Regarding diagnostic criteria for metabolic syndrome (MS), minor cases where the lipid, blood pressure, and blood glucose levels slightly exceed their normal ranges are considered to require careful observation, because they are border line between “normal” and“abnormal” conditions. We devised a method to solve this problem by introducing the concept of an “undeveloped” condition. Based on observations of the MS-score distribution for each examinee, checkup data were numerically processed into three areas representing the “normal”, “undeveloped”, and “critical” conditions, and applied to Self-Organizing Maps (SOM) to develop a tool visualizing the MS indicators. The distinguishing capacity of our method was validated by comparing checkup data between MS judgment results employing our method and those using conventional diagnostic methods. Furthermore, our method can visualize positional relationships between the MS indicators and the three areas on the two-dimensional SOM, promising its application to health guidance.
Purpose : To analyze risk factors for colorectal adenoma in women according to age brackets and examination times to find the proper age for performing colorectal cancer screening. Methods : We studied 8,890 women who underwent their initial endoscopic examinations at the Health Care Center, Takano Hospital over 15 years from April 1992 to March 2007. The calendar years were roughly categorized into first (April 1992-March 1998) and second (April 1998-March 2007) periods. In each period, we investigated age-dependent changes in obesity, total cholesterol (Tcho) , HDL-cholesterol (HDL) , triglycerides (TG) , LDL-cholesterol (LDL) , fasting blood glucose levels (FBS) , and abdominal circumference (WT) to compare data between the two periods. Since as a result of an age-group study of all subjects we found that the age of 50years was a turning point for risk of colorectal adenoma development, we calculated odds ratios using a multivariate logistic regression analysis. Results : In the first period, the risk for developing colorectal adenoma at the age of less than 50 years increased 1.004-fold as TG increased by 1.0, but the risk was significantly increased to 2.682 at TG > or = 150 mg/dl. On the other hand, in the second period, the risk at the same age was significantly increased as follows : 1.003-fold increase with an increment of 1.0 in TG ; 1.663 increase at TG > or = 150 mg/dl ; 2.363 increase at FBS > or = 110 mg/dl ; 1.037 increase with an increment of 1.0 cm in WT ; and 2.684-fold increase at an WT > or = 90 cm. In the age group of 50 years or older, the risk for colorectal adenoma development increased significantly with aging in either period. Conclusions : The prevalence of colorectal adenoma in women was significantly higher in the age of 50 years older. For life style related risk factors, TG, FBS, and WT were more related to progressing adenoma in the group of less than 50 years and the group examined recently.
The purpose of this study was to validate 1-, 2-, 3-, and 4-day dietary records (DRs) by comparing with 7-day weighed dietary records (7-DWDRs). Subjects were 29 university students and 6 graduate students. The order of procedure was as follows : first, the subjects kept 7-DWDRs in which Saturday and Sunday were included ; second, approximately 2 weeks after 7-DWDRs, the subjects kept 4-day DRs without weighing from Sunday to Wednesday. Many of food stuff intakes and nutrient intakes assessed with 2-, 3-, and 4-day DRs moderately to highly correlated with the respective intakes assessed with 7-DWDRs. Less food stuff intakes and nutrient intakes assessed with 1-day DRs correlated with the respective intakes assessed with 7-DWDRs. The results of the present study suggest that minimal days necessary for estimating nutrient consumption are at least 2 days.
Objectives : Implementation of resting electrocardiogram (ECG) is obligated by law and widely conducted in occupational sites in Japan. However usefulness of resting ECG in assessing cardiovascular risk of working people is not clear, partly because the evaluation of abnormal ECG may vary among facilities. We conducted large scale survey of resting ECG implementation status in work site to identify factors influencing assessment of ECG abnormalities. Methods : Self reporting questionnaire was sent to 379 screening institutions which have been under the accuracy control program conducted by the National Federation of Industrial Health Organization. The questionnaire included incidences of abnormal ECG and rate of requiring further evaluation. Results : We received reply from 235 institutions (response rate 62%) and data of 218 institutions were analyzed. A total of 2,770,239 (men : 1,716,697 women : 1,053,542) ECG examinations were conducted during the survey period. In 66.5% institutions, computerized diagnosis system was always utilized. The survey showed that 14.7% of the total ECG examinations were assessed as abnormal, 8.1% resulted in repeated examination, and 2.5% resulted in further evaluation. There were ST • T abnormality (men 2.2%, women 2.4%), abnormal Q wave (men 0.5%, women 0.2%) and atrial fibrillation (men 0.6%, women 0.1%). When assessing clinical significance of ECG abnormalities to determine the need for further evaluation only 57.3% institutions referred to past medical histories, 50.5% referred to blood pressure values, 48.2% referred to subjective symptoms and 31.7% compared with previous ECG. The rate of abnormal findings resulting in further evaluation was significantly higher in institutions that did not refer to subjective symptoms, family history, past history, previous recording or cardiovascular risk factors, than institutions that referred to those factors. About a quarter of institutions were aware of final diagnosis. Conclusion : Resting ECG is useful for medical screening examination in occupational sites since abnormal ECG results needing further evaluation or treatment have been detected. However the rate of abnormal ECG requiring further evaluation varies among institutions. The rate is influenced by whether the institution refer to factors such as subjective symptoms, previous recording and cardiovascular risk factors when assessing ECG abnormalities. Implementation of guidelines for assessment of clinical significance of ECG abnormalities in occupational sites may help enhancing consistent assessment among screening institutions.
The number of employees with adjustment disorders who cannot adjust themselves to their workplace due to interpersonal problems, overwork, or the lack of occupational aptitude is increasing. We classified adjustment disorders into 5 categories and presented a typical case for each category with comments. Main reasons for the increase in the number of employees with adjustment disorders include reduced intimacy in mutually-supporting relationships among employees. Many employees find nobody to consult in their workplace when they face problems they cannot independently solve. Then, they become alienated and suffer from adjustment disorders. In order to help these employees return to work, industrial physicians should support them by building up a network of employees and their superiors and personnel affairs managers.