Purpose: Our hospital prepared an exercise class for the prevention of metabolic and locomotive syndrome. The members of this class included nutritionists, physical therapists, health nurses, and health fitness programmers. This study was performed to establish an efficient exercise class.
 Subjects and methods: The subjects included 13,697 health examinees of our institution (7,860 men and 5,837 women). We compared the physical activity using blood and physical examination data obtained through health examinations. The physical activity was determined based on the standard lifestyle questionnaires used by the Ministry of Health, Labor, and Welfare of Japan.
 Results: The waist circumference, body mass index, and blood pressure (systolic and diastolic blood pressure) were higher in participants with active exercise behavior (n=2,518) and lower in the group with higher physical activity (n=4,901) when compared to those who do not exercise (n=11,179) and who have less physical activity (n=8,777), respectively. Regarding the blood examination data, glucose, ALT, AST, and HDL-C levels were higher and the γGTP level was lower in the group with active exercise compared to those who do not exercise. However, glucose, γGTP, LDL, and TG levels were lower and the HDL level was higher in the group with higher physical activity when compared to lower physical activity.
 Conclusion: Hematologic data and physical examination data were better in the group with higher physical activity than in the active exercise group. The exercise class for the prevention of metabolic syndrome should be managed based on scientific data. The results of the present study will be useful for the preparation of an efficient exercise class.

View full abstract

[in Japanese]

View full abstract

 I collected answers to an 64-item questionnaire about the lifestyle related symptoms from 489 Japanese subjects. For part of the subjects (n=868), DNA was also extracted and three SNPs in the genes UCP1, ADRB2, and ADRB3 were genotyped. The association analysis between the questionnaire and the 3 SNPs were performed by a cumulative logistic regression model. As a result, the presence of neck stiffness was associated with genetic variation of rs1800592 in UCP1 gene (regression coefficient is 0.351, P value is 0.003). I also found several associations of UCP1 with the ease of producing a phlegm, cough, and difficulty with constipation. An ease of palpitations and an eye pain were associated with ADRB3 and ADRB2, respectively. Especially, a significant association with UCP1 was suggested for a combination of several questionnaire items (regression coefficient is 0.458, P value is 0.00003). My results suggest that personalized health guidance based on genetic testing can be helpful.

View full abstract

 [Objective] In Japan, mortality due to gastric cancer has not changed much over the past 35 years and is around 50,000 annually. The relationships between Helicobacter pylori (HP) and gastric cancer has become known since the discovery of HP in 1983. It has been reported that eradication of HP reduces the incidence of gastric cancer by approximately 33%. For early detection of HP, our hospital plans to introduce a latex immunoturbidimetric assay. Therefore, we investigated the usefulness of new reagents for the latex immunoturbidimetric assay.
 [Subjects and Methods] The subjects were volunteers who underwent endoscopy as part of complete medical examination at our hospital in August and September 2016. An automatic analyzer (LABOSPECT 008, Hitachi) was used to analyze the collected serum samples and three newly developed reagents for latex immunoturbidimetric assay were compared. Measurement was outsourced and performed by the conventional ELISA method if there were discrepancies between the endoscopy findings and the results of serum anti-HP antibody measurement.
 [Results and Discussion] Endoscopy was performed in 148 volunteers. The result was HP-negative in 95 volunteers and HP-positive (current infection) in six volunteers, while 47 volunteers were determined to have previous HP infection (including those who had received HP eradication therapy). Of the 95 HP-negative volunteers, anti-HP antibodies were negative in 85 (91.6%) using Reagent A, in 91 (95.8%) using Reagent B, and in 86 (90.5%) using Reagent C. Among the six HP-positive volunteers, anti-HP antibodies were positive in all six (100%) using Reagent A, in four (66.7%) using Reagent B, and in six (100%) using Reagent C. Among the 47 volunteers with previous HP infection, anti-HP antibodies were positive in 29 (61.7%) using Reagent A, in seven (14.9%) using Reagent B, and in 22 (46.8%) using Reagent C. In the volunteers with positive endoscopy results or past infection, the anti-HP antibody-positive rate differed among the three reagents. However, the results obtained with Reagent A or Reagent C were highly consistent with the endoscopy findings. This suggests that measurement of anti-HP antibody using a latex immunoturbidimetric assay is useful for early detection of HP.

View full abstract

[in Japanese]

View full abstract

 I have summarized the current evidence on aging and supplements according to end points. As we discover the anti-oxidative, cardiovascular, and hormonal effects of supplements, more practitioners are incorporating them into clinical settings. However, results of clinical studies are often controversial; differences in types and doses of supplements, outcome measures, and study designs (such as observational vs. interventional) have led to different conclusions.
 For this seminar, I have created tables summarizing studies that evaluated the effects of supplements on mortality, cognitive function, etc. in order to facilitate our understanding of this field.

View full abstract

[in Japanese]

View full abstract

 In addition to an upper gastrointestinal radiograph, an upper gastrointestinal endoscopic examination has also been recommended as a strategic screening method for gastric cancer and is expected to play a central role in the gastric cancer screening in the near future. On the other hand, H. pylori infection and the associated atrophy and inflammation of gastric mucosa have been demonstrated to be closely related to the development of gastric cancer. Therefore it is crucial to determine the H. pylori infection for the gastric cancer screening. Blood tests enable stratification of gastric cancer risk and their use can lead to efficient gastric cancer screening. ABC classification using a combination of the detection of serum anti-H. pylori antibody and measurement of the level of serum pepsinogens is a method to classify the background gastric mucosa by a simple blood test, which enables risk stratification of not only gastric cancer but also the other upper gastrointestinal diseases. Stratification the gastric cancer risk by ABC classification, reduction of the risk by H. pylori eradication, and surveillance after eradication are all important for strategy for the gastric cancer.

View full abstract

 Background: Although the mortality rate of gastric cancer has decreased in recent decades, the incidence of gastric cancer is still high in Japan. Both atrophic and hypertrophic gastritis induced by H. pylori infection are risk factors for gastric cancer. Therefore, early detection of gastric cancer by using an effective mass screening system is very important. Since 2011, Okayama Health Foundation has been attempting to identify patients who are at risk for gastric cancer by classifying the background gastric mucosa to detect gastritis due to H. pylori infection using gastric barium radiography.
 Patients and Methods: Between 2011 and 2013, we obtained the gastric barium radiography results for 41,952 subjects (17,011 men, mean age 68.0yrs) who underwent gastric cancer screening. Their background gastric mucosa classified into three groups: normal (N), atrophic gastritis (AG), and hypertrophic gastritis (HG). The background gastric mucosa classified as normal when the gastric body was smooth and the folds were thin, as AG when the gastric mucosa was coarse, and as HG when the gastric mucosa was coarse and the fold thickness was ≥4.5 mm.
 Results: Among the patients who screened, 63.9% classified into the N group, 34.4% into the AG group, and 1.7% into the HG group. The detection rates of gastric cancer were significantly higher in the AG (0.4%) and HG groups (2.19%) than in the N group (0%) (p<0.01). The positive predictive values were also were significantly higher in the AG and HG groups, at 1.95% (57/2,927) and 2.7% (16/591), respectively than in the N group (0%) (p<0.01).
 Conclusion: Our study demonstrated that screening for H. pylori infection by using barium radiography could improve the detection of gastric cancer in Okayama Prefecture population-based gastric cancer mass screening.

View full abstract

 We examined the present conditions of the measures type gastric cancer examination system in Tokyo. We conducted a questionnaire in the Tokyo District Medical Association and investigated the actual situation of the measures type examination.
 We proved a mortality decrease in examination of gastric cancer risk stratification effect and tried the construction of a more effective examination system. Because there is the suitable evidence indicating the mortality decrease effect, in “the gastric cancer examination guidelines 2014 version based on the effective evaluation,” stomach X-ray examination and a gastroscopy are recommended as a gastric cancer examination in measures type examination and the option type examination. For the smooth induction of the measures type gastroscopy examination, the problems are the choice of the enforcement physician, an irrigation method, and the setting of the interpretation committee. We obtained interpretation that we did not deny that we used function water from Ministry of Health, Labour and Welfare.
 More institutions become able to participate in measures type gastroscopy examination, and it may be thereby said that the way which can plan smooth induction was opened. We are not going to find gastric cancer and judge the examination of gastric cancer risk stratification (examination for ABC) whether you have the gastric mucosa which is at increased risk for being easy to suffer from gastric cancer.
 The case that helicobacter pylori was discovered after sanitization from discovered case and helicobacter pylori antibody of the gastric cancer-negative high level group is reported, and the careful handling is expected.
 A stomach X-rays examination, a gastroscopy examination, an examination of gastric cancer risk stratification may be introduced at the same time in future in many local governments. It is the present conditions to vary in target age, enforcement frequency, self-pay costs in each local government. We hope that it is not a dream to get rid of gastric cancer death from Tokyo by building measures type gastric cancer automated multiphasis health testing system effectively.

View full abstract

 Alcohol habits in the 1.3 million subjects underwent Ningen Dock in 2014 was investigated The subjects were 4826 men underwent a complete medical checkup. The various interview of lifestyle and medical examinations were conducted. The amount of ethanol intake (gram) per week was calculated from the interview sheet. The amount of ethanol intake was correlate with the increased smoking index, passive smoking rate, and working hour per day and decreasing of the holiday number of month. It was related with meal unbalance and salinity excess, and was increased in decrease of the breakfast intake and increase of dinning out in dinner frequency per week. The tooth brushing number per 1 day, the execution rate of the living improvement and the request rate of the health guidance decreased with the amount of ethanol intake. The amount of ethanol intake has influenced on the abdominal circumference, systolic and diastolic blood pressure, MCV, ALT, GGT, HDL cholesterol, plasma glucose, and uric acid. On the contrary, it was inversely correlated with pancreatic amylase. There was no correlation of it with serum cholinesterase. The increasing of ethanol intake showed unhealthy lifestyle and abnormal medical data. These data were correlated with ethanol intake, not but J cube phenomenon.

View full abstract

[in Japanese]

View full abstract

 Preventing deterioration of chronic obstructive pulmonary disease mainly caused by smoking, is a major role of comprehensive medical checkups.
 The “lung age” calculated from the respiratory function test is an index showing the degree of respiratory function compared with the same sex or the same generation.80% of those who undergo medical checkups are nonsmokers. In nonsmokers, 31% had higher lung age than real age by 10 years or more. There were 11% subjects in measured forced expiratory volume in 1 second as percent of forced expiratory volume or forced expiratory volume during the first second less than 70%. When they showed these outliers, we investigated the explaining problem of the cause and countermeasures. In cross-sectional survey, weight gain, especially visceral fat increase, that is, diaphragm elevation was considered to be a cause of deterioration of examination value.
 A longitudinal study confirmed that reducing body weight improved lung age and weight gain got worse. However, it is unknown whether body weight reduction improved true pathological airway inflammation.

View full abstract

 Pulmonary function tests are essential for the diagnosis and management of chronic obstructive pulmonary disease (COPD). It is important to detect the presence of airflow limitation by spirometry at medical examination for screening of COPD. Because spirometry is affected by gender, age, height, and ethnicity, measurement results must be compared to reference values adjusted for these factors. Japan Respiratory Society (JRS) published new spirometric reference values and lower limit of normal (LLN) for Japanese adults in 2014. The new reference values for FEV₁/FVC are smaller than previous values in both genders. The LLN of the FEV₁/FVC for females is larger than previous values. The presence of a post-bronchodilator FEV₁/FVC < 0.7 confirms the presence of persistent airflow limitation and the diagnosis of COPD. Fixed lower limit of 0.7 crossed with the LLN at about 60 years in males and at about 70 years in females. The use of a fixed ratio of FEV₁/FVC<0.7 to define COPD leads to an underdiagnosis apart from the elderly.

View full abstract