n.

全体、総量、総、全

関: all、altogether、common、entire、entirety、gross、overall、total amount、whole

WordNet

determine the sum of; "Add all the people in this town to those of the neighboring town" (同)tot, tot up, sum, sum_up, summate, tote up, add, add together, tally, add up
damage beyond the point of repair; "My son totaled our new car"; "the rock star totals his guitar at every concert"
add up in number or quantity; "The bills amounted to $2,000"; "The bill came to $2,000" (同)number, add up, come, amount
quantifier; used with either mass or count nouns to indicate the whole number or amount of or every one of a class; "we sat up all night"; "ate all the food"; "all men are mortal"; "all parties are welcome"
completely given to or absorbed by; "became all attention"
to be expected; standard; "common decency"
common to or shared by two or more parties; "a common friend"; "the mutual interests of management and labor" (同)mutual
of or associated with the great masses of people; "the common people in those days suffered greatly"; "behavior that branded him as common"; "his square plebeian nose"; "a vulgar and objectionable person"; "the unwashed masses" (同)plebeian, vulgar, unwashed
commonly encountered; "a common (or familiar) complaint"; "the usual greeting" (同)usual
being or characteristic of or appropriate to everyday language; "common parlance"; "a vernacular term"; "vernacular speakers"; "the vulgar tongue of the masses"; "the technical and vulgar names for an animal species" (同)vernacular, vulgar
belonging to or participated in by a community as a whole; public; "for the common good"; "common lands are set aside for use by all members of a community"
having no special distinction or quality; widely known or commonly encountered; average or ordinary or usual; "the common man"; "a common sailor"; "the common cold"; "a common nuisance"; "followed common procedure"; "it is common knowledge that she lives alone"; "the common housefly"; "a common brand of soap"
including all components without exception; being one unit or constituting the full amount or extent or duration; complete; "gave his whole attention"; "a whole wardrobe for the tropics"; "the whole hog"; "a whole week"; "the baby cried the whole trip home"; "a whole loaf of bread"
an assemblage of parts that is regarded as a single entity; "how big is that part compared to the whole?"; "the team is a unit" (同)unit
all of something including all its component elements or parts; "Europe considered as a whole"; "the whole of American literature"
(of siblings) having the same parents; "whole brothers and sisters"
lacking fine distinctions or detail; "the gross details of the structure appear reasonable"
twelve dozen (同)144
the entire amount of income before any deductions are made (同)revenue, receipts
repellently fat; "a bald porcine old man" (同)porcine
before any deductions; "gross income"
earn before taxes, expenses, etc.
involving only main features; "the overall pattern of his life"
a loose protective coverall or smock worn over ordinary clothing for dirty work (同)boilersuit, boilers suit
(usually plural) work clothing consisting of denim trousers (usually with a bib and shoulder straps)
including everything; "the overall cost"
a small amount (especially of a drink); "a tot of rum"
used of automobiles; completely demolished; "the insurance adjuster declared the automobile totaled"

PrepTutorEJDIC

『総計の』,全体の / 『全くの』,完全な(absolute) / 『合計』,総額,総数,総量(sum) / …‘を'合計する / 合計…‘に'なる,総額が…‘に'のぼる(amount to)
《単数形,または数えられない名詞につけて》(ある一つのものについて,その)『全体の』,全…,…じゅう,…全体 / 《複数形につけて》(個々を一つにまとめて)『全部の』,すべての / 《複数形,または数えられない名詞につけて》(ある全体の中の)いずれの,およそどの,あらゆる / 《数えられない名詞につけて》できる限りの,最大の / 《単数扱い》(物事について)『全部』,全体,すべて / 《複数扱い》『全員』,みんな / いっさいの所有物,いっさいがっさい / 『すっかり』,『全く』,もっぱら / 《all the+比較級の形で》かえって,いっそう / どちらも,双方とも
(二つ以上のものに)『共通の』,共同の,共有の / 『一般の』,公共の,公衆の / 『普通の』,ありふれた / 慢凡な,並みの / 品のない,粗野な,野卑な(vulgar) / (数式で)共通の,公約の通約の・ (文法で)通性の,通格の(男性・女性どちらの格も用いることができる) ・〈C〉《時に複数形で》共有地,公有地,共有牧草;(市町村の)公園・〈U〉共有権
《the ~,one's ~ の形で名詞の前に用いて》『全体の』,全部の,全… / 《名詞の前にのみ用いて》(時間・距離などが)『まる』…,満… / (物が)完全な,欠けていない;《名詞の後に置いて》丸ごとで,ひとかたまりに / 《冠詞をつけずに複数名詞の前に用いて》ひじょうに多くの / 《古》(人が)無傷の,(肉体的に)健康な / 整数の,分数を含まない / 〈U〉《the ~》(…の)『全部』,全体,全量《+of+名》 / 〈C〉完全なもの,統一体
『全体の,総計の』(entire) / (人が)太りすぎた,でぶの / 粗野な,下品な(vulgar) / (食物が)粗悪な / (誤り・誤解などが)はなはだしい,全くひどい(very bad) / (植物が)はびこった,伸びほうだいの…(霧などが)濃い,密な / グロス(12ダース,144個) / 《the~》《文》全体;大部分 / …の総利益をあげる
全部の,全般的な,全面的な / (物の)端から端までの / 全般的に,全面的に / 端から端まで / 《複数形で》胸支てつきの仕事ズボン,オーバーオール / 《英》(婦人用)上っ張り
幼児,小児 / (特に酒類の)少量,一杯,一口
…‘を'合計する《+up+名,+名+up》 / 合計(…に)なる《+up to+名》

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/04/07 22:16:14」(JST)

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1. 全人工股関節置換術 total hip arthroplasty
2. 胃全摘術および消化管再建術 total gastrectomy and gastrointestinal reconstruction
3. 重度の関節リウマチに対する全関節置換術 total joint replacement for severe rheumatoid arthritis
4. 中長期的な機械循環補助 intermediate and long term mechanical circulatory support
5. 総肺静脈還流異常症 total anomalous pulmonary venous connection

English Journal

Anti-glycation properties of the aqueous extract solutions of dried algae products and effect of lactic acid fermentation on the properties.

Kuda T1, Eda M2, Kataoka M2, Nemoto M2, Kawahara M2, Oshio S3, Takahashi H2, Kimura B2.
Food chemistry.Food Chem.2016 Feb 1;192:1109-15. doi: 10.1016/j.foodchem.2015.07.073. Epub 2015 Jul 18.
The antioxidant and anti-glycation properties in aqueous extract solutions (AESs) of 11 dried algae products were investigated. AESs of brown algae Ecklonia kurome (kurome) and Ecklonia stolonifera (tsuruarame) showed a strong DPPH radical-scavenging capacity and Fe-reducing power with high total ph
PMID 26304454

Bioactive compounds and antioxidant potential fruit of Ximenia americana L.

Almeida ML1, Freitas WE2, Morais PL3, Sarmento JD4, Alves RE5.
Food chemistry.Food Chem.2016 Feb 1;192:1078-82. doi: 10.1016/j.foodchem.2015.07.129. Epub 2015 Jul 29.
The caatinga ecoregion in northeast Brazil presents a wide variety in plant species. However, the potential of these species as a source of energy, carbohydrates, vitamins, minerals and bioactive properties beneficial to health is still unknown. Among these species we can find the wild plum (Ximenia
PMID 26304450

Evaluation of umami taste in mushroom extracts by chemical analysis, sensory evaluation, and an electronic tongue system.

Phat C1, Moon B2, Lee C3.
Food chemistry.Food Chem.2016 Feb 1;192:1068-77. doi: 10.1016/j.foodchem.2015.07.113. Epub 2015 Jul 23.
Seventeen edible mushrooms commercially available in Korea were analysed for their umami taste compounds (5'-nucleotides: AMP, GMP, IMP, UMP, XMP; free amino acids: aspartic, glutamic acid) and subjected to human sensory evaluation and electronic tongue measurements. Amanita virgineoides featured th
PMID 26304449

Variation in mineral elements in grains of 20 brown rice accessions in two environments.

Huang Y1, Tong C1, Xu F1, Chen Y1, Zhang C2, Bao J3.
Food chemistry.Food Chem.2016 Feb 1;192:873-8. doi: 10.1016/j.foodchem.2015.07.087. Epub 2015 Jul 21.
Twenty rice accessions were planted in Hainan province, China, for 2years to investigate the effects of genotype, environment, and their interactions on the Ca, Mg, Na, K, Fe, Zn, and Cu contents in brown rice. Analysis of variance showed that the Ca, Na and K were mainly affected by the genotypic v
PMID 26304423

Japanese Journal

路面電車停留所へのアクセスに関する研究

大東延幸,本岡哲也
広島工業大学紀要. 研究編 41, 37-40, 39114-00-00
… Not only the performance of public traffic but also it shows and the performance is verified about the total as "Movement" including on foot. …
NAID 120005403162

Enantioselective synthesis of (+)-N-(desmethyl)dysibetaine CPb

Tanaka Kento,Sakai Michihiro,Takamizawa Satoshi,Oikawa Masato
Chemistry Letters, 2015
… (+)-N-(Desmethyl)dysibetaine CPb was finally synthesized in 0.37% yield in total 14 steps. …
NAID 130004712958

The effects of coaching on salivary cortisol stress marker in mothers with young children, a randomized controlled trial

Ohashi Junko,Katsura Toshiki
Journal of Rural Medicine, 2015
… A total of 74 mothers with median EI scores or lower were enrolled in a RCT involving the coaching program. …
NAID 130004705333

Kinetics of Solid-State Reactive Diffusion in the (Pd–Cr)/Sn System

Hashiba Masaki,Masui Koji,Kajihara Masanori
MATERIALS TRANSACTIONS, 2015
… The total thickness of the compound layer is proportional to a power function of the annealing time. …
NAID 130004704648

Related Pictures

★リンクテーブル★

リンク元	「100Cases 33」「overall」「gross」「全体」「common」
拡張検索	「total peripheral resistance」「total amount」「total energy expenditure」

「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)

According to the US CDC definition, one has AIDS if he/she is infected with HIV and present with one of the following:

A CD4+ T-cell count below 200 cells/μl (or a CD4+ T-cell percentage of total lymphocytes of less than 14%).

or he/she has one of the following defining illnesses:

01. Candidiasis of bronchi, trachea, or lungs
02. Candidiasis esophageal
03. Cervical cancer (invasive)
04. Coccidioidomycosis, disseminated or extrapulmonary
05. Cryptococcosis, extrapulmonary
06. Cryptosporidiosis, chronic intestinal for longer than 1 month
07. Cytomegalovirus disease (other than liver, spleen or lymph nodes)
08. Encephalopathy (HIV-related)
09. Herpes simplex: chronic ulcer(s) (for more than 1 month); or bronchitis, pneumonitis, or esophagitis
10. Histoplasmosis, disseminated or extrapulmonary
11. Isosporiasis, chronic intestinal (for more than 1 month)
12. Kaposi's sarcoma
13. Lymphoma Burkitt's, immunoblastic or primary brain
14. Mycobacterium avium complex
15. Mycobacterium, other species, disseminated or extrapulmonary
16. Pneumocystis carinii pneumonia
17. Pneumonia (recurrent)
18. Progressive multifocal leukoencephalopathy
19. Salmonella septicemia (recurrent)
20. Toxoplasmosis of the brain
21. Tuberculosis
22. Wasting syndrome due to HIV

People who are not infected with HIV may also develop these conditions; this does not mean they have AIDS. However, when an individual presents laboratory evidence against HIV infection, a diagnosis of AIDS is ruled out unless the patient has not:

undergone high-dose corticoid therapy or other immunosuppressive/cytotoxic therapy in the three months before the onset of the indicator disease
OR been diagnosed with Hodgkin's disease, non-Hodgkin's lymphoma, lymphocytic leukemia, multiple myeloma, or any cancer of lymphoreticular or histiocytic tissue, or angioimmunoblastic lymphoadenopathy
OR a genetic immunodeficiency syndrome atypical of HIV infection, such as one involving hypogamma globulinemia

AND

the individual has had Pneumocystis carinii pneumonia
OR one of the above defining illnesses AND a CD4+ T-cell count below 200 cells/μl (or a CD4+ T-cell percentage of total lymphocytes of less than 14%).

□AIDSのステージング

Revised World Health Organization (WHO) Clinical Staging of HIV/AIDS For Adults and Adolescents (2005)

http://en.wikipedia.org/wiki/WHO_Disease_Staging_System_for_HIV_Infection_and_Disease_in_Adults_and_Adolescents

■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

「overall」

　　[★]

adj.

全部の。端から端までの。総合的な、全般的な

As long-term survival in ALL improves, more children experience late adverse effects including CNS imparirment, decreased linear growth, cardiotoxicity, infertility, and an increased incidence of secondary cancers, al well as an overall decreased health status due to such factors as neurocognitive dysfunction, depression, fatigue, and anxiety.