Bellevue OutpatientSurgery.net > Spinal Surgery 2007 > Table Of Contents
org Tags: Category: Views: 108 Comments: 0 Added: Jul 22, 08 By: 03:19 Spinal Cord Rehabilitation is a very involved process with many different steps, this video breaks down these different steps and explains the different teams involved in the rehabilitation process.
In Bellevue, SMP typically causes burning, tingling, jolting and electrical sensations in the affected area.
Other activity restrictions may apply.
In Bellevue, A former Chief of Neurological Surgery at San Francisco General Hospital (SFGH) and a principal investigator in the Brain and Spinal Injury Center (BASIC), Dr.
In Bellevue, that may also lead to .
Pain medications can be very powerful and effective.
In Bellevue, Level of injury and extent and extent of paralysis The extent of paralysis depends on the level and severity of the injury to the spinal cord.
This is a more invasive surgery, and takes weeks of recovery.
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Choosing laminectomy or laminotomy depends on the location and severity of the disease.
The new ACL is then secured with a specialized headless screw in each tunnel.
In Bellevue, Some people only stay overnight, while others must stay in much longer.
The surgery is not considered appropriate for patients suffering from spinal instabilities such as scoliosis or nerve damage from past surgeries.
A patient may expect low-back surgery will restore them to a pain-free, youthful existence," he notes, "but that's unreasonable.
specializes in Comprehensive Shoulder Surgery, Sports Medicine, and Arthroscopic Surgery of the Knee, Hip and Elbow.
There was little evidence of harm from either treatment.
This is called a “sublabial” approach.
Spasticity and Surgical Interventions Spasticity or spasms are spontaneous, involuntary, uncoordinated reflex movements of muscles, which can occur following spinal cord injury.
A disc prolapse happens when much pressure is put on the disc and the gelatinous centre bursts out of the coating.
In order for it to be successful there has to be good evidence of nerve and/or spinal cord compression in the neck (preferably with an MRI scan), pain, weakness, or numbness in the arm corresponding to the MRI findings, no evidence of superimposed carpal tunnel syndrome or ulnar nerve compression, and clinical evidence of cervical myelopathy in some cases This picture seen also in the 'arm pain' section although in this case demonstrates a compressed cervical nerve root and the spinal cord due to a prolapsed cervical disc (upper arrow) and 'wear and tear' changes also called cervical spondylosis (lower arrow) When performing an anterior cervical decompression, the entire cervical disc and the excess bone formed by wear and tear in the spine is removed in the region of the upper red arrow.
After two weeks of consistent therapy and sessions on the decompression table, I began to get my mobility back.
Bellevue Fondren Othopedic Group
We are now going to go see a Chiropractor and see what they say.
Most patients with prolactinomas are treated by endocrinologists, who are medical specialists, rather than neurosurgeons.
General Info: Specialties: Locations: Fax: 818-901-6683 Extensions: Practice Coordinator: 818-901-6600 x 3201 Workers' Comp: Yes QME: Yes Spine General Orthopedics Qualified Medical Examinations Independent Medical Examinations Ankle Knee Shoulder Sports Medicine Traumatic Injuries Valencia Phone: 661-254-6364 Fax: 661-254-6787 23929 McBean Parkway #200 Valencia, CA, 91355 Van Nuys Phone: 818-901-6600 Fax: 818-901-6680 6815 Noble Avenue Van Nuys, CA, 91405 | | | | | | | | | | | | | | | | Material on this website copyright ©2008 Southern California Orthopedic Institute.
| The possibility of spinal cord trauma should be considered in anyone who has been in a severe automobile accident or who has experienced significant injury to the head or neck.
" An educational community meeting will be from 6 to 8 p.
"Restless legs syndrome arising after surgery probably has more to do with the surgery itself or with the forced immobilization in the hospital," Crozier said.
• In certain, very specific instances injection of facet joints or epidural injections can help but surgery may ultimately prove to be the only recourse to alleviate the discomfort.
Figures 10 and 11 show the "Pain Doc" that programs multiple programs used with ANS equipment and N'Vision, a hand-held programmer from Medtronic, Inc.
In Bellevue, Any unexplained problems with surgery, watery eyes, sneezing or wheezing while playing with balloons may be due to a latex allergy.
Bellevue Compression of the Spinal Cord: Spinal Cord Disorders: Merck Manual Home Edition
8 months after surgery.
Pressure on the cervical spinal cord can affect the nerves that control your balance, resulting in clumsiness or a tendency to fall.
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In Bellevue, Patients of all ages come to us for comprehensive care for the full spectrum of neck and back disorders.
In Bellevue, This secondary cascade of spinal cord injury, he says, can be reduced.
In Bellevue, Nonsurgical treatment often works to allow most normal activity and relieve mild to moderate symptoms of pain, numbness, and weakness in the legs.
In Bellevue, TIMOTHY JOHNSON May 23, 2006 FONT SIZE The likelihood of having back surgery in the United States is 40 percent higher than in any other country, and five times higher than in the United Kingdom.
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In Bellevue, Research areas include differentiating drugs, osmotic blood-brain barrier disruption, and convection enhanced delivery.
In Bellevue, Perform radiosurgery dose planning.
This is an open defect in the back with elements of spinal cord visualized at the skin.
In Bellevue, You will most likely begin getting out of bed and walking the evening of your surgery.
In Bellevue, Spinal fusion Spinal fusion is a procedure which is done in order to support a weak spine and/or to prevent painful movements.
In Bellevue, The relationship he had with his patients and how people treated him was always amazing to me.
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If you suffer from a herniated disc, sciatica or degenerative disc disease, you may be a candidate for spinal decompression therapy: a non-invasive procedure specialized by Dr.
Researchers are studying the effectiveness of these transplants in protecting blood cells in children with certain types of CNS tumors and in other patients with recurrent or hard to treat CNS cancer, who receive higher than normal doses of chemotherapy.
In addition to caring for your incision(s), you will also be encouraged to: Drink plenty of fluids Maintain a healthy diet (high in protein) Walk or do deep-breathing exercises, and Gradually increase your physical activity.
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In Bellevue, He is highly skilled with these types of surgeries and can use new tools such as BMPs to further enhance the likelihood of a successful fusion being achieved.
Fortunately, there is a new option in sciatica symptom relief that has a high success rate and a very low risk of side-effects.
Call your health care provider if persistent, severe back pain develops, especially if you have any numbness, loss of movement, weakness, or bowel or bladder changes.
Stenosis in the upper part of the spinal cord is called cervical spinal stenosis.
In Bellevue, The fourth trocar is used for the introduction of the interbody devices; it is always inserted at a suprapubic site.
Patellar tendon, hamstring tendon, or Achilles tendon allografts can be used as tissues inserted and fixed with the same techniques that are used for autografts (grafts using the individual's own tissue).
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Degenerative changes.
In Bellevue, It often occurs down both legs (although one leg is usually worse) and is often associated with numbness, burning and leg weakness.
Next, the bony lamina is removed with a drill or bone-biting tools.
Unlike the patellar tendon, the hamstring tendons do not grow back after graft harvest resulting in a slight loss in hamstring strength (approximately.
Spinal fusion involves placing bone graft between two or more opposing vertebrae to promote bone growth between the vertebral bodies.
In Bellevue, The procedure is minimally invasive and can significantly reduce spinal pain caused by cancer or .
The most common reasons are myocardial infarct (heart attack) due to the stress of the surgery, a rare reaction to a drug (anaphylaxis) or pulmonary embolus.
In Bellevue, Roth performs more than 400 microspinal surgeries annually.
Intervertebral disk Between each vertebra is an elastic pad of cartilage called an intervertebral disk.
In Bellevue, This surgery center was in the doctors' minds as a excellent place to expand to.
It is our job to find out the exact cause of the pain in each patient.
In Bellevue, This allows doctors to monitor the individual’s speech and motor functions as a tumor is being removed.
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If, however, the electrophysiologic monitoring seems to be inaccurate or it is unclear whether or not the signals being obtained are accurate, the wake-up test will be performed towards the end of the surgical procedure after the instrumentation is in place.
In recent years, a new development -- bone morphogenic proteins -- has eliminated these risks for some people undergoing spinal fusion.
By | Published 12/8/2005 | Here you'll find a personal account and valuable information on living with cervical spinal stenosis.
Notify your physician of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.
For those with sciatica persisting at six months or increasing, refractory leg pain or neurologic deficits at any point, microdiskectomy was offered.
However, since disruptions along the optic nerve path can result in vision loss, neural monitoring is necessary to reduce the chance of nerve damage.
In Bellevue, ? Incomplete surgery ? inadequate treatment may result in a continuation of symptoms.
Following cervical foramenotomy: You are encouraged to walk on the day after the surgery, and not uncommonly on the day of the surgery.
Alterations in brain blood flow - such as subdural haematoma, subarachnoid haemorrhage and intraventricular bleed.
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The manufacture of a product generally has the most complete information about that product.
Robert Shaw, MD, Rheumatologist Q: As a young adult I had RA, which went into remission.
In Bellevue, For example, L1 is the first vertebra in the lumbar region.
In Bellevue, Although minimally invasive procedures may impart less trauma, patients should realize they are still undergoing spinal surgery and as with all surgeries there is associated risk.
In Bellevue, At Good Samaritan, our oral surgeons interact with other medical specialists on patient-to-patient basis to insure that all aspects of a patient’s other conditions are properly addressed.
In adults, surgery to free (detether) the spinal cord can reduce the size and further development of cysts in the cord and may restore some function or alleviate other symptoms.
Many of the terms discussed here are also defined in the SpineCare glossary and illustrated in the section on anatomy.
Risks Spinal fusion carries a risk of nerve damage.
Following a recommended exercise program before and after surgery.
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In Bellevue, Spinal fusion might relieve your pain and make it easier for you to move around (improve function).
Nonsurgical treatment does not relieve pain, and severe nerve compression symptoms of spinal stenosis (such as numbness or weakness) are getting worse.
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The procedure, known as axial lumbar interbody fusion, or AxiaLF, is performed through one or two small, one-inch incisions in the lower back, as compared with a five- to six-inch incision used in the traditional surgery.
I earned my medical degree from The University of Pennsylvania in 1986.
Animations and illustrations that explain spine conditions and treatment procedures.
In Bellevue, · About 250,000 Americans have surgery to relieve herniated discs annually.
? If you have any questions about spinal stenosis and your surgery.
Myelogram - a liquid dye is injected into the spinal column and appears white against bone on an x-ray film.
This video has been added to your .
com) -- When scientists need to detect and analyze DNA, or traces of a bioweapon or maybe an environmental contaminant, there's a good chance they'll turn to a lab technique called electrophoresis?or one of its many .
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In Bellevue, - BAULOT E, TROUILLOUD P, RAGOIS P, GIROUX EA, GRAMMONT P, La spondylodese anterieure sous thoracoscopie: une technique atraumatique.
In Bellevue, Trauma The senior level resident will be able to: Perform the following surgeries in uncomplicated and complicated cases- craniotomy for SDH, EDH, ICH, GSW, depressed fractures, posterior fossa lesions.
Curvatures of 25 to 40 degrees in adults and children may require a back brace, however, most individuals require no treatment.
In Bellevue, In the case of most spinal curves, the spine is not only bent but twisted like a corkscrew.
In Bellevue, In an open MRI, the sides are open.
In Bellevue, Degenerative changes related to aging, such as osteoarthritis, are the main cause of spinal stenosis.
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This scoliosis often is associated with kyphosis, which is significant for two main reasons.
One new type of spinal procedure that is being used more often to treat spinal back due to tumors is called .
The physician will make an incision over the selected vertebra.
Just as in lumbar discectomy, there are non-operative options that include any or all of the following, and these should be aggressively pursued to try and expedite improvement in symptoms.
In Bellevue, Once you feel comfortable with your doctor, you will feel more comfortable with the procedure.
A urinary catheter may be inserted.
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If the doctor uses a posterior approach,then a pedicle screw system is used to stabilize the spine while it fuses and heals.
Review provided by VeriMed Healthcare Network.
Another consequence of the compromised integrity of the vertebr?¿¦ in patients with skeletal dysplasia is that children may need postoperative bracing despite the use of internal spinal fixation.
In Bellevue, The cages are packed with bone morphogenic protein (BMP), a hormonal substance that stimulates bone growth and allows more rapid fusion of the spine.
ABC News: Back Surgery Not Always the Cure for Pain | | | | | | | | | | | | | | | | | | | | Watch Live > > Back Surgery Not Always the Cure for Pain U.
In Bellevue, After the operation is performed, the average patient suffers a 25% reduction in their spinal ranges of motion5.
In Bellevue, Whether you have a serious condition, such as herniated discs, or just a simple case of back and neck pain, you can now turn your back on surgery with Synergy Chiropractic Wellness Center.
CSM is the most common cause of spinal cord dysfunction in adults older than 55 years.
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Some systems need preparatory pump priming with preservatives or by auto blood transfusions (blood taken from the patient themselves and stored prior to the operation.
In Bellevue, Jeffrey Coe Welcome! Copyright © 2003-2007, Jeffrey D.
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This is why experts at Progressive Medical Center of America, like Dr.
This is done when it is felt that the movement is counterproductive or even dangerous for the patient.
"I had heard a lot about Dr.
In Bellevue, Usually caused by compression of the 5th lumbar spinal nerve.
Just as the tumor can produce an excess of a single pituitary hormone, a deficiency of the other pituitary hormones can arise as a result of compression of the normal pituitary gland by the tumor.
A local anesthetic is applied to numb the skin and the tissue down to the surface of the bone.
· Six patients were discharged in one to two days after surgery, and the rest by post-operative day three.
Bellevue News - Surgery Helps Cancer Patients With Spinal-Cord Compressions to Remain Mobile: Presented at ASTRO
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In Bellevue, In addition to our ongoing research endeavors, members of our division are actively involved in professional organizations such as: the North American Spine Society, the Scoliosis Research Society, and the American Academy of Orthopaedic Surgery.
In Bellevue, 00 Quantity Buy Now Product Code: 001431 £185.
Scar tissue is less, trauma is less, and therefore we can usually solve the problem without making things worse.
In Bellevue, Myelography also can be diagnostic, by revealing a narrow dye column or a complete blockage in advanced forms.
Your use of this information means that you agree to the .
Bellevue iScoliosis.com - Treatment Options - Surgical - Anterior & Posterior Approach
Again, specific recommendations are tailored to the patient.
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For some people, recovery can take weeks or months and may require long-term physical therapy.
Most normal vertebral body end-plates do not have any Modic changes.
In most cases, the surgery may allow you to enjoy improved lifestyle marked with decreased pain and a more stable spine.
In Bellevue, We took her back to the vet where our vet there prescribed Rimadyl to be administered 48 hrs.
Sitting Position In Your Car Back to Sex Being careful about your back does not necessarily mean you cannot enjoy sexual activity.
In Bellevue, The procedure is performed while you are under general anesthesia (unconscious and pain-free).
It has robbed me of my life, my daily living so I would definitely.
In Bellevue, He was in severe pain and couldn't move his arms.
In Bellevue, Laminectomy may also be used in cases of spinal stenosis in which the entire canal is narrowed like a ring on a swollen finger, squeezing all of the nerve roots at that level of the spinal canal.
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In Bellevue, Potential Benefits Most importantly, when fusion surgery is performed, although your pain symptoms may go away, the vertebrae surrounding the disc space are immobilized and therefore typically limit flexibility in that area of the spine.
The University of Maryland School of Medicine Replay of: Webcast on Posterior Lumbar Decompression and Fusion with Instrumentation and Bone Graft First Seen CME Live Webcast: Tuesday, September 21, 2004, 5:30 pm EDT (21:30 UTC) The University of Maryland Medical Center Baltimore, MD- On Tuesday, Sept.
The polyethylene already had pits, abrasions and cracks in the surface.
13 (above): The 6 mm endoscope is now passed through the ventriculostomy to enlarge the stoma.
May 29, 2006 Trinity physician first in Iowa Quad-Cities to perform breakthrough back surgery Dr.
, discusses balloon sinuplasty technology.
The TPS provides immediate stability allowing early mobilization without the need for external orthosis.
Links to other sites are provided for information only -- they do not constitute endorsements of those other sites.
) Cervical and Thoracic Stenosis Congenital stenosis of the cervical spine may predispose an individual to myelopathy as a result of minor trauma or spondylosis.
The pain is too severe to cope with in the short term, e.
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During your head, neck or spinal surgery, a specially trained neurotechnologist (NT) from ORIMtec will continuously monitor (or check) your nervous system.
In Bellevue, Figure 14: The sacroiliac joint Sympathetic nervous system blocks The nervous system of our body is divided into two very separate nervous systems, one system that we can voluntarily control (ie, the system that controls the use of our arms, hands, legs, feet, and our facial expressions) and another system that we have no control over (ie, the system that controls bodily functions such as blood flow, heart function).
In Bellevue, Additionally, stop smoking, chewing tobacco, and drinking alcohol one week before and 2 weeks after surgery as these activities can cause bleeding problems.
In Bellevue, Now here's the rub: NON-SPECIALISTIC care is ineffective, pseudo-symptomatic, and clinically false.
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In Bellevue, We center our practice on the utmost respect of the patient and the patient's best interest by offering invasive and non-invasive procedures targeted toward positive spine health.
In Bellevue, The initial two-year analysis indicates that decompressive surgery without fusion for spinal stenosis offers good value and that fusion surgery for spondylolithesis offers less value for its cost than most accepted interventions.
Fusion of the interdiscal space following decompression is done to provide support to an unstable area.
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Jon Group was a patient himself.
Print copies: Available from the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), 11300 W.
Once this occurs, the compression fracture cannot be treated effectively.
In Bellevue, Vertebrae are the bones that stack up to form the spine.
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Credit to the NINDS or the NIH is appreciated.
In this case, keyhole craniotomies were able to be performed through limited incisions which facilitated the removal of multiple lesions at single sittings.
In Bellevue, Where We Are Click to view our locations and get directions.
Surgery should only be considered when your doctor is sure the narrowing is causing your problem.
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org Tags: Category: Views: 108 Comments: 0 Added: Jul 22, 08 By: 03:19 Spinal Cord Rehabilitation is a very involved process with many different steps, this video breaks down these different steps and explains the different teams involved in the rehabilitation process.
Trinitas is also the sixth hospital in the United States to feature this surgical option, which uses advanced software and a mobile robotic device to guide the surgeon in the precise placement of surgical screws in the spine.
A disk may be displaced or damaged because of injury or wear and tear.
In Bellevue, Risks Risks for any anesthesia include the following: Reactions to medications Problems breathing Risks for any surgery include the following: Bleeding Additional risks of spinal surgery include the following: Nerve damage leading to Muscle weakness Loss of bowel or bladder control Expectations after surgery The outcome depends on what is causing the problem.
Suite 430 Encino, CA 91316 If you are experiencing back pain, you may be suffering from a condition known as Sciatica.
This fast, noninvasive, painless procedure is usually performed in a doctor?s office or at a clinic.
In the past, many spine patients were required to wear heavy plaster casts.
Arthroscopy and outpatient treatment are the future of surgery.
It also contain millions of tiny pores that the patient's own bone cells can bind to, strengthening the new joint.
cartilage - a type of tissue that covers the surface of a bone at a joint.
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Either one can be treated effectively with surgery.
In Bellevue, Many levels may need to be fused from the front of the spine when performing surgery for complex problems such as scoliosis.
In Bellevue, Recovery time can be from one to six months, depending on the procedure and severity of injury.
Patient Profile: Specialty Surgery/Spinal Microsurgery Physician Finder Patient Profile: Specialty Surgery/Spinal Microsurgery Spinal microsurgery gets patients back into action quickly Not too long ago, outpatient surgical repair of herniated discs and other degenerative disc diseases through a one-inch incision was unimaginable to all but a few.
Their study found that patients over the age of 69 are about nine times more likely to suffer complications.
In Bellevue, The patient´s chest harness was attached and tightened to the table.
"I was not my carefree self and telling jokes like I normally do.
In Bellevue, Recently, I had my second spinal surgery.
However, virtually all the reports thus far published show endoscopic surgery to be associated with fewer, and with less severe, complications as compared with conventional surgery.
In persons in whom bilateral total facetectomies (Gill procedures) are performed, some chance of postoperative instability exists.
In Bellevue, Is there a test for this type of spinal headache? For someone suffering from a spinal headache, there is a procedure that can help the headache and in many cases provide relief.
Postoperatively, she developed a lumbar pseudomeningocoele and had 2 attempts elsewhere to try and close the leak.
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In Bellevue, Barcohana is Fellowship trained in Spinal Surgery completing his specialty training at the Southern California Orthopedic Institute.
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He is a member of many professional medical societies.
Surgery is done with minimal post-operative discomfort.
The vet said I need to keep him calm and in a small area during the day while I am work (the less movement the better).
In these cases it can be helpful to perform a NRSI to see if the pain is helped by the injection.
com's health page with an answer from one of our health experts, or by a participant in the CNNhealth community.
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In Bellevue, Peripheral Nerve The senior level resident will be able to: Formulate management for birth brachial plexus injury, acute nerve injury, failed decompression and neuromas.
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In Bellevue, The spinal cord runs through the hole between the arch and the body of the vertebra and is thus protected by bone on all sides.
In Bellevue, "The damage was so severe, the slightest breeze against my skin caused me excruciating pain," said Hall.
Sometimes an endoscope may be used, allowing for a smaller, less invasive incision.
For some people, the radiating pain is a minor annoyance, but for others, it can be debilitating.
Bellevue Techniques & Technology - The Southeastern Spine Institute: spine health and spinal surgery including artificial disc replacement
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In Bellevue, PLF = Posterolateral graft fusion.
You may also experience numbness, weakness or tingling in your leg or foot.
Heart transplants are the fourth most common transplant done in the United States with over 2,200 cases performed each year.
No abnormal pre or paravertebral soft tissue.
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Following his general surgical internship and orthopaedic surgery residency at the University of California, Los Angeles, Dr.
In Bellevue, 42nd Street, Suite 942 / New York, NY 10165 / 212-692-0662.
Cycling and swimming can usually be resumed in 3 to 4 months, unless prohibited by a brace or cast.
Severe thoracic curves can even compromise the function of the heart and lungs.
In Bellevue, Enlarging the foramen takes pressure off the nerve root and gives the surgeon more room to do the TLIF surgery through the foramen.
However, if narrowing places pressure on the spinal cord or nerve roots, there may be a slow onset and progression of symptoms.
When I came to the United States to further my education, I knew my specialty would be in Neurosurgery.
Once the leak occurs, it must be repaired because fluid will continue to leak and may cause headaches, and in rare instances, infection.
Typically, a laminectomy is performed, and the neural foramina, through which the nerves exit, are enlarged (foraminotomy).
Bellevue Medical terms for Herniated Disk
It is surprising that the results so far in comparison to open, instrumented 360° fusion (not minimally invasive fusion) are not dramatically better.
The arteries and veins used for the bypass procedure are taken from the patient's own body; they may be harvested from within the chest, the arms or the legs.
In Bellevue, He also serves on the editorial review board of one of the most prestigious spine surgery journals.
In Bellevue, Affected Sensation / Slow Reflexes Symptoms mainly affect sensation in the lower limbs.
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Your pain is reduced because the mild electrical shocks interrupt the pain signal to your brain.
Chicken Noodle Soup for Low Back Pain.
In Bellevue, Steps for comfort and pain relief You can do the following steps to make yourself more comfortable and to relieve pain: Limit your activities and rest your back for 2 to 4 days if your pain is severe.
While it was simple in design, it required a long period of wearing after the operation, and did not allow segmental adjustment of correction.
In Bellevue, He is board certified by the American Board of Physical Medicine and Rehabilitation.
At the Florida Spine Institute, we perform spinal fusions, laminectomy discectomy, anterior lumbar or cervical interbody fusions and scoliosis correction surgeries.
Spinal Anesthesia for cardiac surgery Regional techniques have been used in cardiac surgery to facilitate early extubation.
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The surgery will relieve pain and allow the back to heal.
Since certain activities may be restricted following your surgery, you will need to arrange for someone to help you for a few days with the household activities and driving.
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In Bellevue, Related Images Definition: Lumbar spinal surgery is used to correct problems with the spinal bones (vertebrae), disks, or nerves of the lower back (lumbar spine).
Nonsurgical options Despite the length discussion about surgery, most patients get better without surgery.
This relieves pressure on the spinal cord or nerve root(s).
As part of the hysterectomy, the fallopian tubes and cervix may also be removed.
Frequently, a fusion surgery is done at this time.
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In Bellevue, The at Rush University Medical Center is now offering a new technique, the Dynesys® Spinal System, to stabilize the spine without fusion.
In Bellevue, This is done by removing or trimming the lamina (roof) of the vertebrae to create more space for the nerves.
It takes approximately 5 minutes and is very effective for pain that is coming from the sacroiliac joint.
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