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Mutual occlusion is an essential feature for augmented reality (AR) displays for allowing the virtual content to be clearly perceived under an excessively illuminated environment. Although a few works have been done to facilitate the performance of occlusion-capable optical see-through augmented reality (OC-OST-AR) displays, the realization of mutual occlusion in a wide field-of-view (FOV) is still challenging. Divergent from typical hard-edge occlusion and soft edge-occlusion designs, we propose the paired-ellipsoidal-mirror (PEM) structure. The proposed system is allowed to support either hard-edge occlusion or enhanced soft-edge occlusion in a wide FOV by optionally fixing a spatial light modulator (SLM) before the entrance pupil or at an inner focal plane. The numerical aperture (NA) of the system is efficiently increased by the combination of paired ellipsoidal mirror imaging and aperture stop restriction. With proof-of-concept prototypes built, virtual display in a FOV of H160°×V74° and mutual occlusion in a FOV of H122°×V74° are demonstrated with a basic design, respectively. Furthermore, a mixed FOV of H95.3°×V52.9° is demonstrated by an optimized design with vertical parallax reduction and virtual display improvement.

Visual SLAM systems targeting static scenes have been developed with satisfactory accuracy and robustness. Dynamic 3D object tracking has then become a significant capability in visual SLAM with the requirement of understanding dynamic surroundings in various scenarios including autonomous driving, augmented and virtual reality. However, performing dynamic SLAM solely with monocular images remains a challenging problem due to the difficulty of associating dynamic features and estimating their positions. In this paper, we present MOTSLAM, a dynamic visual SLAM system with the monocular configuration that tracks both poses and bounding boxes of dynamic objects. MOTSLAM first performs multiple object tracking (MOT) with associated both 2D and 3D bounding box detection to create initial 3D objects. Then, neural-network-based monocular depth estimation is applied to fetch the depth of dynamic features. Finally, camera poses, object poses, and both static, as well as dynamic map points, are jointly optimized using a novel bundle adjustment. Our experiments on the KITTI dataset demonstrate that our system has reached best performance on both camera ego-motion and object tracking on monocular dynamic SLAM.

Background Some patients with the compression of the celiac trunk by the median arcuate ligament (MAL) suffer pancreatic artery aneurysms (PAAs) due to excessive blood flow from the superior mesenteric artery. These aneurysms are in peril because they are prone to rupture irrespective of size. Here, we present two cases of resection and reconstruction of PAAs caused by the compression of the celiac trunk by the MAL. Case presentation Patient 1 was a 44-year-old man who was first diagnosed to have a visceral artery aneurysm with a diameter of 4 cm accidentally found by ultrasound examination at a regular medical check-up. Contrast-enhanced CT revealed the compression of the celiac trunk by the MAL and a PAA originating from the first jejunal artery. First, laparoscopic excision of the MAL followed by a stent placement into the celiac trunk was performed. Although the stent was patent, the PAA still grew. The patient underwent resection and reconstruction of the PAA. Reconstruction of the pancreatic arterial arcade was needed because clamping of the inferior pancreaticoduodenal artery (IPDA) resulted in disappearance of the hepatic arterial blood flow. The follow-up CT 2 years and 9 months after the operation revealed no recurrence of aneurysms and the patent anastomosis. Patient 2 was a 68-year-old man who presented with an epigastric pain. Contrast-enhanced CT revealed the compression of the celiac trunk by the MAL and a PAA approximately 6 cm in diameter originating from the IPDA. The PAA was surrounded by a relatively low-intensity area, suggesting impending rupture of the PAA. The patient underwent resection and reconstruction of the PAA under an emergency situation. Reconstruction of the pancreatic arterial arcade was needed because clamping of the inflow IPDA resulted in disappearance of the hepatic blood flow. The follow-up CT 1 year and 8 months after the operation revealed no recurrence of aneurysms and the patent anastomosis. Conclusions Although long-term follow-up is needed, resection and reconstruction is one of the therapeutic choices for PAAs caused by the compression of the celiac trunk by the MAL in order to prevent catastrophic aneurysm rupture.

Recovering the 3D shape of a person from its 2D appearance is ill-posed due to ambiguities. Nevertheless, with the help of convolutional neural networks (CNN) and prior knowledge on the 3D human body, it is possible to overcome such ambiguities to recover detailed 3D shapes of human bodies from single images. Current solutions, however, fail to reconstruct all the details of a person wearing loose clothes. This is because of either (a) huge memory requirement that cannot be maintained even on modern GPUs or (b) the compact 3D representation that cannot encode all the details. In this paper, we propose the tetrahedral outer shell volumetric truncated signed distance function (TetraTSDF) model for the human body, and its corresponding part connection network (PCN) for 3D human body shape regression. Our proposed model is compact, dense, accurate, and yet well suited for CNN-based regression task. Our proposed PCN allows us to learn the distribution of the TSDF in the tetrahedral volume from a single image in an end-to-end manner. Results show that our proposed method allows to reconstruct detailed shapes of humans wearing loose clothes from single RGB images.

International audience; The standard photometric stereo is a technique to densely reconstruct objects surfaces using light variation under the assumption of a static camera with a moving light source. In this work, we use photometric stereo to reconstruct dense 3D scenes while moving the camera and the light altogether. In such non-static case, camera poses as well as correspondences between pixels of each frame to apply photometric stereo are required. ORB-SLAM is a technique that can be used to estimate camera poses. To retrieve correspondences, our idea is to start from a sparse 3D mesh obtained with ORB SLAM and then densify the mesh by a plane sweep method using a multi-view photometric consistency. By combining ORB-SLAM and photometric stereo, it is possible to reconstruct dense 3D scenes with a off-the-shelf smartphone and its embedded torchlight. Note that SLAM systems usually struggle with textureless object, which is effectively compensated by the photometric stereo in our method. Experiments are conducted to show that our proposed method gives better results than SLAM alone or COLMAP, especially for partially textureless surfaces.

This paper proposes a new approach to visualizing spatial variation of plant status in a tomato greenhouse based on farm work information operated by laborers. Farm work information consists of a farm laborer&rsquo, s position and action. A farm laborer&rsquo, s position is estimated based on radio wave strength measured by using a smartphone carried by the farm laborer and Bluetooth beacons placed in the greenhouse. A farm laborer&rsquo, s action is recognized based on motion data measured by using smartwatches worn on both wrists of the farm laborer. As experiment, harvesting information operated by one farm laborer in a part of a tomato greenhouse is obtained, and the spatial distribution of yields in the experimental field, called a harvesting map, is visualized. The mean absolute error of the number of harvested tomatoes in each small section of the experimental field is 0.35. An interview with the farm manager shows that the harvesting map is useful for intuitively grasping the states of the greenhouse.

Aim The clinical impact of pathological classification based on architectural pattern in hepatocellular carcinoma (HCC) remains elusive in spite of its well-known and common feature. Methods The prognostic impact of pathological classification was examined with prospective database. Three hundred and eighty HCC patients who underwent curative hepatectomy as an initial treatment in Kumamoto University were enrolled as a test cohort. The outcome was confirmed with a validation cohort in Kyushu University. Results Macrotrabecular (macro-T) subtype (n = 38) and compact subtype (n = 43) showed similar biological and prognostic features. Both showed higher AFP level and worse overall survival than microrabecular (micro-T) subtype (n = 266). Multivariate analysis for overall survival revealed that DCP ≥ 40, multiple tumor and macro-T/compact subtype were associated with poor overall survival (risk ratio = 2.2, 1.6 and 1.6; p = 0.002, 0.020, and 0.047, respectively). Of note, 32% of macro-T/compact subtype showed early recurrence within 1 year, which showed substantially low (5%) 5 year overall survival, whereas 16% of micro-T/PG subtype did. Twenty-one percent of macro-T/compact subtype showed multiple intrahepatic metastases (≥ 4) or distant metastases, which resulted in non-curative treatment, whereas 5% of micro-T/PG subtype did. In validation cohort, macro-T/compact subtype was an independent predictor of worse overall survival. Conclusion Macro-T/compact subtype is biologically discriminated from micro-T and PG subtypes due to its aggressive features and poor prognosis after curative treatment. Additional treatment with curative hepatectomy on Macro-T/compact subtype should be discussed because of high possibility of systemic residual cancer cell.

Introduction : Surgery remains the treatment of choice for patients with resectable biliary tract cancer, enhancing the chance of cure and increasing long-term survival. Early recurrence, however, is frequent in patients who have undergone curative resection. To date, no randomized controlled trials have assessed adjuvant chemotherapy in patients with biliary tract cancer. The aim of this study was to evaluate the outcomes of surgical management followed by adjuvant chemotherapy in patients with biliary tract cancer. Materials and Methods : This study enrolled 100 patients with Union for International Cancer Control (UICC) stages I-IV biliary tract cancer who underwent surgical resection, including 16 who received sequential adjuvant chemotherapy with gemcitabine or S-1. Overall survival (OS), disease-free survival (DFS), and prognostic factors were analyzed. Results : The median duration of follow-up was 12.6 months. Forty-one patients had lymph node metastasis and 81 underwent R0 resection. The 1-, 3-, and 5-year OS rates were 80.9%, 48.6%, and 38.3%, respectively, and the 1-, 3-, and 5-year DFS rates were 59.8%, 39.9%, and 24.9%, respectively. Five-year OS rates were similar in patients who did (40.4%) and did not (32.4%) receive adjuvant chemotherapy. The morbidity and mortality rates were 59% and 3%, respectively. Multivariate analysis showed that only lymph node metastasis (p = 0.042) was independently associated with long-term survival. Conclusions : The presence of lymph node metastasis significantly affected long-term survival, whereas adjuvant chemotherapy did not affect outcomes in our patients with resectable biliary tract cancer., 【はじめに】胆道癌は予後不良の疾患であり，治癒切除することが唯一の根治治療と考えられている．しかしながら，手術可能な胆管癌においても術後の再発率は高率である一方で，現在術後補助化学療法として大規模臨床試験で効果が証明されたものは存在しない．【目的】胆道癌の手術成績及び術後補助化学療法の効果について検討した．【対象・方法】1999年7月より2013年8月までにUICCステージでⅠ，Ⅱ，Ⅲ，Ⅳの切除可能胆道癌初回手術症例100例について手術成績，全生存率，無病率，予後規定因子を検討した．また術後補助化学療法の使用状況，副作用とその効果について検討した．【結果】100例中肝内胆管癌：肝門部胆管癌：肝外胆管癌：十二指腸乳頭部癌：胆囊癌がそれぞれ17：12：26：16：29例であった．術後UICCのStageⅠ：Ⅱ：Ⅲ：Ⅳは20：41：30：9例であり，術後補助化学療法を16名(StageⅠ：Ⅱ：Ⅲ：Ⅳで0：5：9：2例)に施行した．9名にジェムザール，7名にTS-1を使用し，半数が6ヶ月間の治療を完遂した．Grade2以上の副作用は10名に認められた．1，3，5年生存率はそれぞれ80.9%，48.6%，38.3%，1，3，5年無病率はそれぞれ59.8%，39.9%，24.9%であった．断端陽性は19名に認めた．術後化学療法施行群と施行なし群の5年生存率は40.4%と32.4%で両群間に有意差を認めなかった．術後の合併症は59%に認め，周術期死亡率は3%であった．多変量解析によってリンパ節転移陽性が唯一予後の独立規定因子であった(p=0.042)【まとめ】胆道癌手術後においてリンパ節陽性が独立予後不良因子であった．一方で術後補助化学療法の有効性は当検討では認められなかった．リンパ節陽性患者に対する術後補助化学療法の必要性が考慮され，今後大規模無作為試験による臨床試験が望まれた．

Background : Pancreatic fistula is major source of postoperative morbidity or mortality. Soft pancreas has been considered to be one of the most important risk factors for pancreatic fistula. The purpose of the study is to clarify the relationship among extravasation of pancreatic secretions from the pancreatic stump, the pancreatic texture and clinical pancreatic fistula after pancreaticoduodenectomy. Methods : For nineteen patients who were treated between July 2007 and August 2008, we performed intraoperative pancreatic leakage test to confirm the extravasation of pancreatic secretions from the pancreatic stump. Degree of fibrosis at the cut surface of the pancreas was reviewed blindly. Results : Serum pancreatic amylase increased on first postoperative day (POD) and returned to preoperative level on 3POD. These change were inversely correlated with fibrosis (P < 0.001), namely the amylase level in patients with normal to mild fibrotic pancreas showed marked increase on 1POD, but not in those with moderate to severe fibrotic pancreas. Positive pancreatic leakage test was recognized in five patients (26.3%), four of 9 patients with soft pancreas (44.4%) and one of 10 with hard pancreas (10.0%). In soft pancreas, all four cases showing positive leakage test developed pancreatic fistula after pancreaticoduodenectomy, while one positive case in hard pancreas did not develop pancreatic fistula. Conclusion : The extravasation of pancreatic secretions from the pancreatic stump occurred frequently in soft pancreas, which might result in postoperative pancreatic fistula. Therefore we should take care in treating branched duct as well as main pancreatic duct at the pancreatic stump of soft pancreas., 【はじめに】膵液漏は膵切除術合併症で特に問題となる合併症である．Soft pancreasは膵液漏の危険因子と言われている．今回膵切離断端からの膵液の漏れと，膵の繊維化の程度，膵液漏の発生との関連性を明らかにした．【方法】膵頭十二指腸切除を行った19症例に対して，切除端の膵管からアトムチューブを挿入しインジコカルミン溶液を注入し断端からの色素の漏れの有無を調べ，切除膵の繊維化の程度と組織学的になし，軽度，中等度，高度に郡別し比較．【結果】血清アミラーゼ値は，術後1日目に上昇し，3 日目には術前値に戻っていたが，1 日目の上昇は繊維化がないほど有意に高値を示した．リークテスト陽性を5例に認めたが，1例をのぞきsoft pancreas症例であった．リークテスト陽性であったsoft pancreas症例4例は全例膵液漏を生じたが，リークテスト陽性であったhard pancreas症例は膵液漏を生じなかった．【まとめ】Soft pancreasにおいては膵断端の分枝膵管からの漏れも多く，膵液漏の原因である可能性があり分枝膵管にも注意を払うべきと考えられる．

Introduction : Previous studies have demonstrated that oxidative stress by mediating the excessive production of reactive oxygen species is involved in tissue damage and organ failure during and after surgery. The impact of the preoperative immunonutrition including antioxidants on the postoperative course of patients undergoing hepatic surgery was investigated in this pilot study. Patients and Methods : Twenty-three living donor liver transplantation (LDLT) donors were randomly assigned to either an experimental (AO) group, received a commercial supplement enriched with antioxidant nutrients for each of the 5 days immediately prior to surgery while maintaining normal food intake, or a control (CT) group, administered no supplement. Antioxidative capacity was measured by spectrophotometry of patient serum using a free-radical analytical system. Results : The antioxidative capacity of 90.9% patients in the AO group increased after immunonutrition. Compared to the CT group, the AO group was found to have higher antioxidant capacity and transferrin levels ; lower WBC, lymphocyte, and neutrophil counts ; and briefer duration of postoperative fever during the postsurgical period. No significant differences were found between the 2 groups regarding the nutritional parameters ; liver functioning parameters ; immunological parameters ; intraoperative factors ; postoperative outcomes. Conclusion : Preoperative immunonutrition including antioxidants might play a beneficial role in improving postsurgical immunological response but the modest biological advantage was not associated with any significant clinical outcome., 【目的】活性酸素が過剰に産生されることで外科手術後に組織破壊や臓器機能不全を招来することがこれまで報告されている．本研究では肝切除を受ける患者に抗酸化物質を含む術前免疫栄養を行い，術後経過に与える効果を検討した．【対象と方法】23名の生体肝移植ドナーを対象とした．通常の食事に加え，術前5日間抗酸化物質を豊富に含む栄養剤を摂取した実験群(AO群)と通常の食事のみのコントロール群(CT群)に無作為に分けた．フリーラジカル自動分析装置を用いて患者血清を吸光光度分析法にて抗酸化力を測定した．【結果】AO群の90.9%において免疫栄養後に抗酸化力が増加した．CT群に比較してAO群は術後により高い抗酸化力とトランスフェリン値を示した．またAO群は術後の白血球数，好中球数が低く，術後発熱期間が短かった．それ以外の栄養学的指標，肝機能，免疫学的指標，手術因子や術後経過に2群間に差を認めなかった．【結論】抗酸化物質を含む術前免疫栄養による明らかな臨床的アウトカムを示せなかったが，術後免疫応答を改善するのに有用である可能性が示唆された．

Biliary leakage is a major complication after hepatectomy. We report the case of a living-donor liver transplantation (LDLT) donor with a late-onset bile leak from the trifurcation of the hepatic duct who was successfully treated using rendezvous technique. A 52-year-old man underwent extended left hepatectomy for donation and was discharged on postoperative day (PD) 13. However, he was rehospitalized on PD 26 with severe abdominal pain. Physical examination suggested panperitonitis, and abdominocentesis showed bilious ascites. Emergent laparotomy for biliary leakage and peritonitis was performed. There was bilious ascites in the peritoneal cavity. A biliary fistula was recognized at the trifurcation of B8a, B8b, and B5. Intraoperative transhepatic biliary drainage of each bile duct was performed. Endoscopic transpapillary drainage was performed on PD 24. Finally, external drains were removed and complete internal drainage established on PD 70. The bile leak was considered to be the result of injury from electrocautery device. Appropriate making choices of the electrocautery devices enable us to avoid over thermal injury of the liver surface. Rendezvous bidirectional drainage effectively treated late-onset bile leakage from the trifurcation of a hepatic bile duct., 【はじめに】肝切除後の胆汁漏は未だ完全には克服されておらず, 難治例も散見される. 今回我々は, 生体肝移植ドナーの拡大左葉切除術後に, 汎発性胆汁性腹膜炎を合併した前区域胆管側壁よりの遅発性胆汁漏の症例を経験した. 胆汁漏原因を考察するとともに, 治療として経肝的, 経乳頭的な双方向性アプローチを駆使したランデブー法が有用であった症例を経験したので報告する. 【症例】52 歳男性, 生体肝移植ドナーとして当科入院となり, 拡大肝左葉切除術を施行. 術後26 日目に突然の腹痛が出現し, 血液検査にて肝胆道系酵素の上昇と腹部CTにて著明な腹水貯留を認めた. 腹水穿刺の結果, 胆汁漏による汎発性腹膜炎が疑われ緊急開腹術を施行した. 手術所見としては, 開腹時に多量の胆汁性腹水が見られ, 瘻孔部は前・後区域胆管合流付近に認められた. 各々にRTBD チューブを留置し経肝的ドレナージと瘻孔部の周囲のドレナージを行った. 開腹ドレナージ術術後も難治化が予想されたため, 術後24 日目にERC での経乳頭的ドレナージを追加して双方向ドレナージを開始した. 術後70日目には完全内瘻化が可能となり良好な経過を得ている. 本症例の胆汁漏の原因の1 つとして, 肝切裏面にグリソンが近接していたこととエネルギーデバイスの使用からグリソンの熱損傷を考えた. エネルギーデバイスの選択によっては組織への過度な熱損傷が防ぎ得ると考えられる. 【まとめ】難治化が予想される肝切除後の遅発性胆汁漏に対して, ランデブー法を用いることにより良好な経過を辿ることが出来た生体肝移植ドナーの1 例を経験した. 胆汁漏の原因についても併せて考察し, 症例を報告する.

Adenosquamous carcinoma of the stomach is very rare; at present, there are only seven published reports. We report here an eighth case involving a 77-year-old Japanese man who was diagnosed with gastric cancer by upper endoscopy and computed tomography (CT). He underwent laparoscopic-assisted distal gastrectomy for early gastric cancer and the resected specimen was diagnosed as adenosquamous carcinoma limited to the submucosal layer. Only one lymph node metastasis was noted. Seven months later, liver metastasis (3 tumors, 15 mm maximum in diameter) was detected by abdominal CT. He was started on chemotherapy with S-1 and cisplatin (CDDP) and is alive 14 months after surgery. Almost all cases of adenosquamous carcinoma of the stomach are diagnosed in advanced stages and carry a very poor prognosis. Most patients with early adenosquamous carcinoma of the stomach survive for 2 or more years without recurrence, however our patient experienced recurrence 7 months after surgery. Therefore, future treatment for recurrent adenosquamous carcinoma of the stomach should be considered., 【はじめに】胃腺扁平上皮癌はまれな疾患であり, 報告は様々だがおよそ胃癌の0.5%といわれている. 早期癌に関する報告は非常に少なく, 現在7例報告されているのみである. 今回我々は本邦で8 例目となる早期胃腺扁平上皮癌を経験したので報告する. 【症例】77歳男性で上部消化管内視鏡検査で, 胃角部に0-IIa + IIc 病変を指摘され, 生検では腺癌の診断であった. 腹腔鏡補助下幽門側胃切除施行され, 病理組織診断では胃腺扁平上皮癌, T1b（SM）N1M0 StageIB と診断された. 術後6か月目のCT で肝臓に3か所の転移を指摘され, 再発に対してS-1/CDDP 療法が施行された. 現在1 年7 か月生存中である. 【考察】腺扁平上皮癌とは腺癌と扁平上皮癌が共存しており, うち扁平上皮癌が4 分の1以上存在することが必要とされている. 腺扁平上皮癌の報告は多数あるが, ほとんどの症例は肝転移や多発リンパ節転移を伴った進行した状態で発見されている. また症例が少なくまだ不明なことが多いが, 基本的には予後不良といわれている. 理由としては①多発肝転移や多発リンパ節転移を伴った進行癌で発見されている, ②早期胃腺扁平上皮癌でも早期に再発する, ということが挙げられる. しかし, これまでの7 例の早期癌症例において3例は言及されていないが, 4例は無再発であり, 4年以上生存している症例もあるため, 胃腺扁平上皮癌が生物学的な特徴を有している可能性がある. 本症例のように早期癌であってもわずか6か月で再発をきたした症例もあることから, 通常の腺癌よりは厳重な経過観察が必要であると考えられた.

【目的】当院は200床の二次救急病院である. 救急搬送された外傷症例中, 一般外科に入院となった高エネルギー外傷症例の臨床学的特徴を明らかにした. 【対象と方法】’08. 4月-’12. 3月の4年間の全救急搬送症例7,826例中, 外科系各科に入院となった外傷症例831例を対象とした. 対象を非高エネルギー外傷群(非高エ群), 高エネルギー外傷群(高エ群)に分類し, 各々につき一般外科入院となった症例を解析した. 【結果】(1)対象831症例は非高エ群741例(89.2%), 高エ群は90例(10.8%)であった. (2)一般外科入院は非高エ群で741例中11例(1.5%), 高エ群で90例中18例(20.0%)と後者において高頻度であった(p < 0.01). (3)非高エ群9例は内臓損傷を伴わない症例であったのに対し, 高エ群18例は胸腔, 腹腔内臓器損傷を伴う症例であった. (4)高エ群18例においてISS15以上の重症患者は11例(61.1%)で，多発外傷は9例(50.0%)であった. (5)胸部, 腹部各単独損傷は6例ずつであり, 残り6例が胸腹部同時受傷であった. (6)治療法は胸腔ドレーン挿入6例, 血管造影下止血術4例, 腹部手術3例であった. (7)ISS15以上の症例の防ぎ得た外傷死は9.1%(1/11)で, 症例数は少ないものの, 三次救急病院を中心とした日本外傷データバンクの報告とほぼ同じ成績であった. 【結論】高エネルギー外傷群では, 胸腹腔内臓器損傷を来たしたために一般外科への入院となった症例が高頻度に認められた. 治療成績は概ね良好であり, 二次救急病院は地域の外傷診療体制において一定の貢献を成し得ると考えられた., Objective : We clarified the characteristics of the high energy trauma patients that entered the general surgery ward of Fukuoka city hospital (FCH), a 200 bed secondary emergency hospital in Japan. Patients and Methods : Of the 7,826 total ambulance cases treated from April 2008 to March 2012 in our emergency room, 831 trauma patients who entered our hospital were analyzed. These patients were classified into a non high energy (NHE) and high energy trauma (HE) group based on the mechanisms of injuries. Results : Of the 831 trauma cases, 741 (89.2%) were in the NHE and 90 (10.8%) were in the HE group. Eleven of the 741 cases (1.5%) in the NHE group and 18 of the 90 cases (20.0%) in the HE group entered the Department of General Surgery as inpatients, with the frequency being significantly higher in the latter group (p < 0.01). 11 of the 18 cases (61.1%) of Department of General Surgery in the HE group were diagnosed to have an injury severity score (ISS) of 15 or higher, and the rate of preventable trauma deaths (PTDs) of those 11 cases was 9.1% (1/11). Conclusions : The proportion of the patients that entered the Department of General Surgery was higher in the HE group than in the NHE group. The surgical departments of secondary emergency facilities are expected to contribute to the local trauma emergency systems.

International audience; We present a fast and accurate method for reconstructing surfaces of revolution (SoR) on 3D data and its application to structural modeling of a cluttered scene in real-time. To estimate a SoR axis, we derive an approximately linear cost function for fast convergence. Also, we design a framework for reconstructing SoR on dense SLAM. In the experiment results, we show our method is accurate, robust to noise and runs in real-time.

Objective : The transition of emergency departments and the current situation of emergency medicine (EM) in Fukuoka City Hospital (FCH) were reviewed. Methods : The data concerning emergency medicine, such as the transition of intra-hospital emergency systems, were obtained from annual reports published in our hospital. Additionally, the data regarding educational programs for emergency room staff, the number of patients taken to the emergency room by ambulances, the activities regarding the Fukuoka Medical Rally (FMR) and the disaster relief team (DRT) were also reviewed and analyzed. Results : Departments of neurology, neurosurgery, emergency, and cardiology were opened sequentially, starting in 2003, with an establishment of facilities of an emergency room (ER), intensive care unit (ICU), stroke care unit (SCU), and coronary care unit (CCU). Regarding educational programs, lectures and demonstrations on basic and advanced life support techniques were given to all staff annually starting in 2004, and resident doctors completed rotations in the ER and the ICU for three months. FCH staff consistently obtained excellent results at the FMR. Ambulance crews attended lectures and received training on EM and intra-tracheal intubation. The numbers of patients taken by ambulance to FCH increased from 129 in 2002 to 2,316 in 2011. The DRT was dispatched to respond to disasters that occurred in Japan. Conclusions : As a secondary emergency hospital, FCH has developed a system to accept emergency patients. This project will contribute to the improvement of the EM system in the area., 日本の救急医療体制は,救急科専門医師数の不足,不十分な財源支援,社会的認知度の低さ等が指摘されており,搬送患者の病院収容時間の遅延,二次病院の救急医療からの離脱などが生じ停滞状況にあると考えられる.病床数200床の二次救急病院である当院では,地域の救急医療に貢献するために,2003年以来救急患者受け入れ体制の充実を図って来た.救急疾患に対応するために,神経内科,脳外科,循環器内科の各診療科を新設し,救急部,集中治療部,脳卒中集中治療室,冠動脈疾患集中治療室等の設備を拡充した.また,全医師,看護師に対する一次,二次心肺蘇生法講習会開催や,研修医に対する救急患者の診療,救急関連学会での発表,メデイカルラリー出場の指導,また全職員に向けた救急症例検討会の開催等の教育活動を行って来た.地域の救急隊員へは,メデイカルコントロール事後検証,救急ワークステーションでのドクターカー出動,救急疾患の講義,手術場での気管挿管実習などを行い,また災害救助活動としてJR福知山線事故や,東北太平洋沖地震被災地への出動,新型インフルエンザ流行時の全病院挙げての患者受け入れ等を行って来た.これら救急診療体制の充実により,救急搬送患者の受け入れが進み,その数は2002年の年間129名から,2011年には2,316名に増加した.二次病院において,救急診療体制の進展を図り,急性期重症患者に対する高度な治療を行うことにより,地域内の三次救急病院の負担を減らすこと,ひいては我が国の救急医療体制の維持,発展に寄与することが可能ではないかと考える.

Purpose : Laparoscopic hepatic resection (LHR) is still a challenging and developing surgical modality because of technical difficulty and a lack of training opportunities and experience. In this study, we present the results of our initial experiences of LHR, focusing on technical evolution in the management of LHR. Methods : Between April 2011 and March 2012, a total of 12 LHRs were performed. The first 5 of these LHRs were performed under laparoscopic assistance (hybrid-LHR), while the last 7 LHRs were performed totally laparoscopically (pure-LHR). Indications for LHR were hepatocellular carcinoma (n = 9) and metastatic liver cancer (n = 3). LHR procedures consisted of partial resection (n = 2), left lateral segmentectomy (n = 2), and left lobectomy (n = 1) in the hybrid-LHR group, and partial resection (n = 4), left lateral segmentectomy (n = 2), and right lobectomy (n = 1) in the pure-LHR group. Operative outcomes were compared between the groups and technical modifications were evaluated. Results : The mean operative time, blood loss, and length of hospital stay in the hybrid- and pure-LHR groups were 3.8 and 6.1 hours, 220 and 611 ml, and 9.4 and 7.4 days, respectively. There were no postoperative complications in both groups. Tumor margins were negative in all cases. Conclusions : LHR is a feasible and effective procedure for patients with various types of liver tumors, although technical challenges still need to be overcome., 【目的】腹腔鏡下肝切除は，未だ発展途上の術式である．今回，当施設における腹腔鏡下肝切除の術式工夫の変遷とその成績を検討した．【方法】2010年４月〜2012年３月までに12 例の腹腔鏡下肝切除：腹腔鏡補助下（Hybirid-LHR）５例，完全腹腔鏡下（Pure-LHR）７例を行った．手術適応はHCC ９例，転移性肝癌３例であった．術式は外側区域切除（n=4：Hybrid-LHR n=2，Pure-LHR n=2），部分切除（n=5：それぞれn=2，n=4)，左葉切除（n=1：Hybrid-LHR n=1），右葉切除（n=1：Pure-LHR n=1）であった．Hybrid-LHR５例は腹腔鏡補助下で肝脱転後，小開腹をおきCUSA，ソフト凝固で直視下に通常の肝切離を行った．Pure-LHR７例では完全腹腔鏡にCUSA，腹腔鏡用ソフト凝固，バイクランプを基本デバイスとして用い通常の開腹肝切離と同様に肝切離を行った．【結果】前半５例と後半７例の平均手術時間3.8 時間vs. 6.1時間，出血量220ml vs. 611ml，術後入院日数9.4 日vs. 7.4 日であった．後半の１例に４単位の輸血を要した．肝切離面の癌浸潤は全例陰性であった．術後合併症は1 例も認めなかった．【結論】腹腔鏡下肝切除はあらゆる腫瘍占拠部位に対して可能であり，有効な手術手技である．

胃癌切除症例において，経口抗癌剤による術後補助化学療法の有効性が示されてきた．今回，根治度B 切除症例における同治療法の十年生存率に及ぼす効果を解析した．, Purpose : The prognosis of gastric cancer patients undergoing curability B surgery was retrospectively examined to determine the effectiveness of the administration of oral anti-cancer drugs as postoperative adjuvant chemotherapy. Methods : This study was based on the outcomes of 86 potentially curative patients who had undergone curability B resection of gastric cancer with or without the subsequent administration of oral 5-fluorouracil analogue. There were 21 patients who underwent surgery alone with no oral anti-cancer agents (group A) and 65 patients who were treated postoperatively, mainly with UFT (Tegafur and uracil ; group B). This study compared the ten-year survival times of these two groups using univariate and multivariate analyses. Results : The amount of UFT in group B was 354.2 ±122.0mg and the administration period was 11.7 ± 7.2 months. The backgrounds showed significantly more older patients in group A compared than group B (P = 0.0002). A univariate analysis showed the ten-year survival rate in group B to be higher than group A (P = 0.0079). A multivariate analysis showed that the postoperative administration of UFT was an independent factor associated with prolongation of survival times as well as the extent of lymph nodes metastasis and pathological stage (P = 0.0096). Conclusion : This study provided conventional evidence that postoperative administration of oral 5-fluorouracil analogue is associated with better long-term prognoses in patients undergoing curability B resection for gastric carcinoma.

Portal annular pancreas (PAP) is a rare variant in which the uncinate process of the pancreas extends to the dorsal surface of the pancreas body and surrounds the portal vein or superior mesenteric vein. Upon pancreaticoduodenectomy (PD), when the pancreas is cut at the neck, two cut surfaces are created. Thus, the cut surface of the pancreas becomes larger than usual and the dorsal cut surface is behind the portal vein, therefore pancreatic fistula after PD has been reported frequently. We planned subtotal stomach-preserving PD in a 45-year-old woman with underlying insulinoma of the pancreas head. When the pancreas head was dissected, the uncinate process was extended and fused to the dorsal surface of the pancreas body. Additional resection of the pancreas body 1 cm distal to the pancreas tail to the left side of the original resection line was performed. The new cut surface became one and pancreaticojejunostomy was performed as usual. No postoperative complications such as pancreatic fistula occurred. Additional resection of the pancreas body may be a standardized procedure in patients with PAP in cases of pancreas cut surface reconstruction.

In living donor liver transplantation (LDLT), it is considered safer to reconstruct hepatic arteries (HAs) under a microscope than under conventional loupe magnification, because graft HA stumps are generally thin and short with an average diameter of approximately 2 mm. We first applied microvascular surgical techniques to HA reconstruction for LDLT in 1996. In most cases, we use a disposable double-clip to secure the graft and recipient arteries, and interrupted 8-0 nonabsorbable monofilament sutures. We next started performing resection and reconstruction of the right HA in a surgery for hilar cholangioma using the same technique as in LDLT. Lately, we have started applying microvascular surgical techniques to various digestive surgeries; namely, supercharge and superdrainage in esophageal surgery, vascular reconstruction in free jejunal interposition grafts for cervical esophageal cancer, resection and reconstruction of spontaneous HA aneurysms, jejunal artery reconstruction for spontaneous superior mesenteric artery dissections, and so forth. Mastering this technique is time consuming. However, once a surgeon masters the technique it has almost unlimited applications, and most vital vessels can be safely reconstructed using this method. We herein provide a technical review of the application of microvascular surgical techniques for various digestive surgeries.

RGB-D sensors have become in recent years a product of easy access to general users. They provide both a color image and a depth image of the scene and, besides being used for object modeling, they can also offer important cues for object detection and tracking in real time. In this context, the work presented in this paper investigates the use of consumer RGB-D sensors for object detection and pose estimation from natural features. Two methods based on depth-assisted rectification are proposed, which transform features extracted from the color image to a canonical view using depth data in order to obtain a representation invariant to rotation, scale and perspective distortions. While one method is suitable for textured objects, either planar or non-planar, the other method focuses on texture-less planar objects. Qualitative and quantitative evaluations of the proposed methods are performed, showing that they can obtain better results than some existing methods for object detection and pose estimation, especially when dealing with oblique poses.

We measured how well alarm signals could be detected in the presence of car noise as a function of interaural time difference (ITD) and interaural phase difference (IPD). Alarm signals intended to warm people of dangerous situations need to be perceived accurately in real environments because noise in a real environment can mask the alarm signals and make them undetectable. Pulse train signals and five alarm signals were used to check whether the spatial release from masking (SRM) occurred. The results showed that SRM occurred for all signals and that alarm signal detectability could be improved by utilizing not only ITD but also IPD of the signal. This effect depended on the relationship between ITD and IPD. In addition, ITD and IPD of the arrival direction difference of the alarm signal in the masker greatly influenced occurrence of SRM: this could be interpreted as binaural masking level difference (BMLD). These results suggest that spatial cues of the arrival direction of an alarm signal in comparison with the masker direction have to be considered in conveying warnings accurately and efficiently without loss of information.

International audience; This paper introduces recent progress on techniques of object detection and pose tracking with a monocular camera for augmented reality applications. To visually merge a virtual object onto a real scene with geometrical consistency, a camera pose with respect to the scene needs to be computed. For this issue, many approaches have been proposed in the literature. In this paper, we classify and summarize the recent trends of the solutions as a survey.

International audience; The work proposed in this document aims to investigate the use of consumer RGB-D sensors for object detection and pose estimation from natural features, with the purpose of using such techniques for developing augmented reality applications. Two methods based on depth-assisted rectification are proposed, which transform features extracted from the color image to a canonical view using depth data in order to obtain a representation invariant to rotation, scale and perspective distortions. While one method is suitable for textured objects, either planar or non-planar, the other method focuses on texture-less planar objects. Qualitative and quantitative evaluations of the proposed methods are performed, comparing it to existing methods for object detection and pose estimation.

International audience; We propose a camera tracking method by on-line learning of keypoint arrange- ments in augmented reality applications. As target objects, we deal with intersection maps from GIS and text documents, which are not dealt with by the popular SIFT and SURF descriptors. For keypoint matching by keypoint arrangement, we use locally likely arrange- ment hashing (LLAH), in which the descriptors of the arrangement in a viewpoint are not invariant to wide viewpoints because the arrangement is changeable with respect to viewpoints. In order to solve this problem, we propose online learning of descriptors using new configurations of keypoints at new viewpoints. The proposed method allows keypoint matching to proceed under new viewpoints. We evaluate the performance and robustness of our tracking method using view changes.

International audience; We extend planar fiducial markers using random dots 8 to non- rigidly deformable markers. Because the recognition and tracking of random dot markers are based on keypoint matching, we can estimate the deformation of the markers with nonrigid surface de- tection from keypoint correspondences. First, the initial pose of the markers is computed from a homography with RANSAC as a planar detection. Second, deformations are estimated from the min- imization of a cost function for deformable surface fitting. We show augmentation results of 2D surface deformation recovery with sev- eral markers.

This paper presents a system for overlaying 3D GIS data information such as 3D buildings onto a 2D physical urban map. We propose a map recognition framework by analysis of distribution of local intersections in order to recognize the area of the physical map from a whole map. The retrieval of the geographical area described by the physical map is based on a hashing scheme, which is called LLAH. In the results, we will show some applications augmenting additional information on the map.

This paper presents a pool supporting system with a camera-mounted handheld display based on augmented reality technology. By using our system, users can get supporting information when they once capture a pool table. They can also watch visual aids through the display while they are capturing the table. First, our system estimates ball positions on the table with one image taken from an arbitrary viewpoint. Next, our system provides several shooting ways considering the next shooting way. Finally, our system presents visual aids such as shooting direction and ball behavior. Main purpose of our system is to estimate and analyze the distribution of balls and to present visual aids. Our system is implemented without special equipment such as a magnetic sensor or artificial markers. For evaluating our system, the accuracy of ball positions and the effectiveness of our supporting information are presented