Background To know the historical change in risk factors for high BP of Japanese.
Methods We verified and analyzed the data of “Ningen Dock” of 1973 and 1997. The subjects were 46,941 adults in 1997 and 12,031 adults in 1973.
Results Compared to 1973, the proportion of high BP in both males and females went down in 1997. According to logistic analysis, the risk factors for high BP in 1973 were being male, aging, and high BMI. In 1997, occupation appeared to be a risk factor in addition to the risks in 1973. According to our new 1997 model with more detailed variables, occupation appeared to be a risk factor for both males and females again. Another common risk factor to males and females was character. Moreover, being single, the drinking and aging were risk factors for males. As for the role of smoking, it was considered that when subjects were obese, the risk was high regardless of smoking, but the risk was depressed when they smoked.
Conclusion Modifications of both lifestyle and occupational circumstances will be a considerable contribution in controlling BP. To prevent lifestyle related disease including high BP of the Japanese, the role of occupational physicians who manage work environment or health for employees is becoming bigger. It is considered that they should contribute more to the health care, by clarifying the clinical role.

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Background The cost of stroke in middle-aged and elderly workers has a large economic impact in Japan. Therefore, to detect individuals with risk factors for the stroke, including silent cerebral infarction (SCI) is crucial. The purpose of the present study is to propose an efficient screening system for detecting SCI in middle-aged and elderly Japanese employees, by using the cost-effectiveness analysis.
Methods The target population is 23 million full-time employees from 40 to 64 years old in Japan. The validity of the screening criteria to detect the SCI was estimated using the data that were collected from the brain check-up at Mominoki Hospital (Kochi, Japan). We defined “effect” as the number of individuals in whom SCI was detected by brain MRI and “HT” as a systolic BP≥140 mmHg or a diastolic BP≥90 mmHg. We evaluated the direct health care costs and estimated the cost per case detected.
Results The cost per case detected for the screening criteria of “age≥60 and HT” proved the best and it was estimated to be 56,000 yen. The results of sensitivity analysis suggested that the screening criteria of “age≥60” or “age≥45 and HT” was more robust and reliable than “age≥60 and HT”.
Conclusion The cost per case detected of this hypothetical screening system for detecting SCI does not appear to be very expensive compared to several other screening systems in Japan.

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Background Personal health checking system (Ningen Dock) is now being popular in Japan. With increase of examinees (clients), arrangement of examination procedures is becoming difficult. As a large quantity of examination data are produced in every client, it spends time in making individual personal medical records correctly and promptly.
Methods To solve this difficulties, Sophia Health Improvement Center (Sophia) constructed digital personal health checking system (Ningen Dock) applied of computer information network system since 1999.
Results Twenty-six thousand eight hundred fifty-six Ningen Dock clients were examined by this system in last 7 years. The images were directly transmitted to Sophia from radiology without using medical Xray film (filmless). The radiologist interpreted them on a high-resolution cathode ray tube (CRT) of Digital Imaging and Communication in Medicine (DICOM) by using personal computer (paperless) and explained them to the client. Examination results including all medical imaging data of each client were recorded on compact disk recordable (CD-R) which was sent to client's home afterwards. The recorded CDR was evaluated to be useful for health improvement of client. Furthermore, gastric virtual endoscopy (VE) processed from CT images was successively developed by using the digital imaging system. Its diagnostic abilities were obtained sensitivity of 92.7% and specificity of 90.9% by comparison with real gastric fiberscopy (GF). This non-invasive method was applied to 1949 cases of Ningen Dock in last 5years, in which 3 cases of gastric cancer were detected in early stage.
Conclusion Digital health checking system was successfully developed by using medical information systern.

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Background RF is occasionally positive even in healthy persons.
Objective We aimed to investigate the association of RF with environmental factors in a nonrheumatologic population.
Methods Subjects consisted of 10,363 nonrheumatologic persons. We measured hepatitis B surface antigen by magnetic agglutination test, hepatitis C virus antibody by third-generation recombinant strip immunoblot assay, and RF by latex immune assay.
Results The prevalence rate of RF was 4.7% (482/10,363) of the total study population. Subjects with hepatitis B virus (HBV) had a higher prevalence of RF (26.0%,38/146, p<0.001) than those without HBV. Similarly, subjects with hepatitis C virus (HCV) had a higher prevalence of RF (12.7%,10/79, p=0.003) than those without HCV. Asymptomatic healthy carriers with HBV had a higher prevalence of RF (26.6%,33/99, p<0.001) than subjects without HBV. Similarly, those with HCV had a higher prevalence of RF (15.3%,9/59, p=0.001) than subjects without HCV. In subjects with neither HBV nor HCV, the prevalence of RF was correlated with age but not smoking status or coffee consumption. It was highest in those in their 40s (4.9%) and low in those in their 20s (1.8%) and over 70s (3.0%), and increased with age under 40s and decreased with age over 50s.
Conclusion Chronic viral infections and age less than 40 might be risk factors for the production of RF in nonrheumatologic persons.

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Background In our on-going research we have been investigating as how the acceleration plethysmogra phy (APG) can possibly be employed as a simple way for detecting autonomic modulations. The quantitative capturing of the autonomic modulations would have a certain merit for primary care. As a preliminary step, it seemed essential to observe autonomic nerve response by a certain mental load. As one of temporary mental loads, we designed the “Kingyo program”. Specifically, it determines the number of the swimming goldfishes in an allotted time. The purpose of the current research is to examine the effectiveness of the “Kingyo program” through which the autonomic nerve response could be observed.
Methods Six healthy male university students were examined. Employing the frequency analysis in the APG system before and after loading games, we obtained total spectral power, the proportion of the spectral element in the low frequency area (LF%), the proportion of the spectral element in the high frequency area (HF%), and the LF/HF ratio. This process was repeated 3 times for each subject on different days. The distribution of each variable obtained before and after the games was compared by Wilcoxon tests.
Results The distribution of HF% significantly moved to lower level, where as the distribution of LF/HF ratio showed a significant shift to upper level after each game.
Conclusion It is considered that the five games of the “Kingyo program” controlled the vagal activity, or emphasized a sympatho/vagal balance. For investigating the autonomic nerve response, this program could have the merit as one of a temporary mental load.

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Background Periodontal disease is a multiple infection caused by bacteria represented by Porphyromonas gingivalis (Pg). The prevalence of periodontal disease is high, as it predominantly affects the people in the same age range as diabetes mellitus, but it is often overlooked because of the lack of subjective symptoms. There has been a need for the introduction of self-sampled device-treated plasma using fingertip capillary blood in routine tests.
Methods Based on the report by Kudo et al. (Beppu Conference 2006, p.46, 2006) on enzyme-linked immunosorbent assay (ELISA) as a blood test for periodontal disease bacteria, the precision and disease specificity were examined towards the establishment of a methodology for routine tests.
Results The intra-assay reproducibility of the measurements using Pg and 3 other types of antigens, Prevotella intermedia (Pi), Eikenella corroders (Ec), and Actinobacillus actinomycetemcomitans (Aa), was coefficient of variation (CV) 4-7%, and the results from capillary blood and those from venous blood were closely analogous to each other with a correlation (r) of 0.900 or more. The difference between the non-periodontal control subjects group and the periodontal disease group in the distribution of data on histograms using the Pg antigen was approximately 7-fold. In addition, the correlation with mean periodontal pocket depth was significant (r=0.597, p<0.001) in the group showing the test results (SD index; SDI) of 20 or more. These results substantiated the specificity of this method.
Conclusion The ability to detect periodontal disease in the setting of “Human Dry Dock” screening examinations using the sampling and test methods proposed by us would be an important means to improve services. This study established the practical feasibility of this approach.

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Background Since hyperuricemia has been linked with an increased risk of atherosclerotic cardiovascular disease, we examined the effects of aging and BW changes on serum uric acid (UA) concentrations.
Methods The subjects were 5309 men (51.8±8.5 years old) and 3080 women (51.0±8.4 years old) who visited our hospital for a health check-up. Serum UA was compared according to age in men and women, and before and after menopause in women. Serum UA and the frequency of hyperuricemia were compared between groups with and without metabolic syndrome. Annual changes in serum UA were examined and correlated with changes in BMI.
Results Serum UA was higher in women aged over 50 years old. In a group of women in whom serum UA was measured before and after menopause, the level was higher after menopause (4.6±1.0 vs.4.3±0.9mg/dl, p<0.001). Serum UA and the frequency of hyperuricemia were higher in men and women with obesity, hypertriglyceridemia or hypertension. Serum UA decreased (6.0±1. I to 5.7±1.1 mg/dl, p<0.001)with a decrease in BMI, and increased (6.2±1.2 to 6.4±1.3 mg/dl, p<0.05) with an increase in BMI in men.
Conclusion Serum UA increases after menopause in women and is related to obesity and other parameters associated with metabolic syndrome in men and women. Management of BW of subjects with hyperuricemia may be important to prevent onset of atherosclerotic disease.

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Background Under diagnosis of obstructive lung diseases (OLD) throughout the world suggests the need for wide spread use of spirometry which would also enable early detection of these diseases. As part of Japan's program of general health evaluation spirometry is performed routinely on asymptomatic subjects permitting early detection of airflow limitation before it is clinically apparent.
Methods We analyzed the one second forced expiratory volume/forced vital capacity (FEV1/FVC) ratio in 8825 (3887 men and 4938 women) never-smokers undergoing general health evaluation at Tokai University Health Examination and Promotion Center.
Results We found that the FEV1/FVC ratio declined with age with a general prevalence of airflow limitation of 5.35% which increased with age in men and women as previously reported. In comparison with the standard values of the Japanese Respiratory Society (JRS), the FEV1/FVC ratio at our center was lower than that of the JRS due possibly to the exclusion of pre-surgical patients with airflow limitation in the JRS population or to the influence of passive smoking and/or environmental pollutants in ours.
Conclusion These data encourage us to detect airflow limitation in asymptomatic subjects for early referral to pulmonary physicians before OLD is clinically apparent and moderately advanced.

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