Format

2022/3/23

To the President of Shinshu University

Academic year of the degree conferral 2022

Name of Graduate School Graduate School of Medicine

Name of Author Maureen Tania Widyasaputra

E-mail*1 maureentania@yahoo.co.id
Phone No. +4798488271

Doctoral Dissertation Institutional Repository Registration Application Form

Based on Article 19 of Shinshu University Degree Regulations (Shinshu University Regulations No. 19,
April 1, 2004), I would like to apply for making my doctoral dissertation below open to the public on the
internet through Shinshu University Institutional Repository.
Permissions have been obtained from all the coworkers and coauthors. Licenses have been obtained from
copyright holders involved in this doctoral dissertation.

（Complete each column and place a checkmark in the “box □” of the appropriate column)
x Dissertation
Doctor of ( □ Course
Type of degree PHILOSOPHY in MEDICAL SCIENCE data already
) □ Dissertation
sent
Increased expression of secreted protein acidic and rich in cysteine and tissue
inhibitor of metalloproteinase-3 in epidermotropic melanoma metastasis
Title of dissertation

x Release within 1 year from the date of the doctoral degree award
In the case that there is a prohibition on disclosure for a specified period
(Release is permitted after Click here to enter a date.)
In the case that there is an unavoidable reason that full text of doctoral
dissertation cannot be released within 1 year from the date the doctoral
Publication date degree was awarded (hereinafter referred to as “the unavoidable reason” )
□ Release is permitted after Click here to enter a date.

※ In this case, content summary of doctoral dissertation will be released.

Full text of doctoral dissertation will be released automatically after
the date when it is permitted to do so.
Bibliographic Journal title (Title/Publisher: In case of Books) The Journal of Dermatology
information of the reprint Publication date 2021/08/29
source (1) Open Access Embargo Expiration Click here to enter a date.
(Published or to be (In case of journal articles, please fill in below.)
published) Volume 48 Issue 11 Page 1772 to 1779
If there are more than Digital Object Identifier:
one, write on the Range used in the dissertation
bottom.
If select 2 or 4, please fill in below.
2.Used in chapter
 4.Others（ ）

Signature of the main

supervisor*2
Remarks
*1
Personal information provided on this form will only be used to contact the author regarding the
registration of the doctoral dissertation. As for E-mail column, describe an address that can be contacted
even after the doctoral degree has been awarded in order to communicate regarding copyrights of
publishers or academic societies.
*2
Signature of the main supervisor is required as for Graduate School of Engineering/Graduate School of
Medicine, Science and Technology (Department of Science and Technology, Department of Biomedical
Engineering 3-year Course.
Submit in paper form. However, if it is difficult to submit in paper form, the person in charge of
accepting the application needs to add the description.
※ Based on the application, full text of doctoral dissertation will be handled as follows.
･ The dissertation will be copied electronically and stored permanently in Shinshu University
Institutional Repository.
･A copy of the doctoral dissertation will be released via the Shinshu University Institutional Repository
(public transmission) based on the conditions described in “Publication date” and “Remarks”.
･Duplication or changing the data storage that is necessary for storage and use may be performed .
※ Submit content summary of doctoral dissertation which is described an outline that can be released,
excluding the parts that cannot be released, in the case that there is the unavoidable reason.

Additional description column in the case that there are multiple published bibliographic items
Journal title (Title/Publisher: In case of Books)
Publication date Click here to enter a date.
Open Access Embargo Expiration Click here to enter a date.
(In case of journal articles, please fill in below.)
Volume Issue Page to
Bibliographic information of
Digital Object Identifier:
the reprint source (2)
Range used in the dissertation

If select 2 or 4, please fill in below.

2.Used in chapter
4.Others（ ）
Journal title (Title/Publisher: In case of Books)
Publication date Click here to enter a date.
Open Access Embargo Expiration Click here to enter a date.
(In case of journal articles, please fill in below.)
Volume Issue Page to
Bibliographic information of
Digital Object Identifier:
the reprint source (3)
Range used in the dissertation

If select 2 or 4, please fill in below.

Bibliographic information of
the reprint source (4)
2.Used in chapter
4.Others（ ）
Journal title (Title/Publisher: In case of Books)
Publication date Click here to enter a date.
Open Access Embargo Expiration Click here to enter a date.
(In case of journal articles, please fill in below.)
Volume Issue Page to
Digital Object Identifier:
Range used in the dissertation

If select 2 or 4, please fill in below.

2.Used in chapter
4.Others（ ）
 Journal title (Title/Publisher: In case of Books)
Publication date Click here to enter a date.
Open Access Embargo Expiration Click here to enter a date.
(In case of journal articles, please fill in below.)
Volume Issue Page to
Bibliographic information of
Digital Object Identifier:
the reprint source (5)
Range used in the dissertation

If select 2 or 4, please fill in below.

2.Used in chapter
4.Others（ ）
Journal title (Title/Publisher: In case of Books)
Publication date Click here to enter a date.
Open Access Embargo Expiration Click here to enter a date.
(In case of journal articles, please fill in below.)
Volume Issue Page to
Bibliographic information of
Digital Object Identifier:
the reprint source (6)
Range used in the dissertation

If select 2 or 4, please fill in below.

2.Used in chapter
4.Others（ ）