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Unknown | 1992-06-06 | 71.9 KB |
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66%
| dexvert
| OS/2 Installation Package (archive/os2InstallPackage)
| ext
| Supported |
1%
| dexvert
| BeOS Installation Package (archive/beOSInstallPackage)
| ext
| Unsupported |
1%
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| Newton Package (archive/newtonPackage)
| ext
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| dexvert
| Independence War 2 mod Package (other/independenceWar2ModPackage)
| ext
| Unsupported |
100%
| file
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| default
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hex view+--------+-------------------------+-------------------------+--------+--------+
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|00000c60| 20 20 4a 61 6d 65 73 20 | 48 2e 20 42 72 61 79 2c | James |H. Bray,|
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|00005010| 20 4a 4d 0d 0a 28 4d 69 | 6e 6e 65 61 70 6f 6c 69 | JM..(Mi|nneapoli|
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|000059c0| 4f 75 2c 20 43 59 0d 0a | 4a 61 73 6f 6e 2c 20 4a |Ou, CY..|Jason, J|
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|000059e0| 4c 6f 6e 67 69 6e 69 2c | 20 49 4d 20 4a 72 0d 0a |Longini,| IM Jr..|
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|00005a60| 7d 0d 0a 24 41 66 66 69 | 6c 69 61 74 69 6f 6e 7b |}..$Affi|liation{|
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|00005a90| 61 6e 74 61 3b 20 45 6d | 6f 72 79 20 55 6e 69 76 |anta; Em|ory Univ|
|00005aa0| 3b 20 42 6f 73 74 6f 6e | 20 44 65 70 74 20 6f 66 |; Boston| Dept of|
|00005ab0| 20 48 65 61 6c 74 68 3b | 20 53 61 6e 20 46 72 61 | Health;| San Fra|
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|00005ae0| 4a 6f 75 72 6e 61 6c 7b | 4c 61 6e 63 65 74 7d 0d |Journal{|Lancet}.|
|00005af0| 0a 24 56 6f 6c 75 6d 65 | 7b 32 7d 0d 0a 24 50 61 |.$Volume|{2}..$Pa|
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|00005b10| 74 65 7b 53 65 70 74 20 | 31 36 2c 20 31 39 38 39 |te{Sept |16, 1989|
|00005b20| 7d 0d 0a 24 59 42 56 6f | 6c 7b 31 39 39 30 20 59 |}..$YBVo|l{1990 Y|
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|00005b50| 31 2d 31 7d 0d 0a 24 59 | 42 45 64 69 74 6f 72 7b |1-1}..$Y|BEditor{|
|00005b60| 44 72 73 2e 20 52 6f 67 | 65 72 73 2c 20 44 65 73 |Drs. Rog|ers, Des|
|00005b70| 20 50 72 65 7a 2c 20 43 | 6c 69 6e 65 2c 20 42 72 | Prez, C|line, Br|
|00005b80| 61 75 6e 77 61 6c 64 2c | 20 47 72 65 65 6e 62 65 |aunwald,| Greenbe|
|00005b90| 72 67 65 72 2c 20 57 69 | 6c 73 6f 6e 2c 20 45 70 |rger, Wi|lson, Ep|
|00005ba0| 73 74 65 69 6e 2c 20 61 | 6e 64 20 4d 61 6c 61 77 |stein, a|nd Malaw|
|00005bb0| 69 73 74 61 7d 0d 0a 24 | 54 61 62 6c 65 7b 7d 0d |ista}..$|Table{}.|
|00005bc0| 0a 24 43 6f 6d 6d 65 6e | 74 61 74 6f 72 7b 44 2e |.$Commen|tator{D.|
|00005bd0| 45 2e 20 52 6f 67 65 72 | 73 2c 20 4d 2e 44 2e 7d |E. Roger|s, M.D.}|
|00005be0| 0d 0a 0d 0a 43 6f 70 79 | 72 69 67 68 74 20 28 63 |....Copy|right (c|
|00005bf0| 29 20 59 65 61 72 62 6f | 6f 6b 20 4d 65 64 69 63 |) Yearbo|ok Medic|
|00005c00| 61 6c 20 50 75 62 6c 69 | 73 68 65 72 73 2c 20 49 |al Publi|shers, I|
|00005c10| 6e 63 2e 2c 20 31 39 39 | 30 0d 0a 0d 0a 31 39 39 |nc., 199|0....199|
|00005c20| 30 20 59 65 61 72 20 42 | 6f 6f 6b 20 6f 66 20 4d |0 Year B|ook of M|
|00005c30| 65 64 69 63 69 6e 65 20 | 28 52 29 0d 0a 0d 0a 50 |edicine |(R)....P|
|00005c40| 61 72 74 20 4f 6e 65 2d | 2d 49 6e 66 65 63 74 69 |art One-|-Infecti|
|00005c50| 6f 75 73 20 44 69 73 65 | 61 73 65 73 0d 0a 0d 0a |ous Dise|ases....|
|00005c60| 43 68 61 70 74 65 72 20 | 31 2d 2d 41 69 64 73 0d |Chapter |1--Aids.|
|00005c70| 0a 0d 0a 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |...-----|--------|
|00005c80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005c90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005ca0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005cb0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005cc0| 2d 0d 0a 44 75 72 61 74 | 69 6f 6e 20 6f 66 20 48 |-..Durat|ion of H|
|00005cd0| 75 6d 61 6e 20 49 6d 6d | 75 6e 6f 64 65 66 69 63 |uman Imm|unodefic|
|00005ce0| 69 65 6e 63 79 20 56 69 | 72 75 73 20 49 6e 66 65 |iency Vi|rus Infe|
|00005cf0| 63 74 69 6f 6e 20 42 65 | 66 6f 72 65 20 44 65 74 |ction Be|fore Det|
|00005d00| 65 63 74 69 6f 6e 20 6f | 66 0d 0a 41 6e 74 69 62 |ection o|f..Antib|
|00005d10| 6f 64 79 0d 0a 0d 0a 48 | 6f 72 73 62 75 72 67 68 |ody....H|orsburgh|
|00005d20| 20 43 52 20 4a 72 3b 20 | 4f 75 20 43 59 3b 20 4a | CR Jr; |Ou CY; J|
|00005d30| 61 73 6f 6e 20 4a 3b 20 | 48 6f 6c 6d 62 65 72 67 |ason J; |Holmberg|
|00005d40| 20 53 44 3b 20 4c 6f 6e | 67 69 6e 69 20 49 4d 20 | SD; Lon|gini IM |
|00005d50| 4a 72 3b 20 53 63 68 61 | 62 6c 65 20 43 3b 0d 0a |Jr; Scha|ble C;..|
|00005d60| 4d 61 79 65 72 20 4b 48 | 3b 20 4c 69 66 73 6f 6e |Mayer KH|; Lifson|
|00005d70| 20 41 52 3b 20 53 63 68 | 6f 63 68 65 74 6d 61 6e | AR; Sch|ochetman|
|00005d80| 20 47 3b 20 57 61 72 64 | 20 4a 57 3b 20 52 75 74 | G; Ward| JW; Rut|
|00005d90| 68 65 72 66 6f 72 64 20 | 47 57 3b 20 45 76 61 74 |herford |GW; Evat|
|00005da0| 74 20 42 4c 3b 0d 0a 53 | 65 61 67 65 20 47 52 20 |t BL;..S|eage GR |
|00005db0| 49 49 49 3b 20 4a 61 66 | 66 65 20 48 57 0d 0a 28 |III; Jaf|fe HW..(|
|00005dc0| 43 65 6e 74 65 72 73 20 | 66 6f 72 20 44 69 73 65 |Centers |for Dise|
|00005dd0| 61 73 65 20 43 6f 6e 74 | 72 6f 6c 2c 20 41 74 6c |ase Cont|rol, Atl|
|00005de0| 61 6e 74 61 3b 20 45 6d | 6f 72 79 20 55 6e 69 76 |anta; Em|ory Univ|
|00005df0| 3b 20 42 6f 73 74 6f 6e | 20 44 65 70 74 20 6f 66 |; Boston| Dept of|
|00005e00| 20 48 65 61 6c 74 68 3b | 0d 0a 53 61 6e 20 46 72 | Health;|..San Fr|
|00005e10| 61 6e 63 69 73 63 6f 20 | 44 65 70 74 20 6f 66 20 |ancisco |Dept of |
|00005e20| 50 75 62 6c 69 63 20 48 | 65 61 6c 74 68 29 0d 0a |Public H|ealth)..|
|00005e30| 4c 61 6e 63 65 74 20 32 | 3a 36 33 37 2d 36 34 30 |Lancet 2|:637-640|
|00005e40| 2c 20 53 65 70 74 20 31 | 36 2c 20 31 39 38 39 0d |, Sept 1|6, 1989.|
|00005e50| 0a 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |.-------|--------|
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|00005ea0| 0a 0d 0a 50 72 65 2d 43 | 6f 6d 6d 65 6e 74 0d 0a |...Pre-C|omment..|
|00005eb0| 0d 0a 20 20 20 20 20 4f | 6e 63 65 20 61 67 61 69 |.. O|nce agai|
|00005ec0| 6e 2c 20 77 65 20 68 61 | 76 65 20 62 65 65 6e 20 |n, we ha|ve been |
|00005ed0| 66 61 63 65 64 20 77 69 | 74 68 20 61 6e 20 65 78 |faced wi|th an ex|
|00005ee0| 74 72 61 6f 72 64 69 6e | 61 72 79 20 6e 75 6d 62 |traordin|ary numb|
|00005ef0| 65 72 20 6f 66 20 61 72 | 74 69 63 6c 65 73 0d 0a |er of ar|ticles..|
|00005f00| 66 72 6f 6d 20 77 68 69 | 63 68 20 74 6f 20 63 68 |from whi|ch to ch|
|00005f10| 6f 6f 73 65 20 74 68 65 | 20 66 65 77 20 74 68 61 |oose the| few tha|
|00005f20| 74 20 63 61 6e 20 61 70 | 70 65 61 72 20 69 6e 20 |t can ap|pear in |
|00005f30| 74 68 69 73 20 73 65 63 | 74 69 6f 6e 2e 20 20 54 |this sec|tion. T|
|00005f40| 68 65 20 63 68 6f 69 63 | 65 73 0d 0a 77 65 72 65 |he choic|es..were|
|00005f50| 20 73 6f 6d 65 77 68 61 | 74 20 61 72 62 69 74 72 | somewha|t arbitr|
|00005f60| 61 72 79 2c 20 72 65 66 | 6c 65 63 74 69 6e 67 20 |ary, ref|lecting |
|00005f70| 6f 75 72 20 69 6e 74 65 | 72 65 73 74 73 20 61 6e |our inte|rests an|
|00005f80| 64 20 63 75 72 69 6f 73 | 69 74 69 65 73 20 61 74 |d curios|ities at|
|00005f90| 20 74 68 65 0d 0a 76 61 | 72 69 6f 75 73 20 74 69 | the..va|rious ti|
|00005fa0| 6d 65 73 20 64 75 72 69 | 6e 67 20 74 68 65 20 79 |mes duri|ng the y|
|00005fb0| 65 61 72 20 77 68 65 6e | 20 77 65 20 73 61 74 20 |ear when| we sat |
|00005fc0| 64 6f 77 6e 20 61 6e 64 | 20 73 69 66 74 65 64 20 |down and| sifted |
|00005fd0| 74 68 72 6f 75 67 68 20 | 74 68 65 20 70 69 6c 65 |through |the pile|
|00005fe0| 73 20 6f 66 0d 0a 74 65 | 61 72 73 68 65 65 74 73 |s of..te|arsheets|
|00005ff0| 20 61 6e 64 20 6a 6f 75 | 72 6e 61 6c 73 2e 0d 0a | and jou|rnals...|
|00006000| 20 20 20 20 20 4f 6e 65 | 20 6f 66 20 74 68 65 20 | One| of the |
|00006010| 6d 6f 72 65 20 70 72 6f | 76 6f 63 61 74 69 76 65 |more pro|vocative|
|00006020| 20 69 73 73 75 65 73 20 | 74 68 69 73 20 79 65 61 | issues |this yea|
|00006030| 72 20 72 65 6c 61 74 65 | 64 20 74 6f 20 73 65 72 |r relate|d to ser|
|00006040| 6f 6c 6f 67 69 63 0d 0a | 74 65 73 74 69 6e 67 2e |ologic..|testing.|
|00006050| 20 20 42 65 63 61 75 73 | 65 20 74 68 65 20 70 72 | Becaus|e the pr|
|00006060| 65 73 65 6e 63 65 20 6f | 66 20 63 69 72 63 75 6c |esence o|f circul|
|00006070| 61 74 69 6e 67 20 48 49 | 56 20 76 69 72 75 73 20 |ating HI|V virus |
|00006080| 70 61 72 74 69 63 6c 65 | 73 20 69 73 20 64 69 66 |particle|s is dif|
|00006090| 66 69 63 75 6c 74 0d 0a | 74 6f 20 61 73 73 61 79 |ficult..|to assay|
|000060a0| 2c 20 77 65 20 68 61 76 | 65 20 72 65 6c 69 65 64 |, we hav|e relied|
|000060b0| 20 6f 6e 20 61 20 73 75 | 72 72 6f 67 61 74 65 20 | on a su|rrogate |
|000060c0| 6d 65 61 6e 73 2c 20 74 | 68 65 20 64 65 6d 6f 6e |means, t|he demon|
|000060d0| 73 74 72 61 74 69 6f 6e | 20 6f 66 20 61 6e 74 69 |stration| of anti|
|000060e0| 62 6f 64 69 65 73 0d 0a | 74 6f 20 48 49 56 2c 20 |bodies..|to HIV, |
|000060f0| 74 6f 20 68 65 6c 70 20 | 6d 61 6b 65 20 74 68 65 |to help |make the|
|00006100| 20 64 69 61 67 6e 6f 73 | 69 73 20 6f 66 20 48 49 | diagnos|is of HI|
|00006110| 56 20 69 6e 66 65 63 74 | 69 6f 6e 2e 20 20 46 6f |V infect|ion. Fo|
|00006120| 72 74 75 6e 61 74 65 6c | 79 2c 20 74 68 65 0d 0a |rtunatel|y, the..|
|00006130| 65 6e 7a 79 6d 65 2d 6c | 69 6e 6b 65 64 20 69 6d |enzyme-l|inked im|
|00006140| 6d 75 6e 6f 73 6f 72 62 | 65 6e 74 20 61 73 73 61 |munosorb|ent assa|
|00006150| 79 20 28 45 4c 49 53 41 | 29 2c 20 66 6f 6c 6c 6f |y (ELISA|), follo|
|00006160| 77 65 64 20 62 79 20 61 | 20 63 6f 6e 66 69 72 6d |wed by a| confirm|
|00006170| 69 6e 67 20 57 65 73 74 | 65 72 6e 0d 0a 62 6c 6f |ing West|ern..blo|
|00006180| 74 2c 20 68 61 73 20 70 | 65 72 66 6f 72 6d 65 64 |t, has p|erformed|
|00006190| 20 76 65 72 79 20 72 65 | 6c 69 61 62 6c 79 2c 20 | very re|liably, |
|000061a0| 61 6e 64 20 62 6f 74 68 | 20 63 6c 69 6e 69 63 69 |and both| clinici|
|000061b0| 61 6e 73 20 61 6e 64 20 | 70 75 62 6c 69 63 20 68 |ans and |public h|
|000061c0| 65 61 6c 74 68 0d 0a 61 | 75 74 68 6f 72 69 74 69 |ealth..a|uthoriti|
|000061d0| 65 73 20 68 61 76 65 20 | 63 6f 6e 66 69 64 65 6e |es have |confiden|
|000061e0| 63 65 20 69 6e 20 69 74 | 2e 0d 0a 20 20 20 20 20 |ce in it|... |
|000061f0| 42 75 74 20 74 65 63 68 | 6e 6f 6c 6f 67 79 20 68 |But tech|nology h|
|00006200| 61 73 20 74 61 6b 65 6e | 20 61 6e 6f 74 68 65 72 |as taken| another|
|00006210| 20 6c 65 61 70 3b 20 61 | 20 6e 65 77 20 74 65 73 | leap; a| new tes|
|00006220| 74 20 68 61 73 20 62 65 | 63 6f 6d 65 20 61 76 61 |t has be|come ava|
|00006230| 69 6c 61 62 6c 65 20 74 | 6f 0d 0a 72 65 73 65 61 |ilable t|o..resea|
|00006240| 72 63 68 65 72 73 3a 20 | 20 74 68 65 20 70 6f 6c |rchers: | the pol|
|00006250| 79 6d 65 72 61 73 65 20 | 63 68 61 69 6e 20 72 65 |ymerase |chain re|
|00006260| 61 63 74 69 6f 6e 20 28 | 50 43 52 29 2e 20 20 54 |action (|PCR). T|
|00006270| 68 69 73 20 66 65 61 74 | 20 6f 66 20 6d 6f 6c 65 |his feat| of mole|
|00006280| 63 75 6c 61 72 0d 0a 65 | 6e 67 69 6e 65 65 72 69 |cular..e|ngineeri|
|00006290| 6e 67 20 68 61 73 20 74 | 68 65 20 63 61 70 61 63 |ng has t|he capac|
|000062a0| 69 74 79 20 74 6f 20 72 | 65 63 6f 67 6e 69 7a 65 |ity to r|ecognize|
|000062b0| 20 61 6e 64 20 61 6d 70 | 6c 69 66 79 20 28 74 68 | and amp|lify (th|
|000062c0| 65 20 63 68 61 69 6e 20 | 72 65 61 63 74 69 6f 6e |e chain |reaction|
|000062d0| 29 0d 0a 73 65 67 6d 65 | 6e 74 73 20 6f 66 20 48 |)..segme|nts of H|
|000062e0| 49 56 20 44 4e 41 2e 20 | 20 54 68 65 20 69 6e 76 |IV DNA. | The inv|
|000062f0| 65 73 74 69 67 61 74 6f | 72 20 6d 75 73 74 20 62 |estigato|r must b|
|00006300| 65 20 6f 62 73 65 73 73 | 69 76 65 20 74 6f 20 61 |e obsess|ive to a|
|00006310| 76 6f 69 64 0d 0a 63 6f | 6e 74 61 6d 69 6e 61 74 |void..co|ntaminat|
|00006320| 69 6f 6e 20 6f 66 20 74 | 68 65 20 73 70 65 63 69 |ion of t|he speci|
|00006330| 6d 65 6e 3b 20 65 76 65 | 6e 20 74 68 65 20 74 69 |men; eve|n the ti|
|00006340| 6e 69 65 73 74 20 74 72 | 61 63 65 20 6f 66 20 63 |niest tr|ace of c|
|00006350| 6f 6e 74 61 6d 69 6e 61 | 74 69 6f 6e 20 77 69 6c |ontamina|tion wil|
|00006360| 6c 0d 0a 62 65 20 61 6d | 70 6c 69 66 69 65 64 20 |l..be am|plified |
|00006370| 62 79 20 74 68 65 20 63 | 68 61 69 6e 20 72 65 61 |by the c|hain rea|
|00006380| 63 74 69 6f 6e 20 61 6e | 64 20 63 61 6e 20 63 72 |ction an|d can cr|
|00006390| 65 61 74 65 20 61 20 66 | 61 6c 73 65 20 70 6f 73 |eate a f|alse pos|
|000063a0| 69 74 69 76 65 20 72 65 | 73 75 6c 74 2e 0d 0a 41 |itive re|sult...A|
|000063b0| 73 73 75 6d 69 6e 67 20 | 74 68 61 74 20 74 68 65 |ssuming |that the|
|000063c0| 20 69 6e 76 65 73 74 69 | 67 61 74 6f 72 20 69 73 | investi|gator is|
|000063d0| 20 6d 65 74 69 63 75 6c | 6f 75 73 2c 20 74 68 65 | meticul|ous, the|
|000063e0| 20 50 43 52 20 68 61 73 | 20 74 68 65 20 63 61 70 | PCR has| the cap|
|000063f0| 61 63 69 74 79 20 74 6f | 0d 0a 64 65 74 65 63 74 |acity to|..detect|
+--------+-------------------------+-------------------------+--------+--------+
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