@Toyofumi Fujiwara:00298 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/@Toyofumi%20Fujiwara/sourceid/00298","sourcedb":"@Toyofumi Fujiwara","sourceid":"00298","text":"298　遺伝性膵炎\n○　概要\n\n１．概要 \n　遺伝性膵炎とは、遺伝により慢性膵炎が多発する稀な疾病である。遺伝性膵炎の定義としてGrossは、①血縁者に３人以上の膵炎症例を認め、②若年発症、③大量飲酒など慢性膵炎の成因と考えられるものが認められず、④２世代以上で患者が発生していることを挙げている。我が国では少子化に伴い明確な家族歴を得ることが困難なため、厚生労働省難治性膵疾患に関する調査研究班の策定した臨床診断基準に基づき診断される。\n\n２．原因 \n　原因遺伝子変異として、カチオニックトリプシノーゲン（PRSS1）遺伝子変異が約４割、膵分泌性トリプシンインヒビター（SPINK1）遺伝子変異が約３割、その他・不明が約３割とされる。膵炎発症の第一段階は、膵腺房細胞内でのトリプシノーゲンの異所性活性化である。生体内には異所性のトリプシノーゲン活性化、さらに活性化したトリプシンを介する他の消化酵素の活性化による自己消化から膵臓を守るための防御機構が存在している。PRSS1遺伝子異常により、トリプシンの活性化・不活性化のアンバランスが生じるとトリプシンの持続的活性化が生じ、膵炎を発症すると考えられている。しかしながら、SPINK遺伝子における最多の変異（p.N34S変異）による膵炎発症機序は解明されておらず、また３割の家系では原因遺伝子異常を認めず、発病機構は明らかではない。\n\n３．症状 \n　発症は10歳以下が多く、幼児期より腹痛、悪心、嘔吐、下痢などの急性膵炎様発作を反復し、多くは慢性膵炎へと進行し、膵外分泌機能不全や糖尿病を高率に合併する。頻回な膵炎発作のための入院や疼痛コントロールのために膵臓手術が必要となる症例も多い。\n\n４．治療法\n　疼痛のコントロールと、膵内外分泌障害に対する補充療法といった対症療法にとどまり、根治的治療はない。\n\n５．予後\n　一般の慢性膵炎に比べて遺伝性膵炎の発症が幼少時と若く有病期間が長いことや、炎症が反復・持続し高度となりやすいため、膵外分泌機能不全や糖尿病を高率に合併し、QOLは著しく低下する。さらに遺伝性膵炎患者の膵癌発症率は一般人口のそれと比べて、約50倍から90倍と高率である。我が国における全国調査においても、遺伝性膵炎82家系中14家系（17％）に膵癌を認めている。\n\n\n\n○　要件の判定に必要な事項\n患者数\n約300～400人\n発病の機構\n不明（主にトリプシンの活性化・不活性化に関する遺伝子異常によることが想定されている。）\n効果的な治療方法\n未確立（膵外分泌及び内分泌機能不全に対する対症療法にとどまる。）\n長期の療養\n必要\n診断基準\nあり（研究班作成の診断基準あり。）\n重症度分類\n急性膵炎発作を直近１年に１回以上起こしている場合を重症とし、対象とする。\n\n○　情報提供元\n「難治性膵疾患に関する調査研究」\n研究代表者　近畿大学　教授　竹山宜典\n\n\n\n＜診断基準＞\n\n再発性急性膵炎あるいは慢性膵炎（確診及び準確診）症例で、以下の①～④の４項目のうち①を満たす場合、あるいは②、③、④の全てを満たす場合、遺伝性膵炎と診断される。\n①カチオニックトリプシノーゲン（PRSS1）遺伝子のp.R122Hないしp.N29I変異が認められる\n②世代にかかわらず、膵炎患者２人以上の家族歴がある\n③少なくとも１人の膵炎患者は、大量飲酒など慢性膵炎の成因と考えられるものが認められない\n④単一世代の場合、少なくとも１人の患者は40歳以下で発症している\n\n＜それぞれの定義＞\n急性膵炎\n上腹部に急性腹痛発作と圧痛がある。\n血中又は尿中に水酵素の上昇がある。\n超音波、CT又はMRIで膵に急性膵炎に伴う異常所見がある。\n上記３項目中２項目以上を満たし、他の膵疾患及び急性腹症を除外したものを急性膵炎と診断する。\n注：膵酵素は膵特異性の高いもの（膵アミラーゼ、リパーゼなど）を測定することが望ましい。\n\n再発性急性膵炎\n慢性膵炎の診断基準を満たさず、急性膵炎発作を複数回反復するものである。多くは微小胆石によるものと推測されているが、遺伝性膵炎の一部も含まれると考えられる。\n\n慢性膵炎\n\u003ctable\u003e\n慢性膵炎の診断項目\n①特徴的な画像所見\n②特徴的な組織所見\n③反復する上腹部痛発作\n④血中又は尿中膵酵素値の異常\n⑤膵外分泌障害\n⑥１日80g以上（純エタノール換算）の持続する飲酒歴 \n\n慢性膵炎確診：a、bのいずれかが認められる。\na．①又は②の確診所見。\nb．①又は②の準確診所見と、③④⑤のうち２項目以上。 慢性膵炎準確診：①又は②の準確診所見が認められる。 早期慢性膵炎：③～⑥のいずれか２項目以上と早期慢性膵炎の画像所見が認められる。 \n\n\u003c/table\u003e\n注１．①、②のいずれも認めず、③～⑥のいずれかのみ２項目以上有する症例のうち、他の疾患が否定されるものを慢性膵炎疑診例とする。疑診例には３か月以内にEUSを含む画像診断を行うことが望ましい。\n注２．③又は④の１項目のみ有し早期慢性膵炎の画像所見を示す症例のうち、他の疾患が否定されるものは早期慢性膵炎の疑いがあり、注意深い経過観察が必要である。\n\u003ctable\u003e\n慢性膵炎の診断項目 ①特徴的な画像所見 確診所見：以下のいずれかが認められる。\na．膵管内の結石。\nb．膵全体に分布する複数ないしび漫性の石灰化。\nc．ERCP像、膵全体に見られる主膵管の不整な拡張と不均等に分布する不均一かつ不規則な分枝膵 　管の拡張。\nd．ERCP像で、主膵管が膵石、蛋白栓などで閉塞又は狭窄している時は、 乳頭側の主膵管と分枝 膵管の不規則な拡張。 準確診所見：以下のいずれかが認められる。\na．MRCPにおいて、主膵管の不整な拡張と共に膵全体に不均一に分布する分枝膵管の不規則な拡 張。\nb．ERCP像において、膵全体に分布するび漫性の分枝膵管の不規則な拡張、主膵管のみの不整な拡 　　 張、蛋白栓のいずれか。\nc．CTにおいて、主膵管の不規則なび漫性の拡張と共に膵辺縁が不規則な凹凸を示す膵の明らかな 変形。\nd．US（EUS）において、膵内の結石又は蛋白栓と思われる高エコー又は膵管の不整な拡張を伴う 辺縁が不規則な凹凸を示す膵の明らかな変形。 ②特徴的な組織所見\n確診所見：膵実質の脱落と線維化が観察される。膵線維化は主に小葉間に観察され、小葉が結節状、 いわゆる硬変様をなす。\n準確診所見：膵実質が脱落し、線維化が小葉間又は小葉間・小葉内に観察される。 ④血中又は尿中膵酵素値の異常\n以下のいずれかが認められる。\na．血中膵酵素が連続して複数回にわたり正常範囲を超えて上昇あるいは正常下限未満に低下。\nb．尿中膵酵素が連続して複数回にわたり正常範囲を超えて上昇。 ⑤膵外分泌障害\nBT-PABA試験で明らかな低下を複数回認める。 \n\n\u003c/table\u003e\n\n\n＜重症度分類＞\n急性膵炎発作を直近１年に１回以上起こしている場合を重症とし、対象とする。\n\n※診断基準及び重症度分類の適応における留意事項\n１．病名診断に用いる臨床症状、検査所見等に関して、診断基準上に特段の規定がない場合には、いずれの時期のものを用いても差し支えない（ただし、当該疾病の経過を示す臨床症状等であって、確認可能なものに限る。）。\n２．治療開始後における重症度分類については、適切な医学的管理の下で治療が行われている状態であって、直近６か月間で最も悪い状態を医師が判断することとする。\n３．なお、症状の程度が上記の重症度分類等で一定以上に該当しない者であるが、高額な医療を継続することが必要なものについては、医療費助成の対象とする。","tracks":[{"project":"Nanbyo-330-20171127","denotations":[{"id":"T1","span":{"begin":7,"end":9},"obj":" HP:0001733"},{"id":"T2","span":{"begin":26,"end":28},"obj":" HP:0001733"},{"id":"T3","span":{"begin":38,"end":40},"obj":" HP:0001733"},{"id":"T4","span":{"begin":56,"end":58},"obj":" HP:0001733"},{"id":"T5","span":{"begin":81,"end":83},"obj":" HP:0001733"},{"id":"T6","span":{"begin":104,"end":106},"obj":" HP:0001733"},{"id":"T7","span":{"begin":318,"end":320},"obj":" HP:0001733"},{"id":"T8","span":{"begin":489,"end":491},"obj":" HP:0001733"},{"id":"T9","span":{"begin":542,"end":544},"obj":" HP:0001733"},{"id":"T10","span":{"begin":634,"end":636},"obj":" HP:0001733"},{"id":"T11","span":{"begin":649,"end":651},"obj":" HP:0001733"},{"id":"T12","span":{"begin":681,"end":683},"obj":" HP:0001733"},{"id":"T13","span":{"begin":791,"end":793},"obj":" HP:0001733"},{"id":"T14","span":{"begin":800,"end":802},"obj":" HP:0001733"},{"id":"T15","span":{"begin":881,"end":883},"obj":" HP:0001733"},{"id":"T16","span":{"begin":940,"end":942},"obj":" HP:0001733"},{"id":"T17","span":{"begin":1130,"end":1132},"obj":" HP:0001733"},{"id":"T18","span":{"begin":1226,"end":1228},"obj":" HP:0001733"},{"id":"T19","span":{"begin":1234,"end":1236},"obj":" HP:0001733"},{"id":"T20","span":{"begin":1292,"end":1294},"obj":" HP:0001733"},{"id":"T21","span":{"begin":1363,"end":1365},"obj":" HP:0001733"},{"id":"T22","span":{"begin":1388,"end":1390},"obj":" HP:0001733"},{"id":"T23","span":{"begin":1402,"end":1404},"obj":" HP:0001733"},{"id":"T24","span":{"begin":1469,"end":1471},"obj":" HP:0001733"},{"id":"T25","span":{"begin":1524,"end":1526},"obj":" HP:0001733"},{"id":"T26","span":{"begin":1575,"end":1577},"obj":" HP:0001733"},{"id":"T27","span":{"begin":1634,"end":1636},"obj":" HP:0001733"},{"id":"T28","span":{"begin":1639,"end":1641},"obj":" HP:0001733"},{"id":"T29","span":{"begin":1654,"end":1656},"obj":" HP:0001733"},{"id":"T30","span":{"begin":1697,"end":1699},"obj":" HP:0001733"},{"id":"T31","span":{"begin":1718,"end":1720},"obj":" HP:0001733"},{"id":"T32","span":{"begin":1731,"end":1733},"obj":" HP:0001733"},{"id":"T33","span":{"begin":1827,"end":1829},"obj":" HP:0001733"},{"id":"T34","span":{"begin":1892,"end":1894},"obj":" HP:0001733"},{"id":"T35","span":{"begin":1922,"end":1924},"obj":" HP:0001733"},{"id":"T36","span":{"begin":1943,"end":1945},"obj":" HP:0001733"},{"id":"T37","span":{"begin":2025,"end":2027},"obj":" HP:0001733"},{"id":"T38","span":{"begin":2086,"end":2088},"obj":" HP:0001733"},{"id":"T39","span":{"begin":2119,"end":2121},"obj":" HP:0001733"},{"id":"T40","span":{"begin":2154,"end":2156},"obj":" HP:0001733"},{"id":"T41","span":{"begin":2896,"end":2898},"obj":" HP:0001733"},{"id":"T42","span":{"begin":36,"end":38},"obj":" HP:0011132"},{"id":"T43","span":{"begin":102,"end":104},"obj":" HP:0011132"},{"id":"T44","span":{"begin":647,"end":649},"obj":" HP:0011132"},{"id":"T45","span":{"begin":789,"end":791},"obj":" HP:0011132"},{"id":"T46","span":{"begin":1232,"end":1234},"obj":" HP:0011132"},{"id":"T47","span":{"begin":1400,"end":1402},"obj":" HP:0011132"},{"id":"T48","span":{"begin":1637,"end":1639},"obj":" HP:0011132"},{"id":"T49","span":{"begin":1716,"end":1718},"obj":" HP:0011132"},{"id":"T50","span":{"begin":1729,"end":1731},"obj":" HP:0011132"},{"id":"T51","span":{"begin":1825,"end":1827},"obj":" HP:0011132"},{"id":"T52","span":{"begin":1890,"end":1892},"obj":" HP:0011132"},{"id":"T53","span":{"begin":1920,"end":1922},"obj":" HP:0011132"},{"id":"T54","span":{"begin":1941,"end":1943},"obj":" HP:0011132"},{"id":"T55","span":{"begin":2023,"end":2025},"obj":" HP:0011132"},{"id":"T56","span":{"begin":2084,"end":2086},"obj":" HP:0011132"},{"id":"T57","span":{"begin":2117,"end":2119},"obj":" HP:0011132"},{"id":"T58","span":{"begin":2152,"end":2154},"obj":" HP:0011132"},{"id":"T59","span":{"begin":36,"end":40},"obj":" HP:0006280"},{"id":"T60","span":{"begin":102,"end":106},"obj":" HP:0006280"},{"id":"T61","span":{"begin":647,"end":651},"obj":" HP:0006280"},{"id":"T62","span":{"begin":789,"end":793},"obj":" HP:0006280"},{"id":"T63","span":{"begin":1232,"end":1236},"obj":" HP:0006280"},{"id":"T64","span":{"begin":1400,"end":1404},"obj":" HP:0006280"},{"id":"T65","span":{"begin":1637,"end":1641},"obj":" HP:0006280"},{"id":"T66","span":{"begin":1716,"end":1720},"obj":" HP:0006280"},{"id":"T67","span":{"begin":1729,"end":1733},"obj":" HP:0006280"},{"id":"T68","span":{"begin":1825,"end":1829},"obj":" HP:0006280"},{"id":"T69","span":{"begin":1890,"end":1894},"obj":" HP:0006280"},{"id":"T70","span":{"begin":1920,"end":1924},"obj":" HP:0006280"},{"id":"T71","span":{"begin":1941,"end":1945},"obj":" HP:0006280"},{"id":"T72","span":{"begin":2023,"end":2027},"obj":" HP:0006280"},{"id":"T73","span":{"begin":2084,"end":2088},"obj":" HP:0006280"},{"id":"T74","span":{"begin":2117,"end":2121},"obj":" HP:0006280"},{"id":"T75","span":{"begin":2152,"end":2156},"obj":" HP:0006280"},{"id":"T76","span":{"begin":618,"end":620},"obj":" HP:0002027"},{"id":"T77","span":{"begin":1478,"end":1480},"obj":" HP:0002027"},{"id":"T78","span":{"begin":624,"end":626},"obj":" HP:0002013"},{"id":"T79","span":{"begin":627,"end":629},"obj":" HP:0002014"},{"id":"T80","span":{"begin":632,"end":636},"obj":" HP:0001735"},{"id":"T81","span":{"begin":1128,"end":1132},"obj":" HP:0001735"},{"id":"T82","span":{"begin":1224,"end":1228},"obj":" HP:0001735"},{"id":"T83","span":{"begin":1467,"end":1471},"obj":" HP:0001735"},{"id":"T84","span":{"begin":1522,"end":1526},"obj":" HP:0001735"},{"id":"T85","span":{"begin":1573,"end":1577},"obj":" HP:0001735"},{"id":"T86","span":{"begin":1632,"end":1636},"obj":" HP:0001735"},{"id":"T87","span":{"begin":1652,"end":1656},"obj":" HP:0001735"},{"id":"T88","span":{"begin":2894,"end":2898},"obj":" HP:0001735"},{"id":"T89","span":{"begin":637,"end":639},"obj":" HP:0001250"},{"id":"T90","span":{"begin":683,"end":685},"obj":" HP:0001250"},{"id":"T91","span":{"begin":1132,"end":1134},"obj":" HP:0001250"},{"id":"T92","span":{"begin":1480,"end":1482},"obj":" HP:0001250"},{"id":"T93","span":{"begin":1656,"end":1658},"obj":" HP:0001250"},{"id":"T94","span":{"begin":1768,"end":1770},"obj":" HP:0001250"},{"id":"T95","span":{"begin":2898,"end":2900},"obj":" HP:0001250"},{"id":"T96","span":{"begin":666,"end":669},"obj":" HP:0000819"},{"id":"T97","span":{"begin":852,"end":855},"obj":" HP:0000819"},{"id":"T98","span":{"begin":692,"end":694},"obj":" HP:0012531"},{"id":"T99","span":{"begin":729,"end":731},"obj":" HP:0012531"},{"id":"T100","span":{"begin":2225,"end":2228},"obj":" HP:0005213"}],"attributes":[{"subj":"T1","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T2","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T3","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T4","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T5","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T6","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T7","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T8","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T9","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T10","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T11","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T12","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T13","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T14","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T15","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T16","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T17","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T18","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T19","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T20","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T21","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T22","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T23","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T24","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T25","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T26","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T27","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T28","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T29","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T30","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T31","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T32","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T33","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T34","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T35","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T36","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T37","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T38","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T39","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T40","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T41","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T42","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T43","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T44","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T45","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T46","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T47","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T48","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T49","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T50","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T51","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T52","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T53","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T54","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T55","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T56","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T57","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T58","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T59","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T60","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T61","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T62","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T63","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T64","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T65","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T66","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T67","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T68","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T69","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T70","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T71","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T72","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T73","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T74","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T75","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T76","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T77","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T78","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T79","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T80","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T81","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T82","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T83","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T84","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T85","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T86","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T87","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T88","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T89","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T90","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T91","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T92","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T93","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T94","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T95","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T96","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T97","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T98","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T99","pred":"source","obj":"Nanbyo-330-20171127"},{"subj":"T100","pred":"source","obj":"Nanbyo-330-20171127"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"Nanbyo-330-20171127","color":"#ec93cf","default":true}]}]}}