研究者詳細 - 城田　千代栄

論文 - 城田　千代栄

分割表示 172 件中 41 - 60 件目／全件表示 >>

Developing an Effective Off-the-job Training Model and an Automated Evaluation System for Thoracoscopic Esophageal Atresia Surgery

Yasui, A; Hayashi, Y; Hinoki, A; Amano, H; Shirota, C; Tainaka, T; Sumida, W; Makita, S; Kano, Y; Takimoto, A; Nakagawa, Y; Takuya, M; Kato, D; Gohda, Y; Liu, JH; Guo, YH; Mori, K; Uchida, H

JOURNAL OF PEDIATRIC SURGERY 60 巻 ( 2 ) 頁： 161615 2025年2月

記述言語：英語出版者・発行元：Journal of Pediatric Surgery

Background: Pediatric minimally invasive surgery requires advanced technical skills. Off-the-job training (OJT), especially when using disease-specific models, is an effective method of acquiring surgical skills. To achieve effective OJT, it is necessary to provide objective and appropriate skill assessment feedback to trainees. We aimed to construct a system that automatically evaluates surgical skills based on forceps movement using deep learning (DL). Methods: Using our original esophageal atresia OJT model, participants were tasked with performing esophageal anastomosis. All tasks were recorded for image analysis. Based on manual objective skill assessments, each participant's surgical skills were categorized into two groups: good and poor. The motion of the forceps in both groups was used as training data. Employing this training data, we constructed an automated system that recognized the movement of forceps and determined the quality of the surgical technique. Results: Thirteen participants were assigned to the good skill group and 32 to the poor skill group. These cases were validated using an automated skill assessment system. This system showed a precision of 75%, a specificity of 94%, and an area under the receiver operating characteristic curve of 0.81. Conclusions: We constructed a system that automatically evaluated the quality of surgical techniques based on the movement of forceps using DL. Artificial intelligence diagnostics further revealed the procedures important for suture manipulation. Levels of Evidence: Level IV

DOI： 10.1016/j.jpedsurg.2024.06.023

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PubMed

Evaluation of the risk factors for postoperative pectus excavatum and scoliosis in cystic lung disease. Open Access

Takahisa T, Chiyoe S, Wataru S, Satoshi M, Hizuru A, Yoko K, Akihiro Y, Daiki K, Takuya M, Yousuke G, Hiroki I, Kazuki O, Akinari H, Hiroo U

Pediatric surgery international 41 巻 ( 1 ) 頁： 62 2025年1月

Automated Skill Evaluation Method for Surgical Images using Optical Flow and Attention Mechanism

Feng, YX; Hayashi, Y; Oda, M; Kitasaka, T; Yasui, A; Shirota, C; Uchida, H; Mori, K

MEDICAL IMAGING 2025: IMAGE-GUIDED PROCEDURES, ROBOTIC INTERVENTIONS, AND MODELING 13408 巻 2025年

出版者・発行元：Progress in Biomedical Optics and Imaging Proceedings of SPIE

This paper describes an automated skill evaluation method for surgical images based on optical flow and self-attention mechanisms. This method uses a segment of a surgical video as input to a deep learning network and outputs scores. Previous methods primarily analyzed the kinematic data of surgical robots to assess surgical skills; however, kinematic data is often unavailable in non-robotic surgeries. Therefore, we propose a regression model that uses surgical video as input data to evaluate surgical skills through optical flow and self-attention mechanisms. We use optical flow to extract motion information from surgical images and employ the ViViT (Video Vision Transformer) model to extract features from both image information and motion information. Finally, we concatenate the two feature vectors and output six scores corresponding to the GRS (Global Rating Scale) evaluation criteria. To validate the evaluation performance of the model, we calculated the RMSE (Root Mean Squared Error) between the model's output scores of surgical videos and the ground truth scores in the surgical skill assessment dataset JIGSAWS. A low RMSE of 0.79 demonstrated that our method can reliably estimate scores, highlighting its potential for surgical skill assessment.

DOI： 10.1117/12.3049068

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Emergency Surgical Management of Chemotherapy-Induced Tumor Rupture in a Patient with MYCN-Amplified Neuroblastoma: A Case Report Open Access

Ogawa, K; Makita, S; Utsunomiya, A; Asai, H; Ishii, H; Kato, D; Nakagawa, Y; Hayashi, K; Takada, S; Takimoto, A; Yasui, A; Okamoto, M; Tainaka, T; Shirota, C; Uchida, H

SURGICAL CASE REPORTS 11 巻 ( 1 ) 頁： n/a 2025年

先天性胆道拡張症の術前肝内胆管形態による長期合併症予測 Open Access

加藤大幾, 内田広夫, 城田千代栄, 田井中貴久, 牧田智, 小川雄大, 岡本眞宗, 安井昭洋, 高田瞬也, 林海斗, 中川洋一, 石井宏樹, 浅井一, 宇都宮有美

日本膵・胆管合流異常研究会プロシーディングス 48 巻 ( 0 ) 頁： 78 - 79 2025年

当科で経験した先天性胆道拡張症術後肝内結石に対する肝切除の4例 Open Access

牧田智, 内田広夫, 檜顕成, 城田千代栄, 田井中貴久, 天野日出, 小川雄大, 岡本慎宗, 安井昭洋, 高田瞬也, 林海斗, 中川洋一, 加藤大幾, 石井宏樹, 浅井一, 宇都宮有美, 村田結衣, Yaohui Guo, Liu Jiahui

日本膵・胆管合流異常研究会プロシーディングス 48 巻 ( 0 ) 頁： 80 - 81 2025年

子どもvs大人：ロボット支援先天性胆道拡張症手術の成績と術中課題 Open Access

林海斗, 内田広夫, 城田千代栄, 田井中貴久, 牧田智, 小川雄大, 安井昭洋, 岡本慎宗, 高田瞬也, 中川洋一, 加藤大幾, 石井宏樹, 浅井一, 太田和樹

日本膵・胆管合流異常研究会プロシーディングス 48 巻 ( 0 ) 頁： 38 - 39 2025年

Safety and feasibility of robot-assisted surgery for pediatric patients weighing ≤ 10 kg with congenital biliary dilatation

Ishii, H; Shirota, C; Tainaka, T; Makita, S; Satomi, M; Kato, D; Maeda, T; Ota, K; Hinoki, A; Uchida, H

JOURNAL OF ROBOTIC SURGERY 19 巻 ( 1 ) 頁： 34 2024年12月

記述言語：英語出版者・発行元：Journal of Robotic Surgery

The advantage of robot-assisted surgery (RAS) is its ability to perform fine surgical operations with higher-resolution images. RAS should be particularly beneficial for small children, but it requires a certain amount of working space. The da Vinci Surgical System instructions state that careful consideration of indications for robotic surgery in patients weighing ≤ 10 kg is required. We aimed to investigate the safety and efficacy of RAS in pediatric patients weighing ≤ 10 kg with congenital biliary dilatation (CBD). Pediatric patients who underwent surgery for CBD at our institution were included. Patients were divided into three groups: the ≤ 10 kg group (RS-S) and the > 10 kg group (RS-L), both of which underwent robotic surgery, and another ≤ 10 kg group (LS-S), which underwent laparoscopic surgery. No patient required conversion to laparotomy. The operative duration was significantly shorter in the RS-S group than in the RS-L group. Intraoperative bleeding and length of hospital stay did not differ significantly between the RS-S and RS-L groups. Postoperative drain removal and hospital stay were shorter in the RS-S group than in the LS-S group. Our findings suggest that RAS can be safely and precisely implemented for infants weighing ≤ 10 kg.

DOI： 10.1007/s11701-024-02181-5

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Characteristics and outcomes of minimally invasive surgery for congenital biliary dilatation in children aged <6 years: Comparison between children and adults Open Access

Nakagawa, Y; Uchida, H; Shirota, C; Tainaka, T; Makita, S; Satomi, M; Yasui, A; Kano, Y; Kato, D; Maeda, T

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 31 巻 ( 12 ) 頁： 876 - 885 2024年12月

記述言語：英語出版者・発行元：Journal of Hepato Biliary Pancreatic Sciences

Background/Purpose: We evaluated the minimally invasive surgery for congenital biliary dilatation (CBD) in adults and children and analyzed the surgical outcomes, especially in children aged <6 years. Methods: Characteristics and surgical outcomes of patients with CBD who underwent minimally invasive surgery at our hospital between 2013 and 2023 were retrospectively reviewed. Results: Overall, 129 patients (89 children aged <6 years, 9 children aged between 6 and 18 years, and 21 adults) were included in this study. Children exhibited more protein plug presence and abnormal biochemical data than adults. Incidence of postoperative pancreatic fistulas was highest in the adult group (3.4%, 11%, and 33%, respectively, p <.01). In children aged <6 years, postoperative bile leakage and pancreatic fistulas occurred in 9.0% and 3.4% of patients, respectively. Multivariate logistic regression analysis revealed that the Todani IVA was associated with a decrease in postoperative bile leakage (odds ratio: −1.7; 95% confidence interval: (−3.3)–(−0.22), p =.03). Conclusion: Adults with CBD required prolonged operative times and had more short-term complications than children with CBD. In children aged <6 years, minimally invasive surgery for CBD can be safely performed; however, a small diameter of the bile duct may be associated with bile leakage.

DOI： 10.1002/jhbp.12069

Usefulness of lateral-anteroposterior dimeter ratio in patients with tracheomalacia associated with esophageal atresia

Sumida, W; Tainaka, T; Shirota, C; Makita, S; Amano, H; Yasui, A; Maeda, T; Kato, D; Goda, Y; Ishii, H; Ota, K; Yaohui, G; Jiahui, L; Hinoki, A; Uchida, H

PEDIATRIC SURGERY INTERNATIONAL 40 巻 ( 1 ) 頁： 282 2024年10月

記述言語：英語出版者・発行元：Pediatric Surgery International

Purpose: Tracheomalacia (TM) is commonly associated with esophageal atresia (EA) and compression by the brachiocephalic artery is a factor for TM. Previous research has focused on the lateral-to-anteroposterior tracheal diameter ratio (LAR). This study aimed to assess the LAR and postoperative outcomes of EA patients. Methods: Patients undergoing thoracoscopic repair for EA between March 2020 and October 2023 were enrolled. Posterior tracheopexy (PT) was performed during thoracoscopic repair of EA on patients with bronchoscopy-confirmed TM; clinical courses and LAR were retrospectively analyzed. Results: Overall, 18 patients were enrolled; 14 patients underwent PT. Their median preoperative and postoperative LARs were 2.26 and 1.50, respectively; this difference was statistically significant. Four patients without TM did not undergo PT and their median LAR was 1.59. Median LAR for patients without PT was lower than that of preoperative patients with PT and no statistical differences were observed from that of postoperative patients with PT. The patients whose LAR improved with PT did not require further surgical intervention for TM. One patient who had a postoperative LAR of 2.25 required external tracheal stenting. Conclusion: LAR is a useful index for determining the severity of TM associated with EA. LAR can reflects the efficacy of PT.

DOI： 10.1007/s00383-024-05877-9

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PubMed

特集必携小児外科レジデントマニュアル2 手術器具

田井中貴久, 城田千代栄, 牧田智, 天野日出, 檜顕成, 内田広夫

小児外科 56 巻 ( 9 ) 頁： 933 - 937 2024年9月

Eicosapentaenoic acid administration ameliorates the progression of liver fibrosis after laparoscopic Kasai portoenterostomy Open Access

Sumida, W; Tainaka, T; Shirota, C; Makita, S; Amano, H; Yasui, A; Maeda, T; Kato, D; Goda, Y; Ishii, H; Ota, K; Guo, YH; Liu, JH; Hinoki, A; Uchida, H

PEDIATRIC SURGERY INTERNATIONAL 40 巻 ( 1 ) 頁： 239 2024年8月

記述言語：英語出版者・発行元：Pediatric Surgery International

Purpose: Biliary atresia (BA) poses a persistent challenge characterized by ongoing liver inflammation and subsequent fibrosis even after the clearance of jaundice (COJ). This study aimed to evaluate the therapeutic potential of eicosapentaenoic acid (EPA) in alleviating liver inflammation and limiting fibrosis during the post-COJ phase of BA. Methods: Among the BA patients undergoing laparoscopic Kasai portoenterostomy (lapKP) between December 2016 and October 2021, EPA (20–40 mg/kg/day) was administered orally to those whose parents consented. The study included patients from January 2014 to October 2021, classifying them into two groups: EPA-treated (Group E) and untreated (Group N). Their liver fibrosis and clinical course at 1 and 2 years post-lapKP were compared. Results: Group E consisted of 25 patients, while Group N comprised 32 patients. Twenty-one patients in Group E and 25 patients in Group N achieved COJ (p = 0.74). Among jaundice-free patients at 1 and 2 years post-lapKP, Group E exhibited significantly lower M2BPGi levels and platelet counts, and Group E showed a significant reduction in Aminotransferase-to-Platelet Ratio Index (APRI) at 2 years post-lapKP. Conclusion: Although EPA administration did not improve COJ, it attenuated the progression of liver fibrosis during the 2 years following lapKP in jaundice-free patients. (200/200Words).

DOI： 10.1007/s00383-024-05800-2

First pediatric pelvic surgery with the Senhance® robotic surgical system: A case series Open Access

Kato, D; Uchida, H; Shirota, C; Tainaka, T; Makita, S; Amano, H; Satomi, M; Yasui, A; Nakagawa, Y; Maeda, T; Ishii, H; Ota, K; Nagata, N; Hinoki, A

ASIAN JOURNAL OF ENDOSCOPIC SURGERY 17 巻 ( 4 ) 頁： e13379 2024年8月

記述言語：英語出版者・発行元：Asian Journal of Endoscopic Surgery

The Senhance® robotic system (Senhance [Asensus Surgical Inc., Naderhan, NC, USA]) is a new surgical assistive robot following the da Vinci Surgical System that has been demonstrated to be safe and efficacious. Herein, we report the first case series of pediatric pelvic surgery using Senhance. Two anorectoplasties and one rectal pull-through coloanal anastomosis for rectal stenosis were performed in three children (5–9 months, 7–9 kg) using a 10-mm three-dimensional (3D) 4K camera and 3 and 5 mm forceps operated with Senhance. None of the patients had intraoperative complications or a good postoperative course. Pediatric pelvic surgery with Senhance could be performed precisely and safely with a small body cavity. With its beautiful 3D images, motion of forceps with reduced tremor, and availability of 3-mm forceps, Senhance may be better suited for children compared with other models.

DOI： 10.1111/ases.13379

特集再手術の戦略と実際先天性横隔膜ヘルニア再発に対する手術アプローチ

合田陽祐, 内田広夫, 横田一樹, 城田千代栄, 田井中貴久, 住田亙, 牧田智, 里見美和, 安井昭洋, 加藤大幾, 前田拓也, 石井宏樹, 太田和樹, 檜顕成

小児外科 56 巻 ( 7 ) 頁： 682 - 685 2024年7月

特集再手術の戦略と実際胆道閉鎖症

城田千代栄, 田井中貴久, 牧田智, 加藤大幾, 前田拓也, 里見美和, 石井宏樹, 太田和樹, 檜顕成, 内田広夫

小児外科 56 巻 ( 7 ) 頁： 701 - 703 2024年7月

Bile lakes in patients with biliary atresia who presented with jaundice-free native liver survival indicating the risk of subsequent liver transplantation due to various factors Open Access

Gohda, Y; Uchida, H; Sumida, W; Shirota, C; Tainaka, T; Makita, S; Satomi, M; Yasui, A; Kato, D; Maeda, T; Ishii, H; Ota, K; Guo, YH; Liu, JH; Hinoki, A

PEDIATRIC SURGERY INTERNATIONAL 40 巻 ( 1 ) 頁： 197 2024年7月

記述言語：英語出版者・発行元：Pediatric Surgery International

Purpose: The prognostic factors of subsequent liver transplantation (LT) in patients with biliary atresia (BA) who presented with jaundice-free native liver survival were investigated. Methods: This study retrospectively reviewed patients who underwent portoenterostomy (PE) for BA. Patients with jaundice-free native liver survival at 1 year postoperatively were divided into the autologous liver survivor and liver transplant recipient groups. Peri- and postoperative data were compared between the two groups. Results: Among 97 patients with BA, 29 who received LT within 1 year after PE were excluded from the analysis. Further, 48 patients currently living with native liver and 20 who received LT after 1 year postoperatively were compared. Bile lake (BL) was the strongest risk factor of LT. The risk score was 2.38∗BLscore+0.00466∗TBA, and the area under the receiver operating characteristic curve was 0.83. Patients with BL and those without significantly differed in terms of the native liver survival rate. Patients with BL who presented with not only cholangitis but also gastrointestinal hemorrhage and hepatopulmonary syndrome received LT. Conclusion: BL can cause different pathologies. Moreover, it is an evident risk factor of subsequent LT in patients with BA who are living with native liver at 1 year after PE.

DOI： 10.1007/s00383-024-05786-x

Cholestasis after Kasai operation predicts portal hypertension in native liver survivors of biliary atresia: a multicenter study Open Access

Chung, PHY; Harumatsu, T; Nakagawa, Y; Tsuboi, K; Chan, EKW; Leung, MWY; Yeung, FY; Muto, M; Kawano, T; Amano, H; Shirota, C; Nakamura, H; Koga, H; Miyano, G; Yamataka, A; Ieiri, S; Uchida, H; Wong, KKY

PEDIATRIC SURGERY INTERNATIONAL 40 巻 ( 1 ) 頁： 196 2024年7月

記述言語：英語出版者・発行元：Pediatric Surgery International

Purpose: This study evaluated portal hypertension (PHT) and its predictors among native liver survivors (NLS) of biliary atresia (BA) after Kasai portoenterostomy (KPE). Methods: This was a multicenter study using prospectively collected data. The subjects were patients who remained transplant-free for 5 years after KPE. Their status of PHT was evaluated and variables that predicted PHT were determined by regression analysis and receiver operating characteristic (ROC) curve. Results: Six centers from East Asia participated in this study and 320 subjects with KPE between 1980 to 2018 were analyzed. The mean follow-up period was 10.6 ± 6.2 years. At the 5th year after KPE, PHT was found in 37.8% of the subjects (n = 121). Patients with KPE done before day 41 of life had the lowest percentage of PHT compared to operation at older age. At 12 months after KPE, PHT + ve subjects had a higher bilirubin level (27.1 ± 11.7 vs 12.3 ± 7.9 µmol/L, p = 0.000) and persistent jaundice conferred a higher risk for PHT (OR = 12.9 [9.2–15.4], p = 0.000). ROC analysis demonstrated that a bilirubin level above 38 µmol/L at 12 months after KPE predicted PHT development (sensitivity: 78%, specificity: 60%, AUROC: 0.75). Conclusions: In BA, early KPE protects against the development of PHT among NLSs. Patients with persistent cholestasis at one year after KPE are at a higher risk of this complication. They should receive a more vigilant follow-up. Level of evidence: Level III

DOI： 10.1007/s00383-024-05775-0

Thoracoscopic primary repair is useful for esophageal atresia with tracheoesophageal fistula in neonates with low body weight Open Access

Gohda, Y; Uchida, H; Shirota, C; Tainaka, T; Sumida, W; Makita, S; Satomi, M; Yasui, A; Kanou, Y; Nakagawa, Y; Kato, D; Maeda, T; Guo, YH; Liu, JH; Ishii, H; Ota, K; Hinoki, A

PEDIATRIC SURGERY INTERNATIONAL 40 巻 ( 1 ) 頁： 149 2024年6月

記述言語：英語出版者・発行元：Pediatric Surgery International

Purpose: The surgical indication of thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula is under debate. The current study aimed to investigate the outcome of thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula in patients weighing < 2000 g and those who underwent emergency surgery at the age of 0 day. Methods: The surgical outcomes were compared between patients weighing < 2000 g and those weighing > 2000 g at surgery and between patients who underwent surgery at the age of 0 day and those who underwent surgery at age ≥ 1 day. Results: In total, 43 patients underwent thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula. The surgical outcomes according to body weight were similar. Patients who underwent surgery at the age of 0 day were more likely to develop anastomotic leakage than those who underwent surgery at the age of ≥ 1 day (2 vs. 0 case, p = 0.02). Anastomotic leakage was treated with conservative therapy. Conclusion: Thoracoscopic primary repair is safe and useful for esophageal atresia with tracheoesophageal fistula even in newborns weighing < 2000 g. However, emergency surgery at the age of 0 day should be cautiously performed due to the risk of anastomotic leakage.

DOI： 10.1007/s00383-024-05724-x

Safe thoracoscopic repair of recurrent congenital diaphragmatic hernia after initial open abdominal repair Open Access

Gohda, Y; Yokota, K; Uchida, H; Shirota, C; Tainaka, T; Sumida, W; Makita, S; Takimoto, A; Takada, S; Nakagawa, Y; Maeda, T; Guo, YH; Hinoki, A

SURGERY TODAY 54 巻 ( 6 ) 頁： 534 - 539 2024年6月

記述言語：英語出版者・発行元：Surgery Today

Purpose: The optimal surgical approach for recurrent congenital diaphragmatic hernia (CDH) remains controversial. We compared the surgical outcomes of a thoracoscopic approach versus an open abdominal approach for recurrent CDH after initial abdominal open repair. Method: The subjects of this comparative study were patients who underwent open abdominal or thoracoscopic surgery for recurrent CDH following an initial open abdominal repair. Results: Among 166 patients with Bochdalek-type CDH, 15 underwent reoperation for recurrent CDH following an open abdominal repair. Seven patients underwent open abdominal surgery (group O) and eight underwent thoracoscopic surgery (group T). The operative duration was similar for the two groups, with less blood loss (17.2 ml/kg vs. 1 ml/kg, P = 0.001) and fewer intraoperative complications in the T group (n = 6 vs. n = 0 cases, P = 0.001). There was no significant difference in the number of postoperative complications (n = 1 vs. n = 1, P = 1.0) or in the number of patients with a second CDH recurrence (n = 2 vs. n = 1, P = 0.569) between the two groups. Conclusion: Thoracoscopic surgery is preferable to the open surgical approach for recurrent CDH following an initial abdominal open repair.

DOI： 10.1007/s00595-023-02757-y

Scoring system for diagnosis and pretreatment risk assessment of neuroblastoma using urinary biomarker combinations Open Access

Amano, H; Uchida, H; Harada, K; Narita, A; Fumino, S; Yamada, Y; Kumano, S; Abe, M; Ishigaki, T; Sakairi, M; Shirota, C; Tainaka, T; Sumida, W; Yokota, K; Makita, S; Karakawa, S; Mitani, Y; Matsumoto, S; Tomioka, Y; Muramatsu, H; Nishio, N; Osawa, T; Taguri, M; Koh, K; Tajiri, T; Kato, M; Matsumoto, K; Takahashi, Y; Hinoki, A

CANCER SCIENCE 115 巻 ( 5 ) 頁： 1634 - 1645 2024年5月

記述言語：英語出版者・発行元：Cancer Science

The urinary catecholamine metabolites, homovanillic acid (HVA) and vanillylmandelic acid (VMA), are used for the adjunctive diagnosis of neuroblastomas. We aimed to develop a scoring system for the diagnosis and pretreatment risk assessment of neuroblastoma, incorporating age and other urinary catecholamine metabolite combinations. Urine samples from 227 controls (227 samples) and 68 patients with neuroblastoma (228 samples) were evaluated. First, the catecholamine metabolites vanillactic acid (VLA) and 3-methoxytyramine sulfate (MTS) were identified as urinary marker candidates through comprehensive analysis using liquid chromatography–mass spectrometry. The concentrations of these marker candidates and conventional markers were then compared among controls, patients, and numerous risk groups to develop a scoring system. Participants were classified into four groups: control, low risk, intermediate risk, and high risk, and the proportional odds model was fitted using the L2-penalized maximum likelihood method, incorporating age on a monthly scale for adjustment. This scoring model using the novel urine catecholamine metabolite combinations, VLA and MTS, had greater area under the curve values than the model using HVA and VMA for diagnosis (0.978 vs. 0.964), pretreatment risk assessment (low and intermediate risk vs. high risk: 0.866 vs. 0.724; low risk vs. intermediate and high risk: 0.871 vs. 0.680), and prognostic factors (MYCN status: 0.741 vs. 0.369, histology: 0.932 vs. 0.747). The new system also had greater accuracy in detecting missing high-risk neuroblastomas, and in predicting the pretreatment risk at the time of screening. The new scoring system employing VLA and MTS has the potential to replace the conventional adjunctive diagnostic method using HVA and VMA.

DOI： 10.1111/cas.16116

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論文 - 城田 千代栄

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論文 - 城田　千代栄