WordNet

strike (the top part of a ball in golf, baseball, or pool) giving it a forward spin
the first half of an inning; while the visiting team is at bat; "a relief pitcher took over in the top of the fifth" (同)top of the inning
covering for a hole (especially a hole in the top of a container); "he removed the top of the carton"; "he couldnt get the top off of the bottle"; "put the cover back on the kettle" (同)cover
a conical childs plaything tapering to a steel point on which it can be made to spin; "he got a bright red top and string for his birthday" (同)whirligig, teetotum, spinning top
a garment (especially for women) that extends from the shoulders to the waist or hips; "he stared as she buttoned her top"
platform surrounding the head of a lower mast
the greatest possible intensity; "he screamed at the top of his lungs"
the highest or uppermost side of anything; "put your books on top of the desk"; "only the top side of the box was painted" (同)top side, upper side, upside
the upper part of anything; "the mower cuts off the tops of the grass"; "the title should be written at the top of the first page"
cut the top off; "top trees and bushes" (同)pinch
finish up or conclude; "They topped off their dinner with a cognac"; "top the evening with champagne" (同)top_off
provide with a top or finish the top (of a structure); "the towers were topped with conical roofs" (同)top_out
be at the top of or constitute the top or highest point; "A star tops the Christmas Tree"
reach or ascend the top of; "The hikers topped the mountain just before noon"
situated at the top or highest position; "the top shelf"

PrepTutorEJDIC

〈C〉《the ~》(…の)『いちばん上の部分』,最先端,頂上 / 〈C〉《the ~》(…の)『最上面』,表面《+of+名》 / 《the ~》(…の)『最高位』,『首位』;上座《+of+名》 / 《the ~》(…の)『最高の程度』,頂点《+of+名》 / 〈C〉《the ~》(びんなどの)ふた,栓;(車の)屋根[カバー],ほろ《+of+名》 / 〈C〉《複数形で》(根菜の)葉の部分《+of+名》 / 〈C〉(上下の服の)上 / 《通例名詞の前にのみ用いて》 / 『最も高い』,いちばんの / 『最上位の』,第一位(一級)の / 最高程度の / …‘に'『おおい(ふた)を付ける』 / …の頂上にある,頂上をおおう / …‘の'頂上に達する,‘を'登りきる / …‘を'しのぐ,‘に'まさる / 〈野菜・果実など〉‘の'葉の部分を切る(刈り力む) / (ゴルフで)〈球〉‘の'上をたたく
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Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/09/12 23:49:17」(JST)

wiki en

A tophus (Latin: "stone", plural tophi) is a deposit of monosodium urate crystals in people with longstanding high levels of uric acid in the blood. Tophi are pathognomonic for the disease gout. Most people with tophi have had previous attacks of acute arthritis, eventually leading to the formation of tophi.

Tophi form in the joints, cartilage, bones, and other places throughout the body. Sometimes, tophi break through the skin and appear as white or yellowish-white, chalky nodules. Without treatment, tophi may develop on average about ten years after the onset of gout, although their first appearance can range from three to forty-two years. The development of gouty tophi can also limit joint function and cause bone destruction, leading to noticeable disabilities, especially when gout cannot successfully be treated.^[1] When uric acid levels and gout symptoms cannot be controlled with standard gout medicines that decrease the production of uric acid (e.g., allopurinol, febuxostat) or increase uric acid elimination from the body through the kidneys (e.g., probenecid), this can be referred to as refractory chronic gout or RCG.^[2] They are more apt to appear early in the course of the disease in people who are older in age.

Although less common, tophi can also form in the kidneys and nasal cartilage.

A tophus inside a knee joint being removed by arthroscopic surgery.

Additional images[edit source | edit]

Micrograph of a gouty tophus.

References[edit source | edit]

^ Edwards, N. Lawrence (2008). Primer on the Rheumatic Diseases: Chaper 12: Gout A. Clinical Features. Springer. pp. 241–248.
^ Ali, S; Lally, EV (2009 Nov). "Treatment failure gout.". Medicine and health, Rhode Island 92 (11): 369–71. PMID 19999896.

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UpToDate Contents

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1. 痛風の臨床症状および診断 clinical manifestations and diagnosis of gout
2. 再発性の痛風の予防：薬理学的尿酸低下療法および痛風結節の治療 prevention of recurrent gout pharmacologic urate lowering therapy and treatment of tophi
3. 変形性関節症の臨床症状と診断 clinical manifestations and diagnosis of osteoarthritis
4. 痛風性関節炎の病態生理 pathophysiology of gouty arthritis
5. 再発性の痛風の予防：生活様式の改善およびその他のリスク低減戦略 prevention of recurrent gout lifestyle modification and other strategies for risk reduction

English Journal

Mechanisms of crystal formation in gout-a structural approach.

Pascual E1, Addadi L2, André M1, Sivera F3.
Nature reviews. Rheumatology.Nat Rev Rheumatol.2015 Sep 15. doi: 10.1038/nrrheum.2015.125. [Epub ahead of print]
The mechanisms and sites of monosodium urate monohydrate (MSU) crystal deposition in gout have received little attention from the scientific community to date. Formalin fixation of tissues leads to the dissolution of MSU crystals, resulting in their absence from routinely processed pathological samp
PMID 26369610

Gouty tophi in the bone marrow.

Agarwaal A1, Green L2, Thiagarajan P2.
British journal of haematology.Br J Haematol.2015 Sep 6. doi: 10.1111/bjh.13633. [Epub ahead of print]
PMID 26343541

Clinical utility of dual-energy CT for gout diagnosis.

Hu HJ1, Liao MY2, Xu LY3.
Clinical imaging.Clin Imaging.2015 Sep-Oct;39(5):880-5. doi: 10.1016/j.clinimag.2014.12.015. Epub 2015 Feb 11.
OBJECTIVE: The present study was to evaluate the clinical value of dual-energy computed tomography (DECT) for detecting monosodium urate crystals in patients with gouty arthritis.METHODS: Two hundred and two patients, who experienced arthrocele and (or) joint pain, were enrolled into our study. DECT
PMID 25725947

Japanese Journal

症例報告多発関節炎を呈した慢性結節性痛風の高齢男性

日本老年医学会雑誌 = Japanese journal of geriatrics 52(4), 415-420, 2015-10
NAID 40020684326

手掌や指腹のIntradermal Urate Tophiを合併した多発痛風結節の1例 (特集代謝異常症・沈着症・黄色腫)

皮膚科の臨床 57(3), 294-298, 2015-03
NAID 40020382634

著明な骨破壊を伴った多発痛風結節の1例 (特集代謝異常症・沈着症・黄色腫)

皮膚科の臨床 57(3), 289-293, 2015-03
NAID 40020382624

Related Pictures

★リンクテーブル★

リンク元	「痛風結節」
拡張検索	「Anaplasma phagocytophilum」「A. phagocytophilum」「maltophilia」「junctophilin」
関連記事	「top」