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Limited evidence exists on the association between malnutrition diagnosis using the Global Leadership Initiative on Malnutrition (GLIM) criteria in hospitalized acute care patients and their outcomes; several aspects still require clarification. This study aimed to evaluate the relationship between malnutrition, as defined by the GLIM criteria, at the time of acute hospital admission and discharge to home. This retrospective observational study was conducted at a hospital that provides acute care in Japan. Adult patients admitted between July 2023 and April 2024 were included in this study. The primary outcome was the number of patients discharged to home, with in-hospital mortality as the secondary outcome. To ensure the reliability of the cohort-wide results, background factors were adjusted using propensity score matching. The two groups were compared based on the presence or absence of malnutrition, as defined by the GLIM criteria at admission. Furthermore, multiple logistic regression analysis was conducted, with the outcome as the dependent variable and malnutrition, diagnosed using the GLIM criteria, as the explanatory variable, adjusting for covariates. A total of 1007 patients were included in the final analysis, of whom 492 (49 %) were diagnosed without malnutrition, while 515 (51 %) were diagnosed with malnutrition according to the GLIM criteria. In the multivariate logistic regression analysis after matching, malnutrition defined by the GLIM criteria emerged as an independent factor associated with discharge to home (odds ratio [OR] = 0.37, 95 % confidence interval = 0.25–0.56, P < 0.001) when adjusting for age, sex, and various comorbidities. Among the GLIM sub-criteria, reduced muscle mass, reduced food intake or assimilation, and disease burden or inflammation were independently associated with discharge to home. Notably, disease burden/inflammation exhibited the lowest OR among the GLIM sub-criteria for discharge. Malnutrition diagnosed using the GLIM criteria upon admission in patients admitted to a regional hospital providing acute care was associated with decreased rates of discharge to home and increased in-hospital mortality. Specifically, attention should be paid to the criteria for reduced muscle mass and disease burden or inflammation within the GLIM framework. [ABSTRACT FROM AUTHOR]

Although congenital portosystemic shunts (CPSSs) are increasingly being recognized, the optimal treatment strategies and natural prognosis remain unclear, as individual CPSSs show different phenotypes. The medical records of 122 patients who were diagnosed with CPSSs at 15 participating hospitals in Japan between 2000 and 2019 were collected for a retrospective analysis based on the state of portal vein (PV) visualization on imaging. Among the 122 patients, 75 (61.5%) showed PV on imaging. The median age at the diagnosis was 5 months. The main complications related to CPSS were hyperammonemia (85.2%), liver masses (25.4%), hepatopulmonary shunts (13.9%), and pulmonary hypertension (11.5%). The prevalence of complications was significantly higher in patients without PV visualization than in those with PV visualization (P < 0.001). Overall, 91 patients (74.6%) received treatment, including shunt closure by surgery or interventional radiology (n = 82) and liver transplantation (LT) or liver resection (n = 9). Over the past 20 years, there has been a decrease in the number of patients undergoing LT. Although most patients showed improvement or reduced progression of symptoms, liver masses and pulmonary hypertension were less likely to improve after shunt closure. Complications related to shunt closure were more likely to occur in patients without PV visualization (P = 0.001). In 25 patients (20.5%) without treatment, those without PV visualization were significantly more likely to develop complications related to CPSS than those with PV visualization (P = 0.011). Patients without PV visualization develop CPSS-related complications and, early treatment using prophylactic approaches should be considered, even if they are asymptomatic. Level III. • What is currently known about this topic? A congenital portosystemic shunt is a rare disease with diverse manifestations and is divided into intra- and extrahepatic shuts. However, it has been mainly mentioned in case reports or small series with short-term follow-up. • What new information is contained in this article? This study focuses on the impact of portal flow on the prognosis of children with congenital portosystemic shunts. Patients without delineation of the portal vein system tend to develop more shunt-related symptoms and are more prone to portal hypertension-related complications after shunt closure. [ABSTRACT FROM AUTHOR]

Acute cholecystitis is occasionally observed after biliary drainage using a covered self-expandable metal stent (CSEMS) for distal biliary obstruction (DBO). Gallbladder drainage before CSEMS placement may reduce cholecystitis. This study aimed to examine the preventive effect of endoscopic gallbladder stent placement (EGBS) on cholecystitis with CSEMSs. We retrospectively analyzed patients with DBO who underwent CSEMS placement across the orifice of the cystic duct between November 2014 and October 2021 and were negative for cholecystitis on biliary drainage. Prophylactic EGBS was attempted before CSEMS placement. The incidence of cholecystitis was compared between patients with and without EGBS. In total, 286 patients (128 men; median age, 75 years) were included in this study. EGBS was attempted in 32 patients before CSEMS placement, and technical success was achieved in 24 patients (75%). Adverse events were noted in 3 patients (9.4%; penetration of cystic duct in 1 and acute pancreatitis in 2). The cumulative incidence of cholecystitis was significantly lower in patients with EGBS than in those without EGBS (1 [4.2%] vs 56 [21.4%], P =.045). In multivariable analysis, EGBS was a significant protective factor against cholecystitis (hazard ratio,.11; 95% confidence interval,.01-.79; P =.028). Although the transpapillary approach to the gallbladder is not easy for patients with DBO, EGBS is effective in preventing cholecystitis associated with CSEMS placement. [Display omitted] [ABSTRACT FROM AUTHOR]

Pleuropulmonary blastoma (PPB) is a rare tumor that arises from mesenchymal cells of the lung or pleura. PPB is classified as type I (cystic), type Ir (regressed), type II (cystic and solid), or type III (solid). Here, we report the case of a 2-year-old boy with type II PPB. The patient was treated with neoadjuvant chemotherapy, and the tumor was completely surgically resected. A DICER1 mutation was detected in the tumor specimen. The risk of recurrence is high, and long–term follow–up is required. [ABSTRACT FROM AUTHOR]

Pseudo-Meigs syndrome (PMS) and gliomatosis peritonei (GP) are rare conditions associated with ovarian teratomas. We report the case of an 11-year-old female patient suffering from immature ovarian teratoma with PMS and GP. Enhanced computed tomography (CT) revealed a tumor measuring 240 × 150 × 100 mm in the lower abdomen, ascites, and right pleural effusion. Before the operation, the right pleural effusion increased and required chest tube drainage. Right adnexectomy was performed, and peritoneal nodules were detected during surgery. A biopsy was performed and pathological examination revealed a right immature ovarian teratoma (Grade 3) and glial tissue (Grade 0), thus confirming the diagnosis of GP. Postoperatively, ascites and pleural effusion disappeared, confirming the diagnosis of PMS. Eight months after the operation, a metachronous contralateral mature ovarian teratoma developed, for which fertility-sparing surgery was performed. Therefore, long-term follow-up is required in this patient. [ABSTRACT FROM AUTHOR]

Abstract: Busulfan, an antineoplastic bifunctional-alkylating agent, is known to induce developmental anomalies and fetal neurotoxicity. We previously reported that busulfan induced p53-dependent neural progenitor cell apoptosis in fetal rat brain (Ohira et al., 2012). The present study was carried out to clarify the characteristics and sequence of busulfan-induced pathological changes in infant rat brain. Six-day-old male infant rats were treated with 10, 20, 30 or 50mg/kg of busulfan, and their brains were examined at 1, 2, 4, 7, and 14 days after treatment (DAT). As a result, histopathological changes were selectively detected in the external granular layer (EGL), deep cerebellar nuclei (DCN) and cerebellar white matter (CWM) in the cerebellum with dose-dependent severity but not in the cerebrum. In the normal infant rat cerebellum, granular cells in the EGL were proliferating and moving to the internal granular layer during the normal developmental process. In the EGL of the busulfan group, apoptotic granular cells increased at 2 DAT simultaneously with increased numbers of p53- and p21-positive cells while mitotic granular cells decreased, suggesting an occurrence of p53-related apoptosis and depression of proliferative activity in granular cells. In the DCN, apoptotic glial cells increased at 2 DAT and glial cells showing abnormal mitosis increased at 4 DAT. In the CWN, edematous change accompanying a few apoptotic cells was found in the CWN, especially in the parafolliculus (PFL), from 2 to 7 DAT. The present study demonstrated for the first time the characteristics and sequence of busulfan-induced pathological changes in infant rat cerebellum. [Copyright &y& Elsevier]

Abstract: The sequence of neural progenitor cell (NPC) damage induced in fetal rat brain by transplacental exposure to busulfan, an antineoplastic bifunctional-alkylating agent, on gestational day 13 was examined by immunohistochemical and real-time RT-PCR analyses. Following busulfan treatment, pyknotic NPCs first appeared in the medial layer and then extended to the dorsal layer of the ventricular zone (VZ) of the telencephalon. Pyknotic NPCs that were immunohistochemically positive for cleaved caspase-3, i.e. apoptotic NPCs, began to increase at 24h after treatment, peaked at 48h, and returned to the control levels at 96h. On the other hand, the index (%) of phospho-histone H3-positive NPCs, i.e. mitotic NPCs, and that of BrdU-positive NPCs, i.e. S-phase cells, decreased in accordance with the increase in the index of apoptotic NPCs. Prior to the peak time of apoptotic NPCs, the indices of p53- and p21-positive NPCs peaked at 36h. In addition, the expression levels of p21 and Puma (p53-target genes) mRNAs were elevated in real-time RT-PCR analysis. These findings indicated that busulfan not only induced apoptosis through the p53-mediated intrinsic pathway but also inhibited cell proliferation in NPCs, resulting in a reduction of the width of the telencephalon. On the other hand, in spite of up-regulation of p21 expression, the expression of cyclin D1, part of the cell cycle machinery of the G1/S transition, and the expression levels of Cdc20 and cyclin B1 which are involved in G2/M transition, showed no changes, giving no possible information of busulfan-induced cell cycle arrest in NPCs. [Copyright &y& Elsevier]

Pheochromocytoma (PCC) and paraganglioma (PGL) are rare neuroendocrine tumors that arise from chromaffin cells. We report the case of an 11-year-old boy with no history of hypertension who presented with an abdominal mass arising from the retroperitoneum. During laparoscopic surgery, the patient developed a hypertensive crisis with a peak systolic blood pressure of over 270 mmHg, although we were able to continue to perform laparoscopic resection. Even if no concomitant symptoms due to catecholamine production are observed before surgery, as in this case, blood pressure may fluctuate during surgery. Intraoperative and postoperative management should be considered in cooperation with anesthesiologists. [ABSTRACT FROM AUTHOR]

A two-year-old girl presented with an abdominal mass, abdominal pain, and fever. A quail egg-sized elastic-hard mass was palpable in the upper left abdomen. The patient's growth was impaired. Laboratory data showed an inflammatory response and elevated pancreatic enzymes. The mass showed a cystic structure adjacent to the caudal side of the bifid tail of the pancreas. A fluid collection was observed around the spleen. Surgery was planned under the diagnosis of pancreatic foregut cystic malformation (FCM) associated with a bifid pancreatic tail. However, as the inflammation worsened, parenteral nutrition (PN) was introduced and cyst drainage was performed first, obtaining 10–14 mL/day, and her symptoms subsided. Cyst drainage continued for six weeks at home. Laparoscopic surgery was performed 47 days after the initiation of drainage. Cystography showed communication between the cyst and the slightly dilated pancreatic duct of the bifid tail during surgery. A partial pancreatectomy with cystectomy was performed. The diagnosis of FCM originating from the pancreas, associated with the bifid tail, was confirmed. The postoperative course was uneventful, and the patient was discharged eight days post-surgery. Pancreatic FCM with a bifid pancreatic tail is rare, and we successfully treated it using minimally invasive surgery. [ABSTRACT FROM AUTHOR]

A 10-month-old girl who had previously undergone Kasai portoenterostomy (KP) for biliary atresia was admitted because of recurrent jaundice. Intrahepatic bile duct (IHBD) dilation was observed in the lateral segment close to the umbilical portion of the portal vein on ultrasonography and computed tomography. Although percutaneous transhepatic biliary drainage by a radiologist alleviated jaundice, internal fistula formation, which was subsequently attempted, was unsuccessful due to the narrow and complicated IHBD morphology. Therefore, side-to-side cholangiojejunostomy between the dilated IHBD and jejunum of the Roux-en-Y limb was performed using intraoperative interventional radiology techniques. The patient's postoperative course was uneventful. In patients with recurrent jaundice after KP, especially that associated with solitary IHBD dilatation, a high success rate of achieving good bile flow can be expected using current techniques. [ABSTRACT FROM AUTHOR]

Benign retroperitoneal teratomas are relatively rare tumors that usually progress slowly and are found in newborns and young adults. Here, we report a case in which a prenatally diagnosed retroperitoneal tumor rapidly increased in diameter from 55 mm to 90 mm during the neonatal period. The tumor was removed while preserving the surrounding organs. Moreover, the patient's postoperative course was uneventful. Pathological examination revealed an immature teratoma with no malignant findings. Notably, even benign neonatal teratomas may exhibit rapid growth of their cystic components after birth. • Benign neonatal teratomas may exhibit rapid growth. • The rapid growth of teratomas may be caused by an increase in cystic tissues. • Rapid growth of teratomas may be associated with elevated serum α-fetoprotein levels. [ABSTRACT FROM AUTHOR]

In rat spontaneous neoplasms of the central nervous system, the discrimination between astrocytoma and malignant reticulosis is sometimes difficult because of their similar cell morphologies and growth and infiltration patterns. The derivation of malignant reticulosis is proposed to be lymphocytes, microglias or histiocytes, although their precise origin has not been established yet. In the present retrospective study we examined immunohistochemical analyses from a total of 43 cases in Sprague-Dawley (SD) rats and 21 cases in F344 rats which were diagnosed as benign astrocytoma, malignant astrocytoma or malignant reticulosis according to the diagnostic criteria of WHO International Classification of Rodent Tumours (IARC No. 122). The tumours were classified into five categories as follows: [(1)] early stage of astrocytoma: 7 cases (SD: 3 cases, F344: 4 cases); they are composed of one lesion of moderate cellularity in the parenchyma. [(2)] common type of astrocytoma: 41 cases (SD: 29 cases, F344: 12 cases), which includes not only a single lesion with dense cellularity but also multiple extending lesions in the parenchyma, with infiltration into peripheral meninges or perivascular space. [(3)] glioblastoma type of astrocytoma: 12 cases (SD: 10 cases, F344: 2 cases); necrosis with peripheral palisading is observed. [(4)] intermediate type of astrocytoma and malignant reticulosis: 2 cases (SD: 1 case, F344: 1 case); neoplastic cells are infiltrated more diffusely in meninges and perivascular space with obvious parenchymal infiltration. [(5)] malignant reticulosis: 2 cases (both in F344); neoplastic cells are infiltrated diffusely in meninges and perivascular space without obvious parenchymal infiltration. The neoplastic cells from all categories showed various immunoreactivities for vimentin, RM-4 (anti-rat macrophages and interdigitating cells) and ED-1. However, no distinct difference among these categories was observed. The positive cells for RM-4 mainly corresponded to those of ED-1. The reactivity for vimentin was more intense than that of RM-4 and ED-1. A few neoplastic cells from the common and glioblastoma types demonstrated positive reaction for nestin. No reactivity for GFAP or S-100 was observed in any case of any category. Perivascular or intercellular reticulin fibers which were stained with Watanabe''s silver impregnation method were observed in some or many cases in each category except for the early stage of astrocytoma. The results of the malignant reticulosis generally coincided with those of astrocytomas. In conclusion, no difference in the cell origin between astrocytoma and malignant reticulosis could be found. [Copyright &y& Elsevier]

To study the compared surgical and radiographic outcomes of Transvertebral foraminotomy (TVF) with anterior cervical discectomy and fusion (ACDF) in patients with unilateral cervical spondylotic radiculopathy (CSR). We performed a retrospective comparative study of 72 consecutive patients with 1- or 2-level CSR treated with ACDF or TVF. 27 patients who underwent TVF (group T) and 45 patients who underwent ACDF (group A) with a minimum 2-year follow-up were enrolled. We evaluated clinical outcomes and radiological assessment. Clinical outcome included Visual analog scale (VAS) scores for axial, arm pain at preoperatively and final follow-up. VAS score for painful swallowing was also evaluated 1 week after surgery. Radiological assessment included C2-7 sagittal Cobb angle (C2-7 CA), range of motion (ROM) of C2-7 CA, the height, angle and ROM of the functional spinal unit (FSU), and tip of the spinous process of the operated segment. We also evaluated the disc height, FSU angle, and ROM of the FSU at the cranial adjacent segment. Both groups had good clinical outcomes. Soft tissue swelling was significantly less prominent in group T than that for group A. VAS scores for painful swallowing is lower in group T without significant difference. The ROM of C2-7 CA, FSU, and spinous processes demonstrated a significant reduction in group A compared with group T.(P < 0.05). Disc height at the cranial adjacent segment was maintained in group T. TVF is as effective as ACDF for unilateral CSR and preserves whole cervical spine and segmental alignment. [ABSTRACT FROM AUTHOR]

This paper analyzes theoretically and experimentally the thermal conductivity of the SiC-oxide additive-pore system. In the developed 6 model structures, the thermal conductivity of an SiC compact (κ b ) with oxide was calculated as functions of the volume fractions of SiC, oxide additive and pores. The calculated κ b decreases in the order of a continuous phase where the other two particulate phases are dispersed: SiC>oxide additive>pores. The measured κ b values of SiC compacts hot-pressed with 4–50 mass% oxide additive (mixture of 33.3 mass% Al 2 O 3 -33.3 mass% Y 2 O 3 -33.3 mass% SiO 2 ) were well explained by the calculated κ b in two types of oxide continuous phase models. The thermal conductivities for only SiC grains in SiC compacts hot-pressed with 4 mass% Al 2 O 3 , Y 2 O 3 , SiO 2 , Al 2 O 3 -Y 2 O 3 , Y 2 O 3 -SiO 2 and Al 2 O 3 -Y 2 O 3 -SiO 2 at 1950 °C were also estimated theoretically in the developed two model structures using the measured κ b (oxide continuous phase model and SiC continuous phase model). Based on the calculated results, the following key factors are identified to achieve a high κ b : (1) high sintered density, (2) a small amount of oxide additive with a high thermal conductivity, (3) no dissolution of foreign atoms from a liquid phase into SiC grains during solidification process. [ABSTRACT FROM AUTHOR]

We retrospectively compared the radiological and clinical outcomes of two different surgical techniques (lumbar spinous process splitting laminectomy [LSPSL] and unilateral laminotomy for bilateral decompression [ULBD]) to treat lumbar spinal canal stenosis (LCS). We performed a retrospective comparative study of 141 consecutive patients with an average age of 70.8 ± 9.4 years who had undergone LSPSL or ULBD for LCS between April 2015 and April 2019. None of the patients had developed remote fractures of the spinous processes using either technique. These cases were divided into 2 groups: group L, 73 patients who had undergone LSPSL from April 2015 to April 2017; and group U, 68 patients who had undergone ULBD from May 2017 to April 2019. The clinical and radiological outcomes and surgical complications at the 1-year postoperative follow-up period were evaluated. We found no significant differences in the operative time between the 2 groups. However, group U had had significantly less blood loss than group L. The facet joints were significantly well preserved in group U. We examined the multilevel and spondylolisthesis cases separately and found that both surgical procedures were equally effective and that the visual analog scale scores for back or leg pain and Japanese Orthopaedic Association scores had significantly improved postoperatively in each group. Group U showed better outcomes in terms of LCS recurrence, with 3 patients in the group L requiring repeat surgery. We found both ULBD and LSPSL to be safe and effective techniques for LCS, even for patients with spondylolisthesis and multilevel disease. ULBD was superior in terms of recurrence prevention, preservation of the facet joints, and less blood loss. [ABSTRACT FROM AUTHOR]

This study aimed to compare the clinical outcomes of intestinal transplantation (ITX) between 2 groups by using medications for induction treatment and assess the utility of the current protocol. From 2003 to 2020, 11 patients underwent ITX. Recipients were classified into 2 groups: group IL-2Ra (interleukin-2 receptor antagonist therapy, n = 6) and ATG (rabbit antithymocyte globulin therapy, n = 5). We conducted a retrospective review of patient and graft survival rates and the postoperative course. The 1-, 5-, and 10-year patient and graft survival rates of the 11 primary grafts in the 11 recipients were 100%, 88.9%, 62.2% and 90.0%, 78.8%, 56.3%, respectively. The median duration of follow-up for the IL-2Ra and ATG groups was 197.3 and 87.3 months, respectively. The 1-, 5-, and 10-year patient survival rates were 100%, 83.3%, 50% and 100%, 100%, 100% for the IL-2Ra and ATG groups, respectively (P =. 25) and 83.3%, 66.7%, 33.3% and 100%, 100%, 100% for graft survival in the IL-2Ra and ATG groups, respectively (P =. 08). The incidence of moderate and severe acute rejection was 100% and 20% in the IL-2Ra and ATG groups, respectively (P =. 02). The 1- and 5-year moderate and severe rejection-free survival rates were 33.3%, 0% and 80%, 80% in the IL-2Ra and ATG groups , respectively (P =. 04). ATG significantly suppressed moderate and severe acute rejection compared with IL-2Ra, thereby showing better short- and mid-term rejection-free survival rates. Additional clinical experience is needed to determine the optimal regimen for the management of ITX recipients. [ABSTRACT FROM AUTHOR]

This manuscript discusses the case of huge presacral Tarlov cysts (TCs) and the substantial neurologic recovery noted in the patient following spontaneous rupture of the most prominent cyst. Perineural or TCs are nerve root cysts, which are usually incidental findings on magnetic resonance imaging (MRI) and are most frequently observed in the sacral spine. Symptomatic lesions are rarely encountered. In this case, a 44-year-old woman presented with anal and vulva pain on the right side, and bladder and bowel dysfunction. MRI of the lumbosacral spine showed multiple huge bilateral TCs located within the presacral space from S1-3. There was a substantially large right-sided S3 cyst that was presumed to be responsible for her symptoms. Surgical intervention was considered; however, her symptoms improved significantly during the waiting period for surgery because of spontaneous rupture of the right-sided S3 cyst, as confirmed on follow-up MRI. On follow-up over a 1-year period, the patient had been very well with no recurrent symptoms. To our knowledge, this is the first report of spontaneous cyst rupture and resultant neurologic improvement in a case of symptomatic presacral TCs. [ABSTRACT FROM AUTHOR]

Spinal myxopapillary ependymoma (SME), generally considered a benign entity, can exhibit brain and whole-spine metastases as well as local recurrence after surgery. However, the presence of preoperative retrograde intracranial dissemination at the time of diagnosis is very rare. We report a case of SME in a 22-year-old man who presented with acute exacerbation of chronic back pain shooting down both thighs and weakness in both legs. Magnetic resonance imaging of the brain and whole spine showed an enhancing mass occupying the majority of the spinal canal at the L1-L2 level and multiple foci dissemination, including in the right pons, lateral midbrain, and occipital lobe, and at the C7, Th6, L4, and S2 levels of the spinal canal at the time of diagnosis. On gross total removal of the dominant tumor located at the L1-L2 level, severe intradural arachnoiditis and syrinx filled with xanthochromic cerebrospinal fluid was noted, indicating the presence of previous tumor hemorrhage. Histopathologic analysis of the tumor supported SME diagnosis, and <1% of cells showed Ki-67 expression. We speculated that distant retrograde dissemination could have been attributed to metastatic spread through cerebrospinal fluid caused by tumor hemorrhage, which may explain distant dissemination despite low expression of Ki-67. Screening of the whole brain and spine at the time of diagnosis is imperative when tumor is detected at any level of the neuraxis. The present case of SME with a preoperative intracranial lesion is the fifth case documented in the medical literature. [ABSTRACT FROM AUTHOR]

Genistein is a dietary-derived flavonoid abundantly present in soybeans and known to possess various biological effects including anti-inflammation and anti-angiogenic activity. To investigate the effects of genistein on intraocular neovascularization, we used an animal model of laser-induced choroidal neovascularization (CNV). Male C57BL/6J mice were treated in accordance with the ARVO Statement for the Use of Animals in Ophthalmic and Vision Research. CNV was induced by laser photocoagulation. The animals were fed a mixture diet containing 0.5% genistein or a control diet ad libitum for 7 days before laser photocoagulation and the treatment was continued until the end of the study. Seven days after laser injury, the size of CNV lesions was quantified. Retinal pigment epithelium (RPE)-choroid complex was also harvested 1 or 3 days after laser injury and the level of monocyte chemoattractant protein (MCP)-1, intercellular adhesion molecule (ICAM)-1, and matrix metalloproteinase (MMP)-9 were measured by enzyme-linked immunosorbent assay. Expression levels of Ets-1 and F4/80 were examined by real-time PCR. A significant decrease in CNV size was observed in animals treated with genistein (15441.9±1511.8 μm 2 ) compared to control mice (21074.0±1940.7μm 2 , P <.05). Genistein significantly reduced the protein level of MCP-1, ICAM-1, and MMP-9 in the RPE-choroid complex ( P <.05). In addition, genistein suppressed the expression levels of Ets-1 and F4/80 ( P <.05). The current data indicate the anti-angiogenic property of genistein during CNV formation. [ABSTRACT FROM AUTHOR]