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out file located in the same directory. We return to this issue in more detail later. The importance of insulin in regulation of protein balance was demonstrated most clearly in subjects with IDDM who rapidly develop negative nitrogen balance with cessation of insulin therapy. 2,7,10,16 The first site of appearance or area of maxi- mum development of cellulitis or subcutaneous emphy- sema should indicate the appropriate anatomic level and likely nature of perforation of the bowel.
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