system

• n.

• 系、システム、体系、体制、方式

関

method、series、strain

　 　 　 　 　 　 　 　

WordNet

1. (physical chemistry) a sample of matter in which substances in different phases are in equilibrium; "in a static system oil cannot be replaced by water on a surface"; "a system generating hydrogen peroxide"
2. instrumentality that combines interrelated interacting artifacts designed to work as a coherent entity; "he bought a new stereo system"; "the system consists of a motor and a small computer"
3. a group of independent but interrelated elements comprising a unified whole; "a vast system of production and distribution and consumption keep the country going" (同)scheme
4. a complex of methods or rules governing behavior; "they have to operate under a system they oppose"; "that language has a complex system for indicating gender" (同)system of rules
5. a group of physiologically or anatomically related organs or parts; "the body has a system of organs for digestion"
6. a procedure or process for obtaining an objective; "they had to devise a system that did not depend on cooperation"
7. the living body considered as made up of interdependent components forming a unified whole; "exercise helped him get the alcohol out of his system"
8. (electronics) connection of components in such a manner that current flows first through one and then through the other; "the voltage divider consisted of a series of fixed resistors"
9. a periodical that appears at scheduled times (同)serial, serial publication
10. (mathematics) the sum of a finite or infinite sequence of expressions
11. (sports) several contests played successively by the same teams; "the visiting team swept the series"
12. a group of postage stamps having a common theme or a group of coins or currency selected as a group for study or collection; "the Post Office issued a series commemorating famous American entertainers"; "his coin collection included the complete series of
13. similar things placed in order or happening one after another; "they were investigating a series of bank robberies"
14. a way of doing something, especially a systematic way; implies an orderly logical arrangement (usually in steps)

PrepTutorEJDIC

1. 〈C〉(関連した部分から成る)『体系』,系統,組織[網],装置 / 〈C〉(教育・政治などの)『制度』,機構;《the~》体制 / 〈C〉(思想・学問などの)『体系』,学説 / 〈C〉(…の)『方法』,方式,やり方《+of doing》 / 〈U〉正しい方針(筋道,順序) / 〈U〉《the~》(身体の)組織,系統 / 〈U〉《the~,one's~》身体,全身
2. (関連のあるもの・同種のものの)(規則的な)『連続』,一続き《+『of』+『名』》 / (同種の貨幣・切手などの)一組(set)《+『of』+『名』》 / (テレビ番組などの)連続物;(出版物の)双書,シリーズ / (電気の)直列 / (電気が)直列の
3. 〈C〉(特に秩序だった)(…の)『方法』,方式《+『of』+『名』(do『ing』)》 / 〈C〉〈U〉(思考行・行為・行動の)きちょうめんさ;秩序,筋道

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/06 20:46:33」(JST)

wiki ja

[Wiki ja表示]

システム（英: system）は、相互に影響を及ぼしあう要素から構成される、まとまりや仕組みの全体。一般性の高い概念であるため、文脈に応じて系、体系、制度、方式、機構、組織といった多種の言葉に該当する。

それ自身がシステムでありながら同時に他のシステムの一部でもあるようなものをサブシステムという。

語源

「結合する」を意味するギリシャ語「σύστημα」（システィマ）を語源にもつ。この「σύστημα」は同じくギリシア語の 「σύνισταναι」（シニスタナイ）を元に作られた語句であるが、 これは「共に」を意味する「σύν」（シン）と「立てる」を意味する「ἵστημι」（イスティミ）を組み合わせた動詞である。

概念

「システム」という言葉に対する、厳密で統一的な定義は今のところ与えられていない。物質主義的に見れば、構造と機能すなわち機構の意味合いが強まる（構造機能主義についても参照されたし）。しかし、多くの場合以下のような性質を持つものであると考えられている。

• システムはいくつかの要素によって構成されている
• システムに含まれる全ての要素は、必ず自分以外の要素に対してなんらかの影響を及ぼす
• システムは時間、または時間に写像できる順序集合（全順序集合）に沿って動作する

システムの分類

システムの境界による分類

開かれた（オープンな）システム	システム外部からの入力を受け付けたり、システム外部への出力を行うシステム
閉じた（クローズドな）システム	システム内の構成要素の間でのみで動作し、外部との入出力がないシステム

システムの動作による分類

決定論的システム（ダイナミカルシステム）	システムの挙動や結果が、時間とその方向に対して一意に決まるシステム
非決定論（確率的決定論）的システム	システムの挙動や結果が、確率的要因に影響され、時間とその方向に対して一意に決まらないシステム

関連項目

• 一般システム理論
• 有機体論
• 状態、遷移
• 神経系、消化系、循環系…
• 力学系
• 制御理論
• 入力、出力

wiki en

[Wiki en表示]

For other uses, see System (disambiguation).

A schematic representation of a closed system and its boundary

A system is a set of interacting or interdependent components forming an integrated whole.

Every system is delineated by its spatial and temporal boundaries, surrounded and influenced by its environment, described by its structure and purpose and expressed in its functioning.

Fields that study the general properties of systems include systems science, systems theory, systems modeling, systems engineering, cybernetics, dynamical systems, thermodynamics, complex systems, system analysis and design and systems architecture. They investigate the abstract properties of systems' matter and organization, looking for concepts and principles that are independent of domain, substance, type, or temporal scale.

Some systems share common characteristics, including:

• A system has structure, it contains parts (or components) that are directly or indirectly related to each other;
• A system has behavior, it exhibits processes that fulfill its function or purpose;
• A system has interconnectivity: the parts and processes are connected by structural and/or behavioral relationships;
• A system's structure and behavior may be decomposed via subsystems and sub-processes to elementary parts and process steps;
• A system has behavior that, in relativity to its surroundings, may be categorized as both fast and strong.

The term system may also refer to a set of rules that governs structure and/or behavior. Alternatively, and usually in the context of complex social systems, the term institution is used to describe the set of rules that govern structure and/or behavior.

Etymology

The term is from the Latin word systēma, in turn from Greek σύστημα systēma, "whole compounded of several parts or members, system", literary "composition"

History

"System" means "something to look at". You must have a very high visual gradient to have systematization. In philosophy, before Descartes, there was no "system". Plato had no "system". Aristotle had no "system".

In the 19th century the first to develop the concept of a "system" in the natural sciences was the French physicist Nicolas Léonard Sadi Carnot who studied thermodynamics. In 1824 he studied the system which he called the working substance, i.e. typically a body of water vapor, in steam engines, in regards to the system's ability to do work when heat is applied to it. The working substance could be put in contact with either a boiler, a cold reservoir (a stream of cold water), or a piston (to which the working body could do work by pushing on it). In 1850, the German physicist Rudolf Clausius generalized this picture to include the concept of the surroundings and began to use the term "working body" when referring to the system.

One of the pioneers of the general systems theory was the biologist Ludwig von Bertalanffy. In 1945 he introduced models, principles, and laws that apply to generalized systems or their subclasses, irrespective of their particular kind, the nature of their component elements, and the relation or 'forces' between them.

Significant development to the concept of a system was done by Norbert Wiener and Ross Ashby who pioneered the use of mathematics to study systems.

In the 1980s the term complex adaptive system was coined at the interdisciplinary Santa Fe Institute by John H. Holland, Murray Gell-Mann and others.

System concepts

Environment and boundaries

Systems theory views the world as a complex system of interconnected parts. We scope a system by defining its boundary; this means choosing which entities are inside the system and which are outside – part of the environment. We then make simplified representations (models) of the system in order to understand it and to predict or impact its future behavior. These models may define the structure and/or the behavior of the system.

Natural and human-made systems

There are natural and human-made (designed) systems. Natural systems may not have an apparent objective but their outputs can be interpreted as purposes. Human-made systems are made with purposes that are achieved by the delivery of outputs. Their parts must be related; they must be “designed to work as a coherent entity” – else they would be two or more distinct systems.

Open system have input and output flows, representing exchanges of matter, energy or information with its surroundings.

Theoretical framework

An open system exchanges matter and energy with its surroundings. Most systems are open systems; like a car, coffeemaker, or computer. A closed system exchanges energy, but not matter, with its environment; like Earth or the project Biosphere2 or 3. An isolated system exchanges neither matter nor energy with its environment. A theoretical example of such system is the Universe.

Process and transformation process

An open system can also be viewed as a bounded transformation process, that is, a black box that is a process or collection of processes that transforms inputs into outputs. Inputs are consumed; outputs are produced. The concept of input and output here is very broad. E.g., an output of a passenger ship is the movement of people from departure to destination.

Subsystem

A subsystem is a set of elements, which is a system itself, and a component of a larger system.

System model

A system comprises multiple views. For the man-made systems it may be such views as concept, analysis, design, implementation, deployment, structure, behavior, input data, and output data views. A system model is required to describe and represent all these multiple views.

Systems architecture

A systems architecture, using one single integrated model for the description of multiple views such as concept, analysis, design, implementation, deployment, structure, behavior, input data, and output data views, is a kind of system model.

Elements of a system: an example

Following are considered as the elements of a system in terms of Information systems: –

1. Input
2. Output
3. Processor
4. Control
5. Feedback
6. Boundary and interface
7. Environment

1. INPUT: Input involves capturing and assembling elements that enter the system to be processed. The inputs are said to be fed to the systems in order to get the output. For example, input of a 'computer system' is an input unit consisting of various input devices like a keyboard, mouse, joystick etc.

2. OUTPUT: Those elements that exists in the system due to the processing of the inputs is known as output. A major objective of a system is to produce output that has value to its user. The output of the system maybe in the form of cash, information, knowledge, reports, documents etc. the system is defined as output is required from it. It is the anticipatory recognition of output that helps in defining the input of the system. For example, output of a 'computer system' is an output unit consisting of various output devices like the screen and the printer etc.

3. PROCESSOR(S): The processor is the element of a system that involves the actual transformation of input into output. It is the operational component of a system. For example, processor of a 'computer system' is central processing unit that further consists of arithmetic and logic unit(ALU), control unit and memory unit etc.

4. CONTROL: The control element guides the system. It is the decision-making sub-system that controls the pattern of activities governing input,processing and output. It also keeps the system within the boundary set. For example,control in a 'computer system' is maintained by the control unit that controls and coordinates various units by means of passing different signals through wires.

5. FEEDBACK: Control in a dynamic system is achieved by feedback. Feedback measures output against a standard input in some form of cybernetic procedure that includes communication and control. The feedback may generally be of three types viz., positive, negative and informational. The positive feedback motivates the system. The negative indicates need of an action. The feedback is a reactive form of control. Outputs from the process of the system are fed back to the control mechanism. The control mechanism then adjusts the control signals to the process on the basis of the data it receives. Feedforward is a protective form of control. For example, in a 'computer system' when logical decisions are taken, the logic unit concludes by comparing the calculated results and the required results.

6. BOUNDARY AND INTERFACE: A system should be defined by its boundaries - the limits that identify its components,processes and interrelationships when it interfaces with another system. For example, in a 'computer system' there is a boundary for the number of bits, the memory size etc. that is responsible for different levels of accuracy on different machines (like 16-bit, 32-bit etc.). The interface in a 'computer system' may be a CUI (Character User Interface) or a GUI (Graphical User Interface).

7. ENVIRONMENT: The environment is the 'supersystem' within which an organisation operates.It excludes input,processes and outputs. It is the source of external elements that impinge on the system. For example,if the results calculated/the output generated by the 'computer system' are to be used for decision-making purposes in the factory,in a business concern,in an organisation,in a school,in a college or in a government office then the system is same but its environment is different.

Types of systems

Systems are classified in different ways:

1. Physical or abstract systems.
2. Open or closed systems.
3. 'Man-made' information systems.
4. Formal information systems.
5. Informal information systems.
6. Computer-based information systems.
7. Real-time system.

Physical systems are tangible entities that may be static or dynamic in operation.

An open system has many interfaces with its environment. i.e. system that interacts freely with its environment, taking input and returning output. It permits interaction across its boundary; it receives inputs from and delivers outputs to the outside. A closed system does not interact with the environment; changes in the environment and adaptability are not issues for closed system.

Analysis of systems

Evidently, there are many types of systems that can be analyzed both quantitatively and qualitatively. For example, with an analysis of urban systems dynamics, [A.W. Steiss] defines five intersecting systems, including the physical subsystem and behavioral system. For sociological models influenced by systems theory, where Kenneth D. Bailey defines systems in terms of conceptual, concrete and abstract systems; either isolated, closed, or open, Walter F. Buckley defines social systems in sociology in terms of mechanical, organic, and process models. Bela H. Banathy cautions that with any inquiry into a system that understanding the type of system is crucial and defines Natural and Designed systems.

Systems that are purposed by man inherently have a major flaw they must have a starting assumption(s) in which this starting assumption(s) is used to build further knowledge upon. This starting assumption(s) is not inherently bad, but it is used as the foundation of the system and as it is assumed to be true, and not definitively so then the system is not as structurally sound as perceived to be. For example in Geometry (a subsystem of Math) this is highly evident when one goes through the process of taking theorems and extrapolates proofs from those set theorems.

In offering these more global definitions, the author maintains that it is important not to confuse one for the other. The theorist explains that natural systems include sub-atomic systems, living systems, the solar system, the galactic system and the Universe. Designed systems are our creations, our physical structures, hybrid systems which include natural and designed systems, and our conceptual knowledge. The human element of organization and activities are emphasized with their relevant abstract systems and representations. A key consideration in making distinctions among various types of systems is to determine how much freedom the system has to select purpose, goals, methods, tools, etc. and how widely is the freedom to select itself distributed (or concentrated) in the system.

George J. Klir maintains that no "classification is complete and perfect for all purposes," and defines systems in terms of abstract, real, and conceptual physical systems, bounded and unbounded systems, discrete to continuous, pulse to hybrid systems, etc. The interaction between systems and their environments are categorized in terms of relatively closed, and open systems. It seems most unlikely that an absolutely closed system can exist or, if it did, that it could be known by us. Important distinctions have also been made between hard and soft systems. Hard systems are technical in nature and amenable to methods such as systems engineering, operations research and quantitative systems analysis. Soft systems involve people and organisations and are commonly associated with concepts developed by Peter Checkland and Brian Wilson through Soft Systems Methodology (SSM) involving methods such as action research and emphasizing participatory designs. Where hard systems might be identified as more "scientific," the distinction between them is actually often hard to define.

Cultural system

Main article: Cultural system

A cultural system may be defined as the interaction of different elements of culture. While a cultural system is quite different from a social system, sometimes both systems together are referred to as the sociocultural system. A major concern in the social sciences is the problem of order.

Economic system

Main article: Economic system

An economic system is a mechanism (social institution) which deals with the production, distribution and consumption of goods and services in a particular society. The economic system is composed of people, institutions and their relationships to resources, such as the convention of property. It addresses the problems of economics, like the allocation and scarcity of resources.

Application of the system concept

Systems modeling is generally a basic principle in engineering and in social sciences. The system is the representation of the entities under concern. Hence inclusion to or exclusion from system context is dependent of the intention of the modeler.

No model of a system will include all features of the real system of concern, and no model of a system must include all entities belonging to a real system of concern.

Systems in information and computer science

In computer science and information science, system is a software system which has components as its structure and observable inter-process communications as its behavior. Again, an example will illustrate: There are systems of counting, as with Roman numerals, and various systems for filing papers, or catalogues, and various library systems, of which the Dewey Decimal System is an example. This still fits with the definition of components which are connected together (in this case in order to facilitate the flow of information).

System can also be used referring to a framework, be it software or hardware, designed to allow software programs to run, see platform.

Systems in engineering and physics

In engineering and physics, a physical system is the portion of the universe that is being studied (of which a thermodynamic system is one major example). Engineering also has the concept of a system that refers to all of the parts and interactions between parts of a complex project. Systems engineering refers to the branch of engineering that studies how this type of system should be planned, designed, implemented, built, and maintained.

Systems in social and cognitive sciences and management research

Social and cognitive sciences recognize systems in human person models and in human societies. They include human brain functions and human mental processes as well as normative ethics systems and social/cultural behavioral patterns.

In management science, operations research and organizational development (OD), human organizations are viewed as systems (conceptual systems) of interacting components such as subsystems or system aggregates, which are carriers of numerous complex business processes (organizational behaviors) and organizational structures. Organizational development theorist Peter Senge developed the notion of organizations as systems in his book The Fifth Discipline.

Systems thinking is a style of thinking/reasoning and problem solving. It starts from the recognition of system properties in a given problem. It can be a leadership competency. Some people can think globally while acting locally. Such people consider the potential consequences of their decisions on other parts of larger systems. This is also a basis of systemic coaching in psychology.

Organizational theorists such as Margaret Wheatley have also described the workings of organizational systems in new metaphoric contexts, such as quantum physics, chaos theory, and the self-organization of systems.

Pure logical systems

There is also such a thing as a logical system. The most obvious example is the calculus developed simultaneously by Leibniz and Isaac Newton. Another example is George Boole's Boolean operators. Other examples have related specifically to philosophy, biology, or cognitive science. Maslow's Hierarchy of Needs applies psychology to biology by using pure logic. Numerous psychologists, including Carl Jung and Sigmund Freud have developed systems which logically organize psychological domains, such as personalities, motivations, or intellect and desire. Often these domains consist of general categories following a Corollary such as a Theorem. Logic has been applied to categories such as Taxonomy, Ontology, Assessment, and Hierarchies.

Systems applied to strategic thinking

In 1988, military strategist, John A. Warden III introduced his Five Ring System model in his book, The Air Campaign contending that any complex system could be broken down into five concentric rings. Each ring—Leadership, Processes, Infrastructure, Population and Action Units—could be used to isolate key elements of any system that needed change. The model was used effectively by Air Force planners in the First Gulf War. In the late 1990s, Warden applied this five ring model to business strategy.

See also

Examples of systems

• List of systems (WikiProject)
• Physical system
• Conceptual system
• Complex system
• Formal system
• Information system
• Meta-system
• Solar System
• Systems in human anatomy
• Market

Theories about systems

• Chaos theory
• Cybernetics
• Systems ecology
• Systems engineering
• Systems psychology
• Systems theory
• Thermodynamic systems
• Control theory

Related topics

• Glossary of systems theory
• Complexity theory and organizations
• Black box
• System of systems (engineering)
• Systems art

References

Bibliography

• Alexander Backlund (2000). "The definition of system". In: Kybernetes Vol. 29 nr. 4, pp. 444–451.
• Kenneth D. Bailey (1994). Sociology and the New Systems Theory: Toward a Theoretical Synthesis. New York: State of New York Press.
• Bela H. Banathy (1997). "A Taste of Systemics", ISSS The Primer Project.
• Walter F. Buckley (1967). Sociology and Modern Systems Theory, New Jersey: Englewood Cliffs.
• Peter Checkland (1997). Systems Thinking, Systems Practice. Chichester: John Wiley & Sons, Ltd.
• Michel Crozier, Erhard Friedberg (1981). Actors and Systems, Chicago University Press.
• Robert L. Flood (1999). Rethinking the Fifth Discipline: Learning within the unknowable. London: Routledge.
• George J. Klir (1969). Approach to General Systems Theory, 1969.
• Brian Wilson (1980). Systems: Concepts, methodologies and Applications, John Wiley
• Brian Wilson (2001). Soft Systems Methodology—Conceptual model building and its contribution, J.H.Wiley.
• Beynon-Davies P. (2009). Business Information + Systems. Palgrave, Basingstoke. ISBN 978-0-230-20368-6

External links

• Definitions of Systems and Models by Michael Pidwirny, 1999–2007.
• Publications with the title "System" (1600–2008) by Roland Müller.
• Definitionen von "System" (1572–2002) by Roland Müller, (most in German).
• Theory and Practical Exercises of System Dynamics by Juan Martin (also in Spanish).

UpToDate Contents

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• System - definition of system by The Free Dictionary

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リンク元	「100Cases 13」「100Cases 48」「series」「method」「系」
拡張検索	「photosystem I」「primary central nervous system lymphoma」

「100Cases 13」

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☆case13　手の筋力の低下

■glossary

brisk adj. (人・態度が)活発な、元気のよい、きびきびした。ぶっきらぼうな、素っ気ない。(商売が)活況の(⇔dull)。小気味のよい、(大気など)爽快な、気持ちのよい。(味などが)ピリッとする。鋭い。(飲料が)盛んに泡立つ

dysarthria n. difficulty in articulating words due to disease of the central nervous system　構音障害

dysphasia n. loss of or deficiency in the power to use or understand language as a result of injury to or disease of the brain　失語症、言語障害

multidisciplinary adj. 集学的な

gastrostomy 胃瘻造設術

feeding gastrostomy n. Surgery A procedure in which an opening is created in the anterior wall of the stomach to allow suction decompression and improved respiratory function by eliminating the need for a nasogastric feeding tube

■症例

67歳、男性　元大学講師(retired university lecturer)

主訴：左手の筋力低下と筋萎縮

現病歴：左手を使った労作後に左手の筋力が低下する(例えば、ドライバーを使った後など)。前腕の筋に疝痛をみとめる。発話はわずかに流暢であり(slight slurred)、水を飲んだあとで窒息しだす。服用薬はシンバスタチン、アスピリン、アテノロール。喫煙はしない。飲酒は週にワインのボトルを1本あける。

既往歴：高血圧が15年間続いている。3年前に心筋梗塞。

家族歴：妻と暮らしている。大きくなった2人の子供がいる。

・診察 examination

　血圧：146/88 mmHg。心血管系、呼吸器系、腹部に異常を認めない。上肢に萎縮を認める。特に左手に著しい萎縮を認める。両側の上腕の筋にいくらか線維性筋攣縮を認める。筋力は左で全般的に低下(globaly reduced)、右手でわずかに低下。筋緊張は正常。上腕二頭筋反射・上腕三頭筋反射は両側ともに活発に認められる(brisk)。感覚喪失(sensory loss)は認めない。わずかに構音障害を認める

■キーワード＆着目するポイント

　筋萎縮、線維性筋攣縮、感覚喪失なし

■解説

(第1パラグラフ)　疫学

・この男は運動ニューロン疾患。

・この疾患は原因不明の疾患で、脊髄、脳神経核、運動皮質に影響を及ぼす。

・この病気は普通50-70歳で出現する。

(第2パラグラフ) 症状

・筋力低下と筋萎縮は一側の手か腕にあらわれるのが一般的　←　両側性でないということか。

・筋力低下は運動後に最も顕著に表れる

・前腕の疝痛は疾患の初期に一般的である。

・患者は下肢の筋力低下あるいは構音障害や言語障害を訴えてやってくることがある。

・この病態の特徴的な生理的徴候は線維性攣縮(筋束の不規則で早い収縮。下位運動ニューロンの障害を示唆)　→　下肢の運動ニューロン損傷による筋肉の脱神経が原因

・反射は著明　→　皮質運動ニューロンの喪失による。

・感覚喪失はない

(第3パラグラフ)　鑑別

・進行例では診断は容易だが、初期ではmore problematic。

・疲労で悪化する四肢の筋力低下は「重症筋無力症」と混乱する。

・老人における失語症と構音障害の原因は、「脳血管障害による偽性球麻痺」であることがより一般的。

・上肢に感覚障害を伴わない筋萎縮、線維束攣縮を呈する他の疾患として「頚髄症」がある。

・「外傷」や「心尖部肺癌(パンコースト腫瘍)」による腕神経叢の損傷で腕に症状があらわれるかもしれない。

・末梢運動神経優位のニューロパチーは対側性の筋力低下と反射の低下というパターンを起こす。　←　？

(第4パラグラフ)　症状・経過

・運動ニューロン疾患は進行性で不治の病態

・足の痙性麻痺を発現する傾向がある

・球麻痺は失語症と構音障害を起こす

・肛門括約筋は普通影響を受けない

・知能は一般的に影響を受けない

(第5パラグラフ)　治療・管理

・この病態に対して治癒的な治療法はない

・発症から平均生存期間は2-4年

・医師は診断と予後について患者と家族に説明しなければならない。

・集学的なチームはサポートを提供しなければいけない。

・病気が進行して発話が悪くなったとき、コンピュータの使用で会話は補助されうる。

・feeding gastrostomyは十分なカロリーの摂取を可能にするために必要かもしれない。

・非侵襲的な呼吸器は呼吸不全を補助するために使われうる

・普通、気管支肺炎で死亡する

■運動ニューロン疾患とは？

運動ニューロン疾患 motor neuron disease MND

■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

「100Cases 48」

　　[★]

44歳　女性

主訴：頭痛

現病歴：前年より頭痛が続いていた。頭痛が増強してきたたため、当院受診となった。

なお頭痛は両側性であり、夜に向かって増悪し、視覚障害、または嘔気は伴わない。その他に食欲減退と早朝覚醒を伴う睡眠障害がある。

嗜好歴：喫煙 15/day、飲酒 15units/week (350mlの缶ビール 10本)

社会歴：パートタイムのoffice cleaner。離婚している。2人の子供(10歳と12歳)の世話をしている。

家族歴：母が脳腫瘍で死亡。

既往歴：皮疹と過敏性腸症候群(当時はそれ以外になにも問題なかった)

服用薬：頭痛に対してパラセタモールかイブプロフェン

身体所見 examination

全身：引きこもっているように見える(withdrawn)。

脈拍：74/分、整。血圧：118/76 mmHg。

システミックレビュー：心血管系、呼吸器系・消化器系、胸部および網内系は正常。神経学所見は正常。眼底所見は正常

Q1. 診断は？

Q2. 鑑別診断は？

Q3. 管理方法は？

• 明確な診断をし、患者の信念と症状についての心配について扱うことは重要
• ある状況下では再保障のために頭部CTをしなければならないかも知れない。
• うつの質問はさらに検索される必要があり、抗うつ薬の処方が必要かも知れない。

■鑑別診断

片頭痛　問診：(典型例では)眼症状に続く片側性、拍動性の頭痛で、悪心・嘔吐もあり、数時間持続。家族歴。

群発頭痛　問診：眼窩の激烈な痛み(行動不能になる程度)。

占拠病変による頭痛

その他　

　副鼻腔炎　問診：頭重感、鼻汁の有無、発熱。診察：上顎洞・前頭洞の圧痛を触診、扁桃腺視診、頚部リンパ節触診

　歯牙障害　歯科コンサルト

　頚椎症　加齢による退行性変性を考慮しつつ、頚部の可動制限、疼痛、凝り感を問診。単純X線、MRIで診断。

　緑内障　問診：視野。検査：視力、眼圧、視野、視神経乳頭形態、隅角検査

　外傷後頭痛　外傷の既往歴、頭皮の視診

□unit

1 unit = 10 ml of ethanol

□350ml アルコール5%

350x0.05/10=1.75 unit

■glossary

withdrawn

　v.

　　withdrawのpp.

　adj.

　　1.(人が)引きこもった、内にこもった、世間と交わらない

　　She looks withdrawn.

　　2.人里離れた、遠くにある

　　3.(商品などが市場から)回収された

　　4.(競争などから)撤退した

reticuloendothelial system

細網内皮系 = 網内系

dental disorder 歯牙障害

bereavement　

　n.

　　死別

sneezing

「series」

　　[★]

• n.

• 系列、一連、連続、シリーズ、(分類学)系

It is not a rare disease; in one series it accounted for between 5 and 24 admissions per year at a pediatric hospital.(HIM.2128)

関

a line of、a sequence of、a series of、barrage、consecutive、continually、continue、continuous、lineage、paradigmatic、sequence、sequential、serial、strain、system

　 　 　 　 　 　 　

「method」

　　[★]

• n.

• 方法、手法、測定法、測定方法、方式

関

assay、fashion、law、manner、means、method for measurement、-metry、mode、procedure、process、system、technique、way

　 　

「系」

　　[★]

• system
• 系統 line

• system、strain、(分類学)series

関

一連、菌株、緊張、系統、系列、シリーズ、歪み、連続、システム、体系、体制、方式、筋挫傷

「photosystem I」

　　[★]

光化学系I

関

photosystem I protein complex

「primary central nervous system lymphoma」

　　[★]

原発性中枢神経系リンパ腫