Changes in cerebrovascular disease-related deaths and their location during the COVID-19 pandemic in Japan.

OBJECTIVE: The COVID-19 pandemic placed an enormous strain on healthcare systems and raised concerns for delays in the management of patients with acute cerebrovascular events. In this study, we investigated cerebrovascular excess deaths in Japan. STUDY DESIGN: Vital mortality statistics from January 2012 to May 2022 were obtained from the Japanese Ministry of Health, Labour and Welfare. METHODS: Using quasi-Poisson regression models, we estimated the expected weekly number of cerebrovascular deaths in Japan from January 2020 through May 2022 by place of death. Estimates were calculated for deaths in all locations, as well as for deaths in hospitals, in geriatric health service facilities, and at home. The age subgroups of ≥75 and <75 years were also considered. Weeks with a statistically significant excess of cerebrovascular deaths were determined when the weekly number of observed deaths exceeded the upper bound of 97.5% prediction interval. RESULTS: Excess deaths were noted in June 2021 and became more pronounced from February 2022 onward. The trend was notable among those aged ≥75 years and for those who died in hospitals. With respect to the location of deaths, the excess was significant in geriatric health services facilities from April 2020 to June 2021, whereas no evidence of excess hospital deaths was observed during the same period. CONCLUSIONS: Beginning in the late 2021, excess cerebrovascular deaths coincided with the spread of the Omicron variant and may be associated with increased healthcare burden. In 2020, COVID-19 altered the geography of cerebrovascular deaths, with fewer people dying in hospitals and more dying in geriatric health service facilities and at home.

Phosphoric acid concentration affects dentinal MMPs activity.

OBJECTIVES: To evaluate whether the concentration of phosphoric acid (PA) has an effect on the proteolytic activity of sound human demineralized dentin. It is hypothesized that the activity of matrix-bound and extracted enzymes depends on the PA concentration used to demineralize dentin. METHODS: One-gram aliquots of mid-coronal human dentin powder were demineralized with 1wt%, 10wt% and 37wt% PA. Concentrations of released calcium were measured for each set of demineralization. Extracted MMP-2 was immunologically identified by western blot and its activity was determined by conventional gelatin zymography. Analysis of released hydroxyproline (HYP) and in situ zymography were performed to evaluate the activity of insoluble, bound-matrix enzymes. RESULTS: The amount of released calcium from dentin powder treated with 37wt% PA was significantly higher (p≤0.05) than that obtained by dentin demineralization with 10wt% and 1wt% PA. Expression and activity of endogenous enzymes, extracted from or bound to dentin matrix, were detected for all samples regardless of the PA concentration. However, the expression and activity of extracted MMP-2 were significantly higher when dentin was treated with 10wt% PA (p<0.05), followed by 1wt% and 37wt% PA. Similarly, the highest concentration of released HYP (i.e. meaning higher percentage of collagen degradation) and the highest activity in in situ zymography were observed when dentin samples were treated with 10wt% PA (p<0.05). CONCLUSIONS: It was confirmed that PA does not denature endogenous enzymes of dentin matrices, but it may somehow modulate the expression and activity of these enzymes in a concentration-dependent manner. CLINICAL SIGNIFICANCE: Endogenous proteases have been identified and suggested to be responsible for the digestion of dentin matrix when activated by the acidic components of dental adhesives. Proteolytic activity of dentinal MMPs showed to be dependent on phosphoric acid concentration. The clinically-used concentration (37%) does not inhibit MMPs activity, but slows it.

Comparação entre dois protocolos de tratamento de ceratoconjuntivite seca experimentalmente induzida em coelhos / Comparison of two treatment protocols of experimentally induced keratoconjunctivitis sicca in rabbits

O objetivo deste estudo foi avaliar e comparar a eficácia de dois protocolos de tratamento de ceratoconjuntivite seca (CCS) experimentalmente induzida em coelhos: uma formulação oftálmica tópica composta por álcool polivinílico 1,4%, adicionado com acetilcisteína 10% e pilocarpina 1% (AAP), e outro protocolo com o uso do óleo de semente de linhaça (OL) tópico em forma de colírio, durante 12 semanas. Foram utilizados 15 coelhos machos, adultos, da raça Nova Zelândia, alocados aleatoriamente em três grupos: grupo C (controle), grupo AAP (formulação oftálmica) e grupo L (OL tópica). Os animais foram avaliados semanalmente pelo teste lacrimal de Schirmer, teste de fluoresceína e teste de Rosa Bengala; uma vez por mês, pelo exame de citologia esfoliativa ocular; ao final do experimento, pela análise histopatológica da córnea e conjuntiva. Os resultados demonstraram que houve um aumento maior na produção lacrimal quando utilizada a formulação oftálmica, e uma resolução mais rápida das úlceras de córnea, bem como diminuição no número de células desvitalizadas quando utilizado o óleo de semente de linhaça, além de aumento no número de células caliciformes em ambos os grupos de tratamento. A associação desses dois protocolos pode ser no futuro uma alternativa no tratamento da CCS.

The objective of this study was to evaluate and compare the effectiveness of two treatment protocol of experimentally induced keratoconjunctivitis sicca (KCS) in rabbits, a topical ophthalmic formulation composed by 1.4% povinilic alcohol added with 10% acetylcysteine and 1% pilocarpine (AAP) and another protocol with the topical use of the linseed seed oil (LO) in eye drop form f or 12 weeks. Fifteen male New Zealand white rabbits were aleatory allocated in 3 groups: Group C (Control), Group AAP (ophthalmic formulation) and Group L (LO topical). The animals were evaluated weekly using the Schirmer's tear test, fluorescein test and Rose Bengal test monthly for ocular cytology, and at the end of the experiment for histopathological analysis of cornea and conjunctive. The results demonstrated that there was a larger increase in the tear production when the ophthalmic formulation was us ed and a faster rapid resolution of corneal ulcers and decrease in the number of devitalized cells when linseed seed oil was used, besides an increase in the number of caliciform cells in both treatment groups. The association of those two protocols can be a future alternative in the treatment of KCS.

Helicobacter spp. infection induces changes in epithelial proliferation and E-cadherin expression in the gastric mucosa of pigs.

Gastric disease is common in finishing pigs. Helicobacter spp. infection has been associated with gastritis, gastric ulcers and gastric neoplasia in man and animals. The aim of this study was to determine the effects of Helicobacter spp. infection on gastric morphology in pigs, with emphasis on glandular cell proliferation and E-cadherin expression. Samples of fundus and antrum from 67 finishing pigs were examined microscopically and by immunohistochemistry. The presence of Helicobacter spp. was confirmed by polymerase chain reaction (PCR). Mucosal changes were evaluated and epithelial proliferation was determined by evaluation of the morphometry of nucleolar organizer regions and counting proliferating cell nuclear antigen-positive cells and mitotic figures. Intercellular adhesion was evaluated by E-cadherin expression. In 47 (70%) pigs, Helicobacter spp. infection was confirmed by PCR. Histological findings associated with the infection included mononuclear cell infiltration of the lamina propria and glandular degeneration. There was a significant association between infection and epithelial proliferation in both regions as well as a decrease in the expression of E-cadherin in the antrum.

Alterações histológicas da pars esophagea de suínos e sua relação com Helicobacter spp / Histological findings in swine pars esophagea and its Helicobacter spp. relationship

A relação entre Helicobacter spp. e a presença de alterações histológicas na pars esophagea de suínos foi avaliada em 67 estômagos de animais em idade de abate. Para a identificação das helicobactérias, utilizou-se a técnica da PCR com primers específicos para o gênero Helicobacter. As alterações histológicas foram identificadas e classificadas como ulceração, erosão, degeneração epitelial, alongamento de papilas, hiperplasia, paraqueratose, intensidade do infiltrado inflamatório e aumento do número de folículos linfoides. As alterações mais frequentemente encontradas na pars esophagea foram a degeneração epitelial e o alongamento de papilas, observadas em 83,5 por cento (n=56) das amostras analisadas. Em 77,5 por cento (n=52) das amostras, observou-se paraqueratose e em 61,1 por cento (n=41) hiperplasia epitelial. Quarenta e sete (70,1 por cento) foram positivas na PCR para Helicobacter spp. Nessas amostras a erosão foi a lesão mais observada (40,2 por cento), seguida de ulceração da mucosa (11,9 por cento). Em 58,2 por cento das amostras positivas na PCR, não foram observadas ulcerações de mucosa. Observou-se associação significativa (P=0,003) entre a presença de Helicobacter spp. e a degeneração epitelial da pars esophagea de suínos em idade de abate.

The association between histological findings of gastric mucosa in pigs at slaughtering age and the presence of Helicobacter spp., identified by PCR, assay was investigated. Stomachs from 67 pigs were examined. Histological changes of pars esophagea were identified and classified as gastric ulcers, erosion, degeneration, distortion of papils, hyperplasia, paraqueratosis, and number of lymphoid follicles. Microscopic analysis revealed the most frequent alteration: 83.5 percent (n= 56) stomachs with epithelial degeneration and distortion of papils. Paraqueratosis of pars esophagea was observed in 77.5 percent (n=52) of the samples and epithelial hyperplasia in 61 percent (n=41). Forty-seven (70.1 percent) pigs were positive to Helycobacter spp. by PCR. Erosion of pars esophagea and ulceration were the most frequent findings in Helicobacter spp. PCR-positive pigs, occurring, respectively, in 40.2 percent and 11.9 percent. The frequency of animals without ulceration and Helicobacter spp. PCR-positive was 58.2 percent. It was observed a significant association (P=0.003) between Helicobacter spp. and epithelial degeneration of gastric mucosa in pigs at slaughtering age.

Routine libraries for pattern recognition in quasispecies.

The results obtained through biological research usually need to be analyzed using computational tools, since manual analysis becomes unfeasible due to the complexity and size of these results. For instance, the study of quasispecies frequently demands the analysis of several, very lengthy sequences of nucleotides and amino acids. Therefore, bioinformatics tools for the study of quasispecies are constantly being developed due to different problems found by biologists. In the present study, we address the development of a software tool for the evaluation of population diversity in quasispecies. Special attention is paid to the localization of genome regions prone to changes, as well as of possible hot spots.

Alterações anátomo-histopatológicas em ratos submetidos à dieta com extrato de broto de samambaia (Pteridium aquilinum var. arachnoideum) de dois municípios do estado do Paraná / Macroscopic and microscopic changes in rats fed on a bracken fern diet (Pteridium aquilinum var. arachnoideum) from different regions of Parana State, Brazil

The carcinogenicity of bracken fern harvest from two regions of Paraná State to induce hematury in rats was studied. In order to do that, 33 Wistar rats were divided in three groups. Groups I and II received an aqueous extract of bracken fern from Londrina-PR or Ibaiti-PR, respectively, in drinking water for 60 days. Group III, control group, received regular plain water with no bracken fern. After 15 months, euthanasia was performed in all animals and samples were collected for histology examination. Histologic analysis revealed that two animals of Group II had ileal adenocarcinoma and soft tissue fibroma of leg.

Disruption of retinoblastoma protein family function by human papillomavirus type 16 E7 oncoprotein inhibits lens development in part through E2F-1.

Complexes between the retinoblastoma protein (pRb) and the transcription factor E2F-1 are thought to be important for regulating cell proliferation. We have shown previously that the E7 oncoprotein from human papillomavirus type 16, dependent upon its binding to pRb proteins, induces proliferation, disrupts differentiation, and induces apoptosis when expressed in the differentiating, or fiber, cells of the ocular lenses in transgenic mice. Mice that carry a null mutation in E2F-1 do not exhibit any defects in proliferation and differentiation in the lens. By examining the lens phenotype in mice that express E7 on an E2F-1 null background, we now show genetic evidence that E7's ability to alter the fate of fiber cells is partially dependent on E2F-1. On the other hand, E2F-1 status does not affect E7-induced proliferation in the undifferentiated lens epithelium. These data provide genetic evidence that E2F-1, while dispensible for normal fiber cell differentiation, is one mediator of E7's activity in vivo and that the requirement for E2F-1 is context dependent. These data suggest that an important role for pRb-E2F-1 complex during fiber cell differentiation is to negatively regulate cell cycle progression, thereby allowing completion of the differentiation program to occur.

No effect of loss of E2F1 on liver regeneration or hepatocarcinogenesis in C57BL/6J or C3H/HeJ mice.

The E2F family of transcription factors regulates the expression of genes needed for DNA synthesis and cell-cycle control. However, the individual contributions of the different E2F family members in regulating proliferation in various tissues have not been well characterized. Mouse liver is an excellent system for investigating proliferation because its growth state can be experimentally manipulated. As observed in cell culture systems, E2F1 protein is present at low levels in the quiescent liver, with an increase in expression during proliferation. Therefore, we expected that E2F1 may play an important role in cell-growth control during periods of robust proliferation. Using E2F1-nullizygous mice, we performed partial hepatectomies to investigate the role of E2F1 in the synchronous proliferation of adult hepatocytes. We found that E2F1 deficiency resulted in only minor changes in gene expression and that the timing of liver regeneration was not altered in E2F1 nullizygous mice. E2F1 has displayed properties of both a tumor suppressor and an oncogene in different model systems. Therefore, we investigated the role of E2F1 in rapidly growing liver tumor cells in strains of mice that have high (C3H/HeJ) and low (C57BL/6J) rates of hepatocarcinogenesis. We observed no significant differences in the number of liver tumors that developed after diethylnitrosamine treatment of wild type versus E2F1-nullizygous mice. We suggest that abundant levels of E2F4 in the mouse liver compensate for loss of E2F1.

Balancing proliferation and apoptosis in vivo: the Goldilocks theory of E2F/DP action.

Stimulation of both proliferation and apoptosis by E2F-1 provides a mechanistic basis for how E2F-1 functions as an oncogene and a tumor suppressor in vivo. In each normal tissue, a precise balance of proliferation versus apoptosis must be maintained, and in many tissues this appears to be controlled by E2F-1 levels. Presumably, variable expression of all E2F family members in each tissue dictates a tissue-specific sensitivity to loss or overexpression of any one family member. At sites where E2F-1 contributes mainly to proliferation and p53 levels remain low, loss of E2F-1 expression may lead to tissue atrophy and overexpression may lead to hyperplasia or tumors. Hence, E2F-1 would act as an oncogene. At other sites where E2F-1 levels induce p19, which stabilizes p53 leading to apoptosis, E2F-1 overexpression may lead to tissue atrophy and loss of expression may lead to hyperplasia or tumors. And thus, E2F-1 would act as a tumor suppressor. Perhaps it is the unique property of E2F-1 within the E2F family to stimulate both proliferation and apoptosis which makes it a bimodal switch that pRB must control so carefully. It is a delicate equilibrium that must be maintained throughout embryonic development and adult life. However, it is easy to envision that mutations which deregulate other E2F family members and which ultimately lead to changes in E2F-1 levels could lead to similar growth aberrations. In summary, although pRB interacts with numerous transcription factors, pRB minimally must restrain the E2F/DP transcription factor family to prevent the cell cycle from whirling onwards out of control.

Key roles for E2F1 in signaling p53-dependent apoptosis and in cell division within developing tumors.

Apoptosis induced by the p53 tumor suppressor can attenuate cancer growth in preclinical animal models. Inactivation of the pRb proteins in mouse brain epithelium by the T121 oncogene induces aberrant proliferation and p53-dependent apoptosis. p53 inactivation causes aggressive tumor growth due to an 85% reduction in apoptosis. Here, we show that E2F1 signals p53-dependent apoptosis since E2F1 deficiency causes an 80% apoptosis reduction. E2F1 acts upstream of p53 since transcriptional activation of p53 target genes is also impaired. Yet, E2F1 deficiency does not accelerate tumor growth. Unlike normal cells, tumor cell proliferation is impaired without E2F1, counterbalancing the effect of apoptosis reduction. These studies may explain the apparent paradox that E2F1 can act as both an oncogene and a tumor suppressor in experimental systems.

Mutation of E2f-1 suppresses apoptosis and inappropriate S phase entry and extends survival of Rb-deficient mouse embryos.

Mice mutant for the Rb tumor suppressor gene die in mid-gestation with defects in erythropoiesis, cell cycle control, and apoptosis. We show here that embryos mutant for both Rb and its downstream target E2f-1 demonstrate significant suppression of apoptosis and S phase entry in certain tissues compared to Rb mutants, implicating E2f-1 as a critical mediator of these effects. Up-regulation of the p53 pathway, required for cell death in these cells in Rb mutants, is also suppressed in the Rb/E2f-1 double mutants. However, double mutants have defects in cell cycle regulation and apoptosis in some tissues and die at approximately E17.0 with anemia and defective skeletal muscle and lung development, demonstrating that E2F-1 regulation is not the sole function of pRB in development.

Loss of E2F-1 reduces tumorigenesis and extends the lifespan of Rb1(+/-)mice.

Mutation of the retinoblastoma tumour-suppressor gene (RB) leads to the deregulation of many proteins and transcription factors that interact with the retinoblastoma gene product (pRB), including members of the E2F transcription factor family. As pRB is known to repress E2F transcriptional activity and overexpression of E2F is sufficient for cell cycle progression, it is thought that pRB suppresses growth in part by repressing E2F-mediated transcription. Previously, we reported that loss of E2f1 in mice results in tissue-specific tumour induction and tissue atrophy, demonstrating that E2F-1 normally controls growth both positively and negatively in a tissue-specific fashion. To determine whether E2F-1 deregulation--as a result of loss of pRB--promotes proliferation in vivo, we have tested whether loss of E2f1 interferes with the pituitary and thyroid tumorigenesis that occurs in Rb1(+/-) mice. We have found that loss of E2f1 reduces the frequency of pituitary and thyroid tumours, and greatly lengthens the lifespan of Rb1(+/-); E2f1(-/-) animals, demonstrating that E2F-1 is an important downstream target of pRB during tumorigenesis. Furthermore, loss of E2f1 reduces a previously reported strain-dependent difference in Rb1(+/-) lifespan, suggesting that E2f1 or an E2F-1-regulated gene acts as a genetic modifier between the 129/Sv and C57BL/6 strains.

Tumor induction and tissue atrophy in mice lacking E2F-1.

The retinoblastoma tumor suppressor protein (pRB) is a transcriptional repressor that regulates gene expression by physically associating with transcription factors such as E2F family members. Although pRB and its upstream regulators are commonly mutated in human cancer, the physiological role of the pRB-E2F pathway is unknown. To address the function of E2F-1 and pRB/E2F-1 complexes in vivo, we have produced mice homozygous for a nonfunctional E2F-1 allele. Mice lacking E2F-1 are viable and fertile, yet experience testicular atrophy and exocrine gland dysplasia. Surprisingly, mice lacking E2F-1 develop a broad and unusual spectrum of tumors. Although overexpression of E2F-1 in tissue culture cells can stimulate cell proliferation and be oncogenic, loss of E2F-1 in mice results in tumorigenesis, demonstrating that E2F-1 also functions as a tumor suppressor.

Nuclear transport: a guide to import receptors.

After synthesis in the cytoplasm, nuclear proteins traverse the nuclear envelope as a result of the specific recognition of nuclear localization signals by import. Various approaches have now uncovered a range of proteins with at least some of the characteristics expected of import receptors. This article focuses on early steps in the nuclear import of proteins and surveys the recently identified candidate import receptors.

Identification of four nuclear transport signal-binding proteins that interact with diverse transport signals.

The transport of proteins into the nucleus requires not only the presence of a nuclear transport signal on the targeted protein but also the signal recognition proteins and the nuclear pore translocation apparatus. Complicating the search for the signal recognition proteins is the fact that the nuclear transport signals identified share little obvious homology. In this study, synthetic peptides homologous to the nuclear transport signals from the simian virus 40 large T antigen, Xenopus oocyte nucleoplasmin, adenovirus E1A, and Saccharomyces cerevisiae MAT alpha 2 proteins were coupled to a UV-photoactivable cross-linker and iodinated for use in an in vitro cross-linking reaction with cellular lysates. Four proteins, p140, p100, p70, and p55, which specifically interacted with the nuclear transport signal peptides were identified. Unique patterns of reactivity were observed with closely related pairs of nuclear transport signal peptides. Competition experiments with labeled and unlabeled peptides demonstrated that heterologous signals were able to bind the same protein and suggested that diverse signals use a common transport pathway. The subcellular distribution of the four nuclear transport signal-binding proteins suggested that nuclear transport involves both cytoplasmic and nuclear receptors. The four proteins were not bound by wheat germ agglutinin and were not associated tightly with the nuclear pore complex.

Characterization of the isozymes of bovine adrenal medullary phenylethanolamine N-methyltransferase.

Bovine adrenal medullary phenylethanolamine N-methyltransferase (EC 2.1.1.28) has been purified to apparent homogeneity. The enzymatically active monomer has a relative molecular weight of 30,000 and can be separated into at least four active charged isozymes. These isozymes, designated PNMT-1, PNMT-2, PNMT-3 and PNMT-4, have isoelectric points of 5.1, 5.2, 5.3 and 5.4, respectively. Kinetic parameters have been determined for each isozyme. The Kms for phenylethanolamine range from 11.9 to 45.9 microM; the Kms for S-adenosylmethionine range from 1.13 to 1.47 microM; and the Kis for the competitive inhibitor, S-adenosylhomocysteine, range from 0.12 to 0.22 microM. For isozymes PNMT-1 and PNMT-4, and Kms for S-adenosylhomocysteine are not significantly different. Vmax values for all of the isozymes do not change significantly in the presence of S-adenosylhomocysteine. Treatment of the purified isozymes with various endo- and exoglycosidases does not alter electrophoretic mobility. Hence, carbohydrate substitution must be minimal. No high mannan, complex sugars or terminal N-acetylglucosamine residues are present. The absence of carbohydrate is further supported by the inability of Schiff-periodic acid to stain the protein. Limited thermolysin digests of each isozyme show distinct peptide cleavage products. In conjunction with the kinetic and glycosylation data, this suggests that the isozymes of phenylethanolamine N-methyltransferase may be primary structural variants.

Increased phenylalanine incorporation in regenerating skeletal muscle grafts.

Skeletal muscle regenerates following grafting, but little is known about protein synthesis and its regulation during regeneration. We determined the sequence of changes in protein synthesis in rat extensor digitorum longus (EDL) muscle by the measurement of phenylalanine (Phe) incorporation into muscle protein at various times after grafting. Compared with control EDL, Phe incorporation in grafts doubled in 1 day, was four- to eight-fold greater from days 2 to 10 after grafting, and then subsided. Tissue mass (wet weight) increased rapidly from days 7 to 20 in EDL grafts. The maximal increase in protein synthesis occurred 7-10 days after grafting, whether or not the nerve was left intact. Autoradiography indicated that incorporated radioactivity was associated with regenerating muscle fibers on day 10. Deficiencies of insulin, pituitary or testicular hormones, or chronic in vivo administration of insulin, growth hormone, testosterone, or tri-iodothyronine did not substantially alter the elevation in incorporation of the Phe into muscle protein 10 days after grafting. The breakdown of EDL protein, measured in vitro simultaneously with protein synthesis, was increased five-fold, and overall protein degradation was elevated six-fold 10 days after grafting. These findings indicate that Phe incorporation is rapidly elevated following grafting of the EDL, and that by days 7-10 reflects synthesis in regenerating muscle fibers. The increase in protein synthesis associated with muscle regeneration at this time appears to be independent of innervation and anabolic hormones.