Atsushi Tasaki

Faculty & Position:Orthopedic Department  doctor
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Last Updated: Aug. 07, 2019 at 14:47

Research Activities

Published Papers

  • Anatomic observation of the running space of the suprascapular nerve at the suprascapular notch in the same direction as the nerve.
    Tasaki A, Nimura A, Mochizuki T, Yamaguchi K, Kato R, Sugaya H, Akita K
    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 23(9) 2667-2673 Sep. 2015 [Refereed]
  • MRI findings of the shoulder and hip joint in patients with polymyalgia rheumatica.
    Ochi J, Nozaki T, Okada M, Suyama Y, Kishimoto M, Akaike G, Tasaki A, Ohde S, Saida Y, Yoshioka H
    Modern rheumatology / the Japan Rheumatism Association 25(5) 761-767 Sep. 2015 [Refereed]
  • Combined Arthroscopic Bankart Repair and Coracoid Process Transfer to Anterior Glenoid for Shoulder Dislocation in Rugby Players: Evaluation Based on Ability to Perform Sport-Specific Movements Effectively.
    Tasaki A, Morita W, Yamakawa A, Nozaki T, Kuroda E, Hoshikawa Y, Phillips BB
    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 31(9) 1693-1701 Sep. 2015 [Refereed]
  • Quantification of Fatty Degeneration Within the Supraspinatus Muscle by Using a 2-Point Dixon Method on 3-T MRI.
    Nozaki T, Tasaki A, Horiuchi S, Osakabe C, Ohde S, Saida Y, Yoshioka H
    AJR. American journal of roentgenology 205(1) 116-122 Jul. 2015 [Refereed]
  • Quantitative and qualitative analyses of subacromial impingement by kinematic open MRI.
    Tasaki A, Nimura A, Nozaki T, Yamakawa A, Niitsu M, Morita W, Hoshikawa Y, Akita K
    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 23(5) 1489-1497 May 2015 [Refereed]
  • Penetrating injury to the cauda equina: a case report and review of the literature.
    Mikami Y, Tasaki A, Morita W, Kuroda E, Hoshikawa Y
    Journal of spinal disorders & techniques 25(1) 64-67 Feb. 2012 [Refereed]
  • Laxity testing of the shoulder: a review.
    Bahk M, Keyurapan E, Tasaki A, Sauers EL, McFarland EG
    The American journal of sports medicine 35(1) 131-144 Jan. 2007 [Refereed]
  • The reverse shoulder prosthesis: A review of imaging features and complications.
    McFarland EG, Sanguanjit P, Tasaki A, Keyurapan E, Fishman EK, Fayad LM
    Skeletal radiology 35(7) 488-496 Jul. 2006 [Refereed]

Misc

  • Return to Play after the Dislocation of the Shoulder in Rugby
    田崎 篤, 真下 翔太, 渡部 亮介
    臨床整形外科 50(8) 739-745 Aug. 2015
  • Simultaneous rupture of the anterior cruciate ligament and the patellar tendon combined with Osgood-Schlatter disease : report of a case
    山川 晃, 田崎 篤, 黒田 栄史
    整形外科 = Orthopedic surgery 64(13) 1383-1386 Dec. 2013
  • A description of the tract of the suprascapular nerve
    田崎 篤, 二村 昭元, 望月 智之
    Bone joint nerve : BJN 3(4) 611-615 Oct. 2013
  • The relationship between initial symptoms and glenoid bony lesions in sport-related traumatic anterior instability of the shoulder
    TASAKI Atsushi, NOZAKI Taiki, MORITA Wataru, KURODA Eishi, HOSHIKAWA Yoshimitsu
    JOSKAS 38(3) 779-783 Jun. 2013
  • Quantification of fatty degeneration/infiltration within supraspinatus muscle by using Dixon technique of MRI
    Nozaki Taiki, Ochi Junko, Tasaki Atsushi, Yamakawa Akira
    Katakansetsu 37(2) 455-459 2013
    Background: The objective of this study was to prospectively quantify the fatty degeneration of supraspinatus (SSP) muscle by using Dixon technique of MRI, and to evaluate the correlation with clinical findings including rotator cuff tears.
    Methods: 258 patients with shoulder pain examined with 2-point Dixon technique of 3.0T-MRI were included in this study. Fatty degeneration was quantified after measurement of signal intensity value within the region of interest (ROI) placed over SSP muscle. Each signal intensity value of the image of in phase and fat image was defined as S(In) and S(Fat). The amount of fat contained in SSP was calculated as S(Fat)/S(In). Radiologists and orthopaedic surgeons evaluated the degree of rotator cuff tears in 3 categories: no tear, partial tear, complete tear. Statistical analysis was performed for correlation between the amount of fat in SSP and age, the degree of rotator cuff tears by using SSPS.
    Results: The patients with full-thickness tear, partial-thickness tear and no tear are 47, 41 and 170 respectively. Correlation coefficient is 0.416 between age and fat amount in SSP. The degree of fat degeneration of SSP in the three groups showed statistically-significant difference (p< 0.001).
    Conclusion: We can quantify and evaluate the degree of fatty degeneration within SSP by using Dixon technique of MRI objectively. Increased supraspinatus fatty infiltration was correlated with the age and severity of a supraspinatus tear.
  • An anatomic study of origins, courses and distributions of the anterior and posterior circumflex humeral arteries
    Uomizu Mari, Nimura Akimoto, Tazaki Atsushi, Akita Keiichi, Mochizuki Tomoyuki, Hagiwara Yoshihiro, Nakagawa Teruhiko
    Katakansetsu 37(3) 911-913 2013
    Background: In previous literature, the anterior (Ac) and posterior (Pc) circumflex humeral arteries were supposed to communicate with each other around the surgical neck of the humerus. However, actual anastomoses between these arteries were rarely observed. The purpose of the present study is examine the origins, courses, and distributions of Ac and Pc.
    Materials and Methods: We evaluated 44 shoulders from 25 cadavers including 21 right and 23 left shoulders.
    Results: In all specimens, Ac directly originated from the axillary artery, sent branches into the insertion of the subscapularis, and then, ascended along the long head of biceps. In some specimens, Ac passed under the long head of biceps. Pc originated from the axillary artery or the subscapular artery, and went around behind the humerus. Pc ran anteriorly from the middle to anterior portion of the deltoid sending branches into them. The diameter of the origin of Ac was an average of 1.7mm (SD; 0.4) and that of Pc was 3.5mm (SD; 0.9). The diameter of Ac was significantly smaller than that of Pc.
    Conclusion: There were no direct anastomoses between Ac and Pc through thick arteries, while they made anastomoses through a capillary vessel inside or outside the deltoid muscle. The running course of each artery was separated by the conjoined tendon, long head of biceps, pectoralis major and subdeltoid bursa. Based on the present results, Ac and Pc would not make a complementary relation, and each artery might have an independent function.
  • Comparison of the diagnostic accuracy of 3-dimentional MRI for
    glenoid morphology with 3-dimentional CT
    Yamakawa Akira, Tasaki Atsushi, Kuroda Eishi, Nozaki Taiki, Ochi Junko
    Katakansetsu 37(2) 451-454 2013
    Background: Evaluation of the glenoid for traumatic anterior shoulder instability is essential and imaging studies by scapula 3DCT and shoulder MRI have become standardized. However, carcinogenic risks by CT radiation have been reported and avoidance would be preferred. We evaluated the glenoid in bony Bankert lesion(BBL) by 3DMRI and compared this with the findings by 3DCT.
    Methods: Six-teen cases that underwent both 3DCT and 3DMRI for traumatic anterior shoulder instability from January 2010 to May 2012 were included. An orthopaedic surgeon and a radiologist who were blinded to each other assessed the findings by 3DCT and 3DMRI, using 3DCT as the gold standard. Based on the results of 3DCT as the gold standard, the sensitivity and specificity of 3DMRI for detection of BBL were determined. Statistical significances of the size of bony fragment and the angle of bony defect between these two methods were calculated.
    Results: Four cases were diagnosed as BBL by 3DCT and 3DMRI. The sensitivity of BBL by 3DMRI was 100% and the specificity was 83-100%. As to the quantification of the size of bony fragment and the angle of bony defect, 3DMRI(15.9 ± 4.8%, 87.5 ± 34.8°) and 3DCT(18.7 ± 5.4%,80.0 ± 29.4°) showed no statistical difference(p=0.144, p=0.109).
    Conclusion: The sensitivity and specificity of BBL by 3DMRI were useful. 3DMRI is a reliable method for evaluating BBL and glenoid morphology. The result of a preceding 3DMRI could indicate the need for a further 3DCT. 3DCT of the shoulder could be omitted from pre-operative evaluation for anterior shoulder instability.
  • Kinematic study for the evaluation of subcoracoid impingement by using 1.2T- kinematic open MRI
    Nozaki Taiki, Tasaki Atsushi, Yamakawa Akira, Hoshikawa Yoshimitsu, Nimura Akimoto, Akita Keiichi, Mochizuki Tomoyuki
    Katakansetsu 36(2) 691-694 2012
    Background: Despite the subcoracoid impingement which occurs between coracoid tip and lesser tuberosity of humeral head being known well as an etiology of the anterior shoulder motion pain, the detail of the mechanism is still unclear. We studied the quantitative image evaluation using kinematic analysis of 1.2T-open MRI.
    Methods: 20 volunteer's shoulders in 20 asymptomatic individuals (18 men and 2 women, mean age of 34.7 ± 13 years ) were included in this study. The subject was placed in supine position with the arm in 90 degrees of forward flexion. Five sequential images of MRI in the transverse plain were evenly taken during segmental rotation from neutral position to 90 degrees of internal rotation. The distance and image findings between the coracoid tip and the lesser tuberosity and the diameter of the humeral head were evaluated on DICOM viewer.
    Results: No individual felt shoulder pain during this study. Thickened subscapularis muscle which contacts with coracoid became less with contraction. The average shortest distance between the coracoid tip and the lesser tuberosity was 10.6mm (5.0-15.8mm). All cases showed space, which was occupied mainly by adipose tissue, between the coracoid tip and the anterior surface of subscapularis. Although all cases showed some amount of space without any direct contact between the coracoid tip and the humeral head, the distance varied appreciably in each individual.
    Conclusion: Smooth tendon gliding along with scapula movement by contraction of scapula muscle is an important function for painless kinematics despite close distance to coracoid. A minute change in joint centralization may produce impingement.
  • Kinematic study for the evaluation of subacromial impingement by using 1.2T kinematic open MRI
    Tasaki Atsushi, Yamakawa Akira, Hoshikawa Yoshimitsu, Nozaki Taiki, Nimura Akimoto, Akita Keiichi, Mochizuki Tomoyuki
    Katakansetsu 36(2) 685-690 2012
    Background: Although subacromial impingement has been well recognized, details such as the location of impingement and the involvement of acromioclavicular joint (ACJ) have not reached an agreement. We studied the quantitative image evaluation of this phenomenon using kinematic analysis by 1.2T open MRI.
    Methods: Twenty dominant shoulders of 20 healthy individuals were intended. Ten sequential evenly spaced images of MRI in the scapular plain were taken from 30 degrees abduction to maximum elevation in neutral and internally rotated position. Image findings were noted and the distance between the rotator cuff and both acromion and ACJ were measured.
    Results: No one complained of shoulder pain during this study. The mean elevation angle and distance when the acromion and rotator cuff came the closest was 92degrees (63-126) and 1.6mm (0-4), respectively. The acromion and rotator cuff osculated in 5 cases, and the location of interface was 5.8mm (1.4-21.1) away from the greater tuberosity. The mean elevation angle and distance when the ACJ came closest to the cuff was 86 degrees (57-121) and 2.5mm (0-5.1), respectively. Four cases showed complete contact 17.1mm (3.2-36) away from the greater tuberosity. There was no significant difference whether the shoulder was in neutral or internally rotated position.
    Discussion: Despite the lack of pain, there were cases with osculation. This indicates the importance of subacromial bursa. Minute change in joint centralization may produce impingement. The fact that the lesion of the cuff differed according to the opponent must be noted. (241 words)
  • Seronegativespondyloarthropathy beginning with the Shoulder
    -A Case Report
    Yamakawa Akira, Tasaki Atsushi, Morita Wataru, Kuroda Eishi, Hoshikawa Yoshimitsu
    Katakansetsu 36(3) 1057-1061 2012
    The initial symptoms of connective tissue disease sometimes present as arthritis of the shoulder. We experienced a case of seronegative spondyloarthropathy(SpA) starting from the shoulder. It was difficult to distinguish infection and connective tissue disease due to the similar clinical presentation.
    A 44-year-old man was admitted with the complaint of persistant left shoulder pain with a duration of four months. Physical examination revealed motion pain and morning pain. The leukocyte count was 6700/μl and CRP 3.86 mg/dl. MRI showed hydroarthrosis with synovial proliferation. Arthroscopic synovectomy showed nonspecific synovial proliferation. Pathological findings of the synovium demonstrated granulomatous change with neutrophil invasion, suggesting purulent synovitis. Cultivation surveys showed negative findings. Thenceforth he started to complain of pain in the contralateral shoulder and bilateral ankles. We suspected the cause to be connective tissue disease at first, but serological examinations of RF, ANA and anti-CCP Ab were all negative. He was treated with antimicrobials for six weeks, but symptoms persisted and laboratory data did not improve. Therefore, after ruling out the possibility of infection, we diagnosed SpA. After introducing Azulfidin, his clinical course and inflammatory signs showed a reduction.
    The initial symptoms of connective tissue disease sometimes present as arthritis of the shoulder. In some cases, it is difficult to distinguish infection and connective tissue disease, due to the similar clinical presentation. Treatment with immunosuppressive drug is contraindicated for infection. We believe that it is important to follow the clinical course and rule out infection first in such cases.
  • Anatomic analysis of the capsular attachment of the shoulder on the glenoid
    Tasaki Atsushi, Nimura Akimoto, Kato Atsuo, Yamaguchi Kumiko, Akita Keiichi, Hoshikawa Yoshimitsu, Mochizuki Tomoyuki
    Katakansetsu 36(3) 787-790 2012
    Background: Anatomical information of the insertion of the capsule around the glenoid is essential to recognize the pathological mechanism of shoulder disorders and perform better surgery.
    Methods: Twenty five shoulders were dissected to investigated the morphology and size of the insertion of the capsule around the glenoid. We treated superior capsule as capsule-CHL. The location of glenoid rim was expressed as the location of the clock face of the glenoid.
    Results: In the superior margin of the glenoid, the insertion of the capsule-CHL complex covered broadly to the base of the coracoid process in a triangular shape. Belt-like shape insertion was observed in posterior margin of the glenoid. Whereas as you followed anterior to the anteroinferior part, 4-5 oclock was thicker, then gradually thin down toward inferior. The average maximum width of the anterior and posterior insertion was 8.1mm (6.6-10.1mm)and 8.1mm (6.6-10.1mm), respectively. Although the width of insertion tapered, the capsule sent its fibers and connected to the lateral part of the LHT. Its attachment was observed as a thick portion from inside of the joint. This portion was observed as the posterior inferior gulenohumeral ligament.
    Conclusion: The fact of thick attachment of the capsule on the glenoid rim should be considered when we perform surgery for shoulder instability. Fibrous connection between the capsule and LHT, which compensates for thin capsular attachment at inferior part, reinforces inferior stability. Since contraction of LHT pulls the inferior capsule inferiorly, this mechanism may have a role to avoid impingement of the inferior capsule.
  • Shoulder subacromional injection for painful shoulder is more effective and also painless than expected
    田崎 篤, 馬場 恭子, 外山 千絵
    Orthopedic surgery 62(9) 955-957 Aug. 2011
  • Clinical symptoms and features and of the partial thickness rotator cuff tear : comparison of tear pattern and result of conservative treatment
    TASAKI Atsushi, TACHIBANA Naohiro, NOZAKI Taiki, OMATA Tomio, KURODA Eishi, HOSHIKAWA Yoshimitsu
    JOSKAS 36(3) 337-342 Jun. 2011
  • The clinical results of TKA using tranexamic acid for reducing blood loss
    TSUJI Soichi, HOSHIKAWA Yoshimitsu, KURODA Eishi, TASAKI Atsushi
    JOSKAS 36(3) 445-447 Jun. 2011
  • Extensive osteolysis by foreign body response after arthroscopic rotator cuff repair: report of a case
    田崎 篤, 黒田 栄史, 天羽 健太郎
    Orthopedic surgery 62(4) 349-353 Apr. 2011
  • Could 3DCT of the Shoulder Be Ommited from Pre-Operative Evaluation for Anterior Instability?-Comparison of MRI and 3D-CT Findings-
    TASAKI Atsushi, MORITA Wataru, KURODA Eishi, HOSHIKAWA Yoshimitsu, NOZAKI Taiki, IWASO Hiroshi
    Katakansetsu 35(2) 321-324 2011
    Evaluation of the glenoid for traumatic anterior shoulder instability is essential and imaging studies by scapula 3DCT and shoulder MRI have become standardized. However, carcinogenic risks from CT radiation have been reported and avoidance would be preferred. We valued the glenoid in bony Bankart lesion (BBL) by MRI and confronted with the findings by 3DCT.
    Thirty-four cases that underwent surgery for traumatic anterior shoulder instability from January 2008 to July 2009 were examined. An orthopaedic surgeon and a radiologist who were blinded to each other assessed the findings by MRI and 3DCT, using the 3DCT as the golden standard.
    18 and 13 cases were diagnosed as BBL by CT and MRI, respectively. The sensitivity of BBL in MRI was 72.2% and the specificity was 100%. The measurements of the glenoid deficit did not show any significance between MRI and CT. The group in which the bony deficit could not be recognized by MRI (MRNB) showed lower measurements by CT than the group which was possible (MRBB). The deficit area did not exceed 16% in MRNB. All MRBB cases were crescentic by CT and were read as bone erosion by MRI.
    BBLs of more than moderate size were able to be noticed by MRI and bone erosion suggested slender BBLs. The figure provided by MRI was relatively reliable. The result of a preceding MRI could indicate the need for a further CT retrenching excessive radiation exposures and medical cost. 3DCT of the shoulder could be omitted from pre-operative evaluation for anterior shoulder instability.
  • The Figure of Internal Impingement Changes by Pitching Counts-Study by Open MRI-
    TASAKI Atsushi, MORITA Wataru, KURODA Eishi, HOSHIKAWA Yoshimitsu, NOZAKI Taiki
    Katakansetsu 35(3) 953-956 2011
    Internal impingement in the late cocking phase (LCP) is a physiological phenomenon but leads to pain and tissue trauma by excessive burden. We studied the change in the figure of internal impingement at LCP by pitching counts using open MRI. Ten high-school pitchers with no history of shoulder disorder were studied. ROM was measured before and after 100 pitches in a bull-pen. Oblique coronal slices of MRI were taken by open MRI with the shoulder in ABER position to simulate LCP, before and after the burden. The figure of the internal impingement was evaluated by a special MRI calculator (image J) by a radiologist. After pitching, the range of external rotation increased, and internal rotation decreased significantly from 143.0° to 146.7°, 51.0° to 45.6°, respectively. The restaged LCP position in the MRI was 131.4° degrees flexion, 117.0° external rotation, 14.6° horizontal abduction on average. All cases showed internal impingement before and after the exercise. The measurement from the greater tubercle, vertical length from the articular level of the rotator cuff to the deepest part of the impinged cuff increased significantly from 10.6 to 12.8mm and 5.0 to 6.27mm, respectively. The cuff had intervened in between the greater tubercle and the glenoid forming a triangular shape and the area had increased significantly from 34.3 to 42.7mm2. Considering the risk of pitching injury by number of pitches, the change of the figure of internal impingement at ABER simulating LCP showed by our study is an important phenomenon for the understanding of pitching injuries.
  • Extremity Muscle Weakness and Sensorimotor System Acuity as Risk Factors of Throwing Shoulder Injury
    TASAKI Atsushi, YAMAKAWA Akira, MORITA Wataru, HOSHIKAWA Yoshimitsu
    Katakansetsu 34(3) 873-877 Aug. 2010
    An excessive number of pitches, disarrayed pitching forms and fatigue of shoulder muscles are known to be risk factors of shoulder disorders after pitching. Although the evidence of shoulder pain in throwing athlete is little, limiting the number of pitches and securing an appropriate interval is suggested for injury prevention. We evaluated the fatigue of shoulder muscles and the change of proprioception quantitatively in pitching. Eleven high-school pitchers were intended in a prospective study. A hand-held dynamometer was used to evaluate the peri-shoulder muscle strength bilaterally (dominant side: DS, non-dominant side: NDS) in 7 directions, and the shoulder joint proprioception was evaluated in 6 directions before and after pitching. Wilcoxon's signed rank test was used. The basic muscle strength before pitching was higher at DS except in the empty can test. There was a significant strength reduction in the empty can test, flexion and internal rotation at DS after pitching in comparison with NDS. There was a significant false recognition at abduction external rotation 30 degrees and 90 degrees after pitching on D. The reduced strength in the empty can test of D suggested a potential superior rotator cuff damage by pitching. The internal rotators were lead to fatigue by repetitive eccentric contraction at the late cocking phase and concentric contraction at acceleration. These differences in exhaustion of the internal and external rotators influenced the sensors which lead to the misconception of the position sense. Individual regular examination of muscular strength and propriocepsion is considerable method to decide an appropriate pitching interval and number for a prevention of throwing shoulder injury.
  • Mediastinal Hemorrhage after Sternoclavicular Joint Fracture caused by Rugby Football
    TASAKI Atsushi, KURODA Eishi, MORITA Wataru, YAMAKAWA Akira, HOSHIKAWA Yoshimitsu
    日本整形外科スポーツ医学会雑誌 = Japanese journal of orthopaedic sports medicine 30(2) 99-101 May 2010
  • Upper Extremity Muscle Weakness after an Actual Pitching Performance in a Real Game Situation
    YAMAKAWA Akira, TASAKI Atsushi, KURODA Eishi, HOSHIKAWA Yoshimitsu
    日本整形外科スポーツ医学会雑誌 = Japanese journal of orthopaedic sports medicine 30(2) 107-112 May 2010
  • Intra-and interobserver reproducibility of the shoulder laxity examination: comparison of Gerber test and modified Gerber test
    田崎 篤, 森田 亘, 黒田 栄史
    Orthopedic surgery 60(11) 1195-1199 Oct. 2009
  • The use of blocking screw in distal femoral fracture treated with retrograde intramedullary nail
    AMAHA K., TASAKI A., ITO M., SATO Y., KURODA E., HOSHIKAWA Y.
    骨折 31(2) 331-333 May 2009
  • Intraarticular arthroscopic repair for isolated subscapularis tear using 70° degree scope
    田崎 篤, 星川 吉光, 黒田 栄史
    Orthopedic surgery 60(4) 361-365 Apr. 2009
  • Intraarticular Arthroscopic Repair for Isolated Subscapularis Tendon Tear
    TASAKI Atsushi
    関節鏡 33(3) Oct. 2008
  • Arthroscopic treatment for synovial chondromatosis located between anterior body of lateral meniscus and tibial articular aspect
    TASAKI Atsushi, HOSHIKAWA Yoshimitu, SATO Yu, MORITA Wataru, AMAHA Kentaro, NIITSU Mamoru
    関節鏡 33(1) 97-101 Feb. 2008
  • Epidural abscess with primary psoas abscess and paravertebral abscess : Report of a case
    ITO Mikihito, KATO Ryuichi, TAZAKI Atsushi, TSUJI Soichi, KURODA Eishi, HOSHIKAWA Yoshimitsu
    関東整形災害外科学会雑誌 35(2) 99-101 Apr. 2004
  • Primary autografting of bone in open fractures with bone defect : report of two cases
    田崎 篤, 星川 吉光, 黒田 栄史
    整形外科 = Orthopedic surgery 54(9) 1187-1190 Aug. 2003
  • Rotationplasty for the treatment of severe crush injury of the femur : A case report
    TASAKI Atsushi, KURODA Eishi, TSUJI Soichi, KATO Ryuichi, HOSHIKAWA Yoshimitsu
    東日本整形災害外科学会雑誌 = Journal of the Eastern Japan Association of Orthopaedics and Traumatology 15(2) 341-344 Jun. 2003
  • Revision of total hip arthroplasty using hydroxy apatite for massive bone defect of acetabulum
    TSUJI Soichi, KATO Ryuichi, TASAKI Atsushi, NIIYAMA Yuji, KURODA Eishi, HOSHIKAWA Yoshimitsu
    東日本整形災害外科学会雑誌 = Journal of the Eastern Japan Association of Orthopaedics and Traumatology 14(1) 68-72 Mar. 2002


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