{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:12:01Z","timestamp":1787800321850,"version":"build-2784847793"},"reference-count":38,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Context.<\/jats:italic>\n                    \u2014Selective internal radiation (SIR) therapy (SIRT) with yttrium 90 microspheres is increasingly used as an alternative therapeutic modality for patients with inoperable liver tumors. During administration of microspheres via the hepatic artery branches, some may on occasion be misdirected and be caught in the capillary bed of the duodenal and\/or stomach.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Objective.<\/jats:italic>\n                    \u2014To better characterize the histopathologic features of these complications.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Design.<\/jats:italic>\n                    \u2014We report herein our experience with 3 patients who received SIR and developed gastroduodenal complications.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results.<\/jats:italic>\n                    \u2014SIR-microsphere\u2013induced gastroduodenitis was diagnosed from 10 days to 5 months after treatment. In all 3 cases, purple particles measuring about 40 ;gmm in diameter were observed. An array of changes ranging from mucosal ulceration to epithelial changes were seen. Fibrinopurulent exudate was admixed with granulation tissue and reactive stromal cells. Epithelial changes included apoptosis and mucin depletion. Glandular cystic dilatation and epithelial flattening were also common as well as foveolar hyperplasia, suggestive of reparative changes in one case. Capillary ectasia and prominent plump endothelial cells were also present.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion.<\/jats:italic>\n                    \u2014The spectrum of the alterations is consistent with radiotherapy-induced changes. Given the recent approval by the US Food and Drug Administration for the use of SIRT, it is anticipated that more patients will be treated with this modality. Pathologists should become aware of the adverse effects associated with its use.\n                  <\/jats:p>","DOI":"10.5858\/132.11.1734","type":"journal-article","created":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T23:51:38Z","timestamp":1613087498000},"page":"1734-1738","source":"Crossref","is-referenced-by-count":47,"title":["Gastroduodenitis Associated With Yttrium 90\u2013Microsphere Selective Internal Radiation: An Iatrogenic Complication in Need of Recognition"],"prefix":"10.5858","volume":"132","author":[{"given":"Fumihiro","family":"Ogawa","sequence":"first","affiliation":[{"name":"From the Gastrointestinal Pathology Service, Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (Drs Ogawa, Mino-Kenudson, and Lauwers); the Department of Pathology, Saitama Medical School, Saitama, Japan (Dr Shimizu); and the Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, Conn (Dr Ligato)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Mino-Kenudson","sequence":"additional","affiliation":[{"name":"From the Gastrointestinal Pathology Service, Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (Drs Ogawa, Mino-Kenudson, and Lauwers); the Department of Pathology, Saitama Medical School, Saitama, Japan (Dr Shimizu); and the Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, Conn (Dr Ligato)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michio","family":"Shimizu","sequence":"additional","affiliation":[{"name":"From the Gastrointestinal Pathology Service, Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (Drs Ogawa, Mino-Kenudson, and Lauwers); the Department of Pathology, Saitama Medical School, Saitama, Japan (Dr Shimizu); and the Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, Conn (Dr Ligato)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saverio","family":"Ligato","sequence":"additional","affiliation":[{"name":"From the Gastrointestinal Pathology Service, Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (Drs Ogawa, Mino-Kenudson, and Lauwers); the Department of Pathology, Saitama Medical School, Saitama, Japan (Dr Shimizu); and the Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, Conn (Dr Ligato)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y.","family":"Lauwers","sequence":"additional","affiliation":[{"name":"From the Gastrointestinal Pathology Service, Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (Drs Ogawa, Mino-Kenudson, and Lauwers); the Department of Pathology, Saitama Medical School, Saitama, Japan (Dr Shimizu); and the Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, Conn (Dr Ligato)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"key":"i1543-2165-132-11-1734-b1","series-title":"Int J Cancer","first-page":"18","article-title":"Estimates of the worldwide mortality from 25 cancers in 1990.","volume":"83","author":"Pisani, P.","year":"1999","unstructured":"Pisani, P., D. M.Parkin, F.Bray, and J.Ferlay. Estimates of the worldwide mortality from 25 cancers in 1990.Int J Cancer1999. 83:18\u201329."},{"key":"i1543-2165-132-11-1734-b2","series-title":"World J Gastroenterol","first-page":"193","article-title":"Current treatment for liver metastases from colorectal cancer.","volume":"9","author":"Liu, L. X.","year":"2003","unstructured":"Liu, L. X., W. H.Zhang, and H. C.Jiang. Current treatment for liver metastases from colorectal cancer.World J Gastroenterol2003. 9:193\u2013200."},{"key":"i1543-2165-132-11-1734-b3","series-title":"J Clin Oncol","first-page":"722","article-title":"Combined liver radiation and chemotherapy for palliation of hepatic metastases from colorectal cancer.","volume":"14","author":"Mohiuddin, M.","year":"1996","unstructured":"Mohiuddin, M., E.Chen, and N.Ahmad. Combined liver radiation and chemotherapy for palliation of hepatic metastases from colorectal cancer.J Clin Oncol1996. 14:722\u2013728."},{"key":"i1543-2165-132-11-1734-b4","series-title":"Pathology","first-page":"526","article-title":"Selective internal radiation therapy: a case of SIR-Sphere associated duodenal ulceration.","volume":"39","author":"Newland, L. R.","year":"2007","unstructured":"Newland, L. R., A.Walsh, D. R.Gilbert, and M. E.Buckland. Selective internal radiation therapy: a case of SIR-Sphere associated duodenal ulceration.Pathology2007. 39:526\u2013528."},{"key":"i1543-2165-132-11-1734-b5","series-title":"Int J Radiat Oncol Biol Phys","first-page":"S62","article-title":"Selective internal radiation therapy (SIRT) for liver metastases secondary to colorectal adenocarcinoma.","volume":"66","author":"Welsh, J. S.","year":"2006","unstructured":"Welsh, J. S., A. S.Kennedy, and B.Thomadsen. Selective internal radiation therapy (SIRT) for liver metastases secondary to colorectal adenocarcinoma.Int J Radiat Oncol Biol Phys2006. 66:(suppl1). S62\u2013S73."},{"key":"i1543-2165-132-11-1734-b6","series-title":"Arch Surg","first-page":"675","article-title":"Yttrium 90 microsphere selective internal radiation treatment of hepatic colorectal metastases.","volume":"142","author":"Gulec, S. A.","year":"2007","unstructured":"Gulec, S. A. and Y.Fong. Yttrium 90 microsphere selective internal radiation treatment of hepatic colorectal metastases.Arch Surg2007. 142:675\u2013682."},{"key":"i1543-2165-132-11-1734-b7","series-title":"Hepatogastroenterology","first-page":"333","article-title":"Selective internal radiation therapy (SIRT) with 90Yttrium microspheres for extensive colorectal liver metastases.","volume":"48","author":"Stubbs, R. S.","year":"2001","unstructured":"Stubbs, R. S., R. J.Cannan, and A. W.Mitchell. Selective internal radiation therapy (SIRT) with 90Yttrium microspheres for extensive colorectal liver metastases.Hepatogastroenterology2001. 48:333\u2013337."},{"key":"i1543-2165-132-11-1734-b8","series-title":"Surg Oncol","first-page":"179","article-title":"Yttrium-90 internal radiation therapy for hepatic malignancy.","volume":"14","author":"Garrean, S.","year":"2005","unstructured":"Garrean, S. and N.Joseph Espat. Yttrium-90 internal radiation therapy for hepatic malignancy.Surg Oncol2005. 14:179\u2013193."},{"key":"i1543-2165-132-11-1734-b9","series-title":"Hum Pathol","first-page":"527","article-title":"Pathological effects of drugs on the gastrointestinal tract: a review.","volume":"38","author":"Parfitt, J. R.","year":"2007","unstructured":"Parfitt, J. R. and D. K.Driman. Pathological effects of drugs on the gastrointestinal tract: a review.Hum Pathol2007. 38:527\u2013536."},{"key":"i1543-2165-132-11-1734-b10","series-title":"Eur J Surg Oncol","first-page":"S64","article-title":"Ablative and catheter-delivered therapies for colorectal liver metastases (CRLM).","volume":"33","author":"Evans, J.","year":"2007","unstructured":"Evans, J.\n          \n          Ablative and catheter-delivered therapies for colorectal liver metastases (CRLM).\n          Eur J Surg Oncol\n          2007. 33:(suppl 2). S64\u2013S75."},{"key":"i1543-2165-132-11-1734-b11","series-title":"Am J Gastroenterol","first-page":"471","article-title":"Outcomes of colorectal cancer in the United States: no change in survival (1986\u20131997).","volume":"98","author":"Rabeneck, L.","year":"2003","unstructured":"Rabeneck, L., H. B.El-Serag, J. A.Davila, and R. S.Sandler. Outcomes of colorectal cancer in the United States: no change in survival (1986\u20131997).Am J Gastroenterol2003. 98:471\u2013477."},{"key":"i1543-2165-132-11-1734-b12","series-title":"Cancer Biother Radiopharm","first-page":"200","article-title":"Selective internal radiation therapy with SIR-Spheres in patients with nonresectable liver tumors.","volume":"20","author":"Popperl, G.","year":"2005","unstructured":"Popperl, G., T.Helmberger, W.Munzing, R.Schmid, T. F.Jacobs, and K.Tatsch. Selective internal radiation therapy with SIR-Spheres in patients with nonresectable liver tumors.Cancer Biother Radiopharm2005. 20:200\u2013208."},{"key":"i1543-2165-132-11-1734-b13","series-title":"Eur J Surg Oncol","first-page":"597","article-title":"Clinical and imaging experience with yttrium-90 microspheres in the management of unresectable liver tumours.","volume":"33","author":"Jiao, L. R.","year":"2007","unstructured":"Jiao, L. R., T.Szyszko, and A.Al-Nahhas. et al. Clinical and imaging experience with yttrium-90 microspheres in the management of unresectable liver tumours.Eur J Surg Oncol2007. 33:597\u2013602."},{"key":"i1543-2165-132-11-1734-b14","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1552","article-title":"Pathologic response and microdosimetry of (90)Y microspheres in man: review of four explanted whole livers.","volume":"60","author":"Kennedy, A. S.","year":"2004","unstructured":"Kennedy, A. S., C.Nutting, D.Coldwell, J.Gaiser, and C.Drachenberg. Pathologic response and microdosimetry of (90)Y microspheres in man: review of four explanted whole livers.Int J Radiat Oncol Biol Phys2004. 60:1552\u20131563."},{"key":"i1543-2165-132-11-1734-b15","series-title":"Cancer Invest","first-page":"173","article-title":"The toxicity of liver directed yttrium-90 microspheres in primary and metastatic liver tumors.","volume":"26","author":"Neff, R.","year":"2008","unstructured":"Neff, R., R.Abdel-Misih, and J.Khatri. et al. The toxicity of liver directed yttrium-90 microspheres in primary and metastatic liver tumors.Cancer Invest2008. 26:173\u2013177."},{"key":"i1543-2165-132-11-1734-b16","series-title":"ANZ J Surg","first-page":"696","article-title":"Selective internal radiation therapy with 90Y microspheres for colorectal liver metastases: single-centre experience with 100 patients.","volume":"76","author":"Stubbs, R. S.","year":"2006","unstructured":"Stubbs, R. S., I.O'Brien, and M. M.Correia. Selective internal radiation therapy with 90Y microspheres for colorectal liver metastases: single-centre experience with 100 patients.ANZ J Surg2006. 76:696\u2013703."},{"key":"i1543-2165-132-11-1734-b17","series-title":"BMC Cancer","first-page":"132","article-title":"A prospective evaluation of treatment with selective internal radiation therapy (SIR-spheres) in patients with unresectable liver metastases from colorectal cancer previously treated with 5-FU based chemotherapy.","volume":"5","author":"Lim, L.","year":"2005","unstructured":"Lim, L., P.Gibbs, and D.Yip. et al. A prospective evaluation of treatment with selective internal radiation therapy (SIR-spheres) in patients with unresectable liver metastases from colorectal cancer previously treated with 5-FU based chemotherapy.BMC Cancer2005. 5:132. doi:10.1186\/1471-2407-5-132."},{"key":"i1543-2165-132-11-1734-b18","series-title":"J Vasc Interv Radiol","first-page":"937","article-title":"Yttrium 90 resin microspheres for the treatment of unresectable colorectal hepatic metastases after failure of multiple chemotherapy regimens: preliminary results.","volume":"16","author":"Murthy, R.","year":"2005","unstructured":"Murthy, R., H.Xiong, and R.Nunez. et al. Yttrium 90 resin microspheres for the treatment of unresectable colorectal hepatic metastases after failure of multiple chemotherapy regimens: preliminary results.J Vasc Interv Radiol2005. 16:937\u2013945."},{"key":"i1543-2165-132-11-1734-b19","series-title":"J Surg Oncol","first-page":"78","article-title":"Randomised phase 2 trial of SIR-Spheres plus fluorouracil\/leucovorin chemotherapy versus fluorouracil\/leucovorin chemotherapy alone in advanced colorectal cancer.","volume":"88","author":"Van Hazel, G.","year":"2004","unstructured":"Van Hazel, G., A.Blackwell, and J.Anderson. et al. Randomised phase 2 trial of SIR-Spheres plus fluorouracil\/leucovorin chemotherapy versus fluorouracil\/leucovorin chemotherapy alone in advanced colorectal cancer.J Surg Oncol2004. 88:78\u201385."},{"key":"i1543-2165-132-11-1734-b1","series-title":"Int J Cancer","first-page":"18","article-title":"Estimates of the worldwide mortality from 25 cancers in 1990.","volume":"83","author":"Pisani, P.","year":"1999","unstructured":"Pisani, P., D. M.Parkin, F.Bray, and J.Ferlay. Estimates of the worldwide mortality from 25 cancers in 1990.Int J Cancer1999. 83:18\u201329."},{"key":"i1543-2165-132-11-1734-b2","series-title":"World J Gastroenterol","first-page":"193","article-title":"Current treatment for liver metastases from colorectal cancer.","volume":"9","author":"Liu, L. X.","year":"2003","unstructured":"Liu, L. X., W. H.Zhang, and H. C.Jiang. Current treatment for liver metastases from colorectal cancer.World J Gastroenterol2003. 9:193\u2013200."},{"key":"i1543-2165-132-11-1734-b3","series-title":"J Clin Oncol","first-page":"722","article-title":"Combined liver radiation and chemotherapy for palliation of hepatic metastases from colorectal cancer.","volume":"14","author":"Mohiuddin, M.","year":"1996","unstructured":"Mohiuddin, M., E.Chen, and N.Ahmad. Combined liver radiation and chemotherapy for palliation of hepatic metastases from colorectal cancer.J Clin Oncol1996. 14:722\u2013728."},{"key":"i1543-2165-132-11-1734-b4","series-title":"Pathology","first-page":"526","article-title":"Selective internal radiation therapy: a case of SIR-Sphere associated duodenal ulceration.","volume":"39","author":"Newland, L. R.","year":"2007","unstructured":"Newland, L. R., A.Walsh, D. R.Gilbert, and M. E.Buckland. Selective internal radiation therapy: a case of SIR-Sphere associated duodenal ulceration.Pathology2007. 39:526\u2013528."},{"key":"i1543-2165-132-11-1734-b5","series-title":"Int J Radiat Oncol Biol Phys","first-page":"S62","article-title":"Selective internal radiation therapy (SIRT) for liver metastases secondary to colorectal adenocarcinoma.","volume":"66","author":"Welsh, J. S.","year":"2006","unstructured":"Welsh, J. S., A. S.Kennedy, and B.Thomadsen. Selective internal radiation therapy (SIRT) for liver metastases secondary to colorectal adenocarcinoma.Int J Radiat Oncol Biol Phys2006. 66:(suppl1). S62\u2013S73."},{"key":"i1543-2165-132-11-1734-b6","series-title":"Arch Surg","first-page":"675","article-title":"Yttrium 90 microsphere selective internal radiation treatment of hepatic colorectal metastases.","volume":"142","author":"Gulec, S. A.","year":"2007","unstructured":"Gulec, S. A. and Y.Fong. Yttrium 90 microsphere selective internal radiation treatment of hepatic colorectal metastases.Arch Surg2007. 142:675\u2013682."},{"key":"i1543-2165-132-11-1734-b7","series-title":"Hepatogastroenterology","first-page":"333","article-title":"Selective internal radiation therapy (SIRT) with 90Yttrium microspheres for extensive colorectal liver metastases.","volume":"48","author":"Stubbs, R. S.","year":"2001","unstructured":"Stubbs, R. S., R. J.Cannan, and A. W.Mitchell. Selective internal radiation therapy (SIRT) with 90Yttrium microspheres for extensive colorectal liver metastases.Hepatogastroenterology2001. 48:333\u2013337."},{"key":"i1543-2165-132-11-1734-b8","series-title":"Surg Oncol","first-page":"179","article-title":"Yttrium-90 internal radiation therapy for hepatic malignancy.","volume":"14","author":"Garrean, S.","year":"2005","unstructured":"Garrean, S. and N.Joseph Espat. Yttrium-90 internal radiation therapy for hepatic malignancy.Surg Oncol2005. 14:179\u2013193."},{"key":"i1543-2165-132-11-1734-b9","series-title":"Hum Pathol","first-page":"527","article-title":"Pathological effects of drugs on the gastrointestinal tract: a review.","volume":"38","author":"Parfitt, J. R.","year":"2007","unstructured":"Parfitt, J. R. and D. K.Driman. Pathological effects of drugs on the gastrointestinal tract: a review.Hum Pathol2007. 38:527\u2013536."},{"key":"i1543-2165-132-11-1734-b10","series-title":"Eur J Surg Oncol","first-page":"S64","article-title":"Ablative and catheter-delivered therapies for colorectal liver metastases (CRLM).","volume":"33","author":"Evans, J.","year":"2007","unstructured":"Evans, J.\n          \n          Ablative and catheter-delivered therapies for colorectal liver metastases (CRLM).\n          Eur J Surg Oncol\n          2007. 33:(suppl 2). S64\u2013S75."},{"key":"i1543-2165-132-11-1734-b11","series-title":"Am J Gastroenterol","first-page":"471","article-title":"Outcomes of colorectal cancer in the United States: no change in survival (1986\u20131997).","volume":"98","author":"Rabeneck, L.","year":"2003","unstructured":"Rabeneck, L., H. B.El-Serag, J. A.Davila, and R. S.Sandler. Outcomes of colorectal cancer in the United States: no change in survival (1986\u20131997).Am J Gastroenterol2003. 98:471\u2013477."},{"key":"i1543-2165-132-11-1734-b12","series-title":"Cancer Biother Radiopharm","first-page":"200","article-title":"Selective internal radiation therapy with SIR-Spheres in patients with nonresectable liver tumors.","volume":"20","author":"Popperl, G.","year":"2005","unstructured":"Popperl, G., T.Helmberger, W.Munzing, R.Schmid, T. F.Jacobs, and K.Tatsch. Selective internal radiation therapy with SIR-Spheres in patients with nonresectable liver tumors.Cancer Biother Radiopharm2005. 20:200\u2013208."},{"key":"i1543-2165-132-11-1734-b13","series-title":"Eur J Surg Oncol","first-page":"597","article-title":"Clinical and imaging experience with yttrium-90 microspheres in the management of unresectable liver tumours.","volume":"33","author":"Jiao, L. R.","year":"2007","unstructured":"Jiao, L. R., T.Szyszko, and A.Al-Nahhas. et al. Clinical and imaging experience with yttrium-90 microspheres in the management of unresectable liver tumours.Eur J Surg Oncol2007. 33:597\u2013602."},{"key":"i1543-2165-132-11-1734-b14","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1552","article-title":"Pathologic response and microdosimetry of (90)Y microspheres in man: review of four explanted whole livers.","volume":"60","author":"Kennedy, A. S.","year":"2004","unstructured":"Kennedy, A. S., C.Nutting, D.Coldwell, J.Gaiser, and C.Drachenberg. Pathologic response and microdosimetry of (90)Y microspheres in man: review of four explanted whole livers.Int J Radiat Oncol Biol Phys2004. 60:1552\u20131563."},{"key":"i1543-2165-132-11-1734-b15","series-title":"Cancer Invest","first-page":"173","article-title":"The toxicity of liver directed yttrium-90 microspheres in primary and metastatic liver tumors.","volume":"26","author":"Neff, R.","year":"2008","unstructured":"Neff, R., R.Abdel-Misih, and J.Khatri. et al. The toxicity of liver directed yttrium-90 microspheres in primary and metastatic liver tumors.Cancer Invest2008. 26:173\u2013177."},{"key":"i1543-2165-132-11-1734-b16","series-title":"ANZ J Surg","first-page":"696","article-title":"Selective internal radiation therapy with 90Y microspheres for colorectal liver metastases: single-centre experience with 100 patients.","volume":"76","author":"Stubbs, R. S.","year":"2006","unstructured":"Stubbs, R. S., I.O'Brien, and M. M.Correia. Selective internal radiation therapy with 90Y microspheres for colorectal liver metastases: single-centre experience with 100 patients.ANZ J Surg2006. 76:696\u2013703."},{"key":"i1543-2165-132-11-1734-b17","series-title":"BMC Cancer","first-page":"132","article-title":"A prospective evaluation of treatment with selective internal radiation therapy (SIR-spheres) in patients with unresectable liver metastases from colorectal cancer previously treated with 5-FU based chemotherapy.","volume":"5","author":"Lim, L.","year":"2005","unstructured":"Lim, L., P.Gibbs, and D.Yip. et al. A prospective evaluation of treatment with selective internal radiation therapy (SIR-spheres) in patients with unresectable liver metastases from colorectal cancer previously treated with 5-FU based chemotherapy.BMC Cancer2005. 5:132. doi:10.1186\/1471-2407-5-132."},{"key":"i1543-2165-132-11-1734-b18","series-title":"J Vasc Interv Radiol","first-page":"937","article-title":"Yttrium 90 resin microspheres for the treatment of unresectable colorectal hepatic metastases after failure of multiple chemotherapy regimens: preliminary results.","volume":"16","author":"Murthy, R.","year":"2005","unstructured":"Murthy, R., H.Xiong, and R.Nunez. et al. Yttrium 90 resin microspheres for the treatment of unresectable colorectal hepatic metastases after failure of multiple chemotherapy regimens: preliminary results.J Vasc Interv Radiol2005. 16:937\u2013945."},{"key":"i1543-2165-132-11-1734-b19","series-title":"J Surg Oncol","first-page":"78","article-title":"Randomised phase 2 trial of SIR-Spheres plus fluorouracil\/leucovorin chemotherapy versus fluorouracil\/leucovorin chemotherapy alone in advanced colorectal cancer.","volume":"88","author":"Van Hazel, G.","year":"2004","unstructured":"Van Hazel, G., A.Blackwell, and J.Anderson. et al. 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