Details of a Researcher - Uchida, Hiroyuki

Papers - Uchida, Hiroyuki

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Placebo effects in adult and adolescent patients with schizophrenia: combined analysis of nine RCTs

Kubo K., Fleischhacker W., Suzuki T., Yasui-Furukori N., Mimura M., Uchida H.

Acta Psychiatrica Scandinavica (Acta Psychiatrica Scandinavica) 139 ( 2 ) 108 - 116 2019.02

ISSN 0001690X

© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Objective: To examine characteristics of placebo responders and seek optimal criteria of early improvement with placebo for predicting subsequent placebo response in patients with schizophrenia. Method: Data of 672 patients with schizophrenia randomized to placebo in nine double-blind antipsychotic trials were analyzed. Multiple logistic regression analyses were conducted to examine associations between placebo response at week 6 (i.e., a ≥ 25% reduction in the Positive and Negative Syndrome Scale [PANSS] score) and gender, age, study locations, baseline PANSS total or Marder 5-Factor scores, and per cent PANSS score reduction at week 1. Predictive power of improvement at week 1 for subsequent response was investigated; sensitivity and specificity of incremental 5% cutoff points between 5% and 25% reduction in the PANSS total score at week 1 were calculated. Results: Per cent PANSS total score reduction at week 1 and lower PANSS Marder disorganized thought scores at baseline were significantly associated with subsequent placebo response. A 10% reduction in a per-protocol analysis or a 15% reduction in last-observation-carried-forward analysis in the PANSS total score at week 1 showed the highest predictive power. Conclusion: These findings are informative to identify potential placebo responders at the earliest opportunity for optimal trial design for schizophrenia.

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Early placebo improvement is a marker for subsequent placebo response in long-acting injectable antipsychotic trials for schizophrenia: Combined analysis of 4 RCTs

Kumagai F., Suzuki T., Fleischhacker W., Yasui-Furukori N., Mimura M., Uchida H.

Journal of Clinical Psychiatry (Journal of Clinical Psychiatry) 80 ( 1 ) 2019.01

ISSN 01606689

© Copyright 2018 Physicians Postgraduate Press, Inc. Objective: Placebo effects remain largely unexplored in clinical trials of long-acting injectable (LAI) antipsychotics for schizophrenia. This study aims to characterize patients showing improvements after placebo injections and to search for criteria for the prediction of subsequent response based on the magnitude of score changes after the first week of treatment. Methods: Data from 450 patients with schizophrenia (DSM-IV) who received placebo injections in 4 double-blind randomized controlled trials evaluating efficacy of LAI paliperidone palmitate obtained through the Yale University Open Data Access (YODA) project were analyzed. These 4 studies were conducted from October 2003 to March 2008. Multiple logistic regression analyses were conducted to examine associations between placebo response and demographic and clinical characteristics. The predictive power of improvement at week 1 for response at week 9 was investigated; sensitivity and specificity of incremental 5% cutoff points between a 5% and 25% reduction in Positive and Negative Syndrome Scale (PANSS) total score at week 1 were calculated. Results: Percent reduction in the PANSS total score at week 1 and a lower PANSS G12 item score (ie, better in judgment and insight) at baseline were significantly associated with placebo response at week 9 (odds ratio [OR] = 1.063; 95% CI, 1.040-1.087, P < .001; and OR= 0.739; 95% CI, 0.553-0.986, P = .040, respectively, in the per-protocol analysis). Cutoffs of a 10% (accuracy = 0.724 in the per-protocol analysis) and 15% (accuracy = 0.722 in the last-observation-carried-forward analysis) reduction in the PANSS total score at week 1 showed the highest predictive power. Conclusions: The appreciation that longer-term response following placebo injections can be predicted by a 10%-15% PANSS total score reduction at week 1 could guide the design of future clinical trials of LAI antipsychotics in schizophrenia to identify and exclude potential placebo responders early during the course of the study.

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Kampo, A Japanese Traditional Medicinal System for Psychiatric Conditions: A Narrative Review

Tatsumi L., Suzuki T., Yamada K., Mimura M., Uchida H.

Pharmacopsychiatry (Pharmacopsychiatry) 52 ( 6 ) 251 - 260 2019

ISSN 01763679

© 2019 Royal Society of Chemistry. All rights reserved. Introduction Kampo is a Japanese traditional medicinal system and is represented by unity of mind and body. It is originally based upon Chinese traditional medicine but has uniquely developed in Japan. Methods A narrative review on the use of Kampo for psychiatric conditions is provided. Results Kampo formula is a combination of several crude ingredients; most derive from natural plants and some from animals and minerals. These Kampo formulae are widely prescribed in almost all medical disciplines, including psychiatry, in Japan; they have been used for various psychiatric disorders such as dementia, schizophrenia spectrum disorders, mood disorders, anxiety disorders, and personality disorders. Kampo is a versatile traditional medicine with a variety of positive effects on mental states with relatively benign side effect profiles. Kampo formulae can be adjunctively combined with or substituted for the Western psychotropic drugs, which will provide more treatment options to patients with psychiatric conditions. Discussion This review summarizes the current knowledge on Kampo for psychiatric conditions, highlighting a paucity of data and a need for further good-quality evidence on these medications.

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Clinical characteristics of patients with schizophrenia who successfully discontinued antipsychotics: A literature review

Tani H., Suzuki T., Wolfgang Fleischhacker W., Tomita M., Mimura M., Uchida H.

Journal of Clinical Psychopharmacology (Journal of Clinical Psychopharmacology) 38 ( 6 ) 582 - 589 2018.12

ISSN 02710749

© Wolters Kluwer Health, Inc. All rights reserved. Purpose/Background Although discontinuing antipsychotics clearly increases the risk of relapse in schizophrenia, some patients remain clinically well without continuous antipsychotic treatment. However, data on the characteristics of such patients are still scarce. Methods/Procedures A systematic literature review was conducted to identify predictive factors for successful antipsychotic discontinuation in schizophrenia using PubMed (last search; June 2018) with the following search terms: (antipsychotic∗ or neuroleptic) AND (withdraw∗ or cessat∗ or terminat∗ or discontinu∗) AND (schizophreni∗ or psychosis). The search was filtered with humans and English. Factors associated with a lower risk of relapse, when replicated in 2 or more studies with a follow-up period of 3 months or longer, were considered successful. Findings/Results Systematic literature search identified 37 relevant articles. Mean relapse rate after antipsychotic discontinuation was 38.3% (95% confidence interval = 16.0%-60.6%) per year. Factors associated with a lower risk of relapse were being maintained on a lower antipsychotic dose before discontinuation, older age, shorter duration of untreated psychosis, older age at the onset of illness, a lower severity of positive symptoms at baseline, better social functioning, and a lower number of previous relapses. Implications/Conclusions Although this literature review suggests some predictors for successful antipsychotic withdrawal in patients with schizophrenia, the very limited evidence base and unequivocally high relapse rates after discontinuation must remain a matter of serious debate for risk/benefit considerations.

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Effects of Sulfate on the Oxygen Reduction Reaction Activity on Stabilized Pt Skin/PtCo Alloy Catalysts from 30 to 80 °C.

Nishikawa H, Yano H, Inukai J, Tryk DA, Iiyama A, Uchida H

Langmuir : the ACS journal of surfaces and colloids 34 ( 45 ) 13558 - 13564 2018.11

ISSN 0743-7463

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Quality of life in stabilized outpatients with bipolar I disorder

Post Fabienne, Pardeller Silvia, Frajo-Apor Beatrice, Kemmler Georg, Sondermann Catherine, Hausmann Armand, Fleischhacker W. Wolfgang, Mizuno Yuya, Uchida Hiroyuki, Hofer Alex

Journal of Affective Disorders 238 399 - 404 2018.10

ISSN 0165-0327

Objectives: Improving Quality of Life (QoL) is an important objective in the treatment of bipolar disorder. The aim of the current study was to examine to which extent resilience, internalized stigma, and psychopathology are correlated to QoL. Methods: We recruited 60 outpatients diagnosed with bipolar I disorder according to DSM-IV criteria and 77 healthy control subjects from the general community. In patients, symptoms were quantified by the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Young Mania Rating Scale (YMRS) and internalized stigma by the Internalized Stigma of Mental Illness (ISMI) scale. In order to assess QoL and resilience, the Berliner Lebensqualitätsprofil (BELP) and the Resilience Scale (RS-25) were used in both patients and control subjects. Results: Despite presenting with a very mild symptom level and relatively low internalized stigma, patients with bipolar I disorder indicated significantly lower QoL and resilience as compared to healthy control subjects. In patients, QoL correlated significantly with resilience, internalized stigma, and residual symptoms of depression. No significant correlations were observed between QoL and residual manic symptoms. Limitations: The cross-sectional design and the relatively small sample size limit the generalizability of our results. Furthermore, levels of resilience and internalized stigma may change over the course of the illness and have different impacts on the long-term outcome of patients with bipolar disorder. Conclusion: Our results show that QoL of patients suffering from bipolar I disorder, even when only mildly ill, is strongly associated with the degree of resilience and internalized stigma, and that particularly residual depressive symptoms have a negative impact on QoL. In addition to drug treatment, psychotherapeutic approaches should be applied to strengthen resilience, to reduce internalized stigma, and, ultimately, to improve quality of life.

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Quality of life in stabilized outpatients with bipolar I disorder: Associations with resilience, internalized stigma, and residual symptoms

Post F., Pardeller S., Frajo-Apor B., Kemmler G., Sondermann C., Hausmann A., Fleischhacker W., Mizuno Y., Uchida H., Hofer A.

Journal of Affective Disorders (Journal of Affective Disorders) 238 399 - 404 2018.10

ISSN 01650327

© 2018 Objectives: Improving Quality of Life (QoL) is an important objective in the treatment of bipolar disorder. The aim of the current study was to examine to which extent resilience, internalized stigma, and psychopathology are correlated to QoL. Methods: We recruited 60 outpatients diagnosed with bipolar I disorder according to DSM-IV criteria and 77 healthy control subjects from the general community. In patients, symptoms were quantified by the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Young Mania Rating Scale (YMRS) and internalized stigma by the Internalized Stigma of Mental Illness (ISMI) scale. In order to assess QoL and resilience, the Berliner Lebensqualitätsprofil (BELP) and the Resilience Scale (RS-25) were used in both patients and control subjects. Results: Despite presenting with a very mild symptom level and relatively low internalized stigma, patients with bipolar I disorder indicated significantly lower QoL and resilience as compared to healthy control subjects. In patients, QoL correlated significantly with resilience, internalized stigma, and residual symptoms of depression. No significant correlations were observed between QoL and residual manic symptoms. Limitations: The cross-sectional design and the relatively small sample size limit the generalizability of our results. Furthermore, levels of resilience and internalized stigma may change over the course of the illness and have different impacts on the long-term outcome of patients with bipolar disorder. Conclusion: Our results show that QoL of patients suffering from bipolar I disorder, even when only mildly ill, is strongly associated with the degree of resilience and internalized stigma, and that particularly residual depressive symptoms have a negative impact on QoL. In addition to drug treatment, psychotherapeutic approaches should be applied to strengthen resilience, to reduce internalized stigma, and, ultimately, to improve quality of life.

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Psychopharmacology in Japan

Yoshida K., Suzuki T., Uchida H.

Journal of Clinical Psychopharmacology (Journal of Clinical Psychopharmacology) 38 ( 5 ) 415 - 419 2018.10

ISSN 02710749

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Low sense of coherence is associated with anxiety among adults: Results based on data from all 47 prefectures of Japan.

Uchida H, Tsujino D, Muguruma T, Hino N, Sasaki K, Miyoshi M, Koyama Y, Hirao K

Comprehensive psychiatry 86 131 - 136 2018.10

ISSN 0010-440X

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Kynurenine pathway in depression

Ogyu Kamiyu, Kubo Kaoruhiko, Noda Yoshihiro, Iwata Yusuke, Tsugawa Sakiko, Omura Yuki, Wada Masataka, Tarumi Ryosuke, Plitman Eric, Moriguchi Sho, Miyazaki Takahiro, Uchida Hiroyuki, Graff-Guerrero Ariel, Mimura Masaru, Nakajima Shinichiro

Neuroscience and Biobehavioral Reviews 90 16 - 25 2018.07

ISSN 0149-7634

Abnormalities of the kynurenine (KYN) pathway may be implicated in the pathophysiology of depression. However, the relationships between depression and each metabolite of the KYN pathway remain uncertain. Therefore, we conducted a meta-analysis about the levels of the metabolites of KYN pathway between patients with depression and controls. Out of 899 initial records, we identified 22 articles to form the empirical basis. Seventeen, 10, and 18 studies examined levels of kynurenic acid (KYNA), quinolinic acid (QUIN), and KYN, respectively. KYNA and KYN levels were lower in patients with depression in comparison to controls, while QUIN levels did not differ between the two groups. Antidepressant-free patients showed decreased KYNA levels and increased QUIN levels compared with controls. Male ratios of the samples were negatively associated with study SMDs for KYNA. In conclusion, this meta-analysis revealed that patients with depression had decreased level of KYNA and KYN, whereas antidepressant-free patients showed increased level of QUIN. Nevertheless, given the heterogeneity among their sample characteristics, further research is clearly needed.

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Kynurenine pathway in depression: A systematic review and meta-analysis

Ogyu K., Kubo K., Noda Y., Iwata Y., Tsugawa S., Omura Y., Wada M., Tarumi R., Plitman E., Moriguchi S., Miyazaki T., Uchida H., Graff-Guerrero A., Mimura M., Nakajima S.

Neuroscience and Biobehavioral Reviews (Neuroscience and Biobehavioral Reviews) 90 16 - 25 2018.07

ISSN 01497634

© 2018 Elsevier Ltd Abnormalities of the kynurenine (KYN) pathway may be implicated in the pathophysiology of depression. However, the relationships between depression and each metabolite of the KYN pathway remain uncertain. Therefore, we conducted a meta-analysis about the levels of the metabolites of KYN pathway between patients with depression and controls. Out of 899 initial records, we identified 22 articles to form the empirical basis. Seventeen, 10, and 18 studies examined levels of kynurenic acid (KYNA), quinolinic acid (QUIN), and KYN, respectively. KYNA and KYN levels were lower in patients with depression in comparison to controls, while QUIN levels did not differ between the two groups. Antidepressant-free patients showed decreased KYNA levels and increased QUIN levels compared with controls. Male ratios of the samples were negatively associated with study SMDs for KYNA. In conclusion, this meta-analysis revealed that patients with depression had decreased level of KYNA and KYN, whereas antidepressant-free patients showed increased level of QUIN. Nevertheless, given the heterogeneity among their sample characteristics, further research is clearly needed.

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Kampo, A Japanese Traditional Medicinal System for Psychiatric Conditions

Tatsumi Laina, Suzuki Takefumi, Yamada Kazuo, Mimura Masaru, Uchida Hiroyuki

Pharmacopsychiatry 2018.06

ISSN 0176-3679

Introduction Kampo is a Japanese traditional medicinal system and is represented by unity of mind and body. It is originally based upon Chinese traditional medicine but has uniquely developed in Japan. Methods A narrative review on the use of Kampo for psychiatric conditions is provided. Results Kampo formula is a combination of several crude ingredients; most derive from natural plants and some from animals and minerals. These Kampo formulae are widely prescribed in almost all medical disciplines, including psychiatry, in Japan; they have been used for various psychiatric disorders such as dementia, schizophrenia spectrum disorders, mood disorders, anxiety disorders, and personality disorders. Kampo is a versatile traditional medicine with a variety of positive effects on mental states with relatively benign side effect profiles. Kampo formulae can be adjunctively combined with or substituted for the Western psychotropic drugs, which will provide more treatment options to patients with psychiatric conditions. Discussion This review summarizes the current knowledge on Kampo for psychiatric conditions, highlighting a paucity of data and a need for further good-quality evidence on these medications.

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Discrepancies Between Nomenclature and Indications of Psychotropics

Minami Fusaka, Zohar Joseph, Suzuki Takefumi, Koizumi Teruki, Mimura Masaru, Yagi Gohei, Uchida Hiroyuki

Pharmacopsychiatry (Pharmacopsychiatry) 52 ( 4 ) 175 - 179 2018.05

ISSN 0176-3679

Introduction While the current nomenclature of psychotropic drugs is disease-based, their approved indications do not always match their classifications. Methods Information on approved indications of “second-generation antipsychotics” and “newer antidepressants” that are available in the United States (US), the United Kingdom (UK), France, Germany, and Japan were extracted from their packet inserts. Results A significant proportion of “atypical antipsychotics” were approved for psychiatric conditions other than psychotic disorders (i. e., bipolar disorder, major depressive disorder, and autistic disorder) as follows: 76.9% in the US, 66.7% in the UK, 66.7% in France, 60.0% in Germany, and 44.4% in Japan. Likewise, more than half of “newer antidepressants” had approved indications for psychiatric conditions other than depression (e. g., panic disorder, obsessive compulsive disorder, social anxiety disorder, general anxiety disorder, and post-traumatic stress disorder): 56.3% in the US, 69.2% in the UK, 69.2% in France, 50.0% in Germany, and 62.5% in Japan. Conclusions Our results raise concerns regarding generic terminologies of “antipsychotics” and “antidepressants” since the conventional indication-based nomenclature does not fit well with the official indication.

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A Possible Role of Takotsubo Cardiomyopathy in Ventricular Fibrillation During Delirium Tremens: A Case Report and Literature Review

Ishida T., Uchida H., Miyazaki K., Yukawa T., Sugiyama K., Hamabe Y., Mimura M., Suzuki T.

Psychosomatics (Psychosomatics) 59 ( 3 ) 293 - 297 2018.05

ISSN 00333182

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Hitomi X-ray studies of Giant Radio Pulses from the Crab pulsar.

Hitomi Collaboration., Aharonian F, Akamatsu H, Akimoto F, Allen SW, Angelini L, Audard M, Awaki H, Axelsson M, Bamba A, Bautz MW, Blandford R, Brenneman LW, Brown GV, Bulbul E, Cackett EM, Chernyakova M, Chiao MP, Coppi PS, Costantini E, De Plaa J, De Vries CP, Den Herder JW, Done C, Dotani T, Ebisawa K, Eckart ME, Enoto T, Ezoe Y, Fabian AC, Ferrigno C, Foster AR, Fujimoto R, Fukazawa Y, Furuzawa A, Galeazzi M, Gallo LC, Gandhi P, Giustini M, Goldwurm A, Gu L, Guainazzi M, Haba Y, Hagino K, Hamaguchi K, Harrus IM, Hatsukade I, Hayashi K, Hayashi T, Hayashida K, Hiraga JS, Hornschemeier A, Hoshino A, Hughes JP, Ichinohe Y, Iizuka R, Inoue H, Inoue Y, Ishida M, Ishikawa K, Ishisaki Y, Iwai M, Kaastra J, Kallman T, Kamae T, Kataoka J, Katsuda S, Kawai N, Kelley RL, Kilbourne CA, Kitaguchi T, Kitamoto S, Kitayama T, Kohmura T, Kokubun M, Koyama K, Koyama S, Kretschmar P, Krimm HA, Kubota A, Kunieda H, Laurent P, Lee SH, Leutenegger MA, Limousin OO, Loewenstein M, Long KS, Lumb D, Madejski G, Maeda Y, Maier D, Makishima K, Markevitch M, Matsumoto H, Matsushita K, Mccammon D, Mcnamara BR, Mehdipour M, Miller ED, Miller JM, Mineshige S, Mitsuda K, Mitsuishi I, Miyazawa T, Mizuno T, Mori H, Mori K, Mukai K, Murakami H, Mushotzky RF, Nakagawa T, Nakajima H, Nakamori T, Nakashima S, Nakazawa K, Nobukawa KK, Nobukawa M, Noda H, Odaka H, Ohashi T, Ohno M, Okajima T, Oshimizu K, Ota N, Ozaki M, Paerels F, Paltani S, Petre R, Pinto C, Porter FS, Pottschmidt K, Reynolds CS, Safi-Harb S, Saito S, Sakai K, Sasaki T, Sato G, Sato K, Sato R, Sawada M, Schartel N, Serlemtsos PJ, Seta H, Shidatsu M, Simionescu A, Smith RK, Soong Y, Stawarz Ł, Sugawara Y, Sugita S, Szymkowiak A, Tajima H, Takahashi H, Takahashi T, Takeda S, Takei Y, Tamagawa T, Tamura T, Tanaka T, Tanaka Y, Tanaka YT, Tashiro MS, Tawara Y, Terada Y, Terashima Y, Tombesi F, Tomida H, Tsuboi Y, Tsujimoto M, Tsunemi H, Tsuru TG, Uchida H, Uchiyama H, Uchiyama Y, Ueda S, Ueda Y, Uno S, Urry CM, Ursino E, Watanabe S, Werner N, Wilkins DR, Williams BJ, Yamada S, Yamaguchi H, Yamaoka K, Yamasaki NY, Yamauchi M, Yamauchi S, Yaqoob T, Yatsu Y, Yonetoku D, Zhuravleva I, Zoghbi A, Terasawa T, Sekido M, Takefuji K, Kawai E, Misawa H, Tsuchiya F, Yamazaki R, Kobayashi E, Kisaka S, Aoki T

Publications of the Astronomical Society of Japan. Nihon Tenmon Gakkai 70 ( 2 ) 2018.04

ISSN 0004-6264

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Crystal structure of an aldehyde oxidase from Methylobacillus sp. KY4400.

Uchida H, Mikami B, Yamane-Tanabe A, Ito A, Hirano K, Oki M

Journal of biochemistry 163 ( 4 ) 321 - 328 2018.04

ISSN 0021-924X

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Religiosity and psychological resilience in patients with schizophrenia and bipolar disorder: an international cross-sectional study

Mizuno Y., Hofer A., Frajo-Apor B., Wartelsteiner F., Kemmler G., Pardeller S., Suzuki T., Mimura M., Fleischhacker W., Uchida H.

Acta Psychiatrica Scandinavica (Acta Psychiatrica Scandinavica) 137 ( 4 ) 316 - 327 2018.04

ISSN 0001690X

© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Objective: The impact of religious/spiritual activities on clinical outcomes in patients with serious mental illnesses remains controversial, which was addressed in this international cross-sectional study. Method: Three-hundred sixty-nine subjects were recruited from Austria (n = 189) and Japan (n = 180), consisting of 112 outpatients with paranoid schizophrenia, 120 with bipolar I disorder (DSM-IV), and 137 healthy controls. Religiosity was assessed in terms of attendance and importance of religious/spiritual activities, while resilience was assessed using the 25-item Resilience Scale. General linear models were used to test whether higher religiosity will be associated with higher resilience, higher social functioning, and lower psychopathology. The association between levels of spiritual well-being and resilience was also examined. Results: Attendance of religious services (F [4,365] = 0.827, P = 0.509) and importance of religion/spirituality (F [3,365] = 1.513, P = 0.211) did not show significant associations with resilience. Regarding clinical measures, a modest association between higher importance of religion/spirituality and residual manic symptoms was observed in bipolar patients (F [3,118] = 3.120, P = 0.029). In contrast to the findings regarding religiosity, spiritual well-being showed a strong positive correlation with resilience (r = 0.584, P < 0.001). Conclusion: The protective effect of religiosity in terms of resilience, social functioning, and psychopathology was not evident in our sample. Spiritual well-being appears more relevant to resilience than religiosity.

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Neuroscience-based Nomenclature

Uchida Hiroyuki

Psychiatry and Clinical Neurosciences 72 ( 2 ) 50 - 51 2018.02

ISSN 1323-1316

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Nucleoside reverse transcriptase inhibitor sparing regimenで腎移植を導入したHIV-associated nephropathyの1例

前野努, 黒川正美, 内田裕之, 渋江寧, 岡秀昭

日本エイズ学会誌 ((一社)日本エイズ学会) 20 ( 1 ) 41 - 46 2018.02

ISSN 1344-9478

症例は52歳男性で、2週間前からの微熱と10日前からの顔面の浮腫を主訴に受診し、血液学的所見と尿検査からネフローゼ症候群による急性腎障害と診断された。発熱が持続し、異型リンパ球、胸腹部CT検査で脾腫を認めた。HIVウエスタンブロット法検査、HIV-PCR法により、HIV-1感染症と診断した。腎生検は施行しなかったが、HIV感染末期腎不全(ESRD)の原因として、一元的にHIV-associated nephropathy(HIVAN)と診断した。週3回の血液透析も併用し第6病目からARTをDRV/RTV+RALのNRTI sparing regimenで開始した。HIV-1 RNA量はART開始後第5週以降では検出感度以下に抑えられ、CD4リンパ球数は200個/μL前後で安定したが、腎機能はCKD stage 5のままであった。腎移植を行うこととなり、タクロリムス併用予定に伴い、その血中濃度に影響を及ぼしにくいABC/3TC+RALへ変更したが、ABCによる過敏反応を起こしたため、DRV/RTV+RALを再度使用した。免疫抑制剤を供用して腎移植を行い、現在まで特に問題なく経過している。

Atomically Flat Pt Skin and Striking Enrichment of Co in Underlying Alloy at Pt3Co(111) Single Crystal with Unprecedented Activity for the Oxygen Reduction Reaction.

Kobayashi S, Aoki M, Wakisaka M, Kawamoto T, Shirasaka R, Suda K, Tryk DA, Inukai J, Kondo T, Uchida H

ACS omega 3 ( 1 ) 154 - 158 2018.01

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