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51.
BACKGROUND: The incidental discovery of an adrenal mass poses the problem of distinguishing between the frequent benign masses and the infrequent malignant ones that require surgery. Univocal guidelines to approach this problem are unavailable. OBJECTIVE: To perform a survey of the clinical management of incidentally discovered adrenal masses (ie, adrenal incidentalomas). DESIGN: A multicentric retrospective analysis of hospital medical records of adrenal incidentalomas diagnosed during a 5-year period; the medical records were scrutinized for demographic data and clinical details by means of a specifically tailored questionnaire. SETTING: The major surgical and medical centers of Piedmont, a northern Italian region with approximately 4 million inhabitants. The recruitment pattern of these centers was unselected. PATIENTS: The definition of adrenal incidentaloma was limited to patients with a physical examination and a clinical history unindicative of adrenal disease. Exclusion criteria also included hypertension of suspected endocrine origin and a history of neoplasms known to metastasize frequently in the adrenal glands. Two hundred twenty-four medical records were collected, and 210 were analyzed (14 excluded a posteriori). RESULTS: Most patients were in their 50s and 60s, and women were predominantly affected. The frequency of adrenocortical cancer was 13% among patients operated on. The tumor diameter was highly correlated with the risk of cancer; a cutoff at 5 cm had a sensitivity of 93% with a specificity of 64% in discriminating between benign and malignant cortical lesions. CONCLUSIONS: The occurrence of adrenocortical carcinoma among adrenal incidentalomas is not rare. The evaluation of the mass size is a simple and effective method for selecting patients at risk for cancer. The indication for surgery of masses larger than 5 cm, or of masses of any diameter that have suspicious imaging characteristics, limits unnecessary operations and costs. 相似文献
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Abdelbaki Benamor Brahim Si Ali Mohamed Kheireddine Aroua 《Korean Journal of Chemical Engineering》2008,25(3):451-460
The absorption rates of CO2 into aqueous solutions of Diethanolamine (DEA) with varying concentrations from 0.2 to 4M and temperature range from 293
to 323 K were measured by using a laboratory stirred reactor. The CO2 partial pressure was varied in a range that the reaction would occur in pseudo first order regime. Experimental data were
analyzed and the kinetic parameters associated with the reaction were determined. The activation energy for the deprotonation
of the intermediate zwitterion was estimated at about 11.4 kcal/mol. The contribution of carbamate formation to the overall
absorbed CO2 was experimentally evaluated and found to be of the order of 100%. 相似文献
55.
Ali J. Koshkouei 《International Journal of Adaptive Control and Signal Processing》2008,22(9):859-874
Passivity with sliding mode control for a class of nonlinear systems with and without unknown parameters is considered in this paper. In fact, a method for deriving a nonlinear system with external disturbances to a passive system is considered. Then a passive sliding mode control is designed corresponding to a given storage function. The passivity property guarantees the system stability while sliding mode control techniques assures the robustness of the proposed controller. When the system includes unknown parameters, an appropriate updated law is obtained so that the new transformed system is passive. The passivation property of linear systems with sliding mode is also analysed. The linear and nonlinear theories are applied to a simple pendulum model and the gravity‐flow/pipeline system, respectively. Copyright © 2008 John Wiley & Sons, Ltd. 相似文献
56.
This study describes a laboratory method for the estimation of emission from preservative-treated wood in the different situations where emissions could enter the environment for use classes 3 (not in contact with ground) and 4 and 5 (in contact with the ground, fresh water or sea water) according to OECD Guidelines. Samples of scotch pine sapwood (Pinus sylvestris L.) were treated with CCA (1% and 2%), ACQ-1900 (3% and 7%), ACQ-2200 (2%), Tanalith E 3491 (2% and 2.8%), and Wolmanit CX-8 (2%). 相似文献
57.
Software plays an increasingly important role in modern safety-critical systems. Although, research has been done to integrate software into the classical probabilistic risk assessment (PRA) framework, current PRA practice overwhelmingly neglects the contribution of software to system risk. Dynamic probabilistic risk assessment (DPRA) is considered to be the next generation of PRA techniques. DPRA is a set of methods and techniques in which simulation models that represent the behavior of the elements of a system are exercised in order to identify risks and vulnerabilities of the system. The fact remains, however, that modeling software for use in the DPRA framework is also quite complex and very little has been done to address the question directly and comprehensively. This paper develops a methodology to integrate software contributions in the DPRA environment. The framework includes a software representation, and an approach to incorporate the software representation into the DPRA environment SimPRA. The software representation is based on multi-level objects and the paper also proposes a framework to simulate the multi-level objects in the simulation-based DPRA environment. This is a new methodology to address the state explosion problem in the DPRA environment. This study is the first systematic effort to integrate software risk contributions into DPRA environments. 相似文献
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In this paper, flexural behavior of horizontally curved prestressed (posttensioned) box bridges is studied by using three-dimensional and refined finite-element modeling and analysis. Bridge length, section geometry, and material properties are the same in all the models, while angle of curvature varies from 0 to 90°. The results of analysis show that in curved bridges, stress distribution is significantly different in comparison to straight bridges. Also, the level of stresses at some locations of section width is considerably high. It is proposed to vary the distribution of the prestressing tendons across section width in order to optimize the bridge capacity. Results show that by proper redistribution of prestressing in section width, significant reduction in resultant stress is possible. 相似文献
60.