Faculty Profiles - CHEN-YOSHIKAWA Toyofumi

Papers - CHEN-YOSHIKAWA Toyofumi

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Various techniques for anastomosis of pulmonary arteries with size mismatch during lung transplantation Reviewed

Yokoyama Y., Chen-Yoshikawa T.F., Nakajima D., Ohsumi A., Date H.

JTCVS Techniques Vol. 9 page： 192 - 194 2021.10

【胸部外科手術の進歩と術前術後のリハビリテーション診療】肺移植サルコペニアと栄養・リハビリテーション治療

芳川豊史, 大島洋平, 大島綾子

MEDICAL REHABILITATION ( 266 ) page： 36 - 42 2021.10

Language：Japanese Publisher：(株)全日本病院出版会

肺移植は、内科的治療が尽くされた末期呼吸不全患者における唯一の治療手段として世界的に確立し、本邦でも、手術手技や一般的な周術期管理以外の患者管理に、焦点が当てられるようになってきた。肺移植適応患者は、末期の慢性呼吸不全患者であり、日常生活における活動性は低い。さらに、運動機能や日常生活動作能力も極めて低下するなど、いわゆるサルコペニアの病態である患者も多い。したがって、長い待機期間だけでなく周術期を生き抜くためにも、肺移植待機患者に対する術前リハビリテーション治療や栄養療法は重要である。また、肺移植によって肺機能は劇的に改善するが、肺の機能を活かすための身体機能は何も変化しない。したがって、肺移植後のリハビリテーション治療では、低下した身体機能の向上をはかり、日常生活動作能力を高めることで、早期社会復帰を目指すことが目標となる。肺移植患者や肺移植待機患者において、サルコペニアと栄養状態の管理の観点からの多角的なリハビリテーション治療が、今後さらに重要となる。(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J03505&link_issn=&doc_id=20211014130006&doc_link_id=%2Fap5meree%2F2021%2F000266%2F008%2F0036-0042%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fap5meree%2F2021%2F000266%2F008%2F0036-0042%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

特集胸部外科領域における再手術up to date II. 呼吸器領域 7. 生体肺移植後の再移植

芳川豊史, 伊達洋至

胸部外科 Vol. 74 ( 10 ) page： 850 - 855 2021.9

Differential impacts of postoperative complications on patients’ survival in completely resected non-small-cell lung cancer Reviewed

Kadomatsu Y., Tsubouchi H., Nakanishi K., Sugiyama T., Ueno H., Goto M., Ozeki N., Nakamura S., Fukui T., Chen-Yoshikawa T.F.

General Thoracic and Cardiovascular Surgery Vol. 69 ( 9 ) page： 1283 - 1290 2021.9

Authorship：Last author Language：English Publisher：General Thoracic and Cardiovascular Surgery

Objective: The aim of this study was to investigate the effects of inflammatory respiratory complications on long-term survival in patients with resected non-small cell lung cancer. We defined inflammatory respiratory complications to include the following six conditions: pneumonia, empyema, bronchial fistula, respiratory dysfunction, acute interstitial pneumonia, and atelectasis. Methods: Part of the National Clinical Database was linked to our prospective database from 2014 to 2017. Linkage was achieved for 866 patients. The Kaplan–Meier method was used to evaluate the overall, relapse-free, and cancer-related survival. The Cox proportional hazard model was used to analyze the impact of each complication. Results: Of the 736 patients included in the study, 149 had complications. The 5-year overall and cancer-specific survival rates were significantly lower in patients with inflammatory respiratory complications. The Cox proportional hazard model showed that the inflammatory respiratory complications had a significant impact on overall survival (hazard ratio 2.48, 95% confidence interval 1.41–4.38) but not air leak (hazard ratio 1.38, 95% confidence interval 0.70–2.70). Conclusions: Our study shows the differential impact of each complication on the survival of patients with non-small cell lung cancer. The presence of inflammatory respiratory complications was the only predictor of poor overall survival.

DOI： 10.1007/s11748-021-01619-z

Scopus

Physical function after lung transplantation for late-onset noninfectious pulmonary complications after allogeneic hematopoietic stem cell transplantation Reviewed

Hamada R., Oshima Y., Sato S., Yoshioka Y., Sato T., Nankaku M., Kondo T., Chen-Yoshikawa T.F., Ikeguchi R., Nakajima D., Date H., Matsuda S.

Supportive Care in Cancer Vol. 29 ( 9 ) page： 5447 - 5454 2021.9

Language：English Publisher：Supportive Care in Cancer

Purpose: Late-onset noninfectious pulmonary complications (LONIPCs) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) are fatal, and lung transplantation is the only curative treatment. Although lung transplantation for LONIPCs may confer good survival rates, it is unclear whether or how impaired physical functioning is restored. Thus, this study aimed to investigate the long-term course and associated changes in physical functions after lung transplantation in patients with LONIPCs after allo-HSCT. Methods: This prospective cohort study enrolled 15 patients who received lung transplantation for LONIPCs after allo-HSCT between 2012 and 2018. Dyspnea scores, performance status, physical function, and exercise tolerance were assessed before lung transplantation and up to 2 years after transplantation. Results: Two years after lung transplantation, the dyspnea scores and performance status improved, but did not recover completely. Physical function was assessed using the knee extensor strength (KES) and 6-min walk test (6MWT); the results were poor until 3 months after transplantation but improved over 2 years. The 6MWT distance showed improvement to a nearly healthy level (562.7 m). Recovery of exercise tolerance was associated with recovery in % vital capacity (%VC; r=0.5) and KES (r=0.4) from 3 months to 2 years after lung transplantation. Furthermore, a flat thorax, which is a characteristic of patients with LONIPCs, affected the %VC at 2 years after transplantation (r=0.8). Conclusion: Lung transplantation for LONIPCs may restore impaired physical function. A multifaceted rehabilitation program should be considered, especially to improve muscle weakness and pulmonary function.

DOI： 10.1007/s00520-021-06118-8

Scopus

肺移植における多職種連携肺移植における術後早期栄養介入の試み

池田政樹, 中島大輔, 大島綾子, 大島洋平, 栢分秀直, 田中里奈, 山田義人, 豊洋次郎, 大角明宏, 濱路政嗣, 芳川豊史, 伊達洋至

移植 Vol. 56 ( 総会臨時 ) page： SWS3 - 4 2021.9

[Retransplantation after Bilateral Living-donor Lobar Lung Transplantation]. Reviewed

Toyofumi F Chen-Yoshikawa, Hiroshi Date

Kyobu geka. The Japanese journal of thoracic surgery Vol. 74 ( 10 ) page： 850 - 855 2021.9

Authorship：Lead author,　Corresponding author Language：Japanese Publishing type：Research paper (scientific journal)

Living-donor lobar lung transplantation( LDLLT) is an established therapy for patients with end-stage lung disease, but living-donor lobar lung retransplantation (re-LDLLT) is rarely reported. We previously reported a case of unilateral antibody-mediated rejection (AMR) after bilateral LDLLT in the presence of newly formed donor-specific antibodies against a right-lobe donor. The same patient developed contralateral bronchiolitis obliterans syndrome (BOS), resulting in bilateral BOS. Re-LDLLT was performed under extracorporeal membrane oxygenation. Eight and a half years after re-LDLLT, the patient is doing well without any anti-human leukocyte antigen antibodies. Four lobes from four different donors were transplanted in this patient. Herein, we report this rare case and discuss several issues in comparison with the findings in the previously reported similar cases.

PubMed

Lessons learned from hybrid surgery with preoperative coil embolization for an aberrant artery in pulmonary sequestration. Reviewed International journal

Keita Nakanishi, Masaki Goto, Shota Nakamura, Toyofumi Fengshi Chen-Yoshikawa

Surgical case reports Vol. 7 ( 1 ) page： 192 - 192 2021.8

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The optimal management of an aberrant artery in pulmonary sequestration (PS) is controversial. Several studies have shown that hybrid surgery with preoperative coil embolization for an aberrant artery and surgical resection of the sequestrated lung is effective. However, there are no clear indications for the procedure. CASE PRESENTATION: A 68-year-old woman without any complaints was diagnosed with right intralobar PS, which was supplied by an aberrant artery from the thoracic aorta, via computed tomography performed during a medical examination. In addition, lung adenocarcinoma was detected over the border between the right upper and middle lobes. Preoperative coil embolization was performed by an interventional radiologist the day before surgery to decrease the risk of severe intraoperative hemorrhage. On the following day, bi-lobectomy of the right upper and middle lobes for lung adenocarcinoma with systemic lymph node dissection and segmentectomy of the sequestrated lung with thoracotomy was performed. Although no active hemorrhage was observed during surgery, the aberrant artery was challenging to dissect using an energy device due to the presence of an intravascular coil. Eventually, the coil stump was exposed, and it was cut with scissors. The postoperative course was uneventful. CONCLUSIONS: We reported the pitfall of the hybrid surgery for intralobar PS. Preoperative coil embolization can prevent fatal intraoperative hemorrhage. If embolization is performed using a coil for an aberrant artery supplied from the thoracic aorta, where and how to dissect the aberrant artery should be cautiously determined based on preoperative images, with consideration of the presence of an intravascular coil.

DOI： 10.1186/s40792-021-01277-6

PubMed

Commentary: Constant dripping wears a stone away Invited Reviewed

Ozeki N.

Journal of Thoracic and Cardiovascular Surgery Vol. 162 ( 2 ) page： e159 - e160 2021.8

Outcomes of lung transplantation for idiopathic pleuroparenchymal fibroelastosis Reviewed

Shiiya H., Nakajima J., Date H., Chen-Yoshikawa T.F., Tanizawa K., Handa T., Oto T., Otani S., Shiotani T., Okada Y., Matsuda Y., Shiraishi T., Moroga T., Minami M., Funaki S., Chida M., Yoshino I., Hatachi G., Uemura Y., Sato M.

Surgery Today Vol. 51 ( 8 ) page： 1276 - 1284 2021.8

Language：English Publisher：Surgery Today

Purpose: This study was performed to compare the outcome of lung transplantation (LT) for idiopathic pleuroparenchymal fibroelastosis (IPPFE) with that of LT for idiopathic pulmonary fibrosis (IPF). Methods: We reviewed, retrospectively, all adult patients who underwent LT for IPPFE or IPF in Japan between 1998 and 2018. Results: There were 100 patients eligible for this study (31 with IPPFE and 69 with IPF). Patients with IPPFE tended to have a significantly lower body mass index (BMI) than those with IPF (median, 16.7 vs. 22.6 kg/m2, respectively; P < 0.01). However, Kaplan–Meier survival curves showed no significant difference in overall survival between the groups. The BMI did not increase in patients with IPPFE, even 1 year after LT (pretransplant, 16.5 ± 3.2 kg/m2 vs. 1 year post-transplant, 15.6 ± 2.5 kg/m2; P = 0.08). The percent predicted forced vital capacity (%FVC) 1 year after LT was significantly lower in the IPPFE group than in the IPF group (48.4% ± 19.5% vs. 68.6% ± 15.5%, respectively; P < 0.01). Conclusions: Despite extrapulmonary problems such as a flat chest, low BMI, and associated restrictive impairment persisting in patients with IPPFE, patient survival after LT for IPPFE or IPF was equivalent.

DOI： 10.1007/s00595-021-02232-6

Scopus

Thymic mucinous adenocarcinoma: A case report

Tsubouchi Hideki, Ozeki Naoki, Suzuki Yuka, Kawaguchi Koji, Fukui Takayuki, F. Chen-Yoshikawa Toyofumi

The Journal of the Japanese Association for Chest Surgery Vol. 35 ( 5 ) page： 547 - 552 2021.7

Language：Japanese Publisher：The Japanese Association for Chest Surgery

A 61-year-old woman presented with a 44-mm well-circumscribed tumor in the anterior mediastinum on chest computed tomography. 18F-Fluorodeoxyglucose positron emission tomography showed a high-level accumulation of 18F-Fluorodeoxyglucose (standardized uptake value: 12.07). She underwent thymectomy with combined resection of partial pericardium. Histopathological findings showed that the tumor was a thymic mucinous adenocarcinoma (pT2N0M0 Stage II, and Masaoka stage III). After receiving adjuvant radiotherapy, she was in good health without any tumor recurrence at 6 months after surgery.

DOI： 10.2995/jacsurg.35.547

CiNii Research

Pulmonary benign metastasizing leiomyoma: A clinicopathological study of 10 cases

Maeda Jun, Higashiyama Masahiko, Nishio Wataru, Yoshikawa Toyofumi, Kadota Yoshihisa, Iwasaki Teruo, Terada Yasuji, Okami Jiro

The Journal of the Japanese Association for Chest Surgery Vol. 35 ( 5 ) page： 537 - 546 2021.7

Language：Japanese Publisher：The Japanese Association for Chest Surgery

Pulmonary benign metastasizing leiomyoma (BML) is a rare disease in which a benign uterine leiomyoma metastasizes to the lung. We herein report a clinicopathological study of 10 cases. The median interval between hysterectomy and lung resection for pulmonary nodules was 114 months (range: 15-240 months). The median tumor size was 11 mm (range: 5-16 mm). While nine patients with multiple nodules underwent wedge resection, one was treated with lobectomy. Hormonal treatment was administered to 3 patients with residual lesions and 1 patient as adjuvant therapy. During the follow-up periods (range: 26-192 months, median: 105 months), seven patients were alive with disease and two without evidence of disease. One patient died of systemic metastases due to atypical leiomyoma diagnosed by reviewing uterine and pulmonary specimens. Diagnostic, surgical, and therapeutic problems associated with this disease were discussed.

DOI： 10.2995/jacsurg.35.537

CiNii Research

Multicellular modeling of ciliopathy by combining ips cells and microfluidic airway-on-a-chip technology Reviewed

Sone N., Konishi S., Igura K., Tamai K., Ikeo S., Korogi Y., Kanagaki S., Namba T., Yamamoto Y., Xu Y., Takeuchi K., Adachi Y., Chen-Yoshikawa T.F., Date H., Hagiwara M., Tsukita S., Hirai T., Torisawa Y.S., Gotoh S.

Science Translational Medicine Vol. 13 ( 601 ) 2021.7

Language：English Publisher：Science Translational Medicine

Mucociliary clearance is an essential lung function that facilitates the removal of inhaled pathogens and foreign matter unidirectionally from the airway tract and is innately achieved by coordinated ciliary beating of multiciliated cells. Should ciliary function become disturbed, mucus can accumulate in the airway causing subsequent obstruction and potentially recurrent pneumonia. However, it has been difficult to recapitulate unidirectional mucociliary flow using human-derived induced pluripotent stem cells (iPSCs) in vitro and the mechanism governing the flow has not yet been elucidated, hampering the proper humanized airway disease modeling. Here, we combine human iPSCs and airway-on-a-chip technology, to demonstrate the effectiveness of fluid shear stress (FSS) for regulating the global axis of multicellular planar cell polarity (PCP), as well as inducing ciliogenesis, thereby contributing to quantifiable unidirectional mucociliary flow. Furthermore, we applied the findings to disease modeling of primary ciliary dyskinesia (PCD), a genetic disease characterized by impaired mucociliary clearance. The application of an airway cell sheet derived from patient-derived iPSCs and their gene-edited counterparts, as well as genetic knockout iPSCs of PCD causative genes, made it possible to recapitulate the abnormal ciliary functions in organized PCP using the airway-on-a-chip. These findings suggest that the disease model of PCD developed here is a potential platform for making diagnoses and identifying therapeutic targets and that airway reconstruction therapy using mechanical stress to regulate PCP might have therapeutic value.

DOI： 10.1126/scitranslmed.abb1298

Scopus

CEBPγ facilitates lamellipodia formation and cancer cell migration through CERS6 upregulation Reviewed

Shi H., Niimi A., Takeuchi T., Shiogama K., Mizutani Y., Kajino T., Inada K., Hase T., Hatta T., Shibata H., Fukui T., Chen-Yoshikawa T.F., Nagano K., Murate T., Kawamoto Y., Tomida S., Takahashi T., Suzuki M.

Cancer Science Vol. 112 ( 7 ) page： 2770 - 2780 2021.7

Language：English Publisher：Cancer Science

Ceramide synthase 6 (CERS6) promotes lung cancer metastasis by stimulating cancer cell migration. To examine the underlying mechanisms, we performed luciferase analysis of the CERS6 promoter region and identified the Y-box as a cis-acting element. As a parallel analysis of database records for 149 non–small-cell lung cancer (NSCLC) cancer patients, we screened for trans-acting factors with an expression level showing a correlation with CERS6 expression. Among the candidates noted, silencing of either CCAAT enhancer-binding protein γ (CEBPγ) or Y-box binding protein 1 (YBX1) reduced the CERS6 expression level. Following knockdown, CEBPγ and YBX1 were found to be independently associated with reductions in ceramide-dependent lamellipodia formation as well as migration activity, while only CEBPγ may have induced CERS6 expression through specific binding to the Y-box. The mRNA expression levels of CERS6, CEBPγ, and YBX1 were positively correlated with adenocarcinoma invasiveness. YBX1 expression was observed in all 20 examined clinical lung cancer specimens, while 6 of those showed a staining pattern similar to that of CERS6. The present findings suggest promotion of lung cancer migration by possible involvement of the transcription factors CEBPγ and YBX1.

DOI： 10.1111/cas.14928

Scopus

Comparison of de novo donor-specific antibodies between living and cadaveric lung transplantation Reviewed

Gochi F., Chen-Yoshikawa T.F., Kayawake H., Ohsumi A., Tanaka S., Yamada Y., Yutaka Y., Nakajima D., Hamaji M., Yurugi K., Hishida R., Date H.

Journal of Heart and Lung Transplantation Vol. 40 ( 7 ) page： 607 - 613 2021.7

Language：English Publisher：Journal of Heart and Lung Transplantation

Background: Despite growing interest in donor-specific antibodies (DSAs) and antibody-mediated rejection (AMR) in lung transplantation (LTx), no study evaluating the outcomes in recipients with de novo DSAs (dnDSAs) in living-donor lobar LTx (LDLLT) exists. We compared various characteristics of DSAs in LDLLT with those in cadaveric LTx (CLT) based on prospectively collected data. Methods: Between October 2009 and September 2019, 211 recipients underwent LTx (128 CLTs and 83 LDLLTs). We reviewed 108 CLTs and 74 LDLLTs to determine the characteristics and clinical impact of dnDSAs. Eighteen data-deficient cases, 7 cases with preformed DSAs, and 4 re-transplants were excluded. Results: There were significant differences between CLT and LDLLT patients in age, primary disease, ischemic time, and number of human leukocyte antigen mismatches per donor. The dnDSA incidence in LDLLT (6.8%) was significantly lower than that in CLT (19.4%, p = 0.02). The dnDSAs appeared later in LDLLT (mean 1,256 days) than in CLT (mean 196 days, p = 0.003). According to Cox models analyzed using dnDSA as a time-dependent covariate, dnDSA positivity was significantly associated with a poor overall survival (OS; hazard ratio [HR] 3.46, 95% confidence interval [CI] 1.59-7.57, p = 0.002) and poor CLAD-free survival in case of CLT (HR: 2.23, 95% CI: 1.08-4.63, p = 0.003). However, no such significant associations were noted in case of LDLLT. Conclusions: The dnDSA occurrence was significantly lower and later in LDLLT than in CLT. Furthermore, dnDSA-positivity was significantly associated with worse OS and CLAD-free survival after CLT but not after LDLLT.

DOI： 10.1016/j.healun.2021.03.019

Scopus

肺移植後の抗体関連拒絶に対するrituximab(遺伝子組換え)

芳川豊史, 伊達洋至, 杉本誠一郎, 白石武史, 中川健, 江川裕人

移植 Vol. 56 ( 1 ) page： 53 - 68 2021.7

Language：Japanese Publisher：(一社)日本移植学会

日本国内で実施された肺移植525例を対象に、肺移植後に抗体関連型拒絶反応(AMR)を発症し、rituximabを使用した症例について検討した。その結果、肺移植後のAMRに対しrituximabを使用した症例は14例(2.7%)であった。移植時年齢は10歳が1例、23〜69歳が13例であった。rituximabは延べ20回投与され、うち11例は375mg/m2の単回投与であった。rituximab治療3ヵ月で移植肺は3例(21%)で生着したが、11例(79%)で廃絶した。重篤な有害事象は11例(79%)に認められ、うち rituximabとの関連性が否定できない事象は成人3例に発現し、肺炎2例、意識変容状態が1例であった。

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脳死肺移植術前における脊柱起立筋CT値の低下は術後の予後不良因子である

大島洋平, 佐藤晋, 芳川豊史, 中島大輔, 田中里奈, 山田義人, 豊洋次郎, 濱路政嗣, 大角明宏, 伊達洋至, 松田秀一

移植 Vol. 56 ( 1 ) page： 96 - 96 2021.7

Mammalian enteral ventilation ameliorates respiratory failure Reviewed

Okabe R., Chen-Yoshikawa T.F., Yoneyama Y., Yokoyama Y., Tanaka S., Yoshizawa A., Thompson W.L., Kannan G., Kobayashi E., Date H., Takebe T.

Med Vol. 2 ( 6 ) page： 773 - 783.e5 2021.6

Language：English Publisher：Med

Background: Several aquatic organisms such as loaches have evolved unique intestinal breathing mechanisms to survive under extensive hypoxia. To date, it is highly controversial whether such capability can be adapted in mammalian species as another site for gas exchange. Here, we report the advent of the intestinal breathing phenomenon in mammalians by exploiting EVA (enteral ventilation via anus). Methods: Two different modes of EVA were investigated in an experimental model of respiratory failure: intra-rectal oxygen O2 gas ventilation (g-EVA) or liquid ventilation (l-EVA) with oxygenated perfluorocarbon. After induction of type 1 respiratory failure, we analyzed the effectiveness of g-EVA and I-EVA in mouse and pig, followed by preclinical safety analysis in rat. Findings: Both intra-rectal O2 gas and oxygenated liquid delivery were shown to provide vital rescue of experimental models of respiratory failure, improving survival, behavior, and systemic O2 level. A rodent and porcine model study confirmed the tolerable and repeatable features of an enema-like l-EVA procedure with no major signs of complications. Conclusions: EVA has proven effective in mammalians such that it oxygenated systemic circulation and ameliorated respiratory failure. Due to the proven safety of perfluorochemicals in clinics, EVA potentially provides an adjunctive means of oxygenation for patients under respiratory distress conditions. Funding: This work is funded by the Research Program on Emerging and Re-emerging Infectious Diseases, Research Projects on COVID-19 (JP20fk0108278, 20fk0108506h0001), from the Japan Agency for Medical Research and Development (AMED), to T.T.; Strategic Promotion for Practical Application of Innovative Medical Technology, Seeds A (A145), to T.T.; and KAKENHI 19K22657, to T.C.-Y. This research is partially supported by the AMED Translational Research Program; Strategic Promotion for Practical Application of Innovative Medical Technology (TR-SPRINT), to T.C.-Y.; and AMED JP18bm0704025h0001 (Program for Technological Innovation of Regenerative Medicine), to T.T.

DOI： 10.1016/j.medj.2021.04.004

Scopus

Association Between Pretransplant Serum Carcinoembryonic Antigen Levels and Immunohistochemical Staining of Explanted Native Lungs in Patients Who Underwent Lung Transplantation

Okabe R.

Seminars in Thoracic and Cardiovascular Surgery Vol. 33 ( 2 ) page： 608 - 615 2021.6

Combined surgical therapy for pulmonary sequestration and aberrant artery from the abdominal aorta

Hakiri S., Fukui T., Chen-Yoshikawa T.F.

General Thoracic and Cardiovascular Surgery Vol. 69 ( 6 ) page： 1031 - 1034 2021.6

Language：Japanese Publisher：General Thoracic and Cardiovascular Surgery

Pulmonary sequestration with feeding vessels from the abdominal aorta is relatively rare. A 56-year-old woman with chronic left thoracic pain was referred to our hospital. Computed tomography showed multiple pulmonary cysts in the left lung and an aberrant artery from the abdominal aorta. She was diagnosed with pulmonary sequestration. She underwent embolization of the aberrant artery and wedge resection of the sequestrated lung under indocyanine green guidance. The surgical treatment combining preoperative embolization of the artery and intraoperative indocyanine green-guided lung resection might be safe and minimally invasive for patients with lung sequestrations accompanied by feeding vessels from the abdominal aorta.

DOI： 10.1007/s11748-021-01612-6

Scopus

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Papers - CHEN-YOSHIKAWA Toyofumi