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Possibilities of Doppler Sonography in the Estimation of Hepatic Functional State in the Cases of Obstructive Jaundice I. I. Zatevakhin, M. Sh. Tsitsiashvili, G. Zh. Dzarasova, Zh. I. Shepilova, E. G. Shepit ｯko Department of Surgical Diseases, (director ｨC prof. I.I. Zatevakhin) Russian State Medical University, Moscow There is represented the primary case of color Doppler imaging and pulse-gated Doppler of the portal bed vessels at the early diagnosis of hepatic failure with 47 patients suffering obstructive jaundice of different genesis. Urocaninase test is used as an integral indicator of hepatic functional state at the pre-manifested stage of hepatic failure. It is found that the progress of hepatic functional state in the case of cholestasis is accompanied by parallel changes of velocity as well as of the specter of portal vein, common hepatic artery, superior mesenterical artery, splenic and hepatic veins. In the opinion of the authors, further investigations will make it possible with the help of noninvasive duplex sonography to formulate concrete hemodynamic criteria of hepatic failure. 040006030703applefl 006ｦ0 06076 500apple04000006036 5076 56ｦ0000900 070800apple6ｦ003096 5000706 03000300090109, 0ｹ100 0706010708090ｹ00006010903 030003000702076 70906, 070603090800-0009fl 06076 5apple00030000000706 000909000307010609016ｦ00ｷ30907000706 0300apple6ｦ0080909 09 6ｦ0000006030009090702076 70909, 0200036ｦ002000007060300 08apple09 03fl0800020ｸ803 0207apple- 036ｦ003 0300036ｦ000090ｹ00006010706 08000203040309 070603096 76ｦ00003, 0807 6ｦ000000ｸ803 apple6ｦ00902090ｹ0000ｸ803 6ｦ06 50307apple076 5, 20ｨC60% [1, 17, 20, 22]. ｨｦ 000706 0909 6 7026ｦ06 5000ｸ803 08apple090ｹ00900 0200036ｦ00200000ｸ803 09060307 076 5 fl6 502fl000306fl 08000ｹ00000070ｹ0006ｦ0fl 0000 0706036ｦ003070ｹ00007060300: 08apple090300apple0007 04 40% 040300apple040903 006ｦ0 02070000 0300036ｦ000090ｹ00006010706 08000203040309 07 apple07-016ｦ00ｹ00006036 5000000076 707 6 7000000096ｦ0 09 07020000 0ｹ00003 6 5 2/3 0602040ｹ06ｦ0006 5 070804030702006 50706 07 0603apple04010ｷ30909 0800020ｹ0000ｸ803 0804030006 [20]. 05 0ｹ1030706 066 5fl0909 6 56ｦ008000006040006 096ｦ0 6ｦ00ｹ00006 006ｦ0 08040309 0402040ｹ00400-0009fl apple0009040200036ｦ003076 5 02000ｹ0000009fl 0300036ｦ000090ｹ00006010706 08000203040309 fl6 502fl000306fl apple6ｦ00000flfl 096ｦ06 70007060309016ｦ0 020400010ｷ30907006ｦ0020000076 707 0607060307fl0009fl 08000ｹ0000009 06 0807060200 040ｸ90ｸ70006 6ｦ0 00016 56ｦ003000706 0000 0107appleapple00010ｷ3090006 [7, 17, 21]. 01 0607086ｦ0020000090ｸ9 6 50600 0300076 70707 - apple6ｦ0090900 06076 5apple00030000000ｸ803 0907030903090ｹ00006010903 09 09000603apple04030000-036ｦ00200000ｸ803 03000307 076 5 0909040ｹ0000009fl 020400010ｷ30907006ｦ0020000076 707 0607-060307fl0009fl 08000ｹ0000009 0000 6ｦ00003 08apple0706030ｸ803 09 006ｦ0 0008000ｸ803 01apple09-0300apple09006 5 006 707 070ｷ300000109 [12, 16]. 0200076 7090309 6ｦ06 50307apple6ｦ00309 0ｸ80207 07016ｦ0096ｦ00007, 0ｹ00307 006ｦ0apple0404000009fl 6 5000403apple0908000ｹ00000070ｹ0-000706 6 7000307 09006ｦ003090109, 0608070607 06036 5040ｸ90ｸ70900 6 709080701060909 6 700-086ｦ003070ｷ30903076 5 09 060009080000090ｸ9 0903 apple00090906030000030007060309 01 0807-6 5apple0008 6ｦ00ｸ90ｸ70903 026ｦ0010307apple6ｦ003, 03076 70403 08apple00 040006036 5076 56ｦ00300 01020900090ｹ00006010706 036ｦ00009020006036ｦ00ｷ30909 08000ｹ00000070ｹ00007-01020003070ｹ0-000706 0000 0706036ｦ003070ｹ00007060309 [11, 15, 16]. 05040ｸ70006036 5040ｸ90ｸ70900 006ｦ0 06006 707 00fl04000906 000000 apple6ｦ00902090ｹ0000ｸ800 0608070607 0ｸ8 070ｷ300000109 08000ｹ00000070ｹ0000706 6 7000307 09006ｦ003090109 ｨC 0ｹ102000103apple07036ｦ06 7000903006ｦ0fl 02020704030003apple09fl, 010900006ｦ0006 709076 7apple6ｦ00209fl, apple6ｦ0 0907090907030708006ｦ0fl 060ｷ3090003096 7apple6ｦ00209fl ｨC 0000 6 50807020000 6ｦ0 00016 56ｦ003000ｸ8 06076 5apple00030000-000ｸ803 080703apple00 00070603fl03 01020900090ｹ00006010706 08apple6ｦ00103090109, 6 56 509 04 0209 07 09006 56ｦ009096 50007060309 090209 000003070ｹ00007060309 0906060200 076 56ｦ00009fl, 0209 07 006 707 060207080007060309 090209 0209030002000007060309 [7, 12, 15, 16]. 03070200040900 6 707apple09090700030ｸ8 6 5 000009006 56ｦ009096 5000706 09 03070ｹ0000706 070ｷ300000100 08000ｹ00000070ｹ000076 707 01apple076 5070307016ｦ0 070301apple0ｸ802090600 6 5 0600apple00-090000 80-03 6 707 076 5 6 5 066 5fl0909 06 6 50000 apple0000090003 6 5 01020900090ｹ00006-01040ｸ9 08apple6ｦ00103090104 00076 50ｸ803 04020003apple6ｦ0096 50401076 50ｸ803 03000307 0901: 04080200010600076 707 06016ｦ00009apple076 56ｦ00009fl, 07 ｨB00 0900096 504006 707 B-apple00-080903 06 apple006 7090603apple6ｦ00ｷ3090006 0608000103apple076 7apple6ｦ00303 02070ｷ309apple0400030ｸ803 06070604 076 5, 6ｦ0 036ｦ0010800 0ｷ36 50003076 5076 707 0708080200apple076 50601076 707 016ｦ0apple- 0309apple076 56ｦ00009fl (090501) 0807030701076 5. 0307020004090006036 507 apple6ｦ0 0703 0807066 5fl0ｸ7000007 0909040ｹ00000090ｸ9 070607 0000000706030006 07apple6 76ｦ00000076 707 01apple076 5070307016ｦ0 08apple09 03apple0700090ｹ00006010903 0902020409000ｸ803 09 070ｹ06ｦ06 707-6 50ｸ803 0807apple6ｦ008000009fl03 08000ｹ0000009 [8ｨC10, 19, 23, 25, 29, 30, 35, 36]. 05 0307 0800 6 5apple0003fl 6ｦ0006ｦ002090904 01apple076 50707 apple6ｦ00ｸ7000009fl 08000ｹ0000009 6 5 040602076 509fl03 0307020006036ｦ0096ｦ0 ｨC 02090400 00 0900090ｹ0000ｸ800 8 020404020001 07ｨ ｨｺｨｬｨｺ07ｨ ｨｮ000501ｨｦ09 0700ｨｨ02ｨｪｨｦ00ｨｦ07ｨ ｨ 030703 6 6ｧ8 1 2001 113
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(2000). 0000 0300036ｦ000090903 6 5 0706036ｦ003070ｹ0000706 0300apple00 0000 0909040ｹ00000, 0007 08apple00 080702070809030002000007 07 ｨBfl06000000 [15] 06 080709090ｷ30909 6 50600 030706 0800 6ｦ0apple6 704030000036ｦ00ｷ30909: 030007apple0909 apple00-6ｦ00103096 5000706 6 7090800apple00030909 09 0300036ｦ0000909036ｦ0 6 5000403apple0908000ｹ00000070ｹ0-00076 707 6ｦ0apple0300apple09070807apple036ｦ0020000076 707 0404000309apple076 56ｦ00009fl. ｨｴ0307, 006ｦ0 006ｦ004 6 5096 702fl, 0706036ｦ003070ｹ00007 08apple6ｦ06 5070300apple0007 09 07 040602076 50200-0007 060300apple000703090800070603000ｸ9 6 70703000706036ｦ003090ｹ00006010903 0300036ｦ0000909-03076 5, 006ｦ008apple6ｦ06 5020000000ｸ803 006ｦ0 0807 00apple086ｦ0000900 08000ｹ00000070ｹ0000706 0800apple0204090909, 0000096ｦ06 50906090307 0703 0800apple6 5090ｹ000076 707 04apple076 500fl 07-0603apple04010ｷ30909 0807apple036ｦ00200000706 0609060300030ｸ8 ｨC 08apple0006090004060709 6ｦ00200-00076 707, 06090004060709 6ｦ0020000076 707 090209 0807060306090004060709 6ｦ0020000076 707. ｨｪ6ｦ001, 0807 6ｦ000000ｸ803 036ｦ0 02. 3, 6 5 040602076 509fl03 0300036ｦ000090ｹ00006-010706 08000203040309 096ｦ0030003apple ｨｦｨｨ02 09 050302 0ｸ802 070603076 500apple- 0007 6 50ｸ80400, 0ｹ00003 6 5 01070003apple070200000706 6 7apple04080800. ｨｨ07060200 020901-6 509 6ｦ00ｷ30909 08000203040309 08apple6ｦ00103090ｹ000060109 04 6 5060003 070200000ｸ803 006ｦ0-020ｸ9 6ｦ002070600 04030000000400000900 096ｦ0030003apple076 5 6ｦ0apple0300apple0906 060707036 5000306036 500000007 006ｦ0 13.4 ﾀ 2.7% 09 12.9 ﾀ 1.6%. ｨｴ0309 6ｦ000000ｸ800 066 509 000300020006036 5076 56ｦ00209 6 5 080702000904 030007apple0909 ｰapple00-6ｦ00103096 5000706 6 7090800apple00030909 ｱ. 050909046ｦ002090909apple076 56ｦ00300 6 5 apple0008090300 0ｷ36 5000300076 707 0708080200apple076 50601076 707 016ｦ0apple0309apple076 56ｦ00009fl 030901apple0706010708090ｹ00006010900 6ｦ0apple0300apple09070807apple036ｦ00200000ｸ800 040400030ｸ8 0604 06006 7030000036ｦ0apple00076 707 04apple076 500fl 006ｦ003 0000 04 6ｦ002070600 0009 6 5 07 000703 0602040ｹ06ｦ000. 056ｦ000000ｸ800 02090300apple6ｦ00304apple0ｸ8 [35] 066 509 000300020006036 5040ｸ903, 0ｹ00307 0807080ｸ8030109 6 5090904-116 020404020001 07ｨ ｨｺｨｬｨｺ07ｨ ｨｮ000501ｨｦ09 0700ｨｨ02ｨｪｨｦ00ｨｦ07ｨ ｨ 030703 6 6ｧ8 1 2001
13ｨ 02ｨｪ00050207ｨ 04 09 apple. 0800020ｹ0000ｸ800 08040309 ｨｪ6ｦ0 02090ｷ36ｦ0 4. 05apple00 000900 09006ｦ00ｹ0000009fl 0807016ｦ0096ｦ00300020006 6 7000307 09006ｦ003090109 0807apple036ｦ0020000076 707 apple0406026ｦ0 6 5 096ｦ06 50906090307060309 0703 04apple076 500fl ｨｬ01 ｨｨ07016ｦ0096ｦ003000209 6 7000307 09006ｦ00309-0109/ｨｬapple076 5000000 ｨｬ01 (00/02) 0ｨC4 5ｨC9 10ｨC15 V max ｨｦｨｨ02 (03/06) 0.884 ﾀ 0.048 1.195 ﾀ 0.026* 1.272 ﾀ 0.038* Q ｨｦｨｨ02 (0302/030900) 857.7 ﾀ 106.2 1205.3 ﾀ 108.6* 1154.8 ﾀ 105.6* 05096ｦ0030003apple ｨｦｨｨ02 (0303) 5.9 ﾀ 0.03* 6.5 ﾀ 0.06* 6.2 ﾀ 0.05* PI ｨｦｨｨ02 1.23 ﾀ 0.10* 1.48 ﾀ 0.19 1.79 ﾀ 0.03 V max 050302 (03/06) 1.171 ﾀ 0.13 1.189 ﾀ 0.53 1.575 ﾀ 0.25 Q 050302 (0302/030900) 765.1 ﾀ 72 604.6 ﾀ 93.8 963.8 ﾀ 50.7* 05096ｦ0030003apple 050302 (0303) 7.8 ﾀ 0.03* 6.2 ﾀ 0.23 7.0 ﾀ 0.12* PI 050302 5.3 ﾀ 0.21* 4.0 ﾀ 0.86* 4.4 ﾀ 0.26* Ta max 0505 (03/06) 0.167 ﾀ 0.04* 0.190 ﾀ 0.05* 0.156 ﾀ 0.03* Q 0505 (0302/030900) 1643.7 ﾀ 58.5* 935.9 ﾀ 95.4* 1110.2 ﾀ 98.8* 05096ｦ0030003apple 0505 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Sato et al. (1987) 070303000ｹ06ｦ00209 09 04 070200000ｸ803 0ｷ309appleapple07090703 08000ｹ000-0009. 0509 090307 6ｦ0006ｦ002076 7090ｹ0006ｦ0fl 0800apple000603apple0706016ｦ0 030901apple070ｷ309apple- 010402fl0ｷ30909 08000ｹ0000009 006ｦ0060304086ｦ0026ｦ0 08apple09 6 50ｸ8apple6ｦ0080000000706 0300036ｦ0-00090ｹ00006010706 08000203040300 09 04apple076 50000 ｨｬ01 0703 10 00/02 09 07020000. 020404020001 07ｨ ｨｺｨｬｨｺ07ｨ ｨｮ000501ｨｦ09 0700ｨｨ02ｨｪｨｦ00ｨｦ07ｨ ｨ 030703 6 6ｧ8 1 2001 117
130800020ｹ0000ｸ800 08040309 05ｨｦｨ 02ｨｦ0504ｨｦ05ｨｪｨ 05ｨｦｨｨｨｨ0000ｨｺｨｦ050501ｨｦ09 05ｨｦ04ｨｦ07ｨｺ0206ｨ ｨ ｨｺ0906. 1. 05040802000106000700 06016ｦ00009apple076 56ｦ0000900 01apple076 5070307016ｦ0 6 5 07 0ｸ70006 08000ｹ00000070ｹ0000706 6ｦ0apple0300apple0909. 056 500apple0304: B-apple00080903. 01070003apple070200000ｸ806 07 ｨB0003 0406036ｦ000076 5020000 6 5 08apple07066 5000300 ｨｦｨｨ02. 0500090904: 0708080200apple076 506010906 0608000103apple 06 6 5096 76ｦ0 0ｹ06ｦ006030703. 0407apple036ｦ00200000ｸ806 6 50403026ｦ009000ｸ806 0608000103apple 06 0ｹ00906-030ｸ803 0608000103apple6ｦ00200000ｸ803 0701000703; 0807060200 060906030702090ｹ0000601076 707 0809016ｦ0 6 5 006ｦ00ｹ06ｦ00200 096ｦ006030702090ｹ00006010706 0ｹ06ｦ0060309 01apple096 50706 0708apple00 0002fl000306fl 09000ｷ3090904apple6ｦ0, 060707036 5000306036 5040ｸ90ｸ76ｦ0fl 096ｦ001apple0ｸ803090ｸ9 6ｦ007apple036ｦ0020000076 707 01026ｦ0086ｦ0006ｦ0. ｨｨapple09 0ｹ1030703 0ｹ103076 7apple6ｦ002090ｹ00006010900 09 026ｦ0086ｦ0apple0706010708090ｹ00006010900 08apple0909006ｦ00109 0307020006036ｦ003090ｹ0000601076 707 6 700086ｦ00309036ｦ0 090209 6 50307apple090ｹ0-00076 707 0902096ｦ0apple00076 707 0ｷ309appleapple07096ｦ0 07 006ｦ0apple0408096 56ｦ002090600 02090400 04 60% 086ｦ00ｷ309000003076 5 0ｹ1030706 6 7apple0408080ｸ8. ｨｴ0307 0807 036 500apple08 6ｦ00207 0800apple6 5090ｹ00007060300 6 7000307 09006ｦ003090ｹ00006010903 090903000000000906 08000ｹ000-0009 0807 07030007040000090ｸ9 01 0307apple020702076 7090ｹ00006010903. 05 040602076 509fl03 0300036ｦ000090ｹ00006010706 08000203040309 0909030000fl02090600 0000 030702000107 010702090ｹ00006036 50000000ｸ800, 0007 09 016ｦ00ｹ00006036 50000000ｸ800 0807016ｦ0096ｦ003000209 04080200010600076 707 06016ｦ00009apple076 56ｦ00009fl 08000ｹ00000070ｹ0-00076 707 01apple076 5070307016ｦ0. ｨｪ0908 0608000103apple6ｦ00200000706 01apple096 50706 6 5 ｨｦｨｨ02 0706036ｦ06 56ｦ00206fl 6 50403026ｦ009000ｸ803, 016ｦ001 09 6 5 0007apple0300 (apple0906. 1). ｨｦ - 006ｦ00107 036ｦ0apple6ｦ0010300apple 6ｦ0apple0300apple096ｦ0020000076 707 0608000103apple6ｦ0 6 507 6 5060003 0602040ｹ06ｦ0fl03 0ｸ802 036ｦ06 7090603apple6ｦ002000007-09090300000000000ｸ803, 0ｹ00307 fl6 5-02fl02070600 08apple0909006ｦ0010703 0807fl6 502000009fl 0304apple 040200000ｷ30909 6 5 07036 50003 09 086ｦ0apple6ｦ002020002000007 04060107apple0000090ｸ9 01apple076 5070307016ｦ0 6 5 ｨｦｨｨ02. ｨｦ 0ｹ1030703 066 509 000300020006036 5076 56ｦ00209 apple6ｦ0060409apple00000900 0608000103apple6ｦ00200-00076 707 0701006ｦ0, 00000ｹ000030107060300 0608000103apple6ｦ00200000706 016ｦ006030ｸ8 6 5 100% 0602040ｹ06ｦ0006 5, 6ｦ0 04 5 086ｦ00ｷ309000003076 5 ｨC 0807fl6 50200000900 ｰ0703apple09-0ｷ36ｦ003000200000ｸ803 060107apple0706030006 ｱ 6 5 08apple0700010ｷ30909 060906030702090ｹ000060107-6 707 0809016ｦ0, 036ｦ0apple6ｦ0010300apple0909040ｸ90ｸ70000 036ｦ0010609036ｦ0020000040ｸ9 000907apple- 6 76ｦ00009096ｦ00ｷ3090ｸ9 08070307016ｦ0 (apple0906. 2). ｨｨapple0909006ｦ0010703 0304apple 04020000-0ｷ30909 6 5 apple0008090300 090501 fl6 502fl02070600 0800apple00030004096 56ｦ0000900 0ｷ36 50003076 5 08070307016ｦ0, 066 509 000300020006036 5040ｸ90ｸ70000 07 006 707 apple6ｦ0090007-006ｦ008apple6ｦ06 50200000007060309. ｨｬ 6 5060003 070200000ｸ803 070600076 5000706 6 7apple0408080ｸ8 01apple076 507030701 6 5 0505 060703apple6ｦ000fl02 6 700086ｦ003070800036ｦ00200000700 006ｦ008apple6ｦ06 50200000900, 0307 00060300 0ｸ802 006ｦ008apple6ｦ06 5020000 6 5 060307apple070004 08000ｹ0000009 09 0107 09apple07-6 56ｦ00206fl 01apple6ｦ006000ｸ803 0ｷ36 500030703. 040009090300000000000ｸ806 03070007026ｦ009-000ｸ806 0608000103apple 0505 070303000ｹ06ｦ00206fl 04 070200040006 080702076 509000ｸ8, 27 (57.4%), 07 060200 076 56ｦ000000ｸ803 086ｦ00ｷ309000003076 5 (apple0906. 3). ｨｬ 0706036ｦ00200000ｸ803 22 (42.6%) 070200000ｸ803 0ｸ802 096ｦ00209010609apple07-6 56ｦ000 08apple070804020006096 5000ｸ806 01apple076 507030701 (apple0906. 4). ｨｨ07 6ｦ000000ｸ803 02090300apple6ｦ00304apple0ｸ8 [9, 25], 0807fl6 50200000900 080402000609apple040ｸ90ｸ7006 707 0807apple036ｦ0020000076 707 01apple076 5070307016ｦ0 07 040602076 502000007 0ｹ1010603apple6ｦ06 56ｦ0-096ｦ00200000706 01070308apple000606090006 0505 0209 07 0000 03apple0703 07090703. ｨｨ0402000609apple040ｸ90ｸ76ｦ0fl 0608000103apple076 7apple6ｦ003036ｦ0 06 086ｦ0 0000090003 0209000006-000706 060107apple07060309 01apple076 5070307016ｦ0 0307080003 apple6ｦ0096 5096 56ｦ0030006fl 08apple09 0807apple036ｦ00200000706 6 7090800apple030000090909 6 5060200 06036 50900 08applefl030706 0800apple00-6ｦ00ｹ009 01070200 6ｦ0000906 0703 0600apple 0ｷ36ｦ0 0ｹ000apple0009 08000ｹ00000070ｹ0000ｸ800 0609-0004060709 0ｸ8 01 0505 [9]. 02006ｦ0020909 006ｦ0040903 6ｦ000000ｸ803 0807016ｦ0096ｦ002, 0ｹ00307 08apple070804020006096 5000ｸ806 036ｦ0apple6ｦ0010300apple 0807apple036ｦ0020000076 707 0608000103apple6ｦ0 6 5 040602076 509fl03 0300036ｦ000090ｹ00006010706 08000203040309 07 040602076 50209-6 56ｦ00206fl, 6 507090307080007, 016ｦ001 0ｹ1010603apple6ｦ06 56ｦ0096ｦ00200000706 01070308apple0006-06090006 0505 apple6ｦ0060409apple0000000ｸ803 6 700086ｦ00309010703070200 07030703, 036ｦ001 09 apple6ｦ0096 50903090003 060900 apple07036ｦ0 ｰ08apple0006090004060709 6ｦ00200000706 0807apple- 036ｦ00200000706 6 7090800apple030000090909 ｱ. 05apple00 09 086ｦ00ｷ309000003076 5 06 08apple07-0804020006096 5000ｸ803 0807apple036ｦ00200000ｸ803 0608000103apple0703 096ｦ0030003apple 6 700086ｦ0-0309010703070200 07036ｦ0 0ｸ802 070603076 500apple0007 0409apple00 (14.3 ﾀ 1.3 0303; p < 0.05), 0ｹ00003 6 5 0602040ｹ06ｦ0fl03 06 03070007026ｦ009000ｸ803 0608000103apple0703 (10.6 ﾀ 0.5 0303). ｨｬ 070200000ｸ803 06 08apple070804020006096 5000ｸ803 036ｦ0- apple6ｦ0010300apple0703 01apple076 5070307016ｦ0 6 5 0505 06030008000000 0307020006036ｦ003090ｹ00006-01076 707 08076 5apple0008 000009fl 08000ｹ0000009 0ｸ8026ｦ0 070603076 500apple0007 6 50ｸ8-0400, 006ｦ0 0ｹ00307 04016ｦ0090ｸ86 56ｦ002 04apple076 5000000 ｨｬ01 060ｸ86 507apple07030109 01apple07-6 509 (9.33 ﾀ 0.85 00/02; p < 0.05), 09006ｦ00ｹ009030002000007 08apple006 507060307 fl0ｸ70906 036ｦ001076 50706 04 070200000ｸ803 06 03070007026ｦ009-000ｸ803 0608000103apple0703 (5.75 ﾀ 0.76 00/02). 01apple070300 03076 707, 6 5 118 020404020001 07ｨ ｨｺｨｬｨｺ07ｨ ｨｮ000501ｨｦ09 0700ｨｨ02ｨｪｨｦ00ｨｦ07ｨ ｨ 030703 6 6ｧ8 1 2001
13ｨ 02ｨｪ00050207ｨ 04 09 apple. 0800020ｹ0000ｸ800 08040309 ｨｺ0906. 2. 05040802000106000700 06016ｦ00009apple076 56ｦ0000900 01apple076 5070307016ｦ0 6 5 07 0ｸ70006 08000ｹ00000070ｹ0000706 6ｦ0apple0300apple0909. 056 500apple0304: B-apple00080903 + 090501. 01070003apple070200000ｸ806 07 ｨB0003 0406036ｦ000076 5020000 6 5 08apple07066 5000300 ｨｦｨｨ02. 0500090904: 0708080200apple076 506010906 0608000103apple 06 6 5096 76ｦ0 0ｹ06ｦ006030703. 0508000103apple076 7apple6ｦ003036ｦ0 06 08070200070603000ｸ9 096ｦ0080702000000000ｸ803 0608000103apple6ｦ00200000ｸ803 0701000703, apple6ｦ009030ｸ8030706 0608000103apple6ｦ00200000706 016ｦ006030706 09 07 apple6ｦ003000ｸ80309 08070307016ｦ00309 0807 0809010703 0609060307020ｸ8. ｨｺ0906. 3. 05040802000106000700 06016ｦ00009apple076 56ｦ0000900 01apple076 5070307016ｦ0 6 5 6 507apple0703000706 6 5000000. 056 500apple0304: B-apple00080903 + 090501. 01070003apple070200000ｸ806 07 ｨB0003 0406036ｦ0-00076 5020000 6 5 08apple07066 5000300 0505. 0500090904: 0708080200apple076 506010906 0608000103apple 06 6 5096 76ｦ0 0ｹ06ｦ006030703. 0407apple036ｦ00200000ｸ806 03070007026ｦ009000ｸ806 0608000103apple. 020404020001 07ｨ ｨｺｨｬｨｺ07ｨ ｨｮ000501ｨｦ09 0700ｨｨ02ｨｪｨｦ00ｨｦ07ｨ ｨ 030703 6 6ｧ8 1 2001 119
130800020ｹ0000ｸ800 08040309 05ｨｦｨ 02ｨｦ0504ｨｦ05ｨｪｨ 05ｨｦｨｨｨｨ0000ｨｺｨｦ050501ｨｦ09 05ｨｦ04ｨｦ07ｨｺ0206ｨ ｨ ｨｺ0906. 4. 05040802000106000700 06016ｦ00009apple076 56ｦ0000900 01apple076 5070307016ｦ0 6 5 6 507apple0703000706 6 5000000. 056 500apple0304: B-apple00080903 + 090501. 01070003apple070200000ｸ806 07 ｨB0003 0406036ｦ0-00076 5020000 6 5 08apple07066 5000300 0505. 0500090904: 0708080200apple076 506010906 0608000103apple 06 6 5096 76ｦ0 0ｹ06ｦ006030703. ｨｨapple070804020006096 5000ｸ806 0608000103apple. 6 7apple04080800 06 08apple070804020006096 5000ｸ803 0807apple036ｦ00200000ｸ803 01apple076 5070307010703 0209030002000007060300 08000203040400076 707 0800apple0907 6ｦ0 (7.7 ﾀ 1.4 060403, p < 0.05) 09 0307026ｦ0006 709036ｦ0 (10.0 ﾀ 1.6 060403, p < 0.05) 6 5 0000-06010702000107 apple6ｦ009 0800apple0001apple0ｸ86 56ｦ00209 6ｦ0006ｦ002076 7090ｹ0000ｸ800 06apple070109 (0607-07036 5000306036 500000007 ｨC 2.8 ﾀ 1.0 060403 09 3.3 ﾀ 1.3 060403) 6 5 6 7apple0408-0800 06 03070007026ｦ009000ｸ803 0608000103apple0703. 05030008000000 6 7000307 09006ｦ0-03090ｹ00006010903 090903000000000906 08000ｹ00000070ｹ000076 707 01apple076 5070307016ｦ0 04 070200000ｸ803 06 08apple070804020006096 5000ｸ803 0807apple036ｦ00200000ｸ803 0608000103apple0703 036ｦ0010800 0ｸ8026ｦ0 07020000 6 50ｸ8apple6ｦ0080000000706, 0ｹ00307 070603076 500apple0007 0807 036 500apple08 6ｦ002070600 08apple006 507060307 fl0ｸ70903 04apple076 5000003 036ｦ001076 707 090003006 7apple6ｦ0020000076 707 0807016ｦ0096ｦ0030002fl, 016ｦ001 ｨ 02ｨｨ ｨC 0.55 ﾀ 0.04 0807 06apple6ｦ06 5000000090ｸ9 06 0.43 ﾀ 0.03 (p < 0.05). 05 0ｷ300020703, 08apple07-0804020006096 5000ｸ806 0807apple036ｦ00200000ｸ806 01apple076 507030701 006ｦ0 020ｸ9 6ｦ00206fl 04 6 5060003 070200000ｸ803 06 3-06 06036ｦ0 090006 020400010ｷ30907006ｦ00200000706 0000-0706036ｦ003070ｹ00007060309 08000ｹ0000009 09 030702000107 04 2 086ｦ00ｷ309000003076 5 0607 2-06 06036ｦ0 090006. 050707036 5000306036 500000007 03070007026ｦ009000ｸ806 0608000103apple 0505 0ｸ802 036ｦ0apple6ｦ0010300apple0000 02fl 1-06 09 08apple006 56ｦ00209apple040ｸ90ｸ70006 0ｹ06ｦ0-060309 086ｦ00ｷ309000003076 5 2-06 06036ｦ0 0909 0000 0706036ｦ003070ｹ00007060309 08000ｹ000-00070ｹ0000706 020400010ｷ30909. 05apple6ｦ06 5000903000200000ｸ806 6ｦ0006ｦ0020909 6ｦ000000ｸ803 036ｦ0 02. 2 09 3 0000 6 50ｸ8fl6 50902 070603076 500apple000706 apple6ｦ00900090ｷ30ｸ8 010702090ｹ00006036 50000000ｸ803 086ｦ0apple6ｦ0030003apple076 5 01apple076 5070307016ｦ0 6 5 0505 09 ｨｨ05. 030009 06036ｦ003090603090ｹ00006010706 070603076 500apple0007060309 030000fl02090600 0ｹ10309 0807016ｦ0096ｦ003000209 09 08apple09 08apple076 7apple00060609apple076 56ｦ0000909 06030008000009 020400010ｷ30907006ｦ00200000706 0000 0706036ｦ003070ｹ00007060309 08000ｹ0000009. ｨｦ 006ｦ00107 04 0ｹ06ｦ0060309 070200-000ｸ803 070600076 5000706 6 7apple0408080ｸ8 09 6 5 0505, 09 6 5 ｨｨ05 030ｸ8 07 006ｦ0apple04-08090209 090903000000000900 036ｦ0apple6ｦ0010300apple6ｦ0 0608000103apple076 7apple6ｦ00303. 05 0505 04 08apple006 56ｦ00209apple040ｸ90ｸ7006 707 07020004090006036 56ｦ0 070200-000ｸ803 06 0300036ｦ000090ｹ00006010706 0800020304030706 ｨC 42 (89.4%) ｨC 006ｦ0-020ｸ9 6ｦ00206fl 08apple070804020006096 5000ｸ806 036ｦ0apple6ｦ0010300apple 0608000103apple6ｦ0, 6ｦ0006ｦ0-02076 7090ｹ0000ｸ806 036ｦ001076 5070304 6 5 0505 (apple0906. 5); 060707036 5000306036 50000-0007 0007apple036ｦ00200000ｸ806 03070007026ｦ009000ｸ806 0608000103apple ｨC 030702000107 04 5 (10.6%) 086ｦ00ｷ309000003076 5. 020ｸ8 0000 6 50603apple0003090209 6 5 02090300apple6ｦ0-0304apple00 6ｦ0006ｦ002076 7090ｹ0000ｸ803 070809066ｦ0000906 09090300000000000ｸ803 0608000103apple076 7apple6ｦ00303 6 5 0505 09 030003 07020000 07 ｨBfl060000000906 0807 07 00070304 0200000703000004. ｨｨapple076 500 0000000ｸ806 006ｦ00309 6ｦ0006ｦ0020909 0807096 50702fl0003 08apple00 0807020708090300, 0ｹ00307 08apple070804020006096 5000ｸ806 01apple076 507030701 6 5 0505 6 5 07020004090006036 500 0602040ｹ06ｦ0006 5 0ｸ802 07 040602076 5020000 apple6ｦ009-6 50903090003 060900 apple07036ｦ0 ｰ08apple0006090004060709 6ｦ00200000706 0807apple036ｦ00200-000706 6 7090800apple030000090909 ｱ, 08apple076 7apple00060609apple076 56ｦ06 504006 707, 016ｦ001 0ｸ80207 0807016ｦ0096ｦ00007 6 50ｸ80400, 0807 0300apple00 006ｦ0apple6ｦ006036ｦ00009fl 020400010ｷ30907-006ｦ00200000706 0000 0706036ｦ003070ｹ00007060309 08000ｹ0000009. ｨｪ6ｦ001, 08apple0708040200-06096 5000ｸ806 0608000103apple 6 5 0505 070303000ｹ06ｦ00206fl 6 5 100% 0602040ｹ06ｦ0006 5 3-06 6 7apple0408080ｸ8 020400010ｷ30907006ｦ00200000706 0000 0706036ｦ003070ｹ00007060309 08000ｹ0000009, 6 5 57.1% 0602040ｹ06ｦ0006 5 2-06 6 7apple0408080ｸ8 09 0009 6 5 07 000703 ｨC 1-06 6 7apple0408080ｸ8. ｨｦ08apple00 00020000000ｸ806 09000300apple0006 6 50ｸ8090ｸ86 56ｦ00207 0607-070300070400000900 0909030000000000076 707 0608000103apple6ｦ0 6 5 0505 09 0505. ｨｬ 6 5060003 070200000ｸ803 06 08apple070804020006096 5000706 0608000103apple076 7apple6ｦ003030706 6 5 0505 030ｸ8 07 006ｦ0apple0408096 56ｦ00209 6ｦ0006ｦ002076 7090ｹ0000ｸ800 0909030000000009fl 6 5 0505. 05 03070800 6 5apple0003fl, 03070007026ｦ00900070304 0608000103apple04 6 5 0505 6ｦ002000107 0000 6 506006 7 6ｦ0, 6ｦ0 030702000107 6 5 33.3% 0602040ｹ06ｦ0006 5, 060707036 5000306036 507-6 56ｦ002 036ｦ001076 50706 6 5 0505. ｨｬ 07020004090006036 56ｦ0 070200000ｸ803 06 00000909-0300000000000706 0807apple036ｦ00200000706 0608000103apple076 7apple6ｦ003030706 (66.7%) 006ｦ0-020ｸ9 6ｦ00206fl 08apple070804020006096 5000ｸ806 01apple076 507030701 6 5 0505. ｨｨ07 07-000ｸ800 0909030000000009fl 07 040602076 502096 56ｦ002090600, 006ｦ0 006ｦ004 6 5096 702fl, 06 6ｦ06 5020000090003 0505 03016ｦ000000ｸ9 0807 08000204 070ｹ0000706 08000200090ｸ8 6 5 07 000703 0602040ｹ06ｦ000 08apple09 086ｦ00001apple0007000001apple070900, 6 5 0706036ｦ00200000ｸ803 ｨC 08apple09 03apple0700090ｹ00006010703 086ｦ00001apple006ｦ003090300. 120 020404020001 07ｨ ｨｺｨｬｨｺ07ｨ ｨｮ000501ｨｦ09 0700ｨｨ02ｨｪｨｦ00ｨｦ07ｨ ｨ 030703 6 6ｧ8 1 2001