JaLCDOI 10.18926/AMO/31032
FullText URL fulltext.pdf
Author Higashi, Toshihiro| Tobe, Kazuo| Asano, Ken-ichiro| Ikeda, Hiroshi| Ohsawa, Toshiya| Iwasaki, Yoshiaki| Nouso, Kazuhiro| Shinji, Noriyuki| Morimoto, Yohichi| Satoh, Yasumasa| Andoh, Masaharu| Araki, Yasuyuki| Tomita, Osamu| Morishita, Hirofumi| Kita, Keiji| Tsuchiya, Takahiro| Morichika, Shigeru| Tanabe, Takahiro| Nagashima, Hideo| Tsuji, Takao|
Abstract

The ultrasonographic characteristics of hepatocellular carcinomas (HCC) were investigated. Four typical features of HCCs, "mosaic internal echo pattern", "halo", "lateral shadow" and "posterior echo enhancement", were not recognized in minute HCCs smaller than 2 cm in diameter. These characteristics developed as the tumors grew. Only hypoechoic space-occupying lesions can be considered as small HCCs. In differentiating small HCCs from hypoechoic non-malignant space-occupying lesions in the cirrhotic liver, the ratios of short to long dimensions of the lesions seemed to be important since the ratios of HCCs were significantly larger than those of non-malignant lesions. The fact that 3 hyperechoic small HCCs could not be diagnosed even by celiac arteriography has suggested to us that ultrasonically guided biopsies should be performed in order to differentiate from small hemangiomas. Serum alpha-fetoprotein (AFP) levels of 1/3 of the patients with HCCs were below 100 ng/ml, indicating that it is impossible to detect small HCCs only by measuring serum AFP.

Keywords ultrasonography hepatocellular carcinoma alpha-fetoprotein
Amo Type Article
Publication Title Acta Medica Okayama
Published Date 1988-06
Volume volume42
Issue issue3
Publisher Okayama University Medical School
Start Page 151
End Page 157
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
File Version publisher
Refereed True
PubMed ID 2456671
Web of Science KeyUT A1988P034000005
JaLCDOI 10.18926/AMO/31989
FullText URL fulltext.pdf
Author Ishii, Yasushi| Shimomura, Hiroyuki| Ito, Mamoru| Miyake, Masanobu| Ikeda, Fusao| Miyake, Jiro| Fujioka, Shin-ichi| Iwasaki, Yoshiaki| Tsuji, Hideyuki| Tsuji, Takao|
Abstract

It has been documented that the serum complement activities measured by hemolytic assay (CH50) are decreased after storage of sera at a low temperature in some patients with chronic hepatitis C. However, the mechanism of this phenomenon has not been identified yet. Here, we tried to elucidate factors involved in the cold activation of complement (CAC). To clarify what pathway is activated in CAC, we measured complement cleavage products after cold storage of sera. C4d increased significantly after 12 h-storage at cold temperatures in 5 CAC (+) sera compared with 5 CAC (-) (P < 0.01) and 3 control sera (P < 0.05), while Bb did not increase in any of the groups. In order to determine whether IgG or IgG complex is necessary for CAC, 8 CAC (+) sera were incubated with Protein G Sepharose gel beads, and all of them retained hemolytic activities to some extent after cold storage. Column chromatography through Superose 6HR of CAC-positive serum identified the fractions containing molecules that induced CAC in normal serum, which were depleted by treatment with protein G Sepharose. In conclusion, CAC in hepatitis C seems to occur via a classical or lectin pathway, and the IgG complex produced in hepatitis C virus infection may be an important factor in inducing CAC, a common extrahepatic manifestation of hepatitis C.

Keywords hepatitis C virus chronic hepatitis complement activation
Amo Type Article
Publication Title Acta Medica Okayama
Published Date 2001-08
Volume volume55
Issue issue4
Publisher Okayama University Medical School
Start Page 229
End Page 235
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
File Version publisher
Refereed True
PubMed ID 11512565
Web of Science KeyUT 000170367200005
Author Nakanishi, Yutaka| Sakaguchi, Kohsaku| Iwasaki, Yoshiaki| Nouso, Kazuhiro| Shimomura, Hiroyuki| Matsuda, Hiroaki| Yagi, Takahito| Tanaka, Noriaki| Tsuji, Takao|
Published Date 2001-08-31
Publication Title 岡山医学会雑誌
Volume volume113
Issue issue2
Content Type Journal Article
JaLCDOI 10.18926/AMO/31685
FullText URL fulltext.pdf
Author Kondo, Junichi| Shimomura, Hiroyuki| Fujioka, Shin-ichi| Iwasaki, Yoshiaki| Takagi, Shinjiro| Ohnishi, Yasuhiro| Tsuji, Hideyuki| Sakaguchi, Kosaku| Yamamoto, Kazuhide| Tsuji, Takao|
Abstract

The preS2 region of the hepatitis B virus (HBV) has been reported to have human polymerized albumin receptor (PAR) activity, which correlates with viral replication. Here, we studied the genomic sequence of the preS region from rare patients lacking PAR activity, despite active viral replication. PAR and DNA polymerase activity was identified in 178 HBe antigen-positive HBV carriers, and a significant correlation between 2 markers was shown, except in 2 hepatitis patients lacking PAR activity. Nucleotide sequences of the preS region of HBV from both patients were examined by direct sequencing of PCR products. In one patient, a 45-base deletion was found to overlap half of the putative polymerized human albumin binding site in the preS2 region. In the other patient, a point mutation at the first nucleotide of the start codon of the preS2 region of HBV was found. There was no such genomic change in the 3 control HBV sequences. These results indicate that the preS2 region is necessary for binding of polymerized human albumin, and this is the first report of naturally existing mutant virus with no or low PAR activity.

Keywords hepatitis B virus preS region polymerized albumin receptor genetic mutation genetic deletion
Amo Type Article
Publication Title Acta Medica Okayama
Published Date 2002-08
Volume volume56
Issue issue4
Publisher Okayama University Medical School
Start Page 193
End Page 198
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
File Version publisher
Refereed True
PubMed ID 12199524
Web of Science KeyUT 000177382600004
JaLCDOI 10.18926/AMO/32825
FullText URL fulltext.pdf
Author Nakajima, Hirofumi| Shimomura, Hiroyuki| Iwasaki, Yoshiaki| Ikeda, Fusao| Umeoka, Fumi| Chengyu, Piao| Taniguchi, Hideaki| Ohnishi, Yasuhiro| Takagi, Shin-jiro| Fujioka, Shin-ichi| Shiratori, Yasushi|
Abstract

To improve the efficacy of interferon (IFN) treatment for chronic hepatitis C, we have proposed the twice-daily administration of IFN-beta as a promising induction therapy. In this study, we demonstrated differences between the clearance of circulating HCV-RNA and the induction of anti-viral actions during the first 2 weeks of treatment. Nine patients with a high viral load and genotype 1b were randomly assigned to 3 groups: group A received 3MU of IFN-beta twice a day at intervals of 5 and 19 h; group B received 3MU of IFN-beta twice a day at intervals of 10 and 14 h; group C received 6MU of IFN-alpha once a day with ribavirin. The expression of OAS2, PKR, and MxA in peripheral blood mononuclear cells (PBMCs) were quantified by real-time polymerase chain reaction method. The viral clearance showed a bi-phasic pattern, and those in the second phase of groups A and B were significantly steeper than that of group C. The peak level of OAS2 during the first phase was correlated with the first phase decay. The MxA expression tended to be higher in group A and B than in group C. The expression of these 3 proteins tended to decrease at day 6 in group C, but increase in groups A and B. These might make differences in the viral decay during the second phase

Keywords chronic hepatitis C(CHC) interferon(IFN)beta hepatitis C virus(HCV)dynamics antiviral actions real time PCR
Amo Type Article
Publication Title Acta Medica Okayama
Published Date 2003-10
Volume volume57
Issue issue5
Publisher Okayama University Medical School
Start Page 217
End Page 225
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
File Version publisher
Refereed True
PubMed ID 14679399
Web of Science KeyUT 000186186000002
Author Hanafusa, Tadashi| Shinji, Toshiyuki| Shiraha, Hidenori| Nouso, Kazuhiro| Iwasaki, Yoshiaki| Yumoto, Eichiro| Ono, Toshiro| Koide, Norio|
Published Date 2005-01-20
Publication Title BMC Cancer
Volume volume5
Content Type Journal Article
JaLCDOI 10.18926/AMO/31969
FullText URL fulltext.pdf
Author Piao, Cheng-Yu| Fujioka, Shin-ichi| Iwasaki, Yoshiaki| Fujio, Kozo| Kaneyoshi, Toshihiko| Araki, Yasuyuki| Hashimoto, Kuniaki| Senoh, Tomonori| Terada, Ryo| Nishida, Tomohiro| Kobashi, Haruhiko| Sakaguchi, Kohsaku| Shiratori, Yasushi|
Abstract

Lamivudine is widely used to treat patients with hepatitis B. However, the outcomes in patients with hepatocellular carcinoma (HCC) treated with lamivudine have not been established. This study was conducted to evaluate the outcomes of lamivudine treatment for patients with HCC using an untreated, matched control group. Thirty patients with controlled HCC orally received lamivudine. As controls, 40 patients with HCC who were not treated with lamivudine and matched for clinical features were selected. The lamivudine-treated and untreated groups were compared with respect to changes in liver function, HCC recurrence, survival, and cause of death. In the lamivudine-treated group, there was significant improvement in the Child-Pugh score at 24 months after starting treatment, while no improvement was observed in the untreated group. There was no significant difference in the cumulative incidence of HCC recurrence and survival between the groups. However, there was a significant difference in the cumulative incidence of death due to liver failure (P= 0.043). A significant improvement in liver function was achieved by lamivudine treatment, even in patients with HCC. These results suggest that lamivudine treatment for patients with HCC may prevent death due to liver failure. Further prospective randomized studies using a larger number of patients are required.

Keywords liver failure Child-Pughscore recurrence survival resistant mutant
Amo Type Article
Publication Title Acta Medica Okayama
Published Date 2005-10
Volume volume59
Issue issue5
Publisher Okayama University Medical School
Start Page 217
End Page 224
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
File Version publisher
Refereed True
PubMed ID 16286955
Web of Science KeyUT 000232835600006
JaLCDOI 10.18926/AMO/30729
FullText URL fulltext.pdf
Author Ohta, Takeyuki| Sakaguchi, Kohsaku| Fujiwara, Akiko| Fujioka, Shin-ichi| Iwasaki, Yoshiaki| Makino, Yasuhiro| Araki, Yasuyuki| Shiratori, Yasushi|
Abstract

This study was conducted to develop a simple surrogate index comprised of routinely available laboratory tests to reflect the histological fibrosis stage. Clinical characteristics and laboratory data from 368 and 249 consecutive patients with chronic hepatitis C, a training cohort and a validation cohort, respectively, were retrospectively evaluated. Platelet (Plt) count and albumin (Alb) level contributed to the discrimination of the respective fibrosis stages. We derived the fi brosis index (FI), FI = 8.0-0.01 x Plt (10 multiply 3/microliter) - Alb (g/dl), from a multiple regression model. FI significantly correlated with the histological fibrosis stage in both the initial and validation cohort at p=0.691 and p=0.661, respectively (Spearman's rank correlation coefficient, p<0.0001). The sensitivity and positive predictive value of FI at a cutoff value < 2.10 for predicting fibrosis stage F0-1 were 66.8% and 78.8% in the initial cohort and 68.5% and 63.6% in the validation cohort, respectively. Corresponding values of FI at a cutoff value >- 3.30 for the prediction of F4 were 67.7% and 75.0% in the initial cohort and 70.8% and 81.0% in the validation cohort. The fibrosis index comprised of platelet count and albumin level reflected the histological fibrosis stage in patients with chronic hepatitis C.

Keywords albumin level chronic hepatitis C fi brosis index fi brosis stage platelet count
Amo Type Article
Publication Title Acta Medica Okayama
Published Date 2006-04
Volume volume60
Issue issue2
Publisher Okayama University Medical School
Start Page 77
End Page 84
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
File Version publisher
Refereed True
PubMed ID 16680183
Web of Science KeyUT 000237001900002
JaLCDOI 10.18926/AMO/32914
FullText URL fulltext.pdf
Author Miyake, Yasuhiro| Iwasaki, Yoshiaki| Ishikawa, Shin| Tatsukawa, Masashi| Nawa, Toru| Kato, Jun| Takaki, Akinobu| Kobashi, Haruhiko| Sakaguchi, Kohsaku| Shiratori, Yasushi|
Abstract We report herein a case with acute hepatitis due to hepatitis B virus genotype Ae, concurrent with amebic colitis. A 39-year-old homosexual Japanese man was admitted to our hospital with jaundice. Laboratory tests showed an elevation of transaminase and positivity for hepatitis B surface antigen and IgM-type antibody to hepatitis B core antigen. The hepatitis B virus genotype was determined to be Ae. Furthermore, a mud-like stool with blood and mucous had sometimes been noted during the past 3 years, and amebic colitis was shown by colonofi berscopy during hospitalization. The patient was diagnosed with acute hepatitis B, concurrent with amebic colitis, and was successfully treated with lamivudine and metronidazole. In Japanese patients with acute hepatitis B virus genotype A infection, homosexual activity tends to be high. Furthermore, in Japanese homosexual men, amebiasis has been increasing. Thus, in Japanese patients with acute hepatitis B, a determination of genotype should be performed in order to investigate the route of transmission of hepatitis B virus, and a search for amebiasis should be performed in patients with acute hepatitis due to hepatitis B virus genotype A. Furthermore, education of homosexual men regarding hepatitis B virus, hepatitis B virus vaccination, and amebiasis is urgently required.
Keywords hepatitis B virus genotype homosexual amebic colitis lamivudine
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2007-02
Volume volume61
Issue issue1
Publisher Okayama University Medical School
Start Page 35
End Page 39
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
File Version publisher
Refereed True
PubMed ID 17332840
Web of Science KeyUT 000244432400005
Author Kubota, Junichi| Ikeda, Fusao| Terada, Ryo| Kobashi, Haruhiko| Fujioka, Shin-ichi| Okamoto, Ryoichi| Baba, Shinsuke| Morimoto, Youichi| Ando, Masaharu| Makino, Yasuhiro| Taniguchi, Hideaki| Yasunaka, Tetsuya| Miyake, Yasuhiro| Iwasaki, Yoshiaki| Yamamoto, Kazuhide|
Published Date 2009-09
Publication Title Journal of Gastroenterology
Volume volume44
Issue issue9
Content Type Journal Article
Author Shoji, Bon| Ikeda, Fusao| Fujioka, Shin-ichi| Kobashi, Haruhiko| Yasunaka, Tetsuya| Miyake, Yasuhiro| Shiraha, Hidenori| Takaki, Akinobu| Nouso, Kazuhiro| Iwasaki, Yoshiaki| Yamamoto, Kazuhide|
Published Date 2010-11
Publication Title Journal of Gastroenterology
Volume volume45
Issue issue11
Content Type Journal Article
JaLCDOI 10.18926/AMO/43825
FullText URL 65_1_11.pdf
Author Kuwaki, Kenji| Nouso, Kazuhiro| Kobayashi, Yoshiyuki| Nakamura, Shinichiro| Ito, Yoichi M.| Iwadou, Shouta| Hagihara, Hiroaki| Yasunaka, Tetsuya| Toshimori, Junichi| Miyatake, Hirokazu| Miyoshi, Kenji| Onishi, Hideki| Miyake, Yasuhiro| Shoji, Bon| Takaki, Akinobu| Shiraha, Hidenori| Iwasaki, Yoshiaki| Kobashi, Haruhiko| Yamamoto, Kazuhide|
Abstract The purpose of this study was to build a prognostic model of hepatocellular carcinoma (HCC) using time-dependent covariates to re-evaluate the prognosis at any stage of the disease. The subjects were consecutive HCC patients who were treated at our institute between 1995 and 2007. We constructed time-fixed and time-dependent prognostic models with a training group (n=336) and compared the prognostic abilities between conventional Cancer of the Liver Italian Program (CLIP) scores, Japan Integrated Staging (JIS) scores, an Okuda classification, and our prognostic models in the testing group (n=227) with the c-index. The time-dependent prognostic model consisted of main tumor size, tumor number, portal vein invasion, distant metastasis, alpha-fetoprotein, des-gamma-carboxy prothrombin (DCP), bilirubin, and albumin and the weighted scores were set for each factor depending on the hazard ratio for the prognosis. The prognostic index was determined by summing the scores. The c-index values for the CLIP scores, JIS scores, Okuda classification, and our time-dependent model were 0.741, 0.727, 0.609, and 0.870, respectively. These results indicate that our time-dependent model can estimate the prognosis of HCC more precisely than traditional time-fixed models and can be used to re-predict the prognosis of HCC.
Keywords hepatocellular carcinoma humans prognosis proportional hazards models time factors
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-02
Volume volume65
Issue issue1
Publisher Okayama University Medical School
Start Page 11
End Page 19
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21339791
Web of Science KeyUT 000287620500002
Author Tatsukawa, Masashi| Takaki, Akinobu| Shiraha, Hidenori| Koike, Kazuko| Iwasaki, Yoshiaki| Kobashi, Haruhiko| Fujioka, Shin-Ichi| Sakaguchi, Kohsaku| Yamamoto, Kazuhide|
Published Date 2011-10-21
Publication Title BMC Cancer
Volume volume11
Content Type Journal Article
Author Mizutani, Shinsuke| Ekuni, Daisuke| Furuta, Michiko| Tomofuji, Takaaki| Irie, Koichiro| Azuma, Tetsuji| Kojima, Azusa| Nagase, Jun| Iwasaki, Yoshiaki| Morita, Manabu|
Published Date 2012-09
Publication Title Journal of Clinical Periodontology
Volume volume39
Issue issue9
Content Type Journal Article
Author Nishimura, Mamoru| Takaki, Akinobu| Tamaki, Naofumi| Maruyama, Takayuki| Onishi, Hideki| Kobayashi, Sayo| Nouso, Kazuhiro| Yasunaka, Tetsuya| Koike, Kazuko| Hagihara, Hiroaki| Kuwaki, Kenji| Nakamura, Shinichiro| Ikeda, Fusao| Iwasaki, Yoshiaki| Tomofuji, Takaaki| Morita, Manabu| Yamamoto, Kazuhide|
Published Date 2013-01-30
Publication Title Hepatology Research
Volume volume43
Issue issue10
Content Type Journal Article
Author Takeuchi, Yasuto| Ikeda, Fusao| Moritou, Yuki| Hagihara, Hiroaki| Yasunaka, Tetsuya| Kuwaki, Kenji| Miyake, Yasuhiro| Ohnishi, Hideki| Nakamura, Shinichiro| Shiraha, Hidenori| Takaki, Akinobu| Iwasaki, Yoshiaki| Nouso, Kazuhiro| Yamamoto, Kazuhide|
Published Date 2013-03
Publication Title Journal of Gastroenterology
Volume volume48
Issue issue3
Content Type Journal Article
JaLCDOI 10.18926/AMO/52139
FullText URL 68_1_17.pdf
Author Moritou, Yuki| Ikeda, Fusao| Iwasaki, Yoshiaki| Baba, Nobuyuki| Takaguchi, Kouichi| Senoh, Tomonori| Nagano, Takuya| Takeuchi, Yasuto| Yasunaka, Tetsuya| Ohnishi, Hideki| Miyake, Yasuhiro| Takaki, Akinobu| Nouso, Kazuhiro| Yamamoto, Kazuhide|
Abstract The impact of hepatic steatosis on interferon therapy for patients with chronic hepatitis C (CHC) has been associated with single-nucleotide polymorphisms (SNP) of IL28B, patatin-like phospholipase domain-containing protein 3 (PNPLA3), and low-density lipoprotein (LDL) receptor. Whether this holds true for Japanese patients, however, remains unresolved. The present study prospectively enrolled 226 Japanese patients with CHC, and investigated the impact of hepatic steatosis and its related SNPs, including rs8099917 of IL28B, rs738409 of PNPLA3, and rs14158 of LDL receptor, on outcomes of peg-interferon and ribavirin therapy. In multivariate logistic regression analysis, significant factors affecting the severity of hepatic steatosis were high body mass index and the minor alleles of IL28B SNP (p=0.020 and 0.039, respectively). The risk alleles of PNPLA3 SNP also showed weak association (p=0.059). Severe steatosis and the minor alleles of IL28B SNP were significantly associated with null or partial virological response in patients with HCV genotype 1, as were female gender, and low LDL cholesterol (p=0.049, and <0.001, respectively). The SNP genotype of PNPLA3 and LDL receptor did not have a significant impact on therapeutic outcomes. With respect to the SNP sites examined, the SNP of PNPLA3 has a weak association with severe hepatic steatosis, but not with the outcome of interferon therapy.
Keywords hepatic steatosis genetic polymorphism interferon HCV
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2014-02
Volume volume68
Issue issue1
Publisher Okayama University Medical School
Start Page 17
End Page 22
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24553484
Web of Science KeyUT 000331592800003
Author Matsushita, Hiroshi| Ikeda, Fusao| Iwasaki, Yoshiaki| Seki, Hiroyuki| Nanba, Shintaro| Takeuchi, Yasuto| Moritou, Yuki| Yasunaka, Tetsuya| Onishi, Hideki| Miyake, Yasuhiro| Takaki, Akinobu| Nouso, Kazuhiro| Yamamoto, Kazuhide|
Published Date 2014-02
Publication Title Journal of Gastroenterology and Hepatology
Volume volume29
Issue issue2
Content Type Journal Article
Author Moritou, Yuki| Ikeda, Fusao| Takeuchi, Yasuto| Seki, Hiroyuki| Nanba, Shintaro| Iwasaki, Yoshiaki| Yamamoto, Kazuhide|
Published Date 2014-02
Publication Title Journal of Clinical Microbiology
Volume volume52
Issue issue2
Content Type Journal Article
JaLCDOI 10.18926/AMO/52894
FullText URL 68_5_263.pdf
Author Namba, Shihoko| Miyake, Kayoko| Ikeda, Fusao| Hazama, Tomoko| Hitobe, Yu| Yamasaki, Noriko| Shiraha, Hidenori| Takaki, Akinobu| Nouso, Kazuhiro| Iwasaki, Yoshiaki| Yamamoto, Kazuhide|
Abstract Nursing support might help patients with chronic hepatitis C (CHC) remain in good mental and physical condition during interferon (IFN) therapy. However, the effects of nursing support have not been studied adequately in this context. This case-control study evaluated the effects of nursing support during IFN therapy. Twenty-four CHC patients who received pegylated IFN and ribavirin were enrolled. Nurses advised patients on the maintenance of their mental and physical condition at weekly visits, based on the results of written questionnaires. An additional 24 patients who received IFN therapy without nursing support and who were matched for age, sex, platelet count, viral serogroup and IFN regimen were selected with propensity score matching as controls. The patients with nursing support during IFN therapy achieved higher sustained virological responses (79%) than those without nursing support (58%). Adherence to the IFN and ribavirin regimens at 24 weeks of therapy were slightly higher in the patients with nursing support than those without it, but these differences were not statistically significant. Adherence to ribavirin after 24 weeks of therapy was significantly higher in those with nursing support than those without it (93% and 66%, p=0.045). These results suggested that nursing support services could contribute to the virological responses of CHC patients by promoting drug-regimen adherence.
Keywords chronic hepatitis C nursing support interferon therapy
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2014-10
Volume volume68
Issue issue5
Publisher Okayama University Medical School
Start Page 263
End Page 268
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25338482
Web of Science KeyUT 000343269300002