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Masahide Kaji

Publications and source records attributed to Masahide Kaji.

At least 19 recordsLinked to original sources

A randomized phase III trial of postoperative adjuvant therapy with S-1 alone versus S-1 plus PSK for stage II/IIIA gastric cancer: Hokuriku-Kinki Immunochemo-Therapy Study Group-Gastric Cancer (HKIT-GC).

In this randomized multicenter Phase III study, patients with curatively resected Stage II/IIIA gastric cancer were assigned to postoperative adjuvant therapy with an oral fluoropyrimidine S-1 alone (2 weeks of treatment and 1 week of rest for 6 months, followed by 2 weeks of treatment and 2 weeks of rest for 6 months) or S-1 combined with an oral biological response modifier PSK (the same regimen of S-1 plus daily PSK for 12 months). The main objective was to evaluate the survival benefit and quality of life (QOL) of combined therapy. The primary end points were the time to relapse and the duration of survival after surgery, i.e. the rates of disease-free survival and overall survival at 3 and 5 years. The secondary end points were the relations of survival rates to drug compliance, QOL, adverse events, postoperative complications, relapse status, and the preoperative expression of immune or tumor markers. The sample size was 140 per treatment arm.

Adenocarcinoma↗

Isolated left thoracic isomerism with lung cancer: report of a case.

Thoracic isomerism, or symmetric morphology, is frequently associated with cardiac and abdominal anomalies. We report an unusual case of isolated left thoracic isomerism with lung cancer. A 67-year-old woman was referred to our hospital for investigation of an abnormal shadow on a chest X-ray. Chest computed tomography (CT) showed bilateral hyparterial bronchi, and bronchofiberscopy showed bifurcation of the right main bronchus into two branches. Pulmonary arteriography subsequently revealed that the right pulmonary artery bifurcated at the hilum and that it was not a mirror image of the left pulmonary artery. No other malformations were found on echocardiography or abdominal CT scan. We performed segmental resection of right S(1+2) and S(3) for lung cancer and the patient had an uneventful postoperative course. It is important to clarify the anatomy of patients with thoracic isomerism before surgical manipulation.

Adenocarcinoma↗

A side effect of neuraminidase inhibitor in a patient with liver cirrhosis.

Neuraminidase inhibitors have been widely used in Japan since 2001, and several side-effects of their use have been reported. However, erythema toxicum has rarely been described as a side-effect of these drugs in patients with liver function disorder. Here, we report a case of generalized rash after treatment with the neuraminidase inhibitors zanamivir and oseltamivir administered prophylactically to prevent influenza infection in two patients with hepatoma associated with liver cirrhosis.

Acetamides↗

Two cases of cervical abscess in rheumatoid arthritis patients.

The prognosis of rheumatoid arthritis (RA) has recently been improved, resulting in longer survival of patients. The incidence of oral diseases increases with age, particularly for periodontal disease and those involving tooth decay, even in normal healthy individuals. Patients with RA display increased incidence of oral diseases, and the use of steroids or methotrexate to treat RA increases susceptibility to infections, sometimes causing serious infections. We present here two cases of cervical abscesses in RA patients who underwent emergency surgery to treat oral infections due to the possibility of mediastinal inflammation.

Journal Article↗

Hematological change in venous blood of the lower leg during prolonged sitting in a low humidity and hypobaric environment.

The present study examined the effects of low humidity and hypobaric conditions on hematological change in venous blood of the lower leg during quiet prolonged sitting. Ten healthy male students participated as the subjects after singing a consent form to participate in this study. Their diet and water intake were controlled from 19:00 on the day before the experiments. The subjects sat for 130 min in a climatic chamber. Four experimental conditions in the chamber were designed from a combination of relative humidity (20% or 60%) and air pressure (sea level or equivalent to an altitude of 2,000 m). Ambient temperature was maintained at 24 degrees C in every condition. Venous blood was sampled from the lower leg before and after exposure to the experimental conditions, and was analyzed for blood viscosity and hematological indices. Also, body weight and leg circumference were measured as indices of total water loss and edema, respectively. Regarding the results of ANOVA, significant interactions between humidity and time were observed in blood viscosity, red blood cell count and hematocrit (each p<0.05). However, there were no significant differences in these indices among the conditions. Significant increases were observed in leg circumference (p<0.01), platelet count (p<0.05) and total protein (p<0.05) after the exposure compared with those before the exposure. There were no noticeable effects of hypobaric conditions in every measurement. In conclusion, prolonged sitting seems to be a more hazardous factor for thrombogenesis low humidity and hypobaric conditions during a long-distance flight.

Adult↗

Herpes simplex encephalitis presenting with bilateral hippocampal lesions on magnetic resonance imaging, simultaneously complicated by small cell lung carcinoma.

We report a 75-year-old man who developed herpes simplex encephalitis (HSE), presenting with bilateral hippocampal lesions on magnetic resonance imaging, and this case was simultaneously complicated by small cell lung carcinoma. We identified a new anti-neuronal antibody in the cerebrospinal fluid of this patient. Our findings suggest that HSE and paraneoplastic limbic encephalitis (PLE) can overlap, and we discuss the relationships of HSE, PLE, and related disorders.

Aged↗

[Influenza vaccine].

Explore the source record for details and available documents.

Adjuvants, Immunologic↗

[Clinical study of ambulatory patient cancer chemotherapy for advanced colorectal cancer].

To evaluate ambulatory patient cancer chemotherapy, the clinical response, toxicities and survival time were analysed among 19 patients with non-curative or recurrent colorectal cancer who were treated by Uracil/Tegafur (UFT) plus oral Leucovorin (UZEL) for the past 2 years. The patients were administered UFT (300 mg/m2/day) and UZEL (75 mg/body/day) for 28 days with a one-week interval every 35 days as one course.A partial response (PR) was observed in 6 patients (31.6%) and stable disease (SD) in 8. The median survival time was 16 months. Although nausea/vomiting, diarrhea and leucopenia were noted, no severe side effects were observed. These results suggested that UFT plus Leucovorin therapy might be a useful cancer chemotherapy for ambulatory patients with advanced colorectal cancer.

Administration, Oral↗

Abnormal calcium homeostasis in disabled stroke patients with low 25-hydroxyvitamin D.

Disabled elderly stroke patients occasionally have very low serum 25-hydroxyvitamin D (25-OHD), which may be due to sunlight deprivation and malnutrition. Many of such patients have very low level of serum 1, 25-dihydroxyvitamin D (1, 25-[OH]2D; calcitriol), and immobilization-induced hypercalcemia may be responsible for inhibition of renal synthesis of calcitriol. To elucidate determinants of serum 1, 25-[OH]2D levels in elderly poststroke patients, we measured serum indices of bone and calcium metabolism and metacarpal bone mineral density (BMD). Patients whose serum 1, 25-[OH]2D concentration was below the mean-3 SD of normal control subjects were defined as the low 1, 25-[OH]2D group and the rest of the patients were designated as the normal group. Mean illness duration was 59 months in the normal group and 20 months in the low group. The Barthel index (BI), which predicts the degree of immobilization, was significantly lower in the low group than in the normal group. Mean serum 1, 25-[OH]2D and 25-OHD concentrations in the normal group were 36.7 pg/ml and 4.4 ng/ml, respectively; and those in the low group were 14.2 pg/ml and 1.8 ng/ml, respectively. Multiple regression analysis identified illness duration and calcium level as independent determinants of 1, 25-[OH]2D in both groups, and PTH in the normal group and 25-OHD in the low group were additional independent determinants. BMD in stroke patients was significantly lower than that in controls, and BMD in the normal group was lower as compared to the low group. BMD correlated negatively with 1, 25-[OH]2D and PTH in the normal group, and hyperparathyroidism may contribute to reduced BMD. These results suggest that treatment of decreased bone mass in stroke patients has to be individualized according to vitamin D status and calcium homeostasis.

Aged↗

Coagulation-fibrinolysis abnormalities in patients receiving antiparkinsonian agents.

Neuroleptic malignant syndrome (NMS) is induced by alteration of medication in Parkinson's disease (PD); and blood coagulation disorder is regarded as one of the mechanisms implicated in NMS. We have studied markers of blood coagulation and fibrinolysis in 270 patients with PD and 159 healthy controls matched in age and gender. The average values of prothrombin time (international normalized ratio) and plasma levels of prothrombin fragment(1+2), D-dimer, plasmin-alpha 2 antiplasmin complex, thrombomodulin and E-selectin were higher in patients receiving antiparkinsonian agents as compared to the patients without any medication or healthy controls. The effect of antiparkinsonian drugs was analyzed by dividing the patients into three groups according to the medication: the patients under the combination therapy with levodopa and a dopamine agonist, the patients administered levodopa, and those that received a dopamine agonist. Of the three groups, the patients under the combination therapy had the highest values of these markers, and those treated with only levodopa had the lowest values. PD patients receiving antiparkinsonian drugs are often associated with blood coagulation abnormalities, and plasma hemostatic markers should be routinely assessed in the management of such patients. Further study is needed to determine whether these abnormalities predispose to the development of NMS.

Aged↗

Differences in clinical features between influenza A H1N1, A H3N2, and B in adult patients.

OBJECTIVE: The differences in clinical features between influenza A H1N1, A H3N2, and B in the past three influenza seasons were examined. METHODOLOGY: Patients with respiratory symptoms who consulted Kurume University Medical Center, Department of Internal Medicine, Kurume, Fukuoka, Japan, from January to March in 1999, 2000, and 2001 were included. Based on virological and serological findings, the influenza patients were divided into the above three groups for comparison of symptoms and laboratory data. RESULTS PATIENTS: (n = 196) included 54 with influenza A H1N1, 98 with A H3N2, and 44 with B. Mean ages in the groups were 33 +/- 8.4 years, 41 +/- 15.2 years, and 29 +/- 9.8 years (influenza B patients tended to be younger). Fever was much greater in the A H3N2 group (38.6 +/- 0.46 degrees C) than in the A H1N1 or B groups. This was also true for laboratory indices of viral infection. Gastrointestinal symptoms such as nausea, epigastralgia, and diarrhoea were prominent in influenza B. Myalgia was common in all groups. CONCLUSIONS: Influenza A H3N2 infection was more severe than A H1N1 or B in terms of fever, leukopenia, and C-reactive protein. Myalgia and other symptoms such as fever, headache, general malaise and sore throat were equally frequent in influenza A H3N2, A H1N1, and B infections. Gastrointestinal symptoms were more common in influenza B.

Adult↗

Epstein-Barr virus infections of the central nervous system.

OBJECTIVE: Epstein-Barr virus (EBV), a lymphotropic herpes virus causing infectious mononucleosis (IM), also causes various central nervous system (CNS) infections. In the present study, EBV CNS infections were investigated. PATIENTS AND METHODS: For adult inpatients in our hospital and related hospitals between 1984-2002, CNS syndromes with IM symptoms were examined, and serologic positives were assessed according to established criteria. Polymerase chain reaction (PCR) was performed for cerebrospinal fluid (CSF) from seven patients. RESULTS: Ten patients with EBV-related CNS infections were found; their mean age was 36 years (20-79 years). The neurologic forms were as follows: acute encephalitis (4 patients), acute cerebellar ataxia (1), acute disseminated encephalomyelitis (ADEM) (2), myelitis (1), and meningitis (2). The PCR from CSF was positive in two patients with meningitis, one patient with ADEM, and one patient with encephalitis-associated chronic EVB infection. One case of encephalitis and another of relapsing ADEM were attributed to chronic EBV infection. CONCLUSION: Our study identified a variety of EBV-related CNS infections. EBV CNS infections are divided into two groups: 1) CNS syndromes associated with primary EBV or reactivated infection, and 2) those associated with chronic EBV infection; it is notable that in the former, diverse CNS syndromes including ADEM can occur, whereas in the latter, chronic or recurrent CNS syndromes are produced.

Adult↗

[Neuraminidase inhibitor, anti-influenzal agent--mechanism of action, and how to use clinically].

Neuraminidase inhibitor has changed the treatment of influenza dramatically. The drug is effective for both influenza A and B whereas amantadine, another anti-influenzal agent, inhibits influenza A virus infection but not B. Neuraminidase inhibitor blocks the process of release of influenza virus from infected cells and inhibit the virus transmission to the neighboring cells. Neuraminidase inhibitor improves the symptoms of influenza and shortens the duration of illness. It is emphasized that this drug should be given within forty-eight hours after the onset, and it must be not noted that the possibility of the drug resistant virus although it is observed infrequently. Prophylactic use of the drug is also discussed.

Acetamides↗

Hyperhomocysteinemia in Japanese patients with convalescent stage ischemic stroke: effect of combined therapy with folic acid and mecobalamine.

Hyperhomocysteinemia is considered to be a risk factor for vascular diseases including ischemic stroke. It has been shown that plasma homocysteine level can be lowered by folic acid supplementation. Vitamin B(12) may be also beneficial when included in the supplement regimen with folic acid. We have examined in Japanese patients with ischemic stroke the homocysteine-lowering potential of a combination therapy with folic acid and vitamin B(12). Patients with ischemic stroke were randomized into three groups and each group received vitamin B(12) (1500 microg/day, n = 63), folic acid (5 mg/day, n = 64), or both vitamin B(12) and folic acid (n = 64) for 8 weeks. Plasma levels of homocysteine and these vitamins were followed. Significant reduction in plasma homocysteine was observed in all three groups, and the combination therapy yielded the most remarkable result, i.e., plasma total homocysteine was reduced by 38.5% and this was significantly larger than the reduction in other two groups (22.4% and 10.9% in the groups received folic acid and vitamin B(12), respectively). Vitamin B(12) synergizes with folic acid in reducing plasma homocysteine in Japanese patients with ischemic stroke and the combined therapy may be particularly effective in the secondary prevention.

Aged↗