{"created":"2023-06-20T16:59:38.211953+00:00","id":18801,"links":{},"metadata":{"_buckets":{"deposit":"5dbc43a5-03d7-401f-9f47-6aef440a42a1"},"_deposit":{"created_by":3,"id":"18801","owners":[3],"pid":{"revision_id":0,"type":"depid","value":"18801"},"status":"published"},"_oai":{"id":"oai:twinkle.repo.nii.ac.jp:00018801","sets":["140:1307:1308:1965:1972"]},"author_link":["266802","266804","266796","266805","266797","266798","266799","266800","266795","266801","266803","266794"],"item_10001_alternative_title_1":{"attribute_name":"別タイトル","attribute_value_mlt":[{"subitem_alternative_title":"重症外傷における血清イオン化カルシウム濃度 : 臨床的ならびに実験的検討"}]},"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2002-11-25","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"10/11","bibliographicPageEnd":"469","bibliographicPageStart":"461","bibliographicVolumeNumber":"72","bibliographic_titles":[{"bibliographic_title":"東京女子医科大学雑誌"}]}]},"item_10001_creator_2":{"attribute_name":"著者名","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"DEGUCHI, Yoshizumi"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"NAKAGAWA, Takao"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SOGA, Yukihiro"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SUGA, Hiroyasu"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"ISHIKAWA, Masatake"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SUZUKI, Tadashi"}],"nameIdentifiers":[{}]}]},"item_10001_date_25":{"attribute_name":"受付日付","attribute_value_mlt":[{"subitem_date_issued_datetime":"2010-08-10","subitem_date_issued_type":"Created"}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"ショックや組織虚血・再灌流時の細胞障害・細胞死の主な原因が,急速な血清中イオン化カルシウム(iCa^<2+>)の細胞内流入であることが最近の研究で明らかになっている.重症外傷患者は,ショックや呼吸不全を伴い組織虚血を合併することから,受傷後の血清中iCa^<2+>の低下が外傷患者の重症度・緊急度や予後を推定するのに有用である可能性がある.また,侵襲のメディエーターであるNO合成酵素(cNOS)は血清中Ca^<2+>の細胞内流入により活性化されることが報告されている.本研究では,ラットを用いた大量出血モデルにおいて,iCa^<2+>,組織内NOおよび炎症性サイトカインであるIL-8,TNF-αを測定し同時に組織病理像を検討することにより,重症外傷の主病態である大量出血が血清中iCa^<2+>,組織内NO,IL-8,TNF-αに影響を与えるか否かを検討した.また,救急搬送された外傷症例において,搬入時および入院後に血清中iCa^<2+>を測定し,injury severity score(ISS),受傷から搬入までの時間,ショック,血液ガス所見,臨床経過,予後等の各指標と,血清中iCa^<2+>との関連を検討することにより,外傷患者における血清中iCa^<2+>の診断,治療上の意義を検討した.その結果,SDラットを用いた大量出血実験モデルにおいて,全血液の30%放血後iCa^<2+>は有意に低下し,IL-8,TNF-αは有意に上昇した.また,組織内NOは経時的に増加傾向を示した.また,外傷患者の血清中iCa^<2+>は死亡に至る重症例,ISS高値,大量出血,ショック,代謝性アシドーシス等により低下した.以上の結果から血清中iCa^<2+>は,外傷の重症度,治療効果,予後を推定する有用な血液学的指標となりうると考えられた.","subitem_description_type":"Abstract"},{"subitem_description":"Recent studies have shown that the rapid inflow of serum ionized calcium (iCa^<2+>) into cells may be the main cause of cell damage and apoptosis in shock, tissue ischemia, and reperfusion. Since patients with serious trauma are often associated with shock and respiratory failure leading to tissue ischemia, reduced serum iCa^<2+> after being injured may be useful for predicting the severity, urgency, and prognosis of patients with trauma. The intracellular inflow of serum iCa^<2+> was reported to activate constitutive nitric oxide synthase (cNOS), which is an invasion mediator. This study measured serum iCa^<2+>, tissue NO, and inflammatory cytokines interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α), and examined histopathological samples in an experimental rat model of heavy bleeding, in order to determine if heavy bleeding, a major morbid state of serious trauma, influenced the measurements of serum iCa^<2+>, tissue NO, IL-8, and TNF-α. This study also measured serum iCa^<2+> in emergency patients with trauma on admission and through the subsequent hospitalization period to examine its relationship with other indicators including trauma severity score (ISS), time from being injured to arrival, presence of shock, blood gas findings, clinical course, and prognosis, thereby evaluating the diagnostic and therapeutic importance of serum iCa^<2+>. The results with the experimental rat model of heavy bleeding showed serum iCa^<2+> lowered significantly and IL-8 and TNF-α increased significantly after 30% of the whole blood was exsanguinated, and that tissue NO tended to increase over time. The results from patients with trauma showed serum iCa^<2+> lowered in serious cases leading to death and those with high ISS, heavy bleeding, shock, and metabolic acidosis. These results indicate that serum iCa^<2+> can be a useful indicator for predicting severity, reaction to treatment, and trauma prognosis.","subitem_description_type":"Abstract"}]},"item_10001_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"266800","nameIdentifierScheme":"WEKO"}],"names":[{"name":"出口, 善純"}]},{"nameIdentifiers":[{"nameIdentifier":"266801","nameIdentifierScheme":"WEKO"}],"names":[{"name":"中川, 隆雄"}]},{"nameIdentifiers":[{"nameIdentifier":"266802","nameIdentifierScheme":"WEKO"}],"names":[{"name":"曽我, 幸弘"}]},{"nameIdentifiers":[{"nameIdentifier":"266803","nameIdentifierScheme":"WEKO"}],"names":[{"name":"須賀, 弘泰"}]},{"nameIdentifiers":[{"nameIdentifier":"266804","nameIdentifierScheme":"WEKO"}],"names":[{"name":"石川, 雅健"}]},{"nameIdentifiers":[{"nameIdentifier":"266805","nameIdentifierScheme":"WEKO"}],"names":[{"name":"鈴木, 忠"}]}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"東京女子医科大学学会"}]},"item_10001_source_id_11":{"attribute_name":"NCID","attribute_value_mlt":[{"subitem_source_identifier":"AN00161368","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0040-9022","subitem_source_identifier_type":"ISSN"}]},"item_10001_text_35":{"attribute_name":"著者所属","attribute_value_mlt":[{"subitem_text_value":"Department of Emergency Medicine, Tokyo Women's Medical University Daini Hospital"},{"subitem_text_value":"Department of Emergency Medicine, Tokyo Women's Medical University Daini Hospital"},{"subitem_text_value":"Department of Emergency Medicine, Tokyo Women's Medical University Daini Hospital"},{"subitem_text_value":"Department of Emergency Medicine, Tokyo Women's Medical University Daini Hospital"},{"subitem_text_value":"Department of Emergency Medicine, Tokyo Women's Medical University School of Medicine"},{"subitem_text_value":"Department of Emergency Medicine, Tokyo Women's Medical University School of Medicine"},{"subitem_text_value":"東京女子医科大学附属第二病院救命救急センター"},{"subitem_text_value":"東京女子医科大学附属第二病院救命救急センター"},{"subitem_text_value":"東京女子医科大学附属第二病院救命救急センター"},{"subitem_text_value":"東京女子医科大学附属第二病院救命救急センター"},{"subitem_text_value":"東京女子医科大学医学部救急医学"},{"subitem_text_value":"東京女子医科大学医学部救急医学"}]},"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_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2017-03-27"}],"displaytype":"detail","filename":"KJ00006019663.pdf","filesize":[{"value":"630.3 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"KJ00006019663.pdf","url":"https://twinkle.repo.nii.ac.jp/record/18801/files/KJ00006019663.pdf"},"version_id":"06c0734c-2d12-4324-8ad8-a929fa50de61"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"eng"}]},"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":"Level of Serum Ionized Calcium in Severe Injury : Clinical and Experimental Study","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"Level of Serum Ionized Calcium in Severe Injury : Clinical and Experimental Study"}]},"item_type_id":"10001","owner":"3","path":["1972"],"pubdate":{"attribute_name":"公開日","attribute_value":"2010-08-10"},"publish_date":"2010-08-10","publish_status":"0","recid":"18801","relation_version_is_last":true,"title":["Level of Serum Ionized Calcium in Severe Injury : Clinical and Experimental Study"],"weko_creator_id":"3","weko_shared_id":-1},"updated":"2023-06-20T22:22:09.076445+00:00"}