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Unknown | 1992-06-06 | 340.6 KB |
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MacOS 8.1
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Win98
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DOS
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Confidence | Program | Detection | Match Type | Support
|
---|
66%
| dexvert
| OS/2 Installation Package (archive/os2InstallPackage)
| ext
| Supported |
1%
| dexvert
| BeOS Installation Package (archive/beOSInstallPackage)
| ext
| Unsupported |
1%
| dexvert
| Newton Package (archive/newtonPackage)
| ext
| Unsupported |
1%
| dexvert
| Independence War 2 mod Package (other/independenceWar2ModPackage)
| ext
| Unsupported |
100%
| file
| data
| default
|
|
hex view+--------+-------------------------+-------------------------+--------+--------+
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|000004b0| 00 00 00 01 10 8c 04 00 | 47 0d 00 00 38 35 00 00 |........|G...85..|
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|000004d0| e9 a5 04 00 d6 0b 00 00 | 38 37 00 00 00 01 bf b1 |........|87......|
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|000004f0| 61 0d 00 00 38 39 00 00 | 00 01 b6 ca 04 00 ff 09 |a...89..|........|
|00000500| 00 00 39 30 00 00 00 01 | b5 d4 04 00 d2 0b 00 00 |..90....|........|
|00000510| 39 31 00 00 00 01 87 e0 | 04 00 7b 09 00 00 39 32 |91......|..{...92|
|00000520| 00 00 00 01 02 ea 04 00 | c8 09 00 00 39 33 00 00 |........|....93..|
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|00000590| 00 00 00 00 91 52 05 00 | 00 00 00 00 24 55 6e 69 |.....R..|....$Uni|
|000005a0| 71 75 65 5f 49 44 7b 59 | 52 42 31 31 37 30 30 7d |que_ID{Y|RB11700}|
|000005b0| 0d 0a 24 54 69 74 6c 65 | 7b 45 61 72 6c 79 20 48 |..$Title|{Early H|
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|000005d0| 20 50 61 74 69 65 6e 74 | 73 20 57 69 74 68 20 4d | Patient|s With M|
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|000005f0| 74 68 6f 72 7b 57 69 6c | 61 6e 73 6b 79 2c 20 44 |thor{Wil|ansky, D|
|00000600| 4c 0d 0a 47 72 65 69 73 | 6d 61 6e 2c 20 42 7d 0d |L..Greis|man, B}.|
|00000610| 0a 24 41 66 66 69 6c 69 | 61 74 69 6f 6e 7b 45 74 |.$Affili|ation{Et|
|00000620| 6f 62 69 63 6f 6b 65 20 | 47 65 6e 20 48 6f 73 70 |obicoke |Gen Hosp|
|00000630| 2c 20 52 65 78 64 61 6c | 65 2c 20 4f 6e 74 7d 0d |, Rexdal|e, Ont}.|
|00000640| 0a 24 4a 6f 75 72 6e 61 | 6c 7b 41 6d 20 4a 20 4f |.$Journa|l{Am J O|
|00000650| 62 73 74 65 74 20 47 79 | 6e 65 63 6f 6c 7d 0d 0a |bstet Gy|necol}..|
|00000660| 24 56 6f 6c 75 6d 65 7b | 31 36 30 7d 0d 0a 24 50 |$Volume{|160}..$P|
|00000670| 61 67 65 7b 36 37 33 2d | 36 37 37 7d 0d 0a 24 44 |age{673-|677}..$D|
|00000680| 61 74 65 7b 4d 61 72 63 | 68 20 31 39 38 39 7d 0d |ate{Marc|h 1989}.|
|00000690| 0a 24 59 42 56 6f 6c 7b | 31 39 39 30 20 59 65 61 |.$YBVol{|1990 Yea|
|000006a0| 72 20 42 6f 6f 6b 20 6f | 66 20 4f 62 73 74 65 74 |r Book o|f Obstet|
|000006b0| 72 69 63 73 20 61 6e 64 | 20 47 79 6e 65 63 6f 6c |rics and| Gynecol|
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|000006d0| 35 2d 32 37 7d 0d 0a 24 | 59 42 45 64 69 74 6f 72 |5-27}..$|YBEditor|
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|00000710| 61 62 6c 65 20 4f 6d 69 | 74 74 65 64 7d 0d 0a 24 |able Omi|tted}..$|
|00000720| 43 6f 6d 6d 65 6e 74 61 | 74 6f 72 7b 44 2e 52 2e |Commenta|tor{D.R.|
|00000730| 20 4d 69 73 68 65 6c 6c | 2c 20 4a 72 2e 2c 20 4d | Mishell|, Jr., M|
|00000740| 2e 44 2e 7d 0d 0a 0d 0a | 43 6f 70 79 72 69 67 68 |.D.}....|Copyrigh|
|00000750| 74 20 28 63 29 20 59 65 | 61 72 62 6f 6f 6b 20 4d |t (c) Ye|arbook M|
|00000760| 65 64 69 63 61 6c 20 50 | 75 62 6c 69 73 68 65 72 |edical P|ublisher|
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|00000780| 0a 31 39 39 30 20 59 65 | 61 72 20 42 6f 6f 6b 20 |.1990 Ye|ar Book |
|00000790| 6f 66 20 4f 62 73 74 65 | 74 72 69 63 73 20 61 6e |of Obste|trics an|
|000007a0| 64 20 47 79 6e 65 63 6f | 6c 6f 67 79 20 28 52 29 |d Gyneco|logy (R)|
|000007b0| 0d 0a 0d 0a 43 68 61 70 | 74 65 72 20 31 35 2d 2d |....Chap|ter 15--|
|000007c0| 45 6e 64 6f 63 72 69 6e | 6f 6c 6f 67 79 0d 0a 0d |Endocrin|ology...|
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|000007f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00000810| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |--------|-------.|
|00000820| 0a 45 61 72 6c 79 20 48 | 79 70 6f 74 68 79 72 6f |.Early H|ypothyro|
|00000830| 69 64 69 73 6d 20 69 6e | 20 50 61 74 69 65 6e 74 |idism in| Patient|
|00000840| 73 20 57 69 74 68 20 4d | 65 6e 6f 72 72 68 61 67 |s With M|enorrhag|
|00000850| 69 61 0d 0a 0d 0a 57 69 | 6c 61 6e 73 6b 79 20 44 |ia....Wi|lansky D|
|00000860| 4c 2c 20 47 72 65 69 73 | 6d 61 6e 20 42 0d 0a 28 |L, Greis|man B..(|
|00000870| 45 74 6f 62 69 63 6f 6b | 65 20 47 65 6e 20 48 6f |Etobicok|e Gen Ho|
|00000880| 73 70 2c 20 52 65 78 64 | 61 6c 65 2c 20 4f 6e 74 |sp, Rexd|ale, Ont|
|00000890| 29 0d 0a 41 6d 20 4a 20 | 4f 62 73 74 65 74 20 47 |)..Am J |Obstet G|
|000008a0| 79 6e 65 63 6f 6c 20 31 | 36 30 3a 36 37 33 2d 36 |ynecol 1|60:673-6|
|000008b0| 37 37 2c 20 4d 61 72 63 | 68 20 31 39 38 39 0d 0a |77, Marc|h 1989..|
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|000008e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00000900| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|00000910| 0d 0a 41 62 73 74 72 61 | 63 74 0d 0a 0d 0a 20 20 |..Abstra|ct.... |
|00000920| 20 20 20 42 65 63 61 75 | 73 65 20 6d 65 6e 73 74 | Becau|se menst|
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|00000940| 20 66 72 65 71 75 65 6e | 74 20 69 6e 20 77 6f 6d | frequen|t in wom|
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|00000aa0| 2e 0d 0a 20 20 20 20 20 | 46 69 66 74 65 65 6e 20 |... |Fifteen |
|00000ab0| 77 6f 6d 65 6e 20 28 32 | 32 25 29 20 68 61 64 20 |women (2|2%) had |
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|00000ad0| 20 6f 6e 20 54 52 48 20 | 74 65 73 74 69 6e 67 2e | on TRH |testing.|
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|00000ba0| 75 74 68 79 72 6f 69 64 | 20 77 6f 6d 65 6e 2e 20 |uthyroid| women. |
|00000bb0| 20 53 65 72 75 6d 20 74 | 72 69 69 6f 64 6f 74 68 | Serum t|riiodoth|
|00000bc0| 79 72 6f 6e 69 6e 65 20 | 76 61 6c 75 65 73 20 77 |yronine |values w|
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|00000c30| 73 69 74 69 76 65 20 54 | 52 48 20 74 65 73 74 73 |sitive T|RH tests|
|00000c40| 2e 20 20 4f 6e 20 66 6f | 6c 6c 6f 77 2d 75 70 2c |. On fo|llow-up,|
|00000c50| 20 6d 6f 73 74 20 74 65 | 73 74 2d 6e 65 67 61 74 | most te|st-negat|
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|00000c70| 75 65 64 20 74 6f 0d 0a | 68 61 76 65 20 6d 65 6e |ued to..|have men|
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|00000ca0| 20 61 6c 6c 20 38 20 77 | 6f 6d 65 6e 20 77 69 74 | all 8 w|omen wit|
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|00000cd0| 65 69 76 65 64 20 74 68 | 79 72 6f 78 69 6e 65 20 |eived th|yroxine |
|00000ce0| 61 6e 64 20 77 65 72 65 | 20 6f 62 73 65 72 76 65 |and were| observe|
|00000cf0| 64 3b 20 6e 6f 6e 65 20 | 72 65 71 75 69 72 65 64 |d; none |required|
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|00000d30| 20 66 65 6c 6c 20 73 69 | 67 6e 69 66 69 63 61 6e | fell si|gnifican|
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|00002f50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002f60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002f70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002f80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002f90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 50 6f |--------|----..Po|
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|00002ff0| 65 72 6e 61 72 64 6f 2c | 20 43 61 6c 69 66 2c 20 |ernardo,| Calif, |
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|00003060| 4a 41 4d 41 20 32 36 31 | 3a 32 30 39 35 2d 32 31 |JAMA 261|:2095-21|
|00003070| 30 30 2c 20 41 70 72 20 | 31 34 2c 20 31 39 38 39 |00, Apr |14, 1989|
|00003080| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00003090| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000030a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000030b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000030c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000030d0| 0d 0a 0d 0a 41 62 73 74 | 72 61 63 74 0d 0a 0d 0a |....Abst|ract....|
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|00003440| 0a 20 20 20 20 20 54 68 | 65 72 65 20 77 61 73 20 |. Th|ere was |
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|00003490| 6e 20 28 4c 44 4c 29 2c | 20 77 69 74 68 20 6c 6f |n (LDL),| with lo|
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|000034b0| 20 61 73 73 6f 63 69 61 | 74 65 64 20 77 69 74 68 | associa|ted with|
|000034c0| 20 69 6e 63 72 65 61 73 | 69 6e 67 20 64 6f 73 65 | increas|ing dose|
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|000034e0| 20 54 72 69 67 6c 79 63 | 65 72 69 64 65 20 6c 65 | Triglyc|eride le|
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|00003560| 2e 20 20 4c 65 76 65 6c | 73 20 6f 66 0d 0a 68 69 |. Level|s of..hi|
|00003570| 67 68 2d 64 65 6e 73 69 | 74 79 20 6c 69 70 6f 70 |gh-densi|ty lipop|
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|000035b0| 69 6e 67 0d 0a 50 72 65 | 6d 61 72 69 6e 2c 20 30 |ing..Pre|marin, 0|
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|00004900| 20 20 54 68 65 73 65 20 | 72 65 73 75 6c 74 73 20 | These |results |
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|00004af0| 6e 6f 6e 66 61 74 61 6c | 20 6d 79 6f 63 61 72 64 |nonfatal| myocard|
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|00004b10| 2d 44 2e 52 2e 20 4d 69 | 73 68 65 6c 6c 2c 20 4a |-D.R. Mi|shell, J|
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|00004b40| 24 54 69 74 6c 65 7b 50 | 6f 73 74 6d 65 6e 6f 70 |$Title{P|ostmenop|
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|00004b60| 54 72 65 61 74 6d 65 6e | 74 20 61 6e 64 20 53 74 |Treatmen|t and St|
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|00004b80| 74 69 76 65 20 53 74 75 | 64 79 7d 0d 0a 24 41 75 |tive Stu|dy}..$Au|
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|00004ba0| 6c 6c 2c 20 41 0d 0a 52 | 6f 73 73 2c 20 52 4b 0d |ll, A..R|oss, RK.|
|00004bb0| 0a 48 65 6e 64 65 72 73 | 6f 6e 2c 20 42 45 7d 0d |.Henders|on, BE}.|
|00004bc0| 0a 24 41 66 66 69 6c 69 | 61 74 69 6f 6e 7b 7d 0d |.$Affili|ation{}.|
|00004bd0| 0a 24 4a 6f 75 72 6e 61 | 6c 7b 42 72 20 4d 65 64 |.$Journa|l{Br Med|
|00004be0| 20 4a 7d 0d 0a 24 56 6f | 6c 75 6d 65 7b 32 39 37 | J}..$Vo|lume{297|
|00004bf0| 7d 0d 0a 24 50 61 67 65 | 7b 35 31 39 2d 35 32 32 |}..$Page|{519-522|
|00004c00| 7d 0d 0a 24 44 61 74 65 | 7b 41 75 67 20 32 30 2d |}..$Date|{Aug 20-|
|00004c10| 32 37 2c 20 31 39 38 38 | 7d 0d 0a 24 59 42 56 6f |27, 1988|}..$YBVo|
|00004c20| 6c 7b 31 39 39 30 20 59 | 65 61 72 20 42 6f 6f 6b |l{1990 Y|ear Book|
|00004c30| 20 6f 66 20 4f 62 73 74 | 65 74 72 69 63 73 20 61 | of Obst|etrics a|
|00004c40| 6e 64 20 47 79 6e 65 63 | 6f 6c 6f 67 79 7d 0d 0a |nd Gynec|ology}..|
|00004c50| 24 43 68 61 70 74 65 72 | 7b 31 36 2d 35 7d 0d 0a |$Chapter|{16-5}..|
|00004c60| 24 59 42 45 64 69 74 6f | 72 7b 44 72 73 2e 20 4d |$YBEdito|r{Drs. M|
|00004c70| 69 73 68 65 6c 6c 2c 20 | 4b 69 72 73 63 68 62 61 |ishell, |Kirschba|
|00004c80| 75 6d 2c 20 61 6e 64 20 | 4d 6f 72 72 6f 77 7d 0d |um, and |Morrow}.|
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|00004ca0| 69 74 74 65 64 7d 0d 0a | 24 43 6f 6d 6d 65 6e 74 |itted}..|$Comment|
|00004cb0| 61 74 6f 72 7b 44 2e 52 | 2e 20 4d 69 73 68 65 6c |ator{D.R|. Mishel|
|00004cc0| 6c 2c 20 4a 72 2e 2c 20 | 4d 2e 44 2e 7d 0d 0a 0d |l, Jr., |M.D.}...|
|00004cd0| 0a 43 6f 70 79 72 69 67 | 68 74 20 28 63 29 20 59 |.Copyrig|ht (c) Y|
|00004ce0| 65 61 72 62 6f 6f 6b 20 | 4d 65 64 69 63 61 6c 20 |earbook |Medical |
|00004cf0| 50 75 62 6c 69 73 68 65 | 72 73 2c 20 49 6e 63 2e |Publishe|rs, Inc.|
|00004d00| 2c 20 31 39 39 30 0d 0a | 0d 0a 31 39 39 30 20 59 |, 1990..|..1990 Y|
|00004d10| 65 61 72 20 42 6f 6f 6b | 20 6f 66 20 4f 62 73 74 |ear Book| of Obst|
|00004d20| 65 74 72 69 63 73 20 61 | 6e 64 20 47 79 6e 65 63 |etrics a|nd Gynec|
|00004d30| 6f 6c 6f 67 79 20 28 52 | 29 0d 0a 0d 0a 43 68 61 |ology (R|)....Cha|
|00004d40| 70 74 65 72 20 31 36 2d | 2d 4d 65 6e 6f 70 61 75 |pter 16-|-Menopau|
|00004d50| 73 65 0d 0a 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |se....--|--------|
|00004d60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004d70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004d80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004d90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004da0| 2d 2d 2d 2d 0d 0a 50 6f | 73 74 6d 65 6e 6f 70 61 |----..Po|stmenopa|
|00004db0| 75 73 61 6c 20 4f 65 73 | 74 72 6f 67 65 6e 20 54 |usal Oes|trogen T|
|00004dc0| 72 65 61 74 6d 65 6e 74 | 20 61 6e 64 20 53 74 72 |reatment| and Str|
|00004dd0| 6f 6b 65 3a 20 20 41 20 | 50 72 6f 73 70 65 63 74 |oke: A |Prospect|
|00004de0| 69 76 65 20 53 74 75 64 | 79 0d 0a 0d 0a 50 61 67 |ive Stud|y....Pag|
|00004df0| 61 6e 69 6e 69 2d 48 69 | 6c 6c 20 41 2c 20 52 6f |anini-Hi|ll A, Ro|
|00004e00| 73 73 20 52 4b 2c 20 48 | 65 6e 64 65 72 73 6f 6e |ss RK, H|enderson|
|00004e10| 20 42 45 0d 0a 42 72 20 | 4d 65 64 20 4a 20 32 39 | BE..Br |Med J 29|
|00004e20| 37 3a 35 31 39 2d 35 32 | 32 2c 20 41 75 67 20 32 |7:519-52|2, Aug 2|
|00004e30| 30 2d 32 37 2c 20 31 39 | 38 38 0d 0a 2d 2d 2d 2d |0-27, 19|88..----|
|00004e40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004e50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004e60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004e70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004e80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 0d 0a 0d 0a 41 62 |--------|--....Ab|
|00004e90| 73 74 72 61 63 74 0d 0a | 0d 0a 20 20 20 20 20 41 |stract..|.. A|
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|00004eb0| 64 79 20 77 61 73 20 75 | 6e 64 65 72 74 61 6b 65 |dy was u|ndertake|
|00004ec0| 6e 20 74 6f 20 65 78 61 | 6d 69 6e 65 20 74 68 65 |n to exa|mine the|
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|00004ef0| 67 65 6e 20 75 73 65 20 | 6f 6e 20 6d 6f 72 74 61 |gen use |on morta|
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|00005e40| 73 70 2c 20 4c 6f 6e 64 | 6f 6e 3b 20 43 6c 69 6e |sp, Lond|on; Clin|
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|00005e80| 0a 42 72 20 4d 65 64 20 | 4a 20 32 39 37 3a 31 35 |.Br Med |J 297:15|
|00005e90| 2d 31 37 2c 20 4a 75 6c | 79 20 32 2c 20 31 39 38 |-17, Jul|y 2, 198|
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|00005ed0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005ee0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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+--------+-------------------------+-------------------------+--------+--------+
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