{"_buckets": {"deposit": "d7302ddd-15de-4eed-8113-8ee0fb805de4"}, "_deposit": {"id": "9602", "owners": [], "pid": {"revision_id": 0, "type": "depid", "value": "9602"}, "status": "published"}, "_oai": {"id": "oai:niigata-u.repo.nii.ac.jp:00009602", "sets": ["456", "939"]}, "item_7_alternative_title_1": {"attribute_name": "その他のタイトル", "attribute_value_mlt": [{"subitem_alternative_title": "Clinical Experience in the Treatment of 4 Cases with IgG4-related Sclerosing Cholangitis"}]}, "item_7_biblio_info_6": {"attribute_name": "書誌情報", "attribute_value_mlt": [{"bibliographicIssueDates": {"bibliographicIssueDate": "2012-09", "bibliographicIssueDateType": "Issued"}, "bibliographicIssueNumber": "9", "bibliographicPageEnd": "495", "bibliographicPageStart": "491", "bibliographicVolumeNumber": "126", "bibliographic_titles": [{"bibliographic_title": "新潟医学会雑誌"}, {"bibliographic_title": "新潟医学会雑誌", "bibliographic_titleLang": "en"}]}]}, "item_7_description_4": {"attribute_name": "抄録", "attribute_value_mlt": [{"subitem_description": "【目的】 IgG4関連硬化性胆管炎は, 自己免疫性膵炎を代表とするIgG4陽性形質細胞の諸臓器への密な浸潤を認める全身性疾患の胆管病変として, 近年報告が増えている. 今回, 我々はIgG4関連硬化性胆管炎4例を経験したので報告する. 【対象・方法】 当院で治療されたIgG4関連硬化性胆管炎4例を対象とした. 内訳は外科的切除例2例, 内科治療例2例であった. IgG4関連硬化性胆管炎の診断は, 胆道造影検査, 自己免疫性膵炎合併の有無, 血清IgG4測定を基準として行った. 外科切除例では, 免疫組織化学にてIgG4陽性形質細胞を同定し組織学的検討により診断した. 【成績】 外科切除例は, 2例とも無症状であり肝機能異常が指摘されたことを契機に精査となった. 症例1 : 81歳, 男性. 右肝管に限局した胆道狭窄を呈する腫瘤を認め, 血清CEA値は7.1ng/mL, 血清CA19-9値は178 U/mLと上昇しており, 肝門部胆管癌の術前診断で胆道再建を伴う肝右葉切除が施行された. 症例2 : 70歳, 女性. 右肝管および下部胆管に限局した胆管狭窄像を認めた. 術前の血清IgG4値は130 mg/dLであり, 正常範囲内(135 mg/dL未満)と判定された. 広範囲胆管癌の術前診断で胆道再建を伴う肝右葉切除が施行された. 外科切除例は, 2例とも自己免疫性膵炎非合併例であり, 病理組織学的検査で悪性所見を認めず, 免疫組織化学にて胆管狭窄部周囲にIgG4陽性形質細胞が多数同定され, IgG4関連硬化性胆管炎と診断された. 内科治療例は2例とも自己免疫性膵炎を合併しており, 黄疸を契機に発見された. 症例3 : 62歳, 男性. 右肝管および下部胆管に限局した胆道狭窄像を認めた. 血清IgG4値が363mg/dLと高値であり, IgG4関連硬化性胆管炎を強く疑った. 症例4 : 70歳, 女性. 右肝管および下部胆管に限局した胆道狭窄像を認めた. 血清IgG4値が404 mg/dLと高値であり, IgG4関連硬化性胆管炎を強く疑った. 2例ともステロイド内服で速やかに胆道狭窄像は改善した. 【結論】 外科切除の対象となる胆道狭窄のなかには, IgG4関連硬化性胆管炎による良性胆道狭窄があることを銘記すべきである. IgG4関連硬化性胆管炎疑診例に対して, 短期ステロイド療法で胆道狭窄が改善するか否かを経過観察する方針は, 診断と治療をかねて妥当と考えられる.", "subitem_description_type": "Abstract"}]}, "item_7_full_name_3": {"attribute_name": "著者別名", "attribute_value_mlt": [{"nameIdentifiers": [{"nameIdentifier": "66459", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Saito, Keita"}]}, {"nameIdentifiers": [{"nameIdentifier": "66460", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Wakai, Toshifumi"}]}, {"nameIdentifiers": [{"nameIdentifier": "66461", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Sakata, Jun"}]}, {"nameIdentifiers": [{"nameIdentifier": "66462", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Ohashi, Taku"}]}, {"nameIdentifiers": [{"nameIdentifier": "66463", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Shirai, Yoshio"}]}, {"nameIdentifiers": [{"nameIdentifier": "66464", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Hatakeyama, Katsuyoshi"}]}, {"nameIdentifiers": [{"nameIdentifier": "66465", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Shioji, Kazuhiko"}]}, {"nameIdentifiers": [{"nameIdentifier": "66466", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Aoyagi, Yutaka"}]}, {"nameIdentifiers": [{"nameIdentifier": "66467", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Ajioka, Yoichi"}]}]}, "item_7_publisher_7": {"attribute_name": "出版者", "attribute_value_mlt": [{"subitem_publisher": "新潟医学会"}]}, "item_7_select_19": {"attribute_name": "著者版フラグ", "attribute_value_mlt": [{"subitem_select_item": "publisher"}]}, "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": "00290440", "subitem_source_identifier_type": "ISSN"}]}, "item_creator": {"attribute_name": "著者", "attribute_type": "creator", "attribute_value_mlt": [{"creatorNames": [{"creatorName": "齋藤, 敬太"}], "nameIdentifiers": [{"nameIdentifier": "66450", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "若井, 俊文"}], "nameIdentifiers": [{"nameIdentifier": "66451", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "坂田, 純"}], "nameIdentifiers": [{"nameIdentifier": "66452", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "大橋, 拓"}], "nameIdentifiers": [{"nameIdentifier": "66453", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "白井, 良夫"}], "nameIdentifiers": [{"nameIdentifier": "66454", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "畠山, 勝義"}], "nameIdentifiers": [{"nameIdentifier": "66455", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "塩路, 和彦"}], "nameIdentifiers": [{"nameIdentifier": "66456", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "青柳, 豊"}], "nameIdentifiers": [{"nameIdentifier": "66457", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "味岡, 洋一"}], "nameIdentifiers": [{"nameIdentifier": "66458", "nameIdentifierScheme": "WEKO"}]}]}, "item_files": {"attribute_name": "ファイル情報", "attribute_type": "file", "attribute_value_mlt": [{"accessrole": "open_date", "date": [{"dateType": "Available", "dateValue": "2019-08-06"}], "displaytype": "detail", "download_preview_message": "", "file_order": 0, "filename": "126(9)_491-495.pdf", "filesize": [{"value": "1.3 MB"}], "format": "application/pdf", "future_date_message": "", "is_thumbnail": false, "licensetype": "license_free", "mimetype": "application/pdf", "size": 1300000.0, "url": {"label": "126(9)_491-495.pdf", "url": "https://niigata-u.repo.nii.ac.jp/record/9602/files/126(9)_491-495.pdf"}, "version_id": "8079253a-9ec3-432e-887d-21c6932cbf1b"}]}, "item_keyword": {"attribute_name": "キーワード", "attribute_value_mlt": [{"subitem_subject": "IgG4関連硬化性胆管炎", "subitem_subject_scheme": "Other"}, {"subitem_subject": "自己免疫性膵炎", "subitem_subject_scheme": "Other"}, {"subitem_subject": "胆管癌", "subitem_subject_scheme": "Other"}, {"subitem_subject": "外科治療", "subitem_subject_scheme": "Other"}, {"subitem_subject": "ステロイド療法", "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": "IgG4関連硬化性胆管炎4例の治療経験", "item_titles": {"attribute_name": "タイトル", "attribute_value_mlt": [{"subitem_title": "IgG4関連硬化性胆管炎4例の治療経験"}, {"subitem_title": "IgG4関連硬化性胆管炎4例の治療経験", "subitem_title_language": "en"}]}, "item_type_id": "7", "owner": "1", "path": ["456", "939"], "permalink_uri": "http://hdl.handle.net/10191/35350", "pubdate": {"attribute_name": "公開日", "attribute_value": "2018-09-11"}, "publish_date": "2018-09-11", "publish_status": "0", "recid": "9602", "relation": {}, "relation_version_is_last": true, "title": ["IgG4関連硬化性胆管炎4例の治療経験"], "weko_shared_id": null}