PSPH contributes to CRC susceptibility in AAs and that the levels of PSPH expression may be correlated with response to anti-EGFR treatment. These possibilities will have to be tested in future studies. Considering down-regulated genes in AAs we found lower expression of the C17orf81 gene. Down regulation of this gene was associated with colon cancer, suggesting that lower expression of this gene can contribute to more aggressive CRC in AAs. Other down regulated genes in AAs include: TRNT1; ARHGAP6; WDR8. Considering the cellular functions of these genes it is not hard to envision how their expression may influence aggressiveness of CRC. Whole-genome gene expression analysis experiments can be prone to findings that are either unique to a selected patient population or are artificially created by the applied technology. This is to date the largest single centre series on Nilotinib msds empyema described, and shows that empyema remains an important cause of morbidity, mortality and hospital admissions in the UK. The results highlight several important points. First, a microbiological diagnosis was only achieved in just over 50% of 406 patients studied, highlighting the necessity for development and evaluation of more sensitive and rapid diagnostics for early identification of the specific microbial aetiologies. This would guide early targeted antimicrobial therapy and likely influence clinical outcomes. Second, it is important to note that is TB is important cause of empyema and may be easily overlooked: 37 cases were identified where biological specimens were sent with specific requests for mycobacterial investigation. Only 313 out of 406 cases of empyema had mycobacterial staining requested, even though this hospital has high awareness of TB as a differential diagnosis. Since the incidence of TB in the UK and elsewhere in Europe is increasing, it now becomes imperative that all patients with empyema are routinely screened. Third, use of VATS led to reduced median duration of hospital stay and may therefore reduce costs of empyema treatment; its cost-effectiveness should now be evaluated against other medical and surgical treatments. Finally, raised RDW appeared to be strongly associated with early mortality. This requires further prospective evaluation as a biomarker for identifying patients at high risk of early death. Adoption of all these points would be predicted to lead to shorter inpatient admissions, improved treatment outcomes and reduced costs of care in an increasingly resource constrained health service setting. Comparison of our study with the UK MIST-1 trial and a Danish multicentre descriptive series revealed several commonalities but also important differences. The median age in our cohort was younger and rates of co-morbidity were correspondingly lower; this may partially reflect referral bias to our tertiary cardiothoracic centre for operative management. Our study confirmed a right-sided predominance of empyema at an approximate ratio of 1.2:1, which closely follows the normal right:left lung volume ratios. The distribution of causative bacterial organisms identified was similar to recent series, except that by contrast with MIST1 we observed a lower frequency of milleri-group streptococci and a corresponding increase in S. pneumoniae. Male predominance was observed in all microbiological categories except S. pneumoniae, consistent with its established epidemiology.