著者

樋口 義治

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.73, no.1, pp.20-21, 2014-02-01 (Released:2015-05-22)

参考文献数

3

被引用文献数

1 1

---

The effectiveness of β-blockers in the management of chronic heart failure has been widely validated. Patients with simple hypertension are not good candidates for β-blockers. β-blockers should be used for complicated cardiovascular diseases, including coronary artery disease, heart failure, and arrhythmia.

著者

赤星 俊樹 赤柴 恒人 植松 昭仁 岡本 直樹 権 寧博 細川 芳文 内山 真 橋本 修

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.69, no.1, pp.17-22, 2010-02-01 (Released:2010-06-14)

参考文献数

23

被引用文献数

1

---

Considerable progress has been made in both the basic research and clinical areas over the last several decades in our understanding of the pathogenesis of obstructive sleep apnea-hypopnea syndrome (OSAHS). This brief review highlights the potential mechanisms of repetitive collapse of the pharyngeal airway during sleep in patients with OSAHS.

著者

相澤 信

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.80, no.3, pp.131-136, 2021-06-01 (Released:2021-08-06)

参考文献数

3

著者

神津 悠

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.79, no.2, pp.65-69, 2020-04-01 (Released:2020-08-14)

参考文献数

20

---

Anaphylaxis is a serious disease that can be encountered in all medical departments. Although the onset may occur in unforeseen circumstances, it is necessary that the initial response be as efficient as possible. This article outlines the initial response and preventive measures based on the guidelines published by the Allergy Society in 2014. In the future, with the development of new drugs such as anti-tumor drugs, monoclonal antibodies, and biologics, dealing with atypical symptoms will become an issue. In order to deepen the understanding of anaphylaxis, it is important to understand the disease state, including the phenotype, end type, and biomarkers.

著者

内ヶ崎 西作 側嶋 絵里菜

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.74, no.4, pp.192-194, 2015-08-01 (Released:2016-01-25)

参考文献数

8

被引用文献数

1 1

著者

鈴木 裕

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.71, no.6, pp.385-389, 2012-12-01 (Released:2013-11-07)

参考文献数

12

---

軽度認知障害 (mild cognitive impairment: MCI)は,Petersen により提唱された疾患である. 1. 認知機能は正常とはいえないが,認知症の診断基準も満たさない.2. 本人または情報提供者から認知機能低下の訴えがある.3. 複雑な日常生活動作の障害は最低限にとどまり,基本的な日常生活機能は正常である,という状態である.罹患率は 65 歳以上の 10-20%で,Alzheimer´s disease (AD) の約 1.5-2 倍である.MCI は記憶障害の有無で amnestic MCI (健忘性 MCI) と non-amnestic MCI (非健忘性 MCI) に分類される.さらに認知機能障害が単一か複数かで single domain か multiple domain に分類される.脳血管障害,認知機能に影響を及ぼす神経系の疾患,精神疾患,全身的な内科疾患,薬物中毒などが原因疾患となる.MCI 全体では約 70%が認知症に進行する.特に健忘性 MCI の多くは進行し,無治療であれば 4 年後には 50%,最終的には 90%以上が AD に進展する.診断の確実度として,アミロイド b (Ab) 蓄積 (アミロイド PET 陽性または脳脊髄液の Ab 42 の低下) と神経細胞障害 (脳脊髄液 tau /リン酸化 tau 増加または FDG-PET で側頭・頭頂葉の糖代謝の低下または MRI による側頭・頭頂葉の萎縮) が示されている.これらのバイオマーカ ーは AD への進展因子でもある.健忘性 MCI の段階ですでに Ab が脳内に蓄積していると考えられている.Abを標的とした薬剤が開発中であるが,順調とはいえない.現時点では MCI から AD への進行を予防する根治的治療法はない.適度な運動とビタミンを多く含むバランスのとれた食事の摂取が,ある程度効果があるといわれている.

著者

阿部 雅紀

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.78, no.4, pp.237-241, 2019-08-01 (Released:2019-09-20)

参考文献数

21

---

慢性腎臓病 (Chronic Kidney Disease: CKD) の食 事療法としてのエネルギー摂取量の設定にあたっては, 目標とする体重とともに,摂取たんぱく質との関係が重 要である.エネルギーは,性,年齢,身体活動レベルな どを考慮するが,25~35 kcal/kg 標準体重/日で指導し, 身体所見や検査所見などの推移により適時に変更する. 過剰なたんぱく質摂取は糸球体過剰濾過を促進し腎機能 に影響を与え,腎機能低下時にはたんぱく質の代謝産物 が尿毒症物質として蓄積する.標準的治療としてのたん ぱく質制限は,ステージ G3a では 0.8~1.0 g/kg 標準体 重/日,ステージ G3b 以降では 0.6~0.8 g/㎏標準体重/日 が推奨されている.たんぱく質制限とともに摂取エネル ギー量も過度に不足すると Protein-energy wasting (PEW) を引き起こす可能性があるため,十分なエネルギー摂取 量を確保することが重要である.CKD においては,高 血圧・尿蛋白の抑制と心血管疾患の予防のため,6 g/日 未満の食塩摂取制限が推奨されている.ただし,過度の 減塩は害となる可能性があるため,3 g を目安として個々 の症例に応じて下限を設定する.血清 K 値は 4.0 mEq/L 以上,5.4 mEq/L 以下で総死亡,心血管疾患の発症リス クが低下する.

著者

山本 範子 千島 史尚 山本 樹生

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.72, no.3, pp.129-136, 2013-06-01 (Released:2014-12-20)

参考文献数

19

---

Genetic sex is determined at the time of conception. In humans, the sexual phenotype is established in three steps (1) The sex chromosome complement of the embryo, (2) Gonadal differentiation, and (3) Differentiation of the internal duct and the external genitalia as female or male occurs as a response to hormones produced by the differentiated gonads. A number of genes, i.e., SRY, SOX9, SF1, DAX1, WT1, have been shown to influence these early and late sexual development processes. Mammalian gonads arise from the bilateral genital ridges and have the potential to develop into testes or ovaries. The Y chromosome (46, XY) is key to the differentiation of germ cells into testes. In the absence of a Y chromosome and the presence of a second X chromosome (46, XX) or in the absence of a gonad, development will be female in nature. The primary testis determinant is the SRY (Sex determining Region Y) gene, which is located on the short arm of the Y chromosome, and initiates the testicular differentiation from the Wolffian duct. Hormones produced from the testis (Müllerian inhibiting substance (MIS, MIF: Müllerian inhibiting factor, AMH: anti Müllerian hormone), secreted from the Sertoli cells, and testosterone, secreted from the Lydig cells steer the further development of the remainder of the genital tract. MIS mediates the regression of the Müllerian ducts (paramesonephric duct), whereas the androgens maintain the Wolffian ducts. In the absence of MIS, the internal ducts differentiate into fallopian tubes, the uterus, and the upper vagina from the Müllerian ducts. Unlike the internal genitalia, the external genitalia are neutral primordially, and can differentiate into either male or female structures depending on the gonadal steroid hormone signals. Gonadal differentiation involves a complex interplay of developmental pathways. Normal sexual differentiation will be considered in order to provide a basis for understanding the various types of abnormal development. This issue will present disorders of sexual development (DSD) as abnormal sexual development based on normal sexual development.

著者

崎元 暢

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.75, no.1, pp.52-53, 2016-02-01 (Released:2016-07-20)

参考文献数

14

著者

川田 望 高橋 悟

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.72, no.3, pp.142-145, 2013-06-01 (Released:2014-12-20)

参考文献数

19

---

The objective this review is to present an overview of current practice in the management of erectile dysfunction and discuss the evidence supporting the clinical effectiveness of these pharmacological treatments. Since sildenafil was introduced more than 10 years ago, highly selective phosphodiesterase type 5 inhibitors (PDE5i) have changed the medical management of erectile dysfunction (ED). Effective treatment of ED may restore quality of life and allow patients to return to the sex life they had before. Current therapeutic management includes oral therapies. Oral administration of PDE5i is considered the first-line treatment for ED. PDE5i can elevate the levels of cGMP in the corpus cavernosum and effectively improve ED of various causes and degrees. Three types of PDE5i are currently available, sildenafil, vardenafil and tadalafil. All of them are effective, with similar efficacy and safety profiles. The use of sildenafil citrate (Viagra®) resulted in a 76% successful intercourse rate with treatment, compared with 22% in a control group. Patients receiving 5, 10 or 20 mg vardenafil (Levitra®) experienced significantly improved erections, with 85% of 20mg vardenafil cases reporting improved erectile function, compared with 28% of placebo cases. The characteristics of this treatment are well known for their immediate effect. On the other hand, management of ED with Tadalafil (Chalis®) is characterized by long-term efficacy and easy acceptance by patients and their partners. Tadalafil is also efficacious in the improvement of male lower urinary tract symptoms, and has been licensed for such symptoms in Europe.

著者

伊崎 聡志 藤田 英樹

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.81, no.6, pp.329-333, 2022-12-01 (Released:2023-02-12)

参考文献数

32

---

Among malignant skin tumors, malignant melanoma (hereinafter referred to as melanoma) is well known forits strong metastatic potency and poor prognosis. Moreover, it is safe to say that it is the most famous malignanttumor of the skin. The field of melanoma is at a stage where new findings are emerging one after another, and thespeed of progress is remarkable. Clark’s classification has been used for a long time to classify melanoma, butproblems have arisen in that there are certain tumor types that do not fit into this classification and that the relationship between tumor types and desirable treatment methods and prognosis is unclear. As a result, new taxonomies have been developed. In addition, what used to be common sense, contraindication for skin biopsy and thesignificance of lymph node dissection, for example, are no longer valid. Treatment methods have also advanceddramatically. The new drugs are already being used in clinical practice, and their effectiveness is already well recognized. In addition, therapeutic methods from new perspectives are now being developed.We have come to an era where we are always required to update our knowledge. This review is primarily forphysicians who wish to start learning malignant skin tumors and those other than dermatologists. We mainly focuson changes in attitudes toward managing melanoma.

著者

井谷 修

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.79, no.6, pp.333-336, 2020-12-01 (Released:2021-02-24)

参考文献数

15

---

This paper reviews some of the representative epidemiological evidence for the relationship between sleep and physical and mental health. Sleep has elements of quantity (sleep duration), quality, and rhythm, and the evidence is summarized by focusing on abnormalities of each element. Regarding sleep duration, we present the results of a systematic review and meta-analysis of short sleep duration and health outcomes. Similarly, the results of a study on longer sleep duration and health outcomes are also presented. Regarding abnormalities in sleep rhythms, a systematic review and meta-analysis of systematic reviews and meta-analyses conducted on shift work and various health outcomes are reviewed to examine the evidence. The relationship between sleep and mental health is discussed in terms of the relationship between sleep and depression in previous epidemiological studies. Based on the findings from these observational epidemiological studies, future research is expected to be based on sleep hygiene education and intervention studies aimed at improving health by improving sleep.

著者

佐藤 美紀子

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.80, no.4, pp.167-171, 2021-08-01 (Released:2021-10-07)

参考文献数

25

---

We live in an era in which half of the population is affected by cancer. Regardless of how much progress hasbeen made in medical science and how high the cure rate is, having cancer significantly impacts patients’ lives aswell as those of their families and friends. Thus, avoiding preventable cancers is an important issue not only for anindividual but also for our society. Cancer prevention consists of two steps. Primary prevention is avoiding factorsthat cause cancer. Secondary preventions include the early detection of cancer or precancer and subsequent earlyand minimally invasive treatment. It is a national policy of Japan to reduce the cancer mortality rate and improvethe quality of life of people through appropriate primary and secondary prevention based on scientific evidence.The Third Basic Plan for the Promotion of Cancer Control, formulated in 2008, declares that more efforts will beput into cancer education and prevention. In this review, I introduce recent findings on endometrial and ovariancancers from the perspective of cancer prevention. Recently, the molecular biological mechanisms of the oncogenesis of these cancers have been elucidated, and progress has been made in cancer treatment and prevention. Ingeneral, cancer is a disease of the relatively older population. However, this review emphasizes the importance ofwomen’s health care from a young age for the prevention of gynecological cancer.

著者

横山 貴一 三原 千恵 横山 登 中江 竜太 山根 冠児

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.68, no.4, pp.244-246, 2009-08-01 (Released:2010-04-20)

参考文献数

12

被引用文献数

4 1

---

症例は 57 歳の女性.2 年前に高 CEA 血症を伴う結腸癌で根治術を行った.今回,頭部 MRI で小脳テントに接する約 2 cm 大の後頭蓋窩病変を認めた.全身FDG-PET で後頭蓋窩病変以外に高集積を示さず,CEAは 2.0 ng/ml であった.このため悪性髄膜腫を疑い摘出術を行った.病理診断は,結腸癌の小脳転移であった.他臓器に転移のない大腸癌の孤立性小脳転移は少なく診断,治療に注意する必要があると考えられた.

著者

阿部 雅紀

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.73, no.1, pp.12-13, 2014-02-01 (Released:2015-05-22)

参考文献数

4

---

Voltage-dependent calcium channels are divided into L-, T- and N-types. Calcium channel blockers (CCBs) are widely used to treat hypertension and generally act on L-type calcium channels. Recent studies have suggested that L-type calcium channel blockade combined with T- or N-type calcium channel blockade may provide additive benefits in preventing cardiovascular and renal diseases.

著者

穐山 真由美

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.71, no.6, pp.401-404, 2012-12-01 (Released:2013-11-07)

参考文献数

10

---

Electroconvulsive therapy (ECT), in which brain seizure discharges are therapeutically induced by transcranial electric stimulation, has been recognized as a treatment for psychiatric disorders including depression, mania and schizophrenia for over 70 years. Many clinical studies have proved its efficacy and safety relative to psychotropic drug therapies. Recent advance in clinical psychiatry has proposed a modification of the ECT procedure, a modified ECT (mECT), in which peripheral muscle relaxant is used to suppress motor manifestations due to the brain seizure discharge. In this article the author carried out a comprehensive review on ECT in respect with its history, clinical indication and practice together with mechanism of action. First, literature review has revealed that indication of ECT is widely described in a variety of disorders. Successful outcome has been reported in the treatment of not only psychiatric disorders but also neurological disorders such as Parkinson´s disease, neuroleptic malignant syndrome or drug resistant chronic pain. Second, the author documented a detailed mECT procedure that has recently been conducted in the department of psychiatry Nihon University School of Medicine. Lastly, clinical considerations on the mechanism of action were made based on recent therapeutic ECT studies using positron emission tomography. Finally the author concluded that the therapeutic effects of ECT involve multiple neurotransmitter systems.

著者

鈴木 正泰

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.80, no.3, pp.147-152, 2021-06-01 (Released:2021-08-06)

参考文献数

27

著者

瀬在 明 高山 忠輝

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.79, no.4, pp.241-245, 2020-08-01 (Released:2020-09-30)

参考文献数

13

---

Japan is at the forefront of super-aging societies worldwide, and a “heart failure pandemic (HF)” is predicted for the near future under the current medical system. This “pandemic” is not temporary but ongoing. We need to work hard to prevent and treat HF throughout the region. We report the importance of regional cooperation for preparedness for a HF pandemic and our University activities. Our hospital established a HF team and conducted regional collaborative activities. Since December 2018, the heart failure team has been upgraded with hospital support and going the following; 1) After the establishment of the heart failure nursing clinic within the heart failure outpatient clinic. 2) HF case conference. 3) HF interdisciplinary conference. 4) Ventricular Assist Device conference. 5) Establishment of study groups in each local medical association (Itabashi, Toshima, Nerima, and Kita). 6) Lecture activities at each branch of the Alumni Association of Nihon University School of Medicine. 7) Mobilization of doctors to each facility. 8) Outpatient hANP treatment was conducted as a multi-center study. 9) continuous positive airway pressure (CPAP) or adaptive servo ventilation (ASV) was actively conducted. 10) Medical Care Stations, a social networking service (SNS) for medical fields, were introduced. 11) HF Registry (SAKURA-HF). To prepare for a HF pandemic, it is important to clarify the role of each facility and share information when engaging in treatment and prevention. University hospitals should take leadership to establish regional collaborations for HF. Information and communication technology (ICT) is considered an effective tool to strengthen such collaboration.

著者

石井 和嘉子

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.82, no.1, pp.67-70, 2023-02-01 (Released:2023-04-09)

参考文献数

29

著者

内山 真

出版者

日本大学医学会

雑誌

日大医学雑誌 (ISSN:00290424)

巻号頁・発行日

vol.79, no.6, pp.327-331, 2020-12-01 (Released:2021-02-24)

参考文献数

15

---

Sleep is a behavioral and physiological state of rest that animals have acquired through their long evolutionary history to efficiently and successfully adapt to changes in the internal biological and external terrestrial environments. Until the middle of the 20th century, mammalian sleep was regarded as neural and physical hypofunction resulting from exhaustion, while neuroscientific progress since the discovery of REM sleep has revealed that it is an actively generated condition consisting of REM and non-REM periods, which are controlled through statespecific sleep centers and networks in the brain. In the present article, the author reviews current advances in physiological aspects of human sleep and describes three major components that cooperatively control sleep amount, timing, and occurrence, with a focus on sleep homeostatic, circadian, and wake-maintenance systems.