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- 저자 : Takashi Matsumura (검색결과 11 건)
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Akira Matsumura,Takashi Namikawa,Minori Kato,Shoichiro Oyama,Yusuke Hori,Akito Yabu,Noriaki Hidaka,Hiroaki Nakamura 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.4
Study Design: Retrospective comparative study. Purpose: To compare the incidence of proximal junctional kyphosis (PJK) between transverse process hooks (TPHs) and pedicle screws (PSs) at the upper instrumented vertebrae (UIV) following adult spinal deformity (ASD) surgery. Overview of Literature: The choice of UIV implant type may be important for avoiding PJK; however, few comparative clinical studies have evaluated the incidence of PJK according to the type of UIV implant used in ASD surgery. Methods: We retrospectively reviewed 39 consecutive patients with ASD (mean age, 67 years; mean follow-up period, 41 months) who underwent corrective surgery between 2009 and 2013. TPH was used in 17 patients and PS in 22 patients. PJK was defined as the presence of a UIV or UIV±1 fracture, or a change in the proximal junctional angle (PJA) of >20°. Data of patients with TPH and PS were compared. Results: The TPH group had a PJK incidence of 17.6% compared with 27.3% in the PS group (p =0.47). In the TPH group, PJK was a result of UIV fracture in one patient, UIV−1 fracture in one patient, and ligamentous failure in one patient. In the PS group, six patients developed PJK because of UIV fracture. No differences in radiographic parameters were found between the two groups. After analyzing the PJA data in the patients with PJK, the changes in PJA were significantly higher in the PS group than in the TPH group (19.0°/5.0°, p =0.04). Conclusions: Our results show that using TPH as a UIV implant may not prevent PJK; however, using TPH as the UIV anchor may prevent vertebral collapse if cases of UIV fracture. The increased risk of UIV fracture collapse in the PS group may be a result of a higher mechanical load on UIV when using PS.
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Autogenic Rib Graft for Atlantoaxial and Occipitocervical Fixation in Pediatric Patients
Akira Matsumura,Takashi Namikawa,Minori Kato,Yusuke Hori,Masayoshi Iwamae,Noriaki Hidaka,Sadahiko Konishi,Hiroaki Nakamura 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.5
Study Design: Retrospective case series. Purpose: To evaluate surgical outcomes and effectiveness of an autogenic rib graft for upper cervical fixation in pediatric patients. Overview of Literature: Autogenic bone grafts have long been considered the ‘gold standard’ bone source for posterior cervical fusion in pediatric patients. However, there are some unsolved problems associated with donor-site morbidity and amount of bone grafting. Methods: We studied five consecutive pediatric patients who underwent atlantoaxial fixation or occipitocervical fixation (OCF) using an autogenic rib graft with at least 2 years of follow-up (mean age, 9.8 years; mean follow-up period, 73.0 months). Two patients underwent OCF without screw-rod constructs and three patients with screw-rod constructs. Autogenic rib grafts were used in all patients. We evaluated the surgical outcomes including radiographic parameter, bony union, and perioperative complications. Results: The atlantoaxial interval (ADI) was corrected from 11.6 to 6.0 mm, and the C1–2 angle was corrected −14.8° to 7.8°. The C2–7 angle was reduced from 31° to 9° spontaneously. Two patients with OCF required revision surgery due to loss of correction. Patients did not experience any complication associated with the donor sites (rib bone grafts). Six months postoperation X-rays clearly showed regeneration of the rib at the donor sites. Bony fusion was achieved in all patients; however, bony fusion occurred more slowly in patients without screw-rod constructs compared with patients with screw-rod constructs. Bone regeneration of the rib was observed in all patients with no complications at the donor site. Conclusions: Autogenic rib grafts have advantages of potential bone regeneration, high fusion rate, and low donor-site morbidity. In addition, a screw-rod construct provides better bony fusion in pediatric patients with OCF and atlantoaxial fixation.
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Yukihiko Matsumura,Soichi Hirota,Shuhei Inoue,Takahito Inoue,Yoshifumi Kawai,Yasutaka Wada,Takashi Noguchi 한국화학공학회 2016 Korean Journal of Chemical Engineering Vol.33 No.4
Supercritical water gasification (SCWG) has attracted attention as a technology for utilizing wet biomass. We used a fluidized bed of alumina particles to prevent blockage of a SCWG reactor. A glucose solution was heated in the reactor with and without fluidized alumina particles. In the absence of alumina particles, char particles formed homogeneously in the reactor, but the use of a fluidized bed resulted in accumulation of char particles at the reactor’s exit rather than inside the reactor. Therefore, the fluidized bed was effective at preventing blockage of the reactor. However, the alumina particles did not remove deposits from the reactor’s walls. Instead, the fluidized bed caused larger char particles to form, preventing their adhesion to the reactor’s wall.
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Prospects of Hospital Information Systems and Patient Safety in Japan
Kiwamu Nagoshi,Takashi Watari,Yasushi Matsumura 대한의료정보학회 2022 Healthcare Informatics Research Vol.28 No.2
Objectives: Approximately 20 years have passed since hospital information systems (HISs) featuring full-scale electronicmedical records were first implemented in Japan. Patient safety is one of the most important of the several “safety” roles thatHISs are expected to fulfill. However, insufficient research has analyzed the contribution of HISs to patient safety. This paperreviews the history of HISs in connection with patient safety in Japan and discusses the future of the patient safety function ofHISs in a favorable environment for digitization. Methods: A review on the history of HISs with functions that contribute topatient safety was conducted, analyzing evidence from reports published by the Japanese government and papers on patientsafety and HISs published in various countries. Results: Patient safety has become a concern, and initiatives to promote patientsafety have progressed simultaneously with the spread of HISs. To address the problem of patient safety, most large hospitalsprioritize patients’ welfare when building HISs. However, no HIS-associated reduction in adverse events due to medicaltreatment could be confirmed. Conclusions: HISs are expected to help prevent medical accidents, such as patient- and drugrelatederrors. It is hoped that the patient safety functions of HISs will become generalized and contribute to patient safety inthe future. To achieve this, the government and academic societies should provide regulations and guidelines on HISs andpatient safety to the medical community and medical-device vendors. Furthermore, departments responsible for HISs andpatient safety should collaborate to gather evidence for the effectiveness of HISs.
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Iwamae Masayoshi,Matsumura Akira,Namikawa Takashi,Kato Minori,Hori Yusuke,Yabu Akito,Sawada Yuta,Noriaki Hidaka,Nakamura Hiroaki 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.4
Study Design: A retrospective case control study.Purpose: The purpose of this study was to compare the surgical outcomes of multilevel lateral lumbar interbody fusion (LIF) and multilevel posterior lumbar interbody fusion (PLIF) in the surgical treatment of adult spinal deformity (ASD) and to evaluate the sagittal plane correction by combining LIF with posterior-column osteotomy (PCO).Overview of Literature: The surgical outcomes between multilevel LIF and multilevel PLIF in ASD patients remain unclear.Methods: We retrospectively reviewed 31 ASD patients who underwent multilevel LIF combined with PCO (LIF group, n=14) or multilevel PLIF (PLIF group, n=17) and with a minimum 2-year follow-up. In the comparison between LIF and PLIF groups, their mean age at surgery was 69.4 vs. 61.8 years while the mean follow-up period was 29.2 vs. 59.3 months. We evaluated the transition of pelvic incidence–lumbar lordosis (PI–LL) and disc angle (DA) in the LIF group, in fulcrum backward bending (FBB), after LIF and after posterior spinal fusion (PSF) with PCO. The spinopelvic radiographic parameters were compared between LIF and PLIF groups.Results: Compared with the PLIF group, the LIF group had less blood loss and comparable surgical outcomes with respect to radiographic data, health-related quality of life scores and surgical time. In the LIF group, the mean DA and PI–LL were unchanged after LIF (DA, 5.8°; PI–LL, 15°) compared with the values using FBB (DA, 4.3°; PI–LL, 15°) and improved significantly after PSF with PCO (DA, 8.1°; PI–LL, 0°).Conclusions: In the surgical treatment of ASD, multilevel LIF is less invasive than multilevel PLIF and combination of LIF and PCO would be necessary for optimal sagittal correction in patients with rigid deformity.
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Candidate Path Selection Method for TCP Performance Improvement in Fixed Robust Routing
Yukinobu Fukushima,Takashi Matsumura,Kazutaka Urushibara,Tokumi Yokohira 대한전자공학회 2016 IEIE Transactions on Smart Processing & Computing Vol.5 No.6
Fixed robust routing is attracting attention as routing that achieves high robustness against changes in traffic patterns without conducting traffic measurement and performing dynamic route changes. Fixed robust routing minimizes the worst-case maximum link load by distributing traffic of every source-destination (s-d) router pair onto multiple candidate paths (multipath routing). Multipath routing, however, can result in performance degradation of Transmission Control Protocol (TCP) because of frequent out-of-order packet arrivals. In this paper, we first investigate the influence of multipath routing on TCP performance under fixed robust routing with a simulation using ns-2. The simulation results clarify that TCP throughput greatly degrades with multipath routing. We next propose a candidate path selection method to improve TCP throughput while suppressing the worst-case maximum link load to less than the allowed level under fixed robust routing. The method selects a single candidate path for each of a predetermined ratio of s-d router pairs in order to avoid TCP performance degradation, and it selects multiple candidate paths for each of the other router pairs in order to suppress the worst-case maximum link load. Numerical examples show that, provided the worst-case maximum link load is less than 1.0, our proposed method achieves about six times the TCP throughput as the original fixed robust routing.
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Takako Komiya,Yosuke Ojima,Takashi Ishikawa,Hajime Matsumura 대한성형외과학회 2022 Archives of Plastic Surgery Vol.49 No.5
Background Appropriate position of the nipple-areolar complex (NAC) is crucial following nipple-sparing mastectomy (NSM). The prevention of NAC malposition in two-stage implant-based breast reconstruction has not been well described, and the efficacy of the techniques has not been evaluated. This study aimed to evaluate the efficacy of our technique to prevent NAC malposition in patients who underwent implant-based breast reconstruction after NSM. Methods Patients who underwent two-stage implant-based breast reconstruction with NSM between January 2012 and December 2019 were included. We used a surgical technique to fix the NAC to the rigid base, assuming a pocket-like appearance, with pectoralismajormuscle and lateral adipofascial flap at the time of tissue expander (TE) insertion. Patients were classified into two groups based on the performance of the technique for the prevention of NAC malposition. Results In 35 patients who underwent implant-based breast reconstruction after NSM, the clavicle-to-nipple distance ratio was 96.05.0% in thosewho underwent NAC fixation and 86.111.5% in those who did not undergo NAC fixation. Conclusions Using our technique, NAC malposition could be prevented in two-stage implant-based breast reconstruction. NAC fixation during TE insertion was found to be extremely effective. This procedure successfully prevented NAC malposition without the formation of extra scars.
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Masahiro Nakamura,Takeshi Yanagita,Tatsushi Matsumura,Takashi Yamashiro,Seiji Iida,Hiroshi Kamioka 대한치과교정학회 2016 대한치과교정학회지 Vol.46 No.6
We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.
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