vt.

発達/発育させる、発展させる(from, into)。(生)発生させる、進化させる
(議論・思索などを)展開する(evolve)、詳しく説く
(新しい物を)創り出す。(資源・土地を)開発する、(宅地を)造成する、(鉱山などを)開く
(潜在力・けいこうなどを)発現/顕出させる、発揮する。(新事実などを)明らかにする。
(事故・火災などを)起こす

vi.

関: buildup, deployment, development, developmental, emergence, engender, evolution, expand, exploit, exploitation, generate, generation, growth, occur, occurrence, onset, transpire, unfold

WordNet

superimpose a three-dimensional surface on a plane without stretching, in geometry
cause to grow and differentiate in ways conforming to its natural development; "The perfect climate here develops the grain"; "He developed a new kind of apple" (同)make grow
be gradually disclosed or unfolded; become manifest; "The plot developed slowly";
elaborate by the unfolding of a musical idea and by the working out of the rhythmic and harmonic changes in the theme; "develop the melody and change the key"
expand in the form of a series; "Develop the function in the following form"
grow, progress, unfold, or evolve through a process of evolution, natural growth, differentiation, or a conducive environment; "A flower developed on the branch"; "The country developed into a mighty superpower"; "The embryo develops into a fetus"; "This situation has developed over a long time"
gain through experience; "I acquired a strong aversion to television"; "Children must develop a sense of right and wrong"; "Dave developed leadership qualities in his new position"; "develop a passion for painting" (同)acquire, evolve
grow emotionally or mature; "The child developed beautifully in her new kindergarten"; "When he spent a summer at camp, the boy grew noticeably and no longer showed some of his old adolescent behavior" (同)grow
generate gradually; "We must develop more potential customers"; "develop a market for the new mobile phone"
make something new, such as a product or a mental or artistic creation; "Her company developed a new kind of building material that withstands all kinds of weather"; "They developed a new technique"
make visible by means of chemical solutions; "Please develop this roll of film for me"
move into a strategically more advantageous position; "develop the rook"
move ones pieces into strategically more advantageous positions; "Spassky developed quickly"
processing a photosensitive material in order to make an image visible; "the development and printing of his pictures took only two hours" (同)developing
a process in which something passes by degrees to a different stage (especially a more advanced or mature stage); "the development of his ideas took many years"; "the evolution of Greek civilization"; "the slow development of her skill as a writer" (同)evolution
a state in which things are improving; the result of developing (as in the early part of a game of chess); "after he saw the latest development he changed his mind and became a supporter"; "in chess your should take care of your development before moving your queen"
act of improving by expanding or enlarging or refining; "he congratulated them on their development of a plan to meet the emergency"; "they funded research and development"
(music) the section of a composition or movement (especially in sonata form) where the major musical themes are developed and elaborated
a district that has been developed to serve some purpose; "such land is practical for small park developments"
a recent event that has some relevance for the present situation; "recent developments in Iraq"; "what a revolting development!"
a stage of technological development or innovation; "the third generation of computers"
the normal time between successive generations; "they had to wait a generation for that prejudice to fade"
the act of producing offspring or multiplying by such production (同)multiplication, propagation
the production of heat or electricity; "dams were built for the generation of electricity"
group of genetically related organisms constituting a single step in the line of descent
make bigger or wider in size, volume, or quantity; "expand the house by adding another wing"
become larger in size or volume or quantity; "his business expanded rapidly"
extend in one or more directions; "The dough expands" (同)spread out
pass through the tissue or substance or its pores or interstices, as of gas (同)transpirate
come about, happen, or occur; "Several important events transpired last week"
come to light; become known; "It transpired that she had worked as spy in East Germany"
exude water vapor; "plants transpire"
give off (water) through the skin
a measure of a childs development (in body size or motor skill or psychological function) expressed in terms of age norms
being changed over time so as to be e.g. stronger or more complete or more useful; "the developed qualities of the Hellenic outlook"; "they have very small limbs with only two fully developed toes on each"
(used of societies) having high industrial development; "developed countries" (同)highly-developed
(of real estate) made more useful and profitable as by building or laying out roads; "condominiums were built on the developed site"
relating to societies in which capital needed to industrialize is in short supply (同)underdeveloped

PrepTutorEJDIC

(今まではなかったが)…‘を'『生じさせる』,‘を'現す / …‘を'『発展させる』,伸ばす,成長させる / 〈病気・悪習など〉‘に'だんだん感染する,かかりはじめる,‘を'発病させる / 〈資源など〉‘を'『開発する』 / …‘を'十分に考える,〈議論・主題など〉‘を'展開する / 〈フイルム〉‘を'現像する / 〈ないもの・隠れているものが〉『現れる』,明らかになる / (…から…に)『発展する』,発育する《+『from』+『名』+『into』+『名』》 / 〈フイルムが〉現像される
〈U〉〈C〉『発達』,発展,発育,成長;『開発』;進化 / 〈U〉(写真の)現像 / 〈C〉発達(発展)の結果できたもの / 〈C〉開発した土地(地区);(特に)住宅団地(housing development) / 〈C〉(最近の)でき事,新事実
〈C〉《the ~》《集合的に》《単数扱い》『同時代の人人』,[同]世代 / 〈C〉〈U〉(家の)『一代』 / 〈C〉世代(ある代の出生から次の代の出生までの期間,約30年) / 〈U〉(電気などの)『発生』,生成《+『of』+『名』》
(…にまで)『拡大する』,膨張する,広がる《+『into』+『名』》 / (…について)さらに詳しく述べる《+『on』(『upon』)+『名』》 / 〈人が〉打ち解ける,心を開く / …‘を'『拡大する』,拡張する,広げる;…‘を'拡大して(…に)する《+『名』+『into』+『名』》
《話》起こる,生ずる(happen) / 〈秘密などが〉もれる,知れる / 〈水分・老廃物などが〉出る,排出される / 〈水分や老廃物など〉‘を'出す,発散する
発達中の,(国家・地域が)発展途上の

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/05/21 11:20:22」(JST)

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1. 慢性B型肝炎ウイルス感染に対するラミブジン単剤療法 lamivudine monotherapy for chronic hepatitis b virus infection
2. 物質使用障害に対する動機づけ面接 motivational interviewing for substance use disorders
3. 遺伝性乳癌・卵巣癌症候群およびBRCA変異を持つ患者のマネージメント management of hereditary breast and ovarian cancer syndrome and patients with brca mutations
4. 再発性または転移性子宮体癌の治療 treatment of recurrent or metastatic endometrial cancer
5. 心房細動患者における洞調律維持のための抗不整脈薬：臨床試験 antiarrhythmic drugs to maintain sinus rhythm in patients with atrial fibrillation clinical trials

English Journal

Chiral separation of four stereoisomers of ketoconazole drugs using capillary electrophoresis.

Wan Ibrahim WA1, Arsad SR, Maarof H, Sanagi MM, Aboul-Enein HY.
Chirality.Chirality.2015 Dec;27(3):223-7. doi: 10.1002/chir.22416. Epub 2014 Dec 18.
This work aimed to develop a chiral separation method of ketoconazole enantiomers using electrokinetic chromatography. The separation was achieved using heptakis (2, 3, 6-tri-O-methyl)-β-cyclodextrin (TMβCD), a commonly used chiral selector (CS), as it is relatively inexpensive and has a low UV ab
PMID 25523071

A time-frequency approach to estimate critical time intervals in postural control.

Zhang H1, Nussbaum MA, Agnew MJ.
Computer methods in biomechanics and biomedical engineering.Comput Methods Biomech Biomed Engin.2015 Nov;18(15):1693-703. doi: 10.1080/10255842.2014.946915. Epub 2014 Aug 8.
The critical time interval (CTI) is a parameter that has been used to distinguish open-loop from closed-loop control during upright stance. The aim of this study was to develop a new method to determine CTIs. The new approach, termed the intermittent critical time interval (ICTI) method, was motivat
PMID 25105745

Bacterial production of conjugated linoleic and linolenic Acid in foods: a technological challenge.

Gorissen L1, Leroy F, De Vuyst L, De Smet S, Raes K.
Critical reviews in food science and nutrition.Crit Rev Food Sci Nutr.2015 Sep 19;55(11):1561-74. doi: 10.1080/10408398.2012.706243.
Conjugated linoleic acid (CLA) and conjugated linolenic acid (CLNA) isomers are present in foods derived from ruminants as a result of the respective linoleic acid (LA) and α-linolenic acid (LNA) metabolism by ruminal microorganisms and in animals' tissues. CLA and CLNA have isomer-specific, health
PMID 24915316

Oral habits--part 2: beyond nutritive and non-nutritive sucking.

Silva M1, Manton D2.
Journal of dentistry for children (Chicago, Ill.).J Dent Child (Chic).2015 Sep-Dec;81(3):140-6.
In addition to sucking habits, a range of other habits have been associated with short- and long-term dental and orthodontic problems. These habits include tongue thrusting and atypical swallowing, lip sucking, oral self-mutilation, mouth breathing, and bruxism. Although the association between form
PMID 25514258

Japanese Journal

チェルノブイリの経験に学ぶ放射能汚染から身を守る食を中心とした生活の仕方

桑守豊美
仁愛大学研究紀要. 人間生活学部篇 3, 13-17, 2012-12-30
… Although 25 years have passed since the disaster in Chernobyl,many lessons can be learned, such as how to develop a system for measurement of the amount ofcesium in food products, how to deal with the public, and more. …
NAID 110009468874

位置透過性のあるシステムコールを有する組み込み制御システム向け分散リアルタイムOS

知場貴洋,齊藤政典,伊丹悠一,兪明連 ,横山孝典
情報処理学会論文誌 53(12), 2702-2714, 2012-12-15
本論文では,異なるノード上のタスク管理やタスク間の同期を可能とする位置透過性のあるシステムコールを有する分散リアルタイムOSについて述べる.本論文の対象は,自動車制御などの分野で用いられている分散型の組み込み制御システムである.まず,全ノードで統一した時刻に基づく動作を可能とするため,ネットワークにTDMAプロトコルに基づくリアルタイムネットワークであるFlexRayを用いてノード間でOSが管理す …
NAID 110009493419

Keynote Speech: Human/Technology Interface and Interactivity

Kia Ng
情報処理学会研究報告. [音楽情報科学] 2012-MUS-97(11), 1, 2012-12-14
… The talk also presents latest research collaborations and activities, with the University of Leeds Cultural and Creative Industries (CCI) Exchange hub, to further understanding of interaction and intelligent interfaces in the performing arts through collaboration between science, arts and technology, to develop shared aims and far-reaching impacts. …
NAID 110009493058

実践力を養うための授業実践の検討

永田直也/長谷川望
東邦学誌 41(3), 81-88, 2012-12-10
NAID 110009495124

Related Pictures

★リンクテーブル★

リンク元	「100Cases 33」「disabling」「exploit」「expand」「development」
拡張検索	「developer」「elution development」「left ventricular developed pressure」

「100Cases 33」

　　[★]

☆case33　頭痛と混乱

■glossary

accompany

vt.

(人)と同行する、(人)に随行する。(もの)に付随する。～と同時に起こる。～に加える(添える、同封する)(with)

slurred n. 不明瞭

強直間代痙攣 tonic-clonic convulsion

　意識消失とともに全身の随意筋に強直痙攣が生じ(強直痙攣期tonic convulsion)、次いで全身の筋の強直と弛緩とが律動的に繰り返される時期(間代痙攣期clonic convulsion)を経て、発作後もうろう状態を呈する一連の発作。

■症例

28歳、女性　黒人　南アフリカ　手術室看護師　ロンドン住在

主訴：頭痛と混乱

現病歴：過去3週間で頭痛が続いており、ひどくなってきた。現在も頭痛が持続しており、頭全体が痛い。友人曰く「過去六ヶ月で体重が10kg減っていて、最近、混乱してきたようだ」。発話は不明瞭。救急室にいる間に強直間代痙攣を起こした。

・診察 examination

やせている。55kg。38.5℃。口腔カンジダ症(oral candidiasis)。リンパ節腫脹無し。心血管、呼吸器系、消化器系正常。痙攣前における神経検査では時間、場所、人の見当識無し。神経局所症状無し(no focal neurological sign)。眼底両側に乳頭浮腫有り。

・検査 investigation

血算：白血球増多

血液生化学：ナトリウム低下

CT：供覧

■キーワード＆着目するポイント

・口腔カンジダ症(oral candidiasis)

・頭痛、精神症状、強直間代痙攣

・眼底両側に乳頭浮腫

・CT 所見

・低ナトリウム血症は二次的なもの

■アプローチ

・口腔カンジダ症(oral candidiasis)　→　細胞免疫低下状態(DM、免疫抑制、AIDSなど) or 常在細菌叢の攪乱(長期の抗菌薬の使用)

　・The occurrence of thrush in a young, otherwise healthy-appearing person should prompt an investigation for underlying HIV infection.(HIM.1254)

　・More commonly, thrush is seen as a nonspecific manifestation of severe debilitating illness.(HIM.1254)

・精神症状、強直間代痙攣　→　一次的、あるいは二次的な脳の疾患がありそう

・頭痛　→　漠然としていて絞れないが、他の症状からして機能性頭痛ではなく症候性頭痛っぽい。

・眼底両側に乳頭浮腫　→　脳圧亢進の徴候　→　原因は・・・脳腫瘍、ことにテント下腫瘍と側頭葉の腫瘍、クモ膜下出血、脳水腫など、そのほか、眼窩内病変、低眼圧などの局所的要因、悪性高血圧、血液疾患、大量出血、肺気腫などの全身的要因 (vindicate本のp342も参考になる)

　・頭痛と脳圧亢進　→　頭蓋内圧占拠性病変、脳炎(IMD.274)

・CT 所見　→　ringformの病変、脳浮腫、脳圧亢進

・低ナトリウム血症　→　脳ヘルニアに続発して起こることがあるらしい。実際には下垂体にトキソプラズマによる病変が形成されることにより起こりうる。

・そのほか出身地、体重減少もHIVを疑わせる点

パターン認識でHIV + 精神症状 + てんかん発作(強直間代痙攣) + 脳圧亢進 + CT 所見 = 一番ありそうなのはToxoplasma gondiiによるトキソプラズマ脳症 cerebral toxoplasosis (トキソプラズマ脳炎 toxoplasmic encephalitis)

■Toxoplasma gondii

　原虫　胞子原虫類

(感染予防学 080521のプリント、CASES p,92、HIM p.1305-)

・疫学：西洋では30-80%の成人がトキソプラズマの感染の既往がある・・・うぇ(CASES)。日本では10%前後(Wikipedia)。

・生活環

　・終宿主：ネコ：ネコの小腸上皮細胞で有性・無性生殖　糞便にオーシストの排泄

　・中間宿主：ヒト.ブタを含むほ乳類と鳥類：無性生殖で増殖、シストの形成

　　　急性期の増殖盛んな急増虫体 tachyzoiteとシスト内の緩増虫体 bradyzoite

・病原、病因 phathogenesis

　・緩増虫体(bradyzoite)、接合子嚢(oocyst)

・感染経路

　1. オーシストの経口摂取

　2. 中間宿主の生肉中のシストの経口摂取

　3. 初感染妊婦からの経胎盤感染。既感染なら胎盤感染しないらしい(HIM.1306)

　(4)移植臓器、輸血。確率は低い(at low rate)(HIM.1306)

・病態

　1. 先天性トキソプラズマ症　congenital toxoplasmosis

　　　①網脈絡膜炎、 ②水頭症、 ③脳内石灰化、 ④精神・運動障害

　2. 後天性トキソプラズマ症　acquired toxoplasmosis

　　(1) 健常者

　　　・多くは不顕性感染。発熱、リンパ節腫脹、皮疹(rash)

　　　・(少数例)筋肉痛、暈疼痛、腹痛、斑状丘疹状皮疹(maculopapular rash)、脳脊髄炎、混乱(HIM.1308)

　　　・(まれ)肺炎、心筋炎、脳症、心膜炎、多発筋炎

　　　・網膜、脈絡叢に瘢痕や、脳に小さい炎症性の病変を残すことあり(CASES)。

　　　・急性感染の症状は数週間で消失　筋肉や中枢神経系に緩増虫体が残存

　　(2)HIV 感染者、臓器移植例、がん化学療法例

　　　シスト内緩増虫体→急増虫体→播種性の多臓器感染

　　　AIDSでは、トキソプラズマ性脳炎が指標疾患 AIDS-defineing illness(CASES)

・治療

　(日本)アセチルスピラマイシン、ファンシダール(感染予防学 080521)

■トキソプラズマ脳炎 toxoplasmic encephalitis、トキソプラズマ脳症 cerebral toxoplasosis

・症状

　発熱、頭痛、混乱ｍ、痙攣、認知の障害、局所神経徴候(不全片麻痺、歯垢、脳神経損傷、視野欠損、感覚喪失)(CASES)

・画像検査

　(CT,MRI)多発性、両側性、ring-enhancing lesion、特に灰白質-白質境界、大脳基底核、脳幹、小脳が冒されやすい(CASES)

・鑑別診断(臨床症状・画像診断の所見で)

　リンパ腫、結核、転移性脳腫瘍(CASES)

・病歴と画像所見からの鑑別診断

　リンパ腫、結核、転移性腫瘍

？

このCTがcerebral toxoplasmosisに特徴的かは不明

□最後に残る疑問

　AIDSでWBC(leukocyte)の数はどうなるんだろう？？？AIDSの初診患者ではWBCが低い人が多いらしいし()、HIVはCD4+ T cellとmacrophageに感染して殺すから、これによってB cellは減るだろうし、CD8+ T cellも若干減少するだろうからWBCは減るんじゃないか？！好中球はAIDSとは関係ない？好中球は他の感染症に反応性に増加している？ちなみに、好酸球は寄生虫(原虫)の感染のために増える傾向にあるらしい(HIMのどこか)。

葉酸拮抗剤である。

サルファ剤と併用され、抗トキソプラズマ薬、抗ニューモシチス・カリニ薬として相乗的に働く。

ST 合剤

SMX-TMP

スルファメトキサゾール・トリメトプリム合剤 sulfamethoxazole and trimethoprim mixture

□AIDSの定義(http://en.wikipedia.org/wiki/CDC_Classification_System_for_HIV_Infection_in_Adults_and_Adolescents)

According to the US CDC definition, one has AIDS if he/she is infected with HIV and present with one of the following:

A CD4+ T-cell count below 200 cells/μl (or a CD4+ T-cell percentage of total lymphocytes of less than 14%).

or he/she has one of the following defining illnesses:

01. Candidiasis of bronchi, trachea, or lungs
02. Candidiasis esophageal
03. Cervical cancer (invasive)
04. Coccidioidomycosis, disseminated or extrapulmonary
05. Cryptococcosis, extrapulmonary
06. Cryptosporidiosis, chronic intestinal for longer than 1 month
07. Cytomegalovirus disease (other than liver, spleen or lymph nodes)
08. Encephalopathy (HIV-related)
09. Herpes simplex: chronic ulcer(s) (for more than 1 month); or bronchitis, pneumonitis, or esophagitis
10. Histoplasmosis, disseminated or extrapulmonary
11. Isosporiasis, chronic intestinal (for more than 1 month)
12. Kaposi's sarcoma
13. Lymphoma Burkitt's, immunoblastic or primary brain
14. Mycobacterium avium complex
15. Mycobacterium, other species, disseminated or extrapulmonary
16. Pneumocystis carinii pneumonia
17. Pneumonia (recurrent)
18. Progressive multifocal leukoencephalopathy
19. Salmonella septicemia (recurrent)
20. Toxoplasmosis of the brain
21. Tuberculosis
22. Wasting syndrome due to HIV

People who are not infected with HIV may also develop these conditions; this does not mean they have AIDS. However, when an individual presents laboratory evidence against HIV infection, a diagnosis of AIDS is ruled out unless the patient has not:

undergone high-dose corticoid therapy or other immunosuppressive/cytotoxic therapy in the three months before the onset of the indicator disease
OR been diagnosed with Hodgkin's disease, non-Hodgkin's lymphoma, lymphocytic leukemia, multiple myeloma, or any cancer of lymphoreticular or histiocytic tissue, or angioimmunoblastic lymphoadenopathy
OR a genetic immunodeficiency syndrome atypical of HIV infection, such as one involving hypogamma globulinemia

AND

the individual has had Pneumocystis carinii pneumonia
OR one of the above defining illnesses AND a CD4+ T-cell count below 200 cells/μl (or a CD4+ T-cell percentage of total lymphocytes of less than 14%).

□AIDSのステージング

Revised World Health Organization (WHO) Clinical Staging of HIV/AIDS For Adults and Adolescents (2005)

http://en.wikipedia.org/wiki/WHO_Disease_Staging_System_for_HIV_Infection_and_Disease_in_Adults_and_Adolescents

■参考文献

HIM = Harrison's Principles of Internal Medicine 17th Edition

CASES = 100 Cases in Clinical Medicine Second edition

IMD = 内科診断学第2版

「disabling」

　　[★]

adj.

無力にする、何もできない状態にする。不自由な、無力な、無能な。法的権利の剥奪。

The disease can be disabling but is rarely fatal.(HIM.2440)(この疾患は(発症すると)何もできないような状態になるが、死に至ることはまれである。)

As a late complication, patients commonly develop severe, disabling proximal lower extremity weakness.(HIM.2692)(晩期合併症として、患者は一般的には重度で不自由となるような(身体障害者となるような)近位下肢の脱力を起こす)