Biomedical subjects

Yoshihiro Kobashi

Publications and source records attributed to Yoshihiro Kobashi.

At least 19 recordsLinked to original sources

PubMed2006

Inflammatory pseudotumor of the lung: clinicopathological analysis in seven adult patients.

BACKGROUND: As the origin and pathology of inflammatory pseudotumor is not clearly understood, there has recently been some confusion regarding the diagnosis of inflammatory pseudotumor. METHODS: We performed clinicopathological analyses in seven patients with inflammatory pseudotumors of the lung histologically diagnosed after surgical resection. The seven patients, selected from patients admitted to Kawasaki Medical School Hospital between April 1989 and December 2005, consisted of four men and three women (average age, 60.4 years). The detection method was from clinical symptoms in two patients and from health examinations in five patients. RESULTS: Five patients had a solitary nodular shadow on chest radiographs and the other two patients had multiple shadows. Because it was difficult to distinguish pseudotumor from lung cancer by chest computed tomography in the five patients showing a solitary nodular shadow, the final diagnosis was obtained by surgical resection. In the other two patients, with multiple shadows, one of whom had nodular shadows with cavitary lesions, surgical resection was performed to distinguish the pseudotumor from metastatic lung cancer. The histological types according to the criteria of Matsubara were fibrous histiocytic in five patients, organizing pneumonia in one, and lymphoplasmocytic in one. The histological types according to the World Health Organization criteria were compact spindle-cell pattern in six patients and hypocellular fibrous pattern in one. CONCLUSION: Because it is difficult to make a preoperative diagnosis of inflammatory pseudotumor by radiological findings or histological findings using specimens obtained by transbronchial lung biopsy, surgical resection, such as video-assisted thoracic surgery or open lung biopsy, is required to differentiate inflammatory pseudotumors from primary or metastatic lung cancers.

Adult↗

PubMed2006

Clinical reevaluation of the QuantiFERON TB-2G test as a diagnostic method for differentiating active tuberculosis from nontuberculous mycobacteriosis.

INTRODUCTION: We reevaluated the usefulness of a whole-blood interferon-gamma enzyme-linked immunosorbent assay (QuantiFERON TB-2G [QFT-TB]; Cellestis) in obtaining a differential diagnosis between active tuberculosis (TB) and nontuberculous mycobacteriosis (NTM). METHODS: The subjects were 50 healthy volunteers, 50 patients with active TB, and 100 patients with NTM who satisfied the diagnostic guidelines of the American Thoracic Society from April 2005 through June 2006. The tuberculin skin test (TST) and the QFT-TB test were performed for all subjects. The QFT-TB test was performed every 2 months. RESULTS: Of the healthy volunteers, 64% had a negative TST result and 94% had a negative QFT-TB test result. Of the patients with active TB, 64% had a positive TST result and 4% had a negative QFT-TB test result. Of the patients with pulmonary Mycobacterium avium complex disease, 60% had a positive TST result and 7% had a positive QFT-TB test result. The QFT-TB test had a mean sensitivity of 86% and a mean specificity of 94%. The QFT-TB test results for patients with active TB transiently decreased during treatment involving antituberculous drugs. The rate of positive QFT-TB test results was 86% at the initiation of treatment, 48% 6 months later, and 33% 12 months later. CONCLUSIONS: We confirmed that the QFT-TB test is a useful diagnostic method for differentiating active pulmonary TB from NTM, compared with the TST. However, because it is possible that the effect of the QFT-TB test may be long lasting after treatment and may not be resolved over time, even with treatment, as in this study, it may not provide any level of certainty regarding cure of infection.

Adult↗

PubMed2006

Sibling cases of Mycobacterium avium complex disease associated with hematological disease.

A 22-year-old man who was admitted to our respiratory division complaining of fever and cough of 1 month's duration had been diagnosed with myelodysplastic syndrome 5 years earlier. On admission, radiological findings showed bilateral diffuse small nodular shadows. Although the results of an acid-fast bacilli examination of blood, sputum, and urine samples were all negative, we initiated antituberculous therapy for suspected miliary tuberculosis because the histological diagnosis from a bone marrow biopsy was epitheloid granuloma. The abnormalities on his chest radiographs improved, but his left cervical lymph nodes became swollen. The histological result of a lymph node biopsy revealed epitheloid granuloma with caseating necrosis. The DNA-DNA hybridization result of a resected lymph node culture indicated Mycobacterium avium. The final diagnosis was disseminated Mycobacterium avium complex (MAC) disease. Both leukocytopenia and thrombocytopenia had been noted in the patient's 19-year-old younger brother, who had been living in the same home 5 years earlier, and for whom a diagnosis of myelodysplastic syndrome was made from bone marrow aspiration on admission. An infiltration shadow with nodular shadows was noted in the right upper lung field on a chest radiograph. A bronchoscopic examination revealed pulmonary MAC disease. As for the route of infection, although we investigated restriction fragment length polymorphism (RFLP), a different pattern was found in the two brothers. We suspect that they were infected by different species of Mycobacterium avium in the same environment rather than by droplet infection from the younger brother to the older brother.

Adult↗

PubMed2006

The microbiological and clinical effects of combined therapy according to guidelines on the treatment of pulmonary Mycobacterium avium complex disease in Japan - including a follow-up study.

BACKGROUND: The difficulty of treatment for pulmonary Mycobacterium avium complex (MAC) in Japan. OBJECTIVES: To investigate the clinical and microbiological effects of treatment according to the guidelines proposed by the American Thoracic Society and the Japanese Society for Tuberculosis and prospective follow-up studies after the completion of treatment of patients with pulmonary MAC disease. METHODS: Analysis of the microbiological effects with regard to sputum conversion rate and the sputum relapsing rate and the clinical effects with regard to clinical symptoms and radiological findings for patients with pulmonary MAC disease treated with a regimen consisting of rifampicin, ethambutol, streptomycin, and clarithromycin over 24 months and follow-up over 12 months. RESULTS: Sixty-five patients with pulmonary MAC disease were enrolled in this trial. In 39 patients, negative sputum conversion was observed within 6 months after the initiation of this regimen, 16 relapsed, and 20 experienced clinical worsening within 1 year after the completion of treatment. Although retreatment with the same regimen or a regimen including new quinolones was carried out for these patients, we could not achieve negative sputum conversion and/or clinical improvement. CONCLUSIONS: We believe that the dose of clarithromycin for pulmonary MAC disease may be increased and recommend surgery for patients with a localized lesion at early-stage MAC disease to prevent a high rate of relapse.

Antitubercular Agents↗

PubMed2006

A double-blind randomized study of aminoglycoside infusion with combined therapy for pulmonary Mycobacterium avium complex disease.

A prospective study of the clinical efficacy of an aminoglycoside antibiotic (streptomycin, SM) for the treatment of pulmonary Mycobacterium avium complex (MAC) disease was carried out. In a multicenter trial, patients with pulmonary MAC disease received protocol-guided combined chemotherapy with or without SM. SM was given to the patients intramuscularly 15 mg/kg three times per week for the initial 3 months and three other antibiotics (rifampicin, ethambutol, and clarithromycin) were added and administered for over 24 months after the conversion of MAC strains. From April 1998 to December 2004, 160 HIV-negative patients were enrolled in this trial. Fourteen patients were found to be ineligible because they could not continue the treatment, and they were excluded from the analysis after randomization. Seventy-three patients were assigned to receive combined chemotherapy with SM (group A) and 73 were assigned to receive combined chemotherapy without SM (group B). The median durations of treatment were 27.6 months in group A and 28.4 months in group B. The difference in the backgrounds of the groups was not statistically significant. There were no differences in microbiological and radiological findings between the groups, but the sputum conversion rate for pulmonary MAC disease at the completion of treatment was significantly higher in group A than that in group B. Although, there were no significant differences in the sputum relapse rate and clinical improvement including both clinical symptoms and radiological findings, group A showed better initial microbiological response than group B. As for adverse reactions and abnormal laboratory findings, there were no significant differences between the groups. Based on the results of this double-blind randomized study, we support treatment including SM according to both the American Thoracic Society (ATS) and the Japanese Society for Tuberculosis (JST) guidelines for patients with pulmonary MAC disease without HIV infection.

Aged↗

PubMed2006

Synchronus presentation of early-stage small cell carcinoma and adenocarcinoma in the same lung lobe.

A 73-year-old man with no symptoms was admitted to our hospital with a nodular shadow (>2 cm) in the left upper lung field on chest X-ray. A histological diagnosis (small cell carcinoma) was obtained by bronchoscopic examination including a transbronchial lung biopsy (TBLB). The preoperative clinical staging was T1N0M0 (StageIA). After preoperative chemotherapy (CDDP + CPT11) was carried out, a nodule in the left S(1+2) diminished remarkably, but a smaller nodule in the left S3 (>8 mm) remained unchanged. While the nodule in the left S(1+2) (small cell carcinoma) had become completely necrotic by the time the final diagnosis was made after resection of the left upper lobe, histological diagnosis of the nodule in the left S3 revealed a well differentiated adenocarcinoma. Synchronous presentation of early-stage lung cancer consisting of small cell carcinoma and adenocarcinoma was identified in the same left upper division of the lung. Because there have been the few previous reports regarding cases of synchronous presentation of early-stage lung cancer in the same lung lobe, we also report on the clinical characteristics, thus adding this case to the five previously reported cases.

Adenocarcinoma↗

PubMed2006

Evaluating the use of a Streptococcus pneumoniae urinary antigen detection kit for the management of community-acquired pneumonia in Japan.

BACKGROUND: The urinary antigen detection kit for Streptococcus pneumoniae was tested. OBJECTIVES: It was our aim to evaluate the usefulness of the immunochromatographic membrane test by doing a large prospective study of community-acquired pneumonia (CAP) in Japan. METHODS: We prospectively evaluated the use of the S. pneumoniae urinary antigen detection kit and analyzed the treatment and clinical effect seen in patients with positive test kit results. One hundred and fifty-six patients with CAP admitted to our hospital between October 2001 and September 2003 were evaluated. RESULTS: In 49% of these CAP patients, the causative microorganisms were isolated. S. pneumoniae was suspected to be the causative microorganism in 15%, but positive results of the urinary antigen detection kit indicated S. pneumoniae to be a probable microorganism in 28%, even though antibiotics had previously been administered to half of the patients. The kit was particularly useful for diagnosing patients with poor quality sputum in whom antibiotics treatment nevertheless had to be selected. Antibiotics appropriate for S. pneumoniae (mainly penicillin) were given. The treatment was found to have excellent clinical results in 89% of the CAP patients. CONCLUSIONS: The S. pneumoniae urinary antigen detection kit was considered to be useful in selecting treatment since there was a high level of clinical effectiveness when the most suitable antibiotics were immediately administered to positive patients. The use of the S. pneumoniae urinary antigen kit is rapid and simple compared with conventional microbiological procedures.

Adolescent↗

PubMed2006

Pulmonary Mycobacterium intracellulare disease with a solitary pulmonary nodule detected at the onset of pneumothorax.

A 61-year-old man with a past history of pulmonary emphysema 6 years earlier was admitted to the emergency department at our hospital because of cough and dyspnea. Left pneumothorax was recognized on a chest radiograph. After his admission to the emergency department, chest drainage was inserted and the left lung was expanded. Afterwards, a nodular shadow (>1.5 cm) was found in the left upper lobe, and differentiation from pulmonary adenocarcinoma was required. As a definite diagnosis could not be made by bronchoscopy, video-assisted thoracoscopic surgery was performed, and a solitary nodule in the left upper lobe was resected. Histologically, a caseating epitheloid granuloma with acid-fast bacilli was found. Regarding the causative pathogen, Mycobacterium intracellulare was identified from the surgically resected specimen. We have reported a peculiar case of pulmonary M. intracellulare disease, detected at the onset of left secondary pneumothorax caused by pulmonary emphysema, which required differentiation from pulmonary adenocarcinoma.

Adenocarcinoma↗

PubMed2006

Relationship between clinical efficacy of treatment of pulmonary Mycobacterium avium complex disease and drug-sensitivity testing of Mycobacterium avium complex isolates.

We prospectively investigated the relationship between the clinical efficacy of treatment of pulmonary Mycobacterium avium complex (MAC) disease and drug-sensitivity testing of MAC isolates for antituberculous drugs, new quinolone antibiotics, and clarithromycin (CAM). Fifty-two patients who satisfied the diagnostic criteria of the American Thoracic Society (ATS) and who received treatment between April 1998 and December 2005, using combined therapy of rifampicin (RFP), ethambutol (EB), streptomycin (SM), and CAM, were enrolled in this study. The causative microorganisms isolated were Mycobacterium avium in 30 patients and M. intracellulare in 22 patients. Although separation of the two strains showed drug sensitivity testing to have slightly better minimal inhibitory concentrations (MIC) for M. intracellulare than for M. avium, there were no significant differences in the sputum eradication rate or clinical improvement between the two strains. The MICs of various antibiotics for the isolated MAC strains were as follows: RFP, 0.125-8 microg/ml; CAM, 0.25-16 microg/ml; SM, 2-128< or =microg/ml; EB, 128< or = microg/ml; levofloxacin (LVFX), 1-32 microg/ml; sparfloxacin (SPFX), 0.5-16 microg/ml; and gatifloxacin (GFLX), 0.25-8 microg/ml. The isolated MAC strains showed the same excellent drug sensitivity test results for RFP, new quinolones, and CAM, but they showed resistant drug-sensitivity results for EB and SM. Regarding the relationship between clinical efficacy and the MICs of RFP, EB, CAM, and SM, there was a good relationship only for CAM. Although the ATS has not yet recommended routine drug susceptibility testing of CAM, we believe that drug susceptibility testing of CAM should be performed before the initial treatment is undertaken for pulmonary MAC disease.

Anti-Bacterial Agents↗

PubMed2006

Four cases of pulmonary Mycobacterium avium intracellulare complex presenting as a solitary pulmonary nodule and a review of other cases in Japan.

OBJECTIVE: To evaluate clinical findings of patients with a solitary pulmonary nodule in Japan caused by pulmonary Mycobacterium avium complex (MAC) disease. METHODS: The authors investigated the clinical features of 12 patients diagnosed as having pulmonary MAC disease who had presented with a solitary pulmonary nodule. RESULTS: The causative microorganisms were M. avium in seven patients, Mycobacterium intracellulare in two and MAC in three. The diagnostic methods were bronchoscopic biopsy or percutaneous lung biopsy in three patients and surgical operations in the remaining nine. Eleven patients had a complete surgical resection of the nodule and antituberculous drugs were administered to eight. On X-ray, there was an absence of calcification, satellite lesions, cavities, or bronchoectasis that are often thought to be characteristic of pulmonary mycobacterial disease. Differentiation from lung cancer was thought necessary in five patients. There was no microbiological or radiological relapse in those who underwent complete surgical resection. CONCLUSIONS: Because treatment is often poorly effective for patients with pulmonary non-tuberculous mycobacterial disease, it is important to identify the causative microorganisms by performing a culture examination of resected lung tissue especially if there is a solitary pulmonary nodule.

Adult↗

PubMed2006

Chronic necrotizing pulmonary aspergillosis as a complication of pulmonary Mycobacterium avium complex disease.

OBJECTIVE AND BACKGROUND: To investigate the characteristic clinical features of chronic necrotizing pulmonary aspergillosis (CNPA) as a complication of pulmonary Mycobacterium avium complex (MAC) disease. METHODS: Clinical analysis of nine cases without a history of old pulmonary tuberculosis in whom CNPA was found to be a complication during the follow-up period for MAC disease. RESULTS: The average duration from the diagnosis of pulmonary MAC disease to the diagnosis of CNPA was 36.0 months. Five patients received antituberculous therapy including clarithromycin for pulmonary MAC disease, but this treatment was ineffective in most. A positive culture for Aspergillus spp. from sputum and a bronchoscopic specimen and clinical evidence of a chronic infective process were recognized in all cases at the time of detection of CNPA. Serological fungal examinations for anti-Aspergillus IgG antibody were initially negative and became positive in all cases during the follow-up period of pulmonary MAC disease. The presence of CNPA surrounding the cavity previously caused by MAC was characterized by local thickening of the cavity with a fungus ball and the appearance of an infiltration shadow surrounding the cavity. In most of the cases, CNPA was at first treated with oral itriconazole and then with i.v. infusion of micafungin, but the clinical efficacy was generally poor. CONCLUSION: The results of this study showed that during the long follow-up period of patients with pulmonary MAC disease it is important to not only carry out serological examinations, but also perform radiological examinations using chest CT.

Aged↗

PubMed2006

[Clinical usefulness of the (1-->3)-beta-D-glucan measurement kit using the improved alkaline pretreatment method--comparison with conventional method].

We had reported that the rate of non-specific reaction in measurement of (1-->3)-beta-D-glucan was decreased by improvement of the alkaline pretreatment reagent of Fungitec G-test MK (MK assay). To compare the clinical usefulness between conventional MK assay and new MK assay using improved alkaline pretreatment reagent, 121 plasma samples were tested. The sensitivity, specificity, positive predictive value (PPV), negative predictive values (NPV) in conventional MK assay were 91.7%, 85.3%, 44.0% and 98.8%, respectively. Those in new MK assay were 75.0%, 91.6%, 52.9% and 96.7%, respectively. On the other hand, area under the curve (AUC) of receiver operating characteristic (ROC) analysis in conventional and new MK assay was 0.9175 and 0.9123 without a significant difference. It has been recognized that the sensitivity in conventional MK assay is higher than those in other beta-glucan assays. Then, the specificity of new MK assay was improved by using improved alkaline pretreatment reagent, without decreasing the sensitivity. Thus, the present findings indicate that the new MK assay is clinically quite useful.

Adolescent↗

PubMed2005

Coexistence of metastatic lung cancer and pulmonary tuberculosis diagnosed in the same cavity.

A 79-year-old woman who had a past history of chronic renal failure 10 years earlier, tongue cancer (T2N2M0) 3 years earlier, and tuberculosis of the cervical lymph nodes 6 months earlier was suddenly admitted with the complaint of right chest pain on April 6, 2004. Right pneumothorax and mild pleural effusion were observed on a chest radiograph. There was no improvement in the patients collapsed lung despite the insertion of a chest drainage tube into the pleural cavity. Three thin-walled cavitary lesions were noted in the right lobe of segment 1 on computed tomography, and the cause of her pneumothorax was thought to be air leakage from the largest cavitary lesion adjacent to the visceral pleura. Partial resection of the right lung by video-assisted thoracoscopic surgery (VATS) was performed at the Department of Thoracic Surgery. Subsequently, it was determined that metastatic squamous cell carcinoma of the lung, corresponding to her tongue cancer, had invaded the visceral pleura adjacent to the largest cavitary lesion. Simultaneously, an epitheloid granuloma with caseating necrosis was observed adjacent to a partially thickened portion of this cavitary lesion. The epitheloid granuloma was found to be acid-fast bacilli-positive and a diagnosis of Mycobacterium tuberculosis pulmonary tuberculosis was made. We report a rare case of the coexistence of metastatic lung cancer originating from tongue cancer and active pulmonary tuberculosis diagnosed in the same large cavitary lesion.

Aged↗

PubMed2005

Infectious bulla of the lung caused by Mycobacterium intracellulare.

A healthy 24-year-old man who was admitted to our hospital was suspected of having an infectious bulla of the lung because an intrabullous effusion was seen on a chest radiograph. A bulla of the right lung had been found 2 years earlier during a periodic health examination. On a chest radiograph, a bullous lesion with a niveau-like shadow (14 x 7 cm) was noted in the right lower lobe of the lung. On puncture aspiration, the bulla fluid was found to be exudative and contained mostly lymphocytes. A smear examination for acid-fast bacilli was positive, as was polymerase chain reaction (PCR) examination for Mycobacterium intracellulare. Therefore, a diagnosis of infectious lung bulla caused by M. intracellulare was made. A right lower lobectomy was performed. On macroscopic examination of the resected lesion, the area surrounding the bulla was whitish in color, and microscopic examination of this area showed a caseating epitheloid granuloma with acid-fast bacilli. We report this case because there have been no previous reports in the literature of infectious lung bulla caused by M. intracellulare although there have been several reports dealing with lung bulla caused by Mycobacterium tuberculosis.

Adult↗

PubMed2005

Community-acquired pneumonia in Japan: a prospective ambulatory and hospitalized patient study.

In this study the aetiology of community-acquired pneumonia (CAP) in Japan was investigated and the incidence of causative pathogens in ambulatory and hospitalized patients was compared. In addition, the roles of Chlamydophila felis and Chlamydophila pecorum as causes of CAP were investigated. Five hundred and six patients with CAP who visited an outpatient clinic or were admitted to one of three different hospitals were enrolled in this study; 106 of them were outpatients and 400 were hospitalized patients. Among the 506 CAP cases, Mycoplasma pneumoniae was the most common pathogen found in the outpatients and Streptococcus pneumoniae was the most common in the hospitalized patients. No cases of Chlamydophila pecorum pneumonia were observed and only one patient had an antibody titre suggestive of recent infection with the feline strain of Chlamydophila. The incidence of infection with M. pneumoniae and Chlamydophila pneumoniae was higher among the outpatients than among hospitalized patients, whereas the incidence of infection with S. pneumoniae and Haemophilus influenzae was higher among the hospitalized patients. Recognition of these results will allow prompt and appropriate antimicrobial therapy to be provided using Japanese CAP guidelines.

Adult↗

PubMed2005

Clinicopathological analysis of lung cancer resembling malignant pleural mesothelioma.

OBJECTIVE: The aim of this study was to evaluate the clinicopathological features of lung cancer resembling malignant pleural mesothelioma. METHODOLOGY: The seven patients studied had tumours showing an extensive pleural growth pattern, and were chosen from 1516 lung cancer patients diagnosed at two affiliated hospitals over a 17-year period. RESULTS: Histologically, five of these lung cancers were adenocarcinomas, one was a small cell carcinoma, and one a large cell carcinoma. Tumour markers such as carcinoembryonic antigen (CEA) were elevated in six patients at admission. However, a clinical diagnosis was difficult and these cancers could only be distinguished from malignant pleural mesothelioma by thoracentesis in two cases, pleural biopsy in two, thoracotomy in two, and in case 7 at autopsy. Treatment consisted of chemotherapy or radiation therapy in four patients, but with little clinical effect. The mean survival time was 6.7 months, which is much less than for true malignant pleural mesothelioma. CONCLUSIONS: Lung cancer resembling malignant pleural mesothelioma is most frequently observed in patients with adenocarcinoma, which is suspected to occur peripherally. To distinguish pseudomesotheliomatous carcinoma from malignant pleural mesothelioma in patients with diffuse pleural thickening and effusion, requires adequate tissue sampling by thoracotomy or video-assisted thoracoscopic surgery and a panel of immunohistochemical stains.

Aged↗

PubMed2005

[Clinical analysis of pulmonary actinomycosis].

A clinical analysis of four patients diagnosed as pulmonary actinomycosis in our respiratory division during the last seven years was performed. All of the patients were males with an average age of 61 years. Three patients had a past history. The clinical diagnosis on admission was lung cancer or pulmonary suppuration in three patients showing a mass-like shadow and pneumonia in one patient with an infiltration shadow. Suspected pulmonary infectious disease was detected from clinical symptoms in two patients, while suspected lung cancer was detected in the other two patients during health examinations. The lesions dominantly existed in the right upper lobe. Such findings as central low attenuation (LAA), bronchiectasis and pleural thickening were characteristic on chest computed tomography (CT). The diagnostic methods were all negative procedures; video-assisted thoracoscopic surgery (VATS) in two patients, a specimen obtained by bronchoscopy in one and a specimen taken by percutaneous aspiration in one. Because penicillin antibiotics were administered for a long time for all patients after obtaining a definite diagnosis, the prognosis was good and there were no relapse.

Actinomycosis↗

PubMed2005

[Non-specific reactions in four methods measuring (1-->3)-beta-D-glucan levels in plasma].

We detected non-specific reactions in the measurement of (1-->3)-beta-D-glucan levels (beta-glucan) in plasma, and the influences of the non-specific reactions on sensitivity and specificity of measurement methods were examined. In this study, 460 plasma samples from 174 patients at Kawasaki Medical School Hospital were used, and the plasma beta-glucan levels were measured by different four methods. The methods included the dilution-heating-endpoint (DHE), dilution-heating-turbidimetric (DHT), alkaline-kinetic (AK), and alkaline-endpoint method (AE) with and without 4-amidinophenyl benzoate hydrochloride (APB) of a protease inhibitor blocking the Limulus reaction. Non-specific reactions were detected from the calculated value under conditions with APB. Therefore, both of the actual values and the values equivalent to non-specific reactions were calculated. The incidence of non-specific reactions was 2.4% in DHE method, 0% in DHT, 53.3% in AK, and 99.3% in AE. The sensitivity and specificity in the methods were 35.7% and 96.0%, 28.6% and 96.0%, 78.6% and 80.1%, and 57.1% and 84.1%, respectively. When subtracted the non-specific reaction values from the actual values in AK and AE method, the specificity was increased by 91.4% and 94.0%, respectively. In these two methods, the non-specific reaction was considered to be a major cause of the low specificity. Finally, to measure plasma beta-glucan levels accurately, non-specific reactions should be excluded as possible by further improvement of measurement methods.

Alkalies↗