論文 - 松村 内久
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介護用移乗サポートロボットの使用経験 ー回復期リハ病棟の適応と療養病棟での効果ー
宮竹 里志, 森山 誠二, 平井 仁, 出口 真弓, 松村 内久
第2回 WAMグループ学術集会誌 4 - 6 2024年12月
担当区分：最終著者, 責任著者
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壁を利用した後方介助歩行練習により立位姿勢と立位動作時のPusher現象の軽減を認めた左片麻痺の1例 症例研究 査読あり
松岡 廣典, 平塚 大貴, 平井 仁, 森山 誠二, 堀 一樹, 後藤 良介, 松村 内久
理学療法-臨床・研究・教育 30 ( 1 ) 45 - 49 2023年07月
担当区分：最終著者 記述言語：日本語 出版者・発行元：(公社)埼玉県理学療法士会
【はじめに】Pusher現象例に対した壁を利用した後方介助歩行練習を実施し,その効果について検証する。【方法】介入は,麻痺側下肢に長下肢装具(Knee ankle foot orthosis:KAFO)を装着し,非麻痺側側に壁が来るように位置づけ,理学療法士による後方介助歩行を実施した。アウトカムはScale for Contraversive Pushing(SCP),Burke Lateropulsion Scale(BLS),Trunk control test(TCT),Scale for the assessment and rating of ataxia(SARA)とした。【結果】介入後に立位姿勢の非対称性や立ち上がり動作,移乗動作のPusher現象は軽減を認めた。【結論】本法は,立位姿勢と立ち上がり動作時のPusher現象を軽減させ,介助量軽減が図られたと考えられる。(著者抄録)
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症例 重症くも膜下出血による意識障害と痙縮が改善してバクロフェン髄注療法から離脱し得た1例 査読あり
旭 雄士, 柏崎 大奈, 高 正圭, 松村 内久, 黒田 敏
Neurological Surgery 脳神経外科 43 ( 3 ) 253 - 7 2015年03月
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An operating microscope with higher magnification and higher resolution for cerebral aneurysm surgery: preliminary experience-technical note. 査読あり
Nobuhisa Matsumura, Takashi Shibata, Emiko Hori, Hironaga Kamiyama, Mariko Tani, Soushi Okamoto, Michiya Kubo, Yukio Horie, Shunro Endo, Satoshi Kuroda
Neurologia medico-chirurgica 54 ( 6 ) 497 - 501 2014年06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）
We describe a higher magnifying power operating microscope system to improve one method of high-quality microsurgical clipping for cerebral aneurysm in some cases. This higher magnification is achieved by a new lens design in the optical system, which makes the image of the object very clear at high magnifications (distinctiveness of 7 μm). This higher-resolution operating microscope system provides the surgeon with higher-magnified images (at the maximum of more than 30× magnifications as each working distance) in the operating field. The magnifications can be changed from low power (2.9×) to high power (62.0×) depending on the circumstances in a given procedure. We have used this operating microscope system on 11 patients with microsurgical clipping for cerebral aneurysms. Microsurgical treatment could be performed safely and precisely. All aneurysms were treated without any technical complications. We think that the use of this microscope would have potential benefits for microsurgical treatment for cerebral aneurysms because of better visualization.
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【妊産婦と脳血管疾患】もやもや病 招待あり
松村 内久, 黒田 敏
産科と婦人科 81 ( 5 ) 595 - 600 2014年05月
担当区分：筆頭著者 記述言語：日本語 出版者・発行元：(株)診断と治療社
もやもや病は、内頸動脈終末部における進行性の狭窄を特徴とし、その周辺にもやもや血管とよばれる異常血管網の発達を伴う疾患である。もやもや病は小児、成人を問わず発生して、脳虚血発作や頭蓋内出血をきたす。現在、唯一の有効な治療法は脳血行再建術である。もやもや病合併妊娠は、脳虚血発作や頭蓋内出血のリスクを高めるため、特に未治療例では頭蓋内出血による生命予後、機能予後の悪化に注意が必要である。妊娠中は妊娠高血圧症候群を回避すること、適切な分娩法を選択することが重要である。もやもや病合併妊娠に対しては、産科医と脳神経外科医が緊密に連携しながら管理すべきである。(著者抄録)
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超入門 手術顕微鏡の特徴と使い方 三鷹光器社手術顕微鏡 超高倍率顕微鏡手術 招待あり
松村 内久, 黒田 敏
脳神経外科速報 23 ( 11 ) 1206 - 1213 2013年11月
担当区分：筆頭著者, 責任著者 記述言語：日本語 出版者・発行元：(株)メディカ出版
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新たに考案したbar handle型外科用ピンセットとその把持法
松村 内久
医療機器学 83 ( 2 ) 218 - 218 2013年04月
担当区分：筆頭著者, 責任著者 記述言語：日本語 出版者・発行元：(一社)日本医療機器学会
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小脳出血との関連が疑われた頭蓋頚椎移行部dAVFの1例 査読あり
堀 恵美子, 松村 内久, 久保 道也, 柴田 孝, 岡本 宗司, 谷 真理子, 堀江 幸男
脳卒中の外科 41 ( 4 ) 281 - 284 2013年
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市販鎮痛薬の長期服用により偽性高クロール血症を認めた片頭痛の1例 査読あり
田口 芳治, 岡本 宗司, 松村 内久, 久保 道也, 堀江 幸男
内科 110 ( 4 ) 669 - 672 2012年10月
出版者・発行元：南江堂
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A new bayonet spring microsurgical instrument handle with a bar for microneurosurgery. 査読あり 国際誌
Nobuhisa Matsumura
Surgical neurology international 3 152 - 152 2012年
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: The bayonet-shaped spring surgical instrument is essential and perhaps the most important tool in microneurosurgery. It is needed to be handled gently, and so stable handling to the spring tension of the long instrument handle is necessary for fine action in narrow and deep operative fields under an operating microscope. METHODS: A bayonet spring microsurgical instrument handle with a bar as a stabilizer is presented for facilitating delicate microsurgical manipulations stably in microneurosurgery. The bar with the handle is a metric projection. The grip of this instrument is a modified writing grasp, which is composed of writing grasp and sandwiching a lateral-projected bar with handle between the medial side of the index finger and the lateral side of the middle finger. Then, this bar as a stabilizer of the instrument is suitable to fix it. RESULTS: Microneurosurgical operations using this instrument system were performed. This was advantageous to stabilize the instrument in deep and narrow operative fields, to be sensitive to move its functional tips by fingertips, and to reduce unwanted movements under an operating microscope. This was disadvantageous to limit the rotational movement within fingers. There were no complications. CONCLUSION: This handle would provide a steady and balanced grip to ensure precise manipulation of the functional tips of the bayonet instrument for microneurosurgery. It may be useful particularly for the beginners or for the non-dominant hand of microsurgeons.
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A newly designed ruler of a 0.1-mm scale on the tip of microsurgical instrument in supermicrosurgery. 査読あり 国際誌
Nobuhisa Matsumura
Microsurgery 31 ( 8 ) 671 - 2 2011年11月
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Basic training model for supermicrosurgery: a novel practice card model. 査読あり 国際誌
Nobuhisa Matsumura, Yukio Horie, Takashi Shibata, Michiya Kubo, Nakamasa Hayashi, Shunro Endo
Journal of reconstructive microsurgery 27 ( 6 ) 377 - 82 2011年07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）
Supermicrosurgery has been developed and reported the anastomosis of vessels with diameters of about 0.5 mm or less. The anastomosis of vessels of about 0.5 mm or less in diameter is technically more difficult than 1.0 mm or larger. This article describes a novel practice card model for acquiring basic supermicrosurgical techniques. A practice card is composed of very small-caliber silicone tubes simulating very small-caliber vessels and a thick paper. The silicone tube external diameters are 0.3, 0.5, or 0.7 mm. The thickness of the tube wall is 0.05 mm. Microsurgeons can easily begin to practice and warm up the supermicrosurgical suturing and anastomosing techniques using this nonvital practice card under a personal desk stereomicroscope in the office and an operating microscope in the operating room. This training model is a simple system for practicing basic supermicrosurgical techniques repeatedly and for warming up before a supermicrosurgical operation. This article also describes basic training regarding its use at high magnifications. This training-based supermicrosurgical skill may become a valuable technique for microsurgeons in many specialties.
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Microvascular anastomosis at 30-50× magnifications (super-microvascular anastomosis) in neurosurgery. 査読あり 国際誌
Nobuhisa Matsumura, Nakamasa Hayashi, Hironaga Kamiyama, Michiya Kubo, Takashi Shibata, Soushi Okamoto, Yukio Horie, Hideo Hamada, Shunro Endo
Surgical neurology international 2 6 - 6 2011年01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 safe and precise technique of microvascular anastomosis at higher magnifications (30 - 50 ×) in neurosurgery and evaluate our experiences to examine the utility of this method for cerebral revascularization in various situations. METHODS: A retrospective review was carried out of patients who underwent microvascular anastomosis using a high-magnified operating microscope. This method was performed in 30 patients with 35 microvascular anastomoses in various situations. This microscope has two optical systems, a standard zooming system and a newly developed high magnification system. High resolution and good depth of focus are achieved by a new lens design in the optical system, which makes the image of the object very clear at higher magnifications. In this operating microscope, the combination of a 10 × eyepiece and the 200, 250, and 300-mm objective lens enables a range of final magnifications from 2.9 × to 50.4 ×. RESULTS: This method enabled one to pay attention to performing atraumatic manipulations of small vessels and correct suturing, intima-to-intima, of vessel walls. Microvascular anastomoses were performed safely and precisely at higher magnifications. All anastomoses were patent. CONCLUSION: It is obvious that practical final magnifications of more than 30 × in neurosurgery would be super-magnified operative views. Microvascular anastomosis at 30 - 50 × magnifications (super-microvascular anastomosis) can help neurosurgeons to improve their skills, with good visualization, and to be safe and accurate when conducting cerebral revascularization in various situations.
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Novel microsurgical precision grip and spring-handled instrument with a stabilizer 査読あり
Nobuhisa Matsumura
Microsurgery 31 ( 7 ) 586 - 588 2011年
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）
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Task-dependent and independent synchronous activity of monkey hippocampal neurons in real and virtual translocation. 査読あり 国際誌
Etsuro Hori, Eiichi Tabuchi, Nobuhisa Matsumura, Taketoshi Ono, Hisao Nishijo
Frontiers in behavioral neuroscience 5 36 - 36 2011年
記述言語：英語 掲載種別：研究論文（学術雑誌）
Previous neurophysiological and behavioral studies relate hippocampal functions to place learning and memory, and encoding of task (or context)-specific information. Encoding of both task-specific information and own location is essential for episodic memory and for animals to navigate to reward-related places. It is suggested that different neural circuits with different assemblies of different hippocampal neurons are created in different environments or behavioral contexts for the hippocampal formation (HF) to encode and retrieve episodic memory. To investigate whether synchronous activity of hippocampal neurons, suggesting functional connectivity between those neurons, is task and position dependent, multiple single unit activities were recorded during performance of real and virtual translocation (VT) tasks. The monkey moved to one of four reward areas by driving a cab (real translocation) or by moving a pointer on a monitor. Of 163 neuron pairs, significant peaks in cross-correlograms (CCGs) were observed in 98 pairs. Most CCGs had positive peaks within 50 ms. Task-dependent cross-correlations (CCRs) were observed in 44% of the neuron pairs, and similarly observed in both the real and VT tasks. These CCRs were frequently observed in pyramidal vs. pyramidal neuron pairs with positive peak and peak shift. However, no consistent patterns of peak polarity, peak shift, and neuronal types were seen in task-independent CCRs. There was no significant difference in frequency of CCG peaks between real and VT tasks. These results suggest that the task-dependent information may be encoded by interaction among pyramidal neurons, and the common information across tasks may be encoded by interaction among pyramidal neurons and interneurons in the HF. These neuronal populations could provide a neural basis for episodic memory to disambiguously guide animals to places associated with reward in different situations.
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Higher magnification microsurgical repair of donor artery dissection in superficial temporal artery to middle cerebral artery anastomosis--technical note. 査読あり
Nobuhisa Matsumura, Takashi Shibata, Hironaga Kamiyama, Takahiro Tomita, Soushi Okamoto, Michiya Kubo, Yukio Horie
Neurologia medico-chirurgica 51 ( 12 ) 872 - 4 2011年
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）
Donor artery dissection is a known cause of technical failure in microvascular anastomosis. A method for detection and direct repair of donor artery dissection before superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis is described using a high magnification operating microscope (maximum 50.4× magnification). Before STA-MCA anastomosis, the stump of the STA is stained using methylrosaniline chloride (pyoctaninum blue) and is observed under higher magnifications. Microsurgical suturing of the arterial dissection is performed before the anastomosis procedure under the high magnification microscope. This method was used in two patients with symptomatic hemodynamic cerebrovascular occlusive disease. Postoperative angiography revealed good patency and no complications occurred. This method may be useful for detection and direct repair of arterial dissection in small vessel walls before STA-MCA anastomosis.
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"Kissing" aneurysms of the internal carotid artery treated by coil embolization. 査読あり
Chiaki Takahashi, Michiya Kubo, Soushi Okamoto, Nobuhisa Matsumura, Yukio Horie, Nakamasa Hayashi, Naoya Kuwayama, Shunro Endo
Neurologia medico-chirurgica 51 ( 9 ) 653 - 6 2011年
記述言語：英語 掲載種別：研究論文（学術雑誌）
A 62-year-old female complaining of sudden severe headache was referred to our stroke center in consultation. Computed tomography showed diffuse spread of thick subarachnoid hemorrhage to the basal cistern and both sylvian fissures, and digital subtraction angiography showed kissing aneurysms arising in the left lateral and occipital directions in the C(1) portion of the internal carotid artery (ICA). The anterior choroidal artery was situated between the two aneurysms, and another small branch originating from the dome of the distal aneurysm was confirmed as a duplicated middle cerebral artery (MCA). Endovascular treatment was successfully performed to spare the two vessels involved. This case of kissing aneurysms and ICA-duplicated MCA is very rare, and presents difficulties for both surgical and endovascular treatments.
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BPSDに対して塩酸ドネペジルが有効であった前頭側頭型認知症の1例 査読あり
田口 芳治, 松村 内久, 久保 道也, 堀江 幸男, 高嶋 修太郎, 田中 耕太郎
精神医学 52 ( 6 ) 595 - 597 2010年06月
出版者・発行元：株式会社医学書院
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Extracranial-intracranial bypass surgery at high magnification using a new high-resolution operating microscope: technical note. 査読あり 国際誌
Nobuhisa Matsumura, Takashi Shibata, Kimiko Umemura, Seiya Nagao, Yukio Horie
Surgical neurology 72 ( 6 ) 690 - 4 2009年12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 precise technique for EC-IC bypass surgery using a stereoscopic high-resolution microscope at magnifications of 40x and 50x. METHODS: A stereoscopic operating microscope (Mitaka MM50 Surgical Microscope; Mitaka Kohoki Co, Tokyo, Japan) was used in STA-MCA anastomosis. This microscope has 2 optical systems, a standard zooming system, a newly developed high-magnification system, and 4 fixed working distances of 200, 250, 300 and 350 mm, with highest magnifications of 50.4x at 200 mm and 40.3x at 250 mm. High resolution is achieved by a new lens design in the optical system, which makes the image of the object very clear at high magnification. The magnification can be changed depending on the circumstances in a given procedure. The STA-MCA anastomoses were performed using this microscope. RESULTS: Very small vessels were observable, and arterial anastomosis could be performed precisely at high magnification. All anastomoses were patent on postoperative angiograms. CONCLUSIONS: Use of the new microscope allows visualization and manipulation of small vessels at high magnification and high resolution and may be very useful in EC-IC bypass surgery.
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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
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Neural representation of real place in the monkey hippocampal formation 査読あり
Etsuro Hori, Eiichi Tabuchi, Ryoi Tamura, Satoshi Eifuku, Nobuhisa Matsumura, Hisao Nishijo, Taketoshi Ono
Neuroscience Research 38 S76 - S76 2000年
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An experimental model for side-to-side microvascular anastomosis. 査読あり 国際誌
Nobuhisa Matsumura, Shunro Endo, Hideo Hamada, Masanori Kurimoto, Yutaka Hirashima, Akira Takaku
Journal of reconstructive microsurgery 15 ( 8 ) 581 - 3 1999年11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）
Side-to-side microvascular anastomosis may be required in certain clinical situations, although the technique is difficult and the incidence of usage remains low. A new experimental model using rat femoral vessels for side-to-side microvascular anastomosis is presented, in which 100 percent patency was accomplished immediately and was maintained for 7 days after anastomosis. This model can provide a training tool for acquisition of advanced microsurgical technique for side-to-side anastomosis of small vessels.
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Spatial- and task-dependent neuronal responses during real and virtual translocation in the monkey hippocampal formation. 査読あり 国際誌
Nobuhisa Matsumura, Hisao Nishijo, Ryoi Tamura, Satoshi Eifuku, Shunro Endo, Taketoshi Ono
The Journal of neuroscience : the official journal of the Society for Neuroscience 19 ( 6 ) 2381 - 93 1999年03月
担当区分：筆頭著者 記述言語：英語 掲載種別：研究論文（学術雑誌）
Neuropsychological data in humans demonstrated a pivotal role of the medial temporal lobe, including the hippocampal formation (HF) and the parahippocampal gyrus (PH), in allocentric (environment-centered) spatial learning and memory. In the present study, the functional significance of the monkey HF and PH neurons in allocentric spatial processing was analyzed during performance of the spatial tasks. In the tasks, the monkey either freely moved to one of four reward areas in the experimental field by driving a cab that the monkey rode (real translocation task) or freely moved a pointer to one of four reward areas on the monitor (virtual translocation task) by manipulating a joystick. Of 389 neurons recorded from the monkey HF and PH, 166 had place fields that displayed increased activity in a specific area in the experimental field and/or on the monitor (location-differential neurons). More HF and PH neurons responded in the real translocation task. These neurons had low mean spontaneous firing rates (0.96 spikes/sec), similar to those of rodent HF place cells. The remaining nonresponsive neurons had significantly higher mean firing rates (8. 39 spikes/sec), similar to interneurons or theta cells in the rodent HF. Furthermore, most location-differential neurons showed different responses in different tasks. These results suggest that the HF and PH are crucial in allocentric information processing and, moreover, that the HF can encode different reference frames that are context or task-dependent. This may be the neural basis of episodic memory.
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Intracranial germinoma associated with Down's syndrome. Report of 2 cases. 査読あり 国際誌
Nobuhisa Matsumura, Masanori Kurimoto, Shunro Endo, Osamu Fukuda, Akira Takaku
Pediatric neurosurgery 29 ( 4 ) 199 - 202 1998年10月
担当区分：筆頭著者 記述言語：英語 掲載種別：研究論文（学術雑誌）
It is well known that Down's syndrome is sometimes associated with leukemia. However, there have been only a few case reports of a relationship between Down's syndrome and brain tumors. We report 2 cases with histological diagnoses of germinoma. The 1st case was a 10-year-old boy with Down's syndrome complaining of seizure and left hemiparesis. Computed tomographic (CT) scan and magnetic resonance imaging (MRI) showed a mass lesion in the right basal ganglia and thalamus. Histological examination indicated two cell pattern germinomas. The 2nd case was a 20-year-old man with Down's syndrome complaining of headache and vomiting. CT scan and MRI showed a pineal region tumor with marked hydrocephalus. Surgical specimens showed typical germinoma. Only 13 cases of brain tumors associated with Down's syndrome have been reported. A higher incidence of germ cell tumors seems to be related to chromosomal abnormalities.
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Monkey hippocampal neurons respond task-dependently during real and virtual navigation in tasks 査読あり
Nobuhisa Matsumura, Hisao Nishijo, Ryoi Tamura, Satoshi Eifuku, Akira Takaku, Taketoshi Ono
Neuroscience Research 31 S232 - S232 1998年01月
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Pyogenic osteomyelitis of an invaginated odontoid process with rapid deterioration of high cervical myelopathy: a case report. 査読あり 国際誌
M Kurimoto, S Endo, M Ohi, Y Hirashima, N Matsumura, A Takaku
Acta neurochirurgica 140 ( 10 ) 1093 - 4 1998年
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Surgically resected brain stem cavernous angioma in an infant. 査読あり 国際誌
Shunro Endo, Nobuhisa Matsumura, Masanori Kurimoto, Akira Takaku
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 13 ( 11-12 ) 613 - 5 1997年
記述言語：英語 掲載種別：研究論文（学術雑誌）
An infantile case of surgically resected brain stem cavernous angioma is presented. This 21-month-old boy was admitted to our department after repeated severe pontine hemorrhage. A deeplying lesion with hematoma was successfully removed via the IV ventricle approach. Few infantile cases of this lesion have been presented previously, and the approaches to brain stem cavernous angiomas in infants are discussed.