231-269
39
0
0
全文
(2) È© T 93 ¯ T 4 Þ 2018 o 4 É. 232. S1!1 µA ]nG/5U>¬a?æ'w\_(GA,B. âu Û|1(!)÷ ¤Ù2(!´ ";2( 'ᦷØSèk¨jl&ª'ʺ1(!ᦷØJͪ'ʺjl&2((. 1ZPµA ]n'RA(FEH*<ø±G/ ,BI!¾oHä!î}CHQÂ=·%H¤ 1:M!<HÍ'+U,IY5aY>9B, U(ä#îHh^1āqGF@B2>"!î >¬PcîÖ¬HN8L9,:GRT>OGM ç:U×OPj|l&FEHÝîYcîGM³ .GRTS©G>ê:U6D1āqGF@>"6HRFsÃH!1ZP RA G/,BI!<V=VHø±G /5UÍDFUä#îY}aD9>!,XQU î}aõ¨1ª'H1Gd19!!£HæDyKB¼ NBÝ,Õ<Yö9!õ¨G/5U6>FüG FTAA+U"6HR-Fî}aõ¨GI!üGv c&t×OPj|l&ßVv1 ,SVU1! 6VSHæI!!£H¬aß=GRTéSVUæ ']îß=ß(DIFT!>O'ä(GRTê >7V!éSVU6D0S! )>¬a?æ$Biologics! w\_*DÑ+7VU"RA I6HCãOË[F: 1MSVUø±C+U" RA I¥1 1% HR~aF÷Ò<HF9< *<ø±C+U1!µA»$!D3G®HK4< *Yi\D:U"?I¤7VB,F,1!ã¾ HQÂ=·%H.ä1î!ä}CS0G7 VB2>"QÂ=GI!ý%H#*GµXUä !<î1µX@B,UDÚ.SVU1!<HYC O! x¹P TNFa!IL! 6 D,@>!,XQU*< f\r`\1Y5aY9B,U6D1S0G 7V>"!RA G/5U¨I!<VLCH{ hp\sÄ×*'NSAID(!hp\sæP¿æ FEHÐSV>ø±þ3× ]n'DMARD(G .B!1990 o6W0Skrbj&r'MTX(Hí 1w9!µAr¥H:ÛY¢ð:U6D1āqD F@B2>"w\_GA,BI!f#!T äY}aD 9>]h£Hvc&t×OGRUõ¨ñÌ 1ùï7V>1!Í<H>N¬Leā1C2;!ÿ FÕ<Yö:6D1C2F0@>"<HÓ!cî Ö¬H«L9,:GRT!Í<YÆÎ9>b Á×OHé?1āqDFT!1990 oG ájre. [úGRT TNFa GP:UbÁHvc&t ×O!cA2'ÓH\z bg{(1é?7V!á H RN.Maini!M.Feldmann SGRTª'ñÌ1ùï!Ë [FÕ<1à7V! ]nG-ÇYā.>"< HÓ!õÌYÅB!1999 oG áC RA õ¨D9B( n7V>"hó¶Gā< TNF j|l&D IgG H Fc DHßVvîC+U^luj|rO(n7V >"Ó!N3Hª'ñÌPw8¨CV>Õ<1 ªn7V!¡¶aFæDF@>"CI!2003 oG (n7V!§æICÀaFw\_DF@>"<9B! ÓLH TNF H§¦G!IL!6!T äY}aD9> rg i{![wlj|r1ô%D(n7V!Ïç! 8 ý«Hw\_1í āqC+U"6HR-Fw\_H d1I RA Hõ¨G/,Bxm\gzrYO>S 9!µAr¥YEG4>NI¶0SHõ¨¢m!õ ¨}I:Û¢ð0S°¤JDhpo|[o|7V! YY5G_&7V>)Treat to Target*D,-l\r er&Hõ¨¨p17g9AA+U"?æD9B O!vc&t×OG/,BI!bÁ0Syr !7SGyrÁD:9!Í<1[93ÆÎ7 V>"L>!~ ^nd e&GRU^! 7SGb`@Z?æ¦GzZ?æOd19!÷Òe āOāqGF@B2>"909F1S!RA G/5Uw \_GRUõ¨GI!L?!,3A0H"¡F U1ì 7VB,U"L;!"jF§ò/!°¤YWHāx! <9BÝehrC+U"D3G!§ò/HãS!ã" ¡FOHI²D*C+U"l ]n¬£CI!w\ _GA,Bõ¨}aGí a\s\1é=7V B,U1!<HYC!¡ZòÜD9B!tFEH² D*DDOGÈ©!{È©<×ë½*GA,BiG¸ å7VB,U'TNF H§GA,BI!È©!{È©× ë½²DG/5UÔ·ØG/5U TNFa H"¡<0 SD3G.äG¸å7VB,U( " UCI!ᦷØCØX!9B,U÷; 0H RA ±ûHª'q&l}&h! )NinJa*Hq&l Y,¢9!G/5U RA Hw\_õ¨HÏ2Y¨B 9>,".
(3) Kekkaku Vol. 93, No. 4, 2018. 233. S1!2 Ø-ôÙºö;DC,1R¢D@9Då¾. Ì4 ì×&ç¼+¢:3ç¼*'. Ø-ôÙº!úC¯ TNF Ùºö;C,)>¢D# Í.Ø-ôÙºV¿>5>)BÇ @'5>ã )3@.ëPS>)R"Ø-ôÙº@)<>L9Dö ;ïD¢D#Í@E=$?(Q¿>C,)>ðV ?6R"¯ TNF ÙºC,)>LúC¯ä¡DÙº.¢ V#Í5M6)@©US>)R.!1´CO<>E¯ ä¡?(T*@B-T*@¯ TNF ÙºC,)>E¢ D#ÍC,)>¶.B)@©*1´L(R"5B.P ¯ TNF Ùºö; @'5>¯ IL! 6 È<ä¯äÙº /GCWog%erkCORÄB C,)>E5PC¢D#Í@.BR"5:.<>Ø-ôÙºD½ >õCO<>Eö;ï¢D#Í@.BRD?µ¬ E«0Cå5āE5>)-B1SFBPB)" 4b}tcZv?E¢Dö;ïD#Í@.²)@© US>)R¯ TNF ¯äÙºVïÒCÊHR" 2001 ÿC Keane CO<>ny%Y}_z}lcx%m |[qwjXd}C#)4S:E.COR@ inflixi! mab ö;COQ¢D#ÍÕ. inliximab (¿> @ '5¢D#ÍÕ.â+!9D#Í5:¢DúñE )UNR"¢?EB0"¢.ã0#¦.ü50 ÓêDîSV$)Ã2Ç.É:@D3@?(R" J:! ¢#ÍE infliximab ö;À¬ 6 \£ûD#Í. ã0ܻ֢Û-PD#*.àò4S:" 9D:KC¯ TNF ¯äÙºö;ÝC7Ó!IGRA J: Eis|^{}%!BPGC᥷COR¢Û Dd^{%n}_V°)ܻ֢ÛÇCå5Y fnWclCOR:3û,V°+F¢D#ÍE32 R3@.`}e}ad@B<:" 5-5B.P!$.°<:ý4C,1RWh{vuq DÁ&¬¢#*ÇD÷ÚCOR@!7Ó!IGRA L50Eis|^{}%!áÓêCOR¢Ûd ^{%n}_C,)>7è.B-<:ÇC,)>L ¢.#Ø5>,Qö;ÝD¢Ûd^{%n}_. E9>?((R.ª.(Qß?EB)3@! J:! µJ?DÑ1?E¯ TNF Ùºö;-P 6 ~£ûD #Í.ã)@©*3@?(<:.ö;¬ 6 ~£±L ¢#Í.þKPSR3@.([email protected]@B< :"5-LYfnWclö;V°<:ÇC,)>L# Í5>)[email protected]¯ TNF Ùºö;C,)>E ¢D#ÍVÐCÝóCí):ÄBV°UB)@)1 B)[email protected]<:"3SEÆE÷:QÝD3@?(Q ¯ TNF Ùºö;5>)B)ÇM¦¤®BpkC ,)>L¢#ÍE÷Þ3QùRU1?(R-P!÷ Þ@)+F÷ÞD3@?(R" ¨»?EØ-ôÙºö;ïC,)>¢.#Í5: ϳCØ-ôÙºö;VïÂ5>¯¢ÄBV°* 3@.ÔË4S>)R"?E!Ø-ôÙºö;ïC¢ V#Í5:P9D¬DÄBEA*5:PC)?(T *-#$EØ-ôÙºVö;4S:Ç.¢V #Í5:ϳ!éØ-ôÙºV85>¯¢ÄB V°<>-PØ-ôÙºV¸ö;.?/R3@VÅ 5:"¨»?ED]YlzY}C,)>LØ-ô ÙºD¸ö;.!?(R@D¹.(R"J:!$ .°<:ý4C,1RWh{vuqDÁ&¬¢#* ÇD÷ÚCOR@!Wh{vuqö;ïD¢#Íà 2ÍDEA¢#ÍÇ?Ø-ôÙºDïÂCO R6DÎBÖCOR3@.§ D=?(R 3@.àò4S:"5:.<>$EØ-ôÙºö; ïC¢V#Í5>LØ-ôÙºVïÂ87C¯¢ ÄB°<:I*.Ø-ôÙºVïÂ5B)OQL ¢ÄB.OQ9CÄB?/R3@VÅ5:":;5 Ø-ôÙºVMK7C¢ÄBV5>9CÄB? /RDEÈÖ¢Dϳ?(Q!8ºæÖ¢Cå5 >E9DªQ?EB)"5:.<>µ¬D¥øè?( R".
(4) « þ 93 þ 4 » 2018 ? 4 ¬. 234. S1!3 íL÷0îÂ4`j'ÔKòo`nh(K16ZG«ë¶Ç¢á. è. -'§lāÜý÷z÷Jo`nho°I:(. íL÷0îÂ^Èa=ZÓéL¿Uù.ÐM òo`nh'RA(G-ZAT!¾LCHGMÔH<F RA ^°ÐH=ZG«ë¶Ç¢á'NTM(K<F 6=Z"RA ÎfLUMY^cê=Z8HGY!íL÷0îÂM RA KWZ@ëLò^¡hK cê=Z"=UGM 2002 ?K¿ÞLíL÷0îÂ3c q&rIGà>:[Aµ!±ÃGM RA Kû<F 7 Öi LíL÷0îÂ3>TX[F.Z"ÚbJKÄaMw óëG!ÖiK]X>óáL)GMÁ¢ëA3¿ Uù."9+0JóáH<FM TNF'tumor necrosis factor$×nÊ|É(÷^Èa)L«3 7X[ Z"TNF M<×L¦ì#yÌKÚbJ\^A= e_kb_rG-Y!8L÷G<×^yÌG4J5 JZATH¸0X[F.Z"AB< TNF ÷^uG U«LR½M-Z"NTM óáM RA jGSHSD AR½3ßJ."ájé3@[RIù5J.8H2Xa mjrf^·(<K55!³%LájGÛÔb|^¸e <J3XÕ#YLäüGÎf^¹DF.Z"<2< NTM ^ÒKdrkq&pG4Z^Â3J.H²] [!RA LtöJÎfõ!K;Ù=Z" íL÷0îÂ^Èa<F NTM ¼O RA ^Îf=Z K-AY!ª<F14A.[ÿMý45M6ZH 2 E-Z"OHEZMíL÷0îÂ3 NTM CáLofc HJY/ZL2!H./2G-Z"RA H./ÐLë Ñ K W D F NTM 3 ø 0 Z L G - [ N!RA ö j G NTM K*v?;Z^8J."-Z.M RA Kû=ZÎ fKWY NTM 3ø0ZLG-[N!Îf^9HK*v =ZQ4B\/"2XLR½GM{EØ$HF< F RA ÓG NTM 3 2 B/3ù5!)GU TNF ÷ ^LÈaÓGM 10 BKâZ!H:[F.Z"=U2XM RA KD/ NTM ^Øð<AR½3-Z3!RA öúL )G NTM MILW/J_Id!md^ÌEL2MR ½3=5J."PAEZMíL÷0îÂ3 NTM øsL ofcHJY/ZL2!H./2G-Z"NTM ^¼O <A RA LÓKû<F RA LÎf^¹DAã¼!Îf ^KWY NTM øsLofc3xJZL2I/2MÚ. bG-Z"2014 ?L )íL÷0îÂH´Ð æf LÕ}4*2XM!NTM Láj^õQNíL÷0î LÈaU6:[Z8HHJDA"5~2XUôy£7 ¥LA NTM Kû<ÕݵKíL÷0îÂ^ÈaG4 AájR½3-Z3!SHSDAR½MßJ."¾! 8[XL[Kû=Z'¯^8ZATK!2012 ?Í2 G5.~)L RA Ó 1648 çKE.F!µSË0K NTM K=Zj&g^ØTA"2012 ?Í2GL NTM ¼OjM 26 jG!8L 26 jKE.F!2012 ?Í2Gí L÷0îÂ^Èa<F.ALM 5 X'19%(BDA"5 Í NTM LJ. 1622 XK<FM 661 X'41%(3íL ÷0îÂ^Èa<F.A 'p+0.05("2016 ? 12 ¬SGL Å)K 9 jLå NTM æ%3-Y!NTM Lm dM RA10 Vç?-AY 158 çBDA"8[M=UL {Eç 10 Vç?-AY 14.7 çH./mdL] 10 B G-DA":XK)!öúG 43 jLÊT!/C NTM ¤G 2 çLÊT^>TA"<2< NTM KWZÊ TjMJ2DA"öÊTK=ZofcH<Fºk'65 Àuâ( !&ë!fiq_lLÈa3 7X[A3!íL ÷0îÂÈaH NTM L_WMÊTofcHJXJ 2DA"SAÅ)K 9 jLå NTM æ%3-D A3!ºk'65 Àuâ(Hfiq_lÈa3"Qgï GLofc|ÉH<F 7X[A"<2<íL÷0î ÈaMofcHJXJ2DA":XK!UHUH NTM ^¼O<F.A 26 jHåæ% 9 jL¼© 35 jKE .F!íL÷0îÂÈaÓ'n=13(HGÈaÓ'n=23( G NTM øsL¼^,QA"íL÷0îÂÈaÓM¨ )Køs^>TAL3 4 j'31,(BDA3!GÈa jM 3 j'14,(BDA'p=0.38("íL÷0îÂ^] 40, GÈa<F.ZH./VVPYL-ZØ$GL 6GM-DA3!RA K1.F NTM LmdMº.U LL!1ñKáj^õQNíL÷0îÂL NTM Kû= ZofcMº5J.H¸0X[A" NTM M RA LF0J¼OáG-Y!N®0¸Å ^0EE!5~GLj&g^Ï<F¾µLÎfLƸ K<A.".
(5) Kekkaku Vol. 93, No. 4, 2018. 235. S1!4 8¤ß¾Ó@,1LáA"â¹&S. Ø. ÍF&NHOāK¶Îê<ukRf_'. áA"â¹ÃZ@^37åÓA/ûB!0 Ë àßåÓ<(L"5?N8!¾HÚåÓ7á =%.±)!èÇAó;]=3;¤Ó.!¬ÇB bj%iZ\`P\6z&PCP'.I0öJM;)L" /@!¤Ó@:);B!æºß¤Ó\Vk%bmW! ¤7ÓRJ&S!áA"â¹ÃZ@^37¤Ó A\Ò"/ûAN@IK6A7á=%Bþ¨3;) L"sH!*4¾<(L8¤ß¾Ó@:); B! 6A7á=%H\Ò"/û@5LC§BI3)" $B!áA"â¹ÃZ@^3768¤ß¾ &NTM'ÓA/ûOX%\Zk%]@IKo|AI*@ C=F7"1' áA"â¹ÃZB!6 NTM ÓÜ°Oî Ü5L!2'ñ0AÊB MAC <!3'7áG÷B!Ñ ¤ã!ÑTø×ß9Ѥã<(L!4'\ÒÓÖB(9; G¢%<!zÓf%T%E}@I3)!5' NTM ÃZ @IKë"!·"é..JML=)*/ûO3 F7"áA"â¹ÃZ^=)*2=<!ýÕ7á5 Lb NTM Ó=ô/?´pB?-97"ãkRf_ B!6 NTM Ó7á=%.±)=)NML"6 NTM ÓA7áUtB!6A®ípÕ=LxVÞ.È<!+ ;Qm^%dSlm γ HQm^%lQUm 12 .6 NTM Ó7á@VÞ"@(0"RA <B!-<E²D= %.±)2=.6AXQ=¯+JML"YQaTQm½ áOVÞ5LáA"â¹ÃZ#{Aô.ÜE=! RA ÇA6 NTM Ó²DB³¬ì5L=¯+JM. L" 6AI*?ÖA?-!kRf_äOrHªäOr B!6 NTM Ó@òÐ5LM.ì+;0L"õ 1 $A eQma=3;!9Ñ?6 NTM ÓO2~@D:1L=)*2=<(L"áA"â¹ÃZè@B!HRCT O¼w3!÷¿úÓH¤ãw!ÑTø×ß9Ѥã! ,<E.ðº5LÔ²B!`a(L)B÷¿¦µ O°*:U.(L"¦µ.vß<(9;G!1!2 n¥ <? X 禵O°*:U.(L" õ 2 $B!RA ÃZ=3;áA"â¹ÃZA:UßO ÌB@¦'5L:Uß<(L"Wy#>WyO¯Y3; +1O£ÿ37Ô²! NTM PA@PÏÉAÂ!ÿ "?Û»=? X 禵AÆÀO×.1L2=<( L"³AZme[Rg<B!üáA"â¹ÃZO °97Ó]A6A¬@:);A!Ä?>°)!6Af c%[hma@:);_OÙF7)"Ƹ!RA AÅ )ßAÝqB©$AÓ]@IKô/0p?L7F! áA"â¹ÃZAÃZ[¨[HøÁ5?Ó]G( K*L"C7!6 NTM ÓGÜ°B©$AÓ]@IKô /02=?K!6<EÜ°.!áA"⹡ï=øÁ <´.?-97GAG(L"«@!Ó]!Ó]Où4@ Û;)02=@:/L"³AZme[Rg<B!ü áA"â¹ÃZO°97Ó]A!Ä?>°)!6Af c%[hma@:);_OÙF7)".
(6) ¶ @ 93 @ 4 È 2018 X 4 ·. 236. S1!5 Interferon!γ Ã;1O=Q9b¶)ÃÛ«ú. Öü. A("?~â3Éf½§¡#/úU). ú)ëH_wgv%tV}KD7B:3H*k K+Ô1`6TB/R!<TQ1dKD9S*;Ul ÝI proinflammatory EQ2VäAOH1í;C+S" Interferon!γ(IFN! γ)I proinflammatory `Yg\Y wD7Bi'H ú)ë!é¾|)ëCë5x F¢9S"<TQHëF/,BIf>V÷09S= NF IFN!γ )H(Vc%^dgD7=*kK +ÔC+S IFN! γ Ã;H`1áMQTB2="t C!IFN! γ D IL!12 VÕ7=o]vnW%aDsw k¨H2¿ ¯IÃÛ«VI8ND7=ÑvU¢*« 0QH*;yÁFF!KE~V=7B,S"ìÓF IFN!γ/IL! 12 ³F USlÝ1}MKFµ97B, SCI!ø¤0QÃÛ«VõND7=ÑvU¢*« /V®Rp7!pwft}M°oY_j]esX{ /úD7BDQTS"5TQHDº0QI IFN!γ Ã; O:3H*kK+ÔRFà ú×V}K9SD RåF!<HãûD7B|g1!TFÃÛ«F< 9S{/)1¸Y6TS"¼åLCùKF6T B,S IFN!γ Ã;I8Õ;:!ùÂH¹P1E6 T=+ÔD7BI Fontolizumab!AMG811 H 2 î1+ S"Fontolizumab I 2006 XF]v%wfF<7BH Â)1sÊ6T=1!<HÀHIáCzE¶Vè9 5D1C2:F`_FIà@B,E,"ãûC/ ú1WNQTSOHH!IFNγ (Fa-DÆ.QTS ÑvU¢*«HZmb%hIWNB,E,"AMG811 I SLE F<7B 2015 XF@ 1 2á»HsÊ16T!< HÀ 2017 XF2æ,CùÂHsÊ16T=1!, :TCO SLE F<7BHÂ)Vè95DIC2E 0@="ãûCIua[ir^ !\î)`tqi rúH¦Ò1+R!5TQIÑvU¢*«C+S5D0 Q!IFN! γ (Fa-{/)1¢7=[)Iè Î6TS"+ÔCÐHؤI 12 ñC+RH¤Ü CH¶CIE,=N!ù1ÇUT=ýÉ0Q. I7B,S[)1+S"<TVr-DºD7Bà IFN!γ é¾Ã;(IFNγ!Ab)Vqä9S\î) NTM ú(dNTM)HDº1ÙÆFERSS"¬XFER{Q 0FE@=£DH|g1Vä=E, dNTM 0Q¹ ô6TS IFNγ!Ab I!ï)F USÝD7BG } V ò N B , S" $ I z w 2 } H F X ö ) H IFNγ!Ab )H dNTM V³»7=5D0Q!²O KE#B1c DÆ.lg¹;0QH¹ôuVÅE7 B2=(J Infect Chemother. 2014)"ÄF 2012 X 1 ·0 QÞ-PR6JyV,=>2 IFNγ! Ab )H ,V%NB2=(Clin Infect Dis. 2017)"3´C 331 HÃÛ«/úH,VÇ,!]±F|g1H{ Q0CE, 37 H dNTM ú0Q 30 H IFNγ!Ab )() 80.1%)Vºô7="õ¤úÿFT|K EOHIE3!:31ān#BD7BÃÛ«ú1©4Q TB/Q:!#BLCFmªC 4 0·V 7B,="¹ ô«H-? 70* 1 MAC C+R!&7`«1 20* C +@="foI^ (66.7%)!Ë (63.0%)!swk. (48.1%) VI8N1$Flh7="1Fëu1!2 FIçD7B Rituximab HN1ÇUT="6 1mª 2.25 XH¤V³BçVð7=11C ÏZVWN="ؤFCCHßxI 3.2% C +@="5-7=¹P¶1èÎ9SP-FzÃ;Vq ä9SúIVþùC49S NTM úDI|ES ùe¼°VäA"<TF.!zëCIé¾Ã;Ú *D,-é¾|¥÷Dóú NTM úH`úHFó E ÷1èÎ6T! &é¾|)b¶)ÃÛ«ú' D ,-YCWê9K2ëDÆ.QTS"*kK+Ô D7BH IFN!γ Ã;1ÍÀ,QTSP-FE@= ÓFI!H¤Ü1ºÌLT!<HÓFI<H×¥÷ 0QOé¾Ã;)úRFÃÛ«F<9S{/ )FIGzVjUGJEQE,!ìù0QSQT=5 TQHDº1*06TS5DV¤=7=,".
(7) Kekkaku Vol. 93, No. 4, 2018. 237. "&$#!% 2 É&R]ãL³öG:Ó. ËB = À¿(¹|Ñ@oÿyp°¢î) ËB ñq ®X(=ÒØj®î). YqLã!M²ïª¼J,[!g$ 28 [J% 9]?*J<\UG.òypÙþ+FM!N£ drsmkfLÅ^]\ 2020 [RFJ!WHO LGā <\ 10 uL*FR`}É+_tÙ<GIBE -R<"°¢î{÷õlisj%JY\G!77 10 [LùMã!M 25,311 ÿ1Z 17,625 ÿG 30.4% ²ï:!2016 [LM 13.9 GI[R:?"yn! É&R]Lã!(2011 [RFMÉ()M 842 ÿ1Z 1,338 ÿG 58.9% 5:!2016 [LùMãJ-U\ ÇM 7.6% GIBE-R<"AFV 20 Í</·J-U \Ç2Æ4!É&R]LãL-U\ÇM!20 Í < F M 2005 [ 2 20.3% F : ? 2!2016 [ M 57.7% GIBE-R<"É&R]LãL[<Ã$_±\ G!77![M=3IiMs4!2015 [M 20 Í<2 48.5% GÌVÆ4!20! 59 ÍRFL-U\ÇM 88.0% G-^X\æ"<2=^F<"÷¦fM[<Ã$_ _z:E0[!2015 [LÉ&R]LãFM *>L7 ô|¨ã+2 29%!*&L#÷&+2 27%!*>L7 Þ¶#Y¶+2 11%!*+¦+2 5% IHæãG& L#÷&284_-UR<"7L,!YqLï×Æ 29ZJýS!Rÿ»2²ï<\7G_Ä/\G!æ "<LÉÿLZ29ZJ5<\7G2y39 ]R<"7]RFLª¼FMZ<\ÉÿL84M Æd?É1ZF,[!AFVaha1Z284IBE -R<"Z<\ÉÿLÉ(__z:!É&R] ãLí&ÉLWxM!Æd?É284!AFV aha2=^_-UR<"h,ýÉL84FM! Æd?ÉíüLvrIHÉ&R]Lÿ$L2!ù MãL84_-UE0[!FLV2t CÉV±Z]R<"YqVÝ?Y.ITH_?H\ \ #2,\?U!J*I:2¡UZ]R<">L?UJ M*4]±L?ULÖ2SD4[+ #*à $ºPLå [2S+ 2ë}GI[R<" *4]±L?ULÖ2SD 4[+G:EZÉ/®û!\áç&W÷&(÷&! Yq¸÷Â&O)IHã]±LÆ-è@PL®ûG ®¾¤x!J*I+øã®ûIH2a}GÄ/Z]R. <"UJ!ZÉ/®ûJ:EMJ-4C1LÉFá Û9]E-R<2!YqFV>]Z_ÔÄJáÛJ¼5 E¯Q<Q3F<"R?! *à $ºPLå[2S+ L >G:E!wÏ;#Lu>W´¸!¬ÎIu>!Ú~ã LcÐIH2Ä/Z]R<"j®îMw G«: E!w Ex_U?ewÚ~!âI`Lä9_Ä :?ãÚ~Jå[2Ta}2,[R<"ÊLgs ohbqFM!yp°¢îL=À¿,&J *h,ýÉJ05\É&R]ãL³öG: Ó+_:E-?@3R<"ß-F!ùì©j®îLe cnjtv,&JM! *Yq¸÷ÂJ05\:Ó+ _ ]b:E-?@3R<"ùì©MYq¸÷Â2?49` ,[!®ûIH!'§II:Ó_áÛ:E-R<L F!>LWzJC-E8lÈ-?@3R<"úµØj® îLPÕ~",&JM*É&R]ãL+øã® ûG VNTR+G-.l%pF!VNTR _|:?.¬ LD JY[! &J*I+øã®ûJCI6\JM' G -.7GF]b:E-?@3R<"=ÒMO3Lw i sj%LK6½,&JM*É&R]ãLð óL>+G-.7GF!kÉLö¥__z:?wÏ; #W´¸!¬ÎIu>_m/?É&R]LãL ðóL>JC-E]b:E-?@3R<" Ì·J! =ÒØj®îLCK×,&J*É&R]ãL ãÚ~Gà $)+G-.7GF!w Gj®î L«!w Ex_U?ewÚ~!âI`Lä9 _Ä:?ãÚ~IH_:E-?@3R<" Ê·! ZÉ<\Æd?ÉíüLÿ$M9ZJ5/!19L ãLAJ05\É&R]ãLÇ25: E-47GMáF<"Ü?AM!Yq&R]L ãGS{!É&R]LãJ::!4]±GJ *Ià !>:E!ãLa}J;?J*IãÚ ~_ÅBE-1KNI[R=`"qgsohbq2!Ê ·L^2ÉJ05\É&R]L:ÓLÁI\é áG:Ó0L?ULêfI|JCI2\7G _.VLF,[R<".
(8) Ä¡ O 93 § O 4 Ý 2018 i 4 Å. 238. S2!1 w=2àJ49Yāà9QZÄ¡©öKÎ,GLç. N£ ×Õ)ÑæQ|3Ä¡~ġɶþ"#¤t*. āà9QZÄ¡©öLçJ41EL!0RKUZGGT -L>SJ. 2016 iJ49Y\6àKCÄ¡.fý©ö)17,625 3* J!ñWRTPG=E0:WZE4X!;ZWK P]15JB?Y56N7IPF0Y"~&nw WF!āà9QZÄ¡©ö)1,338 3*K>SY¥ÞL J41EL!2012 iJ!WHO K~&nwTgJ4 7.6/ F0X!½iF¿ÔJ0YTKK!B 1 ¥÷F 9Yāà9QZÄ¡©ö]L'G?Yã[ÏKLçg 0Y"{!J8Kw=2àJ41E!āà9QZÄ G=E! 'Minimum package for crossborder TB con ¡©ö6CKKf9ý©öWJ>SY¥ÞL 50/ ) trol and care in the WHO European region$a Wolf GICE4X!@KLç]15JÒ_Jôí?Y56 6Ñq<Z!;KuJ49 N7IPGICE1Y" āà9QZÄ¡©öLçL! heze consensus statement( YÄ¡LçK®_IÚ3]ò=E1Y"{!wà# @K7GLnÒ!3%K c^KP!ý esm#à#d&kq_#t}&j& rK 1àKÄ¡÷,º#i#7x#õÂävjÁ 5 eàL!øJY±Må°}ö]L'G?YhàAÄ¡ bJ?YPb!J¯J\AY ]Ú?Yp60 Æ0]6WKà%FÀ=Eôí=E1Y"{!Ä Y" ¡Æ0KôígJD1EL!@Kð±)hàA#hà zßJ41EL!w=2àJ49Yāà9QZÄ¡ ð#hàÐ*!L'ó© )¦c7Ä¡KR5!@å7Ä¡ ©öKÎ,GLçµNPbJ?Y+z]vÈ5W ª?#TL'G?Y5* !L'ö)Ä¡Ü÷à5WKh úû#8=!áÐ\6àJ49Yāà9QZÄ¡©ö àöJÙY5!@KI5*!{| )»t qg é! LçK0X{J?Y+z]]·?Y"QA!2016 iJ Çâ!a l&zc γ ïË!o{f kqöW6z`y |tëJ49Ywuf mslÇâ*bK J41E! àF5IXKMWD tnf)wàUd&kq_bOKMåKASKâ& 760Y" /:ðÆ0ôíí<*G!d&kq_irt&ëK āà9QZÄ¡©öLçKWF!hàÐJ¦c7Ä¡G hૼJ49YîèFeWZASÊbTZ=E 0R<ZEÄ¡Kñ6ê<ZA©ö6³à?Y; zß?Y" G]°}=A*Þ!Ä¡ñKÃH7]15Jy(?Y -w=2àJ49Yāà9QZÄ¡©öK. 5L!PKDF0Y"wàFL!Migrant Clinician 2015 iJ49YÄ¡[÷ 30 eàKzßFL!v Network)MCN*G12oD-6!wàgāJ49 bc&!kbc&p !d&kq_bJ41E!C Y;ZKI1Ä¡h&xk6]·<ZYV2J Ä¡.fý©öWFāà9QZÄ¡©ö6>SY¥Þ ¾ö¬ )%̲!%=²!%©ö! 6 80/ )GICE4X!esm!à!rao!wà āK*ÞL%=yÆ$KÄ¡Lç¨b*FK÷] bJ41ET 60/ )GICE1Y";K 30 eàCK ùCE1Y" FKāà9QZÄ¡©öi¬fý5L!½iÍ!¿ÔJ 0Y6!i¬ 4 3PH6zß<ZE1Y"āà9QZ -QGS. Ä¡[Q^÷JÛ=E1Yw=2ÿàJ41E Ä¡©öi¬f9ýKÍ!GaL!àgý9Ä¡©ö L!CÄ¡.fý©öWFāà9QZÄ¡©ö6>SY J49Y@Z)i¬ 4.9/*VXTU8!i¬ 2.5/ ^G ICE1Y";ZQFKG;[!āà9QZÄ¡©ö6! ¥Þ6Ü8!āà9QZÄ¡©öLç]15JÒ_J ôí?Y56N7IPGICE4X!%IïÛ6ô àg9QZK3%Jª?]TAW?raL!I1;G í<ZE7E1Y"\6àT!Ä¡[Q^÷]KA 64\<ZE1Y" JÖ3!w=2ÿàFKÂË5W¤N!_j_ÿàG -w=2àJ49Yāà9QZÄ¡©öLçGP. KÄ¡LçJ49YÀ]¹=DD!;KTJ`Þ 15IY3ÓûQ]L'G=ET!Ä¡LçKüI 2 =Aāà9QZÄ¡©öLçKØV]ì=E!¾ö DKXL!Ä¡©öK+E±kÊ,G+¢ôIñ,F 0X! āà9QZÄ¡©öLçJ41ETdF0Y" ¬K¸´]2SY;G6pF0Y".
(9) Kekkaku Vol. 93, No. 4, 2018. 239. S2!2 A_¯¶G07S¥~!Â. [Za_. df!æt. î!· e!ó« āÆ!Zà k¦!· %åÚ\§Ý&. nM. cGKD|':C:KA?ÍuN¡ª:?" >H®N! )F *åÚIê° 336,694 ê%2016 D 10 ¦¬Á&D! 2015 DG 1 Íu!2016 DG 1 ÍuH×)öV¡ª: >H.@!{¹êê°I 41,303 êDg 12.3+ VõMC C-S")hÀ"ð¥~* hÀ"ð¥~H ÑGB-C! 0R!µG!$ÁÌ}HF-{¹êI!8Hg 2 GEN OÜÏs2D3<GÏs205FS8EI!UhÈ ë¤9TC-S"åÚHê° 10 a!¥~y rI!8 s V » @ G ; S l q H 1 B D , S"þ À " ð ¥ ~ 8 10 DI 40$50 Dëk:C0R!y rH·9Iù ¹DNáhGh+:C-S"K?!Dvz[y rH %MDR!TB&H Ñ1Q\c^bY`2ö#HP:? ÍuN¡ª:?"8HÍuI!B¹®NF-ÎDH >.E:C!2016 DH;¤DI!20$29 ¾Hqr2 ö#HPD,A??M!A_¯HÖ=NéWD0Q 65.6!70$79 ¾2 44.8 D!20 ¾&Hy r2 70 ¾&H <!ÏsG!;SpwV=S8E2@:5!UhÈs2 >TVáxAC-S"20 ¾&H ÑH 8 2{¹òK »@D,A?"K?!òJHF-A_D0HÏ TD,So^D!70 ¾&H ÑH-GI{¹òKTI sV¢ý;S8EJHQg2KãG5! ½Õ3GI! KTC-F-"åÚGI!43 ¶HA_¯¶2, ¶V%:!]¹DÏs¢ýV;S?MG¹;S8 R!>HíIù¹DNVI-C-S"A_¯¶Ô )UhÈsG07Sv(* A_¯¶Ôò òHþ5I! ¥~y rH·-X]XÞ¹HÛèÑD! EEFA?" H¥~ ÑH-GI!B¹:CNF-òNþ5! Á-G¥~VHà:×)öGËSÍuNÄ©9T ¯!Yu!ÖHl-!¡¿3e(:GPR!ÒçKD C-S" )åÚHA_¯¶¥~§ç*åÚDI!ß ËQ<!K?!Ïs#UhVyÅ:CN-*:C:K. x 63 D1Q?HA_¯¶ÔòG!;S¥~§´ òN-S"8H?M!97H{¹ê¥~ ÑÏs# ç*VDG 1 x!9 ¦GÐÉ:C-S"ÒçÑíI!2012 UhÈspï8Voj:?R! ÑH1:C-SA_ DGI 3,894 ê!>H®û/ý7!2016 DGI 1 aêV //!2017 DGIµGû/C 12,251 êD,A?"o^! ¯¶HtV=S:H²RV:C-S2!ØWEI/F-">G!÷Áð¥~öà%LTBI&GB-CI! ¥~H©rI 0.3+ ø®Dëk:C0R!A_êòH àä2b-GNUQ<!UhHNlðVpw:CNQ ¥~§´ç*G07S¥~H©rHg 100 GE·rD -!ÏsVì9=SHIKãG@:-"1 êHò2 ¥~ Ñ2H©9TC-S" )úH©H@:9* A_¯ LTBI ÏsV-*:!ÓiHòHDN'ÊNOMC ¶H-GI!1 DGVíxHBÎVô7C-S :K0." (E-.Xi÷2³2R!Ïs-*2THw¼ ¶2þ-2!åÚH§çIDG 1 x 9 ¦GÐÉ:C -S?M! §çÎPRN,TCB:C3?òI! E:C|':C:KA?ÍuN¡ª:C-S")º®H !ÂH^±ð*åÚDI!A_¯¶B1QúG nDH§çHÎKD#?F5CIFQF-"B¹ÎG §çVÒç:CNQ.?MG!BÎG¸U=C 1 GHP:C-Sâ¸!f-I!B¹®;6GHP:? DGVíxH§çVÐÉ;S8EV¨<:C-S"A_ â¸G!nDH§çHÎKDç*29T<Gö2| ¯¶ÔòH¥~!ÂI!§çHLDIQØWD!i ':C:KA?ÍuNVí¡ª:C-S"K?!§çD àäÎG,rF5ÒçD3SP.G!ò6O¶Ñ Ijã2CMQTF1A?2!>H®GHP:!H©2 ,TC:KA?ÍuN,S" )A_¯¶DH×)ö* JHSHNÙlD,S"K?!ç*®GüO1GÏ sG£4!ÏsìVdÇ;?MGI!\§ÝEms åÚ?HA_¯¶G07S×)öÍuNVíH !A_¯¶EHw!¯HÈs:! ÑG¸U= ò:C-S"8TI!ç*9T?Î4DE:C-S ?UhÈsH22D3SP.F DOTS ÿïHñLV %5`mð& ÑNþ5!ç*GËSKDGÓiGö2 éMSNl2,S" |':C:K.1QD,S"2013 DGI!öÑ2 127.
(10) D 93 D 4 2018 c 4 . 240. S2!3 ,
(11) 1
(12) "nM. W )! s . !"#9P/ ,$%;&'(! ^)*+/,}+\-./0&,$%; &'(! ^ /,} p+ 25 c ) 1 2L7 2 z& +I 15,000 & +-./0 1,500 & +3456+789+:;5<8=> 1,000 &?@ )ABC(D E+-./0&$yc 1,000 &F;&+p+ 29 c 11 6,015 &HI+1 2L7 17,262 &+I 14,684 &JK&(HB '(3456+:;5<8+789 / ,} 1,000 &L1,500 &)CMNrOI H$+PQRS 117 &→727 & +789PU3 200 &→306 & +VW 8XR34 &→132 & +HY / ,} 10 c8 gZ;&'( ^ `x[\]^_ (*; &'$+p+ 28 c 7 22 `+u~`aab cI`x[\]^_ defg$hOi +p+ 29 c 8 1 `jkQ+fgl{CiHm n+p+ 29 c 10 1 `?opq \]^_ 2 rH+9 ` x[s$p+ 30 c 8 ?opCH, ta $r H+fg$uvwi C( ! xy# ! 2016 c pT
(13) ( 285 &+ &z 10 z@ 18.6 9 13.4 g&{(! v|÷ 2020 f~M+@hl'$I)A'$+
(14) <R9 N&'(2016 cp T
(15) 285 & +60 ?@ {÷
(16) $ 75.0+70 ?@$ 61.4 {÷
(17) $?rOI H( t)+20 B+30 B
(18) *>&'(2016 cpT
(19) 285 & +9c÷) ,.
(20) 25 &+8.8 )A'$+20 B) 13 &I 11 &$ , )+ 84.6 CMHl&"M'( 9 V|)* 20 B pT
(21) 57.7 $ , )+;AI+D Cln$,)A'( 1
(22) "&#,
(23) f,] lt&Ck+5uD 15 f~MM&+D 17 f~N"El(, , ?N m(&)SR0U358&'(3S7.. vYltmHm nHkH$+ C 2 B'B+oMIl' ZM)A'(`x[$ j¡n)A n+,.
(24) Z¢$£ B) ¤¥¦B'§ $AI+ C+¨©A$dª)ABCI' )+o MI&J«$h)A'(
(25) x&*cN¬) MH§*AI+M &n&n_'(M +"l¯°'± BC¥+8*B 3 $²)A'(³ltmC´µ$HN+¶· ¸K'c)A'(¹l X 6³) <lºB "l&BjI3&»jH+÷:$[k. H(¹l X 6¼½ ¾ā$HN+À $OjkH C"+ÁºÂ$rH§$A'( nM #p+ 23 c+Ã,X`jk_'\O5 vÄ%$ri + nM h*$ei C( ! ) p+ 15 cjk.ÅPM&+ Æ Ç£l+nP¬-lBMC(ei. C9 ÆlÇ£&+VNTR uc'n Ml¯°&'()ÈP Æ ÉSÊV C MN 6 nmk +D nk FË\*$b"k. '(`xlÌNÍU3Î3 BeijingwÏÐ cn 'Ñ7Ò$Ó)A'(D I)*+`x? Ð+I?Ð+1?Ð$A'(VNTR uc'ÕRÑ £.cI+VNTR QÑR8¬-)+ wÏÐjYj+ CwÏÐ Hj)+Y Ðj'= )M'cHB'(a 3 c|{ , ?N r#RÐPHÉSÐle&'(Ö×ÑR ©+*Øk F+r#)5&a 3 c|{ fi&CÙÚk '¥$?( »OI#9P Ø+20 B
(26) 4"',
(27) ($;Ú'(À qlÛIÜÚC¯FMl *1
(28) "lQ0¯°&+5ÝClvÞ' t)+Æ$nei C¥ nM Hß+H¯ÕRÑlG.&MC(.
(29) Kekkaku Vol. 93, No. 4, 2018. 241. S2!4 Ö>LU»õG¢)/G÷O. _I Ë1(!¢ ¨2(!¯ +ã3(!3| Ó4(!Ò_ Ìø4(!| 8o4( 'ThÑ= 6NÞxw¦ÏNÞHI5G{ bwc%¢)¾Ø1(! ThÑ= 6NÞxw¦ÏNÞHI5G{ bwc%Yvu]%i2(! ThÑ= 6NÞxw¦ÏNÞHI5G{ bwc%¢)Àªz3(! ThÑ= 6NÞxw¦ÏNÞHI5G{ bwc%D*i4((. +#Ä,»¬4ZLX:>%ÖB¸Ã9U A/TQ0F"Ö>LUÜõ3RG»õt>H Èû>/G÷OCET#ZLXWå;V4ÖF 2/AO"önFF2/AHÖ>LUGõt>4 Ü:A5A2S"=GLH×ÆG»Lß/G^ CÐ1RUT# +\,NÞxjzT}F.TdF27 T"Ö>LU»õWWØ;T8CB"¢)/G÷ OWVÿ:"ÐàWÑ@>GBÕ;T#+ ,2007 n 1 ¼ 1 k3R 2016 n 12 ¼ 31 kLBG 10 n B"d FA»ð Wä:>´;»õG0?"Ö >LUB.TõWL-C:>#kBÿ>:>OGH' :A2S"é3R*¤VÿW:>>N"Yâõ HL-3R¨U>p;4.T#\ud1WÆê\ FWØ:"*¤Wüº$|?:"}¿PëW¤F ÐàWÑ@># +»,L-CE@>*¤H 66 ¤B"S ; 30 ¤'45.5-( "&; 66 ¤C&;GÔ4Ò6"³ n¥ 36.1 Ú'vwa 17&82 Ú(C"n¥OönF4J 3@>#ÿ5ÖBH"UÖ 24 ¤'36.4-( "ï/Bne gp 13 ¤'19.7-( "lZtkw 10 ¤'15.2-( "¢Ö 5 ¤'7.6-("[wfi`Y 4 ¤"ij%u 3 ¤"[wf 2 ¤C"YaY%Ö4CN>#k\4"ù§B.@ >õ4 29 ¤'43.9-(B"ù4 6 ¤'9.1-(B.S" k 2 nyiGõ4 34 ¤'51.2-(B.@>#tÁf¦ H" * 2 ÷ 4 4 53 ¤'80.3-( "½ 4 t Á 4 13 ¤ '19.7-(B.@>#w'þ{.S(BH"s» 56 ¤'84.9-( "t w j B 8 ¤'12.1-( "± 6 ¤ '9.1-( "x» 3 ¤'4.6-(B.@>#Ùð ¤H 7 ¤'10.6-(B"INH ©I RFP FM;G.TJÛM; 'y)MDR*C/0(H"11 ¤'16.7-(CÒ6"g FÙð ¤BG MDR H"42.9- CÒB.@>#« `;H 35 ¤'53.0-( "X E w µ | £ B H"II µ 17 ¤'25.8-("III µ 43 ¤'65.2-(B.@>#HIV ;¤HE3@>4"HIV ÍK¾ØGôç4Z3@ >#48 ¤'72.7-(4l:"³lk9H 66.7 kB. .@>#kǪH"k0>FOE/õ 31 ¤ '46.7-( "(:B5Tõ4 17 ¤'25.8-( "KCXDB5 E/4 18 ¤'27.3-(B.@>#ð <ABH"ð÷ 36 ¤'54.5-("<É 16 ¤'24.2-( "»è 1 ¤"» è"©Ið óq¤HmNE3@>#ð UGÖi { ¦¡JG]{H 4 ¤'6.1-( "ð ¥ UG§Öõ H 9 ¤'13.6-(.S"0? 6 ¤FHkÇL>H} BG4 1[«$4a9UA/>#ð úLBX¥ "ôç:>õ4 1 ¤.S"áSG 2 ¤'òÅcÔB§ Ö 1 ¤":G 1 ¤(BH""O,2OLB5 A/E3@># +Ðà, Ö>LUG»õGt>2° H"eºëFñ9UTÜÖ6GÖ@69!zF £í:A/>#»b©õ1WØn3RM>V4Ö G6G» 2°Fu:"önõ"&;Gu4Ò 6"Ùð ¤GÔP"MDR GÔOÒB.@># lÖÆ9nyiFtw:>Ô4Ò/8C3RO"ÿ5 ÖG» r·F²9UP;/CÐ1RU>#Ü Ö6GÖ@B/zF.TUÖ"negp"lZtk w"msau"[wfi`YEDBH"»ÒyQÖB" MDR P HIV Ô~»4Èû>/G÷OCE@A2 S"×ÆO"V4ÖBt>;TÖ>LUG»*¤F 2/AO"MDR P HIV Ô~»4OCE@A6T p;4.T#kÇBGªFæ.4.TõOJ3@> 4"ù§PùG>NFî@A/>Yā¬W:> S"ÖÇ®ÝEDWâ:>S:A_oqh^%`r wW7@A/>#~zH{ YW:>4"×ÆH ÎF{ YK:Gýô4LUT#MDR GHÒ/ 4"ð÷$<É4ÒB"è"P$UR4(E6" ¡ÊEð <AB.@>#MDR ¤BH"ð 4X¥B .T8C"v4ÒB.T8C4yQCE@A/Tì ¤4.S"÷OCÐ1RU>#L>"ùPù§G¥ 4ú:>OGW£N"§Ö9UTõ4(E3R<. S"āÖ G{ ¦¶4CUA/E/8C4"»ð ¹HG.CE@A/Tp;4.T#.
(30) y Ú 93 } Ú 4 ¡ 2018 ó 4 . 242. S2!5 x¤ÌEMy~·@~·¯k<³5ÈÏ. áç <¬!¾% ÷ð &Ù©"÷½'. Ù©@ 2016 ó@y=~4A 32.8 ;(K!éîþ !É6@ß;¦G ).!22ÆóAÔ¤ì.!ó$ =~4Aãl4:/:)L"i$!x¤ÌEMy~· ÆA!2008 óA 33 Ä!2016 óA 35 Ä<Õn4!|¢< 4:A 2.5% -J 3.9% ?Õn4:)L"ï? 20 Ø;F L< 2008 ó?A 13.6% ;(98@.ó$Õn4!2016 ó?A 46.2% <IKÕn.à<>9:)L"Ô¤; A!2016 ó?AÔó8;A 7.9%!20 Ø;A 58.7% < >9:,K!|¢<4:AÔ¤Olu9:)L.!µÆ <4:A&ó 30%40 ÄÑè:.(K!Ù©?,) :Gx¤ÄyתAº0>qÛ;(L" Ù©;A!Ð?:x¤ÌEMöy~· &2006%2011 ó'@³5ÈÏ@ëO)!ñ%Ä<ú z4Ü1ßÞ#æ»|¢. )2<O#£48"E87 @0j<4:!ò¤ 5 ó(';(L2<!H"Á @)Û>=¶såù@͸Ç.r¨4:)Loô ÇO#£48"7@pO¹1:!Ù©;Añ%{ ā÷ÃHÿ+¯km!x¤Äyת]Y_Pa@Ê û>=!x¤Äyת@mOÅ9:/8.!7@ß ;!x¤ÌEMy~·@³5ÈÏ¿H´@ )~· ¯k?1:!2013 ó-Jh5â,õ± &ê¼AZ. QcWX±'Ow«4:)L"h5â,2/|¢A! ó$Õn4:,K!ß;Gñ%b[a.ñÀs;b[ ael@~·;@h5â,2/|¢. 0>9:)L" 74:!ò¤.Ý)D=ñ%.ñÀs;b[a el@·@|¢. 0!~·@*øÆAò¤ 5 ó('; (98"@!.x¤Ä@÷`VS<>9:)L< )*2<A2ME;G®ä3M:)L.!y?,): Gh{å>ýH³5!ÿ+¯k&E8A DOTS'@; Oñ%;Ë403t5L2<A-g;A>0!ñ% .ñÀs;b[ael@·B@h5â,íòAÎå ?ë3MLC/;(L" µ§!Ù©@x¤ÌEMy~·?,):h5â, Oíò5L2<;!~·¯k.È48±7AÆÖ0# £.(K!Ü1ßÞ|¢AvÒ4:/:)L"%Td\ UR^;A!h5â,õ±@µ°Á<±íò @x¤ÌEMöy~·@³5ÈÏOßÂ?#£5L" E8!~·÷̲@<@9HfÓ<4:Ö) ¤xæ»±7?×5L ¤¯k>=!7@ß;+:/ 8x¤ÌEMy~·@¯k;ü0>2<H¥@q ÛO¢N6:#£48)".
(31) Kekkaku Vol. 93, No. 4, 2018. 243. "&$#!% 3 ,¢Ù¿ÎDPÍDL SÕJP. µû Ô= ¯¾%ªyºñ:×¢H<4ÊÃ0wPÍu¤& µû Q« vÚ%³N0w®÷z2Æ^r_$Pͤ^r_$áΤ2&. øç6P,¢Ù¿ÎGDê¼E>?)O!Ó9 BÄO:LH<:SN5!xÿCUMDý|S &6P3@/¨¹DB.?)P"5.5!8QH?D! 3Dç}ā¬CÂÀJ/..P@E°,NQB*"3D 9J! #EÇõPÍC-2P4½B%ÎL SÕJ! Cï"S@N.@5!KI~(BuOÁ§D÷?*.C ÏÉ1ÖOSâ5>*1.!ÐCR6P-J/) P"[rj\VlDb$kS',¢Ù¿ÎDPÍ DL SÕJP(@47>ü*9"[rj\]dE¿ Î5D?ðK/ôP¡¥;.BÞÛ9@!%Τ? DF/BH5*ÈÉDÞÛ9?®Ú4Q>*P"¢ ¤ÌDàÞÛEp^hdc$_D5Ü¢S*/ 4QP"xÿ5ÜC},!ú¸p^hd5Ü.N!8 DÄOÇìC<*>Dc$_/*/4QP"e[neo c$_i$]E#D¨ÒS@C6P:R+"$?© {0wD÷ßÞÛCE!'H4QP3@Dè*ÖòC÷. 6P=@¶ÓÑ8S-S5ü1"ÖòC÷5>æ²ÿ BL SÕJ9*"!LMR=åóÌ0wD#÷ÞÛC E! 'ÄODÇ·@Za( @ï5>) MAC Î@) M. ab! scessus ÎC-2PjUrdS;1B¡¥@+C Ý ü1"#DÄOC÷6PôÅ@]_r]SG59 *"4ÊÃ0wD´#AÞÛCE!'H4QP3»I@ 8Dê¼C<*>æ²ÿCpY`m$5>ü1"3»I /3;9N!8DE¸SÀJP:2?EÄOãéCE ±£5B*"3»IH<!¦»BAèÿThq$` SF9*"TËíDùäÞÛCE!goWqX fqrC<*>Dtö=2S!6£-MFèØD¡¥. N@C5>ü1"% E¸C<*>ÇõPÍ?Dtö =2SL 5R6P@BP:R+"%Îê¼Dî v7E!=SL Çõ5ïS@C59+,?! âCI29Thq$`Sþs6P3@?)P"=[rj \Vl/3QC±£?0PKD@ë5>*P".
(32) . 93 . 4 2018 C 4 . 244. S3!1
(33) R NTM ,. L1,2 [ 3 A( q 1 9/! :"4 #$ %5 &'( &1 )*+,0X-gZ./011 92-%-%345e%%6/072 *+,0X-gZ.Q89N3:;÷=
(34) 3 ār?@-%4%P4 AlB!/015. CFDE FC KGHIJ)NTMKLMN<P'QR STUVMAPWSXYZ[\]^/0P_`K La'QMbcdZSTUeW\ #Abj<fK LgVhhSsKkifNkEj GCn km lmn kmopqfsKLFDtukmmnfs hwRxyRPldZSfSUAx Sz 23 C gVi@;{|=gV
(35) }
(36) ~)
(37) }
(38) ~h*RW` YZhh TYP_`bj<f NTM %8MD\ TU Cc<E
(39) }
(40) ~hhS NTM %tu kmmnhaP TU CWXE Sz 21 C 9 1 BSz 26 C 12 31 BP
(41) }
(42) ~PWSdZ#A. gV NTM Po TN`MOdZ # gVh7RU7R gV h e-hT TUaP_` KLPPM ifgVhR Rh
(43) }
(44) ~h5RUY ZP_` G NTM sKktufNkh T P KLkmlmntukmopqPR> RU CE p?P+R gVb h^S + ¡qP NTM |1dZL gVd 1 ¢£h7RU7
(45) d 37 \-Rh
(46) ¤ h¥zRRU¦§PIRG NTM K L x 2011 C P 31,951 -)- ¨ 10 - +. 25.02012 CP 32,265 -)- ¨ 10 - + 25.3 © R 2013 CP 31,008 -)-¨ 10 -+ 24.4ª«e;a\ ¬RSUeW\ G NTM fNLax 2010 C 95,182 -)- ¨ 10 - + 74.3 2013 C P x 148,029 -)-¨ 10 -+ 116.3C 12®22¯ \°± RSU¦§KLCnxS² 71.2)SD³±12.3\ ` µGM 66.1¯ h¶wSU2µTCn·$TP sKk¸
(47) ¹x µGx 75! 79 º\-¨ 10 \+ 100.1 2Gx 85 º»°\-¨ 10 -+ 99.9 \¼U[ µGx2GPJ½Cn8¾¿\Xd 1.6 HB!I NÀ~¹MÁSYMbdZU20 º»°KLPW ÂTkmlÃ6x 32.3¯ \` km^lÃ6 x 67.7¯ \¼Ukmtu{|hwÄÅopq 6Æ3x#*\ 46 Ç 2G\ 34 È µG\ 54 È\¼U[ µG 45! 64 ºÉPWSÊ X9Ë 70 Ǭ;dZU CÌpE [/0x [Y\Íw#A_h+¡R NTM %/0\TU[x YZ[\PAAtuÎÏ A\bdZKLa_`X)Ë N<PXVMA \x NTM M]ÐRST,MbdZUÁS^k mÃ69qÄÅopMfNkh°±dÑST DGMbcdZU]^/0\x |1 6 » A e Ò ^ Ó h Ä Å o p à 6 x 69.1%)Hay! ashi,2012ÔAJRCCMÕ 80.4¯)Gochi, BMJ Open, 2015 =MbdZW` "L^kmÃ6x[/0X e4RSTUÖ¿ ×fTØÙfkmlmn> MMi\TU ÚÛ³[/0ePxAl/0IX-B[4m/0 IÜ)AMEDÝÞP_¼^ßZU.
(48) Kekkaku Vol. 93, No. 4, 2018. 245. S3!2 ´½ÔC,2SWì@(UDnZsg. Z:. R&Ò£¨ÍkÆÇ®¥n'. S" |¼/ÌÞ´&NTM'þE<þ?(S-Q!9D( DDH ?lc?/B)ªB´óD!Ñ!3TK?E9 UCE´D¢v.N<@N÷?(S"6-6v å6C´WA6>{gá2Wx 7S6-. 5T:QFc(U@BS¼@zBR!NTM E-O B1!ò£@é£.--<>):"µq MALDI!TOF j"BAC#Ù7S±´BD?!vlc5T:-Q MS «ùW):î§2.ÌÞ´lcCN 5 @)<>c(U@E)+B)"9D:M-=>E½ø T!À(¥?ßs@B<:"î§2CPRK ÷.,PG´§W÷ç6:|#CÜB(U¦ú.I 1D´óDlc.{d+HC!b`bg?,3B+S Ù6:.!2007 qD ATS/IDSA \ZhpZs?E(U P*CB<:"ÓȨý¢Df%cm%bX3.7 ¦ú.OC 5T!®¯BQ 2 ÷!©āä;$B 7MF!lc1iDËÿ.§M5TS" Q 1 ÷Dvā/?´§EV8C(U?/S3@C B<:"3TWHK+> 2008 qCw5T:o÷D( M. abscessus complex E M. abscessus subsp. absces! U¦ú?NlDÖ´d¦ú.ë5T:"´§E(U sus #M. abscessus subsp. massiliense #M. abscessus C¤¹B):M!ÌÞ´h½ÔO®¯`5ÞD subsp. bolletii D 3 =DtóC©5T!ê¥y /O DEÅcd?(R!ÌÞ´v½Ô,PGlc½Ô È.zBS"3TQDtó¢E¨ýdC÷?(S .(UC÷?(S" E8;.! ï×D¨ýC,)>E DDH ?Es?! ï×D¨ý?ECû¿-Qu NTM þW¬*3@. î§2?NÓD@3U¶?/B)"À(¥? (UDpRÊ[email protected])"m^dBZ$8¶D M. abscessus complex Dtó¢.?/S½Ô.4 ©āä]û¿@Ý /WLTF-BR²1¬* 5T>)S" 3@.?/S.!´.v5TB2TF(UCE):Q ´½ÔDE(U;2?EB)"ê¥ÉDD: B)"u NTM þ;@6>N´ó.V-QB2TFê¥ MC!ê¥6>)S£8<@c§dC½¯W¸R6Ï NzBSV2?vlc5T>)B)V?ê¥E *}.(S"(U5T:@:XC´½ÔWOM>6K ?/B)"®¯½Ô.÷;.®ø?/B)ðNK VB)P*C6B2TFBQB)" )"Ð]'-®pOps_kq%gE®¯Ww7S NTM ê¥C,2SØô/èÁDC=)>E! @6>)QTS"®¯½Ô?(U.=-B)! }86Nê¥ÉWG?/S@E)+8¬.(S @3U;.!u MAC þCL7S CAM Dô/èÁD Ñ!©āä³½ÔWÏ)(U7S"N6u NTM þ@( ÷/E£5T>)S"÷Dê¥ã*?EÕê¥ U5T:@6>Nê¥De ?EB)!@Î+QTS! ªO»¦ªDLØô/èÁWïå7S3@C ÑCE©āä³½ÔWÏV8»¡ÛN=QæCBR B<>)S.!BTS D\ZhpZs?E}8ê¥à *S.!¼BAJíDs/CEö\y7S} >CÏ<:*+y ¦é,PGÕt´éCÕ½7S .(S" P*,ü5T>)S"o÷?Eâz5T>)Slrb ÌÞ´Dlc½ÔE/VM>÷?(S"-=>Ew| HiOõ¡DºN$&_!iZYasebgI-0 od^ NTM .)QTS.!+Hw|´CEß+B) d/%BA-Q@ÑdCxU6>):.!µqE{gá @)*Pf.(S"CLSI \ZhpZsCú°6:½ W):lc.ñ¤@B<>)S"PCR BADÞD Ô]dgDâz.KTS" E¼D+HB¢@)*O/B.(S.! VTVTEw>PR NTM D´E~áCY6!@1C MAC BAÅQT:´ó6-âz]dg.IÙ6B)" MAC D´{gᾯWÏ<>/:"§M5TS3@E MAC wD´óDlcCEa# DDH .)QT> <Ã$<»«D¾¯!Õr-Õ<D¢!u )S"ÄÙ NTM D´óE 170 wÿ(S@)VT>, &vc'þªD[ø!ê¥y /DG!)ÏuC¤V SÂ~á5QCE?D~dDTÚBA?(S"3T R!DDH ?lcsB´óE 18 ´ó@41}C70 C=)>NSCÄ%W77S" B).!o#¨ý?B·7S´óEIJ[j%6>).
(49) § ù 93 ù 4 » 2018 ; 4 ¨. 246. S3!3 B§ê¶Æ£à. ,!. ÐgIÑÂE^d. Ä')dPUBñÿÜEîàdbvc%$° 8(. )dPUBñÿÜEJ7h«UHV}g©E<S 850 àI§E/VÎ>G.¡êāED-R!2002 ;2Q 2016 ;I 15 ;H!994 æ3 NTM àE&å þ8TC.S"£ÔI8\J!MAC à 85.9%!M. kan! sasii à 2.2%!M. abscessus à 2.1%!M. fortuitum à 1.6%!M. chelonae à 1.2% IÚD-@>"çô?~£¤ HPSîàIAe3ÏùHò:!M. kansasii àJ Þ¥´H-@>"ÐgH:CN!M. kansasii àIÐ gSJf:C1RhµGÐgëí35QTC.SI Hö:C!MAC à!M. abscessus àIÐgHA.CJ õ5Iú3É'8TC.S"7TQ 2 £ÔHPSî àHö<S0IÐgëíV±RÌ(Hª2:!QI ÐgëíEA:C!ÑÂIiß®áH16SZú*V XQ2H:C.4>."MAC àIÐg MAC àIÐg SE:CJ! )rjWvi_v'RFP(+Ycvke%s 'EB( +]qraumX_v'CAM(H!CaH ;Ca etlemX_v'SM(-S.J[gmX_v'KM( V 0 S" *E . / õ à L ` g S 3!2007 ; ATS/ IDSA!2008 ;V2QNDØgSE:CèÝ8TC .S"ÛÐgjDI=£êeJ 70! 90, EA( hµ?3!ÁÐgjDJ 40!70% E%<SÍ!=£ êjI 22!50% DÁ?3¬QTSÍ3Q½8TC. S"8QH CAM ýÃÐg1IGÖKGÐg3ʹ8T >àjDJ!ºeH 23SrRNA I|+ÈO{HPS5 ÷ê3×®:!CAM ÷ê£îàjDJ=£êe 11.1, EÅl>SëíD-@>Í3Q½8TC.S"0 DJ!6NGd^3G.¯R!DØÐgSVÙÓ:> ÐgVʹ:C4>":2:G3QÑÂHJ!ºkD PS 3%:>àjNõ5!0Û2QDØÐgVÇD4G. .àjO!IÄ`GFId^DDØÐgV-!DO·S.J!Ë=9SV5G.ücàjNõ5¬QT>"P RIÄ`IÞG.t`ov!ä>G[ÃI?3ø>T S"M. abscesss àIÐg 2007 ;I ATS/IDSA \Xf qXvDJ!)ÐgH0>@CJ[ÃÕêªÀI§ HB.C!JéI[ÃVïû:L`<S*7E3èÝ 8TC.S"M¾iߪÀDØy 'CLSI(J!)Ca# Mg XZv<.VPì:>np%q%hvevkua V`. 30+ D>b: 3 :±H@&<S"CAM Õê HA.CJ!3 :YHÕêE@&:>á¼J!>bV #:C 14 :YHN@&<S"*E./RSVèÝ:C .S"3 :YH÷êD-TK!23S rRNA |+ÈIO{H PS÷ê!3 :YHÕêDN 14 :YH÷êD-TK! erm'41(|+ÈI_4HPS÷êEèó<SÍ3D4 S"M. abscessus J!M. abscessus subsp. abscessus!M. abscessus subsp. massiliense!M. abscessus subsp. bolletii IwÔWH_4÷ê?®F.3{[email protected]* HN"z3CaD-S"E7U3$âI 16SrRNA I _%]YvaO HPLC#MALDI!TOF mass spetrome! try DJwÔLDIìG3&3D4G.7E3!Ðg t`ovI¦&OQIÐgëíHA.CIÒV¿ 9E:C.S"0DN!ÑÂH CLSI IèÝ<SRS HB.C![ÃÕêªÀV¹/E!IPM#AMK x÷HÕêI[Ã3T:5!CAM HA.CN_4÷ êI>M]³êHT:.I3®ãD-S"QDIð² eJ M. abscessus subsp. abscessus D 30&50%!M. ab! scessus subsp. massiliense D 50&90% E8TC.S" M. abscessus subsp. abscessus IÐgSI?3¢ IúE¸0QTS".
(50) Kekkaku Vol. 93, No. 4, 2018. 247. S3!4 dAC15K4]é. à'¨ Ä*Ï÷æb@Ä¡®¢(ö̳gh(̳}+. 1 J;MH Ä¡FÓíº3H².Sù¹¬JO`ô30G." HPACù¹}°3Ô9T?6ÚÐ3k <S?M!,où¹H©<³3-S"Þ!ÓÓí ºù¹H².QTS¬åIE]éHB.CÛ <S" 2 ¬å ,oH².QTC.S¬åH^oGV ú<" 1+`z{f~vYd*clarithromycin&CAM+ ¼§!!238!ÝB´E 2+Zcsk(|*ethambutol&EB+ f|Fõ>À4 *õ»k!õ«·è!:¢7!÷ 3!GF+ !¥1>À4 !UÀ§!¬åX}|_(! ÝB´E! 3+{rWvYd¿¬å*{rWqd rifampicin& RFP#{rWsj rifabutin&RBT+ ©4 !4 !ÝB´E!A4 !¬åX}|_(! 238 4+Xwoa{bdl¿¬å*aminoglycoside&AGs+ _>À4 !A4 !¬åX}|_( 5+fhr~^cd*sitafloxacin&STFX+ ¬Kj!¹j!©4 !ÝB´E!¬åX}|_(!2 38 6+Ywtnx/dzfhj*imipenem/Cilastatin& IPM/CS+ fD>À4 !©4 !A4 !¬åX}|_( 3 ^oGE®¢]é ù¹āïÍJm¯oHÅH¤ÆâVØ.!¦"I S0Hg<5]<S³3-S"åHPA C!õ°!h¢%Pn°tVp±Æâ<S" 1+>À38 1$f|Fõ>À4 EB Jõ>À}DwZ{aþ I{íT ç²V<S8E3³EGS" EB DJ°º ZFH3¸3Ù5GS?M!/¯J 20 mg/kg/day*5Ë 1000mg/body/day+D.ā:CN 8 &«Vi0S6ÚJ 15mg/kg*5Ë 750mg/body/day+ 3¡L:."]E:Cm¯oHLªDõ°XmV Ø/8E!¦"H}s/2Q¤v;NIVÇC 3-S2ªë<SP/ðw<S8E!3¶7QTS" 73²UTS6ÚJfòV<SP/-Q2;M·V yS" 2$¥1>À4 EB Jüê4 HPR¥1>À4 V µ:!%ðIÒÁu4 !YIe¢O;u¢Ik VH;S"X^}fÃ!IÊ#G.:2ý!*3¼D J¹+VH;S". 2+4 ¬=!Õ33oD-S3!Steven!Jonson 3Î ¾!f|Fó3IÛJ!RFP#EB DÛ9T C.S"Á3INIJ~×!Ópfhw¬}DÀ Vªë<S3!VvøHH;S6ÚO?Ø<SNI HB.CJ}Vfc<S"ɬåIvmJßDS6Ú3-S" 3+©4 RFP#EB#CAM I.=TN©4 VH;S3!RFP JX}|_(FI©4 VH;S8E3-R!ÑíµC IW[!X}|_(FI38Vl<S6Ú3S"RFP I©4 JÄ¡Ev±Hfò®,V-$< S" 4+A4 RFP J ä ¨ F 4 V l < S 8 E 3 - S"EB J eGFR30 DJ£r¯E<S"CAM J!Ù½"DJ ÙqIO>Vl<S3¼3[.?M!A°HzHg V/"\mvYd!Xw\dJA4 øHJr¯ Jr¯HPS¶÷EV¥:r¯VÃm<S" 5+¬Kj%¹j ÈpDJG.3r|[~^o~¿¬åVr¯ <S6ÚJ!¬Kj%¹jI3Hg<S"X^}f ÃGFIÂÉNR9Ic¾VH;?Û3-S" 4 «Âoù¹ MAC 3Iù¹Dç²VÊ;S?MI«Âoù ¹HB.C! ÜDJdÇ3'I9Tÿñ9TC.S" 2007 I ATS/IDSA ] Y l z Y D nodular/bron! chiectatic disease I÷¯ù¹H!v`~zYlDJ CAM1000mg & 3 G.:JXef~vYd 500) 600mg & 3 !EB25mg/kg & 3 !RFP600mg & 3 Vr¯<Sù¹}eyVú:?"L? 2017 I BTS ]YlzYH1.CN½xV9G.! *{G8! û¢38D-S6Ú!8I«Âoù¹VØ/E:C. S"Wallace QJ 2014 H CAM#EB#RFP r¯H16 S3!3 åV¿D}:?¾D 67,!«Âr¯ D 4, EÛ:?"ù¹GJHáJM=!£ DNV ´H².SK4ù¹EÖ0QTS" 5 ÞÍIù¹I-Rā Ä¡FÓíº3J@2Q@H§M:G.É\ D-S?M!ç²Dù¹3fc:?I@ãr¯VØU G.DÀªë9T?3¼!}ur~^cdGFIr |[~^cdV¦QEr¯9T?3¼3ìÇ9T! :Cù¹H)<S6Ú3-S" ]éJ[(i(y(lD-S3!¬åI VǸM!¦"H·VyC!GSK5,ù¹H». NIE<S]3³D-S".
(51) { È 93 È 4 2018 à 4 . 248. S3!5 â Mycobacterium avium complex'MAC(±>Å5JakRlT_lmô?pÌè1. Ï¿ ¶Ú1(!Ð˽ Ñ©2( 'ÿ ¬Ç}q}éÛx1(!ÿ ¬Ç}q}龸Zm[&2((. âå{¹¢'NTM(±@·zÎ:Àw4!Î: Eâ Mycobacterium avium complex'MAC(±@ïî ?â NTM ±?ó 9 ~L¼DJ'Emerg Infect Dis. 2016%22$1116( "â MAC ±>Å5J箥ý@Ui jYldOWm'CLA(!Q[mb\&k!jaMm` Wm>GJÄ v}ýíL 1 ào³+æø.) J"4-4!ô?Þö¹?òÉF¥ýÒ¹?â MAC ±?¡>GI¥ýº»@«ê:@=*"à? 16 ÷# 1462 µLŲ;47g[N^jWY: @dUliO]ôLC¥ý:?ºû@ 60% ;ì3K9*J'Clin Infect Dis. 2017%65$1077( "3 H>!¥ýªü?ä.Ä * 2 ; F â MAC ± ? CLA ƹv.Ü¥v?s;=89*J" ?ç®Õ=Ä ë÷v}ýí>9áu¹v. ʺ3K=-87â MAC ±>Å49!àakRlT _lmôL÷*7¥ý.Ø3K9/7"Î:E in vitro, in vivo :õ=¹L¦47hTWalTV Wm'MFLX(!W[alTVWm'STFX(.Íñ3K. 'Int J Antimicrob Agents. 2011%37$296.( !§þ°:? y.àì3K7"Koh H@!6 no³?dUl iO]LCÄ v}ýí>ãúù¹.¤Á4 7â MAC ±>Å49!MFLX LC¥ýL87 41 ðLØ4!29% >ãúu¹vLÙHK7;ì47 'Antimicrob Agents Chemother. 2013$57%2281("B 7!Fujita H@äE40@Ü¥¹?â MAC ±>Å4 9 STFX LC¥ýL87 18 ðLØ4!44% >ã úu¹vLÙHK7;ì47'Open Forum Infect Dis. 2016$13%147.( " ïWmcXPf:@2KB:?akRlT_lm ôL÷*7¥ýº»L|ß5J;;E>!×t>, 1J STFX ?£÷º»LÓ¦5J"3H>!Ü¥¹â MAC ±>Å5J6?Ã?ô'NeSWmÖÔ# Ýýí=<(F¨¥ý?º»L¦4Ø5J"2KH >GI!Ü¥¹â MAC ±>Å5JakRlT_lm ô?pÌè1L|ß4=.H!ā?´ý?r¯> =KA*:)J".
(52) Kekkaku Vol. 93, No. 4, 2018. 249. "&$#!% 4 ÍáºGC:U \HØÿLÄ. ÖS 32 Ê&SÜD¢D¢ê¢?Ð÷û¦4þ¢v' ÖS ý} ;¶&ÿ£D¢D¢ê¢?Ð÷ٺ¢v'. Á¡I!ÇÚ AIDS X2!%CIbsÆB¦4þ D8BØP#XH@B+U¦4þC*U"L>e}X «N0"ÒCI!oÁ¡(ÍáºþH@0Q83!d ì(CÈtDFU6D/SÞÓ!òVFFD F@B+U"6HR,FÍẦ4þH¹GC8B& ÉH_XG3GI!ð¥H9Xq38÷Pø C*U"¦4þI!ùõDsÆBH<O2Ð+C+9U 0!`G|EHÍáºI@>āa9Xà+<;!ù õ \îB0ð¥C*U6DX¨MUG!ÍáºG C:U \X÷:U6DHø(0.PYJ/ VU"6HR,F§W/S}CI! (ÍáºGC:Uù õ\HØÿLÄ)DA@>cvd^xX¬8 >"}{G.4U[H÷N.GIQ8+PH0 *Tkrj`eX7BDT*5U6DId8+0!Ó IâH÷óGYK+>?1)X.8+>?3"D ÛD¢HßÜ üæI!C ½~`i~gth%H÷ GJXk8!ÞÓ=VS0b%lsZ`h%Q|v[{ qowmFEHÍáº]çñXgï8î6 X ¤(:U6DXí7V>"Sh!tC*@>6VS ÍáºG`RVF]çñGRU[dzpk¤(X!v ã~u}C:U°VF)X*5SVB+U" mÃHwu ÌËæI!Á¡ºH¦4}%k/Sj. ~ Hø(GO8!ÙzaoxKH=fXlWF +±_¦4(^]}eu`h%X8B!¸FÁ¡ j~`iHÝ)GöT:LVB+U"%VGP² øFSHD½éå/X*p7V!CH`i èÅX|%l7VB+U" ZÔD¢HÕ 1üæI! ÍáºHÙzc®+HrVC*Uw`sZ%dH \Gª:U÷X.LV!Mycobacterium avium ¦4 w`sZ%d0!þô³(H M1 w`sZ%dD ÍþVF M2 w`sZ%dHP©H(ñXëA6 DXS/G7V>"}LÄI!NTM þHdìQ &Hy_nfxDHªX<³7<U"Á¡Ã·ú H¾S T#æI!ÒcIPDRT!āHÁ¡Ï M¼CHs\%}lèÅXä¯7V!Á¡Q NTM þH ð¥¦÷(XãD[d[G.4Us'DH>ªX, G-7VB1>"=HÀ G-Ø»I!ksQ× k|e`X-8!`UHÁ¡º¿^0GÏ+×i X1³6:6DXxÑ7VB.T!Á¡#ÍẦ4 þGª:ULÄH$X 5SV>"6HR,G}c vd^xCI!E5H÷óHy$GØÿH÷) Xn+>?1!÷X!O!=H´QÓÈHð¥& ÉKHÎÂGA+Bµ8>+".
関連したドキュメント
Brix values and glucose, fructose and reduced ascorbic acid contents tended to increase gradually with progressive ripening stage and cluster order, and were higher in
mentofintercostalmuscle,andl5%inthepatientswiththeinvolvementofribormore(parietal
In the literature it is usually studied in one of several different contexts, for example in the game of Wythoff Nim, in connection with Beatty sequences and with so-called
In [LN] we established the boundary Harnack inequality for positive p harmonic functions, 1 < p < ∞, vanishing on a portion of the boundary of a Lipschitz domain Ω ⊂ R n and
For arbitrary 1 < p < ∞ , but again in the starlike case, we obtain a global convergence proof for a particular analytical trial free boundary method for the
We obtain a ‘stability estimate’ for strong solutions of the Navier–Stokes system, which is an L α -version, 1 < α < ∞ , of the estimate that Serrin [Se] used in
In these cases it is natural to consider the behaviour of the operator in the Gevrey classes G s , 1 < s < ∞ (for definition and properties see for example Rodino
[r]
