Automated segmentation of recuts abdominis muscle using shape model in X-ray CT images

Our purpose in this study is to segment the rectus abdominis muscle region in X-ray CT images, and we propose a novel recognition method based on the shape model. In this method, three steps are included in the segmentation process. The first is to generate a shape model for the rectus abdominis muscle. The second is to recognize anatomical feature points corresponding to the origin and insertion of the muscle, and the third is to segment the rectus abdominis muscles based on the shape model. We generated the shape model from 20 CT cases and tested the model to recognize the muscle in 20 other CT cases. The average values for the Jaccard similarity coefficient (JSC) and true segmentation coefficient (TSC) were 0.841 and 0.863, respectively. The results suggest the validity of the model-based segmentation for the rectus abdominis muscle.

Increased CCL18 expression in patients with cutaneous T-cell lymphoma: association with disease severity and prognosis

BACKGROUND

CC chemokine ligand (CCL) 18 is expressed by monocytes and dendritic cells (DCs), and has potent chemotactic activity for T cells, B cells and DCs. CCL18 expression is up-regulated in lesional skin of atopic dermatitis and bullous pemphigoid, suggesting its important roles in the development of these skin diseases.

OBJECTIVE

To investigate roles of CCL18 in cutaneous T-cell lymphoma (CTCL).

METHODS

The CCL18 messenger RNA (mRNA) expression in CTCL skin (n = 21) and in normal skin (n = 7) was examined by quantitative RT-PCR. CCL18 expression was also examined by immunohistochemistry. Serum CCL18 levels were measured in 38 patients with CTCL and 20 healthy controls by enzyme-linked immunosorbent assay. We also analysed correlation between serum CCL18 levels and other clinical and laboratory data.

RESULTS

The CTCL lesional skin contained higher levels of CCL18 mRNA than normal skin. CCL18 was expressed by dermal macrophages and DCs in CTCL skin. Serum CCL18 levels in patients with CTCL were significantly higher than those of healthy controls and correlated with types of skin lesions. They also significantly correlated with modified severity-weighted assessment scores, serum sIL-2R, LDH, IL-4, IL-10, IL-31, CCL17 and CCL26 levels. Patients with high serum levels of CCL18 showed significantly poor prognosis compared with those with low CCL18 levels.

CONCLUSION

CCL18 mRNA is up-regulated in CTCL lesional skin, and serum CCL18 levels are significantly increased and correlated with the severity of CTCL. These results suggest that CCL18 may be associated with the development of CTCL.

Comparisons of the effects of 12-week administration of miglitol and voglibose on the responses of plasma incretins after a mixed meal in Japanese type 2 diabetic patients

To compare the effects of miglitol [an alpha-glucosidase inhibitor (AGI) absorbed in the intestine] and voglibose (an AGI not absorbed) on plasma glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP) levels, 26 and 24 Japanese type 2 diabetic patients were randomly assigned to receive miglitol or voglibose, respectively. After 12-week administration of both drugs, during 2-h meal tolerance test, plasma glucose, serum insulin and total GIP were significantly decreased and active GLP-1 was significantly increased. Miglitol group showed a significantly lower total GIP level than voglibose group. Miglitol, but not voglibose, significantly reduced body weight (BW). In all participants, the relative change in BW was positively correlated with that of insulin significantly and of GIP with a weak tendency, but not of GLP-1. In conclusion, both drugs can enhance postprandial GLP-1 responses and reduce GIP responses. The significant BW reduction by miglitol might be attributable to its strong GIP-reducing efficacy.

Effect of substrate wettability in liquid dielectrophoresis (LDEP) based droplet generation: theoretical analysis and experimental confirmation

The generation of droplets for biological reactions at the microscale can be achieved by many techniques, among which the so-called liquid dielectrophoresis technique (LDEP). This is not a new process, but the parameters influencing actuation voltage still need further insight: size and geometry (electrodes width and gap, dielectric thickness), materials (dielectric constant), liquids (surface tension, dielectric constant, conductivity), working conditions (voltage, frequency) and substrate wettability (contact angle). This large experimental space is firstly reduced using non dimensional numbers and then studied in a systematic way thanks to the design of experiments. The contact angle influence is explained thanks to a new analytical model. To summarize, this paper recalls analytical models used to predict the voltage threshold required to develop a liquid rivulet from a mother drop, taking the contact angle into account and providing a large set of experimental results.

What influences the acidity in the gastric conduit in patients who underwent cervical esophagogastrostomy for cancer?

The aim of this study was to determine the factors influencing acidity in the gastric conduit after esophagectomy for cancer. Acidity and bile reflux in the stomach and in the gastric conduit were examined by 24-h pH monitoring and bilimetry in 40 patients who underwent transthoracic subtotal esophagectomy followed by esophageal reconstruction using a gastric conduit, which was pulled up to the neck through a posterior mediastinal route in 17 patients, through a retrosternal route in 10 patients, and through a subcutaneous route in 13 patients. They were examined at 1 week before surgery, at 1 month after surgery, and at 1 year after surgery. Helicobacter pylori infection was examined pathologically and using the (13) C-urea breath test. The factors influencing acidity of the gastric conduit were analyzed using the stepwise regression model. Gastric acidity assessed by percentage (%) time of pH < 4 was reduced after surgery and was significantly less in patients with H. pylori infection compared with those without H. pylori infection throughout the period from 1 week before surgery to 1 year after surgery. Duodenogastric reflux (DGR) assessed by % time absorbance > 0.14 into the lower portion of the gastric conduit was significantly increased after surgery throughout the period from 1 month after surgery to 1 year after surgery. Multivariate analysis showed that the acidity in the gastric conduit was influenced by H. pylori infection and DGR at 1 month after surgery, and by H. pylori infection and the route for esophageal reconstruction at 1 year after surgery. Acidity in the gastric conduit was significantly decreased after surgery. Acidity in the gastric conduit for esophageal substitutes is influenced by H. pylori infection and surgery. DGR influences the gastric acidity in the short-term after surgery, but not in the long-term after surgery.

Thoracic endovascular aortic repair for aortic complications after esophagectomy for cancer: report of three cases

Aortic complications after esophageal cancer surgery are rare and usually fatal. Here, we report three patients who underwent thoracic endovascular aortic repair (TEVAR) for aortic complications after esophagectomy for cancer. In the first case, aortic rupture was caused by pyothorax due to residual tumor after esophagectomy. In the second case, aortic rupture was caused by pyothorax due to anastomotic leakage. In the third case, a pseudoaneurysm was caused by surgical injury during esophagectomy. TEVAR was safe and effective for severe aortic complications when graft infection was avoided. The first case died of sepsis on the 84th postoperative day, and the other two cases have survived 4 years and 2 years to date.

Dental caries prevalence as a product of agriculture and subsistence pattern at the Yean-ri site, South Korea

Yean-ri human skeletal remains from South Korea have been dated to the fourth to seventh century AD. They have morphological similarities to immigrants of the Yayoi period excavated in northern Kyushu and Yamaguchi prefecture in Japan. The overall dental caries prevalence was 8.1% in the Yean-ri skeletal remains, indicating a much lower prevalence than that of most Yayoi immigrant skeletal remains from Japan, although similar to that of the Kofun people (8.3%) in Japan. There was no significant difference in the dental caries prevalence between the males and females of the same age group, but there were differences in the prevalence by age. The late middle age and elderly males and females had significantly higher dental caries prevalence than the early middle age males and females, indicating increased prevalence with age. Root caries prevalence tended to increase in old age. The percentage of root caries increased, accounting for 80% of all caries in Yean-ri human skeletal remains. Agriculture is believed to have arisen approximately 3,000 years ago in Korea. Therefore, agriculture was practiced during this period, but since the Yean-ri tumuli are from coastal areas, their diet may have retained a significant marine component. Additionally, caries prevalence was not very high in Nukdo human remains (ca. 2100-2000 BC) in Korea. We speculate that they maintained subsistence activities suitable for their environment despite their knowledge of agriculture. This hypothesis is supported by differences in the caries prevalence between excavation sites of the Yayoi and Kofun periods in Japan.

Complete electric dipole response and the neutron skin in 208Pb

A benchmark experiment on (208)Pb shows that polarized proton inelastic scattering at very forward angles including 0° is a powerful tool for high-resolution studies of electric dipole (E1) and spin magnetic dipole (M1) modes in nuclei over a broad excitation energy range to test up-to-date nuclear models. The extracted E1 polarizability leads to a neutron skin thickness r(skin) = 0.156(-0.021)(+0.025) fm in (208)Pb derived within a mean-field model [Phys. Rev. C 81, 051303 (2010)], thereby constraining the symmetry energy and its density dependence relevant to the description of neutron stars.

[Dr Leonor Michaelis and early days of Hokkaido University School of Medicine; episodes among three medical researchers in the roaring twenties]

Little has been known about the personal history of Dr. Takaichi Mohri (Nakashima), the first professor of department of hygiene at Hokkaido University School of Medicine. We, therefore, have been inquiring academic backgrounds of Dr. Mohri for two decades. These inquiries show interesting episodes between Dr. Leonor Michaelis, one of the biggest names in enzymologists, and early days of this Medical School. In this article, we describe that at least two professors, Drs. Takaichi Mohri and Kaoru Ohguro, were in good acquaintances with Dr. Michaelis as follows; 1) the latter half of 1921, Dr. Ohguro visited a laboratory of Dr. Michaelis in Berlin, 2) from November 1922 to June 1923, Dr. Michaelis in Nagoya collaborated with Dr. Mohri in Sapporo, 3) Dr. Michaelis in Nagoya visited Dr. Ohguro's house and office in Sapporo at March 1925, and 4) at the same occasion, Dr. Michaelis made his lecture on biochemistry in Hokkaido University School of Medicine. Since Drs. Ohguro and Mohri were classmates of the University of Tokyo Faculty of Medicine, Dr. Ohguro could introduce Dr. Michaelis to Dr. Mohri who used to be a graduate student in department of biochemistry. As a result of relationships, Drs. Michaelis and Mohri published a paper entitled "Eine weitere Methode zur Bestimmung des isoelektrischen Punktes von Eiweisskoerpern und ihre Anwendung auf die Serumalbumine verschiedener Tiere" in Biochemische Zeitschrift, which was a part of Dr. Mohri's Ph.D. thesis.

Origin of low-energy quadrupole collectivity in vibrational nuclei

The coupling of the giant quadrupole resonance to valence-space configurations is shown to be the origin of the formation of low-lying quadrupole-collective structures in vibrational nuclei with symmetric and mixed-symmetric character with respect to the proton-neutron degree of freedom. For the first time experimental evidence for this picture is obtained from electron- and proton scattering experiments on the nucleus ^{92}Zr that are sensitive to the relative phase of valence-space amplitudes by quantum interference.

Living-donor liver transplantation at the University of Tokyo, 1996-2011: the impact of HLA matching and a positive crossmatch on long-term survival and tolerance

OBJECTIVE

We analyzed a single center's experience during 16 years of living-donor liver transplantation (LDLT). The impacts of HLA mismatches and positive crossmatches on long term outcomes and tolerance were evaluated.

METHODS

This study was of primary LDLTs of consecutive patients from January 1996 to December 2011; re-transplants were not included. Long-term survival was compared by primary disease, number of HLA mismatches, and crossmatches. Demographics and complications after transplantation between pediatric recipients who achieved clinical operational tolerance and those who did not were compared.

RESULTS

One-year liver graft survival rates for adult and pediatric cases were 90.4% and 91.9%, respectively; the 5-year rates were 83.1% and 89.2%, respectively; the 10-year rates were 79.7% and 89.2%, respectively; and 15-year rates were 65.9% and 83.8%, respectively. For the grafts that survived more than one year, the 10-year rates for adult and pediatric cases were 88.2% and 97.0%, respectively. The 10-year rates for adult LDLT in 0 mismatches, 1-2 mismatches, 3-4 mismatches, and 5-6 mismatches were 79.2%, 86.8%, 77.4%, and 69.4%, respectively. Although the survival rates were not significantly different, the survival rates were lowest in LDLT recipients with 5-6 HLA mismatches. Ten-year liver graft survival rates for adult LDLT with negative T-cell crossmatch, and positive T-cell crossmatch were 80.0% and 71.1%, respectively. The 1-year liver graft survival rates for adult LDLT with negative B-cell crossmatch, and positive B-cell crossmatch were 90.6% and 88.2%, respectively. None of the factors--age of recipients and donors, primary disease, donor gender, relationship of donors to recipients, positive crossmatches, or number of HLA mismatches--was significantly different between COT and non-COT recipients, except for recipient gender (p = 0.01); in COT cases, there were more female recipients (88.9%) than male (11.1%). Post-transplant complications--acute rejection rate in one year post-transplant, biliary complications rate, and vascular complication rate--were not significantly different between COT and non-COT recipients.

CONCLUSIONS

High long-term survival was achieved by both adult and pediatric recipients. Even higher survival can be achieved by improving early graft loss. Further studies are necessary to determine the impact of HLA mismatches and positive crossmatches on long-term outcomes and tolerance.

Outcomes of multimodality therapy for stage IVB esophageal cancer with distant organ metastasis (M1-Org)

Esophageal cancer patients with distant organ metastasis have usually been treated only to palliate symptoms without multimodality therapy. The current study evaluates the role of multimodality therapy in esophageal squamous cell cancer patients with distant organ metastasis. Between February 1988 and January 2007, 80 esophageal squamous cell cancer patients with distant organ metastases were treated at our institution. Multimodality therapy was performed in 58 patients: 43 patients received chemoradiotherapy, 13 underwent surgery followed by chemotherapy and/or radiation therapy, and two received chemotherapy or chemoradiotherapy followed by surgery. Thirteen patients received single-modality therapy; chemotherapy, radiotherapy, or surgery alone. The remaining nine patients received best supportive care alone. The metastatic organ was the liver (n= 40), the lungs (n= 33), bone (n= 10), and other (n= 6). Nine patients had metastasis in two organs. There was no difference in the median survival among the sites of organ metastasis, lung, liver, or bone (P= 0.8786). The survival of patients treated with multimodality therapy was significantly better than that of the patients who received single-modality therapy or best supportive care alone (P < 0.0001). In patients treated with multimodallity therapy, there was no difference in survival for patients treated with surgery compared with patients treated without surgery (P= 0.1291). This retrospective study involves an inevitable issue of patient selection bias. However, these results suggested that multimodality therapy could improve survival of the esophageal squamous cell cancer patients with distant organ metastasis.