The evolution of cancer genomic medicine in Japan and the role of the National Cancer Center Japan

The journey to implement cancer genomic medicine(CGM)in oncology practice began in the 1980s,which is considered the dawn of genetic and genomic cancer research.At the time,a variety of activating oncogenic alterations and their functional significance were unveiled in cancer cells,which led to the development of molecular targeted therapies in the 2000s and beyond.Although CGM is still a relatively new discipline and it is difficult to predict to what extent CGM will benefit the diverse pool of cancer patients,the National Cancer Center(NCC)of Japan has already contributed considerably to CGM advancement for the conquest of cancer.Looking back at these past achievements of the NCC,we predict that the future of CGM will involve the following:1)A biobank of paired cancerous and non-cancerous tissues and cells from various cancer types and stages will be developed.The quantity and quality of these samples will be compatible with omics analyses.All biobank samples will be linked to longitudinal clinical information.2)New technologies,such as whole-genome sequencing and artificial intelligence,will be introduced and new bioresources for functional and pharmacologic analyses(e.g.,a patient-derived xenograft library)will be systematically deployed.3)Fast and bidirectional translational research(bench-to-bedside and bedside-to-bench)performed by basic researchers and clinical investigators,preferably working alongside each other at the same institution,will be implemented;4)Close collaborations between academia,industry,regulatory bodies,and funding agencies will be established.5)There will be an investment in the other branch of CGM,personalized preventive medicine,based on the individual's genetic predisposition to cancer.

Liver biopsy in the post-hepatitis C virus era in Japan

In Japan,liver biopsies were previously crucial in evaluating the severity of hepatitis caused by the hepatitis C virus(HCV)and diagnosing HCV-related hepatocellular carcinoma(HCC).However,due to the development of effective antiviral treatments and advanced imaging,the necessity for biopsies has significantly decreased.This change has resulted in fewer chances for diagnosing liver disease,causing many general pathologists to feel less confident in making liver biopsy diagnoses.This article provides a comprehensive overview of the challenges and potential solutions related to liver biopsies in Japan.First,it highlights the importance of considering steatotic liver diseases as independent conditions that can coexist with other liver diseases due to their increasing prevalence.Second,it emphasizes the need to avoid hasty assumptions of HCC in nodular lesions,because clinically diagnosable HCCs are not targets for biopsy.Third,the importance of diagnosing hepatic immune-related adverse events caused by immune checkpoint inhibitors is increasing due to the anticipated widespread use of these drugs.In conclusion,pathologists should be attuned to the changing landscape of liver diseases and approach liver biopsies with care and attention to detail.

Mission of the National Cancer Center Hospital in Japan to promote clinical trials for precision medicine

Precision medicine is a growing field worldwide.Despite its potential benefit to many patients,several major obstacles must be overcome before precision medicine can be more widely used in clinical practice.The main obstacles are associated with the quality of samples used for genomic analysis。

Plain language in the healthcare of Japan:a systematic review of“plain Japanese”

Objective:Despite the decrease in the number of foreign visitors and residents in Japan due to the coronavirus disease 2019,a resurgence is remarkable from 2022.However,Japan's medical support system for foreign patients,especially residents,is inadequate,with language barriers potentially causing health disparities.Comprehensive interpretation and translation services are challenging,but“plain Japanese”may be a viable alternative for foreign patients with basic Japanese language skills.This study explores the application and obstacles of plain Japanese in the medical sector.Methods:A literature review was performed across these databases:Web of Science,PubMed,Google Scholar,Scopus,CINAHL Plus,Springer Link and Ichushi-Web(Japanese medical literature).The search covered themes related to healthcare,care for foreign patients,and scholarly articles,and was conducted in July 2023.Results:The study incorporated five papers.Each paper emphasized the language barriers foreign residents in Japan face when accessing healthcare,highlighting the critical role and necessity of plain Japanese in medical environments.Most of the reports focused on the challenges of delivering medical care to foreign patients and the training of healthcare professionals in using plain Japanese for communication.Conclusion:The knowledge and application of plain Japanese among healthcare professionals are inadequate,and literature also remains scarce.With the increasing number of foreign residents in Japan,the establishment of a healthcare system that effectively uses plain Japanese is essential.However,plain Japanese may not be the optimal linguistic assistance in certain situations,thus it is imperative to encourage more research and reports on healthcare services using plain Japanese.

On the beginning of the Japanese Upper Paleolithic:A review of recent archaeological and anthropological evidence

The beginning of the Japanese Upper Paleolithic has mainly been examined using two major models:the Middle Paleolithic evolutionary model within the archipelago and the continental Upper Paleolithic diffusion/migration model.However,recent archeological data from Japan and nearby countries are challenging such simple models.This paper critically reviews previous chronology of the Japanese Paleolithic,including possible Lower and Middle Paleolithic(LP/MP),and attempts to show an alternative model of the beginning of the Japanese Upper Paleolithic.This paper suggests several possible specimens of LP/MP and recommends further geoarchaeological investigation to understand the reliability and cultural relationship between possible LP/MP specimens and the Early Upper Paleolithic(EUP).The start of the Japanese EUP is presently characterized by a flake industry with trapezoids and denticulates around 39-37 kaBP cal on Paleo-Honshu Island,which has partial resemblance with contemporary assemblages in China and the Korean Peninsula,although trapezoids are endemic only to the Japanese EUP and may have derived from the ancestral lithic tradition.Blade technology appeared earliest on Central Paleo-Honshu Island,about 1000 years later than the earliest flake technology.Although blade technology may have originated from the elongated flake technology of the previous period,the sudden simultaneous emergence implies that it diffused from the Korean Peninsula.This paper proposes that blade technology from the Korean Peninsula arrived on the northeastern Paleo-Honshu Island,including the Japan Sea coastal region of western Honshu,rather than the southwest,where flake technology long prospered,due to differences in ecological settings and adaptation strategies between the two regions.

Nationwide questionnaire survey on pediatric pancreatic tumors in Japan

BACKGROUND Pediatric pancreatic tumors are rare and account for<0.1%of all childhood cancers.The primary treatment for pancreatic tumors is surgical resection.However,because of the lack of knowledge regarding pediatric pancreatic tumors,no comprehensive treatment plans for pediatric pancreatic tumors have been developed.AIM To compared the clinical features,treatment methods,and prognosis of pediatric pancreatic tumors in Japan with those in other countries.METHODS Questionnaires were sent to 213 pediatric surgical units in Japan.Pancreatic tumors that were not surgically treated were excluded from the survey.The primary survey investigated the number of patients aged 0-18 years who underwent pancreatic tumor surgery and the type of tumors managed during the 22-year study period(from January 1,2000 to December 31,2021)by post card.The secondary survey assessed the clinical images,treatment methods,and tumor outcomes via email.RESULTS The primary survey enrolled 228 patients.In the secondary survey,213 patients were eventually enrolled.The most common type of pancreatic tumor was solid pseudopapillary neoplasm(SPN)[n=164(77.0%)],followed by pancreatoblastoma[n=16(7.5%)],pancreatic endocrine tumor[n=14(6.6%)],non-epithelial tumor[n=9(4.2%)],pancreatic tumor[n=7(3.3%)],and metastatic pancreatic tumor[n=3(1.4%)].Overall,123(57.7%)patients underwent distal pancreatectomy,of whom 49 underwent laparoscopic surgery.Forty-four(20.7%)patients underwent enucleation,of whom eight underwent laparoscopic surgery.Thirty-two(15.0%)patients underwent pancreaticoduodenectomy,of whom one underwent laparoscopic surgery.All patients with SPN,including those with distant metastases and recurrent disease,survived.CONCLUSION SPN was more common in Japan than in other countries.Regardless of the histological type,resection is the most effective treatment for pediatric pancreatic tumors.

Need for education of psychiatric evaluation of offenders with mental disorders:A questionnaire survey for Japanese designated psychiatrists

BACKGROUND The management of offenders with mental disorders has been a significant concern in forensic psychiatry.In Japan,the introduction of the Medical Treatment and Supervision Act in 2005 addressed the issue.However,numerous psychiatric patients at risk of violence still find themselves subject to the administrative involuntary hospitalization(AIH)scheme,which lacks clarity and updated standards.AIM To explore current as well as optimized learning strategies for risk assessment in AIH decision making.METHODS We conducted a questionnaire survey among designated psychiatrists to explore their experiences and expectations regarding training methods for psychiatric assessments of offenders with mental disorders.RESULTS The findings of this study’s survey suggest a prevalent reliance on traditional learning approaches such as oral education and on-the-job training.CONCLUSION This underscores the pressing need for structured training protocols in AIH consultations.Moreover,feedback derived from inpatient treatment experiences is identified as a crucial element for enhancing risk assessment skills.

Enhancing clinical proficiency through laparoscopic training using Japanese origami

Objective This study aimed to investigate the clinical efficacy of laparoscopic training using origami,a traditional Japanese papercraft,using laparoscopic forceps to create origami cranes.Methods In this retrospective study,4 surgeons were randomly divided into 2 groups:The training group,consisting of surgeons 1 and 2,and the non-training group,consisting of surgeons 3 and 4.Over the course of a one-year study period,the training group regularly underwent laparoscopic surgery training with a dry box,wherein they folded a total of 1000 origami cranes using laparoscopic instruments.The non-training group periodically underwent common laparoscopic surgery training of techniques such as suturing and ligation.Each surgeon regularly performed the transabdominal preperitoneal approach for inguinal hernias.Each training was conducted concurrently with the surgeries.The procedure time(peritoneum detachment,mesh placement,and closure of the peritoneum),total operation time(time from peritoneum detachment to closure of the peritoneum),and surgical outcomes were examined.Results The training group showed greater improvement in the total operation time and more stable performance than the non-training group.Additionally,the time taken for peritoneum detachment was significantly shorter in the training group.Conclusion Laparoscopic training using origami has the potential to enhance laparoscopic surgical skills and improve surgical outcomes.

Genomic medicine in clinical practice:national genomic medicine program in Japan

Cancer statistics in Japan Cancer is the most common cause of death in Japan based on Statistics 2021~1.Since statistics were first gathered,infectious diseases,such as tuberculosis,and cerebrovascular disease have been the main causes of death in Japan.Cancer surpassed cerebrovascular disease as the main cause of death in 1981,and the number of cancer deaths has increased.Approximately 38,000 people died of cancer in 2021.The National Cancer Center(NCC)reported that the 5-year survival rate for patients with cancer was improving(62%for males and 66.9%for females)in a population-based cancer registry.

Malnutrition Assessed Using the Geriatric Nutritional Risk Index Is Associated with Preoperative Incidence of Deep Vein Thrombosis in Japanese Patients Undergoing Total Knee Arthroplasty

Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate the prevalence of preoperative DVT in Japanese patients undergoing total knee arthroplasty (TKA) and the importance of malnutrition in the risk of preoperative DVT. Methods: We retrospectively analyzed 394 patients admitted for primary TKA at our institution between January 2019 and December 2023. All patients scheduled for TKA at our institution had serum D-dimer levels measured preoperatively. Lower-limb ultrasonography was examined to confirm the presence of DVT in patients with D-dimer levels ≥ 1.0 µg/mL or who were considered to be at high risk of DVT by the treating physician. Based on the results of lower-limb ultrasonography, all patients were divided into the non-DVT and DVT groups. The incidence of and risk factors for preoperative DVT were investigated, as well as the correlation of DVT with the patient’s nutritional parameters. We used two representative tools for nutritional assessment: the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status Score. Results: The mean age was 77.8 ± 6.9 years. Preoperative DVT was diagnosed in 57 of the 394 (14.5%) patients. Multivariate logistic regression analysis showed that advanced age and malnutrition status, assessed using the GNRI, were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients who underwent TKA. Malnutrition status, as assessed using the GNRI, increased the risk of preoperative DVT. Our findings suggest that clinicians should consider these factors when tailoring preventive strategies to mitigate DVT risk in patients undergoing TKA.

Malnutrition and Its Association with the Mortality of Patients with Femoral Intertrochanteric Fractures: A Retrospective Analysis of Japanese Patients

Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Considering the difference in treatment, postoperative complication, and mortality risk, these two fractures should be analyzed separately. This study aimed to analyze 1-year mortality and its risk factors in patients with surgically treated femoral intertrochanteric fractures. Methods: Consecutive patients with intertrochanteric fractures who underwent surgical interventions at our institution between January 2017 and December 2021 were retrospectively reviewed. A total of 238 patients were eligible for inclusion in this study. Patients’ demographic and clinical information were retrospectively collected. Patients were divided into the 1-year mortality (n = 16) and survival (n = 222) groups. The incidence of 1-year mortality and its independent risk factors were investigated using univariate and multivariate logistic regression analyses. Results: The mean age of patients was 85.6 ± 8.5 years. The 1-year mortality rate was 6.7% (16/238). Preoperative albumin level, the Geriatric Nutritional Risk Index (GNRI), and malnutrition status (GNRI p = 0.02, p = 0.02, and p = 0.0011, respectively). Multivariate analysis showed that malnutrition status (GNRI p = 0.035) was an independent risk factor for 1-year mortality. Conclusion: Malnutrition status assessed using GNRI (GNRI < 92) was an independent risk factor for 1-year mortality. Our findings suggest that GNRI may be an effective screening tool for predicting postoperative 1-year mortality of patients with surgically treated femoral intertrochanteric fractures.

The Development of a Feeding Coparenting Scale for Japanese Parents of Fifth- and Sixth-Grade Elementary School Children

Aim: Recently, the role of feeding coparenting has gained attention in the child eating research field. The Feeding Coparenting Scale (FCS), a measure of how caregivers interact with their partners when feeding their children was developed in the United States in 2019. However, there is no valid and reliable measure to assess feeding coparenting among caregivers of school-aged children in Japan. Therefore, this study aimed to develop a Japanese version of the FCS (FCS-J) questionnaire for caregivers with school-aged children. Methods: This was a web-based cross-sectional survey completed by caregivers of children aged 10-12 years. A preliminary survey using interviews and a web-based survey was conducted and found that the translated items of the FCS into Japanese were understandable to Japanese people. The developed survey was administered to parents of children at an elementary school. The reliability of the survey was assessed using both test-retest reliability and internal consistency analysis. Exploratory factor analysis was used to test construct validity, and known population validity was examined in relation to attributes, marital satisfaction, and feeding tasks. Results: Findings with 135 parents of school-aged children showed good internal reliability and validity of the FCS-J. The mean score for the overall FCS-J score was 46.2 (SD = 6.2), with Cronbach’s α of 0.72. For the subscales, Cronbach’s α ranged from 0.75 to 0.79. In sum, the present study’s results support the three-factor structure of the FCS in Japanese caregivers in Japan. Conclusions: The developed FCS-J was found to have a certain degree of reliability and validity. In this study, a Japanese version of the FCS-J was developed. .

Japanese Sign Language Recognition by Combining Joint Skeleton-Based Handcrafted and Pixel-Based Deep Learning Features with Machine Learning Classification

Sign language recognition is vital for enhancing communication accessibility among the Deaf and hard-of-hearing communities.In Japan,approximately 360,000 individualswith hearing and speech disabilities rely on Japanese Sign Language(JSL)for communication.However,existing JSL recognition systems have faced significant performance limitations due to inherent complexities.In response to these challenges,we present a novel JSL recognition system that employs a strategic fusion approach,combining joint skeleton-based handcrafted features and pixel-based deep learning features.Our system incorporates two distinct streams:the first stream extracts crucial handcrafted features,emphasizing the capture of hand and body movements within JSL gestures.Simultaneously,a deep learning-based transfer learning stream captures hierarchical representations of JSL gestures in the second stream.Then,we concatenated the critical information of the first stream and the hierarchy of the second stream features to produce the multiple levels of the fusion features,aiming to create a comprehensive representation of the JSL gestures.After reducing the dimensionality of the feature,a feature selection approach and a kernel-based support vector machine(SVM)were used for the classification.To assess the effectiveness of our approach,we conducted extensive experiments on our Lab JSL dataset and a publicly available Arabic sign language(ArSL)dataset.Our results unequivocally demonstrate that our fusion approach significantly enhances JSL recognition accuracy and robustness compared to individual feature sets or traditional recognition methods.

Population-based X-ray gastric cancer screening in Hiroshima prefecture, Japan

BACKGROUND X-ray gastric cancer(GC)screening has been shown to decrease mortality.Population-based X-ray GC screening has been performed in Hiroshima Prefe-cture,Japan,since 1983 but time trends and the efficacy of the method over 39 years have not been assessed.METHODS This was a population-based retrospective study.The data were derived from aggregated data of the Hiroshima Regional Health Medical Promotion Organization,including the number and rate of participants and those requiring esophagogastroduodenoscopies(EGDs),the number and rate of participants diagnosed as having GC,and the positive predictive value of the abnormal findings detected by X-ray and confirmed by EGDs.The number and rate of esophageal cancers were also collected.Further,the cost of detecting one GC was evaluated.RESULTS The number of participants has decreased during the last four decades,from 39925 in 1983 to 12923 in 2021.The rate of those requiring EGDs decreased significantly in recent years(P<0.001).The number of participants diagnosed as having GC has also declined,from 76 to 10 cases.However,the rate of cases diagnosed as GC among the participants remained around 0.1%.The positive predictive value increased significantly in recent years except during 1983-1991.The number and rate of accidentally detected esophageal cancers have risen recently,from 0%in 2008 to 0.02%in 2021,one-fifth of the diagnosis rate of GC.One GC diagnosis costs approximately 4200000 Japanese Yen(30000 United States Dollars)for the X-ray screenings and EGDs.CONCLUSION X-ray GC screening in Hiroshima has been efficient,but one challenge is the cost.Esophageal cancers may also need to be considered because they have gradually increased in recent years.

Curriculum Development and Teachers for Cultivating OECD Student Agency in Japan:From an Examination of Educational Thought,Educational System,History,and Contemporary Science and Mathematics Education Practices

The purpose of this paper is to examine the development of a curriculum in Japan to foster the agency(OECD Student Agency)necessary for children living in the future,as outlined in the OECD Education2030 Project,and the role of teachers who implement this curriculum.Therefore,I aim to achieve this goal by taking an overview of educational thought,educational systems and history,and examining several initiatives in the OECD Project and the situation of a Japanese high school that practices science and mathematics education.As a result of analyzing previous research and the narratives obtained from interviews with Teacher A(pseudonym)of a certain F High School(pseudonym),it was found that school education should not simply teach subjects,but should aim to enable student to help student exercise agency in the future.It was suggested that it is not necessary to add content to the curriculum,but rather to prepare to provide students with competencies that will enable them to use the content in various contexts,situations,and circumstances,suggesting that in order to discover such important competencies,teachers and other related parties are required to implement curricula that allow students to slowly and carefully explore the competencies surrounding the content,and to conceive and build curricula that include both hidden and intended curriculum that allows student to reflect on the curriculum they have achieved.

Trends in Global Solar Radiation and Sunshine Duration in Past Two Decades in Japan

Global solar radiation (GSR) is an essential physical quantity for agricultural management and designing infrastructures. Because GSR has often been modeled as a function of sunshine duration (SD) and day length for a given set of locations and calendar days, analyzing interannual trends in GSR and SD is important to evaluate, predict or regulate the cycles of energy and water between geosphere and atmosphere. This study aimed to exemplify interannual trends in GSR and SD, which had been recorded from 2001 to 2022 in 40 meteorological stations in Japan, and validate the applicability of an SD-based model to the evaluation of GSR. Both the measured GSR and SD had increased in many of the stations in the study period with averaged rates of 0.252 [W·m−2·y−1] and 0.015 [h·d−1·y−1], respectively. The offset and the slope of the SD-based model were estimated by fitting the model to the measured data sets and were found to have been almost constant with the averages of 0.201[-] and 0.566[-], respectively, indicating that characteristics of the SD-GSR relation had not varied for the 22-year period and that the model and its parameter set can be stationarily applicable to the analyses and predictions of GSR in recent years. The stable trends in both parameters also implied that the upward trend in SD can be a main explanatory factor for that in the measured GSR. The upward trend in SD had coincided with the increase in the frequency of heavy-shortened rains, suggesting that the time period of each rainfall event had gradually decreased, which may be attributable to the obtained upward trend in SD. Further studies are required to clarify if there is some cause-effect relation between the changes in rainfall patterns and the standard level of solar radiation reaching the land surface.

Geographic Differences in Allometric Patterns of Males of the Japanese Firefly Luciola parvula

It has been well known for many years that males of Luciola parvula (Coleoptera, Lampyridae) have two morphs, namely small and large morphs in Japan. This article performed a statistical reanalysis of their morphological measurements based on previously published data and compared them. As a result, the two morphs were found to have different allometric patterns in the Hakone and Nagano areas, Japan. In Hakone, the relationships between their pronotum width and length were expressed by a common allometric line and a shift in location along the line. However, in Nagano, the relationships between their pronotum width and body length were expressed by two parallel allometric lines (a common slope and different intercepts). The allometric pattern of males of this species may vary among different parts of the body or among different areas. Therefore, this article recommends future studies to measure the same parts of the body as previous studies to clarify geographic variation in allometric relationships.

Male Morphological Dimorphism in the Genji Firefly Nipponoluciola cruciata in Central Japan

The Japanese Genji firefly Nipponoluciola cruciata is famous for geographic variation in flash pattern. Such geographic variation has also been well studied in terms of ecology and molecular phylogeny. However, there are very few studies on geographic variation in morphology of this species. This study focused on morphological characteristics of males of this species in Yamanashi and Gunma Prefectures separated by the Kanto Mountains in central Japan. Previous studies have shown that this species in the two prefectures exhibits different genetic features as well as different flash patterns. This study aimed to explore morphological characteristics of males of this species and performed multivariate analysis using measurements previously published in the literature. As a result, allometric analysis between body length and elytra width suggested that this species exhibits different allometric patterns between the two prefectures. Moreover, cluster analysis of measurements of genitalia suggested that this species is completely separated into two different groups between the two prefectures. These results suggest the importance of further morphological studies to clarify the divergence of this species.

Global Warming in Japanese Cities from 1960 to 2019 Using Machine Learning

In this study, we investigated the variations in warming between Japanese cities for 1960-1989, and 1990-2019 using principal component analysis (PCA) and k-means clustering. The precipitation and sunshine hours exhibited opposite tendencies in the PCA results. It was found that 1960M and 1990M had a correlation (r = 0.51). The 1960M and 1990M are the mean temperature anomalies in Japanese cities for 1960-1989 and 1990-2019, respectively. There was a strong correlation between temperature and precipitation (r = 0.62). There was an inverse correlation between 1960M and sunshine hours (r = −0.25), but a correlation between 1990M and sunshine hours (r = 0.11). Sunshine hours had less effect on the 1960M but more impact on the 1990M. The k-means clustering for 1960M and 1990M can be classified into four types: high 1960M and high 1990M, which indicates that global warming is progressing rapidly (Sapporo, Tokyo, Kyoto, Osaka, Fukuoka, Nagasaki), low 1960M and low 1990M, global warming is progressing slowly (Nemuro, Ishinomaki, Yamagata, Niigata, Fushiki, Nagano, Karuizawa, Mito, Suwa, Iida, Hamada, Miyazaki, Naha), low 1960M and high 1990M, global warming has accelerated since 1990 (Utsunomiya, Kofu, Okayama, Hiroshima), and normal 1960M and normal 1990M, the rate of warming is normal among the 38 cities (Asahikawa, Aomori, Akita, Kanazawa, Maebashi, Matsumoto, Yokohama, Gifu, Nagoya, Hamamatsu, Kochi, Kagoshima). Higher annual temperatures were correlated with higher annual precipitation according to the k-means clustering of temperature and precipitation. Two of the four categories consisted of places with high annual temperatures and high precipitation (Fushiki, Kanazawa, Kochi, Miyazaki, Kagoshima, Naha, Ishigakijima), and places with low annual temperatures and low precipitation (Asahikawa, Nemuro, Sapporo, Karuizawa).

Estimation of Return Level for Maximum Daily and Hourly Precipitation in Nagano Prefecture, Japan, Using the Extreme Value Theory

The weather in Nagano Prefecture, Japan, can be roughly classified into four types according to principal component analysis and k-means clustering. We predicted the extreme values of the maximum daily and hourly precipitation in Nagano Prefecture using the extreme value theory. For the maximum daily precipitation, the vales of ξ in Matsumoto, Karuizawa, Sugadaira, and Saku were positive;therefore, it has no upper bound and tends to take large values. Therefore, it is dangerous and caution is required. The values of ξ in Nagano, Kisofukushima, and Minamishinano were determined to be zero, therefore, there was no upper limit, the probability of obtaining a large value was low, and caution was required. We predicted the maximum return levels for return periods of 10, 20, 50, and 100 years along with respective 95% confidence intervals in Nagano, Matsumoto, Karuizawa, Sugadaira, Saku, Kisofukushima, and Minamishinano. In Matsumoto, the 100-year return level was 182 mm, with a 95% CI [129, 236]. In Minamishinano, the 100-year return level was 285 mm, with a 95% CI [173, 398]. The 100-year return levels for the maximum daily rainfall were 285, 271, and 271 mm in Minamishinano, Saku, and Karuizawa, respectively, where the changes in the daily maximum rainfall were larger than those at other points. Because these values are large, caution is required during heavy rainfall. The 100-year return levels for the maximum daily and hourly precipitation were similar in Karuizawa and Saku. In Sugadaira, the 100-year return level for a maximum hourly rainfall of 107.2 mm was larger than the maximum daily rainfall. Hence, it is necessary to be careful about short-term rainfall events.