EGFR遺伝子陽性NSCLCにニボルマブが有効であった１例

Nivolumab is approved for the treatment of patients with advanced non-small cell lung cancer （NSCLC）who experience progression of disease on or after standard platinum-based chemotherapy. But there are still a few reports of nivolumab treatment in after EGFR-TKI treatment since NSCLC patients with EGFR mutations has been said to have poor effect on anti-PD-1/PD-L1 agents. Also, there are several reports of severe interstitial pneumonitis when Nivolumab is used after EGFR-TKI treatment. A88‐year‐old woman was diagnosed with lung adenocarcinoma with an EGFR exon21 L861Q mutation（clinical stage ⅢA ; cT4N0M0）. She had received Gefitinib for 18 months, until she had disease progression（PD）. Re-biopsy showed T790M-negative, ALK-negative and PD-L1 0%. Several other drugs were attempted after Gefitinib, but none of them showed any effect. Nivolumab treatment was initiated as her sixth chemotherapy, four and a half years after being diagnosed. Her tumor responded well to Nivolumab treatment and still remains effective without any severe side effects such as interstitial pneumonitis. Our case suggests that Nivolumab treatment is a treatment option for NSCLC patients with EGFR uncommon mutations who are refractory to EGFR-TKI treatment

Non-HDL-C and CVD

Aims: We aimed to investigate the association between non-high-density lipoprotein cholesterol (non-HDL-C) levels and the risk of cardiovascular disease (CVD) and its subtypes. Methods: In this contemporary cohort study, we analyzed the data of 63,814 Japanese employees aged ≥ 30 years, without known CVD in 2012 and who were followed up for up to 8 years. The non-HDL-C level was divided into 5 groups: ＜110, 110-129, 130-149, 150-169, and ≥ 170 mg/dL. The Cox proportional hazards model was used to calculate the hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) for CVD and its subtypes associated with each non-HDL-C group, considering 130-149 mg/dL as the reference group. Results: During the study period, 271 participants developed CVD, including 78 myocardial infarctions and 193 strokes (102 ischemic strokes, 89 hemorrhagic strokes, and 2 unknowns). A U-shaped association between non-HDL-C and stroke was observed. In the analysis of stroke subtypes, the multivariable-adjusted HR (95% CI) for hemorrhagic stroke was 2.61 (1.19–5.72), 2.02 (0.95–4.29), 2.10 (1.01–4.36), and 1.98 (0.96-4.08), while that for ischemic stroke was 1.54 (0.77-3.07), 0.91 (0.46-1.80), 0.73 (0.38-1.41), and 1.50 (0.87-2.56) in the ＜110, 110-129, 150-169, and ≥ 170 mg/dL groups, respectively. Individuals with elevated non-HDL-C levels had a higher risk of myocardial infarction. Conclusions: High non-HDL-C levels were associated with an increased risk of myocardial infarction. Moreover, high and low non-HDL-C levels were associated with a high risk of stroke and its subtypes among Japanese workers

Adult onset IgAV

Immunoglobulin A vasculitis (IgAV), formerly known as Henoch-Schönlein purpura, primarily occurs during childhood between the ages of 3 and 15 years and is the most common form of systemic vasculitis in children ; its occurrence in adults has been rarely reported. Such low incidence could be attributable to either under-diagnosis or misdiagnosis. Thus, not only pediatricians but also physicians should be able to diagnose IgAV accurately to manage the patients appropriately and avoid its associated complications. In addition, treatment of adult onset IgAV with renal involvement has not been fully established yet. We describe here a case of adult onset IgAV complicated by proteinuria and pharyngitis, which was cured by no specific treatment

Effect of Visuospatial Attention on the Sensorimotor Gating System

The integration of multiple sensory modalities allows us to adapt to the environment of the outside world. It is widely known that visual stimuli interfere with the processing of auditory information, which is involved in the ability to pay attention. Additionally, visuospatial attention has the characteristic of laterality. It is unclear whether this laterality of visuospatial attention affects the processing of auditory stimuli. The sensorimotor gating system is a neurological process, which filters out unnecessary stimuli from environmental stimuli in the brain. Prepulse inhibition (PPI) is an operational measure of the sensorimotor gating system, which a weaker prestimulus (prepulse), such as a visual stimulus, inhibits the startle reflex elicited by a subsequent robust startling stimulus (pulse) such as a tone. Therefore, we investigated whether the visual stimulus from the left or right visual space affects the sensorimotor gating system in a “rest” task (low attentional condition) and a “selective attention” task (high attentional condition). In the selective attention task, we found that the target prepulse presented in the left and bilateral visual fields suppressed the startle reflex more than that presented in the right visual field. By contrast, there was no laterality of PPI in the no-target prepulse condition, and there was no laterality of PPI in the rest task. These results suggest that the laterality of visuospatial attention affects the sensorimotor gating system depending on the attentional condition. Moreover, the process of visual information processing may differ between the left and right brain

Does the scion or rootstock of Citrus sp. affect the feeding and biology of Diaphorina citri Kuwayama (Hemiptera: Liviidae)?

The Asian citrus psyllid (ACP) Diaphorina citri is the main vector of the bacteria associated with Huanglongbing, and can exploit more than 50 species of the family Rutaceae as hosts. The number of possible hosts is even higher if plant varieties are included. This study evaluated the influence of different combinations of scion and rootstock citrus varieties on the development and feeding of ACP. Survival rates for the egg stage were highest on the Valencia and Sicilian varieties, both grafted on Sunki mandarin, with means of 87.99 and 87.98%, respectively; and lowest (67.63%) on Hamlin 9 Rangpur lime. The lowest levels of both nymphal and total viability (egg-adult) were obtained on Hamlin, regardless of the rootstock used. The total development time (egg-adult) ranged from 17.92 to 19.33 days for the Peˆra 9 Sunki and Hamlin 9 Swingle combinations, respectively. Cluster analysis separated the hosts into two groups, the first consisting of the combinations of the Hamlin variety, and the second group formed by the other varieties. The highest food value (assessed by the area of honeydew produced) was observed for the orange scion varieties, and among these, the highest value was observed on Valencia (0.902 cm2); the smallest honeydew area was obtained on Ponkan (0.269 cm2). The rootstocks did not affect the feeding behavior of D. citri. The results of this study could aid in the development of management techniques, mainly in providing information for the installation of new citrus groves and assistance in crop-improvement research

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead