and welcome to my channel, Sick Notes

ようこそ僕のシックノート・チャンネルへ

where I explained medical things in simple terms like

医療を優しい言葉で説明しています

the other week I looked at the medical anime Cells at Work

先週は医療アニメ「はたらく細胞」を取り上げました

and not only did the show blow me away

僕を驚かせたのはこの作品のみならず

but your response to the video did as well

僕の動画が数日間で100万回以上再生された事にもです

over a million views in a few days

皆さんの応援 誠にありがとうございます

guys thank you so, so much for all the support

ということで『はたらく細胞』第2話も見ていきましょう

So it's only fair that I check out episode number two

また赤血球の話になりますが彼女は

of Cells at Work

体中に酸素を届けていて

[anime plays - Japanese audio]

第1話と同じく道に迷ってますね

So, we're following our red blood cell again

あと前回少しだけ出てきましたが

as she carries the oxygen around the body

今回紹介されましたね

and she's lost, like she spent most of the first episode

かわいい血小板 医学用語では「血小板(Thrombocyte)」です

and we met them briefly before

これが血の塊である血栓(Thrombus)を作るので"THROMBO"

but we get properly introduced to the very cute platelets

そして ”CYTE" は成熟した細胞の事を指します

The medical term for them is the thrombocytes

小さい子供で表現していますが

"THROMBO" because they're involved in creating a thrombus-

血小板の大きさが赤血球の三分の一と

That's what we call a blood clot

大変小さい事と関係しているのでしょう

- and CYTE is a name we give to any mature cell

血栓となった時に小さな穴をふさがなければならないからです

[Japanese audio continues]

今回の題名が「かすり傷」なので彼等の働き方が描かれるのだと思います

So in this depiction they're little kids

良いですね血小板が赤血球の事をお姉ちゃんと呼んでいます

and this ties in because platelets are actually very tiny

というのもこれは非常に正確だからです

about a third of the size of a red blood cells

というのも血球の一族としてお互いは血の繋がりがあるからです

That's because their job is to really plug the small gaps

二人は同じ細胞が祖先です

when a thrombus forms.

その祖先は骨の中心にある骨髄と呼ばれる部分で作られます

And this episode is called a scrape wound

「造血」と呼ばれる過程で造られます

so we're probably going to find out all about how they work and everything they're carrying as well

文字通り「血液の製造」ですね

Aw, I like that the platelet calls the red blood cell "Big Sister"

「赤血球と血小板の血縁関係について」

because this is entirely accurate

骨髄の中に幹細胞があって

because the two are related in the kind of family tree

色んな医学研究で皆さんも聴いた事があるかも

of blood cells

幹細胞は様々な種類の細胞に分化する能力があります

So they share the same ancestry of cells all produced

そのうちの一つが…

in the center of the bones, what we call the bone marrow

骨髄前駆細胞…すごく長い名前です

in a process we call hematopoiesis

これも様々な細胞へと発達することが可能です

Quite literally means "production of blood"

そしてようやくErythrocytes…赤血球

So we have our stems cells in

『はたらく細胞』で第三位のお気に入りです

the bone marrow

ERYTHROが「赤」

You've probably heard of these in lots of medical research because they've got the

CYTEは先ほど言いましたが成熟した細胞です

ability to turn into lots of different cell types.

また骨髄前駆細胞は巨核球と言う細胞にもなります

One of these cell types is the myeloid progenitor cells

パワーレンジャーみたいな名前ですよね

quite a long word!

描いているのが巨核球です

And in turn, they can develop into lots of different cells as well

この細胞が血小板を生産します

So we have the erythrocyte

正確に言うと血小板は細胞ではありません

the red blood cell,

巨核球が壊れてできた残骸です

so one our of fan favorites in Cells at Work.

赤血球と血小板がお互いを姉妹と呼ぶのは正しいのです

ERYTHRO means red and CYTE, as we said earlier,

そしてこの図を完成させると

is a mature cell.

骨髄前駆細胞は他の細胞にもなります

The myeloid progenitor cell can also turn into a megakaryocyte

私たちの一番のお気に入り…

which sounds like something out power rangers, doesn't it?

好中球

I'll draw our megakaryocyte here

三人ともいわば家族の一員なのです

And this is the cell that produces platelets

これは素晴らしいですね

Strictly speaking, platelets themselves

想像よりかなり激しいですね

are not cells, they're just fragments

皮膚を表す街全体が被害を受けました

broken up from these big megakaryocyte

これも正しいですね

So when the red blood cell and the platelets refer to themselves

過去に酷いすり傷をした人は分かるでしょう

as sisters, you know, they pretty much are

直るまでに時間がかかりますし色調の変化が戻らない事もあります

And also just to complete the picture, this myeloid progenitor cell

一生の傷になる事もあります

can also turn into our favorite ...

それに実際の彼らはとても小さな存在なので

The neutrophil

小さな傷でも細胞にとっては深刻なのです

So they're kinda all

白血球がこういう事を赤血球にするのか私には良く分かりませんが

one big happy family

演出ですね

So this is our scrape wound, uh

さて第1話では肺炎レンサ球菌だけを相手にしましたが

it's much more radical than I expected

今回の相手は山盛りの雑菌達ですね

I mean the whole city, representing the skin,

皮膚の役割の一つは外部環境と自身の体の防波堤となる事です

has been damaged, but this kinda fits right? Anyone that's

なので皮膚が裂ければいつもは皮膚の上にいて

had a scrape wound or an abrasion before will know that

害の無い細菌が皮膚の下に入り込みます

it takes a long time to heal actually

そして増殖を開始し

you'll notice some discoloration for awhile, sometimes

この画面のような多くの「悪者」に感染するわけです

you'll be permanently left with some kind of scar, so

私達の皮膚に普通に存在していて特に問題の無い細菌の一つが

maybe I underestimated - obviously these guys are very small

黄色ブドウ球菌です

so even small injuries are gonna have big effects

この姿はとても的確です

on individual cells

ブドウ球菌は前回の動画でお話したように

There he is, the man! I'm not sure white blood cells quite

ブドウ状の集団を作ります

do this with red blood cells, but you know

その様子をこの容姿で表現していますね

creative license

そしてAureusは金色や黄色という意味です

Okay so in the first episode we had to deal with

だからあの色なんですね

one bacterium, the streptococcus pneumoniae

黄色ブドウ球菌は一種の顔料を用いて…

and in this one we have to deal with

その金/黄色の顔料が防御機構の一部を形成し

a whole bunch, 'cause one of the functions

免疫系からの攻撃を受けにくくしています

of the skin is to be a physical barrier between the outside

これ良いですね

world and your bodies, so if that gets broken, then any

これは血管収縮を映像的にもとてもよく表していますね

bacteria that's just normally

急激に失血するとそれ以上の失血を防ごうとして動脈が収縮します

happily living on our skin, that doesn't effect us, can then get under

救急医が対応するような深刻な大量出血では

the skin and begin to proliferate

必要となれば末端部から身体が活動を停止していく様子を実感できるでしょう

and cause an infection

その時患者は蒼白となり冷たくなります

like we see all these nasties here

重要な臓器に必要な血液量を維持しようとして

And the classic example of a bacterium that normally lives on our skin

あえて身体がそうしているのですが

and doesn't cause any problems is staphlyococcus aureus

医者にとっては患者の治療が難しくなります

and its really well represented here

医者は輸血や輸液ができる動脈を確保しようとしますが

so the staphlyococcus, remember I talked about in the last video

動脈が収縮しているとそれが困難になります

means it forms these grape like colonies

化膿レンサ球菌

We can see that the shape they've made the bacterium

Pyogenes は化膿の事です

kind of represents that

この細菌は感染すると特に化膿を引き起こします

And aureus means gold or yellow-y color

この人はシュードモナス属ですね

that's obviously why they've picked this color

ではこの二つを説明するとしましょう

because staphlyococcus aureus has this kind of pigment

まず化膿レンサ球菌が出てきました

A gold yellow-y pigment that's part of its

玉が繋がって尻尾になっていますが

defense mechanism that makes it

これは連鎖球菌の集団が鎖状であることを表現しています

harder for the immune system to break down the bacteria

前回に説明しましたね

I love that.

さて皆さんの皮膚の上にもこういう細菌達が存在していますが

Its a great sort of visual depiction

身体に傷を受けた時にはまさにこのような事が起きているのです

and explanation of vasoconstriction

いやまあ…これ程のドラマ仕立てな事は起きていませんが

so when our arteries become more narrow

それでも免疫系の働きとしてこのような敵と戦うのです

during acute blood loss to stop blood from getting lost

このような素晴らしい事が起きていますし

Some of the really scary massive bleeds

他の細胞達も皆さんが生きるためそれぞれに働いています

I've seen as an emergency doctor, you get an idea

そして皆さんは皆さんであり続けるのです

of the scale that the body can shut down peripherally when it needs to

画面に映っている他のウイルスや細菌も後の回に出てくるのでしょう

So the patient would go look very pale and very cold

この作品は非常にこだわって作られているので

and although that's what you want your body to do

彼らも実際の病原体に基づいているのでしょう

because you want to preserve all the blood

後に出てくるかもしれませんね

for the important organs

このような棒状のモノを出す細菌がいるのかは分からないので

for a doctor that makes your job more difficult

ぜひコメントにてお願いします

in treating the patient because, you know, we want

細胞同士の連絡は実際に行われます

to get access into the veins to try and give blood and fluids

その方法を疑問に思うかもしれません

and that's more difficult when the veins are kind of shutting down

好中球は第1話で見たように細胞間を遊走しますから

So streptococcus pyogenes

神経系を介しての連絡はできません

So pyogenes means puss

彼らはサイトカインという化学伝達物質を使います

presumably because this bacteria causes

CYTO は前述のように細胞の事で

lots of puss when it infects, and

KINE は連絡の事です

pseudomonas!

ある細胞がサイトカインを産生すると他の細胞を近くに引き寄せます

I always wondered what these two bacteria looked like close up

今見てるような感じです

When we meet streptococcus pyogenes here

この黄色ブドウ球菌は微生物学講義を履修してますね

its tail is made up of all these

感染における全ての免疫細胞達の

little blobs connected together, I think that represents

活動開始時期の差を説明していましたね

the streptococcus colony

ああ血小板達が助けに現れました

formation of this chain

そして血栓も出てきますね

that we talked about in the last episode

今回の冒頭に出ていました

It does make you think, because you have these colonies

血栓は一連の化学反応でつくられます

of bacteria on your skin, that when you do get a trauma

体中に運ばれている水溶性のフィブリノゲンはフィブリンへと変化します

and they get in to the body, this

これは非水溶性のネットを形成し血栓を包み込みます

exact thing is happening, you know

そして血小板や細胞など色々がこのネットに絡まって栓となり

not quite as bad ass and

血管からそれ以上の血液が失われないようにします

dramatic, but your immune system is doing its job

赤血球と白血球のちょっとしたラブストーリーですね

it is fighting these bugs

残念ですが…実際には起こりません

Its a pretty amazing thing to happen

跳ねている髪の毛が良いと思いますが

just so that all your other cells can carry on living

実際の何かを現しているのかな…

And so that they can carry on making you, you!

ちゃんとコメントは読んでますから

I'm not quite sure what all these other nasties are, the other

フィブリンに何もかもが絡まっていく事を見せてくれましたね

bacterium, but maybe we'll find out in later episodes

流石ですね

I'm judging at how much care and attention has gone into this show

ブラボー

No doubt they are based on some kind

今回も素晴らしいお話でした

of pathogen - maybe we'll find out in later episodes

私のコメントは楽しんで頂けましたか

I don't know of any of them that produce these kinds of

医学的表現についてこの作品はいい仕事をしていますね

stick like projections, but let me know

続きの回も見たい方はぜひこの動画をイイねしてください

in the comments if you do

コメントとチャンネル登録もお願いしますそうすれば

So the ability to communicate between cells

私が次回の動画を上げたら通知が届きますよ

totally happens, and you might think

そして前回の動画について今一度お礼申し上げます

how does that happen? Because these neutrophils as we learnt in the first

皆さんの反応に心から驚きました

episode are migrating cells, so they can't really use things like

大変感謝しております

the nervous system to communicate to each other

出来る限り動画を増やしていきます

well they use chemical messengers

それではまた次回早めにお会いしましょう

that we call cytokines. so CYTO

meaning cells, as we talked about earlier, and KINES meaning

kinetic, because these cytokines are when a cell

produces them, draw other cells to that area

so that would be what would be going on here

So the staphylococcus aureus

has clearly done her microbiology class, discussing

all the immune cells and their kind of rough timelines

in fighting infection

Aw, so we have the platelets come to the rescue

and we see the blood clotting here

what we kind of thought we'd see at the beginning of the episode

essentially the blood clotting is a

load of chemical reactions that turn something that's soluble

in water, fibrinogen, so it can be transported around the body

to fibren, something insoluble

that forms this kind of net that we can see that covers

up the clot

Then lots of stuff gets stuck in that net

like the platelets and other cells to form a kind of plug

and to stop any blood-

any more blood from coming out of the blood vessel

Aw, we got a little bit of a brewing love story between the red

blood cell and the white blood cell

I feel bad telling you that... this stuff doesn't happen

And I like her little curved piece of hair she has here

I wonder if that's something relevant or not

That's right, I've been reading the comments

So they do show the plug that the fibrin sticks everything to in the end

So very good! Bravo!

Aw man, that's another fantastic episode

I hope you guys enjoyed my thoughts on it

I mean the show does such a great job with explaining

the medical science

Anyway, but if you want me to look at more episodes, then please give

this video a thumbs up and a comment

and subscribe to the channel as well because then you'll be notified

when I do the next one

Just, again, thank you so much for all the support on the first video

I was absolutely blown away by the response

and I really appreciate it, so I'll keep doing

as much content as I can, so

until next time

I'll see you soon