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HINTERNET g_hInet; HINTERNET g_hURL; //===========================================================================// /*! @brief WinInetライブラリ初期処理 @param[in] lpszURL 対象URL @return 成否 */ //===========================================================================// BOOL InitWinInet(LPCTSTR lpszURL) { // WinInetライブラリ開始 g_hInet = InternetOpen( L"", INTERNET_OPEN_TYPE_PRECONFIG, NULL, NULL, 0); if (g_hInet == NULL) { return FALSE; } // セッションオープン g_hURL = InternetOpenUrl(g_hInet, lpszURL, NULL, 0, 0, 0); if (g_hURL == NULL) { return FALSE; } return TRUE; } //===========================================================================// /*! @brief WinInetライブラリ終了処理 @return 無し */ //===========================================================================// void TerminateWinInet() { // WinInet関連ハンドル開放 if (g_hURL) { InternetCloseHandle(g_hURL); } if (g_hInet) { InternetCloseHandle(g_hInet); } } //===========================================================================// /*! @brief HTTPソース取得 @param[in] lpszURL 対象URL @param[out] lpOutBuffer HTTPソースバッファ @param[in/out] hMem メモリハンドル @return 成否 */ //===========================================================================// BOOL WINAPI NMAPI_GetHttpHeader(LPCTSTR lpszURL, LPTSTR lpOutBuffer, HGLOBAL hMem) { BOOL bRet = FALSE; // WinInetライブラリ初期処理 if (! InitWinInet(lpszURL)) { goto END; } // バッファバイト数取得 DWORD dwSize = 0; if (! HttpQueryInfo(g_hURL, HTTP_QUERY_RAW_HEADERS_CRLF, (LPVOID)NULL, dwSize, NULL)) { if (GetLastError()==ERROR_HTTP_HEADER_NOT_FOUND) { goto END; } } // メモリ再割り当て hMem = GlobalReAlloc(hMem, (SIZE_T)dwSize+1, GMEM_MOVEABLE); if (hMem == NULL) { goto END; } lpOutBuffer = (TCHAR *)GlobalLock(hMem); if (lpOutBuffer == NULL) { goto END; } // HTTPヘッダ情報取得 if (! HttpQueryInfo(g_hURL, HTTP_QUERY_RAW_HEADERS_CRLF, (LPVOID)lpOutBuffer, dwSize, NULL)) { goto END; } bRet = TRUE; END // WinInetライブラリ終了処理 TerminateWinInet(); return bRet; } //===========================================================================// //呼び出し側 //===========================================================================// { HGLOBAL hMem = GlobalAlloc(GHND, sizeof(TCHAR)); CHAR* lpszSource = (CHAR*)GlobalLock(hMem); if (NMAPI_GetHttpSource(strURL, lpszSource, hMem)) { ・・・ ・・・ ・・・ } // メモリ開放 GlobalUnlock(hMem); GlobalFree(hMem); }
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それでは早速、最初のインストーラーを作ってみよう。 ここで作るインストーラは ソフトウェア名は「hoge soft」 カレントディレクトリ下の .\SOURCE\TEST.TXT というファイルをインストールするものとして組み込む インストール先は C \ 直下 といった感じのものだ。 注：Cドライブ直下へのインストールはWindowsVistaでは許可されていない可能性がある（未確認）ため、Vista上で実験する場合はインストール先を変えるなどの必要があるかもしれない。 以下、実際のWiXのコードになる（コードの解説は「SimpleInstaller解説」を参照） ?xml version="1.0" encoding="shift-jis"? Wix xmlns="http //schemas.microsoft.com/wix/2003/01/wi" Product Id="????????-????-????-????-????????????" Manufacturer="hoge corp" Language="1041" Name="hoge soft" Version="1.0.0" Codepage="932" Package Id="????????-????-????-????-????????????" Compressed="yes" / Media Id="1" EmbedCab="yes" Cabinet="disk1.cab" / Directory Id="TARGETDIR" Name="SOURCE" Component Id="COMPONENT1" Guid="ff746e5c-441b-4772-9fdf-52a105ec37a1" DiskId="1" File Id="MAINFILE" Name="TEST.TXT" / /Component /Directory Feature Id="MAINFEATURE" Level="1" ComponentRef Id="COMPONENT1" / /Feature /Product /Wix 事前準備 上記のコードを適当なファイル名で保存する。ここではひとまず C \WixProject\SimpleInstaller.wxs という名前で保存したと仮定して話をすすめよう。 続いてインストールするダミーファイルとなる、TEST.TXTを用意する。ファイルパスは C \WixProject\SOURCE\TEST.TXT とし、ファイルの中身は特に問わないので、空のファイルでもよい。 コンパイル コマンドプロンプトを立ち上げ、カレントディレクトリを C \WixProject\ に移動する。続いてWiXのコンパイラ「candle.exe」を使って先ほど書いたSimpleInstaller.wxsをコンパイルしよう。（下記はwixのディレクトリにPATHが通っている前提の例になる） C \WixProject candle SimpleInstaller.wxs Microsoft (R) Windows Installer Xml Compiler version 2.0.5325.0 Copyright (C) Microsoft Corporation 2003. All rights reserved. SimpleInstaller.wxs C \WixProject このように何もエラーが出なければコンパイルが成功している。コンパイルできると、SimpleInstaller.wixobjというファイルができあがっているはずだ。 リンク 続いてWiXのリンカー「light.exe」を使い、実際にインストールするファイルを関連付けて、MSIファイルを生成する作業を行う。 C \WixProject light SimpleInstaller.wixobj Microsoft (R) Windows Installer Xml Linker version 2.0.5325.0 Copyright (C) Microsoft Corporation 2003. All rights reserved. C \WixProject このように何もエラーが出なければリンクも成功している。リンクまで完了すると、SimpleInstaller.msiというファイルが出来上がっているはずだ。 インストール それでは初のインストーラを起動してみよう。単にSimpleInstaller.msiをダブルクリックすればOKだ。 こんな感じで味気ないながらも、インストーラが起動しただろう。終了したら C \ 直下を覗いてみて、TEST.TXTというファイルが置かれていれば、インストーラとして正常に動作している。 アンインストール 続いてアンインストールをしてみよう。コントロールパネルからアプリケーションの削除と追加を選び、「hoge soft」の名前でソフトウェアを探し、削除ボタンを押す。すると先ほどと似たような画面が立ち上がり、あっさりと終了するはずだ。 C \ 直下を覗いてみると、TEST.TXTというファイルはなくなっているはずだ。 visitor - (today - ) Author nagatyo コメント （注：コメントは管理人が適宜消去する場合があります） 名前 コメント すべてのコメントを見る
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http //en.wikipedia.org/wiki/Dense_Inert_Metal_Explosive Dense Inert Metal Explosive From Wikipedia, the free encyclopedia Jump to navigation, search Dense Inert Metal Explosive (DIME) is an experimental type of explosive that has a relatively small but effective blast radius. It is manufactured by producing a homogeneous mixture of an explosive material (such as HMX or RDX) and small particles of a chemically inert material such as tungsten. It is intended to limit the distance at which the explosion causes damage, to avoid collateral damage in warfare. The phrase inert metal refers to a chemically inert metal that is not chemically active and therefore not part of the chemical reaction that causes the explosion, as opposed to some metals, such as aluminium that form part of the chemical reaction. An emerging criticism of DIME weapons is that they might turn out to have strong biological effects in those who are hit by the micro-shrapnel from these types of explosives.[1] DIME mixtures have been studied for some time,[2] but apparently only began to be adopted for weapons after the year 2000. Dense Inert Metal ExplosiveMethod of operation Toxic/carcinogenic effects Reported use See also References External links Method of operation DIME weapons consist of a carbon fiber casing filled with mixture of explosive and a very dense powder of a heavy metal tungsten alloy (HMTA) composed of tungsten and other metals such as cobalt and nickel or iron. Two common HMTA alloys are rWNiCo tungsten (91–93%), nickel (3–5%) and cobalt (2–4%) rWNiFe tungsten (91–93%), nickel (3–5%) and iron (2–4%) Upon detonation of the explosive, the casing disintegrates into extremely small particles, as opposed to the shrapnel which results from the fragmentation of a metal shell casing. The HMTA powder acts as micro-shrapnel which is very lethal at close range (about 4 meters or 13 feet), but loses momentum very quickly due to air resistance, coming to a halt within approximately 40 times the diameter of the charge. This increases the probability of killing people within a few meters of the explosion while reducing the probability of causing death and injuries or damage farther away. Survivors close to the lethal zone may have their limbs amputated (as the micro shrapnel can slice through soft tissue and bone) from the HMTA micro-shrapnel embedded in their body tissue.[3] Toxic/carcinogenic effects The carcinogenic effects of heavy metal tungsten alloys (HMTA) have been studied by the U.S. Armed Forces since at least 2000 (along with depleted uranium (DU)). These alloys were found to cause neoplastic transformations of human osteoblast cells.[4] A more recent U.S. Department of Health and Human Services study in 2005 found that HMTA shrapnel rapidly induces rhabdomyosarcoma cancers in rats.[5] The tungsten alloy carcinogenicity may be most closely related to the nickel content of the alloys used in weapons to date. However, pure tungsten and tungsten trioxide are also suspected of causing cancer and other toxic properties, and have been shown to have such effects in animal studies.[6] DIME wounds are considered to be untreatable because the metal is delivered in the form of small pellets rather than larger chunks of metal that could be removed with surgery.[7] Reported use As reported in the French national newspaper Le Monde, according to a team of journalists from the Italian State radio-television RAI, DIME-type bombs were being used in the Gaza Strip by the IDF against Palestinian targets during July/August 2006. The investigation was performed by examining the unusual wounds, and a lab analysis of the metals found in the victims bodies was reportedly "compatible with the hypothesis" that a DIME weapon was involved. Israel denied possessing or using such weapons.[8] Dr. Mads Gilbert and Dr. Erik Fosse, working on wounded from the 2008–2009 Israel–Gaza conflict, report injuries that they believe can only be caused by some new type of weapon used by Israel which they suspect are DIME bombs.[9][10][11] See also GBU-39 Small Diameter Bomb References ^ DIME A New Horror at Question Everything, January 14, 2009 ^ Cooper, Paul W. Explosives Engineering. New York Wiley-VCH, 1996. ISBN 0-471-18636-8. ^ Dense Inert Metal Explosive (DIME) at globalsecurity.org ^ "Neoplastic transformation of human osteoblast cells to the tumorigenic phenotype by heavy metal–tungsten alloy particles induction of genotoxic effects". Carcinogenesis, Vol. 22, No. 1, 115-125, January 2001 ^ Embedded Weapons-Grade Tungsten Alloy Shrapnel Rapidly Induces Metastatic High Grade Rhabdomyosarcomas in F344 Rats by the National Institute of Environmental Health Sciences ^ Tungsten and Selected Tungsten Compounds - Review of Toxicological Literature ^ "Gaza Israel under fire for alleged white phosphorus use", Christian Science Monitor, January 14, 2009, by Robert Marquand and Nicholas Blanford ^ Gaza doctors say patients suffering mystery injuries after Israeli attacks, The Guardian. October 17, 2006. ^ Is Israel Using Banned and Experimental Munitions in Gaza?, Democracy Now!. Retrieved January 19, 2009 ^ Fouché G. Norwegian doctors call for investigation into weapons used on Gaza., BMJ 2009;338 b170. ^ Amira Hass (19/01/2009). "Norwegian doctor Israel used new type of weapon in Gaza". Haaretz (Israel). http //www.haaretz.com/hasen/spages/1056649.html. Retrieved on 19 January 2009. "His best guess, he said, is that the pressure wave is caused by a dense inert metal explosive, or DIME, a type of bomb developed to minimize collateral damage. A military expert working for Human Rights Watch also told Haaretz that the nature of the wounds and descriptions given by Gazans made it seem likely that Israel used DIMEs." External links Dense Inert Metal Explosive (DIME) How Goes the War From Here? Small diameter solutions SF Chronicle, September 12, 2006 Cancer worries for new U.S. bombs by Defense Tech Retrieved from "http //en.wikipedia.org/wiki/Dense_Inert_Metal_Explosive" Categories Ammunition | Explosives | Future American weapons | Weapons of Israel
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- visitors Maize Phosphoenolpyruvate Carboxylase http //www.jbc.org/content/280/12/11798.full A Takahashi-Terada, M Kotera, K Ohshima, T … - Journal of Biological …, 2005 - ASBMB Phosphoenolpyruvate carboxylases (PEPC, EC 4.1.1.31) from higher plants are regulated by both allosteric effects and reversible phosphorylation. Previous x-ray crystallographic analysis of Zea mays PEPC has revealed a binding site for sulfate ion, speculated to be the site for ... 2009 Bacterial-type phosphoenolpyruvate carboxylase (PEPC) functions as a catalytic and regulatory subunit of the novel class-2 PEPC complex of vascular plants http //www.jbc.org/content/284/37/24797.abstract B O Leary, SK Rao, J Kim, WC Plaxton - Journal of Biological Chemistry, 2009 - ASBMB Phosphoenolpyruvate carboxylase (PEPC) is a tightly regulated anaplerotic enzyme situated at a major branch point of the plant C metabolism. Two distinct oligomeric classes of PEPC occur in the triglyceride-rich endosperm of developing castor oil seeds (COS). Class-1 PEPC is ... 2008 Oxidative pentose phosphate pathway-dependent sugar sensing as a mechanism for regulation of root ion transporters by photosynthesis http //www.plantphysiol.org/cgi/content/abstract/146/4/2036 L Lejay, J Wirth, M Pervent, JMF Cross, P Tillard … - Plant …, 2008 - Am Soc Plant Biol Root ion transport systems are regulated by light and/or sugars, but the signaling mechanisms are unknown. We showed previously that induction of the NRT2.1 NO 3 – transporter gene by sugars was dependent on carbon metabolism downstream hexokinase (HXK) in ... Evolution of C4 phosphoenolpyruvate carboxylase in Flaveria determinants for high tolerance towards the inhibitor L-malate http //www3.interscience.wiley.com/journal/119398758/abstract?CRETRY=1 SRETRY=0 B Jacobs, S Engelmann, P Westhoff, … - Plant, Cell …, 2008 - interscience.wiley.com During the evolution of angiosperms, C 4 phosphoenolpyruvate carboxylases have evolved several times independently from ancestral non-photosynthetic isoforms. They show distinct kinetic and regulatory properties when compared with the C 3 isozymes. To identify the ... Kinetic analyses of recombinant isoforms of phosphoenolpyruvate carboxylase from Hydrilla verticillata leaves and the impact of substituting a C4-signature serine http //www.sciencedirect.com/science?_ob=ArticleURL _udi=B6TBH-4RPTJ4W-1 _user=10 _coverDate=04%2F30%2F2008 _rdoc=1 _fmt=high _orig=search _sort=d _docanchor= view=c _rerunOrigin=scholar.google _acct=C000050221 _version=1 _urlVersion=0 _userid=10 md5=ec011bac999ef45d83524838dc0edc5b SK Rao, JB Reiskind, G Bowes - Plant Science, 2008 - Elsevier Hydrilla verticillata (Lf) Royle is a single-cell C 4 NADP-malic enzyme species in which the C4 and Calvin cycles operate in the same cell; phosphoenolpyruvate carboxylase (PEPC; EC 4.1.1.31) is the initial carboxylase. The cDNAs of two Hydrilla PEPC isoforms were ... Maize C4-form phosphoenolpyruvate carboxylase engineered to be functional in C3 plants mutations for diminished sensitivity to feedback inhibitors and for … http //jxb.oxfordjournals.org/cgi/content/abstract/ern018v1 T Endo, Y Mihara, T Furumoto, H … - Journal of …, 2008 - Soc Experiment Biol Introducing a C 4 -like pathway into C 3 plants is one of the proposed strategies for the enhancement of photosynthetic productivity. For this purpose it is necessary to provide each component enzyme that exerts strong activity in the targeted C 3 plants. Here, a maize C 4 -form ... 2007 Physiological impacts of modulating phosphoenolpyruvate carboxylase levels in leaves and seeds of Arabidopsis thaliana http //www.sciencedirect.com/science?_ob=ArticleURL _udi=B6TBH-4M4CTJP-1 _user=10 _coverDate=02%2F28%2F2007 _rdoc=1 _fmt=high _orig=search _sort=d _docanchor= view=c _rerunOrigin=scholar.google _acct=C000050221 _version=1 _urlVersion=0 _userid=10 md5=982911798c6aebe8ea23429dc85bb8b6 B Lebouteiller, A Gousset-Dupont, JN Pierre, J Bleton, … - Plant Science, 2007 - Elsevier Arabidopsis thaliana was transformed with a Sorghum C 4 PEPC cDNA under the control of the 35S promoter. Primary transformants were isolated and classified on a seed PEPC activity basis A lines (two-fold increase) and B lines (four-fold increase). Primary transformants ... 2006 Light regulation of the photosynthetic phosphoenolpyruvate carboxylase (PEPC) in Hydrilla verticillata http //pcp.oxfordjournals.org/cgi/content/abstract/47/9/1206 S Rao, J Reiskind, G Bowes - Plant and cell physiology, 2006 - Jpn Soc Plant Physiol The submersed monocot, Hydrilla verticillata (Lf) Royle, is a facultative C 4 NADP-malic enzyme (NADP-ME) plant in which the C 4 and Calvin cycles co-exist in the same cell. Futile cycling is avoided by an intracellular separation of carboxylases between the cytosol and ... The importance of the strictly conserved, C-terminal glycine residue in phosphoenolpyruvate carboxylase for overall catalysis Mutagenesis and truncation of Gly-961 … http //www.jbc.org/content/281/25/17238.abstract W Xu, S Ahmed, H Moriyama, R Chollet - Journal of Biological Chemistry, 2006 - ASBMB Phosphoenolpyruvate carboxylase (PEPC) is a “multifaceted”, allosteric enzyme involved in C4-acid metabolism in green-plants/- microalgae and prokaryotes. Prior to the elucidation of the three-dimensional structures of maize C4-leaf and Escherichia coli PEPC, our ... 2005 In vitro proteolysis of phosphoenolpyruvate carboxylase from developing castor oil seeds by an endogenous thiol endopeptidase http //pcp.oxfordjournals.org/cgi/content/abstract/46/11/1855 V Crowley, S Gennidakis, WC … - Plant and cell …, 2005 - Jpn Soc Plant Physiol Two novel phosphoenolpyruvate carboxylase (PEPC) isoforms have been biochemically characterized from endosperm of developing castor oil seeds (COS). The association of a 107 kDa PEPC subunit (p107) with an immunologically unrelated bacterial PEPC-type 64 kDa polypeptide leads ...
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http //www.terranova.name/ MusicBest Of + 5 Come Alive Escape Eye To Eye Music Best Of + 5 2005.12.5 [ Frontiers Records ] 1. I Wanna Know 2. Break Away 3. Livin It Up 4. Love Sick 5. Not Here With Me 6. Hey Babe 7. Right Now 8. Once Bitten Twice Shy 9. How 10. Make My Day 11. Holding On 12. Eye To Eye 13. Love Of My Life 14. Against The Wind 15. Reminiscing 16. I m The One 17. Holy Water Leucien Matheeuwsen (b), Lars Beuving (ds), Gesuino Derosas (g), Ron Hendrix (key), Fred Hendrix (vo) Producer Fred Hendrix Come Alive 2010年8月25日 ( HD ) 1. Come Alive / 2. Fighting Yourself / 3. Holy Grail / 4. Here Comes The Night / 5. Those Eyes / 6. Under Pressure / 7. Do Or Die / 8. Who Can You Count On / 9. My Own Way / 10. The Final Curtain / 11. One September Morning produced by Fred Hendrix Fred Hendrix (vo), Gesuino Derosas (g), Ron Hendrix (key), Lars Beuving (ds), Eric Coenen (b) Escape 2005年8月24日 ( HD ) 1. Long Live Rock N Roll / 2. Rock Bottom / 3. Hold The Line / 4. Heaven Knows / 5. Escape / 6. War On War / 7. You Are The One / 8. Sole Survivor / 9. Lonely Is The Night / 10. Back In The Eighties / 11. Part Of The Game / 12. Yesterday produced by Fred Hendrix Fred Hendrix (vo), Ron Hendrix (key), Gesuino Derosas (g), Eric Coenen (b), Hans Eilkenaar (ds) Eye To Eye 1999年7月27日 ( HD ) 1. Eye To Eye / 2. Wild Thing / 3. How / 4. Lovesick / 5. Wasting Time / 6. Promise You Wait / 7. Right Now / 8. Break Away / 9. Not Here With Me / 10. Holding On / 11. Those Were The Days / 12. The Real Thing / 13. Here s To You / 14. Untitled Fred Hendrix (vo,g), Gesuino Derosas (g), Lars Beuving (ds), Ron Hendrix (key), Lucien Matheeuwsen (b)
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クッキー付加 head !-- メタ情報として指定する場合 -- meta http-equiv="Set-Cookie" content="クッキー情報" /head !-- Javaで書く場合 -- script language="JavaScript" TYPE="text/javascript" document.cookie = "クッキー情報" /script !-- 適当なbody -- body WebServer01 br a href="./hoge" hoge /a br body 名前 コメント
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2019 Tour Dates 2019年ツアー予定 March 1st 2019 191 Toole Tucson, AZ March 2nd 2019 BLK Live Scottsdale, AZ March 6th 2019 The Aztec Th San Antonio, TX March 8th 2019 Emo s Austin, TX March 9th 2019 Gas Monkey L Dallas, TX March 10th 2019 House of Blu Houston, TX March 11th 2019 House of Blu New Orleans, LA March 12th 2019 Vinyl Music Pensacola, FL March 14th 2019 The Wilbury Tallahassee, FL March 15th 2019 The High Div Gainesville, FL March 16th 2019 The House of Orlando, FL March 17th 2019 The Orpheum Tampa, FL March 19th 2019 The Culture Fort Lauderdale, FL March 20th 2019 The Ponte Ve Ponte Vedra, FL March 22nd 2019 House of Blu Myrtle Beach, SC March 23rd 2019 Neighborhood Charlotte, NC March 24th 2019 Variety Play Atlanta, GA March 25th 2019 Georgia Thea Athens, GA March 26th 2019 Iron City Birmingham, AL March 27th 2019 Basement Eas Nashville, TN March 29th 2019 The Signal Chattanooga, TN March 31st 2019 The Orange P Asheville, NC April 1st 2019 Lincoln Thea Raleigh, NC April 2nd 2019 5 Points Mus Roanoke, VA April 4th 2019 The NorVa Norfolk, VA April 5th 2019 The National Richmond, VA April 6th 2019 The Fillmore Silver Springs, MD April 7th 2019 The Baltimor Baltimore, MD April 8th 2019 Theater for Philadelphia, PA April 10th 2019 The Stone Po Asbury Park, NJ April 11th 2019 Sony Hall New York, NY April 12th 2019 Toad s Place New Haven, CT April 13th 2019 The Met Pawtucket, RI April 15th 2019 The Wilbur Boston, MA April 16th 2019 Higher Groun South Burlington, VT April 18th 2019 State Theatr Portland, ME April 19th 2019 Pearl Street Northampton, MA April 20th 2019 Upstate Conc Clifton Park, NY April 23rd 2019 Westcott The Syracuse, NY April 24th 2019 Asbury Hall Buffalo, NY April 25th 2019 Jergel s Rhy Warrendale, PA April 26th 2019 Agora Theatr Cleveland, OH April 27th 2019 The Token Lo Westland, MI April 28th 2019 The Westown Bay City, MI April 30th 2019 Elevation The Intersection Grand Rapids, MI May 1st 2019 The Clyde Th Fort Wayne, IN May 3rd 2019 The Vic Chicago, IL May 4th 2019 The Arcada T St. Charles, IL May 5th 2019 The Rave / E Milwaukee, WI May 7th 2019 The Majestic Madison, WI May 9th 2019 First Avenue Minneapolis, MN May 10th 2019 Wildwood Iowa City, IA May 11th 2019 Atomic Cowbo St. Louis, MO May 13th 2019 The Louisvil Louisville, KY May 15th 2019 The Vogue Indianapolis, IN May 16th 2019 Woodlands Ta Columbus, OH May 17th 2019 Bogart s Cincinnati, OH Reference http //www.bucketheadpikes.com/
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～～心血管系の身体診察法～ Patient positioning Basic Exam Supine, head elevated 30 degrees Left lateral decubitus Sitting, leaning slightly forward Inspection and Palpation Inspection of PMI (apical impulse) Palpation of thrill Palpation of retrosternal heave Palpation of PMI Lateral displacement CHF, cardiomyopathy, ischemic heart disease Increased amplitude Hyperthyroidism, severe anemia, pressure or volume overload of LV Once you have found the apical impulse, make finer assessments with your fingertips, and then with one finger Auscultation Listen for rhythm and rate. Listen to at least two of the four cardiac areas for murmurs, rubs, gallops. Listen to the mitral area with the patient on his left side. Auscultate the apex with the bell of the stethoscope. Listen to the base of the heart with the patient leaning forward. Systolic murmur AS (-- carotids) PS (-- back) MR/MVP (-- axilla) TR Diastolic murmur MS , TS AR , PR Extra sounds S3 (flabby ventricle-- dilated cardiomyopathy) S4 (stiff ventricle -- LVH) Opening snap (-- MS) ejection sounds (-- AS, PS) systolic clicks (-- MVP) Split S2 Physiologic Splitting accentuated by inspiration usually disappears on expiration Pathologic Splitting Wide splitting (-- MR, PS) Fixed splitting (-- ASD) Paradoxical or reversed splitting (-- CLBBB, AS) Vascular Listen to the carotids for bruits (use the bell of the stethoscope). Look for JVP (45-degree, use light) Identify the highest point of pulsation in the right internal jugular vein. Measure the height of venous pressure from sternal angle. more than 4 cm above the sternal angle is elevated Right-sided HF, constrictive pericarditis, TS, SVC obstruction Check for pedal edema Check the peripheral pulses dorsalis pedis pulse / posterior tibial pulse Decreased or absent often seen in diabetes mellitus. Check for cyanosis/peripheral bloodflow (palm color)
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働きに行けるのか？ 先日は、パートの面接に行ってまいったんや！ やっってうちが落ち着おったさかい、働きに出られる事になったんや。 やけど、受かるかどないか分からんのややな。 その場でぇ結果を出してくれるわうな面接の仕方でぇはなかったさかい、今からドキドキして待たあらへんっていけまへん。 ちびっと嫌やけど、仕方おまへんやな。そない言えば、結果は後日らしいんやねんそやけど、どないやら合否に関係なく連絡をくれるわうやねん。 本日この時まで「否」やった場合は無連絡やったさかい、びっくりしてん。結果はどないなるでっしゃろな。 http //fieszala.mie1.net/ http //blog.livedoor.jp/gillettex/ http //jeramamia.naganoblog.jp/