home *** CD-ROM | disk | FTP | other *** search
Unknown | 1992-06-05 | 300.5 KB |
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MacOS 8.1
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Win98
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DOS
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Confidence | Program | Detection | Match Type | Support
|
---|
66%
| dexvert
| OS/2 Installation Package (archive/os2InstallPackage)
| ext
| Supported |
1%
| dexvert
| BeOS Installation Package (archive/beOSInstallPackage)
| ext
| Unsupported |
1%
| dexvert
| Newton Package (archive/newtonPackage)
| ext
| Unsupported |
1%
| dexvert
| Independence War 2 mod Package (other/independenceWar2ModPackage)
| ext
| Unsupported |
100%
| file
| data
| default
|
|
hex view+--------+-------------------------+-------------------------+--------+--------+
|00000000| 1a 44 50 31 2e 31 00 00 | 00 00 00 00 00 05 64 00 |.DP1.1..|......d.|
|00000010| 00 00 16 00 00 00 30 30 | 00 00 00 01 9c 05 00 00 |......00|........|
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|000003d0| 00 00 00 01 36 18 03 00 | 06 09 00 00 36 39 00 00 |....6...|....69..|
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|00000400| 03 00 51 0e 00 00 37 32 | 00 00 00 01 36 44 03 00 |..Q...72|....6D..|
|00000410| b7 0c 00 00 37 33 00 00 | 00 01 ed 50 03 00 f7 0a |....73..|...P....|
|00000420| 00 00 37 34 00 00 00 01 | e4 5b 03 00 d2 0a 00 00 |..74....|.[......|
|00000430| 37 35 00 00 00 01 b6 66 | 03 00 4f 11 00 00 37 36 |75.....f|..O...76|
|00000440| 00 00 00 01 05 78 03 00 | 80 0e 00 00 37 37 00 00 |.....x..|....77..|
|00000450| 00 01 85 86 03 00 08 0e | 00 00 37 38 00 00 00 01 |........|..78....|
|00000460| 8d 94 03 00 02 0a 00 00 | 37 39 00 00 00 01 8f 9e |........|79......|
|00000470| 03 00 30 0a 00 00 38 30 | 00 00 00 01 bf a8 03 00 |..0...80|........|
|00000480| 44 0e 00 00 38 31 00 00 | 00 01 03 b7 03 00 c8 0e |D...81..|........|
|00000490| 00 00 38 32 00 00 00 01 | cb c5 03 00 f7 0b 00 00 |..82....|........|
|000004a0| 38 33 00 00 00 01 c2 d1 | 03 00 60 0b 00 00 38 34 |83......|..`...84|
|000004b0| 00 00 00 01 22 dd 03 00 | 4d 0e 00 00 38 35 00 00 |...."...|M...85..|
|000004c0| 00 01 6f eb 03 00 76 0a | 00 00 38 36 00 00 00 01 |..o...v.|..86....|
|000004d0| e5 f5 03 00 08 0d 00 00 | 38 37 00 00 00 01 ed 02 |........|87......|
|000004e0| 04 00 94 0e 00 00 38 38 | 00 00 00 01 81 11 04 00 |......88|........|
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|00000500| 00 00 39 30 00 00 00 01 | 9c 32 04 00 37 10 00 00 |..90....|.2..7...|
|00000510| 39 31 00 00 00 01 d3 42 | 04 00 25 0d 00 00 39 32 |91.....B|..%...92|
|00000520| 00 00 00 01 f8 4f 04 00 | b0 0e 00 00 39 33 00 00 |.....O..|....93..|
|00000530| 00 01 a8 5e 04 00 4c 0e | 00 00 39 34 00 00 00 01 |...^..L.|..94....|
|00000540| f4 6c 04 00 39 0a 00 00 | 39 35 00 00 00 01 2d 77 |.l..9...|95....-w|
|00000550| 04 00 4a 0e 00 00 39 36 | 00 00 00 01 77 85 04 00 |..J...96|....w...|
|00000560| fd 0a 00 00 39 37 00 00 | 00 01 74 90 04 00 93 0d |....97..|..t.....|
|00000570| 00 00 39 38 00 00 00 01 | 07 9e 04 00 6e 0b 00 00 |..98....|....n...|
|00000580| 39 39 00 00 00 01 75 a9 | 04 00 76 08 00 00 00 00 |99....u.|..v.....|
|00000590| 00 00 00 00 eb b1 04 00 | 00 00 00 00 24 55 6e 69 |........|....$Uni|
|000005a0| 71 75 65 5f 49 44 7b 59 | 52 42 30 30 38 30 30 7d |que_ID{Y|RB00800}|
|000005b0| 0d 0a 24 54 69 74 6c 65 | 7b 54 68 65 20 49 6d 70 |..$Title|{The Imp|
|000005c0| 6f 72 74 61 6e 63 65 20 | 6f 66 20 4c 69 70 69 64 |ortance |of Lipid|
|000005d0| 20 53 6f 6c 75 62 69 6c | 69 74 79 20 61 6e 64 20 | Solubil|ity and |
|000005e0| 52 65 63 65 70 74 6f 72 | 20 53 65 6c 65 63 74 69 |Receptor| Selecti|
|000005f0| 76 69 74 79 20 6f 66 0d | 0a 62 65 74 61 2d 41 64 |vity of.|.beta-Ad|
|00000600| 72 65 6e 6f 63 65 70 74 | 6f 72 20 42 6c 6f 63 6b |renocept|or Block|
|00000610| 69 6e 67 20 44 72 75 67 | 73 20 66 6f 72 20 74 68 |ing Drug|s for th|
|00000620| 65 20 4f 63 63 75 72 72 | 65 6e 63 65 20 6f 66 20 |e Occurr|ence of |
|00000630| 53 79 6d 70 74 6f 6d 73 | 20 61 6e 64 0d 0a 53 69 |Symptoms| and..Si|
|00000640| 64 65 2d 45 66 66 65 63 | 74 73 20 69 6e 20 4f 75 |de-Effec|ts in Ou|
|00000650| 74 2d 70 61 74 69 65 6e | 74 73 7d 0d 0a 24 41 75 |t-patien|ts}..$Au|
|00000660| 74 68 6f 72 7b 0d 0a 54 | 68 65 6f 64 6f 72 73 65 |thor{..T|heodorse|
|00000670| 6e 2c 20 4c 0d 0a 42 72 | 6f 72 73 2c 20 4f 7d 0d |n, L..Br|ors, O}.|
|00000680| 0a 24 41 66 66 69 6c 69 | 61 74 69 6f 6e 7b 55 6e |.$Affili|ation{Un|
|00000690| 69 76 20 6f 66 20 4f 73 | 6c 6f 7d 0d 0a 24 4a 6f |iv of Os|lo}..$Jo|
|000006a0| 75 72 6e 61 6c 7b 4a 20 | 49 6e 74 65 72 6e 20 4d |urnal{J |Intern M|
|000006b0| 65 64 7d 0d 0a 24 56 6f | 6c 75 6d 65 7b 32 32 36 |ed}..$Vo|lume{226|
|000006c0| 7d 0d 0a 24 50 61 67 65 | 7b 31 37 2d 32 33 7d 0d |}..$Page|{17-23}.|
|000006d0| 0a 24 44 61 74 65 7b 31 | 39 38 39 7d 0d 0a 24 59 |.$Date{1|989}..$Y|
|000006e0| 42 56 6f 6c 7b 31 39 39 | 31 20 59 65 61 72 20 42 |BVol{199|1 Year B|
|000006f0| 6f 6f 6b 20 6f 66 20 44 | 72 75 67 20 54 68 65 72 |ook of D|rug Ther|
|00000700| 61 70 79 7d 0d 0a 24 43 | 68 61 70 74 65 72 7b 32 |apy}..$C|hapter{2|
|00000710| 2d 31 30 7d 0d 0a 24 59 | 42 45 64 69 74 6f 72 7b |-10}..$Y|BEditor{|
|00000720| 44 72 73 2e 20 4c 61 73 | 61 67 6e 61 20 61 6e 64 |Drs. Las|agna and|
|00000730| 20 57 65 69 6e 74 72 61 | 75 62 7d 0d 0a 24 54 61 | Weintra|ub}..$Ta|
|00000740| 62 6c 65 7b 7d 0d 0a 24 | 43 6f 6d 6d 65 6e 74 61 |ble{}..$|Commenta|
|00000750| 74 6f 72 7b 4c 2e 20 4c | 61 73 61 67 6e 61 2c 20 |tor{L. L|asagna, |
|00000760| 4d 2e 44 2e 7d 0d 0a 0d | 0a 43 6f 70 79 72 69 67 |M.D.}...|.Copyrig|
|00000770| 68 74 20 28 43 29 20 59 | 65 61 72 20 42 6f 6f 6b |ht (C) Y|ear Book|
|00000780| 20 4d 65 64 69 63 61 6c | 20 50 75 62 6c 69 73 68 | Medical| Publish|
|00000790| 65 72 73 2c 20 49 6e 63 | 2e 20 31 39 39 31 0d 0a |ers, Inc|. 1991..|
|000007a0| 0d 0a 31 39 39 31 20 59 | 65 61 72 20 42 6f 6f 6b |..1991 Y|ear Book|
|000007b0| 20 6f 66 20 44 72 75 67 | 20 54 68 65 72 61 70 79 | of Drug| Therapy|
|000007c0| 0d 0a 0d 0a 43 68 61 70 | 74 65 72 20 32 20 2d 2d |....Chap|ter 2 --|
|000007d0| 20 44 72 75 67 20 41 63 | 74 69 6f 6e 0d 0a 0d 0a | Drug Ac|tion....|
|000007e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000007f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000800| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000810| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000820| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|00000830| 54 68 65 20 49 6d 70 6f | 72 74 61 6e 63 65 20 6f |The Impo|rtance o|
|00000840| 66 20 4c 69 70 69 64 20 | 53 6f 6c 75 62 69 6c 69 |f Lipid |Solubili|
|00000850| 74 79 20 61 6e 64 20 52 | 65 63 65 70 74 6f 72 20 |ty and R|eceptor |
|00000860| 53 65 6c 65 63 74 69 76 | 69 74 79 20 6f 66 0d 0a |Selectiv|ity of..|
|00000870| 62 65 74 61 2d 41 64 72 | 65 6e 6f 63 65 70 74 6f |beta-Adr|enocepto|
|00000880| 72 20 42 6c 6f 63 6b 69 | 6e 67 20 44 72 75 67 73 |r Blocki|ng Drugs|
|00000890| 20 66 6f 72 20 74 68 65 | 20 4f 63 63 75 72 72 65 | for the| Occurre|
|000008a0| 6e 63 65 20 6f 66 20 53 | 79 6d 70 74 6f 6d 73 20 |nce of S|ymptoms |
|000008b0| 61 6e 64 0d 0a 53 69 64 | 65 2d 45 66 66 65 63 74 |and..Sid|e-Effect|
|000008c0| 73 20 69 6e 20 4f 75 74 | 2d 70 61 74 69 65 6e 74 |s in Out|-patient|
|000008d0| 73 0d 0a 0d 0a 54 68 65 | 6f 64 6f 72 73 65 6e 20 |s....The|odorsen |
|000008e0| 4c 3b 20 42 72 6f 72 73 | 20 4f 0d 0a 28 55 6e 69 |L; Brors| O..(Uni|
|000008f0| 76 20 6f 66 20 4f 73 6c | 6f 29 0d 0a 4a 20 49 6e |v of Osl|o)..J In|
|00000900| 74 65 72 6e 20 4d 65 64 | 20 32 32 36 3a 31 37 2d |tern Med| 226:17-|
|00000910| 32 33 2c 20 31 39 38 39 | 0d 0a 2d 2d 2d 2d 2d 2d |23, 1989|..------|
|00000920| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000930| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000940| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000950| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000960| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0a 0d 0a 41 62 73 74 |--------|....Abst|
|00000970| 72 61 63 74 0d 0a 0d 0a | 20 20 20 20 20 54 68 65 |ract....| The|
|00000980| 72 65 20 69 73 20 65 76 | 69 64 65 6e 63 65 20 66 |re is ev|idence f|
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|000009d0| 20 62 65 20 69 6e 66 6c | 75 65 6e 63 65 64 20 62 | be infl|uenced b|
|000009e0| 79 20 6c 69 70 69 64 20 | 73 6f 6c 75 62 69 6c 69 |y lipid |solubili|
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|00000a00| 63 65 70 74 6f 72 20 73 | 65 6c 65 63 74 69 76 69 |ceptor s|electivi|
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|00000a20| 2e 20 20 54 68 65 73 65 | 20 70 61 72 61 6d 65 74 |. These| paramet|
|00000a30| 65 72 73 20 77 65 72 65 | 20 72 65 6c 61 74 65 64 |ers were| related|
|00000a40| 20 74 6f 20 73 79 6d 70 | 74 6f 6d 73 20 69 6e 20 | to symp|toms in |
|00000a50| 32 30 35 20 70 61 74 69 | 65 6e 74 73 20 28 6d 65 |205 pati|ents (me|
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|00000a80| 62 65 74 61 2d 62 6c 6f | 63 6b 65 72 20 74 68 65 |beta-blo|cker the|
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|00000ab0| 0d 0a 68 79 70 65 72 74 | 65 6e 73 69 6f 6e 2e 20 |..hypert|ension. |
|00000ac0| 20 41 74 65 6e 6f 6c 6f | 6c 2c 20 74 69 6d 6f 6c | Atenolo|l, timol|
|00000ad0| 6f 6c 2c 20 61 6e 64 20 | 70 72 6f 70 72 61 6e 6f |ol, and |proprano|
|00000ae0| 6c 6f 6c 20 77 65 72 65 | 20 74 68 65 20 6d 6f 73 |lol were| the mos|
|00000af0| 74 20 63 6f 6d 6d 6f 6e | 6c 79 20 75 73 65 64 0d |t common|ly used.|
|00000b00| 0a 64 72 75 67 73 2e 0d | 0a 20 20 20 20 20 54 72 |.drugs..|. Tr|
|00000b10| 65 61 74 6d 65 6e 74 20 | 77 61 73 20 61 73 73 6f |eatment |was asso|
|00000b20| 63 69 61 74 65 64 20 77 | 69 74 68 20 61 20 73 69 |ciated w|ith a si|
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|00000b40| 65 61 73 65 64 20 72 61 | 74 65 20 6f 66 20 43 4e |eased ra|te of CN|
|00000b50| 53 20 61 6e 64 0d 0a 70 | 65 72 69 70 68 65 72 61 |S and..p|eriphera|
|00000b60| 6c 20 73 79 6d 70 74 6f | 6d 73 2e 20 20 54 68 65 |l sympto|ms. The|
|00000b70| 20 69 6e 63 72 65 61 73 | 65 20 69 6e 20 43 4e 53 | increas|e in CNS|
|00000b80| 20 73 79 6d 70 74 6f 6d | 73 20 77 61 73 20 73 69 | symptom|s was si|
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|00000bb0| 6c 6f 63 6b 65 72 73 20 | 77 69 74 68 20 6c 6f 77 |lockers |with low|
|00000bc0| 20 6c 69 70 69 64 20 73 | 6f 6c 75 62 69 6c 69 74 | lipid s|olubilit|
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|00000c10| 77 68 65 74 68 65 72 20 | 61 20 62 65 74 61 20 31 |whether |a beta 1|
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|00000c40| 6b 65 72 20 77 61 73 20 | 61 64 6d 69 6e 69 73 74 |ker was |administ|
|00000c50| 65 72 65 64 2e 20 20 54 | 68 65 20 69 6e 66 6c 75 |ered. T|he influ|
|00000c60| 65 6e 63 65 20 6f 66 20 | 6c 69 70 69 64 20 73 6f |ence of |lipid so|
|00000c70| 6c 75 62 69 6c 69 74 79 | 20 6f 6e 0d 0a 43 4e 53 |lubility| on..CNS|
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|00000c90| 69 65 6e 74 73 20 77 68 | 6f 20 61 72 65 20 74 61 |ients wh|o are ta|
|00000ca0| 6b 69 6e 67 20 62 65 74 | 61 20 62 6c 6f 63 6b 65 |king bet|a blocke|
|00000cb0| 72 73 20 6d 61 79 20 72 | 65 66 6c 65 63 74 0d 0a |rs may r|eflect..|
|00000cc0| 64 69 66 66 65 72 65 6e | 63 65 73 20 69 6e 20 74 |differen|ces in t|
|00000cd0| 68 65 20 64 69 73 74 72 | 69 62 75 74 69 6f 6e 20 |he distr|ibution |
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|00000d10| 64 20 70 6c 61 73 6d 61 | 2e 0d 0a 0d 0a 50 6f 73 |d plasma|.....Pos|
|00000d20| 74 2d 43 6f 6d 6d 65 6e | 74 0d 0a 0d 0a 20 20 20 |t-Commen|t.... |
|00000d30| 20 20 49 74 27 73 20 61 | 6c 77 61 79 73 20 72 65 | It's a|lways re|
|00000d40| 61 73 73 75 72 69 6e 67 | 20 74 6f 20 68 61 76 65 |assuring| to have|
|00000d50| 20 61 20 73 74 75 64 79 | 20 63 6f 6d 65 20 6f 75 | a study| come ou|
|00000d60| 74 20 74 68 65 20 77 61 | 79 20 69 74 20 73 68 6f |t the wa|y it sho|
|00000d70| 75 6c 64 2e 0d 0a 41 64 | 76 65 72 73 65 20 43 4e |uld...Ad|verse CN|
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|00001b50| 4d 65 64 69 63 61 6c 20 | 50 75 62 6c 69 73 68 65 |Medical |Publishe|
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|00001b70| 0a 31 39 39 31 20 59 65 | 61 72 20 42 6f 6f 6b 20 |.1991 Ye|ar Book |
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|00001bd0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001be0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001bf0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 45 |--------|-----..E|
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|00001c40| 46 72 69 65 64 6d 61 6e | 20 41 44 3b 20 42 61 72 |Friedman| AD; Bar|
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|00001c60| 20 53 74 75 64 79 20 47 | 72 6f 75 70 0d 0a 28 53 | Study G|roup..(S|
|00001c70| 74 20 4c 6f 75 69 73 20 | 55 6e 69 76 29 0d 0a 50 |t Louis |Univ)..P|
|00001c80| 65 64 69 61 74 72 20 45 | 6d 65 72 67 20 43 61 72 |ediatr E|merg Car|
|00001c90| 65 20 36 3a 36 2d 37 2c | 20 31 39 39 30 0d 0a 2d |e 6:6-7,| 1990..-|
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|00001cd0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001ce0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 0d |--------|-----...|
|00001cf0| 0a 41 62 73 74 72 61 63 | 74 0d 0a 0d 0a 20 20 20 |.Abstrac|t.... |
|00001d00| 20 20 54 68 72 65 65 20 | 63 6f 6d 6d 6f 6e 20 6d | Three |common m|
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|00001f90| 61 63 65 74 61 6d 69 6e | 6f 70 68 65 6e 20 69 6e |acetamin|ophen in|
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|00002040| 0a 0d 0a 50 6f 73 74 2d | 43 6f 6d 6d 65 6e 74 0d |...Post-|Comment.|
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|00002130| 46 2c 20 61 6e 64 20 74 | 68 65 0d 0a 63 6f 6d 62 |F, and t|he..comb|
|00002140| 69 6e 61 74 69 6f 6e 20 | 6f 66 20 73 70 6f 6e 67 |ination |of spong|
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|00002160| 6f 70 68 65 6e 20 64 69 | 64 20 65 76 65 6e 20 62 |ophen di|d even b|
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|00002190| 20 20 49 66 20 74 68 65 | 20 72 65 61 64 65 72 2c | If the| reader,|
|000021a0| 20 6c 69 6b 65 20 6d 65 | 2c 20 77 6f 6e 64 65 72 | like me|, wonder|
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|000021d0| 67 20 72 65 66 65 72 65 | 6e 63 65 20 69 6e 20 74 |g refere|nce in t|
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|00002220| 65 6c 65 76 61 6e 74 20 | 73 65 6e 74 65 6e 63 65 |elevant |sentence|
|00002230| 2c 20 22 49 6e 20 74 68 | 65 20 68 6f 6d 65 2c 20 |, "In th|e home, |
|00002240| 73 70 6f 6e 67 65 20 62 | 61 74 68 73 20 6d 61 79 |sponge b|aths may|
|00002250| 20 72 65 73 75 6c 74 20 | 69 6e 0d 0a 61 63 63 69 | result |in..acci|
|00002260| 64 65 6e 74 61 6c 20 64 | 72 6f 77 6e 69 6e 67 2c |dental d|rowning,|
|00002270| 20 73 69 6e 63 65 20 62 | 61 74 68 74 75 62 73 20 | since b|athtubs |
|00002280| 72 65 6d 61 69 6e 20 61 | 20 6d 61 6a 6f 72 20 73 |remain a| major s|
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|000022a0| 6c 0d 0a 63 68 69 6c 64 | 68 6f 6f 64 20 64 72 6f |l..child|hood dro|
|000022b0| 77 6e 69 6e 67 20 69 6e | 20 63 69 74 69 65 73 2e |wning in| cities.|
|000022c0| 22 0d 0a 20 20 20 20 20 | 49 66 20 61 6e 79 6f 6e |".. |If anyon|
|000022d0| 65 20 69 73 20 63 75 72 | 69 6f 75 73 20 61 62 6f |e is cur|ious abo|
|000022e0| 75 74 20 74 68 65 20 22 | 53 70 6f 6e 67 69 6e 67 |ut the "|Sponging|
|000022f0| 20 53 74 75 64 79 20 47 | 72 6f 75 70 2c 22 20 69 | Study G|roup," i|
|00002300| 74 27 73 20 61 70 70 61 | 72 65 6e 74 6c 79 20 61 |t's appa|rently a|
|00002310| 0d 0a 63 6f 6e 76 65 6e | 69 65 6e 74 20 77 61 79 |..conven|ient way|
|00002320| 20 6f 66 20 61 63 6b 6e | 6f 77 6c 65 64 67 69 6e | of ackn|owledgin|
|00002330| 67 20 74 68 65 20 68 65 | 6c 70 20 6f 66 20 31 39 |g the he|lp of 19|
|00002340| 20 6e 75 72 73 65 73 20 | 69 6e 20 63 61 72 72 79 | nurses |in carry|
|00002350| 69 6e 67 20 6f 75 74 20 | 74 68 65 0d 0a 72 65 73 |ing out |the..res|
|00002360| 65 61 72 63 68 2e 2d 2d | 4c 2e 20 4c 61 73 61 67 |earch.--|L. Lasag|
|00002370| 6e 61 2c 20 4d 2e 44 2e | 0d 0a 24 55 6e 69 71 75 |na, M.D.|..$Uniqu|
|00002380| 65 5f 49 44 7b 59 52 42 | 30 30 38 30 33 7d 0d 0a |e_ID{YRB|00803}..|
|00002390| 24 54 69 74 6c 65 7b 44 | 65 78 61 6d 65 74 68 61 |$Title{D|exametha|
|000023a0| 73 6f 6e 65 20 69 6e 20 | 74 68 65 20 54 72 65 61 |sone in |the Trea|
|000023b0| 74 6d 65 6e 74 20 6f 66 | 20 41 63 75 74 65 20 4d |tment of| Acute M|
|000023c0| 6f 75 6e 74 61 69 6e 20 | 53 69 63 6b 6e 65 73 73 |ountain |Sickness|
|000023d0| 7d 0d 0a 24 41 75 74 68 | 6f 72 7b 0d 0a 4c 65 76 |}..$Auth|or{..Lev|
|000023e0| 69 6e 65 2c 20 42 44 0d | 0a 59 6f 73 68 69 6d 75 |ine, BD.|.Yoshimu|
|000023f0| 72 61 2c 20 4b 0d 0a 4b | 6f 62 61 79 61 73 68 69 |ra, K..K|obayashi|
|00002400| 2c 20 54 0d 0a 46 75 6b | 75 73 68 69 6d 61 2c 20 |, T..Fuk|ushima, |
|00002410| 4d 0d 0a 53 68 69 62 61 | 6d 6f 74 6f 2c 20 54 0d |M..Shiba|moto, T.|
|00002420| 0a 55 65 64 61 2c 20 47 | 7d 0d 0a 24 41 66 66 69 |.Ueda, G|}..$Affi|
|00002430| 6c 69 61 74 69 6f 6e 7b | 7d 0d 0a 24 4a 6f 75 72 |liation{|}..$Jour|
|00002440| 6e 61 6c 7b 4e 20 45 6e | 67 6c 20 4a 20 4d 65 64 |nal{N En|gl J Med|
|00002450| 7d 0d 0a 24 56 6f 6c 75 | 6d 65 7b 33 32 31 7d 0d |}..$Volu|me{321}.|
|00002460| 0a 24 50 61 67 65 7b 31 | 37 30 37 2d 31 37 31 33 |.$Page{1|707-1713|
|00002470| 7d 0d 0a 24 44 61 74 65 | 7b 31 39 38 39 7d 0d 0a |}..$Date|{1989}..|
|00002480| 24 59 42 56 6f 6c 7b 31 | 39 39 31 20 59 65 61 72 |$YBVol{1|991 Year|
|00002490| 20 42 6f 6f 6b 20 6f 66 | 20 44 72 75 67 20 54 68 | Book of| Drug Th|
|000024a0| 65 72 61 70 79 7d 0d 0a | 24 43 68 61 70 74 65 72 |erapy}..|$Chapter|
|000024b0| 7b 32 2d 31 33 7d 0d 0a | 24 59 42 45 64 69 74 6f |{2-13}..|$YBEdito|
|000024c0| 72 7b 44 72 73 2e 20 4c | 61 73 61 67 6e 61 20 61 |r{Drs. L|asagna a|
|000024d0| 6e 64 20 57 65 69 6e 74 | 72 61 75 62 7d 0d 0a 24 |nd Weint|raub}..$|
|000024e0| 54 61 62 6c 65 7b 7d 0d | 0a 24 43 6f 6d 6d 65 6e |Table{}.|.$Commen|
|000024f0| 74 61 74 6f 72 7b 4d 2e | 20 57 65 69 6e 74 72 61 |tator{M.| Weintra|
|00002500| 75 62 2c 20 4d 2e 44 2e | 7d 0d 0a 0d 0a 43 6f 70 |ub, M.D.|}....Cop|
|00002510| 79 72 69 67 68 74 20 28 | 43 29 20 59 65 61 72 20 |yright (|C) Year |
|00002520| 42 6f 6f 6b 20 4d 65 64 | 69 63 61 6c 20 50 75 62 |Book Med|ical Pub|
|00002530| 6c 69 73 68 65 72 73 2c | 20 49 6e 63 2e 20 31 39 |lishers,| Inc. 19|
|00002540| 39 31 0d 0a 0d 0a 31 39 | 39 31 20 59 65 61 72 20 |91....19|91 Year |
|00002550| 42 6f 6f 6b 20 6f 66 20 | 44 72 75 67 20 54 68 65 |Book of |Drug The|
|00002560| 72 61 70 79 0d 0a 0d 0a | 43 68 61 70 74 65 72 20 |rapy....|Chapter |
|00002570| 32 20 2d 2d 20 44 72 75 | 67 20 41 63 74 69 6f 6e |2 -- Dru|g Action|
|00002580| 0d 0a 0d 0a 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |....----|--------|
|00002590| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000025a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000025b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000025c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000025d0| 2d 2d 0d 0a 44 65 78 61 | 6d 65 74 68 61 73 6f 6e |--..Dexa|methason|
|000025e0| 65 20 69 6e 20 74 68 65 | 20 54 72 65 61 74 6d 65 |e in the| Treatme|
|000025f0| 6e 74 20 6f 66 20 41 63 | 75 74 65 20 4d 6f 75 6e |nt of Ac|ute Moun|
|00002600| 74 61 69 6e 20 53 69 63 | 6b 6e 65 73 73 0d 0a 0d |tain Sic|kness...|
|00002610| 0a 4c 65 76 69 6e 65 20 | 42 44 3b 20 59 6f 73 68 |.Levine |BD; Yosh|
|00002620| 69 6d 75 72 61 20 4b 3b | 20 4b 6f 62 61 79 61 73 |imura K;| Kobayas|
|00002630| 68 69 20 54 3b 20 46 75 | 6b 75 73 68 69 6d 61 20 |hi T; Fu|kushima |
|00002640| 4d 3b 20 53 68 69 62 61 | 6d 6f 74 6f 20 54 3b 20 |M; Shiba|moto T; |
|00002650| 55 65 64 61 20 47 0d 0a | 28 29 0d 0a 4e 20 45 6e |Ueda G..|()..N En|
|00002660| 67 6c 20 4a 20 4d 65 64 | 20 33 32 31 3a 31 37 30 |gl J Med| 321:170|
|00002670| 37 2d 31 37 31 33 2c 20 | 31 39 38 39 0d 0a 2d 2d |7-1713, |1989..--|
|00002680| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002690| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000026a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000026b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000026c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 0d 0a |--------|----....|
|000026d0| 41 62 73 74 72 61 63 74 | 0d 0a 0d 0a 20 20 20 20 |Abstract|.... |
|000026e0| 20 54 72 61 76 65 6c 65 | 72 73 20 77 68 6f 20 72 | Travele|rs who r|
|000026f0| 61 70 69 64 6c 79 20 61 | 73 63 65 6e 64 20 74 6f |apidly a|scend to|
|00002700| 20 68 69 67 68 20 61 6c | 74 69 74 75 64 65 73 20 | high al|titudes |
|00002710| 6f 66 74 65 6e 20 65 78 | 70 65 72 69 65 6e 63 65 |often ex|perience|
|00002720| 20 61 63 75 74 65 0d 0a | 6d 6f 75 6e 74 61 69 6e | acute..|mountain|
|00002730| 20 73 69 63 6b 6e 65 73 | 73 2e 20 20 54 68 65 20 | sicknes|s. The |
|00002740| 69 6c 6c 6e 65 73 73 20 | 69 73 20 75 73 75 61 6c |illness |is usual|
|00002750| 6c 79 20 73 65 6c 66 2d | 6c 69 6d 69 74 65 64 2c |ly self-|limited,|
|00002760| 20 62 75 74 20 69 74 20 | 6f 63 63 61 73 69 6f 6e | but it |occasion|
|00002770| 61 6c 6c 79 0d 0a 70 72 | 6f 67 72 65 73 73 65 73 |ally..pr|ogresses|
|00002780| 20 74 6f 20 6c 69 66 65 | 2d 74 68 72 65 61 74 65 | to life|-threate|
|00002790| 6e 69 6e 67 20 68 69 67 | 68 2d 61 6c 74 69 74 75 |ning hig|h-altitu|
|000027a0| 64 65 20 63 65 72 65 62 | 72 61 6c 20 65 64 65 6d |de cereb|ral edem|
|000027b0| 61 2e 20 20 45 61 72 6c | 79 20 73 77 65 6c 6c 69 |a. Earl|y swelli|
|000027c0| 6e 67 0d 0a 6f 66 20 74 | 68 65 20 62 72 61 69 6e |ng..of t|he brain|
|000027d0| 20 6d 61 79 20 62 65 20 | 74 68 65 20 63 61 75 73 | may be |the caus|
|000027e0| 65 20 6f 66 20 65 76 65 | 6e 20 6d 69 6c 64 20 6d |e of eve|n mild m|
|000027f0| 6f 75 6e 74 61 69 6e 20 | 73 69 63 6b 6e 65 73 73 |ountain |sickness|
|00002800| 2e 20 20 41 6c 74 68 6f | 75 67 68 0d 0a 64 65 73 |. Altho|ugh..des|
|00002810| 63 65 6e 74 20 69 73 20 | 74 68 65 20 64 65 66 69 |cent is |the defi|
|00002820| 6e 69 74 69 76 65 20 63 | 75 72 65 2c 20 74 68 69 |nitive c|ure, thi|
|00002830| 73 20 69 73 20 6e 6f 74 | 20 61 6c 77 61 79 73 20 |s is not| always |
|00002840| 69 6d 6d 65 64 69 61 74 | 65 6c 79 20 70 6f 73 73 |immediat|ely poss|
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|00003640| 62 75 73 2c 20 4f 68 69 | 6f 3b 20 42 6f 6f 74 73 |bus, Ohi|o; Boots|
|00003650| 20 43 6f 20 49 6e 63 2c | 0d 0a 53 68 72 65 76 65 | Co Inc,|..Shreve|
|00003660| 70 6f 72 74 2c 20 4c 61 | 7d 0d 0a 24 4a 6f 75 72 |port, La|}..$Jour|
|00003670| 6e 61 6c 7b 43 6c 69 6e | 20 50 68 61 72 6d 61 63 |nal{Clin| Pharmac|
|00003680| 6f 6c 20 54 68 65 72 7d | 0d 0a 24 56 6f 6c 75 6d |ol Ther}|..$Volum|
|00003690| 65 7b 34 36 7d 0d 0a 24 | 50 61 67 65 7b 39 2d 31 |e{46}..$|Page{9-1|
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|000036b0| 0a 24 59 42 56 6f 6c 7b | 31 39 39 31 20 59 65 61 |.$YBVol{|1991 Yea|
|000036c0| 72 20 42 6f 6f 6b 20 6f | 66 20 44 72 75 67 20 54 |r Book o|f Drug T|
|000036d0| 68 65 72 61 70 79 7d 0d | 0a 24 43 68 61 70 74 65 |herapy}.|.$Chapte|
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|00003790| 20 6f 66 20 44 72 75 67 | 20 54 68 65 72 61 70 79 | of Drug| Therapy|
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|000037b0| 20 44 72 75 67 20 41 63 | 74 69 6f 6e 0d 0a 0d 0a | Drug Ac|tion....|
|000037c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000037d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000037e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000037f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003800| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|00003810| 49 62 75 70 72 6f 66 65 | 6e 2c 20 41 63 65 74 61 |Ibuprofe|n, Aceta|
|00003820| 6d 69 6e 6f 70 68 65 6e | 2c 20 61 6e 64 20 50 6c |minophen|, and Pl|
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|00003920| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003930| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00004240| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004250| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00004350| 6f 6d 65 6e 27 73 20 48 | 6f 73 70 2c 20 42 6f 73 |omen's H|osp, Bos|
|00004360| 74 6f 6e 29 20 41 72 63 | 68 20 49 6e 74 65 72 6e |ton) Arc|h Intern|
|00004370| 20 4d 65 64 20 31 34 39 | 3a 32 37 30 39 2d 32 37 | Med 149|:2709-27|
|00004380| 31 32 2c 20 31 39 38 39 | 0d 0a 2d 2d 2d 2d 2d 2d |12, 1989|..------|
|00004390| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000043a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000043b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000043c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000043d0| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0a 0d 0a 41 62 73 74 |--------|....Abst|
|000043e0| 72 61 63 74 0d 0a 0d 0a | 20 20 20 20 20 43 6c 69 |ract....| Cli|
|000043f0| 6e 69 63 61 6c 20 73 74 | 75 64 69 65 73 20 69 6e |nical st|udies in|
|00004400| 64 69 63 61 74 65 20 61 | 20 64 65 63 72 65 61 73 |dicate a| decreas|
|00004410| 65 64 20 70 72 65 76 61 | 6c 65 6e 63 65 20 6f 66 |ed preva|lence of|
|00004420| 20 76 61 73 6f 76 61 67 | 61 6c 20 73 79 6e 63 6f | vasovag|al synco|
|00004430| 70 65 20 69 6e 0d 0a 65 | 6c 64 65 72 6c 79 20 70 |pe in..e|lderly p|
|00004440| 65 72 73 6f 6e 73 2c 20 | 61 6e 64 20 74 68 65 72 |ersons, |and ther|
|00004450| 65 20 69 73 20 65 76 69 | 64 65 6e 63 65 20 6f 66 |e is evi|dence of|
|00004460| 20 72 65 64 75 63 65 64 | 20 70 61 72 61 73 79 6d | reduced| parasym|
|00004470| 70 61 74 68 65 74 69 63 | 20 61 63 74 69 76 69 74 |pathetic| activit|
|00004480| 79 20 69 6e 0d 0a 74 68 | 65 20 65 6c 64 65 72 6c |y in..th|e elderl|
|00004490| 79 2e 20 20 54 68 65 20 | 70 6f 74 65 6e 74 69 61 |y. The |potentia|
|000044a0| 6c 20 72 6f 6c 65 20 6f | 66 20 62 65 74 61 2d 61 |l role o|f beta-a|
|000044b0| 64 72 65 6e 65 72 67 69 | 63 20 62 6c 6f 63 6b 61 |drenergi|c blocka|
|000044c0| 64 65 20 69 6e 20 70 72 | 6f 74 65 63 74 69 6e 67 |de in pr|otecting|
|000044d0| 0d 0a 61 67 61 69 6e 73 | 74 20 76 61 73 6f 76 61 |..agains|t vasova|
|000044e0| 67 61 6c 20 73 79 6e 63 | 6f 70 65 20 77 61 73 20 |gal sync|ope was |
|000044f0| 65 78 61 6d 69 6e 65 64 | 20 69 6e 20 32 32 20 65 |examined| in 22 e|
|00004500| 6c 64 65 72 6c 79 20 28 | 6d 65 61 6e 20 61 67 65 |lderly (|mean age|
|00004510| 2c 20 38 33 20 79 65 61 | 72 73 29 20 61 6e 64 0d |, 83 yea|rs) and.|
|00004520| 0a 39 20 79 6f 75 6e 67 | 20 28 6d 65 61 6e 20 61 |.9 young| (mean a|
|00004530| 67 65 2c 20 32 36 20 79 | 65 61 72 73 29 20 69 6e |ge, 26 y|ears) in|
|00004540| 64 69 76 69 64 75 61 6c | 73 2e 20 20 48 65 61 64 |dividual|s. Head|
|00004550| 2d 75 70 20 74 69 6c 74 | 69 6e 67 20 77 61 73 20 |-up tilt|ing was |
|00004560| 70 65 72 66 6f 72 6d 65 | 64 20 61 66 74 65 72 0d |performe|d after.|
|00004570| 0a 61 6e 20 6f 76 65 72 | 6e 69 67 68 74 20 66 61 |.an over|night fa|
|00004580| 73 74 2e 20 20 41 20 74 | 72 69 61 6c 20 6f 66 20 |st. A t|rial of |
|00004590| 70 72 6f 70 72 61 6e 6f | 6c 6f 6c 20 76 73 2e 20 |proprano|lol vs. |
|000045a0| 73 61 6c 69 6e 65 20 77 | 61 73 20 70 65 72 66 6f |saline w|as perfo|
|000045b0| 72 6d 65 64 20 69 6e 20 | 31 30 20 6f 6c 64 0d 0a |rmed in |10 old..|
|000045c0| 61 6e 64 20 31 31 20 79 | 6f 75 6e 67 20 70 65 72 |and 11 y|oung per|
|000045d0| 73 6f 6e 73 20 77 68 6f | 73 65 20 66 6f 72 65 61 |sons who|se forea|
|000045e0| 72 6d 20 76 61 73 63 75 | 6c 61 72 20 72 65 73 70 |rm vascu|lar resp|
|000045f0| 6f 6e 73 65 73 20 74 6f | 20 74 69 6c 74 69 6e 67 |onses to| tilting|
|00004600| 20 77 65 72 65 0d 0a 6d | 6f 6e 69 74 6f 72 65 64 | were..m|onitored|
|00004610| 2e 0d 0a 20 20 20 20 20 | 50 72 65 73 79 6e 63 6f |... |Presynco|
|00004620| 70 61 6c 20 76 61 73 6f | 76 61 67 61 6c 20 73 79 |pal vaso|vagal sy|
|00004630| 6d 70 74 6f 6d 73 20 6f | 63 63 75 72 72 65 64 20 |mptoms o|ccurred |
|00004640| 64 75 72 69 6e 67 20 68 | 65 61 64 2d 75 70 20 74 |during h|ead-up t|
|00004650| 69 6c 74 20 69 6e 20 34 | 20 6f 66 20 39 0d 0a 79 |ilt in 4| of 9..y|
|00004660| 6f 75 6e 67 20 73 75 62 | 6a 65 63 74 73 20 62 75 |oung sub|jects bu|
|00004670| 74 20 69 6e 20 6f 6e 6c | 79 20 31 20 6f 66 20 74 |t in onl|y 1 of t|
|00004680| 68 65 20 32 32 20 65 6c | 64 65 72 6c 79 20 70 65 |he 22 el|derly pe|
|00004690| 72 73 6f 6e 73 2e 20 20 | 50 72 6f 70 72 61 6e 6f |rsons. |Proprano|
|000046a0| 6c 6f 6c 0d 0a 61 74 74 | 65 6e 75 61 74 65 64 20 |lol..att|enuated |
|000046b0| 74 68 65 20 68 65 61 72 | 74 20 72 61 74 65 20 61 |the hear|t rate a|
|000046c0| 6e 64 20 66 6f 72 65 61 | 72 6d 20 76 61 73 63 75 |nd forea|rm vascu|
|000046d0| 6c 61 72 20 72 65 73 69 | 73 74 61 6e 63 65 20 72 |lar resi|stance r|
|000046e0| 65 73 70 6f 6e 73 65 73 | 20 74 6f 0d 0a 74 69 6c |esponses| to..til|
|000046f0| 74 69 6e 67 2e 20 20 56 | 61 73 6f 76 61 67 61 6c |ting. V|asovagal|
|00004700| 20 73 79 6d 70 74 6f 6d | 73 20 64 65 76 65 6c 6f | symptom|s develo|
|00004710| 70 65 64 20 69 6e 20 34 | 20 79 6f 75 6e 67 20 69 |ped in 4| young i|
|00004720| 6e 64 69 76 69 64 75 61 | 6c 73 20 62 75 74 20 69 |ndividua|ls but i|
|00004730| 6e 20 6e 6f 6e 65 20 6f | 66 0d 0a 74 68 65 20 65 |n none o|f..the e|
|00004740| 6c 64 65 72 6c 79 2e 0d | 0a 20 20 20 20 20 49 6e |lderly..|. In|
|00004750| 20 63 6f 6e 74 72 61 73 | 74 20 74 6f 20 77 68 61 | contras|t to wha|
|00004760| 74 20 69 73 20 6f 66 74 | 65 6e 20 63 6c 61 69 6d |t is oft|en claim|
|00004770| 65 64 2c 20 70 6f 73 74 | 75 72 61 6c 20 74 69 6c |ed, post|ural til|
|00004780| 74 69 6e 67 20 69 73 20 | 6e 6f 74 20 75 6e 73 61 |ting is |not unsa|
|00004790| 66 65 20 69 6e 0d 0a 65 | 6c 64 65 72 6c 79 20 70 |fe in..e|lderly p|
|000047a0| 65 72 73 6f 6e 73 20 77 | 68 6f 20 68 61 76 65 20 |ersons w|ho have |
|000047b0| 6e 6f 20 6b 6e 6f 77 6e | 20 6f 72 74 68 6f 73 74 |no known| orthost|
|000047c0| 61 74 69 63 20 68 79 70 | 6f 74 65 6e 73 69 6f 6e |atic hyp|otension|
|000047d0| 2e 20 20 54 68 65 20 61 | 63 75 74 65 0d 0a 69 6e |. The a|cute..in|
|000047e0| 74 72 61 76 65 6e 6f 75 | 73 20 61 64 6d 69 6e 69 |travenou|s admini|
|000047f0| 73 74 72 61 74 69 6f 6e | 20 6f 66 20 70 72 6f 70 |stration| of prop|
|00004800| 72 61 6e 6f 6c 6f 6c 20 | 64 6f 65 73 20 6e 6f 74 |ranolol |does not|
|00004810| 20 70 72 65 76 65 6e 74 | 20 76 61 73 6f 76 61 67 | prevent| vasovag|
|00004820| 61 6c 20 73 79 6d 70 74 | 6f 6d 73 0d 0a 69 6e 20 |al sympt|oms..in |
|00004830| 79 6f 75 6e 67 65 72 20 | 70 65 72 73 6f 6e 73 2e |younger |persons.|
|00004840| 0d 0a 0d 0a 50 6f 73 74 | 2d 43 6f 6d 6d 65 6e 74 |....Post|-Comment|
|00004850| 0d 0a 0d 0a 20 20 20 20 | 20 54 68 65 20 6c 6f 67 |.... | The log|
|00004860| 69 63 20 66 6f 72 20 74 | 68 65 73 65 20 65 78 70 |ic for t|hese exp|
|00004870| 65 72 69 6d 65 6e 74 73 | 20 72 61 6e 20 61 73 20 |eriments| ran as |
|00004880| 66 6f 6c 6c 6f 77 73 3a | 20 28 31 29 20 54 68 65 |follows:| (1) The|
|00004890| 20 65 6c 64 65 72 6c 79 | 20 68 61 76 65 20 6c 65 | elderly| have le|
|000048a0| 73 73 0d 0a 74 65 6e 64 | 65 6e 63 79 20 74 6f 20 |ss..tend|ency to |
|000048b0| 76 61 73 6f 76 61 67 61 | 6c 20 73 79 6e 63 6f 70 |vasovaga|l syncop|
|000048c0| 65 20 74 68 61 6e 20 64 | 6f 20 74 68 65 20 79 6f |e than d|o the yo|
|000048d0| 75 6e 67 3b 20 28 32 29 | 20 74 68 65 20 65 6c 64 |ung; (2)| the eld|
|000048e0| 65 72 6c 79 20 68 61 76 | 65 20 6c 65 73 73 0d 0a |erly hav|e less..|
|000048f0| 76 61 73 6f 64 69 6c 61 | 74 6f 72 20 72 65 73 70 |vasodila|tor resp|
|00004900| 6f 6e 73 65 20 74 6f 20 | 62 65 74 61 2d 61 64 72 |onse to |beta-adr|
|00004910| 65 6e 65 72 67 69 63 20 | 73 74 69 6d 75 6c 61 74 |energic |stimulat|
|00004920| 69 6f 6e 2c 20 28 33 29 | 20 70 6f 73 74 75 72 61 |ion, (3)| postura|
|00004930| 6c 20 68 79 70 6f 74 65 | 6e 73 69 6f 6e 0d 0a 6d |l hypote|nsion..m|
|00004940| 69 67 68 74 20 62 65 20 | 70 72 65 76 65 6e 74 65 |ight be |prevente|
|00004950| 64 20 62 79 20 75 6e 6f | 70 70 6f 73 65 64 20 61 |d by uno|pposed a|
|00004960| 6c 70 68 61 2d 61 64 72 | 65 6e 65 72 67 69 63 20 |lpha-adr|energic |
|00004970| 73 74 69 6d 75 6c 61 74 | 69 6f 6e 2c 20 61 6e 64 |stimulat|ion, and|
|00004980| 20 28 34 29 20 67 69 76 | 69 6e 67 0d 0a 62 65 74 | (4) giv|ing..bet|
|00004990| 61 20 62 6c 6f 63 6b 65 | 72 73 20 74 6f 20 74 68 |a blocke|rs to th|
|000049a0| 65 20 79 6f 75 6e 67 20 | 6d 69 67 68 74 20 63 6f |e young |might co|
|000049b0| 6d 62 61 74 20 70 6f 73 | 74 75 72 61 6c 20 68 79 |mbat pos|tural hy|
|000049c0| 70 6f 74 65 6e 73 69 6f | 6e 2e 20 20 55 6e 66 6f |potensio|n. Unfo|
|000049d0| 72 74 75 6e 61 74 65 6c | 79 2c 0d 0a 70 72 6f 70 |rtunatel|y,..prop|
|000049e0| 72 61 6e 6f 6c 6f 6c 20 | 64 69 64 20 6e 6f 74 20 |ranolol |did not |
|000049f0| 70 72 6f 64 75 63 65 20 | 74 68 65 20 65 78 70 65 |produce |the expe|
|00004a00| 63 74 65 64 20 70 72 6f | 74 65 63 74 69 76 65 20 |cted pro|tective |
|00004a10| 65 66 66 65 63 74 2e 20 | 20 57 68 79 20 6e 6f 74 |effect. | Why not|
|00004a20| 3f 20 20 4f 6e 65 0d 0a | 70 6f 73 73 69 62 6c 65 |? One..|possible|
|00004a30| 20 65 78 70 6c 61 6e 61 | 74 69 6f 6e 20 69 73 20 | explana|tion is |
|00004a40| 74 68 61 74 20 74 68 65 | 20 6c 65 73 73 65 72 20 |that the| lesser |
|00004a50| 73 75 73 63 65 70 74 69 | 62 69 6c 69 74 79 20 74 |suscepti|bility t|
|00004a60| 6f 20 76 61 73 6f 76 61 | 67 61 6c 20 73 79 6e 63 |o vasova|gal sync|
|00004a70| 6f 70 65 20 69 6e 0d 0a | 74 68 65 20 6f 6c 64 20 |ope in..|the old |
|00004a80| 72 65 73 75 6c 74 73 20 | 66 72 6f 6d 20 61 6e 20 |results |from an |
|00004a90| 61 67 65 2d 72 65 6c 61 | 74 65 64 20 72 65 64 75 |age-rela|ted redu|
|00004aa0| 63 74 69 6f 6e 20 69 6e | 20 70 61 72 61 73 79 6d |ction in| parasym|
|00004ab0| 70 61 74 68 65 74 69 63 | 20 74 6f 6e 65 20 6f 72 |pathetic| tone or|
|00004ac0| 0d 0a 61 74 74 65 6e 75 | 61 74 69 6f 6e 20 6f 66 |..attenu|ation of|
|00004ad0| 20 64 65 70 72 65 73 73 | 6f 72 20 72 65 66 6c 65 | depress|or refle|
|00004ae0| 78 65 73 20 6f 72 69 67 | 69 6e 61 74 69 6e 67 20 |xes orig|inating |
|00004af0| 69 6e 20 74 68 65 20 68 | 65 61 72 74 20 61 6e 64 |in the h|eart and|
|00004b00| 20 63 61 72 72 69 65 64 | 20 62 79 0d 0a 43 2d 66 | carried| by..C-f|
|00004b10| 69 62 65 72 20 76 61 67 | 61 6c 20 61 66 66 65 72 |iber vag|al affer|
|00004b20| 65 6e 74 73 20 28 74 68 | 65 20 42 65 7a 6f 6c 64 |ents (th|e Bezold|
|00004b30| 2d 4a 61 72 69 73 63 68 | 20 72 65 66 6c 65 78 29 |-Jarisch| reflex)|
|00004b40| 2e 2d 2d 4c 2e 20 4c 61 | 73 61 67 6e 61 2c 20 4d |.--L. La|sagna, M|
|00004b50| 2e 44 2e 0d 0a 24 55 6e | 69 71 75 65 5f 49 44 7b |.D...$Un|ique_ID{|
|00004b60| 59 52 42 30 30 38 30 36 | 7d 0d 0a 24 54 69 74 6c |YRB00806|}..$Titl|
|00004b70| 65 7b 42 65 6e 65 66 69 | 63 69 61 6c 20 45 66 66 |e{Benefi|cial Eff|
|00004b80| 65 63 74 73 20 6f 66 20 | 45 72 79 74 68 72 6f 70 |ects of |Erythrop|
|00004b90| 6f 69 65 74 69 6e 20 6f | 6e 20 48 61 65 6d 61 74 |oietin o|n Haemat|
|00004ba0| 6f 6c 6f 67 69 63 61 6c | 20 50 61 72 61 6d 65 74 |ological| Paramet|
|00004bb0| 65 72 73 2c 0d 0a 41 65 | 72 6f 62 69 63 20 43 61 |ers,..Ae|robic Ca|
|00004bc0| 70 61 63 69 74 79 2c 20 | 61 6e 64 20 42 6f 64 79 |pacity, |and Body|
|00004bd0| 20 46 6c 75 69 64 20 43 | 6f 6d 70 6f 73 69 74 69 | Fluid C|ompositi|
|00004be0| 6f 6e 20 69 6e 20 50 61 | 74 69 65 6e 74 73 20 6f |on in Pa|tients o|
|00004bf0| 6e 20 48 61 65 6d 6f 64 | 69 61 6c 79 73 69 73 7d |n Haemod|ialysis}|
|00004c00| 0d 0a 24 41 75 74 68 6f | 72 7b 0d 0a 52 6f 73 65 |..$Autho|r{..Rose|
|00004c10| 6e 6c 6f 66 2c 20 4b 0d | 0a 47 72 6f 6e 68 61 67 |nlof, K.|.Gronhag|
|00004c20| 65 6e 2d 52 69 73 6b 61 | 2c 20 43 0d 0a 53 6f 76 |en-Riska|, C..Sov|
|00004c30| 69 6a 61 72 76 69 2c 20 | 41 0d 0a 48 6f 6e 6b 61 |ijarvi, |A..Honka|
|00004c40| 6e 65 6e 2c 20 45 0d 0a | 54 69 6b 6b 61 6e 65 6e |nen, E..|Tikkanen|
|00004c50| 2c 20 49 0d 0a 45 6b 73 | 74 72 61 6e 64 2c 20 41 |, I..Eks|trand, A|
|00004c60| 0d 0a 50 69 69 72 69 6c | 61 2c 20 50 0d 0a 46 79 |..Piiril|a, P..Fy|
|00004c70| 68 72 71 75 69 73 74 2c | 20 46 7d 0d 0a 24 41 66 |hrquist,| F}..$Af|
|00004c80| 66 69 6c 69 61 74 69 6f | 6e 7b 48 65 6c 73 69 6e |filiatio|n{Helsin|
|00004c90| 6b 69 20 55 6e 69 76 20 | 43 65 6e 74 72 61 6c 20 |ki Univ |Central |
|00004ca0| 48 6f 73 70 2c 20 46 69 | 6e 6c 61 6e 64 7d 0d 0a |Hosp, Fi|nland}..|
|00004cb0| 24 4a 6f 75 72 6e 61 6c | 7b 4a 20 49 6e 74 65 72 |$Journal|{J Inter|
|00004cc0| 6e 20 4d 65 64 7d 0d 0a | 24 56 6f 6c 75 6d 65 7b |n Med}..|$Volume{|
|00004cd0| 32 32 36 7d 0d 0a 24 50 | 61 67 65 7b 33 31 31 2d |226}..$P|age{311-|
|00004ce0| 33 31 37 7d 0d 0a 24 44 | 61 74 65 7b 31 39 38 39 |317}..$D|ate{1989|
|00004cf0| 7d 0d 0a 24 59 42 56 6f | 6c 7b 31 39 39 31 20 59 |}..$YBVo|l{1991 Y|
|00004d00| 65 61 72 20 42 6f 6f 6b | 20 6f 66 20 44 72 75 67 |ear Book| of Drug|
|00004d10| 20 54 68 65 72 61 70 79 | 7d 0d 0a 24 43 68 61 70 | Therapy|}..$Chap|
|00004d20| 74 65 72 7b 32 2d 31 36 | 7d 0d 0a 24 59 42 45 64 |ter{2-16|}..$YBEd|
|00004d30| 69 74 6f 72 7b 44 72 73 | 2e 20 4c 61 73 61 67 6e |itor{Drs|. Lasagn|
|00004d40| 61 20 61 6e 64 20 57 65 | 69 6e 74 72 61 75 62 7d |a and We|intraub}|
|00004d50| 0d 0a 24 54 61 62 6c 65 | 7b 7d 0d 0a 24 43 6f 6d |..$Table|{}..$Com|
|00004d60| 6d 65 6e 74 61 74 6f 72 | 7b 4c 2e 20 4c 61 73 61 |mentator|{L. Lasa|
|00004d70| 67 6e 61 2c 20 4d 2e 44 | 2e 7d 0d 0a 0d 0a 43 6f |gna, M.D|.}....Co|
|00004d80| 70 79 72 69 67 68 74 20 | 28 43 29 20 59 65 61 72 |pyright |(C) Year|
|00004d90| 20 42 6f 6f 6b 20 4d 65 | 64 69 63 61 6c 20 50 75 | Book Me|dical Pu|
|00004da0| 62 6c 69 73 68 65 72 73 | 2c 20 49 6e 63 2e 20 31 |blishers|, Inc. 1|
|00004db0| 39 39 31 0d 0a 0d 0a 31 | 39 39 31 20 59 65 61 72 |991....1|991 Year|
|00004dc0| 20 42 6f 6f 6b 20 6f 66 | 20 44 72 75 67 20 54 68 | Book of| Drug Th|
|00004dd0| 65 72 61 70 79 0d 0a 0d | 0a 43 68 61 70 74 65 72 |erapy...|.Chapter|
|00004de0| 20 32 20 2d 2d 20 44 72 | 75 67 20 41 63 74 69 6f | 2 -- Dr|ug Actio|
|00004df0| 6e 0d 0a 0d 0a 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |n....---|--------|
|00004e00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004e10| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004e20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004e30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004e40| 2d 2d 2d 0d 0a 42 65 6e | 65 66 69 63 69 61 6c 20 |---..Ben|eficial |
|00004e50| 45 66 66 65 63 74 73 20 | 6f 66 20 45 72 79 74 68 |Effects |of Eryth|
|00004e60| 72 6f 70 6f 69 65 74 69 | 6e 20 6f 6e 20 48 61 65 |ropoieti|n on Hae|
|00004e70| 6d 61 74 6f 6c 6f 67 69 | 63 61 6c 20 50 61 72 61 |matologi|cal Para|
|00004e80| 6d 65 74 65 72 73 2c 20 | 41 65 72 6f 62 69 63 0d |meters, |Aerobic.|
|00004e90| 0a 43 61 70 61 63 69 74 | 79 2c 20 61 6e 64 20 42 |.Capacit|y, and B|
|00004ea0| 6f 64 79 20 46 6c 75 69 | 64 20 43 6f 6d 70 6f 73 |ody Flui|d Compos|
|00004eb0| 69 74 69 6f 6e 20 69 6e | 20 50 61 74 69 65 6e 74 |ition in| Patient|
|00004ec0| 73 20 6f 6e 20 48 61 65 | 6d 6f 64 69 61 6c 79 73 |s on Hae|modialys|
|00004ed0| 69 73 0d 0a 0d 0a 52 6f | 73 65 6e 6c 6f 66 20 4b |is....Ro|senlof K|
|00004ee0| 3b 20 47 72 6f 6e 68 61 | 67 65 6e 2d 52 69 73 6b |; Gronha|gen-Risk|
|00004ef0| 61 20 43 3b 20 53 6f 76 | 69 6a 61 72 76 69 20 41 |a C; Sov|ijarvi A|
|00004f00| 3b 20 48 6f 6e 6b 61 6e | 65 6e 20 45 3b 20 54 69 |; Honkan|en E; Ti|
|00004f10| 6b 6b 61 6e 65 6e 20 49 | 3b 20 45 6b 73 74 72 61 |kkanen I|; Ekstra|
|00004f20| 6e 64 0d 0a 41 3b 20 50 | 69 69 72 69 6c 61 20 50 |nd..A; P|iirila P|
|00004f30| 3b 20 46 79 68 72 71 75 | 69 73 74 20 46 0d 0a 28 |; Fyhrqu|ist F..(|
|00004f40| 48 65 6c 73 69 6e 6b 69 | 20 55 6e 69 76 20 43 65 |Helsinki| Univ Ce|
|00004f50| 6e 74 72 61 6c 20 48 6f | 73 70 2c 20 46 69 6e 6c |ntral Ho|sp, Finl|
|00004f60| 61 6e 64 29 0d 0a 4a 20 | 49 6e 74 65 72 6e 20 4d |and)..J |Intern M|
|00004f70| 65 64 20 32 32 36 3a 33 | 31 31 2d 33 31 37 2c 20 |ed 226:3|11-317, |
|00004f80| 31 39 38 39 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |1989..--|--------|
|00004f90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004fa0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004fb0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004fc0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004fd0| 2d 2d 2d 2d 0d 0a 0d 0a | 41 62 73 74 72 61 63 74 |----....|Abstract|
|00004fe0| 0d 0a 0d 0a 20 20 20 20 | 20 52 65 63 6f 6d 62 69 |.... | Recombi|
|00004ff0| 6e 61 6e 74 20 68 75 6d | 61 6e 20 65 72 79 74 68 |nant hum|an eryth|
|00005000| 72 6f 70 6f 69 65 74 69 | 6e 20 28 45 50 4f 29 20 |ropoieti|n (EPO) |
|00005010| 77 61 73 20 75 73 65 64 | 20 74 6f 20 74 72 65 61 |was used| to trea|
|00005020| 74 20 31 31 20 62 6c 6f | 6f 64 0d 0a 74 72 61 6e |t 11 blo|od..tran|
|00005030| 73 66 75 73 69 6f 6e 2d | 64 65 70 65 6e 64 65 6e |sfusion-|dependen|
|00005040| 74 20 68 65 6d 6f 64 69 | 61 6c 79 73 69 73 20 70 |t hemodi|alysis p|
|00005050| 61 74 69 65 6e 74 73 2e | 20 20 54 68 65 20 65 66 |atients.| The ef|
|00005060| 66 65 63 74 73 20 6f 66 | 20 45 50 4f 20 74 72 65 |fects of| EPO tre|
|00005070| 61 74 6d 65 6e 74 20 6f | 6e 0d 0a 61 65 72 6f 62 |atment o|n..aerob|
|00005080| 69 63 20 65 78 65 72 63 | 69 73 65 20 63 61 70 61 |ic exerc|ise capa|
|00005090| 63 69 74 79 2c 20 68 65 | 6d 61 74 6f 6c 6f 67 69 |city, he|matologi|
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|00005b20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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