Design and baseline characteristics of a study of primary prevention of coronary events with pravastatin among Japanese with mildly elevated cholesterol levels

Abstract

Background Although cholesterol management reportedly reduces fatal and non-fatal coronary heart disease (CHD) events in subjects with or without evident atherosclerotic disease, it is still uncertain whether these benefits extend to Japanese. Methods and Results The study group comprised 8,009 subjects with mildly elevated total cholesterol who were randomized to treatment with 10-20 mg pravastatin plus diet (2,691 women, 1,267 men) or diet alone (2,758 women, 1,293 men). The groups were extremely well balanced with respect to baseline demographics and risk factors such as blood pressure and plasma lipids. Over a 5-year period of follow-up, the primary end-points will be a composite of fatal and non-fatal coronary events. Secondary end-points will include stroke and transient ischemic attack, all cardiovascular events and total mortality. Conclusions The 2 groups will be followed up until the end of March 2004 and end-points will be analyzed by full analysis set.

Full text

Circulation Journal Vol.68, September 2004
ince the development of statins (3-hydroxy-3-methyl-
glutaryl coenzyme A reductase inhibitors) in 1989,
their strong efficacy in lowering blood cholesterol
was first noted in the early 1990s1,2 and it became clear that
evidence was needed to confirm their effects on the athero-
sclerotic process.
Previous studies have consistently shown a slowing of
lesion progression, but there was little actual differences in
stenosis compared with a placebo group.
1–3 However, key
pieces of evidence were still missing: to what extent would
the vascular benefit translate into reduced risk for clinical
events and would substantial lipid lowering be safe.
Cholesterol-lowering therapy has been shown to reduce
fatal and nonfatal coronary heart disease (CHD) events in
Caucasian subjects with or without coronary disease,
4–9
but it is still uncertain whether these benefits extend to
Japanese. Compared with Caucasians, Japanese have some
characteristics that might modify treatment effects, such
as a much lower age-standardized death rate from CHD,
10
a higher proportion of hemorrhagic stroke,
10 overall lower
blood cholesterol concentration,
11 a diet that typically con-
tains less saturated fat and cholesterol intake,
11 and relative-
ly small physical stature.
A large-scale cohort study of the relationship between
serum cholesterol concentration and coronary events with
low-dose simvastatin therapy has been conducted in
Japanese patients with hypercholesterolemia, but without a
control group.
12,13 Thus, a randomized study was designed
to compare the effect on pravastatin plus diet with diet
alone for the prevention of major CHD events in Japanese
men and women without clinically evident atherosclerotic
cardiovascular disease and with mildly elevated total
cholesterol levels. This study will be the largest long-term
controlled study yet conducted among Orientals in Asia.
Methods
Subjects
Between 1994 and 1999, a total of 15,210 subjects were
temporarily registered in 924 hospitals throughout Japan
based on their age, gender and cholesterol concentration,
which was determined by the relevant institutions. The
relatively long period for registration was required because
of alterations to the rules for post-marketing surveys and
the immature infra-structure of the trial’s organization.
After registration, participants were instructed to adhere
to the dietary advice, which was based on the National
Cholesterol Education Program (NCEP) Step I diet.14
After at least a 4-week washout period during which
subjects were encouraged to comply with the low fat and
low cholesterol diet, blood cholesterol was determined by a
standardized procedure on 2 or 3 occasions over 12 weeks.
The baseline cholesterol was estimated as the average of
these measurements and for entry to the study was required
to be 220–270 mg/dl. Of the total cohort, 8,214 subjects
met the inclusion criterion. Eligible subjects included men
aged 40–70 years, and post-menopausal women up to 70
years of age. Exclusion criteria included familial hyper-
cholesterolemia; a history of angina pectoris, myocardial
infarction, coronary artery bypass graft surgery or percu-
taneous coronary intervention; electrocardiographic abnor-
malities consistent with myocardial ischemia; a history of
peripheral arterial disease, stroke or transient ischemic
Circ J 2004; 68: 860 – 867
(Received October 22, 2003; revised manuscript received June 4,
2004; accepted June 23, 2004)
Members of the MEGA Study Group are shown in Appendix 2.
Mailing address: Haruo Nakamura, MD, Mitsukoshi Health and
Welfare Foundation, STEC Jyoho Building, 1-24-1 Nishishinjuku
Shinjuku, Tokyo 160-0023, Japan
Design and Baseline Characteristics of a Study of Primary
Prevention of Coronary Events With Pravastatin Among
Japanese With Mildly Elevated Cholesterol Levels
Management of Elevated Cholesterol in the Primary Prevention Group
of Adult Japanese (MEGA) Study Group
Background Although cholesterol management reportedly reduces fatal and non-fatal coronary heart disease
(CHD) events in subjects with or without evident atherosclerotic disease, it is still uncertain whether these bene-
fits extend to Japanese.
Methods and Results The study group comprised 8,009 subjects with mildly elevated total cholesterol who
were randomized to treatment with 10–20 mg pravastatin plus diet (2,691 women, 1,267 men) or diet alone (2,758
women, 1,293 men). The groups were extremely well balanced with respect to baseline demographics and risk
factors such as blood pressure and plasma lipids. Over a 5-year period of follow-up, the primary end-points will
be a composite of fatal and non-fatal coronary events. Secondary end-points will include stroke and transient
ischemic attack, all cardiovascular events and total mortality.
Conclusions The 2 groups will be followed up until the end of March 2004 and end-points will be analyzed by
full analysis set. (Circ J 2004; 68: 860 – 867)
Key Words: Cholesterol; Coronary heart disease; Pravastatin; Primary prevention
S

861
Management of Elevated Cholesterol Among Japanese
Circulation Journal Vol.68, September 2004
attack; a diagnosis of congenital or rheumatic heart disease;
chronic atrial fibrillation; current diagnosis of malignancy;
severe liver (chronic active hepatitis and cirrhosis) or renal
(creatinine ≥4mg/dl) disease; poorly controlled hyper-
tension or diabetes mellitus; secondary hyperlipidemia;
current use of oral or parenteral corticosteroids; and other
conditions at the discretion of the individual physician.
After exclusions, 8,009 subjects who still met all the
criteria and who provided written informed consent were
randomized to treatment with either diet alone or diet plus
pravastatin (10–20 mg/day, the particular dose needed to
decrease total cholesterol to less than 220 mg/dl) in an
open-label, parallel-group design (Fig l).
Study Management and Follow-up
It is planned that subjects will be followed up over 5
years. The subjects will be seen at 3–6 month intervals and
at each visit dietary advice will be reinforced and fasting
plasma lipids measured. Compliance with the dietary or
drug regimen will be checked at every visit and the sub-
jects’ responses to a questionnaire, which will be given in
every dietary practicing meeting, will be collected. An
electrocardiogram (ECG) will be recorded annually.
Other treatments, both for cardiovascular and non-
cardiovascular conditions, will be at the discretion of the
patients’ primary physicians and this includes commence-
ment of lipid-lowering therapy other than with statins in
those subjects randomized to diet alone, if this is consid-
ered appropriate.
An independent Data and Safety Monitoring Committee
reviews study progress at periodic intervals from the
ethical, safety and efficacy stand points, and is responsible
for taking appropriate action if the data suggest that there
may be an unacceptable risk to the subjects in the study.
The stopping rule will be blinded for all participating
physicians and members of steering committee.
Administrative, clinical and data management are per-
formed by a contract research organization that is indepen-
dent of the sponsors.
Laboratory Methods
All lipid values are measured centrally at the Special
Reference Laboratory (SRL, Hachioji, Tokyo), which is
certified for major lipid measurements by the Center for
Disease Control, Atlanta, Georgia, USA. Total serum
cholesterol and triglyceride (TG) concentrations are deter-
mined enzymatically.
15 Low-density lipoprotein (LDL)
cholesterol is calculated according to the formula described
by Friedewald et al16 using high-density lipoprotein (HDL)
cholesterol values measured with a homogeneous assay
from Daiichi Chemical Co (Tokyo). If the serum TG con-
centration is greater than >300 mg/dl, the LDL cholesterol
is determined by direct assay kit (Cholestest LDL, Daiichi
Pure Chemicals, Tokyo, Japan). Lipoprotein(a) (Lp(a)) is
also measured annually by an antihuman Lp(a) monoclonal
antibody-coated latex assay kit [Lp(a) Latex ‘DAIICHI’,
Daiichi Pure Chemicals]. Hemoglobin A1c is measured
by Hi-AUTO A1c kit of the HA-8150 series (Arkray Co
Kyoto, Japan).
All other laboratory parameters are determined routinely
by automated analyzers in each participating hospital.
Endpoints
The primary endpoint of the study is a composite of
major CHD events, comprising fatal or nonfatal myocardial
infarction, sudden cardiac death, development of unstable
angina and coronary revascularization procedures, either
coronary artery bypass grafting or percutaneous coronary
intervention.
Secondary endpoints include cerebral infarction, cerebral
Fig 1. Flow diagram of participants.

862 MEGA Study Group
Circulation Journal Vol.68, September 2004
hemorrhage, transient ischemic attack, all cardiovascular
events, and total mortality, as listed in Appendix 1.
Tertiary endpoints include tolerability and safety param-
eters, noncardiovascular mortality, fatal and non-fatal
cancer, and the relationship between CHD event rates and
baseline concentrations and changes in lipid parameters.
Reports of the major endpoints are reviewed and classi-
fied by an Endpoint Committee.
Statistical Analysis
Endpoints will be analyzed mainly on full analysis set
and according to treatment actually received (per protocol).
A log-rank test will be used to assess the effect of therapy
on the rate of primary endpoint events. Analyses of relative
reductions in risk resulting from statin treatment are to be
calculated using the Cox proportional hazards regression
model. Cumulative incidence of events and interval esti-
mates are to be calculated using the Kaplan-Meier method.
One-sided probability values of <0.05 will be considered
to indicate a statistically significant difference.
Power Calculations The CHD morbidity and mortality
in the general Japanese population is estimated at 5.3/1,000
person years.
17
The following assumptions are also made: an annual
CHD death for all males aged 40–70 years of 0.9/1,000;18
annual rates of major nonfatal CHD events twice that of
CHD deaths; a combined incidence of fatal and nonfatal
CHD events in those with total cholesterol of 220 mg/dl or
more, twice that of the general population (therefore in this
study cohort a combined incidence of approximately
5.6/1,000 per year); decrease in rates of the composite
CHD endpoint of 10% in the group randomized to diet and
40% in the group randomized to diet plus statin. Also, an
assumed 20% drop-in to treatment in these randomized to
diet alone or drop-out in these randomized to also receive
statin, randomization of 8,000 subjects has 80% power
withα=0.10 (two-sided).
Results
Baseline Characteristics
Recruitment commenced in March, 1994 and concluded
in September 1999. At that time, 8,009 participants were
randomized to treatment with diet alone (2,758 women,
1,293 men) or with pravastatin plus diet (2,691 women,
1,267 men) (Table 1). The groups were extremely well
balanced with respect to the baseline demographics and
risk factors. The difference in diastolic blood pressure was
small in absolute terms.
Combined mean lipid parameters included the mean
(SD) total cholesterol 242.6 (12) mg/dl; mean (SD) LDL-
cholesterol 156.9 (18) mg/dl; mean (SD) HDL-cholesterol
57.3 (15) mg/dl; median TG 128 mg/dl; and median lipo-
protein(a) 15 mg/dl.
Discussion
Compelling epidemiological data have related serum
cholesterol concentrations to the risk of CHD events in
both Western populations19 and in a cross-sectional study
in Japan.
20 However, there has been considerable controver-
sy concerning both the benefits and, to a lesser extent, the
safety of cholesterol-lowering therapy, partly because prior
to the availability of the 3-hydroxymethyl-3-glutaryl coen-
zyme A (HMG CoA) reductase inhibitors, trials had tested
interventions that only lowered cholesterol by approxi-
Table 1 Baseline Characteristics of the Study Subjects With High Cholesterol
Diet Diet plus pravastatin
(n=4,051) (n=3,958)
Men aged 39–71 years (%) 1,293 (50.5) 1,267 (49.5)
Women aged 37–74 years (%) 2,758 (50.6) 2,691 (49.4)
Age, mean (SD) years 59 ( 7) 59 ( 7)
Men 55.2 55
Women 59.8 59.6
≥65 years (%)
Men 224 (17.3) 210 (16.6)
Women 720 (26.1) 695 (25.8)
Height, mean (SD), cm 156.6 ( 8) 156.6 ( 8)
Weight, mean (SD), kg 58.6 (10) 58.7 (10)
Body mass index, mean (SD), kg/m2 23.8 ( 3) 23.9 ( 3)
Current smoker (%) 595 (14.9) 618 (16.0)
Major complications (%)
Hypertension 1,647 (41.2) 1,574 (40.6)
Diabetes 810 (20.3) 779 (20.1)
Liver disease 274 ( 6.9) 264 ( 6.8)
Renal disease 85 ( 2.1) 62 ( 1.6)
Plasma lipid concentrations
TC, mean (SD), mg/dl 242.5 (12.1) 242.6 (12.0)
LDL-C, mean (SD), mg/dl 155.6 (18.6) 156.2 (18.2)
HDL-C, mean (SD), mg/dl 57.4 (15.1) 57.3 (14.8)
TG, median, mg/dl 128 128
Lp(a), median, mg/dl 15 15
Blood pressure, mean (SD), mmHg
Systolic 132.5 (16.7) 132.0 (16.8)
Diastolic 78.9 (10) 78.5 (10)
Blood glucose, mean (SD), mg/dl 109.0 (31.8) 109.1 (32.1)
HemoglobinA1c, mean (SD) % 5.9 ( 1.2) 5.9 ( 1.2)
TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; TG, triglycerides;
Lp(a), lipoprotein(a).

863
Management of Elevated Cholesterol Among Japanese
Circulation Journal Vol.68, September 2004
mately 10%.
Although recently published large-scale trials have
demonstrated both the benefits and safety of the HMG CoA
reductase inhibitors in Western populations either known
to have CHD4–6 or without known CHD,
8,9 it is important
that such studies are also undertaken in different popula-
tions such as in Japan. Atherothrombotic disease results
from the interaction between many genes and a variety of
environmental factors including those that influence cho-
lesterol concentrations. Migration studies have shown
changes in the levels of CHD risk factors, including serum
cholesterol, in Japanese who have migrated from their
homeland to Hawaii and mainland United States.
21 In
Japan, the rates and types of cardiovascular endpoints
differ to those in Caucasian populations, reflecting possible
genetic as well as environmental differences.
Not only might the effects of HMG CoA reductase in-
hibitors on CHD endpoints differ in Japan, but the present
study will provide important data on the effects of pravas-
tatin on both non-hemorrhagic and hemorrhagic stroke, the
rates of which are relatively high in Japan, perhaps related
to the high prevalence of hypertension. An overview of
population studies has shown no association between
serum cholesterol concentrations and strokes rates, when
adjusted for known risk factors including age, blood pres-
sure and cardiac disease,
22 although other studies in both
the USA23 and Asian populations,
22,24 which considered
stroke by subtype, have shown a continuous positive rela-
tion between cholesterol concentrations and non-hemor-
rhagic stroke, and a possible increase in the rates of hemor-
rhagic stroke in association with low serum cholesterol
concentrations. The latter may be a more common occur-
rence in those with hypertension,
23 which highlights the
importance of the present study in this cohort in which
more than 40% of the subjects had a history of hyperten-
sion at baseline.
The baseline cholesterol concentrations and other risk
factors of the cohort in the present trial make them suitably
representative for a study of the effects of an HMG CoA
reductase inhibitor in Japanese. The mean baseline total
cholesterol of 242.6 mg/dl lies between those in the
WOSCOPS8and the AFCAPS/TexCAPS,
9and the range is
typical of cholesterol concentrations in Japanese who
develop CHD. Patients with familial hypercholesterolemia
frequently have total cholesterol levels greater than
270 mg/dl, and generally would have been excluded from
this study.
As already noted, 40% of the cohort has a history of
hypertension at baseline and approximately 20% have self-
reported diabetes mellitus. Smoking rates of 15–16% are
relatively high despite the large number of female subjects.
Therefore, over half of the subjects have other CHD risk
factors, the pattern of which differs from the baseline char-
acteristics in the previous major primary prevention trials
of HMG CoA reductase inhibitors.
8,9
A total of 68% of participants in the study are females,
which reflects the frequent occurrence of elevated choles-
terol concentrations in Japanese women, and is an impor-
tant feature of the present study because in the past they
have either been excluded8or notably underrepresented in
other primary prevention9as well as secondary prevention
studies4–6 of the HMG CoA reductase inhibitors.
The dosage of pravastatin that is being used in this trial,
10–20 mg/day, differs from the higher dose of 40 mg/day
employed in the other major studies.
5,6,8 Approval could not
be obtained to administer a fixed dose (20 mg) of pravas-
tatin, but the dose range being tested reflects usual clinical
prescribing practice in Japan and has been shown to
achieve approximately 20% reduction in total cholesterol
and 25% for LDL-cholesterol reduction in this population,
25
similar to that found in the other studies with a 40 mg daily
dose of the agent.
6,26,27
Finally, the study design allows for commencement of
lipid-lowering therapy with an HMG CoA reductase inhib-
itor during trial follow-up by a treating physician if this is
considered indicated, which overcomes any ethical dilem-
mas in continuing the trial, as has been described previous-
ly.
28
In summary, this is the largest controlled study yet con-
ducted among Orientals in Asia. The difficulties in mount-
ing such a study are reflected by the need for an open rather
than blinded design, because Japanese are uncomfortable
with a placebo-control design. However any bias that might
have been introduced will be minimized because an inde-
pendent Data and Safety Monitoring Committee will over-
see progress in the study, and analyses will be performed
by a group that is independent of the Steering Committee
and investigators. Therefore the study is still able to pro-
vide very important new information on the effects of an
HMG CoA reductase inhibitor in an Oriental population
with a predominance of women.
Acknowledgments
This study is supported by a grant from the Ministry of Health, Labor
and Welfare, Japan and by Sankyo Co Ltd.
The authors are grateful to Drs James Shepherd, Frank Sacks and
Andrew Tonkin for their assistance with the manuscript.
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Appendix 1
All endpoints will be adjudicated by the Endpoint Committee and
major endpoints are defined as follows.
1. Definite fatal and nonfatal myocardial infarction (1 or more of the
following criteria must be met):
(a) Diagnostic ECG at the time of the event.
(b) Ischemic cardiac pain (and /or unexplained acute left ventricular
failure) and diagnostic enzymes.
(c) Ischemic cardiac pain and /or unexplained acute left ventricular
failure with both equivocal enzymes and equivocal ECG.
(d) Diagnostic enzymes and equivocal ECG.
(e) Angiographic evidence of occlusion of a major artery with ap-
propriate ventriculographic wall motion abnormality where previous
angiogram since randomization showed no such abnormality.
(f) Postmortem examination.
2. Angina pectoris (stable or unstable, both of the following criteria
must be met):
(a) Ischemic cardiac pain, relieved by nitrates.
(b) Equivocal ECG.
3. Ischemic stroke (1 of the following conditions must be met):
(a) Rapid onset of focal neurologic deficit lasting at least 24 h or
leading to death plus evidence from neuroimaging (computed tomo-
graphy or magnetic resonance imaging) showing cerebral/cerebellar
infarction or no abnormality, or postmortem examination showing
cerebral and/or cerebellar infarction).
(b) Rapid onset of global neurologic deficit (eg, coma) lasting at
least 24 h or leading to death plus evidence from neuroimaging
showing infarction, or postmortem examination showing infarction.
(c) Focal neurologic deficit (mode of onset uncertain) lasting at least
24 h or leading to death plus evidence from neuroimaging showing
infarction, or postmortem examination showing infarction.
4. Primary intracerebral hemorrhage (1 of the following conditions
must be met):
(a) Rapid onset of focal neurologic deficit lasting at least 24 h or
leading to death, plus neuroimaging or postmortem examination
showing primary intracerebral and/or cerebellar hemorrhage.
(b) Rapid onset of global neurologic deficit (eg, coma) lasting at
least 24 h or leading to death, plus evidence from neuroimaging or
postmortem examination showing primary intracerebral and cerebel-
lar hemorrhage.
(c) Focal neurologic deficit (mode of onset uncertain) lasting at least
24 h or leading to death, plus evidence from neuroimaging or post-
mortem examination showing primary intracerebral and/or cerebellar
hemorrhage.
5. Transient ischemic attack:
(a) Rapid onset of focal neurologic deficit or loss of monocular func-
tion lasting less than 24 h.
(b) Negative neuroimaging.
6. ASO (atherosclerosis obliterans):
(a) At least Fontaine Classification II.
(b) Less than 0.9 (ankle brachial presssure index).
(c) Positive vascular imaging.
Appendix 2
Steering Committee: Nakamura H, Arakawa K, Itakura H, Kitabatake A,
Goto Y, Saito Y, Toyota T, Nakaya N, Nishimoto S, Yamamoto A,
Muranaka M.
Data Reviewing Committee: Nakamura H, Saito Y, Nakaya N,
Yamamoto A, Ishikawa T.
Endpoint Committee: Doba N, Fukuuchi Y.
Data Safety and Monitoring Committee: Kikuchi S, Shibata Y, Shimada
K, Nakamura K, Fujita T, Yokoyama S.
The MEGA study group (*Committee member)
Hokkaido District (142): Abe T, Abiru M*, Adachi T, Aizawa H, Akutsu
M, Aoki K, Aoki S, Ato K, Bekki E, Fujii S, Fujii W, Fujikane T, Fujita
K, Fujita T, Goto S, Haneda T, Hasebe N*, Hasegawa A, Hashimoto A,
Hayasaka T, Hirata H, Hyuuga M, Ibayashi Y, Ide H, Iida Y, Inoue N, Inui
N, Ishida N, Ishii J, Itaya H, Ito H, Ito J, Ito K, Ito Y, Itoh H, Iwashima
Y*, Kakinoki S*, Kamigaki M, Kamoi K, Kato N, Kihara A, Kikuchi K*,
Kimura T, Kitabatake A*, Kobayashi T, Kobayashi T, Kodama T,
Komatsu H, Komori K, Kondo A, Kurihara Y, Kuroda R, Maeda I,
Makiguchi M, Makimura S, Makino T, Maruyama J, Masukawa S,
Matsuo H, Migita N, Miyashita K, Miyazawa K, Mizutani M*, Momose
H, Morimoto H, Morioka M, Morita K, Nagai K, Nagashima K,
Nakagawa N, Nakamura T, Nawate S, Nishiie K, Nishino T, Numazawa
K, Obara A, Ogawa S, Oimatsu H*, Okada H, Okada K, Okada T,
Okamoto K, Ommura H, Omura Y, Onodera Y, Ooiwa H, Ota Y, Otsubo
M, Ozaki T, Saito H, Sakamoto H, Sakuma I*, Sato A, Sato H*, Sato I,
Sato K, Sato M, Sato Y, Sato Y, Sekiguchi M, Senga K, Shibata S,
Shikano Y*, Shimamoto K*, Shimizu H, Shinano H, Shinohara M,
Shogase T*, Shudo H, Sugata T, Suzuki A, Suzuki M, Tabata H, Tagami
S, Taguchi A, Takahashi D, Takahashi K, Takahashi T, Takao K,
Takayanagi N, Takeda H, Takenaka T, Takigami Y*, Takizawa Y, Tani
M, Tobise K, Tomita K, Tsubokura T, Tsujisaki M*, Tsukamoto T,
Uchiyama M, Uchiyama S, Ueda T, Uehara Y, Ura N*, Yamashita H,
Yokota H, Yokota T, Yoshida I, Yoshida K, Yoshimura H, Yoshizawa T.
Tohoku District (208): Abe K*, Abe S, Abe Y, Abukawa T, Aida M,
Ajihara T, Akino Y, Akitsuki T, Akutsu K, Anzai H, Asakura T, Ataka Y,
Baba T*, Eguchi H, Fukui A*, Fukushima M, Funada K, Fushimi E, Goto
Y, Haga E, Hara M, Haraguchi M, Haruyama T, Hashimoto S*, Hayasaka
K, Hayashi M, Hayashi T, Hiramori K*, Hirasawa Y, Hirosaka A*,
Hitomi H, Horino Y, Ikeda K, Ikeda K, Ikeda M, Iriyama S, Ishigaki Y,

865
Management of Elevated Cholesterol Among Japanese
Circulation Journal Vol.68, September 2004
Ishii R, Ishikawa K*, Ito N, Ito S*, Ito S*, Ito T, Kagaya Y*, Kaiyama H,
Kakizaki M, Kamata T, Kanazawa A, Kanazawa M, Kanazawa Y, Kanno
M, Kasai Y, Kato K*, Katono E, Kawamura M, Kawashima S, Kibira S*,
Kikuchi H, Kikuchi J, Kikuchi M, Kikuchi T, Kimura H, Kimura H,
Kimura K, Kimura M, Kitada T, Kitagawa M, Kohzuki M, Komatsu N,
Komatsu T, Kosokabe H, Kubo N, Kubota I*, Kubota Y, Kudo K, Kusano
Y, Kushibiki H, Machii K, Maehara K*, Maruyama Y*, Masuda M,
Matsuda G, Matsuhashi A, Matsuoka H, Matsuoka S, Meguro H*,
Meguro Y, Midorikawa S, Mikuniya A, Minami O, Misawa S, Mitsugi M,
Miura H, Miura M*, Miyabe S, Miyazaki Y, Murakoshi H, Muroi S,
Nakahata H, Nakajima J, Nakajima N, Nakanishi T, Nakano J, Nakazato
K, Nakazono M, Namekawa G, Nemoto T, Nishimura S, Nishiyama A,
Nogae I, Nunokawa T, Ogawa A, Ogawa A, Ohnuma H, Ohtomo E,
Ohwada T, Oikawa M, Oikawa S, Oizumi H, Oka Y*, Okano T, Okuguchi
F, Okumura K*, Omata K*, Ono K, Ono T, Ono Y, Oriso S, Osanai T*,
Otsuka K, Owada K, Owada M, Sagara M, Saito K, Saito K, Saito M,
Sakamoto M, Sakauchi Y, Sano R, Sasaki A, Sasaki M*, Sasaki Y, Sato
M, Sato S, Sato S, Sato S, Sato T, Satoh J*, Seki H, Seki K, Seki N,
Sekikawa A, Shiga N, Shiga Y, Shimizu T, Shindo J, Shinzawa H, Shirata
A, Shirato K*, Shishido Y, Suda T*, Suzuki A, Suzuki F, Suzuki H,
Suzuki H, Suzuki N, Suzuki Y, Taira K, Takagi H, Takahashi A,
Takahashi H, Takahashi K, Takahashi K, Takahashi S, Takeda H, Takeda
H, Takeuchi K*, Tamasawa N*, Tamura Y, Taneda Y, Tani M, Tominaga
Y, Tomoike H*, Toyota T*, Tsukahara Y, Tsunoda K, Ube K, Uehara O,
Uemura T, Ueno A, Ueshima K*, Umemura S, Wakamatsu H, Watanabe
R, Watanabe T*, Yabe R, Yabuki T, Yamada K, Yamada Z, Yamaki M,
Yamaki S, Yamamoto H, Yamane K, Yamane K, Yamazaki T,
Yokoshima T, Yoshino M, Yuuki K.
Tokyo District (521): Abe D, Abe M, Abe R, Aikawa J, Akaishi M*,
Akanuma M, Akashi T, Amaki S, Aoyama N, Arakawa K, Araki Y, Araki
Y, Arao M, Asai K, Asano H, Ashino S, Atarashi H, Atarashi K, Awata T,
Ayaori M, Baba A, Ban T, Bujo H, Chiba A, Doba N*, Ebara F, Ebara T,
Ebisuno M, Eida K, Emoto N, Endo K, Endo T, Endo T, Endo Y, Etou K,
Fujimori S, Fujimoto K, Fujioka M, Fujioka T, Fujishiro K, Fujita H,
Fujita M, Fujita S, Fujita T*, Fujita Y, Fukuma N, Fukuma Y, Fukumoto
M, Fukuo Y, Funatsu K, Furutani N, Geshi E, Haketa A, Hamamoto H,
Hamana G, Han A, Handa S, Handa Y, Hara H, Hara H, Hara T, Hara Y,
Harada Y, Hasegawa A, Hashida J, Hashiguchi S, Hashimoto Y, Hata S,
Hatano T, Hayakawa A, Hayama N, Hayama T, Hayashi K, Hayashi M,
Hayashi R, Hayashi T, Hayashi Y, Hibio S, Hida S, Hiejima K, Higano H,
Higashi K, Hikita M, Hiramatsu M, Hiramoto Y, Hirano T*, Hirayama Y,
Hiroi N, Hirose K, Hirose W, Hisada T, Hisamitsu S*, Hiyoshi T, Hiyoshi
Y, Hojoh M, Homori M, Honda H, Hongo K, Honma H, Hosoya J,
Hosoya T, Houjo K, Ibuki C, Ichiba K, Ichiba T, Ichikawa S, Ikeda M,
Ikehata N, Ikejiri A, Ikemoto S, Iketani T, Ikewaki K, Imai T, Imaizumi T,
Imamura M, Imamura Y, Inami S, Inamura T, Ino T, Inoue M, Inoue M,
Inoue S, Inoue T, Isaka T, Ishibashi F, Ishibashi K, Ishibashi T, Ishida M,
Ishii H, Ishii H, Ishikawa M, Ishikawa M, Ishikawa T*, Ishimaru Y,
Ishiyama T, Isoda K, Isogai Y, Itakura H*, Ito H*, Ito H, Ito K, Ito R, Ito
S, Ito S, Ito T, Ito Y, Iwamoto N, Kaga F, Kageyama A, Kageyama S,
Kaiho T, Kaizuka H, Kamada F, Kamata T, Kamba M, Kamon H, Kanae
K, Kanazawa A, Kanazawa M, Kaneko K, Kariya T, Kashiwado M,
Kashiwagi H, Kashiwazaki K, Kashiwazaki K, Kasuya H, Kato H, Kato S,
Kato T, Kato T, Katoh T, Katsumi T, Kawaguchi H, Kawai M, Kawakami
M*, Kawamura M, Kawamura M, Kawana M, Kawano E, Kawano M,
Kawasaki Y, Kawazu S, Kijima F, Kikkawa K, Kikuchi Y, Kinoshita H,
Kinoshita M, Kishida H, Kishida T, Kitajima W, Kiyomi S, Kobayashi M,
Kobayashi N, Kobayashi Y, Kobayashi Y, Kodani E, Kofune T, Kohashi
E, Koide N, Koike K, Koizumi K, Komi R, Komuro I, Kondo S, Kono T,
Koto F, Kubo A, Kuboki M, Kubota M, Kubota T, Kubouchi Y, Kumagai
Y, Kurata H, Kuroda T, Kurokawa M, Kurumatani H, Kusama Y, Kushida
M, Kushiro T*, Kusuhara M, Kuwahara K, Kuwaki K, Maekawa H,
Mamura M, Maruyama J, Maruyama T, Maruyama Y, Maruyama Y,
Masabayashi H, Mashiko S, Masuda A, Masuda M, Masuo M, Matsumoto
M, Matsumura Y, Matsushima M, Matsuura H, Matsuyama K, Matsuzaki
T, Mikami K, Miki S, Mitsubayashi H, Mituhashi R, Miyaji Y, Miyake Y,
Miyamoto S, Miyanaga T*, Miyashita Y, Miyatake Y, Miyazaki S,
Mizobuchi K, Mizokami T, Mizuno K*, Mizuno O, Mori I, Mori K,
Morita H, Morita Y, Moritani S, Morooka S, Murakawa Y, Murano S,
Nagakura H, Nagano S, Naganuma Y, Nagasawa K*, Nagayama M, Naito
H, Nakajima H, Nakajima K, Nakamoto K, Nakamura K*, Nakamura A,
Nakamura H*, Nakamura K, Nakamura N, Nakano H, Nakaya N*,
Nakayama K, Nakayama K, Nakazato H, Naruse K, Naruse M, Nemoto
M, Niitsu Y, Niitsuma T, Nishida T, Nishikawa H, Nishimura G,
Nishimura R, Nishimura Y, Nishio E, Nishiwaki M, Nishiyama A,
Nishiyama J, Nishiyama K, Nishiyama T, Noda H, Nomoto M, Nomura
A, Notoya Y, Nozawa K, Numano F, Numano F, Obata T, Ogata E, Ogata
K, Ogata N, Ogawa K, Ogawa M, Ogawa T, Ogita K, Ogiwara M, Ogura
H, Ohashi Y*, Ohba T, Ohno A, Ohta M, Oi K, Oka M, Okai M, Okazaki
F, Okimoto T, Okuda K, Okuni S, Onikura S, Ono N, Ono S, Ono Y,
Osuga E, Osuzu F*, Ota M, Ota Y, Otsuka M, Otsuka T, Otsuka Y,
Oyama N, Oyama N, Oyama R, Oyama T, Ozawa K, Ozawa S, Rakue H,
Saiki A, Saito F, Saito T, Saito T, Saito T, Saito Y*, Saitoh H, Sakai H,
Sakai S, Sakai T, Sakamoto N, Sakamoto Y*, Sakurai T, Sano H, Sano J,
Sano M, Sano R, Sasaki H, Sasaki T*, Sato H, Sato H, Sato K, Sawada S,
Sawashige K, Segawa K, Segawa Y, Seimiya K, Seino Y, Sekine M,
Sekine N, Sekine S, Senzui M, Shige H, Shimada A, Shimada H, Shimada
H*, Shimada M, Shimai S, Shimizu M, Shimokado K, Shinohara Y,
Shioiri K, Shirabe S, Shirai K*, Shiratori Y, Shoda T, Shuto H, Soeda H,
Someya Y, Sonoda M, Soya N, Suda A, Sugawara H, Sugii Y, Sumi T,
Suzukawa M, Suzuki K, Suzuki K, Suzuki S, Suzuki T, Suzuki T, Tada
N*, Tadera M, Taguchi H, Taguchi M, Tahara K, Taira K, Tajima N*,
Takahashi A, Takahashi K, Takahashi N, Takahashi S, Takahashi Y,
Takamura H, Takanashi H, Takano M, Takano T*, Takao T, Takata Y,
Takayama E, Takayama M, Takazawa K*, Takazawa M, Take C, Takeda
H, Takeda K, Takeda N, Takegawa S, Takei H, Takei I, Takeichi M,
Tamachi H, Tamano Y, Tamura K, Tamura T, Tanaga K, Tanaka A,
Tanaka A, Tanaka H, Tanaka K, Tanaka N, Tanaka S, Tani M, Taniguchi
K, Taniguchi Y, Tazawa K, Terakado S, Teramoto T*, Teraoka K,
Tohyama Y, Tojo K, Tokuyama Y, Tomaru A, Tomichi N, Tomimura M,
Tomiyasu K, Tomono M, Tsai RC, Tsubaki H*, Tsuchiya T, Tsuji M*,
Tsukada Y, Tsuruoka A, Tsuyuguchi M, Uchida Y, Uchiyama T*, Ueda
Y, Uehara Y, Ueki A*, Uemura R, Ueno K, Uetsuka Y, Ui S, Ushiyama
H, Usui M, Utsumi H, Utsunomiya K, Wakata N, Warabi H, Watanabe I,
Yagi H, Yagura M, Yakubo S, Yamada S, Yamaguchi I, Yamaguchi T,
Yamakado M, Yamamoto T, Yamanaka H, Yamane Y, Yamasaki K,
Yamashita M, Yamashita T, Yamashita T, Yamazaki J, Yamazaki K,
Yanagisawa A, Yanagisawa M, Yanagisawa Y, Yano H, Yashima M, Yo
S, Yokota K, Yokota T, Yokoyama J, Yokoyama S, Yomogita S,
Yonemura A, Yoshida F, Yoshida H, Yoshida M, Yoshimatsu Y, Yoshino
G*, Yoshioka K, Yoshitake N, Yoshizawa N, Yoshizawa N, Yumikura S.
Kanagawa District (196): Abe Y, Amitani K, Aonuma K, Arai K, Arata
N, Ashikaga T, Ban K, Beppu H, Chiguchi M, Chikazoe T, Deguchi Y,
Endo K, Endo Y, Fujikura S, Fujino T, Fukushima F, Fusegawa Y, Genka
C, Hachiya H, Haga T, Hagiwara T, Handa M, Hara F, Hara M, Hatori Y,
Hayashi H, Higuchi Y, Hirao K, Hirata N, Hirota H, Homma J, Homma
Y, Hoshiba Y, Igarashi M, Ikeda Y, Inada M, Inada N, Iseki H, Ishigami
M, Itani O, Ito H, Iwahara S, Iwamoto T, Iwata A, Jin Y, Kagyo H,
Kaneko N, Kanemoto N, Kaneshiro M, Kano H, Kanouchi T, Kato J, Kato
K, Kawata T, Kimu J, Kobayashi A, Kobori Y, Koga I, Koike J, Koizumi
M, Korenaga M, Kubota K, Kudo T, Kuji N, Kumagai K, Kuniyoshi T,
Kurihara K, Kuroda M, Kuroki S, Kushida Y, Kushikata Y, Kuwabara M,
Maeba T, Maeda T, Masuda Y, Masumoto T, Matsuda H, Matsumoto T,
Matsuzaki M, Mikawa T, Mineki H, Miwa W, Miyajima E, Miyake F,
Miyamoto K, Miyao H, Miyazaki H, Miyazaki N, Miyazaki S, Moriyama
M, Munakata K, Muraiso T, Murakami S, Murakami T, Muranaka M*,
Murasawa T, Nagaoka S, Nagase H, Nagashima J, Naka Y, Nakajima S,
Nakajima T, Nakamura T, Nakamura T, Nakao K, Nakayama M*,
Nakazawa K, Namiki M, Narita N, Nasu Y, Nimura I, Nishida A,
Nishikawa T, Nobuoka S, Nomura Y, Noto M, O J, Oguma T, Ohmura K,
Oikawa S, Oishi T, Okada H, Okamatsu K, Okubo Y, Omori N, Omura
M, Ori M, Osako K, Osako R, Owada S, Ozawa K, Ryuzaki M, Saito J,
Saito K, Saito S, Saito T, Saito T, Saito Y, Sato A, Sato K, Sato T, Sato T,
Seki H, Seto K, Shibamoto M, Shiina Y, Shoda M, Sogo Y, Suzuki K,
Suzuki Y, Syoji T, Tada H, Taguchi J, Takada I, Takahashi N, Takahashi
Y, Takamura T, Takao Y, Takeyoshi Y, Takigawa O, Tamura S, Tanaka
H, Tanaka J, Tanaka S, Terada H, Tochihara T, Tohyama S, Tohyo S,
Tokui M, Tomoda H, Toyama K, Toyoda K, Tsunashima K, Uchida T,
Uchida T, Umemura S*, Umezawa S, Umezawa T, Watanabe T,
Watanabe T, Yamada Y, Yamagami J, Yamaguchi T, Yamanaka K,
Yamaoka S, Yamauchi Y, Yamazaki K, Yamazaki Y, Yasuda G, Yasuda
T, Yokoyama Y, Yorozuya M, Yoshida M, Yoshimura N, Yoshimura N,
Yoshitake M.
Kitakanto Koshinetsu District (198): Aizawa T, Aizawa Y*, Akutsu H,
Akutsu T, Ando T, Aoyagi K, Arai K, Arakawa M*, Arisaka H, Banba N,
Fujieda K, Fujiwara H, Fujiwara Y, Fukuuchi Y*, Furuno I, Gejyo F*,
Godo M, Goto K, Goto M, Hama H, Handa Y, Hatano T, Hattori N,
Hayashi K, Hayashi T, Hayata H, Hirahara K, Hirayama K, Hirayama S,
Hirono O, Hoshiyama M, Ichikawa S, Iijima H, Inomata A, Inoue K,
Ishihara M, Ishikawa M, Ishikawa M, Ishikawa M, Ishikawa S, Ishikawa
Y, Ito N, Ito Y, Iwamae S, Iwasaki S, Kado S, Kageyama Y, Kakishita H,
Kamei T, Kamiyama K, Kanazawa H, Kaneko T, Kasai G, Kasai K*,
Kase H, Kato T, Katsura Y, Kawada K, Kawai H, Kawai Y, Kawakami Y,
Kawashima S, Kawauchi A, Kayanuma K, Kimura Y, Kobayashi K,
Kobayashi T, Komori S, Komuro F, Koro T, Koshizuka M, Koyama A*,
Koyata H, Kurabayashi T, Kurihara M, Kuroda H, Machida M, Maeda K,
Matsumoto R, Matsumura M, Matsushima T, Matsushita H, Mimura A,
Miyajima S, Miyazaki M, Mizutani M, Mori K, Mori M*, Mori Y, Morita
E, Morohashi H, Motohashi S, Murakami Y, Murata M, Murayama J,
Murayama N, Murayama Y, Nagai A, Nagai T, Nagano T, Nagase S,

866 MEGA Study Group
Circulation Journal Vol.68, September 2004
Nagashima T, Nagata K, Nagato T, Nagumo H, Naka M, Nakagawa 0,
Nakagawa M, Nakamaru T, Nakazawa A, Narita I, Nawa T, Nezu M,
Nishi S, Nishino H, Noda Y, Noritake M, Oba S, Oguchi H, Oguchi S,
Okabe A, Okada K, Okada S, Okajima H, Okayasu T, Okoshi T, Okubo
M, Okuda Y, Osada K, Osawa Y, Osonoi T, Owada A, Oya M, Oya S,
Ozaki H, Saeki M, Saito A, Saito M, Saito T, Saito Y, Saji M, Sakata I,
Sasagawa Y, Sato K, Sato K, Sato N, Seguchi H, Shimada K*, Shimano
H, Shimazaki K, Shimizu H, Shimizu Y, Shimotori T, Shionoiri F, Shitara
M, Suda H, Sugamata S, Sugaya T, Sugimoto K, Suzuki H, Suzuki S,
Suzuki Y, Suzuki Y, Takagi T, Takahashi A, Takahashi M, Takahashi S,
Takahashi S, Takamatsu M, Takatama M, Takayama Y, Takei K,
Takenaga K, Takizawa S, Tanabe H, Tanaka K, Tani M, Taya T, Tomita
M, Tomono S, Toyoda T, Tsurushima Y, Tsutsui M, Ueda Y, Ueno M,
Ushiyama K, Watanabe K, Watanabe T, Watanabe Y, Yamada N*,
Yamagata K, Yamane Y, Yamashita N, Yato S, Yazawa Y, Yokoyama A,
Yokoyama M, Yonezawa T, Yoshida J.
Tokai District (339): Abo Y, Adachi M, Akahoshi M, Aoi N, Aoki M,
Arai T, Asai M, Asano K, Azuma H, Baba M, Chimori K, Deguchi K,
Eguchi T, Endo S, Enomoto N, Fujihata T, Fujii E, Fujimoto N, Fujioka
M, Fujita K, Fujiwara H*, Goto N, Haga T, Hanaki Y, Haruta J,
Hasegawa H, Hasegawa H, Hasegawa M, Hasegawa R, Hattori H, Hattori
J, Hattori Y, Hattori Y, Hayakawa K, Hayashi K, Hayashi T, Hayashi T,
Hibi N, Hieda N, Hikita H, Hirai M*, Hiramitsu S, Hirano T*, Hirano Y,
Hirayama H, Hirota H, Hishida H*, Hori Y, Horie K, Hoshino T, Ichida S,
Ichikawa T, Iguchi A*, Iida K, Ikeda K, Ikeda N, Imaeda K, Inaba N,
Inaguma D, Inoue K, Io K, Isaka N*, Ishiguro M, Ishiguro T, Ishihara H,
Ishii J, Ishikura N*, Ishizaki S, Isobe S, Itatsu T, Ito A*, Ito H, Ito H, Ito I,
Ito J, Ito T, Ito Y, Itoh M, Iwasaki Y, Iwasaki Y, Iwase M, Jinno M, Jinno
Y, Kabasawa H, Kakehi H, Kambara K, Kamiya H, Kamiya H, Kamiya
M, Kamiya T, Kaneda N, Kani A, Kato K, Kato N, Kato N, Kato R, Kato
T, Kato T, Kato Y, Kato Y, Katsumata H, Kawabe T, Kawada T,
Kawakami K, Kawase K, Kayama M, Kikuchi S*, Kimura G*, Kimura N,
Kin Y, Kinoshita M, Kobayashi T*, Koda A, Koga M, Koie S, Koike T,
Kojima H, Kojima S*, Komata R, Kondo J, Kondo K, Kondo T, Kongo
M, Kosaki T, Kumon S*, Kuraki T, Kurita T, Kuroda M, Kurokawa H,
Kusakabe A, Kushima M, Kushimoto H, Kuzuya M*, Makino K, Mase
M, Masuda Y, Masuoka H, Matsubara T*, Matsubara T, Matsuki T,
Matsunami T, Matsuoka A, Matsushima Y, Matsuura R, Matsuyama H,
Minagawa T, Minami M, Minami N, Minatoguchi S, Miura Y, Miwa M,
Miyabe H, Miyagi Y, Miyata H, Miyata M, Mizuno G, Mizuno M,
Mizuno R, Mizuno Y, Mizutani K, Mokuno T, Mori H, Mori H, Mori N*,
Mori N, Mori S, Mori T, Mori Y, Mori Y, Morimoto S*, Morita H, Motai
Y, Mukawa H, Murakami K, Murase M, Murata K, Nagaoka N, Nagasaka
A, Nagata M, Naito A, Naito M, Nakae M, Nakahara K, Nakajima S,
Nakamura H*, Nakamura S, Nakamura T, Nakano H, Nakano K*,
Nakano T*, Nakazawa K, Narumi J, Naruse H, Niinomi M*, Nishikawa
H, Nishikawa M, Nishimura H, Nishimura K, Nishino M, Niwa H,
Nogimori T, Nomura M, Nonoda K, Obe T, Ogawa H, Ohashi H*, Ohashi
N, Ohtsuki M, Oishi M, Okada M, Okada M, Okamoto N*, Okamoto R,
Okamoto S, Okamoto Y, Oki T*, Okinaka T, Okuma T, Okumura A,
Okumura K*, Ono J, Ono M*, Onodera T, Osugi K, Osugi S, Oya T,
Oyama K, Ri Y, Saito S, Sakagami M, Sakakibara M, Sakakura K, Sakata
K, Sakuma N*, Samejima Y, Sano H, Sano T*, Sarai M, Sasai K, Sassa
H*, Sawai Y, Shimaji T, Shimaji Y, Shimano S, Shimauchi A, Shimizu A,
Shimizu M, Shin K, Shiraki S, Sone T*, Suga T, Sugata Y*, Sugimoto Y,
Sugimura Y, Sugiura A, Sugiyama S, Sumida Y, Suwaki T, Suzuki A,
Suzuki K, Suzumura Y, Taira A, Takada N, Takada N, Takahama S,
Takahashi R, Takase K, Takashima M, Takatsu H, Takaya T, Takayama
S, Takeda N, Takeda N, Takizawa A, Tameda Y, Taminato T, Tanaka H,
Tanaka S, Tanaka T, Tanaka Y, Tatsuta Y, Terada H, Toba T, Tokita Y,
Tokunaga K, Tomihara H, Tomita M, Tomita M, Tomita Y, Torigoe M,
Torikai K, Tozaki T, Tsuboi H, Tsuchiya A, Tsukamoto T, Tsukiyama K,
Tsuyuki M, Ueda M, Uemura A, Uranishi H, Urano O, Urushida T,
Wakida Y, Watanabe A, Watanabe E, Watanabe G, Watanabe S*,
Watanabe Y, Yamada K, Yamada N, Yamada Y, Yamagata K, Yamamori
I, Yamamoto M, Yamamoto N, Yamamoto T, Yamamoto Y, Yamana T,
Yamashita M, Yamauchi T, Yamazaki A, Yamazaki K, Yamazaki M,
Yano Y, Yasuda K, Yasuda Y*, Yasui T, Yokoi H, Yokoi Y, Yokoyama
N, Yokoyama S*, Yoneyama S, Yoshida J, Yoshida M, Yoshida S,
Yoshikane M, Yoshikane M, Yoshimura H, Yoshioka S.
Kansai District (246): Adachi M, Akiyama H, Akiyama I, Amano K,
Amano M, Anaguchi R, Aoki N*, Arako M, Asada K, Asakuma S, Ashida
K, Awata N*, Chiba H, Chimori Y, Chinzei T*, Ekawa K, Fujimoto M,
Fujimura Y, Fujioka Y*, Fujiwara M, Fukunaga H, Fukuoka Y, Fuseno H,
Hachiya T, Harada H, Harada-Shiba M, Harano A, Harano Y*, Hasegawa
T, Hashimoto K, Hashimoto S, Hashimoto T, Hasuike N, Hayashi H,
Haze K, Hino M, Hirai T, Hirano H, Hiura Y, Horibe I, Hoshida S, Hosoai
H, Hosoi F, Hozumi T, Hyodo E, Ichida K, Ida T, Idogaki A, Iharada Y,
Iida M, Ikeda H, Ikeoka K, Imamura M, Imbe H, Inagaki K, Inoue M,
Ishigami H, Ishihara K, Ishii T, Ishikawa H, Ishitani K, Isotani H,
Iwamoto K, Iwasaka T*, Iwasaki T*, Jiko H, Jikuhara T, Kadoya Y,
Kajikawa K, Kamihata H, Kano Y, Kashiwagi Y, Kasuga M*, Kawamori
D, Kawarabayashi T*, Kazumi T*, Kimura Y, Kishida O, Kishitani Y,
Kitagaki Y, Kitagawa Y, Kitaoka H*, Kobatake T, Kobayashi S,
Kobayashi T, Kobayashi Y, Kodama N, Koh H, Koida S, Kondo T,
Korenori S, Kosaki A, Kosugi K, Kubota H, Kubota J, Kubota S, Kuchii
M, Kumada M, Kurioka K, Maeda E*, Maeda Y, Maehashi N, Majima M,
Majima T, Makimura H, Masai M, Masazumi T, Masuda K, Masuda S,
Masutani M*, Matsubara H*, Matsubara N, Matsuda Y, Matsumoto A,
Matsushima H, Matsuyama T, Matsuzaki K, Minami Y, Mitani K*, Miyai
T, Miyakoshi K, Mori Y, Morimoto S, Morita H, Morita T, Mukohara N,
Murata Y, Nagae K, Nagai T, Nagao M, Naito K*, Naka K*, Naka Y,
Nakagawa T, Nakajima T, Nakamichi J, Nakamichi T, Nakamura S,
Nakamura S, Nakamura T, Nakata A, Naruse H, Nishibe A, Nishibori Y,
Nishimura A, Nishiuchi A, Nishiyama M, Nishizawa Y*, Nogami H,
Nomura M*, Nonaka Y, Nose A, Nozaki H, Nukada T, Obana T, Ofuchi
N, Ogawa W, Ohashi M, Okabayashi Y, Okahara K, Okai K, Okamoto Y,
Oki C, Okigaki M, Okumachi F, Okuyama Y, Omatsu T, Omura M, Ono
M, Ono Y*, Oribe T, Oshima Y, Otsuji S, Otsuka M, Otsuki T, Oyagi M,
Ozawa S, Sakaguchi H, Sakamoto T, Sano H, Sato T, Sekine Y, Seo T,
Shibasaki Y, Shimizu H, Shimmei H, Shiomi M, Shoji T*, Shouzu A,
Sorachi K, Sugano W, Sugitani Y, Sugiura T, Suzuki M, Suzuki N,
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Yoshino F, Yuasa F, Yuba M.
Keiji District (97): Akashi K, Asawa Y, Azuma A, Chikayama S, Doi K*,
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Chugoku District (134): Amioka H, Ata K, Ban N, Chishiro T, Egusa G*,
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Koide H, Kuga Y, Kurihara N, Kusumoto T, Maesako N, Makiyama M,
Matsubara K, Matsuda M, Matsuki M*, Matsumoto T, Matsuno Y,
Matsushita H, Matsuura Y, Matsuzaki M*, Michihata T, Miki H, Mino Y,
Mitani Y, Mitsuda H, Mitsunobu F, Miyake H, Miyake Y, Mizuno T,
Murakami T, Naito M, Nakahama H, Nakamaru M, Nakamura N,
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T, Onoyama S, Ookuchi S, Ota T, Ozaki M, Saito M, Saito M, Sakamoto
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Shigemasa C*, Shigemoto K, Shimozaki Y, Shingu T, Shirota K, Sumii
K, Sumitomo S, Tadehara F, Takao Y, Takata K, Takehisa Y*, Takeuchi
T, Takeuchi Y, Teshima S, Toda H, Tsujiyama S, Tsukamoto Y, Tsutsui
Y, Uchida T, Uehara S, Uehara Y, Umemoto S*, Watanabe M, Yamamoto
H, Yamamoto H, Yamamoto S*, Yamauchi K, Yamawaki Y, Yamazaki J,
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Shikoku District (73): Abe M, Akutsu H, Fujii Y, Fujikawa Y, Fujimoto
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867
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