Preclinical Cushing's syndrome in adrenal incidentalomas

Adrenal tumors are usually diagnosed by clinical symptoms of hormone excess. The increasing use of ultrasound and computed tomography results in the detection of a substantial number of incidentally discovered adrenal tumors. Most of these tumors are nonfunctional adrenocortical adenomas, but a few cases of subclinical cortisol production in "incidentalomas" have been reported. We investigated prospectively the prevalence of autonomous cortisol production in 68 patients (44 females and 24 males, aged 25-90 yr) with adrenal incidentalomas at our institution. As a screening procedure all patients with incidentalomas underwent an overnight dexamethasone suppression test (1 mg). Patients who failed to suppress serum cortisol below 140 nmol/L (5 micrograms/dL) underwent more comprehensive studies (prolonged dexamethasone suppression test, determination of the diurnal rhythm of cortisol secretion in saliva, and CRH stimulation test). Eight patients (12% of all patients with incidentalomas; 5 females and 3 males, aged 25-71 yr) were finally identified as having cortisol- producing tumors, and the findings in these patients were compared with those of overt Cushing's syndrome in 8 patients (8 females, aged 26-50 yr) suffering from cortisol-producing adrenal adenomas. The tumor size of patients with cortisol-producing incidentalomas ranged from 2-5 cm. No specific signs and symptoms of hypercortisolism were present, but arterial hypertension (seven of eight subjects), diffuse obesity (four of eight subjects), and noninsulin-dependent diabetes mellitus (NIDDM; two of eight subjects) were frequently observed. Baseline cortisol levels were in the normal to upper normal range, whereas baseline ACTH levels were suppressed in five of the eight patients. In none of the patients was serum cortisol suppressible by low dose or high dose dexamethasone. The ACTH and cortisol responses to CRH were normal in two, blunted in one, and suppressed in four patients. Unilateral adrenalectomy was performed in seven patients and resulted in temporary adrenal insufficiency in four of them. After surgery, improvement of arterial hypertension, a permanent weight loss in obese subjects, and a better metabolic control of NIDDM were noted in the majority of patients. The following conclusions were reached. Incidentally diagnosed adrenal tumors with pathological cortisol secretion in otherwise clinically asymptomatic patients are more frequently observed than previously assumed. Adrenocortical insufficiency is a major risk in these patients after adrenalectomy. After surgery, hypertension, obesity, and NIDDM may improve. Patients with asymptomatic adrenal incidentalomas, therefore, should be screened for cortisol production by means of an overnight dexamethasone suppression test

Stabilized high-power laser system for the gravitational wave detector advanced LIGO

An ultra-stable, high-power cw Nd:YAG laser system, developed for the ground-based gravitational wave detector Advanced LIGO (Laser Interferometer Gravitational-Wave Observatory), was comprehensively characterized. Laser power, frequency, beam pointing and beam quality were simultaneously stabilized using different active and passive schemes. The output beam, the performance of the stabilization, and the cross-coupling between different stabilization feedback control loops were characterized and found to fulfill most design requirements. The employed stabilization schemes and the achieved performance are of relevance to many high-precision optical experiments

Stabilized lasers for advanced gravitational wave detectors

Second generation gravitational wave detectors require high power lasers with more than 100 W of output power and with very low temporal and spatial fluctuations. To achieve the demanding stability levels required, low noise techniques and adequate control actuators have to be part of the high power laser design. In addition feedback control and passive noise filtering is used to reduce the fluctuations in the so-called prestabilized laser system (PSL). In this paper, we discuss the design of a 200 W PSL which is under development for the Advanced LIGO gravitational wave detector and will present the first results. The PSL noise requirements for advanced gravitational wave detectors will be discussed in general and the stabilization scheme proposed for the Advanced LIGO PSL will be described

High Pressure X-Ray Diffraction Study of UMn2Ge2

Uranium manganese germanide, UMn2Ge2, crystallizes in body-centered tetragonal ThCr2Si2 structure with space group I4/mmm, a = 3.993A and c = 10.809A under ambient conditions. Energy dispersive X-ray diffraction was used to study the compression behaviour of UMn2Ge2 in a diamond anvil cell. The sample was studied up to static pressure of 26 GPa and a reversible structural phase transition was observed at a pressure of ~ 16.1 GPa. Unit cell parameters were determined up to 12.4 GPa and the calculated cell volumes were found to be well reproduced by a Murnaghan equation of state with K0 = 73.5 GPa and K' = 11.4. The structure of the high pressure phase above 16.0 GPa is quite complicated with very broad lines and could not be unambiguously determined with the available instrument resolution

Network device interface for digitally interfacing data channels to a controller via a network

A communications system and method are provided for digitally connecting a plurality of data channels, such as sensors, actuators, and subsystems, to a controller using a network bus. The network device interface interprets commands and data received from the controller and polls the data channels in accordance with these commands. Specifically, the network device interface receives digital commands and data from the controller, and based on these commands and data, communicates with the data channels to either retrieve data in the case of a sensor or send data to activate an actuator. Data retrieved from the sensor is converted into digital signals and transmitted to the controller. Network device interfaces associated with different data channels can coordinate communications with the other interfaces based on either a transition in a command message sent by the bus controller or a synchronous clock signal

Network device interface for digitally interfacing data channels to a controller via a network

The present invention provides a network device interface and method for digitally connecting a plurality of data channels, such as sensors, actuators, and subsystems, to a controller using a network bus. The network device interface interprets commands and data received from the controller and polls the data channels in accordance with these commands. Specifically, the network device interface receives digital commands and data from the controller, and based on these commands and data, communicates with the data channels to either retrieve data in the case of a sensor or send data to activate an actuator. Data retrieved from the sensor is then converted by the network device interface into digital signals and transmitted back to the controller. In one advantageous embodiment, the network device interface uses a specialized protocol for communicating across the network bus that uses a low-level instruction set and has low overhead for data communication

Submarine mass wasting and associated tsunami risk offshore western Thailand, Andaman Sea, Indian Ocean

2-D seismic data from the top and the western slope of Mergui Ridge in water depths between 300 and 2200 m off the Thai west coast have been investigated in order to identify mass transport deposits (MTDs) and evaluate the tsunamigenic potential of submarine landslides in this outer shelf area. Based on our newly collected data, 17 mass transport deposits have been identified. Minimum volumes of individual MTDs range between 0.3 km3 and 14 km3. Landslide deposits have been identified in three different settings: (i) stacked MTDs within disturbed and faulted basin sediments at the transition of the East Andaman Basin to the Mergui Ridge; (ii) MTDs within a pile of drift sediments at the basin-ridge transition; and (iii) MTDs near the edge of/on top of Mergui Ridge in relatively shallow water depths ( 1000 m) and/or comprise small volumes suggesting a small tsunami potential. Moreover, the recurrence rates of failure events seem to be low. Some MTDs with tsunami potential, however, have been identified on top of Mergui Ridge. Mass-wasting events that may occur in the future at similar locations may trigger tsunamis if they comprise sufficient volumes. Landslide tsunamis, emerging from slope failures in the working area and affecting western Thailand coastal areas therefore cannot be excluded, though the probability is very small compared to the probability of earthquake-triggered tsunamis, arising from the Sunda Trench