Author Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Hamada, Masanori| Yamaoka, Kiyonori| Tanizaki, Yoshiro|
Published Date 2004-12-01
Publication Title 岡大三朝医療センター研究報告
Volume volume75
Content Type Departmental Bulletin Paper
JaLCDOI 10.18926/21120
Title Alternative Clinical effects of swimming training in a hot spring pool on bronchial asthma
FullText URL 053_035_043.pdf
Author Tanizaki, Yoshiro| Komagoe, Haruki| Sudo, Michiyasu| Murashima, Makoto| Okada, Chiharu| Morinaga, Hiroshi| Kobashi, Hidetoshi| Tada, Shinya| Kimura, Ikuro|
Abstract Five severe bronchial asthma patients with glucocorticoid therapy have had free swimming training in the hot spring pool at Misasa Medical Branch. The clinical effect of the swimming training was evaluated after 3 months' training. 1. A slight increase in pulse rate and blood pressure was observed immediately after 30 minutes, swimming, although no significant increase in the two parameters was shown 30 min. after the training. 2. No significant fall in ventilatory function tests such as % FVC, FEV(1.0)%, V(50) and V(25) was demonstrated following the swimming training in a hot spring pool. The results suggest that the free swimming training in a hot spring pool does not induce bronchoconstriction. 3. Clinical efficacy of the swimming training on bronchial asthma was evaluated according to a treatment score, an attack score and an asthmatic score. These scores were decreased during the swimming training. The results obtained in this study showed that free swimming training in a hot spring pool is one of the most suitable therapies for severe bronchial asthma patients.
Publication Title 岡山大学温泉研究所報告
Published Date 1983-03-25
Volume volume53
Start Page 35
End Page 43
ISSN 0369-7142
language 日本語
File Version publisher
NAID 40000321171
JaLCDOI 10.18926/15518
Title Alternative Clinical significance of spa therapy in patients with steroid-dependent intractable asthma
FullText URL 065_119_127.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Yokota, Satoshi| Takata, Ichiro|
Abstract 気管支喘息のなかでも,副腎皮質ホルモン依存性の喘息は,もっとも重症難治性であり,薬物療法のみでコントロールすることは極めて困難である。著者らの現在までの成績では,このようなステロイド依存性重症難治性喘息に対して,温泉療法は有効であった。このことは,喘息の治療,とりわけ重症難治例の治療には温泉療法が必要不可欠であることを示している。今回は,その臨床的有用性および機序について,若干の考察を加えた。1.臨床病型では,Ib型やII型に重症難治症例が多く,温泉療法はこれらの病型に対して有効であった。2.年齢別検討では,発症年齢では30才以上,また現年齢では40才以上の症例に対して温泉療法は有効であった。3.温泉療法による換気機能の改善では,小ないし細気管支領域の閉塞の改善がより高度であった。4.温泉療法により,気道過敏性が低下することが観察された。5.温泉療法により,高度に低下した副腎皮質機能の改善が見られた。5.ヨードゾル吸入,鉱泥湿布療法,温泉プール水泳ないし歩行訓練などが,喘息の治療に適した温泉療法と判断された。
Abstract Alternative It is very difficult or sometimes impossible for phisicians to control steroid-dependent intractable asthma (SDIA) without glucocorticoids because of the severity of asthma and low responsiveness to usual antiasthma drugs. Our previous studies have shown that spa therapy improves the symptoms and signs of patients with SDIA, suggesting that spa therapy is highly required for the treatment of SDIA. In this article, the effects and action mechanisms of spa therapy on SDIA were summarized according to the results previously described. 1. Spa therapy is more effective in patients with hypersecretion (type Ib) and bronchiolar obstruction (type II) than in those with simple bronchoconstriction (type Ia). 2. Spa therapy is more effective in patients with the age at onset over 30, and in those with the age over 40 years. 3. Obstructive dysfunction in small airways is more improved compared to that in medium or large airways by spa therapy for asthma patients. 4. Bronchial hyperresponsiveness of asthma patients is suppressed by spa therapy. 5. Markedly suppressed function of adrenocortical glands is improved by spa therapy. 6. Complex spa therapy including swimming training in a hot spring pool, inhalation of iodine salt solution and fango therapy is effective and clinically useful for the treatment of asthma patients.
Keywords 重症難治性喘息 (intractable asthma) 換気機能 (ventilatory function) ヨードゾル吸入 (inhalation of iodine salt solution) 鉱泥湿布療法 (fango therapy) 温泉プール水泳訓練 (swimming training in a hot spring pool)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 119
End Page 127
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307310
JaLCDOI 10.18926/15334
Title Alternative Spa therapy for bronchial asthma. Spa therapies effective for bronchial asthma and problems in future.
FullText URL 064_105_110.pdf
Author Tanizaki, Yoshiro|
Abstract 気管支喘息に対する温泉療法の作用,あるいは効果は,直接作用と間接作用,局所作用と全身作用,即時的効果と遠隔効果などに分類される。気管支喘息に対する温泉療法の直接作用としては,呼吸器症状およびそれに関連した検査成績の改善として,また間接作用としては副腎皮質機能の改善作用がみられる。一方,気管支喘息に有用な温泉療法としては,温泉プール水泳訓練,ヨードゾル吸入療法,および鉱泥湿布療法などが明らかにされており,現在これらの温泉療法を組み合わせた複合温泉療法が行われている。気管支喘息はその臨床病態より,Ia-1.Ia-2,Ib,およびII型に分類される。このうち,特にIb型やII型は薬物療法のみではコントロールし難い重症難治性喘息を多く含んでいる。温泉療法は,気管支喘息全般に有効であるばかりでなく,特に薬物療法のみではコントロール困難なIb型やII型の喘息に対しても有効である。しかし,今後新たに気管支喘息に有用な温泉療法を考案して行かねばならない。
Abstract Alternative Actions or effects of spa therapy on bronchial asthma are divided as follows : direct and indirect actions, actions for organs and whole body, and immediate and distant effects. Direct actions of spa therapy on asthma are observed in improvement of clinical symptoms and examination results related to clinical symptoms, and indirect actions of the therapy are found in improvement of suppressed function of adrenocortical glands. It has been clarified that swimming training in a hot spring pool, inhalation of iodine salt solution, and fango therepy are effective in patients with asthma. The combination of these three spa therapies is now administered for the treatment of asthma. Bronchial asthma is classified into four types accoding to clinical symptoms : Ia-1, Ia-2, Ib, and II. Type Ib and type II asthma include many of intractable asthma, and spa therapy is effective even in these intractable asthma that is difficult to control without glucocorticoids. It is necessary to develop newly devised spa therapy that is more effective in patients with asthma.
Keywords 温泉療法 (Spa therapy) 温泉プール水泳訓練 (Swimming training in a hot spring pool) ヨードゾル吸入 (Inhalation of iodine salt solution) 鉱泥湿布療法 (Fango therapy) 気管支喘息 (Bronchial asthma)
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 105
End Page 110
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307660
JaLCDOI 10.18926/15333
Title Alternative Spa therapy for bronchial asthma. Inhalation therapy with hot spnng water and iodine salt solution
FullText URL 064_111_115.pdf
Author Tanizaki, Yoshiro|
Abstract 慢性閉塞性呼吸器疾患,特に気管支喘息に対する温泉療法は.温泉療法そのものの効果以外に,温泉保養地の周囲環境が疾患に極めて良好であるという利点を有している。温泉水やヨードゾルによる吸入療法は,気管支喘息に対して有効であるが,治療効果をより良好なものにするためには,各喘息症例の気道内病態を十分把握しておく必要がある。板状貯留を呈する過分泌型喘息や細気管支閉塞型喘息に対しては,吸入療法の効果は一般的に低い。代表的なヨー ドゾル吸入療法の臨床効果は,気管支喘息20例中,著効4例(20%),有効11例(55%),やや有効4例(20%),無効1例であった。
Abstract Alternative In spa therapy for chronic obstructive pulmonary diseases, especially bronchial asthma, there are some advantages that the atmosphere around the health resort where spa therapy is administered is beneficial for the diseases as well as spa effects themselves. There are several kinds of inhalation methods and drugs used for inhalation. Although inhalation therapy uslng hot spring water and iodine salt solution is effective in bronchial asthma, analysis of pathophysiologlcal changes is the airways of asthma is necessary to increase effects of the therapy. Inhalation therapy is in general low in patients with hypersecretion or with bronchiolar obstruction. The clinical effects of inhalation therapy with iodine salt solution, which is one of the representative inhalation therapies, were marked in 4 (20%), moderate in 11 (55%), slight in 4 (20%), and of no value in one of the 20 asthma patients.
Keywords 温泉療法 (Spa therapy) 吸入療法 (Inhalation therapy) 温泉水 (Hot spring water) ヨードゾル (lodine salt solution) 気管支喘息 (Bronchial asthma)   
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 111
End Page 115
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307467
JaLCDOI 10.18926/15315
Title Alternative Effects of the spring water on the dissolution of aminophylline tablet and theophylline sustained-release preparations
FullText URL 064_060_064.pdf
Author Mimaki, Yuichi| Fujii, Yoshihiro| Furuno, Katsushi| Gomita, Yutaka| Araki, Yasunori| Tanizaki, Yoshiro|
Abstract 薬物のbioavailabilityに影響する因子の一つとして,製剤からの薬物の溶出速度が考えられる。今回,温泉水による薬物溶出への影響を知る目的で,気管支喘息治療薬のアミノフィリン製剤およびテオフィリン徐放製剤の溶出挙動について検討した。溶出試験は第12改正日本薬局方に従い,第1法(回転バスケット法)および第2法(パドル法)で行い,試験液を蒸留水および三朝温泉水として両者の溶出挙動を比較した。アミノフィリン製剤では,10分後まで 温泉水の方が有意に高い溶出率を示した。また,テオフィリン徐放製剤においても温泉水が8時間後まで蒸留水に比べて有意に高い溶出率を示した。以上の結果より,アミノフィリン製剤およびテオフィリン徐放製剤は温泉水により薬物の溶出が促進されることか示唆された。
Abstract Alternative The dissolutions of aminophylline tablet and theophylline sustained-release preparattions in Misasa spring water were examined using the rotating basket and paddle methods. The dissolution rate of aminophylline tablet with the spring water was higher than that with distilled water from starting to 10 min after the test. In theophylline sustained-release preparations, the spring water showed a facilitation on the dissolution rate in comparison to the distilled water for 8 hours after the test. These results indicate that the spring water enhanced the releasing rates of aminophylline tablet and theophylline sustained-release preparations.
Keywords 溶出試験 (Dissolutionte test) 温泉水 (Spring water) 気管支喘息治療薬 (Bronchial asthma therapeutic drug)
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 60
End Page 64.
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307434
JaLCDOI 10.18926/15163
Title Alternative Relationship between vertebral transformation (or fracture) and bone mineral density in lumbar vertebrae.
FullText URL 065_115_118.pdf
Author Nakai, Mutsuo| Akiyama, Tsuneo| Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Mifune, Takashi| Tanizaki, Yoshiro|
Abstract QCTによる腰椎海綿骨骨塩量と,圧迫骨折を含む,椎体(第11胸椎~第4腰椎)の変形率の関係を検討した。椎体変形率と腰椎QCT値の間の強い相関関係が確認され,椎体変形者全体の50%はQCT値70mg/cm(3)以下に分布し,90%は125mg/cm(3)以下に分布した。さらに,この70mg/cm(3)付近での椎体変形者の割合は50%であり,125mg/cm(3)付近での椎体変形の割合は10%であった。QCTによる腰椎海綿骨骨塩量測定値は,腰椎の変形および骨折の危険性を予 測する良好な指標であることが確認できた。
Abstract Alternative In 360 females, Bone mineral density (BMD) in lumbar vertebrae (L2-L4) was assessed by quantitative computed tomography (QCT), and the values obtained were compared with the frequency of vertebral transformation or fracture as assessed by lateral scan image (scanogram) by X-ray CT. A correlation was observed between the frequency of vertebral transformation (or fracture) and lumbar BMD values : BMD under 125mg/cm(3) was observed over 90% of women with vertebral transformation, and BMD under 70mg/cm(3) was found about 50% of them. These results suggest that decrease in BMD in lumbar vertebrae leads to vertebral transformation or fracture. Thus, measurement of BMD by QCT would be very useful in predicting vertebral transformation or fractures.
Keywords 骨粗鬆症 (osteoporosis) 骨塩量 (bone mineral density) QCT (quantitative computed tomography) 腰椎 (lumbar vertebrae)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 115
End Page 118
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307136
JaLCDOI 10.18926/15162
Title Alternative Clinical opplication of a newly developed radiographic system including a fluoroscope equiped with CCD and digital image processor
FullText URL 065_107_114.pdf
Author Akiyama, Tsuneo| Nakai, Mutsuo| Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Mifune, Takashi| Tanizaki, Yoshiro| Ochi, Koji| Riaz, Chowdhury| Satou, Masataka| Ukon, Hiroe|
Abstract 画像の入力部に世界初100万画素の多画素・高精細のCCD(電荷結合素子)を用いたテレビカメラを搭載したX線テレビ装置とDigital・Radiography装置を導入し,主に消化管検査を中心に多目的に任用した。このシステムは従来のscreen/filmシステムの持つ膨大な情報量を確保しながらCCDカメラのメリットを最大限に生かしており,DRシステムの特長であるリアルタイムのCRT撮影画像表示,透視像のFREEZE確認,動態解析,画像処理等を導入することにより診断能の向上がはかれた。更に,従来X線フィルム・撮像管に比較して被曝量の大幅な低減が期待できた。また,デジタルであるため撮影像をHDに保管すると共にMODにも記録・再生が可能である。今後,PACSやフイルムレス電子媒体保管への展開の可能性についても確認できた。
Abstract Alternative We have clinically applied a newly developed radiographic system which was introduced into our institute in April 1994. This system consists of a fluoroscope, CCD (charge-coupled device) which had a million matrix, and digital image processor. This system has following advantages comparison with a conventional radiographic system ; (1) doses of x-ray exposuce during examination is less, (2) a sharp fluoroscopic image can be obtained by real-time image processing, (3) radiographic images can be kept in the recording device such as hard disc (HD) and magnetic optical disc (MOD) since this has a digital radiographic system. By connecting this system with main online system, it is expected to be able to see the various diagnostic images simulataneously as well as laboratory data at different spots of the hospital which is now available in other hospltal.
Keywords 増感紙/フイルム (Screen/Film) 光電子増倍管 (Image・Intensifier (l・I)) デジタル・イメージング (Digital・Imaging) 電荷結合素子 (CCD) 光磁気ディスク (MOD) デジタルラジオグラフィ (Digital Radiography)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 107
End Page 114
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307511
JaLCDOI 10.18926/15161
Title Alternative Clinical studies on polypoid lesions of the colon.
FullText URL 065_101_106.pdf
Author Takata, Ichiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Matsumura, Tadashi| Yokota, Satoshi| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo| Akiyama, Tsuneo| Nakai, Mutsuo|
Abstract 1990年4月より1994年3月末までの間に岡山大学医学部附属病院三朝分院で経験した早期大腸癌を含む大腸ポリープ88例を対象に,病理組織診断,性別,年齢構成,存在部位,精査動機について検討を行い,以下の成績を得た。(1)ポリープの69.2%は腺腫,13.2%は腺癌(早期癌)であった。(2)男女とも加齢による大腸ポリープ及び大腸癌の頻度の増加がみられた。(3)50歳未満の若年者では右側結腸にポリープが発見されることは稀であったが50歳以上では6.5%に認められ,高齢者における積極的なtotal colonoscopyによる観葉が重要であることが再確認された。(4)精査動機では便潜血陽性が最多を占め,便潜血は大腸ポリープのスクリーニングにおいて有用であることが示された。またフォローアップ目的に大腸ファイバーを施行しポリープや早期癌を発見した例も多く,フォローアップの必要性が示唆された。
Abstract Alternative Polypoid lesions, taken by a colon fiberscope, were examined in 88 patients with polyp, who were admitted to Misasa Medical Branch, Okayama University Medical School for last 4 years. (1) Pathohistological examination of the polypoid lesions resulted in 69.2% of adenoma and 13.2% of adenocarcinoma (early cancer) ; (2) 35.5% of the polypoid lesions was detected in the sigmoid colon, 32.7% in the rectum, 16.8% in the transverse colon, 4.7% in the descending colon, 3.7% in the caecum, 1.9% in the ascending colon ; (3) The number of patients with polypoid lesion or colon cancer was increased with aging ; (4) Patients with the age under 50 years did not have polypoid lesion in the right hemicolon, while 6.5% of elder patients over age 50 has polypoid lesions in the right hemicolon ; (5) Occult blood in stool was the most popular motivation for receiving colonoscopic examinations ; (6) The second popular motivation for colonoscopy was for follow up after previous examinations. These results suggest that patients with age over 50 should be examined more carefully by total colonoscopy, and a hemoccult test in stool is an effective method for screening colonic polypoid lesions and after detection of polypoid lesions or polypectomy, reexamination by total colonoscopy is important at regular intervals.
Keywords 大腸ポリープ (Polyp of the colon) 大腸早期癌 (Early cancer of the colon) 便潜血 (Occult blood in stool)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 101
End Page 106
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307396
JaLCDOI 10.18926/15160
Title Alternative A case report of mixed connective tissue disease.
FullText URL 065_096_100.pdf
Author Takata, Ichiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Matsumura, Tadashi| Yokota, Satoshi| Tanizaki, Yoshiro|
Abstract 症例は50歳女性で,1991年頃より両肘関節の疼痛とレイノー現象を自覚するようになり前医にて慢性関節リウマチ(Rheumatoid arthritis, 以下RAと略)との診断を受け加療受けるも症状の改善なく,当科を受診した。典型的な慢性関節リウマチの症状に乏しく,他の膠原病の存在を疑って検索したところ,抗RNP抗体陽性等の所見から,混合性結合組織病(mixed connective tissue disease, 以下MCTDと略)と診断した。MCTDは初診時に慢性関節リウマチと誤診される例が多く,慢性関節リウマチに非典型的な症状を伴う場合は,MCTDが鑑別診断として重要と考えられた。
Abstract Alternative A 50-year-old woman, diagnosed as rheumatoid arthritis (RA) in 1991, had been treated with Lobenzarit disodium and non steroidal anti-inflammatory drugs (NSAIDs) before administration at our hospital. Despite the treatment with these drugs, her symptoms did not improve. She was admitted to our hospital for her progressive bilateral elbow joint pain and Raynaud's phenomenon. Although abnormal values of laboratory examinations such as an increased ESR (64mm/1hr), increased level of serum IgG (2854mg/㎗) and a positive RA test were shown, the clinical features of classical RA were not clear. There, she was diagnosed as mixed connective tissue disease (MCTD), because of high level of anti-RNP antibody in serum, Raynaud's phenomenom, multiple arthritis and constrictive ventilatory disturbance. Her symptoms and the results of labolatory examinations were clearly improved by glucocorticoid therapy.
Keywords 混合性結合組織病 (MCTD) 慢性関節リウマチ (Rheumatoid arthritis) 抗RNP抗体 (Anti-RNP antibody)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 96
End Page 100
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307772
JaLCDOI 10.18926/15159
Title Alternative Effects of salbutamol and disodium cromoglycate on Specific Airway Resistance (sRaw) and Specific Conductance (sGaw) in Bronchial asthma and Rheunmatoid arthritis.
FullText URL 065_087_095.pdf
Author Yokota, Satoshi| Kitani, Hikaru| Mifune, Takashi| Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Takata, Itiro| Tanizaki, Yoshiro| Tada, Shinya| Harada, Mine|
Abstract サルブタモールまたはdisodium cromoglycate(クロモリン)吸入液を,気管支喘息(以下BA)6例,慢性関節リウマチ(以下RA)7例,正常対照5例に吸入させ,吸入前および吸入後約30分に,気道抵抗(sRaw)と気道コンダクタンス(sGaw)を,定容積型体プレチスモグラフ(Sensor Medics Corporation, Anaheim, California, made in U.S.A.)を用いて測定した。吸入前の値をsGawで比較すると,BAはRAや正常対照に比べ有意に閉塞の程度が強く,RAと正常対照の間では有意な差はなかった。サルブタモール吸入の場合,BAでは吸入後にsRawおよびsGawの有意な改善(P<0.01)がみられ,それらの改善率(%)は,RAや正常対照と比べて有意に高く(P<0.01),RAと正常対照の間では改善率の有意な差は認めなかった。クロモリン吸入の場合,いずれの群においても,sRawおよびsGawの吸入後の変化に有意差はみられなかったが,BAにおいて,sRawの改善率(%)はRAと正常対照に対して,またsGawの改善率(%)は正常対照に対して有意に高く(P<0.05),RAと正常対照の間では,sRaw,sGaw共に改善率(%)の明らかな差はみられなかった。
Abstract Alternative We examined effects of salbutamol sulfate and disodium cromoglycate (cromolyn) on specific airway resistance (sRaw) and specific conductance (sGaw) in 6 patients with bronchial asthma (BA), 7 patients with rheumatoid arthritis (RA), and 5 subjects of controls, using a constant volume, whole body plethysmograph (Sensor Medics Corporation, Anaheim, California, U.S.A.). The results before and 30 minutes after inhalation of agents were compared to evaluate their effects on sRaw and sGaw. Before inhalation, the sGaw of BA was significantly lower than that of RA or controls, and there was no difference between that of RA and normal controls. The sGaw and sRaw in BA were significantly improved (P<0.01) after inhalation of salbutamol and those improvement after inhalation were significantly higher (P<0.01) in BA than those in RA or controls, however there was no difference between those of RA and controls. Although there was no sigificant change of sGaw and sRaw in all groups between before and after inhalation of cromolyn, the improvement of sRaw after inhalation was significantly higher in BA than in RA or controls (P<0.05), and that of sGaw was significantly higher in BA than in controls (P<0.05).
Keywords 気道抵抗 (sRaw) 気道コンダクタンス (sGaw) 気管支喘息 (bronchial asthma) 慢性関節リウマチ (rheumatoid arthritis) 気管支拡張作用 (the effect of bronchodialation)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 87
End Page 95
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307239
JaLCDOI 10.18926/15156
Title Alternative Study on the relatjonship between the bone mineral density mesured by QCT and the osteoporosis therapy.
FullText URL 065_069_076.pdf
Author Kajimoto, Kazuhiro| Takata, Ichiro| Yokota, Satoshi| Mitsunobu, Fumihiro| Mifune, Takashi| Kitani, Hikaru| Tanizaki, Yoshiro| Kobayashi, Yasuaki| Nakagiri, Yoshiyasu| Nakai, Mutsuro| Akiyama, Tsuneo|
Abstract 当院通院あるいは入院中の女性患者54例を対象に骨塩量を経時的に3回測定し検討を行った。54例の骨塩量の平均は3回とも有意差はなく,年次骨塩変化量は-3.1±14.6mg/cm(3)/yearであった。平均骨塩量の年齢別比較では40才台,50才台,60才台の順に有意な減少がみられ,60才台と70才以上との間には差は認めなかった。また50才台及び70才以上の年代で1年当たりの骨塩量の減少が大きい傾向が窺われた。身長と骨塩量との間に有意の正の相関を認めたが,体重との間には有意の相関を認めなかった。血清中Ca,P及びALPと骨塩量との検討ではいずれも有意の相関を認めなかった。骨塩変化量減少群と増加群との比較では,平均骨塩量及び背景因子の間に差を認めなかった。女性,特にステロイド療法を必要とする患者については閉経の時期にあたる40~50才台より積極的に骨粗髭症対策を考える必要性があると考えられた。また運動療法については温泉プール療法自体を再検討するとともに,骨粗髭症に特異的な運動療法の確立が必要と思われた。
Abstract Alternative Bone mineral densities (BMD) were mesured 3 times in 54 females aged 40 to 84 years old to evaluate about relationship between BMD and osteoporosis therapy or patient background factors. BMD decreased 3.1±14.6mg/cm(3) per year, and BMD values were more decreased in subjects with the age of 50's and over 70's than in those with the age of 40's and 60's. In patients with bronchial asthma or rheumatoid arthritis, treated with corticosteroids (predonisolone : 3-7.5mg/day), BMD were sigfnificantly more decreased than in patients without corticosteroid therapy. There was a significant positive correlation between BMD and body height, but no correlation between BMD and body weight, serum Ca, P, or alkaline phosphatase. No differences in background factors were found between subjects with increased BMD and those with decreased BMD. These results indicate that female patients with corticosteroids need active treatments for the prophylaxis of osteoporosis at the age of 40's or 50's.
Keywords 骨粗鬆症 (Osteoporosis) 骨塩量 (Bone mineral density) 運動療法 (Exercise therapy) QCT (quantitative computed tomograpy)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 69
End Page 76
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307602
JaLCDOI 10.18926/15155
Title Alternative MASTシステムによる気管支喘息患者の特異的IgE抗体の検討
FullText URL 065_062_068.pdf
Author Mitsunobu, Fumihiro| Kitani, Hikaru| Mifune, Takashi| Kajimoto, Kazuhiro| Yokota, Satoshi| Takada, Ichiro| Tanizaki, Yoshiro|
Abstract The serum levels of specific IgE antibodies to food allergens and inhalant allergens were evaluated in ninety five patients with bronchial asthma using the MAST system, which can measure specific IgE antibodies against sixteen different allergens with a single sample. 1. Higher positivities of specific IgE antibodies were found in inhaled allergens than in food allergens. Specific IgE antibodies against several allergens were detected in individuals more frequently in inhaled allergens than in food allergens. 2. Positivities of specific IgE antibodies against food allergens did not correlate to patients' age and patients' age at onset. In inhaled allergens, positive results in MAST system were frequently observed in patients under age of 50 and under age at onset of 60. 3. In subjects with high serum IgE levels, high positivities of specific IgE antibodies against inhaled allergens and food allergen were found. 4. The MAST system is suggested to be clinically more useful than RAST.
Abstract Alternative 気管支喘息95例を対象に,MASTシステムにより吸入抗原,食餌抗原の陽性率を検討した。その結果,吸入抗原の方が食餌抗原よりも陽性者が高率にみられ,さらに複数個の抗原に陽性の傾向が見られた。また8名の食餌抗原陽性者の内7名が吸入抗原陽性であった。MAST陽性率と年令,発症年令には食餌抗原では明らかな相関は見られなかったが,吸入抗原では,50才以下の症例に陽性率がやや高い傾向が,発症年令が60才以下の症例の陽性率が高い傾向が見られた。食餌抗原では血清IgE値が300IU/ml以上の症例で陽性者がみられ,1001IU/ml以上の症例では66.7%と比較的高率であった。一方,吸入抗原に対する陽性率は,血清IgE値が500IU/ml以上の症例で高く70%以上の陽性率であった。以上の結果より1検体同時多項目(16項目)測定可能なMASTシステムは従来のRASTに比して臨床的に有用であると考えられた。
Keywords bronchial asthma (気管支喘息) specific IgE antibodies (特異的IgE抗体) MAST system (MASTシステム)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 62
End Page 68
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307337
JaLCDOI 10.18926/15154
Title Alternative 気管支喘息における血清免疫グロブリン値,末梢血リンパ球数と気管支肺胞洗浄液中の細胞成分との関連
FullText URL 065_055_061.pdf
Author Mitsunobu, Fumihiro| Kitani, Hikaru| Mifune, Takashi| Kajimoto, Kazuhiro| Yokota, Satoshi| Takata, Ichiro| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo| Tada, Shinya| Harada, Mine|
Abstract Changes in airway inflammation by glucocorticoids were examined in 26 patients with bronchial asthma, divided into two age groups ; 20-59 and 60+ years, in relation to serum immunoglobulin levels and peripheral lymphocyte count. 1. The levels of IgG, IgA and IgM were significantly lower in patients with steroid-dependent intractable asthma (SDIA) of age over 60 years than in those with non-SDIA of the same age group. In patients between the ages of 20 and 59, only serum IgG level was significantly lower in SDIA than in non-SDIA patients. 2. Peripheral lymphocyte count was significantly decreased in SDIA patients than in non-SDIA patients in age group over 60, but not in age group between 20 and 59. 3. Number of lymphocytes in bronchoalveolar lavage (BAL) fluid was significantly lower and number of BAL neutrophils was significantly higher in SDIA patients than in non-SDIA patients in age group over 60, but not in age group between 20 and 59. These results suggest that levels of IgG, IgA and IgM, and peripheral lymphocyte count were significantly suppressed in SDIA patients of age over 60, accompanied with decrease of BAL lymphocytes and increase of BAL neutrophils.
Abstract Alternative 気管支喘息26例(ステロイド依存性重症難治性喘息,SDIA 13例,非SDIA 13例)を対象に,血清免疫グロブリン,IgG,IgAおよびIgM値,および末梢血リンパ球数との関連のもとに,副腎皮質ホルモン長期投与による気道炎症細胞の出現頻度の変化について検討を加えた。なお,年齢による影響を観察する目的で,SDIAおよび非SDIA各13例を,20-59才と60才以上の2群に分けて,それ ぞれのグループの特徴について検討した。1.血清IgG,IgAおよびIgM値は,60才以上の症例において,いずれも非SDIA症例に比べ,SDIA症例で有意に低い値を示した。一方,20-59才の症例群においては,IgG値のみSDIA症例で有意の低下傾向が見られた。2.末梢血リンパ球数は,60才以上の症例では,SDIA症例で,非SDIA症例に比べ有意の低値を示したが,20-59才の症例では両群間に有意の差は見られなかった。3.気管支肺胞洗浄(BAL)液中のリンパ球数 は,60才以上のSDIA症例で,非SDIA症例に比べ有意に少なく,また同時にこれらの症例ではBAL液中好中球が有意に多い傾向が観察された。しかし,20-59才の症例群では,SDIAと非SDIAの間にいずれも有意の差は見られなかっ た。これらの結果より,60才以上の症例では,20-59才の症例群に比べ,副腎皮質ホルモンの長期投与により,血清IgG,IgAおよびIgM値,末梢血リンパ球数の減少とともに,BAL液中のリンパ球減少,好中球増加をきたしやすいことが明らかにされた。
Keywords serum immunoglobulin levels (血清免疫グロブリン値) lymphocytes (リンパ球) neutrophils (好中球) bronchial asthma (気管支喘息) glucocorticoids (副腎皮質ホルモン)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 55
End Page 61
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307607
JaLCDOI 10.18926/15153
Title Alternative Clinical feature of bronchial asthma in relation to patient age
FullText URL 065_048_054.pdf
Author Mifune, Takashi| Takata, Ichiro| Yokota, Satoshi| Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Kitani, Hikaru| Tanizaki, Yoshiro|
Abstract 高齢気管支喘息症例の病態を解明するために30才以降の気管支喘息症例について年齢層別に臨床的特徴を検討した。1)60才以上の高齢気管支喘息症例は全体の41.1%を占めており,年齢層別では50-59才,60-69才の症例が多く認められた。2)ほとんどの症例が成人発症喘息であり,高齢気管支喘息では92.3%が中高年発症型気管支喘息であった。3)加齢に伴って細気管支閉塞型気管支喘息の増加か認められた。4)血清IgE値は50-59才で再増加し,histamine release,LTC(4)産生は40149才で高値であった。5)40-69才の年齢層でステロイド依存性難治性喘息が多く認められた。以上高齢気管支喘息症例は中高年発症型喘息の病態の特徴を有しており,中高年発症型気管支喘息の病態の解明が必要と考えられた。
Abstract Alternative To examine clinical characteristics of asthma in elderly (over 60 years), age at onset, clinical asthma types, glucocorticoid therapy, serum IgE levels and release of chemical mediators (histamine and leukotriene C(4)) were examined in 145 asthmatics over 30 years and divided into five age groups ; 30-39, 40-49, 50-59, 60-69, 70-79 years. 1. The freqeuncy of asthmatics was 13.7% in age group between 30 and 39, 14.4% between 40 and 49, 30.8% between 50 and 59, 28.8% between 60 and 69, 12.3% between 70 and 79 years, respectively. The frequency of elder asthmatics (over age 60) was 41.1%. 2. The frequency of adult onset asthma (over 20 years) was 90.3% of all subjects, and the frequency of late onset asthma (over 40 years) was 92.3% of elderly subjects over age 60. 3. Numbers of asthmatics with bronchiolar obstruction type show a tendency to increase with aging. 4. Serum IgE level was increased in subjects aged 50-59 years. Histamine release (%) and release of leukotriene C(4) from peripheral leukocytes were higher in age group between 40 and 49 compared to those in the other age groups. 5. Number of patients with steroid-dependent intractable asthma was increased in age group between 40 and 69. These results suggest that elderly asthmatics show the characteristics of late onset asthma, and further examinations of late onset asthma is important to clarify the pathogenesis of asthma in elderly.
Keywords 高齢気管支喘息 (bronchial asthma in elderly) 中高年発症型喘息 (late onset asthma) 臨床病態 (clinical types of asthma) ステロイド依存性重症難治性喘息 (steroid dependent intractable asthma) ケミカルメディエーター (chemical mediator)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 48
End Page 54
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307608
JaLCDOI 10.18926/15152
Title Alternative ステロイド依存性重症難治性喘息における気道反応の特徴
FullText URL 065_040_047.pdf
Author Mifune, Takashi| Kitani, Hikaru| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Yokota, Satoshi| Takata, Ichiro| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo| Tada, Shinya| Harada, Mine|
Abstract Characteristics of airway response in steroid-dependent intractable asthma (SDIA) were examined in 86 asthma patients (43 with SDIA and 43 with non-SDIA) divided into three age groups: 20-39, 40-59 and 60+ years, by observing cellular composition of bronchoalveolar lavage (BAL) fluid and ventilatory function. 1. The level of serum cortisol was significantly lower in patients with SDIA than in those with non-SDIA in all age groups. 2. The proportion of lymphocytes in BAL fluid was significantly decreased in patients with SDIA compared to results in non-SDIA patients in the age between 40-59, and over 60+ years, While BAL neutrophils were significantly increased in SDIA patients compared to results in non-SDIA patients in the age group over 60 years. 3. Of ventilatory parameters, the values of % FVC, FEV(1.0%), % MMF and % V(25) were significantly lower in SDIA patients over the age of 60 compared with non-SDIA subjects of the same age group. These results show that in SDIA patients the proportion of BAL lymphocytes decreases and the proportion of BAL neutrophils increases with aging, and that ventilatory function in SDIA patients also decreases with aging compared to non-SDIA patients.
Abstract Alternative 年齢により3群(20-39才,40-59才,60才以上)に分類された気管支喘息86例(ステロイド依存性重症難治性喘息:SDIA;43例,非SDIA;43例)を対象に,気管支肺胞洗浄液(BALF)中の細胞成分および換気機能よりSDIAにおける気 道反応の特徴を検討した。1.血清コーチゾ-ル値は,SDIA症例において, 非SDIA症例に比べいずれの年齢層においても有意の低値を示した。2.BALF中リンパ球頻度は,40-59才および60才以上のSDIA症例において,同年齢の非SDIA症例に比べ有意の低値を示した。一方,BALF中好中球頻度は,60才以上のSDIA症例で,同年齢層の非SDIA症例に比べ有意に高い値を示 した。また,BALF中好酸球頻度は,いずれの年齢層においても,SDIAと非SDIA症例の間に有意の差は見られなかった。3.換気機能では,% FVC, FEV1.0%,% MMF, % V(25)などの換気パラメーターは,60才以上の SDIA症例において,同年齢層の非SDIA症例に比べて有意の低値を示した。 これらの結果は,40-59才あるいは60才以上のSDIA症例では,非SDIA症例に比べ,BALF中リンパ球頻度の低下,好中球頻度の増加,換気パラメーター値の低下などがより高度に見られることを示している。
Keywords bronchial asthma (気管支喘息) bronchoalveolar cells (気管支肺胞洗浄液中の細胞) ventilatory function (換気機能) glucocorticoids (グルココーチコイド) serum cortiosol levels (血清コーチゾール値)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 40
End Page 47
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307402
JaLCDOI 10.18926/15151
FullText URL 065_027_039.pdf
Author Chowdhury, Riaz| Ochi, Koji| Tanaka, Juntaro| Matsumoto, Shooji| Senou, Toshinobu| Harada, Hideo| Mizushima, Takaaki| Tanizaki, Yoshiro|
Abstract Tropical calcific pancreatitis is a nonalcoholic type of chronic pancreatitis affecting the childrens and young adults characterized clinically by recurrent abdominal pain in childhood, diabetes in adolescent and death in early childhood. Although the exact etiology is not known, malnutrition and chronic cassava toxicity either singly or in combination are presumed to be the prime factor in pancreatic injury unopposed by detoxification of free radical. Moreover micronutrients deficiency, oxidant stress and antioxidant deficiency might play substantial role. Diabetes secondary to tropical calcific pancreatitis is a distinctive and frequent problem, being named by W.H.O. study group as 'fibrocalculous pancreatic diabetes (FCPD) and classified as one of the variant of the so-called malnutrition related diabetes mellitus (MRDM).
Abstract Alternative 熱帯地方の貧困層の小児や若干成人にみられる非アルコール性の慢性膵炎で,小児期に反復する腹痛で発症し,10~20歳で膵性糖尿病になり,20~ 30歳で死亡する類似の病像を示す症例をTropical calcific pancreatitis(熱帯性石灰化慢性膵炎)という。高率に膵石を伴う。成因は乳幼児期からの熱量,蛋白貰,micronutrients(亜鉛,銅,セレニウム)の摂取不足に加えて食事中シアン産生物質や環境中oxidantsなど複合因子によると推測されている。病理像は世界各国にみられる慢性膵炎典型例に類似する。最近は,生活環境や医療事情の改善により,全身栄養障害の減少や生存期間 の延長など病像が変貌しっつある。糖尿病を重視する立場からはFibrocalculous pancreatic diabetesと呼ばれ,同一地域にみられるProtein-deficient pancreatic diabetesと合わせてMalnutrition-related diabetes mellitus(MRDM)と総称し,糖尿病の一亜型に分類されている。
Keywords Tropical calcific pancreatitis (TCP) malnutrition cassava diabetes abdominal pain
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 27
End Page 39
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307678
JaLCDOI 10.18926/15150
Title Alternative Study of the preparation with sodium picosulfate and PEG intestinal lavage solution for total colonoscopy.
FullText URL 065_022_026.pdf
Author Ochi, Koji| Harada, Hideo| Chowdhury, Riaz| Tanaka, Juntaro| Matsumoto, Shuji| Seno, Toshinobu| Mizushima, Takaaki| Mitsunobu, Fumihiro| Tanizaki, Yoshiro| Akiyama, Tsuneo| Nakai, Mutsuo| Hasuoka, Hideaki| Kato, Tadahiro|
Abstract Total colonoscopyの前処置における被検者の負担軽減と良好な腸管洗浄を得る目的で,50例の大腸内視鏡検査において,前日の食事制限せず, sodium picosulfate 20mℓ前夜服用,検査当日PEG腸管洗浄液1ℓ以上服用する前処置法の有用性について検討した。本前処置法によってPEG腸管洗浄液平均1230mℓの服用により,50例中48例で観察可能な腸管洗浄が得られ,PEG腸管洗浄液の服用量の減量が可能であった。腹痛,嘔気,腹鳴などの症状出現例は認めたが,重篤な副作用は認めなかった。腸管洗浄度の点で,高齢者の大腸内視鏡検査の前処置として有用である。以上よりSodium Picosulfate 20mℓをPEG腸管洗浄液と併用することにより,優れた腸管洗浄度を得られると同時にPEG腸管洗浄液服用量の減量か可能であり,total colonoscopyの前処置として有用であることが示された。
Abstract Alternative The following results were obtained from a total colonoscopic study of 50 patients who received preparation with 20mℓ of sodium picosulfate (Laxoberon®) and PEG intestinal lavage solution (Niflec®) prior to the examination. (l) The present method in combination with a mean of 1230mℓ of PEG intestinal lavage solution allowed colonic cleaning for which observation was available in 48 of 50 patients. (2) With this method. no adverse reactions were observed except for mild abdominal pain, nausea, and rugitus in a few patients. (3) This method was particularly as a preparation for colonoscopic examination in elderly patients. Thus, we conclude that preparation with 20mℓ of sodium picosulfate and PEG intestinal lavage solution is useful for colonoscopic examination.
Keywords 大腸内視鏡検査 (colonoscopy) 前処置 (preparation)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 22
End Page 26
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307186
JaLCDOI 10.18926/15149
Title Alternative A case report of severe allergic reactionsinduced by black fly bites
FullText URL 065_017_021.pdf
Author Kitani, Hikaru| Takata, Ichiro| Yokota, Satoshi| Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Mifune, Takashi| Tanizaki, Yoshiro|
Abstract 多数のブユに刺されたのを契機に重症反応を呈するようになった29歳男性例について,アレルギー学的検討を行った。血清IgE値が高値(4591U/ml)であったが,免疫グロブリン,抗核抗体,血清補体価,CD4,CD8陽性リンパ球出現頻度などいずれも正常であり,またハウスダスト,カンジダその他16種類の吸入性抗原,ミツバチ,スズメバチ,アシナガバチ,ゴキブリ,ヤブカ,ユスリカなどの昆虫抗原に対する特異的IgE抗体はいずれも陰性であった。一方ニッポンヤマブユ抗原による好塩基球からのヒスタミン遊離は陰性であったが,皮膚反応,IgE抗体は陽性を示したことから,本症例における重症化因子としてIgE系反応の関与が示唆された。なおEBウイルス抗体価の検討では,EBV-EADR抗体はすべて陰性,EBNA-EIA抗体はIgG抗体のみ陽性であり,EBウイルスの既感染状態と判断されたが,病因との関連は明らかではなかった。
Abstract Alternative Allergic examinations were studied on the 29 years old male case, who suffered from severe systemic reactions by black fly bites, after the episode of much black fly bites in 1987. The level of serum IgE was high in the case, and both skin reaction and specitic IgE antibodies to whole body extract of black fly (Simulium nacojapi) were positive. The results obtained here suggest that IgE-mediated allergic reaction would play an important role in the severe systemic reactions induced by black fly bites.
Keywords 昆虫アレルギー (lnsect allergy) ブユ (Black fly) IgE系反応 (lgE-mediated reaction)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 17
End Page 21
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307240
JaLCDOI 10.18926/15148
Title Alternative 気管支喘息における末梢血白血球および気管支肺胞洗浄液中の細胞からのヒスタミンおよびロイコトリエンC(4),B(4)遊離と気道過敏性
FullText URL 065_009_016.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Yokota, Satoshi| Takata, Ichiro| Ochi, Koji| Harada, Hideo| Tada, Shinya| Harada, Mine|
Abstract The proportions of cells in bronchoalveolar lavage (BAL) fluid, the release of histamine, leukotrienes C(4) and B(4) from leucocytes and BAL cells, and bronchial reactivity to methacholine were examined in 40 patients with asthma in relation to patient age. 1. The proportions of lymphocytes and neutrophils in BAL fluid were higher in older patients over age 60 than in younger patients between 20 and 49. The proportions of eosinophils and basophilic cells in BAL fluid were higher in younger patients than in older patients, and the difference in the proportion of BAL basophilic cells was significant between the two groups (p<0.05). 2. The release of histamine from BAL cells was significantly higher in younger patients than in older patients (p<0.001). The release of LTC(4) from BAL cells was higher in older patients compared to younger patients. 3. Bronchial reactivity to methacholine was higher in younger patients than in older patients. The number of patients reactive to low concentration of methacholine (390μg/mℓ or less) was larger in younger patients (12/16 ; 75.0%) than in older patients (5/14 ; 35.7%). These results suggest that bronchial hyperresponsiveness changes with aging, accompanied by changes in the release of chemical mediators from BAL cells and in the proportion of BAL cells.
Abstract Alternative 気管支喘息を対象に,気管支肺胞洗浄(BAL)液中の細胞の出現頻度,末梢血白血球およびBAL細胞からのヒスタミン,ロイコトリエンC(4),B(4)遊離,気道過敏性などについて,患者年齢との関連のもとに検討を加えた。1.BAL液中のリンパ球および好中球頻度は,60才以上の老齢症例で,20-49才の若青年症例に比べやや高い傾向が見られたが,推計学的には有意の差は見られなかった。BAL液中の好酸球,好塩基細胞の頻度は,若青年症例で,老年症例に比べて高く,特に好塩基性細胞の頻度には両症例群間に有意の差が見られ(P<0.05)。 2.BAL細胞からのヒスタミン遊離は,若青年症例で,老年症例に比べ有意に多い傾向が見られた(P<0.001)。一方,BAL細胞からのロイコトリエンC(4)遊離は,若青年症例に比べ,老年症例で多い傾向が見られたが,両症例群間に有意の差は見られなかった。3.メサコリンに対する気道の反応性は,全般的に若青年症例で,老年症例に比べより強い傾向を示した。そして,390μg/mℓまたはそれ以下の低濃度のメサコリンに反応を示す症例は,若青年症例では16例中12例(75.0%),老年症例では14例中5例(35.7%)であった。以上の結果より,気道過敏性は,BAL細胞からの化学伝達物質遊離の変化やBAL細胞の頻度の変化とともに,加齢の影響を受けることが明らかとなった。
Keywords BAL cells (BAL細胞) histamine (ヒスタミン) leukotrienes (ロイコトリエン) bronchial hyperresponsiveness (気道過敏性) asthma (気管支喘息)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 9
End Page 16
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307646