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Hitomi TAKAHASHI, Shoji YAMADA
1989 年 28 巻 3 号 p.
297-302
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
Various thyroid parameters in liver disease which were morphologically diagnosed were measured, and their relationship to liver function was mainly studied. Serum T4 levels were elevated hi acute hepatitis (AH), chronic persistent hepatitis (CPH) and chronic aggressive hepatitis (CAH) compared with in normal controls (C). Serum T3 levels were elevated in CAH and reduced in liver cirrhosis (LC). Serum reverse T3 (rT3) levels were elevated in AH and chronic liver diseases (CLD). T3/T4 ratios decreased in AH, CPH and CAH. RT3/T3 ratios increased in AH and CLD. Serum Free T3 (FT3) levels reduced in CLD in order of CPH, CAH and LC, and were low levels hi AH with the same degree as LC. Moreover, serum FT3 levels revealed negative correlation with ICG-R15 and positive correlation with prothrombin time (PT) and serum albumin levels (Alb). Therefore serum FT3 level was considered to become a sensitive index of liver damage. Serum free T4 (FT4) levels did not change significantly in AH with high levels of transaminases and reduced in only LC. Therefore serum FT4 maybe come an index of severity of liver dysfunction. On the other hand, T3/T4 ratios and rT3/T3 ratios showed less correlation with liver function tests compared with free thyroid hormones.
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Toru HIKITA, Koji FUKUTANI, Yoshimaro YAMAMOTO, Nobuaki YOSHIMIZU, Tak ...
1989 年 28 巻 3 号 p.
303-308
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
We investigated the effect of aminophylline on the pituitary-thyroid axis in 13 asthmatics (21-71 yr). Aminophylline (250 mg), dissolved in 100 ml of saline, was given intravenously for 30 min. Blood was collected, before and 30, 60 and 120 min after beginning the injection. Serum TSH was significantly increased from the 2.2 ± 1.6 μ;U/ml baseline to 2.7 ± 1.9 μ;U/ml at 60 min (p<0.01), and to 2.8 ± 2.1 μ;U/ml at 120 min (p<0.05). Serum T
4 also rose from the 8.8 ± 1.2 μ;Ug/dl baseline to 9.6 ± 1.5 μ;U/dl at 120 min (p<0.05). There were no changes in serum T
3 and rT
3 levels. Correlations between increase of theophylline and TSH levels, and between increases in TSH and T
4 concentrations, were observed. Since aminophylline stimulates the secretions of catecholamine from the sympathetic nerve endings and the adrenal medulla, we assumed that TRH was released from the hypothalamus by a beta-2-receptor mechanism because TSH secretion had been stimulated. These findings suggested that aminophylline-induced T
4 release from the thyroid is mediated by released TSH and by the direct stimulatory effects of raised endogenous catecholamine on the thyroid.
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Yasuo IWASAKI, Masao KiNOSHiTA
1989 年 28 巻 3 号 p.
309-311
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
Thyroid function tests were evaluated in 32 patients with amyotrophic lateral sclerosis (ALS) with radioimmunoassay of triiodothyronine, thyroxine, thyroid-stimulating hormone, and free thyroxine. The presence of antithyroid antibody activities were also tested. All patients were found to have normal thyroid values except one, who had low triiodothyronine and all patients had negative for antithyroid antibody activities. The data suggest that ALS could not be related to a thyroid disorder.
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Munetada OIMOMI, Shogo MASUTA, Makoto SAKAI, Takeshi OHARA, Fumihiko H ...
1989 年 28 巻 3 号 p.
312-315
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
The serum fructosamine level is influenced by the serum protein level. Therefore, we investigated the relationship between serum fructosamine levels and serum total protein and albumin levels measured simultaneously in non-diabetic and diabetic patients. Significant positive correlations were found between them. A correction formula was constructed to express the serum fructosamine level when the serum total protein level was 7 g/dl or when the serum albumin level was 4 g/dl: corrected fructosamine (mmol/l) = measured fructosamine (mmol/l) + A (7 (g/dl) or 4 (g/dl) - serum total protein (g/dl) or serum albumin (g/dl)) where A is 0.28 for serum total protein and 0.30 for serum albumin in non-diabetic subjects; 0.29 for serum total protein and 0.35 for serum albumin in diabetic patients; and 0.29 for serum total protein and 0.31 for serum albumin in non-diabetic and diabetic subjects combined.
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Feiko MORIKAWA, Akinobu NAKANO, Hiroko NAKANO, Fumimaro OSEKO, Shigeru ...
1989 年 28 巻 3 号 p.
316-322
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
The natural killer (NK) cell activity of patients with pulmonary tuberculosis (TB) was studied using blood samples. The patients with pulmonary TB showed higher NK activity to 10 out of 12 NK-sensitive target cell lines than healthy subjects did. When NK activity was compared between active and inactive stages of the disease, the patients with active TB demonstrated higher NK activity than did patients with inactive TB. Furthermore, active patients displayed cytolysis to one out of 4 NK-resistant target cell lines. In study of NK cell cyotoxicity at single cell level, higher killing activity than binding activity to target cells was observed in patients at an active stage. Morphological and surface marker analysis of peripheral mononuclear cells showed an increase in CD16
+ cells in patients with pulmonary TB. These results suggested that NK cell activity is augmented qualitatively and quantitatively in patients with pulmonary TB.
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Yasuo IWASAKI, Masao KINOSHITA
1989 年 28 巻 3 号 p.
323-327
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
A report on 8 patients with idiopathic multiple cranial neuropathy is presented. The syndrome consists of headache, facial pain and diplopia preceding the onset of cranial nerve palsy. The cranial nerves most frequently involved were the third, fifth and seventh. All patients were treated with corticosteroid therapy. The symptoms were self-limiting in their course and corticosteroid therapy appeared to hasten recovery of function. Only in a few cases a noticeable neurological deficiency remained. Differential diagnosis and etiological considerations are discussed.
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Hidenori MATSUO, Tatsufumi NAKAMURA, Mitsuhiro TSUJIHATA, Masakatsu MO ...
1989 年 28 巻 3 号 p.
328-334
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
The clinical features of 21 patients (7 men and 14 women, aged 24-65) with human T-lymphotropic virus type I (HTLV-I) associated myelopathy (HAM) in Nagasaki were reviewed. Gait disturbance with spastic paraplegia and bladder dysfunction were the main clinical symptoms. Gait disturbance was observed in all patients and bladder dysfunction was found in 20/21 (95.2%). Mild sensory disturbance was observed in 11/21 (52.3%) patients. Only 4 patients had received blood transfusions before the onset of illness. On the other hand, 6 patients who had family histories of HAM or spastic paraplegia were included as familial clusters of HAM. The study on the T-cell subpopulations revealed a significant increase in the percentage of OKT11+ cells, OKT3+ cells, OKT4+ cells, OKT8+ cells, OKIa1+ cells and IL-2R+ cells. We treated these 21 patients with plasma exchange (PE) and/or prednisolone in an uncontrolled manner. Both treatments were effective (PE: 11/18, prednisolone: 14/20), though the effects were not sufficient. In 5 patients, PE produced rapid and dramatic improvement. Anti-HTLV-I antibodies in serum and cerebrospinal fluid were not correlated with the efficacy of both treatments.
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Shigenobu UMEKI
1989 年 28 巻 3 号 p.
335-340
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
An analysis of the adverse effects appearing in 101 patients during at least 4 months of chemotherapy for newly detected pulmonary tuberculosis between September, 1985 and July, 1987 was performed. These patients received isoniazid, rifampicin and ethambutol daily (HRE) or isoniazid and rifampicin daily, and streptomycin three times weekly (HRS
3). Adverse effects appeared in 90 patients (90%). Of the 101 patients, 53.5% experienced eosinophilia, 42.6% itching, 25.7% eruption and 19.8% liver damage. Of 25 patients receiving streptomycin, 13 (52%) experienced tinnitus. Liver damage appeared more frequently in males than females. Neutropenia occurred in 31.0% of females, but in only 2.8% of males. In patients who developed severe but reversible adverse effects, such as liver damage, skin eruption and neutropenia, evaluation of the drug-stimulating lymphocyte transformation rate (DLTR) was performed. The results suggest that evaluation of the DLTR may be useful in determining which drugs may cause adverse effects, including liver damage, skin eruption and neutropenia.
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Shigenobu UMEKI
1989 年 28 巻 3 号 p.
341-347
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
A comparison of the clinical features, predisposing factors, side effects by antitubercular drugs and diagnostic procedures in pulmonary tuberculosis in 37 younger and 35 elderly men was carried out. Elderly patients had a higher number of underlying diseases including cardiovascular diseases and hypertension than younger patients. The classic symptoms and signs of tuberculosis, such as productive cough, fever and general fatigue, were observed in relatively high proportions of both patients, whereas weight loss (43% vs. 16%) and crackles in the lung fields (49% vs. 16%) were significantly higher in the elderly patients than the younger ones. As for roentgenographic abnormalities, a higher involvement of middle and lower lung fields was seen in the elderly patients than in the younger. Although leukocytosis was noted in a significantly lower proportion of the elderly patients, neutropenia due to drug treatment was significantly higher (23%) than in younger patients (5%). In a mass survey, the detection of pulmonary tuberculosis in elderly men was significantly lower (23%) than that in younger men (54%). Although improved living conditions, better sanitation and the development of new chemotherapeutic agents have contributed to the decline of pulmonary tuberculosis in general populations, better procedures for early detection or diagnosis of pulmonary tuberculosis in the elderly people should be achieved as soon as possible.
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Hisashi YOSHIDA, Keiji MURAKAMI, Goro MIMURA
1989 年 28 巻 3 号 p.
348-354
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
The primary purpose of the present study was to evaluate the role of lipid and glucose metabolism in vasospastic angina. A group of 93 patients in whom the presence of ischemic heart disease was suggested, were classified into the control (C) group, consisting of 30 patients; the coronary artery disease (CAD) group, consisting of 47 patients; and the vasospastic angina (VSA) group, consisting of 16 patients. Among these three groups, age, total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C), atherogenic index (AI), apolipoproteins and the prevalence of diabetes mellitus were compared. No age difference was seen among the three groups. The TC was the highest in the CAD group, followed by the VSA and C groups. A significant difference in TC was noted between the C and CAD groups and the C and VSA groups. TG levels were higher in the CAD group than in the C and VSA groups, without a significant difference among the three groups. The AI was significantly higher in the CAD group than in the C and VSA groups. No significant difference was noted in the prevalence of diabetes mellitus among the three groups. Apolipoprotein A-I (apo A-I) levels were higher in the VSA group than in the C and CAD groups, and the difference between the VSA and CAD groups was significant. Apolipoprotein A-II (apo A-II) levels were significantly higher in the VSA group than in the C and CAD groups. Although no significant difference was demonstrated in HDL-C levels in the present study, apo A-II levels were significantly higher in the VSA group, suggesting the presence of lipid metabolism abnormalities, including qualitative abnormalities of HDL in VSA.
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Toshiki INOKUCHI, Hisako KAMEYAMA, Miyuki ORITA, Tetsuro KASAI, Sho IS ...
1989 年 28 巻 3 号 p.
355-361
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
To elucidate if the presence of fatty liver and hypertriglyceridemia (HTG) influences pancreatic A-cell function in obesity, basal and arginine-stimulated glucagon (IRG) secretions were studied in 7 normal subjects and in 28 moderately obese patients (OB) with normal glucose tolerance. The patients were divided into 4 groups, based on the presence of fatty liver and/or HTG. BMI was similar in all four obese groups. Basal IRG, as well as the sum of secretory response to arginine, namely ∑IRG values, were significantly (p < 0.01) higher in the OB subgroup having both fatty liver and HTG than in the other three groups; these values were similar in subgroups of OB without fatty liver, and showed no significant difference from the normals. Basal and ∑IRG values in all OB correlated well with the degree of fatty liver and HTG, demonstrating that by stepwise analysis the effects of fatty liver and HTG were independent for basal and ∑IRG values. These results suggest that the combination of fatty liver and HTG may serve as a good predictor of hyperglucagonemia in simple obesity, and, hence, metabolic heterogeneity among obese patients should be considered in evaluating A-cell function.
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Naohiko INASE, Nobuyuki ENOMOTO, Hirohisa SAKAINO, Tatsuo SHIIGAI
1989 年 28 巻 3 号 p.
362-365
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
A previously-well 37-year-old woman presented with pericardial tamponade and pulmonary infiltrates. Systemic lupus erythematosus was diagnosed. Pericardiocentesis and systemic treatment with prednisolone produced dramatic improvement with no recurrence. The patient underwent bronchoalveolar lavage and transbronchial lung biopsy, which established the diagnosis of lupus pneumonitis.
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Kohji SHIRAI, Nobuo MATSUOKA, Pakming WONG, Shigenori FUJIOKA, Yasushi ...
1989 年 28 巻 3 号 p.
366-373
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
Hyperlipidemia of initially Type V and finally of Type III was observed in a patient with Weber-Christian disease. The lipoprotein lipase (LpL) and hepatic triglyceride lipase (HTGL) activities of the post-heparin plasma were low, but detectable. Both lipase activities were higher when assayed with 20 μl of post-heparin plasma than with more than 30 μl indicating the presence of some inhibitory factor in the plasma. This plasma inhibited purified LpL and HTGL from human post-heparin plasma. Zonal ultracentrifugation studies showed that the inhibitor of hepatic lipase was associated with the middle fraction of intermediate lipoprotein and low density lipoproteins (1.020<d<1.040). These results are consistent with the idea that dyslipoprotenemia in this patient was partially due to dysfunction of the catabolic system caused with an inhibitor of lipolytic enzymes.
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Akiko SUGIMOTO, Seiichiro SUGIMOTO, Masayuki TANAKA, Tadanobu KURIBAYA ...
1989 年 28 巻 3 号 p.
374-378
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
We report a case of a 14 year-old girl with Wegener's granulomatosis (WG) complicated by its direct brain invasion and insulin dependent diabetes mellitus (IDDM). This case was diagnosed as WG early hi its onset and successfully treated. As for IDDM of this case, the presence of HLA-DR4 and the islet cell surface antibody (ICSA) was demonstrated. To our knowledge, this is the first case report on IDDM associated with WG. We consider that WG may precipitate the development of IDDM in a genetically predisposed subject.
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Yuriko UEDA, Yoshiharu ARII, Osamu FUJINO, Koichi OKA, Toshio SHIGEKIY ...
1989 年 28 巻 3 号 p.
379-381
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
A successful delivery in a 26-year-old Japanese woman with essential athrombia was reported. A diagnosis of essential athrombia was made by clinical and laboratory features including bleeding tendency, prolonged bleeding time, normal platelet count, normal clot retraction and impaired platelet aggregation induced by ADP. Since the presentation was a frank breech at the end of the 39th week of pregnancy, cesarean section delivery was performed under good hemostatic control with transfusion of 7.3 × 1011 platelets. No hemorrhagic complication was observed during the puerperium.
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Yutaro SHIOTA, Masahiro KITADE, Nobuo UEDA, Keizo FURUYA
1989 年 28 巻 3 号 p.
382-384
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
A 40-year-old woman was presented with a fever, which proved to be due to mediastinal tuberculous lymphadenitis. Up to 1988, 149 cases of tuberculous mediastinal lymphadenitis have been reported in the literature in Japan. This case was very rare because a chest plain film revealed neither mediastinal widening nor lung parenchymal involvement. On the other hand, a CT scan of the chest was very useful because it showed unsuspected mediastinal lymph nodes enlargement. The diagnosis of tuberculous mediastinal lymphadenitis was made by the findings of a supraclavocular lymph node biopsy, which showed granulomas, compatible with tuberculosis. A good response from the patient to antituberculous therapy confirmed this diagnosis.
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Teijiro ASO, Takashi OKAMURA, Tsunefumi SHIBUYA, Mine HARADA, Yoshiyuk ...
1989 年 28 巻 3 号 p.
385-390
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
A case of hybrid phenotypic chronic myelomonocytic leukemia (CMMoL) transformed from a hematological remission state of severe aplastic anemia is reported. A 63-year-old woman was admitted to our hospital with complaints of easy fatigability and dizziness in December 1978. A diagnosis of aplastic anemia was made from findings of pancytopenia and hypoplastic marrow without dysplasia, and she was treated successfully with mepitiostane. Seven years later, anemia and thrombocytopenia reappeared with monocytosis. On the second admission, the peripheral blood showed a white blood cells count of 3.5 × 10
3/ μl with 54% monocytes. The bone marrow was hypercellular with monocytosis, and dysplasia of three cell lineages was noted. Adiagnosis of CMMoL was made. Cytogenetic analysis of bone marrow cells revealed a karyotype of 45 XX, -7, 11q-, and surface markers were polyphenotypic, including CD20
+, CD14
+ and CD13
+. This is the first report of CMMoL with biphenotype which was transformed from aplastic anemia.
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A Case Report and Review of the Literature
Yuichi MANABE, Masashi ARAKI, Katsuyuki TAKEDA, Satoshi YOKOTA, Taeko ...
1989 年 28 巻 3 号 p.
391-395
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
One case of calcification in the striopallidodentate system associated with pseudohypoparathyroidism type I is described. Striopallidodentate calcification accompanying a disturbance in calcium metabolism is, to our knowledge, extremely rare with only thirteen previously documented cases reported, of which only two cases accompany pseudohypoparathyroidism. Moreover, our case showed an elevated titer of antiparietal-cell antibody.
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Naohiko INASE, Masayoshi SHICHIRI, Fumiaki MARUMO
1989 年 28 巻 3 号 p.
396-398
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
A 58-year-old man with polycythemia of more than 8 years duration developed multiple myeloma. Extensive examination indicated his polychthemia to be of a secondary type, but failed to reveal an underlying disorder. To the best of our knowledge, this is the first reported association of multiple myeloma in a patient with definitely-diagnosed secondary polycythemia.
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Satoshi MONNO, Nobuo ITOH
1989 年 28 巻 3 号 p.
399-401
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
The case of a 72-year-old man who developed Sjögren's syndrome three years following gastrectomy and chemotherapy for gastric malignant lymphoma is reported. The patient eventually died of systemic cryptococcal infection, and autopsy revealed no recurrence of the malignant lymphoma. Review of the literature indicates lymphoproliferative disease preceding the development of Sjögren's syndrome is extremely rare.
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Masahiro SUGAWA, Ritsuko TANAKA, Masayuki NAKAMURA, Naoki ISAKA, Junki ...
1989 年 28 巻 3 号 p.
402-405
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
A 67-year-old woman with pneumonia and diabetes mellitus was admitted with the complaints of abdominal and back pain. Sputum culture was positive for Klebsiella pneumoniae. Computed tomographic scanning (CT) of the abdomen and spinal radiograph of the lumber column revealed a paraventebral space-occupying lesion, abdominal aortic aneurysm and destructive change of L
3 and L
4. Pseudoaneurysm of the abdominal aorta associated with infectious spondylitis with paravertebral abscess was suspected and confirmed by aortography. Klebsiella pneumoniae was cultured from the abscess. The patient's condition improved rapidly after drainage of the abscess and administration of LMOX and gentamicin. Infectious pseudoaneurysm of the abdominal aorta associated with infectious spondylitis has rarely been reported. These two in combination due to Klebsiella pneumoniae has not been reported to our knowledge. The pathologic changes were found easily by CT scan. When infectious aneurysm or infectious spondylitis is diagnosed alone, possible combination of these diseases should be kept in mind.
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Hiroyuki KOSHIYAMA, Yuzuru KATO, Hiroshi MASUTANI, Noboru HASHIMOTO, H ...
1989 年 28 巻 3 号 p.
406-409
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
A 71-year-old woman with symptomatic Rathke's cleft cyst is reported. She had visual disturbance, diabetes insipidus and hypopituitarism. Imaging studies with computed tomography and magnetic resonance image revealed the presence of suprasellar mass. After the transsphenoidal surgery and treatment with DDAVP, her symptoms showed an improvement.
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Isao MIYOSHI
1989 年 28 巻 3 号 p.
410-412
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
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Mitsuhiro OSAME, Akihiro IGATA
1989 年 28 巻 3 号 p.
412-414
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
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Toshio HATTORI
1989 年 28 巻 3 号 p.
414-415
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
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Akira MATSUMORI, Chuichi KAWAI
1989 年 28 巻 3 号 p.
416-418
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
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Toyoro OSATO
1989 年 28 巻 3 号 p.
418-419
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー
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Keizo MATSUMOTO
1989 年 28 巻 3 号 p.
419-421
発行日: 1989年
公開日: 2006/03/27
ジャーナル
フリー