Ovarian granulosa cell tumor (GCT) is a malignant tumor with slow progression. The recurrence of granulosa cell tumor often happens after 5 years, leading to a ‘forgotten tumor’ by the patient. We present the case of a 64-year-old woman with a presentation of left flank pain. An initial computed tomography scan revealed a single tumor with multiple adjacent organ invasions. Surgical intervention was prescribed and the pathological results revealed a metastatic granulosa cell tumor. We also review the literature for the follow-up and further management of this tumor.
Here we conducted a retrospective analysis of hospital-based trauma registry database for evaluating the impacts of comorbidities on the prognosis for traumatized patients using Index of Coexistent Comorbidity Disease (ICED) scores. We analyzed the data of patients with blunt trauma who visited emergency department between January 1, 2011, and December 31, 2015 in Chang-Gung Memorial Hospital, Keelung branch, a single level I trauma center in the Northern Taiwan. All consecutive patients with blunt trauma who admitted to the intensive care unit or ordinary ward after initial managements in the emergency department were included. We measured the hospital mortality of blunt traumatized patients using alive discharge as a competing risk. To investigate conditional independence of mortality and ICED scores given Injury Severity Score (ISS), we used log-linear models for modeling independence structures. Overall, we included 4997 patients (median age [IQR], 59 years old (44–75 years); 55.3% male). The mortality rate of blunt traumatized patients was higher in the higher ICED scores group compared to lower ICED scores group (4.7% vs 1.8%, p < 0.001). Meanwhile, the higher ICED scores group were associated with older age, higher ISS, and longer hospital stay than lower ICED scores group. Higher ICED group had higher probability of transition-to-death and lower probability of transition-to-discharge under the competing risk model. In the multivariable analysis of transition-specific Cox models, higher ICED group were associated with higher risk for hospital mortality compared to lower ICED group (HR 1.60; [95% CI 1.04–2.47]; p = 0.032). Also, higher ICED group were associated with lower probability of transition-to-discharge (HR 0.79; [95%CI 0.73–0.86]; p < 0.001). Additionally, higher ICED scores accounted for hospital mortality among patients with ISS < 25. In conclusion, our study suggested that severity of comorbidity was associated with higher hospital mortality among traumatized patients, particularly lower ISS.
Phase change memory (PCM) cells with T-shaped structure using tungsten heater were fabricated and the cell characteristics concerning the programing pulse width were also investigated in this work. The numerical modeling shows the thermal nonuniformity over the active region due to the considerable thermal sink of tungsten heater results in the amorphous-phase residues and the incomplete set programing. The experimental results reveal the existence of residual amorphous phase and indicate that the incomplete set programing is the dominant factor to degrade the PCM cell performances, such as the sensing margin and the endurance. The strategies to eliminate the incomplete set programing are the optimization in programing pulse width and the replacement of the tungsten heater with higher resistivity metal such as TiAlN.
Highly (117)- and (001)-oriented Bi3.25La0.75Ti3O12 (BLT) thin films were fabricated on Pt/TiO2/SiO2/Si(100) substrates by chemical solution deposition under the appropriate baking and crystallization conditions. The (117)-oriented BLT films exhibited higher remanent polarization (2Pr=24 μC/cm2), than did (001)-oriented BLT films, which exhibited only a slight amount of polarization (2Pr=6.6 μC/cm2). The results of fatigue and retention tests revealed that neither film was fatigued up to 1×1010 switching cycles, and the retained charge was unchanged for 1×104 s.
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