|
|
Pulmonary alveolar microlithiasis: an interesting case report with systematic review of Indian literature |
Nidhya Ganesan1(), Marie Moses Ambroise1, Anita Ramdas1, King Herald Kisku2, Kulwant Singh3, Renu G’ Boy Varghese1 |
1. Department of Pathology, Pondicherry Institute of Medical Sciences, Pondicherry 605014, India 2. Department of Pulmonary Medicine, Pondicherry Institute of Medical Sciences, Pondicherry 605014, India 3. Department of Pathology, BPS Government Medical College for Women, Sonepat, Haryana 131305, India |
|
|
Abstract Pulmonary alveolar microlithiasis is a rare disease characterized by intra-alveolar presence of microliths. This study reports an interesting case of pulmonary alveolar microlithiasis and provides a systematic review of cases reported from India. A 23-year-old female presented with a history of cough, wheeze, chest pain, and episodic wheeze for five months. Pulmonary function tests demonstrated an obstructive pattern, and chest X-ray showed fine micronodular opacities predominantly involving the middle and lower zones of both lungs. Transbronchial lung biopsy revealed the diagnosis. She responded well to inhaled steroid therapy. A systematic review of literature was performed and identified 73 cases of pulmonary alveolar microlithiasis reported from India. The mean (SD) age of the patients was 28.8 (14.9) years, with an almost equal male:female ratio. Many patients were asymptomatic at presentation. Breathlessness and cough were the most common symptoms, and the disease progressed into respiratory failure associated with cor pulmonale. About one-third of the cases were initially misdiagnosed and treated as pulmonary tuberculosis. Extra-pulmonary manifestations and co-morbidities were also evident in our series. This systematic review helps to determine epidemiological and clinical characteristics of pulmonary alveolar microlithiasis. Further research is needed to elucidate the etiopathogenesis, diagnosis, and therapeutic options, which are beneficial in developing and identifying cost-effective treatment for pulmonary alveolar microlithiasis.
|
Keywords
pulmonary alveolar microlithiasis
alveolar microlithiasis
microliths
rare diseases
|
Corresponding Author(s):
Nidhya Ganesan
|
Online First Date: 12 May 2015
Issue Date: 22 May 2015
|
|
1 |
Huqun , S Izumi, H Miyazawa, K Ishii, B Uchiyama, T Ishida, S Tanaka, R Tazawa, S Fukuyama, T Tanaka, Y Nagai, A Yokote, H Takahashi, T Fukushima, K Kobayashi, H Chiba, M Nagata, S Sakamoto, K Nakata, Y Takebayashi, Y Shimizu, K Kaneko, M Shimizu, M Kanazawa, S Abe, Y Inoue, S Takenoshita, K Yoshimura, K Kudo, T Tachibana, T Nukiwa, K Hagiwara. Mutations in the SLC34A2 gene are associated with pulmonary alveolar microlithiasis. Am J Respir Crit Care Med2007; 175(3): 263−268
https://doi.org/10.1164/rccm.200609-1274OC
pmid: 17095743
|
2 |
G Castellana, V Lamorgese. Pulmonary alveolar microlithiasis. World cases and review of the literature. Respiration2003; 70(5): 549−555
https://doi.org/10.1159/000074218
pmid: 14665786
|
3 |
R Viswanathan. Pulmonary alveolar microlithiasis. Thorax1962; 17(3): 251−256
https://doi.org/10.1136/thx.17.3.251
pmid: 13926265
|
4 |
ES Ucan, AI Keyf, R Aydilek, Z Yalcin, S Sebit, M Kudu, U Ok. Pulmonary alveolar microlithiasis: review of Turkish reports. Thorax1993; 48(2): 171−173
https://doi.org/10.1136/thx.48.2.171
pmid: 8493634
|
5 |
S Mariotta, L Guidi, M Papale, A Ricci, A Bisetti. Pulmonary alveolar microlithiasis: review of Italian reports. Eur J Epidemiol1997; 13(5): 587−590
https://doi.org/10.1023/A:1007399812798
pmid: 9258573
|
6 |
BK Bhattacharjee, R Barua, JK Duta. Pulmonary alveolar microlithiasis. Indian J Chest Dis1965; 7: 51−53
pmid: 14332631
|
7 |
JC Banerjea, A Mukerji, CR Maiti. Chronic cor pulmonale due to pulmonary alveolar microlithiasis. Indian Heart J1967; 19(1): 47−56
pmid: 6044467
|
8 |
CR Rajagopalan, KVS Krishna, M Rao, TN Babu. Pulmonary alveolar microlithiasis. Report of a case. Indian J Pediatr1967; 34(236): 328−331
https://doi.org/10.1007/BF02753067
pmid: 5586619
|
9 |
CS Rao, YM Rao, DB Reddy, D Sarada. Pulmonary alveolar microlithiasis. J Indian Med Assoc1968; 50(9): 427−428
pmid: 5666164
|
10 |
HN Khattri, JS Sodhi, JS Gujeral, BN Dutta. Microlithiasis alveolaris pulmonale. J Assoc Physicians India1971; 19(4): 335−337
pmid: 5558820
|
11 |
KV Thiruvengadam, K Arunachalam, MR Murali, AV Sarma, MG Varadarajan, BS Shetty, G Swamidasan. Pulmonary alveolar microlithiasis in a family. J Assoc Physicians India1972; 20(9): 707−712
pmid: 4654896
|
12 |
BR Prabhakar, BD Sabharwal, H Prabhakar, RS Sethl. Pulmonary alveolar microlithiasis. A case report with review of literature. Indian J Pathol Bacteriol1974; 17(3): 193−196
pmid: 4455632
|
13 |
JL Bhatia, GS Thind. Pulmonary alveolar microlithiasis. Ind J Tub1976; 23(3): 110−115
|
14 |
AS Mathur, DK Gupta, RK Garg. Pulmonary alveolar microlithiasis. Indian JRadiol1977; 31(3): 207−208
|
15 |
GS Thind, JL Bhatia. Pulmonary alveolar microlithiasis. Br J Dis Chest1978; 72(2): 151−154
https://doi.org/10.1016/0007-0971(78)90027-X
pmid: 646940
|
16 |
VP Taneja, D Sen. Pulmonary alveolar microlithiasis (case report). J Assoc Physicians India1981; 29(5): 411−414
pmid: 7298562
|
17 |
SK Gupta, VK Maini, RS Bedi. Pulmonary alveolar microlithiasis. Indian J Chest Dis Allied Sci1982; 24(1): 29−32
pmid: 7141482
|
18 |
RK Saigal, K Gupta, SK Sandhu, PK Sidhu. Pulmonary alveolar microlithiasis. (A case report.)J Postgrad Med1982; 28(4): 235−237
pmid: 7161725
|
19 |
A Chetty, VK Paul, A Kumar, DK Mitra, P Chopra. Alveolar microlithiasis—a case report with review of literature. Indian J Pediatr1983; 50(405): 453−455
https://doi.org/10.1007/BF02753391
pmid: 6671734
|
20 |
S Challa, IS Dusaj, V Kumar, R Mehrotra. Pulmonary alveolar microlithiasis. Indian J Chest Dis Allied Sci1984; 26(4): 263−266
pmid: 6545268
|
21 |
NatrajaIyer K. Sasikumar S, Devi SS. Pulmonary alveolar microlithiasis- a case report. Indian J Radiol1986; 40(1): 63−65
|
22 |
P Bhadur, ML Seetharaman, H Krishnamurthy. Pulmonary alveolar microlithiasis — a case report. Lung India1987; 5(4): 187−188
|
23 |
K Pant, R Chawla, SK Chhabra, SK Jain, GB Malik, SN Gaur. Pulmonary alveolar microlithiasis—a case report and review of literature. Indian J Chest Dis Allied Sci1988; 30(2): 141−147
pmid: 3066751
|
24 |
JS Swarnkar, TD Wakodkar, SK Kirolikar, RK Diwakar. Pulmonary alveolar microlithiasis— a report of two cases. Lung India1989; 7(3): 140−142
|
25 |
J Venkateswarlu, P Waghray, K Subbarao, LT Kishore, M Subbalakshmi. pleural calcification in pulmonary alveolar microlithiasis − a case report. Lung India1989; 7(3): 143−145
|
26 |
K Pant, A Shah, RK Mathur, SK Chhabra, SK Jain. Pulmonary alveolar microlithiasis with pleural calcification and nephrolithiasis. Chest1990; 98(1): 245−246
https://doi.org/10.1378/chest.98.1.245
pmid: 2131786
|
27 |
SD Rao, S Rekha, MK Chandrasekhara, N Shetty, Srikrishna. Pulmonary alveolar microlithiasis in siblings. Indian Pediatr1991; 28(10): 1206−1210
pmid: 1797680
|
28 |
SK Sharma, S Sharma, S Mukhopadhyaya, AK Padhy, M Vijayraghavan. Pulmonary alveolar microlithiasis–report of three cases with pulmonary function and exercise studies. Indian J Chest Dis Allied Sci1992; 34(4): 205−215
pmid: 1302754
|
29 |
MK Babu, KR Kumar, JA Thomas. Pulmonary alveolar microlithiasis. Indian J Pathol Microbiol1992; 35(2): 149−152
pmid: 1483718
|
30 |
B Malhotra, BM Kailan. Pulmonary alveolarmicrolithiasis–a case report. Ind J Tub1993; 40(1): 31−33
|
31 |
PR Malur, K Ajay, N Jayaram. Alveolar microlithiasis–report of two cases. Indian J Pathol Microbiol1993; 36(2): 163−167
pmid: 8276482
|
32 |
A Boghani, K Kumaresan, C Sundaram, G Bhaskar. Pulmonary alveolar microlithiasis revisited with CT scan, bone scan and broncho-alveolar lavage. Lung India1993; 11(2): 37−39
|
33 |
GS Gaude, MJW Pinto, AS Bagga. Pneumothorax in pulmonary alveolar microlithiasis: a case report. Antiseptic1994; 91(4): 135−136
|
34 |
NK Singh, A Gupta. Pulmonary alveolar microlithiasis. J Assoc Physicians India1995; 43(9): 647−648
pmid: 8773074
|
35 |
S Kashyap, M Kumar, LS Pal. Pulmonary alveolar microlithiasis in a Himachali woman. J Assoc Physicians India1996; 44(1): 56−57
pmid: 8773098
|
36 |
R Chatterji, GS Gaude, PV Patil. Pulmonary alveolar microlithiasis: diagnosed by sputum examination and transbronchial biopsy. Indian J Chest Dis Allied Sci1997; 39(4): 263−267
pmid: 9654825
|
37 |
B Vidyasagar, SD Ranjana, R Jayan, KL NagarajaSetty, GS Shivalingappa. Pulmonary alveolar microlithiasis. Lung India1998; 16(2): 80−82
|
38 |
MK Dwivedi, RK Pal, PB Borkar. Pulmonary alveolar microlithiasis. Indian J Radiol Imaging1999; 9(4): 195−196
|
39 |
HS Hira, T Singh, V Chowdhary. Pulmonary alveolar microlithiasis: role of transbronchial lung biopsy. J Assoc Physicians India2000; 48(8): 832−833
pmid: 11273481
|
40 |
D Gupta, AN Aggarwal, SK Jindal. Lung static pressure- volume analysis can demonstrate alveolar involvement in pulmonary alveolar microlithiasis. Lung India2000; 18(2): 64−65
|
41 |
MS Shah, KJ Nanavati, A Airon, RR Shah, BD Joshi. Case report— pulmonary alveolar microlithiasis. Indian J Radiol Imaging2003; 13(3): 277−279
|
42 |
B Bhalotra, A Gogia, P Gupta, N Jain. A pulmonary snowstorm. Med J Aust2004; 180(9): 454
pmid: 15179944
|
43 |
SS Patro, CR Kar. Pulmonary alveolar microlithiasis. Indian J Radiol Imaging2006; 16(4): 879−881
https://doi.org/10.4103/0971-3026.32373
|
44 |
J Unnithan. Nandagopal. A rare case of pulmonary alveolar microlithiasis. Pulmon2006; 8(1): 27−29
|
45 |
S Mitra, AG Ghoshal. A family of pulmonary alveolar microlithiasis— a case report. Lung India2000; 18(3): 97−100
|
46 |
J Hephzibah, R Oommen, B Mugesh, J Pradhip. Pulmonary alveolar microlithiasis scinitigraphic features. Internet J Pulmonol Med2006; 9(1):12504
|
47 |
R Thapa, D Ganguly, A Ghosh. Pulmonary alveolar microlithiasis in siblings. Indian Pediatr2008; 45(2): 154−156
pmid: 18310798
|
48 |
S Chandra, A Mohan, R Guleria, P Das, C. SarkarPulmonary alveolar microlithiasis. BMJ Case Rep2009; 2009: bcr09.2008.1012
https://doi.org/10.1136/bcr.09.2008.1012
|
49 |
B Malhotra, R Sabharwal, M Singh, A Singh. Pulmonary alveolar microlithiasis with calcified pleural plaques. Lung India2010; 27(4): 250−252
https://doi.org/10.4103/0970-2113.71967
pmid: 21139727
|
50 |
HJ Gayathri Devi, KN Mohan Rao, KM Prathima, JK Das. Pulmonary alveolar microlithiasis. Lung India2011; 28(2): 139−141
https://doi.org/10.4103/0970-2113.80334
pmid: 21712928
|
51 |
M Shah, JM Joshi. Bone scintigraphy in pulmonary alveolar microlithiasis. Indian J Chest Dis Allied Sci2011; 53(4): 221−223
pmid: 22128621
|
52 |
B Gayathri, S Keerthivasan. Pulmonary alveolar microlithiasis. J Med2011; 12(1): 55−57
https://doi.org/10.3329/jom.v12i1.6111
|
53 |
P Sonwalkar, M Karthik, NS Vishal, M Praveen, MM Patil. Pulmonary alveolar microlithiasis. JCDR2012; 6(7): 1296−1297
|
54 |
R Galhotra, K Gupta. Images–pulmonary alveolar microlithiasis (PAM). J Pulmon Resp Med2012; 2: 124
https://doi.org/10.4172/2161-105X.1000124
|
55 |
A Flynn, AD Agastyaraju. Pulmonary alveolar microlithiasis. Int J Case Rep Images2013; 4(2): 108−110
|
56 |
MK Sahoo, S Karunanithi, CS Bal. Pulmonary alveolar microlithiasis: imaging characteristics of planar and SPECT/CT bone scan versus 18F-FDG and 18F-sodium fluoride PET/CT scanning. Jpn J Radiol2013; 31(11): 766−769
https://doi.org/10.1007/s11604-013-0250-4
pmid: 24085587
|
57 |
PR Caffrey, RS Altman. Pulmonary alveolar microlithiasis occurring in premature twins. J Pediatr1965; 66(4): 758−763
https://doi.org/10.1016/S0022-3476(65)80012-9
pmid: 14271368
|
58 |
S Mariotta, A Ricci, M Papale, F De Clementi, B Sposato, L Guidi, F Mannino. Pulmonary alveolar microlithiasis: report on 576 cases published in the literature. Sarcoidosis Vasc Diffuse Lung Dis2004; 21(3): 173−181
pmid: 15554073
|
59 |
G Castellana, M Gentile, R Castellana, P Fiorente, V Lamorgese. Pulmonary alveolar microlithiasis: clinical features, evolution of the phenotype, and review of the literature. Am J Med Genet2002; 111(2): 220−224
https://doi.org/10.1002/ajmg.10530
pmid: 12210357
|
60 |
A Corut, A Senyigit, SA Ugur, S Altin, U Ozcelik, H Calisir, Z Yildirim, A Gocmen, A Tolun. Mutations in SLC34A2 cause pulmonary alveolar microlithiasis and are possibly associated with testicular microlithiasis. Am J Hum Genet2006; 79(4): 650−656
https://doi.org/10.1086/508263
pmid: 16960801
|
61 |
OT Dogan, SL Ozsahin, E Gul, S Arslan, B Koksal, S Berk, O Ozdemir, I Akkurt. A frame-shift mutation in the SLC34A2 gene in three patients with pulmonary alveolar microlithiasis in an inbred family. Intern Med2010; 49(1): 45−49
https://doi.org/10.2169/internalmedicine.49.2702
pmid: 20046000
|
62 |
T Terada. Pulmonary alveolar microlithiasis with cor pulmonale: an autopsy case demonstrating a marked decrease in pulmonary vascular beds. Respir Med2009; 103(11): 1768−1771
https://doi.org/10.1016/j.rmed.2009.05.015
pmid: 19523797
|
63 |
AG Chalmers, J Wyatt, PJ Robinson. Computed tomographic and pathological findings in pulmonary alveolar microlithiasis. Br J Radiol1986; 59(700): 408−411
https://doi.org/10.1259/0007-1285-59-700-408
pmid: 3697621
|
64 |
VM Lauta. Pulmonary alveolar microlithiasis: an overview of clinical and pathological features together with possible therapies. Respir Med2003; 97(10): 1081−1085
https://doi.org/10.1016/S0954-6111(03)00140-9
pmid: 14561014
|
65 |
MR Sears, AR Chang, AJ Taylor. Pulmonary alveolar microlithiasis. Thorax1971; 26(6): 704−711
https://doi.org/10.1136/thx.26.6.704
pmid: 5144648
|
66 |
CA Moran, L Hochholzer, PS Hasleton, FB Johnson, MN Koss. Pulmonary alveolar microlithiasis. A clinicopathologic and chemical analysis of seven cases. Arch Pathol Lab Med1997; 121(6): 607−611
pmid: 9199627
|
67 |
BH Mascie-Taylor, AG Wardman, CA Madden, RL Page. A case of alveolar microlithiasis: observation over 22 years and recovery of material by lavage. Thorax1985; 40(12): 952−953
https://doi.org/10.1136/thx.40.12.952
pmid: 4095678
|
68 |
F Kanat, T Teke, O Imecik. Pulmonary alveolar microlithiasis with epididymal and periurethral calcifications causing obstructive azospermia. Int J Tuberc Lung Dis2004; 8(10): 1275
pmid: 15527164
|
69 |
A Arslan, T Yalin, H Akan, U Belet. Pulmonary alveolar microlithiasis associated with calcifications in the seminal vesicles. J Belge Radiol1996; 79(3): 118−119
pmid: 8765074
|
70 |
T Coetzee. Pulmonary alveolar microlithiasis with involvement of the sympathetic nervous system and gonads. Thorax1970; 25(5): 637−642
https://doi.org/10.1136/thx.25.5.637
pmid: 5489192
|
71 |
R Yesner, AB Skorneck. Pulmonary alveolar microlithiasis in mitral stenosis. Am J Pathol1956; 32(3): 611
|
72 |
H Schmidt, U Lörcher, R Kitz, S Zielen, P Ahrens, R König. Pulmonary alveolar microlithiasis in children. Pediatr Radiol1996; 26(1): 33−36
https://doi.org/10.1007/BF01403701
pmid: 8598991
|
73 |
FA Ratjen, B Schoenfeld, HG Wiesemann. Pulmonary alveolar microlithiasis and lymphocytic interstitial pneumonitis in a ten year old girl. Eur Respir J1992; 5(10): 1283−1285
pmid: 1486977
|
74 |
LM Portnoy, B Amadeo, GR Hennigar. Pulmonary alveolar microlithiasis: an unusual case (associated with milk alkali syndrome). Am J Clin Pathol1964; 41(2): 194−201
pmid: 14124680
|
75 |
DA Ritchie, SA O’Connor, D McGivern. An unusual presentation of pulmonary alveolar microlithiasis and diaphyseal aclasia. Br J Radiol1992; 65(770): 178−181
https://doi.org/10.1259/0007-1285-65-770-178
pmid: 1540813
|
76 |
F Giallauria, G Giallauria. Pulmonary alveolar microlithiasis. Thorax2011; 66(9): 840
https://doi.org/10.1136/thx.2011.159137
pmid: 21551211
|
77 |
EL Gasparetto, P Tazoniero, DL Escuissato, E Marchiori, RL Frare E Silva, D Sakamoto. Pulmonary alveolar microlithiasis presenting with crazy-paving pattern on high resolution CT. Br J Radiol2004; 77(923): 974−976
https://doi.org/10.1259/bjr/96331922
pmid: 15507428
|
78 |
E Marchiori, CM Gonçalves, DL Escuissato, KI Teixeira, R Rodrigues, MM Barreto, M Esteves. Pulmonary alveolar microlithiasis: high-resolution computed tomography findings in 10 patients. J Bras Pneumol2007; 33(5): 552−557
pmid: 18026653
|
79 |
NA Siddiqui, CR Fuhrman. Best cases from the AFIP: pulmonary alveolar microlithiasis. Radiographics2011; 31(2): 585−590
https://doi.org/10.1148/rg.312105157
pmid: 21415198
|
80 |
H Sumikawa, T Johkoh, N Tomiyama, S Hamada, M Koyama, M Tsubamoto, S Murai, A Inoue, H Nakamura, T Tachibana, NL Müller. Pulmonary alveolar microlithiasis: CT and pathologic findings in 10 patients. Monaldi Arch Chest Dis2005; 63(1): 59−64
pmid: 16035566
|
81 |
J Brown, W Leon, C Felton. Hemodynamic and pulmonary studies in pulmonary alveolar microlithiasis. Am J Med1984; 77(1): 176−178
https://doi.org/10.1016/0002-9343(84)90457-1
pmid: 6741979
|
82 |
M Dahabreh, A Najada. Pulmonary alveolar microlithiasis in an 8-month-old infant. Ann Trop Paediatr2009; 29(1): 55−59
https://doi.org/10.1179/146532809X402042
pmid: 19222936
|
83 |
MI Yilmaz, B Koc, M Kantarcioglu, SB Akinci, H Ayta, F Bulucu, S Bal. Pulmonary alveolar microlithiasis after Varicella zoster infection in a patient presenting with antiphospholipid syndrome and discoid lupus. Rheumatol Int2002; 22(5): 213−215
https://doi.org/10.1007/s00296-002-0209-8
pmid: 12215869
|
84 |
U Ozcelik, E Yalcin, M Arıyurek, DD Ersoz, G Cinel, B Gulhan, N Kiper. Long-term results of disodium etidronate treatment in pulmonary alveolar microlithiasis. Pediatr Pulmonol2010; 45(5): 514−517
pmid: 20425862
|
85 |
S Jankovic, N Pavlov, A Ivkosic, I Erceg, M Glavina-Durdov, J Tocilj, S Dragisic-Ivulic, D Primorac. Pulmonary alveolar microlithiasis in childhood: clinical and radiological follow-up. Pediatr Pulmonol2002; 34(5): 384−387
https://doi.org/10.1002/ppul.10183
pmid: 12357485
|
86 |
N Shigemura, C Bermudez, BG Hattler, B Johnson, M Crespo, J Pilewski, Y Toyoda. Lung transplantation for pulmonary alveolar microlithiasis. J Thorac Cardiovasc Surg2010; 139(3): e50−e52
https://doi.org/10.1016/j.jtcvs.2008.07.066
pmid: 19660326
|
87 |
R Borrelli, A Fossi, L Volterrani, L Voltolini. Right single-lung transplantation for pulmonary alveolar microlithiasis. Eur J Cardiothorac Surg2014; 45(2): e40
https://doi.org/10.1093/ejcts/ezt531
pmid: 24258203
|
88 |
JD Edelman, J Bavaria, LR Kaiser, LA Litzky, HI Palevsky, RM Kotloff. Bilateral sequential lung transplantation for pulmonary alveolar microlithiasis. Chest1997; 112(4): 1140−1144
https://doi.org/10.1378/chest.112.4.1140
pmid: 9377936
|
89 |
MN Samano, DR Waisberg, M Canzian, SV Campos, PM Pêgo-Fernandes, FB Jatene. Lung transplantation for pulmonary alveolar microlithiasis: a case report. Clinics (Sao Paulo)2010; 65(2): 233−236
https://doi.org/10.1590/S1807-59322010000200016
pmid: 20186308
|
90 |
X Yin, H Wang, D Wu, G Zhao, J Shao, Y Dai. SLC34A2 Gene mutation of pulmonary alveolar microlithiasis: report of four cases and review of literatures. Respir Med2013; 107(2): 217−222
https://doi.org/10.1016/j.rmed.2012.10.016
pmid: 23164546
|
91 |
H Olauson, V Brandenburg, TE Larsson. Mutation analysis and serum FGF23 level in a patient with pulmonary alveolar microlithiasis. Endocrine2010; 37(2): 244−248
https://doi.org/10.1007/s12020-009-9299-3
pmid: 20960258
|
92 |
H Takahashi, H Chiba, M Shiratori, T Tachibana, S Abe. Elevated serum surfactant protein A and D in pulmonary alveolar microlithiasis. Respirology2006; 11(3): 330−333
https://doi.org/10.1111/j.1440-1843.2006.00844.x
pmid: 16635094
|
|
Viewed |
|
|
|
Full text
|
|
|
|
|
Abstract
|
|
|
|
|
Cited |
|
|
|
|
|
Shared |
|
|
|
|
|
Discussed |
|
|
|
|