研究者詳細 - 武林　亨

論文 - 武林　亨

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Physical Activity, Fitness And Cognitive Function Among Community-dwelling Elderly - baseline Data Of Fujisawa Plusten Project.

武林亨

MEDICINE AND SCIENCE IN SPORTS AND EXERCISE 47 （ 5 ） 216 - 216 2015年05月

研究論文（学術雑誌）, ISSN 0195-9131

Denture wearing during sleep doubles the risk of pneumonia in the very elderly

Iinuma T., Arai Y., Abe Y., Takayama M., Fukumoto M., Fukui Y., Iwase T., Takebayashi T., Hirose N., Gionhaku N., Komiyama K.

Journal of Dental Research 94 28S - 36S 2015年03月

研究論文（学術雑誌）, 共著, ISSN 0022-0345

Poor oral health and hygiene are increasingly recognized as major risk factors for pneumonia among the elderly. To identify modifiable oral health-related risk factors, we prospectively investigated associations between a constellation of oral health behaviors and incident pneumonia in the community-living very elderly (i.e., 85 years of age or older). At baseline, 524 randomly selected seniors (228 men and 296 women; mean age, 87.8 years) were examined for oral health status and oral hygiene behaviors as well as medical assessment, including blood chemistry analysis, and followed up annually until first hospitalization for or death from pneumonia. During a 3-year follow-up period, 48 events associated with pneumonia (20 deaths and 28 acute hospitalizations) were identified. Among 453 denture wearers, 186 (40.8%) who wore their dentures during sleep were at higher risk for pneumonia than those who removed their dentures at night (log rank P = 0.021). In a multivariate Cox model, both perceived swallowing difficulties and overnight denture wearing were independently associated with an approximately 2.3-fold higher risk of the incidence of pneumonia (for perceived swallowing difficulties, hazard ratio [HR], 2.31; and 95% confidence interval [CI], 1.11-4.82; and for denture wearing during sleep, HR, 2.38; and 95% CI, 1.25-4.56), which was comparable with the HR attributable to cognitive impairment (HR, 2.15; 95% CI, 1.06-4.34), history of stroke (HR, 2.46; 95% CI, 1.13-5.35), and respiratory disease (HR, 2.25; 95% CI, 1.20-4.23). In addition, those who wore dentures during sleep were more likely to have tongue and denture plaque, gum inflammation, positive culture for Candida albicans, and higher levels of circulating interleukin-6 as compared with their counterparts. This study provided empirical evidence that denture wearing during sleep is associated not only with oral inflammatory and microbial burden but also with incident pneumonia, suggesting potential implications of oral hygiene programs for pneumonia prevention in the community.

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Place of death and the differences in patient quality of death and dying and caregiver burden

Kinoshita Hiroya, Maeda Isseki, Morita Tatsuya, Miyashita Mitsunori, Yamagishi Akemi, Shirahige Yutaka, Takebayashi Toru, Yamaguchi Takuhiro, Igarashi Ayumi, Eguchi Kenji

Journal of Clinical Oncology 33 （ 4 ） 357 - 363 2015年02月

研究論文（学術雑誌）, 共著, ISSN 0732-183X

Purpose To explore the associations between place of death and quality of death and dying and caregiver burden in terminally ill patients with cancer and their families. Methods Two bereavement surveys were conducted in October 2008 and October 2011. A total of 2,247 family caregivers of patients with cancer who were deceased responded to the mail surveys (response rate, 67%). Family members reported patient quality of death and dying and caregiver burden by using the Good Death Inventory and Caregiving Consequences Inventory. Results Patient quality of death and dying was significantly higher at home relative to other places of dying after adjustment for patient and/or family characteristics (adjusted means): 5.0 (95% CI, 4.9 to 5.2) for home, 4.6 (95% CI, 4.5 to 4.7) for palliative care units, and 4.3 (95% CI, 4.2 to 4.4) for hospitals. For all combinations, pairwise P < .001; the size of the difference between home and hospital was moderate (Hedges' g, 0.45). Home was superior to palliative care units or hospitals with respect to " dying in a favorite place," " good relationships with medical staff," " good relationships with family, " and " maintaining hope and pleasure " ( P < .001 for all combinations of home v palliative care units and home v hospitals). Home death was significantly associated with a lower overall (P = .03) and financial caregiver burden ( P = .004) relative to hospital death. Conclusion Dying at home may contribute to achieving good death in terminally ill patients with cancer without causing remarkably increased caregiver burden. Place of death should be regarded as an essential goal in end-of-life care.

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Cost-effectiveness of adding rituximab to splenectomy and romiplostim for treating steroid-resistant idiopathic thrombocytopenic purpura in adults

Kikuchi, Kayoko, Miyakawa, Yoshitaka, Ikeda, Shunya, Sato, Yuji, Takebayashi, Toru

BMC Health Services Research 15 （ 1 ） 2015年01月

研究論文（学術雑誌）, ISSN 1472-6963

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Grading criteria for disease severity by pemphigus disease area index

Shimizu Tomoko, Takebayashi Toru, Sato Yuji, Niizeki Hironori, Aoyama Yumi, Kitajima Yasuo, Iwatsuki Keiji, Hashimoto Takashi, Yamagami Jun, Werth Victoria P., Amagai Masayuki, Tanikawa Akiko

Journal of Dermatology 41 （ 11 ） 969 - 973 2014年11月

研究論文（学術雑誌）, 共著, ISSN 0385-2407

Pemphigus is a group of autoimmune blistering diseases that affect the skin and mucous membranes. A reliable and accurate disease severity tool to assess pemphigus severity is crucial for managing pemphigus and for clinical trials. The purpose of this study was to compare the pemphigus disease area index activity score (PDAI), the Japanese pemphigus disease severity score (JPDSS) and the physician's subjective impression, and also to find appropriate severity grading cut-offs for the PDAI. We also evaluated the correlation between PDAI activity score and the JPDSS. Thirty-seven pemphigus patients and 110 assessments were analyzed in this study. The optimal points of pemphigus disease severity score in PDAI were: mild (0-8), moderate (9-24) and severe (≥25). In mild or moderate cases, the JPDSS was well correlated with the PDAI, but in severe cases the JPDSS reached a plateau at a PDAI score of approximately 30. The PDAI evaluates disease severity more accurately than the JPDSS, particularly in severe cases. The PDAI is not only a useful tool to measure the extent of cutaneous lesions, but also an excellent scoring system for evaluating pemphigus disease severity.

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Circulating AIM as an indicator of liver damage and hepatocellular carcinoma in humans

Yamazaki Tomoko, Mori Mayumi, Arai Satoko, Tateishi Ryosuke, Abe Masanori, Ban Mihoko, Nishijima Akemi, Maeda Maki, Asano Takeharu, Kai Toshihiro, Izumino Kiyohiro, Takahashi Jun, Aoyama Kayo, Harada Sei, Takebayashi Toru, Gunji Toshiaki, Ohnishi Shin, Seto Shinji, Yoshida Yukio, Hiasa Yoichi, Koike Kazuhiko, Yamamura Ken Ichi, Inoue Ken Ichiro, Miyazaki Toru

PLoS ONE 9 （ 10 ） 2014年10月

研究論文（学術雑誌）, 共著

Background: Hepatocellular carcinoma (HCC), the fifth most common cancer type and the third highest cause of cancer death worldwide, develops in different types of liver injuries, and is mostly associated with cirrhosis. However, non-alcoholic fatty liver disease often causes HCC with less fibrosis, and the number of patients with this disease is rapidly increasing. The high mortality rate and the pathological complexity of liver diseases and HCC require blood biomarkers that accurately reflect the state of liver damage and presence of HCC. Methods and Findings: Here we demonstrate that a circulating protein, apoptosis inhibitor of macrophage (AIM) may meet this requirement. A large-scale analysis of healthy individuals across a wide age range revealed a mean blood AIM of 4.99±1.8 μg/ml in men and 6.06±2.1 μg/ml in women. AIM levels were significantly augmented in the younger generation (20s-40s), particularly in women. Interestingly, AIM levels were markedly higher in patients with advanced liver damage, regardless of disease type, and correlated significantly with multiple parameters representing liver function. In mice, AIM levels increased in response to carbon tetrachloride, confirming that the high AIM observed in humans is the result of liver damage. In addition, carbon tetrachloride caused comparable states of liver damage in AIM-deficient and wild-type mice, indicating no influence of AIM levels on liver injury progression. Intriguingly, certain combinations of AIM indexes normalized to liver marker score significantly distinguished HCC patients from non-HCC patients and thus could be applicable for HCC diagnosis. Conclusion: AIM potently reveals both liver damage and HCC. Thus, our results may provide the basis for novel diagnostic strategies for this widespread and fatal disease.

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Obesity was associated with a decreased postoperative recurrence of rectal cancer in a Japanese population

Seishima Ryo, Okabayashi Koji, Hasegawa Hirotoshi, Sugiyama Daisuke, Ishii Yoshiyuki, Tsuruta Masashi, Takebayashi Toru, Kitagawa Yuko

Surgery Today 2014年05月

研究論文（学術雑誌）, 共著, ISSN 0941-1291

Purpose Obesity contributes to the technical difficulty of rectal surgery and is considered to be a risk factor for postoperative complications. The impact of obesity on the long-term outcomes of rectal cancer surgery remains unclear. Methods A total of 263 consecutive rectal cancer patients who underwent surgery were categorized into two groups according to the body mass index (BMI) based on the Asian BMI classification: non-obese (BMI <25 kg/m²) and obese (BMI ≥25 kg/m²). The postoperative survival and recurrence rates and oncological surgical quality indicators were compared between groups using the univariate and multivariate analyses. The differences in recurrence patterns were assessed by a competing risk regression analysis. Results 64 (24 %) patients were included in the obese group. The number of retrieved lymph nodes was significantly greater in the non-obese group than in the obese group (22.4 vs. 16.0, P < 0.01). The 5-year disease-free survival (DFS) rates were 86.5 and 68.8 % in the obese and non-obese groups, respectively (P = 0.01). The multivariate analysis demonstrated that obesity significantly decreased the postoperative recurrence rate (P = 0.04). Moreover, the BMI was significantly associated with distant metastasis (P = 0.04). Conclusions Obese rectal cancer patients have high DFS rates and a decreased incidence of distant metastases compared to non-obese patients. The BMI may be a key factor for predicting the postoperative prognosis and determination of an appropriate strategy for the treatment of rectal cancer patients. © 2014 Springer Japan.

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Efficacy and Safety of Rikkunshito, a Japanese Herbal Medicine, on the Treatment of Functional Dyspepsia: A Multi-Center, Double-Blind, Randomized, Placebo-Controlled Study

武林亨

GASTROENTEROLOGY 146 （ 5 ） S265 - S265 2014年05月

研究論文（学術雑誌）, ISSN 0016-5085

Steeper increases in body mass index during childhood correlate with blood pressure elevation in adolescence

Kuwahara Erika, Asakura Keiko, Nishiwaki Yuji, Komatsu Hirokazu, Nakazawa Akemi, Ushiku Hideo, Maejima Fumio, Nishigaki Yoshio, Hasegawa Tomonobu, Okamura Tomonori, Takebayashi Toru

Hypertension Research 37 （ 2 ） 179 - 184 2014年02月

研究論文（学術雑誌）, 共著, ISSN 0916-9636

The aim of this study was to clarify the relationship between long-term changes in body mass index (BMI) during childhood and adolescent blood-pressure levels in a general Japanese population. We used health report data from 900 Japanese children between 1983 and 2007. After adjusting for baseline BMI and other confounding factors multivariate linear regression analyses were performed to examine the relationship between changes in BMI (ΔBMI) over a 6-year period (6-12 years) and blood pressure once children reached ages 14 or 15. Sub-group analyses were also performed to ascertain the relationship between ΔBMI and blood pressure at 9th grade for children who had been in the bottom BMI tertile at 1st grade. Endpoint blood-pressure levels in boys (systolic and diastolic) and girls (systolic) from the group whose BMIs increased the most were significantly higher than those from the group whose BMIs increased the least (P<0.05, analysis of variance). After adjustment for baseline BMI and school-entrance year, the former group showed higher blood pressure at the endpoint than the latter (P<0.05, multiple regression analysis). Further adjustment for baseline blood pressure also showed similar results in a combined-sex analysis (n=592). Higher ΔBMI was associated with higher SBP 9 even in children whose BMI was in the lowest tertile at baseline after adjustment for sex and school-entrance year (P=0.02, multiple regression analysis). Steeper BMI increases during primary school lead to adolescent increases in blood pressure even if baseline BMI is low. Growth during childhood should be carefully managed. © 2014 The Japanese Society of Hypertension All rights reserved.

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Effect size and cost-effectiveness estimates of breast and cervical cancer screening reminders by population size through complete enumeration of Japanese local municipalities

Komoto Shigekazu, Nishiwaki Yuji, Okamura Tomonori, Tanaka Hideo, Takebayashi Toru

BMC Public Health 14 （ 1 ） 2014年01月

研究論文（学術雑誌）, 共著

Background: Client reminders are known to increase cancer screening attendance rates. However, there are significant costs associated with them, and their effect by population size is unknown. Methods. In 2007 and 2008, the Japanese Government surveyed breast and cervical cancer screening in every municipality in Japan. From the results, we selected all 1,464 municipalities that carried out both screening types. We examined whether changes in screening attendance rates between 2007 and 2008 were associated with client reminders, number of public health nurses per 100,000 population, financial strength index, and 2007 attendance rates for different population sizes. We then calculated cost-effectiveness estimates of client reminders by population size and screening type. Results: Client reminders were associated with increased attendance rates in populations <100,000. For populations of 50,000-100,000, there was a 2.76% increase in breast cancer screening (95% CI: 0.41, 5.11), and a 2.25% increase in cervical cancer screening (95% CI: 0.89, 3.61). The incremental cost per additional attendance was higher in populations <50,000 than in populations of 50,000-100,000 (breast, $100 versus $54; cervical, $149 versus $67 respectively). Conclusions: Client reminders for breast and cervical cancer screening increased attendance rates in smaller municipalities in Japan. © 2014 Komoto et al.; licensee BioMed Central Ltd.

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Relationship between shift work and clustering of the metabolic syndrome diagnostic components

Kawabe Yuri, Nakamura Yasuyuki, Kikuchi Sayuri, Murakami Yoshitaka, Tanaka Taichiro, Takebayashi Toru, Okayama Akira, Miura Katsuyuki, Okamura Tomonori, Ueshima Hirotsugu

Journal of Atherosclerosis and Thrombosis 21 （ 7 ） 703 - 711 2014年

研究論文（学術雑誌）, 共著, ISSN 1340-3478

Aim: To examine the relationship between the type of work and the number of metabolic syndrome diagnostic componentsS (MetS-DC), as well as the risk of MetS, with adjustment for lifestyle habits in Japanese workers. Methods: We examined the baseline data from 4,427 participants (81.4% male) aged 19 to 69 years old. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). We defined the four MetS-DC in this study as follows: 1) high blood pressure (BP): systolic BP ≥ 130 mmHg, or diastolic BP ≥ 85 mmHg, or the use of antihypertensive drugs; 2) dyslipidemia: high-density lipoprotein-cholesterol concentration <40 mg/dl or triglyceride concentration ≥ 150 mg/dl, or on medication for dyslipidemia; 3) dysglycemia: fasting blood sugar level ≥ 110 mg/dl, or if less than eight hours after meals ≥ 140 mg/dl, or on medication for diabetes mellitus; 4) overweight: a body mass index ≥ 25 kg/m2. We defined MetS as overweight plus two or more of the MetS-DC. Results: There were 3,094 subjects in the daytime work group, 73 in the fixed nighttime work group, 1,017 in the shift work group and 243 in the day-to-night work group. The Poisson regression analysis revealed that fixed nighttime (regression coefficient [b] = -0.233, P=0.028) and shift work (b=0.098, P=0.034) independently contributed to the number of MetS-DC, compared to daytime work. The multivariate logistic analysis not including sleep hours in the model showed that shift work was positively related to MetS (odd ratio = 1.47, P<0.01). Conclusion: Shift work were significantly associated with the number of MetS-DC, and was related to risk of MetS compared to daytime work.

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Randomized clinical trial: rikkunshito in the treatment of functional dyspepsia—a multicenter, double-blind, randomized, placebo-controlled study

Suzuki H., Matsuzaki J., Fukushima Y., Suzaki F., Kasugai K., Nishizawa T., Naito Y., Hayakawa T., Kamiya T., Andoh T., Yoshida H., Tokura Y., Nagata H., Kobayakawa M., Mori M., Kato K., Hosoda H., Takebayashi T., Miura S., Uemura N., Joh T., Hibi T., Tack J., Kasugai Kunio, Nishizawa Toshihiro, Naito Yuji, Joh Takashi, Miura Soichiro, Uemura Naomi, Fukushima Yasushi, Suzaki Fumio, Hayakawa Toshihiko, Ando Takashi, Yoshida Hideo, Tokura Yoshifumi, Nagata Hiroshi, Kobayakawa Masao, Mori Mikiji, Kato Kimihiko, Tsuzuki Yoshikazu, Iwata Akihiro, Kobayashi Kunio, Imaeda Hiroyuki, Yamaguchi Yasuharu, Iwasaki Eisuke, Komatsu Hirokazu, Serizawa Hiroshi, Oyamada Yuichi, Yagou Yuzo, Yoshida Takeshi, Nishida Jiro, Yamamoto Sayuri, Tokita Kazuhiko

Neurogastroenterology and Motility 26 （ 7 ） 950 - 961 2014年

ISSN 1350-1925

Background: Rikkunshito, a standardized Japanese herbal medicine, is thought to accelerate gastric emptying and relieve dyspepsia, although no large-scale, randomized, placebo-controlled trials of rikkunshito have been conducted. This study aimed to determine the efficacy and safety of rikkunshito for treating functional dyspepsia (FD). Methods: FD patients received 2.5 g rikkunshito or placebo three times a day for 8 weeks in this multicenter, randomized, placebo-controlled, parallel-group trial. The primary end point was the proportion of responders at 8 weeks after starting test drug, determined by global patient assessment (GPA). The improvement in four major dyspepsia symptoms severity scale was also evaluated. In addition, plasma ghrelin levels were investigated before and after treatment. Key Results: Two hundred forty-seven patients were randomly assigned. In the eighth week, the rikkunshito group had more GPA responders (33.6%) than the placebo (23.8%), although this did not reach statistical significance (p = 0.09). Epigastric pain was significantly improved (p = 0.04) and postprandial fullness tended to improve (p = 0.06) in the rikkunshito group at week 8. Rikkunshito was relatively more effective among Helicobacter pylori-infected participants (rikkunshito: 40.0% vs placebo: 20.5%, p = 0.07), and seemed less effective among H. pylori-uninfected participants (rikkunshito: 29.3% vs placebo: 25.6%, p = 0.72). Among H. pylori-positive individuals, acyl ghrelin levels were improved just in rikkunshito group. There were no severe adverse events in both groups. Conclusions & Inferences: Administration of rikkunshito for 8 weeks reduced dyspepsia, particularly symptoms of epigastric pain and postprandial fullness. (UMIN Clinical Trials Registry, Number UMIN000003954). © 2014 John Wiley & Sons Ltd.

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Physical independence and mortality at the extreme limit of life span

Arai Yasumichi, Inagaki Hiroki, Takayama Michiyo, Abe Yukiko, Saito Yasuhiko, Takebayashi Toru, Gondo Yasuyuki, Hirose Nobuyoshi

Journals of Gerontology - Series A Biological Sciences and Medical Sciences 69 （ 4 ） 486 - 494 2014年

研究論文（学術雑誌）, 共著, ISSN 1079-5006

Background.Prevention of disability is a major challenge in aging populations; however, the extent to which physical independence can be maintained toward the limit of human life span remains to be determined.Methods.We examined the health and functional status of 642 centenarians: 207 younger centenarians (age: 100-104 years), 351 semi-supercentenarians (age: 105-109 years), and 84 supercentenarians (age: >110 years). All-cause mortality was followed by means of an annual telephone or mailed survey.Results.Age-specific disability patterns revealed that the older the age group, the higher the proportion of those manifesting independence in activities of daily living at any given age of entry. Multiple logistic regression analysis identified male gender and better cognitive function as consistent determinants of physical independence across all age categories. In a longitudinal analysis, better physical function was significantly associated with survival advantage until the age of 110. However, mortality beyond that age was predicted neither by functional status nor biomedical measurements, indicating alternative trajectories of mortality at the highest ages.Conclusions.These findings suggest that maintaining physical independence is a key feature of survival into extreme old age. Future studies illuminating genetic and environmental underpinnings of supercentenarians' phenotypes will provide invaluable opportunities not only to improve preventive strategies but also to test the central hypotheses of human aging. © The Author 2013.

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Glycosylated hemoglobin level is associated with hearing impairment in older Japanese

Michikawa Takehiro, Mizutari Kunio, Saito Hideyuki, Takebayashi Toru, Nishiwaki Yuji

Journal of the American Geriatrics Society 62 （ 7 ） 1231 - 1237 2014年

研究論文（学術雑誌）, 共著, ISSN 0002-8614

Objectives To examine the association between glycemic levels (glycosylated hemoglobin (HbA_1c)) and hearing impairment in a general older population. Design Community-based prospective longitudinal cohort study. Setting Kurabuchi Town, Gunma Prefecture, Japan. Participants Residents (N = 831; 350 men, 481 women) aged 65 and older were examined in 2005 and 2006 and analyzed in a cross-sectional study. Residents without hearing impairment at baseline who participated in audiometric re-examinations 4 years later were analyzed (n = 338). Measurements Hearing impairment was defined as failure to hear a 30-dB signal at 1 kHz and a 40-dB signal at 4 kHz in the better ear in pure-tone audiometric tests. Results Mean HbA_1c level (National Glycohemoglobin Standardization Program) was 5.8 ± 0.8% (40 mmol/mol). Odds ratios (ORs) and 95% confidence intervals (CIs) of hearing impairment associated with HbA_1c were estimated using a logistic regression model. In the cross-sectional analysis, HbA_1c levels were positively associated with hearing impairment (OR per 1.0% increase in HbA_1c = 1.30, 95% CI = 1.00-1.68). This association persisted even after excluding 58 participants with a self-reported history of diagnosed diabetes mellitus. Longitudinal analysis revealed the temporality of the discussed association (OR = 1.52, 95% CI = 1.03-2.23). Conclusion The present study provides supportive evidence for a causal link between hyperglycemia and age-related hearing loss. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

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How and why did a regional palliative care program lead to changes in a region? A qualitative analysis of the Japan OPTIM study

Imura Chizuru, Morita Tatsuya, Kato Masashi, Akizuki Nobuya, Kinoshita Hiroya, Shirahige Yutaka, Suzuki Satoshi, Takebayashi Toru, Yoshihara Ritsuko, Eguchi Kenji

Journal of Pain and Symptom Management 47 （ 5 ） 849 - 859 2014年

研究論文（学術雑誌）, 共著, ISSN 0885-3924

Context Improving palliative care is one of the major issues throughout the world. Objectives The primary aim of this study was to explore how and why a regional palliative care program led to changes in a region. Methods As part of a nationwide mixed-methods study of a regional palliative care program, a qualitative study was performed with 101 health care professionals involved in the implementation of the program. In-depth interviews were done, focusing on perceived changes and the perceived reasons for the changes. We used thematic analyses. Results Seven themes were identified as follows: 1) improved communication and cooperation among regional health care professionals; 2) increased confidence in the system to care for cancer patients at home; 3) improved knowledge/skills, practice, and perception of palliative care; 4) contribution to self-growth; 5) wide variability in perceived changes in the knowledge and perception of patients, family members, and the general public; 6) wide variability in the perceived regionwide effects of the project; and 7) unresolved issues. Participants emphasized improved communication and cooperation among regional health care professionals and stated a variety of ways of how communication and cooperation influenced daily practice. The main reasons for changes included regionwide interdisciplinary conferences and informal interactions at a variety of meetings. Conclusion This study advances understanding of how the regional palliative care program created a change in the region. The findings are useful for developing a conceptual framework and identifying key interventions to improve regional palliative care for clinicians, researchers, and policy makers. © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

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[Work environment measurements of nanoparticles in the nanoparticle-handling-process using portable type particle sizer spectrometers].

Iwasawa Satoko, Tanaka Shigeru, Miyauchi Hiroyuki, Minozoe Aoi, Nakaza Masahiro, Takebayashi Toru

Sangyō eiseigaku zasshi = Journal of occupational health 55 （ 6 ） 269 - 272 2013年12月

研究論文（学術雑誌）, 共著, ISSN 1341-0725

Higher serum dehydroepiandrosterone sulfate levels are protectively associated with depressive symptoms in men, but not in women

Michikawa Takehiro, Nishiwaki Yuji, Nakano Makiko, Iwasawa Satoko, Yamada Mutsuko, Asakura Keiko, Yoshioka Noriyuki, Kuwahara Erika, Takebayashi Toru

American Journal of Geriatric Psychiatry 21 （ 11 ） 1154 - 1163 2013年11月

研究論文（学術雑誌）, 共著, ISSN 1064-7481

Objective: Dehydroepiandrosterone sulfate (DHEAS) appears to have a protective effect against depression, but evidence from prospective cohort studies is sparse. Therefore, weexamined the associationbetweenserumDHEAS levelsand depressive symptoms in older community-dwelling Japanese. Design: A community-based cohort study. Setting: Kurabuchi Town, Gunma Prefecture, Japan. Participants: A total of 554 residents (248 men and 306 women) age 65 years or older without depressive symptoms at baseline. Measurements: We performed a baseline examination of the subjects between 2005 and 2006 to determine serum DHEAS levels. The subjects were categorized into three groups based on age strata- and sex-specific tertiles of DHEAS. Depressive symptoms were assessed with the Geriatric Depression Scale 15-item version (GDS-15) in face-to-face home visit interviews carried out once in 2007 and once in 2008. The association of DHEAS with depressive symptoms (GDS-15 ≥ 6) was analyzed with the use of logistic regression models. Results: The incidence of depressive symptoms was 12.1% in men and 19.6% in women. In men, the multiadjusted odds ratio of depressive symptoms was 0.24 (95% confidence interval: 0.06-0.94, Wald χ₂ = 4.20, degrees of freedom = 1, p = 0.04) for the highest tertile compared with the lowest. The association observed for the highest versus the lowest remained significant even after adjustment for physical performance and cognitive function. In women, DHEAS was not associated with depressive symptoms. Conclusions: In this study, higher serum DHEAS levels were found to be protectively and independently associated with the risk of developing depressive symptoms in men, but not in women. © 2013 American Association for Geriatric Psychiatry.

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Age-Related Hearing Loss and the Factors Determining Continued Usage of Hearing Aids among Elderly Community-Dwelling Residents

Mizutari Kunio, Michikawa Takehiro, Saito Hideyuki, Okamoto Yasuhide, Enomoto Chieko, Takebayashi Toru, Ogawa Kaoru, Nishiwaki Yuji

PLoS ONE 8 （ 9 ） 2013年09月

研究論文（学術雑誌）, 共著

While hearing aids are recommended for people with age-related hearing loss, many with impaired hearing do not use them. In this study, we investigated how many elderly people in the study area needed hearing aids, and the factors that determined continued wearing of the devices. The study area was Kurabuchi Town, Japan, where 1,437 residents (those aged 65 years or over) were eligible for participation in the study; 1,414 participated, of whom, 103 (7.3%) were already using hearing aids at the start of the study. After the primary screening, hearing aids were lent to 68 participants (4.8%) who did not already have one, 38 of whom (60.3% of the borrowers, representing 2.7% of the total aged population) went on to wear the hearing aid continuously. The Hearing Handicap Inventory for the Elderly (HHIE) score was significantly elevated among these 38 participants. This study indicated that hearing aids are of potential benefit to many local residents. Multivariate logistic regression revealed that HHIE scores were associated with the extent of HA usage. The adjusted odds ratio for a 1-unit increase in HHIE score was 1.08 (95% confidence interval: 1.02-1.14). Programs like this, in which people with impaired hearing are identified at the local level and given appropriate assistance, are useful models for future use in societies with aging populations. © 2013 Mizutari et al.

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Identification of microRNAs differentially expressed between lung squamous cell carcinoma and lung adenocarcinoma

Hamamoto Junko, Soejima Kenzo, Yoda Satoshi, Naoki Katsuhiko, Nakayama Sohei, Satomi Ryosuke, Terai Hideki, Ikemura Shinnosuke, Sato Takashi, Yasuda Hiroyuki, Hayashi Yuichiro, Sakamoto Michiie, Takebayashi Toru, Betsuyaku Tomoko

Molecular Medicine Reports 8 （ 2 ） 456 - 462 2013年08月

研究論文（学術雑誌）, 共著, ISSN 1791-2997

Recent advances in the treatment of non-small cell lung cancer (NSCLC) with new agents require accurate histological subtyping at diagnosis to avoid the higher risk of an adverse response and to obtain the maximum therapeutic response. However, interobserver variability, tumor heterogeneity and the degree of differentiation may affect the decision concerning a pathological diagnosis of NSCLC. Therefore, the aim of this study was to identify specific microRNAs (miRNAs) as standardized biomarkers with high sensitivity and specificity in order to distinguish between squamous cell carcinoma (SCC) and adenocarcinoma (AC). Quantitative polymerase chain reaction (qPCR)-based miRNA array analysis was performed to identify microRNAs differentially expressed between SCC and AC using 86 resected NSCLC samples in addition to adjacent normal tissues. The results were confirmed by independent qRT-PCR assays with the same test samples and 88 additional validation samples, and from this we evaluated the usefulness of the identified miRNAs as biomarkers to distinguish between SCC and AC. Three miRNAs (hsa-miR-196b, hsa-miR-205 and hsa-miR-375) were identified. Discriminant analysis combining the three miRNAs appeared to distinguish SCC from AC accurately in the test and validation samples, demonstrating a sensitivity and specificity of 76 and 80%, and 85 and 83%, respectively. hsa-miR-196b, hsa-miR-205 and hsa-miR-375 were identified as biomarkers capable of distinguishing between lung SCC and lung AC. These newly identified miRNAs may prove to be highly valuable molecular markers for the classification of NSCLC histological subtypes and may contribute to the pathogenesis of each subtype of NSCLC.

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Spinal posture in the sagittal plane is associated with future dependence in activities of daily living

Kamitani Kojiro, Michikawa Takehiro, Iwasawa Satoko, Eto Norihito, Tanaka Taichiro, Takebayashi Toru, Nishiwaki Yuji

Journals of Gerontology - Series A Biological Sciences and Medical Sciences 68 （ 7 ） 869 - 875 2013年07月

研究論文（学術雑誌）, 共著, ISSN 1079-5006

Background. Accumulated evidence shows how important spinal posture is for aged populations in maintaining independence in everyday life. However, the cross-sectional designs of most previous studies prevent elucidation of the relationship between spinal posture and future dependence in activities of daily living (ADL). We tried to clarify the association by measuring spinal posture noninvasively in a community-based prospective cohort study of older adults, paying particular attention to thoracic curvature, lumbar curvature, sacral hip angle, and inclination to determine which parameter is most strongly associated with dependence in ADL.Methods. Spinal posture was evaluated in 804 participants (338 men, 466 women, age range: 65-94 years) who were independent in ADL at baseline. We defined dependence in ADL as admission to a nursing home or need of home assistance. During the 4.5-year follow-up period, 126 (15.7%) participants became dependent in ADL. The relationship between the spinal posture parameters and outcome was assessed by dividing the participants into sex-specific quartiles of the parameters.Results. Only inclination (angle subtended between the vertical and a line joining C7 to the sacrum) was associated with outcome, although lumbar curvature also showed a marginal association. The age- and sex-adjusted odds ratio for a 1 unit increase in the quartiles of inclination was 1.79 (confidence interval: 1.44, 2.23). After mutual adjustment for the 4 parameters, statistical significance for inclination still remained, with no substantial changes in the association estimates.Conclusions. This study indicates that spinal inclination is associated with future dependence in ADL among older adults. © 2013 © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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