Unruptured cerebral aneurysms（UCA）are 2.8 times more likely to rupture in Japanese than western aneurysms, resulting in the highest incidence of subarachnoid hemorrhage in the world. Therefore, it is important to detect an unruptured cerebral aneurysm by brain screening（Brain Dock）in Japan. Recently, along with the improvement of computer performance and the progress of communication technology, new technology utilizing artificial intelligence（AI）has been applied to the medical field. Due to the remarkable development of deep learning technology, AI has become widespread in the field of medical image diagnosis, AI is expected to improve the efficacy of diagnosis and prevent oversight. In this paper, we will discuss and explain about UCA image diagnosis and diagnosis by AI.

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【Background & Aim】Immune checkpoint inhibitors（ICI）may cause immune-related adverse events（irAE）, especially diarrhea and colitis. We retrospectively investigated diarrhea and colitis caused by ICI in our hospital.【Subjects & Methods】Ninety-eight patients who ICI were newly administered at our hospital from July 1, 2014 to June 30, 2019 were retrospectively analyzed. The primary endpoint is the frequency of onset of ICI related diarrhea/colitis. Furthermore its clinical characteristics were considered and a clinical comparison with unaffected cases was performed.【Results】 The frequency of onset of ICI related diarrhea/colitis was 9.2％ in nine cases, CTCAE Grade 1 in seven cases in 77.8％, and Grade 2 in two cases in 22.2％. Compared with 89 cases without diarrhea/colitis, the number of ICI administration and response rate（CR + PR）were significantly higher in the cases of occurrence.【Summary】Although the frequency of onset of ICI related diarrhea / colitis in our hospital was at the same level as existing reports, it is necessary for each department to cooperate in dealing with irAE, which may increase in the future.

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The effectiveness of maintaining rhythm by Maze and pulmonary vein isolation（PVI） procedures, which are surgical operations for atrial fibrillation（AF）, is clear, and in addition, it has been shown to improve survival rate and prevent the onset of cerebral infarction. This time, we examined the late results after maze and PVI procedures at our hospital. The subjects were 77 cases from 1999 to June 2019, with 54 cases of chronic AF, 23 cases of paroxysmal atrial fibrillation, average age of 70 years, and 62％（48 cases） were male. The surgical procedure was 50 cases of biatrial maze, 19 cases of PVI, 7 cases of left atrial maze, and one case of right atrial maze. With 3 hospital deaths and 18 remote deaths, the survival rate was 96％ for 1 year, 88％ for 5 years, 71％ for 10 years, and 56％ for 15 years, which is the same as the life expectancy of 70 years old. The AF free rate at discharge was 85％, and the late AF free rate at an average observation period of 5.9 years was 63％. The AF free rate by Kaplan-Meier method decreased over time to 97％ for 1 year, 82％ for 5 years, 57％ for 10 years, and 37％ for 15 years. We compared 47 cases of remote sinus rhythm （SR） with 28 cases of AF. Univariate analysis revealed significant differences in postoperative left atrial（LA）diameter, SR at discharge, and late mortality. In multivariate analysis, the factors of remote SR were Maze procedure, postoperative LA diameter, and discharge at SR. In the ROC curve, the postoperative LA diameter of 47.5 mm was the cut-off value for maintaining SR in the remote period, and 77％ of the postoperative LA diameter of less than 47.5 mm was SR, but that of 47.5 mm or more was 44％. Anticoagulant therapy was continued in 73％ of patients after surgery, and cerebral infarction occurred in 5.5％ of 4 patients, all of whom were on anticoagulant therapy. Left atrial appendage occlusion was performed in 18 of the 20 patients who discontinued anticoagulant therapy, and no cerebral infarction occurred. Catheter ablation was performed in 4 postoperative cases, and all cases recovered to SR and were effective.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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Clear cell carcinoma, not otherwise specified（NOS）is rare and considered to be a low grade malignancy. This tumor is one of the new additions to the 2005 World Health Organization（WHO） classification of salivary gland tumors. We report a case of clear cell carcinoma, NOS of the upper lip. A 32-year-old female was admitted to our hospital with complaint of a mass in the upper lip. The mass was elastic hard and measured 13×10mm in diameter. The clinical diagnosis was a benign salivary gland tumor, and the tumor was surgically enucleated under general anesthesia. The histopathological diagnosis was clear cell carcinoma, NOS. At present, there has been no evidence of recurrence or metastasis. We report this case with some literature review.

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[in Japanese]

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