Faculty Profiles - KIMURA, Hiroyuyki

Papers - KIMURA, Hiroyuyki

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Plasma Levels of Milnacipran and Its Effectiveness for the Treatment of Chronic Pain in the Orofacial Region Reviewed

Hiroyuki Kimura, Keizo Yoshida, Mikiko Ito, Tatsuya Tokura, Wataru Nagashima, Kenichi Kurita, Norio Ozaki

Hum Psychopharmacol Vol. 27 ( 3 ) page： 322-328 2012

Reliability and Validity of the Japanese Version of BEMIB Modified for Patients With Bipolar Disorder: a Self-rating Scale for Medication Adherence Reviewed

Tatsuya Tokura, Hiroyuki Kimura, Akira Yoshimi, Mitsuki Ohashi, Mie Masuda, Koji Senzaki, Keizo Yoshida, Branko Aleksic, Yukihiro Noda, Kiyofumi Yamada, Norio Ozaki

Clinical Neuropsychopharmacology and Therapeutics Vol. 3 page： 26-32 2012

Effectiveness of Duloxetine for the Treatment of Chronic Nonorganic Orofacial Pain Reviewed

Wataru Nagashima, Hiroyuki Kimura, Mikiko Ito, Tatsuya Tokura, Munetaka Arao, Branko Aleksic, Keizo Yoshida, Kenichi Kurita, Norio Ozaki

Clinical Neuropharmacology Vol. 55 ( 1 ) page： 42-49 2012

アルコール関連肝不全に対する肝移植の適応基準に関する心理社会的側面 Invited Reviewed

木村宏之、佐藤直弘、大林昌子、小山真弓、小久保勲、藤岡史枝、山口尚子、坪井千里、亀井秀弥、大西康晴、岡田俊、木内哲也、尾崎紀夫

アルコール精神医学会雑誌 Vol. 47 ( 5 ) page： 00 2012

Total palliative care for a patient suffering from multiple cerebral infarctions that occurred repeatedly in association with gastric cancer (Trousseau's syndrome). Reviewed

Katsuyuki Ukai, Akiko Okajima, Aya Yamauchi, Eiji Sasaki, Yohsuke Yamaguchi, Hiroyuki Kimura, Branko Aleksic, Norio Ozaki

Palliat Support Care Vol. 30 page： 1-4 2012

頭頚部癌領域における精神科リエゾン Invited Reviewed

木村宏之、足立康則、丸尾貴志、平松真理子、安藤篤、藤本保志

頭頸部癌 Vol. 37 ( 3 ) page： 370-375 2011

境界性パーソナリティ障害の病態解明の現状～脳画像による神経回路に関する知見を中心に～ Reviewed

幸村州洋、木村宏之、尾崎紀夫

精神科治療学 Vol. 26 ( 9 ) page： 1157 - 1164 2011

成人期の広汎性発達障害における鑑別診断: 3症例の経験 Reviewed

横山和正、鈴木太、木村宏之、梅田健太郎、木村大樹、吉川徹、尾崎紀夫野→原著へ

精神科 Vol. 18 ( 4 ) page： 474 - 478 2011

頭頚部癌領域における精神科リエゾン Reviewed

木村宏之、足立康則、丸尾貴志、平松真理子、安藤篤、藤本保志

頭頸部癌 Vol. 37 ( 3 ) page： 370 - 375 2011

*Effectiveness of Milnacipran for the Treatment of Chronic Pain in the Orofacial Region Reviewed

Mikiko Ito, Hiroyuki Kimura ,Keizo Yoshida, Yuki Kimura, Norio Ozaki, Kenichi Kurita

Clinical Neuropharmacology Vol. 33 ( 2 ) 2010

Language：English Publishing type：Research paper (scientific journal)

Objectives: The effect of milnacipran for the treatment of chronic pain in the orofacial region, inlcuding burning mouth syndrome (BMS) and atypical odontalgia (AO), was assessed while accounting for the influence of concurrent depressive symptoms on the pain-relieving effect. Methods: Milnacipran was administered for 12 weeks to 36 patients with chronic pain in the orofacial region (3 males and 29 females, aged between 22 and 76 years with a mean age of 59 years). Of those patients, 22 and 10 patients had BMS and AO, respectively. The initial dose level of milnacipran was 15 mg/day, and the dosage was raised up to 100 mg/day. Pain was assessed using the Visual Analog Scale (VAS) and symptoms of depression were evaluated using the Hamilton Depression Rating Scale (HAMD) at baseline and at Weeks 1, 2, 4, 6, 8, 10, and 12 of study treatment. Results: Data from 32 patients who completed the study were included in the analysis. The VAS score significantly decreased after the 12 week treatment, and it showed a simillar time-course of decline irrespective of concurrent depressive symptoms during the 12 weeks. Conclusions: Treatment with milnacipran resulted in a significant improvement of chronic pain in the orofacial region irrespective of concurrent symptoms of depression. The present results suggested that milnacipran may be an effective agent for treatment of such disorders.

精神療法家と救急医 Invited

木村宏之

精神分析研究 Vol. 54 ( 2 ) 2010

Authorship：Lead author Language：Japanese

　力動精神医学の発展に伴い、面接室の中の精神分析は、概念となって様々な領域で応用された。そして乳幼児精神医学、青年期精神医学、死の臨床まで、人間の幅広いライフステージの理解に貢献した。また医療の現場では、チーム医療における集団力動の理解から始まり、現代ではコンサルテーション・リエゾン精神医学をはじめとする多くの実践領域に広く浸透している。そして臨床の場で生じる様々な精神現象は、力動精神医学によって明確になり患者の治療に、直接、生かされるようになった。しかし、力動精神医学による貢献は、面接室の中の精神分析で培われた経験を概念的に用いたり大局的な集団力動として理解したりすることが多いせいか、こうした力動的理解は煮詰まった臨床の場の整理には有用である一方で、少し理論的すぎて生々しい臨場感や実感に乏しい。おそらく面接の中の患者との転移から派生した生の体験が表現されていないからであろう。
　本稿では、面接室の中からみた「精神療法家と救命医の溝」という経験を通じて「臨床の場」について考える。その当時、筆者が勤務していた総合病院における精神科スタッフと救命センターとの感情的な溝は、その病院が救急医療を中心展開していて夜間に多くの自傷した患者が救命センターを受診していたという病院特有の問題、もうすこし言えば筆者を含む精神科スタッフと救命センタースタッフの個人的な資質の問題であろうと考えていた。しかしながら、6年ほど前に大学病院に赴任し、地域の研修医に精神医学レクチャーを提供する機会が多くなった時、研修医が最も困っておりとても関心を示す話題が、救命センターにおける境界性パーソナリティ障害患者の問題で、同じような問題意識を多かれ少なかれ持っていた。同じ頃、総合病院精神医学会と日本救急医学会との合同シンポジウムに参加した際「境界例の治療をしている精神科医は（安易な投薬など）無責任な治療をしている」と批判するある救急医の講演を聞き、　その批判は救急医の立場に立ってみれば、ある程度、妥当な意見に思えた。
　こうした一連の経験を踏まえ「精神療法家と救命医の溝」について、もう少し普遍的問題として捉えようと試みた。

*The psychotherapy for borderline personality disorder -From the view point of flexibility- Reviewed

Hiroyuki Kimura

Japanese Journal of Psychoanalytical Psychiatry Vol. 4 2010

自殺念慮・焦燥感を伴ううつ状態にOlannzapineが著効した３例 Reviewed

小笠原一能、木村宏之、尾崎紀夫

精神科 Vol. 15 ( 6 ) page： 567 - 572 2010

*Relationship of psychopathological symptoms and cognitive function to subjective quality of life in patients with chronic schizophrenia. Reviewed

Psychiatry and Clinical Neuroscience Vol. 64 ( 1 ) 2009

Language：English Publishing type：Research paper (scientific journal)

AIMS: The purpose of the present study was to examine the extent of the effects of psychopathological symptoms and cognitive function on quality of life (QOL) in patients with chronic schizophrenia.

METHODS: Data were obtained using the Japanese Schizophrenia Quality of Life Scale (JSQLS), Positive and Negative Syndrome Scale (PANSS), Wisconsin Card-Sorting Test (WCST) Keio version, and Continuous Performance Test (CPT) for 52 schizophrenia patients.

RESULTS: Stepwise regression analysis showed that PANSS depression/anxiety factors predicted JSQLS psychosocial conditions and motivation/energy, and that WCST Categories Achieved predicted JSQLS symptoms/side-effects.

CONCLUSIONS: Psychopathological symptoms and cognitive function affect subjective QOL in patients with schizophrenia. If the final goal is treatment that improves QOL in a manner that patients themselves are aware of, clinicians probably need to consider a treatment strategy that improves depression/anxiety symptom.

歯科治療恐怖症の２例 Reviewed

荒尾宗孝、木村宏之、徳倉達也、長島渉、伊藤幹子、尾崎紀夫、栗田賢一

日本歯科心身医学会雑誌 Vol. 24 ( 2 ) page： 73 - 78 2009

口の中に痛みを訴える患者に対する対応ー舌痛症を含むー Reviewed

荒尾宗孝、木村宏之、木村有希、伊藤幹子、尾崎紀夫、栗田賢一

心療内科 Vol. 12 ( 3 ) page： 232 - 238 2008

Successful treatment of trigeminal neuralgia with milnacipran. Reviewed

Mikiko Ito, Keizo Yoshida, Hiroyuki Kimura, Norio Ozaki, Kenichi Kurita

Clinical Neuropharmacology Vol. 130 ( 3 ) page： 183-185 2007

Language：English Publishing type：Research paper (scientific journal)

: Paroxysmal pain in a 64-year-old woman diagnosed with trigeminal neuralgia disappeared with the administration of carbamazepine, but carbamazepine had to be discontinued because of intolerable lassitude and liver dysfunction. Afterward the paroxysmal pain reoccurred and depressive symptoms appeared. Milnacipran was then administered at a dose of 50 mg/day for two months, and the paroxysmal pain and depression disappeared completely. Carbamazepine is the drug of first choice for trigeminal neuralgia, but the present results suggest that milnacipran is worth investigating for patients who do not respond to carbamazepine, who cannot stay on carbamazepine because of side effects, and who are accompanied with depressive symptoms.

*Age of onset has limited association with body mass index at time of presentation for anorexia nervosa :Comparison of peak-onset and late-onset anorexia nervosa groups Reviewed

Hiroyuki Kimura, Takashi Tonoike, Tamio Muroya, Keizo Yoshida, Norio Ozaki

Psychiatry and Clinical Neuroscience Vol. 61 page： 646-650 2007

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

Objective: The clinical characteristics differentiating late onset anorexia nervosa (AN) from typical pubertal onset AN remain unclear. The purpose of this study was to examine their differences in a retrospective analysis.
Method: One hundred forty-nine female anorexia nervosa patients were divided into two groups: a peak onset AN group (n=125) in which onset occurred between the ages of 15 and 24 years and a late onset AN group (n=24) in which onset occurred at the age of 25 years or older. A logistic regression analysis was conducted with this classification as the target variable and five clinical factors as explanatory variables for the clinical characteristics at the time of initial examination.
Results: BMI at the time of presentation was identified as a possible factor affecting classification as peak onset or late onset AN. In addition, a negative linear correlation was detected between age of onset and BMI at the time of initial examination.
Conclusion: The results suggest that BMI at the time of the initial examination is an important clinical characteristic to differentiate peak onset AN and late onset AN.

交合不全が機能性胃腸症（呑気症）の原因であると（自ら）確信していた１例 Reviewed

荒尾宗孝、木村宏之、木村有希、伊藤隆子、伊藤幹子、栗田賢一

日本歯科心身医学会雑誌 Vol. 22 ( 1 ) page： 27 - 30 2007

The diagnosis and treatment of depression in dialysis patients Invited

Hiroyuki Kimura , Norio Ozaki

Ther Apher Dial Vol. 10 ( 466-8550 ) page： 328-332 2006

Authorship：Lead author Language：English

A high prevalence of depressive disorder,
between 33% and 50%, has been reported in dialysis
patients, although it is difficult to distinguish the physical
symptoms like general fatigue, insomnia, and loss of appetite
which are common among dialysis patients, from the
psychiatric symptoms seen in depressive patients. Furthermore,
co-occurrence of depression has been shown to be
one of the risk factors of poor prognosis in dialysis patients,
partly because depressed patients are less likely to adhere
to their medication regimen and modify their lifestyle
appropriately. The efficacy of psychiatric interventions,
including pharmacotherapy and psychotherapy, has been
examined for dialysis patients with co-occurrence of
depression. Randomized controlled trials of psychiatric
interventions for depression in dialysis patients are
needed to investigate the impact of such interventions
on depression, quality of life, and mortality.

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Papers - KIMURA, Hiroyuyki