Objective: Reduced elasticity of the skin is thought to be involved in the formation of age-related wrinkles and the maintenance of skin elasticity could prevent aging. There are almost no studies on the relationship between skin elasticity and blood components or physiological functions. In this research, skin viscoelasticity was measured at ningen dock and the relationship between age and various other test parameters was investigated. Methods: The viscoelasticity of the skin in the forearm of 62 healthy males was measured, the correlation with various parameters was assessed, and also multi-regression analysis was performed. Results: Age was not correlated with visco-elasticity index (Uv/Ue), but a negative correlation was observed with elasticity index (Ur/Uf), red blood cell count, alkaline phosphatase level, and forced expiratory volume per second, while a positive correlation was observed with fasting plasma glucose, HbA1c, and prostate specific antigen. A multi-regression analysis showed that age was associated with only Ur/Uf, and Ur/Uf was associated with hematocrit and hemoglobin in addition to age. Conclusion: Skin Ur/Uf is strongly correlated with age, compared to other parameters from tests usually performed at ningen dock. Skin elasticity index is useful as an aging index.

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Objective: This study was performed to clarify the relation between fatty liver and lifestyle, nutrients intake, work shifts in employees with high incidence of fatty liver. Methods: Two thousand three hundred and twenty two employees with high incidence of fatty liver in some workplace (group K) and 2,008 examinees of health check-up (group A)were included in this study. We carried out a questionnaire survey and employed logistic regression analysis. Results: The incidence of fatty liver was low in alcohol drinkers and smokers in both groups. The lack of exercise was the risk factor for fatty liver in both groups. In group K, the intake of meals with irregular intervals was also the risk factor. The everyday intake of meat, the short intake of vegetables and the short intake of seaweeds were the risk factors for fatty liver in group A. The incidence of fatty liver was low in the people with everyday intake of soft drinks which contain sugar in group A. On the contrary, the relation between fatty liver and each nutrient was not observed in group K. Conclusion: Wrong eating habits seemed to be the principal risk factor for fatty liver in group K. It is necessary for employers and employees of the workplace of group K to discuss how to reform eating habits.

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Objective: The relationship between the oral health status situation and the whole body state has been interested in focusing on the periodontal disease. Thus, in this study, the relationship between these three factors in the oral status was determined as one index at the time of improving lifestyle. Also, the relationship between the other two factors was examined using the data of the health examination in a certain company. Methods: Hundred male employees whose mean age was 44.8 ± 6.8 years old ranging from 35 to 60years old were enrolled. the relationship between the results of the questionnaire about lifestyle, the health examination data, and the oral condition were analyzed. Results: The systolic blood pressure and the urinary excretion of glucose were tended to be low in the subjects who have restricted intake of sweets. The systolic blood pressure was also tended to be low in the subjects who are exercising periodically. The periodontal disease and the number of teeth loss were increasing with age. Moreover, smoking increased the periodontal disease and the number of teeth loss. Furthermore, the tendency for the periodontal disease and untreated dental caries were low in the subjects who have the oral cleaning custom. Plasma level of triglyceride was to be tended to be high in the subjects who have untreated dental caries. Conclusions: These results suggest that the relationship between the periodontal disease and lifestyle was not directly correlated, but that the periodontal disease is one of the lifestyle disease. Also, dentistry should support the better living institution from the point of view of the state of periodontal disease.

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Objective: We compared annual changes in the blood cholesterol level between the young and middle-aged subjects. Methods: Changes in the total blood cholesterol level and blood pressure during the 10-year period until 2002 were compared between 117 subjects aged <35 years and 38 aged≥ 55 years who underwent health examination in 1992. Results: In the young subjects, the total cholesterol level significantly increased in those with a total cholesterol level ≤220mg/dl in 1992 (normal cholesterol group) but remained high without changes in those with a total cholesterol level ≥221mg/dl in 1992 (hypercholesterolemia group). In the middle-aged subjects, the total cholesterol level did not change in the normal cholesterol group but tended to decrease in the hypercholesterolemia group. Blood pressure significantly increased only in the young hypercholesterolemia group. Conclusion: In the young with hypercholesterolemia, the hypercholesterolemia state may remain for a long period, and blood pressure tends to increase with age. Active health education from young age is important.

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Objective: Inflammatory bowel disease (IBD) is found occasionally in healthy persons, underwent immunological fecal occult blood test (IFOBT). This investigation was performed to see the clinical features of IBD, diagnosed as a result of IFOBT in ningen dock and mass survey. Methods: In the last 12 years,105 cases of ulcerative colitis (UC), and 39cases of Crohn's disease (CD) were diagnosed in our hospital. The patients with diagnosed as a result of IFOBT positive included 10 of UC, and 3 of CD. We investigated clinical activity and extent of lesion. In cases of UC, evaluated the changes of endoscopic extension during the follow-up periods. Results: The 10 cases of UC consisted of 6 men and 4 women aged 28-57. Types of extent included 2 of left-sided colitis, one proctitis,7 right-sided or segmental colitis. The range of clinical activity index, quantified by the Truelove-Witts criteria was 0-3. Of these right-sided or segmental colitis,5 cases were asymptomatic, and 3 cases developed total colitis in 17-40 months. The 3 cases of CD consisted of one man and 2 women aged 49-64, included 2 of colitis and 1 asymptomatic ileocolitis. Conclusions: Asymptomatic IBD was found in IFOBT positive screening for the colorectal cancer. These patients were mainly right-sided or segmental colitis of UC, and developed total colitis. Therefore, careful follow-up is necessary for these cases.

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Objective: Smoking is a habitual behavior of many people and lifestyle including smoking strongly influences on the health. Smoking is harmful to the health. It causes and worsens many diseases, especially vascular diseases by injuring the blood vessels. So, it is important for young smokers to stop smoking. We intended to evaluate the influence of smoking on the blood vessels by the acceleration plethysmograms (APGs) of arteries and to study the usefulness of this method to analyze the elasticity of arteries. Methods: The APGs of the digital arteries of 95 healthy students,20 females(2 smokers and 18 non-smokers) and 75males(27 smokers and 48 non-smokers) were recorded and parameters derived from them were analyzed. Results: There were no significant differences between the parameters of the APGs of the smokers and non-smokers. Wave patterns of the APGs were stable and fitted for the quantitative analysis. Conclusions: The APGs were not significantly different between the smokers and non-smokers. But, the pulse wave analysis based on the APGs gave us the impression that it was useful and convenient for the evaluation of the arteriosclerosis.

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Objective: There have been few studies on work contents in nurses in ningen dock. The purpose of this study was to clarify the work contents currently performed by nurses in ningen dock and those they consider to be essential duties. Subjects and Methods: The subjects were all nurses in 284 institutions designated as one day ningen dock by Japan Hospital Association in April 2003. A questionnaire was sent to the head nurse in each institution for distribution to all nurses. The questionnaire consisted of 26 items such as the profiles of the responder and institution, the workplace before the change to the present workplace, the main previous workplace, present work contents, and necessary work contents. From the number of answers that the work content is performed at present and the number of answers that the work content should be originally performed, the odds ratio and 95% confidence interval were calculated. Results: Effective responses were obtained from 148 of the 284 institutions, and 877 nurses in these institutions were enrolled as the subjects. According to the categories of each item, nurses in their 30s (39%) as age groups, another medical institution as the workplace before the change to the present workplace (54%), and the ward as the main previous workplace (66%) were the most frequently observed. The odds ratio calculated from the number of answers that the work content is performed at present and the number of answers that the work content should be originally performed was significantly higher than 1 for 2 items (health classes and health/life guidance). The odds ratios for 3 items (telephone counseling, liaison activity, and assistance in lower gastrointestinal endoscopy) were not significant, and those for 11 items (such as assistance in upper gastrointestinal endoscopy) were significantly lower than 1. Conclusions: The work contents frequently performed at present by nurses in ningen dock included blood collection, injection, measurement of blood pressure, leading examinees to examination, assistance in gynecological consultation, inquiry, and assistance in internal medicine consultation. In the future, the importance of health classes and health/life guidance may increase. Our results suggest that nurses working in ningen dock are required to perform broad work contents including work performed by public health nurses such as health/life guidance and liaison activity in addition to assistance in consultation as the original work. We also intend to perform a survey on the opinions of administrators in health examination institutions.

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Obiective: To clarify the influences of smoking on health. Methods: Breslow reported a lower mortality rate with an increase in the applicable items among items such as appropriate body weight, moderate drinking, regular exercise, avoidance of snacks between meals, and eating breakfast. To clarify the influences of the smoking habit on health in subjects undergoing ningen dock, we performed analysis using Breslow's 7 principles of health. Results: According to the applicable items of Breslow's health index, the health index for body mass index(BMI), drinking, exercise, as well as breakfast was significantly lower in smokers than in non-smokers. The health index calculated by scoring for snacks between meals or sleep did not differ between the two groups. Conclusion: In fiscal year 2003, the highest age of examinees at this center was 86 years. Elderly examinees aged≥75years showed a high health index and little smoking experience, suggesting the influences of lifestyle habits. Our goal is to provide health consultations appropriate for individual examinees to bring about behavioral changes based on the data obtained by this survey.

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Objective: There is a possibility of contribution to the prevention of diabetes by seizing the chance of medical checkup, and offering follow-up program referring to an individual characteristic. We did the questionnaire survey to some ningen dock facilities in the Kanto district to understand their follow-up system. Methods: We sent the questionnaire survey to 84 facilities entitled as “excellent ningen dock facility”. The questionnaires were about the current state of follow-up to the “borderline-type” people and the possibility that optional service for follow-up will be provided in the facility. Results: Just half of the facilities provide the service of follow-up to the “borderline-type” people, and one fourth make contacts to the customers to evaluate the effect of the follow-up service. Third of fourth facilities have the negative opinion to outsource follow-up services to a private company. Conclusions: From now on, the program for urging a life improvement of potential lifestyle disease, like borderline-type will require the system to evaluate the effectiveness of the program and to analyze the cost-benefit.

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Objective: To inhibit the progression of diabetes mellitus, factors involved in the aggravation/improvement of glucose tolerance should be clarified. We analyzed these factors in subjects with borderline diabetes mellitus in whom glucose tolerance could be followed up. Methods: The subjects consisted of 155 examinees (128 males and 27 females)who were diagnosed as having the borderline type by glucose tolerance tests in ningen dock of our hospital in 1998 and underwent ningen dock in our hospital again in 2001. The subjects were classified in 2001 according to glucose tolerance into 3 groups: the normal, borderline, and diabetes types, and data were compared among the 3 groups. In addition, the subjects were classified according to body weight changes after the 3-year period, and changes in glucose tolerance in each group were evaluated. Results: After the 3-year follow-up period, glucose tolerance remained borderline in 49% of the subjects but changed to the normal type in 37% and to the diabetes type in 14%. In 1998, glucose tolerance tests showed no significant differences in the value before or 2 hours after loading among the 3groups. However, in subjects with impaired glucose tolerance in 1998, the rate of the change to diabetes mellitus was higher in those with a higher value 2 hours after loading. In 1998, body mass index (BMI) did not significantly differ among the 3 groups. However, in 2001, body weight and BMI were significantly decreased in the group with the normal type compared with the group with the borderline type while those in the group with the diabetes type showed a tendency to increase. In addition, a significant weight loss was observed in the group with a normal type and there was a weight gain tendency in the group with the diabetes type. Evaluation of changes in body weight and glucose tolerance showed a change to the normal type in 60% and to the diabetes type in 8% of subjects with a weight loss of 3kg/3y or more, and a change to the normal type in 8% and to the diabetes type in 39% of subjects with a weight gain of 3kg/3y or more (p<0.01). Conclusions: In subjects with the borderline type, weight gain and loss were associated with the aggravation and improvement, respectively, of glucose tolerance. These results suggested the importance of weight loss guidance in examinees with the borderline type.

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Objective: In examinees with fatty liver in ningen dock, the association with obesity and metabolic syndrome was evaluated. Methods: The subjects were 3,394 examinees who underwent ningen dock at our center in 2004, and the incidence of fatty liver was evaluated. The subjects were classified into the groups with fatty liver[fatty liver (+)group]and without fatty liver[fatty liver (-) group], and the association between fatty liver and obesity or metabolic syndrome was evaluated. Results: Of 3,394 examinees,303(8.9%)had fatty liver. The incidence of obesity was 76.6% in the fatty liver (+) group but 25.4% in the fatty liver (-) group, showing a significant association between fatty liver and obesity. The incidence of metabolic syndrome was 40.3% in the fatty liver (+) group and 9.4% in the fatty liver (-) group, showing a significant association between fatty liver and metabolic syndrome. Conclusion: When fatty liver is observed by ultrasonography in ningen dock, its close association with obesity or metabolic syndrome should be adequately recognized, and appropriate post-guidance is necessary.

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