{"created":"2023-06-19T07:18:09.187886+00:00","id":3274,"links":{},"metadata":{"_buckets":{"deposit":"c7e85898-2954-456b-adc5-ba26bd6af3b3"},"_deposit":{"created_by":4,"id":"3274","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"3274"},"status":"published"},"_oai":{"id":"oai:az.repo.nii.ac.jp:00003274","sets":["370:15:391"]},"author_link":["16370","16371"],"item_10006_date_granted_11":{"attribute_name":"学位授与年月日","attribute_value_mlt":[{"subitem_dategranted":"2003-03-19"}]},"item_10006_degree_grantor_9":{"attribute_name":"学位授与機関","attribute_value_mlt":[{"subitem_degreegrantor":[{"subitem_degreegrantor_name":"麻布大学"}]}]},"item_10006_degree_name_8":{"attribute_name":"学位名","attribute_value_mlt":[{"subitem_degreename":"博士(獣医学)"}]},"item_10006_description_22":{"attribute_name":"Abstract","attribute_value_mlt":[{"subitem_description":"[Background]\n In recent years, because dogs live longer and imaging techniques such as CT and MRI are increasingly used in the field of veterinary medicine, it has become easier to diagnose brain tumors in dogs, and thus the incidence of brain tumors in live dogs is increasing. Of the various canine brain tumors, meningioma is known as a common primary neoplasm that arises mostly in the dorsal area of the cerebrum, such as the temporal, frontal and parietal regions. However, even when meningioma is diagnosed, surgery is not actively performed.\n Neurosurgery is not yet common in dogs, but in the 1960's, Hoerlein and Oliver first applied human techniques to the field of veterinary medicine. The dorsal sagittal sinus exists on the dorsal surface of the cerebrum; starts from the left and right nasal cavity veins; collects blood from the superficial layer of the cerebrum; and is connected to the transverse and straight sinuses in the causal region. As a result, hemostasis or resection of the dorsal sagittal sinus has been contraindicated due to the risk of circulation disorder as well as subsequent severe cerebral edema and increased intracranial pressure (ICP).\n However, in dogs, collateral vessels for the cerebral veins are more developed than in humans. Therefore, the author conducted the present study to confirm the existence of collateral vessels of the cerebral veins in dogs and to establish a surgical technique to approach the broad area of the parietal region by considering surgical effects of the dorsal sagittal sinus on ICP in neurosurgery.\n\n[Experiment 1]\nObservation of collateral vessels of the cerebral veins\n An experiment was conducted to confirm the relationship between the dorsal sagittal sinus, the cerebral superficial veins and other sinuses as well as the existence and distribution of collateral vessels by elucidating the three-dimensional structure of the canine cerebral veins.\n In each of nine healthy adult cadaver beagles, a catheter was placed into the maxillary vein in the cranial direction to inject capillary casting resin into the cerebral veins. After the resin hardened, the soft tissue around the cranium was removed. After a further three days, the soft tissue was immersed in a 20% sodium hydroxide solution to dissolve the cranial tissue and observe the cerebral veins.\n The results showed that the distribution, location and number of sinuses and superficial cerebral veins varied among the nine dogs, and that there was no left and right symmetry in vascularization. On the dorsal side of the cerebrum, blood flowed through seven or eight dorsal cerebral veins into the dorsal sagittal sinus, which originated from the rostral side of the base of the brain. The diploic veins that run inside the cranium were also connected to the dorsal sagittal sinus. In the rostral side of the base of the brain, the dorsal sagittal sinus was connected to branches of the dorsal petrosal sinus. Furthermore, the dorsal sagittal sinus was connected to the vein of the corpus callosum in the longitudinal fissure of the cerebrum. The dorsal cerebral veins, connected to the dorsal sagittal sinus, collected blood from many branches in the temporal region of the cerebrum. Of the various dorsal cerebral veins, the central dorsal cerebral veins were the thickest, and either one or two veins were observed on the left and right sides, and in the temporal region of the cerebrum, the rostral and caudal branches of the central dorsal cerebral veins were connected to branches of the ventral cerebral veins in one of three ways: connected to the rostral branch; connected to the rostral and caudal branches; and two central dorsal cerebral veins were connected separately to the rostral and caudal branches.\nFurthermore, branches of the central dorsal cerebral veins were connected to branches of the dorsal petrosal sinus or the caudal dorsal cerebral veins. The rostral dorsal cerebral vein, which was situated in the rostral side of the cerebrum, arose from the rostral side of the base of the brain, and its branches were connected to branches of the ventral cerebral vein or the dorsal petrosal sinus.\n These findings suggest that the cerebral veins are connected in a plexiform arrangement in the longitudinal fissure, dorsolateral and ventral sides of the cerebrum via the existing collateral vessels, and as a result, changing the flow of blood to treat illnesses that can induce vascular occlusion, such as tumor and thrombus, appears to be relatively simple.\n\n[Experiment2]\nChanges in ICP caused by temporal craniectomy and durotomy\n In the space limited cranium, ICP is resistant to a certain level of stress is markedly elevated when a trauma or a space-occupying lesion exceeds a certain level. An experiment was conducted in order to investigate the effects of craniectomy and durotomy, both of which have been performed to treat increased ICP.\n In six healthy adult beagles, changes in ICP during craniotomy were monitored. At each stage of surgery, external jugular vein compression was performed in order to increase ICP by blocking the flow of blood from the external jugular vein, and changes in ICP were analyzed. After suturing, 300 mmHg of force was applied externally from the site of the craniectomy. \nFurthermore, in order to analyze the effects of a fiberoptic monitoring catheter on brain parenchyma, a histopathology was conducted six weeks after surgery.\n The results showed that ICP under isoflurane anesthesia before the craniotomy was 9.4 mmHg, but this decreased significantly by temporal craniotomy and durotomy to 7.8 and 4.2 mmHg, respectively (p<0.05). After the dural suture, ICP started to increase gradually to 13.5 mmHg when the temporal muscle was sutured. When external jugular vein compression was conducted at each stage, ICP increased rapidly, but decreased markedly at first and then gradually after that. With external jugular vein compression, ICP was 28.4 mmHg before craniotomy and 27.8 mmHg after temporal bone resection. A significant decrease in ICP caused by temporal bone resection seen prior to external jugular vein compression was not detected, and durotomy significantly decreased ICP to 14.1 mmHg (p<0.05). As with external jugular vein compression, external compression from the site of craniectomy caused ICP to increase rapidly at first and then to decrease gradually after that.\n As to the effects of a fiberoptic monitoring catheter on brain tissue, mild local demyelinating changes were observed around the catheter, but no marked changes were detected in other areas. During the experiment, no abnormal symptoms or neurological abnormalities, such as convulsive seizures or circling, were seen. \nbe achieved by this treatment alone, and thus a durotomy is required. Because ICP increased readily in response to external force applied to the site of the craniectomy, an excised cranial bone fragment should be replaced in dogs with thin temporal muscle.\n\n[Experiment 3]\nChanges in ICP caused by ligation of the dorsal sagittal sinus\n The dorsal sagittal sinus is an important sinus that collects a large quantity of blood on the dorsal surface of the cerebrum. The dorsal cerebral veins that were connected to the dorsal sagittal vein were connected to the ventral superficial cerebral veins via collateral vessels. Therefore, an experiment was conducted to measure changes in ICP caused by partial occlusion due to ligation of the dorsal sagittal sinus and to confirm the possibility of ligating the dorsal sagittal sinus during parietal craniotomy.\n Using seven healthy adult beagles, ICP was measured during the following surgery: After resecting the temporal bone, the parietal bone was removed, and the dorsal sagittal sinus located under the dura at the midline was ligated at two locations: rostral and caudal points of the inlet of the central dorsal cerebral vein. Next, the rostral, caudal and rostorocaudal sides of the dorsal sagittal sinus were ligated and released repeatedly in this order.\nFurthermore, after a durotomy, the dorsal sagittal sinus was ligated and released in the same manner in order to determine the changes in ICP. After four weeks, the dogs were euthanatized and a cerebral vein resin specimen was prepared to observe collateral vessels of the cerebral veins.\n The results showed that ICP under isoflurane anesthesia before to the craniotomy was 11.3 mmHg, but it was significantly lower at 5.7 mmHg after the temporal and parietal craniotomy (p<0.05). As to the effects of obstruction of the dorsal sagittal sinus, ICP was 18.7 mmHg with rostral obstruction, 12.8 mmHg with caudal obstruction, and 21.0 mmHg with rostorocaudal obstruction (p<0.05). After durotomy, ICP decreased to 2.6 mmHg, which was significantly lower when compared to that before or after craniotomy (p<0.05). Following durotomy, ICP was 6.3 mmHg with rostral obstruction, 7.2 mmHg with caudal obstruction, and 10.4 mmHg with rostorocaudal obstruction. When comparing ICP before and after durotomy, while ICP decreased slightly with caudal obstruction, it decreased significantly with rostral or rostorocaudal obstruction (p<0.05). The resin-fixed cerebral vein specimens prepared 4 weeks after surgery showed that collateral vessels consisted of branches of the central dorsal cerebral veins and the ventral cerebral veins, and in some dogs, a vein extending from the straight sinus to the ligated dorsal sagittal sinus was seen. During the experimental period, no abnormal symptoms or neurological abnormalities, such as convulsive seizure or circling, were seen.\n These findings suggest that when surgically approaching the parietal region during a parietal craniotomy, it is possible to partially obstruct the dorsal sagittal sinus. Furthermore, a durotomy can minimize the effects of surgery of the dorsal sagittal sinus on ICP.\n\n[Experiment 4]\nChanges in ICP by resection of the dorsal sagittal sinus\n Meningioma arising on the dorsal surface of the cerebrum often affects the falx cerebri or the convexity. In particular, tumors arising in the falx cerebri involve the dorsal sagittal sinus due to physical proximity, and as a result, complete resection of these tumors has been considered difficult.\nTherefore, an experiment was conducted to: assess changes in ICP caused by a change in blood flow due to resection of the dorsal sagittal sinus; and confirm whether it is possible to resect the dorsal sagittal sinus by parietal craniotomy.\n Using seven healthy adult beagles, ICP was measured during the following surgery: After removing the parietal bone, a bilateral durotomy was made, and the central dorsal cerebral vein connected to the dorsal sagittal sinus was blocked. The dorsal sagittal sinus was ligated and resected at two places (rostral and caudal points of the inlet) and changes in ICP were observed. For histopathological examinations, six dogs were sacrificed five days after surgery, and the remaining dog was euthanatized 14 days after surgery. MRI was performed before surgery and at five days post-surgery in the six dogs that were euthanatized at five days after surgery.\n The results showed that ICP was 11.3 mmHg under isoflurane anesthesia prior to the craniotomy, but it decreased to 8.5 mmHg after removing the parietal bone and it then decreased significantly to 4.2 mmHg after bilateral durotomy (p<0.05). ICP during rostral or rostrocaudal obstruction of the dorsal sagittal sinus was 4.5 and 4.6 mmHg, respectively, and these figures were comparable to those after durotomy. Furthermore, when the ligated dorsal sagittal sinus was resected, ICP only slightly increased to 4.8 mmHg. The results of MRI conducted five days after surgery revealed signs indicative of inflammation and edema at the site of the craniotomy and where the ICP catheter was inserted in all dogs. In one dog, a localized high signal intensity area was seen on the right side of the resected dorsal sagittal sinus on a T2-weighted image, but marked changes were not seen in any other dogs. No significant increase in the volume of the lateral ventricle was seen. The histopathology showed mild edematous changes in one dog and mild demyelinating changes in another of the six dogs that were euthanatized five days after surgery, but these changes were localized to the left and right of the longitudinal fissure. No marked changes were seen in the dog that was euthanatized 14 days after surgery. During the experimental period, no abnormal symptoms or neurological abnormalities, such as convulsive seizure or circling, were seen.\n These findings suggest that the dorsal sagittal sinus can be resected during parietal craniotomy, and that the effects of resection on ICP, the cerebral tissue, cerebral spinal fluid, and circulation on the dorsal surface of the cerebrum, are mild.\n\n[Summary]\n In the past, complete resection of a tumor arising in the vicinity of the dorsal sagittal sinus was difficult, but the results of the present study show the existence of collateral vessels connecting the dorsal, ventral and medial superficial cerebral veins in dogs, thus suggesting that it will be possible to alter the flow of blood to treat illnesses that can induce vascular occlusion, such as tumor and thrombus. Furthermore, because of these collateral vessels, it is possible to surgically manipulate the dorsal sagittal sinus that empties blood into the dorsal surface of the cerebrum and to approach a broad area of the parietal region by craniotomy","subitem_description_type":"Other"}]},"item_10006_description_7":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"【背景】\n　近年、犬の脳腫瘍は、動物の高齢化と獣医学領域へCT、MRIなどの画像診断技術の導入により生前診断が容易となり、発見される症例が増加しているといわれている。犬の脳腫瘍の中で髄膜腫は一般的な原発性腫瘍として認められ、その発生は側頭部、前頭部、そして頭頂部など大脳の背側領域を中心に発生がみられる。しかし、診断が付いても積極的な治療につながりにくい。\n　犬に対する脳外科手術は、未だ一般的には行われていないが、その歴史は古く1960年代にHoerleinやOliverらが医学的手技を基礎として、獣医学領域へと応用したのがその始まりである。ただ、臨床応用に際しては、大脳背側面には背側矢状静脈洞が存在し、その静脈洞は左右鼻腔静脈から起始して大脳表層の血液を集め、尾側にて横静脈洞や直動脈洞と合流するため、この背側矢状静脈洞の止血や切除といった操作は、血液の環流障害を引き起こし、重度な脳浮腫や脳圧(Intracranial pressure:以下ICP)の亢進を招くため禁忌とされてきた。\n　しかしながら、犬においては大脳静脈の側副路が人に比べ発達しているともいわれている。そこで著者は、犬における大脳静脈系側副路の存在を確認し、脳外科手術における背側矢状静脈の操作によるICPへの影響を考察し、頭頂部への広範囲なアプローチ法と、背側矢状静脈洞周囲に発生した腫瘍に対する完全切除の臨床応用を目的として実験を行った。\n\n【実験1】脳静脈側副路の観察\n　犬における脳静脈を立体的に表し、背側矢状静脈洞と大脳表在静脈や他の静脈洞との関係を確認し、さらに側副路の存在・走行パターンを知ることを目的に実験を行った。\n　健常なビーグル成犬9頭を安楽死したのち実験を行った。顎静脈より頭側方向にカテーテルを留置し毛細血管鋳型用樹脂を脳静脈に注入した。樹脂の硬化後、頭蓋骨周囲の軟部組織を除去し、20%水酸化ナトリウム溶液に浸し、頭蓋組織を溶解させ脳静脈を観察した。\n　その結果、各個体における静脈洞と脳表在静脈の関係は、走行、位置、数は多様であり、左右の静脈走行も対称性は認められなかった。大脳背側面の血流は、大脳吻側の脳底から起こる背側矢状静脈洞へ、左右各7、8本の背側大脳静脈を介し注がれていた。また、頭蓋骨内を走る板間静脈もこの静脈洞に合流していた。背側矢状静脈洞は、その支流の合流により静脈洞として成立する吻側脳底において、背側錐体静脈洞の支流と吻合が観察された。さらに、背側矢状静脈洞は、大脳縦列内で脳梁静脈と連絡していた。背側矢状静脈洞に注ぐ背側大脳静脈は、側頭領域に存在する多数の支流から血液を集め形成していた。背側大脳静脈の中で最も太い中背側大脳静脈は、左右各1または2本存在し側頭領域で吻側または尾側の中背側大脳静脈の支流が、腹側大脳静脈の支流と吻合していた。この吻合には幾つかのタイプがみられたが、大きくは吻側の支流で吻合しているもの、吻側と尾側の支流で吻合しているもの、二本の中背側大脳静脈が吻側と尾側で別々に吻合しているものの3タイプに分けられた。さらに、中背側大脳静脈の支流は、後背側大脳静脈や背側錐体静脈洞の支流と吻合している例もみられた。大脳吻側に存在する前背側大脳静脈は脳底から起こり、その支流が背側錐体静脈洞や腹側大脳静脈の支流と吻合していた。\n　以上の観察結果より、大脳静脈系は既存の側副路により大脳背側面、腹側面、大脳縦列内が叢状に連絡しており、腫瘍や血栓といった血管閉塞を起こし得る病態に対し、流路変更が可能であることが示唆された。\n\n【実験2】側頭骨切除開頭術ならびに硬膜切開術によるICPの変動\n　空間制限のある頭蓋内にはある一定のコンプライアンスが存在するが、外傷や占拠性病変の発生といったそのコンプライアンスを超える状況が生まれるとICPは著しく亢進する。このようなICP亢進に対し、これまで行われている切除開頭術や硬膜切開術により獲得されるコンプライアンスを知る目的で実験を行った。\n　健常なビーグル成犬6頭に対し、全身麻酔下で開頭手術中のICPを経時的に測定した。さらに、手術操作ごとに外頸静脈圧迫を行い、外頸静脈からの血液排出障害によるICP亢進モデルを作成し、ICPの変動を観察した。また、皮膚縫合終了後、切除開頭領域において外部から300mmHgの力で圧迫し、ICPの測定を行った。術後の観察は6週間行った。\n　その結果、開頭前のイソフルランによる全身麻酔下でのICPは9.4mmHgであったが、側頭骨切除開頭術ならびに硬膜切開術を行うと、7.8mmHg、4.2mmHgと、それぞれ開頭前よりも有意(p<0.05)に減少した。また、硬膜縫合後、側頭筋の縫合を開始するとICPは徐々に上昇し13.5mmHgを示した。各操作において外頸静脈圧迫を行うとICPは急速に上昇し、その後、大きく減少、続いて緩徐な減少変動を示した。外頸静脈圧迫においては、開頭前が28.4mmHg、側頭骨切除後が27.8mmHgと、外頸静脈圧迫前に認められた側頭骨切除によるICPの有意な減少は認められなくなり、硬膜切除を行うと14.1mmHgと有意(p<0.05)に減少が認められるようになった。開頭領域における外部からの圧迫では、外頸静脈圧迫と同様、急速にICPは上昇し、その後、緩徐な減少を示した。また、観察期間中、全頭で臨床症状の異常、ならびに痙攣発作や旋回運動などの神経学的異常は認められなかった。\n　以上の結果より、ICPの急進した症例に対し、外科的治療として行われてきた切除開頭術のみの操作では十分な減圧効果が得られず、硬膜切開の必要性が示唆された。また、開頭領域における外部からの力に対し、ICPは容易に上昇を示すことから、側頭筋の薄い犬種に対しては切除頭蓋骨片の整復の必要性が示唆された。\n\n【実験3】背側矢状静脈洞結紮によるICPの変動\n　背側矢状静脈洞は、大脳背側面の多くの血液を集める主要な静脈洞である。この背側矢状静脈洞へ流入している背側大脳静脈は、大脳腹側の表在静脈と側副路によって連絡していることが確認された。そこで背側矢状静脈洞の結紮を行い部分的閉鎖によりもたらされるICPの変動を測定し、頭頂骨開頭術における背側矢状静脈洞の結紮が可能であることを確認するため実験を行った。\n　健常なビーグル成犬7頭に対し、全身麻酔下で手術操作中のICPを経時的に測定した。側頭骨を切除開頭後、頭頂骨の開頭を行い、硬膜下正中に観察される背側矢状静脈洞に中背側大脳静脈の流入点前後の2ヵ所で結紮糸をかけ、吻側、尾側、両側の順に結紮、開放の操作を繰り返した。さらに硬膜を切開し同様に結紮、開放を行いICPの変動を観察した。また、術後4週目に観察を終了し、脳静脈の樹脂標本を作製、脳静脈の側副路を観察した。\n　その結果、開頭前のイソフルランによる全身麻酔下のICPは11.3mmHgであったが、側頭骨・頭頂骨開頭術後のICPは5.7mmHgと、開頭前よりも有意(p<0.05)に減少した。背側矢状静脈洞の閉鎖において吻側閉鎖では18.7mmHg、尾側閉鎖では12.8mmHg、両側閉鎖では21.0mmHgと、それぞれ閉鎖前よりも有意(p<0.05)な上昇を示した。硬膜切開を行うとICPは2.6mmHgまで減少し開頭前、開頭後よりも有意(p<0.05)な減少を示した。硬膜切開後の吻側閉鎖でICPは6.3mmHg、尾側閉鎖では7.2mmHg、両側閉鎖では10.4mmHgと、硬膜切開前後での尾側閉鎖においてはわずかな減少が、吻側、両側においては有意(p<0.05)な減少が認められた。術後4週目に作成した脳静脈樹脂標本から中背側大脳静脈の支流と腹側大脳静脈の支流による側副路が確認され、さらに脳梁静脈や直静脈洞から背側矢状静脈洞の結紮間へと伸びる静脈も確認された。また、観察期間中、全頭で臨床症状の異常、ならびに痙攣発作や旋回運動などの神経学的異常は認められなかった。\n　以上の結果より、頭頂骨開頭術での頭頂領域への操作において、側副路の存在と発達から背側矢状静脈洞の部分閉鎖が可能であることが示された。さらに、硬膜切開を行うことでICPへの影響は最小限に抑えられることが示唆された。\n\n【実験4】背側矢状静脈洞切除によるICPの変動\n　大脳背側面に発生する髄膜腫は、大脳鎌部や円蓋部に頻発する。特に大脳鎌部に発生した腫瘍は位置的にも背側矢状静脈洞を巻き込んでいることがあり、その完全切除は困難とされてきた。そこで背側矢状静脈洞の切除を行い、血液流出路の変更によりもたらされるICPの変動を測定し、頭頂骨開頭術における背側矢状静脈洞の切除が可能か否かを確認するために実験を行った。\n　健常なビーグル成犬7頭に対し、全身麻酔下で手術操作中のICPを経時的に測定した。頭頂骨を開頭後、両側の硬膜を切開し、背側矢状静脈洞へ流入する中背側大脳静脈を遮断した。中背側側大脳静脈の流入点前後の2ヵ所で結紮、切除を行い、ICPの変動を観察した。また、6頭を術後5日目に、1頭を術後14日目に観察終了し病理組織検査を行った。さらに、術後5日目に観察を終了した6頭では、術前・術後5日目のMRI検査を実施した。\n　その結果、開頭前のイソフルランによる全身麻酔下のICPは11.3mmHgであったが、頭頂骨開頭後のICPは8.5mmHgと、開頭前に比べ減少傾向がみられ、両側硬膜切開を行うと4.2mmHgと有意(p<0.05)な減少を示した。また、背側矢状静脈洞の吻側閉鎖、両側閉鎖においてそれぞれ4.5mmHg、4.6mmHgと、硬膜切開後からほとんどICPの変動はみられず、さらにその結紮間の切除を実施しても4.8mmHgと軽度な上昇に留まっていた。術後5日目のMRI検査では、全頭で開頭領域およびICPカテーテルの刺入領域に炎症、浮腫の所見が観察された。また、1頭で背側矢状静脈洞を切除した右側にT2強調像における高信号領域が限局して確認されたが、他の5頭では著しい変化は観察されなかった。さらに、側脳室体積には有意な増加は認められなかった。病理組織検査においては術後5日目に観察を終了した6頭中1頭で軽度の浮腫性変化が、1頭で軽度の浮腫性変化と軽度の脱髄性変化が認められたが、その変化は術中に操作した大脳縦裂の左右の領域に限局していた。術後14日目に観察を終了した1頭については、著しい変化は観察されなかった。また、観察期間中、全頭で臨床症状の異常、ならびに痙攣発作や旋回運動などの神経学的異常は認められなかった。\n　以上の結果より、頭頂骨開頭術における背側矢状静脈洞に対する操作として切除は可能であり、ICP、脳組織、脳脊髄液の吸収への影響は軽微で、切除による大脳背側面における循環障害の発生も軽微であることが示唆された。\n\n【総括】\n　従来、背側矢状静脈洞周囲に発生した腫瘍の完全切除は困難とされてきたが、本研究により、犬の大脳における表在静脈の循環路には、背側面、腹側面、大脳縦裂面のそれぞれを連絡する側副路が存在しており、腫瘍や血栓などの循環閉鎖障害に対する流路変更が起こることが示唆された。また、その側副路の存在により、これまで禁忌とされてきた大脳背側面の血液を排出している背側矢状静脈洞の閉鎖や切除が可能であることが示唆され、頭頂骨開頭術における広範囲なアプローチが可能となり犬の脳外科手術に新たな手技を示すことができた。","subitem_description_type":"Abstract"}]},"item_10006_dissertation_number_12":{"attribute_name":"学位授与番号","attribute_value_mlt":[{"subitem_dissertationnumber":"甲第97号"}]},"item_10006_version_type_18":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_ab4af688f83e57aa","subitem_version_type":"AM"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"水野, 聡"}],"nameIdentifiers":[{"nameIdentifier":"16370","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Mizuno, Satoshi","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"16371","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":"2013-06-29"}],"displaytype":"detail","filename":"diss_dv_kou0097.pdf","filesize":[{"value":"46.2 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"diss_dv_kou0097","url":"https://az.repo.nii.ac.jp/record/3274/files/diss_dv_kou0097.pdf"},"version_id":"e515b220-c5f0-4d9b-9ddb-d987a6b50b0d"},{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2014-08-19"}],"displaytype":"detail","filename":"diss_dv_kou0097_jab&rev.pdf","filesize":[{"value":"561.1 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"diss_dv_kou0097_jab&rev","url":"https://az.repo.nii.ac.jp/record/3274/files/diss_dv_kou0097_jab&rev.pdf"},"version_id":"97fb0e0a-674c-499b-b6a7-cf167bbc3511"}]},"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":"thesis","resourceuri":"http://purl.org/coar/resource_type/c_46ec"}]},"item_title":"犬の開頭術に関する基礎的研究 : 特に背側矢状静脈洞操作による脳圧(ICP)への影響と脳静脈側副路について","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"犬の開頭術に関する基礎的研究 : 特に背側矢状静脈洞操作による脳圧(ICP)への影響と脳静脈側副路について"},{"subitem_title":"Basic study on craniotomy in dogs : anatomy of collateral vessels of the cerebral veins and surgical effects of the dorsal sagittal sinus on intracranial pressure (ICP)","subitem_title_language":"en"}]},"item_type_id":"10006","owner":"4","path":["391"],"pubdate":{"attribute_name":"公開日","attribute_value":"2013-02-21"},"publish_date":"2013-02-21","publish_status":"0","recid":"3274","relation_version_is_last":true,"title":["犬の開頭術に関する基礎的研究 : 特に背側矢状静脈洞操作による脳圧(ICP)への影響と脳静脈側副路について"],"weko_creator_id":"4","weko_shared_id":4},"updated":"2023-06-19T08:15:30.547279+00:00"}