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Autoantibodies (aAbs) to type I interferons (IFNs) have been found in less than 1% of individuals under the age of 60 in the general population, with the prevalence increasing among those over 65. Neutralizing autoantibodies (naAbs) to type I IFNs have been found in at least 15% of patients with life-threatening COVID-19 pneumonia in several cohorts of primarily European descent. We aimed to evaluate the prevalence of aAbs and naAbs to IFN-α2 or IFN-ω in Japanese patients who suffered from COVID-19 as well as in the general population.Patients who suffered from COVID-19 (n = 622, aged 0-104) and an uninfected healthy control population (n = 3,456, aged 20-91) were enrolled in this study. The severities of the COVID-19 patients were as follows: critical (n = 170), severe (n = 235), moderate (n = 112), and mild (n = 105). ELISA and ISRE reporter assays were used to detect aAbs and naAbs to IFN-α2 and IFN-ω using E. coli-produced IFNs.In an uninfected general Japanese population aged 20-91, aAbs to IFNs were detected in 0.087% of individuals. By contrast, naAbs to type I IFNs (IFN-α2 and/or IFN-ω, 100 pg/mL) were detected in 10.6% of patients with critical infections, 2.6% of patients with severe infections, and 1% of patients with mild infections. The presence of naAbs to IFNs was significantly associated with critical disease (P = 0.0012), age over 50 (P = 0.0002), and male sex (P = 0.137). A significant but not strong correlation between aAbs and naAbs to IFN-α2 existed (r = - 0.307, p value 0.0001) reinforced the importance of measuring naAbs in COVID-19 patients, including those of Japanese ancestry.In this study, we revealed that patients with pre-existing naAbs have a much higher risk of life-threatening COVID-19 pneumonia in Japanese population.

Background The ABC method, which combines the pepsinogen method and anti-Helicobacter pylori antibody titers, has been used for risk screening for gastric cancer in Japan. However, it has been reported that there are cases of gastritis and carcinogenesis risk even in group A, which is considered to be a low-risk group based on the ABC method. Currently, in group A, endoscopic examination is needed to strictly discriminate “patients without gastritis” (defined as true A patients) from those “with gastritis.” A simple and minimally invasive diagnostic criterion for gastritis using serological markers is desirable. In this study, we aimed to identify the normal serum gastrin concentrations in normal stomach cases based on pathological diagnosis and investigate the usefulness of serum gastrin concentrations in diagnosing gastritis. Methods Patients who underwent endoscopy and blood tests at Hiroshima University Hospital were enrolled in the study and categorized into the “pathologically-evaluated group” and “endoscopically-evaluated group,” according to the evaluation method of atrophic gastritis. Initially, we measured serum gastrin concentrations in the normal stomach cases in the pathologically-evaluated group and calculated the normal range of serum gastrin concentrations. We used the upper limit of this normal range of serum gastrin concentrations and performed a validation study to determine its usefulness as a diagnostic marker for distinguishing between cases of gastritis and true A in the endoscopically-evaluated group. Results The 95th percentile of serum gastrin concentrations in pathologically-evaluated normal stomach cases was 34.12–126.03 pg/mL. Using the upper limit of this normal range of serum gastrin concentrations, the sensitivity, specificity, positive predictive value, and negative predictive value for gastritis were 52.8%, 92.6%, 97.0%, and 31.0%, respectively. Additionally, the receiver operating characteristic (ROC) curve for the endoscopically-evaluated group showed an area under the ROC curve of 0.80. Conclusion The gastrin cut-off value of 126 pg/mL has a good positive predictive value (97.0%) for detecting gastritis positing its use as a marker for cases requiring endoscopy. However, the identification of patients with gastritis having normal serum gastrin concentrations due to insufficient sensitivity remains a challenge for the future.

Sarcopenia is well recognized as a prognostic factor of chronic liver diseases. However, its impact on the clinical course of primary sclerosing cholangitis (PSC) is unclear. This study aimed to clarify the importance of trunk muscles evaluated by computed tomography (CT) in the pathophysiology of patients with PSC.22 PSC patients (12 men, mean age 42.8 years) were enrolled in this study. Patients who died of hepatic failure or had to receive liver transplantation were defined as event group. 44 age- and gender-matched individuals without hepatic disorder were served as controls. At the level of third lumbar vertebrae, the area of psoas muscle and trunk muscle as well as the CT values of multifidus muscle and subcutaneous fat were evaluated. Based on these, skeletal muscle index (SMI), psoas muscle mass index (PMI) and intramuscular adipose tissue content (IMAC) were calculated. Then we analyzed the relationship between these parameters and laboratory data, Fibrosis-4 index, MELD score and Mayo risk score.At baseline evaluation, SMI and PMI were statistically lower in male PSC patients compared with those in controls (P 0.05). In male PSC, regarding the laboratory data, PMI was associated with total bilirubin, ALT, ALP, and platelet count (P 0.05). We found close relationship between PMI and MELD score (RSkeletal muscle mass evaluated by CT scan can be suitable for evaluating clinical and prognostic marker in male PSC.

Background Phase-contrast cine cardiovascular magnetic resonance (CMR) of the coronary sinus has emerged as a non-invasive method for measuring coronary sinus blood flow and coronary flow reserve (CFR). However, its clinical utility has not yet been established. Here we performed a meta-analysis to clarify the clinical value of CMR-derived CFR in various cardiovascular diseases. Methods An electronic database search was performed of PubMed, Web of Science Core Collection, Cochrane Advanced Search, and EMBASE. We compared the CMR-derived CFR of various cardiovascular diseases (stable coronary artery disease [CAD], hypertrophic cardiomyopathy [HCM], dilated cardiomyopathy [DCM]) and control subjects. We assessed the prognostic value of CMR-derived CFR for predicting major adverse cardiac events (MACE) in patients with stable CAD. Results A total of 47 eligible studies were identified. The pooled CFR from our meta-analysis was 3.48 (95% confidence interval [CI], 2.98–3.98) in control subjects, 2.50 (95% CI, 2.38–2.61) in stable CAD, 2.01 (95% CI, 1.70–2.32) in cardiomyopathies (HCM and DCM). The meta-analysis showed that CFR was significantly reduced in stable CAD (mean difference [MD] = −1.48; 95% CI, −1.78 to −1.17; p 2 = 0%; p for heterogeneity = 0.33), HCM (MD = −1.20; 95% CI, −1.63 to −0.77; p 2 = 0%; p for heterogeneity = 0.49), and DCM (MD = −1.53; 95% CI, −1.93 to −1.13; p 2 = 0%; p for heterogeneity = 0.45). CMR-derived CFR was an independent predictor of MACE for patients with stable CAD (hazard ratio = 0.52 per unit increase; 95% CI, 0.37–0.73; p 2 = 84%, p for heterogeneity Conclusions CMR-derived CFR was significantly decreased in cardiovascular diseases, and a decreased CFR was associated with a higher occurrence of MACE in patients with stable CAD. These results suggest that CMR-derived CFR has potential for the pathological evaluation of stable CAD, cardiomyopathy, and risk stratification in CAD.

Background Gastric cancer remains a severe public health problem worldwide, particularly in Japan. Recent studies have demonstrated that serum markers are beneficial for risk stratification in gastric cancer development. We aimed to evaluate the usefulness of serum markers either alone or in combination (serum markers plus endoscopy) for effective risk stratification of gastric cancer development. Methods We enrolled 22,736 patients aged 20–95 years who underwent blood sampling and endoscopic examination at Hiroshima University Hospital in Japan between 1990 and 2014. The serum pepsinogen (PG) levels and anti-Helicobacter pylori antibody (Hp-Ab) titers were evaluated in each patient. The enrolled patients were matched with the database of the Hiroshima Prefecture Regional Cancer Registry. We processed the medical records and excluded patients with possible confounding factors for PG levels, such as proton pump inhibitor use, prior successful eradication therapy, post-gastrectomy, severe hepatorenal dysfunction, Zollinger–Ellison syndrome, and autoimmune gastritis. Among the remaining 5131 patients, we reviewed records of endoscopic examinations and selected 1507 patients (mean age, 62.5 years; 985 men and 522 women) who underwent endoscopic examination more than three months after blood sampling. First, based on the ABC method, patients were classified as follows: High PG levels and negative Hp-Ab, group A, high PG levels and positive Hp-Ab, group B, low PG levels and positive Hp-Ab, group C, and low PG levels and negative Hp-Ab, group D. Group A was further classified into two subgroups using endoscopic findings: true A without atrophic gastritis and pseudo A with atrophic gastritis. All patients underwent annual endoscopy follow-up. Results Among the 1,507 patients (mean age, 62.5 years; 985 men), 24 were diagnosed with newly developed gastric cancer. No significant difference in cancer development was found between group A (PG negative and Hp-Ab negative) and the other groups. Remarkably, no true A group subjects developed gastric cancer. Conclusions The combination of serum markers and endoscopic findings is essential for the risk evaluation of gastric cancer.

Attenuation correction (AC) is crucial for ensuring the quantitative accuracy of positron emission tomography (PET) imaging. However, obtaining accurate μ-maps from brain-dedicated PET scanners without AC acquisition mechanism is challenging. Therefore, to overcome these problems, we developed a deep learning-based PET AC (deep AC) framework to synthesize transmission computed tomography (TCT) images from non-AC (NAC) PET images using a convolutional neural network (CNN) with a huge dataset of various radiotracers for brain PET imaging. The proposed framework is comprised of three steps: (1) NAC PET image generation, (2) synthetic TCT generation using CNN, and (3) PET image reconstruction. We trained the CNN by combining the mixed image dataset of six radiotracers to avoid overfitting, including [18F]FDG, [18F]BCPP-EF, [11C]Racropride, [11C]PIB, [11C]DPA-713, and [11C]PBB3. We used 1261 brain NAC PET and TCT images (1091 for training and 70 for testing). We did not include [11C]Methionine subjects in the training dataset, but included them in the testing dataset. The image quality of the synthetic TCT images obtained using the CNN trained on the mixed dataset of six radiotracers was superior to those obtained using the CNN trained on the split dataset generated from each radiotracer. In the [18F]FDG study, the mean relative PET biases of the emission-segmented AC (ESAC) and deep AC were 8.46 ± 5.24 and − 5.69 ± 4.97, respectively. The deep AC PET and TCT AC PET images exhibited excellent correlation for all seven radiotracers (R2 = 0.912–0.982). These results indicate that our proposed deep AC framework can be leveraged to provide quantitatively superior PET images when using the CNN trained on the mixed dataset of PET tracers than when using the CNN trained on the split dataset which means specific for each tracer.

The Japanese Society of Gastroenterology (JSGE) revised the third edition of evidence-based clinical practice guidelines for peptic ulcer disease in 2020 and created an English version. The revised guidelines consist of nine items: epidemiology, hemorrhagic gastric and duodenal ulcers, Helicobacter pylori (H. pylori) eradication therapy, non-eradication therapy, drug-induced ulcers, non-H. pylori, and nonsteroidal anti-inflammatory drug (NSAID) ulcers, remnant gastric ulcers, surgical treatment, and conservative therapy for perforation and stenosis. Therapeutic algorithms for the treatment of peptic ulcers differ based on ulcer complications. In patients with NSAID-induced ulcers, NSAIDs are discontinued and anti-ulcer therapy is administered. If NSAIDs cannot be discontinued, the ulcer is treated with proton pump inhibitors (PPIs). Vonoprazan (VPZ) with antibiotics is recommended as the first-line treatment for H. pylori eradication, and PPIs or VPZ with antibiotics is recommended as a second-line therapy. Patients who do not use NSAIDs and are H. pylori negative are considered to have idiopathic peptic ulcers. Algorithms for the prevention of NSAID- and low-dose aspirin (LDA)-related ulcers are presented in this guideline. These algorithms differ based on the concomitant use of LDA or NSAIDs and ulcer history or hemorrhagic ulcer history. In patients with a history of ulcers receiving NSAID therapy, PPIs with or without celecoxib are recommended and the administration of VPZ is suggested for the prevention of ulcer recurrence. In patients with a history of ulcers receiving LDA therapy, PPIs or VPZ are recommended and the administration of a histamine 2-receptor antagonist is suggested for the prevention of ulcer recurrence.

Background Solitary death is an emerging public health problem in developed countries. Alcohol abuse is associated with social isolation and excess mortality. However, data on the association between alcohol abuse and solitary death are limited. Our purposes were to assess whether alcohol abuse is associated with a long interval from death to discovery among people living alone. Methods This is a cross-sectional study using the data on subjects from the largest forensic database in Kyoto, Japan, from February 2012 to December 2015. Solitary death was defined as a phenomenon of dying alone at home and remaining undiscovered for more than 1 week. All the subjects who lived alone and aged over 18 at the time of death were included in the study. The presence of alcohol abuse was identified via an investigation during home visits. Proportional ratios were calculated using a fitted logit model to evaluate the association of alcohol abuse on solitary death after adjusting for possible confounders. Results A total of 235 subjects were included in the analysis. The mean age (standard deviation) of subjects at the time of death was 63.4 (15.1) years, and approximately 61.8% and 38.9% of subjects in the alcohol and non-alcohol abuse groups, respectively, experienced solitary death. Multivariable analyses revealed that alcohol abuse was associated with solitary death (adjusted proportion ratio: 1.50; 95% confidence interval: 1.12–2.00). Conclusions The findings of this study could help identify individuals at higher risk of solitary death. Moreover, calling the attention of people with alcohol abuse may be beneficial to prevent solitary death.

Deoxycholic acid (DCA), a secondary bile acid, is reportedly increased in the serum of patients with nonalcoholic steatohepatitis and animals with experimentally induced hepatocellular carcinoma (HCC), but its contribution to malignant behaviors of HCC has not been precisely clarified. This study aimed to examine the effect of DCA on hepatic stellate cells (HSCs), a major component of nonparenchymal cells in the liver, and its subsequent indirect effect on HCC cells. LX2 cells, a human HSC line, were treated with DCA in vitro. Then, HuH7 cells, a human hepatoma cell line, were incubated in conditioned media of DCA-treated LX2 to investigate the subsequent effect focusing on malignant behaviors. DCA resulted in cellular senescence in LX2 with the decreased cell proliferation via cell cycle arrest at G0/1 phase, together with the induction of senescence-associated secretory phenotype (SASP) factors. To investigate the influence of SASP factors secreted by HSCs in response to DCA, HCC cells were treated with conditioned media that promoted cell migration and invasion via induction of epithelial mesenchymal transition. These changes were attenuated in the presence of neutralizing antibody against IL8 or TGFβ. Pathological analysis of surgical specimens from HCC patients revealed that senescent HSCs were detected in the stroma surrounding HCC. Our data suggest an important role of HSC senescence caused by DCA for the malignant biological behaviors of HCC via induction of SASP factors, particularly IL8 and TGFβ.

Direct sampling and analysis of fumarolic gas was conducted at Ebinokogen Ioyama volcano, Japan, between December 2015 and July 2020. Notable changes in the chemical composition of gases related to volcanic activity included a sharp increase in SO2 and H2 concentrations in May 2017 and March 2018. The analyses in March 2018 immediately preceded the April 2018 eruption at Ioyama volcano. The isotopic ratios of H2O in fumarolic gas revealed the process of formation. Up to 49% high-enthalpy magmatic vapor mixed with 51% of cold local meteoric water to generate coexisting vapor and liquid phases at 100–160 °C. Portions of the vapor and liquid phases were discharged as fumarolic gases and hot spring water, respectively. The CO2/SO2 ratio of the fumarolic gas was higher than that estimated for magmatic vapor due to SO2 hydrolysis during the formation of the vapor phase. When the flux of the magmatic vapor was high, effects of hydrolysis were small resulting in low CO2/SO2 ratios in fumarolic gases. The high apparent equilibrium temperature defined for reactions involving SO2, H2S, H2 and H2O, together with low CO2/SO2 and H2S /SO2 ratios were regarded to be precursor signals to the phreatic eruption at Ioyama volcano. The apparent equilibrium temperature increased rapidly in May 2017 and March 2018 suggesting an increased flux of magmatic vapor. Between September 2017 and January 2018, the apparent equilibrium temperature was low suggesting the suppression of magmatic vapor flux. During this period, magmatic eruptions took place at Shinmoedake volcano 5 km away from Ioyama volcano. We conclude that magma sealing and transport to Shinmoedake volcano occurred simultaneously in the magma chamber beneath Ioyama volcano.

The serological risk prediction system combines the pepsinogen test and anti-Helicobacter pylori (H. pylori) antibody determination. In this system, chronic atrophic gastritis (CAG) is diagnosed using the pepsinogen test. Patients who are H. pylori negative and pepsinogen negative are classified into group A, are assumed to be H. pylori uninfected, and are at an extremely low risk for gastric cancer. However, gastric cancers are detected in this group. The aim of this study is to clarify the clinicopathological status of group A patients with gastric cancer. A total of 109 gastric cancer patients classified as group A were enrolled in a multicenter study. Group A patients were divided into two subgroups: group AN (H. pylori uninfected) and group AP (H. pylori infected). They were compared to 183 H. pylori-infected gastric cancer patients who were not in group A. Of the 109 patients, only 7 were classified as group AN; the other 102 were classified as group AP. The clinicopathological features of group AP included older age, predominantly differentiated type cancer, endoscopically visualized CAG, and pepsinogen (PG) I/II ratio lower than that of group AN. In group AN, the depressed type was dominant, and the PG I/II ratio was higher than in those gastric cancer patients who were infected with H. pylori. Patients in group AP had CAG, and their gastric cancers were similar to those of H. pylori-eradicated patients. Concerning the recent ABC classification system, advanced decision criteria should be proposed to decrease the false-negative evaluation of gastric cancer risk.

Definite increases in the components ratios of CO2/H2O, CO2/H2S, CO2/CH4 and He/CH4 were observed at the fumarolic gases from Owakudani geothermal area located at the center of Hakone volcanic caldera (Honshu Island, Japan), synchronized with the earthquake swarm in 2015. Such variations were due to the dominance of a magmatic component over a hydrothermal component, suggesting the earthquake swarm was produced by the injection of magmatic gases into the hydrothermal system. The CO2/H2O ratio of magmatic gas was estimated to be 0.0045 before the earthquake swarm, which increased up to 0.013 during the earthquake swarm, likely produced by the pressurization of magma as a result of magma sealing where the pressure increment in magma was estimated to be 3% to the lithostatic pressure. The H2O and CO2 concentration in magma were estimated to be 6.3 wt% and 20 wt ppm, respectively, assuming a temperature 900 °C and a rhyolitic composition. In May 2015, a few months prior to the earthquake swarm in May 2015, a sharp increase in the Ar/CO2 and N2/He ratios and a decrease in the isotopic ratio of H2O were observed at the fumarolic gas. The invasion of air into the hydrothermal system increased the Ar/CO2 and N2/He ratios. The decrease in the isotopic ratio of H2O was induced by partial condensation of H2O vapor.

In the original publication of the article, the article title was published with typo. The word "eradiation" should be "eradication" in the article title and keywords.

Broadband sonar echoes received from individual fish in schools contain information that might be useful for species discrimination. The echo characteristics are closely related to the incident angle of the sound to fish body, corresponding to the apparent tilt angle of a fish from a viewpoint of a transducer. Therefore, it is necessary to isolate individual fish echoes and estimate the incident angles. In this study, a broadband split-beam echo sounder system was used to extract features from free-swimming fish schools. Echoes from individual fish in dense schools were measured and their position was estimated using the system with a downward-oriented acoustic beam. Individual fish were tracked in schools of Japanese jack mackerel Trachurus japonicus, chub mackerel Scomber japonicus, and red sea bream Pagrus major with the system. The target strength (TS) spectra of echoes ranging from 80 to 120 kHz were calculated and sorted on the basis of the incident angle, which was estimated by the tracking result. Using this approach, TS spectra were obtained from entire schools of free-swimming fish, and the obtained TS spectra were found to be dependent on fish species and the incident angles of the individual fish involved.

Chondroid chordoma (CC) is a rare but commonest subtype of chordoma with little reported clinical information. The present study summarizes and updates present knowledge of CC. Literature search for demographic data and clinical appearance of cranial CCs except for those entirely confined to the sinonasal region. A total of 48 English language papers published from 1968–2013 were retrieved describing 132 CCs as skull base tumors. The male-to-female ratio was 1:1. The mean age at diagnosis was 43 years, predisposing to the third to fifth decades of life. The clival (34 %) and spheno-occipital (29 %) regions were the most frequent sites of origin followed by the sellar (12 %) and sphenoid (5 %) regions. Intratumoral calcification and bony erosion were identified as the characteristic neuroimaging findings. Surgical resection by the transcranial, transsphenoidal, transnasal, transpharyngeal, or transpalatal route with or without adjuvant radiotherapy was the main treatment option. The initial treatment outcome was satisfactory in 82 % of cases with considerably better prognosis compared with typical chordomas. CC is a distinct entity to be discriminated from the typical type of chordoma. There are no distinguishing features on magnetic resonance imaging between CC and typical chordoma. Intratumoral calcification and concurrent bony erosion on neuroimaging should suggest the possibility of CC. Extensive surgical resection and adjuvant radiotherapy can achieve satisfactory outcome.

Primary spinal extradural Ewing’s sarcoma (PSEES) or primitive neuroectodermal tumor (PNET) is uncommon. The present study summarizes the magnetic resonance (MR) imaging appearance of PSEES. Literature search from 1994 to 2012 with our representative case presentation. Twenty-one patients, 12 males and 9 females, aged 3 weeks to 44 years, were identified. The thoracic spine was most frequently affected, followed by the cervical, cervicothoracic, and thoracolumbar spine. Superior–inferior extension of lesions was three vertebral levels in 7, two in 7, five in 4, four in 1, one in 1 and unknown in 1. PSEESs appeared isointense in 9 cases, hypointense in 2, hyperintense in 1, and no description in 9 on T1-weighted imaging, while hyperintense in 6, hypointense in 3, heterogeneous in 1, and no description in 11 on T2-weighted imaging. Varying enhancement was noted in 13 cases (62 %), with no description of contrast study in the other 8 cases. Dumbbell-shaped configuration of PSEES was found in 5 cases, foraminal widening in 4, and erosions or scalloping of the adjacent vertebral bodies in 4. The MR imaging appearance of PSEESs is indistinguishable from other tumors. PSEES should be assumed as the differential diagnosis of spinal extradural tumors in pediatric, adolescent, and young adult patients, and prompt surgical exploration should be performed.

The calvarial diploic venous channels (CDVCs) are well-known intraosseous structures, but their distribution and anatomofunctional implications are not fully understood. To investigate the architecture of CDVCs using high-resolution magnetic resonance (MR) imaging. This prospective study enrolled 43 male and 37 female outpatients who underwent a 3.0-T MR imaging equipped by a 32-channel head coil. T1-weighted imaging covering the whole cranial vault was performed after gadolinium injection. In addition, one-piece orbitozygomatic craniotomy was performed in three cadaveric heads to observe the interruption of the CDVCs. The CDVCs showed irregular contours and peculiar branching patterns with four common major pathways: the pteriofrontparietal (PFP), frontoorbital (FO), occipitoparietal (OP), and occipitocervical (OC) routes. The proximal PFP coursed as a single trunk and divided into several branches at the level of the frontal eminence. The orbital part of the FO continued to the subcutaneous vein via the supraorbital rim. The PFP and the pterional part of the FO fused proximally with the sphenoparietal sinus and descended as the middle meningeal vein. The OP coursed in the superoinferior direction and connected the junction part of the transverse-sigmoid sinus to the parietal superior sagittal sinus. The OC occurred as a single trunk in the median occipital bone, drained extracranially, and joined the suboccipital venous channels. The CDVCs seem to be a relatively consistent network functioning not only as conduits connecting the intracranial dural sinuses but also as pathways to the extracranial venous systems. High-resolution MR imaging is useful for investigating the CDVCs.

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Gastrin is a growth factor for the gastric epithelial cells. However, it is unknown how gastric receptor (GR) expression is regulated in the gastric mucosa. We studied GR expression using a newly raised antibody and investigated the relationship between GR expression and gastritis. Gastric receptor expression in 63 human gastric mucosa was studied. Helicobacter pylori infection and histological gastritis status were evaluated in gastric biopsy samples. In gastric ulcer cases, additional biopsy specimens were taken from injured mucosa. Fasting sera were collected and serum gastrin level evaluated. MKN-28 cells were cultured at various pH conditions, and the change in GR expression was determined. Gastric receptor expression was detected in the foveolar epithelium of the gastric mucosa, and its expression was stronger in patients infected with H. pylori. In particular, higher expression was detected in regenerating injured mucosa. There was no association between gastritis score/serum gastrin level and GR expression in H. pylori-positive cases. In MKN-28 cells, GR protein expression was lower in neutral conditions than in acidic or alkaline conditions. Gastric mucosal injury with H. pylori infection destroys the pH barrier on the foveolar epithelium and may induce GR expression through pH changes.

This study aimed at investigating whether phase-contrast (PC) magnetic resonance (MR) angiography is useful for visualizing the ophthalmic artery (OA).This prospective study enrolled 196 consecutive outpatients who underwent three-dimensional PC MR angiography. The basal image parallel to the anteroposterior dimension of the OA was extracted for analysis from the imaging data.The 99 male and 97 female subjects were aged from 10 years to 80 years (mean 47.9 years). The OAs were supplied only by the external carotid system or in combination with the internal carotid artery (ICA) in 18 subjects (9.2%). The bilateral OAs were symmetrical in 12%, asymmetrical in 87%, and unidentified in 1%. The contour of the proximal segment of the OAs could be classified into straight, curved, and tortuous types. The ICA-OA angle defined by the angle between the approximate line of the proximal OA and the vertical line was also variable. The first bend of the OA corresponded to the anastomosis site with the external carotid system. The proximal medial bend was the origin of the posterior ethmoidal artery, and the distal medial bend was the origin of the anterior ethmoidal artery.According to the results the OA not only possesses three characteristic bends, but also shows prominent individual variability and commonly shows bilateral asymmetry. The contour of the OA may be regulated by the anchor effect at the bend sites. PC MR Angiography is useful for visualizing the main trunk of the OA.

The purpose of this study was to evaluate and analyze overall postoperative results from microvascular decompression (MVD) by combining the cure rate of symptoms with the complication rate. A new scoring system for obtaining objective surgical results from MVD for trigeminal neuralgia (TN) and hemifacial spasm (HFS) is proposed to document treatment results using consistent criteria in a standardized manner. Surgical results combining complications , if any, were obtained from a questionnaire sent to patients who had undergone surgery for TN or HFS in recent years and had been followed-up for more than 1 year after surgery (TN patients, n = 54; HFS patients, n = 81) When surgical outcome is complete resolution of symptoms, the efficacy of surgery (E) is designated E-0, but when moderate symptoms are still persist postoperatively, the score is designated E-2. When no complications are seen after surgery, the complication score (C) is C-0, while the score is C-2 if troublesome complications remain. In addition, total evaluation of the results (T) is judged by combining the E and C scores. For example, when E is 0, and C is C-2, the total evaluation is scored as T-2, which is diagnosed as fair. The response rate of the questionnaire was 80.7% (109/135). Overall surgical data were evaluated and analyzed using our new scoring system. Analysis of the collected data revealed an outcome of T-0 was 70% (35/50 patients) and T-1 was 24% (12/50) and T-2 was 6% (3/50) in TN, whereas in HFS, T-0 was 61% (36/59) and T-1 was 27.1% (16/59) and T-2 was 6.8% (4/59) and T-3 was 5.1% (3/59). The total results of MVD should be evaluated and analyzed by combining the cure rate of symptoms together with the complication rate. This new scoring system could allow much more objective analysis of the results of following MVD. Adopting this scoring system to objectively judge treatment results for TN and HFS, individual surgeons can compare their own overall surgical results with those of other institutes. Comparative results of MVD can also be provided to patients considering therapy to allow informed decision-making on the basis of good quality evidence.

Nowadays, robots are used for many types of underwater work, and knowing their position accurately is very important. Conventional positioning systems are based on the time difference or phase lag of sound waves. However, such systems are complex and expensive, and real-time positioning is difficult and not very accurate. We propose a new system using the loss of sound propagation and a sensor network. In a previous study, we separated directly arrived waves from received waves and measured their amplitude or power. Using this data, we calculated the distance. However, the signal included many types of reflected wave, and we were not able to obtain a correct value over long distances where the direct waves cannot be separated from the influence of the reflected waves. In this study, we propose a new method based on sounds at multiple frequencies. This method uses sounds of several different frequencies, and sends them sequentially at constant intervals. The distance can be calculated by taking the average power of the signals received. The advantage of this method is that it is not necessary to use any separating process, and longer distances can be measured.

In this research, we daveloped a swimming robot with a fluttering kick of two legs which can swim freely both on the surface of the water and under the water. We have established control methods for all kinds of motion of this robot. We considered a dynamic model with undulating fins, and this has been used to construct a dynamic model of a propulsion and control system, and to analyze its motion velocity and propulsion efficiency. We proposed and designed the corresponding control algorithms to generate an appropriate thrust force and to decrease the disadvantageous influences of the interference of fluttering kicks. We can now realize free posture control and obtain various forms of motion.

The influence of the interaction between Phoma sp. GS8-2 (GS8-2) and the arbuscular mycorrhizal fungus Glomus mosseae (Gm) on the development of soil-borne diseases, microbial population, and plant growth in cucumber, bentgrass and tomato plants was investigated under controlled conditions. The composite inoculation of GS8-2 and Gm yielded varied effects on suppression of symptoms of soil-borne pathogens depending on the host-pathogen combination involved. The GS8-2 + Gm had neutral effect in reducing damping-off disease of cucumber caused by Rhizoctonia solani AG-4 and the crown and root rot disease of tomato caused by Fusarium oxysporum f. sp. radicis-lycopersici (Forl), but exacerbated the brown patch disease caused by R. solani AG2-2 in bentgrass. In tomato plants, Forl populations in the roots and rhizosphere were significantly reduced by GS8-2 + Gm. Results also show that the composite inoculation of GS8-2 and Gm resulted to a synergistic effect on the reduction of fungal and bacterial populations in roots and rhizosphere of the plants. Plant growth enhancement was due to the individual effect of GS8-2 or Gm but not their interaction. GS8-2 root colonization of cucumber and tomato plants decreased significantly in dual inoculated plants compared to plants inoculated with GS8-2 alone; while no significant differences were found in the Gm root colonization of the three plant species indicating that GS8-2 had no effect on Gm.

Gold was vacuum deposited on one side of 6-μm-diameter silica-gel particles to prepare Janus particles (JPs). Thiol-terminated pH-responsive poly(sodium 6-acrylamidohexanoate) (pAaH-SH) was immobilized onto the gold surface of JPs. pH-responsive flocculation and dispersion behavior of pAaH-grafted JPs can be observed with optical and fluorescence microscopy measurements.

The Virchow-Robin spaces (V-R spaces) are well-known, but not systematically understood fluid-filled perivascular spaces that allow the convexity and basal perforating vessels to penetrate deep into the cerebral parenchyma.This study aims to delineate anatomical characteristics of the normal V-R spaces by MR imaging with considerations on clinical and anatomofunctional implications of the V-R spaces.In this prospective study with 3T magnetic resonance (MR) imaging, the whole extent of the intracranial V-R spaces was classified into basal, cortical, subcortical, paraventricular, and brainstem segments, on the basis of the topological difference in 105 control subjects. Morphological characteristics in each segment of the V-R spaces are described. For comparison with the neuroimaging appearance, V-R spaces were histologically examined in cadaveric human brains. The physiological functions of the V-R spaces and pathognomonic implications of unusually dilated, but asymptomatic, V-R spaces encountered in five subjects are discussed.The V-R spaces were found to form a complicated, while anatomically highly consistent, intraparenchymal canal network distributed over the whole cerebral hemispheres and connect the cerebral convexity, basal cistern, and ventricular system.The V-R spaces may be essential for drainage routes of cerebral metabolites, additional buoyancy for the brain, and maintenance of homogenous intracranial pressure. MR imaging may be more advantageous in depicting the V-R spaces than histological examination.

Pediatric idiopathic intervertebral disk calcification (PIIVDC) is an uncommon entity affecting the intervertebral disks and adjacent vertebral body and musculoligamentous structures. More than 300 cases have been reported so far, but knowledge of PIIVDC is still fragmentary. The purpose of the study was to summarize the demographic and clinical characteristics of PIIVDC, and consider its treatment and natural history. This study is a review of 65 cases identified by literature search from 1990 to 2010. Male-to-female ratio was 40:25. Most patients (83%) were aged 5–12 years. Muscle pain was the most common manifestation (71.9%), followed by sensorimotor disturbance (20.3%) and fever (13.8%). Torticollis or scoliosis were noted in 23.4% of patients, and 15.4% were asymptomatic. The cervical spine was most frequently affected (64.6%), followed by the thoracic (26.2%), cervicothoracic (10.8%), lumbar (4.6%), and thoracolumbar (1.5%) spine. The C6/7 intervertebral disk was most frequently affected (35.7%), followed by C3/4 (21.4%), C2/3 (17.9%), C5/6 (14.3%), and C4/5 (10.7%). Erythrocyte sedimentation rate was the most sensitive laboratory indicator. Conservative treatment was adopted for 89.2% of patients and surgery for 10.8%. Neurological outcome was excellent except for one patient. PIIVDC appears to be a benign disorder associated with self-limiting inflammation. The natural history of PIIVDC will only be established by further experience with long-term follow-up periods into adulthood.

In this research, we have developed a swimming robot with a fluttering kick with two legs, which can swim freely both on the surface of water and under water. We have established a control method for all the different types of motion of this robot, e.g., swimming in a straight line, turning, diving, or rising up in the water. Furthermore, by optimizing the three-dimensional action of this underwater robot, we can expect an improvement in its performance for complex work.

Transplantation-associated thrombotic microangiopathy (TA-TMA) is a rare but devastating syndrome that occurs in allogeneic hematopoietic stem cell transplant recipients, and is associated with a variety of transplantation-related factors, including conditioning regimens, immunosuppressive agents, graft-versus-host disease (GVHD) and opportunistic infections. TA-TMA has an unfavorable prognosis and responds poorly to conventional treatment including plasma exchange (PE). We present a case of a 37-year-old man with membranous nephropathy (MN) and polyserositis caused by GVHD after hematopoietic stem cell transplantation. He developed TA-TMA after steroid pulse therapy for polyserositis. We treated the patient with PE and mycophenolate mofetil (MMF) after which the TA-TMA successfully improved and the MN underwent complete remission. The present case suggests that corticosteroids with severe GVHD might increase the risk of TA-TMA, and that PE in combination with MMF may be a valuable therapy to improve the prognosis.

We are proposing an underwater robot for the work. In this study, we designed the robot, which has body of rectangular plane and 4 legs at each corner. The leg is consisted with parallel mechanism of 2or3 cylinders, and the end of each cylinder is attached on the robot body with free rotational joint and the end of both piston rods are connected with pin joint. 2 cylinder leg's motion is restricted in forward or backward direction but 3 cylinder leg can move any direction. We are studying the control scheme of walking for this robot, which is putting mind especially on smooth and steady movement without rolling, pitching, yawing or heaving motion and keeping the body horizontally. We confirmed the validity of control scheme with simulation and experiments.

Functional lox-like sequences have been identified within the yeast and mammalian genome. These hetero-specific lox sites also allow Cre recombinase to specifically target efficient integration of exogenous DNA into the endogenous pseudo-lox (ψlox) sequences that occur naturally in the host genome using a Cre/loxP integrative recombination system. We investigated whether the Cre/ψlox system is useful for site-specific integration of transgenes and for improving the production efficiency of transgenic animals. This is the first report on Cre-mediated integrative recombination targeting an endogenous lox-like sequence termed pseudo-loxm5 (ψloxm5) in early mouse embryos. We characterized the Cre/ψloxm5 system in embryonic environment. Cre-expressing plasmid and a transgene (CMV/LacZ gene) flanked by ψloxm5 and ψloxcorem5 sites were co-microinjected into the pronucleus of fertilized mouse oocytes. The injected eggs were transferred into foster mothers, and the recombination products were investigated. The results show that the ψloxm5 site is an active substrate for Cre-mediated recombination in the mouse embryonic environment. The transgenesis efficiency was up to 27% (6/22). The site-specific integration of the transgene into the endogenous ψloxm5 site was found in 50 % of the transgenic pups. Our findings demonstrated that the Cre/ψloxm5 integrative recombination system is an efficient and simple strategy for targeting an endogenous lox-like site in mammalian embryos.

To provide highly precise position information for the navigation of an autonomous underwater vehicle (AUV) in a large area, we are developing a new underwater positioning system based on sensor networks. In this system, we set many standard stations on the sea surface and use a sound global positioning system (GPS). To lower the cost of nodes and simplify signal processing, we have proposed a new method based on sound propagation loss (SPL).This study describes a new information integration method to solve two problems: (1) the transmission path of the sound may be blocked by some obstacle; (2) the underwater nodes may get broken.

Motion estimation provides an attractive alternative to cumbersome interface devices for human-computer interaction (HCI). Worthy of note is that the visual recognition of hand gestures can help to achieve an easy and natural interaction between human and computer. The interfaces of HCI and other virtual reality systems depend on accurate, real-time hand and fingertip tracking for an association between real objects and the corresponding digital information. However, they are expensive, and complicated operations can make them troublesome. We are developing a real-time, view-based gesture recognition system. The optical flow is estimated and segmented into motion fragments. Using an artificial neural network (ANN), the system can compute and estimate the motions of gestures. Compared with traditional approaches, theoretical and experimental results show that this method has simpler hardware and algorithms, but is more effective. It can be used in moving object recognition systems for understanding human body languages.

We are developing a new positioning system for an underwater vehicle based on the sound power decreasing with the distance transmitted and sensor network technology. Conventional positioning systems use the difference between the time sound occurs at the station and the time it is received at a vehicle. However, this is very expensive because of the high operational costs and the fact that the measuring field is not very wide. We therefore need a new positioning system with low cost, easy operation, easy maintenance, and high accuracy. Our system is expected to satisfy such requirements. At the first stage, we confirmed the principle with theoretical and experimental methods. In the research, we considered only the direct waves in the received data. These showed good precision for short distances, but also showed that it was easily affected by reflected waves, and the positioning area was limited to within only a few hundred meters when a reflective surface existed near to the receiver. These results were reported at AROB2008. Therefore, in the second stage of this study, we tried a new idea that uses a low-frequency sound and sends plural-frequency sounds simultaneously. We then tried to assess the performance of this method. This article gives the results of the simulation and the water tank experiment. With these improvements, the influence of reflected sound was suppressed and the positioning area became larger than in previous research. Then the underwater positioning system using sound power transmission loss will become useful.

Gastric adaptive relaxation (GAR) is a major factor of functional dyspepsia (FD). Nitric oxide (NO) could be the key molecule responsible for GAR. We previously reported that the physiological gastric reservoir ability can be evaluated by measuring the cross-sectional area of the proximal stomach by abdominal ultrasonography (US). Ecabet sodium (ES), a gastro-protective antiulcer agent, has been shown to improve symptoms in FD patients. We examined the effects of ES on GAR in humans and on NO synthesis in vitro. GAR was measured by US in 14 subjects, 8 of whom had a pressure sensor inserted into their stomach, after treatment with ES, placebo, or no drugs. NO was measured in SH-SY 5Y cells using a fluorescent indicator. Neuronal, endothelial and inducible NO synthase (nNOS, eNOS and iNOS, respectively) expressions were examined in SH-SY 5Y cells by Western blotting. Compared to placebo, ES induced significantly greater dilatation of the proximal stomach after the subjects drank 300–400 ml water (P

Helicobacter pylori (H. pylori) CagA protein plays an important role in the clinical outcome of gastritis treatment. Tyrosine phosphorylated Glu-Pro-Ile-Tyr-Ala motif in CagA (CagA-P) plays a critical role in the morphological transformation of cells. We examine the relationship between serum titer of anti-CagA-P antibody and gastric inflammation as well as the status of the CagA-P expression in gastric mucosa. Fasting sera from 127 dyspeptic patients were collected, and anti-CagA-P antibody was evaluated. Gastric biopsy specimens were collected and histological gastritis was evaluated. We investigate the expression of CagA-P in human gastric mucosa by Western blotting and immunohistochemistry. The titers of anti-CagA-P antibodies in the sera of H. pylori (+) patients were significantly higher than those of H. pylori (–) patients (P

In those days, the performance of underwater robot is improving because requirements for it are becoming higher and more complex than before. For those work, a highly precise and wide regional underwater positioning system is indispensable. However, the conventional positioning system that has three standard stations, is applicable for the field with no obstacle, because its principal depends on the time based measurement. Therefore, we developed a new underwater positioning system based on sensor network technology that is using a lot of standard stations equipping hydrophone and GPS sensor on the water surface. And decreasing the cost of sensor, we applied a simple method for measurement of distance, which is using sound power level. Therefore, this study has started with confirming the new principal for underwater positioning method. This paper is showing the availability with theoretical analysis and the performance of new method under the noise and reflection of sound in the water, and suggestions for the measures and an error compensation method.

We evaluated the topography of histological gastritis, which may be risk factors for gastric cancer (GCa). A total of 530 Helicobacter pylori-positive patients underwent diagnostic upper-gastrointestinal endoscopy. Biopsy specimens were obtained from the gastric antrum and body to assess the grade of gastritis. Subjects were divided into four groups by the topography of active gastritis (antrum predominant gastritis, AP; pan-gastritis with or without corpus atrophy, Pan-1 and Pan-2; and corpus predominant gastritis, CP). A higher prevalence of GCa followed the order of Pan 2--CP--Pan 1--AP. The age of patients decreased in the same order. When we set Pan 2 and CP as a high-risk group, the sensitivity and specificity for GCa detection were 77.3 and 54.7%, which were superior to the serum criteria using pepsinogens. These suggest that topography of histologic gastritis is an important marker to identify the high-risk group.

The independent administrative corporation Japan Agency for Marine–Earth Science and Technology (JAMSTEC) has developed a small light autonomous underwater vehicle (AUV) named marine robot experimental 1 (MR-X1).1 The motion control of MR-X1 is considered in this article. Since the dynamics of MR-X1 mainly depends on its own speed, the motion control is a nonlinear control system. We propose a new controller design method for this system using linear matrix inequalities (LMIs). This algorithm gives a solution as a linear matrix inequality, and can be adapted to solve many LMIs simultaneously. LMIs can be obtained by substituting several speeds into the dynamics of the MR-X1. The proposed controller, which can be derived from the solution of the LMIs, was adapted to MR-X1 and showed good performance in experiments.

Infliximab, a chimeric anti‐tumor necrosis factor-α (TNFα) monoclonal antibody, has proven to be an effective treatment for Crohn’s disease (CD). However, the safety of infliximab has not been evaluated in patients infected with hepatitis B virus (HBV). We describe herein the case of a 28-year-old woman, positive for HBV surface antigen (HBsAg), who developed a mild transient increase in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and HBV DNA levels after a single infusion of infliximab for refractory CD.

Helicobacter pylori infection and associated gastritis are well-known significant factors in many gastrointestinal diseases, and evaluation of these conditions is important for health evaluation. We investigated the utility of serum pepsinogen (PG) concentrations for the diagnosis of H. pylori infection and evaluation of the grade of histologic gastritis. Methods: The subjects consisted of 283 individuals (147 men and 136 women; mean age, 44.0 years). Biopsy specimens were obtained from the gastric antrum and body to assess grade of inflammation and atrophy and histologic evidence of H. pylori infection. H. pylori infection was judged by Giemsa staining and serum IgG antibodies against H. pylori. PG concentrations were determined by radioimmunoassay. Results: In subjects with H. pylori infection, serum PGII concentrations were increased, and the PGI/PGII ratio (I/II ratio) was decreased. In patients with marked atrophy or intestinal metaplasia, both serum PGI and the I/II ratio were decreased. When PGII concentrations of 12 ng/ml or more, or a I/II ratio of 4.0 or less were used as the cutoff points for the diagnosis of H. pylori infection, the sensitivity and specificity of diagnosis were 90.0% and 93.5%, respectively. All subjects with serum PGI concentrations of 85 or more ng/ml, or serum PGII concentrations of 15 or more ng/ml were H. pylori-positive and all subjects with a I/II ratio of more than 6.5 were H. pylori-negative. Conclusions: These results suggest that H. pylori infection, gastritis, and glandular atrophy of the stomach can be evaluated via serum PG concentrations, allowing the evaluation of gastric mucosal integrity.

The aim of this study was to clarify the pathogenesis of Helicobacter pylori-negative duodenal ulcer (DU) by investigating the meal-stimulated serum gastrin (SG) response. The subjects were 9 patients with H. pylori-negative DU, 28 H. pylori-positive DU, 11 H. pylori-positive volunteers, and 30 H. pylori-negative volunteers. Blood samples were taken before and after consumption of a test meal. The integrated 1-hr gastrin response (IGR) was taken to be the area under the SG time curve, calculated by the trapezoid method. H. pylori infection status was determined by histology, serology, and the [13C] urea breath test. The mean basal SG concentration was lower in the H. pylori-negative DU patients than in the H. pylori-positive DU patients, but an exaggerated IGR was observed in three patients (33.3%) with H. pylori-negative DU. In conclusion, our findings indicate that an exaggerated meal-stimulated gastrin response may contribute to the pathogenesis of H. pylori-negative DU.

We investigated an antiinflammatory effect of rebamipide [2-(4-chlorobenzoylamino)-3-[2(1H)-quinolinon-4-yl] propionic acid], a gastroprotective agent, in H. pylori-associated gastritis. Eighty-six patients with H. pylori-positive chronic gastritis were enrolled: 53 were treated with rebamipide (300 mg daily for 12 months) and 33 served as controls. Significant decreases in mononuclear cell infiltration into the antrum and corpus were noted in the rebamipide treatment group (before vs after, 1.42 +/- 0.15 vs 1.02 +/- 0.15; P < 0.01 and 1.60 +/- 0.15 vs 1.21 +/- 0.14; P < 0.05, respectively). Levels of infiltrating neutrophil were also decreased in the antrum (before vs after, 0.98 +/- 0.14 vs 0.70 +/- 0.13; P < 0.05) and were associated with a decrease in iNOS production. Sera from patients treated with rebamipide showed a significant decrease in gastrin (276.3 +/- 58.3 pg/ml vs 173.0 +/- 34.2 pg/ml; P < 0.05), whereas no change was observed in the control group. These suggest that long-term rebamipide treatment improved histologic gastritis and decreased serum gastrin levels in H. pylori-associated gastritis.

We investigated serum levels of anti-parietal cell antibody (APCA) in relation to various gastric diseases. Subjects were 224 Japanese patients including 58 with gastric cancer. All patients underwent gastroscopy, and APCA was investigated by enzyme-linked immunosorbent assay. Unexpectedly, there was no difference in APCA levels between patients with gastric cancer and those with gastritis. Among H. pylori-positive patients, APCA levels were closely correlated with grades of atrophy when no gastric cancer was present, but no correlation was found when gastric cancer was present. APCA-negative gastric cancer was found mainly in males and was characterized by massive infiltration of neutrophils in the background mucosa. The 24 patients with gastric cancer were APCA-negative and showed low pepsinogen levels. The odds ratio for the incidence of gastric cancer in these patients was 7.90 (95% CI 3.4-18.4). This suggests APCA-negative gastric cancer is the predominant form of gastric cancer in Japan.

We have examined the expression of mRNAs for epidermal growth factor (EGF), transforming growth factor-alpha (TGF-alpha), EGF receptor (EGFR), PDGF-A chain (PDGFA), PDGF-B chain (PDGFB) and PDGF receptor (PDGFR) genes in seven human colorectal carcinoma cell lines and 18 human colorectal carcinomas. In surgically resected specimens of the 18 colorectal tumors, TGF-alpha, EGFR, PDGFA, PDGFB and PDGFR mRNAs were detected at various levels in 15 (83%), 9 (50%), 18 (100%), 8 (44%) and 12 (67%), respectively. They were also detected in normal tissues. Interestingly, EGF mRNA was detected in only five (28%) of the tumors, but not in normal mucosa. Expression of EGF was also confirmed immunohistochemically in tumor cells. Of the five tumors expressing EGF, four expressed EGFR mRNA and showed a tendency to invade veins and lymphatics. All the colorectal carcinoma cell lines expressed TGF-alpha mRNA, and five cell lines expressed EGFR mRNA simultaneously. Production of TGF-alpha protein by DLD-1 and CoLo320DM cells was confirmed by TGF-alpha specific monoclonal antibody binding assay. The spontaneous 3H-thymidine uptake by DLD-1 was suppressed by an anti-TGF-alpha monoclonal antibody. PDGFA and PDGFB mRNA were also expressed in four cell lines, but PDGFR and EGF mRNA was not detected. These results suggest that human colorectal carcinomas express multi-loops of growth factors and that TGF-alpha produced by tumor cells functions as an autocrine growth factor in human colonic carcinoma.

Fever is frequently observed in critically ill patients. An independent association of fever with increased mortality has been observed in non-neurological critically ill patients with mixed febrile etiology. The association of fever and antipyretics with mortality, however, may be different between infective and non-infective illness. We designed a prospective observational study to investigate the independent association of fever and the use of antipyretic treatments with mortality in critically ill patients with and without sepsis. We included 1,425 consecutive adult critically ill patients (without neurological injury) requiring > 48 hours intensive care admitted in 25 ICUs. We recorded four-hourly body temperature and all antipyretic treatments until ICU discharge or 28 days after ICU admission, whichever occurred first. For septic and non-septic patients, we separately assessed the association of maximum body temperature during ICU stay (MAXICU) and the use of antipyretic treatments with 28-day mortality. We recorded body temperature 63,441 times. Antipyretic treatment was given 4,863 times to 737 patients (51.7%). We found that treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen independently increased 28-day mortality for septic patients (adjusted odds ratio: NSAIDs: 2.61, P = 0.028, acetaminophen: 2.05, P = 0.01), but not for non-septic patients (adjusted odds ratio: NSAIDs: 0.22, P = 0.15, acetaminophen: 0.58, P = 0.63). Application of physical cooling did not associate with mortality in either group. Relative to the reference range (MAXICU 36.5°C to 37.4°C), MAXICU ≥ 39.5°C increased risk of 28-day mortality in septic patients (adjusted odds ratio 8.14, P = 0.01), but not in non-septic patients (adjusted odds ratio 0.47, P = 0.11). In non-septic patients, high fever (≥ 39.5°C) independently associated with mortality, without association of administration of NSAIDs or acetaminophen with mortality. In contrast, in septic patients, administration of NSAIDs or acetaminophen independently associated with 28-day mortality, without association of fever with mortality. These findings suggest that fever and antipyretics may have different biological or clinical or both implications for patients with and without sepsis. ClinicalTrials.gov: NCT00940654