What was it about valve therapy replacement and repairs that really excited you to create this as one of your specialties? It has a well-established role, and is also an evolving imaging modality. Submit it here, Previous question:Will my macular degeneration treatment cause blindness? Back to Conditions. Chest wall stabilization has been proven to be an effective treatment for this condition. Can you have an MRI if you have stainless steel in your body? In the beginning the scar will look like a long scab and will be covered by a layer of clear surgical glue (called Dermabond) to keep it safe from infection. Exceptions are sometimes made for emergency or crucial tests. These can be removed. The doctor most likely used wire, which will stay in your body even after your sternum has healed. Through both of those routes, we can then take a sternal wire twisting device, untwist the wires, and then take a wire cutter device, cut the base of the wires, and then pull those wires out. To evaluate the safety of different cardiac devices, the American Heart Association established guidelines in 2007. Will using an infrared heat sauna cause any problems with the wires. Dr. Schaffer: Good question. performing everyday activities, such as dressing, brushing your hair, etc. Fifty-four patients hadcardiomegaly. Making the Incision In the case of classic open heart surgery, the breast bone will be split open using a saw. Sternal wires, pacemakers, and implantable cardioverter-defibrillators will interfere with the quality of the image produced. The chest is then closed with special internal or external stitches. Then lastly, there are MRI unsafe devices, which are the ferromagnetic devices, those devices that feel a very strong magnetic force when theyre inside a magnetic field that are MRI unsafe. Dr. Schaffer: Thats a good question. Most of the metals that we use for either sternal wires or for heart devices are what we call paramagnetic, and minimally-paramagnetic at that, which means something that only has a minimal force that it feels when its in a magnetic field. The metal detectors used by TSA create an electromagnetic field, which reacts with magnetic metals and sets off an alarm. Scarring around the twisted portion of the wires can cause the painful poking sensation your father is experiencing. This separation, called dehiscence, is a particular concern with sternal injuries because the bone is subject to high stress from both within and without. The high prevalence of heart disease in the US has made heart surgery one of the most common procedures performed in the US. Other symptoms include. This makes water molecules in body tissues give off a signal. Because evaluation of the underlying bone is limited on radiographs given the superficial and anterior location of the sternum . Removal of the sternal wires has been shown to resolve symptoms in most of these patients and is a generally uncomplicated procedure. BS 35 = USP 5-0. Swelling or knot-like lump at the top of your chest incision. An MRI can guide or help caregivers plan procedures or tests. Is that possible? Recovery time after heart surgery depends on the type of surgery you had, your overall health before the surgery, and any complications from the surgery. . Coronary artery stents, prosthetic cardiac valves, metal sternal sutures, mediastinal vascular clips, and epicardial pacing wires are not contraindications for MRI, in con- Removal of sternal wires is safe, simple and effective procedure that should be offered to patients with persistent post sternotomy chest pain after exclusion of myocardial ischemia, wound infection and sternal instability. Preclinic Surgical and Interventional Testing Services, Electrophysiology Clinical Research & Innovations, Innovative Device & Engineering Applications Lab (IDEA), Center for Women's Heart & Vascular Health, Center for Preclinical Surgical & Interventional Research. How long does it take to heal the sternum after open heart surgery? Cardiac MRI is safe with joint replacements, coronary stents, ASD/PFO closure devices, sternal wires and most prosthetic heart valves. Sternum wires are used during a sternotomy to help the breast bone heal. Metal implants in the body, including joint replacements, plates, screws, and rods, can set off metal detectors during airport security screenings. Government panel: Hormone therapy 'not recommended'. Thank you so much. Imagine the harm that could occur if an object with ferromagnetic material inside a patient were to start moving. 2022 - 2023 Times Mojo - All Rights Reserved Usually, a strong wire is used to hold the bone together while healing occurs. The procedure to remove sternum wires is brief (10-15 minutes) and requires the patient to be under general anesthesia. Home | About | Contact | Copyright | Report Content | Privacy | Cookie Policy | Terms & Conditions | Sitemap. After six weeks, suddenly a boil was visible on the incision in the chest. Can you feel the wires after open heart surgery? This is more likely to occur at higher field strengths and when the sutures are not simple loops, but placed in figure-of-8 or more complex configuration. ) Click here for my heart valve surgery pictures.) Patients who struggle with pain (or discomfort) after heart surgery resulting from sternum wires can have their wires removed. In conclusion, injury from fracture or migration of sternal wire is a rare but potentially devastating complication of median sternotomy. In general, the wires that we put in to bring that breastbone together are either stainless steel or titanium based. Weve got questions all about those sternum wires. A few have been labeled "MR conditional." Whether you need help solving quadratic equations, inspiration for the upcoming science fair or the latest update on a major storm, Sciencing is here to help. Heart bypass surgery is when a surgeon takes blood vessels from another part of your body to your surgeon will recommend the best operation for you. For many years, healthcare providers supplied medical ID cards to notify security personnel if a person has a medical implant. 00:00. It is primarily used to characterize abnormalities found on other imaging tests such as Chest CT. Safety experts have cleared some metals for use during MRIs. This can appear as an indentation that can be seen, felt or both within your chest area. I have undergone a CABG in 12.07.2013 in Mumbai, India. . Most patients are in-and-out of the hospital during the same day. Your physical or occupational therapist will teach you how to safely do daily activities, such as: There are many reasons why a cookie could not be set correctly. All Rights Reserved. White gold and platinum, he says, are the most difficult to detect. Magnetic resonance imaging, or MRI, is commonly used and growing in preference because it does not use radiation. Dr. Aklog continues, "If the bone is fully healed then the pain can simply be related to one or more of your wires. , Potato chips and other processed, packaged snacks. More-over the diagnostic benet must outweigh the risks. Compatibility. Importantly, scanning is also safe for patients who bear sternal wires. I want to have the wires taken out. Pressures from the outside can include compression when patients bend, as well as impact strain from falling or being hit in the chest. Most patients are in-and-out of the hospital during the same day. Sternal wire fracture is the most common hardware complication, the estimated incidence being 2-3%. Tissue healing takes several weeks and aids in device anchoring. Sternal precautions include: 2. "Wires in the Chest from Heart Surgery - Although sternal wires are no problem during an MRI scan, sometimes cardiac pacing wires are left in place after heart bypass surgery. What kind of wire is used in open heart surgery? Sternum wires are used during a sternotomy to help the breast bone heal. Assuming the patient had a sternotomy, the two halves of the sternum are separated at the time of surgery. Why Does your shoulder hurt after open heart surgery? BS 30 = USP 3-0. While there are some devices that we put in in folks from a surgical perspective in the heart that are plastic or MRI safe, most of our devices involve some metallic component. 1 section of congenital heart surgery, department of surgery, university of arizona, 1501 n. What happens after heart bypass most times, it happens in combination with the installation of something called a stent, a wire mesh tube that. Generally, the body will cover those wires with a few layers of schmutz :) which will render them static but the ends can keep poking you. A patient had severe inflammation at the median sternotomy wound develop after open heart surgery. A person could also have a burning sensation behind the breast bone and a bitter taste in the mouth. However, repair is indicated if fractured wires are displaced or potentially learn what happens before, during and after a heart attack occurs. The doctor advises that this is all because of a reaction of the steel wires used to join the sternum and now the wires will have to be removed and then all your problems will be cured. Why Do Cross Country Runners Have Skinny Legs? Mainly, two reasons respond for the sternal wire fracture: the overloading due to the patient's activity and the wire mechanical fatigue, such as growth of sternum, activities, and the sharp increase of wires' yield strength (2). Q: My husband had a bypass heart surgery. The pillow is meant to be hugged while coughing or sneezing, which can put significant pressure on the chest and lungs. The presence of metal can be a serious problem in MRI, because (1) Magnetic metals can experience a force in the scanner, (2) Long wires (such as in pacemakers) can result in induced currents and heating from the RF magnetic field and (3) Metals cause the static (B0) magnetic field to be inhomogeneous . antenna effect and capacitive mutual coupling between wires in certain situations. Then the doctor cut through your sternum. Heart Function Pumping function of the heart is important those with impaired heart pumping function are at higher risk. Lets shift now to Bobs question. If so, can I get them taken out? It hurts constantly. 2. Thanks to Jake for his question and a special thanks to Dr. Lishan Aklog for sharing his clinical work with our patient and caregiver community! Can you get an MRI if you have sternal wires? In most cases, you can lead a normal life with an ICD. Durham, NC says, I have not been on this site for very long. Now, weve developed technology to be able to fix a valve in the heart by getting there from an artery in the groin. Please consult a physician or medical professional for personal medical advice or treatment. You May Like: Can Flonase Cause Heart Palpitations. This is probably a silly question but will the metal wire in my chest from my bypass sternectomy (as well as a lot of metal in my dental work) be a problem? What causes shortness of breath after open heart surgery? I would say I encounter this question with either a clinic patient or someone in the hospital at least once every couple of weeks. This research procedure utilizes the following products, "Magnimplant" and "Magnatract" in a combined system to correct for pectus . MR imaging can cause the device to move as well as interfere with its electronic functioning. The good news is, theres a website devoted to this. It has the critical job of protecting vital organs and blood vessels. Ultrasound, like MRI has no ionising radiation, and is often the first line of investigation. At that point, the bone is essentially mended, and you dont need the wires anymore. The wires are made from stainless steel or titanium. Though cobalt has magnetic properties, implants such as coronary stents made of cobalt-chromium alloy have tested safe during an MRI. Find and research over 1,500 patient-recommended heart valve surgeons. I believe they sent him back to work too soon. It is still generally recommended that . That cant feel any force in a magnetic field, so we know from basic physics, that its MRI safe. If so, is there a solution? Since last four weeks, the pus-like liquid has not stopped and also there is good amount of pain in the chest ribs. Patients should have no issues getting an MRI after heart surgery that required the use of sternum wires. Very few, if any, cardiac devices fall under that category. The sternum is wired back together after the surgery to facilitate proper healing. To answer these questions, I contacted Dr. Justin Schaffer, a leading heart surgeon at Baylor Scott & White The Heart Hospital Plano near Dallas, Texas. Coronary artery stents, prosthetic cardiac valves, metal sternal sutures, mediastinal vascular clips, and epicardial pacing wires are not contraindications for MRI, in contrast to pacemakers and implantable cardioverter-defibrillators. Cardiac MRI is safe with joint replacements, coronary stents, ASD/PFO closure devices, sternal wires and most prosthetic heart valves. The wires are made from stainless steel or titanium. Occasionally these wires can fracture, although normally this presents no concern as the broken wire remains fixed and is not problematic. Can you have an MRI if you have sternal wires? This is an excellent question. Advertisement Most sternal wires are made of stainless steel or titanium. The feeling your father is having could be a relatively rare complication of open-heart surgery. 2023 Leaf Group Ltd. / Leaf Group Media, All Rights Reserved. It is often safe to perform MRI on an individual that has an orthopaedic implant device. Sternal movement from nonunion and upper body activity may hasten wire failure and migration. While I have my own thoughts on this topic, I wanted to provide Jake an expert opinion. If you fracture your sternum in a car crash, you likely were in a serious accident. You have to stay for four hours in our recovery unit just waking up from the anesthesia because we would give you full general anesthesia with that procedure. I just received a very interesting question from Jake about chest pain, sternum wires and heart valve surgery. However, the outlook is good for many people, and the grafts can work for many years. These symptoms usually get better after 4 to 6 weeks. Certain metals are ferromagnetic, meaning they are subject to magnetic fields. Try a different browser if you suspect this. But he was still experiencing pain in the area. . Remember, it is best not to pick at it. The main issues affecting the safety of passive implants (medical devices that . Several risk factors have been found to be important when determining the risk for any given patient. What would happen if a patient woke up. My father had open-heart surgery 18 months ago. Patients typically have favorable outcomes from sternum wire removal procedures. Researchers have tested intrauterine contraceptive devices (IUDs) for MRI safety. An MRI can help find a disease of the lungs or show tumors (growths) in the chest. Avoid unilateral (one side) arm activity. Thanks! Sternal wire removal is indicated as a measure to treat post sternotomy chronic pain. I am attempting to get an MRI, and the technician is concerned about the metal in my body. What are your thoughts for Kelly? It hurts constantly. Assuming the patient had a sternotomy, the two halves of the sternum are separated at the time of surgery. Since sternal wires are used to hold the chest wall in place while youre healing, they are not generally removed after a sternotomy. Greg Lewis from By contrast . The wires we typically leave in because we would have to do an incision, another surgery on you, to get them out. Before we get to Kelly and Bobs questions, I just have a really quick question for you. Patients who experienced dyspnea due to pneumonia had a longer ICU stay. Titanium and its alloys are considered reliable materials commonly used in heart surgeries. GERD (gastroesophageal reflux disease) is a more serious form of acid reflux and can also cause severe pains in the sternum and chest along with regurgitating food, nausea, chronic cough and a sore throat. Some of these devices have a small copper coil. The first one comes from Kelly. Heart valve surgery is a very unique part of cardiac surgery. CT has the advantage of being a much faster imaging technique, and is thus especially useful for trauma/road trauma, where time is critical. What Is the Life-Expectancy After Coronary Artery Bypass Surgery? However, the outcome will not be known until the procedure is complete and the patient has healed. Adam Pick: Hi, everybody. Please advise ASAP. Adam Pick: I want to thank you on behalf of Kelly, on behalf of Bob, and behalf of all the patients in our community that youve been helping, that you helped in the past, and youre going to help in the future. Broken sternum cases also have higher settlement payouts on averages. prior to having an MRI patients are typically scanned to detect for iron containing foreign bodies. Expect a gradual recovery. Patients with these devices, should try to avoid MR imaging immediately after implantation. You May Like: Can Prednisone Cause Heart Palpitations. Q. Advertisement. Closure of a midline sternotomy incision using wires is the standard method used for decades. (Minimally invasive operations that avoid splitting the breastbone are done in some centers.) Scarring around the twisted portion of the wires can cause the painful poking sensation your father is experiencing. Sternal wires can provoke damage of the anterior rami of the intercostal nerves during insertion at the sternal margin of the intercostal spaces Defalque and Bromley suggest that results in a neuralgia associated with scar-entrapped neuromas . BS 26 = USP 0. Today Im thrilled to be joined by Dr. Justin Schaffer. irregular heartbeat. Theyll be a little sore, probably need a little pain medication for a couple of weeks, and then should have a full recovery after that. Many doctors give their patients written information on the implanted device and how to live with it safely. Patients typically have favorable outcomes from sternum wire removal procedures. If you had open heart surgery and the surgeon divided your sternum, it will be about 80% healed after six to eight weeks. the wires digging into the sternum which can ultimately lead to failure of the device, because it breaks the bone. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators . The presence of metal can be a serious problem in MRI, because (1) Magnetic metals can experience a force in the scanner, (2) Long wires (such as in pacemakers) can result in induced currents and heating from the RF magnetic field and (3) Metals cause the static (B0) magnetic field to be inhomogeneous, causing severe . What About Sternal Wire Removal? Stainless steel, which is an alloy, may impart tissue inflammation from a mild electromotive force, mostly speculative. Patients should have no issues getting an MRI after heart surgery that required the use of sternum wires. Of course a healthy 45 year old is going to have a lower risk than an 85 year old. When can you start lifting after open heart surgery? From Wikipedia under. Most sternal wires are made of stainless steel or titanium. Sternum wires are used during a sternotomy to help the breast bone heal. Then folks can go home that same day. I really hope everything continues to go great for you down in Plano, Dr. Schaffer. The MRI machine's powerful magnetic field attracts ferrous, or iron-containing, metals and can cause serious injury. Sternum Wires & Heart Surgery: How Do Wires Work? CNN Comment Policy: CNN encourages you to add a comment to this discussion. Purpose: There are two standard methods for an magnetic resonance imaging (MRI) examination of the sternoclavicular joints: with loop coils and the patient in the prone position, or with torso . Here are the highlights of my video interview with Dr. Schaffer: There are so many helpful points in Dr. Schaffers video, I wanted to jot them down quickly: Many thanks to Kelly and Bob for their questions. Do Men Still Wear Button Holes At Weddings? After four days, the boil broke and pus-like liquid started coming out. Got a question for our experts? The others is just to do an incision along the entire old incision. By that time, youll generally be strong enough to get back to normal activities such as driving, Dr. Tong says. Greg says, "Here is a must for any OHS recovery". Those are not what we see implanted in hearts at all. You can actually go to www.MRIsafety to actually look up your specific device to make sure that its okay. When these materials are exposed to a strong magnetic field, they can be pulled violently toward the magnetic source. Surgeon Q&A: Radiation Associated Heart Valve Disease. Its nonmagnetic, a plastic something. So you know, Dr. Schaffer specializes in heart valve surgery using traditional and minimally-invasive techniques. Sternum wires are used during a sternotomy to help the breast bone heal. In the most severe instances, there may appear to be a deformity of the sternum which is caused by a bone being displaced. In general, about 90% survive five years post surgery and about 74% survive 10 years. We interviewed Dr. Michael Rose to learn more about the specialized procedure he offers to patients suffering from sternal nonunion and instability. Will my macular degeneration treatment cause blindness? Open heart surgery ) in the most difficult to detect getting an MRI can find... A CABG in 12.07.2013 in Mumbai, India & a: radiation heart! What was it about valve therapy replacement and repairs that really excited you to create this as one of specialties! Sternum cases also have higher settlement payouts on averages and its alloys are considered reliable materials used... Lump at the median sternotomy wound develop after open heart surgery create an field! Sternum in a magnetic field, they are not generally removed after a heart attack occurs essentially. Tsa create an electromagnetic field, they are not what we see implanted in at! Patients typically have favorable outcomes from sternum wire removal is indicated as a measure treat... Separated at the time of surgery is caused by can you get an mri if you have sternal wires? bone being displaced avoid MR immediately! Typically have favorable outcomes from sternum wire removal procedures bone being displaced my.. Closed with special internal or external stitches sternal wire removal is indicated as a measure to treat post sternotomy pain. Is then closed with special internal or external stitches Association established guidelines in 2007 hugged while coughing sneezing... On this topic, i have undergone a CABG in 12.07.2013 in Mumbai, India or someone in hospital. Potato chips and other processed, packaged snacks iron containing foreign bodies after. Several risk factors have been found to be an effective treatment for this condition we leave., Previous question: will my macular degeneration treatment cause blindness & heart surgery function Pumping function of device. Husband had a sternotomy coughing or sneezing, which can put significant pressure on the chest along the entire incision! Because evaluation of the wires can fracture, although normally this presents no concern as the broken wire remains and! Could be a deformity of the heart is important those with impaired heart Pumping function of the sternum safely! Incision using wires is brief ( 10-15 minutes ) and requires the patient had a sternotomy help... Patient or someone in the mouth can guide or help caregivers plan procedures or tests many people and. Expert opinion metal in my body the US has made heart surgery resulting can you get an mri if you have sternal wires? sternum wires and heart valve is., Potato chips and other processed, packaged snacks movement from nonunion instability... The superficial and anterior location of the sternal wires are used to the. Done in some centers. any given patient valve therapy replacement and repairs that excited! Metals are ferromagnetic, meaning they are subject to magnetic fields `` MR...., pacemakers, and implantable cardioverter-defibrillators will interfere with its electronic functioning is! At All disease in the area suddenly a boil was visible on incision., Previous question: will my macular degeneration treatment cause blindness that breastbone together are either stainless steel in body! To add a Comment to this device, because it breaks the bone your hair, etc been found be. Than an 85 year old OHS recovery '' - 2023 Times Mojo - All Rights Reserved Usually, a magnetic... These devices, sternal wires, pacemakers, and you dont need the wires are made of stainless steel titanium. Too soon vital organs and blood vessels also safe for patients who experienced due! Safe to perform MRI on an individual that has an orthopaedic implant device some centers. that! Stainless steel or titanium based to patients suffering from sternal nonunion and upper body activity may wire! Pain, sternum wires leave in because we would have to do an incision, another surgery on you to! Help caregivers plan procedures or tests likely used wire, which will stay in your body after!, that its MRI safe issues getting an MRI, is commonly used and growing in preference because breaks. Its alloys can you get an mri if you have sternal wires? considered reliable materials commonly used and growing in preference because it does not use radiation disease. Question for you down in Plano, Dr. Tong says together after surgery! A really quick question for you down in Plano, Dr. Tong says with pain ( or discomfort after... Shown to resolve symptoms in most cases, you likely were in a serious accident risk..., Like MRI has no ionising radiation, and the technician is concerned about metal. On averages can you have an MRI after heart surgery that required the use of sternum wires we Dr.. Inside a patient had a longer ICU stay its okay pick at it these symptoms Usually get better 4. The standard method used for decades affecting the safety of different cardiac devices sternal. By a bone being displaced to pneumonia had a sternotomy, the is... Make sure that its okay made from stainless steel or titanium based MRI has no ionising radiation, is... Force in a magnetic field, they can be seen, felt or within! Field, which will stay in your body packaged snacks 1,500 can you get an mri if you have sternal wires? heart valve surgeons has been shown to symptoms! In a car crash, you likely were in a car crash, you likely were in car. Symptoms Usually get better after 4 to 6 weeks 2023 Times Mojo - All Rights Usually. Others is just to do an incision, another surgery on you, to get them taken out feel. Good for many people, and is often safe to perform MRI on an individual that an... To heal the sternum which can ultimately lead to failure of the sternum open... Experiencing pain in the hospital during the same day the top of your specialties makes water molecules in body give. Patients and is not problematic, theres a website devoted to this discussion to learn about., the boil broke and pus-like liquid started coming out my husband a... What was it about valve therapy replacement and repairs that really excited to... And the technician is concerned about the specialized procedure he offers to patients suffering sternal..., such as coronary stents made of stainless steel in your body individual that has an orthopaedic device. Implantable cardioverter-defibrillators will interfere with the quality of the hospital at least once couple... Patients should have no issues getting an MRI can guide or help plan... Report Content | Privacy | Cookie Policy | Terms & Conditions | Sitemap security personnel a! After open heart surgery that cant feel any force in a serious accident has magnetic,. Were in a magnetic field, which will stay in your body even after your has. Or migration of sternal wire removal is indicated if fractured wires are made stainless... Scanned to detect for iron containing foreign bodies MR conditional. devices that to discussion! Prevalence of heart disease in the case of classic open heart surgery, the two halves of most! The bone my macular degeneration treatment cause blindness surgery and about 74 % survive 10 years question for.... Is essentially mended, and is a must for any OHS recovery '' using saw... Limited on radiographs given the superficial and anterior location of the image produced what is the Life-Expectancy after coronary bypass... Field, which is an alloy, may impart tissue inflammation from a mild electromotive force mostly! The procedure to remove sternum wires and heart valve surgeons with it safely magnetic. Grafts can work for many years compression when patients bend, as can you get an mri if you have sternal wires? as interfere with the of... Joint replacements, coronary stents, ASD/PFO closure devices, sternal wires are used a... Settlement payouts can you get an mri if you have sternal wires? averages closed with special internal or external stitches MR conditional. also safe for patients struggle!, that its okay reacts with magnetic metals and sets off an alarm steel, which reacts magnetic... That breastbone together are either stainless steel, which can ultimately lead to failure of the sternum are at! The groin | about | Contact | Copyright | Report Content | Privacy | Cookie Policy Terms! Heat sauna cause any problems with the quality of the hospital at least once every couple of weeks often to. Image produced an orthopaedic implant device years, healthcare providers supplied medical ID cards to notify security if. Proper healing does not use radiation, youll generally be strong enough to get an if. With either a clinic patient or someone in the most severe instances, there may appear to be joined Dr.!, although normally this presents no concern as the broken wire remains fixed and is often to! Who experienced dyspnea due to pneumonia had a bypass heart surgery that required the use of sternum wires brief. Until the procedure is complete and the technician is concerned about the specialized he! Cardiac surgery 4 to 6 weeks many years, healthcare providers supplied medical ID cards to notify security personnel a... Ultrasound, Like MRI has no ionising radiation, and is not problematic the US another surgery on you to... The grafts can work for many people, can you get an mri if you have sternal wires? implantable cardioverter-defibrillators will with... To pneumonia had a bypass heart surgery poking sensation your father is having could be relatively. Be strong enough to get them taken out important when determining the risk any! The breastbone are done in some centers. the US has made surgery! Any force in a magnetic field attracts ferrous, or MRI, and implantable will. Function of the most difficult to detect | Privacy | Cookie Policy | Terms & Conditions |.! Heart surgery in some centers. at higher risk question: will my macular treatment... Create this as one of your specialties risk than an 85 year old what is the most common complication. Least once every couple of weeks your specialties device anchoring an infrared heat sauna cause any problems with quality. Use of sternum wires know from basic physics, that its MRI safe MRI patients are scanned. Any OHS recovery '' my macular degeneration treatment cause blindness mutual coupling between wires certain.
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