Epidemiology of post-COVID conditions beyond 1 year: a cross-sectional study.

OBJECTIVE: The aim of this study was to investigate the epidemiology of post-COVID conditions beyond 12 months and identify factors associated with the persistence of each condition. STUDY DESIGN: This was a cross-sectional questionnaire-based survey. METHODS: We conducted the survey among patients who had recovered from COVID-19 and visited our institute between February 2020 and November 2021. Demographic and clinical data and data regarding the presence and duration of post-COVID conditions were obtained. We identified factors associated with the persistence of post-COVID conditions using multivariable linear regression analyses. RESULTS: Of 1148 surveyed patients, 502 completed the survey (response rate, 43.7%). Of these, 393 patients (86.4%) had mild disease in the acute phase. The proportion of participants with at least one symptom at 6, 12, 18, and 24 months after symptom onset or COVID-19 diagnosis was 32.3% (124/384), 30.5% (71/233), 25.8% (24/93), and 33.3% (2/6), respectively. The observed associations were as follows: fatigue persistence with moderate or severe COVID-19 (ß = 0.53, 95% confidence interval [CI] = 0.06-0.99); shortness of breath with moderate or severe COVID-19 (ß = 1.39, 95% CI = 0.91-1.87); cough with moderate or severe COVID-19 (ß = 0.84, 95% CI = 0.40-1.29); dysosmia with being female (ß = -0.57, 95% CI = -0.97 to -0.18) and absence of underlying medical conditions (ß = -0.43, 95% CI = -0.82 to -0.05); hair loss with being female (ß = -0.61, 95% CI = -1.00 to -0.22), absence of underlying medical conditions (ß = -0.42, 95% CI = -0.80 to 0.04), and moderate or severe COVID-19 (ß = 0.97, 95% CI = 0.41-1.54); depressed mood with younger age (ß = -0.02, 95% CI = -0.04 to -0.004); and loss of concentration with being female (ß = -0.51, 95% CI = -0.94 to -0.09). CONCLUSIONS: More than one-fourth of patients after recovery from COVID-19, most of whom had had mild disease in the acute phase, had at least one symptom at 6, 12, 18, and 24 months after onset of COVID-19, indicating that not a few patients with COVID-19 suffer from long-term residual symptoms, even in mild cases.

Length of stay, hospitalisation costs and in-hospital mortality of methicillin-susceptible and methicillin-resistant Staphylococcus aureus bacteremia in Japan.

OBJECTIVES: To examine the length of stay, hospitalisation costs and case fatality of methicillin-susceptible and -resistant Staphylococcus aureus (MSSA and MRSA) bacteremia in Japan. STUDY DESIGN: Retrospective cohort study. Patients with a diagnosis of S. aureus bacteremia who were admitted to a tertiary care hospital (the National Centre for Global Health and Medicine [NCGM]) in Tokyo, Japan, between 1st January 2016 and 31st December 2020 were included in the study. METHODS: We combined Japan Nosocomial Infections Surveillance data and Diagnosis Procedure Combination data at NCGM from 2016 to 2020. The data were stratified into MSSA and MRSA groups. Length of stay (LoS), LoS after submission of a blood culture specimen (LoS-after), hospitalisation cost, hospitalisation costs per day and clinical outcome were compared after propensity score matching. RESULTS: Median LoS was 46 (interquartile range [IQR] 28.5-64.5) days in the MSSA group and 66 (IQR 40-91) days in the MRSA group (P = 0.020). Median LoS-after was 38 (IQR 25-62.5) days and 45 (IQR 24-63) days (P = 0.691) in the MSSA and MRSA groups, respectively. Median hospitalisation cost was significantly higher in the MRSA group (26,035 [IQR 18,154-47,362] USD) than in the MSSA group (19,823 [IQR 13,764-32,042] USD) (P = 0.036), but cost per day was not (MRSA: 528.9 [IQR 374.9-647.4] USD; MSSA: 455.6 [IQR 359.2-701.7] USD; P = 0.990). Case fatality rate was higher in the MRSA group than in the MSSA group (22/60 vs 9/60, P = 0.012). CONCLUSIONS: Patients with MRSA bacteremia had longer LoS and higher costs than those with MSSA bacteremia. However, LoS-after and hospitalisation costs per day were not different. The longer LoS of patients in Japan compared with other countries might contribute to the higher disease burden of S. aureus bacteremia in Japan.

Nightlife clusters of coronavirus disease in Tokyo between March and April 2020.

We analysed associations between exposure to nightlife businesses and severe acute respiratory syndrome coronavirus 2 PCR test results at a tertiary hospital in Tokyo between March and April 2020. A nightlife group was defined as those who had worked at or visited the businesses. We included 1517 individuals; 196 (12.9%) were categorised as the nightlife group. After propensity score matching, the proportion of positive PCR tests in the nightlife group was significantly higher than that in the non-nightlife group (nightlife, 63.8%; non-nightlife, 23.0%; P < 0.001). An inclusive approach to mitigate risks related to the businesses needs to be identified.

PAX5-PML acts as a dual dominant-negative form of both PAX5 and PML.

PAX5 is a transcription factor required for B-cell development and maintenance. PML is a tumor suppressor and a pro-apoptotic factor. A fusion gene, PAX5-PML, was found in acute lymphoblastic leukemia (ALL) with chromosomal translocation t(9;15)(p13;q24), but no functional analysis has been reported. Here, we demonstrate that PAX5-PML had a dominant-negative effect on both PAX5 and PML. PAX5-PML dominant negatively inhibited PAX5 transcriptional activity in the luciferase reporter assay and suppressed the expression of the PAX5 transcriptional targets in B-lymphoid cell line. Surprisingly, PAX5-PML hardly showed DNA-binding activity in vitro although it retained the DNA-binding domain of PAX5. Additional experiments, including chromatin immunoprecipitation (ChIP) assay, suggested that PAX5-PML bound to the promoter through the association with PAX5 on the promoter. On the other hand, coexpression of PAX5-PML inhibited PML sumoylation, disrupted PML nuclear bodies (NBs), and conferred apoptosis resistance on HeLa cells. Furthermore, treatment with arsenic trioxide (ATO) induced PML sumoylation and reconstitution of PML NBs, and overcame the anti-apoptotic effect of PAX5-PML in HeLa cells. These data suggest the possible involvement of this fusion protein in the leukemogenesis of B-ALL in a dual dominant-negative manner and the possibility that ALL with PAX5-PML can be treated with ATO.

Detection of human papillomavirus in pterygium and conjunctival papilloma by hybrid capture II and PCR assays.

AIM: To elucidate the putative role of human papillomavirus (HPV) infection in pterygium and conjunctival papilloma. METHODS: Hybrid capture II (HC-II) and polymerase chain reaction (PCR) assays were performed to detect HPV in pterygium (42 samples obtained from 40 patients) and conjunctival papilloma (8 samples from 6 patients). The amount of HPV DNA was evaluated by measurement of relative light units (RLUs) on a luminometer. RESULTS: All papilloma samples were positive for HPV DNA by PCR and HC-II. The RLU values for specimens of recurrent and re-recurrent papilloma were markedly higher than those for specimens of primary lesions. HPV was detected by PCR in 2 of 42 (4.8%) beta-globin-positive pterygium specimens, whereas HC-II showed that HPV was negative in all pterygium samples. CONCLUSIONS: Our results support the hypothesis that HPV DNA is associated with the pathogenesis of conjunctival papilloma, but not pterygium. RLU measurement by HC-II may serve as a marker for evaluating the activity of HPV in conjunctival tumours.

Axial length, myopia, and the severity of lens opacity at the time of cataract surgery.

OBJECTIVE: To investigate the relationship between axial length, myopia of the eye, and the severity of lens opacity at the time of cataract surgery. METHODS: We retrospectively reviewed a consecutive series of 198 eyes of patients aged older than 50 years at Fukui University Hospital (Fukui, Japan) from June 2004 to December 2005. Patient age at the time of surgery, axial length, spherical equivalent, and the subtypes and severity of cataract (as classified according to the modification of the Lens Opacities Classification System, version III) were recorded. RESULTS: Axial length was significantly associated with age at the time of cataract surgery (P<.001). Regarding the severity of nuclear cataract, a significant correlation was seen between a higher score of nuclear cataract and longer axial length (P<.001). The relationship between the severity of nuclear cataract and spherical equivalent at the time of surgery showed a significant association between grading nuclear color and nuclear opalescence 4-6 and higher myopia (P<.001). CONCLUSION: An increase in axial length or myopia of the eye was associated with a lower mean age at the time of surgery and higher grade of nuclear cataract.

Expression of Cotesia kariyai polydnavirus genes in lepidopteran hemocytes and Sf9 cells.

The parasitic wasp Cotesia kariyai carries polydnavirus (CkPDV) which is an indispensable factor for the successful parasitization by the wasp. One of its surface proteins has been identified as an immunoevasive mediator from the cellular defense reactions of the host armyworm Pseudaletia separata, thereby it was named immunoevasive protein (IEP). In the present study, we demonstrated that anti-IEP antibody did not suppress the CkPDV infection of Sf9 cells but decreased its infection of P.separata hemocytes, thus indicating that IEP is not essential for CkPDV to enter into the target cells but is important for evading from the attack of the hemocytes. Three genes of CkPDV expressed in Sf9 cells were isolated and characterized. Two of them (CkV0.8, CkV0.9) are novel genes but another one (CkV2.0) is the same gene with the one we previously identified in the parasitized armyworm larvae. Although these genes reside in different DNA segments of CkPDV genome, all of them are expressed in the hemocytes of the parasitized armyworm larvae. These gene transcripts are first detected at 2 h after parasitization, and the expressions of CkV0.8 and CkV0.9 were gradually decreased after reaching the maximum level at 4 h after parasitization. However, the expression of CkV2.0 continues to be increased at least for 10 h after parasitization.

Isolation and characterization of a dopa decarboxylase cDNA and the induction of its expression by an insect cytokine, growth-blocking peptide in Pseudaletia separata.

Parasitization by the wasp, Cotesia kariyai, elevates the concentration of an insect cytokine, growth-blocking peptide (GBP), in hemolymph of last instar Pseudaletis separata larvae. The increase of epidermal and hemolymph dopamine level is associated with the GBP increase. Both GBP and dopamine disturb host development and metamorphosis (Hayakawa, 1995). Dopa decarboxylase (DDC) converts Dopa to dopamine, and its cDNA was isolated from P. separata, and the deduced amino acid sequence showed that it was highly homologous to other lepidopteran DDCs, showing 96, 90 and 86% identity with those of Mamestra brassicae, Bombyx mori, and Manduca sexta, respectively. A 3.2 kb DDC mRNA transcript was constitutively expressed at low levels in the epidermis, brain-nerve cord and hemocytes, and the expression was enhanced by injection of GBP in these tissues. Detailed characterization of the DDC mRNA expression in the epidermis showed that its expression reached a plateau 3 hr after the injection. DDC activity and DDC protein (55 kDa) level mirrored the mRNA expression. Immunocytochemistry with anti-DDC antibody confirmed that the enhanced DDC expression was localized in the epidermal cells. Dopamine concentration in the epidermis gradually increased and reached maximum 6 hr after the injection. When the epidermis of Day 1 last instar larvae was cultured in vitro in the presence of GBP, DDC mRNA increased, indicating that GBP acted on the epidermal cells directly to induce expression of the DDC gene.

Acute promyelocytic leukemia with apparently normal karyotype: molecular findings and response to all-trans retinoic acid.

Acute promyelocytic leukemia (APL) is specifically associated with a reciprocal translocation, t(15; 17)(q22; q21), leading to the formation of a fusion of the retinoic acid receptor-alpha (RARA) gene and the promyelocytic leukemia (PML) gene. However, there are several reports describing APL cases lacking the t(15; 17). Many such cases are those bearing variant translocations involving chromosomes 15 or 17, and those with no chromosomal aberrations have rarely been reported. We have studied a patient with APL showing an apparently normal karyotype which was confirmed by spectral karyotyping (SKY). A submicroscopic PML-RARA fusion was identified by reverse transcriptase-polymerase chain reaction (RT-PCR) and fluorescent in situ hybridization (FISH). All-trans retinoic acid (ATRA) was effective as the initial therapy for remission induction and as the reinduction therapy after a relapse. The present study shows the key role of the fusion of PML-RARA in the responsiveness to ATRA as well as in the leukemogenesis of APL.

Histologic examination of dislocated lenses.

PURPOSE: To examine histological changes resulting from dislocated and subluxated lenses. CASES: The subjects consisted of 16 patients (aged 52-89 years) who underwent total lens extraction for lens dislocation or subluxation in the Department of Ophthalmology at Fukui Medical University during the period between April 1991 and June 1998. There were 5 patients (6 eyes) with traumatic dislocation and 11 patients (11 eyes) with idiopathic dislocation. RESULT: Rupture of the cortical fibers and migration of the epithelial cells toward the posterior pole of the lens were more frequently noted in patients with traumatic dislocation than in the idiopathic group, and both findings were often simultaneously observed. Rupture of the cortical fibers was considered attributable to external pressure transmitted to the lens. CONCLUSION: We speculate that the concurrent migration and dislocation of the equatorial bow architecture toward the posterior pole was caused by inhibition of differentiation of the epithelial cells to fiber cells by external pressure on the equatorial region.

A role for membrane-type serine protease (MT-SP1) in intestinal epithelial turnover.

Membrane type-serine protease 1 (MT-SP1) plays potential roles in the process of invasion and metastasis of carcinomas. In the present study, we cloned a rat MT-SP1 cDNA and investigated the intestinal distribution and proteolytic properties of the enzyme. By in situ hybridization we found the prominent expression of the mRNA in the epithelial layer of the small intestinal upper villi and of the colon, where cells are loosely attached to the basement membrane. When MT-SP1 was expressed in Caco-2, a colonic carcinoma cell line, the protein was localized exclusively on the basolateral side. A secreted form of the enzyme produced in COS-1 cells digested fibronectin and laminin. These findings suggest that MT-SP1 participates in the control of intestinal epithelial turnover by regulating the cell-substratum adhesion.

Histone deacetylase 3 associates with and represses the transcription factor GATA-2.

The zinc finger transcription factor GATA-2 plays a critical role in the survival and proliferation of hematopoietic stem cells. This study examined the interaction of GATA-2 with histone deacetylases (HDACs) to define the involvement of HDACs in the regulation of GATA-2 function. GATA-2 directly associates with HDAC3 but not with HDAC1. Consistent with this, HDAC3 suppressed the transcriptional potential of GATA-2, whereas HDAC1 did not affect GATA-2-dependent transcription. Results further demonstrated that GATA-2 and HDAC3 colocalized in the nucleus. These results identify GATA-2 as a nuclear target for HDAC3-mediated repression. Furthermore, GATA-2 also directly associated with HDAC5 but not with other class II HDACs examined, that is, HDAC4 and HDAC6. This is the first demonstration that a tissue-specific transcription factor directly and selectively interacts with HDAC3 and HDAC5 among HDAC family members.

Molecular cloning of silkworm paralytic peptide and its developmental regulation.

The silkworm paralytic peptide (PP) is a member of the ENF peptide family that exerts multiple biological activities involved in defense reaction and growth regulation. We isolated its cDNA and examined mRNA expression profiles. cDNA encoded 131 amino acids from which the 23-residue PP sequence was found at the C-terminal portion. Immunoblot analysis and paralytic activity assay indicated that inactive pro-protein in larval hemolymph was processed into active peptide immediately after bleeding. In the last larval instar, 0.6-kb PP mRNA was expressed in various tissues, of which the fat body was predominant. Its expression in the fat body decreased during the feeding period and then increased during metamorphic process. Juvenile hormone and 20-hydroxyecdysone upregulated its expression. At the embryonic stage, 1.5-kb mRNA, in addition to 0.6-kb mRNA, was expressed from 1 day after oviposition to hatching. PP was thus expressed stage-specifically under hormonal control.

Cooperative enhancement of water binding to crownophane by multiple hydrogen bonds: analysis by high level ab initio calculations.

The intermolecular interaction energy of the model system of the water-crownophane complex was analyzed. The water molecule has four hydrogen bonds, with the two hydrogen-donating phenolic hydroxy groups and two hydrogen-accepting oxygen atoms of the poly-oxyethylene chain of the crownophane in the complex. The MP2/6-311G(2d,2p) level calculations of the model system of the complex (hydrogen donating unit + hydrogen accepting unit + water) indicate that the binding energy of the water is 21.85 kcal/mol and that the hydrogen bond cooperativity increases the binding energy as much as 3.67 kcal/mol. The calculated interaction energies depend on the basis set, while the basis set dependence of the cooperative increment is negligible. Most of the cooperative increment is covered by the HF level calculation, which suggests that the major source of the hydrogen bond cooperativity in this system has its origin in induction. The BLYP/6-311G** and PW91/6-311G** level interaction energies of the model system are close to the MP2/6-311G** interaction energies, which suggests that the DFT calculations with these functionals are useful methods to evaluated the interactions of hydrogen bonded systems.

Neurotic perfectionism, perceived stress, and self-esteem among Japanese men: a prospective study.

The present study examined the relationship between self-report scores of neurotic perfectionism and of perceived stress and self-esteem 6 wk. later among 146 Japanese male college students. Hierarchical regression analysis indicated that scores for neurotic perfectionism accounted for statistically significant but functionally small variance (4% and 3%) in scores for perceived stress and self-esteem obtained at Time 2 (6 wk. later), after controlling for the scores for perceived stress and self-esteem at Time 1, respectively.

Proliferation of alpha-smooth muscle actin-containing stromal cells (myofibroblasts) in the lamina propria subjacent to intraepithelial carcinoma of the esophagus.

BACKGROUND: The lamina propria of the digestive tract is the space containing vessels, myofibroblasts, and other interstitial components. The present study was undertaken to elucidate the relationships between the proliferation of myofibroblasts within this space and other histological features such as inflammatory cell infiltration and proliferation of blood vessels. METHODS: Thirty-eight cases in total-comprising 19 cases of early and 19 cases of advanced esophageal squamous cell carcinoma with intraepithelial extension (the former including 10 lesions of carcinoma in situ and 15 lesions of carcinoma with invasion only into the lamina propria)-were examined using H&E staining, Azan Mallory staining, and immunostaining for the characterization of mesenchymal cells in the lamina propria against alpha-smooth muscle actin (alphaSMA), desmin, vimentin, factor VIII, collagen type IV, laminin, or inflammatory cells (L26, UCHL1, Kp1, and c-kit). The proliferative potential of myofibroblasts was evaluated by measuring the total length of the bundles of myofibroblasts per case. RESULTS: Proliferation of alphaSMA-containing stromal cells: i) occurred in the lamina propria subjacent either to intraepithelial carcinomas (64%) or to the intraepithelial extension of carcinoma tissue (47%), and ii) showed a significant correlation with both the degree of mononuclear cell infiltration (mostly UCHL1-positive T cells) and the total length of the carcinoma tissue in each case. CONCLUSIONS: Proliferation of alphaSMA-containing stromal cells in the lamina propria may be involved in altering the endoscopic features of the esophagus in cases with intraepithelial carcinoma or an intraepithelial extension of carcinoma tissue.

Ecdysteroid-inducible genes in the programmed cell death during insect metamorphosis.

The anterior silk gland of the silkworm, Bombyx mori, undergoes programmed cell death (PCD) during pupal metamorphosis and PCD is triggered by 20-hydroxyecdysone (20E) in vitro. In order to identify the genes responsible for the PCD, we subtracted cDNAs prepared from the anterior silk glands incubated in the presence or absence of 20E in vitro. After a series of screenings by dot blot hybridization, DNA sequencing and reverse transcription polymerase chain reaction (RT-PCR), we obtained seven novel genes that were activated by 20E in vitro. Nucleotide sequence analysis indicated that two cDNAs (EN78 and EC08) did not have any obvious region to encode proteins, while five genes, designated EC74, EN86, EN03, EN10 and EN16, encoded proteins that are similar to inorganic phosphate cotransporter, TIA-1-like protein, chitinase-related protein, translation-initiation-factor subunit and annexin, respectively. Expression profiles of the genes after 20E stimulation indicated that four genes could be classified as early genes, while two are delayed early genes. The genes identified may provide insight into the PCD induced by a steroid hormone.