Pyogenic spondylitis with acute course caused by Corynebacterium simulans.

Corynebacterium simulans was first reported in 2000. Although it is a member of the normal skin flora, some cases of C. simulans infection have been reported. Other Corynebacterium spp. rarely cause chronic pyogenic spondylitis, and pyogenic spondylitis caused by C. simulans has not been reported at all. Here we report a case of acute pyogenic spondylitis due to C. simulans. A 78-year-old man with diabetes mellitus visited our hospital with a 3-day history of lower back pain and fever. Blood culture revealed C. simulans and magnetic resonance images of lumbar vertebrae showed pyogenic spondylitis. He recovered after treatment by vancomycin for 9 weeks and was discharged home. No recurrence has been observed for half a year. This is likely the first reported case of pyogenic spondylitis by C. simulans. In general, Corynebacterium spp. cause chronic pyogenic spondylitis, but this case showed an acute course.

Hemodynamic responses to photic stimulation in neonates.

A three-channel near-infrared monitoring system was used to evaluate the regional hemodynamic responses to photic stimulation during spontaneous sleep in seven healthy neonates. Three pairs of parallel light guides, separated by 15 mm each, were placed over a 450-mm(2) occipital region of the head. Increases in oxygenated and total hemoglobin were observed during photic stimulation only in one channel, and no change or decreases in oxygenated, deoxygenated, and total hemoglobin were observed in the other two channels. The change in the direction of deoxygenated hemoglobin accompanying the increases in oxygenated and total hemoglobin (usually a decrease in adults) differed in each subject and also varied with each measurement even in the same subject. An increase, decrease, and no change were observed. The results imply that an increase in regional cerebral blood flow occurs because of stimulation specific to the visual cortex and that the increase in deoxygenated hemoglobin observed in the visual cortex of the neonatal brain is attributable to venous dilation.

Relationship between fluctuations in the cerebral hemoglobin oxygenation state and neuronal activity under resting conditions in man.

Simultaneous measurements by near-infrared spectroscopy and electroencephalography were performed during 15-min resting periods in nine healthy adult brains. The peak frequencies of the frontal and occipital rhythms varied with the time course like the hemoglobin oxygenation state. Changes in the amount of oxygenated hemoglobin in the frontal region by more than 50% of the maximum resting variation range were accompanied by changes in peak frequency at the electrode position between two optodes. The results suggest that spontaneous neuronal activity is responsible for fluctuations in the hemoglobin oxygenation state in the resting state.

On a probabilistic set covering model for diagnosing psychiatric disorders.

Correct diagnosis and treatment of the patients attending a hospital is the foremost requirement if that hospital is to be a profitable proposition. F.T. DeDombal achieved 70% reduction in unwanted surgeries and almost 100% reduction in delayed surgeries in cases of acute abdomen through computer-aided diagnosis. Similarly, R. Boom et al proved an increase in the professional efficiency of internees in diagnosing cases of jaundice, acute abdominal pain & upper G.I. bleeding after they started using computer. N.G. Rao reported diagnostic accuracy of 94% for various types of anemias with the use of expert system developed by him. Johri & Guha showed an enhancement of performance of non-expert clinician in tackling psychiatric disorders from 64% to 86%. Many developed countries have developed data bases for studying the epidemiological patterns of various diseases for future health planning and combating strategy. Another advantage of computer based diagnosis is that it will provide uniformity for defining diseases, symptoms & signs which is very important for pursuing medical research. A very simple methodology is described in this paper which can provide data driven as well as heuristic driven approach to medical decision making. To start with, this approach has been used to analyse psychiatric disorders but can be implemented elsewhere with the same efficiency.