The mortality and direct medical costs of osteoporotic fractures among postmenopausal women in Taiwan.

UNLABELLED: This study estimated the fracture-related mortality and direct medical costs among postmenopausal women in Taiwan by fracture types and age groups by utilizing a nationwide population-based database. Results demonstrated that hip fractures constituted the most severe and expensive complication of osteoporosis across fracture sites. INTRODUCTION: The aims of the study were to evaluate the risk of death and direct medical costs associated with osteoporotic fractures by fracture types and age groups among postmenopausal women in Taiwan. METHODS: This nationwide, population-based study was based on data from the National Health Insurance Research Database in Taiwan. Female patients aged 50 years and older in the fracture case cohort were matched in 1:1 ratio with randomly selected subjects in the reference control cohort by age, income-related insurance amount, urbanization level, and the Charlson comorbidity index. There were two main outcome measures of the study: age-differentiated mortality and direct medical costs in the first and subsequent years after osteoporotic fracture events among postmenopausal women. The bootstrap method by resampling with replacement was conducted to generate descriptive statistics of mortality and direct medical costs of the case and control cohorts. Student's t tests were then performed to compare mortality and costs between the two cohorts. RESULTS: A total of 155,466 postmenopausal women in the database met the inclusion criteria for the fracture case cohort, including 22,791 hip fractures, 72,292 vertebral fractures, 15,621 upper end humerus (closed) fractures, 36,774 wrist fractures, and 7,988 multiple fractures. Analytical results demonstrated that patients experiencing osteoporotic fractures were at considerable excess risk of death and incurred substantially higher treatment costs, notably for hip fractures. Furthermore, results also revealed that the risk of mortality increased with advancing age across the spectrum of fracture sites. CONCLUSIONS: The present study confirmed an excess mortality and higher direct medical costs associated with osteoporotic fractures. Moreover, hip fractures constituted the most severe and expensive complication of osteoporosis among fracture types.

Multidrug-resistant Acinetobacter baumannii bacteraemia: clinical features, antimicrobial therapy and outcome.

Nosocomial infections caused by Acinetobacter baumannii have increased in recent years. Isolates of multidrug-resistant A. baumannii (MDRAB) have been recovered in Taiwan since 1999. The characteristics of 55 patients with MDRAB bacteraemia infections occurring between January 2003 and February 2005 were analysed retrospectively. The overall 30-day mortality rate was 49%. The portal of entry was identified in 80% of patients, with the respiratory tract being implicated most frequently. Among the different antimicrobial regimens prescribed, the combination of a carbapenem and ampicillin-sulbactam was associated with a better outcome than the combination of a carbapenem and amikacin, or a carbapenem alone.

Liquid products from oxidative thermal treatment of oil sludge with different oxygen concentrations of air.

Oxidative thermal treatment of oil sludge with different oxygen concentrations of air by using a dynamic thermogravimetric (TG) reaction system is investigated. The experimental conditions employed are: gas flow rate of 50 cm3/min (value at 298 K) for 300 mg dry waste, a constant heating rate of 5.2 K/min, the oxygen concentrations in air of 1.09, 8.62 and 20.95 vol. % O2, and the temperature (T) range of 378-873 K. From the experimental results, the residual mass fractions (M) are about 78.95, 28.49, 8.77 and 4.13 wt. % at the oxidative T of 563, 713, 763 and 873 K for the case with 20.95 vol. % O2, respectively. The values of M with 8.62 and 1.09 vol. % O2 at T of 873 K are 4.87 and 9.44 wt. %, respectively. The distillation characteristics of the oil portion of liquid products (condensates of gas at 298 K) from the oxidative thermal treatment of oil sludge with 20.95 vol. % O2 at T of 378-873 K is close to those of commercial gasoline. Nevertheless, the liquid product contains a large amount of water. The distillation characteristics of the oil portions of liquid products with 8.62 and 1.09 vol. % O2 at T of 378-873 K are close to those of diesel and fuel oils, respectively. The oil quality with 8.62 vol. % O2 is better than that with 1.09 vol. % O2. However, the liquid product with 8.62 vol. % O2 still contains a large amount of water; nonetheless, that with 1.09 vol. % O2 is with negligible water. Compared with the oil product of nitrogen pyrolysis, the oil quality with 1.09 vol. % O2 is better. Certainly, low oxygen conditions (i.e. 1.09 vol. % O2) not only accelerate the thermal reaction of oil sludge, but also at the same time avoid or reduce the production of water. Further, from the analysis of benzene (B), ethylbenzene (E), toluene (T) and iso-xylene (X) concentrations of the oil portion of liquid products, the BETX concentrations of oil with 20.95 vol. % O2 are higher than those with 8.62 and 1.09 vol. % O2. The yields of liquid products with 20.95, 8.62 and 1.09 vol. % O2 at T of 378-873 K are 31.96, 34.42 and 37.3 wt. %, respectively. From the experimental results, the improvement effects of oxygen on the qualities of the oil portion of liquid products are obvious. The above technique not only formats good quality gasoline and diesel oils but also reduces large amount of oil sludge. If the oil exists with water, it may be obtained by further separation or collected by fractional condensation.

Residue characteristics and pore development of petrochemical industry sludge pyrolysis.

Petrochemical industry bio-sludge was pyrolyzed to investigate the composition and pore size distribution of pyrolytic residue. Results indicated that the carbon, nitrogen, and hydrogen concentrations could be reduced after an increase in pyrolytic temperature. The trace element analysis indicated that Al, Ca, Fe, Mg. K, Cu, Sr, and Sb concentrated during the pyrolytic process. When forty grams of pre-dried sludge were pyrolyzed at various pyrolytic temperatures, the transfers from the gas phase to liquid phase to residue were from 21.2 to 36.0%, from 49.0 to 70.0%, and from 8.3 to 16.5%. Results of the pore size distribution examination indicated that the mesopore had the greatest effect on the bio-sludge pyrolysis. The optimal pyrolytic temperatures and times were approximately 800 degrees C for 30 min and 900 degrees C for 10 min. The conceptual model can reasonably explain the pore structure development during the pyrolysis process.

Transurethral resection of the prostate-related changes in the prostate gland: correlation of MRI and histopathology.

PURPOSE: The purpose of this work was to demonstrate signal changes of the prostatic urethra after transurethral resection of the prostate (TURP) on MR images and histopathologic correlation. METHOD: Sixty-three patients with prostate cancer confirmed by either TURP (Group A, 19 patients) or transrectal biopsy (Group B, 44 patients) were evaluated by endorectal MRI before radical prostatectomies. The MR images of postcurettaged prostatic urethras were correlated with the histopathologic features. RESULTS: On the T2-weighted images, a thin zone of hypointense signal surrounding the curettaged prostatic urethra was identified in 52.6% (10/19) of Group A patients, imaged soon after (mean 21.1 days) TURP, but was indiscernible in Group B patients and the other Group A patients, imaged later after TURP (mean 49.2 days). This hypointense signal zone histopathologically correlates with a zone of inflammatory tissue reaction surrounding the widened urethra. CONCLUSION: Inflammatory tissue reaction surrounding curettaged prostatic urethra after TURP accounts for the presence of a low signal zone on T2-weighted images.

Plasma levels of antioxidant vitamins, selenium, total sulfhydryl groups and oxidative products in ischemic-stroke patients as compared to matched controls in Taiwan.

The possible involvement of oxidative damage and antioxidant protection has been suggested in the pathogenesis of stroke which is the second-leading cause of death in Taiwan. In this study we investigated the relationship between ischemic stroke and plasma status of antioxidants and oxidative products. Plasma levels of vitamin A, alpha-tocopherol, carotenoids, selenium (Se), total SH groups (T-SH), thiobarbituric acid-reactive substances (TBARS) and protein carbonyl, a marker of protein damage, were determined in ischemic-stroke patients (n = 36, blood sampled within 24 hrs after the clinical event) in comparison with 21 matched controls. The cholesterol-adjusted carotenoids and vitamin E were significantly lower (P < 0.05) in the plasma of ischemic-stroke patients than those of the controls. TBARS were higher (P < 0.05) in the patients than in the controls but Se, T-SH and protein carbonyls were not significantly different between the two groups. Separation of the patients into small-artery ischemic stroke (SAIS, n = 17) and large-artery ischemic stroke (LAIS, n = 19) groups revealed that both carotenoids/cholesterol and vitamin E/cholesterol ratios were significantly lower in both LAIS and SAIS groups than the controls (n = 21) while vitamin A/cholesterol was not different among the three groups. TBARS were only significantly higher in the LAIS group. The results demonstrated that, within 24 hrs after the clinical event, the acute-ischemic stroke patients had lowered levels of cholesterol-adjusted carotenoids and alpha-tocopherol but elevated levels of TBARS in the plasma as compared to the matched controls. It remains to be resolved as to whether enhanced lipid peroxidation is a cause or a result of lowered antioxidants in ischemic stroke.

Two human cDNAs, including a homolog of Arabidopsis FUS6 (COP11), suppress G-protein- and mitogen-activated protein kinase-mediated signal transduction in yeast and mammalian cells.

We have isolated two novel human cDNAs, gps1-1 and gps2, that suppress lethal G-protein subunit-activating mutations in the pheromone response pathway of the yeast Saccharomyces cerevisiae. Suppression of other pathway-activating events was examined. In wild-type cells, expression of either gps1-1 or gps2 led to enhanced recovery from cell cycle arrest induced by pheromone. Sequence analysis indicated that gps1-1 contains only the carboxy-terminal half of the gps1 coding sequence. The predicted gene product of gps1 has striking similarity to the protein encoded by the Arabidopsis FUS6 (COP11) gene, a negative regulator of light-mediated signal transduction that is known to be essential for normal development. A chimeric construct containing gps1 and FUS6 sequences also suppressed the yeast pheromone pathway, indicating functional conservation between these human and plant genes. In addition, when overexpressed in mammalian cells, gps1 or gps2 potently suppressed a RAS- and mitogen-activated protein kinase-mediated signal and interfered with JNK activity, suggesting that signal repression is part of their normal function. For gps1, these results are consistent with the proposed function of FUS6 (COP11) as a signal transduction repressor in plants.

Lipid content of antibiotic-resistant and -sensitive strains of Serratia marcescens.

The lipid content of antibiotic-resistant, nonpigmented strain (Bizio) and antibiotic-sensitive, pigmented strain (08) of Serratia marcescens was studied. The resistant strain contains at least three times more total extractable lipid and phospholipid than the sensitive strain. Lysophosphatidylethanolamine, phosphatidylserine, lecithin, phosphatidylglycerol, phosphatidylethanolamine, and polyglycerolphosphatide were identified in the phospholipid fractions of both strains.