into a transgene , encoding what will become the endodomain of the CAR.

Varying arrangements of subunits serve as the endodomain, but they generally consist of the hinge region that attaches to the scFv, a transmembrane region, the intracellular region of a costimulatory molecule such as CD28 , and the intracellular domain of CD3 -zeta containing ITAM repeats.

Other sequences frequently included are: bb and OX In trials these have been a type of T-cell capable of cytotoxicity. Inserting the DNA into the effector cell can be accomplished by several methods.

Most commonly, this is done using a lentivirus that encodes the transgene. Pseudotyped, self-inactivating lentiviruses are an effective method for the stable insertion of a desired transgene into the target cell.

The gene-modified effector cells are then transplanted back into the person. Typically this process is done in conjunction with a conditioning regimen such as cyclophosphamide , which has been shown to potentiate the effects of infused T-cells.

This effect has been attributed to making an immunologic space within which the cells populate. In tisagenlecleucel was approved by the FDA as a CAR-T therapy for people with acute B-cell lymphoblastic leukaemia who did not respond adequately to other treatments or have relapsed.

T cells purified from each person are modified by a virus that inserts genes that encode a chimaeric antigen receptor into their DNA, one that recognizes leukemia cells.

Typically, people who experience a relapse in their ALL after initial treatment have a poorer prognosis than those who remain in complete remission after induction therapy.

It is unlikely that the recurrent leukemia will respond favorably to the standard chemotherapy regimen that was initially implemented, and instead these people should be trialed on reinduction chemotherapy followed by allogeneic bone marrow transplantation.

These people in relapse may also receive blinatumomab , as it has shown to increase remission rates and overall survival rates, without increased toxic effects.

Low dose palliative radiation may also help reduce the burden of tumor inside or outside the central nervous system and alleviate some symptoms. Recently, there has also been evidence and approval of use for dasatinib , a tyrosine kinase inhibitor.

It has shown efficacy in cases of people with Ph1-positive and imatinib -resistant ALL, but more research needs to be done on long term survival and time to relapse.

Chemotherapies or stem cell transplantations may require a platelet transfusion to prevent bleeding. It was evaluated whether mesenchymal stromal cells can be used to prevent a GvHD.

The evidence is very uncertain about the therapeutic effect of mesenchymal stromal cells to treat graft-versus-host diseases after a stem cell transplantation on the all-cause mortality and complete disappear of chronic acute graft-versus-host diseases.

Mesenchymal stromal cells may results in little to no difference in the all-cause mortality, relapse of malignant disease and incidence of acute and chronic graft-versus-host diseases if they are used for prophylactic reason.

Adding physical exercises to the standard treatment for adult patients with haematologicl malignancies like ALL may result in little to no difference in the mortality, the quality of life and the physical functioning.

These exercises may result in a slight reduction in depression. Furthermore, aerobic physical exercises probably reduce fatigue.

The evidence is very uncertain about the effect on anxiety and serious adverse events. Prior to the development of chemotherapy regimens and hematopoietic stem cell transplant, children were surviving a median length of 3 months, largely due to either infection or bleeding.

Pediatrics in Review. However, there are differing prognoses for ALL among individuals depending on a variety of factors:. Cytogenetics, the study of characteristic large changes in the chromosomes of cancer cells , is an important predictor of outcome.

These include: [17]. Unclassified ALL is considered to have an intermediate prognosis risk, [67] somewhere in-between the good and poor risk categories.

ALL affected about , people and resulted in , deaths globally in Accounting for the broad age profiles of those affected, ALL newly occurs in about 1.

Leukemia is rarely associated with pregnancy, affecting only about 1 in 10, pregnant women. Acute leukemias normally require prompt, aggressive treatment, despite significant risks of pregnancy loss and birth defects , especially if chemotherapy is given during the developmentally sensitive first trimester.

From Wikipedia, the free encyclopedia. Blood cancer characterised by overproduction of lymphoblasts. National Cancer Institute. Retrieved 20 December The New England Journal of Medicine.

Elsevier Health Sciences. Retrieved 22 November Vora, Ajay editor. Cham, Switzerland: Springer International Publishing. Mayo Clinic Proceedings.

European Journal of Cancer. October Blueprints Pediatrics. Nelson Textbook of Pediatrics 19th ed. American Society of Hematology. Education Program.

Archives of Disease in Childhood. Pediatric Clinics of North America. Blood Cancer Journal. November January February Part III. Leukemia, lymphoma and multiple myeloma, ".

Radiation Research. Bibcode : RadR.. Journal of Clinical Oncology. Nature Reviews. B Harrison's Principles of Internal Medicine 18 ed.

Merck Manual Professional. Archived from the original on 15 July