home *** CD-ROM | disk | FTP | other *** search
| Unknown | 1992-06-05 | 469.8 KB |
open in: 
MacOS 8.1
|
Win98
|
DOS
view JSON data
|
view as text
This file was not able to be converted.
This format is not currently supported by dexvert.
| 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|........|
|00000020| b2 07 00 00 30 31 00 00 | 00 01 4e 0d 00 00 2f 12 |....01..|..N.../.|
|00000030| 00 00 30 32 00 00 00 01 | 7d 1f 00 00 35 0f 00 00 |..02....|}...5...|
|00000040| 30 33 00 00 00 01 b2 2e | 00 00 1c 09 00 00 30 34 |03......|......04|
|00000050| 00 00 00 01 ce 37 00 00 | 9f 07 00 00 30 35 00 00 |.....7..|....05..|
|00000060| 00 01 6d 3f 00 00 e8 12 | 00 00 30 36 00 00 00 01 |..m?....|..06....|
|00000070| 55 52 00 00 04 12 00 00 | 30 37 00 00 00 01 59 64 |UR......|07....Yd|
|00000080| 00 00 db 15 00 00 30 38 | 00 00 00 01 34 7a 00 00 |......08|....4z..|
|00000090| 44 0a 00 00 30 39 00 00 | 00 01 78 84 00 00 d2 14 |D...09..|..x.....|
|000000a0| 00 00 31 30 00 00 00 01 | 4a 99 00 00 68 1b 00 00 |..10....|J...h...|
|000000b0| 31 31 00 00 00 01 b2 b4 | 00 00 4b 16 00 00 31 32 |11......|..K...12|
|000000c0| 00 00 00 01 fd ca 00 00 | 2b 08 00 00 31 33 00 00 |........|+...13..|
|000000d0| 00 01 28 d3 00 00 6e 1b | 00 00 31 34 00 00 00 01 |..(...n.|..14....|
|000000e0| 96 ee 00 00 25 1a 00 00 | 31 35 00 00 00 01 bb 08 |....%...|15......|
|000000f0| 01 00 f1 14 00 00 31 36 | 00 00 00 01 ac 1d 01 00 |......16|........|
|00000100| 2d 0b 00 00 31 37 00 00 | 00 01 d9 28 01 00 8b 17 |-...17..|...(....|
|00000110| 00 00 31 38 00 00 00 01 | 64 40 01 00 07 0d 00 00 |..18....|d@......|
|00000120| 31 39 00 00 00 01 6b 4d | 01 00 80 17 00 00 32 30 |19....kM|......20|
|00000130| 00 00 00 01 eb 64 01 00 | 89 17 00 00 32 31 00 00 |.....d..|....21..|
|00000140| 00 01 74 7c 01 00 da 17 | 00 00 32 32 00 00 00 01 |..t|....|..22....|
|00000150| 4e 94 01 00 67 15 00 00 | 32 33 00 00 00 01 b5 a9 |N...g...|23......|
|00000160| 01 00 b7 0c 00 00 32 34 | 00 00 00 01 6c b6 01 00 |......24|....l...|
|00000170| 4f 15 00 00 32 35 00 00 | 00 01 bb cb 01 00 a5 13 |O...25..|........|
|00000180| 00 00 32 36 00 00 00 01 | 60 df 01 00 6d 18 00 00 |..26....|`...m...|
|00000190| 32 37 00 00 00 01 cd f7 | 01 00 91 18 00 00 32 38 |27......|......28|
|000001a0| 00 00 00 01 5e 10 02 00 | 3c 16 00 00 32 39 00 00 |....^...|<...29..|
|000001b0| 00 01 9a 26 02 00 a1 16 | 00 00 33 30 00 00 00 01 |...&....|..30....|
|000001c0| 3b 3d 02 00 98 13 00 00 | 33 31 00 00 00 01 d3 50 |;=......|31.....P|
|000001d0| 02 00 5d 0d 00 00 33 32 | 00 00 00 01 30 5e 02 00 |..]...32|....0^..|
|000001e0| af 17 00 00 33 33 00 00 | 00 01 df 75 02 00 93 08 |....33..|...u....|
|000001f0| 00 00 33 34 00 00 00 01 | 72 7e 02 00 8f 16 00 00 |..34....|r~......|
|00000200| 33 35 00 00 00 01 01 95 | 02 00 dc 15 00 00 33 36 |35......|......36|
|00000210| 00 00 00 01 dd aa 02 00 | 54 0d 00 00 33 37 00 00 |........|T...37..|
|00000220| 00 01 31 b8 02 00 e3 19 | 00 00 33 38 00 00 00 01 |..1.....|..38....|
|00000230| 14 d2 02 00 67 13 00 00 | 33 39 00 00 00 01 7b e5 |....g...|39....{.|
|00000240| 02 00 55 13 00 00 34 30 | 00 00 00 01 d0 f8 02 00 |..U...40|........|
|00000250| f5 10 00 00 34 31 00 00 | 00 01 c5 09 03 00 96 18 |....41..|........|
|00000260| 00 00 34 32 00 00 00 01 | 5b 22 03 00 e7 17 00 00 |..42....|["......|
|00000270| 34 33 00 00 00 01 42 3a | 03 00 2d 09 00 00 34 34 |43....B:|..-...44|
|00000280| 00 00 00 01 6f 43 03 00 | eb 15 00 00 34 35 00 00 |....oC..|....45..|
|00000290| 00 01 5a 59 03 00 62 17 | 00 00 34 36 00 00 00 01 |..ZY..b.|..46....|
|000002a0| bc 70 03 00 34 11 00 00 | 34 37 00 00 00 01 f0 81 |.p..4...|47......|
|000002b0| 03 00 91 09 00 00 34 38 | 00 00 00 01 81 8b 03 00 |......48|........|
|000002c0| fe 17 00 00 34 39 00 00 | 00 01 7f a3 03 00 95 0d |....49..|........|
|000002d0| 00 00 35 30 00 00 00 01 | 14 b1 03 00 86 12 00 00 |..50....|........|
|000002e0| 35 31 00 00 00 01 9a c3 | 03 00 db 1a 00 00 35 32 |51......|......52|
|000002f0| 00 00 00 01 75 de 03 00 | 90 0f 00 00 35 33 00 00 |....u...|....53..|
|00000300| 00 01 05 ee 03 00 12 0d | 00 00 35 34 00 00 00 01 |........|..54....|
|00000310| 17 fb 03 00 77 16 00 00 | 35 35 00 00 00 01 8e 11 |....w...|55......|
|00000320| 04 00 e9 0b 00 00 35 36 | 00 00 00 01 77 1d 04 00 |......56|....w...|
|00000330| 41 0a 00 00 35 37 00 00 | 00 01 b8 27 04 00 6e 12 |A...57..|...'..n.|
|00000340| 00 00 35 38 00 00 00 01 | 26 3a 04 00 3d 11 00 00 |..58....|&:..=...|
|00000350| 35 39 00 00 00 01 63 4b | 04 00 9e 10 00 00 36 30 |59....cK|......60|
|00000360| 00 00 00 01 01 5c 04 00 | be 0b 00 00 36 31 00 00 |.....\..|....61..|
|00000370| 00 01 bf 67 04 00 7a 18 | 00 00 36 32 00 00 00 01 |...g..z.|..62....|
|00000380| 39 80 04 00 86 07 00 00 | 36 33 00 00 00 01 bf 87 |9.......|63......|
|00000390| 04 00 ae 10 00 00 36 34 | 00 00 00 01 6d 98 04 00 |......64|....m...|
|000003a0| fe 14 00 00 36 35 00 00 | 00 01 6b ad 04 00 61 12 |....65..|..k...a.|
|000003b0| 00 00 36 36 00 00 00 01 | cc bf 04 00 e6 0e 00 00 |..66....|........|
|000003c0| 36 37 00 00 00 01 b2 ce | 04 00 63 10 00 00 36 38 |67......|..c...68|
|000003d0| 00 00 00 01 15 df 04 00 | 1d 0d 00 00 36 39 00 00 |........|....69..|
|000003e0| 00 01 32 ec 04 00 8c 1e | 00 00 37 30 00 00 00 01 |..2.....|..70....|
|000003f0| be 0a 05 00 1c 11 00 00 | 37 31 00 00 00 01 da 1b |........|71......|
|00000400| 05 00 18 13 00 00 37 32 | 00 00 00 01 f2 2e 05 00 |......72|........|
|00000410| b0 0e 00 00 37 33 00 00 | 00 01 a2 3d 05 00 d6 08 |....73..|...=....|
|00000420| 00 00 37 34 00 00 00 01 | 78 46 05 00 69 17 00 00 |..74....|xF..i...|
|00000430| 37 35 00 00 00 01 e1 5d | 05 00 a3 10 00 00 37 36 |75.....]|......76|
|00000440| 00 00 00 01 84 6e 05 00 | aa 0e 00 00 37 37 00 00 |.....n..|....77..|
|00000450| 00 01 2e 7d 05 00 2d 0f | 00 00 37 38 00 00 00 01 |...}..-.|..78....|
|00000460| 5b 8c 05 00 56 17 00 00 | 37 39 00 00 00 01 b1 a3 |[...V...|79......|
|00000470| 05 00 60 0a 00 00 38 30 | 00 00 00 01 11 ae 05 00 |..`...80|........|
|00000480| 58 18 00 00 38 31 00 00 | 00 01 69 c6 05 00 8e 0e |X...81..|..i.....|
|00000490| 00 00 38 32 00 00 00 01 | f7 d4 05 00 02 16 00 00 |..82....|........|
|000004a0| 38 33 00 00 00 01 f9 ea | 05 00 1c 12 00 00 38 34 |83......|......84|
|000004b0| 00 00 00 01 15 fd 05 00 | f0 11 00 00 38 35 00 00 |........|....85..|
|000004c0| 00 01 05 0f 06 00 81 1c | 00 00 38 36 00 00 00 01 |........|..86....|
|000004d0| 86 2b 06 00 45 17 00 00 | 38 37 00 00 00 01 cb 42 |.+..E...|87.....B|
|000004e0| 06 00 f7 08 00 00 38 38 | 00 00 00 01 c2 4b 06 00 |......88|.....K..|
|000004f0| e1 20 00 00 38 39 00 00 | 00 01 a3 6c 06 00 21 20 |. ..89..|...l..! |
|00000500| 00 00 39 30 00 00 00 01 | c4 8c 06 00 7c 18 00 00 |..90....|....|...|
|00000510| 39 31 00 00 00 01 40 a5 | 06 00 90 0c 00 00 39 32 |91....@.|......92|
|00000520| 00 00 00 01 d0 b1 06 00 | 71 13 00 00 39 33 00 00 |........|q...93..|
|00000530| 00 01 41 c5 06 00 14 14 | 00 00 39 34 00 00 00 01 |..A.....|..94....|
|00000540| 55 d9 06 00 76 17 00 00 | 39 35 00 00 00 01 cb f0 |U...v...|95......|
|00000550| 06 00 c8 15 00 00 39 36 | 00 00 00 01 93 06 07 00 |......96|........|
|00000560| 7d 0a 00 00 39 37 00 00 | 00 01 10 11 07 00 94 1c |}...97..|........|
|00000570| 00 00 39 38 00 00 00 01 | a4 2d 07 00 76 15 00 00 |..98....|.-..v...|
|00000580| 39 39 00 00 00 01 1a 43 | 07 00 4a 14 00 00 00 00 |99.....C|..J.....|
|00000590| 00 00 00 00 64 57 07 00 | 00 00 00 00 24 55 6e 69 |....dW..|....$Uni|
|000005a0| 71 75 65 5f 49 44 7b 59 | 52 42 30 33 30 30 30 7d |que_ID{Y|RB03000}|
|000005b0| 0d 0a 24 54 69 74 6c 65 | 7b 54 68 65 20 52 65 6c |..$Title|{The Rel|
|000005c0| 61 74 69 6f 6e 73 68 69 | 70 20 42 65 74 77 65 65 |ationshi|p Betwee|
|000005d0| 6e 20 43 65 72 65 62 72 | 61 6c 20 50 61 6c 73 79 |n Cerebr|al Palsy|
|000005e0| 20 61 6e 64 20 43 72 79 | 70 74 6f 72 63 68 69 64 | and Cry|ptorchid|
|000005f0| 69 73 6d 7d 0d 0a 24 41 | 75 74 68 6f 72 7b 0d 0a |ism}..$A|uthor{..|
|00000600| 53 6d 69 74 68 2c 20 4a | 41 0d 0a 48 75 74 73 6f |Smith, J|A..Hutso|
|00000610| 6e 2c 20 4a 4d 0d 0a 42 | 65 61 73 6c 65 79 2c 20 |n, JM..B|easley, |
|00000620| 53 57 0d 0a 52 65 64 64 | 69 68 6f 75 67 68 2c 20 |SW..Redd|ihough, |
|00000630| 44 53 7d 0d 0a 24 41 66 | 66 69 6c 69 61 74 69 6f |DS}..$Af|filiatio|
|00000640| 6e 7b 52 6f 79 61 6c 20 | 43 68 69 6c 64 72 65 6e |n{Royal |Children|
|00000650| 27 73 20 48 6f 73 70 2c | 20 4d 65 6c 62 6f 75 72 |'s Hosp,| Melbour|
|00000660| 6e 65 7d 0d 0a 24 4a 6f | 75 72 6e 61 6c 7b 4a 20 |ne}..$Jo|urnal{J |
|00000670| 50 65 64 69 61 74 72 20 | 53 75 72 67 7d 0d 0a 24 |Pediatr |Surg}..$|
|00000680| 56 6f 6c 75 6d 65 7b 32 | 34 7d 0d 0a 24 50 61 67 |Volume{2|4}..$Pag|
|00000690| 65 7b 31 33 30 33 2d 31 | 33 30 35 7d 0d 0a 24 44 |e{1303-1|305}..$D|
|000006a0| 61 74 65 7b 31 39 38 39 | 7d 0d 0a 24 59 42 56 6f |ate{1989|}..$YBVo|
|000006b0| 6c 7b 31 39 39 31 20 59 | 65 61 72 20 42 6f 6f 6b |l{1991 Y|ear Book|
|000006c0| 20 6f 66 20 50 65 64 69 | 61 74 72 69 63 73 3a 7d | of Pedi|atrics:}|
|000006d0| 0d 0a 24 43 68 61 70 74 | 65 72 7b 31 30 2d 31 31 |..$Chapt|er{10-11|
|000006e0| 7d 0d 0a 24 59 42 45 64 | 69 74 6f 72 7b 44 72 73 |}..$YBEd|itor{Drs|
|000006f0| 2e 20 4f 73 6b 69 20 61 | 6e 64 20 53 74 6f 63 6b |. Oski a|nd Stock|
|00000700| 6d 61 6e 7d 0d 0a 24 54 | 61 62 6c 65 7b 7d 0d 0a |man}..$T|able{}..|
|00000710| 24 43 6f 6d 6d 65 6e 74 | 61 74 6f 72 7b 7d 0d 0a |$Comment|ator{}..|
|00000720| 0d 0a 43 6f 70 79 72 69 | 67 68 74 20 28 43 29 20 |..Copyri|ght (C) |
|00000730| 59 65 61 72 20 42 6f 6f | 6b 20 4d 65 64 69 63 61 |Year Boo|k Medica|
|00000740| 6c 20 50 75 62 6c 69 73 | 68 65 72 73 2c 20 49 6e |l Publis|hers, In|
|00000750| 63 2e 20 31 39 39 31 0d | 0a 0d 0a 31 39 39 31 20 |c. 1991.|...1991 |
|00000760| 59 65 61 72 20 42 6f 6f | 6b 20 6f 66 20 50 65 64 |Year Boo|k of Ped|
|00000770| 69 61 74 72 69 63 73 3a | 0d 0a 0d 0a 43 68 61 70 |iatrics:|....Chap|
|00000780| 74 65 72 20 31 30 20 2d | 2d 20 54 68 65 20 47 65 |ter 10 -|- The Ge|
|00000790| 6e 69 74 6f 75 72 69 6e | 61 72 79 20 54 72 61 63 |nitourin|ary Trac|
|000007a0| 74 0d 0a 0d 0a 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |t....---|--------|
|000007b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000007c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000007d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000007e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000007f0| 2d 2d 2d 0d 0a 54 68 65 | 20 52 65 6c 61 74 69 6f |---..The| Relatio|
|00000800| 6e 73 68 69 70 20 42 65 | 74 77 65 65 6e 20 43 65 |nship Be|tween Ce|
|00000810| 72 65 62 72 61 6c 20 50 | 61 6c 73 79 20 61 6e 64 |rebral P|alsy and|
|00000820| 20 43 72 79 70 74 6f 72 | 63 68 69 64 69 73 6d 0d | Cryptor|chidism.|
|00000830| 0a 0d 0a 53 6d 69 74 68 | 20 4a 41 3b 20 48 75 74 |...Smith| JA; Hut|
|00000840| 73 6f 6e 20 4a 4d 3b 20 | 42 65 61 73 6c 65 79 20 |son JM; |Beasley |
|00000850| 53 57 3b 20 52 65 64 64 | 69 68 6f 75 67 68 20 44 |SW; Redd|ihough D|
|00000860| 53 0d 0a 28 52 6f 79 61 | 6c 20 43 68 69 6c 64 72 |S..(Roya|l Childr|
|00000870| 65 6e 27 73 20 48 6f 73 | 70 2c 20 4d 65 6c 62 6f |en's Hos|p, Melbo|
|00000880| 75 72 6e 65 29 0d 0a 4a | 20 50 65 64 69 61 74 72 |urne)..J| Pediatr|
|00000890| 20 53 75 72 67 20 32 34 | 3a 31 33 30 33 2d 31 33 | Surg 24|:1303-13|
|000008a0| 30 35 2c 20 31 39 38 39 | 0d 0a 2d 2d 2d 2d 2d 2d |05, 1989|..------|
|000008b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000008c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000008d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000008e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000008f0| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0a 0d 0a 41 62 73 74 |--------|....Abst|
|00000900| 72 61 63 74 0d 0a 0d 0a | 20 20 20 20 20 52 65 73 |ract....| Res|
|00000910| 65 61 72 63 68 20 68 61 | 73 20 73 68 6f 77 6e 20 |earch ha|s shown |
|00000920| 74 68 61 74 20 74 68 65 | 20 69 6e 63 69 64 65 6e |that the| inciden|
|00000930| 63 65 20 6f 66 20 63 72 | 79 70 74 6f 72 63 68 69 |ce of cr|yptorchi|
|00000940| 64 69 73 6d 20 69 6e 20 | 70 61 74 69 65 6e 74 73 |dism in |patients|
|00000950| 20 77 69 74 68 0d 0a 63 | 65 72 65 62 72 61 6c 20 | with..c|erebral |
|00000960| 70 61 6c 73 79 20 69 73 | 20 68 69 67 68 65 72 20 |palsy is| higher |
|00000970| 74 68 61 6e 20 65 78 70 | 65 63 74 65 64 2e 20 20 |than exp|ected. |
|00000980| 54 68 65 20 72 65 70 6f | 72 74 65 64 20 61 73 73 |The repo|rted ass|
|00000990| 6f 63 69 61 74 69 6f 6e | 20 62 65 74 77 65 65 6e |ociation| between|
|000009a0| 0d 0a 74 68 65 73 65 20 | 32 20 64 69 73 6f 72 64 |..these |2 disord|
|000009b0| 65 72 73 20 77 61 73 20 | 69 6e 76 65 73 74 69 67 |ers was |investig|
|000009c0| 61 74 65 64 20 69 6e 20 | 32 35 20 62 6f 79 73 20 |ated in |25 boys |
|000009d0| 77 69 74 68 20 63 65 72 | 65 62 72 61 6c 20 70 61 |with cer|ebral pa|
|000009e0| 6c 73 79 20 61 67 65 64 | 20 6c 65 73 73 0d 0a 74 |lsy aged| less..t|
|000009f0| 68 61 6e 20 32 20 79 65 | 61 72 73 20 36 20 6d 6f |han 2 ye|ars 6 mo|
|00000a00| 6e 74 68 73 2c 20 32 35 | 20 62 6f 79 73 20 77 69 |nths, 25| boys wi|
|00000a10| 74 68 20 63 65 72 65 62 | 72 61 6c 20 70 61 6c 73 |th cereb|ral pals|
|00000a20| 79 20 61 67 65 64 20 35 | 2d 31 30 20 79 65 61 72 |y aged 5|-10 year|
|00000a30| 73 2c 20 61 6e 64 0d 0a | 61 67 65 2d 6d 61 74 63 |s, and..|age-matc|
|00000a40| 68 65 64 20 63 6f 6e 74 | 72 6f 6c 73 2e 0d 0a 20 |hed cont|rols... |
|00000a50| 20 20 20 20 49 6e 20 74 | 68 65 20 62 6f 79 73 20 | In t|he boys |
|00000a60| 77 69 74 68 20 63 65 72 | 65 62 72 61 6c 20 70 61 |with cer|ebral pa|
|00000a70| 6c 73 79 2c 20 74 68 65 | 20 74 65 73 74 65 73 20 |lsy, the| testes |
|00000a80| 72 65 6d 61 69 6e 65 64 | 20 69 6e 20 74 68 65 20 |remained| in the |
|00000a90| 73 61 6d 65 20 70 6f 73 | 69 74 69 6f 6e 0d 0a 77 |same pos|ition..w|
|00000aa0| 69 74 68 20 61 67 65 2e | 20 20 49 6e 20 68 65 61 |ith age.| In hea|
|00000ab0| 6c 74 68 79 20 62 6f 79 | 73 20 74 68 65 20 74 65 |lthy boy|s the te|
|00000ac0| 73 74 65 73 20 77 65 72 | 65 20 69 6e 69 74 69 61 |stes wer|e initia|
|00000ad0| 6c 6c 79 20 73 6c 69 67 | 68 74 6c 79 20 6c 6f 77 |lly slig|htly low|
|00000ae0| 65 72 20 61 6e 64 20 62 | 65 63 61 6d 65 0d 0a 6c |er and b|ecame..l|
|00000af0| 6f 77 65 72 20 73 74 69 | 6c 6c 20 77 69 74 68 20 |ower sti|ll with |
|00000b00| 61 67 65 2e 20 20 54 68 | 65 20 69 6e 63 72 65 61 |age. Th|e increa|
|00000b10| 73 69 6e 67 20 64 69 73 | 74 61 6e 63 65 20 6f 66 |sing dis|tance of|
|00000b20| 20 74 68 65 20 74 65 73 | 74 69 73 20 62 65 6c 6f | the tes|tis belo|
|00000b30| 77 20 74 68 65 20 70 75 | 62 69 73 0d 0a 69 6e 20 |w the pu|bis..in |
|00000b40| 68 65 61 6c 74 68 79 20 | 62 6f 79 73 20 73 75 67 |healthy |boys sug|
|00000b50| 67 65 73 74 73 20 74 68 | 61 74 20 63 6f 72 64 20 |gests th|at cord |
|00000b60| 65 6c 6f 6e 67 61 74 69 | 6f 6e 20 6d 69 67 68 74 |elongati|on might|
|00000b70| 20 62 65 20 61 20 70 72 | 65 72 65 71 75 69 73 69 | be a pr|erequisi|
|00000b80| 74 65 20 66 6f 72 20 74 | 68 65 0d 0a 74 65 73 74 |te for t|he..test|
|00000b90| 69 73 20 74 6f 20 72 65 | 6d 61 69 6e 20 73 69 74 |is to re|main sit|
|00000ba0| 75 61 74 65 64 20 6e 6f | 72 6d 61 6c 6c 79 20 69 |uated no|rmally i|
|00000bb0| 6e 20 74 68 65 20 73 63 | 72 6f 74 75 6d 20 64 75 |n the sc|rotum du|
|00000bc0| 72 69 6e 67 20 67 72 6f | 77 74 68 2e 0d 0a 20 20 |ring gro|wth... |
|00000bd0| 20 20 20 54 68 65 73 65 | 20 61 6e 64 20 6f 74 68 | These| and oth|
|00000be0| 65 72 20 66 69 6e 64 69 | 6e 67 73 20 63 61 73 74 |er findi|ngs cast|
|00000bf0| 20 64 6f 75 62 74 20 6f | 6e 20 74 68 65 20 74 68 | doubt o|n the th|
|00000c00| 65 6f 72 69 65 73 20 6f | 66 20 65 61 72 6c 79 20 |eories o|f early |
|00000c10| 64 61 6d 61 67 65 20 74 | 6f 0d 0a 74 68 65 20 68 |damage t|o..the h|
|00000c20| 79 70 6f 74 68 61 6c 61 | 6d 69 63 2d 70 69 74 75 |ypothala|mic-pitu|
|00000c30| 69 74 61 72 79 2d 67 6f | 6e 61 64 61 6c 20 61 78 |itary-go|nadal ax|
|00000c40| 69 73 20 61 73 20 74 68 | 65 20 63 61 75 73 65 20 |is as th|e cause |
|00000c50| 6f 66 20 6d 61 6c 64 65 | 73 63 65 6e 74 20 69 6e |of malde|scent in|
|00000c60| 20 70 61 74 69 65 6e 74 | 73 0d 0a 77 69 74 68 20 | patient|s..with |
|00000c70| 63 65 72 65 62 72 61 6c | 20 70 61 6c 73 79 2e 20 |cerebral| palsy. |
|00000c80| 20 41 6e 79 20 61 70 70 | 61 72 65 6e 74 20 69 6e | Any app|arent in|
|00000c90| 63 72 65 61 73 65 20 69 | 6e 20 63 72 79 70 74 6f |crease i|n crypto|
|00000ca0| 72 63 68 69 64 69 73 6d | 20 69 6e 20 6f 6c 64 65 |rchidism| in olde|
|00000cb0| 72 20 62 6f 79 73 0d 0a | 77 69 74 68 20 63 65 72 |r boys..|with cer|
|00000cc0| 65 62 72 61 6c 20 70 61 | 6c 73 79 20 6d 69 67 68 |ebral pa|lsy migh|
|00000cd0| 74 20 62 65 20 74 68 65 | 20 72 65 73 75 6c 74 20 |t be the| result |
|00000ce0| 6f 66 20 73 70 61 73 74 | 69 63 69 74 79 20 6f 66 |of spast|icity of|
|00000cf0| 20 74 68 65 20 63 72 65 | 6d 61 73 74 65 72 20 6d | the cre|master m|
|00000d00| 75 73 63 6c 65 2c 0d 0a | 6c 65 61 64 69 6e 67 20 |uscle,..|leading |
|00000d10| 74 6f 20 74 68 65 20 70 | 61 74 68 6f 6c 6f 67 69 |to the p|athologi|
|00000d20| 63 20 72 65 74 72 61 63 | 74 69 6f 6e 20 6f 66 20 |c retrac|tion of |
|00000d30| 74 68 65 20 74 65 73 74 | 69 73 20 66 72 6f 6d 20 |the test|is from |
|00000d40| 74 68 65 20 73 63 72 6f | 74 75 6d 2e 0d 0a 24 55 |the scro|tum...$U|
|00000d50| 6e 69 71 75 65 5f 49 44 | 7b 59 52 42 30 33 30 30 |nique_ID|{YRB0300|
|00000d60| 31 7d 0d 0a 24 54 69 74 | 6c 65 7b 4d 61 6c 66 6f |1}..$Tit|le{Malfo|
|00000d70| 72 6d 61 74 69 6f 6e 73 | 20 6f 66 20 74 68 65 20 |rmations| of the |
|00000d80| 45 70 69 64 69 64 79 6d | 69 73 20 69 6e 20 55 6e |Epididym|is in Un|
|00000d90| 64 65 73 63 65 6e 64 65 | 64 20 54 65 73 74 69 73 |descende|d Testis|
|00000da0| 7d 0d 0a 24 41 75 74 68 | 6f 72 7b 0d 0a 4b 6f 66 |}..$Auth|or{..Kof|
|00000db0| 66 2c 20 57 4a 0d 0a 53 | 63 61 6c 65 74 73 63 6b |f, WJ..S|caletsck|
|00000dc0| 79 2c 20 52 7d 0d 0a 24 | 41 66 66 69 6c 69 61 74 |y, R}..$|Affiliat|
|00000dd0| 69 6f 6e 7b 46 65 64 65 | 72 61 6c 20 55 6e 69 76 |ion{Fede|ral Univ|
|00000de0| 20 6f 66 20 52 69 6f 20 | 47 72 61 6e 64 65 20 64 | of Rio |Grande d|
|00000df0| 6f 20 53 75 6c 2c 20 50 | 6f 72 74 6f 20 41 6c 65 |o Sul, P|orto Ale|
|00000e00| 67 72 65 2c 20 42 72 61 | 7a 69 6c 7d 0d 0a 24 4a |gre, Bra|zil}..$J|
|00000e10| 6f 75 72 6e 61 6c 7b 4a | 20 55 72 6f 6c 7d 0d 0a |ournal{J| Urol}..|
|00000e20| 24 56 6f 6c 75 6d 65 7b | 31 34 33 7d 0d 0a 24 50 |$Volume{|143}..$P|
|00000e30| 61 67 65 7b 33 34 30 2d | 33 34 33 7d 0d 0a 24 44 |age{340-|343}..$D|
|00000e40| 61 74 65 7b 31 39 39 30 | 7d 0d 0a 24 59 42 56 6f |ate{1990|}..$YBVo|
|00000e50| 6c 7b 31 39 39 31 20 59 | 65 61 72 20 42 6f 6f 6b |l{1991 Y|ear Book|
|00000e60| 20 6f 66 20 50 65 64 69 | 61 74 72 69 63 73 3a 7d | of Pedi|atrics:}|
|00000e70| 0d 0a 24 43 68 61 70 74 | 65 72 7b 31 30 2d 31 32 |..$Chapt|er{10-12|
|00000e80| 7d 0d 0a 24 59 42 45 64 | 69 74 6f 72 7b 44 72 73 |}..$YBEd|itor{Drs|
|00000e90| 2e 20 4f 73 6b 69 20 61 | 6e 64 20 53 74 6f 63 6b |. Oski a|nd Stock|
|00000ea0| 6d 61 6e 7d 0d 0a 24 54 | 61 62 6c 65 7b 7d 0d 0a |man}..$T|able{}..|
|00000eb0| 24 43 6f 6d 6d 65 6e 74 | 61 74 6f 72 7b 4a 2e 41 |$Comment|ator{J.A|
|00000ec0| 2e 20 53 74 6f 63 6b 6d | 61 6e 2c 20 49 49 49 2c |. Stockm|an, III,|
|00000ed0| 20 4d 2e 44 2e 7d 0d 0a | 0d 0a 43 6f 70 79 72 69 | M.D.}..|..Copyri|
|00000ee0| 67 68 74 20 28 43 29 20 | 59 65 61 72 20 42 6f 6f |ght (C) |Year Boo|
|00000ef0| 6b 20 4d 65 64 69 63 61 | 6c 20 50 75 62 6c 69 73 |k Medica|l Publis|
|00000f00| 68 65 72 73 2c 20 49 6e | 63 2e 20 31 39 39 31 0d |hers, In|c. 1991.|
|00000f10| 0a 0d 0a 31 39 39 31 20 | 59 65 61 72 20 42 6f 6f |...1991 |Year Boo|
|00000f20| 6b 20 6f 66 20 50 65 64 | 69 61 74 72 69 63 73 3a |k of Ped|iatrics:|
|00000f30| 0d 0a 0d 0a 43 68 61 70 | 74 65 72 20 31 30 20 2d |....Chap|ter 10 -|
|00000f40| 2d 20 54 68 65 20 47 65 | 6e 69 74 6f 75 72 69 6e |- The Ge|nitourin|
|00000f50| 61 72 79 20 54 72 61 63 | 74 0d 0a 0d 0a 2d 2d 2d |ary Trac|t....---|
|00000f60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000f70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000f80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000f90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000fa0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 4d 61 6c |--------|---..Mal|
|00000fb0| 66 6f 72 6d 61 74 69 6f | 6e 73 20 6f 66 20 74 68 |formatio|ns of th|
|00000fc0| 65 20 45 70 69 64 69 64 | 79 6d 69 73 20 69 6e 20 |e Epidid|ymis in |
|00000fd0| 55 6e 64 65 73 63 65 6e | 64 65 64 20 54 65 73 74 |Undescen|ded Test|
|00000fe0| 69 73 0d 0a 0d 0a 4b 6f | 66 66 20 57 4a 3b 20 53 |is....Ko|ff WJ; S|
|00000ff0| 63 61 6c 65 74 73 63 6b | 79 20 52 0d 0a 28 46 65 |caletsck|y R..(Fe|
|00001000| 64 65 72 61 6c 20 55 6e | 69 76 20 6f 66 20 52 69 |deral Un|iv of Ri|
|00001010| 6f 20 47 72 61 6e 64 65 | 20 64 6f 20 53 75 6c 2c |o Grande| do Sul,|
|00001020| 20 50 6f 72 74 6f 20 41 | 6c 65 67 72 65 2c 20 42 | Porto A|legre, B|
|00001030| 72 61 7a 69 6c 29 0d 0a | 4a 20 55 72 6f 6c 20 31 |razil)..|J Urol 1|
|00001040| 34 33 3a 33 34 30 2d 33 | 34 33 2c 20 31 39 39 30 |43:340-3|43, 1990|
|00001050| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00001060| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001070| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001080| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001090| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000010a0| 0d 0a 0d 0a 41 62 73 74 | 72 61 63 74 0d 0a 0d 0a |....Abst|ract....|
|000010b0| 20 20 20 20 20 41 20 70 | 72 6f 73 70 65 63 74 69 | A p|rospecti|
|000010c0| 76 65 20 73 74 75 64 79 | 20 6f 66 20 65 70 69 64 |ve study| of epid|
|000010d0| 69 64 79 6d 61 6c 20 6d | 61 6c 66 6f 72 6d 61 74 |idymal m|alformat|
|000010e0| 69 6f 6e 73 20 69 6e 63 | 6c 75 64 65 64 20 36 36 |ions inc|luded 66|
|000010f0| 20 70 61 74 69 65 6e 74 | 73 20 77 69 74 68 0d 0a | patient|s with..|
|00001100| 61 6e 20 61 76 65 72 61 | 67 65 20 61 67 65 20 6f |an avera|ge age o|
|00001110| 66 20 38 20 79 65 61 72 | 73 20 77 68 6f 20 68 61 |f 8 year|s who ha|
|00001120| 64 20 61 20 74 6f 74 61 | 6c 20 6f 66 20 38 32 20 |d a tota|l of 82 |
|00001130| 75 6e 64 65 73 63 65 6e | 64 65 64 20 74 65 73 74 |undescen|ded test|
|00001140| 65 73 2e 20 20 46 6f 72 | 74 79 0d 0a 70 61 74 69 |es. For|ty..pati|
|00001150| 65 6e 74 73 20 68 61 64 | 20 65 63 74 6f 70 69 63 |ents had| ectopic|
|00001160| 20 61 6e 64 20 32 36 20 | 68 61 64 20 63 72 79 70 | and 26 |had cryp|
|00001170| 74 6f 72 63 68 69 64 20 | 74 65 73 74 65 73 2e 0d |torchid |testes..|
|00001180| 0a 20 20 20 20 20 4e 65 | 61 72 6c 79 20 36 30 25 |. Ne|arly 60%|
|00001190| 20 6f 66 20 74 65 73 74 | 65 73 20 65 78 68 69 62 | of test|es exhib|
|000011a0| 69 74 65 64 20 65 70 69 | 64 69 64 79 6d 61 6c 20 |ited epi|didymal |
|000011b0| 61 62 6e 6f 72 6d 61 6c | 69 74 69 65 73 20 61 70 |abnormal|ities ap|
|000011c0| 61 72 74 20 66 72 6f 6d | 0d 0a 65 6c 6f 6e 67 61 |art from|..elonga|
|000011d0| 74 69 6f 6e 2e 20 20 53 | 65 76 65 72 65 20 61 62 |tion. S|evere ab|
|000011e0| 6e 6f 72 6d 61 6c 69 74 | 69 65 73 20 77 65 72 65 |normalit|ies were|
|000011f0| 20 6d 75 63 68 20 6d 6f | 72 65 20 66 72 65 71 75 | much mo|re frequ|
|00001200| 65 6e 74 20 69 6e 20 63 | 72 79 70 74 6f 72 63 68 |ent in c|ryptorch|
|00001210| 69 64 20 74 68 61 6e 0d | 0a 69 6e 20 65 63 74 6f |id than.|.in ecto|
|00001220| 70 69 63 20 74 65 73 74 | 65 73 20 61 6e 64 20 69 |pic test|es and i|
|00001230| 6e 63 6c 75 64 65 64 20 | 73 65 70 61 72 61 74 69 |ncluded |separati|
|00001240| 6f 6e 20 6f 66 20 74 68 | 65 20 74 65 73 74 69 73 |on of th|e testis|
|00001250| 20 61 6e 64 20 65 70 69 | 64 69 64 79 6d 69 73 2c | and epi|didymis,|
|00001260| 0d 0a 61 6e 67 75 6c 61 | 74 69 6f 6e 2c 20 61 74 |..angula|tion, at|
|00001270| 72 65 73 69 61 2c 20 61 | 6e 64 20 61 20 6c 6f 6e |resia, a|nd a lon|
|00001280| 67 20 6d 65 73 6f 72 63 | 68 69 75 6d 2e 20 20 53 |g mesorc|hium. S|
|00001290| 65 76 65 6e 20 70 61 74 | 69 65 6e 74 73 20 68 61 |even pat|ients ha|
|000012a0| 64 20 6f 74 68 65 72 0d | 0a 63 6f 6e 67 65 6e 69 |d other.|.congeni|
|000012b0| 74 61 6c 20 6d 61 6c 66 | 6f 72 6d 61 74 69 6f 6e |tal malf|ormation|
|000012c0| 73 20 6f 72 20 73 79 6e | 64 72 6f 6d 65 73 2e 0d |s or syn|dromes..|
|000012d0| 0a 20 20 20 20 20 54 68 | 65 73 65 20 66 69 6e 64 |. Th|ese find|
|000012e0| 69 6e 67 73 20 63 6f 6e | 66 69 72 6d 20 74 68 65 |ings con|firm the|
|000012f0| 20 66 61 63 74 20 74 68 | 61 74 20 75 6e 64 65 73 | fact th|at undes|
|00001300| 63 65 6e 64 65 64 20 74 | 65 73 74 69 73 20 69 73 |cended t|estis is|
|00001310| 20 67 65 6e 65 72 61 6c | 6c 79 20 6e 6f 74 0d 0a | general|ly not..|
|00001320| 61 20 73 69 6e 67 6c 65 | 20 63 6f 6e 67 65 6e 69 |a single| congeni|
|00001330| 74 61 6c 20 61 62 6e 6f | 72 6d 61 6c 69 74 79 2c |tal abno|rmality,|
|00001340| 20 62 75 74 20 70 61 72 | 74 20 6f 66 20 61 20 77 | but par|t of a w|
|00001350| 69 64 65 72 20 73 70 65 | 63 74 72 75 6d 20 6f 66 |ider spe|ctrum of|
|00001360| 20 65 6d 62 72 79 6f 70 | 61 74 68 69 63 0d 0a 63 | embryop|athic..c|
|00001370| 6f 6e 64 69 74 69 6f 6e | 73 2e 0d 0a 0d 0a 50 6f |ondition|s.....Po|
|00001380| 73 74 2d 43 6f 6d 6d 65 | 6e 74 0d 0a 0d 0a 20 20 |st-Comme|nt.... |
|00001390| 20 20 20 54 68 65 20 70 | 72 65 76 69 6f 75 73 20 | The p|revious |
|000013a0| 32 20 61 62 73 74 72 61 | 63 74 73 20 28 41 62 73 |2 abstra|cts (Abs|
|000013b0| 74 72 61 63 74 73 20 31 | 30 2d 31 31 20 61 6e 64 |tracts 1|0-11 and|
|000013c0| 20 31 30 2d 31 32 29 20 | 70 72 6f 76 69 64 65 20 | 10-12) |provide |
|000013d0| 69 6e 74 65 72 65 73 74 | 69 6e 67 0d 0a 69 6e 73 |interest|ing..ins|
|000013e0| 69 67 68 74 73 20 69 6e | 74 6f 20 74 68 65 20 70 |ights in|to the p|
|000013f0| 72 6f 62 6c 65 6d 20 6f | 66 20 63 72 79 70 74 6f |roblem o|f crypto|
|00001400| 72 63 68 69 64 69 73 6d | 2e 20 20 41 6c 74 68 6f |rchidism|. Altho|
|00001410| 75 67 68 20 49 20 68 61 | 76 65 20 70 65 72 73 6f |ugh I ha|ve perso|
|00001420| 6e 61 6c 6c 79 0d 0a 6f | 62 73 65 72 76 65 64 20 |nally..o|bserved |
|00001430| 63 68 69 6c 64 72 65 6e | 20 77 68 6f 20 68 61 76 |children| who hav|
|00001440| 65 20 63 72 79 70 74 6f | 72 63 68 69 64 69 73 6d |e crypto|rchidism|
|00001450| 20 69 6e 20 61 73 73 6f | 63 69 61 74 69 6f 6e 20 | in asso|ciation |
|00001460| 77 69 74 68 20 63 65 72 | 65 62 72 61 6c 20 70 61 |with cer|ebral pa|
|00001470| 6c 73 79 2c 0d 0a 49 20 | 77 61 73 20 6e 6f 74 20 |lsy,..I |was not |
|00001480| 61 77 61 72 65 20 74 68 | 61 74 20 74 68 69 73 20 |aware th|at this |
|00001490| 68 61 64 20 65 76 65 72 | 20 62 65 65 6e 20 72 65 |had ever| been re|
|000014a0| 70 6f 72 74 65 64 2e 20 | 20 48 79 70 6f 67 6f 6e |ported. | Hypogon|
|000014b0| 61 64 6f 74 72 6f 70 69 | 73 6d 20 73 65 63 6f 6e |adotropi|sm secon|
|000014c0| 64 61 72 79 0d 0a 74 6f | 20 64 65 63 72 65 61 73 |dary..to| decreas|
|000014d0| 65 64 20 43 4e 53 20 73 | 65 63 72 65 74 69 6f 6e |ed CNS s|ecretion|
|000014e0| 20 6f 66 20 67 6f 6e 61 | 64 6f 74 72 6f 70 69 6e | of gona|dotropin|
|000014f0| 73 20 69 73 20 61 73 73 | 6f 63 69 61 74 65 64 20 |s is ass|ociated |
|00001500| 6f 6e 20 6f 63 63 61 73 | 69 6f 6e 20 77 69 74 68 |on occas|ion with|
|00001510| 0d 0a 75 6e 64 65 73 63 | 65 6e 64 65 64 20 74 65 |..undesc|ended te|
|00001520| 73 74 65 73 2e 20 20 49 | 74 20 69 73 20 64 69 66 |stes. I|t is dif|
|00001530| 66 69 63 75 6c 74 20 74 | 6f 20 62 65 6c 69 65 76 |ficult t|o believ|
|00001540| 65 20 74 68 61 74 20 63 | 68 69 6c 64 72 65 6e 20 |e that c|hildren |
|00001550| 77 69 74 68 20 63 65 72 | 65 62 72 61 6c 0d 0a 70 |with cer|ebral..p|
|00001560| 61 6c 73 79 20 77 68 6f | 20 68 61 76 65 20 74 68 |alsy who| have th|
|00001570| 69 73 20 70 72 6f 62 6c | 65 6d 20 68 61 76 65 20 |is probl|em have |
|00001580| 69 74 20 6f 6e 20 61 20 | 68 79 70 6f 74 68 61 6c |it on a |hypothal|
|00001590| 61 6d 69 63 2d 70 69 74 | 75 69 74 61 72 79 2d 67 |amic-pit|uitary-g|
|000015a0| 6f 6e 61 64 61 6c 20 61 | 78 69 73 0d 0a 62 61 73 |onadal a|xis..bas|
|000015b0| 69 73 2e 20 20 48 6f 77 | 65 76 65 72 2c 20 69 74 |is. How|ever, it|
|000015c0| 20 63 6f 75 6c 64 20 76 | 65 72 79 20 77 65 6c 6c | could v|ery well|
|000015d0| 20 62 65 20 74 68 61 74 | 20 74 68 65 20 61 75 74 | be that| the aut|
|000015e0| 68 6f 72 73 27 20 73 75 | 73 70 69 63 69 6f 6e 20 |hors' su|spicion |
|000015f0| 6f 66 20 61 0d 0a 22 73 | 70 61 73 74 69 63 22 20 |of a.."s|pastic" |
|00001600| 63 72 65 6d 61 73 74 65 | 72 69 63 20 6d 75 73 63 |cremaste|ric musc|
|00001610| 6c 65 20 68 61 73 20 73 | 6f 6d 65 20 63 72 65 64 |le has s|ome cred|
|00001620| 65 6e 63 65 2e 20 20 50 | 72 65 73 75 6d 61 62 6c |ence. P|resumabl|
|00001630| 79 2c 20 77 68 65 74 68 | 65 72 20 6f 72 20 6e 6f |y, wheth|er or no|
|00001640| 74 0d 0a 74 68 65 20 63 | 72 79 70 74 6f 72 63 68 |t..the c|ryptorch|
|00001650| 69 64 69 73 6d 20 69 73 | 20 63 61 75 73 65 64 20 |idism is| caused |
|00001660| 62 79 20 61 20 68 79 70 | 65 72 74 65 6e 73 69 76 |by a hyp|ertensiv|
|00001670| 65 20 6d 75 73 63 6c 65 | 2c 20 69 74 20 73 74 69 |e muscle|, it sti|
|00001680| 6c 6c 20 73 68 6f 75 6c | 64 20 62 65 0d 0a 64 65 |ll shoul|d be..de|
|00001690| 61 6c 74 20 77 69 74 68 | 20 73 75 72 67 69 63 61 |alt with| surgica|
|000016a0| 6c 6c 79 2e 0d 0a 20 20 | 20 20 20 54 68 65 20 73 |lly... | The s|
|000016b0| 65 63 6f 6e 64 20 6f 66 | 20 74 68 65 20 32 20 61 |econd of| the 2 a|
|000016c0| 72 74 69 63 6c 65 73 20 | 61 62 73 74 72 61 63 74 |rticles |abstract|
|000016d0| 65 64 20 64 65 61 6c 73 | 20 77 69 74 68 20 6d 61 |ed deals| with ma|
|000016e0| 6c 66 6f 72 6d 61 74 69 | 6f 6e 73 20 6f 66 20 74 |lformati|ons of t|
|000016f0| 68 65 0d 0a 65 70 69 64 | 69 64 79 6d 69 73 20 61 |he..epid|idymis a|
|00001700| 73 20 61 20 63 61 75 73 | 65 20 6f 66 20 63 72 79 |s a caus|e of cry|
|00001710| 70 74 6f 72 63 68 69 64 | 69 73 6d 2e 20 20 54 68 |ptorchid|ism. Th|
|00001720| 69 73 20 69 73 20 6e 6f | 74 20 61 20 6e 65 77 20 |is is no|t a new |
|00001730| 6f 62 73 65 72 76 61 74 | 69 6f 6e 2e 20 20 59 6f |observat|ion. Yo|
|00001740| 75 0d 0a 6d 61 79 20 77 | 69 73 68 20 74 6f 20 72 |u..may w|ish to r|
|00001750| 65 61 64 20 74 68 65 20 | 53 75 6d 6d 61 72 79 20 |ead the |Summary |
|00001760| 6f 66 20 41 6e 6e 75 61 | 6c 20 4d 65 65 74 69 6e |of Annua|l Meetin|
|00001770| 67 20 6f 66 20 74 68 65 | 20 53 65 63 74 69 6f 6e |g of the| Section|
|00001780| 20 6f 6e 20 50 65 64 69 | 61 74 72 69 63 0d 0a 55 | on Pedi|atric..U|
|00001790| 72 6f 6c 6f 67 79 20 66 | 72 6f 6d 20 74 68 69 73 |rology f|rom this|
|000017a0| 20 70 61 73 74 20 79 65 | 61 72 20 69 6e 20 50 65 | past ye|ar in Pe|
|000017b0| 64 69 61 74 72 69 63 73 | 20 28 31 29 2e 20 20 54 |diatrics| (1). T|
|000017c0| 68 65 20 61 75 74 68 6f | 72 73 20 6e 6f 74 65 20 |he autho|rs note |
|000017d0| 74 68 61 74 0d 0a 63 6f | 6e 67 65 6e 69 74 61 6c |that..co|ngenital|
|000017e0| 20 61 6e 6f 6d 61 6c 69 | 65 73 20 6f 66 20 74 68 | anomali|es of th|
|000017f0| 65 20 64 75 63 74 61 6c | 20 73 79 73 74 65 6d 20 |e ductal| system |
|00001800| 6d 61 79 20 63 6f 6e 74 | 72 69 62 75 74 65 20 74 |may cont|ribute t|
|00001810| 6f 20 74 68 65 20 69 6e | 66 65 72 74 69 6c 69 74 |o the in|fertilit|
|00001820| 69 65 73 0d 0a 73 65 65 | 6e 20 77 69 74 68 20 63 |ies..see|n with c|
|00001830| 72 79 70 74 6f 72 63 68 | 69 64 69 73 6d 2e 20 20 |ryptorch|idism. |
|00001840| 50 72 65 76 69 6f 75 73 | 20 72 65 70 6f 72 74 73 |Previous| reports|
|00001850| 20 73 68 6f 77 65 64 20 | 74 68 61 74 20 61 73 20 | showed |that as |
|00001860| 6d 61 6e 79 20 61 73 20 | 61 20 74 68 69 72 64 20 |many as |a third |
|00001870| 6f 66 0d 0a 63 61 73 65 | 73 20 6f 66 20 63 72 79 |of..case|s of cry|
|00001880| 70 74 6f 72 63 68 69 64 | 69 73 6d 20 61 72 65 20 |ptorchid|ism are |
|00001890| 61 73 73 6f 63 69 61 74 | 65 64 20 77 69 74 68 20 |associat|ed with |
|000018a0| 63 6f 6e 67 65 6e 69 74 | 61 6c 20 64 75 63 74 61 |congenit|al ducta|
|000018b0| 6c 20 61 6e 6f 6d 61 6c | 69 65 73 0d 0a 72 61 6e |l anomal|ies..ran|
|000018c0| 67 69 6e 67 20 66 72 6f | 6d 20 67 72 6f 73 73 6c |ging fro|m grossl|
|000018d0| 79 20 69 64 65 6e 74 69 | 66 69 61 62 6c 65 20 6c |y identi|fiable l|
|000018e0| 65 73 69 6f 6e 73 20 6f | 66 20 74 68 65 20 76 61 |esions o|f the va|
|000018f0| 73 20 64 65 66 65 72 65 | 6e 73 20 61 6e 64 20 65 |s defere|ns and e|
|00001900| 70 69 64 69 64 79 6d 69 | 73 0d 0a 74 6f 20 6c 65 |pididymi|s..to le|
|00001910| 73 73 20 77 65 6c 6c 2d | 64 65 66 69 6e 65 64 20 |ss well-|defined |
|00001920| 6c 65 73 69 6f 6e 73 2c | 20 65 2e 67 2e 2c 20 73 |lesions,| e.g., s|
|00001930| 65 67 6d 65 6e 74 61 6c | 20 61 74 72 65 73 69 61 |egmental| atresia|
|00001940| 73 20 6f 72 20 6e 6f 6e | 75 6e 69 6f 6e 20 70 61 |s or non|union pa|
|00001950| 72 74 73 20 6f 66 0d 0a | 74 68 65 20 64 75 63 74 |rts of..|the duct|
|00001960| 61 6c 20 73 79 73 74 65 | 6d 2e 20 20 54 68 75 73 |al syste|m. Thus|
|00001970| 20 73 75 63 68 20 61 73 | 73 6f 63 69 61 74 65 64 | such as|sociated|
|00001980| 20 61 6e 6f 6d 61 6c 69 | 65 73 20 61 72 65 20 6e | anomali|es are n|
|00001990| 6f 74 20 72 61 72 65 20 | 61 74 20 61 6c 6c 2e 0d |ot rare |at all..|
|000019a0| 0a 50 61 72 72 6f 74 74 | 20 65 74 20 61 6c 2e 20 |.Parrott| et al. |
|000019b0| 61 6c 73 6f 20 63 6f 6d | 6d 65 6e 74 20 6f 6e 20 |also com|ment on |
|000019c0| 6f 75 72 20 73 74 61 74 | 65 20 6f 66 20 75 6e 64 |our stat|e of und|
|000019d0| 65 72 73 74 61 6e 64 69 | 6e 67 20 63 6f 6e 63 65 |erstandi|ng conce|
|000019e0| 72 6e 69 6e 67 20 66 65 | 72 74 69 6c 69 74 79 0d |rning fe|rtility.|
|000019f0| 0a 69 6e 20 63 68 69 6c | 64 72 65 6e 20 77 69 74 |.in chil|dren wit|
|00001a00| 68 20 75 6e 64 65 73 63 | 65 6e 64 65 64 20 74 65 |h undesc|ended te|
|00001a10| 73 74 65 73 2e 20 20 54 | 68 65 20 64 61 74 61 20 |stes. T|he data |
|00001a20| 6e 6f 77 20 61 72 65 20 | 75 6e 65 71 75 69 76 6f |now are |unequivo|
|00001a30| 63 61 6c 6c 79 20 63 6c | 65 61 72 2e 0d 0a 54 68 |cally cl|ear...Th|
|00001a40| 65 20 75 6e 64 65 73 63 | 65 6e 64 65 64 20 74 65 |e undesc|ended te|
|00001a50| 73 74 69 73 20 6c 61 63 | 6b 73 20 73 69 67 6e 69 |stis lac|ks signi|
|00001a60| 66 69 63 61 6e 74 20 66 | 65 72 74 69 6c 69 74 79 |ficant f|ertility|
|00001a70| 20 62 65 63 61 75 73 65 | 20 6f 66 20 68 69 73 74 | because| of hist|
|00001a80| 6f 6c 6f 67 69 63 0d 0a | 61 62 6e 6f 72 6d 61 6c |ologic..|abnormal|
|00001a90| 69 74 69 65 73 20 74 68 | 61 74 20 61 72 65 20 61 |ities th|at are a|
|00001aa0| 70 70 61 72 65 6e 74 20 | 65 76 65 6e 20 61 74 20 |pparent |even at |
|00001ab0| 62 69 72 74 68 2c 20 70 | 72 65 73 75 6d 61 62 6c |birth, p|resumabl|
|00001ac0| 79 20 72 65 6c 61 74 65 | 64 20 74 6f 0d 0a 64 79 |y relate|d to..dy|
|00001ad0| 73 67 65 6e 65 73 69 73 | 20 6f 66 20 74 68 65 20 |sgenesis| of the |
|00001ae0| 75 6e 64 65 73 63 65 6e | 64 65 64 20 74 65 73 74 |undescen|ded test|
|00001af0| 69 73 2e 20 20 49 66 20 | 74 68 61 74 20 77 65 72 |is. If |that wer|
|00001b00| 65 20 6e 6f 74 20 62 61 | 64 20 65 6e 6f 75 67 68 |e not ba|d enough|
|00001b10| 2c 20 74 68 65 0d 0a 63 | 6f 6e 74 72 61 6c 61 74 |, the..c|ontralat|
|00001b20| 65 72 61 6c 20 64 65 73 | 63 65 6e 64 65 64 20 74 |eral des|cended t|
|00001b30| 65 73 74 69 73 20 61 6c | 73 6f 20 75 73 75 61 6c |estis al|so usual|
|00001b40| 6c 79 20 73 68 6f 77 73 | 20 73 6f 6d 65 20 64 65 |ly shows| some de|
|00001b50| 67 72 65 65 20 6f 66 20 | 61 62 6e 6f 72 6d 61 6c |gree of |abnormal|
|00001b60| 69 74 69 65 73 0d 0a 61 | 73 20 77 65 6c 6c 2e 20 |ities..a|s well. |
|00001b70| 20 54 68 69 73 20 6d 61 | 79 20 65 78 70 6c 61 69 | This ma|y explai|
|00001b80| 6e 20 77 68 79 20 74 68 | 65 20 66 65 72 74 69 6c |n why th|e fertil|
|00001b90| 69 74 79 20 6f 66 20 69 | 6e 64 69 76 69 64 75 61 |ity of i|ndividua|
|00001ba0| 6c 73 20 77 69 74 68 20 | 75 6e 69 6c 61 74 65 72 |ls with |unilater|
|00001bb0| 61 6c 0d 0a 63 72 79 70 | 74 6f 72 63 68 69 64 69 |al..cryp|torchidi|
|00001bc0| 73 6d 20 69 73 20 67 6f | 6f 64 20 28 37 38 25 29 |sm is go|od (78%)|
|00001bd0| 20 62 75 74 20 6e 6f 74 | 20 70 65 72 66 65 63 74 | but not| perfect|
|00001be0| 2e 0d 0a 20 20 20 20 20 | 54 68 65 20 63 61 75 73 |... |The caus|
|00001bf0| 65 20 6f 66 20 69 6e 66 | 65 72 74 69 6c 69 74 79 |e of inf|ertility|
|00001c00| 20 69 6e 20 70 61 74 69 | 65 6e 74 73 20 77 69 74 | in pati|ents wit|
|00001c10| 68 20 63 72 79 70 74 6f | 72 63 68 69 64 69 73 6d |h crypto|rchidism|
|00001c20| 20 68 61 73 20 62 65 65 | 6e 20 74 68 6f 75 67 68 | has bee|n though|
|00001c30| 74 0d 0a 74 6f 20 72 65 | 73 75 6c 74 20 66 72 6f |t..to re|sult fro|
|00001c40| 6d 20 61 20 63 6f 6d 62 | 69 6e 61 74 69 6f 6e 20 |m a comb|ination |
|00001c50| 6f 66 20 68 69 73 74 6f | 6c 6f 67 69 63 20 61 62 |of histo|logic ab|
|00001c60| 6e 6f 72 6d 61 6c 69 74 | 69 65 73 20 61 73 20 77 |normalit|ies as w|
|00001c70| 65 6c 6c 20 61 73 20 74 | 68 65 20 68 69 67 68 65 |ell as t|he highe|
|00001c80| 72 0d 0a 69 6e 74 72 61 | 2d 61 62 64 6f 6d 69 6e |r..intra|-abdomin|
|00001c90| 61 6c 20 74 65 6d 70 65 | 72 61 74 75 72 65 20 72 |al tempe|rature r|
|00001ca0| 65 6c 61 74 65 64 20 74 | 6f 20 70 6c 61 63 65 6d |elated t|o placem|
|00001cb0| 65 6e 74 20 6f 66 20 74 | 68 65 20 75 6e 64 65 73 |ent of t|he undes|
|00001cc0| 63 65 6e 64 65 64 20 74 | 65 73 74 65 73 2e 0d 0a |cended t|estes...|
|00001cd0| 4f 74 68 65 72 20 74 68 | 69 6e 67 73 20 74 68 61 |Other th|ings tha|
|00001ce0| 74 20 61 66 66 65 63 74 | 20 73 70 65 72 6d 61 74 |t affect| spermat|
|00001cf0| 6f 67 65 6e 65 73 69 73 | 20 69 6e 63 6c 75 64 65 |ogenesis| include|
|00001d00| 20 4b 6c 69 6e 65 66 65 | 6c 74 65 72 27 73 20 73 | Klinefe|lter's s|
|00001d10| 79 6e 64 72 6f 6d 65 2c | 0d 0a 61 6e 64 72 6f 67 |yndrome,|..androg|
|00001d20| 65 6e 20 72 65 73 69 73 | 74 61 6e 63 65 2c 20 72 |en resis|tance, r|
|00001d30| 61 64 69 61 74 69 6f 6e | 2c 20 63 68 65 6d 6f 74 |adiation|, chemot|
|00001d40| 68 65 72 61 70 79 20 77 | 69 74 68 20 61 6c 6b 79 |herapy w|ith alky|
|00001d50| 6c 61 74 69 6e 67 20 61 | 67 65 6e 74 73 2c 20 61 |lating a|gents, a|
|00001d60| 6e 64 0d 0a 65 78 70 6f | 73 75 72 65 20 74 6f 20 |nd..expo|sure to |
|00001d70| 65 6e 76 69 72 6f 6e 6d | 65 6e 74 61 6c 20 74 6f |environm|ental to|
|00001d80| 78 69 6e 73 2e 20 20 54 | 6f 20 74 68 69 73 20 6c |xins. T|o this l|
|00001d90| 69 73 74 20 6d 75 73 74 | 20 6e 6f 77 20 62 65 20 |ist must| now be |
|00001da0| 61 64 64 65 64 20 74 68 | 65 0d 0a 6f 62 73 65 72 |added th|e..obser|
|00001db0| 76 61 74 69 6f 6e 20 6f | 66 20 4c 65 76 69 6e 65 |vation o|f Levine|
|00001dc0| 20 65 74 20 61 6c 2e 20 | 28 32 29 2c 20 77 68 6f | et al. |(2), who|
|00001dd0| 20 6e 6f 74 65 20 74 68 | 61 74 20 73 65 6d 65 6e | note th|at semen|
|00001de0| 20 71 75 61 6c 69 74 79 | 20 64 65 74 65 72 69 6f | quality| deterio|
|00001df0| 72 61 74 65 73 0d 0a 6d | 61 72 6b 65 64 6c 79 20 |rates..m|arkedly |
|00001e00| 64 75 72 69 6e 67 20 74 | 68 65 20 73 75 6d 6d 65 |during t|he summe|
|00001e10| 72 2c 20 77 68 69 63 68 | 20 61 63 63 6f 75 6e 74 |r, which| account|
|00001e20| 73 20 66 6f 72 20 74 68 | 65 20 73 69 67 6e 69 66 |s for th|e signif|
|00001e30| 69 63 61 6e 74 20 72 65 | 64 75 63 74 69 6f 6e 20 |icant re|duction |
|00001e40| 69 6e 0d 0a 62 69 72 74 | 68 20 72 61 74 65 73 20 |in..birt|h rates |
|00001e50| 64 75 72 69 6e 67 20 74 | 68 65 20 73 70 72 69 6e |during t|he sprin|
|00001e60| 67 2e 20 20 50 65 72 68 | 61 70 73 20 77 65 20 73 |g. Perh|aps we s|
|00001e70| 68 61 6c 6c 20 63 61 6c | 6c 20 74 68 69 73 20 74 |hall cal|l this t|
|00001e80| 68 65 20 22 67 72 65 65 | 6e 68 6f 75 73 65 0d 0a |he "gree|nhouse..|
|00001e90| 65 66 66 65 63 74 2e 22 | 20 20 49 6e 20 61 6e 79 |effect."| In any|
|00001ea0| 20 65 76 65 6e 74 2c 20 | 66 6f 72 20 74 68 65 20 | event, |for the |
|00001eb0| 6a 6f 63 6b 73 20 61 6d | 6f 6e 67 20 79 6f 75 2c |jocks am|ong you,|
|00001ec0| 20 72 65 63 6f 67 6e 69 | 7a 65 20 74 68 61 74 20 | recogni|ze that |
|00001ed0| 74 69 67 68 74 6c 79 0d | 0a 66 69 74 74 69 6e 67 |tightly.|.fitting|
|00001ee0| 20 61 74 68 6c 65 74 69 | 63 20 73 75 70 70 6f 72 | athleti|c suppor|
|00001ef0| 74 65 72 73 20 63 61 6e | 20 72 65 64 75 63 65 20 |ters can| reduce |
|00001f00| 74 68 65 20 6e 75 6d 62 | 65 72 20 6f 66 20 65 6a |the numb|er of ej|
|00001f10| 61 63 75 6c 61 74 65 64 | 20 73 70 65 72 6d 20 62 |aculated| sperm b|
|00001f20| 79 0d 0a 61 70 70 72 6f | 78 69 6d 61 74 65 6c 79 |y..appro|ximately|
|00001f30| 20 39 30 25 20 28 33 29 | 20 2e 2e 2e 20 74 68 65 | 90% (3)| ... the|
|00001f40| 20 31 2c 32 39 39 74 68 | 20 72 65 61 73 6f 6e 20 | 1,299th| reason |
|00001f50| 6e 6f 74 20 74 6f 20 65 | 78 65 72 63 69 73 65 2e |not to e|xercise.|
|00001f60| 2d 2d 4a 2e 41 2e 20 53 | 74 6f 63 6b 6d 61 6e 2c |--J.A. S|tockman,|
|00001f70| 0d 0a 49 49 49 2c 20 4d | 2e 44 2e 0d 0a 24 55 6e |..III, M|.D...$Un|
|00001f80| 69 71 75 65 5f 49 44 7b | 59 52 42 30 33 30 30 32 |ique_ID{|YRB03002|
|00001f90| 7d 0d 0a 24 54 69 74 6c | 65 7b 54 65 73 74 69 63 |}..$Titl|e{Testic|
|00001fa0| 75 6c 61 72 20 4f 78 69 | 6d 65 74 72 79 3a 20 20 |ular Oxi|metry: |
|00001fb0| 41 20 4e 65 77 20 4d 65 | 74 68 6f 64 20 66 6f 72 |A New Me|thod for|
|00001fc0| 20 74 68 65 20 41 73 73 | 65 73 73 6d 65 6e 74 20 | the Ass|essment |
|00001fd0| 6f 66 20 54 69 73 73 75 | 65 0d 0a 50 65 72 66 75 |of Tissu|e..Perfu|
|00001fe0| 73 69 6f 6e 20 61 6e 64 | 20 56 69 61 62 69 6c 69 |sion and| Viabili|
|00001ff0| 74 79 20 46 6f 6c 6c 6f | 77 69 6e 67 20 54 6f 72 |ty Follo|wing Tor|
|00002000| 73 69 6f 6e 20 61 6e 64 | 20 44 65 74 6f 72 73 69 |sion and| Detorsi|
|00002010| 6f 6e 7d 0d 0a 24 41 75 | 74 68 6f 72 7b 0d 0a 4b |on}..$Au|thor{..K|
|00002020| 72 61 6d 2c 20 48 42 0d | 0a 4d 69 79 61 6d 6f 74 |ram, HB.|.Miyamot|
|00002030| 6f 2c 20 45 0d 0a 52 61 | 6a 66 65 72 2c 20 4a 0d |o, E..Ra|jfer, J.|
|00002040| 0a 41 70 70 65 6c 2c 20 | 50 4c 0d 0a 53 68 6f 65 |.Appel, |PL..Shoe|
|00002050| 6d 61 6b 65 72 2c 20 57 | 43 7d 0d 0a 24 41 66 66 |maker, W|C}..$Aff|
|00002060| 69 6c 69 61 74 69 6f 6e | 7b 55 6e 69 76 20 6f 66 |iliation|{Univ of|
|00002070| 20 43 61 6c 69 66 6f 72 | 6e 69 61 2c 20 4c 6f 73 | Califor|nia, Los|
|00002080| 20 41 6e 67 65 6c 65 73 | 7d 0d 0a 24 4a 6f 75 72 | Angeles|}..$Jour|
|00002090| 6e 61 6c 7b 4a 20 50 65 | 64 69 61 74 72 20 53 75 |nal{J Pe|diatr Su|
|000020a0| 72 67 7d 0d 0a 24 56 6f | 6c 75 6d 65 7b 32 34 7d |rg}..$Vo|lume{24}|
|000020b0| 0d 0a 24 50 61 67 65 7b | 31 32 39 37 2d 31 33 30 |..$Page{|1297-130|
|000020c0| 32 7d 0d 0a 24 44 61 74 | 65 7b 31 39 38 39 7d 0d |2}..$Dat|e{1989}.|
|000020d0| 0a 24 59 42 56 6f 6c 7b | 31 39 39 31 20 59 65 61 |.$YBVol{|1991 Yea|
|000020e0| 72 20 42 6f 6f 6b 20 6f | 66 20 50 65 64 69 61 74 |r Book o|f Pediat|
|000020f0| 72 69 63 73 3a 7d 0d 0a | 24 43 68 61 70 74 65 72 |rics:}..|$Chapter|
|00002100| 7b 31 30 2d 31 33 7d 0d | 0a 24 59 42 45 64 69 74 |{10-13}.|.$YBEdit|
|00002110| 6f 72 7b 44 72 73 2e 20 | 4f 73 6b 69 20 61 6e 64 |or{Drs. |Oski and|
|00002120| 20 53 74 6f 63 6b 6d 61 | 6e 7d 0d 0a 24 54 61 62 | Stockma|n}..$Tab|
|00002130| 6c 65 7b 54 61 62 6c 65 | 20 4f 6d 69 74 74 65 64 |le{Table| Omitted|
|00002140| 7d 0d 0a 24 43 6f 6d 6d | 65 6e 74 61 74 6f 72 7b |}..$Comm|entator{|
|00002150| 4a 2e 41 2e 20 53 74 6f | 63 6b 6d 61 6e 2c 20 49 |J.A. Sto|ckman, I|
|00002160| 49 49 2c 20 4d 2e 44 2e | 7d 0d 0a 0d 0a 43 6f 70 |II, M.D.|}....Cop|
|00002170| 79 72 69 67 68 74 20 28 | 43 29 20 59 65 61 72 20 |yright (|C) Year |
|00002180| 42 6f 6f 6b 20 4d 65 64 | 69 63 61 6c 20 50 75 62 |Book Med|ical Pub|
|00002190| 6c 69 73 68 65 72 73 2c | 20 49 6e 63 2e 20 31 39 |lishers,| Inc. 19|
|000021a0| 39 31 0d 0a 0d 0a 31 39 | 39 31 20 59 65 61 72 20 |91....19|91 Year |
|000021b0| 42 6f 6f 6b 20 6f 66 20 | 50 65 64 69 61 74 72 69 |Book of |Pediatri|
|000021c0| 63 73 3a 0d 0a 0d 0a 43 | 68 61 70 74 65 72 20 31 |cs:....C|hapter 1|
|000021d0| 30 20 2d 2d 20 54 68 65 | 20 47 65 6e 69 74 6f 75 |0 -- The| Genitou|
|000021e0| 72 69 6e 61 72 79 20 54 | 72 61 63 74 0d 0a 0d 0a |rinary T|ract....|
|000021f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002200| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002210| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002220| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002230| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|00002240| 54 65 73 74 69 63 75 6c | 61 72 20 4f 78 69 6d 65 |Testicul|ar Oxime|
|00002250| 74 72 79 3a 20 20 41 20 | 4e 65 77 20 4d 65 74 68 |try: A |New Meth|
|00002260| 6f 64 20 66 6f 72 20 74 | 68 65 20 41 73 73 65 73 |od for t|he Asses|
|00002270| 73 6d 65 6e 74 20 6f 66 | 20 54 69 73 73 75 65 20 |sment of| Tissue |
|00002280| 50 65 72 66 75 73 69 6f | 6e 20 61 6e 64 0d 0a 56 |Perfusio|n and..V|
|00002290| 69 61 62 69 6c 69 74 79 | 20 46 6f 6c 6c 6f 77 69 |iability| Followi|
|000022a0| 6e 67 20 54 6f 72 73 69 | 6f 6e 20 61 6e 64 20 44 |ng Torsi|on and D|
|000022b0| 65 74 6f 72 73 69 6f 6e | 0d 0a 0d 0a 4b 72 61 6d |etorsion|....Kram|
|000022c0| 20 48 42 3b 20 4d 69 79 | 61 6d 6f 74 6f 20 45 3b | HB; Miy|amoto E;|
|000022d0| 20 52 61 6a 66 65 72 20 | 4a 3b 20 41 70 70 65 6c | Rajfer |J; Appel|
|000022e0| 20 50 4c 3b 20 53 68 6f | 65 6d 61 6b 65 72 20 57 | PL; Sho|emaker W|
|000022f0| 43 0d 0a 28 55 6e 69 76 | 20 6f 66 20 43 61 6c 69 |C..(Univ| of Cali|
|00002300| 66 6f 72 6e 69 61 2c 20 | 4c 6f 73 20 41 6e 67 65 |fornia, |Los Ange|
|00002310| 6c 65 73 29 0d 0a 4a 20 | 50 65 64 69 61 74 72 20 |les)..J |Pediatr |
|00002320| 53 75 72 67 20 32 34 3a | 31 32 39 37 2d 31 33 30 |Surg 24:|1297-130|
|00002330| 32 2c 20 31 39 38 39 0d | 0a 2d 2d 2d 2d 2d 2d 2d |2, 1989.|.-------|
|00002340| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002350| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002360| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002370| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002380| 2d 2d 2d 2d 2d 2d 2d 0d | 0a 0d 0a 41 62 73 74 72 |-------.|...Abstr|
|00002390| 61 63 74 0d 0a 0d 0a 20 | 20 20 20 20 55 6e 69 6c |act.... | Unil|
|000023a0| 61 74 65 72 61 6c 20 74 | 65 73 74 69 63 75 6c 61 |ateral t|esticula|
|000023b0| 72 20 74 6f 72 73 69 6f | 6e 20 6d 61 79 20 63 61 |r torsio|n may ca|
|000023c0| 75 73 65 20 63 6f 6e 74 | 72 61 6c 61 74 65 72 61 |use cont|ralatera|
|000023d0| 6c 20 74 65 73 74 69 63 | 75 6c 61 72 20 64 61 6d |l testic|ular dam|
|000023e0| 61 67 65 0d 0a 61 6e 64 | 20 73 75 62 73 65 71 75 |age..and| subsequ|
|000023f0| 65 6e 74 6c 79 20 64 69 | 6d 69 6e 69 73 68 65 64 |ently di|minished|
|00002400| 20 66 65 72 74 69 6c 69 | 74 79 2c 20 65 76 65 6e | fertili|ty, even|
|00002410| 20 69 66 20 64 65 74 6f | 72 73 69 6f 6e 20 69 73 | if deto|rsion is|
|00002420| 20 73 75 63 63 65 73 73 | 66 75 6c 2e 20 20 41 0d | success|ful. A.|
|00002430| 0a 6d 65 74 68 6f 64 20 | 66 6f 72 20 74 68 65 20 |.method |for the |
|00002440| 69 6e 74 72 61 6f 70 65 | 72 61 74 69 76 65 20 61 |intraope|rative a|
|00002450| 73 73 65 73 73 6d 65 6e | 74 20 6f 66 20 74 68 65 |ssessmen|t of the|
|00002460| 20 73 65 76 65 72 69 74 | 79 20 6f 66 20 74 65 73 | severit|y of tes|
|00002470| 74 69 63 75 6c 61 72 20 | 68 79 70 6f 78 69 63 0d |ticular |hypoxic.|
|00002480| 0a 64 61 6d 61 67 65 20 | 63 61 75 73 65 64 20 62 |.damage |caused b|
|00002490| 79 20 74 6f 72 73 69 6f | 6e 20 77 6f 75 6c 64 20 |y torsio|n would |
|000024a0| 74 68 65 72 65 66 6f 72 | 65 20 62 65 20 75 73 65 |therefor|e be use|
|000024b0| 66 75 6c 20 66 6f 72 20 | 73 65 6c 65 63 74 69 6e |ful for |selectin|
|000024c0| 67 20 73 61 6c 76 61 67 | 65 61 62 6c 65 0d 0a 74 |g salvag|eable..t|
|000024d0| 65 73 74 65 73 2e 0d 0a | 20 20 20 20 20 41 20 6d |estes...| A m|
|000024e0| 69 6e 69 61 74 75 72 65 | 20 70 6f 6c 61 72 6f 67 |iniature| polarog|
|000024f0| 72 61 70 68 69 63 20 6f | 72 67 61 6e 20 73 75 72 |raphic o|rgan sur|
|00002500| 66 61 63 65 20 6f 78 79 | 67 65 6e 20 74 65 6e 73 |face oxy|gen tens|
|00002510| 69 6f 6e 20 28 50 4f 32 | 29 20 65 6c 65 63 74 72 |ion (PO2|) electr|
|00002520| 6f 64 65 0d 0a 28 46 69 | 67 20 31 30 2d 33 29 20 |ode..(Fi|g 10-3) |
|00002530| 77 61 73 20 65 76 61 6c | 75 61 74 65 64 20 69 6e |was eval|uated in|
|00002540| 20 72 61 74 73 20 66 6f | 72 20 69 74 73 20 61 62 | rats fo|r its ab|
|00002550| 69 6c 69 74 79 20 74 6f | 20 61 73 73 65 73 73 20 |ility to| assess |
|00002560| 74 65 73 74 69 63 75 6c | 61 72 0d 0a 70 65 72 66 |testicul|ar..perf|
|00002570| 75 73 69 6f 6e 20 61 6e | 64 20 76 69 61 62 69 6c |usion an|d viabil|
|00002580| 69 74 79 20 61 66 74 65 | 72 20 74 6f 72 73 69 6f |ity afte|r torsio|
|00002590| 6e 20 61 6e 64 20 64 65 | 74 6f 72 73 69 6f 6e 2e |n and de|torsion.|
|000025a0| 20 20 41 64 75 6c 74 20 | 6d 61 6c 65 0d 0a 53 70 | Adult |male..Sp|
|000025b0| 72 61 67 75 65 2d 44 61 | 77 6c 65 79 20 72 61 74 |rague-Da|wley rat|
|000025c0| 73 20 77 65 72 65 20 64 | 69 76 69 64 65 64 20 69 |s were d|ivided i|
|000025d0| 6e 74 6f 20 73 6d 61 6c | 6c 20 67 72 6f 75 70 73 |nto smal|l groups|
|000025e0| 20 61 6e 64 20 73 75 62 | 6a 65 63 74 65 64 20 74 | and sub|jected t|
|000025f0| 6f 20 75 6e 69 6c 61 74 | 65 72 61 6c 0d 0a 74 65 |o unilat|eral..te|
|00002600| 73 74 69 63 75 6c 61 72 | 20 74 6f 72 73 69 6f 6e |sticular| torsion|
|00002610| 20 61 6e 64 20 64 65 74 | 6f 72 73 69 6f 6e 20 6f | and det|orsion o|
|00002620| 66 20 76 61 72 79 69 6e | 67 20 64 65 67 72 65 65 |f varyin|g degree|
|00002630| 73 20 61 6e 64 20 64 75 | 72 61 74 69 6f 6e 73 2e |s and du|rations.|
|00002640| 0d 0a 20 20 20 20 20 54 | 65 73 74 69 63 75 6c 61 |.. T|esticula|
|00002650| 72 20 50 4f 32 20 76 61 | 6c 75 65 73 20 70 61 72 |r PO2 va|lues par|
|00002660| 61 6c 6c 65 6c 65 64 20 | 74 65 73 74 69 63 75 6c |alleled |testicul|
|00002670| 61 72 20 70 65 72 66 75 | 73 69 6f 6e 20 61 6e 64 |ar perfu|sion and|
|00002680| 20 6f 78 79 67 65 6e 61 | 74 69 6f 6e 2e 0d 0a 49 | oxygena|tion...I|
|00002690| 6e 63 72 65 61 73 65 64 | 20 74 65 73 74 69 63 75 |ncreased| testicu|
|000026a0| 6c 61 72 20 50 4f 32 20 | 77 61 73 20 63 6c 65 61 |lar PO2 |was clea|
|000026b0| 72 6c 79 20 64 65 6d 6f | 6e 73 74 72 61 74 65 64 |rly demo|nstrated|
|000026c0| 20 77 69 74 68 20 68 79 | 70 65 72 6f 78 69 61 20 | with hy|peroxia |
|000026d0| 61 6e 64 0d 0a 64 65 74 | 6f 72 73 69 6f 6e 2c 20 |and..det|orsion, |
|000026e0| 77 68 65 72 65 61 73 20 | 72 61 70 69 64 20 72 65 |whereas |rapid re|
|000026f0| 64 75 63 74 69 6f 6e 73 | 20 69 6e 20 74 65 73 74 |ductions| in test|
|00002700| 69 63 75 6c 61 72 20 50 | 4f 32 20 6f 63 63 75 72 |icular P|O2 occur|
|00002710| 72 65 64 20 61 66 74 65 | 72 20 63 65 73 73 61 74 |red afte|r cessat|
|00002720| 69 6f 6e 0d 0a 6f 66 20 | 68 79 70 65 72 6f 78 69 |ion..of |hyperoxi|
|00002730| 61 2c 20 68 69 67 68 2d | 64 65 67 72 65 65 20 74 |a, high-|degree t|
|00002740| 6f 72 73 69 6f 6e 2c 20 | 61 6e 64 20 73 70 65 72 |orsion, |and sper|
|00002750| 6d 61 74 69 63 20 63 6f | 72 64 20 6c 69 67 61 74 |matic co|rd ligat|
|00002760| 69 6f 6e 2e 20 20 54 68 | 65 20 50 4f 32 0d 0a 65 |ion. Th|e PO2..e|
|00002770| 6c 65 63 74 72 6f 64 65 | 20 77 61 73 20 65 61 73 |lectrode| was eas|
|00002780| 79 20 74 6f 20 75 73 65 | 2c 20 73 65 6e 73 69 74 |y to use|, sensit|
|00002790| 69 76 65 2c 20 61 63 63 | 75 72 61 74 65 2c 20 61 |ive, acc|urate, a|
|000027a0| 6e 64 20 73 74 61 62 6c | 65 2e 0d 0a 0d 0a 50 6f |nd stabl|e.....Po|
|000027b0| 73 74 2d 43 6f 6d 6d 65 | 6e 74 0d 0a 0d 0a 20 20 |st-Comme|nt.... |
|000027c0| 20 20 20 49 6e 74 72 61 | 6f 70 65 72 61 74 69 76 | Intra|operativ|
|000027d0| 65 20 6d 65 61 73 75 72 | 65 6d 65 6e 74 20 6f 66 |e measur|ement of|
|000027e0| 20 74 65 73 74 69 63 75 | 6c 61 72 20 6f 78 79 67 | testicu|lar oxyg|
|000027f0| 65 6e 61 74 69 6f 6e 20 | 62 79 20 75 73 65 20 6f |enation |by use o|
|00002800| 66 20 74 69 73 73 75 65 | 0d 0a 6f 78 69 6d 65 74 |f tissue|..oximet|
|00002810| 72 79 20 63 6f 6d 65 73 | 20 61 73 20 61 6e 20 61 |ry comes| as an a|
|00002820| 64 64 65 64 20 62 6c 65 | 73 73 69 6e 67 20 74 6f |dded ble|ssing to|
|00002830| 20 77 68 61 74 20 77 65 | 20 61 6c 72 65 61 64 79 | what we| already|
|00002840| 20 6b 6e 6f 77 20 61 62 | 6f 75 74 20 74 68 65 20 | know ab|out the |
|00002850| 73 75 72 67 69 63 61 6c | 0d 0a 6d 61 6e 61 67 65 |surgical|..manage|
|00002860| 6d 65 6e 74 20 6f 66 20 | 74 6f 72 73 69 6f 6e 20 |ment of |torsion |
|00002870| 6f 66 20 74 68 65 20 74 | 65 73 74 69 73 2e 20 20 |of the t|estis. |
|00002880| 54 68 65 20 6c 61 74 74 | 65 72 2c 20 61 74 20 62 |The latt|er, at b|
|00002890| 65 73 74 2c 20 69 73 20 | 61 6e 20 69 6d 70 72 65 |est, is |an impre|
|000028a0| 63 69 73 65 0d 0a 73 63 | 69 65 6e 63 65 2e 20 20 |cise..sc|ience. |
|000028b0| 41 6c 74 68 6f 75 67 68 | 20 69 74 20 69 73 20 61 |Although| it is a|
|000028c0| 67 72 65 65 64 20 74 68 | 61 74 20 74 6f 72 73 69 |greed th|at torsi|
|000028d0| 6f 6e 20 6f 66 20 74 68 | 65 20 74 65 73 74 69 73 |on of th|e testis|
|000028e0| 20 69 73 20 61 20 73 75 | 72 67 69 63 61 6c 0d 0a | is a su|rgical..|
|000028f0| 65 6d 65 72 67 65 6e 63 | 79 20 61 6e 64 20 6e 6f |emergenc|y and no|
|00002900| 20 74 69 6d 65 20 73 68 | 6f 75 6c 64 20 62 65 20 | time sh|ould be |
|00002910| 6c 6f 73 74 20 69 6e 20 | 70 65 72 66 6f 72 6d 69 |lost in |performi|
|00002920| 6e 67 20 74 68 65 20 75 | 72 67 65 6e 74 20 6f 70 |ng the u|rgent op|
|00002930| 65 72 61 74 69 6f 6e 2c | 20 69 74 20 69 73 0d 0a |eration,| it is..|
|00002940| 6e 6f 74 20 71 75 69 74 | 65 20 63 6c 65 61 72 20 |not quit|e clear |
|00002950| 68 6f 77 20 6c 6f 6e 67 | 20 61 20 74 65 73 74 69 |how long| a testi|
|00002960| 73 20 72 65 6d 61 69 6e | 73 20 76 69 61 62 6c 65 |s remain|s viable|
|00002970| 20 61 66 74 65 72 20 74 | 68 65 20 6f 6e 73 65 74 | after t|he onset|
|00002980| 20 6f 66 20 74 6f 72 73 | 69 6f 6e 2e 0d 0a 49 6e | of tors|ion...In|
|00002990| 20 6f 6e 65 20 6c 61 72 | 67 65 20 65 78 70 65 72 | one lar|ge exper|
|000029a0| 69 65 6e 63 65 2c 20 48 | 61 73 74 69 65 20 65 74 |ience, H|astie et|
|000029b0| 20 61 6c 2e 20 28 31 29 | 20 68 61 76 65 20 66 6f | al. (1)| have fo|
|000029c0| 75 6e 64 20 74 68 61 74 | 20 74 68 65 20 74 65 73 |und that| the tes|
|000029d0| 74 69 63 75 6c 61 72 0d | 0a 73 61 6c 76 61 67 65 |ticular.|.salvage|
|000029e0| 20 72 61 74 65 20 66 61 | 6c 6c 73 20 66 72 6f 6d | rate fa|lls from|
|000029f0| 20 38 30 25 20 69 66 20 | 74 65 73 74 65 73 20 61 | 80% if |testes a|
|00002a00| 72 65 20 65 78 70 6c 6f | 72 65 64 20 77 69 74 68 |re explo|red with|
|00002a10| 69 6e 20 35 20 68 6f 75 | 72 73 20 6f 66 20 6f 6e |in 5 hou|rs of on|
|00002a20| 73 65 74 20 6f 66 0d 0a | 70 61 69 6e 20 74 6f 20 |set of..|pain to |
|00002a30| 32 30 25 20 69 66 20 73 | 79 6d 70 74 6f 6d 73 20 |20% if s|ymptoms |
|00002a40| 68 61 76 65 20 62 65 65 | 6e 20 70 72 65 73 65 6e |have bee|n presen|
|00002a50| 74 20 66 6f 72 20 6d 6f | 72 65 20 74 68 61 6e 20 |t for mo|re than |
|00002a60| 31 30 20 68 6f 75 72 73 | 2e 20 20 41 66 74 65 72 |10 hours|. After|
|00002a70| 20 32 34 0d 0a 68 6f 75 | 72 73 20 61 6c 6c 20 74 | 24..hou|rs all t|
|00002a80| 65 73 74 65 73 20 61 72 | 65 20 6e 6f 6e 76 69 61 |estes ar|e nonvia|
|00002a90| 62 6c 65 2e 20 20 54 68 | 69 73 20 64 6f 65 73 20 |ble. Th|is does |
|00002aa0| 6e 6f 74 20 6d 65 61 6e | 20 74 68 61 74 20 61 66 |not mean| that af|
|00002ab0| 74 65 72 20 32 34 20 68 | 6f 75 72 73 20 79 6f 75 |ter 24 h|ours you|
|00002ac0| 0d 0a 64 6f 6e 27 74 20 | 6f 70 65 72 61 74 65 2c |..don't |operate,|
|00002ad0| 20 6a 75 73 74 20 74 68 | 61 74 2c 20 6d 6f 72 65 | just th|at, more|
|00002ae0| 20 6c 69 6b 65 6c 79 20 | 74 68 61 6e 20 6e 6f 74 | likely |than not|
|00002af0| 2c 20 79 6f 75 27 72 65 | 20 67 6f 69 6e 67 20 74 |, you're| going t|
|00002b00| 6f 20 72 65 6d 6f 76 65 | 20 74 68 65 0d 0a 69 6e |o remove| the..in|
|00002b10| 66 61 72 63 74 65 64 20 | 74 65 73 74 69 73 20 74 |farcted |testis t|
|00002b20| 68 61 6e 20 61 6e 79 74 | 68 69 6e 67 20 65 6c 73 |han anyt|hing els|
|00002b30| 65 2e 20 20 57 69 74 68 | 20 74 69 73 73 75 65 20 |e. With| tissue |
|00002b40| 6f 78 69 6d 65 74 72 79 | 20 73 6f 6d 65 20 6f 66 |oximetry| some of|
|00002b50| 20 74 68 65 0d 0a 67 75 | 65 73 73 77 6f 72 6b 20 | the..gu|esswork |
|00002b60| 6f 66 20 22 65 79 65 2d | 62 61 6c 6c 69 6e 67 22 |of "eye-|balling"|
|00002b70| 20 77 68 65 74 68 65 72 | 20 6f 72 20 6e 6f 74 20 | whether| or not |
|00002b80| 61 20 74 65 73 74 69 73 | 20 69 73 20 6e 6f 6e 76 |a testis| is nonv|
|00002b90| 69 61 62 6c 65 20 63 61 | 6e 20 62 65 0d 0a 72 65 |iable ca|n be..re|
|00002ba0| 70 6c 61 63 65 64 20 62 | 79 20 61 20 73 6f 6d 65 |placed b|y a some|
|00002bb0| 77 68 61 74 20 6d 6f 72 | 65 20 73 63 69 65 6e 74 |what mor|e scient|
|00002bc0| 69 66 69 63 20 61 70 70 | 72 6f 61 63 68 2e 20 20 |ific app|roach. |
|00002bd0| 49 74 27 73 20 6e 6f 74 | 20 74 68 61 74 20 79 6f |It's not| that yo|
|00002be0| 75 27 72 65 20 67 6f 69 | 6e 67 0d 0a 74 6f 20 72 |u're goi|ng..to r|
|00002bf0| 61 69 73 65 20 4c 61 7a | 75 72 75 73 20 66 72 6f |aise Laz|urus fro|
|00002c00| 6d 20 74 68 65 20 64 65 | 61 64 2d 2d 61 20 64 65 |m the de|ad--a de|
|00002c10| 61 64 20 74 65 73 74 69 | 73 20 69 73 20 61 20 64 |ad testi|s is a d|
|00002c20| 65 61 64 20 74 65 73 74 | 69 73 2d 2d 69 74 27 73 |ead test|is--it's|
|00002c30| 20 6a 75 73 74 20 74 68 | 61 74 0d 0a 73 6f 6d 65 | just th|at..some|
|00002c40| 20 74 65 73 74 65 73 20 | 6d 61 79 20 69 6e 20 66 | testes |may in f|
|00002c50| 61 63 74 20 62 65 20 72 | 65 73 75 73 63 69 74 61 |act be r|esuscita|
|00002c60| 74 61 62 6c 65 2c 20 61 | 6e 64 20 74 68 65 20 63 |table, a|nd the c|
|00002c70| 6c 75 65 20 74 6f 20 74 | 68 65 20 6c 61 74 74 65 |lue to t|he latte|
|00002c80| 72 20 77 69 6c 6c 0d 0a | 63 6f 6d 65 20 66 72 6f |r will..|come fro|
|00002c90| 6d 20 74 69 73 73 75 65 | 20 6f 78 69 6d 65 74 72 |m tissue| oximetr|
|00002ca0| 79 2e 0d 0a 20 20 20 20 | 20 51 75 69 7a 3a 20 20 |y... | Quiz: |
|00002cb0| 48 6f 77 20 6d 61 6e 79 | 20 63 6f 6d 70 6c 65 74 |How many| complet|
|00002cc0| 65 20 74 75 72 6e 73 20 | 6f 66 20 74 68 65 20 74 |e turns |of the t|
|00002cd0| 65 73 74 65 73 20 77 69 | 6c 6c 20 70 72 6f 64 75 |estes wi|ll produ|
|00002ce0| 63 65 20 61 20 63 6c 69 | 6e 69 63 61 6c 0d 0a 70 |ce a cli|nical..p|
|00002cf0| 72 6f 62 6c 65 6d 20 66 | 72 6f 6d 20 74 6f 72 73 |roblem f|rom tors|
|00002d00| 69 6f 6e 3f 20 20 41 73 | 20 79 6f 75 20 6d 69 67 |ion? As| you mig|
|00002d10| 68 74 20 73 75 73 70 65 | 63 74 2c 20 74 68 65 20 |ht suspe|ct, the |
|00002d20| 61 6e 73 77 65 72 20 74 | 6f 20 74 68 69 73 20 69 |answer t|o this i|
|00002d30| 73 20 6f 62 74 61 69 6e | 61 62 6c 65 0d 0a 6f 6e |s obtain|able..on|
|00002d40| 6c 79 20 66 72 6f 6d 20 | 61 6e 20 61 6e 69 6d 61 |ly from |an anima|
|00002d50| 6c 20 73 74 75 64 79 2c | 20 62 75 74 20 73 75 63 |l study,| but suc|
|00002d60| 68 20 72 65 73 75 6c 74 | 73 20 61 72 65 20 63 6f |h result|s are co|
|00002d70| 6e 74 61 69 6e 65 64 20 | 69 6e 20 74 68 65 20 61 |ntained |in the a|
|00002d80| 72 74 69 63 6c 65 0d 0a | 61 62 73 74 72 61 63 74 |rticle..|abstract|
|00002d90| 65 64 20 61 62 6f 76 65 | 2e 20 20 54 68 65 20 61 |ed above|. The a|
|00002da0| 6e 73 77 65 72 20 69 73 | 20 32 20 63 6f 6d 70 6c |nswer is| 2 compl|
|00002db0| 65 74 65 20 74 75 72 6e | 73 20 6f 66 20 74 68 65 |ete turn|s of the|
|00002dc0| 20 74 65 73 74 65 73 20 | 28 37 32 30 20 64 65 67 | testes |(720 deg|
|00002dd0| 72 65 65 73 29 0d 0a 70 | 72 6f 64 75 63 65 73 20 |rees)..p|roduces |
|00002de0| 61 62 6e 6f 72 6d 61 6c | 20 74 69 73 73 75 65 20 |abnormal| tissue |
|00002df0| 6f 78 79 67 65 6e 61 74 | 69 6f 6e 20 61 66 74 65 |oxygenat|ion afte|
|00002e00| 72 20 36 20 68 6f 75 72 | 73 2e 20 20 46 6f 75 72 |r 6 hour|s. Four|
|00002e10| 20 74 75 72 6e 73 20 28 | 31 38 30 20 64 65 67 72 | turns (|180 degr|
|00002e20| 65 65 73 29 0d 0a 70 72 | 6f 64 75 63 65 73 20 7a |ees)..pr|oduces z|
|00002e30| 65 72 6f 20 6f 78 79 67 | 65 6e 61 74 69 6f 6e 20 |ero oxyg|enation |
|00002e40| 77 69 74 68 69 6e 20 31 | 30 20 6d 69 6e 75 74 65 |within 1|0 minute|
|00002e50| 73 2e 20 20 4f 6e 65 20 | 74 75 72 6e 2c 20 32 20 |s. One |turn, 2 |
|00002e60| 74 75 72 6e 73 2c 20 6f | 72 20 34 20 73 68 6f 75 |turns, o|r 4 shou|
|00002e70| 6c 64 0d 0a 62 65 20 65 | 6e 6f 75 67 68 20 74 6f |ld..be e|nough to|
|00002e80| 20 6d 61 6b 65 20 61 6e | 79 62 6f 64 79 20 75 70 | make an|ybody up|
|00002e90| 74 69 67 68 74 2e 2d 2d | 4a 2e 41 2e 20 53 74 6f |tight.--|J.A. Sto|
|00002ea0| 63 6b 6d 61 6e 2c 20 49 | 49 49 2c 20 4d 2e 44 2e |ckman, I|II, M.D.|
|00002eb0| 0d 0a 24 55 6e 69 71 75 | 65 5f 49 44 7b 59 52 42 |..$Uniqu|e_ID{YRB|
|00002ec0| 30 33 30 30 33 7d 0d 0a | 24 54 69 74 6c 65 7b 4d |03003}..|$Title{M|
|00002ed0| 61 6c 65 20 43 6f 6c 6c | 65 67 65 20 53 74 75 64 |ale Coll|ege Stud|
|00002ee0| 65 6e 74 73 27 20 43 6f | 6d 70 6c 69 61 6e 63 65 |ents' Co|mpliance|
|00002ef0| 20 57 69 74 68 20 54 65 | 73 74 69 63 75 6c 61 72 | With Te|sticular|
|00002f00| 20 53 65 6c 66 2d 45 78 | 61 6d 69 6e 61 74 69 6f | Self-Ex|aminatio|
|00002f10| 6e 7d 0d 0a 24 41 75 74 | 68 6f 72 7b 0d 0a 44 61 |n}..$Aut|hor{..Da|
|00002f20| 63 68 73 2c 20 52 4a 0d | 0a 47 61 72 62 2c 20 4a |chs, RJ.|.Garb, J|
|00002f30| 4c 0d 0a 57 68 69 74 65 | 2c 20 43 0d 0a 42 65 72 |L..White|, C..Ber|
|00002f40| 6d 61 6e 2c 20 4a 7d 0d | 0a 24 41 66 66 69 6c 69 |man, J}.|.$Affili|
|00002f50| 61 74 69 6f 6e 7b 42 61 | 79 73 74 61 74 65 20 4d |ation{Ba|ystate M|
|00002f60| 65 64 20 43 74 72 2c 20 | 53 70 72 69 6e 67 66 69 |ed Ctr, |Springfi|
|00002f70| 65 6c 64 2c 20 4d 61 73 | 73 7d 0d 0a 24 4a 6f 75 |eld, Mas|s}..$Jou|
|00002f80| 72 6e 61 6c 7b 4a 20 41 | 64 6f 6c 65 73 63 20 48 |rnal{J A|dolesc H|
|00002f90| 65 61 6c 74 68 20 43 61 | 72 65 7d 0d 0a 24 56 6f |ealth Ca|re}..$Vo|
|00002fa0| 6c 75 6d 65 7b 31 30 7d | 0d 0a 24 50 61 67 65 7b |lume{10}|..$Page{|
|00002fb0| 32 39 35 2d 32 39 39 7d | 0d 0a 24 44 61 74 65 7b |295-299}|..$Date{|
|00002fc0| 31 39 38 39 7d 0d 0a 24 | 59 42 56 6f 6c 7b 31 39 |1989}..$|YBVol{19|
|00002fd0| 39 31 20 59 65 61 72 20 | 42 6f 6f 6b 20 6f 66 20 |91 Year |Book of |
|00002fe0| 50 65 64 69 61 74 72 69 | 63 73 3a 7d 0d 0a 24 43 |Pediatri|cs:}..$C|
|00002ff0| 68 61 70 74 65 72 7b 31 | 30 2d 31 34 7d 0d 0a 24 |hapter{1|0-14}..$|
|00003000| 59 42 45 64 69 74 6f 72 | 7b 44 72 73 2e 20 4f 73 |YBEditor|{Drs. Os|
|00003010| 6b 69 20 61 6e 64 20 53 | 74 6f 63 6b 6d 61 6e 7d |ki and S|tockman}|
|00003020| 0d 0a 24 54 61 62 6c 65 | 7b 54 61 62 6c 65 20 4f |..$Table|{Table O|
|00003030| 6d 69 74 74 65 64 7d 0d | 0a 24 43 6f 6d 6d 65 6e |mitted}.|.$Commen|
|00003040| 74 61 74 6f 72 7b 7d 0d | 0a 0d 0a 43 6f 70 79 72 |tator{}.|...Copyr|
|00003050| 69 67 68 74 20 28 43 29 | 20 59 65 61 72 20 42 6f |ight (C)| Year Bo|
|00003060| 6f 6b 20 4d 65 64 69 63 | 61 6c 20 50 75 62 6c 69 |ok Medic|al Publi|
|00003070| 73 68 65 72 73 2c 20 49 | 6e 63 2e 20 31 39 39 31 |shers, I|nc. 1991|
|00003080| 0d 0a 0d 0a 31 39 39 31 | 20 59 65 61 72 20 42 6f |....1991| Year Bo|
|00003090| 6f 6b 20 6f 66 20 50 65 | 64 69 61 74 72 69 63 73 |ok of Pe|diatrics|
|000030a0| 3a 0d 0a 0d 0a 43 68 61 | 70 74 65 72 20 31 30 20 |:....Cha|pter 10 |
|000030b0| 2d 2d 20 54 68 65 20 47 | 65 6e 69 74 6f 75 72 69 |-- The G|enitouri|
|000030c0| 6e 61 72 79 20 54 72 61 | 63 74 0d 0a 0d 0a 2d 2d |nary Tra|ct....--|
|000030d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000030e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000030f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003100| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003110| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 4d 61 |--------|----..Ma|
|00003120| 6c 65 20 43 6f 6c 6c 65 | 67 65 20 53 74 75 64 65 |le Colle|ge Stude|
|00003130| 6e 74 73 27 20 43 6f 6d | 70 6c 69 61 6e 63 65 20 |nts' Com|pliance |
|00003140| 57 69 74 68 20 54 65 73 | 74 69 63 75 6c 61 72 20 |With Tes|ticular |
|00003150| 53 65 6c 66 2d 45 78 61 | 6d 69 6e 61 74 69 6f 6e |Self-Exa|mination|
|00003160| 0d 0a 0d 0a 44 61 63 68 | 73 20 52 4a 3b 20 47 61 |....Dach|s RJ; Ga|
|00003170| 72 62 20 4a 4c 3b 20 57 | 68 69 74 65 20 43 3b 20 |rb JL; W|hite C; |
|00003180| 42 65 72 6d 61 6e 20 4a | 0d 0a 28 42 61 79 73 74 |Berman J|..(Bayst|
|00003190| 61 74 65 20 4d 65 64 20 | 43 74 72 2c 20 53 70 72 |ate Med |Ctr, Spr|
|000031a0| 69 6e 67 66 69 65 6c 64 | 2c 20 4d 61 73 73 29 0d |ingfield|, Mass).|
|000031b0| 0a 4a 20 41 64 6f 6c 65 | 73 63 20 48 65 61 6c 74 |.J Adole|sc Healt|
|000031c0| 68 20 43 61 72 65 20 31 | 30 3a 32 39 35 2d 32 39 |h Care 1|0:295-29|
|000031d0| 39 2c 20 31 39 38 39 0d | 0a 2d 2d 2d 2d 2d 2d 2d |9, 1989.|.-------|
|000031e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000031f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003200| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003210| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003220| 2d 2d 2d 2d 2d 2d 2d 0d | 0a 0d 0a 41 62 73 74 72 |-------.|...Abstr|
|00003230| 61 63 74 0d 0a 0d 0a 20 | 20 20 20 20 54 65 73 74 |act.... | Test|
|00003240| 69 63 75 6c 61 72 20 63 | 61 6e 63 65 72 20 69 73 |icular c|ancer is|
|00003250| 20 74 68 65 20 6d 6f 73 | 74 20 63 6f 6d 6d 6f 6e | the mos|t common|
|00003260| 20 63 61 6e 63 65 72 20 | 69 6e 20 6d 61 6c 65 73 | cancer |in males|
|00003270| 20 61 67 65 64 20 31 35 | 2d 33 34 20 79 65 61 72 | aged 15|-34 year|
|00003280| 73 2e 0d 0a 54 6f 20 65 | 76 61 6c 75 61 74 65 20 |s...To e|valuate |
|00003290| 63 6f 6c 6c 65 67 65 20 | 73 74 75 64 65 6e 74 73 |college |students|
|000032a0| 27 20 6b 6e 6f 77 6c 65 | 64 67 65 20 6f 66 20 74 |' knowle|dge of t|
|000032b0| 68 65 20 72 69 73 6b 73 | 20 6f 66 20 74 65 73 74 |he risks| of test|
|000032c0| 69 63 75 6c 61 72 20 63 | 61 6e 63 65 72 20 61 6e |icular c|ancer an|
|000032d0| 64 0d 0a 74 6f 20 64 65 | 74 65 72 6d 69 6e 65 20 |d..to de|termine |
|000032e0| 68 6f 77 20 6d 61 6e 79 | 20 70 72 61 63 74 69 63 |how many| practic|
|000032f0| 65 20 6d 6f 6e 74 68 6c | 79 20 74 65 73 74 69 63 |e monthl|y testic|
|00003300| 75 6c 61 72 20 73 65 6c | 66 2d 65 78 61 6d 69 6e |ular sel|f-examin|
|00003310| 61 74 69 6f 6e 20 28 54 | 53 45 29 2c 20 36 33 33 |ation (T|SE), 633|
|00003320| 0d 0a 6d 65 6e 20 61 74 | 20 33 20 4e 65 77 20 45 |..men at| 3 New E|
|00003330| 6e 67 6c 61 6e 64 20 63 | 6f 6c 6c 65 67 65 73 20 |ngland c|olleges |
|00003340| 77 65 72 65 20 73 74 75 | 64 69 65 64 2e 0d 0a 20 |were stu|died... |
|00003350| 20 20 20 20 4f 66 20 74 | 68 65 20 36 33 33 20 6d | Of t|he 633 m|
|00003360| 65 6e 20 6f 6e 6c 79 20 | 33 30 20 28 34 2e 37 25 |en only |30 (4.7%|
|00003370| 29 20 70 65 72 66 6f 72 | 6d 65 64 20 6d 6f 6e 74 |) perfor|med mont|
|00003380| 68 6c 79 20 54 53 45 2e | 20 20 54 68 65 20 6d 65 |hly TSE.| The me|
|00003390| 6e 20 74 68 65 6e 0d 0a | 72 65 63 65 69 76 65 64 |n then..|received|
|000033a0| 20 77 72 69 74 74 65 6e | 20 6d 61 74 65 72 69 61 | written| materia|
|000033b0| 6c 20 6f 72 20 77 72 69 | 74 74 65 6e 20 6d 61 74 |l or wri|tten mat|
|000033c0| 65 72 69 61 6c 20 70 6c | 75 73 20 61 20 70 68 79 |erial pl|us a phy|
|000033d0| 73 69 63 69 61 6e 27 73 | 20 6c 65 63 74 75 72 65 |sician's| lecture|
|000033e0| 20 6f 6e 0d 0a 74 65 73 | 74 69 63 75 6c 61 72 20 | on..tes|ticular |
|000033f0| 63 61 6e 63 65 72 20 61 | 6e 64 20 54 53 45 2e 20 |cancer a|nd TSE. |
|00003400| 20 41 66 74 65 72 20 74 | 68 69 73 20 69 6e 74 65 | After t|his inte|
|00003410| 72 76 65 6e 74 69 6f 6e | 2c 20 31 38 25 20 6f 66 |rvention|, 18% of|
|00003420| 20 74 68 65 20 6d 65 6e | 20 77 68 6f 0d 0a 72 65 | the men| who..re|
|00003430| 63 65 69 76 65 64 20 74 | 68 65 20 6d 61 74 65 72 |ceived t|he mater|
|00003440| 69 61 6c 20 6f 6e 6c 79 | 20 72 65 70 6f 72 74 65 |ial only| reporte|
|00003450| 64 20 70 65 72 66 6f 72 | 6d 69 6e 67 20 6d 6f 6e |d perfor|ming mon|
|00003460| 74 68 6c 79 20 54 53 45 | 2c 20 63 6f 6d 70 61 72 |thly TSE|, compar|
|00003470| 65 64 20 77 69 74 68 20 | 33 36 25 0d 0a 6f 66 20 |ed with |36%..of |
|00003480| 74 68 6f 73 65 20 77 68 | 6f 20 72 65 63 65 69 76 |those wh|o receiv|
|00003490| 65 64 20 62 6f 74 68 20 | 77 72 69 74 74 65 6e 20 |ed both |written |
|000034a0| 6d 61 74 65 72 69 61 6c | 20 61 6e 64 20 74 68 65 |material| and the|
|000034b0| 20 6c 65 63 74 75 72 65 | 2e 20 20 54 68 69 73 20 | lecture|. This |
|000034c0| 64 69 66 66 65 72 65 6e | 63 65 0d 0a 77 61 73 20 |differen|ce..was |
|000034d0| 73 74 61 74 69 73 74 69 | 63 61 6c 6c 79 20 73 69 |statisti|cally si|
|000034e0| 67 6e 69 66 69 63 61 6e | 74 2e 20 20 48 6f 77 65 |gnifican|t. Howe|
|000034f0| 76 65 72 2c 20 6d 6f 73 | 74 20 6f 66 20 74 68 65 |ver, mos|t of the|
|00003500| 20 6d 65 6e 20 69 6e 20 | 74 68 69 73 20 73 74 75 | men in |this stu|
|00003510| 64 79 20 73 74 69 6c 6c | 0d 0a 64 69 64 20 6e 6f |dy still|..did no|
|00003520| 74 20 61 64 6f 70 74 20 | 74 68 65 20 6d 6f 6e 74 |t adopt |the mont|
|00003530| 68 6c 79 20 70 72 61 63 | 74 69 63 65 20 6f 66 20 |hly prac|tice of |
|00003540| 54 53 45 2e 20 20 4d 6f | 72 65 20 65 66 66 65 63 |TSE. Mo|re effec|
|00003550| 74 69 76 65 20 6d 65 74 | 68 6f 64 73 20 61 72 65 |tive met|hods are|
|00003560| 20 6e 65 65 64 65 64 0d | 0a 74 6f 20 69 6e 63 72 | needed.|.to incr|
|00003570| 65 61 73 65 20 74 68 69 | 73 20 70 6f 70 75 6c 61 |ease thi|s popula|
|00003580| 74 69 6f 6e 27 73 20 70 | 72 61 63 74 69 63 65 20 |tion's p|ractice |
|00003590| 6f 66 20 54 53 45 2e 0d | 0a 0d 0a 50 6f 73 74 2d |of TSE..|...Post-|
|000035a0| 43 6f 6d 6d 65 6e 74 0d | 0a 0d 0a 20 20 20 20 20 |Comment.|... |
|000035b0| 41 73 20 6d 75 63 68 20 | 61 73 20 77 65 20 6b 6e |As much |as we kn|
|000035c0| 6f 77 20 74 68 65 20 76 | 61 6c 75 65 20 6f 66 20 |ow the v|alue of |
|000035d0| 54 53 45 2c 20 69 74 20 | 69 73 20 72 61 72 65 6c |TSE, it |is rarel|
|000035e0| 79 20 64 6f 6e 65 2c 20 | 6e 6f 20 6d 61 74 74 65 |y done, |no matte|
|000035f0| 72 20 68 6f 77 0d 0a 77 | 65 6c 6c 20 69 6e 73 74 |r how..w|ell inst|
|00003600| 72 75 63 74 65 64 20 61 | 6e 20 69 6e 64 69 76 69 |ructed a|n indivi|
|00003610| 64 75 61 6c 20 69 73 2e | 20 20 54 68 65 20 66 61 |dual is.| The fa|
|00003620| 69 6c 75 72 65 20 72 61 | 74 65 20 70 6f 73 74 20 |ilure ra|te post |
|00003630| 69 6e 73 74 72 75 63 74 | 69 6f 6e 20 69 73 0d 0a |instruct|ion is..|
|00003640| 72 65 6d 61 72 6b 61 62 | 6c 79 20 67 72 65 61 74 |remarkab|ly great|
|00003650| 65 72 20 74 68 61 6e 20 | 66 6f 72 20 62 72 65 61 |er than |for brea|
|00003660| 73 74 20 73 65 6c 66 2d | 65 78 61 6d 69 6e 61 74 |st self-|examinat|
|00003670| 69 6f 6e 2e 20 20 4f 6e | 65 20 77 6f 6e 64 65 72 |ion. On|e wonder|
|00003680| 73 20 69 66 20 6d 65 6e | 20 61 72 65 0d 0a 6a 75 |s if men| are..ju|
|00003690| 73 74 20 74 6f 6f 20 6d | 61 63 68 6f 2c 20 6a 75 |st too m|acho, ju|
|000036a0| 73 74 20 61 72 65 6e 27 | 74 20 69 6d 70 72 65 73 |st aren'|t impres|
|000036b0| 73 65 64 20 62 79 20 74 | 68 65 20 73 74 61 74 69 |sed by t|he stati|
|000036c0| 73 74 69 63 73 2c 20 6f | 72 20 6a 75 73 74 20 64 |stics, o|r just d|
|000036d0| 6f 6e 27 74 20 74 61 6b | 65 0d 0a 74 68 65 20 74 |on't tak|e..the t|
|000036e0| 69 6d 65 2e 20 20 54 68 | 65 20 69 6e 63 69 64 65 |ime. Th|e incide|
|000036f0| 6e 63 65 20 6f 66 20 74 | 65 73 74 69 63 75 6c 61 |nce of t|esticula|
|00003700| 72 20 74 75 6d 6f 72 73 | 20 69 73 20 73 75 66 66 |r tumors| is suff|
|00003710| 69 63 69 65 6e 74 6c 79 | 20 68 69 67 68 20 74 68 |iciently| high th|
|00003720| 61 74 20 69 66 20 54 53 | 45 0d 0a 69 73 20 6e 6f |at if TS|E..is no|
|00003730| 74 20 64 6f 6e 65 2c 20 | 74 68 65 20 6f 6e 6c 79 |t done, |the only|
|00003740| 20 73 75 62 73 74 69 74 | 75 74 65 20 77 6f 75 6c | substit|ute woul|
|00003750| 64 20 62 65 20 72 65 67 | 75 6c 61 72 20 70 68 79 |d be reg|ular phy|
|00003760| 73 69 63 61 6c 20 65 78 | 61 6d 69 6e 61 74 69 6f |sical ex|aminatio|
|00003770| 6e 73 20 62 79 20 61 0d | 0a 70 68 79 73 69 63 69 |ns by a.|.physici|
|00003780| 61 6e 2d 2d 63 65 72 74 | 61 69 6e 6c 79 20 6d 6f |an--cert|ainly mo|
|00003790| 72 65 20 74 69 6d 65 20 | 63 6f 6e 73 75 6d 69 6e |re time |consumin|
|000037a0| 67 20 61 6e 64 20 6c 65 | 73 73 20 6d 61 63 68 6f |g and le|ss macho|
|000037b0| 2e 2d 2d 4a 2e 41 2e 20 | 53 74 6f 63 6b 6d 61 6e |.--J.A. |Stockman|
|000037c0| 2c 20 49 49 49 2c 0d 0a | 4d 2e 44 2e 0d 0a 24 55 |, III,..|M.D...$U|
|000037d0| 6e 69 71 75 65 5f 49 44 | 7b 59 52 42 30 33 30 30 |nique_ID|{YRB0300|
|000037e0| 34 7d 0d 0a 24 54 69 74 | 6c 65 7b 41 73 79 6d 6d |4}..$Tit|le{Asymm|
|000037f0| 65 74 72 69 63 61 6c 20 | 50 75 6c 6d 6f 6e 61 72 |etrical |Pulmonar|
|00003800| 79 20 43 68 61 6e 67 65 | 73 20 69 6e 20 50 72 65 |y Change|s in Pre|
|00003810| 6d 61 74 75 72 65 20 49 | 6e 66 61 6e 74 73 20 57 |mature I|nfants W|
|00003820| 69 74 68 20 53 75 72 67 | 69 63 61 6c 0d 0a 43 6c |ith Surg|ical..Cl|
|00003830| 6f 73 75 72 65 20 6f 66 | 20 61 20 50 65 72 73 69 |osure of| a Persi|
|00003840| 73 74 65 6e 74 20 44 75 | 63 74 75 73 20 41 72 74 |stent Du|ctus Art|
|00003850| 65 72 69 6f 73 75 73 7d | 0d 0a 24 41 75 74 68 6f |eriosus}|..$Autho|
|00003860| 72 7b 0d 0a 53 74 65 69 | 6e 62 65 72 67 2c 20 4a |r{..Stei|nberg, J|
|00003870| 44 4a 0d 0a 4f 65 74 6f | 6d 6f 2c 20 53 42 0d 0a |DJ..Oeto|mo, SB..|
|00003880| 4d 61 72 74 69 6a 6e 2c | 20 41 7d 0d 0a 24 41 66 |Martijn,| A}..$Af|
|00003890| 66 69 6c 69 61 74 69 6f | 6e 7b 55 6e 69 76 20 6f |filiatio|n{Univ o|
|000038a0| 66 20 47 72 6f 6e 69 6e | 67 65 6e 2c 20 54 68 65 |f Gronin|gen, The|
|000038b0| 20 4e 65 74 68 65 72 6c | 61 6e 64 73 7d 0d 0a 24 | Netherl|ands}..$|
|000038c0| 4a 6f 75 72 6e 61 6c 7b | 42 72 20 4a 20 52 61 64 |Journal{|Br J Rad|
|000038d0| 69 6f 6c 7d 0d 0a 24 56 | 6f 6c 75 6d 65 7b 36 33 |iol}..$V|olume{63|
|000038e0| 7d 0d 0a 24 50 61 67 65 | 7b 32 32 2d 32 35 7d 0d |}..$Page|{22-25}.|
|000038f0| 0a 24 44 61 74 65 7b 31 | 39 39 30 7d 0d 0a 24 59 |.$Date{1|990}..$Y|
|00003900| 42 56 6f 6c 7b 31 39 39 | 31 20 59 65 61 72 20 42 |BVol{199|1 Year B|
|00003910| 6f 6f 6b 20 6f 66 20 50 | 65 64 69 61 74 72 69 63 |ook of P|ediatric|
|00003920| 73 3a 7d 0d 0a 24 43 68 | 61 70 74 65 72 7b 31 31 |s:}..$Ch|apter{11|
|00003930| 2d 31 7d 0d 0a 24 59 42 | 45 64 69 74 6f 72 7b 44 |-1}..$YB|Editor{D|
|00003940| 72 73 2e 20 4f 73 6b 69 | 20 61 6e 64 20 53 74 6f |rs. Oski| and Sto|
|00003950| 63 6b 6d 61 6e 7d 0d 0a | 24 54 61 62 6c 65 7b 54 |ckman}..|$Table{T|
|00003960| 61 62 6c 65 20 4f 6d 69 | 74 74 65 64 7d 0d 0a 24 |able Omi|tted}..$|
|00003970| 43 6f 6d 6d 65 6e 74 61 | 74 6f 72 7b 7d 0d 0a 0d |Commenta|tor{}...|
|00003980| 0a 43 6f 70 79 72 69 67 | 68 74 20 28 43 29 20 59 |.Copyrig|ht (C) Y|
|00003990| 65 61 72 20 42 6f 6f 6b | 20 4d 65 64 69 63 61 6c |ear Book| Medical|
|000039a0| 20 50 75 62 6c 69 73 68 | 65 72 73 2c 20 49 6e 63 | Publish|ers, Inc|
|000039b0| 2e 20 31 39 39 31 0d 0a | 0d 0a 31 39 39 31 20 59 |. 1991..|..1991 Y|
|000039c0| 65 61 72 20 42 6f 6f 6b | 20 6f 66 20 50 65 64 69 |ear Book| of Pedi|
|000039d0| 61 74 72 69 63 73 3a 0d | 0a 0d 0a 43 68 61 70 74 |atrics:.|...Chapt|
|000039e0| 65 72 20 31 31 20 2d 2d | 20 54 68 65 20 52 65 73 |er 11 --| The Res|
|000039f0| 70 69 72 61 74 6f 72 79 | 20 54 72 61 63 74 0d 0a |piratory| Tract..|
|00003a00| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00003a10| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003a20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003a30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003a40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003a50| 0d 0a 41 73 79 6d 6d 65 | 74 72 69 63 61 6c 20 50 |..Asymme|trical P|
|00003a60| 75 6c 6d 6f 6e 61 72 79 | 20 43 68 61 6e 67 65 73 |ulmonary| Changes|
|00003a70| 20 69 6e 20 50 72 65 6d | 61 74 75 72 65 20 49 6e | in Prem|ature In|
|00003a80| 66 61 6e 74 73 20 57 69 | 74 68 20 53 75 72 67 69 |fants Wi|th Surgi|
|00003a90| 63 61 6c 20 43 6c 6f 73 | 75 72 65 20 6f 66 20 61 |cal Clos|ure of a|
|00003aa0| 0d 0a 50 65 72 73 69 73 | 74 65 6e 74 20 44 75 63 |..Persis|tent Duc|
|00003ab0| 74 75 73 20 41 72 74 65 | 72 69 6f 73 75 73 0d 0a |tus Arte|riosus..|
|00003ac0| 0d 0a 53 74 65 69 6e 62 | 65 72 67 20 4a 44 4a 3b |..Steinb|erg JDJ;|
|00003ad0| 20 4f 65 74 6f 6d 6f 20 | 53 42 3b 20 4d 61 72 74 | Oetomo |SB; Mart|
|00003ae0| 69 6a 6e 20 41 0d 0a 28 | 55 6e 69 76 20 6f 66 20 |ijn A..(|Univ of |
|00003af0| 47 72 6f 6e 69 6e 67 65 | 6e 2c 20 54 68 65 20 4e |Groninge|n, The N|
|00003b00| 65 74 68 65 72 6c 61 6e | 64 73 29 0d 0a 42 72 20 |etherlan|ds)..Br |
|00003b10| 4a 20 52 61 64 69 6f 6c | 20 36 33 3a 32 32 2d 32 |J Radiol| 63:22-2|
|00003b20| 35 2c 20 31 39 39 30 0d | 0a 2d 2d 2d 2d 2d 2d 2d |5, 1990.|.-------|
|00003b30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003b40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003b50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003b60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003b70| 2d 2d 2d 2d 2d 2d 2d 0d | 0a 0d 0a 41 62 73 74 72 |-------.|...Abstr|
|00003b80| 61 63 74 0d 0a 0d 0a 20 | 20 20 20 20 50 61 74 74 |act.... | Patt|
|00003b90| 65 72 6e 73 20 6f 66 20 | 62 72 6f 6e 63 68 6f 70 |erns of |bronchop|
|00003ba0| 75 6c 6d 6f 6e 61 72 79 | 20 64 61 6d 61 67 65 20 |ulmonary| damage |
|00003bb0| 77 65 72 65 20 73 74 75 | 64 69 65 64 20 69 6e 20 |were stu|died in |
|00003bc0| 35 38 20 70 72 65 6d 61 | 74 75 72 65 20 69 6e 66 |58 prema|ture inf|
|00003bd0| 61 6e 74 73 0d 0a 61 64 | 6d 69 74 74 65 64 20 63 |ants..ad|mitted c|
|00003be0| 6f 6e 73 65 63 75 74 69 | 76 65 6c 79 20 77 69 74 |onsecuti|vely wit|
|00003bf0| 68 20 61 20 64 69 61 67 | 6e 6f 73 69 73 20 6f 66 |h a diag|nosis of|
|00003c00| 20 68 79 61 6c 69 6e 65 | 20 6d 65 6d 62 72 61 6e | hyaline| membran|
|00003c10| 65 20 64 69 73 65 61 73 | 65 20 77 68 6f 0d 0a 72 |e diseas|e who..r|
|00003c20| 65 71 75 69 72 65 64 20 | 72 65 73 70 69 72 61 74 |equired |respirat|
|00003c30| 6f 72 79 20 74 68 65 72 | 61 70 79 2e 20 20 46 6f |ory ther|apy. Fo|
|00003c40| 72 74 79 2d 74 68 72 65 | 65 20 69 6e 66 61 6e 74 |rty-thre|e infant|
|00003c50| 73 20 68 61 64 20 61 20 | 70 61 74 65 6e 74 20 64 |s had a |patent d|
|00003c60| 75 63 74 75 73 0d 0a 61 | 72 74 65 72 69 6f 73 75 |uctus..a|rteriosu|
|00003c70| 73 2e 20 20 41 74 74 65 | 6d 70 74 65 64 20 63 6c |s. Atte|mpted cl|
|00003c80| 6f 73 75 72 65 20 77 69 | 74 68 20 69 6e 64 6f 6d |osure wi|th indom|
|00003c90| 65 74 68 61 63 69 6e 20 | 73 75 63 63 65 65 64 65 |ethacin |succeede|
|00003ca0| 64 20 69 6e 20 31 37 20 | 69 6e 66 61 6e 74 73 2c |d in 17 |infants,|
|00003cb0| 20 61 6e 64 0d 0a 32 35 | 20 6f 74 68 65 72 73 20 | and..25| others |
|00003cc0| 68 61 64 20 73 75 72 67 | 69 63 61 6c 20 63 6c 6f |had surg|ical clo|
|00003cd0| 73 75 72 65 2e 20 20 4f | 6e 65 20 69 6e 66 61 6e |sure. O|ne infan|
|00003ce0| 74 20 68 61 64 20 61 20 | 70 61 74 65 6e 74 20 64 |t had a |patent d|
|00003cf0| 75 63 74 75 73 20 70 6f | 73 74 20 6d 6f 72 74 65 |uctus po|st morte|
|00003d00| 6d 2e 0d 0a 54 68 65 20 | 33 20 67 72 6f 75 70 73 |m...The |3 groups|
|00003d10| 20 6f 66 20 69 6e 66 61 | 6e 74 73 20 77 65 72 65 | of infa|nts were|
|00003d20| 20 73 69 6d 69 6c 61 72 | 20 69 6e 20 62 69 72 74 | similar| in birt|
|00003d30| 68 20 77 65 69 67 68 74 | 2c 20 76 65 6e 74 69 6c |h weight|, ventil|
|00003d40| 61 74 69 6f 6e 20 70 72 | 65 73 73 75 72 65 2c 0d |ation pr|essure,.|
|00003d50| 0a 61 6e 64 20 63 6f 6e | 63 65 6e 74 72 61 74 69 |.and con|centrati|
|00003d60| 6f 6e 20 6f 66 20 6f 78 | 79 67 65 6e 2e 0d 0a 20 |on of ox|ygen... |
|00003d70| 20 20 20 20 54 68 65 72 | 65 20 77 65 72 65 20 35 | Ther|e were 5|
|00003d80| 31 20 70 6e 65 75 6d 6f | 74 68 6f 72 61 63 65 73 |1 pneumo|thoraces|
|00003d90| 2c 20 77 68 69 63 68 20 | 6c 61 73 74 65 64 20 66 |, which |lasted f|
|00003da0| 6f 72 20 61 6e 20 61 76 | 65 72 61 67 65 20 6f 66 |or an av|erage of|
|00003db0| 20 37 32 20 68 6f 75 72 | 73 2e 0d 0a 54 77 65 6c | 72 hour|s...Twel|
|00003dc0| 76 65 20 69 6e 66 61 6e | 74 73 20 68 61 64 20 61 |ve infan|ts had a|
|00003dd0| 73 79 6d 6d 65 74 72 69 | 63 20 70 75 6c 6d 6f 6e |symmetri|c pulmon|
|00003de0| 61 72 79 20 61 62 6e 6f | 72 6d 61 6c 69 74 69 65 |ary abno|rmalitie|
|00003df0| 73 2c 20 61 6e 64 20 69 | 6e 20 61 6c 6c 20 62 75 |s, and i|n all bu|
|00003e00| 74 20 31 20 74 68 65 0d | 0a 72 69 67 68 74 20 6c |t 1 the.|.right l|
|00003e10| 75 6e 67 20 77 61 73 20 | 6d 6f 72 65 20 6d 61 72 |ung was |more mar|
|00003e20| 6b 65 64 6c 79 20 61 66 | 66 65 63 74 65 64 2e 20 |kedly af|fected. |
|00003e30| 20 49 6e 66 61 6e 74 73 | 20 77 68 6f 20 68 61 64 | Infants| who had|
|00003e40| 20 73 75 72 67 69 63 61 | 6c 20 63 6c 6f 73 75 72 | surgica|l closur|
|00003e50| 65 20 6f 66 20 61 0d 0a | 70 61 74 65 6e 74 20 64 |e of a..|patent d|
|00003e60| 75 63 74 75 73 20 68 61 | 64 20 73 69 67 6e 69 66 |uctus ha|d signif|
|00003e70| 69 63 61 6e 74 6c 79 20 | 6d 6f 72 65 20 61 73 79 |icantly |more asy|
|00003e80| 6d 6d 65 74 72 69 63 20 | 62 72 6f 6e 63 68 6f 70 |mmetric |bronchop|
|00003e90| 75 6c 6d 6f 6e 61 72 79 | 20 64 61 6d 61 67 65 20 |ulmonary| damage |
|00003ea0| 28 46 69 67 0d 0a 31 31 | 2d 31 29 2e 20 20 49 74 |(Fig..11|-1). It|
|00003eb0| 20 61 70 70 65 61 72 73 | 20 74 68 61 74 20 6c 69 | appears| that li|
|00003ec0| 67 61 74 69 6f 6e 20 6f | 66 20 61 20 70 61 74 65 |gation o|f a pate|
|00003ed0| 6e 74 20 64 75 63 74 75 | 73 20 64 69 73 70 6f 73 |nt ductu|s dispos|
|00003ee0| 65 73 20 74 6f 20 6c 65 | 66 74 2d 73 69 64 65 64 |es to le|ft-sided|
|00003ef0| 0d 0a 70 6e 65 75 6d 6f | 74 68 6f 72 61 78 20 61 |..pneumo|thorax a|
|00003f00| 6e 64 20 61 6e 20 61 73 | 79 6d 6d 65 74 72 69 63 |nd an as|ymmetric|
|00003f10| 20 64 69 73 74 72 69 62 | 75 74 69 6f 6e 20 6f 66 | distrib|ution of|
|00003f20| 20 62 72 6f 6e 63 68 6f | 70 75 6c 6d 6f 6e 61 72 | broncho|pulmonar|
|00003f30| 79 20 64 61 6d 61 67 65 | 2c 20 77 69 74 68 0d 0a |y damage|, with..|
|00003f40| 6d 6f 72 65 20 73 65 72 | 69 6f 75 73 20 69 6e 76 |more ser|ious inv|
|00003f50| 6f 6c 76 65 6d 65 6e 74 | 20 6f 66 20 74 68 65 20 |olvement| of the |
|00003f60| 72 69 67 68 74 20 6c 75 | 6e 67 2e 0d 0a 24 55 6e |right lu|ng...$Un|
|00003f70| 69 71 75 65 5f 49 44 7b | 59 52 42 30 33 30 30 35 |ique_ID{|YRB03005|
|00003f80| 7d 0d 0a 24 54 69 74 6c | 65 7b 4c 75 6e 67 20 46 |}..$Titl|e{Lung F|
|00003f90| 75 6e 63 74 69 6f 6e 20 | 69 6e 20 43 68 69 6c 64 |unction |in Child|
|00003fa0| 72 65 6e 20 6f 66 20 4c | 6f 77 20 42 69 72 74 68 |ren of L|ow Birth|
|00003fb0| 20 57 65 69 67 68 74 7d | 0d 0a 24 41 75 74 68 6f | Weight}|..$Autho|
|00003fc0| 72 7b 0d 0a 43 68 61 6e | 2c 20 4b 4e 0d 0a 4e 6f |r{..Chan|, KN..No|
|00003fd0| 62 6c 65 2d 4a 61 6d 69 | 65 73 6f 6e 2c 20 43 4d |ble-Jami|eson, CM|
|00003fe0| 0d 0a 45 6c 6c 69 6d 61 | 6e 2c 20 41 0d 0a 42 72 |..Ellima|n, A..Br|
|00003ff0| 79 61 6e 2c 20 45 4d 0d | 0a 53 69 6c 76 65 72 6d |yan, EM.|.Silverm|
|00004000| 61 6e 2c 20 4d 7d 0d 0a | 24 41 66 66 69 6c 69 61 |an, M}..|$Affilia|
|00004010| 74 69 6f 6e 7b 52 6f 79 | 61 6c 20 50 6f 73 74 67 |tion{Roy|al Postg|
|00004020| 72 61 64 20 4d 65 64 20 | 53 63 68 6f 6f 6c 3b 20 |rad Med |School; |
|00004030| 48 61 6d 6d 65 72 73 6d | 69 74 68 20 48 6f 73 70 |Hammersm|ith Hosp|
|00004040| 3b 20 51 75 65 65 6e 20 | 43 68 61 72 6c 6f 74 74 |; Queen |Charlott|
|00004050| 65 27 73 0d 0a 4d 61 74 | 65 72 6e 69 74 79 20 48 |e's..Mat|ernity H|
|00004060| 6f 73 70 2c 20 4c 6f 6e | 64 6f 6e 7d 0d 0a 24 4a |osp, Lon|don}..$J|
|00004070| 6f 75 72 6e 61 6c 7b 41 | 72 63 68 20 44 69 73 20 |ournal{A|rch Dis |
|00004080| 43 68 69 6c 64 7d 0d 0a | 24 56 6f 6c 75 6d 65 7b |Child}..|$Volume{|
|00004090| 36 34 7d 0d 0a 24 50 61 | 67 65 7b 31 32 38 34 2d |64}..$Pa|ge{1284-|
|000040a0| 31 32 39 33 7d 0d 0a 24 | 44 61 74 65 7b 31 39 38 |1293}..$|Date{198|
|000040b0| 39 7d 0d 0a 24 59 42 56 | 6f 6c 7b 31 39 39 31 20 |9}..$YBV|ol{1991 |
|000040c0| 59 65 61 72 20 42 6f 6f | 6b 20 6f 66 20 50 65 64 |Year Boo|k of Ped|
|000040d0| 69 61 74 72 69 63 73 3a | 7d 0d 0a 24 43 68 61 70 |iatrics:|}..$Chap|
|000040e0| 74 65 72 7b 31 31 2d 32 | 7d 0d 0a 24 59 42 45 64 |ter{11-2|}..$YBEd|
|000040f0| 69 74 6f 72 7b 44 72 73 | 2e 20 4f 73 6b 69 20 61 |itor{Drs|. Oski a|
|00004100| 6e 64 20 53 74 6f 63 6b | 6d 61 6e 7d 0d 0a 24 54 |nd Stock|man}..$T|
|00004110| 61 62 6c 65 7b 54 61 62 | 6c 65 20 4f 6d 69 74 74 |able{Tab|le Omitt|
|00004120| 65 64 7d 0d 0a 24 43 6f | 6d 6d 65 6e 74 61 74 6f |ed}..$Co|mmentato|
|00004130| 72 7b 4a 2e 41 2e 20 53 | 74 6f 63 6b 6d 61 6e 2c |r{J.A. S|tockman,|
|00004140| 20 49 49 49 2c 20 4d 2e | 44 2e 7d 0d 0a 0d 0a 43 | III, M.|D.}....C|
|00004150| 6f 70 79 72 69 67 68 74 | 20 28 43 29 20 59 65 61 |opyright| (C) Yea|
|00004160| 72 20 42 6f 6f 6b 20 4d | 65 64 69 63 61 6c 20 50 |r Book M|edical P|
|00004170| 75 62 6c 69 73 68 65 72 | 73 2c 20 49 6e 63 2e 20 |ublisher|s, Inc. |
|00004180| 31 39 39 31 0d 0a 0d 0a | 31 39 39 31 20 59 65 61 |1991....|1991 Yea|
|00004190| 72 20 42 6f 6f 6b 20 6f | 66 20 50 65 64 69 61 74 |r Book o|f Pediat|
|000041a0| 72 69 63 73 3a 0d 0a 0d | 0a 43 68 61 70 74 65 72 |rics:...|.Chapter|
|000041b0| 20 31 31 20 2d 2d 20 54 | 68 65 20 52 65 73 70 69 | 11 -- T|he Respi|
|000041c0| 72 61 74 6f 72 79 20 54 | 72 61 63 74 0d 0a 0d 0a |ratory T|ract....|
|000041d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000041e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000041f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004200| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004210| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|00004220| 4c 75 6e 67 20 46 75 6e | 63 74 69 6f 6e 20 69 6e |Lung Fun|ction in|
|00004230| 20 43 68 69 6c 64 72 65 | 6e 20 6f 66 20 4c 6f 77 | Childre|n of Low|
|00004240| 20 42 69 72 74 68 20 57 | 65 69 67 68 74 0d 0a 0d | Birth W|eight...|
|00004250| 0a 43 68 61 6e 20 4b 4e | 3b 20 4e 6f 62 6c 65 2d |.Chan KN|; Noble-|
|00004260| 4a 61 6d 69 65 73 6f 6e | 20 43 4d 3b 20 45 6c 6c |Jamieson| CM; Ell|
|00004270| 69 6d 61 6e 20 41 3b 20 | 42 72 79 61 6e 20 45 4d |iman A; |Bryan EM|
|00004280| 3b 20 53 69 6c 76 65 72 | 6d 61 6e 20 4d 0d 0a 28 |; Silver|man M..(|
|00004290| 52 6f 79 61 6c 20 50 6f | 73 74 67 72 61 64 20 4d |Royal Po|stgrad M|
|000042a0| 65 64 20 53 63 68 6f 6f | 6c 3b 20 48 61 6d 6d 65 |ed Schoo|l; Hamme|
|000042b0| 72 73 6d 69 74 68 20 48 | 6f 73 70 3b 20 51 75 65 |rsmith H|osp; Que|
|000042c0| 65 6e 20 43 68 61 72 6c | 6f 74 74 65 27 73 20 4d |en Charl|otte's M|
|000042d0| 61 74 65 72 6e 69 74 79 | 0d 0a 48 6f 73 70 2c 20 |aternity|..Hosp, |
|000042e0| 4c 6f 6e 64 6f 6e 29 20 | 41 72 63 68 20 44 69 73 |London) |Arch Dis|
|000042f0| 20 43 68 69 6c 64 20 36 | 34 3a 31 32 38 34 2d 31 | Child 6|4:1284-1|
|00004300| 32 39 33 2c 20 31 39 38 | 39 0d 0a 2d 2d 2d 2d 2d |293, 198|9..-----|
|00004310| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004320| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004330| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004340| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004350| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 0d 0a 0d 0a 41 62 73 |--------|-....Abs|
|00004360| 74 72 61 63 74 0d 0a 0d | 0a 20 20 20 20 20 50 72 |tract...|. Pr|
|00004370| 65 74 65 72 6d 20 69 6e | 66 61 6e 74 73 20 77 69 |eterm in|fants wi|
|00004380| 74 68 20 6e 65 6f 6e 61 | 74 61 6c 20 72 65 73 70 |th neona|tal resp|
|00004390| 69 72 61 74 6f 72 79 20 | 64 69 73 6f 72 64 65 72 |iratory |disorder|
|000043a0| 73 20 63 61 6e 20 73 75 | 73 74 61 69 6e 20 73 65 |s can su|stain se|
|000043b0| 76 65 72 65 0d 0a 6c 75 | 6e 67 20 69 6e 6a 75 72 |vere..lu|ng injur|
|000043c0| 79 20 77 68 69 6c 65 20 | 6f 6e 20 6d 65 63 68 61 |y while |on mecha|
|000043d0| 6e 69 63 61 6c 20 76 65 | 6e 74 69 6c 61 74 69 6f |nical ve|ntilatio|
|000043e0| 6e 2e 20 20 54 6f 20 64 | 65 74 65 72 6d 69 6e 65 |n. To d|etermine|
|000043f0| 20 74 68 65 20 6c 6f 6e | 67 2d 74 65 72 6d 0d 0a | the lon|g-term..|
|00004400| 65 66 66 65 63 74 73 20 | 6f 66 20 6e 65 6f 6e 61 |effects |of neona|
|00004410| 74 61 6c 20 72 65 73 70 | 69 72 61 74 6f 72 79 20 |tal resp|iratory |
|00004420| 74 72 65 61 74 6d 65 6e | 74 20 6f 6e 20 6c 75 6e |treatmen|t on lun|
|00004430| 67 20 66 75 6e 63 74 69 | 6f 6e 2c 20 61 20 63 6f |g functi|on, a co|
|00004440| 68 6f 72 74 20 6f 66 20 | 31 33 30 0d 0a 63 68 69 |hort of |130..chi|
|00004450| 6c 64 72 65 6e 20 77 68 | 6f 20 77 65 69 67 68 65 |ldren wh|o weighe|
|00004460| 64 20 6c 65 73 73 20 74 | 68 61 6e 20 32 2c 30 30 |d less t|han 2,00|
|00004470| 30 20 67 20 61 74 20 62 | 69 72 74 68 20 77 65 72 |0 g at b|irth wer|
|00004480| 65 20 65 78 61 6d 69 6e | 65 64 20 61 74 20 37 20 |e examin|ed at 7 |
|00004490| 79 65 61 72 73 20 6f 66 | 0d 0a 61 67 65 2e 20 20 |years of|..age. |
|000044a0| 54 68 65 69 72 20 6c 75 | 6e 67 20 66 75 6e 63 74 |Their lu|ng funct|
|000044b0| 69 6f 6e 20 77 61 73 20 | 72 65 6c 61 74 65 64 20 |ion was |related |
|000044c0| 74 6f 20 62 69 72 74 68 | 20 77 65 69 67 68 74 2c |to birth| weight,|
|000044d0| 20 70 65 72 69 6e 61 74 | 61 6c 20 66 61 63 74 6f | perinat|al facto|
|000044e0| 72 73 2c 20 61 6e 64 0d | 0a 74 68 65 20 6c 65 76 |rs, and.|.the lev|
|000044f0| 65 6c 20 6f 66 20 6e 65 | 6f 6e 61 74 61 6c 20 69 |el of ne|onatal i|
|00004500| 6e 74 65 6e 73 69 76 65 | 20 63 61 72 65 20 72 65 |ntensive| care re|
|00004510| 63 65 69 76 65 64 2e 20 | 20 41 73 20 63 6f 6e 74 |ceived. | As cont|
|00004520| 72 6f 6c 73 2c 20 31 32 | 30 20 75 6e 73 65 6c 65 |rols, 12|0 unsele|
|00004530| 63 74 65 64 0d 0a 73 63 | 68 6f 6f 6c 63 68 69 6c |cted..sc|hoolchil|
|00004540| 64 72 65 6e 20 6f 66 20 | 74 68 65 20 73 61 6d 65 |dren of |the same|
|00004550| 20 61 67 65 20 77 65 72 | 65 20 61 6c 73 6f 20 65 | age wer|e also e|
|00004560| 78 61 6d 69 6e 65 64 2e | 20 20 54 68 65 20 63 68 |xamined.| The ch|
|00004570| 69 6c 64 72 65 6e 20 69 | 6e 20 62 6f 74 68 0d 0a |ildren i|n both..|
|00004580| 67 72 6f 75 70 73 20 77 | 65 72 65 20 73 69 6d 69 |groups w|ere simi|
|00004590| 6c 61 72 20 69 6e 20 68 | 65 69 67 68 74 20 61 6e |lar in h|eight an|
|000045a0| 64 20 66 6f 72 63 65 64 | 20 76 69 74 61 6c 20 63 |d forced| vital c|
|000045b0| 61 70 61 63 69 74 79 2c | 20 62 75 74 20 74 68 65 |apacity,| but the|
|000045c0| 20 67 72 6f 75 70 20 77 | 69 74 68 0d 0a 6c 6f 77 | group w|ith..low|
|000045d0| 20 62 69 72 74 68 20 77 | 65 69 67 68 74 20 68 61 | birth w|eight ha|
|000045e0| 64 20 73 69 67 6e 69 66 | 69 63 61 6e 74 6c 79 20 |d signif|icantly |
|000045f0| 6c 6f 77 65 72 20 66 6f | 72 63 65 64 20 65 78 70 |lower fo|rced exp|
|00004600| 69 72 61 74 6f 72 79 20 | 76 6f 6c 75 6d 65 20 69 |iratory |volume i|
|00004610| 6e 20 2e 37 35 0d 0a 73 | 65 63 6f 6e 64 20 61 6e |n .75..s|econd an|
|00004620| 64 20 65 78 70 69 72 61 | 74 6f 72 79 20 66 6c 6f |d expira|tory flo|
|00004630| 77 20 69 6e 64 69 63 65 | 73 2e 20 20 4e 65 6f 6e |w indice|s. Neon|
|00004640| 61 74 61 6c 20 72 65 73 | 70 69 72 61 74 6f 72 79 |atal res|piratory|
|00004650| 20 69 6c 6c 6e 65 73 73 | 20 77 61 73 0d 0a 61 73 | illness| was..as|
|00004660| 73 6f 63 69 61 74 65 64 | 20 77 69 74 68 20 64 65 |sociated| with de|
|00004670| 63 72 65 61 73 65 64 20 | 61 69 72 77 61 79 20 66 |creased |airway f|
|00004680| 75 6e 63 74 69 6f 6e 2c | 20 62 75 74 20 74 68 69 |unction,| but thi|
|00004690| 73 20 66 69 6e 64 69 6e | 67 20 77 61 73 20 6e 6f |s findin|g was no|
|000046a0| 74 20 70 72 6f 76 65 6e | 20 74 6f 0d 0a 62 65 20 |t proven| to..be |
|000046b0| 61 20 72 65 73 75 6c 74 | 20 6f 66 20 6f 78 79 67 |a result| of oxyg|
|000046c0| 65 6e 20 74 72 65 61 74 | 6d 65 6e 74 20 6f 72 20 |en treat|ment or |
|000046d0| 6d 65 63 68 61 6e 69 63 | 61 6c 20 76 65 6e 74 69 |mechanic|al venti|
|000046e0| 6c 61 74 69 6f 6e 2e 20 | 20 48 6f 77 65 76 65 72 |lation. | However|
|000046f0| 2c 20 6c 6f 77 20 62 69 | 72 74 68 0d 0a 77 65 69 |, low bi|rth..wei|
|00004700| 67 68 74 20 77 61 73 20 | 61 73 73 6f 63 69 61 74 |ght was |associat|
|00004710| 65 64 20 63 6c 6f 73 65 | 6c 79 20 77 69 74 68 20 |ed close|ly with |
|00004720| 70 6f 6f 72 20 61 69 72 | 77 61 79 20 66 75 6e 63 |poor air|way func|
|00004730| 74 69 6f 6e 20 69 6e 64 | 65 70 65 6e 64 65 6e 74 |tion ind|ependent|
|00004740| 20 6f 66 0d 0a 72 65 73 | 70 69 72 61 74 6f 72 79 | of..res|piratory|
|00004750| 20 69 6c 6c 6e 65 73 73 | 20 69 6e 20 74 68 65 20 | illness| in the |
|00004760| 6e 65 6f 6e 61 74 61 6c | 20 70 65 72 69 6f 64 2e |neonatal| period.|
|00004770| 20 20 4d 61 6c 65 20 67 | 65 6e 64 65 72 20 61 6e | Male g|ender an|
|00004780| 64 20 6d 61 74 65 72 6e | 61 6c 20 73 6d 6f 6b 69 |d matern|al smoki|
|00004790| 6e 67 0d 0a 77 65 72 65 | 20 6f 74 68 65 72 20 69 |ng..were| other i|
|000047a0| 6d 70 6f 72 74 61 6e 74 | 20 66 61 63 74 6f 72 73 |mportant| factors|
|000047b0| 2e 20 20 54 68 65 20 64 | 65 63 72 65 61 73 65 20 |. The d|ecrease |
|000047c0| 69 6e 20 61 69 72 77 61 | 79 20 66 75 6e 63 74 69 |in airwa|y functi|
|000047d0| 6f 6e 20 6e 6f 74 65 64 | 20 69 6e 20 74 68 65 0d |on noted| in the.|
|000047e0| 0a 6c 6f 77 2d 62 69 72 | 74 68 2d 77 65 69 67 68 |.low-bir|th-weigh|
|000047f0| 74 20 63 68 69 6c 64 72 | 65 6e 20 77 61 73 20 72 |t childr|en was r|
|00004800| 65 6c 61 74 65 64 20 74 | 6f 20 63 6f 75 67 68 20 |elated t|o cough |
|00004810| 62 75 74 20 6e 6f 74 20 | 77 68 65 65 7a 65 2e 0d |but not |wheeze..|
|00004820| 0a 20 20 20 20 20 54 68 | 65 20 64 69 73 70 61 72 |. Th|e dispar|
|00004830| 69 74 79 20 62 65 74 77 | 65 65 6e 20 66 61 69 72 |ity betw|een fair|
|00004840| 6c 79 20 77 65 6c 6c 2d | 70 72 65 73 65 72 76 65 |ly well-|preserve|
|00004850| 64 20 76 69 74 61 6c 20 | 63 61 70 61 63 69 74 79 |d vital |capacity|
|00004860| 20 61 6e 64 20 64 65 63 | 72 65 61 73 65 64 0d 0a | and dec|reased..|
|00004870| 61 69 72 77 61 79 20 66 | 75 6e 63 74 69 6f 6e 20 |airway f|unction |
|00004880| 73 75 67 67 65 73 74 73 | 20 74 68 61 74 20 76 65 |suggests| that ve|
|00004890| 72 79 20 6c 6f 77 20 62 | 69 72 74 68 20 77 65 69 |ry low b|irth wei|
|000048a0| 67 68 74 20 68 61 73 20 | 69 74 73 20 67 72 65 61 |ght has |its grea|
|000048b0| 74 65 73 74 20 65 66 66 | 65 63 74 20 6f 6e 0d 0a |test eff|ect on..|
|000048c0| 74 68 65 20 73 75 62 73 | 65 71 75 65 6e 74 20 67 |the subs|equent g|
|000048d0| 72 6f 77 74 68 20 6f 66 | 20 61 69 72 77 61 79 20 |rowth of| airway |
|000048e0| 66 75 6e 63 74 69 6f 6e | 2e 20 20 54 68 65 20 6c |function|. The l|
|000048f0| 61 63 6b 20 6f 66 20 61 | 73 73 6f 63 69 61 74 69 |ack of a|ssociati|
|00004900| 6f 6e 20 62 65 74 77 65 | 65 6e 20 74 68 65 0d 0a |on betwe|en the..|
|00004910| 6e 65 6f 6e 61 74 61 6c | 20 6f 78 79 67 65 6e 20 |neonatal| oxygen |
|00004920| 73 63 6f 72 65 20 6f 72 | 20 6d 65 63 68 61 6e 69 |score or| mechani|
|00004930| 63 61 6c 20 76 65 6e 74 | 69 6c 61 74 69 6f 6e 20 |cal vent|ilation |
|00004940| 61 6e 64 20 63 68 69 6c | 64 68 6f 6f 64 20 6c 75 |and chil|dhood lu|
|00004950| 6e 67 20 66 75 6e 63 74 | 69 6f 6e 0d 0a 69 6d 70 |ng funct|ion..imp|
|00004960| 6c 69 65 73 20 74 68 61 | 74 20 74 68 65 20 6c 6f |lies tha|t the lo|
|00004970| 6e 67 2d 74 65 72 6d 20 | 65 66 66 65 63 74 20 6f |ng-term |effect o|
|00004980| 66 20 6e 65 6f 6e 61 74 | 61 6c 20 72 65 73 70 69 |f neonat|al respi|
|00004990| 72 61 74 6f 72 79 20 74 | 68 65 72 61 70 79 20 69 |ratory t|herapy i|
|000049a0| 73 20 6e 6f 74 20 61 73 | 0d 0a 69 6d 70 6f 72 74 |s not as|..import|
|000049b0| 61 6e 74 20 61 73 20 62 | 69 72 74 68 20 77 65 69 |ant as b|irth wei|
|000049c0| 67 68 74 2c 20 6d 61 74 | 65 72 6e 61 6c 20 73 6d |ght, mat|ernal sm|
|000049d0| 6f 6b 69 6e 67 2c 20 61 | 6e 64 20 6d 61 6c 65 20 |oking, a|nd male |
|000049e0| 67 65 6e 64 65 72 20 28 | 46 69 67 20 31 31 2d 32 |gender (|Fig 11-2|
|000049f0| 29 2e 0d 0a 0d 0a 50 6f | 73 74 2d 43 6f 6d 6d 65 |).....Po|st-Comme|
|00004a00| 6e 74 0d 0a 0d 0a 20 20 | 20 20 20 49 6e 74 65 72 |nt.... | Inter|
|00004a10| 65 73 74 20 69 6e 20 77 | 68 61 74 20 68 61 70 70 |est in w|hat happ|
|00004a20| 65 6e 73 20 74 6f 20 74 | 68 65 20 70 75 6c 6d 6f |ens to t|he pulmo|
|00004a30| 6e 61 72 79 20 73 74 61 | 74 75 73 20 6f 66 20 67 |nary sta|tus of g|
|00004a40| 72 61 64 75 61 74 65 73 | 20 6f 66 20 6f 75 72 0d |raduates| of our.|
|00004a50| 0a 6e 75 72 73 65 72 69 | 65 73 20 63 6f 6e 74 69 |.nurseri|es conti|
|00004a60| 6e 75 65 73 20 74 6f 20 | 6d 6f 75 6e 74 2e 20 20 |nues to |mount. |
|00004a70| 54 68 75 73 20 74 68 65 | 20 72 65 61 73 6f 6e 20 |Thus the| reason |
|00004a80| 66 6f 72 20 74 68 65 20 | 32 20 61 72 74 69 63 6c |for the |2 articl|
|00004a90| 65 73 20 61 62 73 74 72 | 61 63 74 65 64 0d 0a 61 |es abstr|acted..a|
|00004aa0| 62 6f 76 65 2e 0d 0a 20 | 20 20 20 20 53 74 65 69 |bove... | Stei|
|00004ab0| 6e 62 65 72 67 20 65 74 | 20 61 6c 2e 20 28 41 62 |nberg et| al. (Ab|
|00004ac0| 73 74 72 61 63 74 20 31 | 31 2d 31 29 20 67 69 76 |stract 1|1-1) giv|
|00004ad0| 65 20 75 73 20 61 20 63 | 6c 75 65 20 74 6f 20 65 |e us a c|lue to e|
|00004ae0| 78 70 6c 61 69 6e 20 77 | 68 79 20 77 65 20 68 61 |xplain w|hy we ha|
|00004af0| 76 65 0d 0a 62 65 65 6e | 20 73 65 65 69 6e 67 20 |ve..been| seeing |
|00004b00| 61 20 70 61 74 63 68 79 | 20 64 69 73 74 72 69 62 |a patchy| distrib|
|00004b10| 75 74 69 6f 6e 20 6f 66 | 20 70 75 6c 6d 6f 6e 61 |ution of| pulmona|
|00004b20| 72 79 20 64 69 73 65 61 | 73 65 20 69 6e 20 70 72 |ry disea|se in pr|
|00004b30| 65 74 65 72 6d 20 69 6e | 66 61 6e 74 73 2e 20 20 |eterm in|fants. |
|00004b40| 49 66 0d 0a 61 20 70 61 | 72 74 69 63 75 6c 61 72 |If..a pa|rticular|
|00004b50| 20 69 6e 66 61 6e 74 20 | 69 73 20 6f 70 65 72 61 | infant |is opera|
|00004b60| 74 65 64 20 6f 6e 20 66 | 6f 72 20 73 75 72 67 69 |ted on f|or surgi|
|00004b70| 63 61 6c 20 63 6c 6f 73 | 75 72 65 20 6f 66 20 61 |cal clos|ure of a|
|00004b80| 20 70 61 74 65 6e 74 20 | 64 75 63 74 75 73 0d 0a | patent |ductus..|
|00004b90| 61 72 74 65 72 69 6f 73 | 75 73 2c 20 69 74 20 69 |arterios|us, it i|
|00004ba0| 73 20 73 69 67 6e 69 66 | 69 63 61 6e 74 6c 79 20 |s signif|icantly |
|00004bb0| 6d 6f 72 65 20 6c 69 6b | 65 6c 79 20 74 68 61 74 |more lik|ely that|
|00004bc0| 20 61 73 79 6d 6d 65 74 | 72 69 63 20 63 68 61 6e | asymmet|ric chan|
|00004bd0| 67 65 73 20 77 69 6c 6c | 20 62 65 0d 0a 6f 62 73 |ges will| be..obs|
|00004be0| 65 72 76 65 64 20 6f 6e | 20 74 68 65 20 63 68 65 |erved on| the che|
|00004bf0| 73 74 20 78 2d 72 61 79 | 20 66 69 6c 6d 2e 20 20 |st x-ray| film. |
|00004c00| 41 73 20 6e 6f 74 65 64 | 2c 20 74 68 65 72 65 20 |As noted|, there |
|00004c10| 61 72 65 20 73 69 67 6e | 69 66 69 63 61 6e 74 6c |are sign|ificantl|
|00004c20| 79 20 66 65 77 65 72 0d | 0a 72 61 64 69 6f 6c 6f |y fewer.|.radiolo|
|00004c30| 67 69 63 20 66 69 6e 64 | 69 6e 67 73 20 6f 6e 20 |gic find|ings on |
|00004c40| 74 68 65 20 6c 65 66 74 | 20 73 69 64 65 20 74 68 |the left| side th|
|00004c50| 61 6e 20 6f 6e 20 74 68 | 65 20 72 69 67 68 74 20 |an on th|e right |
|00004c60| 73 69 64 65 20 69 66 20 | 61 20 70 61 74 65 6e 74 |side if |a patent|
|00004c70| 20 64 75 63 74 75 73 0d | 0a 61 72 74 65 72 69 6f | ductus.|.arterio|
|00004c80| 73 75 73 20 6c 69 67 61 | 74 69 6f 6e 20 68 61 73 |sus liga|tion has|
|00004c90| 20 74 61 6b 65 6e 20 70 | 6c 61 63 65 2e 0d 0a 20 | taken p|lace... |
|00004ca0| 20 20 20 20 53 6f 20 77 | 68 61 74 20 68 61 70 70 | So w|hat happ|
|00004cb0| 65 6e 73 20 74 6f 20 74 | 68 65 73 65 20 62 61 62 |ens to t|hese bab|
|00004cc0| 69 65 73 20 77 68 65 6e | 20 74 68 65 79 20 67 65 |ies when| they ge|
|00004cd0| 74 20 6f 75 74 20 6f 66 | 20 74 68 65 20 6e 75 72 |t out of| the nur|
|00004ce0| 73 65 72 79 3f 20 20 43 | 68 61 6e 0d 0a 65 74 20 |sery? C|han..et |
|00004cf0| 61 6c 2e 20 28 41 62 73 | 74 72 61 63 74 20 31 31 |al. (Abs|tract 11|
|00004d00| 2d 32 29 20 65 78 61 6d | 69 6e 65 64 20 61 20 6c |-2) exam|ined a l|
|00004d10| 61 72 67 65 20 67 72 6f | 75 70 20 6f 66 20 6e 75 |arge gro|up of nu|
|00004d20| 72 73 65 72 79 20 67 72 | 61 64 75 61 74 65 73 20 |rsery gr|aduates |
|00004d30| 77 68 65 6e 20 74 68 65 | 79 0d 0a 72 65 61 63 68 |when the|y..reach|
|00004d40| 65 64 20 74 68 65 69 72 | 20 73 65 76 65 6e 74 68 |ed their| seventh|
|00004d50| 20 62 69 72 74 68 64 61 | 79 2e 20 20 41 6c 6c 20 | birthda|y. All |
|00004d60| 69 6e 66 61 6e 74 73 20 | 77 68 6f 20 77 65 72 65 |infants |who were|
|00004d70| 20 66 6f 6c 6c 6f 77 65 | 64 20 77 65 69 67 68 65 | followe|d weighe|
|00004d80| 64 20 6c 65 73 73 0d 0a | 74 68 61 6e 20 32 2c 30 |d less..|than 2,0|
|00004d90| 30 30 20 67 20 61 74 20 | 62 69 72 74 68 2e 20 20 |00 g at |birth. |
|00004da0| 57 68 61 74 20 77 61 73 | 20 66 6f 75 6e 64 20 61 |What was| found a|
|00004db0| 66 74 65 72 20 37 20 79 | 65 61 72 73 20 77 61 73 |fter 7 y|ears was|
|00004dc0| 20 74 68 61 74 20 6d 65 | 63 68 61 6e 69 63 61 6c | that me|chanical|
|00004dd0| 0d 0a 76 65 6e 74 69 6c | 61 74 69 6f 6e 20 64 75 |..ventil|ation du|
|00004de0| 72 69 6e 67 20 74 68 65 | 20 6e 65 6f 6e 61 74 61 |ring the| neonata|
|00004df0| 6c 20 70 65 72 69 6f 64 | 20 77 61 73 20 6e 6f 74 |l period| was not|
|00004e00| 20 61 73 73 6f 63 69 61 | 74 65 64 20 77 69 74 68 | associa|ted with|
|00004e10| 20 69 6e 63 72 65 61 73 | 65 64 0d 0a 73 79 6d 70 | increas|ed..symp|
|00004e20| 74 6f 6d 73 20 74 68 61 | 74 20 77 65 72 65 20 69 |toms tha|t were i|
|00004e30| 6e 64 65 70 65 6e 64 65 | 6e 74 20 6f 66 20 6f 78 |ndepende|nt of ox|
|00004e40| 79 67 65 6e 20 75 73 65 | 2e 20 20 4c 6f 77 2d 62 |ygen use|. Low-b|
|00004e50| 69 72 74 68 2d 77 65 69 | 67 68 74 20 63 68 69 6c |irth-wei|ght chil|
|00004e60| 64 72 65 6e 20 77 65 72 | 65 0d 0a 6e 6f 20 6d 6f |dren wer|e..no mo|
|00004e70| 72 65 20 6c 69 6b 65 6c | 79 20 74 6f 20 77 68 65 |re likel|y to whe|
|00004e80| 65 7a 65 20 74 68 61 6e | 20 61 20 63 6f 6e 74 72 |eze than| a contr|
|00004e90| 6f 6c 20 67 72 6f 75 70 | 2e 20 20 54 68 65 79 20 |ol group|. They |
|00004ea0| 68 61 64 20 61 20 76 65 | 72 79 20 70 72 6f 6d 69 |had a ve|ry promi|
|00004eb0| 6e 65 6e 74 0d 0a 73 79 | 6d 70 74 6f 6d 2c 20 68 |nent..sy|mptom, h|
|00004ec0| 6f 77 65 76 65 72 2e 20 | 20 54 68 69 73 20 77 61 |owever. | This wa|
|00004ed0| 73 20 61 20 66 72 65 71 | 75 65 6e 74 20 61 6e 64 |s a freq|uent and|
|00004ee0| 20 74 72 6f 75 62 6c 65 | 73 6f 6d 65 20 63 6f 75 | trouble|some cou|
|00004ef0| 67 68 2c 20 6e 6f 74 65 | 64 0d 0a 70 61 72 74 69 |gh, note|d..parti|
|00004f00| 63 75 6c 61 72 6c 79 20 | 69 6e 20 69 6e 66 61 6e |cularly |in infan|
|00004f10| 74 73 20 77 65 69 67 68 | 69 6e 67 20 6c 65 73 73 |ts weigh|ing less|
|00004f20| 20 74 68 61 6e 20 31 2c | 35 30 30 20 67 20 61 74 | than 1,|500 g at|
|00004f30| 20 62 69 72 74 68 2e 20 | 20 41 73 20 77 69 74 68 | birth. | As with|
|00004f40| 20 6d 61 6e 79 0d 0a 73 | 74 75 64 69 65 73 20 70 | many..s|tudies p|
|00004f50| 72 65 63 65 64 69 6e 67 | 20 74 68 69 73 20 6f 6e |receding| this on|
|00004f60| 65 2c 20 6d 61 74 65 72 | 6e 61 6c 20 73 6d 6f 6b |e, mater|nal smok|
|00004f70| 69 6e 67 20 77 61 73 20 | 61 73 73 6f 63 69 61 74 |ing was |associat|
|00004f80| 65 64 20 77 69 74 68 20 | 69 6e 63 72 65 61 73 65 |ed with |increase|
|00004f90| 64 0d 0a 70 75 6c 6d 6f | 6e 61 72 79 20 73 79 6d |d..pulmo|nary sym|
|00004fa0| 70 74 6f 6d 61 74 6f 6c | 6f 67 79 20 69 6e 20 74 |ptomatol|ogy in t|
|00004fb0| 68 65 20 66 69 72 73 74 | 20 37 20 79 65 61 72 73 |he first| 7 years|
|00004fc0| 20 6f 66 20 6c 69 66 65 | 20 69 6e 20 73 75 72 76 | of life| in surv|
|00004fd0| 69 76 6f 72 73 20 6f 66 | 20 74 68 65 0d 0a 6e 65 |ivors of| the..ne|
|00004fe0| 6f 6e 61 74 61 6c 20 69 | 6e 74 65 6e 73 69 76 65 |onatal i|ntensive|
|00004ff0| 20 63 61 72 65 20 75 6e | 69 74 2e 0d 0a 20 20 20 | care un|it... |
|00005000| 20 20 49 74 20 73 65 65 | 6d 73 20 6f 62 76 69 6f | It see|ms obvio|
|00005010| 75 73 20 74 68 61 74 20 | 77 68 61 74 65 76 65 72 |us that |whatever|
|00005020| 20 77 65 20 6c 65 61 72 | 6e 20 6f 66 20 72 65 73 | we lear|n of res|
|00005030| 70 69 72 61 74 6f 72 79 | 20 73 79 6d 70 74 6f 6d |piratory| symptom|
|00005040| 73 20 6c 61 74 65 72 20 | 69 6e 0d 0a 74 68 65 20 |s later |in..the |
|00005050| 6c 69 66 65 20 6f 66 20 | 63 68 69 6c 64 72 65 6e |life of |children|
|00005060| 20 6f 66 20 6c 6f 77 20 | 62 69 72 74 68 20 77 65 | of low |birth we|
|00005070| 69 67 68 74 20 6f 75 67 | 68 74 20 74 6f 20 62 65 |ight oug|ht to be|
|00005080| 20 6c 65 61 72 6e 69 6e | 67 20 73 75 73 63 65 70 | learnin|g suscep|
|00005090| 74 69 62 6c 65 20 74 6f | 0d 0a 66 75 74 75 72 65 |tible to|..future|
|000050a0| 20 6d 6f 64 69 66 69 63 | 61 74 69 6f 6e 2e 20 20 | modific|ation. |
|000050b0| 43 75 72 72 65 6e 74 20 | 75 6e 64 65 72 73 74 61 |Current |understa|
|000050c0| 6e 64 69 6e 67 73 2c 20 | 66 6f 72 20 74 68 65 20 |ndings, |for the |
|000050d0| 6d 6f 73 74 20 70 61 72 | 74 2c 20 61 72 65 20 62 |most par|t, are b|
|000050e0| 61 73 65 64 20 6f 6e 0d | 0a 73 74 75 64 69 65 73 |ased on.|.studies|
|000050f0| 20 74 68 61 74 20 77 65 | 72 65 20 62 65 69 6e 67 | that we|re being|
|00005100| 20 63 61 72 72 69 65 64 | 20 6f 75 74 20 61 74 20 | carried| out at |
|00005110| 61 20 74 69 6d 65 20 77 | 68 65 6e 20 22 6c 6f 77 |a time w|hen "low|
|00005120| 22 20 62 69 72 74 68 20 | 77 65 69 67 68 74 20 6d |" birth |weight m|
|00005130| 65 61 6e 74 0d 0a 73 6f | 6d 65 74 68 69 6e 67 20 |eant..so|mething |
|00005140| 6f 74 68 65 72 20 74 68 | 61 6e 20 69 74 20 6e 6f |other th|an it no|
|00005150| 77 20 64 6f 65 73 2e 20 | 20 54 68 65 20 77 68 6f |w does. | The who|
|00005160| 6c 65 20 62 61 6c 6c 67 | 61 6d 65 20 77 69 6c 6c |le ballg|ame will|
|00005170| 20 70 72 6f 62 61 62 6c | 79 20 63 68 61 6e 67 65 | probabl|y change|
|00005180| 20 69 6e 0d 0a 61 6e 6f | 74 68 65 72 20 37 20 79 | in..ano|ther 7 y|
|00005190| 65 61 72 73 2c 20 67 69 | 76 65 6e 20 74 68 65 20 |ears, gi|ven the |
|000051a0| 65 66 66 65 63 74 73 20 | 6f 66 20 74 68 65 20 61 |effects |of the a|
|000051b0| 62 69 6c 69 74 79 20 74 | 6f 20 63 61 72 65 20 66 |bility t|o care f|
|000051c0| 6f 72 20 69 6e 63 72 65 | 61 73 69 6e 67 6c 79 0d |or incre|asingly.|
|000051d0| 0a 74 69 6e 79 20 70 72 | 65 74 65 72 6d 20 69 6e |.tiny pr|eterm in|
|000051e0| 66 61 6e 74 73 20 61 6e | 64 20 75 74 69 6c 69 7a |fants an|d utiliz|
|000051f0| 61 74 69 6f 6e 20 6f 66 | 20 73 61 6c 76 61 67 65 |ation of| salvage|
|00005200| 20 74 65 63 68 6e 69 71 | 75 65 73 20 73 75 63 68 | techniq|ues such|
|00005210| 20 61 73 0d 0a 65 78 74 | 72 61 63 6f 72 70 6f 72 | as..ext|racorpor|
|00005220| 65 61 6c 20 6d 65 6d 62 | 72 61 6e 65 20 6f 78 79 |eal memb|rane oxy|
|00005230| 67 65 6e 61 74 69 6f 6e | 2e 2d 2d 4a 2e 41 2e 20 |genation|.--J.A. |
|00005240| 53 74 6f 63 6b 6d 61 6e | 2c 20 49 49 49 2c 20 4d |Stockman|, III, M|
|00005250| 2e 44 2e 0d 0a 24 55 6e | 69 71 75 65 5f 49 44 7b |.D...$Un|ique_ID{|
|00005260| 59 52 42 30 33 30 30 36 | 7d 0d 0a 24 54 69 74 6c |YRB03006|}..$Titl|
|00005270| 65 7b 45 78 65 72 63 69 | 73 65 20 52 65 73 70 6f |e{Exerci|se Respo|
|00005280| 6e 73 65 20 42 65 66 6f | 72 65 20 61 6e 64 20 41 |nse Befo|re and A|
|00005290| 66 74 65 72 20 54 65 72 | 6d 69 6e 61 74 69 6f 6e |fter Ter|mination|
|000052a0| 20 6f 66 20 41 74 72 69 | 61 6c 20 54 61 63 68 79 | of Atri|al Tachy|
|000052b0| 63 61 72 64 69 61 0d 0a | 41 66 74 65 72 20 43 6f |cardia..|After Co|
|000052c0| 6e 67 65 6e 69 74 61 6c | 20 48 65 61 72 74 20 44 |ngenital| Heart D|
|000052d0| 69 73 65 61 73 65 20 53 | 75 72 67 65 72 79 7d 0d |isease S|urgery}.|
|000052e0| 0a 24 41 75 74 68 6f 72 | 7b 0d 0a 57 65 73 73 65 |.$Author|{..Wesse|
|000052f0| 6c 2c 20 48 55 0d 0a 42 | 65 6e 73 6f 6e 2c 20 44 |l, HU..B|enson, D|
|00005300| 57 2c 20 4a 72 0d 0a 42 | 72 61 75 6e 6c 69 6e 2c |W, Jr..B|raunlin,|
|00005310| 20 45 41 0d 0a 44 75 6e | 6e 69 67 61 6e 2c 20 41 | EA..Dun|nigan, A|
|00005320| 0d 0a 50 61 75 6c 2c 20 | 4d 48 7d 0d 0a 24 41 66 |..Paul, |MH}..$Af|
|00005330| 66 69 6c 69 61 74 69 6f | 6e 7b 43 68 69 6c 64 72 |filiatio|n{Childr|
|00005340| 65 6e 27 73 20 4d 65 6d | 20 48 6f 73 70 2c 20 43 |en's Mem| Hosp, C|
|00005350| 68 69 63 61 67 6f 3b 20 | 4e 6f 72 74 68 77 65 73 |hicago; |Northwes|
|00005360| 74 65 72 6e 20 55 6e 69 | 76 3b 20 55 6e 69 76 20 |tern Uni|v; Univ |
|00005370| 6f 66 0d 0a 4d 69 6e 6e | 65 73 6f 74 61 7d 0d 0a |of..Minn|esota}..|
|00005380| 24 4a 6f 75 72 6e 61 6c | 7b 43 69 72 63 75 6c 61 |$Journal|{Circula|
|00005390| 74 69 6f 6e 7d 0d 0a 24 | 56 6f 6c 75 6d 65 7b 38 |tion}..$|Volume{8|
|000053a0| 30 7d 0d 0a 24 50 61 67 | 65 7b 31 30 36 2d 31 31 |0}..$Pag|e{106-11|
|000053b0| 31 7d 0d 0a 24 44 61 74 | 65 7b 31 39 38 39 7d 0d |1}..$Dat|e{1989}.|
|000053c0| 0a 24 59 42 56 6f 6c 7b | 31 39 39 31 20 59 65 61 |.$YBVol{|1991 Yea|
|000053d0| 72 20 42 6f 6f 6b 20 6f | 66 20 50 65 64 69 61 74 |r Book o|f Pediat|
|000053e0| 72 69 63 73 3a 7d 0d 0a | 24 43 68 61 70 74 65 72 |rics:}..|$Chapter|
|000053f0| 7b 31 31 2d 33 7d 0d 0a | 24 59 42 45 64 69 74 6f |{11-3}..|$YBEdito|
|00005400| 72 7b 44 72 73 2e 20 4f | 73 6b 69 20 61 6e 64 20 |r{Drs. O|ski and |
|00005410| 53 74 6f 63 6b 6d 61 6e | 7d 0d 0a 24 54 61 62 6c |Stockman|}..$Tabl|
|00005420| 65 7b 7d 0d 0a 24 43 6f | 6d 6d 65 6e 74 61 74 6f |e{}..$Co|mmentato|
|00005430| 72 7b 4a 2e 41 2e 20 53 | 74 6f 63 6b 6d 61 6e 2c |r{J.A. S|tockman,|
|00005440| 20 49 49 49 2c 20 4d 2e | 44 2e 7d 0d 0a 0d 0a 43 | III, M.|D.}....C|
|00005450| 6f 70 79 72 69 67 68 74 | 20 28 43 29 20 59 65 61 |opyright| (C) Yea|
|00005460| 72 20 42 6f 6f 6b 20 4d | 65 64 69 63 61 6c 20 50 |r Book M|edical P|
|00005470| 75 62 6c 69 73 68 65 72 | 73 2c 20 49 6e 63 2e 20 |ublisher|s, Inc. |
|00005480| 31 39 39 31 0d 0a 0d 0a | 31 39 39 31 20 59 65 61 |1991....|1991 Yea|
|00005490| 72 20 42 6f 6f 6b 20 6f | 66 20 50 65 64 69 61 74 |r Book o|f Pediat|
|000054a0| 72 69 63 73 3a 0d 0a 0d | 0a 43 68 61 70 74 65 72 |rics:...|.Chapter|
|000054b0| 20 31 31 20 2d 2d 20 54 | 68 65 20 52 65 73 70 69 | 11 -- T|he Respi|
|000054c0| 72 61 74 6f 72 79 20 54 | 72 61 63 74 0d 0a 0d 0a |ratory T|ract....|
|000054d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000054e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000054f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005500| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005510| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|00005520| 45 78 65 72 63 69 73 65 | 20 52 65 73 70 6f 6e 73 |Exercise| Respons|
|00005530| 65 20 42 65 66 6f 72 65 | 20 61 6e 64 20 41 66 74 |e Before| and Aft|
|00005540| 65 72 20 54 65 72 6d 69 | 6e 61 74 69 6f 6e 20 6f |er Termi|nation o|
|00005550| 66 20 41 74 72 69 61 6c | 20 54 61 63 68 79 63 61 |f Atrial| Tachyca|
|00005560| 72 64 69 61 20 41 66 74 | 65 72 0d 0a 43 6f 6e 67 |rdia Aft|er..Cong|
|00005570| 65 6e 69 74 61 6c 20 48 | 65 61 72 74 20 44 69 73 |enital H|eart Dis|
|00005580| 65 61 73 65 20 53 75 72 | 67 65 72 79 0d 0a 0d 0a |ease Sur|gery....|
|00005590| 57 65 73 73 65 6c 20 48 | 55 3b 20 42 65 6e 73 6f |Wessel H|U; Benso|
|000055a0| 6e 20 44 57 20 4a 72 3b | 20 42 72 61 75 6e 6c 69 |n DW Jr;| Braunli|
|000055b0| 6e 20 45 41 3b 20 44 75 | 6e 6e 69 67 61 6e 20 41 |n EA; Du|nnigan A|
|000055c0| 3b 20 50 61 75 6c 20 4d | 48 0d 0a 28 43 68 69 6c |; Paul M|H..(Chil|
|000055d0| 64 72 65 6e 27 73 20 4d | 65 6d 20 48 6f 73 70 2c |dren's M|em Hosp,|
|000055e0| 20 43 68 69 63 61 67 6f | 3b 20 4e 6f 72 74 68 77 | Chicago|; Northw|
|000055f0| 65 73 74 65 72 6e 20 55 | 6e 69 76 3b 20 55 6e 69 |estern U|niv; Uni|
|00005600| 76 20 6f 66 20 4d 69 6e | 6e 65 73 6f 74 61 29 0d |v of Min|nesota).|
|00005610| 0a 43 69 72 63 75 6c 61 | 74 69 6f 6e 20 38 30 3a |.Circula|tion 80:|
|00005620| 31 30 36 2d 31 31 31 2c | 20 31 39 38 39 0d 0a 2d |106-111,| 1989..-|
|00005630| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005640| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005650| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005660| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005670| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 0d |--------|-----...|
|00005680| 0a 41 62 73 74 72 61 63 | 74 0d 0a 0d 0a 20 20 20 |.Abstrac|t.... |
|00005690| 20 20 41 74 72 69 61 6c | 20 74 61 63 68 79 63 61 | Atrial| tachyca|
|000056a0| 72 64 69 61 20 69 73 20 | 61 20 63 6f 6d 6d 6f 6e |rdia is |a common|
|000056b0| 2c 20 74 72 6f 75 62 6c | 65 73 6f 6d 65 20 6c 61 |, troubl|esome la|
|000056c0| 74 65 20 63 6f 6d 70 6c | 69 63 61 74 69 6f 6e 20 |te compl|ication |
|000056d0| 6f 66 20 74 68 65 0d 0a | 73 75 72 67 69 63 61 6c |of the..|surgical|
|000056e0| 20 74 72 65 61 74 6d 65 | 6e 74 20 6f 66 20 63 6f | treatme|nt of co|
|000056f0| 6e 67 65 6e 69 74 61 6c | 20 63 61 72 64 69 61 63 |ngenital| cardiac|
|00005700| 20 64 65 66 65 63 74 73 | 20 74 68 61 74 20 69 6e | defects| that in|
|00005710| 76 6f 6c 76 65 20 65 78 | 74 65 6e 73 69 76 65 0d |volve ex|tensive.|
|00005720| 0a 69 6e 74 72 61 2d 61 | 74 72 69 61 6c 20 70 72 |.intra-a|trial pr|
|00005730| 6f 63 65 64 75 72 65 73 | 2e 20 20 54 68 69 73 20 |ocedures|. This |
|00005740| 63 6f 6d 70 6c 69 63 61 | 74 69 6f 6e 20 69 73 20 |complica|tion is |
|00005750| 62 65 6c 69 65 76 65 64 | 20 74 6f 20 62 65 20 63 |believed| to be c|
|00005760| 61 75 73 65 64 20 62 79 | 0d 0a 69 6e 74 72 61 2d |aused by|..intra-|
|00005770| 61 74 72 69 61 6c 20 72 | 65 65 6e 74 72 79 2e 20 |atrial r|eentry. |
|00005780| 20 45 6c 65 63 74 72 69 | 63 61 6c 20 6f 72 20 70 | Electri|cal or p|
|00005790| 68 61 72 6d 61 63 6f 6c | 6f 67 69 63 20 74 65 72 |harmacol|ogic ter|
|000057a0| 6d 69 6e 61 74 69 6f 6e | 20 6f 66 20 61 74 72 69 |mination| of atri|
|000057b0| 61 6c 0d 0a 74 61 63 68 | 79 63 61 72 64 69 61 20 |al..tach|ycardia |
|000057c0| 69 73 20 61 6e 20 61 63 | 63 65 70 74 65 64 20 74 |is an ac|cepted t|
|000057d0| 68 65 72 61 70 79 2e 20 | 20 54 6f 20 65 78 61 6d |herapy. | To exam|
|000057e0| 69 6e 65 20 74 68 65 20 | 65 66 66 65 63 74 20 6f |ine the |effect o|
|000057f0| 66 20 61 74 72 69 61 6c | 0d 0a 74 61 63 68 79 63 |f atrial|..tachyc|
|00005800| 61 72 64 69 61 20 6f 6e | 20 65 78 65 72 63 69 73 |ardia on| exercis|
|00005810| 65 20 70 65 72 66 6f 72 | 6d 61 6e 63 65 2c 20 74 |e perfor|mance, t|
|00005820| 68 65 20 72 65 73 70 6f | 6e 73 65 20 74 6f 20 65 |he respo|nse to e|
|00005830| 78 65 72 63 69 73 65 20 | 62 65 66 6f 72 65 20 61 |xercise |before a|
|00005840| 6e 64 20 61 66 74 65 72 | 0d 0a 61 74 72 69 61 6c |nd after|..atrial|
|00005850| 20 74 61 63 68 79 63 61 | 72 64 69 61 20 74 65 72 | tachyca|rdia ter|
|00005860| 6d 69 6e 61 74 69 6f 6e | 20 77 61 73 20 63 6f 6d |mination| was com|
|00005870| 70 61 72 65 64 20 69 6e | 20 31 30 20 70 61 74 69 |pared in| 10 pati|
|00005880| 65 6e 74 73 20 61 67 65 | 64 20 39 2d 32 35 20 79 |ents age|d 9-25 y|
|00005890| 65 61 72 73 2e 0d 0a 20 | 20 20 20 20 45 78 65 72 |ears... | Exer|
|000058a0| 63 69 73 65 20 70 65 72 | 66 6f 72 6d 61 6e 63 65 |cise per|formance|
|000058b0| 20 77 61 73 20 61 6e 61 | 6c 79 7a 65 64 20 62 65 | was ana|lyzed be|
|000058c0| 66 6f 72 65 20 61 6e 64 | 20 61 66 74 65 72 20 63 |fore and| after c|
|000058d0| 6f 6e 76 65 72 73 69 6f | 6e 20 6f 66 20 61 74 72 |onversio|n of atr|
|000058e0| 69 61 6c 0d 0a 74 61 63 | 68 79 63 61 72 64 69 61 |ial..tac|hycardia|
|000058f0| 20 74 6f 20 73 69 6e 75 | 73 20 72 68 79 74 68 6d | to sinu|s rhythm|
|00005900| 2c 20 61 74 72 69 61 6c | 20 62 72 61 64 79 63 61 |, atrial| bradyca|
|00005910| 72 64 69 61 2c 20 6f 72 | 20 6a 75 6e 63 74 69 6f |rdia, or| junctio|
|00005920| 6e 61 6c 20 72 68 79 74 | 68 6d 20 69 6e 0d 0a 70 |nal rhyt|hm in..p|
|00005930| 61 74 69 65 6e 74 73 20 | 38 2d 32 30 20 79 65 61 |atients |8-20 yea|
|00005940| 72 73 20 61 66 74 65 72 | 20 73 75 72 67 65 72 79 |rs after| surgery|
|00005950| 20 66 6f 72 20 63 6f 6e | 67 65 6e 69 74 61 6c 20 | for con|genital |
|00005960| 68 65 61 72 74 20 64 69 | 73 65 61 73 65 2e 20 20 |heart di|sease. |
|00005970| 46 69 76 65 20 70 61 74 | 69 65 6e 74 73 0d 0a 70 |Five pat|ients..p|
|00005980| 65 72 66 6f 72 6d 65 64 | 20 61 20 6d 61 78 69 6d |erformed| a maxim|
|00005990| 61 6c 20 63 79 63 6c 65 | 20 61 6e 64 20 35 20 61 |al cycle| and 5 a|
|000059a0| 20 74 72 65 61 64 6d 69 | 6c 6c 20 65 78 65 72 63 | treadmi|ll exerc|
|000059b0| 69 73 65 20 70 72 6f 74 | 6f 63 6f 6c 20 69 6e 20 |ise prot|ocol in |
|000059c0| 61 74 72 69 61 6c 0d 0a | 74 61 63 68 79 63 61 72 |atrial..|tachycar|
|000059d0| 64 69 61 20 61 6e 64 20 | 73 69 6e 75 73 20 72 68 |dia and |sinus rh|
|000059e0| 79 74 68 6d 20 31 2d 32 | 33 32 20 64 61 79 73 20 |ythm 1-2|32 days |
|000059f0| 61 66 74 65 72 20 61 74 | 72 69 61 6c 20 74 61 63 |after at|rial tac|
|00005a00| 68 79 63 61 72 64 69 61 | 2e 20 20 53 69 6e 75 73 |hycardia|. Sinus|
|00005a10| 0d 0a 72 68 79 74 68 6d | 20 65 78 65 72 63 69 73 |..rhythm| exercis|
|00005a20| 65 20 69 6e 63 72 65 61 | 73 65 64 20 70 65 61 6b |e increa|sed peak|
|00005a30| 20 6f 78 79 67 65 6e 20 | 75 70 74 61 6b 65 2c 20 | oxygen |uptake, |
|00005a40| 65 78 65 72 63 69 73 65 | 20 74 69 6d 65 2c 20 61 |exercise| time, a|
|00005a50| 6e 64 20 4f 32 20 70 75 | 6c 73 65 20 61 74 0d 0a |nd O2 pu|lse at..|
|00005a60| 72 65 73 74 2e 20 20 54 | 68 65 20 6d 65 61 6e 20 |rest. T|he mean |
|00005a70| 72 65 73 74 69 6e 67 20 | 68 65 61 72 74 20 72 61 |resting |heart ra|
|00005a80| 74 65 20 64 72 6f 70 70 | 65 64 20 66 72 6f 6d 20 |te dropp|ed from |
|00005a90| 31 30 39 20 62 65 61 74 | 73 20 70 65 72 20 6d 69 |109 beat|s per mi|
|00005aa0| 6e 75 74 65 20 74 6f 20 | 37 30 0d 0a 62 65 61 74 |nute to |70..beat|
|00005ab0| 73 20 70 65 72 20 6d 69 | 6e 75 74 65 2e 20 20 54 |s per mi|nute. T|
|00005ac0| 68 65 20 70 65 61 6b 20 | 65 78 65 72 63 69 73 65 |he peak |exercise|
|00005ad0| 20 68 65 61 72 74 20 72 | 61 74 65 20 77 61 73 20 | heart r|ate was |
|00005ae0| 6c 6f 77 20 69 6e 20 61 | 74 72 69 61 6c 20 74 61 |low in a|trial ta|
|00005af0| 63 68 79 63 61 72 64 69 | 61 0d 0a 62 65 63 61 75 |chycardi|a..becau|
|00005b00| 73 65 20 6f 66 20 66 69 | 78 65 64 20 63 6f 6e 64 |se of fi|xed cond|
|00005b10| 75 63 74 69 6f 6e 20 6f | 72 20 68 69 67 68 20 61 |uction o|r high a|
|00005b20| 73 20 63 6f 6e 64 75 63 | 74 69 6f 6e 20 61 70 70 |s conduc|tion app|
|00005b30| 72 6f 61 63 68 65 64 20 | 31 3a 31 2e 20 20 49 6e |roached |1:1. In|
|00005b40| 20 73 69 6e 75 73 0d 0a | 72 68 79 74 68 6d 2c 20 | sinus..|rhythm, |
|00005b50| 74 68 65 20 72 65 73 74 | 20 74 6f 20 70 65 61 6b |the rest| to peak|
|00005b60| 20 65 78 65 72 63 69 73 | 65 20 68 65 61 72 74 20 | exercis|e heart |
|00005b70| 72 61 74 65 20 72 6f 73 | 65 20 69 6e 20 36 20 70 |rate ros|e in 6 p|
|00005b80| 61 74 69 65 6e 74 73 2e | 0d 0a 20 20 20 20 20 41 |atients.|.. A|
|00005b90| 20 73 69 67 6e 69 66 69 | 63 61 6e 74 20 69 6e 63 | signifi|cant inc|
|00005ba0| 72 65 61 73 65 20 69 6e | 20 65 78 65 72 63 69 73 |rease in| exercis|
|00005bb0| 65 20 70 65 72 66 6f 72 | 6d 61 6e 63 65 20 6f 63 |e perfor|mance oc|
|00005bc0| 63 75 72 72 65 64 20 69 | 6e 20 74 68 65 73 65 20 |curred i|n these |
|00005bd0| 70 61 74 69 65 6e 74 73 | 0d 0a 61 66 74 65 72 20 |patients|..after |
|00005be0| 63 6f 6e 76 65 72 73 69 | 6f 6e 20 6f 66 20 61 74 |conversi|on of at|
|00005bf0| 72 69 61 6c 20 74 61 63 | 68 79 63 61 72 64 69 61 |rial tac|hycardia|
|00005c00| 20 74 6f 20 73 69 6e 75 | 73 20 72 68 79 74 68 6d | to sinu|s rhythm|
|00005c10| 2e 20 20 4d 6f 73 74 20 | 68 61 64 20 75 6e 64 65 |. Most |had unde|
|00005c20| 72 67 6f 6e 65 20 61 6e | 0d 0a 61 74 72 69 61 6c |rgone an|..atrial|
|00005c30| 20 62 61 66 66 6c 65 20 | 70 72 6f 63 65 64 75 72 | baffle |procedur|
|00005c40| 65 20 66 6f 72 20 67 72 | 65 61 74 20 61 72 74 65 |e for gr|eat arte|
|00005c50| 72 79 20 74 72 61 6e 73 | 70 6f 73 69 74 69 6f 6e |ry trans|position|
|00005c60| 2e 20 20 54 68 65 20 69 | 6d 70 72 6f 76 65 64 20 |. The i|mproved |
|00005c70| 65 78 65 72 63 69 73 65 | 0d 0a 70 65 72 66 6f 72 |exercise|..perfor|
|00005c80| 6d 61 6e 63 65 20 69 6e | 20 73 69 6e 75 73 20 72 |mance in| sinus r|
|00005c90| 68 79 74 68 6d 20 6f 63 | 63 75 72 72 65 64 20 70 |hythm oc|curred p|
|00005ca0| 72 69 6d 61 72 69 6c 79 | 20 62 65 63 61 75 73 65 |rimarily| because|
|00005cb0| 20 6f 66 20 69 6d 70 72 | 6f 76 65 64 20 68 65 61 | of impr|oved hea|
|00005cc0| 72 74 20 72 61 74 65 0d | 0a 61 64 61 70 74 61 74 |rt rate.|.adaptat|
|00005cd0| 69 6f 6e 20 74 6f 20 65 | 78 65 72 63 69 73 65 2c |ion to e|xercise,|
|00005ce0| 20 65 69 74 68 65 72 20 | 62 79 20 61 6c 6c 6f 77 | either |by allow|
|00005cf0| 69 6e 67 20 61 6e 20 69 | 6e 63 72 65 61 73 65 64 |ing an i|ncreased|
|00005d00| 20 68 65 61 72 74 20 72 | 61 74 65 20 72 65 73 70 | heart r|ate resp|
|00005d10| 6f 6e 73 65 20 6f 72 0d | 0a 65 6c 69 6d 69 6e 61 |onse or.|.elimina|
|00005d20| 74 69 6e 67 20 61 6e 20 | 65 78 63 65 73 73 69 76 |ting an |excessiv|
|00005d30| 65 6c 79 20 68 69 67 68 | 20 68 65 61 72 74 20 72 |ely high| heart r|
|00005d40| 61 74 65 20 77 69 74 68 | 20 69 6e 61 64 65 71 75 |ate with| inadequ|
|00005d50| 61 74 65 20 64 69 61 73 | 74 6f 6c 69 63 20 66 69 |ate dias|tolic fi|
|00005d60| 6c 6c 69 6e 67 2e 0d 0a | 0d 0a 50 6f 73 74 2d 43 |lling...|..Post-C|
|00005d70| 6f 6d 6d 65 6e 74 0d 0a | 0d 0a 20 20 20 20 20 54 |omment..|.. T|
|00005d80| 68 65 72 65 20 61 72 65 | 20 61 20 77 68 6f 6c 65 |here are| a whole|
|00005d90| 20 62 75 6e 63 68 20 6f | 66 20 63 68 69 6c 64 72 | bunch o|f childr|
|00005da0| 65 6e 20 6f 75 74 20 74 | 68 65 72 65 20 77 68 6f |en out t|here who|
|00005db0| 20 68 61 76 65 20 75 6e | 64 65 72 67 6f 6e 65 20 | have un|dergone |
|00005dc0| 73 75 72 67 69 63 61 6c | 0d 0a 70 72 6f 63 65 64 |surgical|..proced|
|00005dd0| 75 72 65 73 20 74 6f 20 | 63 6f 72 72 65 63 74 20 |ures to |correct |
|00005de0| 63 6f 6e 67 65 6e 69 74 | 61 6c 20 68 65 61 72 74 |congenit|al heart|
|00005df0| 20 64 69 73 65 61 73 65 | 2e 20 20 54 68 6f 73 65 | disease|. Those|
|00005e00| 20 77 68 6f 20 68 61 76 | 65 20 68 61 64 20 61 20 | who hav|e had a |
|00005e10| 4d 75 73 74 61 72 64 0d | 0a 72 65 70 61 69 72 20 |Mustard.|.repair |
|00005e20| 6f 66 20 74 72 61 6e 73 | 70 6f 73 69 74 69 6f 6e |of trans|position|
|00005e30| 20 6f 66 20 74 68 65 20 | 67 72 65 61 74 20 76 65 | of the |great ve|
|00005e40| 73 73 65 6c 73 20 61 72 | 65 20 61 74 20 70 61 72 |ssels ar|e at par|
|00005e50| 74 69 63 75 6c 61 72 6c | 79 20 68 69 67 68 20 72 |ticularl|y high r|
|00005e60| 69 73 6b 20 66 6f 72 0d | 0a 63 6f 6e 74 69 6e 75 |isk for.|.continu|
|00005e70| 69 6e 67 20 61 72 72 68 | 79 74 68 6d 69 61 73 20 |ing arrh|ythmias |
|00005e80| 74 68 72 6f 75 67 68 6f | 75 74 20 74 68 65 20 72 |througho|ut the r|
|00005e90| 65 73 74 20 6f 66 20 74 | 68 65 69 72 20 6c 69 76 |est of t|heir liv|
|00005ea0| 65 73 2e 20 20 54 68 65 | 20 6d 6f 73 74 20 63 6f |es. The| most co|
|00005eb0| 6d 6d 6f 6e 20 6f 66 0d | 0a 74 68 65 73 65 20 61 |mmon of.|.these a|
|00005ec0| 72 72 68 79 74 68 6d 69 | 61 73 20 61 72 65 20 73 |rrhythmi|as are s|
|00005ed0| 75 70 72 61 76 65 6e 74 | 72 69 63 75 6c 61 72 20 |upravent|ricular |
|00005ee0| 74 61 63 68 79 63 61 72 | 64 69 61 2c 20 61 74 72 |tachycar|dia, atr|
|00005ef0| 69 61 6c 20 66 6c 75 74 | 74 65 72 2c 20 61 6e 64 |ial flut|ter, and|
|00005f00| 20 61 74 72 69 61 6c 0d | 0a 66 69 62 72 69 6c 6c | atrial.|.fibrill|
|00005f10| 61 74 69 6f 6e 2e 20 20 | 54 68 65 20 69 73 73 75 |ation. |The issu|
|00005f20| 65 20 69 73 20 77 68 65 | 74 68 65 72 20 6f 72 20 |e is whe|ther or |
|00005f30| 6e 6f 74 20 69 74 20 69 | 73 20 77 6f 72 74 68 20 |not it i|s worth |
|00005f40| 61 74 74 65 6d 70 74 69 | 6e 67 20 74 6f 20 64 6f |attempti|ng to do|
|00005f50| 20 6d 75 63 68 0d 0a 61 | 62 6f 75 74 20 74 68 69 | much..a|bout thi|
|00005f60| 73 20 77 68 65 6e 20 74 | 68 65 20 70 61 74 69 65 |s when t|he patie|
|00005f70| 6e 74 20 68 61 73 20 6e | 6f 20 73 79 6d 70 74 6f |nt has n|o sympto|
|00005f80| 6d 73 2e 20 20 49 6e 20 | 74 68 65 20 73 74 75 64 |ms. In |the stud|
|00005f90| 79 20 61 62 73 74 72 61 | 63 74 65 64 20 61 62 6f |y abstra|cted abo|
|00005fa0| 76 65 2c 0d 0a 74 68 65 | 72 65 20 77 61 73 20 61 |ve,..the|re was a|
|00005fb0| 20 73 69 67 6e 69 66 69 | 63 61 6e 74 20 69 6e 63 | signifi|cant inc|
|00005fc0| 72 65 61 73 65 20 69 6e | 20 65 78 65 72 63 69 73 |rease in| exercis|
|00005fd0| 65 20 70 65 72 66 6f 72 | 6d 61 6e 63 65 20 61 66 |e perfor|mance af|
|00005fe0| 74 65 72 20 63 6f 6e 76 | 65 72 73 69 6f 6e 20 6f |ter conv|ersion o|
|00005ff0| 66 0d 0a 61 74 72 69 61 | 6c 20 74 61 63 68 79 63 |f..atria|l tachyc|
|00006000| 61 72 64 69 61 20 74 6f | 20 73 69 6e 75 73 20 72 |ardia to| sinus r|
|00006010| 68 79 74 68 6d 20 69 6e | 20 61 20 67 72 6f 75 70 |hythm in| a group|
|00006020| 20 6f 66 20 6c 61 74 65 | 20 73 75 72 76 69 76 6f | of late| survivo|
|00006030| 72 73 20 6f 66 20 73 75 | 72 67 65 72 79 20 66 6f |rs of su|rgery fo|
|00006040| 72 0d 0a 63 6f 6d 70 6c | 65 78 20 63 61 72 64 69 |r..compl|ex cardi|
|00006050| 61 63 20 64 65 66 65 63 | 74 73 2e 20 20 54 68 65 |ac defec|ts. The|
|00006060| 20 66 61 63 74 20 74 68 | 61 74 20 74 68 65 73 65 | fact th|at these|
|00006070| 20 63 68 69 6c 64 72 65 | 6e 20 73 65 65 6d 20 74 | childre|n seem t|
|00006080| 6f 20 74 6f 6c 65 72 61 | 74 65 20 61 74 72 69 61 |o tolera|te atria|
|00006090| 6c 0d 0a 74 61 63 68 79 | 63 61 72 64 69 61 73 20 |l..tachy|cardias |
|000060a0| 77 65 6c 6c 20 69 73 20 | 70 72 6f 62 61 62 6c 79 |well is |probably|
|000060b0| 20 62 65 63 61 75 73 65 | 20 6f 66 20 61 20 73 65 | because| of a se|
|000060c0| 6c 66 2d 69 6d 70 6f 73 | 65 64 20 72 65 73 74 72 |lf-impos|ed restr|
|000060d0| 69 63 74 69 6f 6e 20 6f | 6e 0d 0a 70 68 79 73 69 |iction o|n..physi|
|000060e0| 63 61 6c 20 61 63 74 69 | 76 69 74 79 2e 20 20 41 |cal acti|vity. A|
|000060f0| 74 72 69 61 6c 20 74 61 | 63 68 79 63 61 72 64 69 |trial ta|chycardi|
|00006100| 61 20 61 66 66 65 63 74 | 73 20 63 61 72 64 69 61 |a affect|s cardia|
|00006110| 63 20 70 65 72 66 6f 72 | 6d 61 6e 63 65 20 61 74 |c perfor|mance at|
|00006120| 20 72 65 73 74 20 61 6e | 64 0d 0a 69 6e 20 72 65 | rest an|d..in re|
|00006130| 73 70 6f 6e 73 65 20 74 | 6f 20 65 78 65 72 63 69 |sponse t|o exerci|
|00006140| 73 65 20 69 6e 20 61 20 | 6e 75 6d 62 65 72 20 6f |se in a |number o|
|00006150| 66 20 77 61 79 73 2e 20 | 20 49 74 20 61 6c 74 65 |f ways. | It alte|
|00006160| 72 73 20 76 65 6e 74 72 | 69 63 75 6c 61 72 20 66 |rs ventr|icular f|
|00006170| 69 6c 6c 69 6e 67 20 61 | 73 0d 0a 61 20 72 65 73 |illing a|s..a res|
|00006180| 75 6c 74 20 6f 66 20 61 | 62 73 65 6e 63 65 20 6f |ult of a|bsence o|
|00006190| 66 20 61 6e 20 65 66 66 | 65 63 74 69 76 65 20 61 |f an eff|ective a|
|000061a0| 74 72 69 61 6c 20 73 79 | 73 74 6f 6c 65 2e 20 20 |trial sy|stole. |
|000061b0| 49 74 20 6c 69 6d 69 74 | 73 20 74 68 65 20 68 65 |It limit|s the he|
|000061c0| 61 72 74 20 72 61 74 65 | 0d 0a 72 65 73 70 6f 6e |art rate|..respon|
|000061d0| 73 65 20 74 6f 20 65 78 | 65 72 63 69 73 65 20 62 |se to ex|ercise b|
|000061e0| 65 63 61 75 73 65 20 6f | 66 20 74 68 65 20 63 6f |ecause o|f the co|
|000061f0| 6e 64 75 63 74 69 6f 6e | 20 62 6c 6f 63 6b 20 74 |nduction| block t|
|00006200| 68 61 74 20 69 73 20 69 | 6e 76 61 72 69 61 62 6c |hat is i|nvariabl|
|00006210| 79 0d 0a 70 72 65 73 65 | 6e 74 2e 20 20 54 68 65 |y..prese|nt. The|
|00006220| 73 65 20 61 72 65 20 73 | 69 67 6e 69 66 69 63 61 |se are s|ignifica|
|00006230| 6e 74 20 70 72 6f 62 6c | 65 6d 73 2e 20 20 41 73 |nt probl|ems. As|
|00006240| 20 6d 61 6e 79 20 61 73 | 20 35 35 25 20 6f 66 20 | many as| 55% of |
|00006250| 63 68 69 6c 64 72 65 6e | 20 77 68 6f 20 68 61 76 |children| who hav|
|00006260| 65 0d 0a 75 6e 64 65 72 | 67 6f 6e 65 20 73 75 72 |e..under|gone sur|
|00006270| 67 69 63 61 6c 20 70 72 | 6f 63 65 64 75 72 65 73 |gical pr|ocedures|
|00006280| 20 74 68 61 74 20 22 6d | 75 63 6b 22 20 61 72 6f | that "m|uck" aro|
|00006290| 75 6e 64 20 77 69 74 68 | 20 74 68 65 20 61 74 72 |und with| the atr|
|000062a0| 69 61 6c 20 73 65 70 74 | 75 6d 20 77 69 6c 6c 0d |ial sept|um will.|
|000062b0| 0a 68 61 76 65 20 65 6c | 65 63 74 72 6f 70 68 79 |.have el|ectrophy|
|000062c0| 73 69 6f 6c 6f 67 69 63 | 61 6c 6c 79 20 69 6e 64 |siologic|ally ind|
|000062d0| 75 63 69 62 6c 65 20 73 | 75 73 74 61 69 6e 65 64 |ucible s|ustained|
|000062e0| 20 61 74 72 69 61 6c 20 | 66 6c 75 74 74 65 72 20 | atrial |flutter |
|000062f0| 61 6e 64 2c 20 6c 65 73 | 73 0d 0a 63 6f 6d 6d 6f |and, les|s..commo|
|00006300| 6e 6c 79 2c 20 6f 74 68 | 65 72 20 66 6f 72 6d 73 |nly, oth|er forms|
|00006310| 20 6f 66 20 74 61 63 68 | 79 63 61 72 64 69 61 73 | of tach|ycardias|
|00006320| 2e 0d 0a 20 20 20 20 20 | 41 6c 74 68 6f 75 67 68 |... |Although|
|00006330| 20 72 75 6e 6e 69 6e 67 | 20 69 73 20 61 6e 20 75 | running| is an u|
|00006340| 6e 6e 61 74 75 72 61 6c | 20 61 63 74 2c 20 65 78 |nnatural| act, ex|
|00006350| 63 65 70 74 20 66 72 6f | 6d 20 65 6e 65 6d 69 65 |cept fro|m enemie|
|00006360| 73 20 61 6e 64 20 74 6f | 20 74 68 65 0d 0a 62 61 |s and to| the..ba|
|00006370| 74 68 72 6f 6f 6d 2c 20 | 6f 6e 65 20 73 68 6f 75 |throom, |one shou|
|00006380| 6c 64 20 61 63 63 65 70 | 74 20 74 68 61 74 20 74 |ld accep|t that t|
|00006390| 68 65 73 65 20 63 68 69 | 6c 64 72 65 6e 20 68 61 |hese chi|ldren ha|
|000063a0| 76 65 20 62 65 65 6e 20 | 74 68 72 6f 75 67 68 20 |ve been |through |
|000063b0| 61 20 67 72 65 61 74 20 | 64 65 61 6c 0d 0a 65 61 |a great |deal..ea|
|000063c0| 72 6c 79 20 69 6e 20 6c | 69 66 65 20 61 6e 64 20 |rly in l|ife and |
|000063d0| 64 65 73 65 72 76 65 20 | 65 76 65 72 79 20 6f 70 |deserve |every op|
|000063e0| 70 6f 72 74 75 6e 69 74 | 79 20 74 6f 20 66 75 6e |portunit|y to fun|
|000063f0| 63 74 69 6f 6e 20 61 74 | 20 61 20 6e 6f 72 6d 61 |ction at| a norma|
+--------+-------------------------+-------------------------+--------+--------+
Only 25.0 KB of data is shown above.
