adj.

一次の、第一次の、主要な、(化学)第一級の、一級の、初生の、(病名)原発性の、原発の、プライマリーの

関: cardinal、chief、first-order、foremost、main、mainly、major、master、primarily、principal、principally

WordNet

of first rank or importance or value; direct and immediate rather than secondary; "primary goals"; "a primary effect"; "primary sources"; "a primary interest"
a preliminary election where delegates or nominees are chosen (同)primary_election
one of the main flight feathers projecting along the outer edge of a birds wing (同)primary feather, primary quill
(astronomy) a celestial body (especially a star) relative to other objects in orbit around it
not derived from or reducible to something else; basic; "a primary instinct"
of the field of academic study in which one concentrates or specializes; "his major field was mathematics"
a commissioned military officer in the United States Army or Air Force or Marines; below lieutenant colonel and above captain
a university student who is studying a particular field as the principal subject; "she is a linguistics major"
the principal field of study of a student at a university; "her major is linguistics"
greater in number or size or amount; "a major portion (a majority) of the population"; "Ursa Major"; "a major portion of the winnings"
greater in scope or effect; "a major contribution"; "a major improvement"; "a major break with tradition"; "a major misunderstanding"
have as ones principal field of study; "She is majoring in linguistics"
of a scale or mode; "major scales"; "the key of D major"
of full legal age
of greater importance or stature or rank; "a major artist"; "a major role"; "major highways"
of greater seriousness or danger; "a major earthquake"; "a major hurricane"; "a major illness"
of the elder of two boys with the same family name; "Jones major"
be or become completely proficient or skilled in; "She mastered Japanese in less than two years" (同)get the hang
an original creation (i.e., an audio recording) from which copies can be made (同)master copy, original
an officer who is licensed to command a merchant ship (同)captain, sea_captain, skipper
an authority qualified to teach apprentices (同)professional
directs the work of others
someone who holds a masters degree from academic institution
have a firm understanding or knowledge of; be on top of; "Do you control these data?" (同)control
being or denoting a numerical quantity but not order; "cardinal numbers"
crested thick-billed North American finch having bright red plumage in the male (同)cardinal grosbeak, Richmondena Cardinalis, Cardinalis cardinalis, redbird
a variable color averaging a vivid red (同)carmine
(Roman Catholic Church) one of a group of more than 100 prominent bishops in the Sacred College who advise the Pope and elect new Popes
serving as an essential component; "a cardinal rule"; "the central cause of the problem"; "an example that was fundamental to the argument"; "computers are fundamental to modern industrial structure" (同)central, fundamental, key, primal
capital as contrasted with the income derived from it (同)corpus, principal sum
the original amount of a debt on which interest is calculated
the major party to a financial transaction at a stock exchange; buys and sells for his own account (同)dealer
the educator who has executive authority for a school; "she sent unruly pupils to see the principal" (同)school principal, head teacher, head
(criminal law) any person involved in a criminal offense, regardless of whether the person profits from such involvement

PrepTutorEJDIC

『第一の』,『主要な』 / 『初期の』,『初等の』,初級の / 『根本的な』,基本的な,本来の,直接的な / 《名詞の前にのみ用いて》(回路・コイル・巻き・電流などが)一次の / 原色(三原色の一つ) / 《米》=primary election
『大きい』(『多い』)『ほうの』,いっそう重要な / (音階が)長調の,長音階の / 《英》《昔の学校で同姓または兄弟生徒を区別するために姓の後につけて》年長の,兄の / 《しばしばM-》陸軍(空軍)少佐 / 《米》専攻科目;専攻学生 / 《the majors》《米》=major leagues / (科目を)専攻する《+『in』+『名』》
〈C〉『主人』,支配者(人),雇主;(動物の)飼い主 / 〈C〉(…を)自由に駆使できる人,如理する能力のある人《+『of』+『名』》 / 〈C〉(…の)『大家』,『名人』,精通者;師匠《+『of』(『in, at』)+『名』(do『ing』)》 / 〈C〉(商船の)船長 / 〈C〉(学校の男の)『先生』 / 《the M-, our M-》主キリスト(Jesus Christ) / 〈C〉《しばしばM-》修士;修士号 / 〈U〉《M-》《古》…様 / 〈C〉(レコードなどの)原盤,金型,(フイル専の)原板,ネガ / 《名詞の前にのみ用いて》 / 一本立ちで仕事のできる職人の,自営の / 主要な,最上の / 腕のいい,名人の,達人の / (機械・レコードなどの)親になる,元になる / 〈人・物〉‘を'『征服する』,支配する;〈感情・欲望〉‘を'『抑える』 / 〈特技・技術など〉‘を'修得する,‘に'熟達する
『基本的な』;主要な / 深紅(しんこう)色の / 〈C〉枢機卿(教皇の最高顧問;その数は70人で深紅色の衣装をまとう) / 〈U〉深紅色 / 〈C〉=cardinal number / (また『cardinal bird』)〈C〉(北米産の)ショウジョウコウカンチョウ
(重要性・地位・価値などが)『第1の』;おもな,主要な / 『長』,かしら;重要人物,主役 / 《しばしばP-》(小・中学校,高校の)『校長』;(特に《英》でcollegeの)学長,(時に)学寮長 / 《単数形で》(interest(利子),revenue(運用収益)と区別して)『元金』,基本財産

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/06/21 12:16:03」(JST)

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[Wiki en表示]

Look up primary in Wiktionary, the free dictionary.

Primary may refer to:

Arts and culture

Primary (film), 1960 documentary
Primary (band), from Australia
Primary (musician), a South Korean musician
"Primary" (song), by The Cure
Primary Music, Israeli record label
"Primary", a song by Spoon from the album Telephono
Primaries or primary beams, in E. E. Smith's science-fiction series Lensman

Mathematics

Prime power, positive integer power of a prime number
Primary decomposition, a decomposition into primary ideals
p-group, a group of prime power order
Primary ideals, a concept in commutative algebra

Politics

Primary election, an election by which a political party selects and nominates a candidate
Primary vote, the first vote total in the Electoral system of Australia

Science and mechanics

Primary (astronomy), the larger of two co-orbiting bodies
Primary mirror, principal light-gathering surface of a reflecting telescope
Primary circuit, electrical circuit in a transformer that receives current, as opposed to secondary circuit
Primary field, a type of field in conformal field theory
Power line, electric power transmission line fed to or from a transformer
Primary, the oldest period in the Geologic time scale (obsolete)
Primaries, remiges (wing feathers) in birds
The first stage in a thermonuclear explosive, may also be used alone in a lower-yield nuclear explosive, see nuclear weapon design

Other

Primary (LDS Church), children's Sunday School organization
Primary education, the first stage of compulsory education
Primary Flight Training, in the U.S. Navy
Primary FRCA, academic examination for anaesthetists in the U.K.
Primary school, a school providing primary education
Primary source, original materials

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. Primary sclerosing cholangitis in adults: Clinical manifestations and diagnosis
2. 原発性中枢神経系リンパ腫の臨床症状、病理学的特徴、および診断 clinical presentation pathologic features and diagnosis of primary central nervous system lymphoma
3. ST上昇型心筋梗塞におけるプライマリ経皮的冠動脈インターベンション：転帰の決定因子 primary percutaneous coronary intervention in acute st elevation myocardial infarction determinants of outcome
4. 原発不明の腺癌 adenocarcinoma of unknown primary site
5. 一次性咳嗽性頭痛 primary cough headache

English Journal

Impact of binge alcohol on mortality among people who inject drugs.

Johnson C1, Dong H1, Ahamad K2, Hayashi K3, Milloy MJ3, Kerr T3, Wood E3.
Addictive behaviors reports.Addict Behav Rep.2015 Dec 1;2:28-32.
INTRODUCTION: While the impacts of illicit drug use on mortality have been well described, the impact of poly-substance that includes alcohol has received less attention. We examined the impact of binge alcohol use on mortality among a cohort of people who inject drugs (PWID) in a Canadian setting.M
PMID 26097893

Timing and causes of death in septic shock.

Daviaud F1, Grimaldi D, Dechartres A, Charpentier J, Geri G, Marin N, Chiche JD, Cariou A, Mira JP, Pène F.
Annals of intensive care.Ann Intensive Care.2015 Dec;5(1):58. doi: 10.1186/s13613-015-0058-8. Epub 2015 Jun 20.
BACKGROUND: Most studies about septic shock report a crude mortality rate that neither distinguishes between early and late deaths nor addresses the direct causes of death. We herein aimed to determine the modalities of death in septic shock.METHODS: This was a 6-year (2008-2013) monocenter retrospe
PMID 26092499

Lower bone mineral density in Somali women living in Sweden compared with African-Americans.

Demeke T1, El-Gawad GA, Osmancevic A, Gillstedt M, Landin-Wilhelmsen K.
Archives of osteoporosis.Arch Osteoporos.2015 Dec;10(1):208. doi: 10.1007/s11657-015-0208-5. Epub 2015 Feb 19.
Vitamin D deficiency can lead to osteomalacia. Bone mineral density was lower in Somali women, living in Sweden, in relation to both the American and the African-American reference populations. The majority, 73 %, had vitamin D deficiency, and supplementation should be considered to prevent from ost
PMID 25693756

Comparison between remote sensing and a dynamic vegetation model for estimating terrestrial primary production of Africa.

Ardö J1.
Carbon balance and management.Carbon Balance Manag.2015 Mar 31;10:8. eCollection 2015.
BACKGROUND: Africa is an important part of the global carbon cycle. It is also a continent facing potential problems due to increasing resource demand in combination with climate change-induced changes in resource supply. Quantifying the pools and fluxes constituting the terrestrial African carbon c
PMID 25960765

Japanese Journal

数字は語る原油価格の下落は日本経済にはプラスさらなる金融緩和は不要 27.5% : ドバイ原油価格の11月の下落率(対前年同月比) : 「IMF Primary Commodity Prices」のドバイ原油のスポット価格(月平均)を基に算出

須田美矢子
週刊ダイヤモンド 103(1), 30, 2015-12-27
NAID 40020303028

Determinants of community structure in the global plankton interactome.

Lima-Mendez Gipsi,Faust Karoline,Henry Nicolas,Decelle Johan,Colin Sébastien,Carcillo Fabrizio,Chaffron Samuel,Ignacio-Espinosa J Cesar,Roux Simon,Vincent Flora,Bittner Lucie,Darzi Youssef,Wang Jun,Audic Stéphane,Berline Léo,Bontempi Gianluca,Cabello Ana M,Coppola Laurent,Cornejo-Castillo Francisco M,d'Ovidio Francesco,De Meester Luc,Ferrera Isabel,Garet-Delmas Marie-José,Guidi Lionel,Lara Elena,Pesant Stéphane,Royo-Llonch Marta,Salazar Guillem,Sánchez Pablo,Sebastian Marta,Souffreau Caroline,Dimier Céline,Picheral Marc,Searson Sarah,Kandels-Lewis Stefanie,Tara Oceans coordinators,Gorsky Gabriel,Not Fabrice,Ogata Hiroyuki,Speich Sabrina,Stemmann Lars,Weissenbach Jean,Wincker Patrick,Acinas Silvia G,Sunagawa Shinichi,Bork Peer,Sullivan Matthew B,Karsenti Eric,Bowler Chris,de Vargas Colomban,Raes Jeroen
Science 348(6237), 2015-05-22
… We identified interactions among grazers, primary producers, viruses, and (mainly parasitic) symbionts and validated network-generated hypotheses using microscopy to confirm symbiotic relationships. …
NAID 120005608039

Dispersion and coalescence of oil droplets by ultrasound and application for solvent extraction of gallium

Yasuda Keiji,Nguyen Tam,Okura Risa,Nakayama Shingo,Asakura Yoshiyuki,Jin Jiye
Jpn. J. Appl. Phys. 54(7S1), 07HE03, 2015-05-20
… The demulsification time decreased with increasing ultrasonic frequency and power because the primary and secondary acoustic forces of droplets become stronger. …
NAID 150000110847

On the Fermi-level pinning of InN grown surfaces

Le Binh,Zhao Songrui,Tran Nhung,Szkopek Thomas,Mi Zetian
Appl. Phys. Express 8(6), 061001, 2015-05-20
… Furthermore, this suggests that defects and incorporation of impurities on the grown surfaces of InN are the primary causes of the commonly measured accumulation of electrons and Fermi-level pinning. …
NAID 150000110733

Related Pictures

★リンクテーブル★

リンク元	「100Cases 33」「主要」「cardinal」「primarily」「major」
拡張検索	「primary amyloidosis」「primary extracapillary proliferative glomerulonephritis」「primary central nervous system lymphoma」「vestibular primary afferent fiber」

「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)