岡山医学会雑誌
Online ISSN : 1882-4528
Print ISSN : 0030-1558
106 巻, 5-6 号
選択された号の論文の22件中1~22を表示しています
  • 北村 吉宏
    1994 年 106 巻 5-6 号 p. 443-450
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    Rgional cerebral blood flow (rCBF) was evaluated in 63 patients with Parkinson's disease (PD) by single-photon emission computed tomography (SPECT) using N-isopropyl-p-123I-iodoamphetamine (123I-IMP) as a tracer. Evaluation of the SPECT images was performed in accordance with the rCBF quantification method using a microsphere model. Patients in stage IV demonstrated significantly lower rCBF than those in stage II at the frontal, temporal, parietal, occipital regions and in the thalamus and celebellum. Subjects with mental sumptoms demonstrated decreased rCBF in every region in the brain. The present study indicates that clinical exacerbation and manifestation of dementia and other psychiatric symptoms in Parkinson's disease are associated with decreased blood flow in various brain regions.
  • 小林 博夫
    1994 年 106 巻 5-6 号 p. 451-460
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    To evaluate the role of the KATP channel in regulating coronary tonus in response to increases in myocardial oxygen consumption, and reactive hyperemia following ischemia, coronary blood flow was measured with glibenclamide, a KATP channel blocker (50μmol/l ic.) and pinacidil, a KATP channel opener, (10μmol/l ic.)
    The following interventions were applied in the control and during intracoronary infusions of glibenclamide alone or glibenclamide plus pinacidil: 1) intravenous infusion of isoproterenol (0.125μg/kg/min), 2) aortic constriction to raise the mean aortic pressure by 30%.
    The slope of the regression line of coronary conductance of myocardial oxygen consumption was significantly decreased with glibenclamide (p<0.05), but returned to the baseline with pinacidil, both during isoproterenol infusion and aortic constriction. Reactive hyperemia following a 20-sec coronary occlusion was also attennuated with glibenclamide and recovered with pinacidil.
    These findings suggest that the KATP channel regulates coronary artery tonus during the increase in myocardial oxygen consumption and transient myocardial ischemia.
  • 佐々木 高
    1994 年 106 巻 5-6 号 p. 461-471
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    The pathogenesis of pneumoconiosis following exposure to inorganic dust rsmains obscure. HTLV-I, known as a cause of adult T cell leukemia, has been reported to participate in various interstitial lung diseases. So, HTLV-I infection in patients with pneumoconiosis was investigated by detecting anti-HTLV-I antibodies by the indirect immunofluorescent method and the pX gene by polymerase chain reaction (PCR) and Southern blotting. Furthermore, various malignancies in pneumoconiosis were also analyzed in relation to HTLV-I infection. Three of 24 patients (12.5%) demonstrated anti-HTLV-I antibodies. Four of 5 patients including the 3 patients with antibodies demonstrated the pX gene. Various malignant diseases including myelodysplastic syndrome and lung cancer showed a higher incidence in patients with HTLV-I infection than in those without HTLV-I infection.
    These findings indicate that HTLV-I infection could play an important role in the pathogenesis of pneumoconiosis and complications of malignancy.
  • 水尾 浩三
    1994 年 106 巻 5-6 号 p. 473-482
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    To determine the role of the ATP-sensitive potassium channel (KATP channel) in myocardial function during myocardial ischemia, we evaluated regional myocardial shortening and myocardial blood flow using a constant, low flow perfusion system in open-chest dogs.
    Coronary blood flow was decreased to half the control level by constricting the perfusion line with a constant pressure throughout the experiment. Glibenclamide (G), a KATP channel blocker, and pinacidil (P), a KATP channel opener, was infused into the coronary perfusion line after the flow was reduced. When coronary flow was reduced, coronary perfusion pressure was decreased to 55% of the control value, segmental shortening (%SS) of the subendocardial myocardium from 18±2% to 13±2% (mean ± SEM) (P<0.05) and the subendocardial to subepicardial (endo/epi) blood flow ratio measured with colored microspheres ranged from 1.17±0.04 to 0.82±0.05 (p<0.05). The infusion of G caused further reduction of %SS to 3±1% (p<0.001) without eignificant change in the endo/epi blood flow ratio. Additional infusion of P improved %SS to 11±2%, which did not significantly differ from the pre-G value.
    The findings strongly suggest that KATP channels participate in maintaining myocardial function during ischemia.
  • 伊丹 滋人
    1994 年 106 巻 5-6 号 p. 483-492
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    A method for separating erythroblasts and measuring transferrin receptor (TfR) mRNA was developed to investigate the mechanism of TfR expression. Using this method, the relationship between TfR mRNA and the average number of stainable iron granules was examined. Erythroblasts were separated using immunomagnetic beads and mouse antiglycophorin A monoclonal antibody with a purity of 89.5±4.5% and a yield of 19.9±6.7%. Northern blot analysis was performed with these separated cells and the following results were obtained. A patient with iron deficiency anemia presented a higher TfR mRNA level and a lower average number of stainable iron granules than healthy volunteers. However, another patient with iron deficiency anemia and two patients with myelodysplastic syndrome demonstrated almost the same TfR mRNA levels as healthy volunteers. TfR mRNA appeared to be regulated by cellular iron, but other factovs such as hemoglobin may participate in this regulation. This newly developed method will be helpful in investigating the regulation of TfR mRNA and in clarifying the mechanism of iron metabolism in hematological disorders.
  • 第1編 悪性リンパ腫化学療法後の2次癌発症についての検討
    田川 真也
    1994 年 106 巻 5-6 号 p. 493-503
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    The risk of a second malignancy was analyzed in 23 patients with Hodgkin's disease (HD) and 177 with non-Hodgkin's lymphoma (NHL) who were initially treated with combination chemotherapy between 1976 and 1990. Amcng these patients, 3 cases of gastric cancer, 2 cases of lung cancer, 2 cases of hepatoma, one case of colon cancer, one case of cholangiocarcinoma and one case of acute myeloblastic leukemia were subsequently observed. Median age at diagnosis of lymphoma was 64 years in patients who developed subsequent malignancies but was 9 years higher than that for the entire lymphoma group. Median interval from start of chemotherapy to the appearance of second malignancy was 4.9 years and ranged from 1.9 years to 8.8 years. The 7-year cumulative risk of second malignancy in HD and NHL were 7.7% and 11.7%, respectively. In Hodgkin's disease, the incidence of stomach and lung cancers was significantly greater than expected incidence calculated on the basis of age-adjusted person-years. In non-Hodgkin's lymphoma, the incidence was also greater than expected for all malignancies except stomach cancer. This indicates that the incidence of solid malignancy as well as leukemia is higher in lymphoma patients after chemotherapy than in the general population.
  • 第2編 悪性リンパ腫におけるnatural killer活性の検討
    田川 真也
    1994 年 106 巻 5-6 号 p. 505-516
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    The natural killer (NK) activity of peripheral blood mononuclear cells (PBMC) from patients with malignant lymphoma was examined. In 54 untreated patients, the mean NK activity did not differ significantly from that in healthy controls. However, 17 (31%) of 54 patients showed low NK activity. NK activity did not correlate with the stage, histologic type or patient age. Significant reduction of NK activity was observed during combination chemotherapy. The mean NK activity in complete respondors (CRs) did not differ significantly from that in healthy controls. However, 5 (14%) of 37 patients who were disease-free for more than 3 years showed low NK activity. Low NK activity was frequently observed in long-term CRs with non-Hodgkin's lymphoma compared with negative PPD skin test, negative PHA skin test, low CD4/CD8 ratio and decreased response of PBMC to PHA and/or Con A. These results indicate that patients with malignant lymphoma have decreased immunity even while in long-term continuous remission and that measuring NK activity is useful for evaluating their immunologic status.
  • 第1編 抗原の繰り返し吸入による慢性喘息モデルの作製
    菅野 尚
    1994 年 106 巻 5-6 号 p. 517-525
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    To elucidate the cause of intractable asthma, guinea pigs were actively sensitized by intraperitoneal injection of ascaris suum as an antigen. We repeated the inhalation of aerosolized ascaris antigen eight times in the animal models which consisted of a non-treated group, a metopirone-treated group and a steroid-treated group. We investigated the course of asthmatic response by evaluating the ratio of expirations to inspirations after the inhalation challenge. The frequency of late asthmatic response (LAR) was increased by repeated inhalation of the antigen. There was no significant difference in the frequency between non-treated group and steroid-treated group, but the metopirone-treated group showed strong LAR compared with the other two groups. The intensity of LAR was gradually increased and that of immediate asthmatic response (IAR) was decreased in the metopironetreated group. Finally, we established a chronic asthma model in which LAR was strong and the asthma attack was prolonged over twenty-four hours. These results suggest that the model will be useful in clarifying the causes of intractable asthma in humans.
  • 第2編 肺局所や血液中における出現細胞及び液性反応に関する検討
    菅野 尚
    1994 年 106 巻 5-6 号 p. 527-537
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    To clarify the mechanism of intractable asthma, we examined the cellular content and chemical mediators in BALF and peripheral blood of a chronic asthma model which we had already established by inhalation of ascaris suum antigen. The serum levels of antigen specific IgG antibody on the eighth day were significantly higher than those before inhalation. The serum levels of antigen specific IgG1 antibody increased on the eighth day compared with levels before inhalation. The serum levels of antigen specific IgG2 antibody as a blocking antibody increased and immediate asthmatic response (IAR) gradually improved until the fourth day. The number of eosinophils after eight days of inhalation was decreased in peripheral blood but was significantly increased in BAL and lung tissue. The serum levels of LTC4 after eight days of inhalation decreased significantly compared to those after one day of inhalation. LTB4 concentrations in BAL after eight days of inhalation were significantly lower than those after one day of inhalation. Histamine concentrations were increased in BAL in both the IAR and dual asthmatic response (DAR) animal model. These data suggest that intractable asthma was induced by many kinds of chemical mediators produced by inflammatory cells including eosinophils, mast cell-basophils, neutrophils and lymphocytes.
  • 片木 幸恵
    1994 年 106 巻 5-6 号 p. 539-547
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    To clarify the mechanism of immunotherapy in bronchial asthma, the level of mite specific IgG subclass antibodies (total IgG, IgG1, IgG4) and the production of leukotrienes (LTB4, LTC4) released from leukocytes were examined.
    Eighteen mite-sensitive asthmatic patients who received immunotherapy with house dust extract for 1 year were divided into two groups, the responsive patients and non-responsive patients. Before treatment and 1 year after treatment, the levels of mite specific serum IgG subclass antibodies were measured by enzyme-linked immunosorbent assay (ELISA) and the levels of LTs were measured by high performance liquid chromatography (HPLC).
    In the responsive group, the level of mite specific serum IgG4 antibody was significantly increased (p<0.05), and the level of mite specific serum total IgG and IgG1 antibody was decreased. The release of LTB4 and LTC4 from leukocytes stimulated by mite antigen was significantly decreased (p<0.05, p<0.05).
    These results indicate that increases in the antigen specific IgG4 and the inhibition of chemical mediators play important roles in the mechanism of immunotherapy.
  • 野中 研一
    1994 年 106 巻 5-6 号 p. 549-560
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    Plasma levels of cyclic nucleotides were measured in 71 patients with acute leukemia [50 patients with acute nonlymphocytic leukemia (ANLL), five patients with hypoplastic leukemia, and 16 patients with acute lymphocytic leukemia (ALL)], five patients with myelodysplastic syndrome (MDS), and 47 healthy volunteers.
    The cyclic GMP (c-GMP) level, cyclic AMP (c-AMP) level, and c-AMP/c-GMP ratio in healthy volunteers were 15.74±5.10 pmol/ml, 3.20±1.15 pmol/ml and 5.39±2.18, respectively. In the patients with untreated acute leukemia other than hypoplastic leukemia, c-GMP levels were significantly elevated (ANLL: 11.31±13.61 pmol/ml; ALL: 10.66±7.23 pmol/ml) and c-AMP/c-GMP ratios were significantly reduced (ANLL: 2.01±1.03; ALL: 1.66±1.03). These values normalized at remission, then increased or decreased again with recurrence of the disease. Although patients with MDS showed normal c-GMP levels or c-AMP/c-GMP ratios, these values were increased or decreased when progression to acute leukemia occurred. There was correlation between c-GMP levels and peripheral leukocyte counts (r=0.429, p<0.05), plasma c-GMP levels and peripheral leukemic cell counts (r=0.412, p<0.05), c-AMP/c-GMP ratios and peripheral leukocyte counts (r=-0.577, p<0.05), c-AMP/c-GMP ratios and peripheral leukemic cell counts (r=-0.512, p<0.05), and c-AMP/c-GMP ratios and maximum counts of colonies derived from leukemic blast progenitors (r=-0.996, p<0.01).
    Since plasma levels of cyclic nucleotides reflect the leukemic cell proliferation, measurement of these nucleotides was considered useful for monitoring leukemic cell volume.
  • 猪木 篤弘
    1994 年 106 巻 5-6 号 p. 561-571
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    Various allergic mechanisms participate in the reversible bronchospasms of an asthma attack. Candida albicans was suspected as the causative antigen in late-onset and severe intractable asthma. In this study, inhalation provocation test was performed with Candida antigen to evaluate the asthmatic responses of asthmatic patients with positive skin reaction to Candida antigen. More than 20% decrease in peak flow after antigen inhalation was considered an asthmatic response and such responses were classified as immediate (IAR), late (LAR) or delayed (DeAR) depending on the time course after antigen inhalation.
    Provocation tests induced asthmatic responses in 26 (42.6%) patients and 11 (42.3%) showed DeAR. Eight of the 11 patients with DeARs had late onset asthma and 7 patients had intractable asthma. Furthermore, patients with DeAR showed higher lymphocyte responses to Candida antigen than those with IAR or LAR. These data indicate that EeAR to Canidia antigen plays an important role in the pathogenesis of severe intractable asthma.
  • 花房 純弘
    1994 年 106 巻 5-6 号 p. 573-585
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    To measure the intracellular ferritin (Ft) content in human erythroid cells, a new method was developed using human bone marrow smears. With this method, Ft, transferrin receptors (TfR) and stainable iron granules (SIG) were semiquantified at the single cell level and the cell's maturation level was identified. The relationship between Ft and other parameters was investigated. Ft-H subunit concentrations were found to decrease with maturation from basophilic to orthochromatic erythroblasts (r=-0.62, p<0.05) and further decreased after denucleation. There was significant positive correlation between the Ft-H subunit concentration and TfR density (r=0.52, p<0.01), but the relation between the Ft-L subunit and TfR or the density of SIG was obscure. These data indicate that: 1) The Ft-H subunit might play a more important role than the Ft-L subunit during iron metabolism and differentiation of erythroid cells. 2) Some factors other than intracellular iron level, such as maturation, seem to play important roles in the Ft expression in erythroid cells.
  • 中村 達
    1994 年 106 巻 5-6 号 p. 587-598
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    To investigate clinical management of acute nonlymphocytic leukemia (ANLL) in the aged, the chemotherapeutic effects of aclarubicin (ACR) were studied in 20 ANLL patients (M1 5, M2 3, M4 5, M5b 6, M6 1). All patients were over 70 years old. The ratio of male to female was 16:4 and age ranged from 70 to 84 years old (median: 76y/o). Nineteen patients were untreated, one case had previous treatment and 2 patients showed hypoplastic marrow on admission. ACR was administered by intravenous drip infusion at a dose of 14mg/m2/day for 7-10 days and repeated after recovery of myelosuppression. Eight patients (40%) obtained complete remission (CR): 1 of 5 M1 (20%), 3of 5 M4 (60%), 4 of 6 M5b (66.7%) and none of M2 or M6. CR ratio was 44% in 18 typical ANLL patients excluding the two patients with hypoplastic marrow, who did not attain CR. The duration of CR was from 1.3 to 11.3 months (median: 7.3 months) and survial time ranged from 6.6 to 15.6 months (median: 11.8 months) in patients with CR. Although side effects on the digestive system such as nausea, vomiting and anorexia were seen in 11 of 20 patients, these effects were controllable. None of the patients showed cardiac toxicity. ACR is expected to be useful in the clinical management of ANLL in patients over 70 years old, especially for M4 and M5 in the aged.
  • 中東 廣志
    1994 年 106 巻 5-6 号 p. 599-611
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    Eosinophils were isolated from peripheral blood of healthy individuals, asthmatic subjects and patients with PIE syndrome using discontinuous Percoll gradients. Morphological changes of eosinophils stimulated with anti-IgG, anti-IgE and CaI were observed by the direct count method. Furthermore, the number of immunoglobulin receptors on eosinophils was evaluated by SEM using anti-IgG and anti-IgE linked carboxylate modified latex particles. Eosinophil reactivity after these stimuli was significantly elevated compared to controls. Reactivity was dependent on calcium ions, but FMLP did not affect the reactivity. IgE as well as IgG receptors were significantly expressed on the surface of eosinophils. A positive correlation between the appearance of reactive eosinophils and the expression of these immunoglobulin receptors was recognized. Correlation in patients with bronchial asthma or PIE syndrome was signifcantly higher than that in healthy individuals. The appearance of reactive eosinophils after stimulation with anti-IgG was remarkably higher than that after anti-IgE stimulation. The expression of IgG receptors was also higher than that of IgE receptors.
    These results suggest that observing morphological changes in eosinophils may be useful for analyzing the pathogenesis of allergic diseases.
  • 前川 清明
    1994 年 106 巻 5-6 号 p. 613-620
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    To investigate the role of endothelium-derived nitric oxide (EDNO) and adenosine in functional myocardial hyperemia, we examined the effect of NG-nitro-L-arginine (NNLA) and 8-p-sulfophenyl-theophylline (8-ST) on coronary vasodilation in response to increased myocardial oxygen consumption (MVO2) in anesthesized dogs. NNLA significantly attenuated the increase in coronary conductance from 28±6% to 16±2% with atrial pacing, from 69±5 to 36±6% with isoproterenol and from 25±6% to 9±4% with constriction of the aorta. The combined administration of NNLA and 8-ST did not further change coronary conductance. It appears that EDNO may play an important role in functional hyperemia. EDNO and adenosine may interact to produce coronary vasodilation when MVO2 increases.
  • 第1編 早期腺癌の検討
    森 公介
    1994 年 106 巻 5-6 号 p. 621-629
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    One-hundred-twelve patients with pulmonary adenocarcinoma 2cm or less in diameter on chest radiograph were found by mass screening between 1981 and 1989. Of these patients, 92 underwent surgical resection of the tumor. To detect early pulmonary adenocarcinoma more efficiently by mass screening using annual chest radiographs, clinical and radiographic features of the 92 patients were examined and the following results were obtained.
    1) Twenty-nine patients with a tumor 1.5cm or less in diameter on the resected specimen were all in pathological stage I and the five-year survival rate was 100%.
    2) In 63 patients with a tumor between 1.6cm and 2.0cm in diameter, the five-year survival rate was 83.5%. Of those, 6 (13%) patients had advanced lung cancer, all of which could be detected on the previous chest radiograph by retrospective analysis.
    These results indicate that efforts to detect tumors 1.5cm or less in diameter are important to improving the efficiency of mass screening. For this purpose, it is necessary to obtain a chest radiograph of good quality and learn to identify the radiographic features of early pulmonary adenocarcinoma.
  • 第2編 早期X線所見に関する検討
    森 公介
    1994 年 106 巻 5-6 号 p. 631-639
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    To clarify the radiographic features of early lung cancer, the author investigated annual chest radiographs of 234 patients with lung cancer detected by mass screening. Abnormality could be detected on the previous radiographs in 79% of the patients when reviewed retrospectively. The causes for failing to detect the tumor on the previous examination were as follows: 1) It was too small or too faint to detect. 2) It overlapped with other organs such as vessels or ribs or coexisted with the preceding pulmonary lesions. 3) In some instances, only a linear (non-tumorous) shadow was initially present on chest radiograph.
    These results indicate that systematic and careful reading of chest radiograph and comparative reading with the previous films are necessary, and that it is important to learn the causes for failing to detect the tumor shadow.
  • 杉本 啓介
    1994 年 106 巻 5-6 号 p. 641-654
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    Various cytokines are known to participate in the pathogenesis of interstitial pneumonia follewed by lung fibrosis due to the proliferation of fibroblasts and production of collagen fibers.
    Patients with interstitial pneumonia including idiopathic interstitial pneumonia (IIP) and interstitial pneumonia with collagen vascular disease (IP with CVD) were examined by bronchoalveolar lavage (BAL). Cytokines such as IL-1α, TGF-α, and TGF-β in BAL fluid were measured by enzyme linked immunosorbent assay (ELISA). The concentrations of TGF-α and TGF-β in BAL fluid of patients with IIP and IP with CVD were higher than those of normal control, while IL-1α in BAL fluid was detected in few patients. The level of TGF-β in BAL fluid was higher in patients with greater decreases in pulmonary function and overt fibrosis on chest X-ray film, although TGF-α was higher in patients with milder disorders. The concentrations of TGF-α and TGF-β showed positive correlation with soluble IL-2 receptor as well as procollagen type III in BAL fluid.
    These results indicated that cytokines regulating lung fibrosis play important roles in the pathogenesis of interstitial pneumonia.
  • 小倉 俊郎, 長宅 芳男, 槇野 博史, 原本 俊則, 松本 光仁, 平松 信, 味埜 泰明, 西村 誠明, 谷合 一陽, 熊谷 功, 河本 ...
    1994 年 106 巻 5-6 号 p. 655-661
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    The beneficial effect of recombinant human erythropoietin (EPO) for renal anemia in patients with chronic hemodialysis has been established. EPO is reported to be effective against renal anemia when administered at a dose of 3, 000 units three times a week. However, only a few studies have been made on the therapy to maintain the anemia-improving effect of EPO. In the present study, we performed EPO maintenance therapy on 22 hemodialysis patients with renal anemia. EPO was initially administered at a dose of 3, 000 units three times a week, and maintenance therapy was initiated after 12 weeks of treatment. The patients were divided into two groups, with EPO being administered at a dose of 1, 500 units twice a week to one group and three times a week to the other. The duration of maintenance therapy was set at eight weeks. The anemia-improving effect of EPO was found to be satisfactorily maintained in both groups and no significant difference was noted between them. Accordingly, it may be better to use the lower dose regimen of 1, 500 units twice a week for the maintenance therapy of renal anemia.
  • 岡 隆彦, 友田 純, 小橋 春彦, 坂井 宣行, 坂口 孝作, 山本 和秀, 東 俊宏, 伊藤 俊雄, 山田 剛太郎, 辻 孝夫
    1994 年 106 巻 5-6 号 p. 663-668
    発行日: 1994年
    公開日: 2009/03/30
    ジャーナル フリー
    We report a 75-year-old female with diabetes mellitus complicated with celiac arterial obliteration and hepatocellular carcinoma (HCC). She had been treated with diet therapy by her family doctor for essential hypertension and diabetes mellitus and was referred to our hospital because a space occupying lesion (SOL) was detected in the liver by abdominal CT examination. The SOL was confirmed as hepatocellular carcinoma by ultrasonography and magnetic resoance imaging. Celiac angiography revealed complete obliteration of the celiac artery probably due to diabetic macroangiopathy. Since the deterioration of the liver function was not conspicuous, it was suggested that the development of HCC was affected by diabetes mellitus.
  • 1994 年 106 巻 5-6 号 p. 669-700
    発行日: 1994年
    公開日: 2012/10/29
    ジャーナル フリー
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