日大医学雑誌
Online ISSN : 1884-0779
Print ISSN : 0029-0424
ISSN-L : 0029-0424
最新号
日大医学雑誌
選択された号の論文の10件中1~10を表示しています
巻頭言
シリーズ COVID-19
特  集
  • ─健康の向上を目的とした運動─
    中西 一義
    2021 年 80 巻 1 号 p. 7-10
    発行日: 2021/02/01
    公開日: 2021/04/22
    ジャーナル フリー
    Sports medicine is generally recognized as a specialty in the field of musculoskeletal medicine and encompasses the prevention and treatment of injuries related to sports and exercise. Additionally, sports medicine plays a role in our daily life, as it is important for maintaining our physical and mental health and preventing the onset of lifestyle-related diseases. Approximately 2400 years ago, the Greek doctor and philosopher Hippocrates stated that “walking is the best medicine”. I aim review the trends in insufficient physical activity among Japanese people and the intensity and amount of exercise required to maintain a healthy lifestyle.
  • 早川 智, 早川 純子
    2021 年 80 巻 1 号 p. 11-13
    発行日: 2021/02/01
    公開日: 2021/04/22
    ジャーナル フリー
    Exercise affects human immune functions through the hypothalamus-pituitary-adrenal (HPA) axis and reward systems in the brain. Most immune cells, including T cells, B cells and phagocytes, express functional hormone and neurotransmitter receptors and are regulated through the neuroendocrine immune network. Light-to-moderate exercise improves the defense activity against pathogens and prevents metabolic disorders. Many epidemiological and experimental studies have suggested there is an inverse relationship between moderate exercise training and illness risk. Furthermore, habitual exercise might improve immune regulation, reduce the activity of autoimmune disorders and delay age-related dysfunctions, such as sarcopenia. On the other hand, high-intensity exercise suppresses immune defense activity, especially against upper respiratory infections. Thus, high-intensity training and competitions possibly increase the risk of infection in athletes. Appropriate nutritional intake and hygiene control are also essential to protect both athletes and non-athletes.
  • 片渕 剛, 槇島 誠
    2021 年 80 巻 1 号 p. 15-19
    発行日: 2021/02/01
    公開日: 2021/04/22
    ジャーナル フリー
    Obesity-induced metabolic syndrome is becoming a severe health problem in Japan due to the increasing popularity of the Western-style diet and fast food. Endurance exercise is one of the most effective ways to reduce fat content and thus prevent metabolic syndrome, as endurance exercise leads to larger amounts of fatty acids being used to create energy with higher efficiency in skeletal muscle. There are two major types of skeletal muscle fibers: type I muscle fibers, which contain a large number of mitochondria and burn fatty acids for energy, and type II fibers, which contain fewer mitochondria and depend on glycolysis to acquire energy. Endurance exercise results in the development of type I muscle fibers and enhanced mitochondrial function, with increased expression and activity of mitochondrial enzymes such as carnitine palmitoyltransferase 1, β-hydroxy-acyl-CoA dehydrogenase and citrate synthase. On the other hand, in adipose tissues, higher amounts of fatty acids are released to support their increased usage in muscle fibers by increasing the activity levels of adipocyte triglyceride lipase and hormone-sensitive lipase following endurance exercise. The increased usage of fatty acids is considered an outcome of activated peroxidase proliferator-activated receptors (PPARs), nuclear receptors for fatty acids, and the induced transcription of proteins that play essential roles in fatty acid metabolism upon stimulation of those fatty acids. In three PPAR isoforms, muscle fibers predominantly express PPARγ, a regulator of mitochondrial enzyme transcription and type I muscle fiber development. In adipocytes, PPARγ is abundantly expressed to regulate fatty acid catabolism. Furthermore, skeletal muscles, adipose tissues and other tissues communicate through hormones such as myokines and adipokines, which optimize fatty acid metabolism in the entire body during endurance exercise. Collectively, endurance exercise shifts our energy metabolism to be more lipolytic for a healthier lifestyle.
  • 伊藤 玲子
    2021 年 80 巻 1 号 p. 21-25
    発行日: 2021/02/01
    公開日: 2021/04/22
    ジャーナル フリー
    It is expected that knowledge on the relationship between respiration and sports is beneficial for promoting both physical and mental health. With that knowledge, we can learn to exercise effectively every day. We supply oxygen to tissues by breathing. During exercise, respiration and circulation work closely together to carry oxygen to the mitochondria in muscles to generate energy. Exercise increases oxygen demand and carbon dioxide emissions. We increase the minute ventilation volume (MVV), thereby increasing V̇ O2 (oxygen consumption) as the exercise intensity increases. Endurance athletes exhibit higher levels of these parameters. MVV (maximum voluntary ventilation), which is a parameter used for evaluating the strength and endurance of inspiratory and expiratory muscles, improves after strength training. Strength training is thought to be effective in increasing the strength of the respiratory muscles. The combination of endurance training and strength training can improve lung function. Not only strengthening the respiratory muscles but also increasing the elastic contraction force of the lungs by training can improve respiratory ability. There are diseases in which sports affect lung function. Attention should be paid to exercise-induced asthma, vocal cord dysfunction, and COPD (chronic obstructive disease).
原  著
  • Wakabayashi Masakazu, Aoki Kana, Yoshida Hayato, Kimura Tomohiro, Domo ...
    2021 年 80 巻 1 号 p. 27-33
    発行日: 2021/02/01
    公開日: 2021/04/22
    ジャーナル フリー
    Since 2013, we have been performing laparoscopic inguinal hernia repair (transabdominal preperitoneal repair: TAPP) for inguinal hernias in adults, and it is currently the first-choice treatment at our institution. Herein, we report the treatment outcomes and strategies of TAPP for inguinal hernia at our hospital. 【Materials and Methods】 We investigated the surgical time, amount of blood loss, length of postoperative hospital stay, and postoperative complication rate of 700 patients (792 lesions) who underwent TAPP from February 2013 to July 2020 at our hospital. 【Results】 The median operation time was 61 minutes (one side), bleeding was negligible, and the median postoperative hospital stay was 1 day. Two patients (0.3%) experienced postoperative recurrence, but there were no reports of chronic pain. 【Conclusion】 The short-term treatment results of TAPP for inguinal hernia at our hospital were generally satisfactory. For surgeons skilled in laparoscopic surgery, TAPP could be a reasonable first-choice treatment for inguinal hernias.
  • 吉田 努, 入山 規良, 内野 慶人, 高橋 宏通, 中川 優, 濱田 高志, 飯塚 和秀, 小池 隆, 栗原 一也, 遠藤 聖英, 野口 ...
    2021 年 80 巻 1 号 p. 35-40
    発行日: 2021/02/01
    公開日: 2021/04/22
    ジャーナル フリー
    本研究は bortezomib 導入以後の治療の変遷が 多発性骨髄腫 (MM) 患者の予後の改善に寄与している か検討した。2006 年 12 月~2020 年 3 月に診断された MM 患者を,2011 年 5 月をカットラインとして層別化 し,患者背景,治療実態および予後を解析した。対象症 例は 154 例で,2011 年 5 月以前の治療開始(before 群, B 群)が 52 例で以降(after 群,A 群)が 110 例であり, 両群間で患者背景に有意な違いは認めなかった。3 年全 生存率は B 群が 46%,A 群が 75%であり A 群が有意に 良好であった。投与された薬剤としては,B 群は thalidomide の使用が有意に多く,A 群は bortezomib,pomalidomide,elotuzumab,daratumumab の使用が有意に多かっ た。新規治療薬の早期導入と各種レジメンの有効な活用 が患者の生存率改善に寄与していることを示唆する結果 であった。
症例報告
  • 一和多 信孝, 春日 悠岐, 大澤 大和, 高野 智圭, 山田 隆太郎, 小川 えりか, 石毛 美夏, 浦上 達彦, 渕上 達夫, Ngan ...
    2021 年 80 巻 1 号 p. 41-44
    発行日: 2021/02/01
    公開日: 2021/04/22
    ジャーナル フリー
    症例は日齢 24 の男児.発熱を主訴に当院に入 院した.対症療法で経過を見ていたが,入院 3 日目から 活気不良と網状チアノーゼを認め敗血症様症候群と診断 した.血清や便の逆転写 PCR 検査と遺伝子解析でヒト パレコウイルス 4 型が同定され,免疫グロブリンの投与 を行った.ヒトパレコウイルス 4 型による敗血症様症候 群は報告が少なく,その臨床像や治療法については確立 されていないが,重症例では免疫グロブリン療法が有効 と考える.
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