吉村　公雄 （ヨシムラ　キミオ）

Yoshimura, Kimio

写真a

所属（所属キャンパス）

医学部 医療政策・管理学教室 （信濃町）

職名

専任講師

外部リンク
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総合紹介 【 表示 ／ 非表示 】

  • 医療政策・管理学、疫学、臨床疫学、遺伝疫学、生物統計学

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研究分野 【 表示 ／ 非表示 】

  • ライフサイエンス / 医療管理学、医療系社会学 （医療政策・管理学）

  • ライフサイエンス / 精神神経科学 （計量心理学）

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著書 【 表示 ／ 非表示 】

  • QOL評価ハンドブック

    吉村公雄，山内慶太, 医学書院、東京, 2001年04月

    担当範囲: 106－111

  • WHO SUBI 手引き

    大野裕、吉村公雄, 金子書房、東京, 2001年

  • 家族性腫瘍遺伝カウンセリング－理論と実際－

    吉村公雄, 金原出版，東京, 2000年10月

    担当範囲: 115－120

  • Somatoform disorders: a worldwide perspective.

    Ono Y, Araki N, Mitani M, Yoshimura K., Springer-Verlag, Tokyo, 1999年

    担当範囲: 132-140

  • Somatoform disorders: a worldwide perspective.

    Yoshimura K, Nakamura K, Maeda F, Saito N, Sakazume H, Ishii R, Araki N, Ono Y., Springer-Verlag, Tokyo, 1999年

    担当範囲: 263-268

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  • Well-being of cancer survivors with exceptional longevity: A cross-sectional and prospective cohort study of centenarians and very old adults

    Shikimoto R., Gondo Y., Yasumoto S., Abe Y., Yagasaki K., Yoshimura K., Mimura M., Hirose N., Arai Y.

    Journal of Geriatric Oncology 16 （ 7 ）  2025年09月

    ISSN  18794068

    　概要を見る

    Introduction: Studies on well-being and life expectancy of cancer survivors with exceptional longevity are scarce. We explored the relationship between cancer history and well-being and blood biomarkers in centenarians and very old adults. We also aimed to examine the life expectancy of cancer survivors. Materials and Methods: Within three population-based cohorts in Japan, we recruited very old adults (85–94 years) and centenarians (100–115 years) between 2000 and 2020, and followed them up. Cancer survivors were defined as having been diagnosed with cancer regardless of whether they had been treated or not. Participants lacking history of cancer diagnosis or those who were not assessed using the Philadelphia Geriatric Center (PGC) Morale Scale were excluded. Participants' well-being was measured using the PGC Morale Scale, which included three subcategories: age attitude, social well-being, and psychological well-being. Multivariate LASSO (Least Absolute Shrinkage and Selection Operator) regression analysis and linear regression analysis were used to investigate whether having been diagnosed with cancer predicted the total PGC Morale Scale score, and multivariate Cox regression analysis was performed to assess life expectancy from the baseline survey. Results: Among 1531 participants (very old, n = 532; centenarians, n = 999), 207 (13.5%) had been diagnosed with cancer. The association between cancer history and well-being differed significantly by age group. Very old individuals with a cancer history were not significantly associated with well-being scores. In contrast, centenarians with a cancer history had higher total well-being (B [95% CI] = 1.28 [0.08–2.49]) and showed a trend toward higher social well-being (B [95% CI] = 0.46 [−0.08–0.99]). No significant life expectancy differences were found between the very old and centenarian cancer survivors. Discussion: The impact of a history of cancer on well-being differed between very old adults and centenarians. Centenarian cancer survivors showed greater well-being, particularly in social well-being. Moreover, the life expectancy of cancer survivors did not differ significantly from that of individuals without a cancer history.

  • Risk of falls associated with non-GABAergic hypnotics and benzodiazepines in hospitalized patients

    Shishida K, Nishimura W, Shimomura Y, Murayama M, Yoshimura K, Uchida H, Mimura M, Takeuchi H.

    General Hospital Psychiatry 94 （ May-June 2025 ） 10 - 15 2025年02月

    　概要を見る

    Objective: Non-GABAergic hypnotics introduced into clinical practice within the last two decades are pharmacologically presumed to have a lower risk of falls, but clinical investigations are scarce. We aimed to evaluate the risk of falls associated with different classes of hypnotics, namely benzodiazepines, ramelteon, suvorexant, and trazodone, in hospitalized individuals at a general hospital. Method: In this retrospective cohort study, data on the incidence of falls, hypnotic use, age, sex, body mass index (BMI), activities of daily living (ADL) score, presence of surgery, emergency admission, and ambulance use were collected for hospitalized patients aged 20 years or older who had been discharged from a tertiary general hospital in Japan between April 1, 2014, and March 31, 2019. The Cox proportional hazards model was used to examine factors associated with falls, adjusting for other demographics as covariates. Results: Among 28,029 patients, 383 falls occurred in 322 patients. Ramelteon or suvorexant was not associated with an elevated incidence of falls (adjusted hazard ratio [aHR], 0.78; 95 % CI, 0.34 to 1.81 and 0.44; 95 % CI, 0.13–1.46, respectively), in contrast to benzodiazepines (aHR, 2.17; 95 % CI 1.67–2.83) or trazodone (aHR, 1.96; 95 % CI 1.25–3.07). Advanced age, lower BMI, wheelchair dependency, non-surgical status, absence of emergency admissions, and ambulance use were also associated with the elevated incidence of falls. Conclusions: In hospitalized patients at general hospitals, ramelteon and suvorexant may not increase the risk of falls, while the use of benzodiazepines and trazodone requires careful attention to minimize this risk.

  • Efficacy and safety of intravenous ketamine treatment in Japanese patients with treatment-resistant depression: A double-blind, randomized, placebo-controlled trial

    Ohtani Y., Tani H., Nomoto-Takahashi K., Yatomi T., Yonezawa K., Tomiyama S., Nagai N., Kusudo K., Honda S., Moriyama S., Nakajima S., Yamada T., Morisaki H., Iwabuchi Y., Jinzaki M., Yoshimura K., Eiro T., Tsugawa S., Ichijo S., Fujimoto Y., Miyazaki T., Takahashi T., Uchida H.

    Psychiatry and Clinical Neurosciences 78 （ 12 ） 765 - 775 2024年12月

    ISSN  13231316

    　概要を見る

    Aim: Although the antidepressant effect of ketamine on treatment-resistant depression (TRD) has been frequently reported in North American and European countries, evidence is scarce among the Asian population. We aimed to evaluate the efficacy and safety of intravenous ketamine in Japanese patients with TRD. Methods: In this double-blind randomized placebo-controlled trial, 34 Japanese patients with TRD were randomized to receive either intravenous ketamine (0.5 mg/kg) or placebo, administered over 40 min, twice a week, for 2 weeks. The primary outcome was the change in the Montgomery Åsberg Depression Rating Scale (MADRS) total score from baseline to post-treatment. Secondary outcomes included changes in other depressive symptomatology scores and remission, response, and partial response rates. We also examined the association between baseline clinical demographic characteristics and changes in the MADRS total score. Results: Intention-to-treat analysis indicated no significant difference in the decrease in MADRS total score between the groups (−8.1 ± 10.0 vs −2.5 ± 5.2, t[32] = 2.02, P = 0.052), whereas per-protocol analysis showed a significant reduction in the ketamine group compared to the placebo group (−9.1 ± 10.2 vs −2.7 ± 5.3, t[29] = 2.22, P = 0.034). No significant group differences were observed in other outcomes. Adverse events were more frequent in the ketamine group than in the placebo group, and no serious adverse events were reported. A higher baseline MADRS total score and body mass index were associated with a greater reduction in the MADRS total score. Conclusion: Intravenous ketamine outperformed placebo in Japanese patients with TRD who completed the study, suggesting that ketamine could alleviate depressive symptoms of TRD across diverse ethnic populations.

  • The spectrum of TP53 mutations in Rwandan patients with gastric cancer

    Nzitakera A., Surwumwe J.B., Ndoricyimpaye E.L., Uwamungu S., Uwamariya D., Manirakiza F., Ndayisaba M.C., Ntakirutimana G., Seminega B., Dusabejambo V., Rutaganda E., Kamali P., Ngabonziza F., Ishikawa R., Rugwizangonga B., Iwashita Y., Yamada H., Yoshimura K., Sugimura H., Shinmura K.

    Genes and Environment 46 （ 1 ）  2024年12月

    ISSN  18807046

    　概要を見る

    Background: Gastric cancer is the sixth most frequently diagnosed cancer and third in causing cancer-related death globally. The most frequently mutated gene in human cancers is TP53, which plays a pivotal role in cancer initiation and progression. In Africa, particularly in Rwanda, data on TP53 mutations are lacking. Therefore, this study intended to obtain TP53 mutation status in Rwandan patients with gastric cancer. Results: Formalin-fixed paraffin-embedded tissue blocks of 95 Rwandan patients with histopathologically proven gastric carcinoma were obtained from the University Teaching Hospital of Kigali. After DNA extraction, all coding regions of the TP53 gene and the exon–intron boundary region of TP53 were sequenced using the Sanger sequencing. Mutated TP53 were observed in 24 (25.3%) of the 95 cases, and a total of 29 mutations were identified. These TP53 mutations were distributed between exon 4 and 8 and most of them were missense mutations (19/29; 65.5%). Immunohistochemical analysis for TP53 revealed that most of the TP53 missense mutations were associated with TP53 protein accumulation. Among the 29 mutations, one was novel (c.459_477delCGGCACCCGCGTCCGCGCC). This 19-bp deletion mutation in exon 5 caused the production of truncated TP53 protein (p.G154Wfs*10). Regarding the spectrum of TP53 mutations, G:C > A:T at CpG sites was the most prevalent (10/29; 34.5%) and G:C > T:A was the second most prevalent (7/29; 24.1%). Interestingly, when the mutation spectrum of TP53 was compared to three previous TP53 mutational studies on non-Rwandan patients with gastric cancer, G:C > T:A mutations were significantly more frequent in this study than in our previous study (p = 0.013), the TCGA database (p = 0.017), and a previous study on patients from Hong Kong (p = 0.006). Even after correcting for false discovery, statistical significance was observed. Conclusions: Our results suggested that TP53 G:C > T:A transversion mutation in Rwandan patients with gastric cancer is more frequent than in non-Rwandan patients with gastric cancer, indicating at an alternative etiological and carcinogenic progression of gastric cancer in Rwanda.

  • Influence of dementia-specialized care team on clinical outcomes in a general hospital

    Shimomura Y., Nishimura W., Murayama M., Yoshimura K., Mimura M., Uchida H., Takeuchi H., Shishida K.

    Asian Journal of Psychiatry 102 2024年12月

    ISSN  18762018

    　概要を見る

    Background: Because of the increasing prevalence of dementia in Japan, the government introduced financial incentives for specialized care for dementia at acute care hospitals in 2016. Our hospital then introduced a multidisciplinary collaborative specialized team, referred to as dementia-specialized care team. The aim of this study is to examine the influence of dementia-specialized care team on clinical outcomes for elderly inpatients. Methods: In this retrospective observational study at a general hospital with 650 beds in Japan, we compared clinical outcomes such as incidence of falls, prescription of hypnotics, length of hospital stay, in-hospital mortality, and discharge destinations in inpatients aged 65 years and older between a two-year pre-intervention period (2014–2015) and a two-year post-intervention period (2017–2018). Results: During the observation period, a total of 34,097 patients were admitted, with 16,237 patients in the pre-intervention period and 17,860 patients in the post-intervention period. The proportion of patients receiving any hypnotics decreased from 21.2 % to 19.2 %, notably with benzodiazepine from 19.8 % to 13.2 %. The incidence of falls from a seated or lying position, particularly at night, was significantly lower (from 0.5 % to 0.2 %) as was the length of hospital stay (from 13.7 days to 13.2 days) during the post-intervention period. Conclusion: After the implementation of dementia-specialized care team, favorable outcomes such as a reduction in the use of hypnotics, the incidence of falls, and the length of hospitalization were observed. Introduction of the team and associated incentives may be effective in improving clinical outcomes in elderly inpatients.

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研究発表 【 表示 ／ 非表示 】

  • 当事者や他科との協働による診療ガイド作成　Mindsガイドラインに基づく診療ガイドラインにおける患者・市民参画

    吉村 公雄

    第121回日本精神神経学会学術総会, 

    2025年06月

  • ベンゾジアゼピン系および非GABA作動性睡眠薬の時間帯別の転倒リスク

    志々田 一宏, 片山 雄太, 中島 えり菜, 橋本 善太, 竹内 啓善, 吉村 公雄

    第37回日本総合病院精神医学総会, 

    2024年11月

  • 当事者・家族版ガイドの作成過程について　当事者・家族版作成過程のガイドラインについて

    吉村 公雄

    第119回日本精神神経学会学術総会, 

    2023年06月

  • 肺腫瘍における一次繊毛の検討　小細胞肺癌における一次繊毛の高頻度同定とその機能について

    新村 和也, 加藤 寿美, 河崎 秀陽, 針山 孝彦, 吉村 公雄, 渡邉 裕文, 太田 勲, 川瀬 晃和, 船井 和仁, 椙村 春彦

    第112回日本病理学会総会, 

    2023年04月

  • 横浜市立市民病院における認知症専門ケアチーム発足前後での臨床的アウトカムの比較

    下村 雄太郎, 西村 和華, 村山 真之, 山口 滋紀, 内芝 恵, 加藤 剛, 吉村 公雄, 内田 裕之, 三村 將, 竹内 啓善, 志々田 一宏

    第35回日本総合病院精神医学総会, 

    2022年10月

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担当授業科目 【 表示 ／ 非表示 】

  • 科学技術と現代社会

    2025年度

  • メディカル・プロフェッショナリズムⅤ

    2025年度

  • メディカル・プロフェッショナリズムⅡ

    2025年度

  • データ対話型病院経営論Ⅱ

    2025年度

  • データ対話型病院経営論Ⅰ

    2025年度

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