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"subitem_description_type": "Other"}]}, "item_3_description_9": {"attribute_name": "抄録", "attribute_value_mlt": [{"subitem_description": "46,XY性分化疾患（differences/disorders of sex development : DSD）は，46,XYの核型をもつ性分化疾患であり，性腺，内外性器に様々な程度の男性化障害を認める．社会的に女性として養育されていた児において，腹腔鏡下鼠径ヘルニア手術の際に精巣を指摘され，46,XY DSDの診断に至った2症例を報告する．2例とも会陰部に膣を認め，その直上に尿道が開口しており，女性型外性器を呈していた．症例1（0歳6か月）は子宮は認めず，両側鼠径部に精巣を有し，十分なテストステロン分泌が認められた．症例2（1歳8か月）は，陰核肥大と左鼠径部に精巣を有し，低形成の子宮を認めた．hCG負荷試験にてテストステロンの上昇を認めた．以上より，いずれの症例も胎児期に脳がアンドロゲン暴露を受けた可能性を有するため，性自認の確認が必要と考えられた．\n女児の鼠経ヘルニアの診察時にはDSDを念頭におく必要があり，DSDを疑った場合には，慎重な精査と包括的対応が必要となる．", "subitem_description_language": "ja", "subitem_description_type": "Abstract"}]}, "item_3_publisher_6": {"attribute_name": "出版者", "attribute_value_mlt": [{"subitem_publisher": "浜松医科大学小児科学雑誌編集部", "subitem_publisher_language": "ja"}]}, "item_3_select_2": {"attribute_name": "資源タイプ", "attribute_value_mlt": [{"subitem_select_item": "Journal Article", "subitem_select_language": "en"}]}, "item_3_source_id_20": 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