Publications (29)38.64 Total impact
-
Article: Assessment of Olfactory Nerve by SPECT-MRI Image with Nasal Thallium-201 Administration in Patients with Olfactory Impairments in Comparison to Healthy Volunteers.
[show abstract] [hide abstract]
ABSTRACT: The aim of this study was to assess whether migration of thallium-201 (Tl) to the olfactory bulb were reduced in patients with olfactory impairments in comparison to healthy volunteers after nasal administration of Tl. 10 healthy volunteers and 21 patients enrolled in the study (19 males and 12 females; 26-71 years old). The causes of olfactory dysfunction in the patients were head trauma (n = 7), upper respiratory tract infection (n = 7), and chronic rhinosinusitis (n = 7). TlCl was administered unilaterally to the olfactory cleft, and SPECT-CT was conducted 24 h later. Separate MRI images were merged with the SPECT images. Tl olfactory migration was also correlated with the volume of the olfactory bulb determined from MRI images, as well as with odor recognition thresholds measured by using T&T olfactometry. Nasal Tl migration to the olfactory bulb was significantly lower in the olfactory-impaired patients than in healthy volunteers. The migration of Tl to the olfactory bulb was significantly correlated with odor recognition thresholds obtained with T&T olfactometry and correlated with the volume of the olfactory bulb determined from MRI images when all subjects were included. Assessment of the Tl migration to the olfactory bulb was the new method for the evaluation of the olfactory nerve connectivity in patients with impaired olfaction.PLoS ONE 01/2013; 8(2):e57671. · 4.09 Impact Factor -
Article: Clinical diagnosis of the olfactory nerve transport function.
[show abstract] [hide abstract]
ABSTRACT: Nasal administration of macromolecular drugs (peptides, nanoparticles) has a possibility to enable a drug delivery system beyond the blood brain barrier via olfactory nerve transport. Basic research on nasal drug delivery to the brain has been well studied. However, evaluation of the olfactory nerve transport function in patients with olfactory disorders has yet to be done, although such an evaluation is important in selecting candidates for clinical trials. Current olfactory function tests are useful for the analysis of olfactory thresholds in olfaction-impaired patients. However, the usefulness of using the increase in olfactory thresholds in patients as an index for evaluating olfactory nerve damage has not been confirmed because of the difficulty in directly evaluating the viability of the peripheral olfactory nerves. Nasally administered thallium-201 migrates to the olfactory bulb, as has been shown in healthy volunteers. Furthermore, transection of olfactory nerve fibers in mice significantly decreases migration of nasally administered thallium-201 to the olfactory bulb. The migration of thallium-201 to the olfactory bulb is reduced in patients with impaired olfaction due to head trauma, upper respiratory tract infections, and chronic rhinosinusitis, relative to the values in healthy volunteers. Nasally administrating thallium-201 followed by single photon emission computed tomography, X-ray computed tomography and magnetic resonance imaging might be useful in choosing candidates for clinical trials of nasal drug delivery methods to the brain.YAKUGAKU ZASSHI 01/2012; 132(11):1263-6. · 0.37 Impact Factor -
Article: Efficacy and safety of garenoxacin in the treatment of upper respiratory tract infections.
[show abstract] [hide abstract]
ABSTRACT: To determine the efficacy and safety of garenoxacin, a new generation of quinolone antimicrobial agent, in the treatment of adult upper respiratory tract infections. A total of 113 subjects were enrolled in this study. Garenoxacin (400mg/day) was administered to patients with pharyngolaryngitis, tonsillitis, and otitis media for 5-7 days and to those with sinusitis for 7-10 days. Clinical symptoms and findings were examined and quantitatively evaluated using a scoring system. We found 80 to 100% improvement rate in symptoms and findings for each infection. In addition, we found significant improvement in subjective evaluations from patient questionnaires even in the early stage of the treatment. X-ray examination for acute sinusitis demonstrated that the clinical efficacy was 84% (27/32) and 76% (19/25) patients were already improved within seven days. Among the detected 84 bacteria, 75 (89%) were identified as the major pathogenic bacteria of respiratory tract infections such as Streptococcus pneumoniae (27 strains) and Haemophillus influenzae (14 strains). Garenoxacin administration completely eradicated bacteria in 53 out of 54 cases (98%). There were 8 adverse events (8.3%) including 3 diarrhea cases (3.1%). These results suggest that garenoxacin is a highly effective and safe antimicrobial agent in the treatment of community-acquired upper respiratory infections. Additionally, garenoxacin did not induce the growth of resistant bacteria because of its strong antimicrobial activity.Auris, nasus, larynx 11/2011; 39(5):512-8. · 0.58 Impact Factor -
Article: Biological safety of nasal thallium-201 administration: a preclinical study for olfacto-scintigraphy.
Journal of Radiation Research 01/2011; 52(4):450-5. · 1.68 Impact Factor -
Article: Evaluation of the olfactory nerve transport function by SPECT-MRI fusion image with nasal thallium-201 administration.
[show abstract] [hide abstract]
ABSTRACT: The aim of this study was to visualize the human olfactory transport pathway to the brain by performing imaging after nasal thallium-201 ((201)Tl) administration. Healthy volunteers were enrolled in this study after giving informed consent (five males, 35-51 years old). The subjects were nasally administered (201)TlCl into either the olfactory cleft. Twenty-four hours later, uptake of (201)Tl was detected by a single photon emission computed tomography (SPECT)/X-ray computed tomography hybrid system. For each subject, an MRI image was obtained and merged with the SPECT image. The peak of the (201)Tl uptake entered into the olfactory bulb in the anterior skull base through the cribriform lamina 24 h after nasal administration of (201)Tl. No participant had olfactory disturbance after treatment. Nasal (201)Tl administration was safely used to assess the direct pathway to the brain via the nose in healthy volunteers with normal olfactory threshold.Molecular imaging and biology: MIB: the official publication of the Academy of Molecular Imaging 12/2010; 13(6):1262-6. · 2.47 Impact Factor -
Article: Use of thallium transport to visualize functional olfactory nerve regeneration in vivo.
[show abstract] [hide abstract]
ABSTRACT: To image olfactory nerve regeneration in vivo using a high-resolution gamma cam- era and radiography after nasal administration of thallium-201 (olfacto-scintigraphy). Six Wistar rats were trained to avoid the smell of cycloheximide as a test of olfactory function. The olfactory nerve fibers of 3 rats were then carefully transected bilaterally with a Teflon knife, avoiding damage to the olfactory bulbs. The remaining 3 rats underwent sham operations and were used as controls. Steel wires were implanted in the left olfactory bulb of each rat for locating the bulbs with plain X-rays. The rats were assessed 2, 14, 28, and 42 d after the olfactory nerve transection or sham operation for their ability to detect odours and for transport of 201Tl to the olfactory bulb area 8 h after nasal administration of 201Tl. Both transport of 201Tl to the olfactory bulb area (p < 0.04) and ability to detect odours (p < 0.04) significantly increased with a time course after olfactory nerve transection. 201Tl transport to the olfactory bulb may be useful to visually assess olfactory ability in vivo. We plan to test olfacto-scintigraphy clinically by nasal administration of 201Tl in patients with posttraumatic olfactory loss.Rhinology 12/2009; 47(4):460-4. · 1.32 Impact Factor -
Article: Usefulness of curry odorant of odor stick identification test for Japanese in olfactory impairment screening.
[show abstract] [hide abstract]
ABSTRACT: The curry odorant of the odor stick identification test for Japanese (OSIT-J) is useful in screening for olfactory impairment in Japanese subjects. The present study was designed to determine the most useful odorant of the OSIT-J in screening for olfactory impairment in Japanese subjects. We studied olfactory impairment screening with the OSIT-J in 83 participants (49 male, 34 female; average age 50 years) in an executive check-up at NTT West Kanazawa Hospital. Olfactory discrimination acuity was evaluated with three odorants of the OSIT-J (rose, curry, and sweaty-smelling clothes), each known to be significantly correlated with the assessment of the Japanese standard olfaction test (T&T olfactometer). Those participants who did not score full marks in tests with the three odors were assessed with another nine odorants of the OSIT-J. The positive predictive value was 100% in the screening with the curry odorant. In 38 participants who did not identify all three odors correctly, the identification of the curry odor was significantly correlated with the scores for all 12 odors (p<0.005). Identification of the curry odor was not significantly correlated with identification of the menthol odor of OSIT-J.Acta oto-laryngologica. Supplementum 06/2009; -
Article: Odor detection ability and thallium-201 transport in the olfactory nerve of traumatic olfactory-impaired mice.
[show abstract] [hide abstract]
ABSTRACT: Although olfactory nerve damage is a contributing factor in the diagnosis of posttraumatic olfactory loss, at present, there are no methods to directly assess injury to these nerves. We have shown that following olfactory nerve injury in mice, thallium-201 (201 Tl) transport from the nasal cavity to the olfactory bulb decreases. To determine if olfactory function after nerve injury could be assessed with nasal administration of 201 Tl, we measured the correlation between odor detection ability (ODA) and the rate of transport of 201 Tl in olfactory nerves. Both ODA and 201 Tl transport were measured after bilateral olfactory nerve transection for a 4-week period. Cycloheximide solution was used for ODA against tap water. 201 Tl transport was measured as the ratio of radioactivity in the nasal cavity and olfactory bulb with gamma spectrometry. There was a significant correlation between ODA and the rate of 201 Tl transport in the olfactory nerve. These findings suggest that olfactory function after nerve injury can be objectively evaluated with the nasal administration of 201 Tl.Chemical Senses 07/2008; 33(7):633-7. · 2.60 Impact Factor -
Article: Thallium transport and the evaluation of olfactory nerve connectivity between the nasal cavity and olfactory bulb.
[show abstract] [hide abstract]
ABSTRACT: Little is known regarding how alkali metal ions are transported in the olfactory nerve following their intranasal administration. In this study, we show that an alkali metal ion, thallium is transported in the olfactory nerve fibers to the olfactory bulb in mice. The olfactory nerve fibers of mice were transected on both sides of the body under anesthesia. A double tracer solution (thallium-201, (201)Tl; manganese-54, (54)Mn) was administered into the nasal cavity the following day. Radioactivity in the olfactory bulb and nasal turbinate was analyzed with gamma spectrometry. Auto radiographic images were obtained from coronal slices of frozen heads of mice administered with (201)Tl or (54)Mn. The transection of the olfactory nerve fibers was confirmed with a neuronal tracer. The transport of intranasal administered (201)Tl/(54)Mn to the olfactory bulb was significantly reduced by the transection of olfactory nerve fibers. The olfactory nerve transection also significantly inhibited the accumulation of fluoro-ruby in the olfactory bulb. Findings indicate that thallium is transported by the olfactory nerve fibers to the olfactory bulb in mice. The assessment of thallium transport following head injury may provide a new diagnostic method for the evaluation of olfactory nerve injury.Chemical Senses 02/2008; 33(1):73-8. · 2.60 Impact Factor -
Article: [Olfactory disturbance screening with the odor stick identification test (OSIT-J) in executive checkups].
[show abstract] [hide abstract]
ABSTRACT: The odor stick identification test for Japanese (OSIT-J) has been shown to be useful for detecting and evaluating olfactory disturbances in Japanese people. We studied the usefulness of OSIT-J in screening for olfactory disturbances in 83 Japanese participants (49 male, 34 female) participating in an executive checkup at NTT West Kanazawa Hospital in Japan. The olfactory ability was self-reported on a grade scale. Olfactory function was then evaluated with a three-odors OSIT-J (rose, curry and sweaty socks). Participants with low self-reported olfactory ability or less-than-full scores in the three-odor test were evaluated with an additional 10 odors of OSIT-J. Eight or less points are considered to be lower than average in the 13-odor test of OSIT-J (Saito S, et al.). Eleven of the 83 participants had low self-reported olfactory ability. Four participants with a full score in the three odors test with low self-reported olfactory ability scored more than eight points in the 13-odor test. Thirty-eight participants scored less than three points in the three-odor test. Seven of 29 participants with two points in the three-odor test scored eight or less in the 13-odor test. In the 29 participants, subjects with low self-reported olfactory ability scored significantly lower scores than those without a low self-reported olfactory ability in the 13-odor test. The self-reported olfactory ability was not related to the score in the 13-odor test in the nine participants with one point or less in the three-odor test. Males scored significantly lower scores than females in the three-odor test. However, gender was not significantly related to the rate of olfactory disability estimated based on the 13-odor test. Use of a three-odor OSIT-J along with a self-administered questionnaire pertaining to olfactory disability is useful for olfactory disturbance screening during executive health checkups.Nippon Jibiinkoka Gakkai Kaiho 09/2007; 110(8):586-91. -
Article: Lipopolysaccharide-induced apoptosis of olfactory receptor neurons in rats.
[show abstract] [hide abstract]
ABSTRACT: Daily intranasal perfusion of lipopolysaccharide (LPS) for 14 days in rats induced apoptosis of olfactory receptor neurons (ORNs) over >3 but <7 days. Smoking is one of the factors causing olfactory dysfunction. LPS is a major glycolipid component of the gram-negative bacterial cell wall and an active component of cigarette smoke. We studied whether LPS is one of the causes of tobacco-induced olfactory dysfunction by examining apoptosis in the olfactory epithelium after local exposure to LPS. Rats received intranasal instillation of LPS or saline. Histochemical changes in the olfactory epithelium were examined using antibodies against single-stranded DNA, Bcl-2, Bax, and Caspase-3. We used different concentrations of LPS to examine the dose dependency and observed changes in the olfactory epithelium for a week after exposure cessation to see the duration of the effect of smoking. We found that numbers of cells positive for ssDNA, Bcl-2, Bax, and Caspase-3 were increased on the exposed side. The number of ssDNA-positive cells reached a maximum on the first day and decreased to normal levels on the seventh day after cessation of exposure.Acta Oto-Laryngologica 07/2007; 127(7):748-53. · 1.08 Impact Factor -
Article: OK-432 therapy for a cervical thoracic duct cyst.
Otolaryngology Head and Neck Surgery 06/2007; 136(5):852-3. · 1.72 Impact Factor -
Article: Expression and localization of the cell adhesion molecule SgIGSF during regeneration of the olfactory epithelium in mice.
[show abstract] [hide abstract]
ABSTRACT: Spermatogenic immunoglobulin superfamily (SgIGSF) is a cell adhesion molecule originally discovered in mouse testis. SgIGSF is expressed not only in spermatogenic cells but also in lung and liver epithelial cells and in neurons and glia of the central and peripheral nervous systems. In the present study, we examined the expression and localization of SgIGSF in mouse olfactory epithelium before and after transection of the olfactory nerves, by RT-PCR, Western blotting and immunohistochemistry. In normal olfactory mucosa, SgIGSF showed 100 kDa in molecular weight, which was identical with that in the lung but different from that in the brain. SgIGSF was expressed on the membrane of all olfactory, sustentacular and basal cells, but more abundantly in the apical portions of the olfactory epithelium where the dendrites of olfactory cells are in contact with sustentacular cells. After olfactory nerve transection, mature olfactory cells disappeared in 4 days but were regenerated around 7-15 days by proliferation and differentiation of basal cells into mature olfactory cells through the step of immature olfactory cells. During this period, both the mRNA and protein for SgIGSF showed a transient increase, with peak levels at 7 days and 11 days, respectively, after the transection. Immunohistochemistry showed that the enriched immunoreactivity for SgIGSF at 7-11 days was localized primarily to the membrane of immature olfactory cells. These results suggested that, during regeneration of the olfactory epithelium, the adhesion molecule SgIGSF plays physiological roles in differentiation, migration, and maturation of immature olfactory cells.Acta histochemica et cytochemica official journal of the Japan Society of Histochemistry and Cytochemistry 06/2007; 40(2):43-52. · 1.11 Impact Factor -
Article: Posttraumatic olfactory loss.
[show abstract] [hide abstract]
ABSTRACT: Head injury is the leading cause of posttraumatic anosmia. Complete or partial loss of olfactory function may occur when the nasal passages are blocked, olfactory nerves are injured or there are contusions or hemorrhages in olfactory centers of the brain. Evaluation of patients with posttraumatic olfactory loss should include a physical examination by the otolaryngologist. Nasal endoscopy and radiological studies should be performed as well as olfactory function tests to determine the degree and type of olfactory impairment. Although treatment options may be limited, physicians should provide information and counseling regarding the risks and hazards associated with loss of olfactory function. For some individuals such as cooks, firefighters, and research scientists, an assessment of vocational activities should be performed prior to reentry into the workplace. Individuals with impaired olfactory function may be unable to detect important warning signs such as gas leaks, volatile chemical fumes and fires and therefore place themselves and coworkers at an increased risk for serious injury or death.Advances in oto-rhino-laryngology 02/2006; 63:99-107. -
Article: Comparison of diagnostic findings using different olfactory test methods.
[show abstract] [hide abstract]
ABSTRACT: To quantify discrepancies in the diagnosis of olfactory function that might exist when comparing results obtained from centers using different methods of olfactory testing. Prospective study of 50 healthy adult volunteers and 25 adult patients with olfactory complaints. Two test methods, the Connecticut Chemosensory Clinical Research Center (CCCRC) test widely used in the United States, and the Jet Stream Olfactometer (JSO) test used in Japan, were used to measure and categorize the diagnostic level of olfactory function (normosmia, mild hyposmia, moderate hyposmia, severe hyposmia, anosmia). Olfactory function was measured separately for each nostril. There was a significant correlation (rs = 0.788, P < .01, n = 150 nostrils) between diagnostic categories assigned by the CCCRC and JSO test methods. Diagnostic categories were identical for 66.7% of the nostrils tested, and in only 7.3% of the cases did the results differ by more than one category. For the anosmic and normosmic categories, test results were in agreement 91.7% of the time, whereas for the hyposmic categories (mild, moderate, and severe) results were in agreement only 22.2% of the time. Our results demonstrate that when comparing clinical or research data obtained from centers using different olfactory test methods, subjects with diagnoses of anosmia or normosmia may be more reliably compared than those with different levels of hyposmia.The Laryngoscope 06/2005; 115(6):1114-7. · 1.75 Impact Factor -
Article: Middle turbinate fenestration method: a new technique for the treatment of olfactory disturbance due to chronic sinusitis.
Chemical Senses 02/2005; 30 Suppl 1:i214-5. · 2.60 Impact Factor -
Article: [Clinical usefulness of odor stick identification test for patients with olfactory disturbance].
[show abstract] [hide abstract]
ABSTRACT: The odor stick identification test for Japanese (OSITJ) is the latest in measuring olfactory identification. It consists of 13 odorants familiar to the Japanese population. We studied the relationship between the Japanese standard olfactory test (T & T olfactometer) and the OSITJ in 182 patients with olfactory disturbance. The identification ratio in 2 of OSITJ tests using 13 odorants was correlated significantly negatively with the detection and recognition threshold measured by the T & T olfactometer. A high correlation between identification ratio and olfactory thresholds was maintained even when the number of odorants in the OSITJ was reduced to 2. For each odorant used, the identification ratio correlated significantly with olfactory thresholds. Results from the OSITJ provide a measure of the degree of olfactory deficit because the ratio of correct answers obtained by the OSITJ decreased gradually with of the severity of olfactory disturbance. Compared to the T & T olfactometer, the OSITJ has several advantages for use in the clinic. These include minimal odor pollution of the test room, simplicity of use, and shorter clinical time needed to administer the test. The OSITJ may be ideal for use in screening due to the minimum number of odorants needed. In conclusion, the OSITJ is useful for detecting and evaluating olfactory disturbance in Japanese people.Nippon Jibiinkoka Gakkai Kaiho 11/2004; 107(10):956-65. -
Article: Olfactory impairment and Parkinson's disease-like symptoms observed in the common marmoset following administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine.
[show abstract] [hide abstract]
ABSTRACT: Although olfactory disturbance appears to occur in the early stages of Parkinson's disease (PD) in humans, little is known about its mechanism. The aim of this study was to make a PD model using injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) in the common marmoset and to discover the mechanism of olfactory disturbance in this animal. Olfactory disturbance induced by MPTP in the common marmoset was observed by behavioral, biochemical and immunohistochemical means. Administration of MPTP caused common marmosets to enter an akinetic state within a few days and to show signs of impaired olfactory function. Biochemical study showed a decrease in dopamine levels, especially in tissue samples from the caudate nucleus and putamen. Immunohistochemical analysis revealed a lack of tyrosine hydroxylase immunoreactivity, not only in the substantia nigra, caudate nucleus and putamen but also in the olfactory tubercle. These results demonstrate that MPTP causes both PD-like symptoms and olfactory disturbance in the common marmoset. The olfactory disturbance observed in these animals may be due to the lack of dopamine in the olfactory tubercle.Acta oto-laryngologica. Supplementum 09/2004; -
Article: Potential oscillation elicited by i.v. olfaction and its applicability as an objective clinical olfaction test.
[show abstract] [hide abstract]
ABSTRACT: Alinamin has long been applied in Japan for testing i.v. olfaction and to diagnose olfactory disorders. The test is subjective, each subject being asked about the presence or absence of olfaction. The credibility of the answers is highly questionable in some cases; as a result, the reliability of the test is poor. Recent studies demonstrated an induced electric potential in the scalp during i.v. olfactory testing. Some patients complain of the pain of the injection during i.v. olfactory testing; therefore, the effect of this pain must be considered with respect to measurement of the i.v. olfaction-elicited potential (IVOP). This investigation involved 179 subjects with various olfaction levels. Each subject received an Alinamin injection; the elicited potential amplitude was compared before and after the injection and the increasing ratio (IR) was computed. Gender, age, level of olfactory disorder, the presence or absence of olfaction and the presence or absence of the pain of injection were considered as factors affecting IR. IR showed significant increases in groups characterized by the presence of olfaction as well as in groups reporting pain of injection. The test subjects were further divided into four groups based on their olfaction and pain of injection patterns as follows: Group A, no smell and no pain; Group B, smell and no pain; Group C, no smell and pain; and Group D, smell and pain. Subjects exhibiting no recognizable olfaction or pain of injection (Group A) revealed no increase in IVOP following injection. Subjects with either recognizable olfaction or pain of injection (Groups B and C) exhibited a slight increase in IVOP following injection. Subjects with both noticeable olfaction and pain of injection (Group D) demonstrated a significant increase in IVOP following the injection with a very high value of IR (>2). Furthermore, there were significant differences between the four groups in terms of IR level, with the exception of Groups B and C. Olfaction is largely involved with the generation of IVOP. However, pain resulting from injection of Alinamin is considered to be a significant factor. IVOP showed significant effectiveness for diagnosing olfactory disorders in cases who did not experience pain of injection.Acta oto-laryngologica. Supplementum 08/2004; -
Article: [Head and neck reconstruction using laparoscopically harvested omentum].
[show abstract] [hide abstract]
ABSTRACT: Since the need for laparotomy in harvesting the omentum is the most significant drawback, the omentum has not been the tissue of choice for reconstructive surgery. To compensate for this drawback, we started laparoscopic harvesting of the omentum and clarified the advantages and disadvantages of this procedure. Ten patients underwent laparoscopic harvesting of the omentum by abdominal surgeons, followed by reconstruction of head and neck defects. Surgery was conducted in 5 cases of defect reconstructions for parotid gland tumor surgery and 5 of oropharyngeal defect after cancer surgery. The average harvesting time was 107 minutes (55-140 minutes) and used the omentum and different amounts and length of the vascular pedicle. Although the omentum was successfully transplanted in 9 of 10 cases, 2 cases showed partial peripheral necrosis and 1 total necrosis. With the advantage of laparoscopic harvesting of the omentum, we could obtain appropriate omental size for the defect size. Especially after total parotidecomy, the omentum was useful to fill in the defect, reducing the patients' worries about postoperative deformity. In one case, the omentum was used to treat Frey syndrome, successfully relieving the symptoms. In oropharyngeal reconstruction, the omentum is used to fill dead space and prevented postoperative infection. Although mild abdominal pain was observed a few days after surgery, no major abdominal complications such as intestinal perforation or ileus occurred in the 8 to 39 months following laparoscopic harvest of the omentum. Since the omentum is pliable and easily fills a complicated defect, the omentum is considered satisfactory for reconstructing defects of the lateral face after parotid tumor surgery and small defects after oropharyngeal tumor surgery.Nippon Jibiinkoka Gakkai Kaiho 07/2004; 107(6):658-64.
Top co-authors
Top Journals
Institutions
-
2002–2013
-
Kanazawa University
- • Department of Quantum Medical Technology
- • Graduate School of Medical Sciences
- • Department of Otorhinolaryngology and Head and Neck Surgery
- • School of Medicine
Kanazawa-shi, Ishikawa-ken, Japan
-
-
2010–2012
-
Kanazawa Medical University
Kanazawa-shi, Ishikawa-ken, Japan
-
-
2006
-
Virginia Commonwealth University
- School of Medicine
Richmond, VA, USA
-
