Safety and immunogenicity of sequential administration of PCV13 followed by PPSV23 in pneumococcal vaccine-naïve adults aged ≥ 65 years : Comparison of booster effects based on intervals of 0.5 and 1.0 year

Objective: An open-label study was conducted to compare the safety and immunogenicity of a　sequential administration of 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) between an interval of 0.5 (0.5-y) and 1 year (1.0-y) in adults aged ≥ 65 years. Methods: Pneumococcal vaccine-naïve adults aged ≥ 65 years (n = 129) received a sequential administration with an interval of 0.5-y or 1.0-y or received a single administration of PPSV23 (single PPSV23). We evaluated the immunogenicity before and 1 month after each vaccination and at 0.5-y intervals for 2 years. The primary endpoint was the increase in geometric mean fold rises (GMFRs) of immunoglobulin G (IgG) or opsonophagocytic activity (OPA) for eight common serotypes one month after one dose of PPSV23. The secondary endpoint was the safety profile for one dose of PPSV23. Results: One month after administration of PPSV23, the GMFRs of IgG considerably increased for five of eight serotypes in the 1.0-y interval group, whereas the GMFRs of IgG considerably increased for two serotypes in the 0.5-y interval group. Furthermore, GMFRs of OPA markedly increased for all eight serotypes in the 1.0-y interval group, while GMFRs of OPA markedly increased for four serotypes in the 0.5-y interval group. At 2 years after initial vaccination, GMFRs of IgG or OPA were higher for all serotypes, except for serotype 3, than those in the single PPSV23 group irrespective of intervals. No significant difference was found in the frequencies of local reactions of all grades between the two intervals. Conclusions: The 1.0-y interval provided better booster effects induced by PPSV23 than those of the 0.5-y interval in a sequential administration in pneumococcal vaccine-naïve adults aged ≥ 65 years. No difference was found in the safety profile between both intervals

Effects of Pulmonary Rehabilitation for Patients with Chronic Pulmonary Diseases with Different Types of Ventilatory Defects: Relationships between Pulmonary Function Parameters and Exercise Torelance

This prospective cohort study was conducted to determine which pulmonary function parameters are useful in the prediction of exercise torelance and exercise-induced hypoxemia (EIH) among patients with chronic pulmonary diseases with different types of ventilatory defects. Fifty one patients with chronic pulmonary diseases who underwent comprehensive pulmonary rehabilitation for periods of 4 to 8 weeks, and who were classified as to different types of ventilatory defects; obstructive, restrictive and mixed type based on their pulmonary functions. All patients were measured for pulmonary function parameters, 6-minute walking distance (6MD) and the activity of daily living (ADL) before and after pulmonary rehabilitation. After pulmonary rehabilitation, the patients demonstrated a significant (p<0.001) increase in 6 MD and ADL scores for all types of ventilatory defects. In the relationship between 6 MD and pulmonary function parameters, the forced expiratory volume in 1 sec. (FEV1.0) was significantly correlated with 6 MD for all types of ventilatory defect. Vital capacity (VC) and maximal voluntary ventilation (MVV) correlated with 6MD in the obstructive and the mixed ventilatory defects, and PaO2 correlated with 6 MD relative to mixed ventilatory defects. In the relationship between EIH and pulmonary function parameters, VC significantly correlated with EIH relative to restrictive ventilatory defects. FEV1.0 and MVV correlated with EIH relative to obstructive ventilatory defects. Our present data suggest that specific pulmonary function parameters which can be correlated with 6 MD and EIH for different types of ventilatory defects, may be useful in terms of devising pulmonary rehabilitation protocols for these patients

Animal Wastewater Treatment Using Constructed Wetland

Symposium Pape

Loss of Tumor Necrosis Factor Production by Human Monocytes in Falciparum Malaria after Their Maturation in Vitro

In Plasmodium-infected mammals, phagocytosis and production of tumor necrosis factor (TNF) by monocytes and macrophages are prominent features. The present work aimed at clarifying the relationship between the maturation of human monocytes to macrophages and their TNF productivity and phagocytic ability in the presence of Plasmodium falciparum-infected erythrocytes. Fresh monocytes produced a significantly higher quantity of TNF in the presence of schizont-infected erythrocytes than macrophages obtained by in vitro monocyte maturation on autologous serum, whereas phagocytic activity of macrophages was much higher than that of fresh monocytes. This indicated that the TNF-inducing factors from P. falciparum-infected erythrocytes could stimulate fresh monocytes, but not macrophages, to release TNF, regardless of their development of phagocytosis. Activation of macrophages by interferon-{gamma} could not recover their TNF productivity in the presence of P. falciparum-infected erythrocytes, but it enhanced their TNF productivity in the presence of lipopolysaccharide(s). The TNF-inducing factors were contained mainly in erythrocytes infected with mature schizonts but not in erythrocytes infected with the younger stages of the parasites. Fractionation of infected erythrocytes revealed that both soluble and insoluble components almost equally contained those factors

A case of asymptomatic right-sided adult Bochdalek hernia presented incidentally with rectal tumor

　We encountered a patient with an adult Bochdalek hernia discovered asymptomatically. A 77-year-old Japanese woman visited a local clinic with chief complaints of melena and difficulty in defecation. Based on the results of the detailed examination in our hospital, she was diagnosed with a rectal gastrointestinal stromal tumor (GIST) with a concurrent asymptomatic adult right-sided Bochdalek hernia. Because the tumor was large, laparoscopic abdominoperineal rectal amputation was performed after systemic imatinib therapy. During the surgery, we found a right diaphragmatic defect more than 13cm in long dia., through which the right hepatic lobe, colon, and greater omentum had prolapsed into the right thoracic cavity. No visceral adhesions were noted. No hernia sac was observed. Adult Bochdalek hernia is a relatively rare condition, and only three (incidentally discovered) cases of asymptomatic Bochdalek hernia, including the present case, have been reported in Japan. Here we provide a case report for the patient, who was followed-up without hernia surgery, plus a review of the literature

Association of dengue virus type-specific IgG on platelets is specific for the acute phase in an imported Japanese patient with secondary dengue 2 virus infection

The mechanism of thrombocytopenia in dengue virus infection remains unknown. We report herein an imported case of a 21-year-old male Japanese with dengue fever caused by secondary dengue 2 virus infection. The thrombocytopenia detected around the day of defervescence was associated with an increased level of plateletassociated IgG (PAIgG). The eluate from the platelets during the acute phase of this case contained an increased activity of anti-dengue virus 2 IgG, while the eluate from platelets during the convalescent phase contained a low level of anti-dengue 2 IgG. These findings suggest the transient formation of PAIgG involving anti-dengue 2 virus IgG during the acute phase of secondary dengue 2 virus infection

Aseptic Meningoencephalitis Complicated by Retrobulbar Neuritis

A 25-year-old man was admitted to our hospital for testing and follow-up of aseptic meningoencephalitis. After admission to our hospital, the patient suddenly complained of visual field disorder and a decrease of visual acuity in the right eye. We diagnosed aseptic meningitis complicated by retrobulbar neuritis using MRI. We immediately initiated weekly steroid pulse therapy, and eventually, marked improvement in visual acuity and the visual field disorder was observed without any late effects

Population-Based Study of Streptococcus suis Infection in Humans in Phayao Province in Northern Thailand

BACKGROUND: Streptococcus suis infection in humans has received increasing worldwide recognition. METHODS AND FINDINGS: A prospective study of S. suis infection in humans was conducted in Phayao Province in northern Thailand to determine the incidence and the risk behaviors of the disease in this region in 2010. Thirty-one cases were confirmed. The case fatality rate was 16.1%, and the estimated incidence rate was 6.2 per 100,000 in the general population. The peak incidence occurred in May. The median age of the patients was 53 years and 64.5% were men. Consumption of raw pork products was confirmed in 22 cases and the median incubation period (range) was 2 days (0-11) after consumption of raw pork products. Isolates from 31 patients were confirmed as serotype 2 in 23 patients (74.2%) and serotype 14 in eight patients (25.8%). The major sequence types (STs) were ST1 (n = 20) for serotype 2 and ST105 (n = 8) for serotype 14. The epidemiological analysis suggested three possible clusters, which included 17 cases. In the largest possible cluster of 10 cases in Chiang Kham and its neighboring districts in May, the source of infection in four cases was identified as a raw pork dish served at the same restaurant in this district. Microbiological analysis confirmed that three of four cases associated with consumption of raw pork at this restaurant were attributable to an identical strain of serotype 2 with ST1 and pulsotype A2. CONCLUSIONS: Our data suggest a high incidence rate of S. suis infection in the general population in Phayao Province in 2010 and confirm a cluster of three cases in 31 human cases. Food safety control should be strengthened especially for raw pork products in northern Thailand

MAFB is dispensable for the fetal testis morphogenesis and the maintenance of spermatogenesis in adult mice

The transcription factor MAFB is an important regulator of the development and differentiation of various organs and tissues. Previous studies have shown that MAFB is expressed in embryonic and adult mouse testes and is expected to act as the downstream target of retinoic acid (RA) to initiate spermatogenesis. However, its exact localization and function remain unclear. Here, we localized MAFB expression in embryonic and adult testes and analyzed its gene function using Mafb-deficient mice. We found that MAFB and c-MAF are the only large MAF transcription factors expressed in testes, while MAFA and NRL are not. MAFB was localized in Leydig and Sertoli cells at embryonic day (E) 18.5 but in Leydig cells, Sertoli cells, and pachytene spermatocytes in adults. Mafb-deficient testes at E18.5 showed fully formed seminiferous tubules with no abnormal structure or differences in testicular somatic cell numbers compared with those of control wild-type mice. Additionally, the expression levels of genes related to development and function of testicular cells were unchanged between genotypes. In adults, the expression of MAFB in Sertoli cells was shown to be stage specific and induced by RA. By generating Mafbfl/fl CAG-CreER™ (Mafb-cKO) mice, in which Cre recombinase was activated upon tamoxifen treatment, we found that the neonatal cKO mice died shortly upon Mafb deletion, but adult cKO mice were alive upon deletion. Adult cKO mice were fertile, and spermatogenesis maintenance was normal, as indicated by histological analysis, hormone levels, and germ cell stage-specific markers. Moreover, there were no differences in the proportion of seminiferous stages between cKO mice and controls. However, RNA-Seq analysis of cKO Sertoli cells revealed that the down-regulated genes were related to immune function and phagocytosis activity but not spermatogenesis. In conclusion, we found that MAFB is dispensable for fetal testis morphogenesis and spermatogenesis maintenance in adult mice, despite the significant gene expression in different cell types, but MAFB might be critical for phagocytosis activity of Sertoli cells