We have analyzed the cases of breast cancer detected during the breast cancer screening by ultrasonography (US) and further discussed usefulness of US. The rate of the cases requiring detailed examination was 3.7% (374/9, 978 subjects), while the detection rate of cancer was 0.29% (29/9, 978 subjects) . The 29 cases with breast cancer were all detected by US with the largest diameter of mass being 0.4-3.0 cm (a mean value 1.32 cm) and 26 (90%) of them were early-stage breast cancer. Of the US detected breast cancer, 52% (15/29) were detectable by palpation and 55% (12/22) were positive for mammography (MMG) . The mean diameter of masses of palpable/nonpalpable cases was 1.61±0.68 cm/1.01±0.28 cm respectively, indicating the diameters were significantly smaller in the nonpalpable cases. At the same time, the mean diameter of the masses detectable/nondetectable by MMG was 1.63±0.74 cm/0.91±0.31 cm respectively, indicating the diameters of masses were significantly smaller in the cases nondetectable by MMG and thus US excelled in detecting small masses, compared with clinical examination or MMG. On the other hand, when looking into the relationship between diameter of mass and conservative surgery, the masses with rather smaller diameters were observed in those having undergone the mastectomy. Moreover, among five cases with positive histological lymph node metastasis, four cases were early-stage breast cancers with the diameters less than 1.5 cm. Also, of those four cases three were nondetectable by both clinical examination and MMG. Meanwhile, as regards three out of five cases with minute calcification detected by MMG, the punctate hyper echo was detected even with US though only rough images of masses were portrayed for the rest of the two. Thus calcification in the hypoechoic area (LEA) was recognizable even by US to some extent.
In this study US excels anothers in the detecting of small breast cancer (especially invasive carcinoma) . With all these in mind, we consider US should be more proactively used for breast cancer screening.

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This study measured the improvement in health that the elderly showed by attending a fitness program aimed at helping them build their bodies so that they can lead a life free of nursing care. The sample of this study was those aged 60 or older who attended at least ten out of a total of twenty-five lessons. A questionnaire was given at the beginning and end of the program to collect data on their definition of health and improvement in their bodily movements in their daily lives. Also, physical fitness tests were carried out before and after the program, and the results showed that the agility of those in their 70's had improved significantly by attending the program for six months and voluntarily continuing the exercise at home while those in their 60's even demonstrated better flexibility and overall physical capabilities in addition to improved agility. Furthermore, the subjects indicated in the questionnaire that the subjective symptoms of back and knee pain had lessened. They also mentioned that they enjoyed going out and felt better-proof that their mental and physical health had improved-and that their outlook on life had become more positive. In conclusion, a fitness program that repeats basic exercises is not only safer for the elderly but can effectively help in fall prevention. It can also help the elderly stay physically healthy, eliminating the need for nursing care.

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Health examination data should be evaluated appropriately to instruct the health examinee what to do. Health examination organizations should determine reasonable criteria for detecting unhealthy conditions. Here we describe the latest criteria of obesity, diabetes, hypertension, hyperlipidemia, and hyperurinemia that have been developed by the corresponding expert panels. We discuss how to evaluate health examination data.

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Many workers of the food processing company to whom I am advising complain fatigues. A questionnaire study for the fatigue symptoms : Rating cumulative fatigue symptoms Index developed by Institute for Labor Sciences, Japan was carried out during 2002 and 2003. This company has four factories in Chiba prefecture, and the workers of three factories gave answer for the questionnaire. These factories were operating day and night all days a year. Most of the workers are paid by work-time bases. Health conditions and life habits of these workers were analyzed by questionnaires at the time of annual physical health examinations, 2002. Workers were classified into groups; day and night workers, male and female, ages below and over 35 years, and types of work (cooking, packing and distribution, and others (administration, production control, and quality control) ) . The results from these groups were compared. The results from three independent factories were also compared.
Average total fatigue scores of the workers from three factories were not so different. Average sores of each symptom were high in general fatigues, and decreased in the order of depressive states, daunted states, chronic fatigues, discouraged states, physical disorders, insecurities, and nervousness. Actual scores were no so high in general, higher scores observed were mostly recoverable fatigues, and scores for nervousness were very low. These results suggested that the fatigues of the workers in these factories were relatively healthy. The scores of the workers for cooking and packing were almost same, but higher than those for other works. This result suggested that scores of fatigues of the workers were depending on the hardness of the physical works. The fatigue scores of adults were not so dependent on factories, sexes and work-shifts, but those of young generations were higher in male than female, but those of day-time workers and night time workers were different depending on the factories.

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