Invasive procedures have been carried out inadvertently owing to the carelessness of the endoscopist. At the Health Management Center in Toranomon Hospital, a new safety measure was introduced in August 2009. In this measure, the endoscopist directly interviews the patient regarding the status of medication of antithrombotic therapy just before examination, and attaches forceps valves of one of two colors. A blue forceps valve is attached for patients undergoing antithrombotic therapy, and a black forceps valve is attached for patients not undergoing antithrombotic therapy. At the Endoscopic Room in Toranomon Hospital, no such safety measure was introduced. Two years after introduction, a questionnaire survey was conducted in 10 endoscopists who conducted GI endoscopy at both centers regarding experiences of careless mistakes in the 2 years. In the 2 years, 6 cases of careless mistakes were reported by 5 endoscopists in the Endoscopic Room in Toranomon Hospital. No careless mistake was reported in the Health Management Center. This safety measure is expected to facilitate safer GI endoscopy for patients receiving antithrombotic therapy.

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We evaluated the accuracy of primary colorectal cancer screening using CT colonography (CTC). The subjects consisted of 1,209 examinees who underwent primary colorectal cancer screening using CTC between July 2009 and November 2011. Close examination was required in 60 subjects. Based on the results of close examination in these subjects, the detection ability of CTC according to the location, size, and gross type of the lesion were evaluated. The sensitivity according to the location of the lesion was 92.9% in the ascending colon, 86.7% in the transverse colon, 66.7% in the descending colon, 100% in the sigmoid colon, and 100% in the rectum. The sensitivity according to the size of the lesion was 85.3% for 6-9 mm, 100% for 10-19 mm, and 100% for ≥ 20 mm. The sensitivity according to the gross type was 93.8% for the sessile type (I s), 100% for the semipedunculated type (I sp), 100% for the pedunculated type (I p), and 40.0% for the superficial elevated type (II a). Colorectal cancer was detected in 3 subjects (M cancer in 2 patients and SM cancer in 1 patient). The cancer detection rate was 0.25%. Colorectal cancer screening using CTC may be a useful new colorectal cancer screening method.

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To identify patients with serious pathogenesis, we proposed a new classification system for fatty liver, which is the most common finding in medical ultrasonographic examination of the abdomen. The thicknesses of subcutaneous and visceral fat measured by ultrasonography exhibits a good correlation with the areas of subcutaneous and visceral fat, respectively, measured by abdominal computed tomography (CT) (r = 0.781 and 0.532, respectively). Compared to subjects having fatty liver without hepatomegaly, subjects having fatty liver with hepatomegaly have larger waist, higher body mass index (BMI), higher blood pressure, higher serum triglyceride levels, higher levels of serum aspartate aminotransferase (AST) and alanine aminotranferease (ALT), and lager visceral fat area (determined by CT findings). Subjects having fatty liver with hepatomegaly exhibit higher comorbidities of metabolic syndrome than those having fatty liver without hepatomegaly.
Subjects having fatty liver with thick fat tissue have greater body weight, larger waist, higher BMI, larger visceral fat area (determined by CT), higher blood sugar levels, higher glycated hemoglobin (HbA1c) levels, and higher levels of serum AST and ALT than subjects having fatty liver with thin fat tissue. Subjects having fatty liver with thick fat tissue exhibit higher comorbidities of metabolic syndrome than those having fatty liver with thin fat tissue. Fatty liver with hepatomegaly or thick fat tissue (measured by ultrasonography) may be a serious pathological condition; therefore, it should be monitored carefully as a high-risk condition associated with metabolic disorders.

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