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Batch processing refers to the batching, or grouping, of related jobs. If several programs require the same support program (a compiler, for instance), it makes sense to batch the jobs together so the support program is loaded once, rather than once per job. Let s look at an example of batch processing. Input jobs are collected and grouped by the computer operator and written to a magnetic tape by a dedicated computer. Once a job threshold is reached, the operator moves the tape to the main computer, which begins processing the tape without operator or programmer interaction. All jobs on the input tape are processed sequentially, and output is written to another tape. After running all jobs, the output tape is moved to another computer, which transfers the stored output to the printer. An important element of this process is how the computer loads and executes each job from the input tape. The program that handles this operation, called a monitor or supervisory system, is the precursor of the modern operating system (see the Resources section of this book: Lee 1992, 14; Tanenbaum 1997, 6; Silberschatz, Peterson 1989, 6 9). Control cards were added to the process to help the monitor program control the loading and execution of jobs. Batch processing was better than its predecessor, but it did little to reduce program development time or to address fully CPU utilization. The main problem resolved was the reduction of operator time. In the late 1950s, researchers within academia (as well as their counterparts in industry) began investigating alternatives and extensions to batch-processing systems. Some thought batch processing with expansion and improvement was the correct course of action. Others, however, thought that pursuing designs based on batch processing was myopic and prohibitive to developing the next generation of systems.

Radiation therapy is reserved for patients with macroadenomas that are growing despite treatment with dopamine agonists A single gamma knife or cyberknife treatment is preferable for certain patients whose optic chiasm is clear of tumor, since it is generally safer and more convenient than conventional radiation therapy Conventional radiation therapy must be given over 5 weeks and carries a high risk of eventual hypopituitarism Other possible side effects include some degree of memory impairment and an increased longterm risk of second tumors and small vessel ischemic strokes After radiation therapy, patients are advised to take low-dose aspirin to reduce their stroke risk

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Colao A et al Outcome of cabergoline treatment in men with prolactinoma: effects of a 24-month treatment on prolactin levels, tumor mass, recovery of pituitary function, and semen analysis J Clin Endocrinol Metab 2004 Apr;89(4):1704 11 [PMID: 15070934] Delgrange E Cabergoline and mitral regurgitation N Engl J Med 2006 Jan 26;354(4):420 [PMID: 16436779] Gibney J et al The impact on clinical practice of routine screening for macroprolactin J Clin Endocrinol Metab 2005 Jul;90(7):3927 32 [PMID: 15811931] Haddad PM et al Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management Drugs 2004; 64(20):2291 314 [PMID: 15456328] Molitch ME Medication-induced hyperprolactinemia Mayo Clin Proc 2005 Aug;80(8):1050 7 [PMID: 16092584] Sodi R et al Testosterone replacement-induced hyperprolactinaemia: case report and review of the literature Ann Clin Biochem 2005 Mar;42(Pt 2):153 9 [PMID: 15829128]

Assays for FT4, total triiodothyronine (T3), and free triiodothyronine (FT3) have largely supplanted measurements of total T4, resin T3 uptake (RT3U), and free thyroxine index (FT4I) It is particularly important to determine free serum levels (FT4 and FT3) in conditions associated with high circulating levels of thyroid binding globulin, such as during pregnancy or therapy with oral estrogen Ultrasensitive assays for serum TSH have largely replaced older TSH assays Table 26 3 shows the appropriate use of thyroid tests

Question 4-1. What is the difference between the = and == operators Question 4-2. Suppose I have four different variables, a, b, c, and d. What s the shortest way to assign them all the value 36 Question 4-3. What s the difference between dividing two ints and dividing two doubles Question 4-4. What is the purpose of the % operator Question 4-5. What is the output of these operations 4*8 (4 + 8) / (4 2) 4+8/4 2

Transsphenoidal pituitary surgery may be urgently required for large tumors undergoing apoplexy or those severely compromising visual fields It is also used electively for patients who do not tolerate or respond to dopamine agonists Pituitary transsphenoidal surgery is generally well-tolerated, with a surgical mortality rate of less than 05% Complications, such as cerebrospinal fluid leakage, meningitis, stroke, or visual loss, occur in about 3% of cases; sinusitis, nasal septal perforation, or infection complicates about 65% of surgeries Postoperative hyponatremia occurs quite commonly, and it is advisable to monitor serum sodium levels for the first 2 weeks postoperatively For pituitary microprolactinomas, skilled

Many factors affect thyroid function tests, causing misleading laboratory evidence of hypothyroidism (Table 26 4) or

Test Screening Serum thyroid-stimulating hormone (TSH) (sensitive assay) Free thyroxine (FT4) Serum TSH Antithyroglobulin and antithyroperoxidase antibodies Serum TSH (sensitive assay) Triiodothyronine (T3) (radioiodine) 123 I uptake and scan Antithyroglobulin and antimicrosomal antibodies Thyroid-stimulating immunoglobulin (TSI); TSH receptor antibody (TSH-R Ab [stim]) Fine-needle aspiration (FNA) biopsy 123 I uptake and scan 99m Tc scan Ultrasonography Comment Most sensitive test for primary hypothyroidism and hyperthyroidism Excellent test High in primary and low in secondary hypothyroidism Elevated in Hashimoto s thyroiditis Suppressed except in TSH-secreting pituitary tumor or pituitary hyperplasia (rare) Elevated Increased uptake; diffuse versus hot areas on scan Elevated in Graves disease Usually (65%) positive in Graves disease Best diagnostic method for thyroid cancer Cancer is usually cold ; less reliable than FNA biopsy Vascular versus avascular Useful to assist FNA biopsy Useful in assessing the risk of malignancy (multinodular goiter or pure cysts are less likely to be malignant) Useful to monitor nodules and patients after thyroid surgery for carcinoma

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