Biomedical subjects

M Tani

Publications and source records attributed to M Tani.

471 records · Page 27Linked to original sources

PubMedDate not supplied

Technical devices in jejunal pouch reconstruction following total gastrectomy, including postoperative results.

BACKGROUND/AIMS: Either straight Roux-en-Y anastomosis or jejunal interposition used to be adopted following total gastrectomy. However, dissatisfaction with regard to postoperative quality of life has prompted the development of new techniques. The purpose of this study is to describe and assess the authors' technical devices in jejunal pouch (J-pouch) reconstruction following total gastrectomy and the results of these operations. PATIENTS AND METHODS: A prospective study of 17 patients with malignant gastric disease (nine with J-pouch interposition, eight with J-pouch Roux-en-Y reconstruction) was performed. To facilitate the side-to-side anastomosis of the jejunal loop, the authors used an autosuture instrument. The anastomosis was then checked for hemostasis using a vaginoscope. RESULTS: An Endo GIA with a 60-mm long white cartridge (closed height of staples, 1.0 mm) is the instrument of choice to create the J-pouch. This autosuture instrument fires triple staggered staple lines, which minimizes bleeding from the anastomosed site and reduces operative time. No anastomotic leaks were associated with the autosuture instrument. The vaginoscope facilitates a direct observation of the staple lines internally and if necessary, enables secure hemostasis with sutures. Bowel motility was satisfactory for both surgical procedures, as measured by the percentage of radiopaque markers which were expelled from the pouch. There were no serious complications, and all patients have currently survived, a maximum of 5 years and 6 months after surgery, except for one patient who died from recurrent disease. CONCLUSION: The authors' procedures for J-pouch reconstruction are advantageous due to a favorable postoperative quality of life, with low complication rates.

Adult↗

PubMedDate not supplied

A new method of endoscopic mucosal resection of neoplastic lesions in the stomach: its technical features and results.

BACKGROUND/AIMS: In gastric cancer, endoscopic treatment can be expected to provide an absolute cure only if the lesion is mucosal and not accompanied by metastatic lymph nodes. To further evaluate such possibly curable lesions, we retrospectively reviewed 208 cases of early gastric cancer surgically resected over the past 20 years. METHODOLOGY: Our new method of endoscopic mucosal resection using a cap-fitted panendoscope, which is called EMRC, has been employed in the treatment of 73 gastric neoplastic lesions. RESULTS: It was found that curable lesions would, as the primary condition, be histologically well-differentiated carcinomas and measure 2 cm or less of the elevated type and less than 1 cm of the depressed type. The lesions were consequently identified as 49 early cancers (46 mucosal, 3 submucosal), 23 adenomas and 1 carcinoid. Although resection was completed in a single session of EMRC treatment in all cases, approximately 40% of them required fractionated resection, leaving an ulcer measuring 3 cm or more in approximately 30%. Bleeding or muscle resection occurred in 7 patients, in whom conservative treatment was effective. No recurrence has been found in any of the 73 lesions, demonstrating a favorable outcome. CONCLUSIONS: This method is advantageous in that it is simple and relatively easily applied at almost any location within the stomach. In addition, the size of the specimen obtained by en bloc resection is approximately 2 cm. The method is thus fairly likely to come into widespread use.

Aged↗

PubMedDate not supplied

Absence of mutations in the analysis of coding sequences of the entire transforming growth factor-beta type II receptor gene in sporadic human breast cancers.

The transforming growth factor-beta (TGFbeta) binds the type II TGFbeta growth factor receptor (TGFbetaRII) to inhibit the growth of most epithelial tissues. Most human colon and gastric cancers with microsatellite instability (MI) have frameshift mutations in polynucleotide repeats within the TGFbetaRII coding region; these mutations truncate the receptor protein and disable the serine/threonine kinase to produce TGF-beta resistance. To further investigate the type, frequency and tissue distribution of TGFbetaRII gene mutations, in this study, we examined 36 sporadic breast cancers. We previously produced eight intron based primer pairs for mutational analysis of the entire coding region of the TGFbetaRII gene. Using these primers, we developed protocols for polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) analysis of PCR products from genomic DNA samples of 36 breast cancer patients and we tested them for microsatellite instability (MI) at eight microsatellite loci. One case demonstrated MI (2.8%) and we found no mutations. These and other recent data indicate that TGFbetaRII mutations are essentially confined to colon and gastric cancers with MI. The narrow spectrum of tissues containing RII mutations illustrates the complexity of genetic checkpoints in human carcinogenesis.

Base Sequence↗