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13. Long-term outcomes of functional single ventricles associated with heterotaxy syndrome†.

Author

Tanimoto, Kazuki, Hoashi, Takaya, Shibagaki, Keisuke, Ono, Yoshikazu, Komori, Motoki, Okuda, Naoki, Imai, Kenta, Iwai, Shigemitsu, and Ichikawa, Hajime

Subjects
NEONATAL surgery, MORTALITY risk factors, PULMONARY veins, OVERALL survival, PATIENTS' rights, OPERATIVE surgery
Abstract

Open in new tab Download slide OBJECTIVES The goal of this study was to determine the long-term surgical outcomes of patients with functional single ventricles associated with heterotaxy syndrome, risk factors for mortality and factors associated with Fontan stage completion. METHODS Overall, 279 patients with a functional single ventricle associated with heterotaxy syndrome who underwent an initial surgical procedure at our institute between 1978 and 2021 were grouped into 4 "eras" based on the surgical year during which the initial procedure was performed: era 1 (1978–1989, n = 71), era 2 (1990–1999, n = 98), era 3 (2000–2009, n = 64) and era 4 (2010–2021, n = 46). Neonatal surgery was more frequent in eras 3 and 4 than in eras 1 and 2. RESULTS Overall, 228 patients had right atrial isomerism; 120 patients (43.0%) had a total anomalous pulmonary venous connection; and 58 patients (20.8%) underwent an initial procedure as neonates. Overall survival rates at 10, 20 and 30 years after the initial procedure were 47.1%, 40.6% and 36.1%, respectively. Neonatal surgery (P  <   0.001), total anomalous pulmonary venous connection repair at the initial procedure (P  <   0.001) and early era (P  <   0.001) were identified as risk factors for mortality, with the last 2 variables being negatively associated with Fontan stage completion (P  <   0.001 for both). CONCLUSIONS Although era had a favourable effect on survival, total anomalous pulmonary venous connection with intrinsic pulmonary vein obstruction was associated with both mortality and Fontan stage completion. Clinical registration number R19092 [ABSTRACT FROM AUTHOR]

Published
2023
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30. A Case Report of Efficiency of Double Filtration Plasmapheresis in Treatment of Goodpasture's Syndrome

Author

Kawai Tatsuo, Kuwabara Atsunori, Abe Michiko, Nagasu Hajime, Okuda Naoki, Sakaguchi Katsuhiko, and Nishi Yuko

Subjects
Adult, Male, Nephrology, medicine.medical_specialty, Pathology, Anti-Glomerular Basement Membrane Disease, medicine.medical_treatment, urologic and male genital diseases, Methylprednisolone, Gastroenterology, Internal medicine, medicine, Goodpasture's syndrome, Humans, Cyclophosphamide, Autoantibodies, medicine.diagnostic_test, business.industry, Glomerulonephritis, Plasmapheresis, Hematology, medicine.disease, Immunoglobulin G, Renal biopsy, Pulmonary hemorrhage, Hemodialysis, business, Immunosuppressive Agents, medicine.drug
Abstract

Goodpasture's syndrome is characterized by pulmonary hemorrhage, rapid progressive glomerulonephritis and the presence of anti-glomerular basement membrane (anti-GBM) antibodies. Here, we report a case of Goodpasture's syndrome that we treated with double filtration plasmapheresis (DFPP) combined with immunosuppression therapy. The patient was a 32-year-old man with the main complaints of low-grade fever, general fatigue and dyspnea. The clinical diagnosis was renal-pulmonary syndrome based on pulmonary hemorrhage on chest X-ray, rapid progressive renal insufficiency, and elevated C-reactive protein (CRP). Goodpasture's syndrome was diagnosed because the patient was negative for MPO-ANCA and PR3-ANCA, and positive for anti-GBM antibodies. Renal biopsy showed crescentic glomerulonephritis. Hemodialysis, immunosuppression therapy (methylprednisolone and cyclophosphamide) and DFPP were performed. Anti-GBM antibodies were followed pre- and post-DFPP, and removal efficiency, cost performance and complications were evaluated. The antibody levels were 121 and 84 EU/mL before and after the first DFPP procedure, respectively, giving a removal efficiency of 24%. Subsequently, the removal efficiencies were 52%, 55% and 60% after the second, third and fourth DFPP procedures. For comparison, the immunoglobulin G (IgG) removal efficiencies were 53%, 57%, 60% and 55% after the four respective DFPP procedures; therefore, the removal efficiencies were similar for anti-GBM antibodies and IgG in all except the first DFPP procedure. The serum anti-GBM antibody and IgG concentrations decreased from pre- to post-DFPP, indicating that DFPP may be an effective therapeutic approach in Goodpasture's syndrome.

Published
2009
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34. 看護師国家試験の語彙の様相 : 日本語能力試験出題基準語彙表との比較から <原著論文>

Author

Okuda, Naoki and Okuda, Naoki

Abstract

This paper focuses on aspects of the vocabulary used in the National Nurse's Examination, which tests the general knowledge of nurses, by comparing it with Test Content Specifications of the Japanese Language Proficiency Test. The results reveal that words used as the standard vocabulary below the level 2 Japanese Language Proficiency Test cover 65% and the level 2 Japanese Language Proficiency Test covers 24.4% of the 36,119 words that appeared in six examinations. However, words used out of the standard vocabulary of the Japanese Language Proficiency Test cover 26.5%. Results also indicate that less than 40% of the words in the standard vocabulary are used in six examinations. Especially, just 24% of the words in the level 1 Japanese Language Proficiency Test are used, and 40.3% of the words in level 2 Japanese Language Proficiency Test are used in six examinations. The results suggest that learners have to learn the vocabularies below level 2 of the Japanese Language Proficiency Test as well as those vocabularies out of the standard vocabulary of Japanese Language Proficiency Test in order to fully comprehend the questions and problems in the National Nurse's Examination. Furthermore, the words in the standard vocabulary of the Japanese Language Proficiency Test, which were also used in the National Nurse's Examination, have some tendencies in the usage.

Published
2011

35. Comparison of long-term outcomes of atrial switch with Rastelli and physiological repair using left ventricle-to-pulmonary artery conduit for levo-transposition of the great arteries.

Author

Ono, Yoshikazu, Hoashi, Takaya, Imai, Kenta, Okuda, Naoki, Komori, Motoki, Tanimoto, Kazuki, Kurosaki, Kenichi, and Ichikawa, Hajime

Abstract

The objectives of this study was to compare the long-term outcomes of anatomic repair using atrial switch with the Rastelli procedure versus physiological repair with left ventricle-to-pulmonary artery conduit for patients with levo-transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction. Of patients with levo-transposition of the great arteries who underwent biventricular repair between 1978 and 2001, 31 hospital survivors after anatomic repair of atrial switch and the Rastelli (anatomic group) and 14 hospital survivors after physiological repair with left ventricle-to-pulmonary artery conduit (physiological group) were enrolled. Survival rates, reoperation rates, and most recent conditions were compared. The overall survival rate at 20 years was 79.7% (95% CI, 66.4%-95.6%) in the anatomic group and 85.1% (95% CI, 68.0%-100%) in the physiological group (P =.87). The reoperation rate at 10 years was 19.8% (95% CI, 5.6%-34.0%) in the anatomic group and 52.0% (95% CI, 25.0%-79.1%) in the physiological group (P =.067). Only patients in the physiological group underwent systemic tricuspid valve replacement. The anatomic group showed a better cardiac index at catheterization (2.79 ± 0.75 L/min/m2 vs 2.30 ± 0.54 L/min/m2; P =.035), lower serum brain natriuretic peptide (73 ± 86 pg/mL vs 163 ± 171 pg/mL; P =.024), and better maximal oxygen uptake in the treadmill test (64.1 ± 16.5% vs 52.7 ± 17.8% of predicted normal; P =.036), although the period until most recent catheterization, blood inspection, and treadmill testing were earlier in the anatomic group. Preservation of the left ventricle as the systemic ventricle using anatomic repair contributes to better cardiopulmonary condition compared with physiological repair. [Display omitted] [ABSTRACT FROM AUTHOR]

Published
2023
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