{"created":"2023-06-19T10:43:44.918551+00:00","id":4047,"links":{},"metadata":{"_buckets":{"deposit":"21b5c734-cfe6-4c83-80ad-80b1e053e544"},"_deposit":{"created_by":11,"id":"4047","owners":[11],"pid":{"revision_id":0,"type":"depid","value":"4047"},"status":"published"},"_oai":{"id":"oai:shiga-med.repo.nii.ac.jp:00004047","sets":["30:66:216"]},"author_link":["6922","7829","564","6781","8356","797","6357","802","799","3319","6782"],"item_4_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2020-08","bibliographicIssueDateType":"Issued"},"bibliographicPageEnd":"20","bibliographicPageStart":"17","bibliographicVolumeNumber":"12","bibliographic_titles":[{"bibliographic_title":"滋賀県産科婦人科雑誌"}]}]},"item_4_creator_3":{"attribute_name":"著者別名","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"MURAKAMI, Atsushi"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Takahashi, Akimasa"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"KASAHARA, Kyoko"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"WAKINOUE, Shiro"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"AMANO, Tsukuru"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"YAMANAKA, Akiyoshi"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"HIGUCHI, Asuka"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"NISHIMURA, Hiroki"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"YOSHINO, Fumi"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"KIMURA, Fuminori"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"MURAKAMI, Takashi"}],"nameIdentifiers":[{},{},{}]}]},"item_4_description_14":{"attribute_name":"フォーマット","attribute_value_mlt":[{"subitem_description":"pdf","subitem_description_type":"Other"}]},"item_4_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"　ディスジャーミノーマの術後経過観察において、腫瘍マーカーや内診による身体診察が推奨される一方、CT検査での全身検索については一定の見解が得られていない。今回、ディスジャーミノーマIA期術後に、CTが診断契機となったディスジャーミノーマIA期の傍大動脈リンパ節への単独再発症例を経験したので報告する。\n　症例は17歳、未妊。下腹部痛を主訴に来院した。MRIで臍高に達する右卵巣の充実性腫瘍を認めた。血液検査にてLDH、ALP、CA125、β-human chorionic gonadotropin(β-hCG)は高値を示したが、α-fetoprotein(AFP)は正常値であった。ディスジャーミノーマを疑い、右付属器切除および大網切除を施行した。術前のCTおよび腹腔内検索でリンパ節腫大や播種性病変を認めなかったため、リンパ節生検は省略した。術後病理でディスジャーミノーマIA期と診断され、術後化学療法は行わず、1ヵ月間隔で経過観察した。術後いずれの腫瘍マーカーも陰性化し、身体診察でも異常を認めず経過したが、術後6ヵ月で虫垂炎を発症。その際に撮影されたCTで、偶発的に傍大動脈リンパ節腫大を認めた。腹腔鏡下傍大動脈リンパ節摘出および虫垂切除術を施行し、ディスジャーミノーマの傍大動脈リンパ節への遠隔再発と診断された。術後BEP療法を3コース行い、現在再発なく経過している。\n　リンパ節郭清および術後補助化学療法が省略されたディスジャーミノーマIA期は再発のリスクが高いことを認識し、CT検査を含む厳重な経過観察が必要であることが示唆された。(著者抄録)","subitem_description_type":"Abstract"}]},"item_4_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"Journal Article","subitem_description_type":"Other"}]},"item_4_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"滋賀医科大学産科学婦人科学講座"}]},"item_4_relation_29":{"attribute_name":"医中誌ID","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"2020376838","subitem_relation_type_select":"ICHUSHI"}}]},"item_4_rights_12":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"滋賀県産科婦人科医会の許可を得て掲載"}]},"item_4_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"2185-4580","subitem_source_identifier_type":"ISSN"}]},"item_4_source_id_9":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AA12430250","subitem_source_identifier_type":"NCID"}]},"item_4_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":"村頭, 温"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"高橋, 顕雅"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"笠原, 恭子"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"脇ノ上, 史朗"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"天野, 創"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"山中, 章義"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"樋口, 明日香"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"西村, 宙起"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"吉野, 芙美"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"木村, 文則"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"村上, 節"}],"nameIdentifiers":[{},{},{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2021-11-26"}],"displaytype":"detail","filename":"murakami001.pdf","filesize":[{"value":"3.6 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