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Items: 1 to 50 of 153

1.

Implementation of a Systematic Tumor Screening Program for Lynch Syndrome in an Integrated Health Care Setting.

Clarke EV, Muessig KR, Zepp J, Hunter JE, Syngal S, Acheson LS, Wiesner GL, Peterson SK, Bergen KM, Shuster E, Davis JV, Schneider JL, Kauffman TL, Gilmore MJ, Reiss JA, Rope AF, Cook JE, Goddard KAB.

Fam Cancer. 2019 Jul;18(3):317-325. doi: 10.1007/s10689-019-00123-x.

PMID:
30729418
2.

Recent advances in Lynch syndrome.

Biller LH, Syngal S, Yurgelun MB.

Fam Cancer. 2019 Apr;18(2):211-219. doi: 10.1007/s10689-018-00117-1.

PMID:
30627969
3.

Intercepting Pancreatic Cancer: Our Dream Team's Resolve to Stop Pancreatic Cancer.

Goggins MG, Lippman SM, Constantinou PE, Jacks T, Petersen GM, Syngal S, Maitra A.

Pancreas. 2018 Nov/Dec;47(10):1175-1176. doi: 10.1097/MPA.0000000000001165. No abstract available.

PMID:
30325853
4.

Germline cancer susceptibility gene variants, somatic second hits, and survival outcomes in patients with resected pancreatic cancer.

Yurgelun MB, Chittenden AB, Morales-Oyarvide V, Rubinson DA, Dunne RF, Kozak MM, Qian ZR, Welch MW, Brais LK, Da Silva A, Bui JL, Yuan C, Li T, Li W, Masuda A, Gu M, Bullock AJ, Chang DT, Clancy TE, Linehan DC, Findeis-Hosey JJ, Doyle LA, Thorner AR, Ducar MD, Wollison BM, Khalaf N, Perez K, Syngal S, Aguirre AJ, Hahn WC, Meyerson ML, Fuchs CS, Ogino S, Hornick JL, Hezel AF, Koong AC, Nowak JA, Wolpin BM.

Genet Med. 2019 Jan;21(1):213-223. doi: 10.1038/s41436-018-0009-5. Epub 2018 Jul 2.

PMID:
29961768
5.

Germline Genetic Testing for Pancreatic Ductal Adenocarcinoma at Time of Diagnosis.

Syngal S, Furniss CS.

JAMA. 2018 Jun 19;319(23):2383-2385. doi: 10.1001/jama.2018.6227. No abstract available.

PMID:
29922810
6.

Precision Prevention and Early Detection of Cancer: Fundamental Principles.

Rebbeck TR, Burns-White K, Chan AT, Emmons K, Freedman M, Hunter DJ, Kraft P, Laden F, Mucci L, Parmigiani G, Schrag D, Syngal S, Tamimi RM, Viswanath K, Yurgelun MB, Garber JE.

Cancer Discov. 2018 Jul;8(7):803-811. doi: 10.1158/2159-8290.CD-17-1415. Epub 2018 Jun 15.

PMID:
29907587
7.

Patient and provider perspectives on adherence to and care coordination of lynch syndrome surveillance recommendations: findings from qualitative interviews.

Schneider JL, Goddard KAB, Muessig KR, Davis JV, Rope AF, Hunter JE, Peterson SK, Acheson LS, Syngal S, Wiesner GL, Reiss JA.

Hered Cancer Clin Pract. 2018 May 10;16:11. doi: 10.1186/s13053-018-0090-4. eCollection 2018.

8.

Mutations in the pancreatic secretory enzymes CPA1 and CPB1 are associated with pancreatic cancer.

Tamura K, Yu J, Hata T, Suenaga M, Shindo K, Abe T, MacGregor-Das A, Borges M, Wolfgang CL, Weiss MJ, He J, Canto MI, Petersen GM, Gallinger S, Syngal S, Brand RE, Rustgi A, Olson SH, Stoffel E, Cote ML, Zogopoulos G, Potash JB, Goes FS, McCombie RW, Zandi PP, Pirooznia M, Kramer M, Parla J, Eshleman JR, Roberts NJ, Hruban RH, Klein AP, Goggins M.

Proc Natl Acad Sci U S A. 2018 May 1;115(18):4767-4772. doi: 10.1073/pnas.1720588115. Epub 2018 Apr 18.

9.

Relationship between individual and family characteristics and psychosocial factors in persons with familial pancreatic cancer.

Underhill M, Hong F, Lawrence J, Blonquist T, Syngal S.

Psychooncology. 2018 Jul;27(7):1711-1718. doi: 10.1002/pon.4712. Epub 2018 Apr 19.

PMID:
29570238
10.

Inherited DNA-Repair Defects in Colorectal Cancer.

AlDubayan SH, Giannakis M, Moore ND, Han GC, Reardon B, Hamada T, Mu XJ, Nishihara R, Qian Z, Liu L, Yurgelun MB, Syngal S, Garraway LA, Ogino S, Fuchs CS, Van Allen EM.

Am J Hum Genet. 2018 Mar 1;102(3):401-414. doi: 10.1016/j.ajhg.2018.01.018. Epub 2018 Feb 22.

11.

Commentary: PREMM5 threshold of 2.5% is recommended to improve identification of PMS2 carriers.

Kastrinos F, Uno H, Syngal S.

Fam Cancer. 2018 Oct;17(4):567. doi: 10.1007/s10689-018-0074-6. No abstract available.

PMID:
29380099
12.

Community Practice Implementation of a Self-administered Version of PREMM1,2,6 to Assess Risk for Lynch Syndrome.

Luba DG, DiSario JA, Rock C, Saraiya D, Moyes K, Brown K, Rushton K, Ogara MM, Raphael M, Zimmerman D, Garrido K, Silguero E, Nelson J, Yurgelun MB, Kastrinos F, Wenstrup RJ, Syngal S.

Clin Gastroenterol Hepatol. 2018 Jan;16(1):49-58. doi: 10.1016/j.cgh.2017.06.038. Epub 2017 Jun 28.

13.

Reply to M.S. Daniels et al.

Yurgelun MB, Syngal S.

J Clin Oncol. 2017 Aug 1;35(22):2588-2589. doi: 10.1200/JCO.2017.73.3840. Epub 2017 May 16. No abstract available.

PMID:
28510494
14.

Development and Validation of the PREMM5 Model for Comprehensive Risk Assessment of Lynch Syndrome.

Kastrinos F, Uno H, Ukaegbu C, Alvero C, McFarland A, Yurgelun MB, Kulke MH, Schrag D, Meyerhardt JA, Fuchs CS, Mayer RJ, Ng K, Steyerberg EW, Syngal S.

J Clin Oncol. 2017 Jul 1;35(19):2165-2172. doi: 10.1200/JCO.2016.69.6120. Epub 2017 May 10.

15.

Biallelic Mismatch Repair Deficiency: Management and Prevention of a Devastating Manifestation of the Lynch Syndrome.

Q Rana H, Syngal S.

Gastroenterology. 2017 May;152(6):1254-1257. doi: 10.1053/j.gastro.2017.03.013. Epub 2017 Mar 19. No abstract available.

PMID:
28327367
16.

Universal screening for Lynch syndrome among patients with colorectal cancer: patient perspectives on screening and sharing results with at-risk relatives.

Hunter JE, Arnold KA, Cook JE, Zepp J, Gilmore MJ, Rope AF, Davis JV, Bergen KM, Esterberg E, Muessig KR, Peterson SK, Syngal S, Acheson L, Wiesner G, Reiss J, Goddard KAB.

Fam Cancer. 2017 Jul;16(3):377-387. doi: 10.1007/s10689-017-9972-2.

17.

Cancer Susceptibility Gene Mutations in Individuals With Colorectal Cancer.

Yurgelun MB, Kulke MH, Fuchs CS, Allen BA, Uno H, Hornick JL, Ukaegbu CI, Brais LK, McNamara PG, Mayer RJ, Schrag D, Meyerhardt JA, Ng K, Kidd J, Singh N, Hartman AR, Wenstrup RJ, Syngal S.

J Clin Oncol. 2017 Apr 1;35(10):1086-1095. doi: 10.1200/JCO.2016.71.0012. Epub 2017 Jan 30.

18.

Comparison of Colonoscopy Quality Measures Across Various Practice Settings and the Impact of Performance Scorecards.

Inra JA, Nayor J, Rosenblatt M, Mutinga M, Reddy SI, Syngal S, Kastrinos F.

Dig Dis Sci. 2017 Apr;62(4):894-902. doi: 10.1007/s10620-016-4410-0. Epub 2016 Dec 19.

PMID:
27995405
19.

Universal Screening for Mismatch-Repair Deficiency in Endometrial Cancers to Identify Patients With Lynch Syndrome and Lynch-like Syndrome.

Watkins JC, Yang EJ, Muto MG, Feltmate CM, Berkowitz RS, Horowitz NS, Syngal S, Yurgelun MB, Chittenden A, Hornick JL, Crum CP, Sholl LM, Howitt BE.

Int J Gynecol Pathol. 2017 Mar;36(2):115-127. doi: 10.1097/PGP.0000000000000312.

PMID:
27556954
20.

Understanding the contribution of family history to colorectal cancer risk and its clinical implications: A state-of-the-science review.

Lowery JT, Ahnen DJ, Schroy PC 3rd, Hampel H, Baxter N, Boland CR, Burt RW, Butterly L, Doerr M, Doroshenk M, Feero WG, Henrikson N, Ladabaum U, Lieberman D, McFarland EG, Peterson SK, Raymond M, Samadder NJ, Syngal S, Weber TK, Zauber AG, Smith R.

Cancer. 2016 Sep 1;122(17):2633-45. doi: 10.1002/cncr.30080. Epub 2016 Jun 3. Review. Erratum in: Cancer. 2017 Oct 1;123(19):3857.

21.

Association of a let-7 miRNA binding region of TGFBR1 with hereditary mismatch repair proficient colorectal cancer (MSS HNPCC).

Xicola RM, Bontu S, Doyle BJ, Rawson J, Garre P, Lee E, de la Hoya M, Bessa X, Clofent J, Bujanda L, Balaguer F, Castellví-Bel S, Alenda C, Jover R, Ruiz-Ponte C, Syngal S, Andreu M, Carracedo A, Castells A, Newcomb PA, Lindor N, Potter JD, Baron JA, Ellis NA, Caldes T, LLor X.

Carcinogenesis. 2016 Aug;37(8):751-8. doi: 10.1093/carcin/bgw064. Epub 2016 May 27.

22.

Association of Common Susceptibility Variants of Pancreatic Cancer in Higher-Risk Patients: A PACGENE Study.

Childs EJ, Chaffee KG, Gallinger S, Syngal S, Schwartz AG, Cote ML, Bondy ML, Hruban RH, Chanock SJ, Hoover RN, Fuchs CS, Rider DN, Amundadottir LT, Stolzenberg-Solomon R, Wolpin BM, Risch HA, Goggins MG, Petersen GM, Klein AP.

Cancer Epidemiol Biomarkers Prev. 2016 Jul;25(7):1185-91. doi: 10.1158/1055-9965.EPI-15-1217. Epub 2016 May 16.

23.

Oncologists' Selection of Genetic and Molecular Testing in the Evolving Landscape of Stage II Colorectal Cancer.

Parikh AR, Keating NL, Liu PH, Gray SW, Klabunde CN, Kahn KL, Haggstrom DA, Syngal S, Kim B.

J Oncol Pract. 2016 Mar;12(3):e308-19, 259-60. doi: 10.1200/JOP.2015.007062.

24.

Oncogastroenterology.

Grover S, Lim RM, Blumberg RS, Syngal S.

J Clin Oncol. 2016 Apr 1;34(10):1154-5. doi: 10.1200/JCO.2015.65.7973. Epub 2016 Feb 1. No abstract available.

PMID:
26834060
25.

A proposed staging system and stage-specific interventions for familial adenomatous polyposis.

Lynch PM, Morris JS, Wen S, Advani SM, Ross W, Chang GJ, Rodriguez-Bigas M, Raju GS, Ricciardiello L, Iwama T, Rossi BM, Pellise M, Stoffel E, Wise PE, Bertario L, Saunders B, Burt R, Belluzzi A, Ahnen D, Matsubara N, Bülow S, Jespersen N, Clark SK, Erdman SH, Markowitz AJ, Bernstein I, De Haas N, Syngal S, Moeslein G.

Gastrointest Endosc. 2016 Jul;84(1):115-125.e4. doi: 10.1016/j.gie.2015.12.029. Epub 2016 Jan 6.

26.

Whole Genome Sequencing Defines the Genetic Heterogeneity of Familial Pancreatic Cancer.

Roberts NJ, Norris AL, Petersen GM, Bondy ML, Brand R, Gallinger S, Kurtz RC, Olson SH, Rustgi AK, Schwartz AG, Stoffel E, Syngal S, Zogopoulos G, Ali SZ, Axilbund J, Chaffee KG, Chen YC, Cote ML, Childs EJ, Douville C, Goes FS, Herman JM, Iacobuzio-Donahue C, Kramer M, Makohon-Moore A, McCombie RW, McMahon KW, Niknafs N, Parla J, Pirooznia M, Potash JB, Rhim AD, Smith AL, Wang Y, Wolfgang CL, Wood LD, Zandi PP, Goggins M, Karchin R, Eshleman JR, Papadopoulos N, Kinzler KW, Vogelstein B, Hruban RH, Klein AP.

Cancer Discov. 2016 Feb;6(2):166-75. doi: 10.1158/2159-8290.CD-15-0402. Epub 2015 Dec 9.

27.

Comparison of Prediction Models for Lynch Syndrome Among Individuals With Colorectal Cancer.

Kastrinos F, Ojha RP, Leenen C, Alvero C, Mercado RC, Balmaña J, Valenzuela I, Balaguer F, Green R, Lindor NM, Thibodeau SN, Newcomb P, Win AK, Jenkins M, Buchanan DD, Bertario L, Sala P, Hampel H, Syngal S, Steyerberg EW; Lynch Syndrome prediction model validation study group.

J Natl Cancer Inst. 2015 Nov 18;108(2). pii: djv308. doi: 10.1093/jnci/djv308. Print 2016 Feb.

28.

American Society of Clinical Oncology Policy Statement Update: Genetic and Genomic Testing for Cancer Susceptibility.

Robson ME, Bradbury AR, Arun B, Domchek SM, Ford JM, Hampel HL, Lipkin SM, Syngal S, Wollins DS, Lindor NM.

J Clin Oncol. 2015 Nov 1;33(31):3660-7. doi: 10.1200/JCO.2015.63.0996. Epub 2015 Aug 31.

PMID:
26324357
29.

Germline TP53 Mutations in Patients With Early-Onset Colorectal Cancer in the Colon Cancer Family Registry.

Yurgelun MB, Masciari S, Joshi VA, Mercado RC, Lindor NM, Gallinger S, Hopper JL, Jenkins MA, Buchanan DD, Newcomb PA, Potter JD, Haile RW, Kucherlapati R, Syngal S; Colon Cancer Family Registry.

JAMA Oncol. 2015 May;1(2):214-21.

30.

Universal tumor screening for Lynch syndrome: Assessment of the perspectives of patients with colorectal cancer regarding benefits and barriers.

Hunter JE, Zepp JM, Gilmore MJ, Davis JV, Esterberg EJ, Muessig KR, Peterson SK, Syngal S, Acheson LS, Wiesner GL, Reiss JA, Goddard KA.

Cancer. 2015 Sep 15;121(18):3281-9. doi: 10.1002/cncr.29470. Epub 2015 Jun 2.

31.

Patient experiences living with pancreatic cancer risk.

Underhill M, Berry D, Dalton E, Schienda J, Syngal S.

Hered Cancer Clin Pract. 2015 May 21;13(1):13. doi: 10.1186/s13053-015-0034-1. eCollection 2015.

32.

Identification of a Variety of Mutations in Cancer Predisposition Genes in Patients With Suspected Lynch Syndrome.

Yurgelun MB, Allen B, Kaldate RR, Bowles KR, Judkins T, Kaushik P, Roa BB, Wenstrup RJ, Hartman AR, Syngal S.

Gastroenterology. 2015 Sep;149(3):604-13.e20. doi: 10.1053/j.gastro.2015.05.006. Epub 2015 May 14.

33.

Linear-array EUS improves detection of pancreatic lesions in high-risk individuals: a randomized tandem study.

Shin EJ, Topazian M, Goggins MG, Syngal S, Saltzman JR, Lee JH, Farrell JJ, Canto MI.

Gastrointest Endosc. 2015 Nov;82(5):812-8. doi: 10.1016/j.gie.2015.02.028. Epub 2015 Apr 27.

34.

Stakeholder perspectives on implementing a universal Lynch syndrome screening program: a qualitative study of early barriers and facilitators.

Schneider JL, Davis J, Kauffman TL, Reiss JA, McGinley C, Arnold K, Zepp J, Gilmore M, Muessig KR, Syngal S, Acheson L, Wiesner GL, Peterson SK, Goddard KA.

Genet Med. 2016 Feb;18(2):152-61. doi: 10.1038/gim.2015.43. Epub 2015 Apr 16.

35.

PMS2 monoallelic mutation carriers: the known unknown.

Goodenberger ML, Thomas BC, Riegert-Johnson D, Boland CR, Plon SE, Clendenning M, Win AK, Senter L, Lipkin SM, Stadler ZK, Macrae FA, Lynch HT, Weitzel JN, de la Chapelle A, Syngal S, Lynch P, Parry S, Jenkins MA, Gallinger S, Holter S, Aronson M, Newcomb PA, Burnett T, Le Marchand L, Pichurin P, Hampel H, Terdiman JP, Lu KH, Thibodeau S, Lindor NM.

Genet Med. 2016 Jan;18(1):13-9. doi: 10.1038/gim.2015.27. Epub 2015 Apr 9. Review.

36.

ACG clinical guideline: Genetic testing and management of hereditary gastrointestinal cancer syndromes.

Syngal S, Brand RE, Church JM, Giardiello FM, Hampel HL, Burt RW; American College of Gastroenterology.

Am J Gastroenterol. 2015 Feb;110(2):223-62; quiz 263. doi: 10.1038/ajg.2014.435. Epub 2015 Feb 3. Review.

37.

Incremental value of secretin-enhanced magnetic resonance cholangiopancreatography in detecting ductal communication in a population with high prevalence of small pancreatic cysts.

Rastegar N, Matteoni-Athayde LG, Eng J, Takahashi N, Tamm EP, Mortele KJ, Syngal S, Margolis D, Lennon AM, Wolfgang CL, Fishman EK, Hruban RH, Goggins M, Canto MI, Kamel IR.

Eur J Radiol. 2015 Apr;84(4):575-80. doi: 10.1016/j.ejrad.2014.12.028. Epub 2015 Jan 13.

38.

Racial variation in frequency and phenotypes of APC and MUTYH mutations in 6,169 individuals undergoing genetic testing.

Inra JA, Steyerberg EW, Grover S, McFarland A, Syngal S, Kastrinos F.

Genet Med. 2015 Oct;17(10):815-21. doi: 10.1038/gim.2014.199. Epub 2015 Jan 15.

39.

KRAS and guanine nucleotide-binding protein mutations in pancreatic juice collected from the duodenum of patients at high risk for neoplasia undergoing endoscopic ultrasound.

Eshleman JR, Norris AL, Sadakari Y, Debeljak M, Borges M, Harrington C, Lin E, Brant A, Barkley T, Almario JA, Topazian M, Farrell J, Syngal S, Lee JH, Yu J, Hruban RH, Kanda M, Canto MI, Goggins M.

Clin Gastroenterol Hepatol. 2015 May;13(5):963-9.e4. doi: 10.1016/j.cgh.2014.11.028. Epub 2014 Dec 4.

40.

Colorectal cancer in young adults.

Inra JA, Syngal S.

Dig Dis Sci. 2015 Mar;60(3):722-33. doi: 10.1007/s10620-014-3464-0. Epub 2014 Dec 6. Review.

PMID:
25480403
41.

BRCA1, BRCA2, PALB2, and CDKN2A mutations in familial pancreatic cancer: a PACGENE study.

Zhen DB, Rabe KG, Gallinger S, Syngal S, Schwartz AG, Goggins MG, Hruban RH, Cote ML, McWilliams RR, Roberts NJ, Cannon-Albright LA, Li D, Moyes K, Wenstrup RJ, Hartman AR, Seminara D, Klein AP, Petersen GM.

Genet Med. 2015 Jul;17(7):569-77. doi: 10.1038/gim.2014.153. Epub 2014 Nov 20.

42.

Changes in colorectal cancer screening intention among people aged 18-49 in the United States.

Greaney ML, Puleo E, Sprunck-Harrild K, Syngal S, Suarez EG, Emmons KM.

BMC Public Health. 2014 Sep 1;14:901. doi: 10.1186/1471-2458-14-901.

43.

Guidelines on genetic evaluation and management of Lynch syndrome: a consensus statement by the US Multi-society Task Force on colorectal cancer.

Giardiello FM, Allen JI, Axilbund JE, Boland CR, Burke CA, Burt RW, Church JM, Dominitz JA, Johnson DA, Kaltenbach T, Levin TR, Lieberman DA, Robertson DJ, Syngal S, Rex DK.

Am J Gastroenterol. 2014 Aug;109(8):1159-79. doi: 10.1038/ajg.2014.186. Epub 2014 Jul 22.

PMID:
25070057
44.

Guidelines on genetic evaluation and management of Lynch syndrome: a consensus statement by the US Multi-Society Task Force on colorectal cancer.

Giardiello FM, Allen JI, Axilbund JE, Boland CR, Burke CA, Burt RW, Church JM, Dominitz JA, Johnson DA, Kaltenbach T, Levin TR, Lieberman DA, Robertson DJ, Syngal S, Rex DK; US Multi-Society Task Force on Colorectal Cancer.

Gastroenterology. 2014 Aug;147(2):502-26. doi: 10.1053/j.gastro.2014.04.001. Review.

PMID:
25043945
45.

Guidelines on genetic evaluation and management of Lynch syndrome: a consensus statement by the U.S. Multi-Society Task Force on Colorectal Cancer.

Giardiello FM, Allen JI, Axilbund JE, Boland CR, Burke CA, Burt RW, Church JM, Dominitz JA, Johnson DA, Kaltenbach T, Levin TR, Lieberman DA, Robertson DJ, Syngal S, Rex DK; American Society for Gastrointestinal Endoscopy.

Gastrointest Endosc. 2014 Aug;80(2):197-220. doi: 10.1016/j.gie.2014.06.006. Review. No abstract available.

PMID:
25034835
46.

Screening for germline mismatch repair mutations following diagnosis of sebaceous neoplasm.

Everett JN, Raymond VM, Dandapani M, Marvin M, Kohlmann W, Chittenden A, Koeppe E, Gustafson SL, Else T, Fullen DR, Johnson TM, Syngal S, Gruber SB, Stoffel EM.

JAMA Dermatol. 2014 Dec;150(12):1315-21.

47.

Guidelines on genetic evaluation and management of Lynch syndrome: a consensus statement by the US Multi-Society Task Force on Colorectal Cancer.

Giardiello FM, Allen JI, Axilbund JE, Boland CR, Burke CA, Burt RW, Church JM, Dominitz JA, Johnson DA, Kaltenbach T, Levin TR, Lieberman DA, Robertson DJ, Syngal S, Rex DK.

Dis Colon Rectum. 2014 Aug;57(8):1025-48. doi: 10.1097/DCR.000000000000000.

PMID:
25003300
48.

Recurrences are common after endoscopic ampullectomy for adenoma in the familial adenomatous polyposis (FAP) syndrome.

Ma T, Jang EJ, Zukerberg LR, Odze R, Gala MK, Kelsey PB, Forcione DG, Brugge WR, Casey BW, Syngal S, Chung DC.

Surg Endosc. 2014 Aug;28(8):2349-56. doi: 10.1007/s00464-014-3467-0. Epub 2014 Feb 25.

49.

American Society of Clinical Oncology Expert Statement: collection and use of a cancer family history for oncology providers.

Lu KH, Wood ME, Daniels M, Burke C, Ford J, Kauff ND, Kohlmann W, Lindor NM, Mulvey TM, Robinson L, Rubinstein WS, Stoffel EM, Snyder C, Syngal S, Merrill JK, Wollins DS, Hughes KS; American Society of Clinical Oncology.

J Clin Oncol. 2014 Mar 10;32(8):833-40. doi: 10.1200/JCO.2013.50.9257. Epub 2014 Feb 3. No abstract available.

50.

Therapy-associated polyposis as a late sequela of cancer treatment.

Yurgelun MB, Hornick JL, Curry VK, Ukaegbu CI, Brown EK, Hiller E, Chittenden A, Goldberg JE, Syngal S.

Clin Gastroenterol Hepatol. 2014 Jun;12(6):1046-50. doi: 10.1016/j.cgh.2013.11.040. Epub 2013 Dec 19.

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