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| 1 | Developmental dysplasia of the hip in the newborn: A systematic review显示文摘Developmental dysplasia of the hip(DDH) denotes a wide spectrum of conditions ranging from subtle acetabular dysplasia to irreducible hip dislocations. Clinical diagnostic tests complement ultrasound imaging in allowing diagnosis, classification and monitoring of this condition. Classification systems relate to the alpha and beta angles in addition to the dynamic coverage index(DCI). Screening programmes for DDH show considerable geographic variation; certain risk factors have been identified which necessitate ultrasound assessment of the newborn. The treatment of DDH has undergone significant evolution, but the current gold standard is still the Pavlik harness. Duration of Pavlik harness treatment has been reported to range from 3 to 9.3 mo. The beta angle, DCI and the superior/lateral femoral head displacement can be assessed via ultrasound to estimate the likelihood of success. Success rates of between 7% and 99% have been reported when using the harness to treat DDH. Avascular necrosis remains the most devastating complication of harness usage with a reported rate of between 0% and 28%. Alternative non-surgical treatment methods used for DDH include devices proposed by LeD amany, Frejka, Lorenz and Ortolani. The Rosen splint and Wagner stocking have also been used for DDH treatment. Surgical treatment for DDH comprises open reduction alongside a combination of femoral or pelvic osteotomies. Femoral osteotomies are carried out in cases of excessive anteversion or valgus deformity of the femoral neck. The two principal pelvic osteotomies most commonly performed are the Salter osteotomy and Pemberton acetabuloplasty. Serious surgical complications include epiphyseal damage, sciatic nerve damage and femoral neck fracture. | Vivek Gulati Kelechi Eseonu Junaid Sayani Nizar Ismail Chika Uzoigwe Muhammed Zaki Choudhury Pooja Gulati Adeel Aqil Saket Tibrewal | 2013 | World Journal of Orthopedics2013,4,2: | 29 |
| 2 | Development of Helicobacter pylori treatment: How do we manage antimicrobial resistance?显示文摘Helicobacter pylori(H. pylori) antimicrobial resistance is an urgent, global issue. In2017, the World Health Organization designated clarithromycin-resistant H.pylori as a high priority bacterium for antibiotic research and development. In addition to clarithromycin, resistance to metronidazole and fluoroquinolones has also increased worldwide. Recent international guidelines for management of H.pylori infection recommend bismuth or non-bismuth quadruple therapy for 14 d as a first-line treatment for H. pylori in areas of high clarithromycin and/or metronidazole resistance. Although these treatment regimens provide acceptable H. pylori eradication rates, the regimens used should not contribute to future resistance of H. pylori to antimicrobials. Moreover, these regimens can promote resistance, due to prolonged therapy with multiple antibiotics. A new strategy that can eradicate H. pylori as well as reduce the antibiotics used is required to prevent future antimicrobial resistance in H. pylori. Dual-therapy with vonoprazan and amoxicillin could be a breakthrough for H. pylori eradication in an era of growing antimicrobial resistance. This regimen may provide a satisfactory eradication rate of H. pylori and also minimize antimicrobial resistance due to single antibiotic use and the strong inhibitory effect of vonoprazan on gastric acid secretion. | Sho Suzuki Mitsuru Esaki Chika Kusano Hisatomo Ikehara Takuji Gotoda | 2019 | World Journal of Gastroenterology2019,25,16: | 17 |
| 3 | Nutritional status in relation to lifestyle in patients with compensated viral cirrhosis显示文摘AIM:To assess the nourishment status and lifestyle of non-hospitalized patients with compensated cirrhosis by using noninvasive methods.METHODS:The subjects for this study consisted of 27 healthy volunteers,59 patients with chronic viral hepatitis,and 74 patients with viral cirrhosis,from urban areas.We assessed the biochemical blood tests,anthropometric parameters,diet,lifestyle and physical activity of the patients.A homeostasis model assessment-insulin resistance(HOMA-IR) value of ≥ 2.5 was considered to indicate insulin resistance.We measured height,weight,waist circumference,arm circumference,triceps skin-fold thickness,and handgrip strength,and calculated body mass index,arm muscle circumference(AMC),and arm muscle area(AMA).We interviewed the subjects about their dietary habits and lifestyle using health assessment computer software.We surveyed daily physical activity using a pedometer.Univariate and multivariate logistic regression modeling were used to identify the relevant factors for insulin resistance.RESULTS:The rate of patients with HOMA-IR ≥ 2.5(which was considered to indicate insulin resistance) was 14(35.9%) in the chronic hepatitis and 17(37.8%) in the cirrhotic patients.AMC(%)(control vs chronic hepatitis,111.9% ± 10.5% vs 104.9% ± 10.7%,P = 0.021;control vs cirrhosis,111.9% ± 10.5% vs 102.7% ± 10.8%,P = 0.001) and AMA(%)(control vs chronic hepatitis,128.2% ± 25.1% vs 112.2% ± 22.9%,P = 0.013;control vs cirrhosis,128.2% ± 25.1% vs 107.5% ± 22.5%,P = 0.001) in patients with chronic hepatitis and liver cirrhosis were significantly lower than in the control subjects.Handgrip strength(%) in the cirrhosis group was significantly lower than in the controls(control vs cirrhosis,92.1% ± 16.2% vs 66.9% ± 17.6%,P < 0.001).The results might reflect a decrease in muscle mass.The total nutrition intake and amounts of carbohydrates,protein and fat were not significantly different amongst the groups.Physical activity levels(kcal/d)(control vs cirrhosis,210 ± 113 kcal/d vs 125 ± 74 kcal/d,P = 0.001),number of steps(step/d)(control vs cirrhosis,8070 ±3027 step/d vs 5789 ± 3368 step/d,P = 0.011),and exercise(Ex)(Ex/wk)(control vs cirrhosis,12.4 ± 9.3 Ex/wk vs 7.0 ± 7.7 Ex/wk,P = 0.013) in the cirrhosis group was significantly lower than the control group.The results indicate that the physical activity level of the chronic hepatitis and cirrhosis groups were low.Univariate and multivariate logistic regression modeling suggested that Ex was associated with insulin resistance(odds ratio,6.809;95% CI,1.288-36.001;P = 0.024).The results seem to point towards decreased physical activity being a relevant factor for insulin resistance.CONCLUSION:Non-hospitalized cirrhotic patients may need to maintain an adequate dietary intake and receive lifestyle guidance to increase their physical activity levels. | Fumikazu Hayashi Chika Momoki Miho Yuikawa Yuko Simotani Etsushi Kawamura Atsushi Hagihara Hideki Fujii Sawako Kobayashi Shuji Iwai Hiroyasu Morikawa Masaru Enomoto Akihiro Tamori Norifumi Kawada Satoko Ohfuji Wakaba Fukusima Daiki Habu | 2012 | World Journal of Gastroenterology2012,18,40: | 11 |
| 4 | Cytokines in adipose-derived mesenchymal stem cells promote the healing of liver disease显示文摘Adipose-derived mesenchymal stem cells(ADSCs) are a treatment cell source for patients with chronic liver injury. ADSCs are characterized by being harvested from the patient's own subcutaneous adipose tissue, a high cell yield(i.e., reduced immune rejection response), accumulation at a disease nidus, suppression of excessive immune response, production of various growth factors and cytokines, angiogenic effects, antiapoptotic effects, and control of immune cells via cellcell interaction. We previously showed that conditioned medium of ADSCs promoted hepatocyte proliferation and improved the liver function in a mouse model of acute liver failure. Furthermore, as found by many other groups, the administration of ADSCs improved liver tissue fibrosis in a mouse model of liver cirrhosis. A comprehensive protein expression analysis by liquid chromatography with tandem mass spectrometry showed that the various cytokines and chemokines produced by ADSCs promote the healing of liver disease. In this review, we examine the ability of expressed protein components of ADSCs to promote healing in cell therapy for liver disease. Previous studies demonstrated that ADSCs are a treatment cell source for patients with chronic liver injury. This review describes the various cytokines and chemokines produced by ADSCs that promote the healing of liver disease. | Saifun Nahar Yoshiki Nakashima Chika Miyagi-Shiohira Takao Kinjo Zensei Toyoda Naoya Kobayashi Issei Saitoh Masami Watanabe Hirofumi Noguchi Jiro Fujita | 2018 | World Journal of Stem Cells2018,10,11: | 11 |
| 5 | Epithelial ovarian cancer:An overview显示文摘Ovarian cancer is the second most common gyneco-logical cancer and the leading cause of death in the United States. In this article we review the diagnosis and current management of epithelial ovarian cancer which accounts for over 95 percent of the ovarian malignancies. We will present various theories about the potential origin of ovarian malignancies. We will discuss the genetic anomalies and syndromes that may cause ovarian cancers with emphasis on Breast cancer type 1/2 mutations. The pathology and pathogenesis of ovarian carcinoma will also be presented. Lastly, we provide a comprehensive overview of treatment strategies and staging of ovarian cancer, conclusions and future directions. | Arpita Desai Jingyao Xu Kartik Aysola Yunlong Qin Chika Okoli Ravipati Hariprasad Ugorji Chinemerem Candace Gates Avinash Reddy Omar Danner Geary Franklin Anachebe Ngozi Guilherme Cantuaria Karan Singh William Grizzle Charles Landen Edward E Partridge Valerie Montgomery Rice E Shyam P Reddy Veena N Rao | 2014 | World Journal of Translational Medicine2014,3,1: | 10 |
| 6 | Endoscopic diagnosis and treatment of superficial nonampullary duodenal tumors显示文摘The diagnostic and treatment guidelines of superficial non-ampullary duodenal tumors have not been standardized due to their low prevalence.Previous reports suggested that a superficial adenocarcinoma(SAC) should be treated via local resection because of its low risk of lymph node metastasis,whereas a highgrade adenoma(HGA) should be resected because of its high risk of progression to adenocarcinoma.Therefore,pretreatment diagnosis of SAC or HGA is important to determine the appropriate treatment strategy.There are certain endoscopic features known to be associated with SAC or HGA,and current practice prioritizes the endoscopic and biopsy diagnosis of these conditions.Surgical treatment of these duodenal lesions is often related to high risk of morbidity,and therefore endoscopic resection has become increasingly common in recent years.Endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD) are the commonly performed endoscopic resection methods.EMR is preferred due to its lower risk of adverse events;however,it has a higher risk of recurrence than ESD.Recently,a new and safer endoscopic procedure that reduces adverse events from EMR or ESD has been reported. | Mitsuru Esaki Sho Suzuki Hisatomo Ikehara Chika Kusano Takuji Gotoda | 2018 | World Journal of Gastrointestinal Endoscopy2018,10,9: | 7 |
| 7 | Clinical impact of endoscopy position detecting unit(UPD-3) for a non-sedated colonoscopy显示文摘AIM:To evaluate whether an endoscopy position detecting unit(UPD-3) can improve cecal intubation rates, cecal intubation times and visual analog scale(VAS) pain scores, regardless of the colonoscopist's level of experience.METHODS:A total of 260 patients(170 men and 90women)who underwent a colonoscopy were divided into the UPD-3-guided group or the conventional group(no UPD-3 guidance).Colonoscopies were performed by experts(experience of more than 1000colonoscopies)or trainees(experience of less than 100colonoscopies).Cecal intubation rates,cecal intubation times,insertion methods(straight insertion:shortening the colonic fold through the bending technique;roping insertion:right turn shortening technique)and patient discomfort were assessed.Patient discomfort during the endoscope insertion was scored by the VAS that was divided into 6 degrees of pain.RESULTS:The cecum intubation rates,cecal intubation times,number of cecal intubations that were performed in<15 min and insertion methods were not significantly different between the conventional group and the UPD-3-guided group.The number of patients who experienced pain during the insertion was markedly less in the UPD-3-guided group than in the conventional group.Univariate and multivariate analysis showed that the following factors were associated with lower VAS pain scores during endoscope insertion:insertion method(straight insertion)and UPD-3guidance in the trainee group.For the experts group,univariate analysis showed that only the insertion method(straight insertion)was associated with lower VAS pain scores.CONCLUSION:Although UPD-3 guidance did not shorten intubation times,it resulted in less patient painduring endoscope insertion compared with conventional endoscopy for the procedures performed by trainees. | Masakatsu Fukuzawa Junichi Uematsu Shin Kono Sho Suzuki Takemasa Sato Naoko Yagi Yuichiro Tsuji Kenji Yagi Chika Kusano Takuji Gotoda Takashi Kawai Fuminori Moriyasu | 2015 | World Journal of Gastroenterology2015,21,16: | 5 |
| 8 | Serum Neutrophil Gelatinase-associated Lipocalin(NGAL)Is Elevated in Patients with Asthma and Airway Obstruction显示文摘Neutrophilic airway inflammation is one of the features of severe asthma.Neutrophil gelatinase-associated lipocalin(NGAL),or lipocalin-2,is a glycoprotein associated with neutrophilic inflammation and can be detected in blood.Recently,blood NGAL levels have been reported to be elevated in chronic obstructive pulmonary disease.However,the clinical significance of serum NGAL levels in patients with asthma has not been elucidated.The aim of this study was to explore the association between serum NGAL level and clinical parameters in patients with asthma.Sixty.one non-smoking people with stable asthma were enrolled in this study.All patients underwent blood ollction and pulmonary function tests.The associations between serum NGAL levels and clinical parameters were analyzed retrospectively.Serum NGAL levels in patients with asthma and obstructive ventilatory defect were higher than those in patients with asthma without obstructive ventilatory defect(76.4±51.4 ng/mL vs.39.3±27.4 ng/mL,P=0.0019).Serum NGAL levels were correlated with forced expired flow at 50%of vital capacity%predicted and forced expired flow at 75%of vital capacity%predicted(r=-0.3373,P=0.0078 and r=0.2900,P=0.0234,respectively).Results of a multiple regression analysis demonstrated that serum NGAL level was independently associated with obstructive ventilatory defect.Serum NGAL levels were elevated in patients with asthma and obstructive ventilatory defect.NGAL may be involved in airway remodeling possibly mediated by neutrophilic inflammation in asthma. | Junichiro Kawagoe Yuta Kono Yuki Togashi Mayuko Ishiwari Kazutoshi Toriyama Chika Yajima Hideaki Nakayama Satoshi Kasagi Shinji Abe Yasuhiro Setoguchi | 2021 | Current Medical Science2021,41,2: | 5 |
| 9 | Management of achilles tendon injury: A current concepts systematic review显示文摘Achilles tendon rupture has been on the rise over recent years due to a variety of reasons. It is a debilitating injury with a protracted and sometimes incomplete recovery. Management strategy is a controversial topic and evidence supporting a definite approach is limited. Opinion is divided between surgical repair and conservative immobilisation in conjunction with functional orthoses. A systematic search of the literature was performed. Pubmed, Medline and EmB ase databases were searched for Achilles tendon and a variety of synonymous terms. A recent wealth of reporting suggests that conservative regimens with early weight bearing or mobilisation have equivalent or improved rates of re-rupture to operative regimes. The application of dynamic ultrasound assessment of tendon gap may prove crucial in minimising re-rupture and improving outcomes. Studies employing functional assessments have found equivalent function between operative and conservative treatments. However, no specific tests in peak power, push off strength or athletic performance have been reported and whether an advantage in operative treatment exists remains undetermined. | Vivek Gulati Matthew Jaggard Shafic Said Al-Nammari Chika Uzoigwe Pooja Gulati Nizar Ismail Charles Gibbons Chinmay Gupte | 2015 | World Journal of Orthopedics2015,6,4: | 5 |
| 10 | Clear cell adenocarcinoma of the colon:A case report and review of literature显示文摘A primary clear cell adenocarcinoma of the colon is a rare oncologic entity. We herein report a case of such a tumor of the sigmoid colon in a 71-year-old woman who was successfully treated by an endoscopic polypectomy in our hospital. We also reviewed the published reports regarding cases of primary clear cell tumors in the colon. | Koichi Soga Hideyuki Konishi Natsuko Tatsumi Chika Konishi Keimei Nakano Naoki Wakabayashi Shoji Mitsufuji Keisho Kataoka Takeshi Okanoue Ken-Ichi Mukaisho Takanori Hattori | 2008 | World Journal of Gastroenterology2008,14,7: | 4 |
| 11 | Multicenter study of the long-term outcomes of endoscopic submucosal dissection for early gastric cancer in patients 80 years of age or older显示文摘 | Nobutsugu Abe Takuji Gotoda Toshiaki Hirasawa Shu Hoteya Kenji Ishido Yosuke Ida Hiroyuki Imaeda Eiji Ishii Atsushi Kokawa Chika Kusano Tadateru Maehata Satoshi Ono Hirohisa Takeuchi Masanori Sugiyama Shinichi Takahashi | 2012 | Gastric Cancer2012,,1: | 2 |
| 12 | Low prevalence of epilepsy and onchocerciasis after more than 20 years of ivermectin treatment in the Imo River Basin in Nigeria显示文摘Background:High epilepsy prevalence and incidence have been reported in areas with high onchocerciasis transmission.Recent findings suggest that proper community-directed treatment with ivermectin(CDTI)is potentially able to prevent onchocerciasis-associated epilepsy(OAE).We assessed the epilepsy prevalence and onchocerciasis transmission in two Nigerian villages following more than 20 years of CDTI.Methods:A cross-sectional door-to-door survey was performed in two villages in the Imo River Basin reported to be mesoendomic for onchocerciasis(Umuoparaodu and Umuezeala).Individuals were screened for epilepsy using a validated 5-item questionnaire.Persons suspected to have epilepsy were examined by a neurologist or a physician with training in epilepsy for confirmation.Onchocerciasis was investigated via skin snip microscopy and rapid diagnostic tests for Ov16 antibodies.Results were compared with previous findings from the Imo river basin.Results:A total of 843 individuals from 257 households in the two villages were encountered.We detected four persons with epilepsy(PWE)giving a crude epilepsy prevalence of 0.5%.This finding differs from observations reported 14 years ago which showed an epilepsy prevalence of 2.8%in the neighbouring village of Umulolo(P=0.0001),and 1.2%from 13 villages in the Imo river basin(P=0.07).The seroprevalence of Ov16 antibodies was found to be 0%.Only 4.6%of skin snips were positive compared to 26.8%in previous surveys(P<0.0001).Ivermectin mass distribution coverage in the study sites in 2017 was 79.7%.Conclusions:A low epilepsy and onchocerciasis prevalence was observed following more than 20 years of CDTI in the Imo River Basin.Absence of Ov16 antibodies indicates minimal transmission of onchocerciasis.These results contrast with observations from areas of high onchocerciasis transmission,where epilepsy prevalence and incidence remain high.Findings from this study suggest that sustained efforts could eventually achieve elimination of onchocerciasis in these villages. | Joseph N.F.Siewe Chinyere N.Ukaga Ernest O.Nwazor Murphy O.Nwoke Modebelu C.Nwokeji Blessing C.Onuoha Simon O.Nwanjor Joel Okeke Kate Osahor Lilian Chimechefulam Ann I.Ogomaka Augustine A.Amaechi Chika I.Ezenwa Monika N.Ezike Chidimma I.kpeama Ogechi Nwachukwu Austine I.Eriama-Joseph Berthram E.B.Nwoke Robert Colebunders | 2019 | Infectious Diseases of Poverty2019,8,1: | 2 |
| 13 | Association of gastric cancer risk factors with DNA methylation levels in gastric mucosa of healthy Japanese: a cross-sectional study显示文摘 | Shimazu Taichi Asada Kiyoshi Charvat Hadrien Kusano Chika Otake Yosuke Kakugawa Yasuo Watanabe Hidenobu Gotoda Takuji Ushijima Toshikazu Tsugane Shoichiro | 2015 | Carcinogenesis2015,,: | 2 |
| 14 | Endoscopic resection for residual lesion of metastatic gastric cancer:A case report显示文摘BACKGROUND Chemotherapy is a standard strategy for stage IV gastric cancer patients.However, some cases cannot undergo conversion surgery because of their frailty,even if the patients had response to chemotherapy. For these patients, local tumor progression is a problem. We report here the case of a patient whose residual gastric cancer was resected through endoscopic submucosal dissection(ESD)after concomitant chemotherapy for metastatic gastric cancer.CASE SUMMARY An 85-year-old male complained of difficulty swallowing, and examination revealed gastric cancer with multiple liver metastases. Although he received concomitant chemotherapy, a residual tumor was observed in the primary lesion while the metastatic lesions disappeared completely. Conversion surgery was considered optional treatment; however, he could not undergo that because of advanced age and comorbidities. Thus, we performed ESD to treat the residual tumor. As a result, we resected the residual lesion completely. The patient has been alive for 29 mo since ESD, without recurrence.CONCLUSION We achieved local control using ESD, and these findings may provide therapeutic improvements both in local control and patient survival outcomes. | Kaori Hayashi Sho Suzuki Hisatomo Ikehara Hiroaki Okuno Akira Irie Mitsuru Esaki Chika Kusano Takuji Gotoda Mitsuhiko Moriyama | 2019 | World Journal of Clinical Cases2019,7,4: | 2 |
| 15 | Endoscopic submucosal dissection for early gastric cancer in anastomosis site after distal gastrectomy显示文摘 | Shinwa Tanaka Takashi Toyonaga Yoshinori Morita Tsuyoshi Fujita Tetsuya Yoshizaki Fumiaki Kawara Chika Wakahara Daisuke Obata Aya Sakai Tsukasa Ishida Nobunao Ikehara Takeshi Azuma | 2014 | Gastric Cancer2014,,2: | 2 |
| 16 | Hyperdry human amniotic membrane application as a wound dressing for a full-thickness skin excision after a third-degree burn injury显示文摘Background:Severe burn injuries create large skin defects that render the host susceptible to bacterial infections.Burn wound infection often causes systemic sepsis and severe septicemia,resulting in an increase in the mortality of patients with severe burn injuries.Therefore,appropriate wound care is important to prevent infection and improve patient outcomes.However,it is difficult to heal a third-degree burn injury.The aim of this studywas to investigate whether hyperdry human amniotic membrane(HD-AM)could promote early granulation tissue formation after full-thickness skin excision in third-degree burn injury sites in mice.Methods:After the development of HD-AM and creation of a third-degree burn injury model,the HD-AM was either placed or not placed on the wound area in the HD-AM group or HD-AM group,respectively.The groups were prepared for evaluation on postoperative days 1,4 and 7.Azan staining was used for granulation tissue evaluation,and estimation of CD163,transforming growth factor beta-1(TGF-β1),vascular endothelial growth factor(VEGF),CD31,alpha-smooth muscle actin(α-SMA)and Iba1 expression was performed by immunohistochemical staining.Quantitative reverse-transcription polymerase chain reaction(PCR)was used to investigate gene expression of growth factors,cell migration chemokines and angiogenic and inflammatory markers.Results:The HD-AM group showed significant early and qualitatively good growth of granulation tissue on the full-thickness skin excision site.HD-AM promoted early-phase inflammatory cell infiltration,fibroblast migration and angiogenesis in the granulation tissue.Additionally,the early infiltration of cells of the immune system was observed.Conclusions:HD-AM may be useful as a new wound dressing material for full-thickness skin excision sites after third-degree burn injuries,and may be a new therapeutic technique for improving the survival rate of patients with severe burn injuries. | Jiro Oba Motonori Okabe Toshiko Yoshida Chika Soko Moustafa Fathy Koji Amano Daisuke Kobashi Masahiro Wakasugi Hiroshi Okudera | 2020 | Burns & Trauma2020,8,1: | 2 |
| 17 | Safe and effective sedation in endoscopic submucosal dissection for early gastric cancer: a randomized comparison between propofol continuous infusion and intermittent midazolam injection显示文摘 | Shinsuke Kiriyama Takuji Gotoda Hiromi Sano Ichiro Oda Fumiya Nishimoto Tetsuro Hirashima Chika Kusano Hiroyuki Kuwano | 2010 | Journal of Gastroenterology2010,,8: | 2 |
| 18 | Factors affecting attitudes towards mother-to- child transmission of HIV among pregnant women in a maternal and child hospital in Thailand显示文摘 | Chika Hyodo MA | 2000 | International Journal of STD & AIDS2000,11,: | 1 |
| 19 | Ex vivo pig training model for esophageal endosopic submucosal dissection (ESD) for endoscopists with experience in gastric ESD显示文摘 | Shinwa Tanaka Yoshinori Morita Tsuyoshi Fujita Chika Wakahara Atsuki Ikeda Takashi Toyonaga Takeshi Azuma | 2012 | Surgical Endoscopy2012,,6: | 1 |
| 20 | Linkage analysis of RFLP markers for clubroot resistance and pigmentation in Chinese cabbage (Brassica rapa ssp. pekinensis)显示文摘 | Etsuo Matsumoto Chika Yasui Michio Ohi Motohisa Tsukada | 1998 | Euphytica1998,,2: | 1 |