Ischaemia-reperfusion injury with Pringle's maneuver induces unusually large von Willebrand factor multimers after hepatectomy.

• 資料種別: 博士論文
• ISSN: 0049-3848
• タイトル: Ischaemia-reperfusion injury with Pringle's maneuver induces unusually large von Willebrand factor multimers after hepatectomy.
• 巻次・部編番号: 183
• 著者・編者: Yoshikawa, Takahiro; Nomi, Takeo; Sakai, Kazuya; Hayakawa, Masaki; Hokuto, Daisuke; Matsuo, Yasuko; Sho, Masayuki; Matsumoto, Masanori
• 著者標目: Yoshikawa, Takahiro; Nomi, Takeo; Sakai, Kazuya; Hayakawa, Masaki; Hokuto, Daisuke; Matsuo, Yasuko; Sho, Masayuki; Matsumoto, Masanori
• 出版事項: Elsevier
• 出版年月日等: 2019-11; 183
• 出版年（W3CDTF）: 2019-11
• 並列タイトル等: Pringle法に伴う虚血再灌流障害はUnusually Large Von Willebrand Factor Multimersを誘導する
• タイトル（掲載誌）: Thrombosis research
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2020-03-16
• 授与年月日（W3CDTF）: 2020-03-16
• 報告番号: 乙第1455号
• 学位: 博士（医学）
• 博論授与番号: 乙第1455号
• 本文の言語コード: eng
• 件名標目: ADAMTS13; Unusually large VWF multimers; Hepatectomy
• 対象利用者: 一般
• 一般注記: type:Thesis; Introduction: von Willebrand factor (VWF) is synthesised in vascular endothelial cells and released into the plasma as unusually large VWF multimers (UL-VWFMs). Sinusoidal endothelial cells are a major target of ischaemia-reperfusion injury due to liver surgery. This study aimed to clarify the effect of hepatectomy on UL-VWFMs. Materials and methods: Thirty-five patients who underwent hepatectomy were eligible for the study. Plasma ADAMTS13 activity and VWF antigen levels were measured by enzyme-linked immunosorbent assay and multimer analysis of plasma VWF was performed according to Ruggeri and Zimmerman's method. For analyses, patients were categorised according to UL-VWFM positivity after hepatectomy. Results: Plasma ADAMTS13 activity significantly decreased from 61.0% (27.7%-126.2%) before operation to 37.4% (20.2%-71.4%) on postoperative day 7 (p < 0.001). Plasma VWF antigen levels significantly increased from 172.1% (80.5%-412.8%) before operation to 361.0% (154.7%-745.8%) on postoperative day 2, which remained high until postoperative day 7 (p < 0.001). Seven patients remained UL-VWFMs-negative and 22 patients became UL-VWFMs-positive after operation. Pringle's maneuver duration was significantly longer and blood loss volume was significantly higher in the UL-VWFMs-positive group (p = 0.001 and p = 0.003, respectively). By multivariable analysis, Pringle's maneuver duration [odds ratio 1.049, 95% confidence interval (CI) 1.001-1.098; p = 0.043] was significantly associated with increased UL-VWFMs level after hepatectomy. UL-VWFMs index was significantly correlated with Pringle's maneuver duration (r = 0.444, p = 0.017). Conclusions: Plasma UL-VWFMs levels increased after hepatectomy due to ischaemia-reperfusion injury with Pringle's maneuver.; 博士（医学）・乙第1455号・令和2年3月16日; Copyright © 2019 Elsevier Ltd. All rights reserved.; identifier:Thrombosis research Vol.183 p.20-27 (2019 Nov); identifier:00493848; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3745; identifier:Thrombosis research, 183: 20-27
• DOI: info:doi/10.1016/j.thromres.2019.09.005; https://doi.org/info:doi/10.1016/j.thromres.2019.09.005
• 国立国会図書館永続的識別子: info:ndljp/pid/11570076; https://dl.ndl.go.jp/pid/11570076
• コレクション（共通）: 障害者向け資料
• コレクション（障害者向け資料：レベル1）: テキストデータ
• コレクション（個別）: 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• 収集根拠: 博士論文（自動収集）
• 受理日（W3CDTF）: 2020-11-10T19:58:22+09:00
• 記録形式（IMT）: application/pdf
• オンライン閲覧公開範囲: 国立国会図書館内限定公開
• デジタル化資料送信: 図書館・個人送信対象外
• 遠隔複写可否（NDL）: 可
• 掲載誌（URI）: http://hdl.handle.net/10564/3745
• 連携機関・データベース: 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

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