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Cryotherapy and Other Ablative Procedures

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Abstract

Hepatic malignancies represent a substantial medical problem. Not only is the liver a common site for primary cancers, it is also a common site for growth of a variety of metastatic cancers. Because of its vascularity, and its position at the delta of the portal circulation, growth of metastatic gastrointestinal cancers in the liver is particularly common. For example, 25% of patients presenting with colorectal cancer will be found to have metastases to the liver at the time of diagnosis,1,2 and 50% of patients treated with colonic/rectal resection will have tumour recurrence in the liver within five years.3

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References

  1. Lise M, Da Pian PP, Nitti D, Pilati PL. Colorectal metastases to the liver: present results and future strategies. J Surg Oncol (Suppl) 1991; 2:69–73.

    CAS  Google Scholar 

  2. Fong Y, Blumgart LH, Cohen AE. Surgical resection of colorectal metastases. Ca: Cancer J Clin 1995; 45:50–62.

    Article  CAS  Google Scholar 

  3. Kavolius J, Fong Y, Blumgart LH. Surgical resection of metastatic liver tumors. Surg Oncol Clin N Am 1996; 5:337–351.

    PubMed  CAS  Google Scholar 

  4. Bengtsson G, Carlsson G, Hafstrom L et al. Natural history of patients with untreated liver metastases from colorectal cancer. Am J Surg 1981; 141:586–589.

    Article  PubMed  CAS  Google Scholar 

  5. Scheele J. Liver resection for colorectal metastases. World J Surg 1995; 19:59–71.

    Article  PubMed  CAS  Google Scholar 

  6. Nordlinger B, Jaeck D, Guiget M et al. (eds) Surgical Resection of Hepatic Metastases: Multicentric Retrospective Study by the French Association of Surgery 1992: 129–146. Paris, Springer.

    Google Scholar 

  7. Fong Y, Cohen AM, Fortner JG et al. Liver Resection for colorectal metastases J Clin Oncol 1997; 15(3):938–946.

    CAS  Google Scholar 

  8. Fong Y, Blumgart LH, Fortner JG, Brennan MF. Pancreatic or liver resection for malignancy is safe and effective for the elderly. Ann Surg 1995; 222:426–437.

    PubMed  CAS  Google Scholar 

  9. Holm A, Bradley E, Aldrete S. Hepatic resection of metastasis from colorectal carcinoma. Ann Surg 1989; 209:428–434.

    Article  PubMed  CAS  Google Scholar 

  10. Armstrong JG, Anderson LL, Harrison LB. Treatment ofliver metastases from colorectal cancer with radioactive implants. Cancer 1994; 73:1800–1804.

    Article  PubMed  CAS  Google Scholar 

  11. Pederson IK, Burcharth F, Roikjaer 0, Baden H. Resection of liver metastases from colorectal cancer: indication and results. Dis Colon Rectum 1994; 37:1078–1082.

    Article  Google Scholar 

  12. Cozzi PJ, Englund R, Morris DL. Cryotherapy treatment of patients with hepatic metastases from neuroendocrine tumors. Cancer 1995; 76:501–509.

    Article  PubMed  CAS  Google Scholar 

  13. Lau WY, Leung TW, Leung KL, Ho S, Leung N, Chan M, Lin J, Li AK. Cryoreductive surgery for hepatocellular carcinoma. SurgOncol 1994; 3:161–166.

    CAS  Google Scholar 

  14. Nauta RJ, Heres EK, Thomas DS, Harter KW, Rodgers JE, Holt RW, Lee TC, Walsh DB, Dritschilo A. Intraoperative single-dose radiotherapy. Observations and staging. Arch Surg 1987; 122:1392–1395.

    CAS  Google Scholar 

  15. Copper IS. Cryogenic surgery: a new method of destruction or extirpation of benign or malignant tissues. New Engl J Med 1963; 268:743–749.

    CAS  Google Scholar 

  16. Dutta MM, Gage AA. Large volume freezing in experimental hepatic cryosurgery. Cryobiology 1979; 16:50–55.

    Article  PubMed  CAS  Google Scholar 

  17. Onik GM, Atkinson D, Zemel R, Weaver ML. Cryosurgery of liver cancer. Semin SurgOncol 1993; 9:309–317.

    Article  CAS  Google Scholar 

  18. Ravikumar TS, Kane R, Cady B, Jenkins R, Clouse M, Steele G, Jr. A 5-year study of cryosurgery in the treatment ofliver tumors. Arch Surg 1991; 126:1520–1523.

    PubMed  CAS  Google Scholar 

  19. Stewart GJ, Preketes A, Horton M, Ross WB, Morris DL. Hepatic cryotherapy: double-freeze cycles achieve greater hepatocellular injury in man. Cryobiology 1995; 32:215–219.

    Article  PubMed  CAS  Google Scholar 

  20. McLoughlin RF, Saliken JF, McKinnon G, Wiseman D, Temple W. CT of the liver after cryotherapy of hepatic metastases: imaging findings. Am I Roentgen 1995; 165:329–332.

    CAS  Google Scholar 

  21. Charnley RM, Thomas M, Morris DL. Effects of hepatic cryotherapy on serum CEA concentration in patients with multiple inoperable hepatic metastases from colorectal cancer. Aust NZ J Surg 1991; 61:55–58.

    Article  CAS  Google Scholar 

  22. Preketes AP, King J, Caplehorn JRM, Clingan PR, Ross WB, Morris DL. CEA reduction after cryotherapy for liver metastases from colon cancer. Aust NZ J Surg 1994; 64:612–614.

    Article  CAS  Google Scholar 

  23. Ravikumar TS, Kane R, Cady B. Hepatic cryosurgery with intraoperative ultrasound monitoring for patients with metastatic colon carcinoma. Arch Surg 1987; 122:403–409.

    PubMed  CAS  Google Scholar 

  24. Masters A, Steger AC, Bown SG. Role of interstitial therapy in the treatment of liver cancer. Br J Surg 1991; 78:518–523.

    Article  PubMed  CAS  Google Scholar 

  25. Ravikumar TS, Steele G, Jr., Kane R, King V. Experimental and clinical observations on hepatic cryosurgery for colorectal metastases. Cancer Res 1991; 51:6323–6327.

    PubMed  CAS  Google Scholar 

  26. Charnley RM, Doran J, Morris DL. Cryotherapy for liver metastases: a new approach [see comments]. Br J Surg 1989; 76:1040–1041.

    Google Scholar 

  27. Sako S, Seitzinger GL, Garside E. Carcinoma of the extrahepatic ducts. Review of the literature and report of six cases. Surgery 1957; 41:416–417.

    PubMed  CAS  Google Scholar 

  28. Ross WB, Horton M, Bertolino P, Morris DL. Cryotherapy of liver tumours - a practical guide. HPB 1995; 8:167–173.

    Article  PubMed  CAS  Google Scholar 

  29. Goodie DB, Horton MD, Morris RW, Nagy LS, Morris DL. Anaesthetic experience with cryotherapy for treatment of hepatic malignancy. Anaesthesia Intensive Care 1992; 20:491–496.

    CAS  Google Scholar 

  30. Onik G, Rubinsky B, Zemel R, Weaver L, Diamond D, Cobb C, Porterfield B. Ultrasound-guided hepatic cryosurgery in the treatment of metastatic colon carcinoma. Preliminary results. Cancer 1991; 67:901–907.

    Article  PubMed  CAS  Google Scholar 

  31. Shafir M, Shapiro R, Sung M, Warmer R, Sicular A, Klipfel A. Cryoablation of unresectable malignant liver tumors. Am j Surg 1996; 171:27–31.

    Article  CAS  Google Scholar 

  32. Onik GM, Chambers N, Chernus SA, Zemel R, Atkinson D, Weaver ML. Hepatic cryosurgery with and without the Bair Hugger. J Surg Oncol 1993; 52:185–187.

    Article  CAS  Google Scholar 

  33. Cozzi PJ, Stewart GJ, Morris DL. Thrombocytopenia after hepatic cryotherapy for colorectal metastases: correlates with hepatocellular injury. World J Surg 1994; 18:774–776.

    Article  PubMed  CAS  Google Scholar 

  34. Ross WB, Morris DL, Morris R, Warlters A. Cardiac rhythm disturbances due to caval occlusion during hepatic cryosurgery. Cryobiology 1994; 31:501–505.

    Article  PubMed  CAS  Google Scholar 

  35. Preketes AP, Caplehorn JRM, King J, Clingan PR, Ross WB, Morris DL. Effect of hepatic artery chemotherapy on survival of patients with hepatic metastases from colorectal carcinoma treated with cryotherapy. World I Surg 1995; 19:768–771.

    Article  CAS  Google Scholar 

  36. Morris DL, Ross WB. Australian experience of cryoablation ofliver tumors. Surg Oncol Clin N Am 1996; 5:391–397.

    CAS  Google Scholar 

  37. Blumgart LH, Fong Y. Surgical management of colorectal metastases to the liver. Curr Probl Surg 1995; 5:333–428.

    Article  Google Scholar 

  38. Cuschieri A, Crosthwaite G, Shimi S, Pietrabissa A, Joypaul V, Tair I, Naziri W. Hepatic cryotherapy for liver tumors. Development and clinical evaluation of a high efficiency insulated multineedle probe system for open and laparoscopic use. Surg Endosc 1995; 9:483–489.

    Article  PubMed  CAS  Google Scholar 

  39. Cuschieri A. Laparoscopic management of cancer patients. I Roy Coli Surg (Edin) 1995; 40:1–9.

    CAS  Google Scholar 

  40. Maeda T, Hasebe Y, Hanawa S, Watanabe M, Nakazaki H, Kuramoto S, Yoshio T. Trial of percutaneous hepatic cryotherapy: preliminary report [in Japanese]. Nippon Geka Gakkai Zasshi (J lap Surg Soc) 1992; 93:666.

    CAS  Google Scholar 

  41. Morris DL, Horton MD, Dilley AV, Warlters A, Clingan PR. Treatment of hepatic metastases by cryotherapy and regional cytotoxic perfusion. Gut 1993; 34:1158–1161.

    Article  Google Scholar 

  42. Kakehi M, Ueda K, Mukojima T, Hiraoka M, Seto 0, Akanuma A, Nakatsugawa S. Multi-institutional clinical studies on hyperthermia combined with radiotherapy or chemotherapy in advanced cancer of deep-seated organs. Int I Hyperthermia 1990; 6:719–740.

    Article  CAS  Google Scholar 

  43. Kondo M, Itani K, Yoshikawa T, Tanaka Y, Watanabe N, Hiraoka M, Noguchi M, Miura K. [A prospective randomized clinical trial comparing intra-arterial chemotherapy alone and when combined with hyperthermia for metastatic liver cancer.] Gan to Kagaku Ryoho Uap j Cancer Chem 1995; 22:12,1807–11.

    CAS  Google Scholar 

  44. Seki T, Wakabayashi M, Nakagawa T, Itho T, Shiro T, Kunieda K, Sato M, Uchiyama S, Inoue K. Ultrasonically guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma. Cancer 1994; 74:817–825.

    Article  PubMed  CAS  Google Scholar 

  45. Hamazoe R, Hirooka Y, Ohtani s, Katoh T, Kaibara N. Intraoperative microwave tissue coagulation as treatment for patients with nonresectable hepatocellular carcinoma. Cancer 1995; 75:794–800.

    CAS  Google Scholar 

  46. Zhou XD, Tang ZY, Yu YQ, Ma ZC, Xu DB, Zheng YX, Zhang BH. Microwave surgery in the treatment of hepatocellular carcinoma. Semin Surg Oncol 1993; 9:318–322.

    Article  PubMed  CAS  Google Scholar 

  47. Saitsu H, Mada Y, Taniwaki S, Okuda K, Nakayama T, Oishi K, Yoshida K. [Investigation of microwave coagulo-necrotic therapy for 21 patients with small hepatocellular carcinoma less than 5 cm in diameter.] Nippon Geka Gakkai Zasshi U Jap Surg Soc] 1993; 94:4,359–65.

    CAS  Google Scholar 

  48. Shibata T, Takami M, Fujimoto T, Takada T, Kitada M, Tsukahara Y, Okumura Y, Saito M, Murotani M, Sugimoto K. [Microwave tumor coagulation (MTC) in liver tumor: indication and percutaneous approach.] Gan to Kagaku Ryoho Uap J Cancer Chem) 1994; 21:13, 2128–31.

    CAS  Google Scholar 

  49. Ogawa M, Shibata T, Takami M, Tsujinaka T, Takada T, Kitada M, Tsukahara Y, Murotani M, Nlinobu T, Iihara K. [Long-term survival in two cases of multiple liver metastasis successfully treated with intraoperative ultrasound-guided microwave tumor coagulation (MTC)] Gan to Kagaku Ryoho Uap J Cancer Chem 1995; 22:11,1679–83.

    Google Scholar 

  50. Cheung AY. Microwaves and radiofrequency techniques in hyperthermia. Br j Cancer 1982; 45:16–24.

    Google Scholar 

  51. Hashimoto D, Takami M, Idezuki Y. In depth radiation therapy by Nd:YAG laser for malignant tumors of the liver under ultrasonic imaging. Gastroenterology 1985; A1663:88.

    Google Scholar 

  52. Jacques SL. Laser-tissue interactions: photochemical, photothermal and photo mechanical. Surg Clin N Am 1992; 8:242–249.

    Google Scholar 

  53. Masters A, Bown SG. Interstitial laser hyperthermia. [Review.] Semin Surg Oncol 1992; 8:242–249.

    Article  PubMed  CAS  Google Scholar 

  54. Schneider PD. Liver resection and laser hyperthermia. [Review.] Surg Clin N Am 1992; 72:623–639.

    CAS  Google Scholar 

  55. Perring S, Hind R, Fleming I, Birch S, Batty V, Taylor l. Dosimetric assessment of radiolabelled lipiodol. Nucl Med Commun 1994; 15:34–38.

    CAS  Google Scholar 

  56. Vogi TI, Muller PK, Hammerstingl R, Weinhold N, Mack MG, Philipp C, Deimling M, Beuthan I, Pegios W, Riess H. Malignant liver tumors treated with MR imaging-guided laser-induced thermotherapy: technique and prospective results. Radiology 1995; 196:257–265.

    Google Scholar 

  57. Amin Z, Donald H, Masters A, Kant R, Steger AC, Bown SG, Lees WR. Hepatic metastases: interstitial laser photocoagulation with real-time US monitoring and dynamic CT evaluation of treatment. Radiology 1993; 187:339–347.

    PubMed  CAS  Google Scholar 

  58. Nolsoe CP, Torp-Pedersen S, Burcharth F, Horn T, Pedersen S, Christensen NE, Olldag ES, Andersen PH, Karstrup S, Lorentzen T. Interstitial hyperthermia of color ectal liver metastases with a US-guide Nd-YAG laser with a diffuser tip: a pilot clinical study. Radiology 1993; 187:333–337.

    PubMed  CAS  Google Scholar 

  59. Malone DE, Lesiuk L, Brady AP, Wyman DR, Wilson BC. Hepatic interstitial laser photocoagulation: demonstration and possible importance of intravascular gas. Radiology 1994; 193:233–237.

    PubMed  CAS  Google Scholar 

  60. Hahl I, Haapianen R, Ovaska I, Puolakkainen P, Schroder T. Laser-induced hyperthermia in the treatment ofliver tumors. Lasers Surg Med 1990; 10:319–321.

    Article  PubMed  CAS  Google Scholar 

  61. Masters A, Steger AC, Lees WR, Walmsley KM, Bown SG. Interstitial laser hyperthermia: a new approach for treating liver metastases. Br J Cancer 1992; 66:518–22.

    Article  PubMed  CAS  Google Scholar 

  62. Vogi TJ, Muller P, Hirsch H, Philipp C, Hammerstingl R, Bottcher H, Riess H, Beuthan I, Felix R. Laser-induced thermotherapy of liver metastases with MRI control. Prospective results of an optimized therapy procedure. Radiologie 1995; 35:188–199.

    Google Scholar 

  63. Saitsu H, Nakayama T. Microwave coagulo-necrotic therapy for hepatocellular carcinoma. lap J Clin Med 1993; 51:4,1002–7.

    Google Scholar 

  64. Watanabe Y, Sato M, Abe Y, Horiuchi S, Kito K, Kimura S. Laparoscopic microwave coagulo-necrotic therapy for hepatocellular carcinoma: a feasibility study of an alternative option for poor-risk patients. J Laparoendosc Surg 1995; 5:169–175

    Article  PubMed  CAS  Google Scholar 

  65. Shiina S, Tagawa K, Niwa Y, Unuma T, Komatsu Y, Yoshiura K, Hamada E, Takahashi M, Shira tori Y, Terano A. Percutaneous ethanol injection therapy for hepatocellular carcinoma. Am J Roentgen 1993; 160:1023–1028.

    CAS  Google Scholar 

  66. Ebara M, Ohto M, Sugiura N et al. Percutaneous ethanol injection for the treatment of small hepatocellular carcinoma. Study of 95 patients. J Gastroenterol Hepatol 1990; 5:616–620.

    Article  PubMed  CAS  Google Scholar 

  67. Livraghi T, Giorgio A, Marin G, Salmi A, de Sio I, Bolondi L, Pompili M, Brunello F, Lazzaroni S, Torzilli G. Hepatocellular carcinoma and cirrhosis in 746 patients. Radiology 1995; 197:101–108.

    PubMed  CAS  Google Scholar 

  68. Livraghi T, Bolondi L, Buscarini L, Cottone M, Mazziotti A, Morabito A, Torzilli G. No treatment, resection and ethanol injection in hepatocellular carcinoma: a retrospective analysis of survival in 391 patients with cirrhosis. J Hepatol1995; 22:522–526.

    Google Scholar 

  69. Giovannini M, Seitz JF. Ultrasound-guided percutaneous injection of small liver metastases. Cancer 1994; 73:294–297.

    Article  PubMed  CAS  Google Scholar 

  70. Amin Z, Bown SG, Lees WR. Local treatment of colorectal liver metastases: a comparison of interstitial laser photocoagulation (ILP) and percutaneous alcohol injection (PAl). Clin Radiol 1993; 48:166–171.

    CAS  Google Scholar 

  71. Giovannini M, Seitz JF, Rosello R, Gauthier A. Treatment of minor hepatic tumors with ultrasonically-guided percutaneous ethanol injection. Clinique et Biologique 1989; 13:974–977.

    CAS  Google Scholar 

  72. Lee MI, Mueller PR, Dawson SL, Gazelle SG, Hahn PF, Goldberg MA, Boland GW. Percutaneous ethanol injection for the treatment of hepatic tumors: indications, mechanism of action, technique and efficacy. Am J Roentgen 1995; 164:215–220

    CAS  Google Scholar 

  73. Livraghi T, Lazzaroni S, Pellicano S, Ravasi S, Torzilli G, Vettori C. Percutaneous ethanol injection of hepatic tumors: single-session. Am J Roentgen 1993; 161:1065–1069.

    CAS  Google Scholar 

  74. Ebara M, Kita K, Sugiura N, Yoshikawa M, Fukuda H, Ohto M, Kondo F, Kondo Y. Therapeutic effect of percutaneous ethanol injection on small hepatocellular carcinoma: evaluation with CT. Radiology 1995; 195:371–377.

    PubMed  CAS  Google Scholar 

  75. Kohno E, Chen S, Numata K, Nakamura S, Tanaka K, Endo 0, Inoue S, Takamura Y. A case ofbiloma: complication of percutaneous ethanol injection therapy for hepatocellular carcinoma. lap J Gastroenterol 1992; 89(11), 2719–2724.

    CAS  Google Scholar 

  76. Solinas A, Erbella GS, Distrutti E, Malaspina C, Fiorucci S, Clerici C, Bassotti G, Morelli A. Abscess formation in hepatocellular carcinoma: complications of percutaneous ultrasoundguided ethanol injection. J Clin Ultrasound 1993; 21:531–533.

    Article  PubMed  CAS  Google Scholar 

  77. Okada S, Aoki K, Okazaki N, Nose H, Yoshimori M, Shimada K, Yamamoto J, Takayama T, Kosuge T, Yamasaki S. Liver abscess after percutaneous ethanol injection (PEl) therapy for hepatocellular carcinoma. A case report. Hepato-gastroenterology 1993; 40:496–498.

    PubMed  CAS  Google Scholar 

  78. Shimada M, Maeda T, Saitoh A, Morotomi I, Kano T. Needle track seeding after percutaneous ethanol injection therapy for small hepatocellular carcinoma. J Surg Oncol 1995; 58:278–281.

    Article  PubMed  CAS  Google Scholar 

  79. Borghetti M, Reduzzi L, Bonardi R, Parziale M. The dynamic computed tomography of small hepatocarcinomas treated by US-guided percutaneous ethanol injections. The short- and long-term follow-up aspects. Radiol Med 1992; 83:361–365.

    PubMed  CAS  Google Scholar 

  80. Cedrone A, Rapaccini GL, Porn pili M, Grattagliano A, Aliotta A, Trombino C. Neoplastic seeding complicating percutaneous etha nol injection for treatment of hepatocellular carcinoma. Radiology 1992; 183:787–788.

    PubMed  CAS  Google Scholar 

  81. Goletti 0, De Negri F, Pucciarelli M, Sidoti F, Bertolucci A, Chiarugi M, Seccia M. Subcutaneous seeding after percutaneous ethanol injection of liver metastasis. Radiology 1992; 183:785–786.

    Google Scholar 

  82. Livraghi T, Vettori C, Lazzaroni S. Liver metastases: Results of percutaneous ethanol injection in 14 patients. Radiology 1991; 179:709–712.

    PubMed  CAS  Google Scholar 

  83. Livraghi T, Festi D, Monti F, Salmi A, Vettori C. US-guided percutaneous alcohol injection of small hepatic and abdominal tumours. Radiology 1986; 161:309–32.

    Google Scholar 

  84. Kotoh K, Sakai H, Sakamoto S, Nakayama S, Satoh M, Morotomi I, Nawata H. The effect of percutaneous ethanol injection therapy on small solitary hepatocellular carcinoma is comparable to that of hepatectomy. Am J Roentgen 1994; 89:194–198.

    CAS  Google Scholar 

  85. Veltri A, Martina C, Bonenti G, Dore D, Cirillo S, Grosso M, Fava C. Therapy of malignant hepatic tumors using percutaneous hot saline injections. Feasibility study and preliminary results.,Radiol Med 1995; 90:463–469.

    CAS  Google Scholar 

  86. Honda A, Martina C, Bonenti G, Dore D, Cirillo S, Grosso M, Fava C. Percutaneous hot saline injection therapy for hepatic tumors: an alternative to percutaneous ethanol injection therapy [see comments]. Radiology 1994; 190:53–57.

    PubMed  CAS  Google Scholar 

  87. Honda A, Guo Q, Uchida H, Nishida H, Hirai T, Ohishi H, Hiasa Y. Percutaneous hot water injection therapy (PHoT) for hepatic tumors: a clinical study. Nippon Igaku Hoshasen Gakkai Zasshi [Nippon Acta Radiologica] 1993; 53(7), 781–789.

    CAS  Google Scholar 

  88. McGahan JP, Browning JP, Brock JM et al. Hepatic ablation using radiofrequency electrocautery. Invest Radiol 1990; 25:267–270.

    Article  PubMed  CAS  Google Scholar 

  89. Darzi A, Goldin R, Guillou PJ, Monson JR. High-energy shock waves pyrotherapy. A new concept in extracorporeal tumor therapy. Surg Oncol 1993; 2:197–203.

    Article  PubMed  CAS  Google Scholar 

  90. Chapelon JY, Prat F, Sibille A, Abou El Fadil F, Henry L, Theillere Y, Cathignol D. Extracorporeal, selective focused destruction of hepatic tumours by high intensity ultrasound in rabbits bearing VX-2 carcinoma. Minimally Invasive Therapy 1992; 1:287–293.

    Google Scholar 

  91. Vallencien G, Harouni M, Veillon B, Mombet A, Prapotnich D, Brisset JM, Bougaran J. Focused extracorporeal pyrotherapy: feasibility study in man. J Endourol 1992; 6:173–181.

    Article  Google Scholar 

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Karpoff, H.M., Fong, Y., Blumgart, L.H. (1998). Cryotherapy and Other Ablative Procedures. In: Garden, O.J., Geraghty, J.G., Nagorney, D.M., Audisio, R.A., Stoldt, H.S. (eds) Liver Metastases. Springer, London. https://doi.org/10.1007/978-1-4471-1506-9_9

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