Clinical Characteristics of Patients with SARS-CoV-2 N501Y Variants in General Practitioner Clinic in Japan.

The clinical characteristics of patients with N501Y mutation in SARS-CoV-2 variants (N501YV) is not fully understood, especially in the setting of general practice. In this retrospective cohort study, COVID-19 patients admitted to one general practitioner clinic between 26 March and 26 May 2021 were retrospectively analyzed. The characteristics, clinical symptoms and radiological findings before treatment were compared between N501YV and wild-type 501N. Twenty-eight patients were classified as wild-type 501N and 24 as N501YV. The mean (±standard deviation) age was 37.4 (±16.1) years, with no significant difference between groups. Among clinical symptoms, prevalence of fever of 38 degrees Celsius (°C) or higher was significantly higher in the N501YV group than in the wild-type 501N group (p = 0.001). Multivariate analysis showed that fever of 38 °C or higher remained significantly associated with N501YV (adjust odds ratio [aOR]: 6.07, 95% confidence interval [CI]: 1.68 to 21.94). For radiological findings, the lung involvement area was significantly larger in patients infected with N501YV (p = 0.013). In conclusion, in the N501YV group, fever of 38 °C or higher and extensive pneumonia were more frequently observed compared to the wild-type 501N group. There was no significant difference in terms of other demographics and clinical symptoms.

A Case of Multiple Intratumoral Hemorrhage and Rupture of Hepatocellular Carcinoma after Starting Lenvatinib.

A man in his 80s was administered lenvatinib to treat multiple hepatocellular carcinomas. After starting lenvatinib, he was admitted to our hospital for fever and epigastric tenderness. Conjunctival icterus and conjunctival pallor were observed. Computed tomography showed high density areas in his tumors which were suggestive of intratumoral hemorrhage and tumor rupture. As a result, the patient underwent an emergent angiography and arterial embolization.

Sliding thin slab, minimum intensity projection of the lung in asymptomatic subjects: lower limits of lung attenuation, without airways.

PURPOSE: A sliding thin slab, minimum intensity projection (STS-MinIP) is considered to be useful for detecting diseases that decrease lung attenuation. For evaluating these diseases, it would be useful to ascertain the lower limits of normal lung attenuation, allowing a division between normal and subnormal attenuation. However, normal lung attenuation may vary depending on respiratory status, anatomical position, and patient background factors. Our aim was to determine whether the lower limits of lung attenuation, without airways, in asymptomatic subjects using STS-MinIP varies under different conditions. MATERIALS AND METHODS: The study subjects were 43 volunteers without pulmonary symptoms. STS-MinIP was performed at full inspiration and full expiration at three levels of the lung. The lower limits of lung attenuation were compared among the three lung levels and between full inspiration and full expiration, the sexes, age groups, smokers and nonsmokers, and the right and left lungs. RESULTS: The lower limits of lung attenuation had significantly different Hounsfield unit values among lung levels, between the sexes at full inspiration, and between age groups at full expiration. CONCLUSION: This study shows that the lower limits of lung attenuation are influenced by lung fields, sex, and, on expiration, age.

Computed tomography features of portal hypertensive gastropathy.

OBJECTIVE: The aim of this study was to detect the computed tomography features in portal hypertensive gastropathy (PHG). METHODS: This study included 32 patients with portal hypertension. Ten of 32 patients were diagnosed with (PHG), and the other 22 patients were not diagnosed with PHG on the basis of upper endoscopic examination. Dynamic computed tomography studies were performed in all 32 patients. Each computed tomography scan was evaluated with regard to whether the gastric inner layer was enhanced or not. RESULTS: Nine patients with PHG had delayed enhancement on the inner layers of gastric walls, but in 17 of 22 patients without PHG, delayed enhancement was not observed. CONCLUSION: Enhancement on the inner layer of gastric walls may reflect gastric congestion. Portal hypertensive gastropathy should be suspected when this finding is detected on computed tomography scans in patients with portal hypertension.

Genomic organization of the gene that encodes the precursor to EGF-related peptides, exogastrula-inducing peptides, of the sea urchin Anthocidaris crassispina.

Exogastrula-inducing peptides (EGIPs) were identified in embryos of the sea urchin Anthocidaris crassispina as polypeptides with structural similarity to epidermal growth factor (EGF) that severely affect gastrulation of sea urchin embryos to induce exogastrulation. Here we have obtained genomic clones for the EGIP precursor gene (EGIP) and determined its genomic organization. The EGIP gene spans the length of 9 kb in the genome and is composed of seven exons and six introns. Each of the four EGF motifs in the precursor protein is encoded by a single exon, and all the exon boundaries are in phase 1, suggesting that EGIP have been generated during evolution by duplication of an exon encoding a single ancient EGIP sequence. The 5'-flanking sequence of EGIP from -4372 to +194 revealed the presence of multiple repeat sequences including direct and inverted repeats as well as two clusters of GGGG/CCCC elements. The function of the upstream flanking region of EGIP was examined by introducing the gene constructs into embryos in which different regions from the flanking DNA were placed upstream to the GFP reporter gene. Systematic deletion of the upstream DNA revealed the presence of potent enhancer activity between -372 and -210.

A Protein That Binds an Exogastrula-Inducing Peptide, EGIP-D, in the Hyaline Layer of Sea Urchin Embryos: (exogastrula-inducing peptide (EGIP)/binding protein/hyaline layer/sea urchin/exogastrulation).

Exogastrula-inducing peptides are present in eggs and embryos of the sea urchin Anthocidaris crassispina. They induce exogastrulation when added exogenously to the embryos. In the present study, we investigated an EGIP-D-binding protein in the embryos. EGIP-D was incubated with homogenates of embryos. EGIP-D was then cross-linked to the binding protein by use of disuccinimidyl suberate (DSS) and the complex was analyzed by western blotting with an EGIP-D-specific antibody. A 30-kDa protein was detected in both eggs and embryos. To examine the localization of this protein, EGIP-D was added to intact embryos, cross-linked to proteins by use of DSS, and the complexes were again analyzed by western blotting. The EGIP-D-binding protein was detected in intact embryos but not in embryos treated with Ca2+ - and Mg2+ -free seawater (CMF-SW) that removes the hyaline layer (HL). It appeared, therefore, that this protein was present on the outer surface of the embryo, being a constituent of the HL. The CMF-SW extract that contained EGIP-D-binding protein, inhibited the induction of exogastrulation by EGIP-D. Furthermore, the treatment of embryos with CMF-SW prevented EGIP-D from inducing exogastrulation. Our observations indicate that the interaction between EGIP-D and the binding protein is a prerequisite for induction of exogastrulation by EGIP-D.

Localization of an Exogastrula-Inducing Peptide (EGIP) in Embryos of the Sea Urchin Anthocidaris crassispina: (Exogastrula-inducing peptide (EGIP)/gastrulation/acidic vesicle/sea urchin/exogastrulation).

Exogastrula-inducing peptides (EGIPs) are present in the unfertilized eggs and embryos of the sea urchin Anthocidaris crassispina. They induce exogastrulation when added exogenously to the embryos. The localization of EGIP-D during embryogenesis has been explored using polyclonal antibodies against EGIP-D. Immunofluorescent staining revealed that EGIP-D is stored in the cytoplasm of immature oocytes and is concentrated into vesicles in unfertilized eggs. At fertilization, the vesicles containing EGIP-D (EGIP-vesicles) migrate to the cortical surface of the zygotes and are distributed in a ring-like pattern at the apical surface of blastomeres, disappearing from basal surfaces and those adjacent to neighboring cells, during development from cleavage stages to larval stages. Mesenchyme cells also contain the vesicles but no such polarized distribution of vesicles is apparent. Acidic vesicles with a similar polarized distribution were examined by staining with acridine orange, which revealed that acidic vesicles were in close proximity to the surface of eggs at fertilization and were then distributed in a ring-like pattern at the apical surface of blastomeres as are the EGIP-vesicles. Furthermore, immunoelectron microscopy revealed that EGIP-D is present in vesicles that are located at the apical surface of blastomeres. The significance of the localized distribution of EGIP-D is discussed in relation to its function.

Maternal Exogastrula-Inducing Peptides (EGIPs) and Their Changes during Development in the Sea Urchin Anthocidaris crassispina.

Exogastrula-inducing activity was examined in eggs and embryos of the sea urchin Anthocidaris crassispina at various stages. During fractionation on a column of DEAE-cellulose, the exogastrula-inducing activity was found in the flow-through fraction at all developmental stages. In particular, the activity present in the flow-through fraction of unfertilized eggs represents the presence of maternal exogastrula-inducing peptides (EGIPs). The flow-through fractions from the column of DEAE-cellulose were applied to a column of Sephadex G-100 and the activities in the eluate were assayed. The active low-molecular-weight fraction was obtained in all cases with the exception of pluteus larvae, extracts of which contained another active fraction. Immunoblots of protein samples from eggs and embryos probed with antiserum against EGIP-D indicated that there is a major immunoreactive protein that migrates with an apparent molecular weight of about 6 kDa in all cases with the exception of pluteus larvae, and that there are two major immunoreactive proteins that migrate with apparent molecular weights of 6 kDa and 35 kDa, respectively, in pluteus larvae.

Pattern and Time Course of Cleavages in Early Development of the Ovoviviparous Pond Snail, Sinotaia quadratus historica: (pond snail/ovoviviparity/spiral cleavage/polar lobe).

The pattern and time course of cleavage during early development of the ovoviviparous pond snail, Sinotaia quadratus historica, in in vitro culture were investigated. The fertilized egg, 25-30 µm in diameter, underwent cleavage by repeated constriction and compaction as in blastocyst formation in mammalian embryos. The cleavage was slightly unequal and dextrally spiral, although a slight time lag in cleavages of blastomeres was observed after the 2nd cleavage. A small polar lobe was formed at the 1st cleavage, but not at the 2nd cleavage. Each cleavage proceeded very slowly under the experimental conditions, the 1st, 2nd, 3rd and 4th cleavages taking 22 hr or more, 9 hr and 10 hr, respectively. The cleavage pattern in in vitro cultures observed by light microscopy was confirmed by scanning electron microscopy.

INDUCTION OF THE ACROSOME REACTION ON THE EGG SURFACE OF DE-JELLIED SEA URCHIN EGGS BEFORE AND AFTER FERTILIZATION.

The capacity of the surface of sea urchin eggs to induce the acrosome reaction was assayed by estimating the rate of acrosome reaction of supernumerary spermatozoa in the presence of variously treated eggs before and after fertilization. DTT-disruption of the vitelline coat did not eliminate the acrosome reaction-inducing capacity. This capacity was retained after fertilization in eggs of both H. pulcherrimus and A. crassispina. The acrosome reaction-inducing capacity of the eggs was markedly decreased by treatment with trypsin. The low capacity of the trypsin-treated eggs was maintained after fertilization in H. pulcherrimus, but in A. crassispina the capacity returned to the pre-trypsin treatment level after fertilization. Fertilized eggs from which the fertilization membrane was mechanically removed retained the inducing capacity to a considerable extent, independent of the presence or absence of the hyaline layer, but the capacity diminished rapidly as cleavage proceeded. It was concluded from these data that the acrosome reaction of spermatozoa actually occurred at the surface of de-jellied eggs and that the inducing substance resides in the plasma membrane in addition to the fertilization membrane. A chemical difference between the inducing substance of egg surface and jelly substance is discussed.