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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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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   
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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   
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The philosophy of group technology (GT) is an important concept in the design of flexible manufacturing systems and manufacturing cells. Group technology is a manufacturing philosophy that identifies similar parts and groups them into families. Beside assigning unique codes to these parts, group technology developers intend to take advantage of part similarities during design and manufacturing processes. GT is not the answer to all manufacturing problems, but it is a good management technique with which to standardize efforts and eliminate duplication. Group technology classifies parts by assigning them to different families based on their similarities in: (1) design attributes (physical shape and size), and/or (2) manufacturing attributes (processing sequence). The manufacturing industry today is process focused; departments and sub units are no longer independent but are interdependent. If the product development process is to be optimized, engineering and manufacturing cannot remain independent any more: they must be coordinated. Each sub-system is a critical component within an integrated manufacturing framework. The coding and classification system is the basis of CAPP and the functioning and reliability of CAPP depends on the robustness of the coding system. The proposed coding system is considered superior to the previously proposed coding systems, in that it has the capability to migrate into multiple manufacturing environments. This article presents the design of a coding and classification system and the supporting database for manufacturing processes based on both design and manufacturing attributes of parts. An interface with the spreadsheet will calculate the machine operation costs for various processes. This menu-driven interactive package is implemented using dBASE-IV. Part Family formation is achieved using a KAMCELL package developed in TURBO Pascal.  相似文献   
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Several sealed-off triggered vacuum gaps are connected in series to improve hold-off voltage. The characteristics of impulse breakdown voltage of these series-connected gaps are investigated experimentally. The sum hold-off voltage of series-connected gaps decreases to a unit hold-off voltage when the maximum value of voltage division ratio across the gaps increases to unity. Self-breakdown probability of the series-connected gaps is always higher than that of a single gap under the same conditions. Hence, stage efficiency of the multistage gap decreases with increasing number of stages. Its value is 90 percent with 2-stage gap and 75 percent with 5-stage gap, respectively, under the same voltage division ratio and the same gap length (2.0 mm) in each stage. Triggered breakdown voltage of 2- or 3- stage gap is several hundred volts when all gaps are triggered simultaneously at the peak of the main impulse wave and a working voltage range is nearly 100 percent in this case. The working voltage range decreases with number of stages. Its value is 45 percent with 3-stage gap and 15 percent with 5-stage gap, respectively, when one triggered gap is fired for switching.  相似文献   
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The influences of the Samarra impoundment on the ecology of the downstream sector of the river Tigris are investigated. Zooplankton were collected monthly from July 1987 to July 1988. It was found that zooplankton were most abundant during high river discharges in March. During the month of low river discharge, September, the zooplankton population was greatly reduced immediately below the barrage and remained so to the last downstream station. Several factors seem to explain such differences. The high discharge from the impoundment was found to be the dominating factor and may flush the small backwaters in which zooplankton were abundant, thus increasing the population in the river. Zooplankton species vary in their ability to sustain populations in the river, variations which are due mainly to species-specific characteristics.  相似文献   
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Bahri? ?ahi?n  Ali? Kodal  Hasbi? Yavuz 《Energy》1996,21(12):1219-1225
An analysis using maximum power-density criteria has been carried out for an endoreversible Carnot heat engine. The results have been compared with known results on maximum power analysis. The design parameters at maximum power density lead to smaller and more efficient endoreversible Carnot heat engines than those working at maximum power output.  相似文献   
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