- n.
- adv.
- 良く、順調に
WordNet
- without unusual distress or resentment; with good humor; "took the joke well"; "took the tragic news well"
- a cavity or vessel used to contain liquid
- a deep hole or shaft dug or drilled to obtain water or oil or gas or brine
- an enclosed compartment in a ship or plane for holding something as e.g. fish or a planes landing gear or for protecting something as e.g. a ships pumps
- an open shaft through the floors of a building (as for a stairway)
- an abundant source; "she was a well of information" (同)wellspring, fountainhead
- in a manner affording benefit or advantage; "she married well"; "The children were settled advantageously in Seattle" (同)advantageously
- in financial comfort; "They live well"; "she has been able to live comfortably since her husband died" (同)comfortably
- to a great extent or degree; "Im afraid the film was well over budget"; "painting the room white made it seem considerably (or substantially) larger"; "the house has fallen considerably in value"; "the price went up substantially" (同)considerably, substantially
- indicating high probability; in all likelihood; "I might well do it"; "a mistake that could easily have ended in disaster"; "you may well need your umbrella"; "he could equally well be trying to deceive us" (同)easily
- (often used as a combining form) in a good or proper or satisfactory manner or to a high standard (`good is a nonstandard dialectal variant for `well' (同)good
- with great or especially intimate knowledge; "we knew them well" (同)intimately
- come up, as of a liquid; "Tears well in her eyes"; "the currents well up" (同)swell
- (used for emphasis or as an intensifier) entirely or fully; "a book well worth reading"; "was well aware of the difficulties ahead"; "suspected only too well what might be going on"
- favorably; with approval; "their neighbors spoke well of them"; "he thought well of the book"
- in good health especially after having suffered illness or injury; "appears to be entirely well"; "the wound is nearly well"; "a well man"; "I think Im well; at least I feel well"
- thoroughly or completely; fully; often used as a combining form; "The problem is well understood"; "she was well informed"; "shake well before using"; "in order to avoid food poisoning be sure the meat is well cooked"; "well-done beef", "well-satisfied customers"; "well-educated"
- to a suitable or appropriate extent or degree; "the project was well underway"; "the fetus has well developed organs"; "his father was well pleased with his grades"
- wise or advantageous and hence advisable; "it would be well to start early"
- with prudence or propriety; "You would do well to say nothing more"; "could not well refuse"
- with skill or in a pleasing manner; "she dances well"; "he writes well"
- occurring at a convenient or suitable time; "an opportune time to receive guests" (同)favourable
- (of winds or weather) tending to promote or facilitate; "the days were fair and the winds were favorable" (同)favourable
- encouraging or approving or pleasing; "a favorable reply"; "he received a favorable rating"; "listened with a favorable ear"; "made a favorable impression" (同)favourable
- giving satisfaction; "satisfactory living conditions"; "his grades were satisfactory"
- meeting requirements; "the step makes a satisfactory seat" (同)acceptable
- in a satisfactory manner
- showing approval; "he reviewed the play favorably" (同)favourably
- North American annual with small white flowers widely naturalized as a weed in South America and Europe (同)Veronica peregrina
- of or relating to fish and marine life that dwell on the bottom of a body of water
- say good-bye or bid farewell
PrepTutorEJDIC
- 『井戸』 / (石油・天然ガスを取るための)井 / 『泉』,《比喩的に》源 / 井戸状のくぼみ;(エレベーターの)縦穴;(回り階段の)階段穴 / 《英》(法廷の)弁護士席 / 〈水などが〉わき出る,噴出する《+out》 / わき上がる《+up》
- 『よく』,満足に,申し分なく / じょうずに,うまく,巧みに / 『十分に』,全く / 《他の副詞または前置詞句と共に用いて》『相当に』,かなり / (個人的に)親しく,親密に / 《can't, couldn't と共に用いて》『正当に』,適切に / はっきりと,確かに,全く / 親切に,好意的に / 《おもに補語に用いて》『健康な』,じょうぶな / 《複語にのみ用いて》『好都合の』,満足すべき,申し分のない / 《驚いて》『おや』,まあ,へ‐ / 《ためらい・同意を表し,文・言葉を切り出して》『え‐と』,さて,ところで / 《譲歩を表して》『それじゃ』,まあ / 《安心・あきらめを表して》『やれやれ』,どうも
- 『満足を与える』,満足な,申し分のない
- 満足に,申し分なく
- 『私たちは(が)』,われわれは(が) / 《総称的に》『人は』,われわれは / 《論説・評論などで I の代りに用いて》私たちは,吾人(ごじん)は,筆者は / 《子供・病人などに対して,you の代りに養いて》あなたは / 《君主が公式の場でI の代りに用いて》余は
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- Simmelink J, Lightfoot E, Dube A, Blevins J, Lum T.SourceUniversity of Minnesota School of Social Work, St. Paul, MN, USA. simm0055@umn.edu.
- American journal of health behavior.Am J Health Behav.2013 Mar;37(2):155-61. doi: 10.5993/AJHB.37.2.2.
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- Our previous study demonstrated that Toll-like receptor 4 (TLR4) could act as a co-receptor with annexin A2 (ANX2) mediating anti-β2-glycoprotein I/β2-glycoprotein I (anti-β(2)GPI/β(2)GPI)-induced tissue factor (TF) expression in human acute monocytic leukemia cell line THP-1. In the current stu
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- Sex hormones, both estrogens and androgens, have a strong impact on immunity in mammals. In fish, the role of androgens in immunity has received little attention and contradictory conclusions have been obtained. However, it is well known that sex steroids are involved in fish growth, osmoregulation
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★リンクテーブル★
| リンク元 | 「100Cases 14」「satisfactorily」「favorable」「順調」「favorably」 |
| 拡張検索 | 「Caldwell projection」「Caldwell撮影」 |
「100Cases 14」
- ☆case14 複視
- ■glossary
- diplopia n. 複視
- 筋力低下、筋無力、筋脱力 muscle weakness, muscular weakness
- sunken
- vt. sinkのpp.
- adj.
- 沈没した、沈んだ、水中の
- 沈下した、一段低いところにある
- 落ち込んだ、くぼんだ
- 3,4-ジアミノピリジン 3,4-diaminopyridine 3,4-DAP K+チャネル阻害薬;ランバート・イートン筋無力症治療
- ■症例
- 43-year-old woman
- cheif complaint: diplopia
- present history: diplopia and holding her head up ; more marked in the evenings, for the last 3 months. difficulty of chewing. voice has become quieter. weight loss (3kg / 6months). non-smoker. drinks about 15 units/week. no regular medication.
- past history: no significant previous medical illnesses.
- family history: lives with her husband and three children.
- ・診察 examination
- looks well.
- organ systems: normal; cardiovascular, respiratory, and abdominal systems.
- muscle power; grossly normal. decrease after testing a movement repetitively.
- motor function: normal; tone, coordination, reflexes and sensation.
- bilateral ptosis. exacerbated by prolonged upward gaze
- eye: normal; pupillary reflexes, eye movements, and funduscopy
- ■答え
- diagnosis: myathenia gravis
- differential diagnoses:
- CASES
- 上位and/or下位運動ニューロン motor neurone disease 運動ニューロン疾患：線維束性攣縮。進行例では筋力低下
- 筋 muscular dystrophy 筋ジストロフィー：ある種の筋肉が選択的に筋力低下する。家族歴がある。
- 筋 dystrophia myotonica 強直性筋ジストロフィー：咬筋、側頭筋、胸鎖乳突筋の筋萎縮、四肢遠位端の筋萎縮。顔貌が特徴的(前頭部脱毛、無表情、窪んだ頬)。家族歴ある。筋電図が診断に有用(急降下爆撃音)。
- 筋 polymyositis 多発筋炎：普通は皮疹と関節痛が出現。CKが上昇。筋生検が診断に有用
- 筋 myopathy ミオパチー：甲状腺中毒性ミオパチー、甲状腺機能低下症によるミオパチー、クッシング症候群によるミオパチー、アルコール性のミオパチー
- 神経筋接合部？ non-metastatic associations of malignancy (paraneoplastic syndrome(傍腫瘍性症候群 = 腫瘍随伴症候群)のこと)：胸腺腫の症例の10%に重症筋無力症がみられる。ランバート・イートン筋無力症症候群は小細胞癌と関連がある。
- HIM.2674
- Treatment with penicillamine (used for scleroderma or rheumatoid arthritis) may result in true autoimmune MG, but the weakness is usually mild, and recovery occurs within weeks or months after discontinuing its use.
- 重症筋無力症の誘発：ペニシラミン(強皮症や関節リウマチの治療に用いられる)。
- mildだし、薬剤の中断で改善する。
- Aminoglycoside antibiotics or procainamide can cause exacerbation of weakness in myasthenic patients; very large doses can cause neuromuscular weakness in normal individuals.
- 重症筋無力症の悪化：アミドグリコシド系抗菌薬、プロカインアミド
- MGの患者の筋脱力が悪化する。
- 神経筋接合部 Lambert-Eaton myasthenic syndrome ランバート・イートン筋無力症症候群：全身の筋肉が冒されるが、特に下肢の近位筋が冒される。MGと同じように～70%の患者で脳神経所見(眼瞼下垂、複視など)が認められる。MGと違うのは(1)反射が消失・減弱すること、(2)自律神経系の変化(口渇、勃起不全)を生じる、(3)神経刺激検査で漸増(waxing)が見られることである。病因は神経筋接合部のP/Q type calcium channelsに対する抗体の出現であり、85%の患者で見いだされる。治療はMGのように血漿交換や免疫抑制薬が使われる。3,4-DAPやpyridostigmineは症状に対する治療のために用いる。前者は運動神経の終末部でカルシウムチャネルをブロックし活動電位を延長させる。後者はアセチルコリンエステラーゼを阻害してシナプスにおける神経伝達物質の濃度を上げる。
- 精神疾患 neurasthenia 神経衰弱症：歴史的な用語。器質的な障害を伴わない筋無力症のような脱力を伴う症候群。患者は筋脱力や疲労を訴えてやってくる。筋肉の検査では器質的変化は認めないが"jerky release"あるいは"give-away weakness"が認められる。患者の主訴は反復動作による筋力低下よりむしろ疲労や感情鈍麻である。
- 内分泌疾患 hyperthyroidism 甲状腺機能亢進症：MGが疑われる患者にはthyroid function testをルーチンにやる。甲状腺機能異常は筋無力症の筋力低下を大きくすることがある。
- 神経筋接合部 botulism ボツリヌス症：ボツリヌス毒素はシナプス前膜からの神経伝達物質の開口分泌を妨げる。症状はbulbar weakness (複視、構音障害、嚥下困難)。感覚障害はない。深部腱反射は初期には保たれている。進行すれば反射は見られなくなる。筋脱力は全身性。呼吸困難に陥ることがある。精神状態は正常。自律神経症状(麻痺性イレウス、便秘、urinary retention、瞳孔の散大、瞳孔の反応性低下、口渇)。確定診断は血清中の毒素の検出だけど、見つかることはまれ。神経伝導検査(nerve conduction studies)：compound muscle action potentials (CMAPs)の低下。高頻度の刺激で振幅が増加。治療：intubation for airway protection、呼吸補助、aggressive inpatient supportive care(e.g., nutrition, DVT prophylaxis)。馬の抗毒素を検査結果が帰ってくる前に投与する(？)。
- 上位運動ニューロン intracranial mass lesions 頭蓋内占拠病変：複視はintracranial mass lesionが外眼筋の神経を圧迫することにより生じる。
- 筋 progressive external ophthalmoplegia 進行性外眼筋麻痺：外眼筋の筋脱力を伴う。四肢の近位筋の筋力低下やそのほかの全身症状を伴うことがある。ミトコンドリアの異常を有する。
- ■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
「satisfactorily」
- adv.
- 満足に、良好に、十分に、順調に
- 関
- adequate、adequately、ample、enough、excellent、favorable、favorably、full、fully、pleasure、richly、satisfaction、satisfactory、satisfy、sufficient、sufficiently、well
「favorable」
- adj.
- 関
- advantage、advantageous、beneficial、beneficially、benefit、convenient、expedient、favorably、favourable、pleasant、preferable、satisfactorily、satisfactory、well
「順調」
「favorably」
- adv.
- 都合良く、順調に、有利に
- 関
- advantage、advantageous、beneficial、beneficially、benefit、favorable、favourable、satisfactorily、satisfactory、well