日本気管食道科学会会報

シンポジウムI: 粘液線毛輸送系とその病態まとめ

滝沢敬夫, 大山勝

1985 年 36 巻 2 号 p. 59
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.59

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粘液線毛輪送系とその病態粘液線毛輸送系の超微形態

川上雅彦

1985 年 36 巻 2 号 p. 60-63
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.60

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Fine structures of cilia of airways in rats and mice, including the microtubular organization, crown, basal body and rootlet, were outlined. Fixation from behind the walls of airways reserved the surface film covering the mucous membrane and the trachea was shown to be covered with two layers; all cilia were underneath a thin top layer of fine fibrillar material and the tips were sticked into the underside. On the other hand, the bottom layer where the main body of a cilium was located, was lucent. In small airways, all cilia were embedded in a single layer of fine granular material. In addition, changes in tracheal mucous membrane in rats which received a single dose of porcine pancreatic elastase intratracheally were reported. The principal finding seen 12 hours after elastase instillation was the nonciliated cells covering almost totally the surface of the trachea. Ciliogenesis was a very frequent finding and distinct increment of ciliated cells was seen by 72 hours. These findings were compared with those seen in the mucus membrane of the bronchial walls in patients with chronic bronchitis.

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粘液線毛輸送系の形態と機能

生化学とくにアラキドン酸カスケード代謝物を中心に

昇卓夫, 島哲也, 森山一郎, 坂本邦彦, 大山勝

1985 年 36 巻 2 号 p. 64-68
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.64

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12-and 15-HETE were detected in the cultured ciliated epithelium obtained from the canine trachea, but no lipoxygenase metabolites of arachidonic acid cascade were observed in this culture medium. The cinematographic analysis revealed that the mucociliary activity in the cultured rat tracheal epithelium was inhibited by LTC₄. The results of photoelectrical analysis of the ciliary beat in vivo indicated that PGE₂ showed a little promotion of mucociliary activity in the guinea pig trachea, while LTD₄ inhibited it. Both lipoxygenase and cyclooxygenase metabolites of arachidonic acid cascade in the nasal secretion, retention cyst and tissue fluids obtained from the patients with some nasal lesions were measured using RP-HPLC, radioimmunoassay and bioassay. It was found that the almost equal amounts of SRS-A were detected in the sinus mucosa of chronic sinusitis and inferior turbinate of nasal allergy. The influences of these substances on mucociliary function and nasal mucosal pathology were discussed briefly.

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粘液線毛輸送系と気道クリアランス

電気光学的方法による線毛運動の観察

大橋淑宏, 中井義明, 池岡博之, 丸岡健一, 古下博之

1985 年 36 巻 2 号 p. 69-78
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.69

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The function and morphology of the nasal mucociliary system in a normal and some pathological states was studied with special reference to the ciliary activity and morphology of nasal epithelial cells.
The following results have been derived from the present investigation.
1. The value of the nasal ciliary activity of the healthy human and animal was about 700-900 beats per minute at 30°C in the physiological saline solution.
2. The first appearance of the ciliary activity at the nose of fetal rabbits was on the 26th day of the fetal stage. The nasal ciliary activity in fetal rabbits had the quantitative maturity but did not have the qualitive maturity indicated by the disorder in its direction.
3. The ciliary activity was not affected by a single antigen-antibody interaction. On the other hand, the ciliary activity was declined by the frequent reccurence of antigen-antibody interaction.
4. The ciliary activity of the nasal mucosa derived from rabbits was declined in association with the irradiation dose. In addition, the functional and morphological damages of the nasal epithelium after the irradiation were not easily recovered.
5. The exposure to tetrahydrofuran affected the nasal ciliary activity of rabbits and the recovery of the nasal ciliary activity was observed in a few hours when the concentration of tetrahydrofuran was rather low.
6. The ciliary activity at the nasal epithelium was declined by 4 weeks exposure to SO₂ of 20 ppm. The complete recovery of the nasal ciliary activity was not observed 2 weeks after the stoppage of the exposure to SO₂.
7. The functional and morphological damages of the nasal mucosa with intact basal cells by the mechanical injury were recovered in about 5 days. On the other hand, it took about 6 weeks to recover from the damages when the basal cells and basement membrane were affected.

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気道線毛運動の実際

ビデオによる映像を中心に

川田博, 工藤律, 川上雅彦, 滝沢敬夫

1985 年 36 巻 2 号 p. 79-84
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.79

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A video camera with high photosensitivity, a 100X objective and a microscope equipped with Nomarski differential interference contrast were used to record the movement of human respiratory cilia as seen from the side of the cell surface clearly. By using a fiber guide light source, the reflected light from the human bronchial membrane obtained by a bronchofiberscope allowed the surface observation of the human respiratory cilia. A surface view of the cilia of the cases without bronchial diseases showed metachronal waves with an ileoplectic fashion. An activity on the epithelial surface was comprised in many small patches. Each of those has an area covering only one or two cells. The metachronal waves generally traveled about one cell length before disappearing. Cilia of a case with inner dynein arm defect moved stiffly with reduced amplitude, but, metachronal coordination was maintained. In a case of chronic bronchitis, the direction of the effective stroke of ciliary beat in areas having immature short cilia was variable and irregular. The dynamics of human respiratory cilia have been previously described by studying mainly the side view.
These results indicate that the surface view of respiratory cilia as well as the side view of those is very important to show the metachronal waves and the precise direction of the effective stroke.

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粘液線毛輸送に関する客観的表示法

昇卓夫, 清田隆二

1985 年 36 巻 2 号 p. 85-87
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.85

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Mucociliary movement and transport features were studied in bird's-eye view using a microzoom light microscope, in addition to the photoelectrical analysis.
The movement of charcoal powder in the superficial layer was smooth without the influence of the ripplelike mucus undulation, while dryness of mucus decreased markedly mucociliary activity. These phenomena could be recorded successfully as TV images.
On the basis of the results obtained, this new technique was useful as one of the dynamic studies of the mucociliary function.

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粘液線毛輸送

鵜飼幸太郎

1985 年 36 巻 2 号 p. 88-92
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.88

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Relationship between the mucociliary transport time and the ciliary beat frequency in the chicken nose was studied under the conditions of the water deprivation, the administration of cocaine and atropine and Newcastle disease virus infection.
Internal dehydration produced progressive deceleration of mucociliary flow without the influence on ciliary best frequency.
Administration of 5% cocaine to the sinus decelerated the mucociliary transport time in vivo. 20% of cocaine caused the ciliary paralysis 5 minutes after application in vitro.
Atropine neither had apparent effect on the mucociliary flow nor on ciliary beat frequency.
NDV infection induced the deceleration of the turbinate clearance time but no effect on ciliary beat frequency on day 3. On day 14, ciliary beat frequency was significantly decreased, however, mucociliary flow was not influenced.
These results indicated that the mucociliary function might be more important factor than the ciliary beat.

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気道クリアランス

井沢豊春

1985 年 36 巻 2 号 p. 93-99
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.93

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Not only visualization but also quantification of the mucociliary clearance mechanisms in the lungs in vivo have become possible by means of “radioaerosol inhalation lung cinescintigraphy”. Developmental processes of this new research and clinical tool to evaluate the mucociliary clearance mechanisms were described and how the mechanisms are operating in health and disease states such as chronic obstructive airways disease, bronchogenic carcinoma, bronchiectasis, pulmonary fibrosis, pulmonary vascular diseases, immotile cilia syndrome and so on was briefly presented. Furthermore, a simplified revision of our original method was introduced in which only the initial measurement of radioactivity for 60min and FEV_1.0% were required, whereas in our original method, a continuous measurement of radioactivity initially for 120min and a repeat measurement at 24 hours were mandatory.

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ウイルス感染と粘液線毛輸送能

鵜飼幸太郎

1985 年 36 巻 2 号 p. 100-107
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.100

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Relationship between the susceptibility to Newcastle disease virus (NDV) and mucociliary function in the chicken nose was studied.
Intranasal inoculations of different amount of virus had similar effect on the mucociliary function, on viral amount recovered from throat swabs and on pathological changes of the chicken turbinate.
The lesions induced by NDV following intranasal inoculation produced a selective destruction of significant portions of the inner surface of the turbinate scroll, but sinus lesions were not common. These results were supported by the amount of virus and the mucociliary transport time in turbinate and sinus.
Deceleration of the mucociliary transport time induced by dehydration did increase the amount of NDV by 100 to 1000 times over the control values. 20% cocaine and atropine had little effect on the mucociliary function 30 minutes after administration, but susceptibility of nasal mucosa decreased about 10 times in cocaine and 100 to 1000 times in atropine. These results indicated that the susceptibility of nasal mucosa to NDV might be actually affected by the mucociliary function.

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Immotile Cilia 症候群

渡辺雄司, 奥田稔

1985 年 36 巻 2 号 p. 108-112
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.108

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In a recent year congenital anomalies of the cilia of the respiratory mucosal epithelium have been thought of as a cause of chronic airway disease, and electron microscopic observations on cilia in patients with airway disease have revealed that axonemes containing ATP-ase called dynein arms are missing in those cilia. This was first reported in 1977 by Eliasson as immotile cilia syndrome.
In order to detect the patients with immotile cilia syndrome, 103 patients with one or more involved conditions such as paranasal sinusitis, bronchiectasis, situs inversus and sterility were examined using a ciliary function test and electron microscopic observation of the nasal cilia and sperm tails (male only). Ten of the examined patients were diagnosed as having the immotile cilia syndrome on the basis of the presence of the characteristic ultrastructural patterns of the nasal cilia i. e., disorders of the dynein arms.
As the election microscopic findings of this syndrome, Afzelius has reported defects of the dynein arms, spoke head and central sheath. In the present study, besides these abnormalities, we have revealed new findings such as abnormal attachment of the dynein arms and twist of the peripheral microtubules near the distal end of central microtubules.

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シンポジウムII: 気道再建法まとめ

大畑正昭

1985 年 36 巻 2 号 p. 113-114
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.113

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上部気管再建について

廣瀬毅

1985 年 36 巻 2 号 p. 115-122
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.115

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The treatment of late cases with stenosis of the larynx and upper trachea is complicated because of the complex situation of this portion.
Although various methods have been proposed by many physicians, most of them require multiple operations to reconstruct an adequate airpassage. It also requires a long period with perseverance of both patients and doctors to complete the procedure.
Since my subject of this symposium is to report reconstructive surgery of the airpassage, representative methods which consist of multi-stage operations were reviewed and then our one stage operation method was presented.
Multi-stage operation is combination of the following techniques:
I. Reconstruction of the framework; by scar tissue, cartilage transplantation, bone transplantation, or artificial materials.
II. Reconstruction of the inner lining; by mucosa transplantation (free or pedicle), or skin transplantation (free or pedicle).
III. Insertion of a stent; metal, rubber, acrylic resin, silicone, etc.
Technique of our one stage operation is as follow:
First, the scar tissue of the stenotic area is resected. To reconstruct the lining of the lumen, the skin pedicle flap from the cervical region is inserted and to reconstruct the framework, the costal cartilage is used. A rubber glove finger packed with silicone sponge is inserted into the newly reconstructed lumen as a stent for about four weeks. Operated site is covered directly by the skin at the surgery. The tracheostoma should remain open for about four months.
Ten cases have been treated by this method with satisfactory results.

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気道再建と気管の物性

林崎勝武, 矢原三十美, 川島明美, 金子敏郎

1985 年 36 巻 2 号 p. 123-128
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.123

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In spite of the remarkable progress of the radio-and chemotherapy for larngeal cancer, surgical therapy, especially total laryngenctomy, is still playing an important role.
In this paper, voice restoration surgery after the total laryngectomy, namely, tracheo-or crico-hyoidopexia was discussed.
In order to anastomose the trachea with the hyoid bone, lifting of the trachea is indispensable without excessive tension. Since the extensibility of the trachea is closely related with the mechanical properties of the tracheal wall, measurment of the tracheal elasticity prior to surgery might be of importance in performing tracheo-, or crico-hyoidopexia.
As one of the representative factors, Yerzley's resilience of the tranchea was evaluated in human adult trachea and resected canine trachea using variant M-mode display by ultrasonic pulse method after a single impulse excitation of the tracheal wall.
Results obtained indicated that resilience value of the trachea expresses the elastic energy and the extensibility of the tracheal wall.

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喉頭気管吻合術

前田昌純

1985 年 36 巻 2 号 p. 129-132
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.129

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Twenty-one cases of Laryngotracheal stricture were successfully operated by end-to-end direct anastomosis between the larynx and the trachea.
One case died of heart failure 3 months after operation, one of bleeding due to infiltration of thyroid cancer a month postoperatively and four of malignant courses of thyroid cancer. None died from technical failure of this operation.
These results indicate that this operation is a stable typical technique for subglottic stenosis originating from the lesion of the upper trachea, especially thyroid cancer and difficult decannulation.

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気管腺様嚢胞癌に対する切除と再建

井上宏司, 石原恒夫

1985 年 36 巻 2 号 p. 133-138
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.133

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Nine patients with adenoid cystic carcinoma of the trachea were managed by resection, on occasion combined with postoperative radiation therapy. In all patients the trachea was reconstructed by primary anastomosis and there were no serious postoperative complications. Residual microscopic disease was found in 6 patients and they received a course of postoperative irradiation. Of the 6 patients, one died of advanced multiple pulmonary metastases without local recurrence in the fifth year after treatment, and five are alive and clinically free of tumor at 1, 2, 3, 4, and 5 years respectively after finishing the treatment. It is suggested that postoperative radiation therapy may be effective to delay or obviate local recurrence in patients with adenoid cystic carcinoma of the trachea.

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気管形成術とくに分岐部形成について

大森一光

1985 年 36 巻 2 号 p. 139-143
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.139

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Recently cases of carinal resection have increased. We have performed 6 carinal resections; 5 for lung cancer and 1 for tuberculous stenosis. Sleeve pneumonectomy was carried out in 4 cases. In the remaining 2 cases, the trachea was sutured to the right bronchus intermedius and to the left main bronchus.
Right posterolateral incision was made in 4 cases and median sternotomy was made in 2 cases. Median sternotomy is the favorable incision for selected cases. Three of the 6 patients who underwent carinal resections died within a month, 1 died of myocardial infarction, 1 died of disruption of suture line and 1 died of pneumonia.
One case with Y-shaped reconstrution died of massive hemoptysis during laser surgery to the granulation tissue at the anastomotic site. Autopsy revealed bronchopulmonary arterial fistula.
In carinal resections complications frequently occur, postoperative mortality rate is high and the number of long-term survivors is small as compared to that with standard resections. Postoperative management is very important.

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人工気管による気道再建術

松原義人, 畠中陸郎, 船津武志, 池田貞雄

1985 年 36 巻 2 号 p. 144-149
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.144

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Because of the limitation of tracheal resection in the primary end-to-end. anastomotis, there is a necessity of prosthetic reconstruction.
We performed prosthetic reconstruction of the airway since 1979. We used straight type of Neville prosthesis in 5 patients, bifurcated type of Neville prosthesis in 2 patients and Katsura prosthesis in 3 patients. Five patients were operated for lung cancer (squamous cell carcinoma) extending to carina and trachea, 2 patients for adenoid cystic carcinoma of the trachea, and the others each for large cell carcinoma, thyroid cancer and tuberculous granuloma.
Circumferential resection of the trachea was performed in 4 patients, right sleeve pneumonectomy in 4 patients and resection of the carina in 2 patients. One patient died of cardiac insufficiency from intraoperative ventilatory failure at 2 days, 1 patient died of recurrent cancer at 3 months and 1 patient died of accidental cardiac attack at 4 months postoperatively.
The postoperative complications related to the prosthesis occurred in 7 patients. Four patients died of the complications; 1 tracheo-innominate arterial fistula after 1 month, 1 suture insufficiency at the anastomotic site due to uncontrollable diabetes mellitus after 40 days, 2 migrations of prosthesis after 15 months. In spite of dehiscence and granulation at the anastomotic site 1 patient died of an accident after 25 months and 1 patient died of multiple metastases after 43 months. One patient is alive with slight granulation at the proximal anastomotic site for 5 months.
Prosthetic reconstruction of the airway has the advantage with regard to the possibility for extending the resectable limitation and easiness for operative procedure, but there are problems of prosthetic migration and granulation at the anastomotic site.
The patients easily expectorated sputa by coughing after the prosthetic reconstruction.
We produced Katsura prosthesis with elasticity and flexibility for the purpose of improving Neville prosthesis.

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食道を切除した気管形成術の問題点

池田高明

1985 年 36 巻 2 号 p. 150-153
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.150

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In the case of tracheobronchoplasty combined with esophageal resection, healing of the tracheobronchial anastomosis may be compromised by interference with the blood supply to the anastomosis, as the tracheal lateral vessels are removed with the esophagus and the posterior membranous portion of the trachea is no longer supported by the esophagus. Covering of the anastomosis by the muscle flap is one of the methods for these disadvantages, but preservation of bronchial arteries and feeding vessels to the trachea is better. Indication for these procedures should be determined by precise judgement of the extent of malignancy.

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再建できた気道狭窄の2症例

弓削庫太

1985 年 36 巻 2 号 p. 154-156
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.154

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The author reported two cases of airway strictures which have been successfully reconstructed in the past four years. In both cases respiratory tracts were injured by traffic accidents.
Case 1 was a 47-year-old male. The anterior portion of his neck was severely damaged by a frontal clash between cars. Consequently his thyroid cartilage was fractured and the displacement of cartilage fragment induced a stricture of glottis. An incision was made in the midline of the thyroid cartilage. The fracture of the thyroid cartilage was reduced. Silicone T-tube was inserted into glottis and was fixed. Finally the thyroid cartilage was sutured with silver wires. Approximately three months after the operation, the airway improved without any difficulty in breathing or swallowing. There was a hoarseness. However, he has been back to his job.
Case 2 was a 7-year-old boy. He sustained a head trauma by a car accident and was urgently hospitalized in the Neurosurgery unit. Emergency tracheotomy was performed. Decannulation was failed due to excessively proliferated granuloma around the tracheostoma. Therefore, the tracheal granuloma was entirely removed under general anesthesia. Approximately 1.5cm of the skin around the lesion was resected. A suture between the trachea and the insiced skin was tightly performed, and then silicone cuffs button-type cannula was inserted. Approximately eight months after the operation, the airway improved and cannula was removed. Only a small fistula of about 2mm in diameter is present in the operated area with cicatricial healing. The patient has been back to school again without any troubles.

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パネルディスカッション: 気管切開術をめぐって

各科の現況と問題点-まとめ

高山乙彦

1985 年 36 巻 2 号 p. 157-158
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.157

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耳鼻科医の立場から (とくに合併症に対する治療)

吉田哲二, 平野実, 三橋重信, 栗田茂二朗, 宮崎俊己

1985 年 36 巻 2 号 p. 159-160
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.159

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小児の気管切開の最近の傾向 (適応, 手技, 術後管理)

古賀慶次郎

1985 年 36 巻 2 号 p. 161-163
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.161

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気管食道科医の立場よりの適応と術後管理

日野原正

1985 年 36 巻 2 号 p. 164-165
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.164

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内科の立場から

細川芳文, 岡安大仁

1985 年 36 巻 2 号 p. 166-168
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.166

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胸部外科の立場から

中岡康, 大畑正昭

1985 年 36 巻 2 号 p. 169-172
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.169

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食道外科における気管切開術

森昌造, 村上弘治

1985 年 36 巻 2 号 p. 173-174
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.173

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麻酔科の立場からみた気管切開の問題点

鈴木英弘, 佐藤正光

1985 年 36 巻 2 号 p. 175-177
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.175

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Nottracheotomy (Emergency Tracheotomy)

Hans-Jürgen Nickol

1985 年 36 巻 2 号 p. 178-180
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.178

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シネパネルディスカッション: 下咽頭頸部食道癌の切除・再建まとめ

鍋谷欣市, 戸川清

1985 年 36 巻 2 号 p. 181
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.181

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頸部郭清を含む切除手術

村上泰, 猪狩武詔, 原口茂徳, 岡田康司, 丸山毅, 舘野秀樹, 藤村昭子, 浦尾彌須子, 斎藤成司

1985 年 36 巻 2 号 p. 182-183
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.182

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喉頭を保存する下咽頭癌の手術

平野実

1985 年 36 巻 2 号 p. 184-185
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.184

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広背筋皮弁による下咽頭頸部食道再建術

とくに全線量照射後症例における再建術式について

今野昭義, 花沢秀, 西平茂樹, 岡本美孝, 戸川清

1985 年 36 巻 2 号 p. 186-188
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.186

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胃管による再建術

掛川暉夫, 岩本元一, 山名秀明, 植田正信, 大森聖也

1985 年 36 巻 2 号 p. 189-191
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.189

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有茎結腸による再建

藤巻雅夫, 唐木芳昭, 真保俊, 坂本隆, 山田明, 小田切治世, 田沢賢次, 伊藤博, 佐野宗明, 田島健三

1985 年 36 巻 2 号 p. 192-194
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.192

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遊離腸管による再建

野崎幹弘, 佐々木健司, 平山峻, 遠藤光夫, 井手博子, 吉田操, 竹生田勝次

1985 年 36 巻 2 号 p. 195-197
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.195

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気管食道科学会への提言

小野譲, 斎藤英雄, 中山恒明

1985 年 36 巻 2 号 p. 198-208
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.198

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演題・質疑・応答、記録

1985 年 36 巻 2 号 p. 209-222
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.209

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演題・質疑・応答、記録 (2)

1985 年 36 巻 2 号 p. 223-253
発行日: 1985/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.36.223

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