GPS and chemotherapy for elderly NSCLC

Background : Although platinum-combination chemotherapy is widely used to treat advanced non-small cell lung cancer (NSCLC), not all elderly patients benefit from this regimen. In this retrospective study, we aimed to evaluate whether the Glasgow Prognostic Score (GPS), an indicator of systemic inflammation and malnutrition, could predict the tolerability and efficacy of platinum-combination chemotherapy among elderly patients with NSCLC. Methods : The eligibility criteria included patients aged ≥ 70 years with NSCLC treated with first-line platinum-combination chemotherapy at Shimane University Hospital between January 2015 and December 2018. Results : Thirty-two patients with NSCLC (median age, 74 years) were included. The GPS scores were 0–1 for 19 patients and 2 for 13 patients. Four chemotherapy cycles were completed by 57.9% and 30.8% of patients in the GPS 0–1 and GPS 2 groups, respectively. The GPS 0–1 group experienced better outcomes than the GPS 2 group (response rate : 26% vs. 15%, P = 0.67 ; median progression-free survival : 4.1 vs. 2.1 months, P = 0.0026 ; median overall survival : 22.8 vs. 9.6 months, P = 0.0092). Conclusions : Platinum-combination chemotherapy demonstrated promising efficacy among elderly NSCLC patients with a GPS 0–1. Therefore, GPS may be crucial in determining whether treatments recommended for younger patients are suitable for older patients with NSCLC

Frail patients with respiratory failure

Background : Older patients with severe respiratory failure have higher mortality rates and are more likely to experience impairments in activities of daily living (ADL). Methods : We retrospectively reviewed patients (≥ 75 years) who received intubation and artificial ventilation for respiratory failure at Shimane University Hospital between November 2014 and December 2020. We compared the outcomes of frail patients with those of self-sufficient patients. Results : Thirty-two patients were included. ADL ability before respiratory failure was rated self-sufficient in 18 patients (self-sufficient group) and not self-sufficient in 14 patients (frail group). None of the patients in either group underwent advanced care planning prior to the onset of respiratory failure. In the self-sufficient and frail groups, the in-hospital mortality rates were 33% and 50%, and the incidence of bedridden patients at discharge was 6% and 43%, respectively. Most patients in the frail group (93%) died or were bedridden. The median hospitalization cost was JPY 2,984,000 for the self-sufficient group and JPY 3,008,000 for the frail group. Conclusion : The overall prognosis of frail older patients who underwent intubation and artificial ventilation was poor. When providing intensive care to such patients, it is important to carefully consider their suitability for the treatment

Studies on Infection and Multiplication of Plant VIruses in Variegated Tobacco Plants (2) : Infection and Multiplication of Tobacco Mosaic Virus in Variegated Leaves of Tobacco Cultivar Samsun Nc

The sensitivity of withe (W) and green (G) areas of variegated tobacco leaves (NIcotiana tabacum cv. Samsun Nc) to infection and multiplication of tobacco mosaic virus (TMV) was compared. 1. The number of local lesions produced on W was double of that on G. 2. The enlargement of local lesions was relatively faster on W, however, TMV concentration at 3-4 days after inoculation was 2-6 times higher in the lesions produced on G as compared to that in the lesions on W. 3. The central and marginal tissues of local lesions developed on W and G were observed by electron microscopy to clarify the processes of collapse and necrotization of cells in relation to TMV amultiplication. The results are as follows. 1) In the central tissues of lesions on both areas of W and G, all cellsd were completely collapsed, shrinked and star-shaped. In these cells, TMV particles were aggregated in crystalline form in altered electron-dense cytoplasm. The size and number of the virus-aggregates in G cells were greater than those in W cells. 2) In marginal tissues of the lesions, various stages of cell necrotization were observed. The first events of cell necrotization were plasmolysis and rupturing of tonoplast. Following these events, the plastids or chloroplasts burst and the continuity in the cytoplasmic membrane occurred earlier than bursting of plastids. TMV particles were scattered in the cytoplasm with bursting of the tonoplast in W and G cells. 3) No remarkable difference was observed in the ultrastructure of margins of the lesions from W and G. TMV particles were observed in the cytoplasm of several cells beyond the necrotic region. 4. From these results, the fact that TMV concentration in local lesions on W is lower than that in the lesions on G, contrasting to highersensitivity (in terms of lesion formation) of the former than the latter, may be attributed to the rapid cell necrotization in W cell as compared to that in G cells resulting in early inhibition of virus multiplication.タバコ(Nicotiana tabacum cv. Samsun Nc)の斑入り葉の白色部と緑色部とにおけるTMV の感染･増殖を比較した.1. TMV局部病斑は白色部において多く現われ,その数は線色部における病斑数の約2倍であった.2. 局部病斑の拡大は白色部においてやや速やかであったが,接種3, 4日目の病斑部から回収されるTMV量は緑色部の病斑において高く,白色部の病斑から回収される量の2-6倍であった.3. 白色部と緑色部とにおける4日目の局部病斑の内部およびその周縁部組織を電顕観察して,細胞え死に伴う崩壊過程とTMV粒子の存在状態を詳細に比較した結果次のような所見が得られた.1) 白色および線色両組織における局部病斑内部の細胞は完全に崩壊し,収縮して屋形を呈した.これらの細胞においてはTMV粒子は変質した細胞質内に結晶状に集合した状態で存在し,白色細胞より緑色細胞でより大きな集団を形成し,またその数も緑色細胞で多かった.2) 病斑周縁部の組織においては細胞え死化の種々の段階の像が見られ,え死化の第1段階は原形質分離とtonoplastの崩壊であった. これに続いてplastidまたは葉緑体と細胞質膜の崩壊が起こった.細胞質膜の連続性は緑色組織より白色組織でより早く失われた.TMV粒子は白色および緑色細胞のいずれにおいてもtonoplastの崩壊によって細胞質内に散在していた.3) 病斑を取り巻く細胞内で見られる形態的変化においては白色,緑色両組織の間に顕著な差異が認められなかった.TMV粒子はえ死細胞の数層外側の細胞においても見られた.4) 以上の結果から,白色部のTMV感受性(柄斑形成数)は緑色部のそれに比べて高いにもかかわらず白色病斑部のTMV量が緑色病斑部の量に比べて低い原因はウイルス増殖に伴う細胞え死化が白色細胞において緑色細胞におけるよりもより早く現れ,TMVが十分に増殖する前に細胞機能の低下を引き起こすためと考えられる

Transport characteristics of a silicene nanoribbon on Ag(110)

We present the transport characteristics of individual silicene nanoribbons (SiNRs) grown on Ag(110). By lifting up a single SiNR with a low-temperature scanning tunneling microscope tip, a nanojunction consisting of tip, SiNR and Ag is fabricated. In the differential conductance spectra of the nanojunctions fabricated by this methodology, a peak appears at the Fermi level which is not observed in the spectra measured either for the SiNRs before being lifted up or the clean Ag substrate. We discuss the origin of the peak as it relates to the SiNR

Cytoplasmic Inclusions in Rice Leaf Cells Infected with Rice Necrosis Mosaic Virus

Ultrathin sections of mesophyll cells of the rice(Oryza sativa L. cv. Kibiyoshi) infected with rice necrosis mosaic virus were examined with an electron microscope. Two types of cytoplasmic inclusion were observed in the cells. One was similar to the cylindrical inclusion which was observed as pinwheels or bundles mainly produced by filamentous viruses. The other was the membranous inclusion(MI) which seemed to be composed of the tubules closely assembled. Cross sections of MI showed elliptic or circular shape, about 4μm in diameter. The membranes composed of the tubules communicated with each other and associated with endoplasmic reticula at the terminal sites. The tubules were disposed in a hexagonal pattern like honeycomb and each tubule was surrounded by 6 spots which appeared like particles, about 10-12nm in diameter. The spots in cross view turned into filaments by tilting the sections at an angle of 40°. Therefore, it seems that these spots are cross view of the filaments running in parallel with the tubules but not the virus particles. MI observed in this experiment seems to have the most complex structure among the inclusions related to plant viruses reported hitherto.イネえそモザイクウイルスに侵されたイネ葉肉細胞の電顕観察を行なった結果,健全細胞には見られない2種類の細胞質内封入体が観察された.1つはEdwardsonらが名付けた管状封入体(cylindrical inclusion)と同類と思われるもので, pinwheelやbundle型として観察される.他は管状物が密に集まってできた膜状封入体(MI)である.MIの横断像は楕円形あるいは円形で,径4μmに達するものもあった.その構造は管状物の切断される角度によって,ハチの巣状,網目状,あるいはラメラ構造を呈し,非常に複雑であった.ハチの巣状に見える部分では,個々の穴の直径は20～30nmであり,相接する3個の穴の真中に径10～12nmの電子密度の高いスポットが見られた.このスポットはその径がウイルス粒子の幅(13～14nm)に近い値であったが,切片を傾斜して観察したときの像変化から,管状物を相互に結合する繊維の断面であろうと思われる.また細胞質のvesicle化が認められる細胞ではvesicleが変化したと思われるbundle型の像が観察されたが,この構造物が管状封入体やMIの形成に関係あるかどうか明らかでない.ウイルス様粒子は細胞質内にのみ存在し,散在するかあるいはbundleに付随して見られた.封入体やウイルス様粒子の見られる細胞では葉緑体の両端が細くなったり,一部突出した形のものが多かったが,核,ミトコンドリアに変化は認められなかった

イネえそモザイク病葉に見られる細胞質内封入体

Ultrathin sections of mesophyll cells of the rice(Oryza sativa L. cv. Kibiyoshi) infected with rice necrosis mosaic virus were examined with an electron microscope. Two types of cytoplasmic inclusion were observed in the cells. One was similar to the cylindrical inclusion which was observed as pinwheels or bundles mainly produced by filamentous viruses. The other was the membranous inclusion(MI) which seemed to be composed of the tubules closely assembled. Cross sections of MI showed elliptic or circular shape, about 4μm in diameter. The membranes composed of the tubules communicated with each other and associated with endoplasmic reticula at the terminal sites. The tubules were disposed in a hexagonal pattern like honeycomb and each tubule was surrounded by 6 spots which appeared like particles, about 10-12nm in diameter. The spots in cross view turned into filaments by tilting the sections at an angle of 40°. Therefore, it seems that these spots are cross view of the filaments running in parallel with the tubules but not the virus particles. MI observed in this experiment seems to have the most complex structure among the inclusions related to plant viruses reported hitherto.イネえそモザイクウイルスに侵されたイネ葉肉細胞の電顕観察を行なった結果,健全細胞には見られない2種類の細胞質内封入体が観察された.1つはEdwardsonらが名付けた管状封入体(cylindrical inclusion)と同類と思われるもので, pinwheelやbundle型として観察される.他は管状物が密に集まってできた膜状封入体(MI)である.MIの横断像は楕円形あるいは円形で,径4μmに達するものもあった.その構造は管状物の切断される角度によって,ハチの巣状,網目状,あるいはラメラ構造を呈し,非常に複雑であった.ハチの巣状に見える部分では,個々の穴の直径は20～30nmであり,相接する3個の穴の真中に径10～12nmの電子密度の高いスポットが見られた.このスポットはその径がウイルス粒子の幅(13～14nm)に近い値であったが,切片を傾斜して観察したときの像変化から,管状物を相互に結合する繊維の断面であろうと思われる.また細胞質のvesicle化が認められる細胞ではvesicleが変化したと思われるbundle型の像が観察されたが,この構造物が管状封入体やMIの形成に関係あるかどうか明らかでない.ウイルス様粒子は細胞質内にのみ存在し,散在するかあるいはbundleに付随して見られた.封入体やウイルス様粒子の見られる細胞では葉緑体の両端が細くなったり,一部突出した形のものが多かったが,核,ミトコンドリアに変化は認められなかった

Noninvasive regional cerebral oxygen saturation for neurological prognostication of patients with out-of-hospital cardiac arrest: a prospective multicenter observational study.

[Aim]To investigate the association between regional brain oxygen saturation (rSO2) at hospital arrival and neurological outcomes at 90 days in patients with out-of-hospital cardiac arrest (OHCA). [Methods]The Japan-Prediction of neurological Outcomes in patients post cardiac arrest (J-POP) registry is a prospective, multicenter, cohort study to test whether rSO2 predicts neurological outcomes after OHCA. We measured rSO2 in OHCA patients immediately after hospital arrival using a near-infrared spectrometer placed on the forehead with non-blinded fashion. The primary endpoint was “neurological outcomes” at 90 days after OHCA. [Results]EMS providers are not permitted to terminate CPR in the field in Japan, and so most patients with OHCA who are treated by EMS personnel are transported to emergency hospitals. Among 1017 OHCA patients, 672 patients including 52 comatose patients with pulses detectable (8%) and 620 cardiac arrest patients (92%) at hospital arrival were enrolled prospectively and consecutively. Twenty-nine patients with good neurological outcome had a significantly higher value of rSO2 at hospital arrival than 643 patients with poor neurological outcome (mean [±SD] 55.6 ± 20.8% vs. 19.7 ± 11.0%, p 42% for predicting good neurological outcome, with sensitivity 0.79 (95% confidence interval [CI], 0.60?0.92), specificity 0.95 (95% CI, 0.93?0.96), positive predictive value, 0.41 (95% CI, 0.28?0.55), negative predictive value, 0.99 (95% CI, 0.98?1.00), and area under the curve 0.90 (95% CI, 0.88?0.92). [ConclusionThe rSO2 at hospital arrival can predict good neurological outcome at 90 days after OHCA