Clinical diagnosis of upper lumbar disc herniation: Pain and/or numbness distribution are more useful for appropriate level diagnosis.
Identifieur interne : 001967 ( Main/Exploration ); précédent : 001966; suivant : 001968Clinical diagnosis of upper lumbar disc herniation: Pain and/or numbness distribution are more useful for appropriate level diagnosis.
Auteurs : Tadato Kido [Japon] ; Koichiro Okuyama [Japon] ; Mitsuho Chiba [Japon] ; Hiroshi Sasaki [Japon] ; Nobutoshi Seki [Japon] ; Keiji Kamo [Japon] ; Naohisa Miyakoshi [Japon] ; Yoichi Shimada [Japon]Source :
- Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association [ 1436-2023 ] ; 2016.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen (MeSH), Déplacement de disque intervertébral (complications), Déplacement de disque intervertébral (diagnostic), Déplacement de disque intervertébral (physiopathologie), Femelle (MeSH), Force musculaire (MeSH), Humains (MeSH), Hypoesthésie (diagnostic), Hypoesthésie (étiologie), Lombalgie (diagnostic), Lombalgie (étiologie), Mâle (MeSH), Radiculopathie (diagnostic), Radiculopathie (étiologie), Sensibilité et spécificité (MeSH), Vertèbres lombales (MeSH), Études rétrospectives (MeSH).
- MESH :
- diagnostic : Déplacement de disque intervertébral, Hypoesthésie, Lombalgie, Radiculopathie.
- physiopathologie : Déplacement de disque intervertébral.
- étiologie : Hypoesthésie, Lombalgie, Radiculopathie.
- complications : Adulte d'âge moyen, Déplacement de disque intervertébral, Femelle, Force musculaire, Humains, Mâle, Sensibilité et spécificité, Vertèbres lombales, Études rétrospectives.
English descriptors
- KwdEn :
- Female (MeSH), Humans (MeSH), Hypesthesia (diagnosis), Hypesthesia (etiology), Intervertebral Disc Displacement (complications), Intervertebral Disc Displacement (diagnosis), Intervertebral Disc Displacement (physiopathology), Low Back Pain (diagnosis), Low Back Pain (etiology), Lumbar Vertebrae (MeSH), Male (MeSH), Middle Aged (MeSH), Muscle Strength (MeSH), Radiculopathy (diagnosis), Radiculopathy (etiology), Retrospective Studies (MeSH), Sensitivity and Specificity (MeSH).
- MESH :
- complications : Intervertebral Disc Displacement.
- diagnosis : Hypesthesia, Intervertebral Disc Displacement, Low Back Pain, Radiculopathy.
- etiology : Hypesthesia, Low Back Pain, Radiculopathy.
- physiopathology : Intervertebral Disc Displacement.
- Female, Humans, Lumbar Vertebrae, Male, Middle Aged, Muscle Strength, Retrospective Studies, Sensitivity and Specificity.
Abstract
OBJECTIVE
The purpose of this study is to disclose the characteristic symptoms and signs in L2, L3 and L4 nerve root disturbance.
MATERIALS AND METHODS
Fifty eight patients who underwent lateral herniotomy were analyzed. Breakdowns are 15 patients with L2/3 lateral disc herniation (group A), 20 patients with L3/4 lateral disc herniation (group B), and 23 patients with L4/5 lateral disc herniation (group C). The following items were examined: 1) localization of the subjective pain and numbness, 2) objective neurological findings, including deep tendon reflex, manual muscle strength (MMT), straight leg raising test (SLRT) and femoral nerve stretch test (FNST).
RESULTS
In group A, subjective pain and/or numbness was present in the thigh aspect, proximal to the knee joint in all patients. In group B, 80% of the patients had subjective pain and/or numbness in the medial site of the knee joint. In group C, the subjective pain and/or numbness was localized in various aspects of the lower extremity. Weakness in the iliopsoas, the femoral quadriceps, and the anterior tibial muscle were observed in 60-95%, 27-70%, 0-43% of three groups, respectively. Depression or absence of the patella tendon reflex was present in 27-100% of three groups. SLRT and FNST were positive in 13-87% and 91-95% of three groups.
CONCLUSION
Symptomatic levels of nerve root disturbance in the upper lumbar spine could not be accurately identified by objective neurological findings alone. Pain and/or numbness localized in the thigh area proximal to the knee joint is a specific sign of L2 nerve root disturbance. Either subjective pain or numbness in the medial knee joint aspect is another key sign which strongly suggests L3 nerve root disturbance.
DOI: 10.1016/j.jos.2016.03.003
PubMed: 27053156
Affiliations:
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Electronic address: takido@poplar.ocn.ne.jp.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Orthopedic Surgery, Akita Rosai Hospital</wicri:regionArea><wicri:noRegion>Akita Rosai Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Okuyama, Koichiro" sort="Okuyama, Koichiro" uniqKey="Okuyama K" first="Koichiro" last="Okuyama">Koichiro Okuyama</name><affiliation wicri:level="1"><nlm:affiliation>Department of Orthopedic Surgery, Akita Rosai Hospital, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Orthopedic Surgery, Akita Rosai Hospital</wicri:regionArea><wicri:noRegion>Akita Rosai Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Chiba, Mitsuho" sort="Chiba, Mitsuho" uniqKey="Chiba M" first="Mitsuho" last="Chiba">Mitsuho Chiba</name><affiliation wicri:level="1"><nlm:affiliation>Department of Orthopedic Surgery, Akita Rosai Hospital, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Orthopedic Surgery, Akita Rosai Hospital</wicri:regionArea><wicri:noRegion>Akita Rosai Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Sasaki, Hiroshi" sort="Sasaki, Hiroshi" uniqKey="Sasaki H" first="Hiroshi" last="Sasaki">Hiroshi Sasaki</name><affiliation wicri:level="1"><nlm:affiliation>Department of Orthopedic Surgery, Akita Rosai Hospital, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Orthopedic Surgery, Akita Rosai Hospital</wicri:regionArea><wicri:noRegion>Akita Rosai Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Seki, Nobutoshi" sort="Seki, Nobutoshi" uniqKey="Seki N" first="Nobutoshi" last="Seki">Nobutoshi Seki</name><affiliation wicri:level="1"><nlm:affiliation>Department of Orthopedic Surgery, Akita Rosai Hospital, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Orthopedic Surgery, Akita Rosai Hospital</wicri:regionArea><wicri:noRegion>Akita Rosai Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Kamo, Keiji" sort="Kamo, Keiji" uniqKey="Kamo K" first="Keiji" last="Kamo">Keiji Kamo</name><affiliation wicri:level="1"><nlm:affiliation>Department of Orthopedic Surgery, Akita Rosai Hospital, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Orthopedic Surgery, Akita Rosai Hospital</wicri:regionArea><wicri:noRegion>Akita Rosai Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Miyakoshi, Naohisa" sort="Miyakoshi, Naohisa" uniqKey="Miyakoshi N" first="Naohisa" last="Miyakoshi">Naohisa Miyakoshi</name><affiliation wicri:level="1"><nlm:affiliation>Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Orthopedic Surgery, Akita University Graduate School of Medicine</wicri:regionArea><wicri:noRegion>Akita University Graduate School of Medicine</wicri:noRegion></affiliation></author><author><name sortKey="Shimada, Yoichi" sort="Shimada, Yoichi" uniqKey="Shimada Y" first="Yoichi" last="Shimada">Yoichi Shimada</name><affiliation wicri:level="1"><nlm:affiliation>Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Orthopedic Surgery, Akita University Graduate School of Medicine</wicri:regionArea><wicri:noRegion>Akita University Graduate School of Medicine</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association</title><idno type="eISSN">1436-2023</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Hypesthesia (diagnosis)</term><term>Hypesthesia (etiology)</term><term>Intervertebral Disc Displacement (complications)</term><term>Intervertebral Disc Displacement (diagnosis)</term><term>Intervertebral Disc Displacement (physiopathology)</term><term>Low Back Pain (diagnosis)</term><term>Low Back Pain (etiology)</term><term>Lumbar Vertebrae (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Muscle Strength (MeSH)</term><term>Radiculopathy (diagnosis)</term><term>Radiculopathy (etiology)</term><term>Retrospective Studies (MeSH)</term><term>Sensitivity and Specificity (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term><term>Déplacement de disque intervertébral (complications)</term><term>Déplacement de disque intervertébral (diagnostic)</term><term>Déplacement de disque intervertébral (physiopathologie)</term><term>Femelle (MeSH)</term><term>Force musculaire (MeSH)</term><term>Humains (MeSH)</term><term>Hypoesthésie (diagnostic)</term><term>Hypoesthésie (étiologie)</term><term>Lombalgie (diagnostic)</term><term>Lombalgie (étiologie)</term><term>Mâle (MeSH)</term><term>Radiculopathie (diagnostic)</term><term>Radiculopathie (étiologie)</term><term>Sensibilité et spécificité (MeSH)</term><term>Vertèbres lombales (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Intervertebral Disc Displacement</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Hypesthesia</term><term>Intervertebral Disc Displacement</term><term>Low Back Pain</term><term>Radiculopathy</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Déplacement de disque intervertébral</term><term>Hypoesthésie</term><term>Lombalgie</term><term>Radiculopathie</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Hypesthesia</term><term>Low Back Pain</term><term>Radiculopathy</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Déplacement de disque intervertébral</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Intervertebral Disc Displacement</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Hypoesthésie</term><term>Lombalgie</term><term>Radiculopathie</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Female</term><term>Humans</term><term>Lumbar Vertebrae</term><term>Male</term><term>Middle Aged</term><term>Muscle Strength</term><term>Retrospective Studies</term><term>Sensitivity and Specificity</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Déplacement de disque intervertébral</term><term>Femelle</term><term>Force musculaire</term><term>Humains</term><term>Mâle</term><term>Sensibilité et spécificité</term><term>Vertèbres lombales</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>The purpose of this study is to disclose the characteristic symptoms and signs in L2, L3 and L4 nerve root disturbance.</p></div><div type="abstract" xml:lang="en"><p><b>MATERIALS AND METHODS</b></p><p>Fifty eight patients who underwent lateral herniotomy were analyzed. Breakdowns are 15 patients with L2/3 lateral disc herniation (group A), 20 patients with L3/4 lateral disc herniation (group B), and 23 patients with L4/5 lateral disc herniation (group C). The following items were examined: 1) localization of the subjective pain and numbness, 2) objective neurological findings, including deep tendon reflex, manual muscle strength (MMT), straight leg raising test (SLRT) and femoral nerve stretch test (FNST).</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>In group A, subjective pain and/or numbness was present in the thigh aspect, proximal to the knee joint in all patients. In group B, 80% of the patients had subjective pain and/or numbness in the medial site of the knee joint. In group C, the subjective pain and/or numbness was localized in various aspects of the lower extremity. Weakness in the iliopsoas, the femoral quadriceps, and the anterior tibial muscle were observed in 60-95%, 27-70%, 0-43% of three groups, respectively. Depression or absence of the patella tendon reflex was present in 27-100% of three groups. SLRT and FNST were positive in 13-87% and 91-95% of three groups.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Symptomatic levels of nerve root disturbance in the upper lumbar spine could not be accurately identified by objective neurological findings alone. Pain and/or numbness localized in the thigh area proximal to the knee joint is a specific sign of L2 nerve root disturbance. Either subjective pain or numbness in the medial knee joint aspect is another key sign which strongly suggests L3 nerve root disturbance.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27053156</PMID><DateCompleted><Year>2017</Year><Month>08</Month><Day>10</Day></DateCompleted><DateRevised><Year>2017</Year><Month>08</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1436-2023</ISSN><JournalIssue CitedMedium="Internet"><Volume>21</Volume><Issue>4</Issue><PubDate><Year>2016</Year><Month>Jul</Month></PubDate></JournalIssue><Title>Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association</Title><ISOAbbreviation>J Orthop Sci</ISOAbbreviation></Journal><ArticleTitle>Clinical diagnosis of upper lumbar disc herniation: Pain and/or numbness distribution are more useful for appropriate level diagnosis.</ArticleTitle><Pagination><MedlinePgn>419-424</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0949-2658(16)30001-X</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jos.2016.03.003</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">The purpose of this study is to disclose the characteristic symptoms and signs in L2, L3 and L4 nerve root disturbance.</AbstractText><AbstractText Label="MATERIALS AND METHODS" NlmCategory="METHODS">Fifty eight patients who underwent lateral herniotomy were analyzed. Breakdowns are 15 patients with L2/3 lateral disc herniation (group A), 20 patients with L3/4 lateral disc herniation (group B), and 23 patients with L4/5 lateral disc herniation (group C). The following items were examined: 1) localization of the subjective pain and numbness, 2) objective neurological findings, including deep tendon reflex, manual muscle strength (MMT), straight leg raising test (SLRT) and femoral nerve stretch test (FNST).</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">In group A, subjective pain and/or numbness was present in the thigh aspect, proximal to the knee joint in all patients. In group B, 80% of the patients had subjective pain and/or numbness in the medial site of the knee joint. In group C, the subjective pain and/or numbness was localized in various aspects of the lower extremity. Weakness in the iliopsoas, the femoral quadriceps, and the anterior tibial muscle were observed in 60-95%, 27-70%, 0-43% of three groups, respectively. Depression or absence of the patella tendon reflex was present in 27-100% of three groups. SLRT and FNST were positive in 13-87% and 91-95% of three groups.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Symptomatic levels of nerve root disturbance in the upper lumbar spine could not be accurately identified by objective neurological findings alone. Pain and/or numbness localized in the thigh area proximal to the knee joint is a specific sign of L2 nerve root disturbance. Either subjective pain or numbness in the medial knee joint aspect is another key sign which strongly suggests L3 nerve root disturbance.</AbstractText><CopyrightInformation>Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kido</LastName><ForeName>Tadato</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Orthopedic Surgery, Akita Rosai Hospital, Japan. Electronic address: takido@poplar.ocn.ne.jp.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Okuyama</LastName><ForeName>Koichiro</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Orthopedic Surgery, Akita Rosai Hospital, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chiba</LastName><ForeName>Mitsuho</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Orthopedic Surgery, Akita Rosai Hospital, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sasaki</LastName><ForeName>Hiroshi</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Orthopedic Surgery, Akita Rosai Hospital, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Seki</LastName><ForeName>Nobutoshi</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Orthopedic Surgery, Akita Rosai Hospital, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kamo</LastName><ForeName>Keiji</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Orthopedic Surgery, Akita Rosai Hospital, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Miyakoshi</LastName><ForeName>Naohisa</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shimada</LastName><ForeName>Yoichi</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Japan.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>04</Month><Day>02</Day></ArticleDate></Article><MedlineJournalInfo><Country>Japan</Country><MedlineTA>J Orthop Sci</MedlineTA><NlmUniqueID>9604934</NlmUniqueID><ISSNLinking>0949-2658</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006987" MajorTopicYN="N">Hypesthesia</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007405" MajorTopicYN="N">Intervertebral Disc Displacement</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017116" MajorTopicYN="N">Low Back Pain</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008159" MajorTopicYN="Y">Lumbar Vertebrae</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053580" MajorTopicYN="N">Muscle Strength</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011843" MajorTopicYN="N">Radiculopathy</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012680" MajorTopicYN="N">Sensitivity and Specificity</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>09</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2016</Year><Month>02</Month><Day>23</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2016</Year><Month>03</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>4</Month><Day>8</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>4</Month><Day>8</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>8</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">27053156</ArticleId><ArticleId IdType="pii">S0949-2658(16)30001-X</ArticleId><ArticleId IdType="doi">10.1016/j.jos.2016.03.003</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Japon</li></country></list><tree><country name="Japon"><noRegion><name sortKey="Kido, Tadato" sort="Kido, Tadato" uniqKey="Kido T" first="Tadato" last="Kido">Tadato Kido</name></noRegion><name sortKey="Chiba, Mitsuho" sort="Chiba, Mitsuho" uniqKey="Chiba M" first="Mitsuho" last="Chiba">Mitsuho Chiba</name><name sortKey="Kamo, Keiji" sort="Kamo, Keiji" uniqKey="Kamo K" first="Keiji" last="Kamo">Keiji Kamo</name><name sortKey="Miyakoshi, Naohisa" sort="Miyakoshi, Naohisa" uniqKey="Miyakoshi N" first="Naohisa" last="Miyakoshi">Naohisa Miyakoshi</name><name sortKey="Okuyama, Koichiro" sort="Okuyama, Koichiro" uniqKey="Okuyama K" first="Koichiro" last="Okuyama">Koichiro Okuyama</name><name sortKey="Sasaki, Hiroshi" sort="Sasaki, Hiroshi" uniqKey="Sasaki H" first="Hiroshi" last="Sasaki">Hiroshi Sasaki</name><name sortKey="Seki, Nobutoshi" sort="Seki, Nobutoshi" uniqKey="Seki N" first="Nobutoshi" last="Seki">Nobutoshi Seki</name><name sortKey="Shimada, Yoichi" sort="Shimada, Yoichi" uniqKey="Shimada Y" first="Yoichi" last="Shimada">Yoichi Shimada</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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