home *** CD-ROM | disk | FTP | other *** search
/ Year Books 1991 / Year Books 1991.iso / dp / 05 / 057.pkg < prev    next >
Unknown  |  1992-06-06  |  317.3 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.

ConfidenceProgramDetectionMatch TypeSupport
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| c2 0b 00 00 30 31 00 00 | 00 01 5e 11 00 00 25 0b |....01..|..^...%.|
|00000030| 00 00 30 32 00 00 00 01 | 83 1c 00 00 83 0c 00 00 |..02....|........|
|00000040| 30 33 00 00 00 01 06 29 | 00 00 fb 0b 00 00 30 34 |03.....)|......04|
|00000050| 00 00 00 01 01 35 00 00 | 12 0d 00 00 30 35 00 00 |.....5..|....05..|
|00000060| 00 01 13 42 00 00 ab 0c | 00 00 30 36 00 00 00 01 |...B....|..06....|
|00000070| be 4e 00 00 ab 0b 00 00 | 30 37 00 00 00 01 69 5a |.N......|07....iZ|
|00000080| 00 00 3b 0e 00 00 30 38 | 00 00 00 01 a4 68 00 00 |..;...08|.....h..|
|00000090| 7f 0e 00 00 30 39 00 00 | 00 01 23 77 00 00 34 0d |....09..|..#w..4.|
|000000a0| 00 00 31 30 00 00 00 01 | 57 84 00 00 97 0a 00 00 |..10....|W.......|
|000000b0| 31 31 00 00 00 01 ee 8e | 00 00 78 0d 00 00 31 32 |11......|..x...12|
|000000c0| 00 00 00 01 66 9c 00 00 | 94 0c 00 00 31 33 00 00 |....f...|....13..|
|000000d0| 00 01 fa a8 00 00 4d 0f | 00 00 31 34 00 00 00 01 |......M.|..14....|
|000000e0| 47 b8 00 00 d2 0b 00 00 | 31 35 00 00 00 01 19 c4 |G.......|15......|
|000000f0| 00 00 0f 0c 00 00 31 36 | 00 00 00 01 28 d0 00 00 |......16|....(...|
|00000100| 54 10 00 00 31 37 00 00 | 00 01 7c e0 00 00 22 0e |T...17..|..|...".|
|00000110| 00 00 31 38 00 00 00 01 | 9e ee 00 00 59 09 00 00 |..18....|....Y...|
|00000120| 31 39 00 00 00 01 f7 f7 | 00 00 cf 0d 00 00 32 30 |19......|......20|
|00000130| 00 00 00 01 c6 05 01 00 | 3e 0c 00 00 32 31 00 00 |........|>...21..|
|00000140| 00 01 04 12 01 00 42 0d | 00 00 32 32 00 00 00 01 |......B.|..22....|
|00000150| 46 1f 01 00 54 0b 00 00 | 32 33 00 00 00 01 9a 2a |F...T...|23.....*|
|00000160| 01 00 f2 0a 00 00 32 34 | 00 00 00 01 8c 35 01 00 |......24|.....5..|
|00000170| 34 11 00 00 32 35 00 00 | 00 01 c0 46 01 00 c4 0c |4...25..|...F....|
|00000180| 00 00 32 36 00 00 00 01 | 84 53 01 00 68 0e 00 00 |..26....|.S..h...|
|00000190| 32 37 00 00 00 01 ec 61 | 01 00 11 14 00 00 32 38 |27.....a|......28|
|000001a0| 00 00 00 01 fd 75 01 00 | d9 0e 00 00 32 39 00 00 |.....u..|....29..|
|000001b0| 00 01 d6 84 01 00 34 0e | 00 00 33 30 00 00 00 01 |......4.|..30....|
|000001c0| 0a 93 01 00 fc 0b 00 00 | 33 31 00 00 00 01 06 9f |........|31......|
|000001d0| 01 00 02 0d 00 00 33 32 | 00 00 00 01 08 ac 01 00 |......32|........|
|000001e0| b8 0e 00 00 33 33 00 00 | 00 01 c0 ba 01 00 ca 11 |....33..|........|
|000001f0| 00 00 33 34 00 00 00 01 | 8a cc 01 00 6f 0b 00 00 |..34....|....o...|
|00000200| 33 35 00 00 00 01 f9 d7 | 01 00 1a 0b 00 00 33 36 |35......|......36|
|00000210| 00 00 00 01 13 e3 01 00 | 71 0c 00 00 33 37 00 00 |........|q...37..|
|00000220| 00 01 84 ef 01 00 c6 09 | 00 00 33 38 00 00 00 01 |........|..38....|
|00000230| 4a f9 01 00 98 0b 00 00 | 33 39 00 00 00 01 e2 04 |J.......|39......|
|00000240| 02 00 b0 0a 00 00 34 30 | 00 00 00 01 92 0f 02 00 |......40|........|
|00000250| ba 09 00 00 34 31 00 00 | 00 01 4c 19 02 00 89 0c |....41..|..L.....|
|00000260| 00 00 34 32 00 00 00 01 | d5 25 02 00 4f 0a 00 00 |..42....|.%..O...|
|00000270| 34 33 00 00 00 01 24 30 | 02 00 57 0a 00 00 34 34 |43....$0|..W...44|
|00000280| 00 00 00 01 7b 3a 02 00 | de 09 00 00 34 35 00 00 |....{:..|....45..|
|00000290| 00 01 59 44 02 00 81 12 | 00 00 34 36 00 00 00 01 |..YD....|..46....|
|000002a0| da 56 02 00 53 0c 00 00 | 34 37 00 00 00 01 2d 63 |.V..S...|47....-c|
|000002b0| 02 00 10 10 00 00 34 38 | 00 00 00 01 3d 73 02 00 |......48|....=s..|
|000002c0| 40 0e 00 00 34 39 00 00 | 00 01 7d 81 02 00 9c 0b |@...49..|..}.....|
|000002d0| 00 00 35 30 00 00 00 01 | 19 8d 02 00 07 0b 00 00 |..50....|........|
|000002e0| 35 31 00 00 00 01 20 98 | 02 00 e4 0b 00 00 35 32 |51.... .|......52|
|000002f0| 00 00 00 01 04 a4 02 00 | dc 0b 00 00 35 33 00 00 |........|....53..|
|00000300| 00 01 e0 af 02 00 49 0c | 00 00 35 34 00 00 00 01 |......I.|..54....|
|00000310| 29 bc 02 00 3c 0c 00 00 | 35 35 00 00 00 01 65 c8 |)...<...|55....e.|
|00000320| 02 00 ae 0d 00 00 35 36 | 00 00 00 01 13 d6 02 00 |......56|........|
|00000330| 1e 0b 00 00 35 37 00 00 | 00 01 31 e1 02 00 56 0a |....57..|..1...V.|
|00000340| 00 00 35 38 00 00 00 01 | 87 eb 02 00 ae 09 00 00 |..58....|........|
|00000350| 35 39 00 00 00 01 35 f5 | 02 00 67 0d 00 00 36 30 |59....5.|..g...60|
|00000360| 00 00 00 01 9c 02 03 00 | 56 0c 00 00 36 31 00 00 |........|V...61..|
|00000370| 00 01 f2 0e 03 00 ee 0a | 00 00 36 32 00 00 00 01 |........|..62....|
|00000380| e0 19 03 00 cb 0d 00 00 | 36 33 00 00 00 01 ab 27 |........|63.....'|
|00000390| 03 00 e0 0b 00 00 36 34 | 00 00 00 01 8b 33 03 00 |......64|.....3..|
|000003a0| 8c 0d 00 00 36 35 00 00 | 00 01 17 41 03 00 ec 0a |....65..|...A....|
|000003b0| 00 00 36 36 00 00 00 01 | 03 4c 03 00 0f 0b 00 00 |..66....|.L......|
|000003c0| 36 37 00 00 00 01 12 57 | 03 00 ee 0a 00 00 36 38 |67.....W|......68|
|000003d0| 00 00 00 01 00 62 03 00 | cb 0e 00 00 36 39 00 00 |.....b..|....69..|
|000003e0| 00 01 cb 70 03 00 ae 0e | 00 00 37 30 00 00 00 01 |...p....|..70....|
|000003f0| 79 7f 03 00 7f 0a 00 00 | 37 31 00 00 00 01 f8 89 |y.......|71......|
|00000400| 03 00 5a 0e 00 00 37 32 | 00 00 00 01 52 98 03 00 |..Z...72|....R...|
|00000410| 23 0b 00 00 37 33 00 00 | 00 01 75 a3 03 00 96 0c |#...73..|..u.....|
|00000420| 00 00 37 34 00 00 00 01 | 0b b0 03 00 c7 0b 00 00 |..74....|........|
|00000430| 37 35 00 00 00 01 d2 bb | 03 00 cd 11 00 00 37 36 |75......|......76|
|00000440| 00 00 00 01 9f cd 03 00 | 4d 09 00 00 37 37 00 00 |........|M...77..|
|00000450| 00 01 ec d6 03 00 0c 0f | 00 00 37 38 00 00 00 01 |........|..78....|
|00000460| f8 e5 03 00 d0 0a 00 00 | 37 39 00 00 00 01 c8 f0 |........|79......|
|00000470| 03 00 18 0d 00 00 38 30 | 00 00 00 01 e0 fd 03 00 |......80|........|
|00000480| fd 0f 00 00 38 31 00 00 | 00 01 dd 0d 04 00 4b 0a |....81..|......K.|
|00000490| 00 00 38 32 00 00 00 01 | 28 18 04 00 02 0d 00 00 |..82....|(.......|
|000004a0| 38 33 00 00 00 01 2a 25 | 04 00 4e 09 00 00 38 34 |83....*%|..N...84|
|000004b0| 00 00 00 01 78 2e 04 00 | 18 0e 00 00 38 35 00 00 |....x...|....85..|
|000004c0| 00 01 90 3c 04 00 6c 0a | 00 00 38 36 00 00 00 01 |...<..l.|..86....|
|000004d0| fc 46 04 00 8f 0f 00 00 | 38 37 00 00 00 01 8b 56 |.F......|87.....V|
|000004e0| 04 00 4f 0c 00 00 38 38 | 00 00 00 01 da 62 04 00 |..O...88|.....b..|
|000004f0| 76 0a 00 00 38 39 00 00 | 00 01 50 6d 04 00 24 0f |v...89..|..Pm..$.|
|00000500| 00 00 39 30 00 00 00 01 | 74 7c 04 00 8b 0a 00 00 |..90....|t|......|
|00000510| 39 31 00 00 00 01 ff 86 | 04 00 73 0d 00 00 39 32 |91......|..s...92|
|00000520| 00 00 00 01 72 94 04 00 | 26 0e 00 00 39 33 00 00 |....r...|&...93..|
|00000530| 00 01 98 a2 04 00 e4 0a | 00 00 39 34 00 00 00 01 |........|..94....|
|00000540| 7c ad 04 00 71 0d 00 00 | 39 35 00 00 00 01 ed ba ||...q...|95......|
|00000550| 04 00 a1 0b 00 00 39 36 | 00 00 00 01 8e c6 04 00 |......96|........|
|00000560| 4e 0d 00 00 39 37 00 00 | 00 01 dc d3 04 00 b6 0c |N...97..|........|
|00000570| 00 00 39 38 00 00 00 01 | 92 e0 04 00 4c 0a 00 00 |..98....|....L...|
|00000580| 39 39 00 00 00 01 de ea | 04 00 2a 0a 00 00 00 00 |99......|..*.....|
|00000590| 00 00 00 00 08 f5 04 00 | 00 00 00 00 24 55 6e 69 |........|....$Uni|
|000005a0| 71 75 65 5f 49 44 7b 59 | 52 42 30 35 37 30 30 7d |que_ID{Y|RB05700}|
|000005b0| 0d 0a 24 54 69 74 6c 65 | 7b 47 6c 79 62 75 72 69 |..$Title|{Glyburi|
|000005c0| 64 65 20 6f 72 20 49 6e | 73 75 6c 69 6e 20 66 6f |de or In|sulin fo|
|000005d0| 72 20 4d 65 74 61 62 6f | 6c 69 63 20 43 6f 6e 74 |r Metabo|lic Cont|
|000005e0| 72 6f 6c 20 69 6e 20 4e | 6f 6e 2d 49 6e 73 75 6c |rol in N|on-Insul|
|000005f0| 69 6e 2d 44 65 70 65 6e | 64 65 6e 74 20 44 69 61 |in-Depen|dent Dia|
|00000600| 62 65 74 65 73 20 4d 65 | 6c 6c 69 74 75 73 3a 20 |betes Me|llitus: |
|00000610| 20 41 20 52 61 6e 64 6f | 6d 69 7a 65 64 2c 20 44 | A Rando|mized, D|
|00000620| 6f 75 62 6c 65 2d 42 6c | 69 6e 64 20 53 74 75 64 |ouble-Bl|ind Stud|
|00000630| 79 7d 0d 0a 24 41 75 74 | 68 6f 72 7b 0d 0a 4e 61 |y}..$Aut|hor{..Na|
|00000640| 74 68 61 6e 2c 20 44 4d | 0d 0a 52 6f 75 73 73 65 |than, DM|..Rousse|
|00000650| 6c 6c 2c 20 41 0d 0a 47 | 6f 64 69 6e 65 2c 20 4a |ll, A..G|odine, J|
|00000660| 45 7d 0d 0a 24 41 66 66 | 69 6c 69 61 74 69 6f 6e |E}..$Aff|iliation|
|00000670| 7b 4d 61 73 73 61 63 68 | 75 73 65 74 74 73 20 47 |{Massach|usetts G|
|00000680| 65 6e 20 48 6f 73 70 2c | 20 42 6f 73 74 6f 6e 3b |en Hosp,| Boston;|
|00000690| 20 48 61 72 76 61 72 64 | 20 4d 65 64 20 53 63 68 | Harvard| Med Sch|
|000006a0| 6f 6f 6c 2c 20 42 6f 73 | 74 6f 6e 7d 0d 0a 24 53 |ool, Bos|ton}..$S|
|000006b0| 75 62 6a 65 63 74 7b 49 | 6e 73 75 6c 69 6e 20 69 |ubject{I|nsulin i|
|000006c0| 6e 20 64 69 61 62 65 74 | 65 73 20 6e 6f 6e 2d 69 |n diabet|es non-i|
|000006d0| 6e 73 75 6c 69 6e 20 64 | 65 70 65 6e 64 65 6e 74 |nsulin d|ependent|
|000006e0| 3b 0d 0a 47 6c 79 62 75 | 72 69 64 65 20 66 6f 72 |;..Glybu|ride for|
|000006f0| 20 6d 65 74 61 62 6f 6c | 69 63 20 63 6f 6e 74 72 | metabol|ic contr|
|00000700| 6f 6c 20 69 6e 20 6e 6f | 6e 2d 69 6e 73 75 6c 69 |ol in no|n-insuli|
|00000710| 6e 2d 64 65 70 65 6e 64 | 65 6e 74 20 64 69 61 62 |n-depend|ent diab|
|00000720| 65 74 65 73 3b 0d 0a 44 | 69 61 62 65 74 65 73 20 |etes;..D|iabetes |
|00000730| 6d 65 6c 6c 69 74 75 73 | 20 6e 6f 6e 2d 69 6e 73 |mellitus| non-ins|
|00000740| 75 6c 69 6e 2d 64 65 70 | 65 6e 64 65 6e 74 2c 20 |ulin-dep|endent, |
|00000750| 67 6c 79 62 75 72 69 64 | 65 20 6f 72 20 69 6e 73 |glyburid|e or ins|
|00000760| 75 6c 69 6e 20 66 6f 72 | 20 6d 65 74 61 62 6f 6c |ulin for| metabol|
|00000770| 69 63 20 63 6f 6e 74 72 | 6f 6c 20 69 6e 7d 0d 0a |ic contr|ol in}..|
|00000780| 24 4a 6f 75 72 6e 61 6c | 7b 41 6e 6e 20 49 6e 74 |$Journal|{Ann Int|
|00000790| 65 72 6e 20 4d 65 64 7d | 0d 0a 24 56 6f 6c 75 6d |ern Med}|..$Volum|
|000007a0| 65 7b 31 30 38 7d 0d 0a | 24 50 61 67 65 7b 33 33 |e{108}..|$Page{33|
|000007b0| 34 2d 33 34 30 7d 0d 0a | 24 44 61 74 65 7b 4d 61 |4-340}..|$Date{Ma|
|000007c0| 72 63 68 20 31 39 38 38 | 7d 0d 0a 24 59 42 56 6f |rch 1988|}..$YBVo|
|000007d0| 6c 7b 31 39 38 39 20 59 | 65 61 72 20 42 6f 6f 6b |l{1989 Y|ear Book|
|000007e0| 20 6f 66 20 44 72 75 67 | 20 54 68 65 72 61 70 79 | of Drug| Therapy|
|000007f0| 7d 0d 0a 24 43 68 61 70 | 74 65 72 7b 37 2d 37 7d |}..$Chap|ter{7-7}|
|00000800| 0d 0a 24 59 42 45 64 69 | 74 6f 72 7b 44 72 73 2e |..$YBEdi|tor{Drs.|
|00000810| 20 48 6f 6c 6c 69 73 74 | 65 72 20 61 6e 64 20 4c | Hollist|er and L|
|00000820| 61 73 61 67 6e 61 7d 0d | 0a 24 54 61 62 6c 65 7b |asagna}.|.$Table{|
|00000830| 54 61 62 6c 65 20 4f 6d | 69 74 74 65 64 7d 0d 0a |Table Om|itted}..|
|00000840| 24 43 6f 6d 6d 65 6e 74 | 61 74 6f 72 7b 4c 2e 45 |$Comment|ator{L.E|
|00000850| 2e 20 48 6f 6c 6c 69 73 | 74 65 72 2c 20 4d 2e 44 |. Hollis|ter, M.D|
|00000860| 2e 7d 0d 0a 0d 0a 43 6f | 70 79 72 69 67 68 74 20 |.}....Co|pyright |
|00000870| 28 63 29 20 59 65 61 72 | 20 42 6f 6f 6b 20 4d 65 |(c) Year| Book Me|
|00000880| 64 69 63 61 6c 20 50 75 | 62 6c 69 73 68 65 72 73 |dical Pu|blishers|
|00000890| 2c 20 49 6e 63 2e 2c 20 | 31 39 38 39 0d 0a 0d 0a |, Inc., |1989....|
|000008a0| 31 39 38 39 20 59 65 61 | 72 20 42 6f 6f 6b 20 6f |1989 Yea|r Book o|
|000008b0| 66 20 44 72 75 67 20 54 | 68 65 72 61 70 79 20 28 |f Drug T|herapy (|
|000008c0| 52 29 0d 0a 0d 0a 43 68 | 61 70 74 65 72 20 37 2d |R)....Ch|apter 7-|
|000008d0| 2d 45 6e 64 6f 63 72 69 | 6e 65 20 61 6e 64 20 4d |-Endocri|ne and M|
|000008e0| 65 74 61 62 6f 6c 69 63 | 20 44 69 73 6f 72 64 65 |etabolic| Disorde|
|000008f0| 72 73 0d 0a 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |rs....--|--------|
|00000900| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000910| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000920| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000930| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000940| 2d 2d 2d 2d 2d 2d 0d 0a | 47 6c 79 62 75 72 69 64 |------..|Glyburid|
|00000950| 65 20 6f 72 20 49 6e 73 | 75 6c 69 6e 20 66 6f 72 |e or Ins|ulin for|
|00000960| 20 4d 65 74 61 62 6f 6c | 69 63 20 43 6f 6e 74 72 | Metabol|ic Contr|
|00000970| 6f 6c 20 69 6e 20 4e 6f | 6e 2d 49 6e 73 75 6c 69 |ol in No|n-Insuli|
|00000980| 6e 2d 44 65 70 65 6e 64 | 65 6e 74 20 44 69 61 62 |n-Depend|ent Diab|
|00000990| 65 74 65 73 0d 0a 4d 65 | 6c 6c 69 74 75 73 3a 20 |etes..Me|llitus: |
|000009a0| 20 41 20 52 61 6e 64 6f | 6d 69 7a 65 64 2c 20 44 | A Rando|mized, D|
|000009b0| 6f 75 62 6c 65 2d 42 6c | 69 6e 64 20 53 74 75 64 |ouble-Bl|ind Stud|
|000009c0| 79 0d 0a 0d 0a 4e 61 74 | 68 61 6e 20 44 4d 2c 20 |y....Nat|han DM, |
|000009d0| 52 6f 75 73 73 65 6c 6c | 20 41 2c 20 47 6f 64 69 |Roussell| A, Godi|
|000009e0| 6e 65 20 4a 45 0d 0a 28 | 4d 61 73 73 61 63 68 75 |ne JE..(|Massachu|
|000009f0| 73 65 74 74 73 20 47 65 | 6e 20 48 6f 73 70 2c 20 |setts Ge|n Hosp, |
|00000a00| 42 6f 73 74 6f 6e 3b 20 | 48 61 72 76 61 72 64 20 |Boston; |Harvard |
|00000a10| 4d 65 64 20 53 63 68 6f | 6f 6c 2c 20 42 6f 73 74 |Med Scho|ol, Bost|
|00000a20| 6f 6e 29 0d 0a 41 6e 6e | 20 49 6e 74 65 72 6e 20 |on)..Ann| Intern |
|00000a30| 4d 65 64 20 31 30 38 3a | 33 33 34 2d 33 34 30 2c |Med 108:|334-340,|
|00000a40| 20 4d 61 72 63 68 20 31 | 39 38 38 0d 0a 2d 2d 2d | March 1|988..---|
|00000a50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000a60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000a70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000a80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000a90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 0d |--------|-----...|
|00000aa0| 0a 41 62 73 74 72 61 63 | 74 0d 0a 0d 0a 20 20 20 |.Abstrac|t.... |
|00000ab0| 20 20 4d 61 6e 79 20 61 | 75 74 68 6f 72 73 20 71 | Many a|uthors q|
|00000ac0| 75 65 73 74 69 6f 6e 20 | 74 68 65 20 72 65 6c 61 |uestion |the rela|
|00000ad0| 74 69 76 65 20 73 61 66 | 65 74 79 20 61 6e 64 20 |tive saf|ety and |
|00000ae0| 62 65 6e 65 66 69 74 73 | 20 6f 66 20 6f 72 61 6c |benefits| of oral|
|00000af0| 20 61 67 65 6e 74 73 0d | 0a 76 65 72 73 75 73 20 | agents.|.versus |
|00000b00| 69 6e 73 75 6c 69 6e 20 | 66 6f 72 20 6d 65 74 61 |insulin |for meta|
|00000b10| 62 6f 6c 69 63 20 63 6f | 6e 74 72 6f 6c 20 69 6e |bolic co|ntrol in|
|00000b20| 20 6e 6f 6e 2d 69 6e 73 | 75 6c 69 6e 2d 64 65 70 | non-ins|ulin-dep|
|00000b30| 65 6e 64 65 6e 74 20 70 | 61 74 69 65 6e 74 73 20 |endent p|atients |
|00000b40| 77 69 74 68 0d 0a 64 69 | 61 62 65 74 65 73 20 6d |with..di|abetes m|
|00000b50| 65 6c 6c 69 74 75 73 2e | 20 20 41 20 72 61 6e 64 |ellitus.| A rand|
|00000b60| 6f 6d 69 7a 65 64 2c 20 | 64 6f 75 62 6c 65 2d 62 |omized, |double-b|
|00000b70| 6c 69 6e 64 20 73 74 75 | 64 79 20 77 61 73 20 64 |lind stu|dy was d|
|00000b80| 65 73 69 67 6e 65 64 20 | 74 6f 20 63 6f 6d 70 61 |esigned |to compa|
|00000b90| 72 65 0d 0a 69 6e 73 75 | 6c 69 6e 20 76 65 72 73 |re..insu|lin vers|
|00000ba0| 75 73 20 67 6c 79 62 75 | 72 69 64 65 20 69 6e 20 |us glybu|ride in |
|00000bb0| 61 63 68 69 65 76 69 6e | 67 20 6e 6f 72 6d 6f 67 |achievin|g normog|
|00000bc0| 6c 79 63 65 6d 69 61 20 | 69 6e 20 74 68 65 73 65 |lycemia |in these|
|00000bd0| 20 70 61 74 69 65 6e 74 | 73 2e 0d 0a 54 68 69 72 | patient|s...Thir|
|00000be0| 74 79 2d 6f 6e 65 20 70 | 61 74 69 65 6e 74 73 20 |ty-one p|atients |
|00000bf0| 69 6e 20 77 68 6f 6d 20 | 64 69 65 74 20 63 6f 75 |in whom |diet cou|
|00000c00| 6c 64 20 6e 6f 74 20 61 | 63 68 69 65 76 65 20 6e |ld not a|chieve n|
|00000c10| 6f 72 6d 61 6c 20 67 6c | 75 63 6f 73 65 20 63 6f |ormal gl|ucose co|
|00000c20| 6e 74 72 6f 6c 20 77 65 | 72 65 0d 0a 72 61 6e 64 |ntrol we|re..rand|
|00000c30| 6f 6d 69 7a 65 64 20 74 | 6f 20 72 65 63 65 69 76 |omized t|o receiv|
|00000c40| 65 20 65 69 74 68 65 72 | 20 6f 72 61 6c 20 67 6c |e either| oral gl|
|00000c50| 79 62 75 72 69 64 65 20 | 6f 72 20 69 6e 73 75 6c |yburide |or insul|
|00000c60| 69 6e 20 69 6e 6a 65 63 | 74 69 6f 6e 20 61 6e 64 |in injec|tion and|
|00000c70| 20 70 6c 61 63 65 62 6f | 0d 0a 69 6e 6a 65 63 74 | placebo|..inject|
|00000c80| 69 6f 6e 20 6f 72 20 70 | 6c 61 63 65 62 6f 20 74 |ion or p|lacebo t|
|00000c90| 61 62 6c 65 74 20 66 6f | 72 20 74 68 65 20 61 6c |ablet fo|r the al|
|00000ca0| 74 65 72 6e 61 74 65 20 | 64 72 75 67 2e 0d 0a 20 |ternate |drug... |
|00000cb0| 20 20 20 20 47 72 6f 75 | 70 73 20 77 65 72 65 20 | Grou|ps were |
|00000cc0| 73 69 6d 69 6c 61 72 20 | 69 6e 20 69 6d 70 72 6f |similar |in impro|
|00000cd0| 76 65 6d 65 6e 74 20 69 | 6e 20 66 61 73 74 69 6e |vement i|n fastin|
|00000ce0| 67 20 62 6c 6f 6f 64 20 | 67 6c 75 63 6f 73 65 20 |g blood |glucose |
|00000cf0| 6c 65 76 65 6c 73 20 61 | 6e 64 0d 0a 68 65 6d 6f |levels a|nd..hemo|
|00000d00| 67 6c 6f 62 69 6e 20 41 | 31 63 20 63 6f 6e 63 65 |globin A|1c conce|
|00000d10| 6e 74 72 61 74 69 6f 6e | 73 2c 20 66 72 65 71 75 |ntration|s, frequ|
|00000d20| 65 6e 63 79 20 6f 66 20 | 6d 69 6c 64 20 68 79 70 |ency of |mild hyp|
|00000d30| 6f 67 6c 79 63 65 6d 69 | 61 2c 20 61 6e 64 20 77 |oglycemi|a, and w|
|00000d40| 65 69 67 68 74 20 67 61 | 69 6e 2e 0d 0a 49 6e 20 |eight ga|in...In |
|00000d50| 62 6f 74 68 20 67 72 6f | 75 70 73 20 74 72 69 67 |both gro|ups trig|
|00000d60| 6c 79 63 65 72 69 64 65 | 20 61 6e 64 20 63 68 6f |lyceride| and cho|
|00000d70| 6c 65 73 74 65 72 6f 6c | 20 6c 65 76 65 6c 73 20 |lesterol| levels |
|00000d80| 64 65 63 72 65 61 73 65 | 64 2e 20 20 48 69 67 68 |decrease|d. High|
|00000d90| 2d 64 65 6e 73 69 74 79 | 0d 0a 6c 69 70 6f 70 72 |-density|..lipopr|
|00000da0| 6f 74 65 69 6e 20 28 48 | 44 4c 29 20 63 68 6f 6c |otein (H|DL) chol|
|00000db0| 65 73 74 65 72 6f 6c 20 | 61 6e 64 20 72 61 74 69 |esterol |and rati|
|00000dc0| 6f 73 20 6f 66 20 48 44 | 4c 20 74 6f 20 74 6f 74 |os of HD|L to tot|
|00000dd0| 61 6c 20 70 72 6f 74 65 | 69 6e 20 69 6e 63 72 65 |al prote|in incre|
|00000de0| 61 73 65 64 20 69 6e 0d | 0a 62 6f 74 68 20 67 72 |ased in.|.both gr|
|00000df0| 6f 75 70 73 2c 20 62 75 | 74 20 73 69 67 6e 69 66 |oups, bu|t signif|
|00000e00| 69 63 61 6e 74 6c 79 20 | 67 72 65 61 74 65 72 20 |icantly |greater |
|00000e10| 69 6d 70 72 6f 76 65 6d | 65 6e 74 20 6f 63 63 75 |improvem|ent occu|
|00000e20| 72 72 65 64 20 69 6e 20 | 74 68 65 0d 0a 69 6e 73 |rred in |the..ins|
|00000e30| 75 6c 69 6e 2d 74 72 65 | 61 74 65 64 20 67 72 6f |ulin-tre|ated gro|
|00000e40| 75 70 20 28 74 61 62 6c | 65 29 2e 0d 0a 20 20 20 |up (tabl|e)... |
|00000e50| 20 20 47 6c 79 62 75 72 | 69 64 65 20 61 6e 64 20 | Glybur|ide and |
|00000e60| 6f 6e 63 65 2d 61 2d 64 | 61 79 20 69 6e 73 75 6c |once-a-d|ay insul|
|00000e70| 69 6e 20 70 72 6f 76 69 | 64 65 20 73 69 6d 69 6c |in provi|de simil|
|00000e80| 61 72 20 67 6c 75 63 6f | 73 65 20 63 6f 6e 74 72 |ar gluco|se contr|
|00000e90| 6f 6c 20 69 6e 0d 0a 70 | 61 74 69 65 6e 74 73 20 |ol in..p|atients |
|00000ea0| 77 69 74 68 20 6e 6f 6e | 2d 69 6e 73 75 6c 69 6e |with non|-insulin|
|00000eb0| 2d 64 65 70 65 6e 64 65 | 6e 74 20 64 69 61 62 65 |-depende|nt diabe|
|00000ec0| 74 65 73 20 6d 65 6c 6c | 69 74 75 73 2e 20 20 49 |tes mell|itus. I|
|00000ed0| 6e 73 75 6c 69 6e 20 6d | 61 79 20 6f 66 66 65 72 |nsulin m|ay offer|
|00000ee0| 20 61 6e 0d 0a 61 64 76 | 61 6e 74 61 67 65 20 62 | an..adv|antage b|
|00000ef0| 65 63 61 75 73 65 20 69 | 74 20 69 73 20 61 73 73 |ecause i|t is ass|
|00000f00| 6f 63 69 61 74 65 64 20 | 77 69 74 68 20 68 69 67 |ociated |with hig|
|00000f10| 68 65 72 20 6c 65 76 65 | 6c 73 20 6f 66 20 48 44 |her leve|ls of HD|
|00000f20| 4c 20 63 68 6f 6c 65 73 | 74 65 72 6f 6c 20 61 6e |L choles|terol an|
|00000f30| 64 0d 0a 68 69 67 68 65 | 72 20 72 61 74 69 6f 73 |d..highe|r ratios|
|00000f40| 20 6f 66 20 48 44 4c 20 | 74 6f 20 74 6f 74 61 6c | of HDL |to total|
|00000f50| 20 63 68 6f 6c 65 73 74 | 65 72 6f 6c 2e 0d 0a 0d | cholest|erol....|
|00000f60| 0a 50 6f 73 74 2d 43 6f | 6d 6d 65 6e 74 0d 0a 0d |.Post-Co|mment...|
|00000f70| 0a 20 20 20 20 20 42 6f | 74 68 20 74 68 65 20 6f |. Bo|th the o|
|00000f80| 72 61 6c 20 68 79 70 6f | 67 6c 79 63 65 6d 69 63 |ral hypo|glycemic|
|00000f90| 2c 20 67 6c 79 62 75 72 | 69 64 65 20 28 4d 69 63 |, glybur|ide (Mic|
|00000fa0| 72 6f 6e 61 73 65 29 2c | 20 61 6e 64 20 69 6e 73 |ronase),| and ins|
|00000fb0| 75 6c 69 6e 20 77 65 72 | 65 20 65 71 75 61 6c 6c |ulin wer|e equall|
|00000fc0| 79 0d 0a 65 66 66 65 63 | 74 69 76 65 20 69 6e 20 |y..effec|tive in |
|00000fd0| 63 6f 6e 74 72 6f 6c 6c | 69 6e 67 20 70 72 65 73 |controll|ing pres|
|00000fe0| 75 6d 65 64 20 6e 6f 6e | 2d 69 6e 73 75 6c 69 6e |umed non|-insulin|
|00000ff0| 2d 64 65 70 65 6e 64 65 | 6e 74 20 64 69 61 62 65 |-depende|nt diabe|
|00001000| 74 69 63 73 2e 20 20 54 | 68 65 20 6f 72 61 6c 0d |tics. T|he oral.|
|00001010| 0a 61 67 65 6e 74 20 68 | 61 73 20 74 68 65 20 61 |.agent h|as the a|
|00001020| 64 76 61 6e 74 61 67 65 | 20 6f 66 20 67 72 65 61 |dvantage| of grea|
|00001030| 74 65 72 20 63 6f 6e 76 | 65 6e 69 65 6e 63 65 2e |ter conv|enience.|
|00001040| 20 20 57 68 65 74 68 65 | 72 20 74 68 65 20 69 6d | Whethe|r the im|
|00001050| 70 72 6f 76 65 6d 65 6e | 74 73 20 69 6e 0d 0a 73 |provemen|ts in..s|
|00001060| 65 72 75 6d 20 6c 69 70 | 69 64 20 70 61 72 61 6d |erum lip|id param|
|00001070| 65 74 65 72 73 20 66 6f | 6c 6c 6f 77 69 6e 67 20 |eters fo|llowing |
|00001080| 69 6e 73 75 6c 69 6e 20 | 73 75 72 70 61 73 73 20 |insulin |surpass |
|00001090| 74 68 69 73 20 61 64 76 | 61 6e 74 61 67 65 20 72 |this adv|antage r|
|000010a0| 65 6d 61 69 6e 73 20 74 | 6f 20 62 65 0d 0a 73 65 |emains t|o be..se|
|000010b0| 65 6e 2e 20 20 41 20 74 | 72 75 65 72 20 74 65 73 |en. A t|ruer tes|
|000010c0| 74 20 6d 69 67 68 74 20 | 62 65 20 74 6f 20 63 6f |t might |be to co|
|000010d0| 6d 70 61 72 65 20 74 68 | 65 20 32 20 74 72 65 61 |mpare th|e 2 trea|
|000010e0| 74 6d 65 6e 74 73 20 77 | 68 65 6e 20 61 6e 79 20 |tments w|hen any |
|000010f0| 65 76 69 64 65 6e 63 65 | 20 6f 66 0d 0a 69 6e 73 |evidence| of..ins|
|00001100| 75 6c 69 6e 20 64 65 70 | 65 6e 64 65 6e 63 65 20 |ulin dep|endence |
|00001110| 69 73 20 65 6c 69 6d 69 | 6e 61 74 65 64 2c 20 61 |is elimi|nated, a|
|00001120| 73 20 6d 65 6e 74 69 6f | 6e 65 64 20 69 6e 20 74 |s mentio|ned in t|
|00001130| 68 65 20 70 72 65 76 69 | 6f 75 73 20 61 62 73 74 |he previ|ous abst|
|00001140| 72 61 63 74 2e 2d 2d 4c | 2e 45 2e 0d 0a 48 6f 6c |ract.--L|.E...Hol|
|00001150| 6c 69 73 74 65 72 2c 20 | 4d 2e 44 2e 0d 0a 24 55 |lister, |M.D...$U|
|00001160| 6e 69 71 75 65 5f 49 44 | 7b 59 52 42 30 35 37 30 |nique_ID|{YRB0570|
|00001170| 31 7d 0d 0a 24 54 69 74 | 6c 65 7b 4c 69 6e 6f 67 |1}..$Tit|le{Linog|
|00001180| 6c 69 72 69 64 65 20 46 | 75 6d 61 72 61 74 65 2c |liride F|umarate,|
|00001190| 20 52 65 70 72 65 73 65 | 6e 74 69 6e 67 20 61 20 | Represe|nting a |
|000011a0| 4e 65 77 20 43 6c 61 73 | 73 20 6f 66 20 4f 72 61 |New Clas|s of Ora|
|000011b0| 6c 20 48 79 70 6f 67 6c | 79 63 65 6d 69 63 20 41 |l Hypogl|ycemic A|
|000011c0| 67 65 6e 74 20 66 6f 72 | 20 44 69 61 62 65 74 65 |gent for| Diabete|
|000011d0| 73 7d 0d 0a 24 41 75 74 | 68 6f 72 7b 0d 0a 4c 65 |s}..$Aut|hor{..Le|
|000011e0| 76 69 6e 2c 20 50 41 0d | 0a 4a 6f 76 61 6e 6f 76 |vin, PA.|.Jovanov|
|000011f0| 69 63 2c 20 4c 0d 0a 43 | 68 61 6c 65 77 2c 20 53 |ic, L..C|halew, S|
|00001200| 41 0d 0a 4d 61 72 74 69 | 6e 2c 20 4c 0d 0a 50 69 |A..Marti|n, L..Pi|
|00001210| 74 61 72 72 61 2c 20 44 | 4b 0d 0a 4b 69 6d 2c 20 |tarra, D|K..Kim, |
|00001220| 46 0d 0a 4b 6f 77 61 72 | 73 6b 69 2c 20 41 41 7d |F..Kowar|ski, AA}|
|00001230| 0d 0a 24 41 66 66 69 6c | 69 61 74 69 6f 6e 7b 55 |..$Affil|iation{U|
|00001240| 6e 69 76 20 6f 66 20 4d | 61 72 79 6c 61 6e 64 2c |niv of M|aryland,|
|00001250| 20 42 61 6c 74 69 6d 6f | 72 65 3b 20 53 61 6e 73 | Baltimo|re; Sans|
|00001260| 75 6d 20 4d 65 64 20 52 | 65 73 65 61 72 63 68 20 |um Med R|esearch |
|00001270| 46 6f 75 6e 64 2c 20 53 | 61 6e 74 61 20 42 61 72 |Found, S|anta Bar|
|00001280| 62 61 72 61 2c 20 43 61 | 6c 69 66 7d 0d 0a 24 53 |bara, Ca|lif}..$S|
|00001290| 75 62 6a 65 63 74 7b 4c | 69 6e 6f 67 6c 69 72 69 |ubject{L|inogliri|
|000012a0| 64 65 20 66 75 6d 61 72 | 61 74 65 20 69 6e 20 64 |de fumar|ate in d|
|000012b0| 69 61 62 65 74 65 73 3b | 0d 0a 44 69 61 62 65 74 |iabetes;|..Diabet|
|000012c0| 65 73 20 6d 65 6c 6c 69 | 74 75 73 20 6c 69 6e 6f |es melli|tus lino|
|000012d0| 67 6c 69 72 69 64 65 20 | 66 75 6d 61 72 61 74 65 |gliride |fumarate|
|000012e0| 20 69 6e 7d 0d 0a 24 4a | 6f 75 72 6e 61 6c 7b 43 | in}..$J|ournal{C|
|000012f0| 6c 69 6e 20 50 68 61 72 | 6d 61 63 6f 6c 20 54 68 |lin Phar|macol Th|
|00001300| 65 72 7d 0d 0a 24 56 6f | 6c 75 6d 65 7b 34 32 7d |er}..$Vo|lume{42}|
|00001310| 0d 0a 24 50 61 67 65 7b | 34 39 38 2d 35 30 33 7d |..$Page{|498-503}|
|00001320| 0d 0a 24 44 61 74 65 7b | 4e 6f 76 65 6d 62 65 72 |..$Date{|November|
|00001330| 20 31 39 38 37 7d 0d 0a | 24 59 42 56 6f 6c 7b 31 | 1987}..|$YBVol{1|
|00001340| 39 38 39 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |989 Year| Book of|
|00001350| 20 44 72 75 67 20 54 68 | 65 72 61 70 79 7d 0d 0a | Drug Th|erapy}..|
|00001360| 24 43 68 61 70 74 65 72 | 7b 37 2d 38 7d 0d 0a 24 |$Chapter|{7-8}..$|
|00001370| 59 42 45 64 69 74 6f 72 | 7b 44 72 73 2e 20 48 6f |YBEditor|{Drs. Ho|
|00001380| 6c 6c 69 73 74 65 72 20 | 61 6e 64 20 4c 61 73 61 |llister |and Lasa|
|00001390| 67 6e 61 7d 0d 0a 24 54 | 61 62 6c 65 7b 54 61 62 |gna}..$T|able{Tab|
|000013a0| 6c 65 20 4f 6d 69 74 74 | 65 64 7d 0d 0a 24 43 6f |le Omitt|ed}..$Co|
|000013b0| 6d 6d 65 6e 74 61 74 6f | 72 7b 4c 2e 45 2e 20 48 |mmentato|r{L.E. H|
|000013c0| 6f 6c 6c 69 73 74 65 72 | 2c 20 4d 2e 44 2e 7d 0d |ollister|, M.D.}.|
|000013d0| 0a 0d 0a 43 6f 70 79 72 | 69 67 68 74 20 28 63 29 |...Copyr|ight (c)|
|000013e0| 20 59 65 61 72 20 42 6f | 6f 6b 20 4d 65 64 69 63 | Year Bo|ok Medic|
|000013f0| 61 6c 20 50 75 62 6c 69 | 73 68 65 72 73 2c 20 49 |al Publi|shers, I|
|00001400| 6e 63 2e 2c 20 31 39 38 | 39 0d 0a 0d 0a 31 39 38 |nc., 198|9....198|
|00001410| 39 20 59 65 61 72 20 42 | 6f 6f 6b 20 6f 66 20 44 |9 Year B|ook of D|
|00001420| 72 75 67 20 54 68 65 72 | 61 70 79 20 28 52 29 0d |rug Ther|apy (R).|
|00001430| 0a 0d 0a 43 68 61 70 74 | 65 72 20 37 2d 2d 45 6e |...Chapt|er 7--En|
|00001440| 64 6f 63 72 69 6e 65 20 | 61 6e 64 20 4d 65 74 61 |docrine |and Meta|
|00001450| 62 6f 6c 69 63 20 44 69 | 73 6f 72 64 65 72 73 0d |bolic Di|sorders.|
|00001460| 0a 0d 0a 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |...-----|--------|
|00001470| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001480| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001490| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000014a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000014b0| 2d 2d 2d 0d 0a 4c 69 6e | 6f 67 6c 69 72 69 64 65 |---..Lin|ogliride|
|000014c0| 20 46 75 6d 61 72 61 74 | 65 2c 20 52 65 70 72 65 | Fumarat|e, Repre|
|000014d0| 73 65 6e 74 69 6e 67 20 | 61 20 4e 65 77 20 43 6c |senting |a New Cl|
|000014e0| 61 73 73 20 6f 66 20 4f | 72 61 6c 20 48 79 70 6f |ass of O|ral Hypo|
|000014f0| 67 6c 79 63 65 6d 69 63 | 20 41 67 65 6e 74 20 66 |glycemic| Agent f|
|00001500| 6f 72 0d 0a 44 69 61 62 | 65 74 65 73 0d 0a 0d 0a |or..Diab|etes....|
|00001510| 4c 65 76 69 6e 20 50 41 | 2c 20 4a 6f 76 61 6e 6f |Levin PA|, Jovano|
|00001520| 76 69 63 20 4c 2c 20 43 | 68 61 6c 65 77 20 53 41 |vic L, C|halew SA|
|00001530| 2c 20 4d 61 72 74 69 6e | 20 4c 2c 20 50 69 74 61 |, Martin| L, Pita|
|00001540| 72 72 61 20 44 4b 2c 20 | 4b 69 6d 20 46 2c 20 4b |rra DK, |Kim F, K|
|00001550| 6f 77 61 72 73 6b 69 20 | 41 41 0d 0a 28 55 6e 69 |owarski |AA..(Uni|
|00001560| 76 20 6f 66 20 4d 61 72 | 79 6c 61 6e 64 2c 20 42 |v of Mar|yland, B|
|00001570| 61 6c 74 69 6d 6f 72 65 | 3b 20 53 61 6e 73 75 6d |altimore|; Sansum|
|00001580| 20 4d 65 64 20 52 65 73 | 65 61 72 63 68 20 46 6f | Med Res|earch Fo|
|00001590| 75 6e 64 2c 20 53 61 6e | 74 61 20 42 61 72 62 61 |und, San|ta Barba|
|000015a0| 72 61 2c 20 43 61 6c 69 | 66 29 0d 0a 43 6c 69 6e |ra, Cali|f)..Clin|
|000015b0| 20 50 68 61 72 6d 61 63 | 6f 6c 20 54 68 65 72 20 | Pharmac|ol Ther |
|000015c0| 34 32 3a 34 39 38 2d 35 | 30 33 2c 20 4e 6f 76 65 |42:498-5|03, Nove|
|000015d0| 6d 62 65 72 20 31 39 38 | 37 0d 0a 2d 2d 2d 2d 2d |mber 198|7..-----|
|000015e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000015f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001600| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001610| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001620| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 0d 0a 41 |--------|---....A|
|00001630| 62 73 74 72 61 63 74 0d | 0a 0d 0a 20 20 20 20 20 |bstract.|... |
|00001640| 4c 69 6e 6f 67 6c 69 72 | 69 64 65 20 66 75 6d 61 |Linoglir|ide fuma|
|00001650| 72 61 74 65 20 69 73 20 | 61 6e 20 6f 72 61 6c 20 |rate is |an oral |
|00001660| 68 79 70 6f 67 6c 79 63 | 65 6d 69 63 20 61 67 65 |hypoglyc|emic age|
|00001670| 6e 74 20 74 68 61 74 20 | 64 69 66 66 65 72 73 0d |nt that |differs.|
|00001680| 0a 73 74 72 75 63 74 75 | 72 61 6c 6c 79 20 66 72 |.structu|rally fr|
|00001690| 6f 6d 20 62 6f 74 68 20 | 74 68 65 20 73 75 6c 66 |om both |the sulf|
|000016a0| 6f 6e 79 6c 75 72 65 61 | 73 20 61 6e 64 20 74 68 |onylurea|s and th|
|000016b0| 65 20 62 69 67 75 61 6e | 69 64 65 73 2e 20 20 41 |e biguan|ides. A|
|000016c0| 20 6d 75 6c 74 69 64 6f | 73 65 20 74 72 69 61 6c | multido|se trial|
|000016d0| 0d 0a 77 61 73 20 63 61 | 72 72 69 65 64 20 6f 75 |..was ca|rried ou|
|000016e0| 74 20 69 6e 20 32 36 20 | 6e 6f 6e 2d 69 6e 73 75 |t in 26 |non-insu|
|000016f0| 6c 69 6e 2d 64 65 70 65 | 6e 64 65 6e 74 20 64 69 |lin-depe|ndent di|
|00001700| 61 62 65 74 69 63 20 70 | 61 74 69 65 6e 74 73 2e |abetic p|atients.|
|00001710| 20 20 44 6f 73 65 73 20 | 6f 66 20 31 35 30 2c 0d | Doses |of 150,.|
|00001720| 0a 33 30 30 2c 20 61 6e | 64 20 34 30 30 20 6d 67 |.300, an|d 400 mg|
|00001730| 20 77 65 72 65 20 67 69 | 76 65 6e 20 74 77 69 63 | were gi|ven twic|
|00001740| 65 20 64 61 69 6c 79 20 | 6f 6e 20 61 20 73 69 6e |e daily |on a sin|
|00001750| 67 6c 65 2d 62 6c 69 6e | 64 20 62 61 73 69 73 2e |gle-blin|d basis.|
|00001760| 0d 0a 20 20 20 20 20 46 | 61 73 74 69 6e 67 20 61 |.. F|asting a|
|00001770| 6e 64 20 70 6f 73 74 70 | 72 61 6e 64 69 61 6c 20 |nd postp|randial |
|00001780| 70 6c 61 73 6d 61 20 67 | 6c 75 63 6f 73 65 20 6c |plasma g|lucose l|
|00001790| 65 76 65 6c 73 20 67 65 | 6e 65 72 61 6c 6c 79 20 |evels ge|nerally |
|000017a0| 66 65 6c 6c 20 73 69 67 | 6e 69 66 69 63 61 6e 74 |fell sig|nificant|
|000017b0| 6c 79 0d 0a 77 69 74 68 | 20 6c 69 6e 6f 67 6c 69 |ly..with| linogli|
|000017c0| 72 69 64 65 20 61 64 6d | 69 6e 69 73 74 72 61 74 |ride adm|inistrat|
|000017d0| 69 6f 6e 2e 20 20 41 20 | 64 65 63 72 65 61 73 65 |ion. A |decrease|
|000017e0| 20 69 6e 20 74 68 65 20 | 61 72 65 61 20 75 6e 64 | in the |area und|
|000017f0| 65 72 20 74 68 65 20 63 | 6f 6e 63 65 6e 74 72 61 |er the c|oncentra|
|00001800| 74 69 6f 6e 0d 0a 63 75 | 72 76 65 20 28 41 55 43 |tion..cu|rve (AUC|
|00001810| 29 20 66 6f 72 20 67 6c | 75 63 6f 73 65 20 77 61 |) for gl|ucose wa|
|00001820| 73 20 67 65 6e 65 72 61 | 6c 6c 79 20 61 73 73 6f |s genera|lly asso|
|00001830| 63 69 61 74 65 64 20 77 | 69 74 68 20 61 20 73 69 |ciated w|ith a si|
|00001840| 67 6e 69 66 69 63 61 6e | 74 20 69 6e 63 72 65 61 |gnifican|t increa|
|00001850| 73 65 20 69 6e 0d 0a 74 | 68 65 20 41 55 43 20 66 |se in..t|he AUC f|
|00001860| 6f 72 20 69 6e 73 75 6c | 69 6e 2e 20 20 4f 6e 20 |or insul|in. On |
|00001870| 65 61 63 68 20 64 61 79 | 20 6f 66 20 74 72 65 61 |each day| of trea|
|00001880| 74 6d 65 6e 74 2c 20 74 | 68 65 20 6d 65 61 6e 20 |tment, t|he mean |
|00001890| 66 61 73 74 69 6e 67 20 | 70 6c 61 73 6d 61 20 67 |fasting |plasma g|
|000018a0| 6c 75 63 6f 73 65 0d 0a | 63 6f 6e 63 65 6e 74 72 |lucose..|concentr|
|000018b0| 61 74 69 6f 6e 20 64 69 | 66 66 65 72 65 64 20 73 |ation di|ffered s|
|000018c0| 69 67 6e 69 66 69 63 61 | 6e 74 6c 79 20 66 72 6f |ignifica|ntly fro|
|000018d0| 6d 20 74 68 65 20 62 61 | 73 65 6c 69 6e 65 20 70 |m the ba|seline p|
|000018e0| 6c 61 63 65 62 6f 20 76 | 61 6c 75 65 20 28 46 69 |lacebo v|alue (Fi|
|000018f0| 67 20 37 2d 32 29 2e 0d | 0a 55 72 69 6e 61 72 79 |g 7-2)..|.Urinary|
|00001900| 20 43 20 70 65 70 74 69 | 64 65 20 76 61 6c 75 65 | C pepti|de value|
|00001910| 73 20 77 65 72 65 20 73 | 69 67 6e 69 66 69 63 61 |s were s|ignifica|
|00001920| 6e 74 6c 79 20 61 62 6f | 76 65 20 62 61 73 65 6c |ntly abo|ve basel|
|00001930| 69 6e 65 2e 20 20 54 68 | 65 72 65 20 77 65 72 65 |ine. Th|ere were|
|00001940| 20 6e 6f 20 6d 61 6a 6f | 72 0d 0a 61 64 76 65 72 | no majo|r..adver|
|00001950| 73 65 20 65 66 66 65 63 | 74 73 2e 0d 0a 20 20 20 |se effec|ts... |
|00001960| 20 20 4c 69 6e 6f 67 6c | 69 72 69 64 65 20 66 75 | Linogl|iride fu|
|00001970| 6d 61 72 61 74 65 20 69 | 73 20 61 6e 20 65 66 66 |marate i|s an eff|
|00001980| 65 63 74 69 76 65 20 68 | 79 70 6f 67 6c 79 63 65 |ective h|ypoglyce|
|00001990| 6d 69 63 20 61 67 65 6e | 74 2c 20 61 74 20 6c 65 |mic agen|t, at le|
|000019a0| 61 73 74 20 69 6e 20 74 | 68 65 0d 0a 73 68 6f 72 |ast in t|he..shor|
|000019b0| 74 20 74 65 72 6d 2e 20 | 20 44 61 69 6c 79 20 64 |t term. | Daily d|
|000019c0| 6f 73 65 73 20 6f 66 20 | 33 30 30 2d 38 30 30 20 |oses of |300-800 |
|000019d0| 6d 67 20 77 69 6c 6c 20 | 65 66 66 65 63 74 69 76 |mg will |effectiv|
|000019e0| 65 6c 79 20 6c 6f 77 65 | 72 20 74 68 65 20 62 6c |ely lowe|r the bl|
|000019f0| 6f 6f 64 20 67 6c 75 63 | 6f 73 65 0d 0a 6c 65 76 |ood gluc|ose..lev|
|00001a00| 65 6c 20 69 6e 20 61 20 | 6c 61 72 67 65 20 70 72 |el in a |large pr|
|00001a10| 6f 70 6f 72 74 69 6f 6e | 20 6f 66 20 6e 6f 6e 2d |oportion| of non-|
|00001a20| 69 6e 73 75 6c 69 6e 2d | 64 65 70 65 6e 64 65 6e |insulin-|dependen|
|00001a30| 74 20 64 69 61 62 65 74 | 69 63 20 70 61 74 69 65 |t diabet|ic patie|
|00001a40| 6e 74 73 2e 20 20 54 68 | 65 0d 0a 69 6e 73 75 6c |nts. Th|e..insul|
|00001a50| 69 6e 6f 74 72 6f 70 69 | 63 20 61 63 74 69 6f 6e |inotropi|c action|
|00001a60| 20 6f 66 20 6c 69 6e 6f | 67 6c 69 72 69 64 65 20 | of lino|gliride |
|00001a70| 6d 61 79 20 64 65 70 65 | 6e 64 20 70 61 72 74 6c |may depe|nd partl|
|00001a80| 79 20 6f 6e 20 70 6f 74 | 65 6e 74 69 61 74 69 6f |y on pot|entiatio|
|00001a90| 6e 20 6f 66 20 74 68 65 | 0d 0a 73 74 69 6d 75 6c |n of the|..stimul|
|00001aa0| 61 74 6f 72 79 20 65 66 | 66 65 63 74 20 6f 66 20 |atory ef|fect of |
|00001ab0| 67 6c 75 63 6f 73 65 20 | 6f 6e 20 74 68 65 20 70 |glucose |on the p|
|00001ac0| 61 6e 63 72 65 61 74 69 | 63 20 62 65 74 61 20 63 |ancreati|c beta c|
|00001ad0| 65 6c 6c 73 2e 0d 0a 0d | 0a 50 6f 73 74 2d 43 6f |ells....|.Post-Co|
|00001ae0| 6d 6d 65 6e 74 0d 0a 0d | 0a 20 20 20 20 20 43 6f |mment...|. Co|
|00001af0| 75 6c 64 20 74 68 69 73 | 20 6e 6f 76 65 6c 20 63 |uld this| novel c|
|00001b00| 68 65 6d 69 63 61 6c 20 | 73 74 72 75 63 74 75 72 |hemical |structur|
|00001b10| 65 2c 20 6c 69 6e 6f 67 | 6c 69 72 69 64 65 20 66 |e, linog|liride f|
|00001b20| 75 6d 61 72 61 74 65 2c | 20 72 65 70 72 65 73 65 |umarate,| represe|
|00001b30| 6e 74 20 74 68 65 0d 0a | 66 69 72 73 74 20 6f 66 |nt the..|first of|
|00001b40| 20 61 20 22 74 68 69 72 | 64 20 67 65 6e 65 72 61 | a "thir|d genera|
|00001b50| 74 69 6f 6e 22 20 6f 66 | 20 6f 72 61 6c 20 68 79 |tion" of| oral hy|
|00001b60| 70 6f 67 6c 79 63 65 6d | 69 63 73 2c 20 6f 72 20 |poglycem|ics, or |
|00001b70| 69 73 20 69 74 20 6a 75 | 73 74 20 74 68 65 20 66 |is it ju|st the f|
|00001b80| 69 72 73 74 20 32 0d 0a | 67 65 6e 65 72 61 74 69 |irst 2..|generati|
|00001b90| 6f 6e 73 20 72 65 76 69 | 73 69 74 65 64 3f 20 20 |ons revi|sited? |
|00001ba0| 41 20 73 69 6e 67 6c 65 | 20 63 6c 69 6e 69 63 61 |A single| clinica|
|00001bb0| 6c 20 74 72 69 61 6c 2c | 20 73 75 63 68 20 61 73 |l trial,| such as|
|00001bc0| 20 74 68 65 20 6f 6e 65 | 20 72 65 70 6f 72 74 65 | the one| reporte|
|00001bd0| 64 20 61 62 6f 76 65 2c | 0d 0a 64 6f 65 73 20 6e |d above,|..does n|
|00001be0| 6f 74 20 61 6e 73 77 65 | 72 20 74 68 69 73 20 71 |ot answe|r this q|
|00001bf0| 75 65 73 74 69 6f 6e 2c | 20 6e 6f 72 20 74 68 65 |uestion,| nor the|
|00001c00| 20 6d 61 6e 79 20 61 62 | 6f 75 74 20 61 64 76 65 | many ab|out adve|
|00001c10| 72 73 65 20 65 66 66 65 | 63 74 73 2c 20 74 6f 6c |rse effe|cts, tol|
|00001c20| 65 72 61 6e 63 65 2c 0d | 0a 61 6e 64 20 74 68 65 |erance,.|.and the|
|00001c30| 20 6c 69 6b 65 2e 20 20 | 4c 65 74 27 73 20 6b 65 | like. |Let's ke|
|00001c40| 65 70 20 6f 75 72 20 65 | 79 65 73 20 6f 6e 20 74 |ep our e|yes on t|
|00001c50| 68 69 73 20 6f 6e 65 20 | 61 73 20 69 74 20 63 6f |his one |as it co|
|00001c60| 6d 65 73 20 61 6c 6f 6e | 67 2e 2d 2d 4c 2e 45 2e |mes alon|g.--L.E.|
|00001c70| 0d 0a 48 6f 6c 6c 69 73 | 74 65 72 2c 20 4d 2e 44 |..Hollis|ter, M.D|
|00001c80| 2e 0d 0a 24 55 6e 69 71 | 75 65 5f 49 44 7b 59 52 |...$Uniq|ue_ID{YR|
|00001c90| 42 30 35 37 30 32 7d 0d | 0a 24 54 69 74 6c 65 7b |B05702}.|.$Title{|
|00001ca0| 54 72 65 61 74 6d 65 6e | 74 20 6f 66 20 44 69 61 |Treatmen|t of Dia|
|00001cb0| 62 65 74 69 63 20 44 69 | 61 72 72 68 65 61 20 61 |betic Di|arrhea a|
|00001cc0| 6e 64 20 4f 72 74 68 6f | 73 74 61 74 69 63 20 48 |nd Ortho|static H|
|00001cd0| 79 70 6f 74 65 6e 73 69 | 6f 6e 20 57 69 74 68 20 |ypotensi|on With |
|00001ce0| 53 6f 6d 61 74 6f 73 74 | 61 74 69 6e 20 41 6e 61 |Somatost|atin Ana|
|00001cf0| 6c 6f 67 75 65 20 53 4d | 53 20 32 30 31 2d 39 39 |logue SM|S 201-99|
|00001d00| 35 7d 0d 0a 24 41 75 74 | 68 6f 72 7b 0d 0a 44 75 |5}..$Aut|hor{..Du|
|00001d10| 64 6c 2c 20 52 4a 0d 0a | 41 6e 64 65 72 73 6f 6e |dl, RJ..|Anderson|
|00001d20| 2c 20 44 53 0d 0a 46 6f | 72 73 79 74 68 65 2c 20 |, DS..Fo|rsythe, |
|00001d30| 41 42 0d 0a 5a 69 65 67 | 6c 65 72 2c 20 4d 47 0d |AB..Zieg|ler, MG.|
|00001d40| 0a 4f 27 44 6f 72 69 73 | 69 6f 2c 20 54 4d 7d 0d |.O'Doris|io, TM}.|
|00001d50| 0a 24 41 66 66 69 6c 69 | 61 74 69 6f 6e 7b 4b 61 |.$Affili|ation{Ka|
|00001d60| 69 73 65 72 20 50 65 72 | 6d 61 6e 65 6e 74 65 20 |iser Per|manente |
|00001d70| 4d 65 64 20 43 74 72 2c | 20 53 61 6e 20 44 69 65 |Med Ctr,| San Die|
|00001d80| 67 6f 3b 20 55 6e 69 76 | 20 6f 66 20 43 61 6c 69 |go; Univ| of Cali|
|00001d90| 66 6f 72 6e 69 61 2c 20 | 53 61 6e 20 44 69 65 67 |fornia, |San Dieg|
|00001da0| 6f 3b 20 4f 68 69 6f 20 | 53 74 61 74 65 20 55 6e |o; Ohio |State Un|
|00001db0| 69 76 7d 0d 0a 24 53 75 | 62 6a 65 63 74 7b 53 6f |iv}..$Su|bject{So|
|00001dc0| 6d 61 74 6f 73 74 61 74 | 69 6e 20 61 6e 61 6c 6f |matostat|in analo|
|00001dd0| 67 75 65 20 53 4d 53 20 | 32 30 31 2d 39 39 35 20 |gue SMS |201-995 |
|00001de0| 69 6e 20 64 69 61 62 65 | 74 69 63 20 64 69 61 72 |in diabe|tic diar|
|00001df0| 72 68 65 61 20 61 6e 64 | 20 6f 72 74 68 6f 73 74 |rhea and| orthost|
|00001e00| 61 74 69 63 20 68 79 70 | 6f 74 65 6e 73 69 6f 6e |atic hyp|otension|
|00001e10| 3b 0d 0a 53 4d 53 20 32 | 30 31 2d 39 39 35 20 69 |;..SMS 2|01-995 i|
|00001e20| 6e 20 64 69 61 62 65 74 | 69 63 20 64 69 61 72 72 |n diabet|ic diarr|
|00001e30| 68 65 61 20 61 6e 64 20 | 6f 72 74 68 6f 73 74 61 |hea and |orthosta|
|00001e40| 74 69 63 20 68 79 70 6f | 74 65 6e 73 69 6f 6e 3b |tic hypo|tension;|
|00001e50| 0d 0a 4f 72 74 68 6f 73 | 74 61 74 69 63 20 68 79 |..Orthos|tatic hy|
|00001e60| 70 6f 74 65 6e 73 69 6f | 6e 2c 20 73 6f 6d 61 74 |potensio|n, somat|
|00001e70| 6f 73 74 61 74 69 6e 20 | 61 6e 61 6c 6f 67 75 65 |ostatin |analogue|
|00001e80| 20 53 4d 41 20 32 30 31 | 2d 39 39 35 20 69 6e 3b | SMA 201|-995 in;|
|00001e90| 0d 0a 48 79 70 6f 74 65 | 6e 73 69 6f 6e 20 6f 72 |..Hypote|nsion or|
|00001ea0| 74 68 6f 73 74 61 74 69 | 63 2c 20 73 6f 6d 61 74 |thostati|c, somat|
|00001eb0| 6f 73 74 61 74 69 6e 20 | 61 6e 61 6c 6f 67 75 65 |ostatin |analogue|
|00001ec0| 20 53 4d 41 20 69 6e 3b | 0d 0a 44 69 61 72 72 68 | SMA in;|..Diarrh|
|00001ed0| 65 61 20 64 69 61 62 65 | 74 69 63 2c 20 73 6f 6d |ea diabe|tic, som|
|00001ee0| 61 74 6f 73 74 61 74 69 | 6e 20 61 6e 61 6c 6f 67 |atostati|n analog|
|00001ef0| 75 65 20 53 4d 53 20 69 | 6e 3b 0d 0a 44 69 61 62 |ue SMS i|n;..Diab|
|00001f00| 65 74 65 73 20 6d 65 6c | 6c 69 74 75 73 20 64 69 |etes mel|litus di|
|00001f10| 61 72 72 68 65 61 20 69 | 6e 2c 20 73 6f 6d 61 74 |arrhea i|n, somat|
|00001f20| 6f 73 74 61 74 69 6e 20 | 61 6e 61 6c 6f 67 75 65 |ostatin |analogue|
|00001f30| 20 53 4d 53 20 69 6e 7d | 0d 0a 24 4a 6f 75 72 6e | SMS in}|..$Journ|
|00001f40| 61 6c 7b 41 6d 20 4a 20 | 4d 65 64 7d 0d 0a 24 56 |al{Am J |Med}..$V|
|00001f50| 6f 6c 75 6d 65 7b 38 33 | 7d 0d 0a 24 50 61 67 65 |olume{83|}..$Page|
|00001f60| 7b 35 38 34 2d 35 38 38 | 7d 0d 0a 24 44 61 74 65 |{584-588|}..$Date|
|00001f70| 7b 53 65 70 74 65 6d 62 | 65 72 20 31 39 38 37 7d |{Septemb|er 1987}|
|00001f80| 0d 0a 24 59 42 56 6f 6c | 7b 31 39 38 39 20 59 65 |..$YBVol|{1989 Ye|
|00001f90| 61 72 20 42 6f 6f 6b 20 | 6f 66 20 44 72 75 67 20 |ar Book |of Drug |
|00001fa0| 54 68 65 72 61 70 79 7d | 0d 0a 24 43 68 61 70 74 |Therapy}|..$Chapt|
|00001fb0| 65 72 7b 37 2d 39 7d 0d | 0a 24 59 42 45 64 69 74 |er{7-9}.|.$YBEdit|
|00001fc0| 6f 72 7b 44 72 73 2e 20 | 48 6f 6c 6c 69 73 74 65 |or{Drs. |Holliste|
|00001fd0| 72 20 61 6e 64 20 4c 61 | 73 61 67 6e 61 7d 0d 0a |r and La|sagna}..|
|00001fe0| 24 54 61 62 6c 65 7b 54 | 61 62 6c 65 20 4f 6d 69 |$Table{T|able Omi|
|00001ff0| 74 74 65 64 7d 0d 0a 24 | 43 6f 6d 6d 65 6e 74 61 |tted}..$|Commenta|
|00002000| 74 6f 72 7b 4c 2e 45 2e | 20 48 6f 6c 6c 69 73 74 |tor{L.E.| Hollist|
|00002010| 65 72 2c 20 4d 2e 44 2e | 7d 0d 0a 0d 0a 43 6f 70 |er, M.D.|}....Cop|
|00002020| 79 72 69 67 68 74 20 28 | 63 29 20 59 65 61 72 20 |yright (|c) Year |
|00002030| 42 6f 6f 6b 20 4d 65 64 | 69 63 61 6c 20 50 75 62 |Book Med|ical Pub|
|00002040| 6c 69 73 68 65 72 73 2c | 20 49 6e 63 2e 2c 20 31 |lishers,| Inc., 1|
|00002050| 39 38 39 0d 0a 0d 0a 31 | 39 38 39 20 59 65 61 72 |989....1|989 Year|
|00002060| 20 42 6f 6f 6b 20 6f 66 | 20 44 72 75 67 20 54 68 | Book of| Drug Th|
|00002070| 65 72 61 70 79 20 28 52 | 29 0d 0a 0d 0a 43 68 61 |erapy (R|)....Cha|
|00002080| 70 74 65 72 20 37 2d 2d | 45 6e 64 6f 63 72 69 6e |pter 7--|Endocrin|
|00002090| 65 20 61 6e 64 20 4d 65 | 74 61 62 6f 6c 69 63 20 |e and Me|tabolic |
|000020a0| 44 69 73 6f 72 64 65 72 | 73 0d 0a 0d 0a 2d 2d 2d |Disorder|s....---|
|000020b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000020c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000020d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000020e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000020f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 54 |--------|-----..T|
|00002100| 72 65 61 74 6d 65 6e 74 | 20 6f 66 20 44 69 61 62 |reatment| of Diab|
|00002110| 65 74 69 63 20 44 69 61 | 72 72 68 65 61 20 61 6e |etic Dia|rrhea an|
|00002120| 64 20 4f 72 74 68 6f 73 | 74 61 74 69 63 20 48 79 |d Orthos|tatic Hy|
|00002130| 70 6f 74 65 6e 73 69 6f | 6e 20 57 69 74 68 20 53 |potensio|n With S|
|00002140| 6f 6d 61 74 6f 73 74 61 | 74 69 6e 0d 0a 41 6e 61 |omatosta|tin..Ana|
|00002150| 6c 6f 67 75 65 20 53 4d | 53 20 32 30 31 2d 39 39 |logue SM|S 201-99|
|00002160| 35 0d 0a 0d 0a 44 75 64 | 6c 20 52 4a 2c 20 41 6e |5....Dud|l RJ, An|
|00002170| 64 65 72 73 6f 6e 20 44 | 53 2c 20 46 6f 72 73 79 |derson D|S, Forsy|
|00002180| 74 68 65 20 41 42 2c 20 | 5a 69 65 67 6c 65 72 20 |the AB, |Ziegler |
|00002190| 4d 47 2c 20 4f 27 44 6f | 72 69 73 69 6f 20 54 4d |MG, O'Do|risio TM|
|000021a0| 0d 0a 28 4b 61 69 73 65 | 72 20 50 65 72 6d 61 6e |..(Kaise|r Perman|
|000021b0| 65 6e 74 65 20 4d 65 64 | 20 43 74 72 2c 20 53 61 |ente Med| Ctr, Sa|
|000021c0| 6e 20 44 69 65 67 6f 3b | 20 55 6e 69 76 20 6f 66 |n Diego;| Univ of|
|000021d0| 20 43 61 6c 69 66 6f 72 | 6e 69 61 2c 20 53 61 6e | Califor|nia, San|
|000021e0| 20 44 69 65 67 6f 3b 20 | 4f 68 69 6f 20 53 74 61 | Diego; |Ohio Sta|
|000021f0| 74 65 0d 0a 55 6e 69 76 | 29 0d 0a 41 6d 20 4a 20 |te..Univ|)..Am J |
|00002200| 4d 65 64 20 38 33 3a 35 | 38 34 2d 35 38 38 2c 20 |Med 83:5|84-588, |
|00002210| 53 65 70 74 65 6d 62 65 | 72 20 31 39 38 37 0d 0a |Septembe|r 1987..|
|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 2d 2d |--------|--------|
|00002240| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002250| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002260| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002270| 0d 0a 0d 0a 41 62 73 74 | 72 61 63 74 0d 0a 0d 0a |....Abst|ract....|
|00002280| 20 20 20 20 20 49 6e 20 | 61 20 72 65 63 65 6e 74 | In |a recent|
|00002290| 20 74 72 69 61 6c 20 6f | 66 20 61 20 73 6f 6d 61 | trial o|f a soma|
|000022a0| 74 6f 73 74 61 74 69 6e | 20 61 6e 61 6c 6f 67 75 |tostatin| analogu|
|000022b0| 65 2c 20 53 4d 53 20 32 | 30 31 2d 39 39 35 2c 20 |e, SMS 2|01-995, |
|000022c0| 73 6f 6d 65 20 73 75 63 | 63 65 73 73 20 69 6e 0d |some suc|cess in.|
|000022d0| 0a 63 6f 6e 74 72 6f 6c | 6c 69 6e 67 20 64 69 61 |.control|ling dia|
|000022e0| 62 65 74 69 63 20 64 69 | 61 72 72 68 65 61 20 77 |betic di|arrhea w|
|000022f0| 61 73 20 72 65 70 6f 72 | 74 65 64 2e 20 20 41 20 |as repor|ted. A |
|00002300| 77 6f 6d 61 6e 20 77 69 | 74 68 20 69 6e 73 75 6c |woman wi|th insul|
|00002310| 69 6e 2d 64 65 70 65 6e | 64 65 6e 74 0d 0a 64 69 |in-depen|dent..di|
|00002320| 61 62 65 74 65 73 20 6d | 65 6c 6c 69 74 75 73 20 |abetes m|ellitus |
|00002330| 77 61 73 20 73 75 63 63 | 65 73 73 66 75 6c 6c 79 |was succ|essfully|
|00002340| 20 74 72 65 61 74 65 64 | 20 77 69 74 68 20 53 4d | treated| with SM|
|00002350| 53 20 32 30 31 2d 39 39 | 35 20 74 6f 20 63 6f 6e |S 201-99|5 to con|
|00002360| 74 72 6f 6c 20 63 68 72 | 6f 6e 69 63 0d 0a 64 69 |trol chr|onic..di|
|00002370| 61 72 72 68 65 61 20 61 | 6e 64 20 6f 72 74 68 6f |arrhea a|nd ortho|
|00002380| 73 74 61 74 69 63 20 68 | 79 70 6f 74 65 6e 73 69 |static h|ypotensi|
|00002390| 6f 6e 2e 0d 0a 0d 0a 20 | 20 20 20 20 57 6f 6d 61 |on..... | Woma|
|000023a0| 6e 2c 20 64 69 61 62 65 | 74 69 63 2c 20 77 61 73 |n, diabe|tic, was|
|000023b0| 20 61 64 6d 69 74 74 65 | 64 20 62 65 63 61 75 73 | admitte|d becaus|
|000023c0| 65 20 6f 66 20 73 65 76 | 65 72 65 20 64 69 61 72 |e of sev|ere diar|
|000023d0| 72 68 65 61 20 74 68 61 | 74 20 77 61 73 0d 0a 72 |rhea tha|t was..r|
|000023e0| 65 66 72 61 63 74 6f 72 | 79 20 74 6f 20 61 6c 6c |efractor|y to all|
|000023f0| 20 66 6f 72 6d 73 20 6f | 66 20 74 68 65 72 61 70 | forms o|f therap|
|00002400| 79 2e 20 20 45 78 63 65 | 70 74 20 66 6f 72 20 61 |y. Exce|pt for a|
|00002410| 20 72 61 70 69 64 20 62 | 61 72 69 75 6d 20 74 72 | rapid b|arium tr|
|00002420| 61 6e 73 69 74 20 74 69 | 6d 65 2c 0d 0a 72 65 73 |ansit ti|me,..res|
|00002430| 75 6c 74 73 20 6f 66 20 | 61 6c 6c 20 64 69 61 67 |ults of |all diag|
|00002440| 6e 6f 73 74 69 63 20 74 | 65 73 74 73 20 69 6e 20 |nostic t|ests in |
|00002450| 74 68 65 20 67 61 73 74 | 72 6f 69 6e 74 65 73 74 |the gast|rointest|
|00002460| 69 6e 61 6c 20 74 72 61 | 63 74 20 77 65 72 65 20 |inal tra|ct were |
|00002470| 6e 65 67 61 74 69 76 65 | 2e 0d 0a 48 65 72 20 77 |negative|...Her w|
|00002480| 65 69 67 68 74 20 64 65 | 63 72 65 61 73 65 64 20 |eight de|creased |
|00002490| 74 6f 20 77 68 65 72 65 | 20 73 68 65 20 72 65 71 |to where| she req|
|000024a0| 75 69 72 65 64 20 69 6e | 74 72 61 76 65 6e 6f 75 |uired in|travenou|
|000024b0| 73 20 68 79 70 65 72 61 | 6c 69 6d 65 6e 74 61 74 |s hypera|limentat|
|000024c0| 69 6f 6e 2e 0d 0a 4f 72 | 74 68 6f 73 74 61 74 69 |ion...Or|thostati|
|000024d0| 63 20 68 79 70 6f 74 65 | 6e 73 69 6f 6e 20 64 65 |c hypote|nsion de|
|000024e0| 76 65 6c 6f 70 65 64 20 | 74 68 61 74 20 77 61 73 |veloped |that was|
|000024f0| 20 73 65 76 65 72 65 20 | 65 6e 6f 75 67 68 20 74 | severe |enough t|
|00002500| 6f 20 72 65 6e 64 65 72 | 20 68 65 72 0d 0a 68 6f |o render| her..ho|
|00002510| 75 73 65 62 6f 75 6e 64 | 2e 20 20 53 68 65 20 77 |usebound|. She w|
|00002520| 61 73 20 67 69 76 65 6e | 20 73 75 62 63 75 74 61 |as given| subcuta|
|00002530| 6e 65 6f 75 73 20 69 6e | 6a 65 63 74 69 6f 6e 73 |neous in|jections|
|00002540| 20 6f 66 20 35 30 2c 20 | 31 30 30 2c 20 61 6e 64 | of 50, |100, and|
|00002550| 20 31 35 30 20 20 6d 75 | 5f 67 20 6f 66 0d 0a 53 | 150 mu|_g of..S|
|00002560| 4d 53 20 32 30 31 2d 39 | 39 35 20 74 77 69 63 65 |MS 201-9|95 twice|
|00002570| 20 64 61 69 6c 79 20 66 | 6f 72 20 33 20 64 61 79 | daily f|or 3 day|
|00002580| 73 20 61 74 20 65 61 63 | 68 20 64 6f 73 65 2c 20 |s at eac|h dose, |
|00002590| 77 68 69 63 68 20 65 66 | 66 65 63 74 69 76 65 6c |which ef|fectivel|
|000025a0| 79 20 64 65 63 72 65 61 | 73 65 64 20 68 65 72 0d |y decrea|sed her.|
|000025b0| 0a 64 69 61 72 72 68 65 | 61 20 61 6e 64 20 69 6e |.diarrhe|a and in|
|000025c0| 63 72 65 61 73 65 64 20 | 68 65 72 20 62 6c 6f 6f |creased |her bloo|
|000025d0| 64 20 70 72 65 73 73 75 | 72 65 20 28 46 69 67 20 |d pressu|re (Fig |
|000025e0| 37 2d 33 29 2e 20 20 41 | 20 6d 61 69 6e 74 65 6e |7-3). A| mainten|
|000025f0| 61 6e 63 65 20 72 65 67 | 69 6d 65 6e 20 6f 66 0d |ance reg|imen of.|
|00002600| 0a 37 35 20 6d 75 5f 67 | 20 6f 66 20 53 4d 53 20 |.75 mu_g| of SMS |
|00002610| 32 30 31 2d 39 39 35 20 | 65 76 65 72 79 20 36 20 |201-995 |every 6 |
|00002620| 68 6f 75 72 73 20 77 61 | 73 20 69 6e 73 74 69 74 |hours wa|s instit|
|00002630| 75 74 65 64 2c 20 62 75 | 74 20 62 65 63 61 75 73 |uted, bu|t becaus|
|00002640| 65 20 6f 66 20 70 65 61 | 6b 0d 0a 72 65 61 63 74 |e of pea|k..react|
|00002650| 69 6f 6e 73 20 63 6f 6e | 74 69 6e 75 6f 75 73 20 |ions con|tinuous |
|00002660| 61 64 6d 69 6e 69 73 74 | 72 61 74 69 6f 6e 20 62 |administ|ration b|
|00002670| 79 20 69 6e 66 75 73 69 | 6f 6e 20 70 75 6d 70 20 |y infusi|on pump |
|00002680| 77 61 73 20 61 74 74 65 | 6d 70 74 65 64 2e 20 20 |was atte|mpted. |
|00002690| 54 68 65 20 70 61 74 69 | 65 6e 74 0d 0a 64 69 64 |The pati|ent..did|
|000026a0| 20 6e 6f 74 20 62 65 63 | 6f 6d 65 20 72 65 66 72 | not bec|ome refr|
|000026b0| 61 63 74 6f 72 79 20 74 | 6f 20 74 72 65 61 74 6d |actory t|o treatm|
|000026c0| 65 6e 74 2c 20 69 6e 74 | 72 61 76 65 6e 6f 75 73 |ent, int|ravenous|
|000026d0| 20 68 79 70 65 72 61 6c | 69 6d 65 6e 74 61 74 69 | hyperal|imentati|
|000026e0| 6f 6e 20 63 6f 75 6c 64 | 20 62 65 0d 0a 64 69 73 |on could| be..dis|
|000026f0| 63 6f 6e 74 69 6e 75 65 | 64 2c 20 61 6e 64 20 74 |continue|d, and t|
|00002700| 68 65 20 64 69 61 72 72 | 68 65 61 20 68 61 64 20 |he diarr|hea had |
|00002710| 72 65 6d 61 69 6e 65 64 | 20 69 6e 20 63 6f 6e 74 |remained| in cont|
|00002720| 72 6f 6c 20 66 6f 72 20 | 31 38 20 6d 6f 6e 74 68 |rol for |18 month|
|00002730| 73 20 61 74 20 74 68 65 | 20 6c 61 73 74 0d 0a 66 |s at the| last..f|
|00002740| 6f 6c 6c 6f 77 2d 75 70 | 20 76 69 73 69 74 2e 0d |ollow-up| visit..|
|00002750| 0a 0d 0a 50 6f 73 74 2d | 43 6f 6d 6d 65 6e 74 0d |...Post-|Comment.|
|00002760| 0a 0d 0a 20 20 20 20 20 | 53 6f 6d 61 74 6f 73 74 |... |Somatost|
|00002770| 61 74 69 6e 20 61 6e 64 | 20 69 74 73 20 61 6e 61 |atin and| its ana|
|00002780| 6c 6f 67 75 65 73 20 68 | 61 76 65 20 62 65 65 6e |logues h|ave been|
|00002790| 20 66 6f 75 6e 64 20 75 | 73 65 66 75 6c 20 69 6e | found u|seful in|
|000027a0| 20 61 20 76 61 72 69 65 | 74 79 20 6f 66 0d 0a 67 | a varie|ty of..g|
|000027b0| 61 73 74 72 6f 69 6e 74 | 65 73 74 69 6e 61 6c 20 |astroint|estinal |
|000027c0| 74 72 61 63 74 20 64 69 | 73 6f 72 64 65 72 73 2c |tract di|sorders,|
|000027d0| 20 69 6e 63 6c 75 64 69 | 6e 67 20 73 65 63 72 65 | includi|ng secre|
|000027e0| 74 6f 72 79 20 64 69 61 | 72 72 68 65 61 73 20 28 |tory dia|rrheas (|
|000027f0| 31 39 38 38 20 59 45 41 | 52 20 42 4f 4f 4b 2c 0d |1988 YEA|R BOOK,.|
|00002800| 0a 70 20 33 33 31 29 2e | 20 20 4e 6f 77 20 69 74 |.p 331).| Now it|
|00002810| 20 68 61 73 20 66 6f 75 | 6e 64 20 61 6e 6f 74 68 | has fou|nd anoth|
|00002820| 65 72 20 75 73 65 20 69 | 6e 20 64 69 61 62 65 74 |er use i|n diabet|
|00002830| 69 63 20 64 69 61 72 72 | 68 65 61 2e 20 20 57 68 |ic diarr|hea. Wh|
|00002840| 65 74 68 65 72 20 74 68 | 65 20 65 66 66 65 63 74 |ether th|e effect|
|00002850| 0d 0a 6f 6e 20 6f 72 74 | 68 6f 73 74 61 74 69 63 |..on ort|hostatic|
|00002860| 20 68 79 70 6f 74 65 6e | 73 69 6f 6e 20 77 61 73 | hypoten|sion was|
|00002870| 20 73 65 63 6f 6e 64 61 | 72 79 20 74 6f 20 72 65 | seconda|ry to re|
|00002880| 70 6c 65 74 69 6e 67 20 | 64 69 6d 69 6e 69 73 68 |pleting |diminish|
|00002890| 65 64 20 62 6c 6f 6f 64 | 20 76 6f 6c 75 6d 65 20 |ed blood| volume |
|000028a0| 62 79 0d 0a 73 74 6f 70 | 70 69 6e 67 20 74 68 65 |by..stop|ping the|
|000028b0| 20 64 69 61 72 72 68 65 | 61 20 6f 72 20 61 20 6d | diarrhe|a or a m|
|000028c0| 6f 72 65 20 73 70 65 63 | 69 66 69 63 20 61 63 74 |ore spec|ific act|
|000028d0| 69 6f 6e 20 72 65 6d 61 | 69 6e 73 20 74 6f 20 62 |ion rema|ins to b|
|000028e0| 65 20 64 65 74 65 72 6d | 69 6e 65 64 2e 2d 2d 4c |e determ|ined.--L|
|000028f0| 2e 45 2e 0d 0a 48 6f 6c | 6c 69 73 74 65 72 2c 20 |.E...Hol|lister, |
|00002900| 4d 2e 44 2e 0d 0a 24 55 | 6e 69 71 75 65 5f 49 44 |M.D...$U|nique_ID|
|00002910| 7b 59 52 42 30 35 37 30 | 33 7d 0d 0a 24 54 69 74 |{YRB0570|3}..$Tit|
|00002920| 6c 65 7b 50 72 6f 6c 6f | 6e 67 65 64 20 57 65 69 |le{Prolo|nged Wei|
|00002930| 67 68 74 20 4c 6f 73 73 | 20 57 69 74 68 20 44 65 |ght Loss| With De|
|00002940| 78 66 65 6e 66 6c 75 72 | 61 6d 69 6e 65 20 54 72 |xfenflur|amine Tr|
|00002950| 65 61 74 6d 65 6e 74 20 | 69 6e 20 4f 62 65 73 65 |eatment |in Obese|
|00002960| 20 50 61 74 69 65 6e 74 | 73 7d 0d 0a 24 41 75 74 | Patient|s}..$Aut|
|00002970| 68 6f 72 7b 0d 0a 46 69 | 6e 65 72 2c 20 4e 0d 0a |hor{..Fi|ner, N..|
|00002980| 43 72 61 64 64 6f 63 6b | 2c 20 44 0d 0a 4c 61 76 |Craddock|, D..Lav|
|00002990| 69 65 6c 6c 65 2c 20 52 | 0d 0a 4b 65 65 6e 2c 20 |ielle, R|..Keen, |
|000029a0| 48 7d 0d 0a 24 41 66 66 | 69 6c 69 61 74 69 6f 6e |H}..$Aff|iliation|
|000029b0| 7b 47 75 79 27 73 20 48 | 6f 73 70 2c 20 4c 6f 6e |{Guy's H|osp, Lon|
|000029c0| 64 6f 6e 3b 20 49 6e 73 | 74 20 64 65 20 52 65 63 |don; Ins|t de Rec|
|000029d0| 68 65 72 63 68 65 73 20 | 49 6e 74 6c 20 53 65 72 |herches |Intl Ser|
|000029e0| 76 69 65 72 2c 20 4e 65 | 75 69 6c 6c 79 2d 73 75 |vier, Ne|uilly-su|
|000029f0| 72 2d 53 65 69 6e 65 2c | 20 46 72 61 6e 63 65 7d |r-Seine,| France}|
|00002a00| 0d 0a 24 53 75 62 6a 65 | 63 74 7b 57 65 69 67 68 |..$Subje|ct{Weigh|
|00002a10| 74 20 6c 6f 73 73 20 77 | 69 74 68 20 64 65 78 66 |t loss w|ith dexf|
|00002a20| 65 6e 66 6c 75 72 61 6d | 69 6e 65 20 69 6e 20 6f |enfluram|ine in o|
|00002a30| 62 65 73 69 74 79 3b 0d | 0a 4f 62 65 73 69 74 79 |besity;.|.Obesity|
|00002a40| 20 64 65 78 66 65 6e 66 | 6c 75 72 61 6d 69 6e 65 | dexfenf|luramine|
|00002a50| 20 66 6f 72 20 70 72 6f | 6c 6f 6e 67 65 64 20 77 | for pro|longed w|
|00002a60| 65 69 67 68 74 20 6c 6f | 73 73 20 69 6e 3b 0d 0a |eight lo|ss in;..|
|00002a70| 44 65 78 66 65 6e 66 6c | 75 72 61 6d 69 6e 65 20 |Dexfenfl|uramine |
|00002a80| 66 6f 72 20 70 72 6f 6c | 6f 6e 67 65 64 20 77 65 |for prol|onged we|
|00002a90| 69 67 68 74 20 6c 6f 73 | 73 20 69 6e 20 6f 62 65 |ight los|s in obe|
|00002aa0| 73 69 74 79 7d 0d 0a 24 | 4a 6f 75 72 6e 61 6c 7b |sity}..$|Journal{|
|00002ab0| 44 69 61 62 65 74 65 73 | 20 4d 65 74 61 62 20 28 |Diabetes| Metab (|
|00002ac0| 50 61 72 69 73 29 7d 0d | 0a 24 56 6f 6c 75 6d 65 |Paris)}.|.$Volume|
|00002ad0| 7b 31 33 7d 0d 0a 24 50 | 61 67 65 7b 35 39 38 2d |{13}..$P|age{598-|
|00002ae0| 36 30 32 7d 0d 0a 24 44 | 61 74 65 7b 4e 6f 76 65 |602}..$D|ate{Nove|
|00002af0| 6d 62 65 72 2d 44 65 63 | 65 6d 62 65 72 20 31 39 |mber-Dec|ember 19|
|00002b00| 38 37 7d 0d 0a 24 59 42 | 56 6f 6c 7b 31 39 38 39 |87}..$YB|Vol{1989|
|00002b10| 20 59 65 61 72 20 42 6f | 6f 6b 20 6f 66 20 44 72 | Year Bo|ok of Dr|
|00002b20| 75 67 20 54 68 65 72 61 | 70 79 7d 0d 0a 24 43 68 |ug Thera|py}..$Ch|
|00002b30| 61 70 74 65 72 7b 37 2d | 31 30 7d 0d 0a 24 59 42 |apter{7-|10}..$YB|
|00002b40| 45 64 69 74 6f 72 7b 44 | 72 73 2e 20 48 6f 6c 6c |Editor{D|rs. Holl|
|00002b50| 69 73 74 65 72 20 61 6e | 64 20 4c 61 73 61 67 6e |ister an|d Lasagn|
|00002b60| 61 7d 0d 0a 24 54 61 62 | 6c 65 7b 7d 0d 0a 24 43 |a}..$Tab|le{}..$C|
|00002b70| 6f 6d 6d 65 6e 74 61 74 | 6f 72 7b 4c 2e 20 4c 61 |ommentat|or{L. La|
|00002b80| 73 61 67 6e 61 2c 20 4d | 2e 44 2e 7d 0d 0a 0d 0a |sagna, M|.D.}....|
|00002b90| 43 6f 70 79 72 69 67 68 | 74 20 28 63 29 20 59 65 |Copyrigh|t (c) Ye|
|00002ba0| 61 72 20 42 6f 6f 6b 20 | 4d 65 64 69 63 61 6c 20 |ar Book |Medical |
|00002bb0| 50 75 62 6c 69 73 68 65 | 72 73 2c 20 49 6e 63 2e |Publishe|rs, Inc.|
|00002bc0| 2c 20 31 39 38 39 0d 0a | 0d 0a 31 39 38 39 20 59 |, 1989..|..1989 Y|
|00002bd0| 65 61 72 20 42 6f 6f 6b | 20 6f 66 20 44 72 75 67 |ear Book| of Drug|
|00002be0| 20 54 68 65 72 61 70 79 | 20 28 52 29 0d 0a 0d 0a | Therapy| (R)....|
|00002bf0| 43 68 61 70 74 65 72 20 | 37 2d 2d 45 6e 64 6f 63 |Chapter |7--Endoc|
|00002c00| 72 69 6e 65 20 61 6e 64 | 20 4d 65 74 61 62 6f 6c |rine and| Metabol|
|00002c10| 69 63 20 44 69 73 6f 72 | 64 65 72 73 0d 0a 0d 0a |ic Disor|ders....|
|00002c20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002c30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002c40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002c50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002c60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002c70| 0d 0a 50 72 6f 6c 6f 6e | 67 65 64 20 57 65 69 67 |..Prolon|ged Weig|
|00002c80| 68 74 20 4c 6f 73 73 20 | 57 69 74 68 20 44 65 78 |ht Loss |With Dex|
|00002c90| 66 65 6e 66 6c 75 72 61 | 6d 69 6e 65 20 54 72 65 |fenflura|mine Tre|
|00002ca0| 61 74 6d 65 6e 74 20 69 | 6e 20 4f 62 65 73 65 20 |atment i|n Obese |
|00002cb0| 50 61 74 69 65 6e 74 73 | 0d 0a 0d 0a 46 69 6e 65 |Patients|....Fine|
|00002cc0| 72 20 4e 2c 20 43 72 61 | 64 64 6f 63 6b 20 44 2c |r N, Cra|ddock D,|
|00002cd0| 20 4c 61 76 69 65 6c 6c | 65 20 52 2c 20 4b 65 65 | Laviell|e R, Kee|
|00002ce0| 6e 20 48 0d 0a 28 47 75 | 79 27 73 20 48 6f 73 70 |n H..(Gu|y's Hosp|
|00002cf0| 2c 20 4c 6f 6e 64 6f 6e | 3b 20 49 6e 73 74 20 64 |, London|; Inst d|
|00002d00| 65 20 52 65 63 68 65 72 | 63 68 65 73 20 49 6e 74 |e Recher|ches Int|
|00002d10| 6c 20 53 65 72 76 69 65 | 72 2c 20 4e 65 75 69 6c |l Servie|r, Neuil|
|00002d20| 6c 79 2d 73 75 72 2d 53 | 65 69 6e 65 2c 0d 0a 46 |ly-sur-S|eine,..F|
|00002d30| 72 61 6e 63 65 29 0d 0a | 44 69 61 62 65 74 65 73 |rance)..|Diabetes|
|00002d40| 20 4d 65 74 61 62 20 28 | 50 61 72 69 73 29 20 31 | Metab (|Paris) 1|
|00002d50| 33 3a 35 39 38 2d 36 30 | 32 2c 20 4e 6f 76 65 6d |3:598-60|2, Novem|
|00002d60| 62 65 72 2d 44 65 63 65 | 6d 62 65 72 20 31 39 0d |ber-Dece|mber 19.|
|00002d70| 0a 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |.-------|--------|
|00002d80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002d90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002da0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002db0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002dc0| 2d 0d 0a 0d 0a 41 62 73 | 74 72 61 63 74 0d 0a 0d |-....Abs|tract...|
|00002dd0| 0a 20 20 20 20 20 44 65 | 78 66 65 6e 66 6c 75 72 |. De|xfenflur|
|00002de0| 61 6d 69 6e 65 2c 20 61 | 6e 20 69 73 6f 6d 65 72 |amine, a|n isomer|
|00002df0| 20 6f 66 20 66 65 6e 66 | 6c 75 72 61 6d 69 6e 65 | of fenf|luramine|
|00002e00| 2c 20 77 61 73 20 65 76 | 61 6c 75 61 74 65 64 20 |, was ev|aluated |
|00002e10| 69 6e 20 31 37 20 70 61 | 74 69 65 6e 74 73 0d 0a |in 17 pa|tients..|
|00002e20| 77 69 74 68 20 72 65 73 | 69 73 74 61 6e 74 20 6f |with res|istant o|
|00002e30| 62 65 73 69 74 79 20 77 | 68 6f 20 68 61 64 20 67 |besity w|ho had g|
|00002e40| 61 69 6e 65 64 20 61 6e | 20 61 76 65 72 61 67 65 |ained an| average|
|00002e50| 20 6f 66 20 30 2e 37 20 | 6b 67 20 64 75 72 69 6e | of 0.7 |kg durin|
|00002e60| 67 20 31 32 20 77 65 65 | 6b 73 20 6f 66 0d 0a 64 |g 12 wee|ks of..d|
|00002e70| 69 65 74 61 72 79 20 74 | 72 65 61 74 6d 65 6e 74 |ietary t|reatment|
|00002e80| 20 77 69 74 68 20 70 6c | 61 63 65 62 6f 2e 20 20 | with pl|acebo. |
|00002e90| 49 6e 20 61 64 64 69 74 | 69 6f 6e 2c 20 32 39 20 |In addit|ion, 29 |
|00002ea0| 70 61 74 69 65 6e 74 73 | 20 72 65 63 65 69 76 65 |patients| receive|
|00002eb0| 64 0d 0a 64 65 78 66 65 | 6e 66 6c 75 72 61 6d 69 |d..dexfe|nflurami|
|00002ec0| 6e 65 20 66 6f 72 20 32 | 34 20 77 65 65 6b 73 2e |ne for 2|4 weeks.|
|00002ed0| 20 20 54 68 65 73 65 20 | 70 61 74 69 65 6e 74 73 | These |patients|
|00002ee0| 20 72 65 63 65 69 76 65 | 64 20 31 35 20 6d 67 20 | receive|d 15 mg |
|00002ef0| 6f 66 20 64 65 78 66 65 | 6e 66 6c 75 72 61 6d 69 |of dexfe|nflurami|
|00002f00| 6e 65 0d 0a 74 77 69 63 | 65 20 64 61 69 6c 79 20 |ne..twic|e daily |
|00002f10| 66 6f 72 20 36 20 6d 6f | 6e 74 68 73 2e 0d 0a 20 |for 6 mo|nths... |
|00002f20| 20 20 20 20 54 68 65 20 | 66 69 72 73 74 20 67 72 | The |first gr|
|00002f30| 6f 75 70 20 6f 66 20 70 | 61 74 69 65 6e 74 73 2c |oup of p|atients,|
|00002f40| 20 67 69 76 65 6e 20 64 | 65 78 66 65 6e 66 6c 75 | given d|exfenflu|
|00002f50| 72 61 6d 69 6e 65 20 66 | 6f 72 20 31 32 20 77 65 |ramine f|or 12 we|
|00002f60| 65 6b 73 2c 20 6c 6f 73 | 74 20 61 0d 0a 6d 65 61 |eks, los|t a..mea|
|00002f70| 6e 20 6f 66 20 32 2e 39 | 20 6b 67 2e 20 20 4e 6f |n of 2.9| kg. No|
|00002f80| 20 70 61 74 69 65 6e 74 | 20 77 61 73 20 77 69 74 | patient| was wit|
|00002f90| 68 64 72 61 77 6e 20 62 | 65 63 61 75 73 65 20 6f |hdrawn b|ecause o|
|00002fa0| 66 20 73 69 64 65 20 65 | 66 66 65 63 74 73 2e 20 |f side e|ffects. |
|00002fb0| 20 49 6e 20 74 68 65 0d | 0a 6c 6f 6e 67 2d 74 65 | In the.|.long-te|
|00002fc0| 72 6d 20 74 72 69 61 6c | 2c 20 74 68 65 20 61 76 |rm trial|, the av|
|00002fd0| 65 72 61 67 65 20 63 75 | 6d 75 6c 61 74 69 76 65 |erage cu|mulative|
|00002fe0| 20 77 65 69 67 68 74 20 | 6c 6f 73 73 20 61 74 20 | weight |loss at |
|00002ff0| 31 32 20 77 65 65 6b 73 | 20 77 61 73 20 35 2e 37 |12 weeks| was 5.7|
|00003000| 20 6b 67 3b 20 61 6e 64 | 0d 0a 61 66 74 65 72 20 | kg; and|..after |
|00003010| 32 34 20 77 65 65 6b 73 | 20 6f 6e 20 64 65 78 66 |24 weeks| on dexf|
|00003020| 65 6e 66 6c 75 72 61 6d | 69 6e 65 2c 20 74 68 65 |enfluram|ine, the|
|00003030| 20 63 75 6d 75 6c 61 74 | 69 76 65 20 6c 6f 73 73 | cumulat|ive loss|
|00003040| 20 77 61 73 20 37 20 6b | 67 2e 20 20 53 69 64 65 | was 7 k|g. Side|
|00003050| 20 65 66 66 65 63 74 73 | 0d 0a 77 65 72 65 20 6d | effects|..were m|
|00003060| 6f 73 74 20 66 72 65 71 | 75 65 6e 74 20 69 6e 20 |ost freq|uent in |
|00003070| 74 68 65 20 66 69 72 73 | 74 20 6d 6f 6e 74 68 20 |the firs|t month |
|00003080| 6f 66 20 74 72 65 61 74 | 6d 65 6e 74 2e 0d 0a 20 |of treat|ment... |
|00003090| 20 20 20 20 44 65 78 66 | 65 6e 66 6c 75 72 61 6d | Dexf|enfluram|
|000030a0| 69 6e 65 20 72 65 6d 61 | 69 6e 73 20 65 66 66 65 |ine rema|ins effe|
|000030b0| 63 74 69 76 65 20 69 6e | 20 70 61 74 69 65 6e 74 |ctive in| patient|
|000030c0| 73 20 77 69 74 68 20 72 | 65 66 72 61 63 74 6f 72 |s with r|efractor|
|000030d0| 79 20 6f 62 65 73 69 74 | 79 20 61 66 74 65 72 0d |y obesit|y after.|
|000030e0| 0a 32 34 20 77 65 65 6b | 73 20 6f 66 20 75 73 65 |.24 week|s of use|
|000030f0| 2c 20 62 75 74 20 65 76 | 65 6e 20 6c 6f 6e 67 65 |, but ev|en longe|
|00003100| 72 2d 74 65 72 6d 20 73 | 74 75 64 69 65 73 20 61 |r-term s|tudies a|
|00003110| 72 65 20 6e 65 65 64 65 | 64 2e 20 20 53 69 64 65 |re neede|d. Side|
|00003120| 20 65 66 66 65 63 74 73 | 20 77 65 72 65 0d 0a 6c | effects| were..l|
|00003130| 6f 77 65 72 20 74 68 61 | 6e 20 69 6e 20 6d 6f 73 |ower tha|n in mos|
|00003140| 74 20 73 74 75 64 69 65 | 73 20 77 69 74 68 20 64 |t studie|s with d|
|00003150| 6c 2d 66 65 6e 66 6c 75 | 72 61 6d 69 6e 65 2e 0d |l-fenflu|ramine..|
|00003160| 0a 0d 0a 50 6f 73 74 2d | 43 6f 6d 6d 65 6e 74 0d |...Post-|Comment.|
|00003170| 0a 0d 0a 20 20 20 20 20 | 44 65 78 66 65 6e 66 6c |... |Dexfenfl|
|00003180| 75 72 61 6d 69 6e 65 2c | 20 74 68 65 20 64 65 78 |uramine,| the dex|
|00003190| 74 72 6f 73 74 65 72 65 | 6f 69 73 6f 6d 65 72 20 |trostere|oisomer |
|000031a0| 6f 66 20 66 65 6e 66 6c | 75 72 61 6d 69 6e 65 20 |of fenfl|uramine |
|000031b0| 28 77 68 69 63 68 20 69 | 73 20 61 20 72 61 63 65 |(which i|s a race|
|000031c0| 6d 69 63 0d 0a 6d 69 78 | 74 75 72 65 29 2c 20 69 |mic..mix|ture), i|
|000031d0| 73 20 74 77 69 63 65 20 | 61 73 20 65 66 66 65 63 |s twice |as effec|
|000031e0| 74 69 76 65 20 61 73 20 | 74 68 65 20 72 61 63 65 |tive as |the race|
|000031f0| 6d 61 74 65 20 69 6e 20 | 72 65 64 75 63 69 6e 67 |mate in |reducing|
|00003200| 20 66 6f 6f 64 20 69 6e | 74 61 6b 65 20 69 6e 0d | food in|take in.|
|00003210| 0a 65 78 70 65 72 69 6d | 65 6e 74 61 6c 20 61 6e |.experim|ental an|
|00003220| 69 6d 61 6c 73 2e 20 20 | 49 66 2c 20 61 73 20 73 |imals. |If, as s|
|00003230| 65 65 6d 73 20 74 6f 20 | 62 65 20 74 68 65 20 63 |eems to |be the c|
|00003240| 61 73 65 20 66 72 6f 6d | 20 74 68 65 20 70 75 62 |ase from| the pub|
|00003250| 6c 69 73 68 65 64 0d 0a | 6c 69 74 65 72 61 74 75 |lished..|literatu|
|00003260| 72 65 2c 20 74 68 65 20 | 64 65 78 74 72 6f 69 73 |re, the |dextrois|
|00003270| 6f 6d 65 72 20 69 73 20 | 6e 6f 74 20 6f 6e 6c 79 |omer is |not only|
|00003280| 20 6d 6f 72 65 20 65 66 | 66 65 63 74 69 76 65 20 | more ef|fective |
|00003290| 74 68 61 6e 20 72 61 63 | 65 6d 61 74 65 20 62 75 |than rac|emate bu|
|000032a0| 74 20 6c 65 73 73 0d 0a | 6c 69 6b 65 6c 79 20 74 |t less..|likely t|
|000032b0| 6f 20 70 72 6f 64 75 63 | 65 20 73 75 63 68 20 73 |o produc|e such s|
|000032c0| 69 64 65 20 65 66 66 65 | 63 74 73 20 61 73 20 67 |ide effe|cts as g|
|000032d0| 61 73 74 72 6f 69 6e 74 | 65 73 74 69 6e 61 6c 20 |astroint|estinal |
|000032e0| 74 72 61 63 74 20 63 6f | 6d 70 6c 61 69 6e 74 73 |tract co|mplaints|
|000032f0| 20 61 6e 64 0d 0a 64 69 | 7a 7a 69 6e 65 73 73 2c | and..di|zziness,|
|00003300| 20 77 65 20 73 68 61 6c | 6c 20 68 61 76 65 20 74 | we shal|l have t|
|00003310| 61 6b 65 6e 20 61 20 6e | 69 63 65 20 73 74 65 70 |aken a n|ice step|
|00003320| 20 66 6f 72 77 61 72 64 | 2e 0d 0a 20 20 20 20 20 | forward|... |
|00003330| 55 6e 6c 69 6b 65 20 74 | 68 65 20 73 69 74 75 61 |Unlike t|he situa|
|00003340| 74 69 6f 6e 20 69 6e 20 | 45 75 72 6f 70 65 2c 20 |tion in |Europe, |
|00003350| 66 65 6e 66 6c 75 72 61 | 6d 69 6e 65 20 68 61 73 |fenflura|mine has|
|00003360| 20 6e 6f 74 20 62 65 65 | 6e 20 61 20 70 6f 70 75 | not bee|n a popu|
|00003370| 6c 61 72 0d 0a 61 6e 6f | 72 65 63 74 69 63 20 69 |lar..ano|rectic i|
|00003380| 6e 20 74 68 65 20 55 6e | 69 74 65 64 20 53 74 61 |n the Un|ited Sta|
|00003390| 74 65 73 2c 20 69 6e 20 | 70 61 72 74 20 62 65 63 |tes, in |part bec|
|000033a0| 61 75 73 65 20 6f 66 20 | 69 74 73 20 67 61 73 74 |ause of |its gast|
|000033b0| 72 6f 69 6e 74 65 73 74 | 69 6e 61 6c 20 74 72 61 |rointest|inal tra|
|000033c0| 63 74 0d 0a 65 66 66 65 | 63 74 73 2c 20 62 75 74 |ct..effe|cts, but|
|000033d0| 20 61 6c 73 6f 20 62 65 | 63 61 75 73 65 20 69 74 | also be|cause it|
|000033e0| 20 69 73 20 61 20 22 64 | 6f 77 6e 65 72 2c 22 20 | is a "d|owner," |
|000033f0| 61 20 73 65 64 61 74 69 | 76 65 20 73 6f 6d 65 20 |a sedati|ve some |
|00003400| 70 61 74 69 65 6e 74 73 | 20 66 69 6e 64 0d 0a 64 |patients| find..d|
|00003410| 65 70 72 65 73 73 69 6e | 67 20 74 6f 20 74 61 6b |epressin|g to tak|
|00003420| 65 2e 0d 0a 20 20 20 20 | 20 54 68 65 20 70 61 74 |e... | The pat|
|00003430| 69 65 6e 74 73 20 73 74 | 75 64 69 65 64 20 62 79 |ients st|udied by|
|00003440| 20 46 69 6e 65 72 20 65 | 74 20 61 6c 2e 20 77 65 | Finer e|t al. we|
|00003450| 72 65 20 61 20 74 6f 75 | 67 68 20 63 68 61 6c 6c |re a tou|gh chall|
|00003460| 65 6e 67 65 2e 20 20 49 | 20 61 6d 0d 0a 69 6d 70 |enge. I| am..imp|
|00003470| 72 65 73 73 65 64 20 62 | 6f 74 68 20 62 79 20 74 |ressed b|oth by t|
|00003480| 68 65 20 77 65 69 67 68 | 74 20 6c 6f 73 73 20 61 |he weigh|t loss a|
|00003490| 63 68 69 65 76 65 64 20 | 61 6e 64 20 74 68 65 20 |chieved |and the |
|000034a0| 65 76 69 64 65 6e 63 65 | 20 73 75 67 67 65 73 74 |evidence| suggest|
|000034b0| 69 6e 67 20 61 0d 0a 63 | 6f 6e 74 69 6e 75 65 64 |ing a..c|ontinued|
|000034c0| 20 65 66 66 65 63 74 20 | 61 66 74 65 72 20 6d 61 | effect |after ma|
|000034d0| 6e 79 20 6d 6f 6e 74 68 | 73 20 6f 66 20 74 61 6b |ny month|s of tak|
|000034e0| 69 6e 67 20 74 68 65 20 | 64 72 75 67 2e 2d 2d 4c |ing the |drug.--L|
|000034f0| 2e 20 4c 61 73 61 67 6e | 61 2c 20 4d 2e 44 2e 0d |. Lasagn|a, M.D..|
|00003500| 0a 24 55 6e 69 71 75 65 | 5f 49 44 7b 59 52 42 30 |.$Unique|_ID{YRB0|
|00003510| 35 37 30 34 7d 0d 0a 24 | 54 69 74 6c 65 7b 55 6e |5704}..$|Title{Un|
|00003520| 69 74 65 64 20 4b 69 6e | 67 64 6f 6d 20 4d 75 6c |ited Kin|gdom Mul|
|00003530| 74 69 63 65 6e 74 72 65 | 20 43 6c 69 6e 69 63 61 |ticentre| Clinica|
|00003540| 6c 20 54 72 69 61 6c 20 | 6f 66 20 53 6f 6d 61 74 |l Trial |of Somat|
|00003550| 72 65 6d 7d 0d 0a 24 41 | 75 74 68 6f 72 7b 0d 0a |rem}..$A|uthor{..|
|00003560| 4d 69 6c 6e 65 72 2c 20 | 52 44 47 0d 0a 42 61 72 |Milner, |RDG..Bar|
|00003570| 6e 65 73 2c 20 4e 44 0d | 0a 42 75 63 6b 6c 65 72 |nes, ND.|.Buckler|
|00003580| 2c 20 4a 4d 48 0d 0a 43 | 61 72 73 6f 6e 2c 20 44 |, JMH..C|arson, D|
|00003590| 4a 0d 0a 48 61 64 64 65 | 6e 2c 20 44 52 0d 0a 48 |J..Hadde|n, DR..H|
|000035a0| 75 67 68 65 73 2c 20 49 | 41 0d 0a 4a 6f 68 6e 73 |ughes, I|A..Johns|
|000035b0| 74 6f 6e 2c 20 44 49 0d | 0a 50 61 72 6b 69 6e 2c |ton, DI.|.Parkin,|
|000035c0| 20 4a 4d 0d 0a 50 72 69 | 63 65 2c 20 44 41 0d 0a | JM..Pri|ce, DA..|
|000035d0| 52 61 79 6e 65 72 2c 20 | 50 48 57 0d 0a 53 61 76 |Rayner, |PHW..Sav|
|000035e0| 61 67 65 2c 20 44 43 4c | 0d 0a 53 61 76 61 67 65 |age, DCL|..Savage|
|000035f0| 2c 20 4d 4f 0d 0a 53 6d | 69 74 68 2c 20 43 53 0d |, MO..Sm|ith, CS.|
|00003600| 0a 53 77 69 66 74 2c 20 | 50 47 46 7d 0d 0a 24 41 |.Swift, |PGF}..$A|
|00003610| 66 66 69 6c 69 61 74 69 | 6f 6e 7b 43 68 69 6c 64 |ffiliati|on{Child|
|00003620| 72 65 6e 27 73 20 48 6f | 73 70 2c 20 53 68 65 66 |ren's Ho|sp, Shef|
|00003630| 66 69 65 6c 64 3b 20 41 | 64 64 65 6e 62 72 6f 6f |field; A|ddenbroo|
|00003640| 6b 65 73 20 48 6f 73 70 | 2c 20 43 61 6d 62 72 69 |kes Hosp|, Cambri|
|00003650| 64 67 65 3b 20 47 65 6e | 20 49 6e 66 69 72 6d 61 |dge; Gen| Infirma|
|00003660| 72 79 2c 20 4c 65 65 64 | 73 3b 20 52 6f 79 61 6c |ry, Leed|s; Royal|
|00003670| 20 42 65 6c 66 61 73 74 | 20 48 6f 73 70 20 66 6f | Belfast| Hosp fo|
|00003680| 72 20 53 69 63 6b 20 43 | 68 69 6c 64 72 65 6e 2c |r Sick C|hildren,|
|00003690| 20 42 65 6c 66 61 73 74 | 3b 20 55 6e 69 76 20 48 | Belfast|; Univ H|
|000036a0| 6f 73 70 20 6f 66 20 57 | 61 6c 65 73 2c 20 43 61 |osp of W|ales, Ca|
|000036b0| 72 64 69 66 66 7d 0d 0a | 24 53 75 62 6a 65 63 74 |rdiff}..|$Subject|
|000036c0| 7b 53 6f 6d 61 74 72 65 | 6d 20 74 72 69 61 6c 20 |{Somatre|m trial |
|000036d0| 6f 66 7d 0d 0a 24 4a 6f | 75 72 6e 61 6c 7b 41 72 |of}..$Jo|urnal{Ar|
|000036e0| 63 68 20 44 69 73 20 43 | 68 69 6c 64 7d 0d 0a 24 |ch Dis C|hild}..$|
|000036f0| 56 6f 6c 75 6d 65 7b 36 | 32 7d 0d 0a 24 50 61 67 |Volume{6|2}..$Pag|
|00003700| 65 7b 37 37 36 2d 37 37 | 39 7d 0d 0a 24 44 61 74 |e{776-77|9}..$Dat|
|00003710| 65 7b 41 75 67 75 73 74 | 20 31 39 38 37 7d 0d 0a |e{August| 1987}..|
|00003720| 24 59 42 56 6f 6c 7b 31 | 39 38 39 20 59 65 61 72 |$YBVol{1|989 Year|
|00003730| 20 42 6f 6f 6b 20 6f 66 | 20 44 72 75 67 20 54 68 | Book of| Drug Th|
|00003740| 65 72 61 70 79 7d 0d 0a | 24 43 68 61 70 74 65 72 |erapy}..|$Chapter|
|00003750| 7b 37 2d 31 31 7d 0d 0a | 24 59 42 45 64 69 74 6f |{7-11}..|$YBEdito|
|00003760| 72 7b 44 72 73 2e 20 48 | 6f 6c 6c 69 73 74 65 72 |r{Drs. H|ollister|
|00003770| 20 61 6e 64 20 4c 61 73 | 61 67 6e 61 7d 0d 0a 24 | and Las|agna}..$|
|00003780| 54 61 62 6c 65 7b 7d 0d | 0a 24 43 6f 6d 6d 65 6e |Table{}.|.$Commen|
|00003790| 74 61 74 6f 72 7b 4c 2e | 45 2e 20 48 6f 6c 6c 69 |tator{L.|E. Holli|
|000037a0| 73 74 65 72 2c 20 4d 2e | 44 2e 7d 0d 0a 0d 0a 43 |ster, M.|D.}....C|
|000037b0| 6f 70 79 72 69 67 68 74 | 20 28 63 29 20 59 65 61 |opyright| (c) Yea|
|000037c0| 72 20 42 6f 6f 6b 20 4d | 65 64 69 63 61 6c 20 50 |r Book M|edical P|
|000037d0| 75 62 6c 69 73 68 65 72 | 73 2c 20 49 6e 63 2e 2c |ublisher|s, Inc.,|
|000037e0| 20 31 39 38 39 0d 0a 0d | 0a 31 39 38 39 20 59 65 | 1989...|.1989 Ye|
|000037f0| 61 72 20 42 6f 6f 6b 20 | 6f 66 20 44 72 75 67 20 |ar Book |of Drug |
|00003800| 54 68 65 72 61 70 79 20 | 28 52 29 0d 0a 0d 0a 43 |Therapy |(R)....C|
|00003810| 68 61 70 74 65 72 20 37 | 2d 2d 45 6e 64 6f 63 72 |hapter 7|--Endocr|
|00003820| 69 6e 65 20 61 6e 64 20 | 4d 65 74 61 62 6f 6c 69 |ine and |Metaboli|
|00003830| 63 20 44 69 73 6f 72 64 | 65 72 73 0d 0a 0d 0a 2d |c Disord|ers....-|
|00003840| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003850| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003860| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003870| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003880| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |--------|-------.|
|00003890| 0a 55 6e 69 74 65 64 20 | 4b 69 6e 67 64 6f 6d 20 |.United |Kingdom |
|000038a0| 4d 75 6c 74 69 63 65 6e | 74 72 65 20 43 6c 69 6e |Multicen|tre Clin|
|000038b0| 69 63 61 6c 20 54 72 69 | 61 6c 20 6f 66 20 53 6f |ical Tri|al of So|
|000038c0| 6d 61 74 72 65 6d 0d 0a | 0d 0a 4d 69 6c 6e 65 72 |matrem..|..Milner|
|000038d0| 20 52 44 47 2c 20 42 61 | 72 6e 65 73 20 4e 44 2c | RDG, Ba|rnes ND,|
|000038e0| 20 42 75 63 6b 6c 65 72 | 20 4a 4d 48 2c 20 43 61 | Buckler| JMH, Ca|
|000038f0| 72 73 6f 6e 20 44 4a 2c | 20 48 61 64 64 65 6e 20 |rson DJ,| Hadden |
|00003900| 44 52 2c 20 48 75 67 68 | 65 73 20 49 41 2c 20 4a |DR, Hugh|es IA, J|
|00003910| 6f 68 6e 73 74 6f 6e 0d | 0a 44 49 2c 20 50 61 72 |ohnston.|.DI, Par|
|00003920| 6b 69 6e 20 4a 4d 2c 20 | 50 72 69 63 65 20 44 41 |kin JM, |Price DA|
|00003930| 2c 20 52 61 79 6e 65 72 | 20 50 48 57 2c 20 53 61 |, Rayner| PHW, Sa|
|00003940| 76 61 67 65 20 44 43 4c | 2c 20 53 61 76 61 67 65 |vage DCL|, Savage|
|00003950| 20 4d 4f 2c 20 53 6d 69 | 74 68 20 43 53 2c 20 53 | MO, Smi|th CS, S|
|00003960| 77 69 66 74 20 50 47 46 | 0d 0a 28 43 68 69 6c 64 |wift PGF|..(Child|
|00003970| 72 65 6e 27 73 20 48 6f | 73 70 2c 20 53 68 65 66 |ren's Ho|sp, Shef|
|00003980| 66 69 65 6c 64 3b 20 41 | 64 64 65 6e 62 72 6f 6f |field; A|ddenbroo|
|00003990| 6b 65 73 20 48 6f 73 70 | 2c 20 43 61 6d 62 72 69 |kes Hosp|, Cambri|
|000039a0| 64 67 65 3b 20 47 65 6e | 20 49 6e 66 69 72 6d 61 |dge; Gen| Infirma|
|000039b0| 72 79 2c 20 4c 65 65 64 | 73 3b 0d 0a 52 6f 79 61 |ry, Leed|s;..Roya|
|000039c0| 6c 20 42 65 6c 66 61 73 | 74 20 48 6f 73 70 20 66 |l Belfas|t Hosp f|
|000039d0| 6f 72 20 53 69 63 6b 20 | 43 68 69 6c 64 72 65 6e |or Sick |Children|
|000039e0| 2c 20 42 65 6c 66 61 73 | 74 3b 20 55 6e 69 76 20 |, Belfas|t; Univ |
|000039f0| 48 6f 73 70 20 6f 66 20 | 57 61 6c 65 73 2c 20 43 |Hosp of |Wales, C|
|00003a00| 61 72 64 69 66 66 29 0d | 0a 41 72 63 68 20 44 69 |ardiff).|.Arch Di|
|00003a10| 73 20 43 68 69 6c 64 20 | 36 32 3a 37 37 36 2d 37 |s Child |62:776-7|
|00003a20| 37 39 2c 20 41 75 67 75 | 73 74 20 31 39 38 37 0d |79, Augu|st 1987.|
|00003a30| 0a 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| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003a60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003a70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003a80| 2d 0d 0a 0d 0a 41 62 73 | 74 72 61 63 74 0d 0a 0d |-....Abs|tract...|
|00003a90| 0a 20 20 20 20 20 54 68 | 65 20 62 69 6f 73 79 6e |. Th|e biosyn|
|00003aa0| 74 68 65 74 69 63 20 67 | 72 6f 77 74 68 20 68 6f |thetic g|rowth ho|
|00003ab0| 72 6d 6f 6e 65 20 28 6d | 65 74 2d 47 48 2c 20 73 |rmone (m|et-GH, s|
|00003ac0| 6f 6d 61 74 72 65 6d 29 | 20 69 73 20 6e 6f 77 20 |omatrem)| is now |
|00003ad0| 61 76 61 69 6c 61 62 6c | 65 20 69 6e 20 74 68 65 |availabl|e in the|
|00003ae0| 0d 0a 55 6e 69 74 65 64 | 20 4b 69 6e 67 64 6f 6d |..United| Kingdom|
|00003af0| 20 66 6f 72 20 74 68 65 | 20 74 72 65 61 74 6d 65 | for the| treatme|
|00003b00| 6e 74 20 6f 66 20 63 68 | 69 6c 64 72 65 6e 20 77 |nt of ch|ildren w|
|00003b10| 69 74 68 20 67 72 6f 77 | 74 68 20 68 6f 72 6d 6f |ith grow|th hormo|
|00003b20| 6e 65 20 64 65 66 69 63 | 69 65 6e 63 79 2e 20 20 |ne defic|iency. |
|00003b30| 49 6e 0d 0a 61 20 6d 75 | 6c 74 69 63 65 6e 74 65 |In..a mu|lticente|
|00003b40| 72 20 74 72 69 61 6c 2c | 20 35 34 20 63 68 69 6c |r trial,| 54 chil|
|00003b50| 64 72 65 6e 2c 20 61 67 | 65 64 20 34 2d 31 37 20 |dren, ag|ed 4-17 |
|00003b60| 79 65 61 72 73 2c 20 77 | 69 74 68 20 70 72 65 76 |years, w|ith prev|
|00003b70| 69 6f 75 73 6c 79 20 75 | 6e 74 72 65 61 74 65 64 |iously u|ntreated|
|00003b80| 0d 0a 67 72 6f 77 74 68 | 20 68 6f 72 6d 6f 6e 65 |..growth| hormone|
|00003b90| 20 64 65 66 69 63 69 65 | 6e 63 79 20 72 65 63 65 | deficie|ncy rece|
|00003ba0| 69 76 65 64 20 34 20 75 | 6e 69 74 73 20 6f 66 20 |ived 4 u|nits of |
|00003bb0| 73 6f 6d 61 74 72 65 6d | 20 33 20 74 69 6d 65 73 |somatrem| 3 times|
|00003bc0| 20 61 20 77 65 65 6b 2c | 20 69 6e 6a 65 63 74 65 | a week,| injecte|
|00003bd0| 64 0d 0a 65 69 74 68 65 | 72 20 73 75 62 63 75 74 |d..eithe|r subcut|
|00003be0| 61 6e 65 6f 75 73 6c 79 | 20 6f 72 20 69 6e 74 72 |aneously| or intr|
|00003bf0| 61 6d 75 73 63 75 6c 61 | 72 6c 79 20 66 6f 72 20 |amuscula|rly for |
|00003c00| 31 20 79 65 61 72 2e 20 | 20 52 65 73 70 6f 6e 73 |1 year. | Respons|
|00003c10| 65 20 74 6f 20 74 72 65 | 61 74 6d 65 6e 74 20 77 |e to tre|atment w|
|00003c20| 61 73 0d 0a 64 65 66 69 | 6e 65 64 20 61 73 20 61 |as..defi|ned as a|
|00003c30| 6e 20 69 6e 63 72 65 61 | 73 65 20 69 6e 20 67 72 |n increa|se in gr|
|00003c40| 6f 77 74 68 20 72 61 74 | 65 20 6f 66 20 61 74 20 |owth rat|e of at |
|00003c50| 6c 65 61 73 74 20 31 2e | 35 20 63 6d 2f 79 65 61 |least 1.|5 cm/yea|
|00003c60| 72 20 69 6e 20 74 68 65 | 20 70 72 65 63 65 64 69 |r in the| precedi|
|00003c70| 6e 67 0d 0a 79 65 61 72 | 2e 0d 0a 20 20 20 20 20 |ng..year|... |
|00003c80| 46 6f 72 74 79 2d 74 77 | 6f 20 70 61 74 69 65 6e |Forty-tw|o patien|
|00003c90| 74 73 20 72 65 73 70 6f | 6e 64 65 64 20 74 6f 20 |ts respo|nded to |
|00003ca0| 74 72 65 61 74 6d 65 6e | 74 2c 20 77 69 74 68 20 |treatmen|t, with |
|00003cb0| 61 20 6d 65 61 6e 20 67 | 72 6f 77 74 68 20 72 61 |a mean g|rowth ra|
|00003cc0| 74 65 20 6f 66 20 34 2e | 36 0d 0a 63 6d 2f 79 65 |te of 4.|6..cm/ye|
|00003cd0| 61 72 2e 20 20 4f 66 20 | 74 68 65 20 31 32 20 77 |ar. Of |the 12 w|
|00003ce0| 68 6f 20 64 69 64 20 6e | 6f 74 20 72 65 73 70 6f |ho did n|ot respo|
|00003cf0| 6e 64 2c 20 39 20 68 61 | 64 20 69 64 69 6f 70 61 |nd, 9 ha|d idiopa|
|00003d00| 74 68 69 63 20 74 6f 74 | 61 6c 20 6f 72 20 70 61 |thic tot|al or pa|
|00003d10| 72 74 69 61 6c 0d 0a 67 | 72 6f 77 74 68 20 68 6f |rtial..g|rowth ho|
|00003d20| 72 6d 6f 6e 65 20 64 65 | 66 69 63 69 65 6e 63 79 |rmone de|ficiency|
|00003d30| 20 62 75 74 20 68 61 64 | 20 72 65 6c 61 74 69 76 | but had| relativ|
|00003d40| 65 6c 79 20 68 69 67 68 | 20 70 72 65 74 72 65 61 |ely high| pretrea|
|00003d50| 74 6d 65 6e 74 20 67 72 | 6f 77 74 68 20 72 61 74 |tment gr|owth rat|
|00003d60| 65 73 2e 20 20 49 66 0d | 0a 61 20 77 68 6f 6c 65 |es. If.|.a whole|
|00003d70| 20 79 65 61 72 27 73 20 | 70 72 65 74 72 65 61 74 | year's |pretreat|
|00003d80| 6d 65 6e 74 20 67 72 6f | 77 74 68 20 72 61 74 65 |ment gro|wth rate|
|00003d90| 20 6f 66 20 35 20 63 6d | 2f 79 65 61 72 20 77 61 | of 5 cm|/year wa|
|00003da0| 73 20 75 73 65 64 20 61 | 73 20 61 20 64 69 61 67 |s used a|s a diag|
|00003db0| 6e 6f 73 74 69 63 0d 0a | 63 72 69 74 65 72 69 6f |nostic..|criterio|
|00003dc0| 6e 2c 20 74 68 65 20 70 | 72 65 64 69 63 74 69 6f |n, the p|redictio|
|00003dd0| 6e 20 6f 66 20 74 68 6f | 73 65 20 77 68 6f 20 72 |n of tho|se who r|
|00003de0| 65 73 70 6f 6e 64 65 64 | 20 77 6f 75 6c 64 20 68 |esponded| would h|
|00003df0| 61 76 65 20 73 6c 69 67 | 68 74 6c 79 20 69 6d 70 |ave slig|htly imp|
|00003e00| 72 6f 76 65 64 2c 0d 0a | 77 69 74 68 20 34 34 20 |roved,..|with 44 |
|00003e10| 28 38 31 25 29 20 6f 66 | 20 35 34 20 62 65 69 6e |(81%) of| 54 bein|
|00003e20| 67 20 63 6f 72 72 65 63 | 74 6c 79 20 69 64 65 6e |g correc|tly iden|
|00003e30| 74 69 66 69 65 64 2e 0d | 0a 20 20 20 20 20 41 6e |tified..|. An|
|00003e40| 74 69 62 6f 64 69 65 73 | 20 74 6f 20 67 72 6f 77 |tibodies| to grow|
|00003e50| 74 68 20 68 6f 72 6d 6f | 6e 65 20 61 6e 64 20 45 |th hormo|ne and E|
|00003e60| 73 63 68 65 72 69 63 68 | 69 61 20 63 6f 6c 69 20 |scherich|ia coli |
|00003e70| 70 72 6f 74 65 69 6e 20 | 64 65 76 65 6c 6f 70 65 |protein |develope|
|00003e80| 64 20 69 6e 20 6d 6f 73 | 74 0d 0a 70 61 74 69 65 |d in mos|t..patie|
|00003e90| 6e 74 73 2c 20 62 75 74 | 20 74 68 65 20 74 69 74 |nts, but| the tit|
|00003ea0| 65 72 73 20 77 65 72 65 | 20 6c 6f 77 20 61 6e 64 |ers were| low and|
|00003eb0| 20 66 6c 75 63 74 75 61 | 74 65 64 2e 20 20 4d 6f | fluctua|ted. Mo|
|00003ec0| 72 65 20 69 6d 70 6f 72 | 74 61 6e 74 6c 79 2c 20 |re impor|tantly, |
|00003ed0| 6e 6f 20 67 72 6f 77 74 | 68 0d 0a 68 6f 72 6d 6f |no growt|h..hormo|
|00003ee0| 6e 65 20 62 69 6e 64 69 | 6e 67 20 63 61 70 61 63 |ne bindi|ng capac|
|00003ef0| 69 74 79 20 6f 66 20 6d | 6f 72 65 20 74 68 61 6e |ity of m|ore than|
|00003f00| 20 37 2e 35 20 6d 67 2f | 4c 20 64 65 76 65 6c 6f | 7.5 mg/|L develo|
|00003f10| 70 65 64 2c 20 77 68 69 | 63 68 20 63 6f 75 6c 64 |ped, whi|ch could|
|00003f20| 20 68 61 76 65 0d 0a 69 | 6e 68 69 62 69 74 65 64 | have..i|nhibited|
|00003f30| 20 74 68 65 20 74 68 65 | 72 61 70 65 75 74 69 63 | the the|rapeutic|
|00003f40| 20 65 66 66 65 63 74 2e | 20 20 4e 6f 20 61 64 76 | effect.| No adv|
|00003f50| 65 72 73 65 20 73 69 64 | 65 20 65 66 66 65 63 74 |erse sid|e effect|
|00003f60| 73 20 77 65 72 65 20 6e | 6f 74 65 64 2e 0d 0a 20 |s were n|oted... |
|00003f70| 20 20 20 20 53 6f 6d 61 | 74 72 65 6d 20 69 73 20 | Soma|trem is |
|00003f80| 61 20 73 61 66 65 20 61 | 6e 64 20 65 66 66 65 63 |a safe a|nd effec|
|00003f90| 74 69 76 65 20 61 6c 74 | 65 72 6e 61 74 69 76 65 |tive alt|ernative|
|00003fa0| 20 74 6f 20 68 75 6d 61 | 6e 20 70 69 74 75 69 74 | to huma|n pituit|
|00003fb0| 61 72 79 20 67 72 6f 77 | 74 68 0d 0a 68 6f 72 6d |ary grow|th..horm|
|00003fc0| 6f 6e 65 20 66 6f 72 20 | 74 68 65 20 74 72 65 61 |one for |the trea|
|00003fd0| 74 6d 65 6e 74 20 6f 66 | 20 63 68 69 6c 64 72 65 |tment of| childre|
|00003fe0| 6e 20 77 69 74 68 20 67 | 72 6f 77 74 68 20 68 6f |n with g|rowth ho|
|00003ff0| 72 6d 6f 6e 65 20 64 65 | 66 69 63 69 65 6e 63 79 |rmone de|ficiency|
|00004000| 2e 0d 0a 0d 0a 50 6f 73 | 74 2d 43 6f 6d 6d 65 6e |.....Pos|t-Commen|
|00004010| 74 0d 0a 0d 0a 20 20 20 | 20 20 42 69 6f 73 79 6e |t.... | Biosyn|
|00004020| 74 68 65 74 69 63 20 67 | 72 6f 77 74 68 20 68 6f |thetic g|rowth ho|
|00004030| 72 6d 6f 6e 65 20 69 73 | 20 63 6c 65 61 72 6c 79 |rmone is| clearly|
|00004040| 20 74 68 65 20 77 61 79 | 20 74 6f 20 67 6f 20 69 | the way| to go i|
|00004050| 6e 20 74 72 65 61 74 69 | 6e 67 20 63 68 69 6c 64 |n treati|ng child|
|00004060| 72 65 6e 0d 0a 77 69 74 | 68 20 67 72 6f 77 74 68 |ren..wit|h growth|
|00004070| 20 68 6f 72 6d 6f 6e 65 | 20 64 65 66 69 63 69 65 | hormone| deficie|
|00004080| 6e 63 79 2e 20 20 48 75 | 6d 61 6e 20 67 72 6f 77 |ncy. Hu|man grow|
|00004090| 74 68 20 68 6f 72 6d 6f | 6e 65 20 69 73 20 6c 61 |th hormo|ne is la|
|000040a0| 62 6f 72 69 6f 75 73 20 | 74 6f 20 70 72 6f 64 75 |borious |to produ|
|000040b0| 63 65 0d 0a 61 6e 64 20 | 68 61 73 20 62 65 65 6e |ce..and |has been|
|000040c0| 20 61 73 73 6f 63 69 61 | 74 65 64 20 77 69 74 68 | associa|ted with|
|000040d0| 20 74 72 61 6e 73 6d 69 | 73 73 69 6f 6e 20 6f 66 | transmi|ssion of|
|000040e0| 20 76 69 72 61 6c 20 64 | 69 73 65 61 73 65 2c 20 | viral d|isease, |
|000040f0| 73 75 63 68 20 61 73 0d | 0a 43 72 65 75 74 7a 66 |such as.|.Creutzf|
|00004100| 65 6c 64 2d 4a 61 63 6f | 62 2c 20 61 6e 64 20 63 |eld-Jaco|b, and c|
|00004110| 6f 6e 63 65 69 76 61 62 | 6c 79 20 63 6f 75 6c 64 |onceivab|ly could|
|00004120| 20 74 72 61 6e 73 6d 69 | 74 20 68 75 6d 61 6e 20 | transmi|t human |
|00004130| 69 6d 6d 75 6e 6f 64 65 | 66 69 63 69 65 6e 63 79 |immunode|ficiency|
|00004140| 20 76 69 72 75 73 2e 0d | 0a 54 68 65 20 62 69 6f | virus..|.The bio|
|00004150| 73 79 6e 74 68 65 74 69 | 63 20 68 6f 72 6d 6f 6e |syntheti|c hormon|
|00004160| 65 20 64 6f 65 73 20 74 | 68 65 20 6a 6f 62 2c 20 |e does t|he job, |
|00004170| 61 73 20 61 74 74 65 73 | 74 65 64 20 74 6f 20 62 |as attes|ted to b|
|00004180| 79 20 74 68 65 20 61 62 | 6f 76 65 20 61 72 74 69 |y the ab|ove arti|
|00004190| 63 6c 65 2e 0d 0a 49 6e | 64 69 72 65 63 74 20 6d |cle...In|direct m|
|000041a0| 65 74 68 6f 64 73 20 6f | 66 20 73 74 69 6d 75 6c |ethods o|f stimul|
|000041b0| 61 74 69 6f 6e 2c 20 77 | 69 74 68 20 63 79 70 72 |ation, w|ith cypr|
|000041c0| 6f 68 65 70 74 61 64 69 | 6e 65 20 6f 72 20 63 6c |oheptadi|ne or cl|
|000041d0| 6f 6e 69 64 69 6e 65 2c | 20 6e 6f 20 6c 6f 6e 67 |onidine,| no long|
|000041e0| 65 72 0d 0a 73 65 65 6d | 20 72 65 61 73 6f 6e 61 |er..seem| reasona|
|000041f0| 62 6c 65 20 74 6f 20 74 | 72 79 2e 2d 2d 4c 2e 45 |ble to t|ry.--L.E|
|00004200| 2e 20 48 6f 6c 6c 69 73 | 74 65 72 2c 20 4d 2e 44 |. Hollis|ter, M.D|
|00004210| 2e 0d 0a 24 55 6e 69 71 | 75 65 5f 49 44 7b 59 52 |...$Uniq|ue_ID{YR|
|00004220| 42 30 35 37 30 35 7d 0d | 0a 24 54 69 74 6c 65 7b |B05705}.|.$Title{|
|00004230| 4c 6f 6e 67 2d 74 65 72 | 6d 20 54 72 65 61 74 6d |Long-ter|m Treatm|
|00004240| 65 6e 74 20 6f 66 20 48 | 79 70 65 72 70 72 6f 6c |ent of H|yperprol|
|00004250| 61 63 74 69 6e 61 65 6d | 69 61 20 57 69 74 68 20 |actinaem|ia With |
|00004260| 42 72 6f 6d 6f 63 72 69 | 70 74 69 6e 65 3a 20 20 |Bromocri|ptine: |
|00004270| 45 66 66 65 63 74 20 6f | 66 20 44 72 75 67 20 57 |Effect o|f Drug W|
|00004280| 69 74 68 64 72 61 77 61 | 6c 7d 0d 0a 24 41 75 74 |ithdrawa|l}..$Aut|
|00004290| 68 6f 72 7b 0d 0a 57 61 | 6e 67 2c 20 43 0d 0a 4c |hor{..Wa|ng, C..L|
|000042a0| 61 6d 2c 20 4b 53 4c 0d | 0a 4d 61 2c 20 4a 54 43 |am, KSL.|.Ma, JTC|
|000042b0| 0d 0a 43 68 61 6e 2c 20 | 54 0d 0a 4c 69 75 2c 20 |..Chan, |T..Liu, |
|000042c0| 4d 59 0d 0a 59 65 75 6e | 67 2c 20 52 54 54 7d 0d |MY..Yeun|g, RTT}.|
|000042d0| 0a 24 41 66 66 69 6c 69 | 61 74 69 6f 6e 7b 55 6e |.$Affili|ation{Un|
|000042e0| 69 76 20 6f 66 20 48 6f | 6e 67 20 4b 6f 6e 67 7d |iv of Ho|ng Kong}|
|000042f0| 0d 0a 24 53 75 62 6a 65 | 63 74 7b 57 69 74 68 64 |..$Subje|ct{Withd|
|00004300| 72 61 77 61 6c 20 61 66 | 74 65 72 20 62 72 6f 6d |rawal af|ter brom|
|00004310| 6f 63 72 69 70 74 69 6e | 65 20 69 6e 20 68 79 70 |ocriptin|e in hyp|
|00004320| 65 72 70 72 6f 6c 61 63 | 74 69 6e 65 6d 69 61 3b |erprolac|tinemia;|
|00004330| 0d 0a 48 79 70 65 72 70 | 72 6f 6c 61 63 74 69 6e |..Hyperp|rolactin|
|00004340| 65 6d 69 61 20 62 72 6f | 6d 6f 63 72 69 70 74 69 |emia bro|mocripti|
|00004350| 6e 65 20 69 6e 2c 20 77 | 69 74 68 64 72 61 77 61 |ne in, w|ithdrawa|
|00004360| 6c 20 6f 66 3b 0d 0a 42 | 72 6f 6d 6f 63 72 69 70 |l of;..B|romocrip|
|00004370| 74 69 6e 65 20 69 6e 20 | 68 79 70 65 72 70 72 6f |tine in |hyperpro|
|00004380| 6c 61 63 74 69 6e 65 6d | 69 61 2c 20 77 69 74 68 |lactinem|ia, with|
|00004390| 64 72 61 77 61 6c 20 69 | 6e 7d 0d 0a 24 4a 6f 75 |drawal i|n}..$Jou|
|000043a0| 72 6e 61 6c 7b 43 6c 69 | 6e 20 45 6e 64 6f 63 72 |rnal{Cli|n Endocr|
|000043b0| 69 6e 6f 6c 20 28 4f 78 | 66 29 7d 0d 0a 24 56 6f |inol (Ox|f)}..$Vo|
|000043c0| 6c 75 6d 65 7b 32 37 7d | 0d 0a 24 50 61 67 65 7b |lume{27}|..$Page{|
|000043d0| 33 36 33 2d 33 37 31 7d | 0d 0a 24 44 61 74 65 7b |363-371}|..$Date{|
|000043e0| 53 65 70 74 65 6d 62 65 | 72 20 31 39 38 37 7d 0d |Septembe|r 1987}.|
|000043f0| 0a 24 59 42 56 6f 6c 7b | 31 39 38 39 20 59 65 61 |.$YBVol{|1989 Yea|
|00004400| 72 20 42 6f 6f 6b 20 6f | 66 20 44 72 75 67 20 54 |r Book o|f Drug T|
|00004410| 68 65 72 61 70 79 7d 0d | 0a 24 43 68 61 70 74 65 |herapy}.|.$Chapte|
|00004420| 72 7b 37 2d 31 32 7d 0d | 0a 24 59 42 45 64 69 74 |r{7-12}.|.$YBEdit|
|00004430| 6f 72 7b 44 72 73 2e 20 | 48 6f 6c 6c 69 73 74 65 |or{Drs. |Holliste|
|00004440| 72 20 61 6e 64 20 4c 61 | 73 61 67 6e 61 7d 0d 0a |r and La|sagna}..|
|00004450| 24 54 61 62 6c 65 7b 7d | 0d 0a 24 43 6f 6d 6d 65 |$Table{}|..$Comme|
|00004460| 6e 74 61 74 6f 72 7b 4c | 2e 45 2e 20 48 6f 6c 6c |ntator{L|.E. Holl|
|00004470| 69 73 74 65 72 2c 20 4d | 2e 44 2e 7d 0d 0a 0d 0a |ister, M|.D.}....|
|00004480| 43 6f 70 79 72 69 67 68 | 74 20 28 63 29 20 59 65 |Copyrigh|t (c) Ye|
|00004490| 61 72 20 42 6f 6f 6b 20 | 4d 65 64 69 63 61 6c 20 |ar Book |Medical |
|000044a0| 50 75 62 6c 69 73 68 65 | 72 73 2c 20 49 6e 63 2e |Publishe|rs, Inc.|
|000044b0| 2c 20 31 39 38 39 0d 0a | 0d 0a 31 39 38 39 20 59 |, 1989..|..1989 Y|
|000044c0| 65 61 72 20 42 6f 6f 6b | 20 6f 66 20 44 72 75 67 |ear Book| of Drug|
|000044d0| 20 54 68 65 72 61 70 79 | 20 28 52 29 0d 0a 0d 0a | Therapy| (R)....|
|000044e0| 43 68 61 70 74 65 72 20 | 37 2d 2d 45 6e 64 6f 63 |Chapter |7--Endoc|
|000044f0| 72 69 6e 65 20 61 6e 64 | 20 4d 65 74 61 62 6f 6c |rine and| Metabol|
|00004500| 69 63 20 44 69 73 6f 72 | 64 65 72 73 0d 0a 0d 0a |ic Disor|ders....|
|00004510| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004520| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004530| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004540| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004550| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004560| 0d 0a 4c 6f 6e 67 2d 74 | 65 72 6d 20 54 72 65 61 |..Long-t|erm Trea|
|00004570| 74 6d 65 6e 74 20 6f 66 | 20 48 79 70 65 72 70 72 |tment of| Hyperpr|
|00004580| 6f 6c 61 63 74 69 6e 61 | 65 6d 69 61 20 57 69 74 |olactina|emia Wit|
|00004590| 68 20 42 72 6f 6d 6f 63 | 72 69 70 74 69 6e 65 3a |h Bromoc|riptine:|
|000045a0| 20 20 45 66 66 65 63 74 | 20 6f 66 20 44 72 75 67 | Effect| of Drug|
|000045b0| 0d 0a 57 69 74 68 64 72 | 61 77 61 6c 0d 0a 0d 0a |..Withdr|awal....|
|000045c0| 57 61 6e 67 20 43 2c 20 | 4c 61 6d 20 4b 53 4c 2c |Wang C, |Lam KSL,|
|000045d0| 20 4d 61 20 4a 54 43 2c | 20 43 68 61 6e 20 54 2c | Ma JTC,| Chan T,|
|000045e0| 20 4c 69 75 20 4d 59 2c | 20 59 65 75 6e 67 20 52 | Liu MY,| Yeung R|
|000045f0| 54 54 0d 0a 28 55 6e 69 | 76 20 6f 66 20 48 6f 6e |TT..(Uni|v of Hon|
|00004600| 67 20 4b 6f 6e 67 29 0d | 0a 43 6c 69 6e 20 45 6e |g Kong).|.Clin En|
|00004610| 64 6f 63 72 69 6e 6f 6c | 20 28 4f 78 66 29 20 32 |docrinol| (Oxf) 2|
|00004620| 37 3a 33 36 33 2d 33 37 | 31 2c 20 53 65 70 74 65 |7:363-37|1, Septe|
|00004630| 6d 62 65 72 20 31 39 38 | 37 0d 0a 2d 2d 2d 2d 2d |mber 198|7..-----|
|00004640| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004650| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004660| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004670| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004680| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 0d 0a 41 |--------|---....A|
|00004690| 62 73 74 72 61 63 74 0d | 0a 0d 0a 20 20 20 20 20 |bstract.|... |
|000046a0| 54 68 65 20 65 66 66 65 | 63 74 20 6f 66 20 64 72 |The effe|ct of dr|
|000046b0| 75 67 20 77 69 74 68 64 | 72 61 77 61 6c 20 61 66 |ug withd|rawal af|
|000046c0| 74 65 72 20 32 2d 31 32 | 20 79 65 61 72 73 20 28 |ter 2-12| years (|
|000046d0| 6d 65 61 6e 2c 20 34 2e | 39 20 2b 2f 2d 20 32 2e |mean, 4.|9 +/- 2.|
|000046e0| 39 20 79 65 61 72 73 29 | 20 6f 66 0d 0a 74 72 65 |9 years)| of..tre|
|000046f0| 61 74 6d 65 6e 74 20 77 | 69 74 68 20 62 72 6f 6d |atment w|ith brom|
|00004700| 6f 63 72 69 70 74 69 6e | 65 20 77 61 73 20 73 74 |ocriptin|e was st|
|00004710| 75 64 69 65 64 20 69 6e | 20 35 31 20 70 61 74 69 |udied in| 51 pati|
|00004720| 65 6e 74 73 20 77 69 74 | 68 20 68 79 70 65 72 70 |ents wit|h hyperp|
|00004730| 72 6f 6c 61 63 74 69 6e | 65 6d 69 61 2c 0d 0a 69 |rolactin|emia,..i|
|00004740| 6e 63 6c 75 64 69 6e 67 | 20 32 33 20 77 69 74 68 |ncluding| 23 with|
|00004750| 20 6d 61 63 72 6f 61 64 | 65 6e 6f 6d 61 73 2c 20 | macroad|enomas, |
|00004760| 32 33 20 77 69 74 68 20 | 6d 69 63 72 6f 61 64 65 |23 with |microade|
|00004770| 6e 6f 6d 61 73 2c 20 61 | 6e 64 20 35 20 77 69 74 |nomas, a|nd 5 wit|
|00004780| 68 20 69 64 69 6f 70 61 | 74 68 69 63 0d 0a 68 79 |h idiopa|thic..hy|
|00004790| 70 65 72 70 72 6f 6c 61 | 63 74 69 6e 65 6d 69 61 |perprola|ctinemia|
|000047a0| 2e 0d 0a 20 20 20 20 20 | 53 65 72 75 6d 20 50 52 |... |Serum PR|
|000047b0| 4c 20 6c 65 76 65 6c 73 | 20 77 65 72 65 20 73 75 |L levels| were su|
|000047c0| 70 70 72 65 73 73 65 64 | 20 74 6f 20 74 68 65 20 |ppressed| to the |
|000047d0| 6e 6f 72 6d 61 6c 20 72 | 61 6e 67 65 20 69 6e 20 |normal r|ange in |
|000047e0| 61 6c 6c 20 62 75 74 20 | 35 20 70 61 74 69 65 6e |all but |5 patien|
|000047f0| 74 73 2e 0d 0a 47 6f 6e | 61 64 61 6c 20 66 75 6e |ts...Gon|adal fun|
|00004800| 63 74 69 6f 6e 20 62 65 | 63 61 6d 65 20 6e 6f 72 |ction be|came nor|
|00004810| 6d 61 6c 20 69 6e 20 33 | 20 6f 66 20 74 68 65 20 |mal in 3| of the |
|00004820| 35 20 70 61 74 69 65 6e | 74 73 20 64 65 73 70 69 |5 patien|ts despi|
|00004830| 74 65 20 70 65 72 73 69 | 73 74 65 6e 74 6c 79 20 |te persi|stently |
|00004840| 68 69 67 68 0d 0a 73 65 | 72 75 6d 20 50 52 4c 20 |high..se|rum PRL |
|00004850| 6c 65 76 65 6c 73 3b 20 | 67 6f 6e 61 64 6f 74 72 |levels; |gonadotr|
|00004860| 6f 70 69 6e 20 72 65 73 | 65 72 76 65 20 68 61 64 |opin res|erve had|
|00004870| 20 62 65 65 6e 20 69 6d | 70 61 69 72 65 64 20 69 | been im|paired i|
|00004880| 6e 20 74 68 65 20 6f 74 | 68 65 72 20 32 20 65 76 |n the ot|her 2 ev|
|00004890| 65 6e 0d 0a 62 65 66 6f | 72 65 20 74 68 65 72 61 |en..befo|re thera|
|000048a0| 70 79 2e 20 20 4f 6e 65 | 20 6f 66 20 74 68 65 20 |py. One| of the |
|000048b0| 33 20 70 61 74 69 65 6e | 74 73 20 77 69 74 68 20 |3 patien|ts with |
|000048c0| 6e 6f 72 6d 61 6c 20 67 | 6f 6e 61 64 61 6c 20 66 |normal g|onadal f|
|000048d0| 75 6e 63 74 69 6f 6e 20 | 68 61 64 20 61 20 68 69 |unction |had a hi|
|000048e0| 67 68 0d 0a 70 72 6f 70 | 6f 72 74 69 6f 6e 20 6f |gh..prop|ortion o|
|000048f0| 66 20 61 20 66 6f 72 6d | 20 6f 66 20 50 52 4c 20 |f a form| of PRL |
|00004900| 77 69 74 68 20 61 20 6c | 61 72 67 65 20 6d 6f 6c |with a l|arge mol|
|00004910| 65 63 75 6c 61 72 20 77 | 65 69 67 68 74 20 6f 6e |ecular w|eight on|
|00004920| 20 67 65 6c 20 63 68 72 | 6f 6d 61 74 6f 67 72 61 | gel chr|omatogra|
|00004930| 70 68 79 2e 0d 0a 54 77 | 65 6e 74 79 2d 66 6f 75 |phy...Tw|enty-fou|
|00004940| 72 20 73 75 62 6a 65 63 | 74 73 20 77 65 72 65 20 |r subjec|ts were |
|00004950| 74 72 65 61 74 65 64 20 | 73 6f 6c 65 6c 79 20 77 |treated |solely w|
|00004960| 69 74 68 20 62 72 6f 6d | 6f 63 72 69 70 74 69 6e |ith brom|ocriptin|
|00004970| 65 20 66 6f 72 20 61 20 | 6d 65 61 6e 20 33 2e 34 |e for a |mean 3.4|
|00004980| 20 2b 2f 2d 0d 0a 32 2e | 33 20 79 65 61 72 73 2e | +/-..2.|3 years.|
|00004990| 0d 0a 20 20 20 20 20 53 | 65 72 75 6d 20 50 52 4c |.. S|erum PRL|
|000049a0| 20 6c 65 76 65 6c 73 20 | 72 65 6d 61 69 6e 65 64 | levels |remained|
|000049b0| 20 6e 6f 72 6d 61 6c 20 | 69 6e 20 35 20 28 32 31 | normal |in 5 (21|
|000049c0| 25 29 20 6f 66 20 74 68 | 65 20 32 34 20 73 75 62 |%) of th|e 24 sub|
|000049d0| 6a 65 63 74 73 20 61 66 | 74 65 72 0d 0a 70 72 6f |jects af|ter..pro|
|000049e0| 6c 6f 6e 67 65 64 20 28 | 31 2d 34 20 79 65 61 72 |longed (|1-4 year|
|000049f0| 73 29 20 64 72 75 67 20 | 77 69 74 68 64 72 61 77 |s) drug |withdraw|
|00004a00| 61 6c 2e 20 20 54 77 65 | 6e 74 79 2d 6f 6e 65 20 |al. Twe|nty-one |
|00004a10| 70 61 74 69 65 6e 74 73 | 20 72 65 63 65 69 76 65 |patients| receive|
|00004a20| 64 20 65 78 74 65 72 6e | 61 6c 0d 0a 70 69 74 75 |d extern|al..pitu|
|00004a30| 69 74 61 72 79 20 69 72 | 72 61 64 69 61 74 69 6f |itary ir|radiatio|
|00004a40| 6e 20 69 6e 20 63 6f 6e | 6a 75 6e 63 74 69 6f 6e |n in con|junction|
|00004a50| 20 77 69 74 68 20 62 72 | 6f 6d 6f 63 72 69 70 74 | with br|omocript|
|00004a60| 69 6e 65 20 74 68 65 72 | 61 70 79 2e 20 20 41 74 |ine ther|apy. At|
|00004a70| 20 61 20 6d 65 61 6e 20 | 6f 66 0d 0a 36 2e 30 20 | a mean |of..6.0 |
|00004a80| 2b 2f 2d 20 33 2e 30 20 | 79 65 61 72 73 20 61 66 |+/- 3.0 |years af|
|00004a90| 74 65 72 20 72 61 64 69 | 6f 74 68 65 72 61 70 79 |ter radi|otherapy|
|00004aa0| 2c 20 6f 6e 6c 79 20 36 | 20 28 32 39 25 29 20 6f |, only 6| (29%) o|
|00004ab0| 66 20 74 68 65 20 32 31 | 20 70 61 74 69 65 6e 74 |f the 21| patient|
|00004ac0| 73 20 68 61 64 20 6e 6f | 72 6d 61 6c 0d 0a 73 65 |s had no|rmal..se|
|00004ad0| 72 75 6d 20 50 52 4c 20 | 6c 65 76 65 6c 73 20 31 |rum PRL |levels 1|
|00004ae0| 2d 34 20 79 65 61 72 73 | 20 61 66 74 65 72 20 62 |-4 years| after b|
|00004af0| 72 6f 6d 6f 63 72 69 70 | 74 69 6e 65 20 77 69 74 |romocrip|tine wit|
|00004b00| 68 64 72 61 77 61 6c 2e | 20 20 49 6e 61 64 65 71 |hdrawal.| Inadeq|
|00004b10| 75 61 74 65 20 47 48 0d | 0a 72 65 73 70 6f 6e 73 |uate GH.|.respons|
|00004b20| 65 20 74 6f 20 69 6e 73 | 75 6c 69 6e 20 68 79 70 |e to ins|ulin hyp|
|00004b30| 6f 67 6c 79 63 65 6d 69 | 61 20 61 66 74 65 72 20 |oglycemi|a after |
|00004b40| 72 61 64 69 6f 74 68 65 | 72 61 70 79 20 6f 63 63 |radiothe|rapy occ|
|00004b50| 75 72 72 65 64 20 69 6e | 20 6f 6e 6c 79 20 31 20 |urred in| only 1 |
|00004b60| 70 61 74 69 65 6e 74 2e | 0d 0a 20 20 20 20 20 42 |patient.|.. B|
|00004b70| 72 6f 6d 6f 63 72 69 70 | 74 69 6e 65 20 61 6c 6f |romocrip|tine alo|
|00004b80| 6e 65 20 69 73 20 68 69 | 67 68 6c 79 20 65 66 66 |ne is hi|ghly eff|
|00004b90| 65 63 74 69 76 65 20 66 | 6f 72 20 74 68 65 20 74 |ective f|or the t|
|00004ba0| 72 65 61 74 6d 65 6e 74 | 20 6f 66 20 69 64 69 6f |reatment| of idio|
|00004bb0| 70 61 74 68 69 63 0d 0a | 68 79 70 65 72 70 72 6f |pathic..|hyperpro|
|00004bc0| 6c 61 63 74 69 6e 65 6d | 69 61 2c 20 6d 69 63 72 |lactinem|ia, micr|
|00004bd0| 6f 61 64 65 6e 6f 6d 61 | 73 2c 20 61 6e 64 20 73 |oadenoma|s, and s|
|00004be0| 6d 61 6c 6c 20 6d 61 63 | 72 6f 61 64 65 6e 6f 6d |mall mac|roadenom|
|00004bf0| 61 73 2e 20 20 50 65 72 | 6d 61 6e 65 6e 74 20 6c |as. Per|manent l|
|00004c00| 6f 77 65 72 69 6e 67 0d | 0a 6f 66 20 74 68 65 20 |owering.|.of the |
|00004c10| 50 52 4c 20 6c 65 76 65 | 6c 20 63 61 6e 20 62 65 |PRL leve|l can be|
|00004c20| 20 61 63 68 69 65 76 65 | 64 20 69 6e 20 66 65 77 | achieve|d in few|
|00004c30| 65 72 20 74 68 61 6e 20 | 6f 6e 65 20 66 69 66 74 |er than |one fift|
|00004c40| 68 20 6f 66 20 74 68 65 | 20 70 61 74 69 65 6e 74 |h of the| patient|
|00004c50| 73 20 77 69 74 68 0d 0a | 70 72 6f 6c 61 63 74 69 |s with..|prolacti|
|00004c60| 6e 6f 6d 61 73 20 77 68 | 6f 20 72 65 63 65 69 76 |nomas wh|o receiv|
|00004c70| 65 20 70 72 6f 6c 6f 6e | 67 65 64 20 62 72 6f 6d |e prolon|ged brom|
|00004c80| 6f 63 72 69 70 74 69 6e | 65 20 74 68 65 72 61 70 |ocriptin|e therap|
|00004c90| 79 2e 0d 0a 0d 0a 50 6f | 73 74 2d 43 6f 6d 6d 65 |y.....Po|st-Comme|
|00004ca0| 6e 74 0d 0a 0d 0a 20 20 | 20 20 20 54 68 65 20 64 |nt.... | The d|
|00004cb0| 6f 70 61 6d 69 6e 65 20 | 61 67 6f 6e 69 73 74 2c |opamine |agonist,|
|00004cc0| 20 62 72 6f 6d 6f 63 72 | 69 70 74 69 6e 65 20 28 | bromocr|iptine (|
|00004cd0| 50 61 72 6c 6f 64 65 6c | 29 2c 20 68 61 73 20 62 |Parlodel|), has b|
|00004ce0| 65 65 6e 20 75 73 65 64 | 20 63 6c 69 6e 69 63 61 |een used| clinica|
|00004cf0| 6c 6c 79 0d 0a 66 6f 72 | 20 74 72 65 61 74 6d 65 |lly..for| treatme|
|00004d00| 6e 74 20 6f 66 20 68 79 | 70 65 72 70 72 6f 6c 61 |nt of hy|perprola|
|00004d10| 63 74 69 6e 65 6d 69 61 | 2c 20 61 63 72 6f 6d 65 |ctinemia|, acrome|
|00004d20| 67 61 6c 79 2c 20 61 6e | 64 20 50 61 72 6b 69 6e |galy, an|d Parkin|
|00004d30| 73 6f 6e 27 73 20 64 69 | 73 65 61 73 65 2e 20 20 |son's di|sease. |
|00004d40| 49 74 0d 0a 6e 6f 74 20 | 6f 6e 6c 79 20 63 6f 6e |It..not |only con|
|00004d50| 74 72 6f 6c 73 20 65 78 | 63 65 73 73 69 76 65 20 |trols ex|cessive |
|00004d60| 70 72 6f 6c 61 63 74 69 | 6e 20 73 65 63 72 65 74 |prolacti|n secret|
|00004d70| 69 6f 6e 20 62 75 74 20 | 61 6c 73 6f 20 72 65 64 |ion but |also red|
|00004d80| 75 63 65 73 20 74 68 65 | 20 73 69 7a 65 20 6f 66 |uces the| size of|
|00004d90| 0d 0a 6d 61 63 72 6f 61 | 64 65 6e 6f 6d 61 73 2e |..macroa|denomas.|
|00004da0| 20 20 49 74 20 77 6f 75 | 6c 64 20 62 65 20 6e 69 | It wou|ld be ni|
|00004db0| 63 65 20 77 65 72 65 20 | 74 72 65 61 74 6d 65 6e |ce were |treatmen|
|00004dc0| 74 20 61 62 6c 65 20 74 | 6f 20 62 65 20 64 69 73 |t able t|o be dis|
|00004dd0| 63 6f 6e 74 69 6e 75 65 | 64 20 77 69 74 68 0d 0a |continue|d with..|
|00004de0| 70 72 65 73 65 72 76 61 | 74 69 6f 6e 20 6f 66 20 |preserva|tion of |
|00004df0| 63 6f 6e 74 72 6f 6c 2e | 20 20 54 68 69 73 20 73 |control.| This s|
|00004e00| 74 75 64 79 20 69 6e 64 | 69 63 61 74 65 73 20 74 |tudy ind|icates t|
|00004e10| 68 61 74 20 73 75 63 68 | 20 62 65 6e 65 66 69 74 |hat such| benefit|
|00004e20| 73 20 6f 63 63 75 72 20 | 69 6e 20 6c 65 73 73 0d |s occur |in less.|
|00004e30| 0a 74 68 61 6e 20 32 30 | 25 20 6f 66 20 70 61 74 |.than 20|% of pat|
|00004e40| 69 65 6e 74 73 20 74 72 | 65 61 74 65 64 20 66 6f |ients tr|eated fo|
|00004e50| 72 20 72 61 74 68 65 72 | 20 6c 6f 6e 67 20 70 65 |r rather| long pe|
|00004e60| 72 69 6f 64 73 2e 20 20 | 54 6f 6f 20 62 61 64 2c |riods. |Too bad,|
|00004e70| 20 61 73 20 74 72 65 61 | 74 6d 65 6e 74 0d 0a 77 | as trea|tment..w|
|00004e80| 69 74 68 20 62 72 6f 6d | 6f 63 72 69 70 74 69 6e |ith brom|ocriptin|
|00004e90| 65 20 69 73 20 66 61 69 | 72 6c 79 20 65 78 70 65 |e is fai|rly expe|
|00004ea0| 6e 73 69 76 65 2e 2d 2d | 4c 2e 45 2e 20 48 6f 6c |nsive.--|L.E. Hol|
|00004eb0| 6c 69 73 74 65 72 2c 20 | 4d 2e 44 2e 0d 0a 24 55 |lister, |M.D...$U|
|00004ec0| 6e 69 71 75 65 5f 49 44 | 7b 59 52 42 30 35 37 30 |nique_ID|{YRB0570|
|00004ed0| 36 7d 0d 0a 24 54 69 74 | 6c 65 7b 49 6e 64 75 63 |6}..$Tit|le{Induc|
|00004ee0| 74 69 6f 6e 20 6f 66 20 | 50 75 62 65 72 74 79 20 |tion of |Puberty |
|00004ef0| 62 79 20 50 75 6c 73 61 | 74 69 6c 65 20 47 6f 6e |by Pulsa|tile Gon|
|00004f00| 61 64 6f 74 72 6f 70 69 | 6e 20 52 65 6c 65 61 73 |adotropi|n Releas|
|00004f10| 69 6e 67 20 48 6f 72 6d | 6f 6e 65 7d 0d 0a 24 41 |ing Horm|one}..$A|
|00004f20| 75 74 68 6f 72 7b 0d 0a | 53 74 61 6e 68 6f 70 65 |uthor{..|Stanhope|
|00004f30| 2c 20 52 0d 0a 42 72 6f | 6f 6b 2c 20 43 47 44 0d |, R..Bro|ok, CGD.|
|00004f40| 0a 50 72 69 6e 67 6c 65 | 2c 20 50 4a 0d 0a 41 64 |.Pringle|, PJ..Ad|
|00004f50| 61 6d 73 2c 20 4a 0d 0a | 4a 61 63 6f 62 73 2c 20 |ams, J..|Jacobs, |
|00004f60| 48 53 7d 0d 0a 24 41 66 | 66 69 6c 69 61 74 69 6f |HS}..$Af|filiatio|
|00004f70| 6e 7b 54 68 65 20 4d 69 | 64 64 6c 65 73 65 78 20 |n{The Mi|ddlesex |
|00004f80| 48 6f 73 70 2c 20 4c 6f | 6e 64 6f 6e 7d 0d 0a 24 |Hosp, Lo|ndon}..$|
|00004f90| 53 75 62 6a 65 63 74 7b | 50 75 62 65 72 74 79 20 |Subject{|Puberty |
|00004fa0| 69 6e 64 75 63 74 69 6f | 6e 20 62 79 20 70 75 6c |inductio|n by pul|
|00004fb0| 73 61 74 69 6c 65 20 67 | 6f 6e 61 64 6f 74 72 6f |satile g|onadotro|
|00004fc0| 70 69 6e 20 72 65 6c 65 | 61 73 69 6e 67 20 68 6f |pin rele|asing ho|
|00004fd0| 72 6d 6f 6e 65 3b 0d 0a | 48 6f 72 6d 6f 6e 65 28 |rmone;..|Hormone(|
|00004fe0| 73 29 20 67 6f 6e 61 64 | 6f 74 72 6f 70 69 6e 20 |s) gonad|otropin |
|00004ff0| 72 65 6c 65 61 73 69 6e | 67 2c 20 70 75 6c 73 61 |releasin|g, pulsa|
|00005000| 74 69 6c 65 2c 20 66 6f | 72 20 70 75 62 65 72 74 |tile, fo|r pubert|
|00005010| 79 20 69 6e 64 75 63 74 | 69 6f 6e 3b 0d 0a 47 6f |y induct|ion;..Go|
|00005020| 6e 61 64 6f 74 72 6f 70 | 69 6e 20 72 65 6c 65 61 |nadotrop|in relea|
|00005030| 73 69 6e 67 20 68 6f 72 | 6d 6f 6e 65 2c 20 70 75 |sing hor|mone, pu|
|00005040| 6c 73 61 74 69 6c 65 2c | 20 66 6f 72 20 70 75 62 |lsatile,| for pub|
|00005050| 65 72 74 79 20 69 6e 64 | 75 63 74 69 6f 6e 7d 0d |erty ind|uction}.|
|00005060| 0a 24 4a 6f 75 72 6e 61 | 6c 7b 4c 61 6e 63 65 74 |.$Journa|l{Lancet|
|00005070| 7d 0d 0a 24 56 6f 6c 75 | 6d 65 7b 32 7d 0d 0a 24 |}..$Volu|me{2}..$|
|00005080| 50 61 67 65 7b 35 35 32 | 2d 35 35 35 7d 0d 0a 24 |Page{552|-555}..$|
|00005090| 44 61 74 65 7b 53 65 70 | 74 20 35 2c 20 31 39 38 |Date{Sep|t 5, 198|
|000050a0| 37 7d 0d 0a 24 59 42 56 | 6f 6c 7b 31 39 38 39 20 |7}..$YBV|ol{1989 |
|000050b0| 59 65 61 72 20 42 6f 6f | 6b 20 6f 66 20 44 72 75 |Year Boo|k of Dru|
|000050c0| 67 20 54 68 65 72 61 70 | 79 7d 0d 0a 24 43 68 61 |g Therap|y}..$Cha|
|000050d0| 70 74 65 72 7b 37 2d 31 | 33 7d 0d 0a 24 59 42 45 |pter{7-1|3}..$YBE|
|000050e0| 64 69 74 6f 72 7b 44 72 | 73 2e 20 48 6f 6c 6c 69 |ditor{Dr|s. Holli|
|000050f0| 73 74 65 72 20 61 6e 64 | 20 4c 61 73 61 67 6e 61 |ster and| Lasagna|
|00005100| 7d 0d 0a 24 54 61 62 6c | 65 7b 7d 0d 0a 24 43 6f |}..$Tabl|e{}..$Co|
|00005110| 6d 6d 65 6e 74 61 74 6f | 72 7b 4c 2e 45 2e 20 48 |mmentato|r{L.E. H|
|00005120| 6f 6c 6c 69 73 74 65 72 | 2c 20 4d 2e 44 2e 7d 0d |ollister|, M.D.}.|
|00005130| 0a 0d 0a 43 6f 70 79 72 | 69 67 68 74 20 28 63 29 |...Copyr|ight (c)|
|00005140| 20 59 65 61 72 20 42 6f | 6f 6b 20 4d 65 64 69 63 | Year Bo|ok Medic|
|00005150| 61 6c 20 50 75 62 6c 69 | 73 68 65 72 73 2c 20 49 |al Publi|shers, I|
|00005160| 6e 63 2e 2c 20 31 39 38 | 39 0d 0a 0d 0a 31 39 38 |nc., 198|9....198|
|00005170| 39 20 59 65 61 72 20 42 | 6f 6f 6b 20 6f 66 20 44 |9 Year B|ook of D|
|00005180| 72 75 67 20 54 68 65 72 | 61 70 79 20 28 52 29 0d |rug Ther|apy (R).|
|00005190| 0a 0d 0a 43 68 61 70 74 | 65 72 20 37 2d 2d 45 6e |...Chapt|er 7--En|
|000051a0| 64 6f 63 72 69 6e 65 20 | 61 6e 64 20 4d 65 74 61 |docrine |and Meta|
|000051b0| 62 6f 6c 69 63 20 44 69 | 73 6f 72 64 65 72 73 0d |bolic Di|sorders.|
|000051c0| 0a 0d 0a 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |...-----|--------|
|000051d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000051e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000051f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005200| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005210| 2d 2d 2d 0d 0a 49 6e 64 | 75 63 74 69 6f 6e 20 6f |---..Ind|uction o|
|00005220| 66 20 50 75 62 65 72 74 | 79 20 62 79 20 50 75 6c |f Pubert|y by Pul|
|00005230| 73 61 74 69 6c 65 20 47 | 6f 6e 61 64 6f 74 72 6f |satile G|onadotro|
|00005240| 70 69 6e 20 52 65 6c 65 | 61 73 69 6e 67 20 48 6f |pin Rele|asing Ho|
|00005250| 72 6d 6f 6e 65 0d 0a 0d | 0a 53 74 61 6e 68 6f 70 |rmone...|.Stanhop|
|00005260| 65 20 52 2c 20 42 72 6f | 6f 6b 20 43 47 44 2c 20 |e R, Bro|ok CGD, |
|00005270| 50 72 69 6e 67 6c 65 20 | 50 4a 2c 20 41 64 61 6d |Pringle |PJ, Adam|
|00005280| 73 20 4a 2c 20 4a 61 63 | 6f 62 73 20 48 53 0d 0a |s J, Jac|obs HS..|
|00005290| 28 54 68 65 20 4d 69 64 | 64 6c 65 73 65 78 20 48 |(The Mid|dlesex H|
|000052a0| 6f 73 70 2c 20 4c 6f 6e | 64 6f 6e 29 0d 0a 4c 61 |osp, Lon|don)..La|
|000052b0| 6e 63 65 74 20 32 3a 35 | 35 32 2d 35 35 35 2c 20 |ncet 2:5|52-555, |
|000052c0| 53 65 70 74 20 35 2c 20 | 31 39 38 37 0d 0a 2d 2d |Sept 5, |1987..--|
|000052d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000052e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000052f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005300| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005310| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|00005320| 0d 0a 41 62 73 74 72 61 | 63 74 0d 0a 0d 0a 20 20 |..Abstra|ct.... |
|00005330| 20 20 20 4c 6f 77 2d 64 | 6f 73 65 20 70 75 6c 73 | Low-d|ose puls|
|00005340| 61 74 69 6c 65 20 67 6f | 6e 61 64 6f 74 72 6f 70 |atile go|nadotrop|
|00005350| 69 6e 2d 72 65 6c 65 61 | 73 69 6e 67 20 68 6f 72 |in-relea|sing hor|
|00005360| 6d 6f 6e 65 20 28 47 6e | 52 48 2c 20 77 68 69 63 |mone (Gn|RH, whic|
|00005370| 68 20 6d 69 6d 69 63 6b | 73 20 74 68 65 0d 0a 6e |h mimick|s the..n|
|00005380| 6f 72 6d 61 6c 20 70 68 | 79 73 69 6f 6c 6f 67 79 |ormal ph|ysiology|
|00005390| 20 6f 66 20 70 75 62 65 | 72 74 79 29 2c 20 77 61 | of pube|rty), wa|
|000053a0| 73 20 61 64 6d 69 6e 69 | 73 74 65 72 65 64 20 74 |s admini|stered t|
|000053b0| 6f 20 31 35 20 66 65 6d | 61 6c 65 73 20 28 61 67 |o 15 fem|ales (ag|
|000053c0| 65 64 20 31 32 2e 37 2d | 32 38 2e 32 0d 0a 79 65 |ed 12.7-|28.2..ye|
|000053d0| 61 72 73 29 20 61 6e 64 | 20 31 37 20 62 6f 79 73 |ars) and| 17 boys|
|000053e0| 20 28 61 67 65 64 20 31 | 34 2e 31 2d 31 39 2e 34 | (aged 1|4.1-19.4|
|000053f0| 20 79 65 61 72 73 29 20 | 77 69 74 68 20 64 65 6c | years) |with del|
|00005400| 61 79 65 64 20 6f 72 20 | 61 72 72 65 73 74 65 64 |ayed or |arrested|
|00005410| 20 70 75 62 65 72 74 79 | 2e 0d 0a 54 68 72 65 65 | puberty|...Three|
|00005420| 20 70 61 74 69 65 6e 74 | 73 20 68 61 64 20 69 64 | patient|s had id|
|00005430| 69 6f 70 61 74 68 69 63 | 20 67 72 6f 77 74 68 20 |iopathic| growth |
|00005440| 68 6f 72 6d 6f 6e 65 20 | 64 65 66 69 63 69 65 6e |hormone |deficien|
|00005450| 63 79 2c 20 61 6e 64 20 | 33 20 68 61 64 20 67 72 |cy, and |3 had gr|
|00005460| 6f 77 74 68 0d 0a 68 6f | 72 6d 6f 6e 65 20 64 65 |owth..ho|rmone de|
|00005470| 66 69 63 69 65 6e 63 79 | 20 61 66 74 65 72 20 69 |ficiency| after i|
|00005480| 72 72 61 64 69 61 74 69 | 6f 6e 2e 20 20 54 68 65 |rradiati|on. The|
|00005490| 20 68 6f 72 6d 6f 6e 65 | 20 28 31 2d 32 20 20 6d | hormone| (1-2 m|
|000054a0| 75 5f 67 2f 70 75 6c 73 | 65 20 69 6e 20 74 68 65 |u_g/puls|e in the|
|000054b0| 20 67 69 72 6c 73 0d 0a | 61 6e 64 20 32 2d 34 20 | girls..|and 2-4 |
|000054c0| 20 6d 75 5f 67 2f 70 75 | 6c 73 65 20 69 6e 20 74 | mu_g/pu|lse in t|
|000054d0| 68 65 20 62 6f 79 73 29 | 20 77 61 73 20 67 69 76 |he boys)| was giv|
|000054e0| 65 6e 20 61 74 20 39 30 | 2d 6d 69 6e 75 74 65 20 |en at 90|-minute |
|000054f0| 69 6e 74 65 72 76 61 6c | 73 20 69 6e 69 74 69 61 |interval|s initia|
|00005500| 6c 6c 79 20 61 74 0d 0a | 6e 69 67 68 74 20 61 6e |lly at..|night an|
|00005510| 64 20 6c 61 74 65 72 20 | 66 6f 72 20 32 34 20 68 |d later |for 24 h|
|00005520| 6f 75 72 73 2e 20 20 53 | 65 72 69 61 6c 20 6f 76 |ours. S|erial ov|
|00005530| 65 72 6e 69 67 68 74 20 | 67 6f 6e 61 64 6f 74 72 |ernight |gonadotr|
|00005540| 6f 70 69 6e 20 70 72 6f | 66 69 6c 65 73 20 77 65 |opin pro|files we|
|00005550| 72 65 20 75 73 65 64 0d | 0a 74 6f 20 6d 6f 6e 69 |re used.|.to moni|
|00005560| 74 6f 72 20 74 68 69 73 | 20 74 68 65 72 61 70 79 |tor this| therapy|
|00005570| 2e 20 20 47 69 72 6c 73 | 20 77 65 72 65 20 61 6c |. Girls| were al|
|00005580| 73 6f 20 6d 6f 6e 69 74 | 6f 72 65 64 20 62 79 20 |so monit|ored by |
|00005590| 70 65 6c 76 69 63 20 75 | 6c 74 72 61 73 6f 75 6e |pelvic u|ltrasoun|
|000055a0| 64 2e 0d 0a 20 20 20 20 | 20 54 68 65 20 70 72 6f |d... | The pro|
|000055b0| 67 72 65 73 73 20 6f 66 | 20 70 75 62 65 72 74 79 |gress of| puberty|
|000055c0| 20 69 6e 20 74 68 65 73 | 65 20 70 61 74 69 65 6e | in thes|e patien|
|000055d0| 74 73 20 77 61 73 20 73 | 69 6d 69 6c 61 72 20 74 |ts was s|imilar t|
|000055e0| 6f 20 74 68 61 74 20 73 | 65 65 6e 20 69 6e 0d 0a |o that s|een in..|
|000055f0| 6e 6f 72 6d 61 6c 20 61 | 64 6f 6c 65 73 63 65 6e |normal a|dolescen|
|00005600| 74 73 20 62 79 20 63 6c | 69 6e 69 63 61 6c 20 65 |ts by cl|inical e|
|00005610| 76 61 6c 75 61 74 69 6f | 6e 2c 20 67 72 6f 77 74 |valuatio|n, growt|
|00005620| 68 2c 20 65 6e 64 6f 63 | 72 69 6e 6f 6c 6f 67 79 |h, endoc|rinology|
|00005630| 2c 20 61 6e 64 20 6f 76 | 61 72 69 61 6e 0d 0a 75 |, and ov|arian..u|
|00005640| 6c 74 72 61 73 6f 75 6e | 64 20 6d 6f 72 70 68 6f |ltrasoun|d morpho|
|00005650| 6c 6f 67 69 63 61 6c 20 | 66 69 6e 64 69 6e 67 73 |logical |findings|
|00005660| 2e 20 20 50 61 74 69 65 | 6e 74 73 20 77 65 72 65 |. Patie|nts were|
|00005670| 20 73 65 70 61 72 61 74 | 65 64 20 69 6e 74 6f 20 | separat|ed into |
|00005680| 32 20 67 72 6f 75 70 73 | 2d 2d 32 30 0d 0a 77 69 |2 groups|--20..wi|
|00005690| 74 68 20 68 79 70 6f 67 | 6f 6e 61 64 6f 74 72 6f |th hypog|onadotro|
|000056a0| 70 69 63 20 68 79 70 6f | 67 6f 6e 61 64 69 73 6d |pic hypo|gonadism|
|000056b0| 20 61 6e 64 20 31 32 20 | 77 69 74 68 20 63 6f 6e | and 12 |with con|
|000056c0| 73 74 69 74 75 74 69 6f | 6e 61 6c 20 64 65 6c 61 |stitutio|nal dela|
|000056d0| 79 20 6f 66 0d 0a 70 75 | 62 65 72 74 79 2d 2d 62 |y of..pu|berty--b|
|000056e0| 79 20 6d 65 61 73 75 72 | 65 6d 65 6e 74 20 6f 66 |y measur|ement of|
|000056f0| 20 73 70 6f 6e 74 61 6e | 65 6f 75 73 20 67 6f 6e | spontan|eous gon|
|00005700| 61 64 6f 74 72 6f 70 69 | 6e 20 70 75 6c 73 65 73 |adotropi|n pulses|
|00005710| 20 61 74 20 74 68 65 20 | 65 6e 64 20 6f 66 0d 0a | at the |end of..|
|00005720| 74 68 65 72 61 70 79 2e | 0d 0a 20 20 20 20 20 54 |therapy.|.. T|
|00005730| 68 65 20 70 65 72 69 6f | 64 69 63 69 74 79 2c 20 |he perio|dicity, |
|00005740| 61 6d 70 6c 69 74 75 64 | 65 2c 20 61 6e 64 20 66 |amplitud|e, and f|
|00005750| 72 65 71 75 65 6e 63 79 | 20 6f 66 20 47 6e 52 48 |requency| of GnRH|
|00005760| 20 73 65 63 72 65 74 69 | 6f 6e 20 69 6e 63 72 65 | secreti|on incre|
|00005770| 61 73 65 73 20 6f 76 65 | 72 0d 0a 74 68 65 20 63 |ases ove|r..the c|
|00005780| 6f 75 72 73 65 20 6f 66 | 20 63 68 69 6c 64 68 6f |ourse of| childho|
|00005790| 6f 64 20 75 6e 74 69 6c | 20 69 74 20 74 72 69 67 |od until| it trig|
|000057a0| 67 65 72 73 20 73 75 66 | 66 69 63 69 65 6e 74 20 |gers suf|ficient |
|000057b0| 73 65 78 20 73 74 65 72 | 6f 69 64 20 73 65 63 72 |sex ster|oid secr|
|000057c0| 65 74 69 6f 6e 20 74 6f | 0d 0a 62 65 67 69 6e 20 |etion to|..begin |
|000057d0| 70 75 62 65 72 74 79 2e | 20 20 54 68 69 73 20 77 |puberty.| This w|
|000057e0| 6f 75 6c 64 20 65 78 70 | 6c 61 69 6e 20 77 68 79 |ould exp|lain why|
|000057f0| 20 70 61 74 69 65 6e 74 | 73 20 63 61 6e 20 68 61 | patient|s can ha|
|00005800| 76 65 20 61 62 73 65 6e | 74 20 70 75 62 65 72 74 |ve absen|t pubert|
|00005810| 79 2c 0d 0a 61 72 72 65 | 73 74 65 64 20 70 75 62 |y,..arre|sted pub|
|00005820| 65 72 74 79 2c 20 6f 72 | 20 69 6e 66 65 72 74 69 |erty, or| inferti|
|00005830| 6c 69 74 79 2c 20 62 61 | 73 65 64 20 6f 6e 20 74 |lity, ba|sed on t|
|00005840| 68 65 69 72 20 64 65 67 | 72 65 65 20 6f 66 20 47 |heir deg|ree of G|
|00005850| 6e 52 48 20 69 6e 73 75 | 66 66 69 63 69 65 6e 63 |nRH insu|fficienc|
|00005860| 79 2e 0d 0a 0d 0a 50 6f | 73 74 2d 43 6f 6d 6d 65 |y.....Po|st-Comme|
|00005870| 6e 74 0d 0a 0d 0a 20 20 | 20 20 20 57 68 65 6e 20 |nt.... | When |
|00005880| 61 64 6d 69 6e 69 73 74 | 65 72 65 64 20 69 6e 20 |administ|ered in |
|00005890| 61 20 70 75 6c 73 61 74 | 69 6c 65 20 66 61 73 68 |a pulsat|ile fash|
|000058a0| 69 6f 6e 2c 20 73 75 63 | 68 20 61 73 20 6f 63 63 |ion, suc|h as occ|
|000058b0| 75 72 73 20 70 68 79 73 | 69 6f 6c 6f 67 69 63 61 |urs phys|iologica|
|000058c0| 6c 6c 79 2c 0d 0a 67 6f | 6e 61 64 6f 74 72 6f 70 |lly,..go|nadotrop|
|000058d0| 69 6e 2d 72 65 6c 65 61 | 73 69 6e 67 20 68 6f 72 |in-relea|sing hor|
|000058e0| 6d 6f 6e 65 20 28 47 6e | 52 48 29 20 73 74 69 6d |mone (Gn|RH) stim|
|000058f0| 75 6c 61 74 65 73 20 67 | 6f 6e 61 64 61 6c 20 66 |ulates g|onadal f|
|00005900| 75 6e 63 74 69 6f 6e 20 | 61 6e 64 2c 20 61 73 20 |unction |and, as |
|00005910| 75 73 65 64 0d 0a 69 6e | 20 74 68 65 20 61 62 6f |used..in| the abo|
|00005920| 76 65 20 73 74 75 64 79 | 2c 20 6d 61 79 20 69 6e |ve study|, may in|
|00005930| 64 75 63 65 20 70 75 62 | 65 72 74 79 2e 20 20 4f |duce pub|erty. O|
|00005940| 6e 20 74 68 65 20 6f 74 | 68 65 72 20 68 61 6e 64 |n the ot|her hand|
|00005950| 2c 20 77 68 65 6e 20 75 | 73 65 64 0d 0a 63 6f 6e |, when u|sed..con|
|00005960| 74 69 6e 75 61 6c 6c 79 | 2c 20 69 74 20 68 61 73 |tinually|, it has|
|00005970| 20 74 68 65 20 6f 70 70 | 6f 73 69 74 65 20 65 66 | the opp|osite ef|
|00005980| 66 65 63 74 20 61 6e 64 | 20 6d 61 79 20 62 65 20 |fect and| may be |
|00005990| 75 73 65 64 20 74 6f 20 | 73 75 70 70 72 65 73 73 |used to |suppress|
|000059a0| 20 67 6f 6e 61 64 61 6c | 0d 0a 66 75 6e 63 74 69 | gonadal|..functi|
|000059b0| 6f 6e 2c 20 61 73 20 69 | 6e 20 70 72 65 63 6f 63 |on, as i|n precoc|
|000059c0| 69 6f 75 73 20 70 75 62 | 65 72 74 79 20 28 31 39 |ious pub|erty (19|
|000059d0| 38 37 20 59 45 41 52 20 | 42 4f 4f 4b 2c 20 70 20 |87 YEAR |BOOK, p |
|000059e0| 31 38 37 29 2e 20 20 54 | 68 65 20 74 69 6d 69 6e |187). T|he timin|
|000059f0| 67 0d 0a 6d 65 63 68 61 | 6e 69 73 6d 20 74 68 61 |g..mecha|nism tha|
|00005a00| 74 20 6d 61 6b 65 73 20 | 70 75 62 65 72 74 79 20 |t makes |puberty |
|00005a10| 61 70 70 65 61 72 20 77 | 69 74 68 69 6e 20 73 75 |appear w|ithin su|
|00005a20| 63 68 20 61 20 66 61 69 | 72 6c 79 20 6e 61 72 72 |ch a fai|rly narr|
|00005a30| 6f 77 20 61 67 65 20 72 | 61 6e 67 65 20 69 73 0d |ow age r|ange is.|
|00005a40| 0a 73 74 69 6c 6c 20 75 | 6e 63 65 72 74 61 69 6e |.still u|ncertain|
|00005a50| 2e 2d 2d 4c 2e 45 2e 20 | 48 6f 6c 6c 69 73 74 65 |.--L.E. |Holliste|
|00005a60| 72 2c 20 4d 2e 44 2e 0d | 0a 24 55 6e 69 71 75 65 |r, M.D..|.$Unique|
|00005a70| 5f 49 44 7b 59 52 42 30 | 35 37 30 37 7d 0d 0a 24 |_ID{YRB0|5707}..$|
|00005a80| 54 69 74 6c 65 7b 41 6e | 64 72 6f 67 65 6e 20 54 |Title{An|drogen T|
|00005a90| 68 65 72 61 70 79 20 6f | 66 20 48 79 70 6f 67 6f |herapy o|f Hypogo|
|00005aa0| 6e 61 64 61 6c 20 4d 65 | 6e 20 57 69 74 68 20 54 |nadal Me|n With T|
|00005ab0| 72 61 6e 73 73 63 72 6f | 74 61 6c 20 54 65 73 74 |ransscro|tal Test|
|00005ac0| 6f 73 74 65 72 6f 6e 65 | 20 53 79 73 74 65 6d 73 |osterone| Systems|
|00005ad0| 7d 0d 0a 24 41 75 74 68 | 6f 72 7b 0d 0a 4b 6f 72 |}..$Auth|or{..Kor|
|00005ae0| 65 6e 6d 61 6e 2c 20 47 | 0d 0a 56 69 6f 73 63 61 |enman, G|..Viosca|
|00005af0| 2c 20 53 0d 0a 47 61 72 | 7a 61 2c 20 44 0d 0a 47 |, S..Gar|za, D..G|
|00005b00| 75 72 61 6c 6e 69 6b 2c | 20 4d 0d 0a 50 6c 61 63 |uralnik,| M..Plac|
|00005b10| 65 2c 20 56 0d 0a 43 61 | 6d 70 62 65 6c 6c 2c 20 |e, V..Ca|mpbell, |
|00005b20| 50 0d 0a 44 61 76 69 73 | 2c 20 53 53 7d 0d 0a 24 |P..Davis|, SS}..$|
|00005b30| 41 66 66 69 6c 69 61 74 | 69 6f 6e 7b 56 41 20 4d |Affiliat|ion{VA M|
|00005b40| 65 64 20 43 74 72 2c 20 | 53 65 70 75 6c 76 65 64 |ed Ctr, |Sepulved|
|00005b50| 61 2c 20 43 61 6c 69 66 | 3b 20 55 6e 69 76 20 6f |a, Calif|; Univ o|
|00005b60| 66 20 43 61 6c 69 66 6f | 72 6e 69 61 20 61 74 20 |f Califo|rnia at |
|00005b70| 4c 6f 73 20 41 6e 67 65 | 6c 65 73 3b 20 41 6c 7a |Los Ange|les; Alz|
|00005b80| 61 20 43 6f 72 70 2c 20 | 50 61 6c 6f 20 41 6c 74 |a Corp, |Palo Alt|
|00005b90| 6f 2c 20 43 61 6c 69 66 | 7d 0d 0a 24 53 75 62 6a |o, Calif|}..$Subj|
|00005ba0| 65 63 74 7b 54 65 73 74 | 6f 73 74 65 72 6f 6e 65 |ect{Test|osterone|
|00005bb0| 20 74 72 61 6e 73 73 63 | 72 6f 74 61 6c 20 73 79 | transsc|rotal sy|
|00005bc0| 73 74 65 6d 73 2c 20 68 | 79 70 6f 67 6f 6e 61 64 |stems, h|ypogonad|
|00005bd0| 61 6c 20 6d 65 6e 20 77 | 69 74 68 2c 20 61 6e 64 |al men w|ith, and|
|00005be0| 72 6f 67 65 6e 20 66 6f | 72 3b 0d 0a 48 79 70 6f |rogen fo|r;..Hypo|
|00005bf0| 67 6f 6e 61 64 61 6c 20 | 6d 65 6e 20 77 69 74 68 |gonadal |men with|
|00005c00| 20 74 72 61 6e 73 73 63 | 72 6f 74 61 6c 20 74 65 | transsc|rotal te|
|00005c10| 73 74 6f 73 74 65 72 6f | 6e 65 20 73 79 73 74 65 |stostero|ne syste|
|00005c20| 6d 73 2c 20 61 6e 64 72 | 6f 67 65 6e 20 66 6f 72 |ms, andr|ogen for|
|00005c30| 3b 0d 0a 41 6e 64 72 6f | 67 65 6e 20 66 6f 72 20 |;..Andro|gen for |
|00005c40| 68 79 70 6f 67 6f 6e 61 | 64 61 6c 20 6d 65 6e 20 |hypogona|dal men |
|00005c50| 77 69 74 68 20 74 72 61 | 6e 73 73 63 72 6f 74 61 |with tra|nsscrota|
|00005c60| 6c 20 74 65 73 74 6f 73 | 74 65 72 6f 6e 65 20 73 |l testos|terone s|
|00005c70| 79 73 74 65 6d 73 7d 0d | 0a 24 4a 6f 75 72 6e 61 |ystems}.|.$Journa|
|00005c80| 6c 7b 41 6d 20 4a 20 4d | 65 64 7d 0d 0a 24 56 6f |l{Am J M|ed}..$Vo|
|00005c90| 6c 75 6d 65 7b 38 33 7d | 0d 0a 24 50 61 67 65 7b |lume{83}|..$Page{|
|00005ca0| 34 37 31 2d 34 37 38 7d | 0d 0a 24 44 61 74 65 7b |471-478}|..$Date{|
|00005cb0| 53 65 70 74 65 6d 62 65 | 72 20 31 39 38 37 7d 0d |Septembe|r 1987}.|
|00005cc0| 0a 24 59 42 56 6f 6c 7b | 31 39 38 39 20 59 65 61 |.$YBVol{|1989 Yea|
|00005cd0| 72 20 42 6f 6f 6b 20 6f | 66 20 44 72 75 67 20 54 |r Book o|f Drug T|
|00005ce0| 68 65 72 61 70 79 7d 0d | 0a 24 43 68 61 70 74 65 |herapy}.|.$Chapte|
|00005cf0| 72 7b 37 2d 31 34 7d 0d | 0a 24 59 42 45 64 69 74 |r{7-14}.|.$YBEdit|
|00005d00| 6f 72 7b 44 72 73 2e 20 | 48 6f 6c 6c 69 73 74 65 |or{Drs. |Holliste|
|00005d10| 72 20 61 6e 64 20 4c 61 | 73 61 67 6e 61 7d 0d 0a |r and La|sagna}..|
|00005d20| 24 54 61 62 6c 65 7b 7d | 0d 0a 24 43 6f 6d 6d 65 |$Table{}|..$Comme|
|00005d30| 6e 74 61 74 6f 72 7b 4c | 2e 45 2e 20 48 6f 6c 6c |ntator{L|.E. Holl|
|00005d40| 69 73 74 65 72 2c 20 48 | 2e 44 2e 7d 0d 0a 0d 0a |ister, H|.D.}....|
|00005d50| 43 6f 70 79 72 69 67 68 | 74 20 28 63 29 20 59 65 |Copyrigh|t (c) Ye|
|00005d60| 61 72 20 42 6f 6f 6b 20 | 4d 65 64 69 63 61 6c 20 |ar Book |Medical |
|00005d70| 50 75 62 6c 69 73 68 65 | 72 73 2c 20 49 6e 63 2e |Publishe|rs, Inc.|
|00005d80| 2c 20 31 39 38 39 0d 0a | 0d 0a 31 39 38 39 20 59 |, 1989..|..1989 Y|
|00005d90| 65 61 72 20 42 6f 6f 6b | 20 6f 66 20 44 72 75 67 |ear Book| of Drug|
|00005da0| 20 54 68 65 72 61 70 79 | 20 28 52 29 0d 0a 0d 0a | Therapy| (R)....|
|00005db0| 43 68 61 70 74 65 72 20 | 37 2d 2d 45 6e 64 6f 63 |Chapter |7--Endoc|
|00005dc0| 72 69 6e 65 20 61 6e 64 | 20 4d 65 74 61 62 6f 6c |rine and| Metabol|
|00005dd0| 69 63 20 44 69 73 6f 72 | 64 65 72 73 0d 0a 0d 0a |ic Disor|ders....|
|00005de0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005df0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005e00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005e10| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005e20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005e30| 0d 0a 41 6e 64 72 6f 67 | 65 6e 20 54 68 65 72 61 |..Androg|en Thera|
|00005e40| 70 79 20 6f 66 20 48 79 | 70 6f 67 6f 6e 61 64 61 |py of Hy|pogonada|
|00005e50| 6c 20 4d 65 6e 20 57 69 | 74 68 20 54 72 61 6e 73 |l Men Wi|th Trans|
|00005e60| 73 63 72 6f 74 61 6c 20 | 54 65 73 74 6f 73 74 65 |scrotal |Testoste|
|00005e70| 72 6f 6e 65 20 53 79 73 | 74 65 6d 73 0d 0a 0d 0a |rone Sys|tems....|
|00005e80| 4b 6f 72 65 6e 6d 61 6e | 20 47 2c 20 56 69 6f 73 |Korenman| G, Vios|
|00005e90| 63 61 20 53 2c 20 47 61 | 72 7a 61 20 44 2c 20 47 |ca S, Ga|rza D, G|
|00005ea0| 75 72 61 6c 6e 69 6b 20 | 4d 2c 20 50 6c 61 63 65 |uralnik |M, Place|
|00005eb0| 20 56 2c 20 43 61 6d 70 | 62 65 6c 6c 20 50 2c 20 | V, Camp|bell P, |
|00005ec0| 44 61 76 69 73 20 53 53 | 0d 0a 28 56 41 20 4d 65 |Davis SS|..(VA Me|
|00005ed0| 64 20 43 74 72 2c 20 53 | 65 70 75 6c 76 65 64 61 |d Ctr, S|epulveda|
|00005ee0| 2c 20 43 61 6c 69 66 3b | 20 55 6e 69 76 20 6f 66 |, Calif;| Univ of|
|00005ef0| 20 43 61 6c 69 66 6f 72 | 6e 69 61 20 61 74 20 4c | Califor|nia at L|
|00005f00| 6f 73 20 41 6e 67 65 6c | 65 73 3b 20 41 6c 7a 61 |os Angel|es; Alza|
|00005f10| 20 43 6f 72 70 2c 0d 0a | 50 61 6c 6f 20 41 6c 74 | Corp,..|Palo Alt|
|00005f20| 6f 2c 20 43 61 6c 69 66 | 29 0d 0a 41 6d 20 4a 20 |o, Calif|)..Am J |
|00005f30| 4d 65 64 20 38 33 3a 34 | 37 31 2d 34 37 38 2c 20 |Med 83:4|71-478, |
|00005f40| 53 65 70 74 65 6d 62 65 | 72 20 31 39 38 37 0d 0a |Septembe|r 1987..|
|00005f50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005f60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005f70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005f80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005f90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005fa0| 0d 0a 0d 0a 41 62 73 74 | 72 61 63 74 0d 0a 0d 0a |....Abst|ract....|
|00005fb0| 20 20 20 20 20 41 20 73 | 65 6c 66 2d 61 64 68 65 | A s|elf-adhe|
|00005fc0| 72 65 6e 74 20 74 72 61 | 6e 73 73 63 72 6f 74 61 |rent tra|nsscrota|
|00005fd0| 6c 20 74 65 73 74 6f 73 | 74 65 72 6f 6e 65 20 73 |l testos|terone s|
|00005fe0| 79 73 74 65 6d 20 28 54 | 54 53 29 20 74 6f 20 70 |ystem (T|TS) to p|
|00005ff0| 72 6f 76 69 64 65 0d 0a | 70 72 6f 67 72 61 6d 6d |rovide..|programm|
|00006000| 65 64 20 74 65 73 74 6f | 73 74 65 72 6f 6e 65 20 |ed testo|sterone |
|00006010| 64 65 6c 69 76 65 72 79 | 20 74 68 72 6f 75 67 68 |delivery| through|
|00006020| 20 74 68 65 20 75 6e 69 | 71 75 65 6c 79 20 70 65 | the uni|quely pe|
|00006030| 72 6d 65 61 62 6c 65 20 | 73 63 72 6f 74 61 6c 20 |rmeable |scrotal |
|00006040| 73 6b 69 6e 20 77 61 73 | 0d 0a 64 65 76 65 6c 6f |skin was|..develo|
|00006050| 70 65 64 20 62 65 63 61 | 75 73 65 20 6f 66 20 74 |ped beca|use of t|
|00006060| 68 65 20 6e 65 65 64 20 | 66 6f 72 20 61 20 62 65 |he need |for a be|
|00006070| 74 74 65 72 20 6d 65 74 | 68 6f 64 20 6f 66 20 74 |tter met|hod of t|
|00006080| 65 73 74 6f 73 74 65 72 | 6f 6e 65 20 61 64 6d 69 |estoster|one admi|
|00006090| 6e 69 73 74 72 61 74 69 | 6f 6e 0d 0a 74 6f 20 68 |nistrati|on..to h|
|000060a0| 79 70 6f 67 6f 6e 61 64 | 61 6c 20 6d 65 6e 2e 20 |ypogonad|al men. |
|000060b0| 20 42 65 66 6f 72 65 20 | 74 68 65 20 74 72 69 61 | Before |the tria|
|000060c0| 6c 2c 20 74 68 65 20 33 | 20 70 61 74 69 65 6e 74 |l, the 3| patient|
|000060d0| 73 20 72 65 63 65 69 76 | 65 64 20 61 6e 20 69 6e |s receiv|ed an in|
|000060e0| 6a 65 63 74 69 6f 6e 20 | 6f 66 0d 0a 32 30 30 20 |jection |of..200 |
|000060f0| 6d 67 20 6f 66 20 74 65 | 73 74 6f 73 74 65 72 6f |mg of te|stostero|
|00006100| 6e 65 20 65 6e 61 6e 74 | 68 61 74 65 2c 20 61 6e |ne enant|hate, an|
|00006110| 64 20 73 65 72 75 6d 20 | 63 6f 6e 63 65 6e 74 72 |d serum |concentr|
|00006120| 61 74 69 6f 6e 73 20 6f | 66 20 65 61 63 68 20 72 |ations o|f each r|
|00006130| 65 70 72 6f 64 75 63 74 | 69 76 65 0d 0a 68 6f 72 |eproduct|ive..hor|
|00006140| 6d 6f 6e 65 20 77 65 72 | 65 20 6d 65 61 73 75 72 |mone wer|e measur|
|00006150| 65 64 20 61 74 20 30 2c | 20 34 2c 20 38 2c 20 32 |ed at 0,| 4, 8, 2|
|00006160| 34 2c 20 61 6e 64 20 34 | 38 20 68 6f 75 72 73 20 |4, and 4|8 hours |
|00006170| 61 6e 64 20 74 68 65 6e | 20 77 65 65 6b 6c 79 20 |and then| weekly |
|00006180| 66 6f 72 20 34 20 77 65 | 65 6b 73 2e 0d 0a 46 69 |for 4 we|eks...Fi|
|00006190| 76 65 20 77 65 65 6b 73 | 20 61 66 74 65 72 20 74 |ve weeks| after t|
|000061a0| 68 65 20 69 6e 6a 65 63 | 74 69 6f 6e 2c 20 74 68 |he injec|tion, th|
|000061b0| 65 20 54 54 53 20 74 72 | 69 61 6c 20 77 61 73 20 |e TTS tr|ial was |
|000061c0| 62 65 67 75 6e 2c 20 77 | 69 74 68 20 65 61 63 68 |begun, w|ith each|
|000061d0| 20 70 61 74 69 65 6e 74 | 0d 0a 75 6e 64 65 72 67 | patient|..underg|
|000061e0| 6f 69 6e 67 20 35 20 74 | 72 69 61 6c 73 20 63 6f |oing 5 t|rials co|
|000061f0| 6e 73 69 73 74 69 6e 67 | 20 6f 66 20 34 20 64 61 |nsisting| of 4 da|
|00006200| 69 6c 79 20 32 33 2d 68 | 6f 75 72 20 61 70 70 6c |ily 23-h|our appl|
|00006210| 69 63 61 74 69 6f 6e 73 | 20 66 6f 6c 6c 6f 77 65 |ications| followe|
|00006220| 64 20 62 79 20 33 0d 0a | 64 61 79 73 20 6f 66 20 |d by 3..|days of |
|00006230| 72 65 73 74 2e 20 20 49 | 6e 20 72 61 6e 64 6f 6d |rest. I|n random|
|00006240| 69 7a 65 64 20 6f 72 64 | 65 72 2c 20 65 61 63 68 |ized ord|er, each|
|00006250| 20 70 61 74 69 65 6e 74 | 20 72 65 63 65 69 76 65 | patient| receive|
|00006260| 64 20 54 54 53 73 20 6f | 66 20 76 61 72 79 69 6e |d TTSs o|f varyin|
|00006270| 67 0d 0a 74 65 73 74 6f | 73 74 65 72 6f 6e 65 20 |g..testo|sterone |
|00006280| 63 6f 6e 74 65 6e 74 2c | 20 31 20 6f 66 20 77 68 |content,| 1 of wh|
|00006290| 69 63 68 20 77 61 73 20 | 70 6c 61 63 65 64 20 6f |ich was |placed o|
|000062a0| 6e 20 74 68 65 20 69 6e | 6e 65 72 20 61 73 70 65 |n the in|ner aspe|
|000062b0| 63 74 20 6f 66 20 74 68 | 65 20 74 68 69 67 68 2e |ct of th|e thigh.|
|000062c0| 0d 0a 20 20 20 20 20 41 | 66 74 65 72 20 65 61 63 |.. A|fter eac|
|000062d0| 68 20 6f 66 20 74 68 65 | 20 34 20 64 69 66 66 65 |h of the| 4 diffe|
|000062e0| 72 65 6e 74 20 73 63 72 | 6f 74 61 6c 20 61 70 70 |rent scr|otal app|
|000062f0| 6c 69 63 61 74 69 6f 6e | 73 2c 20 62 75 74 20 6e |lication|s, but n|
|00006300| 6f 74 20 74 68 65 20 74 | 68 69 67 68 0d 0a 61 70 |ot the t|high..ap|
|00006310| 70 6c 69 63 61 74 69 6f | 6e 2c 20 74 65 73 74 6f |plicatio|n, testo|
|00006320| 73 74 65 72 6f 6e 65 20 | 61 6e 64 20 62 69 6f 61 |sterone |and bioa|
|00006330| 76 61 69 6c 61 62 6c 65 | 20 74 65 73 74 6f 73 74 |vailable| testost|
|00006340| 65 72 6f 6e 65 20 6c 65 | 76 65 6c 73 20 69 6e 63 |erone le|vels inc|
|00006350| 72 65 61 73 65 64 0d 0a | 73 69 67 6e 69 66 69 63 |reased..|signific|
|00006360| 61 6e 74 6c 79 20 62 79 | 20 32 20 68 6f 75 72 73 |antly by| 2 hours|
|00006370| 2e 20 20 41 74 20 34 20 | 68 6f 75 72 73 2c 20 74 |. At 4 |hours, t|
|00006380| 68 65 20 64 69 68 79 64 | 72 6f 74 65 73 74 6f 73 |he dihyd|rotestos|
|00006390| 74 65 72 6f 6e 65 20 76 | 61 6c 75 65 20 77 61 73 |terone v|alue was|
|000063a0| 0d 0a 73 69 67 6e 69 66 | 69 63 61 6e 74 6c 79 20 |..signif|icantly |
|000063b0| 65 6c 65 76 61 74 65 64 | 20 74 6f 20 77 69 74 68 |elevated| to with|
|000063c0| 69 6e 20 74 68 65 20 6e | 6f 72 6d 61 6c 20 72 61 |in the n|ormal ra|
|000063d0| 6e 67 65 2e 20 20 41 6c | 74 68 6f 75 67 68 20 69 |nge. Al|though i|
|000063e0| 6e 74 65 67 72 61 74 65 | 64 20 6d 65 61 6e 0d 0a |ntegrate|d mean..|
|000063f0| 68 6f 72 6d 6f 6e 65 20 | 6c 65 76 65 6c 73 20 64 |hormone |levels d|
+--------+-------------------------+-------------------------+--------+--------+
Only 25.0 KB of data is shown above.