{"created":"2023-06-19T11:21:17.715684+00:00","id":1472,"links":{},"metadata":{"_buckets":{"deposit":"2c0518bc-562c-4d19-9d4f-3f83d141a2f4"},"_deposit":{"created_by":3,"id":"1472","owners":[3],"pid":{"revision_id":0,"type":"depid","value":"1472"},"status":"published"},"_oai":{"id":"oai:asahikawa-med.repo.nii.ac.jp:00001472","sets":["7","7:23"]},"author_link":["4721","4722","4723","4724","4725","4726","4727","4728","4729","4730","4731","4732"],"item_5_biblio_info_21":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2003-12-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"5","bibliographicPageEnd":"161","bibliographicPageStart":"158","bibliographicVolumeNumber":"48","bibliographic_titles":[{"bibliographic_title":"北海道外科雑誌"}]}]},"item_5_description_33":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"78歳男.9年前よりC型慢性肝炎・胆石症で経過観察されていた.今回,腹部CT所見で胆嚢腫瘍を指摘され精査加療目的で入院となった.腹部エコー所見では胆嚢底部から体部を占拠する径42×41×48mm大の内部不均一な腫瘍を認め,カラードプラ法にてflow signalがあり胆嚢癌が示唆された.腹部CT所見では胆嚢底体部壁は肥厚し,内部不均一な造影を示す腫瘍が存在,胆嚢癌が示唆されたが肝への直接浸潤は指摘できず,12番リンパ節の腫大がみられ転移が示唆された.12番リンパ節転移を伴う胆嚢癌の術前診断で,胆嚢を含めS4a・S5肝部分切除術を施行した.摘出標本の病理組織学的所見からリンパ節12cに転移陽性の結節浸潤型胆嚢小細胞癌と診断され,免疫化学的染色ではセロトニン産生腫瘍と診断された.術後抗癌剤投与は希望せず退院となったが,術後5ヵ月目に黄疸が発症し癌性腹膜炎で死亡した","subitem_description_type":"Abstract"}]},"item_5_description_36":{"attribute_name":"注記","attribute_value_mlt":[{"subitem_description":"出版社版","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_5_description_37":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"text","subitem_description_type":"Other"}]},"item_5_description_41":{"attribute_name":"フォーマット","attribute_value_mlt":[{"subitem_description":"application/pdf","subitem_description_type":"Other"}]},"item_5_source_id_22":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0288-7509","subitem_source_identifier_type":"ISSN"}]},"item_5_text_44":{"attribute_name":"ID(XooNIps)","attribute_value_mlt":[{"subitem_text_value":"2004104822"}]},"item_5_text_54":{"attribute_name":"閲覧数(XooNIps)","attribute_value_mlt":[{"subitem_text_value":"2940"}]},"item_5_text_55":{"attribute_name":"ダウンロード数(XooNIps)","attribute_value_mlt":[{"subitem_text_value":"2449"}]},"item_5_text_7":{"attribute_name":"著者 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