$BF|K\D62;GH0e3X2q!!ElKLCOJ}2q(B
$BBh(B28$B2s3X=Q=82q!!%W%m%0%i%`!&>6O?=8(B

$B!!!!!!(B
$BF|!!;~!'(B $BJ?@.(B16$BG/(B9$B7n(B12$BF|!JF|!K(B9$B;~(B00$BJ,(B - 16$B;~(B40$BJ,(B
$B>l!!=j!'(B $B%[%F%kC$8J20(B
  $BJ!Eg;T1ID.(B5-1 (tel$B!'(B 024-522-5111)
$BBg2qD9!'(B $BJ!Eg8)N)0e2JBg3X;:2JIX?M2J!!:4F#!!>O(B
$B;22CHq!'(B 1,000$B1_(B
$BCOJ}2q(BURL$B!'(B http://www.ecei.tohoku.ac.jp/~jsum/
$BO"Mm@h!'(B $B")(B960-1295$BJ!Eg;T8w(I9$B5V#1HVCO(B
 $BJ!Eg8)N)0e2JBg3X;:IX?M2J65<
  $BF|K\D62;GH0e3X2qElKLCOJ}2qBh(B28$B2s3X=Q=82q;vL36I(B
  Tel: 024-547-1290$B!$(BFax: 024-548-3878
  E-mail: obgyn@fmu.ac.jp
 



$B9V1i
$B!&0lHL1iBj$O!$(B1$BBj$K$D$-H/I=;~4V(B6$BJ,!$F$O@;~4V(B4$BJ,$N9g7W(B10$BJ,4V$G$9!%(B
$B!!>INcJs9p$O!$(B1$BBj$K$D$-H/I=;~4V(B5$BJ,!$F$O@;~4V(B3$BJ,$N9g7W(B 8$BJ,4V$G$9!%(B
$B!&H/I=J}K!$O86B'$H$7$F$9$Y$F2q>l(BPC$B;HMQ$G!$(BPower Point$B$N$_$H$J$j$^$9!%(B
$B!&2q>l$K$O!$(BPowerPoint2002$B$,;HMQ$G$-$k2hLL%5%$%:(B1024$B!_(B768$B$N(BWindows$B%3%s%T%e!<%?!$(BMacintosh$B%3%s%T%e!<%?!$$=$N(Bprojector$B$rMQ0U$7$^$9!%(B
$B!&;vA0?=9~$N:]$N%3%s%T%e!<%?(B(WindowsWin$B!&(BMacintoshMac)$B!$5-O?%a%G%#%"(B(CD-ROMCD-ROM$B!$(BMOMO)$B$r9V1iHV9f$K5-$7$F$"$j$^$9$,!$EvF|$O
$B!&1i
$B!&(BPower Point$B$N%9%i%$%IKg?t$O@)8B$7$^$;$s$,H/I=;~4V$r87
 
$BH/9TF|!'J?@.(B16$BG/(B9$B7n(B12$BF|(B







$BF|K\D62;GH0e3X2q!!Bh(B6$B2sElKLCOJ}2q9V=,2q(B
$B!JBh(B28$B2s3X=Q=82qJ;@_!K$N$*CN$i$;(B


$BBh(B6$B2sElKLCOJ}2q9V=,2q(B($BBh(B28$B2s3X=Q=82qJ;@_(B)$B$r2<5-$NMW9`$G3+:E$$$?$7$^$9!%$4=P@J$$$?$@$$$?D62;GH@lLg0e!$D62;GH9)3X%U%'%m!5$BC10L(B$B$N8&=$!&6H@SC10L$,M?$($i$l$^$9!%(B


$B5-(B


$B3+:EF|;~!'(B $BJ?@.(B16$BG/(B9$B7n(B12$BF|(B($BF|(B)$B!!(B13$B!'(B00$B!A(B15$B!'(B15
$B2q!!!!>l!'(B $B%[%F%kC$8J20!!!!J!Eg;T1ID.(B5-1$B!!!!(BTEL: 024-522-5111
$B9V1iBjL\!'(B 1)$B!!(B13:00$B!A(B13:45$B!!!!:BD9!'J!Eg8)N)0e2JBg3X!!;:2JIX?M2J!!Bg@nIR><(B
$B!VD62;GH$K$*$1$k=P@8A0?GCG!W(B
$B9V;U!!=gE7F2Bg3X1:0BIB1!!!;:IX?M2J!!!!5HED!!9,MN!!@h@8(B
  2)$B!!(B13:45-14:30$B!!!!:BD9!'ElKL8|@8G/6bIB1!!!=[4D4o%;%s%?!
$B!VD62;GH$K$h$j8!=P$G$-$k7l4IFb$NHy>.@r;R%7%0%J%k$H$=$N0U5A!W(B
$B9V;U!!?73cBg3XBg3X1!0e;u3XAm9g8&5f2J!!8F5[=[4D302J!!!!?:BtOBI'!!@h@8(B
  3)$B!!(B14:30-15:15$B!!!!:BD9!'5\>k8)N)$,$s%;%s%?!C2=4o2J!!>.Ln;{Gn5A!!@h@8(B
$B!VJ"It7l9TF0BV0[>o$ND62;GH?GCG!W(B
$B9V;U!!F#865-G0IB1!!!Fb2J!!!!:0Ln!!7
$B;2(B $B2C(B $BHq!'(B
1,000$B1_(B $B!J3X=Q=82q;22CHq$H$OJLESD'<}$$$?$7$^$9!%!K(B
$B;vA0?=$79~$_$OITMW$G$9!%(B




















$B%i%s%A%g%s%;%_%J!<$N$*CN$i$;(B


$B5-(B


$B3+:EF|;~!'(B$BJ?@.(B16$BG/(B9$B7n(B12$BF|(B($BF|(B)$B!!(B12$B!'(B00$B!A(B12$B!'(B50
$B2q!!!!>l!'(B$B%[%F%kC$8J20!!!!J!Eg;T1ID.(B5-1$B!!!!(BTEL: 024-522-5111
$B9V1iBjL\!'(B$B:BD9!';{BtNIIW!!@h@8!!!J@gBf
$B4N4b$KBP$9$k(BReal-time Virtual Sonography
 $B9V;U!!ElKLBg3XBg3X1!!!>C2=4oIBBV3X9V:B!!4d:j!!N4M:!!@h@8(B
 
 
$B6&!!!!:E!'(B$B!J3t!KF|N)%a%G%$%3(B





$BD62;GH5!4oE8<($N8f0FFb(B


$B3X=Q=82q2q>l$NNY<<$G!$3F%a!<%+!<$ND62;GH5!4o$NE8<($r9T$$$^$9!%(B
 
$B!!!!%"%m%+!J3t!K(B
$B!!!!%7!<%a%s%900%a%G%$%F%C%/!J3t!K(B
$B!!!!El
$B!!!!!J3t!KF|N)%a%G%$%3(B
$B!!!!%U%$%j%C%W%9%a%G%$%+%k%7%9%F%`%:!J3t!K(B
$B!!!!;}ED@=Lt!J3t!K(B
$B!!!!(BGE$B2#2O%a%G%$%+%k%7%9%F%`%:!J3t!K(B
 







$B$J$*!$F|K\D62;GH0e3X2qElKLCOJ}2qBh(B29$B2s3X=Q=82q!$Bh(B7$B2s9V=,2q$O!$(B
$BJ?@.(B17$BG/(B3$B7n(B20$BF|@gBf;T$G3+:E$NM=Dj$G$9!%(B


$B!!(B $B!!(B $B!!(B
$B3+2q$N0';"!!(B(9:00-9:05) $BBg2qD9!!J!Eg8)N)0e2JBg3X;:2JIX?M2J!!:4F#!!>O(B
 
$B#1!!=[4D4o!$8F5[4o(BI$B!!(B(9:05-9:43) $B:BD9!'ElKLCf1{IB1!!!=[4D4oFb2J!!!!6bC+F)!!@h@8(B
 
28-1.$B!!(B3D-TUS$B$G4Q;!$7$?GYF0@EL.aq$N0lNc(B
$B!!!!!!:bCDK!?MB@EDAn9gIB1!ImB0B@ED@>%NFbIB1!!!@8M}8!::2J(B $B;3;{!!9,M:!$IpF#!!J8I'!$(B
  $B>>EDH~DE;R!$>.<
$B2f!9$O!$D94|7P2a4Q;!$7$?GYF0@EL.aq$r(B3D-TUS$B$G4Q;!$7!$6=L#$"$k=j8+$rF@$?$N$GJs9s$9$k!%!Z>INc![(B46$B:P!$CK@-!%!Zo1F!Z8=IBNr![(BH6.5.25$B8!?G$G(BC.C.$B;XE&!%(B5.30$B8F5[4o2J$7(BH16.4.13$BF~1!!%!ZF~1!8e7P2a![(BMRI$B$GG>(BAVM(-),3D-CT$B$GGYF0@EL.$NN.F~N.=P7l4I$K2C$(!$(BIVC$B$X$b$I$k0[>o7l4I$rG'$a$?!%1&(BB4$B$h$jD62;GH%W%m!<%V$rA^F~$7(B3D-TUS$B$GJ;Av$9$k(BAVM$B$r%j%"%k%?%$%`$K(B3$B
 
28-2.$B!!:G?7$N2<;h@EL.an<#NE$K$*$1$k7l4ID62;GH%(%3!<$NLr3d(B
$B!!!!!!J!EgBh0lIB1!?4B!7l4IIB%;%s%?!<(B $B>.@n!!CR90!$@1Ln!!=S0l!$NP@n!!GnJ8(B
  $B:4F#!!980l(B
$B2<;h@EL.an$KBP$7!$%+%F!<%F%k$K$h$k@EL.an7l4IJD:?=Q$r;n$_$F$*$j!$$=$N=QA08e$NI>2A$O$b$A$m$s=QCf$N%+%F!<%F%kA`:n$N?.Mj$G$-$k%,%$%I$H$7$F(BDuplex$B!!(BUltrasound $B!J(BDU$B!K$rMQ$$$F$$$k!%K\=Q<0$K$*$1$k(BDU$B$NM-MQ@-$K$D$$$FJs9p$9$k!%BP>]$O%+%F!<%F%k@EL.an7l4IJD:?=Q$r;\9T$7$?(B19$BNc$G!$$=$NA4Nc$K=QCf$K(BDU$B$,;HMQ$5$l$?!%%+%F!<%F%k$OI(22<$NBgIz:_@EL.$h$jG.>F<^$K$h$j7l4IJD:?$r9T$C$?!%(BDU$B$NM-MQ@-!'(B
$B#1!%@|;IK!$K$h$k%+%F!<%F%k%"%/%;%9$N:]$N%,%$%I$H$7$F!%(B
$B#2!%%+%F!<%F%k$N@hC<$r@53N$K@uJ"JI@EL.J,4tD>2<$NBgIz:_@EL.$K%,%$%I$G$-$?!%(B
$B#3!%3N $B#4!%G.>F<^Cf$K%j%"%k%?%$%`$N7l4I$N<}=L$,3NG'$G$-$?!%(B
$B#5!%=QD>8e$N7l4I$NJD:?$,3NG'$G$-$?!%(B
$B7kO@!'=QCf$N@53N$J(BDU$B$K$h$kI>2A$K$F!$A4Nc$G0BA4!$3N
 
28-3.$B!!D69bNp
$B!!!!!!28!::It(B $B@PDM!!5#I'!$4];3!!N';R!$;3:j!!NQ;R(B
  $B9)F#!!5~;R(B
$B!!!!!!F1=[4D4oFb2J(B $B9b66!!5*;R!$@iMU!!=cLi!$G.3$!!M5G7(B
$B!ZL\E*![D9]![J?@.(B15$BG/(B2$B7n$+$iJ?@.(B16$BG/(B6$B7n$^$G$N(B1$BG/(B4$B%v7n4V$K7[F0L.%(%3!<$r;\9T$7$($?(B 90$B:P0J>e$NO"B3(B45$B>INc(B($BCK@-(B13$BL>!$=w@-(B32$BL>!%(B92.7$B!^(B2.2$B:P!%(B)$B!%(B $B!ZJ}K!![;HMQ5!INc$G7WB,$7$?!%2p8nJ]81$K$*$1$kCTJrEY(BII**$BL$K~$+$DF|>o@83hEY(BA1**$BL$K~$r7r9/$J@83h%l%Y%k$H9M$((BH$B72(B(19$BL>(B)$B!$$=$l0J30$r(BD$B72(B(26$BL>(B)$B$H$7$?!%$^$?9b7l05!$E|G"IB!$9b;i7l>I$$$:$l$+;XE&$N$"$k(Brisk$B72(B(24$BL>(B)$B$H(Bnon-risk$B72(B(21$BL>(B)$B$H$7$?!%$3$l$i$N724V$G%Q%i%a!<%?Hf3S$r9T$C$?!%(B $B!Z7k2L![(Bmax-IMT$B!J1&!K(BH$B72(B1.31$B!^(B0.48$B-P!$(BD$B72(B1.23$B!^(B0.42$B-P!$(Brisk$B72(B1.40$B!^(B0.51$B-P!$(Bnon-risk$B72(B1.10$B!^(B0.29$B-P!$(Bmax-IMT$B!J:8!K(BH$B72(B1.27$B!^(B0.49$B-P!$(BD$B72(B1.46$B!^(B0.77$B-P!$(Brisk$B72(B1.63$B!^(B0.79$B-P!$(Bnon-risk$B72(B1.10$B!^(B0.33$B-P(B
 
28-4.$B!!2<;hF0L.69:u$KBP$9$k%$%s%?!<%Y%s%7%g%s;\9TA08e$N7l4IFbD62;GH=j8+(B
$B!!!!!!ElKLCf1{IB1!!!=[4D4oFb2J(B $B]/0f!!@6M[!$6bC+!!!!F)!$;38}!!2B;R(B
  $B:XF#!!!!O/(B
$B!!!!!!F1J| $BBgC]!!=$0l(B
$B2<;hF0L.$NJD:I@-F0L.9E2=>I$KBP$9$k%$%s%?!<%Y%s%7%g%s$ODc?/=1E*$J<#NEK!$H$7$F5^B.$KIa5Z$7$F$$$k!%Ev1!$G$O!$D29|F0L.%$%s%?!<%Y%s%7%g%s$N:]7l4IFbD62;GH8!::!J(BIVUS$B!K$r9T$C$F$*$jNI9%$J7k2L$rF@$F$$$k!%:#2s$=$N(B1$BNc$rJs9p$9$k!%>INc$O(B78$B:MCK@-!%4V7g@-ll9T$K$FEv2J>R2p$H$J$C$?!%2<;h%"%s%.%*$r;\9T$7$?$H$3$m:8AmD29|F0L.$K(B90%$B69:u$,G'$a$i$l$?$?$a%$%s%?!<%Y%s%7%g%s$r9T$C$?!%F1B&BgB\F0L.%"%W%m!<%A$G%,%$%I%o%$%d!<$rDL2a$5$;!$(BIVUS$B$r9T$C$?!J(BUltra cross 30 MHz$B!K!%IBJQ$,8B6I@-$G$"$k$3$H$d!$7l4I7B$r3NG'$7$?!%%P%k!<%s$K$FA03HD%8e!$(BPalmaz$B%9%F%s%H$rN1CV$7$?!%%9%F%s%HN1CV8e!$:FEY(BIVUS$B$r9T$$%9%F%s%H$NNI9%$J3HD%$r3NG'$7u$d!$%9%F%s%H3HD%ITA4$N?GCG$KLrN)$A2<;hF0L.%$%s%?!<%Y%s%7%g%s$K$*$$$F$bM-MQ$G$"$k$H9M$($i$l$?(B
 
$B#2!!J"It(BI$B!!(B(9:43-10:15) $B:BD9!'=)ED@V==;zIB1!!!>C2=4oIB%;%s%?!
 
28-5.$B!!g#E>0\$rH<$&BgD24b$NFsNc(B
$B!!!!!!=)EDAH9gAm9gIB1!!!@8M}8!::<<(B $B5HED@iJf;R!$Bg;3!!MU;R!$:0Ln!!=c;R(B
  $B>.>B!!CN;R(B
$B!!!!!!F1!!>C2=4o2J(B $B@1Ln!!9'CK(B
$B!!!!!!=)ED@V==;zIB1!!!D62;GH%;%s%?!<(B $B@PED!!=(L@!$>.>>EDCRLi!$8E@n2BBe;R(B
$B!!g#E>0\$OHf3SE*5)$G!$$=$NJs9p$O;68+$5$l$kDxEY$G$"$k!%:#2s2f!9$O!$g#E>0\5Z$S4NE>0\$rH<$&BgD24b$N(B2$BNc$r7P83$7$?$N$G$=$N(BUS$B=j8+$rCf?4$KJs9p$9$k!%(B $B!!;HMQ5!4o!'>INc#1!(F|N)(BEUB6500,$B>INc#2!(ElINc(B1$B!J(B77$B:P=w@-!K!'B>1!$h$j4NR2p!%(BUS$B>e!$4N1&MU$K(B13cm$BBg$N9b%(%3!<INc(B2$B!J(B65$B:PCK@-!K!'J"ItKDK~46$rMU$KB??t$Ne9T7kD2$Kl9g$O>eD24VKl@EL.$r2p$7!$2<9T7kD2$KB8:_$9$k>l9g$O20\$7$&$k$H9M$($i$l$k!%:#8e4N5Z$Sg#$Kl9g$K$O!$BgD24b$NE>0\$r5?$&I,MW$,$"$k$H;W$o$l$?!%(B
 
28-6.$B!!LgL.
$B!!!!!!$$$o$-;TN)Am9gHX>k6&N)IB1!!!>C2=4o2J(B $BApLn!!>;CK!$EOJU!!!!?r!$6aF#!!;VHA!$(B
  $B9bNS!!9-L@!$Di!!9/0lO:!$0$It!!LwI'!$(B
  $B>.Eg!!9/90!$6-!!!!5H9'!$>.Eg!!IRL@!$(B
  $BBg3Z!!>090!$
  $BCf;3!!@2IW!$?\3-!!5H
$B!!>INc(B1$B$O(B69$B:P!$CK@-!%J?@.(B16$BG/(B2$B7n$h$j2<;hIbR2p$5$leD24VKl@EL.$KeIt>C2=4IFb;k6@8!::$G$O!$J.LgD>2<$+$iM)LgIt$K$+$1$F(B3/4$B<~@-$N(B4$B7?$N0_4b$G$"$C$?!%(BCEA 12.2ng/ml$B!$(BCA19-9 12U/ml$B!$(BAFP 4.1ng/ml$B!%>INc(B2$B$O(B63$B:P!$CK@-!%J?@.(B16$BG/(B3$B7n$h$j?4c]It$KF_DK!$(B6$B7n6a0e$reIt>C2=4IFb;k6@8!::$G#17?$N0_4b$,G'$a$i$l!$Ev1!$r>R2p$5$lINc$H9M$(Js9p$9$k!%(B
 
28-7.$B!!B$1FD62;GH$,M-MQ$G$"$C$?0_FbJ,Hg:YK&4b$N4NE>0\IBJQ$N0lNc(B
$B!!!!!!ElKL8|@8G/6bIB1!!!>C2=4o2J(B $B0$It!!bC=((B
$B!!!!!!F1!!8!::<<(B $BHuEO!!L@CK!$7'C+!!L@9-(B
$B!Z>INc![(B89$B:P!$=w@-!%!ZI!%J?@.(B15$BG/!$C@@P$K$FC@4I%I%l%J!<%8!%0_INEK!$N$_!%!Z8=IBNr![J?@.(B16$BG/(B1$B7n(B4$BF|!$>eJ"ItDK$K$F5_5^HBAw!%D62;GH!$(BCT$B$K$FB??t$N4NFb
 
28-8.$B!!CxL@$J@P3%2=$rH<$&0_4b4NE>0\$NFsNc(B
$B!!!!!!=)ED@V==;zIB1!!!>C2=4oIB%;%s%?!<(B $B>!1:!!M3H~!$@PED!!=(L@!$>.>>EDCRLi!$(B
  $B8E@n2BBe;R!$H,LZ!!Bt?N!$>>2
$B!!!!!!F1!!J| $B5\Fb!!9'<#!$J?0BL>>o0l(B
$BBgD24b0J30$N4NE>0\$,@P3%2=$r<($9;v$OHf3SE*$^$l$G$"$k!%:#2s0_4b$N@P3%2=4NE>0\$N(B2$BNc$r7P83$7$?$N$GD62;GH=j8+$rCf?4$KJs9p$9$k!%;HMQ5!INc#1(B;71M$B!%J"ItIT2w46$GMh1!!%D62;GH>e4N:8MU$K?t(Bcm$BBg$Nu@P3%2=$"$j!%Fb;k6@$GJ.LgItA0JI$K0_4b$"$j(B(SMT$BMM(B,por 1)$B!%INc#2(B;56M$B!%J"ItIT2w46$GMh1!!%D62;GH>e4N:8N>MU$K?t(Bcm$BBg$Nu@P3%2=$"$j!%Fb;k6@$GA0DmIt>.W?$K0_4b$"$j(B(B-111,por 1)$B!%@82=3X>e(BAFP$B$N0[>o9bCM$"$j!%D62;GHB$1F8!::$G$O!$E>0\AcA4BN$,(Bhypervascular$B$G$"$C$?!%$J$*!$BPHf$N$?$aBgD24b$N@P3%2=4NE>0\$b6!Mw$9$k!%(B
 
$B#3!!=[4D4o!$8F5[4o(BII$B!!(B(10:26-11:00) $B:BD9!'ElKLBg3XBg3X1!!!Fb2JIBBV3X9V:B!!!!>.4d4nO:!!@h@8(B
 
28-9.$B!!GY4bptIt%j%s%Q@a:FH/$KBP$7!$D62;GH%,%$%I2<%i%8%*GH>F<^=Q$,M-MQ$G$"$C$?0lNc(B
$B!!!!!!:bCDK!?MB@EDAn9gIB1!ImB0B@ED@>%NFbIB1!!!@8M}8!::2JD62;GH<<(B $B;3;{!!9,M:!$IpF#!!J8I'!$>>EDH~DE;R!$(B
  $B>.<
$B!!!!!!:bCDK!?MB@EDAn9gIB1!ImB0B@ED@>%NFbIB1!!!8F5[4o%;%s%?!<302J(B $B9b66!!Gn?M(B
$B!Z$O$8$a$K![(BRFA$B$O%i%8%*GH$r;HMQ$7$?>F<^K!$G!$4N:YK&4b$KJ]81E,1~$,G'$a$i$l$?$,!$GY0\Nc$KBP$7!$(BRFA$B$r;\9T$7NI9%$J7k2L$rF@$?$N$GJs9p$9$k!%!Z>INc![(B62$B:P!$CK@-!Z.:YK&GY4b$N?GCG$GJ|e%j%s%Q@a7B(B3cm$B$NH>5e>u$K9-$,$k!%(BUS$B%,%$%I2<$K@|;I$7!$(B70$B!n(B5 $BJ,>F<^$9$k!%(B8.26$B!!(B1$B2sL\$N(BRFA$B;\9T!%(BPR$B!%(B9.30$B!!(B2$B2sL\$N(BRFA$B;\9T!%(B12.2$B!!(B3$B2sL\$N(BRFA$B;\9T!%.$rF@$?!%(B
 
28-10.$B!!(BASD$B=Q8e$KANK
$B!!!!!!J!Eg8)N)0e2JBg3X!!Bh0lFb2J(B $B5Z@n!!2m7
  $BH,4,!!>0MN!$NkLZ!!!!6Q!$LpHxHDM59,(B
  $B@P66!!IR9,!$4];3!!9,IW(B
$B!!!!!!F1!!?4B!7l4I302J(B $B>.Ln!!N4;V!$2#;3!!!!@F(B
$B?4KI(B(ASD)$B$KANK9J[7A@.ITA4$r9gJ;$7!$(BASD$BJD:?=Q8e$KANK9J[5UN.(B(MR)$B$NA}0-$rG'$a$?>INc$r7P83$7$?$N$GJs9p$9$k!%!Z>INc![(B16$B:PCK@-!%(B13$B:P;~(BASD(II$B7?(B)$B$KBP$7$FD>@\JD:?=Q$r;\9T$5$l$?!%=QA0?4%(%3!<$K$F!$ANKI$7$?5)$J>INc$H9M$($i$l!$=QA0$KCm0U$,I,MW$H9M$($i$l$?!%(B
 
28-11.$B!!:8K
$B!!!!!!ElKL8|@8G/6bIB1!!!=[4D4o%;%s%?!<=[4D4oFb2J(B $B6b2,!!@i?R!$?{86!!=E@8!$;38}!!!!:Q!$(B
  $B;3Cf!!B?J9!$;00z!!5AL@!$JRJ?!!H~L@(B
$B!!!!!!F1!!?4B!7l4I302J(B $B
$B!!!!!!F1!!Cf1{8!::It(B $BCfEg!!Gn9T!$;M%N5\M45-!$7'C+!!L@9-(B
$B!!!!!!F1!!IBM}It(B $BB<>e!!0l9((B
74$B:PCK@-!%9b7l05!$K}@-?4ITA4$N4{1}$"$j!%(B1$B%v7nA0$h$jO+:n;~B)@Z$l$,=P8=!$?4EE?^>e?4K<:YF0$G!$7P6;JI?4B!D62;GH8!::$K$F:8KA0$N7P?)F;?4B!D62;GH8!::$K$F:8K7B(B3$B!A(B4cm$B$N7B(B2cm$B$N5e>u$G!$:8?4<*$KIUCe$7$F$$$?!%:8KINc$G$O?4K<:YF05Z$S$b$d$b$d%(%3!<$,G'$a$i$l!$B?H/@-$N
 
28-12.$B!!5^@-?46Z9<:I>INc$N?4%(%3!<$K$h$k?46Z(Bviability$B$NI>2A(B
$B!!!!!!J? $BIz8+!!1Y;R!$C]Fb!!2m<#!$9b66!!=SL@(B
  $B4X8}!!E8Be!$NS!!!!2m?M!$(B
$B!!!!!!F1!!NW>28!::2J(B $BC0GH!!42;R(B
$B!ZL\E*![5^@-?46Z9<:I>INc$N(BPCI$B8e$N(Bviability$BI>2A$rDcMFNL%I%V%?%_%sIi2Y%(%3!<$*$h$S7P@EL.E*?46Z%3%s%H%i%9%H%(%3!<$G2DG=$+$I$&$+8!F$$9$k$3$H!%!ZBP>]![(B2003$BG/(B2$B7n$+$i(B2004$BG/(B5$B7n$^$G$N5^@-?46Z9<:I$N$&$A!$5^@-4|$K(BPCI$B$r;\9T$7$?O"B3(B33$BNc!J(BPCI$BIT@.8yNc!$?4ITA4Ey$N9gJ;Nc$O=|30$7$?!KCK(B28$B!$=w(B5$BNc!$J?6QG/Np(B64.4$B!^(B12.9$B:P$G!$(BLAD:12$BNc!$(B LCX: 4$BNc!$(B RCA: 17$BNc!$40A4JD:INc(B24$BNc!$9bEY69:uNc(B9$BNc$G$"$C$?!%!ZJ}K!![5^@-4|I>2A!'(BPCI$B;\9T(B48$B;~4V0JFb$K45o$N2~A1$NM-L5!$DxEY$rH=Dj!%%l%\%S%9%H$rMQ$$$?7P@EL.@-?46Z%3%s%H%i%9%H%(%3!<$r;\9T!$5u7lNN0h$N?46Z@w1F$r4Q;!!%$3$N(B2$B$D$NJ}K!$G5u7l6-0h$N?46Z(Bviability$B$rM=B,$7$?!%K}@-4|I>2A!'?46Z9<:IH/>I(B1$B$+7n0J9_$K?4%(%3!<$r;\9T!%JI1?F00[>o$NHO0O!$DxEY$r4Q;!$7!$5^@-4|$NJI1?F00[>o$HHf3S8!F$$7$?!%(BTotal Asynergy Score$B$,(B2$B%]%$%s%H0J>e8:>/$7$?$b$N$r(Bviability$B$"$j$HH=CG$7!$5^@-4|$NM=B,$H$N0lCWN($rI>2A$7$?!%!Z7k2L![DcMFNL%I%V%?%_%sIi2Y%(%3!<$G$N46EY(B0.75$B!$FC0[EY(B0.88$B$G!$?46Z%3%s%H%i%9%H%(%3!$l(B0.71$B!$(B0.88$B$G$"$C$?!%!Z$^$H$a![5^@-?46Z9<:I$N(BPCI$B8e$N?46Z(Bviability$B$NI>2AK!$H$7$FDcMFNL%I%V%?%_%sIi2Y%(%3!o$KM-MQ$G$"$C$?!%(B
 
$B#4!!4pAC!!(B(11:00-11:50) $B:BD9!'ElKLBg3XBg3X1!9)3X8&5f2JEE;R9)3X@l96!!!!6b0f9@!!@h@8(B
 
28-13.$B!!1zLL(BPVDF$B%H%i%s%9%G%e!<%5$rMQ$$$?%$%s%Q%k%9D62;GH$N2hA|2=$N4pAC
$B!!!!!!=)EDBg3X!!9)3X;q8;3XIt(B $BBg20I_29;R!$5HED!!BYIW!$0f>e!!!!9@(B
$B$3$l$^$G!$%Y!<%/%i%$%H%P%C%-%s%0$7$?1zLL(BPVDF$B%H%i%s%9%G%e!<%5$rMQ$$$F!$C16K@-%Q%k%9D62;GH$rAwl9g!$$=$N46EY$,Dc$$$?$a!$2hA|9=@.;~$N(BS/N$B$r8~>e$5$;$J$1$l$P$J$i$J$$!%$3$NE@$r2~A1$9$k$?$a$K!$%H%i%s%9%G%e!<%5$N6nF0$K9bEE058;$r;HMQ$7$F!$(BS/N$B$r8~>e$5$;$l$P!$%$%s%T!<%@%s%9$N:9$,>.$5$$FpItAH?%$N$h$&$JBP>]J*$KBP$7$F$b2hA|2=$,$G$-$k$h$&$K$J$k$N$G$O$J$$$+$H9M$($i$l$k!%$=$3$G!$9bEE058;$rMQ$$$F6nF0$7$?>l9g$N(BB$B%b!<%I!$(BC$B%b!<%IA|$NI=<($r;n$_$?$N$GJs9p$9$k!%(B
 
28-14.$B!!CF@-N(%i%$%V%i%j$K4p$E$$$?F0L.JI$NAH?%@->u?GCG$N8!F$(B
$B!!!!!!ElKLBg3XBg3X1!9)3X8&5f2J(B $B0p3@!!!!=_!$D9C+@n1QG7!$6b0f!!!!9@(B
$B!!!!!!#J#R@gBfIB1!(B $B;TMh!!@5N4(B
$B!!!!!!FHN)9T@/K!?M9qN)IB1!5!9=@gBf0eNE%;%s%?!<(B $B
$B!ZL\E*![D62;GH$K$h$j7WB,$7$?F0L.JI$NCF@-N(CGAXA|$HIBM}@w?'2hA|$H$NHf3S$K$h$j!$7l4IAH?%(B($B@~0]AH?%!$@P3%2=AH?%!$;iu$N?GCG$N
 
28-15.$B!!F0L.JICF@-N(CGAXA|$ND62;GH7WB,$K$h$kJI$NAX9=B$$NIA=P(B
$B!!!!!!ElKLBg3XBg3X1!9)3X8&5f2J(B $BD9C+@n1QG7!$6b0f!!!!9@(B
$B!!!!!!#J#R@gBfIB1!(B $B;TMh!!@5N4(B
$B!!!!!!FHN)9T@/K!?M9qN)IB1!5!9=@gBf0eNE%;%s%?!<(B $B
$B!ZL\E*![CxI$N?GCG$rL\E*$H$7$F!$F0L.JI$NCF@-N(CGAXA|$r7WB,$9$k\:Y$K8!F$$G$-$k$3$H$,4|BT$5$l$k!%(B
 
28-16.$B!!F0L.JIHy>.8|$_JQ2=$N<~GH?t2r@O$K$h$kJIG4@-FC@-$N?dDj(B
$B!!!!!!ElKLBg3XBg3X1!9)3X8&5f2J(B $BD9C+@n1QG7!$6b0f!!!!9@(B
$B!ZL\E*![K\8&5f$G$O!$F0L.JICF@-N($N7WB,$K$h$kAH?%@->u?GCG$r;n$_$F$$$k!%$7$+$7!$;iKC$H7l@r!$@~0]AH?%$H@P3%2=$J$I$OCF@-$@$1$G$NJ,N`$,Fq$7$$!%$=$3$GK\8&5f$G$O!$AH?%@->u?GCG$N@:EY8~>e$rL\E*$H$7$F!$$b$&(B1$B$D$N5!3#E*FC@-$G$"$kJIG4@-$N7WB,$r;n$_$?!%!ZJ}K!![GoF0$KH<$&%R%HptF0L.JI$N8|$_JQ2=(B($B$R$:$_(B)$B$r!$0LAj:9%H%i%C%-%s%0K!(B[H. Kanai$B!$(Bet al, IEEE Trans. UFFC, 43, 791 (1996)]$B$rMQ$$$F7WB,$7$?!%$^$?!$\v9|F0L.$K$*$$$F!$%H%N%a%H%j7l057W$rMQ$$$F7l05$bF1;~$K7WB,$7$?!%!Z7k2L![BgF0L.J[$NJD:?$K$h$jH/@8$9$k5^=T$J7l05JQ2=$K$h$j@8$8$kJI$N8|$_JQ2=$r<~GH?t2r@O$7!$3F<~GH?t$K$*$1$kCF@-N($r;;=P$7$?$H$3$m!$<~GH?t$H$H$b$KCF@-N($,>e>:$9$k(B($B9E$/$J$k(B)$B798~$,8+$i$l$?!%CF@-N($N<~GH?tFC@-$N79$-$+$iG4@-N($r?dDj$7$?$H$3$m!$(B23 kPa$B!&(Bs$B$G$"$C$?!%(B
 
28-17.$B!!<}=LKv4|$K?4<u?6F0$N0LAjB.EY$N7WB,$K$h$k?46ZG4@-FC@-$N7WB,(B
$B!!!!!!ElKLBg3XBg3X1!9)3X8&5f2JEE;R9)3X@l96(B $B6b0f!!!!9@(B
$B2f!9$O!$GoF0$K$h$C$FBg$-$/F0$$$F$$$k?4B!JI>e$N?6I}?t==%_%/%m%s0J2<$NHy>.?6F0$rB.EYGH7A$H$7$F(B100Hz$B$^$G$NBS0h$K$o$?$j6;JI>e$+$i7WB,$9$k0LAj:9%H%i%C%-%s%0K!$r3+H/$7$?!%$5$i$KD62;GH%S!<%`$NAw?.J}8~$rLs(B10$BJ}8~$K8BDj$9$k$3$H$K$h$j!$%(%$%j%"%7%s%0$J$7$K!$:8?4<<$N?tI4E@$K$*$1$kB.EYGH7A$rF1;~7WB,$7$F$$$k!%$3$l$i$NGH7A$N7WB,$H>\:Y$J4Q;!$+$i!$<}=LKv4|$K?4<u$N?6F0(B($B?6I}$O?4<J}8~(B)$B$,EAHB$9$k$3$H$r8+$$=P$7$?!%K\Js9p$G$O!$7r>o/$9$kMM;R$N7WB,$r9T$C$?!%(B
 
$B#5!!;:IX?M2J!!(B(15:25-15:51) $B:BD9!'4d
 
28-18.$B!!AmGS]u9P;0>INc$H$=$ND62;GH=j8+$NFCD'$K$D$$$F(B
$B!!!!!!J!Eg8)N)0e2JBg3X;:2JIX?M2J(B $BLnB
  $BBg@n!!IR>O(B
$BAmGS]u9P$O5)$J<@45$GB?$/$N4q7A$rH<$$B?:L$JD62;GH=j8+$rDh$7=P@8A0?GCG$O:$Fq$H$5$l$k!%2f!9$OAmGS]u9P$,=P@8A0$K5?$o$l$?(B3$BNc$r7P83$7$?!%!Z>INc(B1$B![G%?1(B27$B=5=w@-B[;y9|HWFb$K(B2$BK<@-G9K&$r3NG'!%G9K&7BA}Bg$7N>B&?e?U>I=P8=!%G%?1(B31$B=5>R2p!$9|HWFb$K(B57$B!_(B50mm$B$N(B2$BK<@-G9K&$HN>B&?e?U>I!$G9K&Fb$K9b51EY0h!$J"?e$J$/g/fy$bIA=P$5$l$:MS?eNL$O@5>o!%AmGS]u9P5?$$!%!Z>INc(B2$B![(B $BG%?1(B22$B=5!$=w@-B[;y9|HWFb$KG9K&$r3NG'!%J"?e$OG'$a$:!%G%?1(B33$B=5>R2p!$9|HWFb$KB?K<@-G9K&!%?e?U>I$HJ"?e$OG'$a$:(BAFI3.4$B!%g/fyIA=P$J$/AmGS]u9P5?$$!%!Z>INc(B3$B![G%?1(B31$B=5!$=w@-B[;y9|HWFbG9K&$HN>B&?e?U>I!$MS?e2a>/>I$rG'$aG%?1(B32$B=5>R2p!%9|HWFb$K(B37$B!_(B18mm$B$N(B3$BK<@-G9K&$H?e?U>I!$G9K&FbIt$K9b51EY0h!%J"?eG'$a$:(BAFI9.6$B!%g/fy$OIA=P$5$l$:AmGS]u9P5?$$!%!Z9M;!![(B(1)$B=w;y(B(2)$B9|HWFb$N(B2-3$BK<@-DxEY$NG9K&(B($Bg5?e>I$d?e;R5\g5>I!)(B)(3)$BG9KB&?e?U>I$HMS?e2a>/>I!%$3$l$i$N=j8+$,?GCG$N7h$a
 
28-19.$B!!D62;GH$H$K$F8!F$$7$?Cf?u?@7P7O0[>oB[;y$N8^>INc(B
$B!!!!!!J!Eg8)N)0e2JBg3X;:2JIX?M2J(B $BGr8M!!CRMN!$LnB
  $BBg@n!!IR>O(B
$B!!6aG/!$D62;GH$rMQ$$$F!$Cf?u?@7P7O0[>oB[;y$N?GCG$,2DG=$H$J$C$?$,!$D62;GH?GCG$5$l$?;~4|$,G%?18e4|$G$"$k$3$H$d!$B[;y$N0LCVEy$J$I$N@)8B$K$h$j3NDj?GCG$,:$Fq$H$J$k>l9g$,@8$8$k!%:#2s!$B[;yD62;GH$H9g$o$;$FB[;y(BMRI$B$r;\9T$7!$B[;yD62;GH$H(BMRI$B$NN>B&LL$+$i8!F$$r9T$C$?(B5$B>INc7P83$7$?$N$GJs9p$9$k!%(B $B>INc$O!$D62;GH$K$FB[;yCf?u?@7P7O0[>o$H?GCG$5$l$?$,0[>o860x$H$J$k<@45$N3NDj?GCG$,:$Fq$G$"$C$?(B5$B>INc$G$"$k!%(B $B$3$l$i$N>INc$KBP$7(BMRI$B;\9T$7$?$H$3$m!$>.G><@45$HFsJ,@TDG>IEy$N?GCG$KM-MQ$G!$J,JZMM<0$N7hDj$d?7@8;y<#NE$K$*$$$FM-1W$G$"$C$?!%$^$?!$D62;GH$K$F?GCG$,:$Fq$H$J$kG%?18e4|$K$*$$$F$b!$$I$NJ}8~$+$i$b;#1F2DG=$J(BMRI$B?GCG$,M-MQ$G$"$C$?!%(B $B0J>e$N;v$h$j!$Cf?u?@7P7O0[>oB[;y$KBP$7$F$O!$D62;GH8!::$K$*$1$kAa4|0[>oH/8+$H!$(BMRI$B$rMQ$$$FN>B&LL$+$i$N8!F$$r$9$k$3$H$,!$$=$N8e$N<#NEJ}?K$N7hDj$KBP$7$FM-1W$H9M$($i$l$?!%(B
 
28-20.$B!!APB[4VM"7l>I8u72$KBP$9$kD62;GH2
$B!!!!!!4d $B<<7n!!!!=_!$J!Eg!!L@=!!$>.;3!!M}7C!$(B
  $B0fE{!!=SI'!$?y;3!!!!E0(B
$BAPB[4VM"7l>I8u72!J(BTTTS$B!K$O!$0le0LS@-APB[$NLs(B15$B!s$KH/>I$9$kB[;yM=8eITNI$N<@45$G!$B[HW>e$NJ-9g7l4I$rDL$8$FAPB[$NN>;y$N4V$K7lN.$NC;Mm$HIT6Q9U$,@8$8$k$b$N$G$"$k!%0lJ}$NB[;y$O=[4D7l1UNL$,A}2C$7$?>uBV$H$J$j!J/$7$?>uBV!J6!7l;y!K$H$J$j!$$=$l$>$l$&$C7l@-?4ITA4!$=[4DITA4$r9gJ;$7$F;R5\FbB[;y;`K4$K;j$k!%:#$^$G$OM-8z$J<#NEK!$,$J$+$C$?<@45$G$"$C$?$,!$6aG/2$JF$N0lIt$GB[;y6@$rMQ$$$?!VA*BrE*B[HWJ-9g7l4I%l!<%6!<>F<^=Q!W$,3+H/$5$l!$Hs>o$KCmL\$5$l$F$$$k!%B[;y6@$r;R5\Fb$KM6F3$9$k$H$-$d%l!<%6!<>F<^$N%*%j%(%s%F!<%7%g%s$N$?$a!$D62;GH2hA|$K$h$k%b%K%?!<$OHs>o$K=EMW$JLr3d$r2L$?$9!%Ev;\@_$G$O(BTTTS$B$KBP$9$kB[;y6@2<F<^=Q$NR2p$9$k!%(B
 
$B#6!!J"It(BII$B!!(B(15:51-16:35) $B:BD9!'J!Eg8)N)0e2JBg3X!!BhFsFb2J!!!!BgJ?90@5!!@h@8(B
 
28-21.$B!!8!?G$GH/8+$5$l$?4NFbB?H/7k@aIBJQ$N0lNc(B
$B!!!!!!J!EgO+:RIB1!!!>C2=4o2J(B $BNkLZ!!CR9@!$;T0f!!!!E}!$ED0f!!??5](B
  $B9>?,!!!!K-(B
$B>INc$O(B51$B:P!$CK@-!%(B2004$BG/(B1$B7n$K?M4V%I%C%/$reB?H/$9$k4NFbB?H/7k@a@-IBJQ$r;XE&$5$l>R2p$H$J$C$?!%0{e>:$7$F$$$?$,!$B>$O0[>o$J$7!%(BUS$B$G$O4NFb$K(B10$B!A(B20mm$BBg$NB?H/$9$k6Q0l$G6-3&L@NF$J9b%(%3!C<:$7$F$$$?!%2hA|=j8+$d!$IBJQ$r;XE&$5$l$F$+$i6XC<:$7$?$H9M$($i$l$k$3$H$+$i!$%"%k%3!<%k@]INc$OE57?E*$J=j8+$rDh$7$F$$$k$H;W$o$l$k$,B?H/$9$k8B6I@-;iKC4N$OHf3SE*5)$J>INc$G$"$j!$J88%E*9M;!$r2C$(Js9p$9$k!%(B
 
28-22.$B!!D62;GH8!::$G7P2a$rDI$($?4N7l4I6Z;iKC
$B!!!!!!J!Eg8)N)0e2JBg3X!!0e3XItBhFsFb2J(B $B9b66!!FX;K!$0$It!!OBF;!$Mk!!!!5#!!!$(B
  $BBgJ?!!90@5!$>.86!!>!IR!$:4F#M35*IW(B
69$B:P!$=w@-!%J?@.(B13$BG/!$7r?G$K$F9b;i7l>I$r;XE&$5$l!$F1G/(B9$B7n(B24$BF|$K6a0e$ro!$4N1j%&%$%k%91"@-!$
 
28-23.$B!!8!?G(BUS$B$G8!=P$5$l$??U4b?GCG$NLdBjE@(B
$B!!!!!!@gBf $B;{Bt!!NIIW(B
$B!!!!!!F1!!D62;GH8!::<<(B $B9-ED$`$D;R!$?\F#!!@?Fs!$LnB
  $BLnB
$B?U4b$NM=8e8~>e$N$?$a$K$O!$L5>I>u$G.$5$$$&$A$K8!=P$9$k$3$H$,=EMW$G$"$k!%$=$N$?$a$K$O8!?G(BUS$B$G?GCG$9$k$3$H$,:G$bBg@Z$G$"$k!%Ev1!?U4bINc$,(B200$B?M!J(B30$B!s!K$r$7$a$F$$$k!%?U4b0J30$N?Ue!$99$K$O8!?G$K$*$1$k(BUS$B$N40A4
 
28-24.$B!!(Bsandwich sign$BMM$N=j8+$r<($7$?2sLUItIBJQ$NFsNc(B
$B!!!!!!8xN)2# $BD9>B!!M5;R!$OB@t@i9a;R!$;0?9!!E8Li!$(B
  $BgU2,!!@5?M!$F#@9!!=$@.!$;01:!!3Y;K(B
$B!!!!!!F1!!J| $BJ?Ln!!90;R!$K!2Z!!F23X(B
$B!!!!!!F1!!8!::2J(B $B>.C0$^$f$_(B
$B!Z>INc(B1$B![(B67$B:PCK@-!%4V7gE*$J1&2e9T7kD2$NJIHn8|$rG'$a!$0lIt(Bsandwich sign$BMM$N=j8+!$<~0O%j%s%Q@a$N.DYag$rG'$a!$>e9T7kD2$K$b1j>I=j8+$rG'$a$?!%@88!$G0-@-%j%s%QINc(B2$B![(B81$B:P=w@-!%1&B&J"ItDK$N$?$ae9T7kD2$NJIHn8|$H(Bsandwich sign$BMM$N=j8+!$<~0O%j%s%Q@a$NI=j8+$G$"$C$?!%!Z;HMQAuCV![F|N)I$N$?$a(Bsandwich sign$BMM$N=j8+$r<($7$?$H9M$($i$l$?!%D24VKl$,F~$j9~$^$J$$$?$a$KAX9=B$$,MF0W$KDI$(!$>v$_9~$^$l$?ItJ,$,Hf3SE*C;$$$3$H$d05=L$5$l$F$$$J$$$3$H$J$I$,D2=E@Q$H0[$J$kE@$H9M$($i$l$?!%(B
 
28-25.$B!!D62;GH%,%$%I2<@8M}?)1v?e9b05CmD2$K$h$kD2=E@Q$N@0I|(B
$B!!!!!!KL>e:Q@82qIB1!!!>.;y2J(B $BB<>e!!MN0l!$@P66!!=UH~!$B<>e!!=_;R(B
  $B:4F#!!M[;R(B
$BD62;GH%,%$%I2<@8M}?)1v?e!J@8?)!K9b05CmD2$K$h$kD2=E@Q$N@0I|$,Js9p$5$l$?!J(BWang G,et.al:J Pediatr Surg 23:814-918,1988$B!K!%(B6$BG/4V!J(B1997-2003$BG/!K$KD2=E@Q(B15$BNc!J(B0-6$B:P!K$KBP$7D62;GH%,%$%I2<@0I|$r9T$C$?!%(B15$BNcCf(B8$BNc$,@0I|2DG=$G$"$C$?$,!$=i4|$K7P83$7$?(B4$BNc$O@0I|$,IT40A4$G$"$C$?$?$a!$(BX$B@~F);k2<%P%j%&%`9b05CmD2$K$h$j@0I|$7$?!%;D$j$N(B3$BNc$O@0I|ITG=$J$?$a!$C<:$72sLUJ[$,IA=P$5$l!J(Bcrab-claw$B%5%$%s!K!$@8?)$,2sLUJ[$rDL2a$72sD2Fb$KN.F~$9$k=j8+!J(Bhoneycomb$B%5%$%s!K$HIb

u$KHn8|$7$?2sD2KvC

 
$BJD2q$N$"$$$5$D!!(B(16:35-16:40) $BElKLCOJ}2q1?1D0Q0wD9!!C*66A19n!!@h@8(B