Antibody level dynamics until after the third dose of COVID-19 vaccination

The antibody titers of volunteers, including elderly people, were investigated after the second dose of the BNT162b2 vaccine (Pfizer-BioNTech) as an mRNA vaccine against the coronavirus disease 2019 (COVID-19). Serum samples were collected from 105 volunteers (44 healthcare workers and 61 elderly people) 7–14 days after the second vaccine dose, and antibody titers were measured. The antibody titers of study participants in their 20s were significantly higher than those of other age groups. Furthermore, the antibody titers of participants aged <60 years were significantly higher than those of participants aged ≥60 years. Serum samples were repeatedly collected from 44 healthcare workers until after the third vaccine dose. Eight months after the second round of vaccination, the antibody titer levels decreased to the same level as that before the second vaccine dose. After the third booster vaccination, the antibody titer recovered to the same level as that after the second dose. Neutralizing activities were also investigated at four time points before and after the second vaccine dose. The antibody titers and neutralizing activity were positively correlated. Therefore, neutralizing activity can be predicted by measuring the antibody titer. In conclusion, the antibody titers in the elderly population were significantly lower than those in the younger population. Although the antibody titers increased following vaccination, their levels showed a decline after several months, returning to the same level as that after a single dose of mRNA vaccination. The antibody titer levels recovered after the third dose of vaccination, which had already been administered in Japan. Routine administration of vaccine should be considered in the future

医療安全向上のための戦略ツールとしての電子医療記録 : 教育研修病院における臨床過程評価を目指した構造転換

研究期間:平成17-19年度 ; 研究種目:基盤研究B ; 課題番号: 1739015

A Novel Combination of Prion Strain Co-Occurrence in Patients with Sporadic Creutzfeldt-Jakob Disease

Six subgroups of sporadic Creutzfeldt-Jakob disease have been identified by distinctive clinicopathologic features, genotype at polymorphic codon 129 [methionine (M)/valine (V)] of the PRNP gene, and type of abnormal prion proteins (type 1 or 2). In addition to the pure subgroups, mixed neuropathologic features and the coexistence of two types of abnormal prion proteins in the same patient also have been reported. Here, we found that a portion of the patients previously diagnosed as MM1 had neuropathologic characteristics of the MM2 thalamic form (ie, neuronal loss of the inferior olivary nucleus of the medulla). Furthermore, coexistence of biochemical features of the MM2 thalamic form also was confirmed in the identified cases. In addition, in transmission experiments using prion protein humanized mice, the brain material from the identified case showed weak infectivity and generated characteristic abnormal prion proteins in the inoculated mice resembling those after inoculation with brain material of MM2 thalamic form. Taken together, these results show that the co-occurrence of MM1 and MM2 thalamic form is a novel entity of sporadic Creutzfeldt-Jakob disease prion strain co-occurrence. The present study raises the possibility that the co-occurrence of the MM2 thalamic form might have been overlooked so far because of the scarcity of abnormal prion protein accumulation and restricted neuropathology

A Case of Pneumothorax Complicated by Multiple Large Pulmonary Nodules Due to Mycobacterium Kansasii Infection

We report a rare case of pulmonary infection with Mycobacterium kansasii complicated by pneumothorax and multiple large nodules in both lungs. A 68-year-old man presented with sudden right chest pain and dyspnea. He was diagnosed with pneumothorax on the right side and immediately treated by insertion of a chest tube and drainage. After admission, the pneumothorax was cured, but a high fever continued. A chest x-ray and computed tomography scan showed multiple large nodules with and without cavities in both lungs. We suspected malignant disease, inflammatory granulomatosis, or pneumomycosis and subsequently performed bronchofiberscopy. The results of a transbronchial lung biopsy indicated caceous necrosis surrounded by epithelioid cells, without forming distinct granulomas on histology, and the results of acid-fast bacilli smear tests were positive. Mycobacterium could not be detected by polymerase chain reaction. Because the patient\u27s condition was poor, we started him on anti-Mycobacterium therapy: rifampin, isoniazid, and ethambutol. His condition subsequently improved. Bacterial culture confirmed the presence of M. kansasii, so the antibiotic therapy was continued. The patient\u27s temperature decreased to below 37°C, and the nodules in his lungs reduced in size. In this atypical case of M. kansasii infection, the patient presented with severe symptoms. Bronchofiberscopy enabled prompt diagnosis and early treatment