みんなで走りを科学する短距離走の授業研究 : 身体感覚を「探り」・「深める」ことからのアプローチ <第2部 教科研究>

速く走るためには,「腕振り」やキックからの「踵の引きつけ」「もも上げ」「膝下の振り出し」等の動き方に中心があると従来は解釈されており,その理論を授業でも取り上げて展開してきた。しかし,陸上競技における短距離走の世界では,この十数年の間に,そのような外面的な動きにとらわれる考え方が根本から見直され,新たなフォームや個々の選手にあった身体の使い方が研究されている。今回の中学生を対象にした授業では,現在トップアスリートがベースにしている考え方や感覚に触れ,走ることについての身体感覚を個々の生徒が磨きながら学習するようにした。さらに,個々の生徒がつかんだ感覚を他の生徒にも還元することで,自分にとって効率よく速く「走る」方法を獲得するための身体感覚にはどのようなものがあるのかを「探り」・「深め」,ひいては記録の向上をも図った。その結果,走ることが苦手な生徒に特に成果が現れたと思われる

Beneficial effects of tonsillectomy plus steroid pulse therapy on inflammatory and tubular markers in patients with IgA nephropathy

Background: IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide. Tonsillectomy plus steroid pulse therapy has been able to induce clinical remission in early-stage IgAN. However, its possible effect on systemic and local cytokines and tubular markers has not been fully investigated. Methods: We obtained serum and urine samples from 38 patients just before renal biopsy and third steroid pulse therapy. Markers of tubular damage such as N-acetyl-β-d-glucosaminidase, and kidney injury molecule-1 and inflammation such as interleukin (IL)-6, monocyte chemotactic protein (MCP)-1, intercellular adhesion molecule (ICAM)-1, and vascular cell adhesion molecule (VCAM)-1 were measured by immunoassay. Results: Before renal biopsy, only urinary inflammatory markers, except MCP-1, were associated with glomerular (proteinuria) and/or tubular damage markers. Proteinuria, hematuria, and estimated glomerular filtration rate dramatically improved after therapy. In addition, levels of serum IL-6 and ICAM-1 and all urinary markers declined significantly; however, serum MCP-1 and VCAM-1 levels did not. None of the urinary markers correlated with the serum inflammatory markers. Conclusion: Tonsillectomy plus steroid pulse therapy for patients with IgAN might be useful for improving not only glomerular damage marker but also tubular damage markers through the improvement of local renal inflammation

Circulating TNF Receptors 1 and 2 Are Associated with the Severity of Renal Interstitial Fibrosis in IgA Nephropathy

<div><p>The current study aimed to examine whether the levels of TNF receptors 1 and 2 (TNFR1 and TNFR2) in serum and urine were associated with other markers of kidney injury and renal histological findings, including TNFR expression, in IgA nephropathy (IgAN). The levels of the parameters of interest were measured by immunoassay in 106 biopsy-proven IgAN patients using samples obtained immediately before renal biopsy and in 34 healthy subjects. Renal histological findings were evaluated using immunohistochemistry. The levels of serum TNFRs were higher in IgAN patients than in healthy subjects. The levels of both TNFRs in serum or urine were strongly correlated with each other (<i>r</i> > 0.9). Serum TNFR levels were positively correlated with the urinary protein to creatinine ratio (UPCR) and four markers of tubular damage of interest (N-acetyl-β-D-glucosaminidase [NAG], β2 microglobulin [β2m], liver-type fatty acid-binding protein [L-FABP], and kidney injury molecule-1 [KIM-1]) and negatively correlated with estimated glomerular filtration rate (eGFR). Patients in the highest tertile of serum TNFR levels showed more severe renal interstitial fibrosis than did those in the lowest or second tertiles. The tubulointerstitial TNFR2-, but not TNFR1-, positive area was significantly correlated with the serum levels of TNFRs and eGFR. Stepwise multiple regression analysis revealed that elevated serum TNFR1 or TNFR2 levels were a significant determinant of renal interstitial fibrosis after adjusting for eGFR, UPCR, and other markers of tubular damage. In conclusion, elevated serum TNFR levels were significantly associated with the severity of renal interstitial fibrosis in IgAN patients. However, the source of TNFRs in serum and urine remains unclear.</p></div

Clinical characteristics and levels of inflammatory markers in IgAN patients and healthy subjects.

<p>Data are mean ± SD, median (quartiles), or %.</p><p>BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; ACEI, angiotensin converting enzyme inhibitor; ARB, angiotensin receptor blocker; Rx, treatment; GFR, glomerular filtration ratio; UPCR, the ratio of urinary protein to creatinine; HPF, high power field; TNFR, TNF receptor; NA, not applicable</p><p>Clinical characteristics and levels of inflammatory markers in IgAN patients and healthy subjects.</p

Clinical characteristics and levels of inflammatory and tubular damage markers according to tertile of serum TNFR2 levels in IgAN patients.

<p>Data are mean ± SD, median (quartiles), or %. Abbreviations used in this table are the same as in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122212#pone.0122212.t001" target="_blank">Table 1</a>. NAG, N-acetyl-β-D-glucosaminidase; β2m, β2-microglobulin; L-FABP, liver-type fatty acid binding protein; KIM-1, kidney injury molecule-1.</p><p>Clinical characteristics and levels of inflammatory and tubular damage markers according to tertile of serum TNFR2 levels in IgAN patients.</p

Simple and stepwise multiple regression analysis of variables that were associated with renal interstitial fibrosis in IgAN patients.

<p>*P<0.05</p><p>**P<0.01</p><p>^†P<0.001</p><p>^††P<0.0001</p><p>Abbreviations used in this table are the same as in Table <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122212#pone.0122212.t001" target="_blank">1</a> and <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122212#pone.0122212.t002" target="_blank">2</a>.</p><p>Simple and stepwise multiple regression analysis of variables that were associated with renal interstitial fibrosis in IgAN patients.</p

Histological findings according to serum TNFR2 levels.

<p>Patients were grouped according to distribution tertiles for each histological finding and serum TNFR2 levels. The severity of interstitial fibrosis, tubular atrophy, and glomerulosclerosis was significantly associated with serum TNFR2 levels.</p

Spearman correlation coefficients between markers of tubular damage or inflammation and impaired renal function in IgAN patients.

<p>*P<0.05</p><p>**P<0.01</p><p>†P<0.001</p><p>††P<0.0001</p><p>Abbreviations used in this table are the same as in Table <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122212#pone.0122212.t001" target="_blank">1</a> and <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122212#pone.0122212.t002" target="_blank">2</a>. sTNFR, serum TNF receptor; uTNFR, urinary TNF receptor.</p><p>Spearman correlation coefficients between markers of tubular damage or inflammation and impaired renal function in IgAN patients.</p