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"
a legal document signed and sealed and delivered to effect a transfer of property and to show the legal right to possess it; "he signed the deed"; "he kept the title to his car in the glove compartment" (同)deed of conveyance, title
go `ding dong, like a bell (同)dong, dingdong
a ringing sound
French poet and writer (1810-1857) (同)Alfred de Musset, Louis Charles Alfred de Musset

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
『行為』,行動 / (正式の)捺印証書,権利書 / …'を'証書を作製して譲渡する
〈鐘など〉‘を'ガンガン鳴らす / 〈鐘などが〉ガンガン鳴る / (鐘の)ガンガン鳴る音
(おもに人称代名詞・固有名詞(人名),thereの後で)had, wouldの短縮形 / (疑問文でwhere,what,whenの後で)didの短縮形;Where'd he go?=Where did he go?

UpToDate Contents

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1. 亜急性または慢性の手首の疼痛を有する成人の評価 evaluation of the adult with subacute or chronic wrist pain
2. ドケルバン腱鞘炎 de quervains tenosynovitis
3. 成人における限局性強皮症の病因、臨床症状、および診断 pathogenesis clinical manifestations and diagnosis of morphea localized scleroderma in adults
4. 急性の手首の疼痛を有する成人患者の評価 evaluation of the adult with acute wrist pain
5. I群抗不整脈薬の主な副作用 major side effects of class i antiarrhythmic drugs

English Journal

Stamps in cardiology: de Musset sign.

Davies MK, Hollman A.PMID: 10455070 [PubMed - indexed for MEDLINE] PMCID: PMC1729193 Free PMC ArticleImages from this publication.See all images (1) Free text
Heart (British Cardiac Society).Heart.1999 Sep;82(3):262.
PMID 10455070

Quincke, de Musset, Duroziez, and Hill: some aortic regurgitations.

Sapira JD.AbstractFour peripheral signs of aortic insufficiency are considered in terms of their original descriptions, their popularity, and their potential future clinical contribution. It is concluded that: (1) Quincke's capillary pulse sign is not useful. (2) de Musset's head bobbing sign is of undetermined but apparently low sensitivity and specificity. (3) Duroziez's femoral double intermittent murmur sign, as modified by Blumgart and Ernstene, is almost 100% specific for the diagnosis of aortic insufficiency. Since its sensitivity, when properly performed, is about 90%, especially in pure aortic insufficiency, it is highly recommended. (4) Hill's sign (a popliteal indirect systolic blood pressure which is 20 mm Hg greater than a simultaneously measured brachial indirect systolic blood pressure) though almost unknown, is useful in diagnosing all but the mild cases of aortic insufficiency, and is the only sign that may predict the degree of aortic insufficiency subsequently found angiographically.
Southern medical journal.South Med J.1981 Apr;74(4):459-67.
Four peripheral signs of aortic insufficiency are considered in terms of their original descriptions, their popularity, and their potential future clinical contribution. It is concluded that: (1) Quincke's capillary pulse sign is not useful. (2) de Musset's head bobbing sign is of undetermined but a
PMID 7013091

「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)