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Upper Half (upper + half)
Selected AbstractsExperimental study of rill bank collapseEARTH SURFACE PROCESSES AND LANDFORMS, Issue 2 2007Jovan R. Stefanovic Abstract Rill bank collapse is an important component in the adjustment of channel morphology to changes in discharge and sediment flux. Sediment inputs from bank collapse cause abrupt changes in flow resistance, flow patterns and downstream sediment concentrations. Generally, bank retreat involves gradual lateral erosion, caused by flow shear stress, and sudden bank collapse, triggered by complex interactions between channel flow and bank and soil water conditions. Collapse occurs when bank height exceeds the critical height where gravitational forces overcome soil shear strength. An experimental study examined conditions for collapse in eroding rill channels. Experiments with and without a deep water table were carried out on a meandering rill channel in a loamy sand and sandy loam in a laboratory flume under simulated rainfall and controlled runon. Different discharges were used to initiate knickpoint and rill incision. Soil water dynamics were monitored using microstandpipes, tensiometers and time domain reflectometer probes (TDR probes). Bank collapse occurred with newly developed or rising pre-existing water tables near rill banks, associated with knickpoint migration. Knickpoint scour increased effective bank height, caused positive pore water pressure in the bank toe and reduced negative pore pressures in the unsaturated zone to near zero. Matric tension in unsaturated parts of the bank and a surface seal on the ,interrill' zone behind the bank enhanced stability, while increased effective bank height and positive pore water pressure at the bank toe caused instability. With soil water contents >35 per cent (sandy loam) and >23 per cent (loamy sand), critical bank heights were 0·11,0·12 m and 0·06,0·07 m, respectively. Bank toe undercutting at the outside of the rill bends also triggered instability. Bank displacement was quite different on the two soils. On the loamy sand, the failed block slid to the channel bed, revealing only the upper half of the failure plane, while on the sandy loam the failed block toppled forwards, exposing the failure plane for the complete bank height. This study has shown that it is possible to predict location, frequency and magnitude of the rill bank collapse, providing a basis for incorporation into predictive models for hillslope soil loss or rill network development. Copyright © 2006 John Wiley & Sons, Ltd. [source] Instrumental Variables Estimates of the Effect of Subsidized Training on the Quantiles of Trainee EarningsECONOMETRICA, Issue 1 2002Alberto Abadie This paper reports estimates of the effects of JTPA training programs on the distribution of earnings. The estimation uses a new instrumental variable (IV) method that measures program impacts on quantiles. The quantile treatment effects (QTE) estimator reduces to quantile regression when selection for treatment is exogenously determined. QTE can be computed as the solution to a convex linear programming problem, although this requires first-step estimation of a nuisance function. We develop distribution theory for the case where the first step is estimated nonparametrically. For women, the empirical results show that the JTPA program had the largest proportional impact at low quantiles. Perhaps surprisingly, however, JTPA training raised the quantiles of earnings for men only in the upper half of the trainee earnings distribution. [source] Magnetic polarity stratigraphy of Siwalik Group sediments of Karnali River section in western NepalGEOPHYSICAL JOURNAL INTERNATIONAL, Issue 3 2000Pitambar Gautam The remanent magnetization of siltstones and sandstones sampled at 476 levels/sites throughout a 3560 m thick molasse sequence belonging to the Siwalik Group (0,2015 m: Lower; 2015,3560 m: Middle) has been studied by stepwise thermal demagnetization. This section is exposed along the Karnali River in Nepal. The natural remanent magnetization (NRM) usually consists of two components: a viscous or thermoviscous component of recent field origin, and an ancient characteristic component (ChRM). The former component is of normal polarity and resides either in goethite (unblocking temperature < 150 °C; resistant to AFD up to 150 mT) or in maghemite (unblocking temperature 150,400 °C). Goethite contributes up to 90 per cent of the total intensity in the finer variegated muddy samples belonging to the lower half of the section. Maghemite content is significant in the grey mud-free lithologies from the upper half of the section. The main component, unblocked in the high-temperature range (commonly 610,680 °C) and believed to reside in haematite, presumably of mostly detrital origin, represents a characteristic remanence (ChRM). The tilt-corrected ChRM directions at individual sites show antipodal clusters (ratio of normal- to reverse-polarity sites: 0.62), and yield mean inclinations recording significant inclination shallowing,a feature well recorded in the Siwaliks. This ChRM is interpreted to represent a largely primary detrital remanence. The ChRM data from 430 sites yield the Karnali River magnetic polarity sequence, whose correlation with the geomagnetic polarity timescale (Cande & Kent 1995) suggests a depositional age of 16 Ma (younger than chron C5Cn.1n) to 5.2 Ma (around the top of chron C3r) for the 3560 m section sampled. Hence, the Karnali River exposes the oldest part of the Siwalik Group in Nepal. Estimates of the sediment accumulation rate (SAR) average to 32.9 cm kyr,1 for the 10.8 Myr time span of deposition. [source] The influence of the construction process on the deformation behaviour of diaphragm walls in soft clayey groundINTERNATIONAL JOURNAL FOR NUMERICAL AND ANALYTICAL METHODS IN GEOMECHANICS, Issue 7 2006R. Schäfer Abstract Conventional numerical predictions of deep excavations normally neglect the construction process of the retaining structure and choose the earth pressure at rest as initial condition at the beginning of the simulation. The presented results of simulation and measurements during the construction process of the Taipei National Enterprise Center show, that such an assumption leads to an underestimation of the horizontal wall deflection, the surface ground settlements as well as the loading of the struts in case of normally to slightly over-consolidated clayey soil deposits. The stepwise installation process of the individual diaphragm wall panels results in a substantial modification of the lateral effective stresses in the adjacent ground. Especially the pouring process of the panel and the fresh concrete pressure causes a partial mobilization of the passive earth pressure and a distinct stress level increase in the upper half of the wall. As a consequence of the increased stresses prior to the pit excavation, up to 15% greater ground and wall movements are predicted. Moreover, the increased stress level due to the installation process of the diaphragm wall leads to substantial higher strut loadings during the excavation of the pit. Copyright © 2006 John Wiley & Sons, Ltd. [source] Modelling of earth and water pressure development during diaphragm wall construction in soft clayINTERNATIONAL JOURNAL FOR NUMERICAL AND ANALYTICAL METHODS IN GEOMECHANICS, Issue 13 2004R. Schäfer Abstract The influence of a diaphragm wall construction on the stress field in a soft clayey soil is investigated by the use of a three-dimensional FE-model of seven adjacent wall panels. The installation procedure comprises the excavation and the subsequent pouring of each panel taking into account the increasing stiffness of the placed fresh concrete. The soft clay deposit is described by a visco-hypoplastic constitutive model considering the rheological properties and the small-strain stiffness of the soil. The construction process considerably affects the effective earth and pore water pressures adjacent to the wall. Due to concreting, a high excess pore water pressure arises, which dissipates during the following construction steps. The earth pressure finally shows an oscillating, distinct three-dimensional distribution along the retaining wall which depends on the installation sequence of the panels and the difference between the fresh concrete pressure and the total horizontal earth pressure at rest. In comparison to FE-calculations adopting the earth pressure at rest as initial condition, greater wall deflections and surface ground settlements during the subsequent pit excavation can be expected, as the average stress level especially in the upper half of the wall is increased by the construction procedure of the retaining structure. Copyright © 2004 John Wiley & Sons, Ltd. [source] Biofiltration of waste gases in a reactor with a split-feedJOURNAL OF CHEMICAL TECHNOLOGY & BIOTECHNOLOGY, Issue 6 2003JA Mendoza Abstract The efficiency of using different feed strategies was evaluated in the case of a gas-phase biofilter packed with an inert carrier material. During a preliminary control-period, the biofilter was first fed with a single downflow feed of toluene. Reactor performance and biomass distribution were evaluated. The feed was then split into two flows before entering the reactor. Different feed ratios were tested during a 6-month period, following the preliminary control stage. Splitting the feed into equal flow rates through the upper and middle part of the biofilter (in a 50 : 50 ratio) improved the performance compared with the single-feed period. Such a high performance could also be maintained when using a higher flow rate for the upper port than for the middle port, with a feed-ratio of approximately 70 : 30, when more biomass was formed in the upper half of the filter bed. However, performance decreased when inverting this ratio from 70 : 30 to 30 : 70, ie when the highest flow rate was fed through the middle port of the biofilter. Copyright © 2003 Society of Chemical Industry [source] Random-Groups Equating with Samples of 50 to 400 Test TakersJOURNAL OF EDUCATIONAL MEASUREMENT, Issue 2 2010Samuel A. Livingston Five methods for equating in a random groups design were investigated in a series of resampling studies with samples of 400, 200, 100, and 50 test takers. Six operational test forms, each taken by 9,000 or more test takers, were used as item pools to construct pairs of forms to be equated. The criterion equating was the direct equipercentile equating in the group of all test takers. Equating accuracy was indicated by the root-mean-squared deviation, over 1,000 replications, of the sample equatings from the criterion equating. The methods investigated were equipercentile equating of smoothed distributions, linear equating, mean equating, symmetric circle-arc equating, and simplified circle-arc equating. The circle-arc methods produced the most accurate results for all sample sizes investigated, particularly in the upper half of the score distribution. The difference in equating accuracy between the two circle-arc methods was negligible. [source] Physical modelling of bedrock brecciation by ice segregation in permafrostPERMAFROST AND PERIGLACIAL PROCESSES, Issue 3 2001J. B. Murton Abstract The lower half of a large block of moist chalk was maintained at subzero temperatures while the upper half was cyclically frozen and thawed, simulating 19 seasonal temperature cycles in an active layer above permafrost. During the experiment, the rock surface heaved vertically by at least 34.7 mm. Sixty-one percent of the heave occurred during freezing periods, and is attributed primarily to ice segregation accompanying upward freezing from the permafrost table during the early stages of simulated winters. Thirty-nine percent of the heave occurred during thawing periods, and is attributed to ice segregation in the frozen rock beneath the thaw front during the mid to late stages of simulated summers. By the end of the experiment, the middle horizon of the chalk, representing the upper part of the simulated permafrost and the basal part of the active layer, had become strongly brecciated and rich in segregated ice. The style of brecciation has similarities with that in perennially-frozen limestone, sandstone and shale in Svalbard and Canada, and chalk frozen during Quaternary cold stages in France and England. These similarities suggest that ice segregation during perennial and seasonal freezing is an important process of weathering and coarse-sediment supply in areas of frost-susceptible bedrock. Copyright © 2001 John Wiley & Sons, Ltd. RÉSUMÉ La moitié inférieure d'un gros bloc de craie humide a été maintenue à des températures inférieures à zéro degré (maintien d'un pergélisol) pendant que sa moitié supérieure était soumise alternativement au gel et au dégel, simulant ainsi 19 cycles saisonniers dans la couche active. Pendant l'expérience, la surface de la roche s'est soulevée verticalement de 34,7 mm. Soixante et un % du gonflement a été acquis pendant les périodes de gel simulant les hivers et attribué essentiellement à la ségrégation de glace accompagnant un gel à partir du sommet du pergélisol au début de ces périodes. Trente neuf % du gonflement a été enregistré pendant le milieu et la fin des périodes de dégel simulant les étés. Ceci est considéré comme le résultat de regels en-dessous du niveau atteint par le front de dégel. A la fin de l'expérience, la partie médiane du bloc, correspondant au sommet du pergélisol et à la base de la couche active, est apparue très fragmentée et riche en glace de ségrégation. Le type de fragmentation offre des aspects semblables à ceux qu'on observe dans les calcaires, grès et schistes gelés en permanence du Svalbard et du Canada et les craies soumises aux gels des stades froids du Quaternaire en France et en Angleterre. Cela suggère que la ségrégation de la glace pendant les périodes de gel permanent ou saisonnier est un important processus de fragmentation des roches et de fourniture de sédiments grossiers dans les régions où les roches sont sensibles au gel. Copyright © 2001 John Wiley & Sons, Ltd. [source] Dielectric modeling of transmittance and ellipsometric spectra of thin In2O3:Sn filmsPHYSICA STATUS SOLIDI (A) APPLICATIONS AND MATERIALS SCIENCE, Issue 7 2010Zhaohui Qiao Abstract Thin ITO films with thickness between 0.05 and 0.4,µm were deposited on quartz substrates by direct-current magnetron-sputtering. The films' ellipsometric and transmittance spectra between 280 and 2500,nm were simulated simultaneously with a computer program based on dielectric modeling. The dielectric function used is the sum of three types of electronic excitations: intraband transitions of free electrons (extended Drude model), band gap transitions, and interband transitions into the upper half of the conduction band. A successful fit of the simulated to the experimental curves was obtained with a two-layer model (bulk and surface layers) and applying the Bruggeman effective-medium approach. From the simulation, film thickness, refractive index, band gap, and free carrier density can be obtained. The thickness of the surface layer is comparable with the surface roughness determined by AFM measurements. [source] Ectopia of meningeal fibroblasts and reactive gliosis in the cerebral cortex of the mouse model of muscle-eye-brain diseaseTHE JOURNAL OF COMPARATIVE NEUROLOGY, Issue 5 2007Yuan Yang Abstract Congenital muscular dystrophies with brain malformations, such as muscle-eye-brain disease, exhibit neural ectopias caused by overmigration of neurons. Such overmigration is evident in protein O-mannose ,-1,2-N-acetylglucosaminyltransferase (POMGnT1) knockout mouse, a model of muscle-eye-brain disease, caused by breaches in the pial basement membrane. We hypothesize that breaches in pial basement membrane disrupt the neural-meningeal boundary, resulting in ectopia of meningeal fibroblasts in the cerebral cortex and reactive gliosis. To test this hypothesis, the cerebral cortices of developing and adult POMGnT1 knockout mice were analyzed by immunostaining with cell-specific markers and by electron microscopy. The upper half of the cerebral cortex in the knockout mouse contained increased numbers of fibroblasts closely associated with capillaries. During development of the cerebral cortex in the knockout mice, breaches in pial basement membrane allowed emigration of overmigrated neurons into the developing pia-arachnoid, scattering its mesenchymal cells throughout the diffuse cell zone and resulting in ectopia of mesenchyme-derived fibroblasts in the upper half of the cortex. Glial fibrillary acidic protein (GFAP) immunostaining revealed that the upper half of the cerebral cortex in the knockout also contained increased numbers of cells with morphologies typical of reactive astrocytes compared with the wild type. Moreover, most of the GFAP-positive reactive astrocytes were in close contact with ectopic fibroblasts, suggesting that they were induced by the fibroblasts. Collectively, the data support the hypothesis that the cerebral cortex of POMGnT1 knockout mice is characterized by migration defects leading to disruption of the pia-arachnoid, ectopia of fibroblasts in the cortex, and reactive gliosis. J. Comp. Neurol. 505:459,477, 2007. © 2007 Wiley-Liss, Inc. [source] Turbulent length-scales in the marine atmospheric mixed layerTHE QUARTERLY JOURNAL OF THE ROYAL METEOROLOGICAL SOCIETY, Issue 566 2000P. Durand Abstract The spectra of turbulence signals can be characterized by several independent scales. To provide a parametrization of these spectra requires knowledge of the relationships between these scales. This paper focuses on three independent scales: the integral scale (which is influenced by the low-frequency behaviour of the spectra); the wavelength of the spectrum peak (which characterizes the energy-containing domain); and the dissipation scale (which is relevant for the inertial subrange). First, we present definitions of these various scales, and the possible relationships between them. The profiles of the scales were computed from airborne measurements made in the atmospheric mixed layer over the open ocean, in a region where horizontal homogeneity can be assumed, at least for several tens of km. Furthermore, the diurnal cycle being very weak in this oceanic area, and aircraft moving at high speed through the air mass, stationarity is well verified on the runs, and Taylor's hypothesis may be used. The meteorological conditions correspond to a slightly unstable mixed layer, with weak to moderate winds. In a first part, we analyse the integral scales of various parameters on a 180-km run and demonstrate that these parameters cannot be computed with any soundness from horizontal-wind, temperature and moisture signals, because of the continuous increase in the spectral energy when moving towards lower frequencies. For the same reasons, the spectrum peak and the corresponding wavelength cannot be determined for these parameters. The computation of the integral and energy-containing scale is therefore restricted to the vertical velocity, and to the various covariances. The turbulence field is characterized by a stretching of the eddies along the mean wind direction which results in greater integral and energy-containing scales (but not in greater dissipation scales) when computed for along-wind runs than for the cross-wind runs. The profiles of the various scales increase with altitude and are well defined in the lower half of the mixed layer, but are much more scattered in the upper half. This behaviour is related to the source of turbulence, which lies in the surface buoyancy flux in the lower half of the mixed layer, and comes from higher altitude sources in the upper half. The integral scales have values comparable with those found in previous work, except for parameters related to temperature fluctuations, which have lower values. The ratio of the energy-containing scale to the integral scale, which determines the sharpness of the ,spectral knee', varies considerably from one parameter to another, and sometimes with altitude. This demonstrates that a single unique parametrization cannot be defined for turbulence spectra. As a consequence, the eddy-exchange coefficients, which depend on a characteristic length-scale, should vary from one parameter to another. This would then have to be taken into account in model parametrization based on mixing length-scales. [source] The prevalence of anatomical variations that can cause inadvertent dural puncture when performing caudal block in Koreans: a study using magnetic resonance imagingANAESTHESIA, Issue 1 2010J. Joo Summary The purpose of this study was to investigate the prevalence of the anatomical abnormalities that can induce inadvertent dural puncture when performing caudal block. The anatomy of the lumbo-sacral area was evaluated using magnetic resonance imaging. In 2462 of the 2669 patients imaged, the dural sac terminal was located between the upper half of the 1st sacral vertebra and the lower half of the 2nd sacral vertebra. In 22 cases (0.8%), the dural sac terminal and the spinal canal were located at or below the 3rd sacral vertebra, and these were cases of simple anatomical variations. As regards pathologic conditions, there was one case of sacral meningocoele and 46 cases of sacral perineural cyst. In 21 cases (0.8%) out of the 46 perineural cyst cases, the cyst could be found at or below the 3rd sacral vertebra level. Inadvertent dural puncture may happen when performing caudal block in patients with such abnormal anatomy. [source] Using One Rotary Blood Pump to Produce Separate Pulsatile Circulations in the Upper and Lower Halves of the BodyARTIFICIAL ORGANS, Issue 8 2000Takashi Isoyama Abstract: Separate systemic circulations with pulsatile flow were obtained using 1 rotary blood pump as a left ventricular assist device. The outlet of the pump was divided into 2 conduits, 1 connected to the upper half of the body and the other connected to the lower half. An electric actuator that clamped the 2 outlet conduits alternately provided pulsatile flows. An in vitro experiment showed that the pulsatility phases of the upper and lower halves of the body were complementary with pulsatile flow, and an in vivo experiment showed that controlled flow distributions of continuous flows could be obtained. [source] Energielösungen für die Zukunft?CHEMIE IN UNSERER ZEIT (CHIUZ), Issue 2 2007Weiße Biotechnologie Abstract Angesichts hoher Ölpreise und der sich abzeichnenden globalen Klimaveränderungen erscheinen biotechnisch hergestellte Energieträger als vielversprechende Zukunftsoption. Mit seinen Jahresproduktionsmengen von 2 Mio t Biodiesel, 560.000 t Bioethanol und seinen 2.700 Biogasanlagen befindet sich Deutschland in Sachen Bioenergie in der vorderen Hälfte der Industrienationen. Vorgestellt werden die Möglichkeiten, die die weiße Biotechnologie zur Herstellung von Energieträgern bietet. In view of the high price of oil and the emerging global climate changes, biotechnologically produced energy sources appear to be a promising option for the future. Of the industrial nations, Germany with annual production figures of 2 m tons of biodiesel, 560,000 tons of bioethanol and some 2,700 biogas plants is in the upper half of the bioenergy rankings. Here, the potential of industrial biotechnology for energy production is presented in detail. [source] Locating the arcuate line of Douglas: Is it of surgical relevance?CLINICAL ANATOMY, Issue 1 2010P.M. Mwachaka Abstract Ventral hernia formation is a common complication of rectus abdominis musculocutaneous flap harvest. The site and extent of harvest of the flap are known contributing factors. Therefore, an accurate location of the arcuate line of Douglas, which marks the lower extent of the posterior wall of the rectus sheath, may be relevant before harvesting the flap. This study is aimed at determining the position of the arcuate line in relation to anatomical landmarks of the anterior abdominal wall. Arcuate lines were examined in 80 (44 male, 36 female) subjects, aged between 18 and 70 years, during autopsies and dissection. The position of the arcuate line was determined in relation to the umbilicus, pubic symphysis, and intersections of rectus abdominis muscle. Sixty four (80.4%) cases had the arcuate line. In most cases (52), this line was located in the upper half of a line between the umbilicus and the pubic symphysis. Most males (93%) had the arcuate line, while more than a third of females did not have it. In all these cases, the line occurred bilaterally as a single arcade, constantly at the most distal intersection of the rectus abdominis muscle. Consequently, the arcuate line is most reliably marked superficially by the distal tendinous intersection of the rectus abdominis muscle. Harvesting of the muscle cranial to this point will minimize defects in the anterior abdominal wall that may lead to hernia formation. Clin. Anat. 23:84,86, 2010. © 2009 Wiley-Liss, Inc. [source] Insulin, adiponectin, IGFBP-1 levels and body composition in small for gestational age born non-obese children during prepubertal agesCLINICAL ENDOCRINOLOGY, Issue 1 2008Ozlem Sancakli Summary Background, Being small for gestational age (SGA) at birth and postnatal growth pattern may have an impact on insulin resistance and body composition in later life. Adiponectin is a strong determinant of insulin sensitivity. Objective, The aim of this study was to evaluate insulin resistance and adiponectin levels in SGA born children with catch-up growth (CUG) in the absence of obesity in prepubertal ages and relations with body composition and insulin-like growth factor binding protein (IGFBP)-1. Methods, Twenty-four (15F, 9M) SGA born children with CUG but without obesity were evaluated at age 6·3 ± 0·5 years with respect to glucose, insulin, IGFBP-1, leptin and adiponectin levels, and body composition by dual-energy X-ray absorptiometry (DEXA). Their data were compared to that of 62 (27F, 35M) appropriate for gestational age (AGA) children. Results, SGA and AGA children had similar height standard deviation score (SDS) corrected for parental height and body mass index (BMI) SDS. Homeostasis model for insulin resistance (HOMA-IR) was significantly high in SGA (0·7 ± 0·6) than in AGA children (0·4 ± 0·2) (P = 0·029). There were no significant differences in leptin, IGFBP-1, adiponectin, and total and truncal fat between SGA and AGA children. However, being born SGA and having higher BMI in the upper half for the distribution in the sample, although within normal ranges, was associated with lower adiponectin levels (estimated means of log adiponectin levels 3·8 ± 0·3 vs. 4·4 ± 0·1 µg/ml, P = 0·040). Conclusions, SGA children with CUG and with no obesity have higher insulin levels compared to AGA children. Both SGA birth and recent size seem to have an effect on serum adiponectin levels in childhood. [source] A novel therapeutic paradigm to treat congenital hypothyroidismCLINICAL ENDOCRINOLOGY, Issue 1 2008Sarah Mathai Summary Objective, To determine the effectiveness of a novel therapeutic paradigm to treat congenital hypothyroidism (CH) incorporating variable initial doses of L-T4 based on the underlying aetiology and frequent monitoring, up to 2 years of age. Design, Retrospective cohort study. Patients, Infants with primary CH diagnosed by newborn screening. Measurements, Treatment with L-T4 suspension initiated at 10, 12 and 15 µg/kg/day for dyshormonogenesis, ectopia and athyreosis, respectively. Serum TSH and free T4 (FT4) levels monitored weekly during the first 4 weeks, at 6 weeks, thereafter monthly during the first 2 years. Dose changes were made to keep FT4 level in upper half of the normal range. Results, Sixty-nine infants; 17 had dyshormonogenesis, 35 ectopia and 17 athyreosis. Seventy-eight percent of subjects normalized FT4 levels within 7 days of treatment and 100% within 14 days. TSH levels normalized in 26% of infants within 7 days and in 92% by 21 days. Supraphysiological levels of FT4 were noted in 28% of infants, for a maximum of 2 weeks. 48% infants needed one dose adjustment and 30% needed at least two in the first month. In 52 infants over the first 2 years, mean FT4 levels were consistently in the upper half of the normal range. Two or more dose adjustments every 3 months were made 57 times in the first year as compared to 19 times in the second year. Conclusions, A variable initial dose paradigm based on aetiology with frequent testing and using T4 suspension rapidly normalizes FT4 levels without producing persistent hyperthyroxinaemia. [source] Unmasking of central hypothyroidism following growth hormone replacement in adult hypopituitary patientsCLINICAL ENDOCRINOLOGY, Issue 1 2007Amar Agha Summary Background, The effect of GH replacement on thyroid function in hypopituitary patients has hitherto been studied in small groups of children and adults with conflicting results. Objective, We aimed to define the effect and clinical significance of adult GH replacement on thyroid status in a large cohort of GH-deficient patients. Patients and method, We studied 243 patients with severe GH deficiency due to various hypothalamo-pituitary disorders. Before GH treatment, 159 patients had treated central hypothyroidism (treated group) while 84 patients were considered euthyroid (untreated group). GH dose was titrated over 3 months to achieve serum IGF-1 concentration in the upper half of the age-adjusted normal range. Serial measurements of serum T4, T3, TSH and quality of life were made at baseline and at 3 and 6 months after commencing GH replacement. Results, In the untreated group, we observed a significant reduction in serum T4 concentration without a significant increase in serum T3 or TSH concentration; 30/84 patients (36%) became hypothyroid and needed initiation of T4 therapy. Similar but lesser changes were seen in the treated group, 25 of whom (16%) required an increase in T4 dose. Patients who became hypothyroid after GH replacement had lower baseline serum T4 concentration, were more likely to have multiple pituitary hormone deficiencies and showed less improvement in quality of life compared with patients who remained euthyroid. Conclusion, GH deficiency masks central hypothyroidism in a significant proportion of hypopituitary patients and this is exposed after GH replacement. We recommend that hypopituitary patients with GH deficiency and low normal serum T4 concentration should be considered for T4 replacement prior to commencement of GH in order to provide a robust baseline from which to judge the clinical effects of GH replacement. [source] Do ,1 -adrenoceptor antagonists improve lower urinary tract symptoms by reducing bladder outlet resistance?,NEUROUROLOGY AND URODYNAMICS, Issue 3 2008Maurits M. Barendrecht Abstract Aims To test the hypothesis that improvements of lower urinary tract symptoms (IPSS) upon treatment with an ,-blocker are due to reduction of bladder outlet obstruction (assessed as the bladder outlet obstruction index, BOOI); relationships of either with free flow Qmax were also explored. Methods The database of a large placebo-controlled, randomized, double-blind study with the ,-blocker tamsulosin was analyzed retrospectively. Patients were stratified into lower and upper halves according to baseline IPSS, Qmax or BOOI and treatment-associated alterations thereof. In these strata differences between values for the other two parameters were analyzed, for example, improvement of IPSS and Qmax were compared in patients with below and above median improvement of BOOI. Results Patients with below and above median baseline for one parameter, for example, IPSS had rather similar values for the other two parameters, for example, Qmax and BOOI. Likewise, patients based upon baseline strata for one parameter had rather similar improvements of the other two parameters. Most importantly, patients with below and above median treatment-associated improvements of one parameter, for example, BOOI exhibited only small if any difference for alterations of the other two parameters, for example, IPPS and Qmax. Conclusions We conclude that IPSS, free flow Qmax and BOOI are only loosely related at baseline. More importantly, treatment-induced improvements of these parameters are also only loosely related. These data do question the hypothesis that ,-blockers largely improve lower urinary tract symptoms by reducing bladder outlet obstruction and suggest that they may also act independent of prostatic smooth muscle tone. Neurourol. Urodynam. 27:226,230, 2008. © 2007 Wiley-Liss, Inc. [source] | |||||||||||||||||||