This paper describes the Anti-aging Dock, which is a complete medical check-up facility focusing on assessing, degree of aging and an advanced form of the conventional Human Dock that aims to achieve early intervention in lifestyle disease and cancer. The Anti-aging Dock features additional programs to realize the early diagnosis of, and intervention in, pathological aging and deterioration of quality of life (QOL). Anti-aging medicine, which has been drawing increasing attention in recent years, is centered on improving people's QOL and achieving successful aging. This field brings forth all categories of science to identify the mechanism responsible for aging, and uses Anti-aging Dock to diagnose the level of aging, consider ways to attain successful aging, and practice anti-aging medicine. Results of a survey on healthy centenarians have revealed two important facts that their bodies have aged in a well-balanced manner, and that they have few weaknesses related to aging. People who present themselves at the Anti-aging Dock have their skeletal, muscle, blood vessel, neurological, and hormone ages evaluated, in addition to routine examinations. The goal of the evaluation is to obtain “optimal health”. Anti-aging medicine detects the weaknesses of aging that deviate from optimal health, and then correct and harmonize them. This is also the royal road to successful aging.

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Background The prevalence of gastroesophageal reflux disease (GERD) is increasing in Japan. Anti-acid secretion medication, such as H2-receptor antagonists and proton pump inhibitors, can effectively ameliorate its symptoms. Reflux esophagitis is usually diagnosed by endoscopic examination, but the degree of inflammation and the severity of subjective symptoms do not necessarily agree. Hiatal hernia and barium reflux, readily detectable in a barium meal study, may be associated with GERD symptoms. Methods Double contrast barium and gas upper gastrointestinal X-ray films and video tapes from 1680men and 580 women with an average age of 50.1 years, who attended a health appraisal program, were reviewed, concentrating, on hiatal hernia, barium reflux, and other findings suggestive of lower esophageal inflammation. The relationship between these X-ray findings and subjective symptoms, such as heartburn and dyspepsia, was then analyzed. Results On barium meal examination, a hiatal hernia was found in 19.6% of the time, and barium reflux was positive in 40.0% and 5.4% of the time in the prone right anterior oblique and flat supine positions, respectively. The presence of heartburn was significantly associated with hiatal hernia with an odds ratio of 3.5 (95% CI: 2.7-4.5), barium reflux in the prone right anterior oblique position of 3.6 (2.8-4.6) and in the flat supine position of 2.1 (1.3-3.2), and changes in the esophagus such as granular mucous image of 3.9 (3.0-5.2), thickened longitudinal folds of 2.5 (1.9-3.4), and small erosions of 2.8 (1.6-5.2). The association between these X-ray findings and other subjective symptoms, including dyspepsia and stomachache, was weak. Conclusion Hiatal hernia and gastroesophageal barium reflux on upper GI series, as well as esophageal changes suggestive of esophagitis, are significantly associated with heartburn.

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Background and Methods The prevalence, clinical background and reproducibility of Brugada-type electrocardiogram (ECG) in cases who received regular check-up at our institute in 2001 were studied. Results Among the electrocardiograms of 7844 men and 5681 women aged 15-84 years,95 (0.70%; 86men and 9 women) showed a Brugada-type ECG pattern. Coved type and saddle-back type were found in 10 and 83 cases, respectively, and coexistence of both types was found in 2 cases. The prevalence of Brugada-type ECG was higher in the older groups (60s: 1.06%, p<0.05; 70s: 1.72%, p<0.01; 80s: 11.1%, p<0.001) than in the younger group (30s: 0.46%), and seven cases experienced syncope. Also, the cause of syncope in three cases was due to arrhythmia, and one case with syncope had a family history of sudden death, although no sudden death had been observed for two years. Among 67 cases in which ECGs were consecutively recorded for 2 to 3 years,41 (61.1%) maintained a Brugada-type ECG pattern. Conclusions The prevalence of Brugada-type ECG varies greatly between reports, and this may be due to differences in the subjects studied, the gender proportion and the criteria of Brugada-type ECG. The prevalence of Brugada-type ECG was higher in the older groups than in the younger group, although its cause as well as its universality remains unknown. Repeated ECG recording is necessary to detect Brugada-type ECG, because its degree of reproducibility is not high.

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Background and Methods To assess the clinical implications of atherosclerotic plaques in the carotid artery and evaluate the usefulness of ultrasonic tissue characterization, we performed carotid ultrasonography using an improved ultrasonic device and magnetic resonance imaging of the head in 297 patients 158 who underwent cerebrovascular disease screening and 139 with essential hypertension. Results High frequencies of pathological atherosclerotic and cerebral ischemic changes were found in patients who had soft plaques with a low-density lipid core and in patients who had hard plaques. Conclusions Our results suggest that the presence of plaques in the carotid arteries is an important index of carotid atherosclerotic changes. Soft plaques with a low-density lipid core and hard plaques are often associated with cerebral ischemic changes and are characteristic of pathological atherosclerotic changes.

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Purpose The aim of this study was to assess the prevalence of carotid atherosclerosis in people of both genders who underwent general health screening.
Results Of 8144 enrolled subjects (5473 men,2671 women),29.4% of the men and 16.5% of women, and 14.9% of the men and 9.2% of the women had carotid plaque and intima-media thickening, respectively, and the prevalence of both increased with age in both genders. The male-to-female rations for the prevalence of carotid plaque and intima-media thickening peaked at 41-45 years (8.62) and 46-50 years (5.72), respectively. The gender gap for these values declined thereafter, and the male-to-female ratios for the prevalence of carotid plaque and intima-media thickening was 1.29 and 0.93 at age ≥76 years. Conclusion A gender gap in terms of the prevalence of carotid plaque and intima-media thickening is present in mid-life, and thereafter the deference declines in the Japanese population.

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Background The pulse wave velocity (PWV) has been measured in the aorta, and it is recognized that PWV is associated with atherosclerosis. However, measurement of the PWV in the aorta is inconvenient and difficult.
Methods The present study was conducted to examine the usefulness of non-invasive brachial-ankle pulse wave velocity (baPWV) measurements in NTT employees who received the Human Dry Dock at our institute consisting of 1272 males and 162 females.
Results In a multiple regression analysis, the number of atherosclerotic factors including hypertension, diabetes, hyperlipidemia and obesity was correlated with the degree of elevation of baPWV (p <0.0001). Systolic blood pressure age, heart rate, sex, body mass index (BMI) and triglycerides were positively correlated with the baPWV using multiple regression analysis. The highest correlation coefficient was that for systolic blood pressure and the heart rate was also highly correlated with baPWV. In addition, BMI was negatively correlated with the baPWV.
Conclusions These results suggest that the baPWV is influenced by not only age and sex but also blood pressure and heart rate. Furthermore, it is necessary to consider the possibility that baPWV is underestimated in obese subjects.

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Purpose The aim of the present study was to analyze the presence of metabolic syndrome in the Japanese population.
Methods Data from 49375 subjects (16886 women,32489 men) with a mean age of 52.2±10.2 years who underwent general health screening between 1994 and 2003 at our institute were analyzed. Metabolic syndrome was diagnosed using modified criteria of the National Cholesterol Education Program Adult Treatment Panel III including five components; increased body mass index, hypertension, increased serum triglycerides, decreased serum HDL cholesterol, and increased fasting glucose.
Results The mean overall rate of metabolic syndrome was 10.0% (women,4.1%; men,13.1%), seeming to reach a plateau after 50 years of age in men, but with a continual age-associated increase in women. HOMA-IR rose as the number of metabolic syndrome risk factors increased in both genders. After adjusting for age, serum total cholesterol levels, and smoking status, the frequency of metabolic syndrome was greatest in men (odds ratio,3.17,95% CI 2.89-3.48, p<0.0001).
Conclusion In this large Japanese study population undergoing general health screening, metabolic syndrome was found to be over three times more frequent in men than women.

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Background Remnant lipoproteins appear in insulin resistance syndrome and cause atherosclerosis. We investigated the relationship between insulin resistance and remnant-like particle lipoprotein cholesterol (RLPC)levels in 415 middle-aged non-diabetic men 49.6±3.8 years of age. Methods Insulin resistance was evaluated by homeostasis model assessment (HOMA-IR). We divided the subjects into quartiles according to their levels of HOMA-IR, and then divided them into two groups; an insulin resistance (IR) group (HOMA-IR 1.85) and a normal group (HOMA-IR<1.85). Finally, we examined the relationship between the levels of RLP-C and HOMA-IR. Results Correlations were found between HOMA-IR and triglyceride (TG), and HOMA-IR and RLP-C. The value of RLP-C increased as the level of HOMA-IR increased, and the values of RLP-C were higher in the IR group than in the normal group (7.7±3.4 vs.6.0±3.2 mg/dl, p <0.0001). Conclusions There exists a correlation between HOMA-IR and RLP-C. The values of RLP-C in IR subjects without overt diabetes and coronary artery disease (CAD) were as high as those of with diabetes and CAD in previous reports on Japanese patients.

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Background and Methods The urine protein/urine creatinine (P/C) ratio measured by fully automatic equipment was compared with the urine albumin excretion index (AEI), and pathophysiological changes in dissociation cases of urine P/C ratio and AEI were determined.
Results The quantitative value of the P/C ratio was significantly correlated with that measured by Clinitek® ATLAS XL. Dissociation between the urine P/C ratio and AEI was observed in cases of hypertension, hyperlipidemia, and hypoalbuminemia, and they were complicated by cerebral infarction and heart disease.
Conclusions These results suggest that atherosclerosis plays a role in the pathogenesis of the dissociation. Also, the urine P/C ratio being higher than the AEI suggests that globulin was excreted more than albumin under pathological conditions. In conclusion, the urine P/C ratio may be used to detect pathological conditions which might not be detected by AEI, and thus, measurement of the P/C ratio with the AEI may be more useful.

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Background and Methods In this study, we examined the incidence, symptoms, characteristics of laboratory findings, background diseases, the status of treatment and complications of atrial fibrillation in cases that received regular check-up at our institute in 2000.
Results Among 14117 subjects with a mean age of 46.1 y. o.,49 cases (0.35%) consisting of 46 men and 3 women had atrial fibrillation. No significant differences were found in the body mass index, fasting plasma glucose and HbA lc between cases with sinus rhythm and atrial fibrillation. Systolic blood pressure of 123±18 mmHg versus 130±17 mmHg, y-GTP of 37.2±48.4 IU/1 versus 60.0±40.5 IU/1, C-reactive protein (CRP) of 0.09±0.11 mg/dl versus 0.21±0.21 mg/di, and the incidence of cardiomegaly on chest X-ray at 10% versus 42% were significantly higher in cases with atrial fibrillation. Of the cases,58.5% were symptom free. Symptoms found were palpitations (26.8%), chest pain (14.6%) and shortness of breath (9.8%). Among cases with atrial fibrillation,78.0% underwent further examination and 73.2% were already taking medication, including aspirin (35.7%), digoxin (35.7%), warfarin (21.4%), ticlopidine (17.9%)and verapamil (10.7%). Background diseases and complications consisted of hypertension (62.5%), hyperlipidemia (33.3%), valvular heart disease (20.0%), angina pectoris (8.3%), myocardial infarction (8.3%), cerebral infarction (8.3%), hyperuricemia (4.2%), diabetes mellitus (4.2%) and cardiomyopathy (4.2%). One case died of cerebral infarction in spite of ordinary anticoagulant therapy. Conclusion CRP elevation in cases with atrial fibrillation (p<0.025) may reflect an inflammatory state that promotes the persistence of atrial fibrillation.

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Background Human dry dock (Ningen Dock) permits not only the early detection of lifestyle related disease but also the promotion of health and the quality of life (QOL). Although sexual function is an important factor in a person's QOL, discussion of this topic is still taboo in Japan. This study was conducted to determine the rate of male sexual function in Japan and to investigate whether any association exists between sexual function and the health-related QOL.
Methods A self-administrated questionnaire assessing sexual function, aging male symptoms and health-related QOL factors was given to 4389 clients, all adult males ranging in age from 20 to 89 years, at six health care centers in Japan between June and August,2002. We evaluated sexual function using the 5-item index of sexual function (SF5) questionnaire, modified from the Sapporo Medical University sexual function questionnaire. Of the 4389 subjects,2909 (66.3%) completed the questionnaire.
Results Scores on the SF 5 decreased as age increased (p<0.0001). However, the aging male symptoms (AMS) score was constant (p=0.9815) across all age groups. The AMS scores also increased as the SF5scores decreased. Also scores on factors such as “general health condition”, “satisfaction with partner”, “satisfaction with home life”, and “satisfaction with life in general” decreased as the SF5 score decreased.
Conclusions Sexual function correlated with aging male symptoms and health-related QOL factors, suggesting that human dry dock should offer support to men with sexual dysfunction to promote QOL. Additionally, the use of the SF5 as an index for sexual function is recommended for general health screening tests.

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Background Genetic variations in alcohol dehydrogenase 2 (ADH2) enzyme and aldehyde dehydrogenase 2(ALDH2) enzyme are associated with an aversion to alcohol and a lower risk of alcoholism in Japanese population. The aim of this study was to assess the relationship between gamma-glutamyltranspeptidase (GGT) levels and polymorphisms of ADH2 and ALDH2.
Methods This study included 476 Japanese taking medical check-up at Nagoya University Hospital. Alcohol intake was assessed through responses to a semiquantitative food frequency questionnaire. Genotypes of ADH2 His47Arg and ALDH2 GIu487Lys were determined by a duplex polymerase chain reaction with confronting two-pair primers (PCR-CTPP) method. Results Polymorphism of ADH2 His47Arg did not affect serum GGT levels. However, alcohol consumption affected GGT levels. In ADH2 47His/His and His/Arg genotypes, subjects with an alcohol intake of >20 g/day showed significantly higher GGT levels than those with 0 g/day. In contrast to ADH2, polymorphism of ALDH2 Glu487Lys significantly affected GGT levels in Japanese men. Male subjects with ALDH2 487Glu/Glu genotypes showed significantly higher GGT levels than those with Lys/Lys genotype. In ALDH2 487Glu/Gluand Glu/Lvs genotypes, subjects with an alcohol intake of>20 g/day showed significantly higher GGT levels than those with 0 g/day. Notably, male subjects with ALDH2 487Glu/Glu genotype showed a significantly increased risk for high GGT levels compared with Lys/Lys genotype. Conclusions Polymorphism of ALDH2 Glu487Lys affected GGT levels in Japanese men. Especially, those with ALDH2 487Glu/Glu genotype showed an increased risk for high GGT levels in Japanese men, because of their tendency to high alcohol consumption, although they are considered to have strong tolerance to alcohol.

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