Prediction Model for Annual Variation in Total Pollen by Allergenic Trees in Korean Cities.

PURPOSE: Pollen forecasting systems can provide information for coping with respiratory allergies. They estimate daily pollen production, dispersal, deposition, and removal based on daily weather conditions to predict daily pollen concentrations and provide allergy warnings. As of 2023, the Korea Meteorological Administration (KMA) provides 2-day forecast of allergenic pollens. However, unlike these models, long-term analysis of annual observations of tree pollen reveal annual variations. Therefore, in this study, we aimed to develop annual prediction models for allergenic tree pollens based on long-term multi-site pollen and meteorological data. METHODS: Daily pollen concentrations were observed using Hirst-type volumetric spore traps at nine sites in Korea from 1998 to 2021, and daily weather data from the closest KMA stations were utilized. Models were developed to predict the seasonal pollen integral of seven tree species based on monthly mean temperature, wind speed, and total precipitation using three variable selection methods: 1) the t-test based key variable screening followed by linear regression with stepwise procedure (TM), 2) direct linear regression with stepwise procedure from the full variable model (FM), and 3) LASSO regression from the full variable model (LM). RESULTS: Data obtained during 1998-2017 and 2018=2021 were utilized for model development and validation, respectively. The root mean squared error, mean absolute error, mean error, and coefficient of determination (R²) revealed that the TM models were best suited for actual forecasting, even though R² in the TM model was lower than those of the FM and LM models. CONCLUSIONS: The annual variation model in this study can be integrated with the daily pollen forecast model by controlling the annual pollen potential, and the accuracy of the daily forecast can be improved accordingly.

Quantitative gas pressure measurement by molecular spectroscopy using chip-based supercontinuum in the mid-infrared.

We demonstrate the quantitative pressure measurement of gas molecules in the mid-infrared using chip-based supercontinuum and cepstrum analysis without additional measurements for baseline normalization. A supercontinuum generated in an on-chip waveguide made of chalcogenide glass having high nonlinearity passes through CO gas and provides a transmission spectrum. The gas absorption information is deconvoluted from the original supercontinuum spectral information containing temporal fluctuation by cepstrum analysis and extracted simply by applying a bandpass filter in the temporal domain. The gas pressure estimated from the extracted absorption information is consistent with the value measured by a pressure gauge within a difference of 1.25%, despite spectral fluctuations in the supercontinuum baseline comparable to the spectral depth of the gas absorption lines.

PD-L1 Expression by RNA-Sequencing in Non-Small Cell Lung Cancer: Concordance with Immunohistochemistry and Associations with Pembrolizumab Treatment Outcomes.

Programmed cell death ligand (PD-L1) expression by immunohistochemistry (IHC) lacks sensitivity for pembrolizumab immunotherapy selection in non-small cell lung cancer (NSCLC), particularly for tumors with low expression. We retrospectively evaluated transcriptomic PD-L1 by mRNA next-generation sequencing (RNA-seq). In an unselected NSCLC patient cohort (n = 3168) tested during standard care (2017-2021), PD-L1 IHC and RNA-seq demonstrated moderate concordance, with 80% agreement overall. Most discordant cases were either low or negative for PD-L1 expression by IHC but high by RNA-seq. RNA-seq accurately discriminated PD-L1 IHC high from low tumors by receiver operator curve (ROC) analysis but could not distinguish PD-L1 IHC low from negative tumors. In a separate pembrolizumab monotherapy cohort (n = 102), NSCLC tumors classified as PD-L1 high versus not high by RNA-seq had significantly improved response, progression-free survival, and overall survival as an individual measure and in combination with IHC high or low status. PD-L1 IHC status (high or low) trended toward but had no significant associations with improved outcomes. Conventional PD-L1 IHC testing has inherent limitations, making it an imperfect reference standard for evaluating novel testing technologies. RNA-seq offers an objective PD-L1 measure that could represent a complementary method to IHC to improve NSCLC patient selection for immunotherapy.

MicroRNA 29a therapy for CEACAM6-expressing lung adenocarcinoma.

BACKGROUND: Non-coding microRNAs (miRNAs) play critical roles in tumor progression and hold great promise as therapeutic agents for multiple cancers. MicroRNA 29a (miR-29a) is a tumor suppressor miRNA that inhibits cancer cell growth and tumor progression in non-small cell lung cancer. Carcinoembryonic antigen-related cell adhesion molecule 6 (CEACAM6), which plays an important role in lung cancer progression, has been identified as a target of miR-29a. Here, we evaluated the therapeutic efficacy of a peptide vector capable of delivering miR-29a intracellularly using the acidic tumor microenvironment in a lung adenocarcinoma xenograft mouse model. METHODS: A miRNA delivery vector was constructed by tethering the peptide nucleic acid form of miR-29a to a peptide with a low pH-induced transmembrane structure (pHLIP) to enable transport of the miRNAs across the plasma membrane. Tumor suppressive effects of pHLIP-miR29a on lung adenocarcinoma development in vivo were assessed using a BALB/c xenograft model injected with A549 cells. RESULTS: Incubation of A549 cells with pHLIP-miR-29a at an acidic pH downregulated endogenous CEACAM6 expression and reduced cell viability. Intravenous injection of the mice with pHLIP-miR-29a inhibited tumor growth by up to 18.1%. Intraperitoneal injection of cisplatin reduced tumor volume by 29.9%. Combined pHLIP-miR-29a + cisplatin treatment had an additive effect, reducing tumor volume up to 39.7%. CONCLUSIONS: Delivery of miR-29a to lung adenocarcinoma cells using a pHLIP-mediated method has therapeutic potential as a unique cancer treatment approach.

Correlation between the Surface Undulation and Luminescence Characteristics in Semi-Polar 112¯2 InGaN/GaN Multi-Quantum Wells.

Surface undulation was formed while growing InGaN/GaN multi-quantum wells on a semi-polar m-plane (1-100) sapphire substrate. Two distinct facets, parallel to 112¯2 and 011¯1, were formed in the embedded multi-quantum wells (MQWs). The structural and luminescence characteristics of the two facets were investigated using transmission electron microscopy equipped with cathodoluminescence. Those well-defined quantum wells, parallel and slanted to the growth plane, showed distinct differences in indium incorporation from both the X-ray yield and the contrast difference in annular darkfield images. Quantitative measurements of concentration in 011¯1 MQWs show an approximately 4 at% higher indium incorporation compared to the corresponding 112¯2 when the MQWs were formed under the same growth condition.

BBT-176, a Novel Fourth-Generation Tyrosine Kinase Inhibitor for Osimertinib-Resistant EGFR Mutations in Non-Small Cell Lung Cancer.

PURPOSE: Resistance to third-generation EGFR inhibitors including osimertinib arises in part from the C797S mutation in EGFR. Currently, no targeted treatment option is available for these patients. We have developed a new EGFR tyrosine kinase inhibitor (TKI), BBT-176, targeting the C797S mutation. PATIENTS AND METHODS: Recombinant EGFR proteins and Ba/F3 cell lines, patient-derived cells, and patient-derived xenografts expressing mutant EGFRs were used to test the inhibitory potency and the anticancer efficacy of BBT-176 both in vitro and in vivo. Patient case data are also available from an ongoing phase I clinical trial (NCT04820023). RESULTS: The half maximal inhibitory concentration (IC50) of BBT-176 against EGFR 19Del/C797S, EGFR 19Del/T790M/C797S, and EGFR L858R/C797S proteins were measured at 4.36, 1.79, and 5.35 nmol/L, respectively (vs. 304.39, 124.82, and 573.72 nmol/L, for osimertinib). IC50 values of BBT-176 against Ba/F3 cells expressing EGFR 19Del/C797S, EGFR 19Del/T790M/C797S, EGFR L858R/C797S, and EGFR L858R/T790M/C797S were 42, 49, 183, and 202 nmol/L, respectively (vs. 869, 1,134, 2,799, and 2,685 nmol/L for osimertinib). N-ethyl-N-nitrosourea mutagenesis suggested that BBT-176 treatment does not introduce any secondary mutations in the EGFR gene but increases EGFR expression levels. Combined with the EGFR antibody cetuximab, BBT-176 effectively suppressed the growth of BBT-176-resistant clones. BBT-176 strongly inhibited the tumor growth, and in some conditions induced tumor regression in mouse models. In the clinical trial, two patients harboring EGFR 19Del/T790M/C797S in blood showed tumor shrinkage and radiologic improvements. CONCLUSIONS: BBT-176 is a fourth-generation EGFR inhibitor showing promising preclinical activity against NSCLC resistant to current EGFR TKI, with early clinical efficacy and safety.

DEVELOPMENT OF SCORE SYSTEM BASED ON POINT-OF-CARE ULTRASOUND TO PREDICT VASOPRESSOR REQUIREMENT FOR EMERGENCY PATIENTS WITH CARDIOPULMONARY SYMPTOMS.

ABSTRACT: Objectives : Patients with cardiopulmonary symptoms admitted to the emergency department (ED) have high mortality and intensive care unit admission rates. We developed a new scoring system comprising concise triage information, point-of-care ultrasound, and lactate levels to predict vasopressor requirements. Methods : This retrospective observational study was conducted at a tertiary academic hospital. Patients with cardiopulmonary symptoms who visited the ED and underwent point-of-care ultrasound between January 2018 and December 2021 were enrolled. The influence of demographic and clinical findings on the requirement for vasopressor support within 24 h of ED admission was investigated. A new scoring system was developed using key components after stepwise multivariable logistic regression analysis. Prediction performance was evaluated using the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results : A total of 2,057 patients were analyzed. A stepwise multivariable logistic regression model showed high predictive performance in the validation cohort (AUC, 0.87). Eight key components were selected: hypotension, chief complaint, and fever at ED admission, and way of ED visit, systolic dysfunction, regional wall motion abnormalities, inferior vena cava status, and serum lactate level. The scoring system was developed based on the ß coefficients of each component: accuracy, 0.8079; sensitivity, 0.8057; specificity, 0.8214; PPV, 0.9658; and NPV, 0.4035, with a cutoff value according to the Youden index. Conclusions : A new scoring system was developed to predict vasopressor requirements in adult ED patients with cardiopulmonary symptoms. This system can serve as a decision-support tool to guide efficient assignment of emergency medical resources.

Simulation-Based Cybersecurity Testing and Evaluation Method for Connected Car V2X Application Using Virtual Machine.

In a connected car, the vehicle's internal network is connected to the outside through communication technology. However, this can cause new security vulnerabilities. In particular, V2X communication, to provide the safety of connected cars, can directly threaten the lives of passengers if a security attack occurs. For V2X communication security, standards such as IEEE 1609.2 define the technical functions that digital signature and encryption to provide security of V2X messages. However, it is difficult to verify the security technology by applying it to the environment with real roads because it can be made up of other safety accidents. In addition, vehicle simulation R&D is steadily being carried out, but there is no simulation that evaluates security for the V2X application level. Therefore, in this paper, a virtual machine was used to implement a V2X communication simulation environment that satisfies the requirements for the security evaluation of connected cars. Then, we proposed scenarios for cybersecurity testing and evaluation, implemented and verified through CANoe Option.Car2X. Through this, it is possible to perform sufficient preliminary verification to minimize the variables before verifying security technology in a real road environment.

Evaluation of tumor microenvironment and biomarkers of immune checkpoint inhibitor response in metastatic renal cell carcinoma.

BACKGROUND: Immunotherapy combinations including ipilimumab and nivolumab are now the standard of care for untreated metastatic renal cell carcinoma (mRCC). Biomarkers of response are lacking to predict patients who will have a favorable or unfavorable response to immunotherapy. This study aimed to use the OmniSeq transcriptome-based platform to develop biomarkers of response to immunotherapy. METHODS: Two cohorts of patients were retrospectively collected. These included an investigational cohort of patients with mRCC treated with immune checkpoint inhibitor therapy from five institutions, and a subsequent validation cohort of patients with mRCC treated with combination ipilimumab and nivolumab from two institutions (Duke Cancer Institute and Cleveland Clinic Taussig Cancer Center). Tissue-based RNA sequencing was performed using the OmniSeq Immune Report Card on banked specimens to identify gene signatures and immune checkpoints associated with differential clinical outcomes. A 5-gene expression panel was developed based on the investigational cohort and was subsequently evaluated in the validation cohort. Clinical outcomes including progression-free survival (PFS) and overall survival (OS) were extracted by retrospective chart review. Objective response rate (ORR) was assessed by Response Evaluation Criteria in Solid Tumors (RECIST) V.1.1. RESULTS: The initial investigation cohort identified 86 patients with mRCC who received nivolumab (80%, 69/86), ipilimumab/nivolumab (14%, 12/86), or pembrolizumab (6%, 5/86). A gene expression score was created using the top five genes found in responders versus non-responders (FOXP3, CCR4, KLRK1, ITK, TIGIT). The ORR in patients with high gene expression (GEhigh) on the 5-gene panel was 29% (14/48), compared with low gene expression (GElow) 3% (1/38, χ2 p=0.001). The validation cohort was comprised of 62 patients who received ipilimumab/nivolumab. There was no difference between GEhigh and GElow in terms of ORR (44% vs 38.5%), PFS (HR 1.5, 95% CI 0.58 to 3.89), or OS (HR 0.96, 95% CI 0.51 to 1.83). Similarly, no differences in ORR, PFS or OS were observed when patients were stratified by tumor mutational burden (high=top 20%), PD-L1 (programmed death-ligand 1) expression by immunohistochemistry or RNA expression, or CTLA-4 (cytotoxic T-lymphocytes-associated protein 4) RNA expression. The International Metastatic RCC Database Consortium (IMDC) risk score was prognostic for OS but not PFS. CONCLUSION: A 5-gene panel that was associated with improved ORR in a predominantly nivolumab monotherapy population of patients with mRCC was not predictive for radiographic response, PFS, or OS among patients with mRCC treated with ipilimumab and nivolumab.

Stage-Dependent Changes of Visual Function and Electrical Response of the Retina in the rd10 Mouse Model.

One of the critical prerequisites for the successful development of retinal prostheses is understanding the physiological features of retinal ganglion cells (RGCs) in the different stages of retinal degeneration (RD). This study used our custom-made rd10 mice, C57BL/6-Pde6bem1(R560C)Dkl /Korl mutated on the Pde6b gene in C57BL/6J mouse with the CRISPR/Cas9-based gene-editing method. We selected the postnatal day (P) 45, P70, P140, and P238 as representative ages for RD stages. The optomotor response measured the visual acuity across degeneration stages. At P45, the rd10 mice exhibited lower visual acuity than wild-type (WT) mice. At P140 and older, no optomotor response was observed. We classified RGC responses to the flashed light into ON, OFF, and ON/OFF RGCs via in vitro multichannel recording. With degeneration, the number of RGCs responding to the light stimulation decreased in all three types of RGCs. The OFF response disappeared faster than the ON response with older postnatal ages. We elicited RGC spikes with electrical stimulation and analyzed the network-mediated RGC response in the rd10 mice. Across all postnatal ages, the spikes of rd10 RGCs were less elicited by pulse amplitude modulation than in WT RGCs. The ratio of RGCs showing multiple peaks of spike burst increased in older ages. The electrically evoked RGC spikes by the pulse amplitude modulation differ across postnatal ages. Therefore, degeneration stage-dependent stimulation strategies should be considered for developing retinal prosthesis and successful vision restoration.

Association between focused cardiac ultrasound and time to furosemide administration in acute heart failure.

BACKGROUND: Heart failure (HF) is a global health burden, and its management in the emergency department (ED) is important. This study aimed to evaluate the association between focused cardiac ultrasound (FoCUS) and early administration of diuretics in patients with acute HF admitted to the ED. METHODS: This retrospective observational study was conducted at a tertiary academic hospital. Patients with acute HF patients who were admitted to the ED and receiving intravenous medication between January 2018 and December 2019 were enrolled. The main exposure was a FoCUS examination performed within 2 h of ED triage. The primary outcome was the time to furosemide administration. RESULTS: Of 1154 patients with acute HF, 787 were included in the study, with 116 of them having undergone FoCUS. The time to furosemide was significantly shorter in the FoCUS group (median time (q1-q3), 112 min; range, 65-163 min) compared to the non-FoCUS group (median time, 131 min; range, 71-229 min). In the multivariable logistic regression analysis adjusting for age, sex, chief complaint, mode of arrival, triage level, shock status, and desaturation at triage, early administration of furosemide within 2 h from triage was significantly higher in the FoCUS group (adjusted odds ratio, 1.63; 95% confidence intervals, 1.04-2.55) than in the non-FoCUS group. CONCLUSIONS: Early administration of intravenous furosemide was associated with FoCUS examination in patients with acute HF admitted to the ED. An early screening protocol could be useful for improving levels in clinical practice at EDs.

Optimization of a renewable hydrogen production system from food waste: A combination of anaerobic digestion and biogas reforming.

In this study, hydrogen production using food waste was optimized by investigating the effect of agitator types in anaerobic digestion reactors and catalysts for biogas reforming. The applied agitators were pitched blade and hydrofoil, and their effect on homogeneity was estimated using computational fluid dynamics. Reactors with different agitators were operated for 60 days for biogas production. Increased biogas production was observed in the reactor equipped with a hydrofoil agitator owing to its high homogeneity. In addition, Ni-CeZrO2 catalysts promoted with La2O3, CaO, or MgO were investigated for stable hydrogen production during the biogas reforming reaction using simulated gas based on biogas from the anaerobic digestion equipped the hydrofoil. Among the promoted catalysts, the MgO-promoted Ni-CeZrO2 catalyst displayed the best results for hydrogen production without significant deactivation. The stable catalytic performance of the MgO-promoted catalyst resulted from the close interaction between Ni and MgO, and its high oxygen storage capacity. Thus, 1216 L hydrogen and 646 L carbon monoxide were produced per kilogram volatile solid via the hydrogen production system that included anaerobic digestion and biogas reforming.

Tumor Inflammation, Obesity, and Proliferative Status as Biomarkers in Gastroesophageal Adenocarcinoma.

Recent epidemiological studies have shown that obesity, typically measured by increased body mass index (BMI), is associated with an increased risk of gastroesophageal adenocarcinoma (GEAC), but the contributing molecular and immune mechanisms remain unknown. Since obesity is known to promote chronic inflammation, we hypothesized that obesity leads to inflammation-related immune dysfunction, which can be reversed by immune-modulating therapy. To test our hypothesis, we examined the clinical and molecular data from advanced GEAC patients. To this end, 46 GEAC tumors were evaluated for biomarkers representing tumor inflammation, cell proliferation, and PD-L1 expression. A CoxPH regression model with potential co-variates, followed by pairwise post hoc analysis, revealed that inflammation in the GEAC tumor microenvironment is associated with improved overall survival, regardless of BMI. We also observed a significant association between cell proliferation and progression-free survival in overweight individuals who received immune-modulating therapy. In conclusion, our data confirm the role of the immune system in the natural course of GEAC and its responses to immunotherapies, but do not support the role of BMI as an independent clinically relevant biomarker in this group of patients.

A scalable high-throughput targeted next-generation sequencing assay for comprehensive genomic profiling of solid tumors.

Timely and accurate identification of molecular alterations in solid tumors is essential for proper management of patients with advanced cancers. This has created a need for rapid, scalable comprehensive genomic profiling (CGP) systems that detect an increasing number of therapeutically-relevant variant types and molecular signatures. In this study, we assessed the analytical performance of the TruSight Oncology 500 High-Throughput assay for detection of somatic alterations from formalin-fixed paraffin-embedded tissue specimens. In parallel, we developed supporting software and automated sample preparation systems designed to process up to 70 clinical samples in a single NovaSeq 6000TM sequencing run with a turnaround time of <7 days from specimen receipt to report. The results demonstrate that the scalable assay accurately and reproducibly detects small variants, copy number alterations, microsatellite instability (MSI) and tumor mutational burden (TMB) from 40ng DNA, and multiple gene fusions, including known and unknown partners and splice variants from 20ng RNA. 717 tumor samples and reference materials with previously known alterations in 96 cancer-related genes were sequenced to evaluate assay performance. All variant classes were reliably detected at consistent and reportable variant allele percentages with >99% overall accuracy and precision. Our results demonstrate that the high-throughput CGP assay is a reliable method for accurate detection of molecular alterations in support of precision therapeutics in oncology. The supporting systems and scalable workflow allow for efficient interpretation and prompt reporting of hundreds of patient cancer genomes per week with excellent analytical performance.

Polymorphism in the HaeIII single nucleotide polymorphism of the SLC2A1 gene and cardiovascular disease in the early type 2 diabetes mellitus.

INTRODUCTION: SLC2A1 polymorphism may play a role in the smooth muscle cell proliferation and extracellular matrix synthesis in vessels. However, the role of SLC2A1 polymorphism on diabetic cardiovascular disease (CVD) have not yet been identified. In this study, we aimed to investigate the association between SLC2A1 HaeIII polymorphism and CVD in Korean patients with type 2 diabetes mellitus (T2DM) according to disease duration. METHODS: A total of 846 patients with T2DM who visited the Chungbuk National University Hospital were investigated. The HaeIII polymorphism of SLC2A1 gene was determined by real time polymerase chain reaction method. Genotyping results were presented GG, AG, or AA. Subgroup analysis was performed according to duration of T2DM (⩽10, 11-20, >20 years). RESULTS: The AA genotype was significantly associated with higher prevalence of CVD in patients with DM duration less than 10 years (26.3% vs 9.2%, p = 0.014). There was no significant association between SLC2A1 HaeIII polymorphism and other diabetic complications including, retinopathy, nephropathy, neuropathy, cerebrovascular disease, and peripheral artery disease. CONCLUSIONS: The SLC2A1 HaeIII polymorphism was associated with CVD in Korean patients with T2DM with short disease duration.

Supercontinuum generation in As2S3 waveguides fabricated without direct etching.

We report a supercontinuum generation (SCG) in a waveguide that spontaneously forms without an etching process during the deposition of a core material on a preformed ${\rm{Si}}{{\rm{O}}_2}$ substructure. The mechanism of dispersion control for this new, to the best of our knowledge, type of waveguide is analyzed by numerical simulation, which results in a design rule to achieve a target dispersion profile by adjusting the substructure geometry. SCG is experimentally demonstrated with a waveguide made of ${\rm{A}}{{\rm{s}}_2}{{\rm{S}}_3}$, chalcogenide glass, which has low material absorption over the mid-IR range. A dispersion-controlled waveguide with a length of 10 mm pumped with 77 pJ pulses at a telecommunication wavelength of 1560 nm resulted in a supercontinuum that extends by more than 1.5 octaves.

Operating bedside cardiac ultrasound program in emergency medicine residency: A retrospective observation study from the perspective of performance improvement.

BACKGROUND: Point-of-care ultrasound is one of useful diagnostic tools in emergency medicine practice and considerably depends on physician's performance. This study was performed to evaluate performance improvements and favorable attitudes through structured cardiac ultrasound program for emergency medicine residents. METHODS: Retrospective observational study using the point-of-care ultrasound (PoCUS) database in one tertiary academic-teaching hospital emergency department has been conducted. Cardiac ultrasound education and rotation program has been implemented in emergency medicine residency program. Structured evaluation sheet for cardiac ultrasound and questionnaire toward PoCUS have been developed. An early-phase and a late-phase case were selected randomly for each participant. Two emergency medicine specialists with expertise in PoCUS evaluated saved images independently. We used a paired t-test to compare the performance score of each phase and the results of the questionnaire. Multivariable linear regression analysis was conducted to evaluate the association between the characteristics of participants and performance improvements. RESULTS: During the study period, a total of 1,652 bedside cardiac ultrasounds were administered. Forty-six examinations conducted by 23 emergency medicine residents were randomly selected for analysis. The performance score increased from 39.5 to 56.1 according to expert A and 45.3 to 62.9 according to expert B (p-value <0.01 for both). The average questionnaire score, which was analyzed for 17 participants, showed improvement from 18.9 to 20.7 (p-value <0.01). In multivariable linear regression analysis, younger age, higher early-phase score and higher confidence had a negative association with a greater improvement of performance, while the number of examinations had a positive association. CONCLUSIONS: Bedside cardiac ultrasound performance and attitudes toward PoCUS have been improved through structured residency program.

Anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma in Korea: three case reports.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune paraneoplastic syndrome associated with ovarian teratomas. Most patients develop neurologic symptoms, including psychosis, memory deficits, seizures, or abnormal movements, and experience abdominal pain related to ovarian neoplasm. We present a case report of three patients diagnosed with anti-NMDAR encephalitis accompanied by ovarian teratomas at Ajou University Hospital in Korea. The patients demonstrated a different clinical course of the disease. However, upon diagnosis, all patients underwent surgical removal of the ovarian teratoma followed by intensive immunotherapy. The symptoms progressively improved following treatment. This is a case report of a rare autoimmune anti-NMDAR encephalitis associated with ovarian neoplasms, including immature teratoma.