WordNet

a disease of poultry
a minor nonspecific ailment
a small hard seed found in some fruits
the 16th letter of the Roman alphabet (同)p

PrepTutorEJDIC

(りんご・なしなどの)種
《the~》飼鳥の舌の伝染病・《英話》意気消沈
(ラジオ・電話の時報,鳥の鳴き声などの)ピッ[という音]・ピッという電子音
《話》(さいころ・カード・ドミノのこまなどの)目,点 / ピップ(レーダーの映像板に光の点として現れる像) / 《英話》(英国陸軍士官の肩章につける階級を示す)星
…‘を'打ち負かす / …‘を'落第させる;‥‘に'落第する / …‘を'撃つ
parking
phosphorusの化学記号

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/08/22 19:08:10」(JST)

wiki en

[Wiki en表示]

Look up pip or PIP in Wiktionary, the free dictionary.

Common meanings

The seed of some fruits, such as the orange
Pip (counting), a small but easily countable item, such as the dots on dice or symbols on playing cards
A decoration worn on a military uniform to denote rank, such as on British Army officer rank insignia
Greenwich Time Signal, popularly known as the pips

People

Pip (musician) Contestant on Season 2 of NBC's The_Voice_(U.S._season_2)
one half of the British television writing team Pip and Jane Baker
Phillipa "Pip" Brown (born 1979), stage name Ladyhawke (musician), New Zealand singer, songwriter and musician
Pip Carter, British actor
Pip Karmel (born 1963), Australian film director, editor and screenwriter
Pip Proud (1947–2010), Australian singer-songwriter, poet, novelist and dramatist
Pip Pyle (1950-2006), English-born drummer
Pip Rippon (1888-1950), English footballer
Pip Simmonds, New Zealand freestyle skier
Philippa Tattersall (born 1975), only woman to pass the All Arms Commando Course to join the British Royal Marines
Pip Williams (born 1947), British musician and record producer
Wally Pipp (1893-1965), Major League Baseball first baseman best known for being replaced by Lou Gehrig
Pip, nickname of British Army Major General George Philip Bradley Roberts (1906-1997)
Pip, nickname of British Army Brigadier General Philip Hugh Whitby Hicks (1895-1967)
Pips, nickname of German fighter ace Josef Priller (1915-1961)
The backup singers in the musical group Gladys Knight & the Pips
Scroobius Pip, alias of rapper David Meads

Fictional characters

Pip (Philip Pirrip), from Charles Dickens' novel Great Expectations
Pip, in Herman Melville's novel Moby-Dick
Peregrin Took, in J. R. R. Tolkien's fantasy The Lord of the Rings
Pip, in numerous science fiction novels by Alan Dean Foster
Pip, part of a diesel engine in The Railway Series of books
Pip, in the British newspaper strip cartoon Pip, Squeak and Wilfred
Pip (Chrono Cross)
Pip the Troll, a Marvel Comics character
Pip, in the Grailquest gamebook series
Pip Bernadotte, in the manga Hellsing
Pip Pirrup, in South Park
Pip, an Animaniacs character
Pip, in the Nickelodeon animated show Back at the Barnyard
Chiana, nicknamed "Pip", in the Australian television series Farscape
Pip, in the film Enchanted'
Pip, in the film The Halloween Tree
Pip, a persona featured on the Tori Amos album American Doll Posse
Pip Phillips, a character in The Twilight Zone episode " In Praise Of Pip"

Places

Pip Cliffs, Graham Land, Antarctica
Pipp Brook, a tributary of the River Mole in Surrey, England
Pilot Point Airport, an airport with the IATA code "PIP"

Business and finance

Percentage in point (pip), a currency exchange rate fluctuation
Performance improvement plan, a management technique
Personal injury protection, a type of car insurance
Policy Ineffectiveness Proposition, an economic theory
Personal Independence Payment, a welfare benefit proposed in 2010 and part of the Welfare Reform Bill 2011 which is to be paid to disabled people in the United Kingdom as a replacement for the Disability Living Allowance (DLA)
Poly Implant Prothèse, a French firm which made breast implants, involved in a scandal
PiP Animation Services, a Canadian animation studio

Computing

Peripheral Interchange Program, a file transfer utility under CP/M and several Digital Equipment operating systems
Point in polygon, a concept in computational geometry
Policy Information Point, a term used in eXtensible Access Control Markup Language
Private Internet Protocol
Pip (Python), a Python package installer
P.I.P.S. Is POSIX on Symbian, known as P.I.P.S.

Biology and medicine

Phosphatidylinositol 3-phosphate, also known as PI(3)P
Phosphatidylinositol 4-phosphate, also known as PI(4)P
Phosphatidylinositol 5-phosphate, also known as PI(5)P
Prolactin-induced protein
Proximal interphalangeal joints, one of two sets of interphalangeal articulations of hand
Patient intelligence panel

Science and technology

Predicted impact point, the location at which a projectile is expected to strike
Profile ignition pickup, a term in automotive technology
Proper indecomposable past set, a concept in the study of causal structures of spacetime
Pakistan Institute of Physics, a physics research institute of the University of Engineering and Technology of Pakistan

Other uses

"Pip" (South Park), an episode of South Park
Palisades Interstate Parkway
Picture-in-picture, a television feature
Police Information Point, a kiosk run by British police
Puerto Rican Independence Party, a political party
Peruvian Investigative Police, plainclothes police unit
Battle of the Pips, an incident in World War II
Punjab International Public School, a high school in Pakistan
Pakistan International Public School and College, a school and college in Pakistan
Pug Impression Pad, an object used for the census of tigers
Plastic Irrigation Pipe, a designation for plastic pipe sizes used in agricultural irrigation
Plug-in Prius, a Toyota PHEV (Plug-in Hybrid Electric Vehicle}

This disambiguation page lists articles associated with the same title.
If an internal link led you here, you may wish to change the link to point directly to the intended article.

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. 人工呼吸患者における呼吸窮迫の評価 assessment of respiratory distress in the mechanically ventilated patient
2. 機械的人工換気の概要 overview of mechanical ventilation
3. 機械的人工換気中の肺気圧障害 pulmonary barotrauma during mechanical ventilation
4. 機械的人工換気のモード modes of mechanical ventilation
5. 新生児における機械的人工換気 mechanical ventilation in neonates

English Journal

Controlling actin cytoskeletal organization and dynamics during neuronal morphogenesis.

Kessels MM, Schwintzer L, Schlobinski D, Qualmann B.SourceInstitute for Biochemistry I, University Hospital Jena - Friedrich-Schiller-University Jena, Nonnenplan 2, 07743 Jena, Germany.
European journal of cell biology.Eur J Cell Biol.2011 Nov;90(11):926-33. Epub 2010 Oct 20.
Coordinated functions of the actin cytoskeleton and microtubules, which need to be carefully controlled in time and space, are required for the drastic alterations of neuronal morphology during neuromorphogenesis and neuronal network formation. A key process in neuronal actin dynamics is filament fo
PMID 20965607

Pharmacological investigations of the cellular transduction pathways used by cholecystokinin to activate nodose neurons.

Zhao H, Kinch DC, Simasko SM.AbstractCholecystokinin (CCK) directly activates vagal afferent neurons resulting in coordinated gastrointestinal functions and satiation. In vitro, the effects of CCK on dissociated vagal afferent neurons are mediated via activation of the vanilloid family of transient receptor potential (TRPV) cation channels leading to membrane depolarization and an increase in cytosolic calcium. However, the cellular transduction pathway(s) involved in this process between CCK receptors and channel opening have not been identified. To address this question, we monitored CCK-induced cytosolic calcium responses in dissociated nodose neurons from rat in the presence or absence of reagents that interact with various intracellular signaling pathways. We found that the phospholipase C (PLC) inhibitor U-73122 significantly attenuated CCK-induced responses, whereas the inactive analog U-73433 had no effect. Responses to CCK were also cross-desensitized by a brief pretreatment with m-3M3FBS, a PLC stimulator. Together these observations strongly support the participation of PLC in the effects of CCK on vagal afferent neurons. In contrast, pharmacological antagonism of phospholipase A(2), protein kinase A, and phosphatidylinositol 3-kinase revealed that they are not critical in the CCK-induced calcium response in nodose neurons. Further investigations of the cellular pathways downstream of PLC showed that neither protein kinase C (PKC) nor generation of diacylglycerol (DAG) or release of calcium from intracellular stores participates in the response to CCK. These results suggest that alteration of membrane phosphatidylinositol 4,5-bisphosphate (PIP(2)) content by PLC activity mediates CCK-induced calcium response and that this pathway may underlie the vagally-mediated actions of CCK to induce satiation and alter gastrointestinal functions.
Autonomic neuroscience : basic & clinical.Auton Neurosci.2011 Oct 28;164(1-2):20-6. Epub 2011 Jun 12.
Cholecystokinin (CCK) directly activates vagal afferent neurons resulting in coordinated gastrointestinal functions and satiation. In vitro, the effects of CCK on dissociated vagal afferent neurons are mediated via activation of the vanilloid family of transient receptor potential (TRPV) cation chan
PMID 21664195

Japanese Journal

Investigation of the defense responses induced by the novel plant immunity-activating peptide, PIP-1(Chemical Ecology & Natural Product,Poster,1) Pest Management, Crop Protection and Vector Control)

Miyashita M.
Journal of pesticide science 36(1), 156, 2011-02-20
NAID 110008463118

PIP関節症(Bouchard結節)に対して低出力レーザー治療が有効だった1症例

金子翔拓,池本吉一
北海道作業療法 28(1), 23-27, 2011-06
NAID 40018925917

Related Pictures

Pip Chinese rose 386031 PiP Studio accessoires :: pip_birds_quilt MadeByMaly: Kaartjes, een beetje pip stijl PiP Flowers in the Mix Lichtblauw behang PiP Chinese Rose Roze behang | Traditional Eijffinger PIP studio behang Flowers in PiP Flowers in the Mix Pink wallpaper

★リンクテーブル★

リンク元	「100Cases 27」「100Cases 34」「近位指節間関節」「血漿鉄プール」
拡張検索	「PIP-TZ」「PIPC」「PIPD」
関連記事	「PI」「P」「pip」

「100Cases 27」

　　[★]

☆case27　関節痛

■症例

37歳　女性

主訴：関節痛

現病歴：数ヶ月、膝の痛みがだんだん強くなっていると感じていた。痛みは手や足の小関節に多く、朝歩くときに最もこわばる。痛みはジクロフェナクを飲むと和らぐ。そのほかの症状として疲労感を感じ、最近、体重が３ヶ月で４ｋｇ減っている。

喫煙歴：なし。

飲酒歴：機会飲酒

既往歴：なし

家族歴：既婚、子供は２人

服薬歴：ジクロフェナク

職業歴：legal sevretary

身体所見 examination

　顔貌　青白、臨床的な貧血を認める。近位指節間関節・中手指節関節　腫脹・effusionを伴う疼痛。中足趾節関節　圧痛。それ以外は正常。

検査　 investigation

　血液検査

　　Hb低下

　　ESR 上昇

　　尿素軽度上昇

　　クレアチニン軽度上昇

　　正常：白血球、MCV、血小板、ナトリウム、カリウム、グルコース、アルブミン

　尿検査

　　蛋白(-)、尿糖(-)、潜血(-)、

■問題

　本症例では診断とその根拠を考えるのは簡単なので、鑑別疾患をあげてその疾患に特徴的な症候を列挙しましょう。

■関節痛 DIF.283

　V Vascular

　　血友病 hemophilia　血友病性関節症(急性：疼痛、腫脹、熱感(SOR.241)

慢性：可動域の低下、変形、関節周囲筋萎縮(SOR.241))。家族歴

　　壊血病 scurvy　。生活環境。食事歴

　　無菌性骨壊死 aseptic bone necrosis (Osgood-Schlatter diseaseとか)

　I Inflammatory

　　感染性関節炎(細菌性関節炎(化膿性関節炎・淋菌性関節炎・結核性関節炎・嫌気性菌関節炎 )、真菌性関節炎、スピロヘータ関節炎(梅毒性関節炎・ライム関節炎)、マイコプラズマ関節炎、ウイルス性関節炎)

　N Neoplastic disorders

　　骨原性肉腫 osteogenic sarcoma

　　巨細胞腫 giant cell tumors

　D Degenerative disorders

　　degenerative joint disease

　　変形性関節症 osteoarthritis

　I Intoxication

　　痛風 gout (uric acid)

　　偽痛風 pseudogout (calcium pyrophosphate)

　　ループス症候群 lupus syndrome of hydralazine (Apresoline) and procainamide

　　gout syndrome of diuretics

　C Congenital and acquired malformations bring to mind the joint deformities of tabes dorsalis and syringomyelia and congenital dislocation of the hip. Alkaptonuria is also considered here.

　A Autoimmune indicates

　　関節リウマチ RA

　　血清病 serum sickness

　　全身性エリテマトーデス lupus erythematosus

　　リウマチ熱 rheumatic fever

　　ライター症候群 Reiter syndrome

　　潰瘍性大腸炎 ulcerative colitis

　　クローン病=限局性回腸炎 regional ileitis

　　乾癬性関節炎 psoriatic arthritis

　　リウマチ性多発筋痛症 polymyalgia rheumatica

　T Trauma

　E Endcrine

　　先端肥大症 acromegaly

　　閉経 menopause

　　糖尿病 diabetes mellitus

■関節炎の分類

・炎症部位の数

　単関節炎：痛風、偽痛風、離断性骨軟骨炎、血行性の化膿性関節炎のほとんど

　多関節炎：リウマチ性疾患、ウイルス性疾患、白血病での関節症状、易感染性宿主における血行性の化膿性関節炎

■関節リウマチ

　診断基準

　関節症状

　　朝のこわばり、疼痛、腫脹、関節の動揺、関節可動域制限、変形(手指、足趾、膝関節)。(SOR.211)

　　手指の近位指節間関節(PIP 関節)、中手指節関節(MP 関節)。遠位指節間関節(DIP 関節)に初発することは稀。(SOR.211)

　　左右対称性に生じることが多い。手関節、足趾、膝関節に初発する。(SOR.211)

　関節外症状

　　全身症状：発熱

　　皮膚症状：リウマトイド結節(肘の伸側、後頭部、手指)

　　眼症状：上胸膜炎(10日の経過で治癒)、強膜炎(予後不良)。稀に角膜穿孔

　　血液障害：(高頻度)貧血、白血球減少(Felty病。DMARDs投与中の場合は薬剤性の骨髄抑制を考慮)

　　アミロイドーシス：ネフローゼや下痢を来した症例で疑う。アミロイド蛋白はAA

　　腎障害：稀。アミロイドーシスの続発症か薬剤性を考慮。

　　呼吸器症状：間質性肺炎の合併多い。下肺野に好発。通常無症状。メトトレキセートなどの使用により薬剤性の急性間質性肺炎を生じることがある。

　　心・血管障害：リンパ管炎による難治性の浮腫。

　　神経症状：環軸関節亜脱臼により項部痛や脊髄症上が出現しうる。

　　骨粗鬆症

　　腱鞘滑膜炎：手指、手関節、足関節

■両側性多関節炎の鑑別疾患

　OA：遠位指節間関節を冒すのが特徴的で、近位指節間関節、中手指節関節を冒しうる。

　RA：

　SLE：軽度、症状の程度が変動する非びらん性の関節炎

　gout：単関節炎からはじまる。

　血清陰性関節炎：強直性脊椎炎、感染、ライター病：中～大関節に非対称性の関節炎。仙腸関節と遠位指節間関節にも関節炎

　急性ウイルス性関節炎：風疹。

■KEY POINTS

・RAでは遠位指節間関節は冒されない傾向がある。

・RAの全身症状は関節症状に先行することがある。

・RAの活動性と貧血及びESRは相関している。

・NSAIDsは腎機能に悪影響を与えることがある。

■initial plan

　Dx 1. 単純X線写真

　　　　・亜脱臼、関節周囲の骨萎縮(傍関節性骨骨粗鬆症,juxta-articular osteoporosis)、関節裂隙の狭小化、関節辺縁のびらん(bony erosion)

　　　　　・初期のRAで第5趾に骨びらんが一般的に見られる。

　　　　・血液検査

　　　　　・RF、抗DNA 抗体

　Tx 1. 鎮痛薬

　　　　・NSAIDs：鎮痛とこわばりの軽減

　　 2. DMARDs(メトトレキセート、レフルノミド、金製剤、ペニシラミン)

　　　　・NSAIDsで症状が治まらない場合に考慮

　　 3. 抗TNF 抗体

　　　　・重症のRAで効果がある場合がある。

■参考文献

SOR　標準整形外科学第10版医学書院

DIF　Differential Diagnosis in Primary Care Fourth Edition版 Lippincott Williams & Wilkins

「100Cases 34」

　　[★]

☆case34　てんかん発作

■症例

23歳　アフリカ-カリブ系　女性　銀行の店員

主訴：てんかん発作

現病歴：強直間代発作を2回起こしたところを母親が目撃していた。娘の行動は次第におかしくなり、また娘は自分のことを話している声が聞こえていた(幻聴)。最近、頭痛を訴えていた。体重が減少し、脱毛があった。盗汗と主に足と手の小関節に及ぶflitting 関節痛を訴えていた。服用薬なし。タバコ1日5-10本、アルコール10 unit/week(缶ビール(350ml)6本弱)

既往歴：特記なし(medical or psychiatric history)

家族歴：

生活歴：

・身体診断

意識：眠そうだが痛みに反応。頚部硬直：なし。頭髪：薄く斑状。体温38.5℃。リンパ節：たくさんの部位で触知。

心拍：104/分、整。血圧：164/102 mmHg。心血管系、呼吸器系、腹部：異常なし。

神経所見：focal anormalityなし(局所性異常)。乳頭浮腫：認めず。

・検査

(血液生化学)

上昇：erythrocyte sedimentation rate、urea、creatinine

低下：hemoglobin、white cell count、platelet

正常：mean corpuscular volume、sodium、potassium、glucose

(腰椎穿刺)

上昇：leukocytes、CSF protein

正常：CSF glucose

(尿検査)

蛋白：＋＋＋。血尿：＋＋＋。赤血球：＋＋。赤血球円柱：あり。

(その他)

胸部X線：異常なし。ECG：洞性頻脈。頭部 CT：正常。CSF グラム染色：陰性(光顕レベルで細菌なし)

■glossary

fall out　(毛髪などが)抜ける

night sweat 盗汗、寝汗

tonic-clonic generalized seizure 全般性強直間代発作

flit　vi (鳥・蝶など)すいすい/ひらひら飛ぶ、飛び回る、飛翔する。(人が)軽やかに通る、行き交う。(時が)(飛ぶように)すぎる。(幻想など)去来する、よぎる、(表情が)かすめる

drowsy　adj. 眠い。眠そうな。眠気を誘う。ものうい。眠ったような

stiffness　n. 堅いこと、堅ぐるしさ、がんこさ

delirium tremens 振戦譫妄

hypertensive encephalopathy 高血圧性脳症

alopecia　脱毛症

African-Caribbean アフリカ-カリブ系

fit n.　(病気の)発作。引きつけ、痙攣。(感情の)激発、一時的興奮、気まぐれ

chorea n. 舞踏病

recreational drug 耽溺性があり乱用される脱法薬物

urgent adj. (物・事が)急を要する、緊急の、背拍質(pressing)。(～を)緊急に必要とする(in)。(S is ～ (with O1) for [in] O2)(人が)(O1(人)に)O2(物・事)をしつこく求める。(人に/～するように)催促する(for/to do)。(要求などが)執拗な。

□てんかん発作

・新規発生したてんかん発作の原因(ICU.805-806)

・薬物中毒(テオフィリンなど)

・薬物からの離脱(アルコールなど)

・感染症(髄膜炎、膿瘍など)

・頭部外傷

・虚血障害(虚血あるいはびまん性)

・占拠性病変(腫瘍あるいは血腫)

・代謝性障害(肝性脳症、尿毒症性脳症、敗血症、低血糖、低ナトリウム血症、低カルシウム血症など)

・合併症(ICU.805-806)