論文 - 松村 内久
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短報 うつ状態による食欲低下が誘因となったWernicke脳症の1例 査読あり
田口 芳治, 柴田 孝, 松村 内久, 久保 道也, 堀江 幸夫
精神医学 51 ( 9 ) 885 - 887 2009年09月
記述言語：日本語 出版者・発行元：株式会社医学書院
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A newly designed training tool for microvascular anastomosis techniques: Microvascular Practice Card. 査読あり 国際誌
Nobuhisa Matsumura, Nakamasa Hayashi, Hideo Hamada, Takashi Shibata, Yukio Horie, Shunrou Endo
Surgical neurology 71 ( 5 ) 616 - 20 2009年05月
担当区分：筆頭著者, 責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌）
BACKGROUND: We report a newly designed training card (Microvascular Practice Card) that is a non-animal practice tool for surgical training and practicing the skills for microvascular anastomosis techniques. METHODS: The Microvascular Practice Card is a pocketbook-sized card that has silicone tubes affixed to it. On the card, 6 small-diameter, 4-cm-long tubes side by side are arranged in 4 directions with both ends secured. The tubes are available in diameters of 2.0, 1.0, 0.5, and 0.3 mm. The thickness of the tube wall is 0.05 or 0.1 mm. The card includes a record area that allows records to be written. Four directional tubes are arranged on one card, making it possible to practice various directional suturing and anastomosing. RESULTS: Beginners begin to practice suturing with larger diameter tubes (2.0 mm) and refine their skills using 1.0 mm diameter tubes as they get used to the practice. For vascular anastomosis, the card provides for end-to-end anastomosis, end-to-side anastomosis, and side-to-side anastomosis. Furthermore, superfine diameter tubes (0.5 and 0.3 mm) help microsurgeons to gain experience at higher magnifications. Training on this card is performed through a plastic box with a small hole using long microinstruments. CONCLUSION: Microvascular Practice Card is a new training tool for repeatedly practicing microvascular anastomosis in various situations. This non-animal practice tool would help trainees practice under safe and hygienic conditions and reduce the number of laboratory animals used during technical training.
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高位頸動脈狭窄病変に対する頸動脈血栓内膜剥離術の問題点と手術手技 査読あり
林 央周, 堀 恵美子, 秋岡 直樹, 松村 内久, 栗本 昌紀, 桑山 直也, 遠藤 俊郎
脳卒中の外科 36 ( 3 ) 163 - 167 2008年
記述言語：日本語 出版者・発行元：一般社団法人 日本脳卒中の外科学会
DOI： 10.2335/scs.36.163
DOI： 10.2335/scs.38.380_references_DOI_9UC62BQVdhIK1OHN18iZeTaqz89
その他リンク： https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-18390391/
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A new training method to improve deep microsurgical skills using a mannequin head. 査読あり 国際誌
Mikinobu Takeuchi, Nakamasa Hayashi, Hideo Hamada, Nobuhisa Matsumura, Hisao Nishijo, Shunro Endo
Microsurgery 28 ( 3 ) 168 - 70 2008年
記述言語：英語 掲載種別：研究論文（学術雑誌）
Neurosurgeons need fine and special microsurgical techniques, such as the ability to suture deep microvasculature. Intensive training is required to perform microsurgery, especially in deep microvascular anastomosis. There have been many previous reports of training methods for typical microsurgical techniques, including suturing of surgical gloves, Silastic tubes, living animals, and chicken wing arteries. However, there have been no reports of training methods to improve deep microsurgical skills under the various hand positions specific to neurosurgical operation. Here, we report a new training method using a mannequin head, water balloons, and clay to mimic actual deep microsurgery in the brain. This method allows trainees to experience microsurgery under various hand positions to approach the affected areas located at various depths in the brain from various angles.
DOI： 10.1002/micr.20473
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3D-CT angiography を用いた頸動脈の石灰化の評価 査読あり
柴田 孝, 松村 内久, 堀江 幸男, 堀 恵美子, 林 央周, 桑山 直也, 遠藤 俊郎
CI研究 : progress in computed imaging 29 ( 1 ) 21 - 26 2007年06月
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頸動脈と頭蓋内動脈における石灰化の評価 : 3D-CT angiography (curved MPR 法)の有用性 査読あり
柴田 孝, 松村 内久, 池田 宏明, 堀江 幸男, 林 央周, 桑山 直也, 遠藤 俊郎
CI研究 : progress in computed imaging 28 ( 3 ) 135 - 141 2007年03月
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Multiple aneurysms arising from the origin of a duplication of the middle cerebral artery. 査読あり 国際誌
Emiko Hori, Kunikazu Kurosaki, Nobuhisa Matsumura, Kazumasa Yamatani, Mutsuo Kusunose, Naoya Kuwayama, Shunro Endo
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 12 ( 7 ) 812 - 5 2005年09月
記述言語：英語 掲載種別：研究論文（学術雑誌）
Duplication of the middle cerebral artery is an anomalous vessel arising from the internal carotid artery. There have only been 14 reports of aneurysms arising from the origin of a duplication of the middle cerebral artery and 5 of these patients had multiple aneurysms. Aneurysms at this site have a high rupture rate compared to aneurysms in other locations and aggressive management is indicated.
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Impact of neuronavigation and image-guided extensive resection for adult patients with supratentorial malignant astrocytomas: a single-institution retrospective study. 査読あり 国際誌
M Kurimoto, N Hayashi, H Kamiyama, S Nagai, T Shibata, T Asahi, N Matsumura, Y Hirashima, S Endo
Minimally invasive neurosurgery : MIN 47 ( 5 ) 278 - 83 2004年10月
記述言語：英語 掲載種別：研究論文（学術雑誌）
Neuronavigation has become an effective therapeutic modality and is used routinely for intra-axial tumor removal. This retrospective study was conducted to evaluate the clinical impact of neuronavigation and image-guided extensive resection for adult patients with supratentorial malignant astrocytomas. Between 1990 and 2002, 76 adult patients with pathologically confirmed malignant astrocytomas underwent craniotomy and removal of the tumors at the Toyama Medical and Pharmaceutical University Hospital. Of these 76 patients, 42 were treated using neuronavigation with conventional microneurosurgery and the other 34 were treated with conventional microneurosurgery alone. Postoperative early MRI with contrast enhancement was done, and gross total resection was defined as the complete absence of residual tumor. Survival time was analyzed with the Kaplan-Meier method. Prognostic factors were obtained from the Cox proportional hazards model. In univariate analysis, age (< 65), grade 3, preoperative KPS (>/= 80), use of neuronavigation, and gross total resection were significantly associated with longer survival. However, when the data were submitted to multivariate analysis, grade 3, preoperative KPS (>/= 80), and gross total resection were independent prognostic factors. The median survival periods of patients receiving gross total resection (vs. partial resection) and neuronavigation (vs. no neuronavigation) were 16 (vs. 9) months and 16 (vs. 10) months, respectively. The percentage of a gross total resection was significantly higher in the neuronavigation group compared to that in the no-navigation group (64.3 % vs. 38.2 %, p < 0.05). Neurological deterioration occurred in 4 of 42 (9.5 %) and in 6 of 34 (17.6 %) patients after surgery with neuronavigation and surgery without neuronavigation, respectively, although this difference was not statistically significant. Our results showed that neuronavigation increases the radicality in the resection of malignant astrocytomas and is objectively useful for improving survival time.
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Vertebrobasilar artery dissection presenting with simultaneous subarachnoid hemorrhage and brain stem infarction: case report. 査読あり 国際誌
Kensuke Murakami, Noboru Takahashi, Nobuhisa Matsumura, Kunihiko Umezawa, Hiroshi Midorikawa, Michiharu Nishijima
Surgical neurology 59 ( 1 ) 18 - 22 2003年01月
記述言語：英語 掲載種別：研究論文（学術雑誌）
BACKGROUND: Intracranial dissecting aneurysms have been associated with subarachnoid hemorrhage (SAH) or cerebral ischemia. We encountered a patient presenting with simultaneous subarachnoid hemorrhage and brainstem infarction caused by a dissecting aneurysm of the vertebrobasilar artery, which was diagnosed by magnetic resonance imaging (MRI) but did not show abnormal findings on cerebral angiography. CASE DESCRIPTION: A 55-year-old man had sudden onset of headache and left abducens palsy. Computed tomography revealed a subarachnoid hemorrhage localized in the left prepontine cistern and the left cerebellomedullary fissure. Cerebral angiography showed neither a saccular aneurysm nor fusiform dilatation causing the subarachnoid hemorrhage. MRI demonstrated a small infarction in the left dorsal pons, and an intramural hematoma of the left vertebral artery and lower basilar artery. CONCLUSION: This is a rare case of a vertebrobasilar dissecting aneurysm that simultaneously caused both SAH and brain stem infarction. MRI should be performed in the acute phase of SAH of unknown origin to determine the possible coexistence of a dissecting aneurysm, as occurred in this case.
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頚動脈内膜剥離術の際に留意すべき解剖学的知識と手術手技の工夫 査読あり
林 央周, 松村 内久, 山本 博道, 増岡 徹, 桑山 直也, 平島 豊, 遠藤 俊郎
脳卒中の外科 31 ( 5 ) 370 - 374 2003年
記述言語：日本語 出版者・発行元：一般社団法人 日本脳卒中の外科学会
Based on our clinical experience of 240 cases, we present the noticeable anatomical structures and our principles of procedures during carotid endarterectomy (CEA). We also present a newly developed self-retaining retractor and spring hook for CEA. The noticeable anatomical structures are as follows: the internal jugular and facial veins, the hypogrossal nerve and ansa cervicals, vagus nerve, superoir laryngeal nerve, and branches of the external carotid artery. Our principles of exposure of the carotid arteries during CEA are the meticulous anatomical dissection and identification of the cervical structures and the intentional circumferential dissection of the carotid complex. Our perioperative cerebral complication rate (mortality and morbidity) is 2.4%, and the incidence of the basic technical complications such as cranial nerve palsy and wound hematoma are 0.4% and 1.3%, respectively. The meticulous anatomical dissection and the intentional circumferential dissection of the carotid complex are essential to minimize postoperative complications.
DOI： 10.2335/scs.31.370
DOI： 10.7887/jcns.21.943_references_DOI_Gb71E4uPXjCCHI83P1xIbRWE1Ls
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Representation of place by monkey hippocampal neurons in real and virtual translocation. 査読あり 国際誌
Etsuro Hori, Eiichi Tabuchi, Nobuhisa Matsumura, Ryoi Tamura, Satoshi Eifuku, Shunro Endo, Hisao Nishijo, Taketoshi Ono
Hippocampus 13 ( 2 ) 190 - 6 2003年
記述言語：英語 掲載種別：研究論文（学術雑誌）
The hippocampal formation (HF) is hypothesized as a neuronal substrate of a cognitive map, which represents environmental spatial information by an ensemble of neural activity. However, the relationships between the hippocampal place cells and the cognitive map have not been clarified in monkeys. The present study was designed to investigate how activity patterns of place-selective neurons encode spatial relationships of various environmental stimuli; to do this, we used multidimensional scaling (MDS) for hippocampal neuronal activity in the monkey during the performance of real and virtual translocation. Of 389 neurons recorded from the monkey HF and parahippocampal gyrus (PH), 166 had place fields that displayed increased activity in a specific area of an experimental field and/or on a monitor (place-selective neurons). The MDS transformed relationships among the 16 places in the experimental field and the monitor, expressed as correlation coefficients between all possible pairs of two places based on the 166 place-selective responses, into geometric relationships in a two-dimensional MDS space. In the real translocation tasks, the 16 places were distributed throughout the MDS space, and their relative positions were well correlated to real positions in the experimental laboratory. However, the correlation between the MDS space and real arrangements was significantly smaller in virtual than real translocation tasks. The present results strongly suggest that activity patterns of the HF and PH neurons represent spatial information and might provide a neurophysiological basis for a cognitive map.
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Emergency carotid endarterectomy 査読あり
Shunro Endo, Mohamed Ahmed Abdelaal, Nakamasa Hayashi, Naoya Kuwayama, Yutaka Hirashima, Michiya Kubo, Nobuhisa Matsumura
International Congress Series 1247 ( C ) 367 - 370 2002年12月
掲載種別：研究論文（学術雑誌）
Although carotid endarterectomy (CEA) is an established treatment, evaluation of emergency revascularization is still obscure, especially in patients with stroke. The purpose of this study is to discuss the efficacy and limitation of emergency CEA. The subjects are 88 patients who had acute atherothrombotic TIAs or stroke, and angiographically critical stenosis (>90%) of the cervical ICA. A patient with apparent low-density lesion on the initial CT was not included. There were 86 men and 4 women, aged 49 to 78 years. All patients were admitted and diagnosed within 6 h after the last attack, and treated by CEA in different timing or medical treatment. Results of treatment were evaluated. In 33 patients with only TIAs, results of CEAs were excellent compared with medical treatment group. In 29 with mild neurologic deficits, results of CEAs were more satisfactory in emergency procedures in comparison with delayed surgery. In other 26 patients with profound deficits, sufficient results were not obtained in any treatments. In conclusion, emergency CEA should be selected without hesitation, in patients with critical ICA stenosis and TIAs or mild ischemic stroke. We also present our small experiences and discuss about endovascular PTA/stenting in this clinical category. © 2002, Elsevier B.V. All rights reserved.
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村上 謙介, 高橋 昇, 松村 内久, 梅澤 邦彦, 緑川 宏, 貝森 光大, 西嶌 美知春
Neurological Surgery 脳神経外科 30 ( 10 ) 1089 - 1094 2002年10月
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画像誘導定位脳手術支援システム (Evans) の各種脳神経外科疾患への応用 : グリオーマ手術に対する効果 査読あり
林 央周, 栗本 昌紀, 旭 雄士, 柴田 孝, 松村 内久, 池田 宏明, 平島 豊, 遠藤 俊郎
Functional neurosurgery : proceedings of the annual meeting of the Japan Society for Stereotactic and Functional Neurosurgery 41 ( 1 ) 41 - 44 2002年06月
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林 央周, 桑山 直也, 久保 道也, 松村 内久, 平島 豊, 遠藤 俊郎
脳卒中の外科 30 ( 5 ) 387 - 391 2002年
記述言語：日本語 出版者・発行元：一般社団法人 日本脳卒中の外科学会
DOI： 10.2335/scs.30.387
DOI： 10.2335/scs.49.480_references_DOI_PGkwZn8DuasIcpxxJRv6tUiZpqJ
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Right sylvian fissure subarachnoid hemorrhage has electrocardiographic consequences. 査読あり 国際誌
Yutaka Hirashima, Shutaro Takashima, Nobuhisa Matsumura, Masanori Kurimoto, Hideki Origasa, Shunro Endo
Stroke 32 ( 10 ) 2278 - 81 2001年10月
記述言語：英語 掲載種別：研究論文（学術雑誌）
BACKGROUND AND PURPOSE: Abnormal ECG changes are frequently observed in patients with subarachnoid hemorrhage (SAH). Recently, evidence has been obtained that right insular cortex mediates sympathetic cardiovascular effects. We therefore assessed the laterality and location of SAH dominance in inducing cardiovascular changes as measured by ECG, blood pressure, and heart rate. METHODS: After exclusion of 11 SAH patients who died within 1 month after onset, we studied 118 consecutive patients. Data were obtained from records of blood pressure and pulse on admission. Abnormal ECG changes were determined from ECGs on admission and almost 1 month later. From brain CT scans performed immediately after admission, the amount of SAH in each of the 8 cisterns and fissures was measured semiquantitatively. RESULTS: Twenty-six patients had abnormal changes on admission ECG, while 92 patients did not. Systolic blood pressure, diastolic blood pressure, and the amounts of blood in the left ambient cistern, left suprasellar cistern, quadrigeminal cistern, right ambient cistern, right suprasellar cistern, right sylvian fissure, and the set of all cisterns were significantly greater in the group with ECG change than in the group without ECG change. Multivariate logistic regression analysis with stepwise method indicated that systolic blood pressure >160 mm Hg (P=0.0006) and the amounts of SAH in the quadrigeminal cistern (P=0.022) and right sylvian fissure (P=0.0019) were independently associated with abnormal ECG change. CONCLUSIONS: Cardiac consequences are possible in patients with massive right sylvian fissure SAH or when systolic blood pressure is >160 mm Hg.
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Side-to-side arterial anastomosis model in the rat internal and external carotid arteries. 査読あり 国際誌
Nobuhisa Matsumura, Hideo Hamada, Kazumasa Yamatani, Nakamasa Hayashi, Yutaka Hirashima, Shunro Endo
Journal of reconstructive microsurgery 17 ( 4 ) 263 - 6 2001年05月
担当区分：筆頭著者, 責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌）
Microvascular anastomosis has become a general and essential technique in the field of vascular reconstructive surgery. Side-to-side microvascular anastomosis is rarely performed by microsurgeons. Laboratory training models are essential for the development and refinement of microsurgical techniques. A new experimental model of a side-to-side "arterial" anastomosis in the rat internal and external carotid arteries is presented, in which 100 percent patency was accomplished immediately, and was maintained 7 days after anastomosis. This model can provide an experimental and training tool for side-to-side anastomosis of small arteries.
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Intramedullary spinal teratoma with spina bifida. 査読あり 国際誌
Hideo Hamada, Masanori Kurimoto, Nakamasa Hayashi, Yutaka Hirashima, Nobuhisa Matsumura, Shunro Endo
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 17 ( 1-2 ) 109 - 11 2001年01月
記述言語：英語 掲載種別：研究論文（学術雑誌）
Spinal intramedullary teratoma is a rare tumor. We report a case of intramedullary teratoma of the conus medullaris with spina bifida. A 5-year-old boy was admitted to our hospital for removal of a lumbosacral tumor sited in an intramedullary location at the conus medullaris, which was totally resected with neuroendoscopic assistance. The pathological diagnosis was mature teratoma consisting of three germ cell layers. The pathogenesis of spinal intramedullary teratoma is discussed with special reference to spina bifida.
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頚動脈内膜切除術後の創部出血 自験例の検討と対策―自験例の検討と対策― 査読あり
遠藤 俊郎, 桑山 直也, 平島 豊, 松村 内久, 濱田 秀雄, 栗本 昌紀
脳卒中の外科 29 ( 3 ) 203 - 207 2001年
記述言語：日本語 出版者・発行元：一般社団法人 日本脳卒中の外科学会
DOI： 10.2335/scs.29.203
DOI： 10.2335/scs.35.192_references_DOI_WmabegKUReWbdcK83Ow0Jcq3SQ1
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遠藤 俊郎, 富田 隆浩, 松村 内久, 林 央周, 桑山 直也, 平島 豊
脳神経外科ジャーナル 10 ( 1 ) 3 - 9 2001年
記述言語：日本語 出版者・発行元：日本脳神経外科コングレス
頚部頚動脈内膜切除術(carotid endarterectomy;CEA)は, 動脈硬化性高度狭窄病変に対する根治的かつ確立された治療法であり, 周術期合併症の発生をいかに低く抑えるかは, 常に術者に求められる課題である.CEAの施行に際しては, 虚血性心疾患など重篤な全身疾患の合併, 対側内頚動脈閉塞や頭蓋内病変合併, 脳虚血発症急性期の不安定な神経症状など、手術成績に影響する危険因子に対する配慮が必須である.Sundtらは, このようなCEAのrisk factorについて, medical risk, angiographic risk, neurologic riskの3項に大別し, 諸項目をあげている.彼らの分類に従い, これらhigh risk症例に対するCEAの安全性と問題点, 手技に関する工夫などについて, 諸家の報告と自験例の治療経験より概説する.
DOI： 10.7887/jcns.10.3
DOI： 10.7887/jcns.15.647_references_DOI_AQa1r25aUk9T9UWm1bJrModvo6K