•Endoscopic treatment takes longer, but is useful and safe, in CSDH surgery.•Endoscopic treatment is useful for complicated CSDH with a clot and/or a septum.•Endoscopic treatment in CSDH surgery ...reduces the incidence of CSDH recurrence.•Endoscopic treatment is an independent factor for reducing postoperative rebleeding.•Complicated CSDH may be an optimal indication for endoscopic treatment.
Endoscopic treatment is a potential therapeutic addition to chronic subdural hematoma (CSDH) surgery. However, the effect of endoscopic treatment remains controversial. Herein, we examined the optimal indication for endoscopic treatment in CSDH surgery. We retrospectively analyzed 380 consecutive patients with CSDH who underwent single burr-hole craniostomy. We defined postoperative rebleeding as radiological re-accumulation or increased computed tomography value of the hematoma. Reoperation was performed following further hematoma accumulation and/or neurological deterioration. Complicated CSDH was radiologically defined as a hematoma with a clot and/or fibrous septum. There were no differences in baseline characteristics or postoperative mortality and morbidity between the endoscope (97 patients) and control (283 patients) groups. The incidence of postoperative rebleeding (9.3% vs 25.1%, respectively; P = 0.001) and reoperation (0% vs 9.2%, respectively; P = 0.004) were significantly lower in the endoscope group versus controls. Multivariate analysis showed that males (odds ratio 2.14, 95% confidence interval 1.19–3.81; P = 0.012) and endoscopy (odds ratio 0.29, 95% confidence interval 0.13–0.59; P = 0.001) were independently associated with postoperative rebleeding. When CSDHs were divided into two types based on hematoma component, 175 patients exhibited complicated CSDH. There was a significant reduction in postoperative rebleeding (6.5% vs 23.0%, respectively; P = 0.010) and reoperation (0% vs 9.7%, respectively; P = 0.027) in complicated CSDH patients. Endoscopic treatment in CSDH surgery does not increase the risk of surgical complications. Complicated CSDH with a clot and/or septum may be an optimal indication for endoscopic treatment in CSDH surgery to reduce postoperative recurrence.
The fundamental issues in Augmented Reality (AR) are on how to naturally mediate the reality with virtual content as seen by users. In AR applications with Optical See-Through Head-Mounted Displays ...(OST-HMD), the issues often raise the problem of rendering color on the OST-HMD consistently to input colors. However, due to various display constraints and eye properties, it is still a challenging task to indistinguishably reproduce the colors on OST-HMDs. An approach to solve this problem is to pre-process the input color so that a user perceives the output color on the display to be the same as the input. We propose a color calibration method for OST-HMDs. We start from modeling the physical optics in the rendering and perception process between the HMD and the eye. We treat the color distortion as a semi-parametric model which separates the non-linear color distortion and the linear color shift. We demonstrate that calibrated images regain their original appearance on two OST-HMD setups with both synthetic and real datasets. Furthermore, we analyze the limitations of the proposed method and remaining problems of the color reproduction in OST-HMDs. We then discuss how to realize more practical color reproduction methods for future HMD-eye system.
We present a display for optical see-through near-eye displays based on light attenuation, a new paradigm that forms images by spatially subtracting colors of light. Existing optical see-through ...head-mounted displays (OST-HMDs) form virtual images in an additive manner-they optically combine the light from an embedded light source such as a microdisplay into the users' field of view (FoV). Instead, our light attenuation display filters the color of the real background light pixel-wise in the users' see-through view, resulting in an image as a spatial color filter. Our image formation is complementary to existing light-additive OST-HMDs. The core optical component in our system is a phase-only spatial light modulator (PSLM), a liquid crystal module that can control the phase of the light in each pixel. By combining PSLMs with polarization optics, our system realizes a spatially programmable color filter. In this paper, we introduce our optics design, evaluate the spatial color filter, consider applications including image rendering and FoV color control, and discuss the limitations of the current prototype.
In this study, we introduce the concept of driver vision support using pixelated headlights with imperceptive pattern illumination for automotive lighting. Our lighting technique improves the ...visibility of the driver without harming the sight of pedestrians and oncoming vehicles. In addition, we introduce a simultaneous and separate information service concept for pedestrians and drivers with pixelated headlights. We also present an alignment error-correction method for projections from a continuously moving vehicle.
Abstract
Glioblastoma is the most common brain tumor with dismal outcomes in adults. Metabolic remodeling is now widely acknowledged as a hallmark of cancer cells, but glioblastoma-specific metabolic ...pathways remain unclear. Here we show, using a large-scale targeted proteomics platform and integrated molecular pathway-level analysis tool, that the de novo pyrimidine synthesis pathway and serine synthesis pathway (SSP) are the major enriched pathways in vivo for patients with glioblastoma. Among the enzymes associated with nucleotide synthesis, RRM1 and NME1 are significantly upregulated in glioblastoma. In the SSP, SHMT2 and PSPH are upregulated but the upstream enzyme PSAT1 is downregulated in glioblastoma. Kaplan–Meier curves of overall survival for the GSE16011 and The Cancer Genome Atlas datasets revealed that high SSP activity correlated with poor outcome. Enzymes relating to the pyrimidine synthesis pathway and SSP might offer therapeutic targets for new glioblastoma treatments.
The poor survival of patients with human malignant gliomas relates partly to the inability to deliver therapeutic agents to the tumor. Because it has been suggested that circulating bone ...marrow-derived stem cells can be recruited into solid organs in response to tissue stresses, we hypothesized that human bone marrow-derived mesenchymal stem cells (hMSC) may have a tropism for brain tumors and thus could be used as delivery vehicles for glioma therapy. To test this, we isolated hMSCs from bone marrow of normal volunteers, fluorescently labeled the cells, and injected them into the carotid artery of mice bearing human glioma intracranial xenografts (U87, U251, and LN229). hMSCs were seen exclusively within the brain tumors regardless of whether the cells were injected into the ipsilateral or contralateral carotid artery. In contrast, intracarotid injections of fibroblasts or U87 glioma cells resulted in widespread distribution of delivered cells without tumor specificity. To assess the potential of hMSCs to track human gliomas, we injected hMSCs directly into the cerebral hemisphere opposite an established human glioma and showed that the hMSCs were capable of migrating into the xenograft in vivo. Likewise, in vitro Matrigel invasion assays showed that conditioned medium from gliomas, but not from fibroblasts or astrocytes, supported the migration of hMSCs and that platelet-derived growth factor, epidermal growth factor, or stromal cell-derived factor-1alpha, but not basic fibroblast growth factor or vascular endothelial growth factor, enhanced hMSC migration. To test the potential of hMSCs to deliver a therapeutic agent, hMSCs were engineered to release IFN-beta (hMSC-IFN-beta). In vitro coculture and Transwell experiments showed the efficacy of hMSC-IFN-beta against human gliomas. In vivo experiments showed that treatment of human U87 intracranial glioma xenografts with hMSC-IFN-beta significantly increase animal survival compared with controls (P < 0.05). We conclude that hMSCs can integrate into human gliomas after intravascular or local delivery, that this engraftment may be mediated by growth factors, and that this tropism of hMSCs for human gliomas can be exploited to therapeutic advantage.
We propose a method to calibrate viewpoint-dependent, channel-wise image blur of near-eye displays, especially of Optical See-Through Head-Mounted Displays (OST-HMDs). Imperfections in HMD optics ...cause channel-wise image shift and blur that degrade the image quality of the display at a user's viewpoint. If we can estimate such characteristics perfectly, we could mitigate the effect by applying correction techniques from the computational photography in computer vision as analogous to cameras. Unfortunately, directly applying existing calibration techniques of cameras to OST-HMDs is not a straightforward task. Unlike ordinary imaging systems, image blur in OST-HMDs is viewpoint-dependent, i.e., the optical characteristic of a display dynamically changes depending on the current viewpoint of the user. This constraint makes the problem challenging since we must measure image blur of an HMD, ideally, over the entire 3D eyebox in which a user can see an image. To overcome this problem, we model the viewpoint-dependent blur as a Gaussian Light Field (GLF) that stores spatial information of the display screen as a (4D) light field with depth information and the blur as point-spread functions in the form of Gaussian kernels, respectively. We first describe both our GLF model and a calibration procedure to learn a GLF for a given OST-HMD. We then apply our calibration method to two HMDs that use different optics: a cubic prism or holographic gratings. The results show that our method achieves significantly better accuracy in Point-Spread Function (PSF) estimations with an accuracy about 2 to 7 dB in Peak SNR.
Background
Moyamoya disease (MMD) and non-MMD have different pathogenesis, clinical presentation, and treatment policy.
Purpose
To identify differences in hemodynamics between MMD and non-MMD using ...intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT).
Material and Methods
Patients who had undergone 99mTc-ECD or 123I-IMP SPECT, and IVIM imaging were retrospectively studied. IVIM imaging was acquired using six different b-values. Cerebral blood flow ratio (CBFR) in the basal ganglia was calculated using a standardized volume-of-interest template. The cerebellum was used as a reference region. IVIM perfusion fraction (f) was obtained using a two-step fitting algorithm. Elliptical regions of interest were placed in bilateral basal ganglia on the IVIM f map. Patients were classified into MMD and non-MMD groups. The correlation between CBFR and mean IVIM f (fmean) in the basal ganglia was evaluated using Spearman's rank correlation coefficient.
Results
In total, 20 patients with MMD and 28 non-MMD patients were analyzed. No significant differences in fmean were observed among MMD, affected hemisphere with non-MMD (non-MMDaff), and unaffected hemispheres with non-MMD (non-MMDunaff). A negative correlation was seen between fmean and CBFR in the MMD group (r = –0.40, P = 0.0108), but not in the non-MMD group (non-MMDaff, r = 0.07, P = 0.69; non-MMDunaff, r = –0.22, P = 0.29). No significant differences were found among MMD and non-MMD patients, irrespective of SPECT tracers.
Conclusion
The combination of IVIM MRI and SPECT appears to allow non-invasive identification of differences in hemodynamics between MMD and non-MMD.
We report a case of cystic meningioma at the left cerebellopontine angle (CPA). Magnetic resonance imaging demonstrated both solid and cystic components in the tumor. The cystic component appeared ...slightly hyperintense compared to cerebrospinal fluid on fluid-attenuated inversion recovery (FLAIR) imaging. A hypointense tubular structure was identified in the cystic component on 3D driven equilibrium sequencing. These imaging findings are unusual for cystic meningioma. However, awareness of these unusual imaging features is important to determine appropriate treatment strategies although cystic meningioma at the CPA is extremely rare.
Objective: Patients with carotid stenosis risk cognitive impairment even after carotid endarterectomy (CEA) because of the long-term presence of vascular risk factors. Early prediction of cognitive ...decline is useful because early appropriate training for impaired cognitive domains can improve their functions. Ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI) are frequently used as general indicators of systemic atherosclerosis and are associated with cognitive function in the general population. This study aimed to evaluate the utility of those vascular biomarkers for predicting cognitive decline in patients after CEA.Methods: Patients who had undergone both CEA at our institute and cognitive evaluations between March 2016 and January 2022 were invited to participate in this study. Associations between ABI or CAVI three years before baseline and cognitive function at baseline were assessed retrospectively in 94 patients, and associations between ABI or CAVI at baseline and three-year changes in cognitive functions were assessed prospectively in 24 patients. Cognitive functions were assessed using the Frontal Assessment Battery (FAB) and Neurobehavioral Cognitive Status Examination (Cognistat).Results: Low ABI three years before baseline was associated with poor performances on Cognistat and FAB at baseline. ABI, as a continuous measure, three years before baseline, showed positive linear associations with total Cognistat score and subscores for naming, construction, and judgment at baseline. The Wilcoxon signed-rank test showed that the total Cognistat score, total FAB score, and subscores for attention and inhibitory control declined after three years. CAVI at baseline was negatively associated with three-year changes in total Cognistat score and subscores for naming, construction, and memory.Conclusion: Cognitive function can decline over time in patients with carotid stenosis even after CEA. ABI and CAVI might be useful to predict cognitive function and its decline among patients who have undergone CEA.
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