{"created":"2023-05-15T09:03:24.493980+00:00","id":7721,"links":{},"metadata":{"_buckets":{"deposit":"3c5a9fa3-8fa4-484a-bf6d-9e364b14f2fd"},"_deposit":{"created_by":14,"id":"7721","owners":[14],"pid":{"revision_id":0,"type":"depid","value":"7721"},"status":"published"},"_oai":{"id":"oai:sapmed.repo.nii.ac.jp:00007721","sets":["1875:1885:1886"]},"author_link":["4689","4690","4691","4692","4693","4694","4695","4696","4697"],"control_number":"7721","item_2_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2003-03","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"23","bibliographicPageStart":"21","bibliographicVolumeNumber":"28","bibliographic_titles":[{"bibliographic_title":"市立室蘭総合病院医誌 = Journal of Muroran City General Hospital"}]}]},"item_2_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は67歳男性.心窩部痛にて当院救急搬送，腹部CT，血液検査にて急性胆嚢炎，急性膵炎と診断した.経皮経肝胆嚢ドレナージ（PTGBD）および膵炎に対する治療を開始するも翌日には全身状態が急速に増悪，腹部CTを再検したところ胆道内ガス像，胆嚢周囲の著明な気腫性変化を認め緊急手術を行った.PTGBDにて採取した胆汁の培養にてklebsiella属に加え嫌気性のガス産生菌であるClostridium perfringensが検出され，これらにより気腫性胆嚢炎を生じたと考えた.気腫性胆嚢炎は動脈硬化による胆嚢動脈閉塞などにより胆嚢壁の虚血状態が生じ，そこへガス産生菌が感染して発症する，という機序が推測されているが，本症例では病理学的には胆嚢壁の虚血を示唆する所見は認めず，慢性閉塞性肺疾患に対するステロイド長期内服のため易感染状態が生じ，胆嚢内で嫌気性ガス産生菌が繁殖した可能性が考えられた","subitem_description_type":"Abstract"}]},"item_2_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"市立室蘭総合病院"}]},"item_2_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0289-2774","subitem_source_identifier_type":"ISSN"}]},"item_2_version_type_15":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"大橋, 広和"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"金戸, 宏行"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"鈴木, 秀一郎"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"大関, 令奈"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"田沼, 徳真"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"佐藤, 修司"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"下地, 英樹"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"清水, 晴夫"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"安達, 雄哉"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"本田,佐保"}]},{"creatorNames":[{"creatorName":"一柳,伸吾"}]},{"creatorNames":[{"creatorName":"近藤,吉宏"}]},{"creatorNames":[{"creatorName":"赤保内,良和"}]},{"creatorNames":[{"creatorName":"佐々木, 賢一"}]},{"creatorNames":[{"creatorName":"澁谷,均"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2018-07-21"}],"displaytype":"detail","filename":"n0289277428121.pdf","filesize":[{"value":"502.8 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"n0289277428121.pdf","url":"https://sapmed.repo.nii.ac.jp/record/7721/files/n0289277428121.pdf"},"version_id":"51dbde81-5075-486b-996b-d2fc6b4bf201"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"気腫性胆嚢炎","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"経皮経肝胆嚢ドレナージ（PTGBD）","subitem_subject_language":"ja","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"胆嚢周囲に気腫性変化を生じた急性胆嚢炎の一例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"胆嚢周囲に気腫性変化を生じた急性胆嚢炎の一例","subitem_title_language":"ja"}]},"item_type_id":"2","owner":"14","path":["1886"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2009-03-18"},"publish_date":"2009-03-18","publish_status":"0","recid":"7721","relation_version_is_last":true,"title":["胆嚢周囲に気腫性変化を生じた急性胆嚢炎の一例"],"weko_creator_id":"14","weko_shared_id":-1},"updated":"2023-12-13T03:13:56.246501+00:00"}