Search

For assessment of the potential of the Beppu Bay sediments as a Global boundary Stratotype Section and Point (GSSP) candidate for the Anthropocene, we have integrated datasets of 99 proxies. The datasets for the sequences date back 100 years for most proxy records and 1300 years for several records. The cumulative number of occurrences of the anthropogenic fingerprint reveal unprecedented increases above the base of the 1953 flood layer at 64.6 cm (1953 CE), which coincides with an initial increase in global fallout of 239Pu+240Pu. The onset of the proliferation of anthropogenic fingerprints was followed by diverse human-associated events, including a rapid increase in percent modern 14C in anchovy scales, changes in nitrogen and carbon cycling as recorded by anchovy δ15N and δ13C, elevated pollution of heavy metals, increased deposition of novel materials (spheroidal carbonaceous particles, microplastics, polychlorinated biphenyls), the occurrence of hypoxia (Re/Mo ratio) and eutrophication (biogenic opal, TOC, TN, diatoms, chlorophyll a), unprecedented microplankton community changes (compositions of carotenoids, diatoms, dinoflagellates), abnormally high spring air temperatures as inferred from diatom fossils, and lithological changes. These lines of evidence indicate that the base of the 1953 layer is the best GSSP level candidate in the stratigraphy at this site.

Background The joint committee of the Japanese Society of Intensive Care Medicine/Japanese Respiratory Society/Japanese Society of Respiratory Care Medicine on ARDS Clinical Practice Guideline has created and released the ARDS Clinical Practice Guideline 2021. Methods The 2016 edition of the Clinical Practice Guideline covered clinical questions (CQs) that targeted only adults, but the present guideline includes 15 CQs for children in addition to 46 CQs for adults. As with the previous edition, we used a systematic review method with the Grading of Recommendations Assessment Development and Evaluation (GRADE) system as well as a degree of recommendation determination method. We also conducted systematic reviews that used meta-analyses of diagnostic accuracy and network meta-analyses as a new method. Results Recommendations for adult patients with ARDS are described: we suggest against using serum C-reactive protein and procalcitonin levels to identify bacterial pneumonia as the underlying disease (GRADE 2D); we recommend limiting tidal volume to 4–8 mL/kg for mechanical ventilation (GRADE 1D); we recommend against managements targeting an excessively low SpO2 (PaO2) (GRADE 2D); we suggest against using transpulmonary pressure as a routine basis in positive end-expiratory pressure settings (GRADE 2B); we suggest implementing extracorporeal membrane oxygenation for those with severe ARDS (GRADE 2B); we suggest against using high-dose steroids (GRADE 2C); and we recommend using low-dose steroids (GRADE 1B). The recommendations for pediatric patients with ARDS are as follows: we suggest against using non-invasive respiratory support (non-invasive positive pressure ventilation/high-flow nasal cannula oxygen therapy) (GRADE 2D), we suggest placing pediatric patients with moderate ARDS in the prone position (GRADE 2D), we suggest against routinely implementing NO inhalation therapy (GRADE 2C), and we suggest against implementing daily sedation interruption for pediatric patients with respiratory failure (GRADE 2D). Conclusions This article is a translated summary of the full version of the ARDS Clinical Practice Guideline 2021 published in Japanese (URL: https://www.jsicm.org/publication/guideline.html). The original text, which was written for Japanese healthcare professionals, may include different perspectives from healthcare professionals of other countries.

Although diabetic peripheral neuropathy is the most common diabetic microangiopathic complication, several other neuropathy syndromes can occur in the context of diabetes. We describe a rare case of polyneuropathy associated with diabetic ketoacidosis in a patient with new-onset type 1 diabetes. A 42-year-old man with diabetic ketoacidosis was admitted to our hospital with complications of respiratory and renal failure requiring mechanical ventilation and hemodialysis, respectively. After diabetic ketoacidosis improved from the critical state, he developed upper- and lower-limb paralysis with sensory disturbances and pain, as well as right facial paralysis, left recurrent nerve paralysis, and left hypoglossal nerve paralysis. Autonomic nervous function was also impaired. As the pathophysiology, prevention, and treatment of polyneuropathy associated with diabetic ketoacidosis are unclear, the neurologic function of diabetic ketoacidosis patients should be closely monitored.

Aging is closely associated with high morbidity and mortality of various diseasesincluding cardiovascular disease. Cellular senescence has been cruciallyinvolved in the mechanisms underlying age-related diseases, and vascularendothelial cells become senescent during aging. Spermidine, a naturallyoccurring polyamine, is an emerging organic compound that shows various anti-aging effects. Serum spermidine concentration decreases during aging inhuman, and dietary spermidine has been reported to extend healthy lifespanand delay the age-related decline in cognitive and physical performance inmany species such as yeast, worms, flies, and mice. Here, we explored aneffect of spermidine on age-associated decline in angiogenesis. Replicativesenescent ECs were prepared by culturing human ECs for an extended perioduntil passage 18-20, and cellular senescence was confirmed by loss ofproliferation capacity, increased CDK inhibitors expression, and senescence-associated beta-Gal activity. Intracellular polyamine contents were significantlyreduced in replicative senescent ECs, which was recovered by spermidinesupplementation. Spermidine supplementation improved the declinedangiogenic capacities including tube-formation on Matrigel in senescent ECs,while senescence features such as reduced proliferation and senescence-associated beta-Gal activity were not affected. Mechanistically, spermidinesupplementation accelerated the static autophagy flux, and improvedmitochondrial quality, e.g. reduced mitochondrial ROS and preservedmitochondrial membrane potential, in senescent ECs. Ischemia-inducedneovascularization was assessed using the hind-limb ischemia model in youngand aged mice. Blood flow recovery and neovascularization in ischemic musclewere considerably impaired in aged mice comparing to those in young mice. Ofnote, dietary spermidine significantly enhanced ischemia-induced angiogenesis,and improved the blood flow recovery in the ischemic limb, especially in agedmice. Our results reveal new mechanistic insights in anti-aging property ofspermidine, and suggest its therapeutic potential against ischemiccardiovascular disease, particularly in elderly population.

Introduction: The pandemic of coronavirus disease 2019 (COVID-19), induced by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has posed a global health emergency. COVID-19 vaccines are certainly effective to prevent infection, severe disease, and hospitalization; however, its spreading remains to be uncontrolled worldwide. The striking feature of COVID-19 is the high mortality in the elderly; every 1,000 people infected with SARS-CoV-2, around 116 will die if they are mid-seventies or older, while little will die if they are under the age of 50. Though elderly is more fragile than younger people in general, this substantial difference in mortality strongly suggest a specific factor(s) that aggravate the disease in elder people. Systemic thrombosis has been highlighted in the pathogenesis of COVID-19, and lung microangiopathy in association with endothelial cells (ECs) injury has been reported by post-mortem analysis of the lungs. Hypothesis: Senescent endothelial cells are highly susceptible to SARS-CoV-2 infection. Methods: We experimentally investigated the SARS-CoV-2 infection in ECs, and performed a comparative analysis for post-infection molecular events using young and replicative senescent ECs. Results: We identify that; 1) SARS-CoV-2 infects ECs largely through endocytosis, 2) Senescent ECs are highly susceptible to SARS-CoV-2 infection, possibly through enhanced caveolae-mediated endocytosis, 3) SARS-CoV-2 infection alters various genes expression, which could cause EC dysfunctions, 4) More genes expression is affected in senescent ECs by SARS-CoV-2 infection than in young ECs, which might causes further exacerbated dysfunction in senescent ECs, 5) SARS-CoV-2 infection significantly affected coagulation cascade only in senescent ECs. Conclusions: These data strongly suggest that sustained EC dysfunctions due to SARS-CoV-2 infection may contribute to the microangiopathy in the lungs, leading to deteriorated inflammation and thrombosis in COVID-19. Our data also suggest a possible causative role of EC senescence in the aggravated disease in elder COVID-19 patients.

Background: Mild behavioral impairment (MBI) is associated with accelerated cognitive decline and greater risk of dementia. However, the neural correlates of MBI have not been completely elucidated. Objective: The study aimed to investigate the correlation between cognitively normal participants and participants with amnestic mild cognitive impairment (aMCI) using resting-state functional magnetic resonance imaging. Methods: The study included 30 cognitively normal participants and 13 participants with aMCI (20 men and 23 women; mean age, 76.9 years). The MBI was assessed using the MBI checklist (MBI-C). Region of interest (ROI)-to-ROI analysis was performed to examine the correlation between MBI-C scores and functional connectivity (FC) of the default mode network, salience network, and frontoparietal control network (FPCN). Age, Mini-Mental State Examination score, sex, and education were used as covariates. A p-value of 0.05, with false discovery rate correction, was considered significant. Results: A negative correlation was observed between the MBI-C total score and FC of the left posterior parietal cortex with the right middle frontal gyrus. A similar result was obtained for the MBI-C affective dysregulation domain score. Conclusion: FPCN dysfunction was detected as a neural correlate of MBI, especially in the affective dysregulation domain. This dysfunction may be associated with cognitive impairment in MBI and conversion of MBI to dementia; however, further longitudinal data are needed to examine this relationship.

Guided bone regeneration is the most commonly used technique for vertical ridge augmentation (VRA), and it is popular because it is less invasive and highly formative. Since the augmented site is exposed to external pressure, it is preferable to support the membrane using a framework to maintain the shape of the VRA. Recently, a titanium framework–reinforced ultrafine titanium membrane was developed by laser processing technology. The technique allows microperforations to be made (φ20 μm) into a titanium membrane, which is expected to prevent fibrous tissue ingrowth from outside the membrane. In addition, significant bone regeneration was confirmed on ridge defects in previous animal studies. However, the membrane tends to crumple during the bending process, because it is very thin (20 nμm); thus, the bending procedures are technically sensitive. Since this titanium honeycomb membrane was first approved for clinical use in Japan, no international clinical reports have been published. The purpose of this case report is to describe a technical note for a 3-dimensional curvature bending method in VRA using the newly developed honeycomb structure titanium membrane.

Threespine sticklebacks of the genus Gasterosteus, are small teleost fish that are widely distributed across the northern hemisphere. The fish is believed to have two major types of life history, freshwater resident and anadromous; however little is known about their migration ecology. Comprehensive research on the migratory history, habitat use and relative composition of migratory types was conducted by analysing the otolith strontium and calcium concentrations collected in various environments of northern Japan. The present study first demonstrated that approximately 90% of morphologically anadromous sticklebacks had estuarine resident migration pattern, consistently living in brackish water and/or marine environments through their life cycle without any time spent in freshwater. The dominant occurrence of the estuarine resident was temporally and spatially consistent with their general migration ecology. The estuarine resident is thought to be the ancestral migrations of G. aculeatus and G. nipponicus, which thereafter gradually immigrated into freshwater habitats and settled in the anadromous form in both species and finally became the freshwater resident G. aculeatus. Thus, this study provides novel insights into the evolutionary migration of these fish, as well as a new discovery regarding the dominant migratory history and habitat use in threespine sticklebacks.

Patient: Female, 76 Final Diagnosis: Right ventricular free wall rupture Symptoms: Chest pain Medication: — Clinical Procedure: Echocardiography Specialty: Cardiology Objective: Rare disease Background: Ventricular rupture is a complication of acute myocardial infarction (AMI) that results in hemopericardium and cardiac tamponade and has a high mortality rate. Most cases involve the left ventricular free wall, and there have been few previous reports of solitary right ventricular free wall rupture. This report is of a case of fatal right ventricular free wall rupture during percutaneous coronary intervention (PCI) for inferior acute myocardial infarction (AMI). Case Report: A 76-year-old woman underwent emergency coronary angiography following inferior AMI. During angiography and attempted percutaneous coronary intervention (PCI), sudden onset of cardiac arrest occurred due to cardiac tamponade. Blood was drained from the pericardium by pericardiocentesis. Despite of advanced cardiac support, the patient died. The post mortem findings showed a solitary right ventricular free wall rupture due to inferior myocardial infarction. Conclusions: A rare case is presented of right ventricular free wall rupture following AMI that occurred during PCI. This case demonstrates that early diagnosis and management are required to prevent patient mortality.

Sinus floor augmentation (SFA) is the most predictable treatment option in the atrophic posterior maxilla. However, exposure of the apical implant body into the maxillary sinus cavity is an occasionally observed phenomenon after SFA. Although most penetrating dental implants remain completely asymptomatic, they may induce recurrent rhinosinusitis or implant loss. Removal of the implant should be considered if there is significant implant exposure that results in prolonged treatment and increased costs. This case report demonstrates a recovery approach using sinus floor reaugmentation without implant removal in a patient with an apically exposed implant into the maxillary sinus cavity.

Key Clinical Message Neoatherosclerosis is emerging as a stent‐associated problem that has not yet been fully resolved. Because in‐stent restenosis with a neoatherosclerotic etiology is associated with a high risk of acute coronary syndrome and a poor survival prognosis, it is essential to precisely identify patients at risk using advanced imaging modalities.

Patient: Male, 43 Final Diagnosis: Isolated idiopathic inferior mesenteric artery dissection Symptoms: Lower abdominal pain Medication: — Clinical Procedure: — Specialty: Cardiology Objective: Rare disease Background: Isolated dissection of a mesenteric artery is very rare and usually presents with acute gastrointestinal symptoms. There have been previously published reports on the isolated dissection of the superior mesenteric artery. However, isolated dissection of the inferior mesenteric artery is rare. Case Report: A 43-year-old man presented with sudden onset of lower abdominal pain. Abdominal computed tomography (CT) imaging confirmed isolated dissection of the inferior mesenteric artery. To prevent exacerbation of the dissection, his systolic blood pressure was controlled to

BackgroundYamakagashi venom is a prothrombin activator, leading to disseminated intravascular coagulation. We report a fatal case of severe coagulopathy from head trauma assumed to be caused by a yamakagashi bite.Case presentationAn 80-year-old man fell and developed systemic tonic–clonic convulsions. Head computed tomography revealed brain contusion and acute subdural hematoma. Physical examination revealed two bite marks with persistent bleeding on the right lower leg. The patient stated that he had been bitten by some creature 3 days prior, but the bite was left untreated. Laboratory tests showed fibrinogen levels below the detection limit. Although eighteen units of fresh frozen plasma were administered for coagulopathy, fibrinogen levels did not improve. He died about 18 h after a head injury.ConclusionIn this case of a yamakagashi bite with active bleeding due to trauma, early administration of yamakagashi antivenom should be considered to control coagulopathy.

The environmental monitoring survey using this organisms was called “Caddisfly Watch” and this activity has involved both scientists and local people for collecting them. A simple method is needed for the continuous monitoring of radiocesium (137Cs) contamination in riverine environments after the 2011 accident at the Fukushima Dai-ichi Nuclear Power Plant (FDNPP) in Japan. In a program called “Caddisfly Watch”, we used larvae of the caddisfly Stenopsyche marmorata (Trichoptera: Stenopsychidae) to monitor the spatial distribution and estimate effective half-life (Teff) of 137Cs pollution in riverine environments. Caddisfly larvae showed that the highest concentration of 137Cs among several aquatic organisms and no apparent variation between growth stage. In addition, caddisfly larvae reflected 137Cs concentrations in suspended particulate matter in their gut, and that showed no seasonal variation, better reproducibility, and significant correlation with those in sediment. Results indicate that caddisfly larvae can be used as a biological sampler of suspended particulate matters. The Teff values of 137Cs concentrations in caddisfly larvae estimated by single component decay function model showed significant fit. The Teff values in Kuma, Maeda, downstream Niida, upstream Niida, Ohkawa, and Ukedo river showed 2.8, 5.7, 3.1, 6.7, 0.6, and 4.8 years (34, 68, 38, 80, 6.9, and 58 months), respectively. The results of declining trend in this study were similar to those in previous reported in Fukushima. Further continuous observations using this simple approach of “Caddisfly Watch” make it possible to predict the future of the contamination with radioactive Cs in the river environment.

Interoceptive accuracy refers to the ability to consciously perceive the physical condition of the inner body, including one’s heartbeat. In younger adults, interoceptive accuracy is correlated with insular and orbitofrontal cortical connectivity within the salience network (SN). As interoceptive accuracy and insular cortex volume are known to decrease with aging, we aimed to evaluate the correlation between SN connectivity and interoceptive accuracy in older adults. 27 older adults (mean age, 77.29 years, SD = 6.24; 19 female) underwent resting-state functional magnetic resonance imaging, followed by a heartbeat counting task and neuropsychological test. We evaluated the correlation between interoceptive accuracy and SN connectivity with age, sex, cognitive function, and total gray matter volume as covariates. Region of interest-to-region of interest analyses showed that interoceptive accuracy was positively correlated with the functional connectivity (FC) of the left rostral prefrontal cortex with the right insular, right orbitofrontal, and anterior cingulate cortices [F(6,16) = 4.52, false discovery rate (FDR)-corrected p < 0.05]. Moreover, interoceptive accuracy was negatively correlated to the FC of the left anterior insular cortex with right intra-calcarine and visual medial cortices (F(6,16) = 2.04, FDR-corrected p < 0.10). These findings suggest that coordination between systems, with a positive correlation between left rostral prefrontal cortex and the SN and a negative correlation between left insular cortex and vision-related exteroceptive brain regions, is important for maintaining interoceptive accuracy in older adults.

In recent years, concern about the release of anthropogenic organic micropollutants referred to as contaminants of emerging concern (CECs) has been growing. The objective of this study was to find potential CECs by means of an analytical screening method referred to as comprehensive target analysis with an automated identification and quantification system (CTA-AIQS), which uses gas and liquid chromatography combined with mass spectrometry (GC-MS and LC-QTOF-MS). We used CTA-AIQS to analyze samples from a sediment core collected in Beppu Bay, Japan. With this method, we detected 80 compounds in the samples and CTA-AIQA could work to useful tool to find CECs in environmental media. Among the detected chemicals, three PAHs (anthracene, chrysene, and fluoranthene) and tris(isopropylphenyl)phosphate (TIPPP) isomers were found to increase in concentration with decreasing sediment depth. We quantified TIPPP isomers in the samples by means of targeted analysis using LC-MS/MS for confirmation. The concentration profiles, combined with previous reports indicating persistent, bioaccumulative, and toxic properties, suggest that these chemicals can be categorized as potential CECs in marine environments.

Patient: Female, 74-year-old Final Diagnosis: Arteriosclerosis obliterans Symptoms: Skin ulcers Medication: — Clinical Procedure: — Specialty: Cardiology Objective: Unusual or unexpected effect of treatment Background: In practical settings of endovascular treatment (EVT) for below-the-knee arteries, we often encounter cases of severe calcification. To overcome problems regarding device uncrossing due to severe calcifications, a bidirectional approach and subsequent guidewire externalization is one of critical methods. Case Report: A 74-year-old female with refractory skin ulcers on the lower frontal thigh and necrotic toes on the left side showed occlusion in both the anterior tibial artery (ATA) and tibio-peroneal trunk. Both occluded vessels were accompanied with dense calcification. In the process of EVT targeting the occluded ATA, the retrograde guide-wire successfully passed the occlusion and was advanced into the antegrade guide sheath. Next, we attempted guidewire externalization, but severe calcification of the ATA hampered the procedure. Therefore, we introduced a guide extension catheter and a balloon catheter in an antegrade fashion to establish a system of trapping the retrograde guidewire between these devices. Then, we pulled the system back outside the guide sheath, which completed guidewire externalization. We performed prolonged balloon dilatation and finally achieved favorable revascularization of the ATA. Conclusions: Our novel method led to successful retrograde guidewire externalization, overcoming severely calcified lesions. It is generally essential for clinicians to increase their expertise regarding EVT procedures to attain better outcomes.

On April 16, 2016, a series of earthquakes with a maximum magnitude of 7.0 struck Kumamoto Prefecture, Japan, and about 1,300,000 metric tons of land-derived debris (building materials, household appliances, furniture, and wood) required disposal. Because public lands were used as emergency debris storage sites, environmental contamination by organic micropollutants from the debris has been a public concern. To identify chemicals of concern in the soil, our research group used a novel scheme in the combination of comprehensive target analysis (CTA) with an automated identification and quantification system (AIQS) that made use of gas chromatography–mass spectrometry (GC-MS). CTA-AIQS identified a total of 120 organic micropollutants in the soil samples from the debris storage sites. The predominant chemical groups in debris soils were PAHs, plasticizers, and pesticides. Higher concentrations of pesticides (insecticides and fungicides) were detected in soil under waste wood because those chemicals were used as wood preservation and termiticides. Estimated hazard quotients of the detected chemicals via soil ingestion by children (a high-risk group) suggested that the health risk was probably negligible. It was concluded that CTA-AIQS would be a useful tool for emergencies such as natural disasters.

The negative influence of agrochemicals (pesticides: insecticide, fungicide, and herbicide) on biodiversity is a major ecological concern. In recent decades, many insect species are reported to have rapidly declined worldwide, and pesticides, including neonicotinoids and fipronil, are suspected to be partially responsible. In Japan, application of systemic insecticides to nursery boxes in rice paddies is considered to have caused rapid declines in Sympetrum (Odonata: Libellulidae) and other dragonfly and damselfly populations since the 1990s. In addition to the direct lethal effects of pesticides, agrochemicals indirectly affect Odonata populations through reductions in macrophytes, which provide a habitat, and prey organisms. Due to technical restrictions, most previous studies first selected target chemicals and then analyzed their influence on focal organisms at various levels, from the laboratory to the field. However, in natural and agricultural environments, various chemicals co-occur and can act synergistically. Under such circumstances, targeted analyses might lead to spurious correlations between a target chemical and the abundance of organisms. To address such problems, in this study we adopted a novel technique, “Comprehensive Target Analysis with an Automated Identification and Quantification System (CTA-AIQS)” to detect wide range of agrochemicals in water environment. The relationships between a wide range of pesticides and lentic Odonata communities were surveyed in agricultural and non-agricultural areas in Saga Plain, Kyushu, Japan. We detected significant negative relationships between several insecticides, i.e., acephate, clothianidin, dinotefuran, flubendiamide, pymetrozine, and thiametoxam (marginal for benthic odonates) and the abundance of lentic Epiprocta and benthic Odonates. In contrast, the herbicides we detected were not significantly related to the abundance of aquatic macrophytes, suggesting a lower impact of herbicides on aquatic vegetation at the field level. These results highlight the need for further assessments of the influence of non-neonicotinoid insecticides on aquatic organisms.

BACKGROUND As primary percutaneous coronary intervention (PCI) has been commonly performed for acute myocardial infarction (AMI), we rarely encounter ventricular septal rupture (VSR), which is one of the mechanical complications of AMI. However, the associated mortality rate is still very high unless treated appropriately. CASE REPORT We encountered a very rare case of VSR that was considered to have occurred during primary PCI for AMI. The manifestation of sudden coronary flow disturbance may correspond with the emergence of VSR. We introduced a veno-arterial extracorporeal membrane oxygenation (ECMO) system for sudden hemodynamic instability. As a result, the existence of VSR under the operation of the ECMO system led to unusual hemodynamics in the heart, but the vital signs were stabilized by ECMO. VSR was surgically treated and the patient fully recovered without any neurological or physical sequelae. CONCLUSIONS Although we now encounter markedly fewer mechanical complications of AMI in this era of primary PCI, we should always be conscious of its possibility in the acute phase of myocardial infarction.

Background: Oily fish and their extracted oils may be a source of polychlorinated biphenyls (PCBs) which can induce toxic effects on the consumers. The main aim of this survey was estimation of PCBs intake through fish oil-derived dietary supplements and prescription drugs in the Japanese population. Methods: PCBs levels were determined in 20 fish oil-derived dietary supplements and 6 oil-derived prescription drugs from the Japanese market using Gas Chromatography-Mass Spectrometry. Then, the daily exposure to PCBs was estimated. Data were statistically analyzed using JMP software suite. Results: Totally, 17 of the 26 fish oil-derived products were contaminated with PCBs. The median PCB concentrations in the total set of fish oil-derived products was 2.2 ng/g oil wt. with a range of