1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)
1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)
1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)
1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)
1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => OpenAccess
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)


  
    























































































































































    Initial Experience in Using Continuous Arterial Spin-Labeled MR Imaging for Early Detection of Alzheimer Disease | American Journal of Neuroradiology  
    



















    































    
  
  




    
    

  

      


    

      

  
  
  

    

  

    

  

                
    

      

  

    

  
      
  
  

    


Advertisement



  



  


  
  



  



    

  


  


  


  
  
  
  
  
  

  	      



          


    
      

    
  
    
        
    

  

    
                        

  

                
    

      

	  

		
		

			

			  

  
      
  
  

    

  
  
      
Research ArticleBrain

  
      
Open Access

  
      
Initial Experience in Using Continuous Arterial Spin-Labeled MR Imaging for Early Detection of Alzheimer Disease
  
    	
C.A. Raji, C. Lee, O.L. Lopez, J. Tsay, J.F. Boardman, E.D. Schwartz, W.S. Bartynski, H.M. Hefzy, H.M. Gach, W. Dai and J.T. Becker

  
    	
American Journal of Neuroradiology May 2010,  31 (5) 847-855; DOI: https://doi.org/10.3174/ajnr.A1955 

  
  
  



  


  
  



			

		

	
	
 	
	  
  

		
		

			

			  

  
      
  
  

    
  


  
  



  
      
  
  

    

  

    

  
      
  
  

    
References
  1. 1.↵


    1. Sloane  PD, 
    2. Zimmerman  S, 
    3. Suchindran  C, 
    4. et al
    . The public health impact of Alzheimer's disease, 2000–2050: potential implication of treatment advances. Annu Rev Public Health 2002;23:213–31
    CrossRefPubMedWeb of Science
    

  2. 2.↵


    1. Frisoni  GB, 
    2. Testa  C, 
    3. Sabattoli  F, 
    4. et al
    . Structural correlates of early and late onset Alzheimer's disease: voxel based morphometric study. J Neurol Neurosurg Psychiatry 2005;76:112–14
    Abstract/FREE Full Text
    

  3. 3.↵


    1. Ohnishi  T, 
    2. Matsuda  H, 
    3. Tabira  T, 
    4. et al
    . Changes in brain morphology in Alzheimer disease and normal aging: is Alzheimer disease an exaggerated aging process? AJNR Am J Neuroradiol 2001;22:1680–85
    Abstract/FREE Full Text
    

  4. 4.↵


    1. Knopman  DS, 
    2. DeKosky  ST, 
    3. Cummings  JL, 
    4. et al
    . Practice parameter: diagnosis of dementia (an evidence-based review)—report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2001;56:1143–53
    Abstract/FREE Full Text
    

  5. 5.↵


    1. Karas  GB, 
    2. Burton  EJ, 
    3. Rombouts  SA, 
    4. et al
    . A comprehensive study of gray matter loss in patients with Alzheimer's disease using optimized voxel-based morphometry. Neuroimage 2003;18:895–907
    CrossRefPubMedWeb of Science
    

  6. 6.↵


    1. Silverman  DH, 
    2. Small  GW, 
    3. Chang  CY, 
    4. et al
    . Positron emission tomography in evaluation of dementia: regional brain metabolism and long-term outcome. JAMA 2001;286:2120–27
    CrossRefPubMedWeb of Science
    

  7. 7.↵


    1. Jagust  WJ, 
    2. Johnson  KA, 
    3. Holman  BL
    . SPECT perfusion imaging in the diagnosis of dementia. J Neuroimaging 1995;5:S45–S52
    PubMed
    

  8. 8.↵


    1. Detre  JA, 
    2. Leigh  JS, 
    3. Williams  DS, 
    4. et al
    . Perfusion imaging. Magn Reson Med 1992;23:37–45
    CrossRefPubMedWeb of Science
    

  9. 9.↵


    1. Detre  JA, 
    2. Alsop  DC, 
    3. Vives  LR, 
    4. et al.
    >. Noninvasive MRI evaluation of cerebral blood flow in cerebrovascular disease. Neurology 1998;50:633–41
    Abstract/FREE Full Text
    

  10. 10.↵


    1. Ye  FQ, 
    2. Berman  KF
    . H215O PET validation of steady-state arterial spin tagging cerebral blood flow measurements in humans. Magn Reson Med 2000;44:450–56
    CrossRefPubMedWeb of Science
    

  11. 11.↵


    1. Alsop  DC, 
    2. Detre  JA, 
    3. Grossman  M
    . Assessment of cerebral blood flow in Alzheimer's disease by spin-labeled magnetic resonance imaging. Ann Neurol 2000;47:93–100
    CrossRefPubMedWeb of Science
    

  12. 12.↵


    1. Du  AT, 
    2. Jahng  GH, 
    3. Hayasaka  S, 
    4. et al
    . Hypoperfusion in frontotemporal dementia and Alzheimer disease by arterial spin labeling MRI. Neurology 2006;67:1215–20
    Abstract/FREE Full Text
    

  13. 13.↵


    1. Johnson  NA, 
    2. Jahng  G-H, 
    3. Weiner  MW, 
    4. et al
    . Pattern of cerebral hypoperfusion in Alzheimer disease and mild cognitive impairment measured with arterial spin-labeling MR imaging: initial experience. Radiology 2005;234:851–59
    CrossRefPubMedWeb of Science
    

  14. 14.↵


    1. Alsop  DC, 
    2. Casement  M, 
    3. de Bazelaire  C, 
    4. et al
    . Hippocampal hyperperfusion in Alzheimer's disease. Neuroimage 2008;42:1267–74
    CrossRefPubMedWeb of Science
    

  15. 15.↵


    1. Jagust  WJ
    . Neuroimaging in dementia. Neurol Clin 2000;18:885–902
    CrossRefPubMedWeb of Science
    

  16. 16.↵


    1. Claus  JJ, 
    2. van Harskamp  F, 
    3. Breteler  MM, 
    4. et al
    . The diagnostic value of SPECT with Tc 99m HMPAO in Alzheimer's disease: a population-based study. Neurology 1994;44:454–61
    Abstract/FREE Full Text
    

  17. 17.↵


    1. Powers  WJ, 
    2. Perlmutter  JS, 
    3. Videen  TO, 
    4. et al
    . Blinded clinical evaluation of positron emission tomography for diagnosis of probable Alzheimer's disease. Neurology 1992;42:765–70
    Abstract/FREE Full Text
    

  18. 18.↵


    1. Lopez  OL, 
    2. Becker  JT, 
    3. Jagust  WJ, 
    4. et al
    . Neuropsychological characteristics of mild cognitive impairment subgroups. J Neurol Neurosurg Psychiatry 2006;77:159–65
    Abstract/FREE Full Text
    

  19. 19.↵


    1. Kuller  LH, 
    2. Lopez  OL, 
    3. Jagust  WJ, 
    4. et al
    . Determinants of vascular dementia in the Cardiovascular Health Cognition Study. Neurology 2005;64:1548–52
    Abstract/FREE Full Text
    

  20. 20.↵


    1. Fried  LP, 
    2. Borhani  NO, 
    3. Enright  P, 
    4. et al
    . The Cardiovascular Health Study: design and rationale. Ann Epidemiol 1991;1:263–76
    CrossRefPubMed
    

  21. 21.↵


    1. Lopez  OL, 
    2. Kuller  LH, 
    3. Fitzpatrick  A, 
    4. et al
    . Evaluations of dementia in the Cardiovascular Health Cognition Study. Neuroepidemiology 2003;22:1–12
    CrossRefPubMedWeb of Science
    

  22. 22.↵


    1. Lopez  OL, 
    2. Jagust  WJ, 
    3. DeKosky  ST, 
    4. et al
    . Prevalence and classification of mild cognitive impairment in the Cardiovascular Health Study Cognition Study: part 1. Arch Neurology 2003;60:1385–89
    CrossRefPubMedWeb of Science
    

  23. 23.↵


    1. Dai  W, 
    2. Lopez  OL, 
    3. Carmichael  OT, 
    4. et al
    . Mild cognitive impairment and Alzheimer disease: patterns of altered cerebral blood flow at MR imaging. Radiology 2009;250:856–66
    CrossRefPubMedWeb of Science
    

  24. 24.↵


    1. McKhann  G, 
    2. Drachman  DA, 
    3. Folstein  MF, 
    4. et al
    . Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 1984;34:939–44
    Abstract/FREE Full Text
    

  25. 25.↵


    1. Manolio  TA, 
    2. Kronmal  RA, 
    3. Burke  GL, 
    4. et al
    . Magnetic resonance abnormalities and cardiovascular disease in older adults: the Cardiovascular Health Study. Stroke 1994;25:318–27
    Abstract/FREE Full Text
    

  26. 26.↵


    1. O'Leary  DH, 
    2. Polak  JF, 
    3. Kronmal  RA, 
    4. et al
    . Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults: Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999;340:14–22
    CrossRefPubMedWeb of Science
    

  27. 27.↵


    1. Laurienti  PJ, 
    2. Field  AS, 
    3. Burdette  JH, 
    4. et al
    . Relationship between caffeine-induced changes in resting cerebral perfusion and blood oxygenation level-dependent signal. AJNR Am J Neuroradiol 2003;24:1607–11
    Abstract/FREE Full Text
    

  28. 28.↵


    1. Yue  NC, 
    2. Arnold  AM, 
    3. Longstreth  WT, 
    4. et al
    . Sulcal, ventricular, and white matter changes at MR imaging in the aging brain: data from the Cardiovascular Health Study. Radiology 1997;202:33–39
    PubMedWeb of Science
    

  29. 29.↵


    1. Bryan  RN, 
    2. Wells  SW, 
    3. Miller  TJ, 
    4. et al
    . Infarctlike lesions in the brain: prevalence and anatomic characteristics at MR imaging of the elderly—data from the Cardiovascular Health Study. Radiology 1997;202:47–54
    PubMedWeb of Science
    

  30. 30.↵


    1. Bernick  C, 
    2. Kuller  L, 
    3. Dulberg  C, 
    4. et al
    . Silent MRI infarcts and the risk of future stroke: the Cardiovascular Health Study. Neurology 2001;57:1222–29
    Abstract/FREE Full Text
    

  31. 31.↵


    1. Longstreth  WT, 
    2. Manolio  TA, 
    3. Arnold  A, 
    4. et al
    . Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. Stroke 1996;27:1274–82
    Abstract/FREE Full Text
    

  32. 32.↵


    1. Longstreth  WT, 
    2. Bernick  C, 
    3. Manolio  TA, 
    4. et al
    . Lacunar infarcts defined by magnetic resonance imaging of 3660 elderly people. Arch Neurol 1998;55:1217–25
    CrossRefPubMedWeb of Science
    

  33. 33.↵


    1. Teng  EL, 
    2. Chui  HC
    . The Modified Mini-Mental State (3MS) examination. J Clin Psychiatry 1987;48:314–18
    PubMedWeb of Science
    

  34. 34.↵


    1. Graham  JE, 
    2. Rockwood  K, 
    3. Beattie  BL
    . Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet 1997;349:1793–96
    CrossRefPubMedWeb of Science
    

  35. 35.↵


    1. Alsop  DC, 
    2. Detre  JA
    . Multisection cerebral blood flow MR imaging with continuous arterial spin labeling. Radiology 1998;208:410–16
    PubMedWeb of Science
    

  36. 36.↵


    1. Gach  HM, 
    2. Dai  W
    . Simple model of double adiabatic inversion (DAI) efficiency. Magn Reson Med 2004;52:941–46
    CrossRefPubMed
    

  37. 37.↵


    1. Dai  W
    . Advancements in Quantitative Perfusion Magnetic Resonance Imaging (MRI) of Dementia [dissertation].  Pittsburgh: University of Pittsburgh; 2006
  38. 38.↵

    1. Buxton  RB, 
    2. Frank  LR, 
    3. Wong  EC, 
    4. et al
    .
A general kinetic model for quantitative perfusion imaging with arterial spin labeling.
Magn Reson Med
1998;
40:
383–
96

    CrossRefPubMedWeb of Science
    

  39. 39.↵


    1. Dai  W, 
    2. Lopez  OL, 
    3. Carmichael  OT, 
    4. et al
    . Abnormal regional cerebral blood flow in cognitively normal elderly subjects with hypertension. Stroke 2008;39:349–54
    Abstract/FREE Full Text
    

  40. 40.↵


    1. Chen  M
    . 3-D Deformable Registration Using a Statistical Atlas with Applications in Medicine [dissertation].  Pittsburgh: Carnegie Mellon University; 1999
  41. 41.↵

    1. Meltzer  CC, 
    2. Cantwell  MN, 
    3. Greer  PJ, 
    4. et al
    .
Does cerebral blood flow decline in healthy aging? A PET study with partial-volume correction.
J Nucl Med
2000;
41:
1842–
48

    Abstract/FREE Full Text
    

  42. 42.↵


    1. Prince  SE, 
    2. Woo  S, 
    3. Doraiswamy  PM, 
    4. et al
    . Functional MRI in the early diagnosis of Alzheimer's disease: is it time to refocus? Expert Rev Neurother 2008;8:169–75
    CrossRefPubMed
    

  43. 43.↵


    1. Bryan  RN, 
    2. Manolio  TA, 
    3. Scertz  LD, 
    4. et al
    . A method for using MR to evaluate the effects of cardiovascular disease on the brain: the Cardiovascular Health Study. AJNR Am J Neuroradiol 1994;15:1625–33
    Abstract/FREE Full Text
    

  44. 44.↵


    1. Braak  H, 
    2. Braak  E
    . Neuropathological stageing of Alzheimer-related changes. Acta Neuropathol 1991;82:239–59
    CrossRefPubMedWeb of Science
    

  45. 45.↵


    1. Jack  CR, 
    2. Petersen  RC, 
    3. Xu  YC, 
    4. et al
    . Medial temporal atrophy on MRI in normal aging and very mild Alzheimer's disease. Neurology 1997;49:786–94
    Abstract/FREE Full Text
    

  46. 46.↵


    1. Jack  CR  Jr., 
    2. Petersen  RC, 
    3. Xu  Y, 
    4. et al
    . Rate of medial temporal lobe atrophy in typical aging and Alzheimer's disease. Neurology 1998;51:993–99
    Abstract/FREE Full Text
    

  47. 47.↵


    1. Lee  C, 
    2. Lopez  OL, 
    3. Becker  JT, 
    4. et al
    . Imaging cerebral blood flow in the cognitively normal aging brain with arterial spin labeling: implications for imaging of neurodegenerative disease. J Neuroimaging 2009;19:344–52.Epub 2009 Mar 9

    CrossRefPubMed
    

  48. 48.↵


    1. Komorita  SS
    . Attitude content, intensity, and the neutral point on a Likert scale. J Soc Psychol 1963;61:327–34
    CrossRefPubMedWeb of Science
    

  49. 49.↵


    1. Jack  CR  Jr., 
    2. Lowe  VJ, 
    3. Senjem  ML, 
    4. et al
    . 11C PiB and structural MRI provide complementary information in imaging of Alzheimer's disease and amnestic mild cognitive impairment. Brain 2008;131(pt 3):665–80.
Epub 2008 Feb 7

    Abstract/FREE Full Text
    

  50. 50.↵


    1. Landis  JR, 
    2. Koch  GG
    . The measurement of observer agreement for categorical data. Biometrics 1977;33:159–74
    CrossRefPubMedWeb of Science
    

  51. 51.↵


    1. Lopez  OL, 
    2. Kuller  LH, 
    3. Becker  JT, 
    4. et al
    . Incidence of dementia in mild cognitive impairment in the Cardiovascular Health Study. Arch Neurol 2007;64:416–20
    CrossRefPubMedWeb of Science
    

  52. 52.↵


    1. Petersen  RC, 
    2. Smith  GE, 
    3. Waring  SC, 
    4. et al
    . Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999;56:303–08
    CrossRefPubMedWeb of Science
    

  53. 53.↵


    1. Roberts  DA, 
    2. Detre  JA, 
    3. Bolinger  L, 
    4. et al
    . Quantitative magnetic resonance imaging of human brain perfusion at 1.5T using steady state inversion of arterial water. Proc Natl Acad Sci U S A 1994;91:33–37
    Abstract/FREE Full Text
    

  54. 54.↵


    1. Silverman  DH, 
    2. Gambhir  SS, 
    3. Huang  HW, 
    4. et al
    . Evaluating early dementia with and without assessment of regional cerebral metabolism by PET: a comparison of predicted costs and benefits. J Nucl Med 2002;43:253–66
    Abstract/FREE Full Text
    

  55. 55.↵


    1. McNeill  R, 
    2. Sare  GM, 
    3. Manoharan  M, 
    4. et al
    . Accuracy of single-photon emission computed tomography in differentiating frontotemporal dementia from Alzheimer's disease. J Neurol Neurosurg Psychiatry 2007;78:350–55
    Abstract/FREE Full Text
    

  56. 56.↵


    1. Klunk  WE, 
    2. Engler  H, 
    3. Nordberg  A, 
    4. et al
    . Imaging brain amyloid in Alzheimer's disease with Pittsburgh Compond-B. Ann Neurol 2004;55:306–19
    CrossRefPubMedWeb of Science
    

  57. 57.↵


    1. Buckner  RL, 
    2. Snyder  AZ, 
    3. Shannon  BJ, 
    4. et al
    . Molecular, structural, and functional characterization of Alzheimer's disease: evidence for a relationship between default activity, amyloid, and memory. J Neurosci 2005;25:7709–17
    Abstract/FREE Full Text
    

  58. 58.↵


    1. Mintun  MA, 
    2. Larossa  GN, 
    3. Sheline  YI, 
    4. et al
    . [11C]PIB in a nondemented population: potential antecedent marker of Alzheimer disease. Neurology 2006;67:446–52
    Abstract/FREE Full Text
    

  59. 59.↵


    1. Deibler  AR, 
    2. Pollock  JM, 
    3. Kraft  RA, 
    4. et al
    . Arterial spin-labeling in routine clinical practice. Part 2. Hypoperfusion patterns. AJNR Am J Neuroradiol 2008;29:1235–41
    Abstract/FREE Full Text
    

  60. 60.↵


    1. Scheltens  P, 
    2. Leys  D, 
    3. Barkhof  F, 
    4. et al
    . Atrophy of medial temporal lobes on MRI in “probable” Alzheimer's disease and normal ageing: diagnostic value and neuropsychological correlates. J Neurol Neurosurg Psychiatry 1992;55:967–72
    Abstract/FREE Full Text
    

  61. 61.↵


    1. Duara  R, 
    2. Loewenstein  DA, 
    3. Potter  E, 
    4. et al
    . Medial temporal lobe atrophy on MRI scans and the diagnosis of Alzheimer disease. Neurology 2008;71:1986–92
    Abstract/FREE Full Text
    

  62. 62.↵


    1. Aviv  RI, 
    2. Shelef  I, 
    3. Malam  S, 
    4. et al
    . Early stroke detection and extent: impact of experience and the role of computed tomography angiography source images. Clin Radiol 2007;62:447–52
    CrossRefPubMed
    

  63. 63.↵


    1. Barber  PA, 
    2. Demchuk  AM, 
    3. Zhang  J, 
    4. et al
    . Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy: ASPECTS Study Group—Alberta Stroke Programme Early CT Score. Lancet 2000;355:1670–74
    CrossRefPubMedWeb of Science
    

  64. 64.↵


    1. Bozzali  M, 
    2. Cercignani  M, 
    3. Caltagirone  C
    . Brain volumetrics to investigate aging and the principal forms of degenerative cognitive decline: a brief review. Magn Reson Imaging 2008;26:1065–70
    CrossRefPubMed
    

  65. 65.↵


    1. Bonte  FJ, 
    2. Weiner  MF, 
    3. Bigio  EH, 
    4. et al
    . Brain blood flow in the dementias: SPECT with histopathologic correlation in 54 patients. Radiology 1997;202:793–97
    PubMedWeb of Science
    

  


  
  



  




  


  
  



  
      
  
  

    
  


  
  



  
      
  
  

     Back to top  


  
  



			

		

		
		

			

			  

  
        
In this issue

    
  
  

    
  


  
  



  
      
  
  

    

  

    

  
      
  
  

    


Advertisement



  



  


  
  



  



  


  
  



  
      
  
  

    

	  
  

		

          

            

  
      
  
  

     Print  


  
  



  
      
  
  

     Download PDF  


  
  



  
      
  
  

    
 Email Article
  


  
  



  
      
  
  

    
 Citation Tools
  


  
  



          

        

        
        

          

            



  
      
  
  

    

  

    

  
      
  
  

    

  
  
  
  
      
Initial Experience in Using Continuous Arterial Spin-Labeled MR Imaging for Early Detection of Alzheimer Disease
  
    	
C.A. Raji, C. Lee, O.L. Lopez, J. Tsay, J.F. Boardman, E.D. Schwartz, W.S. Bartynski, H.M. Hefzy, H.M. Gach, W. Dai, J.T. Becker

  
    	
 American Journal of Neuroradiology May 2010, 31 (5) 847-855; DOI: 10.3174/ajnr.A1955 

  
  
  



  


  
  



  
      
  
  

    

  
    
  
  
    
  
  
    
  


  


  
  



  
      
  
  

    
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  


  
  



  



  


  
  



  
      
  
  

    
  


  
  



          

        

	
 	
	
	


  


  
  



  
      
  
  

    
              Purchase  


  
  



  
        
Jump to section

    
  
  

    
  


  
  



  
      
  
  

    
  


  
  



			

		

	
	
 	
	
	


    

  



  

                
    

      

  

    

  
      
  
  

    


Advertisement