• 検索結果がありません。

285-383

N/A
N/A
Protected

Academic year: 2021

シェア "285-383"

Copied!
99
0
0

読み込み中.... (全文を見る)

全文

(1)Kekkaku Vol. 93, No. 4, 2018. 001. 285. K¨à¯¿šGb`碔E in vitro B‡ì 8P. 002. ßøCo¯¿š3)E.3P superoxide dis! mutase A&sodA'm+À\%YXi\iZF ]_à. , œ\1,2'!’,. ä9 ^ŽÀ1'!eæ îg2'!W, â®3'! G‹ I²À2'!íò hÇ4'!ÔX ó’2' þ¼Áeþ‚þ‚qn‚¤•vLù.µ¾¡~¤•Ï ! ܃þ‚þ‚qnĂô²¤•v¹š‚N[2'! ³eKq°.µ¾Kq3'! Æāniv‚þ‚qþ‚4' 1'. 81'!‘#. ¦1'. /—ÐÀnvþ‚‡ìÕv1'! 2' W{4þ‚Kq9vI&«“Œ9v‚N['. K¨à¯¿šG!@eYhcU%]L II @UÖF¹ (G7JE)ßøCo¯¿šBG!16SrRNA m+ÀAk ÿ7FEBG3)0´:B*P4C0!NQA+P UE‡ì6!¢sFfQEF?AfiaêL;FûïÝ FðÙE‡ì6!?ËàF‡ìÕS÷48"Ã=>G! =JjÓFª×BG house keeping gene B*P rpoB m+ÀC hsp65 m+ÀF\%YXi^zåS_+Aš Mycobacterium avium complex&MAC'0碔C˜ Ë3)0±RQP4C0ü+"6/6›=!lateral gene »6A+P4CS MAC †ÊFèÑ@L MAC S‡ì transfer EMP rpoB m+ÀðIˆ-Fu>àKÂ*5 5:=eW^F@èPFKbðÙB¥Î6=";4Bç QA.O֏ 2 m+ÀF\%YXi^zåF¡w0p ¢”C˜»6A+P4C0K¨àC‹R?A+P/£ $:9šË03)B1D+[%^Kú»8P"4F=J 26="H9!MAC 0b`碔Eé%6!/@Û; x$G superoxide dismutase A&sodA'm+À\%YX 8P4C S - À § H ™ B € < 6 ="Mycobacterium i\iZS±+!ßøCo¯¿šFšË3)E.3P] avium subsp. hominissuis&MAH'0碔Eé%8P _àS£26=" (ST)1'jÓ£ýMONc5Q=ß 4CGRýFú»B÷Þ5Q!¯Rý &CR1' ¯ýEM? øCo¯¿š„&288 „'E@+A hsp65 m+À!rpoB Añ}5Q="碔F¹UYJZF\Vg¿Sі8 m+À!sodA m+ÀF\%YXi^zåS±+!;Q< PCé%0]kE©Ò6="碔0B"&Eú»8P QFm+ÀE@+A 1ÌS½á6šË3)S±?= C!MAC L¡~šG'62õØ6="4FõØG(é ,-B!m+ÀŠFšËp$d&M. abscessus. subsp é%6=ÅE<JNQ!碔F|FšSÑ|8PC÷ GjËHB'SE6="2'rpoB m+À!hsp65 m+ 1D/?="碔Eé%6=¯¿šG THP!1 ^`e ÀFŠBlD?=šËC3)5Q=š„E@+A£2 YhcU%]EM2nÚ5Q="4QNF¡w/N!K S±?="(¡w) ¸Í3)BG M.abscessus 0 67.0%# ¨à¯¿šGb`碔E CR1 L\Vh0_iaYÉ M.fortuitum 0 14.6%#M.chelonae 0 10.1%#;Fû0 Sy6A‡ì8P4C0R/?="b`碔G¢fB 8.3% SëJ="rpoB m+ÀC hsp65 m+ÀBšË0p CR1 Sy6AHãMLlMSQH-!;QNS‡ìV­ EŸRP‰öLmöErTB+P4C0!NQA+P" $6D/?=FG 8.7% B*?="rpoB m+ÀC hsp65 m+ÀBp$6D/?=„F,> rpoB m+ÀF\% EK//RN9Ã=>05=!¥G!K¨à¯¿š0‡ YXi^zåE.+A M. fortuitum C M. houstonense ìV­°Sa_6A?Ëà‡ìS÷46A+Pu> DO0´:B*?=Zg%dC!hsp65 m+ÀF\%Y àSȶ6A+P" Xi^zåE.+A M. septicum C›tšËFDO0 ´:B*?=Zg%dB sodA m+À\%YXi^z åEMPDO0u>B*?=" (¡l) 3 @Fm+ÀF+ 9QFðI²R:BKšË3)p$dG 90% í¬Cþ 1D·S<JD/?="6E M. fortuitum L M. septi! cum S3)8PºEG sod A m+À\%YXi^Fz å0]_CDPu>à0*P".

(2) Ä£ N 93 ª N 4 Ù 2018 r 4 Æ. 286. 003. Ó¼srjn LL!37 D MAC ¼CK7PÓ ¼§6C=->. 004. r~kZw^dCMP&HãL6'Ä£)! .MF Mycobacterium avium complex )p ›ûD‚ë|¤¥aā9. é ˜œ1'!ƒg +1,2'!³T £’3'! &= Ëo4'!\O= ]ü5'!ª• Ûā2'! gn U6'!Ce kÖ7'!c† '8'!-ô 'S1'. 4Ð /I¬1'!. Õè2'!´b »3'! dŠ zmë1'!(” ‰z1'!v: ›ð3'! Ce kÖ2'!Á\ ]11,4'. ‘Í“ì¥M¥Îµ¯$“÷$V}|]%n˜¥1'! ½²Y‘¹€ò«e€h%2'! -¦M¥Îµ¯$¬>)n˜3'! Ý¥|Œ±Ôf‘Í“|Œ4'! Á’M¥ˆ¥€¬>5Ñe€h%5'! =ˆ¦e€h%6'! þï|Œ7'! fŽM¥8'. Ä£Ä£É¶$8JÑ€1'! Ä£þï|ŒÎµ¯n˜2'! Ä£þï|ŒÎµ¯¢˜3'! Ä£Ä£É¶$4'. *–a+Ä£)&Ä£'.MF Mycobacterium avium complex&MAC')D¬>B,C.->!p›û0À7 5QP"p›ûD|¤¥aBj[C=->!4QH?C H2D‰Ü0B5Q>-P"6/6!¬>B,SÔW7 *tÂ$– a+p m Ó ¼ s r j n ? , P cathelicidins Ph€o^óC­6>EG@TA‰Ü5Q>-B-" &LL!37'EŠxâ¼CK7PÓ¼§6LÓ¼—@DE ɶC.->!HãL6Ä£.MFu MAC )C.3P – å Ÿ 0 ‰ Ü 5 Q > - P 0 Mycobacterium avium “÷ð¦‹Lÿøh€o^óS{a@6;•¥¦‹D complex&MAC'¼CK6>E~’?,P"ޟ MAC ¡wS–í6!r~kZw^dā9CM<>!¬>B, ¼CK6>DÈhS.4B<;" *Š‹+u MAC )«õ ?wÌ0F–6>-Ph€o^óSQæ6;" *Š‹+ù š¡D 22 ¨&M.avium 12 ¨!M.intracellulare 10 ¨'S "<%6;&Hã L 6'Ä £&5 ©'. M F u MAC Ÿ-Ó¼—@ LL!37 D°ö«SBIÚR8; 96 Ãr )&4 ©'D¬>B,Dt|v{€Ï`ozqW€ˆ÷ }%mSå7"LL! 37 DGä”?D MIC D •S¤q {/N!}%a%vX^~iXe^by€‹CM<> 7P"ޟŸ-PÓ¼—E CAM#RFP#EB#SM#MFLX p›ûB,S<O!6;"jC!©¢ îD@9Dý† D 5 —ãC.->Èh7P4@@6;"*ę+LL! 37 D?‡•6;âŒDS¾„6>š‚6;"<O!6;B P l ? E @ 22 ¨ C . - > MIC E 20µg/ml ‚ * ? , O!Ó¼§6E÷-4@0ñß5Q;"6/6B0N! ,€„/Nh€o^óSZ!6>!m{rb€#¤SÖ -!J^~vm_zqW%ó§‚9¯?” ah€o ޟÈhSÖ<; 5 =D—ã@>C.-> LL! 37 S^ –7P4@CMO™ B MIC D_”SqJ;"*Ä­+ ^ói`SÖ<;"*ę+9Q:QD¬>B,/N 2000 ‚*Dh€o^óSi`7P4@0?1;"Ä£ LL!37 D MAC ¼CK7PÓ¼§6E ÷ - 0!MAC p›û©¢ îD?E plasminogen L‡JBADÅ® )ð¦CŸ-P—ãDÓ¼§6SF¸7PåŸ0qJ h€o^ó0X;6>-P4@0’N/CB<;"H NQ;" ;!NADPH Z\bi%fL v!ATPase![k{bc€ LlWqY€b€BADç¼h€o^ó@-<;qU `g%xCºä7Ph€o^óKX;6>-;"Ä£p ›ûâŒD?E{ug%xSÔW7Ph€o^óL{ gg%xC®HQP–2‚āØA0X;6>-;" MAC )p›ûC.3P©¢ îD.MFâŒDC. 3Pj†aBh€o^ó¿E!Ä£C.3Ph€o^ó ¿@’N/BàEÊNQB/<;"9Q:QD¬>j† ah€o^óSÈæ6;ę!MAC )C.3P©¢  îDC.->3ú¨Dh€o^óSÊ!74@0?1 ;" *Ä­+ ‚*DęE!Ä£.MF MAC )p›ûD r~kZw^dā9CM<>!Ä£.MFu MAC )¬ >B,?j†aCwÌ6>-P‚ëv%[%Si`7 P4@0—s?,P4@Sñß7P" (y‹·iɶ õ)Žb r&}(ˆ˜M¥ÇҘ¥×á' !³Vƒê &Ä£þï|Œ|¤0R€' !:=œŠ&0TÉ ¶0Tɶ$|¤€'.

(3) Kekkaku Vol. 93, No. 4, 2018. 005. lu|Pi÷

(4)  -9gW. O c`1 :1$‚ B1 !Œ "#15$ “˜1%€ ~1,2 &'( 01,2 ()*@x+,-†z.,-/01p1 I2;3;3456„3/7/0€-932. :M;< 88 <{3. =>?,-1@AP ÷ BCu|&t=

(5) DEFGHI)Jk{XKP ÷ L4S,lu|k{XKP÷. MCryo!TEM

(6) 89NvgO Cryo!TEM ÷ PQZQRS89NvTUVW‹ XY XZ [\]v^OS_`<,-]a b 20 c d>? Cryo!TEM ÷ X8- 9Nv]eZOgWOS_ :f‘\wx;gMATCC No.h,- H37Rv M27294iM. abscessusM23006iM. aurumM23366i M. austroafricanum M33464iM. avium M25291iM. celatum M31150iM. celatum M31151iM. chelonae M35749iM. chitaeM19627 iM. fortuitumM11440iM. fortuitum M6841iM. gilvum M43909iM. gordonae M14470iM. intermedium M51848iM. intracellulare M13950iM. marinumM927iM. scrofulaceumM19981i M. smegmatisM19420iM. ulceransM19423iM. xenopi M19520jwxhMiddlebrook 7H9 bCM0.05% Tween 80ADC enrichment NkXb‰O2.5% glutaralde! hyde XlLmnoqr M0.1 MipH7.4 ?(s_ t+€3/0uv"3/01MNIPS ?L4S, Owo x y z y { | } ] ‡ > ? JEOL JEM! 3100FFCi JEM!2200FS X÷  ~€OS_ Fiji/ImageJ ]‡>?€‚2ƒX8J„8I perimetericircularityiaspect ratio ]3L †Oc] c‡XgW]ˆ‰S_ :,\‹ ; ƒŒ8J„8Icircular! ityiaspect ratio rā±SDM,-Ž 0.605±0.097 M0.543μm2.253±0.673M2.645μm0.634±0.136 M0.5263.593±1.293M4.376XZ‰S_8J„Žc ]H?O?>S_OPO8IŽY‘c] = >?V8’\ “”#UI/U?ML/SgŽ 1.2 PQ 9.0 •Xc‡X;Y–“”‰?>S_L/S gT 2 —˜c8IŽ?–™šXZ‰S_‘w9 dcXŽ L/S gT 3 —ƒX›yq—ToāUXZ [\TœžRS_ MCryo!TEM ÷ Ž NIPS \†‚ŸD‘f Y/0 ”QD G¡x£.¤¥¦>÷

(7) #§ˆ OS. 287. 006. h,-¨YL =© ª”q%x

(8) #Rm«. %¬ ­®1,27ƒ š‘1V e1,2 ¯ °Š1,2E' =2_² ³´1µ' ¶_2 }·;3„3p1 \÷ˆ¸x+¹÷n4uvT}º»n4•¼/0p2. :M;h,-¨Mnontuberculous mycobacte! ria½NTMYLwx\O?¾Š DNA! DNA Hybridi! zation xMDDH x”¿T‡>QR?> TDDH xŽ,?]À­ dsÁ [\Ž^O–•S dL ‡]ˆÁ _‘wÃS”›YLx\O?G žR?> MALDI!TOF MS ]‡>Sª”q%xŽ Ä%‡T?– 6Å8]‘R dLÆaXZ _ `<MALDI!TOF MS ]‡>?NTM YL =© ‡¨W]ˆ‰S_ :wx;ŽNHO T}º »n4 =>?qŽžRS M. avium subsp. hominis! suisMnÇ10M. kansasiiMnÇ18M. abscessus subsp. abscessus MnÇ11M. abscessus subsp. massiliense MnÇ7]‡>S_*ȍ\O?ÉÊ|! ËFÌx ]ˆ‰SmMALDI!TOF MS MBruker Daltonics ¤. ?Ä%]ˆ‰S_žQ M. abscessus =>?Ž 10 8MM. abscessus subsp. abscessus M. abscessus subsp. masilliense Í 5 8InQ™mY L=

(9) DÎcYL]m«OS_”=score1.7 —ƒ] YLÆa\OžQ score2.0 —ƒ]W‹¨%>YL ,\O?m«OS_ :,;Bruker In =©  c Y L  ŽM. avium M100Ï M. kansasii M88.9Ï M. abscessus M100ÏXZ‰STscore2.0 —ƒ8YLŽ M. avium M30.0Ï M. kansasii M72.2Ï M. abscessusM75.0ÏXZ‰S_Îc•X‘ DOSŽM. avium X 40.0ÏM. abscessus X 0Ï XZ‰S_M. abscessus =>?ŽInÐÑm cYLT Bruker InXYL 75.0Ï PQ 100Ï ¥\ƒT‰S_OPOÎc ÒO?ŽYL , 2 dÎcTÓÔO?=#dsŽÕ^XZ‰S_ :‹ ;NTM cYL =>?score2.0 —ƒW ‹#RXm«]Á \ M. avium YLTUVK– `m\tIn]ÐÑOYL]ˆÖjˆTZ _M. abscessus ŽÎc×>

(10) #„ØŽÚ¨ . ×TZ SÛÎcYLÁ [\ŽÜ’݁†3 Þ ˆ”[\XZ _OPO`<wxXŽÎc•X! À”dAŽÕ^XZ‰SSÛ`mŽ[“MßÄ %

(11) #Îcq–TÆaP]WÁ jˆTZ _.

(12) °Œ ) 93 ‘ ) 4 à 2018 E 4 ±. 288. 007. fk'j2 Hµx§ Mycobacterium ul! cerans subsp. shinshuense HNŽ]chˆ û. 008. °Œ§¼µ T cell epitope |uH HLA class II °Äˆû. 8 »M!øn ñQ. øn ñQ1)!zt {i2)!Í ó3). Æy”ý財ã”ýõºY. Æy”ý財ã”ýõºY1)! ÆyUy™¾;¢Uy2)! °Œqd‡ZÞÔUy3). fk'j2 I!úXej[1QJZ'_aijXW. îGLù:B/TPXU]WÚèíD;T”ýèC. S!WHO GQS*¸MRUF/D'U+Hv@D:B õnlRG.7RUB/T" fk'j2 Hµx§I! gY^i\amÎù¼Ï§HvÜC.T Mycobacte! rium ulcerans C.S!ebG1/BO 1980 EG0n³ CâNB^Å9U>"PXU]2R*x9U>§I! DNA hybridization `GQS M. ulcerans G¦NB¨/ 3!/5@2HöíGiFq/3´RU>>N!M. ulcerans subsp. shinshuense(o!M. shunshuense )D hW6RU!Rá÷ ShT! P D:B9„9U>"¥fï/ 8DG!ÉâHL´2RÇBLC!ebG16Tfk' j2 “Ù2R*x9U>HI;KB M. shunshuense C.?>"=8C†&I!M. shunshuense HA/Wšß :!=H7G®ƒWiR2G;T>NG!ShT! P 1QJ þÆQS*x9U> 26 H M. shunshuense ~ç\x÷ H]chì^WÛ?:!$HgY^i\amÎù¼Ï§ DHNŽ]chˆûWÁ?>" L<!ShT!P H’þ]chW¯3:!$HgY^i\a mÎù¼Ï§D Average Nucleotide Identity `GQT NŽW18F?>D8V!99% oëHÂ/ÿ>öW×: >"ÖG!ShT! P HþBH`md\Ø^'bJ(CDS) W$HgY^i\amÎù¼Ï§H CDS DNŽ:>D 8V!96 ·3 M. shunshuense Ap5GMRU!=H. GI ESX! 1 \O­P MCE `md\ØFEUµöG• r;TxÒ3–LUB/>"L>!M. shunshuense ~ç \x÷Hv~—%«G—A5­=ˆû2RI!1)M. shunshuense I M. ulcerans DpFT*­=ªW¬÷ :!2) ebH 5 @H,uG16Tl'[kF”ý$7G 3›4B/T„Fö3×È9U>" ‡w‰£>²¡Ù% e oÐ1#æg œà2# } 6m2#üt !ā1 1 Æy”ý財㠔ýõºY#2 ©Ý((y s ²¡y ʧ\n. ,l5-°Œ§G&;Tj|€<GI§¼µG&;T CD4 vö T cell 3•r;T"=HéÊF™äD HLA r7Ò«DH•‚WiR2G;T>N!I°Œè“ÙW &êD:> HLA class II typing ŸJÊaj|ˆûWÁ /!°Œ§¼µH T Êa epitope |uWò#:LS: >"e²¡CI!‹ T cell epitope H HLA ½"öWiR 2G;T8DWl5D:B!“ÙªGÂV:C´RUT class II haplotype ëH HLA!DRB1#DRB3#4#5#DQ allele Î[G@/B¼µ T cell epitope |uDHÿ¹Ë t¤:Wˆû:>" ,_`-†&3˜GLS:>_`W}t:!HLA L¶{ WÓRD:>ˆû­Wt/B!HLA class II D peptide DHÿ¹ËtH¤9Wò#:>"8Hˆû­CI!HLA class II D¼µ peptide JDWpÄ`md\ØD:B KwÊa÷GSkL¶:!ÊaSkH HLA L¶{W flowcytometer C3{‚;T8DGQS!HLA D pep! tide DHÿ¹Ët¤:WTƒ;T" ,° $ÀÌ-I°Œè“ÙªGÂV:GCNRU> HLA!DR!DQ haplotype 3^'b;T HLA!DR(14 ܀) !HLA! DQ(7 ܀)G@/B!ÚuF T cell epi! tope 9 |uDHÿ¹ËtH¤9Wò#:>"8H° W —G‹ HLA!DR!DQ haplotype G1/B!T cell epi! tope W¤54×:0T HLA! DR#DQ XjkWò#: >"CFP!10 H C +¨c|uIZôH HLA! DQ allele Î[G¤54×9UT8D2R!%sF HLA haplotype £1H T cell epitope C.TD×È9U>"eLSCI 8ULCG?RU>° HŠuW^Å;T" ,‡w‰²¡Ù- Õ¿Ò(-H(ssz­) !@z åÑ(;¢(ð€r7).

(13) Kekkaku Vol. 93, No. 4, 2018. 009. 289. 0J • :

(14) 3  9&€;R€ RNA Œ˜N. _ƒ xf1% "V W.2. x11! ,D¦1. ’†# $%!5E†&{  ’†# $%!2 1. 'o()€ RNA*miRNA+y[Ž] q- b[.2&/9‹0 12”3zI.4. 56–Ž7 M89:;lP<=5>5 ?@ A œ • B C D -

(15)  2500 E ¢ P < = 5  miRNA RF<:

(16) 3 9&G qz rH I miRNA q-JK:LMN==OPEzI rH/ Q€FR[S5E>Ty*€ Un3:V? 'ƒ )iW›X ™YZ#$j[C\]^_ `a(cdefŸ d5Kgh i€‘šjk*IGRA lm/n ;. RNA oZpq \r/5£`A/ sF<; RNA TM/ ?7t.Cu1n= miRNA "v<w xy z.Illumina { small RNA •|}CD~ ~€w4 x NextSeq 500 • 5  x BaseSpace ONSITE • 5 miRNA Œ˜ q-‚6 xy ? ' ā)n„ IGRA 3e*n=3 —3e*n=3F< 1 †‡V ˆ 4000 ˆ€‰ d 9Š 1000 E¢ mature miRNA p¤.R 5q-‹‚6: UnDVˆŒ8 5 Ž miRNA : IGRA —3eD ÷.q-DVy ?IGRA 3e*n=68—3e *n=41F<4L‘J’‡ • €“‡K] RT/ PCR*miScript PCR”QIAGEND;R miRNA Z ā xy 9Š98 1 R miRNA :÷. IGRA —3•DODVy ?LhJ’‡*n=237D –a¡#0—)‚˜™ š@/5xy5 ? ' §) 0J • 5;R miRNA Œ˜q-‚6 x IGRA 3e›ˆ—3eDqāC miRNA LM/ ?œz qz÷‰ -

(17) ^_`.4 5gž“}†R)‚ Ÿ  ¡5‚6/€/5Un3 N<. –aI? 'v#Z¢c$%e)Nguyen Thi Le Hang”Do Bang Tam”Pham Thu Anh”Vu Cao Cuong”Pham Huu Thuong. 010. ^¦. c‘Ž]£CqG3 ¤ V02 •Ž] ~. §¨1©‡. „S2¨^. /m3. Kªa«o;¬t$%!w5|{­¤®1 -!`¯°a$%!9&{2 V±K—kH—$%!X²a—}3. '+³´.)KªCqG3 Q÷}0— ā CqG3 ¤¶·D¸4N=CqG3 ¤ 12¹ º' 8´K>c‘Ž]£•*ºV02 • qL/ ?V02 •.?I 15 ¶ ¤ ;»_ ]‚6/•gu¼.›9½¥‚ŠBŽ]£ •u¼.› V02 •¶Ž][e3‚Š j· D‚¾I? 'ƒ ) Illumina HiSeq .›ˆ Pair! end D»_]p¤ d ?P¶»_]p¤ ¤y¿¤ ¶ H37Rv .€}ÀÁ/d<= ~€C u¼ I9.›ˆV02 •¶ÂD‘ì~*SNP UÄ9½¥ UÅ/ ?V02 • 15 ¶v V02 • ¤ 11 ¶.R 5;»_] SNPs u¼/V02 •.·¢X.·<= SNPs*V02 •e[~ eZ/ ? ' āÆÇ)○V02 •¶ÂD»_]u¼É 15 ¶+ 2 F!~÷‰.›ˆK>u 2 R.}F= ?V02 •¶8 3 ¶+|_Ê3¶DVy :9=< 3 ¶+|_G3˓Ž]~ÌÍD uB SNPs s|_G3 V02 • 12 ¶+ 9:}Fy ?|_Ê3¶ºÎ 12 ¶+N< . 4 Á‡†.}F= ?V02 •¶ 15 ¶Â SNPs + 51 F!DVˆV02 •¶+¢X9ÏF<]s/ sÐÑN=}0—UÅF<Ò = 4ˆÓ. 93 ÷I¤¶•DVÆÔ<= ?○V02 •¶ BŽ]£•Ž]u¼ÉV02 •¶+ 113 F!  V02 •e[vcÕ[~ Öy5 ?V02 •e [vcÕ[~VŽ].R 5“_ØÙ K[ UniProtKB .5Ún UÄ ā53 Ž.R. 5Ún:Š<F.y ?53 Ž8 ¤=+ .˓IŽ]: 16 ŽVˆŒ8 4 Ž:zÛ3 .˓IÚn ÷/5 ?4 ŽzÛ3˓Ž]  8  pknI Ž ]   · :  ¤  = +  negative regulation Ún Öy54ˆpknI Ž]~.› ˆØ3*ID ¤=+=r€gÜÝg D ¤=+=r‹0Y€Þ.FI hy! pervirlence p:‚¾N=5 ?9=< āF<V 02 •e[~8 pknI Ž]~: V02 •¶  93.ߓ/5 Un3:VÆÔ<= ?.

(18)  E 93  E 4  2018 g 4 . 290. 011. BCG / THP!1 €

(19)  +. ‘ •1wv u2 RDāāvā1 qDā|—xāv2. 012. ¨8©ªR)«1¬Z­®¯mt1K; BCG 6°:] 7"Gc  X„. D} S‰1,2[ š† Vs6. %h3±² ā4,5. ³´DāDāµ¶‹ā4R—˜·¸¹r+yāzŠ1 ³´Dā¶āv.H™º—˜»E72 Q¼DāfAā—˜-|āzŠ3 ”/½—˜- +v4 ”/½—˜-/'¾v5 ›`Dā#¿‰T/½»E7ÀD ?Á7 v ˆ6. ‡XOsteopontin OPN!"#$āM K%&' (b)* +2,-./!012345678/ ‡XÃÄ^!@Å`¨ÆÇ?©ª@( B„~ +(9:;<&'(= OPN K!ƒ>$?@AB÷ „1J;\&BCG 1¨8©ªR)«1 ThyX B® := ELISPOT / C2DE75F4+€ ¯mtbn;Gc 6°:]%7"bU;dGBlm &GH3IBJ; /23456781K;aL (=<c B„~„1J;dGB‡XG(9‘ª C•È›BMÉ1z^BÊ =< XMN?7€Œ5O IBWP(=<OPN ! T €& D

(20) Q?1RJ;GSTU;<OPN ! Â}~Ãi7H10!ADC ËYkL&/6°bn= BCG To! kyo f !fG ThyX Ìmtf pThyX„~0 RNA V4W1K;zX/Y=ZD[Q?Rv BN](=<RNA! seq ~1K‚–#/mt˜ LZ; %œ]J;%Ž^Z_4

(21) `7a1-JbU;<cd /eVGA(l$t€f THP!1 B÷:PMA gh ¬Z­BN](?`©EDÍ RT! PCR ~BÊÎdG i BCG /1K;0Qj FLk;:!-Jj N! /mt˜ ÏBzÐ(=<iii/Ï Ñ~U=¬Z­ half OPN +Blm(=<}~PMA ghi THP! B BCG Tokyo f1_d(=fBÒ,(=<iiiii/Ò ,(=®¯mtfBo>kLk;:! 7H10! ADC ËY 1 €1 BCG /bnk’&*€XopKq kL/k’(6°:]Bz^(=< /€Brs1÷:=<OPN Ilmt! ELISAWest! ern blot WBuvwx>~ IF/Py=<ELISA ÂGŠmÃRNA!Seq ~ pThyX /! dfrA /!Full length G N!half OPN Bz](=<OPN z] G gcvT mt%&'(9:=<‡}H1 folD metH 1! N!H{_|x} +x> O!17-Jv{_ mt!ÓÔ(9:=<dU~ dG„~ ThyX Ì |x} +x> 34E3b~1 C 8{_|x} +x mt1K‚THF→5u10! CH2!THF→THF C•È› > ab8488 B÷:=<WB /!PMA gh THP! !7"bU5u10! CH2!THF „~;Ö< C•È›! 1 €!pgh€1ny OPN mt&'%e€~U “'bU;dG%$9bU=<dfrA BÌmtbn=G =<FL! OPN 66kDmtGG1 C 8-Jj OPN d×6°%ØO17"(=%gcvT BÌmtbn9 %z]bU=<34E3 x>1K‚ N! half!OPN z]/ 6°:]1ØOZ{Ž!e€~Z„ =<€& dG„ ƒ=%O!17 x>/! FL! OPN („z]/ƒZ„ ~ THF Ûܘ% 6°:]1I(9:;÷i =<ELISA /!BCG /1K‚ FL! OPN % 4 c‡/ (%ÞßbU=< ! 1 c‡ 5!6 j6(=<‡} N! half!OPN ! BCG p//! 4 c‡1 11 j6(BCG //! 20 j 6(=<IF /!34E3 1K; N!half pKq ab8488 1K; C! 8mtˆ‰mt%lmbU=<Šm‹Œr s1K‚ PMA gh THP!1 BCG /1K 9 OPN zoUBŽe(=<+bU= OPN -JGtB O ‘’1“:9!‹i ”F/k;<•–‚—˜ !c‚——˜™mš AMED›œG žVŸ7 3B ÷(==¡@( 4RX?¢1£J;—˜ 1K‚¤¥B¦§=<.

(22) Kekkaku Vol. 93, No. 4, 2018. 013. 291. `<2y'|gâ¬<ì DNA €bkI§ ³$ 1 r†6D¤<ëH÷9@èÈ. —– p2!Îì éA!‡W ï i©!ºy á4. È!õö. ˆh!. ÿ꼌¿ûÖÀŠ•ÐÂ?³ij&ðSèÈi j&. -ڔ.ÍîG`<2â¬<ì€bkI§³7lÌ; WD2V"¡%J!toâ¬Õ H37Rv ÞçI HSP65 DNA F IL!12 DNA Y plasmid vbj&H¤«<@!€ bk'HVJ!_v~&u'HVJ!E( /Hsp65 DNA+IL! 12 DNA €bk(Jx]hIÜ5SKtoI⬴o H$QÖ2arb\e|IÜEâ¬<ìõāY=<@" <@7BD! :I€bkIðS–âY9NV@PI! ¶ðS9ëèÈYýB@" -ÊËFâā. toI⬴o H$QÖ2arb\e|I{n|Eâ¬<ìõāY³ ½<@'‘Õ!׏´–!k÷(";TH!:I€bk Y€*€¯!ÿ꼌¿û!â¬ßÍ£€*¼Œ! PMDA!¹ÒTFI0¯²Ì£èÈE¶ðS9ëY ýB@"PMDA {ØOð'½@9ë(E!€bk¾ ‚“g9둛ò<ëLdO:F7œ¯FIê¤Y¦ @";TH!¶ðS‚pg9ëF<Dd|IÜE„¥€ íœà§g9ë5SK´Ãœà§g9ë!ÓN1ág9 ë!TK 9ë!‚pgÜè9ë) 'ŠfbÝÜ(F'^ã µ!z˜!ñÇ»(*YýB@"PMDA {ØOðI¶ð S‚pg»šE<ëLdO:FY¼Î”Hë¤Y¦@" 'd|ãúŠI pDNA It“9ëò( -ü,.΀bk I 1 r†6D¤<ëYߢŠ"'Î9ëJ AMED ´ oUAâ™èÈ:ÒI8’HSV( Ì£èÈB-‹ƒÔ! jT7Ç!ٗ޸4!j–~4'ÿ꼌¿ûÖÀŠ •ÐÂ?³ij&ðSèÈij&(!Š›Lá'g^ syn[ZèÈN(!ז‚3!Û÷•!ØsÑM!Ù –²'€*€¯€¯Œ†¯Üèȝ( !R2LÈ!/"V 'Ë¼Œ( !üŸÁÅ'ýX¼Œ(!T·h'â¬ß Í£€*¼Œ( !.Wò4 '¦€¯( !David McMurray 'Texas A0M €¯( !Dr. Esterlina Tan#Dr. Paul Saun! derson#Dr. Marjorie Cang '}`q|p]lpèÈN( .. 014. Æ·. ⬳BIFc$c†$³êI‰WF·ô= Vã‹H·=Vç . a1(!€­. úù1(!Än. H¿2(. ô÷) Ëeâ¬ßÍ£â¬èÈN1(! 'ì(yÏÀŠÇåN'ï(yÏênÇåN2(. -ڔ.Ë™yÏÀŠÇåNµ¨I⬳BI+FcI ‰W, $ +c†I‰W, $+³êI‰W,Iªã‹YÖT6 H=V" -ÊË. Æh 20 ­6TÆh 23 ­I 4 ­¶H!yÏÀŠÇ åNH52D`@H˜ö;W@øû—Ðäg$±åä g$PCR ägI°â¬$‰¡$ø¡â¬³B 537 ÔI ⬘öºF⬳B˜öfhmz6Tª³BIug [ÉYGI!Iß<@" +FcI‰W, 'U\Kï6TFc ME 2 6äƒW( !+c†I‰W, 'Fc6Tc†ME 1 6äƒW(ÆK+³êI‰W, 'U\Kï6Tc†ME 3 6äƒW(HC2D!>W?W‰W1UIÙF‰WG< IÙHÄ9Dµ®ç <@" -âā. +FcI‰W,J!65 %ÒÑ!Ŕ'ï(IeF  ÊIe(<D2Ve!Ý&”!É1U!w&z}h! 66UC9†IÓ2e!Çåý¢IÝmgIG2e!¼ Œæ2Ie!}oc-ŽóG<!©ù!zJîQ! ]æ¾_E¬PTW@" +c†I‰W, J!Pg!p8Å ”7G2!Çåý¢IÝmg1U!c††ì¿·7™¥ Àé$5Žw꼌!³ê;U\IEñ7ñÇ»U\/ >IxIU\! ³ê;U\IEñ7>IxIU\IN! ³ê;U\IEñ7U\G< 'åc³ê¸O(!Fì\Ï 7¨ç<ìŠ'’Œ( !°â¬°¢g—Ѝg!c†;— Ðç#7g!c†; PCR ç#7g!ÐÂ}oc I¯£Äñ'g\( 7 III Û!ÐÂ}ocI¯£Äñ '«7U(7 1 E¬PTW@" +³êI‰W,J!FcI ‰W71Ve!c†I‰W71VeE¬PTW@" -âó. +FcI‰W, H{<DJ!â¬F·ô=VU\R >IS3GU\7Þv=VYþHJ!KçVA9q8† ì¿·HFc=VS3Œ ±Â$Ú³7¹ãFü4T W@" +c†I‰W, H{<DJ!¼\7àšI\}Eq ¾HFc<@YþEQKçVA9q8â¬Ic†Y= VS3!ªZcìH52DZHâ¬Iœ¯gY®¡Hˆ 2D¹ãGç#YdPV:F7JãFü4TW@" -C>.ÎèÈJyÏÀŠÇåN6TI„‚HDýXW @" -£Š¨Ì£“B. yÏÀŠÇåN –íGVN!£Ç å{+Ÿ'ā;(s–÷Á.

(23)  K 93  K 4  2018 s 4 . 292. 015. ‰~. x1QS

(24) ¬ h. 0J . €P2©’. 016. “* L? £^. d¦ —’

(25) ©r„² §3:. /1Lm^ ¨Y2L"© ª«3L ¬`1L­% ]t1LJW N¤1L ®`3L. l°G72¯°ƒ¦ā²9Š ƒ¦mS³PQRS1L J‡´°ƒ¦PQRmS2L J‡Ju+u†PQR³µ@&mSuB¶3L. ¡\c`F” TŒm !1Q S"¬ #Ÿ$%

(26) & Ž‰6 25 s 8  1 o%$ 8  31 o 1 %'  F” TŒm(#1Q

(27) )u5*

(28) + ,#G' x1Q-[ ·

(29) U.#¨C /01/2&-3:45D‹4#¢16¸º .789:8;<=>1Q ?=@

(30) A¡6 BCDB§œE/l°‹4#+,D56F== }=>E/O‹³3:EF‹³3:#GH2& I858 2T 490 2J57.1KL%$0f#k$2& ‰Ms¶4 57.7±12.7 N(73.9K 41±O›(*H 2&63.5K @PQRSTmS(*V5.7K @PQR S(*H2&1Q W¬EXY$

(31) .e#; Z\ GH[\

(32) ]^#r_24D>@`z1± T+,D>@`z1±(mSJPQRS4 abL+,(*H2&cd¥#eŽ

(33) +f ghi jkl8m#§n Ao(\

(34) +,4s¶ 56 NT( +, pqkr 29 sT(st+6uv+wx*V cyd.#zF

(35) B{e |}*V( *H2& F‹³3:(§n~@[\

(36) €#

(37) E cyd.#zF

(38) +,4#, ‚Š1Qƒ „9 \

(39) ]^ *H2&   D>@`z1±+,D>@`z1± (mST+,JPQRS4abL4.#; Z\ GH[\=\]^@r_$2&†$+, .#GH[€$‡ˆ‡

(40) 2_ B{e |}/[€$\‰yŠi#G‡‹@€¬(*

(41) EX Y$2&Œ2cd¥#eŽ

(42) +f@‚Š `? Ž@

(43) .(ghijkl8‘«4 |’

(44) ˆ‡ /€/‘«

(45) +f 4#=bE€¸ º.(_–“5#÷r/ghijkl8¥H5 y8#’•2_ Park $–JInt J Tuberc Lung Dis. 2007L *

(46) E—Vbª˜'4 10 oš˜@3 !™

(47) & š›“4F” TŒ%$œM [G 2& žŸj   F” TŒV ^¡=

(48) jŒ G¢£VJd¤Lv•*%¥. w·o“ —’

(49) ¹¯4 2015 s( 10 —2 d2V 14.4 Eš¸T™¯(*

(50) @ºx — ’

(51) ©r„² §“÷%$–4#=\»©r„² §4´$w-®3³¼±½Y³¼ ±6<‚¾e §€=-#Z¿

(52) €(*

(53) » ¡\ p¦À‘ G

(54) ©r„² §#3 :

(55) » Ž2013 s%$ 2014 sŒ( 2 s' 9Š ƒ¦ (¼±#D’2B 253 &µ#G'E/2» 3:ŽŽA¡ G/[·EÂiÃ4 t YºāC ÂiÃ4ÄÅn)Y#GH2»PÆ0.05 (§n~#r _

(56) E/2»O‹³{Ç —\[§n~@2€ G/[4º2 AlȄÉÊËY#G\©r„² §E =

(57) €#h/2»3:4 IBM SPSSJver24L#‘« /2» IÀ‘Ì@ 46 µ(*H2»À‘Ì@Ͷ(%? performance statusJPSL@Îbºgqƒfˆ@Fbº ÏÐÑÒ8ºƒ8ÓÔ4@¦Õ X%H2»F‹³3: (4ÏÐÑÒ8JPÖ0.003LE PSJPÖ0.034L §n~ #r_2» X×-Ø(4s¶º8ŠÙ°aºÚ­„²=> @©r„² §E/[–™[\

(58) »Û0(€ ÏÐÑÒ8@Ú­.IºPS @8ŠÙ°a#Ü 2_ºØEÝ/=\I(*H2»F‹³3:(s¶ 4§n~#Þ2=%H2@º¡ E/[“ —’

(59)  ‰Ms¶@-ØE{Ç/[Ͷ(*H2† E@XY$2»Í¶ F\Rß —\[4s¶ˆV €ÏÐÑÒ86 PS @x©r„² §E=

(60) ) u5@*

(61) ».

(62) Kekkaku Vol. 93, No. 4, 2018. 017. 30! 40  ƒ _

(63) € U. J6 /6 † ` A 6 j*6 lM+ M[6 5j ‰$ a .g uŽ6 !. 293. 018. :™G72 Nzšx _ n›4 ?='" 2 \*. `œ žŸ<. R . #w¡6¢sP£¤÷¦@™. !"#Z$. %h4&§‘J" 91 ¨B`P©W¢Wn€N %h4& zOPª «]^¬­®1)0 Performance Status 30! 40  ƒ _' _() _* +,-./01h4!"# 30!40  ';¯ PS*Q{jG72 Nzšx _ n›4 0=‚ q0Š‹‡}/01\°=@5±¨†€  ƒ _2 F341U.5 10².0>ªVc†k³´KNz@p˜ %]^& k‚ˆ.=Nzšx _ n›4˜k‚µ9? 2011!2015 C !"#68„G72 4,466 %¶·0]^&Wv 22 C;¸:™k‚N 8 9:  ƒ _72 961 81 30!40 0 ==@5 z=@¹jºf‰}@G†€,‡ˆHsrK 50 ;<0U~=L>?==@'χ2 ?2AB 0H{k³»¼K½¾¿ÀÁÂt@ 185 €'Nzšxª Fisher CDDv?2mEF 5% dc*5GHUIh wcÃ140 €/Nzšx _Ã45 €*1¶·Nz JKXL? me‡ˆ7b?MNzOPQ 1 RS;@ _ZTUUVW4XYZ '[$Q2 _āj41&@Å72 CKXE¹ Nz,'‚Sk\}2H=]^_`^akTbc |L? mePÆ €j{Nz‚ meNzg ȌnQÉÊ1o‹ËDK oVc† mek def7gh4i#Pij1k 7 Ih*;0= ³´K meOFNzÁÌ ËKz@NzOPª @5 PSHbX®ÍÎÏAlb%IBW )˜k‚%Y| %l& Ð1ÁÌ5| l1¼‚ƒ ÑÒYÓÔÕZ¨  ƒ _72 F3m68„G72 9: U1Ìp@5¶·72 W×CJ 70±18 KXJ  ƒ _J30!40 j 693 8, 23 8'3.3%*50 (KÃ127 €/ÙKÃ58 €E¹|J7bÚKÃ69 €/ ;<j 3,490 8, 938 8'26.9%*nop@5qq4 7brKÃ116 €L?Je=Ã131 €/m{Ã54 €P  ƒ _ rs'30! 40 /50 ;<*1t Æ €j{JÛ2Ã141 €/3Ã44 €Nz‚Je=Ã162 0L?uv'55.6%/31.4%* NzOPQ 1 RS €/m{Ã23 €Vc†Je=Ã86 €/m{Ã99 €k ; @ _'77.8%/40.5%* w x Z y z @ J e Z T ³´KJe=Ã166 €/m{Ã19 €OFNzJÁÌ '60.0%/36.9%* VW4XYZo{'88.2%/56.8%*j| ËÃ153 €/KÃ32 €PS JÛ3Ã156 €/4Ã29 €nW }~}2nmE€p@5 × HbX®ÍÎÏAlb%IBW )J|}~} 11.7 % & ±2.1g/dl1002±557/µl3.4±0.8g/dl92.6±15.6% 30! 40 nJ ƒ _J,Hkj30! 40  nop@5 %l&%Y|ÐnJCPÆ €j{  ƒ _J 50 ;<  ƒ _0L>=‚ L?mjƒ„NzOPQ 1 RS;@ _jƒk/0 V c †N z @ pPS B HbX ® Í Î ÏAlb )jmEnop@5ƒ ÑÒYÓÔÕZ¨Un A{0=‚A{ †0Hp‚‡Iˆ‰}‚k JC'Odds LÃ1.079P=0.020395%CIÃ1.012Û 0Š‹‡}@530! 40  †Iˆ q40=‚Z V c †'Odds LÃ6.821P=0.004495%CIà T meVW4XYZj ƒ=‚k0Š‹‡}30! 1.151* 1.818Û25.594* Nz@p'Odds LÃ4.489 P=0.0137 40  eZT2Œ| Ž1{„8‘’ ey 95%CIÃ1.361Û14.807* PS 'Odds LÃ2.140P=0.0125 “ ”\3•H–—I]^Œ@p˜k‚ˆ. 95%CIÃ1.178Û3.888* Hb 'Odds LÃ0.687P=0.0470 .Nqjo0Š‹‡}@5 95%CIÃ0.474Û0.995* 5 ˜jNzšx _ n› 40=‚-‰}@5 % &G72 Nzšx _J€Vc† cÝNz@p ÞßNz OPª PS Q{0 Hb 1)jÉÊ.0Š‹‡}@5.

(64) ·” F 93 — F 4 Ì 2018 l 4 ¹. 294. 019. àOy|B16O·”ā®áˆûªC¨øW ºa. 020. HIV š8ëB16Or¸«€)ÆO«*/ qui«*u neutrophil to lymphocyte ra tio&NLR*@·”sû1LEáˆq`ZCā ®. Ÿ+ ùw •g ð1*!ÛZ. ¦K1,2*!§Û )1,2*. 6›2>Íy|©¡gŠ ·”˜‰Ž~òåy|1*! ·”˜‰Ž%·”»¬ô2*. “W&·”yøR—8A.àOy|B16O·”ā® ሪCêDR’M2B:O$†‡&. 26 l 10 ¹2 M. 29 l 9 ¹H?C 3 lœB_|?Ö±–WB%J 8P;·”ûªRÆâWBºa9áˆûªRO$B ¨øWºaRÊ=;$·‹&3 l?·”û@%J8P ; 41 ª)K 30 ª!õ 11 ª!°l¬ 68.9 Õ*OCy µDp·” 37 ª!·”-®Œ‚ 3 ª!´|qui5·” 1 ª?! 20 ª37”y|FX|! 5 ª3’ā‡–¥‡! 16 ª3j|‰¥Rï6;$7C/<áˆûªD 10 ª )K 7 ª!õ 3 ª!44(99 Õ!°l¬ 86.0 Õ*!:G> p·”? 9 ªD 80 ÕxÿCˬë?-=;$:ªBˆ M2C¢;é™RkI!j|æC PS3 3 1 ÷!4 3 9 ÷?:G>:&"D3v‡9>1N 8 ªBkMûRk I;$ç¥D‡–¥‡3 5 ªBÊQP;3!5 ªD:& "Dz¦2Mç¥zm?-=;$á{D·”á 3 ª!‰ ¬@¢;é™BLO(ì3 4 ª!n¸û 1 ª!$z: 1 ª!ı-p‚ 1 ª?-N·”3T4á{@AOJCD ÷A2=;$<l¤Báˆ9; 1 ª?DN‘WA doc tors’ delay 3kIMP;$Éw&àOy|B16O·” ā®áˆûªDEt3Sˬë?-N!:&"D3v5 óeA¢;é™R—9>.;$£?é™BLN®| X 9?}€R—:OJC3A5dBˬ·”™ëC=¤ s½BDÖ±–WºÙ3óœ@É0MPO$|gš8C Øÿ?Jj|æC°³ÇܱºÒ3—š?!|g[º ÒCB,/v3—š?-=;$˜ÃD·”óû]LNJ l¬K¢;é™!:&"DBÑ~8PO7@3A2= ;$j|ûªD·”%JæY?:G>Á蕢8P>1 NkMûC8MAOv‡!ADL CU†3:ª?kIM P>1N™ë›¡Ci983{4RN@A=;$ıK ±†þ“J@JA.g}ç¥3zmAûªJt*Bk IMPÐÃCE4AŒG@É0MP;$. +o¶@“W,hSjqYC»¬?!H«*/qui«* u)monocyte to lymphocyte ratio&MLR*`Cr¸«€ 3!Ç HIV –ç¥R‘Þ9;.' HIV š8ë!H; öä HIV š8ëC·”sûq`ZBā®3-O@ Î 8P;"S_S'ñIB1.>Jb™Aā®3kIMP O2ºa9;" +†‡,bTÏcVupT¼C HIV š8ëBC:OfT [Saub')day care center&DCC*\¯ë]l'g »¬Rš.!DCC \¯æBÔ¸38P·”£„­CA . HIV š8ëRCýB39;"·”sûKáˆC! D!]l'gCjWt'SdkC@B¼C·”\¯^ `enKbTÏgüώ\¯R š9;"r¸«€ @·”sû%áˆ@Cā®D!]dZ`÷¥ofr@ Kaplan!Meier 1?3Rš.>ºa9;" +·‹,1,095 ÷C·”£„CA. HIV -™ë)l¬O ƒL 35 Õ!K- 46%*R]l'g39;"70 ÷3! jWt'Sdk¤OB·”Rsû9 100 'l_NC ²™£D 7.5)95% #Ÿ² 5.9! 9.5*?-=;"·”² ™£C ¾{ßDK-!Tuberculin Skin Testing )TST* -!CD4 * 200 x†!Ç HIV –祭!\¯æ·”ā ®û"—!®|sug\uô½—?-=;"7PMC  ¾{ß@l¬!'î?„0ÃBr¸«€C€¯R½; A‚§3·‹?D!NLR)neutrophil! to!lymphocyte ratio*3ÓJË.³)75th i'aubTrxÿ*D!Ó J NLR 3U.³ )25th i'aubTrx†*@uG>! f¤9>·”sûq`Z3ÿú9;)adjusted Hazard Ratio=4.0#95% #Ÿ² 1.5! 10.7*"H; NLR D·”á ˆCq`Z@Jā®9>.;)adjusted Hazard Ratio= 9.1#95% #Ÿ² 1.2! 72.4*"MLR D©ã9;´Å?D -=;3!NLR @u9>¿Q?DA5—y?A2=;" +ÉÚ,NLR D·”sû¨Eáˆ@f¤9>ā®3-= ;"ŠbTC@ HIV š8ë]l'g?D MLR 3f¤ 9>—yB·”sy@ā®9>.O ÎJ-N!ÈBÖ 2.€3%ÉÚ3xœ?D-O3!r¸«€D·”˜ ‰Kç¥BPy3xœAËq`Z³RbV:O„˜W hTXm'Y'BANcO" ‹»¬D!·”y–Žz’CbT'YUub'i'g@ ªÀ«ßqÝ!^ ׃qÝ3íBC­b»¬C.‹? -O".

(65) Kekkaku Vol. 93, No. 4, 2018. 021. ³‹ :û Ӌ q8. –Þ¬†÷%EBTB&C$G#©õ«~Cy yB-2N 3D!CT €;°ÊC—œ*C°]. z¨!¬÷ Š!ÃÔ '!#“ r¡Ü! –Õ!ˆ° ér!P“ QÜ!ö¨ ËJ! ©@!wV ˜—Ü!¡‹  /!L Ä! ³„!3 ÿ—!)Ù v&. 295. 022. ”ƒT&»Œ–Q59l¬†÷«Cä¦+ 0. W‚ ó&!öl ½!ql r!2X .™! ÙÉ ø!EX ÿä!¬÷ ïÜ!sV ¸v! V= ¹™!¬÷ î!EV ¯ `¢Â,ˆ&Ç¢zo”¿Y zo. Ç¢ÇÑk¦±āWeY$µ›’a|. 'kª#‘T(–Þ¬†÷%EBTB&D–ÞC¢Ö# €ÎC¶j÷QÚ5„|Tä¦/À¤4ONûÅI) N9H"ìA«~ŽØ/w?4ON"F9–Þ£° ÊBKN‹çEC!ë#íçECŠ®CÃ4A@I’ F?AN9H!–Þ£°ÊBDPNu!ëT>¥Mƒ 5ßÂ>0N°ÊC‡¢/w>)N"¤g CT €;° ÊC% Bn* 3D! CT Qœ*9^$Zbc`deT VT_$/–Þ£°ÊCDC?5=ۜ>0A*. M‘4O=*N"EBTB ÷«C$G#©õ«~CyyB -*= 3D!CT €;?–Þ£°Ê?Qs‰6N3? >!^$Zbc`deTVT_$C—œ*Q‡f6N3 ?Q‘T?59" '‡ˆ( 2010 g 1 ® 1 c.L 2017 g 10 ® 1 cF>>[o> CT €;?©õ÷ü>–Þ¬† ÷Q˜;9‹çC+:!–ÞaᣰÊQßÂ5$G 59 46 ÷«Q 3D! CT €;°Ê?s‰5¶‡áTB° ]6N"F9!䦁d%SX]RU\›d!V[dS \›d#a}A@&BKNxB<*=I‡fQÂ;= *1" '¬}( –Þ£°Ê#CT €;°Ê/?IBÂP O9 46 «DH*/ 15 «!31 «>” 67% /ò*>); 9"m÷g­CKuID5«>D 42.5 Ï>)N/!H* D 45 Ï!ò*D 32 Ï?~ŸC±ā?^›Bègò*B ?*¦º/²LO9"^$Zbc`deTVT_$BK M–#–ÞC¢ÖJhŒzB<*=Dyy{i >);9/!aÁhŒñ²%ýÅ*#*üA@&B<* =ùÐAyyD>07!F9䦁d%¾¬†•a}# ¾¬†•›d#V[dS\ۜ&BKN–_C ND‡ f>09/!aÁhŒñ²CxB<*=D–Þ£° Ê?s‰5=yyDÈb>);9" '¬·(aÁñ²>‡ f>0N–ÞhŒCm1A@Ct÷*xB÷5= D 3D!CT €;>Dyy>0A*/!–Þ¢ÖJ– hŒCt¹#{-D‡f>0!3D!CT €;Qœ*9 ^$Zbc`deTVT_$D–Þ¬†C$G#© õ«~CyyB—œ>)N". 'kª?‘T(œ*µ›{5QŸ95”ƒT&»Œ–Q 59¬†÷«B÷5=F?HLO9†ÆDôA*/! moTBš¶D{§?4O=*N"[o>D 1993 g. L 1997 gF>C 5 g>ðm¬†BKNœ*µ›{5 C9H”ƒT&»Œ–Q59 9 «B<*=†Æ5= -M!8 «/à‰5=*N"RST%respiratory support team&A@&»µ›’A×/|š59´Ò!œ*µ›{ 5Q095&»µ› Q59ì÷l¬†÷«B< *=8CU•#kªnÜB<*=©õT°]QÂ;9" '‡ˆ(2012 g 1 ®.L 2017 g 10 ®CB[oC¬† zZBdo59¬†÷«C+:”ƒT&»Œ–Q5 9 18 «QAú?59n#kªnÜ#U•A@B< *=°]59" '¬}(Aú 18 «K9n>GN?l ¬†BKNµ›{5 9 «%3 «à‰& #±­ 3 «%2 «à ‰& #¬†*(Œt 2 «%1 «à‰& #7/¶j÷ 2 «# O¬†í¶ 1 «#þ_‘ÌmlUh 1 «%1 «à‰&> );9"n?5=Í?>);9l¬†BKNµ›{5 «>D 9 «K!H* 6 «#ò* 3 «>g­CKuI%p g&D 58 Ï%38 Ï.L 68 Ï&>);9"“6æ‹Qâ <÷«D 3 «>!l–ê#\ez#iR²A@/); 9"lB“6æ‹QI< 1 «%l–ê&>D¬†m÷4 Bµ›{5DfHLO=*A.;9"pāüBQå6Ý x?5=doãCRc`aeIQ°]59/ 9 «5« > Alb DSI>);9"Š‚~ªBKNz§D5«/ ¥<z> /M 3 ?¼pAzQfH9"U•D 9 «K 3 «/à‰5!l¬†÷« 6 «K 2 «/à‰!f£ ¬†÷« 3 «K 1 «/à‰59" '¬¯(ì÷l¬†÷« B-*=I>æ‹?^›B&»µ› BKMŽC {i*D¼/N?À,LO9".

(66) ²‹ ; 93  ; 4 Ê 2018 b 4 ´. 296. 023. *‹. NrG16T²‹H Paradoxical Response )ì™k}*G8:TZ]gY^֑œH›ó GµR ëH!DI ÷\. Y–È'|þ̖qršÅMWLo™[h\(½Ÿ— Z. 024. g²‹‘àG16T©V­&D‡w%u”ú :H” GA.BHµR. Bn ûþ!6ô åä!âp ÎQ vv. Žz!‰. ŒJ!. jA·À)e¥¢U1ˠ˃‡[qr½Ÿ—Z. ¨b#g•G1.B‡w™|3ÈVUTQ/GF +ŠG,²‹Ý™ÜH Paradoxical Response)ì™k}* +f®, S#u”G¾u”Ø#)PNI*PÂB dh` l G8:TZ]gY^֑œDm֑œH›ó2WlŒ µR9=" +8øD{|,8øI#x& 26 bK2Rx& )NLR*FEH‡w%u”ØpD¾Pݙj{%DH ” 3ÑCŠ8UB.T$7ULC²‹G1.BI#³ 29 bKG26BNrG1.B²‹Dü>9ݙÈ@= (Xeach@P€õ³dh` ##PNI FED²‹i / ² ‹ ‘ à 199 œ B Paradoxical Response)ì ™ k ö1QJ¾DH” GA.B÷'FµR3F8UB }*Wœ79= 7 œD9="7URH›óí¸G”9B .T$g²‹CH©V­&GA.BO#‡wPu”ú: ¾{ÚGµRWÈ@="+²‚,8øHx¦bāI 67 ÒC?% 5 œ!î% 2 œCg²‹ 5 œ!l—²‹ 1 œ! DH” 3ÞÏ8UB.T3#©V­&D‡w%u”Ø pDH” GA.BIƒ>çuGµR8UB.F.$ ²‹%£~x 1 œC-@="g²‹ 5 œH/? 3 œI² ‹%£~xWËw9B.="ì™k}Höú!í¸D9 +ŠG,NrG16Tg²‹‘àG16T©V­&D‡ BIia3 6 œ!gqy3k3 2 œ!£"3~3 4 œ! w%u”ØpH” GA.BµR:T$+{|,2008 b 4 ´2R 2016 b 3 ´G#NrG1.BÄÕ§h”C ±sdh`-áE3 1 œC-S) G–¹W1QK: ²‹§3“%DF@=g²‹‘àW8øG#³(Xea Q/FèXFöœIF2@="7 œBÉa3Û59= 3 ch@P€õ³dh` ##PNI#NLR#BMI FED© œCZ]gY^3֑8U!ˆ×šIbf^_h 10mg V­&H” GA.B¾{ÚGGµRWÈ@=$Ó§% 3 1 œ!20mg 3 2 œ!֑™“Ix¦ 52)38! 63*]C gxËw3†R2FöœI}µR2Rï‰9=$ +²‚, -@="¡¢ÄÕ§h”s%}LCH™“IZ]gY^ ŽT%g²‹Dü>8U=HI 149 œC#Ó§%gxË Ö‘ª3x¦ 4.7 æ!m֑ª3x¦ 4 æDÐIF5˜ wœWï.=}µRH8øàI 137 œC-@=$?/ ªDOG²‹HÑi!ÑcIMRUB.F."ì™k} î&77/60 œ#bāBz@&75 Ò)16! 94 Ò* #yŸê»2R° LCH™“IZ]gY^֑ª3x¦ 57 S/F9/r÷&66/54/17#ãüÜG½Ÿ—öú3-S& ]!m֑ª3 81 ]!^r™“IZ]gY^֑ª3x 55 œ#„öúãü&44 œC-@=$˜0ߑD9BIP ¦ 94 ]!m֑ª3 124 ]DZ]gY^֑ªGlŒ _q&24 œ#%ÿ4q%S+&14 œ#k%á£&17 Gèöœ37.GO22VR;E?RO=.¬ÁG œ#‡w•$ݙB 10 œ#%’x%’Æy 8 œC-@ -@=" +ÇÔ,Paradoxical response)ì™k}*G1 =)èt-S* $iö2RãüLC 2 i´mùW’9=ö .B/ýú:Gt¤WāK:èöœCIZ]gY^H œI 25 œC-@=$©V­&œCIy¯ºàP½Ÿ ֑3!ð8UB.T3!BOöœG1.BOòš=™ —öú3-Töœ#qyHŠ3S3ÃkFöœ3nG HZ]gY^֑GQS²‹Wk}8<T7DF5 72@=$u”1QJ‡wØpD©V­&H„GA. QOL H†.P^r™“H=é3™9C4T€d%3BI#Xeach 3g/dl ƒ‚PÂB  6000/µl mù#d TDÇ0=" h` # 1000/µl ƒ‚#NLR&5 mùFE3nG”  9B.=$7yš„+COFXeachP NLR É@3 ©V­&D” 9B.=$ +²¿,g²‹‘àG1.BF u”PÉxöú:D©V­&GA.BH” 3`NR U=$<Ù,Hñ›ˆFµRC-S#L=|>¶¡CT=Nq‚”«GA.BI¼āC4;#;8RFTµ R3o’DÇ0RU=$.

(67) Kekkaku Vol. 93, No. 4, 2018. 025. 297. (÷" €

(68) [  . . `  !".  U=K. #$T%4&'()*. . 026. 7› YH. Leicester Cough Monitor JO8÷ ™b3š. œ^ž Ÿ: ž ¡¢‰£ M9 l¤¥K ¦§. 7¨©Tª*c«&'()*. +'-I./€

(69) 0(÷+4123 -45 +'/™b0÷‹2.G;p 1 o 9÷™bJ­.3šM8>@0G  678€

(70) 9(÷:;<=>? -? > }®VŽR_†™b9°_²<<? O05G @ABC5 9BA €

(71) -(÷=\ o 678÷0³f"9/Po 9‘d >@0DEFG8EH÷4I" ÷ro´97 8E"fyN¶96O JKLM86+KL-?@/H÷4I 2013 G6 +I./ ÷P·oH*¸R"-G{8;X $ 1 NOC 2016 $ 12 N"M8(÷JKL PV_OC€

(72) [JMQ€

(73) RS€

(74)  JKL™b¹-÷=\? º0-=\J3š T" 1 UNVWXY

(75) Z-€

(76) 8 [5\5 M"fyN¶9»%OM86 +?@/÷ ]^_`"abc&dW M86ea 9 FT~ 3 F 6 F54.4±19.9 €Z"a™¼½ fgh]ijkElmnQo€

(77) pq ¾¿TLeicester Cough MonitorÀLCMZ ™ÁJ1 ÷rOCsE8:tuJvk:t€

(78) TLeicester Cough questionnaireÀLCQÂvisual analog scaleÀVASZÃÄTWBCmTPmAlbmCRPmBSRZ S-M,wM86 +÷r/ xfyH÷4I" ac‘dJ ´ÅÆJD8?7o!¹ M8(÷0 468 Fo€

(79) [ z_9 -*QÈG 7o! GO{ 8 29 F J | } 439 FT~  314 Fm: t $ Z T’Cm*Q 3 Œ\ÇÈZ ¹TÉE*QÈG{8—ÊË!Z-=\J 66.1 € 125 Fm:t$Z 68.7 €ZJ‚ƒKL-M Ì864C™b¹9˜O{8;X=M0ÍN 86Q€

(80) S0~ 39.9„ 20.0„ o †~m LCMLCQ JÎM´7oŽRJÌ86 +÷r/ -Avk:tQ€

(81) S_†L‡ˆ}78~ _†L‡ˆO{86 $Z‰Š;o0 "aϙb¹TŒ/!Z0:t 356.2±446.7 Œ/ !TbÐu 2 Œ/!bcu 1103 Œ/!Z-ÑC ÒJ# ~o0 30 €‹VWoe$ZŠvk:tQ€

(82) S E89LCQmVAS -L‡GÓ==>J#E8678 JWŒ†A 30 €‹VWe$Z Švk:tQ€

(83) S 2 )VWˆuJM86 WBC&dW"fy-yAÓ=J#E*QÈ 7ofy-0Ó=”āJ#E86MOMCRPBSR Q€

(84) RS€

(85) JŽ8]^0~ 50 €‹-y=\0#EGO{86x57o LCM Ô 60 €‹o 90% M86"abc&dW9‘d’ >@OC™b¹ 48 Œ/!J cut off -M 2 Õ8 C 3+o0±,wMQ€

(86) ]^9 ,wM8-xÖ™b9˜ÕoL‡"fy9× ˆ}-€

(87) ]^9“”āJ#E86 +7-E/ ( ³M86™b˜Õ 3 ;XKMØÙM8÷" Q€

(88) S0$ZŠ_{–9 A v—-Mvk:tQ€

(89) S_†ˆ} xÖŽa.™b¹0ÚF? A*QÈÛA™ b0ÜÇM†™b¹9ÔÝÞ7oÚF? X 78Q€

(90) o0bc&dWA˜”āJ#E86 ´ÅÆJD8M8;X0GO{86 +÷ß/ ÷ ™bJ3š? x-_†"fyN¶9»% OAM5G6.

(91)  D 93  D 4  2018 b 4 . 298. 027.  Œ

(92) f”e  CDI ™,. 028. @˜5:S‡¤ā?!¥ ™. W‚ 1CM R1¡ <1 9 „2š €-3—€ ‰2. *¦ §41>’ Pm1*¦ 3h .Q1¨" g©2. NHO!"I#$r%&'()*+r1 NHO!"I#$r%&'()\2 NHO!"I#$r%&'()”-.&'()/5 0-.r3. [Ž`.x'9ŽpDª«]¬­pD®¯°1 ²³TCāCāDµ¶ā;·-.®¯°\ā2. 123456÷895:Ÿ2;<  =ip2~>“N? @˜8C=) ABCVDf=–EA2FG1H8I ^F==CJK L2lM5N Œ:NOPƒ5NQ‘ RSCI Clostridium difficile /50UV? CDI i0W pA8XZYWC Œ CDI i0™ ,5ZL[ LAv\WC 1wx62016 b 11 ]2017 b 10 ^A 1 b_5 Œ `aL  10 } ?b CDI i0Bc A di0F B d5sSLCb˜BMIe/ ALB HU Œfg hdij,Yh¢  |Pƒk•CDI i05jKƒlum |dij,Y^A_)5Z kn LC 1Ž6 A d 6 'B d 4 'paLCtqb ˜2 A d 80±5.7 rB d 75.3±12.3 rtq BMI 2 A d 17.3±4.59B d 14.6±0.91e/ ALB H2 Œ fghA A d 2.1±0.74g/dLB d 2.5±0.95g/dLdi j , Y h A A d 2.1±0.36g/dLB d 2.7±0.81g/dL paLC¢ 2 A d 3 'B d 0 'paLCstu'v w'URFPxŠ8BaL2A d 6 'B d 4 'paLCCDI i05jKƒlum8BaL2 A d 5 'B d 0 'paLCdij,Y^Atq_)2 A d 67±14.6 _B d 68±18.4 _paLC 1yz6 Q‘{)|}~AB RFP UˆW€A CDI NKFX0/50 ‚Wƒc,8BL4`D h„ Œ#A o† :‡FˆA NST ‰`. `KFŠ Œ#A ‹6ŒŽc8X‹ABC 1œ6 Œ `K2 A dB d=5N Œ #AAB8A dK8NcXZABaLC^L A dA2¢ ‘-8 50’ @„aLCPƒIA =Pi“”•–}—˜ RFP 2K\™i5š› ˆ œWž ŸSN Œ#A UˆW€A i¡B¢b †i Wƒc,8BcJ£8n‹A BC. §z1. 1O6 @˜Y¸¹8&ºI$»R›=@˜Y 8&` @˜A2¼y=@C^Lā?! ¥ jK@˜=<FGFC¼y½¾  2b˜N ŒÀYSN?Á8%Â FŠ8v\ŒÃ:cā?!¥=@˜ ‡¤™ ÄŌÃC{-.A2@˜ 5:ā?!¥8‡¤5™W„ÆXWC 1wx62011 b 4 Nc 2017 b 5 ^AVDA 80 rV"$»R›5:ā?!¥ Ǻ kȁ5Z¼y½¾AB„Éʓ ËÌ~•ÍÎs05NcÏ0 LC 1Ž60–;) 51 –Ab˜ tq 86.4 rU80]98 rG, 27 –Ð, 24 –f 50 –UKя  11 –£rs'Ò2 1 –di– 29 –ƒl@ ,2 INHEB @, 1 –SM @, 1 –ABaLC1 HI^F@Sā?!¥2 8 –5a4 ÃLCQÎ2Q ‘Ó( 35 –Q‘I 4 –¼y 12 –U%E„ ¼y^ A_) 1]253 _ ABaLCÏ0Ž £F¼y ½¾2@Sā?!¥UOdds RatioÔOR=18.50 b˜ UOR=1.20  UOR=6.80%Eh Perform! ance StatusUOR=10.98 %Eh®¯q7UOR=6.25 INHRFP ÷l=ǺQ‘A2F UOR=8.57%E h Body Mass IndexUOR=0.55ÕÖÉ×'H UOR=0.54ØÙÚÛ'HUOR=0.05;ÜݓËÉ) ÙHUOR=0.95CRP HUOR=1.22ABaLC 1œ6ā?!¥2@˜¼y½¾ X ‹ABJ8ÄŌÃN ŒPlQ‘+ Þā?,fßi0FŠ5š› ‡¤5™WJ8 yœ ÃLC.

(93) Kekkaku Vol. 93, No. 4, 2018. 029. 299. ÅÝ­üéāE/4T¦7¼˜Úā€. ©ƒ ¹|1)!" C‹1)!-V {* ¦n1)!@T ·2). )‘2)!. Йp} ÆX¨p}Øs1)! Йp} ÆX¨p}¾¤œdue&2). 030. j‡ !u rT ûz @T. gµ”E8h7<¡ª£F¸[. ÎË!ÓZ œ<!®Œ ß!ûˆ ‡! «<!‰Œ ß{!¥- ¦à!H9 &Ç! ¯<!,Þ õŒ!(ƒ é!Tƒ Èc! Ä !T9 £!,- áFI!ÜÒ ý! ·. Йp} ÆX¨p}. *‰Q+ØZsr^&WN7<—îE>7@!‚yAG ¦7¼˜Úā€(rapid drug desensitization therapy$ RDD)1Ã3ËVU@-T"ƒE/-@ RDD G!ā }G,TOFFKBXCËVU@-D-"я!ÅÝ­ üéāE>7@ RDD WË><ü£E/4Tw2' W¸[7<" *~€+2015 b 10 ¶0R 2017 b 10 ¶Eg µ”—î#mµ”'ÅÝ­ü—î/-@tڕE@!é āWHE7 RDD 1ËVU<ü£W>þB7;Fw2 'E?-@JÕ7<"“çþFo G CTCAE ver.4.0 W•-<"*µˆ+RDD 1Ë V U < F G 29 ü £!52 A,S!éā1HEBD><—÷B7@G!Grade3% k# 2 £!™ÿ“%7 £!Grade2%k# 18 £!™ÿ“ 1 £!Crade1%ha 1 £A,><"RDD âˍØG!q lYukau(RFP)22 ![c_fu(INH)17 ! \eumh&r(EB)10 !kpbjoi(PZA)1 !snlt]`au(LVFX)1 !aelt]`au (STFX)1 A,><"Ø]`(À˜(l¢0i0 ŠV9)G!RFP 1 81.8%!INH 1 82.3%!EB 1 70%! PZA#LVFX#STFX AF“çþGD0><"RDD ð›¿F“çþG 52 H 10 Eô½7HãBDS ;F_ŽG RFP A Grade3%k# 1 £!$ÿ“ 1 £! Grade2%k# 2 £!INH A Grade3%$ÿ“ 1 £!™ÿ “ 1 £!Grade2 k# 1 £!EB A Grade2%k# 2 £! Grede1%\L#ha 1 £A,><"RDD âËHFHE GD0><"/WGƒQE RDD WË.× LT ï” =§Å!H1 ï”=§ÅWW“8TQ.ED>@/ S!;F:!cgt[iBFw•P/W1D-ü£O ,><" *ÉÛ+ яF}ÏGƒFā}Bj•7@ INH x’AG]`˜GÌ3!“çþFh*GM0><"L <!íâü£%GùD-D1ROā}EGD- PZA! LVFX!STFX E?-@OËVU!“çþ1h*8T 5BD3éāåR LA5 8T5B1A2<"½ÙË VU@-T¼˜ÚAG!éāåR EYC8TLA/Q ; 2 ñ›/¿FŸ›W–7!éāŸ›P`}Ÿ›€KF »|BD>@-T"RDD 1.B†dA,UH5URF ŠAWŽ´E?D1T†d'OêÔ6UT"Ñ¿ü£W ò+7!w2'#Á'E?-@Fj•¸[W8T". *f±+gµ”EG¡ª1Íw8T5B1GRU@-T 1!;URFü£W¸[7<}ÏGùD-" *‰Q+gµ”E¡ª18h7<ü£F¡úQ^IW¸ [8T5B" *~€#>þ+2015 b 4 ¶0R 2016 b 12 ¶LAFŸ› E!Йp} ÆX¨p}E`}7<FJ 787 £Fµ” ü£0R!8h'¡ªWhü7< 28 ü£W>þB7<" y»'¡ªWÍw7<ü£Gø’7<"gµ”F‹4ö º!`}èFe­F†!gF3ì—!¡ªFPUP éā_”!µ”Féā²ŠDCE?-@!¿~æQE¸ [7<" *µ ˆ+F ' 23 £!÷ ' 5 £ A x ¬ b ¤ G 72 Ö(35 Ö'91 Ö)A,><"–v¢AG 1 °G 1 £!2 °G 14 £(8J@6')!3 °G 12 £(1 £FMz6'! 4 £Gvšµ”)A,><"¡ªFóüUE?-@G! z6'F 1 U¡ªG 12 £!2 U¡ªG 7 £!3 U¡ªG 4 £!ª„E 2 U¡ªWÍw7<F1 4 £!6'F 1 U¡ªG 1 £A,><"17 £1²ŠšÛFMA‘0 7!ª„E¡ª1Íw7< 1 £G²ŠšÛA§DFL LwO7<"11 £AªÊisj&b1âË6U!;F. = 7 £G‘07!1 £G§DFLLwO!3 £G¾¤q2 F<Nä‚7<"µ”Féā²ŠB7@G!18 £Ae­ 1~'„7?}O73GS}BD><1!9 £1µ”E QSä‚7!3 U¡ªF 1 £G¡ªEQSä‚7<" *µ¥+ gµ”E8h7<¡ªG!ªÊisj&bWâË :9Eë1³÷8Tü£O;-"707D1R!¡ªW Íw8Tgµ”Góü£1;3!;F’¿GqŸ0O7 UD-".

(94) ­† @ 93 Š @ 4 Ä 2018 d 4 ®. 300. 031.   øØ. k­†?Ϥ)kuCÅ|B÷7P°_. •!$œ ?![ ó. Õ!*ƒ. G!. 032. ]oB.3PUZ]TX\>)­†üCm* Fj? ù8C°_. š1 Ž&Ù1&! ˆ ’<1&!kW B2&! ?[ vg1&!ÖW 1&!W; G½1&! Öº ûÕ¤1&!S‹ ¼g1&. Ó7Åto¶›‘} ¨þ²œIvto¶›‘b}1&! ¨þ²œIvtoϤ°Ëç2&. k­†?Ϥ)kuCñzŽ2D¢ê>D5G@˜ AKC>DA+"lƒ>Dk­†æ=0õ”Bku?n D5Q=¾¤÷C\”S,3=+PW$YK÷A2A +KC?¿-NQP"ȂÞ8:D!2002 deÁB]o >%D5Q8k­†ü¡%—a°=/NC¤{š¡&B ÷6=!Ϥ)x—aŽ2üC`âÅ|uY!%D5¸ B.3PC]hCnD!¾¤÷Cז!¡^B÷7P¸ ƒßRA+SàI8"„]7Pk­†ü¡D 93 ¡>! 4C,:k­†C%D5¸B¾¤÷\”0A/;8ü ¡0 40 ¡!¾¤÷\”¡D 53 ¡>!b‘D%D5C I#21 ¡!%D¸CI 22 ¡!%D5¸?K#10 ¡!? A;=+8"%D5\”¡Dpqæ=Sku?nD68 W$Y!.MEkuäāIBeC8JÍì68°=>H Q=l™˜)y68W$YA@0ÉÑ6=.O!%D¸ \”¡DC]h0k­†Bku0Å|6=+P?sz 68ü¡0?w{S0J=+8"d¢!݇›A@C_ b`$[$S ¦>oˆ6=IP?!}£d¢D\”A 6 68.4 Î!%D5\” 73.2 Î!%D¸\” 78.8 Î!­† äā“O”îH>Cê݇›D\”A6 12.5)! %D5\” 35.5)!%D¸\” 56.3)!??1AÊ0c JNQ8"7AR:¢ê>ku¦Sª•?6=%D 5Q8M,Aü¡¦C“¸DpÿBvŸ9;8"H8­ †C%DýŒA?AP{h)0*P]a$V^cd÷ C/À\”B÷6=D!%D5\”¦C,: 29)!6 êC,:C 10) ë>‡c5Q80!ȂCü¡CA/ >DV^cd\”B™n68?yA%DCHsS18 68ü¡DcJNQA/;8". 'j«(UZ]TX\%INH&D­†rôäāCõ”äā B–+NQP 4 ÐCI>>)›0K;?KÂ2!ˆ†B .+= 2007 dCLË>D!õ‚>) 3.1%!“äā>) 12% ?5QP0!¥d INH >)›ýúSÛQ7P‚Æ 0*P"Ȃ]oB.3P INH >)­†¤Cò´uY ?!>)¤S°ò68êj«!m*Fj? ù8B< +=°_68" 'ƒ„(2005 d 1 ®/N 2016 d 9 ®H>B!]oB=÷ Ўí)°Ë0‡c>18­†ü 317 ¡B<+=!INH %0.2&>)êSJò6°_68" '­~(317 ¡C,:!INH%0.2&>)D!48 ¡%15%& BcJ8"d¢ 23!94%IvE 60.5&Î"7F=k­† ü>*O! ,: 22 ¡%45.8%&kƒ­†SÅ|6=+8" INH %0.2&>)êB<+=!õ‚>)D 44 ¡%91.7%& ! “äā>)D!Ìäā 3 ¡ LTBI äā£ 1 ¡%¬ 4 ¡ 8.3%&!%DâC¥§X‰˜)D!31 ¡%64.6%&>*; 8"U–B<+=!äā‹(>18CD!37 ¡%77%&! ݇ 5 ¡%10.4%& !Uh 6 ¡%12.5%&"Ž2³0nŠ6 =+PCD 3 ¡%2 ¡D~µC|9bŽ2!1 ¡D."ê ¯%& >*;8"êāðFD!²b 12 CÚK;?²ƒ %ƒÇ 2 ¡&Bm*6=+80!I>K²b K Úāðê D 30 ¡%62.5%&?›>*;8"K ÚbC 9 ¡B,Ò ¢!¨kC“wScJ8"€¯öB.+=!JATA%12& ! VNTR „BMPgVÙ©S°Ë68­~!K ÚbC 10 ¡0`lgVÙ_[$dSå6!K Ú6=>A2Ça X Ä4t4BïI7PFj)C§»ScJ8" '­¹(]o>D!INH%0.2&>)­†D 15% BcJN Q!õ‚>)0Â/;8"K ÚbBmüdã0fAO. "£0ŠN/>A+ 10 ¡CêB VNTR „>C`l gVÙ_[$dScJ!K ÚBm*Fj)C§»ScJ 8"M+3x”Sá<­†¤C)èL!¢yBMPb n)CÌfA@!ȸK>)¤Cmü0:2{h)0* O!M”CN-!Ží)°ËCéÜ!{Ùr‰R{+ SK:+8Ž2ViCLË!#8A>)¤SÔNA+ DOTS CTP0q—?5QP" €mƒŸ`±ê ZiŒ’%'·€¯ö&.

(95) Kekkaku Vol. 93, No. 4, 2018. 033. UN ;z. R}E04R±’˜æ0OH±’©‚Ñ6ÿ FWÀ. †Ø1(!‹N LØ2,3(!Ô¤ ÍAØ1(! u2,3(. ˏo}¡Å[ Õz’atb&•÷´Î‰1(! º¥Z‰2(! ±’z’0>%£ðۂatb&3(. 301. 034. 4Ñ6ÿ±’˜æF•÷I´V. uq Ø1(!-¸ ƒ1(!™¿ |!2(! € öØ1(!|~ ùáš1(!ô” •m1(! ” "]1(!—€ ʉ1( NHOª¢C„¨qã˜atb&Z‰1(! NHOª¢C„¨qã˜atb&•÷µ¦atb&2(. )e®*R}G}ZE±’z’0>%£ðۂatb& )e®*4Ñ6ÿ±’G™êÿ±’ElI@\âÿA‡ ¼p“A-Q#±’5ÒFî‹DŒ9A-R$ )IB5 U'B7< Õ¶±’û’§Mo}B7@¶Z÷F± ú*2011 a 1 ³ 1 ^1P 2016 a 12 ³ 31 ^JAE4Ñ ’˜æFû’UÇ.!:F˜æ.GQGÂP¶1P$G 6ÿ±’A_}ˆ’U05D>< 31 –F•÷I¯E s»¶EJ<2>@.R" )I* R}E04R±’˜æ ?.@¼wÝIE´V7<$ )±Š*=ÿ 24 –#óÿ 7 Fa˜!ÿt0OHr6S<±’©E58R‚Ñ6ÿ –$a˜C„?G 59 Ð$BMI C„?G 19.8kg/m2$ā ŽU 2000 a8+i!¼i!2010 a8F 3  Er4:F ,ã˜GT`o 4 –#c²šã˜ 3 –A-><$±’F WÀE?.@r%7<")5úBwx*2001 a1P 2016 òŽâ’G 15 –#Ÿâ’G 16 –A#ouqwG‘f2 aF 16 a›A±’©U´ï7<±’˜æ 1693 }U5 20 –BÂjDø–243#«YU„8R–G 22 –B úEhøa˜!=ól!⒏×àEr6S<©—E 71, U(L@.<$™êÿ‚Ñ2 5 Ñv†Fø–G 13 58R‚Ñ6ÿŽE?.@EÎ7<"J<è‹ 4 ‚Ñ –AF4Ñ6ÿ±’'XDR(G 4 –A-><$⒠› 'INH!RFP!EB!SM(E58R6ÿŽU÷ËýB^z A›gŒ~ÿ‡–'‡¼“Á¬(G 18 –#ß2d©– ýAl“7<" )±Š*˜æþG!2000 a+i!¼i! G 1 –#±’EORÜyG 4 –#3ã˜ÜG 4 –A-> 2010 a8A:S;S 678 }!558 }!457 }B¹õ­À <$‡¼“Á¬G‡¼p“¬'ß2d©–#Üy–(B A-><"œ˜a˜FC„?G 72 Ð!76 Ð!79 ÐBÈ l“7#BMI GÈ3'18.4kg/m2'16.0+25.6(vs 17.6 ˜‡7@0QóÿlŽE 33,!36,!44, B1ˆ­À2 kg/m2 '13.6+20.7((#_}à²"Vqjnt?2È1> ·PS<"‚Ñ™êÿ´ÎG!2000 a8¼iEG!‘‚ <'3.8g/dL'3.0+4.3(vs 2.7 g/dL'1.7+3.9(($J<‘ ÑE58R6ÿŽE¹õ­À2·PS<2!2010 a8 ˜æ¬E0.@fo&\gst‚'rlis\]^t EG INH!SM!LVFX E57@ÏH1ˆ­À2·PS LVFX(֊–2 11 –'61.1%(vs 3 –'33.3%(#Då <"6ÿ—F–ÉG^zýAG 2000 a8¼i1P¹õ ‚'ZemW^t KM#`crkcmW^t SM#Xt 7@.<2÷ËýAG 2010 a8E1ˆ7@.<")Æ hYmW^t EVM(֊–G 16 –'88.9%(vs 6 – Ó* R}F±’˜æþG 16 a›A¹õ­ÀA-R2!: Fa˜GȘ‡7óÿEORhøŽ21ˆ7@.<"5 '66.7%(B.9SM‡¼“Á¬A41><$÷‰Iéð U05D>< 7 –F/= 6 –2‡¼“ÁA-><$|w SGóÿFȘ‡2üKȘóÿ˜æEORhø21 A‡¼p“¬G„xEa˜.2È3'72 Ð'46+89(vs ˆ7@.RyBÚTSR"‚Ñ6ÿŽGnñâ’FKH 49 Ð'25+77( (#±’Ÿâ’–24.­ÀE-><'6 B DOTS X_F¾ŠEOQ 2000 a8¼iE¹õ­À –'66.7%(vs 8 –'44.4%(( $J<™êÿ‚Ñ2 5 Ñv A-><2!2010 a8E INH!SM!LVFX AÏ1ˆ­ †F‡¼p“–G 5 –B 55.6, U(L# XDR4 –F/= ÀA-><"5SG!ªa@wOÙA-RR}ëv@{ 1 –G‡¼“Á#2 –G‡¼p“A-><$ )±½*̎ AM÷Ëý÷”#N£bäì#SB7@CË!Q[V_ F´VE0.@!4Ñ6ÿ±’F‡¼p“¬GȘA_ VDCF±’{Ë1PF_Ëæ21ˆ7@0Q!Ïâ }à²"VqjntG?A-Q#Ÿâ’–24.­ÀE ’ŽFÈ.5SPFË1PF_Ë÷ËýEORËZh -><$fo&\gst‚NDå‚F֊–Néð–G ø2‚Ñ6ÿ—FÏ1ˆEœˆ7@.RBÚTSR"Ì ‡¼“Á¬A41><$ ¼!÷Ëý÷”#F±’høEOR^z½”ÄSFça .AFí<™)ޖM·PSR5BOQï#ËDCF ˜æe®Bñ’‚E58R‚Ñ6ÿFWÀED8 RBBME÷ËýEOR±’F/ h·!J&D⒂ F*:!7}¼F DOTS UākB8R[WdpWtE ƒ><â’F°2DC2î‹ED>@3RBÚTSR".

(96)  5 93  5 4  2018 [ 4 . 302. 035. (`. ’ :oF f

(97)  fˆ . !"#M $%. UŽ&'’fT(. 036. °}±²³f

(98) 230 J ˆ xN. DM ´"r µh;0. m¶. ·?!¸¹f †‡º»¼. )]*+J,’ rIi -:. :oF / )yB+J, 6

(99) °}±²³f

(100) 0 ˆ ]^0@J Pˆno D½¾_x s 0123045 ~6789Ž; 3 N3@ )op+2014 [ 4  1 Vkl2017 [ 3  31 <26:.=ˆ>{ 200

(101) f Vc? 6?Pˆ š›3FŠ ¿À3@ ?>@A;,\BC9ŽDEFY9FG ;H IJK9Ž ]*L”M^N8O# Pˆ/QRS )no+70 ŠPˆUQW\©WU 50 Šƒ U 20 Š?>^@^U 56 ŠÁX 3 ŠUƒ  Q yBT6;U2@V WX €?[Z MtN€kU 3 ŠQ‚%U 2 Š?>^ Š A;.[30f

(102) |\ ? @MtN, 12 Š?> ^ @70 Š}66.1±2.4 ]^0_ˆ`0na6@ )3<2op+3<, |7M 44 ŠzM 26 Š^Š?, 66.9±2.7 | 2003 [ 6 b2016 [ 3 c? -J?ˆJ ^ 69 Š A;@ˆ÷ āefg_fh 7 M 35 Šz M 21 ŠW  Š 67.1±2.9 |7 M 33 A p 51 ŠÁB p 19 Šm]3 A;]*T/W ijTkl6VZ6p ŠzM 17 Š~ Du€MŠ, 33 ŠÄRÅn, 14 ŠYp@a Pˆm$PˆpPˆno`0c2p@cJ F ÆǧÈ230,@ BMI 28 ŠKXfU 9 ? ˆ3<230qr2Z &p=ˆs45t Š––€kU 15 ŠÉÊËÌTjU 5 ŠÍÎÏ; ^N2Pu]* |6v=ˆs45twt U 9 Š?>^@PˆQW 1 [‰T ЍEь,4 30rxN3@)y+69 Š A;,7/z vYp@HIV €k, 0 ŠÒPˆ, 3 ŠYp@ 47/22[‹;{8 75 |}20b100 |~ ^ 59}t Follow «-; ¤q, 6 Š4M, 2 Š_ŸM N€k 7—iQ‚%€k 1~tN 4Q‚ c? «-, 54.9±8.9 V?>^@“•Du€MŠB % 1Ot% 2ƒ  3@T ij,a oPˆÓ?|Ô«-UÕ=3@ )‘+J Z8„lk †‡F 35^ˆA‰?T/W [- ^PˆŠ`_xN3@2016 [ *ÖL 17x?‹Œ A 17 Š@f+ˆA230,Ž  16KXf 16x‚‘Pˆ; 7’"“ 3”^ 2 À2c÷62Du€MŠU2Ø[‹84MÙ c„KXf€k„G,<lUk^@ÚÛÙDu •M–– 2B—O˜ 2@v=ˆs45tw, 37 €M, _ŸMc? «-2|Ô-t30@ Š?>^@J?63 61 Š? Tkl6c ? VZ,14 V‰T 33}47.8%~ 60 Vc? 64}92.8%~ SÝ2‹ªPˆ; –– 7 ŠÞH Y9F 10 Šßˆ30@ 61 V‰™ 5}7.2%~ @Pˆš›œ 6ž,“•/ ’—/BALF Du€M 20DuŸM U TB!PCR € M 5_€M 20¡/8 QFT G? ‰

(103) 6 16@ Pˆ ¢,'zf?WPˆ 21J?WP ˆ 24J?>Pˆ 151> 1@* 69 Š Pˆ no,Pˆ£‡ 48Pˆ;¤q 16}¤Dbw 2~C ?g¥ 5@16 Š ¤q¦§, 10d 6@ )‘+ f †‡ˆ0r,Œ ¨†\©e~U>@Wª,«6Pˆš›30 ¬)M ‘­Gp®¯l@.

参照

関連したドキュメント

強力粉…150g 無塩バター…10g 砂糖…大さじ1 塩…小さじ1/3 卵…1/2個 牛乳…45mL ドライイースト…3g ぬるま湯…25mL

WAV/AIFF ファイルから BR シリーズのデータへの変換(Import)において、サンプリング周波 数が 44.1kHz 以外の WAV ファイルが選択されました。.

7) CDC: Cleaning and Disinfection for Community Facilities (Interim Recommendations for U.S. Community Facilities with Suspected/Confirmed Coronavirus Disease 2019), 1 April, 2020

なお、政令第121条第1項第3号、同項第6号及び第3項の規定による避難上有効なバルコ ニー等の「避難上有効な」の判断基準は、 「建築物の防火避難規定の解説 2016/

地方自治法施行令第 167 条の 16 及び大崎市契約規則第 35 条により,落札者は,契約締結までに請負代金の 100 分の

③ 新産業ビジョン岸和田本編の 24 ページ、25 ページについて、説明文の最終段落に経営 者の年齢別に分析した説明があり、本件が今回の新ビジョンの中で謳うデジタル化の

[r]

7.法第 25 条第 10 項の規定により準用する第 24 条の2第4項に定めた施設設置管理