[in Japanese]

View full abstract

Objective: Recently, the health guidance in regard to lifestyle related disease has been performed depending on the stage of the subject. However, we cannot lead behavior modification if the subjects of guidance do not have motivation to expect behavior modification. In this study, the self-motivation test (SMT) investigated utility for the scale which evaluated motivation of behavior modification. Methods: We intended for 42 elderly who participated in the fall prevention programs and the questionnaire survey was performed at the beginning and three months later. Results: The stages of 11 participants were improved by this program. As for prediction of the motivation of behavior modification for health guidance, the sensibility was 0.64 and the specificity was 0.45. According to the receiver operating characteristics (ROC) curve, the SMT was not regarded as a useful diagnostic tool. However, concerning of the likelihood rate of a positive result, it is thought the SMT is a diagnostic tool with high specificity when we assumed 21 points of SMT score cutoff value (sensitivity 0.33, specificity 0.91). Conclusions: In the guidance planning depending on the stage of behavior modification, the SMT may become a useful tool at a point evaluating the motivation of behavior modification.

View full abstract

Objective: For upper digestive tract examination on general health screening and/or ningen dock, endoscopy has increasingly replaced radiography. Upper digestive tract endoscopy is useful for detecting malignant disorders of the upper digestive tract, especially cancer, in the early stage. In this study, we report patients in whom biopsy under a tentative diagnosis of gastric cancer or duodenal polyp suggested mucosa-associated lymphoid tissue(MALT)lymphoma. As this disorder must be differentiated from cancer, we accumulated and analyzed patients with MALT lymphomas in the upper digestive tract. Methods: Among a total of 28,122 subjects who underwent upper digestive tract endoscopy on ningen dock in our hospital between January 2001 and December 2006, we clinically examined 13 patients in whom upper digestive tract biopsy was performed, and histopathological examination diagnosed MALT lymphoma. Results: Ages ranged from 41 to 77 years, with a mean of 56.8 years. The male-to-female ratio was 9: 4. The detection rate was 0.046%. Symptoms, including ardor ventriculi, epigastric pain, and abdominal pain, were noted in 1 patient. In all patients, the LDH levels were within the normal range. The performance status(PS)was 0 in all patients. The clinical stage was evaluated as I in 11patients in whom investigation was possible. The subjects were divided into gastric and duodenal lesion groups. In the former group, there was no relapse after eradication therapy. Conclusion: To detect MALT lymphomas of the upper digestive tract, regular screening should be performed in Halicobactor pylori-positive patients. Most gastric lesions show slight changes; close follow-up andbiopsy are important. Duodenal lesions must be differentiated from follicular lymphomas.

View full abstract

Objective: The obese develop considerably the glucose and fat metabolic disorders, or hypertension. We investigated the metabolic disorders or hypertension in the obese in the executive annual medical chekup, and followed up the obese for 10 years. Results: The obese were found 19.2% in women and 17.7% in men. In women the age was not different by the obese degree but the more obese were the younger in men. In obese women the degree of obesity correlated with the frequency of metabolic disorders and hypertension. In contrast, the obesity did not correlated with metabolic disorder in men. After ten years follow-up of these obese persons, obese women were hard to reduce their fat body mass and developped more the metabolic disoders or hypertension. On the other hand, obese men improved the obesity and the risk of metabolic disorders or of hypertension. Conclusions: These suggest the difference of the obese charcteristic between women and men.

View full abstract

Objective: The prevalence and characteristics of gastroesophageal reflux disease (GERD)was investigated in subjects, who visited our health check-up institution for routine physical examinations. Methods: The subjects,659 persons without medication for upper gastrointestinal disease, were divided into 3 groups, erosive gastroesophageal reflux disease (e-GERD), non-erosive gastroesophageal reflux disease (NERD) and non-GERD, according to evaluation of esophagitis observed by endoscopy and Frequency Scale for the Symptoms of GERD (FSSG) questionnaire scores. The prevalence in male and female, factors related to lifestyle, such as serum lipid, blood sugar, high sensitivity C-reactive protein (CRP) and blood pressure, and the associated ratio of metabolic syndrome, were compared in these 3 groups. Results: NERD was more frequently observed than e-GERD in both of male and female. E-GERD was more common in male than in female. The subjects with e-GERD showed higher blood pressure than those with NERD or non-GERD. Higher titer of lifestyle related factors, such as blood sugar, serum lipids, and high sensitivity CRP was observed in e-GERD, compared to NERD or non-GERD. Metabolic syndrome was more frequently associated with e-GERD than with other 2 groups. Subjects with NERD, who were leaner than those with e-GERD, showed lower titer of these lifestyle related factors even compared to those with non-GERD. Conclusion: While e-GERD was found in relatively fatty persons and considered to be one of lifestyle related diseases caused by obesity, NERD was common in leaner subjects without any abnormalities of lifestyle related factors. This indicates that pathogenesis of e-GERD and NERD is different.

View full abstract