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Assessment of humoral responses in COVID-19 using various quantitative antibody tests

Wakui M., Uwamino Y., Kurafuji T., Noguchi M., Ohno A., Yokota H., Kikuchi H., Hasegawa N., Saya H., Murata M.

Annals of Clinical Biochemistry （Annals of Clinical Biochemistry） 58 （ 4 ） 368 - 376 2021年07月

ISSN 00045632

Background: Quantitative antibody tests are expected to be useful in diagnostics of COVID-19 and investigation of herd immunity against SARS-CoV-2. To make it proper to perform them, understanding of the immunological aspects is critically important. The present study aimed to assess humoral responses in COVID-19 using various quantitative antibody tests. Methods: Four quantitative antibody tests that are different in targeted antigens, detectable immunoglobulin classes and avidity were used. Diagnosis was confirmed by RT-PCR for SARS-CoV-2 detection. Antibody titres of 117 samples collected from 24 COVID-19 patients and 23 non-COVID-19 patients were measured to evaluate correlations between different tests. For 24 COVID-19 patients, antibody titres measured at various time points after the onset or the RT-PCR diagnosis were subjected to assessment of humoral responses. Results: Correlations between tests were observed to some degree, although there were discrepancies putatively due to differences in measurement principle. Seronegative COVID-19 was diagnosed for some patients, in whom antibody titres were less than the cut-off value in each test throughout the time courses. IgG seroconversion without prior IgM seroconversion most frequently occurred, while predominance of IgM responses over IgG responses was observed in some severe cases. Viral burdens estimated according to threshold cycle values at the RT-PCR seemed to impact antibody responses. Conclusions: The results provide insights into the nature of humoral responses to SARS-CoV-2 and diagnostic performance of antibody tests.

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Digestive Decolonization of Colorectal Carriage of Vancomycin-resistant Enterococcus faecium in a Japanese Adult

Uno S., Takano Y., Iketani O., Abiko T., Miwa T., Nanki K., Kurihara T., Tamura Y., Ara M., Uwamino Y., Shinjoh M., Mori T., Hasegawa N.

Internal Medicine （Internal Medicine） 61 （ 2 ） 249 - 252 2021年06月

ISSN 09182918

Patients with vancomycin-resistant Enterococcus (VRE) colonization should be managed in an isolation room with contact precautions. We herein report a patient whose colorectal carriage of VRE was successfully decolonized using concomitant bowel irrigation with polyethylene glycol, probiotics, and oral antimicrobials, linezolid and orally-administered daptomycin, for release from isolation and contact precautions. We therefore would like to suggest a potential strategy for managing patients with VRE colonization.

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Potential biomarker enhancing the activity of tuberculosis, hsa-miR-346

Uno S., Nishimura T., Nishio K., Kohsaka A., Tamizu E., Nakano Y., Kagyo J., Nakajima Y., Arai R., Hasegawa H., Arakawa K., Kashimura S., Ishii R., Miyazaki N., Uwamino Y., Hasegawa N.

Tuberculosis （Tuberculosis） 129 102101 - 102101 2021年06月

ISSN 14729792

Objectives: To determine the usefulness of hsa-miR-346, a potential biomarker enhancing the activity of non-tuberculous mycobacterial diseases, as a biomarker of tuberculosis activity. Methods: We investigated whether hsa-miR-346 is secreted by human macrophages infected with Mycobacterium tuberculosis (M. tuberculosis) in an in vitro study. In addition, a cross-sectional study was conducted first to evaluate whether serum hsa-miR-346 is elevated in patients with tuberculosis compared with that in healthy individuals. Second, we conducted a retrospective study to evaluate whether anti-tuberculosis treatment reduces serum hsa-miR-346 levels. Results: Log hsa-miR-346 levels were significantly elevated in the supernatant of human macrophages infected with M. tuberculosis in a dose-dependent manner. The mean serum log hsa-miR-346 levels were −15.48 (−15.76 to −15.21) in patients with tuberculosis and −16.12 (−16.29 to −15.95) in healthy volunteers, which significantly differed. In addition, hsa-miR-346 significantly decreased at 2 months from starting an anti-tuberculosis treatment. Conclusions: We consider hsa-miR-346 as a potential biomarker enhancing the tuberculosis activity.

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R-CHOP Chemotherapy for Disseminated Mycobacterium avium Complex Disease due to Anti-Interferon-Gamma Autoantibodies: A Case Report

Uno S., Uehara E., Kimura T., Sakagami T., Namkoong H., Uchida S., Uwamino Y., Hasegawa N.

Open Forum Infectious Diseases （Open Forum Infectious Diseases） 8 （ 6 ） ofab181 2021年06月

ISSN 2328-8957

A 77-year-old Japanese man with disseminated Mycobacterium avium complex (MAC) disease due to anti-interferon-gamma autoantibodies received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) chemotherapy because of non-Hodgkin lymphoma complication. The hepatobiliary nodules due to MAC resolved with R-CHOP and multidrug antimycobacterial treatment. R-CHOP could serve as an alternative adjunctive therapy for patients with anti-interferon-gamma autoantibodies.

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Retrospective study of the efficacy and safety of metronidazole and vancomycin for Clostridioides difficile infection

Misawa K., Iketani O., Enoki Y., Taguchi K., Uno S., Uwamino Y., Hasegawa N., Matsumoto K.

Journal of Infection and Chemotherapy （Journal of Infection and Chemotherapy） 27 （ 10 ） 1407 - 1412 2021年05月

ISSN 1341321X

Introduction: According to the Japanese guidelines for the management of Clostridioides difficile infection (CDI), the first choice is metronidazole (MNZ) for non-severe cases and vancomycin (VCM) for severe cases. However, the appropriateness of this first choice in Japanese patients is unclear. We therefore evaluated the appropriateness of the CDI management guidelines and the incidence of adverse drug reactions. Methods: The electronic chart data at Keio University Hospital between January 2012 and June 2019 were retrospectively reviewed. The response rate, the relapse rate, and the adverse reaction rate of treatment for CDI using MNZ or VCM were investigated according to the disease severity. Factorial analysis associated with the response, relapse, and adverse reaction was also performed. Results: In the 352 patients surveyed, no significant difference was observed in the response rate between MNZ and VCM regardless of the severity of CDI. The presence of cancer was a factor related to the persistence of diarrheal symptoms and older age was a risk factor for relapse. MNZ induced nausea significantly more frequently than VCM, and young age and female sex were risk factors for nausea. Conclusion: As no significant difference was observed in the response rate of CDI between MNZ and VCM, the Japanese CDI management guidelines, which recommend MNZ as the first choice, were demonstrated to be appropriate. Attention to nausea was also suggested to be necessary when administering MNZ to young females.

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Evaluation of the usability of various rapid antibody tests in the diagnostic application for COVID-19

Uwamino Y., Wakui M., Aoki W., Kurafuji T., Yanagita E., Morita M., Nagata M., Inose R., Noguchi M., Yokota H., Hasegawa N., Saya H., Murata M.

Annals of Clinical Biochemistry （Annals of Clinical Biochemistry） 58 （ 3 ） 174 - 180 2021年05月

ISSN 00045632

Background: The usability of laboratory tests related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critically important for the world undergoing the COVID-19 pandemic. The present study aimed to assess the diagnostic usability of rapid tests for the detection of antibody against SARS-CoV-2 through comparison of their results with the results of reverse transcription polymerase chain reaction (RT-PCR) test for the detection of SARS-CoV-2 genomic RNA and with the results of a quantitative test for antibody detection. Methods: Serum samples were collected from 18 patients undergoing RT-PCR testing for SARS-CoV-2. Twelve patients were RT-PCR positive while six were negative. A quantitative test based on chemiluminescent immunoassay and three rapid tests based on immunochromatography were performed to detect anti-SARS-CoV-2 IgG and IgM. Results: All the antibody tests exhibited poor sensitivity at the timing of initial RT-PCR diagnosis. IgG responses occurring prior to or simultaneously with IgM responses were observed through not only the quantitative test but also the three rapid tests. Based on concordance with the quantitative test results, the large variance among the three rapid tests was revealed. Conclusions: All antibody tests were unsatisfactory to replace RT-PCR for the early diagnosis of COVID-19. Rapid antibody tests as well as a quantitative antibody test were useful in the assessment of immune responses in COVID-19. The obvious variance among the three rapid tests suggested limited accuracy and difficult standardization. Diagnostic usability of rapid antibody tests for COVID-19 should be investigated rigorously.

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The real-time reverse transcription-polymerase chain reaction threshold cycle values for severe acute respiratory syndrome coronavirus 2 predict the prognosis of coronavirus disease 2019 pneumonia

Fukushima T., Kabata H., Yamamoto R., Suhara T., Uwamino Y., Kondo Y., Masaki K., Kamata H., Nagata H., Homma K., Kaneko Y., Ishii M., Sasaki J., Morisaki H., Hasegawa N., Fukunaga K.

Respiratory Investigation （Respiratory Investigation） 59 （ 3 ） 360 - 363 2021年05月

ISSN 22125345

The clinical course of coronavirus disease 2019 (COVID-19) varies from mild to critical. We retrospectively examined whether clinical and laboratory findings on admission could predict COVID-19 prognosis. Among various factors associated with COVID-19 severity, our results indicated that the real-time reverse transcription-polymerase chain reaction (RT-PCR) threshold cycle (Ct) values for severe acute respiratory syndrome coronavirus 2 were the most useful predictor of COVID-19 prognosis.

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ステロイドによりヒストプラスマ腫が再活性化し播種性ヒストプラスマ症を引き起こした日本人高齢男性の一例

小林慧悟, 朝倉崇徳, 川田一郎, 藤島清太郎, 岩田敏, 梅山隆, 片野晴隆, 上蓑義典, 宮崎義継, 亀井克彦, 長谷川直樹

感染症学雑誌（(一社)日本感染症学会） 95 （臨増） 299 - 299 2021年04月

ISSN 0387-5911

Incomplete humoral response including neutralizing antibodies in asymptomatic to mild COVID-19 patients in Japan

Takeshita M., Nishina N., Moriyama S., Takahashi Y., Uwamino Y., Nagata M., Aoki W., Masaki K., Ishii M., Saya H., Kondo Y., Kaneko Y., Suzuki K., Fukunaga K., Takeuchi T.

Virology （Virology） 555 35 - 43 2021年03月

ISSN 0042-6822

The pandemic of COVID-19 is still ongoing, and many studies on serum antibodies have been reported, however, there are few studies about asymptomatic and mild patients. In this study, we enrolled 44 COVID-19 patients with relatively mild disease and 48 pre-pandemic controls. We measured serum antibodies against extracellular domain, S1 domain, and receptor-binding domain of Spike and N protein, examined neutralization titers by authentic virus neutralization assay and newly-developed bead/cell-based Spike-ACE2 inhibition assay, and compared them with clinical features. Most of these antibodies, including neutralizing titers, were mutually correlated, and the production of antibodies were associated with low Ct values of PCR test, disease severity, symptoms especially pneumonia, lymphopenia, and serological test including CRP, LD, D-dimer, and procalcitonin. Notably, 87.5% of asymptomatic and 23.5% of mild patients did not have antibody against SARS-CoV-2. Our results revealed the inadequate acquisition of humoral immunity in patients with asymptomatic and mild COVID-19 patients.

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Two case reports of Mycobacterium marinum infection with psoriatic arthritis treated by tumor necrosis factor-α inhibitors

Furuichi Y., Ito Y., Tanese K., Mukai M., Uwamino Y., Hasegawa N., Amagai M., Umegaki-Arao N.

Journal of Dermatology （Journal of Dermatology） 48 （ 2 ） e106-e107 - e107 2021年02月

ISSN 03852407

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CT screening for COVID-19 in asymptomatic patients before hospital admission

Uchida S., Uno S., Uwamino Y., Hashimoto M., Matsumoto S., Obara H., Jinzaki M., Kitagawa Y., Hasegawa N.

Journal of Infection and Chemotherapy （Journal of Infection and Chemotherapy） 27 （ 2 ） 232 - 236 2021年02月

ISSN 1341321X

Introduction: In the novel coronavirus disease (COVID-19) pandemic era, it is essential to rule out COVID-19 effectively to prevent transmission in both communities and medical facilities. According to previous reports in high prevalence areas, CT screening may be useful in the diagnosis of COVID-19. However, the value of CT screening in low prevalence areas has scarcely been reported. Methods: This report examines the diagnostic efficacy of CT screening before admission to a hospital in Tokyo. We conducted a retrospective analysis at Keio University Hospital from April 6, 2020, through May 29, 2020. We set up an outpatient screening clinic on April 6 for COVID-19, administering both PCR with nasopharyngeal swabs and chest CT for all patients scheduled for surgery under general anesthesia. Results: A total of 292 asymptomatic patients were included in this study. There were three PCR-positive patients, and they all had negative CT findings, which revealed that both the sensitivity and positive predictive value of CT (PPV) were 0%. There were nine CT-positive patients; the specificity and the negative predictive value (NPV) were 96.9% and 98.9%, respectively. Conclusion: CT screening was not useful in low prevalence areas at this time in Tokyo, even with the inclusion of the most prevalent phase. Given that the utility of CT screening depends on disease prevalence, the criteria for performing CT screening based on the prevalence of COVID-19 should be established.

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Stability of antimicrobial agents in an elastomeric infusion pump used for outpatient parenteral antimicrobial therapy

Akahane M., Enoki Y., Saiki R., Hayashi Y., Hiraoka K., Honma K., Itagaki M., Gotoda M., Shinoda K., Hanyu S., Hamamura Y., Miyajima T., Ito C., Taguchi K., Uno S., Uwamino Y., Iketani O., Hasegawa N., Matsumoto K.

International Journal of Infectious Diseases （International Journal of Infectious Diseases） 103 464 - 468 2021年02月

ISSN 12019712

Objectives: The long-term stability of antimicrobials dissolved in infusion solution is necessary to establish and spread the outpatient parenteral antimicrobial therapy (OPAT). In this study, we evaluated the stability of antimicrobial agents dissolved in infusion solutions. Methods: The antimicrobial agents were dissolved in infusion solutions and kept at 25 °C and 31.1 °C for 24 h or 4 °C for 10 days in a polypropylene tube or an elastomeric infusion pump. The stability was measured by high-performance liquid chromatography. Results and conclusion: The residual ratio of cefazolin (CEZ), cefmetazole (CMZ), piperacillin (PIPC), and tazobactam (TAZ) at 31.1 °C for 24 h was as follows: 95.7 ± 3.0%, 94.8 ± 0.9%, 102.6 ± 1.8%, and 103.9 ± 3.6% in saline, respectively; 94.7 ± 3.0%, 94.3 ± 1.5%, 106.1 ± 3.0%, and 107.3 ± 2.4% in 5% dextrose solution, respectively. The residual ratio of these antimicrobials at 4 °C for 10 days was maintained above 90% in both saline and 5% dextrose solution. The residual ratio of all the above antimicrobials in an elastomeric infusion pump at 31.1 °C for 24 h was equivalent to that in the polypropylene tube. On the other hand, doripenem and meropenem were not stable in any infusion solution at 31.1 °C. CEZ, CMZ, and PIPC/TAZ dissolved in saline or 5% dextrose solution can be used in OPAT with continuous infusion pumps.

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Identification of b.1.346 lineage of sars-cov-2 in japan: Genomic evidence of re-entry of clade 20c

Abe K., Shimura T., Takenouchi T., Iwasaki Y.W., Ishizu H., Uwamino Y., Uno S., Gotoh J., Tachikawa N., Takeuchi Y., Katayama J., Nozaki H., Fujii S., Seki S., Nakamura M., Uda K., Misumi T., Ishihara J., Yamada K., Kanai T., Murai S., Araki K., Ebihara T., Siomi H., Hasegawa N., Kitagawa Y., Amagai M., Suematsu M., Kosaki K.

Keio Journal of Medicine （Keio Journal of Medicine） 70 （ 2 ） 44 - 50 2021年

ISSN 0022-9717

SARS-CoV-2 whole-genome sequencing of samples from COVID-19 patients is useful for informing infection control. Datasets of these genomes assembled from multiple hospitals can give critical clues to regional or national trends in infection. Herein, we report a lineage summary based on data collected from hospitals located in the Tokyo metropolitan area. We performed SARS-CoV-2 whole-genome sequencing of specimens from 198 patients with COVID-19 at 13 collaborating hospitals located in the Kanto region. Phylogenetic analysis and fingerprinting of the nucleotide substitutions were performed to differentiate and classify the viral lineages. More than 90% of the identified strains belonged to Clade 20B, which has been prevalent in European countries since March 2020. Only two lineages (B.1.1.284 and B.1.1.214) were found to be predominant in Japan. However, one sample from a COVID-19 patient admitted to a hospital in the Kanto region in November 2020 belonged to the B.1.346 lineage of Clade 20C, which has been prevalent in the western United States since November 2020. The patient had no history of overseas travel or any known contact with anyone who had travelled abroad. Consequently, the Clade 20C strain belonging to the B.1.346 lineage appeared likely to have been imported from the western United States to Japan across the strict quarantine barrier. B.1.1.284 and B.1.1.214 lineages were found to be predominant in the Kanto region, but a single case of the B.1.346 lineage of clade 20C, probably imported from the western United States, was also identified. These results illustrate that a de-centralized network of hospitals offers significant advantages as a highly responsive system for monitor-ing regional molecular epidemiologic trends.

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Control of a Nosocomial Outbreak of COVID-19 in a University Hospital.

Sei Harada, Shunsuke Uno, Takayuki Ando, Miho Iida, Yaoko Takano, Yoshiki Ishibashi, Yoshifumi Uwamino, Tomoyasu Nishimura, Ayano Takeda, Sho Uchida, Aya Hirata, Mizuki Sata, Minako Matsumoto, Ayano Takeuchi, Hideaki Obara, Hirokazu Yokoyama, Koichi Fukunaga, Masayuki Amagai, Yuko Kitagawa, Toru Takebayashi, Naoki Hasegawa

Open forum infectious diseases 7 （ 12 ） ofaa512 2020年12月

Background: Nosocomial spread of coronavirus disease 2019 (COVID-19) causes clusters of infection among high-risk individuals. Controlling this spread is critical to reducing COVID-19 morbidity and mortality. We describe an outbreak of COVID-19 in Keio University Hospital, Japan, and its control and propose effective control measures. Methods: When an outbreak was suspected, immediate isolation and thorough polymerase chain reaction (PCR) testing of patients and health care workers (HCWs) using an in-house system, together with extensive contact tracing and social distancing measures, were conducted. Nosocomial infections (NIs) were defined as having an onset or positive test after the fifth day of admission for patients and having high-risk contacts in our hospital for HCWs. We performed descriptive analyses for this outbreak. Results: Between March 24 and April 24, 2020, 27 of 562 tested patients were confirmed positive, of whom 5 (18.5%) were suspected as NIs. For HCWs, 52 of 697 tested positive, and 40 (76.9%) were considered NIs. Among transmissions, 95.5% were suspected of having occurred during the asymptomatic period. Large-scale isolation and testing at the first sign of outbreak terminated NIs. The number of secondary cases directly generated by a single primary case found before March 31 was 1.74, compared with 0 after April 1. Only 4 of 28 primary cases generated definite secondary infection; these were all asymptomatic. Conclusions: Viral shedding from asymptomatic cases played a major role in NIs. PCR screening of asymptomatic individuals helped clarify the pattern of spread. Immediate large-scale isolation, contact tracing, and social distancing measures were essential to containing outbreaks.

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Pro108Ser mutant of SARS-CoV-2 3CLpro reduces the enzymatic activity and ameliorates COVID-19 severity in Japan

Kodai Abe, Yasuaki Kabe, Susumu Uchiyama, Yuka Iwasaki W., Hirotsugu Ishizu, Yoshifumi Uwamino, Toshiki Takenouchi, Shunsuke Uno, Makoto Ishii, Maruno Takahiro, Noda Masanori, Mitsuru Murata, Naoki Hasegawa, Hideyuki Saya, Yuko Kitagawa, Koichi Fukunaga, Masayuki Amagai, Haruhiko Siomi, Makoto Suematsu, Kenjiro Kosaki

（Cold Spring Harbor Laboratory） 2020年11月

SARS-CoV-2 genome accumulates point mutations constantly. However, whether non-synonymous mutations affect COVID-19 severity through altering viral protein function remains unknown. SARS-CoV-2 genome sequencing revealed that the number of non-synonymous mutations correlated inversely with COVID-19 severity in Tokyo Metropolitan area. Phylogenic tree analyses identified two predominant groups which were differentiated by a set of six-point mutations (four non-synonymous amino acid mutations). Among them, Pro108Ser in 3 chymotrypsin-like protease (3CLpro) and Pro151Leu in nucleocapsid protein occurred at conserved locations among β-coronaviruses. Patients with these mutations (N = 48) indicated significantly lower odds ratio for developing hypoxia which required supplemental oxygen (odds ratio 0.24 [95% CI 0.07-0.88, p-value = 0.032]) after adjustments for age and sex, versus those lacking this haplotype in the canonical Clade 20B (N = 37). The Pro108Ser 3CLpro enzyme in vitro decreases in the activity by 58%, and the hydrogen/deuterium exchange mass spectrometry reveals that mechanisms for reduced activities involve structural perturbation at the substrate-binding region which is positioned behind and distant from the 108th amino acid residue of the enzyme. This mutant strain rapidly outcompeted pre-existing variants to become predominant in Japan. Our results may benefit the efforts underway to design small molecular compounds or antibodies targeting 3CLpro.

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受診・治療中断を繰り返した患者への服薬継続支援

戸蒔祐子, 宇野俊介, 藤澤大介, 矢永由里子, 小谷宙, 西松直美, 上田裕美, 根岸昌功, 河村祐貴子, 河野小夜子, 和山郁美, 滝口紗彩, 的場由木, 浦澤智佐, 小倉由美子, 新田七恵, 佐久川裕美, 上蓑義典, 藤原宏, 長谷川直樹

日本エイズ学会誌（(一社)日本エイズ学会） 22 （ 4 ） 452 - 452 2020年11月

ISSN 1344-9478

受診・治療中断を繰り返した患者への服薬継続支援

日本エイズ学会誌（(一社)日本エイズ学会） 22 （ 4 ） 452 - 452 2020年11月

ISSN 1344-9478

Comorbidities associated with nontuberculous mycobacterial disease in Japanese adults: a claims-data analysis.

Shunsuke Uno, Takanori Asakura, Kozo Morimoto, Kimio Yoshimura, Yoshifumi Uwamino, Tomoyasu Nishimura, Yoshihiko Hoshino, Naoki Hasegawa

BMC pulmonary medicine 20 （ 1 ） 262 - 262 2020年10月

BACKGROUND: Nontuberculous mycobacterial (NTM) lung disease is one of a growing number of chronic health problems that is difficult to cure in aging societies. While it is important to be vigilant about associated comorbidities in order to provide better patient care, data on the prevalence of comorbidities stratified by country or region are scarce. We aimed to elucidate the comorbidities associated with NTM disease based on Japanese health insurance claims data. METHODS: Cross-sectional analyses were performed using the claims data for 2014 provided by the Japan Medical Data Center Co., Ltd. Patients aged 20-75 years with ≥3 claims associated with NTM disease were identified and matched to 10 sex-and-age-matched controls that had never made a claim for NTM disease. Thirty-one comorbidities previously suspected to be associated with NTM disease were selected, and the prevalence of these comorbidities compared between cases and controls. RESULT: Overall, 419 NTM patients (134 males and 285 females) and 4190 non-NTM controls were identified from the JMDC database. Aspergillosis, asthma, chronic heart failure, diffuse panbronchiolitis, gastroesophageal reflux, interstitial pneumonia, lung cancer, cancer other than breast, lung, ovary, or prostate cancer, and rheumatoid arthritis were associated with NTM disease in both males and females. Chronic obstructive pulmonary disease was associated with NTM in males while chronic kidney disease, osteoporosis, and Sjögren syndrome were associated with NTM in females. CONCLUSION: NTM disease was associated with multiple comorbidities that should be considered when providing medical care to individuals with NTM disease.

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Acute onset olfactory/taste disorders are associated with a high viral burden in mild or asymptomatic SARS-CoV-2 infections.

Kensuke Nakagawara, Katsunori Masaki, Yoshifumi Uwamino, Hiroki Kabata, Sho Uchida, Shunsuke Uno, Takanori Asakura, Takeru Funakoshi, Sho Kanzaki, Makoto Ishii, Naoki Hasegawa, Koichi Fukunaga

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 99 19 - 22 2020年10月

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Accuracy and stability of saliva as a sample for reverse transcription PCR detection of SARS-CoV-2

Uwamino Y., Nagata M., Aoki W., Fujimori Y., Nakagawa T., Yokota H., Sakai-Tagawa Y., Iwatsuki-Horimoto K., Shiraki T., Uchida S., Uno S., Kabata H., Ikemura S., Kamata H., Ishii M., Fukunaga K., Kawaoka Y., Hasegawa N., Murata M.

Journal of Clinical Pathology （Journal of Clinical Pathology） 74 （ 1 ） 67 - 68 2020年09月

ISSN 00219746

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