:root{
  --ink:#173238;
  --muted:#60757a;
  --primary:#164b52;
  --primary-2:#0f6870;
  --deep:#10393f;
  --accent:#b85f52;
  --accent-soft:#fbefec;
  --teal-soft:#e9f3f2;
  --sage:#dfeae5;
  --paper:#fffdfa;
  --surface:#ffffff;
  --line:#d8e2df;
  --warn:#7c3e34;
  --warn-bg:#fff2ef;
  --shadow:0 18px 55px rgba(16,57,63,.10);
  --shadow-sm:0 8px 26px rgba(16,57,63,.08);
  --radius:24px;
  --radius-sm:16px;
  --max:1180px;
}
*{box-sizing:border-box}
html{scroll-behavior:smooth}
body{margin:0;color:var(--ink);background:#f5f7f5;font-family:-apple-system,BlinkMacSystemFont,"Hiragino Kaku Gothic ProN","Yu Gothic",Meiryo,sans-serif;line-height:1.82;letter-spacing:.01em}
img{max-width:100%;height:auto;display:block}
a{color:var(--primary-2);text-decoration-thickness:1px;text-underline-offset:3px}
a:hover{color:var(--accent)}
.container{width:min(calc(100% - 40px),var(--max));margin:auto}
.skip{position:absolute;left:-9999px;top:auto}.skip:focus{left:16px;top:12px;z-index:999;background:#fff;padding:10px 14px;border-radius:10px}
.topnote{background:var(--deep);color:#eef8f7;font-size:12px;text-align:center;padding:7px 15px}.topnote a{color:#fff}
.header{position:sticky;top:0;z-index:50;background:rgba(255,253,250,.96);backdrop-filter:blur(14px);border-bottom:1px solid rgba(22,75,82,.12)}
.header-row{height:78px;display:flex;align-items:center;justify-content:space-between;gap:20px}
.brand{display:flex;align-items:center;gap:12px;text-decoration:none;color:var(--ink);min-width:225px}.brand img{width:54px;height:42px;object-fit:contain}.brand strong{display:block;font-size:18px;letter-spacing:.06em}.brand small{display:block;color:var(--muted);font-size:10px;letter-spacing:.12em;line-height:1.2}.brand .guide{font-weight:700;color:var(--primary);font-size:12px;display:block;margin-top:2px}
.nav{display:flex;align-items:center;gap:4px}.nav a{color:var(--ink);text-decoration:none;font-size:13px;font-weight:700;padding:12px 10px;border-radius:10px}.nav a:hover,.nav a[aria-current="page"]{background:var(--teal-soft);color:var(--primary)}.nav .official{background:var(--primary);color:white;padding-inline:15px}.nav .official:hover{background:var(--deep);color:#fff}
.menu{display:none;border:0;background:var(--teal-soft);color:var(--primary);font-weight:700;border-radius:10px;padding:10px 12px}
.breadcrumbs{font-size:12px;color:var(--muted);padding:14px 0}.breadcrumbs a{color:var(--muted);text-decoration:none}.breadcrumbs span{margin:0 7px;color:#9aa9ac}
.hero{position:relative;overflow:hidden;background:linear-gradient(135deg,#f7fbf9 0%,#edf5f2 55%,#fbefec 100%);border-bottom:1px solid var(--line)}
.hero:before{content:"";position:absolute;width:540px;height:540px;border-radius:50%;right:-150px;top:-190px;background:radial-gradient(circle at center,rgba(184,95,82,.12),rgba(22,75,82,.04) 58%,transparent 60%)}
.hero-grid{min-height:590px;display:grid;grid-template-columns:1.04fr .96fr;gap:54px;align-items:center;padding:62px 0 68px;position:relative}
.eyebrow{display:inline-flex;align-items:center;gap:7px;font-size:12px;font-weight:800;letter-spacing:.12em;color:var(--primary);text-transform:uppercase;background:#fff;border:1px solid var(--line);border-radius:99px;padding:6px 11px;margin-bottom:18px}.eyebrow:before{content:"";width:7px;height:7px;background:var(--accent);border-radius:50%}
h1{font-size:clamp(35px,4.8vw,60px);line-height:1.22;letter-spacing:-.025em;margin:0 0 24px;color:var(--deep)}
h1 .accent{color:var(--accent)}
.lead{font-size:18px;line-height:1.95;color:#435e63;margin:0 0 26px;max-width:720px}.hero .lead{font-size:19px}
.hero-actions{display:flex;gap:12px;flex-wrap:wrap;margin:27px 0}.button{display:inline-flex;align-items:center;justify-content:center;gap:8px;background:var(--primary);color:#fff!important;text-decoration:none;font-weight:800;padding:13px 20px;border-radius:12px;box-shadow:0 6px 18px rgba(22,75,82,.16)}.button:hover{background:var(--deep);transform:translateY(-1px)}.button.light{background:#fff;color:var(--primary)!important;border:1px solid var(--line);box-shadow:none}.button.accent{background:var(--accent)}
.hero-points{display:flex;gap:20px;flex-wrap:wrap;padding-top:8px;color:var(--muted);font-size:13px}.hero-points span{display:flex;align-items:center;gap:6px}.hero-points span:before{content:"✓";font-weight:900;color:var(--primary-2)}
.hero-visual{position:relative}.hero-visual img{width:100%;filter:drop-shadow(0 24px 28px rgba(16,57,63,.12))}.hero-caption{position:absolute;left:6%;bottom:2%;background:rgba(255,255,255,.94);border:1px solid var(--line);border-radius:14px;padding:11px 14px;font-size:12px;color:var(--muted);box-shadow:var(--shadow-sm)}
.alert{background:var(--warn-bg);border:1px solid #efd0c9;border-left:5px solid var(--accent);border-radius:16px;padding:20px 22px;margin:28px 0}.alert strong{color:var(--warn);font-size:17px}.alert p:last-child{margin-bottom:0}
.quickbar{margin-top:-28px;position:relative;z-index:4}.quickgrid{display:grid;grid-template-columns:repeat(4,1fr);background:#fff;border:1px solid var(--line);box-shadow:var(--shadow);border-radius:20px;overflow:hidden}.quickgrid a{padding:21px 18px;text-decoration:none;color:var(--ink);border-right:1px solid var(--line);font-size:13px}.quickgrid a:last-child{border-right:0}.quickgrid b{display:block;color:var(--primary);font-size:15px;margin-bottom:3px}
.section{padding:86px 0}.section.tight{padding:58px 0}.section.white{background:var(--surface)}.section.soft{background:var(--teal-soft)}.section.warm{background:#fbf4f1}.section.dark{background:var(--deep);color:#e9f6f4}.section.dark h2,.section.dark h3{color:#fff}.section.dark p{color:#d0e2df}
.section-head{max-width:820px;margin-bottom:38px}.section-head.center{text-align:center;margin:0 auto 42px}.kicker{font-size:12px;color:var(--accent);font-weight:900;letter-spacing:.13em;text-transform:uppercase;margin-bottom:8px}h2{font-size:clamp(28px,3.6vw,43px);line-height:1.36;letter-spacing:-.018em;color:var(--deep);margin:0 0 18px}h3{font-size:22px;line-height:1.5;color:var(--deep);margin:0 0 12px}h4{font-size:17px;color:var(--primary);margin:0 0 8px}p{margin:0 0 18px}.small{font-size:12px;color:var(--muted)}
.grid2{display:grid;grid-template-columns:repeat(2,minmax(0,1fr));gap:24px}.grid3{display:grid;grid-template-columns:repeat(3,minmax(0,1fr));gap:22px}.grid4{display:grid;grid-template-columns:repeat(4,minmax(0,1fr));gap:18px}
.card{background:#fff;border:1px solid var(--line);border-radius:var(--radius-sm);padding:27px;box-shadow:var(--shadow-sm)}.card.clean{box-shadow:none}.card h3 a{text-decoration:none;color:inherit}.card p:last-child{margin-bottom:0}.card .icon{width:44px;height:44px;border-radius:12px;display:grid;place-items:center;background:var(--teal-soft);color:var(--primary);font-weight:900;margin-bottom:17px}.card.urgent{border-color:#e7beb7;background:#fff8f6}.card.urgent .icon{background:#fae1dc;color:var(--accent)}.card-link{display:inline-flex;gap:6px;align-items:center;font-weight:800;text-decoration:none;margin-top:8px}.card-link:after{content:"→"}
.symptom-card{position:relative;padding-top:32px}.symptom-card:before{content:attr(data-no);position:absolute;right:20px;top:12px;color:#d8e5e2;font-size:40px;font-weight:900;line-height:1}
.definition{background:#fff;border:1px solid var(--line);border-radius:20px;padding:30px;display:grid;grid-template-columns:210px 1fr;gap:28px;align-items:center}.definition img{border-radius:14px;background:#edf5f2;padding:8px}
.figure{background:#fff;border:1px solid var(--line);border-radius:20px;padding:18px}.figure img{border-radius:14px}.figure figcaption{font-size:12px;color:var(--muted);padding:10px 5px 1px}
.article-layout{display:grid;grid-template-columns:minmax(0,1fr) 300px;gap:45px;align-items:start}.article{background:#fff;border:1px solid var(--line);border-radius:24px;padding:48px;box-shadow:var(--shadow-sm)}.article h2{font-size:32px;margin-top:58px;padding-top:8px}.article h2:first-child{margin-top:0}.article h3{margin-top:34px}.article ul,.article ol{padding-left:1.4em;margin:0 0 24px}.article li{margin:7px 0}.article blockquote{margin:28px 0;background:var(--teal-soft);border-left:4px solid var(--primary-2);padding:20px 23px;border-radius:0 14px 14px 0}.article table{width:100%;border-collapse:separate;border-spacing:0;margin:22px 0;font-size:14px;border:1px solid var(--line);border-radius:14px;overflow:hidden}.article th,.article td{padding:13px 14px;text-align:left;vertical-align:top;border-bottom:1px solid var(--line)}.article th{background:var(--teal-soft);color:var(--primary)}.article tr:last-child td{border-bottom:0}
.sidebar{position:sticky;top:105px}.sidebox{background:#fff;border:1px solid var(--line);border-radius:16px;padding:20px;margin-bottom:16px}.sidebox h3{font-size:15px}.toc a{display:block;padding:8px 0;border-bottom:1px dashed var(--line);font-size:13px;text-decoration:none;color:#486368}.toc a:last-child{border-bottom:0}
.summary-box{background:linear-gradient(135deg,#e8f4f2,#f9f4f1);border:1px solid #d7e5e2;border-radius:20px;padding:28px;margin:28px 0}.summary-box .label{font-size:12px;font-weight:900;color:var(--primary);letter-spacing:.12em;margin-bottom:8px}.summary-box ul{margin-bottom:0}
.evidence{border-radius:20px;background:#f5f7f5;border:1px solid var(--line);padding:30px;margin:34px 0}.evidence .level{display:inline-block;font-size:11px;font-weight:900;color:#fff;background:var(--primary);padding:4px 9px;border-radius:99px;margin-bottom:11px}.evidence h3{font-size:20px}.evidence cite{font-style:normal;font-size:12px;color:var(--muted)}
.refs{font-size:13px}.refs li{margin-bottom:9px;word-break:break-word}.refs a{overflow-wrap:anywhere}
.metric-row{display:grid;grid-template-columns:repeat(3,1fr);gap:16px;margin:26px 0}.metric{background:#fff;border:1px solid var(--line);border-radius:16px;padding:21px;text-align:center}.metric strong{display:block;font-size:32px;color:var(--primary);line-height:1.2}.metric span{font-size:12px;color:var(--muted)}
.process{counter-reset:step}.process-item{display:grid;grid-template-columns:48px 1fr;gap:16px;padding:20px 0;border-bottom:1px solid var(--line)}.process-item:last-child{border-bottom:0}.process-item:before{counter-increment:step;content:counter(step);width:40px;height:40px;border-radius:50%;display:grid;place-items:center;background:var(--primary);color:#fff;font-weight:900}.process-item h3{font-size:18px;margin:3px 0 5px}.process-item p{margin:0;color:var(--muted);font-size:14px}
.compare{display:grid;grid-template-columns:repeat(2,1fr);gap:18px}.compare>div{border-radius:16px;border:1px solid var(--line);padding:24px;background:#fff}.compare .before{background:#fff8f6;border-color:#edd1cb}.compare ul{margin-bottom:0}
.tagrow{display:flex;flex-wrap:wrap;gap:8px}.tag{font-size:12px;border:1px solid var(--line);background:#fff;border-radius:99px;padding:5px 10px;color:#536d72}
.region-hero{background:linear-gradient(135deg,#f1f7f5,#fff8f6);border:1px solid var(--line);border-radius:26px;padding:36px;display:grid;grid-template-columns:1.05fr .95fr;gap:30px;align-items:center}.region-hero h1{font-size:clamp(31px,4vw,48px)}.region-hero img{max-height:390px;margin:auto}.region-grid .card{min-height:250px}
.faq details{background:#fff;border:1px solid var(--line);border-radius:14px;margin:11px 0;padding:0 20px}.faq summary{cursor:pointer;font-weight:800;padding:18px 28px 18px 0;list-style:none;position:relative}.faq summary::-webkit-details-marker{display:none}.faq summary:after{content:"＋";position:absolute;right:0;color:var(--primary);font-size:20px}.faq details[open] summary:after{content:"−"}.faq details p{padding-bottom:18px;color:#50686d}
.doctor{display:grid;grid-template-columns:220px 1fr;gap:30px;align-items:center;background:#fff;border:1px solid var(--line);border-radius:24px;padding:28px}.doctor img{width:220px;height:220px;object-fit:cover;object-position:center 18%;border-radius:18px}.doctor .name{font-size:27px;font-weight:900;color:var(--deep)}
.crosslinks{display:grid;grid-template-columns:repeat(3,1fr);gap:18px}.crosslink{display:block;background:#fff;border:1px solid var(--line);border-radius:16px;padding:22px;text-decoration:none;color:var(--ink)}.crosslink strong{display:block;color:var(--primary);font-size:17px}.crosslink small{color:var(--muted)}
.cta{background:linear-gradient(135deg,var(--primary),var(--deep));color:white;border-radius:28px;padding:42px;display:flex;align-items:center;justify-content:space-between;gap:28px;box-shadow:var(--shadow)}.cta h2{color:#fff;margin-bottom:8px}.cta p{color:#d5e8e5;margin:0}.cta .button{background:#fff;color:var(--primary)!important}.cta .button.light{background:transparent;color:#fff!important;border-color:rgba(255,255,255,.35)}
.footer{background:#0e3439;color:#d2e3e1;padding:58px 0 90px}.footer a{color:#e8f3f1}.footer-grid{display:grid;grid-template-columns:1.25fr 1fr 1fr;gap:48px}.footer h3{color:#fff;font-size:15px}.footer ul{list-style:none;padding:0;margin:0}.footer li{margin:7px 0;font-size:13px}.footer .brand{color:#fff;margin-bottom:16px}.footer .brand small,.footer .brand .guide{color:#b9d0cc}.footer p{font-size:13px}.supervisor-footer-line{border-top:1px solid rgba(255,255,255,.14);padding-top:20px;margin-top:30px}.copyright{font-size:11px;color:#97b4b1;margin-top:10px}
.mobilebar{display:none}
.note{font-size:13px;color:var(--muted);border-left:3px solid var(--line);padding-left:13px}.external:after{content:" ↗";font-size:.85em}
.updated{font-size:12px;color:var(--muted);margin-top:10px}
.no-margin{margin:0!important}
@media(max-width:980px){.nav a:not(.official){display:none}.hero-grid{grid-template-columns:1fr;gap:20px;min-height:auto}.hero-visual{max-width:680px;margin:auto}.article-layout{grid-template-columns:1fr}.sidebar{position:static;display:none}.grid4{grid-template-columns:repeat(2,1fr)}.region-hero{grid-template-columns:1fr}.footer-grid{grid-template-columns:1fr 1fr}.footer-grid>div:first-child{grid-column:1/-1}.crosslinks{grid-template-columns:1fr}}
@media(max-width:850px){.header-row{height:68px}.nav{position:absolute;display:none;left:0;right:0;top:68px;background:#fff;padding:12px 20px 22px;border-bottom:1px solid var(--line);box-shadow:var(--shadow-sm);flex-direction:column;align-items:stretch}.nav.open{display:flex}.nav a:not(.official){display:block}.nav a{text-align:left;padding:12px}.menu{display:block}.nav .official{text-align:center;margin-top:6px}.brand img{width:45px;height:36px}.brand strong{font-size:15px}.brand .guide{font-size:11px}.quickgrid{grid-template-columns:repeat(2,1fr)}.quickgrid a:nth-child(2){border-right:0}.quickgrid a:nth-child(-n+2){border-bottom:1px solid var(--line)}.grid3{grid-template-columns:1fr 1fr}.definition{grid-template-columns:1fr}.definition img{max-width:320px;margin:auto}.article{padding:32px}.doctor{grid-template-columns:160px 1fr}.doctor img{width:160px;height:180px}.metric-row{grid-template-columns:1fr 1fr}.cta{display:block}.cta .hero-actions{margin-bottom:0}}
@media(max-width:640px){body{font-size:15px;padding-bottom:68px}.container{width:min(calc(100% - 28px),var(--max))}.topnote{font-size:10px}.brand{min-width:0}.brand small{display:none}.hero-grid{padding:42px 0 58px}.hero .lead{font-size:16px}.hero-visual{margin-top:6px}.hero-caption{position:static;margin-top:9px}.quickbar{margin-top:-20px}.quickgrid a{padding:16px 13px}.section{padding:64px 0}.section.tight{padding:44px 0}.grid2,.grid3,.grid4,.compare{grid-template-columns:1fr}.card{padding:22px}.article{padding:23px;border-radius:18px}.article h2{font-size:26px;margin-top:46px}.article table{font-size:12px}.article th,.article td{padding:10px}.region-hero{padding:24px}.metric-row{grid-template-columns:1fr}.doctor{grid-template-columns:1fr;text-align:left}.doctor img{width:160px;height:180px}.footer-grid{grid-template-columns:1fr}.footer-grid>div:first-child{grid-column:auto}.footer{padding-bottom:35px}.cta{padding:28px 22px;border-radius:20px}.mobilebar{display:grid;grid-template-columns:1fr 1fr;gap:8px;position:fixed;z-index:80;left:0;right:0;bottom:0;padding:8px;background:rgba(255,255,255,.97);border-top:1px solid var(--line)}.mobilebar .button{padding:11px 8px;font-size:12px;border-radius:10px;box-shadow:none}.mobilebar .button.light{color:var(--primary)!important;border:1px solid var(--line);background:#fff}.hero-actions .button{width:100%}.h-scroll{overflow:auto}.h-scroll table{min-width:620px}}
@media print{.header,.topnote,.mobilebar,.cta,.menu{display:none!important}.section{padding:30px 0}.article{box-shadow:none}.footer{background:#fff;color:#333}.footer a{color:#333}}

/* Official-site clinical photos */
.hero-visual img{border-radius:22px;object-fit:contain;background:#fff}
.region-hero img{width:100%;max-height:390px;object-fit:contain;border-radius:18px;background:#fff}
.figure img{width:100%;max-height:560px;object-fit:contain;background:#fff}
.section.warm>.container>.figure{max-width:900px;margin:0 auto 30px}
.section.dark .figure{border-color:rgba(255,255,255,.18);padding:10px;background:rgba(255,255,255,.98)}

/* v4 clinical image + evidence review refinements */
.clinical-gallery-v4{margin:24px 0;}
.clinical-gallery-v4 .grid2{align-items:start;}
.clinical-gallery-v4 .figure img{width:100%;max-height:420px;object-fit:contain;background:#f5f8f7;}
.evidence-review-v4 .evidence{margin:30px 0;}
.evidence-review-v4 .source-list li{margin:.55rem 0;}
@media(max-width:720px){.clinical-gallery-v4 .figure img{max-height:320px;}}