Morbidity, survival, and site of recurrence after mediastinal lymph-node dissection versus systematic sampling after complete resection for non-small cell lung cancer

BACKGROUND: Mediastinal lymph-node dissection was compared to systematic mediastinal lymph-node sampling in patients undergoing complete resection for non-small cell lung cancer with respect to morbidity, duration of chest tube drainage and hospitalization, survival, disease-free survival, and site of recurrence. METHODS: A consecutive series of one hundred patients with non-small-cell lung cancer, clinical stage T1-3 N0-1 after standardized staging, was divided into two groups of 50 patients each, according to the technique of intraoperative mediastinal lymph-node assessment (dissection versus sampling). Mediastinal lymph-node dissection consisted of removal of all lymphatic tissues within defined anatomic landmarks of stations 2-4 and 7-9 on the right side, and stations 4-9 on the left side according to the classification of the American Thoracic Society. Systematic mediastinal lymph-node sampling consisted of harvesting of one or more representative lymph nodes from stations 2-4 and 7-9 on the right side, and stations 4-9 on the left side. RESULTS: All patients had complete resection. A mean follow-up time of 89 months was achieved in 92 patients. The two groups of patients were comparable with respect to age, gender, performance status, tumor stage, histology, extent of lung resection, and follow-up time. No significant difference was found between both groups regarding the duration of chest tube drainage, hospitalization, and morbidity. However, dissection required a longer operation time than sampling (179 +/- 38 min versus 149 +/- 37 min, p < 0.001). There was no significant difference in overall survival between the two groups; however, patients with stage I disease had a significantly longer disease-free survival after dissection than after sampling (60.2 +/- 7 versus 44.8 +/- 8 months, p < 0.03). Local recurrence was significantly higher after sampling than after dissection in patients with stage I tumor (12.5% versus 45%, p = 0.02) and in patients with nodal tumor negative mediastinum (N0/N1 disease) (46% versus 13%, p = 0.004). CONCLUSION: Our results suggest that mediastinal lymph-node dissection may provide a longer disease-free survival in stage I non-small cell lung cancer and, most importantly, a better local tumor control than mediastinal lymph-node sampling after complete resection for N0/N1 disease without leading to increased morbidity.

A Camera-Projector System for Robot Positioning by Visual Servoing

Positioning a robot with respect to objects by using data provided by a camera is a well known technique called visual servoing. In order to perform a task, the object must exhibit visual features which can be extracted from different points of view. Then, visual servoing is object-dependent as it depends on the object appearance. Therefore, performing the positioning task is not possible in presence of nontextured objets or objets for which extracting visual features is too complex or too costly. This paper proposes a solution to tackle this limitation inherent to the current visual servoing techniques. Our proposal is based on the coded structured light approach as a reliable and fast way to solve the correspondence problem. In this case, a coded light pattern is projected providing robust visual features independently of the object appearance

An approach to visual servoing based on coded light

Positioning a robot with respect to objects by using data provided by a camera is a well known technique called visual servoing. In order to perform a task, the object must exhibit visual features which can be extracted from different points of view. Then, visual servoing is object-dependent as it depends on the object appearance. Therefore, performing the positioning task is not possible in presence of non-textured objects or objects for which extracting visual features is too complex or too costly. This paper proposes a solution to tackle this limitation inherent to the current visual servoing techniques. Our proposal is based on the coded structured light approach as a reliable and fast way to solve the correspondence problem. In this case, a coded light pattern is projected providing robust visual features independently of the object appearance

Robust decoupled visual servoing based on structured light

This paper focuses on the problem of realizing a plane-to-plane virtual link between a camera attached to the end-effector of a robot and a planar object. In order to do the system independent to the object surface appearance, a structured light emitter is linked to the camera so that 4 laser pointers are projected onto the object. In a previous paper we showed that such a system has good performance and nice characteristics like partial decoupling near the desired state and robustness against misalignment of the emitter and the camera (J. Pages et al., 2004). However, no analytical results concerning the global asymptotic stability of the system were obtained due to the high complexity of the visual features utilized. In this work we present a better set of visual features which improves the properties of the features in (J. Pages et al., 2004) and for which it is possible to prove the global asymptotic stability

Plane-to-plane positioning from image-based visual servoing and structured light

In this paper we face the problem of positioning a camera attached to the end-effector of a robotic manipulator so that it gets parallel to a planar object. Such problem has been treated for a long time in visual servoing. Our approach is based on linking to the camera several laser pointers so that its configuration is aimed to produce a suitable set of visual features. The aim of using structured light is not only for easing the image processing and to allow low-textured objects to be treated, but also for producing a control scheme with nice properties like decoupling, stability, well conditioning and good camera trajectory

Comparison of visual preservation after transplantation of BDNF or GDNF secreting mesenchymal stem cells in glaucomatous rat eyes

Purpose:To functionally and morphologically characterize the retina and optic nerve after transplantation of Brain-derived neurotrophic factor (BDNF) and Glial-derived neurotrophic factor (GDNF) secreting mesenchymal stem cells (MSCs) into glaucomatous rat eyes. Methods:Chronic ocular hypertension (COH) was induced in Brown Norway rats. Lentiviral constructs were used to transduce rat MSCs to produce BDNF, GDNF, or green fluorescent protein (GFP). The fellow eyes served as internal controls. Two days following COH induction, eyes received intravitreal injections of transduced MSCs. Electroretinography was performed to assess retinal function. Tonometry was performed throughout the experiment to monitor IOP. 42 days after MSC transplantation, rats were euthanized and the eyes and optic nerves were prepared for analysis. Results:Increased expression and secretion of BDNF and GDNF from lentiviral-transduced MSCs was verified using ELISA, and a bioactivity assay. Ratio metric analysis (COH eye/ Internal control eye response) of the Max combined response A-Wave showed animals with BDNF-MSCs (23.35 ± 5.15%, p=0.021) and GDNF-MSCs (28.73 ± 3.61%, p=0.025) preserved significantly more visual function than GFP-MSC treated eyes MSCs (18.05 ± 5.51%). Animals receiving BDNF-MSCs also had significantly better B-wave (33.80 ± 7.19%) and flicker ERG responses (28.52 ± 10.43%) than GFP-MSC treated animals (14.06 ± 12.67%; 3.52 ± 0.07%, respectively). Animals receiving GDNF-MSC transplants tended to have better function than animals with GFP-MSC transplants, but were not statistically significant (p=0.057 and p=0.0639). Conclusions:Mesenchymal stem cells are an excellent source of cells for autologous transplantation for the treatment of neurodegenerative diseases. We have demonstrated that lentiviral- transduced MSCs can survive following transplantation and preserve visual function in glaucomatous eyes. These results suggest that MSCs may be an ideal cellular vehicle for delivery of specific neurotrophic factors to the retina.

Medical image registration based on random line sampling

One of the key aspects in 3D-image registration is the computation of the joint intensity histogram. We propose a new approach to compute this histogram using uniformly distributed random lines to sample stochastically the overlapping volume between two 3D-images. The intensity values are captured from the lines at evenly spaced positions, taking an initial random offset different for each line. This method provides us with an accurate, robust and fast mutual information-based registration. The interpolation effects are drastically reduced, due to the stochastic nature of the line generation, and the alignment process is also accelerated. The results obtained show a better performance of the introduced method than the classic computation of the joint histogram

Field optimisation of MosquiTRAP sampling for monitoring Aedes aegypti Linnaeus (Diptera: Culicidae)

A sticky trap designed to capture gravid Aedes (Stegomyia) aegypti mosquitoes, MosquiTRAP, has been evaluated for monitoring this species in Brazil. However, the effects of trap densities on the capture rate of Ae. aegypti females and the sensitivity of vector detection are still unknown. After a preliminary study has identified areas of high and low female mosquito abundance, a set of experiments was conducted in four neighbourhoods of Belo Horizonte (state of Minas Gerais, Brazil) using densities of 1, 2, 4, 8, 16, 32 and 64 traps per block. Trap sensitivity (positive MosquiTRAP index) increased significantly when 1-8 MosquiTRAPs were installed per block in both high and low abundance areas. A strong fit was obtained for the total number of mosquitoes captured with increasing trap densities through a non-linear function (Box-Lucas) (r² = 0,994), which likely exhibits saturation towards an equilibrium level. The capacity of the Mean Female Aedes Index to distinguish between areas of high and low Ae. aegypti abundance was also investigated; the achieved differentiation was shown to be dependent on the MosquiTRAP density.

Upper Triassic foraminifers from Panthalassan carbonate buildups of Southwestern Japan and their paleobiogeographic implications

Detailed sampling of the Upper Triassic atoll-type carbonates of the Sambosan Accretionary Complex throughout Southwest Japan yielded highly abundant and diversified porcelaneous, microgranular, agglutinated and hyaline foraminifers of Carnian-Rhaetian age, as well as some microproblematica and ostracods. The foraminiferal assemblages were collected from shallow-water carbonates originated upon volcanic seamounts surrounded by deep-water radiolarian chert in a mid-open oceanic realm of the Panthalassan Ocean during Triassic time. Because most studies of the Upper Triassic microfauna come from the former Tethys, counterparts of the Panthalassan Ocean are pivotal to decipher the micropalaeontological biodiversity of the western circum Pacific, as well as to evaluate the distribution patterns of organisms and their evolution trends throughout the Tethys and Panthalassa. This study reports on 42 genera and 60 species whose associations can be used as sedimentary facies indicators of carbonate buildup environments. Japanese specimens show a strong Tethyan affinity, and especially with the Peri- and Southern Tethyan forms. A palaeobiogeographic distribution analysis using a large foraminiferal database is led, in order to evaluate the extraordinary spreading of these Upper Triassic foraminifers between the Neo-Tethys and the Panthalassa. Data are finally integrated in a new plate tectonic model, where six faunistic provinces are defined, each containing a characteristic foraminiferal assemblage. This map provides for the first time a useful and visual synthesis of the Upper Triassic foraminifer palaeobiogeographic distribution.

Surface-sampling and analysis of TATP by swabbing and gas chromatography/mass spectrometry

The method of sample recovery for trace detection and identification of explosives plays a critical role in several criminal investigations. After bombing, there can be difficulties in sending big objects to a laboratory for analysis. Traces can also be searched for on large surfaces, on hands of suspects or on surfaces where the explosive was placed during preparatory phases (e.g. places where an IED was assembled, vehicles used for transportation, etc.). In this work, triacetone triperoxide (TATP) was synthesized from commercial precursors following reported methods. Several portions of about 6 mg of TATP were then spread on different surfaces (e.g. floors, tables, etc.) or used in handling tests. Three different swabbing systems were used: a commercial swab, pre-wetted with propan-2-ol (isopropanol) and water (7:3), dry paper swabs, and cotton swabs wetted with propan-2-ol. Paper and commercial swabs were also used to sample a metal plate, where a small charge of about 4 g of TATP was detonated. Swabs were sealed in small glass jars with screw caps and Parafilm® M and sent to the laboratory for analysis. Swabs were extracted and analysed several weeks later by gas chromatography/mass spectrometry. All the three systems gave positive results, but wetted swabs collected higher amounts of TATP. The developed procedure showed its suitability for use in real cases, allowing TATP detection in several simulations, including a situation in which people wash their hands after handling the explosive.

Characteristics of eyes with secondary loss of visual acuity receiving variable dosing ranibizumab for neovascular age-related macular degeneration.

PURPOSE: The aim of this work is to investigate the characteristics of eyes failing to maintain visual acuity (VA) receiving variable dosing ranibizumab for neovascular age-related macular degeneration (nAMD) after three initial loading doses. METHODS: A consecutive series of patients with nAMD, who, after three loading doses of intravitreal ranibizumab (0.5 mg each), were re-treated for fluid seen on optical coherence tomography. After exclusion of eyes with previous treatment, follow-up less than 12 months, or missed visits, 99 patients were included in the analysis. The influence of baseline characteristics, initial VA response, and central retinal thickness (CRT) fluctuations on the VA stability from month 3 to month 24 were analyzed using subgroups and multiple regression analyses. RESULTS: Mean follow-up duration was 21.3 months (range 12-40 months, 32 patients followed-up for ≥24 months). Secondary loss of VA (loss of five letters or more) after month 3 was seen in 30 patients (mean VA improvement from baseline +5.8 letters at month 3, mean loss from baseline -5.3 letters at month 12 and -9.7 at final visit up to month 24), while 69 patients maintained vision (mean gain +8.9 letters at month 3, +10.4 letters at month 12, and +12.8 letters at final visit up to month 24). Secondary loss of VA was associated with the presence of pigment epithelial detachment (PED) at baseline (p 0.01), but not with baseline fibrosis/atrophy/hemorrhage, CRT fluctuations, or initial VA response. Chart analysis revealed additional individual explanations for the secondary loss of VA, including retinal pigment epithelial tears, progressive fibrosis, and atrophy. CONCLUSIONS: Tissue damage due to degeneration of PED, retinal pigment epithelial tears, progressive fibrosis, progressive atrophy, or massive hemorrhage, appears to be relevant in causing secondary loss of VA despite vascular endothelial growth factor suppression. PED at baseline may represent a risk factor.

Selective integration of auditory-visual looming cues by humans.

An object's motion relative to an observer can confer ethologically meaningful information. Approaching or looming stimuli can signal threats/collisions to be avoided or prey to be confronted, whereas receding stimuli can signal successful escape or failed pursuit. Using movement detection and subjective ratings, we investigated the multisensory integration of looming and receding auditory and visual information by humans. While prior research has demonstrated a perceptual bias for unisensory and more recently multisensory looming stimuli, none has investigated whether there is integration of looming signals between modalities. Our findings reveal selective integration of multisensory looming stimuli. Performance was significantly enhanced for looming stimuli over all other multisensory conditions. Contrasts with static multisensory conditions indicate that only multisensory looming stimuli resulted in facilitation beyond that induced by the sheer presence of auditory-visual stimuli. Controlling for variation in physical energy replicated the advantage for multisensory looming stimuli. Finally, only looming stimuli exhibited a negative linear relationship between enhancement indices for detection speed and for subjective ratings. Maximal detection speed was attained when motion perception was already robust under unisensory conditions. The preferential integration of multisensory looming stimuli highlights that complex ethologically salient stimuli likely require synergistic cooperation between existing principles of multisensory integration. A new conceptualization of the neurophysiologic mechanisms mediating real-world multisensory perceptions and action is therefore supported.

Bilateral sequential nonarteritic anterior ischemic optic neuropathy: a comparison of visual outcomes in fellow eyes using quantitative analysis of goldmann visual fields.

OBJECTIVE To better define the concordance of visual loss in patients with nonarteritic anterior ischemic optic neuropathy (NAION). METHODS The medical records of 86 patients with bilateral sequential NAION were reviewed retrospectively, and visual function was assessed using visual acuity, Goldmann visual fields, color vision, and relative afferent papillary defect. A quantitative total visual field score and score per quadrant were analyzed for each eye using the numerical Goldmann visual field scoring method. RESULTS Outcome measures were visual acuity, visual field, color vision, and relative afferent papillary defect. A statistically significant correlation was found between fellow eyes for multiple parameters, including logMAR visual acuity (P = .01), global visual field (P < .001), superior visual field (P < .001), and inferior visual field (P < .001). The mean deviation of total (P < .001) and pattern (P < .001) deviation analyses was significantly less between fellow eyes than between first and second eyes of different patients. CONCLUSIONS Visual function between fellow eyes showed a fair to moderate correlation that was statistically significant. The pattern of vision loss was also more similar in fellow eyes than between eyes of different patients. These results may help allow better prediction of visual outcome for the second eye in patients with NAION.

Décrire et convaincre: rhétoriques visuelles de la cinématographie en médecine [Describe and convince: visual rhetoric of cinematography in medicine]

The tools of visualisation occupy a central place in medicine. Far from being simple accessories of glance, they literally constitute objects of medicine. Such empirical acknowledgement and epistemological position open a vast field of investigation: visual technologies of medical knowledge. This article studies the development and transformation of medical objects which have permitted to assess the role of temporality in the epistemology of medicine. It firstly examines the general problem of the relationships between cinema, animated image and medicine and secondly, the contribution of the German doctor Martin Weiser to medical cinematography as a method. Finally, a typology is sketched out organising the variety of the visual technology of movement under the perspective of the development of specific visual techniques in medicine.