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Biomedical subjects

Shigeyuki Matsui

Publications and source records attributed to Shigeyuki Matsui.

10 recordsLinked to original sources

Predicting survival outcomes using subsets of significant genes in prognostic marker studies with microarrays.

BACKGROUND: Genetic markers hold great promise for refining our ability to establish precise prognostic prediction for diseases. The development of comprehensive gene expression microarray technology has allowed the selection of relevant marker genes from a large pool of candidate genes in early-phased, developmental prognostic marker studies. The primary analytical task in such studies is to select a small fraction of relevant genes, typically from a list of significant genes, for further investigation in subsequent studies. RESULTS: We develop a methodology for predicting survival outcomes using subsets of significant genes in prognostic marker studies with microarrays. Key components in this methodology include building prediction models, assessing predictive performance of prediction models, and assessing significance of prediction results. As particular specifications, we assume Cox proportional hazard models with a compound covariate. For assessing predictive accuracy, we propose to use the cross-validated log partial likelihood. To assess significance of prediction results, we apply permutation procedures in cross-validated prediction. As an additional key component peculiar to prognostic prediction, we also consider incorporation of standard prognostic factors. The methodology is evaluated using both simulated and real data. CONCLUSION: The developed methodology for prognostic prediction using a subset of significant genes can provide new insights based on predictive capability, possibly incorporating standard prognostic factors, in selecting a fraction of relevant genes for subsequent studies.

Biomarkers↗

Erythropoietin as a retinal angiogenic factor in proliferative diabetic retinopathy.

BACKGROUND: Although vascular endothelial growth factor (VEGF) is a primary mediator of retinal angiogenesis, VEGF inhibition alone is insufficient to prevent retinal neovascularization. Hence, it is postulated that there are other potent ischemia-induced angiogenic factors. Erythropoietin possesses angiogenic activity, but its potential role in ocular angiogenesis is not established. METHODS: We measured both erythropoietin and VEGF levels in the vitreous fluid of 144 patients with the use of radioimmunoassay and enzyme-linked immunosorbent assay. Vitreous proliferative potential was measured according to the growth of retinal endothelial cells in vitro and with soluble erythropoietin receptor. In addition, a murine model of ischemia-induced retinal neovascularization was used to evaluate erythropoietin expression and regulation in vivo. RESULTS: The median vitreous erythropoietin level in 73 patients with proliferative diabetic retinopathy was significantly higher than that in 71 patients without diabetes (464.0 vs. 36.5 mIU per milliliter, P<0.001). The median VEGF level in patients with retinopathy was also significantly higher than that in patients without diabetes (345.0 vs. 3.9 pg per milliliter, P<0.001). Multivariate logistic-regression analyses indicated that erythropoietin and VEGF were independently associated with proliferative diabetic retinopathy and that erythropoietin was more strongly associated with the presence of proliferative diabetic retinopathy than was VEGF. Erythropoietin and VEGF gene-expression levels are up-regulated in the murine ischemic retina, and the blockade of erythropoietin inhibits retinal neovascularization in vivo and endothelial-cell proliferation in the vitreous of patients with diabetic retinopathy in vitro. CONCLUSIONS: Our data suggest that erythropoietin is a potent ischemia-induced angiogenic factor that acts independently of VEGF during retinal angiogenesis in proliferative diabetic retinopathy.

Animals↗

Sample size calculations for comparative clinical trials with over-dispersed Poisson process data.

This paper develops a new formula for sample size calculations for comparative clinical trials with Poisson or over-dispersed Poisson process data. The criteria for sample size calculations is developed on the basis of asymptotic approximations for a two-sample non-parametric test to compare the empirical event rate function between treatment groups. This formula can accommodate time heterogeneity, inter-patient heterogeneity in event rate, and also, time-varying treatment effects. An application of the formula to a trial for chronic granulomatous disease is provided.

Clinical Trials as Topic↗

Stratified analysis in randomized trials with noncompliance.

This article develops methods for stratified analyses of additive or multiplicative causal effect on binary outcomes in randomized trials with noncompliance. The methods are based on a weighted estimating function for an unbiased estimating function under randomization in each stratum. When known weights are used, the derived estimator is a natural extension of the instrumental variable estimator for stratified analyses, and test-based confidence limits are solutions of a quadratic equation in the causal parameter. Optimal weights that maximize asymptotic efficiency incorporate variability in compliance aspects across strata. An assessment based on asymptotic relative efficiency shows that a substantial enhancement in efficiency can be gained by using optimal weights instead of conventional ones, which do not incorporate the variability in compliance aspects across strata. Application to a field trial for coronary heart disease is provided.

Cholesterol↗

Prognostic factor analysis for plaque psoriasis.

BACKGROUND: Little is known about the long-term prognostic factors which affect clinical outcomes after the diagnosis of psoriasis. OBJECTIVE: To identify the prognostic factors which predict long-term outcomes after diagnosis. METHODS: Patients' clinical characteristics at diagnosis were associated with long-term prognosis using the logistic regression method for 169 psoriasis patients (median follow-up time 11.6 years). RESULTS: The factors age > or =40 [odds ratio 0.27, 95% confidence interval (CI) 0.10-0.72, p = 0.0091], male (odds ratio 2.67, 95% CI 1.02-7.00,p = 0.0459) and BMI > or =25 (odds ratio 2.74, 95% CI 1.01-7.42, p = 0.0480) had significant effects on long-term prognosis after diagnosis. A simple prognostic index based on these factors was proposed. CONCLUSIONS: Three major prognostic factors were identified. The proposed index may be useful in the design of future clinical trials for psoriasis and in the selection of appropriate therapeutic approaches for individual patients.

Adolescent↗

Creutzfeldt-Jakob disease and cadaveric dura mater grafts in Japan: an updated analysis of incubation time.

The incubation time for 76 patients with cadaveric dura mater-transmitted Creutzfeldt-Jakob disease reported in Japan by November 2001 was analyzed to clarify its distributional feature and the risk factors which affect the earlier onset of the disease. Cluster analysis indicated that cases could be divided into 3 clusters with respect to the incubation time, i.e., short (1.4-6.2 years), medium (7.0-11.9 years) and long (12.9-17.6 years). The incubation time in females was significantly shorter than those in males. Patients who were transplanted dura mater for facial spasms had a significantly shorter incubation time than those who received transplantation for other diseases including meningioma, aneurysm, or acoustic schwannoma. These results suggest that some host factors may have an influence on the incubation time of the disease.

Cadaver↗

Analysis of times to repeated events in two-arm randomized trials with noncompliance and dependent censoring.

This article develops randomization-based methods for times to repeated events in two-arm randomized trials with noncompliance and dependent censoring. Structural accelerated failure time models are assumed to capture causal effects on repeated event times and dependent censoring time, but the dependence structure among repeated event times and dependent censoring time is unspecified. Artificial censoring techniques to accommodate nonrandom noncompliance and dependent censoring are proposed. Estimation of the acceleration parameters are based on rank-based estimating functions. A simulation study is conducted to evaluate the performance of the developed methods. An illustration of the methods using data from an acute myeloid leukemia trial is provided.

Biometry↗

Functional assessment of self-renewal activity of male germline stem cells following cytotoxic damage and serial transplantation.

Spermatogenesis is dependent on a small population of stem cells. Although stem cells are believed to expand infinitely, there is little functional evidence regarding whether spermatogonial stem cells can increase in their number. Using the spermatogonial transplantation technique, we evaluated the proliferative potential of spermatogonial stem cells in two models of regeneration. After busulfan injection to deplete stem cells, the surviving stem cells were able to expand by at least 15.8-fold within 2 mo. On the other hand, a serial transplantation study indicated that one transplanted stem cell was able to expand by 3.8- and 12-fold within 2 and 4 mo, respectively. These results provide direct functional evidence for the expansion of stem cells and establish the basis for further characterization of the stem cell self-renewal process.

Alkylating Agents↗