RedirectedDoors+: Door-Opening Redirection with Dynamic Haptics in Room-Scale VR.

RedirectedDoors is a visuo-haptic door-opening redirection technique in VR, and it has shown promise in its ability to efficiently compress the physical space required for a room-scale VR experience. However, its previous implementation has only supported laboratory experiments with a single door opening at a fixed location. To significantly expand this technique for room-scale VR, we have developed RedirectedDoors+, a robot-based system that permits consecutive door-opening redirection with haptics. Specifically, our system is mainly achieved with the use of three components: (1) door robots, a small number of wheeled robots equipped with a doorknob-like prop, (2) a robot-positioning algorithm that arbitrarily positions the door robots to provide the user with just-in-time haptic feedback during door opening, and (3) a user-steering algorithm that determines the redirection gain for every instance of door opening to keep the user away from the boundary of the play area. Results of simulated VR exploration in six virtual environments reveal our system's performance relative to user walking speed, paths, and number of door robots, from which we derive its usage guidelines. We then conduct a user study ($N=12$) in which participants experience a walkthrough application using the actual system. The results demonstrate that the system is able to provide haptic feedback while redirecting the user within a limited play area.

Exploring Visual-Auditory Redirected Walking using Auditory Cues in Reality.

We examine the effect of auditory cues occurring in reality on redirection. Specifically, we set two hypotheses: the auditory cues emanating from fixed positions in reality (Fixed sound, FS) increase the noticeability of redirection, while the auditory cues whose positions are manipulated consistently with the visual manipulation (Redirected sound, RDS) decrease the noticeability of redirection. To verify these hypotheses, we implemented an experimental environment that virtually reproduced FS and RDS conditions using binaural recording, and then we conducted a user study ( N=18) to investigate the detection thresholds (DTs) for rotational manipulation and the sound localization accuracy of the auditory cues under FS and RDS, as well as the baseline condition without auditory cues (No sound, NS). The results show, against the hypotheses, FS gave a wider range of DTs than NS, while RDS gave a similar range of DTs to NS. Combining these results with those of sound localization accuracy reveals that, rather than the auditory cues affecting the participants' spatial perception in VR, the visual manipulation made their sound localization less accurate, which would be a reason for the increased range of DTs under FS. Furthermore, we conducted a follow-up user study ( N=11) to measure the sound localization accuracy of FS where the auditory cues were actually placed in a real setting, and we found that the accuracy tended to be similar to that of virtually reproduced FS, suggesting the validity of the auditory cues used in this study. Given these findings, we also discuss potential applications.

UV-Induced Formation of Ice XI Observed Using an Ultra-High Vacuum Cryogenic Transmission Electron Microscope and its Implications for Planetary Science.

The occurrence of hydrogen atom-ordered form of ice Ih, ice XI, in the outer Solar System has been discussed based on laboratory experiments because its ferroelectricity influences the physical processes in the outer Solar System. However, the formation of ice XI in that region is still unknown due to a lack of formation conditions at temperatures higher than 72 K and the effect of UV-rays on the phase transition from ice I to ice XI. As a result, we observed the UV-irradiation process on ice Ih and ice Ic using a newly developed ultra-high vacuum cryogenic transmission electron microscope. We found that ice Ih transformed to ice XI at temperatures between 75 and 140 K with a relatively small UV dose. Although ice Ic partially transformed to ice XI at 83 K, the rate of transformation was slower than for ice Ih. These findings point to the formation of ice XI at temperatures greater than 72 K via UV irradiation of ice I crystals in the Solar System; icy grains and the surfaces of icy satellites in the Jovian and Saturnian regions.

Antithyroid drug-associated MPO-ANCA-positive tubulointerstitial nephritis in a type 2 diabetes patient: a case report.

A 54-year-old man diagnosed with type 2 diabetes and hyperthyroidism was prescribed propylthiouracil (PTU) after the patient developed hepatic dysfunction on thiamazole. At 50 mg/day of PTU, he was stable with thyroid-stimulating hormone receptor and thyrotropic antibody titers remaining stable. After four years of taking PTU, he was referred to the Department of Nephrology due to a rapid increase in his serum creatinine (Cr) level. He showed impaired renal function (Cr 2.26 mg/dL; estimated glomerular filtration rate (eGFR), 25 mL/min). In addition, urinary ß2-microglobulin (ß2 MG) was increased to 71,980 µg/L and was positive for myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA) (33.9 U/mL). Gallium scintigraphy demonstrated a remarkable accumulation in both kidneys. The patient was diagnosed with tubulointerstitial nephritis based on a renal biopsy, the results of which suggested that it might have been induced by PTU. He was treated with prednisolone (PSL) at 30 mg/day. As a result, within two weeks, Cr, eGFR, and urinary ß2 MG levels were progressively improved to 1.72 mg/dL, 34 mL/min, and 22,020 µg/L, respectively. Therefore, we tapered off the PSL with a dose of 5 mg/day after approximately one year. There have been no exacerbated renal function parameters. Although there are many reports on patients developing MPO-ANCA-positive crescentic glomerulonephritis after the administration of PTU, we report on a relatively rare case in which interstitial nephritis occurred after the administration of PTU.

[A case of HELLP syndrome at 34w-pregnancy with systemic lupus erythematosus and antiphospholipid antibody syndrome;Importance of measurement of VW factor].

SUMMARY: A 39-year-old woman was diagnosed with Systemic lupus erthymatosus (SLE) in 1993, and initially received 30 mg of prednisolone (PSL) daily as treatment. In 2012, the patient was diagnosed with pregnancy-induced hypertension (PIH) complecated with proteinurea, hypertension and pretibial edema at 24 weeks of gestation. At onset, protein urea was 1.6 g/day and she was given bed rest in the hospital with a protein-restricted and low salt diet, which led to a decrease in protein urea to approximately 1 g/day. At 34 weeks of gestation epigastric pain developed, and laboratory examinations showed liver dysfunction and low platelets. We made a diagnosis of hemolysis, elevated liver enzymes, low platelet (HELLP) syndrome and performed an emergency cesarean procedure. Thereafter blood pressure was elevated, protein urea was 3.2 g/daily, anti-ds-DNA antibody level was elevated and serum C3/C4/CH50 was reduced, thus we gave. plasma exchange therapy, along with immunoadsorption and steroid pulse therapy (methyl-prednisolone 500 mg/daily for 3 days), as well as PSL at 30 mg/day. Overtime clinical symptoms and laboratory data gradually improved. CONCLUSION: Some reports suggest that SLE during pregnancy is a risk factor for hypertension, nephritis, SLE relapse and HELLP syndrome. In the patient, ADAMTS13 activity did not decrease, while there was an increase in VW factor level. We assessed this case was as atypical thrombotic microangiopathy. And herein report HELLP syndrome during pregnancy associated with SLE in our patient.

A phase II study of paclitaxel and carboplatin with a biweekly schedule in patients with epithelial ovarian cancer: Gynecologic Cancer Network trial.

AIM: The objective of this multicenter phase II study was to evaluate the effects of biweekly paclitaxel and carboplatin combination chemotherapy on response rate and toxicities in patients with epithelial ovarian cancer. PATIENTS AND METHODS: Patients with International Federation of Gynecology and Obstetrics stage II to IV ovarian cancer received paclitaxel at a dose of 120 mg/m(2) and carboplatin at an area under the curve of 3 mg/mL per minute every 2 weeks for 8 or more cycles. Inclusion criteria included an Eastern Cooperative Oncology Group performance status of 0 to 2 and no previous chemotherapy. Informed consent was obtained from each patient before the start of treatment. RESULTS: From March 2003 through July 2009, 42 patients from 5 institutions were eligible to be evaluated for response and toxicity. The median age was 60.5 years (age range, 34-81 years). The International Federation of Gynecology and Obstetrics stage was stage II in 3 patients, stage III in 31 patients, and stage IV in 8 patients. The response rate was 66.7% (95% confidence interval: 50.5%-80.4%). Sixty-nine percent (29 of 42) of patients received 8 or more cycles of chemotherapy. The median progression-free survival was 18.5 months, and overall survival was 59.1 months. The most common grade 3 or 4 hematological toxicity was neutropenia (61.0%). No patients had grade 3 or 4 thrombocytopenia. The most common grade 3 nonhematological toxicities were neuropathy (4.9%) and nausea (2.4%). CONCLUSION: Paclitaxel combined with carboplatin using a biweekly schedule is a safe and effective chemotherapy regimen for patients with epithelial ovarian cancer. Our results suggest that a biweekly schedule is well tolerated and is less toxic than a triweekly schedule.

Outcomes of fertility-sparing surgery for women of reproductive age with FIGO stage IC epithelial ovarian cancer.

OBJECTIVE: To report the clinical outcomes of patients with FIGO stage IC epithelial ovarian cancer (EOC) treated by fertility-sparing surgery (FSS). METHODS: A retrospective review was conducted of 18 women who underwent FSS at Niigata University Hospital, Japan, between December 15, 1986, and December 31, 2010. RESULTS: Tumors were mucinous (n=9), clear cell (n=4), endometrioid (n=3), and serous (n=2). Median follow-up was 78.0 months (range, 9.3-181.3 months). Five patients (27.8%) developed tumor recurrence at 7.4-19.2 months after initial surgery. The sites of recurrence were peritoneal lymph nodes (n=2), contralateral ovary (n=1), contralateral ovary and peritoneal cavity (n=1), and brain (n=1). In all, 7 full-term singleton pregnancies were recorded among 5 of the 10 women who attempted to conceive after FSS. CONCLUSION: Favorable reproductive outcomes were observed following FSS, suggesting that this procedure may be a valid treatment option for women with FIGO stage IC EOC who wish to conceive.

Ovarian pregnancy resulting from cryopreserved blastocyst transfer.

Ovarian pregnancy very rarely occurs and its exact mechanism is unclear. Here, we report a case of ovarian pregnancy resulting from cryopreserved blastocyst transfer. The patient was a 34-year-old woman who had undergone bilateral ovarian cystectomy for endometriosis. Both fallopian tubes indicated normal findings on laparoscopic surgery, and we removed the gestational product of the right ovary. Pathological analysis confirmed the diagnosis of right ovarian pregnancy. Ectopic pregnancy is one of the major complications of in vitro fertilization-embryo transfer. Although ovarian pregnancy is an extremely rare occurrence, the possibility of developing this event after cryopreserved blastocyst transfer should be recognized.

Polycystic ovary syndrome: association of a C/T single nucleotide polymorphism at tyrosine kinase domain of insulin receptor gene with pathogenesis among lean Japanese women.

OBJECTIVE: To assess whether the insulin receptor (INSR) gene contributes to genetic susceptibility to polycystic ovary syndrome (PCOS) in a Japanese population. STUDY DESIGN: We ex-amined the frequency of the His 1058 C/T single nucleotide polymorphism (SNP) found in exon 17 of the INSR gene in 61 Japanese PCOS patients and 99 Japanese healthy controls. In addition, we analyzed the association between the genotype of this SNP and the clinical phenotypes. RESULTS: The frequency of the C/C genotype was not significantly different between all PCOS patients (47.5%) and controls (35.4%). However, among the lean cases (body mass index < or = 20 kg/m2) the frequency of the C/C genotype was significantly increased (p < 0.05) in PCOS patients (65.0%) as compared with controls (36.6%). CONCLUSION: We concluded that the His 1058 C/T polymorphism at the tyrosine kinase domain of the INSR gene had a relationship to the pathogenesis of lean PCOS patients in a Japanese population.

Kinetic resolution of racemic amines using provisional molecular chirality generated by spontaneous crystallization.

N-(2-methoxy-1-naphthoyl)pyrrolidine afforded chiral crystals by spontaneous crystallization. The molecular chirality in the crystal was retained after dissolving the crystals in a cooled solvent. Kinetic resolution of racemic amines was performed using the provisional chiral molecular conformation derived from chiral crystals.

[Marked efficacy of metronidazole for the intestinal pseudoobstruction associated with systemic sclerosis].

In May 2009, a 57-year-old woman who had rheumatoid arthritis since 9 years was admitted to our hospital for dyspnea due to interstitial pneumonia (IP). On admission, she exhibited proximal scleroderma, finger edema, Raynaud's phenomenon, digital pitting scars, ankyloglossia, and esophageal dysmotility. The patient was diagnosed as having systemic sclerosis (SSc), according to the American College of Rheumatology criteria. After initiation of high-dose corticosteroid therapy, gradual amelioration of IP was observed. However, the patient complained of abdominal fullness. Computed tomography and intestine series findings revealed significant dilatation of the small intestine due to intra-abdominal free air and pneumatosis cystoides intestinalis but no mechanical obstruction, leading to a diagnosis of SSc with pseudo-obstruction. The patient underwent decompression with a long intestinal tube, which led to improvement in her symptoms. Although erythromycin (EM) and some prokinetic agents were administered, abdominal involvement recurred several days after resumption of oral ingestion. Therefore, we changed the antibiotic from EM to metronidazole (750 mg/day). Her manifestations were promptly ameliorated by metronidazole therapy in 4 days and did not recur. Metronidazole is an antibiotic used to treat intra-abdominal anaerobic bacterial infections and is also commonly used in preoperative treatment for colorectal surgery. In conclusion, we report a case where SSc-associated pseudo-obstruction was successfully managed by metronidazole therapy.

[Tuberculous peritonitis during etanercept therapy for rheumatoid arthritis].

In August 2010, a 73-year-old woman with rheumatoid arthritis receiving etanercept (ETN) therapy for two years, developed high-fever and abdominal fullness. Though she had not been exposed to tuberculosis, isoniazid prophylaxis was administrated. Antibiotics were not effective. CT images revealed the massive ascites and peritonitis, and Ga scintigraphy demonstrated notable uptake in the peritoneum. Ascites analysis showed an elevated adenosine deaminase activity value (104.9 IU/l) without malignant cells. Moreover, PCR and culture for Mycobacterium tuberculosis were positive. Finally, a diagnosis of tuberculous peritonitis was established. After initiating a standard anti-tuberculosis regimen with four drugs, her clinical condition ameliorated and ascites promptly regressed. Although the tuberculous peritonitis during ETN therapy is rare, this report emphasized the importance of initial suspicion of tuberculosis in these patients with tumor necrosis factor inhibitors such as ETN.

Conservative treatment of stage IA1 adenocarcinoma of the uterine cervix with a long-term follow-up.

OBJECTIVES: The adenocarcinoma of the uterine cervix tends to arise in women of childbearing age. Conservative treatment by conization is an alternative to a hysterectomy that allows future pregnancy; however, much less is known about the management of adenocarcinoma because of its rarity and relatively short time frame of follow-up. The purpose of this study was to determine the long-term outcome of patients treated by conization alone. METHODS: All patients diagnosed to have FIGO (International Federation of Gynecology and Obstetrics) stage IA1 cervical adenocarcinoma between 1990 and 2004 with more than 5 years' follow-up at 2 institutions were reviewed. Information was abstracted on clinical data including margin status of conization and recurrence. RESULTS: Twenty-seven patients were identified, and 10 patients who expressed a strong desire to preserve fertility were offered a conization and careful surveillance without hysterectomy. The median age was 35 years, and 40% were nulliparous. All tumors were endocervical-type adenocarcinoma, and all tumors were grade 1. None had lymphovascular space invasion. Two patients had a repeated conization because of a positive margin. No recurrence was observed during an average follow-up of 75 months. CONCLUSIONS: Although further studies on the management of microinvasive cervical adenocarcinoma are desirable, conization seems to be acceptable treatment modality for patients with stage IA1 cervical adenocarcinoma who desire to preserve their fertility. A careful and long-term follow-up is needed because of lack of sufficient evidence for the safety of this treatment.

Analysis of the complications after radical hysterectomy for stage IB, IIA and IIB uterine cervical cancer patients.

AIM: This study was undertaken to assess whether radical hysterectomy and pelvic lymphadenectomy could be carried out within acceptable complications in uterine cervical cancer patients. MATERIAL & METHODS: One hundred and forty-six patients of the International Federation of Gynecology and Obstetrics stage IB, IIA and IIB cervical cancer treated by radical hysterectomy or combined with postoperative radiation therapy were enrolled in this study. The study population was 41 women over the age of 60 and 105 women under the age of 59. Complications after the treatment of all patients were examined. RESULTS: The complications were significantly high with the patients over the age of 60 (53.7%) in comparison with the patients under the age of 59 (24.8%). Especially, the cases combined with radiation therapy had higher complication rate. The most commonly recorded complications were lymphedema (13.7%) and small bowel obstruction (8.2%). CONCLUSION: We conclude that the complications influenced on the quality of life were more frequent in patients over the age of 60.

Increased apoptosis of germ cells in patients with AZFc deletions.

PURPOSE: AZFc deletions are associated with variable testicular histology ranging from the Sertoli cell only to spermatogenic arrest and hypospermatogenesis. Such variable phenotypes may be explained by progressive germ cell regression over time. Increased apoptosis is likely responsible for progressive regression of spermatogenic potential. This study evaluated germ cell apoptosis as a cause of the progressive decrease in the number of germ cells in patients with AZFc deletions. METHODS: This study evaluated germ cell apoptosis in patients with AZFc deletions. A total of 151 patients who were diagnosed with either severe oligozoospermia or non-obstructive azoospermia were screened for Y chromosome microdeletions. Germ cell apoptosis was examined using terminal deoxy-nucleotidyl transferase-mediated digoxigenin-dUTP nick-end labeling (TUNEL) on formalin-fixed 5-microm sections of testicular specimens. RESULTS: Seven out of 117 (6.0%) patients with azoospermia and 4 of 34 (11.8%) patients with severe oligozoospermia had Y chromosome microdeletions. The percentage of apoptotic germ cells in the testes of patients with AZFc deletions were significantly increased compared to those of patients without AZFc deletions. CONCLUSIONS: These results suggest that increased apoptosis of germ cells is responsible for the progressive decline of spermatogenic potential in patients with AZFc deletions.

Extranodal Rosai-Dorfman disease involving bilateral ovaries in a patient with a ventriculoperitoneal shunt.

Rosai-Dorfman disease (RDD) is a rare condition of unknown etiology, and female genital tract involvement in RDD is uncommon. We describe the first case of RDD with bilateral ovarian involvement in a patient implanted with a ventriculoperitoneal (VP) shunt. The patient was a 17-year-old Japanese woman who had undergone radiotherapy, surgery for extranodal RDD involving the brain, and VP shunt insertion at age 12. Bilateral pelvic masses were incidentally detected on a computed tomography scan. She underwent laparotomy for lesion extirpation. On abdominal washing cytology, histiocytes showing emperipolesis were identified. Bilateral salpingo-oophorectomy was performed instead of extirpation, as it was difficult to identify the lesion margins. At 24 months after surgery, the patient is well and has not developed local recurrence. Thus, RDD can recur because of implantation of lesion cells into the abdominal cavity through a VP shunt, as is observed in the case of cerebral neoplasms.

Conservative treatment of stage IA1 adenocarcinoma of the cervix during pregnancy.

OBJECTIVE: The incidence of glandular neoplasms of the uterine cervix has been steadily increasing over the past 2 decades. These lesions tend to arise in women of childbearing age. Few reports have described the treatment of glandular neoplasms of the cervix in gravid women. This report describes the preliminary results of treating stage IA1 cervical adenocarcinoma by cervical conization during pregnancy. METHODS: All patients diagnosed to have FIGO stage IA1 cervical adenocarcinoma between 1990 and 2006 were reviewed and patients diagnosed during pregnancy were identified. Information was abstracted on the clinical data including the presence or absence of disease at the margins of conization, pregnancy outcome, and the follow-up. RESULTS: Sixteen patients with stage IA1 cervical adenocarcinoma were identified. Four out of the 16 patients were diagnosed during pregnancy. Four women ages 29-37 underwent KTP LASER conization and vaporization at 16 to 23 weeks' gestation. The histology showed that all of the tumors were endocervical type adenocarcinoma. None had lymph-vascular space invasion. All of these patients expressed a strong desire to continue their pregnancy. Two patients had positive conization margins for invasive cancer and underwent a second conization at 20 weeks' gestation and 5 weeks after delivery, respectively. No residual disease was identified in the second conization specimens. All patients delivered at term. One patient was treated with cervical conization alone and 3 patients were treated with an extended radical hysterectomy with pelvic lymph nodes dissection after delivery. No patient had residual invasive cancer in a subsequent surgical specimen. None of the patients had developed recurrent disease after a 2-13-year follow-up. CONCLUSION: These preliminary data suggest that patients with FIGO stage IA1 cervical adenocarcinoma may be treated conservatively by cervical conization during pregnancy. Although a hysterectomy should be considered at the completion of childbearing, fertility sparing postpartum management could be an option for selected patients.

An asymmetric S(N)Ar reaction using the molecular chirality in a crystal.

An asymmetric S(N)Ar reaction was performed by using molecular chirality generated and amplified by the spontaneous crystallization of achiral naphthamides; the chirality was retained in a cold solution, caused by slow racemization, and was transferred to stable axially chiral materials with high enantiomeric excesses.

Advanced malignant rhabdoid tumor of the ovary effectively responding to chemotherapy: a case report and review of the literature.

BACKGROUND: Malignant rhabdoid tumors (MRTs) are highly malignant neoplasms that consist of both renal and extrarenal subtypes. Primary ovarian cases are extremely rare. We herein describe the third known case of ovarian origin, which effectively responded to combination chemotherapy with ifosfamide, epirubicin, and cisplatin (IEP chemotherapy). CASE: A 19-year-old woman was diagnosed to have stage IIIc primary MRT of the ovary following the resection of tumors. Two months after surgery, an 8 cm-sized pelvic mass and enlarged retroperitoneal lymphnodes were detected. The patient received intravenous tri-weekly IEP chemotherapy. After the second course of chemotherapy, she demonstrated a complete clinical response. CONCLUSION: Although this type of tumor is quite aggressive and chemotherapy is generally not considered to be effective, IEP chemotherapy may be useful in the treatment of MRT of the ovary.