同: chronic obstructive lung disease, 慢性閉塞性肺疾患

WordNet

unconscious from a blow or shock or intoxication; "the boxer was out cold"; "pass out cold"
a mild viral infection involving the nose and respiratory passages (but not the lungs); "will they never find a cure for the common cold?" (同)common_cold
the sensation produced by low temperatures; "he shivered from the cold"; "the cold helped clear his head" (同)coldness
without compunction or human feeling; "in cold blood"; "cold-blooded killing"; "insensate destruction" (同)cold-blooded, inhuman, insensate
sexually unresponsive; "was cold to his advances"; "a frigid woman" (同)frigid
lacking originality or spontaneity; no longer new; "moth-eaten theories about race"; "stale news" (同)stale, dusty, moth-eaten
(color) giving no sensation of warmth; "a cold bluish grey"
extended meanings; especially of psychological coldness; without human warmth or emotion; "a cold unfriendly nod"; "a cold and unaffectionate person"; "a cold impersonal manner"; "cold logic"; "the concert left me cold"
feeling or showing no enthusiasm; "a cold audience"; "a cold response to the new play"
having a low or inadequate temperature or feeling a sensation of coldness or having been made cold by e.g. ice or refrigeration; "a cold climate"; "a cold room"; "dinner has gotten cold"; "cold fingers"; "if you are cold, turn up the heat"; "a cold beer"
having lost freshness through passage of time; "a cold trail"; "dogs attempting to catch a cold scent"
lacking the warmth of life; "cold in his grave"
marked by errorless familiarity; "had her lines cold before rehearsals started"
of a seeker; far from the object sought
so intense as to be almost uncontrollable; "cold fury gripped him"

PrepTutorEJDIC

『寒い』,冷たい;冷えた,冷やした / (性格・態度などが)『冷たい』,冷淡な,熱意のない;無情な,冷酷な / (物事が)人をがっかりさせる,つまらない / (色調が)冷たい,寒色の / (獲物のにおい臭が)かすかな,弱い / 《話》(打撃などで)意識を失った,失神した / 完全に,全く / 〈U〉《しばしばthe~》『寒さ』,寒け,冷たさ / 〈C〉,時に〈U〉『かぜ』,感冒
Colorado
cost of living消費者物価

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/09/02 12:38:32」(JST)

wiki en

[Wiki en表示]

An iceberg

Look up cold in Wiktionary, the free dictionary.

Cold refers to the condition or subjective perception of having low temperature, the absence of hot.^{[note 1]}

A lower bound to temperature is absolute zero, defined as 0 K on the Kelvin scale, an absolute thermodynamic temperature scale. This corresponds to −273.15 °C on the Celsius scale, −459.67 °F on the Fahrenheit scale, and 0 °R on the Rankine scale.

Since temperature relates to the thermal energy held by an object or a sample of matter, which is the kinetic energy of the random motion of the particle constituents of matter, an object will have less thermal energy when it is colder and more when it is hotter. If it were possible to cool a system to absolute zero, all motion of the particles in a sample of matter would cease and they would be at complete rest in this classical sense. The object would be described as having zero thermal energy. Microscopically in the description of quantum mechanics, however, matter still has zero-point energy even at absolute zero, because of the uncertainty principle.

Cooling

Out In The Cold, Léon Bazille Perrault

Signal "cold" - unofficial (except recommended by CMAS), however used by many schools of diving and propagated through the portals on the diving as one of the useful additional signals^[1]^[2].^[3]

Goose bumps, a common physiological response to cold, aiming to reduce the loss of body heat in a cold environment.

Cooling refers to the process of becoming cold, or lowering in temperature. This could be accomplished by removing heat from a system, or exposing the system to an environment with a lower temperature.

Fluids used to cool objects are commonly called coolants.

Air cooling is the process of cooling an object by exposing it to air. This will only work if the air is at a lower temperature than the object, and the process can be enhanced by increasing the surface area or decreasing the mass of the object.

Another common method of cooling is exposing an object to ice, dry ice, or liquid nitrogen. This works by convection; the heat is transferred from the relatively warm object to the relatively cold coolant.

Laser cooling and Magnetic evaporative cooling are techniques used to reach very low temperatures.

Physiological effects

Cold has numerous physiological and pathological effects on the human body, as well as on other organisms. Cold environments may promote certain psychological traits, as well as having direct effects on the ability to move. Coordination is one of the first abilities to be affected. Extreme cold temperatures may lead to frostbite as well as hypothermia, which in turn may result in death.^{[citation needed]}

Notable cold locations and objects

A photograph of the snow surface at Dome C Station, Antarctica a part of the notoriously cold polar plateau, it is representative of the majority of the continent's surface.

The coldest known temperature ever achieved is a state of matter called the Bose–Einstein condensate which was first theorized to exist by Satyendra Nath Bose in 1924 and first created by Eric Cornell, Carl Wieman, and co-workers at JILA on June 5, 1995. They did this by cooling a dilute vapor consisting of approximately two thousand rubidium-87 atoms to below 170 nK (one nK or nano K is a billionth (10^-9) of a Kelvin) using a combination of laser cooling (a technique that won its inventors Steven Chu, Claude Cohen-Tannoudji, and William D. Phillips the 1997 Nobel Prize in Physics) and magnetic evaporative cooling.
The Boomerang Nebula is the coldest known natural location in the universe, with a temperature that is estimated at 1 K (−272.15 °C/−457.87 °F).^[4]
The Planck spacecraft's instruments are kept at 0.1 K (−273.05 °C/−459.49 °F) via passive and active cooling.^[5]
Absent any other source of heat, the temperature of the Universe is roughly 2.725 kelvin, due to the Cosmic microwave background radiation, a remnant of the Big Bang.^[6]
Neptune's moon Triton has a surface temperature of −235 °C (−390 °F).
Uranus with a black-body temperature of 58.2 K (-215.0 °C, -354.9 °F).^[7]
Saturn with a black-body temperature of 81.1 K (-192.0 °C, -313.7 °F).^[8]
Mercury, despite being close to the Sun, is actually cold during its night, with a temperature of about −170 °C (−275 °F). Mercury is cold during its night because it has no atmosphere to trap in heat from the Sun.^[9]
Jupiter with a black-body temperature of 110.0 K (-163.2 °C, -261.67 °F).^[10]
Mars with a black-body temperature of 210.1 K (-63.05 °C, -81.49 °F).^[11]
The coldest continent on Earth is Antarctica.^[12] The coldest place on Earth is the Antarctic Plateau,^[13] an area of Antarctica around the South Pole that has an altitude of around 3,000 metres (9,800 ft). The lowest reliably measured temperature on Earth of 183.9 K (-89.2 °C, -128.6 °F) was recorded there at Vostok Station on 21 July 1983^[14] (See List of weather records).

Notes

^ A cold body is often described as having less heat, although this use of "heat" would be incorrect in the context of physics, as heat refers to the transfer of energy between bodies, which do not "have" heat themselves.

References

Wikimedia Commons has media related to Cold.

^ Portal "Argonaut": Sygnały ręczne
^ Scuba Diving – Hand Signals – strona w języku angielskim
^ Diving Hand Signals (Additional signals) – strona w języku angielskim
^ "Boomerang Nebula boasts the coolest spot in the Universe". NASA's Jet Propulsion Laboratory. June 20, 1997. Retrieved July 8, 2009.
^ Staff (July 7, 2009). "Coldest Known Object in Space Is Very Unnatural". Space.com. Retrieved July 3, 2013.
^ Hinshaw, Gary (December 15, 2005). "Tests of the Big Bang: The CMB". NASA WMAP. Retrieved 2007-01-09.
^ Uranus Fact Sheet
^ Saturn Fact Sheet
^ http://www.nasa.gov/worldbook/mercury_worldbook.html^{[dead link]}
^ Jupiter Fact Sheet
^ Mars Fact Sheet
^ Melting Ice in Antarctica : Image of the Day
^ Bignell, Paul (2007-01-21). "Polar explorers reach coldest place on Earth". The Independent (London). Retrieved 2010-04-30.
^ Budretsky, A.B. (1984). "New absolute minimum of air temperature". Bulletin of the Soviet Antarctic Expedition (in Russian) (Leningrad: Gidrometeoizdat) (105).

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 成人における感冒：治療および予防 the common cold in adults treatment and prevention
2. 成人における感冒：診断と臨床的特徴 the common cold in adults diagnosis and clinical features
3. The common cold in children: Management and prevention
4. 小児における感冒：臨床的特徴および診断 the common cold in children clinical features and diagnosis
5. 患者情報：成人における感冒（詳細） the common cold in adults beyond the basics

English Journal

Properties of bioadhesive ketoprofen liquid suppositories: preparation, determination of gelation temperature, viscosity studies and evaluation of mechanical properties using texture analyzer by 4 × 4 factorial design.

Ozgüney I, Kardhiqi A.Author information Faculty of Pharmacy, Department of Pharmaceutical Technology, Ege University, Bornova, İzmir , Turkey.AbstractCONTEXT: Development and evaluation of thermosensitive and bioadhesive liquid suppositories containing ketoprofen (KP).
Pharmaceutical development and technology.Pharm Dev Technol.2014 Dec;19(8):968-75. doi: 10.3109/10837450.2013.846373. Epub 2013 Oct 24.
CONTEXT: Development and evaluation of thermosensitive and bioadhesive liquid suppositories containing ketoprofen (KP).OBJECTIVE: This study was conducted to develope thermosensitive and bioadhesive liquid suppositories containing KP using poloxamer and different bioadhesive polymers and to investig
PMID 24156540

Adverse effects of propranolol treatment for infantile hemangiomas in China.

Jian D, Chen X, Babajee K, Su J, Li J, Hu X, Xie H, Li J.Author information Department of Dermatology, Central South University, XiangYa Hospital , Changsha, Hunan , China.AbstractOBJECTIVES: The β-blocker propranolol was discovered to be highly effective for the treatment of infantile hemangiomas (IHs), since 2008. Although some side effects have been reported earlier, no serious side effects of its use have been reported so far in Asia, especially in China. To determine the safety of this therapy, the side effects were analyzed in 97 infants who used propranolol (2 mg kg(-1)·d(-1)) against hemangioma from 2010 to 2011.
The Journal of dermatological treatment.J Dermatolog Treat.2014 Oct;25(5):388-90. doi: 10.3109/09546634.2012.755249. Epub 2013 Feb 24.
OBJECTIVES: The β-blocker propranolol was discovered to be highly effective for the treatment of infantile hemangiomas (IHs), since 2008. Although some side effects have been reported earlier, no serious side effects of its use have been reported so far in Asia, especially in China. To determine th
PMID 23216314

High encapsulation efficiency of poloxamer-based injectable thermoresponsive hydrogels of etoposide.

Soni G, Yadav KS.Author information Department of Pharmaceutics, Rajeev Gandhi College of Pharmacy, Bhopal , Madhya Pradesh , India.AbstractCONTEXT: Hydrogels are promising polymeric network capable of sustaining the release of drug but have a major limitation for encapsulation of hydrophobic drugs.
Pharmaceutical development and technology.Pharm Dev Technol.2014 Sep;19(6):651-61. doi: 10.3109/10837450.2013.819014. Epub 2013 Jul 24.
CONTEXT: Hydrogels are promising polymeric network capable of sustaining the release of drug but have a major limitation for encapsulation of hydrophobic drugs.OBJECTIVE: This study was undertaken to encapsulate etoposide in poloxamer 407-based thermosensitive hydrogels with an aim to sustain its re
PMID 23879721

Japanese Journal

Macroecological patterns of American Cutaneous Leishmaniasis transmission across the health areas of Panamá (1980–2012)

Parasite Epidemiology and Control 1(2), 42-55, 2016-06
NAID 120005740468

インドのコールドチェーン : Cold Chain : A Weak Link in the Fruits and Vegetables Supply Chain in India

Logi biz 16(1), 50-53, 2016-04
NAID 40020778237

兵力100万の総合戦力陸軍 : 世界最強ランドパワーの全貌 The Giant of the Cold War Weapon, U.S. Army 冷戦兵器の大巨人『アメリカ陸軍』(Vol 1)陸軍生誕240年 : 今ロシアの脅威

軍事研究 51(4), 123-146, 2016-04
NAID 40020754700

Related Pictures

★リンクテーブル★

リンク元	「慢性閉塞性肺疾患」「脈拍」
関連記事	「cold」「CO」

「慢性閉塞性肺疾患」

　　[★]

英: chronic obstructive pulmonary disease, COPD
同: chronic obstructive lung disease COLD
関: 慢性気道閉塞

日本語訳としての「慢性閉塞性肺疾患」より「COPD」を使用することが勧められている

概念

1.

「COPD とは有毒な粒子やガスの吸入によって生じた肺の炎症反応に基づく進行性の気流制限を呈する疾患である．この気流制限には様々な程度の可逆性を認め、発症と経過が緩徐であり、労作性呼吸困難を生じる」疾患
完全に可逆性ではない気流制限が特徴　←　気管支喘息ではβ2受容体作動薬により気流制限の改善をみる。

2. ICU.387

慢性気管支炎や肺気腫により常に気道閉塞(一秒率:一秒量 FEV1/努力肺活量 FVC<70%)に陥っている病態で、気管支拡張薬に対する反応は乏しく、症状(呼吸困難)が恒常的・慢性的である。

疫学

患者の9割が喫煙者

病因

参考1

臨床上のリスク因子

喫煙
気道の過敏性
環境からの暴露
アトピー体質
抗酸化物質の欠乏
気管支肺低形成
結核

遺伝形式

α1アンチトリプシン欠損症は常染色体優性遺伝 AD

症状

身体所見

視診

打診上、鼓音
聴診上、呼吸音減弱、呼気延長

検査

血液ガス検査

PaO2：低下
PaCO2：上昇
A-aDO2：上昇

呼吸機能検査

%VC：軽度の肺気腫においては時に正常より増えていることがあるが、進行した肺気腫においては低下する。(093E019)
%DLCO：肺胞領域の破壊により拡散能低下

胸部単純X線写真：

肺肝境界の下降、肺の過膨張、
気管短縮(輪状軟骨上縁から胸骨上炎までが4-5cm未満に短縮していることがある、らしい)(出典不明、機序不明)

胸部CT

診断

スパイロメータの結果による

呼吸器学会ガイドライン

1. 気管支拡張薬投与後のスパイロ検査で、FEV1/FVC<70%
2. 他の気流制限を来しうる疾患を除外する

気管支拡張薬投与方法

検査は原則として急性呼吸器感染症のない臨床安定期に行う
短時間作用型気管支拡張薬は少なくとも 6 時間、長時間作用型気管支拡張薬は 24 時間中止したうえで検査を行う
検査に用いる気管支拡張薬は、通常、短時間作用型吸入用 β2刺激薬を原則とするが、抗コリン薬あるいは両者の併用であってもよい
投与方法はスペーサーを用いた β2刺激薬定量噴霧式吸入薬(MDI)吸入、ネブライザー吸入のいずれであってもよい
気管支拡張薬吸入後の検査は吸入後 30～60 分後に行うべきものとする．
気管支拡張薬吸入効果の評価は、吸入前の FEV1．0 と吸入後 FEV1．0 を比較して、200ml 以上の増加かつ前値に対して 12%以上の増加があったときに有意と判定

鑑別診断

喘息、びまん性汎細気管支炎、先天性副鼻腔気管支症候群、閉塞性細気管支炎、気管支拡張症、肺結核、塵肺症、リンパ脈管筋腫症、うっ血性心不全、間質性肺疾患、肺癌

評価法

mMRC(the Modified British Medical Research Council):日常生活に対する呼吸困難（息切れ）の影響を測定
CAT(COPD assessment test)：COPDの症状やQOLに関する8項目を0〜40点で評価
IPAG(International Primary Care Airways Group)：COPD 関連症状と危険因子を測定

BODE指数：予後評価
ADO指数：予後評価

治療

病期分類

ガイドライン1

0期：リスク群：慢性症状(咳嗽・喀痰)：(a) 禁煙、インフルエンザワクチン接種(肺炎球菌ワクチンはガイドライン上では推奨されていないが(COPD増悪予防に対する効果が証明されなかった？)、接種した方がよいとする意見がある)
I期：軽症：80%≦%FEV1：(a)。(b) 必要に応じ短時間作用型の気管支拡張薬を使用。
II期：中等症：50%≦%FEV1＜80%：(a)。(b)。(c) 呼吸リハビリテーション、長時間作用型気管支拡張薬の定期的使用
III期：重症：30%≦%FEV1＜50%：(a)。(b)。(c)。(d) 吸入ステロイド薬の考慮(増悪を繰り返す)
IV期：最重症：%FEV1＜30%または%FEV1＜50%かつ慢性呼吸不全あるいは右心不全合併：(a)。(b)。(c)。(d)。(e) 長期酸素療法、外科的治療の考慮

安定期の治療

治療のmodality：薬物療法、包括的呼吸リハビリテーション、患者教育、栄養管理、酸素療法、換気補助療法、肺容量減量手術、肺移植、在宅管理

急性増悪

COPDの急性増悪や重症度の分類には定説はない (ガイドライン1)
COPDの急性増悪とは「病態が日内変動を超えて悪化し、日常施行していた治療内容を変更せざるを得ない状態」(呼吸器疾患最新の治療2004-2006 p.267)
原因：気道感染と大気汚染が最多。1/3は原因不明。

COPDの急性増悪

定義

COPDの自然の進行の中で起きる現象で、呼吸困難、咳嗽、喀痰といった症状が日常の変動を超えて増悪したもの

入院適応

突然の安静時呼吸器困難の出現など、症状の顕著な増悪
基盤にあるCOPDが重症(III度,IV度)
新たな身体所見の発言
増悪に対する初期治療に反応しない
重大な合併症の存在
頻回の増悪
新たに発生した不整脈
診断が不確実な例
高齢者
不十分な住宅サポート

modality (ガイドライン1)

気管支拡張薬吸入の容量/回数の増加(例えば、短期間作用型β2刺激薬が用いられる)
ステロイドの全身投与(経口/静脈注射)：増悪からの回復、肺機能の回復までの時間を短縮する
(喀痰から感染症が疑われる場合)抗菌薬の投与

外来　：経口ペニシリン系薬、ニューキノロン系薬
入院例：注射用β-ラクタム系薬/β-ラクタマーゼ阻害薬、第3,4世代セフェム系薬、カルバペネム系薬、ニューキノロン系薬

病原体

三大病原体の一つがMoraxella catarrhalis

予後

参考

1. [charged] Chronic obstructive pulmonary disease: Risk factors and risk reduction - uptodate [1]

ガイドライン

1. COPD診断と治療のためのガイドライン第2版

http://www.jrs.or.jp/quicklink/glsm/guideline/nopass_pdf/copd_summary.pdf

国試

104I036、102A051

「脈拍」

　　[★]

英: pulse
同: 脈
関: 脈拍数

see. IMD.42,44-45

大きさ

脈拍の大きさ：収縮期と拡張期の間の動脈壁の動きの幅　→　脈圧を反映

1. 大脈(large pulse)

大動脈弁閉鎖不全症、甲状腺機能亢進症、高熱

2. 小脈(small pulse)

大動脈弁狭窄症

速さ

動脈壁が上下に動く速さ　→　血圧の上昇、下降の急峻さを反映
速脈---大脈で、遅脈---小脈

1. 速脈(rapid pulse)

大動脈弁閉鎖不全症、甲状腺機能亢進症、貧血、発熱
動脈管開存症　←　駆出された血液が動脈管を通って肺動脈に流れるため？

2. 遅脈(slow pulse)

大動脈弁狭窄症。動脈硬化症？(QB.C-353)

その他

1. 二峰性脈(double apical pulse)

最初に急峻な峰があり、続いて緩徐な峰を生じる。
左室流出路狭窄を伴う肥大型心筋症(HCM)　→　HOCM
IHSS、AR(QB.C-351)

2. 交互脈(alternating pulse)

脈拍の大きさが交互に変化する
心筋梗塞や心筋炎など心筋障害があるときにみられる。
心拍出量が一定しない重症心不全の徴候

3. 奇脈(paradoxical pulse)

吸気時に脈拍が小さくなる。
吸気時に左室の拡張が制限される病態で生じうる。
心タンポナーデ、気道閉塞、上大静脈閉塞
COLD 重症気管支喘息発作でも起こりうる QB.C-351

呼吸による変化

(吸気時)拍出量が減る　→　駆出時間短縮　→　脈拍の間隔短縮　→　脈拍↑

(II音のページより)吸気時には、肺静脈が拡張　→　左房・左室への血液還流量が減少　→　左室を充満する血液量減少　→　一回拍出量減少　→　駆出時間の短縮　→　A弁の開放時間が短縮

糖尿病により呼吸性変化がなくなるらしい。

成長と脈拍(SPE.50)

	脈拍数
新生児	120
乳児	120
幼児	90
学童	80
中高生	70

「cold」

　　[★]

adj.

寒い、冷たい、寒気がする。冷やした、冷えた(opp.hot)。加熱せずに処理する
冷たくなった、死んでいる
冷静な。冷淡な。よそよそしい。(やっと抑えている)激しい(怒り)。不感症の。気を滅入らせる、寒々とした
興ざましの、つまらない。気乗りのしない。(味が)弱い
客観的な(事実)

「CO」

　　[★]

[1] A cold body is often described as having less heat, although this use of "heat" would be incorrect in the context of physics, as heat refers to the transfer of energy between bodies, which do not "have" heat themselves.

[2] Portal "Argonaut": Sygnały ręczne

[3] Scuba Diving – Hand Signals – strona w języku angielskim

[4] Diving Hand Signals (Additional signals) – strona w języku angielskim

[5] "Boomerang Nebula boasts the coolest spot in the Universe". NASA's Jet Propulsion Laboratory. June 20, 1997. Retrieved July 8, 2009.

[space20090707-6] Staff (July 7, 2009). "Coldest Known Object in Space Is Very Unnatural". Space.com. Retrieved July 3, 2013.

[7] Hinshaw, Gary (December 15, 2005). "Tests of the Big Bang: The CMB". NASA WMAP. Retrieved 2007-01-09.

[8] Uranus Fact Sheet

[9] Saturn Fact Sheet

[10] ttp://www.nasa.gov/worldbook/mercury_worldbook.html^{[dead link]}

[11] Jupiter Fact Sheet

[12] Mars Fact Sheet

[13] Melting Ice in Antarctica : Image of the Day

[14] Bignell, Paul (2007-01-21). "Polar explorers reach coldest place on Earth". The Independent (London). Retrieved 2010-04-30.

[15] Budretsky, A.B. (1984). "New absolute minimum of air temperature". Bulletin of the Soviet Antarctic Expedition (in Russian) (Leningrad: Gidrometeoizdat) (105).

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