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the kidneys were stated to be normal. The percentages of uric acid
excreted by these three patients were none, 8.6 per cent, and 24 per
cent, within from one to two days. In their fourth case of gout the
patient had "beginning albuminuria." In this case 23.6 per cent, of
the injected uric acid was excreted within the first twenty-four hours.
The results of this test in four cases have been published by Burger
and Schweriner.^® One retained all the uric acid. The urine of this
patient was free from albtunin and casts. In the other cases small
amounts were excreted. The urine of only one of these patients con-
tained albumin and casts.

We have given four patients with gout intravenous injections of
0.5 gm. of uric acid. One patient had a severe type of nephritis. Of
the others one showed no signs of nephritis and two such slight synrp-
toms of that disease that kidney lesions could not be definitely diag-
nosed. The condition of the kidneys in these cases will be discussed
in another communication on the study of the renal function in gout.
The findings in the blood and urine after the uric acid injections are
given in the following protocols.



27. Umber and RetzlafF: Zur Harnsaure-Retention bei der Gicht. Verhandl.
d. Kong. f. inn. Med., Wiesbaden, 1910, 27, 436.

28. Burger, M., and Schweriner, F.: Ueber das Verhalten intravenous ein-
verleibten GlykokoUs bei gesunden und krankheiten Menschen (mit besonderer
Berticksichtigung der Gicht und Lebercirrhose). Arch. f. exper. Pathol, u.
Pharmakol., 1913, 74, 353.



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URIC ACID IN GOUT



495



Case 6.— D. J. T., Med. No. 2963. White, male, aged 55.

Diagnosis: Acute and chronic gout; arteriosclerosis; chronic nephritis;
hypertension; chronic myocarditis; angina pectoris.

The patient had used one pint of rum a day for many years. He had had
five attacks of typical podagra in the metatarsophalangeal joint of the right
hallux during the previous fifteen years. One attack occurred while he was
under observation in the hospital. Physical examination showed that the heart
was enlarged to the left. The radial artery walls were tortuous and sclerotic.
Blood pressure was 184 mm. systolic and 140 mm. diastolic. The urine contained
a trace of albumin and an occasional cast. Phthalein excretion was 5 per
cent, in two hours.





Time Of
OoUectlon


Urine


Blood




Date


Amount
inO.c.


Uric Add
in Qm.


Urie Add
inMg.

100O.C.


Nonpro-
telnNin

ioo'o!cf


Bemarks


1915
June 28






seo


0.07


8.5


68.6




Joly
l-£


7 a jn. - 7 p.in.


begun


^8




600
620
485

1,060
065

1,010
780
710
80O
570
865


0.07
0.10
0.18
0.88








8-4






4-5


'




5^






5-7




0.88
0.88








7-8






8-0




0.88
0.25
0.27
0.20
0.27


8.1
"ii'






0-10






IMl






11-12






12-18






18


1 p.m.
1 p.m.
5 p.m.


0.5 gm. uric acid
intravenously


18-U


7 a.m. - 7 a.m.


950


0.47








14


11 a.m.





....


4.1






14-15


7 a.m. • 7 a.m.


085


0.85








15


11a.m.




....


4.7






15-16


7 a.m. - 7 a.m.


660


0.17








16


11 a.m.




....


2.9






16-17


7 a.m. - 7 a.m.


023


0.85








17-18


7 a.m. - 7 a.m.


904


0.84









Endogenous output of uric acid July 5 to 13 = 2.36 gm.
Endogenous output of uric acid per day = 0.30 gm.
Exogenous output of uric acid July 14 to 15 = 022 gm.
Per cent, of injected uric acid excreted = 44 per cent.
Uric acid determinations were made by the original method.



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ARCH. ISl



Case 7.— W. P. G., Med. No. 5471. Negro, male, aged 43.

Diagnosis: Gout; questionable chronic nephritis.

The patient's habits were good. During the last ten years he had had a
dozen attacks of gout affecting the joints of the lower extremities and of the
phalanges of the fingers. On physical examination numerous tophi were found
in the ears and about the finger joints. Otherwise physical examination was
negative. The blood pressure was 135 mm. systolic and 95 diastolic. The
urine contained no casts, no blood and no epithelium. A scant trace of albumin
was found once in the examination of several urine specimens. Phthalein
excretion was 42 per cent, in two hours.





Time of
CoUectlon


Urine


Blood




Date


Amount
inO.c.


Uric Add
InGm.


Uric Add
InMg.

100C.C.


Nonpro-
tein N In

looa?


Remarks


1910
Oct. 21-2S

22-23


7 a.m. • 7 a.m.


1.800
1.165

780

705

880

990

115
90

*"96

"iao

480
910

905

625

840

1,080

890
1.850
1.080
1.086


0.57
OM

0.87

0.41

0.41

0.87

0.05
0.08

0^04

6.07

0.21
0.44

0.41
0.28
0.89
0.69
. *••
0.62
0.69
0.61
a68


8.8

4.1
5.1

4.8
4.8


48.5
. .«•

49.5


Purin-free diet
began


28






28-24






24-25






25-28






28-27






27

27-28

28
28-29

29-ao


7 a.m. - 10 a.m.

10a.m.-12N.

12 N.

12:16 p.m.

12 • 2 p.m.

4 p.m.
2 • 6 p.m.

5 p.m. • 7 a.m.

4:16 p.m.
7 a.m. - 7 a jn.


Intravenoualy 0.5
gm. uric add

Total amount for
24 hours


804{1






81-Nov. 1






1




Mild attack of


1-2




gout
Mild attack of


2-8




gout


8-4






4-5






9













Endogenous output of uric acid October 24 to 27 = 1.56 gm.

Endogenous output of uric acid per day = 0.39 gm.

Exogenous output of uric acid October 28 to 29=0.07 gm.

Per cent, of injected uric acid excreted = 14 per cent.

Uric acid determinations were made by the uric acid phenol reagent method.



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1917



URIC ACID IN GOUT



497



Case 8.— J. G., Med. No. 5421. White, male, aged 43.

Diagnosis: Gout; arteriosclerosis; hypertension; chronic myocarditis; very
questionable chronic nephritis.

The patient had used beer freely. He had about sixteen attacks of severe
polyarthritis of gouty character during the previous twenty-six years. Physical
examination showed numerous tophi in the ears and on the fingers. The
joints showed the changes of chronic arthritis. The radial artery walls were
sclerosed. The blood pressure was 185 mm. systolic and 117 mm. diastolic.
Otherwise physical examination was negative. The urine examinations were
negative. Phthalein excretion was 52 per cent, in two hours.





Time of
CoUectfon


Urine


Blood




Date


Amount
in C.c.


Uric Acid
InQm.


Uric Acid
inMg.

per
100 C.c.


Nonpro-
tein N In
Mg. per
100 c.c.


Remarks


1916
Oct. 10




1.006
960

1.260

1,280

Lost

960

906

1,870

1,865
870
830
870
840
700
670

"165
74
171
106

"830
786

820
980
950
750
670




1.00
1.01

0.71
0.96

0.89

0.68

0.78

0.80
0.44
0.70
0.69
0.71
0.47
0.41

0.06
0.06
0.11
0.06

6.22
0.62

0.51
0.49
0.68

o.ei

0.46


6.4
5.4

....

4.1

4.8

4.0

4.3




Mixed diet


11








Purin-free diet


18




begun
Acute attack of


16-16
16-17


7 a.m. - 7 a.m.


gout
Acute attack of

gout
Acute attack of


17




gout
Acute attack of


17-18




gout
Acute attack of


18-19




gout
Acute attack of


19-20




gout
Acute attack of


20-21




gout
Acute attack of


21-22




gout
Acute attack of


22-28




gout
Acute attack of


28-24




88.4

80.0


gout


24-25






26-26




Attack subsided


26-27
27-28






28-29






29^
80

80«

81
Oct. 81-
Nov.l

1-2


"*"l2N."*"

12:16
7 a.m. - 10 a.m.
10 a.m. • 12 N.
12 N. • 2 p.m.
2 - 6 p.m.
4:16 p.m.
5 p.m. • 7 a.m.

12:16 p.m.
7 a.m. -7 a.m.


0.6 gm. uric acid
intravenously

Total amount for
24 hours


2-8






8-4






4-6






6






Dec. 7

















The daily output of uric acid was too variable to permit an accurate deter-
mination of an average endogenous level.

Endogenous output of uric acid October 21 to 30 = 6.57 gm.

Endogenous output of uric acid per day = 0.66 gm.

Exogenous output of uric acid October 31 to November 5 = 0.

Uric acid determinations were made by the uric acid phenol reagent method.



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ARCH. m.



Case 9.— A. L. E., Med. No. 5297. White, male, aged 48.

Diagnosis: Gout; cirrhosis of the liver; questionable nephritis.

The patient had used large quantities of beer and whisky for many years.
In the previous five years the patient had had five attacks resembling more the
exacerbations of a chronic arthritis than gout. Three of these attacks occurred
in the Peter Bent Brighara Hospital. Physical examination showed several
tophi in the ears. The joints of the hands showed some periarticular thick-
ening. The radial arteries were palpable. Blood pressure was 156 mm. systolic
and 96 mm. diastolic. The liver edge was palpable 4 cm. below the right costal
margin. Otherwise the physical examination was negative. The urine showed
occasionally a scant trace of albumin and a few casts. Phthalein excretion was
24 per cent, in two hours.





Tbne of
OoUeetloo


Urine


Blood




Date


Amomit
InO.c


Uric Acid
In Qm.


Uric Acid
InMff.

100O.C.


Nonpro-
telnNln
Mg. per
100 0.C


Bemarka


Oct. 14




MO
760
660

LOBt
690
48!)

680

480

870

786

1.010

1.100

720

786

526

786

710

476

42

67

*"ii

67

"219
416

"218

660
866
400

480
400
486


0.94
0.98
0.66

0.48
0.44
0.61
0.88
0.86
0.62
0.64
0.78
0.88
0.49
0.85

0.44

0.85
0.0ft
0.06

6.06
0.06

0.18
0.87

6.26

0.40
0.10
0.28
0.82
0.29
0.29


4.6

8.6
6.7
6.1

4.1




Pnrin-free diet


16








begnn
Acute goat


16-17
17-18


7 a.m. - 7 a jn.


Acute gout
Acute gout


18-10




Acute gout


19-20






20-21






21-22




Mild acute gout


22-28




Mild acute gout


28-24




Mild acute gout


24-25




Mild acute gout


26-26




Mild acute gout


26-27




Mild acute gout


27-28




Mild acute gout


28-20




Mild acute gout


29-80




Mild acute gout


8041




Mild acute gout


81-Nov. 1
1-2




Mild acute gout


2-8




52.6




8

8^
4


7 a.m. - 10 a.m.

10 a.m. - 12 N.

12 N.

12:16 p.m.
12 N. - 2 p.m.

2 • 6 p.m.

4:15 p.m.
5 p.m. • 7 a.m.


OJS gm. uric add
Intravenously

Total amount for
24 hours


4-5
5-6


7 a.m. - 7 a.m.


of one voiding
of urine


6-7






7-8






8-9
910






10-11






14

















The daily output of uric acid was too variable to permit an accurate deter-
mination of an average endogenous level.

Endogenous output of uric acid October 21 to November 3 = 6.42 gm.

Endogenous output of uric acid per day = 0.46 gm.

Exogenous output of uric acid November 4 to 11=0.

Uric acid determinations were made by the uric acid phenol reagent method.



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5i?* 1917 URIC ACID IN GOUT 499

A study of the foregoing protocols shows that in Case 6, of nephri-
tis, 44 per cent, of the injected uric acid was excreted. It will be
noted that from July 2 to 4 the daily excretion of uric acid in this
case was less than 0.1 gm., while a few days later it had risen to more
than 0.3 gm. Case 7, without evidences of nephritis, put out 14 per
cent, of the uric acid injected. In Cases 8 and 9 the daily excretion of
uric acid was too variable to permit the calculation of an average endo-
genous level with accuracy. There was, however, no apparent rise
above the endogenous output after the intravenous injections. There,
is a question as to whether one voiding of urine was lost the second
night following the uric acid injection in Case 9. The variability in
the endogenous excretion of uric acid in these two cases, 8 and 9, is
connected with the gouty attacks which occurred during the periods
of observation. Comparable findings were obtained in another case of
gout with tophi, not included here, in which we studied the uric acid
excretion during an acute attack. A very mild gouty attack occurred
the night of the sixth day following the injection of uric acid in Case 7.
These findings confirm the observation of Brugsch and Schittenhelm*®
who reported that in the same cases of gout there were periods of low
and periods of high endogenous uric acid excretion.

A study of the tables shows that the amounts of uric acid*® found
in the blood in different cases of gout while on a purin-f ree diet varied
from 3.1 to 4.1 mg. per 100 c.c. Higher values than these were pres-
ent in Cases 8 and 9 during acute attacks and at a time when the patient,
Case 8, was receiving a mixed diet. An increase in the blood under
these two conditions has been pointed out by one of us.'^ In all of the
cases a rise of from 0.5 to 1.8 mg. of uric acid was present in the blood
four hours after the intravenous injection of uric acid. This increase
in blood uric acid persisted for forty-eight hours or longer in three of
the cases (6, 8 and 9). In the remaining case (7) it disappeared
within the first twenty-four hours. Three of these patients with gout
retained the increase of uric acid in the blood twenty- four hours longer
after the injection than did any of the nongouty patients.

Summary of the Results Obtained by the Intravenous Injections of
Uric Acid. — Nine patients, five without gout and four with gout, have
been given 0.5 gm. of uric acid intravenously. Determinations of the
amounts of uric acid in the blood have shown a small but definite
increase four hours after the injections in eight of the patients. From
these findings it would seem highly probable that by the methods



29. Brugsch, T., and Schittenhelm, A. : Zur Stoffwechselpathologie der Gicht
III Mittheilung. Ztschr. f. exper. Path. u. Therap., 1907, 4» 480.

30. By uric acid in the blood w^ mean the substance determined by the
colorimetric method of Folin and Denis.

31. Pratt, J. H. : Studies on the Uric Acid in the Blood in Gout. Am. Jour.
Med. Sc, 1916, 151, 92.



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500



C. W. M'CLURE—J, H, PRATT



ARCH, m



employed the substance quantitated in the blood after the intravenous
injections was really uric acid. The increase in blood uric acid result-
ing after injection of uric acid disappeared within forty-eight hours
after the injection in four nongouty and one of the gouty patients
(Case 7). In the remaining three cases of gout it still persisted at the
end of forty-eight hours.

The five nongouty patients excreted from 22 per cent, to 138 per
cent, of the uric acid injected. Of the four cases of gout the one with
nephritis put out 44 per cent, of the uric acid injected, while very little
or none was excreted by the other three. These findings show that the
failure to excrete a large percentage of uric acid after uric acid injec-
tions (exogenous uric acid) is not a pathognomonic symptom of gout,
although it would seem to occur more frequently in gouty than in non-
gouty persons.

We have followed the method adopted by previous writers in com-
puting the output of exogenous uric acid, to make our findings com-
parable with theirs. The method has been to determine the average
daily endogenous uric acid excretion prior to the administration of
purin-containing substances. After the injection or feeding of purin-
containing materials all outputs in excess of the previously determined
average endogenous output have been considered as exogenous uric
acid.

This generally accepted method of calculation is often open to
criticism. The daily outputs of endogenous uric acid are somewhat
variable. It would probably be more correct to consider as exogenous
uric acid only those outputs whose amounts are in excess of the maxi-

TABLE 4.— Results Obtained by the Two Methods of Calcxh-ating
Exogenous Uric Acid Output



Oase


Average

DaUy

Endogenous

Output of

Uric Add

fnGm.


Exogenous Uric Add
Output


Maximum

Daily

Output of

Endogenous

Uric Add

InQm.


Exogenous Output of

Uric Add

Exceeding Maximum

Dally Endogenous Output




Gm.


Per Cent.


Om.


Per Cent.


1
2
8
4
5
6
7
8
9


0.54

o.e»
o.ao

0.81
0.56
0.80
0.39
0.66
0.46


0.41
0.69
0.82
0.11
0.29
0.22
0.07






82
188
64
22
58
44
14




0.61
0.78
0.86
0.84
0.68
0.88
0.41
0.89
0.78


0.20
0.42
0.20
0.08
0.15
0.09
0.08






40
84
40
16
80
18
6





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URIC ACID IN GOUT 501

mum endogenous output. Otherwise one cannot be sure that a certain
amount of what is really endogenous uric acid has not been included
in the portion computed as exogenous uric acid. We have calculated
the exogenous output after the intravenous injections of uric acid in
our cases on this basis and the results are given in Table 4. For pur-
poses of comparison the exogenous outputs as determined by the gen-
erally accepted method are also given.

Considering as exogenous uric acid only those outputs which
exceeded the maximum endogenous excretion gives lower figures for
the percentages of uric acid excreted. By this method of calculation '
the anomalous exogenous excretion of 138 per cent, in Case 2 drops
to the reasonable figure of 84 per cent. The excretion of 44 per cent,
of exogenous uric acid by gout Case 6 becomes 18 per cent, by this
method of calculation, which is a more reasonable amount in a case
of gout with nephritis of severe type.

III. EXOGENOUS URIC ACID EXCRETION AFTER THE FEEDING
OF PURIN OR NUCLEIN CONTAINING SUBSTANCES

We have studied the exogenous uric acid excretion after feeding
sweetbreads to a patient with chronic arthritis and to two with gout.
Previous observers have employed the results obtained by studies on
the excretion of exogenous uric acid (1) as a basis for theories rela-
ting to the etiology of gout, and (2) as an aid in the diagnosis of that
disease. It is generally accepted that gouty patients eliminate less
exogenous uric acid than do normal persons. But whether or not this
phenomenon is of diagnostic importance is not well established. Cer-
tainly there is much controversy regarding the role of uric acid in the
etiology of gout.

For purposes of comparison we have tabulated from the literature
figures for the output of exogenous uric acid derived from the feeding
of purin or nuclein containing substances to normal persons, to patients
with chronic arthritis, and to patients with gout. In all of the tables
exogenous uric acid will be expressed as the percentage of purin
nitrogen in the substances fed which was excreted as uric acid nitrogen.
In making the tabulations figures given by the observers quoted have
been subjected to certain changes. In expressing the amounts of uric
acid and of purin nitrogen, numerals beyond the second decimal place
have been dropped. No decimals have been used in expressing the
percentages of purin nitrogen excreted as uric acid nitrogen. We have
supplied calculations wherever those requisite for our purposes had
not been made by the author. Our additional calculations are desig-
nated in the tables by an asterisk. Observations have been collected
only in which the experimental subjects received a known amount of
some purin or nuclein containing substance while on an otherwise
purin-free diet. The findings for normal man are given in Table 5.



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C, W, M'CLURE—J, H, PRATT



ARCH. ;A7.



TABLE 5.— Summary of Previous Observations on Exogenous Uric Acid
Excretion by Normal Man on a Purin-Free Diet







Dally




Per


Number




Porin






Average


Output


Oeiit.of


of Days




Nitro-




Obaer-


Endog-


Of Exog-


Puiln


of Exog-




gen


Obaerver


▼ation


enous


enous


Nitrogen


enous


Substance CHven


In




Period


Output of


UrieAcid


Excreted


Uric Add




Sub-






Uric Add


inOm.


asUne


Excre-




stance






inQm.




AddN


tion




Qivent


Mlnkowakl"....


18


0.23


1J2»


4»»





8gm. hypoxan-
tbin In 1 day


1^*


EiHger and


1


0.4a


2.81


62


8


Sgm. hypoxan-
thin in 2 days


1.24


Smith"














Ackpoyd"


la


0.46


oag


21


2


0.75 gm. hypoxan-
thin in 1 day


0.81




lb


0.45


o.ao


66


4


0.75 gm. hypoxan-
thin in 1 day


0.81




2


0.42


0.66


72


2


0.75 gm. hypoxan-
thln in 1 day


0.81




8


0.86


0.86


89


8


0.75 gm. hypoxan-
thin in 1 day


0.81


Brogscb and


10


0.24


1.28


28


2


Sodium thymonu-


1J6


Scblttenbelm**












ddnate 80 gm.
in 8 days






12


0.88


1.64


24


1


Sodium nuddnate

from yeast, 80 gm.

in 8 days


2.17


Pollak"


1


0.48


0.66


80


2


Sodium nudeinate
20 gm. In 1 day


0.79*




2


0.42


0.45


88


2


10 gm. In 1 day


0.40-




8


0.27


0.61


22


8


SO gm. in 1 day


0.79*


Mendel and


W.W.H.


0.87


0.74


64


8


1.5 gm. hypoxan-


0.89


Lyman**












thin nitrate






J.P.L.


0.S8


0.66


67


8


1^ gm. hypoxan-
thln nitrate


0.89


Pllmmer, Dick,




0.48


0.12


,^


1


18 gm. nudeic add




and Lieb*7












in 8 days




Bloch"


1


0.40


OM


48


2


10 gm. nudele add

in 1 day
10 gm. nudeic add


0.66


















2


O.BO


0.88


42


8


0.66














In 1 day
10 gm. nucleic acid

In 1 day
4 gm. nuddc add






8


0.88


1.06


62


2


0.66


MaUory"


1


0.42


0.81


89


8


0.26














In 1 day





* This figure represents our calculation made from the table given by the author quoted.
t The method of administration was per os In eadi instance.



32. Minkowski, O. : Untersuchungen zur Physiolog^ie und Pathologic der
Harnsaure bei Saugethieren. Arch. f. exper. Path. u. Pharmakol., 1898, 41, 375.

33. Kriiger, M., and Schmid, J.: Die Entstehung der Harnsaure aus frcien
Purinbasen. Ztschr. f. Physiol. Chem., 1901-1902, 84, 549.

34. Ackroyd, H. : Observations on Purin Metabolism. Bull. Com. for Study
of Special Diseases, Edinburgh, 1907, 2, 146.

35. Pollak, L. : Ueber Harnsauresscheidung bei Gicht und Alkoholismus.
Deutsch. Arch. f. klin. Med., 1907, 88, 224.

36. Mendel, L. B., and Lyman, J. E. : A metabolism of Some Purin Com-
pounds in the Rabbit, Dog, Pig, and Man. Jour. Biol. Chem., 1910-1911, 8, 115.

37. Plimmer, R. H. A., Dick, M., and Lieb, C, C: A Metabolism Experiment
with Special Reference to the Origin of Uric Acid. Jour. Physiol., 1909-1910,
8^ 98.

38. Bloch, B. : Beitrage zur Kenntniss des Purinstoffwechsels beim Menschen.
Deutsch. Arch. f. klin. Med., 1905, 88, 499.

39. Mallory, W. J. : Observations on Uric Acid Excretion in Gout and Rheu-
matoid Arthritis. Bull. Com. for Study of Special Diseases, 1908-1909, 8, 17.



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1917



URIC ACID IN GOUT



503



TABLE 5. — Summary of Previous Observations on Exogenous Uric Acid
Excretion by Normal Man on a Purin-Free Diet^ (Continued)



Observer


Obser-
vation
Period


Dally
Average
Endog-
enous
Output of
Uric Acid
inGm.


Output
of Exog-
enous
Uric Add
inGm.


Per

Cent, of

Purin

Nitrogen

Excreted

as Uric

AddN


Number
of Days
of Exog-
enous
Uric Add
Excre-
tion


Substance Given


Purin
Nitro-
gen
in

Sub-
stance
Glvent


Morris"

Smith**
HlrscfaBtein«^..


1

la
lb
4


0.40
0.46
0.8«»


0.17
0.16
O.SL
1.46*


22

41
41
11*


2

2


4 gm. nudde add

in 1 day
0.8 gm. adenin In 1

0.6 gm. adenin in 1

day
1.000 gm. thymus

in 2 days

620 gm. thymus In

2 days


0.26
4.50»


Burian and
Schur**


10


0.62


1.77


26




2.48


LJungdahl**....


1




1.01


28




800 gm. thymus In

1 day
800 gm. thymus In

1 day
800 gm. thymus hi

1 day
800 gm. thymus in

1 day
800 gm. thymus in

Iday

800 gm. thymus in

1 day

500 gm. liver in

Iday

800 gm. ham hi

1 day

1,000 gm. beef in 4

days
760 gm. beef hi 4

days
000 gm. veal in 4

days
900 gm. beef in 4

days
500 gm. beef hi 8

days

8,500 gm. beef in 7

days


1.20




2




1.87


88




1.90




8




0.46


18




1.20




4




0.87


24




IJO




6




0.88


26




1.20









1.17


88




1.20


Burian ana
Sdiur**


10
18


0.62
0.56


0.96
0.24


68
44




0.6

0.18




8


0.66


1.84*


74*




0.6»




5


0.89


0J2*


88*




0.46»


Kautmann and
Mohr**


7


0.64*


2.71*


44*


2*


0.64*




0.64*


0.12*





8*


0.64*




8


0.47*


0.58*


59*


2*


0.80»



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