Machine Learning Model for Predicting Postoperative Survival of Patients with Colorectal Cancer / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Machine learning (ML) is a strong candidate for making accurate predictions, as we can use large amount of data with powerful computational algorithms. We developed a ML based model to predict survival of patients with colorectal cancer (CRC) using data from two independent datasets. @*Materials and Methods@#A total of 364,316 and 1,572 CRC patients were included from the Surveillance, Epidemiology, and End Results (SEER) and a Korean dataset, respectively. As SEER combines data from 18 cancer registries, internal validation was done using 18-Fold-Cross-Validation then external validation was performed by testing the trained model on the Korean dataset. Performance was evaluated using area under the receiver operating characteristic curve (AUROC), sensitivity and positive predictive values. @*Results@#Clinicopathological characteristics were significantly different between the two datasets and the SEER showed a significant lower 5-year survival rate compared to the Korean dataset (60.1% vs. 75.3%, p < 0.001). The ML-based model using the Light gradient boosting algorithm achieved a better performance in predicting 5-year-survival compared to American Joint Committee on Cancer stage (AUROC, 0.804 vs. 0.736; p < 0.001). The most important features which influenced model performance were age, number of examined lymph nodes, and tumor size. Sensitivity and positive predictive values of predicting 5-year-survival for classes including dead or alive were reported as 68.14%, 77.51% and 49.88%, 88.1% respectively in the validation set. Survival probability can be checked using the web-based survival predictor (http://colorectalcancer.pythonanywhere.com). @*Conclusion@#ML-based model achieved a much better performance compared to staging in individualized estimation of survival of patients with CRC.

Ultrastructural and muscular modifications of adult schistosoma mansoni worms induced by artemether [ART] in vitro

Schistosomiasis is one of the most important public health problems worldwide. In spite of two decades of safe and effective widespread chemotherapy with praziquantel, the number of individuals with schistosomiasis remains high with the appearance of drug resistance. So, it diverts the attention to other anti-parasitic drugs like artemesinin derivatives e.g. artemether [ART]. This study was done to assess the effects of ART on the tegument and musculature of adult Schistosoma mansoni worms in vitro. Five groups of S. mansoni coupled adult worms, each of 10 couples, were used. Four groups were tested in vitro using different concentrations of ART [20, 40, 80 and 100microg/ml] for 24 hours of exposure. These adult worms were obtained by hepatic perfusion technique seven weeks postinfection by 100+/-10 S. mansoni cercariae in male white albino mice using tail immersion method. Ultrastructural and muscular modifications of adult S. mansoni worms were assessed using Scanning Electron Microscopy [SEM] and a special device respectively. SEM examination revealed that after 24 hours of exposure to 40microg/ml ART, the tegument showed vesicles and loss of spines. On exposure to 80microg/ml ART, the tegument showed cracking and more loss of spines. After exposure to 100microg/ml ART, tegument appeared mostly distorted with cracking, peeling, bleb formation and the spines covering the tubercles appeared to be partially lost. ART elicited muscle contraction and reached the highest response with 100microg/ml ART. The maximal increase in muscle tension [% shortening of worms] was 44.1 +/- 1.79 % shortening induced by the highest concentration [100microg/ml] of ART

Microbiological studies on the effect of medicinal plant extracts on diabetic foot ulcer bacteria

Background: The emergence of microbial resistance towards antibiotics increased in a terrible rate. Screening of antimicrobial effect of plant extracts represents hope for discovery of new antimicrobial agents

Objectives:This research aimed to study the influence of the extracts of several medicinal plants on diabetic foot ulcer bacteria

Methodology: Swabs from deep tissues were collected from 56 patients attending the Outpatient clinic of diabetic foot Unit, and diagnosed clinically as diabetic foot infections. The specimens were examined to identify the causative bacteria and their antibiotic susceptibility pattern. Antimicrobial activity of ethanol extracts of ten medicinal plant parts [cinnamon, henna, fennel, black cumin, eucalyptus, clove, chamomile, ginger, sloenstemma and basil] were investigated using well diffusion method. Phytochemical screening of effective plants extracts were performed using tests for alkaloids, glycosides, cardiac glycosides, saponins, phenols, sterols, tannins, flavonoids and diterpen

Results: The commonest isolated organisms were S. aureus [33.9%], followed by S. epidermidis [16.9%], P. aeruginosa [15.3%], P. mirabilis [13.6%], K. pneumoniae [10.2%], E. coli [6.8%] and P. vulgaris [3.4%]. Most bacteria were resistant to tested antibiotics and 33.9% were multi-drug resistant bacteria. Ethanol extract of solenstemma, clove, black cumin, and basil had effective growth inhibition effect against isolated bacteria. Phytochemical screening clarified that these plant parts contain powerful secondary metabolites and active materials which explained their antimicrobial activity

Conclusions: Some medical plants showed antimicrobial activity against resistant bacteria, thus could be leading and useful therapeutic agents against many bacterial infections

Uncoupling protein 3 andhypothalamic neuropeptide yexpression in response todietary fat in rats

Objective:Obesity results when energy intake is greater than energyexpenditure. Skeletal muscles [SK.M] UCP3 and central NPY play an im-portant role in energy balance. The aim is to study the changes of [SK.M]UCP3 expression, and hypothalamic NPYmRNA expression after pro-longed feeding with high-fat diet [HFD]

Design:Obese-prone Sprague Dawley rats were fed beef tallow[46%] of energy as fat "HFD" and control group fed libitum diets contain-ing 4.5% of energy as fat [control], for 16 weeks. Body weight and foodintake were measured every 3 days throughout the experimental period.After the feeding period is completed, hindlimb skeletal muscle was iso-lated for subsequent determinations of triglyceride. Skeletal UCP3 mRNAand hypothalamic NPY mRNA were assessed by [RT-PCR] respectively

Results:Plasma glucose, triglyceride, insulin, leptin and free fatty ac-ids levels were higher in rats fed the HFD compared to control group. HFDresulted in significant increase in [SK.M] triglyceride, and mRNA levels of[SK.M] UCP3 by [3.84 folds], but without significant change in hypotha-lamic NPY mRNA expression compared to control group

Conclusion:high fat diet induces obesity with marked induction ofUCP3. The dissociation between the UCP3 mRNA levels and NPY mRNAexpression could point that obesity may be caused by mechanisms inde-pendent of thermogensis

comparison of laryngeal mask airway [LMA [TM]] and peilaryngeal airway cobra [C PLA [TM]] in mechancally ventilated anaesthetised pediatrics

The laryngeal mask airway is [LMA[TM]] is a frequently used efficient airway device, yet it sometime seals poorly thus reducing the efficacy of positive -pressure ventilation. The Cobra perilaryngeal airway [CPLA [TM]] is a new supraglottic device which consists of a tube and inflatable cuff. The present study compared the LMA[TM] and CPLA[TM] in mechanically ventilated anaesthetized pediatrics. This study was carried out in 46 pediatric patients age range between 6 months and 2 years scheduled for elective surgery, they were divided into 2 group 23 patients each, group I CPLA[TM], Group II LMA[TM] both were inserted after fentanyl, propofol and vecuronium, Mean time of insertion, number of attempts of insertion and repositioning, airway sealing pressure, adequacy of the airway and side effects was recorded. There was no statistically significant differences between groups as regard the mean time of insertion, number of attempts of insertion and repositioning and adequacy of the airway [no leak at 15 cm water peak pressure]. There was statistically significant higher airway sealing pressure in the CPLA[TM] group and higher incidence of sore throat when compared to LMA[TM] group. Cobra Perilaryngeal Airway [CPLA[TM]] is as efficient as the Laryngeal Mask Airway[LMA[TM]] but with better air way sealing pressure and higher incidence of sore throat in mechanically ventilated anaesthestised pediatrics

Early experience with totally implantable venous access port system for pediatric cancer patients

Background and Aim of work: vascular access in children receiving chemotherapy often poses an important problem. The irritating drugs used destroy peripheral veins, leading to a progressive decrease of available surface vessels. This can delay or prevent the administration of a planned therapy. Several methods of venous access have been developed, from arteriovenous fistula to indwelling right atrial silicon rubber catheters. Totally implanted devices, consisting of a subcutaneous inaction port attached to a silicon catheter, have been tried for those children. We are reporting here our early experience to assess the efficiency of this device

Patients and Method: between February 2001 and February 2004, 28 devices were placed in 28 patients with solid neoplasm or hematologic malignancy. All the catheters were inserted by cut down of the subclavian veins. The age of the patients ranged from 6 months 12 years old. Follow up period ranged from 4 to 20 months

Results: we did not have any early complication of insertion. System obstruction was the most frequent late complication. The mean life of the implanted system was 288 days

Conclusion: totally implanted devices roved safe 6 efficient venous access. Implantation should be performed by experienced surgeon. Obstruction is the most common complication 6 nay be prevented by adequate information and training of the users

Effect of leptin on renal functions in rabbits

The aim of this work is to evaluate the hemodynamic changes of leptin administration to rabbits. A total of 18 male New Zealand rabbits, weighing from 1 to 1.5 kg were included in this study. After induction of anesthesia, basal arterial blood pressure [Am, sodium [Na+], potassium [K+] and creatinine concentrations in both blood and urine samples were evaluated. The animals were then randomly assigned to 3 groups of 6 each. Group I [control] received isotonic saline by intravenous infusion. Group II [study group] received intra-arterial injection of leptin [10 micro g/kg] for one Hour followed by a 10-Jold higher dose of leptin. Group III [negative control] received intravenous bolus injection of propranolol [0.1 mg] for one hour followed by a similar dose for the next hour. Administration of leptin resulted in slight increase in mean arterial pressure [MAP] that reached significance after 90 min and persisted above the basal level for the recording period of 2 hours. There were no parallel changes, at either doses, infraction reabsorption of Na+, K+, H20 and glomerular filtration rate [GFR] as compared to both basal values and to control animals. It was concluded that the elevation in MAP induced by leptin was most probably not related to renal mechanism, as there were no significant changes in renal parameters studied. This suggests another mechanism for the rise in MAP, a suggestion which needs further studies