Elucidation of mechanism of cytomegalovirus reactivation and infection in inflammatory bowel disease.

• Project/Area Number: 21590810
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Gastroenterology
• Research Institution: Kyoto University
• Principal Investigator: NAKASE Hiroshi 京都大学, 医学研究科, 講師 (60362498)
• Project Period (FY): 2009 – 2011
• Project Status: Completed (Fiscal Year 2011)
• Budget Amount: ¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000); Fiscal Year 2011: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2010: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2009: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
• Keywords: 炎症性腸疾患 / サイトメガロウイルス / マクロファージ / サイトカイン

Research Abstract

Analysis of function of macrophages infected with cytomegalovirus(CMV). Macrophages, in which CMV was reactivated, strongly produced more pro-inflammatory cytokines in comparison with macrophages with no CMV reactivation. TGF-βdid not inhibit pro-inflammatory cytokine production from macrophages with CMV reactivation because Smad signal transduction was blocked in those cells.(2)Elucidation of mechanism of CMV infection in intestine of IBD. Gene expressions of PDGFR, etc., which could be entry site of CMV, were up-regulated in inflamed colonic mucosa in comparison with non-inflamed colonic mucosa. Interestingly, immunohistochemistry study revealed that CMV is mainly infected in mesenchymal cells of intestine.

Research Products

• [Journal Article] Involvement of Mycobacterium avium subspecies para tuberculosis with TNF-αproduction from Macrophage-possible link between MAP and immune response in Crohn's disease-Inflammatory Bowel Disease (2011)
  • Author(s): Nakase H, Tamaki H, Matsuura M, Chiba T, Okazaki K
  • Journal Title: Inflamm Bowel Dis Volume: 17 Issue: 11 Pages: 140-2
  • DOI: 10.1002/ibd.21750
  • Peer Reviewed
• [Journal Article] Importance of CXCL16 as a biomarker for granulocytapheresis in patients with Crohn's disease (2011)
  • Author(s): Nakase H, Uza N, Matsuura M, Chiba T
  • Journal Title: Inflamm Bowel Dis Volume: 17 Issue: 10 Pages: 2211-2
  • DOI: 10.1002/ibd.21657
• [Journal Article] Potential role of granulocyte/monocyte adsorptive apheresis for ulcerative colitis with concomitant CMV infection (2011)
  • Author(s): Nakase H, Matsuura M, Chiba T
  • Journal Title: Aliment Pharmacol Ther Volume: 33 Pages: 497-8
• [Journal Article] Tacrolimus suppresses IL-12/IL-23p40 in Crohn's disease and heals fistulae refractory to anti-TNF-αtherapy (2011)
  • Author(s): Nakase H, Uza N, Matsuura M, Chiba T
  • Journal Title: Aliment Pharmacol Ther Volume: 33 Pages: 979-80
• [Journal Article] SR-PSOX/CXCL16 plays a critical role in the progression of colonic inflammation (2011)
  • Author(s): Uza N, Nakase H, Yamamoto S, Yoshino T, Takeda Y, Ueno S, Inoue S, Mikami S, Matsuura M, Shimaoka T, Kume N, Minami M, Yonehara S, Ikeuchi H, Chiba T
  • Journal Title: Gut Volume: 60 Issue: 11 Pages: 1494-1505
  • DOI: 10.1136/gut.2010.221879
  • NAID: 120003497105
  • Peer Reviewed
• [Journal Article] Effect and Safety of Granulocyte-Monocyte Adsorption Apheresis for UC Patients Positive for Cytomegalovirus in Comparison with Immunosuppressants (2011)
  • Author(s): Yoshino T, Nakase H, Matsuura M, Matsumura K, Honzawa Y, Fukuchi T, Watanabe K, Murano M, Tsujikawa T, Fukunaga K, Matsumoto T, Chiba T
  • Journal Title: Digestion Volume: 84 Issue: 1 Pages: 3-9
  • DOI: 10.1159/000321911
• [Journal Article] Tacrolimus : rescue therapy or experimental drug for severe ulcerative colitis (2011)
  • Author(s): Nakase H, Yamamoto S, Matsuura M, Chiba T
  • Journal Title: Aliment Pharmacol Ther Volume: 33 Pages: 413-4
• [Journal Article] Positive finding of Colonic PCR for CMV-DNA is not false positive but warning for treating patients with UC refractory to immunosuppressive therapies Inflammatory Bowel Disease (2011)
  • Author(s): Nakase H Yoshino T, Matsumura K, Honzawa Y, Yamamoto S, Matsuura M, Chiba T
  • Journal Title: Inflammatory Bowel Diseases Volume: 17 Issue: 2 Pages: 13-4
  • DOI: 10.1002/ibd.21401
  • ISSN: 1078-0998
• [Journal Article] tential role of granulocyte/monocyte adsorptive apheresis for UC concomitant CMV infecti (2011)
  • Author(s): Nakase H, et al
  • Journal Title: Aliment Pharmacol Ther Volume: 33 Pages: 497-498
  • Peer Reviewed
• [Journal Article] Effect and Safety of Granulocyte-Monocyte Adsorption Apheresis for UC Patients Positive for Cytomegalovirus in Comparison with Immunosuppressants. (2011)
  • Author(s): Yoshino T, Nakase H, Matsuura M, Matsumura K, Honzawa Y, Fukuchi T, Watanabe K, Murano M, Tsujikawa T, Fukunaga K, Matsumoto T, Chiba T.
  • Journal Title: Digestion Volume: 84 Pages: 3-9
  • Peer Reviewed
• [Journal Article] Fat restriction is associated with impaired quality of life (QOL) in patients with ulcerative colitis and Crohn' s disease. (2011)
  • Author(s): Kuwabara A, Nakase H, Tsuji H, Shide K Chiba T, Inagaki N, Tanaka K.
  • Journal Title: Ulcers Volume
  • Peer Reviewed
• [Journal Article] Clinical significance of serum diamine oxidase activity in inflammatory bowel disease.-importance of evaluation of small intestinal permeability-. (2011)
  • Author(s): Honzawa Y, Nakase H, Matsuura M, Chiba T.
  • Journal Title: Inflammatory Bowel Disease Volume: 17
  • Peer Reviewed
• [Journal Article] Tacrolimus is a promising as a rescue therapy for severe ulcerative colitis, but never experimental trial (2011)
  • Author(s): Nakase H, Yamamoto S, Matsuura M, Chiba T.
  • Journal Title: Aliment Pharmacol Ther Volume: 33 Pages: 413-414
  • Peer Reviewed
• [Journal Article] Potential role of granulocyte/monocyte adsorptive apheresis for ulcerative colitis with concomitant CMV infection. (2011)
  • Author(s): Nakase H, Matsuura M, Chiba T.
  • Journal Title: Aliment Pharmacol Ther Volume: 33 Pages: 497-498
  • Peer Reviewed
• [Journal Article] Role of Heat Shock Protein 47 in Intestinal Fibrosis of Experimental Colitis. (2011)
  • Author(s): Kitamura H, Yamamoto S, Nakase H, Matsuura M, Honzawa Y, Matsumura K, Takeda Y, Uza N, Nagata K, Chiba T.
  • Journal Title: Biochem Biophys Res Commun. Volume: 404 Pages: 599-604
  • Peer Reviewed
• [Journal Article] Ectopic pancreas at the jejunum. (2011)
  • Author(s): Takeda Y, Nakase H, Chiba T.
  • Journal Title: Digest liver Dis Volume: 43
  • Peer Reviewed
• [Journal Article] Positive finding of Colonic PCR for CMV-DNA is not false positive but warning for treating patients with UC refractory to immunosuppressive therapies. (2011)
  • Author(s): Nakase H, Yoshino T, Matsumura K, Honzawa Y, Yamamoto S, Matsuura M, Chiba T.
  • Journal Title: Inflammatory Bowel Disease Volume: 17
  • Peer Reviewed
• [Journal Article] Tacrolimus therapy as an alternative to thiopurines for maintaining remission inpatients with refractory ulcerative colitis (2011)
  • Author(s): Yamamoto S, Nakase H, et al.
  • Journal Title: Journal of Clinical Gastroenterology Volume: (Epub ahead of print)
  • Peer Reviewed
• [Journal Article] TNFαis an important pathogenic factor contributing to reactivation of cytomegalovirus in inflamed mucosa of colon in patients with ulcerative colitis-lesson from clinical experiences-. (2010)
  • Author(s): Nakase H, Chiba T
  • Journal Title: Inflammatory Bowel Disease Volume: 16 Issue: 4 Pages: 550-551
  • DOI: 10.1002/ibd.21047
• [Journal Article] Immunosuppressive effects of tacrolimus on macrophages ameliorate experimental colitis (2010)
  • Author(s): Yoshino T, Nakase H, Honzawa Y, Matsumura K, Yamamoto S, Takeda Y, Ueno S, Uza N, Masuda S, Inui K, Chiba T
  • Journal Title: Inflammatory Bowel Disease Volume: 16 Issue: 12 Pages: 2022-33
  • DOI: 10.1002/ibd.21318
• [Journal Article] Low Prevalence of CMV Infection in Patients with Crohn's Disease in Comparison with Ulcerative colitis-Effect of different immune response on prevalence of CMV infection- (2010)
  • Author(s): Yoshino T, Honzawa Y, Chiba T.
  • Journal Title: Dig Dis Sci Volume: 55 Pages: 1498-1499
  • Peer Reviewed
• [Journal Article] Cytomegalovirus affects clinical outcome of infliximab therapy on patients with ulcerative colitis refractory to tacrolimus. (2010)
  • Author(s): Nakase H, Yamamoto S, Matsuura M, Honzawa Y, Chiba T.
  • Journal Title: Aliment Pharmacol Ther Volume: 32 Pages: 510-511
  • Peer Reviewed
• [Journal Article] Immunosuppressive effects of tacrolimus on macrophages ameliorate experimental colitis. (2010)
  • Author(s): Yoshino T, Nakase H, et al.
  • Journal Title: Inflammatory Bowel Disease Volume: 16 Pages: 2022-2033
  • Peer Reviewed
• [Journal Article] Efficacy of Oral Tacrolimus on Intestinal Behcet's Disease. (2010)
  • Author(s): Matsumura K, Nakase H, Chiba T.
  • Journal Title: Inflammatory Bowel Disease Volume: 16 Pages: 188-189
  • Peer Reviewed
• [Journal Article] TNF α is an important pathogenic factor contributing to reactivation of cytomegalovirus in inflamed mucosa of colon in patients with ulcerative colitis.-lesson from clinical experiences-. (2010)
  • Author(s): Nakase H, Chiba T.
  • Journal Title: Inflammatory Bowel Disease Volume: 16 Pages: 550-551
  • Peer Reviewed
• [Journal Article] Effect of EP4 agonist (ONO-4819CD) for patients with mild to moderate ulcerative colitis refractory to 5-aminosalicylates : A randomized phase 2, placebo-controlled trial. (2010)
  • Author(s): Nakase H, Fujiyama Y, Oshitani N, Oga T, Nonomura K, Matsuoka T, Murayama T, Teramukai S, Chiba T, Narumiya S.
  • Journal Title: Inflammatory Bowel Disease Volume: 16 Pages: 731-733
  • Peer Reviewed
• [Journal Article] Sustained abdominal discomfort in a 57-year-old-woman. (2010)
  • Author(s): Nishiura H, Nakase H, Chiba T.
  • Journal Title: Gut Volume: 59 Pages: 578-594
  • Peer Reviewed
• [Journal Article] Gastrointestinal follicular lymphoma : review of the literature. (2010)
  • Author(s): Yamamoto S, Nakase H, Yamashita K, Matsuura M, Takada M, Kawanami C, Chiba T.
  • Journal Title: Journal of Gastroenterology Volume: 45 Pages: 370-388
  • NAID: 10027215379
  • Peer Reviewed
• [Journal Article] Efficacy and safety of infliximab as rescue therapy for ulcerative colitis refractory to tacrolimus. (2010)
  • Author(s): Yamamoto S, Nakase H, Matsuura M, Honzawa Y, Masuda S, Inui Ken-ichi, Chiba T.
  • Journal Title: J Gastroenterol Hepatol Volume: 25 Pages: 886-891
  • Peer Reviewed
• [Journal Article] Oral tacrolimus (FK 506) in refractory pediatric ulcerative colitis. Authors' reply (2010)
  • Author(s): Yamamoto S, Nakase H, Chiba T.
  • Journal Title: Aliment Pharmacol Ther Volume: 31 Pages: 677-678
  • Peer Reviewed
• [Journal Article] Heat shock protein 47 can be a new target molecule for intestinal fibrosis related to inflammatory bowel disease. (2010)
  • Author(s): Honzawa Y, Nakase H, Takeda Y, Nagata K, Chiba T.
  • Journal Title: Inflammatory Bowel Disease Volume: 16 Pages: 2004-2006
  • Peer Reviewed
• [Journal Article] Heat shock protein 47 is a new candidate molecule as anti-fibrotic treatment of Crohn's disease. (2010)
  • Author(s): Nakase H, Honzawa Y, Chiba T.
  • Journal Title: Aliment Pharmacol Ther Volume: 31 Pages: 926-927
  • Peer Reviewed
• [Journal Article] Pedunculated Cavernous Hemangioma mimicking inflammatory fibroid polyp in a Patient with Ulcerative Colitis. (2010)
  • Author(s): Ueda K, Nakase H, Yaku H, Honzawa, Y, Chiba T.
  • Journal Title: Endoscopy Volume: 42
  • Peer Reviewed
• [Journal Article] Successful Endoscopic Dilation Treatment of Small Intestinal Stricture that occurred during Chemotherapy for Malignant Lymphoma. (2010)
  • Author(s): Honzawa Y, Kondo M, Hayakumo T, Matsuura M, Nakase H.
  • Journal Title: Case report in Gastroenterol Volume: 4 Pages: 323-329
  • Peer Reviewed
• [Journal Article] Bifidobacterium longum BB536の潰瘍性大腸炎に対する治療機序の解明 (2010)
  • Author(s): 難波和美、伊藤彩子、仲瀬裕志、千葉勉
  • Journal Title: 食品工業 Volume: 53 Pages: 44-51
• [Journal Article] IBDドラッグ&マニュピュレーションIBD治療におけるシクロスポリン、タクロリムスの使用法 (2010)
  • Author(s): 仲瀬裕志, 本澤有介, 千葉勉
  • Journal Title: IBD research 4 Volume: 4 Pages: 44-47
• [Journal Article] Q&A-専門医に聞くIBDとIBSはどのように違うのですか? (2010)
  • Author(s): 仲瀬裕志, 本澤有介, 松浦稔, 千葉勉
  • Journal Title: IBD research Volume: 4 Pages: 74-76
• [Journal Article] 特集 炎症性消化器疾患の治療と発癌予防 潰瘍性大腸炎における新たな薬剤をどう使うか-免疫抑制剤- (2010)
  • Author(s): 仲瀬裕志, 松浦稔, 千葉勉
  • Journal Title: 消化器の臨床 Volume: 13 Pages: 659-663
• [Journal Article] メサラジン製剤(pH依存型放出調節製剤)が有効であった直腸炎型潰瘍性大腸炎の1例 (2010)
  • Author(s): 仲瀬裕志
  • Journal Title: 消化器内科 Volume: 51 Pages: 577-580
  • NAID: 40018275446
• [Journal Article] Alteration of CXCR4 expression and Th1/Th2 balance of peripheral CD4 positive Tcells can be a biomarker for Leukocytapheresis therapy for patients with refractory ulcerative colitis. (2009)
  • Author(s): Nakase H, et al.
  • Journal Title: Inflamm Bowel Dis 15 Pages: 963-964
  • Peer Reviewed
• [Journal Article] Modulation of Th1/Th2 balance by infliximab improves hyperthyroidism associated with flare-up of ulcerative colitis. (2009)
  • Author(s): Matsumura K, Nakase H, et al
  • Journal Title: Inflamm Bowel Dis 15 Pages: 967-968
  • Peer Reviewed
• [Journal Article] The Effect of Proteasome Inhibitor MG132 on Experimental Inflammatory Bowel Disease. (2009)
  • Author(s): Inoue S, Nakase, H, et al
  • Journal Title: Clin Exp Immunol 156 Pages: 172-182
  • Peer Reviewed
• [Journal Article] 小さな小腸炎症性病変Crohn病の小病変の診断:術後再発病変診断の意義 (2009)
  • Author(s): 仲瀬裕志
  • Journal Title: 胃と腸 44 Pages: 967-974
  • Peer Reviewed
• [Presentation] Use of Tacrolimus and Infliximab for refractory ulcerative colitis (2012)
  • Author(s): Nakase H
  • Organizer: The 6th Korea-Japan inflammatory bowel disease Symposium
  • Place of Presentation: 東京
  • Year and Date: 2012-01-28
• [Presentation] Characteristics of colonoscopic features in patients with ulcerative colitis concomitant with cytomegalovirus reactivation (2011)
  • Author(s): Matsuura M, Nakase H, Honzawa Y, Yamamoto S, Matsumura K, Uza N, Chiba T
  • Organizer: DDW
  • Place of Presentation: Chicago
  • Year and Date: 2011-05-09
• [Presentation] IL-17 promotes HSP47 expression and intestinal fibrosis in Crohn's disease (2011)
  • Author(s): Honzawa Y, Nakase H, Matsumura K, Yamamoto S, Uza N, Matsuura M, Chiba T
  • Organizer: DDW
  • Place of Presentation: Chicago
  • Year and Date: 2011-05-08
• [Presentation] Serum level of heat shock protein 47 could be a useful marker for intestinal fibrosis in patients with Crohn's disease (2010)
  • Author(s): Honzawa Y, Nakase H, Matsumura K, Yamamoto S, Uza N, Matsuura M, Chiba T
  • Organizer: Gut
  • Place of Presentation: UEGW, Barcelona
  • Year and Date: 2010-10-26
• [Presentation] Measurement of serum diamine oxidase(DAO) activity can be a predictive factor of disease onset of human IBD (2010)
  • Author(s): Honzawa Y, Nakase H, Matsumura K, Yamamoto S, Yoshino T, Takeda Y, Ueno S, Uza N, Chiba T
  • Organizer: DDW
  • Place of Presentation: New Orleans
  • Year and Date: 2010-05-05
• [Presentation] Role of Heat shock protein 47 in the pathogenesis of patients with Crohn's disease (2010)
  • Author(s): Honzawa Y, Nakase H, Matsumura K, Yamamoto S, Yoshino T, Takeda Y, Ueno S, Uza N, Chiba T
  • Organizer: DDW
  • Place of Presentation: New Orleans
  • Year and Date: 2010-05-04
• [Presentation] Novel immunomodulating effect of tacrolimus : induction of apoptosis on macrophage attenuates immune-mediated colitis (2010)
  • Author(s): Yoshino T, Nakase H, Chiba T
  • Organizer: DDW
  • Place of Presentation: New Orleans
  • Year and Date: 2010-05-03
• [Presentation] Role of osteopontin in acute graft-versus-host disease (2010)
  • Author(s): Takeda Y, Nakase H, Honzawa Y, Matsumura K, Yamamoto S, Yoshino T, Uza N, Ueno S, Chiba T
  • Organizer: DDW
  • Place of Presentation: New Orleans
  • Year and Date: 2010-05-02
• [Presentation] Use of tacrolimus in in flammatory bowel disease (2010)
  • Author(s): Nakase H
  • Organizer: The 4th Korea-Japan Inflammatory bowel disease Symposium Japan
  • Year and Date: 2010-01-23
• [Presentation] クローン病に対する内視鏡的拡張術と免疫調節剤との併用における長期予後の検討 (2010)
  • Author(s): 本澤有介, 仲瀬裕志, 千葉勉
  • Organizer: 第96回日本消化器病学会総会
  • Place of Presentation: 新潟
• [Presentation] インフリキマブの難治性潰瘍性大腸炎に対する治療効果の検討 (2010)
  • Author(s): 本澤有介, 仲瀬裕志, 千葉勉
  • Organizer: 第18回日本消化器関連学会週間
  • Place of Presentation: 横浜
• [Presentation] CMV再活性化を有する難治性潰瘍性大腸炎の今後の治療戦略 (2010)
  • Author(s): 松村佳代子, 仲瀬裕志, 千葉勉
  • Organizer: 第18回日本消化器関運学会週間
  • Place of Presentation: 横浜
• [Presentation] 重症潰瘍性大腸炎にたいするタクロリムスによる寛解導入療法の短期および長期成績の検討 (2010)
  • Author(s): 山本修司, 仲瀬裕志, 千葉勉
  • Organizer: 第18回日本消化器関連学会週間
  • Place of Presentation: 横浜
• [Presentation] Hes1は腸腫瘍の増殖や未分化性の維持に重要である (2010)
  • Author(s): 上尾太郎, 妹尾浩, 仲瀬裕志
  • Organizer: 第18回日本消化器関連学会週間
  • Place of Presentation: 横浜
• [Presentation] Overview:炎症性腸疾患(IBD)の病態と免疫調節療法 (2010)
  • Author(s): 仲瀬裕志, 千葉勉
  • Organizer: 第31回 日本臨床薬理学会年会
  • Place of Presentation: 京都
• [Presentation] Role of Heat shock protein 47 in the pathogenesis of patients with Crohn's disease. (2010)
  • Author(s): Honzawa Y, Nakase H, Matsumura K, Yamamoto S, Yoshino T, Takeda Y, Ueno S, Uza N, Chiba T.
  • Organizer: Digestive Disease Week
  • Place of Presentation: New Orleans, 米国
• [Presentation] Role of osteopontin in acute graft-versus-host disease. (2010)
  • Author(s): Takeda Y, Nakase H, Honzawa Y, Matsumura K, Yamamoto S, Yoshino T, Uza N, Ueno S, Chiba T.
  • Organizer: Digestive Disease Week
  • Place of Presentation: New Orleans, 米国
• [Presentation] Novel immunomodulating effect of tacrolimus : induction of apoptosis on macrophage attenuates immune-mediated colitis. (2010)
  • Author(s): Yoshino T, Nakase H, Chiba T.
  • Organizer: Digestive Disease Week
  • Place of Presentation: New Orleans, 米国
• [Presentation] Measurement of serum diamine oxidase (DAO) activity can be a predictive factor of disease onset of human IBD. (2010)
  • Author(s): Honzawa Y, Nakase H, Matsumura K, Yamamoto S, Yoshino T, Takeda Y, Ueno S, Uza N, Chiba T.
  • Organizer: Digestive Disease Week
  • Place of Presentation: New Orleans, 米国
• [Presentation] 潰瘍性大腸炎における効果的な治療選択 (2009)
  • Author(s): 仲瀬裕志
  • Organizer: 第51回日本消化器病学会大会
  • Place of Presentation: 京都国際会議場(京都)
  • Year and Date: 2009-10-15
• [Presentation] Suppression of LPS-induced NF-kB and p38MAPK activation by FK506 ameliorates murine colitis (2009)
  • Author(s): Yoshino T, Nakase H, Matsumura K, Yamamoto S, Takeda Y, Ueno S, Uza N, Chiba T
  • Organizer: 14th international congress of mucosal immunology
  • Place of Presentation: Boston
  • Year and Date: 2009-07-05
• [Presentation] Acitvation of Innate immune response by osteopontine prevent onset of spontaneous colitis (2009)
  • Author(s): Ueno S, Nakase H, Chiba T
  • Organizer: DDW
  • Place of Presentation: Chicago
  • Year and Date: 2009-06-02
• [Presentation] Regulation of activate macrophages by FK506 attenuates immune-mediated colitis (2009)
  • Author(s): Yoshino T, Nakase H, Matsumura K, Yamamoto S, Takeda Y, Ueno S, Uza N, Chiba T
  • Organizer: DDW
  • Place of Presentation: Chicago
  • Year and Date: 2009-06-01
• [Presentation] The Critical role of CXC chemokine ligand 16/scavenger receptor in the pathogenesis of inflammatory bowel disease (2009)
  • Author(s): Uza N, Nakase H, Chiba T
  • Organizer: DDW
  • Place of Presentation: Chicago
  • Year and Date: 2009-05-31
• [Book] シクロスポリン・タクロリムス炎症性腸疾患の内科的治療IBDを極める (2011)
  • Author(s): 仲瀬裕志
  • Total Pages: 303
  • Publisher: Medical view社
• [Book] 炎症性腸疾患を日常診療で診る (2010)
  • Author(s): 仲瀬裕志
  • Total Pages: 211
  • Publisher: 羊土社