論文 - 吉村　公雄

Associations of cardiovascular biomarkers and plasma albumin with exceptional survival to the highest ages

Hirata T., Arai Y., Yuasa S., Abe Y., Takayama M., Sasaki T., Kunitomi A., Inagaki H., Endo M., Morinaga J., Yoshimura K., Adachi T., Oike Y., Takebayashi T., Okano H., Hirose N.

Nature Communications （Nature Communications）  11 （ 1 ）  2020年12月

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© 2020, The Author(s). Supercentenarians (those aged ≥110 years) are approaching the current human longevity limit by preventing or surviving major illness. Identifying specific biomarkers conducive to exceptional survival might provide insights into counter-regulatory mechanisms against aging-related disease. Here, we report associations between cardiovascular disease-related biomarkers and survival to the highest ages using a unique dataset of 1,427 oldest individuals from three longitudinal cohort studies, including 36 supercentenarians, 572 semi-supercentenarians (105–109 years), 288 centenarians (100–104 years), and 531 very old people (85–99 years). During follow-up, 1,000 participants (70.1%) died. Overall, N-terminal pro-B-type natriuretic peptide (NT-proBNP), interleukin-6, cystatin C and cholinesterase are associated with all-cause mortality independent of traditional cardiovascular risk factors and plasma albumin. Of these, low NT-proBNP levels are statistically associated with a survival advantage to supercentenarian age. Only low albumin is associated with high mortality across age groups. These findings expand our knowledge on the biology of human longevity.

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Comorbidities associated with nontuberculous mycobacterial disease in Japanese adults: A claims-data analysis

Uno S., Asakura T., Morimoto K., Yoshimura K., Uwamino Y., Nishimura T., Hoshino Y., Hasegawa N.

BMC Pulmonary Medicine （BMC Pulmonary Medicine）  20 （ 1 ）  2020年10月

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© 2020 The Author(s). Background: Nontuberculous mycobacterial (NTM) lung disease is one of a growing number of chronic health problems that is difficult to cure in aging societies. While it is important to be vigilant about associated comorbidities in order to provide better patient care, data on the prevalence of comorbidities stratified by country or region are scarce. We aimed to elucidate the comorbidities associated with NTM disease based on Japanese health insurance claims data. Methods: Cross-sectional analyses were performed using the claims data for 2014 provided by the Japan Medical Data Center Co., Ltd. Patients aged 20-75 years with ≥3 claims associated with NTM disease were identified and matched to 10 sex-and-age-matched controls that had never made a claim for NTM disease. Thirty-one comorbidities previously suspected to be associated with NTM disease were selected, and the prevalence of these comorbidities compared between cases and controls. Result: Overall, 419 NTM patients (134 males and 285 females) and 4190 non-NTM controls were identified from the JMDC database. Aspergillosis, asthma, chronic heart failure, diffuse panbronchiolitis, gastroesophageal reflux, interstitial pneumonia, lung cancer, cancer other than breast, lung, ovary, or prostate cancer, and rheumatoid arthritis were associated with NTM disease in both males and females. Chronic obstructive pulmonary disease was associated with NTM in males while chronic kidney disease, osteoporosis, and Sjögren syndrome were associated with NTM in females. Conclusion: NTM disease was associated with multiple comorbidities that should be considered when providing medical care to individuals with NTM disease.

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Prescription patterns of psychotropics in patients receiving synthetic glucocorticoids

Yatomi T., Uchida T., Takeuchi H., Kuramochi S., Yoshimura K., Mimura M., Uchida H.

Acta Psychiatrica Scandinavica （Acta Psychiatrica Scandinavica）  142 （ 3 ） 242 - 248 2020年09月

査読有り,  ISSN  0001690X

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© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Objective: Synthetic glucocorticoids cause various psychiatric symptoms. Prescription of psychotropic drugs could be considered to be a proxy for manifestation of psychiatric symptoms. The aim of this study was to investigate the prescriptions of psychotropics in outpatients receiving synthetic glucocorticoids. Methods: We used the claims sampling data during January 2015 from the National Database of Health Insurance Claims and Specific Health Checkups of Japan made by the Ministry of Health, Labor, and Welfare in Japan. We compared the prescription rates of psychotropics between outpatients receiving oral synthetic glucocorticoids and age- and sex-matched controls and the prescription rates of psychotropics among the eight dosage groups of synthetic glucocorticoids by chi-squared test, and chlorpromazine/imipramine/diazepam equivalent doses (or daily defined doses) of respective psychotropics among these groups using Welch's t-test. Results: Synthetic glucocorticoids were prescribed to 3.1% (n = 18 122) of 581 990 patients. The prescription rates of psychotropics were significantly higher among the synthetic glucocorticoid recipients than among the non-recipients: antipsychotics, 1.8% (n = 321) vs. 1.1% (n = 201) (P = 1.4 × 10−7); antidepressants, 4.0% (n = 724) vs. 2.0% (n = 359) (P = 8.7 × 10−30); anxiolytics/hypnotics, 16.7% (n = 3029) vs. 10.2% (n = 1841) (P = 2.7 × 10−75); and mood stabilizers, 1.3% (n = 238) vs. 0.7% (n = 120) (P = 3.6 × 10−10) respectively. There was no significant difference in the prescription rates of any psychotropic drugs, other than anxiolytics/hypnotics, among the eight synthetic glucocorticoid dosage groups. Conclusion: Prescriptions of oral synthetic glucocorticoids were found to be associated with the use of any of the types of psychotropic drugs, other than anxiolytics/hypnotics, although a causal relationship could not be confirmed due to the retrospective and cross-sectional nature of this study.

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Circadian patterns of hallucinatory experiences in patients with schizophrenia: Potentials for chrono-pharmacology

Koizumi T., Suzuki T., Pillai N.S., Bies R.R., Takeuchi H., Yoshimura K., Mimura M., Uchida H.

Journal of Psychiatric Research （Journal of Psychiatric Research）  117   1 - 6 2019年10月

査読有り,  ISSN  00223956

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© 2019 Elsevier Ltd The objective of this study was to investigate possible circadian pattern of psychotic symptoms in patients with schizophrenia, which could be reflected on the dosing schedule/regimen, i.e. chrono-pharmacology. Patients with schizophrenia (ICD-10) who reported having auditory hallucination, receiving monotherapy with risperidone, olanzapine or paliperidone for at least two weeks were included. The subjects were provided a diary and asked to record the time and duration of auditory hallucinations during the eight time periods (i.e. 00:00–03:00, 03:00–06:00, 06:00–09:00, 09:00–12:00, 12:00–15:00, 15:00–18:00, 18:00–21:00, and 21:00–24:00). In the diary, times of medication doses and sleep were also recorded. Time and degree of peak and trough dopamine D2 receptor blockade with antipsychotics were estimated from 2 sparsely collected plasma drug concentrations. The prevalence and duration of auditory hallucinations were statistically examined among the eight time periods, respectively. Forty-nine patients participated in this study (mean ± SD age, 50.7 ± 14.8 years; 36 men (73.5%); 34 inpatients (69.4%)). Auditory hallucinations occurred most frequently and lasted for the longest duration in the period of 18:00–21:00 (75.5% (37/49) and 1.37 ± 1.67 h). This happened despite the fact that the difference in D2 receptor occupancy between the peak and trough was less than 2%, indicating a stable drug delivery. Since the dopamine D2 receptor blockade by antipsychotics was stable, the nocturnal circadian pattern found in this study may reflect intrinsic dopaminergic fluctuation or generally quieter environments at night. These circadian patterns may be considered to devise individualized treatment approach in the context of “chrono-pharmacology” for patients with schizophrenia.

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The estimated cost of dementia in Japan, the most aged society in the world

Sado M., Ninomiya A., Shikimoto R., Ikeda B., Baba T., Yoshimura K., Mimura M.

PLoS ONE （PLoS ONE）  13 （ 11 ）  2018年11月

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© 2018 Sado et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Objective Dementia has become a global critical issue. It is estimated that the global cost of dementia was 818 billion USD in 2015. The situation in Japan, which is the most aged country in the world, should be critical. However, the societal cost of dementia in Japan has not yet been estimated. This study was designed to estimate cost of dementia from societal perspective. Design We estimated the cost from societal perspective with prevalence based approach. Setting, participants and measures Main data sources for the parameters to estimate the costs are the National Data Base, a nationwide representative individual-level database for healthcare utilization, the Survey of Long-Term Care Benefit Expenditures, a nationwide survey based on individual-level secondary data for formal long-term care utilization, and the results of an informal care time survey for informal care cost. We conducted the analyses with ‘probabilistic modeling’ using the parameters obtained to estimate the costs of dementia. We also projected future costs. Results The societal costs of dementia in Japan in 2014 were estimated at JPY 14.5 trillion (se 66.0 billion). Of these, the costs for healthcare, long-term care, and informal care are JPY 1.91 trillion (se 4.91 billion), JPY 6.44 trillion (se 63.2 billion), and JPY 6.16 trillion (se 12.5 billion) respectively. The cost per person with dementia appeared to be JPY5.95 million (se 27 thousand). The total costs would reach JPY 24.3 trillion by 2060, which is 1.6 times higher than that in 2014. Conclusions The societal cost of dementia in Japan appeared to be considerable. Interventions to mitigate this impact should be considered.

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Predictive factors associated with psychological distress of caregivers of people with dementia in Japan: A cross-sectional study

Shikimoto R., Sado M., Ninomiya A., Yoshimura K., Ikeda B., Baba T., Mimura M.

International Psychogeriatrics （International Psychogeriatrics）  30 （ 8 ） 1089 - 1098 2018年08月

査読有り,  ISSN  10416102

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© 2017 International Psychogeriatric Association. Background: Caregivers of people with dementia are likely to have psychological distress that sometimes results in mental health problems, such as depression. The objective of this study was to examine some predictive factors that are thought to be associated with psychological distress of caregivers of people with dementia in Japan. Methods: Design: A cross-sectional study. Sample: As part of a study to estimate the cost of dementia in Japan, 1,437 people with dementia-caregiver dyads were enrolled in the current informal care time study. The measurements in the study included were the basic characteristics of the caregivers and the people with dementia, and the informal care time during a week.Analysis: Factors that predict caregivers' psychological distress, which was measured by Kessler's Psychological Distress scale (K6) score, were evaluated using univariate and multivariate regression analyses. Results: Approximately 69% of the caregivers recorded a K6 score higher than 4, while 18% scored higher than 12. According to the results of the logistic regression analysis (cut-off 4/5), the K6 score was associated with mental and comorbid diseases of people with dementia, informal care time, its lower number of caregivers, and the level of nursing care. According to the results of logistic regression analysis (cut-off 12/13), the K6 score was associated with mental symptoms and comorbid disease of people with dementia, sex of caregivers, informal care time, and its lower number of caregivers. Conclusion: Our findings indicated that the psychological distress of the caregivers is quite high and that informal care time and behavioral and psychological symptoms of dementia are associated with it. These results corroborate with previous findings.

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Mindfulness-based cognitive therapy for Japanese breast cancer patients-a feasibility study

Park S., Sado M., Fujisawa D., Sato Y., Takeuchi M., Ninomiya A., Takahashi M., Yoshimura K., Jinno H., Takeda Y.

Japanese Journal of Clinical Oncology （Japanese Journal of Clinical Oncology）  48 （ 1 ） 68 - 74 2018年01月

査読有り,  ISSN  03682811

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© The Author 2017. Published by Oxford University Press. All rights reserved. Objectives: Mindfulness-based intervention has been receiving growing attention in cancer care. This study aimed to examine feasibility and to preliminary explore effectiveness of mindfulnessbased cognitive therapy (MBCT) in Japanese breast cancer patients, and to explore possible modification of the program so that it fits better with this population. Methods: Twelve participants with diagnosis of Stage I-III breast cancer received an eight session, weekly MBCT intervention in a group therapy format. The participants were followed up until 3 months after the completion of the program. Results: All the participants completed the program with high attendance rate (mean number of attended sessions = 7.7). Significant improvement in anxiety (Hospital Anxiety and Depression Scale (HADS) - anxiety subscale; effect size Cohen's d = 0.88, P < 0.05), trauma-related psychological symptoms (Impact of Event Scale-revised; d = 0.64, P < 0.01) and quality of life (Functional Assessment of Cancer Therapy-Breast Cancer: FACT-B; d = 0.72, P < 0.01), and trend-level improvement in depression (HADS - depression subscale; d = 0.53, P = 0.054) were observed. Qualitative analyses suggested the program may be beneficial for alleviating fear of cancer recurrence and for increasing spiritual well-being. Some recommended modification of the program was indicated from the post-intervention interviews. Conclusions: Mindfulness-based cognitive therapy was well accepted by Japanese breast cancer patients and yielded favorable effect on their psychological status and quality of life. Further effectiveness study in a randomized-control design is warranted.

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Reduced expression of the DNA glycosylase gene MUTYH is associated with an increased number of somatic mutations via a reduction in the DNA repair capacity in prostate adenocarcinoma

Kazuya Shinmura , Hisami Kato , Yuichi Kawanishi , Kimio Yoshimura , Hisaki Igarashi , Masanori Goto , Hong Tao , Yusuke Inoue , Takayuki Sugiyama , Hiroshi Furuse , Seiichiro Ozono , Haruhiko Sugimura

Mol Carcinog 56   781 - 788 2017年

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【精神医療・精神医学に関するガイドラインの現状と問題点】英国の精神医療におけるNICEガイドラインの影響

リー・アンドリュー・キセイン, 田村 法子, 吉村 公雄

精神神経学雑誌 119   166 - 172 2017年

精神医療に関するガイドラインの現状と問題点　法的位置付けも含む

田村 法子, 木ノ元 直樹, 橋本 亮太, リー・アンドリュー・キセイン , 倉田 知佳, 岸本 年史, 細田 眞司, 鹿島 晴雄, 吉村 公雄

 臨床精神薬理 20   1407 - 1415 2017年

Predicting relapse with individual residual symptoms in major depressive disorder: a reanalysis of the STAR*D data

Hitoshi Sakurai , Takefumi Suzuki , Kimio Yoshimura , Masaru Mimura , Hiroyuki Uchida

Psychopharmacology (Berl) 234   2453 - 2461 2017年

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The Impact of NICE Guidance on UK Psychiatry

Lee Andrew Kissane, Noriko Tamura, Kimio Yoshimura

Seishin Shinkeigaku Zasshi 119   166 - 172 2017年

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【最新遺伝医学研究と遺伝カウンセリング(シリーズ1)　最新遺伝性腫瘍・家族性腫瘍研究と遺伝カウンセリング】 (第1章)がん家系登録と情報管理

吉村 公雄

遺伝子医学MOOK 別冊   52 - 56 2016年

End-of-life preferences of the general public: Results from a Japanese national survey

Kissane L. A., Ikeda B., Akizuki R., Nozaki S., Yoshimura K. and Ikegami N.

Health Policy 119   1472 - 1481 2015年

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Association between Quality of End-of-Life Care and Possible Complicated Grief among Bereaved Family Members

Miyajima K., Fujisawa D., Yoshimura K., Ito M., Nakajima S., Shirahase J., Mimura M. and Miyashita M.

J Palliat Med    22 2014年

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Predictors of repeated sick leave in the workplace because of mental disorders

Sado M., Shirahase J., Yoshimura K., Miura Y., Yamamoto K., Tabuchi H., Kato M. and Mimura M.

Neuropsychiatr Dis Treat 10   193 - 200 2014年

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Current nursing practice for patients on oral chemotherapy: a multicenter survey in Japan

Komatsu H., Yagasaki K. and Yoshimura K.

BMC Res Notes 23   259 2014年

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Cost of anxiety disorders in Japan in 2008: a prevalence-based approach

Sado M., Takechi S., Inagaki A., Fujisawa D., Koreki A., Mimura M. and Yoshimura K.

BMC Psychiatry 13   13 - 338 2013年

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Two cohort and three independent anonymous twin projects at the Keio Twin Research Center (KoTReC)

Ando J., Fujisawa K. K., Shikishima C., Hiraishi K., Nozaki M., Yamagata S., Takahashi Y., Ozaki K., Suzuki K., Deno M., Sasaki S., Toda T., Kobayashi K., Sugimoto Y., Okada M., Kijima N., Ono Y., Yoshimura K., Kakihana S., Maekawa H., Kamakura T., Nonaka K., Kato N. and Ooki S.

Twin Res Hum Genet 16   202 - 216 2013年

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The cost of schizophrenia in Japan

Sado M., Inagaki A., Koreki A., Knapp M., Kissane L. A., Mimura M. and Yoshimura K.

Neuropsychiatr Dis Treat 9   787 - 798 2013年

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