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16. A Computer-Aided Diagnosis System Using Artificial Intelligence for Hip Fractures -Multi-Institutional Joint Development Research-

Author

Sato, Yoichi, Takegami, Yasuhiko, Asamoto, Takamune, Ono, Yutaro, Hidetoshi, Tsugeno, Goto, Ryosuke, Kitamura, Akira, and Honda, Seiwa

Subjects
Physics - Medical Physics, Computer Science - Computer Vision and Pattern Recognition, Electrical Engineering and Systems Science - Image and Video Processing, Quantitative Biology - Tissues and Organs, 68-T01
Abstract

[Objective] To develop a Computer-aided diagnosis (CAD) system for plane frontal hip X-rays with a deep learning model trained on a large dataset collected at multiple centers. [Materials and Methods]. We included 5295 cases with neck fracture or trochanteric fracture who were diagnosed and treated by orthopedic surgeons using plane X-rays or computed tomography (CT) or magnetic resonance imaging (MRI) who visited each institution between April 2009 and March 2019 were enrolled. Cases in which both hips were not included in the photographing range, femoral shaft fractures, and periprosthetic fractures were excluded, and 5242 plane frontal pelvic X-rays obtained from 4,851 cases were used for machine learning. These images were divided into 5242 images including the fracture side and 5242 images without the fracture side, and a total of 10484 images were used for machine learning. A deep convolutional neural network approach was used for machine learning. Pytorch 1.3 and Fast.ai 1.0 were used as frameworks, and EfficientNet-B4, which is pre-trained ImageNet model, was used. In the final evaluation, accuracy, sensitivity, specificity, F-value and area under the curve (AUC) were evaluated. Gradient-weighted class activation mapping (Grad-CAM) was used to conceptualize the diagnostic basis of the CAD system. [Results] The diagnostic accuracy of the learning model was accuracy of 96. 1 %, sensitivity of 95.2 %, specificity of 96.9 %, F-value of 0.961, and AUC of 0.99. The cases who were correct for the diagnosis showed generally correct diagnostic basis using Grad-CAM. [Conclusions] The CAD system using deep learning model which we developed was able to diagnose hip fracture in the plane X-ray with the high accuracy, and it was possible to present the decision reason., Comment: 9 pages, 4 tables, 7 figures. / author's homepage : https://www.fracture-ai.org

Published
2020

23. Comparison of conjoined tendon-preserving posterior approach and conventional posterolateral approach in hemiarthroplasty for femoral neck fracture in the elderly: A multicenter (TRON group) retrospective study

Author

Ogura, Keisuke, primary, Takegami, Yasuhiko, additional, Kuwahara, Yutaro, additional, Tokutake, Katsuhiro, additional, Nakashima, Ryo, additional, Yamamoto, Shigeto, additional, Naito, Kenta, additional, Kasai, Takehiro, additional, Makida, Kazuya, additional, and Imagama, Shiro, additional

Published
2024
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24. Obesity Is Associated with Asymptomatic Vertebral Fractures: A Yakumo Study

Author

Miyairi, Yuichi, primary, Nakashima, Hiroaki, additional, Ito, Sadayuki, additional, Segi, Naoki, additional, Ouchida, Jun, additional, Oishi, Ryotaro, additional, Yamauchi, Ippei, additional, Machino, Masaaki, additional, Seki, Taisuke, additional, Ishizuka, Shinya, additional, Takegami, Yasuhiko, additional, Hasegawa, Yukiharu, additional, and Imagama, Shiro, additional

Published
2024
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28. Preoperative Sarcopenia Severity and Clinical Outcomes after Total Hip Arthroplasty.

Author

Tanaka, Shinya, Kayamoto, Azusa, Terai, Chiaki, Nojiri, Shusuke, Fugane, Yuki, Mori, Tomohiro, Nagaya, Motoki, Kako, Masato, Iida, Hiroki, Osawa, Yusuke, Takegami, Yasuhiko, and Nishida, Yoshihiro

Abstract

The outcome of total hip arthroplasty (THA) in patients with end-stage arthritis of the hip is associated with preoperative physical status. This study was performed to examine the relationship between the preoperative severity of sarcopenia and clinical outcomes after THA. This retrospective cohort study was performed among 306 consecutive patients (mean age: 63.7 ± 12.9 years, 222 women) undergoing THA at a university hospital. The severity of sarcopenia was determined based on the skeletal muscle mass index (SMI), handgrip strength, and gait speed according to the criteria of the Asian Working Group for Sarcopenia 2019. The severe sarcopenia prevalence rate was 10.6%. Severe sarcopenia was significantly associated with the risk of delayed functional recovery (adjusted odds ratio, 2.82; 95% confidence interval, 1.03–7.72; p = 0.043) compared with the non-sarcopenia group after adjusting for pre-existing risk factors, including preoperative hip function and physical activity. The addition of SMI, handgrip strength, and gait speed to the model for risk of functional recovery delay significantly increased the area under the receiver operating characteristic curve (p = 0.038). Severe sarcopenia was significantly associated with poorer hip function and patient-reported outcomes at 6 months after surgery compared with the non-sarcopenia group. Severe sarcopenia was adversely associated with postoperative clinical outcomes in patients undergoing THA. [ABSTRACT FROM AUTHOR]

Published
2024
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30. A Longitudinal Study on the Effect of Exercise Habits on Locomotive Syndrome and Quality of Life during the Coronavirus Disease 2019 Pandemic

Author

Ito, Sadayuki, primary, Nakashima, Hiroaki, additional, Segi, Naoki, additional, Ouchida, Jun, additional, Oishi, Ryotaro, additional, Yamauchi, Ippei, additional, Ishizuka, Shinya, additional, Takegami, Yasuhiko, additional, Seki, Taisuke, additional, Hasegawa, Yukiharu, additional, and Imagama, Shiro, additional

Published
2024
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31. Do Postural and Walking Stabilities Change over a Decade by Aging? A Longitudinal Study

Author

Segi, Naoki, primary, Nakashima, Hiroaki, additional, Ito, Sadayuki, additional, Ouchida, Jun, additional, Oishi, Ryotaro, additional, Yamauchi, Ippei, additional, Miyairi, Yuichi, additional, Morita, Yoshinori, additional, Takegami, Yasuhiko, additional, Ishizuka, Shinya, additional, Seki, Taisuke, additional, Hasegawa, Yukiharu, additional, and Imagama, Shiro, additional

Published
2024
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35. Long-term oral meclozine administration improves survival rate and spinal canal stenosis during postnatal growth in a mouse model of achondroplasia in both sexes.

Author

Funahashi, Hiroto, Matsushita, Masaki, Esaki, Ryusaku, Mishima, Kenichi, Ohkawara, Bisei, Kamiya, Yasunari, Takegami, Yasuhiko, Ohno, Kinji, Kitoh, Hiroshi, and Imagama, Shiro

Subjects
ENDOCHONDRAL ossification, SPINAL stenosis, DYSPLASIA, ORAL drug administration, FIBROBLAST growth factor receptors, LABORATORY mice, SURVIVAL rate
Abstract

Achondroplasia (ACH) is a skeletal dysplasia characterized by short-limbed short stature caused by the gain-of-function mutations in the fibroblast growth factor receptor 3 (FGFR3) gene. Activated FGFR3, which is a negative regulator of bone elongation, impairs the growth of long bones and the spinal arch by inhibiting chondrocyte proliferation and differentiation. Most patients with ACH have spinal canal stenosis in addition to short stature. Meclozine has been found to inhibit FGFR3 via drug repurposing. A 10-d treatment with meclozine promoted long-bone growth in a mouse model of ACH (Fgfr3 ach mice). This study aimed to evaluate the effects of long-term meclozine administration on promoting bone growth and the spinal canal in Fgfr3 ach mice. Meclozine (2 mg/kg/d) was orally administered to Fgfr3 ach mice for 5 d per wk from the age of 7 d to 56 d. Meclozine (2 mg/kg/d) significantly reduced the rate of death or paralysis and improved the length of the body, cranium, and long bones in male and female Fgfr3 ach mice. Micro-computed tomography analysis revealed that meclozine ameliorated kyphotic deformities and trabecular parameters, including BMD, bone volume/tissue volume, trabecular thickness, and trabecular number at distal femur of Fgfr3 ach mice in both sexes. Histological analyses revealed that the hypertrophic zone in the growth plate was restored in Fgfr3 ach mice following meclozine treatment, suggesting upregulation of endochondral ossification. Skeletal preparations demonstrated that meclozine restored the spinal canal diameter in Fgfr3 ach mice in addition to improving the length of each bone. The 2 mg/kg/d dose of meclozine reduced the rate of spinal paralysis caused by spinal canal stenosis, maintained the growth plate structure, and recovered the bone quality and growth of axial and appendicular skeletons of Fgfr3 ach mice in both sexes. Long-term meclozine administration has the potential to ameliorate spinal paralysis and bone growth in patients with ACH. [ABSTRACT FROM AUTHOR]

Published
2024
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39. Hook plate fixation versus locking plate fixation for distal clavicle fracture: a multicenter propensity score-matched study

Author

Takahashi, Hiroshi, Takegami, Yasuhiko, Tokutake, Katsuhiro, Katayama, Yujiro, and Imagama, Shiro

Subjects
hook plate, propensity score matching, clavicle, distal clavicle fracture, locking plate
Abstract

Hook plate fixation and locking plate fixation are two standard internal fixation implants for treating distal clavicle fractures. We aimed to clarify the following: 1) Does the locking plate offer better clinical outcomes than the hook plate? 2) Is bone union better with a locking plate than hook plate? and 3) Are complications different between the locking plate and hook plate? We conducted a retrospective multicenter study of 338 patients who underwent surgery from 2014 to 2018 in our 10 hospitals, which comprise the TRON group. Of them, 208 patients treated using any plates were eligible. After 30 patients were excluded for various reasons, 178 patients were included. We classified them into two groups, locking plate group (Group L) and hook plate group (Group H), using propensity score matching. We confirmed bone union with an X-ray, evaluated the UCLA shoulder score, and compared the frequency of complications. After matching, Group L and Group H included 49 patients each. The UCLA score was higher in Group L than in Group H at each follow-up point. We confirmed bone union in all patients in Group L, but it was not confirmed in three patients (6.1%) in Group H. No statistically significant differences were observed except for plate migration, which was observed in nine patients (18.4%) in Group H but in no patients in Group L. The postoperative UCLA score was significantly better in Group L. We recommend the locking plate as a surgical treatment for distal clavicle fractures., This is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Published
2023

50. DNA methylation is associated with muscle loss in community-dwelling older men -the Yakumo study-: a preliminary experimental study

Author

Kato, Daisaku, Takegami, Yasuhiko, Seki, Taisuke, Nakashima, Hiroaki, Osawa, Yusuke, Suzuki, Koji, Yamada, Hiroya, Hasegawa, Yukiharu, and Imagama, Shiro

Subjects
muscle loss, LINE-1 DNA methylation, cross-sectional study, frailty, osteoporosis
Abstract

Frailty is a state of reduced muscle strength and activity in older people. DNA methylation is associated with osteoporosis and muscle loss in murine and other animal studies, but there are no epidemiological studies in humans. This study aimed to assess the association of osteoporosis and muscle loss with DNA methylation in community-dwelling older people. This cross-sectional study was performed in a rural part of Japan. We analyzed 204 subjects (98 men and 106 women). In univariate analysis, the two groups were compared according to the presence or absence of osteoporosis and of muscle loss. Logistic regression analysis was performed to determine predictors of frailty in the muscle loss group. We used age, sex, body mass index, smoking history, drinking history, serum albumin and C-reactive protein levels, diabetes, hypertension, hyperlipidemia, heart disease history, and LINE-1 DNA methylation as the factors. Probability values < 0.05 were considered to be statistically significant. The levels of LINE-1 DNA methylation in leukocytes were associated with muscle loss in men over the age of 60. LINE-1 DNA methylation levels were not associated with bone mineral density in either the men or women over the age of 60. LINE-1 DNA methylation levels in leukocytes correlated significantly with the risk of frailty in men over the age of 60. Promoting an understanding of DNA methylation may lead to a better understanding of the pathophysiology of muscle loss., This is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Published
2022

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