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Growth Hormone And Glucose

Biochemical Investigations In Laboratory Medicine > Investigation Protocols > Pituitary Protocols > Glucose Tolerance Test For Acromegaly

Biochemical Investigations In Laboratory Medicine > Investigation Protocols > Pituitary Protocols > Glucose Tolerance Test For Acromegaly

Oral GTT for the Diagnosis of Growth Hormone Excess Oral GTT for the diagnosis of growth hormone excess Clinical suspicion of acromegaly or gigantism. Baseline GH values cannot be used to exclude acromegaly since elevated GH may be occur with stress and low values < 5 mIU/L are seen in up to 8% acromegalic patients who are subsequently identified by the failure of GH to suppress during GTT. This test is unnecessary in diabetic patients who should already have a suppressed GH in the presence of hyperglycaemia. GH secretion is part of the counter-regulatory defence against hypoglycaemia and physiological GH secretion is inhibited by hyperglycaemia. In acromegaly, or gigantism, GH secretion is autonomous and does not suppress and may paradoxically rise with hyperglycaemia. Some subjects feel nauseated and may have vaso-vagal symptoms during this test. Patients should be advised to fast for 10-16 hours prior to this test but may drink small volumes of water. Adults: 75 g anhydrous glucose in cold water. The solution should be chilled to improve palatability. An alternative is this Polycal (113 mL) which is still more palatable and should be followed by 150mL water (total volume should be 250-300mL) Children: the dose is weight related 1.75g/kg body weight: the maximum load is 75g. Polycal contains 0.66g anhydrous glucose per mL (or 1.51mL contains 1g anhydrous glucose). Insert an indwelling cannula and take blood samples for GH, IGF-1and glucose (1-2 mL in plain & 1-2 mL in fluoride oxalate tubes). Take further blood samples for GH and glucose Normal subjects will exhibit suppression of GH to undetectable values (< 0.3 g/L) during the test. NB paradoxical rise in GH may occur during GTT during normal adolescence. Fasting GH may be normal in 8% of acromegalic subjects but G Continue reading >>

Effects Of Growth Hormone On Glucose, Lipid, And Protein Metabolism In Human Subjects

Effects Of Growth Hormone On Glucose, Lipid, And Protein Metabolism In Human Subjects

In evolutionary terms, GH and intracellular STAT 5 signaling is a very old regulatory system. Whereas insulin dominates periprandially, GH may be viewed as the primary anabolic hormone during stress and fasting. GH exerts anabolic effects directly and through stimulation of IGF-I, insulin, and free fatty acids (FFA). When subjects are well nourished, the GH-induced stimulation of IGF-I and insulin is important for anabolic storage and growth of lean body mass (LBM), adipose tissue, and glycogen reserves. During fasting and other catabolic states, GH predominantly stimulates the release and oxidation of FFA, which leads to decreased glucose and protein oxidation and preservation of LBM and glycogen stores. The most prominent metabolic effect of GH is a marked increase in lipolysis and FFA levels. In the basal state, the effects of GH on protein metabolism are modest and include increased protein synthesis and decreased breakdown at the whole body level and in muscle together with decreased amino acid degradation/oxidation and decreased hepatic urea formation. During fasting and stress, the effects of GH on protein metabolism become more pronounced; lack of GH during fasting increases protein loss and urea production rates by approximately 50%, with a similar increase in muscle protein breakdown. GH is a counterregulatory hormone that antagonizes the hepatic and peripheral effects of insulin on glucose metabolism via mechanisms involving the concomitant increase in FFA flux and uptake. This ability of GH to induce insulin resistance is significant for the defense against hypoglycemia, for the development of “stress” diabetes during fasting and inflammatory illness, and perhaps for the “Dawn” phenomenon (the increase in insulin requirements in the early morning hou Continue reading >>

Oral Glucose Tolerance Test With Growth Hormone Levels - Imperial Centre For Endocrinology

Oral Glucose Tolerance Test With Growth Hormone Levels - Imperial Centre For Endocrinology

Oral Glucose Tolerance Test with Growth Hormone Levels You are booked to come in for an : Oral Glucose tolerance test (OGTT) with Growth hormone levels An OGTT with GH levels looks to see if your body is making too much of a hormone called growth hormone (GH). A hormone is a chemical which is made in one part of the body but passes into the bloodstream and has effects on other parts of the body. GH is produced by your pituitary gland (a small gland that lies just under the brain.) GH has important effects on growth in childhood and influences adult body composition and the functioning of several body systems. Overproduction of GH in adulthood is called acromegaly . Measuring a single level of GH is not helpful as the body produces GH in pulses. GH tends to increase blood sugar and conversely, when things are working normally, a fixed dose of sugar by mouth lowers GH to undetectable levels. In acromegaly, the GH levels remain high (or may even increase) after a dose of sugar by mouth. This test looks at what happens to both your blood sugar levels and growth hormone levels after drinking a sugar solution. You should fast overnight before the test, drinking only water from midnight. You should take your medications as usual the day before the test unless your doctor has advised you not to. You should come to the ward on the date of the test, by 9am. You will have a bed to lie down in throughout the test. A cannula (a small needle with a tube attached for taking blood samples) will be placed in a vein in your arm. After the first blood sample has been taken from the cannula you will be given a sugary drink. Further blood samples will be taken from the cannula at half hour intervals for 2 hours. Once the test is completed, the cannula will be removed and you will be able t Continue reading >>

Short Time Effects Of Growth Hormone On Glucose Metabolism And Insulin And Glucagon Secretion In Normal Man

Short Time Effects Of Growth Hormone On Glucose Metabolism And Insulin And Glucagon Secretion In Normal Man

, Volume 14, Issue1 , pp 2530 | Cite as Short time effects of growth hormone on glucose metabolism and insulin and glucagon secretion in normal man The present study was undertaken in order to evaluate the acute metabolic and hormonal effects of human growth hormone in healthy subjects. Glucose turnover, plasma glucose, FFA, insulin, C-peptide, glucagon, and somatostatin concentrations were determined in the fasting state after a bolus injection of placebo or growth hormone in quantities producing increases in plasma growth hormone levels within the normal physiological range. We found that growth hormone administration resulted in negligible changes in plasma glucose, no significant changes in appearance or disappearance rates of glucose, a moderate increase in FFA and a moderate fall in plasma insulin, C-peptide and glucagon concentrations, while plasma somatostatin levels were unchanged. These findings suggest that rapid changes in plasma growth hormone concentrations, corresponding to the fluctuations seen during normal daily life, may play a role in the short time regulation of blood glucose concentration through an inhibition of insulin and glucagon secretion. Growth hormoneglucosefree fatty acidsinsulinglucagonsomatostatin This is a preview of subscription content, log in to check access Unable to display preview. Download preview PDF. Luft R., Cerasi E., Madison L.L., van Euler U.S., Della Casa L., Roovete A. Effect of a small decrease in blood glucose on plasma growth hormone and urinary excretion of catecholamines in man. Lancet 2: 254, 1966. PubMed CrossRef Google Scholar Christensen N.J., Hansen A.A.P., rskov H. Significance of glucose load in oral glucose tolerance tests. Blood glucose, serum insulin, growth hormone and free fatty acids. Acta Med. Scand. 1 Continue reading >>

Payperview: Effects Of Growth Hormone On Glucose Metabolism - Karger Publishers

Payperview: Effects Of Growth Hormone On Glucose Metabolism - Karger Publishers

Effects of Growth Hormone on Glucose Metabolism Mller N. Jrgensen J.O.L. Abildgrd N. rskov L. Schmitz O. Christiansen J.S. I have read the Karger Terms and Conditions and agree. Growth hormone (GH) counteracts in general the effects of insulin on glucose and lipid metabolism, but shares protein anabolic properties with insulin. Under physiological circumstances GH does not affect total glucose turnover directly. There is however evidence that GH acutely decreases glucose oxidation (secondary to an increase in lipid oxidation) and suppresses muscle uptake of glucose, suggesting that GH redistributes glucose fluxes into a non-oxidative pathway, which could be a build up of glycogen depots through gluconeogenesis. Since GH secretion is inhibited in the fed state these actions are mainly important in the postprandial or fasting state. Under pathological conditions of GH excess (e.g. acromegaly, poorly controlled tp. 1 diabetes or high dose GH treatment) the diabetogenic actions of GH become apparent. In these patients increased endogenous glucose production, decreased muscle glucose uptake and rising blood glucose levels are observed. In patients with intact -cell function these changes are counterbalanced by hyperinsulinemia such hyperinsulinemia may in the long term induce increased cardiovascular morbidity and mortality (Reavens syndrome X). When stimulated with insulin these patients exhibit insulin resistance at the liver, in adipose tissue and in muscle. Few elaborate studies on the effects of GH on glucose metabolism in GH deficient patients have been conducted. These patients are hypersensitive to the actions of insulin on glucose metabolism and there is some evidence that when GH initially is given to such patients in the GH deprived state, paradox insulin-like ef Continue reading >>

Growth Hormone (somatotropin)

Growth Hormone (somatotropin)

Growth hormone is a protein hormone of about 190 amino acids that is synthesized and secreted by cells called somatotrophs in the anterior pituitary. It is a major participant in control of several complex physiologic processes, including growth and metabolism. Growth hormone is also of considerable interest as a drug used in both humans and animals. Physiologic Effects of Growth Hormone A critical concept in understanding growth hormone activity is that it has two distinct types of effects: Direct effects are the result of growth hormone binding its receptor on target cells. Fat cells (adipocytes), for example, have growth hormone receptors, and growth hormone stimulates them to break down triglyceride and supresses their ability to take up and accumulate circulating lipids. Indirect effects are mediated primarily by a insulin-like growth factor-I (IGF-I), a hormone that is secreted from the liver and other tissues in response to growth hormone. A majority of the growth promoting effects of growth hormone is actually due to IGF-I acting on its target cells. Keeping this distinction in mind, we can discuss two major roles of growth hormone and its minion IGF-I in physiology. Effects on Growth Growth is a very complex process, and requires the coordinated action of several hormones. The major role of growth hormone in stimulating body growth is to stimulate the liver and other tissues to secrete IGF-I. IGF-I stimulates proliferation of chondrocytes (cartilage cells), resulting in bone growth. Growth hormone does seem to have a direct effect on bone growth in stimulating differentiation of chondrocytes. IGF-I also appears to be the key player in muscle growth. It stimulates both the differentiation and proliferation of myoblasts. It also stimulates amino acid uptake and p Continue reading >>

Effects Of Growth Hormone On Glucose Metabolism.

Effects Of Growth Hormone On Glucose Metabolism.

Abstract Growth hormone (GH) counteracts in general the effects of insulin on glucose and lipid metabolism, but shares protein anabolic properties with insulin. Under physiological circumstances GH does not affect total glucose turnover directly. There is however evidence that GH acutely decreases glucose oxidation (secondary to an increase in lipid oxidation) and suppresses muscle uptake of glucose, suggesting that GH redistributes glucose fluxes into a non-oxidative pathway, which could be a build up of glycogen depots through gluconeogenesis. Since GH secretion is inhibited in the fed state these actions are mainly important in the postprandial or fasting state. Under pathological conditions of GH excess (e.g. acromegaly, poorly controlled tp. 1 diabetes or high dose GH treatment) the diabetogenic actions of GH become apparent. In these patients increased endogenous glucose production, decreased muscle glucose uptake and rising blood glucose levels are observed. In patients with intact beta-cell function these changes are counterbalanced by hyperinsulinemia--such hyperinsulinemia may in the long term induce increased cardiovascular morbidity and mortality ('Reavens syndrome X'). When stimulated with insulin these patients exhibit insulin resistance at the liver, in adipose tissue and in muscle. Few elaborate studies on the effects of GH on glucose metabolism in GH deficient patients have been conducted. These patients are hypersensitive to the actions of insulin on glucose metabolism and there is some evidence that when GH initially is given to such patients in the GH deprived state, paradox insulin-like effects of GH may be observed. Whether this may relate to increased activity of insulin-like growth factors is unsettled. Continue reading >>

Effects Of Growth Hormone On Glucose Metabolism And Insulin Resistance In Human

Effects Of Growth Hormone On Glucose Metabolism And Insulin Resistance In Human

Effects of growth hormone on glucose metabolism and insulin resistance in human Shin-Hye Kim , MD, PhD and Mi-Jung Park , MD, PhD Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea Address for correspondence: Mi-Jung Park, MD, PhD , Department of Pediatrics, Inje University Sanggye Paik Hospital, 1342 Dongilro, Nowon-gu, Seoul 01767, Korea Tel: +82-2-950-8826 Fax: +82-2-950-1246 E-mail: [email protected] Received 2017 Aug 31; Accepted 2017 Sep 11. Copyright 2017 Annals of Pediatric Endocrinology & Metabolism This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Growth hormone (GH) is important for promotion of somatic growth and the regulation of substrate metabolism. Metabolic action of GH occurs in multiple tissues including the liver, muscle, fat and pancreas either directly or indirectly through insulin-like growth factor 1. The diabetogenic action of GH has been well-described in previous in vivo studies. In this paper, we review the metabolic effects of GH on peripheral tissues focusing on glucose metabolism and insulin resistance, and discuss results from human studies on the long-term effects of GH administration on insulin resistance and hyperglycemia. Keywords: Growth hormone, Glucose, Metabolism, Insulin resistance Glucose balance in circulation is tightly maintained within normal range by dynamic regulation of both glucose production (from liver and kidney) and glucose usage by peripheral tissues including the liver, muscle, fat, and kidney [ 1 ]. Insulin, the primary regulator of glucose balance, lowers postprandial plasma glucos Continue reading >>

Blood Sugar & Other Hormones

Blood Sugar & Other Hormones

Other hormones also affect blood sugar. Glucagon, amylin, GIP, GLP-1, epinephrine, cortisol, and growth hormone also affect blood sugar levels. Glucagon: Made by islet cells (alpha cells) in the pancreas, controls the production of glucose and another fuel, ketones, in the liver. Glucagon is released overnight and between meals and is important in maintaining the body’s sugar and fuel balance. It signals the liver to break down its starch or glycogen stores and helps to form new glucose units and ketone units from other substances. It also promotes the breakdown of fat in fat cells. In contrast, after a meal, when sugar from the ingested food rushes into your bloodstream, your liver doesn’t need to make sugar. The consequence? Glucagon levels fall. Unfortunately, in individuals with diabetes, the opposite occurs. While eating, their glucagon levels rise, which causes blood sugar levels to rise after the meal. WITH DIABETES, GLUCAGON LEVELS ARE TOO HIGH AT MEALTIMES GLP-1 (glucagon-like peptide-1), GIP (glucose-dependent insulinotropic polypeptide) and amylin: GLP-1 (glucagon-like peptide-1), GIP (glucose-dependent insulinotropic polypeptide) and amylin are other hormones that also regulate mealtime insulin. GLP-1 and GIP are incretin hormones. When released from your gut, they signal the beta cells to increase their insulin secretion and, at the same time, decrease the alpha cells’ release of glucagon. GLP-1 also slows down the rate at which food empties from your stomach, and it acts on the brain to make you feel full and satisfied. People with type 1 diabetes have absent or malfunctioning beta cells so the hormones insulin and amylin are missing and the hormone GLP1 cannot work properly. This may explain, in part, why individuals with diabetes do not suppress gl Continue reading >>

Growth Hormone Suppression Test

Growth Hormone Suppression Test

URL of this page: //medlineplus.gov/ency/article/003376.htm The growth hormone suppression test determines whether growth hormone (GH) production is being suppressed by high blood sugar. The first blood sample is collected between 6 a.m. and 8 a.m. before you eat or drink anything. You then drink a solution containing glucose (sugar). You may be told to drink slowly to avoid becoming nauseated. But you must drink the solution within 5 minutes to ensure the test result is accurate. The next blood samples are usually collected for 1 to 2 hours after you finish drinking the glucose solution. Sometimes they are taken every 30 or 60 minutes. Each sample is sent to the laboratory right away. The lab measures the glucose and GH levels in each sample. DO NOT eat anything and limit physical activity for 10 to 12 hours before the test. You may also be told to stop taking medicines that can affect the test results. These medicines include glucocorticoids such as prednisone, hydrocortisone, or dexamethasone. Check with your health care provider before stopping any medicines. You will be asked to relax for at least 90 minutes before the test. This is because exercise or increased activity can change GH levels. If your child is to have this test done, it may be helpful to explain how the test will feel and even demonstrate on a doll. The more familiar your child is with what will happen and why, the less anxiety the child will feel. When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or slight bruising. This soon goes away. This test checks for a high level of GH, a condition that leads to gigantism in children and acromegaly in adults. It is not used as a routine screening test. This Continue reading >>

Effect Of Human Growth Hormone On Glucose Tolerance And Some Intermediary Metabolites In Man

Effect Of Human Growth Hormone On Glucose Tolerance And Some Intermediary Metabolites In Man

EFFECT OF HUMAN GROWTH HORMONE ON GLUCOSE TOLERANCE AND SOME INTERMEDIARY METABOLITES IN MAN Thirty mg of human growth hormone (HGH) was given daily for three days to 11 non-diabetic subjects with normal pituitary function. A decrease in glucose tolerance was observed in 7 of these 11 subjects. The administration of HGH increased the plasma concentration of non-esterified fatty acids, but had no effect on the fasting concentration of pyruvate, lactate, citrate, alpha-ketoglutarate or inorganic phosphate. The increase in the blood level of pyruvate, lactate and/or citrate after an intravenous glucose load was more marked after than before HGH administration in the three patients whose glucose tolerance was decreased to the greatest extent by HGH. The changes in the blood levels of these metabolites in the remaining eight patients as well as the response of the concentrations of alpha-ketoglutarate, inorganic phosphate and non-esterified fatty acids to glucose loading in all eleven cases, were not influenced by HGH-treatment. Glucose tolerance tests were also performed in 17 unselected cases of acromegaly. The glucose tolerance was often decreased but no correlation could be demonstrated between the glucose tolerance and the activity of the disease, this latter being measured by estimations of the activity of the sulfation factor in serum. The increases in the blood concentration of pyruvate, lactate, citrate and alpha-ketoglutarate during a glucose load were normal in the cases of acromegaly. Continue reading >>

Acromegaly Diagnosis

Acromegaly Diagnosis

Your doctor may suspect that you have acromegaly because of physical changes-your feet and hands may have grown, in addition to facial changes. Some doctors may even ask to see older photographs of you so that they can compare facial features. (You can read more about the physical changes in the article on acromegaly symptoms). However, to make an accurate diagnosis of acromegaly, he or she will need to run some tests. Diagnosing acromegaly involves 2 key blood tests: a test to check the level of the insulin-like growth factor-1 (IGF-1) and an oral glucose tolerance test (OGTT). Doctors can't simply test for the level of growth hormone (GH) in your body because the level varies so much in one day—even in someone without acromegaly. That means that a doctor could randomly test for GH and get a normal level in a person with acromegaly. However, because of GH fluctuations, the doctor could also test GH levels in someone without acromegaly and get a level far above normal. Therefore, doctors rely on IGF-1 and OGTT tests to help diagnose acromegaly. Testing Insulin-like Growth Factor-1 (IGF-1) Insulin-like growth factor-1 (IGF-1) is a hormone that's closely tied to growth hormone. GH tells the body to make IGF-1, which in turn causes tissues in your body to grow. In someone without acromegaly, a high IGF-1 level is the body's signal to stop producing GH. For a person with acromegaly, though, the body continues producing GH, regardless of high IGF-1 levels. IGF-1 levels are much more constant throughout the day than GH levels, so doctors measure IGF-1 levels using a blood test. An elevated IGF-1 level may indicate acromegaly. Oral Glucose Tolerance Test (OGTT) Growth hormone levels and blood glucose levels are also connected. In someone without acromegaly, a higher blood gl Continue reading >>

Human Growth Hormone And Insulin Are Friends

Human Growth Hormone And Insulin Are Friends

Hormone balance, and the cycle by which our hormones are regulated, is very complicated. That’s why we have doctors who specialize in endocrinology. This article is intended as a basic explanation of the function of a few hormones and their interactions within the human body, as well as how nutrition/exercise affect their production and utilization. That said, hormone manipulation through diet and exercise does NOT account for a great deal of your results – you should focus on getting better at exercise, eating enough, and recovering properly before you lose sleep over whether or not you have optimal HGH or insulin levels. Insulin vs. HGH I’ll get down to brass tacks and make myself clear: insulin and growth hormone play antagonist roles against one another. When one is elevated, the other will be low. That does not, however, mean that their functions are all that dissimilar; they’re both responsible for growth in different ways and looking at them as synergists is much more productive. We want to find a way to make the best of insulin’s ability to pull nutrients into cells, but we also want to elicit the muscular, skeletal and neurological growth that (as the name implies) growth hormone is responsible for. Intraday nutrient cycling is the best way to do this. Understanding why is complicated as all heck, but we’ve tried to make it easy to digest (Get it? Digest? Haha?) Before we continue, I am going to ask that you take a look at our articles on insulin and leptin, as well as the sleep tutorial. They’ll help you understand some of the terms in this section and get a better idea of what’s really going on behind the scenes. Growth Hormone and IGF-1 Growth Hormone (GH) is a hormone responsible for cellular growth in the human body. Throughout the day, GH Continue reading >>

Effect Of Exogenous Growth Hormone On Glucose Utilization In Burn Patients

Effect Of Exogenous Growth Hormone On Glucose Utilization In Burn Patients

Volume 51, Issue 6 , December 1991, Pages 518-523 Effect of exogenous growth hormone on glucose utilization in burn patients Author links open overlay panel Dennis C.GoreM.D. Get rights and content The treatment of burn patients with recombinantly derived human growth hormone (rHGH) appears effective in counteracting protein catabolism. However, exogenous growth hormone is frequently associated with hyperglycemia, an aspect which may limit its usefulness. Therefore, to assess the affect of rHGH on glucose utilization, 13 severely burned patients (65% 4 TBSA burn; mean SEM) began receiving on admission either placebo or rHGH (0.2 mg/kg.d) in a double-blind randomized fashion. While hypermetabolic (percentage REE/predicted REE 1.41 0.11) fasting oxygen consumption and CO2 production were measured using indirect calorimetry prior to and then during a hyperinsulinemic euglycemic clamp. This experiment demonstrated that rHGH significantly reduced glucose uptake and inhibited glucose oxidation compared to the placebo patients. Since the decreases in glucose oxidation and uptake were proportional, glucose utilization (percentage glucose uptake oxidized) remained similar in both patient groups. Furthermore, the hyperinsulinemic clamp lowered the plasma amino acid concentrations in the control patients while rHGH-treated patients had no significant alterations. In conclusion, exogenous growth hormone therapy induces an insulin resistance in burn patients. Furthermore, since the glucose utilization did not change, it is likely that the mechanism of insulin resistance is due to a deficiency in glucose transport. Continue reading >>

Growth Hormone

Growth Hormone

"HGH" redirects here. For other uses, see HGH (disambiguation). Growth hormone (GH), also known as somatotropin (or as human growth hormone [hGH or HGH] in its human form), is a peptide hormone that stimulates growth, cell reproduction, and cell regeneration in humans and other animals. It is thus important in human development. It is a type of mitogen which is specific only to certain kinds of cells. Growth hormone is a 191-amino acid, single-chain polypeptide that is synthesized, stored and secreted by somatotropic cells within the lateral wings of the anterior pituitary gland. GH is a stress hormone that raises the concentration of glucose and free fatty acids.[1][2] It also stimulates production of IGF-1. A recombinant form of hGH called somatropin (INN) is used as a prescription drug to treat children's growth disorders and adult growth hormone deficiency. In the United States, it is only available legally from pharmacies, by prescription from a doctor. In recent years in the United States, some doctors have started to prescribe growth hormone in GH-deficient older patients (but not on healthy people) to increase vitality. While legal, the efficacy and safety of this use for HGH has not been tested in a clinical trial. At this time, HGH is still considered a very complex hormone, and many of its functions are still unknown.[3] In its role as an anabolic agent, HGH has been used by competitors in sports since at least 1982, and has been banned by the IOC and NCAA. Traditional urine analysis does not detect doping with HGH, so the ban was unenforceable until the early 2000s, when blood tests that could distinguish between natural and artificial HGH were starting to be developed. Blood tests conducted by WADA at the 2004 Olympic Games in Athens, Greece targeted primar Continue reading >>

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