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Esophagogastroduodenoscopy is important for the detection of curable gastric cancer (GC). However, there are no appropriate surveillance data during routine endoscopic inspections. This study aimed to clarify the risk factors of pT1b- or deeper-GC detection during surveillance endoscopy.This was a retrospective, multicenter, cross-sectional study conducted in 15 Japanese hospitals. We retrospectively analyzed patients with GC who had previously undergone surveillance endoscopy at each institution from January 2014 to March 2020. Patients who had undergone gastrectomy, non-infection of Helicobacter pylori (Hp), and those with intervals 3 months or10 years from a previous endoscopy were excluded.In total, 1085 patients with GCs detected during surveillance endoscopy were enrolled. The multivariate logistic analysis revealed that current Hp infection (odds ratio [OR], 2.18; 95% confidence interval [CI] 1.50-3.16) and a surveillance interval of1.5 years (OR, 1.96; 95% CI, 1.35-2.84) were independent risk factors for pT1b- or deeper-GC. The 5-year disease-specific survival (5y-DSS) rate of GC was significantly lower in patients with surveillance interval of1.5 years than in those with surveillance interval of ≤1.5 years (93.7% vs. 98.3%, P0.001). Similarly, the 5y-DSS rate of GC was significantly lower in patients with active Hp infection than in those without (93.7% vs. 99.4%, P0.001).In this study, a surveillance interval of1.5 years and current Hp infection were independent risk factors for detecting pT1b- or deeper-GC. Additionally, these factors were poor prognostic factors of the detected GC during surveillance endoscopy.

AJM300 is an oral, small-molecule α4-integrin antagonist. We assessed the efficacy and safety of AJM300 in patients with moderately active ulcerative colitis.This multicentre, randomised, double-blind, placebo-controlled, phase 3 study consisted of two phases: a treatment phase and an open-label re-treatment phase. The study was done at 82 hospitals and clinics in Japan. Patients with a Mayo Clinic score of 6-10, endoscopic subscore of 2 or more, rectal bleeding subscore of 1 or more, and an inadequate response or intolerance to mesalazine were enrolled. Patients were randomly allocated (1:1) via a website to either AJM300 (960 mg) or placebo by the minimisation method, which was adjusted centrally by dynamic assignment against the Mayo Clinic score (≥6 to ≤7, ≥8 to ≤10 points), any use of corticosteroid, anti-TNFα antibody, or immunosuppressants during the disease-active period (yes vs no), duration of induction therapy until randomisation (4 weeks vs ≥4 weeks) as the minimisation factors. Patients, investigators, site staff, assessors, and the sponsor were masked to treatment assignments. The study drug was administered orally, three times daily, for 8 weeks, and continued for up to 24 weeks if endoscopic remission was not achieved or rectal bleeding did not stop. The primary endpoint was the proportion of patients with a clinical response at week 8, and was analysed in the full analysis set. Clinical response was defined as a reduction in Mayo Clinic score of 30% or more and 3 or more, a reduction in rectal bleeding score of 1 or more or rectal bleeding subscore of 1 or less, and an endoscopic subscore of 1 or less at week 8. The study is registered with ClinicalTrials.gov, NCT03531892, and is closed to recruitment.Between June 6, 2018, and July 22, 2020, 203 patients were randomly assigned to AJM300 (n=102) or placebo (n=101). At week 8, 46 (45%) patients in the AJM300 group and 21 (21%) patients in the placebo group had a clinical response (odds ratio 3·30, 95% CI 1·73-6·29; p=0·00028). During the 8-week treatment and 16-week extension treatment periods, adverse events occurred in 39 (39%) of 101 patients in the placebo group and 39 (38%) of 102 patients in the AJM300 group. We found no difference in the incidence of adverse events between groups or after repeated administration of AJM300. The most common adverse event was nasopharyngitis (11 [11%] of 101 patients in the placebo group and ten [10%] of 102 patients in the AJM300 group). The most common treatment-related adverse event was also nasopharyngitis (four [4%] of 101 patients in the placebo group and three [3%] of 102 patients in the AJM300 group). Most adverse events were mild-to-moderate in severity. No deaths were reported. A serious adverse event was reported in the AJM300 group (one patient with anal abscess), but this was judged to be unrelated to study drug.AJM300 was well tolerated and induced a clinical response in patients with moderately active ulcerative colitis who had an inadequate response or intolerance to mesalazine. AJM300 could be a novel induction therapy for the treatment of patients with moderately active ulcerative colitis.EA Pharma and Kissei Pharmaceutical.For the Japanese translation of the abstract see Supplementary Materials section.

Proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD) leads to a clinical decline in the quality of life (QOL). Therefore, new treatment options are needed. We performed a multicenter, randomized, parallel-group exploratory trial to determine the efficacy of hangeshashinto (HST) in patients with PPI-refractory GERD. We enrolled 78 patients with PPI-refractory GERD for standard PPI regimens for at least 4 weeks and randomly assigned patients to receive either a combination of usual dose of rabeprazole (10 mg/day) + HST (7.5 g/day; HST group) or a double dose of rabeprazole (20 mg/day; double-dose PPI group). The primary end points were the extent of improvement in FSSG (Frequency Scale for the Symptoms of GERD) score and the change over time in FSSG score. There was no significant difference in terms of the improvement degree of the FSSG score between the two groups. Although the total FSSG score and reflux syndrome score decreased significantly for both groups over time (p

Background Granulocyte and monocyte adsorptive apheresis (GMA) has been used for therapy of steroid-dependent/refractory ulcerative colitis (UC). The aim of this study was to investigate the effectiveness of GMA in UC patients not receiving steroids. Methods We conducted a single-arm, open-label, and multicenter prospective clinical trial. UC patients who had insufficient responses to 5-aminosalicylic acid received GMA twice a week for 5 weeks. Results The response rate of all patients was 58.2% (39/67). Of the 39 patients who achieved a response, 74.4% achieved endoscopically confirmed mucosal healing. Conclusions GMA shows effectiveness in inducing remission in UC patients not receiving steroid., Lay Summary EXPECT study demonstrates that granulocyte and monocyte adsorptive apheresis has promising effectiveness with regard to inducing remission in patients with active ulcerative colitis (UC) who are not receiving steroid treatment. The first episode of UC was an independent predictor of a response in multiple logistic regression.

Background: During the COVID-19 pandemic, safe treatment of inflammatory bowel disease is required. Granulocyte and monocyte adsorptive apheresis (GMA) has been used for therapy of steroid-dependent/refractory ulcerative colitis (UC) with few adverse events. Therefore, elucidating the effectiveness of GMA without steroids is important in the current situation. The aim of this study was to investigate the effectiveness of GMA in active UC patients who are not receiving steroids. Methods: A single-arm, open-label, and multicenter prospective clinical trial was conducted at ten facilities in Japan.UC patients who had insufficient responses to 5-aminosalicylic acid without steroids received GMA twice a week for five consecutive weeks. The primary and secondary endpoints were the induction of a response and endoscopic mucosal healing in the patients who achieved a response. Findings: A total of 67 patients were enrolled. The response rate of all patients who received GMA ten times was 58·2%. Of the 39 patients who achieved a response, 74·4% achieved endoscopically confirmed mucosal healing. Both the median Mayo score and ulcerative colitis endoscopic index of severity score were significantly decreased in the patients who achieved a response. The response rate of the patients who were suffering from their first episode was significantly higher than that of those with relapse-remitting UC (80·0% [16/20] vs. 48·9% [23/47], p=0·029). Undergoing the first episode of UC (odds ratio [OR]: 4·952, 95% confidence interval [CI]: 1·292-18·981, p>0.001) was defined as an independent predictor of a response. Interpretation: This study strongly suggest that GMA shows promising effectiveness in inducing remission in active UC patients who are not receiving steroid treatment. We expect that GMA can be made available during the COVID-19 pandemic. Trial Registration: UMIN registration No. 000013702 Funding Statement: Health and Labor Sciences Research Grants from the Ministry of Health, Labor and Welfare of Japan (Investigation and Research for intractable Inflammatory Bowel Disease to HN). Declaration of Interests: MM reports personal fees from Janssen Pharmaceutical K.K., and commercial research funding from AbbVie GK. and Nippon Kayaku Co., Ltd. SN reports receiving personal fees from EA Pharma Co., Ltd., AbbVie GK., Mitsubishi Tanabe Pharma Corporation, Janssen Pharmaceutical K.K., Mochida Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd. KH reports receiving research funding from EA Pharma Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Co., Ltd. HN reports receiving personal fees from AbbVie GK., Kissei Pharmaceutical Co., Ltd., Kyorin Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Janssen Pharmaceutical K.K., Takeda Pharmaceutical Co., Ltd., Pfizer Lnc., Cell gene Corporation., EA Pharma Co., Ltd., Zeria Pharmaceutical CO., Ltd., Mochida Pharmaceutical Co., Ltd., Nippon Kayaku Co., Ltd., Daiichi Sankyo Company, Limited., JIMRO Co., Ltd., as well as grants for commissioned/joint research from Hoya Group Pentax Medical, Boehringer Ingelheim GmbH, Bristol-Myers Squibb Company. All other authors declare no competing interests. Ethics Approval Statement: The protocol of the clinical trial was approved by the IRB at each institution. Informed consent to participate in the study was obtained from each participant before inclusion.

Background and Aims: MicroRNA (miRNA) are endogenous, approximately 22-nucleotide non-coding RNA that suppress gene expression at post-transcriptional levels by binding to the 3′-untranslated region of specific mRNA targets through base-pairing. It has been recently reported that miRNA have critical functions in key biological processes such as cell proliferation and cell death in various cancer cells. However, the relationship between intestinal inflammation and miRNA expression remains unclear. In the present study, we used microarray technology to identify miRNA induced in the colonic mucosa of patients with active ulcerative colitis (UC). Methods: Two colonic biopsy specimens from patients with active stage (>Matts grade 2) of UC under colonoscopy and two colonic biopsy specimens from healthy volunteers were obtained for gene expression profiles. Total RNA was extracted, and miRNA expression profiles were investigated using miRNA Microarray. Subsequently, to confirm the result of the Microarray investigation, we checked the expression of several selected miRNA using real-time polymerase chain reaction (PCR) in 12 colonic biopsy specimens from patients with active UC under colonoscopy and 12 specimens from the healthy volunteers. Results: In the microarray study, the expression of several miRNA was upregulated in the colonic mucosa of patients with active UC. Furthermore, two miRNA (miR-21, miR-155) were selected in the study using real-time PCR. Conclusion: Upregulated miRNA may be responsible for the development of intestinal inflammation in UC.

The purpose of this paper is to propose a new approach to obstacles detection using a single camera mounted on a vehicle when the vehicle is backing or turning round at an intersection at a low speed. Using equations among feature point locations and optical flows in geometrically transferred top-view images, ground-movement information can be estimated. We compensate for the ground-movement between consecutive top-view images using the estimated ground-movement information and compute the difference image using the compensated previous top-view image and the current top-view image. Finally, obstacle regions on top-view image can be easily extracted using the difference image. The proposed approach is demonstrated to be effective by evaluation images captured by an in-vehicle camera

We describe a practical and precise calibration method for generating a top view image that is transformed so that a planar object such as the road can be observed from a direction perpendicular to its surface. The geometric relation between the input and output images is described by a 3×3 homography matrix. Conventional methods use large planar calibration patterns to achieve precise transformations. The proposed method uses much smaller element patterns that are placed in arbitrary positions within the view of the camera. One of the patterns is used to obtain an initial homography. Then, the information from all of the patterns is used by a non-linear optimization scheme to reach a global optimum homography. The experiment done to evaluate the method showed that the precision of the proposed method is comparable to that of the conventional method where a large calibration pattern is used, making it more practical for automotive applications.

We studied the relationship between purchasing behavior and physiological measurement using an eye camera, including the correlation of physiological measurement based on an analysis of eye movement data at the behavioral level (close to intention) using conjoint analysis and with the attitude level using the analytic hierarchy process. Results showed poor correlation between data on eye movement, i.e., physiological reaction to stimulus, and the attitude level but a fairly good correlation between data on eye movement and the behavioral level.

We propose a high speed iris detection method for man-machine interface. In order to communicate between humans and computers comfortably, it is required that high speed processing and adapting the changes of the face direction and the individual variation of the face. Our iris detection method consists of a face detection function, a facial parts extraction function and an iris detection function. The face detection function adapts to individual variation or a light condition by using standard skin color method which decides the standard skin color by a color histogram every frame. The facial parts extraction function adapts to changes of face direction and the individual variation in order to by using the hybrid template matching which consists the four directional features field and the color different features. The iris detection function performs high speed and stable detection by segmentation of iris region using color information and the Hough transform. We conducted the comparison experiment with our past method which uses the least approximation method. By this result, processing time of our method realized equivalent to our past method. In addition, accuracy rate of iris detection with our method improved.

To track and recognize the movements of multiple people using multiple cameras, each person needs to be segmented and identified in the image of each camera We describe a method that tracks multiple people and identifies their body parts in multiple camera images Estimating the positions of people and identifying the multiple cameras are mainly based on the silhouette method combining the background and frame subtraction Our method was improved by using the existence probability map on noise problems The existence probability map consists of the position probability and height cumulus maps. A gesture event is detected by comparing the human and motion blocks that are extracted from the voting space using the silhouette method We demonstrate experimental results and the validity of our method

We propose the use of an adaptive discriminant space constructed from facial images of candidate faces to optimally distinguish the faces of certain candidates. Firstly, our method to select the set of candidates uses a hierarchical combination of the four-directional features for face-direction estimation and recognition based on linear discriminant analysis. Next, the exact directions of the faces are estimated from the respective discriminant spaces for face-direction estimation. Finally, our method creates a new discriminant space from the facial images of candidates that were selected on the basis of the results of the procedure for face-direction estimation. This adaptive discriminant space is used in opimally selecting from among the candidates. Experiments showed that our method improved the accuracy in recognition by 1.6% to 99.2% by hierarchical face recognition of 105, 000 images from 150 subjects facing in 35 different directions.

We propose a method to detect face regions by using the standard skin color which is taken from an image in a color histogram. Extraction of the face regions is based on an area in motion and the deviation from the standard skin color obtained by discriminant analysis. The standard skin color is updated from information obtained from the detected face region. To judge a face, we use templates composed of directional features and color features to detect eyes and mouth. In the face detection experiment, our algorithm could detect a face region by using motion of a subject's head. In addition, the updated standard skin color was correct. In the facial parts detection experiment, by updating the templates, our method worked better than the method that used only directional features. Consequently, our algorithm can extract the facial features even when a person tilts his or her head. With a SGI/O 2 workstation, it is possible to achieve a speed of approximately 0.25 sec/frame.

To clarify the human mechanism that controls the relation between information processing and eye movements, we propose a fixation masking method that detects fixations and masks only those fixations. This paper describes how we examined the time required to obtain information on Japanese characters as well as the quantity of information acquired at each fixation point. Subjects were instructed to recognize incorrect characters from text they read. The results indicated that at least 67 ms were required to obtain visual information after viewing the stimulus. However, the masking affected the character recognition process in brain. From the distribution of fixation duration, approximately 130 ms were required to invoke the saccade once the subject had perceived the mask. Our results were different from Rayner's results. We assume that more complex information processing is required to read Japanese than to read English.

MicroRNA (miRNA) are endogenous, approximately 22-nucleotide non-coding RNA that suppress gene expression at post-transcriptional levels by binding to the 3'-untranslated region of specific mRNA targets through base-pairing. It has been recently reported that miRNA have critical functions in key biological processes such as cell proliferation and cell death in various cancer cells. However, the relationship between intestinal inflammation and miRNA expression remains unclear. In the present study, we used microarray technology to identify miRNA induced in the colonic mucosa of patients with active ulcerative colitis (UC).Two colonic biopsy specimens from patients with active stage (Matts grade 2) of UC under colonoscopy and two colonic biopsy specimens from healthy volunteers were obtained for gene expression profiles. Total RNA was extracted, and miRNA expression profiles were investigated using miRNA Microarray. Subsequently, to confirm the result of the Microarray investigation, we checked the expression of several selected miRNA using real-time polymerase chain reaction (PCR) in 12 colonic biopsy specimens from patients with active UC under colonoscopy and 12 specimens from the healthy volunteers.In the microarray study, the expression of several miRNA was upregulated in the colonic mucosa of patients with active UC. Furthermore, two miRNA (miR-21, miR-155) were selected in the study using real-time PCR.Upregulated miRNA may be responsible for the development of intestinal inflammation in UC.

This paper describes a practical calibration method to generate a top view image from an image of a rear view camera for automobile. The geometric relation between the input and output images is described by a 3 x 3 homography matrix. Conventional methods have to use a large planar pattern to achieve precise calibration. The proposed method uses much smaller patterns, and enables to place those patterns on arbitrary positions within the view of the camera. The experimental results show that the method has equivalent calibration precision with much easier setting than the conventional methods.

Omeprazole is mainly metabolized in the liver by CYP2C19, a genetically determined enzyme, while rabeprazole is mainly nonenzymatically degraded with a minor involvement by CYP2C19. We investigated the gastric ulcer healing effect of omeprazole versus rabeprazole evaluated endoscopically with reference to the different CYP2C19 genotypes. Eighty patients with active gastric ulcer were treated with a daily dose of 20 mg of omeprazole or 10 mg of rabeprazole. The endoscopic evaluation was performed at the baseline and 2- and 8-week posttreatment periods. The endoscopic improvement of gastric ulcer size and ulcer healing rates using a thin rubber disc with a diameter of 6 mm, were evaluated in relation to the CYP2C19 genotypic status. The mean 2-week posttreatment ulcer size value by rabeprazole did not significantly differ among the different CYP2C19 genotypes, whereas the mean value in the homozygous extensive metabolizer patients treated with omeprazole was significantly (P = 0.0057) greater than in those with rabeprazole. However, after the 8-week treatment, omeprazole and rabeprazole showed the similarly high healing rates of 87.8% (31/37) and 88.9% (32/36), respectively. Although both omeprazole and rabeprazole showed a high healing rate of gastric ulcer after the 8-week treatment period, the healing effect of rabeprazole appears to be relatively independent of the CYP2C19 status, resulting in an earlier repair of gastric mucosal damage evaluated endoscopically compared to that of omeprazole.

A 75-year-old man was admitted to our hospital complaining of gastric fatigue. Endoscope and CT scan revealed type 3 gastric cancer with paraaortic lymph nodal metastasis. Histological examination of the endoscopic biopsy revealed poorly differentiated adenocarcinoma. A blood examination and bone marrow biopsy revealed DIC causing bone marrow carcinosis. Chemotherapy with sequential therapy consisting of MTX and 5-FU was performed. Stretch of the fold and flatness of the ulcer were obtained against the gastric primary lesion observed endoscopically. Complete response was obtained against the lymph node around the abdominal aorta. Reduction of low back pain and DIC were observed. He was thus able to be discharged and sequential therapy was performed again over 2 months in outpatient care.

Recently, gender estimation from face images has been studied for frontal facial images. However, it is difficult to obtain such facial images constantly in the case of application systems for security, surveillance and marketing research. In order to build such systems, a method is required to estimate gender from the image of various facial poses. In this paper, three different classifiers are compared in appearance-based gender estimation, which use four directional features (FDF). The classifiers are linear discriminant analysis (LDA), Support Vector Machines (SVMs) and Sparse Network of Winnows (SNoW). Face images used for experiments were obtained from 35 viewpoints. The direction of viewpoints varied ±45 degrees horizontally, ±30 degrees vertically at 15 degree intervals respectively. Although LDA showed the best performance for frontal facial images, SVM with Gaussian kernel was found the best performance (86.0%) for the facial images of 35 viewpoints. It is considered that SVM with Gaussian kernel is robust to changes in viewpoint when estimating gender from these results. Furthermore, the estimation rate was quite close to the average estimation rate at 35 viewpoints respectively. It is supposed that the methods are reasonable to estimate gender within the range of experimented viewpoints by learning face images from multiple directions by one class.

A facial parts detection technique that is robust for face poses is described. The initial probability is obtained by template matching of the four directional features. Positions of facial parts are detected by relaxation matching using the spring connection of each facial part. The relaxation method has a problem that requires much computation time. We propose a high-speed relaxation technique for facial parts detection. Experiments show that facial parts are detectable to the multi-directional face image database.

We propose a multi-camera system that can track multiple human faces and hands as well as focus on them for face and hand-sign recognition. Our current system consists of four video cameras. Two cameras are fixed and used as a stereo camera to estimate position. The stereo camera detects faces and hands using a standard skin color method we proposed. The distances of targets are then estimated. To track multiple targets, we evaluated position and size of targets in consecutive frames. The other two cameras perform target tracking. Our system selects a target for recognition by using size and motion information sequentially. If size of the selected target is too small for recognition, tracking cameras acquire its zoomed image. Using our system, we experimented on multiple target tracking.

This paper proposes a method for estimating continuous face directions with the discrete face direction feature classes. The feature classes are composed by the linear discriminant analysis of the "four directional features" that are extracted from some people's faces looking in specified directions. Estimation by a single camera gives ambiguous results for non-frontal view of faces. Especially, it is impossible from the back of the face. However, integrating the information from the multiple cameras allows more precise face direction estimation. Experiments show that our proposed method can achieve a mean error of at most 8° and a variance of 22.4 for all face directions.

The importance of pancreatic enzymes, particularly phospholipase A2 (PLA2), for bacterial translocation, which is considered to be one of the aggravating causes of acute pancreatitis, was investigated. Male rats were administered an intraperitoneal or intravenous injection of normal saline, PLA2, or amylase. Four days later, the mesenteric lymph nodes (MLNs) and portal blood of the animals were cultured. None of the animals had a positive portal blood culture. The MLNs contained enteric bacteria in 78% of the animals given 50 mg/kg of PLA2 intraperitoneally. 5 mg/kg of PLA2 intraperitoneally, 50 mg/kg of amylase intraperitoneally, or 50 mg/kg of PLA2 intravenously showed positive cultures in 25%, 20%, and 11%, respectively. None of the animals given intraperitoneal or intravenous normal saline had positive cultures of their MLNs. Intraperitoneal injection of 25 mg/kg of nafamostat mesilate just before intraperitoneal PLA2 (50 mg/kg) resulted in a reduction of positive MLNs from 70% to 30%. The cecal myeroperoxidase (MPO) activity of animals administered 50 mg/kg of PLA2 intraperitoneally was significantly higher compared with animals administered saline intraperitoneally. These results indicate that intraperitoneal leakage of PLA2 plays an important role in bacterial translocation during acute pancreatitis and that administration of a protease inhibitor may be effective against the bacterial translocation.