Recent reports have described that early detection of pancreatic cancer can be facilitated by using endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) for histological or cytological examinations, or by close follow-up observation of high-risk groups, such as branch duct intraductal papillary mucinous neoplasm (branch duct IPMN) cases. We studied the results of medical checkups for pancreatic cancer by abdominal ultrasonography on 14,151 subjects (9,355 males and 4,796 females; mean age 52) receiving general medical checkups in fiscal 2011. The results showed findings in 2.0% of subjects, and the detection rates of pancreatic cysts and dilated pancreatic ducts, which are indirect findings of pancreatic cancer, were 1.0% and 0.6%, respectively. The detection rate of pancreatic cysts was above that reported at other institutions (0.7%). Among subjects advised to receive a thorough pancreatic cancer examination, 78% did so, and the pancreatic cancer detection rate was 0.007%, which both compared well to other medical checkup facilities. Branch duct IPMN, involving a high pancreatic cancer risk, had a 0.12% detection rate, occurring more often with complications of pancreatic cysts with dilated pancreatic ducts. Such cases would require thorough examinations and follow-up observation. The detection rate of pancreatic tumors in the thorough examinations was 0.15%. The detection rate with EUS was 100%, but CT/MRI was lower (18%). However, most cases underwent only CT/MRI, and no more than 10% underwent EUS. To enhance screening efficiency, it is important for a screening facility to increase pancreatic imaging capacity and elevate detection rates for groups with higher risks of pancreatic cancers including pancreatic cysts, dilated pancreatic ducts, and branch duct IPMN.

View full abstract

 Introduction: In recent years, it has been widely reported that diabetes, hypertension and dyslipidemia may be associated with the onset and progression of age-related hearing loss. However, the implications of glucose intolerance, early hypertension and dyslipidemia on hearing loss are not well understood. Therefore, we attempted to clarify the relationship between hearing loss and glucose intolerance, early hypertension and dyslipidemia.
 Subjects: The subjects were 57,836 individuals between the ages of 40 and 79 who underwent medical examinations and audiometric testing at our facility between April 1, 2011 and March 31, 2012.
 Methods: The prevalence of subjects with glucose intolerance, early hypertension and dyslipidemia, respectively were compared between subjects suffering from hearing loss and those with no hearing abnormalities by age group. Glucose intolerance was defined as HbA1c of 5.9-6.4% (NGSP) or fasting blood glucose of 110-125 mg/dL; hypertension was defined as systolic blood pressure of 140-159 mmHg or diastolic blood pressure of 90-99 mmHg; dyslipidemia was defined as triglycerides of 200-399 mg/dL or LDL cholesterol of 140-159 mg/dL.
 Subjects receiving medical treatment for metabolic syndrome-related factors were excluded from the analysis.
 Results: Early stage of hypertension and glucose intolerance seemed to affect hearing loss in the middle-aged subjects.
 The prevalence of glucose intolerance and mild hypertension among the subjects with hearing loss was significantly higher than among those without hearing loss in the 40-60 year-old group (p < 0.01).
 The prevalence of dyslipidemia among the subjects with hearing loss was significantly lower than among those without hearing loss in the over 60 years old group (p < 0.05).
 hearing loss, between two groups Chi square test is used as statistical analysis of prevalence between two groups.
 Conclusion: Early stage of hypertension and glucose intolerance may affect hearing loss among the middle aged.

View full abstract

 To obtain basic data to plan nutritional support for individuals with anemia, a total of 42 female students from university volleyball, tennis, and karate clubs were evaluated regarding their nutrient and food-group intakes and blood biochemical parameters. The students were classified into three groups on the basis of their serum ferritin levels (Low, Middle, and High). In all three groups, nutrient intakes were below adequate levels for all nutrients except copper, and significantly lower cryptoxanthin and vitamin C intakes were observed in the Low group. All blood biochemical parameters, except for iron saturation, were within normal ranges in these three groups, although significantly lower hemoglobin and serum iron levels and significantly higher total and unsaturated iron-binding capacity levels were noted in the Low group. Taken together, although anemia was absent in these students, the Low group was found to have pre-latent iron deficiency. This may be partly due to reduced non-heme iron absorption associated with decreased cryptoxanthin and vitamin C intakes, and an insufficient supply of non-heme iron.

View full abstract

 Healthcare in all its aspects as both physical and mental healthcare is a crucial issue in the modern world. The purpose of this research is to find a relationship between lifestyles and mental health in young adults. In this research, college students were asked about their lifestyles including about meals, sleeping, participation in daily activities, and their mental health including their stress levels.
 As a result, we found that the subjects who got enough sleep and had positive eating habits and adequate nutrition had less stress. They also had stable moods and participated in many daily activities. On the other hand, the subjects who slept less and had negative lifestyle habits such as not eating well and not receiving adequate nutrition had more stress. This second group of college students had unstable moods and participated in less activities.
 Mental disease such as depression sometimes appears and physical disease such as metabolic syndrome rarely appears in young adults. A negative lifestyle in a young person is more likely to cause mental and physical disease when the subjects become adults. Healthcare in young adults could prevent them from diseases in late middle age and old age.

View full abstract

 We examined the effect of chronic Helicobacter pylori infection on both fasting blood glucose and HbA1c levels. The 18,429 adults who received a medical checkup at Kameda Medical Center Makuhari between January 2010 and December 2010 were enrolled as study subjects. From these study patients, we excluded those with factors which could potentially influence H. pylori, fasting blood glucose and HbA1c levels. The final number of eligible subjects was 16,046.
 Using propensity score calculated by multiple logistic regression analysis, we estimated causal effects by matching method and Inverse Probability Weighting. Results indicated that fasting blood glucose levels displayed a significant negative correlation with Helicobacter pylori infection (risk difference: -0.8163, risk ratio: -0.0087, p < 0.0001), while HbA1c levels displayed a nonsignificant negative correlation (risk difference: -0.0089, risk ratio: -0.0017, p=0.0682).
 These results raise the possibility that chronic Helicobacter pylori infection may reduce the risk of diabetes mellitus, but the influence is minimal at most

View full abstract

[in Japanese]

View full abstract

 Pepsinogen (PG) method (positive: PGI < 70, PGI/II ratio < 3.0) is useful for investigating the of risk of early gastric cancer however the PG value is influenced by H. pylori infection. After eradication of H. pylori, the conversion of the evaluation of pepsinogen method occurs over 80% (from positive to negative). So the PG method is recommended only before eradication. Recently it has been reported that the PG value is useful for evaluation of H. pylori infection. Sensitivity, specificity of PGII (cut off: 10) for H. pylori infection is 91.0 and 85.7 respectively. In the future it is necessary for a more detailed investigation with reference to PG value and PG method.

View full abstract

 In Japan, the numbers of patients with prostate cancer and deaths from the disease are both increasing as of now. Therefore, countermeasures against the disease are vital. Introduction of prostate specific antigen (PSA) screening has helped detect early-stage prostate cancer and increased the possibility of permanent cure. A study in Europe reports a 20% decrease in mortality by PSA screening and PSA tests are considered to be gaining importance. But there are opinions not necessarily recommending PSA screening from medical economic perspectives and in fact arguments exist regarding this issue. In addition, it is known that prostate cancer often develops as latent cancer with a higher incidence along with aging. We cannot ignore the fact either that early detection of cancer can lead to overdiagnosis on one hand, considering that a constant rate of well-differentiated, small-volume cancer is included in prostate cancer detected without subjective symptoms but only by increases in PSA levels. However, the exposure rate of PSA screening in Japan is low in the first place and we are not in the circumstances to accept advisory from the U.S. unrecommending PSA tests straight. Urologists are responsible for continuous efforts to provide patients with clear information on benefits and disadvantages of PSA screening, biopsies, and prostate cancer treatment and for establishment of a system to avoid unnecessary biopsies and overdiagnosis. This article explains these issues related to PSA screening and introduces part of studies to help avoid overtreatment including active surveillance of prostate cancer that is currently being examined.

View full abstract

 The purpose of cancer screening is to reduce cancer mortality. While mammography is the only method of breast cancer screening for which there is established evidence of a reduction in mortality, low sensitivity of the technique in dense breasts is a serious issue to be resolved. Although ultrasonography is a useful candidate for overcoming this problem, the recent trend toward introducing ultrasonography for population-based screening is still too early. Ultrasonography may offer higher sensitivity because it can detect breast cancer at an early stage based on mass shape, even in the dense parenchyma of premenopausal women. However, there is no manual on a standardized method of examination, no diagnostic criteria, and no evidence that ultrasonography screening reduces mortality. The Japan Strategic Anticancer Randomized Trial (J-START) was the first large-scale RCT to verify the quality and effectiveness of ultrasonography for breast cancer screening in women aged 40-49 years. The primary endpoints of this trial were inter-group comparisons of sensitivity and specificity, and the secondary endpoint was the inter-group comparison of the accumulated incidence rate of advanced breast cancer during the follow-up period. The primary and secondary endpoints are expected to be published at the end of 2014. Endorsement of the new modality is expected to increase the detection rate; however, it might also increase the recall rate, which would be an adverse effect of screening. It is necessary to make ultrasonography screening available, but it should not be introduced too hastily until evidence has been established.

View full abstract

 Every year about 15,000 people in Japan are diagnosed with cervical cancer, and there are approximately 3,500 deaths. Cervical cancer in young adults is still increasing.
 There are a number of issues facing cervical cancer screening in Japan. Firstly, the attendance rate for cervical cancer screening is very low. Secondly, although the Bethesda System is gradually spreading in Japan, conventional cytology is still the major approach, and liquid based cytology is not popular. Thirdly, HPV and Pap co-test has not been introduced as a method of mass public screening. Fourthly, without scientific discussion, the Japanese Government abruptly ceased to recomend HPV vaccination in June 2013.
 Cervical cancer is already a preventable disease. The Japanese Government must pay attention to WHO and FIGO specialists.

View full abstract