WordNet

without sharpness or clearness of edge or point; "the dullness of the pencil made his writing illegible" (同)bluntness
a lack of visual brightness; "the brightness of the orange sky was reflected in the dullness of the orange sea"
lack of sensibility; "there was a dullness in his heart"; "without him the dullness of her life crept into her work no matter how she tried to compartmentalize it."
the quality of being slow to understand (同)obtuseness
the quality of lacking interestingness; "the stories were of a dullness to bring a buffalo to its knees"
continuously varying; "taffeta with shifting colors"
changing position or direction; "he drifted into the shifting crowd"; "their nervous shifting glances"; "shifty winds" (同)shifty
(of soil) unstable; "shifting sands"; "unfirm earth" (同)unfirm

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鈍さ,鈍感,不活発,退屈

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/09/26 12:39:28」(JST)

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"Dullness" redirects here. For the goddess in The Dunciad, see Dulness.

In medicine, shifting dullness refers to a sign, elicited on physical examination, for ascites (fluid in the peritoneal cavity).^[1]

The two steps of shifting dullness. Percussion of the green section shifts from a dull note to a tympanic note after the patient changes from supine to lateral decubitus position.

To perform the test, first the midline of the abdomen is percussed eliciting a resonant note due to gas in the bowel. If there is no area of resonance then the test cannot be performed. Percussion is then moved progressively more lateral (away from the examiner) - this is depicted as the red section in the diagram on the right - until the note becomes dull, as depicted by the green section. The examiner's index finger remains on the resonant side, and the middle finger remains on the dull side, straddling the fluid-air level. The patient is then asked to lean on their right lateral side (assuming the examiner used the traditional right sided approach). This stabilises the patient by sandwiching them between the examiner's hands and body. It is imperative that the examiner's fingers stay in the same position. After waiting sufficient time for any fluid to shift (up to 30 seconds), the dull position is then percussed. It may now be resonant. The percussion may now be performed down the anterior side until a new dullness is found. To confirm a positive result it is recommended that the now resonant area become dull again when the patient is back in the supine position.

If the borders between tympanic (resonant) and dull notes remain the same, the person probably does not have ascites, or has less than 2 litres of free fluid present.^[2] If the fluid causing the dullness was not free, then the air-fluid level would not move. Shifting dullness is usually present if the volume of ascitic fluid is greater than 1500 ml^{[citation needed]}. If low volume ascites is suspected, then an attempt to elicit the puddle sign may be performed.

References[edit]

^ Murray Longmore, Ian B. Wilinson, Edward H. Dawvidson, Alexander Foulkes and Ahmad R. Mafi Oxford Handbook of Clinical Medicine 8thEdition Oxford University Press 2010 ISBN 978-0-19-923217-8
^ Clark, ed. by Parveen Kumar, Michael (2005). Kumar and Clark clinical medicine (6th ed. ed.). Edinburgh [etc.]: Elsevier Saunders. p. 267. ISBN 0702027642.

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1. 成人における腹水の診断および評価 evaluation of adults with ascites
2. 腹痛を有する成人における既往歴および身体的診察 history and physical examination in adults with abdominal pain
3. 小児における浮腫の評価およびマネージメント evaluation and management of edema in children
4. 乳糜性、血性、および膵性腹水 chylous bloody and pancreatic ascites
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English Journal

Characterization of the syndrome of acute liver failure caused by metastases from breast carcinoma.

Mogrovejo E1, Manickam P, Amin M, Cappell MS.
Digestive diseases and sciences.Dig Dis Sci.2014 Apr;59(4):724-36. doi: 10.1007/s10620-013-2943-z. Epub 2013 Dec 27.
AIM: To characterize syndrome of acute liver failure (ALF) from metastatic breast cancer to promote premortem diagnosis. Up to now, only 25 % of the reported 32 cases of this syndrome were diagnosed premortem.METHODS: Cases identified by computerized literature review and review of files maintained
PMID 24370782

A huge renal cyst mimicking ascites: a case report.

Riyach O1, Ahsaini M, Tazi K, Tazi MF, Mellas S, El Ammari JE, Khallouk A, El Fassi MJ, Farih MH.
BMC research notes.BMC Res Notes.2014 Jan 15;7:39. doi: 10.1186/1756-0500-7-39.
BACKGROUND: Renal cysts are common in old patients, and usually remain untreated. Giant renal cyst measuring more than 15 cm in diameter and containing more than 1500 mls of serous fluid are rarely seen. We report a case of a 75-year-old man with a giant right renal cyst.CASE PRESENTATION: A 75-year
PMID 24428865

A rare large symptomatic simple hepatic cyst.

Banerjee R1, Lakhoo K.
BMJ case reports.BMJ Case Rep.2013 Sep 2;2013. pii: bcr2013200094. doi: 10.1136/bcr-2013-200094.
A fit and well 4-year-old girl presented with a 1-year history of abdominal distension, pain and vomiting with signs of non-shifting dullness on the right side of the abdomen. An abdominal CT revealed a 19 cm epigastric cyst that did not appear to connect to any solid organ and was therefore thought
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Japanese Journal

睡眠時刻の推移にともなう生理・心理諸機能の変動とそれらの関係

斉藤良夫,松本一弥
産業医学 30(3), 196-205, 1988-05-20
… On the 2nd d when the shifting was started after the subjects had slept from 00:00 to 08:00 and on the 3rd d after sleeping h of 06:00 to 14:00, the variations of sublingual temperature, pulse rate and CFF showed a pattern of circadian rhythm. … The variation of SFF (the scale of "sleepiness and dullness") was similar to that of CFF, although the change of the score was in the opposite direction. …
NAID 110006645491