{"created":"2023-06-20T16:47:42.992911+00:00","id":19456,"links":{},"metadata":{"_buckets":{"deposit":"afdcda17-baed-4e2f-a89a-6c8204e9d7b9"},"_deposit":{"created_by":3,"id":"19456","owners":[3],"pid":{"revision_id":0,"type":"depid","value":"19456"},"status":"published"},"_oai":{"id":"oai:kindai.repo.nii.ac.jp:00019456","sets":["14:923:1477:4433"]},"author_link":["32966","32967"],"item_2_biblio_info_21":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2018-06-20","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1-2","bibliographicPageEnd":"65","bibliographicPageStart":"55","bibliographicVolumeNumber":"43","bibliographic_titles":[{"bibliographic_title":"近畿大学医学雑誌"},{"bibliographic_title":"Medical Journal of Kindai University","bibliographic_titleLang":"en"}]}]},"item_2_description_33":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"[抄録]症例は56歳男性．突然左手足の不全麻痺，呂律困難が出現し妻運転の自家用車での来院となった．神経診察では瞳孔右２mm 左2.5mm と左右差あり，Barre 試験左回内くぼみ手肘落ち10秒で５cm 下垂，Mingazzini 試験左下肢動揺して５秒で５cm 下垂，指鼻試験左拙劣運動分解あり，回内回外試験左拙劣，膝かかと試験左拙劣，触覚左下肢低下，構音障害軽度認め，NIHSS スコア７であった．急性発症で小脳性または感覚性協調運動障害を伴った錐体路症状，解離性感覚障害，右不全型ホルネル現象を示す脳卒中を疑い，病変は橋中下部右側もしくは延髄右内側，腹側から背側への病変を考え頭部CT 検査を施行したが，延髄，橋下部右内側に明らかな病変は認めなかった．血液検査結果を確認しrt-PA による血栓溶解療法の適応と判断した．禁忌項目に該当ないことを確認し，発症から63分後にrt-PA 投与開始となった．rt-PA 直後より活性酸素消去薬にて神経保護を期待し麻痺改善を目指した．投与中のNIHSS スコアは投与開始時で７，15分時点２，30分時点０，以降０を維持し劇的改善を得た．再灌流を確認するためrt-PA 投与終了直後にMRI 検査を実施した．MRA で脳底動脈に50%の狭窄残存認めたが，閉塞した部位が再灌流したのではないかと考えた．以上より脳底動脈を責任血管とするアテローム血栓性脳梗塞，虚血病変は脳幹と診断した．rt-PA 投与終了後24時間経過してから，急性期再発予防治療を開始し入院から１週間後に完全寛解, 独歩退院となり現在当院外来に定期受診されている.","subitem_description_type":"Abstract"}]},"item_2_description_41":{"attribute_name":"フォーマット","attribute_value_mlt":[{"subitem_description":"application/pdf","subitem_description_type":"Other"}]},"item_2_publisher_14":{"attribute_name":"出版者 名前","attribute_value_mlt":[{"subitem_publisher":"近畿大学医学会"}]},"item_2_source_id_22":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"03858367","subitem_source_identifier_type":"ISSN"}]},"item_2_text_7":{"attribute_name":"著者(英)","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Horikawa,Yukiko"},{"subitem_text_language":"en","subitem_text_value":"Ohtsuki,Toshiho"}]},"item_2_text_8":{"attribute_name":"著者 所属","attribute_value_mlt":[{"subitem_text_value":"近畿大学医学部附属病院 総合医学教育研修センター: 脳卒中センター: 現腎臓内科"},{"subitem_text_value":"近畿大学医学部附属病院 総合医学教育研修センター: 脳卒中センター"}]},"item_2_text_9":{"attribute_name":"著者所属(翻訳)","attribute_value_mlt":[{"subitem_text_value":"Stroke Centre, Kindai University Hospital"},{"subitem_text_value":"Stroke Centre, Kindai University Hospital"}]},"item_2_version_type_12":{"attribute_name":"版","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_be7fb7dd8ff6fe43","subitem_version_type":"NA"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"堀川, 有希子"},{"creatorName":"ホリカワ, ユキコ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"大槻, 俊輔"},{"creatorName":"オオツキ, トシホ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2018-07-18"}],"displaytype":"detail","filename":"AN00063584-20180620-0055.pdf","filesize":[{"value":"3.4 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"AN00063584-20180620-0055.pdf","url":"https://kindai.repo.nii.ac.jp/record/19456/files/AN00063584-20180620-0055.pdf"},"version_id":"24522008-5f54-4c7c-94f0-26410845e871"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"recombinant tissue-type plasminogen activator (rt-PA)","subitem_subject_scheme":"Other"},{"subitem_subject":"アテローム血栓性脳梗塞","subitem_subject_scheme":"Other"},{"subitem_subject":"抗動脈硬化治療","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":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"〈モーニングセミナーから〉アテローム血栓性脳梗塞超急性期治療","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"〈モーニングセミナーから〉アテローム血栓性脳梗塞超急性期治療"},{"subitem_title":"Thrombolytic therapy and subsequent secondary prevention against atherothrombotic brain infarction.","subitem_title_language":"en"}]},"item_type_id":"2","owner":"3","path":["4433"],"pubdate":{"attribute_name":"公開日","attribute_value":"2018-07-18"},"publish_date":"2018-07-18","publish_status":"0","recid":"19456","relation_version_is_last":true,"title":["〈モーニングセミナーから〉アテローム血栓性脳梗塞超急性期治療"],"weko_creator_id":"3","weko_shared_id":-1},"updated":"2023-06-20T21:39:48.595492+00:00"}