皮膚科

線状IgA水疱症 linear IgA bullous dermatosis

循環器

免疫学

白血球粘着不全症 leukocyte adhesion deficiency

WordNet

the 12th letter of the Roman alphabet (同)l

PrepTutorEJDIC

lira(イタリアの貨幣単位リラ)
若者,少年(boy) / 《話》《おもにイギリス北部で,親愛を表す呼び掛けに用いて》男,やつ

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2018/05/13 00:34:59」(JST)

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1. 白血球粘着不全症 leukocyte adhesion deficiency
2. 心筋梗塞後の冠動脈の開存および転帰 coronary artery patency and outcome after myocardial infarction
3. 心筋虚血および心筋梗塞の診断における心電図 electrocardiogram in the diagnosis of myocardial ischemia and infarction
4. 重大な冠動脈左前下行枝近位部病変のマネージメント management of significant proximal left anterior descending coronary artery disease
5. 低侵襲冠動脈バイパス術：定義および技術的な問題 minimally invasive coronary artery bypass graft surgery definitions and technical issues

English Journal

Multidisciplinary management in Merkel cell carcinoma.

Matkowski R, Lata E, Zietek M, Halon A, Forgacz J, Szynglarewicz B.Author information Department of Oncology, Division of Oncological Surgery, Wroclaw Medical University , Plac Hirszfelda 12, Wroclaw , Poland.AbstractHerein, the authors describe the experience with the treatment of Merkel cell carcinoma (MCC) and review the literature regarding MCC treatment regimens. Nine patients underwent treatment due to stage I, II, or III MCC. The median follow up was 39 months. In five cases, tumors were excised with skin margins of >2 cm, and skin margins were <2 cm in four patients. Local adjuvant radiotherapy (RT) was given to four patients, while three patients underwent local lymphadenectomy (LAD). Local recurrence occurred in four patients who did not undergo RT (among them three patients had excision margins <2 cm) after a mean time of 9 months. Despite retreatment, two of those patients developed metastases. Recurrence-free survival after primary therapy was achieved: (a) in three patients with stage I and II MCC treated surgically with excision margins <2 cm combined with RT or wide excision >2 cm alone and (b) in two patients with stage III MCC treated with wide excision and LAD combined with local and regional RT. A review of the literature supports the following recommendations: (a) excision with adequate margins combined with RT; (b) LAD with regional RT in cases of lymph node involvement; and (c) sentinel lymph node biopsy in patients without clinically suspicious lymph nodes.
The Journal of dermatological treatment.J Dermatolog Treat.2014 Oct;25(5):409-14. doi: 10.3109/09546634.2012.756969. Epub 2013 Aug 13.
Herein, the authors describe the experience with the treatment of Merkel cell carcinoma (MCC) and review the literature regarding MCC treatment regimens. Nine patients underwent treatment due to stage I, II, or III MCC. The median follow up was 39 months. In five cases, tumors were excised with skin
PMID 23216365

Prenatal diagnosis of leukocyte adhesion deficiency type-1 (five cases from iran with two new mutations).

Esmaeili B, Ghadami M, Fazlollahi MR, Niroomanesh S, Atarod L, Chavoshzadeh Z, Moradi Z, Alizadeh Z, Pourpak Z.Author information Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran. esmaeili.behnaz@yahoo.com.AbstractLeukocyte adhesion deficiency type-1(LAD-1) is one of the immunodeficiency autosomal recessive diseases that results from mutation in integrin, beta 2 (complement component 3 receptor 3 and 4 subunit) ITGB2 gene. The aim of this study was to investigate molecular prenatal diagnosis of LAD-1.Four pregnant women with five fetuses (one pregnancy was twin) with clinical and laboratory diagnosis of LAD-1 in their previous children were studied. The chorionic villus sampling (CVS) was obtained when mothers were in 10-12th weeks of gestation.Mutation analysis of ITGB2 gene for affected children revealed 3 misssense mutations (c.382G>A, a novel mutation, c.2146G>C, and c.715G>A) and one splice site novel mutation (c.1877+2G>A). All of Parents were heterozygous for these mutations. Consideration of affected gene regions for five CVS samples showed two homozygotes and one heterozygote for mutant allele and two homozygotes for normal allele. Interestingly, one of the twin fetuses was affected and another was normal. Briefly, two cases of CVS samples were affected and three cases of remained CVS samples were unaffected.This is the first report of prenatal diagnosis of LAD-1 from Iran with two new mutations that can be used for genetic and prenatal diagnosis for all patients suspected to LAD1 and can be helpful to prevent the birth of affected children with LAD-1. This abstract presented in the second international congress of Immunology, Asthma and Allergy, Tehran, Iran 2013.
Iranian journal of allergy, asthma, and immunology.Iran J Allergy Asthma Immunol.2014 Feb;13(1):61-5.
Leukocyte adhesion deficiency type-1(LAD-1) is one of the immunodeficiency autosomal recessive diseases that results from mutation in integrin, beta 2 (complement component 3 receptor 3 and 4 subunit) ITGB2 gene. The aim of this study was to investigate molecular prenatal diagnosis of LAD-1.Four pre
PMID 24338230

Salvianolic acid A promotes the acceleration of neovascularization in the ischemic rat myocardium and the functions of endothelial progenitor cells.

Li YJ1, Duan CL2, Liu JX3.Author information 1Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing 100700, China. Electronic address: lyjdcl@163.com.2Research and Development Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China.3Research and Development Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China. Electronic address: liujx0324@sina.com.AbstractETHNOPHARMACOLOGICAL RELEVANCE: Salvia miltiorrhiza (SM, also known as DanShen) is one of the well-known widely used Chinese herbal medicines in clinical, containing phenolic compounds and potent antioxidant properties. Salvianolic acid A (SAA) is the most potent component of SM. A modern experimental strategy for treating myocardial ischemia is to induce neovascularization of the heart by the use of "angiogens", mediators that induce the formation of blood vessels, or angiogenesis. Studies demonstrated that coronary collateral vessels protect ischemic myocardium after coronary obstruction; therefore, we sought to examine whether SAA could stimulate myocardial angiogenesis.
Journal of ethnopharmacology.J Ethnopharmacol.2014 Jan 10;151(1):218-27. doi: 10.1016/j.jep.2013.10.019. Epub 2013 Nov 1.
ETHNOPHARMACOLOGICAL RELEVANCE: Salvia miltiorrhiza (SM, also known as DanShen) is one of the well-known widely used Chinese herbal medicines in clinical, containing phenolic compounds and potent antioxidant properties. Salvianolic acid A (SAA) is the most potent component of SM. A modern experiment
PMID 24189032

Japanese Journal

Measurement of M-mode echocardiographic parameters in healthy adult Van cats

Kayar Abdullah,Ozkan Cumali,Iskefli Onur,Kaya Abdullah,Kozat Suleyman,Akgul Yakup,Gonul Remzi,Or Mehmet Erman
Japanese Journal of Veterinary Research 62(1), 5-15, 2014-05
… There was a significant relationship between gender and left atrial dimension during ventricular systole (LAD) and aortic root dimension at end-diastole (AOD) as well as between BW and interventricular septal thickness at end-diastole (IVSd) and end-systole (IVSs), left ventricular internal dimension at end-diastole (LVIDd), left ventricular posterior wall thickness at end-diastole (LVPWd), LAD, AOD, the left ventricular end diastolic volume (EDV) and the stroke volume (SV). …
NAID 120005438295

循環器内科における睡眠障害とうつ病に関する観察研究(睡眠医学が心身医学に寄与できること,2013年,第54回日本心身医学会総会ならびに学術講演会(横浜))

小鳥居望,石田重信,橋爪祐二,小城公宏,森裕之,川口満希,弥吉江理奈,福本義弘,杉雄介,室谷健太,内村直尚,伊藤弘人
心身医学 54(3), 230-241, 2014-03-01
本研究では循環器疾患患者の気分状態,睡眠時無呼吸症候群(SAS)を含む睡眠障害,眠気,QOL,心機能などを多角的に評価した.今回,中等度以上のうつ症状を認めたのは5.7%と少数であったが,うつ症状の程度は不眠やQOLとともに右心系への後負荷とも関連性が認められた.一方,中等症以上(AHI≧15)のSASの罹患予測率は58.5%と高率で,その重症度は気分状態や眠気などと関連性がなく無症候性であったが …
NAID 110009806435

メタルステントを留置後，亜急性ステント血栓症を認めた1 例

玉置哲也,猪野靖,久保隆史,谷本貴志,山口智由,田中篤,今西敏雄,赤阪隆史
Journal of the Japanese Coronary Association, 2014
… 歳男性．急性前壁心筋梗塞にて緊急冠動脈造影を施行し，左冠動脈前下行枝（LAD）＃ 6 および回旋枝（LCX）＃ 11 の完全閉塞を認めた．大動脈内バルーンパンピング補助下に責任病変のLAD に対しeverolimus-eluting stent（ EES）3.5×15 mm を留置し，引き続き血栓像を認めたLCX に対してもbare metal stent（BMS）4.0×23 mm を留置し再灌流に成功した．術後2 剤による抗血小板療法を開始し，経過良好であった …
NAID 130004698227

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★リンクテーブル★

リンク元	「白血球」「冠状動脈」「白血球粘着不全症」「白血球接着不全症」「前下行枝」
拡張検索	「ALAD」「LADH」
関連記事	「L」「LA」

「白血球」

　　[★]

英: leukocyte, leucocyte (Z), white blood cell (Z), WBC, white corpuscle, white cell
関: 赤血球、血球、血液

白血球

顆粒球

基準値

4000-9000 (/μl)　(2007前期解剖学授業プリント)

異常値の出るメカニズム第5版

5000- 8400 (/μl) (健常者の2/3)
4500-11000 (/μl) (95%範囲)

年齢との関連

新生児期>幼児期>成人期(20歳までに成人値)
妊婦でも増加(妊娠#妊娠による変化)

生理的な変動

精神的ストレス↑　　→　交感神経の刺激により好中球の血管壁遊離が促進されるため
午前↓、午後↑

基準値

			07解	異メ	流マ		HIM.A-1
顆粒球	好中球	桿状核球	40～70	44～66	40～60	4～14	0～5
		分葉核球				43～59	40～70
	好酸球		2～4	0～ 4	2～4		0～6
	好塩基球		0～2	0～0.5	0～2		0～2
無顆粒球	リンパ球		25～40	30～38	26～40		20～50
	単球		3～6	0～ 5	3～6		4～8

07解: 2007前期解剖学授業プリント
異メ: 異常値の出るメカニズム第5版 p.91
流マ: 流れが分かる実践検査マニュアル上巻 p.10

血管外滲出 extravasation (SMB.37 BPT.37)

(margination)

1. 赤血球は軽く早く流れるので血管の中央をながれ、白血球は血管のへりを流れている

(rolling)

2. IL-1, TNFで血管内皮細胞が活性化し、血管内腔にE-selectinを発現する
3. P-selectinはヒスタミンやトロンビンの働きにより、血管内腔に発現する
4. 白血球と血管内皮細胞の接着分子で接着することで、白血球がrollingを始める
3. 次第にselectinによる接着はdown regulateされる

(adheresion & arrested)

4. 炎症部位から出されたケモカインが血管内皮細胞の表面ののペプチドグリカンに結合し、白血球に提示される
5. 白血球表面のインテグリンが活性化し、血管内皮細胞のICAM-1, VCAM-1と強く結合する

(transmigration)

6. 白血球と血管内皮細胞に発現しているPECAM-1(CD31)がお互い接着し、白血球が血管内皮細胞の間隙を通って細胞外マトリックスに入る

血管内皮細胞		白血球
Rolling
E-selectin	－	糖鎖(SLe^x)
P-selectin	－	糖鎖
糖鎖(GlyCAM-1)(=CD34)	－	L-selectin
Adhestion
ICAM-1	－	LFA-1 integlin(CD11a/CD18), Mac-1 integlin(CD11b/CD18)
VCAM-1	－	VLA-1 integlin
transmigration
PECAM-1(CD31)	－	PECAM-1(CD31)

白血球の染色

ギムザ染色

好酸性：赤く染まる→ヘモグロビン
好塩基性：青く染まる→リボソーム、核内のヒストン蛋白
好酸性でも好塩基性でもない：淡いピンクに染まる

MPO myeloperoxidase反応（染色）

MPOをもつ：顆粒球（前骨髄球～分葉核球）、単球（前単球～単球）
MPOをもたない：リンパ球系細胞

エステラーゼ esterase

好中球：長鎖エステルを分解
単球：短鎖エステルを分解

関節液

　　炎症感染
200 2000 20000
500 5000 50000

臨床関連

LAD(leukocyte adhesion deficiency)症候群 (SMB.37)

白血球のインテグリンが欠損または減少する先天性疾患

反復性の細菌皮膚感染

SIRSの診断基準：＜4,000/ul or ＞12,000/ul

「冠状動脈」

　　[★]

英: coronary artery (M)
ラ: arteria coronaria
同: 冠動脈
関: 心臓

図：N.212

枝の命名法：http://www.m-junkanki.com/case_study/lecture7/CAGnameRCA.html。http://www.sakai-iin.com/image/CAG.pdf

右冠状動脈

1 proximal
2 middle
3 distal
4

4AV AV node artery 房室結節枝
4PD PD descending artery 後下行枝

左冠状動脈

5 left main trunk LMT 左主幹部
6 proximal 前下行枝の第一中隔枝(first major septal branch)まで
7 middle septal branch
8 dista
9 first diagonal branch D1 第1対角枝
10 second diagonal branch D2 第2対角枝
11 proximal 回旋枝から鈍縁枝まで
12 obtuse maginal branch OM 鈍縁枝
13 distal 鈍縁枝以遠で後房室間溝を走行するもの
14 posterolateral PL 側壁枝
15 posterior descending artery PD

枝

右冠状動脈

洞房結節枝
右縁枝
後下行枝 = 後室間枝
房室結節枝

左冠状動脈

左前下行枝

対角枝

回旋枝

左縁枝

冠動脈の血流 (SPC.227)

冠動脈血からの酸素除去能は高い→酸素需要を上げるためには冠動脈血流量を増やすことによって達成可能
冠動脈血流量∝拡張期大動脈圧&拡張期の時間
冠動脈血流量∝(冠血管抵抗)^-1

PHD.102

Localization of Myocardial Infarction
Anatomic Site	Lead with Abnormal ECG Complexes	Coronary Artery Most Often Responsible
inferior	II, III, aVF	RCA
anteroseptal	V1-V2	LAD
anteroapical	V3-V4	LAD(distal)
anterolateral	V5-V6, I, aVL	CFX
posterior	V1-V2(tall R wave, not Q wave)	RCA

PHD.191

Blood Supply of the Conduction System
Conduction Pathway		Primary Arterial Supply
SA node		RCA (70%)
AV node		RCA (85%)
Bundle of His		LAD
RBB	Proximal portion	LAD
	Distal portion	RCA
LBB	Left anterior fascicle	LAD
	Left posterior fascicle	LAD
		PDA