Purpose: Current guidelines recommend vaccination at least 2 weeks before chemotherapy initiation to optimize the immune response despite limited evidence. Our previous study indicated no differences in short-term immune response for the 13-valent pneumococcal conjugate vaccine (PCV13) according to the vaccination timing. This study aims to investigate the long-term efficacy of PCV13 and clinical factors associated with the respective antibody response. Materials and Methods: Patients with gastric or colorectal cancer who received adjuvant chemotherapy were enrolled and divided into two groups: vaccinated 2 weeks before chemotherapy (arm A) and vaccinated concurrently with chemotherapy (arm B). Serum samples were collected before vaccination and in one month, 3 years, and 5 years. Immune responses were measured using enzyme-linked immunosorbent assay and multiplex opsonophagocytosis assay. Results: Including 63 patients, both groups showed an initial increase in the geometric mean titers of opsonophagocytic activity and the geometric mean concentrations of serotype-specific IgG levels after one month, followed by a decline at 3 and 5 years, particularly for serotypes 1, 14, 18C, and 19A. Despite the decline, global protection was maintained for 5 years, although global response decreased. The two arms did not show significant differences in immunogenicity nor in factors such as vaccination timing, age, cancer type, or chemotherapy regimen. Conclusion Vaccination timing is not a significant factor for the immunogenicity of PCV13 in cancer patients undergoing adjuvant chemotherapy. Global protection against pneumococcal infection was sustained for > 5 years, and global response remained in over half of patients.

Background: Evidence regarding the association between variabilities in obesity measures and health outcomes is limited. We aimed to examine the association between variabilities in obesity measures and cardiovascular outcomes and all-cause mortality. Methods: We identified 4,244,460 individuals who underwent health examination conducted by the Korean National Health Insurance Service during 2012, with ≥3 anthropometric measurements between 2009 and 2012. Variabilities in body weight (BW) and waist circumference (WC) were assessed using four indices including variability independent of the mean (VIM). We performed multivariable Cox proportional hazards regression analyses. Results: During follow-up of 4.4 years, 16,095, 18,957, and 30,200 cases of myocardial infarction (MI), stroke, and all-cause mortality were recorded. Compared to individuals with the lowest quartiles, incrementally higher risks of study outcomes and those of stroke and all-cause mortality were observed among individuals in higher quartiles of VIM for BW and VIM for WC, respectively. The multivariable adjusted hazard ratios and 95% confidence intervals comparing the highest versus lowest quartile groups of VIM for BW were 1.17 (1.12 to 1.22) for MI, 1.20 (1.16 to 1.25) for stroke, and 1.66 (1.60 to 1.71) for all-cause mortality; 1.07 (1.03 to 1.12) for stroke and 1.29 (1.25 to 1.33) for all-cause mortality regarding VIM for WC. These associations were similar with respect to the other indices for variability. Conclusion This study revealed positive associations between variabilities in BW and WC and cardiovascular outcomes and allcause mortality. Our findings suggest that variabilities in obesity measures are associated with adverse health outcomes in the general population.

PURPOSE: To demonstrate the presence of nerve fibers including nociceptive fibers in synovium of human knee joint using immunohistochemistry. MATERIALS AND METHODS: 10 Synovial membrane tissues of knee joint obtained from 5 cadavers were analyzed immunohistochemically using antibodies to protein gene product 9.5, betaIII-tubulin, substance P and calcitonin gene-related peptide (CGRP). RESULTS: Many nerve fibers immunoreactive for protein gene product 9.5 and betaIII-tubulin were demonstrated in synovial folds of human knee joints. Also, immunostaining showed the presence of free nerve ending fibers immunoreactive for substance P and calcitonin gene-related peptide in synovium. CONCLUSION: The presence of putative nerve fibers including nociceptive fibers in synovial folds supports a possible role for theses structures as source of knee joint pain.
Antibodies ; Cadaver ; Calcitonin Gene-Related Peptide ; Humans* ; Immunohistochemistry ; Knee Joint ; Knee* ; Nerve Endings ; Nerve Fibers* ; Substance P ; Synovial Membrane*

Inflammatory pseudotumor (IPT) is an uncommon benign neoplasm of unknown etiology presenting as an incidental mass, fever, malaise, anemia, and weight loss. Generally, IPT in the lung is asymptomatic. A case of pulmonary IPT presenting as prolonged fever in a 59 year old man is presented with clinicopathological findings. The patient had been febrile for three months before admission. Five months before admission, a chest X-ray showed a small left pulmonary mass which was regarded as old tuberculosis. An chest X-ray taken on admission revealed a left pulmonary mass two times the size of the one on the first x-ray. Percutaneous needle aspiration and biopsy were performed, and the microscopic examination revealed a plasma cell reaction with myofibroblastic proliferation, consistent with IPT. As prolonged unexplained fever is a frequent symptom in patients with IPTs, this disease entity should be included in the differential diagnosis of fever of unknown origin.
Anemia ; Biopsy ; Diagnosis, Differential ; Fever of Unknown Origin* ; Fever* ; Granuloma, Plasma Cell ; Humans ; Lung ; Middle Aged ; Myofibroblasts ; Needles ; Plasma Cell Granuloma, Pulmonary* ; Plasma Cells ; Thorax ; Tuberculosis ; Weight Loss

Inflammatory pseudotumor (IPT) is an uncommon benign neoplasm of unknown etiology presenting as an incidental mass, fever, malaise, anemia, and weight loss. Generally, IPT in the lung is asymptomatic. A case of pulmonary IPT presenting as prolonged fever in a 59 year old man is presented with clinicopathological findings. The patient had been febrile for three months before admission. Five months before admission, a chest X-ray showed a small left pulmonary mass which was regarded as old tuberculosis. An chest X-ray taken on admission revealed a left pulmonary mass two times the size of the one on the first x-ray. Percutaneous needle aspiration and biopsy were performed, and the microscopic examination revealed a plasma cell reaction with myofibroblastic proliferation, consistent with IPT. As prolonged unexplained fever is a frequent symptom in patients with IPTs, this disease entity should be included in the differential diagnosis of fever of unknown origin.
Anemia ; Biopsy ; Diagnosis, Differential ; Fever of Unknown Origin* ; Fever* ; Granuloma, Plasma Cell ; Humans ; Lung ; Middle Aged ; Myofibroblasts ; Needles ; Plasma Cell Granuloma, Pulmonary* ; Plasma Cells ; Thorax ; Tuberculosis ; Weight Loss