- ヘンレループの上行脚で水の移動なしにNaClが再吸収されて尿浸透圧が低下することから、この領域を形容した用語
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- 1. 代謝性アルカローシスの原因causes of metabolic alkalosis [show details]
…persistent loop diuretic effect. Gitelman syndrome impairs sodium chloride reabsorption in the "diluting segment" of the distal tubule and mimics the action of a persistent thiazide diuretic effect. Pendrin…
- 2. 心筋梗塞または不安定狭心症の予後における心電図electrocardiogram in the prognosis of myocardial infarction or unstable angina [show details]
…mortality . The importance of ST segment elevation resolution is reviewed in detail elsewhere. ST segment depression (in leads other than those initially showing ST segment elevation) is commonly seen in …
- 3. ST上昇型急性心筋梗塞での血栓溶解療法：効果の指標fibrinolytic thrombolytic agents in acute st elevation myocardial infarction markers of efficacy [show details]
…had >2 mm ST-segment elevation in any of the inferior leads or V5 to V6 or >2 mm ST-segment depression in any leads V1 to V4. Low-risk patients with an anterior wall MI had ≤2 mm ST-segment elevation and …
- 4. 心電図チュートリアル：心筋虚血および心筋梗塞ecg tutorial myocardial ischemia and infarction [show details]
… J point and the ST segment retains its concave configuration but may become convex or rounded upward Over time, the ST-segment elevation becomes more pronounced and the ST segment changes its morphology …
- 5. バレット食道：疫学、臨床症状、および診断barretts esophagus epidemiology clinical manifestations and diagnosis [show details]
…"short-segment". Long-segment Barrett was especially uncommon in those without a history of heartburn. Among patients who have endoscopic examinations because of chronic GERD symptoms, long-segment Barrett …
English Journal
- ReMixT: clone-specific genomic structure estimation in cancer.
- McPherson AW, Roth A, Ha G, Chauve C, Steif A, de Souza CPE, Eirew P, Bouchard-Côté A, Aparicio S, Sahinalp SC, Shah SP.
- Genome biology. 2017 07;18(1)140.
- Somatic evolution of malignant cells produces tumors composed of multiple clonal populations, distinguished in part by rearrangements and copy number changes affecting chromosomal segments. Whole genome sequencing mixes the signals of sampled populations, diluting the signals of clone-specific aberr
- PMID 28750660
- Morphological and molecular investigations of the holocephalan elephant fish nephron: the existence of a countercurrent-like configuration and two separate diluting segments in the distal tubule.
- Kakumura K, Takabe S, Takagi W, Hasegawa K, Konno N, Bell JD, Toop T, Donald JA, Kaneko T, Hyodo S.
- Cell and tissue research. 2015 Dec;362(3)677-88.
- In marine cartilaginous fish, reabsorption of filtered urea by the kidney is essential for retaining a large amount of urea in their body. However, the mechanism for urea reabsorption is poorly understood due to the complexity of the kidney. To address this problem, we focused on elephant fish (Call
- PMID 26183720
- [Study of bioavailability of paclitaxel after sublingual administration].
- Samsonia M, Lesiovskaia E, Ghibradze O, Kandelaki M.
- Georgian medical news. 2015 May;(242)59-64.
- The bioavailability of sublingual form of paclitaxel, developed in the pharmacology laboratory of pharmaceutical company - Legion "Provisus" is studied. Sublingual form of paclitaxel is an alcoholic solution of paclitaxel (1 mg/ml) with penetrator - dimethyl sulfoxide (DMSO) addition. Experiments we
- PMID 26042449
Japanese Journal
- 松本歯学 30(1), 1-8, 2004-04-30
- … The diluting segment, an early part of the distal nephron, highly develops basolateral interdigitation and reabsorbs approximately 40% offiltered Na^+, K^+, and Cl^-, but is impermeable to water; …
- NAID 80016804478
- 脊椎動物の進化における陸生適応と腎臓の多様性-両生類の中心に-
- 内山 実,上条 雅,松田 恒平 [他],吉沢 英樹
- 宇宙生物科学 = Biological sciences in space 14(1), 22-31, 2000-03
- … The diluting segment, early parts of distal nephron, highly develops basolateral interdigitation and reabsorbs approximately 40% of filtered Na<SUP>+</SUP>, K<SUP>+</SUP>, and Cl<SUP>-</SUP>, but is impermeable to water, thus this part results in the formation of hypo-osmotic tubular fluid. …
- NAID 10004491416
- Calcium-activated potassium channels in the luminal membrane of Amphiuma diluting segment : voltage-dependent block by intracellular Na^+ upon depolarisation
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★リンクテーブル★
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- 英
- hypothyroidism
- 同
- 甲状腺機能不全症
- 関
- 粘液水腫、甲状腺ホルモン、甲状腺
- 甲状腺機能亢進症
概念
- 甲状腺ホルモンの合成、分泌が低下し、血液中の甲状腺ホルモンが不足している状態である。
病因
病態
- 参考1
- → 代謝の低下
- → 多くの組織の組織間隙にグリコサミノグリカンが蓄積
症候
- 全身：全身倦怠感、易疲労感、体重増加、低体温、嗄声、
貧血(EPO↓)、滲出液貯留(心膜液貯留(約30%の症例で見られる)、胸水貯留 ←血管透過性の亢進による)
- 消化器：絶肥大、便秘、食欲低下
- 循環器：粘液水腫心、心拍出量の低下？
- 骨格筋：こむらがえり、アキレス腱反射の子癇層の遅延(Lamberts徴候)、筋力低下(骨格筋ミオパチー)、筋肥大(Hoffmann症候群)、筋痛
- 皮膚 ：四肢・顔面の粘液水腫、発汗減少、皮膚乾燥、頭皮脱毛、眉毛外1/3の脱毛、皮膚の黄染
- 神経 ：末梢神経と中枢神経のいずれも影響が生じる。 (参考1)
- 橋本脳症：疾患概念についてはcontroversial
- 粘液水腫性昏睡(ICU.762)(低体温、浮腫性皮膚、意識レベル低下)
- 手根管症候群：よく見られる合併症。ホルモン療法により軽快。 ← 組織間質にグリコサミノグリカンが蓄積して手根管を狭窄せしめるのか
- 精神 ：記銘力低下、計算力低下、言語緩慢、活動性低下
- 生殖系：月経不順(月経過多、無月経)。不妊、流産。 ← 初期に月経過多、後期に無月経を起こす(出典不明)。
- その他：乳汁分泌(三次性以外。TRH↑)、難聴、貧血。 ← 甲状腺ホルモンがエリスロポエチンの分泌を亢進させるので
生殖系の異常
| 月経前の婦人集団
|
集団サイズ(人)
|
患者全体に占める割合(%)
|
| 月経周期正常
|
無月経・希発月経
|
過多月経
|
| 甲状腺機能低下症
|
171
|
77
|
16
|
7
|
| 健常者
|
214
|
92
|
7
|
1
|
検査
胸部単純X線写真
心電図
血液検査
- AST,LDH,CKなど筋酵素が増加
- (1)心拍出量の低下 → 頚動脈圧受容器 → ADH分泌 (時に尿Na濃度が低下せず、SIADHの基準を満たす例がある)
- (2)GFR低下((1)の影響？) → ヘンレループの上行脚(diluting segment)に至る尿量減少 → 排泄できる自由水減少
診断基準
- a)かつb)を満たすもの
- 無気力、易疲労感、眼瞼浮腫、寒がり、体重増加、動作緩慢、嗜眠、記憶力低下、便秘、嗄声等いずれかの症状
治療
参考
- 1. [charged] 甲状腺機能低下症の臨床症状 - uptodate [1]
- 2. [charged] 甲状腺機能低下症における低ナトリウム血症 - uptodate [2]
- 3. [charged] 甲状腺機能低下症の治療 - uptodate [3]
- 4. [charged] 甲状腺機能低下性ミオパチー - uptodate [4]
- 5. 甲状腺機能低下症 - 甲状腺疾患診断ガイドライン
- http://www.japanthyroid.jp/doctor/guideline/japanese.html#teika
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- 関
- area、metameric、region、segmental、somite、somitic