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The Japan Marine Science and Technology Center (JAMSTEC), the Ocean Research Institute, University of Tokyo and the Laboratoire de Ge´ologie, Ecole Normale Supe´rieure at Paris carried out in collaboration a 120-channel reflection seismic survey using an airgun array with total 4200 cubic inch capacity around the eastern Nankai trough in 1996. Data obtained by R/V Hakuho, University of Tokyo were primarily processed by JAMSTEC and were shared by the above three main bodies of this program to complete geoscientific interpretation. The fault configuration around the eastern Nankai trough is very complicated due to the collision of the Izu Peninsula against central Japan. The major remarkable faults around the eastern Nankai area are the Zenisu, the Kodaiba and the Tokai thrusts. The main objective of this paper is to clarify these fault configurations. The Zenisu thrust dips gently northward from the southern slope of the Zenisu ridge, and reaches the oceanic Moho. The location of the Tokai thrust may jump at the Tenryu canyon, and appears to reach the top of the subducting oceanic plate. The Kodaiba fault penetrates a 5.5–5.6-km/s layer, which is the crust of the central Japan forearc. A large fault in the trough axis cuts the entire oceanic crust and has a flower structure, which indicates that it has strike-slip component. Its strike is NW–SE, parallel to the plate motion and perpendicular to the strike of the Zenisu ridge. The top of the subducting oceanic crust of the Philippine Sea plate was defined beneath the continental slope of the central Japan forearc. The angle of subduction becomes abruptly steeper 50 km north of the deformation front. We also observed at the southern roof of the Zenis thrust a drape fold structure which is proof of subduction. We suggest a subduction on the southern side of the Zenisu ridge, strongly deformed oceanic crust at the trough axis and some major faults in the forearc region reaching subducting oceanic crust. [Copyright &y& Elsevier]

Background: The risk of restenosis after intervention is higher in femoropopliteal than in aortoiliac lesions. However, the appropriate endovascular therapy (EVT) for preventing restenosis after intervention for femoropopliteal lesions remains unknown. This study aimed to elucidate the relationship between lesion characteristics and patency after EVT using intravascular ultrasound (IVUS) measurement and to determine the predictors of restenosis on IVUS., Methods and results: This prospective observational study was performed at 18 Japanese centers. We evaluated the lesion characteristics before and after EVT for femoropopliteal lesion using IVUS. Angiographic or duplex ultrasound follow-up was performed at 1 year after EVT. A total of 263 lesions underwent EVT between December 2016 and December 2017. In total, 20 lesions (8 cases of isolated common femoral artery lesion and 12 cases of restenosis lesion) were excluded, and 243 lesions were enrolled in this study. A total of 181 lesions were treated with stent placement, and 62 lesions were treated only with balloon angioplasty. In the case of stent use, a larger distal plaque burden was associated with restenosis, while a lower calcification angle was associated with higher patency in the case of balloon angioplasty alone., Conclusions: The factors related to patency differed depending on the treating modality. The findings suggest that IVUS is a useful tool for predicting patency because it can provide a more accurate evaluation after EVT for femoropopliteal lesions.

Background: Low birth weight (LBW) is a risk factor for chronic kidney disease (CKD) in later life and is becoming increasingly common in developed countries, including Japan. Furthermore, a serial decrease in birth weight has been associated with an increasing prevalence of CKD stage 2 in male Japanese adolescents. Sex-specific differences affect CKD susceptibility, and the association between birth weight and CKD in women, has not been elucidated. In this study, we investigated the sex-specific effect of LBW on renal function., Methods: Annual cross-sectional data of 2417 Japanese adolescents (males 1736; females 681), aged 15-16 years, were evaluated over 8 years (2007-2014)., Results: Over the study period, mean birth weights decreased significantly in males (p < 0.01) and females (p < 0.05). Furthermore, both sexes showed significant decrease in estimated glomerular filtration rates corresponding to the birth weight reduction. The prevalence of CKD stage 2 also increased in males (from 26.0 to 32.4%, p < 0.01) and females (from 6.3 to 18.5%, p < 0.05). The incidence of CKD stage 2 was significantly related to history of LBW (males: odds ratio 1.73; 95% confidence interval 1.06-2.80; p < 0.05; females: odds ratio 3.29; 95% confidence interval 1.25-8.02; p < 0.05)., Conclusions: Our data revealed that renal function and birth weight have decreased over time, in healthy Japanese adolescents. In view of the recent declining trend demonstrated by birth weight in Japan, we speculate that the prevalence of CKD might increase in the future.

A prospective, multicentre, open-label, blinded-endpoint, randomized controlled study was conducted to evaluate the efficacy of treatment with ipragliflozin (sodium-dependent glucose transporter-2 inhibitor) versus metformin for visceral fat reduction and glycaemic control among Japanese patients with type 2 diabetes treated with sitagliptin, HbA1c levels of 7%-10%, and body mass index (BMI) ≥ 22 kg/m 2 . Patients were randomly assigned (1:1) to receive ipragliflozin 50 mg or metformin 1000-1500 mg daily. The primary outcome was change in visceral fat area as measured by computed tomography after 24 weeks of therapy. The secondary outcomes were effects on glucose metabolism and lipid metabolism. Mean percentage reduction in visceral fat area was significantly greater in the ipragliflozin group than in the metformin group (-12.06% vs. -3.65%, P = 0.040). Ipragliflozin also significantly reduced BMI, subcutaneous fat area, waist circumference, fasting insulin, and homeostatic model assessment (HOMA)-resistance, and increased HDL-cholesterol levels. Metformin significantly reduced HbA1c and LDL-cholesterol levels and increased HOMA-beta. There were no severe adverse events. The use of ipragliflozin or metformin in combination with dipeptidyl peptidase-4 inhibitors, widely used in Japan, may have beneficial effects in ameliorating multiple cardiovascular risk factors., (© 2019 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)

Aim: Laparoscopic sleeve gastrectomy (LSG) has proven to be the most effective strategy for the treatment of morbid obesity, however its efficacy and safety in an aging population has not yet been confirmed. In this study, we evaluated the effectiveness and safety of LSG in elderly obese Japanese patients., Methods: Three obese individuals aged >60 years and 11 obese individuals aged <60 years who underwent LSG were enrolled. Pre- and postoperative changes after at least 12 months were examined, including bodyweight, body mass index, total weight loss, excess weight loss, bone mineral density and bone-related markers., Results: There were no significant differences between patients aged <60 years and >60 years in terms of percent total weight loss (24.4 ± 11 vs 23 ± 4.4%, respectively) and percent excess weight loss (49.1 ± 23.4 vs 47.6 ± 10 %, respectively). Dual-energy X-ray absorptiometry was carried out before and 12 months after LSG. There were no significant differences in bone mineral density changes at the lumbar spine and femoral neck between the two groups (0.01 ± 0.06 vs 0.02 ± 0.03 g/cm 2 , -0.03 ± 0.06 vs -0.08 ± 0.02 g/cm 2 , respectively). There were no peri- and postoperative complications. All three patients aged >60 years had reduced bone mineral density in the femoral neck after LSG; one was diagnosed with osteoporosis., Conclusions: Although the present results suggest that LSG could be of considerable benefit to elderly obese Japanese patients, long-term careful observation after bariatric surgery is especially important in elderly patients to prevent future osteoporosis. Geriatr Gerontol Int 2017; 17: 2068-2073., (© 2017 Japan Geriatrics Society.)

Introduction: Although helicopters have been used in an air ambulance system for the past decade in Japan, the appropriate selection of patients for this transport mode has not been investigated. The present study investigates which patients could potentially benefit the most from helicopter emergency medical service (HEMS)., Methods: We investigated the extent of circulatory and respiratory support required in the intensive care unit (ICU) and ultimate outcomes of 2340 patients with cardiovascular disease admitted to 1 institution between October 2001 and December 2009. Two hundred and seventy were transported by HEMS (HEMS group), and 2070 were transported by other means (non-HEMS group)., Results: Temporary cardiac pacing, ventilator management, intra-aortic balloon pumping, percutaneous cardiopulmonary support, electrical defibrillation, and therapeutic hypothermia were more frequently required by patients in the HEMS group vs. the non-HEMS group (10.4%, 28.1%, 17.0%, 5.2%, 10.0% and 3.4% vs. 8%, 17.9%, 10.9%, 2.3%, 4.5% and 0.4%, respectively). The mortality rate was higher in the HEMS group than in the non-HEMS group in the ICU (9.6% vs. 5.3%)., Conclusion: Disease was more clinically severe and the outcome was poorer among patients with cardiovascular diseases transported by HEMS than by other means., (Copyright © 2011 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.)

The elevation of the concentration of tissue free water tritium (TFWT) in pine needles was discernible in trees growing around a nuclear power plant. The values varied from 2.6 Bq/l to 6.1 Bq/l with a mean value of 3.8 Bq/l. Analysis of pine needles collected at Fukui City as control samples was done. The values averaged 1.7 Bq/l and fell within 1.5 B/l-1.8 Bq/l which was obtained nation-wide survey of TFWT in pine needles in Japan. The present study also revealed that reactor tritium incorporated into pine needles decreased rapidly with a half time of 6 days and then tissue free water tritium has a short retention time.