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Robust and automated image segmentation in high-throughput image-based plant phenotyping has received considerable attention in the last decade. The possibility of this approach has not been well studied due to the time-consuming manual segmentation and lack of appropriate datasets. Segmenting images of greenhouse and open-field grown crops from the background is a challenging task linked to various factors such as complex background (presence of humans, equipment, devices, and machinery for crop management practices), environmental conditions (humidity, cloudy/sunny, fog, rain), occlusion, low-contrast and variability in crops and pose over time. This paper presents a new ubiquitous deep learning architecture ThelR547v1 (Thermal RGB 547 layers version 1) that segmented each pixel as crop or crop canopy from the background (non-crop) in real time by abstracting multi-scale contextual information with reduced memory cost. By evaluating over 37,328 augmented images (aug1: thermal RGB and RGB), our method achieves mean IoU of 0.94 and 0.87 for leaves and background and mean Bf scores of 0.93 and 0.86, respectively. ThelR547v1 has a training accuracy of 96.27%, a training loss of 0.09, a validation accuracy of 96.15%, and a validation loss of 0.10. Qualitative analysis further shows that despite the low resolution of training data, ThelR547v1 successfully distinguishes leaf/canopy pixels from complex and noisy background pixels, enabling it to be used for real-time semantic segmentation of horticultural crops.

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Massive intrapulmonary haemorrhage and haemothorax are uncommon presentations associated with pulmonary sequestration. Here, we describe the case of a 40-year-old man who suffered from high fever and haemoptysis for 1 week before he was admitted to our hospital with a complaint of chest discomfort with shock. Computed tomography revealed that pulmonary sequestration supplied from the coeliac artery with persistent bleeding. The patient underwent right lower lobectomy and an emergent laparotomy for ligation of the aberrant artery. A pulmonary sequestration has a severe complication resulting in shock due to intrapulmonary haemorrhage and haemothorax. Accordingly, early resection of a sequestered lung should be the choice of the treatment in these cases.

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A 79-year-old male whose chest X-ray revealed a localized reticular shadow in health check was once treated medically with a diagnosis of interstitial pneumonia. Regardless of the treatment, the shadow increased in its size. Positron emission tomography (PET)-computed tomography(CT) was suggestive of a primary lung cancer in clinical stage IIIA. CA19-9 and CEA were 3,568.5 U/ml and 178.2 ng/ml respectively, and a left lower lobectomy was performed. The postoperative course was uneventful. Both tumor markers declined shortly after the surgery. But they increased in 8 months after the surgery associated with tumor recurrence. In spite of chemotherapy, the patient was expired 15 months following the surgery. Immunohistochemical staining showed the tumor was a well differentiated adenocarcinoma with positive findings of both CEA and CA19-9.

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We report a case of complete remission after treatment with tegafur-uracil (UFT)/Leucovorin (LV) therapy for pulumonary metastasis of rectal cancer. A 56-year-old male was admitted to our hospital with a diagnosis of rectal cancer (Ra, type2). Chest CT on admission demonstrated bilateral lung metastases (rt S2 and lt S4). After anterior resection of the primary tumor, oral UFT/LV was administered (UFT 400 mg/LV 75 mg, 4-week administration and 1-week no-administration period) on an outpatient basis. After 2 courses, chest CT revealed reduction of both metastases, and complete resection of the metastases by video assisted thoracic surgery (VATS) was planned. Pathological findings of a specimen revealed no residual cancer cells, indicating a complete response to UFT/LV therapy. After these treatments, combined therapy of UFT/LV was continued for 3 months, and the single administration of UFT was continued for 1 year. The patient experienced no adverse reactions, and has had no recurrent disease in 4 years. Oral UFT/LV therapy is considered to be a promising regimen for patients with resectable metastatic lesion from a standpoint of clinical efficacy and safety.

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A case of combined germ cell tumor and adenocarcinoma that arose in the colon of a 62-year-old man is described. The clinical and pathological findings are presented. The patient had widespread metastases at diagnosis and poor prognosis after operation (right hemicolectomy) was performed in spite of receiving chemotherapy. Pathologically, the germ cell tumor was composed of a yolk sac tumor and choriocarcinoma. Further, all the metastatic lesions showed a germ cell phenotype. An extragonadal germ cell tumor is extremely rare. To our knowledge, only a few cases have been reported in the English-language literature. Our present report will contribute to the understanding of the characteristics of this rare neoplasm.

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PURPOSE: Four-dimensional (4D) radiotherapy, in particular respiration gating for the treatment of lung tumors, is gaining popularity. Its utility for other sites, however, has not been investigated fully. The purpose of this study was to see whether 4D therapy is feasible for liver tumors. MATERIAL AND METHODS: Six patients (five with hepatomas and one with metastatic liver tumor) had a fiducial, gold marker 1.5 mm in diameter implanted in the vicinity of their liver tumors. The inner and external (i.e., upper abdominal wall) respiratory movements were simultaneously recorded using a real-time tumor-tracking radiotherapy system and respiration monitor equipment applied to the mid to upper abdomen. RESULTS: The fluctuations from the baseline position of liver tumors were small; the mean absolute value was 3.92 +/- 1.94 mm. The mean right-left, anteroposterior, and craniocaudal total movements were 4.19 +/- 2.46, 7.23 +/- 2.96, and 15.98 +/- 6.02 mm, respectively. The phase shift was negligible. CONCLUSION: Liver tumors may be suitable for respiration-gated radiotherapy, and they may become curable with 4D radiotherapy.

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PURPOSE: For optimal respiratory-gated radiotherapy, exhale fluctuation was assessed by monitoring internal fiducials in a synchronized internal/external marker detection system. METHODS: Synchronized internal/external position data were collected during the entire course of treatments for 12 lung patients with 24 fiducials. Baseline was determined in the exhale phase during pre-treatment observation time, and a gating level of external waves was set in each treatment session in a simulation of respiratory-gated radiotherapy. Patients were treated under a real-time tumor-tracking (RTRT) system with an external (abdominal) respiratory motion detector. In the simulation, external gating windows were defined as those below the 30% amplitude level (i.e., imaginary beams would be triggered when part of the respiratory wave falls into this window). Exhale fluctuation (EF) was defined as the phenomenon in which the lowest point of the external wave crossed downward past the pre-determined baseline. Gating efficiency (GE) was defined as the ratio between the amount of gate-ON time and the total treatment time. RESULTS: EF occurred in 18.4% of total measurements. EF varied depending on the patient, fiducial sites, and treatment session. The mean incidence of EF for each patient varied from 2.9% to 37.5% (18.4+/-9.9). The EF magnitude was 0.2-12.2 mm in the left-right direction, 0.7-12.7 mm in the cranio-caudal direction, and 0.4-9.7 mm in the anterior-posterior direction. Total fiducial movement was 0.5-28.7 mm. GE was 36.1-69.2% (55.4+/-11.0). EF magnitude correlated with total fiducial movement. CONCLUSION: This study showed that EF is not a rare phenomenon and needs to be taken into consideration for individualized precise 4D radiotherapy.

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BACKGROUND: Obturator hernia is a relatively rare pelvic hernia and usually occurs in elderly, thin, multiparous women. Because symptoms are nonspecific, the diagnosis is often delayed until laparotomy is performed form to treat bowel obstruction. METHODS: Forty-three patients with obturator hernia undergoing surgery at Tokyo Metropolitan Geriatric Hospital were divided retrospectively into two groups (group A = 23 patients from 1968 to 1986 before computed axial tomography [CAT] was developed; group B = 20 patients from 1987 to 1999 after CAT). Preoperative diagnosis, operative procedures, and postoperative course were reviewed and compared between the 2 groups. RESULTS: Preoperative diagnostic accuracy was significantly higher in group B at 80.0% (16 of 20 patients) than in group A at 43.5% (10 of 23 patients) (P = 0.0146). Rate of gut resection and mortality were significantly lower in group B at 25.0% (4 of 20) and 5.0% (1 of 20) than in group A at 52.2% (12 and 23) and 30.4% (7 of 23) (P = 0.0295 and P = 0.0385, respectively). CONCLUSIONS: The use of pelvic CAT in cases of suspected obturator hernia significantly enhances preoperative diagnostic accuracy and helps to decrease both intestinal resection rate and surgical mortality.

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We report a rare case of familial urachal disease associated with a congenital malformation. A 34-year-old woman was referred to our hospital with recurrent umbilical purulent discharge. She had undergone partial resection of the small intestine for obstruction and, later, a pyeloplasty for a stricture of the ureter-pyelo junction. Her younger brother had also undergone surgery for a urachal sinus 1 year earlier. She was found to have an umbilical granuloma with a fistulous track that could be probed for 3 cm distally. Computed tomography (CT) and ultrasonography confirmed the fistulous track. Under a diagnosis of urachal sinus, a urachal remnant was excised. Histological analysis of the excised specimen revealed only inflammatory granulomatous tissue with marked infiltration of lymphocytes and foreign body giant cells. Urachal cysts are associated with a risk of intestinal strangulation and therefore, the finding of urachal disease justifies detailed evaluation.

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We performed hepatic arterial infusion (HAI) chemotherapy for 4 patients with advanced gastric cancer who had undergone curative resection except for liver metastasis. The main antineoplastic drugs were 5-fluorouracil (5-FU), mitomycin C (MMC) and cisplatin (CDDP). A catheter was inserted into the hepatic artery by interventional radiological techniques in 3 patients and operatively in 1 patient. The response rate for 4 patients was 75% (CR2, PR1, PD1). The adverse events were Grade 3/4 nausea and/or vomiting in 2 cases. The HAI chemotherapy was effective and useful for patients with advanced gastric cancer who had no unresectable lesions except for liver metastasis.

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Telomerase is known to be activated and telomere length altered in various types of malignant and benign tumors, but whether this is also the case for parathyroid lesions has hitherto been unclear. We therefore investigated telomerase activity and telomere length in 3 parathyroid metastatic cancers, 6 adenomas, 2 cases of parathyroid hyperplasia, and 16 samples of normal parathyroid tissue. Telomerase activity, assayed by the telomeric repeat amplification protocol, was detected in all of the parathyroid cancers (100%), in none of the 8 parathyroid benign lesions, and in only 1 of the 16 normal parathyroid samples (8.3%). Telomere length, determined by the terminal restriction fragment assay, was reduced in the tumor tissues with a mean telomere length of 8.23 +/- 0.86 kbp compared with the 12.61 +/- 0.81 kbp for the 16 age-matched subjects (p = 0.002). The results indicate that telomerase activity and telomere length may reflect the biologic behavior of individual parathyroid lesions.

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BACKGROUND: [corrected] The distribution of angiogenin (ANG) in normal colorectal and colorectal cancer tissues has not been precisely elucidated, while studies on the clinical significance of ANG have been scanty at best. PATIENTS AND METHODS: We investigated the distribution of ANG and its gene message in 58 colorectal cancer and 58 corresponding normal colorectal tissue pairs by immunohistochemistry and in situ hybridization, the circulating ANG levels in sera by ELISA from 94 colorectal cancer patients and 52 healthy volunteers, as well as the clinical significance of ANG expression. RESULTS: Strong, moderate and weak ANG immunoreactivity of cancer cells was observed in 22, 31 and 5 patients, respectively. ANG immunoreactivity was also observed in interstitial cells in the vicinity of and at the invasion front of cancer cells, as well as in normal superficial epithelial cells and in some interstitial cells. The distribution of the ANG gene message was coherent with the ANG protein localization. The mean serum ANG concentration was significantly (p =0.00005) higher in cancer patients as compared with that in the healthy volunteers and the degree of its elevation was more significant in the more progressed cancer subgroups. The degrees of ANG protein and mRNA expression correlated with serum ANG concentration (p<0.05). Survival analyses revealed a significant correlation between higher serum ANG concentrations (> or = 400ng/ml) and worse disease-free (p=0.003) or disease-specific (p=0.03) survivals. CONCLUSION: These results suggest that ANG is expressed in colorectal cancer cells and in normal colorectal superficial cells as well as in interstitial cells and that serum levels of ANG reflect the degree of tissue ANG expression that could be a predictor of postoperative outcome.

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Progressive telomere shortening with aging was studied using normal thyroid tissue specimens from 46 human subjects aged between 0 and 98 yr and normal parathyroid tissue specimens from 21 human subjects aged between 0 and 83 yrs. There has hitherto been no information documented about telomere length in such thyroid and parathyroid tissues. Age-related shortening at rates of 91 and 92 base pairs (bp) per year, respectively, were observed. Telomere lengths of normal thyroid tissues were 16.53 +/- 1.10 (mean +/- SE), 14.31 +/- 0.80, 11.27 +/- 0.68 and 8.73 +/- 1.08 kbp for age groups less than 2, 20-50, 51-80 and more than 80 yr. Telomere lengths of normal parathyroid tissues were 15.80 +/- 1.46 (mean +/- SE), 15.36 +/- 0.86 and 10.93 +/- 0.78 kbp for age groups less than 4, 20-50 and 51-80 yr. Telomere shortening occurred after 50 yr of age in thyroid and parathyroid tissues. Human thyroid and parathyroid tissues do not seem to show the rapid reduction in telomere length early in life that was reported for some human cell types, suggesting that the rate of telomere shortening has tissue-specific characteristics.

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Telomerase activity is present in most malignant tumors and provides a mechanism for unlimited replication of neoplastic cells. Expression of the gene encoding human telomerase reverse transcriptase (hTERT), the telomerase catalytic subunit gene, is associated with telomerase activity, and it is overexpressed in most colorectal carcinomas. In the present study we assayed telomerase activity by the telomeric repeat amplification protocol (TRAP) and used in situ hybridization (ISH) and the reverse transcription polymerase chain reaction (RT-PCR) to study hTERT expression in colorectal carcinomas and adjacent normal tissues. Telomerase activity was found in 30/35 (85.7%) of normal mucosae and 35/35 (100%) of adenocarcinomas, and RT-PCR detected hTERT in 33/35 (94.3%) of the carcinomas. ISH, on the other hand, detected weak but significant expression of hTERT in a significant percentage of lymphocytes infiltrating normal colorectal mucosa. hTERT gene expression was detected in the nuclei of adenocarcinoma cells in 27/35 (77.1%) of the lesions. The results of our comparison of telomerase activity and hTERT gene expression by RT-PCR-based ISH appeared contradictory, but a careful review suggested that the discrepancy was attributable to contamination by infiltrating lymphocytes. Our findings suggest that ISH-based analysis of hTERT gene expression is superior to both TRAP telomerase activity and hTERT mRNA RT-PCR analysis as a means of determining telomerase status during carcinogenesis.

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