Biomedical subjects

Shinichi Miura

Publications and source records attributed to Shinichi Miura.

6 recordsLinked to original sources

PubMed2005

Laparoscopy-assisted distal gastrectomy with systemic lymph node dissection: a phase II study following the learning curve.

BACKGROUND AND OBJECTIVES: A preliminary study on the use of laparoscopy-assisted approach to treat gastric carcinoma resulted in higher morbidity. STUDY DESIGN: A prospective phase II study of laparoscopy-assisted distal gastrectomy (LADG) was performed for patients with preoperative diagnosis of T1 N0 stage cancer located in the lower or middle-third stomach. Bleeding amount, operating time, mortality, morbidity, and the number of lymph node retrieval were recorded and compared with the preliminary series reported previously by the same authors. RESULTS: Between 2000 and 2002, 47 patients were accrued. The mean blood loss and postoperative hospital stay were significantly decreased compared with the previous series, whereas the operating time was not. There were no in-hospital deaths, with the incidence of anastomotic leakage significantly decreased. All patients remain disease-free to date. CONCLUSIONS: LADG can be performed safely and morbidity, no longer, is a drawback by experienced hands that have reached plateau of the learning curve, although it remains a time-consuming procedure. Its application to gastric cancer surgery is feasible for early stage cancer, and its applicability to the treatment of T2 stage cancer will be the next issue to be explored.

Adult↗

PubMed2004

Path integral hybrid Monte Carlo algorithm for correlated Bose fluids.

Path integral hybrid Monte Carlo (PIHMC) algorithm for strongly correlated Bose fluids has been developed. This is an extended version of our previous method [S. Miura and S. Okazaki, Chem. Phys. Lett. 308, 115 (1999)] applied to a model system consisting of noninteracting bosons. Our PIHMC method for the correlated Bose fluids is constituted of two trial moves to sample path-variables describing system coordinates along imaginary time and a permutation of particle labels giving a boundary condition with respect to imaginary time. The path-variables for a given permutation are generated by a hybrid Monte Carlo method based on path integral molecular dynamics techniques. Equations of motion for the path-variables are formulated on the basis of a collective coordinate representation of the path, staging variables, to enhance the sampling efficiency. The permutation sampling to satisfy Bose-Einstein statistics is performed using the multilevel Metropolis method developed by Ceperley and Pollock [Phys. Rev. Lett. 56, 351 (1986)]. Our PIHMC method has successfully been applied to liquid helium-4 at a state point where the system is in a superfluid phase. Parameters determining the sampling efficiency are optimized in such a way that correlation among successive PIHMC steps is minimized.

Journal Article↗

PubMed2004

Laparoscopy-assisted distal gastrectomy with systemic lymph node dissection: a critical reappraisal from the viewpoint of lymph node retrieval.

BACKGROUND: Laparoscopy-assisted surgery has proved useful in the treatment of early gastric cancer, but its use in advanced cancer may be hindered by limitations in lymphadenectomy. STUDY DESIGN: Data on lymph node retrieval after distal gastrectomy with D1 or D2 lymphadenectomy (n = 89) performed by the laparoscopy-assisted approach were collected between 1998 and 2002 and compared with data obtained from conventional open surgery performed for T1 cancer at a high-volume hospital (n = 342) during the same period. Comparisons of total number of lymph nodes, retrieval at each lymph node station, and the rate of noncompliance (no nodal tissue documented at a node station that should have been resected) were conducted using Student's t-test and the chi-square test. RESULTS: D2 resection by the laparoscopy-assisted approach harvested a sufficient number of nodes for adequate TNM classification (>15 nodes) in 86% of patients. Nevertheless, a significantly greater number of lymph nodes were harvested by open surgery. The difference was significant for the perigastric lymph nodes along the major curvature (Nos. 4 and 6) and second tier nodes along the celiac and splenic arteries (Nos. 9 and 11). CONCLUSIONS: The extent of lymphadenectomy achieved by current laparoscopic procedure approaches the global standard for accurate staging, although performing extended resection as recommended in Japan remains a challenge.

Feasibility Studies↗

PubMed2003

Laparoscopic distal gastrectomy for severe corrosive gastritis: report of a case.

We report a case of severe corrosive gastritis caused by alkali ingestion, which was successfully treated by laparoscopic gastrectomy. A 38-year-old Japanese woman attempted suicide by ingesting Drano. She was treated conservatively for 3 months, but severe stenosis of the antrum secondary to scarification resulted in outlet obstruction. A Billroth I distal gastrectomy was performed through a laparoscopy-assisted approach. The patient had an uneventful postoperative course and was discharged on the 13th day after her operation. She was subsequently able to tolerate a normal diet, gained weight, and is now emotionally stable.

Acute Disease↗

PubMedDate not supplied

Combination of oral fluoropyrimidine and docetaxel: reappraisal of synergistic effect against gastric carcinoma xenografts.

BACKGROUND: The synergistic antitumor effect of a combination of docetaxel and capecitabine is reported to be attributable to docetaxel-mediated up-regulation of thymidine phosphorylase (dThdPase). MATERIALS AND METHODS: Intravenous docetaxel (15 mg/kg) was given to nude mice bearing xenografts of the gastric cancer cell lines MKN45 and MKN28. Mice were sacrificed on days 7, 10 and 22 and tumor samples were taken to measure the activities of thymidylate synthase, dihydropyrimidine dehydrogenase, dThdPase and orotate phosphoribosyltransferase. The efficacy of capecitabine or S-1, alone and in combination with docetaxel, was then evaluated in vivo. Docetaxel was administered intravenously on days 8 and 22 at 15 mg/kg, while capecitabine (269 mg/kg) or S-1 (7.5 mg/kg) were administered orally 5 times a week for 4 weeks. RESULTS: Tumor regression was observed only for a combination of capecitabine and docetaxel against MKN28, while additive growth inhibition was obtained by the combination of docetaxel and both S-1 and capecitabine on MKN45 tumor xenografts. Induction of dThdPase activity was observed only for MKN45. The activity of no other enzyme was significantly affected following administration of docetaxel. CONCLUSION: The combination of oral fluoropyrimidine and docetaxel showed augmented antitumor activity, but this may be attributed to mechanisms other than changes in 5-fluorouracil-metabolizing enzymes.

Administration, Oral↗

PubMedDate not supplied

Laparoscopy-assisted total gastrectomy for a case of MALT lymphoma: a case report.

A case of laparoscopy-assisted total gastrectomy with regional lymph node dissection for MALT (mucosa-associated lymphoid tissue) lymphoma is reported. The patient was a 45-year-old male with MALT lymphoma. Eradication of Helicobacter pylori as the initial therapy had failed to halt progression of the tumor. Considering certainty of the second therapy, he was transferred to surgical treatment. Total gastrectomy was required and this was performed by the laparoscopy-assisted approach. The postoperative course was satisfactory and the patient has been disease-free for 5 years after the operation. Laparoscopic operation could be a useful option in the second-line treatment for MALT lymphoma after failure to eradicate H. pylori.

Gastrectomy↗