Purpose: Thyroid transcription factor 1 (TTF-1) expression is a useful predictor of treatment efficacy in advanced non-squamous non–small cell lung cancer (NSCLC). This study aimed to evaluate whether TTF-1 could predict the effectiveness of chemotherapy versus chemoimmunotherapy in patients with non-squamous NSCLC with programmed death ligand-1 (PD-L1) expression between 1% and 49%. Materials and Methods: We conducted a retrospective study of patients with NSCLC who were treated with chemotherapy or chemoimmunotherapy between March 2016 and May 2023. The patients had histologically confirmed NSCLC, stage III-IV or postoperative recurrence, TTF-1 measurements, and PD-L1 expression levels between 1% and 49%. Clinical data were analyzed to evaluate the effect of TTF-1 expression on treatment efficacy. Results: This study included 283 of 624 patients. TTF-1–positive patients showed longer progression-free survival (PFS) and overall survival (OS) (PFS: 6.4 months [95% confidence interval (CI), 5.0 to 9.4] vs. 4.1 months [95% CI, 2.7 to 6.1], p=0.03; OS: 17.9 months [95% CI, 15.2 to 28.1] vs. 9.4 months [95% CI, 6.3 to 17.0], p < 0.01) in the chemotherapy cohorts (n=93). In the chemoimmunotherapy cohort (n=190), there was no significant difference in PFS and OS between TTF-1–positive and –negative groups (PFS: 7.6 months [95% CI, 6.4 to 11.0] vs. 6.0 months [95% CI, 3.6 to 12.6], p=0.59; OS: 25.0 months [95% CI, 18.0 to 49.2] vs. 21.3 months [95% CI, 9.8 to 28.8], p=0.09). Conclusion In patients with NSCLC with PD-L1 expression between 1% and 49%, TTF-1 expression was a predictor of chemotherapeutic, but not chemoimmunotherapeutic, efficacy.

Purpose: Thyroid transcription factor 1 (TTF-1) expression is a useful predictor of treatment efficacy in advanced non-squamous non–small cell lung cancer (NSCLC). This study aimed to evaluate whether TTF-1 could predict the effectiveness of chemotherapy versus chemoimmunotherapy in patients with non-squamous NSCLC with programmed death ligand-1 (PD-L1) expression between 1% and 49%. Materials and Methods: We conducted a retrospective study of patients with NSCLC who were treated with chemotherapy or chemoimmunotherapy between March 2016 and May 2023. The patients had histologically confirmed NSCLC, stage III-IV or postoperative recurrence, TTF-1 measurements, and PD-L1 expression levels between 1% and 49%. Clinical data were analyzed to evaluate the effect of TTF-1 expression on treatment efficacy. Results: This study included 283 of 624 patients. TTF-1–positive patients showed longer progression-free survival (PFS) and overall survival (OS) (PFS: 6.4 months [95% confidence interval (CI), 5.0 to 9.4] vs. 4.1 months [95% CI, 2.7 to 6.1], p=0.03; OS: 17.9 months [95% CI, 15.2 to 28.1] vs. 9.4 months [95% CI, 6.3 to 17.0], p < 0.01) in the chemotherapy cohorts (n=93). In the chemoimmunotherapy cohort (n=190), there was no significant difference in PFS and OS between TTF-1–positive and –negative groups (PFS: 7.6 months [95% CI, 6.4 to 11.0] vs. 6.0 months [95% CI, 3.6 to 12.6], p=0.59; OS: 25.0 months [95% CI, 18.0 to 49.2] vs. 21.3 months [95% CI, 9.8 to 28.8], p=0.09). Conclusion In patients with NSCLC with PD-L1 expression between 1% and 49%, TTF-1 expression was a predictor of chemotherapeutic, but not chemoimmunotherapeutic, efficacy.

Purpose: Thyroid transcription factor 1 (TTF-1) expression is a useful predictor of treatment efficacy in advanced non-squamous non–small cell lung cancer (NSCLC). This study aimed to evaluate whether TTF-1 could predict the effectiveness of chemotherapy versus chemoimmunotherapy in patients with non-squamous NSCLC with programmed death ligand-1 (PD-L1) expression between 1% and 49%. Materials and Methods: We conducted a retrospective study of patients with NSCLC who were treated with chemotherapy or chemoimmunotherapy between March 2016 and May 2023. The patients had histologically confirmed NSCLC, stage III-IV or postoperative recurrence, TTF-1 measurements, and PD-L1 expression levels between 1% and 49%. Clinical data were analyzed to evaluate the effect of TTF-1 expression on treatment efficacy. Results: This study included 283 of 624 patients. TTF-1–positive patients showed longer progression-free survival (PFS) and overall survival (OS) (PFS: 6.4 months [95% confidence interval (CI), 5.0 to 9.4] vs. 4.1 months [95% CI, 2.7 to 6.1], p=0.03; OS: 17.9 months [95% CI, 15.2 to 28.1] vs. 9.4 months [95% CI, 6.3 to 17.0], p < 0.01) in the chemotherapy cohorts (n=93). In the chemoimmunotherapy cohort (n=190), there was no significant difference in PFS and OS between TTF-1–positive and –negative groups (PFS: 7.6 months [95% CI, 6.4 to 11.0] vs. 6.0 months [95% CI, 3.6 to 12.6], p=0.59; OS: 25.0 months [95% CI, 18.0 to 49.2] vs. 21.3 months [95% CI, 9.8 to 28.8], p=0.09). Conclusion In patients with NSCLC with PD-L1 expression between 1% and 49%, TTF-1 expression was a predictor of chemotherapeutic, but not chemoimmunotherapeutic, efficacy.

The incredible speed at which research into the human genome has recently progressed has led to the widespread use of genomic data in clinical settings. The day will soon come when clinical practice that fails to utilize patients' genomic data will be considered outdated and will pose a high risk of legal action. In this lecture, I discuss several topics: 1.the progress of human genomic research, 2. Homo sapiens as just one of the many species on Earth; 3. the clinical applications of genomic research findings, with Kawasaki disease as an example;and 4.the current state of genomic research and its future prospects. 　　Medical researchers and doctors have long dreamed of a day when health care services based on each individual's genomic data will be a reality;this is usually referred to as “madeto-order medicine,” “tailor-made medicine,” “personalized medicine,” and most recently, “precision medicine.” Thanks to the recent rapid development of genomic analysis,such as next-generation sequencing,as well as that of statistical analysis methods, it has been said that individual genomic data were available at a cost as low as$1,000 in 2014. 　　Our planet is 4.6 billion years old, and life began 3.8 billion years ago. Since then,the Earth has witnessed the evolution of prokaryotic and eukaryotic unicellular organisms, followed by multicellular organisms, photosynthetic plants, the Cambrian explosion of marine life, and the emergence of land-dwelling creatures. Our mammalian ancestors appeared during the age of the dinosaurs, which suffered a mass extinction due to a dramatic change in climate caused by an asteroid impact. The small dinosaurs that survived evolved into today's birds while the mammals of that era evolved to successfully occupy a diverse array of ecological niches. The human family appeared about 2.5 million years ago in Africa. Archaic humans, such as Homo neanderthalensis, lived among our Homo sapiens ancestors, who appeared about 200,000 years ago. Now we know that 21%of the human genome has genes in common with prokaryotes and other eukaryotes. The difference between our genome and that of the gorilla and the chimpanzee is only 2% and 1%, respectively. Among Homo sapiens, the difference between any two individuals is only 0.2%, which manifests as differences in skin color, disease susceptibility, and other traits. 　　Kawasaki disease was identified by Dr.Tomisaku Kawasaki, who reported his findings in 1967. Since then, vigorous efforts have been made to identify the cause of the disease, but so far, nothing specific has been found. We therefore took a genome-based approach and identified several genes responsible for the development of Kawasaki disease. Because some of the identified genes are thought to participate in the Ca2+-NFAT signal transduction pathway, we hypothesized that cyclosporine A, which is known as a suppressor of this pathway, might be useful in the treatment of the disease. We performed an investigator-initiated clinical trial and confirmed our hypothesis. This was one of the first clinical applications based on human genome research. 　　Now, there are several large-scale genome-based projects, such as the UK Biobank, that are open to any researcher who would like to make use of their resources. They also contain clinical information and patient data, such as socioeconomic status, and educational background. With these kinds of resources at our disposal, we can expect great accomplishments in the not-too-distant future.

Objective: To identify the clinical and epidemiological characteristics of pernicious anemia (PA) in patients treated at Miyagami hospital on Tokunoshima Island.

Methods: We evaluated 14 patients with PA who were enrolled and treated from March 2009 to May 2014.

Results: The majority of patients were older than 50 years of age and primarily consisted of elderly women. Routine medical examinations revealed macrocytic anemia in 6 of the 14 patients (43%), although they were clinically asymptomatic and subsequently diagnosed with PA. The average number of patients per year was reported to be 3 (95% confidence interval [CI]: 1.25-3.42).

Conclusions: The annual incidence of PA per 100,000 individuals on Tokunoshima Island is possibly much higher than that previously reported in Japan. An increase in the elderly population, a negligence of the disease, and an ethnic and regional diversity may explain this discrepancy. As the annual incidence of PA may be higher than that previously reported, anemia must be carefully evaluated in the differential diagnosis of PA.

　　As part of the special study project of the Japanese Association of Rural Medicine (JARM), a questionnaire survey was conducted to probe into the attitude of rural people toward their eating habits and health. Most of the people surveyed had received health checkups carried out by medical facilities affiliated with the JARM.　　Questionnaires were distributed to a total of 5,397 people (2,588 men; 2,809 women) living in and around provincial cities. Mean age was 53.4 for men and 53.8 for women. More than half of those questioned were farmers or had experienced in farming. The people aged 80 and older accounted for 3.2% of the total.　　Eighty percent of the total said they felt happy, and those who felt short of exercise also represented 80%, but with advancing age, the ratio decreased. Those over the age of 70 who said they had a habit of taking exercise made up as high as 60%.　　Many said they were satisfied with food in terms of quantity, but not a few people expressed uneasiness about food safety, dietary life and supply of food. Regarding favorite foodstuffs, many gave rice, vegetables and dairy products. There was a tendency for older people to eat meat less. It was found that, with increasing age, people took to eat dairy products, soybeans, vegetables, fruits and fish were ranked among the most popular foodstuffs.　　A study of factors related to local production for local consumption and commitment to agriculture found that a significantly large number of people were interested in social participation, eating breakfast, securing food supply and purchasing foodstuffs at outlet stores run by local agricultural cooperatives.　　From these findings, it was suggested that many residents in and around provincial cities oriented themselves to healthy eating habits and lifestyle, and were very interested in social participation, local economy, agricultural production and consumption of local farm produce.

BACKGROUND: Focusing on the respiratory function for health effect indices, we conducted a cross-sectional study on workers who did and did not handle toner to compare the longitudinal changes. METHODS: Among 116 individuals who worked for a Japanese business equipment manufacturer and participated in the study, the analysis included 69 male workers who we were able to follow up for 4 years. We categorized the 40 workers engaged in toner-handling work as the exposed group and the 29 workers not engaged in these tasks as the referent group, and compared their respiratory function test results: peak expiratory flow rate (PEFR), vital capacity (VC), predicted vital capacity (%VC), forced expiratory volume in 1 second (FEV1), and forced expiratory volume in 1 second as a percent of forced vital capacity (FEV1%). RESULTS: The cross-sectional study of the respiratory function test results at the baseline and at the 5th year showed no statistically significant differences in PEFR, VC, %VC, FEV1, and FEV1% between the exposed and referent workers. Also, respiratory function time-course for 4 years was calculated and compared between the groups. No statistically significant differences were shown. CONCLUSION: Our study does not suggest any toner exposure effects on respiratory function. However, the number of subjects was small in our study; studies of larger populations will be desired in the future.
Asian Continental Ancestry Group ; Cohort Studies* ; Commerce ; Copying Processes ; Cross-Sectional Studies ; Follow-Up Studies* ; Forced Expiratory Volume ; Humans ; Male ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Vital Capacity

BACKGROUND/AIMS: Left-sided diverticulitis is increasing in Japan, and many studies report that left-sided diverticulitis is more likely to be severe. Therefore, it is important to identify the features and risk factors for left-sided diverticulitis. We hypothesized that left-sided diverticulitis in Japan is related to obesity and conducted a study of the features and risk factors for this disorder in Japan. METHODS: Right-sided diverticulitis and left-sided diverticulitis patients (total of 215) were compared with respect to background, particularly obesity-related factors to identify risk factors for diverticulitis. RESULTS: There were 166 (77.2%) right-sided diverticulitis patients and 49 (22.8%) left-sided diverticulitis patients. The proportions of obese patients (body mass index > or =25 kg/m2, p=0.0349), viscerally obese patients (visceral fat area > or =100 cm2, p=0.0019), patients of mean age (p=0.0003), and elderly patients (age > or =65 years, p=0.0177) were significantly higher in the left-sided-diverticulitis group than in the right-sided-diverticulitis group. The proportion of viscerally obese patients was significantly higher in the left-sided-diverticulitis group than in the left-sided-diverticulosis group (p=0.0390). CONCLUSIONS: This study showed that obesity, particularly visceral obesity, was a risk factor for left-sided diverticulitis in Japan.
Aged ; Diverticulitis ; Humans ; Japan ; Obesity ; Obesity, Abdominal ; Retrospective Studies ; Risk Factors

Infectious abdominal aortic aneurysm is a relatively rare disease, and there is no consensus regarding its surgical treatment. Medical infectious control should be concerned comparison with surgical treatment if there is sepsis, however we sometimes have no other choice but emergency operation for uncontrollable cases. In many reports, cryopreserved homografts were used as in-situ alternative grafts for infectious aortic aneurysms because they had some merits such as anti-infectious effects, suitability and so on. However the number of in-situ cryopreserved homograft replacement cases are few, and the long term result is unclear. We encountered a ruptured cropreserved homograft case 7 months after urgent in-situ cryopreserved homograft replacement. We report the case and refer to the relevans literature.

Objective: Early life events connected with the risk of later disease can occur not only in utero, but also in infancy. In study of the developmental origins of health and disease, the relationship between infantile growth patterns and adolescent body mass index and blood pressure is one of the most important issues to verify.
Materials and Methods: We analyzed the correlation of current body mass index and systolic blood pressure of 168 female college students with their growth patterns in utero and in infancy.
Results: Body mass index and systolic blood pressure in adolescence showed positive correlations with changes in weight-for-age z scores between 1 and 18 months but not with those between 18 and 36 months. Stepwise multiple regression analysis showed that both change in weight-for-age z scores from 1 to 18 months and body mass index at 1 month were significantly and independently associated with systolic blood pressure in adolescence. Body mass index at 36 months was positively correlated with body mass index in adolescence, while body mass index at birth was negatively correlated with body mass index in adolescence.
Conclusion: Our findings shows that restricted growth in utero and accelerated weight gain in early infancy are associated with the cardiovascular risk factors of high systolic blood pressure and high body mass index in adolescence. In Japan, an increasing proportion of low birth weight infants and accelerated catch-up growth after birth have been observed in recent decades. This might be an alarming harbinger of an increase in diseases related to the developmental origins of health and disease in Japan.