Of the 173, 265 people who had general health checkups at Oriental Clinic for the 11year period from 1987 to 1997, 33 cases of renal cell carcinoma have been discovered. In all of the cases, renal abnormalities were first indicated in abdominal ultrasound tests and patients were transferred to other medical institutions, where they were submitted to histological diagnoses and operations. The author studied the patients subjective symptoms, whether or not abnormal data was found in their clinical tests, relations among the size of tumors, progressive stages, pathological grades (atypia) and echoes inside the tumors (echo brightness and patterns), and also patients prognoses. As a result, it was found that in most of the cases none of the three major signs characteristic of renal cell carcinoma (gross hematuria, pain in the kidney or tactile tumors) was detected. In main abnormal findings in clinical tests, abnormal erythrocyte sedimentation rates were indicated in two cases and CRP positive was found in one case. There was not any case of anemia, polycythemia or hypercalcemia. Major axes of the tumors ranged from 15mm to 107mm. Regarding the progressive stages of tumors, which were mainly diagnosed at the other medical institutions, six cases of pT₁, 20 cases of pT₂, two cases of pT₃, one case of pT₄ and four cases of unknown stages were found with the TMN staging. According to the Robson staging, on the other hand, the patients were classified into 26 cases of the I stage, four of the II stage, one of the III, another one of the IV and one case of unknown stage. In the relation among the size of tumors, progressive stages, echo brightness and echo patterns, cases with smaller and less progressed tumors tended to show more hyperechoic and homogenous tumors. Mean tumor size was 31.0 ±13.4mm and 50.9±15.1mm in diameter in the eight cases with G₁ atypia and eight cases with G₂, respectively. It showed that the tumor size tended to be smaller in G₁ cases than G₂.
In all of the 33cases, the patients received radical nephrectomy, excluding one case in which partial nephrectomy was performed.
Observation periods for patients' prognoses ranged from one year to 11 years (5.5 years in average) . One patient died, one was lost to followup and 31patients were alive.

View full abstract

The purpose of this study was to examine sex differences in serum lipids and systolic and diastolic blood pressures (SBP and DBP, respectively) .The subjects were divided into 4 groups : subjects who were neither drinkers not smokers (A Group), were smokers but were not drinkers (B Group), were drinkers but were not smokers (C Group), and smokers and drinkers (D Group) . In the A Group, after adjusting for age, body mass index, and physical activity, women showed significantly higher total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) and significantly lower triglycerides (TG), TC/ HDL-C ratio, SBP and DBP. In addition to age, body mass index, and physical activity, number of smoking and amount of alcohol intake per day were adjusted where appropriate in the B, C and D Groups. In the B Group, women showed significantly higher TC and HDL-C and significantly lower TG, TC/HDL-C ratio, SBP, and DBP. In the C and D Group, women showed significantly higher HDL-C, and significantly lower TG, TC/HDL-C, SBP, and DBP. These results indicate that women show more favorable serum lipids and blood pressure than men, however, the differences were more pronounced in A Group and were diminished with smoking and drinking habits.

View full abstract

The relationship between Body Mass Index (BMI) and blood pressure, serum lipids and lipoproteins was studied in 1, 680 young Japanese men aged 20-39 years. The data was adjusted for age, cigarette smoking and alcohol intake. Subjects were divided into three groups by BMI : a Low group (BMI<21.8), a Middle group (21.8≤BMI<24.2), and a High group (BMI≥24.2) . High group had significantly lower mean value of high density lipoprotein cholesterol (HDL-C) than Middle group and Low group. High group had significantly higher mean value of systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglycerides (TG) and low density lipoprotein cholesterol (LDL-C), and the ratio of TC to HDL-C (TC/HDL-C) than Middle group and Low group. The present study shows that there was a higher risk of blood pressure, serum lipids and lipoproteins in high BMI group in young Japanese men aged 20-39 years. It is important to control the weight with change in the percent body fat and the waist circumference in these persons.

View full abstract

It is possible to measure human mental and physical conditions by analyzing human voice using a method based on the chaos theory. In order to derive exponents indicating degree of tiredness, we calculated the first Lyapunov exponent from reading voices.
As a result, we found that it is possible to predict subject's fatigue. About 50 minutes after the subject had started reading, the subject complained of excessive fatigue, and the experiment was finished. In fact, the exponent had already reached the same level as the level that the subject complained of excessive fatigue 20 minutes after the subject had started reading.
We also found that there were four patterns of variation of the exponent according to psychosomatic conditions of the subject. In the first phase, the averages of the exponent are decreasing. In the second, the exponent is gradually increasing. In the third, fluctuation is observed. And in the fourth, the load level increases at a fast rate.
The phenomena, which“continuing to read aloud causes rise in the averages of the first Lyapunov exponent”and“stress condition of a person accompanies with the variation of the exponent”, occur because of the following reason.
When the brain-processing load is increasing, the situation-recognition-function that makes quality of“information aiming at control”for the physical-control-function decreases in order the brain to avoid overload. That makes quality of control toward speech organ by the physical-control-function decrease. Consequently, that is to say that quality of the speech or reading decreases.
When the brain has enough space to functions, speech organ is controlled well, and the value of the first Lyapunov exponent is in the appropriate range. However, control of the speech organ becomes insufficient when the brain loses its space to functions, and the value of the first Lyapunov exponent increase beyond proper value.

View full abstract

Our major health task of the 21^St Century is to prolong high-quality healthy life span. To this aim, we need to realize a society that will enable us to:
1) thoroughly learn the numerous epidemiological/clinical evidence for habits that raise the risks of diseases through effective health education;
2) make an informed choice of individual health program, out of many choices presented to us based on the evidence;
3) receive full support from the local community; and
4) maintain the spirit to enjoy and practice the health program for living independently until the last day of our lives.
Evidence-based medicine as well as narrative-based medicine and family medicine should receive great attention.
In order to change undesirable habits, health professionals first need to discuss with the individual clients face-to-face, find the barriers that may hinder their health behavior change, and work together with the clints towards overcoming these barriers.
Putting informed choice and evidence into practice is where the challenge lies ; understanding one's health program is necessary but not sufficient for a successful behavior change. Our efforts to date include the following:
1) opened Healthy Village, rich in its natural, athletic, cultural offers;
2) opened Sports Community Dynamic;
3) incorporated Komatsu Sports Association to promote‘Sports for all’, aiming for half the citizens to participate in sports;
4) complete health examination by the HIWSS method;
5) developed and distributed HIWSS computer software for health promotion;
6) established partnership with the local, prefectural, and national government;
7) established Komatsu Health Promotion Foundation;
8) sponsored four-day refresh seminars;
9) implemented anti-smoking programs;
10) appointed as the model city for‘Healthy Japan 21’Project by the Ministry of Health, Welfare and Labor.

View full abstract

The conventional health evaluation and promotion are based on the phenotypic biochemical and physiological analyses of lifestyle-related diseases including hypertension, diabetes, obesity and hypercholesterolemia. These phenotypes are the results of both nutritional and genetic factors. The genetic factor is mainly composed of single nucleotide polymorphism (SNP) . The ethnic difference in the frequency of SNP may be caused by natural selection depending on the types of agricultures in human history. The SNPs including beta-adrenergic receptor, uncoupling proteins, calpain 10, PPAR-gamma, leptin receptor are responsible to obesity and diabetes. Hypertension of Japanese is also caused by SNP for factors retaining salt, such as angiotensinogen, aldosterone synthase and angiotensin converting enzyme. T-type SNP of angiotensinogen was needed for apes living in the tropical fores, but is predisposing hypertension in the modern sosiety. There is strong impact of Westernization. We have studied SNPs in mongoloids because of their rapid increase in diabetes by Westernization. SNPs saving energy were found in PPAR-gamma, UCP 3 promotor, leptin receptor etc. (Biochem. Biophys Res. Commun. 281: 772, 2001) . We also analyzed SNPs of the patients who was educated 25-31 years before. Despite differeces in SNPs (beta-adrenergic receptor, apoE and mtDNA), the special dietary habits (four-group point method) prevented most of the lifestyle related diseases. In conclusion, health evaluation will include genetic analysis in order to implement tailor-made medicine.

View full abstract

Introduction of new diagnostic technology often brings about a change of clinical medicine. When introduced to multiphase health test areas, new techniques in rapid testing require special preparations and considerations.
Ultrasonography (US) and high-speed spiral CT of the lung are the recent examples.
Accuracy and coverage of US depends on visibility of the scanned areas as well as examiner skill. Such provisos mean that every US report must include the names of target organs and the degree of visibility for each scanned organ. If colon gas, thick fat layers or insufficient urine in the bladder limits visibility, causing US to fail to be fully diagnostic, examiners should honestly inform their examinees of these limitations to avoid overconfidence in the results.
High density-resolution of computed tomography (CT) is so far the only tool that can detect pale opacity of minute pulmonary adenocarcinoma not visible on plain chest X-rays. Therefore, CT is mandatory when health tests aim for early detection of lung cancer. Good throughput for high-speed spiral CT enables taking scout lung CT during multiphase health testing, but proper preparation for prompt film reading and reporting is necessary to complete all processes involved in comprehensive health evaluation in the three hours allowed for such testing.

View full abstract