亀井 哲也

ICEBPが実施している成人体外循環症例登録の入力項目を日本の実情に合致させた体外循環症例データベースを構築することを目的に各施設における体外循環の実施に関する基本情報を調査した。調査対象施設は、JaSECT正会員が所属する557施設。基本調査項目および体外循環の実施に関する項目の108問を調査した。<BR> 回収率は48％であった。インターネット接続可能な施設は87％。データを取り扱うアプリケーションソフトウェアの所持率は、MS-Excelが81％、次いでFileMaker 51％であった。回路調査において、体外循環記録方法は手書きが最多で53％であった。分離体外循環使用回路は35％であった。無輸血組成の回路充填液は87％であった。<BR> 体外循環症例数はJACVSDの2010年の年間登録数の74％に達し、JaSECT会員の施設がすべて体外循環症例登録事業に参加し、順調に登録数が増加すれば、統計解析機能を早期に提供できると考えられる。<BR> ICEBP等のデータベース項目が日本で共通して使用できると判断できた。また、本邦の開心術症例分類の結果から冠動脈疾患、弁疾患、大動脈疾患に対する体外循環症例がほぼ均等に登録可能であり、世界的に見ても特徴ある疫学的評価が行える環境にある。

To construct a perfusion database in Japan by modifying the input parameters of the adult perfusion registry of the International Consortium for Evidence-based Perfusion (ICEBP) to suit the present status of Japan, we surveyed basic information on perfusion using a questionnaire consisting of 108 questions (basic survey items and items regarding the practice of perfusion) in 557 institutions to which regular members of the Japanese Society of Extra-Corporeal Technology in Medicine (JaSECT) were affiliated.<br>The questionnaire recovery rate was 48%. Access to the Internet was possible in 87% of the responder institutions. As applications for data processing, 81% possessed MS-Excel, and 51% possessed FileMaker. Concerning circuits, handwriting was used for perfusion recording for 53% of circuits, and selective cerebral perfusion was used for 35%. A crystalloid priming solution was used for 87%.<br>The number of perfusion cases in these institutions accounted for 74% of that of registered cases during this year in the Japan Adult Cardiovascular Surgery Database (JACVSD). If all institutions where JaSECT members work participate in the perfusion case registration project, the number of registered cases will steadily increase, and a sufficient statistical power will be achieved early.<br>This survey suggested that the database parameters used by the ICEBP can be used commonly in Japan. In addition, based on the results of the open heart surgery cases in Japan, almost equal numbers of perfusion cases of coronary heart diseases, those of valve disease, and those of aortic diseases can be registered, which allows globally valuable characteristic epidemiological evaluation.

Background: There have been few reports on longitudinal change in activities of daily living (ADL), functional capacity, and life satisfaction in patients with subacute myelo-optico-neuropathy (SMON). Methods: A total of 1309 SMON patients 40 to 79 years of age underwent a medical examination conducted by the SMON Research Committee during the period from 1993 through 1995 (baseline) in Japan; 666 (51%) were followed-up after 12 years and were thus eligible for analysis. We calculated scores for ADL, functional capacity, and life satisfaction at baseline, and at 3, 6, 9, and 12 years after baseline, using data from medical examinations conducted in 1993 through 2007. The Barthel Index, the Tokyo Metropolitan Institute of Gerontology Index of Competence, and the patient&apos;s response to the question "Are you satisfied with life?" were used to assess ADL, functional capacity, and life satisfaction, respectively. Results: As compared with baseline, the mean scores for ADL, functional capacity, and life satisfaction were all significantly lower after 12 years in men and women, with the exception of life satisfaction in women. The change in scores for functional capacity from baseline to year 12 was significantly associated with change in life satisfaction; however, the changes in ADL and age at baseline were not. Conclusions: We observed decreases in ADL, functional capacity, and life satisfaction among SMON patients. Our results suggest that a decrease in life satisfaction can be prevented by maintaining or improving functional capacity.