Faculty Profiles - NAKAHARA Ryuuichi

Papers - NAKAHARA Ryuuichi

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長谷井嬢, 中原龍一, 藤原智洋, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S1371 - S1371 2024.3

人工膝関節置換術後の関節リウマチ患者における生物学的製剤・JAK阻害剤使用とD-dimer値の関係

志水紀之, 市川千夏, 浪花崇一, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 68回 846 - 846 2024.3

High Fracture Rate of AVANTA Silicone Implant Following Arthroplasty of the Thumb MCP Joint of Rheumatoid Arthritis Patients with Boutonniere Deformities.

Daisuke Kaneda, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Ryozo Harada, Yoshifumi Hotta, Shuichi Naniwa, Toshifumi Ozaki

Acta medica Okayama 78 ( 1 ) 71 - 78 2024.2

Language：English Publishing type：Research paper (scientific journal)

We retrospectively investigated the mid-term outcomes of arthroplasty using the AVANTA silicone implant for thumb metacarpophalangeal (MCP) joints with boutonniere deformity in patients with rheumatoid arthritis (RA). This study involved 36 thumbs of 33 RA patients with a mean follow-up period of 5.1 years (range, 2.0-13.3). Postoperatively, the mean extension was significantly increased and the mean flexion was significantly decreased (p<0.001, p<0.001, respectively), resulting in the mean arc of range of motion (ROM) shifting in the direction of extension after surgery. Implant fracture was observed in 10 thumbs (28%), and 4 of these (11%) underwent revision surgery. The survivorship with implant fracture and revision surgery as endpoints were 73.4% and 91.8% at 5 years, respectively. The preoperative arc of ROM and the postoperative flexion range of the implant-fracture group were significantly greater than those in the no-implant-fracture group (p=0.039, 0.034, respectively). These results suggest the importance of patient education and careful rehabilitation to prevent excessive flexion. Overall, the AVANTA silicone implant showed a relatively high rate of implant fracture at our institute.

DOI： 10.18926/AMO/66673

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Inhibitory Effect of a Tankyrase Inhibitor on Mechanical Stress-Induced Protease Expression in Human Articular Chondrocytes. International journal

Yoshifumi Hotta, Keiichiro Nishida, Aki Yoshida, Yoshihisa Nasu, Ryuichi Nakahara, Shuichi Naniwa, Noriyuki Shimizu, Chinatsu Ichikawa, Deting Lin, Tomohiro Fujiwara, Toshifumi Ozaki

International journal of molecular sciences 25 ( 3 ) 2024.1

Language：English Publishing type：Research paper (scientific journal)

We investigated the effects of a Tankyrase (TNKS-1/2) inhibitor on mechanical stress-induced gene expression in human chondrocytes and examined TNKS-1/2 expression in human osteoarthritis (OA) cartilage. Cells were seeded onto stretch chambers and incubated with or without a TNKS-1/2 inhibitor (XAV939) for 12 h. Uni-axial cyclic tensile strain (CTS) (0.5 Hz, 8% elongation, 30 min) was applied and the gene expression of type II collagen a1 chain (COL2A1), aggrecan (ACAN), SRY-box9 (SOX9), TNKS-1/2, a disintegrin and metalloproteinase with thrombospondin motifs-5 (ADAMTS-5), and matrix metalloproteinase-13 (MMP-13) were examined by real-time PCR. The expression of ADAMTS-5, MMP-13, nuclear translocation of nuclear factor-κB (NF-κB), and β-catenin were examined by immunocytochemistry and Western blotting. The concentration of IL-1β in the supernatant was examined by enzyme-linked immunosorbent assay (ELISA). TNKS-1/2 expression was assessed by immunohistochemistry in human OA cartilage obtained at the total knee arthroplasty. TNKS-1/2 expression was increased after CTS. The expression of anabolic factors were decreased by CTS, however, these declines were abrogated by XAV939. XAV939 suppressed the CTS-induced expression of catabolic factors, the release of IL-1β, as well as the nuclear translocation of NF-κB and β-catenin. TNKS-1/2 expression increased in mild and moderate OA cartilage. Our results demonstrated that XAV939 suppressed mechanical stress-induced expression of catabolic proteases by the inhibition of NF-κB and activation of β-catenin, indicating that TNKS-1/2 expression might be associated with OA pathogenesis.

DOI： 10.3390/ijms25031443

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Changes in Spinal Instability After Conventional Radiotherapy for Painful Vertebral Bone Metastases

Eiji Nakata, Shinsuke Sugihara, Ryuichi Nakahara, Haruyoshi Katayama, Takuto Itano, Toshifumi Ozaki

Cancer Control 31 2024.1

Publishing type：Research paper (scientific journal) Publisher：SAGE Publications

Objective: Precise assessment of spinal instability is critical before and after radiotherapy (RT) for evaluating the effectiveness of RT. Therefore, we retrospectively evaluated the efficacy of RT in spinal instability over a period of 6 months after RT, utilizing the spinal instability neoplastic score (SINS) in patients with painful spinal metastasis. We retrospectively evaluated 108 patients who received RT for painful vertebral metastasis in our institution. Mechanical pain at metastatic vertebrae, radiological responses of irradiated vertebrae, and spinal instability were assessed. Follow-up assessments were done at the start of and at intervals of 1, 2, 3, 4, and 6 months after RT, with the pain disappearing in 67%, 85%, 93%, 97%, and 100% of the patients, respectively. The median SINS were 8, 6, 6, 5, 5, and 4 at the beginning and after 1, 2, 3, 4, and 6 months of RT, respectively. Multivariate analysis revealed that posterolateral involvement of spinal elements (PLISE) was the only risk factor for continuous potentially unstable/unstable spine at 1 month. In conclusion, there was improvement of pain, and recalcification results in regaining spinal stability over time after RT although vertebral body collapse and malalignment occur in some irradiated vertebrae. Clinicians should pay attention to PLISE in predicting continuous potentially unstable/unstable spine.

DOI： 10.1177/10732748241250219

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Other Link： https://journals.sagepub.com/doi/full-xml/10.1177/10732748241250219

関節リウマチ患者における人工関節置換術のリスクファクターの検討

志水紀之, 大塚憲昭, 市川千夏, 浪花崇一, 中原龍一, 那須義久, 尾崎敏文, 西田圭一郎

関節の外科 51 ( 2 ) 70 - 70 2024

最適な治療を目指した周術期管理 JAK阻害剤

西田圭一郎, 市川千夏, 那須義久, 中原龍一, 原田遼三, 浪花崇一, 志水紀之, 林徳てい, 大塚憲昭

関節の外科 51 ( 2 ) 40 - 40 2024

Unlinked TEAを第一選択とする治療戦略

那須義久, 西田圭一郎, 中原龍一, 大塚憲昭, 市川千夏, 志水紀之, 浪花崇一, 尾崎敏文

関節の外科 51 ( 2 ) 51 - 51 2024

Deep learning approach for discrimination of liver lesions using nine time-phase images of contrast-enhanced ultrasound.

Naohisa Kamiyama, Katsutoshi Sugimoto, Ryuichi Nakahara, Tatsuya Kakegawa, Takao Itoi

Journal of medical ultrasonics (2001) 2023.12

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Contrast-enhanced ultrasound (CEUS) shows different enhancement patterns depending on the time after administration of the contrast agent. The aim of this study was to evaluate the diagnostic performance of liver nodule characterization using our proposed deep learning model with input of nine CEUS images. METHODS: A total of 181 liver lesions (48 benign, 78 hepatocellular carcinoma (HCC), and 55 non-HCC malignant) were included in this prospective study. CEUS were performed using the contrast agent Sonazoid, and in addition to B-mode images before injection, image clips were stored every minute up to 10 min. A deep learning model was developed by arranging three ResNet50 transfer learning models in parallel. This proposed model allowed inputting up to nine datasets of different phases of CEUS and performing image augmentation of nine images synchronously. Using the results, the correct prediction rate, sensitivity, and specificity between "benign" and "malignant" cases were analyzed for each combination of the time phase. These accuracy values were also compared with the washout score judged by a human. RESULTS: The proposed model showed performance superior to the referential standard model when the dataset from B-mode to the 10-min images were used (sensitivity: 93.2%, specificity: 65.3%, average correct answer rate: 60.1%). It also maintained 90.2% sensitivity and 61.2% specificity even when the dataset was limited to 2 min after injection, and this accuracy was equivalent to or better than human scoring by experts. CONCLUSION: Our proposed model has the potential to identify tumor types earlier than the Kupffer phase, but at the same time, machine learning confirmed that Kupffer-phase Sonazoid images contain essential information for the classification of liver nodules.

DOI： 10.1007/s10396-023-01390-z

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The Effectiveness of Rehabilitation after Open Surgical Release for Trigger Finger: A Prospective, Randomized, Controlled Study

Taichi Saito, Ryo Nakamichi, Ryuichi Nakahara, Keiichiro Nishida, Toshifumi Ozaki

Journal of Clinical Medicine 12 ( 22 ) 7187 - 7187 2023.11

Publishing type：Research paper (scientific journal) Publisher：MDPI AG

Background: It is not clear whether rehabilitation after surgery for trigger finger is effective. The aim of this study was to reveal its effectiveness for trigger finger. Methods: This study was a randomized, controlled trial that included patients who underwent operations for trigger fingers. The patients in the rehabilitation group had postoperative occupational therapy (OT) for 3 months, while the patients in the control group were not referred for rehabilitation but received advice for a range of motion exercises. We evaluated the severity of trigger finger, Disability of Arm-Shoulder-Hand (DASH) score, pain-visual analogue scale (VAS), grip strength, whether they gained a full range of motion (ROM), and complications before and after surgery. Results: Finally, 29 and 28 patients were included in the control and rehabilitation groups, respectively. At final follow-up, the DASH score, grip strength, and ROM were significantly improved in the rehabilitation group compared to that preoperatively. At final follow-up, pain was significantly improved in both groups from that preoperatively. There were no significant differences in the results, including the DASH score, grip strength, ROM and pain-VAS between the control and rehabilitation groups at the final follow-up. Subgroup analysis showed that there is a significant difference in the DASH score of patients doing housework or light work and those with a duration of symptoms >12 months between the control and rehabilitation groups at the final follow-up.

DOI： 10.3390/jcm12227187

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特集整形外科領域における人工知能(AI) 言語AIと言語解析

高橋康, 中原龍一

整形･災害外科 66 ( 10 ) 1209 - 1217 2023.9

深層学習と民生用3Dセンサを用いた低コスト高精度肘関節可動域自動計測システムの試み

鈴木諒, 吉岡健太郎, 速川湧気, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 2 ) 219 - 224 2023.9

完全Web化された医工連携の試み関節可動域自動計測システムの開発

速川湧気, 吉岡健太郎, 鈴木諒, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 2 ) 225 - 230 2023.9

Wrist arthrodesis combined with a bulk bone allograft for implant loosening after total wrist arthroplasty: a case report. International journal

Yoshihisa Nasu, Keiichiro Nishida, Masamitsu Natsumeda, Ryuichi Nakahara, Ryozo Harada, Toshifumi Ozaki

Modern rheumatology case reports 2023.8

Language：English Publishing type：Research paper (scientific journal)

Total wrist arthroplasty is a challenging procedure for wrist joints severely destroyed by rheumatoid arthritis. The most common postoperative complication of total wrist arthroplasty is the loosening of the carpal component. Revision surgeries for failed total wrist arthroplasties can be complicated owing to severe bone loss and concomitant soft-tissue problems. Here we report a case (68-year-old woman with a history of rheumatoid arthritis for 24 years) of severe aseptic loosening of semi-constrained total wrist arthroplasty and its salvage surgery. During the primary arthroplasty procedure, severe instability at the second through fifth carpometacarpal joints was observed, and arthrodesis of these joints was required. The radiographs obtained nine months after surgery showed loosening of the carpal component. Subsequently, she suffered a stroke, resulting in a loss of follow-up, and higher stress was loaded on her upper extremities during standing and walking. In the radiograph taken at her revisit 25 months after the primary surgery, the subsidence of the carpal component progressed, and loosening of the radial component was observed. Total wrist arthrodesis was performed using a bulk bone allograft of the femoral head, combined with a penetrating Wrist Fusion Rod®. Rapid bone union was achieved without soft tissue irritation. We conclude that wrist arthrodesis with a bulk bone allograft combined with an intramedullary nail is a reasonable option for failed total wrist arthroplasty.

DOI： 10.1093/mrcr/rxad048

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大規模言語モデル(AI)の医師国家試験解答解析 ChatGPTとGPT-4の比較

中原龍一, 西田圭一郎, 那須義久, 堀田佳史, 浪花崇一, 志水紀之, 高橋康, 長谷川嬢

日本整形外科学会雑誌 97 ( 8 ) S1609 - S1609 2023.8

Computer assisted orthopaedic surgeryがもたらす整形外科の次世代診療希少疾患に対するAI開発戦略

長谷井嬢, 中原龍一, 藤原智洋, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1783 - S1783 2023.8

Computer assisted orthopaedic surgeryがもたらす整形外科の次世代診療希少疾患に対するAI開発戦略

長谷井嬢, 中原龍一, 藤原智洋, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1783 - S1783 2023.8

大規模言語モデル(AI)の医師国家試験解答解析 ChatGPTとGPT-4の比較

中原龍一, 西田圭一郎, 那須義久, 堀田佳史, 浪花崇一, 志水紀之, 高橋康, 長谷川嬢

日本整形外科学会雑誌 97 ( 8 ) S1609 - S1609 2023.8

Influence of Janus kinase inhibitors on early postoperative complications in patients with rheumatoid arthritis undergoing orthopaedic surgeries. International journal

Keiichiro Nishida, Ryozo Harada, Yoshihisa Nasu, Shuichi Naniwa, Ryuichi Nakahara, Yoshifumi Hotta, Noriyuki Shimizu, Deting Lin, Toshifumi Ozaki

Modern rheumatology 2023.6

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: We retrospectively reviewed the records of rheumatoid arthritis (RA) patients who underwent orthopaedic surgery to examine the influence of the perioperative use of Janus kinase (JAK) inhibitors on early postoperative complications. PATIENTS AND METHODS: Thirty-two patients with RA under disease control with JAK inhibitors who underwent 49 orthopaedic procedures were included in the study. Patient records after surgery were investigated for surgical site infection (SSI), delayed wound healing (DWH), flare-up of the disease, pre-and postoperative absolute lymphocyte counts (ALCs), venous thromboembolism and other postoperative complications. RESULTS: JAK inhibitors were continued during the perioperative period in 31 procedures. In the remaining 18 procedures, JAK inhibitors were discontinued perioperatively with a mean discontinuation period of 2.4 days. No instances of SSI were identified in any patient during at least 90 days' follow-up, while DWH was seen in one patient. Disease flare-up was noted in two patients after 3 and 9 days of discontinuation of JAK inhibitors, respectively. The ALCs significantly decreased on postoperative Day 1 (P < 0.0001) and there was a significant correlation between pre- and post-one day ALCs (r = 0.75, P < 0.0001). CONCLUSION: JAK inhibitors seem to be safe during the perioperative period of orthopaedic surgery.

DOI： 10.1093/mr/road047

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骨吸収抑制薬長期使用下で高度変形肘を伴う関節リウマチ患者に生じた尺骨非定形骨折の一例

原田遼三, 西田圭一郎, 那須義久, 中原龍一

日本関節病学会誌 42 ( 3 ) 208 - 208 2023.6

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