Occlusion Handling using Semantic Segmentation and Visibility-Based Rendering for Mixed Reality

Real-time occlusion handling is a major problem in outdoor mixed reality system because it requires great computational cost mainly due to the complexity of the scene. Using only segmentation, it is difficult to accurately render a virtual object occluded by complex objects such as trees, bushes etc. In this paper, we propose a novel occlusion handling method for real-time, outdoor, and omni-directional mixed reality system using only the information from a monocular image sequence. We first present a semantic segmentation scheme for predicting the amount of visibility for different type of objects in the scene. We also simultaneously calculate a foreground probability map using depth estimation derived from optical flow. Finally, we combine the segmentation result and the probability map to render the computer generated object and the real scene using a visibility-based rendering method. Our results show great improvement in handling occlusions compared to existing blending based methods

Busulfan for lymphoma with CNS involvement

The prognosis of relapsed or refractory lymphoma with central nervous system (CNS) involvement remains poor because of the lack of anticancer drugs with sufficient CNS penetration. [Case 1] A 65-year-old man was diagnosed with Stage IV mantle cell lymphoma. After two courses of chemotherapy and autologous hematopoietic stem cell (HSC) collection, urinary retention with fever developed. Cerebrospinal fluid analysis revealed leptomeningeal involvement, which was refractory to high-dose methotrexate therapy. Autologous peripheral blood stem cell transplantation (ASCT) was performed, followed by intravenous busulfan (ivBU), cyclophosphamide, and etoposide ; thereafter, no relapse has been detected for over six years. [Case 2] A 40-year-old woman with right lower hemiplegia was diagnosed with primary CNS lymphoma. Although four courses of high-dose methotrexate therapy were administered, the cerebral tumor increased in size. HSCs were collected after methotrexate therapy, and ASCT was performed in addition to conditioning using ivBU, cyclophosphamide, and etoposide, followed by whole-brain and local boost irradiation. She achieved complete remission, but relapsed two years after ASCT. High-dose ivBU-containing conditioning regimens with ASCT may be useful for refractory B-cell lymphoma with CNS involvement

Stimulation of G proteincoupled bile acid receptor enhances vascular endothelial barrier function via activation of protein kinase A and Rac1

ABSTRACT Bile acids are end products of cholesterol metabolism, and they constantly exist at high concentrations in the blood. Since vascular endothelial cells express G protein-coupled bile acid receptor (GPBAR), bile acids potentially modulate endothelial function. Here, we investigated whether and how GPBAR agonism affects endothelial barrier function. In bovine aortic endothelial cells (BAECs), treatment with a GPBAR agonist, taurolithocholic acid (TLCA) increased the transendothelial electrical resistance. In addition, TLCA suppressed the thrombin-induced dextran infiltration through the endothelial monolayer. Knockdown of GPBAR abolished the inhibitory effect of TLCA on hyperpermeability. These results indicate that stimulation of GPBAR enhances endothelial barrier function. TLCA increased intracellular cAMP production in BAECs. Inhibition of protein kinase A (PKA) or Rac1 significantly attenuated the TLCA-induced endothelial barrier protection. TLCA induced cortical actin polymerization, which was attenuated by a Rac1 inhibitor. In vivo, local administration of TLCA into the mouse ear significantly inhibited vascular leakage and edema formation induced by croton oil or vascular endothelial growth factor. These results indicate that stimulation of GPBAR enhances endothelial barrier function by cAMP/PKA/Rac1-dependent cytoskeletal rearrangement

Adult T-cell leukemia/lymphoma with multiple intracranial masses and CMV and HHV-6 reactivation at initial presentation

症例は55歳，男性。1ヶ月前からの咽頭痛の精査目的で紹介された。意識障害と項部硬直，口腔内の多発性有痛性潰瘍，全身に米粒大の紅斑を認めた。白血球数7,910/μL (異常リンパ球2%)，LDH 203U/L，補正カルシウム11.2mg/dL,可溶性IL-2受容体11,800U/mL，サイトメガロウイルス抗原(C10，C11)43/49。末梢血や骨髄，皮膚にCD4，25陽性の異常リンパ球あり，末梢血でHTLV-1プロウイルスDNAのモノクローナルな組み込みを確認し，成人T細胞白血病リンパ腫(ATLL)と診断した。CTで，脳実質内にリング状造影効果を有する腫瘤が多発し，髄液検査で細胞数1,320/mm3 (フローサイトメトリー法でATLL細胞が79%)，蛋白244mg/dL，HHV-6 DNA陽性を認めた。ヘルペスウイルス属感染症に対する治療や髄注を併用してmodified LSG15療法を行うも，意識障害が急速に進行し，入院21日目で死亡した。ATLLでは，中枢神経浸潤のさらなる病態の解明と標準治療の確立が求められる。A 55-year-old man, suffering from a sore throat for a month was referred to our hospital. Physical examination revealed disturbance of consciousness, nuchal rigidity, painful multiple ulcers in the oral cavity and rice grain sized erythema on the whole body. Hematological examination showed the following: white blood cell 7,910/μL (abnormal lymphocytes 2%), LDH 203U/L, corrected calcium 11.2mg/dL, soluble IL-2 receptor 11,800U/mL, and cytomegalovirus antigenemia (C10,C11) 43/49. Abnormal lymphocytes (CD4+CD25+) were found in the peripheral blood, bone marrow and skin samples. Southern blotting of peripheral blood confirmed monoclonal integration of HTLV-1 provirus DNA, consequently, he was diagnosed with adult T-cell leukemia/lymphoma (ATLL). Contrast-enhanced computed tomography revealed multiple tumors with ringed contrast effect in the brain parenchyma. Examination of the cerebrospinal fluid showed that the cell number was 1,320/mm3 (ATLL cells were 79% in flow cytometry), and the protein level was 244mg/dL; further, the examination revealed a positive result for human herpesvirus 6 DNA. Although treatment for herpesvirus genus and modified LSG15 therapy combined with intrathecal chemotherapy were performed, the patient became comatose, and he died on day 21 of hospitalization. A deeper understanding of the pathogenesis of and the establishment of standard treatment for ATLL with CNS involvement are required

Phase angle and extracellular water-to-total body water ratio estimated by bioelectrical impedance analysis are associated with levels of hemoglobin and hematocrit in patients with diabetes

Background: Anemia is one of the common complications of diabetes and is associated with mortality. Phase angle (PhA), ratio of extracellular water to total body water (ECW/TBW) and skeletal muscle mass index (SMI) estimated by bioelectrical impedance analysis (BIA) have been used as prognostic indicators for various chronic diseases and frailty. We aimed to clarify the clinical significance of PhA, ECW/TBW and SMI for anemia in patients with diabetes. Materials and methods: The values of PhA, ECW/TBW and SMI were estimated by a portable BIA device and blood samples were collected in 371 Japanese patients with diabetes. The relationships of PhA, ECW/TBW and SMI with hemoglobin (Hgb) and hematocrit (Hct) were statistically evaluated. Results: In simple linear regression analysis, PhA and SMI were positively correlated with Hgb and Hct levels in total subjects, male subjects and female subjects. In contrast, ECW/TBW was negatively correlated with Hgb and Hct levels regardless of sex. Multivariate regression analysis showed that both PhA and ECW/TBW but not SMI independently contributed to Hgb and Hct levels after adjustment of clinical confounding factors in both males and females. Conclusions: PhA and ECW/TBW but not SMI were associated with levels of Hgb and Hct in patients with diabetes. Therefore, aberrant values of PhA and ECW/TBW suggest a risk of anemia in diabetic patients