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.

保健統計に基づいて,糖尿病と高血圧の受療者数について,1995〜2002年の年次推移を観察した.また,複数の保健統計を組み合わせて,受療の有無別の有病者数の推移を検討し,これらの推移について,人口の年齢構成を調整した場合も検討した.糖尿病の年次推移は,通院者数と主傷病通院者数が増加傾向,総患者数と1日患者数がほぼ横ばい傾向であった.高血圧の年次推移は,通院者数が増加傾向,主傷病通院者数,総患者数と1日患者数が減少傾向であった.入口の年齢構成を調整すると,通院者数は糖尿病で増加傾向,高血圧でほぼ横ばい傾向となった.有病者数は両疾患ともに増加傾向で,人口の年齢構成を調整すると糖尿病で増加傾向,高血圧で減少傾向となった.有病者の受療割合は両疾患ともに20%程度で,やや上昇傾向であった

The mean mammary gland dose, which is used as an index of the dose of exposure to radiation in mammography, is obtained by multiplying the in-air exposure on the entrance surface by the absorbed dose conversion factor. Sobol et al. reported a method of calculating the absorbed dose conversion factor that is determined by x-ray quality(tube voltage and half-value layer), compressed dreast thickness, and breast composition. A method of calculating mean mammary gland dose, however, has not been established, and no software for estimation of the dose of exposure to radiation in mammography has been developed. Recently, the authors developed software for the estimation of exposure dose that can be easily used in a facility without a dosimeter. They confirmed that the use of this new software enabled the calculation of meanmammary gland dose based on the mammary gland ratio. In a facility without measurement equipment such as a dosimeter, a user can estimate the exposure dose without difficulty simply by entering the exposure conditions. Furthermore, half-value layer, in-air exposure, and conversion factor can be calculated by using the newly developed software. This technique seemed to be sufficienlty useful if a user simply estimates'exposure dose.