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Little is known about the ecology of insect species in the hyporheic zone of rivers, despite its importance in understanding how species survive in specialized habitats. We report on the life history and trophic characteristics of the hyporheic stonefly species Alloperla ishikariana Kohno, 1953 (Order: Plecoptera, Family: Chloroperlidae) in a gravel-bed river in northern Japan, using year-round sampling of both benthic and hyporheic larvae, as well as flying adults in the riparian zone. Adults emerged between May and August, and the larval cohort structure consisted of three sized groups with some sex dimorphism in their body size, with an average growth rate of 0.0043 mg/day. Diet analyses based on C and N stable isotope ratios indicated minimal ontogenetic diet shifts. In contrast, the temporal diet shift was more apparent with higher dependence on Oligochaeta in winter, with an increasing dependence on Chironomidae in spring and early summer. Other insect taxa, namely, Leuctridae and small-sized Lepidostoma, demonstrated a high to moderate affinity for the hyporheic zone. Alloperla ishikariana spent most of its larval stage in the hyporheic zone. With adults living from 7 to 10 days, A. ishikariana completes a life span of approximately 3 years with its larval stage in the dark. [ABSTRACT FROM AUTHOR]

Background: The prevalence of Helicobacter pylori infection in Crohn's disease (CD) patients was investigated to determine whether the presence and severity of gastroduodenal lesions were related to H. pylori infection.Methods: Infection rates were compared between CD group (n = 90) and the control group (n = 525). Correlations between endoscopically detected lesions and H. pylori positive rates were investigated. The relationship between drug therapy and the prevalence of H. pylori infection was also analyzed.Results: H. pylori-positive rate of the 90 CD patients attending our clinic was 16.7%, significantly lower than the rate in healthy controls (40.2%) (P = 0.0001). The involvement of H. pylori infection in the gastroduodenal lesions of CD patients was also examined. The prevalence of gastroduodenal lesions in all CD patients was high, 92.2%. The lesions observed included ulcers, erosion, and "bamboo joint-like lesions" of the stomach, and ulcers, erosion, stenosis, and elevated lesions of the duodenum. None of these lesions were found to be related to H. pylori infection. However, H. pylori infection was found to exacerbate gastric ulcers (P = 0.036). The analysis of a possible relationship between a history of drug therapy and the low prevalence of H. pylori infection in CD patients showed that the prevalence of H. pylori infection was significantly lower in patients who had received antibiotics for 2 weeks or more (P = 0.002).Conclusions: The results suggest that H. pylori infection is essentially unrelated to the gastroduodenal lesions observed in CD. It seems likely, however, that H. pylori infection may exacerbate gastric ulcers and that H. pylori can be eradicated by prolonged use of antibiotics. [ABSTRACT FROM AUTHOR]

In Japan, secondary forests associated with agriculture (satoyama) had been maintained traditionally by small-scale clearcutting and short-rotation coppice forestry. After forest management was discontinued due to modernization, shade-intolerant, deciduous trees such as Q. serrata and Q. variabilis have become dominant in many secondary forests of southwestern Japan. In recent years, however, tree death from Japanese oak wilt has become wide-spread. To identify forest communities that will be most affected by oak wilt, we investigated stand structure and species composition in a 64-ha unmanaged secondary forest in Kobe, Japan. We identified three forest communities using cluster analysis of 27 survey plots. We then analyzed and visualized vegetation similarity among the communities using non-metric multidimensional scaling (nMDS). In secondary forests, Pinus densiflora–Rhododendron macrosepalum and Quercus serrata–Quercus variabilis communities, which established after pine wilt were identified. We also found communities dominated by Cryptomeria japonica, a plantation species. We predicted that Quercus serrata–Quercus variabilis communities will experience significant vegetation change after oak wilt and become low-statured, evergreen-deciduous forests. These communities, therefore, should be prioritized for active management by small-scale clear cutting to prevent further spread of oak wilt and subsequent biodiversity decline. [ABSTRACT FROM AUTHOR]

The standard treatment for platinum-sensitive relapsed ovarian cancer (PSROC) is platinum-based chemotherapy followed by olaparib monotherapy. A retrospective study was conducted to identify factors affecting the survival of patients with PSROC undergoing olaparib monotherapy in real-world clinical settings. The study enrolled 122 patients who received olaparib monotherapy between April 2018 and December 2020 at three national centers in Japan. The study used the Kaplan–Meier method and univariable and multivariable Cox proportional hazards models to evaluate the associations between factors and progression-free survival (PFS). Patients with BRCA1/2 mutations had a significantly longer median PFS than those without these mutations. Both the BRCA1/2 mutation-positive and mutation-negative groups exhibited a prolonged PFS when the platinum-free interval (PFI) was ≥ 12 months. Cancer antigen 125 (CA-125) level within reference values was significantly linked to prolonged PFS, while a high platelet-to-lymphocyte ratio (≥ 210) was significantly associated with poor PFS in the BRCA1/2 mutation-negative group. The study suggests that a PFI of ≥ 12 months may predict survival after olaparib monotherapy in patients with PSROC, regardless of their BRCA1/2 mutation status. Additionally, a CA-125 level within reference values may be associated with extended survival in patients without BRCA1/2 mutations. A larger prospective study should confirm these findings. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about the prognostic factors for survival after endoscopic submucosal dissection (ESD) in elderly patients with early gastric cancer (EGC). The aim of this study is to determine prognostic factors and a prediction model of 3-year survival after ESD for EGC in patients aged ≥ 85 years. Methods: We retrospectively evaluated the clinical outcomes of 740 patients with EGC aged ≥ 85 years, who were treated by ESD at 30 institutions in Japan. Overall survival (OS) and disease-specific survival (DSS) were calculated with the Kaplan–Meier method. Prediction models for 3-year OS after ESD were estimated using the Cox proportional hazards model based on Uno's C-statistics. Results: During the follow-up period, 309 patients died of any cause and 10 patients died of gastric cancer. OS and DSS after 3 years were 82.7% and 99.2%, respectively. No significant differences in OS were found among curability categories. The Cox proportional hazards model revealed the geriatric nutritional risk index (GNRI) and the Charlson comorbidity index (CCI) to be predictors of 3-year survival. We established a final model (EGC-2 model) expressed by GNRI − (2.2×CCI) with a cutoff value of 96. The overall survival rate was significantly lower in the model value < 96 group than in the model value ≥ 96 group (P < 0.001). Conclusions: The prediction model using GNRI and CCI will be useful to support decision-making for the treatment of EGC in elderly patients aged ≥ 85 years. [ABSTRACT FROM AUTHOR]

Background: Hyporesponsiveness to erythropoiesis-stimulating agents (ESAs) has been highlighted as a potential risk factor for cardiovascular disease in patients with chronic kidney disease (CKD). Methods: We assessed cross-sectionally the prevalence, associated factors, and treatment status of anemia and ESA hyporesponsiveness in 4460 non-dialysis-dependent CKD patients enrolled in a multicenter cohort in Japan. Anemia was defined as a hemoglobin (Hb) level of less than 11 g/dL or receiving ESA therapy. ESA hyporesponsiveness was defined by the erythropoietin-resistance index (ERI), which was the erythropoietin dose per week divided by body weight and Hb level (U/kg/week/g/dl). Results: Of the 4460 patients, 1050 (23.5%) had anemia. ESAs were administered to 626 patients, reaching a percentage of 57.5% of patients with stage G5 CKD. However, the ESA treatment rate was only 49.0% in patients with a hemoglobin level of < 11 g/dL. The proportion of patients receiving iron supplementation was lower than that of patients receiving ESAs regardless of CKD stage or hemoglobin level, and a significant proportion of patients did not receive iron supplementation, even those with iron deficiency. The ERI increased with CKD stage progression, and the multiple regression analysis showed that age, female sex, body mass index, cholesterol, glomerular filtration rate, and intact parathyroid hormone level were independent contributors. Conclusions: Our findings demonstrate that many Japanese patients with non-dialysis-dependent CKD receiving ESAs fail to maintain adequate hemoglobin levels. These results suggest the need for interventions for ESA hyporesponsiveness factors in addition to iron supplementation. [ABSTRACT FROM AUTHOR]

Animals affect element cycling in ecosystems by consumption and excretion. Amphidromous shrimps frequently dominate low-mid altitude streams, where downstream connectivity to oceans is sustained. Although shrimps' direct influence on benthic communities has been studied, little is known about their influences on nutrient cycling. Here, we hypothesized that the dominance of shrimps alters nutrient mineralization by benthic macroinvertebrates in streams due to the difference in the quality and quantity of excretion between shrimps and aquatic insects. We tested this hypothesis through a field manipulative experiment, excretion measurements of animals, and field surveys. In the field manipulative experiment, the presence of shrimps slightly decreased the biomass of aquatic insects but tripled total benthic macroinvertebrate biomass directly through their own biomass. The mass-specific NH4+ excretion rate by shrimps was similar to aquatic insects, and the areal NH4+ excretion by benthic macroinvertebrates was increased by 2.5 times in the presence of shrimps. In contrast, shrimps excreted significantly less soluble reactive phosphorus (SRP) than aquatic insects, and the presence of shrimps did not affect areal SRP excretion by benthic macroinvertebrates. The field survey showed a positive correlation of NO3− concentration with the shrimp density, inferring the excess NH4+ was nitrified. Although the nutrient concentration of stream water is frequently attributed to watershed conditions, the results of this study indicate that downstream connectivity to oceans may also influence nutrient dynamics of the stream through the density of amphidromous shrimps. [ABSTRACT FROM AUTHOR]

Recent studies have shown that an increase in the population size of sika deer (Cervus nippon) decreases the abundance of rodents but increases that of several invertebrates (Scarabaeidae, Rhaphidophoridae, and earthworms) outside a deep-proof fence in Oku-Nikko, Japan. Therefore, the diet of red foxes (Vulpes vulpes) feeding on these animals is expected to vary according to changes in prey abundance. As red foxes also scavenge deer carcasses, an increase in the number of deer is expected to lead to changes in the red fox diet. In this study, the diet and sightings of red foxes inside and outside the fence were compared. Generalized linear mixed models indicate that the sika deer remains, ground-dwelling insects (Scarabaeidae and Rhaphidophoridae as a group, and Carabidae), and earthworms increased in the fox diet outside the fence, while the ingestion of voles decreased. The difference in prey consumption by red foxes was probably caused by differences in prey availability inside and outside the fence or the presence of available alternative food. These results suggest that red foxes demonstrate dietary plasticity in areas where habitat structure has been substantially modified by deer grazing. Although the abundance of voles, the primary food of red foxes, decreased outside the fence, the sighting rates of red foxes obtained by spotlight count were not significantly different between inside and outside the fence, suggesting that the presence of the others increased or available alternative food may have compensated for the negative effects of decreasing vole abundance. [ABSTRACT FROM AUTHOR]

Background: Hyporesponsiveness to erythropoiesis-stimulating agents (ESAs) is associated with cardiovascular events and poor renal outcome in patients with chronic kidney disease (CKD). This study aimed to investigate the initial responsiveness to darbepoetin alfa (DA) and its contributing factors using the data from the BRIGHTEN. Methods: Of 1980 patients enrolled at 168 facilities, 1695 were included in this analysis [285 patients were excluded mainly due to lack of hemoglobin (Hb) values]. The initial ESA response index (iEResI) was defined as a ratio of Hb changes over 12 weeks after DA administration per weight-adjusted total DA dose and contributing factors to iEResI were analyzed. Results: The mean age was 70 ± 12 years (male 58.8%; diabetic nephropathy 27.6%). The median creatinine and mean Hb levels at DA initiation were 2.62 mg/dL and 9.8 g/dL, respectively. The most frequent number of DA administration during 12 weeks was 3 times (41.1%), followed by 4 (15.6%) times with a wide distribution of the total DA dose (15–900 μg). Remarkably, 225 patients (13.3%) did not respond to DA. Multivariate analysis showed that male gender, hypoglycemic agent use, iron supplementation, high eGFR, low Hb, low CRP, low NT-proBNP, and low urinary protein–creatinine ratio were independently associated with better initial response to DA (P = < 0.0001, 0.0108, < 0.0001, 0.0476, < 0.0001, 0.0004, 0.0435, and 0.0009, respectively). Conclusions: Non-responder to DA accounted for 13.3% of patients with non-dialysis CKD. Iron supplementation, low CRP, low NT-proBNP, and less proteinuria were predictive and modifiable factors associated with better initial response to DA. [ABSTRACT FROM AUTHOR]

Overabundant deer populations have direct and indirect effects on forest vegetation. For forest regeneration, it is important to identify the response of tree seedlings to deer browsing following a reduction in deer density. We examined the effects of deer density, dwarf bamboo coverage, light availability, and tree species on seedling survival and growth inside and outside deer-excluding fences, from 2009 to 2011 in a cool-temperate mixed forest on Hokkaido Island, Japan. The occurrence probability of browsing was high in the plots with high pellet density. Bamboo coverage decreased significantly with increased pellet density. The survival rate of seedlings was negatively affected by both the occurrence of browsing and bamboo coverage. The growth of seedlings was negatively affected by the occurrence of browsing. Our study showed that deer browsing had both a direct negative effect by decreasing seedling survival and an indirect positive effect by reducing bamboo coverage. These results suggest that we should examine browsing intensity and the response of forest vegetation and recognize the competitive and facilitative effects of neighbouring plants on tree seedlings. [ABSTRACT FROM AUTHOR]

Background: Previous studies have suggested that a healthy lifestyle (HL) may prolong the years of life spent in good health. However, the impact of HL on disability-free survival (DFS) among the elderly is still uncertain.Objective: To investigate the relationship between HL and DFS in the general elderly population.Design: Prospective cohort study with a 10-year follow-up (2006-2016).Participants: 9910 community-dwelling elderly people (≥ 65 years).Main Measures: A HL index derived by summing the number of HL behaviors. Data on incident disability were retrieved from the public Long-term Care Insurance database. Multivariate-adjusted 50th percentile differences (PDs) in age at disability or death (months) and their 95% CIs were estimated with the Laplace regression model.Key Results: During the 10 years, 4562 disability or death events occurred. Participants who adhered to all three HL behaviors lived 17.1 (95% CI 12.7, 21.5) months longer without disability than those who adhered to zero or one. Each 1-point increase of the index score conferred 8.8 months additional life without disability. The tendency for the 50th PDs to increase with a higher HL index score did not differ according to age (< 75 or ≥ 75 years), sex, or the presence of chronic conditions (none, or ≥ 1 chronic condition).Conclusions: A combination of HL behaviors may substantially increase DFS, even for late-elderly (≥ 75 years), or elderly people with chronic conditions. [ABSTRACT FROM AUTHOR]

A large number of children with developmental disorders like autism spectrum disorder (ASD), learning disabilities, and attention deficit hyperactivity disorder have high anxiety. It has also been shown that the high anxiety has harmful effects on them, directly and indirectly. In this study, we conducted a survey on community samples on the level of anxiety of children with developmental disorders in Japan that had hardly been studied so far, and compared them with the anxiety in children in a general population sample in previous studies. Analysis on the 203 participants showed that children with developmental disorders have high anxiety as compared to children as in previous studies in other countries. Particularly children with ASD had a higher anxiety compared with children with developmental disorders without ASD. [ABSTRACT FROM AUTHOR]

Background: This post-marketing surveillance (PMS) study evaluated the safety and effectiveness of long-term darbepoetin alfa (darbepoetin) for the treatment of renal anemia in Japanese non-dialysis chronic kidney disease patients.Methods: Patients were treated with darbepoetin and followed up for 3 years. Adverse events (AEs), adverse drug reactions (ADRs), hemoglobin (Hb) levels, and renal function were assessed. Patients were stratified by Hb level at the time of occurrence of cardiovascular-related AEs. Statistical analyses were performed to explore factors affecting the occurrence of AEs, cardiovascular-related AEs, and composite renal endpoints.Results: In the safety analysis set (5547 patients), AEs and ADRs occurred in 44.4 and 7.1% of patients, respectively. Cardiovascular-related AEs were observed in 12.6% of the overall population. The proportion of patients who presented cardiovascular-related AEs was lower among those with a higher Hb level at the time of occurrence. In the effectiveness analysis set (5024 patients), mean Hb levels remained between 10.0 and 10.6 g/dL (Weeks 4-156). Three months after darbepoetin administration, patients with Hb ≥ 11 g/dL presented fewer composite renal endpoints than those with Hb < 11 g/dL (p = 0.0013), and the cumulative proportion of renal survival was higher in those with Hb ≥ 11 g/dL vs. Hb < 11 g/dL (p < 0.0001).Conclusions: This PMS study showed the safety and effectiveness of long-term use of darbepoetin in a large number of patients. Patients with Hb ≥ 11 g/dL presented fewer composite renal endpoints than those with Hb < 11 g/dL, without an increase in the incidence of cardiovascular-related AEs. [ABSTRACT FROM AUTHOR]

Background: In this study, survival and cause of death were investigated in patients with Crohn's disease (CD) at a tertiary referral center.Methods: A database was created based on the medical records of 1108 CD patients who had a history of visiting our hospital to investigate background characteristics, cumulative survival rates from diagnosis, causes of death, and the standardized mortality ratio (SMR) for each cause of death. A follow-up questionnaire survey of patients followed up inadequately was also conducted. The cumulative survival rate from diagnosis was determined using the life table method and compared with that of a sex- and age-matched population model from the year 2000.Results: The study included 1108 patients whose mean age at diagnosis was 25.6 ± 10.8 years. The mean duration of follow-up was 14.6 ± 9.4 years, and there were 52 deaths. The cumulative survival rate was significantly lower 25 years after the diagnosis of CD (91.7%) than in the standard population model (95.7%). SMRs for both all causes [3.5; 95% confidence interval (CI): 2.7-4.6] and CD-specific causes (36.7; 95% CI 26.1-51.6) were high. Among the CD-specific causes, SMRs were especially high for small intestine and colorectal cancers, gastrointestinal diseases including intestinal failure (IF), perioperative complications, and amyloidosis.Conclusion: The SMRs for both all causes and CD-specific causes were high in CD patients. CD-specific causes including intestinal cancer, IF, perioperative complications, and amyloidosis showed especially high SMRs. [ABSTRACT FROM AUTHOR]

The young leaves of Clethra barbinervis Sieb. et Zucc, which is a deciduous tree species found in secondary forests widely in Japan, are used in spring as a local traditional food by local populations, and the bark of this plant is also preferred by sika deer, Cervus nippon. However, C. barbinervis has been known to accumulate heavy metals in its leaves. Then, we aimed to clarify the characteristics of microelement contents in C. barbinervis and to discuss the value of this species as food for humans and animals through the analysis of seasonal changes and distribution in various organs of C. barbinervis growing under two different geological conditions. We found that C. barbinervis is an accumulating and tolerant plant for Ni, Co and Mn. It accumulates Ni from serpentine soil containing Ni at high concentration, and Co and Mn from acidic soils based on crystalline schist. The seasonal variation in element concentrations in leaves indicates that the young leaves contain Cu at high concentration and that eating them in spring season may be advantageous to humans, due to the associated increase in Cu intake. The high concentrations of Cu and Zn in the bark of C. barbinervis might explain why deer prefer to eat the bark of this species. [ABSTRACT FROM AUTHOR]

Irreversible shifts in ecosystems caused by large herbivores are becoming widespread around the world. We analyzed data derived from the 2009-2010 Sika Deer Impact Survey, which assessed the geographical distribution of deer impacts on vegetation through a questionnaire, on a scale of 5-km grid-cells. Our aim was to identify areas facing irreversible ecosystem shifts caused by deer overpopulation and in need of management prioritization. Our results demonstrated that the areas with heavy impacts on vegetation were widely distributed across Japan from north to south and from the coastal to the alpine areas. Grid-cells with heavy impacts are especially expanding in the southwestern part of the Pacific side of Japan. The intensity of deer impacts was explained by four factors: (1) the number of 5-km grid-cells with sika deer in neighboring 5 km-grid-cells in 1978 and 2003, (2) the year sika deer were first recorded in a grid-cell, (3) the number of months in which maximum snow depth exceeded 50 cm, and (4) the proportion of urban areas in a particular grid-cell. Based on our model, areas with long-persistent deer populations, short snow periods, and fewer urban areas were predicted to be the most vulnerable to deer impact. Although many areas matching these criteria already have heavy deer impact, there are some areas that remain only slightly impacted. These areas may need to be designated as having high management priority because of the possibility of a rapid intensification of deer impact. [ABSTRACT FROM AUTHOR]

Background: In Japan, Crohn's disease (CD) is diagnosed according to a single, well-established set of diagnostic criteria. However, no nationwide attempt has been made to determine which specific criteria within these diagnostic criteria are used to make diagnoses. Methods: A questionnaire-based survey was conducted of patients given a definitive or suspected diagnosis of CD before January 2011 according to the Japanese Diagnostic Criteria for Crohn's Disease. The survey included 579 patients with a definitive diagnosis of CD and 59 patients with a suspected diagnosis of CD at 34 Japanese medical institutions. Results: A total of 87.4 % of definitive diagnoses of CD were based on the criterion in the definite category: major finding A 'longitudinal ulcer (LU)' or B 'cobblestone-like appearance (CSA)'. A total of 30.4 % of definitive diagnoses were based on the criterion: major finding C 'non-caseating epithelioid cell granuloma (NCEG)' with minor finding a 'irregularshaped and/or quasi-circular ulcers or aphthous ulcerations found extensively in the gastrointestinal tract' or b 'characteristic perianal lesions'. Finally, 7.1 % of definitive diagnoses were made according to the criterion: all minor findings a, b and c 'characteristic gastric and/or duodenal lesions'. Among suspected diagnoses of CD, 74.6 % were based on the criterion in the suspected category: one or two minor findings. Conclusions: The Japanese diagnostic criteria for Crohn's disease consist of combinations of specific morphological findings. Many of the diagnoses were based on the findings of LU or CSA. [ABSTRACT FROM AUTHOR]

Landscape change is of crucial ecological importance because of its impacts on biodiversity and the sustainability of habitats and landscapes. The ability to infer ecological processes from landscape changes provides a powerful new tool for large-scale and regional ecological research. Accordingly, we investigated landscape changes in Nikko National Park (Japan) from 1981 to 2006 using an integration of remote sensing images to track ecological processes in the park. We showed that natural succession and anthropogenic disturbance have caused an enormous expansion of coniferous forest (mostly Larix kaempferi and Tsuga diverifolia), which has resulted in an alteration of sika deer ( Cervus nippon) habitat structure. The deer population has vastly increased in size, with concomitantly negative effects on the biodiversity of forest-floor vegetation. All changes that we detected have degraded landscape and ecosystem sustainability. Our integrated use of remote sensing images in 2006 accurately identified and classified landscape pattern in the study area. We achieved an overall accuracy of 96.48%, demonstrating that the procedure has an enormous potential for synthetic processing of multitemporal and multiresource remote sensing images. [ABSTRACT FROM AUTHOR]

Crohn's disease is a disorder of unknown etiology and complicated pathogenesis. A substantial amount of evidence has accumulated recently and has been applied to clinical practice. The present guidelines were developed based on recent evidence and the formal consensus of experts relevant to this disease. Here we provide an overview of these guidelines, as follows. These guidelines were intended primarily to be used by practitioners in Japan, and the goal of these guidelines is to improve the outcomes of patients with Crohn's disease. [ABSTRACT FROM AUTHOR]

We reviewed articles on the epidemiology and clinical characteristics of gastroesophageal reflux disease (GERD) in Japan to clarify these features of GERD in this country. Although the definition of GERD depends on the individual study, the prevalence of GERD has been increasing since the end of the 1990s. The reasons for the increase in the prevalence of GERD may be due to increases in gastric acid secretion, a decrease in the Helicobacter pylori infection rate, more attention being paid to GERD, and advances in the concept of GERD. More than half of GERD patients had non-erosive reflux disease, and the majority (87%) of erosive esophagitis was mild type, such as Los Angeles classification grade A and grade B. There were several identified risk factors, such as older age, obesity, and hiatal hernia. In particular, mild gastric atrophy and absence of H. pylori infection influence the characteristics of GERD in the Japanese population. We also discuss GERD in the elderly; asymptomatic GERD; the natural history of GERD; and associations between GERD and peptic ulcer disease and H. pylori eradication. We examined the prevalence of GERD in patients with specific diseases, and found a higher prevalence of GERD, compared with that in the general population, in patients with diabetes mellitus, those with obstructive sleep apnea syndrome, and those with bronchial asthma. We provide a comprehensive review of GERD in the Japanese population and raise several clinical issues. [ABSTRACT FROM AUTHOR]

There is increasing awareness of nonerosive reflux disease (NERD) as a disease requiring treatment in Japan. This randomized, double-blind, placebo-controlled, parallel-group study was conducted to investigate the efficacy and safety of omeprazole 10 mg and 20 mg once daily in Japanese patients with NERD. Patients with heartburn for at least 2 days a week during the month before entry into the study and no endoscopic signs of a mucosal break (grade M or N according to Hoshihara’s modification of the Los Angeles classification) were randomly assigned to one of three groups (omeprazole 10 mg or 20 mg, or placebo) once daily for 4 weeks. Overall, 355 patients were enrolled, of whom 284 were randomly assigned to one of the three groups (omeprazole 10 mg, n = 96; omeprazole 20 mg, n = 93; placebo, n = 95). The rate of complete resolution of heartburn in week 4 was significantly higher in patients treated with omeprazole 10 mg [32.3%, 95% confidence interval (CI), 22.9%–41.6%] or 20 mg (25.8%, 95% CI, 16.9%–34.7%) than in the placebo group (12.0%, 95% CI, 5.3%–18.6%). No significant difference between the two omeprazole groups was observed. The rate of complete resolution of heartburn by omeprazole was similar between patients with grade M and those with grade N esophagus. Omeprazole also increased the rate of sufficient relief from heartburn. Omeprazole was well tolerated. Omeprazole 10 mg or 20 mg once daily is effective and well tolerated in patients with NERD regardless of their endoscopic classification. [ABSTRACT FROM AUTHOR]

This article presents a report on APNOMS 2007, which was held October 10-12, 2007 in Sapporo, Japan. The theme of APNOMS 2007 was ''Managing the Next Generation Networks and Services.'' [ABSTRACT FROM AUTHOR]

In recent years, various endoscopic treatments have become available to treat gastroesophageal reflux disease (GERD) in Western countries. The Stretta procedure, which uses radiofrequency energy, is one type of safe and effective endoluminal treatment for GERD. However, the feasibility, safety, and efficacy of the Stretta procedure in Japanese patients with GERD, who differ from Western peoples in their physiological characteristics, are not known. In 2006, we imported a Stretta system from the United States and investigated important clinical aspects of the system in Japanese patients with GERD. This study was an open-label trial that enrolled patients with GERD who desired to undergo the Stretta procedure. Heartburn scores, medication use, overall satisfaction with the procedure, and adverse events were evaluated. Nine patients received the Stretta treatment between February and September 2006. Esophagogastroduodenoscopy just after treatment revealed a remarkable reduction in the expansion of the gastric cardia and small erosions in all patients. At 3 or 6 months after treatment, heartburn scores were significantly improved compared with pretreatment scores (5.0 ± 1.7 pretreatment vs. 0.7 ± 1.4 posttreatment, P = 0.007). In six of nine patients (66.7%), treatment significantly ( P = 0.009) decreased medication use. There were no major adverse events. All patients were satisfied with this treatment. The Stretta procedure safely reduced GERD symptoms and decreased medication use in Japanese patients with GERD. This treatment may thus be very useful for such patients, and it is hoped that a nationwide trial will be undertaken in Japan to obtain more extensive data. [ABSTRACT FROM AUTHOR]

In Japan, nutritional therapy as both a primary and as a secondary treatment is widely used for Crohn's disease (CD). The rationale for its use is based on a variety of reasons. The first is its ability to induce remission and to ameliorate the activity of intestinal lesions in the short term by enteral (EN) or by parenteral nutritional therapy in which overexpressions of chemokine receptors in an active stage are decreased significantly in the remission stage. Seeond is its ability to maintain remission over the long term through home-based enteral nutrition in which tube feeding during the nighttime is encouraged. Third is its ability to reduce the steroid dosage over the period of a long-term treatment course. However, several disadvantages of this therapy such as unpalatability and sluggish effect have been pointed out. Several studies have attempted to resolve this issue and determine the best components of EN. especially in fat composition. Some data have been suggestive of too much long-chained fatty acid having a hazardous effect on EN"s clinical efficacy because it works as a precursor of inflammatory prostaglandins. Our recent data show that medium-chained triglyeeride did not have such a hazardous effect on clinical effieacy. Several studies suggested that the patient factors that were resistant to inducing remission in the short term were a long period of suffering CD. a high aetivity (on Crohn's Disease Activity Index, CDAI). hemorrhagic colitis, and colitis with marked cobblestoning. Japanese guidelines for the treatment of CD recommended nutritional therapy as a Hrst-Iine therapy and as a maintenance therapy after inducing remission. This treatment policy has led to Japanese CD patients having lower mortality rates than that of patients who do not receive EN. If this therapy could be combined with other drug therapies, including strong immunosuppressants, treatment strategies would be improved over those we have at present. [ABSTRACT FROM AUTHOR]

Reports on the 32nd annual meeting of the Japanese Society of Neuroradiology on February 26 to 28, 2004 in Ibaraki, Japan. Categories of contributed papers.

Studies the effects of additives on the thermal gelation of the common squid natural actomyosin in surimi-based products in Japan. Possibility that the gel elasticity decreases because the myosin heavy chain is degraded when surimi or natural actomyosin is prepared from Japanese common squid meat; Analysis of pertinent topics and relevant issues; Implications on fisheries sciences.

The Jōmon period/culture corresponds to the Neolithic period/culture in Japanese prehistory. The Sannai-Maruyama site (5.9–4.2 cal. kyr BP), the most famous, the largest, and the well-studied mid-Holocene (mid-Jōmon) archeological site inhabited by hunter-gatherers with sedentary lifestyle in northern Japan, started at early Bond event 4 and collapsed at late Bond event 3 (4.2 cal. kyr BP at the boundary between mid-Holocene, Northgrippian, and late-Holocene, Meghalayan), synchronous with the decline of the north Mesopotamian civilization and the Yangtze River civilization in China. Alkenone sea surface temperatures (SSTs), a proxy for early-midsummer SSTs, generally suggest that the early-midsummer SSTs (and atmospheric temperatures (ATs)) at 41° 00′ N, 140° 46′ E, about 20 km north to the Sannai-Maruyama site, located in Aomori Prefecture, peaked around 4.8–4.3 cal. kyr BP and showed minima at 5.9 and 4.1 cal. kyr BP. In spite of some discrepancy in short periods, this feature is consistent with that estimated from the assemblages of Ostracodas. δ18O value of benthic foraminifera of Nonionellina labradorica and Nonionella stella, alkenone production flux, and pollen assemblages could reflect annual-based temperature, which generally suggests that the climate was warmer at 6.0–4.2 cal. kyr BP, which could show the warmer environments at 6.0–5.0 cal. than expected from alkenone SST in early-midsummer. Overall, northward shift of the westerly jet, in association with a strengthened East Asian Summer Monsoon, could cause a relatively warm climate around 6.0–4.3 cal. kyr BP, when the Sannai-Maruyama site flourished. High food production density, by effective hansaibai (selective preservation or growth) in Castanea- and Aesculus-dominated forests, up to one sixth of the rice production density, could have supported high population density, resulting large community at the Sannai-Maruyama site. Cooling episode at 4.2 cal. kyr BP could have resulted in the decline of chestnut hansaibai, leading to the collapse of the site. Recent results from a compiled archeological site map suggested no large decline of the population but, instead, a dispersal to the surrounding area at 4.2 cal. kyr BP. It is consistent with ancestral population dynamics for the descendent from Jōmon people, in contrast to those from the immigrants from Far East Asia to the Japanese Archipelago with paddy rice cultivation technology after 2.9 cal. kyr BP, based on modern Japanese molecular sequences. [ABSTRACT FROM AUTHOR]

Stratigraphic and paleontological investigations in Mugi Town, on the Pacific coast of Shikoku Island, revealed evidence of as many as five tsunami inundations from events along the Nankai Trough between 5581 and 3640 cal yr BP. Nine event deposits (E1–E9) were identified in cores ranging in length from 2 to 6 m, consisting of sandy and gravelly layers interbedded with organic-rich mud. Sedimentary structures in the event deposits observed by computed tomography included normal grading and sharp lower stratigraphic contacts. Event deposits E3, E6, E7, and E8 contained mainly brackish-marine diatom species, suggesting that they had been deposited during inundation by seawater. In addition, fossil diatom assemblages were markedly different above and below event deposits E3, E4, E6, and E8. For example, assemblages below event deposit E6 were dominated by a freshwater species (Ulnaria acus), whereas assemblages above it were predominantly brackish-marine (Diploneis smithii, Fallacia forcipata, and Fallacia tenera). We attributed these changes to the increase of marine influence due to coastal subsidence associated with subduction-zone earthquakes, as documented in the 1946 Showa-Nankai earthquakes. We conclude that event deposits E3, E6, and E8 and perhaps E4 and E7 were deposited by tsunamis generated by subduction zone earthquakes along the Nankai Trough. The ages of these event deposits, as constrained by ten radiocarbon ages, suggest that some of the tsunamis that impacted Mugi Town were correlated with those reported elsewhere along the Nankai Trough, thereby complementing the existing but still incomplete geological record for these events. [ABSTRACT FROM AUTHOR]

The article comments on the cost-effectiveness analyses of utilizing proton-pump inhibitors and of using step-up strategy for gastroesophageal reflux disease (GERD) in Japanese patients. The article explains that cost-effectiveness analyses done in areas other than Japan may not be applicable to Japan since the medical system and medical costs differ from other countries. The author concludes that the analyses is important for those carrying out medical treatment of patients with GERD in Japan.