Braille Block Detection via Multi-Objective Optimization from an Egocentric Viewpoint.

In this paper, we propose a method to detect Braille blocks from an egocentric viewpoint, which is a key part of many walking support devices for visually impaired people. Our main contribution is to cast this task as a multi-objective optimization problem and exploits both the geometric and the appearance features for detection. Specifically, two objective functions were designed under an evolutionary optimization framework with a line pair modeled as an individual (i.e., solution). Both of the objectives follow the basic characteristics of the Braille blocks, which aim to clarify the boundaries and estimate the likelihood of the Braille block surface. Our proposed method was assessed by an originally collected and annotated dataset under real scenarios. Both quantitative and qualitative experimental results show that the proposed method can detect Braille blocks under various environments. We also provide a comprehensive comparison of the detection performance with respect to different multi-objective optimization algorithms.

Prediction of hemodynamics under left ventricular assist device.

Left ventricular assist device (LVAD) saves lives in patients with severe left ventricular (LV) failure. However, predicting how much LVAD boosts total cardiac output (CO) remains difficult. This study aimed to develop a framework to quantitatively predict the impact of LVAD on hemodynamics. We adopted the circulatory equilibrium framework and incorporated LVAD into the integrated CO curve to derive the circulatory equilibrium. In anesthetized dogs, we ligated left coronary arteries to create LV failure and inserted a centrifugal pump as LVAD. Using CO and right (PRA) and left atrial pressure (PLA) measured before LVAD support, we predetermined the stressed volume (V) and logarithmic slope of right heart CO curve (SR). Next, we initiated LVAD at maximum level and then decreased LVAD flow stepwise while monitoring hemodynamic changes. We predicted LVAD-induced CO and PRA for given PLA from the predetermined SR and V and compared with those measured experimentally. The predicted CO [r2 = 0.907, SE of estimate (SEE) = 5.59 ml·min-1·kg-1, P < 0.001] and PRA (r2 = 0.967, SEE = 0.307 mmHg, P < 0.001) matched well with measured values indicating the validity of the proposed framework. We further conducted simulation using the validated framework to analyze the impact of LVAD on PRA under various right ventricular (RV) functions. It indicated that PRA is relatively insensitive to changes in RV end-systolic elastance or pulmonary arterial resistance, but sensitive to changes in V. In conclusion, the circulatory equilibrium framework predicts quantitatively the hemodynamic impact of LVAD. This knowledge would contribute to safe management of patients with LV failure undergoing LVAD implantation. NEW & NOTEWORTHY: Hemodynamic response to left ventricular assist device (LVAD) has not been quantitatively investigated. This is the first report of quantitative prediction of the hemodynamics on LVAD using circulatory equilibrium framework. The validated framework allows us to simulate the impact of LVAD on right atrial pressure under various right ventricular functions.

Optimal Titration Is Important to Maximize the Beneficial Effects of Vagal Nerve Stimulation in Chronic Heart Failure.

BACKGROUND: Although vagal nerve stimulation (VNS) benefits patients with chronic heart failure (CHF), the optimal dose of VNS remains unknown. In clinical trials, adverse symptoms limited up-titration. In this study, we evaluated the impact of various voltages of VNS which were titrated below symptom threshold on cardiac function and CHF parameters in rat myocardial infarction (MI) models. METHODS AND RESULTS: We randomly allocated MI rats to vagal (VNS; n = 41) and sham (Sham; n = 16) stimulation groups. We stimulated the right vagal nerve with 20 Hz at 3 different voltages for 4 weeks. We defined Max as the highest voltage that did not evoke any symptom, Half as one-half of Max, and Quarter as one-fourth of Max. All 3 VNS groups significantly reduced biventricular weight compared with Sham (P < .05). In contrast, only Half decreased left ventricular (LV) end-diastolic pressure (Half: 17.5 ± 2.0 mm Hg; Sham: 24.2 ± 1.2 mm Hg; P < .05) and increased LV ejection fraction (Half: 37.9 ± 3.1%; Sham: 28.4 ± 2.3%,-P < .05) and LV maximum +dP/dt (Half: 5918.6 ± 2.0 mm/Hg/s; Sham: 5001.2 ± 563.2 mm Hg/s; P < .05). The number of large vagal nerve fibers was reduced with Max (Max: 163.1 ± 43.0 counts/bundle; Sham: 360.0 ±61.6 counts/bundle; P < .05), indicating significant neural damage by VNS. CONCLUSION: The optimal titration of VNS would maximize benefits for CHF and minimize adverse effects.

Effects of eicosapentaenoic acid on biochemical failure after radical prostatectomy for prostate cancer.

AIM: To study the effects of eicosapentaenoic acid (EPA) on prostate-specific antigen (PSA) failure in prostate cancer patients who underwent prostatectomy. PATIENTS AND METHODS: Sixty-two prostate cancer patients whose PSA levels were less than 0.2 ng/ml 3 months after surgery were randomized to either an EPA group (n=32) or a control group (n=30). EPA (2.4 g/day) was administered in the EPA group for 2 years. PSA was measured every two months. RESULTS: The EPA concentration increased but the docosahexaenoic acid concentration decreased significantly (P<0.001) in erythrocytes. The PSA recurrence rates during a mean follow-up of 53.8 months were not different between the two groups (p=0.16). CONCLUSION: A longer and/or larger intervention or docosahexaenoic acid supplementation might be necessary to identify significant preventive effects of mega-3 polyunsaturated fatty acids on PSA recurrence.

Serum active hepatocyte growth factor (AHGF) in benign prostatic disease and prostate cancer.

BACKGROUND: Hepatocyte growth factor (HGF) is secreted as an inactive single-chain precursor called pro-HGF. Pro-HGF is converted to an active two-chain form by HGF activator and matriptase. We attempted to clarify whether serum levels of active HGF (AHGF) could be used as a marker of prostate cancer. METHODS: Serum levels of AHGF and total HGF (THGF; pro-HGF + AHGF) were measured by enzyme-linked immunosorbent assay in 38 patients with benign prostatic disease and 160 patients with prostate cancer. RESULTS: Serum levels of AHGF in patients with untreated prostate cancer (0.37 +/- 0.12 ng/ml) were significantly higher than those in patients with benign prostatic disease (0.28 +/- 0.08 ng/ml) (P = 0.0001). Serum AHGF levels were increased in patients with stage D or D3 compared with stage B. In addition, there were significant differences in serum AHGF levels between patients with well-differentiated and poorly differentiated adenocarcinoma. Furthermore, the mean serum AHGF/THGF ratio in patients with stage D3 prostate cancer was significantly higher than that in patients with stage B. CONCLUSIONS: AHGF may be a potential tumor marker for prostate cancer. Further studies in large groups of patients are needed to define the clinical value of AHGF.

Chemokine receptor CXCR4 expression and prognosis in patients with metastatic prostate cancer.

The chemokine receptor CXCR4 has been reported to be aberrantly expressed in human cancers and has also been shown to participate in the development of cancer metastasis. The present study was carried out to assess immunohistochemically the pattern of CXCR4 expression in patients with metastatic prostate cancer. We analyzed whether there may be an association between CXCR4 expression and prognosis. Fifty-two patients who received hormonal therapy were enrolled. Specimens were obtained from transperineal needle biopsy before treatment, and were stained with antihuman CXCR4 antibody. We also evaluated the pathological grade, extent of bony metastasis, clinical response to hormonal therapy, and patient prognosis. CXCR4 was detected in 94.2% patients. Its expression showed no association with pathological grade, extent of bony metastasis, or clinical response to hormonal therapy. Patients with a high expression of CXCR4 in tumors had poorer cancer-specific survival than those with low expression of CXCR4. CXCR4 expression is a useful prognostic factor for patients with metastatic prostate cancer treated with androgen-withdrawal therapy.

Usefulness of single photon emission computed tomography imaging in the detection of lumbar vertebral metastases from prostate cancer.

OBJECTIVE: To determine whether single photon emission computed tomography (SPECT) is useful in the detection of prostate cancer bone metastases in the lumbar vertebrae. METHODS: Thirty-nine patients (12 with benign prostatic hyperplasia, 27 with prostate cancer) were considered and submitted to bone SPECT. All of them had increased uptake in lumbar vertebrae on bone scintigraphy. In those with prostate cancer, definitive diagnosis of bone metastases was established by magnetic resonance imaging (MRI). SPECT axial images were classified into five accumulation patterns: mosaic, large hot, diffuse, peripheral, and articular (or pediculate). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of bone SPECT were calculated. RESULTS: Overall, 116 vertebral lesions (49 metastatic, 67 degenerative) were studied. Mosaic, large hot and diffuse patterns were more frequently associated with metastatic lesions (84.2%, 70.3%, and 63.1% of the cases, respectively). On the other hand, peripheral and articular (or pediculate) patterns were mostly ascribed to degenerative lesions (100% and 87.5% of the cases, respectively). Sensitivity, specificity, PPV and NPV of bone SPECT were 95.9% (47/49), 73.1% (49/67), 72.3% (47/65), and 96.1% (49/51), respectively. CONCLUSIONS: Bone SPECT provides better accuracy than bone scintigraphy in differential diagnosis of lumbar vertebral lesions from prostate cancer.

Chemokine receptors in cancer metastasis and cancer cell-derived chemokines in host immune response.

The chemotactic cytokines called chemokines are a superfamily of small secreted cytokines that were initially characterized through their ability to prompt the migration of leukocytes. Attention has been focused on the chemokine receptors expressed on cancer cells because cancer cell migration and metastasis show similarities to leukocyte trafficking. CXC chemokine receptor 4 (CXCR4) was first investigated as a chemokine receptor that is associated with lung metastasis of breast cancers. Recently, CXCR4 was reported to be a key molecule in the formation of peritoneal carcinomatosis in gastric cancer. In the present review, we highlight current knowledge about the role of CXCR4 in cancer metastases. In contrast to chemokine receptors expressed on cancer cells, little is known about the roles of cancer cell-derived chemokines. Cancer tissue consists of both cancer cells and various stromal cells, and leukocytes that infiltrate into cancer are of particular importance in cancer progression. Although colorectal cancer invasion is regulated by the chemokine CCL9-induced infiltration of immature myeloid cells into cancer, high-level expression of cancer cell-derived chemokine CXCL16 increases infiltrating CD8(+) and CD4(+) T cells into cancer tissues, and correlates with a good prognosis. We discuss the conflicting biological effects of cancer cell-derived chemokines on cancer progression, using CCL9 and CXCL16 as examples.

Hand-assisted laparoscopic radical cystoprostatectomy and urethrectomy with ileal conduit construction.

INTRODUCTION: Hand-assisted laparoscopy was first performed in the 1990s by inserting the surgeon's finger or hand through a small tight wound. Although leakage of gas from the incision initially limited the usefulness of the technique, the hand-assisted procedures have advanced extensively since the introduction of the hand-assisted laparoscopy port. Laparoscopic procedure has only rarely been applied to radical cystoprostatectomy. Favorable reports for laparoscopic radical prostatectomy encouraged us to attempt a cystoprostatectomy under hand-assisted laparoscopy. PATIENT: The patient was a 70-year-old male with an invasive bladder tumor and no distant metastasis. Informed consent for undergoing hand-assisted laparoscopic radical cystoprostatectomy and ileal conduit construction was obtained. METHODS AND RESULTS: The bladder was dissected free and extracted whole through the incision for the hand port. The bilateral ureters and a loop of small intestine were withdrawn through the same incision. An ileal segment was isolated and small intestine continuity was recovered. Each ureter was anastomosed to one extreme of the ileal segment that was then reintroduced into the abdomen. The stoma was constructed through the right side port without additional incision. No intraoperative complications were observed. Recuperation was unusually quick and painless, and few postoperative analgesics were needed. CONCLUSIONS: Hand-assisted laparoscopic cystoprostatectomy and urinary diversion could provide the advantage of decreased postoperative morbidity without the long operation time and technical difficulty of a strictly laparoscopic procedure.

Solitary Renal Pelvic Lesion as the Primary Manifestation of Hodgkin Lymphoma: A Case Report.

Primary extranodal Hodgkin lymphoma (HL) is very rare. We report the first case of primary renal Hodgkin lymphoma and with the absence of supra- and sub-diaphragmatic adenopathy.

A novel rat head gaze determination system based on optomotor responses.

The optomotor response of animals is commonly used to measure their visual performance, e.g., rats of different genetically altered strains or various drug tests. With the presentation of stimuli using computer screens or projectors, the common idea focuses on measuring the eye movement or head and/or body movement to characterize changes of the head gaze. However, traditional methods rely on either the invasive fixation of animals, or the judgment of a human observer who reports the stimulus-tracking movements. In this paper, we propose a novel head gaze determination system to automatically track the head movement of rats without artificial markers. The experiments were done to demonstrate the process of optimizing parameters in image processing. As a result, the head angle curve of the proposed method is consistent with that of ground-truth data annotated manually according to predefined rules. Hence, the proposed method provides a simple, convenient, and objective solution to automatically generate the head gaze orientations from massive amounts of recorded data for further visual performance analysis.

Androgen receptor negatively influences the expression of chemokine receptors (CXCR4, CCR1) and ligand-mediated migration in prostate cancer DU-145.

We previously reported that androgen receptor (AR) plays a role in the regulation of adhesion to the extracellular matrix and invasion of human prostate cancer cells by influencing the expression of specific integrin subunits. It is now considered that chemokines play a significant role in organ-selective cancer metastasis. In this study, we hypothesized that AR may influence the expression of these chemokine receptors and cell function. The mRNA expression of chemokine receptors in human prostate cancer cell line DU-145 and DU-145 cells expressing AR (DU-145/AR) was investigated by RT-PCR. DU-145 cells selectively expressed CXCR4 and CCR1 mRNA at high levels compared with DU-145/AR cells. DU-145 showed vigorous migratory responses to its ligand CXCL12 (also called stromal-derived factor-1alpha, SDF-1alpha) and CCL3 (also called macrophage inflammatory protein-1, MIP-1alpha). In contrast, neither CXCL12 nor CCL3 affected the migration of DU-145/AR cells. These results indicate that expression of AR down-regulates the migratory responses of human prostate cancer cells via chemokine and its receptor systems.

Primary adenocarcinoma of the appendix invading the urinary bladder.

We report a case of adenocarcinoma of the appendix invading the urinary bladder in a 75-year-old man. Although cystoscopic examination and computed tomography suggested a primary or secondary bladder tumor, repeated transurethral bladder biopsy could not confirm the neoplasm. At operation a primary neoplasm of the appendix invading the bladder was discovered and en bloc resection of the urinary bladder with the adherent cecum followed by an ileocolonic anastomosis and ureterocutaneostomy was performed. The patient died of carcinoma 13 months later.

[The efficacy of Gosyajinkigan for pollakisuria].

We investigated the efficacy of Gosyajinkigan in 20 patients with prostatic disease, in whom pollakisuria was not improved by treatment with drugs for lower urinary tract symptoms. Four and 8 weeks after treatment, the urinary frequency was significantly improved during both daytime and night. The efficacy rates for diurnal frequency and nocturia were 45% and 65%, respectively. The International Prostate Symptom Score (IPSS) was decreased 4 weeks after treatment, and the parameters of uroflowmetry, the residual urine volume and quality of life score were improved 8 weeks after therapy. It was concluded that Goshajinkigan was effective for pollakisuria with prostatic disease, and the administration of the agent for 8 weeks or longer was needed to improve lower urinary tract symptoms.

Vasoactive intestinal peptide and pituitary adenylate cyclase activating polypeptide stimulate interleukin-6 production in prostate cancer cells and prostatic epithelial cells.

We investigated the effect of the vasoactive intestinal (VIP) and pituitary adenylate cyclase activating peptides (PACAP) on the production of interleukin-6 (IL-6) in normal prostate epithelial and stromal cells and prostate cancer cells. We performed RT-PCR analysis to assess the expression of VIP receptor (VPAC1, VPAC2 and PAC1) mRNA in normal prostate epithelial and stromal cells and prostate cancer cells, and investigated the effect of VIP and PACAP on the production of IL-6. VPAC1, VPAC2 and PAC1 receptor mRNAs were expressed in LNCaP and DU-145/AR prostate cancer cells and PrEC cells (prostate epithelial cells). VIP stimulated the production of IL-6 in DU-145/AR prostate cancer and PrEC cells. PACAP showed a similar effect on IL-6 production in PrEC cells. VIP stimulated IL-6 promoter transcriptional activity in DU-145/AR cells. These results indicate that VIP and PACAP may modulate the IL-6 production of normal prostate epithelial and prostate cancer cells.

Birth after intracytoplasmic sperm injection of ejaculated spermatozoa from a man with mosaic Klinefelter's syndrome.

AIM: To report a birth after intracytoplasmic sperm injection (ICSI) of ejaculated spermatozoa from a man with mosaic Klinefelter's syndrome detected by fluorescence in situ hybridization (FISH) analysis. METHODS: A 35-year-old man with a normal appearance consulted our hospital because of sterility over a 5-year period. Chromosome analysis showed low-incidence mosaic Klinefelter's syndrome. Using FISH, 96 % hyperploidy of the lymphocytes was found. We examined the sex chromosome of the ejaculated spermatozoa. Using FISH, we examined 200 ejaculated spermatozoa and no hyperploidy was found. RESULTS: The 33-year-old female partner of the male patient underwent an uncomplicated controlled ovarian hyperstimulation sequence using a combined recombinant-follicle stimulating hormone (rec-FSH) + human menopausal gonadotrophin (hMG) protocol, following late luteal phase pituitary down regulation. This culminated in the retrieval of seven oocytes, six of which were fertilized with ICSI. One ICSI attempt led to clinical pregnancy with a healthy baby girl. CONCLUSION: We report a male patient with low-incidence mosaic Klinefelter's syndrome whose ejaculated spermatozoa were identified as being haploid by FISH before ICSI, leading to the successful pregnancy of his wife and the birth of a healthy baby girl.

Differential expression of integrin subunits in DU-145/AR prostate cancer cells.

We have established a clonal DU-145 prostate cancer cell line (DU-145/AR) stably transfected with androgen receptor cDNA. We investigated the expression of integrin subunits, adhesion to extracellular matrices, the invasion of DU-145/AR prostate cancer cells. The expression of various integrin subunits and adhesion to various extracellular matrices in DU-145, DU-145/Neo and DU-145/AR cells were examined. The haptoinvasion and the haptotactic migration of these cells were investigated using a Transwell cell culture chamber assay. DU-145/AR cells exhibited lower expression of alpha6 and beta4 integrin subunits and higher expression of alpha2 and alpha5 than DU-145 cells. DU-145/AR cells showed significantly lower adhesion to fibronectin, laminin-1 and laminin-5 than DU-145/ Neo cells, whereas DU-145/AR cells showed higher adhesion to type I and type IV collagen. Haptoinvasion of DU-145/AR cells into Matrigel/fibronectin-coated filter was significantly reduced as compared with DU-145/Neo or DU-145 cells, but there was no significant difference between DU-145/AR and control cells in the haptotactic migration to fibronectin. Dihydrotestosterone (DHT) inhibited the invasive ability of DU-145/AR cells. These results indicate that androgen receptor may play a role in the regulation of adhesion to the extracellular matrices and invasion of prostate cancer cells through influencing the expression of specific integrin subunits.

Changes in male reproductive function after high altitude mountaineering.

The male reproductive functions of the members of the Masherbrum (7821 m) Expedition in 1999 were examined via semen analyses and endocrine tests. Specimens were collected from three subjects who had stayed above 5100 m for 21 to 24 days and above 6700 m for 4 to 5 days before departure and 1 month, 3 months, and 2 yr after returning from the expedition. Semen analyses showed no change in the semen volume. Sperm counts decreased after 1 month and had not recovered after 3 months, but they had recovered after 2 yr in all subjects. An increase in abnormally shaped sperm was also observed after 1 month, but had nearly recovered to the preexpedition state after 3 months. Endocrine tests revealed slightly decreased testosterone in the blood after 1 month, which had decreased still further after 3 months. The tests were completely normal after 2 yr. We suggest that a high altitude sojourn may induce reversible spermatogenic and Leydig cell dysfunction.

[Treatment of traditional Chinese medicine for idiopathic male infertility].

Several Chinese herbal medicines have been used to treat patients with idiopathic male infertility and have been reported to improve semen quality. The clinical efficacy of these medicines was reviewed. The therapeutic effect of Hochu-ekki-to based on the pretreatment traditional diagnosis (Sho) was examined. Three months after the administration of Hochu-ekki-to, the semen count and motility significantly increased in comparison with pretreatment values. When the patients were classified into 3 categories based on "Sho", Hochu-ekki-to was effective in semen motility in patients with vacuity pattern (Kyo-Sho). Seminal plasma soluble Fas (sFas) levels before and three months after the administration of drug were analyzed. Seminal plasma sFas level elevated significantly after the administration of Hochu-ekki-to. After the administration of Hochu-ekki-to, seminal plasma sFas levels significantly correlated with sperm concentration. To make the best use of traditional medicine, it is important to give medication according to the traditional diagnosis (Sho).