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Preoperative depletion of psoas muscle mass index (PMI) in lung cancer patients is an unfavorable prognostic factor. The relationship between post-surgical changes in PMI and survival is not clear. Therefore, we conducted a retrospective study to clarify the prognostic significance of preoperative and postoperative PMI changes.We retrospectively reviewed lung cancer patients, who underwent curative surgical resection with lymph node dissection and computed tomography (CT) approximately six months post-surgery between 2010 and 2019. Pre- and postoperative PMI was measured from CT images at the third lumbar vertebra level. A sex-dependent PMI change ratio (postoperative PMI/preoperative PMI) was used to divide patients into two groups: high PMI loss (67 patients, ≤25Age ≥70 years, elevated preoperative carcinoembryonic antigen levels, advanced pathological stage, lymphatic permeation, vascular invasion, performance of adjuvant platinum-doublet chemotherapy, low body mass index, and postoperative recurrence were significantly higher in the high PMI loss group. Logistic regression analysis found that Charlson comorbidity index, low body mass index, advanced pathological stage, and postoperative recurrence were associated with high PMI loss. The five-year postoperative overall survival rate was 50% in the high PMI loss group and 79% in the low PMI loss/PMI increase group (p0.001). High PMI loss was also an unfavorable factor in a multivariable Cox's proportional hazard model (p=0.002).Postoperative muscle loss was an independent prognostic factor for poorer overall survival regardless of preoperative sarcopenia, in non-small cell lung cancer.

Background: Real-world data on the clinical outcomes of first-line osimertinib treatment for non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations is lacking. This study aimed to evaluate the treatment outcomes and the prognostic factors of osimertinib as first-line therapy in clinical practice settings.Methods: We retrospectively evaluated clinical outcomes of patients with EGFR-mutated NSCLC treated with osimertinib as first-line therapy across 12 institutions in Japan between August 2018 and March 2020.Results: Among 158 enrolled patients, the objective response rate (ORR) was 68% and the estimated median progression-free survival (PFS) was 17.1 months (95% confidence interval [CI], 14.5-19.7). Subgroup analysis showed that PFS in the group with high programmed death-ligand 1 (PD-L1) expression was significantly shorter than that in groups with low or no PD-L1 expression (10.1 vs. 16.1 vs. 19.0 months; p = 0.03). Univariate and multivariate analyses demonstrated that high PD-L1 expression was the only independent adverse prognostic factor of osimertinib outcome for PFS (hazard ratio, 2.71; 95% CI: 1.26-5.84; p = 0.01). In terms of the ORR, there was no statistically significant difference regardless of PD-L1 expression (67% vs. 76% vs. 65%; p = 0.51).Conclusion: Osimertinib showed favorable treatment outcomes in clinical practice. Although the ORR was similar regardless of PD-L1 expression, high PD-L1 expression could be an independent adverse prognostic factor related to PFS in osimertinib treatment.

Aim To clarify the clinicopathological features in elderly anaplastic lymphoma kinase (ALK) rearranged non-small cell lung cancer (NSCLC) patients. Patients and methods A retrospective study was performed in 129 ALK rearranged NSCLC patients diagnosed between April 2008 and March 2019 in fifteen Institutions of the Ibaraki prefecture, Japan. Results Median age of patients was 63 years. In 59 patients aged 65 and older, the proportions of patients with advanced stage and those treated with ALK-tyrosine kinase inhibitor (TKI) were lower than those younger than 65 years. There was no difference in overall survival (OS) between the two age groups. Among the elderly patients, no difference was observed in OS between the patients aged 65-69 and those aged 70 and older. In 89 patients treated with TKI, no significant differences were observed in the progression-free survival of TKIs and OS between patients aged 65 and older and those younger than 65, respectively. Conclusion Evaluation of ALK gene status and TKI treatment are desirable even for elderly patients.

Aim To clarify the correlation between serum levels of carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA) and metastasis and survival in anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC) patients. Patients and methods CEA and CYFRA levels in 131 ALK-rearranged NSCLC patients were determined using fluorescence in situ hybridization (FISH), real time-reverse transcription polymerase chain reaction, and immunohistochemistry, using biopsy specimens, cytology specimens, and plasma specimens. Cut-off value of each marker was determined as 10 ng/ml. Results In logistic regression analysis, higher levels of both markers had a positive relationship with bone metastases, and higher levels of CYFRA was relevant to liver metastases, and multiple-organ metastases. However, these markers were not proven to be poor prognostic factors in Cox's proportional model analysis. Conclusion Elevated serum CEA and CYFRA levels seem to provide useful clinical information about presence of bone and liver metastasis and multiple-organ metastases, although they were not a powerful indicator of prognosis. These two markers may suggest the extension of metastasis and would be helpful in considering treatment options.

Introduction Skeletal muscle depletion, referred to as sarcopenia, has recently been identified as a risk factor for poor outcomes in various malignancies. However, the prognostic significance of sarcopenia in patients with NSCLC after surgery has not been adequately determined. This study investigated the impact of sarcopenia in patients undergoing pulmonary resection for lung cancer. Methods This retrospective study consisted of 328 patients with pathologically confirmed NSCLC who underwent curative resection between January 2005 and April 2017. Preoperative computed tomography imaging at the third lumbar vertebrae level was assessed to measure the psoas muscle mass index (PMI, cm2/m2). Sarcopenia was defined as a cutoff value of PMI less than 6.36 cm2/m2 for males and 3.92 cm2/m2 for females, based on PMI values from “healthy” subjects. Results The median patient age was 71 years and 59% were male. Sarcopenia was present in 183 (55.8%) and was significantly related with increasing age (p Conclusions Sarcopenia as determined using preoperative computed tomography could be used to predict postoperative major complication and prognosis in patients with resected NSCLC. Our results may provide some important information for preoperative management.

A 39-year-old woman received a seasonal influenza vaccine in November 2015 and subsequently experienced malaise, low-grade fever, and chest discomfort. A chest X-ray performed 2 weeks after vaccination showed multiple nodular shadows in both lungs and ground-glass shadows in both lower lung fields. Her bronchoalveolar lavage fluid contained an unusually high number of lymphocytes, and a drug-induced lymphocyte stimulation test for seasonal influenza vaccine was positive. Transbronchial lung biopsy revealed the presence of granulomatous inflammation. Thereafter her abnormal chest shadow spontaneously improved. Based on these findings, the patient was diagnosed with drug-induced pneumonitis due to an influenza vaccine.

In the Application for Construction Plan License after the Great East Japan Earthquake, it was needed to revalidate the damping ratio to apply 3% for seismic analyses of Reactor Coolant Loop (RCL) with two-point-support Steam Generators (SGs) which was normally 0.5% or 1% in the past Applications. For the revalidation, vibration tests of SGs were carried out at Unit 2 and Unit 3 in Mihama Power Station of the Kansai Electric Power Co., Inc. In the test at Mihama Unit 2, SG top was hit horizontally by the pendulum type hammering device. As a result, in the hot leg (HL) direction, 9% damping ratio has been obtained. In the test at Mihama Unit 3, electro-hydraulic actuators were installed at the top of reinforced concrete wall surrounding SG and SG upper manhole was excited. In the excitation test, frequency response curves were obtained by changing the frequency stepwise in sinusoidal wave at constant amplitude. The damping ratio has been confirmed as more than 3%, specified in JEAG 4601-1991 as standard value, in the HL perpendicular direction which provided smaller damping ratio compared to the HL direction. Dissipation energy of snubber was measured and it has been confirmed that snubbers themselves do not contribute damping effect for small SG displacement like tests in Mihama Unit 2 and Unit 3. Large dissipation energy of snubbers would be expected in earthquake. It has been realized that conservative large responses are computed in RCL seismic analysis if the damping ratios obtained are used.

BackgroundThe purpose of this study was to retrospectively compare the volume doubling time (VDT) on serial computed tomography (CT) of non–small-cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutation with that of NSCLC without the mutation.MethodsOne hundred and two pathologically proven NSCLCs, including 69 patients with lung adenocarcinoma, were reviewed with helical CT. Each tumor underwent at least two CT scans. The VDT was calculated using a modified Schwartz formula. EGFR mutations at exons 18–21 were determined by common fragment analysis and Cycleave method.ResultThe median VDT of all the patients was 188 days. EGFR mutations were noted in 35 of the 102 patients. The VDT in the 35 patients with EGFR mutations (median 676 days) was longer than that in the 67 patients without EGFR mutations (median 139 days) (p

In this study, the total materials requirement (TMR) to recycle chemical elements from the urban ore by recycling (urban ore TMR, UO-TMR) has been compared with the TMR to extract the element from the natural ore by smelting (natural ore TMR, NO-TMR) in order to evaluate the urban ore grade on an equal footing with the natural ore. A framework of UO-TMR based on the NO-TMR framework is developed. To validate the developed framework, the UO-TMR of a laptop PC is estimated assuming gold, silver, copper, iron, aluminum, tantalum and indium are recycled. It is found that the UO-TMRs for gold, silver, copper, iron, aluminum and tantalum are lower than NO-TMR, but that for indium is higher. The ratio of “urban tailings” is at most 60% of the total, which is smaller than that of NO-TMR “tailings”. In contrast to the contributions of energy and material inputs for the recycling process, the contribution of transportation is not very large. For the UO-TMR of indium, the contribution of materials for recycling process is extremely large. The availability and scalability of UO-TMR are also discussed.

In this study, the total materials requirement (TMR) to recycle chemical elements from the urban ore by recycling (urban ore TMR, UO-TMR) has been compared with the TMR to extract the element from the natural ore by smelting (natural ore TMR, NO-TMR) in order to evaluate the urban ore grade on an equal footing with the natural ore. A framework of UO-TMR based on the NO-TMR framework is developed. To validate the developed framework, the UO-TMR of a laptop PC is estimated assuming gold, silver, copper, iron, aluminum, tantalum and indium are recycled. It is found that the UO-TMRs for gold, silver, copper, iron, aluminum and tantalum are lower than NO-TMR, but that for indium is higher. The ratio of "urban tailings" is at most 60% of the total, which is smaller than that of NO-TMR "tailings". In contrast to the contributions of energy and material inputs for the recycling process, the contribution of transportation is not very large. For the UO-TMR of indium, the contribution of materials for recycling process is extremely large. The availability and scalability of UO-TMR are also discussed.

We report 3 cases of long-term control achieved via S-1 monotherapy in elderly patients with advanced non-small-cell lung cancer. In case 1, a 75-year-old man clinically diagnosed with stage IIIA lung adenocarcinoma received S-1 as fourthline chemotherapy. PR was achieved, and PFS was 8 months. In case 2, a 78-year-old woman clinically diagnosed with stage IV lung squamous cell carcinoma received S-1 as third-line chemotherapy. A PR was achieved, and PFS was 14 months. In case 3, an 83-year-old man clinically diagnosed with stage IV lung squamous cell carcinoma received CBDCA plus PTX, followed by S-1 on alternate days. Although tumor size was not reduced, SD was maintained for 11 months.

Structural strengths of the piping and components in NPPs have been designed with seismic margin. They are classified seismically S, B and C class in terms of the influence rate to nuclear safety. For the highest seismic class (Class S) equipment, it is clarified that they have enough seismic margins against design seismic conditions by shaking table tests or numerical simulations. However, for the lower seismic class (Class B and C) equipment, their seismic margins have not been clarified quantitatively. In this paper, in order to evaluate seismic robustness of the lower seismic class equipment with no clarification of seismic margin, seismic influences of the lower seismic class equipment in NPPs damaged by actual large earthquakes have been surveyed and sorted as a database, and the integrity of the lower class equipment have been discussed. Seismic effects on 24 plants damaged by the recent large 6-earthquakes are surveyed, sorted as a database, and investigated. As a result, a total of 29 cases of function deterioration or loss were observed. Considering the total number of components and piping, the frequency of those cases in class B and C components and piping was low. And also, as it is found there are a few cases of degradation or loss of function in the equipment installed on the bedrock or in the buildings.

A new epizootic causing mass mortalities among cultured Japanese abalone, Sulculus diversicolor supratexta, occurred in Kanagawa Prefecture, Japan, during the period from June to October in 1997. Diseased abalone lost the ability to adhere and eventually died on the bottom of aquaria. White spots on the foot were a characteristic sign of the disease. In sections of tissues with lesions, there was necrotic degeneration in muscle fibers, and homogeneous bacterial cells were isolated from the infected tissue. Isolates of this bacterium were Gramnegative, facultatively anaerobic, rod shaped organisms that were motile by a single polar flagellum. They were identified as Vibrio carchariae on the basis of phenotypic characteristics, 16S rRNA gene sequences and DNA-DNA hybridization, although some phenotypic properties of the isolates differed from those of references. Infection experiments confirmed the pathogenicity of the bacterium to Japanese abalone. This is the first report of the isolation of V. carchariae from a diseased shellfish.

A pectin-releasing enzyme produced by Kluyveromyces wickerhamii IFO 1675 (PPase-W) was purified to homogeneity from a culture filtrate by cation-exchange and size-exclusion chromatographies. This enzyme had a molecular weight of 35,000 determined by both size exclusion chromatography and ultracentrifugal analysis, and of 40,000 by SDS-PAGE. It contained 2.4% sugar, and its isoelectric point was at pH 5.2. PPase-W catalyzed the release of highly polymerized pectin from various protopectins, and also showed endopolygalacturonase (endo-PGase) activity. The purified enzyme had optimum PGase activity at about pH 5.2 and 50°C and was stable in the range of pH from 4.0 to 7.0 and up to 50°C. The properties of PPase-W were compared with those of PPase-F from Kluyveromyces fragilis IFO 0288, and some differences were found. Also, some preliminary data dealing with the relationship between enzyme activities (PPase and endo-PGase) and protein structure are discussed.

The amounts discarded laptop PC for home and business use from 1989-2025, desktop PC for home and business use from 1989-2025, mobile phone from 1991-2025 and PHS (handy phone system) from 1996-2025 have been estimated using population balance model. It is found that the discarded amounts of home PC are still increasing after 2010, while that increase rates in case of mobile phone and PHS are slight. The amounts of elements in all the discarded products have been estimated too using literatures and measured values. The impacts of the elements are discussed based on the comparison with domestic demands, the values weighted by total materials requirement (TMR) and the elemental concentration in the products normalized by that in crude ore.