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Showing papers by "Université catholique de Louvain published in 1993"


Journal ArticleDOI
01 Apr 1993
TL;DR: An approach to requirements acquisition is presented which is driven by higher-level concepts that are currently not supported by existing formal specification languages, such as goals to be achieved, agents to be assigned, alternatives to be negotiated, etc.
Abstract: Requirements analysis includes a preliminary acquisition step where a global model for the specification of the system and its environment is elaborated This model, called requirements model, involves concepts that are currently not supported by existing formal specification languages, such as goals to be achieved, agents to be assigned, alternatives to be negotiated, etc The paper presents an approach to requirements acquisition which is driven by such higher-level concepts Requirements models are acquired as instances of a conceptual meta-model The latter can be represented as a graph where each node captures an abstraction such as, eg, goal, action, agent, entity, or event, and where the edges capture semantic links between such abstractions Well-formedness properties on nodes and links constrain their instances-that is, elements of requirements models Requirements acquisition processes then correspond to particular ways of traversing the meta-model graph to acquire appropriate instances of the various nodes and links according to such constraints Acquisition processes are governed by strategies telling which way to follow systematically in that graph; at each node specific tactics can be used to acquire the corresponding instances The paper describes a significant portion of the meta-model related to system goals, and one particular acquisition strategy where the meta-model is traversed backwards from such goals The meta-model and the strategy are illustrated by excerpts of a university library system

2,092 citations


Journal ArticleDOI
TL;DR: In this paper, the authors proposed a mechanism in which CO adsorbed on gold particles migrates toward the perimeter on support oxides and there it reacts with oxygen to form bidentate carbonate species.

2,073 citations


Journal ArticleDOI
02 May 1993
TL;DR: The structure of the kinematic and dynamic models of wheeled mobile robots is analyzed and it is shown that, for a large class of possible configurations, they can be classified into five types, characterized by generic structures of the model equations.
Abstract: The structure of the kinematic and dynamic models of wheeled mobile robots is analyzed. It is shown that, for a large class of possible configurations, they can be classified into five types, characterized by generic structures of the model equations. For each type of model the following questions are addressed: (ir)reducibility and (non)holonomy, mobility and controllability, configuration of the motorization, and feedback equivalence.

1,066 citations


Journal ArticleDOI
TL;DR: In this article, the methodology of free disposal hull (FDH) measure of productive efficiency is defined and put in perspectivevis-a-vis other nonparametric techniques, in terms of the postulates on which they respectively rest.
Abstract: The methodology of free disposal hull (FDH) measure of productive efficiency is defined and put in perspectivevis-a-vis other nonparametric techniques, in terms of the postulates on which they respectively rest. Computational issues are also considered, in relation to the linear programming techniques used in DEA. The first application bears on a comparison between a private and a public bank, in terms of the relative efficiency of their branches. Important characteristics of the data are revealed by FDH that are not by DEA, due to a better data fit. Next, efficiency estimates of judicial activities are used to evaluate what part of the existing backlog could be reduced by efficiency increases. Finally, with monthly data of an urban transit firm over 12 years, the FDH methodology is extended to a sequential treatment of time series, that supplements efficiency estimation with a measure of technical progress.

696 citations


Journal ArticleDOI
TL;DR: It is concluded from this review that "nondigestible fructo-oligosaccharides," even though they are not included in the carbohydrate fraction that is quantified as dietary fiber by classic analytical methods, have most of the physiological effects of a dietary fiber.
Abstract: Dietary fiber is a general term. It covers a wide variety of substances that belong to the family of carbohydrates that resist hydrolysis by human alimentary enzymes but are fermented by colonic microflora. The main physiological effects of dietary fiber are primarily on gastric emptying and small intestinal transit time, resulting in an improved glucose tolerance and a decreased digestion of starch: second, on colonic transit time and large bowel functions due to fermentation by ceco-colonic microbial flora or bulking action. The so-called soluble dietary fibers are fermented to a large extent by a wide variety of anaerobic bacteria that result in an increase in bacterial biomass, an increase in fecal mass, a change in intracolonic pH, and production of short chain fatty acids and various gases as metabolic end products. The insoluble fibers are only marginally fermented: they serve almost exclusively as bulking agents that result in shorter transit time and increased fecal mass. The short chain fatty acids resulting from the colonic fermentation of dietary fiber are largely absorbed via the portal blood and reach both the liver and the peripheral tissues. They induce changes in glucose and fat metabolism leading to post-prandial hypoglycemia and long-term hypolipidemia. Inulin and oligofructose are fructans with a degree of polymerization of 2 to 60 and 2 to 20, respectively. Due to the structural conformation of their osidic bridge (beta 2-1), they both resist the hydrolysis by human alimentary enzymes. Moreover, when reaching the colon, both inulin and oligofructose are almost quantitatively fermented almost exclusively by colonic bifidobacteria and bacteroides. Such an extensive fermentation causes an increase in fecal bacterial biomass, a decrease in ceco-colonic pH, and produces a large amount of fermentation products among which the short chain fatty acids that exert systemic effects on lipid metabolism. Thus, both inulin and oligofructose have most of the characteristics of a dietary fiber and the proposal is made to classify them as such. Moreover, they are bifidogenic factors, because, due to still unknown reasons, they are primarily fermented by bifidobacteria. It is concluded from this review that "nondigestible fructo-oligosaccharides," even though they are not included in the carbohydrate fraction that is quantified as dietary fiber by classic analytical methods, have most of the physiological effects of a dietary fiber.(ABSTRACT TRUNCATED AT 400 WORDS)

643 citations


Journal ArticleDOI
TL;DR: The Charlson Index is a useful approach to risk adjustment in outcomes research from administrative databases using the MED-ECHO database ( Quebec) to measure the burden of comorbid diseases.
Abstract: To measure the burden of comorbid diseases using the MED-ECHO database (Quebec), the so-called Charlson index was adapted to International Classification of Disease (ICD-9) codes. The resulting comorbidity index was applied to the study of inpatient death in a group of 62,456 patients having one of the following conditions: ischemic heart disease, congestive heart failure, stroke, or bacterial pneumonia. Multiple logistic regression was used to relate inpatient death to its predictors, including gender, principal diagnosis, age, and the comorbidity index. Various transformations of the comorbidity score were performed, and their effect on predictive accuracy was assessed. The comorbidity index was constantly and strongly associated with death. When gender, age, comorbidity and the principal diagnoses were taken into account, the area under the receiver-operating curve was 0.83. Therefore, the Charlson Index is a useful approach to risk adjustment in outcomes research from administrative databases.

523 citations


Journal ArticleDOI
TL;DR: Results indicated that the use of transverse field steering current improved selectivity in cats to study selective activation of medial gastrocnemius, soleus, tibialis anterior, and extensor digitorium longus with a cuff electrode.
Abstract: Acute experiments were performed on adult cats to study selective activation of medial gastrocnemius, soleus, tibialis anterior, and extensor digitorium longus with a cuff electrode. A spiral nerve cuff containing twelve dot electrodes was implanted around the sciatic nerve, and evoked muscle twitch forces were recorded in six experiments. Spatially isolated dot electrodes in four geometries (monopolar, longitudinal tripolar, tripolar with four common anodes, and two parallel tripoles) were combined with transverse field steering current(s) from an anode(s) located 180 degrees around from the cathode(s) to activate different regions of the nerve trunk. A selectivity index was used to construct recruitment curves for a muscle with the optimal degree of selectivity. Physiological responses were correlated with the anatomical structure of the sciatic nerve by identifying the nerve fascicles innervating the four muscles, and by determining the relative positions of the electrodes and the nerve fascicles. The results indicated that the use of transverse field steering current improved selectivity. The relative performance of the various electrode arrangements is discussed. >

420 citations


Journal ArticleDOI
TL;DR: A study of 6,273 consecutive relatively unselected patients with heart failure or left ventricular dysfunction, or both (mean age 62 +/- 12 years, mean ejection fraction 31 +/- 9%), were enrolled in the Studies of Left Ventricular Dysfunction (SOLVD) Registry over a period of 14 months.

357 citations


Book ChapterDOI
01 Jan 1993
TL;DR: The central message of this paper is to show that the global control performance criterion must determine the identification criterion, which leads to non standard identification criteria, which can be minimized by appropriate experimental set-ups.
Abstract: This paper aims at introducing the reader to the various issues that arise in the development of a coherent methodology for the development of robust control design on the basis of models identified from data. When a reduced complexity model is identified with the purpose of designing a robust controller, the model is just a vehicle for the computation of a controller. The design of the identification and of the controller must be seen as two parts of a joint design problem. The central message of this paper is to show that the global control performance criterion must determine the identification criterion. This leads to non standard identification criteria, which can be minimized by appropriate experimental set-ups.

330 citations


Journal ArticleDOI
TL;DR: Results show that EDL muscles from mdx mice are more vulnerable than their controls, supporting the structural role hypothesis for dystrophin and suggesting that contractions with stretches may contribute to the muscle damage and degeneration observed in DMD-patients.
Abstract: Absence of dystrophin in mdx muscles may render the muscle more susceptible to damage when submitted to high stress levels. To test this, typically slow (soleus) and fast (EDL) limb muscles of dystrophic (mdx) and normal (C57BL/10) mice were submitted (in vitro) to a series of isometric contractions, followed by a series of contractions with stretches. Muscle injury was assessed by monitoring the force signal. Membrane damage was evaluated by bathing the muscle in Procion Red, a dye that does not penetrate intact fibres, and subsequent analysis by light microscopy. After isometric contractions, only a very small force drop (< 3% of maximal isometric force) was observed which indicated that no injury had occurred in soleus and EDL muscles in either mdx or C57 strains. After contractions with a stretch, a force drop of 10% was observed in soleus muscles from both strains and in EDL muscles from C57 mice. However, in mdx mice EDL muscles displayed an irreversible force drop of 40-60%. Histological analysis of the muscles indicates that force drop is associated with membrane damage. These results show that EDL muscles from mdx mice are more vulnerable than their controls, supporting the structural role hypothesis for dystrophin. Furthermore, they suggest that contractions with stretches may contribute to the muscle damage and degeneration observed in DMD-patients.

320 citations


Journal ArticleDOI
TL;DR: A standardized skin‐surface biopsy of the cheek was performed in 49 patients with rosacea and 45 controls to establish a pattern of inflammation in the cheek during the period of EMT.
Abstract: A standardized skin-surface biopsy (1 cm2) of the cheek was performed in 49 patients with rosacea [13 with erythematotelangiectatic rosacea (ETR), three with squamous rosacea (SR), 33 with papulopustular rosacea (PPR)], and 45 controls. A mean density of 0.7 Demodex folliculorum/cm2 was found in controls, 98% of whom had less than five Demodex/cm2. When all clinical types of rosacea were considered collectively, the density of Demodex was significantly higher in patients with rosacea than in controls (mean = 10.8/cm2; P < 0.001). When the various clinical types of rosacea were considered separately, Demodex density was statistically significantly higher than in controls only in the PPR patients (mean = 12.8/cm2; P < 0.001). The same type of comparison was also made for three other groups of subjects-patients with isolated inflammatory papules (n = 4), rhinophyma (n = 3), and HIV infection (n = 21), respectively: in these groups, the Demodex density did not differ significantly from controls. The present study demonstrates a high density of D. folliculorum in PPR, and supports its pathogenic role in the papulopustular phase of rosacea. The study suggests that standardized surface biopsy could be a useful diagnostic tool for PPR, with a 98% specificity when Demodex density is higher than 5/cm2.


Journal ArticleDOI
TL;DR: The extracellular lipase of Bacillus subtilis 168 was purified from the growth medium of an overproducing strain by ammonium sulfate precipitation followed by phenyl-Sepharose and hydroxyapatite column chromatography and showed maximum stability at pH 12 and maximum activity at pH 10.9.
Abstract: The extracellular lipase of Bacillus subtilis 168 was purified from the growth medium of an overproducing strain by ammonium sulfate precipitation followed by phenyl-Sepharose and hydroxyapatite column chromatography. The purified lipase had a strong tendency to aggregate. It exhibited a molecular mass of 19,000 Da by SDS-PAGE and a pI of 9.9 by chromatofocusing. The enzyme showed maximum stability at pH 12 and maximum activity at pH 10. The lipase was active toward p-nitrophenyl esters and triacylglycerides with a marked preference for esters with C8 acyl groups. Using trioleyl glycerol as substrate, the enzyme preferentially cleaved the 1(3)-position ester bond. No interfacial activation effect was observed with triacetyl glycerol as substrate.

Journal ArticleDOI
TL;DR: The resin-dentin interdiffusion zone produced by a dentin-adhesive system that removes the smear layer and concurrently decalcifies superficial dentin was morphologically examined by both scanning and transmission electron microscopy and confirmed the presence of the resin- dentin interDiffusion zone as the junction between the deep unaltered dentin structure and the restorative resin.
Abstract: The resin-dentin interdiffusion zone produced by a dentin-adhesive system that removes the smear layer and concurrently decalcifies superficial dentin was morphologically examined by both scanning and transmission electron microscopy. Cross-sectioned resin-bonded dentin discs were etched with an argon-ion beam to make the resin-dentin interface observable by SEM. For the TEM examination, the sections were partly decalcified by an aqueous EDTA solution to facilitate ultramicrotomy and to disclose the ultrastructure of the interdiffusion zone. Both SEM and TEM confirmed the presence of the resin-dentin interdiffusion zone as the junction between the deep unaltered dentin structure and the restorative resin. Within the interdiffusion zone, three sublayers with characteristic ultrastructure and staining were identified by TEM. An upper diffuse black layer contained few structural features. Underneath, partially-altered collagen fibrils were closely packed, mostly running parallel with the interface and perpendicular to the dentinal tubules. Their outline was electron-dense, forming tunnel-like structures. At the base of the upper layer, several stained projections were found to bulge out into the underlying collagen network and appeared to be confined by obstructive, parallel-running collagen fibrils. Finally, the third dense layer, containing hydroxyapatite crystals, demarcated the superficially demineralized dentin layer from the deeper unaltered dentin. Resin diffusion into the decalcified dentin surface layer was evident, but diminished with depth, presumably reducing deeper resin impregnation into the interfibrillar spaces. The citric acid dentin-pretreatment probably caused denaturation of the superficial collagen fibrils. Its decalcifying effect gradually weakened with depth, leaving behind hydroxyapatite crystals at the base of the interdiffusion zone. These crystals appeared to have been resistant to the EDTA TEM-sample decalcification procedure, which suggests that they were protected by resin encapsulation.

Journal ArticleDOI
TL;DR: In this article, the authors conduct a performance evaluation of credit unions and use nonparametric, nonstochastic techniques to measure performance, and use parametric, stochastic technique to attribute performance variation to features of credit union and their operating environment.
Abstract: Credit unions are small, cooperative, not-for-profit institutions, which distinguishes them from other financial intermediaries In this study we conduct a performance evaluation of credit unions The criteria respect the unique organizational and institutional features of credit unions, without losing sight of the fact that they must compete with other financial intermediaries We use nonparametric, nonstochastic techniques to measure performance, and we use parametric, stochastic techniques to attribute performance variation to features of credit unions and their operating environment Our sample consists of two-thirds of all active credit unions in 1990

Journal ArticleDOI
TL;DR: This work discusses the general properties of the CWT and applies it, both analytically and graphically, to a number of simple geometrical objects: a line, a square, an angle, etc.

Journal ArticleDOI
TL;DR: The novelty of the technique, as compared with endoscopic sutureless coagulating methods, consists of stapling the esophageal to the diverticular wall using the Endo-GIA 30 stapler, which protects the neck from any contamination from the digestive lumen and ensures optimal hemostasis of the wound edges.

Journal ArticleDOI
TL;DR: It is demonstrated that the gene product of yerA regulates the production of YopE at a post‐transcriptional level and it is hypothesized that SycE is a link between translation and the specific Yop export machinery, the first representative of a new family of pYV‐encoded proteins.
Abstract: Pathogenic yersiniae secrete a set of 11 anti-host proteins called Yops. The yop genes, scattered around the pYV plasmid, constitute a thermoinduced regulon controlled by the product of virF gene. The secretion of the Yops also requires the presence of the products of the other vir genes and operons, namely virA, virB and virC. The large virC operon and presumably some genes of the virA region encode a new secretion system. Mutations in any of these vir genes impair the production of all the Yops. In contrast, mutations in the yerA locus, located close to yopE, specifically abolish the expression of the cytotoxin YopE. We describe here the counterpart of yerA in Yersinia enterocolitica W22703. We demonstrate that the gene product of yerA regulates the production of YopE at a post-transcriptional level. It specifically binds the YopE protein. We consider that it acts as a specific chaperone and we call it SycE (for specific YopE chaperone). We hypothesize that SycE is a link between translation and the specific Yop export machinery. It is the first representative of a new family of pYV-encoded proteins.

Journal ArticleDOI
TL;DR: The recent recommendation by the American Conference of Governmental Industrial Hygienists (ACGIH) of 5 micrograms Cd/g creatinine in urine as the biological exposure limit for occupational exposure to Cd appears justified, although for most of the effects occurring around this threshold the link with the subsequent development of overt Cd nephropathy is not established.
Abstract: The present study has been carried out in the framework of a collaborative research project on the development of new markers of nephrotoxicity. A battery of more than 20 potential indicators of renal changes has been applied to 50 workers exposed to lead (Pb) and 50 control subjects. After application of selection criteria 41 exposed and 41 control workers were eventually retained for the final statistical analysis. The average blood Pb concentration of exposed workers was 480 micrograms/l and their mean duration of exposure was 14 years. The battery of tests included parameters capable of detecting functional deficits (for example, urinary proteins of low or high molecular weight), biochemical alterations (for example, urinary eicosanoids, glycosaminoglycans, sialic acid) or cell damage (for example, urinary tubular antigens or enzymes) at different sites of the nephron or the kidney. The most outstanding effect found in workers exposed to Pb was an interference with the renal synthesis of eicosanoids, resulting in lower urinary excretion of 6-keto-PGF1 alpha and an enhanced excretion of thromboxane (TXB2). The health significance of these biochemical alterations, detectable at low exposure to Pb is unknown. As they were not associated with any sign of renal dysfunction, they may represent reversible biochemical effects or only contribute to the degradation of the renal function from the onset of clinical Pb nephropathy. The urinary excretion of some tubular antigens was also positively associated with duration of exposure to Pb. Another effect of Pb that might deserve further study is a significant increase in urinary sialic acid concentration.


Journal ArticleDOI
15 Oct 1993-Blood
TL;DR: It is concluded that evaluation of anti-FVIII antibodies by a functional method does not provide an accurate evaluation of the specific antibody response and has important implications for the comparison of the immunogenicity of FVIII molecules produced by different technologies and for the development of methods to control anti-VIII antibody production.

Journal ArticleDOI
TL;DR: In this article, the freezing of water adsorbed on high surface area materials such as silica gel, controlled-pore glass, and activated charcoal is investigated with NMR methods.


Journal ArticleDOI
TL;DR: It is concluded that factor H bound to YadA reduces the C3B deposition on the bacterial surface, probably by a rapid inactivation of C3b.
Abstract: When mixed with normal human serum, wild-type pathogenic Yersinia enterocolitica, previously incubated at 37 degrees C, fixed less C3b than its variant cured of the virulence plasmid pYV. Mutants unable to secrete the Yop proteins were still protected against C3b deposition. By contrast, mutants deficient in the production of outer membrane protein YadA fixed more C3b than their YadA+ parent. Gene yadA, cloned as a minimal polymerase chain reaction fragment and introduced in trans, complemented the mutations. Production of YadA by recombinant Escherichia coli LK111 also resulted in a reduction of the amount of C3b deposited on the bacterial surface. The reduction of C3b at the surface of Y. enterocolitica YadA+ compared with YadA- cells correlated with an increase of the amount of factor H fixed at the bacterial surface. The YadA monomer separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and transferred to a nitrocellulose membrane was able to bind factor H. We conclude that factor H bound to YadA reduces the C3b deposition on the bacterial surface, probably by a rapid inactivation of C3b.

Journal ArticleDOI
TL;DR: Sequential radiographic and magnetic resonance imaging examinations were performed in patients with an intravertebral vacuum cleft indicative of avascular necrosis, and a fluidlike high-signal-intensity pattern appeared on T2- or T2*-weighted MR images, suggestive of a slow fluid inflow within the intraverTEbral cleft.
Abstract: Sequential radiographic and magnetic resonance (MR) imaging examinations were performed in nine patients with an intravertebral vacuum cleft indicative of avascular necrosis. Progressive changes in the content of the cleft occurred within an hour after the patients were placed in a supine position. Initially, the cleft showed a gaslike pattern during extension of the spine, with a radiolucent band on radiographs and a signal void on MR images. Later, the vacuum phenomenon disappeared on radiographs, and a fluidlike high-signal-intensity pattern appeared on T2- or T2*-weighted MR images, suggestive of a slow fluid inflow within the intravertebral cleft. Because the recognition of a vacuum cleft in a collapsed vertebral body helps avoid confusion with malignancy or infection, it is important to search for this in examinations performed immediately after supine positioning.

Journal ArticleDOI
TL;DR: Comparison with all the proka‐ryotic transposable elements sequenced so far revealed that the IS231 transposases share two conserved regions with those of 35 other insertion sequences of wide origins.
Abstract: The eight IS231 variants characterized so far (IS231 A-F, V and W) display similar transposases with an overall 40% identity. Comparison with all the prokaryotic transposable elements sequenced so far revealed that the IS231 transposases share two conserved regions with those of 35 other insertion sequences of wide origins. These insertion sequences, defining the IS4 family, have a common bipartite organization of their ends and are divided into two similarity groups. Interestingly, the transposase domains conserved within this family display similarities with the well known integrase domain shared by transposases of the IS3 and IS15 families, and integrases of retroelements. This domain is also found in IS30-related elements and Tn7 TnsB protein. Amino acid residues conserved throughout all these prokaryotic and eukaryotic mobile genetic elements define a major transposase/integrase motif, likely to play an important role in the transposition process.

Journal ArticleDOI
TL;DR: The study shows that esophageal resections as extensive as those carried out by thoracotomy can be performed by Thoracoscopy, and suggests that prompt management of untoward injury to any mediastinal structure adjacent to the esophagus is less easy by thorcoscopy than byThoracotomy.

Journal ArticleDOI
TL;DR: It is proposed that osteoclastic collagenase is secreted in the resorbing compartment where it may cooperate with the lysosomal cysteine proteinases in the degradation of the collagen component of the matrix during the resOrption of bone.
Abstract: Osteoclasts resorb the extracellular matrix of bone by secreting enzymes and acid into a sealed-off compartment that they form upon attachment to the bone surface. Although the lysosomal cysteine proteinases can degrade collagen after the demineralization of bone at low pH, several lines of evidence suggest that collagenase (matrix metalloproteinase-1, EC 3.4.24.7) may also be involved in this process. The question of whether collagenase is present in the osteoclast and/or in the bone-resorbing compartment has however not been resolved. We have prepared an anti-mouse collagenase antiserum and affinity-purified an IgG fraction that specifically immunoblots and immunoprecipitates (pro)collagenase. Using these antibodies, we demonstrate by immunolocalization the presence of (pro)collagenase both in the osteoclasts and in the extracellular subosteoclastic bone-resorbing compartment. These specific localizations were observed not only in mice but also in rat and rabbit osteoclasts and using not only the antibody we have prepared but also antibodies raised in other laboratories against rat (Jeffrey et al., J. Cell. Physiol. 143, 396-403, 1990) and rabbit (Brinckerhoff et al., J. Biol. Chem. 265, 22262-22269, 1990) collagenase. Intracellular collagenase was observed in the osteoclasts whether the cells were plated on bone or cultured on glass coverslips. It is proposed that osteoclastic collagenase is secreted in the resorbing compartment where it may cooperate with the lysosomal cysteine proteinases in the degradation of the collagen component of the matrix during the resorption of bone.

Posted Content
01 Jan 1993
TL;DR: In this article, the authors considered the problem of lot-sizing with constant production capacities and a variant in which the capacity in each period is an integer multiple of some basic batch size LCB and proposed an On2 min{n, C} algorithm where n is the number of periods and C the batch size.
Abstract: We consider the classical lot-sizing problem with constant production capacities LCC and a variant in which the capacity in each period is an integer multiple of some basic batch size LCB We first show that the classical dynamic program for LCC simplifies for LCB leading to an On2 min{n, C} algorithm where n is the number of periods and C the batch size Using this new algorithm, we show how to formulate both problems as linear programs with On3 variables and constraints A class of so-called k, l, S, I inequalities are described for LCB which capture both the dynamic nature of the problem as well as the capacity aspects For LCB, we prove that these inequalities are the only facet-defining inequalities of a certain form For LCC, we show that these inequalities include all the known classes of valid inequalities Finally, we discuss several open questions and possible extensions

Journal ArticleDOI
TL;DR: The present studies confirm the role of hCG as an important thyroidal regulator during normal pregnancy and indicate for the first time that in these women, circulating hCG is characterized by elevated free β-hCG subunit and intact hCG levels, perhaps resulting from an imbalanced production of h CG.
Abstract: The main objective of the present study was to present additional evidence of the potentially important thyrotropic role of hCG to regulate the maternal thyroid gland during normal pregnancy. Sequential determinations (first and last trimesters) of intact hCG, free alpha and beta-hCG subunits concentrations (using monoclonal IRMAs), and assessment of parameters of thyroid function and thyroid volume were carried out in 62 pregnant women who exhibited during the first trimester of gestation low TSH levels (< or = 0.20 mU/L), and compared to 276 pregnant women with normal TSH levels. The prevalence of having low serum TSH represented 18% of all pregnancies, with almost one half of cases who transiently had undetectable TSH levels. Lowering of TSH was associated with high hCG levels, and occurred primarily during the first trimester. About 10% of women with low TSH presented transient gestational thyrotoxicosis, frequently associated with vomiting. In comparison to control subjects, women with a suppressed serum TSH had significantly and markedly higher intact hCG and free beta-hCG subunit concentrations. The results suggest that TSH reduction may result from a relative oversecretion of both intact hCG and free beta-hCG subunits, compatible with three hypotheses: a) transient overexpression of the beta-hCG gene, leading to enhanced production of hCG heterodimer; b) increased glycosylation of circulating hCG, with in turn a prolonged half life; c) larger syncytiotrophoblast mass with increased hCG production.(ABSTRACT TRUNCATED AT 250 WORDS)