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1.
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
2.
The purpose of this paper is to evaluate two methods of assessing the productivity and quality impact of Computer Aided Software Engineering (CASE) and Fourth Generation Language (4GL) technologies: (1) by the retrospective method; and (2) the cross-sectional method. Both methods involve the use of questionnaire surveys. Developers' perceptions depend on the context in which they are expressed and this includes expectations about the effectiveness of a given software product. Consequently, it is generally not reliable to base inferences about the relative merits of CASE and 4GLs on a cross-sectional comparison of two separate samples of users. The retrospective method that requires each respondent to directly compare different products is shown to be more reliable. However, there may be scope to employ cross-sectional comparisons of the findings from different samples where both sets of respondents use the same reference point for their judgements, and where numerical rather than verbal rating scales are used to measure perceptions. 相似文献
3.
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5.
J-M Choe 《欧洲信息系统杂志》2002,11(2):142-158
This study empirically examined the organisational learning effects of the nonfinancial performance information provided by management accounting information systems (MAISs) under advanced manufacturing technology (AMT). In this study, a target costing system and the frequent and quick reporting of information were considered the facilitators of learning. First, we examined the relationships between AMT level and the amount of nonfinancial performance information produced by MAISs. The empirical results showed that there are significant positive relationships between the level of AMT and nonfinancial performance information. With a systems approach, we also proved the impact of the relationships among AMT levels, nonfinancial performance information and learning facilitators on the organisational performance of a firm. The results of our research suggest that under a high level of AMT, for the provision of information to result in an increase of performance through organisational learning, a target costing system must be introduced and a large amount of information should be provided frequently and quickly. The results of this study also showed that although AMT level may be low, fairly well-arranged facilitators and a moderately large amount of information may be necessary for the improvement of performance. In conclusion, effective organisational learning depends on the provision of relevant information as well as efficient learning support mechanisms. 相似文献
6.
7.
Jon T. Carter Paul E. Krajewski Ravi Verma 《JOM Journal of the Minerals, Metals and Materials Society》2008,60(11):77-81
The hot blow forming of magnesium sheet offers significant opportunity for forming complex, lightweight parts for automotive
applications. This paper characterizes the elevated-temperature formability of AZ31 magnesium sheet materials and the effect
of processing conditions on the performance of these materials. In addition, magnesium sheet application development at General
Motors Corporation is reviewed. 相似文献
8.
Toshihiko Hoshide Junpei Fujita 《Journal of Materials Engineering and Performance》2008,17(5):627-632
Strength of ground ceramics may be affected by residual stress as well as surface flaws induced by grinding. Strength prediction
for ground ceramics is convenient for mechanical design of ceramic components. In this article, a numerical procedure based
on fracture mechanics was proposed to estimate strength distribution of ground ceramics by considering grinding-induced residual
stress. Bending strength and residual stress of ground ceramics were measured for three grinding-conditions. By comparison
of simulated results with experimental ones, it was revealed that strength characteristics in experiments were well simulated
by using the proposed procedure. 相似文献
9.
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
10.
Nguyen An Tien I. Ya. Mittova O. V. Almjasheva S. A. Kirillova V. V. Gusarov 《Glass Physics and Chemistry》2008,34(6):756-761
Nanocrystalline LaFeO3 is prepared by the dehydration of coprecipitated lanthanum and iron(III) hydroxides. It is shown that the behavior of the samples during heating and the size distribution of LaFeO3 nanocrystals can be considerably different depending on the scheme used for coprecipitation of lanthanum and iron hydroxides; independently of the method employed for coprecipitation of the initial compounds, sintering of the samples at 950°C leads to the formation of lanthanum orthoferrite crystals up to 100 nm in size. 相似文献