{"created":"2023-06-19T10:43:09.013938+00:00","id":3310,"links":{},"metadata":{"_buckets":{"deposit":"5dff3d9b-a2bb-4338-9ac3-3cbcd3dc352e"},"_deposit":{"created_by":11,"id":"3310","owners":[11],"pid":{"revision_id":0,"type":"depid","value":"3310"},"status":"published"},"_oai":{"id":"oai:shiga-med.repo.nii.ac.jp:00003310","sets":["6:7:208:209"]},"author_link":["6864","6959","696","464","268","3247","6759","844","811","812","627","629","874","6765"],"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"ハイガン ショウチョウ テンイ オ センシンブ トシタ セイジン チョウジュウセキ ノ 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12.59mg/dLと著明に高値であった。腹部造影CT検査の結果、３ヶ所の小腸腫瘍を認め、そのうち１ヶ所で腫瘍を先進部とした腸重積とそれに伴う腸閉塞所見認めたため、同日緊急手術を施行した。術中所見では、小腸に３ヶ所腫瘍を触知し（Treitz靭帯より10cm、40cm、100cm部位）、そのうち100cm部位で腸重積と口側腸管の拡張を認めた。腸重積をHutchinson手技にて整復したのちに、３ヶ所の腫瘍部の小腸を部分切除した。病理組織学的検査では、腫瘍は粘膜固有層から粘膜下層に存在し、腫大した類円形核を持つ充実性シート状に増殖した分化度の低い癌腫であり、腫瘍内に強い好中球浸潤を認めた。免疫組織学的検査でTTF-1(-),CDX2(-),p40(-),CK7(+)/CK20(-)であり、転移性腫瘍と診断された。術後の全身検索で、左肺上葉に腫瘍を認め、病理結果と併せて、肺癌を原発とする転移性小腸癌との診断に至った。また、術後経過中に白血球・CRP高値が持続したことからG-CSF産生腫瘍が示唆された。肺癌の小腸転移を原因とした成人の腸重積は稀であり、文献的考察を加えて報告する。","subitem_description_type":"Abstract"}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"Departmental Bulletin 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直美"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"飯田, 洋也"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"竹林, 克士"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"前平, 博充"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"森, 治樹"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"新田, 信人"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"谷, 眞至"}],"nameIdentifiers":[{},{},{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2018-10-31"}],"displaytype":"detail","filename":"jsums3101p004.pdf","filesize":[{"value":"674.5 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