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Biomedical subjects

Shinichi Tamura

Publications and source records attributed to Shinichi Tamura.

At least 37 records · Page 2Linked to original sources
PubMed2004

Kinematics of the subaxial cervical spine in rotation in vivo three-dimensional analysis.

STUDY DESIGN: Three-dimensional intervertebral motions of the subaxial cervical spine during head rotation were investigated in healthy volunteers using three-dimensional magnetic resonance imaging (MRI). OBJECTIVES: To document intervertebral coupled motions of the subaxial cervical spine during rotation. SUMMARY OF BACKGROUND DATA: In vivo three-dimensional kinematics of the subaxial cervical spine in rotation have not previously been well described, since they are too complicated to follow using conventional radiography or computed tomography techniques. METHODS: Ten healthy volunteers underwent three-dimensional MRI of the cervical spine in 11 positions with 15 degrees increments during head rotation using a 1.0-T imager. Relative motions of the subaxial cervical spine were calculated by automatically superimposing a segmented three-dimensional MRI of the vertebra in the neutral position over images of each position using volume registration. Three-dimensional motions of adjacent vertebrae were represented with 6 df (6 degrees of freedoms) by Euler angles and translations on the coordinate system defined by Panjabi, then visualized in animations using surface bone models. RESULTS: Mean axial rotation of the subaxial cervical spine in maximum head rotation (69.5 degrees ) was 2.2 degrees at C2-C3, 4.5 degrees at C3-C4, 4.6 degrees at C4-C5, 4.0 degrees at C5-C6, 1.6 degrees at C6-C7, and 1.5 degrees at C7-T1. Coupled lateral bending with axial rotation was observed in the same direction as axial rotation at all levels (C2-C3, 3.6 degrees ; C3-C4, 5.4 degrees; C4-C5, 5.0 degrees ; C5-C6, 5.3 degrees ; C6-C7, 4.9 degrees ; C7-T1, 1.2 degrees ). Coupled extension with axial rotation occurred in the middle cervical region (C2-C3, 1.4 degrees ; C3-C4, 2.3 degrees ; C4-C5, 1.5 degrees ), while in the lower cervical region, flexion was coupled with axial rotation (C5-C6, 0.9 degrees ; C6-C7, 2.4 degrees ; C7-T1, 3.0 degrees ). CONCLUSIONS: We investigated intervertebral motions of the subaxial cervical spine during head rotation using a three-dimensional imaging system, and obtained the first accurate depictions of in vivo coupled motion. These findings will be helpful as the basis for understanding abnormal conditions.

Adult↗
PubMed2004

Surface-based registration accuracy of CT-based image-guided spine surgery.

Registration is a critical and important process in maintaining the accuracy of CT-based image-guided surgery. The aim of this study was to evaluate the effects of the area of intraoperative data sampling and number of sampling points on the accuracy of surface-based registration in a CT-based spinal-navigation system, using an optical three-dimensional localizer. A cadaveric dry-bone phantom of the lumbar spine was used. To evaluate registration accuracy, three alumina ceramic balls were attached to the anterior and lateral aspects of the vertebral body. CT images of the phantom were obtained (1-mm slice thickness, at1-mm intervals) using a helical CT scanner. Twenty surface points were digitized from five zones defined on the basis of anatomical classification on the posterior aspects of the target vertebra. A total of 20 sets of sampling data were obtained. Evaluation of registration accuracy accounted for positional and rotational errors. Of the five zones, the area that was the largest and easiest to expose surgically and to digitize surface points was the lamina. The lamina was defined as standard zone. On this zone, the effect of the number of sampling points on the positional and rotational accuracy of registration was evaluated. And the effects of the additional area selected for intraoperative data sampling on the registration accuracy were evaluated. Using 20 surface points on the posterior side of the lamina, positional error was 0.96 mm +/- 0.24 mm root-mean-square (RMS) and rotational error was 0.91 degrees +/- 0.38 degrees RMS. The use of 20 surface points on the lamina usually allows surgeons to carry out sufficiently accurate registration to conduct computer-aided spine surgery. In the case of severe spondylosis, however, it might be difficult to digitize the surface points from the lamina, due to a hypertrophic facet joint or the deformity of the lamina and noisy sampling data. In such cases, registration accuracy can be improved by combining use of the 20 surface points on the lamina with surface points on other zones, such as on the both sides of the spinous process.

Analysis of Variance↗
PubMed2004

Automated segmentation of necrotic femoral head from 3D MR data.

Segmentation of diseased organs is an important topic in computer assisted medical image analysis. In particular, automatic segmentation of necrotic femoral head is of importance for various corresponding clinical tasks including visualization, quantitative assessment, early diagnosis and adequate management of patients suffering from avascular necrosis of the femoral head (ANFH). Early diagnosis and treatment of ANFH is crucial since the disease occurs in relatively young individuals with an average age of 20-50, and since treatment options for more advanced disease are frequently unsuccessful. The present paper describes several new techniques and software for automatic segmentation of necrotic femoral head based on clinically obtained multi-slice T1-weighted MR data. In vivo MR data sets of 50 actual patients are used in the study. An automatic method built up to manage the segmentation task according to image intensity of bone tissues, shape of the femoral head, and other characters. The processing scheme consisted of the following five steps. (1) Rough segmentation of non-necrotic lesions of the femur by applying a 3D gray morphological operation and a 3D region growing technique. (2) Fitting a 3D ellipse to the femoral head by a new approach utilizing the constraint of the shape of the femur, and employing a principle component analysis and a simulated annealing technique. (3) Estimating the femoral neck location, and also femoral head axis by integrating anatomical information of the femur and boundary of estimated 3D ellipse. (4) Removal of non-bony tissues around the femoral neck and femoral head ligament by utilizing the estimated femoral neck axis. (5) Classification of necrotic lesions inside the estimated femoral head by a k-means technique. The above method was implemented in a Microsoft Windows software package. The feasibility of this method was tested on the data sets of 50 clinical cases (3000 MR images).

Automation↗
PubMed2004

In vivo kinematics of mobile-bearing knee arthroplasty in deep knee bending motion.

The current study aimed to analyze kinematics during deep knee bending motion by subjects with fully congruent mobile-bearing total knee arthroplasties allowing axial rotation and anteroposterior (AP) gliding. Twelve subjects were implanted with Dual Bearing Knee prostheses (DBK, slot type: Finsbury Orthopaedics, Surrey, UK). These implants include a mobile-bearing insert that is fully congruent with the femoral component throughout flexion and allows axial rotation and limited AP translation. Sequential fluoroscopic images were taken in the sagittal plane during loaded knee bending motion. In vivo kinematics were analyzed using a two- to three-dimensional registration technique, which uses computer-assisted design models to reproduce the spatial position of femoral and tibial components from single-view fluoroscopic images. The average femoral component demonstrated 13.4 degrees external axial rotation for 0-120 degrees flexion. On average, the medial condyle moved anteriorly 6.2 mm for 0-100 degrees flexion, then posteriorly 4.0 mm for 100-120 degrees flexion. On average, the lateral condyle moved anteriorly 1.0 mm for 0-40 degrees flexion, then posteriorly 8.7 mm for 40-120 degrees flexion. The typical subject exhibited a lateral pivot pattern from extension to 60 degrees flexion and a central pivot pattern from 60 degrees to 100 degrees flexion, patterns that are not usually observed in normal knees. Subsequently from 100 degrees to 120 degrees flexion, a rollback pattern was reproduced in which bilateral condyles moved backward.

Aged↗
PubMed2004

Non-T-cell-depleted HLA-haploidentical hematopoietic stem cell transplantation from a family donor based on fetomaternal microchimerism in pediatric hematologic malignancies.

Based on recent fetomaternal microchimerism/tolerance theory, two children with acute lymphoblastic leukemia underwent non-T-cell-depleted hematopoietic stem cell transplants (SCT) from haploidentical HLA 2 loci-mismatched family donors (one from a sibling, one from the mother). Engraftment was achieved in two patients. In two recipients, acute graft-versus-host disease was limited to grade II or less, and no chronic graft-versus-host disease developed. Both of these patients have maintained complete remission for more than 8 months post-SCT. Non-T-cell-depleted SCT from haploidentical HLA 2 loci-mismatched family donors seems feasible if microchimerism is detectable.

Child↗
PubMed2004

High-performance computing service over the internet for intraoperative image processing.

This paper presents a framework for a cluster system that is suited for high-resolution image processing over the Internet during surgery. The system realizes high-performance computing (HPC) assisted surgery, which allows surgeons to utilize HPC resources remote from the operating room. One application available in the system is an intraoperative estimator for the range of motion (ROM) adjustment in total hip replacement (THR) surgery. In order to perform this computation-intensive estimation during surgery, we parallelize the ROM estimator on a cluster of 64 PCs, each with two CPUs. Acceleration techniques such as dynamic load balancing and data compression methods are incorporated into the system. The system also provides a remote-access service over the Internet with a secure execution environment. We applied the system to an actual THR surgery performed at Osaka University Hospital and confirmed that it realizes intraoperative ROM estimation without degrading the resolution of images and limiting the area for estimations.

Arthroplasty, Replacement, Hip↗
PubMed2004

Improvement of depth position in 2-D/3-D registration of knee implants using single-plane fluoroscopy.

Two-dimensional (2-D)/three-dimensional (3-D) registration techniques using single-plane fluoroscopy are highly important for analyzing 3-D kinematics in applications such as total knee arthroplasty (TKA) implants. The accuracy of single-plane fluoroscopy-based techniques in the determination of translation perpendicular to the image plane (depth position), however, is relatively poor because a change in the depth position causes only small changes in the 2-D silhouette. Accuracies achieved in depth position using conventional 2-D/3-D registration techniques are insufficient for clinical applications. Therefore, we propose a technique for improving the accuracy of depth position determination in order to develop a system for analyzing knee kinematics over the full six degrees of freedom (6 DOF) using single-plane fluoroscopy. In preliminary experiments, the behaviors of errors for each free variable were quantified as evaluation curves by examining changes in cost function with variations in the free variable. The evaluation curve for depth position was more jagged, and the curve peak less pointy, compared to the evaluation curves of the other five variables, and the curve was found to behave differently. Depth position is therefore optimized independently of the other variables, using an approximate evaluation curve of depth position prepared after initial registration. Accuracy of the proposed technique was evaluated by computer simulation and in vitro tests, with validation of absolute position and orientation performed for each knee component. In computer simulation tests, root-mean-square error (RMSE) in depth position was improved from 2.6 mm (conventional) to 0.9 mm (proposed), whereas for in vitro tests, RMSE improved from 3.2 mm to 1.4 mm. Accuracy of the estimation of the remaining two translational and three rotational variables was found to be almost the same as that obtained by conventional techniques. Results of in vivo tests are also described in which the possibility of full 6 DOF kinematic analysis of TKA implants is shown.

Algorithms↗
PubMed2004

Development of a camera model and calibration procedure for oblique-viewing endoscopes.

Oblique-viewing endoscopes (oblique scopes) are widely used in medical practice. They are essential for certain procedures such as laparoscopy, arthroscopy and sinus endoscopy. In an oblique scope the viewing directions are changeable by rotating the scope cylinder. Although a camera calibration method is necessary to apply augmented reality technologies to oblique endoscopic procedures, no method for oblique scope calibration has yet been developed. In the present paper, we formulate a camera model and a calibration procedure for oblique scopes. In the calibration procedure, Tsai's calibration is performed at zero rotation of the scope cylinder, then the variation of the external camera parameters corresponding to the rotation of the scope cylinder is modeled and estimated as a function of the rotation angle. Accurate estimation of the rotational axis is included in the procedure. The accuracy of this estimation was demonstrated to have a significant effect on overall calibration accuracy in the experimental evaluation, especially with large rotation angles. The projection error in the image plane was approximately two pixels. The proposed method was shown to be clinically applicable.

Algorithms↗
PubMed2004

[Correlation between 24-hour urinary protein excretion and protein/creatinine ratio in the first voided morning urine samples].

To collect 24-hour urine of infants and young children is so difficult that 24-hour urinary protein excretion (24 H-UP) has been estimated from single voided urine samples. We investigated the correlation between 24 H-UP and the protein/creatinine ratio of the first voided morning urine samples (MUP/Cr) and evaluated the problems associated with this method. Six hundred and thirty-nine specimens, pairs of morning spot urine and 24-hour collected urine, were collected from 158 patients, aged 3 to 28, who were being followed at Kyoto City Hospital. The study population was divided into different subgroups by age, disease category and inpatient or outpatient status and linear regression analysis was performed for every subgroup. Although MUP/Cr correlated well with 24 H-UP, it was necessary to revise the estimation of 24 H-UP from MUP/Cr, which is lower in infants and young children because of age-related differences in creatinine excretion. If the patient's age is younger, the creatinine excretion rate is lower. The difference in 24 H-UP estimated from MUP/Cr was significant between inpatients and outpatients, with the estimated value being higher in outpatients than inpatients. The estimated value was also different according to disease category. We speculated that the difference in estimated 24 H-UP was affected by different rate of creatinine excretion related to age and other factors.

Adolescent↗
PubMed2003

Protective mucosal immunity in aging is associated with functional CD4+ T cells in nasopharyngeal-associated lymphoreticular tissue.

Our previous studies showed that mucosal immunity was impaired in 1-year-old mice that had been orally immunized with OVA and native cholera toxin (nCT) as mucosal adjuvant. In this study, we queried whether similar immune dysregulation was also present in mucosal compartments of mice immunized by the nasal route. Both 1-year-old and young adult mice were immunized weekly with three nasal doses of OVA and nCT or with a nontoxic chimeric enterotoxin (mutant cholera toxin-A E112K/B subunit of native labile toxin) from Brevibacillus choshinensis. Elevated levels of OVA-specific IgG Abs in plasma and secretory IgA Abs in mucosal secretions (nasal washes, saliva, and fecal extracts) were noted in both young adult and 1-year-old mice given nCT or chimeric enterotoxin as mucosal adjuvants. Significant levels of OVA-specific CD4(+) T cell proliferative and OVA-induced Th1- and Th2-type cytokine responses were noted in cervical lymph nodes and spleen of 1-year-old mice. In this regard, CD4(+), CD45RB(+) T cells were detected in greater numbers in the nasopharyngeal-associated lymphoreticular tissues of 1-year-old mice than of young adult mice, but the same did not hold true for Peyer's patches or spleen. One-year-old mice given nasal tetanus toxoid plus the chimeric toxin as adjuvant were protected from lethal challenge with tetanus toxin. This result reinforced our findings that age-associated immune alterations occur first in gut-associated lymphoreticular tissues, and thus nasal delivery of vaccines for nasopharyngeal-associated lymphoreticular tissue-based mucosal immunity offers an attractive possibility to protect the elderly.

Administration, Intranasal↗
PubMed2003

A similarity measure for nonrigid volume registration using known joint distribution of targeted tissue: application to dynamic CT data of the liver.

A similarity measure for nonrigid volume registration with known joint distribution of a targeted tissue is developed to process tissue slide at the boundaries between the targeted and non-targeted tissues. Pre-segmentation of the targeted tissue is unnecessary. This measure is applied to registering volumes acquired at different time-phases in dynamic CT scans of the liver using contrast materials and can be derived for the case where only the joint distribution of the targeted tissue is known. The similarity measure is formulated as a likelihood by introducing a concept termed 'exclusivity condition' and embedded into a cost function for nonrigid registration to be combined with the smoothness term. In addition, a practical method for estimating the joint distribution of the liver from unregistered clinical CT data is described. We demonstrate experimentally that tissue slide is effectively processed by this proposed measure using simulated dynamic CT data generated from a software phantom and clinical CT data of eight patients.

Contrast Media↗
PubMed2003

Automated segmentation of acetabulum and femoral head from 3-D CT images.

This paper describes several new methods and software for automatic segmentation of the pelvis and the femur, based on clinically obtained multislice computed tomography (CT) data. The hip joint is composed of the acetabulum, cavity of the pelvic bone, and the femoral head. In vivo CT data sets of 60 actual patients were used in the study. The 120 (60 x 2) hip joints in the data sets were divided into four groups according to several key features for segmentation. Conventional techniques for classification of bony tissues were first employed to distinguish the pelvis and the femur from other CT tissue images in the hip joint. Automatic techniques were developed to extract the boundary between the acetabulum and the femoral head. An automatic method was built up to manage the segmentation task according to image intensity of bone tissues, size, center, shape of the femoral heads, and other characters. The processing scheme consisted of the following five steps: 1) preprocessing, including resampling 3-D CT data by a modified Sinc interpolation to create isotropic volume and to avoid Gibbs ringing, and smoothing the resulting images by a 3-D Gaussian filter; 2) detecting bone tissues from CT images by conventional techniques including histogram-based thresholding and binary morphological operations; 3) estimating initial boundary of the femoral head and the joint space between the acetabulum and the femoral head by a new approach utilizing the constraints of the greater trochanter and the shapes of the femoral head; 4) enhancing the joint space by a Hessian filter; and 5) refining the rough boundary obtained in step 3) by a moving disk technique and the filtered images obtained in step 4). The above method was implemented in a Microsoft Windows software package and the resulting software is freely available on the Internet. The feasibility of this method was tested on the data sets of 60 clinical cases (5000 CT images).

Acetabulum↗
PubMed2003

Limits on the accuracy of 3-D thickness measurement in magnetic resonance images--effects of voxel anisotropy.

Measuring the thickness of sheet-like thin anatomical structures, such as articular cartilage and brain cortex, in three-dimensional (3-D) magnetic resonance (MR) images is an important diagnostic procedure. This paper investigates the fundamental limits on the accuracy of thickness determination in MR images. We defined thickness here as the distance between the two sides of boundaries measured at the subvoxel resolution, which are the zero-crossings of the second directional derivatives combined with Gaussian blurring along the normal directions of the sheet surface. Based on MR imaging and computer postprocessing parameters, characteristics for the accuracy of thickness determination were derived by a theoretical simulation. We especially focused on the effects of voxel anisotropy in MR imaging with variable orientation of sheet-like structure. Improved and stable accuracy features were observed when the standard deviation of Gaussian blurring combined with thickness determination processes was around square root of 2/2 times as large as the pixel size. The relation between voxel anisotropy in MR imaging and the range of sheet normal orientation within which acceptable accuracy is attainable was also clarified, based on the dependences of voxel anisotropy and the sheet normal orientation obtained by numerical simulations. Finally, in vitro experiments were conducted using an acrylic plate phantom and a resected femoral head to validate the results of theoretical simulation. The simulated thickness was demonstrated to be well-correlated with the actual in vitro thickness.

Anatomy, Cross-Sectional↗
PubMed2003

Accuracy evaluation of a shape-based registration method for a computer navigation system for total knee arthroplasty.

This study evaluated the effect of computed tomography (CT) slice thickness, reconstruction pitch, intraoperative data sampling area, and data sampling volume on the accuracy of registration and determined a clinically acceptable trade-off between accuracy and surgical invasiveness. One cadaveric femur and one cadaveric tibia were used. Computed tomography of the femur and tibia were obtained using a helical scanner. Three sets of slice thickness and slice pitch were chosen for data acquisition, and two additional sets of reconstructed data were made. Bone contours were extracted by removing surrounding substrate. Surface models of bones were made from the resulting data. Registration of surface models to real objects was performed by measuring the position of various surface points on various areas of each object using an OPTOTRAK pen-probe (Northern Digital Inc, Ontario, Canada). The following trade-off is proposed as clinically optimal: perform CT with 3-mm slice thickness and 1-mm reconstruction pitch, and sample a periarticular area of 30 sampling points. The accuracy of registration in terms of position and angle was 0.8 mm and 0.6 degrees of bias with 0.2 mm and 0.3 degrees of root-mean-square in the femur, and 0.5 mm and 0.4 degrees of bias with 0.2 mm and 0.3 degrees of root-mean-square in the tibia.

Arthroplasty, Replacement, Knee↗
PubMed2002

A nontoxic chimeric enterotoxin adjuvant induces protective immunity in both mucosal and systemic compartments with reduced IgE antibodies.

A novel nontoxic form of chimeric mucosal adjuvant that combines the A subunit of mutant cholera toxin E112K with the pentameric B subunit of heat-labile enterotoxin from enterotoxigenic Escherichia coli was constructed by use of the Brevibacillus choshinensis expression system (mCTA/LTB). Nasal immunization of mice with tetanus toxoid (TT) plus mCTA/LTB elicited significant TT-specific immunoglobulin A responses in mucosal compartments and induced high serum immunoglobulin G and immunoglobulin A anti-TT antibody responses. Although TT plus native CT induced high total and TT-specific immunoglobulin E responses, use of the chimera molecule as mucosal adjuvant did not. Furthermore, all mice immunized with TT plus mCTA/LTB were protected from lethal systemic challenge with tetanus toxin. Importantly, the mice were completely protected from influenza virus infection after nasal immunization with inactivated influenza vaccine together with mCTA/LTB. These results show that B. choshinensis-derived mCTA/LTB is an effective and safe mucosal adjuvant for the induction of protective immunity against potent bacterial exotoxin and influenza virus infection.

Amino Acid Sequence↗