High Levels of Tetrodotoxin in the Flesh, Usually an Edible Part of the Pufferfish Takifugu flavipterus, Caused by Migration from the Skin and the Regional Characteristics of Toxin Accumulation

The consumption of a pufferfish, Takifugu flavipterus or komonfugu in Japanese, formerly known as Takifugu poecilonotus, is popular in Japan. However, T. flavipterus is frequently involved in cases of tetrodotoxin (TTX) poisoning in Japan. Although victims have usually consumed inedible parts, some cases are related to consumption of flesh. To improve the risk management of pufferfish poisoning, we studied TTX level in the flesh and skin of T. flavipterus. Ninety-seven specimens obtained from the Seto Inland Sea and landed in Fukuoka Prefecture were analyzed by liquid chromatography-tandem mass spectrometry. The flesh from six specimens was toxic (>10 MU/g = 2.2 mg/kg): one was in poor condition (not freeze–thawed); three were freeze–thawed before sample preparation; and two freshly prepared and in good condition (not freeze–thawed). The fillets were divided into outer and inner portions; the TTX levels in the outer portions were notably higher. The skin of the six specimens was moderately to extremely toxic: 165 MU/g (36.3 mg/kg) in the fresh specimen not in good condition, 600–950 MU/g (132–200 mg/kg) in freeze–thawed specimens, and 4500 and 6000 MU/g (990 and 1320 mg/kg) in the two fresh specimens. We concluded that TTX in the flesh migrated from the highly toxic skin. In addition, TTX levels in the skin appeared to be regionally specific. We recommend that toxic portions of T. flavipterus are removed as soon as possible after individuals are caught, and that fish from known highly toxic areas are not consumed.

Elucidating variations in outcomes among older end-stage renal disease patients on hemodialysis in Fukuoka Prefecture, Japan

Variations in health care outcomes and services potentially indicate resource allocation inefficiency. Therefore, this study was conducted to examine variations in mortality and hospitalization cases among end-stage renal disease (ESRD) patients receiving hemodialysis (HD) care from medical facilities located in 13 secondary medical care areas (SMAs) of Fukuoka prefecture, Japan. The research was designed as a retrospective, cross-sectional study using insurance claims data. The subjects of the study were older patients (over 65 years old) insured by the Fukuoka prefecture’s Latter-Stage Elderly Healthcare Insurance. Using an electronic claims database, we identified patients with chronic kidney disease (CKD) who had received HD care from April 1, 2017 to March 31, 2018. The CKD status was identified using International Classification of Disease, 10th revision code, and HD maintenance status was ascertained using specific insurance procedure codes. A total of 5,243 patients met our inclusion criteria and their records were subsequently reviewed. About 73% (n = 3,809) of patients had admission records during the period studied. Thus, the data regarding hospital length of stay (LOS) and admission costs were analyzed separately. Significant differences in terms of increased risks in hospitalization were evident in a number of SMAs. An increase in mortality risk due to heart failure and malignancy was observed in two separate SMAs. Also, analyzed LOS, total hospitalization cost, and cost per day according to SMAs showed statistically significant variations. The findings highlight the magnitude of the burden of CKD and ESRD in the community. The high prevalence of ESRD, associated mortality, and hospitalized HD patients signal the need for clinicians to assume broader roles in measures against chronic kidney disease through involvement in community awareness programs. To improve patient outcomes, improvement of regional health care provision, the level of medical care, and the development of existing human resources are needed.

Stress state inferred from b-value and focal mechanism distributions in the aftershock area of the 2005 West Off Fukuoka Prefecture earthquake

The spatiotemporal stress states in the aftershock region of the 2005 west off Fukuoka prefecture earthquake are examined via an analysis of the b -values and focal mechanism solutions. The aftershocks are aligned roughly NW–SE, with the southeastern part of the aftershock region believed to correspond to Kego Fault, which extends beneath the Fukuoka metropolitan area. This study reveals depth-dependent b -values in the focal region, where the b -values ( b = 0.7–1.4) are generally higher above the mainshock depth (9.5 km) and lower ( b = 0.5–1.0) at greater depths. The shallower region possesses a significant temporal increase in b -values, whereas a lateral b -value heterogeneity is observed in the deeper region. The b -values ( b ~ 1.0) near the mainshock are relatively high, whereas the northwestern and southeastern edges of the deep region have lower b -values ( b = 0.5–0.7). On the other hand, many of the focal mechanisms for the M ≥ 3.5 events are located in the low b -value area of the deep region. The stress-tensor inversion results reveal a change in stress state from strike-slip to strike-slip/normal faulting . These findings imply that the stress state remains high and/or slightly decreased in the northwestern and southeastern parts of the deep region. These results and the findings of previous research on this earthquake sequence suggest that the likelihood of future large earthquakes along the southeastern part of the aftershock region should be considered relatively high.

Spatial Distribution of Drifted-wood Hazard following the July 2017 Sediment-hazards in the Akatani river, Fukuoka Prefecture, Japan

In recent years, heavy rainfall leading to floods, landslides and debris-flow hazards have had increasing impacts on communities in Japan, because of climate change and structural immobilism in a changing and ageing society. Decreasing rural population lowers the human vulnerability in mountains, but hazards can still leave the mountain to the plains and sea, potentially carrying drifted-wood. The aim of the paper is to measure the distribution of wood-debris deposits created by the 2017 Asakura disaster and to rethink the distribution and spatial extension of associated disaster-risk zoning. For this purpose, the authors: (1) digitized and measured the distribution of drifted-wood, (2) statistically analyzed its distribution and (3) calculated the potential impact force of individual drifted timber as a minimal value. The results have shown that there is a shortening of the wood debris as they travel downstream and that the geomorphology has an important control over deposition zones. The result of momentum calculation for different stems’ length show spatially differentiated hazard-zones, which limit different disaster-risk potentials. From the present finding, we can state that we (1) need to develop separate strategies for sediments and wood debris (2) and for wood hazards, zonations can be generated depending on the location and the size of the deposited trees that differs spatially in a watershed.

A questionnaire-based survey to evaluate and improve the current HHT medical and social condition in Japan

Background: Hereditary hemorrhagic telangiectasia (HHT) is a genetic systemic vascular disease affecting multiple organs and shows recurrent intractable symptoms. This disease has not been widely recognized in Japan until recently. Both diagnosed HHT patients and potential ones have faced difficulties because of the unfamiliarity with the disease in Japan. To evaluate the effect and degree of such a Japanese situation, a questionnaire-based survey was executed in this study. Methods: This survey was carried out among the members of HHT Japan Association. The organization consisted of 102 members (as of 6/2019), mainly HHT patients and their family members. A questionnaire was used to gather demographic data, the effort to reach the diagnosis, and information regarding current patients’ and their families’ medical managements. Results: Of the 102 questionnaires distributed, we have got 56 responses. The participants were mostly female (30) with an average age of 55.4 ± 14.8 (mean ± standard deviation [SD]) years. The average age of males was 53.5 ± 16.4. Relatively many HHT patients were born in huge cities such as Tokyo, Osaka, and Fukuoka Prefecture (n = 4 to 8 patients). The duration between the initial symptoms and the definite diagnosis was 8.8 ± 10.9 years. The number of hospitals involved in the final diagnosis was 2.38 ± 1.83. More than 70% of patients now have to visit at least two departments and 24% of HHT patients did not want their family to screen for HHT. Conclusion: HHT medical practice in Japan should be further modified, for example, by establishing HHT centers and educating primary care physicians and HHT patients.