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Objective This study assessed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody responses to the BNT162b2 mRNA vaccine in Japanese healthcare workers. Methods In this prospective cohort study, participants received two doses of the BNT162b2 mRNA vaccine on days 0 and 21 and provided blood for anti-SARS-CoV-2 antibody testing before the first vaccine and on days 21 and 35 after vaccination. Anti-spike protein immunoglobulin G (S-IgG) was measured using Abbott and Fujirebio chemiluminescent immunoassays. Participants One hundred healthcare workers (median age: 39 years old, interquartile range: 30-48 years old), including 6 who had been previously infected with SARS-CoV-2 and 3 individuals taking immunosuppressive drugs, participated in the study. ResultsThe S-IgG antibody titers (AU/mL) measured using both the Abbott and Fujirebio assays increased significantly (p<0.001) over time, both with a prevalence of 100% at 35 days after the first vaccination. The multivariate log-normal linear regression analysis indicated the effect of immunosuppressant medication using both the Abbott (p=0.013) and Fujirebio (p=0.039) assays on S-IgG levels after complete vaccination. Pearson's correlation coefficient between the Abbott and Fujirebio S-IgG results in all 300 samples collected before and after vaccination and 50 positive controls from patients with coronavirus disease 2019 were 0.963 [95% confidence interval (CI): 0.954-0.970, p<0.001] and 0.909 (95% CI: 0.845-0.948, p<0.001), respectively. Conclusion The BNT162b2 mRNA vaccine was effective at increasing S-IgG levels in Japanese immunocompetent healthcare workers. The Fujirebio S-IgG assay showed high diagnostic accuracy, using the Abbott S-IgG assay as the reference test.

We report a case of Peutz-Jeghers syndrome with gallolyticus endocarditis which has not yet been reported. Colon cancer was observed and implicated in Peutz-Jeghers syndrome. A 44-year-old female with fever and heart murmur was diagnosed as infective endocarditis caused by streptococcus gallolyticus. After treatment with antibiotics and mitral valbuloplasty, we performed gastrointestinal endoscopic studies and found polyps in stomach and colon. Histological findings of a large pedunculated colon polyp revealed hamartomatous polyp with a lesion of adenocarcinoma with adenoma. She had pigmentation of digits. Her father had also digits pigmentation and died of pancreas cancer. Peutz-Jeghers syndrome with colon cancer was incidentally diagnosed by infective endocarditis and subsequent colonoscopy.

A 34-year-old healthy man with no significant medical history experienced a seizure for the first time which started with the stiffening of his right leg and thereafter progressed into generalized convulsion while he was playing computer games. Three weeks later, he experienced a similar seizure for the fourth time and was transferred to an ER. The test results of blood, cerebrospinal fluid, brain MRI, EEG and bone mineral density were normal. A diagnosis of focal epilepsy of focal to bilateral tonic-clonic seizure and due to an unknown etiology was thus made.The patient continued to suffer from right shoulder pain. 3D CT of his shoulders revealed bilateral scapula body fractures (Picture 1). MRI also further revealed right proximal humeral bone bruises (Picture 2).The frequency of bone fractures from epileptic convulsion ranges from 0.3-5.2% (1). Most vulnerable bones tend to be the humerus and vertebra. Bilateral scapula fractures have been reported in only four cases with renal osteodystrophy (2). This patient had scapula fractures with humerus

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