{"created":"2023-06-19T11:22:42.893483+00:00","id":611,"links":{},"metadata":{"_buckets":{"deposit":"2badf962-47f8-4daf-9359-1e10a93622bf"},"_deposit":{"created_by":12,"id":"611","owners":[12],"pid":{"revision_id":0,"type":"depid","value":"611"},"status":"published"},"_oai":{"id":"oai:jichi-ir.repo.nii.ac.jp:00000611","sets":["14:28"]},"author_link":[],"item_2_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2011-03","bibliographicIssueDateType":"Issued"},"bibliographicPageEnd":"146","bibliographicPageStart":"141","bibliographicVolumeNumber":"33","bibliographic_titles":[{"bibliographic_title":"自治医科大学紀要"},{"bibliographic_title":"Jichi Medical University Journal","bibliographic_titleLang":"en"}]}]},"item_2_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は双極性障害の31歳男性で炭酸リチウムにて治療中であった。主訴は意識障害。経過中口渇感を自覚し清涼飲料水を多飲するようになり，定期受診でHbA1c13％と高血糖であった。その後他院を受診し，尿ケトンが2+とケトーシスの状態で内服治療が開始となった。その９日後に意識障害が出現し昏睡状態に至ったため当センターへ緊急転院した。リチウム血中濃度は4.0mEq/Lと高値で救命はできたが後遺症として小脳失調症状が残存した。リチウムは治療域が狭く，中毒域では重篤な症状をきたす。高血糖に伴う血管内脱水は，腎前性腎機能障害も引き起こす危険性があり一旦腎機能障害を起こすとリチウム排泄障害も加わり重篤なリチウム中毒の誘因となる。糖尿病に関連したリチウム中毒の報告例はまれであり，今回教訓的な症例を経験したので，炭酸リチウム治療中には糖尿病の発症や血管内脱水に注意する必要がある。加えてリチウム中毒による小脳失調の機序についての文献的考察を交え報告する。","subitem_description_type":"Abstract"}]},"item_2_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"names":[{"name":"Akira, ISHII","nameLang":"en"}]},{"names":[{"name":"Hitoshi, SUGAWARA","nameLang":"en"}]},{"names":[{"name":"Tamami, WATANABE","nameLang":"en"}]},{"names":[{"name":"Shuhei, YOSHIKAWA","nameLang":"en"}]},{"names":[{"name":"Ken, TASHIRO","nameLang":"en"}]},{"names":[{"name":"Haruhiko, ISHIOKA","nameLang":"en"}]},{"names":[{"name":"Ken, HUKATU","nameLang":"en"}]},{"names":[{"name":"Tetsu, OONUMA","nameLang":"en"}]},{"names":[{"name":"Mariko, USHIKI","nameLang":"en"}]},{"names":[{"name":"Hiromitu, SANUI","nameLang":"en"}]},{"names":[{"name":"Masanobu, KAWAKAMI","nameLang":"en"}]}]},"item_2_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"自治医科大学"}]},"item_2_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"1881-252X","subitem_source_identifier_type":"PISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"石井, 彰","creatorNameLang":"ja"}]},{"creatorNames":[{"creatorName":"菅原, 斉","creatorNameLang":"ja"}]},{"creatorNames":[{"creatorName":"渡辺, 珠美","creatorNameLang":"ja"}]},{"creatorNames":[{"creatorName":"吉川, 修平","creatorNameLang":"ja"}]},{"creatorNames":[{"creatorName":"田代, 研","creatorNameLang":"ja"}]},{"creatorNames":[{"creatorName":"石岡, 春彦","creatorNameLang":"ja"}]},{"creatorNames":[{"creatorName":"深津, 健","creatorNameLang":"ja"}]},{"creatorNames":[{"creatorName":"大沼, 哲","creatorNameLang":"ja"}]},{"creatorNames":[{"creatorName":"牛木, 真理子","creatorNameLang":"ja"}]},{"creatorNames":[{"creatorName":"讃井, 將満","creatorNameLang":"ja"}]},{"creatorNames":[{"creatorName":"川上, 正舒","creatorNameLang":"ja"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-07-01"}],"displaytype":"detail","filename":"自治医科大学紀要1881-252X(33)p141-146.pdf","filesize":[{"value":"1.3 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