Low-grade myofibroblastic sarcoma (LGMS) is a rare, malignant tumor with myofibroblastic differentiation. Despite it being classified as a distinct entity by the World Health Organization, a few cases were reported in the oral and maxillofacial region. Here, a LGMS developed on the palate of a 73-year-old man who presented with a 1-cm tumor on the posterior border of the palate. Based on the histological and immunohistochemical features, a diagnosis of LGMS was established. The tumor was resected, and no recurrence was observed over 2 years. Although the tongue is the most preferred site for LGMS, it may occur in any region of the oral cavity.
Aged ; Humans ; Male ; Myofibroblasts ; pathology ; Osteosarcoma ; pathology ; surgery ; Palatal Neoplasms ; pathology ; surgery ; Palate, Hard ; pathology

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic disease characterized by suprapubic pain and lower urinary tract symptoms. Perhaps because of the heterogeneous nature of this disease and its multifactorial etiology, clinical trials in allinclusive populations of IC/BPS patients without phenotyping in the last decade have mainly failed to discover new therapeutic modalities of IC/BPS. Thus, phenotyping IC/BPS, aimed at identifying bladder-centric and/or bladder-beyond pathologies, including cystoscopic observation of Hunner or non-Hunner lesions of the bladder mucosa, is particularly important for the future of IC/BPS management. Based on recent discussions at international conferences, including the International Consultation on IC, Japan, it has been proposed that Hunner-lesion IC should be separated from other non-Hunner IC/BPS because of its distinct inflammatory profiles and epithelial denudation compared with non-Hunner IC/BPS. However, there are still no standard criteria for the diagnosis of Hunner lesions other than typical lesions, while conventional cystoscopic observations may miss atypical or small Hunner lesions. Furthermore, diagnosis of the bladder-centric phenotype of IC/BPS requires confirmation that identified mucosal lesions are truly a cause of bladder pain in IC/BPS patients. This review article discusses the current status of IC/BPS pathophysiology and diagnosis, as well as future directions of the proper diagnosis of bladder-centric IC/BPS, in which pathophysiological mechanisms other than those in inflammatory pathways, such as angiogenic and immunogenic abnormalities, could also be involved in both Hunner-lesion IC and non-Hunner IC/BPS. It is hoped that this new paradigm in the pathophysiological evaluation and diagnosis of IC/BPS could lead to pathology-based phenotyping and new treatments for this heterogeneous disease.

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic disease characterized by suprapubic pain and lower urinary tract symptoms. Perhaps because of the heterogeneous nature of this disease and its multifactorial etiology, clinical trials in allinclusive populations of IC/BPS patients without phenotyping in the last decade have mainly failed to discover new therapeutic modalities of IC/BPS. Thus, phenotyping IC/BPS, aimed at identifying bladder-centric and/or bladder-beyond pathologies, including cystoscopic observation of Hunner or non-Hunner lesions of the bladder mucosa, is particularly important for the future of IC/BPS management. Based on recent discussions at international conferences, including the International Consultation on IC, Japan, it has been proposed that Hunner-lesion IC should be separated from other non-Hunner IC/BPS because of its distinct inflammatory profiles and epithelial denudation compared with non-Hunner IC/BPS. However, there are still no standard criteria for the diagnosis of Hunner lesions other than typical lesions, while conventional cystoscopic observations may miss atypical or small Hunner lesions. Furthermore, diagnosis of the bladder-centric phenotype of IC/BPS requires confirmation that identified mucosal lesions are truly a cause of bladder pain in IC/BPS patients. This review article discusses the current status of IC/BPS pathophysiology and diagnosis, as well as future directions of the proper diagnosis of bladder-centric IC/BPS, in which pathophysiological mechanisms other than those in inflammatory pathways, such as angiogenic and immunogenic abnormalities, could also be involved in both Hunner-lesion IC and non-Hunner IC/BPS. It is hoped that this new paradigm in the pathophysiological evaluation and diagnosis of IC/BPS could lead to pathology-based phenotyping and new treatments for this heterogeneous disease.

Objective：The Clinical Trunk Control Test (CTCT) is used to assess trunk function worldwide, particularly for patients with spinal cord injury (SCI), with good reliability and validity. In Japan, trunk function evaluation methods specialized for patients with SCI are scarce. The aim of the present study was to create a Japanese version of CTCT (CTCT-J) and verify its reliability.Methods：CTCT-J was created using the double-back translation format. The inter-rater reliability was calculated based on the total CTCT-J score and intraclass correlation coefficient (ICC) for each item. The weighted kappa coefficient was calculated for each subtest. To verify internal consistency, Cronbach's alpha coefficient was calculated for the CTCT-J total score and each item.Results：We enrolled 12 patients with SCI, including ten men and two women, with an average age of 51.9 ± 17.8 years. Nine and three patients had cervical and thoracic SCI, respectively. The ICC for inter-rater reliability ranged from 0.995 to 1.000 (p ＜0.05). The weighted kappa coefficient for each subtest ranged from 0.756 to 1.000 (p ＜0.05). In the internal consistency test, the Cronbach's alpha coefficient for all items was 0.995 (p ＜0.05).Conclusion：We created the CTCT-J with double back translation and verified its reliability. Good inter-rater reliability and internal consistency were observed, indicating its applicability in Japan.

Objective：The Clinical Trunk Control Test (CTCT) is used to assess trunk function worldwide, particularly for patients with spinal cord injury (SCI), with good reliability and validity. In Japan, trunk function evaluation methods specialized for patients with SCI are scarce. The aim of the present study was to create a Japanese version of CTCT (CTCT-J) and verify its reliability.Methods：CTCT-J was created using the double-back translation format. The inter-rater reliability was calculated based on the total CTCT-J score and intraclass correlation coefficient (ICC) for each item. The weighted kappa coefficient was calculated for each subtest. To verify internal consistency, Cronbach's alpha coefficient was calculated for the CTCT-J total score and each item.Results：We enrolled 12 patients with SCI, including ten men and two women, with an average age of 51.9 ± 17.8 years. Nine and three patients had cervical and thoracic SCI, respectively. The ICC for inter-rater reliability ranged from 0.995 to 1.000 (p ＜0.05). The weighted kappa coefficient for each subtest ranged from 0.756 to 1.000 (p ＜0.05). In the internal consistency test, the Cronbach's alpha coefficient for all items was 0.995 (p ＜0.05).Conclusion：We created the CTCT-J with double back translation and verified its reliability. Good inter-rater reliability and internal consistency were observed, indicating its applicability in Japan.

Purpose: Thyroid transcription factor 1 (TTF-1) expression is a useful predictor of treatment efficacy in advanced non-squamous non–small cell lung cancer (NSCLC). This study aimed to evaluate whether TTF-1 could predict the effectiveness of chemotherapy versus chemoimmunotherapy in patients with non-squamous NSCLC with programmed death ligand-1 (PD-L1) expression between 1% and 49%. Materials and Methods: We conducted a retrospective study of patients with NSCLC who were treated with chemotherapy or chemoimmunotherapy between March 2016 and May 2023. The patients had histologically confirmed NSCLC, stage III-IV or postoperative recurrence, TTF-1 measurements, and PD-L1 expression levels between 1% and 49%. Clinical data were analyzed to evaluate the effect of TTF-1 expression on treatment efficacy. Results: This study included 283 of 624 patients. TTF-1–positive patients showed longer progression-free survival (PFS) and overall survival (OS) (PFS: 6.4 months [95% confidence interval (CI), 5.0 to 9.4] vs. 4.1 months [95% CI, 2.7 to 6.1], p=0.03; OS: 17.9 months [95% CI, 15.2 to 28.1] vs. 9.4 months [95% CI, 6.3 to 17.0], p < 0.01) in the chemotherapy cohorts (n=93). In the chemoimmunotherapy cohort (n=190), there was no significant difference in PFS and OS between TTF-1–positive and –negative groups (PFS: 7.6 months [95% CI, 6.4 to 11.0] vs. 6.0 months [95% CI, 3.6 to 12.6], p=0.59; OS: 25.0 months [95% CI, 18.0 to 49.2] vs. 21.3 months [95% CI, 9.8 to 28.8], p=0.09). Conclusion In patients with NSCLC with PD-L1 expression between 1% and 49%, TTF-1 expression was a predictor of chemotherapeutic, but not chemoimmunotherapeutic, efficacy.

Purpose: Thyroid transcription factor 1 (TTF-1) expression is a useful predictor of treatment efficacy in advanced non-squamous non–small cell lung cancer (NSCLC). This study aimed to evaluate whether TTF-1 could predict the effectiveness of chemotherapy versus chemoimmunotherapy in patients with non-squamous NSCLC with programmed death ligand-1 (PD-L1) expression between 1% and 49%. Materials and Methods: We conducted a retrospective study of patients with NSCLC who were treated with chemotherapy or chemoimmunotherapy between March 2016 and May 2023. The patients had histologically confirmed NSCLC, stage III-IV or postoperative recurrence, TTF-1 measurements, and PD-L1 expression levels between 1% and 49%. Clinical data were analyzed to evaluate the effect of TTF-1 expression on treatment efficacy. Results: This study included 283 of 624 patients. TTF-1–positive patients showed longer progression-free survival (PFS) and overall survival (OS) (PFS: 6.4 months [95% confidence interval (CI), 5.0 to 9.4] vs. 4.1 months [95% CI, 2.7 to 6.1], p=0.03; OS: 17.9 months [95% CI, 15.2 to 28.1] vs. 9.4 months [95% CI, 6.3 to 17.0], p < 0.01) in the chemotherapy cohorts (n=93). In the chemoimmunotherapy cohort (n=190), there was no significant difference in PFS and OS between TTF-1–positive and –negative groups (PFS: 7.6 months [95% CI, 6.4 to 11.0] vs. 6.0 months [95% CI, 3.6 to 12.6], p=0.59; OS: 25.0 months [95% CI, 18.0 to 49.2] vs. 21.3 months [95% CI, 9.8 to 28.8], p=0.09). Conclusion In patients with NSCLC with PD-L1 expression between 1% and 49%, TTF-1 expression was a predictor of chemotherapeutic, but not chemoimmunotherapeutic, efficacy.

Purpose: Thyroid transcription factor 1 (TTF-1) expression is a useful predictor of treatment efficacy in advanced non-squamous non–small cell lung cancer (NSCLC). This study aimed to evaluate whether TTF-1 could predict the effectiveness of chemotherapy versus chemoimmunotherapy in patients with non-squamous NSCLC with programmed death ligand-1 (PD-L1) expression between 1% and 49%. Materials and Methods: We conducted a retrospective study of patients with NSCLC who were treated with chemotherapy or chemoimmunotherapy between March 2016 and May 2023. The patients had histologically confirmed NSCLC, stage III-IV or postoperative recurrence, TTF-1 measurements, and PD-L1 expression levels between 1% and 49%. Clinical data were analyzed to evaluate the effect of TTF-1 expression on treatment efficacy. Results: This study included 283 of 624 patients. TTF-1–positive patients showed longer progression-free survival (PFS) and overall survival (OS) (PFS: 6.4 months [95% confidence interval (CI), 5.0 to 9.4] vs. 4.1 months [95% CI, 2.7 to 6.1], p=0.03; OS: 17.9 months [95% CI, 15.2 to 28.1] vs. 9.4 months [95% CI, 6.3 to 17.0], p < 0.01) in the chemotherapy cohorts (n=93). In the chemoimmunotherapy cohort (n=190), there was no significant difference in PFS and OS between TTF-1–positive and –negative groups (PFS: 7.6 months [95% CI, 6.4 to 11.0] vs. 6.0 months [95% CI, 3.6 to 12.6], p=0.59; OS: 25.0 months [95% CI, 18.0 to 49.2] vs. 21.3 months [95% CI, 9.8 to 28.8], p=0.09). Conclusion In patients with NSCLC with PD-L1 expression between 1% and 49%, TTF-1 expression was a predictor of chemotherapeutic, but not chemoimmunotherapeutic, efficacy.

Introduction：There are few detailed evaluations of upper extremity function in Japan, especially for cervical spinal cord injury (CSCI). The capabilities of upper extremity test (CUE-T) evaluates upper extremity function, is specialized for CSCI, and is internationally used；however, there are few reports from Japan. This study verified the reliability, validity, and responsiveness of the CUE-T in Japan.Methods：We determined the interrater reliability, internal consistency, weighted kappa coefficient, intraclass correlation coefficient, and Cronbach's α coefficient for acute and chronic CSCI. The correlation coefficient with other evaluations was calculated and validated. Furthermore, the evaluation was performed twice at regular intervals, and the correlation between the change in CUE-T and other evaluations and the sensitivity to change using the standardized response mean (SRM) were verified.Results：The weighted kappa coefficient was 0.61-1.00, intraclass correlation coefficient was ≥0.9, and Cronbach's α coefficient were ≥0.9. The CUE-T and other evaluation methods showed moderate to strong correlations. In addition, the amount of change between CUE-T and the other evaluations were significantly correlated, and the SRM was ≥0.8.Discussion：In Japan, the CUE-T has been suggested to have good reliability, validity, responsiveness, and interpretability as an evaluation of upper extremity function in patients with CSCI. We will continue to verify the interpretability of the CUE-T and consider its dissemination in Japan.

Introduction：There are few detailed evaluations of upper extremity function in Japan, especially for cervical spinal cord injury (CSCI). The capabilities of upper extremity test (CUE-T) evaluates upper extremity function, is specialized for CSCI, and is internationally used；however, there are few reports from Japan. This study verified the reliability, validity, and responsiveness of the CUE-T in Japan.Methods：We determined the interrater reliability, internal consistency, weighted kappa coefficient, intraclass correlation coefficient, and Cronbach's α coefficient for acute and chronic CSCI. The correlation coefficient with other evaluations was calculated and validated. Furthermore, the evaluation was performed twice at regular intervals, and the correlation between the change in CUE-T and other evaluations and the sensitivity to change using the standardized response mean (SRM) were verified.Results：The weighted kappa coefficient was 0.61-1.00, intraclass correlation coefficient was ≥0.9, and Cronbach's α coefficient were ≥0.9. The CUE-T and other evaluation methods showed moderate to strong correlations. In addition, the amount of change between CUE-T and the other evaluations were significantly correlated, and the SRM was ≥0.8.Discussion：In Japan, the CUE-T has been suggested to have good reliability, validity, responsiveness, and interpretability as an evaluation of upper extremity function in patients with CSCI. We will continue to verify the interpretability of the CUE-T and consider its dissemination in Japan.