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| 1.
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Nakamura, Hideta ; Tateyama, Masao ; Tasato, Daisuke ; Haranaga, Shusaku ; Higa, Futoshi ; Matsuzaki, Akiko ; Yoshimi, Naoki ; Fujita, Jiro
概要:
Asymptomatic pulmonary sarcoidosis can develop after starting antiretroviral therapy. The decision on whether to treat sarcoidosis with corticosteroids should be based on the disease severity.
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| 2.
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Yamauchi, Momoko ; Kinjo, Takeshi ; Parrott, Gretchen ; Miyagi, Kazuya ; Haranaga, Shusaku ; Nakayama, Yuko ; Chibana, Kenji ; Fujita, Kaori ; Nakamoto, Atsushi ; Higa, Futoshi ; Owan, Isoko ; Yonemoto, Koji ; Fujita, Jiro
概要:
Serum markers that differentiate between tuberculous and non-tuberculous pneumonia would be clinically useful. However,
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few serum markers have been investigated for their association with either disease. In this study, serum levels of interferon gamma (IFN-γ), matrix metalloproteinases 1 and 9 (MMP-1 and MMP-9, respectively), and periostin were compared between 40 pulmonary tuberculosis (PTB) and 28 non-tuberculous pneumonia (non-PTB) patients. Diagnostic performance was assessed by analysis of receiver-operating characteristic (ROC) curves and classification trees. Serum IFN-γ and MMP-1 levels were significantly higher and serum MMP-9 levels significantly lower in PTB than in non- PTB patients (p < 0.001, p = 0.002, p < 0.001, respectively). No significant difference was observed in serum periostin levels between groups. ROC curve analysis could not determine the appropriate cut-off value with high sensitivity and specificity; therefore, a classification tree method was applied. This method identified patients with limited infiltration into three groups with statistical significance (p = 0.01), and those with MMP-1 levels < 0.01 ng/ mL and periostin levels ≥ 118.8 ng/mL included only non-PTB patients (95% confidence interval 0.0–41.0). Patients with extensive infiltration were also divided into three groups with statistical significance (p < 0.001), and those with MMP-9 levels < 3.009 ng/mL included only PTB patients (95% confidence interval 76.8–100.0). In conclusion, the novel classification tree developed using MMP-1, MMP-9, and periostin data distinguished PTB from non- PTB patients. Further studies are needed to validate our cut-off values and the overall clinical usefulness of these markers.
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| 3.
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Sunagawa, Satoko ; Iha, Yoshikazu ; Taira, Katsuya ; Okano, Sho ; Kinjo, Takeshi ; Higa, Futoshi ; Kuba, Kazufumi ; Tateyama, Masao ; Nakamura, Katsunori ; Nakamura, Shota ; Motooka, Daisuke ; Horii, Toshihiro ; Parrott, Gretchen L. ; Fujita, Jiro
概要:
Objective This study evaluates the difference between winter influenza and summer influenza in Okinawa.\nMethods From Ja
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nuary 2007 to June 2014, weekly rapid antigen test (RAT) results performed in four acute care hospitals were collected for the surveillance of regional influenza prevalence in the Naha region of the Okinawa Islands.\nResults An antigenic data analysis revealed that multiple H1N1 and H3N2 viruses consistently co-circulate in Okinawa, creating synchronized seasonal patterns and a high genetic diversity of influenza A. Additionally, influenza B viruses play a significant role in summer epidemics, almost every year. To further understand influenza epidemics during the summer in Okinawa, we evaluated the full genome sequences of some representative human influenza A and influenza B viruses isolated in Okinawa. Phylogenetic data analysis also revealed that multiple H1N1 and H3N2 viruses consistently co-circulate in Okinawa.\nConclusion This surveillance revealed a distinct epidemic pattern of seasonal and pandemic influenza in this subtropical region.
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| 4.
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Shiohira, Hideo ; Nakamatsu, Masashi ; Kise, Yuya ; Higa, Futoshi ; Tateyama, Masao ; Hokama, Nobuo ; Kuniyoshi, Yukio ; Ueda, Shinichiro ; Nakamura, Katsunori ; Fujita, Jiro
概要:
Teicoplanin, a glycopeptide antibiotic for methicillin-resistant Staphylococcus aureus, is recommended for therapeutic d
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rug monitoring during treatment. Maintaining a high trough range of teicoplanin is also recommended for severe infectious disease. However, the optimal dose and interval of treatment for severe renal impairment is unknown. We report a 79-year-old man who received long-term teicoplanin treatment for methicillin-resistant Staphylococcus aureus bacteremia due to postoperative sternal osteomyelitis with renal impairment. Plasma teicoplanin trough levels were maintained at a high range (20-30 μg/mL). Although the patient required long-term teicoplanin treatment, a further decline in renal function was not observed, and blood culture remained negative after the start of treatment. Teicoplanin treatment that is maintained at a high trough level by therapeutic drug monitoring might be beneficial for severe methicillin-resistant Staphylococcus aureus infection accompanied by renal impairment.
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| 5.
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Shibahara, Daisuke ; Kinjo, Takeshi ; Nishiyama, Naoya ; Kami, Wakaki ; Nabeya, Daijiro ; Haranaga, Shusaku ; Higa, Futoshi ; Tateyama, Masao ; Shinzato, Takashi ; Toma, Hiromu ; Kishimoto, Hidehiro ; Fujita, Jiro
概要:
A 65-year-old man, who recently returned from Liberia, visited a clinic complaining of fever, and azithromycin was presc
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ribed. The patient presented to a general hospital 5 days after the onset of symptoms, however, a blood smear examination failed to detect malaria. Contrary to the blood smear result, a rapid antigen test in our hospital was strongly-positive for falciparum malaria, indicating a high level of malarial antigen in the blood. Moreover, laboratory examinations on admission showed a tendency for improvement. We assumed that the administration of azithromycin partially treated malaria, thus complicating the blood smear diagnosis. We should be careful in prescribing azithromycin, which is widely used in clinics, to travelers returning from malaria-endemic countries.
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Tamaki, Yuichiro ; Higa, Futoshi ; Tasato, Daisuke ; Nakamura, Hideta ; Uechi, Kayoko ; Tamayose, Maki ; Haranaga, Shusaku ; Yara, Satomi ; Tateyama, Masao ; Fujita, Jiro
概要:
Acute lung injury during pregnancy results in morbidity and mortality in both the mother and the fetus. Pneumocystis jir
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ovecii pneumonia (PCP) is a rare disease but may occur in pregnant immune-suppressed women. Here, we describe a case of acute lung injury due to PCP and alveolar hemorrhage in a pregnant woman who was a human T lymphotropic virus type-1 (HTLV-1) carrier. PCP should be considered in the differential diagnosis of pulmonary complications during pregnancy in HTLV-1 endemic areas.
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| 7.
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Takamatsu, Reika ; Teruya, Hiromitsu ; Takeshima, Eriko ; Ishikawa, Chie ; Matsumoto, Kunihiro ; Mukaida, Naofumi ; Li, Jian-Dong ; Heuner, Klaus ; Higa, Futoshi ; Fujita, Jiro ; Mori, Naoki
概要:
[Background]Legionella pneumophila is the causative agent of human Legionnaire's disease. During infection, the bacteriu
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m invades macrophages and lung epithelial cells, and replicates intracellularly. However, little is known about its interaction with T cells. We investigated the ability of L. pneumophila to infect and stimulate the production of interleukin-8 (IL-8) in T cells. The objective of this study was to assess whether L. pneumophila interferes with the immune system by interacting and infecting T cells.
[Results]Wild-type L. pneumophila and flagellin-deficient Legionella, but not L. pneumophila lacking a functional type IV secretion system Dot/Icm, replicated in T cells. On the other hand, wild-type L. pneumophila and Dot/Icm-deficient Legionella, but not flagellin-deficient Legionella or heat-killed Legionella induced IL-8 expression. L. pneumophila activated an IL-8 promoter through the NF-κB and AP-1 binding regions. Wild-type L. pneumophila but not flagellin-deficient Legionella activated NF-κB, p38 mitogen-activated protein kinase (MAPK), Jun N-terminal kinase (JNK), and transforming growth factor β-associated kinase 1 (TAK1). Transfection of dominant negative mutants of IκBα, IκB kinase, NF-κB-inducing kinase, TAK1, MyD88, and p38 MAPK inhibited L. pneumophila-induced IL-8 activation. Inhibitors of NF-κB, p38 MAPK, and JNK blocked L. pneumophila-induced IL-8 expression. In addition, c-Jun, JunD, cyclic AMP response element binding protein, and activating transcription factor 1, which are substrates of p38 MAPK and JNK, bound to the AP-1 site of the IL-8 promoter. [Conclusions]Taken together, L. pneumophila induced a flagellin-dependent activation of TAK1, p38 MAPK, and JNK, as well as NF-κB and AP-1, which resulted in IL-8 production in human T cells, presumably contributing to the immune response in Legionnaire's disease. 論文 続きを見る |
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| 8.
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外間, 昭 ; 比嘉, 太 ; Hokama, Akira ; Higa, Futoshi
概要:
科研費番号: 16590608
平成16年度～平成18年度科学研究費補助金(基盤研究(C))研究成果報告書 研究概要：沖縄県宮古群島の一離島の住民を対象に1994年から、B型とD型肝炎の調査を行っている。これまでに257 … 5名が調査され、そのうちB型肝炎ウイルス(HBV)の保有者は236名(9.2%)で、これらの保有者のうち49名(21.2%)がHBVとD型肝炎ウイルス(HDV)の重感染者であった。また、同群島内にある総合病院の受診者を対象とした調査で、HDVの重感染は肝硬変、肝癌への進行に関連していることが判った。HDVは、これまでに世界中から多数の株が分離され、これらの株間には多様性が大きい。そこで、株間で相同性の高い領域にプライマーを設定し、独自のPCRを開発した。これを用いて、HDV抗体陽性者を検査したところ、約半数はHDV-RNAが陽性で、残りは陰性であった。また、HDV-RNAが陽性者は、高率に肝障害を有したのに反し、陰性者は肝障害がなかった。よって、HDVは感染後、HBVが存在するにもかかわらず、排除される症例が存在することが判った。また、HDVの定量法をリアルタイムPCR法にて開発し、病態との関連を検討した。その結果、HBVとHDVの重感染の肝障害は、主にHDV量と関連することが判った。HDVはその系統樹解析から、大きく3つのタイプ(I、II、III型)に分類される。宮古群島で見つかったHDVはほとんどがII型に属し、しかもIIbと亜分類された。IIb型は台湾からも報告されているが、宮古群島で見つかったHDV株はより多様性があり、また、その多様性が病態にも影響していると思われた。また、HBVは95%がgenotype Bで、残り5%がgenotype Cであった。 要約（欧文）:To clarify the correlation between HBV DNA levels and serum ALT levels in patients with chronic hepatitis HDV infection, sensitive HBV quantitative assays were used. Thirty-four consecutive patients with CLD who were positive for both HBsAg and anti-HDV, including 19 patients with CH, 8 patients with LC and 7 patients with HCC. All were negative for HBeAg and positive for antibody to HBeAg. HBV DNA was detected in 25 (73.5%) of the 34 patients using real-time detection PCR, and the HBV DNA levels of these patients were significantly lower compared with HBeAg status and ALT level-matched patients with CLD positive for HBsAg but negative for anti-HDV. There was no correlation between serum HBV DNA and ALT levels among the 34 patients with CLD positive for anti-HDV. ALT levels in anti-HDV-positive HBsAg carriers with HDV RNA were significantly higher than those without HDV RNA. Liver damage in patients with HDV infection may be caused mainly by ongoing HDV infection not by HBV replication. We determined the sequence of HDV genome in 40 patients from the Miyako Islands, Okinawa. Consensus sequences from 33 HDV full genomes were determined by directly sequencing four partially overlapping PCR products. Phylogenetic tree analysis classified these 33 complete HDV genomes as HDV genotype I, IIa and IIb. Among the 30 genotype IIb patients, there were two clusters of genetic variants. One group consisted of six isolates showing significant homology with genotype IIb, previously reported from Taiwan. The other group consisted of 24 isolates, whose sequences formed a new genetic subgroup (genotype IIb-Miyako; IIb-M). Characteristic variations were found in the C-terminal sequence of the large delta antigen-conferring packaging signal as well as the RNA editing site. Determination of subclasses of genotype IIb, including HDV patients whose partial HDV sequence was determined, revealed eight patients with IIb and 29 patients with IIb-M. Patients with genotype IIb-M showed greater progression of CH and LC than those with genotype IIb. These data indicate the existence of a genetic subgroup of HDV genotype IIb, which is associated with different clinical characteristics and which could be related to genetic variations in functionally important parts of the HDV genome. 未公開：P.4以降（別刷論文のため） 研究報告書 続きを見る |
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| 9.
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Furugen, Makoto ; Yamashiro, Shin ; Tamayose, Maki ; Naha, Yui ; Miyagi, Kazuya ; Nakasone, Chikara ; Uchihara, Teruhito ; Haranaga, Shusaku ; Azuma, Masato ; Yara, Satomi ; Takashi, Shinzato ; Higa, Futoshi ; Toma, Hiromu ; Tateyama, Masao ; Fujita, Jiro
概要:
A 42-year-old man was admitted to our hospital with a history of fever, headache and disorientation. His cerebrospinal f
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luid revealed eosinophilia and his serum had an antibody against Angiostrongylus cantonensis (A. cantonensis). Then, he was diagnosed as eosinophilic meningoencephalitis caused by A. cantonensis. He was treated with repeated lumbar punctures and oral prednisolone. Although a symptom he had been suffering from at the time of his admission was urinary retention, this symptom disappeared as his general condition improved. Therefore his case was considered to be Elsberg syndrome with eosinophilic meningoencephalitis caused by A. cantonensis.
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| 10.
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Zhang Kou-Xing ; Higa, Futoshi ; Koide, Michio ; Kusano, Nobuchika ; Saito, Atsushi
概要:
The polymerase chain reaction (PCR) for identification of Mycobacterium tuberculosis in uncultured clinical specimens wa
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s evaluated prospectively. Two oligonuleotide primers were derived from the nucleotide sequence of IS 6110, which amplified a 123-bp sequence found in members of the M. tuberculosis complex. The detection limit of M. tuberculosis DNA was 10 fg by gel electrophoresis and ethidium bromide staining after a forty cycle amplification. A total of 100 clinical specimens (from 70 patients) were investigated using the PCR method. Twenty-one samples were found to be positive and seventy-nine were negative. Compared with the conventional culture method, sensitivity and specificity of the PCR method's were 94.0% and 94.1%, respectively. Cases with PCR repeatedly positive revealed definite tuberculosis. Nineteen of the positive samples were from active culture positive tuberculosis cases, and one from a patient with inproved condition after anti-tuberculosis treatment. Seventy-nine negative samples were from various respiratory diseases, including old inactive tuberculosis or active tuberculosis which had already been treated with anti-tuberculosis drugs. In this study, PCR results could be obtained within two days. The PCR method was found to be rapid, sensitive, and reliable test for clinical consideration.
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