The Department of Otolaryngology and the University of Iowa wish to acknowledge the support of those who share our goal in improving the care of patients we serve. Diagnostic imaging is generally used in cases of recurrent or complicated sinus disease. Ramakrishnan VR, et al. CT paranasal sinus (protocol).
CT Image - Guided Sinus Procedures | OCEANN ENT Noninvasive allergic sinus congestion and resolution assessments using `l\/ c+f>@@@@@V &x&p'@@@@@sb++ Leave jewelry at home and wear loose, comfortable clothing. Carver College of Medicine
Storz fiberoptic light cable, 3.5 mm x 230 cm. He received multiple courses of oral antibiotics, nasal steroids, and decongestants, with only temporary relief. After a prolonged course of antibiotics, serial CT scans revealed resolution of the frontal abscess and sinusitis. CT of the sinuses can help plan the safest and most effective surgery. Intra-Operative Use of Computer Aided Surgery, Sinus Surgery and Transnasal Skull Base Surgery, Otology, Neurotology, and Lateral Skull Base Surgery, Electromagnetic Compatibility for Cardiac Devices, California Transparency in Supply Chains Act, Information About Proposition 65 for California Customers, Digital Millennium Copyright Act (DMCA) Notification, Distorted sinus anatomy of development, postoperative, or traumatic origin, Pathology involving the frontal, posterior ethmoid and sphenoid sinuses, Disease abutting the skull base, orbit, optic nerve, or carotid artery, Cerebrospinal fluid rhinorrhea or conditions where there is a skull base defect, Benign and malignant sino-nasal neoplasms, Scanning and registration protocols that enable accuracy, StealthMerge ENT software that fuses different imaging modalities (CT, MRI) togetherfor improved visualization, Instruments that are designed and calibrated for use in image-guided surgery.
Navigation and non-navigation CT scan of the sinuses: comparison of the In many protocols a standard dose is given related to the weight of the patient: Weight < 75kg : 100cc. They will cover the tiny hole made by the needle with a small dressing. Image 4: The electromagnetic field generator (EMG) is generally stored with the brace and bracket (shown in fig. A coronal CT image is the preferred initial procedure. This leads to the formation of posterosuperior attic pockets. x@Qhm@0%\&'HD(qQCn,nG>ioR}lwlk~lo
x8v?f\[/v]d\m~yKl;~L~~ncOxpb,}0Ng|n}08OSD_@@@@@t2?~axNO|vw7}0sgAew-xW q>6>w7Wrn sm@@@@@g>GnG?'@uX
x[o~7|'l_/}@t_c_v@@@@@.5>O7ao/?FA?[c}R}qO?45}O,5G[?n{=]_T_Yo!ISK5h_|0x>h\_TAov/O}yiNn_)4X>y+OW?
Head CT Protocols - CTisus.com CT Scanning `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{
CT of the sinuses - Radiologyinfo.org 28K views 4 years ago This video provides a basic tutorial for anybody without a medical background to look at a CT Sinus scan and understand what they are looking at.
It's also the most reliable imaging technique for . CT Protocols Frequently used policies (MCN links) Creatinine Testing Prior to Injecting Intravenous Iodinated Contrast Media Iodinated Contrast Administration in Patients Receiving Metformin Management of Acute Contrast Reactions IV Contrast Extravasation Patient Sedation Guidelines for Periprocedural Coagulation Management Post Mortem CT The CT paranasal sinus protocol serves as an examination for the assessment of the study of the mucosa and bone system of the sinonasal cavities. The aim of FESS is to preserve mucosa while restoring drainage and ventilation of the sinuses. Like traditional x-rays, it produces multiple images or pictures of the inside of the body. Although mucosal thickening is seen in more than 90 percent of sinusitis cases, it is very nonspecific.68 Air-fluid levels and complete opacification are more specific for sinusitis but are seen in only 60 percent of sinusitis cases.6 Interpretation of plain radiographs can vary widely among different observers, and there is a high rate of false-negative results.2,9, Radiographs of the sinuses in infants aged three years or younger are not useful because of false opacification from undeveloped sinuses.10 Other important limitations of plain radiographs include poor visualization of ethmoid air spaces and difficulty differentiating between infection, tumor, and polyp in an opacified sinus.2, Because clinical judgment is sufficient to diagnose sinusitis in a majority of cases, and empiric treatments are inexpensive and safe, only a small percentage of patients who develop recurrent or complicated sinusitis are candidates for imaging studies. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Alternatively, 4% cocaine (no more than 4 ml) may be used for pre-surgical vasoconstriction and to assist with hemostasis. Our CT scanner uses cone beam technology to focus just on the sinuses.
The Preoperative Sinus CT: Avoiding a "CLOSE" Call with - PubMed Image guidance provides surgeons with a more detailed view of intra-cranial and extra-cranial structures such as . The endoscopic view obtained of the surgical field and positioned instrumentation should be the primary focus while performing the surgery. Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the Radiological Society of North America (RSNA) and the American College of Radiology (ACR), comprising physicians with expertise in several radiologic areas. Better surgical outcome by image-guided navigation system in endoscopic removal of sinonasal inverted papilloma.
CT scanning is painless, noninvasive and accurate. Temporal Bones.
Immunocompromised persons and smokers are at increased risk for serious sinusitis complications. Learn how we can help 5.8k views Reviewed >2 years ago Thank Dr. Mazen Ghani agrees 4 thanks Wanted to be landmarx try a much lower radiation exposures for the symptoms may need while remaining at the site. The patient was started on a four-week course of broad-spectrum antibiotics in combination with an oral steroid pulse. 70486- CT Maxillofacial without contrast This loss of image quality can resemble the blurring seen on a photograph taken of a moving object. Ear, Nose & Throat The technologist may ask you to hold your breath during the scanning.
PDF CT scanning protocol - Stryker Corporation Number along the monitor exactly where a soft tissue or the sinuses. Air appears black. Possible findings in acute sinusitis include mucosal thickening, air-fluid levels, and complete opacification of the involved sinus. endobj CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems. At UIHC, this is equipment is kept in a mobile storage unit that can be positioned outside the room prior to the start of the case. 4 0 obj Some policies are stating that they won't allow the three codes to be billed together.
The Radiology Assistant : CT Protocols Though the scanning itself causes no pain, there may be some discomfort from having to remain still for several minutes. Our CT techs do a Sinus CT with out contrast (70486). 74170, 72194, 76376 Ste nt Protocol Question of: diverticulitis, appendicitis, abscess, cancer, prior abdominal surgery. This study should be downloaded from the server or onto a CD to be taken to the OR. Intra-Operative Use of Computer Aided Surgery. RTAnswers.org: Radiation Therapy for Head and Neck Cancer, This page was reviewed on November, 01, 2022. It is imperative that the correct patient, study from the desired date and the appropriate anatomical study are selected. The MRI showed extension of the neoplasm into the medial anterior maxilla and septum (Figure 4).
Some CT exams use a contrast material to enhance visibility in the body area under examination.
CT Brain Special Protocols | Cedars-Sinai Endoscopic Sinus Surgery | Iowa Head and Neck Protocols The patient is a 20-year-old healthy man with an upper respiratory tract infection that has lasted two weeks. the ct also deployed in the surgical system. Protocol specifics will vary depending on CT scanner type, specific hardware and software, radiologist and perhaps referrer preference, and patient factors, e.g.
The CT images and direct views from the endoscope are visualized throughout the procedure.
Sinus Surgery | Medtronic Uncomplicated sinusitis does not require radiologic imagery. CT is usually the first test ordered when a sinus tumor is suspected. % The system displays the images on a computer monitor. NB: This article aims to frame a general concept of a CT protocol for the assessment of the paranasal sinuses. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Soft tissue, such as the heart or liver, shows up in shades of gray. A major advantage of CT is its ability to image bone, soft tissue, and blood vessels all at the same time. The technologist will be able to hear and talk to you using a speaker and microphone. Dalgorf M, et al. Being the most widely accepted theory, it states that the weakest part of the tympanic membrane (TM), i.e., pars flaccida, retracts because of the negative pressure in the middle ear cavity caused by long-standing eustachian tube dysfunction. CT scanning is painless, noninvasive, and accurate. Image-guided surgery (IGS) is the use of a real-time correlation of the operative field to a preoperative imaging data set that reflects the precise location of a selected surgical instrument to the surrounding anatomic structures. A CT scan of the face produces images that also show a patient's paranasal sinus cavities. Otolaryngol Clin North Am. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Immuno-compromised patients are at increased risk for complicated bacterial or fungal infections. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Video-Telemedicine for Salivary Gland Swelling (Sialadenitis), The AAO-HNS currently maintains surgical navigation systems are deemed appropriate in "select cases to assist the surgeon in clarifying complex anatomy during sinus and skull base surgery.". implants, specific indications.
PDF Multiplanar Sinus CT: A Systematic Approach to Imaging Before Allergy induction protocol used to induce allergic rhinosinusitis in guinea pigs with intranasal (i.n.) CT is beneficial in studying chronic disease of the paranasal sinuses, not least to assess whether it has spread to surrounding structures. His nasal symptoms improved after he started taking decongestants and antibiotics, but a persistent headache prompted a visit back to his family physician. In general, intravenous contrast material is not necessary. Medtronic Operational Headquarters 710 Medtronic Parkway Minneapolis, MN 55432-5640 USA, Central/Eastern Europe, Middle East & Africa, Electromagnetic Compatibility Guide for Cardiac Devices, American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS), American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS). Mucosal thickening, polyps, and other sinus abnormalities can be seen in 40 percent of symptomatic adults; however, clinical correlation is needed to avoid overdiagnosis of sinusitis because of nonspecific CT findings. Unlike MRI, an implanted medical device of any kind will not prevent you from having a CT scan. This is accomplished through: Benefits of image-guided navigated surgery include improvements in visualization, enabling surgeons to work within complex sinus anatomy and optimize surgical strategies for their patients.5-9. STEALTH PROTOCOL REQUEST. Robin Smithuis. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ CT Landmark Sinus without IV Contrast 70486 Pre-Surgical Scan- Sinus . Balloon sinus surgery performed in-office with the Nuvent EM Sinus Dilation System is a minimally invasive procedure to open and drain blocked sinuses. He progressed to an acute sinusitis with associated fevers and left facial pressure, pain, and swelling. CT contrast injection and protocols.
What is a stealth ct of sinuses? | HealthTap Online Doctor <> This allows us to minimize radiation while providing a high tech three-dimensional image of the sinuses. Tell your doctor if there's a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you're taking, and allergies. . CT-paranasal sinuses are a vital tool in the assessment of patients with CRS. ENT Navigation Solutions
PDF NEURO CT PROTOCOLS - University of California, San Diego Appears as to quickly inspect a high quality. NB: This article aims to frame a general concept of a CT protocol for the assessment of the paranasal sinuses. With pediatric patients, a parent may be allowed in the room but may need to wear a lead apron to minimize radiation exposure. d ;w&$@B!Cp "**((((+.x,f_Ut:3==!(/3SzI"D!BHp!~"DC {Wgd\I-[lm/~{C}ac}8qF=zP+{{v!~aaak 7fyw]Z!B,X7x7b\ID@acO?) Centrifugal frontal sinus dissection technique: addressing anterior and posterior frontoethmoidal air cells. The olfactory pathway is composed of peripheral sinonasal and central sensorineural components. A CT scan may help detect sinusitis, evaluate sinuses filled with thickened sinus membranes, give additional information on tumors of the nasal cavity, diagnose inflammatory disorders, and plan for surgery by defining anatomy (12). `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Sometimes, the exam table will move during the scan. Does anyone have some insight on this? Image-guided sinus surgery: practical and financial experiences from a UK centre 2001-2009. Computed tomography (CT) of the sinuses uses special x-ray equipment to evaluate the paranasal sinus cavities hollow, air-filled spaces within the bones of the face surrounding the nasal cavity. These occur as the CT scanner's internal parts, not usually visible to you, revolve around you during the imaging process. endstream To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database. CT scanning is painless, noninvasive and accurate. Otolarnygology. Although rare, complications from sinusitis can be serious if not promptly diagnosed and adequately treated. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. With modern CT scanners, you may hear slight buzzing, clicking and whirring sounds. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Women should always inform their physician and the CT technologist if there is any possibility that they may be pregnant. from the hard palate to above the end of the frontal sinuses, bone kernel (e.g. Also tell your doctor about any recent illnesses or other medical conditions and whether you have a history of heart disease, asthma, diabetes, kidney disease, or thyroid problems. This study should be downloaded from the server or onto a CD to be taken to the OR. Int Forum Allergy Rhinol. Sinusitis is one of the most common conditions encountered by primary care physicians, accounting for approximately 25 million office visits annually1 and costing more than $2 billion annually in direct medical expenses.2,3 According to the National Ambulatory Medical Care Survey, sinusitis is the fifth most common medical diagnosis for which antibiotics are prescribed.4,5. Next, the table will move quickly through the scanner to determine the correct starting position for the scans. 70480- CT Orbits without contrast 2.
Stereotactic anatomical localization in complex sinus surgery: A systematic review and meta-analysis. 2). Three aspects of direct coronal imaging of the paranasal . However, the technologist will always be able to see, hear and speak with you through a built-in intercom system. CT because of the universal sinus CT protocol, total saving was estimated as $142,162, which translated to $147,628 when adjusted for inflation. Ahn S, et al. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Our understanding and management of paranasal sinus infections have improved since the introduction of nasal endoscopy, CT scans, and MRI. Then, the table will move slowly through the machine for the actual CT scan. Discuss the fees associated with your prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a better understanding of the possible charges you will incur. The CT paranasal sinus protocol serves as an examination for the assessment of the study of the mucosa and bone system of the sinonasal cavities. A single Waters' view (occipitomental) appears to provide as much information as the standard four-view series.11, CT scans can provide much more detailed information about the anatomy and abnormalities of the paranasal sinuses than plain films.12 A CT scan provides greater definition of the sinuses and is more sensitive than plain radiography for detecting sinus pathology, especially within the sphenoid and ethmoid sinuses.6,13 CT scan findings can also be quite nonspecific, however, and should not be used routinely in the diagnosis of acute sinusitis.6,14 The primary role of CT scans is to aid in the diagnosis and management of recurrent and chronic sinusitis, or to define the anatomy of the sinuses prior to surgery.2 In many institutions, a limited CT scan costs about the same as a full radiographic series but provides more useful information.2,15,16, A coronal CT image is the preferred initial procedure. Outside links: For the convenience of our users, RadiologyInfo.org provides links to relevant websites. xQ_GMBfhf=9uv:'n-bL'7>|_>%QQw? Safety in X-ray, Interventional Radiology and Nuclear Medicine Procedures, Radiation Therapy for Head and Neck Cancer, evaluate sinuses that are filled with fluid or thickened sinus. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ For some systems, a special mask or markers are placed on the patient's face during the scan to serve as reference points. o Process images with bone algorithm. Copyright 2023 Radiological Society of North America, Inc. (RSNA).
PDF Neuroradiology CT Protocols - North Star Radiology You will lie on a narrow table that slides in and out of this short tunnel. CT is less sensitive to patient movement than MRI. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ All Rights Reserved
3-D reconstructions are done as needed. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ 2018;46(6):937-941. He appeared healthy on examination and had hyponasal speech. endstream Prostate Specific Protocol *Schedule at Bremerton Prostate Coil only MRI Shoulder with and without IV Contrast 73223 Inflammation, Infection, Osteomyelitis, . The CT protocols listed are generic versions of scan protocols and need to be modified for scanner make and model.
Ct sinus with and without contrast | HealthTap Online Doctor In many ways, a CT scan works like other x-ray exams. When you enter the CT scanner, you may see special light lines projected onto your body. Web Privacy Policy | Nondiscrimination Statement. A special computer program processes this large volume of data to create two-dimensional cross-sectional images of your body. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ He had a slight right cheek swelling visible externally. Use of bone anchoring device in electromagnetic computer-assisted navigation in lateral skull base surgery. No radiation remains in a patient's body after a CT exam.
CT paranasal sinus (protocol) | Radiology Reference Article
If a Stealth protocol CT cannot be obtained, a normal sinus CT can be utilized but may not provide the same level of accuracy. The technologist or nurse, under the direction of a physician, may offer you some medication to help you tolerate the CT scanning procedure. See permissionsforcopyrightquestions and/or permission requests. CT of the brain with Lorenz protocol. With few exceptions, neck CT should be performed with intravenous contrast material . Any motion, including breathing and body movements, can lead to artifactson the images.
CT Sinus Scan - Los Angeles | Cedars-Sinai PDF Commonly Used CPT Codes for CT (Computed Tomography) When the exam is complete, the technologist will ask you to wait until they verify that the images are of high enough quality for accurate interpretation by the radiologist. To help answer those questions we have put together our protocols that we thought might prove useful. The paranasal sinusesare hollow, air-filled spaces located within the bones of the face and surrounding the nasal cavity, a system of air channels connecting the nose with the back of the throat. However, the benefit of an accurate diagnosis far outweighs the risk involved with CT scanning. What are the limitations of CT of the Sinuses?
2006 Apr;116(4):564-72. Vreugdenburg TD, et al. Gantry Tilt: 15 to 20 degrees angulation of the gantry to the canthomeatal line or tilting the patient's chin toward the chest ("tucked" position). A computed tomography scan (CT or CAT) of your sinuses uses X-ray technology and advanced computer analysis to create detailed pictures of the sinus. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Excellent test to evaluate for sinus disease including acute and chronic sinusitis, polyps, masses, postoperative evaluation. Metal objects, including jewelry, eyeglasses, dentures, and hairpins, may affect the CT images.
CT sinus fusion protocol, axial view. Midline septal mass and notable Procedure Report: Frontal sinuses are well developed and exhibit no mucoperiosteal thickening.
CT imaging provides real-time imaging, making it a good tool for guiding.
Recognition and utilization of surgical landmarks is imperative for the surgeon.
HRCT imaging of acquired cholesteatoma: a pictorial review The insurance companies are giving us a hard time with getting authorization. Bone window views provide excellent resolution and a good definition of the complete osteomeatal complex and other anatomic details that play a role in sinusitis.2 The coronal view also correlates best with findings from sinus surgery. Evaluation of a navigation system for ENT with surgical efficiency criteria. Up to 40 percent of asymptomatic adults have abnormalities on sinus CT scans, as do more than 80 percent of those with minor upper respiratory tract infections.14. Sometimes a follow-up exam further evaluates a potential issue with more views or a special imaging technique.
Ct pns - SlideShare
Computerized Tomography (CT) Image Guided Sinus Procedures allows the surgeon to simultaneously visualize 4 different views on a monitor: the coronal, sagittal and axial CT scan images at the same time as the real time surgical endoscopic view. The patient underwent endoscopic sinus surgery with improvement of his symptoms. Contrast agents may be injected before scanning Contiguous, non-overlapping slices Constant slice thickness Axial slices inbqo@O[nF{su:t(//A (hA222=h)D'@/w8}{aaaEB[xxeqJyg-w3h7 . CT scans are minimally-invasive and can accurately help doctors diagnose nose and sinus issues.
Noncontrast coronal computed tomographic (CT) images can define the nasal anatomy much more precisely. Risk factors for complicated infections include prolonged tobacco use and chronic occupational exposure to wood dust, nickel, or chrome pigment. CT Sinus, Facial Bones, Orbits, Temporal Bones, Maxilla CPT Codes 1. 2017;50(3):617-632. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Helical Position/Landmark: 2-3 cm (20-30 mm) above the vertex. However in chronic rhinosinusitis, the lining will be thickened and the sinuses are outlined by grey soft . This will pass. There was no seasonal variation to his symptoms, and allergy testing was negative.
Galletti, et al. Weight > 90kg : 150cc. 2013; 149(1):17-29. Surgeon and OR staff ensure the appropriate equipment are available and present in or near the OR room prior to transport of the patient to the OR. Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical imaging test. Depending on the type of CT scan, the machine may make several passes. All Rights Reserved. This results in more detail.
Ct Sinus Medtronic Protocol - Google 2012;126(12):1224-1230. {"url":"/signup-modal-props.json?lang=us"}, Macori F, Yap J, Murphy A, et al. Findings on CT scan should be interpreted in conjunction with clinical and endoscopic findings because of high rates of false-positive findings. Angle NO gantr y angle }K?~_fTP~z~}]_[{>>O{>;1*m7o|[v7?o\?z^1R_'mTz|||xxoo_^~wQQoWn__?7*_:eH!Qvt!QvS3feeH&SsZD_D!QvJUDS3fef2$NM^e .CSSeH1(;,C6eH2$N2$Nw&S2$NeH1(;5c!Qvn(;NpeeH:]eH,CYD=fe,C!Qv!Qvj3eHR!Qvj,CYDSwWDu(;/C*C5fef2$N1(;Mde&SS .CS3fef2$NeH2$N\D)~eNWe1(;5c!QvjYDm"(;57eH:eHZLpeTeH1(;5c!Qvj,C!Qvj2$N(;u(;uYDS{2$NmYDI-C/Czg(;*CYDS3fe&S!Qv_DUDk2$NeHc!Qvj2$NMje|e;\D)Uef2$NeH1(;u7yeHZ'S2$N2$N]c!Qvj,CSD!QvjnR(;u(;2$N(;5c!Qvj,CYD+C:eH!Qvt!QvS3feeH&SsZD_D!QvJUDS3fef2$NM^e .CSSeH1(;,C6eH2$N2$Nw&S2$NeH1(;5c!Qvn(;NpeeH:]eH,CYD=fe,C!Qv!Qvj3eHR!Qvj,CYDSwWDu(;/C*C5fef2$N1(;Mde&SS .CS3fef2$NeH2$N\D)~eNWe1(;5c!QvjYDm"(;57eH:eHZLpeTeH1(;5c!Qvj,C!Qvj2$N(;u(;uYDS{2$NmYDI-C/Czg(;*CYDS3fe&S!Qv_DUDk2$NeHc!Qvj2$NMje|e;\D)Uef2$NeH1(;u7yeHZ'S2$N2$N]c!Qvj,CSD!QvjnR(;u(;2$N(;5c!Qvj,CYD+C:eH!Qvt!QvS3feeH&SsZD_D!QvJUDS3fef2$NM^e .CSSeH1(;,C6eH2$N2$Nw&S2$NeH1(;5c!Qvn(;NpeeH:]eH,CYD=fe,C!Qv!Qvj3eHR!Qvj,CYDSwWDu(;/C*C5fef2$N1(;Mde&SS .CS3fef2$NeH2$N\D)~eNWe1(;5c!QvjYDm"(;57eH:eHZLpeTeH1(;5c!Qvj,C!Qvj2$N(;u(;uYDS{2$NmYDI-C/Czg(;*CYDS3fe&S!Qv_DUDk2$NeHc!Qvj2$NMje|e;\D)Uef2$NeH1(;u7yeHZ'S2$N2$N]c!Qvj,CSD!QvjnR(;u(;2$N(;5c!Qvj,CYD+C:eH!Qvt!QvS3feeH&SsZD_D!QvJUDS3fef2$NM^e .CSSeH1(;,C6eH2$N2$Nw&S2$NeH1(;5c!Qvn(;NpeeH:]eH,CYD=fe,C!Qv!Qvj3eHR!Qvj,CYDSwWDu(;/C*C5fef2$N1(;Mde&SS .CS3fef2$NeH2$N\D)~eNWe1(;5c!QvjYDm"(;57eH:eHZLpeTeH1(;5c!Qvj,C!Qvj2$N(;u(;uYDS{2$NmYDI-C/Czg(;*CYDS3fe&S!Qv_DUDk2$NeHc!Qvj2$NMje|e;\D)Uef2$NeH1(;u7yeHZ'S2$N2$N]c!Qvj,CSD!QvjnR(;u(;2$N(;5c!Qvj,CYD+C:eH!Qvt!QvS3feeH&SsZD_D!QvJUDS3fef2$NM^e .CSSeH1(;,C6eH2$N2$Nw&S2$NeH1(;5c!Qvn(;NpeeH:]eH,CYD=fe,C!Qv!Qvj3eHR!Qvj,CYDSwWDu(;/C*C5fef2$N1(;Mde&SS .CS3fef2$NeH2$N\D)~eNWe1(;5c!QvjYDm"(;57eH:eHZLpeTeH1(;5c!Qvj,C!Qvj2$N(;u(;uYDS{2$NmYDI-C/Czg(;*CYDS3fe&S!Qv_DUDk2$NeHc!Qvj2$NMje|e;\D)Uef2$NeH1(;u7yeHZ'S2$N2$N]c!Qvj,CSD!QvjnR(;u(;2$N(;5c!Qvj,CYD+C:eH!Qvt!QvS3feeH&SsZD_D!QvJUDS3fef2$NM^e .CSSeH1(;,C6eH2$N2$Nw&S2$NeH1(;5c!Qvn(;NpeeH:]eH,CYD=fe,C!Qv!Qvj3eHR!Qvj,CYDSwWDu(;/C*C5fef2$N1(;Mde&SS .CS3fef2$NeH2$N\D)~eNWe1(;5c!QvjYDm"(;57eH:eHZLpeTeH1(;5c!Qvj,C!Qvj2$N(;u(;uYDS{2$NmYDI-C/Czg(;*CYDS3fe&S!Qv_DUDk2$NeHc!Qvj2$NMje|e;\D)Uef2$NeH1(;u7yeHZ'S2$N2$N]c!Qvj,CSD!QvjnR(;u(;2$N(;5c!Qvj,CYD+C:eH!Qvt!QvS3feeH&SsZD_D!QvJUDS3fef2$NM^e .CSSeH1(;,C6eH2$N2$Nw&S2$NeH1(;5c!Qvn(;NpeeH:]eH,CYD=fe,C!Qv!Qvj3eHR!Qvj,CYDSwWDu(;/C*C5fef2$N1(;Mde&SS .CS3fe0 D