Comparison of Antibody Response Elicited by ChAdOx1 and BNT162b2 COVID-19 Vaccine

Background@#ChAdOx1 and BNT162b2 vaccines are currently commonly used against coronavirus disease 2019 worldwide. Our study was designed to determine the serostatus and relative levels of anti-S and neutralizing antibodies in patients who were administered either ChAdOx1 or BNT162b2 vaccine. In addition, we investigated whether the antibody response to each vaccine differed according to sex and age. @*Methods@#Healthcare workers (HCWs) at a general hospital who were vaccinated with two doses of either ChAdOx1 or BNT162b2 were invited to participate in this prospective cohort study. Blood samples of HCWs vaccinated with both ChAdOx1 doses over a period of 12 weeks were collected at weeks 4 and 8 post first vaccination and 2 weeks post second vaccination. Blood samples of HCWs vaccinated with BNT162b2 were collected in the third week after the first dose, and the second dose was then administered on the same day; two weeks post second dose (5 weeks after the first dose), blood samples were collected to assess the antibody response. The titers of anti-S antibodies against the severe acute respiratory syndrome coronavirus 2 spike (S) protein receptor-binding domain and the neutralizing antibodies in the collected blood were evaluated. @*Results@#Of the 309 HCWs enrolled in the study, 205 received ChAdOx1 and 104 received BNT162b2. Blood samples from participants receiving either the ChAdOx1 or BNT162b2 vaccine exhibited substantial anti-S and neutralizing antibody seropositivity subsequent to the second dose. All participants (100%) from both vaccine groups were seropositive for anti-S antibody, while 98% (201/205) of ChAdOx1-vaccinated individuals and 100% (104/104) of BNT162b2-vaccinated individuals were seropositive for neutralizing antibodies.The median levels of anti-S and neutralizing antibodies were significantly higher in the BNT162b2-vaccinated group than the ChAdOx1-vaccinated group; in particular, anti-S antibody titers of 1,020 (interquartile range, 571.0–1,631.0) U/mL vs. 2,360 (1,243–2,500) U/mL, P < 0.05, were recorded for the ChAdOx1 and BNT162b2 groups, respectively, and neutralizing antibody titers of 85.0 (65.9–92.1%) vs. 95.8 (94.4–96.6%), P < 0.05, were recorded for the ChAdOx1 and BNT162b2 groups, respectively. In the ChAdOx1 vaccine group, the neutralizing antibody level was significantly higher in women than in men (85.7 [70.3–92.5%] vs. 77.7 [59.2–91.0%], P < 0.05); however, the neutralizing antibody titer in the BNT162b2 vaccine group did not vary between the two sexes (95.9 [95.2–96.6%] vs. 95.2 [93.5–96.3%], P = 0.200). Analysis of the correlation of antibody profiles with age revealed that the levels of anti-S antibodies and signal inhibition rate (SIR) of neutralizing antibodies decreased significantly with age. @*Conclusion@#Both the ChAdOx1- and BNT162b2-vaccinated groups showed high seropositivity for anti-S and neutralizing antibodies. The SIR of neutralizing antibodies in the ChAdOx1 vaccine group was higher in women than in men. Enhanced antibody responses were observed in participants vaccinated with BNT162b2 compared to those vaccinated with the ChAdOx1 vaccine.

Reactogenicity after the first and second doses of BNT162b2 mRNA coronavirus disease vaccine: a single-center study

Purpose@#This study was conducted to determine differences in adverse events associated with the first and second doses of the BNT162b2 coronavirus disease 2019 vaccine based on the age and sex of recipients. @*Materials and Methods@#An online survey on the post-vaccination adverse events of healthcare workers was conducted from March 2021 to April 2021. The differences in the types of adverse events, including severity, onset time, and duration of symptoms, and how the adverse events were dealt with by the patient were analyzed based on the age and sex. The profiles of adverse events were compared after the first and second vaccination doses. @*Results@#Among the 131 participants who participated in the online survey out of 208 vaccine recipients, 43 and 80 recipients of the BNT162b2 vaccine experienced adverse events after the first and second dose, respectively. No sex-related differences were observed in the profiles of adverse events in vaccinated recipients. The overall frequency of adverse events did not differ based on age after the first dose. After the second dose, the frequency of adverse events, including both local and systemic reactions was significantly higher in the younger age group than in the older age group. @*Conclusion@#The BNT162b2 vaccine resulted in a higher frequency of adverse events after the second dose than after the first dose especially in the younger age group; however, no sex-related differences associated with these adverse events were observed.

SARS-CoV-2 Antibody Response to the BNT162b2 mRNA Vaccine in Persons with Past Natural Infection

There are still no agreed guidelines on the vaccination of coronavirus disease 2019 (COVID-19) for previously infected patients. Here, we present two seropositive healthcare workers (HCWs) working in an isolation ward who recovered from COVID-19 in April 2020 and got vaccinated with BNT162b2 vaccine in March 2021. We have assessed the clinical course, vaccine-related adverse events, and antibody response after natural infection and after first and second dose vaccination. One of the two HCWs was asymptomatic during quarantine, but the other had mild upper respiratory infection symptoms 1 day before admission, and the symptoms continued for 9 days. There was no pneumonic infiltration in chest X-ray in both patients, and no COVID-19 specific treatment was administered.Total immunoglobulin antibody and neutralizing antibody to anti-spike protein receptorbinding domain of severe acute respiratory syndrome coronavirus 2 were confirmed to be present in both HCWs in blood tests performed at 2 weeks and 4 weeks after discharge.Antibody response to mRNA vaccination showed marked elevation after the first vaccination, which was 30–40 times higher than that of antibody titer after natural infection in each patient (83.2 U/mL vs. > 2,500 U/mL in patient 1; 61.6 U/mL vs. > 2,500 U/mL in patient 2).Signal inhibition rate of neutralizing antibodies was also increased to over 97%. Due to this increased effect, there was little difference in antibody levels after the first and second dose. Both patients 1 and 2 suffered more from adverse vaccine reactions after the second vaccination than from COVID-19 symptoms.

SARS-CoV-2 Antibody Response to the BNT162b2 mRNA Vaccine in Persons with Past Natural Infection

There are still no agreed guidelines on the vaccination of coronavirus disease 2019 (COVID-19) for previously infected patients. Here, we present two seropositive healthcare workers (HCWs) working in an isolation ward who recovered from COVID-19 in April 2020 and got vaccinated with BNT162b2 vaccine in March 2021. We have assessed the clinical course, vaccine-related adverse events, and antibody response after natural infection and after first and second dose vaccination. One of the two HCWs was asymptomatic during quarantine, but the other had mild upper respiratory infection symptoms 1 day before admission, and the symptoms continued for 9 days. There was no pneumonic infiltration in chest X-ray in both patients, and no COVID-19 specific treatment was administered.Total immunoglobulin antibody and neutralizing antibody to anti-spike protein receptorbinding domain of severe acute respiratory syndrome coronavirus 2 were confirmed to be present in both HCWs in blood tests performed at 2 weeks and 4 weeks after discharge.Antibody response to mRNA vaccination showed marked elevation after the first vaccination, which was 30–40 times higher than that of antibody titer after natural infection in each patient (83.2 U/mL vs. > 2,500 U/mL in patient 1; 61.6 U/mL vs. > 2,500 U/mL in patient 2).Signal inhibition rate of neutralizing antibodies was also increased to over 97%. Due to this increased effect, there was little difference in antibody levels after the first and second dose. Both patients 1 and 2 suffered more from adverse vaccine reactions after the second vaccination than from COVID-19 symptoms.

Diagnosis of scrub typhus: introduction of the immunochromatographic test in Korea

No abstract available.

Emphysematous Pyelonephritis Caused by Citrobacter freundii in a Patient with Type 2 Diabetes and Neurogenic Bladder

Emphysematous pyelonephritis (EPN) is a rare, life-threatening complication of upper urinary tract infections that is characterized by the presence of gas in the renal parenchyma and perirenal space. It commonly occurs in diabetic patients. Escherichia coli are the most common causative organisms, with few reports implicating Citrobacter freundii as the etiologic agent in EPN. A 57-year-old woman with diabetes and neurogenic bladder visited at our department with confused mentality, myalgia, and general weakness. Further investigation revealed that the patient suffered from unilateral EPN with sepsis caused by C. freundii. The patient's condition was improved considerably with percutaneous drainage and use of intravenous antibiotics for several weeks. However, renal function eventually deteriorated to permanent renal failure, which required hemodialysis. In conclusion, C. freundii may be the causative pathogen of EPN in a patient with type 2 diabetes and neurogenic bladder.

Effect of curing modes on micro-hardness of dual-cure resin cements / 대한치과보존학회지

OBJECTIVES: The purpose of this study was to evaluate curing degree of three dual-cure resin cements with the elapsed time in self-cure and dual-cure mode by means of the repeated measure of micro-hardness. MATERIALS AND METHODS: Two dual-cure self-adhesive resin cements studied were Maxcem Elite (Kerr), Rely-X Unicem (3M ESPE) and one conventional dual-cure resin cement was Rely-X ARC resin cement (3M ESPE). Twenty specimens for each cements were made in Teflon mould and divided equally by self-cure and dual-cure mode and left in dark, 36degrees C, 100% relative humidity conditional-micro-hardness was measured at 10 min, 30 min, 1 hr, 3 hr, 6 hr, 12 hr and 24 hr after baseline. The results of micro-hardness value were statistically analyzed using independent samples t-test and one-way ANOVA with multiple comparisons using Scheffe's test. RESULTS: The micro-hardness values were increased with time in every test groups. Dual-cure mode obtained higher micro-hardness value than self-cure mode except after one hour of Maxcem. Self-cured Rely-X Unicem showed lowest value and dual-cured Rely-X Unicem showed highest value in every measuring time. CONCLUSIONS: Sufficient light curing to dual-cure resin cements should provided for achieve maximum curing.

Health-related Quality of Life Measurement with St. George's Respiratory Questionnaire in Post-tuberculous Destroyed Lung / 결핵및호흡기질환

BACKGROUND: The control of active pulmonary tuberculosis is still an issue in community medicine. But there are also considerable needs for supportive management of symptomatic patients with post-tuberculous destroyed lung. Few studies have evaluated clinical characteristics and health-related quality of life in patients with post-tuberculous destroyed lung. METHODS: We evaluated lung function, exercise tolerance, HRCT and health-related quality of life measurements using the Korean version of St. George's Respiratory Questionnaire (SGRQ) in 22 patients with parenchymal damage to more than a half of one lung due to pulmonary tuberculosis. RESULTS: In the pulmonary function test, mixed defects and obstructive defects were observed in 10 (45.0%) and 9 (40.9%) of patients, respectively. In the cardiopulmonary exercise test, the mean VO2max% predicted (39.0%+/-10.9%) and O2 pulse% predicted (61.3%+/-13.6%) were markedly decreased. In the SGRQ, the impact score (mean 27.8+/-18.5) was significantly lower than the symptom score (mean 53.9+/-20.9) or activity score (mean 50.8+/-27.3) (p<0.05, p<0.01). Cronbach's alpha coefficient value for reliability was more than 0.7 for each subscale and total score. The total score showed a significant negative correlation with FEV1% predicted (r=-0.46, p<0.05) and SaO2 (r=-0.60, p<0.05). On HRCT, a median of 9 (range 5~15) bronchopulmonary segments were destroyed by less than half, which significantly correlated with SGRQ total score (r=-0.52, p=0.02). CONCLUSION: The reliability and validity of the Korean version of the SGRQ was acceptable for the measurement of health-related quality of life in patients with post-tuberculous destroyed lung.

Paradoxical Response Developed during the Antituberculous Treatment in Tuberculous Pleurisy / 결핵및호흡기질환

BACKGROUND: A paradoxical response is defined as the radiological and clinical worsening of a previous lesion or the development of new lesion after initial improvement during theprocess of antituberculous treatment. The related factors for the development of a paradoxical response in patients with tuberculous pleurisy are not certain. METHODS: We selected patients with tuberculous pleurisy who had been treated for more than 4 months. The changes onthe serial chest X-ray findings before and after treatment were reviewed. Paradoxical responses were regarded as any worsening or development of new lesion at least 2 weeks after the initiation of treatment. The baseline clinical characteristics and laboratory findings of the peripheral blood and pleural fluid were compared between the patients with a paradoxical response and the patients without a paradoxical response. RESULTS: Paradoxical responses appeared in sixteen patients (21%) among the 77 patients.It took a mean of 38.6 days after the treatment and the time to resolve the paradoxical response was a mean of 32.1 days. For the patients with a paradoxical response, the median age was younger (30.5 years vs 39.0 years, respectively) and the lymphocytic percentage of white blood cells in the pleural fluid was higher (82.1% vs 69.6%, respectively) than for the patients without a paradoxical response. CONCLUSION: The development of a paradoxical response during the treatment of patients with tuberculous pleurisy was not rare and this was related with the age of the patients and the percentage of lymphocytic white blood cells in the pleural fluid.

Retraction: Pertussis as a Differential Diagnosis of Chronic Cough in Adults

No abstract available.

Retraction: Pertussis as a Differential Diagnosis of Chronic Cough in Adults

No abstract available.

A Case of Secondary Organizing Pneumonia Associated with Endobronchial Actinomycosis / 결핵및호흡기질환

Several types of infection can cause organizing pneumonia when the inflammatory process remains active with the further organization of the intra-alveolar fibrinous exudates, despite the control of the infectious organism by antibiotics. We report a case of 37-year-old male with secondary organizing pneumonia associated with an endobronchial actinomycosis. The patient presented with a subacute cough, sputum and fever. Bronchial biopsy revealed sulfur granule to be consistent with the actinomycosis, and percutaneous needle biopsy revealed typical pattern of organizing pneumonia. The patient was treated with the appropriate antibiotics and corticosteroid. There was rapid improvement in the symptoms and radiological findings, and after six months of treatment, the corticosteroid dose was tapered off without a recurrence of the organizing pneumonia.

The prevalence of adverse drug reactions to a short course anti-tuberculosis regimen / 대한내과학회지

BACKGROUND: Anti-tuberculosis drugs used in combination cause adverse drug reactions, but the prevalence of the reactions and risk factors have not been determined. This study aims to identify the prevalence and risk factors of adverse drug reactions (ADR) to the use of first line anti-tuberculosis drugs. METHODS: A total of 435 newly diagnosed patients with tuberculosis (44.1 years+/-19.0 years) were eligible for this study. All patients received daily oral isoniazid (300 or 400 mg), rifampicin (450 or 600 mg) and ethambutol (800 mg) for 6 months, and pyrazinamide (20 mg/kg) for 2 months. Blood tests were performed regularly (before treatment, 2 weeks after treatment, and bimonthly there after). Patients were interviewed 2 months and 6 months after treatment. A serious ADR was defined as any ADR that resulted in the discontinuation of one or more of the drugs. RESULTS: An ADR was noted in 52.6% of all patients. Gastrointestinal (19.3%), cutaneous (17.7%), hepatic (13.8%), renal (12.6%), and neurological (10.3%) ADRs were frequent and hematological (4.4%), musculoskeletal (3.0%) ADRs were less frequent. A skin ADR was associated with an elevated baseline of liver enzymes (odds ratio, 3.48; 95% CI, 1.2 to 9.9), whereas a hepatic ADR was associated with a history of chronic liver disease (odds ratio, 4.82; 95% CI, 1.7 to 13.2). The prevalence of any serious ADR was 9.7%. Occurrence of any serious ADR was associated with a history of chronic liver disease (odds ratio, 4.29; 95% CI, 1.4 to 13.6). CONCLUSIONS: Anti-tuberculosis drugs given in combination frequently caused a ADR and the findings suggest that a patient receiving anti-tuberculosis treatment should be closely monitored.

Evaluation of a New Diagnostic Test for Invasive Fungal Infections Using Prophenoloxydase System to Measure (1->3)-beta-D-glucan Concentration

BACKGROUND: Prognosis of invasive fungal infection is supposed to be better when diagnosed earlier. (1->3)-beta-D-glucan (BDG) test is considered useful in early diagnosis of invasive fungal infections among high-risk patients. A new diagnostic test using prophenoloxydase system to measure BDG level is developed. A study was performed to evaluate clinical usefulness of this new diagnostic test. MATERIALS AND METHODS: 15 patients of confirmed invasive fungal infections and 38 healthy normal volunteers were enrolled. Plasma or serum BDG concentrations were measured using prophenoloxydase system. Assays for intra-run variability and inter-run variability were performed. A cut-off value was determined and sensitivity and specificity of the test were evaluated. RESULTS: A cut-off value of 94.90 pg/mL was determined. Sensitivity and specificity of the test were 86.7% and 52.6%, respectively. Statistical analyses of inter-run variability and intra-run variability revealed the test is reliable (P< or =0.001). CONCLUSION: BDG test using prophenoloxydase system is a sensitive and reliable test in non-invasive detection of invasive fungal infection.

Evaluation of a New Diagnostic Test for Invasive Fungal Infections Using Prophenoloxydase System to Measure (1->3)-beta-D-glucan Concentration

BACKGROUND: Prognosis of invasive fungal infection is supposed to be better when diagnosed earlier. (1->3)-beta-D-glucan (BDG) test is considered useful in early diagnosis of invasive fungal infections among high-risk patients. A new diagnostic test using prophenoloxydase system to measure BDG level is developed. A study was performed to evaluate clinical usefulness of this new diagnostic test. MATERIALS AND METHODS: 15 patients of confirmed invasive fungal infections and 38 healthy normal volunteers were enrolled. Plasma or serum BDG concentrations were measured using prophenoloxydase system. Assays for intra-run variability and inter-run variability were performed. A cut-off value was determined and sensitivity and specificity of the test were evaluated. RESULTS: A cut-off value of 94.90 pg/mL was determined. Sensitivity and specificity of the test were 86.7% and 52.6%, respectively. Statistical analyses of inter-run variability and intra-run variability revealed the test is reliable (P< or =0.001). CONCLUSION: BDG test using prophenoloxydase system is a sensitive and reliable test in non-invasive detection of invasive fungal infection.

Two Cases of Anal Cancer in Patient with Acquired Immunodeficiency Syndrome Infected by Human Papillomavirus

We report two cases of anal cancer in patient with acquired immunodeficiency syndrome infected by human papillomavirus (HPV). One patient presented with huge anal abscess of long duration which developed after incomplete resection of anal warts 2 years ago and the other patient presented with anal bleeding. They were diagnosed as having anal squamous cell carcinoma. Highly oncogenic HPV 69 and 16 were detected by HPV-DNA chip on the previous specimen of warts and anal cancer tissue, respectively. The possibility of anal cancer should be considered in patients infected with human immunodeficiency virus who present anal problems such as anal abscess, anal bleeding, or condyloma accuminatum in anus.

Two Cases of Anal Cancer in Patient with Acquired Immunodeficiency Syndrome Infected by Human Papillomavirus

We report two cases of anal cancer in patient with acquired immunodeficiency syndrome infected by human papillomavirus (HPV). One patient presented with huge anal abscess of long duration which developed after incomplete resection of anal warts 2 years ago and the other patient presented with anal bleeding. They were diagnosed as having anal squamous cell carcinoma. Highly oncogenic HPV 69 and 16 were detected by HPV-DNA chip on the previous specimen of warts and anal cancer tissue, respectively. The possibility of anal cancer should be considered in patients infected with human immunodeficiency virus who present anal problems such as anal abscess, anal bleeding, or condyloma accuminatum in anus.

Outbreak of Primary and Secondary Syphilis Among HIV Sero-positive Patients in Korea

BACKGROUND: This study was performed to characterize the epidemiologic and clinical features of outbreak of syphilis among HIV sero-positive patients in Korea. MATERIALS AND METHODS: A retrospective case review of patients diagnosed with primary and secondary syphilis from July 1999 to September 2003 was carried out at Seoul National University Hospital in Korea. To estimate the incidence, person-years (PYs) of all HIV sero-positive patients, who visited the hospital in the same period, were calculated every 6 months. RESULTS: In a 51 month period, 465 HIV-positive patients were followed up at Seoul National University Hospital. 38 cases of primary and secondary syphilis were diagnosed. The incidence of primary and secondary syphilis was 4.1 per 100 PYs during the study period. There was no case from July 1999 to December 2001, and then the incidence rose until September 2003 from 5.5 per 100 PYs in 1999 to 18.8 per 100 PYs in 2003. The rate of primary and secondary syphilis was 4.3 times higher among homosexual and bisexual men than heterosexual men (95% CI 1.87 to 11.17), and 10.9 times higher among patients who did not receive HAART than patients who were receiving HAART (95% CI 5.47 to 21.79). CONCLUSION: The outbreak of primary and secondary syphilis among HIV-positive patients started in 2002 and has been escalating, especially among homosexual/bisexual men and in patients who did not receive HAART.

Metabolic Complications in Korean HIV/AIDS Patients Receiving Highly Active Anti-retroviral Therapy

BACKGROUND: Since the introduction of HAART (Highly Active Anti-Retroviral Therapy), metabolic com- plications have been reported with varying prevalence. We performed a retrospective study to evaluate the incidence and risk factors of metabolic complications arising in Korean HIV/AIDS patients. MATERIALS AND METHODS: 66 HIV positive patients on combination therapy between 1998 June to 2002 June with at least 1 protease inhibitor (PI) or/and Non-nucleoside reverse transcriptase inhibitors (NNRTI) were reviewed. Hyperglycemia was defined as serum glucose >140 mg/dL on 2 or more occasions; diabetes as any random serum glucose >200 mg/dl; hypercholesterolemia as serum cholesterol >240 mg/dL; hypertriglyceridemia as serum triglyceride >200 mg/dL. We used SPSS version 9.0 for statistical analysis. One way ANOVA was used to compare the treatment groups. Multinominal logistic regression analysis was used for risk factor analysis. RESULTS: 66 patients were analyzed and total duration of follow up was 138 patient-years. The incidence of metabolic complication was 20.3%. Incidence of hypertriglyceridemia, hypercholesterolemia, hyperglycemia, and diabetes were 12.3%, 5.8%. 1.4%, 4.3% respectively. On risk factor analysis, factors contributing to the development of metabolic complication were age>35 years (P= 0.020) and baseline serum triglyceride >140 mg/dL (P=0.001). Baseline CD4 count 6 months (P=0.055) were associated with development of metabolic complications with borderline significance. CONCLUSION: The incidence of metabolic complication among Korean HIV/AIDS patients receiving HAART is 20.3%. Older age and high baseline triglyceride were risk factors for development of metabolic complications.

Pertussis as a Differential Diagnosis of Chronic Cough in Adults

BACKGROUND: Pertussis was long considered a childhood illness. However, in the last two decades, it has been reported as a cause of prolonged cough in adolescents and adults in other countries. Infection of Bordetella pertussis was prospectively searched among adults with a persistent cough. MATERIALS AND METHODS: Adult patients, who visited either the outpatient clinic of a municipal hospital or a university health service center due to cough of more than six days' duration without underlying pulmonary disease, from September 2002 to May 2003, were enrolled. The culture and polymerase chain reaction (PCR) were used for confirming of B. pertussis infection. RESULTS: 102 adult patients with persistent cough were evaluated. 3 (2.9%) patients were PCR positive for B. pertussis. There were no patients with positive culture. All patients with positive PCR had one or more classic symptoms of pertussis and their cough persisted for 3-7 weeks. CONCLUSION: We confirmed the morbidity of pertussis in Korean adults with persistent cough. Pertussis should be considered as a differential diagnosis of chronic cough in adults.