university

• 大学

関

college、Univ

　 　 　 　

WordNet

1. establishment where a seat of higher learning is housed, including administrative and living quarters as well as facilities for research and teaching
2. a large and diverse institution of higher learning created to educate for life and for a profession and to grant degrees
3. the body of faculty and students at a university
4. a complex of buildings in which an institution of higher education is housed
5. an institution of higher education created to educate and grant degrees; often a part of a university
6. the body of faculty and students of a college
7. (British informal) a provincial British university of relatively recent founding; distinguished from Oxford University and Cambridge University
8. an urban university in a large city

PrepTutorEJDIC

1. {C}『[総合]大学』 / 〈U〉《the university》《集合的に》大学生,大学当局
2. 《しばしば冠詞をつけず単数形で》(一般に)『大学』,カレッジ / 『単科大学』,教養課程大学　《米》(総合大学 universityの)学部 / 《英》(Oxford・Cambridge 大学などの)学寮(university の一部で,教師・外生・研究育で自治組織を作っている) / (特定の)パブリックスクール(public school) / 《英》(universityに併設の)専門学校 / (共通の特権・目的などを持つ人々の)団体,協会,学会
3. 自由大学(大学生が非公式に運営し従来の大学にはないコースや方法をとった学校)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/12/19 03:04:02」(JST)

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For other uses, see University (disambiguation).

See also: College

Degree ceremony at the University of Oxford. The Pro-Vice-Chancellor in MA gown and hood, Proctor in official dress and new Doctors of Philosophy in scarlet full dress. Behind them, a bedel, a Doctor and Bachelors of Arts and Medicine graduate.

A university is an institution of higher education and research which grants academic degrees in a variety of subjects and provides both undergraduate education and postgraduate education. The word "university" is derived from the Latin universitas magistrorum et scholarium, which roughly means "community of teachers and scholars."

History

Representation of a university lecture in the 1350s

Definition

The original Latin word "universitas" refers in general to "a number of persons associated into one body, a society, company, community, guild, corporation, etc." At the time of the emergence of urban town life and medieval guilds, specialised "associations of students and teachers with collective legal rights usually guaranteed by charters issued by princes, prelates, or the towns in which they were located" came to be denominated by this general term. Like other guilds, they were self-regulating and determined the qualifications of their members. The original Latin word referred to degree-granting institutions of learning in Western Europe, where this form of legal organisation was prevalent, and from where the institution spread around the world. For non-related educational institutions of antiquity which did not stand in the tradition of the university and to which the term is only loosely and retrospectively applied, see ancient higher-learning institutions.

Academic freedom

An important idea in the definition of a university is the notion of academic freedom. The first documentary evidence of this comes from early in the life of the first university. The University of Bologna adopted an academic charter, the Constitutio Habita, in 1158 or 1155, which guaranteed the right of a traveling scholar to unhindered passage in the interests of education. Today this is claimed as the origin of "academic freedom". This is now widely recognised internationally - on 18 September 1988 430 university rectors signed the Magna Charta Universitatum, marking the 900th anniversary of Bologna's foundation. The number of universities signing the Magna Charta Universitatum continues to grow, drawing from all parts of the world.

Medieval universities

Main articles: Medieval university and List of medieval universities

Area above the Old University of Bologna buildings, founded in 1088

European higher education took place for hundreds of years in Christian cathedral schools or monastic schools (Scholae monasticae), in which monks and nuns taught classes; evidence of these immediate forerunners of the later university at many places dates back to the 6th century AD. The earliest universities were developed under the aegis of the Latin Church, usually from cathedral schools or by papal bull as studia generalia (n.b. The development of cathedral schools into universities actually appears to be quite rare, with the University of Paris being an exception — see Leff, Paris and Oxford Universities), later they were also founded by Kings (University of Naples Federico II, Charles University in Prague, Jagiellonian University in Kraków) or municipal administrations (University of Cologne, University of Erfurt). In the early medieval period, most new universities were founded from pre-existing schools, usually when these schools were deemed to have become primarily sites of higher education. Many historians state that universities and cathedral schools were a continuation of the interest in learning promoted by monasteries.

The first universities in Europe with a form of corporate/guild structure were the University of Bologna (1088), the University of Paris (c. 1150, later associated with the Sorbonne), the University of Oxford (1167), the University of Palencia (1208), the University of Cambridge (1209), the University of Salamanca (1218), the University of Montpellier (1220), the University of Padua (1222), the University of Naples Federico II (1224), the University of Toulouse (1229), the University of Siena (1240).

The University of Bologna began as a law school teaching the ius gentium or Roman law of peoples which was in demand across Europe for those defending the right of incipient nations against empire and church. Bologna’s special claim to Alma Mater Studiorum is based on its autonomy, its awarding of degrees, and other structural arrangements, making it the oldest continuously operating institution independent of kings, emperors or any kind of direct religious authority.

Meeting of doctors at the University of Paris. From a medieval manuscript.

The conventional date of 1088, or 1087 according to some, records when a certain Irnerius commences teaching Emperor Justinian’s 6th century codification of Roman law, the Corpus Iuris Civilis, recently discovered at Pisa. Lay students arrived in the city from many lands entering into a contract to gain this knowledge, organising themselves into ‘Learning Nations’ of Hungarians, Greeks, North Africans, Arabs, Franks, Germans, Iberians etc. The students “had all the power … and dominated the masters”.

In Europe, young men proceeded to university when they had completed their study of the trivium–the preparatory arts of grammar, rhetoric and dialectic or logic–and the quadrivium: arithmetic, geometry, music, and astronomy. (See Degrees of the University of Oxford for the history of how the trivium and quadrivium developed in relation to degrees, especially in anglophone universities).

Universities became popular all over Europe, as rulers and city governments began to create them to satisfy a European thirst for knowledge, and the belief that society would benefit from the scholarly expertise generated from these institutions. Princes and leaders of city governments perceived the potential benefit of having a scholarly expertise develop with the ability to address difficult problems and achieve desired ends. The emergence of humanism was essential to this understanding of the possible utility of universities as well as the revival of interest in knowledge gained from ancient Greek texts.

The rediscovery of Aristotle's works - more than 3000 pages of it would eventually be translated - fuelled a spirit of inquiry into natural processes that had already begun to emerge in the 12th century. Some scholars believe that these works represented one of the most important document discoveries in Western intellectual history. Richard Dales, for instance, calls the discovery of Aristotle's works “a turning point in the history of Western thought." After Aristotle re-emerged, a community of scholars, primarily communicating in Latin, accelerated the process and practice of attempting to reconcile the thoughts of Greek antiquity, and especially ideas related to understanding the natural world, with those of the church. The efforts of this “scholasticism” were focused on applying Aristotelian logic and thoughts about natural processes to biblical passages and attempting to prove the viability of those passages through reason. This became the primary mission of lecturers, and the expectation of students.

The university culture developed differently in northern Europe than it did in the south, although the northern (primarily Germany, France and Great Britain) and southern universities (primarily Italy) did have many elements in common. Latin was the language of the university, used for all texts, lectures, disputations and examinations. Professors lectured on the books of Aristotle for logic, natural philosophy, and metaphysics; while Hippocrates, Galen, and Avicenna were used for medicine. Outside of these commonalities, great differences separated north and south, primarily in subject matter. Italian universities focused on law and medicine, while the northern universities focused on the arts and theology. There were distinct differences in the quality of instruction in these areas which were congruent with their focus, so scholars would travel north or south based on their interests and means. There was also a difference in the types of degrees awarded at these universities. English, French and German universities usually awarded bachelor's degrees, with the exception of degrees in theology, for which the doctorate was more common. Italian universities awarded primarily doctorates. The distinction can be attributed to the intent of the degree holder after graduation – in the north the focus tended to be on acquiring teaching positions, while in the south students often went on to professional positions. The structure of Northern Universities tended to be modeled after the system of faculty governance developed at the University of Paris. Southern universities tended to be patterned after the student-controlled model begun at the University of Bologna.

Scholars like Arnold H. Green and Hossein Nasr have argued that starting in the 10th century, some medieval Islamic madrasahs became universities. George Makdisi and others, however, argue that the European university has no parallel in the medieval Islamic world. Courtenay et al. partially critique this view by stating similarities between madrasahs and southern European universities. Other scholars regard the university as uniquely European in origin and characteristics.

Many scholars (including Makdisi) have argued that early medieval universities were influenced by the religious madrasahs in Al-Andalus, the Emirate of Sicily, and the Middle East (during the Crusades). Other scholars see this argument as overstated.

Early modern universities

See also: List of early modern universities in Europe and List of colonial universities in Latin America

During the Early Modern period (approximately late 1400s to 1800), the universities of Europe would see a tremendous amount of growth, productivity and innovative research. At the end of the Middle Ages, about 400 years after the first university was founded, there were twenty-nine universities spread throughout Europe. In the 15th century, twenty-eight new ones were created, with another eighteen added between 1500 and 1625. This pace continued until by the end of the 18th century there were approximately 143 universities in Europe and Eastern Europe, with the highest concentrations in the German Empire (34), Italian countries (26), France (25), and Spain (23) – this was close to a 500% increase over the number of universities toward the end of the Middle Ages. This number does not include the numerous universities that disappeared, or institutions that merged with other universities during this time. It should be noted that the identification of a university was not necessarily obvious during the Early Modern period, as the term is applied to a burgeoning number of institutions. In fact, the term “university” was not always used to designate a higher education institution. In Mediterranean countries, the term studium generale was still often used, while “Academy” was common in Northern European countries.

17th century classroom at the University of Salamanca

The propagation of universities was not necessarily a steady progression, as the seventeenth century was rife with events that adversely effected university expansion. Many wars, and especially the Thirty Years' War, disrupted the university landscape throughout Europe at different times. War, plague, famine, regicide, and changes in religious power and structure often adversely affected the societies that provided support for universities. Internal strife within the universities themselves, such as student brawling and absentee professors, acted to destabilize these institutions as well. Universities were also reluctant to give up older curricula, and the continued reliance on the works of Aristotle defied contemporary advancements in science and the arts. This era was also affected by the rise of the nation-state. As universities increasingly came under state control, or formed under the auspices of the state, the faculty governance model (begun by the University of Paris) became more and more prominent. Although the older student-controlled universities still existed, they slowly started to move toward this structural organization. Control of universities still tended to be independent, although university leadership was increasingly appointed by the state.

Although the structural model provided by the University of Paris, where student members are controlled by faculty “masters,” provided a standard for universities, the application of this model took at least three different forms. There were universities that had a system of faculties whose teaching was centralized around a very specific curriculum; this model tended to train specialists. There was a collegiate or tutorial model based on the system at University of Oxford where teaching and organization was decentralized and knowledge was more of a generalist nature. There were also universities that combined these models, using the collegiate model but having a centralized organization.

Early Modern universities initially continued the curriculum and research of the Middle Ages: natural philosophy, logic, medicine, theology, mathematics, astronomy (and astrology), law, grammar and rhetoric. Aristotle was prevalent throughout the curriculum, while medicine also depended on Galen and Arabic scholarship. The importance of humanism for changing this state-of-affairs cannot be underestimated. Once humanist professors joined the university faculty, they began to transform the study of grammar and rhetoric through the studia humanitatis. Humanist professors focused on the ability of students to write and speak with distinction, to translate and interpret classical texts, and to live honorable lives. Other scholars within the university were affected by the humanist approaches to learning and their linguistic expertise in relation to ancient texts, as well as the ideology that advocated the ultimate importance of those texts. Professors of medicine such as Niccolò Leoniceno, Thomas Linacre and William Cop were often trained in and taught from a humanist perspective as well as translated important ancient medical texts. The critical mindset imparted by humanism was imperative for changes in universities and scholarship. For instance, Andreas Vesalius was educated in a humanist fashion before producing a translation of Galen, whose ideas he verified through his own dissections. In law, Andreas Alciatus infused the Corpus Juris with a humanist perspective, while Jacques Cujas humanist writings were paramount to his reputation as a jurist. Philipp Melanchthon cited the works of Erasmus as a highly influential guide for connecting theology back to original texts, which was important for the reform at Protestant universities. Galileo Galilei, who taught at the Universities of Pisa and Padua, and Martin Luther, who taught at the University of Wittenberg (as did Melanchthon), also had humanist training. The task of the humanists was to slowly permeate the university; to increase the humanist presence in professorships and chairs, syllabi and textbooks so that published works would demonstrate the humanistic ideal of science and scholarship.

Although the initial focus of the humanist scholars in the university was the discovery, exposition and insertion of ancient texts and languages into the university, and the ideas of those texts into society generally, their influence was ultimately quite progressive. The emergence of classical texts brought new ideas and lead to a more creative university climate (as the notable list of scholars above attests to). A focus on knowledge coming from self, from the human, has a direct implication for new forms of scholarship and instruction, and was the foundation for what is commonly known as the humanities. This disposition toward knowledge manifested in not simply the translation and propagation of ancient texts, but also their adaptation and expansion. For instance, Vesalius was imperative for advocating the use of Galen, but he also invigorated this text with experimentation, disagreements and further research. The propagation of these texts, especially within the universities, was greatly aided by the emergence of the printing press and the beginning of the use of the vernacular, which allowed for the printing of relatively large texts at reasonable prices.

Examining the influence of humanism on scholars in medicine, mathematics, astronomy and physics may suggest that humanism and universities were a strong impetus for the scientific revolution. Although the connection between humanism and the scientific discovery may very well have begun within the confines of the university, the connection has been commonly perceived as having been severed by the changing nature of science during the scientific revolution. Historians such as Richard Westfall have argued that the overt traditionalism of universities inhibited attempts to re-conceptualize nature and knowledge and caused an indelible tension between universities and scientists. This resistance to changes in science may have been a significant factor in driving many scientists away from the university and toward private benefactors, usually in princely courts, and associations with newly forming scientific societies.

Other historians find incongruity in the proposition that the very place where the vast number of the scholars that influenced the scientific revolution received their education should also be the place that inhibits their research and the advancement of science. In fact, more than 80% of the European scientists between 1450-1650 included in the Dictionary of Scientific Biography were university trained, of which approximately 45% held university posts. It was the case that the academic foundations remaining from the Middle Ages were stable, and they did provide for an environment that fostered considerable growth and development. There was considerable reluctance on the part of universities to relinquish the symmetry and comprehensiveness provided by the Aristotelian system, which was effective as a coherent system for understanding and interpreting the world. However, university professors still utilized some autonomy, at least in the sciences, to choose epistemological foundations and methods. For instance, Melanchthon and his disciples at University of Wittenberg were instrumental for integrating Copernican mathematical constructs into astronomical debate and instruction. Another example was the short-lived but fairly rapid adoption of Cartesian epistemology and methodology in European universities, and the debates surrounding that adoption, which led to more mechanistic approaches to scientific problems as well as demonstrated an openness to change. There are many examples which belie the commonly perceived intransigence of universities. Although universities may have been slow to accept new sciences and methodologies as they emerged, when they did accept new ideas it helped to convey legitimacy and respectability, and supported the scientific changes through providing a stable environment for instruction and material resources.

Regardless of the way the tension between universities, individual scientists, and the scientific revolution itself is perceived, there was a discernible impact on the way that university education was constructed. Aristotelian epistemology provided a coherent framework not simply for knowledge and knowledge construction, but also for the training of scholars within the higher education setting. The creation of new scientific constructs during the scientific revolution, and the epistemological challenges that were inherent within this creation, initiated the idea of both the autonomy of science and the hierarchy of the disciplines. Instead of entering higher education to become a “general scholar” immersed in becoming proficient in the entire curriculum, there emerged a type of scholar that put science first and viewed it as a vocation in itself. The divergence between those focused on science and those still entrenched in the idea of a general scholar exacerbated the epistemological tensions that were already beginning to emerge.

Ohio University, the first university in the American mid-west, in the autumn

The epistemological tensions between scientists and universities were also heightened by the economic realities of research during this time, as individual scientists, associations and universities were vying for limited resources. There was also competition from the formation of new colleges funded by private benefactors and designed to provide free education to the public, or established by local governments to provide a knowledge hungry populace with an alternative to traditional universities. Even when universities supported new scientific endeavors, and the university provided foundational training and authority for the research and conclusions, they could not compete with the resources available through private benefactors.

By the end of the early modern period, the structure and orientation of higher education had changed in ways that are eminently recognizable for the modern context. Aristotle was no longer a force providing the epistemological and methodological focus for universities and a more mechanistic orientation was emerging. The hierarchical place of theological knowledge had for the most part been displaced and the humanities had become a fixture, and a new openness was beginning to take hold in the construction and dissemination of knowledge that were to become imperative for the formation of the modern state.

Modern universities

Main articles: History of European research universities and List of modern universities in Europe (1801–1945)

The tower of the University of Coimbra, the oldest Portuguese university

Karlsruhe Institute of Technology, a German technical university, founded in the 19th century

By the 18th century, universities published their own research journals and by the 19th century, the German and the French university models had arisen. The German, or Humboldtian model, was conceived by Wilhelm von Humboldt and based on Friedrich Schleiermacher’s liberal ideas pertaining to the importance of freedom, seminars, and laboratories in universities.^{[citation needed]} The French university model involved strict discipline and control over every aspect of the university.

Until the 19th century, religion played a significant role in university curriculum; however, the role of religion in research universities decreased in the 19th century, and by the end of the 19th century, the German university model had spread around the world. Universities concentrated on science in the 19th and 20th centuries and became increasingly accessible to the masses. In Britain, the move from Industrial Revolution to modernity saw the arrival of new civic universities with an emphasis on science and engineering, a movement initiated in 1960 by Sir Keith Murray (chairman of the University Grants Committee) and Sir Samuel Curran, with the formation of the University of Strathclyde. The British also established universities worldwide, and higher education became available to the masses not only in Europe.

In 1963, the Robbins Report on universities in the United Kingdom concluded that such institutions should have four main "objectives essential to any properly balanced system: instruction in skills; the promotion of the general powers of the mind so as to produce not mere specialists but rather cultivated men and women; to maintain research in balance with teaching, since teaching should not be separated from the advancement of learning and the search for truth; and to transmit a common culture and common standards of citizenship."

National universities

A national university is generally a university created or run by a national state but at the same time represents a state autonomic institution which functions as a completely independent body inside of the same state. Some national universities are closely associated with national cultural or political aspirations, for instance the National University of Ireland in the early days of Irish independence collected a large amount of information on the Irish language and Irish culture. Reforms in Argentina were the result of the University Revolution of 1918 and its posterior reforms by incorporating values that sought for a more equal and laic higher education system.

Intergovernmental universities

Universities created by bilateral or multilateral treaty between states are intergovernmental. Such as Academy of European Law offering training in European law to lawyers, judges, barristers, solicitors, in-house counsel and academics. EUCLID (Pôle Universitaire Euclide, Euclid University) is chartered as a university and umbrella organization dedicated to sustainable development in signatory countries and United Nations University efforts to resolve the pressing global problems that are the concern of the United Nations, its Peoples and Member States. The European University Institute, a post-graduate university specialised in the social sciences, is officially an intergovernmental organisation, set up by the member states of the European Union.

Organization

The University of Sydney is Australia's oldest university.

Although each institution is organized differently, nearly all universities have a board of trustees; a president, chancellor, or rector; at least one vice president, vice-chancellor, or vice-rector; and deans of various divisions. Universities are generally divided into a number of academic departments, schools or faculties. Public university systems are ruled over by government-run higher education boards. They review financial requests and budget proposals and then allocate funds for each university in the system. They also approve new programs of instruction and cancel or make changes in existing programs. In addition, they plan for the further coordinated growth and development of the various institutions of higher education in the state or country. However, many public universities in the world have a considerable degree of financial, research and pedagogical autonomy. Private universities are privately funded and generally have broader independence from state policies. However, they may have less independence from business corporations depending on the source of their finances.

Universities around the world

See also: List of universities and colleges by country

University of Gujrat in Gujrat, Pakistan

The funding and organization of universities varies widely between different countries around the world. In some countries universities are predominantly funded by the state, while in others funding may come from donors or from fees which students attending the university must pay. In some countries the vast majority of students attend university in their local town, while in other countries universities attract students from all over the world, and may provide university accommodation for their students.

Classification

The definition of a university varies widely even within some countries. For example, there is no nationally standardized definition of the term in the United States although the term has traditionally been used to designate research institutions and was once reserved for research doctorate-granting institutions. Some states, such as Massachusetts, will only grant a school "university status" if it grants at least two doctoral degrees. In the United Kingdom, the Privy Council is responsible for approving the use of the word "university" in the title of an institution, under the terms of the Further and Higher Education Act 1992. In India, a new tag deemed universities has been created for high performing universities, giving them additional autonomy. Through this provision many universities sprung up in India, which are commercial in nature and have been established just to exploit the demand of higher education.

Colloquial usage

Colloquially, the term university may be used to describe a phase in one's life: "When I was at university..." (in the United States and Ireland, college is often used instead: "When I was in college..."; see the college article for further discussion). In Australia, New Zealand, Canada, the United Kingdom, the Netherlands and the German-speaking countries university is often contracted to uni.^{[citation needed]} In New Zealand and in South Africa it is sometimes called "varsity" (although this has become uncommon in New Zealand in recent years), which was also common usage in the UK in the 19th century.^{[citation needed]}

Cost

Main article: Tuition payments

Many students look to get 'student grants' to cover the cost of university. In 2012, the average outstanding student loan balance per borrower in the United States is $23,300 USD. In many countries, costs are anticipated to rise for students as a result of decreased national or state funding given to public universities.

There are some big exceptions on tuition fees. In many European countries, it is possible to study without tuition fees. Public universities in Nordic countries where entirely without tuition fees until the latter part of the 2000. Denmark, Sweden and Finland then moved to put in place tuition fees for foreign students. But still, citizens of EU and EEA member states and citizens from Switzerland are exempted from tuitions fees and the amount of public grants granted to promising foreign students was increased to offset some of the impact.

See also

• Alternative university
• Catholic University
• College and university rankings
• Corporate university
• International university
  • G. I. American Universities
• Land-grant university
• List of academic disciplines
• Lists of universities and colleges
• Nation (university)
• Pontifical university
• School and university in literature
• University student retention
• University system
• UnCollege
• Urban university

Notes

References

• Aronowitz, Stanley (2000). The Knowledge Factory: Dismantling the Corporate University and Creating True Higher Learning. Boston: Beacon Press. ISBN 978-0-8070-3122-3.
• Barrow, Clyde W. (1990). Universities and the Capitalist State: Corporate Liberalism and the Reconstruction of American Higher Education, 1894-1928. Madison, Wis: University of Wisconsin Press. ISBN 978-0-299-12400-7.
• Diamond, Sigmund (1992). Compromised Campus: The Collaboration of Universities with the Intelligence Community, 1945-1955. New York, NY: Oxford Univ. Press. ISBN 978-0-19-505382-1.
• Pedersen, Olaf (1997). The First Universities: Studium Generale and the Origins of University Education in Europe. Cambridge: Cambridge Univ. Press. ISBN 978-0-521-59431-8.
• Ridder-Symoens, Hilde de, ed. (1992). A History of the University in Europe. Volume 1: Universities in the Middle Ages. Rüegg, Walter (general ed.). Cambridge: Cambridge University Press. ISBN 0-521-36105-2.
• Ridder-Symoens, Hilde de, ed. (1996). A History of the University in Europe. Volume 2: Universities in Early Modern Europe (1500-1800). Rüegg, Walter (general ed.). Cambridge: Cambridge University Press. ISBN 0-521-36106-0.
• Rüegg, Walter, ed. (2004). A History of the University in Europe. Volume 3: Universities in the Nineteenth and Early Twentieth Centuries (1800-1945). Cambridge: Cambridge University Press. ISBN 0-521-36107-9.

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• 函館のデジタルアーカイブに含まれる大量の写真資料はメタデータが少なく,写真間が歴史的関連で関連付けられていない.そこで,函館の歴史に関する文献を利用することで写真資料のメタデータを補い写真間が関連付く可能性がある.写真資料と函館市史年表編,はこだて人物誌を Linked Open Data (LOD) として作成し公開する. LOD とは外部とのデータ連携を実現する技術である.函館の歴史資料を L …
• NAID 110009509320

• 統合ソフトウェアドキュメンテーション環境としてのDITAベースCMSの開発

• 坂井 麻里恵,大場 みち子,伊藤 恵,奥野 拓
• 情報処理学会研究報告. DD, [デジタル・ドキュメント] 2013-DD-88(8), 1-8, 2013-01-11
• ソフトウェアの開発プロセスにおいて,多くのドキュメントが作成される.しかし,ワードプロセッサ等のアプリケーションで作成された一般的なドキュメントでは,ドキュメント数の増加に伴ってトレーサビリティの低下,メンテナンスコストの増大という問題が発生する.技術文書向けの XML 標準である DITA に基づいてドキュメントを記述し,コンポーネント単位で再利用することで,それらの問題を解決する.ソフトウェア …
• NAID 110009509319

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★リンクテーブル★

リンク元	「100Cases 13」「college」「大学」「Univ」

「100Cases 13」

　　[★]

☆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

「college」

　　[★]

• 大学、単科大学

関

Univ、university

　 　 　 　

「大学」

　　[★]

英

university、college、Univ

関

単科大学

「Univ」

　　[★]

• 大学

関

college、university