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原稿種別: 表紙
1994 年 34 巻 5 号 p.
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原稿種別: 目次
1994 年 34 巻 5 号 p.
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原稿種別: 付録等
1994 年 34 巻 5 号 p.
356-
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原稿種別: 付録等
1994 年 34 巻 5 号 p.
357-
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池見 酉次郎
原稿種別: 本文
1994 年 34 巻 5 号 p.
360-
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藤川 徳美, 山脇 成人, 東方田 芳邦
原稿種別: 本文
1994 年 34 巻 5 号 p.
361-367
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In the last paper, we reported that depressive patients after presenile age are frequently combined with silent cerebral infarction (i.e. SCI), and those patients are at high risk of occurrence of stroke. In the present study, we divided depressive patients after presenile age onset into depressive patients without SCI (Group A) and depressive patients with SCI (Group B) by using MRI (magnetic resonance imaging), and examined clinical symptoms and risk factors of cerebral infarction in each group. For diagnosis, the diagnostic criteria of major depression according to DSM-III.R were used. Patients in whom stroke had occurred or who had local neurological symptoms were not included. Group B showed significantly higher Self-rating Depression Scale (SDS) total scores and also had significantly higher levels in the areas of crying spells, weight loss, constipation, confusion and emptiness, than Group A. About risk factors of cerebral infarction, no difference was found in combination rates of hypertension, diabetes mellitus and hyperlipidemia in both groups. Coagulation markers abnormality was higher in Group B, especially β-thromboglobulin and thrombinantithrombin III complex (TAT) were considered to be useful as an index for diagnosis and treatment of SCI.
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可知 佳世子, 幸田 克好, 松本 英夫
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1994 年 34 巻 5 号 p.
369-375
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Recently periodic ACTH-ADH discharge syndrome has drawn much attention as one of the diseases whose main complaint lies in vomiting in children. It was supposed that the number of the patients of this disease has been increased, for the cases which would have been diagnosed as cyclic vomiting are now diagnosed to have this disease through the detail clinical observations and laboratory data. However, few cases have been reported which complain of abdominal pain in addition to main symptoms such as periodic attack of vomiting and hypertension. We have recently experienced 2 cases complaining of severe abdominal pain together with vomiting attack. Both cases have been observed for a long period without any effective therapies. Their onset was the attack of vomiting and during the observation they began to complain of abdominal pain. Then, it was thought psychological factors might play important roles. They were recommended to come to our department. Precise examinations led to a diagnosis of periodic ACTH-ADH discharge syndrome. Then medical treatment was initiated by administration of the drugs. They claimed that they were much worried about the abdominal pain and vomiting even at the intermission of the attacks. This was thought to be a psychosomatic aspect of the patients due to the distrust in and a sense of insecurity to the treatment. Then, it was considered significant that pediatric physicians treat the underling periodic ACTH-ADH and that pediatric psychiatrists take part in the improvement of the psychological aspects which developed secondarily. Looking through these cases, it seemed noteworthy to treat the children with chronic diseases with much attention to their psychosomatic aspects.
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篠田 知璋
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1994 年 34 巻 5 号 p.
375-
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堤 由美子, 鹿島 友義, 野添 新一, 牛山 陽子
原稿種別: 本文
1994 年 34 巻 5 号 p.
377-384
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Terminal cares for patients with malignant tumors were examined using questionnaires to families of the deceased during 1990 and 1991 in medical wards of Kagoshima University Hospital. The questionnaires were mailed back from 40 families (46%). Most of the patients (37 patients, 93%) were not told about their real diagnoses but seven (19%) of them were aware of it; 19 (51%) doubted and 10 (27%) were not aware of it (according to families' impressions). Twenty-two (59%) stated positive evaluation for the fact that the deceased were not told about their real diagnoses. Only three patients were told about the diagnoses and two of their families evaluated the fact positively and none did it negatively. Twenty-seven patients had sustained pains due to their diseases during their terminal stages but their pains were satisfactorily controlled in 23 (85%) of them; fairly controlled in 4 (15%) and poorly in none. Mechanical respirators were applied to 17 patients but only 5 of their families made positive assessment as to the life-prolongation even using respirators. In general, 22% of families were very satisfied with doctors' medical cares; 38% were satisfied; 5% were not satisfied and 28% very satisfied with nursing cares; 43% satisfied; 2% not satisfied.
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松本 めぐみ, 木村 一博, 山澤 〓宏, 平山 陽示, 永井 義一, 室田 敬一, 伊吹山 千晴
原稿種別: 本文
1994 年 34 巻 5 号 p.
385-393
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It is said that the characteristic of the Type A behavior pattern among Japanese males is different from that among Western males, -that is low hostility, but high job-involvement in Japanese males. Therefore, the coronary-prone behavior among Japanese males may be also different from Western males. This study investigated the relationships between Type A components assessed by JAS and traditional coronary risk factors divided by ages, and the behavioral characteristics of tastes, and also occupational levels or school careers. A total of 2528 males undergoing regular health check-ups was evaluated with regard to the behavior pattern by JAS (form-C). The subjects were divided into three groups by ages (less than 44 y.o., 45 to 54 y.o., more than 55 y.o.) and analyzed by the Spearman correlation coefficients of JAS standard scores with coronary risk factors. The mean scores of JAS in the four groups were divided by the levels of cigarettes smoking, alcohol drinking or coffee consumption, and also divided by the occupational levels or school careers. These scores were compared by the analysis of variance with the Bonferroni test. The following results were obtained : 1) In the JAS scales, the score of factor J was significantly correlated (p<0.01) with some of coronary risk factors (obesity, triglycerides, HDL-cholesterol and uric acid). This tendency was distinct in the age group of less than 44 y.o. 2) The mean scores of factor J in the high levels of cigarettes smoking, alcohol drinking and coffee tasting were significantly greater (p<0.05) than the no-smoking, no-drinking and no-taste level. This tendency in the factor J was more distinct than other JAS scales. 3) The mean scores of the type A scale and factor J in managers were significantly greater (p=0.0001) than clerks, salesmen or technicians and self-supporters. And the mean scores of the three JAS scales without factor H in the subjects who had better than college educations were significantly greater (p=0.0001) than those of high-school graduates. These results show that the job-involvement is a noteworthy factor for healthy life, and suggest that this factor might be one of coronary-prone behaviors among Japanese younger males of Tokyo area.
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菊池 長徳, 滝本 浩俊, 中川 眞澄, 笠貫 宏, 細田 瑳一, 今井 保次, 久保田 浩也, 橋口 英俊, 内山 喜久雄
原稿種別: 本文
1994 年 34 巻 5 号 p.
395-400
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A Psychosomatic study was performed on 78 cases of male workers with ischemic heart disease using the Japan Productivity Center Mental Health Inventory (JMI), and the results were compared with age-matched control. As to the subjective symptoms, high scores were found in ear, cardiovascular, respiratory, intestine and anus, skin, urogenital, frequency of disease, multicomplain and fatigue. On the mental scales, the score of explosive (anger and impatience), suggestable, hypochondriacal, anxiety, social irresponsible were higher, while hypomanic, paranoia, cohesive, inferiority feeling and addiction (to alcohol) were lower than control. On the personality scales they recorded high scores of spontaneity, extraversion. assertiveness, flexibility, immediate reactiveness and future oriented. The relationship with their colleagues was poor and their sense of belongingness was low as compared with control on the occupational adjustment scales. These results indicated that personality profiles in Japanese ischemic heart disease was similar to those of type A behavior pattern fundamentally, while flexibility and empathy were demonstrated as Japanese characteristic personality. Although, they showed a neurotic tendency on mental scale, it seems that this may be results of their serious disease.
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村林 信行, 坪井 康次, 中野 弘一, 筒井 末春
原稿種別: 本文
1994 年 34 巻 5 号 p.
401-408
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Technostress has been implicated in a variety of pathological conditions (pathema). However, the clinical aspects of this syndrome have rarely been investigated in a large population. In this study, we investigated the clinical aspects of the technostress syndrome in visual display terminal (VDT) operators, who were considered to be representative of computer operators. We selected 97 VDT operators (VDT group) who consulted our department of psychosomatic medicine between June 1986 and November 1988. The control group consisted of 97 patients who consulted our department during the same period, matched with the VDT group for age, sex and disease type. We analyzed and compared the medical records of the two groups for the period from the onset of the illness to the initial consultation, concerning the motives for the initial consultation, work performance at the time of the consultation and the results of psychological tests. We also noted the prognosis of the two groups of patients. The results indicate that the period from the onset of the illness to the first consultation was shorter in the VDT group. Less patients in the VDT group consulted us voluntarily. Patients in the VDT group bad more work related adjustment problems. The rate of improvement was 50.7% in the VDT group, it was not significantly different from the control group. It is suggested that the prognosis of VDT operators compares favorable with control patients.
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原稿種別: 付録等
1994 年 34 巻 5 号 p.
408-
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春日 伸予
原稿種別: 本文
1994 年 34 巻 5 号 p.
409-414
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This study was conducted to revise the questionnaire to evaluate technostress tendency (Q1), which was made on "Study on technostress syndrome-Report 1" and to examine its reliability. Twenty computer operators were interviewed about their mental conditions when operating computers. Based on the answers of the interview, 8 questions were obtained (2 for techno-centered tendency, and 6 for techno-anxious tendency) and they were added to Q1 to complete a new questionnaire which consisted of 24 questions on techno-centered tendency and 15 questions on techno-anxious tendency. Each question has 3 answers-Yes, No, or Unknown. The questionnaires were sent out to 280 computer operators to collect data. Analysis was conducted by separating the questions on techno-centered tendency from questions on techno-anxious tendency. Each question was given a point according to the answer- Yes=1,Unknown=0.5,& No=0. The total points were used as the score to evaluate technostress tendency of each subject. With this score, principal component analysis was conducted and questions which were regarded as representative of each factor were selected. Selected questions were further analyzed by factor analysis in order to be classified. Using selected questions, the scores to evaluate technostress tendency were recalculated to pick out 3 subjects whose scores were high and 3 subjects whose scores were low, for both techno-centered tendency and techno-anxious tendency. The subjects were interviewed to examine their technostress tendency and the results of the interview were compared with those of the questionnaire. Further, they made questionnaires again to compare the scores of 2 surveys. As results of the analysis, 16 questions were obtained for techno-centered tendency and were classified into 6 factors. Ten questions were obtained for techno-anxious tendency and were classified into 3 factors. The result obtained by interview proved the reliability of the questionnaire and 2 surveys by questionnaires showed that the result of the questionnaire was reproducible. It was suggested that the questionnaire obtained in this study was appropriate to evaluate technostress tendency
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原稿種別: 付録等
1994 年 34 巻 5 号 p.
414-
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津久井 要, 山本 晴義, 江花 昭一, 川原 健資, 末松 弘行
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1994 年 34 巻 5 号 p.
415-421
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Metabolic mimicry of Bartter's syndrome induced by self-vomiting, laxatives abuse, and diuretics abuse has recently been reported. We here report a case of eating disorder with pseudo-Bartter's syndrome caused by long term ingestion of furosemide in which fasting therapy was useful in breaking the dependence on furosemide. A 22-year-old unmarried woman consulted our hospital complaining of overall physical rigidity and breathing difficulty. She had a 5-year history of ingestion of furosemide (400 mg/day) and many characteristic symptoms of Bartter's syndrome, including hypokalemia, metabolic alkalosis, elevated plasma renin activity and serum aldosterone level without hypertension, and insensitivity to the pressor effect of angiotensin-II infusion. Serum CPK and uric acid were elevated. Creatinine clearance was within the normal range. and Fishberg's concentration test disclosed a poor concentration ability. The needle biopsy specimen from the kidney showed a hypertrophy of the juxtaglomerular apparatus and a large number of secretory granules and mitochondria. The granules, some of which contained crystalloid structures, were of various shapes and sizes. Additionally, after she was hospitalized, she presented the characteristic behavior of eating disorders including anorexia, binge eating, and self-vomiting. The behavior was accelerated when we tried to prohibit the furosemide. Therefore, we diagnosed the case as eating disorder with pseudo-Bartter's syndrome due to furosemide abuse, and tried to decrease the intake of the drug. Three months later, when the daily dose of furosemide was decreased to 40mg, plasma renin activity and serum aldosteron levels returned to almost normal ranges. At this stage, she strongly resisted complete cessation of the furosemide, then we followed her condition as an outpatient. After one month, the dosage again increased to 120-160 mg/day and she revisited us complaining that she could not discontinue the drug by herself, and asked for help. We then introduced her into fasting therapy and she succeeded in discontinuing the furosemide. Her eating disorder returned to normal after the therapy and she became well enough to obtain a job as a nurses' aid. We feel that fasting therapy is useful in helping patients, with diuretics abuse induced pseudo-Bartter's syndrome, discontinue the drug. But in the case of eating disorders, a careful observation must be made. Among the possible reasons why the fasting therapy was successful are as follows. 1. Patients who have a desire to become thinner are willing to undergo fasting therapy. 2. Since fasting therapy has a strong externally imposed structure, it is effective in stopping the patients from seeking the drug. 3. During the period of fasting, there is an increase of sodium excretion and a negative sodium balance even when a sodium supplement is given, therefore fasting is effective in changing the cognitive distortion of the patients that they can not excrete enough urine without furosemide. 4. Since refeeding is started with a low salt and low calorie diet, sodium retention is rarely found. 5. A successful fasting therapy would elevate self-efficacy and in turn improve the behavioral patterns of the patients.
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原稿種別: 付録等
1994 年 34 巻 5 号 p.
421-
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外島 敬久, 八島 祐子, 遠藤 正俊, 柳内 務, 黒須 貞利, 伊藤 光宏, 星野 仁彦, 熊代 永
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1994 年 34 巻 5 号 p.
423-
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岩田 泰秀, 増子 博文, 橋本 慎一, 星野 仁彦, 熊代 永, 八島 祐子
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1994 年 34 巻 5 号 p.
423-
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村松 英司, 和嶋 朗, 佐藤 時治郎, 桜田 高
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1994 年 34 巻 5 号 p.
423-
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菅原 隆, 佐々木 雅之, 田代 敦志, 福土 審, 村中 一文
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1994 年 34 巻 5 号 p.
423-424
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鞍掛 彰秀, 斎藤 秀樹, 高橋 恒男, 石川 誠, 森岡 由起子, 灘岡 壽英
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1994 年 34 巻 5 号 p.
424-
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水野 紹夫, 千葉 太郎, 田村 昌士, 板倉 康太郎
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1994 年 34 巻 5 号 p.
424-
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本多 和雄, 鹿島 満江, 釜野 安昭, 釜野 聖子, 本田 龍三, 岡本 章寛, 山崎 美佐子
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1994 年 34 巻 5 号 p.
424-
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國井 啓子, 松崎 博光, 熊坂 しのぶ, 宇留賀 一夫
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1994 年 34 巻 5 号 p.
424-
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青木 茂美, 田中 義規, 福土 審, 村中 一文
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1994 年 34 巻 5 号 p.
424-425
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高橋 修三, 真木 正博
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1994 年 34 巻 5 号 p.
425-
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高橋 洋, 岩橋 成寿, 金澤 素, 村中 一文
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1994 年 34 巻 5 号 p.
425-
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金澤 素, 岩橋 成寿, 高橋 洋, 福土 審, 村中 一文
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1994 年 34 巻 5 号 p.
425-
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太田 亮一, 丹野 優次, 杉田 敬
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1994 年 34 巻 5 号 p.
425-
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須藤 智行, 若杉 宏一, 吉田 豊, 佐々木 大輔
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1994 年 34 巻 5 号 p.
425-
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菅野 智行, 沼田 吉彦, 堀越 立, 田子 久夫, 金子 元久, 熊代 永
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1994 年 34 巻 5 号 p.
426-
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黒田 正宏, 黒田 迪子, 石渡 喜和子, 泉山 裕子
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1994 年 34 巻 5 号 p.
426-
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神田 秀人, 灘岡 壽英, 井上 勝夫, 林 博史, 粟野 美穂, 井原 一成, 高橋 誠一郎, 渡部 由里, 生地 新, 森岡 由起子, ...
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1994 年 34 巻 5 号 p.
426-
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福土 審, 村中 一文, 田中 義規, 岩橋 成寿, 佐々木 雅之, 野村 泰輔, 田代 敦志, 高橋 洋, 青木 茂美, 菅原 隆, 金澤 ...
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1994 年 34 巻 5 号 p.
426-
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若杉 宏一, 須藤 智行, 佐々木 大輔
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1994 年 34 巻 5 号 p.
427-
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斉藤 恵子
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1994 年 34 巻 5 号 p.
427-
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村中 一文
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1994 年 34 巻 5 号 p.
427-
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杉田 敬, 陳 華毅
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1994 年 34 巻 5 号 p.
429-
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陳 華毅, 杉田 敬
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1994 年 34 巻 5 号 p.
429-
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古暮 恒夫, 武井 あおい
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1994 年 34 巻 5 号 p.
429-
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武井 あおい, 古暮 恒夫
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1994 年 34 巻 5 号 p.
429-
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星野 仁彦, 増子 博文, 橋本 慎一, 金子 元久, 熊代 永
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1994 年 34 巻 5 号 p.
430-
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柳沼 典正, 新国 茂, 竹内 賢, 金子 元久, 熊代 永
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1994 年 34 巻 5 号 p.
430-
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伊藤 光宏, 鈴木 裕樹, 堀越 立, 熊代 永, 穴沢 卯三郎, 吉田 遼
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1994 年 34 巻 5 号 p.
430-
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藤 京子, 東谷 慶昭, 灘岡 壽英, 十束 支朗
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1994 年 34 巻 5 号 p.
430-
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太田 亮一, 福土 審, 村中 一文
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1994 年 34 巻 5 号 p.
430-431
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高橋 洋, 岩橋 成寿, 佐々木 雅之, 村中 一文
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1994 年 34 巻 5 号 p.
431-
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黒田 正宏, 黒田 迪子, 石渡 喜和子, 泉山 裕子
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1994 年 34 巻 5 号 p.
431-
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田口 文人, 田中 恵子, 山内 祐一
原稿種別: 本文
1994 年 34 巻 5 号 p.
431-
発行日: 1994/06/01
公開日: 2017/08/01
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