医療データ解析へのサポートベクトルマシン(SVM)の応用

In our previous papers we proposed a novel screening methodbthat assists the diagnosis of Grave\u27s hyperthyrodism via two types of neural networks by making use of routine test data.This method can be applied by non-specialists during physical check-ups at a low cost and is expected to lead to rapid referrals for examination and treatment by thyroid specialists, that is,toimprove patient\u27QOL. In this report,we apply the support vector machine,which is a novel learning method building on kernels, to the classification problems of madical data such as Wisconsin breast cancer data or our screening of hyperthyroid.It turned out that the support vector machine ,after best turning of parameters based on the grid-search method,works quite well to correctly the lacated in the bordering area between two classes.Our results suggest that the SVM would work as a useful methods in our screening in addition to previous two types of neural networks

Total transferrin in cerebrospinal fluid is a novel biomarker for spontaneous intracranial hypotension

Spontaneous intracranial hypotension (SIH) is caused by cerebrospinal fluid (CSF) leakage. Patients with SIH experience postural headaches, nausea, etc., due to CSF hypovolemia. Imaging studies and clinical examinations, such as radioisotope (RI) scintigraphy, are useful for diagnosing SIH. However, 20-30% of patients do not show typical morphology and clinical test results. We previously reported that CSF contains transferrin (Tf) isoforms:"brain-type" Tf derived from the choroid plexus and "serum-type" Tf derived from blood. We showed that both isoforms increased in the CSF of patients with SIH by Western blotting. In the present study, we demonstrate that conventional ELISA for quantifying total Tf is useful for diagnosing SIH more accurately than Western blotting. In addition, SIH with chronic subdural hematoma (CSDH) was also accurately diagnosed. Total Tf in the CSF can serve as a useful biomarker for diagnosing SIH with or without CSDH

基本的検査からの甲状腺機能亢進症患者のスクリーニング

A complementary study to our former work is performed about screening of the patient with hyperthyroidism using routine test data. The same calculation is done, however, adopting 17 routine tests in addition to former 14 tests. The result adopting 4 routine tests such as ALP, AST, ALT and T-Cho which thyroid specialist often consider as important to suspect hyperthyroidism, is evaluated. The importance of S-Cr to make screening the patients with hyperthyroidism is stressed

Quercetin metabolism by fecal microbiota from healthy elderly human subjects.

Quercetin is a polyphenol found in food that has numerous health benefits. This study investigated the relationship between quercetin metabolism, gut microbiota composition, and dietary intake in elderly Japanese subjects. A food frequency questionnaire was used to assess dietary intake during the week prior to stool sample collection. Fecal suspensions from 56 subjects were anaerobically incubated with quercetin and fecal microbiota composition was analyzed by next-generation sequencing. Inter-individual variations in quercetin concentration and fecal microbiota composition at family level suggested differences in microbial quercetin metabolism. The abundance of Sutterellaceae (r = -0.292) and Oscillospiraceae (r = -0.334) was negatively correlated whereas that of Fusobacteriaceae (r = 0.361) and Enterobacteriaceae (r = 0.321) was positively correlated with quercetin concentration. Niacin (r = -0.313), vitamin B6 (r = -0.297), vitamin B12 (r = -0.266), vitamin D (r = -0.301), and ratio of animal protein to total protein (r = -0.27) were also negatively correlated with quercetin concentration. Bacterial abundance was positively or negatively related to intake of food components. This is the first report describing the relationship between fecal quercetin metabolism, human microbiota, and dietary intake in the elderly

Compensation, insurance, and management of injuries in investigator-initiated clinical trials in Japan

Introduction: The recent revision of the Declaration of Helsinki strengthened the ethical obligation to provide compensation for harm of research subjects. However, the actual status of providing compensation has rarely been disclosed, especially in the situation of investigator-initiated clinical trials (IITs).Objectives: To figure out the actual situation of compensation for injured subjects of IITs in Japan and to identify the necessary steps to fulfill the ethical obligation of compensation.Method: We conducted two types of surveys of compensation in IITs in Japan over the past five years. A: questionnaire survey delivered to 1,700 institutions on (1) number and paid amount of compensation cases; number and amount of contract fees paid to insurance companies; and (2) institutional management system of compensation cases. B: complementary survey to the item (1) of the survey A, at two institutions, on contract fees paid to and insurance paid from insurance companies.Result: In the survey A, we found only two cases of compensation provided, but could not find any serious cases claiming payment from insurance companies, although we could not exclude possibility of undisclosed cases. In the survey B, at the two institutions, a substantial amount of contract fees has been paid to insurance companies without claiming insurance payment; however, the total amount for each institution is less than that expected for one case of a serious injury. Also we found that there remain several points to improve the institutional management system of compensation in IITs in Japan.Conclusion: To provide appropriate compensation for injured subjects of IITs, we need to develop an institutional management system, along with a system to gather statistical information of compensation cases, to achieve proper resource allocation. This system should also provide education for investigators and support staff to manage injury cases