研究者詳細 - 内田　裕之

論文 - 内田　裕之

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Characterization of systemic and histologic injury after crush syndrome and intervals of reperfusion in a small animal model.

Murata I, Ooi K, Sasaki H, Kimura S, Ohtake K, Ueda H, Uchida H, Yasui N, Tsutsui Y, Yoshizawa N, Hirotsu I, Morimoto Y, Kobayashi J

The Journal of trauma 70 （ 6 ） 1453 - 63 2011年06月

ISSN 0022-5282

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Predicting dopamine D<inf>2</inf> receptor occupancy from plasma levels of antipsychotic drugs: A systematic review and pooled analysis

Uchida H., Takeuchi H., Graff-Guerrero A., Suzuki T., Watanabe K., Mamo D.

Journal of Clinical Psychopharmacology （Journal of Clinical Psychopharmacology） 31 （ 3 ） 318 - 325 2011年06月

ISSN 02710749

Measuring dopamine D2 receptor occupancy levels using positron emission tomography (PET) is still widely unavailable. The objective of this study was to evaluate the accuracy of predicting D2 occupancy from the antipsychotic plasma level in patients with schizophrenia. Positron emission tomographic studies that measured plasma levels of antipsychotics and their corresponding D2 occupancy levels were identified, using MEDLINE and EMBASE (last search: March 2010). Antipsychotics that were investigated in a total of 20 subjects or more were included. All data points for each antipsychotic were fit to a one-site binding model to estimate the total plasma concentration of each antipsychotic associated with a 50% occupancy (ED50) of brain D2 receptors. The mean prediction error and the root mean squared prediction error were used to measure the predictive performance of individual D2 receptor occupancies from plasma drug levels derived from a one-site occupancy model using an ED50 value calculated for each data point. A total of 34 treatment arms from 23 studies involving 281 subjects were included. The mean (95% confidence interval) prediction errors and root squared prediction errors were as low as 0.0 (-1.8 to 1.8) and 8.9 (7.6-10.2) for risperidone (n = 98); 0.0 (-3.5 to 3.5) and 15.1 (12.9-17.3) for clozapine (n = 75); -0.1 (-1.2 to 1.2), 0.0 (-1.9 to 1.9), and 4.6 (3.5-5.8) for olanzapine (n = 42); 0.1 (-3.4 to 3.5) and 9.9 (7.3-12.5) for haloperidol (n = 35); and -0.1 (-3.3 to 3.1) and 12.3 (8.8-15.7) for ziprasidone (n = 31), respectively. These findings suggest that D2 occupancy of antipsychotics could be estimated with a high degree of accuracy using widely available plasma levels. © 2011 Lippincott Williams & Wilkins.

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広汎性発達障害児の人物画研究　DAM項目による身体部位表現の分析

明翫光宜, 望月知世, 内田裕之, 辻井正次

小児の精神と神経（(一社)日本小児精神神経学会） 51 （ 2 ） 157 - 168 2011年06月

ISSN 0559-9040

本研究では、広汎性発達障害児の人物画の特徴を捉えるために、定型発達児との比較研究を行った。対象は広汎性発達障害群30名(男児)、定型発達群97名(男児)であった。DAM項目について両群を比較したところ、DAM-IQなどの総合指標だけの分析では広汎性発達障害の心理査定に限界があり、人物画に描かれている身体部位表現に注目することの重要性を示唆した。(著者抄録)

Electrochemical quartz crystal microbalance analysis of the oxygen reduction reaction on Pt-based electrodes. Part 1: Effect of adsorbed anions on the oxygen reduction activities of Pt in HF, HClO4, and H2SO4 solutions.

Omura J, Yano H, Watanabe M, Uchida H

Langmuir : the ACS journal of surfaces and colloids 27 （ 10 ） 6464 - 70 2011年05月

ISSN 0743-7463

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[Age-, period-, and birth-cohort-specific effects on the male proportion in Japanese newborns and projections for male proportion for 20 periods (2008-2027)].

Uchida H, Watanabe M, Naiki M, Ito J, Ohtake K, Odagiri Y, Kobayashi J

Nihon eiseigaku zasshi. Japanese journal of hygiene 66 （ 3 ） 582 - 8 2011年05月

ISSN 0021-5082

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Pisa syndrome caused by an acetylcholinesterase inhibitor in a patient with dementia with Lewy bodies

Shinfuku Masaki, Nakajima Shinichiro, Uchida Hiroyuki, Watanabe Koichiro, Kocha Hiroki, Kashima Haruo

Psychiatry and Clinical Neurosciences 65 （ 3 ） 299 2011年04月

ISSN 1323-1316

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Patients' attitudes toward side effects of antidepressants

Kikuchi Toshiaki, Uchida Hiroyuki, Suzuki Takefumi, Watanabe Koichiro, Kashima Haruo

European Archives of Psychiatry and Clinical Neuroscience 261 （ 2 ） 103 - 109 2011年03月

ISSN 0940-1334

Patients' attitudes toward side effects of antidepressants are likely to differ according to gender, which has not yet been fully addressed in the literature. From the 228,310 registrants, 1,305 participants who had received antidepressant drugs within the past year were identified with the Yahoo Japan research monitor through four-step screening procedures. Participants were asked as to which side effect(s) they had experienced, whether they had reported those side effects to their physicians, and whether they had taken any action to counteract them. The questionnaire was completed by 1,187 participants. Side effects were reported in 73.4% of the participants; the prevalence of self-reported side effects was significantly higher in men than women (80.4% vs. 68.3%, P <0.05). The percentage of participants who reported side effects to their physicians widely differed depending on the nature of their experience, ranging from 45.7% to 89.9%; the lowest was for sexual dysfunction. The percentage of participants who had taken any action to relieve side effects varied among side effects from 26.3% for sexual dysfunction to 89.5% for dry mouth. Moreover, a lower percentage of women had reported sexual dysfunction to physicians (36.6% vs. 60.7%, P <0.05) and had taken any action to counteract the problem (19.8% vs. 36.9%, P <0.05). Given that patients experienced with antidepressants are likely to be reluctant to report sexual side effects, physicians should be cognizant of the potential presence of sexual dysfunction in patients who are taking antidepressants, especially for women.

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Patients' attitudes toward side effects of antidepressants: An Internet survey

Kikuchi T., Uchida H., Suzuki T., Watanabe K., Kashima H.

European Archives of Psychiatry and Clinical Neuroscience （European Archives of Psychiatry and Clinical Neuroscience） 261 （ 2 ） 103 - 109 2011年03月

ISSN 09401334

Patients' attitudes toward side effects of antidepressants are likely to differ according to gender, which has not yet been fully addressed in the literature. From the 228,310 registrants, 1,305 participants who had received antidepressant drugs within the past year were identified with the Yahoo Japan research monitor through four-step screening procedures. Participants were asked as to which side effect(s) they had experienced, whether they had reported those side effects to their physicians, and whether they had taken any action to counteract them. The questionnaire was completed by 1,187 participants. Side effects were reported in 73.4% of the participants; the prevalence of self-reported side effects was significantly higher in men than women (80.4% vs. 68.3%, P <0.05). The percentage of participants who reported side effects to their physicians widely differed depending on the nature of their experience, ranging from 45.7% to 89.9%; the lowest was for sexual dysfunction. The percentage of participants who had taken any action to relieve side effects varied among side effects from 26.3% for sexual dysfunction to 89.5% for dry mouth. Moreover, a lower percentage of women had reported sexual dysfunction to physicians (36.6% vs. 60.7%, P <0.05) and had taken any action to counteract the problem (19.8% vs. 36.9%, P <0.05). Given that patients experienced with antidepressants are likely to be reluctant to report sexual side effects, physicians should be cognizant of the potential presence of sexual dysfunction in patients who are taking antidepressants, especially for women. © 2010 Springer-Verlag.

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Influence of anticholinergic activity in serum on clinical symptoms of Alzheimer's disease

Hori K., Konishi K., Watanabe K., Uchida H., Tsuboi T., Moriyasu M., Tominaga I., Hachisu M.

Neuropsychobiology （Neuropsychobiology） 63 （ 3 ） 147 - 153 2011年02月

ISSN 0302-282X

Alzheimer's disease (AD) is well known as a disease characterized by degeneration of cholinergic neuronal activity in the brain. It follows that patients with AD would be sensitive to an 'anticholinergic burden', and also that medicine with anticholinergic properties would promote various clinical symptoms of AD. Despite the relevance of this important phenomenon to the clinical therapeutics of AD patients, few reports have been seen concerning the relationship between anticholinergic burden and clinical AD symptoms. Therefore, we wished to investigate the relationship between serum anticholinergic activity (SAA) and the severity of clinical symptoms of AD patients. Twenty-six out of 76 AD patients referred by practitioners to our hospital were positive for anticholinergic activity in their serum, and the remaining 50 patients were negative. Cognitive and psychiatric symptoms in AD patients were compared between the positive SAA (SAA+) group and the negative SAA (SAA-) group. The SAA+ group showed a significantly (p < 0.05) lower total score on the Mini-Mental State Examination, and significantly (p < 0.05) higher scores on the Functional Assessment Staging and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). In particular, certain subscales of the BEHAVE-AD, i.e. the items of paranoid and delusional ideation, hallucinations and diurnal rhythm disturbances, had higher scores in the SAA+ group. Moreover, it was shown that many more psychotropic medicines were prescribed to the SAA+ group. By means of logistic regression analysis, the items of paranoid and delusional ideation and diurnal rhythm disturbances in the BEHAVE-AD were positively correlated with SAA in patients. We hypothesized that SAA in AD patients would be associated with clinical symptoms, especially delusion and diurnal rhythm disturbances. Copyright © 2011 S. Karger AG.

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Balancing potential risks and benefits of adjunctive use of aripiprazole with risperidone for the treatment of schizophrenia

Uchida Hiroyuki, Mamo David C.

Journal of Clinical Psychopharmacology 31 （ 1 ） 136 - 137 2011年02月

ISSN 0271-0749

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Clinical and demographic characteristics associated with postural instability in patients with schizophrenia

Koreki A., Tsunoda K., Suzuki T., Hirano J., Watanabe K., Kashima H., Uchida H.

Journal of Clinical Psychopharmacology （Journal of Clinical Psychopharmacology） 31 （ 1 ） 16 - 21 2011年02月

ISSN 0271-0749

As people with schizophrenia grow older, prevention of falls in this older population has become a public health priority. It is therefore critically important to identify risk factors to effectively prevent falls. For this purpose, the degree of postural sway can serve as a convenient index of risk assessment. The objective of this study was to find clinical and demographic characteristics associated with postural instability. Inpatients and outpatients with schizophrenia or related psychosis were recruited at 2 hospitals in Japan. The clinical stabilometric platform, which measured a range of the trunk motion, and extrapyramidal side effects were evaluated between 9 and 11 a.m. Four hundred two subjects were enrolled (age: mean, 55.5 [SD, 14.4] years). A univariate general linear model showed that the use of antipsychotic drugs with a chlorpromazine equivalent of 10 or greater, being overweight, and inpatient treatment setting were associated with a greater degree of the range of postural sway. Another general linear model, including a subgroup of 300 subjects who did not present any extrapyramidal side effects, not only consolidated these findings, but also revealed a great degree of postural sway in older subjects. In addition, quetiapine was found to be associated with a greater range of postural sway among atypical antipsychotics. Schizophrenia patients generally showed a greater degree of postural instability, compared with the reference data of healthy people. These findings highlight truncal instability as a risk factor of falls in patients with schizophrenia, especially when they are overweight, old, and/or receiving antipsychotics with a chlorpromazine equivalent of 10 or greater, including quetiapine. Copyright © 2011 by Lippincott Williams & Wilkins.

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Management of schizophrenia in late life with antipsychotic medications

Suzuki Takefumi, Remington Gary, Uchida Hiroyuki, Rajji Tarek K., Graff-Guerrero Ariel, Mamo David C.

Drugs and Aging 28 （ 12 ） 961 - 980 2011年

ISSN 1170-229X

Although patients with schizophrenia are reported to have excess mortality compared with the general population, many affected patients will nonetheless survive and continue to have the disorder in later life. Consequently, geriatric schizophrenia will be a significant public health concern in the years to come, and evidence-based treatment of schizophrenia in older patients is becoming an urgent issue. However, there has been a paucity of comparative data to guide selection of antipsychotics for schizophrenia in late life.The primary aim of this review was to synthesize the available evidence on management of late-life schizophrenia with antipsychotic medications; a secondary aim was to evaluate treatment resistance in this population. Accordingly, PubMed and EMBASE were searched using the keywords 'antipsychotics', 'age' and 'schizophrenia' to identify psychopharmacological studies of antipsychotics in late-life schizophrenia (last search 30 April 2011). The literature search identified 23 prospective studies of use of antipsychotics for schizophrenia in older patients (generally age ≥65 years), including eight double-blind trials. The sample size was smaller than 40 patients for 52 of the studies. Two of the double-blind studies were post hoc analyses and one was a placebo-controlled trial. In the largest double-blind study, olanzapine (n88, median dose 10mgday) and risperidone (n87, median dose 2mgday) were compared in patients not resistant to these therapies, with similar effects. There have also been several open-label trials of these two agents that have shown efficacy and tolerability in non-resistant patients. Evidence on other antipsychotics has been scarce and less robust.The gold standard for treatment-resistant schizophrenia is clozapine. However, almost all of the studies of clozapine to date have effectively excluded older patients with schizophrenia. Only one small study has evaluated clozapine (n24, mean dose 300mgday) in comparison with chlorpromazine (n18, mean dose 600mgday) in a difficult-to-treat older population; the investigators reported that both treatments were similarly efficacious. Furthermore, there has been little compelling evidence in favour of or against augmentation of antipsychotics with other psychotropic medications in the older age group.Treatment of non-resistant, late-life schizophrenia with olanzapine and risperidone appears to be supported by the available evidence. However, data on geriatric patients with schizophrenia are generally scarce, particularly for treatment-resistant subpopulations, underscoring the need for more research in this important area.

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統合失調症の維持期におけるより安全な抗精神病薬治療

内田裕之

医学のあゆみ 2011年

研究論文（学術雑誌）, 単著

Factors associated with response to clozapine in schizophrenia

Suzuki Takefumi, Uchida Hiroyuki, Watanabe Koichiro, Kashima Haruo

Psychopharmacology Bulletin 44 （ 1 ） 32 - 60 2011年

ISSN 0048-5764

Background: Clozapine has been serving as the gold standard medication for patients with treatment-resistant schizophrenia who failed to respond to other antipsychotics. However, factors affecting response to this medication have not been comprehensively reviewed recently. Methods: In order to find factors associated with response to clozapine in schizophrenia, a literature search was conducted using PubMed through January 2011 with keywords of clozapine, response, and schizophrenia. Cross-referencing of relevant articles was also performed. Factors were arbitrarily classified into the following: demographic/clinical, oral dosage/pharmacokinetic, biochemical, (electro)physiological, genetic, imaging, and combinations. Results: A synthesis from 280 articles indicated that demographic and clinical variables such as high baseline symptoms and low premorbid functioning have not been particularly useful in predicting response to clozapine. Pharmacokinetic evidence points to a threshold clozapine level of 350 ng/ml but in a context of significant inter- as well as intra-individual variability. Pharmacokinetic perspectives appear to have more implication in special situations including poor response, suspected toxicity and nonadherence. A number of laboratory-based studies have reported on many potential candidates for response prediction to clozapine, however, reproducibility, specificity, robustness of the findings, as well as clinical feasibility and cost-effectiveness all pose a significant practical challenge, in relation with the fact that pathophysiological bases of treatment resistance in schizophrenia largely remain to be elucidated. Conclusions: No unequivocal factors to clozapine response were found despite a relatively rich body of the literature, which calls for more works on this important topic. Clozapine level of 350 ng/ml appears to be useful in case of nonresponse.

Fub1p, a novel protein isolated by boundary screening, binds the proteasome complex.

Hatanaka A, Chen B, Sun JQ, Mano Y, Funakoshi M, Kobayashi H, Ju Y, Mizutani T, Shinmyozu K, Nakayama J, Miyamoto K, Uchida H, Oki M

Genes & genetic systems 86 （ 5 ） 305 - 14 2011年

ISSN 1341-7568

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Intracranial germinoma presenting with hemiatrophy--follow-up results and literature review--two case reports.

Sadamura Y, Sugiyama K, Uchida H, Hanaya R, Eguchi K, Kurisu K, Arita K, Hirano H

Neurologia medico-chirurgica 51 （ 2 ） 148 - 52 2011年

ISSN 0470-8105

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Identification of CD133+ cells in pituitary adenomas.

Yunoue S, Arita K, Kawano H, Uchida H, Tokimura H, Hirano H

Neuroendocrinology 94 （ 4 ） 302 - 12 2011年

ISSN 0028-3835

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The 2nd Schizophrenia International Research Society Conference, 10-14 April 2010, Florence, Italy

Baharnoori Moogeh, Bartholomeusz Cali, Boucher Aurelie A., Buchy Lisa, Chaddock Christopher, Chiliza Bonga, Föcking Melanie, Fornito Alex, Gallego Juan A., Hori Hiroaki, Huf Gisele, Jabbar Gul A., Kang Shi Hyun, El Kissi Yousri, Merchán-Naranjo Jessica, Modinos Gemma, Abdel-Fadeel Nashaat A M, Neubeck Anna Karin, Ng Hsiao Piau, Novak Gabriela, Owolabi Olasunmbo O., Prata Diana P., Rao Naren P., Riecansky Igor, Smith Darryl C., Souza Renan P., Thienel Renate, Trotman Hanan D., Uchida Hiroyuki, Woodberry Kristen A., O'Shea Anne, DeLisi Lynn E.

Schizophrenia Research 124 （ 1-3 ） 2010年12月

ISSN 0920-9964

The 2nd Schizophrenia International Research Society Conference, was held in Florence, Italy, April 10-15, 2010. Student travel awardees served as rapporteurs of each oral session and focused their summaries on the most significant findings that emerged from each session and the discussions that followed. The following report is a composite of these reviews. It is hoped that it will provide an overview for those who were present, but could not participate in all sessions, and those who did not have the opportunity to attend, but who would be interested in an update on current investigations ongoing in the field of schizophrenia research.

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Effects of discontinuing benzodiazepine-derivative hypnotics on postural sway and cognitive functions in the elderly

Tsunoda K., Uchida H., Suzuki T., Watanabe K., Yamashima T., Kashima H.

International Journal of Geriatric Psychiatry （International Journal of Geriatric Psychiatry） 25 （ 12 ） 1259 - 1265 2010年12月

ISSN 0885-6230

Objective: Benzodiazepines (BZDs) have been reported to cause negative impacts on body stability and cognitive functions, which in turn could result in lethal incidents, including falls, especially in the elderly. This fact notwithstanding, no systematic trial has evaluated the feasibility and benefits of discontinuing BZD-derivative hypnotics in this population, which was addressed in this study. Methods In this 8-week open-label study, subjects aged ≥60 living in a nursing home who received BZD as a hypnotic were recruited. The BZD dose was tapered off over 3 weeks. The following assessments were performed 12 h post-dose at baseline and at endpoint: the Clinical Stabilometric Platform (CSP), the Critical Flicker Fusion Test (CFF), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Leeds Sleep Evaluation Questionnaire (LSEQ). Results Thirty subjects were enrolled (mean ± SD age = 79.1 ± 8.9 years, mean ± SD flurazepam equivalent BZD dose = 19.5 ± 10.9 mg/day). Psychiatric diagnoses (DSM-IV) of subjects were as follows: schizophrenia (n = 12), primary insomnia (n = 9), dementia (n = 7), and bipolar disorder (n = 2). In 26 completers, significant changes were found in a total length and a range of trunk motion with eyes closed. Significant improvements were also observed in the CFF and RBANS immediate memory, language, and attention index scores. Subjective worsening in sleep was not reported in those completers, assessed with the LSEQ. Conclusions Our results suggest that discontinuation of BZD hypnotics is feasible in a majority of elderly persons and leads to an improvement in the stability of body and a recovery in cognitive functions during the daytime. Copyright © 2010 John Wiley & Sons, Ltd.

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The 2nd Schizophrenia International Research Society Conference, 10-14 April 2010, Florence, Italy: Summaries of oral sessions

Baharnoori M., Bartholomeusz C., Boucher A.A., Buchy L., Chaddock C., Chiliza B., Föcking M., Fornito A., Gallego J.A., Hori H., Huf G., Jabbar G.A., Kang S.H., El Kissi Y., Merchán-Naranjo J., Modinos G., Abdel-Fadeel N.A.M., Neubeck A.K., Ng H.P., Novak G., Owolabi O.O., Prata D.P., Rao N.P., Riecansky I., Smith D.C., Souza R.P., Thienel R., Trotman H.D., Uchida H., Woodberry K.A., O'Shea A., DeLisi L.E.

Schizophrenia Research （Schizophrenia Research） 124 （ 1-3 ） e1 - 62 2010年12月

ISSN 09209964

The 2nd Schizophrenia International Research Society Conference, was held in Florence, Italy, April 10-15, 2010. Student travel awardees served as rapporteurs of each oral session and focused their summaries on the most significant findings that emerged from each session and the discussions that followed. The following report is a composite of these reviews. It is hoped that it will provide an overview for those who were present, but could not participate in all sessions, and those who did not have the opportunity to attend, but who would be interested in an update on current investigations ongoing in the field of schizophrenia research. © 2010 Elsevier B.V.

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