Osteomyelitis of Multiple Lumbar Vertebrae Associated with Infected Aortic Aneurysm: A Case Report

A 73-year-old male patient presented with a pulsating abdominal mass and intractable low back pain for several days. Magnetic resonance imaging revealed an infected abdominal aortic aneurysm invading the second, third, and fourth lumbar vertebrae. He underwent radical debridement of the infected aneurysm with reconstruction using vascular bypass, partial corpectomy of the L2 to L4 vertebrae, anterior reconstruction with autogenous fibular shaft, and posterior instrumentation with posterolateral fusion. Culture of the necrotic tissues grew oxacillin-resistant Staphylococcus aureus. He received intravenous vancomycin infusion for 4 weeks and oral ciprofloxacin for 6 months postoperatively. After a 15-month follow-up, no apparent signs of further infection were noted. C-reactive protein and erythrocyte sedimentation rate returned to normal during follow-up. No neurologic symptoms other than mild low back soreness were noted. The stability of the lumbar spine was maintained using long segment reconstruction with autogenous fibula shaft and posterior instrumentation along with posterolateral fusion. Infected aortic aneurysm with vertebral osteomyelitis is a rare clinical entity. Prompt diagnosis and adequate treatment are essential

Gender Differences and the Trend in the Acute Myocardial Infarction: A 10-Year Nationwide Population-Based Analysis

It is not clear whether gender is associated with different hospitalization cost and lengths for acute myocardial infarction (AMI). We identified patients hospitalized for primary diagnosis of AMI with (STEMI) or without (NSTEMI) ST elevation from 1999 to 2008 through a national database containing 1,000,000 subjects. As compared to that in 1999~2000, total (0.35‰  versus 0.06‰, P<0.001) and male (0.59‰  versus 0.07‰, P<0.001) STEMI hospitalization percentages were decreased in 2007~2008, but female STEMI hospitalization percentages were not different from 1999 to 2008. However, NSTEMI hospitalization percentages were similar over the 10-year period. The hospitalization age for AMI, STEMI, and NSTEMI was increased over the 10-year period by 14, 9, and 7 years in male, and by 18, 18, and 21 years in female. The female and male hospitalization cost and lengths were similar in the period. As compared to nonmedical center, the hospitalization cost for STEMI in medical center was higher in male patients, but not in female patients, and the hospitalization cost for NSTEMI was higher in both male and female gender. We found significant differences between male and female, medical center and non-medical center, or STEMI and NSTEMI on medical care over the 10-year period

A novel regulatory event-based gene set analysis method for exploring global functional changes in heterogeneous genomic data sets

<p>Abstract</p> <p>Background</p> <p>Analyzing gene expression data by assessing the significance of pre-defined gene sets, rather than individual genes, has become a main approach in microarray data analysis and this has promisingly derive new biological interpretations of microarray data. However, the detection power of conventional gene list or gene set-based approaches is limited on highly heterogeneous samples, such as tumors.</p> <p>Results</p> <p>We developed a novel method, the regulatory <b>e</b>vent-based <b>G</b>ene <b>S</b>et <b>A</b>nalysis (eGSA), which considers not only the consistently changed genes but also every gene regulation (event) of each sample to overcome the detection limit. In comparison with conventional methods, eGSA can detect functional changes in heterogeneous samples more precisely and robustly. Furthermore, by utilizing eGSA, we successfully revealed novel functional characteristics and potential mechanisms of very early hepatocellular carcinoma (HCC).</p> <p>Conclusion</p> <p>Our study creates a novel scheme to directly target the major cellular functional changes in heterogeneous samples. All potential regulatory routines of a functional change can be further analyzed by the regulatory event frequency. We also provide a case study on early HCCs and reveal a novel insight at the initial stage of hepatocarcinogenesis. eGSA therefore accelerates and refines the interpretation of heterogeneous genomic data sets in the absence of gene-phenotype correlations.</p

The Relationship between Qi Deficiency, Cancer-related Fatigue and Quality of Life in Cancer Patients

AbstractBackgroundQi (氣 qì) refers to the vital energy of the body in Traditional Chinese medicines (TCM). Qi deficiency (氣虛 qì xū) is the most common symptom in cancer patients according to the concept of TCM. We hypothesized that cancer patients with Qi deficiency suffer from poor quality of life (QOL) and fatigue.MethodAmong the 256 registered cancer patients screened at our outpatient clinic, a total of 198 were enrolled. The inclusion criteria were (1) age between 18 and 70years, (2) cancer diagnosis confirmed by the professional physician, (3) being Chinese, and (4) Eastern Cooperative Oncology Group (ECOG) performance status rating (PSR)≤3. The major outcome is the difference in QOL score in cancer patients with and without Qi deficiency.ResultsThe initial results showed statistically significant differences in WHO-QOL scores in physical, psychological, and social domains between the groups with and without Qi deficiency as well as the groups with and without cancerrelated fatigue (CRF). All patients with CRF present were also diagnosed as Qi deficient. In addition, among the patients with no CRF, 39.9% (69/173) were diagnosed as suffering from Qi deficiency, which led to poor QOL.ConclusionsThe present study showed statistically significant difference in WHO-QOL scores in physical, psychological, and social domains between the groups with and without Qi deficiency as well as the groups with and without CRF. Cancer patients diagnosed with Qi deficiency or CRF have poor QOL. The concept of Qi deficiency in TCM might be applied to cancer health care