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In this study, we report a case of a patient on dialysis who presented necrotic lesions on the legs and penile ulceration 7 years after a mechanical aortic valve replacement. The diagnosis of calciphylaxis was not confirmed even after skin biopsy, and multidisciplinary management was not initiated until the patient was admitted with septic shock. Cardiovascular surgeons should be aware of warfarin-induced calciphylaxis, whose pathophysiology differs from that of atherosclerosis. Considering poor long-term survival of dialysis patients, mechanical valves should be reserved only for those patients whose estimated survival is longer than the time taken for a biological valve to deteriorate. more...

Background. Optimal treatment practices and factors associated with in-hospital mortality in spontaneous pneumothorax (SP) are not fully understood. We evaluated prevalence, clinical characteristics, and in-hospital mortality among Japanese patients with primary or secondary SP (PSP/SSP).Methods. We retrospectively reviewed and stratified 938 instances of pneumothorax in 751 consecutive patients diagnosed with SP into the PSP and SSP groups. Factors associated with in-hospital mortality in SSP were identified by multiple logistic regression analysis.Results. In the SSP group (n=327; 34.9%), patient age, requirement for emergency transport, and length of stay were greater (all,p<0.001), while the prevalence of smoking (p=0.023) and number of surgical interventions (p<0.001) were lower compared to those in the PSP group (n=611; 65.1%). Among the 16 in-hospital deceased patients, 12 (75.0%) received emergency transportation and 10 (62.5%) exhibited performance status (PS) of 3-4. In the SSP group, emergency transportation was an independent factor for in-hospital mortality (odds ratio 16.37; 95% confidence interval, 4.85–55.20;p<0.001).Conclusions. The prevalence and clinical characteristics of PSP and SSP differ considerably. Patients with SSP receiving emergency transportation should receive careful attention. more...

This paper describes the detection of faces in complex backgrounds where their sizes, positions and directions are arbitrary. We detect the faces by, extracting face components such as eyes, a mouth and so on. We first extract face features and then calculate their likelihoods as each face component. Second we detect the face features which satisfy, geometrical relations of the face. In order to reduce the number of combinations of all labels for all features, we determine face candidate regions using generalized Hough transform and then apply, a relaxation method to each candidate region. more...

This paper describes the detection of faces and the estimation of the face direction from an image where their sizes, positions and poses are unknown. As the candidate regions of the face, we first extract the regions whose upper part is hair color and lower part is skin color. To make sure that there is a face actually in the face candidate region, we next extract facial features, pupils, a nostril and a mouth, using color, shape and the geometrical conditions of the facial features. After the face detection, the face direction is estimated on the basis of the position of the pupils and face contour. We show the effectiveness of this method by experimental results. more...