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1
6 5 1 9 9 4 1 4
2 0 1 3 3 1 9 0 2 5 . 1
2 01 4 2 0 60 8 4 . 1
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2 7 .7 2
2 0 1 4
1
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Ac tiv it y o f D a ily Li vin g AD L
Q u a lity o f Li fe QO L
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3
, 1 9 9 7 Q O L
Q O L
( 1 9 89 1 9 96 2 0 12 )
Q O L Q O L
( 1 9 97 )
1
1 -2
Se l ye , H . 8 0
Se l ye
S e l ye , 1 9 74
2
d e h yd ro e p ian dro s te ron e : DHEA
d e h yd ro e p ia nd ro s te ro ne s u lp hate D HEA -S
DHEA Co rtis o l
C o rtis o l
E va n s , & Hu c k le bridg e , e t a l. , 2 00 0 Wo lf, & Kirs c h b a u m,
19 9 9 C o rt iso l
2 0 0 7 1
A C h ro mo gra n in A : C gA
Den, & Toda, et al. 2007
C gA
Nakane, & Asami, et al. 1998 Ng, & Koh, et al.
2003 Ca n n on 1 9 3 2
M c E wen & Ste lla r, 1 99 3
2 4
2 0 1 3
2 0 11 3
2013 1
A Se c re to r y Immu n o glob u lin A : S -Ig A
S -Ig A
G le s s on , 2 00 0 ; J e mmott & Mc C lella nd , 19 8 9 ; N ie ma n , & Du mke , e t a l. , 20 0 3 S -Ig A
2.
2 0 0 7
C R H : G n R H :
A C T H : C o r t i s o l: D H E A :
D H E A - S :
S - I g A : A C g A : A
S - I g A
C o r t i s o l D H E A / D H E A - S
C g A A C T H
1 -3
S e l ye
H o lme s La z a ru s
Ke s s le r &Wittch o w, 20 0 2 B a s o witz , a nd P e rs k y, e t a l. 1 9 5 5
e t a l., 1 98 8
La z a ru s, a nd Fo lk man 1 9 8 4
e u s tress
d is tre s s
7 0 3 2 0
2 0 11
2 0 1 2
1
1 -4
J a co b son 1 92 9
Wo lp e , & La z a ru s, 1 96 6
B en s o n, 2 00 1
(M o ye r, & R o un d s, e t a l. , 2 0 04 ; Wan g , & Ke c k , 20 0 4 )
N a tio na l C en te r fo r C o mp le me n ta r y a n d A lte rn a tive
M ed icin e NCCA M N a tu ral p ro d u c ts
M ind and b od y med ic i ne M a n ip ula ti ve a nd b od y -b a s e d p rac tic e s
3
2 0 0 7
2 0 0 0
R R
2000
2002 2003 1998
2007
1 -5
2 33 0
Wills 2 0 01 2 0 6
1
2 0 0 9
3 Wil ls 2 0 01
1 9 P eh r H e n rik Lin g
M o n ta gu , 1 9 8 6
H a rlo w a n d Zi mmerma n (1 9 5 8 )
P re s c ott, & Wa lla c e, 1 97 6
Fis h e r, & G a lla n t, 1 99 0
N g u ye n , & H e s lin , e t a l., 1 97 5 Willia ms & B a rgh 2 0 08
M o n ta gu , 1 9 8 6
O 'N e il, & C a lhou n , 1 9 75
M o n tag u , 19 8 6
1 -6
5 1 4
1 6 18 M o n tag u ,
4
5
4
Ga n on g 1 9 93
(P e n field , & R a s mu s e e n , 19 5 0 )
5 . .
(P e n fie ld , & R a smu s e e n , 1 95 0 )
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3 G a no n g , 2 0 06 A B
C
C la y, 2 0 04
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ma s s
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2
Wil ls, 2 00 1
Ku n z , 200 6 C la y, 2 0 0 4
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Fitz g era ld Wills, 2 0 01 Zo n e Th e ra p y
1 0 5
3
5
2 -3
1
2
3
1 0 1 5 5
6
7
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2
1 0 0 8 0 c m × 3 5 c m 2
1
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4
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3
5
6
7 8
9
8 9
8 9 10
2 -7
6
6 2
7
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N
( 1 9 8 8 ) N
( 1 98 8 )
P e rc e ive d Stre s s S c a l e : P SS
2 0 02 C oh e n , Ka ma rc k , &
M e rme ls te in (1 9 83
1 4 0
4 5 6 7
QO L E u roQo l EQ -5 D
E u ro Qo l 1 9 9 8 5
3 1 Vis u a l
An a logu e S c a le ( VAS ) 0 10 0
5 H RQO L
7 HRQO L 5 2 4 3
2 45
HRQO L 1
1 . 0 00 3 -0 . 59 4
2 .
1
3 -2
3
P O M S 20 0 0 P O M S
D e rma to lo g y Lif e Qu a lit y Ind ex D LQ I 2 0 0 1
2 0 07 1
1 0
1 0
VAS
1 0
1 2
3 4 5
6 7
8 9
1 0
2 VA S ( 0 )
(1 0 0 ) 3 VAS
(0 ) (1 0 0 ) 4 9
VAS (0 ) (1 0 0 )
1 0 VA S (0 )
(1 0 0 ) 1 0 10
VA S
VAS
A itk e n 19 6 9
M cC o rma c k 1 98 8
1 0
3
2 0 1 0
4 -1
S a li ve tt e , S a rs ted t A k tle n res e lls c ha ft &
Co .
Co rtis o l
d e h yd roe p ia n d ro s te ron e , D HEA
d e h yd ro e p ia nd ro s te ro ne s u lp ha te , DH EA -S
A C h ro mog ran i n A C gA A
S -Ig A
DHE A
Ga lla gh e r, & Le itc h, e t a l. , 2 0 06 ; G ran g e r, & S ch wa rtz , e t a l. , 1 9 9 9 ; G ra n ge r,
& S h irtc liff, 2 00 4; Sh i rtc liff, & G ran g er, 20 0 1
P a s s ive D ro o l
D HEA -S
DHEA -S
DHEA
DH EA
4 -2
P a s s ive Dro o l
3 1
2 .
1
1 ml
2 S a live tte ,
Sa rs te d t A k tle n re s e lls ch aft & Co . , Ge rma n y
3 O ra l Swab , S a li me tric s LLC, U SA
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3
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D HEA E IA k it S a li me t ric . LLC , US A 5 . 3
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1
DHE A
SP SS
ve r1 5 .0 5 %
4 -4
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1
r = . 66 , p < . 0 1
r = . 63 , p < .0 1 r = . 62 , p < . 0 5
DHEA
r = . 5 9, p < . 01 DHEA -S
F (2 , 18 ) = 3 1 .4 9 , p < .0 1 r = . 73 ,
p < . 0 1 r = . 83 , p < . 0 1
r = .7 2 , p< . 0 1
4 -5
P a s s ive Dro o l
DHEA DHE A -S
3 3
S h irtc liff e t a l. , 20 0 1 D HEA
S h irtc l i ff e t a l. , 20 0 1 DHEA -S
2
3
C o rtis o l C gA S -Ig A
DHEA -S C o rtis o l CgA S -Ig A
1 -1 2 0 1 4
07 2 8
5 -1
5 -2
1
2 0 0 8 2 0 11 A
6 5
1 00
5 0 9 5
7 5
3
N ( 1988) 4 0 N
( 1988) 2 5
3 6
± 8 4 . 5 ±8 . 8
2 .4 5 ±1. 0
1 8 8 5 . 9 ±7 .0 1 8
8 3 . 1 ±10. 2
2
1 1 6 1 8
8
3
8 .
2 a
HE M -7 6 2
15 15 16 15 17 15
3
b
CO RNEO MET ER C M 825 COURA GE+ KH A ZA KA
e le c tron ic G MBH TE WA METER T M3 00
COURAG E+ KHA ZA KA e lec tron ic GMBH
MPA 5 C OURAG E+ KHA ZA KA e le c tro n ic GM BH
6
G an o ng 2 0 06
6
1 1 0
1 M PA5 1
1 0
1 4 0
1 2
4 5 3
6
3
C o rtis o l C g A S -Ig A
1 . 5 c m S a rs ted t
3 1
1
1 6 18
1
3 , 00 0 rp m 1 5 2 0 °C
Co rtis o l E IA kit S a li me tric s LLC C gA Y K0 7 0 Hu ma n
Ch ro mo gra n in A EIA k it S -Ig A
, 1998 B ra d ford
P ro te in A s sa y Kit B IO -RAD C gA
S -Ig A
S mirno v -G ru b b s
2 4 1 2
3 2
1 0 0 %
3 1
L
1 5
5 -3
1
10 1
×
F(1 , 3 4) 7 . 44 p . 01
F(1 , 34 ) 4 . 64 p . 0 5 F(1 , 34 ) 4 6 . 89 p
. 0 1 F(1 , 34) 6 . 7 6 p .0 5
F(1 , 34) 5 . 75 p . 0 5 F(1 , 3 4) 1 5 . 92 p . 0 1
F(1 , 3 4 ) 6 . 70 p . 0 5
F(1 , 3 4) 3 .4 8 p .1 0 F(1 , 34) 3 . 6 8 p . 1 0
F(1 , 3 4 ) 3 . 60 p . 10
3 VAS
8 7 . 0±1 8.3 8 9 . 4 ±1 4. 7
7 8 .1 ±2 2.2 8 8 .3 ±24 . 6
8 6 .1 ±24 . 8
A B 61.1 (19.7) 65.0 (20.7) 54.6 (15.3) 70.8 (12.0) 0.01 12.37** 4.64* 65.0 (21.2) 70.6 (21.0) 55.6 (24.3) 82.7 (18.3) 0.05 17.08** 7.44**
14.4 (29.6) 8.3 (21.5) 37.8 (30.4) 10.6 (19.2) 2.89 16.84** 6.76* 20.1 (33.7) 19.5 (29.3) 41.6 (17.8) 53.5 (26.5) 10.61** 2.99 3.60 25.0 (34.7) 18.3 (31.5) 46.7 (29.3) 16.7 (20.9) 1.37 14.19** 5.75* 23.3 (36.0) 13.9 (26.8) 40.6 (22.1) 16.7 (19.7) 1.53 18.56** 3.48 12.8 (25.2) 7.8 (19.6) 45.0 (29.0) 10.0 (16.1) 6.66* 28.30** 15.92**
60.6 (43.6) 56.7 (40.3) 47.2 (27.2) 23.3 (31.6) 3.68 7.10* 3.68 10.0 (29.3) 8.3 (25.7) 29.2 (25.1) 13.3 (21.1) 2.26 10.23** 6.70* 47.8 (26.2) 42.8 (29.9) 43.3 (17.8) 83.9 (13.3) 7.21* 28.56** 46.89**
** : p <.01 * : p < .05 A: B: =(1, 34
1. 10 VAS SD
(F )
SD) SD) SD) SD)
2
7 2 . 2 ± 9. 4 b p m 7 1 .8 ± 1 0 .5 b p m 8 2 .1 ± 6 . 9
bp m 7 4 . 4 ± 7 .8 b p m
F(1, 3 4 ) 9 .7 1 p . 0 1
1 4 8 . 4 ±20 . 3 mmH g
15 0 . 7 ±25 .3 mmH g 1 5 1. 9 ±24. 1 mmH g
14 8 . 1 ±21 .1 mmH g
7 9 . 3 ±11. 7 mmH g
1 °C
±S D 3
F(1 , 3 4) 5 . 03 p . 0 5
2. SD
A B
29.7 (2.0) 29.1 (2.4) 31.4 (2.2) 32.0 (2.3) 9.97** 0.02 10.36**
28.3 (3.5) 27.7 (3.8) 30.1 (4.5) 31.6 (2.9) 5.70* 1.28 7.74**
29.5 (2.1) 28.6 (2.8) 30.5 (2.9) 31.9 (2.5) 6.99* 0.94 19.42**
29.6 (3.1) 29.4 (2.5) 31.2 (2.3) 31.9 (2.3) 6.29* 0.84 1.88 28.0 (3.4) 27.5 (3.5) 29.5 (4.5) 31.2 (3.1) 4.88* 2.03 7.17* 29.3 (2.7) 28.6 (2.8) 30.2 (3.0) 31.4 (2.7) 4.03 1.12 14.00**
**:p <.01 *:p < .05 p < .10 A: B: =(1, 34
SD) SD) SD)
(F ) SD)
3. g / h SD
A B
13.39 (5.7) 13.28 (6.2) 14.85 (8.9) 16.22 (7.4) 2.38 0.49 0.93 13.34 (4.6) 11.69 (4.4) 21.03 (9.7) 20.88 (9.1) 12.74** 0.32 0.81 12.05 (7.5) 12.39 (6.6) 15.34 (11.9) 16.15 (11.9) 0.83 0.90 0.71 14.41 (10.3) 11.13 (4.0) 16.27 (9.9) 15.86 (10.5) 0.17 0.93 0.91 11.10 (5.3) 11.73 (7.9) 19.80 (16.8) 17.86 (11.4) 6.03* 3.60 0.26 14.03 (9.7) 10.23 (5.7) 13.83 (9.9) 14.76 (13.7) 0.34 0.32 0.39
**:p <.01 *:p < .05 p < .10 A: B: =(1, 34
(F )
SD) SD)
SD) SD)
3
C o rtis o l
5 . 0 1 .8 g /d L 6 . 5 3 .3 g /d L 4 . 2 2 .4 g /d L 3 . 7 2 . 6 g /d L 2
F(1 , 22 ) 4 . 2 6 p . 1 0
CgA 1 . 4 1 . 5 p mo l/ mg
1 . 1 0. 7 p mo l/ mg 0 . 8 0. 7
p mo l/ mg 0 . 6 0 . 5 p mo l/ mg
S -IgA 1 3 9. 6 1 43 . 6 g
/mg 11 2. 3 6 7 .0 g / mg 116 . 7
VA S
(2 0 0 6 )
2 00 0 2 0 06 (2 0 0 3 )
(2 0 10 )
(20 1 0 )
2 0 10
C o rtis o l
C o rtis o l
1 6
C gA C o rtis o l HPA
C gA
S -Ig A S -IgA
2
3
1
( 20 0 8 )
1
5 (P e rce ive d Stre ss S c a le : P S S
6 -1
5
6 -2
.
5 A
6 5 P S S 3 6
9 ( ±S D 8 3 .9 ±1 0. 6 )
9 ( ±SD 8 4 .7 ±6 .6 ) 1 8 P S S
1 9 . 3 ±6.3 P S S
9
( ±S D 8 2 . 3 ±10 . 4 ) 9 (
±SD 87 . 2 ± 7. 6 ) 1 8 P S S 5 . 5± 2 . 1
2 . 2
3 1 5
10 0
VAS
1 0 VA S 0
1 0 0
(2 )
HE M -76 2 3
6
(3 )
S a rs te d t
C o rtis o l E IA k it S a li me tric s LLC C gA Y K0 7 0 Hu ma n
Ch ro mo gra n in A E IA k it S -IgA
, 1998 B ra d ford
P ro te in A s s a y Kit B IO -RAD Cg A
S -Ig A
(S mirn o v -G rub b s) 2 4
4 .
±
SD ×
2 5 %
SP S S Ve r. 17 j fo r Win do ws
6 -3
1
1 0
SD 4 ×
F(3, 3 2 )
3 . 57 p . 1 0 F(3 , 32 ) 6 . 6 5
p . 05 , F(3 , 3 2 ) 7 . 30 p . 0 5
F(3 , 3 2 ) 3 . 8 2 p .1 0 , F(3 , 32 ) 3 . 6 4 p . 1 0
F(3 , 3 2 ) 7 . 63 p
. 0 1 F(3 , 32 ) 5 . 4 9 p . 0 5 F(3, 3 2 )
SD 1 . 6 4± 2 8 .6 3
mmH g -4 . 37 ± 11. 3 4 mmH g 2
SD
1 . 74 ± 6 . 97 mmH g 1 . 44 ± 7. 6 0 mmH g
SD
-2 . 2 9 ±7 . 92 mmH g -0 . 3 0 ±7 . 72
mmH g 2
5. SD
A B
-0.66 (1.15) -0.69 (1.29) 0.39 (1.02) 0.86 (1.38) 9.91** 0.29 0.36 -0.53 (2.51) -0.77 (2.60) 2.14 (2.38) 0.95 (1.97) 7.48** 0.79 0.35 -0.91 (1.49) -0.86 (2.09) 1.38 (0.89) 1.38 (1.56) 18.24** 0.00 0.00 -0.53 (1.31) 0.22 (2.53) 1.12 (0.91) 0.17 (1.44) 2.00 0.03 2.26 -0.41 (2.67) -0.62 (2.51) 2.54 (2.63) 0.88 (2.03) 7.13* 1.26 0.76 -0.34 (1.43) -0.90 (1.57) 1.40 (1.44) 0.88 (1.21) 13.42** 1.27 0.00
** : p <.01 * : p < .05 A: B: =(3, 32
SD) SD) SD) SD)
(F )
SD 5
Co rtis o l
SD 1 . 5 2 ± 1 .9 7 g /d L
-1 . 5 7 ± 2 . 27 g /d L
S D 1 . 5 9 ± 3 .2 7 g /d L
0 .6 1 ± 1. 6 4 g /d L 9 2
F(3 , 20 ) 5 . 4 7 p . 0 5
C g A SD
-0 .0 1 ± 0. 0 3 p mo l / mg 0 . 09 ±0 . 29
p mo l/ mg C gA
S D 0 . 4 7 ± 1 .7 5 p mo l/ mg 0 . 0 7
± 0. 1 4 p mo l / mg 2
S -IgA SD
- 8 .9 0 ±26 . 24 g /mg - 1 .7 5 ±10 0 .6 5
g /mg S -IgA
S D -5 4 .7 7 ± 2 30 . 5 4 g / mg
4 .0 7 ± 63 . 46 g /mg 2
6 -4
1 9 9 7 2 0 08 2 0 0 3
2 0 00 2 00 6
QO L
2 0 0 0
2 0 0 6
1 2 0 03 (2 0 1 0 )
Will ia ms , e t a l. 2 00 8
C o rtis o l
C gA
P SS
S -Ig A
S -Ig A
, 20 0 3 C o rtis o l
S -IgA
2008
1
1 5 6
QO L
2 2
3
2 2
7 -1
2 2
7 -2
1
2 0 0 8 2 0 11 A
6 5 N
19 9 8 4 0 N
1 9 9 8 25
7 8 3 . 9 ± 12 . 4
2
3
2
2 2
1 0 2 .
1 2 1
1 6 1 8
1
P S S 20 0 2
14 0 4
5 Q O L E u roQo l
1 - - - - 2 - - - - 2
2
EQ-5D E u ro Qo l 1 9 9 8
5 3
1 VAS 0 1 0 0
5 H RQO L
2
H E M -7 6 2 3
3
C o rtis o l C gA S -Ig A
1 . 5 c m S a rs te d t
3 1
1
1 6 1 8
20 1 0
3 , 00 0 rp m 1 5 2 0 °C
5
3 2
3 1 5
1 00
2 2 1 5
1 6 1 8 1 5
4
± S D
t S P S S
Ve r. 1 7 j fo r Win do ws 5
7 -3
1 .
2 P SS E Q -5D 6
P S S 6 3
t t( 6 )= 1 .4 3 , n . s .
EQ -5D H RQO L 5
t t(6 )=
0 .2 1 , n . s . EQ -5D VA S t
t(6 )= 1 .11 , n . s .
6 SD
ID
A 23 14 0.667 0.850 70 70
B 15 7 0.596 0.091 70 60
C 8 7 0.580 0.850 50 50
D 2 2 0.774 1.000 80 80
E 20 28 0.306 0.177 70 80
F 10 5 0.768 0.796 75 90
G 24 16 0.774 0.850 50 60
14.57 11.29 0.638 0.659 66.43 70.00
SD 8.28 8.86 0.17 0.37 11.80 14.14
EQ-5D(VAS)
PSS EQ-5D
2 2
SD 7
D 174.00 144.00 78.00 81.00 71.00 69.67
E 126.67 121.33 85.00 94.00 84.33 91.67
F 136.33 117.33 61.33 56.00 75.00 77.00
G 145.33 124.67 68.67 73.33 63.00 72.33
145.81 134.62 78.48 80.43 75.14 78.24
SD 15.29 16.06 11.25 15.03 7.16 7.51
t t(6 )= 0. 8 3 ,
n . s .
t t(6 )= 1 . 34 , n . s .
3 2
SD 8
8 SD
ID
A 5.53 4.52 0.38 0.18 138.52 200.99
B 3.04 4.05 0.73 1.73 101.60 417.72
C 11.42 4.23 0.13 0.42 25.18 59.81
D 4.13 8.25 0.24 0.70 132.93 175.16
E 6.92 - 2.53 - 182.12 -
F - 8.87 - 0.66 - 231.65
G 11.94 8.33 0.45 0.25 202.68 173.17
7.16 6.38 0.74 0.65 130.50 209.75
SD 3.74 2.32 0.90 0.57 63.04 117.32
CgA (pmol/mg)
C o rtis o l
t t(4 )= 0 .6 9 , n . s . C g A
t t(4 )=1 . 1 9, n . s . S -Ig A 1
8 0 g /mg
t t(4 )=1 . 4 3 , n . s.
7 -4
P SS
EQ-5D H RQO L VAS 5
E
HRQ O L VA S
P SS VAS P SS
QO L
2 0 1 4
14 0 mmH g 9 0 mmH g
2
Co rtis o l C
G 2 1
Cg A 2
1 /2 S -Ig A
G
S -Ig A E va n s ,
e t a l., 2 00 0 Ta n ida , e t a l. , 2 0 01 , 2 0 0 3
3 C o rtis o l C g A
S -Ig A
C o rtis o l CgA
S -Ig A
A
G P SS
C o rtis o l CgA QO L
2 3
P as s ive D roo l
3
( 2 0 08 )
1
Q O L
8 -1
3
1
2 , 3 4 2
5 6 3
7
E vid en c e -b a s ed me d ic in e E BM
C o rtis o l C gA
S -Ig A
C o rtis o l
Co rtis o l
(M o ye r, e t a l. , 2 00 4 ; Wa n g e a l. , 2 0 04 )
2 0 07
2 0 12 QO L
1
La z a ru s, 1 99 3
O 'N e il, e t a l. 1 9 7 5
1
QO L
8 -2
20 0 7
9
1
Cortisol
Stre s s . N e w Yo rk , To ron to , Lo n d on : Mc G ra w-H ill.
Be n so n . H . 2 00 1
Ca nn o n , W. B . 1 9 32 . Th e wis d o m o f th e bo d y. N e w York , N o rton.
C la y, J .H . , & P ou n d s, D. M . (200 2 ). B a s ic C lin ic a l Ma s s a g e T h e rap y:
In te g ra tin gA n a to my a n d Tre a tme n t ( LW W Ma s s ag e T hera p y a n d Bo dywo rk Ed u ca tio n a l Se rie s ). Lip p inc o tt Wil lia ms & Wilk in s .
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(2 0 03 ). s -Ig A
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, 3 58, 23 27
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, , , (1 9 98 ). Ig A
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, , , (19 9 8 ).
( ) .
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2 011 . 2 3 (
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(2 0 14 ). 2 5 (2 01 3 .
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(2 0 08 ). 2 0 -
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(2 0 14 ) 2 6 -
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