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論文(リポジトリ)

論文(リポジトリ)
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
出版情報: PLoS ONE.  15  2020-07-09.  Public Library of Science
URL: http://hdl.handle.net/20.500.12000/47365
概要: Serum markers that differentiate between tuberculous and non-tuberculous pneumonia would be clinically useful. However, 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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2.

論文(リポジトリ)

論文(リポジトリ)
Kami-Onaga, Kaoru ; Tateyama, Masao ; Kinjo, Takeshi ; Parrott, Gretchen ; Tominaga, Daisuke ; Takahashi-Nakazato, Ai ; Nakamura, Hideta ; Tasato, Daisuke ; Miyagi, Kyoko ; Maeda, Saori ; Arae, Hirotaka ; Uehara, Hitoshi ; Miyagi, Kazuya ; Haranaga, Shusaku ; Fujita, Jiro
出版情報: PLOS ONE.  13  2018-06-14.  Public Library of Science
URL: http://hdl.handle.net/20.500.12000/45641
概要: In this study, we demonstrated the pervasiveness of HIV-associated neurocognitive disorders (HAND) among a selection of Japanese patients as well as evaluated and comparedthe Mini Mental State Examination (MMSE) and the International HIV Dementia Scale(IHDS) for use as a screening tool among combination anti-retroviral therapy (cART)-naïveand cART experienced patients. The MMSE and the IHDS have both been used as HANDscreening tests around the world with variable success. It has been reported the increasedusage of cART the utility of these screening tests may have been diminished due to thedecreased severity of impairment and the altered pattern of neurocognitive impairments incART era HAND patients. It is therefore possible the MMSE and the IHDS may still be usefulamong cART-naïve patients even in the cART era. However, only one study has investigated and compared the screening results of the IHDS among cART-naïve and cART experienced patients. All HIV positive patients who visited, or were admitted, to the RyukyuUniversity Hospital between January 2009 and March 2014 were evaluated for inclusion.Selected patients (n = 49) had data without omission for all tests. The overall prevalence ofHAND in our cohort was 44%. The area under the curve (AUC), for all subjects using theMMSE and the IHDS, were 0.60 and 0.69, respectively. However, the AUC among cARTnaïve patients were 0.58 and 0.76 for the MMSE and the IHDS, respectively. Whereas,cART experienced patients had an AUC of 0.60 and 0.61, respectively. Overall, the MMSEdemonstrated a poor screening ability for HAND, regardless of cART usage (the cut-offvalue of 27 had a Youden’s J-Index of 0.1, in all groups). Alternatively, the IHDS was moderately useful for HAND screening among cART-naïve patients (the cut-off value of 11 had aYouden’s J-Index of 0.4), but performed poorly as a screening test among cART experienced patients (the cut-off value of 11 had a Youden’s J-Index of 0.1).
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