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During the surge of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) delta variant, our institution operated an intensive care unit (ICU) for patients with severe COVID-19. The study aim was to determine the survival rate and treatment outcomes of patients with severe COVID-19 treated in the ICU during the surge. A total of 23 consecutive patients with severe COVID-19 were admitted to the ICU between August 5 and October 6, 2021. Patients received multidrug therapy consisting of remdesivir, tocilizumab, heparin, and methylprednisolone. The patients were divided into two groups based on the ordinal scale (OS): a non-invasive oxygen therapy (OS-6) group, and an invasive oxygen therapy (OS-7) group. There were 13 (57%) and 10 (43%) patients in the OS-7 and OS-6 groups, respectively. All patients were unvaccinated. Sixteen patients (70%) were male. The median age was 53 years; the median body mass index (BMI) was 30.3 kg/m2; and the median P/F ratio on admission was 96. The 30-day survival rate was 69% and was significantly poorer in the OS-7 group (54%) than in the OS-6 group (89%; p = 0.05). The prevalence of obesity (p = 0.05) and the Sequential Organ Failure Assessment (SOFA) score on admission (p < 0.01) were significantly higher in the OS-7 group. Seven patients in the OS-7 group (54%) developed bacteremia. A low P/F ratio on admission was a significant unfavorable prognostic factor (hazard ratio: 10.9; p = 0.03). The survival rate was poor, especially in patients requiring invasive oxygen therapy. More measures are needed to improve the treatment outcomes of patients with severe COVID 19.

We report three cases of Waterhouse-Friderichsen syndrome (WFS) that were confirmed during forensic autopsies. Case 1 involved a man in his 50s post-splenectomy. Bacteriological examination revealed Streptococcus pneumoniae (S. pneumonia). The patient was considered to have died of asphyxiation after aspirating vomit. Case 2 involved a man in his 40s. Bacteriological examination again revealed S. pneumoniae. Histopathological examination showed hypoplasia of the spleen. This patient was considered to have died of multiple-organ failure due to sepsis, disseminated intravascular coagulation, and WFS. Case 3 involved a post-splenectomy woman in her 60s with a history of systemic lupus erythematosus. Bacteriological examination revealed Streptococcus oralis. This patient was considered to have died of multiple-organ failure due to sepsis, disseminated intravascular coagulation, and WFS. These three cases were included among forensic autopsies conducted in the last 5 years. WFS has been considered a rare disease, but may be more frequent than previously assumed. If a mildly ill patient displays a sudden change in status and dies within a short period of time, we consider it necessary to perform not only bacteriological examinations, but also histopathological examination of the spleen during autopsy.

The effect of the head group on the oxidation of unsaturated phospholipids under low-level ozone was investigated. The phospholipids with head groups of glycerol and choline show different surface-...

Sex determination is a crucial factor in the identification of unidentified human remains. Sex determination by DNA analysis is particularly useful because it can be applied to samples for which morphological characteristics are unavailable. Because samples handled in forensic DNA typing are easily degraded by environmental factors and microorganisms, there is a need for a method that can accurately determine sex even in highly decayed samples. Previous studies mainly used sex differences in an intron of the amelogenin gene. However, this region is highly polymorphic, and there are cases where accurate sexing cannot be performed because of genetic mutations in the target region. Thus, for reliable sex determination, it is desirable to select loci with as few non-sexual polymorphisms as possible. In this study, we focused on the exon 1 region of the amelogenin gene, which has very little polymorphism other than sex differences. We developed a primer set for sex determination and compared it with the GlobalFiler™ PCR Amplification Kit (GF), which is widely used for forensic DNA typing. The results showed that the amount of DNA required for accurate sex determination was 25 pg for both methods, achieving equivalent sensitivity. Next, we compared the two methods using ancient human skeletons and found that the present method with its shorter amplicon was considerably superior to GF. The present method is simple, rapid, inexpensive, and suitable for analyzing highly degraded samples. Therefore, this method is expected to contribute to forensic sciences and physical anthropology.

Background: Even though the mother and the fetus of placental mammals are immunologically non-self with respect to one other, mutual exchange of small numbers of cells between them is known to occur. Maternal cells entering the fetus, called maternal microchimeric cells (MMc cells), are thought to be involved in different physiological phenomena, such as establishing immune tolerance, tissue repair, and the pathogenesis or deterioration of some inflammatory diseases and congenital malformations. While specific MMc cell types have been reported as associated with these phenomena, the contribution of MMc cells to these different outcomes remains unknown. As one possibility, we hypothesized that different embryos have differing repertoires of MMc cell types, leading to or biasing embryos toward different fates. To date, no studies have succeeded in identifying the MMc cell type repertoire of a single embryo. Accordingly, here, we isolated MMc cells from whole mouse embryos, determined their types, and analyzed their MMc cell type variability.Results: By combining our previously established, whole-embryonic MMc isolation method with single-cell RNA sequencing, we successfully estimated the cell type repertoires of MMc cells isolated from 26 mouse embryos. The majority of MMc cells were immune-related cells, such as myeloid cell and granulocyte. We also detected stem cell-like MMc cells expressing proliferation marker genes and terminally differentiated cells. As hypothesized, we noted statistically significant inter-individual variation in the proportion of immune-related cells in the different embryos.Conclusions: We here successfully estimated MMc cell types in individual whole mouse embryos. The proportion of immune-related cells significantly differed among the individual embryos, suggesting this as one of the potential mechanisms underlying the differing MMc-related physiological phenomena in offspring. These findings provide insight into cell-level epigenetics by maternal cells.

Anxiety and depression may be under-recognized in patients with heart failure (HF). We therefore investigated the prevalence and temporal change of these symptoms in hospitalized patients with HF.We prospectively evaluated consecutive hospitalized patients with HF using the Hospital Anxiety and Depression Scale (HADS) on admission and at discharge. The HADS-A (anxiety) and HADS-D (depression) scores were categorized as follows; 0-7, no symptoms; 8-10, mild; and 11-21, significant anxiety or depression. Symptom worsening was defined as the HADS category at discharge being poorer than that on admission. Of 224 patients (mean age 77.5 years), 35 (16%) and 62 (28%) had significant symptoms of anxiety and depression, respectively. During hospitalization, the HADS-A significantly decreased (on admission; median 6 [interquartile range (IQR) 3-9] vs at discharge; median 4 [IQR 2-7], P.01), whereas the HADS-D did not improve (on admission; median 8 [IQR 5-11] vs at discharge; median 8 [IQR 4-11], P =.82). Anxiety and depression worsened during hospitalization in 19 (10%) and 40 (21%) patients, respectively. Advanced age, higher natriuretic peptide levels, and acute-on-chronic HF were associated with worsening anxiety, and longer hospitalization length was associated with worsening depression.Anxiety and depression were common and depression persisted during HF hospitalization.

The aim of the study was to examine lateral pterygoid muscle (LPM) and temporomandibular joint (TMJ) disc before and after Le Fort I osteotomy with and without intentional pterygoid plate fracture and sagittal split ramus osteotomy (SSRO) in class II and class III patients. Le Fort I osteotomy and SSRO were performed in class II and class III patients. LPM measurements using oblique sagittal computed tomography (CT) images and TMJ disc position using magnetic resonance imaging (MRI) were examined. Statistical comparisons were performed for the LPM and TMJ between class II and class III patients and between those with and without intentional pterygoid plate fracture in Le Fort I osteotomy. The subjects comprised 60 female patients (120 sides), with 30 diagnosed as class II and 30 as class III. Preoperatively, the width of the condylar attachment, width at eminence, length of the LPM, angle of the LPM, and square of the LPM were significantly smaller in the class II group than in the class III group (p 0.05). After 1 year, the width of the condylar attachment, width at eminence, and angle of the LPM remained significantly smaller in the class II group than in the class III group (p 0.0001). TMJ disc position was significantly related to the width of the condylar attachment of the LPM, both pre- and postoperatively (p 0.0001). However, postoperative disc position did not change in all patients. Next, the class II patients (60 sides) were divided into two groups who underwent Le Fort I osteotomy with or without intentional pterygoid plate fracture. Changes in all measurements of the LPM showed no significant differences between these two groups. Our study suggested that TMJ disc position classification could be associated with the width of condylar attachment of the LPM before and after surgery, while the surgical procedure, including Le Fort I osteotomy with intentional pterygoid plate fracture, might not affect postoperative LMP or disc position in class II patients.

This study aimed to assess mandibular morphologic changes to the condyle, ramus, mandibular body, and inferior mandibular border defect after sagittal split ramus osteotomy in class II and III patients.The relationships among the condyle, ramus, and mandibular body measured by computed tomography preoperatively and postoperatively were assessed and factors related to the reduction of the condylar square and mandibular inferior border defect were examined.Patients included 72 female patients with jaw deformity (36 skeletal class II cases, 36 skeletal class III cases). Postoperative reduction of the condylar square was significantly correlated with preoperative condylar height in patients with class II (P = .0297) vs preoperative condylar height and preoperative mandibular height in patients with class III (P.0001). A mandibular inferior border defect was found in 18 of 72 class II sides (25.0%) and was significantly related to the position of the osteotomy line and attachment side of the inferior border cortex (P.0001).This study's findings suggest that the postoperative reduction of the condyle could be associated with preoperative condylar height. However, the mandibular inferior border defect in class II advancement surgery could be independently associated with technical factors in sagittal split ramus osteotomy.

This study was performed to evaluate the relationship between condylar height reduction and changes in condylar surface computed tomography (CT) values in jaw deformity patients following orthognathic surgery. Mandibular advancement by sagittal split ramus osteotomy (SSRO) with Le Fort I osteotomy was performed in class II patients, and mandibular setback by SSRO with Le Fort I osteotomy was performed in class III patients. The maximum CT values (pixel values) at five points on the condylar surface and the condylar height, ramus height, condylar square, ramus angle, and gonial angle in the sagittal plane were measured preoperatively and 1 year postoperatively. Disc position was classified as anterior disc displacement (ADD) or other types by using magnetic resonance imaging (MRI). Ninety-two condyles of 46 female patients were prepared for this study. Their temporomandibular joints (TMJs) were divided into two groups based on class (46 joints in class II and 46 joints in class III) and two groups based on the findings (25 joints with ADD and 67 joints with other findings). ADD with and without reduction was observed in two joints in the class III group and in 23 joints in the class II group. The distribution of ADD incidence had not changed 1 year after surgery. Condylar height decreased 1 year after surgery in both class II patients (mandibular advancement) (p < 0.0001) and class III patients (mandibular setback) (p = 0.0306). Similarly, condylar height decreased 1 year after surgery both in patients who showed ADD (p = 0.0087) and those with other types (p = 0.0023). Significant postoperative increases at all angle sites on the condylar surface were found in the class II (p < 0.05) and ADD (p < 0.05) groups. This study showed that an enhanced condylar surface CT value might be one sign of condylar height reduction related to sequential condylar resorption, in combination with ADD.

山口県では，コムギはふつう11月に播種するが，10月に早播きすると穂数と一穂小穂数が減少して収量が少なくなる場合が多いことが知られている．本試験は，幼穂形成期間における窒素追肥処理が，早播栽培により減少した収量をいかに増加することができるかを調査した．品種は，早播栽培において比較的多収を示す秋播性程度がIVのイワイノダイチと秋播性程度がIIIのアイラコムギ，さらに秋播性程度がVのあきたっこを供試した．これら品種は，2003/2004年，2004/2005年，2007/2008年の3シーズンに早播栽培した上で品種それぞれの二重隆起期あるいは頂端小穂期，止葉期に窒素追肥処理を行った．その結果，イワイノダイチとアイラコムギでは，早播栽培は収穫指数を低下し，穂数あるいは一穂粒数を減少することで収量を減少したが，幼穂形成期間に追肥することで，収穫指数あるいは穂数を増加して収量を増加した．あきたっこでは，早播栽培は収量が減少することはなかった．さらに，幼穂形成期間に追肥しても収量を増加しなかった．イワイノダイチとアイラコムギは，早播栽培が幼穂形成期を2カ月早めて12月から1月とし，一穂粒重が軽く，一穂粒数の少ない穂を多く発生した．これらの穂は，追肥することでイワイノダイチでは減少したが，アイラコムギでは増加した．あきたっこは，早播栽培が幼穂形成期を10日しか早めずに3月とし，粒数の少ない穂は少なかった．

山口県でコムギを早播栽培した時にみられる小穂数の増減の品種による違いが生じる原因を明らかにするため, 幼穂形成過程における小穂位置別の小花分化パターンを調査した. 試験は1999/2000年, 2000/2001年, 2001/2002年の3シーズンに実施し, 品種は, 春播性を示すものから強い秋播性を示すものまで育成地の異なる9品種を用いた. 小花は, 慣行栽培した標準区では, 供試したすべての品種において幼穂の中央部の小穂で早く分化し, 先端および基部の小穂ほど遅く分化した. 早播栽培した早播区でも, 春播性の品種および強い秋播性の品種では標準区と同様に, 中央部の小穂で早く, 先端および基部の小穂で遅く分化した. 一方, 中程度の秋播性を示す九州育成品種のイワイノダイチと関東育成品種のアイラコムギは, 早播区では先端の小穂で早く分化し, 基部の小穂ほど遅く分化した. 一穂小穂数は, イワイノダイチとアイラコムギでは3シーズンとも早播区が標準区よりも多く, 春播性品種の農林61号と春のあけぼのでは3シーズンとも早播区が標準区よりも少なかった. ただし, 小穂別の着生粒数は, イワイノダイチの早播区では, 先端の小穂が, 早く分化したにもかかわらず, これよりも遅く分化した中央部の小穂よりも少なかった.

Grain number per spike of wheat is lower in early sowing than in the conventional standard cultivation in Yamaguchi, Prefecture, Japan. Components of the grain number per spike in five cultivars were analyzed with respect to temperature during the spike development period throughout three growing seasons 2001/2002, 2002/2003 and 2003/2004 to find the cause of the problem of early sowing cultivation. The plants sown in early-October and late-November were called the early sown group and the standard group, respectively, in the following. Three of the five cultivars, Hokushin, Akitakko and Nanbukomugi, showed a strong winter habit, which requires very cold temperatures for spike differentiation. The other two cultivars, Iwainodaichi and Airakomugi, had a moderate winter habit. Grain number per spike and grain yield were decreased by early-sowing (compare with the standard group) in almost all cultivars throughout the three growing seasons. The three cultivars which had a strong winter habit had fewer spikelets per spike in the early-sown group than in the standard group. The other two cultivars which had a moderate winter habit had fewer grains per spikelet in the early-sown group. The higher the temperature during the spikelet formation phase, which is from flag leaf initiation to terminal spikelet initiation, the higher the number of spikelets per spike in the standard group. The spikelet number per spike in the early-sown group increased with the increase in productive tillers under fertile conditions. Such conditions also increased the grain number per spike.

The spring-type cultivar (Triticum aestivum L.) is usually sown in November. However, the sowing time is sometimes delayed considerably because of much rain in October, and the seed bed does not become suitably dry for sowing due to cold temperature. To find a solution to this problem, we compared the yielding ability of wheat sown early (early-sown group) with wheat sown at the standard date (standard group) in Yamaguchi. The grain yield for nine cultivars averaged for three growing seasons, 1999/2000, 2001/2002 and 2002/2003 was 230 gm -2 in the early-sown group, and significantly lower than that in the standard group (334 gm -2 ). The spike number and grain number per spike were lower in the early-sown group than in the standard group. Akitakko, Iwainodaichi, Airakomugi had a higher grain yield, and Akitakko had a higher spikelet number per spike and higher grain number per spike than the other cultivars when sown earlier. Iwainodaichi showed higher spike number when sown earlier. Airakomugi showed higher grain number per spike and grain weight when sown earlier. Akitakko was the only cultivar that showed a higher grain yield by early sowing.