home *** CD-ROM | disk | FTP | other *** search
| Unknown | 1992-06-06 | 145.3 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.
| Confidence | Program | Detection | Match Type | Support
|
|---|
| 66%
| dexvert
| OS/2 Installation Package (archive/os2InstallPackage)
| ext
| Supported |
| 1%
| dexvert
| BeOS Installation Package (archive/beOSInstallPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Newton Package (archive/newtonPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Independence War 2 mod Package (other/independenceWar2ModPackage)
| ext
| Unsupported |
| 100%
| file
| data
| default
|
|
hex view+--------+-------------------------+-------------------------+--------+--------+
|00000000| 1a 44 50 31 2e 31 00 00 | 00 00 00 00 00 05 27 00 |.DP1.1..|......'.|
|00000010| 00 00 16 00 00 00 34 30 | 00 00 00 01 46 02 00 00 |......40|....F...|
|00000020| 5c 0b 00 00 34 31 00 00 | 00 01 a2 0d 00 00 e9 0d |\...41..|........|
|00000030| 00 00 34 32 00 00 00 01 | 8b 1b 00 00 05 0b 00 00 |..42....|........|
|00000040| 34 33 00 00 00 01 90 26 | 00 00 a5 0b 00 00 35 30 |43.....&|......50|
|00000050| 00 00 00 01 35 32 00 00 | bd 12 00 00 35 31 00 00 |....52..|....51..|
|00000060| 00 01 f2 44 00 00 31 0f | 00 00 35 32 00 00 00 01 |...D..1.|..52....|
|00000070| 23 54 00 00 36 10 00 00 | 35 33 00 00 00 01 59 64 |#T..6...|53....Yd|
|00000080| 00 00 dd 0e 00 00 35 34 | 00 00 00 01 36 73 00 00 |......54|....6s..|
|00000090| f9 0b 00 00 35 35 00 00 | 00 01 2f 7f 00 00 64 10 |....55..|../...d.|
|000000a0| 00 00 35 36 00 00 00 01 | 93 8f 00 00 7e 12 00 00 |..56....|....~...|
|000000b0| 35 37 00 00 00 01 11 a2 | 00 00 49 11 00 00 35 38 |57......|..I...58|
|000000c0| 00 00 00 01 5a b3 00 00 | 56 0b 00 00 36 30 00 00 |....Z...|V...60..|
|000000d0| 00 01 b0 be 00 00 4a 0b | 00 00 36 31 00 00 00 01 |......J.|..61....|
|000000e0| fa c9 00 00 93 0e 00 00 | 36 32 00 00 00 01 8d d8 |........|62......|
|000000f0| 00 00 f2 12 00 00 36 33 | 00 00 00 01 7f eb 00 00 |......63|........|
|00000100| c5 0e 00 00 36 34 00 00 | 00 01 44 fa 00 00 89 0d |....64..|..D.....|
|00000110| 00 00 37 30 00 00 00 01 | cd 07 01 00 91 0b 00 00 |..70....|........|
|00000120| 38 30 00 00 00 01 5e 13 | 01 00 35 10 00 00 38 31 |80....^.|..5...81|
|00000130| 00 00 00 01 93 23 01 00 | 8d 15 00 00 38 32 00 00 |.....#..|....82..|
|00000140| 00 01 20 39 01 00 60 0f | 00 00 38 33 00 00 00 01 |.. 9..`.|..83....|
|00000150| 80 48 01 00 d6 0d 00 00 | 38 34 00 00 00 01 56 56 |.H......|84....VV|
|00000160| 01 00 da 10 00 00 38 35 | 00 00 00 01 30 67 01 00 |......85|....0g..|
|00000170| 2c 0d 00 00 38 36 00 00 | 00 01 5c 74 01 00 22 0c |,...86..|..\t..".|
|00000180| 00 00 38 37 00 00 00 01 | 7e 80 01 00 ee 0c 00 00 |..87....|~.......|
|00000190| 38 38 00 00 00 01 6c 8d | 01 00 31 0e 00 00 38 39 |88....l.|..1...89|
|000001a0| 00 00 00 01 9d 9b 01 00 | a5 0c 00 00 39 30 00 00 |........|....90..|
|000001b0| 00 01 42 a8 01 00 51 12 | 00 00 39 31 00 00 00 01 |..B...Q.|..91....|
|000001c0| 93 ba 01 00 46 10 00 00 | 39 32 00 00 00 01 d9 ca |....F...|92......|
|000001d0| 01 00 da 11 00 00 39 33 | 00 00 00 01 b3 dc 01 00 |......93|........|
|000001e0| b2 0c 00 00 39 34 00 00 | 00 01 65 e9 01 00 3f 0f |....94..|..e...?.|
|000001f0| 00 00 39 35 00 00 00 01 | a4 f8 01 00 06 0e 00 00 |..95....|........|
|00000200| 39 36 00 00 00 01 aa 06 | 02 00 65 0a 00 00 39 37 |96......|..e...97|
|00000210| 00 00 00 01 0f 11 02 00 | 1c 10 00 00 39 38 00 00 |........|....98..|
|00000220| 00 01 2b 21 02 00 66 17 | 00 00 39 39 00 00 00 01 |..+!..f.|..99....|
|00000230| 91 38 02 00 73 0c 00 00 | 00 00 00 00 00 00 04 45 |.8..s...|.......E|
|00000240| 02 00 00 00 00 00 24 55 | 6e 69 71 75 65 5f 49 44 |......$U|nique_ID|
|00000250| 7b 59 52 42 31 33 32 34 | 30 7d 0d 0a 24 54 69 74 |{YRB1324|0}..$Tit|
|00000260| 6c 65 7b 44 69 61 67 6e | 6f 73 74 69 63 20 52 61 |le{Diagn|ostic Ra|
|00000270| 64 69 6f 6e 75 63 6c 69 | 64 65 20 49 6d 61 67 69 |dionucli|de Imagi|
|00000280| 6e 67 20 6f 66 20 41 6d | 79 6c 6f 69 64 3a 20 20 |ng of Am|yloid: |
|00000290| 42 69 6f 6c 6f 67 69 63 | 61 6c 20 54 61 72 67 65 |Biologic|al Targe|
|000002a0| 74 69 6e 67 20 62 79 20 | 43 69 72 63 75 6c 61 74 |ting by |Circulat|
|000002b0| 69 6e 67 20 48 75 6d 61 | 6e 20 53 65 72 75 6d 20 |ing Huma|n Serum |
|000002c0| 41 6d 79 6c 6f 69 64 20 | 50 20 43 6f 6d 70 6f 6e |Amyloid |P Compon|
|000002d0| 65 6e 74 7d 0d 0a 24 41 | 75 74 68 6f 72 7b 48 61 |ent}..$A|uthor{Ha|
|000002e0| 77 6b 69 6e 73 2c 20 50 | 4e 0d 0a 4d 79 65 72 73 |wkins, P|N..Myers|
|000002f0| 2c 20 4d 4a 0d 0a 4c 61 | 76 65 6e 64 65 72 2c 20 |, MJ..La|vender, |
|00000300| 4a 50 0d 0a 50 65 70 79 | 73 2c 20 4d 42 7d 0d 0a |JP..Pepy|s, MB}..|
|00000310| 24 41 66 66 69 6c 69 61 | 74 69 6f 6e 7b 52 6f 79 |$Affilia|tion{Roy|
|00000320| 61 6c 20 50 6f 73 74 67 | 72 61 64 20 4d 65 64 20 |al Postg|rad Med |
|00000330| 53 63 68 6f 6f 6c 2c 20 | 48 61 6d 6d 65 72 73 6d |School, |Hammersm|
|00000340| 69 74 68 20 48 6f 73 70 | 2c 20 4c 6f 6e 64 6f 6e |ith Hosp|, London|
|00000350| 7d 0d 0a 24 4a 6f 75 72 | 6e 61 6c 7b 4c 61 6e 63 |}..$Jour|nal{Lanc|
|00000360| 65 74 7d 0d 0a 24 56 6f | 6c 75 6d 65 7b 32 7d 0d |et}..$Vo|lume{2}.|
|00000370| 0a 24 50 61 67 65 7b 31 | 34 31 33 2d 31 34 31 38 |.$Page{1|413-1418|
|00000380| 7d 0d 0a 24 44 61 74 65 | 7b 4a 75 6e 65 20 32 35 |}..$Date|{June 25|
|00000390| 2c 20 31 39 38 38 7d 0d | 0a 24 59 42 56 6f 6c 7b |, 1988}.|.$YBVol{|
|000003a0| 31 39 39 30 20 59 65 61 | 72 20 42 6f 6f 6b 20 6f |1990 Yea|r Book o|
|000003b0| 66 20 4e 75 63 6c 65 61 | 72 20 4d 65 64 69 63 69 |f Nuclea|r Medici|
|000003c0| 6e 65 7d 0d 0a 24 43 68 | 61 70 74 65 72 7b 36 2d |ne}..$Ch|apter{6-|
|000003d0| 31 30 7d 0d 0a 24 59 42 | 45 64 69 74 6f 72 7b 44 |10}..$YB|Editor{D|
|000003e0| 72 73 2e 20 48 6f 66 66 | 65 72 2c 20 47 6f 72 65 |rs. Hoff|er, Gore|
|000003f0| 2c 20 47 6f 74 74 73 63 | 68 61 6c 6b 2c 20 53 6f |, Gottsc|halk, So|
|00000400| 73 74 6d 61 6e 2c 20 5a | 61 72 65 74 2c 20 61 6e |stman, Z|aret, an|
|00000410| 64 20 5a 75 62 61 6c 7d | 0d 0a 24 54 61 62 6c 65 |d Zubal}|..$Table|
|00000420| 7b 7d 0d 0a 24 43 6f 6d | 6d 65 6e 74 61 74 6f 72 |{}..$Com|mentator|
|00000430| 7b 41 2e 20 47 6f 74 74 | 73 63 68 61 6c 6b 2c 20 |{A. Gott|schalk, |
|00000440| 4d 2e 44 2e 7d 0d 0a 0d | 0a 43 6f 70 79 72 69 67 |M.D.}...|.Copyrig|
|00000450| 68 74 20 28 63 29 20 59 | 65 61 72 62 6f 6f 6b 20 |ht (c) Y|earbook |
|00000460| 4d 65 64 69 63 61 6c 20 | 50 75 62 6c 69 73 68 65 |Medical |Publishe|
|00000470| 72 73 2c 20 49 6e 63 2e | 2c 20 31 39 39 30 0d 0a |rs, Inc.|, 1990..|
|00000480| 0d 0a 31 39 39 30 20 59 | 65 61 72 20 42 6f 6f 6b |..1990 Y|ear Book|
|00000490| 20 6f 66 20 4e 75 63 6c | 65 61 72 20 4d 65 64 69 | of Nucl|ear Medi|
|000004a0| 63 69 6e 65 20 28 52 29 | 0d 0a 0d 0a 43 68 61 70 |cine (R)|....Chap|
|000004b0| 74 65 72 20 36 2d 2d 52 | 61 64 69 6f 63 68 65 6d |ter 6--R|adiochem|
|000004c0| 69 73 74 72 79 20 61 6e | 64 20 52 61 64 69 6f 70 |istry an|d Radiop|
|000004d0| 68 61 72 6d 61 63 6f 6c | 6f 67 79 0d 0a 0d 0a 2d |harmacol|ogy....-|
|000004e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000004f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000500| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000510| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000520| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 44 |--------|-----..D|
|00000530| 69 61 67 6e 6f 73 74 69 | 63 20 52 61 64 69 6f 6e |iagnosti|c Radion|
|00000540| 75 63 6c 69 64 65 20 49 | 6d 61 67 69 6e 67 20 6f |uclide I|maging o|
|00000550| 66 20 41 6d 79 6c 6f 69 | 64 3a 20 20 42 69 6f 6c |f Amyloi|d: Biol|
|00000560| 6f 67 69 63 61 6c 20 54 | 61 72 67 65 74 69 6e 67 |ogical T|argeting|
|00000570| 20 62 79 0d 0a 43 69 72 | 63 75 6c 61 74 69 6e 67 | by..Cir|culating|
|00000580| 20 48 75 6d 61 6e 20 53 | 65 72 75 6d 20 41 6d 79 | Human S|erum Amy|
|00000590| 6c 6f 69 64 20 50 20 43 | 6f 6d 70 6f 6e 65 6e 74 |loid P C|omponent|
|000005a0| 0d 0a 0d 0a 48 61 77 6b | 69 6e 73 20 50 4e 2c 20 |....Hawk|ins PN, |
|000005b0| 4d 79 65 72 73 20 4d 4a | 2c 20 4c 61 76 65 6e 64 |Myers MJ|, Lavend|
|000005c0| 65 72 20 4a 50 2c 20 50 | 65 70 79 73 20 4d 42 0d |er JP, P|epys MB.|
|000005d0| 0a 28 52 6f 79 61 6c 20 | 50 6f 73 74 67 72 61 64 |.(Royal |Postgrad|
|000005e0| 20 4d 65 64 20 53 63 68 | 6f 6f 6c 2c 20 48 61 6d | Med Sch|ool, Ham|
|000005f0| 6d 65 72 73 6d 69 74 68 | 20 48 6f 73 70 2c 20 4c |mersmith| Hosp, L|
|00000600| 6f 6e 64 6f 6e 29 0d 0a | 4c 61 6e 63 65 74 20 32 |ondon)..|Lancet 2|
|00000610| 3a 31 34 31 33 2d 31 34 | 31 38 2c 20 4a 75 6e 65 |:1413-14|18, June|
|00000620| 20 32 35 2c 20 31 39 38 | 38 0d 0a 2d 2d 2d 2d 2d | 25, 198|8..-----|
|00000630| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000640| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000650| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000660| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000670| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 0d 0a 0d 0a 41 62 73 |--------|-....Abs|
|00000680| 74 72 61 63 74 0d 0a 0d | 0a 20 20 20 20 20 45 61 |tract...|. Ea|
|00000690| 72 6c 79 20 64 69 61 67 | 6e 6f 73 69 73 20 6f 66 |rly diag|nosis of|
|000006a0| 20 61 6d 79 6c 6f 69 64 | 6f 73 69 73 20 69 73 20 | amyloid|osis is |
|000006b0| 69 6e 63 72 65 61 73 69 | 6e 67 6c 79 20 69 6d 70 |increasi|ngly imp|
|000006c0| 6f 72 74 61 6e 74 20 61 | 73 20 61 67 67 72 65 73 |ortant a|s aggres|
|000006d0| 73 69 76 65 0d 0a 61 6e | 74 69 2d 69 6e 66 6c 61 |sive..an|ti-infla|
|000006e0| 6d 6d 61 74 6f 72 79 20 | 74 72 65 61 74 6d 65 6e |mmatory |treatmen|
|000006f0| 74 20 62 65 63 6f 6d 65 | 73 20 61 76 61 69 6c 61 |t become|s availa|
|00000700| 62 6c 65 20 66 6f 72 20 | 72 65 74 61 72 64 69 6e |ble for |retardin|
|00000710| 67 20 74 68 65 20 70 72 | 6f 67 72 65 73 73 20 6f |g the pr|ogress o|
|00000720| 66 0d 0a 74 68 65 20 64 | 69 73 65 61 73 65 2e 20 |f..the d|isease. |
|00000730| 20 41 6e 20 69 6d 61 67 | 69 6e 67 20 6d 65 74 68 | An imag|ing meth|
|00000740| 6f 64 20 62 61 73 65 64 | 20 6f 6e 20 74 68 65 20 |od based| on the |
|00000750| 68 69 67 68 6c 79 20 73 | 70 65 63 69 66 69 63 20 |highly s|pecific |
|00000760| 62 69 6e 64 69 6e 67 20 | 61 66 66 69 6e 69 74 79 |binding |affinity|
|00000770| 0d 0a 6f 66 20 73 65 72 | 75 6d 20 61 6d 79 6c 6f |..of ser|um amylo|
|00000780| 69 64 20 50 20 63 6f 6d | 70 6f 6e 65 6e 74 20 28 |id P com|ponent (|
|00000790| 53 41 50 29 20 66 6f 72 | 20 61 6c 6c 20 74 79 70 |SAP) for| all typ|
|000007a0| 65 73 20 6f 66 20 61 6d | 79 6c 6f 69 64 20 66 69 |es of am|yloid fi|
|000007b0| 62 72 69 6c 73 20 77 61 | 73 0d 0a 64 65 76 65 6c |brils wa|s..devel|
|000007c0| 6f 70 65 64 2e 20 20 54 | 68 65 20 53 41 50 20 77 |oped. T|he SAP w|
|000007d0| 61 73 20 6c 61 62 65 6c | 65 64 20 77 69 74 68 20 |as label|ed with |
|000007e0| 4e 61 2d 31 32 33 2d 49 | 20 61 6e 64 20 74 68 65 |Na-123-I| and the|
|000007f0| 20 6c 61 62 65 6c 65 64 | 20 70 72 6f 74 65 69 6e | labeled| protein|
|00000800| 0d 0a 66 69 6c 74 65 72 | 65 64 20 61 6e 64 20 61 |..filter|ed and a|
|00000810| 64 6d 69 6e 69 73 74 65 | 72 65 64 20 69 6e 20 61 |dministe|red in a|
|00000820| 20 64 6f 73 65 20 6f 66 | 20 61 62 6f 75 74 20 36 | dose of| about 6|
|00000830| 30 30 20 6d 75 5f 67 20 | 6f 66 20 53 41 50 2c 20 |00 mu_g |of SAP, |
|00000840| 62 65 61 72 69 6e 67 20 | 31 39 30 20 4d 42 71 0d |bearing |190 MBq.|
|00000850| 0a 6f 66 20 31 32 33 2d | 49 2e 0d 0a 20 20 20 20 |.of 123-|I... |
|00000860| 20 49 6e 20 37 20 70 61 | 74 69 65 6e 74 73 20 77 | In 7 pa|tients w|
|00000870| 69 74 68 20 73 79 73 74 | 65 6d 69 63 20 61 6d 79 |ith syst|emic amy|
|00000880| 6c 6f 69 64 20 74 79 70 | 65 20 41 4c 2c 20 35 20 |loid typ|e AL, 5 |
|00000890| 77 69 74 68 20 74 79 70 | 65 20 41 41 2c 20 61 6e |with typ|e AA, an|
|000008a0| 64 20 32 20 77 69 74 68 | 0d 0a 62 65 74 61 32 4d |d 2 with|..beta2M|
|000008b0| 20 61 6d 79 6c 6f 69 64 | 2c 20 73 70 65 63 69 66 | amyloid|, specif|
|000008c0| 69 63 20 75 70 74 61 6b | 65 20 6f 66 20 61 63 74 |ic uptak|e of act|
|000008d0| 69 76 69 74 79 20 69 6e | 74 6f 20 61 6d 79 6c 6f |ivity in|to amylo|
|000008e0| 69 64 20 64 65 70 6f 73 | 69 74 73 20 77 61 73 0d |id depos|its was.|
|000008f0| 0a 6f 62 73 65 72 76 65 | 64 2c 20 77 68 65 72 65 |.observe|d, where|
|00000900| 61 73 20 6e 6f 20 74 69 | 73 73 75 65 20 6c 6f 63 |as no ti|ssue loc|
|00000910| 61 6c 69 7a 61 74 69 6f | 6e 20 77 61 73 20 73 65 |alizatio|n was se|
|00000920| 65 6e 20 69 6e 20 35 20 | 63 6f 6e 74 72 6f 6c 73 |en in 5 |controls|
|00000930| 2e 0d 0a 48 69 67 68 2d | 72 65 73 6f 6c 75 74 69 |...High-|resoluti|
|00000940| 6f 6e 20 69 6d 61 67 65 | 73 20 6f 66 20 6f 72 67 |on image|s of org|
|00000950| 61 6e 73 20 6f 72 20 74 | 69 73 73 75 65 73 20 63 |ans or t|issues c|
|00000960| 6f 6e 74 61 69 6e 69 6e | 67 20 61 6d 79 6c 6f 69 |ontainin|g amyloi|
|00000970| 64 20 77 65 72 65 20 6f | 62 74 61 69 6e 65 64 0d |d were o|btained.|
|00000980| 0a 69 6e 20 74 68 65 20 | 70 61 74 69 65 6e 74 73 |.in the |patients|
|00000990| 2e 20 20 4d 65 61 6e 20 | 77 68 6f 6c 65 20 62 6f |. Mean |whole bo|
|000009a0| 64 79 20 72 65 74 65 6e | 74 69 6f 6e 20 6f 66 20 |dy reten|tion of |
|000009b0| 61 63 74 69 76 69 74 79 | 20 61 74 20 36 20 64 61 |activity| at 6 da|
|000009c0| 79 73 20 77 61 73 20 36 | 30 25 20 69 6e 0d 0a 70 |ys was 6|0% in..p|
|000009d0| 61 74 69 65 6e 74 73 20 | 77 69 74 68 20 61 6d 79 |atients |with amy|
|000009e0| 6c 6f 69 64 20 64 69 73 | 65 61 73 65 20 61 6e 64 |loid dis|ease and|
|000009f0| 20 31 39 25 20 69 6e 20 | 63 6f 6e 74 72 6f 6c 73 | 19% in |controls|
|00000a00| 2e 20 20 4d 65 74 61 62 | 6f 6c 69 63 20 73 74 75 |. Metab|olic stu|
|00000a10| 64 69 65 73 20 73 68 6f | 77 65 64 0d 0a 74 68 61 |dies sho|wed..tha|
|00000a20| 74 20 74 68 65 20 72 61 | 74 65 20 6f 66 20 53 41 |t the ra|te of SA|
|00000a30| 50 20 73 79 6e 74 68 65 | 73 69 73 20 77 61 73 20 |P synthe|sis was |
|00000a40| 6d 61 72 6b 65 64 6c 79 | 20 69 6e 63 72 65 61 73 |markedly| increas|
|00000a50| 65 64 20 69 6e 20 74 68 | 65 20 70 72 65 73 65 6e |ed in th|e presen|
|00000a60| 63 65 20 6f 66 0d 0a 65 | 78 74 65 6e 73 69 76 65 |ce of..e|xtensive|
|00000a70| 20 61 6d 79 6c 6f 69 64 | 6f 73 69 73 2c 20 64 65 | amyloid|osis, de|
|00000a80| 73 70 69 74 65 20 6e 6f | 72 6d 61 6c 20 70 6c 61 |spite no|rmal pla|
|00000a90| 73 6d 61 20 6c 65 76 65 | 6c 73 2e 20 20 57 68 6f |sma leve|ls. Who|
|00000aa0| 6c 65 20 62 6f 64 79 20 | 63 6c 65 61 72 61 6e 63 |le body |clearanc|
|00000ab0| 65 20 6f 66 0d 0a 61 63 | 74 69 76 69 74 79 20 77 |e of..ac|tivity w|
|00000ac0| 61 73 20 69 6e 76 65 72 | 73 65 6c 79 20 72 65 6c |as inver|sely rel|
|00000ad0| 61 74 65 64 20 74 6f 20 | 74 68 65 20 70 6c 61 73 |ated to |the plas|
|00000ae0| 6d 61 20 63 6c 65 61 72 | 61 6e 63 65 20 6f 66 20 |ma clear|ance of |
|00000af0| 31 32 33 2d 49 2d 53 41 | 50 2e 0d 0a 20 20 20 20 |123-I-SA|P... |
|00000b00| 20 54 69 73 73 75 65 20 | 61 63 63 75 6d 75 6c 61 | Tissue |accumula|
|00000b10| 74 69 6f 6e 20 6f 66 20 | 53 41 50 20 64 6f 65 73 |tion of |SAP does|
|00000b20| 20 6e 6f 74 20 6f 63 63 | 75 72 20 69 6e 20 64 69 | not occ|ur in di|
|00000b30| 73 6f 72 64 65 72 73 20 | 6f 74 68 65 72 20 74 68 |sorders |other th|
|00000b40| 61 6e 0d 0a 61 6d 79 6c | 6f 69 64 6f 73 69 73 2e |an..amyl|oidosis.|
|00000b50| 20 20 54 68 65 20 68 69 | 67 68 6c 79 20 73 70 65 | The hi|ghly spe|
|00000b60| 63 69 66 69 63 20 6e 61 | 74 75 72 65 20 6f 66 20 |cific na|ture of |
|00000b70| 53 41 50 20 73 75 67 67 | 65 73 74 73 20 74 68 61 |SAP sugg|ests tha|
|00000b80| 74 20 69 74 20 6d 69 67 | 68 74 20 62 65 0d 0a 63 |t it mig|ht be..c|
|00000b90| 6f 75 70 6c 65 64 20 74 | 6f 20 61 6e 20 61 67 65 |oupled t|o an age|
|00000ba0| 6e 74 20 74 68 61 74 20 | 70 72 6f 6d 6f 74 65 73 |nt that |promotes|
|00000bb0| 20 74 68 65 20 64 65 73 | 74 72 75 63 74 69 6f 6e | the des|truction|
|00000bc0| 20 6f 66 20 61 6d 79 6c | 6f 69 64 20 66 69 62 72 | of amyl|oid fibr|
|00000bd0| 69 6c 73 2e 0d 0a 0d 0a | 50 6f 73 74 2d 43 6f 6d |ils.....|Post-Com|
|00000be0| 6d 65 6e 74 0d 0a 0d 0a | 20 20 20 20 20 54 68 69 |ment....| Thi|
|00000bf0| 73 20 69 73 20 65 78 63 | 69 74 69 6e 67 20 73 74 |s is exc|iting st|
|00000c00| 75 66 66 2e 20 20 57 65 | 20 6c 6f 6f 6b 20 66 6f |uff. We| look fo|
|00000c10| 72 77 61 72 64 20 74 6f | 20 66 75 72 74 68 65 72 |rward to| further|
|00000c20| 20 63 6c 69 6e 69 63 61 | 6c 20 77 6f 72 6b 20 74 | clinica|l work t|
|00000c30| 6f 0d 0a 63 6f 6e 66 69 | 72 6d 20 74 68 65 20 68 |o..confi|rm the h|
|00000c40| 69 67 68 20 28 70 65 72 | 66 65 63 74 3f 29 20 73 |igh (per|fect?) s|
|00000c50| 70 65 63 69 66 69 63 69 | 74 79 20 6f 66 20 49 2d |pecifici|ty of I-|
|00000c60| 31 32 33 20 53 41 50 20 | 66 6f 72 20 61 6d 79 6c |123 SAP |for amyl|
|00000c70| 6f 69 64 2e 20 20 57 65 | 20 61 72 65 20 6e 6f 74 |oid. We| are not|
|00000c80| 0d 0a 73 75 72 70 72 69 | 73 65 64 20 61 74 20 74 |..surpri|sed at t|
|00000c90| 68 65 20 75 62 69 71 75 | 69 74 6f 75 73 20 6e 61 |he ubiqu|itous na|
|00000ca0| 74 75 72 65 20 6f 66 20 | 74 68 65 20 61 6d 79 6c |ture of |the amyl|
|00000cb0| 6f 69 64 20 75 70 74 61 | 6b 65 20 61 6e 64 20 74 |oid upta|ke and t|
|00000cc0| 68 65 20 66 61 63 74 20 | 74 68 61 74 0d 0a 74 68 |he fact |that..th|
|00000cd0| 65 73 65 20 61 75 74 68 | 6f 72 73 20 66 6f 75 6e |ese auth|ors foun|
|00000ce0| 64 20 69 74 20 69 6e 20 | 63 6c 69 6e 69 63 61 6c |d it in |clinical|
|00000cf0| 6c 79 20 75 6e 73 75 73 | 70 65 63 74 65 64 20 61 |ly unsus|pected a|
|00000d00| 72 65 61 73 2e 20 20 57 | 65 20 72 65 63 65 6e 74 |reas. W|e recent|
|00000d10| 6c 79 20 73 61 77 20 61 | 0d 0a 63 61 73 65 20 6f |ly saw a|..case o|
|00000d20| 66 20 53 56 43 20 6f 62 | 73 74 72 75 63 74 69 6f |f SVC ob|structio|
|00000d30| 6e 20 63 61 75 73 65 64 | 20 62 79 20 61 6d 79 6c |n caused| by amyl|
|00000d40| 6f 69 64 2c 20 6a 75 73 | 74 20 74 6f 20 69 6c 6c |oid, jus|t to ill|
|00000d50| 75 73 74 72 61 74 65 20 | 68 6f 77 20 77 69 64 65 |ustrate |how wide|
|00000d60| 73 70 72 65 61 64 0d 0a | 61 6e 64 20 62 69 7a 61 |spread..|and biza|
|00000d70| 72 72 65 20 74 68 69 73 | 20 63 6f 6e 64 69 74 69 |rre this| conditi|
|00000d80| 6f 6e 20 63 61 6e 20 67 | 65 74 2e 2d 2d 41 2e 20 |on can g|et.--A. |
|00000d90| 47 6f 74 74 73 63 68 61 | 6c 6b 2c 20 4d 2e 44 2e |Gottscha|lk, M.D.|
|00000da0| 0d 0a 24 55 6e 69 71 75 | 65 5f 49 44 7b 59 52 42 |..$Uniqu|e_ID{YRB|
|00000db0| 31 33 32 34 31 7d 0d 0a | 24 54 69 74 6c 65 7b 52 |13241}..|$Title{R|
|00000dc0| 65 63 75 72 72 65 6e 63 | 65 20 6f 66 20 54 68 79 |ecurrenc|e of Thy|
|00000dd0| 72 6f 69 64 20 4e 6f 64 | 75 6c 65 73 20 41 66 74 |roid Nod|ules Aft|
|00000de0| 65 72 20 53 75 72 67 69 | 63 61 6c 20 52 65 6d 6f |er Surgi|cal Remo|
|00000df0| 76 61 6c 20 69 6e 20 50 | 61 74 69 65 6e 74 73 20 |val in P|atients |
|00000e00| 49 72 72 61 64 69 61 74 | 65 64 20 69 6e 20 43 68 |Irradiat|ed in Ch|
|00000e10| 69 6c 64 68 6f 6f 64 20 | 66 6f 72 20 42 65 6e 69 |ildhood |for Beni|
|00000e20| 67 6e 20 43 6f 6e 64 69 | 74 69 6f 6e 73 7d 0d 0a |gn Condi|tions}..|
|00000e30| 24 41 75 74 68 6f 72 7b | 46 6f 67 65 6c 66 65 6c |$Author{|Fogelfel|
|00000e40| 64 2c 20 4c 0d 0a 57 69 | 76 69 6f 74 74 2c 20 4d |d, L..Wi|viott, M|
|00000e50| 42 54 0d 0a 53 68 6f 72 | 65 2d 46 72 65 65 64 6d |BT..Shor|e-Freedm|
|00000e60| 61 6e 2c 20 45 0d 0a 42 | 6c 65 6e 64 2c 20 4d 0d |an, E..B|lend, M.|
|00000e70| 0a 42 65 6b 65 72 6d 61 | 6e 2c 20 43 0d 0a 50 69 |.Bekerma|n, C..Pi|
|00000e80| 6e 73 6b 79 2c 20 53 0d | 0a 53 63 68 6e 65 69 64 |nsky, S.|.Schneid|
|00000e90| 65 72 2c 20 41 42 7d 0d | 0a 24 41 66 66 69 6c 69 |er, AB}.|.$Affili|
|00000ea0| 61 74 69 6f 6e 7b 4d 69 | 63 68 61 65 6c 20 52 65 |ation{Mi|chael Re|
|00000eb0| 65 73 65 20 48 6f 73 70 | 2c 20 43 68 69 63 61 67 |ese Hosp|, Chicag|
|00000ec0| 6f 7d 0d 0a 24 4a 6f 75 | 72 6e 61 6c 7b 4e 20 45 |o}..$Jou|rnal{N E|
|00000ed0| 6e 67 6c 20 4a 20 4d 65 | 64 7d 0d 0a 24 56 6f 6c |ngl J Me|d}..$Vol|
|00000ee0| 75 6d 65 7b 33 32 30 7d | 0d 0a 24 50 61 67 65 7b |ume{320}|..$Page{|
|00000ef0| 38 33 35 2d 38 34 30 7d | 0d 0a 24 44 61 74 65 7b |835-840}|..$Date{|
|00000f00| 4d 61 72 63 68 20 33 30 | 2c 20 31 39 38 39 7d 0d |March 30|, 1989}.|
|00000f10| 0a 24 59 42 56 6f 6c 7b | 31 39 39 30 20 59 65 61 |.$YBVol{|1990 Yea|
|00000f20| 72 20 42 6f 6f 6b 20 6f | 66 20 4e 75 63 6c 65 61 |r Book o|f Nuclea|
|00000f30| 72 20 4d 65 64 69 63 69 | 6e 65 7d 0d 0a 24 43 68 |r Medici|ne}..$Ch|
|00000f40| 61 70 74 65 72 7b 31 31 | 2d 31 7d 0d 0a 24 59 42 |apter{11|-1}..$YB|
|00000f50| 45 64 69 74 6f 72 7b 44 | 72 73 2e 20 48 6f 66 66 |Editor{D|rs. Hoff|
|00000f60| 65 72 2c 20 47 6f 72 65 | 2c 20 47 6f 74 74 73 63 |er, Gore|, Gottsc|
|00000f70| 68 61 6c 6b 2c 20 53 6f | 73 74 6d 61 6e 2c 20 5a |halk, So|stman, Z|
|00000f80| 61 72 65 74 2c 20 61 6e | 64 20 5a 75 62 61 6c 7d |aret, an|d Zubal}|
|00000f90| 0d 0a 24 54 61 62 6c 65 | 7b 54 61 62 6c 65 20 4f |..$Table|{Table O|
|00000fa0| 6d 69 74 74 65 64 7d 0d | 0a 24 43 6f 6d 6d 65 6e |mitted}.|.$Commen|
|00000fb0| 74 61 74 6f 72 7b 50 2e | 42 2e 20 48 6f 66 66 65 |tator{P.|B. Hoffe|
|00000fc0| 72 2c 20 4d 2e 44 2e 7d | 0d 0a 0d 0a 43 6f 70 79 |r, M.D.}|....Copy|
|00000fd0| 72 69 67 68 74 20 28 63 | 29 20 59 65 61 72 62 6f |right (c|) Yearbo|
|00000fe0| 6f 6b 20 4d 65 64 69 63 | 61 6c 20 50 75 62 6c 69 |ok Medic|al Publi|
|00000ff0| 73 68 65 72 73 2c 20 49 | 6e 63 2e 2c 20 31 39 39 |shers, I|nc., 199|
|00001000| 30 0d 0a 0d 0a 31 39 39 | 30 20 59 65 61 72 20 42 |0....199|0 Year B|
|00001010| 6f 6f 6b 20 6f 66 20 4e | 75 63 6c 65 61 72 20 4d |ook of N|uclear M|
|00001020| 65 64 69 63 69 6e 65 20 | 28 52 29 0d 0a 0d 0a 43 |edicine |(R)....C|
|00001030| 68 61 70 74 65 72 20 31 | 31 2d 2d 45 6e 64 69 63 |hapter 1|1--Endic|
|00001040| 72 69 6e 65 20 53 79 73 | 74 65 6d 0d 0a 0d 0a 2d |rine Sys|tem....-|
|00001050| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001060| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001070| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001080| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001090| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 52 |--------|-----..R|
|000010a0| 65 63 75 72 72 65 6e 63 | 65 20 6f 66 20 54 68 79 |ecurrenc|e of Thy|
|000010b0| 72 6f 69 64 20 4e 6f 64 | 75 6c 65 73 20 41 66 74 |roid Nod|ules Aft|
|000010c0| 65 72 20 53 75 72 67 69 | 63 61 6c 20 52 65 6d 6f |er Surgi|cal Remo|
|000010d0| 76 61 6c 20 69 6e 20 50 | 61 74 69 65 6e 74 73 20 |val in P|atients |
|000010e0| 49 72 72 61 64 69 61 74 | 65 64 20 69 6e 0d 0a 43 |Irradiat|ed in..C|
|000010f0| 68 69 6c 64 68 6f 6f 64 | 20 66 6f 72 20 42 65 6e |hildhood| for Ben|
|00001100| 69 67 6e 20 43 6f 6e 64 | 69 74 69 6f 6e 73 0d 0a |ign Cond|itions..|
|00001110| 0d 0a 46 6f 67 65 6c 66 | 65 6c 64 20 4c 2c 20 57 |..Fogelf|eld L, W|
|00001120| 69 76 69 6f 74 74 20 4d | 42 54 2c 20 53 68 6f 72 |iviott M|BT, Shor|
|00001130| 65 2d 46 72 65 65 64 6d | 61 6e 20 45 2c 20 42 6c |e-Freedm|an E, Bl|
|00001140| 65 6e 64 20 4d 2c 20 42 | 65 6b 65 72 6d 61 6e 20 |end M, B|ekerman |
|00001150| 43 2c 20 50 69 6e 73 6b | 79 20 53 2c 0d 0a 53 63 |C, Pinsk|y S,..Sc|
|00001160| 68 6e 65 69 64 65 72 20 | 41 42 0d 0a 28 4d 69 63 |hneider |AB..(Mic|
|00001170| 68 61 65 6c 20 52 65 65 | 73 65 20 48 6f 73 70 2c |hael Ree|se Hosp,|
|00001180| 20 43 68 69 63 61 67 6f | 29 0d 0a 4e 20 45 6e 67 | Chicago|)..N Eng|
|00001190| 6c 20 4a 20 4d 65 64 20 | 33 32 30 3a 38 33 35 2d |l J Med |320:835-|
|000011a0| 38 34 30 2c 20 4d 61 72 | 63 68 20 33 30 2c 20 31 |840, Mar|ch 30, 1|
|000011b0| 39 38 39 0d 0a 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |989..---|--------|
|000011c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000011d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000011e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000011f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001200| 2d 2d 2d 0d 0a 0d 0a 41 | 62 73 74 72 61 63 74 0d |---....A|bstract.|
|00001210| 0a 0d 0a 20 20 20 20 20 | 50 72 6f 70 68 79 6c 61 |... |Prophyla|
|00001220| 63 74 69 63 20 74 72 65 | 61 74 6d 65 6e 74 20 77 |ctic tre|atment w|
|00001230| 69 74 68 20 74 68 79 72 | 6f 69 64 20 68 6f 72 6d |ith thyr|oid horm|
|00001240| 6f 6e 65 20 69 73 20 66 | 72 65 71 75 65 6e 74 6c |one is f|requentl|
|00001250| 79 20 72 65 63 6f 6d 6d | 65 6e 64 65 64 20 74 6f |y recomm|ended to|
|00001260| 0d 0a 64 65 63 72 65 61 | 73 65 20 72 65 63 75 72 |..decrea|se recur|
|00001270| 72 65 6e 63 65 73 20 69 | 6e 20 70 61 74 69 65 6e |rences i|n patien|
|00001280| 74 73 20 61 66 74 65 72 | 20 70 61 72 74 69 61 6c |ts after| partial|
|00001290| 20 74 68 79 72 6f 69 64 | 65 63 74 6f 6d 79 20 66 | thyroid|ectomy f|
|000012a0| 6f 72 20 62 65 6e 69 67 | 6e 0d 0a 74 68 79 72 6f |or benig|n..thyro|
|000012b0| 69 64 20 6e 6f 64 75 6c | 65 73 2e 20 20 43 6c 69 |id nodul|es. Cli|
|000012c0| 6e 69 63 61 6c 20 73 74 | 75 64 69 65 73 20 68 61 |nical st|udies ha|
|000012d0| 76 65 20 72 61 69 73 65 | 64 20 64 6f 75 62 74 73 |ve raise|d doubts|
|000012e0| 20 61 62 6f 75 74 20 77 | 68 65 74 68 65 72 20 73 | about w|hether s|
|000012f0| 75 63 68 0d 0a 74 68 65 | 72 61 70 79 20 72 65 64 |uch..the|rapy red|
|00001300| 75 63 65 73 20 74 68 65 | 20 72 61 74 65 20 6f 66 |uces the| rate of|
|00001310| 20 72 65 63 75 72 72 65 | 6e 63 65 20 6f 66 20 62 | recurre|nce of b|
|00001320| 65 6e 69 67 6e 20 74 68 | 79 72 6f 69 64 20 6e 6f |enign th|yroid no|
|00001330| 64 75 6c 65 73 2e 20 20 | 54 6f 0d 0a 64 65 74 65 |dules. |To..dete|
|00001340| 72 6d 69 6e 65 20 74 68 | 65 20 69 6e 63 69 64 65 |rmine th|e incide|
|00001350| 6e 63 65 20 6f 66 20 62 | 65 6e 69 67 6e 20 74 68 |nce of b|enign th|
|00001360| 79 72 6f 69 64 20 6e 6f | 64 75 6c 65 73 20 61 6e |yroid no|dules an|
|00001370| 64 20 74 68 65 20 72 69 | 73 6b 20 66 61 63 74 6f |d the ri|sk facto|
|00001380| 72 73 20 66 6f 72 0d 0a | 74 68 65 69 72 20 72 65 |rs for..|their re|
|00001390| 63 75 72 72 65 6e 63 65 | 20 61 66 74 65 72 20 73 |currence| after s|
|000013a0| 75 72 67 69 63 61 6c 20 | 72 65 6d 6f 76 61 6c 2c |urgical |removal,|
|000013b0| 20 35 31 31 20 70 61 74 | 69 65 6e 74 73 20 77 65 | 511 pat|ients we|
|000013c0| 72 65 20 66 6f 6c 6c 6f | 77 65 64 20 66 6f 72 20 |re follo|wed for |
|000013d0| 31 2d 34 30 2e 36 0d 0a | 79 65 61 72 73 20 61 66 |1-40.6..|years af|
|000013e0| 74 65 72 20 73 75 72 67 | 65 72 79 20 66 6f 72 20 |ter surg|ery for |
|000013f0| 62 65 6e 69 67 6e 20 74 | 68 79 72 6f 69 64 20 6e |benign t|hyroid n|
|00001400| 6f 64 75 6c 65 73 20 61 | 72 69 73 69 6e 67 20 61 |odules a|rising a|
|00001410| 66 74 65 72 20 6c 6f 63 | 61 6c 20 69 72 72 61 64 |fter loc|al irrad|
|00001420| 69 61 74 69 6f 6e 0d 0a | 66 6f 72 20 75 6e 72 65 |iation..|for unre|
|00001430| 6c 61 74 65 64 20 62 65 | 6e 69 67 6e 20 64 69 73 |lated be|nign dis|
|00001440| 65 61 73 65 20 69 6e 20 | 63 68 69 6c 64 68 6f 6f |ease in |childhoo|
|00001450| 64 2e 0d 0a 20 20 20 20 | 20 52 65 63 75 72 72 65 |d... | Recurre|
|00001460| 6e 74 20 74 68 79 72 6f | 69 64 20 6e 6f 64 75 6c |nt thyro|id nodul|
|00001470| 65 73 20 77 65 72 65 20 | 66 6f 75 6e 64 20 69 6e |es were |found in|
|00001480| 20 31 39 2e 35 25 20 6f | 66 20 74 68 65 20 70 61 | 19.5% o|f the pa|
|00001490| 74 69 65 6e 74 73 2e 20 | 20 54 68 65 20 72 69 73 |tients. | The ris|
|000014a0| 6b 0d 0a 6f 66 20 72 65 | 63 75 72 72 65 6e 63 65 |k..of re|currence|
|000014b0| 20 77 61 73 20 69 6e 76 | 65 72 73 65 6c 79 20 63 | was inv|ersely c|
|000014c0| 6f 72 72 65 6c 61 74 65 | 64 20 77 69 74 68 20 74 |orrelate|d with t|
|000014d0| 68 65 20 61 6d 6f 75 6e | 74 20 6f 66 20 74 68 79 |he amoun|t of thy|
|000014e0| 72 6f 69 64 20 74 69 73 | 73 75 65 0d 0a 72 65 6d |roid tis|sue..rem|
|000014f0| 6f 76 65 64 2e 20 20 52 | 65 63 75 72 72 65 6e 63 |oved. R|ecurrenc|
|00001500| 65 73 20 64 65 76 65 6c | 6f 70 65 64 20 69 6e 20 |es devel|oped in |
|00001510| 32 38 2e 34 25 20 6f 66 | 20 74 68 65 20 77 6f 6d |28.4% of| the wom|
|00001520| 65 6e 2c 20 63 6f 6d 70 | 61 72 65 64 20 77 69 74 |en, comp|ared wit|
|00001530| 68 20 31 30 2e 33 25 20 | 6f 66 0d 0a 74 68 65 20 |h 10.3% |of..the |
|00001540| 6d 65 6e 20 28 54 61 62 | 6c 65 20 31 29 2e 20 20 |men (Tab|le 1). |
|00001550| 4f 66 20 74 68 65 20 32 | 39 39 20 70 61 74 69 65 |Of the 2|99 patie|
|00001560| 6e 74 73 20 74 72 65 61 | 74 65 64 20 77 69 74 68 |nts trea|ted with|
|00001570| 20 74 68 79 72 6f 69 64 | 20 68 6f 72 6d 6f 6e 65 | thyroid| hormone|
|00001580| 20 74 6f 0d 0a 73 75 70 | 70 72 65 73 73 20 73 74 | to..sup|press st|
|00001590| 69 6d 75 6c 61 74 69 6e | 67 20 68 6f 72 6d 6f 6e |imulatin|g hormon|
|000015a0| 65 2c 20 38 2e 34 25 20 | 68 61 64 20 72 65 63 75 |e, 8.4% |had recu|
|000015b0| 72 72 65 6e 63 65 73 2e | 20 20 41 6d 6f 6e 67 20 |rrences.| Among |
|000015c0| 74 68 65 20 32 30 31 20 | 77 68 6f 20 64 69 64 20 |the 201 |who did |
|000015d0| 6e 6f 74 0d 0a 72 65 63 | 65 69 76 65 20 74 68 79 |not..rec|eive thy|
|000015e0| 72 6f 69 64 20 68 6f 72 | 6d 6f 6e 65 2c 20 33 35 |roid hor|mone, 35|
|000015f0| 2e 38 25 20 68 61 64 20 | 72 65 63 75 72 72 65 6e |.8% had |recurren|
|00001600| 63 65 73 20 28 54 61 62 | 6c 65 20 32 29 2e 20 20 |ces (Tab|le 2). |
|00001610| 48 69 73 74 6f 6c 6f 67 | 69 63 20 73 74 75 64 79 |Histolog|ic study|
|00001620| 20 6f 66 0d 0a 37 33 20 | 74 69 73 73 75 65 20 73 | of..73 |tissue s|
|00001630| 61 6d 70 6c 65 73 20 66 | 72 6f 6d 20 70 61 74 69 |amples f|rom pati|
|00001640| 65 6e 74 73 20 77 69 74 | 68 20 72 65 63 75 72 72 |ents wit|h recurr|
|00001650| 65 6e 63 65 73 20 73 68 | 6f 77 65 64 20 74 68 61 |ences sh|owed tha|
|00001660| 74 20 31 34 20 28 31 39 | 2e 32 25 29 20 77 65 72 |t 14 (19|.2%) wer|
|00001670| 65 0d 0a 6d 61 6c 69 67 | 6e 61 6e 74 2e 20 20 54 |e..malig|nant. T|
|00001680| 68 79 72 6f 69 64 20 68 | 6f 72 6d 6f 6e 65 20 74 |hyroid h|ormone t|
|00001690| 68 65 72 61 70 79 20 64 | 69 64 20 6e 6f 74 20 61 |herapy d|id not a|
|000016a0| 66 66 65 63 74 20 74 68 | 65 20 72 61 74 65 20 6f |ffect th|e rate o|
|000016b0| 66 20 74 68 79 72 6f 69 | 64 20 63 61 6e 63 65 72 |f thyroi|d cancer|
|000016c0| 2e 0d 0a 20 20 20 20 20 | 52 61 64 69 61 74 69 6f |... |Radiatio|
|000016d0| 6e 2d 61 73 73 6f 63 69 | 61 74 65 64 20 62 65 6e |n-associ|ated ben|
|000016e0| 69 67 6e 20 74 68 79 72 | 6f 69 64 20 6e 6f 64 75 |ign thyr|oid nodu|
|000016f0| 6c 65 73 20 68 61 76 65 | 20 61 20 68 69 67 68 20 |les have| a high |
|00001700| 72 61 74 65 20 6f 66 0d | 0a 72 65 63 75 72 72 65 |rate of.|.recurre|
|00001710| 6e 63 65 2c 20 63 6f 6d | 70 61 72 61 62 6c 65 20 |nce, com|parable |
|00001720| 74 6f 20 74 68 61 74 20 | 66 6f 75 6e 64 20 61 6d |to that |found am|
|00001730| 6f 6e 67 20 6e 6f 6e 69 | 72 72 61 64 69 61 74 65 |ong noni|rradiate|
|00001740| 64 20 70 61 74 69 65 6e | 74 73 20 77 69 74 68 20 |d patien|ts with |
|00001750| 62 65 6e 69 67 6e 0d 0a | 74 68 79 72 6f 69 64 20 |benign..|thyroid |
|00001760| 6e 6f 64 75 6c 65 73 2e | 20 20 54 72 65 61 74 6d |nodules.| Treatm|
|00001770| 65 6e 74 20 77 69 74 68 | 20 74 68 79 72 6f 69 64 |ent with| thyroid|
|00001780| 20 68 6f 72 6d 6f 6e 65 | 20 72 65 64 75 63 65 64 | hormone| reduced|
|00001790| 20 74 68 65 20 72 69 73 | 6b 20 6f 66 20 62 65 6e | the ris|k of ben|
|000017a0| 69 67 6e 0d 0a 72 65 63 | 75 72 72 65 6e 63 65 73 |ign..rec|urrences|
|000017b0| 2c 20 65 73 70 65 63 69 | 61 6c 6c 79 20 61 6d 6f |, especi|ally amo|
|000017c0| 6e 67 20 77 6f 6d 65 6e | 2c 20 62 75 74 20 6e 6f |ng women|, but no|
|000017d0| 74 20 74 68 65 20 72 69 | 73 6b 20 6f 66 20 63 61 |t the ri|sk of ca|
|000017e0| 6e 63 65 72 2e 0d 0a 0d | 0a 50 6f 73 74 2d 43 6f |ncer....|.Post-Co|
|000017f0| 6d 6d 65 6e 74 0d 0a 0d | 0a 20 20 20 20 20 53 6f |mment...|. So|
|00001800| 6d 65 74 69 6d 65 73 20 | 77 65 20 64 6f 20 74 68 |metimes |we do th|
|00001810| 65 20 72 69 67 68 74 20 | 74 68 69 6e 67 20 66 6f |e right |thing fo|
|00001820| 72 20 74 68 65 20 77 72 | 6f 6e 67 20 72 65 61 73 |r the wr|ong reas|
|00001830| 6f 6e 73 2e 20 20 49 20 | 68 61 76 65 20 61 6c 77 |ons. I |have alw|
|00001840| 61 79 73 0d 0a 61 64 76 | 6f 63 61 74 65 64 20 74 |ays..adv|ocated t|
|00001850| 72 65 61 74 69 6e 67 20 | 70 61 74 69 65 6e 74 73 |reating |patients|
|00001860| 20 77 68 6f 20 68 61 76 | 65 20 72 61 64 69 61 74 | who hav|e radiat|
|00001870| 69 6f 6e 2d 69 6e 64 75 | 63 65 64 20 28 73 75 72 |ion-indu|ced (sur|
|00001880| 67 69 63 61 6c 6c 79 20 | 72 65 6d 6f 76 65 64 29 |gically |removed)|
|00001890| 0d 0a 62 65 6e 69 67 6e | 20 6e 6f 64 75 6c 65 73 |..benign| nodules|
|000018a0| 20 77 69 74 68 20 73 75 | 70 70 72 65 73 73 69 76 | with su|ppressiv|
|000018b0| 65 20 64 6f 73 65 73 20 | 6f 66 20 74 68 79 72 6f |e doses |of thyro|
|000018c0| 69 64 20 68 6f 72 6d 6f | 6e 65 2e 20 20 4d 79 20 |id hormo|ne. My |
|000018d0| 72 61 74 69 6f 6e 61 6c | 65 20 68 61 73 0d 0a 62 |rational|e has..b|
|000018e0| 65 65 6e 20 74 68 61 74 | 20 70 75 74 74 69 6e 67 |een that| putting|
|000018f0| 20 74 68 65 20 67 6c 61 | 6e 64 20 61 74 20 72 65 | the gla|nd at re|
|00001900| 73 74 20 64 65 63 72 65 | 61 73 65 73 20 74 68 65 |st decre|ases the|
|00001910| 20 70 72 6f 62 61 62 69 | 6c 69 74 79 20 6f 66 20 | probabi|lity of |
|00001920| 74 68 65 0d 0a 73 75 62 | 73 65 71 75 65 6e 74 20 |the..sub|sequent |
|00001930| 64 65 76 65 6c 6f 70 6d | 65 6e 74 20 6f 66 20 6d |developm|ent of m|
|00001940| 61 6c 69 67 6e 61 6e 74 | 20 74 75 6d 6f 72 73 2e |alignant| tumors.|
|00001950| 20 20 4f 6e 65 20 6f 66 | 20 74 68 65 20 69 6e 63 | One of| the inc|
|00001960| 69 64 65 6e 74 61 6c 20 | 66 69 6e 64 69 6e 67 73 |idental |findings|
|00001970| 20 69 6e 0d 0a 74 68 69 | 73 20 73 74 75 64 79 2c | in..thi|s study,|
|00001980| 20 61 6c 62 65 69 74 20 | 62 61 73 65 64 20 6f 6e | albeit |based on|
|00001990| 20 61 20 73 6d 61 6c 6c | 20 70 6f 70 75 6c 61 74 | a small| populat|
|000019a0| 69 6f 6e 2c 20 69 73 20 | 74 68 61 74 20 74 68 79 |ion, is |that thy|
|000019b0| 72 6f 69 64 20 68 6f 72 | 6d 6f 6e 65 0d 0a 74 72 |roid hor|mone..tr|
|000019c0| 65 61 74 6d 65 6e 74 20 | 73 75 70 70 72 65 73 73 |eatment |suppress|
|000019d0| 65 73 20 74 68 65 20 64 | 65 76 65 6c 6f 70 6d 65 |es the d|evelopme|
|000019e0| 6e 74 20 6f 66 20 62 65 | 6e 69 67 6e 20 6e 6f 64 |nt of be|nign nod|
|000019f0| 75 6c 65 73 20 62 75 74 | 20 6e 6f 74 20 6d 61 6c |ules but| not mal|
|00001a00| 69 67 6e 61 6e 74 20 6f | 6e 65 73 2e 0d 0a 50 61 |ignant o|nes...Pa|
|00001a10| 72 61 64 6f 78 69 63 61 | 6c 6c 79 2c 20 69 74 20 |radoxica|lly, it |
|00001a20| 74 75 72 6e 73 20 6f 75 | 74 20 74 68 61 74 20 74 |turns ou|t that t|
|00001a30| 68 79 72 6f 69 64 20 68 | 6f 72 6d 6f 6e 65 20 74 |hyroid h|ormone t|
|00001a40| 72 65 61 74 6d 65 6e 74 | 20 69 73 20 68 65 6c 70 |reatment| is help|
|00001a50| 66 75 6c 20 62 65 63 61 | 75 73 65 0d 0a 70 61 74 |ful beca|use..pat|
|00001a60| 69 65 6e 74 73 20 67 69 | 76 65 6e 20 74 68 79 72 |ients gi|ven thyr|
|00001a70| 6f 69 64 20 72 65 70 6c | 61 63 65 6d 65 6e 74 20 |oid repl|acement |
|00001a80| 69 6e 20 77 68 6f 6d 20 | 6e 6f 64 75 6c 65 73 20 |in whom |nodules |
|00001a90| 64 6f 20 64 65 76 65 6c | 6f 70 20 68 61 76 65 20 |do devel|op have |
|00001aa0| 61 20 6d 75 63 68 0d 0a | 68 69 67 68 65 72 20 70 |a much..|higher p|
|00001ab0| 72 6f 62 61 62 69 6c 69 | 74 79 20 6f 66 20 74 68 |robabili|ty of th|
|00001ac0| 65 20 67 72 6f 77 74 68 | 20 62 65 69 6e 67 20 6d |e growth| being m|
|00001ad0| 61 6c 69 67 6e 61 6e 74 | 2e 20 20 54 68 75 73 2c |alignant|. Thus,|
|00001ae0| 20 61 6c 74 68 6f 75 67 | 68 20 74 68 65 20 75 73 | althoug|h the us|
|00001af0| 65 20 6f 66 0d 0a 74 68 | 79 72 6f 69 64 20 73 75 |e of..th|yroid su|
|00001b00| 70 70 72 65 73 73 69 6f | 6e 20 64 6f 65 73 20 6e |ppressio|n does n|
|00001b10| 6f 74 20 72 65 64 75 63 | 65 20 74 68 65 20 69 6e |ot reduc|e the in|
|00001b20| 63 69 64 65 6e 63 65 20 | 6f 66 20 6d 61 6c 69 67 |cidence |of malig|
|00001b30| 6e 61 6e 63 79 2c 20 69 | 74 20 68 65 6c 70 73 20 |nancy, i|t helps |
|00001b40| 69 6e 0d 0a 74 68 65 20 | 6d 61 6e 61 67 65 6d 65 |in..the |manageme|
|00001b50| 6e 74 20 6f 66 20 70 61 | 74 69 65 6e 74 73 20 77 |nt of pa|tients w|
|00001b60| 69 74 68 20 72 65 63 75 | 72 72 65 6e 74 20 6e 6f |ith recu|rrent no|
|00001b70| 64 75 6c 65 73 2e 2d 2d | 50 2e 42 2e 20 48 6f 66 |dules.--|P.B. Hof|
|00001b80| 66 65 72 2c 20 4d 2e 44 | 2e 0d 0a 24 55 6e 69 71 |fer, M.D|...$Uniq|
|00001b90| 75 65 5f 49 44 7b 59 52 | 42 31 33 32 34 32 7d 0d |ue_ID{YR|B13242}.|
|00001ba0| 0a 24 54 69 74 6c 65 7b | 54 72 65 61 74 6d 65 6e |.$Title{|Treatmen|
|00001bb0| 74 20 6f 66 20 48 79 70 | 65 72 74 68 79 72 6f 69 |t of Hyp|erthyroi|
|00001bc0| 64 69 73 6d 20 57 69 74 | 68 20 52 61 64 69 6f 69 |dism Wit|h Radioi|
|00001bd0| 6f 64 69 6e 65 3a 20 20 | 41 64 6a 75 6e 63 74 69 |odine: |Adjuncti|
|00001be0| 76 65 20 54 68 65 72 61 | 70 79 20 57 69 74 68 20 |ve Thera|py With |
|00001bf0| 41 6e 74 69 74 68 79 72 | 6f 69 64 20 44 72 75 67 |Antithyr|oid Drug|
|00001c00| 73 20 52 65 63 6f 6e 73 | 69 64 65 72 65 64 7d 0d |s Recons|idered}.|
|00001c10| 0a 24 41 75 74 68 6f 72 | 7b 56 65 6c 6b 65 6e 69 |.$Author|{Velkeni|
|00001c20| 65 72 73 2c 20 42 0d 0a | 43 79 74 72 79 6e 2c 20 |ers, B..|Cytryn, |
|00001c30| 52 0d 0a 56 61 6e 68 61 | 65 6c 73 74 2c 20 4c 0d |R..Vanha|elst, L.|
|00001c40| 0a 4a 6f 6e 63 6b 68 65 | 65 72 2c 20 4d 48 7d 0d |.Jonckhe|er, MH}.|
|00001c50| 0a 24 41 66 66 69 6c 69 | 61 74 69 6f 6e 7b 41 63 |.$Affili|ation{Ac|
|00001c60| 61 64 65 6d 69 63 20 48 | 6f 73 70 20 56 55 42 2c |ademic H|osp VUB,|
|00001c70| 20 42 72 75 73 73 65 6c | 73 7d 0d 0a 24 4a 6f 75 | Brussel|s}..$Jou|
|00001c80| 72 6e 61 6c 7b 4c 61 6e | 63 65 74 7d 0d 0a 24 56 |rnal{Lan|cet}..$V|
|00001c90| 6f 6c 75 6d 65 7b 31 7d | 0d 0a 24 50 61 67 65 7b |olume{1}|..$Page{|
|00001ca0| 31 31 32 37 2d 31 31 32 | 39 7d 0d 0a 24 44 61 74 |1127-112|9}..$Dat|
|00001cb0| 65 7b 4d 61 79 20 32 31 | 2c 20 31 39 38 38 7d 0d |e{May 21|, 1988}.|
|00001cc0| 0a 24 59 42 56 6f 6c 7b | 31 39 39 30 20 59 65 61 |.$YBVol{|1990 Yea|
|00001cd0| 72 20 42 6f 6f 6b 20 6f | 66 20 4e 75 63 6c 65 61 |r Book o|f Nuclea|
|00001ce0| 72 20 4d 65 64 69 63 69 | 6e 65 7d 0d 0a 24 43 68 |r Medici|ne}..$Ch|
|00001cf0| 61 70 74 65 72 7b 31 31 | 2d 36 7d 0d 0a 24 59 42 |apter{11|-6}..$YB|
|00001d00| 45 64 69 74 6f 72 7b 44 | 72 73 2e 20 48 6f 66 66 |Editor{D|rs. Hoff|
|00001d10| 65 72 2c 20 47 6f 72 65 | 2c 20 47 6f 74 74 73 63 |er, Gore|, Gottsc|
|00001d20| 68 61 6c 6b 2c 20 53 6f | 73 74 6d 61 6e 2c 20 5a |halk, So|stman, Z|
|00001d30| 61 72 65 74 2c 20 61 6e | 64 20 5a 75 62 61 6c 7d |aret, an|d Zubal}|
|00001d40| 0d 0a 24 54 61 62 6c 65 | 7b 54 61 62 6c 65 20 4f |..$Table|{Table O|
|00001d50| 6d 69 74 74 65 64 7d 0d | 0a 24 43 6f 6d 6d 65 6e |mitted}.|.$Commen|
|00001d60| 74 61 74 6f 72 7b 50 2e | 42 2e 20 48 6f 66 66 65 |tator{P.|B. Hoffe|
|00001d70| 72 2c 20 4d 2e 44 2e 7d | 0d 0a 0d 0a 43 6f 70 79 |r, M.D.}|....Copy|
|00001d80| 72 69 67 68 74 20 28 63 | 29 20 59 65 61 72 62 6f |right (c|) Yearbo|
|00001d90| 6f 6b 20 4d 65 64 69 63 | 61 6c 20 50 75 62 6c 69 |ok Medic|al Publi|
|00001da0| 73 68 65 72 73 2c 20 49 | 6e 63 2e 2c 20 31 39 39 |shers, I|nc., 199|
|00001db0| 30 0d 0a 0d 0a 31 39 39 | 30 20 59 65 61 72 20 42 |0....199|0 Year B|
|00001dc0| 6f 6f 6b 20 6f 66 20 4e | 75 63 6c 65 61 72 20 4d |ook of N|uclear M|
|00001dd0| 65 64 69 63 69 6e 65 20 | 28 52 29 0d 0a 0d 0a 43 |edicine |(R)....C|
|00001de0| 68 61 70 74 65 72 20 31 | 31 2d 2d 45 6e 64 69 63 |hapter 1|1--Endic|
|00001df0| 72 69 6e 65 20 53 79 73 | 74 65 6d 0d 0a 0d 0a 2d |rine Sys|tem....-|
|00001e00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001e10| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001e20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001e30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001e40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 54 |--------|-----..T|
|00001e50| 72 65 61 74 6d 65 6e 74 | 20 6f 66 20 48 79 70 65 |reatment| of Hype|
|00001e60| 72 74 68 79 72 6f 69 64 | 69 73 6d 20 57 69 74 68 |rthyroid|ism With|
|00001e70| 20 52 61 64 69 6f 69 6f | 64 69 6e 65 3a 20 20 41 | Radioio|dine: A|
|00001e80| 64 6a 75 6e 63 74 69 76 | 65 20 54 68 65 72 61 70 |djunctiv|e Therap|
|00001e90| 79 20 57 69 74 68 0d 0a | 41 6e 74 69 74 68 79 72 |y With..|Antithyr|
|00001ea0| 6f 69 64 20 44 72 75 67 | 73 20 52 65 63 6f 6e 73 |oid Drug|s Recons|
|00001eb0| 69 64 65 72 65 64 0d 0a | 0d 0a 56 65 6c 6b 65 6e |idered..|..Velken|
|00001ec0| 69 65 72 73 20 42 2c 20 | 43 79 74 72 79 6e 20 52 |iers B, |Cytryn R|
|00001ed0| 2c 20 56 61 6e 68 61 65 | 6c 73 74 20 4c 2c 20 4a |, Vanhae|lst L, J|
|00001ee0| 6f 6e 63 6b 68 65 65 72 | 20 4d 48 0d 0a 28 41 63 |onckheer| MH..(Ac|
|00001ef0| 61 64 65 6d 69 63 20 48 | 6f 73 70 20 56 55 42 2c |ademic H|osp VUB,|
|00001f00| 20 42 72 75 73 73 65 6c | 73 29 0d 0a 4c 61 6e 63 | Brussel|s)..Lanc|
|00001f10| 65 74 20 31 3a 31 31 32 | 37 2d 31 31 32 39 2c 20 |et 1:112|7-1129, |
|00001f20| 4d 61 79 20 32 31 2c 20 | 31 39 38 38 0d 0a 2d 2d |May 21, |1988..--|
|00001f30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001f40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001f50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001f60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001f70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 0d 0a |--------|----....|
|00001f80| 41 62 73 74 72 61 63 74 | 0d 0a 0d 0a 20 20 20 20 |Abstract|.... |
|00001f90| 20 54 68 65 20 76 61 6c | 75 65 20 6f 66 20 61 6e | The val|ue of an|
|00001fa0| 74 69 74 68 79 72 6f 69 | 64 20 64 72 75 67 20 74 |tithyroi|d drug t|
|00001fb0| 68 65 72 61 70 79 20 61 | 66 74 65 72 20 72 61 64 |herapy a|fter rad|
|00001fc0| 69 6f 69 6f 64 69 6e 65 | 20 74 72 65 61 74 6d 65 |ioiodine| treatme|
|00001fd0| 6e 74 20 77 61 73 0d 0a | 65 78 61 6d 69 6e 65 64 |nt was..|examined|
|00001fe0| 20 69 6e 20 32 30 36 20 | 70 61 74 69 65 6e 74 73 | in 206 |patients|
|00001ff0| 20 66 6f 6c 6c 6f 77 65 | 64 20 66 6f 72 20 32 2d | followe|d for 2-|
|00002000| 37 20 79 65 61 72 73 2e | 20 20 4e 69 6e 65 74 79 |7 years.| Ninety|
|00002010| 2d 65 69 67 68 74 20 70 | 61 74 69 65 6e 74 73 0d |-eight p|atients.|
|00002020| 0a 72 65 63 65 69 76 65 | 64 20 74 72 65 61 74 6d |.receive|d treatm|
|00002030| 65 6e 74 20 77 69 74 68 | 20 6d 65 74 68 69 6d 61 |ent with| methima|
|00002040| 7a 6f 6c 65 2c 20 69 6e | 20 61 20 6d 65 61 6e 20 |zole, in| a mean |
|00002050| 6f 66 20 33 30 20 6d 67 | 20 64 61 69 6c 79 2c 20 |of 30 mg| daily, |
|00002060| 6f 72 0d 0a 70 72 6f 70 | 79 6c 74 68 69 6f 75 72 |or..prop|ylthiour|
|00002070| 61 63 69 6c 2c 20 69 6e | 20 61 20 6d 65 61 6e 20 |acil, in| a mean |
|00002080| 64 6f 73 65 20 6f 66 20 | 32 30 30 20 6d 67 20 64 |dose of |200 mg d|
|00002090| 61 69 6c 79 2c 20 61 66 | 74 65 72 20 74 72 65 61 |aily, af|ter trea|
|000020a0| 74 6d 65 6e 74 20 77 69 | 74 68 0d 0a 72 61 64 69 |tment wi|th..radi|
|000020b0| 6f 69 6f 64 69 6e 65 2e | 20 20 54 68 65 20 6f 74 |oiodine.| The ot|
|000020c0| 68 65 72 20 31 30 38 20 | 70 61 74 69 65 6e 74 73 |her 108 |patients|
|000020d0| 20 72 65 63 65 69 76 65 | 64 20 72 61 64 69 6f 69 | receive|d radioi|
|000020e0| 6f 64 69 6e 65 20 74 68 | 65 72 61 70 79 20 6f 6e |odine th|erapy on|
|000020f0| 6c 79 2e 20 20 54 68 65 | 0d 0a 67 72 6f 75 70 73 |ly. The|..groups|
|00002100| 20 77 65 72 65 20 63 6c | 69 6e 69 63 61 6c 6c 79 | were cl|inically|
|00002110| 20 63 6f 6d 70 61 72 61 | 62 6c 65 20 65 78 63 65 | compara|ble exce|
|00002120| 70 74 20 74 68 61 74 20 | 6d 6f 72 65 20 6f 66 20 |pt that |more of |
|00002130| 74 68 6f 73 65 20 72 65 | 63 65 69 76 69 6e 67 0d |those re|ceiving.|
|00002140| 0a 74 72 65 61 74 6d 65 | 6e 74 20 77 69 74 68 20 |.treatme|nt with |
|00002150| 61 6e 74 69 74 68 79 72 | 6f 69 64 20 64 72 75 67 |antithyr|oid drug|
|00002160| 73 20 68 61 64 20 70 6f | 73 69 74 69 76 65 20 61 |s had po|sitive a|
|00002170| 6e 74 69 62 6f 64 79 20 | 74 65 73 74 20 72 65 73 |ntibody |test res|
|00002180| 75 6c 74 73 2e 0d 0a 20 | 20 20 20 20 48 79 70 65 |ults... | Hype|
|00002190| 72 74 68 79 72 6f 69 64 | 69 73 6d 20 72 65 63 75 |rthyroid|ism recu|
|000021a0| 72 72 65 64 20 69 6e 20 | 68 61 6c 66 20 6f 66 20 |rred in |half of |
|000021b0| 74 68 65 20 70 61 74 69 | 65 6e 74 73 20 67 69 76 |the pati|ents giv|
|000021c0| 65 6e 20 61 6e 74 69 74 | 68 79 72 6f 69 64 20 64 |en antit|hyroid d|
|000021d0| 72 75 67 0d 0a 74 68 65 | 72 61 70 79 2c 20 62 75 |rug..the|rapy, bu|
|000021e0| 74 20 68 79 70 6f 74 68 | 79 72 6f 69 64 69 73 6d |t hypoth|yroidism|
|000021f0| 20 6f 63 63 75 72 72 65 | 64 20 69 6e 20 6f 6e 6c | occurre|d in onl|
|00002200| 79 20 37 2e 20 20 49 6e | 20 74 68 65 20 67 72 6f |y 7. In| the gro|
|00002210| 75 70 20 67 69 76 65 6e | 0d 0a 72 61 64 69 6f 2d |up given|..radio-|
|00002220| 69 6f 64 69 6e 65 20 6f | 6e 6c 79 2c 20 31 32 20 |iodine o|nly, 12 |
|00002230| 70 61 74 69 65 6e 74 73 | 20 65 78 70 65 72 69 65 |patients| experie|
|00002240| 6e 63 65 64 20 72 65 6c | 61 70 73 65 20 62 75 74 |nced rel|apse but|
|00002250| 20 68 79 70 6f 74 68 79 | 72 6f 69 64 69 73 6d 20 | hypothy|roidism |
|00002260| 6f 63 63 75 72 72 65 64 | 0d 0a 69 6e 20 32 35 2e |occurred|..in 25.|
|00002270| 20 20 48 79 70 6f 74 68 | 79 72 6f 69 64 69 73 6d | Hypoth|yroidism|
|00002280| 20 77 61 73 20 6d 6f 73 | 74 20 6c 69 6b 65 6c 79 | was mos|t likely|
|00002290| 20 74 6f 20 6f 63 63 75 | 72 20 69 6e 20 68 79 70 | to occu|r in hyp|
|000022a0| 65 72 74 68 79 72 6f 69 | 64 20 70 61 74 69 65 6e |erthyroi|d patien|
|000022b0| 74 73 20 77 69 74 68 0d | 0a 64 69 66 66 75 73 65 |ts with.|.diffuse|
|000022c0| 20 67 6f 69 74 65 72 2e | 20 20 52 65 6c 61 70 73 | goiter.| Relaps|
|000022d0| 65 20 77 61 73 20 6d 6f | 72 65 20 66 72 65 71 75 |e was mo|re frequ|
|000022e0| 65 6e 74 20 77 68 65 6e | 20 61 6e 74 69 74 68 79 |ent when| antithy|
|000022f0| 72 6f 69 64 20 64 72 75 | 67 73 20 77 65 72 65 0d |roid dru|gs were.|
|00002300| 0a 61 64 6d 69 6e 69 73 | 74 65 72 65 64 20 35 2d |.adminis|tered 5-|
|00002310| 37 20 64 61 79 73 20 61 | 66 74 65 72 20 72 61 64 |7 days a|fter rad|
|00002320| 69 6f 69 6f 64 69 6e 65 | 20 74 68 61 6e 20 77 68 |ioiodine| than wh|
|00002330| 65 6e 20 74 68 65 79 20 | 77 65 72 65 20 67 69 76 |en they |were giv|
|00002340| 65 6e 20 61 66 74 65 72 | 20 37 20 64 61 79 73 0d |en after| 7 days.|
|00002350| 0a 28 74 61 62 6c 65 29 | 2e 0d 0a 20 20 20 20 20 |.(table)|... |
|00002360| 41 6e 74 69 74 68 79 72 | 6f 69 64 20 64 72 75 67 |Antithyr|oid drug|
|00002370| 73 20 61 64 6d 69 6e 69 | 73 74 65 72 65 64 20 77 |s admini|stered w|
|00002380| 69 74 68 69 6e 20 61 20 | 77 65 65 6b 20 61 66 74 |ithin a |week aft|
|00002390| 65 72 20 72 61 64 69 6f | 69 6f 64 69 6e 65 20 74 |er radio|iodine t|
|000023a0| 68 65 72 61 70 79 0d 0a | 61 72 65 20 61 73 73 6f |herapy..|are asso|
|000023b0| 63 69 61 74 65 64 20 77 | 69 74 68 20 61 20 6c 6f |ciated w|ith a lo|
|000023c0| 77 65 72 20 72 61 74 65 | 20 6f 66 20 68 79 70 6f |wer rate| of hypo|
|000023d0| 74 68 79 72 6f 69 64 69 | 73 6d 20 62 75 74 20 6d |thyroidi|sm but m|
|000023e0| 6f 72 65 20 66 72 65 71 | 75 65 6e 74 20 72 65 6c |ore freq|uent rel|
|000023f0| 61 70 73 65 0d 0a 6f 66 | 20 68 79 70 65 72 74 68 |apse..of| hyperth|
|00002400| 79 72 6f 69 64 69 73 6d | 2e 20 20 4f 6e 6c 79 20 |yroidism|. Only |
|00002410| 61 64 6a 75 6e 63 74 69 | 76 65 20 6d 65 64 69 63 |adjuncti|ve medic|
|00002420| 61 6c 20 74 68 65 72 61 | 70 79 20 65 78 70 6c 61 |al thera|py expla|
|00002430| 69 6e 65 64 20 74 68 65 | 20 6d 6f 72 65 0d 0a 66 |ined the| more..f|
|00002440| 72 65 71 75 65 6e 74 20 | 72 65 63 75 72 72 65 6e |requent |recurren|
|00002450| 63 65 20 6f 72 20 70 65 | 72 73 69 73 74 65 6e 63 |ce or pe|rsistenc|
|00002460| 65 20 6f 66 20 68 79 70 | 65 72 74 68 79 72 6f 69 |e of hyp|erthyroi|
|00002470| 64 69 73 6d 2e 0d 0a 0d | 0a 50 6f 73 74 2d 43 6f |dism....|.Post-Co|
|00002480| 6d 6d 65 6e 74 0d 0a 0d | 0a 20 20 20 20 20 54 68 |mment...|. Th|
|00002490| 69 73 20 73 65 72 65 6e | 64 69 70 69 74 6f 75 73 |is seren|dipitous|
|000024a0| 20 70 72 6f 73 70 65 63 | 74 69 76 65 20 65 78 70 | prospec|tive exp|
|000024b0| 65 72 69 6d 65 6e 74 20 | 67 69 76 65 73 20 73 6f |eriment |gives so|
|000024c0| 6d 65 20 73 74 61 74 69 | 73 74 69 63 61 6c 20 73 |me stati|stical s|
|000024d0| 75 70 70 6f 72 74 0d 0a | 74 6f 20 74 68 65 20 67 |upport..|to the g|
|000024e0| 65 6e 65 72 61 6c 20 6f | 62 73 65 72 76 61 74 69 |eneral o|bservati|
|000024f0| 6f 6e 20 74 68 61 74 20 | 70 61 74 69 65 6e 74 73 |on that |patients|
|00002500| 20 69 6e 20 77 68 6f 6d | 20 61 6e 74 69 74 68 79 | in whom| antithy|
|00002510| 72 6f 69 64 20 6d 65 64 | 69 63 61 74 69 6f 6e 73 |roid med|ications|
|00002520| 20 61 72 65 0d 0a 72 65 | 69 6e 73 74 69 74 75 74 | are..re|institut|
|00002530| 65 64 20 77 69 74 68 69 | 6e 20 61 20 77 65 65 6b |ed withi|n a week|
|00002540| 20 6f 66 20 72 61 64 69 | 6f 69 6f 64 69 6e 65 20 | of radi|oiodine |
|00002550| 74 72 65 61 74 6d 65 6e | 74 20 68 61 76 65 20 61 |treatmen|t have a|
|00002560| 20 68 69 67 68 65 72 20 | 69 6e 63 69 64 65 6e 63 | higher |incidenc|
|00002570| 65 20 6f 66 0d 0a 70 65 | 72 73 69 73 74 65 6e 74 |e of..pe|rsistent|
|00002580| 20 68 79 70 65 72 74 68 | 79 72 6f 69 64 69 73 6d | hyperth|yroidism|
|00002590| 2e 20 20 53 6f 6d 65 20 | 65 6e 64 6f 63 72 69 6e |. Some |endocrin|
|000025a0| 6f 6c 6f 67 69 73 74 73 | 20 68 61 76 65 20 61 20 |ologists| have a |
|000025b0| 64 65 63 69 64 65 64 20 | 62 69 61 73 20 74 6f 77 |decided |bias tow|
|000025c0| 61 72 64 0d 0a 72 65 73 | 75 6d 69 6e 67 20 61 6e |ard..res|uming an|
|000025d0| 74 69 74 68 79 72 6f 69 | 64 20 64 72 75 67 73 20 |tithyroi|d drugs |
|000025e0| 77 69 74 68 69 6e 20 74 | 68 69 73 20 74 69 6d 65 |within t|his time|
|000025f0| 20 69 6e 74 65 72 76 61 | 6c 2e 20 20 54 68 65 20 | interva|l. The |
|00002600| 61 75 74 68 6f 72 73 20 | 61 64 76 69 73 65 0d 0a |authors |advise..|
|00002610| 74 68 61 74 2c 20 69 6e | 20 73 75 63 68 20 63 61 |that, in| such ca|
|00002620| 73 65 73 2c 20 74 68 65 | 20 72 61 64 69 6f 69 6f |ses, the| radioio|
|00002630| 64 69 6e 65 20 64 6f 73 | 65 20 62 65 20 61 64 6a |dine dos|e be adj|
|00002640| 75 73 74 65 64 2e 20 20 | 47 75 69 64 65 6c 69 6e |usted. |Guidelin|
|00002650| 65 73 20 66 6f 72 20 73 | 75 63 68 0d 0a 61 64 6a |es for s|uch..adj|
|00002660| 75 73 74 6d 65 6e 74 20 | 61 72 65 20 68 69 67 68 |ustment |are high|
|00002670| 6c 79 20 65 6d 70 69 72 | 69 63 2e 2d 2d 50 2e 42 |ly empir|ic.--P.B|
|00002680| 2e 20 48 6f 66 66 65 72 | 2c 20 4d 2e 44 2e 0d 0a |. Hoffer|, M.D...|
|00002690| 24 55 6e 69 71 75 65 5f | 49 44 7b 59 52 42 31 33 |$Unique_|ID{YRB13|
|000026a0| 32 34 33 7d 0d 0a 24 54 | 69 74 6c 65 7b 44 69 61 |243}..$T|itle{Dia|
|000026b0| 67 6e 6f 73 69 73 20 6f | 66 20 41 63 75 74 65 20 |gnosis o|f Acute |
|000026c0| 48 65 72 70 65 73 20 53 | 69 6d 70 6c 65 78 20 45 |Herpes S|implex E|
|000026d0| 6e 63 65 70 68 61 6c 69 | 74 69 73 20 62 79 20 42 |ncephali|tis by B|
|000026e0| 72 61 69 6e 20 50 65 72 | 66 75 73 69 6f 6e 20 53 |rain Per|fusion S|
|000026f0| 69 6e 67 6c 65 20 50 68 | 6f 74 6f 6e 20 45 6d 69 |ingle Ph|oton Emi|
|00002700| 73 73 69 6f 6e 20 43 6f | 6d 70 75 74 65 64 20 54 |ssion Co|mputed T|
|00002710| 6f 6d 6f 67 72 61 70 68 | 79 7d 0d 0a 24 41 75 74 |omograph|y}..$Aut|
|00002720| 68 6f 72 7b 4c 61 75 6e | 65 73 2c 20 4a 0d 0a 4e |hor{Laun|es, J..N|
|00002730| 69 6b 6b 69 6e 65 6e 2c | 20 50 0d 0a 4c 69 6e 64 |ikkinen,| P..Lind|
|00002740| 72 6f 74 68 2c 20 4c 0d | 0a 42 72 6f 77 6e 65 6c |roth, L.|.Brownel|
|00002750| 6c 2c 20 41 2d 4c 0d 0a | 4c 69 65 77 65 6e 64 61 |l, A-L..|Liewenda|
|00002760| 68 6c 2c 20 4b 0d 0a 49 | 69 76 61 6e 61 69 6e 65 |hl, K..I|ivanaine|
|00002770| 6e 2c 20 4d 7d 0d 0a 24 | 41 66 66 69 6c 69 61 74 |n, M}..$|Affiliat|
|00002780| 69 6f 6e 7b 48 65 6c 73 | 69 6e 6b 69 20 55 6e 69 |ion{Hels|inki Uni|
|00002790| 76 20 43 65 6e 74 72 61 | 6c 20 48 6f 73 70 7d 0d |v Centra|l Hosp}.|
|000027a0| 0a 24 4a 6f 75 72 6e 61 | 6c 7b 4c 61 6e 63 65 74 |.$Journa|l{Lancet|
|000027b0| 7d 0d 0a 24 56 6f 6c 75 | 6d 65 7b 31 7d 0d 0a 24 |}..$Volu|me{1}..$|
|000027c0| 50 61 67 65 7b 31 31 38 | 38 2d 31 31 39 31 7d 0d |Page{118|8-1191}.|
|000027d0| 0a 24 44 61 74 65 7b 4d | 61 79 20 32 38 2c 20 31 |.$Date{M|ay 28, 1|
|000027e0| 39 38 38 7d 0d 0a 24 59 | 42 56 6f 6c 7b 31 39 39 |988}..$Y|BVol{199|
|000027f0| 30 20 59 65 61 72 20 42 | 6f 6f 6b 20 6f 66 20 4e |0 Year B|ook of N|
|00002800| 75 63 6c 65 61 72 20 4d | 65 64 69 63 69 6e 65 7d |uclear M|edicine}|
|00002810| 0d 0a 24 43 68 61 70 74 | 65 72 7b 31 35 2d 37 7d |..$Chapt|er{15-7}|
|00002820| 0d 0a 24 59 42 45 64 69 | 74 6f 72 7b 44 72 73 2e |..$YBEdi|tor{Drs.|
|00002830| 20 48 6f 66 66 65 72 2c | 20 47 6f 72 65 2c 20 47 | Hoffer,| Gore, G|
|00002840| 6f 74 74 73 63 68 61 6c | 6b 2c 20 53 6f 73 74 6d |ottschal|k, Sostm|
|00002850| 61 6e 2c 20 5a 61 72 65 | 74 2c 20 61 6e 64 20 5a |an, Zare|t, and Z|
|00002860| 75 62 61 6c 7d 0d 0a 24 | 54 61 62 6c 65 7b 7d 0d |ubal}..$|Table{}.|
|00002870| 0a 24 43 6f 6d 6d 65 6e | 74 61 74 6f 72 7b 41 2e |.$Commen|tator{A.|
|00002880| 20 47 6f 74 74 73 63 68 | 61 6c 6b 2c 20 4d 2e 44 | Gottsch|alk, M.D|
|00002890| 2e 7d 0d 0a 0d 0a 43 6f | 70 79 72 69 67 68 74 20 |.}....Co|pyright |
|000028a0| 28 63 29 20 59 65 61 72 | 62 6f 6f 6b 20 4d 65 64 |(c) Year|book Med|
|000028b0| 69 63 61 6c 20 50 75 62 | 6c 69 73 68 65 72 73 2c |ical Pub|lishers,|
|000028c0| 20 49 6e 63 2e 2c 20 31 | 39 39 30 0d 0a 0d 0a 31 | Inc., 1|990....1|
|000028d0| 39 39 30 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |990 Year| Book of|
|000028e0| 20 4e 75 63 6c 65 61 72 | 20 4d 65 64 69 63 69 6e | Nuclear| Medicin|
|000028f0| 65 20 28 52 29 0d 0a 0d | 0a 43 68 61 70 74 65 72 |e (R)...|.Chapter|
|00002900| 20 31 35 2d 2d 43 65 6e | 74 72 61 6c 20 4e 65 72 | 15--Cen|tral Ner|
|00002910| 76 6f 75 73 20 53 79 73 | 74 65 6d 0d 0a 0d 0a 2d |vous Sys|tem....-|
|00002920| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002930| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002940| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002950| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002960| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 44 |--------|-----..D|
|00002970| 69 61 67 6e 6f 73 69 73 | 20 6f 66 20 41 63 75 74 |iagnosis| of Acut|
|00002980| 65 20 48 65 72 70 65 73 | 20 53 69 6d 70 6c 65 78 |e Herpes| Simplex|
|00002990| 20 45 6e 63 65 70 68 61 | 6c 69 74 69 73 20 62 79 | Encepha|litis by|
|000029a0| 20 42 72 61 69 6e 20 50 | 65 72 66 75 73 69 6f 6e | Brain P|erfusion|
|000029b0| 20 53 69 6e 67 6c 65 0d | 0a 50 68 6f 74 6f 6e 20 | Single.|.Photon |
|000029c0| 45 6d 69 73 73 69 6f 6e | 20 43 6f 6d 70 75 74 65 |Emission| Compute|
|000029d0| 64 20 54 6f 6d 6f 67 72 | 61 70 68 79 0d 0a 0d 0a |d Tomogr|aphy....|
|000029e0| 4c 61 75 6e 65 73 20 4a | 2c 20 4e 69 6b 6b 69 6e |Launes J|, Nikkin|
|000029f0| 65 6e 20 50 2c 20 4c 69 | 6e 64 72 6f 74 68 20 4c |en P, Li|ndroth L|
|00002a00| 2c 20 42 72 6f 77 6e 65 | 6c 6c 20 41 2d 4c 2c 20 |, Browne|ll A-L, |
|00002a10| 4c 69 65 77 65 6e 64 61 | 68 6c 20 4b 2c 20 49 69 |Liewenda|hl K, Ii|
|00002a20| 76 61 6e 61 69 6e 65 6e | 20 4d 0d 0a 28 48 65 6c |vanainen| M..(Hel|
|00002a30| 73 69 6e 6b 69 20 55 6e | 69 76 20 43 65 6e 74 72 |sinki Un|iv Centr|
|00002a40| 61 6c 20 48 6f 73 70 29 | 0d 0a 4c 61 6e 63 65 74 |al Hosp)|..Lancet|
|00002a50| 20 31 3a 31 31 38 38 2d | 31 31 39 31 2c 20 4d 61 | 1:1188-|1191, Ma|
|00002a60| 79 20 32 38 2c 20 31 39 | 38 38 0d 0a 2d 2d 2d 2d |y 28, 19|88..----|
|00002a70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002a80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002a90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002aa0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002ab0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 0d 0a 0d 0a 41 62 |--------|--....Ab|
|00002ac0| 73 74 72 61 63 74 0d 0a | 0d 0a 20 20 20 20 20 54 |stract..|.. T|
|00002ad0| 68 65 20 63 6c 69 6e 69 | 63 61 6c 20 70 69 63 74 |he clini|cal pict|
|00002ae0| 75 72 65 20 6f 66 20 68 | 65 72 70 65 73 20 73 69 |ure of h|erpes si|
|00002af0| 6d 70 6c 65 78 20 76 69 | 72 75 73 20 28 48 53 56 |mplex vi|rus (HSV|
|00002b00| 29 20 65 6e 63 65 70 68 | 61 6c 69 74 69 73 20 6d |) enceph|alitis m|
|00002b10| 61 79 20 62 65 0d 0a 6d | 69 73 6c 65 61 64 69 6e |ay be..m|isleadin|
|00002b20| 67 2c 20 61 6e 64 20 65 | 76 65 6e 20 62 72 61 69 |g, and e|ven brai|
|00002b30| 6e 20 62 69 6f 70 73 79 | 20 72 65 73 75 6c 74 73 |n biopsy| results|
|00002b40| 20 6d 61 79 20 62 65 20 | 66 61 6c 73 65 6c 79 20 | may be |falsely |
|00002b50| 6e 65 67 61 74 69 76 65 | 2e 20 20 42 65 63 61 75 |negative|. Becau|
|00002b60| 73 65 20 6f 66 0d 0a 74 | 68 65 20 69 6d 70 6f 72 |se of..t|he impor|
|00002b70| 74 61 6e 63 65 20 6f 66 | 20 65 61 72 6c 79 20 74 |tance of| early t|
|00002b80| 72 65 61 74 6d 65 6e 74 | 2c 20 74 68 65 20 70 6f |reatment|, the po|
|00002b90| 74 65 6e 74 69 61 6c 20 | 6f 66 20 62 72 61 69 6e |tential |of brain|
|00002ba0| 20 70 65 72 66 75 73 69 | 6f 6e 0d 0a 73 63 69 6e | perfusi|on..scin|
|00002bb0| 74 69 67 72 61 70 68 79 | 20 75 73 69 6e 67 20 53 |tigraphy| using S|
|00002bc0| 50 45 43 54 20 77 61 73 | 20 65 78 61 6d 69 6e 65 |PECT was| examine|
|00002bd0| 64 20 69 6e 20 31 34 20 | 70 61 74 69 65 6e 74 73 |d in 14 |patients|
|00002be0| 20 77 69 74 68 20 76 69 | 72 61 6c 20 65 6e 63 65 | with vi|ral ence|
|00002bf0| 70 68 61 6c 69 74 69 73 | 2e 0d 0a 45 69 74 68 65 |phalitis|...Eithe|
|00002c00| 72 20 31 32 35 2d 49 2d | 69 6f 64 6f 61 6d 70 68 |r 125-I-|iodoamph|
|00002c10| 65 74 61 6d 69 6e 65 20 | 28 49 4d 50 29 20 6f 72 |etamine |(IMP) or|
|00002c20| 20 39 39 6d 2d 54 63 2d | 68 65 78 61 6d 65 74 68 | 99m-Tc-|hexameth|
|00002c30| 79 6c 70 72 6f 70 79 6c | 65 6e 65 61 6d 69 6e 65 |ylpropyl|eneamine|
|00002c40| 20 6f 78 69 6d 65 0d 0a | 28 48 4d 50 41 4f 29 20 | oxime..|(HMPAO) |
|00002c50| 77 61 73 20 75 73 65 64 | 2e 20 20 53 65 76 65 6e |was used|. Seven|
|00002c60| 74 65 65 6e 20 53 50 45 | 43 54 20 73 74 75 64 69 |teen SPE|CT studi|
|00002c70| 65 73 20 77 65 72 65 20 | 70 65 72 66 6f 72 6d 65 |es were |performe|
|00002c80| 64 20 69 6e 20 36 20 70 | 61 74 69 65 6e 74 73 20 |d in 6 p|atients |
|00002c90| 77 69 74 68 0d 0a 48 53 | 56 20 65 6e 63 65 70 68 |with..HS|V enceph|
|00002ca0| 61 6c 69 74 69 73 2c 20 | 61 6e 64 20 31 30 20 73 |alitis, |and 10 s|
|00002cb0| 74 75 64 69 65 73 20 77 | 65 72 65 20 70 65 72 66 |tudies w|ere perf|
|00002cc0| 6f 72 6d 65 64 20 69 6e | 20 38 20 70 61 74 69 65 |ormed in| 8 patie|
|00002cd0| 6e 74 73 20 77 69 74 68 | 20 6e 6f 6e 2d 48 53 56 |nts with| non-HSV|
|00002ce0| 0d 0a 65 6e 63 65 70 68 | 61 6c 69 74 69 73 2e 20 |..enceph|alitis. |
|00002cf0| 20 41 6c 6c 20 70 61 74 | 69 65 6e 74 73 20 72 65 | All pat|ients re|
|00002d00| 63 65 69 76 65 64 20 61 | 63 79 63 6c 6f 76 69 72 |ceived a|cyclovir|
|00002d10| 20 74 68 65 72 61 70 79 | 2e 0d 0a 20 20 20 20 20 | therapy|... |
|00002d20| 41 6c 6c 20 70 61 74 69 | 65 6e 74 73 20 77 69 74 |All pati|ents wit|
|00002d30| 68 20 48 53 56 20 65 6e | 63 65 70 68 61 6c 69 74 |h HSV en|cephalit|
|00002d40| 69 73 20 68 61 64 20 61 | 6e 20 61 72 65 61 20 6f |is had a|n area o|
|00002d50| 66 20 69 6e 63 72 65 61 | 73 65 64 20 74 72 61 63 |f increa|sed trac|
|00002d60| 65 72 20 75 70 74 61 6b | 65 0d 0a 69 6e 20 74 68 |er uptak|e..in th|
|00002d70| 65 20 61 66 66 65 63 74 | 65 64 20 74 65 6d 70 6f |e affect|ed tempo|
|00002d80| 72 61 6c 20 6c 6f 62 65 | 20 6f 6e 20 69 6e 69 74 |ral lobe| on init|
|00002d90| 69 61 6c 20 53 50 45 43 | 54 20 73 74 75 64 79 2e |ial SPEC|T study.|
|00002da0| 20 20 48 79 70 65 72 70 | 65 72 66 75 73 69 6f 6e | Hyperp|erfusion|
|00002db0| 0d 0a 69 6e 63 72 65 61 | 73 65 64 20 73 75 62 73 |..increa|sed subs|
|00002dc0| 65 71 75 65 6e 74 6c 79 | 20 69 6e 20 32 20 70 61 |equently| in 2 pa|
|00002dd0| 74 69 65 6e 74 73 2c 20 | 62 75 74 20 68 79 70 6f |tients, |but hypo|
|00002de0| 70 65 72 66 75 73 69 6f | 6e 20 66 6f 6c 6c 6f 77 |perfusio|n follow|
|00002df0| 65 64 20 74 68 65 0d 0a | 68 79 70 65 72 70 65 72 |ed the..|hyperper|
|00002e00| 66 75 73 69 6f 6e 20 73 | 74 61 67 65 2c 20 73 74 |fusion s|tage, st|
|00002e10| 61 72 74 69 6e 67 20 33 | 37 20 64 61 79 73 20 61 |arting 3|7 days a|
|00002e20| 66 74 65 72 20 69 6e 69 | 74 69 61 6c 20 73 79 6d |fter ini|tial sym|
|00002e30| 70 74 6f 6d 73 20 6f 66 | 20 65 6e 63 65 70 68 61 |ptoms of| encepha|
|00002e40| 6c 69 74 69 73 2e 0d 0a | 4e 6f 20 70 61 74 69 65 |litis...|No patie|
|00002e50| 6e 74 20 77 69 74 68 20 | 6e 6f 6e 2d 48 53 56 20 |nt with |non-HSV |
|00002e60| 65 6e 63 65 70 68 61 6c | 69 74 69 73 20 68 61 64 |encephal|itis had|
|00002e70| 20 66 6f 63 61 6c 20 68 | 79 70 65 72 70 65 72 66 | focal h|yperperf|
|00002e80| 75 73 69 6f 6e 20 69 6e | 20 74 68 65 20 66 69 72 |usion in| the fir|
|00002e90| 73 74 20 32 0d 0a 77 65 | 65 6b 73 2e 20 20 49 6e |st 2..we|eks. In|
|00002ea0| 69 74 69 61 6c 20 43 54 | 20 73 74 75 64 69 65 73 |itial CT| studies|
|00002eb0| 20 77 65 72 65 20 6e 6f | 72 6d 61 6c 20 69 6e 20 | were no|rmal in |
|00002ec0| 61 6c 6c 20 70 61 74 69 | 65 6e 74 73 2c 20 61 6e |all pati|ents, an|
|00002ed0| 64 20 32 20 70 61 74 69 | 65 6e 74 73 20 77 69 74 |d 2 pati|ents wit|
|00002ee0| 68 0d 0a 48 53 56 20 65 | 6e 63 65 70 68 61 6c 69 |h..HSV e|ncephali|
|00002ef0| 74 69 73 20 68 61 64 20 | 6e 6f 72 6d 61 6c 20 66 |tis had |normal f|
|00002f00| 69 6e 64 69 6e 67 73 20 | 6f 6e 20 63 6f 6e 76 65 |indings |on conve|
|00002f10| 6e 74 69 6f 6e 61 6c 20 | 73 63 69 6e 74 69 67 72 |ntional |scintigr|
|00002f20| 61 6d 73 20 64 75 72 69 | 6e 67 20 74 68 65 0d 0a |ams duri|ng the..|
|00002f30| 74 69 6d 65 20 77 68 65 | 6e 20 53 50 45 43 54 20 |time whe|n SPECT |
|00002f40| 64 65 6d 6f 6e 73 74 72 | 61 74 65 64 20 68 79 70 |demonstr|ated hyp|
|00002f50| 65 72 70 65 72 66 75 73 | 69 6f 6e 2e 0d 0a 20 20 |erperfus|ion... |
|00002f60| 20 20 20 41 63 79 63 6c | 6f 76 69 72 20 74 68 65 | Acycl|ovir the|
|00002f70| 72 61 70 79 20 73 68 6f | 75 6c 64 20 62 65 20 73 |rapy sho|uld be s|
|00002f80| 74 61 72 74 65 64 20 77 | 68 65 6e 20 48 53 56 20 |tarted w|hen HSV |
|00002f90| 65 6e 63 65 70 68 61 6c | 69 74 69 73 20 69 73 20 |encephal|itis is |
|00002fa0| 73 75 73 70 65 63 74 65 | 64 2e 0d 0a 54 68 65 20 |suspecte|d...The |
|00002fb0| 75 73 65 20 6f 66 20 63 | 6f 6e 74 72 61 73 74 20 |use of c|ontrast |
|00002fc0| 6d 61 74 65 72 69 61 6c | 20 69 6e 20 53 50 45 43 |material| in SPEC|
|00002fd0| 54 20 69 73 20 68 65 6c | 70 66 75 6c 20 69 6e 20 |T is hel|pful in |
|00002fe0| 64 69 73 74 69 6e 67 75 | 69 73 68 69 6e 67 20 48 |distingu|ishing H|
|00002ff0| 53 56 0d 0a 65 6e 63 65 | 70 68 61 6c 69 74 69 73 |SV..ence|phalitis|
|00003000| 20 66 72 6f 6d 20 63 6c | 69 6e 69 63 61 6c 6c 79 | from cl|inically|
|00003010| 20 73 69 6d 69 6c 61 72 | 20 73 74 61 74 65 73 2e | similar| states.|
|00003020| 20 20 48 6f 77 65 76 65 | 72 2c 20 61 63 79 63 6c | Howeve|r, acycl|
|00003030| 6f 76 69 72 20 74 68 65 | 72 61 70 79 0d 0a 73 68 |ovir the|rapy..sh|
|00003040| 6f 75 6c 64 20 6e 6f 74 | 20 62 65 20 64 69 73 63 |ould not| be disc|
|00003050| 6f 6e 74 69 6e 75 65 64 | 20 69 66 20 53 50 45 43 |ontinued| if SPEC|
|00003060| 54 20 66 61 69 6c 73 20 | 74 6f 20 64 65 6d 6f 6e |T fails |to demon|
|00003070| 73 74 72 61 74 65 20 66 | 6f 63 61 6c 20 61 62 6e |strate f|ocal abn|
|00003080| 6f 72 6d 61 6c 69 74 79 | 2e 0d 0a 0d 0a 50 6f 73 |ormality|.....Pos|
|00003090| 74 2d 43 6f 6d 6d 65 6e | 74 0d 0a 0d 0a 20 20 20 |t-Commen|t.... |
|000030a0| 20 20 54 68 69 73 20 69 | 6e 74 72 69 67 75 65 64 | This i|ntrigued|
|000030b0| 20 75 73 20 62 65 63 61 | 75 73 65 20 6d 6f 73 74 | us beca|use most|
|000030c0| 20 6f 66 20 74 68 65 20 | 6c 65 73 69 6f 6e 73 20 | of the |lesions |
|000030d0| 77 65 20 75 73 75 61 6c | 6c 79 20 73 65 65 20 77 |we usual|ly see w|
|000030e0| 69 74 68 20 53 50 45 43 | 54 0d 0a 61 72 65 20 64 |ith SPEC|T..are d|
|000030f0| 65 6d 6f 6e 73 74 72 61 | 74 65 64 20 61 73 20 63 |emonstra|ted as c|
|00003100| 65 72 65 62 72 61 6c 20 | 70 65 72 66 75 73 69 6f |erebral |perfusio|
|00003110| 6e 20 64 65 66 65 63 74 | 73 2e 20 20 46 75 72 74 |n defect|s. Furt|
|00003120| 68 65 72 6d 6f 72 65 2c | 20 77 65 20 61 72 65 20 |hermore,| we are |
|00003130| 6f 6c 64 0d 0a 65 6e 6f | 75 67 68 20 74 6f 20 72 |old..eno|ugh to r|
|00003140| 65 6d 65 6d 62 65 72 20 | 74 68 61 74 20 74 68 65 |emember |that the|
|00003150| 20 66 6c 6f 77 20 73 74 | 75 64 79 20 6f 6e 20 74 | flow st|udy on t|
|00003160| 68 65 20 6f 6c 64 20 70 | 65 72 74 65 63 68 6e 65 |he old p|ertechne|
|00003170| 74 61 74 65 20 62 72 61 | 69 6e 20 73 63 61 6e 20 |tate bra|in scan |
|00003180| 77 61 73 0d 0a 22 68 6f | 74 22 20 77 69 74 68 20 |was.."ho|t" with |
|00003190| 68 65 72 70 65 73 2c 20 | 61 20 6e 69 63 65 20 63 |herpes, |a nice c|
|000031a0| 6f 72 72 65 6c 61 74 69 | 6f 6e 20 74 6f 20 74 68 |orrelati|on to th|
|000031b0| 65 73 65 20 66 69 6e 64 | 69 6e 67 73 2e 20 20 41 |ese find|ings. A|
|000031c0| 6c 74 68 6f 75 67 68 20 | 77 65 20 77 65 72 65 0d |lthough |we were.|
|000031d0| 0a 75 6e 64 65 72 77 68 | 65 6c 6d 65 64 20 62 79 |.underwh|elmed by|
|000031e0| 20 74 68 65 20 69 6d 61 | 67 65 73 20 69 6e 20 74 | the ima|ges in t|
|000031f0| 68 65 20 6f 72 69 67 69 | 6e 61 6c 20 61 72 74 69 |he origi|nal arti|
|00003200| 63 6c 65 2c 20 74 68 65 | 79 20 64 6f 20 6d 61 6b |cle, the|y do mak|
|00003210| 65 20 74 68 65 20 70 6f | 69 6e 74 2e 2d 2d 0d 0a |e the po|int.--..|
|00003220| 41 2e 20 47 6f 74 74 73 | 63 68 61 6c 6b 2c 20 4d |A. Gotts|chalk, M|
|00003230| 2e 44 2e 0d 0a 24 55 6e | 69 71 75 65 5f 49 44 7b |.D...$Un|ique_ID{|
|00003240| 59 52 42 31 33 32 35 30 | 7d 0d 0a 24 54 69 74 6c |YRB13250|}..$Titl|
|00003250| 65 7b 50 61 73 73 69 76 | 65 20 53 6d 6f 6b 69 6e |e{Passiv|e Smokin|
|00003260| 67 20 6f 6e 20 43 6f 6d | 6d 65 72 63 69 61 6c 20 |g on Com|mercial |
|00003270| 41 69 72 6c 69 6e 65 20 | 46 6c 69 67 68 74 73 7d |Airline |Flights}|
|00003280| 0d 0a 24 41 75 74 68 6f | 72 7b 4d 61 74 74 73 6f |..$Autho|r{Mattso|
|00003290| 6e 2c 20 4d 45 0d 0a 42 | 6f 79 64 2c 20 47 0d 0a |n, ME..B|oyd, G..|
|000032a0| 42 79 61 72 2c 20 44 0d | 0a 42 72 6f 77 6e 2c 20 |Byar, D.|.Brown, |
|000032b0| 43 0d 0a 43 61 6c 6c 61 | 68 61 6e 2c 20 4a 46 0d |C..Calla|han, JF.|
|000032c0| 0a 43 6f 72 6c 65 2c 20 | 44 0d 0a 43 75 6c 6c 65 |.Corle, |D..Culle|
|000032d0| 6e 2c 20 4a 57 0d 0a 47 | 72 65 65 6e 62 6c 61 74 |n, JW..G|reenblat|
|000032e0| 74 2c 20 4a 0d 0a 48 61 | 6c 65 79 2c 20 4e 4a 0d |t, J..Ha|ley, NJ.|
|000032f0| 0a 48 61 6d 6d 6f 6e 64 | 2c 20 53 4b 0d 0a 4c 65 |.Hammond|, SK..Le|
|00003300| 77 74 61 73 2c 20 4a 0d | 0a 52 65 65 76 65 73 2c |wtas, J.|.Reeves,|
|00003310| 20 57 7d 0d 0a 24 41 66 | 66 69 6c 69 61 74 69 6f | W}..$Af|filiatio|
|00003320| 6e 7b 4e 61 74 6c 20 43 | 61 6e 63 65 72 20 49 6e |n{Natl C|ancer In|
|00003330| 73 74 2c 20 42 65 74 68 | 65 73 64 61 2c 20 4d 64 |st, Beth|esda, Md|
|00003340| 3b 20 50 72 6f 73 70 65 | 63 74 20 41 73 73 6f 63 |; Prospe|ct Assoc|
|00003350| 69 61 74 65 73 2c 20 52 | 6f 63 6b 76 69 6c 6c 65 |iates, R|ockville|
|00003360| 2c 20 4d 64 3b 20 41 6d | 65 72 69 63 61 6e 20 48 |, Md; Am|erican H|
|00003370| 65 61 6c 74 68 20 46 6f | 75 6e 64 2c 20 56 61 6c |ealth Fo|und, Val|
|00003380| 68 61 6c 6c 61 2c 20 4e | 59 3b 20 55 6e 69 76 20 |halla, N|Y; Univ |
|00003390| 6f 66 20 4d 61 73 73 61 | 63 68 75 73 65 74 74 73 |of Massa|chusetts|
|000033a0| 2c 20 57 6f 72 63 65 73 | 74 65 72 3b 20 45 6e 76 |, Worces|ter; Env|
|000033b0| 69 72 6f 6e 6d 65 6e 74 | 61 6c 20 50 72 6f 74 65 |ironment|al Prote|
|000033c0| 63 74 69 6f 6e 20 41 67 | 65 6e 63 79 2c 20 52 65 |ction Ag|ency, Re|
|000033d0| 73 65 61 72 63 68 20 54 | 72 69 61 6e 67 6c 65 20 |search T|riangle |
|000033e0| 50 61 72 6b 2c 20 4e 43 | 3b 20 65 74 20 61 6c 7d |Park, NC|; et al}|
|000033f0| 0d 0a 24 4a 6f 75 72 6e | 61 6c 7b 4a 41 4d 41 7d |..$Journ|al{JAMA}|
|00003400| 0d 0a 24 56 6f 6c 75 6d | 65 7b 32 36 31 7d 0d 0a |..$Volum|e{261}..|
|00003410| 24 50 61 67 65 7b 38 36 | 37 2d 38 37 32 7d 0d 0a |$Page{86|7-872}..|
|00003420| 24 44 61 74 65 7b 46 65 | 62 20 31 30 2c 20 31 39 |$Date{Fe|b 10, 19|
|00003430| 38 39 7d 0d 0a 24 59 42 | 56 6f 6c 7b 31 39 39 30 |89}..$YB|Vol{1990|
|00003440| 20 59 65 61 72 20 42 6f | 6f 6b 20 6f 66 20 4f 63 | Year Bo|ok of Oc|
|00003450| 63 75 70 61 74 69 6f 6e | 61 6c 20 61 6e 64 20 45 |cupation|al and E|
|00003460| 6e 76 69 72 6f 6e 6d 65 | 6e 74 61 6c 20 4d 65 64 |nvironme|ntal Med|
|00003470| 69 63 69 6e 65 7d 0d 0a | 24 43 68 61 70 74 65 72 |icine}..|$Chapter|
|00003480| 7b 31 2d 36 7d 0d 0a 24 | 59 42 45 64 69 74 6f 72 |{1-6}..$|YBEditor|
|00003490| 7b 44 72 73 2e 20 45 6d | 6d 65 74 74 2c 20 42 72 |{Drs. Em|mett, Br|
|000034a0| 6f 6f 6b 73 2c 20 48 61 | 72 72 69 73 2c 20 61 6e |ooks, Ha|rris, an|
|000034b0| 64 20 53 63 68 65 6e 6b | 65 72 7d 0d 0a 24 54 61 |d Schenk|er}..$Ta|
|000034c0| 62 6c 65 7b 7d 0d 0a 24 | 43 6f 6d 6d 65 6e 74 61 |ble{}..$|Commenta|
|000034d0| 74 6f 72 7b 53 2e 4d 2e | 20 42 72 6f 6f 6b 73 2c |tor{S.M.| Brooks,|
|000034e0| 20 4d 2e 44 2e 7d 0d 0a | 0d 0a 43 6f 70 79 72 69 | M.D.}..|..Copyri|
|000034f0| 67 68 74 20 28 63 29 20 | 59 65 61 72 62 6f 6f 6b |ght (c) |Yearbook|
|00003500| 20 4d 65 64 69 63 61 6c | 20 50 75 62 6c 69 73 68 | Medical| Publish|
|00003510| 65 72 73 2c 20 49 6e 63 | 2e 2c 20 31 39 39 30 0d |ers, Inc|., 1990.|
|00003520| 0a 0d 0a 31 39 39 30 20 | 59 65 61 72 20 42 6f 6f |...1990 |Year Boo|
|00003530| 6b 20 6f 66 20 4f 63 63 | 75 70 61 74 69 6f 6e 61 |k of Occ|upationa|
|00003540| 6c 20 61 6e 64 20 45 6e | 76 69 72 6f 6e 6d 65 6e |l and En|vironmen|
|00003550| 74 61 6c 20 4d 65 64 69 | 63 69 6e 65 20 28 52 29 |tal Medi|cine (R)|
|00003560| 0d 0a 0d 0a 43 68 61 70 | 74 65 72 20 31 2d 2d 52 |....Chap|ter 1--R|
|00003570| 65 73 70 69 72 61 74 6f | 72 79 20 53 79 73 74 65 |espirato|ry Syste|
|00003580| 6d 0d 0a 0d 0a 45 6e 76 | 69 72 6f 6e 6d 65 6e 74 |m....Env|ironment|
|00003590| 61 6c 20 43 69 67 61 72 | 65 74 74 65 20 53 6d 6f |al Cigar|ette Smo|
|000035a0| 6b 69 6e 67 0d 0a 0d 0a | 2d 2d 2d 2d 2d 2d 2d 2d |king....|--------|
|000035b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000035c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000035d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000035e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000035f0| 2d 2d 2d 2d 2d 2d 0d 0a | 50 61 73 73 69 76 65 20 |------..|Passive |
|00003600| 53 6d 6f 6b 69 6e 67 20 | 6f 6e 20 43 6f 6d 6d 65 |Smoking |on Comme|
|00003610| 72 63 69 61 6c 20 41 69 | 72 6c 69 6e 65 20 46 6c |rcial Ai|rline Fl|
|00003620| 69 67 68 74 73 0d 0a 0d | 0a 4d 61 74 74 73 6f 6e |ights...|.Mattson|
|00003630| 20 4d 45 2c 20 42 6f 79 | 64 20 47 2c 20 42 79 61 | ME, Boy|d G, Bya|
|00003640| 72 20 44 2c 20 42 72 6f | 77 6e 20 43 2c 20 43 61 |r D, Bro|wn C, Ca|
|00003650| 6c 6c 61 68 61 6e 20 4a | 46 2c 20 43 6f 72 6c 65 |llahan J|F, Corle|
|00003660| 20 44 2c 20 43 75 6c 6c | 65 6e 20 4a 57 2c 0d 0a | D, Cull|en JW,..|
|00003670| 47 72 65 65 6e 62 6c 61 | 74 74 20 4a 2c 20 48 61 |Greenbla|tt J, Ha|
|00003680| 6c 65 79 20 4e 4a 2c 20 | 48 61 6d 6d 6f 6e 64 20 |ley NJ, |Hammond |
|00003690| 53 4b 2c 20 4c 65 77 74 | 61 73 20 4a 2c 20 52 65 |SK, Lewt|as J, Re|
|000036a0| 65 76 65 73 20 57 0d 0a | 28 4e 61 74 6c 20 43 61 |eves W..|(Natl Ca|
|000036b0| 6e 63 65 72 20 49 6e 73 | 74 2c 20 42 65 74 68 65 |ncer Ins|t, Bethe|
|000036c0| 73 64 61 2c 20 4d 64 3b | 20 50 72 6f 73 70 65 63 |sda, Md;| Prospec|
|000036d0| 74 20 41 73 73 6f 63 69 | 61 74 65 73 2c 20 52 6f |t Associ|ates, Ro|
|000036e0| 63 6b 76 69 6c 6c 65 2c | 20 4d 64 3b 20 41 6d 65 |ckville,| Md; Ame|
|000036f0| 72 69 63 61 6e 0d 0a 48 | 65 61 6c 74 68 20 46 6f |rican..H|ealth Fo|
|00003700| 75 6e 64 2c 20 56 61 6c | 68 61 6c 6c 61 2c 20 4e |und, Val|halla, N|
|00003710| 59 3b 20 55 6e 69 76 20 | 6f 66 20 4d 61 73 73 61 |Y; Univ |of Massa|
|00003720| 63 68 75 73 65 74 74 73 | 2c 20 57 6f 72 63 65 73 |chusetts|, Worces|
|00003730| 74 65 72 3b 20 45 6e 76 | 69 72 6f 6e 6d 65 6e 74 |ter; Env|ironment|
|00003740| 61 6c 0d 0a 50 72 6f 74 | 65 63 74 69 6f 6e 20 41 |al..Prot|ection A|
|00003750| 67 65 6e 63 79 2c 20 52 | 65 73 65 61 72 63 68 20 |gency, R|esearch |
|00003760| 54 72 69 61 6e 67 6c 65 | 20 50 61 72 6b 2c 20 4e |Triangle| Park, N|
|00003770| 43 3b 20 65 74 20 61 6c | 29 0d 0a 4a 41 4d 41 20 |C; et al|)..JAMA |
|00003780| 32 36 31 3a 38 36 37 2d | 38 37 32 2c 20 46 65 62 |261:867-|872, Feb|
|00003790| 20 31 30 2c 20 31 39 38 | 39 0d 0a 2d 2d 2d 2d 2d | 10, 198|9..-----|
|000037a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000037b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000037c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000037d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000037e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 0d 0a 0d 0a 41 62 73 |--------|-....Abs|
|000037f0| 74 72 61 63 74 0d 0a 0d | 0a 20 20 20 20 20 54 68 |tract...|. Th|
|00003800| 65 72 65 20 61 72 65 20 | 6e 6f 20 73 74 61 6e 64 |ere are |no stand|
|00003810| 61 72 64 73 20 66 6f 72 | 20 72 65 67 75 6c 61 74 |ards for| regulat|
|00003820| 69 6e 67 20 6c 69 6d 69 | 74 73 20 6f 6e 20 70 6f |ing limi|ts on po|
|00003830| 6c 6c 75 74 61 6e 74 73 | 20 74 68 61 74 20 61 66 |llutants| that af|
|00003840| 66 65 63 74 0d 0a 61 69 | 72 20 71 75 61 6c 69 74 |fect..ai|r qualit|
|00003850| 79 20 69 6e 20 61 69 72 | 70 6c 61 6e 65 73 2e 20 |y in air|planes. |
|00003860| 20 49 6e 2d 66 6c 69 67 | 68 74 20 65 78 70 6f 73 | In-flig|ht expos|
|00003870| 75 72 65 20 74 6f 20 6e | 69 63 6f 74 69 6e 65 2c |ure to n|icotine,|
|00003880| 20 75 72 69 6e 61 72 79 | 20 63 6f 74 69 6e 69 6e | urinary| cotinin|
|00003890| 65 0d 0a 6c 65 76 65 6c | 73 2c 20 61 6e 64 20 73 |e..level|s, and s|
|000038a0| 79 6d 70 74 6f 6d 73 20 | 77 65 72 65 20 65 78 61 |ymptoms |were exa|
|000038b0| 6d 69 6e 65 64 20 69 6e | 20 35 20 70 61 73 73 65 |mined in| 5 passe|
|000038c0| 6e 67 65 72 73 20 61 6e | 64 20 34 20 61 74 74 65 |ngers an|d 4 atte|
|000038d0| 6e 64 61 6e 74 73 20 6f | 6e 20 34 0d 0a 63 6f 6d |ndants o|n 4..com|
|000038e0| 6d 65 72 63 69 61 6c 20 | 66 6c 69 67 68 74 73 20 |mercial |flights |
|000038f0| 6c 61 73 74 69 6e 67 20 | 61 62 6f 75 74 20 34 20 |lasting |about 4 |
|00003900| 68 6f 75 72 73 20 65 61 | 63 68 2e 20 20 50 65 72 |hours ea|ch. Per|
|00003910| 73 6f 6e 61 6c 20 65 78 | 70 6f 73 75 72 65 20 6d |sonal ex|posure m|
|00003920| 6f 6e 69 74 6f 72 73 0d | 0a 77 65 72 65 20 75 73 |onitors.|.were us|
|00003930| 65 64 20 74 6f 20 6d 6f | 6e 69 74 6f 72 20 6e 69 |ed to mo|nitor ni|
|00003940| 63 6f 74 69 6e 65 20 65 | 78 70 6f 73 75 72 65 2c |cotine e|xposure,|
|00003950| 20 61 6e 64 20 75 72 69 | 6e 65 20 77 61 73 20 63 | and uri|ne was c|
|00003960| 6f 6c 6c 65 63 74 65 64 | 20 66 6f 72 20 37 32 20 |ollected| for 72 |
|00003970| 68 6f 75 72 73 0d 0a 61 | 66 74 65 72 20 65 61 63 |hours..a|fter eac|
|00003980| 68 20 66 6c 69 67 68 74 | 2e 0d 0a 20 20 20 20 20 |h flight|... |
|00003990| 45 78 70 6f 73 75 72 65 | 20 74 6f 20 6e 69 63 6f |Exposure| to nico|
|000039a0| 74 69 6e 65 20 77 61 73 | 20 71 75 69 74 65 20 76 |tine was| quite v|
|000039b0| 61 72 69 61 62 6c 65 3b | 20 73 6f 6d 65 20 6e 6f |ariable;| some no|
|000039c0| 6e 73 6d 6f 6b 69 6e 67 | 20 61 72 65 61 73 20 72 |nsmoking| areas r|
|000039d0| 65 61 63 68 65 64 0d 0a | 6c 65 76 65 6c 73 20 63 |eached..|levels c|
|000039e0| 6f 6d 70 61 72 61 62 6c | 65 20 74 6f 20 74 68 6f |omparabl|e to tho|
|000039f0| 73 65 20 69 6e 20 74 68 | 65 20 73 6d 6f 6b 69 6e |se in th|e smokin|
|00003a00| 67 20 73 65 63 74 69 6f | 6e 2e 20 20 41 74 74 65 |g sectio|n. Atte|
|00003a10| 6e 64 61 6e 74 73 20 77 | 6f 72 6b 69 6e 67 20 69 |ndants w|orking i|
|00003a20| 6e 0d 0a 6e 6f 6e 73 6d | 6f 6b 69 6e 67 20 61 72 |n..nonsm|oking ar|
|00003a30| 65 61 73 20 77 65 72 65 | 20 6e 6f 74 20 70 72 6f |eas were| not pro|
|00003a40| 74 65 63 74 65 64 20 66 | 72 6f 6d 20 65 78 70 6f |tected f|rom expo|
|00003a50| 73 75 72 65 2e 20 20 42 | 6f 74 68 20 70 61 73 73 |sure. B|oth pass|
|00003a60| 65 6e 67 65 72 73 20 61 | 6e 64 0d 0a 61 74 74 65 |engers a|nd..atte|
|00003a70| 6e 64 61 6e 74 73 20 68 | 61 64 20 6d 65 61 73 75 |ndants h|ad measu|
|00003a80| 72 61 62 6c 65 20 75 72 | 69 6e 61 72 79 20 63 6f |rable ur|inary co|
|00003a90| 74 69 6e 69 6e 65 20 6c | 65 76 65 6c 73 2c 20 62 |tinine l|evels, b|
|00003aa0| 75 74 20 70 61 73 73 65 | 6e 67 65 72 73 20 77 69 |ut passe|ngers wi|
|00003ab0| 74 68 20 74 68 65 0d 0a | 67 72 65 61 74 65 73 74 |th the..|greatest|
|00003ac0| 20 65 78 70 6f 73 75 72 | 65 20 68 61 64 20 74 68 | exposur|e had th|
|00003ad0| 65 20 68 69 67 68 65 73 | 74 20 63 6f 74 69 6e 69 |e highes|t cotini|
|00003ae0| 6e 65 20 6c 65 76 65 6c | 73 2e 20 20 49 6e 2d 66 |ne level|s. In-f|
|00003af0| 6c 69 67 68 74 20 65 78 | 70 6f 73 75 72 65 20 72 |light ex|posure r|
|00003b00| 65 6c 61 74 65 64 0d 0a | 74 6f 20 65 79 65 20 61 |elated..|to eye a|
|00003b10| 6e 64 20 6e 6f 73 65 20 | 73 79 6d 70 74 6f 6d 73 |nd nose |symptoms|
|00003b20| 20 61 73 20 77 65 6c 6c | 20 61 73 20 74 6f 20 6c | as well| as to l|
|00003b30| 61 74 65 72 20 75 72 69 | 6e 61 72 79 20 63 6f 74 |ater uri|nary cot|
|00003b40| 69 6e 69 6e 65 20 65 78 | 63 72 65 74 69 6f 6e 2e |inine ex|cretion.|
|00003b50| 0d 0a 20 20 20 20 20 50 | 61 73 73 65 6e 67 65 72 |.. P|assenger|
|00003b60| 73 20 61 6e 64 20 61 74 | 74 65 6e 64 61 6e 74 73 |s and at|tendants|
|00003b70| 20 6f 6e 20 61 69 72 70 | 6c 61 6e 65 73 20 61 72 | on airp|lanes ar|
|00003b80| 65 20 65 78 70 6f 73 65 | 64 20 74 6f 20 73 6d 6f |e expose|d to smo|
|00003b90| 6b 65 20 61 73 20 69 6e | 20 6f 74 68 65 72 0d 0a |ke as in| other..|
|00003ba0| 63 6c 6f 73 65 64 20 65 | 6e 76 69 72 6f 6e 6d 65 |closed e|nvironme|
|00003bb0| 6e 74 73 20 77 68 65 72 | 65 20 73 6d 6f 6b 69 6e |nts wher|e smokin|
|00003bc0| 67 20 69 73 20 61 6c 6c | 6f 77 65 64 2e 20 20 54 |g is all|owed. T|
|00003bd0| 79 70 65 20 6f 66 20 76 | 65 6e 74 69 6c 61 74 69 |ype of v|entilati|
|00003be0| 6f 6e 20 61 70 70 65 61 | 72 73 20 74 6f 0d 0a 62 |on appea|rs to..b|
|00003bf0| 65 20 61 6e 20 69 6d 70 | 6f 72 74 61 6e 74 20 66 |e an imp|ortant f|
|00003c00| 61 63 74 6f 72 3b 20 70 | 6c 61 6e 65 73 20 77 69 |actor; p|lanes wi|
|00003c10| 74 68 20 31 30 30 25 20 | 66 72 65 73 68 20 61 69 |th 100% |fresh ai|
|00003c20| 72 20 68 61 76 65 20 6c | 6f 77 65 72 20 61 6d 62 |r have l|ower amb|
|00003c30| 69 65 6e 74 20 6e 69 63 | 6f 74 69 6e 65 0d 0a 6c |ient nic|otine..l|
|00003c40| 65 76 65 6c 73 20 74 68 | 61 6e 20 74 68 6f 73 65 |evels th|an those|
|00003c50| 20 77 69 74 68 20 35 30 | 25 20 72 65 63 69 72 63 | with 50|% recirc|
|00003c60| 75 6c 61 74 69 6e 67 20 | 73 79 73 74 65 6d 73 2e |ulating |systems.|
|00003c70| 0d 0a 0d 0a 50 6f 73 74 | 2d 43 6f 6d 6d 65 6e 74 |....Post|-Comment|
|00003c80| 0d 0a 0d 0a 20 20 20 20 | 20 54 68 65 20 4e 61 74 |.... | The Nat|
|00003c90| 69 6f 6e 61 6c 20 41 63 | 61 64 65 6d 79 20 6f 66 |ional Ac|ademy of|
|00003ca0| 20 53 63 69 65 6e 63 65 | 73 20 72 65 76 69 65 77 | Science|s review|
|00003cb0| 65 64 20 64 61 74 61 20 | 6f 6e 20 70 61 73 73 69 |ed data |on passi|
|00003cc0| 76 65 20 73 6d 6f 6b 69 | 6e 67 20 69 6e 0d 0a 69 |ve smoki|ng in..i|
|00003cd0| 6e 64 6f 6f 72 20 61 69 | 72 20 65 6e 76 69 72 6f |ndoor ai|r enviro|
|00003ce0| 6e 6d 65 6e 74 73 20 69 | 6e 20 31 39 38 36 20 28 |nments i|n 1986 (|
|00003cf0| 31 2c 20 32 29 2e 20 20 | 50 75 62 6c 69 63 20 6f |1, 2). |Public o|
|00003d00| 70 69 6e 69 6f 6e 2c 20 | 62 79 20 73 6d 6f 6b 65 |pinion, |by smoke|
|00003d10| 72 73 20 61 6e 64 0d 0a | 6e 6f 6e 73 6d 6f 6b 65 |rs and..|nonsmoke|
|00003d20| 72 73 20 61 6c 69 6b 65 | 2c 20 69 73 20 69 6e 63 |rs alike|, is inc|
|00003d30| 72 65 61 73 69 6e 67 6c | 79 20 69 6e 20 66 61 76 |reasingl|y in fav|
|00003d40| 6f 72 20 6f 66 20 72 65 | 73 74 72 69 63 74 69 6f |or of re|strictio|
|00003d50| 6e 73 20 6f 6e 20 73 6d | 6f 6b 69 6e 67 20 69 6e |ns on sm|oking in|
|00003d60| 0d 0a 70 75 62 6c 69 63 | 20 61 72 65 61 73 20 61 |..public| areas a|
|00003d70| 6e 64 20 69 6e 20 74 68 | 65 20 77 6f 72 6b 70 6c |nd in th|e workpl|
|00003d80| 61 63 65 2e 20 20 54 68 | 65 72 65 20 61 72 65 20 |ace. Th|ere are |
|00003d90| 63 75 72 72 65 6e 74 6c | 79 20 6e 6f 20 72 65 67 |currentl|y no reg|
|00003da0| 75 6c 61 74 6f 72 79 0d | 0a 73 74 61 6e 64 61 72 |ulatory.|.standar|
|00003db0| 64 73 20 74 68 61 74 20 | 73 70 65 63 69 66 79 20 |ds that |specify |
|00003dc0| 65 78 70 6f 73 75 72 65 | 20 6c 69 6d 69 74 73 20 |exposure| limits |
|00003dd0| 6f 6e 20 70 6f 6c 6c 75 | 74 61 6e 74 73 20 61 66 |on pollu|tants af|
|00003de0| 66 65 63 74 69 6e 67 20 | 61 69 72 20 71 75 61 6c |fecting |air qual|
|00003df0| 69 74 79 20 6f 66 0d 0a | 61 69 72 70 6c 61 6e 65 |ity of..|airplane|
|00003e00| 73 2e 20 20 52 65 63 65 | 6e 74 20 6c 65 67 69 73 |s. Rece|nt legis|
|00003e10| 6c 61 74 69 6f 6e 20 69 | 6e 20 74 68 65 20 55 6e |lation i|n the Un|
|00003e20| 69 74 65 64 20 53 74 61 | 74 65 73 2c 20 65 6e 61 |ited Sta|tes, ena|
|00003e30| 63 74 65 64 20 69 6e 20 | 31 39 38 38 20 6f 6e 20 |cted in |1988 on |
|00003e40| 61 0d 0a 74 72 69 61 6c | 20 62 61 73 69 73 2c 20 |a..trial| basis, |
|00003e50| 62 61 6e 6e 65 64 20 73 | 6d 6f 6b 69 6e 67 20 6f |banned s|moking o|
|00003e60| 6e 20 61 6c 6c 20 55 2e | 53 2e 20 63 61 72 72 69 |n all U.|S. carri|
|00003e70| 65 72 20 64 6f 6d 65 73 | 74 69 63 20 66 6c 69 67 |er domes|tic flig|
|00003e80| 68 74 73 20 6f 66 20 32 | 20 68 6f 75 72 73 20 6f |hts of 2| hours o|
|00003e90| 72 0d 0a 6c 65 73 73 2e | 20 20 54 68 65 20 62 61 |r..less.| The ba|
|00003ea0| 6e 20 69 73 20 64 75 65 | 20 74 6f 20 74 65 72 6d |n is due| to term|
|00003eb0| 69 6e 61 74 65 2c 20 62 | 75 74 20 77 69 6c 6c 20 |inate, b|ut will |
|00003ec0| 6c 69 6b 65 6c 79 20 62 | 65 20 63 6f 6e 74 69 6e |likely b|e contin|
|00003ed0| 75 65 64 20 6f 72 20 65 | 76 65 6e 0d 0a 65 78 70 |ued or e|ven..exp|
|00003ee0| 61 6e 64 65 64 20 28 33 | 29 2e 20 20 49 6e 20 31 |anded (3|). In 1|
|00003ef0| 39 38 38 2c 20 43 61 6c | 69 66 6f 72 6e 69 61 20 |988, Cal|ifornia |
|00003f00| 65 6e 61 63 74 65 64 20 | 61 20 6c 61 77 20 62 61 |enacted |a law ba|
|00003f10| 6e 6e 69 6e 67 20 73 6d | 6f 6b 69 6e 67 20 6f 6e |nning sm|oking on|
|00003f20| 20 61 6c 6c 20 66 6f 72 | 6d 73 0d 0a 6f 66 20 70 | all for|ms..of p|
|00003f30| 75 62 6c 69 63 20 74 72 | 61 6e 73 70 6f 72 74 61 |ublic tr|ansporta|
|00003f40| 74 69 6f 6e 2c 20 69 6e | 63 6c 75 64 69 6e 67 20 |tion, in|cluding |
|00003f50| 69 6e 74 72 61 73 74 61 | 74 65 20 61 69 72 20 66 |intrasta|te air f|
|00003f60| 6c 69 67 68 74 73 2c 20 | 61 6e 64 20 6c 69 6d 69 |lights, |and limi|
|00003f70| 74 65 64 0d 0a 73 6d 6f | 6b 69 6e 67 20 69 6e 20 |ted..smo|king in |
|00003f80| 74 72 61 6e 73 70 6f 72 | 74 61 74 69 6f 6e 20 77 |transpor|tation w|
|00003f90| 61 69 74 69 6e 67 20 61 | 72 65 61 73 2e 0d 0a 20 |aiting a|reas... |
|00003fa0| 20 20 20 20 49 6e 20 61 | 6e 20 61 69 72 70 6c 61 | In a|n airpla|
|00003fb0| 6e 65 2c 20 74 68 65 20 | 65 6e 76 69 72 6f 6e 6d |ne, the |environm|
|00003fc0| 65 6e 74 61 6c 20 61 69 | 72 20 70 6f 6c 6c 75 74 |ental ai|r pollut|
|00003fd0| 61 6e 74 73 20 61 72 65 | 20 64 65 74 65 72 6d 69 |ants are| determi|
|00003fe0| 6e 65 64 20 62 79 20 6d | 61 6e 79 0d 0a 66 61 63 |ned by m|any..fac|
|00003ff0| 74 6f 72 73 2c 20 69 6e | 63 6c 75 64 69 6e 67 20 |tors, in|cluding |
|00004000| 74 68 65 20 6e 75 6d 62 | 65 72 20 6f 66 20 63 69 |the numb|er of ci|
|00004010| 67 61 72 65 74 74 65 73 | 20 73 6d 6f 6b 65 64 20 |garettes| smoked |
|00004020| 62 79 20 6e 65 69 67 68 | 62 6f 72 73 2c 20 73 65 |by neigh|bors, se|
|00004030| 61 74 69 6e 67 0d 0a 63 | 6f 6e 66 69 67 75 72 61 |ating..c|onfigura|
|00004040| 74 69 6f 6e 2c 20 61 69 | 72 20 66 6c 6f 77 20 70 |tion, ai|r flow p|
|00004050| 61 74 74 65 72 6e 73 2c | 20 61 6e 64 20 74 68 65 |atterns,| and the|
|00004060| 20 70 65 72 63 65 6e 74 | 61 67 65 20 6f 66 20 72 | percent|age of r|
|00004070| 65 63 69 72 63 75 6c 61 | 74 65 64 20 61 69 72 2e |ecircula|ted air.|
|00004080| 0d 0a 45 73 70 65 63 69 | 61 6c 6c 79 20 69 6d 70 |..Especi|ally imp|
|00004090| 6f 72 74 61 6e 74 20 69 | 73 20 74 68 65 20 74 79 |ortant i|s the ty|
|000040a0| 70 65 20 6f 66 20 76 65 | 6e 74 69 6c 61 74 69 6f |pe of ve|ntilatio|
|000040b0| 6e 2e 20 20 50 6c 61 6e | 65 73 20 68 61 76 69 6e |n. Plan|es havin|
|000040c0| 67 20 31 30 30 25 20 66 | 72 65 73 68 20 61 69 72 |g 100% f|resh air|
|000040d0| 0d 0a 64 65 6d 6f 6e 73 | 74 72 61 74 65 64 20 6c |..demons|trated l|
|000040e0| 65 73 73 20 61 6d 62 69 | 65 6e 74 20 6e 69 63 6f |ess ambi|ent nico|
|000040f0| 74 69 6e 65 20 6c 65 76 | 65 6c 73 20 74 68 61 6e |tine lev|els than|
|00004100| 20 70 6c 61 6e 65 73 20 | 68 61 76 69 6e 67 20 35 | planes |having 5|
|00004110| 30 25 20 66 72 65 73 68 | 20 61 69 72 20 61 6e 64 |0% fresh| air and|
|00004120| 0d 0a 35 30 25 20 72 65 | 63 69 72 63 75 6c 61 74 |..50% re|circulat|
|00004130| 65 64 20 61 69 72 2e 20 | 20 4d 6f 6e 65 79 20 69 |ed air. | Money i|
|00004140| 73 20 74 68 65 20 72 65 | 61 73 6f 6e 20 66 6f 72 |s the re|ason for|
|00004150| 20 64 69 66 66 65 72 65 | 6e 63 65 73 21 20 20 47 | differe|nces! G|
|00004160| 72 65 61 74 65 72 0d 0a | 72 65 63 69 72 63 75 6c |reater..|recircul|
|00004170| 61 74 69 6f 6e 20 73 69 | 67 6e 69 66 69 63 61 6e |ation si|gnifican|
|00004180| 74 6c 79 20 69 6e 63 72 | 65 61 73 65 73 20 66 75 |tly incr|eases fu|
|00004190| 65 6c 20 63 6f 73 74 73 | 20 61 6e 64 20 73 6f 20 |el costs| and so |
|000041a0| 61 72 65 20 61 6e 20 69 | 6e 74 65 67 72 61 6c 20 |are an i|ntegral |
|000041b0| 70 61 72 74 0d 0a 6f 66 | 20 64 65 73 69 67 6e 20 |part..of| design |
|000041c0| 6f 66 20 73 6f 6d 65 20 | 6e 65 77 65 72 20 61 69 |of some |newer ai|
|000041d0| 72 63 72 61 66 74 73 2e | 20 20 55 6e 66 6f 72 74 |rcrafts.| Unfort|
|000041e0| 75 6e 61 74 65 6c 79 2c | 20 75 6e 6c 65 73 73 20 |unately,| unless |
|000041f0| 73 6f 6d 65 74 68 69 6e | 67 20 69 73 20 64 6f 6e |somethin|g is don|
|00004200| 65 0d 0a 61 62 6f 75 74 | 20 69 74 2c 20 70 61 73 |e..about| it, pas|
|00004210| 73 65 6e 67 65 72 73 20 | 61 6e 64 20 61 74 74 65 |sengers |and atte|
|00004220| 6e 64 61 6e 74 73 20 6d | 61 79 20 62 65 20 65 78 |ndants m|ay be ex|
|00004230| 70 6f 73 65 64 20 74 6f | 20 68 69 67 68 65 72 20 |posed to| higher |
|00004240| 6c 65 76 65 6c 73 20 6f | 66 0d 0a 65 6e 76 69 72 |levels o|f..envir|
|00004250| 6f 6e 6d 65 6e 74 61 6c | 20 74 6f 62 61 63 63 6f |onmental| tobacco|
|00004260| 20 73 6d 6f 6b 65 20 69 | 6e 20 74 68 65 20 6e 65 | smoke i|n the ne|
|00004270| 78 74 20 64 65 63 61 64 | 65 20 61 73 20 74 68 65 |xt decad|e as the|
|00004280| 20 70 65 72 63 65 6e 74 | 61 67 65 20 6f 66 20 73 | percent|age of s|
|00004290| 65 61 74 2d 68 6f 75 72 | 73 0d 0a 69 6e 63 72 65 |eat-hour|s..incre|
|000042a0| 61 73 65 73 20 66 72 6f | 6d 20 33 30 25 20 69 6e |ases fro|m 30% in|
|000042b0| 20 31 39 38 35 20 74 6f | 20 61 6e 20 65 73 74 69 | 1985 to| an esti|
|000042c0| 6d 61 74 65 64 20 34 30 | 25 20 69 6e 20 31 39 39 |mated 40|% in 199|
|000042d0| 30 20 28 32 29 2e 0d 0a | 20 20 20 20 20 4e 6f 6e |0 (2)...| Non|
|000042e0| 73 6d 6f 6b 65 72 73 20 | 61 72 65 20 62 6f 74 68 |smokers |are both|
|000042f0| 65 72 65 64 20 62 79 20 | 69 6e 76 6f 6c 75 6e 74 |ered by |involunt|
|00004300| 61 72 79 20 6f 72 20 70 | 61 73 73 69 76 65 20 63 |ary or p|assive c|
|00004310| 69 67 61 72 65 74 74 65 | 20 73 6d 6f 6b 69 6e 67 |igarette| smoking|
|00004320| 20 28 34 29 2e 0d 0a 54 | 68 65 72 65 20 61 72 65 | (4)...T|here are|
|00004330| 20 6e 75 6d 65 72 6f 75 | 73 20 63 6f 6d 70 6c 61 | numerou|s compla|
|00004340| 69 6e 74 73 20 62 79 20 | 61 74 74 65 6e 64 61 6e |ints by |attendan|
|00004350| 74 73 20 61 6e 64 20 70 | 61 73 73 65 6e 67 65 72 |ts and p|assenger|
|00004360| 73 20 61 6c 69 6b 65 20 | 69 6e 20 72 65 63 6f 72 |s alike |in recor|
|00004370| 64 73 0d 0a 63 6f 6d 70 | 69 6c 65 64 20 62 79 20 |ds..comp|iled by |
|00004380| 74 68 65 20 41 73 73 6f | 63 69 61 74 69 6f 6e 20 |the Asso|ciation |
|00004390| 6f 66 20 46 6c 69 67 68 | 74 20 41 74 74 65 6e 64 |of Fligh|t Attend|
|000043a0| 61 6e 74 73 20 61 6e 64 | 20 69 6e 20 67 6f 76 65 |ants and| in gove|
|000043b0| 72 6e 6d 65 6e 74 20 61 | 6e 64 0d 0a 69 6e 64 75 |rnment a|nd..indu|
|000043c0| 73 74 72 79 20 73 75 72 | 76 65 79 73 2e 20 20 44 |stry sur|veys. D|
|000043d0| 61 74 61 20 66 72 6f 6d | 20 74 68 69 73 20 73 74 |ata from| this st|
|000043e0| 75 64 79 20 6f 6e 20 69 | 6e 2d 66 6c 69 67 68 74 |udy on i|n-flight|
|000043f0| 20 6e 69 63 6f 74 69 6e | 65 20 65 78 70 6f 73 75 | nicotin|e exposu|
|00004400| 72 65 2c 0d 0a 73 75 62 | 73 65 71 75 65 6e 74 20 |re,..sub|sequent |
|00004410| 63 6f 74 69 6e 69 6e 65 | 20 65 78 63 72 65 74 69 |cotinine| excreti|
|00004420| 6f 6e 2c 20 61 6e 64 20 | 61 63 75 74 65 20 73 79 |on, and |acute sy|
|00004430| 6d 70 74 6f 6d 73 20 64 | 65 6d 6f 6e 73 74 72 61 |mptoms d|emonstra|
|00004440| 74 65 20 74 68 61 74 20 | 74 6f 74 61 6c 0d 0a 73 |te that |total..s|
|00004450| 65 70 61 72 61 74 69 6f | 6e 20 6f 66 20 73 6d 6f |eparatio|n of smo|
|00004460| 6b 69 6e 67 20 61 6e 64 | 20 6e 6f 6e 73 6d 6f 6b |king and| nonsmok|
|00004470| 69 6e 67 20 73 65 63 74 | 69 6f 6e 73 20 77 61 73 |ing sect|ions was|
|00004480| 20 6e 6f 74 20 61 63 68 | 69 65 76 65 64 20 6f 6e | not ach|ieved on|
|00004490| 20 74 68 65 20 66 6c 69 | 67 68 74 73 0d 0a 73 74 | the fli|ghts..st|
|000044a0| 75 64 69 65 64 20 61 6e | 64 20 73 6f 6d 65 74 68 |udied an|d someth|
|000044b0| 69 6e 67 20 73 68 6f 75 | 6c 64 20 62 65 20 64 6f |ing shou|ld be do|
|000044c0| 6e 65 20 74 6f 20 72 65 | 6d 65 64 79 20 74 68 69 |ne to re|medy thi|
|000044d0| 73 20 73 69 74 75 61 74 | 69 6f 6e 2e 2d 2d 53 2e |s situat|ion.--S.|
|000044e0| 4d 2e 20 42 72 6f 6f 6b | 73 2c 0d 0a 4d 2e 44 2e |M. Brook|s,..M.D.|
|000044f0| 0d 0a 24 55 6e 69 71 75 | 65 5f 49 44 7b 59 52 42 |..$Uniqu|e_ID{YRB|
|00004500| 31 33 32 35 31 7d 0d 0a | 24 54 69 74 6c 65 7b 43 |13251}..|$Title{C|
|00004510| 6f 6d 6d 75 6e 69 74 79 | 20 4f 75 74 62 72 65 61 |ommunity| Outbrea|
|00004520| 6b 73 20 6f 66 20 41 73 | 74 68 6d 61 20 41 73 73 |ks of As|thma Ass|
|00004530| 6f 63 69 61 74 65 64 20 | 57 69 74 68 20 49 6e 68 |ociated |With Inh|
|00004540| 61 6c 61 74 69 6f 6e 20 | 6f 66 20 53 6f 79 62 65 |alation |of Soybe|
|00004550| 61 6e 20 44 75 73 74 7d | 0d 0a 24 41 75 74 68 6f |an Dust}|..$Autho|
|00004560| 72 7b 41 6e 74 6f 2c 20 | 4a 4d 0d 0a 53 75 6e 79 |r{Anto, |JM..Suny|
|00004570| 65 72 2c 20 4a 0d 0a 52 | 6f 64 72 69 67 75 65 7a |er, J..R|odriguez|
|00004580| 2d 52 6f 69 73 69 6e 2c | 20 52 0d 0a 53 75 61 72 |-Roisin,| R..Suar|
|00004590| 65 7a 2d 43 65 72 76 65 | 72 61 2c 20 4d 0d 0a 56 |ez-Cerve|ra, M..V|
|000045a0| 61 7a 71 75 65 7a 2c 20 | 4c 0d 0a 54 6f 78 69 63 |azquez, |L..Toxic|
|000045b0| 6f 65 70 69 64 65 6d 69 | 6f 6c 6f 67 69 63 61 6c |oepidemi|ological|
|000045c0| 20 43 6f 6d 6d 69 74 74 | 65 65 7d 0d 0a 24 41 66 | Committ|ee}..$Af|
|000045d0| 66 69 6c 69 61 74 69 6f | 6e 7b 55 6e 69 76 20 6f |filiatio|n{Univ o|
|000045e0| 66 20 42 61 72 63 65 6c | 6f 6e 61 2c 20 53 70 61 |f Barcel|ona, Spa|
|000045f0| 69 6e 7d 0d 0a 24 4a 6f | 75 72 6e 61 6c 7b 4e 20 |in}..$Jo|urnal{N |
|00004600| 45 6e 67 6c 20 4a 20 4d | 65 64 7d 0d 0a 24 56 6f |Engl J M|ed}..$Vo|
|00004610| 6c 75 6d 65 7b 33 32 30 | 7d 0d 0a 24 50 61 67 65 |lume{320|}..$Page|
|00004620| 7b 31 30 39 37 2d 31 31 | 30 32 7d 0d 0a 24 44 61 |{1097-11|02}..$Da|
|00004630| 74 65 7b 41 70 72 20 32 | 37 2c 20 31 39 38 39 7d |te{Apr 2|7, 1989}|
|00004640| 0d 0a 24 59 42 56 6f 6c | 7b 31 39 39 30 20 59 65 |..$YBVol|{1990 Ye|
|00004650| 61 72 20 42 6f 6f 6b 20 | 6f 66 20 4f 63 63 75 70 |ar Book |of Occup|
|00004660| 61 74 69 6f 6e 61 6c 20 | 61 6e 64 20 45 6e 76 69 |ational |and Envi|
|00004670| 72 6f 6e 6d 65 6e 74 61 | 6c 20 4d 65 64 69 63 69 |ronmenta|l Medici|
|00004680| 6e 65 7d 0d 0a 24 43 68 | 61 70 74 65 72 7b 31 2d |ne}..$Ch|apter{1-|
|00004690| 31 39 7d 0d 0a 24 59 42 | 45 64 69 74 6f 72 7b 44 |19}..$YB|Editor{D|
|000046a0| 72 73 2e 20 45 6d 6d 65 | 74 74 2c 20 42 72 6f 6f |rs. Emme|tt, Broo|
|000046b0| 6b 73 2c 20 48 61 72 72 | 69 73 2c 20 61 6e 64 20 |ks, Harr|is, and |
|000046c0| 53 63 68 65 6e 6b 65 72 | 7d 0d 0a 24 54 61 62 6c |Schenker|}..$Tabl|
|000046d0| 65 7b 7d 0d 0a 24 43 6f | 6d 6d 65 6e 74 61 74 6f |e{}..$Co|mmentato|
|000046e0| 72 7b 53 2e 4d 2e 20 42 | 72 6f 6f 6b 73 2c 20 4d |r{S.M. B|rooks, M|
|000046f0| 2e 44 2e 7d 0d 0a 0d 0a | 43 6f 70 79 72 69 67 68 |.D.}....|Copyrigh|
|00004700| 74 20 28 63 29 20 59 65 | 61 72 62 6f 6f 6b 20 4d |t (c) Ye|arbook M|
|00004710| 65 64 69 63 61 6c 20 50 | 75 62 6c 69 73 68 65 72 |edical P|ublisher|
|00004720| 73 2c 20 49 6e 63 2e 2c | 20 31 39 39 30 0d 0a 0d |s, Inc.,| 1990...|
|00004730| 0a 31 39 39 30 20 59 65 | 61 72 20 42 6f 6f 6b 20 |.1990 Ye|ar Book |
|00004740| 6f 66 20 4f 63 63 75 70 | 61 74 69 6f 6e 61 6c 20 |of Occup|ational |
|00004750| 61 6e 64 20 45 6e 76 69 | 72 6f 6e 6d 65 6e 74 61 |and Envi|ronmenta|
|00004760| 6c 20 4d 65 64 69 63 69 | 6e 65 20 28 52 29 0d 0a |l Medici|ne (R)..|
|00004770| 0d 0a 43 68 61 70 74 65 | 72 20 31 2d 2d 52 65 73 |..Chapte|r 1--Res|
|00004780| 70 69 72 61 74 6f 72 79 | 20 53 79 73 74 65 6d 0d |piratory| System.|
|00004790| 0a 0d 0a 4f 63 63 75 70 | 61 74 69 6f 6e 61 6c 20 |...Occup|ational |
|000047a0| 41 73 74 68 6d 61 0d 0a | 0d 0a 2d 2d 2d 2d 2d 2d |Asthma..|..------|
|000047b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000047c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000047d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000047e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000047f0| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0a 43 6f 6d 6d 75 6e |--------|..Commun|
|00004800| 69 74 79 20 4f 75 74 62 | 72 65 61 6b 73 20 6f 66 |ity Outb|reaks of|
|00004810| 20 41 73 74 68 6d 61 20 | 41 73 73 6f 63 69 61 74 | Asthma |Associat|
|00004820| 65 64 20 57 69 74 68 20 | 49 6e 68 61 6c 61 74 69 |ed With |Inhalati|
|00004830| 6f 6e 20 6f 66 20 53 6f | 79 62 65 61 6e 20 44 75 |on of So|ybean Du|
|00004840| 73 74 0d 0a 0d 0a 41 6e | 74 6f 20 4a 4d 2c 20 53 |st....An|to JM, S|
|00004850| 75 6e 79 65 72 20 4a 2c | 20 52 6f 64 72 69 67 75 |unyer J,| Rodrigu|
|00004860| 65 7a 2d 52 6f 69 73 69 | 6e 20 52 2c 20 53 75 61 |ez-Roisi|n R, Sua|
|00004870| 72 65 7a 2d 43 65 72 76 | 65 72 61 20 4d 2c 20 56 |rez-Cerv|era M, V|
|00004880| 61 7a 71 75 65 7a 20 4c | 2c 0d 0a 54 6f 78 69 63 |azquez L|,..Toxic|
|00004890| 6f 65 70 69 64 65 6d 69 | 6f 6c 6f 67 69 63 61 6c |oepidemi|ological|
|000048a0| 20 43 6f 6d 6d 69 74 74 | 65 65 0d 0a 28 55 6e 69 | Committ|ee..(Uni|
|000048b0| 76 20 6f 66 20 42 61 72 | 63 65 6c 6f 6e 61 2c 20 |v of Bar|celona, |
|000048c0| 53 70 61 69 6e 29 0d 0a | 4e 20 45 6e 67 6c 20 4a |Spain)..|N Engl J|
|000048d0| 20 4d 65 64 20 33 32 30 | 3a 31 30 39 37 2d 31 31 | Med 320|:1097-11|
|000048e0| 30 32 2c 20 41 70 72 20 | 32 37 2c 20 31 39 38 39 |02, Apr |27, 1989|
|000048f0| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00004900| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004910| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004920| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004930| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004940| 0d 0a 0d 0a 50 72 65 2d | 43 6f 6d 6d 65 6e 74 0d |....Pre-|Comment.|
|00004950| 0a 0d 0a 20 20 20 20 20 | 54 68 69 73 20 73 65 63 |... |This sec|
|00004960| 74 69 6f 6e 20 64 69 73 | 63 75 73 73 65 73 20 36 |tion dis|cusses 6|
|00004970| 20 70 61 70 65 72 73 20 | 64 65 61 6c 69 6e 67 20 | papers |dealing |
|00004980| 77 69 74 68 20 6f 63 63 | 75 70 61 74 69 6f 6e 61 |with occ|upationa|
|00004990| 6c 20 61 73 74 68 6d 61 | 2e 20 20 54 68 65 0d 0a |l asthma|. The..|
|000049a0| 66 69 72 73 74 20 72 65 | 6c 61 74 65 73 20 74 6f |first re|lates to|
|000049b0| 20 73 6f 6c 76 69 6e 67 | 20 61 20 6d 65 64 69 63 | solving| a medic|
|000049c0| 61 6c 20 70 75 7a 7a 6c | 65 20 6f 66 20 63 61 75 |al puzzl|e of cau|
|000049d0| 73 61 74 69 6f 6e 20 62 | 79 20 75 73 69 6e 67 20 |sation b|y using |
|000049e0| 65 70 69 64 65 6d 69 6f | 6c 6f 67 69 63 0d 0a 74 |epidemio|logic..t|
|000049f0| 65 63 68 6e 69 71 75 65 | 73 2e 20 20 54 68 65 20 |echnique|s. The |
|00004a00| 6e 65 78 74 20 33 20 64 | 69 73 63 75 73 73 20 73 |next 3 d|iscuss s|
|00004a10| 70 65 63 69 66 69 63 20 | 74 79 70 65 73 20 6f 66 |pecific |types of|
|00004a20| 20 61 73 74 68 6d 61 20 | 77 69 74 68 20 73 6f 6d | asthma |with som|
|00004a30| 65 20 69 6e 74 65 72 65 | 73 74 69 6e 67 0d 0a 6e |e intere|sting..n|
|00004a40| 65 77 20 64 65 76 65 6c | 6f 70 6d 65 6e 74 73 2e |ew devel|opments.|
|00004a50| 20 20 54 68 65 20 66 69 | 6e 61 6c 20 32 20 64 65 | The fi|nal 2 de|
|00004a60| 61 6c 20 77 69 74 68 20 | 64 69 69 73 6f 63 79 61 |al with |diisocya|
|00004a70| 6e 61 74 65 20 61 73 74 | 68 6d 61 2c 20 69 6e 63 |nate ast|hma, inc|
|00004a80| 6c 75 64 69 6e 67 20 74 | 68 65 0d 0a 72 6f 6c 65 |luding t|he..role|
|00004a90| 20 6f 66 20 69 6e 68 61 | 6c 61 74 69 6f 6e 20 63 | of inha|lation c|
|00004aa0| 68 61 6c 6c 65 6e 67 65 | 20 74 65 73 74 69 6e 67 |hallenge| testing|
|00004ab0| 20 61 6e 64 20 74 68 65 | 20 72 69 73 6b 20 6f 66 | and the| risk of|
|00004ac0| 20 61 20 66 61 74 61 6c | 20 63 6f 6e 73 65 71 75 | a fatal| consequ|
|00004ad0| 65 6e 63 65 20 66 72 6f | 6d 0d 0a 61 6e 20 65 78 |ence fro|m..an ex|
|00004ae0| 70 6f 73 75 72 65 20 69 | 6e 20 61 20 73 65 6e 73 |posure i|n a sens|
|00004af0| 69 74 69 7a 65 64 20 69 | 6e 64 69 76 69 64 75 61 |itized i|ndividua|
|00004b00| 6c 2e 2d 2d 53 2e 4d 2e | 20 42 72 6f 6f 6b 73 2c |l.--S.M.| Brooks,|
|00004b10| 20 4d 2e 44 2e 0d 0a 0d | 0a 41 62 73 74 72 61 63 | M.D....|.Abstrac|
|00004b20| 74 0d 0a 0d 0a 20 20 20 | 20 20 54 77 65 6e 74 79 |t.... | Twenty|
|00004b30| 2d 73 69 78 20 6f 75 74 | 62 72 65 61 6b 73 20 6f |-six out|breaks o|
|00004b40| 66 20 61 73 74 68 6d 61 | 20 68 61 76 65 20 6f 63 |f asthma| have oc|
|00004b50| 63 75 72 72 65 64 20 69 | 6e 20 42 61 72 63 65 6c |curred i|n Barcel|
|00004b60| 6f 6e 61 20 73 69 6e 63 | 65 20 31 39 38 31 20 69 |ona sinc|e 1981 i|
|00004b70| 6e 0d 0a 67 65 6f 67 72 | 61 70 68 69 63 20 72 65 |n..geogr|aphic re|
|00004b80| 6c 61 74 69 6f 6e 20 74 | 6f 20 74 68 65 20 68 61 |lation t|o the ha|
|00004b90| 72 62 6f 72 2e 20 20 54 | 68 65 20 72 65 6c 61 74 |rbor. T|he relat|
|00004ba0| 69 6f 6e 73 68 69 70 20 | 62 65 74 77 65 65 6e 20 |ionship |between |
|00004bb0| 6f 75 74 62 72 65 61 6b | 73 0d 0a 6f 63 63 75 72 |outbreak|s..occur|
|00004bc0| 72 69 6e 67 20 66 72 6f | 6d 20 31 39 38 35 20 74 |ring fro|m 1985 t|
|00004bd0| 6f 20 31 39 38 36 20 61 | 6e 64 20 74 68 65 20 70 |o 1986 a|nd the p|
|00004be0| 72 6f 64 75 63 74 73 20 | 75 6e 6c 6f 61 64 65 64 |roducts |unloaded|
|00004bf0| 20 61 74 20 74 68 65 20 | 68 61 72 62 6f 72 20 61 | at the |harbor a|
|00004c00| 74 20 74 68 6f 73 65 0d | 0a 74 69 6d 65 73 20 77 |t those.|.times w|
|00004c10| 61 73 20 61 6e 61 6c 79 | 7a 65 64 20 61 66 74 65 |as analy|zed afte|
|00004c20| 72 20 61 73 74 68 6d 61 | 20 69 6e 20 31 39 38 37 |r asthma| in 1987|
|00004c30| 20 77 61 73 20 72 65 6c | 61 74 65 64 20 74 6f 20 | was rel|ated to |
|00004c40| 74 68 65 20 75 6e 6c 6f | 61 64 69 6e 67 20 6f 66 |the unlo|ading of|
|00004c50| 0d 0a 73 6f 79 62 65 61 | 6e 73 2e 0d 0a 20 20 20 |..soybea|ns... |
|00004c60| 20 20 41 6c 6c 20 31 33 | 20 61 73 74 68 6d 61 2d | All 13| asthma-|
|00004c70| 65 70 69 64 65 6d 69 63 | 20 64 61 79 73 20 69 6e |epidemic| days in|
|00004c80| 20 74 68 65 20 32 2d 79 | 65 61 72 20 70 65 72 69 | the 2-y|ear peri|
|00004c90| 6f 64 20 63 6f 69 6e 63 | 69 64 65 64 20 77 69 74 |od coinc|ided wit|
|00004ca0| 68 20 75 6e 6c 6f 61 64 | 69 6e 67 0d 0a 6f 66 20 |h unload|ing..of |
|00004cb0| 73 6f 79 62 65 61 6e 73 | 20 66 72 6f 6d 20 73 68 |soybeans| from sh|
|00004cc0| 69 70 73 20 69 6e 20 74 | 68 65 20 68 61 72 62 6f |ips in t|he harbo|
|00004cd0| 72 2e 20 20 4f 6e 20 65 | 70 69 64 65 6d 69 63 20 |r. On e|pidemic |
|00004ce0| 64 61 79 73 20 68 69 67 | 68 2d 70 72 65 73 73 75 |days hig|h-pressu|
|00004cf0| 72 65 20 61 72 65 61 73 | 0d 0a 61 6e 64 20 6d 69 |re areas|..and mi|
|00004d00| 6c 64 20 77 69 6e 64 73 | 20 66 61 76 6f 72 65 64 |ld winds| favored|
|00004d10| 20 74 68 65 20 6d 6f 76 | 65 6d 65 6e 74 20 6f 66 | the mov|ement of|
|00004d20| 20 61 69 72 20 74 6f 20 | 74 68 65 20 63 69 74 79 | air to |the city|
|00004d30| 2e 20 20 50 61 72 74 69 | 63 6c 65 73 20 6f 66 20 |. Parti|cles of |
|00004d40| 73 74 61 72 63 68 0d 0a | 61 6e 64 20 65 70 69 73 |starch..|and epis|
|00004d50| 70 65 72 6d 20 63 65 6c | 6c 73 20 72 65 63 6f 76 |perm cel|ls recov|
|00004d60| 65 72 65 64 20 66 72 6f | 6d 20 61 69 72 20 73 61 |ered fro|m air sa|
|00004d70| 6d 70 6c 65 72 73 20 69 | 6e 20 74 68 65 20 63 69 |mplers i|n the ci|
|00004d80| 74 79 20 77 65 72 65 20 | 69 64 65 6e 74 69 63 61 |ty were |identica|
|00004d90| 6c 20 74 6f 0d 0a 74 68 | 65 20 63 68 61 72 61 63 |l to..th|e charac|
|00004da0| 74 65 72 69 73 74 69 63 | 73 20 6f 66 20 73 6f 79 |teristic|s of soy|
|00004db0| 62 65 61 6e 20 70 61 72 | 74 69 63 6c 65 73 2e 20 |bean par|ticles. |
|00004dc0| 20 4f 6e 65 20 6f 66 20 | 74 68 65 20 68 61 72 62 | One of |the harb|
|00004dd0| 6f 72 20 73 69 6c 6f 73 | 20 69 6e 74 6f 20 77 68 |or silos| into wh|
|00004de0| 69 63 68 0d 0a 73 6f 79 | 62 65 61 6e 73 20 77 65 |ich..soy|beans we|
|00004df0| 72 65 20 75 6e 6c 6f 61 | 64 65 64 20 6c 61 63 6b |re unloa|ded lack|
|00004e00| 65 64 20 62 61 67 20 66 | 69 6c 74 65 72 73 2c 20 |ed bag f|ilters, |
|00004e10| 61 6c 6c 6f 77 69 6e 67 | 20 74 68 65 20 72 65 6c |allowing| the rel|
|00004e20| 65 61 73 65 20 6f 66 20 | 73 6f 79 62 65 61 6e 0d |ease of |soybean.|
|00004e30| 0a 64 75 73 74 20 69 6e | 74 6f 20 74 68 65 20 61 |.dust in|to the a|
|00004e40| 69 72 2e 0d 0a 20 20 20 | 20 20 52 65 6c 65 61 73 |ir... | Releas|
|00004e50| 65 20 6f 66 20 73 6f 79 | 62 65 61 6e 20 64 75 73 |e of soy|bean dus|
|00004e60| 74 20 73 68 6f 75 6c 64 | 20 62 65 20 63 6f 6e 73 |t should| be cons|
|00004e70| 69 64 65 72 65 64 20 77 | 68 65 6e 65 76 65 72 20 |idered w|henever |
|00004e80| 6f 75 74 62 72 65 61 6b | 73 20 6f 66 20 61 73 74 |outbreak|s of ast|
|00004e90| 68 6d 61 0d 0a 6f 63 63 | 75 72 2e 0d 0a 0d 0a 50 |hma..occ|ur.....P|
|00004ea0| 6f 73 74 2d 43 6f 6d 6d | 65 6e 74 0d 0a 0d 0a 20 |ost-Comm|ent.... |
|00004eb0| 20 20 20 20 41 73 74 68 | 6d 61 20 65 70 69 64 65 | Asth|ma epide|
|00004ec0| 6d 69 63 73 20 68 61 76 | 65 20 62 65 65 6e 20 72 |mics hav|e been r|
|00004ed0| 65 70 6f 72 74 65 64 20 | 69 6e 20 76 61 72 69 6f |eported |in vario|
|00004ee0| 75 73 20 70 61 72 74 73 | 20 6f 66 20 74 68 65 20 |us parts| of the |
|00004ef0| 77 6f 72 6c 64 2e 0d 0a | 43 61 73 74 6f 72 2d 62 |world...|Castor-b|
|00004f00| 65 61 6e 20 64 75 73 74 | 20 77 61 73 20 72 65 70 |ean dust| was rep|
|00004f10| 6f 72 74 65 64 20 74 6f | 20 62 65 20 61 20 73 70 |orted to| be a sp|
|00004f20| 65 63 69 66 69 63 20 63 | 61 75 73 65 20 6f 66 20 |ecific c|ause of |
|00004f30| 61 73 74 68 6d 61 20 65 | 70 69 64 65 6d 69 63 73 |asthma e|pidemics|
|00004f40| 2c 20 62 75 74 0d 0a 74 | 68 65 20 63 61 75 73 65 |, but..t|he cause|
|00004f50| 73 20 6f 66 20 6d 6f 73 | 74 20 6f 74 68 65 72 20 |s of mos|t other |
|00004f60| 61 73 74 68 6d 61 20 65 | 70 69 64 65 6d 69 63 73 |asthma e|pidemics|
|00004f70| 20 72 65 6d 61 69 6e 20 | 75 6e 63 6c 65 61 72 20 | remain |unclear |
|00004f80| 28 31 29 2e 20 20 41 6e | 20 69 6e 74 65 72 65 73 |(1). An| interes|
|00004f90| 74 69 6e 67 0d 0a 66 65 | 61 74 75 72 65 20 6f 66 |ting..fe|ature of|
|00004fa0| 20 74 68 69 73 20 66 69 | 72 73 74 20 70 61 70 65 | this fi|rst pape|
|00004fb0| 72 20 69 73 20 74 68 65 | 20 63 6c 65 76 65 72 20 |r is the| clever |
|00004fc0| 65 70 69 64 65 6d 69 6f | 6c 6f 67 69 63 20 6d 65 |epidemio|logic me|
|00004fd0| 74 68 6f 64 6f 6c 6f 67 | 79 20 75 73 65 64 2e 20 |thodolog|y used. |
|00004fe0| 20 41 6e 0d 0a 22 75 6e | 75 73 75 61 6c 20 61 73 | An.."un|usual as|
|00004ff0| 74 68 6d 61 20 64 61 79 | 22 20 77 61 73 20 64 65 |thma day|" was de|
|00005000| 66 69 6e 65 64 20 61 73 | 20 61 20 64 61 79 20 6f |fined as| a day o|
|00005010| 6e 20 77 68 69 63 68 20 | 74 68 65 20 6e 75 6d 62 |n which |the numb|
|00005020| 65 72 20 6f 66 20 65 6d | 65 72 67 65 6e 63 79 0d |er of em|ergency.|
|00005030| 0a 72 6f 6f 6d 20 76 69 | 73 69 74 73 20 69 73 20 |.room vi|sits is |
|00005040| 73 6f 20 67 72 65 61 74 | 20 74 68 61 74 20 74 68 |so great| that th|
|00005050| 65 20 70 72 6f 62 61 62 | 69 6c 69 74 79 20 74 68 |e probab|ility th|
|00005060| 61 74 20 73 75 63 68 20 | 61 20 6e 75 6d 62 65 72 |at such |a number|
|00005070| 20 6f 72 20 61 20 67 72 | 65 61 74 65 72 0d 0a 6f | or a gr|eater..o|
|00005080| 6e 65 20 69 73 20 74 68 | 65 20 72 65 73 75 6c 74 |ne is th|e result|
|00005090| 20 6f 66 20 63 68 61 6e | 63 65 20 69 73 20 30 2e | of chan|ce is 0.|
|000050a0| 30 32 35 20 6f 72 20 6c | 65 73 73 2e 20 20 41 6e |025 or l|ess. An|
|000050b0| 20 22 61 73 74 68 6d 61 | 2d 65 70 69 64 65 6d 69 | "asthma|-epidemi|
|000050c0| 63 20 64 61 79 22 20 77 | 61 73 0d 0a 64 65 66 69 |c day" w|as..defi|
|000050d0| 6e 65 64 20 61 73 20 61 | 6e 20 75 6e 75 73 75 61 |ned as a|n unusua|
|000050e0| 6c 20 61 73 74 68 6d 61 | 20 64 61 79 20 6f 6e 20 |l asthma| day on |
|000050f0| 77 68 69 63 68 20 74 68 | 65 20 63 61 73 65 73 20 |which th|e cases |
|00005100| 77 65 72 65 20 63 6c 75 | 73 74 65 72 65 64 20 6f |were clu|stered o|
|00005110| 6e 20 61 6e 0d 0a 68 6f | 75 72 6c 79 20 62 61 73 |n an..ho|urly bas|
|00005120| 69 73 2c 20 74 68 61 74 | 20 69 73 2c 20 74 68 65 |is, that| is, the|
|00005130| 20 6f 63 63 75 72 72 65 | 6e 63 65 20 69 6e 20 6f | occurre|nce in o|
|00005140| 6e 65 20 34 2d 68 6f 75 | 72 20 70 65 72 69 6f 64 |ne 4-hou|r period|
|00005150| 20 6f 66 20 73 6f 20 6d | 61 6e 79 0d 0a 65 6d 65 | of so m|any..eme|
|00005160| 72 67 65 6e 63 79 20 76 | 69 73 69 74 73 20 66 6f |rgency v|isits fo|
|00005170| 72 20 61 73 74 68 6d 61 | 20 74 68 61 74 20 74 68 |r asthma| that th|
|00005180| 65 20 70 72 6f 62 61 62 | 69 6c 69 74 79 20 74 68 |e probab|ility th|
|00005190| 65 20 6e 75 6d 62 65 72 | 20 6f 63 63 75 72 72 65 |e number| occurre|
|000051a0| 64 20 62 79 20 63 68 61 | 6e 63 65 0d 0a 69 73 20 |d by cha|nce..is |
|000051b0| 30 2e 30 35 20 6f 72 20 | 6c 65 73 73 2e 0d 0a 20 |0.05 or |less... |
|000051c0| 20 20 20 20 41 20 76 61 | 72 69 65 74 79 20 6f 66 | A va|riety of|
|000051d0| 20 66 61 63 74 6f 72 73 | 20 77 65 72 65 20 65 78 | factors| were ex|
|000051e0| 70 6c 6f 72 65 64 2c 20 | 69 6e 63 6c 75 64 69 6e |plored, |includin|
|000051f0| 67 20 75 6e 6c 6f 61 64 | 69 6e 67 20 6f 66 20 73 |g unload|ing of s|
|00005200| 6f 79 62 65 61 6e 73 20 | 69 6e 0d 0a 64 69 66 66 |oybeans |in..diff|
|00005210| 65 72 65 6e 74 20 73 69 | 6c 6f 73 2c 20 70 72 6f |erent si|los, pro|
|00005220| 78 69 6d 69 74 79 20 6f | 66 20 73 69 6c 6f 73 20 |ximity o|f silos |
|00005230| 74 6f 20 75 72 62 61 6e | 20 61 72 65 61 73 2c 20 |to urban| areas, |
|00005240| 74 79 70 65 73 20 6f 66 | 20 75 6e 6c 6f 61 64 69 |types of| unloadi|
|00005250| 6e 67 0d 0a 70 72 6f 63 | 65 64 75 72 65 73 20 75 |ng..proc|edures u|
|00005260| 73 65 64 2c 20 70 72 65 | 73 65 6e 63 65 20 6f 72 |sed, pre|sence or|
|00005270| 20 61 62 73 65 6e 63 65 | 20 6f 66 20 62 61 67 20 | absence| of bag |
|00005280| 66 69 6c 74 65 72 73 20 | 69 6e 20 64 75 73 74 20 |filters |in dust |
|00005290| 63 6f 6c 6c 65 63 74 6f | 72 73 20 6f 6e 0d 0a 73 |collecto|rs on..s|
|000052a0| 69 6c 6f 73 2c 20 62 61 | 72 6f 6d 65 74 72 69 63 |ilos, ba|rometric|
|000052b0| 20 70 72 65 73 73 75 72 | 65 20 61 6e 64 20 77 69 | pressur|e and wi|
|000052c0| 6e 64 20 63 6f 6e 64 69 | 74 69 6f 6e 73 20 6f 6e |nd condi|tions on|
|000052d0| 20 65 70 69 64 65 6d 69 | 63 20 64 61 79 73 2c 20 | epidemi|c days, |
|000052e0| 61 6e 64 20 61 69 72 0d | 0a 73 61 6d 70 6c 69 6e |and air.|.samplin|
|000052f0| 67 20 6d 65 61 73 75 72 | 65 6d 65 6e 74 73 20 61 |g measur|ements a|
|00005300| 6e 64 20 6d 6f 72 70 68 | 6f 6c 6f 67 69 63 61 6c |nd morph|ological|
|00005310| 20 65 78 61 6d 69 6e 61 | 74 69 6f 6e 73 20 6f 66 | examina|tions of|
|00005320| 20 64 75 73 74 20 63 6f | 6c 6c 65 63 74 65 64 2e | dust co|llected.|
|00005330| 20 20 41 6c 6c 0d 0a 74 | 68 65 20 61 6e 61 6c 79 | All..t|he analy|
|00005340| 73 65 73 20 6c 65 64 20 | 74 6f 20 74 68 65 20 63 |ses led |to the c|
|00005350| 6f 6e 63 6c 75 73 69 6f | 6e 20 74 68 61 74 20 75 |onclusio|n that u|
|00005360| 6e 6c 6f 61 64 69 6e 67 | 20 6f 66 20 73 6f 79 62 |nloading| of soyb|
|00005370| 65 61 6e 73 20 67 61 76 | 65 20 72 69 73 65 20 74 |eans gav|e rise t|
|00005380| 6f 0d 0a 73 75 64 64 65 | 6e 2c 20 6d 61 73 73 69 |o..sudde|n, massi|
|00005390| 76 65 20 72 65 6c 65 61 | 73 65 20 6f 66 20 73 6f |ve relea|se of so|
|000053a0| 79 62 65 61 6e 20 64 75 | 73 74 20 74 68 61 74 20 |ybean du|st that |
|000053b0| 72 65 61 63 68 65 64 20 | 74 68 65 20 75 72 62 61 |reached |the urba|
|000053c0| 6e 20 61 72 65 61 20 75 | 6e 64 65 72 0d 0a 61 70 |n area u|nder..ap|
|000053d0| 70 72 6f 70 72 69 61 74 | 65 20 6d 65 74 65 6f 72 |propriat|e meteor|
|000053e0| 6f 6c 6f 67 69 63 20 63 | 6f 6e 64 69 74 69 6f 6e |ologic c|ondition|
|000053f0| 73 20 61 6e 64 20 63 61 | 75 73 65 64 20 74 68 65 |s and ca|used the|
|00005400| 20 6f 75 74 62 72 65 61 | 6b 73 2e 2d 2d 53 2e 4d | outbrea|ks.--S.M|
|00005410| 2e 20 42 72 6f 6f 6b 73 | 2c 0d 0a 4d 2e 44 2e 0d |. Brooks|,..M.D..|
|00005420| 0a 0d 0a 24 55 6e 69 71 | 75 65 5f 49 44 7b 59 52 |...$Uniq|ue_ID{YR|
|00005430| 42 31 33 32 35 32 7d 0d | 0a 24 54 69 74 6c 65 7b |B13252}.|.$Title{|
|00005440| 4d 6f 74 6f 6e 65 75 72 | 6f 6e 20 44 69 73 65 61 |Motoneur|on Disea|
|00005450| 73 65 3a 20 20 41 20 44 | 69 73 6f 72 64 65 72 20 |se: A D|isorder |
|00005460| 53 65 63 6f 6e 64 61 72 | 79 20 74 6f 20 53 6f 6c |Secondar|y to Sol|
|00005470| 76 65 6e 74 20 45 78 70 | 6f 73 75 72 65 3f 7d 0d |vent Exp|osure?}.|
|00005480| 0a 24 41 75 74 68 6f 72 | 7b 48 61 77 6b 65 73 2c |.$Author|{Hawkes,|
|00005490| 20 43 48 0d 0a 43 61 76 | 61 6e 61 67 68 2c 20 4a | CH..Cav|anagh, J|
|000054a0| 42 0d 0a 46 6f 78 2c 20 | 41 4a 7d 0d 0a 24 41 66 |B..Fox, |AJ}..$Af|
|000054b0| 66 69 6c 69 61 74 69 6f | 6e 7b 49 70 73 77 69 63 |filiatio|n{Ipswic|
|000054c0| 68 20 48 6f 73 70 2c 20 | 49 70 73 77 69 63 68 3b |h Hosp, |Ipswich;|
|000054d0| 20 4d 52 43 20 54 6f 78 | 69 63 6f 6c 6f 67 79 20 | MRC Tox|icology |
|000054e0| 52 65 73 65 61 72 63 68 | 20 55 6e 69 74 2c 20 53 |Research| Unit, S|
|000054f0| 75 72 72 65 79 2c 20 45 | 6e 67 6c 61 6e 64 3b 20 |urrey, E|ngland; |
|00005500| 43 69 74 79 20 55 6e 69 | 76 2c 20 4c 6f 6e 64 6f |City Uni|v, Londo|
|00005510| 6e 7d 0d 0a 24 4a 6f 75 | 72 6e 61 6c 7b 4c 61 6e |n}..$Jou|rnal{Lan|
|00005520| 63 65 74 7d 0d 0a 24 56 | 6f 6c 75 6d 65 7b 31 7d |cet}..$V|olume{1}|
|00005530| 0d 0a 24 50 61 67 65 7b | 37 33 2d 37 36 7d 0d 0a |..$Page{|73-76}..|
|00005540| 24 44 61 74 65 7b 4a 61 | 6e 20 31 34 2c 20 31 39 |$Date{Ja|n 14, 19|
|00005550| 38 39 7d 0d 0a 24 59 42 | 56 6f 6c 7b 31 39 39 30 |89}..$YB|Vol{1990|
|00005560| 20 59 65 61 72 20 42 6f | 6f 6b 20 6f 66 20 4f 63 | Year Bo|ok of Oc|
|00005570| 63 75 70 61 74 69 6f 6e | 61 6c 20 61 6e 64 20 45 |cupation|al and E|
|00005580| 6e 76 69 72 6f 6e 6d 65 | 6e 74 61 6c 20 4d 65 64 |nvironme|ntal Med|
|00005590| 69 63 69 6e 65 7d 0d 0a | 24 43 68 61 70 74 65 72 |icine}..|$Chapter|
|000055a0| 7b 31 2d 34 38 7d 0d 0a | 24 59 42 45 64 69 74 6f |{1-48}..|$YBEdito|
|000055b0| 72 7b 44 72 73 2e 20 45 | 6d 6d 65 74 74 2c 20 42 |r{Drs. E|mmett, B|
|000055c0| 72 6f 6f 6b 73 2c 20 48 | 61 72 72 69 73 2c 20 61 |rooks, H|arris, a|
|000055d0| 6e 64 20 53 63 68 65 6e | 6b 65 72 7d 0d 0a 24 54 |nd Schen|ker}..$T|
|000055e0| 61 62 6c 65 7b 7d 0d 0a | 24 43 6f 6d 6d 65 6e 74 |able{}..|$Comment|
|000055f0| 61 74 6f 72 7b 53 2e 4d | 2e 20 42 72 6f 6f 6b 73 |ator{S.M|. Brooks|
|00005600| 2c 20 4d 2e 44 2e 7d 0d | 0a 0d 0a 43 6f 70 79 72 |, M.D.}.|...Copyr|
|00005610| 69 67 68 74 20 28 63 29 | 20 59 65 61 72 62 6f 6f |ight (c)| Yearboo|
|00005620| 6b 20 4d 65 64 69 63 61 | 6c 20 50 75 62 6c 69 73 |k Medica|l Publis|
|00005630| 68 65 72 73 2c 20 49 6e | 63 2e 2c 20 31 39 39 30 |hers, In|c., 1990|
|00005640| 0d 0a 0d 0a 31 39 39 30 | 20 59 65 61 72 20 42 6f |....1990| Year Bo|
|00005650| 6f 6b 20 6f 66 20 4f 63 | 63 75 70 61 74 69 6f 6e |ok of Oc|cupation|
|00005660| 61 6c 20 61 6e 64 20 45 | 6e 76 69 72 6f 6e 6d 65 |al and E|nvironme|
|00005670| 6e 74 61 6c 20 4d 65 64 | 69 63 69 6e 65 20 28 52 |ntal Med|icine (R|
|00005680| 29 0d 0a 0d 0a 43 68 61 | 70 74 65 72 20 31 2d 2d |)....Cha|pter 1--|
|00005690| 52 65 73 70 69 72 61 74 | 6f 72 79 20 53 79 73 74 |Respirat|ory Syst|
|000056a0| 65 6d 0d 0a 0d 0a 4d 69 | 73 63 65 6c 6c 61 6e 65 |em....Mi|scellane|
|000056b0| 6f 75 73 20 54 6f 70 69 | 63 73 0d 0a 0d 0a 2d 2d |ous Topi|cs....--|
|000056c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000056d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000056e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000056f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005700| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 4d 6f |--------|----..Mo|
|00005710| 74 6f 6e 65 75 72 6f 6e | 20 44 69 73 65 61 73 65 |toneuron| Disease|
|00005720| 3a 20 20 41 20 44 69 73 | 6f 72 64 65 72 20 53 65 |: A Dis|order Se|
|00005730| 63 6f 6e 64 61 72 79 20 | 74 6f 20 53 6f 6c 76 65 |condary |to Solve|
|00005740| 6e 74 20 45 78 70 6f 73 | 75 72 65 3f 0d 0a 0d 0a |nt Expos|ure?....|
|00005750| 48 61 77 6b 65 73 20 43 | 48 2c 20 43 61 76 61 6e |Hawkes C|H, Cavan|
|00005760| 61 67 68 20 4a 42 2c 20 | 46 6f 78 20 41 4a 0d 0a |agh JB, |Fox AJ..|
|00005770| 28 49 70 73 77 69 63 68 | 20 48 6f 73 70 2c 20 49 |(Ipswich| Hosp, I|
|00005780| 70 73 77 69 63 68 3b 20 | 4d 52 43 20 54 6f 78 69 |pswich; |MRC Toxi|
|00005790| 63 6f 6c 6f 67 79 20 52 | 65 73 65 61 72 63 68 20 |cology R|esearch |
|000057a0| 55 6e 69 74 2c 20 53 75 | 72 72 65 79 2c 20 45 6e |Unit, Su|rrey, En|
|000057b0| 67 6c 61 6e 64 3b 20 43 | 69 74 79 0d 0a 55 6e 69 |gland; C|ity..Uni|
|000057c0| 76 2c 20 4c 6f 6e 64 6f | 6e 29 0d 0a 4c 61 6e 63 |v, Londo|n)..Lanc|
|000057d0| 65 74 20 31 3a 37 33 2d | 37 36 2c 20 4a 61 6e 20 |et 1:73-|76, Jan |
|000057e0| 31 34 2c 20 31 39 38 39 | 0d 0a 2d 2d 2d 2d 2d 2d |14, 1989|..------|
|000057f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005800| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005810| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005820| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005830| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0a 0d 0a 41 62 73 74 |--------|....Abst|
|00005840| 72 61 63 74 0d 0a 0d 0a | 20 20 20 20 20 45 78 63 |ract....| Exc|
|00005850| 65 73 73 20 6d 6f 72 74 | 61 6c 69 74 79 20 66 72 |ess mort|ality fr|
|00005860| 6f 6d 20 6d 6f 74 6f 72 | 6e 65 75 72 6f 6e 20 64 |om motor|neuron d|
|00005870| 69 73 65 61 73 65 20 28 | 4d 4e 44 29 20 68 61 73 |isease (|MND) has|
|00005880| 20 62 65 65 6e 20 6f 62 | 73 65 72 76 65 64 20 69 | been ob|served i|
|00005890| 6e 0d 0a 77 6f 72 6b 65 | 72 73 20 69 6e 20 74 68 |n..worke|rs in th|
|000058a0| 65 20 6c 65 61 74 68 65 | 72 20 69 6e 64 75 73 74 |e leathe|r indust|
|000058b0| 72 79 20 69 6e 20 64 69 | 66 66 65 72 65 6e 74 20 |ry in di|fferent |
|000058c0| 63 6f 75 6e 74 72 69 65 | 73 2e 20 20 41 67 65 2d |countrie|s. Age-|
|000058d0| 61 64 6a 75 73 74 65 64 | 0d 0a 6d 6f 72 74 61 6c |adjusted|..mortal|
|000058e0| 69 74 79 20 66 6f 72 20 | 4d 4e 44 20 68 61 73 20 |ity for |MND has |
|000058f0| 72 69 73 65 6e 20 67 72 | 61 64 75 61 6c 6c 79 20 |risen gr|adually |
|00005900| 6f 76 65 72 20 74 68 65 | 20 70 61 73 74 20 32 20 |over the| past 2 |
|00005910| 64 65 63 61 64 65 73 20 | 69 6e 20 47 72 65 61 74 |decades |in Great|
|00005920| 0d 0a 42 72 69 74 61 69 | 6e 2c 20 65 73 70 65 63 |..Britai|n, espec|
|00005930| 69 61 6c 6c 79 20 61 6d | 6f 6e 67 20 77 6f 6d 65 |ially am|ong wome|
|00005940| 6e 2e 20 20 54 68 65 20 | 6e 61 74 75 72 65 20 6f |n. The |nature o|
|00005950| 66 20 6c 65 61 74 68 65 | 72 20 77 6f 72 6b 20 68 |f leathe|r work h|
|00005960| 61 73 20 63 68 61 6e 67 | 65 64 20 61 74 0d 0a 74 |as chang|ed at..t|
|00005970| 68 65 20 73 61 6d 65 20 | 74 69 6d 65 2c 20 77 69 |he same |time, wi|
|00005980| 74 68 20 74 68 65 20 69 | 6e 74 72 6f 64 75 63 74 |th the i|ntroduct|
|00005990| 69 6f 6e 20 6f 66 20 73 | 79 6e 74 68 65 74 69 63 |ion of s|ynthetic|
|000059a0| 20 62 6f 6e 64 69 6e 67 | 20 70 72 6f 63 65 73 73 | bonding| process|
|000059b0| 65 73 20 61 6e 64 20 64 | 69 72 65 63 74 0d 0a 6f |es and d|irect..o|
|000059c0| 6e 2d 73 6f 6c 65 20 69 | 6e 6a 65 63 74 69 6f 6e |n-sole i|njection|
|000059d0| 20 6d 6f 6c 64 69 6e 67 | 2e 20 20 49 74 20 69 73 | molding|. It is|
|000059e0| 20 6e 6f 74 20 63 6c 65 | 61 72 20 77 68 65 74 68 | not cle|ar wheth|
|000059f0| 65 72 20 74 68 65 20 72 | 69 73 6b 20 6f 66 20 4d |er the r|isk of M|
|00005a00| 4e 44 20 69 73 0d 0a 69 | 6e 63 72 65 61 73 65 64 |ND is..i|ncreased|
|00005a10| 20 61 6d 6f 6e 67 20 70 | 65 72 73 6f 6e 73 20 68 | among p|ersons h|
|00005a20| 61 76 69 6e 67 20 63 6f | 6e 74 61 63 74 20 77 69 |aving co|ntact wi|
|00005a30| 74 68 20 63 61 72 63 61 | 73 73 65 73 20 6f 72 20 |th carca|sses or |
|00005a40| 68 69 64 65 73 2e 20 20 | 4e 6f 20 64 69 72 65 63 |hides. |No direc|
|00005a50| 74 0d 0a 72 65 6c 61 74 | 69 6f 6e 20 77 61 73 20 |t..relat|ion was |
|00005a60| 66 6f 75 6e 64 20 62 65 | 74 77 65 65 6e 20 4d 4e |found be|tween MN|
|00005a70| 44 20 61 6e 64 20 74 68 | 65 20 74 61 6e 6e 69 6e |D and th|e tannin|
|00005a80| 67 20 70 72 6f 63 65 73 | 73 2e 20 20 44 61 74 61 |g proces|s. Data|
|00005a90| 20 66 72 6f 6d 0d 0a 4c | 65 69 63 65 73 74 65 72 | from..L|eicester|
|00005aa0| 73 68 69 72 65 20 73 75 | 67 67 65 73 74 65 64 20 |shire su|ggested |
|00005ab0| 61 20 72 65 6c 61 74 69 | 6f 6e 20 62 65 74 77 65 |a relati|on betwe|
|00005ac0| 65 6e 20 6c 65 61 74 68 | 65 72 20 77 6f 72 6b 20 |en leath|er work |
|00005ad0| 61 6e 64 20 74 68 65 20 | 72 69 73 6b 20 6f 66 0d |and the |risk of.|
|00005ae0| 0a 70 65 72 69 6e 61 74 | 61 6c 20 64 65 61 74 68 |.perinat|al death|
|00005af0| 2e 0d 0a 20 20 20 20 20 | 54 68 65 72 65 20 69 73 |... |There is|
|00005b00| 20 72 65 61 73 6f 6e 61 | 62 6c 79 20 67 6f 6f 64 | reasona|bly good|
|00005b10| 20 65 70 69 64 65 6d 69 | 6f 6c 6f 67 69 63 20 65 | epidemi|ologic e|
|00005b20| 76 69 64 65 6e 63 65 20 | 74 68 61 74 20 6c 65 61 |vidence |that lea|
|00005b30| 74 68 65 72 20 77 6f 72 | 6b 65 72 73 20 61 72 65 |ther wor|kers are|
|00005b40| 0d 0a 61 74 20 69 6e 63 | 72 65 61 73 65 64 20 72 |..at inc|reased r|
|00005b50| 69 73 6b 20 6f 66 20 4d | 4e 44 2e 20 20 41 20 64 |isk of M|ND. A d|
|00005b60| 69 72 65 63 74 20 6e 65 | 75 72 6f 74 6f 78 69 63 |irect ne|urotoxic|
|00005b70| 20 65 66 66 65 63 74 20 | 69 73 20 61 20 70 6f 73 | effect |is a pos|
|00005b80| 73 69 62 69 6c 69 74 79 | 2e 0d 0a 53 6f 6c 76 65 |sibility|...Solve|
|00005b90| 6e 74 73 20 75 6e 64 6f | 75 62 74 65 64 6c 79 20 |nts undo|ubtedly |
|00005ba0| 63 61 6e 20 70 72 6f 64 | 75 63 65 20 68 61 6c 6c |can prod|uce hall|
|00005bb0| 75 63 69 6e 61 74 6f 72 | 79 20 61 6e 64 20 6f 74 |ucinator|y and ot|
|00005bc0| 68 65 72 20 61 62 6e 6f | 72 6d 61 6c 20 6d 65 6e |her abno|rmal men|
|00005bd0| 74 61 6c 0d 0a 73 74 61 | 74 65 73 2c 20 62 75 74 |tal..sta|tes, but|
|00005be0| 20 69 6e 66 6f 72 6d 61 | 74 69 6f 6e 20 6f 6e 20 | informa|tion on |
|00005bf0| 74 68 65 69 72 20 6c 6f | 6e 67 2d 74 65 72 6d 20 |their lo|ng-term |
|00005c00| 65 66 66 65 63 74 73 20 | 69 73 20 69 6e 63 6f 6d |effects |is incom|
|00005c10| 70 6c 65 74 65 2e 20 20 | 41 6c 74 68 6f 75 67 68 |plete. |Although|
|00005c20| 0d 0a 75 73 65 20 6f 66 | 20 73 6f 6c 76 65 6e 74 |..use of| solvent|
|00005c30| 73 20 69 6e 20 6c 65 61 | 74 68 65 72 20 77 6f 72 |s in lea|ther wor|
|00005c40| 6b 20 69 73 20 66 61 69 | 72 6c 79 20 77 69 64 65 |k is fai|rly wide|
|00005c50| 73 70 72 65 61 64 2c 20 | 6e 6f 20 65 78 63 65 73 |spread, |no exces|
|00005c60| 73 20 6f 66 20 4d 4e 44 | 20 64 65 61 74 68 73 0d |s of MND| deaths.|
|00005c70| 0a 68 61 73 20 62 65 65 | 6e 20 64 6f 63 75 6d 65 |.has bee|n docume|
|00005c80| 6e 74 65 64 20 69 6e 20 | 6f 74 68 65 72 20 69 6e |nted in |other in|
|00005c90| 64 75 73 74 72 69 65 73 | 2e 0d 0a 0d 0a 50 6f 73 |dustries|.....Pos|
|00005ca0| 74 2d 43 6f 6d 6d 65 6e | 74 0d 0a 0d 0a 20 20 20 |t-Commen|t.... |
|00005cb0| 20 20 54 68 65 20 72 6f | 6c 65 20 6f 66 20 74 6f | The ro|le of to|
|00005cc0| 78 69 63 20 63 68 65 6d | 69 63 61 6c 73 20 69 6e |xic chem|icals in|
|00005cd0| 20 43 4e 53 20 64 69 73 | 65 61 73 65 20 68 61 73 | CNS dis|ease has|
|00005ce0| 20 61 73 73 75 6d 65 64 | 20 67 72 65 61 74 65 72 | assumed| greater|
|00005cf0| 20 69 6d 70 6f 72 74 61 | 6e 63 65 0d 0a 73 69 6e | importa|nce..sin|
|00005d00| 63 65 20 74 68 65 20 64 | 69 73 63 6f 76 65 72 79 |ce the d|iscovery|
|00005d10| 20 6f 66 20 70 61 72 6b | 69 6e 73 6f 6e 69 61 6e | of park|insonian|
|00005d20| 20 73 79 6e 64 72 6f 6d | 65 20 69 6e 64 75 63 65 | syndrom|e induce|
|00005d30| 64 20 62 79 0d 0a 6d 65 | 74 68 79 6c 2d 70 68 65 |d by..me|thyl-phe|
|00005d40| 6e 79 6c 2d 74 65 74 72 | 61 2d 68 79 64 72 6f 70 |nyl-tetr|a-hydrop|
|00005d50| 79 72 69 64 69 6e 65 2c | 20 61 6e 64 20 74 68 65 |yridine,| and the|
|00005d60| 72 65 20 69 73 20 61 20 | 70 6f 73 73 69 62 69 6c |re is a |possibil|
|00005d70| 69 74 79 20 74 68 61 74 | 20 62 6f 74 68 0d 0a 6c |ity that| both..l|
|00005d80| 61 74 68 79 72 69 73 6d | 20 61 6e 64 20 74 68 65 |athyrism| and the|
|00005d90| 20 47 75 61 6d 20 66 6f | 72 6d 20 6f 66 20 4d 4e | Guam fo|rm of MN|
|00005da0| 44 20 6d 61 79 20 62 65 | 20 63 61 75 73 65 64 20 |D may be| caused |
|00005db0| 62 79 20 6e 61 74 75 72 | 61 6c 6c 79 20 6f 63 63 |by natur|ally occ|
|00005dc0| 75 72 72 69 6e 67 20 61 | 6d 69 6e 6f 0d 0a 61 63 |urring a|mino..ac|
|00005dd0| 69 64 73 20 77 69 74 68 | 20 73 74 72 6f 6e 67 20 |ids with| strong |
|00005de0| 6e 65 75 72 6f 74 6f 78 | 69 63 20 61 63 74 69 6f |neurotox|ic actio|
|00005df0| 6e 73 20 28 31 2d 33 29 | 2e 20 20 54 68 65 20 74 |ns (1-3)|. The t|
|00005e00| 65 72 6d 20 6d 6f 74 6f | 72 20 6e 65 75 72 6f 6e |erm moto|r neuron|
|00005e10| 20 64 69 73 65 61 73 65 | 0d 0a 28 4d 4e 44 29 20 | disease|..(MND) |
|00005e20| 61 6e 64 20 61 6d 79 6f | 74 72 6f 70 68 69 63 20 |and amyo|trophic |
|00005e30| 6c 61 74 65 72 61 6c 20 | 73 63 6c 65 72 6f 73 69 |lateral |sclerosi|
|00005e40| 73 20 61 72 65 20 6f 66 | 74 65 6e 20 75 73 65 64 |s are of|ten used|
|00005e50| 20 69 6e 74 65 72 63 68 | 61 6e 67 65 61 62 6c 79 | interch|angeably|
|00005e60| 2e 0d 0a 56 61 72 69 6f | 75 73 20 66 61 63 74 6f |...Vario|us facto|
|00005e70| 72 73 2c 20 69 6e 63 6c | 75 64 69 6e 67 20 76 69 |rs, incl|uding vi|
|00005e80| 72 75 73 65 73 2c 20 6d | 65 74 61 6c 73 2c 20 74 |ruses, m|etals, t|
|00005e90| 6f 78 69 6e 73 2c 20 69 | 6d 6d 75 6e 65 20 64 79 |oxins, i|mmune dy|
|00005ea0| 73 66 75 6e 63 74 69 6f | 6e 2c 0d 0a 65 6e 64 6f |sfunctio|n,..endo|
|00005eb0| 63 72 69 6e 65 20 61 62 | 6e 6f 72 6d 61 6c 69 74 |crine ab|normalit|
|00005ec0| 69 65 73 2c 20 61 6e 64 | 20 6f 74 68 65 72 20 66 |ies, and| other f|
|00005ed0| 61 63 74 6f 72 73 2c 20 | 68 61 76 65 20 62 65 65 |actors, |have bee|
|00005ee0| 6e 20 6c 69 6e 6b 65 64 | 20 74 6f 20 74 68 65 0d |n linked| to the.|
|00005ef0| 0a 70 61 74 68 6f 67 65 | 6e 65 73 69 73 20 6f 66 |.pathoge|nesis of|
|00005f00| 20 4d 4e 44 2e 0d 0a 20 | 20 20 20 20 54 68 69 73 | MND... | This|
|00005f10| 20 62 72 69 65 66 20 72 | 65 70 6f 72 74 20 61 64 | brief r|eport ad|
|00005f20| 64 72 65 73 73 65 73 20 | 70 6f 73 73 69 62 6c 65 |dresses |possible|
|00005f30| 20 4d 4e 44 20 69 6e 20 | 6c 65 61 74 68 65 72 20 | MND in |leather |
|00005f40| 69 6e 64 75 73 74 72 79 | 20 77 6f 72 6b 65 72 73 |industry| workers|
|00005f50| 2e 0d 0a 41 6c 74 68 6f | 75 67 68 20 74 68 65 72 |...Altho|ugh ther|
|00005f60| 65 20 61 72 65 20 72 65 | 70 6f 72 74 73 20 6f 66 |e are re|ports of|
|00005f70| 20 70 65 72 69 70 68 65 | 72 61 6c 20 6e 65 75 72 | periphe|ral neur|
|00005f80| 6f 70 61 74 68 69 65 73 | 20 69 6e 20 49 74 61 6c |opathies| in Ital|
|00005f90| 69 61 6e 20 6c 65 61 74 | 68 65 72 0d 0a 77 6f 72 |ian leat|her..wor|
|00005fa0| 6b 65 72 73 2c 20 6c 69 | 6b 65 6c 79 20 66 72 6f |kers, li|kely fro|
|00005fb0| 6d 20 68 65 78 61 6e 65 | 20 61 6e 64 20 69 74 73 |m hexane| and its|
|00005fc0| 20 63 6f 6e 67 65 6e 65 | 72 73 20 28 34 29 2c 20 | congene|rs (4), |
|00005fd0| 74 68 65 20 69 6e 76 65 | 73 74 69 67 61 74 6f 72 |the inve|stigator|
|00005fe0| 73 20 6e 6f 74 65 20 61 | 6e 0d 0a 61 70 70 61 72 |s note a|n..appar|
|00005ff0| 65 6e 74 20 67 72 61 64 | 75 61 6c 20 69 6e 63 72 |ent grad|ual incr|
|00006000| 65 61 73 65 20 69 6e 20 | 61 67 65 2d 61 64 6a 75 |ease in |age-adju|
|00006010| 73 74 65 64 20 6d 6f 72 | 74 61 6c 69 74 79 20 66 |sted mor|tality f|
|00006020| 6f 72 20 4d 4e 44 20 69 | 6e 20 47 72 65 61 74 20 |or MND i|n Great |
|00006030| 42 72 69 74 61 69 6e 0d | 0a 6f 76 65 72 20 74 68 |Britain.|.over th|
|00006040| 65 20 70 61 73 74 20 32 | 30 20 79 65 61 72 73 2c |e past 2|0 years,|
|00006050| 20 6d 61 69 6e 6c 79 20 | 61 6d 6f 6e 67 20 77 6f | mainly |among wo|
|00006060| 6d 65 6e 2e 20 20 54 68 | 69 73 20 69 6e 63 72 65 |men. Th|is incre|
|00006070| 61 73 65 20 68 61 73 20 | 6f 63 63 75 72 72 65 64 |ase has |occurred|
|00006080| 20 65 76 65 6e 0d 0a 74 | 68 6f 75 67 68 20 63 6f | even..t|hough co|
|00006090| 6e 73 69 64 65 72 61 62 | 6c 65 20 63 68 61 6e 67 |nsiderab|le chang|
|000060a0| 65 73 20 68 61 76 65 20 | 62 65 65 6e 20 69 6e 74 |es have |been int|
|000060b0| 72 6f 64 75 63 65 64 20 | 69 6e 74 6f 20 74 68 65 |roduced |into the|
|000060c0| 20 69 6e 64 75 73 74 72 | 79 2c 20 69 6e 63 6c 75 | industr|y, inclu|
|000060d0| 64 69 6e 67 0d 0a 69 6e | 74 72 6f 64 75 63 74 69 |ding..in|troducti|
|000060e0| 6f 6e 20 6f 66 20 73 79 | 6e 74 68 65 74 69 63 20 |on of sy|nthetic |
|000060f0| 62 6f 6e 64 69 6e 67 20 | 70 72 6f 63 65 73 73 65 |bonding |processe|
|00006100| 73 20 61 6e 64 20 64 69 | 72 65 63 74 20 6f 6e 2d |s and di|rect on-|
|00006110| 73 6f 6c 65 20 69 6e 6a | 65 63 74 69 6f 6e 0d 0a |sole inj|ection..|
|00006120| 6d 6f 6c 64 69 6e 67 2e | 0d 0a 20 20 20 20 20 54 |molding.|.. T|
|00006130| 68 65 20 70 61 70 65 72 | 20 64 69 73 63 75 73 73 |he paper| discuss|
|00006140| 65 73 20 63 75 72 72 65 | 6e 74 20 61 6e 64 20 70 |es curre|nt and p|
|00006150| 61 73 74 20 73 6f 6c 76 | 65 6e 74 20 65 78 70 6f |ast solv|ent expo|
|00006160| 73 75 72 65 73 20 69 6e | 20 74 68 65 20 69 6e 64 |sures in| the ind|
|00006170| 75 73 74 72 79 3a 0d 0a | 6d 61 6e 79 20 61 72 65 |ustry:..|many are|
|00006180| 20 6b 6e 6f 77 6e 20 74 | 6f 20 63 61 75 73 65 20 | known t|o cause |
|00006190| 70 65 72 69 70 68 65 72 | 61 6c 20 6e 65 75 72 6f |peripher|al neuro|
|000061a0| 70 61 74 68 69 65 73 2c | 20 62 75 74 20 74 68 65 |pathies,| but the|
|000061b0| 20 64 61 74 61 20 6f 6e | 20 74 68 65 73 65 0d 0a | data on| these..|
|000061c0| 73 6f 6c 76 65 6e 74 73 | 20 66 6f 72 20 4d 4e 44 |solvents| for MND|
|000061d0| 20 61 72 65 20 73 70 61 | 72 73 65 2e 20 20 54 68 | are spa|rse. Th|
|000061e0| 65 20 73 6f 6c 76 65 6e | 74 73 20 69 6e 63 6c 75 |e solven|ts inclu|
|000061f0| 64 65 20 74 72 69 63 68 | 6c 6f 72 6f 65 74 68 79 |de trich|loroethy|
|00006200| 6c 65 6e 65 2c 20 63 61 | 72 62 6f 6e 0d 0a 74 65 |lene, ca|rbon..te|
|00006210| 74 72 61 63 68 6c 6f 72 | 69 64 65 2c 20 6e 2d 68 |trachlor|ide, n-h|
|00006220| 65 78 61 6e 65 2c 20 74 | 72 69 2d 6f 72 74 68 6f |exane, t|ri-ortho|
|00006230| 2d 63 72 65 73 79 6c 2d | 70 68 6f 73 70 68 61 74 |-cresyl-|phosphat|
|00006240| 65 2c 20 6d 65 74 68 79 | 6c 2d 6e 2d 62 75 74 79 |e, methy|l-n-buty|
|00006250| 6c 2d 6b 65 74 6f 6e 65 | 2c 0d 0a 74 6f 6c 75 65 |l-ketone|,..tolue|
|00006260| 6e 65 2c 20 61 6e 64 20 | 6d 65 74 68 79 6c 2d 65 |ne, and |methyl-e|
|00006270| 74 68 79 6c 2d 6b 65 74 | 6f 6e 65 2e 0d 0a 20 20 |thyl-ket|one... |
|00006280| 20 20 20 54 68 65 20 61 | 75 74 68 6f 72 73 20 62 | The a|uthors b|
|00006290| 65 6c 69 65 76 65 20 69 | 6e 20 61 20 70 6f 74 65 |elieve i|n a pote|
|000062a0| 6e 74 69 61 6c 20 66 6f | 72 20 6c 6f 6e 67 2d 74 |ntial fo|r long-t|
|000062b0| 65 72 6d 20 73 65 71 75 | 65 6c 61 65 20 66 72 6f |erm sequ|elae fro|
|000062c0| 6d 20 73 6f 6c 76 65 6e | 74 0d 0a 75 73 65 20 69 |m solven|t..use i|
|000062d0| 6e 20 74 68 65 20 69 6e | 64 75 73 74 72 79 2c 20 |n the in|dustry, |
|000062e0| 65 76 65 6e 20 69 66 20 | 74 68 65 20 65 78 70 6f |even if |the expo|
|000062f0| 73 75 72 65 20 69 73 20 | 62 72 69 65 66 3b 20 69 |sure is |brief; i|
|00006300| 6e 69 74 69 61 6c 20 63 | 68 61 6e 67 65 73 20 6d |nitial c|hanges m|
|00006310| 61 79 20 6f 63 63 75 72 | 0d 0a 61 66 74 65 72 20 |ay occur|..after |
|00006320| 6e 65 72 76 65 20 63 65 | 6c 6c 20 64 61 6d 61 67 |nerve ce|ll damag|
|00006330| 65 20 61 6e 64 20 70 72 | 6f 67 72 65 73 73 69 6f |e and pr|ogressio|
|00006340| 6e 20 6f 63 63 75 72 73 | 20 77 69 74 68 20 74 68 |n occurs| with th|
|00006350| 65 20 6e 61 74 75 72 61 | 6c 20 61 67 69 6e 67 20 |e natura|l aging |
|00006360| 70 72 6f 63 65 73 73 2e | 0d 0a 41 6e 6f 74 68 65 |process.|..Anothe|
|00006370| 72 20 72 65 70 6f 72 74 | 20 66 72 6f 6d 20 49 73 |r report| from Is|
|00006380| 72 61 65 6c 20 73 75 67 | 67 65 73 74 73 20 74 68 |rael sug|gests th|
|00006390| 61 74 20 4d 4e 44 20 6d | 61 79 20 6f 63 63 75 72 |at MND m|ay occur|
|000063a0| 20 77 69 74 68 20 67 72 | 65 61 74 65 72 20 66 72 | with gr|eater fr|
|000063b0| 65 71 75 65 6e 63 79 0d | 0a 69 6e 20 74 65 78 74 |equency.|.in text|
|000063c0| 69 6c 65 20 77 6f 72 6b | 65 72 73 20 28 35 29 2e |ile work|ers (5).|
|000063d0| 20 20 49 20 62 65 6c 69 | 65 76 65 20 74 68 61 74 | I beli|eve that|
|000063e0| 2c 20 61 6c 74 68 6f 75 | 67 68 20 74 68 65 20 74 |, althou|gh the t|
|000063f0| 68 65 6f 72 79 20 69 73 | 20 69 6e 74 65 72 65 73 |heory is| interes|
+--------+-------------------------+-------------------------+--------+--------+
Only 25.0 KB of data is shown above.
