Purpose: Advanced glycation end products (AGEs), which increase with age, cause dysfunction in skeletal muscles by altering protein functions. Furthermore, animal studies show that AGEs accelerate the decline in skeletal muscle mass. This study aimed to investigate the relationship between AGE accumulation and skeletal muscle mass.
 Methods: Seventy men and women (men, 55%; mean age, 58±10 years) enrolled in this study. Skin autofluorescence (SAF) was measured as a parameter of AGEs. Skeletal muscle index (SMI) was measured using dual-energy X-ray absorptiometry as a parameter of appendicular skeletal muscle mass. Hand grip was measured as a parameter of muscle strength. Multiple regression analysis was conducted to identify determinants that influence SMI.
 Results: SMI was significantly correlated with age, gender, body mass index, serum triglyceride, serum creatinine, hand grip and SAF (r=0.312, P=0.011; r= -0.692, P<0.001; r=0.607, P<0.001; r=0.302, P=0.028; r=0.464, P<0.001; r=0.741, P<0.001; r= -0.413, P<0.001, respectively). SAF was identified as a significant independent factor associated with SMI, based on multiple regression analysis.
 Conclusion: SAF was an independent factor associated with SMI.

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 In order to improve patients’ level of satisfaction, it is important to reduce their burden of waiting for examination. Therefore we have performed each examination procedure more efficiently, and maintained this efficiency at a high rate. This study examined the relationship between changes in the rate of gastric radiography use and patients’ burden of waiting.
 The maintenance of a high rate of gastric radiography use from early in the morning was shown to contribute to a reduced burden of waiting. On the other hand, as the priority was given to increasing such a rate, services were centralized in gastric radiography, consequently complicating the line of flow toward other examinations; the possibility of this inversely leading to a reduced patient satisfaction level was undeniable.
 As future perspectives, it may be necessary to observe patients’ burden of waiting for examination to the extent possible, and continuously analyze it as a basis for multifaceted approaches to improvement. Further studies may also be necessary to examine methods for patients to effectively use the waiting time.

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 The relationship between obesity and occupation has recently become a popular topic of research. Engineers have been found to have higher prevalence of obesity. Sedentary occupational activities, like seated deskwork, can be determinants of energy expenditure. Additionally, work-related stress can induce unhealthy eating behaviors and high total caloric intake. However, cross-sectional studies have not clarified whether obesity starts before a new job is begun. We therefore investigated whether those who intend to be engineers (hereinafter “engineers-to-be”) were already obese (based on BMI > 25). Observations were made during medical examinations at the time of starting employment for 179 engineers. Their obesity rate averaged 30%, which is 10% higher than that of non-engineers in the same age range, according to the National Health and Nutrition Survey conducted by the Ministry of Health, Labour and Welfare, Japan. Most of the observed obese young engineers-to-be had abdominal obesity. However, there was no significant difference between the rate of metabolic syndrome among engineers-to-be and non-engineers of the same age as reported in the survey. Obesity in young adulthood and midlife has been found to increase the risk of subsequently acquiring metabolic syndrome or dementia. Therefore, interventions targeting weight loss among young obese people and preventing obesity among engineers-to-be are essential not only at the individual level but also at the company level.

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 ABC classification for gastric cancer risk to determine the requirement of further imaging test has been widely used. As an unresolved issue, however, gastric cancer sometimes occurs in Group A categorized as the lowest risk population. This issue is attributed to false negative in the test for H. pylori infection and inclusion of preexisting H. pylori infection. Serum anti-H. pylori antibody test has been developed to detect H. pylori infection; therefore there are no criteria to determine preexisting H. pylori infection. In order to determine “true” Group A population, it is critical to distinguish H. pylori infection-free cases from both preexisting and current H. pylori infection cases. Among Group A population, false negative and preexisting infection cases called false Group A population need to be excluded from Group A since they have gastric cancer risks. In this study, we examined 1,081 subjects that received health screening including gastroendoscopy as well as serum anti-H. pylori antibody test and pepsinogen test (ie, ABC screening) at our hospital in 2014. After removing 311 subjects completing H. pylori eradication before gastroendoscopy, the 770 remaining subjects were clarified into Groups A, B, C and D. There were 632 cases classified to Group A, accounting for 82.1% of total subjects. We determined “true” Group A population based on the exclusion criteria eliminating false Group A population reported by Inoue et al, ie, anti-H. pylori antibody titer of ≥3 U/mL, pepsinogen I level of ≤30 ng/mL, pepsinogen II of ≥12 ng/mL and I/II ratio of ≤4.5.“True” Group A included 480 cases (62.3%) versus 632 cases (82.1%) in the initial Group A population, and infection was endoscopically detected only in 7 subjects from “true” Group A, successfully decreasing the number of false negative Group A population to 1.1%.

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 Background: Japan has an extremely low rate of participation in cervical cancer screening of approx. 30%. To promote participation, many companies and health insurance associations have adopted a cytological self-sampling method, instead of evidence-based physician-sampling.
 Objectives: The purpose of this study is to evaluate the usefulness of the cytological self-sampling method in population-based health check-up programs for employees and their family members.
 Subjects: Physician-collected and self-collected samples from 61,489 and 5,927 women, respectively, who participated in cervical cancer screening at Kyoto Industrial Health Association from April 1, 2013 through March 31, 2015 were evaluated.
 Method: Samples were classified into two groups- an employee group and a family member group. Cytological positive rates in both groups were compared and evaluated according to age using Fisher’s exact test.
 Results: In both groups, cytological positive rates of physician-collected samples were higher, and a significant difference (p<0.01) was observed. No glandular cell lesions were detected in self-collected samples.
 Discussion: According to the above results, self-sampling showed a lower accuracy in health check-ups for employees and their family members. False negative results were frequently obtained with the self-sampling method, especially in women 20-40 years old, the peak age range of cervical cancer onset, responsible for reduced fertility, and decreased quality of life. This study also indicated that self-sampling may not be suitable as a detection method for cervical adenocarcinoma, which is also on the rise. Self-sampling HPV testing has recently been reported as an effective alternative to physician-sampling testing, and is expected to serve as an alternative method.
Conclusion: Companies and health insurance associations should not adopt the cytological self-sampling method for cervical cancer screening.

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 We retrospectively studied tracheal deviation on chest X-rays in 52,516 subjects (28,052 males and 24,464 females) who received health check-ups at the Health Service Association Clinic (Kenko Life Plaza) over a period of three years and three months.
 The grade of tracheal deviation was classified as mild (I), moderate (II), severe (III) and parallel or arched (IV). The causes of tracheal deviation were investigated by physical findings, personal history, family history and thyroid function tests from medical records and patient referral documents.
We found 49 patients with tracheal deviation due to thyroid disease (0.1%), of which 14(28.6%) were grade I, 11 (22.4%) were II, 12 (24.5%) were III and 12 (24.5%) were IV.
 Of the 49 patients, 13 had had thyroid nodules and cysts larger than 10 mm in diameter detected by thyroid ultrasonography.
 The underlying cause of tracheal deviation was benign thyroid nodule in 53% : benign thyroid nodule with Hashimoto’s disease in 8%: Hashimoto’s disease in 15%: Graves’ disease, goiter in 6%: and papillary thyroid cancer, follicular tumor, intrathoracic mediastinal thyroid goiter, multiple thyroid cysts, Plummer’s disease, benign thyroid nodule with cysts in 2%.
 These findings suggest that it is very important to consider further examinations for thyroid disease in case of detection of tracheal deviation on chest X-rays in health check-ups.

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 Objectives: As the Internet becomes progressively more diffuse and its services develop, Internet-dependence (Internet-addiction) is becoming a widespread concern. Additionally, its effects on mental health and lifestyle require consideration. This study aimed to investigate the current status of internet-dependence by using a validated questionnaire.
 Design: A survey was conducted on checkup examinees at our Foundation.
 Setting: The objective of the medical consultation examinations for the fiscal year 2015 was to investigate the current status of internet dependence in our target sample of 235 people.
Participants: Of the 235 people examined, 129 were men and 106 were women.
 Main outcome measures: We used Young’s Internet Addiction Test. This is a valid measure of internet dependence that determines if there is an internet-dependent trend when participants score 40 or more points.
 Results: The average age was 40.0 years and the average score of internet-dependence was 34.2 points. With respect to gender, men scored an average of 34.7 points and women 33.7 points. Internet-use is said to be more common in young people and this was supported by our results; as age decreased, the scores on the test increased. There was an internet-dependent tendency in about 60 percent of the respondents, especially those in their 20s.
 Conclusions: As the network society accelerates, people are vulnerable to adverse effects of the Internet including both mental and physical disturbances. Hence, we want to raise awareness regarding the risk of Internet-dependence through medical examinations.

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 We established a system for gastric cancer risk screening (ABC classification) in Matsumoto city by referring to the results of the ABC classification used in individuals who had undergone upper gastrointestinal endoscopy using a new Helicobacter pylori (Hp) antibody reagent, SphereLight H. pylori antibody∙J, with higher sensitivity for measuring Hp antibody levels than the currently used reagent. Group B was subdivided into groups B-1 (pepsinogen II <30 ng/mL) and B-2 (pepsinogen II ≥30 ng/mL) to identify group B individuals at high risk for undifferentiated carcinoma. The ABC classification in Matsumoto city consists of 4 groups: group A, B-1, B-2, and C (C and D). Groups A, B-1, and B-2 and C together were defined as low-, middle-, and high-risk groups, respectively. Individuals in group B-1 or higher had to undergo detailed endoscopic examination. Group B-1 subjects were recommended to undergo endoscopy every 2 or 3 years; yearly endoscopic examination was recommended for group B-2 and C subjects. To avoid including high-risk individuals (false A) into group A, pepsinogen (PG) levels (PGI ≤35 ng/mL and PG I/II ≤4.0, PGII ≥15 ng/mL) were used to screen these individuals.
 Continuous follow-up after risk screening is important. Matsumoto city introduced a “gastric health” handbook for individuals who had undergone screening to improve their understanding of gastric cancer risk and motivate them to undergo endoscopic examination. We aimed at establishing a system that allows continuous endoscopic follow-up, such as recording, results of check-ups, endoscopic findings, and eradication success and failure can be recorded in the handbook.
 A gastric cancer risk screening (ABC classification) was initiated in 2014 using this screening system.
 It is important to examine the efficacy and issues of this screening system and to further develop it in cooperation with the local government in the future.

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 Japan’s colorectal cancer age-adjusted mortality rate has been decreasing for over 10 years, but it has been decreasing in the US and UK for even longer, and their rates are now lower than Japan’s. The number of deaths from colorectal cancer continues to grow in Japan and decrease in the US. In 2015 it was the same in Japan and the US, which has 2.5 times Japan’s population. The US decrease is attributable to a high colonoscopy rate (approximately 60% every 10 years). Screening in Japan and the EU is performed through fecal occult blood tests.
 This method (chemical method) has proven effective in RCT, but interval cancers are discovered through subjective symptoms, etc., despite testing negative. We checked the cancer registry records of colorectal cancer screening recipients in Fukui Prefecture from 1995 to 2002 (272,813 people; 5.3% required close examination based on OC-Sensor results, of whom 69.8% received one) to ascertain the invasive colorectal cancers identified within 2 years after screening. There were 409 cases of colorectal cancer; 76 cases (19%) were interval cancers. Cancer on the right side of the colon accounted for 51% (39/76), which was significantly higher than non-interval cancer, at 31% (103/333) (P<0.001).
 Colorectal cancer screening using fecal occult blood tests is reliable, but the percentage undergoing close examination in 2013 was only 66.0%. The examination rate for 40- to 69-year olds based on the Comprehensive Survey of Living Conditions was only 37.9%. To reduce the number of deaths from colorectal cancer in Japan, it is necessary to increase the examination rate for the current colorectal cancer screening using fecal occult blood tests, and establish a low-pain close examination method that would increase the close examination rate. A screening method highly sensitive to cancer on the right side of the colon is required.

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