Language：Japanese   Publisher：(株)医学書院  

＜文献概要＞目的:渦静脈浸潤がみられたぶどう膜悪性黒色腫2症例の経過を報告する。症例1:67歳,女性。右眼内腫瘍の診断で当科を紹介され初診。右眼毛様体付近に腫瘍高12mm大の黒色腫瘤を認めた。ぶどう膜悪性黒色腫と診断し,初診から20日後に眼球摘出術を施行。病理診断はぶどう膜悪性黒色腫で,渦静脈浸潤がみられた。眼球摘出後7ヵ月で結膜下に局所再発を生じたため腫瘤のみを一塊にして摘出し,後療法としてインターフェロンβ(IFN-β)結膜下注射を施行した。眼球摘出後9ヵ月で肝転移が生じ,肝動脈化学塞栓療法および免疫チェックポイント阻害薬(ICI)による加療が行われたが,肝転移診断後7ヵ月で死亡した。症例2:69歳,女性。右眼内腫瘍の診断で当科を紹介され初診。右眼内に腫瘍高8.5mmの黒色腫瘤を認めた。ぶどう膜悪性黒色腫と診断し,初診から13日後に眼球摘出術を施行。術中所見で黒色に変色した渦静脈が認められた。病理診断はぶどう膜悪性黒色腫で,渦静脈として提出した検体にも腫瘍細胞が認められた。後療法としてIFN-β結膜下注射を施行した。眼球摘出後12ヵ月で多発肝転移を生じ,ICIによる加療が行われたが,肝転移診断後12ヵ月で死亡した。結論:ぶどう膜悪性黒色腫の渦静脈浸潤例は局所再発・肝転移の高リスク症例であり,後療法の確立が望まれる。

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Language：English   Publishing type：Research paper (scientific journal)  

Although eyelid reconstruction by transplanting an autologous free tarsoconjunctival graft (FTG) is a well-established technique, few studies have examined the postoperative course of FTG transplantation for East Asian eyelids, including those of Japanese patients. Therefore, this study investigated complication and reoperation rates after FTG transplantation in the reconstruction of East Asian (Japanese) eyelids. This study included 42 eyelids wherein posterior lobe reconstruction after resection of a malignant tumour of the eyelid was performed by FTG transplantation between 2007 and 2019 at Niigata University Medical and Dental Hospital. We investigated complications and need for revision surgery during the patients' postoperative courses. The relationship between postoperative complications, tumour diameter, and eyelid defect width was statistically examined. Of 42 cases reconstructed with FTG, the upper eyelid was reconstructed in 23. Postoperative complications were observed in 12 cases (52%): entropion in eight and corneal epithelial disorder in four. Revision surgery was required in three of those cases (13%). There were 19 cases of lower eyelid reconstruction. Postoperative complications were observed in seven cases (32%): ectropion in three and corneal epithelial disorder in two and one lower eyelid ptosis. Two of these cases (11%) required revision surgery. There was no statistically significant difference in tumour diameter between cases with and without postoperative complications. There was also no significant association between the width of the eyelid defect and the presence/absence of complications. Entropion and ectropion were more likely to occur in the upper and lower eyelids, respectively. For Japanese eyelids, complication rates after FTG transplantation were approximately 50% and 30% for the upper and lower eyelids, respectively. The revision surgery rate was approximately 10% for both upper and lower eyelids. As these revision surgery rates are low, FTG transplantation may be an option for the reconstruction of Japanese eyelids.

DOI： 10.1016/j.jpra.2022.04.003

PubMed

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Objective: This study aimed to examine the natural course and relapse rate of IgG4-related ophthalmic disease (IgG4-ROD) after debulking surgery in Japanese patients. Methods and analysis: This retrospective review included patients with IgG4-ROD who did not undergo further treatment following debulking surgery. The patients were diagnosed between January 2009 and December 2018 at the Department of Ophthalmology and Pathology, Niigata University Medical and Dental Hospital. The main outcome measures included postoperative IgG4-ROD recurrence rate and differences between patients with and without recurrent disease. Results: Fifteen patients (six male, 9 female; 61.8±16.2 years) were included. Twelve patients (80.0%) had dacryoadenitis disease and three patients (20.0%) had orbital fat tissue disease. About 70%-100% of the lesion was resected in the debulking surgery and the pathological diagnosis was rendered. A definitive diagnosis was made in 13 cases (86.7%) and a probable diagnosis in 2 cases (13.3%). Patients were followed up for 39.0±25.5 months following operation. All patients had lesion volume reduction and patients with dacryoadenitis had eyelid swelling improvement after surgery. Two patients (13.3%) had disease recurrence and six patients (40.0%) had extraophthalmic lesions. There was no statistically significant difference in clinical features between relapsed and non-recurring cases. Conclusion: We observed a 13.3% relapse rate following debulking surgery in patients with IgG4-ROD who did not undergo further treatment. This rate is lower than the documented relapse rate of 30%-70% following oral prednisolone therapy. Therefore, debulking surgery may be a treatment option for IgG4-ROD.

DOI： 10.1136/bmjophth-2019-000295

PubMed

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

GNAQ and GNA11 mutations are thought to be important for the tumorigenesis of uveal melanoma. Although previous studies have reported on mutation rates in cases of uveal melanoma, presently, no such report for the Japanese population exists. In this study, we examined the frequency of GNAQ and GNA11 somatic mutations in cases of uveal melanoma in Japan and their relationship with clinicopathologic features or Ki-67-positive cell rates (Ki-67 labeling index: Ki-67 LI) using immunofluorescence methods. The study involved 19 cases of uveal melanoma. We extracted the template DNA from formalin-fixed, paraffin-embedded specimens using a DNA extraction kit. We amplified the DNA sequences of GNAQ and GNA11 using polymerase chain reaction and analyzed mutations by direct sequencing. We evaluated Ki-67 LI using immunofluorescence methods. The frequencies of GNAQ and GNA11 somatic mutations were 26.3% (5/19) and 31.6% (6/19), respectively. The GNAQ and GNA11 mutations were mutually exclusive, as indicated in previous reports. The frequency of GNA11 mutations was significantly higher in epithelioid cells; however, no significant association between GNAQ mutations and cell type was evident, and there was no significant difference in Ki-67 LI between the mutation-positive and mutation-negative tumors. GNAQ and GNA11 mutations were identified in cases of uveal melanoma in Japan, although at lower frequencies than in white counterparts. The mutation frequency of GNA11 was significantly higher in epithelioid cells.

DOI： 10.1097/PAI.0000000000000505

PubMed

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Authorship：Lead author   Language：Japanese  

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Total pages：xxiii, 1143p   Language：Japanese

CiNii Books

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Total pages：xi, 231p   Language：Japanese

CiNii Books

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Total pages：xv, 398p   Language：Japanese

CiNii Books

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Total pages：xiii, 459p   Language：Japanese

CiNii Books

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Total pages：xiii, 459p   Language：Japanese

CiNii Books

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J-GLOBAL

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Language：Japanese   Publisher：(一社)日本リンパ網内系学会  

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Language：Japanese   Publisher：(一社)日本リンパ網内系学会  

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J-GLOBAL

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Language：Japanese   Presentation type：Oral presentation (general)  

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Language：Japanese   Presentation type：Oral presentation (general)  

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Language：English   Presentation type：Poster presentation  

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Language：English   Presentation type：Poster presentation  

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