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Promod K. Mehta,Ankush Raj,Netrapal Singh,Krishna B. Gupta,Dhruva Chaudhary,Aparna Yadav,Anil Chaudhary,Kshitij Agarwal,Mandira Varma-Basil,Rajendra Prasad,Gopal K. Khuller 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.1
Purpose: Diagnosis of extrapulmonary tuberculosis (EPTB) poses serious challenges. A careful selection of appropriate gene targetsis essential for designing a multiplex-polymerase chain reaction (M-PCR) assay. Materials and Methods: We compared several gene targets of Mycobacterium tuberculosis, including IS6110, devR, and genes encodingMPB-64 (mpb64), 38kDa (pstS1), 65kDa (hsp65), 30kDa (fbpB), ESAT-6 (esat6), and CFP-10 (cfp10) proteins, using PCR assayson 105 EPTB specimens. From these data, we chose the two best gene targets to design an M-PCR. Results: Among all gene targets tested, mpb64 showed the highest sensitivity (84% in confirmed cases and 77.5% in clinically suspectedcases), followed by IS6110, hsp65, 38kDa, 30kDa, esat6, cfp10, and devR. We used mpb64+IS6110 for designing an M-PCR assay. Our M-PCR assay demonstrated a high sensitivity of 96% in confirmed EPTB cases and 88.75% in clinically suspected EPTB cases with a high specificity of 100%, taking clinical diagnosis as the gold standard. Conclusion: These M-PCR results along with the clinical findings may facilitate an early diagnosis of EPTB patients and clinical management of disease.