⮫ᗋᏛ◊✲ᐊ ᐊ㛗 ୕⏣ⱥ ⮫ᗋᏛ◊✲ᐊࡣᾘჾᝈࡢ≉ᚩࢆศᏊᏛ㠃ࡽ᳨ドࡋࠊ᭱㐺࡞⒪᪉ἲࡸ Ᏻᛶࢆ᳨ウࡋ࡚࠸ࡲࡍࠋ௦⾲ⓗ࡞◊✲ෆᐜࢆ♧ࡋࡲࡍࠋ C ᆺ⫢⅖㛵ࡋ࡚ࡣࠊ࣌ࢢࣥࢱ࣮ࣇ࢙࣭ࣟࣥࣜࣂࣅࣜࣥే⏝⒪ἲ࡛⒪ຠᯝࢆつᐃ ࡋࡓ IL-28B ࡢ SNP ࡀᘬࡁ⥆ࡁࣥࢱ࣮ࣇ࢙ࣟࣥࣇ࣮ࣜ⒪࡛ࡶ㔜せ࡞ពࢆᣢࡘ ࢆ᳨ウࡋ࡚࠸ࡲࡍࠋࡲࡓᚰᶵ⬟పୗࡸ⭈ᶵ⬟పୗᑐࡍࡿᢠ HCV ⒪ἲࡢᏳᛶࢆ ㄪᰝࡋ࡚࠸ࡲࡍࠋHIV ឤᰁྜే࡛ࡢࣥࢱ࣮ࣇ࢙ࣟࣥࣇ࣮ࣜ⒪ࡢᡂ⦼ࡶࡲࡵ࡚࠾ ࡾࠊᢠࣞࢺࣟ࢘ࣝࢫ⒪ࡢ⸆≀┦స⏝ࡶ᳨ウࡋ࡚࠸ࡲࡍࠋ ḟ B ᆺ⫢⅖࡛ࡣࠊ᰾㓟ࢼࣟࢢࡢ㛗ᮇᢞᡂ⦼ࡽᑟࢀࡿ⪏ᛶࡢၥ㢟Ⅼࢆ᳨ ウࡋ࡚࠸ࡲࡍࠋࡑࡋ࡚ࠊ࣑ࣛࣈࢪ࣭ࣥࢹ࣍ࣅࣝే⏝⒪ἲຠᯝⰋᑐࡋࠊࢹ࣍ࣅ ࣝࢆࢸࣀ࣍ࣅࣝษࡾ᭰࠼ࡿࡇࡢ᭷ຠᛶࢆ᫂ࡽࡋࡲࡋࡓࠋ㏆ᖺᩓⓎⓗⓎ⏕ࡋ࡚ ࠸ࡿ B ᆺᛴᛶ⫢⅖࡛ࡣ genotype A ࡀ༙ࢆ༨ࡵ࡚࠸ࡲࡍࡀࠊࡑࡢ≉ᚩࢆゎᯒࡋࠊ៏ᛶ ࡢ㛵ࡘ࠸࡚ࡶ᳨ウࡋ࡚࠸ࡲࡍࠋ ࠙2014 ᖺᗘ◊✲Ⓨ⾲ᴗ⦼ࠚ A-0 Oze T, Hiramatsu N, Yakushijin T, Miyazaki M, Iio S, Oshita M, Hagiwara H, Mita E, Inui Y, Hijioka T, Inada M, Tamura S, Yoshihara H, Inoue A, Imai Y, Miyagi T, Yoshida Y, Tatsumi T, Kanto T, Kasahara A, Hayashi N, Takehara T. Using early viral kinetics to predict antiviral outcome in response-guided pegylated interferon plus ribavirin therapy among patients with hepatitis C virus genotype 1. J Gastroenterol. 2014 Apr;49(4):737-47㸦2014 ᖺ 4 ᭶㸧 Harada N, Hiramatsu N, Oze T, Morishita N, Yamada R, Hikita H, Miyazaki M, Yakushijin T, Miyagi T, Yoshida Y, Tatsumi T, Kanto T, Kasahara A, Oshita M, Mita E, Hagiwara H, Inui Y, Katayama K, Tamura S, Yoshihara H, Imai Y, Inoue A, Hayashi N, Takehara T. Risk factors for hepatocellular carcinoma in hepatitis C patients with normal alanine aminotransferase treated with pegylated interferon and ribavirin. J Viral Hepat. 2014 May;21(5):357-65㸦2014 ᖺ 5 ᭶㸧 Oze T, Hiramatsu N, Yakushijin T, Miyazaki M, Yamada A, Oshita M, Hagiwara H, Mita E, Ito T, Fukui H, Inui Y, Hijioka T, Inada M, Katayama K, Tamura S, Yoshihara H, Inoue A, Imai Y, Hayashi E, Kato M, Miyagi T, Yoshida Y, Tatsumi T, Kasahara A, Hamasaki T, Hayashi N, Takehara T; Osaka Liver Forum. Post-treatment levels of Į-fetoprotein predict incidence of hepatocellular carcinoma after interferon therapy. Clin Gastroenterol Hepatol. 2014 Jul;12(7):1186-95㸦2014 ᖺ 7 ᭶㸧 ─ 328 ─ Hasegawa H, Fujitani K, Nakazuru S, Hirao M, Mita E, Tsujinaka T. Optimal Treatment Change Criteria for Advanced Gastric Cancer with Non-measurable Peritoneal Metastasis:symptom/tumor marker-based or CT-based. Anticancer Research 2014;34 (9):51695174㸦2014 ᖺ 9 ᭶㸧 Yajima K, Uehira T, Otera H, Koizumi Y, Watanabe D, Kodama Y, Kuzushita N, Nishida Y, Mita E, Mano M, Shirasaka T. A case of non-cirrhotic portal hypertension associated with antiretroviral therapy in a Japanese patient with human immunodeficiency virus infection. J Infect Chemother. 2014 Sep;20(9):582-5. Ishida H, Sakane S, Toyama T, Fukutomi K, Kimura K, Sugimoto A, Hibino K, Tamura T, Iwasaki T, Iwasaki R, Hasegawa H, Sakakibara Y, Yamada T, Nakazuru S, Mita E. Administration of lowdose epoetin-alpha facilitates adherence to ribavirin in triple therapy with pegylated interferonalpha-2b and telaprevir. Hepatology Research 2014;44(10):E84-91㸦2014 ᖺ 10 ᭶㸧 Oze T, Hiramatsu N, Yakushijin T, Yamada R, Harada N, Morishita N, Oshita M, Mita E, Ito T, Inui Y, Inada M, Tamura S, Yoshihara H, Imai Y, Kato M, Miyagi T, Yoshida Y, Tatsumi T, Kasahara A, Hayashi N, Takehara T. The real impact of telaprevir dosage on the antiviral and side effects of telaprevir, pegylated interferon and ribavirin therapy for chronic hepatitis C patients with HCV genotype 1. J Viral Hepat. 2015;22(3):254-262㸦2015 ᖺ 3 ᭶㸧 B-2 Nakazuru S, Matsumura Y, Harada Y, Iwasaki R, Iwasaki T, Nishio K, Hasegawa H, Sakakibara Y, Yamada T, Nishikawa K, Ishida H, Mori K, Mita E. Simultaneous Large Cell Neuroendocrine Carcinoma and Adenocarcinoma of the Stomach: A Case Report and Literature Review. 12th European Neuroendocrine Tumor Society Annual Conference, Barcelona, Spain, 2015 ᖺ 3 ᭶ Hasegawa H, Fujitani K, Sugimoto A, Nakazuru S, Hirao M, Tsujinaka T, Mita E. Optimal indications for palliative chemotherapy in elderly patients with metastatic or recurrent gastric cancer. American society of clinical oncology Gastrointestinal Cancers Symposium 2015, San Francisco, USA, 2015 ᖺ 1 ᭶ Iwasaki T, Yamada T, Fukutomi K, Kimura K, Sugimoto A, Hibino K, Sakane S, Tamura T, Iwasaki R, Hasegawa H, Sakakibara Y, Toyama T, Nakazuru S, Ishida H, Mita E㸸Endoscopic submucosal dissection for elderly individuals with early gastric cancer㸬DDW 2014,Chicago, ─ 329 ─ USA, 2014 ᖺ 5 ᭶ B-3 ▼⏣ Ọࠊእᒣ 㝯ࠊ୕⏣ⱥ㸸HCV/HIV ඹឤᰁ⪅ᑐࡍࡿ࣌ࢢࣥࢱ࣮ࣇ࢙ࣟࣥ/ࣜ ࣂࣅࣜࣥే⏝⒪ἲࡢ⒪ᡂ⦼ࠋ➨ 50 ᅇ᪥ᮏ⫢⮚Ꮫ⥲ࠊᮾிࠊ2014 ᖺ 5 ᭶ ୕⏣ⱥ㸸⒪⥅⥆ᝈ⪅࠾ࡅࡿὀពⅬ TDF ࡢᙺࠋ➨ 40 ᅇ᪥ᮏ⫢⮚Ꮫᮾ㒊 ࣛ ࣥࢳࣙࣥࢭ࣑ࢼ࣮7ࠊᮾிࠊ2014 ᖺ 11 ᭶ ୕⏣ⱥ㸸㧗ࢫࢺࣞࢫ♫࠾ࡅࡿ⫋ᇦ⫢ᝈࡢ⟶⌮ 㹼⬡⫫⫢ࡽࠊ࢘ࣝࢫᛶ⫢⅖ ࡲ࡛㹼ࠋ➨ 22 ᅇ᪥ᮏ⏘ᴗࢫࢺࣞࢫᏛ ࣛࣥࢳࣙࣥࢭ࣑ࢼ࣮ࠊ㜰ࠊ2014 ᖺ 11 ᭶ ୕⏣ⱥ㸸ᛶឤᰁࡋ࡚ࡢ࢘ࣝࢫᛶ⫢⅖ࠋ᪥ᮏᛶឤᰁᏛ➨ 27 ᅇᏛ⾡ ᣍ ㄳㅮ₇ 2ࠊ⚄ᡞࠊ2014 ᖺ 12 ᭶ B-4 ୰Ỉὶṇ୍ࠊ⚟ᐩၨ♸ࠊ᪥ẚ㔝㈼Ⴙࠊᮡᮏ ᙬࠊᮌᮧᆂ୍ࠊ⏣ᮧ ⊛ࠊᆏ᰿㈆Ⴙࠊᒾᓮ ဴஓࠊᒾᓮ❳୍ᮁࠊ㛗㇂ᕝ⿱Ꮚࠊᴬཎ♸Ꮚࠊᒣ⏣ᣅဢࠊእᒣ 㝯ࠊ▼⏣ Ọࠊụ⏣ᘯ ࠊඣ⋢Ⰻࠊ୕⏣ⱥ㸸ℐ⬊ᛶࣜࣥࣃ⭘⭠⒴ࡢྠᛶ㔜」⒴ࡢ 2 ࠋ➨ 87 ᅇ᪥ ᮏᾘჾෆど㙾Ꮫ⥲ࠊ⚟ᒸࠊ2014 ᖺ 5 ᭶ ୰Ỉὶṇ୍ࠊᒣ⏣ᣅဢࠊὸᒸᛅྐࠊᐑᮏᩔྐࠊ୰᳃ṇࠊ୕⏣ⱥ㸸80 ṓ௨ୖࡢ㧗㱋 ⪅ษ㝖⬟⮅⒴࠾ࡅࡿᏛ⒪ἲࡢ᳨ウࠋ➨ 45 ᅇ᪥ᮏ⮅⮚Ꮫࠊᕞࠊ2014 ᖺ7᭶ ᴬཎ♸Ꮚࠊ୰ᕝኴ㑻ࠊᯇᮧ㞝୍ᮁࠊ⚟ᐩၨ♸ࠊᮡᮏᙬࠊᮌᮧᆂ୍ࠊ᪥ẚ㔝㈼Ⴙࠊᒾ ᓮဴஓࠊᒾᓮ❳୍ᮁࠊすᑿබ⨾Ꮚࠊ㛗㇂ᕝ⿱Ꮚࠊᒣ⏣ᣅဢࠊ୰Ỉὶṇ୍ࠊ▼⏣Ọࠊ୕ ⏣ⱥࠊ▮ᔱᩗྐ㑻ࠊୖᖹᮅᏊࠊⓑ㜰⌶☻㸸HIV ឤᰁ⪅ྜేࡋࡓᾘ⟶ࢧࢺ࣓࢞ ࣟ࢘ࣝࢫឤᰁࡢ᳨ウࠋJDDW2014ࠊ⚄ᡞࠊ2014 ᖺ 10 ᭶ ᴬཎ♸Ꮚࠊ⚟ᐩၨ♸ࠊ᪥ẚ㔝㈼Ⴙࠊᮡᮏᙬࠊᮌᮧᆂ୍ࠊᆏ᰿㈆Ⴙࠊ⏣ᮧ⊛ࠊᒾ㷂❳୍ ᮁࠊᒾᓮဴஓࠊ㛗㇂ᕝ⿱Ꮚࠊᒣ⏣ᣅဢࠊ୰Ỉὶṇ୍ࠊእᒣ㝯ࠊ▼⏣Ọࠊ୕⏣ⱥ㸸ᙜ ⛉࡛ࡢ㞴ᛶ₽⒆ᛶ⭠⅖࠾ࡅࡿࢱࢡ࣒ࣟࣜࢫཬࡧࣥࣇࣜ࢟ࢩ࣐ࣈࡼࡿ⒪ᡂ ⦼ࡢ᳨ウࠋ➨ 100 ᅇ᪥ᮏᾘჾᏛ⥲ࠊᮾிࠊ2014 ᖺ 4 ᭶ ᴬཎ♸Ꮚࠊ⚟ᐩၨ♸ࠊ᪥ẚ㔝㈼Ⴙࠊᮡᮏᙬࠊᮌᮧᆂ୍ࠊᆏ᰿㈆Ⴙࠊ⏣ᮧ⊛ࠊᒾ㷂❳୍ ᮁࠊᒾᓮဴஓࠊ㛗㇂ᕝ⿱Ꮚࠊᒣ⏣ᣅဢࠊ୰Ỉὶṇ୍ࠊእᒣ㝯ࠊ▼⏣Ọࠊ୕⏣ⱥ㸸ୗ ─ 330 ─ 㒊ᾘ⟶ෆど㙾᳨ᰝ࡛ᣦࡉࢀࡓ HIV ឤᰁ⪅࠾ࡅࡿᑤᆂࢥࣥࢪ࣮࣐ࣟࡢ᳨ウࠋ➨ 87 ᅇ᪥ᮏᾘჾෆど㙾Ꮫ⥲ࠊ⚟ᒸࠊ2014 ᖺ 5 ᭶ 㛗㇂ᕝ⿱Ꮚࠊ⚟ᐩၨ♸ࠊᮡᮏᙬࠊᮌᮧᆂ୍ࠊ᪥ẚ㔝㈼Ⴙࠊᒾᓮဴஓࠊᒾᓮ❳୍ᮁࠊᴬ ཎ ♸Ꮚࠊᒣ⏣ᣅဢࠊ୰Ỉὶṇ୍ࠊ▼⏣Ọࠊ㛵ᮏ㈉Ⴙࠊ୕⏣ⱥ㸸ษ㝖⬟㐍⾜⭠ ࡀࢇᑐࡍࡿ୍ḟ⒪ࡋ࡚ࡢ Capecitabine+Bevacizumab ే⏝⒪ἲࠋ᪥ᮏᾘჾ㛵㐃 Ꮫࠊ⚄ᡞࠊ2014 ᖺ 10 ᭶ ᮡᮏ ᙬࠊ୰Ỉὶṇ୍ࠊ⚟ᐩၨ♸ࠊ᪥ẚ㔝㈼Ⴙࠊᮌᮧᆂ୍ࠊ⏣ᮧ ⊛ࠊᆏ᰿㈆Ⴙࠊᒾᓮ ဴஓࠊᒾᓮ❳୍ᮁࠊ㛗㇂ᕝ⿱Ꮚࠊᴬཎ♸Ꮚࠊᒣ⏣ᣅဢࠊእᒣ 㝯ࠊ▼⏣ Ọࠊᑠᕝྜྷ ᙪࠊ▮ᔱᩗྐ㑻ࠊୖᖹᮅᏊࠊඣ⋢Ⰻࠊ୕⏣ⱥ㸸⫢⏕᳨࡛デ᩿ࡉࢀࡓ AIDS 㛵㐃ࣂ ࣮࢟ࢵࢺࣜࣥࣃ⭘ࡢ 2 ࠋ➨ 100 ᅇ᪥ᮏᾘჾᏛ⥲ࠊᮾிࠊ2014 ᖺ 4 ᭶ ᮡᮏ ᙬࠊᒣ⏣ᣅဢࠊ⚟ᐩၨ♸ࠊᮌᮧᆂ୍ࠊ᪥ẚ㔝㈼Ⴙࠊᆏ᰿㈆Ⴙࠊ⏣ᮧ ⊛ࠊᒾᓮဴ ஓࠊᒾᓮ❳୍ᮁࠊ㛗㇂ᕝ⿱Ꮚࠊᴬཎ♸Ꮚࠊእᒣ 㝯ࠊ୰Ỉὶṇ୍ࠊ▼⏣ Ọࠊୖᖹᮅ Ꮚࠊ᳃ Ύࠊ୕⏣ⱥ㸸HIV ឤᰁ⪅Ⓨࡋࡓᾘ⟶࣏࢝ࢪ⫗⭘ᑐࡍࡿෆど㙾ⓗデ᩿ ⌮⤌⧊デ᩿ࡢ᳨ウࠋ➨ 87 ᅇ᪥ᮏᾘჾෆど㙾Ꮫ⥲ࠊ⚟ᒸࠊ2014 ᖺ 5 ᭶ ᮡᮏ ᙬࠊ୰Ỉὶṇ୍ࠊᒾᓮ❳୍ᮁࠊ㛗㇂ᕝ⿱Ꮚࠊᴬཎ♸Ꮚࠊᒣ⏣ᣅဢࠊ▮ᔱᩗྐ㑻ࠊ ୖᖹᮅᏊࠊ᳃ Ύࠊ୕⏣ⱥ㸸Ꮫᨺᑕ⥺⒪ἲ࡛ዌຠࢆᚓࡓ HIV ឤᰁྜే⫠㛛⟶ ᡥᖹୖ⓶⒴ࡢ 1 ࠋ➨ 12 ᅇ᪥ᮏ⮫ᗋ⭘⒆ᏛᏛ⾡㞟ࠊ⚟ᒸࠊ2014 ᖺ 7 ᭶ ᮡᮏ ᙬࠊ㛗㇂ᕝ⿱Ꮚࠊ⚟ᐩၨ♸ࠊᮌᮧᆂ୍ࠊ᪥ẚ㔝㈼Ⴙࠊᒾᓮဴஓࠊᒾᓮ❳୍ᮁࠊᴬ ཎ♸Ꮚࠊᒣ⏣ᣅဢࠊ୰Ỉὶṇ୍ࠊ▼⏣ Ọࠊᖹᑿ⣲ᏹࠊ୕⏣ⱥ㸸㧗㱋⪅ษ㝖⬟㐍 ⾜࣭Ⓨ⫶⒴ᑐࡍࡿᏛ⒪ἲ࠾ࡅࡿணᚋᅉᏊゎᯒࠋ➨ 52 ᅇ᪥ᮏ⒴⒪ᏛᏛ⾡㞟 ࠊᶓࠊ2014 ᖺ 8 ᭶ ᮡᮏ ᙬࠊ୰Ỉὶṇ୍ࠊᒾᓮဴஓࠊᒾᓮ❳୍ᮁࠊすᑿබ⨾Ꮚࠊ㛗㇂ᕝ⿱Ꮚࠊᴬཎ♸Ꮚࠊ ᒣ⏣ᣅဢࠊ▼⏣ Ọࠊὸᒸᛅྐࠊᐑᮏᩔྐࠊ୰᳃ṇࠊ୕⏣ⱥ㸸⫢ෆ⫹⟶⒴⫢⣽⬊ ⒴ࡢ␗ᛶ㔜」⒴ࡢ᳨ウࠋ➨ 50 ᅇ᪥ᮏ⫹㐨ᏛᏛ⾡㞟ࠊᮾிࠊ2014 ᖺ 9 ᭶ ᮡᮏ ᙬࠊᒣ⏣ᣅဢࠊ⚟ᐩၨ♸ࠊᮌᮧᆂ୍ࠊ᪥ẚ㔝㈼Ⴙࠊᒾᓮဴஓࠊᒾᓮ❳୍ᮁࠊ㛗㇂ ᕝ⿱Ꮚࠊᴬཎ♸Ꮚࠊ୰Ỉὶṇ୍ࠊ▼⏣ ỌࠊୖᖹᮅᏊࠊ᳃ Ύࠊ୕⏣ⱥ㸸HIV ឤᰁ⪅ Ⓨࡋࡓᾘ⟶࣏࢝ࢪ⫗⭘ᑐࡍࡿ⫗║ᆺデ᩿⌮⤌⧊デ᩿ࡢ᳨ウࠋ➨ 56 ᅇ᪥ ᮏᾘჾᏛࠊ⚄ᡞࠊ2014 ᖺ 10 ᭶ ᪥ẚ㔝㈼Ⴙࠊ୰Ỉὶṇ୍ࠊ⚟ᐩၨ♸ࠊᮡᮏᙬࠊᮌᮧᆂ୍ࠊ⏣ᮧ⊛ࠊᆏ᰿㈆Ⴙࠊᒾᓮဴ ─ 331 ─ ஓࠊᒾᓮ❳୍ᮁࠊ㛗㇂ᕝ⿱Ꮚࠊᴬཎ♸Ꮚࠊᒣ⏣ᣅဢࠊእᒣ㝯ࠊ▼⏣Ọࠊὸᒸᛅྐࠊᐑ ᮏᩔྐࠊ୰᳃ṇࠊ୕⏣ⱥ㸸ᙜ㝔࠾ࡅࡿ⫹㐨⒴ࡢ㔜」⒴ࡢ᳨ウࠋ➨ 100 ᅇ᪥ᮏᾘ ჾᏛ⥲ࠊᮾிࠊ2014 ᖺ 4 ᭶ࠋ ᮌᮧᆂ୍ࠊ୰Ỉὶṇ୍ࠊᒾᓮ❳୍ᮁࠊ㛗㇂ᕝ⿱Ꮚࠊᴬཎ♸Ꮚࠊᒣ⏣ᣅဢࠊ▼⏣ Ọࠊ ከ⏣㞝┿ࠊ᳃Ύࠊ୕⏣ⱥ㸸⫹ᄷཎⓎ⣽⬊ᆺ⚄⤒ෆศἪ⒴ࡢ 1 ➨ 12 ᅇ᪥ᮏ⮫ᗋ ⭘⒆Ꮫ⥲ࠊ⚟ᒸࠊ2014 ᖺ 7 ᭶ ᮌᮧᆂ୍ࠊᒣ⏣ᣅဢࠊᴬཎ♸Ꮚࠊཎཱྀ┤⤂ࠊ୕Ꮿṇࠊᐑᓮ㐨ᙪࠊụ⏣ṇᏕࠊ㛵ᮏ㈉ Ⴙࠊ୕⏣ⱥ㸸ᙜ㝔࠾ࡅࡿ⭠ SM ⒴ᑐࡍࡿ⒪ᚋ⤒㐣ࡢ᳨ウ ➨ 69 ᅇ᪥ᮏ⭠ ⫠㛛Ꮫࠊᶓࠊ2014 ᖺ 11 ᭶ ୕⏣ⱥ㸸ྖࠊࢭࢵࢩࣙࣥ 15 C ᆺ⫢⅖࣭⮫ᗋ 2 ➨ 50 ᅇ᪥ᮏ⫢⮚Ꮫ⥲ࠊᮾ ிࠊ2014 ᖺ 5 ᭶ ୕⏣ⱥ㸸ྖࠊ୍⯡₇㢟㸦ཱྀ₇㸧20 ⭘⒆࣐࣮࣮࢝ ➨ 50 ᅇ᪥ᮏ⫢⒴◊✲ࠊி 㒔ࠊ2014 ᖺ 6 ᭶ B-5 ᒣ⏣ᣅဢࠊᖹᑿ⣲ᏹࠊ୕⏣ⱥ㸸ᙜ㝔࠾ࡅࡿ Barrett 㣗㐨⒴ࡢ᳨ウࠋ᪥ᮏᾘჾ ෆど㙾Ꮫ㏆␥ᨭ㒊➨ 92 ᅇᨭ㒊ࠊ㜰ࠊ2014 ᖺ 6 ᭶ ᴬཎ♸Ꮚࠊᒣ⏣ᣅဢࠊ୰Ỉὶṇ୍ࠊ୕⏣ⱥ㸸HIV ឤᰁ⪅ྜేࡋࡓᾘ⟶ࢧࢺ࣓ ࢞ࣟ࢘ࣝࢫឤᰁࡢ᳨ウࠋ➨ 92 ᅇ᪥ᮏᾘჾෆど㙾Ꮫ㏆␥ᨭ㒊ࠊ㜰ࠊ2014 ᖺ6᭶ すᑿබ⨾Ꮚࠊ▼⏣Ọࠊ୕⏣ⱥ㸸᰾㓟ࢼࣟࢢᛂⰋ࠾ࡼࡧ⪏ᛶᑐࡍࡿࢸ ࣀ࣍ࣅࣝࡢᙜ㝔࠾ࡅࡿ⒪ᡂ⦼ࠊ᪥ᮏᾘჾᏛ㏆␥ᨭ㒊➨ 102 ᅇᨭ㒊ࠊி 㒔ࠊ2015 ᖺ 2 ᭶ ᒾᓮ❳୍ᮁࠊᒣ⏣ᣅဢࠊ୕⏣ⱥ㸸ᙜ㝔࠾ࡅࡿᾘ⟶⢓⭷ୗ⭘⒆ᑐࡍࡿ EUS-FNA ࡢᡂ⦼ࠋ᪥ᮏᾘჾෆど㙾Ꮫ㏆␥ᨭ㒊 ➨ 92 ᅇᨭ㒊ࠊ㜰ࠊ2014 ᖺ 6 ᭶ ᒾᓮ❳୍ᮁࠊᒣ⏣ᣅဢࠊ୕⏣ⱥ㸸ᙜ㝔࠾ࡅࡿ⫶⭘⒆ᑐࡍࡿෆど㙾ⓗ⢓⭷ୗᒙ 㞳⾡(ESD)ࡢഅⓎࡢ᳨ウࠊᮏᾘჾෆど㙾Ꮫ㏆␥ᨭ㒊 ➨ 92 ᅇᨭ㒊ࠊ㜰ࠊ 2014 ᖺ 11 ᭶ ─ 332 ─ ᒾᓮ❳୍ᮁࠊᒣ⏣ᣅဢࠊ⚟ᐩၨ♸ࠊᮡᮏᙬࠊᮌᮧᆂ୍ࠊ᪥ẚ㔝㈼Ⴙࠊ⏣ᮧ⊛ࠊᆏ᰿㈆ Ⴙࠊᒾᓮဴஓࠊ㛗㇂ᕝ⿱Ꮚࠊᴬཎ♸Ꮚࠊ୰Ỉὶṇ୍ࠊእᒣ㝯ࠊ▼⏣Ọࠊ୕⏣ⱥ㸸 Verification of endoscopic submucosal dissection for early gastric cancer with HIV infection 㸦HIV ឤᰁ⪅࠾ࡅࡿ᪩ᮇ⫶ࡀࢇ ESD ࡢ᳨ウ㸧ࠋ➨ 87 ᅇ ᪥ᮏᾘჾෆど㙾Ꮫ⥲ ࠊ⚟ᒸࠊ2014 ᖺ 5 ᭶ ᮌᮧᆂ୍ࠊᴬཎ♸Ꮚࠊ୰ᕝኴ㑻ࠊᯇᮧ㞝୍ᮁࠊ⚟ᐩၨ♸ࠊᮡᮏᙬࠊ᪥ẚ㔝㈼Ⴙࠊ ᒾᓮဴஓࠊᒾᓮ❳୍ᮁࠊすᑿබ⨾Ꮚࠊ㛗㇂ᕝ⿱Ꮚࠊᒣ⏣ᣅဢࠊ୰Ỉὶṇ୍ࠊ▼⏣Ọࠊ ୕⏣ⱥ㸸༑ᣦ⭠⒴ࢆྜేࡋࡓࢡ࣮ࣟࣥࡢ 1 ࠋ➨ 93 ᅇ᪥ᮏᾘჾෆど㙾Ꮫ㏆ ␥ᨭ㒊➨ᨭ㒊ࠊ㜰ࠊ2014 ᖺ 11 ᭶ Ύ⏣Ⰻࠊ᪥ẚ㔝㈼Ⴙࠊ㛗㇂ᕝ⿱Ꮚࠊすᑿஂ⨾Ꮚࠊᴬཎ♸Ꮚࠊᒣ⏣ᣅဢࠊ୰Ỉὶṇ ୍ࠊ▼⏣Ọࠊⓑ㜰⌶☻ࠊ୕⏣ⱥ㸸Ꮫᨺᑕ⥺⒪ἲࡼࡾᐶゎࡀᚓࡽࢀࡓ HIV ឤ ᰁྜే㐍⾜㣗㐨⒴ࡢ 1 ࠋ➨ 205 ᅇ᪥ᮏෆ⛉Ꮫ㏆␥ᆅ᪉ࠊ㜰ࠊ2014 ᖺ 9 ᭶ࠋ 㔝ῧளᕼᏊࠊすᑿබ⨾Ꮚࠊ㛗㇂ᕝ⿱Ꮚࠊᴬཎ♸Ꮚࠊᒣ⏣ᣅဢࠊ୰Ỉὶṇ୍ࠊ▼⏣Ọࠊ ୕⏣ⱥࠊඣ⋢Ⰻࠊᕝ➃ᾈ㸬№⾑ࡢຠᯝࢆ⤒ⓗ⫢⤌⧊᳨࡛ウ࡛ࡁࡓ࣊ࣔࢡ࣐ࣟ ࢺ࣮ࢩࢫࡢ 1 㸬➨ 205 ᅇ᪥ᮏෆ⛉Ꮫ㏆␥ᆅ᪉ࠊ㜰ࠊ2014 ᖺ 9 ᭶ࠋ B-8 ୕⏣ⱥ㸸CROIࠊEASL ࣏࣮ࣞࢺ๓⦅ࠋ⫢⮚ᑓ㛛་⫱ᡂࣉࣟࢪ࢙ࢡࢺ ᖹᡂ 26 ᖺᗘ ➨ 1 ᅇຮᙉࠊ㜰ࠊ2014 ᖺ 4 ᭶ ୕⏣ⱥ㸸B ᆺ⫢⅖ ᭱᪂ࡢヰ㢟ࠋ➨ 13 ᅇ྿⏣ᾘჾ࢝ࣥࣇࣞࣥࢫࠊ྿⏣ࠊ2014 ᖺ 5᭶ ୕⏣ⱥ㸸᭱᪂ࡢ⫢⅖⒪ࠋ㉥ᇉࢡࣜࢽࢵࢡ㦂ᑂᰝጤဨ 100 ᅇグᛕㅮ₇ࠊ㜰ࠊ2014 ᖺ6᭶ ୕⏣ⱥ㸸ᾘჾࡢࡀࢇ࡞ࡽ࡞࠸ࡓࡵ࡛ࡁࡿࡇࠋ᪥ᮏᾘჾᏛ㏆␥ᨭ㒊 ➨ 51 ᅇᕷẸබ㛤ㅮᗙࠊ྿⏣ࠊ2014 ᖺ 5 ᭶ ୕⏣ⱥ㸸B ᆺ⫢⅖ࡢ᭱᪂⒪ࠋHBV infection Forum in Mieࠊὠࠊ2014 ᖺ 6 ᭶ ୕⏣ⱥ㸸HIV ࢘ࣝࢫᛶ⫢⅖ʊ⒪ࡢ᭱๓⥺ʊࠋJapan HIV and Hepatitis Study Group ( JHSG ) ㅮ₇ࠊᮾிࠊ2014 ᖺ 6 ᭶ ─ 333 ─ ୕⏣ⱥ㸸ྖࠊ⫢⒴⒪ࡢᚋࢆ⪃࠼ࡿࠋ㜰ࠊ2014 ᖺ 6 ᭶ ୕⏣ⱥ㸸ྖࠊ⫢⮚ᑓ㛛་⫱ᡂࣉࣟࢪ࢙ࢡࢺ ᖹᡂ 26 ᖺᗘ➨ 2 ᅇຮᙉࠊ㜰ࠊ2014 ᖺ7᭶ ୕⏣ⱥ㸸B ᆺ⫢⅖᰾㓟ࢼࣟࢢ⒪ࠋᐃᮇሗㄅࠕExpert Opinion on Hepatitis Bࠖ18 ྕᥖ㍕ᗙㄯࠊᮾிࠊ2014 ᖺ 7 ᭶ ୕⏣ⱥ㸸C ᆺ⫢⅖ࡢ᪂つ⒪ࠋ㜰ᕷ୰ኸ༊༡་ᖌᏛ⾡ㅮ₇ࠊ㜰ᚰᩪᶫࠊ2014 ᖺ9᭶ ୕⏣ⱥ㸸C ᆺ⫢⅖ࡢ᪂つ⒪ࠋ୰ኸ༊ᮾ࣭༡⸆ᖌ◊ಟࠊ㜰ࠊ2014 ᖺ 10 ᭶ ୕⏣ⱥ㸸᭱᪂ࡢ C ᆺ⫢⅖デ⒪ࠋ㜰ᕷ⫢⅖㐃ᦠㅮ₇ࠊ㜰ࠊ2014 ᖺ 10 ᭶ ୕⏣ⱥ㸸C ᆺ⫢⅖ࡢ᪂つ⒪ࠋ༊⸆ᖌ⏕ᾭ◊ಟࠊ㜰ࠊ2014 ᖺ 10 ᭶ ୕⏣ⱥ㸸B ᆺ࣭C ᆺ⫢⅖ࡢ᪂つ⒪ࠋ⫢ᝈᆅᇦ㐃ᦠࠊ㜰ࠊ2014 ᖺ 11 ᭶ ୕⏣ⱥ㸸HCV NS3 ࠾ࡼࡧ NS5A ኚ␗㛵ࡍࡿ᳨ウࠋ⫢⮚ᑓ㛛་⫱ᡂࣉࣟࢪ࢙ࢡࢺ ᖹ ᡂ 26 ᖺᗘ➨ 3 ᅇຮᙉࠊ㜰ࠊ2014 ᖺ 12 ᭶ ୕⏣ⱥ㸸C ᆺ⫢⅖ࡢ᪂つ⒪ࠋ㜰ᕷ୰ኸ༊ᮾ་ᖌᏛ⾡ㅮ⩦ࠊ㜰ࠊ2015 ᖺ 3 ᭶ B-9 ୕⏣ⱥ㸸B ᆺ⫢⅖ࡢ᭱᪂⒪㹼㐺ṇ⏝ࡢほⅬࡼࡾ㹼ࠋB ᆺ⫢⅖ Live Meetingࠊ㜰ࠊ 2014 ᖺ 11 ᭶ ୕⏣ⱥ㸸GSK B ᆺ៏ᛶ⫢ᝈ⒪ Webinarࠊᰴᘧ♫ࣇࣝࣇࣝࣃࣥࢲࢫࢱࢪ࢜㜰ࠊ 2015 ᖺ 2 ᭶ ୕⏣ⱥ㸸⫢⮚ࡢẼ 㐍ࡍࡿ⫢⅖ࡢ᭱᪂⒪ ࠾ࡣࡼ࠺㸟ࢻࢡࢱ࣮#17ࠊㄞࢸࣞ ࣅࠊ2014 ᖺ 8 ᭶ ୕⏣ⱥ㸸⫢ࡀࢇ ᪂ࡋ࠸᳨ᰝࡽ᭱᪂⒪ࡲ࡛ ࠾ࡣࡼ࠺㸟ࢻࢡࢱ࣮#18ࠊㄞࢸࣞ ࣅࠊ2014 ᖺ 8 ᭶ ─ 334 ─ ᖹᡂ ᖺᗘ ◊✲⤖ᯝሗ࿌᭩ ℧⚽ᶞ ◊✲ㄢ㢟ྡ ᖹᡂ ᖺᗘᅜ❧㝔ᶵᵓඹྠ⮫ᗋ◊✲ࡼࡿ (%0 ᥎㐍ࡢࡓࡵࡢつᶍ⮫ᗋ◊✲ᴗ㸸 ᆺ⢾ᒀࢆేࡏᣢࡘ㧗⾑ᅽᝈ⪅࠾ࡅࡿ࣓ࢺ࣑࣍ࣝࣥࡢᚰ⫧࣭ᚰᶵ⬟ᑐࡍࡿຠᯝࡢ ᳨ウ ┠ⓗ 㸰ᆺ⢾ᒀࢆేࡏᣢࡘ㧗⾑ᅽᝈ⪅ࢆᑐ㇟ࡋࠊ࣓ࢺ࣑࣍ࣝࣥࢆᢞࡋࡓ㝿ࡢᚰ⫧࣭ᚰᶵ ⬟ᑐࡍࡿຠᯝࢆࠊᚰ⮚㉸㡢Ἴ᳨ᰝࡼࡿᕥᐊ㔜㔞࣭ᣑᙇ⬟ࠊ⾑୰ᚰࣂ࣐࣮࣮࢜࢝ ࢆᣦᶆࡋ᳨࡚ウࡍࡿ ◊✲ࢹࢨࣥ㸸་ᖌᑟᆺከタඹྠ㠀┣᳨ࣛࣥࢲ࣒⩌㛫୪⾜ẚ㍑ヨ㦂 ᪉ἲ㸸 ᆺ⢾ᒀࢆేࡏᣢࡘ㧗⾑ᅽᝈ⪅࣓ࢺࢢࣝࢥࢆᢞࡍࡿ⩌㸦 ྡ㸧㠀ᢞ⩌ 㸦 ྡ㸧ࠋ๓࣭ ᭶࣭ ᭶ᚋࡢᚰ⮚㉸㡢Ἴ᳨ᰝ⾑୰ᚰࣂ࣐࣮࣮࢜࢝ࢆ ᐃࠋ ⤖ᯝ Ⓩ㘓୰ࠋ ࡢⓏ㘓ࢆ⾜࠸ ⤊ࠋ ─ 335 ─ ─ 336 ─ ─ 337 ─ ─ 338 ─ ─ 339 ─ ─ 340 ─ ─ 341 ─ ─ 342 ─ ─ 343 ─ ─ 344 ─ ཌ⏕ປാ⛉Ꮫ◊✲ጤクᴗ 㞴ᛶᝈᐇ⏝◊✲ᴗ ࠕ≉Ⓨᛶ⭣㦵㢌ቯṚࡢ⒪ἲ☜❧㠉᪂ⓗண㜵ἲ㛤ⓎࡴࡅࡓᅜᏛ㝿◊✲ࠖ ⭣㦵㢌ቯṚ㛵ࡍࡿ⸆≀ண㜵⒪㛵ࡍࡿ◊✲ࠊேᕤ⫤㛵⠇➼ࡢእ⛉ⓗ⒪㛵ࡍ ࡿ◊✲ࡀ࠾ࡇ࡞ࢃࢀ࡚࠾ࡾࠋᙜ㝔ࡢ㛵ࢃࡾࡋ࡚ࡣࠊᙜヱᝈࡢእ⛉ⓗ⒪ࡢᡂ⦼ࡢ㛗 ᮇ㏣㊧ㄪᰝࡽእ⛉ⓗ⒪ࡢ᭷ຠ࡞㑅ᢥࢆ᫂ࡽࡍࡿ┠ⓗ࡛ᮏᴗࡢ୰࠾ࢀࡓ ேᕤ㛵⠇⒪ UHJLVWU\ ࢆⓏ㘓ࡍࡿࡇ࡛ᐤࡋ࡚࠸ࡿࠋ⌧ᅾ㸰㸯㸮ࡢᝈ⪅Ⓩ 㘓ࢆࡋ࡚࠾ࡾࠊᙜヱᴗࡢࢹ࣮ࢱࡢ᰿ᖿ࡞ࡗ࡚࠸ࡿࠋ ཌ⏕ປാ⛉Ꮫ◊✲⿵ຓ㔠 㞴ᛶᝈ➼ᨻ⟇◊✲ᴗ ࠕ≉Ⓨᛶ⭣㦵㢌ቯṚࡢᏛㄪᰝ࣭デ᩿ᇶ‽࣭㔜ᗘศ㢮ࡢᨵゞデ⒪࢞ࢻࣛࣥ ⟇ᐃࢆ┠ᣦࡋࡓつᶍከタ◊✲ࠖ ≉Ⓨᛶ⭣㦵㢌ቯṚࡢᏛࡘ࠸࡚ࡣ㐣ཤሗ࿌ࡣከᩘ࠶ࡗࡓࡀࠊࣂࢫࡢࡗ ࡓ୍㠃ⓗ࡞ゎᯒࢹ࣮ࢱࡀ࡛࠶ࡗࡓࡓࡵࠊṇ☜࡞⤫ィᏛⓗᡭἲࢆ⏝࠸ࠊࡑࡢᏛࢆ᫂ࡽ ࡋࡼ࠺ࡍࡿ◊✲ᴗ࡛࠶ࡾࠊᮏᖺᗘࡽᅜᏛㄪᰝࡀ㛤ጞ࡞ࡗ࡚࠸ࡿࠋᙜ㝔 ࡣࡑࡢᑐ㇟タ࡞ࡗ࡚࠾ࡾࠊᚋࢹ࣮ࢱࡢ౪ฟࡼࡗ࡚ᮏᴗ㈉⊩ࡋ࡚࠸ࡃணᐃ࠶ ࡿࠋ ─ 345 ─ PCPS ࢩࢫࢸ࣒࠾ࡅࡿ࢟ࣕࣅࢸ࣮ࢩࣙࣥࡼࡿ ẼἻⓎ⏕ࡢ᳨ウ ᅜ❧㝔ᶵᵓ 㜰་⒪ࢭࣥࢱ࣮ ⮫ᗋᕤᏛᢏኈ ⸨ 㡰ஓ ᨃ⾑ᾮࡋ࡚ࢢࣜࢭࣜࣥ㸦ศᏊ㔞 92Da,ග⣧ Ϩ㸬⥴ゝ ⸆㸪㜰㸧ࢆ Reverse Osmosis water㸦RO ⤒⓶ⓗᚰ⫵⿵ຓἲ㸦PCPS㸸Percutaneous Cardio Pulmonary Support system㸧ࡣࠊࢡࣜ Ỉ㸧⁐ゎࡋࠊ40vol%ࢢࣜࢭࣜࣥỈ⁐ᾮ࡞ࡿ ࢸ࢝ࣝࢣ㡿ᇦ࡛ᚰ⫵ᶵ⬟ࡢ⿵ຓࡋ࡚ᗈࡃ ࡼ࠺ㄪᩚࡋࡓࠋPCPS ᅇ㊰ࡣࠊ⇕ჾᅇ ⏝࠸ࡽࢀ࡚࠸ࡿࠋPCPS ࡛ࡣࠊᝈ⪅ࡽ⬺⾑ࡋ ㊰㸦ࢸࣝࣔ EBS ᅇ㊰ࠊࢸࣝࣔᰴᘧ♫ࠊᮾி㸧 ࡓ㟼⬦⾑ࡀ㐲ᚰ࣏ࣥࣉ㏦ࡽࢀࠊࡑࡇࡽேᕤ ⏝ࡋࠊẼἻィ ჾ㸦ultrasonic Bublle ⫵࡛㓟⣲ࡉࢀࡓࡢࡕᝈ⪅ࡢື⬦㏉⾑ࡉࢀ Detecter CMD-20㸪Hatteland Inc㸪norway㸧 ࡿࠋࡑࡢ㝿ࠊ㐲ᚰ࣏ࣥࣉෆ࡛ࡣࠊࣉࣟ࣌ࣛࡀ㧗 ࢆ⏝࠸࡚ࠊ㐲ᚰ࣏ࣥࣉධཱྀഃ㸦⬺⾑ഃ㸧ேᕤ ㏿࡛ᅇ㌿ࡍࡿࡇࡼࡾ⏕ࡲࢀࡿ㐲ᚰຊࢆ⏝ ⫵ฟཱྀഃ㸦㏦⾑ഃ㸧࡚Ⓨ⏕ࡍࡿẼἻࢆ ᐃࡋ ࡋ࡚⾑ᾮࢆ㏦ࡾࡔࡋ࡚࠸ࡿࡀࠊࡦࡓࡧ⬺⾑ ࡓࠋ㛢ሰ⋡ࡢㄪᩚࡣࠊ࢜ࢡ࣮ࣝࢲ࣮㸦HASϩ Ⰻࡢ≧ែ࠾ࢀࡿ࢟ࣕࣅࢸ࣮ࢩࣙࣥࡼࡿ ̺RE㸪Ἠᕤ་⛉ᕤᴗ㸪ᇸ⋢㸧 ࢆ⏝ࠋ㏦⬺⾑ ẼἻⓎ⏕ࢆㄏⓎࡍࡿࡇࡣᗈࡃ▱ࡽࢀ࡚࠸ࡿ ࢝ࢽ࣮ࣗࣞࡣࠊ⤒⓶ⓗᤄධ࢝ࢽ࣮ࣗࣞ㸦࢝ࢽࣗ 1)2)3)ࠋࡋࡋࠊ⮫ᗋୖ PCPS ⏝୰ࡢ⬺⾑Ⰻ ࣮ࣞ㸦CBAS㸧㸪Medtronic Inc㸪⡿ᅜ㸧⬺⾑ ࡣ㑊ࡅࡽࢀ࡞࠸㇟࡛࠶ࡿࠋ㛢㙐ᆺᅇ㊰࡛࠶ࡿ 23Frࠊ㏦⾑ 15Frࠊ17Frࠊ19Fr ࢆ⏝ࡋࡓࠋࡲ PCPS ࠾࠸࡚ᅇ㊰ෆ✵Ẽࡀΰධࡍࡿࠊ⬻ ࡓࠊᅇ㊰ෆࡣࠊ༑ศ࡞㝖Ἳࢆ⾜࠺ࡓࡵࣜࢨ࣮ ࡞ࡢẟ⣽⾑⟶┤᥋㏦ࡽࢀ㔜⠜࡞✵Ẽሰᰦ ࣂ࣮ࢆタ⨨ࡋࡓࠋ ࢆᘬࡁ㉳ࡇࡍ༴㝤ᛶࡀ࠶ࡿࡀࠊ࢟ࣕࣅࢸ࣮ࢩࣙ ࣥࡼࡿẼἻࡣ┠ど࡛☜ㄆ࡛ࡁ࡞࠸ᑠࡉ࠸ ࡓࡵ 4)5)ᨺ⨨ࡉࢀࡿࡇࡀከࡃࠊࡑࡢ༴㝤ᛶࡀ 㔜せどࡉࢀ࡚࠸࡞࠸ࠋᮏ◊✲࡛ࡣ࢟ࣕࣅࢸ࣮ࢩ ࣙࣥࡼࡿẼἻⓎ⏕ࡢ⛬ᗘࠊPCPS ࡢタᐃ᮲௳ ࡢ㛵㐃ᛶࢆ᳨ウࡋࡓࡢ࡛ሗ࿌ࡍࡿࠋ ϩ㸬᪉ἲ ᅗ ᐇ㦂ᅇ㊰ᵓᡂ 㸯㸬ᐇ㦂ᅇ㊰ ᐇ㦂ᅇ㊰ᅗࢆᅗ 1 ♧ࡍࠋᐇ㦂⁐ᾮࡣࠊᶍ ─ 346 ─ 㸰㸬ᐇ㦂᮲௳ ࡣࠊ⬺⾑ഃ࡛ࡼࡾከࡃࡢࣂࣈࣝᩘࢆㄆࡵࡓࡓࡵ ᐇ㦂ࡢྛ✀᮲௳ࡢ⤌ྜࡏࢆᅗ 2 ♧ࡍࠋᇶᮏ ⬺⾑ഃ࡛ࡢᅇ㌿ᩘ㛢ሰ⋡ࢆᇶẼἻⓎ⏕᮲௳ ᮲௳ࡋ࡚ࠊேᕤ⫵ὶࡍ࢞ࢫ㸦Flow㸸 ࢆᩚ⌮ࡋࠊ࢞ࢫ᮲௳ ᗘኚࡘ࠸࡚ゎᯒࢆ 3.0L/minࠊFiO2㸸60%㸧ࠊᅇ㊰ෆ ᗘࢆ 36.0Υ ⾜ࡗࡓࠋࡲࡓࠊ⬺⾑ഃ㏦⾑ഃ࡛ࡢࣂࣈࣝᩘ タᐃࡋࠊࡇࢀࢆᇶ FlowࠊFiO2ࠊ ᗘࢆ㸯ࡘ ࡢ㛵ಀᛶࡘ࠸࡚ࡣࠊேᕤ⫵࡛ࡢẼἻ㝖ཤࡢ ࡎࡘኚࡉࡏࡓࠋࡇࢀ㐲ᚰ࣏ࣥࣉࡢᅇ㌿ᩘ 㛵ಀࡀ⪃࠼ࡽࢀࡿࡓࡵู㏵ゎᯒࢆ⾜ࡗࡓࠋヲ⣽ ᅇ㊰㛢ሰ⋡ࡢྛ✀᮲௳ࢆኚࡉࡏࡓ࡚ࡢ⤌ྜ ࢆ௨ୗ♧ࡍࠋ ࡏ 375 ㏻ࡾࡘ࠸࡚ࠊ㏦⾑⟶ࡢ 3 ࢧࢬ㸦15ࠊ 1㸬 ᅇ㌿ᩘ㛢ሰ⋡ࡀẼἻⓎ⏕࠾ࡼࡰࡍᙳ㡪 17ࠊ19Fr㸧ࡢኚ᭦ࢆຍ࠼ࡓ 975 ㏻ࡾ࡚࠾ࡅ ᅇ㌿ᩘࣂࣈࣝᩘࡢ㛵ಀࢆᅗ 3 ♧ࡍࠋᅇ㌿ ࡿẼἻⓎ⏕ࡘ࠸࡚ࡢࢹ࣮ࢱ᥇ྲྀࢆ⾜ࡗࡓࠋ ᩘࣂࣈࣝᩘࡢ㛵ಀࢆぢࡿ㏦⾑⟶ࡢኴࡉ㛵 ྛࠎࡢヲ⣽࠸࡚ࡣ௨ୗ㏙ࡿࠋ ಀ࡞ࡃᅇ㌿ᩘࡢቑຍࡶ࡞࠸ࣂࣈࣝࡢᩘࡣṇ ẚⓗቑຍࡋࠊ2500rpm ௨ୖ࡛ࡣ᫂ࡽ࡞ࣂ ࣈࣝⓎ⏕ࢆㄆࡵࡿഴྥࡀᙉࡗࡓࠋࡲࡓࠊ㛢ሰ ⋡ูࡳࡿ㛢ሰ⋡ࢆቑࡍࡈࣂࣈࣝᩘࡣቑ ຍࡋࠊࡑࡢᚋ㛢ሰ⋡ 80%࡛᭱ࢆ㏄࠼㛢ሰ⋡ 100%࡛ࡣ᮰ࡍࡿ⤖ᯝ࡞ࡗࡓࠋࡋࡋࠊࣂࣈ ࣝⓎ⏕ࡢࣂࣈࣝᩘࡣࣂࣛࡘࡁࡀ࠶ࡾࠊࡢ ᮲௳ࡀ㛵ࡍࡿࡇࢆ♧၀ࡍࡿ⤖ᯝ࡞ࡗࡓࠋ ᅗ ᐇ㦂᮲௳ࣇ࣮ࣟࢳ࣮ࣕࢺ 2㸬 ᅇ㌿ᩘᶍᨃ⾑ᾮὶ㔞ࡢ㛵ಀ 2̺1㸬࢞ࢫ᮲௳ ᗘኚ ᅇ㌿ᩘᶍᨃ⾑ᾮὶ㔞ࡢ㛵ಀᛶࢆᅗ 4 ♧ ேᕤ⫵ὶࡍ࢞ࢫὶ㔞ࢆ 1ࠊ3ࠊ5ࠊ7ࠊ ࡍࠋᅇ㌿ᩘὶ㔞ࡢ㛵ಀࢆぢࡿ㛢ሰ⋡ࡸ㏦⾑ 10L/min ࡢ 5 ẁ㝵ኚࢆࡉࡏࠊྠᵝ FiO2 ⟶ࡢኴࡉ㛵ಀ࡞ࡃ࡚ࡢ᮲௳࠾࠸࡚ᅇ㌿ᩘ ࡶ 21ࠊ40ࠊ60ࠊ80ࠊ100%ࡢ 5 ẁ㝵ኚࡉࡏ ࡢቑຍక࠸ὶ㔞ࡢቑຍࢆㄆࡵࡓࠋࡲࡓࠊࡇࢀ ࡓࠋࡲࡓࠊᅇ㊰ෆ ᗘࡘ࠸࡚ࡶ 10ࠊ20ࠊ30ࠊ ࡽࡢ㛵ಀᛶࡘ࠸࡚ᅇᖐศᯒࢆ⾜ࡗࡓࡇࢁ㧗 36ࠊ37Υࡢ 5 ẁ㝵ኚࡉࡏࡓࠋ ࠸ᐤ⋡ࢆ♧ࡋᙉ࠸ṇࡢ┦㛵ࢆ♧ࡍ⤖ᯝ࡞ࡗ ࡓࡔࡋࠊ㸯ࡘࡢ᮲௳ࢆኚ᭦ࡍࡿ㝿ࡣࡢ᮲௳ࢆ ࡓࠋ ᇶᮏ᮲௳ᡠࡍࡇࡋࡓࠋ 3㸬 ಀᩘࣂࣈࣝᩘࡢ㛵ಀ 2̺2㸬ᅇ㌿ᩘ㛢ሰ⋡ࡢኚ ᅇ㌿ᩘὶ㔞ࡢ㛵ಀᛶ࠾࠸࡚ᙉ࠸ṇࡢ┦㛵 ᅇ㌿ᩘࡣࠊ1000 ࡽ 3000rpm ࡲ࡛ 500rpm ࢆㄆࡵࡓࡇࡽὶ㔞ࢆᅇ㌿ᩘ࡛㝖ࡋ࡚ồࡵࡽ ࡈࡢ 5 ẁ㝵ኚࡉࡏࠊྠᵝᅇ㊰ࡢ㛢ሰ⋡ ࢀࡓࡶࡢࢆಀᩘࡋࠊಀᩘࣂࣈࣝᩘࡢ㛵ಀᛶ ࡘ࠸࡚ࡶ 20㹼100%ࡲ࡛ࡢ 20%ࡈࡢ 5 ẁ㝵 ࡘ࠸࡚ᅗ 5 ♧ࡋࡓࠋᅗ 5 ࠾ࡅࡿᅇ㌿ᩘ ࡘ࠸࡚ኚࡉࡏࡓࠋẼἻ ᐃ᮲௳ࡣࠊ࡚ࡢ ࡘ࠸࡚ࡣᅗ 3 ࡼࡾ᫂ࡽ࡞ࣂࣈࣝⓎ⏕ࢆㄆࡵࡓ ⤌ྜࡏࡘ࠸࡚ 10 ⛊㛫ࡋྛࠎ5 ᅇࡎࡘ ᐃࡋ ᅇ㌿ᩘ 2500rpm ௨ୖ࡛ࡢ㛵ಀᛶࡘ࠸࡚ࡢࡳ ࡓࠋ ♧ࡋ࡚࠸ࡿࠋᅗ 5 ࡼࡾࣂࣈࣝᩘࡀከࡃⓎ⏕ࡍࡿ Ϫ㸬⤖ᯝ ಀᩘ್ࡣ 0.8㹼1.4㸦mL / rpm࣭min㸧ࡢ⠊ᅖ࡛ ྛ✀᮲௳࠾ࡅࡿ ᐃ⤖ᯝࢆ⾲ 1 ♧ࡍࠋẼ 㞟୰ࡋ࡚࠾ࡾࠊᅇ㌿ᩘὶ㔞ࡢ 2 ࡘࡢせ⣲ࢆྵ Ἳ㸦ࣂࣈࣝ㸧Ⓨ⏕ࡘ࠸࡚ࡣࠊ࢞ࢫ᮲௳ࡸ ᗘ ࡴಀᩘࡀࣂࣈࣝᩘ࠾ࡼࡰࡍᙳ㡪ࡁࡃ㛵 ኚẚᅇ㌿ᩘ㛢ሰ⋡ࢆኚࡉࡏࡓሙྜ ࡍࡿࡇࡀ♧ࡉࢀࡓࠋࡲࡓࠊ㏦⾑ഃ⬺⾑ഃ࡛ Ⓨ⏕⋡ࡀ㧗ࡗࡓࠋࡲࡓࠊ⬺⾑ഃ㏦⾑ഃ࡛ ࡢẚ㍑࠾࠸࡚ࡶࣂࣈࣝᩘ࡛ࡢⱝᖸࡢᕪࡣㄆࡵ ─ 347 ─ ⾲ ྛ᮲௳࠾ࡅࡿ ᐃ⤖ᯝ ─ 348 ─ ─ 349 ─ ─ 350 ─ ᅗ ᅇ㌿ᩘࣂࣈࣝᩘࡢ㛵ಀ ─ 351 ─ ᅗ ᅇ㌿ᩘᶍᨃ⾑ᾮὶ㔞ࡢ㛵ಀ ─ 352 ─ 㸺⬺⾑ഃ㸼 㸺㏦⾑ഃ㸼 ᅗ ಀᩘࣂࣈࣝᩘࡢ㛵ಀ ─ 353 ─ ࡽࢀࡿࡶࡢࡢࣂࣈࣝࡢⓎ⏕ࡍࡿಀᩘ⠊ᅖࡘ࠸ ࡢ⢓ᛶኚࡀࡁࡃᙳ㡪ࡋࡓ⪃࠼ࡽࢀࡓࠋ ࡚ࡣྠ್ࢆ♧ࡍ⤖ᯝ࡞ࡗࡓࠋ ୍᪉ࠊྛ✀᮲௳ࡀಀᩘ⠊ᅖ࠼ࡿᙳ㡪ࡘ 4㸬 ྛ✀᮲௳ࡀಀᩘ⠊ᅖ࠼ࡿᙳ㡪 ࠸࡚ࠊ ᗘኚࡢࡳ࡛ᕪࡀࡳࡽࢀࡿⅬ㛵ࡋ࡚ ᅗ 5 ࡛ồࡵࡓࣂࣈࣝᩘࡀከࡃⓎ⏕ࡍࡿಀᩘ⠊ ࡶ ᗘኚࡼࡿ⢓ᛶኚࡀཎᅉ⪃࠼ࡽࢀ ᅖࡘ࠸࡚ࠊᇶᮏタᐃࠊ࢞ࢫ᮲௳㸦ὶ㔞ࠊ ࡓࠋࡑࡇ࡛ ᗘ᮲௳ࡢ୰࡛ࡶపయ 㸦10Υࠊ FiO2㸧ࠊ ᗘኚࡀಀᩘ⠊ᅖᙳ㡪ࢆཬࡰࡉ࡞ 20Υ㸧ࢆ㝖࠸ࡓࠊ⮫ᗋୖ㉳ࡇࡾᚓࡿ᮲௳ ࠸⤫ィᏛⓗฎ⌮㸦p<0.05㸪Tukey-Kramer 㸦30Υࠊ36Υࠊ37Υ㸧ࡢࡳᗘ⤫ィᏛⓗฎ⌮ ἲ㸧ࢆ⾜ࡗࡓࡇࢁ ᗘኚ࡛ࡢࡳⱝᖸࡢ᭷ព 㸦p<0.05㸪Tukey-Kramer ἲ㸧ࢆ⾜ࡗ࡚ࡳࡿ ᕪࢆㄆࡵࡿ⤖ᯝ࡞ࡗࡓࠋ ᭷ពᕪࡣㄆࡵࡽࢀࡎಀᩘࡀ⮫ᗋ⏝ୖၥ㢟࡞࠸ ϫ㸬⪃ᐹ ࡇࡀ♧ࡉࢀࡓࠋ ࡇࢀࡲ࡛ PCPS ⏝୰ࡢ࢟ࣕࣅࢸ࣮ࢩࣙࣥ ࡇࡇ࡛ࠊࡇࡢಀᩘࢆ⏝࠸࡚ PCPS ࠾ࡅࡿ࢟ ࡼࡿ࣐ࢡࣟࣂࣈࣝࡢⓎ⏕ࡘ࠸࡚ࡣࠊⰍࠎ࡞ ࣕࣅࢸ࣮ࢩࣙࣥ㜵Ṇࢆ┠ⓗࡋࡓ᪩ぢ⾲ࢆసᡂ ሗ࿌ࡀ࡞ࡉࢀ 6)7)ࠊẼἻࡢⓎ⏕ᑐ⟇ 8)9)ࡸࡑࡢ༴ ࡋࡓࠋ 㝤ᛶ 10)11)ࡘ࠸࡚ࡶ᳨ウࡉࢀ࡚ࡁࡓࠋࡋࡋࠊ 1㸬⮳㐺℺ὶ㔞ࢆồࡵࡿ᪩ぢ⾲ ࡑࡢཎᅉࡘ࠸࡚ከࡃࡢሙྜࠊ⬺⾑Ⰻࡸᅇ㊰ ࣏ࣥࣉᅇ㌿ᩘ㸦rpm㸧ಀᩘ㸦mL/rpm࣭ 㛢ሰ࡞ཎᅉࡣ᫂ࡽ࡛࠶ࡿࡀࠊࡇࢀࡲ࡛ලయ min㸧ࡽ⮳㐺℺ὶ㔞ࢆồࡵࡿ᪩ぢ⾲ࢆᅗ 6 ⓗᣦᶆ࡞ࡿ᳨ウࡣᑡ࡞ࡗࡓࠋ ♧ࡍࠋࡇࢀࡣࠊಀᩘࡢ୰࡛ࡶ᭱ࡶࣂࣈࣝᩘࡀ㞟 ᅇࡢㄪᰝ⤖ᯝ࡛ࡣࠊࡲࡎᅇ㌿ᩘ㛢ሰ⋡ࡢ ୰ࡋࡓ್᭱ 0.8㸦㉥Ⰽ㸧 ࠊ᭱ᑠ್ 1.4㸦㯤Ⰽ㸧 㛵ಀᛶ㸦ᅗ 3㸧࠾࠸࡚ࣂࣈࣝᩘࡢࣂࣛࡘࡁ ᐇ㦂୰ࠊྛ㏦⾑⟶ࡢኴࡉ㸦Fr㸧ูࡢ࠺ࡕẼἻ 㛢ሰ⋡ࡼࡿศᕸ୍㒊つ๎ᛶࡀㄆࡵࡽࢀ࡞ ィ ჾ࡚ 1 ࡘ࡛ࡶࣂࣈࣝࡀㄆࡵࡽࢀࡓࡢ್ ࡗࡓࠋࡋࡋࠊᶍᨃ⾑ᾮὶ㔞ᅇ㌿ᩘࡽồࡵ 㸦㟷Ⰽ㸧ࡢ 3 ࡘࡢಀᩘᅇ㌿ᩘࡽ⌮ㄽ್ࢆồ ࡓಀᩘࣂࣈࣝࡢ㛵ಀ㸦ᅗ 5㸧࠾࠸࡚ࡣࠊ㛢 ࡵసᅗࡋࡓࠋ ሰ⋡ࡸ㏦⾑⟶ࡢࢧࢬ㛵ಀ࡞ࡃ⤫ィᏛୖ 㸦ࡓࡔࡋࠊ᮲௳ࡋ࡚㠀⮫ᗋⓗ࡞᮲௳ࢆ┬࠸ 㸦p<0.05㸪Tukey-Kramer ἲ㸧ࡢ᭷ពᕪࡣㄆࡵ ࡓࠊ⾑ᾮὶ㔞 ᗘ 30Υ㹼37Υࠊ㛢ሰ⋡ 0㹼80% ࡽࢀ࡞ࡗࡓࠋࡋࡋࠊ၏୍ࠊಀᩘ ᗘኚ ௨ෆࡢሙྜ㝈ࡿࠋ 㸧 ࡢ㛵ಀ࠾࠸࡚ࡣⱝᖸࡢ᭷ពᕪࢆㄆࡵࡓࠋ ⏝᪉ἲࡋ࡚ࡣࠊᅇ㌿ᩘࢆࡶὶ㔞ࢆぢ ࡇࡢ⌮⏤ࡋ࡚ࠊⴭ⪅ࡽࡀ⾜ࡗࡓ⮫ᗋ≧ែࢆ ࡓሙྜࠊ㉥Ⰽ㯤Ⰽࡢ┤⥺࡛ᅖࡲࢀࡓ⠊ᅖ࠶ ᶍᨃࡋࡓỈ⣔ᐇ㦂࡛ࡣࠊࡲࡎᅗ 3 ࡢ㛢ሰ⋡ࢆኚ ࢀࡤࣂࣈࣝࡢⓎ⏕㢖ᗘࡀ㠀ᖖ㧗࠸≧ែ࡛࠶ ࡉࡏࡓࡁ㧗࠸㛢ሰ⋡࡛つ๎ᛶࡀㄆࡵࡽࢀ ࡾࠊ㯤Ⰽ㟷Ⰽᅖࡲࢀࡓ⠊ᅖ࠶ࢀࡤࣂࣈࣝ ࡞ࡗࡓࡇࡣࠊ㛢ሰ⋡ 80%࡛ࡣ⦆ࡸ࡛ࡣ࠶ ࡢⓎ⏕ࡀᴟࡵ࡚ప࠸ప༴㝤㡿ᇦ࡞ࡿࠋࡲࡓࠊ ࡿࡀ㐲ᚰ࣏ࣥࣉᶍᨃ⾑ᾮࡀ㏦ࡽࢀࡿࡢᑐ 㟷Ⰽࡢ┤⥺ࡼࡾୖ⾜ࡅࡤᏳᇦ࡞ࡿࡇࡀ ࡋࠊ㛢ሰ⋡ 100%࡛ࡣ୍ⓗὶࢀࡀ㐽᩿ࡉࢀ ᐜ᫆᥎ᐃ࡛ࡁࡿࠋ ࡿࠋࡇࡢ㛫⣽࠸ẼἻࡣจ㞟ࡋ୍ሢࡢࡁ࡞ ᮏ◊✲࡛ᑟࡁฟࡉࢀࡓ⌮ㄽ್⾲ࡣ᪂つࡢࢹࣂ ࣂࣈࣝ࡞ࡿࡇ࡛ࣂࣈࣝᩘࡀῶᑡࡋࡓ⪃࠼ ࢫࢆᚲせࡏࡎࠊ㏻ᖖࣔࢽࢱࣜࣥࢢࡉࢀ࡚࠸ ࡽࢀࡓࠋࡲࡓࠊࣂࣈࣝᩘࣂࣛࡘࡁࡀࡳࡽࢀࡓ ࡿᅇ㌿ᩘὶ㔞ࡢࢥࣥࢺ࣮ࣟࣝࡼࡾ࢟ࣕࣅࢸ ࡢࡣࠊ㏻ᖖᾮయࡣࠊప ≧ែ࡛ࡣ⢓ᛶಀᩘࡀ ࣮ࢩࣙࣥࡼࡿẼἻⓎ⏕ࢆᢚṆ࡛ࡁࡿྍ⬟ᛶࡀ ࡁࡃ࡞ࡾ┦ᑐⓗ࢟ࣕࣅࢸ࣮ࢩࣙࣥࡀ㉳ࡇࡾࡸ ࠶ࡿⅬ࡛᭷⏝࡛࠶ࡿ⪃࠼࡚࠸ࡿࠋࡓࡔࡋ㐲ᚰ ࡍࡃ࡞ࡿ࠸࠺ሗ࿌ࡀ࠶ࡿ 12)ࠋࡇࡢࡇࡽࡶ ࣏ࣥࣉࡢᚄࡼࡾಀᩘࡣኚືࡍࡿࡓࡵࠊࡢ㐲 ప ≧ែ㸦10Υࠊ20Υ㸧࠾࠸࡚ࡣࠊᶍᨃ⾑ᾮ ᚰ࣏ࣥࣉ࡛ࡣಀᩘࢆ ᐃࡋ࡞࠾ࡍᚲせࡀ࠶ࡿࠋ ─ 354 ─ ࡲࡓࠊᅇࡣࢢࣜࢭࣜࣥỈ⁐ᾮࢆ⏝࠸ࡓỈ⣔ᐇ ‖ᣅᕭ࣭ᅜ❧㝔ᶵᵓ㜰་⒪ࢭࣥࢱ࣮࣭⮫ᗋ 㦂࡛࠶ࡗࡓࡓࡵ⾑ᾮ࡛ࡶ⌧ᛶࡀᚓࡽࢀࡿ ᕤᏛᢏኈ ᚋ᭦࡞ࡿ᳨ウࡀᚲせ࡛࠶ࡿ⪃࠼ࡿࠋ ụᐑ⿱ኴ࣭ᅜ❧㝔ᶵᵓ㜰་⒪ࢭࣥࢱ࣮࣭⮫ ᗋᕤᏛᢏኈ ᰘ⏣⣧୍࣭ᅜ❧㝔ᶵᵓ㜰་⒪ࢭࣥࢱ࣮࣭⮫ ᗋᕤᏛᢏኈ Ϯ㸬ཧ⪃ᩥ⊩ ➲ᒣᖾ:ேᕤᚰ⫵ჾᮦ Gaseous Microemboli ࡢண㜵.ேᕤ⮚ჾ 2013;Vol.42,No.3:236-240 ᪥ᮏᶵᲔᏛ(⦅):ᶵᲔᕤᏛ౽ぴ ᇶ♏⦅ Ș4 ὶయᕤᏛ.ᮾி.ၿฟ∧;2006.136-143 CE Brennen:Cavitation ond Bubble Dynamics.New York.Oxford University Press;1995.35-7 Ᏻ㐩⚽㞝,ⓒ℩┤ᶞ,ཪྜྷ┒༤:ேᕤᚰ⫵ࣁࣥ ࢻࣈࢵࢡ.ᮾி.୰እ་Ꮫ♫;2004.122-124 ᓥ┤ᶞ,Ⱚᮏ㝯,ᑠሜ:㐲ᚰ࣏ࣥࣉ㏦⾑ ࠾ࡅࡿ࢚࣮ΰධࡢᏳᑐ⟇.యእᚠ⎔ᢏ ⾡ 2008;Vol.35,No.4:416-419 ᅗ ᪩ぢ⾲ Takahashi M:Zeta potential of microbubbles in aqueous Ϭ㸬⤖ㄒ solutions.Journal of Phisical Chemistry B 1㸬⮫ᗋⓗ࡞᮲௳࡛࠶ࢀࡤ࢟ࣕࣅࢸ࣮ࢩࣙࣥࡼ 2005;109:21858-21864 ࡿẼἻⓎ⏕ PCPS ࡢタᐃ᮲௳ࡢ㛵㐃ᛶࡣ ᒾ⏣ᾈ୍,㜿㒊ᩗᮁ,Ᏹ㒔ᐑ⢭෬㑻:PCPS ಀᩘ(L/rpm࣭min)ࢆ⏝࠸ࡿࡇ࡛⾲ࡍࡇ ࡢ≧ែࡢ㐪࠸ࡼࡿẼἻⓎ⏕ࡢᐇ㦂ⓗ᳨ウ. ࡀྍ⬟࡛࠶ࡿࠋ యእᚠ⎔ᢏ⾡ 2004;Vol.31,No.1:68-70 2㸬ᅇᥦࡋࡓ᪩ぢ⾲ࡼࡾࠊಶࠎࡢᝈ⪅ࡢ≧ ຍ⸨ඃ,㛗㇂ᕝṊ⏕,๓୰๎Ṋ,:⤒⓶ⓗᚰ ែྜࢃࡏ࡚࢟ࣕࣅࢸ࣮ࢩࣙࣥࡼࡿẼἻⓎ ⫵⿵ຓἲ࠾ࡅࡿ Bublle-Trap ࡢ᭷ຠᛶ.య ⏕ࡢ༴㝤ᛶࢆண ࡍࡿࡇࡀྍ⬟࡛࠶ࡿࠋ እᚠ⎔ᢏ⾡ 2005;Vol.32,No.4:395-399 3㸬ᐇ㦂ࡣࠊỈ⣔ᐇ㦂ࡢࡓࡵᚋࡉࡽ࡞ࡿ᳨ウࡀ ⚟㛗୍⩏,⯚ஂಖኵ,ᵽୖဴဢ,:⭷ᆺே ᕤ⫵ࡀ᭷ࡍࡿ Bublle Trap Performance ࡢ ᚲせ࡛࠶ࡿࠋ ᐃ.ேᕤ⮚ჾ 2000;Vol.29,No.1:93-98 ϭ㸬◊✲༠ຊ⪅ ཪྜྷᚭ:యእᚠ⎔୰ࡢᚤᑠẼἻࡀ࠼ࡿேయ ᓠᯇభ㍜࣭ᅜ❧㝔ᶵᵓ㜰་⒪ࢭࣥࢱ࣮࣭⮫ ࡢᙳ㡪ࡘ࠸࡚.యእᚠ⎔ᢏ⾡ ᗋᕤᏛᢏኈ 2012;Vol.39,No3:289 ᐑᕝᖾᜨ࣭ᅜ❧㝔ᶵᵓ㜰་⒪ࢭࣥࢱ࣮࣭⮫ Claus M.Muth,Erik S.Shank:GAS EMBOLISM.The New England Journal of ᗋᕤᏛᢏኈ ─ 355 ─ Medicine 2000;Vol.342,No.7:476-482 Ụ㐃ಇᶞ,୕Ꮿᗣὒ,㣕⏣,:ᾮ୰ ࢟ࣕ ࣅࢸ࣮ࢩࣙࣥ㛵ࡍࡿᇶ♏ⓗ◊✲.JAEAResearch 2012;005:1-49 ─ 356 ─
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