single S2

単一II音

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• 1. 心音の聴診auscultation of heart sounds [show details]
  …occurs in Eisenmenger syndrome with VSD and in patients with a single ventricle. However, a truly single S2 is rare. An apparently single S2 usually results from the inability to hear or record P2 due …
• 2. 心雑音が認められる乳児や小児へのアプローチapproach to the infant or child with a cardiac murmur [show details]
  …outlined with normal patients produce a single S2. Occasionally, patients with severe aortic stenosis can also have this feature. Intensity — The intensity of S2 depends on the pressure that closes the …
• 3. 脊髄麻酔：手技spinal anesthesia technique [show details]
  … The splanchnic component of the parasympathetic nervous system travels in the ventral roots of S2 to S4 and supplies the organs of the pelvis,… Dermatomes – A dermatome is defined as the cutaneous area supplied by a single spinal nerve root The term "spinal level" refers…
• 4. 筋層非浸潤性膀胱癌の再発癌あるいは残存癌のマネージメントmanagement of recurrent or persistent non muscle invasive bladder cancer [show details]
  …lesions on cystoscopy. Single-dose perioperative intravesical chemotherapy is most efficacious for low-grade lesions at the time of initial diagnosis. The benefit of a single dose of perioperative chemotherapy …
• 5. Multiple myeloma: Regimens used for relapsed or refractory diseasemultiple myeloma regimens used for relapsed or refractory disease [show details]
  …tolerate three-drug regimens. The following sections describe the efficacy and toxicity of single agents in MM. Single agent therapy is used occasionally in frail patients who are unable to tolerate steroids …

English Journal

• Anti-diarrhea effects and identification of Musca domestica larvae low molecular weight peptides (LMWP).

• Chu F, Jin X, Ma H.
• Journal of pharmaceutical and biomedical analysis. 2019 Sep;173()162-168.
• Musca domestica larvae have been used clinically to cure children malnutritional stagnation and low molecular weight peptides (LMWP) of Musca domestica larvae showed more useful bioactivities. But there is no report on anti-diarrhea effects and identification of the LWMP. The purposes of this study
• PMID 31146171

• Ultrastructure of the anterior adhesive apparatus of the gill parasite Macrogyrodactylus clarii and skin parasite M. congolensis (Monogenea; Gyrodactylidae) from the catfish Clarias gariepinus.

• El-Naggar MM, Arafa SZ, El-Abbassy SA, Kearn GC, Cable J.
• Parasitology international. 2019 Aug;71()151-159.
• Transmission electron microscopy (TEM) was used for the first time to study the anterior adhesive apparatus of the monogeneans Macrogyrodactylus clarii Gussev, 1961 and M. congolensis (Prudhoe, 1957) Yamaguti, 1963 inhabiting gills and skin respectively of the same catfish Clarias gariepinus. Despit
• PMID 30853449

• Kinesiologic tape for labor pain control: Randomized controlled trial.

• Miquelutti MA, Silveira C, Cecatti JG.
• Physiotherapy theory and practice. 2019 Jul;35(7)614-621.
• Array p
• PMID 29608125

Japanese Journal

• 日本獸醫學雜誌(The Japanese Journal of Veterinary Science)

• KATO Atsushi,OGURO Shiori,KURIHARA Yukino,KOJIMA Hiroe,INAYOSHI Yujin,LIN Zhifeng,SASAKAWA Chihiro,SHIBUYA Kazumoto
• Ｔｈｅ　Ｊｏｕｒｎａｌ　ｏｆ　Ｖｅｔｅｒｉｎａｒｙ　Ｍｅｄｉｃａｌ　Ｓｃｉｅｎｃｅ 81(4), 636-640, 2019
• … <p>Genotyping of avian infectious bronchitis virus (IBV) was performed on trachea and kidney samples of six chickens obtained from a single farm in Japan. … Using two primer sets targeting the spike (S) protein gene, the S1 and S2 regions of DNA fragments were amplified. … Sequences of amplified S2 fragments differed between trachea and kidney samples. …
• NAID 130007638797

• Yonago Acta Medica

• Okazaki Tetsuya,Kawashima Yuki,Takano Shuichi,Kai Masachika,Adachi Kaori,Yamamoto Osamu,Nanba Eiji,Maegaki Yoshihiro,Saito Yoshiaki,Sugita Kazunari,Nosaka Kanae,Ohno Koyo,Hiraoka Yumie,Kasagi Noriko,Ebiki Mitsutaka,Narai Satoshi
• Yonago Acta Medica 62(1), 159-162, 2019
• … A heterozygous single nucleotide variant in the <i>SHOC2</i> … G, p.S2G) was identified. …
• NAID 130007626298

• Repeated avian infectious bronchitis virus infections within a single chicken farm

• KATO Atsushi,OGURO Shiori,KURIHARA Yukino,KOJIMA Hiroe,INAYOSHI Yujin,LIN Zhifeng,SASAKAWA Chihiro,SHIBUYA Kazumoto
• Ｔｈｅ　Ｊｏｕｒｎａｌ　ｏｆ　Ｖｅｔｅｒｉｎａｒｙ　Ｍｅｄｉｃａｌ　Ｓｃｉｅｎｃｅ, 2019
• … <p>Genotyping of avian infectious bronchitis virus (IBV) was performed on trachea and kidney samples of six chickens obtained from a single farm in Japan. … Using two primer sets targeting the spike (S) protein gene, the S1 and S2 regions of DNA fragments were amplified. … Sequences of amplified S2 fragments differed between trachea and kidney samples. …
• NAID 130007607508

Related Links

• Single s2 room｜HOTEL TOYOTA CASTLE official site

Only 2 minutes from Toyotashi Station, Hotel Toyota Castle is surrounded with every kind of amenity. Breakfast buffet with many choices,Decked out guest rooms,Fine dining for gourmet palettes -HOTEL TOYOTA CASTLE official ...

• Cardiac Second Sounds | Stanford Medicine 25 | Stanford ...

The cardiac second sounds can provide a number of valuable clues to what is going on with the heart. Diagnoses like pulmonary hypertension, severe aortic stenosis, an atrial septal defect and delays in the electrical conduction can ...

• Single Second Heart Sound S2 - USMLE Forums

While auscultation of a baby with congenital heart disease, you noticed single S2, which of the following is NOT among your differential? 1. TOF. ... confused between truncusarteriosus and pda..but i thinkit is pda which has no single ...

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★リンクテーブル★

リンク元	「II音」「単一II音」
関連記事	「single」「S2」「sing」「S」

「II音」

　　[★]

英

second heart sounds, S2

関

心音

まとめ

II音亢進	IIA	高血圧	AR	動脈硬化
	IIP	肺高血圧	PR	MS
II音減弱	IIA	低血圧	AS
	IIP		PS

II音増大

MSとASとでは、同じstenosisでも心音の大きさに関与の仕方が違うんですね。

• (体循環)高血圧症、肺動脈高血圧症。(PHD.35)

拡張期における大動脈圧、肺動脈圧が高い　→　弁に衝突する血液の流速が早い　→　弁の閉鎖音が大きい

• 動脈硬化の強いとき

• 大動脈弁が閉じるとき、拡張期早期 back pressureが高い？

• 大動脈弁閉鎖不全症 AR

• 拡張期に大動脈弁を挟んだback pressureが高いから？

• 肺動脈弁閉鎖不全症 PR

• 心室中隔欠損症

• 右室へのvolume load。PHで顕著

II音減弱

• 大動脈弁狭窄症(AS)、肺動脈弁狭窄症(PS)。(PHD.35)

• 駆出できる血液量がへるから？

分裂音

呼吸性分裂

PHD.33-35

• 生理的状態では、

		横隔膜の相対的位置	II音
呼気	expiration	￣	｜	single sound
吸気	inspiration	＿	｜　｜	splitting sound

• (1)吸気時には、肺の血管抵抗性が低下　→　拡張期におけるP弁へのback pressureは呼気時と比べ比較的低下する　→P弁の開放時間が延長
• (2)吸気時には、肺静脈が拡張　→　左房・左室への血液還流量が減少　→　左室を充満する血液量減少　→　一回拍出量減少　→　駆出時間の短縮　→　A弁の開放時間が短縮

• 心音#まとめ

widened splitting

• right bundle branch block(RBBB), pulmonic stenosis(PS)

IIAが早まる：MR, VSD

IIPが遅れる：RBBB, PS, pulmonary hypertension

固定性分裂 fixed splitting

• atrial septal defect (ASD)

奇異性分裂 paradoxical splitting

• left bundle branch block(LBBB), advanced aortic stenosis(AS), 高血圧？

単一II音 single S2

• Eisenmenger症候群、Fallot四徴症、肺動脈狭窄・肺動脈弁閉鎖

「単一II音」

　　[★]

同

single S2

関

II音

原因

• Eisenmenger症候群：肺高血圧のために肺動脈弁の閉鎖音が大きくなり、大動脈弁閉鎖音に近づくため。
• Fallot四徴症：肺動脈への駆出路が狭窄しており、かつ肺動脈弁は低形成であるためP2成分は小さく聴取できない。そのためA2成分のみS2として聴くことになる。(PHD.393)
• 肺動脈狭窄、肺動脈弁閉鎖

「single」

　　[★]

• adj.

• 単一の、一回の、単、(薬物投与)単回の

• n.

• 個人、選抜する

関

individual、mono、private、select、simple、unity

　 　 　 　 　 　 　

「S2」

　　[★]

• II音 second heart sounds
• 肝臓の後外側区域

「sing」

　　[★]

• v.

• 歌う

過去sang-過去分詞sung

　 　 　 　

「S」

　　[★]

• セリン serine
• 胸骨上縁