Seminars in Nuclear Medicine
Volume 37, Issue 2 , Pages 103-119 , March 2007

Detection of Age-Related Changes in Thoracic Structure and Function by Computed Tomography, Magnetic Resonance Imaging, and Positron Emission Tomography

  • David S. Well, MSE

      Affiliations

    • Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
    • ,
  • Jeffrey M. Meier, MSc

      Affiliations

    • Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
    • ,
  • Anton Mahne, MD

      Affiliations

    • Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
    • ,
  • Mohamed Houseni, MD

      Affiliations

    • Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
    • ,
  • Miguel Hernandez-Pampaloni, MD, PhD

      Affiliations

    • Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
    • ,
  • Andrew Mong, MD

      Affiliations

    • Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
    • ,
  • Shipra Mishra, BSc

      Affiliations

    • Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
    • ,
  • Ying Zhuge, PhD

      Affiliations

    • Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
    • ,
  • Andre Souza, PhD

      Affiliations

    • Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
    • ,
  • Jayaram K. Udupa, PhD

      Affiliations

    • Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
    • ,
  • Abass Alavi, MD

      Affiliations

    • Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
    • ,
  • Drew A. Torigian, MD, MA

      Affiliations

    • Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
    • Corresponding Author InformationAddress reprint requests to Drew A. Torigian, MD, MA, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104-4283.

References 

  1. Crapo RO, Morris AH, Gardner RM. Reference spirometric values using techniques and equipment that meet ATS recommendations. Am Rev Respir Dis. 1981;123:659–664
  2. Stam H, Hrachovina V, Stijnen T, et al. Diffusing capacity dependent on lung volume and age in normal subjects. J Appl Physiol. 1994;76:2356–2363
  3. Roberts CM, MacRae KD, Winning AJ, et al. Reference values and prediction equations for normal lung function in a non-smoking white urban population. Thorax. 1991;46:643–650
  4. Knudson RJ, Lebowitz MD, Holberg CJ, et al. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis. 1983;127:725–734
  5. Glindmeyer HW, Diem JE, Jones RN, et al. Noncomparability of longitudinally and cross-sectionally determined annual change in spirometry. Am Rev Respir Dis. 1982;125:544–548
  6. Kanber GJ, King FW, Eschar YR, et al. The alveolar-arterial oxygen gradient in young and elderly men during air and oxygen breathing. Am Rev Respir Dis. 1968;97:376–381
  7. Mittman C, Edelman NH, Norris AH, et al. Relationship between chest wall and pulmonary compliance with age. J Appl Physiol. 1965;20:1211–1216
  8. Tenney SM, Miller RM. Dead space ventilation in old age. J Appl Physiol. 1956;9:321–327
  9. Udupa JK, Odhner D, Samarasekara S, et al. 3DVIEWNIX: An open, transportable, multidimensional, multimodality, multiparametric imaging software system. Proc SPIE Med Imaging. 1994;2164:58–73
  10. Reid L. 1976 Edward B.D. Neuhauser lecture: the lung growth and remodeling in health and disease. AJR Am J Roentgenol. 1977;129:777–788
  11. Hislop AA. Airway and blood vessel interaction during lung development. J Anat. 2002;201:325–334
  12. Thurlbeck WM. Postnatal human lung growth. Thorax. 1982;37:564–571
  13. Dunnill M. Postnatal growth of the lung. Thorax. 1962;17:329–333
  14. Thurlbeck WM. Postnatal growth and development of the lung. Am Rev Respir Dis. 1975;111:803–844
  15. Zeltner TB, Burri PH. The postnatal development and growth of the human lung (II. Morphology). Respir Physiol. 1987;67:269–282
  16. Hislop A, Wigglesworth J, Desai R. Alveolar development in the human fetus and infant. Early Hum Dev. 1986;13:1–11
  17. Hogg JC, Williams J, Richardson JB, et al. Age as a factor in the distribution of lower-airway conductance and in the pathologic anatomy of obstructive lung disease. N Engl J Med. 1970;282:1283–1287
  18. Mansell AL, Bryan AC, Levison H. Relationship of lung recoil to lung volume and maximum expiratory flow in normal children. J Appl Physiol. 1977;42:817–823
  19. Cotes JE, Chinn DJ, Miller MR. Lung Function: Physiology, Assessment and Application in Medicine. (ed 6). Oxford, UK: Blackwell Scientific Publications; 2006;
  20. Cook CD, Helliesen PJ, Agathon S. Relation between mechanics of respiration, lung size and body size from birth to young adulthood. J Appl Physiol. 1958;13:349–352
  21. Zapletal A, Paul T, Samanek M. Pulmonary elasticity in children and adolescents. J Appl Physiol. 1976;40:953–961
  22. Knudson RJ, Slatin RC, Lebowitz MD, et al. The maximal expiratory flow-volume curve (Normal standards, variability, and effects of age). Am Rev Respir Dis. 1976;113:587–600
  23. Taussig LM, Helms PJ. Basic Physiology. In:  Stocks J,  Sly PD,  Tepper RS,  Morgan WJ editor. Infant Respiratory Function Testing. New York: Wiley-Liss; 1996;
  24. Mansell AL, Bryan AC, Levison H. Relationship of lung recoil to lung volume and max expiratory flow in normal children. J Appl Physiol. 1977;42:817–823
  25. Cotes JE, Dabbs JM, Hall AM, et al. Sitting height, fat-free mass and body fat as reference variables for lung function in healthy British children: comparison with stature. Ann Hum Biol. 1979;6:307–314
  26. Rosenthal M, Cramer D, Bain SH, et al. Lung function in white children aged 4 to 19 years: II—Single breath analysis and plethysmography. Thorax. 1993;48:803–808
  27. Jones M, Castile R, Davis S, et al. Forced expiratory flows and volumes in infants (Normative data and lung growth). Am J Respir Crit Care Med. 2000;161:353–359
  28. Lambert RK, Castile RG, Tepper RS. Model of forced expiratory flows and airway geometry in infants. J Appl Physiol. 2004;96:688–692
  29. Stocks J. The functional growth and development of the lung during the first year of life. Early Hum Dev. 1977;1:285–309
  30. Tepper RS, Morgan WJ, Cota K, et al. Physiologic growth and development of the lung during the first year of life. Am Rev Respir Dis. 1986;134:513–519
  31. Hislop A, Muir DC, Jacobsen M, et al. Postnatal growth and function of the pre-acinar airways. Thorax. 1972;27:265–274
  32. Horsfield K, Gordon WI, Kemp W, et al. Growth of the bronchial tree in man. Thorax. 1987;42:383–388
  33. Cudmore R, Emery J, Mithal A. Postnatal growth of the bronchi and bronchioles. Arch Dis Child. 1962;37:481–484
  34. Davies G, Reid L. Growth of the alveoli and pulmonary arteries in childhood. Thorax. 1970;25:669–681
  35. Hogg JC, Williams J, Richardson JB, et al. Age as a factor in the distribution of lower-airway conductance and in the pathologic anatomy of obstructive lung disease. N Engl J Med. 1970;282:1283–1287
  36. Hibbert M, Lannigan A, Raven J, et al. Gender differences in lung growth. Pediatr Pulmonol. 1995;19:129–134
  37. Green M, Mead J, Turner JM. Variability of maximum expiratory flow-volume curves. J Appl Physiol. 1974;37:67–74
  38. Martin TR, Castile RG, Fredberg JJ, et al. Airway size is related to sex but not lung size in normal adults. J Appl Physiol. 1987;63:2042–2047
  39. Pagtakhan RD, Bjelland JC, Landau LI, et al. Sex differences in growth patterns of the airways and lung parenchyma in children. J Appl Physiol. 1984;56:1204–1210
  40. Martin TR, Feldman HA, Fredberg JJ, et al. Relationship between maximal expiratory flows and lung volumes in growing humans. J Appl Physiol. 1988;65:822–828
  41. Briscoe W, Dubois A. The relationship between airway resistance, airway conductance and lung volume in subjects of different age and body size. J Clin Invest. 1958;37:1279–1285
  42. Merkus PJ, Borsboom GJ, Van Pelt W, et al. Growth of airways and air spaces in teenagers is related to sex but not to symptoms. J Appl Physiol. 1993;75:2045–2053
  43. Merkus PJ, ten Have-Opbroek AA, Quanjer PH. Human lung growth: A review. Pediatr Pulmonol. 1996;21:383–397
  44. Hibbert ME, Couriel JM, Landau LI. Changes in lung, airway, and chest wall function in boys and girls between 8 and 12 yr. J Appl Physiol. 1984;57:304–308
  45. Neve V, Girard F, Flahault A, et al. Lung and thorax development during adolescence: relationship with pubertal status. Eur Respir J. 2002;20:1292–1298
  46. Hislop AA. Lung growth and computed tomography. Eur Respir J. 2003;22:195–196
  47. Nakano Y, Muro S, Sakai H, et al. Computed tomographic measurements of airway dimensions and emphysema in smokers (Correlation with lung function). Am J Respir Crit Care Med. 2000;162:1102–1108
  48. Nakano Y, Whittall KP, Kalloger SE, et al. Development and validation of human airway analysis algorithm using multidetector row CT. Proc SPIE. 2002;4683:460–469
  49. Coxson HO, Mayo JR, Behzad H, et al. Measurement of lung expansion with computed tomography and comparison with quantitative histology. J Appl Physiol. 1995;79:1525–1530
  50. Coxson HO, Rogers RM, Whittall KP, et al. A quantification of the lung surface area in emphysema using computed tomography. Am J Respir Crit Care Med. 1999;159:851–856
  51. de Jong PA, Long FR, Wong JC, et al. Computed tomographic estimation of lung dimensions throughout the growth period. Eur Respir J. 2006;27:261–267
  52. Griscom NT, Wohl ME. Dimensions of the growing trachea related to body height (Length, anteroposterior and transverse diameters, cross-sectional area, and volume in subjects younger than 20 years of age). Am Rev Respir Dis. 1985;131:840–844
  53. Gollogly S, Smith JT, White SK, et al. The volume of lung parenchyma as a function of age: A review of 1050 normal CT scans of the chest with three-dimensional volumetric reconstruction of the pulmonary system. Spine. 2004;29:2061–2066
  54. Brengle M, Cohen MD, Katz B. Normal appearance and size of the diaphragmatic crura in children: CT evaluation. Pediatr Radiol. 1996;26:811–814
  55. Janssens JP. Aging of the respiratory system: impact on pulmonary function tests and adaptation to exertion. Clin Chest Med. 2005;26:469–484
  56. Estenne M, Yernault JC, De Troyer A. Rib cage and diaphragm-abdomen compliance in humans: Effects of age and posture. J Appl Physiol. 1985;59:1842–1848
  57. Teale C, Romaniuk C, Mulley G. Calcification on chest radiographs: The association with age. Age Aging. 1989;18:333–336
  58. Edge JR, Millard FJ, Reid L, et al. The radiographic appearances of the chest in persons of advanced age. Br J Radiol. 1964;37:769–774
  59. Tolep K, Kelsen S. Effect of aging on respiratory skeletal muscles. Clin Chest Med. 1993;14:363–378
  60. Evans WJ. What is sarcopenia?. J Gerontol A Biol Sci Med Sci. 1995;50:5–8
  61. Carmeli E, Reznick AZ. The physiology and biochemistry of skeletal muscle atrophy as a function of age. Proc Soc Exp Biol Med. 1994;206:103–113
  62. Carmeli E, Coleman R, Reznick AZ. The biochemistry of aging muscle. Exp Gerontol. 2002;37:477–489
  63. Booth FW, Weeden SH, Tseng BS. Effect of aging on human skeletal muscle and motor function. Med Sci Sports Exerc. 1994;26:556–560
  64. Baumgartner RN, Stauber PM, McHugh D. Cross-sectional age differences in body composition in persons 60+ years of age. J Gerontol A Biol Sci Med Sci. 1995;50:M307–M316
  65. Newman AB, Haggerty CL, Goodpaster B. Strength and muscle quality in a well-functioning cohort of older adults: The Health, Aging and Body Composition Study. J Am Geriatr Soc. 2003;51:323–330
  66. Zeleznik J. Normative aging of the respiratory system. Clin Geriatr Med. 2003;19:1–18
  67. Pierce JA. Age related changes in the fibrous proteins of the lungs. Arch Environ Health. 1963;6:50–54
  68. Turner JM, Mead J, Wohl ME. Elasticity of human lungs in relation to age. J Appl Physiol. 1968;25:664–671
  69. McClaran SR, Babcock MA, Pegelow DF, et al. Longitudinal effects of aging on lung function at rest and exercise in healthy active fit elderly adults. J Appl Physiol. 1995;78:1957–1968
  70. Crapo RO. The aging lung. In:  Mahler DA editors. Pulmonary Disease in the Elderly Patient. New York, NY: Marcel Dekker; 1993;p. 1–26
  71. van Pelt W, Borsboom GJ, Rijcken B, et al. Discrepancies between longitudinal and cross-sectional change in ventilatory function in 12 years of follow-up. Am J Respir Crit Care Med. 1994;149:1218–1226
  72. Dockery DW, Ware JH, Ferris BG, et al. Distribution of forced expiratory volume in one second and forced vital capacity in healthy, white, adult never-smokers in six U.S. cities. Am Rev Respir Dis. 1985;131:511–520
  73. Enright PL, Kronmal RA, Higgins M, et al. Spirometry reference values for women and men 65 to 85 years of age (Cardiovascular health study). Am Rev Respir Dis. 1993;147:125–133
  74. Dice JF. Cellular and molecular mechanisms of aging. Physiol Rev. 1993;73:149–159
  75. Lakatta EG. Cardiovascular regulatory mechanisms in advanced age. Physiol Rev. 1993;73:413–467
  76. Folkow B, Svanborg A. Physiology of cardiovascular aging. Physiol Rev. 1993;73:725–764
  77. Holland J, Milic-Emili J, Macklem PT, et al. Regional distribution of pulmonary ventilation and perfusion in elderly subjects. J Clin Invest. 1968;47:81–92
  78. Righini M, Goehring C, Bounameaux H, et al. Effects of age on the performance of common diagnostic tests for pulmonary embolism. Am J Med. 2000;109:357–361
  79. Brischetto MJ, Millman RP, Peterson DD, et al. Effect of aging on ventilatory response to exercise and CO2. J Appl Physiol. 1984;56:1143–1150
  80. Begin R, Renzetti AD, Bigler AH, et al. Flow and age dependence of airway closure and dynamic compliance. J Appl Physiol. 1975;38:199–206
  81. Mellemgaard K. The alveolar-arterial oxygen difference: Its size and components in normal men. Acta Physiol Scand. 1966;67:10–20
  82. Sorbini CA, Grassi V, Solinas E, et al. Arterial oxygen tension in relation to age in health subjects. Respiration. 1968;25:3–13
  83. Gillooly M, Lamb D. Airspace size in lungs of lifelong non-smokers: Effect of age and sex. Thorax. 1993;48:39–43
  84. Verbeken EK, Cauberghs M, Mertens I, et al. The senile lung. Comparison with normal and emphysematous lungs. 2. Functional aspects. Chest. 1992;101:800–809
  85. Thompson AB, Scholer SG, Daughton DM, et al. Altered epithelial lining fluid parameters in old normal individuals. J Gerontol. 1992;47:M171–M176
  86. Meyer KC, Rosenthal NS, Soergel P, et al. Neutrophils and low-grade inflammation in the seemingly normal lung. Mech Ageing Dev. 1998;104:169–181
  87. Gyetko MR, Toews GB. Immunology of the aging lung. Clin Chest Med. 1993;14:379–391
  88. Lee KW, Chung SY, Yang I, et al. Correlation of aging and smoking with air trapping at thin-section CT of the lung in asymptomatic subjects. Radiology. 2000;214:831–836
  89. Fain SB, Altes TA, Panth SR, et al. Detection of age-dependent changes in healthy adult lungs with diffusion-weighted 3He MRI. Acad Radiol. 2005;12:1385–1393
  90. Breatnach E, Abbott GC, Fraser RG. Dimensions of the normal human trachea. AJR Am J Roentgenol. 1984;142:903–906
  91. In:  Fraser RG,  Pare JAP editor. (ed 2). Diagnosis of Diseases of the Chest. vol 1:Philadelphia, PA: Saunders; 1977;
  92. Suwatanapongched T, Gierada DS, Slone RM, et al. Variation in diaphragm position and shape in adults with normal pulmonary function. Chest. 2003;123:2019–2027
  93. Holley HS, Milic-Emili J, Becklake MR, et al. Regional distribution of pulmonary ventilation and perfusion in obesity. J Clin Invest. 1967;46:475–481
  94. von Ungern-Sternberg BS, Regli A, Schneider MC, et al. Effect of obesity and site of surgery on perioperative lung volumes. Br J Anaesth. 2004;92:202–207
  95. Brown MS, McNitt-Gray MF, Goldin JG, et al. Automated measurement of single and total lung volume from CT. J Comput Assist Tomogr. 1999;23:632–640
  96. Flores KG, Li J, Sempowski GD, et al. Analysis of the human thymic perivascular space during aging. J Clin Invest. 1999;104:1031–1039
  97. Sempowski GD, Hale LP, Sundy JS, et al. Leukemia inhibitory factor, oncostatin M, IL-6, and stem cell factor mRNA expression in human thymus increases with age and is associated with thymic atrophy. J Immunol. 2000;164:2180–2187
  98. Kendall MD, Johnson HR, Singh J. The weight of the human thymus gland at necropsy. J Anat. 1980;131:483–497
  99. Linton PJ, Dorshkind K. Age-related changes in lymphocyte development and function. Nat Immunol. 2004;5:133–139
  100. Montecino-Rodriquez E, Min H, Dorshkind K. Reevaluating current models of thymic involution. Semin Immunol. 2005;17:356–361
  101. Chiodi H. The relationship between the thymus and the sexual organs. Endocrinology. 1940;26:107–116
  102. Utsuyama M, Hirokawa K. Hypertrophy of the thymus and restoration of immune functions in mice and rats by gonadectomy. Mech Ageing Dev. 1989;47:175–185
  103. In:  Janeway CA,  Travers P,  Walport M editor. Immunobiology. (ed 6). New York, NY: Garland Sciences Publishing; 2005;
  104. Henderson J. On the relationship of the thymus to the sexual organs (I. The influence of castration on the thymus). J Physiol. 1904;31:222–229
  105. Greenstein BD, Fitzpatrick FT, Adcock IM, et al. Reappearance of the thymus in old rats after orchidectomy: inhibition of regeneration by testosterone. J Endocrinol. 1986;110:417–422
  106. Windmill KF, Lee VW. Influences of surgical castration on the thymus of male rats. J Reprod Immunol. 1999;44:29–39
  107. Olsen NJ, Kovacs WJ. Gonadal steroids and immunity. Endocr Rev. 1996;17:369–384
  108. Leposavic G, Karapetrovic B, Obradovic S, et al. Differential effects of gonadectomy on the thymocyte phenotypic profile in male and female rats. Pharmacol Biochem Behav. 1996;54:269–276
  109. Steinmann GG, Klaus B, Muller-Hermelink HK. The involution of the ageing human thymic epithelium is independent of puberty (A morphometric study). Scand J Immunol. 1985;22:563–575
  110. Steinmann GG. Changes in the human thymus during aging. Curr Top Pathol. 1986;75:43–88
  111. Yekeler E, Tambag A, Tunaci A, et al. Analysis of the thymus in 151 healthy infants from 0 to 2 years of age. J Ultrasound Med. 2004;23:1321–1326
  112. Weerkamp F, de Haas EF, Naber BA, et al. Age-related changes in the cellular composition of the thymus in children. J Allergy Clin Immunol. 2005;115:834–840
  113. Min H, Montecino-Rodriguez E, Dorshkind K. Reduction in the developmental potential of intrathymic T cell progenitors with age. J Immunol. 2004;173:245–250
  114. Schwarz BA, Bhandoola A. Circulating hematopoietic progenitors with T lineage potential. Nat Immunol. 2004;5:953–960
  115. Allman D, Sambandam A, Kim S, et al. Thymopoiesis independent of common lymphoid progenitors. Nat Immunol. 2003;4:168–174
  116. Porritt HE, Rumfelt LL, Tabrizifard S, et al. Heterogeneity among DN1 prothymocytes reveals multiple progenitors with different capacities to generate T cell and non-T cell lineages. Immunity. 2004;20:735–745
  117. Hasselbalch H, Jeppesen DL, Ersboll AK, et al. Sonographic measurement of thymic size in healthy neonates (Relation to clinical variables). Acta Radiol. 1997;38:95–98
  118. Hasselbalch H, Jeppesen DL, Engelmann MD, et al. Decreased thymus size in formula-fed infants compared with breastfed infants. Acta Paediatr. 1996;85:1029–1032
  119. Baron RL, Lee JK, Sagel SS, et al. Computed tomography of the normal thymus. Radiology. 1982;142:121–125
  120. de Geer G, Webb WR, Gamsu G. Normal thymus: Assessment with MR and CT. Radiology. 1986;158:313–317
  121. Inaoka T, Takahashi K, Iwata K, et al. Evaluation of normal fatty replacement of the thymus with chemical-shift MR imaging for identification of the normal thymus. J Magn Reson Imaging. 2005;22:341–346
  122. Heiberg E, Wolverson MK, Sundaram M, et al. Normal thymus: CT characteristics in subjects under age 20. AJR Am J Roentgenol. 1982;138:491–494
  123. Moore AV, Korobkin M, Olanow W, et al. Age-related changes in the thymus gland: CT-pathologic correlation. AJR Am J Roentgenol. 1983;141:241–246
  124. Francis IR, Glazer GM, Bookstein FL, et al. The thymus: reexamination of age-related changes in size and shape. AJR Am J Roentgenol. 1985;145:249–254
  125. St Amour TE, Siegel MJ, Glazer HS, et al. CT appearances of the normal and abnormal thymus in childhood. J Comput Assist Tomogr. 1987;11:645–650
  126. Siegel MJ, Glazer HS, Wiener JI, et al. Normal and abnormal thymus in childhood: MR imaging. Radiology. 1989;172:367–371
  127. Sklair-Levy M, Agid R, Sella T, et al. Age-related changes in CT attenuation of the thymus in children. Pediatr Radiol. 2000;30:566–569
  128. Patel PM, Alibazoglu H, Ali A, et al. Normal thymic uptake of FDG on PET imaging. Clin Nucl Med. 1996;21:772–775
  129. Nakahara T, Fujii H, Ide M, et al. FDG uptake in the morphologically normal thymus: Comparison of FDG positron emission tomography and CT. Br J Radiol. 2001;74:821–824
  130. Dominguez-Gerpe L, Rey-Mendez M. Time-course of the murine lymphoid tissue involution during and following stressor exposure. Life Sci. 1997;61:1019–1027
  131. Doppman JL, Oldfield EH, Chrousos GP, et al. Rebound thymic hyperplasia after treatment of Cushing’s syndrome. AJR Am J Roentgenol. 1986;147:1145–1147
  132. Kincade PW, Medina KL, Smithson G. Sex hormones as negative regulators of lymphopoiesis. Immunol Rev. 1994;137:119–134
  133. Brink I, Reinhardt MJ, Hoegerle S, et al. Increased metabolic activity in the thymus gland studied with 18F-FDG PET: Age dependency and frequency after chemotherapy. J Nucl Med. 2001;42:591–595
  134. Alibazoglu H, Alibazoglu B, Hollinger EF, et al. Normal thymic uptake of 2-deoxy-2[F-18]fluoro-D-glucose. Clin Nucl Med. 1999;24:597–600

PII: S0001-2998(06)00081-X

doi: 10.1053/j.semnuclmed.2006.10.004

Seminars in Nuclear Medicine
Volume 37, Issue 2 , Pages 103-119 , March 2007

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