Objective: The main cause of chronic obstructive pulmonary disease (COPD) is smoking. COPD is the 4^th greatest cause of the death in the world. As the prevalence and mortality rate continue to increase, it is a major issue in preventive medicine.In recent years, it has become possible to treat COPD and with proper treatment, we can prevent decline in pulmonary function and improve the prognosis. To discover and diagnose COPD efficiently at the early stage, it is important to check the pulmonary function in individuals at high risk of airway obstruction. We investigated whether an electrocardiogram (ECG) can be used as a tool for discovering COPD.
Methods: We investigated a relationship between airway obstruction and an abnormal ECG in 13,834 subjects receiving an annual health check-up including pulmonary function testing and an ECG at the Kyoto Preventive Medical Center between January 2007 and November 2009.
Results: In our subjects, those who had never smoked accounted for 53.0%, ex-smokers accounted for 24.7% and current smokers accounted for 22.3%. The prevalence of airway obstruction in the subjects overall was 9.9%. In subjects with a smoking history, there was a significantly higher prSevalence of airway obstruction in those with atrial fibrillation, complete right bundle branch block, incomplete right bundle branch block, premature ventricular contraction, left axis deviation, left ventricular hypertrophy and pacemaker rhythm abnormality.
Conclusion: The prevalence of airway obstruction was higher in subjects with a smoking history and ECG abnormalities, showing that ECG can be a useful tool in spirometry. We recommend that pulmonary function is checked in persons with a smoking history and ECG abnormalities.

View full abstract

Objective: In this study, we examined the effect of obesity on the location of colorectal adenoma.
Methods: The subjects were 14,582 persons who underwent routine screening colonoscopy at the Health Care Center of Takano Hospital during a 15-year period from April 1992. In those in whom a single colorectal adenoma was detected, multivariate logistic regression analysis was performed to examine a relationship between the location and obesity by size (BMI ≧25) to calculate the odds ratio (OR) and p<0.05 was considered to be statistically significant. The locations where colorectal adenomas were detected included the rectum (including anus), sigmoid colon, sigmoid-descending colon junction, descending colon, splenic flexure, transverse colon, hepatic flexure, ascending colon, and cecum. The size of the colorectal adenomas was classified as <5, 5 to <10, and ≧10 mm.
Results: Obesity was associated with colorectal adenoma size in males, and this was exclusively observed for >5 mm in diameter. Colorectal adenoma was observed with significantly greater incidence for 5 to <10mm: OR=1.93 (p=0.003)and≧ 10 mm : OR=2.35(p=0.004), in the ascending colon of obese males.
Conclusion: The results of this study indicate that the location and size of colorectal adenoma differs with gender and is dependent on obesity. Generally, obesity in males tends to be visceral fat obesity, and it cannot be precluded that pathology may be involved, although a causal relationship between visceral fat obesity and the location of colorectal adenoma remains unclear. Further study will be needed in the future.

View full abstract

Objective: A randomized comparative study was performed to examine the effectiveness and safety of a method developed to inhibit peristalsis during transnasal endoscopy using lemon juice.
Methods: The subjects were 80 patients who underwent transnasal endoscopy at our hospital from June to August 2011. They were randomly divided into 2 groups using the envelope method. During the examination, 15 ml of lemon juice (Group A) or distilled water (Group B) was injected into the duodenum. Peristalsis in the gastric antrum was scored from 1 (no peristalsis) to 4 (severe peristalsis) before and after injection. Blood pressure, heart rate, and SpO₂ were measured before, immediately after, and 3 minutes after injection.
Results: The percentage of patients with no peristalsis after injection was significantly higher in Group A (39.5%) than in Group B (0%) (p<0.00001). The mean peristalsis scores before and after injection were 2.34 and 1.79, respectively, in Group A, and 2.47 and 2.64, respectively, in Group B. There was no significant difference in scores between the groups before injection. The score in Group A significantly decreased after injection (p<0.01) and was significantly lower than that in Group B (p<0.0001). Blood pressure, heart rate, and SpO₂ did not differ significantly between the groups.
Conclusion: These results show that use of lemon juice to inhibit peristalsis during transnasal endoscopy is effective and safe. This method is widely applicable and should contribute to improving the accuracy of transnasal endoscopy.

View full abstract

Background: Plasma amino acid profiles are known to change in various diseases, including cancer. “AminoIndex technology” estimates health and disease risk based on plasma amino acid profiles using multivariate analysis. “AminoIndex Technology” could be a useful, novel biomarker for the detection of several cancers. In this multicenter study, we created and evaluated a plasma amino acid index suitable for screening for different gynecologic cancers: cervical, endometrial, and ovarian cancer.
Methods: In this study, plasma amino acid concentrations were measured by liquid chromatography-mass spectrometry in patients with cervical cancer (n=208) , endometrial cancer (n=186) and ovarian cancer (n=102) , as well as in patients with benign gynecologic diseases (n=305) and in healthy controls (n=1,631) .
Results: Plasma levels of several amino acids differed significantly between patients with gynecologic cancer and healthy controls. In contrast, plasma amino acid patterns were similar in patients with each type of gynecologic cancer. We therefore created a plasma amino acid profile-based index for the detection of all three types of gynecologic cancer. The sensitivities of the index were 52%, 58%, and 77% at a specificity of 95% for cervical, endometrial, and ovarian cancer, respectively. The index showed particularly high sensitivity for the early stage (stage I) of each cancer. It also showed similar sensitivities for cervical adenocarcinoma and squamous cell carcinoma. The sensitivity of the index was significantly higher than that of CA125 for endometrial cancer, and comparable to CA125 for ovarian cancer.
Conclusion: This novel index could be a potential biomarker for the early detection of gynecologic cancers.

View full abstract

Objective: Evaluation of importance of cardiac auscultation in health check-ups.
Methods: Our subjects were 5,492 persons (average age 47.8±12.0 years; 2,296 males, 3,196 females) who underwent health check-ups at our center from April 2009 to March 2011. They were all examined by cardiac auscultation for presence of heart murmur and the findings were compared with those from clinical histories, chest X-ray examinations (XP) and electrocardiograms (ECGs). Also, the results of further examinations were followed-up.
Results: Hear murmur was noted in 49 subjects (0.89%), among whom 35 (0.64%) were undiagnosed. Among these 35 subjects, 29 underwent an XP, 2 (7%) of whom required further examination. ECGs were also performed on 29 of these subjects and 4 (14%)required further examination. Abnormalities in either XP or ECGs, or in both, were found in 6 subjects (17%). In 19 of the 35 undiagnosed subjects, it was possible to follow-up the results of further examination. Among them, there were 3 serious cases requiring surgery (I case of mitral regurgitation (MR), 1 case of aortic regurgitation (AR), 1 case of patent ductus arteriosus), 7 moderate cases requiring management by a specialist (3 cases of MR, 2 cases of AR, 2 cases of aortic valvular stenosis), 4 cases of slight abnormality (2 cases of MR, 1 case of AR, 1 case of unspecified abnormality) and 5 cases of no abnormality. In the 10 subjects with moderate to severe symptoms, there was 1 case of cardiac enlargement on XP with no ECG abnormality and the remaining 9 subjects had no abnormality other than heart murmur, which could be diagnosed solely by cardiac auscultation.
Conclusion: Cardiac auscultation is important for the diagnosis of cardiac valvular disease and congenital cardiac disease in health check-ups.

View full abstract