The Journal of the Japan Society for Respiratory Endoscopy
Online ISSN : 2186-0149
Print ISSN : 0287-2137
ISSN-L : 0287-2137
Volume 13 , Issue 2
Showing 1-50 articles out of 89 articles from the selected issue
  • Type: Cover
    1991 Volume 13 Issue 2 Pages Cover1-
    Published: March 25, 1991
    Released: October 01, 2016
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  • Type: Cover
    1991 Volume 13 Issue 2 Pages Cover2-
    Published: March 25, 1991
    Released: October 01, 2016
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  • Type: Bibliography
    1991 Volume 13 Issue 2 Pages Misc1-
    Published: March 25, 1991
    Released: October 01, 2016
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  • Type: Appendix
    1991 Volume 13 Issue 2 Pages App1-
    Published: March 25, 1991
    Released: October 01, 2016
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  • Type: Appendix
    1991 Volume 13 Issue 2 Pages App2-
    Published: March 25, 1991
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  • Type: Appendix
    1991 Volume 13 Issue 2 Pages App3-
    Published: March 25, 1991
    Released: October 01, 2016
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  • Type: Appendix
    1991 Volume 13 Issue 2 Pages App4-
    Published: March 25, 1991
    Released: October 01, 2016
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  • Type: Index
    1991 Volume 13 Issue 2 Pages Toc1-
    Published: March 25, 1991
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  • Type: Index
    1991 Volume 13 Issue 2 Pages Toc2-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese]
    Type: Article
    1991 Volume 13 Issue 2 Pages 115-116
    Published: March 25, 1991
    Released: October 01, 2016
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  • Keigo Takagi, Koji Sensaki, Yozo Uriuda, Katsuichi Kase, Hideo Masuda, ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 117-124
    Published: March 25, 1991
    Released: October 01, 2016
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    The effects of bronchoscopy on respiratory and cardiovascular systems were analyzed in 109 procedures in 37 cases and in 134 procedures in 41 cases, respectively, by monitoring transcutanous oxygen tension (PtcO_2), chest wall movement, blood pressure, and ECG. Risk factors in the bronchoscopic examinations and the protective steps against complications were discussed. Decline in PtcO_2 was remarkable during TBLB, BAL, or bronchography, and respiratory patterns were affected during the procedures. The median values of cardiac load index during the examination doubled compared to the starting levels. PVCs were recognized in 13 cases (62%), and some correlation between myocardial ischemia and a high grade of PVCs were recognized during the examination. The risk factors of the load on the cardiopulmonary systems during the bronchofiberscopic examination included mechanical irritations of the airway by the scopes and examinations inducing airway obstruction. The selection of methods of anesthesia suitable for each patient and development of the longacting local anesthesic agents, small caliber bronchoscopes with a large working channel are required in future. Close attention must always be paid to the patient even in routine examinations.
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  • Niro Okimoto, Koji Hashiguchi, Masaru Sumi, Masamitu Nakasima, Masatos ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 125-129
    Published: March 25, 1991
    Released: October 01, 2016
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    Bronchoscopic examination was performed in 206 patients with lung cancer. In 164 of the patients (76.9%) the diagnosis of lung cancer was made by biopsy and brushing cytology. Additional cytologic examination of all aspirated fluids during bronchoscopic examination, fluids used to wash biopsy and brushing instruments, broncho-alveolar lavage fluids and sputum following bronchoscopic examination increased the rate to 85.4% (176 patients). Cytologic examination of all aspirated fluids during bronchoscopic examination was especially useful.
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  • Maki Ohi, Kazuyoshi Nakamura, Naohiro Terada, Kan Takeda, Tuyosi Nakag ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 130-138
    Published: March 25, 1991
    Released: October 01, 2016
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    Bronchial adenocarcinoma showing intraluminal polypoid growth is quite rare. Recently we experienced five such cases. The purpose of this study is to compare the bronchoscopic findings with those of small cell carcinoma manifesting as a protruding mass covered with bronchial mucosa. Five cases of adenocarcinoma and 10 of small cell carcinoma were examined. Bronchoscopic findings were reviewed with respect to the appearance and color of the tumor surface, submucosal vessels, the site of the tumor, the relation between the tumor and the surrounding bronchial wall and the appearance of the surrounding bronchial wall. All of the polypoid adenocarcinomas had smooth, normal colored surface identical to the adjacent bronchial wall. No case showed abnormal subepithelial vessels. Submucosal patchyhemorrhage was seen in 4 cases, at the segmental or more peripheral bronchi and occluded them completely. The surrounding bronchial wall appeared normal in 4 cases. However, the protruding masses of small cell carcinoma, on the contrary, had an irregular reddish colored surface. Dilated tortuous submucosal vessels were seen in all cases in segmental or more proximal bronchi. Most of the tumors had a broad base and showed eccentric growth in the bronchial lumen. In 8 cases, the surrounding bronchial wall revealed reddness, suggesting submucosal tumor extension. These bronchoscopic findings are likely to be of help in differentiating these two entities.
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  • Haruya Koshiishi
    Type: Article
    1991 Volume 13 Issue 2 Pages 139-151
    Published: March 25, 1991
    Released: October 01, 2016
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    The distribution of the bronchial artery in the tracheo-bronchial tree, and the therapeutic effect of the BAI were studied based on bronchial arterial injection of fluorescein. The distribution of the bronchial artery was clearly recognized by the bronchial mucosal staining findings of fluorescein- assisted bronchoscopy (FAB) technique. The results of bronchial arteriography (BAG) and FAB were compared. There was increased bronchial arterial flow in the lower trachea within 4 rings from the carina. In the membranous portion the flow is mainly from the right bronchial artery and in the cartilaginous portion the flow is mainly from the left bronchial artery. Both bronchial arteries were recognized to supply the proximal contralateral main bronchus and carina, as well as the ipsilateral main bronchus. The relationship between hypervascularity seen on BAG and bronchial arterial flow was not recognized in the trachea or carina, but was recognized in lobar bronchi. When FAB findings revealed the staining of bronchi related to the tumor and staining of the tumor itself, BAI was effective.
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  • Hideo Mashimoto, Hironobu Koga, Naohumi Suyama, Jun Araki, Sadahiro As ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 152-158
    Published: March 25, 1991
    Released: October 01, 2016
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    A 72-year-old female was admitted for further examination of an abnormal chest shadow. She had been treated for rheumatoid arthritis for 10 years. Chest X-ray film on admission showed a solitary nodular shadow in right S^7b. Thoracic CT demonstrated a round tumor with central calcification in right S^7b and tumor with calcification at the posterior wall of the left main bronchus. Bronchoscopic findings showed a nodular lesion with capillary dilatations at the posterior wall of the left main bronchus. Microscopic findings of biopsied specimen from the tumors both in right S^7b and in the left main bronchus showed amyloid deposition. The amyloid in this case stained positively with Congo- red after potassium permanganate treatment, and weakly stained with anti-light chain λ type antiserum by the PAP method. Consequently, this amyloid was interpreted as being composed of AL protein λ type. It seemed that rheumatoid arthritis in this case was not directly associated with amyloidosis. This case corresponded with localized bronchopulmonary amyloidosis may be very rare in Japan. If the enlarged amyloid nodule obstructs the left main bronchus in the near furture, laser therapy may be the first choice of therapy.
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  • Haruhito Tanaka, Koji Nakahara, Hiromichi Mimoto, Ryosho Tomida, Aki Y ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 159-164
    Published: March 25, 1991
    Released: October 01, 2016
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    A 62-year-old male visited a local doctor complaining of a productive cough in September 1989. Chest X-ray showed obstructive pneumonia of the lower right lung field. With bronchoscopic examination, lung carcinoma was suspected and he was referred to another hospital. Subsequently another bronchoscopy revealed a whiteyellowish colored, multinodular tumor, which obstructed the truncus intermedius completely. The tumor was found to be non-mobile, with a smooth surface and no vascular engorgement. It was hard on biopsy, but judged to be squamous metaplasia histologically and Papanicolaou class II cytologically. In January 1990, the patient was admitted to our hospital in order to undergo bronchoscopic Nd-YAG laser therapy. During vaporizing the tumor, a shell of pistachio nut was found, so it was concluded that the problem was caused by the foreign body. A histological examination of the extirpated tumor revealed squamous metaplasia and fibrous stroma rich in collagen fiber, with slight inflammatory infiltration. It was judged to be inflammatory polyp of the fibromotous type in Peroni's classification.
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  • Hiroshi Tonotsuka, Kazuo Mizukoshi, Toshirou Kawai
    Type: Article
    1991 Volume 13 Issue 2 Pages 165-170
    Published: March 25, 1991
    Released: October 01, 2016
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    A 32-year-old female presented in September 1989 with a 2-month history of cough and white sputum. Chest X-ray film and subsequent CT scanning showed bilateral hilar lymphadenopathy with atelectasis of right middle lobe. Fiberoptic bronchoscopy revealed vascular dilatation of bronchial mucosa and obstruction of right middle lobe orifice with extrinsic bronchial compression. Bronchial biopsy revealed noncaseating granulomas composed of epithelioid cells with Langhans type giant cells compatible with sarcoidosis. Diagnosis was confirmed by transbronchial lung biopsy and right inguinal node biopsy. Three weeks after institution of steroid therapy, bronchial mucosal lesion and obstruction of middle lobe almost totally disappeared. Atelectasis is uncommon in sarcoidosis. There have been only 4 such cases in the previous Japanese literature, However, in cases of atelectasis such as middle lobe syndrome, sarcoidosis must be considered.
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  • Hiroyuki Wakiyama, Katuichi Kase, Hideo Masuda, Keigo Takagi, Keiichi ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 171-175
    Published: March 25, 1991
    Released: October 01, 2016
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    A 55-year-old female was admitted with repeated hemoptysis. The chest roentgenogram showed atelectasis of the middle lobe. Fiberoptic-bronchoscopy revealed a polypoid tumor at the orifice of the right B^5a. Sulfur granules of actinomyces were identified on the transbronchial biopsy specimen. Hemoptysis was improved by penicillin, but the bronchial arteriogram still showed hypervascularity in the middle lobe, and shunts from the bronchial artery to the pulmonary artery. She underwent middle lobe resection to treat the repeated hemoptysis.
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  • Jun Naitoh, Kenkichi Oho, Hiroshi Saitoh, Masahiro Tsuboi, Eisuke Taka ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 176-181
    Published: March 25, 1991
    Released: October 01, 2016
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    Intraluminal irradiation has been used increasingly in an attempt to control inoperable endotracheobronchial malignant tumors. Recently combination of intraluminal irradiation with Nd-YAG laser vaporization has also been attempted. A case of adenoid cystic carcinoma extending widely around the carina was treated with ^<60>Co intraluminal irradiation following Nd-YAG laser debulking and Linac external beam irradiation. Ten days after ^<60>Co intraluminal irradiation, complete remission was obtained endoscopically. Finally, 5 months after intraluminal irradiation, this case died of hemoptysis. Autopsy revealed broncho- pulmonary arterial fistula which seemed to have been caused by necrosis due to compression by a Y-T tube inserted 3 weeks before her death. But, pathologically, there was no malignant tumor. It was recognized that ^<60>Co intraluminal irradiation can be very useful for adenoid cystic carcinoma. However, further clinical studies are required to fully clarify the effectiveness of this method.
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  • Toshinori Hashizume, Masazumi Watanabe, Masafumi Kawamura, Ryoichi Kat ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 182-186
    Published: March 25, 1991
    Released: October 01, 2016
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    A 43 year-old female complained of severe dyspnea and was admitted to a local hospital. Tracheostomy was performed but dyspnea did not disappear and she was referred to our hospital. Bronchoscopy revealed subglottal stenosis, lower tracheal stenosis and left main bronchial obstruction due to tuberculosis. We enlarged lower trachea by bougienage and treated the subglottal stenosis with Nd- YAG laser vaporization. In order to prevent restenosis of the subglottis and lower trachea, we inserted long T-tube with 12.4cm length. She did not complain of discomfortableness or difficulty in extpectorating sputum. The T-tube was removed 4 years and 8 months after insertion. She has been followed up 1 year and 10 months after removal of the T-tube without recurrence of the subglottal or tracheal stenosis.
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  • Makoto Nonaka, Takashi Arai, Keizou Inagaki, Takatomo Morita, Makoto Y ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 187-192
    Published: March 25, 1991
    Released: October 01, 2016
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    We experienced two cases of broncholithiasis. Case 1 was a 64-year-old male who was admitted with cough. The chest radiograph showed a tumor-like shadow 6×5cm in size in the left lower lung field. Bronchoscopy revealed obstruction of B^<10>. Obstructive pneumonia or pulmonary suppuration due to inflammatory bronchial stenosis was suspected, but lung cancer could not be ruled out. Left lower lobectomy was performed. The histological diagnosis was organized obstructive pneumonia due to a broncholith (B^<10>). The structure of the decalcificated broncholith (silver stain) suggested that it was derived from calcified lymph node. Case 2 was a 41-year-old male with continuous hemoptysis. The chest radiograph showed calcifications near right B^7 and a pneumonia-like shadow in S^7. Bronchoscopically, right B^7 B^8 and B^9 were obstructed by a blood clot. Since hemoptysis continued after admission, right lower lobectomy was performed. A broncholith was found in the lumen of B^7, which had a shape of a bronchial plug. The distal part of B^7 was dilated and filled with calcigerous mucus. The broncholith seemed to be caused by calcification of mucus in the bronchus. It was proved by calcium analysis that more than 98% of this broncholith consisted of calcium carbonate.
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  • Ryohei Matsuda, Toyoaki Hida, Takahiko Sugiura
    Type: Article
    1991 Volume 13 Issue 2 Pages 193-196
    Published: March 25, 1991
    Released: October 01, 2016
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    A 50-year-old male was admitted because a mass survey chest X-ray revealed nodular shadows in the left lower lung field. The patient had no complaint. The transbronchial lung biopsy specimens taken from these lesions revealed many cryptococci. Further examination indicated that the patient had no immunological problems, nor did he have any lesions other than those in the left lung. A diagnosis of primary pulmonary cryptococcosis was made. No improvement was observed during the fifty day non therapy observation period. An antimycotic agent, Fluconazole, was tentatively applied with remarkabl results. Now that new antimycotic agents such as Fluconazole are available and it has been demonstrated that the immediate effects of such agents can be relied on to a great extent, it is no longer necessary to operate on primary pulmonary cryptococcosis patients immediately, nor should they simply be observed in the hope that they will recover without medical intervention. It is recommended that chemotherapy be commenced at an early stage, using the optimal antimycotic agent.
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  • Takashi Suzuki, Gouichi Hori, Mototoshi Yamashiro, Akihiko Kitami, Haj ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 197-203
    Published: March 25, 1991
    Released: October 01, 2016
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    A 62-year-old man was admitted complaining of cough syncope. Sputum cytology yielded squamous cell carcinoma. Bronchoscopy revealed stenosis of the intrathoracic trachea and the obstruction of one branch of the superior bronchus of the right lower lobe (B^6b). Computed tomography also disclosed a "saber-sheath" trachea, and the upper mediastinal and the right hilar lymphadenopathy. Although preoperative pulmonary function test revealed a decrease in FEV_<1.0> and a low predicted FEV_<1.0> value after right pneumonectomy, it was supposed that the tracheobronchomalacia caused these obstructive change. Right pneumonectomy and dissection of the mediastinal lymph nodes were performed, followed by dilatation and fixation of the cartilaginous portion of the intrathoracic trachea using inverted ringed Gore- Tex. Although obtaining temporary respiration relief, the patient died of progressive distal airway obstruction 9 months after the operation. This patient had "saber sheath" tracheobronchomalacia associated with advanced pulmonary emphysema, therefore localized strut operation was not completely successful, as malacia developed below the position of the strut. Indications for surgery should be restrictive for patients with pure central pressure dependent obstruction without peripheral airway collapse.
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  • Kiyoshi Yoshizawa, Taizoh Fukumoto, Kazumasa Miura, Junji Morita, Taka ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 204-208
    Published: March 25, 1991
    Released: October 01, 2016
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    A surgical adhesive, n-butyl-2-cyanoacrylate, together with an occluding spring embolus was used successfully for a case of postpneumonectomy bronchial fistula. Right pneumonectomy was acomplished in a 61-year-old male suffering from hilar adenocarcinoma. The patient had postoperative chemotherapy, but a bronchial fistula developed three weeks later. Since transbronchoscopic therapy with fibrin glue was ineffective, we used the above two agents via bronchoscopy. Bronchial leakage ceased immediately. This method is therefore effective for relative major bronchial fistulae in which reoperation is not indicated.
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  • Takashige Miyazaki, Akira Sakamoto, Katsuro Taketomi, Shigeru Kohno, K ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 209-213
    Published: March 25, 1991
    Released: October 01, 2016
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    A 73-year-old man was admitted with dyspnea. His right lung was completely collapsed on the chest X-ray examination. Immediately thoracic cavity drainage was begun, but air leakage did not improve for more than one month. Since he refused thoracotomy, bronchial obstruction was performed by bronchofiberscope on the 40th hospital day. A fogarty balloon catheter was used to close the bronchopleural fistula, followed by filling the fistula with fibrin glue according to the technique of Muramatsu. The first attempt of bronchial obstruction was not successful. Coagulation factor XIII (total 1, 500×) was given intravenously but small air leakage was also continued. On the 54th hospital day a second attempt of bronchial obstruction was performed using his blood as the bronchial filler. Immediately after the second attempt, the air leakage stopped completely and the thoracic cavity drainage was withdrawn on the 64th hospital day. No complications were noticed.
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    Type: Article
    1991 Volume 13 Issue 2 Pages 214-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 214-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 214-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 214-215
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 215-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 215-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese]
    Type: Article
    1991 Volume 13 Issue 2 Pages 215-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 215-216
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    Type: Article
    1991 Volume 13 Issue 2 Pages 216-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 216-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese]
    Type: Article
    1991 Volume 13 Issue 2 Pages 216-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 216-217
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 217-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 217-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 217-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 217-218
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 218-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 218-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 218-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 218-219
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese]
    Type: Article
    1991 Volume 13 Issue 2 Pages 219-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 219-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    Type: Article
    1991 Volume 13 Issue 2 Pages 219-
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    Type: Article
    1991 Volume 13 Issue 2 Pages 219-220
    Published: March 25, 1991
    Released: October 01, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    1991 Volume 13 Issue 2 Pages 220-
    Published: March 25, 1991
    Released: October 01, 2016
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