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Volume 36, Issue 1
Displaying 1-25 of 25 articles from this issue
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[in Japanese]1994 Volume 36 Issue 1 Pages 1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
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[in Japanese]1994 Volume 36 Issue 1 Pages 2
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (126K) -
-ESPECIALLY, DIFFERENCE OF THE LINEAR AND SINGLE ULCERS FROM HISTOLOGY AND DETECTABLE RATE OF HELICOBACTER PYLORI-Masahiro KANAZAWA1994 Volume 36 Issue 1 Pages 3-15
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe recurrence of the linear ulcer in the duodenum is more often observed, but recurrence of the single ulcer, especially that of single ulcer which is seen just beyond the pyloric ring is rare. In order to elucidate this difference, histology using operative materials and detectable rate of Helicobacter pylori (H. pylori) using biopsy materials were studied. The linear ulcer including scar was continuously found, and Ul-III in the shallowest site and Ul-IV in the deepest site of its depth were observed. As single ulcer which was seen just beyond the pyloric ring, Ul-II in 5 cases and Ul-III in 2 cases were observed. The detectable rate of H. pylori in the duodenal mucosa was 18.5% in the open linear ulcer, 23.1% in the linear ulcer scar, 20.0% in the open single ulcer and 13.6% in the single ulcer scar, and no significant difference was observed. The detectable rate of H, pylori in the gastric mucosa was 80.6% in the open linear ulcer, 70.4% in the linear ulcer scar, 100% in the open single ulcer and 31.8% in the single ulcer scar, and significantly low in the single ulcer scar. In conclusion, the depth of these ulcers and difference of H. pylori infectious state in the gastric mucosa are related to the incidence of the linear and single ulcers.View full abstractDownload PDF (3450K) -
Nobuyuki HAYASHI, Ryuichi HAYASHI, Yuichiro SAITO, Shigeo ENDO, Tadaka ...1994 Volume 36 Issue 1 Pages 16-20_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic findings of ulcer base were analyzed in consecutive 177 inpatients with bleeding gastric ulcer and 205 outpatients with non-bleeding gastric ulcer. The findings of ulcer base were classified into 5 types; 1. active bleeding, 2. thin or thick coagulation, 3. discrete mound forwation, 4. pigmented spots, and 5. clear base. We found that ulcers with clear base, flat pigmented spots, thin adherent clots or white mound forwation were at low risk for rebleeding, while those with dense adherent clots, white mound f orwation with central clot or pinkish transparent mound f orwation are at high risk for rebleeding. We also found that spurting arterial bleeding sometimes originates from flat ulcer base, indicating some of the pigmented protuberances are in fact clots plugging the bleeding point rather than protruding vessels.View full abstractDownload PDF (3066K) -
Shinji NASU, Shigeaki YOSHIDA, Daizoh SAITOH, Hajime YAMAGUCHI, Toshih ...1994 Volume 36 Issue 1 Pages 23-30_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDuring the period from 1962 and 1990, 27 lesions of 27 cases had been diagnosed histologically as upper gastrointestinal (Gl) carcinoid tumor at the NCCH. The endoscopic and pathological findings, and clinical aspects (diagnostic results, clinical course, etc., ) of these 27 cases were examined retrospectively and the following resutlts were obtained. lesions. Distant metastasis was detected in 5 of the 22 gastric lesions, and in 1 of the 5 lesions, liver metastasis was found 8 years after the curative resection. 2) Endoscopic gross appearance of the 27 lesions could be classified into the following 3 types; superficial, polypoid and advanced cancer-like types. Distant metastasis was seen in 5 gastric cases regardless of the endoscopic typing. In superficial type, it was very difficult to estimate the correct tumor size endoscopically, and in all of the cases affected area confirmed histologically was far broader than that estimated preoperatively, except for one case in which a minute duodenal lesion disappeared after biopsy. 3) In the 20 resected cases, the preoperative diagnosis of carcinoid tumor was extremely poor and it was correctly made in only 60% (12/20) of the cases. In conclusion, upper GI carcinoid tumor should be regarded as evidently malignat neoplasma, and followed up carefully after operation. Endoscopically, carcinoid tumor should be suspected not only from tumourous apperance but also from the superficial or hyperplastic changes.View full abstractDownload PDF (3434K) -
Masaki SUZUKI, Toru MATSUDA, Hirotaka TODA, Yoshimi OKUYAMA, Jun-ichi ...1994 Volume 36 Issue 1 Pages 31-36_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic sphincterotomy (EST) was performed in 112 cases of cholelithiasis from May 1980 to May 1989 at Yamagata prefectural central hospital. Recurrence of biliary stones as the late complication occurred in 8 cases (7.1%). There were 4 cases of residual or recurrent choledocholithiasis after cholecystectomy, and 4 cases of choledocholithias is with gallbladder without gallstones. There was no difference between with and without gallbladder for recurrent stones. At the initial incision, 1 case was by medium incision and the others were by major incision and all of then had no restenosis of Vaters papilla. In 3 cases, a piece of food was found in the center of recurrent stones. It was suggested that a piece of food was closely related with recurrence of biliary stones.View full abstractDownload PDF (4673K) -
Hajime ARAI, Hiroyuki HANAI, Eizo KANEKO, Tomio ARAI, Isamu KINO, Yasu ...1994 Volume 36 Issue 1 Pages 37-42_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of early esophageal carcinoma with adenoid cystic differentiation is reported. A 54-year-old man without any sympton was admitted to our hospital because of esophageal abnormalities detected by a group health examination. Double contrast radiograph showed an elevated lesion with central depression in the middle portion of the esophagus. Subtotal esophagectomy was performed under the diagnosis of squamous cell carcinoma. Histologically, most of submucosal cancer tissue demonstrated adenoid cystic differentiation with cribriform patterns, whereas mucosal lesion was squamous cell carcinoma. Seventy-two cases with adenoid cystic carcinoma of the esophagus (or esophageal carcinoma with adenoid cystic differentiation) have been reported in the world. Early esophageal carcinoma of this pathological type, however, is very rare.View full abstractDownload PDF (6736K) -
Eiji TARUYA, Kiyoshi MAEDA, Akira HAYASHIBE, Hideki KITOH, Kazutsugu S ...1994 Volume 36 Issue 1 Pages 43-48_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 66-year-old male was admitted to hospital because of epigastric pain due to cholelithiasis, with no complaint of coughing. On esophagography, an esophagobronchial fistula with diverticulum was incidentally discovered in the middle of the thoracic esophagus. Esophagoscopy revealed the presence of a fistula, mucosal bridges and postinflammatory changes in the f undus of the diverticulum. Bronchoscopy showed a f istulous opening with fold convergence in the right main bronchus. CT scanning demonstrated calcified mediastinal lymphnodes around the diverticulum. On January 29, 1992, excision of the fistula and diverticulum was performed. During the operation, inflammatory changes and lymph nodes adherent to the diverticulum were seen. The patient's postoperative course was uneventful. It appeared that this fistula was produced by formation and perforation of the diverticulum resulting from mediastinal lymphadenitis.View full abstractDownload PDF (3619K) -
Tohru FUJIKAWA, Ryouji OHMASA, Katunori MASUDA, Hironori AKIBA, Kengo ...1994 Volume 36 Issue 1 Pages 51-57_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSBleeding from rectal varices in 2 cases who had previously treated by injection sclerotherapies for esophageal varices were controlled by colonoscopic injection sclerotherapy with the use of 0.5% Aethoxysklerol (AS). Case 1 was 49 yearn old male of idipathic portal hypertension. Case 2 was 67 years old male of ldver cirrhosis with hepatocellural carcinoma (HCC) . Early colonoscopy (U turn observation in the rectum) showed white plug on the rectal varices which was the typical sign of variceal ruptume in both cases and bleeding varices were well treated by colonoscopic injection sclerotherapies. Rectal varices should be cared during the follow up study in casen of esophageal varicen treated by endoscopic injection sclerotherapy.View full abstractDownload PDF (1012K) -
-REVIEW OF 21 CASES OF ESOPHAGEAL LIPOMA IN JAPAN-Masaki MIYAMOTO, Koichiro NAKASHIMA, Kazunari MASUDA, Shinya DOJYO, Ku ...1994 Volume 36 Issue 1 Pages 58-64_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA patient, 83 years old female, visited our hospital with complaint of throat irritation. She had a history of vomiting tumor-like material. The endoscopic examination showed a pedunculated submucosal tumor at the cervical esophagus. The computed tomography at the level of the tumor showed minus level. The echo level of the tumor was high on endoscopic ultrasonography. Therefore, we suspected the lipoma preoperatively. Under the general anesthesia, we inserted rigid esophagoscope and took the tumor out of her oral space. We ligated the stalk and removed the tumor (10.5 × 3.5 cm). The result of the pathology was lipoma. Lipomas of the esophagus often arise at cervical esophagus and the majority of these have stalk, we report the endoscopic ultrasonography and computed tomography are quite useful for diagnosis of esophageal lipoma.View full abstractDownload PDF (6642K) -
Kazuo NOTSUMATA, Hideyuki RYORIN, Hiroshi MINATO1994 Volume 36 Issue 1 Pages 65-70_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 57-year-old male was admitted to our hospital because of ascites (class 5 in cytology). Examinations of chest X-ray, whole body computed tomograpy, Ga-scintigram and bone marrow biopsy showed normal. X-ray examination of the stomach demonstrated a submucosal tumor like lesion in the upper body. Endoscopic findings showed a submucosal tumor with an irregular ulcer in the upper body of the stomach. The specimens taken from this lesion revealed marked infiltration of atypical medium-sized lymphocytes, and the findings were consistent with a diagnosis of non-Hodgkin's lymphoma of diffuse medium-sized cell type, and immunohistochemical study revealed atypical lymphocytes which might be derived from T-lymphocytes. Thus, this case was diagnosed as T-cell malignant lymphoma stage 4 originating in the stomach. Intraperitoneal infusion of CDDP was carried out three times and total doses amounted to 150mg. After infusions ascites was diminised and gastric submucosal lesion was markedly decreased.View full abstractDownload PDF (4836K) -
Makoto HATAKEYAMA, Hiroshi KANAGAWA, Kenichirou GOTO, Harukazu KOHYAMA ...1994 Volume 36 Issue 1 Pages 73-78_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 55-year-old female who complained of hematemesis and melena was admitted to our hospital in a semicomatous state. Laboratory data on admission indicated severe anemia and marked liver dysfunction. Emergent EGD revealed F3 blue varices in the second portion of the duodenum surrounded by fresh blood, on the top of which a white plug existed a diagnosis of rupture of duodenal varices due to liver cirrhosis of type C was made. Since blood pressure fell down to shock level during endoscopy, emergent endoscopic injection sclerotherapy with N-butyl-2-cyanoacrylate (HISTOACRYL blau ; NC) for the varices was conducted. We injected 1.5 ml of NC intravariceally and succeeded in hemostasis. Then, her condition was stabilized with no evidence of further bleeding. One month after injection, the NC polymer fell away from duodenal wall and the varices almost disappeared 2 months after without any significant complications related to this therapy. In conclusion, endoscopic injection sclerothrapy with NC is an effective hemostatic method for rupture of duodenal varices.View full abstractDownload PDF (7647K) -
Hitoshi OGASAWARA, Hitoshi NAKAJIMA, Akihiro MUNAKATA, Yutaka YOSHIDA, ...1994 Volume 36 Issue 1 Pages 79-84_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report a case with a carcinoma in adenoma and cavernous lymphangioma of the transverse colon, a carcinoma in adenoma, and a cavernous lymphangioma of the other site of the colon. A 78-year-old man was admitted to our hospital for further examination of loose stools. Ba-enema study showed protruded lesions in the cecum, hepatic flexure, and transverse colon. Endoscopic examination suggested an adenoma of the cecum, a lymphangioma of the hepatic flexure, and a lymphangioma accompanied with red elevation of the transverse colon. All of the lesions were resected endoscopically and diagnosed histologically as follows. The lesion of the cecum was carcinoma in adenoma, the lesin of the hepatic flexure was cavernous lymphangioma, and the lesion of the transverse colon was carcinoma in adenoma overlaid on the cavernous lymphangioma.View full abstractDownload PDF (8190K) -
Katsushi WATANABE, Akira IWAI, Masahiro YAMAKOSHI, Takayuki OHIWA, Tak ...1994 Volume 36 Issue 1 Pages 87-93_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA rare case of intussusception caused by a malignant lymphoma which was diagnosed before surgery is reported. A 45-year-old male was admitted to our hospital complaining of intermittent abdominal pain over the previous 3 months. Barium enema examination showed a spheroid tumor in the ileocecal region. Abdominal sonography, CT, and a superior mesenteric arteriogram revealed intussusception caused by the tumor. Colonoscopy revealed a round mass with redness and erosion, and invaginated ileac mucosa. Since intact mucasa was observed on the surface, the tumor appeared to be located in the submucosa. Therefore, biopsy specimens were carefully obtained from the part of the erosion involving submucosal tumor tissue. The lesion was diagnosed histologically as malignant lymphoma. From these findings, we concluded that this was a case of ileocolic intussusception caused by a malignant lymphoma of the terminal ileum. An operation was performed. The tumor (5 x 4 x 4cm) was located in the ileum 15cm from the ileocecal valve and histological examination of resected tissue revealed a diffuse type of malignant lymphoma. It is well known that most cases of intussusception in adults are due to intestinal tumors. Colonoscopic examination is strongly recommended to determine an accurate diagnosis before surgery in cases of intussusception in adults.View full abstractDownload PDF (7556K) -
Katsuya NAKANO, Sumiko ISHIMARU, Kenji YAMAMOTO, Hiroshi UEHIRA, Hidey ...1994 Volume 36 Issue 1 Pages 94-101
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported a case of adult intussusception due to malignant lymphoma of the terminal ileum involving stomach. A 29-year-old man complaing of abdominal pain was admitted to our hospital. Abdominal CT revealed concentric layering structure in the dilated colon, which was diagnosed as intussusception. Barium enema showed Crabsclaw-like finding in the middle portion of the transvers colon. As the barium proceeded towards the proximal portion of the colon, the intussusception was reduced and a irregular surfaced mass was revealed in the ileocaecal region. Colonof iberscopy disclosed a irregular surfaced tumor with redness and erosion. Biopsy specimens were obtained and the diagnosis of malignant lymphoma, diffuse medium cell type, was established. Furthermore Gastro-duodenal f iberscopy revealed the gastric involvement of malignant lymphoma. We diagnosed this case as intussusception caused by malignant lymphoma of the terminal ileum involving stomach. Diagnosis of intussusception by ultrasonography, CT, barium enema and so on is easy. But the preoperative diagnosis of its cause is difficult. Colonofiberscopy is most useful for the diagnosis of its cause because we can see the leading point directly and can obtain biopsy specimen for histopathological dignosis. It is concluded that colonof iberscopy should be performed in the case of intussusception.View full abstractDownload PDF (6838K) -
Takao SHIBAYAMA, Hiroo OHTAKE, Takeshi TANAKA, Shunichi SAEKI, Seishu ...1994 Volume 36 Issue 1 Pages 102-107_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe nonexistence and later appearance of reddish markings on the liver surface were examined by laparoscopy in a case of severe drug-induced hepatic injury. Although the reddish markings were not initially distinguished when laparoscopy was conducted in the acute phase of liver injury, they were recognized to accompany the growth and dilatation of capillary vessels on the liver surface on the second laparoscopy examination made about 1 year following liver function normalization. One of the main causes for this later appearance of reddish markings on the liver surface is speculated to be that blood flow from the portal area to the regions of liver cell destruction and also to the liver capsule itself was improved by the restoration mechanism.View full abstractDownload PDF (8474K) -
A CASE OF MIDDLE BILE DUCT CANCER SUCCESSFULLY TREATED WITH GIATURCO TYPE EXPANDABLE METALLIC STENTSJinya SUZUKI, Teruyuki KANE, Toshiaki TAKAHASHI, Tokio YAMAZAKI, Kenji ...1994 Volume 36 Issue 1 Pages 108-115
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic retrograde bile duct stenting was successfully performed in a patient with middle bile duct cancer using Giaturco type expandable metallic stents (Z stent). The case was 77 years old man admitted to our hospital with jaundice and liver disfunction. Endoscopic nasal bile drainage (ENBD) was performed and cholangiography by the ENBD tube showed stricture of middle bile duct that was compatible with middle bile duct cancer. After jaundice was diminished endoscopic retrograde bile duct stenting was performed with Giaturco type expandable metallic stents (Z stents). The procedure is as follows: 1. Insert the endoscope into duodenum guided by guidewire. 2. Add Endoscopic sphincterotomy. 3. Insert the sheath catheter (∅ 3.7 mm) over the stricture. 4. Insert the Z stents into the sheath catheter and push them by pusher tube to the distal end of the sheath catheter. 5. Holding the Z stents and pusher tube in the appropriate position, extract the sheath catheter to release the Z stents. The patient discharged from our hospital 9 days after implantation of Z stents and had no jaundice during 120 days after implantation. Although there are some ploblems, it is considered that endoscopic retrograde bile duct stenting by Z stent is useful for malignant biliary stricture.View full abstractDownload PDF (8931K) -
Junji SHIODE, Jinki NISHIYAMA, Hiroshi MORIYAMA, Tamotsu FUKUOKA, Kazu ...1994 Volume 36 Issue 1 Pages 116-122_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported two cirrhotic patients with diffuse antral vascular ectasia. Case 1, 74-year-old female was referred to our hospital because of acute gastrointestinal bleeding. Laboratory studies showed hypergastrinemia (1, 500 pg/ml) and marked anemia. Case 2, 68-year-old female was admitted because of severe iron deficiency anemia. Endoscopic examination of both patients demonstrated erythematous spots diffusely scattered over the gastric antrum. The spots were found to be dilated small vessels under close-up observation. Histology of the specimens obtained by strip biopsy showed several ectatic vessels in the deep mucosa occasionally extending to the thickened muscularis mucosae. Series of endoscopic examination of gastrointestinal tract showed that anemia was secondary to persistent blood loss from the dilated vessels. Bleeding of case 1 ceased by treatment with an H2 blocker. However, in case 2, three times of endoscopic electrocoagulation were needed to stop progressive anemia even after repeated blood transfusions, and marked improvement was observed on follow-up endoscopy.View full abstractDownload PDF (5777K) -
A CASE OF CHOLECYSTO-CHOLEDOCHOLITHIASIS TREATED BY PERORAL CHOLEDOCHO-CHOLECYSTOSCOPY (POCS, POCCS)Yutaka NODA, Naotaka FUJITA, Go KOBAYASHI, Katsumi KIMURA, Hiromitsu W ...1994 Volume 36 Issue 1 Pages 123-129
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe performed peroral choledocho-cholecystoscopy (POCS, POCCS) for a 80-year-old man with choledocho-cholecystolithiasis, and removed all the stones endoscopically. This patient was admitted to our hospital with complaints of epigastric pain and j audice. ERCP revealed stones in the choledochus and in the gallbladder. After EST (endoscopical sphincterotomy), a stone was removed from the choledochus using a mechanical lithotriptor. Under POCCS the other stone in the gallbladder was treated by electrohydraulic lithotripsy (EHL). In that case it was very easy to reach the gallbladder endoscopically because the cystic duct was dilated.View full abstractDownload PDF (5722K) -
Kazunori SUGI, Osamu SAITOH, Takamasa IWASHITA, Hiroya TAKIUCHI, Yujir ...1994 Volume 36 Issue 1 Pages 130-136_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 72-year-old male with multiple myeloma complained of bloody stools. Colonoscopic examination revealed a sessile polypoid lesion (8 mm in diameter) with smooth yellow surface and a nodular protruding lesion (20×10 mm in size) in the rectum. Endoscopic treatment was chosen because this patient had multiple myeloma. Endoscopic mucosal resection (ER) was performed for the sessile polypoid lesion. Histological examination showed carcinoid cells. The nodular protruding lesion, treated by endoscopic piecemeal resection, proved to be tubulovillous adenoma.View full abstractDownload PDF (9453K) -
-THE TECHNIQUE AND CURRENT RESULTS-Kazuhiko YOSHIKAWA, Michio SOWA, Yoshiyuki KAWAZOE, Masaichi OHIRA, Ts ...1994 Volume 36 Issue 1 Pages 137-143_1
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic variceal ligation (EVL) was performed for 12 patients with esophageal varices from June 1992. As favorable results were obtained, the actual technique used for EVL and the outcome are reported. EVL was performed using a Stiegmann-Goff ligator kit (Bard Co., USA). The 12 subjects consisted of 8 males and 4 females. Their mean age was 55.2 years. Hepatic function just before the procedure was Child's classification A in 2 cases, B in 4 cases, and C in 6 cases. The timing of therapy was emergency in 1 cases, prophylactic in 6 cases, and elective in 5 cases. Before treatment, the findings of the esophageal varices were a form of F2 or above in all cases and red color signs were likewise positive in all cases. Complete disappearance of esophageal varices was obtained by ligation therapy in 7 (58%) of the 12 cases. In the remaining 5 cases, F factor became F1 or F0 and RC signs became negative in 100% of the patients. As for prognosis, all patients are currently alive and variceal bleeding has not been noted in any patient. EVL therapy is easy to perform and effectively eradicates varices whithin a short period of time. In addition, EVL is a safe procedure since a risk of complication is low.View full abstractDownload PDF (4034K) -
Motohiko KUSHIGAMI, Fuyuhiko HIGASHI, Masakatu SUMITANI, Norihiko KUNI ...1994 Volume 36 Issue 1 Pages 144-149
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe most effective treatment for gastric anisakiasis is usually direct endoscopic removal of Anisakis marina. Recently, we experienced one patient with gastric anisakiasis in whom demonstration and removal of the worm were very difficult. After gastrografin spray over the larvae burrowing into the swollen folds of the stomach, we could easily remove the larvae without resistence. Thereafter, in two patients with anisakiasis we scattered gastrografin over the worm in the gastric mucosa and obtained almost similar f idings. Patients with gastric anisakiasis may develop acute gastric mucosal lesions (AGML) after endoscopy. It is considered due to excessive extension of gastric wall caused by massive amount of air. These findings suggest that scattering of gastrografin over the lesion is very useful for patients with anisakiasis in whom the larvae have invaded between the swollen folds, in whom several larvae have invaded, or in whom the head of the larvae can not be easily hold.View full abstractDownload PDF (2725K) -
1994 Volume 36 Issue 1 Pages 150-163
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
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1994 Volume 36 Issue 1 Pages 163-211
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
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1994 Volume 36 Issue 1 Pages 211-221
Published: January 20, 1994
Released on J-STAGE: May 09, 2011
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