{"created":"2023-06-20T15:46:05.865663+00:00","id":585,"links":{},"metadata":{"_buckets":{"deposit":"d0eb0c7f-2bf7-47da-a63f-cab1aebd19c6"},"_deposit":{"created_by":4,"id":"585","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"585"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:00000585","sets":["1:11"]},"author_link":["1800","1801","1802","1803","1804","1805","1806","1807"],"item_3_alternative_title_1":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Steroid-withdrawal radiation pneumonitis after postoperative radiotherapy for a primary lung cancer"}]},"item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2002-01-15","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"70","bibliographicPageStart":"65","bibliographicVolumeNumber":"16","bibliographic_titles":[{"bibliographic_title":"日本呼吸器外科学会雑誌 The journal of the Japanese Association for Chest Surgery"}]}]},"item_3_description_9":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は53歳,アルコール性肝硬変のある男性.左肺腺癌に対し左肺下葉切除ND2a施行.pN2(#7,#8)のため,術後に両側肺門,縦隔および鎖骨上部に放射線照射50Gyを追加した.照射終了1週間後より,発熱を認め放射線肺臓炎と診断した.prednisolone(PSL)内服により軽快したが,PSL減量中に再度高熱を認めた.CTで放射線非照射部位にもすりガラス様陰影を認め,放射線肺臓炎の急性増悪の診断で,methylprednisolone(mPSL)によるパルス療法を行ったが,PSLによる維持療法中に急性呼吸不全に陥った.CTでは両肺全体にすりガラス様陰影の拡大を認めた.ステロイドパルス療法の追加により症状は改善し,またCT上陰影も消失し,入院後97日目に退院した.経過中に血中Cytomegalovirus antigenemiaおよびCandida抗原が陽転した.放射線肺臓炎はステロイド漸減中にも急性増悪を来すことがあり,ステロイド投与法および二次感染には十分な注意を要する.  A 53-year-old man with alcoholic liver cirrhosis underwent left lower lobectomy for primary lung cancer, well differentiated adenocarcinoma, pT1N2M0-IIIA. He received postoperative radiation therapy of a total dose of 50 Gy in 25 fractions to the bilateral hilar, mediastinal and supuraclavicular regions. A week after the completion of radiation therapy, he developed radiation pneumonitis, and prednisolone, at a dose of 30mg/day, was initiated. While tapering prednisolone, the pneumonitis was exacerbated. Although the patient responded immediately to methylpredonisolone pulse therapy, the condition exacerbated again when maintenance therapy of prednisolone was started after pulse therapy. Subsequently, the patient developed acute respiratory insufficiency. Adding methylpredonisolone pulse therapy improved the pneumonitis, and prednisolone was tapered gradually from 60mg/day and the withdrawal of glucocorticoids was successful. At the second exacerbation, Cytomegalovirus and Candida antigens were seropositive. In treating radiation pneumonitis with glucocorticoids, the possibility of steroid-withdrawal radiation pneumonitis and secondary infection should be considered.","subitem_description_type":"Abstract"}]},"item_3_publisher_6":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"日本呼吸器外科学会"}]},"item_3_relation_22":{"attribute_name":"NII論文ID","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"110001269916","subitem_relation_type_select":"NAID"}}]},"item_3_rights_7":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"日本呼吸器外科学会"},{"subitem_rights":"本文データは学協会の許諾に基づきCiNiiから複製したものである"}]},"item_3_source_id_19":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"09190945","subitem_source_identifier_type":"ISSN"}]},"item_3_version_type_32":{"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":"朝井, 克之"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"閨谷, 洋"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"浅野, 寿利"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"鈴木, 一也"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"大井, 諭"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"伊藤, 靖"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"高橋, 毅"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"数井, 暉久"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2018-08-27"}],"displaytype":"detail","filename":"110001269916.pdf","filesize":[{"value":"1.1 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"110001269916.pdf","url":"https://hama-med.repo.nii.ac.jp/record/585/files/110001269916.pdf"},"version_id":"0e6679f2-f85c-47e5-b4ee-dfe7444323e5"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"肺癌","subitem_subject_scheme":"Other"},{"subitem_subject":"放射線肺臓炎","subitem_subject_scheme":"Other"},{"subitem_subject":"ステロイド療法","subitem_subject_scheme":"Other"},{"subitem_subject":"サイトメガロウイルス","subitem_subject_scheme":"Other"},{"subitem_subject":"lung cancer","subitem_subject_scheme":"Other"},{"subitem_subject":"radiation pneumonitis","subitem_subject_scheme":"Other"},{"subitem_subject":"steroid therapy","subitem_subject_scheme":"Other"},{"subitem_subject":"cytomegalovirus","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":"ステロイド漸減中に増悪を来した肺癌術後放射線肺臓炎の1例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"ステロイド漸減中に増悪を来した肺癌術後放射線肺臓炎の1例","subitem_title_language":"ja"}]},"item_type_id":"3","owner":"4","path":["11"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2013-08-27"},"publish_date":"2013-08-27","publish_status":"0","recid":"585","relation_version_is_last":true,"title":["ステロイド漸減中に増悪を来した肺癌術後放射線肺臓炎の1例"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-08-02T05:47:49.720364+00:00"}