74歳男性．48歳時突然の低血糖で搬送され，インスリン，抗甲状腺剤の使用歴がなくインスリン自己免疫症候群と診断された．低血糖症状には補食で対処してきたが，61歳からはボグリボースを投与された．しかし，数日おきに深夜，早朝，食前などに，低血糖(25∼59 mg/dl)を繰り返していた．72歳時からプレドニゾロン(PSL) 30mg/日を投与開始し，低血糖の頻度の減少とともに10 mg/日まで漸減した． その後1年間の継続投与後は月2回ほどの早朝低血糖のみとなった．空腹時血清IRI，インスリン抗体結合率は，PSL治療前116.0 μU/ml, 75.4%だったが，1年後77.7 μU/ml, 69.0%まで低下した．Scatchard解析では本抗体は低親和性高結合能のmonoclonal抗体で，PSL投与により，親和性に変化はないが，結合部位数が減少した．HLAの検索ではDR4を有しておらず，DRB1^*0901を認めた．

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　There is an increasing flowability of shops along the shopping street in the central part of the metropolis of Osaka. In this situation, the central objective of activation in the shopping street is to create a community centered on shop owners. This paper focuses on the shop ownersʼ social relationships through a case study of the shopping street “Shinsekai” in Osaka. Through analysis, we show the social conditions that caused the formation of this shopping street. The results demonstrate that the shop owners formed communities by forging links through diverse social relationships in the practice of activation in the shopping street. First, the shop owners practiced the activation by building personal relationships founded on community-based organization (shopping street organization and neighborhood associations). In the next stage, the established shop owners made concerted efforts to cooperate with newer shop owners, who raised capital externally, to create an attractive “regional image.”
　This paper presents the following significant findings: 1) We point out the importance of personal relationships among the shop owners to form a community through practices of activation in the shopping street. 2) We discovered that organic social relationships among shop owners provided the foundation for community-based organization.

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