{"created":"2023-06-19T10:29:46.980499+00:00","id":1888,"links":{},"metadata":{"_buckets":{"deposit":"887931bb-bb8c-4b3a-a483-69823dd67780"},"_deposit":{"created_by":31,"id":"1888","owners":[31],"pid":{"revision_id":0,"type":"depid","value":"1888"},"status":"published"},"_oai":{"id":"oai:kwmed.repo.nii.ac.jp:00001888","sets":["1709617079800:35:604:611"]},"author_link":["110557","110558","110559","110560","110561","110562","110563","110564"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2017","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"100","bibliographicPageStart":"95","bibliographicVolumeNumber":"43","bibliographic_titles":[{"bibliographic_title":"川崎医学会誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Kawasaki medical journal","bibliographic_titleLang":"en"}]}]},"item_10001_description_33":{"attribute_name":"記事種別(日)","attribute_value_mlt":[{"subitem_description":"症例報告","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_10001_description_34":{"attribute_name":"記事種別(英)","attribute_value_mlt":[{"subitem_description":"Case Report","subitem_description_language":"en","subitem_description_type":"Other"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"川崎医学会","subitem_publisher_language":"ja"}]},"item_10001_relation_14":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"https://doi.org/10.11482/KMJ-J43(2)95","subitem_relation_type_select":"DOI"}}]},"item_10001_relation_17":{"attribute_name":"関連サイト","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"http://igakkai.kms-igakkai.com/wp/wp-content/uploads/2017/KMJ-J43(2)95.pdf","subitem_relation_type_select":"URI"}}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00045593","subitem_source_identifier_type":"NCID"},{"subitem_source_identifier":"AN12940574","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0386-5924","subitem_source_identifier_type":"PISSN"},{"subitem_source_identifier":"2758-089X","subitem_source_identifier_type":"EISSN"}]},"item_10001_text_31":{"attribute_name":"著者所属(日)","attribute_value_mlt":[{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学神経内科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学神経内科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学神経内科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学神経内科学"}]},"item_10001_text_32":{"attribute_name":"著者所属(英)","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Department of Neurology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurology, Kawasaki Medical School"}]},"item_10001_textarea_5":{"attribute_name":"抄録(英)","attribute_value_mlt":[{"subitem_textarea_language":"en","subitem_textarea_value":"68-year-old woman was admitted to our hospital for five months’ episode of progressive gait disturbance and bradykinesia. Neurological examination showed a mild unconsciousness, asterixis, symmetrical akinesia, rigospasticity, hyperreflexia, foot clonus, and extensor toes. Brain MRI disclosed symmetrical hyperintense lesion on T2-weighted images in the centrum semiovale, posterior limb of internal capsule, and cerebral peduncle. The serum ammonia level was increased to 155 μg/dL, whereas the levels of serum copper and caeruloplasmin were normal. The electroencephalogram did not show triphasic wave. Abdominal contrast CT examination revealed a large splenorenal shunt between splenic vein and left renal vein. The patient was diagnosed as acquired hepatocerebral degeneration (AHD) caused by splenorenal shunt. A protein-restricted diet and lactulose preparations ameliorated neurological symptoms and normalized serum ammonia level to 34 μg/dL. However, the abnormalities in the brain MRI were unchanged after the treatment. We report the case an AHD patient who had an unique hyperintense pyramidal tract lesion on T2-weighted magnetic resonance images. Future studies are required to clarify underlying pathophysiological mechanisms causing pyramidal tract lesion."}]},"item_10001_textarea_6":{"attribute_name":"抄録(日)","attribute_value_mlt":[{"subitem_textarea_language":"ja","subitem_textarea_value":"患者は68歳女性．５か月前より徐々に動作緩慢や歩行障害が出現し当科を受診した．神経学的所見では，軽度の意識障害とasterixis を認め，左右差のない無動，痙固縮，下肢腱反射亢進，足クローヌスおよびバビンスキー徴候があった．頭部MRI 検査では，半卵円中心から内包後脚，および大脳脚にかけて拡散強調画像，T2強調画像，FLAIR 画像で高信号，T1強調画像で低信号の病変を認めた．採血ではアンモニア値が155 μg/dL と高値で，血清銅やセルロプラスミンは正常範囲内であった．脳波検査で基礎律動はθ波であったが，三相波は認められなかった．腹部造影CT 検査では，巨大な脾静脈－左腎静脈シャントを認め，Acquired hepatocerebral degenerationと診断した．蛋白制限食とラクツロース製剤内服を開始し，意識障害やパーキンソニズムなどの神経症状は改善し，アンモニア値は34 μg/dL と正常化したが，頭部MRI 病変の改善は認められなかった．本例は巨大脾腎シャントによるAcquired hepatocerebral degeneration（AHD）と考えられた．頭部MRIT2強調画像で両側錐体路に高信号病変を認めるAHD が散見され，文献的考察を含めて報告する． "}]},"item_10001_version_type_20":{"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":"深井, 雄太","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"大澤, 裕","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"久徳, 弓子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"砂田, 芳秀","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"FUKAI, Yuta","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"OHSAWA, Yutaka","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"KUTOKU, Yumiko","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SUNADA, Yoshihide","creatorNameLang":"en"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2018-03-01"}],"displaytype":"detail","filename":"KMJ-J43(2)95.pdf","filesize":[{"value":"1.0 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"PDF","objectType":"fulltext","url":"https://kwmed.repo.nii.ac.jp/record/1888/files/KMJ-J43(2)95.pdf"},"version_id":"1dc965e3-73b7-4606-a8ba-237974674a83"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"頭部MRI","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"錐体路","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"脾腎シャント","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"Acquired hepatocerebral degeneration","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Brain magnetic resonance image (MRI)","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Pyramidal tract","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Splenorenal shunt","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Acquired hepatocerebral degeneration","subitem_subject_language":"en","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":"頭部MRI上両側錐体路にT2高信号域を認めた脾静脈－腎静脈シャントによるAcquired hepatocerebral degeneration","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"頭部MRI上両側錐体路にT2高信号域を認めた脾静脈－腎静脈シャントによるAcquired hepatocerebral degeneration","subitem_title_language":"ja"},{"subitem_title":"Acquired hepatocerebral degeneration caused by a large splenorenal shunt with hyperintense signal changes in the bilateral pyramidal tract on T2-weighted magnetic resonance imaging","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"31","path":["611"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2018-03-01"},"publish_date":"2018-03-01","publish_status":"0","recid":"1888","relation_version_is_last":true,"title":["頭部MRI上両側錐体路にT2高信号域を認めた脾静脈－腎静脈シャントによるAcquired hepatocerebral degeneration"],"weko_creator_id":"31","weko_shared_id":-1},"updated":"2024-04-16T01:24:58.615158+00:00"}