{"created":"2022-09-02T07:00:56.965702+00:00","id":2000688,"links":{},"metadata":{"_buckets":{"deposit":"caa62200-7e56-42fd-9db6-76fa082cc201"},"_deposit":{"id":"2000688","owners":[1],"pid":{"revision_id":0,"type":"depid","value":"2000688"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:02000688","sets":["453:456","471:537:538:1662101276062"]},"author_link":[],"item_1627361970403":{"attribute_name":"出版タイプ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2021-09","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"9","bibliographicPageEnd":"201","bibliographicPageStart":"193","bibliographicVolumeNumber":"135","bibliographic_titles":[{"bibliographic_title":"新潟医学会雑誌","bibliographic_titleLang":"ja"}]}]},"item_7_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"中田瑞穂は，45日の間隔を開けて自身に起こった2度に亘るWallenberg症候群の臨床徴候を観察し，延髄病変を推察して，1953年本誌に報告した．本稿はその延髄病変の剖検所見の要約である．中田が1回目の発作と2回目の発作で傷害されたと推測した断面をJD Fixのアトラスを参考に特定し，その中間点である，橋・延髄境界より8.0mm尾側が，検索に最も影響しないと考えて切断し，2つのパラフィンブロックを作成し，7µm厚の連続切片を作成した．延髄病変の拡がりは，橋・延髄境界の尾側2.9mmから13.9mmまでの10.9mmの長さに認められた．中田が推測した第1回発作の病変は，実際の標本では，橋・延髄境界から4.6～6.3mm尾側に相当し，第2回発作の病変は，橋・延髄境界から9.7～11.4mm尾側に相当すると考えられた．病変の最大の広がりは，検索に影響しないと考えて切断したレベルに極めて近い，橋・延髄境界から8.1mm尾側の断面に認められた．左椎骨動脈は，後下小脳動脈(PICA)の分岐直後から，脳底動脈に移行する手前まで10mmに亘り，強い動脈硬化により完全に閉塞していた．この閉塞部から，PICAとは異なる実質的で索状の細い動脈が分岐し，その8mm末梢側で，7～8本の更に細い動脈に分岐し，下オリーブ核後溝の陥凹部から箒状に穿通枝として侵入していた．その侵入範囲は，最初の延髄断面から，吻側へ3mm，尾側へ7mm，全長10mmの長さに亘り，光顕的に確認した病変分布とよく符合していることから，これが中田瑞穂の延髄梗塞を作った元凶の穿通枝(あくまでも後下小脳動脈とは異なる)であると結論した．そして，第1回発作時の病変は，やや不完全な梗塞として，延髄吻側から，迷走神経が出るより尾側のレベルまで一気に発生し，45日後の第2回発作の病変は，それら不完全病変の上に，閉塞していた穿通枝が侵入している延髄尾側部の完全閉塞による病変が新たに加わった，と考えた．","subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_7_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟医学会","subitem_publisher_language":"ja"}]},"item_7_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00182415","subitem_source_identifier_type":"NCID"}]},"item_7_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0029-0440","subitem_source_identifier_type":"PISSN"}]},"item_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"生田, 房弘","creatorNameLang":"ja"},{"creatorName":"Ikuta, Fusahiro","creatorNameLang":"en"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2022-09-02"}],"displaytype":"detail","filename":"135(9)_193-201.pdf","filesize":[{"value":"3.15MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"objectType":"fulltext","url":"https://niigata-u.repo.nii.ac.jp/record/2000688/files/135(9)_193-201.pdf"},"version_id":"4b9cdce1-7038-4e54-9123-f3e14fd17135"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"Wallenberg症候群","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"延髄梗塞","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"椎骨動脈","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"病理","subitem_subject_language":"ja","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":"中田瑞穂先生 : 剖検依頼書と剖検報告書N68(75)【要約】","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"中田瑞穂先生 : 剖検依頼書と剖検報告書N68(75)【要約】","subitem_title_language":"ja"},{"subitem_title":"Summary of the autopsy report of Professor Dr. Mizuho Nakata","subitem_title_language":"en"}]},"item_type_id":"7","owner":"1","path":["456","1662101276062"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2022-09-02"},"publish_date":"2022-09-02","publish_status":"0","recid":"2000688","relation_version_is_last":true,"title":["中田瑞穂先生 : 剖検依頼書と剖検報告書N68(75)【要約】"],"weko_creator_id":"1","weko_shared_id":-1},"updated":"2022-12-15T04:18:20.338937+00:00"}