The Journal of the Japan Society for Respiratory Endoscopy
Online ISSN : 2186-0149
Print ISSN : 0287-2137
ISSN-L : 0287-2137
Volume 26 , Issue 8
Showing 1-33 articles out of 33 articles from the selected issue
  • Type: Cover
    2004 Volume 26 Issue 8 Pages Cover1-
    Published: December 25, 2004
    Released: October 15, 2016
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  • Type: Index
    2004 Volume 26 Issue 8 Pages Toc1-
    Published: December 25, 2004
    Released: October 15, 2016
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  • Type: Appendix
    2004 Volume 26 Issue 8 Pages App1-
    Published: December 25, 2004
    Released: October 15, 2016
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  • Type: Index
    2004 Volume 26 Issue 8 Pages Toc2-
    Published: December 25, 2004
    Released: October 15, 2016
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  • Type: Index
    2004 Volume 26 Issue 8 Pages Toc3-
    Published: December 25, 2004
    Released: October 15, 2016
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  • Koichi Yamazaki, Naofumi Shinagawa, Yuya Onodera, Hajime Asahina, Imu ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 689-693
    Published: December 25, 2004
    Released: October 15, 2016
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    The methods to simulate the proper bronchi to reach the small peripheral pulmonary lesions by virtual bronchoscopy has been reported. We have also reported the usefulness of virtual bronchoscopy to simulate the proper bronchi to reach the small peripheral pulmonary lesions for CT-guided transbronchial biopsy. In addition, we have developed the new system, the VBS navigation system, to navigate the proper bronchi to reach the small peripheral pulmonary lesions during transbronchial biopsy on real time. The navigation of the bronchi by virtual bronchoscopy is expected to improve the diagnostic yields, and reduce the time for examination and irradiation exposure, when it is applied to CT-guided transbronchial biopsy as well as endobronchial ultrasonography with guide-sheath ( EBUS-GS ) guided transbronchial biopsy. Furthermore, the use of virtual bronchoscopic navigation and an ultrathin bronchoscope could enhance the accuracy of preoperable barium marking around the lesions. In this symposium, we discuss the advantages, disadvantages and future directions of virtual bronchoscopy.
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  • Fumihiro Asano, Hirokazu Adachi, Hiroyuki Sato, Hirokazu Kirii, Yoshih ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 694-696
    Published: December 25, 2004
    Released: October 15, 2016
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  • Gen Yamada, Katsuyuki Aketa, Takiko Omote, Takahashi Takahashi, Masayu ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 697-703
    Published: December 25, 2004
    Released: October 15, 2016
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    Fine vascular network is developed in subepithelial layer of bronchial mucosa. We examined the changes of fine vascular network of bronchial mucosa of airway diseases by using a side viewing type high magnification bronchovideoscope (XBF240HM5, Olympus Co.) . Patieuts and methods. Eleven cases with bronchial asthma (BA), 12 cases with chronic bronchitis and 17 cases with sarcoidosis were examined by using image analyzing apparatus (Solemio ENDO ProStudy, Olympus Co.) about vessel area ratio, vessel length ratio, vessel length to area ratio, and hemoglobin index (IHb). Twenty three cases with neoplastic diseases (6 cases with adenocarcinoma, 6 cases with squamous cell carcinoma, 4 cases with small cell carcinoma, 7 cases with metastatic lung cancer) were examined in the same way. Control subjects were 15 cases without airway disease.
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  • Kazuhiro Yasufuku, Masako Chiyo, Takekazu Iwata, Tomoyasu Yashiro, Har ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 704-710
    Published: December 25, 2004
    Released: October 15, 2016
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    Endobronchial ultrasound (EBUS) guided biopsy in respiratory disease is a promising new modality. The radial probe EBUS has been used for the biopsy of peripheral lung lesions using the guide sheath. In addition, theradial probe EBUS guided TBNA has increased the yield of TBNA of mediastinal lymph nodes. However it is still not areal-time procedure with target visualization. To overcome these problems, a new convex probe endobronchial ultrasound (CP-EBUS) with ability to perform real-time EBUS guided TBNA (EBUS-TBNA) was developed. EBUS-TBNAcan be used for (a) lymph node staging in lung cancer patients; (b) diagnosis of intrapulmonary tumors; (c) diagnosisof unknown hilar and/or mediastinal lymphadenopathy; and (d) diagnosis of mediastinal tumors. A total of 161 procedures have been done using the CP-EBUS. In 98 patients with lung cancer or suspected lung cancer, EBUS-TBNA wasperformed to obtain samples from 121 lymph nodes. The sensitivity, specificity, and accuracy of EBUS-TBNA in distinguishing benign from malignant lymph nodes were 92.3%, 100%, and 93.9%, respectively. EBUS-TBNA of mediastinaltumors or mediastinal lymphadenopathy was successfully performed in 26 patients. The procedure was uneventful andthere were no complications. EBUS-TBNA is a novel approach that is safe and has a good diagnostic yield. This new ultrasound puncture bronchoscope has an excellent potential in assisting safe and accurate diagnostic interventionalbronchoscopy in respiratory diseases.
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  • Michiaki Narushima, Jun Matsuishi, Jun Yamashita, Hajime Suzuki
    Type: Article
    2004 Volume 26 Issue 8 Pages 711-716
    Published: December 25, 2004
    Released: October 15, 2016
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    Medical thoracoscopy is used for the diagnosis of the pleurai diseases, and there are many reports about usefulness of this method. For domestic 26 facilities, the questionnmaire survey about current situations of medical thoracoscopy for pleural diseases was carried out. In the examination purpose, there were 16 facilities for diagnosis of pleural exsudates, and also 9 facilities on carrying out the treatment of acute empyema. In the optimal timing of this method, there were most many facilities which replied that it was done, when the diagnosis was not given in the examination of pleural effusion, with 1 5 facilities. Though there were many facilities with high diagnostic rate , the high rate t,ended to have been obtained in the facilities which carried out this examination early. Average number of this examination in one month is I or 2 cases in each facility, so this method has not been widely spread yet. Medical thoracoscopy is a useful method for the diagnosis of pleural diseases wlth the high diagnostic rate, and pulmonologists who are most familiar to flexible bronchoscope can relatively perform it easily. So we strongly desire this method with flexible bronchoscope widely spread in Japan.
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  • Katsuhiko Shimizu, Norihiko Ikeda, Masahiro Tsuboi, Takashi Hirano, Ha ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 717-721
    Published: December 25, 2004
    Released: October 15, 2016
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    he purpose of this study was to evaluate the usefulness of percutaneous CTguided transthoracic needle biopsy (CTNB) for lung cancers less than 2 cm in size and to analyze the factors influencing the diagnostic yield, especially the difference between ground-glass opacity (GGO) and solid lesions. Patients and Methods. From 1999 to 2002,151 small lung cancers were resected in Tokyo Medical University Hospital. Among them, 96 patients (63.6%) received CTNB using the 19-gauge Tokyo Medical College Needle in order to obtain a preoperative diagnosis. Results. The diagnostic yields were 48.50/0 for lesions smaller than 10 mm, 62.50/0 for those 1 1-15 mm, and 83.90/0 for those 16-20 mm, respectively. The diagnostic yield in GGO-dominant lesions (GGO ratio ≧50%) and soliddominant lesions (GGO ratio < 49%) were 51.20/0 and 75.6%. (p=0.018) In the GGO-dominant group, the diagnostic yields were 35.2% for lesions smaller than 10 mm, 50.0% for those 11-15 mm, and 80.0% for those 16-20 mm.
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  • Fumio Imamura, Kiyonobu Ueno, Mana Yoshimura, Junji Uchida, Yoko Kusun ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 722-724
    Published: December 25, 2004
    Released: October 15, 2016
    JOURNALS FREE ACCESS
    We have developed a new staining method, rapid Shorr stain, and introduced it into brochoscopic examination. When the material obtained bronchoscopically is not diagnostic by rapid staining, additional procedures for diagnosis were performed immediately. This method improved diagnostic yield from 72% to 91%. We have applied brachytherapy for small peripherally-located lung cancer. Radioactive iridium needle was introduced into the tumors bronchoscopically or percutaneously. Radiation with I or 2 fractions was done. Radiation pneumonitis was generally mild, and local control of the tumors seemed to be almost comparable to surgical resection.
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  • Takeshi Shiraishi, Masafumi Hiratsuka, Satoshi Yamamoto, Akinori Iwasa ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 725-729
    Published: December 25, 2004
    Released: October 15, 2016
    JOURNALS FREE ACCESS
    The current acceptable procedure for surgical resection in Stage I non-small cell lung cancer (NSCLC) is generally full lobar or greater resection rather than limited resection. Segmental resection for Stage I disease remains controversial. Materials and Methods. We retrospectively analyzed patients undergoing lobectomy ( n=258) or segmentectomy (n=36) with systemic mediastinal dissection for clinically diagnosed Stage I non-small cell lung cancer between January 1994 and March 2003. This study was conducted to clarify whether segmentectomy is acceptable. Results. Cumulative survival in both groups was similar (p=0.646) , with a 5-year survival of 69.1% for lobectomy and 64.6% for segmentectomy. In patients with T≦2.0 cm, the pathologically node-negative group, 5-year survivals were 84.1% for lobectomy and 71.0% for segmentectomy, respectively.
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  • Isao Matsumoto, Makoto Oda, Yoshio Tsunezuka, Masaya Tamura, Masaya Ta ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 730-734
    Published: December 25, 2004
    Released: October 15, 2016
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    In recent years, small peripheral pulmonary lesions have been diagnosed with increasing frequency due to the development of high-resolution CT scanners. It is difficult to diagnose such lesions, which present as ground glass attenuation on chest CT and are often very small lesions. In such cases, thoracoscopic surgery is very useful. In addition, trials of limited resection for periphery small lung cancer have recently been conducted. In the present study, we evaluated the effects of thoracoscopic diagnosis and treatment for small peripheral pulmonary le
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  • Yoshinobu Ohsaki, Kiyoko Shibukawa, Shoko Nakao
    Type: Article
    2004 Volume 26 Issue 8 Pages 735-739
    Published: December 25, 2004
    Released: October 15, 2016
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    Bronchoscopy is one of the safest procedures in terms of incidence of major adverse events. However, even the incidence is rare; the adverse events can be fatal once it occurred. Adverse events, which are considered to be common in bronchoscopy, include major bleeding, pneumothorax, respiratory failure, asthmatic attack, myocardial infarction, arrhythmias, Iidocaine over-dosing, inflammation, worsening of airway obstruction. Improvement of unsafe condition under immediate discussion after the procedures rather than through the incident reporting system seems to be vital to decrease incidence of adverse events of bronchoscopy which are expected to be encountered during the procedure. Simulations imaging occurrence of the major adverse events seem to be another good way to reduce fatal accidents of bronchoscopy because a fail-safe can be measured by doing this. Surveillance of published articles about rare adverse events and sharing such information among members who will perform bronchoscopy seems to be important to avoid adverse events which are occasionally encountered in bronchoscopy.
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  • Makoto Oda, Isao Matsumoto, Yoshio Tsunezuka, Tetsuhiko Go, Masaya Tam ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 740-742
    Published: December 25, 2004
    Released: October 15, 2016
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    We reported and evaluated the efficacy, safety, complications of our methods for bronchoscopy. Patients and Methods. We reviewed consecutive 1235 patients who underwent bronchoscopy from April 1998. Patients were given no atropine sulfate. Midazolam was intravenously administered with different doses according to age. Results. No patients required atropine sulfate and no patients had mild to severe infections. Nine patients were inadequately sedated and 12 patients had hemorrhage. Conclusions. Our methods for bronchoscopy with intravenous sedation were safe and effective for patients.
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  • Hiroshi Semba
    Type: Article
    2004 Volume 26 Issue 8 Pages 743-745
    Published: December 25, 2004
    Released: October 15, 2016
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  • Yoshimasa Tanikawa, Masahiro Aoyama, Kousuke Honda, Seita Tsuji, Yoshi ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 746-750
    Published: December 25, 2004
    Released: October 15, 2016
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    As one of safety measures in the bronchoscope enforcement, disinfection and check of machinery are important matters. A guideline should have been observed about choice and a cleansing method of disinfectant, but there was always a problem in case of the practice in each institution, and we needed a disinfectant change to ortho-phthalaldehyde (OPA) from glutaraldehyde (GA) . Purpose. In order to investigate about the effectiveness of bronchoscope disinfection procedure by OPA. Methods. We cultured bacteria and mycobacterium of an internal channel, a biopsy port and a suction port after cleaning and disinfection by automatic washers/disinfectors in a 0.55% OPA after brush cleansing, about a series of 83 cases that performed a bronchoscope. Result. Bacterial culture became positive in 11 cases out of 83, an 1 1 specimen out of a 249 specimen. S. epidermidis was cultured in 7 specimens from biopsy port and I specimen from suction port, and Propionibacterium was in I specimen from biopsy port.
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  • Yasuhiro Shibuya, Yoshitoshi Komazaki, Hiroki Hayashi, Kumiko Baba, Ri ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 751-756
    Published: December 25, 2004
    Released: October 15, 2016
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    Testing Patients for blood-transmitted diseases such as HBS antigen, HCV antibody, HCV antibody before bronchoscopy have been performed widely in Japanese hospitals. Since introduction of diagnosis related group / prospective payment systems and evidence based infection controls into hospitals , screening for bloodtransmitted diseases before endoscopy have been reconsidered. We discussed the needs for such screening before bronchoscopy. Methods and results. We analysed a total of 406 bronchoscopy between 2002 to 2003 in Hiroo-general hospital. A total of 99.3% of brochoscopy was performed after screening. There was no occupational exposure of blood including sharps injury during the sametime at division of endoscopy. Discussions and Conclusions . Fiberoptic bronchoscopies are changed by every patients and wash and disinfected with orthophthalaldehyde by automatic sysyems in our hospital. We have no sharp injury related to bronchoscopy. When sharp injury was happened, blood infection examination can be performed at any time. We concluded screening for blood-transmitted diseases is unnecessary before bronchoscopy in the case of observance standard precautions.
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  • Hidehiko Yamamoto
    Type: Article
    2004 Volume 26 Issue 8 Pages 757-761
    Published: December 25, 2004
    Released: October 15, 2016
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    The most important factor pertaining to risk management in bronchoscopy is the informed consent. The physician should explain to the patient the purpose of bronchoscopy, the procedure itself, the possible complications, the safety measures, the alternative procedures if available, and the rights of the patient to decline or postpone the procedure. The physician should then get a written consent from the patient, if possible. During the procedure, the physician should strive for utmost comfort for the patient by administering the appropriate medication. In order to perform the procedure safely, the physician should gather information such as drug history, allergies, cardiac and pulmonary functions, liver functions and so forth. In order to prevent infection, the instruments used in bronchoscopy must be sterilized. Preventive measures for infection should be taken both for the patient and the medicai staff. When operating invasive measures such as biopsies, the physician must be prepared for massive hemorrhage. The operator must be able to distinguish subtle signs of hemorrhage, and must be able to respond to emergency situations.
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  • Masako Chiyo, Kiyoshi Shibuya, Hidehisa Hoshino, Takekazu Iwata, Tomoy ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 762-765
    Published: December 25, 2004
    Released: October 15, 2016
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    From October 2003 to May 2004, we conducted a detailed investigation on the use of a New AutoFluorescence Imaging (AFI) bronchovideoscope system: combined fluorescence-two reflectance imaging in the detection of early lung cancer and bronchial dysplasia. AFI consists of three signals which are an autofluorescence (460-690 nm) on excitation blue light (395-445nm) and two different bands of reflected light; G' (550nm) and R' (610nm). A total of 75 patients with suspected or known lung cancer were entered into this study. WLB and AFI detected 43 lesions, which consisted of lung cancers (n=12), squamous dysplasia (n=12), epipharynx carcinoma (N=1 ) and others (n=18) . The sensitivities of detecting cancer and dysplasia by WLB and AFI were 92% (23/25) and 96% (24/25) , respectively. And the specificity of AFI (66.6%) was higher than that of LIFE (38.8%). We conclude that AFI appears to be a signfficant advance in distimguishing preinvasive and malignant lesions from bronchitis.
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  • Koji Kanoh, Noriaki Kurimoto, Teruomi Miyazawa, Yasuo Iwamoto, Yuka Mi ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 766-771
    Published: December 25, 2004
    Released: October 15, 2016
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    We compared the usefulness of EBUS-guided TBNA using a double-channel bronchoscope (Double) and EBUS-guided TBNA using a single-channel bronchoscope (Single) and endoscopic ultrasound (EUS). Patients. 85 patients with mediastinal and/or hilar lymphadenopathy were included. Patients were randomized to undergo Double (n=30) or Single (n=25) or EUS (n=30). Methods. Double: The EBUS probe and the 19-gauge TBNA catheter were inserted simultaneously through a double-channel bronchoscope. Once the needle place
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  • Kenji Tsushima, Keishi Kubo, Takayuki Honda
    Type: Article
    2004 Volume 26 Issue 8 Pages 772-776
    Published: December 25, 2004
    Released: October 15, 2016
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    For the diagnosis of peripheral lung nodules, we compared the sensitivity of real-time multi-slice computed tomography-and X-ray television fluoroscopic guidance for performing bronchoscopy. Methods. First author performed and interpreted all bronchoscopies described in this study. Fiberoptic bronchoscopes (model BF 3C40 and BF P1O) were used. The diagnosis of malignant and benign was based on results of histopathologic examination, as well as clinical and imaging follow-up computed tomography. We also compared the diagnostic yields of tumor size between multi-slice computed tomography fluoroscopic guidance and X-ray TV fluoroscopic guidance. Results. Real-time multi-slice computed tomography fluoroscopic guidance was conducted in 82 patients. The tumor size of 82 peripheral nodules detected by real-time multi-slice computed tomography fluoroscopic guidance was < 10mm (n=21), 11-15mm (n=24), 16-20mm (n=19), 21-25mm (n=9), and >26mm (n=9) . The sensitivity of real-time multislice computed tomography fluoroscopic guidance was 62.2%.
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  • Yuka Miyazu, Teruomi Miyazawa, Keiko Hiyama, Yasuo Iwamoto, Atsuko Ish ...
    Type: Article
    2004 Volume 26 Issue 8 Pages 777-779
    Published: December 25, 2004
    Released: October 15, 2016
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    Although properly selected candidates for PDT with centrally located early-stage lung cancer have a good therapeutic outcome, some cases develop recurrence or multiple metachronous cancers shortly after successful PDT. We selected the patients with early stage lung cancer who were treated by PDT and followed for a long term after PDT. The preserved bronchial biopsy specimens taken from them were retrospectively examined for the expression of the telomerase protein i.n situ, by immunohistochemistry. While the patients who achieved long term CR after PDT showed no telomerase protein expression in non-cancerous epithelia, the patients who developed recurrence or multiple metachronous cancers showed positive telomerase protein expression in adjacent bronchial epithelia diagnosed as "normal epithelia" by H-E staining before cancer development. We propose that the detection of hTERT protein expression in non-cancerous bronchial epithelia in situ might become a possible indicator of a high-risk of developing lung cancer after PDT.
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  • Type: Appendix
    2004 Volume 26 Issue 8 Pages App2-
    Published: December 25, 2004
    Released: October 15, 2016
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  • Type: Appendix
    2004 Volume 26 Issue 8 Pages App3-
    Published: December 25, 2004
    Released: October 15, 2016
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  • Type: Index
    2004 Volume 26 Issue 8 Pages 1-4
    Published: December 25, 2004
    Released: October 15, 2016
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  • Type: Index
    2004 Volume 26 Issue 8 Pages 5-9
    Published: December 25, 2004
    Released: October 15, 2016
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  • Type: Appendix
    2004 Volume 26 Issue 8 Pages 10-11
    Published: December 25, 2004
    Released: October 15, 2016
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  • Type: Index
    2004 Volume 26 Issue 8 Pages 1-5
    Published: December 25, 2004
    Released: October 15, 2016
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  • Type: Index
    2004 Volume 26 Issue 8 Pages 6-11
    Published: December 25, 2004
    Released: October 15, 2016
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  • Type: Index
    2004 Volume 26 Issue 8 Pages 12-17
    Published: December 25, 2004
    Released: October 15, 2016
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  • Type: Cover
    2004 Volume 26 Issue 8 Pages Cover2-
    Published: December 25, 2004
    Released: October 15, 2016
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