Prediction of Intramolecular Reorganization Energy Using Machine Learning.

Facile charge transport is desired for many applications of organic semiconductors (OSCs). To take advantage of high-throughput screening methodologies for the discovery of novel OSCs, parameters relevant to charge transport are of high interest. The intramolecular reorganization energy (RE) is one of the important charge transport parameters suitable for molecular-level screening. Because the calculation of the RE with quantum-chemical methods is expensive for large-scale screening, we investigated the possibility of predicting the RE from the molecular structure by means of machine learning methods. We combinatorially generated a molecular library of 5631 molecules with extended conjugated backbones using benzene, thiophene, furan, pyrrole, pyridine, pyridazine, and cyclopentadiene as building blocks and obtained the target electronic data at the B3LYP level of theory with the 6-31G* basis set. We compared ridge, kernel ridge, and deep neural net (DNN) regression models based on graph- and geometry-based descriptors. We found that DNNs outperform the other methods and can predict the RE with a coefficient of determination of 0.92 and root-mean-square error of ∼12 meV. This study shows that the REs of organic semiconductor molecules can be predicted from the molecular structures with high accuracy.

Is pneumoconiosis a factor of severity in acute exacerbation of chronic obstructive pulmonary disease?

BACKGROUND AND AIM: Although working in a coal mine is a wellknown risk factor for chronic obstructive pulmonary disease (COPD), there insufficient data explaining the association between acute exacerbation of COPD (AECOPD) and coal worker pneumoconiosis (CWP). This study aimed to evaluate the features of patients with complicated CWP admitted for AECOPD and whether complicated CWP has any effect on increasing the severity of this disease. MATERIALS AND METHODS: This study was designed as a retrospective cohort study. A total of 106 hospitalized patients were identified to have CWP. Patients who did not perform spirometry and with simple CWP were excluded. A total of 51 patients with complicated CWP, was included in the study group. Comparison group was selected from the patients with AECOPD without pneumoconiosis. RESULTS: Patients with complicated CWP, when compared to patients without pneumoconiosis, had longer hospitalization times (12.96 ± 8.49 days, 9.67 ± 5.21 days respectively, p=0.021), a higher cost of hospitalization (€2029 ± 2724, €931 ± 820 respectively, p=0.003), and higher rates of infective microorganisms in respiratory secretions and/ or blood cultures (61.3%, 29.6% respectively, p=0.016). We found that significance of high cost was dependent on duration of hospitalization and culture positivity. The most frequently encountered infective microorganism in both groups with complicated CWP and without pneumoconiosis was pseudomonas aeruginosa. CONCLUSIONS: Preventive measures for CWP in regions with high prevalence of coal mining have a very important role in the fight against COPD, which has significant morbidity and mortality rates.

Is the 2009 FIGO staging system really valuable for stage I endometrial cancer?

PURPOSE: The aim of this study was to compare the survival predictive values of the 1988 and 2009 FIGO staging systems for the staging of patients with early-stage endometrioid type endometrial cancer. MATERIALS AND METHODS: Two hundred twenty-four patients treated for endometrial cancer from 1996 to 2006 at Ankara Oncology Education and Research Hospital were staged according to the two staging systems. Early-stage patients with a histological diagnosis of endometrioid adenocarcinoma were included in the study. The Kaplan-Meier method was used for survival analysis. RESULTS: The charts of 224 patients treated for endometrial cancer were retrospectively evaluated. The five-year overall survival (OS) for Stage IA and IB cases was 100% (n = 19) and 96.2% (n = 79), respectively, with no significant difference between the OS values (p = 0.126) with the FIGO 1988 system and 96,4% (n = 112) and 87.5% (n = 48), respectively with a statistically significant difference (p = 0.05) with the FIGO 2009 system. CONCLUSION: The authors found that the survival prognostic value of the 2009 FIGO staging system was more effective than the 1988 FIGO staging system for cases with early-stage endometrioid type endometrial cancer.

Sildenafil treatment attenuates lung and kidney injury due to overproduction of oxidant activity in a rat model of sepsis: a biochemical and histopathological study.

Sepsis is a systemic inflammatory response to infection and a major cause of morbidity and mortality. Sildenafil (SLD) is a selective and potent inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase PDE5. We aimed to investigate the protective effects of sildenafil on caecal ligation and puncture (CLP)-induced sepsis in rats. Four groups of rats were used, each composed of 10 rats: (i) 10 mg/kg SLD-treated CLP group; (ii) 20 mg/kg SLD-treated CLP group; (iii) CLP group; and (iv) sham-operated control group. A CLP polymicrobial sepsis model was applied to the rats. All groups were killed 16 h later, and lung, kidney and blood samples were analysed histopathologically and biochemically. Sildenafil increased glutathione (GSH) and decreased the activation of myeloperoxidase (MPO) and of lipid peroxidase (LPO) and levels of superoxide dismutase (SOD) in the septic rats. We observed a significant decrease in LPO and MPO and a decrease in SOD activity in the sildenafil-treated CLP rats compared with the sham group. In addition, 20 mg/kg sildenafil treatment in the sham-operated rats improved the biochemical status of lungs and kidneys. Histopathological analysis revealed significant differences in inflammation scores between the sepsis group and the other groups, except the CLP + sildenafil 10 mg/kg group. The CLP + sildenafil 20 mg/kg group had the lowest inflammation score. Sildenafil treatment decreased the serum tumour necrosis factor (TNF)-α level when compared to the CLP group. Our results indicate that sildenafil is a highly protective agent in preventing lung and kidney damage caused by CLP-induced sepsis via maintenance of the oxidant-anti-oxidant status and decrease in the level of TNF-α.

Preoperative staging of colon cancer patients: ultrasound can be a valuable alternative to computed tomography.

OBJECTIVE: The aim of this study was to compare the results of ultrasound and CT assessment in preoperative staging of colonic cancer, and to determine whether CT offers any benefits beyond ultrasound. PATIENTS AND METHODS: Sixty-one cases of intraperitoneal colon cancer were assessed by preoperative abdominal ultrasound and CT. The ultrasound and CT findings were assessed for ascites, hepatic and peritoneal metastases, invasion of adjacent organs, and findings of other diseases. RESULTS: The sensitivity rates of CT for liver metastases, adjacent organ invasion, ascites and peritoneal metastases were 81 %, 25 %, 29 % and 20 % respectively, while those of ultrasound were 69 %, 6 %, 43 % and 0%, respectively. Both methods had similar sensitivity, specificity and accuracy rates regarding the detection of all criteria. Ultrasound was more sensitive for detecting ascites and liver metastasis when compared to peritoneal metastasis and invasion (p<0.05). CT allowed the detection of liver metastasis to be more sensitive when compared to the other three criteria (p<0.05). In addition to ultrasound, CT gave no more additional knowledge indicating the necessity of altering the clinical management in patients. CONCLUSION: The first-line scanning technique should be the ultrasound and there is no need for CT scan, should no abnormalities be found upon ultrasound examination. CT investigation plays a role in cases where the ultrasound findings are suspicious (Tab. 1, Ref. 16). Full Text in free PDF www.bmj.sk.

E-cadherin expression in endometrial malignancies: comparison between endometrioid and non-endometrioid carcinomas.

This study examined the frequency of E-cadherin expression in endometrial biopsy or hysterectomy specimens from patients diagnosed with endometrial adenocarcinoma and in normal endometrial tissue specimens. E-cadherin expression was detected by immunohistochemistry using monoclonal antibody to E-cadherin. Specimens were classified as positive when >or= 5% of the tumour cells showed staining for E-cadherin, irrespective of the pattern of staining. Twenty-three endometrioid carcinomas and nine non-endometrioid (four papillary serous and five clear cell) carcinomas were studied, along with 10 normal endometrial tissue specimens as controls. E-cadherin expression was significantly less frequent in non-endometrioid carcinomas compared with endometrioid carcinomas and controls. There was no statistically significant difference in the frequency of E-cadherin expression between endometrioid carcinomas and controls. In conclusion, this study demonstrated that uterine non-endometrioid (papillary serous and clear cell) carcinomas were less likely to express E-cadherin compared with endometrioid carcinomas and normal endometrial tissue. This may help to explain the more aggressive behaviour of non-endometrioid carcinomas.

Pulmonary parenchymal alveolar histological study in experimental tracheo-oesophageal malformations.

OBJECTIVE: Children operated on for tracheo-oesophageal malformation (TOM) often suffer from postoperative respiratory system difficulties. There is little current literature about this subject. This study aimed to investigate the causes of these problems in rats with experimental TOM by evaluating the lung alveolar histology. SUBJECTS AND METHODS: Twenty Wistar albino rats were used for the experiment. Twelve rats with a sperm positive vaginal smear received 1.75 mg/kg intraperitoneal adriamycin on days six to nine of gestation. A sham group was infused with saline instead of adriamycin. A control group was not subjected to any additional procedure. Their fetuses were dissected under surgical microscope. After examining the trachea and oesophagus, the lungs were dissected and fixed in 10% formalin. The groups were compared with respect to alveolar flat cell (Type-1), capillary density and air space percentage in the samples obtained under light microscopy. Statistical evaluation was performed through Mann-Whitney-U tests and Pearson Chi-squared tests. RESULTS: Type-1 cell ratio and air space percentage were the highest for the control and sham groups. However, the group that received adriamycin and developed TOM had the lowest values. There were no statistically significant differences between the groups with respect to capillary density. CONCLUSION: In rats with experimentally produced TOM, the pulmonary parenchyma showed delayed maturation. This could be the cause of the frequently seen respiratory system pathologies in children suffering from TOM. Further studies should be done to elucidate this.

Prevalence of IgA-antiendomysial antibody in a patient cohort with idiopathic low bone mineral density.

AIM: To investigate the frequency of serum IgA-antiendomysial antibody positivity in patients with low bone mineral density and to assess the risk group for screening of celiac disease. METHODS: One hundred and thirty-five patients (14 male, 121 female) with idiopathic low bone mineral density were evaluated. The median age was 57.2 years (24-81). Antiendomysial antibody was determined by the immunofluorescence method using a commercial kit (INOVA Diagnostics Inc., CA, USA), which employs a 5 microm thin cryostat section of monkey esophagus as a substrate. RESULTS: Of the 135 patients evaluated, 13 were found to have positive IgA antiendomysial antibody test (9.6%) response. None of the patients had IgA deficiency. Endoscopic appearance and histological examination were normal in all of these patients. Seropositive patients had significantly lower age (48.9 +/- 4.3 vs 59.2 +/- 6.2, P < 0.05), higher ratio of male gender (61.5% vs 4.9%, P < 0.01) and pre-menopausal status (8.7% vs 1.3%, P < 0.01). Lumbar spine and femoral neck z-scores, but not t-scores were significantly lower in seropositive patients. Seropositive patients had lower serum 25 (OH) vitamin D, calcium and higher serum parathormone levels than seronegative patients. CONCLUSION: The screening of celiac disease in idiopathic osteoporosis should be restricted to patients without classical risk factors (younger, pre-menopausal, male gender) for osteoporosis. Bone mineral density measurements using z-scores should be considered for identifying risk groups for celiac disease.

Comparison of complications after D2 and D3 dissection for gastric cancer.

BACKGROUND: D3 dissection is accepted as having higher rates of mortality and morbidity than D2 dissection. In this study, we aimed to evaluate the mortality and morbidity rates of D3 dissection in our department and to compare these with mortality and morbidity after D2 dissection. PATIENTS AND METHODS: All patients who underwent radical gastric resection with lymph node dissection for gastric adenocarcinoma between June 1999 and June 2002 were evaluated. Clinicopathologic features of the tumour, the resection and lymphadenectomy, the postoperative mortality and morbidity were analysed. RESULTS: There were 359 patients admitted for the treatment of gastric cancer. One hundred twenty four underwent palliative resection and 134 underwent resection with curative intent. Of 34/134 patients, underwent gastric resection with D3 dissection, and 100 underwent D2 dissection. The overall operative mortality rate of D2 and D3 dissections was 1 and 8.8%, respectively (p<0.05). The relaparotomy rate was almost doubled in D3 dissection group (11.8% vs. 6%) but this difference was not statistically significant. D3 dissection was also associated with an increase in morbidity (35.3% vs. 10%, p<0.05). CONCLUSIONS: This study indicates that D3 dissection can be performed with reasonable safety. It may be a useful alternative procedure in advanced cases for which additional risks of surgical morbidity and mortality are felt to be outweighed by potential benefits to patients.

Evaluation of the outcomes of short bowel syndrome and indications for intestinal transplantation.

Long-term parenteral nutrition (PN) and intestinal transplantation (IT) are life-saving therapies for patients with short bowel syndrome (SBS). However, indications and timing of these therapies are controversial. In this study we aimed to evaluate the indications for IT. Forty-two patients, each with <100 cm of small bowel, were divided into three groups according to the length of remnant: group I patients (n = 18): colon plus 50 to 100 cm of small bowel (SB); group II patients (n = 14): colon plus <50 cm of SB; and group III patients (n = 10): <50 cm of SB without colon. One-year mortality rates for groups I, II, and III were 50%, 72%, and 100%, respectively. All group I survivors developed intestinal adaptation, returning to regular oral feedings at 1 year. Interestingly, three of four surviving patients in group II developed adaptation and were fed an oral short bowel diet (SBD) at 1 year. None of the group III patients survived >1 year, dying due to multiorgan failure in the early postoperative period or from sepsis within 1 year. We conclude that patients with a very short bowel are candidates for IT when stable. If the colon is intact, however, regardless of small bowel remnant length, the patient should be given a chance to develop intestinal adaptation before making the decision for permanent PN or IT.

An unusual case of hydatid disease located in the erector spinae muscle.

We present a case of hydatid disease localized to the erector spinae muscle. A 60-year-old male was admitted to our hospital with back pain. The diagnosis was made preoperatively by US, CT, and MRI. They showed hydatid disease in erector spinae muscle. Cysts and some part of the erector spinae muscle were resected. Postoperatively pathology confirmed the diagnosis.

Surgical treatment of intrabiliary rupture of hydatid cysts of liver: comparison of choledochoduodenostomy with T-tube drainage.

BACKGROUND: Intrabiliary rupture is one of the most serious complications of liver hydatid cysts (LHC). The kind of surgery for these patients is still controversial. T-tube drainage and choledochoduodenostomy (CD) are used by most of the surgeons. But there is no comparative study in the literature. METHODS: Eighty patients with symptomatic intrabiliary rupture were treated between 1980 and 1995. All patients had jaundice. In addition to treatment of the cyst cavity, T-tube drainage of the common bile duct (CBD) was performed in 53 patients, 25 patients underwent a CD for biliary drainage and two patients were treated by a T-tube placed in the CBD without treating the cyst. The T-tube drainage and CD groups were compared in regard to morbidity, mortality, duration of the operation, rate of relaparatomy and duration of postoperative hospital stay. RESULTS: The morbidity rate was 40% (10/25) after CD and 18.1% (10/55) after T-tube drainage. Relaparatomy was necessary in 8% (2/25) and 1.8% (1/55) of patients treated with CD and T-tube drainage, respectively. T-tube drainage was performed much more rapidly than CD (p < 0.05). The length of hospital stay for both groups was the same. One patient who was treated with CD died postoperatively. CONCLUSION: Our results suggest that T-tube drainage is superior to CD for intrabiliary rupture of LHC in most cases.

Beneficial effects of iloprost during experimentally induced hemorrhagic shock.

BACKGROUND: The aim of the study was to evaluate the efficacy of iloprost on myocardial insufficiency associated with hypovolemic shock in dogs. We designed the study as a controlled randomized study. METHODS: Sixteen mixed-breed dogs were included into the study and divided into two equal groups as the control and iloprost groups. Mean arterial pressure was reduced to 45 mmHg by withdrawing the arterial blood into citrated bags. The control group did not receive any drug but the other group received iloprost at a rate of 20 ng/kg/min by an infusion pump. Iloprost infusion was started 30 min after the blood pressure was reduced to 45 mmHg. All measurements were made before removal of blood, 45 min after exsanguination and at 1 hour intervals for 3 hours. Left ventricular stroke work index was measured 72 hours after the study. The hemodynamic and biochemical parameters and blood gas analysis were obtained. RESULTS: After hemorrhage, cardiac index (CI) decreased significantly from 132 +/- 14 to 51 +/- 8 ml/kg/min in the control group and from 128 +/- 11 ml/kg/min to 47 +/- 13 ml/kg/min in the iloprost group, respectively but at the end of the third hour it was 81 +/- 8 ml/kg/min in the control group and 105 +/- 6 ml/kg/min in the iloprost group (p < 0.05). Tumor necrosis factor-alpha (TNF alpha) was 41 +/- 8 pg/ml in the control group and 18 +/- 6 in the iloprost group 3 hours after bleeding (p < 0.05). Tumor necrosis factor-alpha concentration was significantly higher in the control group than in the iloprost group. There was no significant difference in pH between the groups but actual bicarbonate concentrations were different between the groups (p < 0.05). At the end of the third hour total body oxygen consumption was 105 +/- 11 ml/min in the control group and 132 +/- 12 ml/min in the iloprost group (p < 0.05). Oxygen delivery 3 hours after hemorrhage was 201 +/- 19 ml/min in the control group and 252 +/- 24 ml/min in the iloprost group (p > 0.05). Left ventricular stroke work index was higher in the iloprost group (p < 0.05). CONCLUSIONS: Hemorrhagic shock causes tumor necrosis factor-alpha release which may lead to multiple organ failure. Organ dysfunction still persists even after the appropriate treatment. Iloprost attenuates the release of tumor necrosis factor-alpha which may improve the adverse effects of hemorrhagic shock.

Sister chromatid exchange rate from pleural fluid cells in patients with malignant mesothelioma.

This study assessed the impact of malignant mesothelioma on the frequencies of sister chromatid exchange (SCE) in the pleural effusion cells. Ten patients with mesothelioma and 20 control subjects were included in the study. The control subjects were the patients with tuberculosis pleurisy, and the remaining 10 subjects of control group were healthy volunteers and only heparinized blood samples were collected from these subjects. The pleural effusion cells were cultured with conventional culture methods. The samples were obtained from the patients after histopathologic confirmation of the malignancy but before the initiation of chemotherapy or radiotherapy. At the end of the culture period and 48 h prior the harvesting, BrdU was added into flasks. Totally, 100 metaphases were scored for each sample. In this study, we found that the SCE frequencies of malignant pleural mesotheliomas were significantly higher than the control subjects (P<0.001). Six of 10 patients came from central Anatolia, which is of great importance due to high rate of exposure to asbestosis in this region.

Myocardial hemodynamic and metabolic changes during abdominal insufflation with carbon dioxide.

It is a well-known fact that laparoscopic procedures performed with carbon dioxide insufflation impair myocardial function. In this study, we aimed to determine the safety limitations of various intra-abdominal pressure values during abdominal insufflation with carbon dioxide. Of the 24 mongrel dogs, 6 were assigned to one of four different pressure groups (10, 15, 20 and 30 mm Hg), respectively. Cardiac output, right/left heart pressures, and the first derivative of ventricular pressure were monitored. Myocardial oxygen consumption, myocardial lactate/oxygen extraction, tissue lactate and adenosine triphosphate levels were determined. Measurements were performed initially as a control, at 15-min intervals during 1 h of insufflation and 1 h after desufflation. At 10 mm Hg carbon dioxide pressure, hemodynamic and metabolic parameters were not significantly different. Cardiac output decreased significantly in the 20 and 30 mm Hg groups (p < 0.05: 10, 15 vs. 20, 30 mm Hg). Although cardiac output did not change at 15 mm Hg, the dp/dt value was significantly reduced. Cardiac output at the 60th min was 1,960+/-75 ml/min in the 10 mm Hg group, 1,885+/-40 ml/min in the 15 mm Hg group, 1,770+/-45 ml/min in the 20 mm Hg group and 1,695+/-40 ml/min in the 30 mm Hg group. Myocardial oxygen consumption was reduced at 15, 20 and 30 mm Hg (p < 0.05: 10 vs. 15, 20 and 30 mm Hg). In the myocardial tissue, ATP decreased from 19+/-2 to 12+/-1.2 micromol/g at 15 mm Hg, from 19+/-1.9 to 9.4+/-1.3 micromol/g at 20 mm Hg and from 18+/-3.2 to 8.2+/-1.9 micromol/g at 30 mm Hg. Changes in hemodynamic and metabolic parameters of the heart are reversible and may not lead to any significant impairments in patients having normal cardiopulmonary function, but pose a risk in patients with respiratory disease and limited myocardial reserve.

Caroli's disease: 1977-1995 experiences.

OBJECTIVE: Until recently, congenital cystic dilatation of the intrahepatic biliary ducts (Caroli's disease) has been recognized infrequently. This report aimed to analyse and discuss our observations on 21 adult patients with the disease. PATIENTS: From 1977 to 1995, 21 patients (eight women and 13 men), aged 17 to 68 years, were diagnosed and treated for Caroli's disease at Yuksek Ihtisas Hospital. The mean duration of the disease was 6.5 years. RESULTS: The commonest presenting symptom was abdominal pain, a feature in 18 cases. The distribution of the biliary lesions was bilobar in 12 patients and monolobar in nine. Two of them were congenital hepatic fibrosis. Twenty-one patients had coexisting hepatobiliary disease, associated with Caroli's disease. Approximately 95% of our patients had cystolithiasis, cholelithiasis or both. Surgical treatment was used in 18 patients, a partial hepatectomy being carried out in seven of them, an internal biliary drainage by choledocystojejunostomy in five cases, and by choledochotomy in four cases. Three cases with Caroli's disease were treated with endoscopic sphincterotomy and stone extraction. In the follow-up period, four of our patients died. CONCLUSION: Caroli's disease is being diagnosed more frequently as a result of improved diagnostic capabilities. The aim of the treatment is to obtain sufficient biliary drainage and to relieve the symptoms.