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To elucidate the clinical, pathologic, and prognostic impacts of epidermal growth factor receptor (EGFR) mutation and mutation subtypes in early-stage lung cancer, the study investigators conducted a retrospective analysis of the Japanese Joint Committee of Lung Cancer Registry database (a nationwide database for patients with surgically resected lung cancer; n = 18,973). Of 13,951 patients classified as having nonsquamous non-small cell lung cancer in the database, 5780 patients (41.0%) had been tested for an EGFR mutation and were included in this study. An EGFR mutation was detected in 2410 patients (41.7%), and the presence of an EGFR mutation was significantly correlated with clinicopathologic factors such as the presence of ground-glass opacity (P <.001) and better prognosis. Analysis of initial recurrence sites identified significantly higher frequencies of brain and adrenal gland metastases in patients with and without an EGFR mutation, respectively. Of 2410 patients with EGFR mutations, 983 (40.8%) had an exon 19 deletion (Exon 19 Del), 1170 (48.5%) had an L858R mutation, and 257 (10.7%) had other EGFR mutations. A higher smoking rate was found in patients with other EGFR mutations (P =.02). In the comparison of Exon 19 Del and L858R, we found that Exon 19 Del correlated with younger age (P <.001), a higher rate of pure solid tumors (P <.001), advanced pathologic stage (trend P <.001), and poorer recurrence-free survival (P =.001). In addition to the clinicopathologic and prognostic impacts of EGFR mutation status, tumors with Exon 19 Del have a more aggressive phenotype and patients have a poorer prognosis than with L858R in early-stage lung cancers. [ABSTRACT FROM AUTHOR]

Setting priorities for limited public resources has become a topic of heated discussion the world over. Assigning different weights for the health gains of different population groups allows for equity considerations in cost-effectiveness analysis. However, only a few empirical works have elicited the preferences of the general public. To compare the equity preferemce assigned by Japanese and Koreans. We conducted a Web-based survey in March 2013, including a discrete choice experiment, to elicit the equity preferences of the general public for the life expectancy gains of different population groups. We selected attributes and designed the experiment following Norman et al.'s study (Norman R, Hall J, Street D, Viney R. Efficiency and equity: a stated preference approach. Health Econ 2013;22:568–81). Accordingly, we analyzed preference for sex, smoking status, lifestyle, caring status, income, and age. The Japanese assigned a higher preference for males (P < 0.001), nonsmokers (P < 0.001), those with lower income (P < 0.001), and carers (P < 0.001), and they assigned a lower preference for those with a life expectancy of 60 years (P = 0.002) and 75-year-olds (P < 0.001). Koreans have the same patterns of preference for lower income (P < 0.001), caring (P < 0.001), and smoking status (P = 0.026). However, they prefer both sexes (P = 0.331) and different age groups equally. In both countries, respondents tend to prefer groups with characteristics similar to their own. People from the two Asian developed countries, with universal health insurance, show different equity preferences. These may reflect the variations in cultural background and coverage of health care services. [ABSTRACT FROM AUTHOR]

Background Prognosis beyond 5 years after segmentectomy for non-small cell lung cancer (NSCLC) has not been well studied. Methods This study is a retrospective analysis of a previous prospective cohort study of patients with peripheral cT1 N0 M0 NSCLC who underwent segmentectomy between 2005 and 2009. Exclusion criteria were right middle lobe tumors, multiple tumors in same lobe, patients having considerable risk for segmentectomy, and patients requesting lobectomy rather than segmentectomy. The median follow-up period was 108 months. Study outcomes included overall survival, recurrence-free probability, and local recurrence. Results Of 179 patients with cT1 N0 M0 who were treated by segmentectomy, clinical T stages were Tis in 57 patients, T1mi or T1a in 34, T1b in 57, and T1c in 31. All tumors were pathologic N0 tumors. The 10-year recurrence-free probability rates in each clinical stage were 100% in Tis, 97% in T1mi or T1a, 90% in T1b, and 69% in T1c, which were significantly lower in advanced T stages (p < 0.001). Fourteen patients (8%) experienced recurrences after segmentectomy; these were local in 8 patients (five recurrences at the surgical margin and three in the preserved lobe) and nonlocal in 6 patients. Six of the eight local recurrences developed more than 5 years after segmentectomy. All eight local recurrences were treated by local therapy, resulting in 6 patients surviving without disease at 55 months of median follow-up after the additional treatments. Conclusions Although segmentectomy may be a viable curative option for treating T1 N0 M0 NSCLC, monitoring for local recurrence should be continued beyond 5 years after segmentectomy to avoid missing opportunities to effect a cure. Visual Abstract Graphical/Visual Abstract Margin-recurrences in the recurrence-free probability curves. [ABSTRACT FROM AUTHOR]

The precise mechanism by which butyrate-producing bacteria in the gut contribute to resistance to respiratory viral infections remains to be elucidated. Here, we describe a gut-lung axis mechanism and report that orally administered Clostridium butyricum (CB) enhances influenza virus infection resistance through upregulation of interferon (IFN)-λ in lung epithelial cells. Gut microbiome-induced ω-3 fatty acid 18-hydroxy eicosapentaenoic acid (18-HEPE) promotes IFN-λ production through the G protein-coupled receptor (GPR)120 and IFN regulatory factor (IRF)-1/-7 activations. CB promotes 18-HEPE production in the gut and enhances ω-3 fatty acid sensitivity in the lungs by promoting GPR120 expression. This study finds a gut-lung axis mechanism and provides insights into the treatments and prophylaxis for viral respiratory infections. [Display omitted] • Oral administration of Clostridium butyricum attenuates influenza virus pneumonia • Clostridium butyricum -induced IFN-λ can enhance influenza virus infection resistance • Orally administered Clostridium butyricum enhances 18-HEPE production in the gut • 18-HEPE upregulates IFN-λ in lungs through GPR120 and IRF-1/-7 activation Hagihara et al. show that orally administered butyrate-producing Clostridium butyricum (CB) enhances influenza virus infection resistance through interferon (IFN)-λ upregulation in lung epithelial cells. A gut microbe-induced ω-3 fatty acid, 18-hydroxy eicosapentaenoic acid (18-HEPE), promotes IFN-λ production through G protein-coupled receptor (GPR)120 and IFN regulatory factor (IRF)-1/-7 activation. [ABSTRACT FROM AUTHOR]

Background Solute carrier family 5 member A8 ( SLC5A8 ) is a sodium-coupled transporter for several chemicals. The SLC5A8 gene has been reported to function as a tumor suppressor gene that contributes to carcinogenesis and tumor progression. The expression of SLC5A8 is silenced in colon neoplasia by hypermethylation of CpG-rich islands located in exon 1. In this study, we assessed the significance of aberrant methylation of the SLC5A8 gene as a prognostic factor for lung adenocarcinoma (AD). Methods We analyzed the methylation levels of a consecutive series of 143 node-negative stage I and II lung AD samples using pyrosequencing. Results The methylation level of exon 1 in the SLC5A8 gene was significantly associated with poor prognosis in cases of node-negative stage I and II lung AD. Conclusions Gene silencing of SLC5A8 by hypermethylation was associated with poor prognosis in cases of node-negative stage I and II lung AD. [ABSTRACT FROM AUTHOR]

Clostridioides difficile causes nosocomial antibiotic-associated diarrhea on a global scale. Susceptibility to C. difficile infection (CDI) is influenced by the composition and metabolism of gut microbiota, which in turn are affected by diet. However, the mechanism underlying the interplay between diet and gut microbiota that modulates susceptibility to CDI remains unclear. Here, we show that a soy protein diet increases the mortality of antibiotic-treated, C. difficile -infected mice while also enhancing the intestinal levels of amino acids (aas) and relative abundance of Lactobacillus genus. Indeed, Ligilactobacillus murinus -mediated fermentation of soy protein results in the generation of aas, thereby promoting C. difficile growth, and the process involves the anchored cell wall proteinase PrtP. Thus, mutual interaction between dietary protein and the gut microbiota is a critical factor affecting host susceptibility to CDI, suggesting that dietary protein sources can be an important determinant in controlling the disease. [Display omitted] • A soy protein diet increases the susceptibility to C. difficile infection • A soy protein diet increases the gut amino acids, which promote C. difficile growth • A soy protein diet enhances the relative abundance of Lactobacillus genus • Lactobacillus supplies gut amino acids by digestion of soy protein Susceptibility to Clostridioides difficile infection is influenced by gut microbiota and diet. Yakabe et al. demonstrate that soy protein promotes the growth of C. difficile by enhancing the intestinal levels of amino acids (aas). Furthermore, soy protein enhances the relative abundance of Lactobacillus , which digests soy protein to generate aas. [ABSTRACT FROM AUTHOR]

Lung adenocarcinoma has never before been reported to be associated with von Hippel-Lindau (VHL) disease. Here, we report a case of VHL disease in a patient who had metachronous multiple lung adenocarcinomas. The patient is a 64-year-old-woman with VHL disease. She underwent surgical resection of one adenocarcinoma and one atypical adenomatous hyperplasia. A second lung adenocarcinoma developed metachronously. A point mutation in the VHL gene was confirmed in DNA from a blood sample, and loss of heterozygosity at the VHL locus was detected in the lung adenocarcinoma. The VHL dysfunction may have a role in the development of multiple lung adenocarcinomas. [ABSTRACT FROM AUTHOR]

Abstract: High-surface-area carbon xerogels were prepared in the form of disks via carbonization of precursor resorcinol–formaldehyde (RF) polymer disks and subsequent activation of the resultant RF carbon xerogels by CO2. RF carbon xerogels allow the preparation of a set of pre-activated carbon disks having different mesopore volumes. Analysis of the relationship between the mesopore volume of the samples and their CO2 activation efficiency showed that the presence of mesopores is crucial for obtaining a high-surface-area carbon with minimal burn-off of carbon atoms. Activation of an RF carbon disk with a mesopore volume of 1.0cm3 g−1 up to a burn-off of 81% yielded an activated carbon disk with a high BET surface area of ∼3000m2 g−1. Such disks could be readily used as electrode materials for an electric double layer capacitor without filler or binder addition and exhibited competitive EDLC performance against other electrode materials previously reported. [Copyright &y& Elsevier]