WordNet

place signs, as along a road; "sign an intersection"; "This road has been signed"
(medicine) any objective evidence of the presence of a disorder or disease; "there were no signs of asphyxiation"
a perceptible indication of something not immediately apparent (as a visible clue that something has happened); "he showed signs of strain"; "they welcomed the signs of spring" (同)mark
a character indicating a relation between quantities; "dont forget the minus sign"
a fundamental linguistic unit linking a signifier to that which is signified; "The bond between the signifier and the signified is arbitrary"--de Saussure
a gesture that is part of a sign language
a public display of a message; "he posted signs in all the shop windows"
engage by written agreement; "They signed two new pitchers for the next season" (同)contract, sign on, sign_up
approve and express assent, responsibility, or obligation; "All parties ratified the peace treaty"; "Have you signed your contract yet?" (同)ratify
communicate silently and non-verbally by signals or signs; "He signed his disapproval with a dismissive hand gesture"; "The diner signaled the waiters to bring the menu" (同)signal, signalize, signalise
mark with ones signature; write ones name (on); "She signed the letter and sent it off"; "Please sign here" (同)subscribe
be engaged by a written agreement; "He signed to play the casino on Dec. 18"; "The soprano signed to sing the new opera"
communicate in sign language; "I dont know how to sign, so I could not communicate with my deaf cousin"
form into a hill
a local and well-defined elevation of the land; "they loved to roam the hills of West Virginia"
risque English comedian (1925-1992) (同)Benny Hill, Alfred Hawthorne
United States railroad tycoon (1838-1916) (同)J. J. Hill, James Jerome Hill
having a handwritten signature; "a signed letter"

PrepTutorEJDIC

(ある事実・状態・感情などの)『表れ』,印,気配,徴侯(indication);(…の)こん跡,計跡《+『of』+『名』》・『身ぶり』,手まね,合図 / 『標識』,看板 / (数学・音楽などの)記号 / (…の)『象徴』,シンボル(symbol)《+『of』+『名』》・《文》(…の)『前兆』,きざし《+『of』+『名』》・宮(きゅう)(黄道12区分の一つ) ・〈手紙・書類・作品など〉‘に'『署名する』・(…に)〈名前など〉‘を'書く《+『名』+『on』(『to』)+『名』》 / …‘を'雇う契約に署名する・…‘を'合図する,知らせる;…に合図する・署名する・契約書に署名して雇われる
『丘』,小山 / (特に道路の)傾斜,坂 / 盛り上げた土砂,塚
=ti

UpToDate Contents

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1. 成人における慢性大動脈弁閉鎖不全症の臨床症状および診断 clinical manifestations and diagnosis of chronic aortic regurgitation in adults
2. 小児における大動脈弁閉鎖不全 aortic regurgitation in children

English Journal

Severe traumatic pneumocephalus in association with epistaxis: the "twin peaks" sign.

Demetriades AK, Bhangoo RS, Bassi S.SourceDepartment of Neurosurgery, King's College Hospital, Denmark Hill, London, SE5 9RS, UK, andreas.demetriades@gmail.com.
Acta neurochirurgica.2011 May;153(5):1151-2. Epub 2011 Feb 18.
PMID 21331477

Laparoscopic Versus Open Left Pancreatectomy: Can Preoperative Factors Indicate the Safer Technique?

Cho CS, Kooby DA, Schmidt CM, Nakeeb A, Bentrem DJ, Merchant NB, Parikh AA, Martin RC 2nd, Scoggins CR, Ahmad SA, Kim HJ, Hamilton N, Hawkins WG, Weber SM.Source*Central Pancreas Consortium †Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI ‡William S. Middleton Memorial VA Hospital, Madison, WI §Department of Surgery, Emory University School of Medicine, Atlanta, GA ¶Department of Surgery, Indiana University School of Medicine, Indianapolis, IN #Department of Surgery, Jesse Brown Veterans Affairs Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL **Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN ††Department of Surgery, University of Louisville School of Medicine, Louisville, KY ‡‡Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH §§Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC ¶¶Department of Surgery, Washington University School of Medicine, St. Louis, MO.
Annals of surgery.2011 May;253(5):975-980.
PMID 21394014

Japanese Journal

全身関節弛緩性を伴った外傷性肩関節前方不安定症に対する鏡視下手術

舟崎裕記,吉田衛,菅巖,加藤壮紀,笠間憲太郎,丸毛啓史
肩関節 35(2), 357-360, 2011
… All patients had a shallow Hill-Sachs lesion. … The range of motion after surgery was satisfactory in most cases, in which an early recovery was obtained, though the apprehension sign remained positive at even one year after surgery, especially in athletes. …
NAID 130001413703

四神相応と植物 : 『営造宅経』と『作庭記』を中心として

水野杏紀
人間社会学研究集録 3, 161-200, 2007-00-00
… Shishin-Souou is a landscape configuration of a stream to the east (Qing Long), a large road to the west (Bai Hu), a pond to the south (Zue Que), and a hill to the north (Xuan Wu). … In Japan, a location that had these four features was regarded as a sign of good fortune. …
NAID 110007029716

水系の発達からみた線状凹地と崩壊・地すべりとの関係

檜垣大助
季刊地理学 = Quarterly journal of geography 48(1), 33-41, 1996-03-15
… Linear depressions are the graben-like landform on the crest slopes with multiple ridges or up-hill facing scarps. … Because groundwater infiltration is the main cause of landslides, linear depresions are considered to be a sign of landslide occurrences on the flank slopes. …
NAID 10002695247

「大動脈弁閉鎖不全症」

　　[★]

日本では、英語表記ではaortic regurgitation AR、日本語表記では「大動脈弁閉鎖不全症」とするのが一般的？
同: 大動脈弁閉鎖不全症大動脈弁閉鎖不全 aortic valve insufficiency, AI
同: 大動脈弁逆流症大動脈弁逆流 aortic regurgitation AR, aortic valve regurgitation
関: 弁膜症

[show details]

ja

大動脈弁閉鎖不全症 : 約 28,700 件
大動脈弁閉鎖不全 : 約 41,400 件
大動脈弁逆流症 : 約 18,300 件
大動脈弁逆流 : 約 6,780 件

aortic valve insufficiency : 56 件
aortic insufficiency : 約 643 件
aortic valve regurgitation : 約 419 件
aortic regurgitation : 約 1,830 件

en

aortic valve insufficiency : 約 125,000 件
aortic insufficiency : 約 89,400 件
aortic valve regurgitation : 約 125,000 件
aortic regurgitation : 約 183,000 件

概念

大動脈弁の閉鎖不全により、拡張期に大動脈の血液が左心室に逆流する病態。
左室の容量負荷が特徴

身体所見

聴診

心音：S1↑, S2？, S3？,S4？

参考6

S1：soft
S2：variable
A2：soft～absent
P2：normal
S3：左心機能が落ちれば聴取される

心雑音

拡張期逆流性雑音 = 拡張期灌水様雑音 = blowing murmur in early diastole along the left sternal border

最強点：3LSB。

持続時間：軽症・急性型では持続時間は短い。

音量は一定かだんだん小さくなる(decrescendo)

重症度と音量は相関しないが、雑音の持続時間は参考になる。軽症では拡張期の初期にのみ吹くような(blowing)音が聴取される。重症になるにつれだんだん伸びていき、しまいには拡張期全体に聴取されるようになり、音は粗な音である(rougher)。

(参考6) :::持続時間は重症度を反映しないが、軽度ARでは持続時間は短い(なぜ?)。また急性ARでも短いが、これは拡張期にすぐに大動脈と左心室の圧が均衡するからである(圧較差が小さいということか？)。(up2date)

Austin Flint murmur：拡張期中期に低音を心尖で聴取。拡張期に大動脈弁から逆流してくる血液の乱流により、僧帽弁前尖が下方に押し下げられMS様の雑音を生じる。Austin Flint雑音はMSと違ってopening snapがなく、収縮期前期の雑音の増強がない。(PHD.214)

特徴的な身体所見 PHD.215

二峰性脈	bisferiens pulse	頚動脈や腕頭動脈で収縮期に二峰性の脈を感じる
コリガン脈	Corrigan pulse	著しく膨張し虚脱する脈
ミュッセ徴候	de Musset sign	収縮期に頭が上下に動く
デュロジェ雑音	Duroziez sign	大腿動脈を軽く押さえると往復雑音が聴取される
ヒル徴候	Hill sign	収縮期の膝窩動脈圧が上腕動脈圧よりも60mmHg高い
ミュラー徴候	Muller sign	uvulaの収縮期のは駆動
クインケ徴候	Quincke sign	口唇や近位爪床で毛細血管の拍動が見える
トラウベ徴候	Traube sign	Pistol-shot音が大腿動脈で聴取される

末梢の症状にトラウベ徴候、デュロジェ雑音、コリガン脈(water hammer pulse)があるが、これらは慢性ARでは特徴的だが、急性ARではほとんど見られない。急性ARではstroke volume and diastolic filling volumeが増えないためである(uptodate)