Objective: To identify factors associated with the absence of cervical spine instability in patients with rheumatoid arthritis (RA). Methods: Cervical spine instability was defined as the presence of at least one of the following: atlantoaxial subluxation, vertical subluxation of the axis, or subaxial subluxation. In 2001–2002, 634 enrolled outpatients with “classical” or “definite” RA underwent a radiographic cervical spine checkup. In 2012–2013, 233 (36.8%) prospectively underwent routine clinical follow-ups with a >10-year radiographic evaluation. The prevalence and independent predictive factors for no instability were analyzed by multivariable logistic regression. Next, 85 of 292 outpatients (29.1%) without baseline cervical spine instability completed consecutive >5-year and >10-year radiographic examinations. The incidence and predictors for no new development of instability were assessed similarly. Results: Among 233 patients, those without cervical spine instability decreased from 114 (48.9%) to 47 (20.2%) during >10 years. Steinbrocker peripheral joint destruction stages I–II (odds ratio [OR], 3.797; p=0.001), no corticosteroid administration (OR, 2.700; p=0.007), and no previous joint surgery (OR, 2.480; p=0.020) were predictors for no instability. Then, 33 of 85 (38.8%) consecutively followed patients without baseline cervical spine lesions did not develop instability throughout. Steinbrocker stages I–II (OR, 5.355; p=0.005) and no corticosteroid therapy (OR, 3.868; p=0.010) were predictors for no new onset of instability. C-reactive protein (CRP) level≤1.0 mg/dL was marginal in both models (n=233 [OR, 2.013; p=0.057], n=85 [OR, 2.453; p=0.075]). Conclusion Steinbrocker stages I–II, no corticosteroids, no previous joint surgery, and possibly CRP ≤1.0 mg/dL are factors associated with >10-year absence of cervical spine instability in RA.

Objective: To identify factors associated with the absence of cervical spine instability in patients with rheumatoid arthritis (RA). Methods: Cervical spine instability was defined as the presence of at least one of the following: atlantoaxial subluxation, vertical subluxation of the axis, or subaxial subluxation. In 2001–2002, 634 enrolled outpatients with “classical” or “definite” RA underwent a radiographic cervical spine checkup. In 2012–2013, 233 (36.8%) prospectively underwent routine clinical follow-ups with a >10-year radiographic evaluation. The prevalence and independent predictive factors for no instability were analyzed by multivariable logistic regression. Next, 85 of 292 outpatients (29.1%) without baseline cervical spine instability completed consecutive >5-year and >10-year radiographic examinations. The incidence and predictors for no new development of instability were assessed similarly. Results: Among 233 patients, those without cervical spine instability decreased from 114 (48.9%) to 47 (20.2%) during >10 years. Steinbrocker peripheral joint destruction stages I–II (odds ratio [OR], 3.797; p=0.001), no corticosteroid administration (OR, 2.700; p=0.007), and no previous joint surgery (OR, 2.480; p=0.020) were predictors for no instability. Then, 33 of 85 (38.8%) consecutively followed patients without baseline cervical spine lesions did not develop instability throughout. Steinbrocker stages I–II (OR, 5.355; p=0.005) and no corticosteroid therapy (OR, 3.868; p=0.010) were predictors for no new onset of instability. C-reactive protein (CRP) level≤1.0 mg/dL was marginal in both models (n=233 [OR, 2.013; p=0.057], n=85 [OR, 2.453; p=0.075]). Conclusion Steinbrocker stages I–II, no corticosteroids, no previous joint surgery, and possibly CRP ≤1.0 mg/dL are factors associated with >10-year absence of cervical spine instability in RA.

Objective: To identify factors associated with the absence of cervical spine instability in patients with rheumatoid arthritis (RA). Methods: Cervical spine instability was defined as the presence of at least one of the following: atlantoaxial subluxation, vertical subluxation of the axis, or subaxial subluxation. In 2001–2002, 634 enrolled outpatients with “classical” or “definite” RA underwent a radiographic cervical spine checkup. In 2012–2013, 233 (36.8%) prospectively underwent routine clinical follow-ups with a >10-year radiographic evaluation. The prevalence and independent predictive factors for no instability were analyzed by multivariable logistic regression. Next, 85 of 292 outpatients (29.1%) without baseline cervical spine instability completed consecutive >5-year and >10-year radiographic examinations. The incidence and predictors for no new development of instability were assessed similarly. Results: Among 233 patients, those without cervical spine instability decreased from 114 (48.9%) to 47 (20.2%) during >10 years. Steinbrocker peripheral joint destruction stages I–II (odds ratio [OR], 3.797; p=0.001), no corticosteroid administration (OR, 2.700; p=0.007), and no previous joint surgery (OR, 2.480; p=0.020) were predictors for no instability. Then, 33 of 85 (38.8%) consecutively followed patients without baseline cervical spine lesions did not develop instability throughout. Steinbrocker stages I–II (OR, 5.355; p=0.005) and no corticosteroid therapy (OR, 3.868; p=0.010) were predictors for no new onset of instability. C-reactive protein (CRP) level≤1.0 mg/dL was marginal in both models (n=233 [OR, 2.013; p=0.057], n=85 [OR, 2.453; p=0.075]). Conclusion Steinbrocker stages I–II, no corticosteroids, no previous joint surgery, and possibly CRP ≤1.0 mg/dL are factors associated with >10-year absence of cervical spine instability in RA.

Objective: To identify factors associated with the absence of cervical spine instability in patients with rheumatoid arthritis (RA). Methods: Cervical spine instability was defined as the presence of at least one of the following: atlantoaxial subluxation, vertical subluxation of the axis, or subaxial subluxation. In 2001–2002, 634 enrolled outpatients with “classical” or “definite” RA underwent a radiographic cervical spine checkup. In 2012–2013, 233 (36.8%) prospectively underwent routine clinical follow-ups with a >10-year radiographic evaluation. The prevalence and independent predictive factors for no instability were analyzed by multivariable logistic regression. Next, 85 of 292 outpatients (29.1%) without baseline cervical spine instability completed consecutive >5-year and >10-year radiographic examinations. The incidence and predictors for no new development of instability were assessed similarly. Results: Among 233 patients, those without cervical spine instability decreased from 114 (48.9%) to 47 (20.2%) during >10 years. Steinbrocker peripheral joint destruction stages I–II (odds ratio [OR], 3.797; p=0.001), no corticosteroid administration (OR, 2.700; p=0.007), and no previous joint surgery (OR, 2.480; p=0.020) were predictors for no instability. Then, 33 of 85 (38.8%) consecutively followed patients without baseline cervical spine lesions did not develop instability throughout. Steinbrocker stages I–II (OR, 5.355; p=0.005) and no corticosteroid therapy (OR, 3.868; p=0.010) were predictors for no new onset of instability. C-reactive protein (CRP) level≤1.0 mg/dL was marginal in both models (n=233 [OR, 2.013; p=0.057], n=85 [OR, 2.453; p=0.075]). Conclusion Steinbrocker stages I–II, no corticosteroids, no previous joint surgery, and possibly CRP ≤1.0 mg/dL are factors associated with >10-year absence of cervical spine instability in RA.

Objective: To identify factors associated with the absence of cervical spine instability in patients with rheumatoid arthritis (RA). Methods: Cervical spine instability was defined as the presence of at least one of the following: atlantoaxial subluxation, vertical subluxation of the axis, or subaxial subluxation. In 2001–2002, 634 enrolled outpatients with “classical” or “definite” RA underwent a radiographic cervical spine checkup. In 2012–2013, 233 (36.8%) prospectively underwent routine clinical follow-ups with a >10-year radiographic evaluation. The prevalence and independent predictive factors for no instability were analyzed by multivariable logistic regression. Next, 85 of 292 outpatients (29.1%) without baseline cervical spine instability completed consecutive >5-year and >10-year radiographic examinations. The incidence and predictors for no new development of instability were assessed similarly. Results: Among 233 patients, those without cervical spine instability decreased from 114 (48.9%) to 47 (20.2%) during >10 years. Steinbrocker peripheral joint destruction stages I–II (odds ratio [OR], 3.797; p=0.001), no corticosteroid administration (OR, 2.700; p=0.007), and no previous joint surgery (OR, 2.480; p=0.020) were predictors for no instability. Then, 33 of 85 (38.8%) consecutively followed patients without baseline cervical spine lesions did not develop instability throughout. Steinbrocker stages I–II (OR, 5.355; p=0.005) and no corticosteroid therapy (OR, 3.868; p=0.010) were predictors for no new onset of instability. C-reactive protein (CRP) level≤1.0 mg/dL was marginal in both models (n=233 [OR, 2.013; p=0.057], n=85 [OR, 2.453; p=0.075]). Conclusion Steinbrocker stages I–II, no corticosteroids, no previous joint surgery, and possibly CRP ≤1.0 mg/dL are factors associated with >10-year absence of cervical spine instability in RA.

Objectives : We analyzed the mortality and morbidity of congenital heart surgery in Japan by using Japan Cardiovascular Surgery Database (JCVSD). Methods : The congenital heart surgery performed between January 2017 to December 2018 were obtained from JCVSD. From the data obtained, the most frequent twenty procedures were selected, and the mortalities and major morbidities were analyzed. In addition, all the procedures were classified into STAT Mortality Categories and mortalities in each category were also analyzed. Results : The mortality of ASD repair and VSD repair were 0% and 0.2% respectively. The mortality of TOF repair, complete AVSD repair, Rastelli operation, CoA complex repair, bidirectional Glenn, TCPC were 2-3%. The mortality of systemic to pulmonary shunt was 4.9%, and the mortality of TAPVC repair and Norwood procedure were 11.1% and 15.7% respectively and not different from the results of 2015-2016. The mortalities according to the STAT categories 1-5 were 0.3%, 2.7%, 2.9%, 5.9% and 15.5% respectively and comparable to those of STS database (2013-2016). Conclusion : The analysis of the JCVSD-congenital data revealed the mortality rate of major surgical procedures for congenital heart disease performed in Japan in 2017-2018, the frequency of complications, and the mortality rate by STAT Mortality Categories. We believe that these statistics will play an important role as a basis for trends in Japan and for comparison of results with other countries.

Methods : We collated the nationwide data on congenital heart operations performed between January 2015 and December 2016 from the Japan Cardiovascular Surgery Database (JCVSD). The mortality and morbidity data for the 20 most-frequently performed procedures were analyzed. We also classified the surgical centers into three groups, according to the number of cardiopulmonary cases over a year and estimated the institution-wise distribution of major operations. Results : The mortality rate of the ASD and VSD repair procedures was ＜1%, while the mortality rate of procedures including TOF repair, complete AVSD repair, Rastelli operation, CoA complex repair, bidirectional Glenn and TCPC was found to be between 2-3%. The mortality rate of surgeries such as the Norwood procedure and TAPVC repair was comparably higher (＞10%). These complicated procedures were mainly performed at the surgical institutes handling a large volume of cases. Conclusion : Using the JCVSD, the nationwide data of congenital heart surgery, including postoperative complications, were analyzed.

Objectives : We analyzed the mortality and morbidity of congenital heart surgery in Japan by using the Japan Cardiovascular Surgery Database (JCVSD). Methods : Data regarding congenital heart surgery performed between January 2013 and December 2014 were obtained from JCVSD. The 20 most frequent procedures were selected and the mortality rates and major morbidities were analyzed. Results : The mortality rates of atrial septal defect (ASD) repair and ventricular septal defect (VSD) repair were less than 1%, and the mortality rates of tetralogy of Fallot (TOF) repair, complete atrioventricular septal defect (AVSD) repair, bidirectional Glenn, and total cavopulmonary connection (TCPC) were less than 2%. The mortality rates of the Norwood procedure and total anomalous pulmonary venous connection (TAPVC) repair were more than 10%. The rates of unplanned reoperation, pacemaker implantation, chylothorax, deep sternal infection, phrenic nerve injury, and neurological deficit were shown for each procedure. Conclusion : Using JCVSD, the national data for congenital heart surgery, including postoperative complications, were analyzed. Further improvements of the database and feedback for clinical practice are required.