adj.

(the ～)最後の、終わりの、最終の(opp. first)
最後に残った。臨終の
すぐ/この前の、昨～、去る～、先～(opp. next)
(the ～)最近の、最新の、最新流行の
(the ～)最も～しそうもない。持っても不適当/不相当な
決定的な、最後の、究極の。(the ～)最上の、再開の、最低の(lowest)
(強意)個々の

adv.
n.

WordNet

occurring at the time of death; "his last words"; "the last rites"
a unit of capacity for grain equal to 80 bushels
a unit of weight equal to 4,000 pounds
the last or lowest in an ordering or series; "he was the last to leave"; "he finished an inglorious last"
holding device shaped like a human foot that is used to fashion or repair shoes (同)shoemaker''s last, cobbler''s last
a persons dying act; the final thing a person can do; "he breathed his last"
persist for a specified period of time; "The bad weather lasted for three days" (同)endure
the item at the end; "last, Ill discuss family values" (同)lastly, in_conclusion, finally
lowest in rank or importance; "last prize"; "in last place" (同)last-place, lowest
highest in extent or degree; "to the last measure of human endurance"; "whether they were accomplices in the last degree or a lesser one was...to be determined individually" (同)utmost
coming after all others in time or space or degree or being the only one remaining; "the last time I saw Paris"; "the last day of the month"; "had the last word"; "waited until the last minute"; "he raised his voice in a last supreme call"; "the last game of the season"; "down to his last nickel"
immediately past; "last Thursday"; "the last chapter we read"
most unlikely or unsuitable; "the last person we would have suspected"; "the last man they would have chosen for the job"
most_recently; "I saw him last in London"
preceding all others in time or space or degree; "the first house on the right"; "the first day of spring"; "his first political race"; "her first baby"; "the first time"; "the first meetings of the new party"; "the first phase of his training"
the first or highest in an ordering or series; "He wanted to be the first" (同)number_one
the first element in a countable series; "the first of the month" (同)number_one, number 1
an honours degree of the highest class (同)first-class honours degree
indicating the beginning unit in a series (同)1st
before anything else; "first we must consider the garter snake" (同)firstly, foremost, first of all, first off
the initial time; "when Felix first saw a garter snake" (同)for_the_first_time
ranking above all others; "was first in her class"; "the foremost figure among marine artists"; "the top graduate" (同)foremost, world-class
before another in time, space, or importance; "I was here first"; "lets do this job first"
highest in pitch or chief among parts or voices or instruments or orchestra sections; "first soprano"; "the first violin section"; "played first horn"
to take an action to protect against future problems; "Count the cash in the drawer twice just to cover yourself"
clothe, as if for protection from the elements; "cover your head!" (同)wrap up
a recording of a song that was first recorded or made popular by somebody else; "they made a cover of a Beatles song" (同)cover version, cover song
fire that makes it difficult for the enemy to fire on your own individuals or formations; "artillery provided covering fire for the withdrawal" (同)covering fire
the act of concealing the existence of something by obstructing the view of it; "the cover concealed their guns from enemy aircraft" (同)covering, screening, masking
a false identity and background (especially one created for an undercover agent); "her new name and passport are cover for her next assignment"
make up for shortcomings or a feeling of inferiority by exaggerating good qualities; "he is compensating for being a bad father" (同)compensate, overcompensate
span an interval of distance, space or time; "The war extended over five years"; "The period covered the turn of the century"; "My land extends over the hills on the horizon"; "This farm covers some 200 acres"; "The Archipelago continues for another 500 miles" (同)continue, extend
hide from view or knowledge; "The President covered the fact that he bugged the offices in the White House" (同)cover up
protect by insurance; "The insurance wont cover this" (同)insure, underwrite
form a cover over; "The grass covered the grave" (同)spread over
act on verbally or in some form of artistic expression; "This book deals with incest"; "The course covered all of Western Civilization"; "The new book treats the history of China" (同)treat, handle, plow, deal, address
be responsible for guarding an opponent in a game
be sufficient to meet, defray, or offset the charge or cost of; "Is this enough to cover the check?"
help out by taking someones place and temporarily assuming his responsibilities; "She is covering for our secretary who is ill this week"
hold within range of an aimed firearm
invest with a large or excessive amount of something; "She covered herself with glory"
maintain a check on; especially by patrolling; "The second officer covered the top floor"
play a higher card than the one previously played; "Smith covered again"
protect or defend (a position in a game); "he covered left field"
provide for; "The grant doesnt cover my salary"
provide with a covering or cause to be covered; "cover her face with a handkerchief"; "cover the child with a blanket"; "cover the grave with flowers"
spread over a surface to conceal or protect; "This paint covers well"
admit as valid; "The court sustained the motion"
supply with necessities and support; "She alone sustained her family"; "The money will sustain our good cause"; "Theres little to earn and many to keep" (同)keep, maintain
uninterrupted connection or union
the property of a continuous and connected period of time (同)persistence
a detailed script used in making a film in order to avoid discontinuities from shot to shot
the period of time during which something continues (同)continuance
the property of enduring or continuing in time (同)continuance
continuance in time; "the ceremony was of short duration"; "he complained about the length of time required" (同)length
any of various yeastlike budding fungi of the genus Blastomyces; cause disease in humans and other animals
the syllable naming the sixth (submediant) note of a major or minor scale in solmization (同)lah
lasting a long time without change; "a lasting relationship"

PrepTutorEJDIC

《the ~》(順序・時間について)『最後の』;(行為・でき事について)最後の / 最後に残った,後のない / 《時を表す語につけて》『すぐ前の』,この前の,昨…,先…;最近の,この,ここ / 『最新の』,最近の / 《the ~》『最も』(…)『しそうにない』,最も(…)でない《+『名』+『to』 do(『that節』『wh-節』)》 / 《the ~》(地位・評価・重要さなどが)最も劣る / (特に人生の)終末の / 《the ~》最大の,この上ない(utmost) / (lateの最上級) / (順序・時間が)『最後に』,いちばん遅く / 『この前に』,最近 / (講演・論文などで)最後に,終りに臨んで / 《the ~》『最後の人』(『物』) / 最近のもの,この前のもの / 『最後』,終り,臨終;(月・週の)終り
(時間的に)『続く』,継続する / 〈物が〉『使用に耐える』,〈力・精力などが〉もつ / 〈物が〉足りる,なくならない / …‘の'『間をもちこたえる』,‘を'生き続ける / 〈物などが〉(ある期間の間)〈人〉‘の'必要を満たす
靴型
(順序・時間的に)『第1の』,1番目の;最初の / (階級・等級・重要度などが)『1番の』,第一級の,首席の,最も重要な / 『最初に』,まっ先に;1番目に,第1位に;初めて / (…するくらいなら)むしろ,いっそ(…のほうがいい)(rather, sooner) / 《通例the~》『最初のもの』;(月の)第1日;(時代の)第1年 / 《通例the~》初め,始まり / 〈U〉ファーストギヤ,低速ギヤ / 〈C〉《英》(競技などの)第1位,1等(試験の)第一級 / 《複数形で》最高級品,一級品 / 〈U〉=first base
(…で)…‘の'『表面をおおう』,'を'包む,かぶせる《+『名』+『with』+『名』》 / (範囲が)…‘に'『及ぶ』,わたる,'を'取り扱う範囲に入れる / 〈ある距離〉'を'行く,進む(受動態にできない) / …‘に'保険を掛ける / …'を'報道する,取材する / 〈要塞・砲などが〉'を'制圧する / (ピストルなどで)〈人〉'を'ねらう《+『名』+『with』+『名』》 / (球技などで)〈相手〉の動きなど〉'を'ふせぐ;〈地域など〉'を'守る / (…の)代役をする,身代りをする《+『for』+『名』》 / 〈C〉『おおい』,包むもの,カバー;ふた / 〈C〉『表紙』 / 〈U〉隠れ場所,潜伏所 / 〈U〉姿を隠してくれるもの(暗闇,煙など) / 〈C〉(秘密を隠すための)見せかけ / 〈U〉(…の)保険《+『against』+『名』》 / 〈C〉封筒;(郵便小包などの)包装紙 / 〈C〉毛布,ふとん
…‘を'『持続する』,続けてする / 〈人〉‘を'『元気づける』 / 〈家族など〉‘を'『養う』 / 《文》(物が下から)…‘を'『支える』 / 〈損害・傷害など〉‘を'『受ける』,こうむる / 〈苦難など〉‘に'耐える,耐え抜く / (法的に)…‘を'認める / …‘を'立証する,確証する
〈U〉連続,断続,一貫性 / 〈U〉(映画・ラジオ・テレビの)コンテ,撮影(録音)用台本;〈C〉コンテに書かれた個々の指示
(時間の)持続,存続,継続 / 存続期間,持続時間
ラ(全音階の第6音)
『永続する』;長持ちする

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/12/17 01:51:14」(JST)

wiki en

[Wiki en表示]

A pair of wooden lasts.

A last is a mechanical form that has a shape similar to that of a human foot. It is used by shoemakers and cordwainers in the manufacture and repair of shoes. Lasts typically come in pairs and have been made from various materials, including hardwoods, cast iron, and high-density plastics.^[1]

Production

Lasts come in many styles and sizes, depending on the exact job they are designed for. Common variations include simple one-size lasts used for repairing soles and heels, durable lasts used in modern mass production, and custom-made lasts used in the making of bespoke footwear. Though a last is made approximately in the shape of a human foot, the precise shape is tailored to the kind of footwear being made. For example, a boot last would be designed to hug the instep for a close fit. Modern last shapes are typically designed using dedicated computer-aided design software.

Historically, lasts were typically made from hardwoods and cast iron because these materials retain their shape, even when in contact with wet materials (like leather) and subjected to the mechanical stresses of stretching and shaping shoes on them. Today, wooden lasts are generally used only for bespoke shoemaking, particularly in Europe and North America.

The materials used in modern lasts must be strong enough to withstand the forces of mass production machinery, such as that applied by pullover machines when bottoming the shoe, and must also be able to hold tacks (known as "lasting tacks"), which are used to hold shoe parts together temporarily before the sole is added. Although hardwoods satisfy these criteria, modern lasts, especially those used by mass production factories in places such as China, are often made from high-density polyethylene plastic (HMW-HDPE), which allows for many tack holes before needing repair. Such plastics also have the benefit that they can be recycled and remoulded when they wear out.

Custom lasts

Cordwainers, or bespoke shoemakers, often use lasts that are specifically designed to the proportions of individual customers' feet. Made from various modern materials, they don't need to withstand the pressures of mass production machinery, but they must be able to handle constant tacking and pinning, and the wet environment associated with stretching and shaping materials such as leather.

References

^ Luximon, Ameersing; Ma, Xiao (30 September 2013). Handbook of Footwear Design and Manufacture. Elsevier Science. p. 177. ISBN 978-0-85709-879-5. Retrieved 14 February 2015.

External links

Media related to Lasts at Wikimedia Commons

Lastmakingschool.com

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Related Pictures

★リンクテーブル★

リンク元	「100Cases 14」「sustain」「persistence」「cover」「持続」
拡張検索	「plastic operation」「acute myeloblastic leukemia with maturation」「acute myeloblastic leukemia, with granulocytic maturation」

「100Cases 14」

　　[★]

☆case14　複視

■glossary

diplopia n. 複視

筋力低下、筋無力、筋脱力 muscle weakness, muscular weakness

sunken

vt. sinkのpp.

adj.

沈没した、沈んだ、水中の

沈下した、一段低いところにある

落ち込んだ、くぼんだ

3,4-ジアミノピリジン 3,4-diaminopyridine 3,4-DAP K+チャネル阻害薬;ランバート・イートン筋無力症治療

■症例

43-year-old woman

cheif complaint: diplopia

present history: diplopia and holding her head up ; more marked in the evenings, for the last 3 months. difficulty of chewing. voice has become quieter. weight loss (3kg / 6months). non-smoker. drinks about 15 units/week. no regular medication.

past history: no significant previous medical illnesses.

family history: lives with her husband and three children.

・診察 examination

looks well.

organ systems: normal; cardiovascular, respiratory, and abdominal systems.

muscle power; grossly normal. decrease after testing a movement repetitively.

motor function: normal; tone, coordination, reflexes and sensation.

bilateral ptosis. exacerbated by prolonged upward gaze

eye: normal; pupillary reflexes, eye movements, and funduscopy

■答え

diagnosis: myathenia gravis

differential diagnoses:

CASES

上位and/or下位運動ニューロン motor neurone disease　運動ニューロン疾患：線維束性攣縮。進行例では筋力低下

筋 muscular dystrophy　筋ジストロフィー：ある種の筋肉が選択的に筋力低下する。家族歴がある。

筋 dystrophia myotonica　強直性筋ジストロフィー：咬筋、側頭筋、胸鎖乳突筋の筋萎縮、四肢遠位端の筋萎縮。顔貌が特徴的(前頭部脱毛、無表情、窪んだ頬)。家族歴ある。筋電図が診断に有用(急降下爆撃音)。

筋 polymyositis　多発筋炎：普通は皮疹と関節痛が出現。CKが上昇。筋生検が診断に有用

筋 myopathy　ミオパチー：甲状腺中毒性ミオパチー、甲状腺機能低下症によるミオパチー、クッシング症候群によるミオパチー、アルコール性のミオパチー

神経筋接合部？ non-metastatic associations of malignancy (paraneoplastic syndrome(傍腫瘍性症候群 = 腫瘍随伴症候群)のこと)：胸腺腫の症例の10%に重症筋無力症がみられる。ランバート・イートン筋無力症症候群は小細胞癌と関連がある。

HIM.2674

神経筋接合部 congenital myasthenia syndrome　先天性筋無力症症候群
神経筋接合部 drug-induced myasthenia　薬剤性筋無力症

Treatment with penicillamine (used for scleroderma or rheumatoid arthritis) may result in true autoimmune MG, but the weakness is usually mild, and recovery occurs within weeks or months after discontinuing its use.

　重症筋無力症の誘発：ペニシラミン(強皮症や関節リウマチの治療に用いられる)。

　　mildだし、薬剤の中断で改善する。

Aminoglycoside antibiotics or procainamide can cause exacerbation of weakness in myasthenic patients; very large doses can cause neuromuscular weakness in normal individuals.

　重症筋無力症の悪化：アミドグリコシド系抗菌薬、プロカインアミド

　　MGの患者の筋脱力が悪化する。

神経筋接合部 Lambert-Eaton myasthenic syndrome　ランバート・イートン筋無力症症候群：全身の筋肉が冒されるが、特に下肢の近位筋が冒される。MGと同じように～70%の患者で脳神経所見(眼瞼下垂、複視など)が認められる。MGと違うのは(1)反射が消失・減弱すること、(2)自律神経系の変化(口渇、勃起不全)を生じる、(3)神経刺激検査で漸増(waxing)が見られることである。病因は神経筋接合部のP/Q type calcium channelsに対する抗体の出現であり、85%の患者で見いだされる。治療はMGのように血漿交換や免疫抑制薬が使われる。3,4-DAPやpyridostigmineは症状に対する治療のために用いる。前者は運動神経の終末部でカルシウムチャネルをブロックし活動電位を延長させる。後者はアセチルコリンエステラーゼを阻害してシナプスにおける神経伝達物質の濃度を上げる。
精神疾患 neurasthenia　神経衰弱症：歴史的な用語。器質的な障害を伴わない筋無力症のような脱力を伴う症候群。患者は筋脱力や疲労を訴えてやってくる。筋肉の検査では器質的変化は認めないが"jerky release"あるいは"give-away weakness"が認められる。患者の主訴は反復動作による筋力低下よりむしろ疲労や感情鈍麻である。
内分泌疾患 hyperthyroidism　甲状腺機能亢進症：MGが疑われる患者にはthyroid function testをルーチンにやる。甲状腺機能異常は筋無力症の筋力低下を大きくすることがある。
神経筋接合部 botulism　ボツリヌス症：ボツリヌス毒素はシナプス前膜からの神経伝達物質の開口分泌を妨げる。症状はbulbar weakness (複視、構音障害、嚥下困難)。感覚障害はない。深部腱反射は初期には保たれている。進行すれば反射は見られなくなる。筋脱力は全身性。呼吸困難に陥ることがある。精神状態は正常。自律神経症状(麻痺性イレウス、便秘、urinary retention、瞳孔の散大、瞳孔の反応性低下、口渇)。確定診断は血清中の毒素の検出だけど、見つかることはまれ。神経伝導検査(nerve conduction studies)：compound muscle action potentials (CMAPs)の低下。高頻度の刺激で振幅が増加。治療：intubation for airway protection、呼吸補助、aggressive inpatient supportive care(e.g., nutrition, DVT prophylaxis)。馬の抗毒素を検査結果が帰ってくる前に投与する(？)。
上位運動ニューロン intracranial mass lesions　頭蓋内占拠病変：複視はintracranial mass lesionが外眼筋の神経を圧迫することにより生じる。
筋 progressive external ophthalmoplegia　進行性外眼筋麻痺：外眼筋の筋脱力を伴う。四肢の近位筋の筋力低下やそのほかの全身症状を伴うことがある。ミトコンドリアの異常を有する。

■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

「sustain」

　　[★]

vt.

下から支える。(重責など)になう。…に耐える
(損害などを)うける、こうむる。経験する。(役を)演ずる

A 24-year^old woman is involved in an automobile accident and sustains a splenic laceration.

補給する、持続させる。継続する。～に栄養を補給する。～の生命を維持する
指示する、支援する。励ます、元気づける
正当と認める、認可する。確認する、確証する。立証する。

関: continuity、duration、hold、keep、last、maintain、maintenance、persist、persistence、retention

「persistence」

　　[★]

n.

頑固、固執、しつこさ、根深さ。永続、持続性、しっかりした忍耐。(刺激が無くなった後の感覚の)残留/残留性。(生)(有害遺伝子の)残存/残存率

this altered immune state allows the persistence of tachyzoites and gives rise to progressive focal destruction that results in organ failure(HIM.1306)