1/15号 - 京都府医師会
Contents
1.2. 0000 00000000 10 0
3. 18 000000 0 000 35 0 d J 0 00 0 0000000000 00000000000000 IHHHHHHHHHHHH 00 IHHHHHHHHH 000000000000 0 IHHHHHHHHHHHHHHHHHHHH 00 00 0 1000000000 IHHHHHHHHHHH 0 10000000 4 2 IHHH 000 8 31 0 00 18 31 0 60 18 0 11 0000000 HHHHHHHHHH 0 0 10000 IHHHH IHHHHHHHHHHHHHHHHHHHH 100 00000
4. 111111 111111 111 1 IHHHHHHH HHHHHHHHHHHHHHHHHH 000 020000000000000000000000000000000 00000000 001000000000000000000000 8 0 000 Ver25HHHHHHHHHHHHHHHHH 00180000 0 00 0000000000 0 00200000000 00000 2500000 000000000000000 0 0 25 1840000000000000000000000000 00 0000000 00000000000000000 000 00 WinH HHHHHH 000000000 HHHHHHHHHHHH IHHHHHHHHHHH IHHHHHHHHH 00000000000000 IHHHHHHH IHHHHHHHHHH 000000000 HHHHHHHH Java MS Windows Macintosh LO 000 00000 Ve2 5 CD ROM D 1
5. gt i 1 ES g i Pai ca i soo at 60 o 1 0 il 8 1 SHO 5 i _ CJ ot of 2 a EN i HEY 1 1 To 8 5 A 3 i o o O O I O I O od of O I N a of i
6. 00 IHA o 5 ITA 5 ITA AF Pa 5 pa LI a anag g a anao 2 a aao g g a a a a a a a a aag a a a o a
7. HHHHHHH MONO NN IlHHHHHHHHHHHHHHHHHHHHHH 00 0 00000 0000029 IHHHHHHHHHHHHH 180 11 1 10000000000000 29 00 0 0 100 18 1 11 1 1 1 11 111 00000 0000000000 5 2 18 10000 HHHHHHHHHHHHH 00 11 17 11 4 1 1 0000 3 1000000000 000000 0000
8. 4 5 x 0S 1 I Ed i 1 1 x x 5 1 1 x 161 U a LLI CI 5 Se 6 i LLI _ 162 x 5 CJ o IDI deal lt EAI 1 x z x aaa Do N i 5 N 1 o x 1 x i U gt U E o d 5 z x x se T 4 1 o o o g 1031 OI x r o go IDI Aes a Y o o o DEt o o e o 11 11 1 11 EE x o o o 3
9. 1 1 io MS Windows Windows2000 WindowsxXP 0000 Pentiundll 0 20 0 256MB 512MB 100MB 50MB CD ROMH 0000 1024x 76810 00 100000000 O Macintosh OS X GH PowePC 6000 256MB 0 512MB Java Update 1 42 Update 1000000600 18 0 http www jrreri med or jp 000 0000000000000 http www orca med or j p 0000 e mail ikensyo orca med or jp 03 3942 6474 03 3946 8 6 69 sss ems sas aaj umaj emsa m s 9
10. 5 18 0 0 00000 0000000 10 15400000000000 0 00 0 00000 00 0000 00000 100000000 00 00 000 19 00 00000 000000 00 00 10 0000600 1000000 1000 18 00 0000000000000000 00000000 000000000 0000000000000 00 00000 00 50 30 40 000000 00000 10 1 1
11. 0000 00 sea mas sss 8 R sook 20028 AAO JOO 80662003 105000 2004 000000000 25400 2004 000 OR Book2003 000 Red Bok 000000000000000000000000000000000 0 0 00000000 000000000 00000000 000000 0 0 0000 00000000 000000000000000 00000 000000000000000000000000000000000 CJ CJ 0000000000 0000000000 000000 0000 0 0 0 0 0 0 0 0 0000000000000 0 000 Red BookHHHH 26th 20030 0 HHHHHHHHHHHHH 00000000000000000000000000000 3 JO
12. 0 0000 0000 000000000000000 0000000 00000 000000000000 a aa sas as zmaj sma man saa uma 8 1 O O O O 9 ERRARE HHHHHHHHHH 140000000 1000000000000 12
13. kinh 368 lt lt 3 2 PRETE DEMIR amp gt L L 00 000000000 00 0 000000000000000 200000120000000 0 000000000000000 O 1 1 0 1 2 0 0 0 3 0 1 4 0 fiz 0 0 5 0 1 n 6 0 0 0
14. 1 0 V 0 0 0 0 0 0 0 21 CINE PA 1 0 22 2 1 0 23 2 1 0 10 HHHHHHHHHHHHH 24 2 1 0 200 0 11 1 21000 25 2 1 o GE BMI kg m m 18 5 sss ems saa aaj s s sms 9 10 1 1 11 1 11 11
15. OA AASB Er Es roo NOD oo oo oo oa EE oo a 53 53 51 0 11 5 1 5 3 ra E an an 53 52 m o o o o o o o o o o o o o o o o tno pa B7 13 2 48 gt 58 gt 6 5 y N NG MA J lt x 4 wW S S S 58 x s s o o o o o o o o o o o o o o o o o o o o E E 11 o o o o o o o o o o o o o o o o o o o o o o o o asal o 1000000008 00000000000000000000 00000 00000 in KYOTOH 00000000000000 0000000000
16. OY DY o lt a A A A A o O aa Na 1 IA oon 2 lt lt E gele 9 6 o lt 5 5 E NAO 3 53 3 22 5 o lale 5 o 8 05 gA I S 2 Dard aja Eh 8 e gt NG oc o 1 o o KA 1 0 x o le w 8t 2 EJ LT CJ oC lt o o Hai OC a o o o o Ooo ACC 2 3 go 7 KI KA CJT L HHHH
17. au ua aS aee ee E Dy Q 00 00 i TN A coliti iiss 0000000 0 s nani sss uma sas m mam sas 9198 inan man 0 ba 1 1 88 Hai Ha ss 000000 6500000000 00000000000 10000 000000 HHHHHHHHHHHHHHHHHHHHHHHHHHHHH 390 00000 000000000000 00 WANDERING 000000000000000000000000000 10 000000000000000000000 000 1000 0000 1000000000000000 0000 10000000 0000000000000 000000000000 HHHHHHHHHH HHHHHHHHHHHHHHH 000000000000000 012 190
18. 0000000000000 first hit first hit second hit second hit BEARER nnn 00000 NASH gt HHHHHHHHH NASHH ASTO ALT 1 Two hit theory NASH AST ALT y GTPH HH VLDL 0000 HOMA TG 10000 dope ROOM steatosis 0 405 B 1610000 251000000 00 0 0 0 000000 ATP 1000000 5 0 0 0 0 ATP free electron IV ROS reactive oxygen spiecies NASH 0 00 0000 ChE B 1 NASH 10 10 10 10 0 PPARa 0 B 00 0 0 NASH 0000000000 B 0 BHHHHHH HO 0 m NASHIDH 00000 0 0 00 0 0 1000000 00 NASH 0 0000000 00 00 UDCA 00 NASH 1000000 sas
19. aa moa ea Eq aaa aa gA 0 o aaa mo oo a aa ee er es o o aao a oa e a aa aaa a a Doo 2a ESS 9 oo 9 aa ES Ok gS mo gt man
20. po o ai 229 o0 o lt o a 3 o o O o a da BG CI 3 o o o CXS aa o less ao CJ o od Kas o o o o o 20 mp O LU m NM o o a r 3 20000 o o a SOOO I a o O O o e A 3 o O g iaia l DS o ado oO G BE E 900000 US oo o 212
21. ET E tr CJ CJ ee AN CJ CJ CJ CJ soo 1 o CI Jia EME m 88 8 868 888 4 WEE Rene BMI 25295 DRL OBAR REAT 28 Rana AOR ANBS 7758
22. 900000 00000000000 http Www pre kyoto jp yakumukaisei i ndex fesse mas saa iama sas iama manj sea vV mm 259 0 0 1 6 5 2 A Yea m N O Oo oa o o0 oa ee e e 5 52 poe ph ee a en o o EJ oja o o O x x CI PAA l Es AE EBA 151 6 68 9 sc ES 5 2 o2 ee O OOH RA AHA 2 820955200000004 SO 6 0
23. HHHHHHHH 9 sss sss FF mm ss 0000000000000 OS Og sao Es ET 3 2 E oe nA CA El ET ES AO Hina FET om oo 6 3 3 3 Pa FJ aa EEST saa ooo
24. TG SREBP 1 c PPARo mRNA ER TG B VLDL TNFa TGFB 11 8 5 2 NASH 00000 00180002000 CJ 000 0 0 HHHHHHHHHHHHH 000 00 0 0 000000000000000000000 00 0 0 00000000000000000000000000000000000 0000000 CJ HHHHHHHHH 00000000000000000 CJ 0 0 0 0 0 0 0 0 18 0 0 000000 0 0 0 0 250 0 0 271 0 0000 0 181 0 170 00000000 0 15 0 20 000 0 0 0 0 O CJ L I LT CJ CJ CJ CJ CJ CJ CJ CJ CJ CJ 0 4 LT CJ LT LT OT OT TJ TJ CJ CJ CJ CJ CJ EJ CJ CJ CJ HHHHHHHHH 0 HHHHHHH CJ CJ CJ CJ CJ CJ CJ CJ CJ CJ HHHHHHHHH HHHHHHHHHHHHHHHHHHH LT LT CJ LT LT
25. Bo il a To o BO So ola 1 5 Ro ool ool 1 1 11 00000 gy OAH 28 o 8 p Em
26. o z J i 8 1 x i 5 x o o o Di 1 lt 7 SI x JL U 1 3 x i z lt DI 1071 o I x o eeeece 1 29221 i x o BS EG o 10000 1000000000 IHHHHHHHHHHHH 10000 ll Jl CJ CJ 100000000
27. JC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 CE sA 1 o CC 0 00000000000000000 100000000000000000000000000000 0000 70 0028000 250 HHHHHHH HH 000000 HHHHHHHHHHHHHHHHHHHH Go 0 0000000000000000200000000000000000 000002450000 002900000000000003000000000 HHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHHHHHH 0 CJ LT LT LT LT LT EZ CC 0 0 250 0 010 0 HH 0 18 0 17100000000 0 000000 0000000209003 00 00000 0000 180 00000000 7000 00000 CJ CJ CJ CJ CJ CJ CJ CJ CJ CJ X 000000000 0000 0000 CJ CJ CJ 0000 00000000000 00000 214028 CJ CJ CJ CJ CJ o
28. 2 a 25 25 a 5 25 a 25 aaa aao 2 a 2 a a a 5 o ada a anog es a 25 a 25 25 et i 25 2 a a 2 ao 3 1 a AHE 3 o o o 100000 IHHHHHHHHHHHHHHHHHHHHHHHHHHH IHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH 00 0 l 31 31 11 1 3
29. 60 10000000000000000 20000 r 0 00 100 0000000 0 00000000000000000 0000000000000000 0000000000000000000 00000 00000 0000 00000000 10000 1000 0000000000000 00 0 0000000000000 11 11 HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHHHHHHHHHHHHHHHHHH 00 1000 HHHHHHHHHHHHHHHHHHHH 00000000000 0000 00 00000000000000 00000000 0000000000000000000 00 0 O 0 00 R Se s EAT 3 8 RRA 582 HOSE 28 CJ CJ 1 3
30. 9 7 7 7 O_o CJ O CJ CJ CJ Eu IE ET CJ HHHHHHHHH 53 3 53 3 CJ CJ CJ CJ CJ CJ CJ CJ CJ ET gr g Ac aa sm NG fo NA QO 53 53 qq HHHHHHH 00 000 00000000000 Did bng 0000000000000 TEL 075 315 5276
31. O00 0000000000000 111111 1111101101 HHHHHHHHHHHHHH 0 H u 000 0000000 214 1973 0000 1000000090 200000000 pp ao aa EHG am HHHHH ODO 210 197 000000 0000 00000 00 333 1995 00000 00000 1995 350 00000 0 0000 0000 OO 317 1979 00 O0 OO 372 1997 000 226 1998 000 00 2000 317 0000 262 2001 0 0000 OO 110 2003 0000000 000 0000 OO 210 2003 00000600 00000 Sei te i 408 2003 5 HHHHHHHHHH 100 215 2003 1 6 77 203 HHHHHHHHHHH 5 90 0 sss 166119 ama ama 9 0 000000 Do mm H u H HAL H J u 00000 1956 000 1962 1963 0000000 19590 19650 1973 000 000000 1988
32. 12 EU 17 10 000 0000 1 3 03 Ga x2 0 x x 1 0 O 0 2 0 x 1 0 O O 1 2 O 1 2 O 1 2 BE 0 0 0 1 2 6 69 sas ss s s aoe os es 8
33. s sms Heel Bde Erle Barrels Erasers HHHHHHHHHHHHHHH No 29 0 0 0 0 00000000000000 HHHHHHHHHHHHHHH 000190900000 0000000000000000000 00000 1 1 1 1 00000 0000 0 0 0 0 0 00 HHHHHHHHHHHHHHHHHH HHHHHHHH HHHHHHHHHHHHHHHHHHUHHHHHH
34. 0000000 00000000000000 0000000000000000 0000000000000000 0000000000000000000000 000000000000000000 0000000000000 000000000000 00000 0000 0000000000000000 PARTY 0000 0000000000000 HH 00000000 0000000000 000000000 00000 0000000000000 HHHHHHHHHHHHH a CC 1 21 OO 2 L 1 Ek HH HHHHHHHHHHHHHHHH HHHHHHHHHHHHHH 00000 0 00000000000000 000 00000000 00000000000 HHHHHHHHHHHHHHHHH 9 5 HHHHHHHHHHHHHHHHHHHH
35. sas sma sa san man amo uma s Issa 8 00000 000000000000 0000000 00000000 00 0000000000 100 1000 5 000000000 NASH 0 0 TNFa 100 Thiazolinediones 0000000000000 cYP 00000 00 aS 5 D 0 00000000000 000000 00000 0 nonalcoholic stesohepatitis O 0 0 0 0000000 NASH D virus induced steatohepatitis VISH 0000000 00 000000 0 HHHHHHHHHH mRNA
36. 0 0 0 0 0 0 0 0 0 0 0 7 0 1 n 8 15 0 1 9 1 1 10 1 10 11 6 2 3kg 1 10 1001 12 cm BMI 13 1 000 0000000011000 O 14 1 15 1 JOA HHHHHHHHHHHHHHHH 16 1 0 17 1 0 0 0 18 1 0 0 0 19 0 1 n NAN 20
37. 00 HHHHHHHHHHHH 0 000000000 00000000000000 0 00000000000 0 0000000000 00000000000000000000000000 0000000000 000 075 314 5042 HHHHHHHHHH el 18100 191 0000000 HHHHHHH 00000000000000000000 0090 HHHHHHHHHHHH 00 00 o o o e000 0 O HHHHHHHHHHHH 00000000 0000D0 HHHHHHH 00 HHHHHHHHHHH 00 0000 00 HHHHHHH 00 00000000000003000000000000 00000000 00000000000000000000000000 0 000000000000000000000000000000000000 0000000000000000000000000000 00 000000 000 000 supported by ORCA project Y ttp iiwwwi jma receipt jpi 0120 544 170 4 36 url 001700 00000 00 18 21 0 30 UU 00000000 Ooo 0000000000
38. 0000 2 1 1 1 200 000 NASH 111 1000 Zong balooning 0 HHHHHH perivenular fibrosis peicdlular HHHHH HHHHHHHHH 00 00 100000 000000000 0 000000 NASH 1 1 0000 1000000000 non steatohepatitis alcoholic fatty liver disease NAFLD NASH overlap 000 UU Smple 0000 NASH steatosis 0 0 0 100000000 alcoholic steatohepatitis NASH 0 0 Tamoxifen GOOD NASH 5 00000 000000 HHHHHHHHHHH NASH HHHUHHHHHHH NASHHHHHHHHHH two hits theory NAFLD 000 0001 0 First 00 100 11 0000 BMI 25 O 000000 1000 25 TNFa 00000000 second hit 0 000 10 NASH 1000000000 00 0 10000 100 NASH 10000000 NASH m 0000 stestohepatitis 00000 00 0 OOO 000000
39. 000600 40100 0000060600 0 0020 0000000000 1 0 0020 000000000 03000000 20 00 00 000000000 00000000000000 0 0 0000000000 0 000000000 Ia000000000000 0 2 0000000000000 000000000600 0 0000000 0 000000000 10000000000000000000 1 00000000000000000 HHHHHHHHHHHHHHHH 12 HHHHHHHHHHH 13 HHHHHHHHHHHHHHHHHH 0000 14 0000000000 15 010000000000000 16 0 15000 0000 00 00000 17 100000000000000 18 000 00000 00000 0000 19 000 0000 00 00 0000 20 HHHHHHHHHHHHHHHHHH HH 21 HHHHHHHHHHHHHHHHHH HHHHHHH 22 44HHHHHHHHHHHHHHH 00 23 00000000000000000 00000 24 000 00000000000 00 00 2 26 HHHHHHHHHHH 27 HHHHHHHHHHHHHHHHHH HHHHHH 28 HHHHHHHHHHHHHHHHHH HH 29 HHHHHHHHHHHHHHHHHH HHHHHHHHHHHHHHHHHH 00 30 00000000000000000 HHHHHH 31 00310002000000000 0000 0000000000000 HHHHHHH 32 HHHHHHHHHHHHHHHHH 33 01000000000000000 020 000000 34 00500000200000000 HHHHHHHHHHHHHHHHHH 0000000000 HHHHHHHHHHHHHHHH 00000 0 0 HHHHHHHHHHHHHHH 0000 03000000 50 00 00 21 000000000 0 0
40. 014012000000000 0 0 00 18100281 0 1030 100000 4238 400 HHHHHHHHH 0 000000000 2 040000000000000000 0 00000000000 0000 0 0 00000000000000 23 000000000000000 HHHHHHHHHHHHHH 24 0000000000000 0 20000000000000 2 00000000000 001000000000000 000 26 000000000000 00600 0 0000000000000 0 000000000 27 001000000000000000 0 10000000000000 HHHHHHH 10 00 20000 00 0 00 00000 0 28 00000000000000000 000000 0000000000000000 1 110000000000 0000 12 10 0000200000000 29 0000 00 0000 0 13 0 000000000 30 000000000000000 14 0 00000 00000 31 00000000000000000 15 000000000000 00 16 000000000000000000 32 42HHHHHHHHHHHHHHHH 17 HHHHHHHHHHHHHH HHHHHHHH 33 0010000000000000 00 00 3 18 0000000000 35 00000 00 00 0 0 0 2 0 0 0 0 0 0 19 0 0 00000 0000 36 UJU 20 00000 0000 00000 20 0000000000000000 HHHHHHHHHH 000 001900000 0 1900 37 0 2200 00000 000 000 000 HHHHHHHHHH HHHHHHHHH 0 00190000 0 14030 38 000000000000000 HHHHHHHHHHH 0 000000 00000 HH HH 10 0 000000 HH 10 0 000000 HHHHHHHHH gt 00 19 0 000000 0000000000 0000000 HHHHHHHHH 00000 a jes iwan sas uma asa
41. 2000 0000000 10000 19570 1960 D0000 19550 1962 0000000000000 1993 0000000000 19270 1965 B000 0000000 1956 1963 p000 1969 0000000 1928 1937 100000 1957 1958 00000 1956 1960 LARYNGLOGICA 19680 1971 00000 1963 19650 1967 ABSIRACTS QEpiciNE 1967 1971 0000000 1969 1971 MODERN MEDICINE 1982 0000000 19560 1960 0 19591 Asian Medical Joumal 1963 1964 000000 1956 9 1960 1961 Be weg 0000000000 0000000000000000000000000 0 0000000003700 HHHHHHHHHHHHHHHHHH 00000 9315 5276 000000 HHHHHHHHHHH 12 HHHHHHHHHH 13 0000 50 HHHHHH 16 HHHHHHH 10 HHHHHHHH 19 000000000 20 HHHHHH 20 HHHHHHH 20 HHHHHHHHHHH 28 27 29 30 0 0 0 0 0 28 0 0 0 30 D 0 0 320 LT T 00 33 0000 34 350 000 360 00000 37 38 0000 00000000000000000000000 000 000 000 000000 HHHHHHHHHH 00000 HHHHHHHHHHHHHHHHHHHHHH
42. 5 IHHHHHHHHHHHHHHHH 0 0 1 bE iO 0 000 000 0000000000 HHHHHHHHHHHHHHHH IHHHHHHHHHHHHHHHHHHHHHHHHHHHH 00000000 1 1 00000000 HHHHHHHHHHHHHH CJ CJ CJ CJ DO 55 HHHHHHHHHHHHH 0018990030 0 000 0000000000 1800000000000000 uu 100 1 1 11 1 bo jess es ss 0
43. 5400 00000 00 250 000 0000 00000000 0 0 220 0 0 55588 1 1829 02 604 8585 0000000000000 TEL 075 312 3671 000 0000 000 0000 18 15 nA nasara a oma AA ma OD AOE SET AA 20H80 8 m BABABA ka 8 5 00 00 00 0000 000 0000 00 5 H HHHHHHHHHHHHHHH 000000000000000 00000 356 1611 000 000000 00000000 0000000 AA 0000 0000000
44. HHHHH 000000 O HHHHHHHHHHH 0000000 HH HHHHHHHH HH HH 075 TI IA EO W lt t oo RBS RS am DH EE 4 CI oa P EY r OO Q 3 pp mo om oa 2 N mm Bi AG Es 00000045 an G O O 124 241 29 OS mono o Rao sg TS ES E 63 827 oa
45. HHHHHHHHHHHHHH 000000 HHHHHHH 0000000000 00000000000000000 0000000000000 TEL 075 315 5276 FAX 075 314 5042 0000000000000029000000000 000000 m 00000000000000 0000000 HHHHHHD 0000000 000 000 00000 00 0000000 0000000 000000000 000000000 HH 0 0000000000 00000000000 0000000000 000000 000000000000000000000000000000000 HHHHHHHH 0000000000000 00 1790 m 00000000000000 HH HHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHHHHHHHH 000000000 00000 0 HHHHHHHHHH HHHHHHHHHHHHHHH 0 0000000 000000000 00000 HHHHHHHHHHHHHH HHHHHHHHHHHHHHHH HHHHHHHHHHHHHHHH 0 00 0000000 HHHH RFA 00000 000 00 0000 0000000000000 0 000 000 000 000 5 o 5 5 E 00 00 00 00 5 G HHHHHHHHH 000000000 HHHHHHHHHHHHH HHHHHHHHHHHHHHHHHHHHHHHHHH 00 000000 gt T hm HHHHHHHHHH 9 00000000 1 00000 0 0000000000000000000000000 000000 00000000000000 000000000000000 075 315 5276 HHHHHH 075 314 5042 HHHHHHHHHH
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