Objective: Japan Society of Ningen Dock (JSND) created a database of subjects receiving annual health examinations at 21 institutions nationwide. Using this database, we evaluated the efficacy of current treatment for patients with dyslipidemia, hypertension and diabetes mellitus based on the recommendations of the Japan Atherosclerosis Society (JAS), the Japanese Society of Hypertension (JSH) and the Japan Diabetes Society (JDS), respectively.
Results: 1. Status of dyslipidemia treatment (n=17,694): According to the JAS 2007 guidelines, the achievement rates of serum lipid management goals were as follows: LDL-C, 72.3%; HDL-C, 94.6%; and TG, 69.7%. 2. Status of hypertension treatment (n=31,754): According to the JSH 2009 guidelines, the target office blood pressure was achieved by 45.2% of all subjects. When 140/90 mmHg were used as the hypertension criteria for conventional blood pressure measurements, the achievement rate was 69.8%. 3. Status of diabetes treatment (n=7,020): According to the JDS 2013 guidelines, 44.8% of the patients fell into the good glycemic control category with a HbA1c level < 7.0%. 4. Lifestyle and lipids, blood pressure and glycemic control: Lifestyle habits were strongly associated with lipids, blood pressure and glycemic control in patients with dyslipidemia, hypertension and diabetes treatment.
Conclusions: Our results indicate that management of lifestyle-related diseases in Japanese patients receiving treatment for dyslipidemia, hypertension and diabetes is insufficient. Stricter management including lifestyle modification is necessary for reducing rates of complications.

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Objective: We analyzed the efficacy of position change in relieving the pain and burden of examinees undergoing bowel preparation with electrolytes for colonoscopy.
Method: We randomized subjects requiring colonoscopy due to being positive in an immunological fecal occult blood test in primary medical examinations from May 2010 to June 2011 to one of 3 groups. The 3 groups were standard group using conventional bowel cleaning method and no position change, group with 5-minutes in left lateral position during bowel preparation and group with 15 min in left lateral position during bowel preparation. We analyzed the time taken until inspection was considered possible (preparation time), volume of electrolyte intake, as well as the volume of residual fluid in the colon and colon cleaning rate as measured by the endoscopist, for each of the 3 groups.
Results: There were no significant differences among the groups regarding preparation time, electrolyte intake volume and residual fluid volume. The colon cleaning rate was excellent in 90.0% of the 15-minute group and in 77.2% and 33.0% of the 5-minute group and standard group (p<0.01), respectively.
Conclusion: It is considered effective to use the left lateral position to prepare patients for colonoscopy.

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Objective: We conducted a customer survey by questionnaire and analyzed the results to determine areas for improvement.
Methods: In 2012, a customer satisfaction survey was conducted by questionnaire for all Ningen Dock examinees at Uji-Takeda Examination Center. Levels of satisfaction regarding 9 items were evaluated according to 4 grades: excellent, good, poor and bad. The surveys was performed once a month and all staff were informed of the results as well as any complaints.
Results: Twelve hundred thirty-one persons (91.0% of 1353 customers) provided responses to the questionnaire. Levels of satisfaction for almost all items was high, in particular attitude of staff, explanations by doctors and nurses and cleanliness of lavatories. Assessment of the customer satisfaction survey results resulted in a new procedure, “issue of brief medical referral letter containing information for the day of examination” to customers.
Conclusion: The customer satisfaction survey produced very important information for all staff.

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Objective: To investigate factors which influence cervical cancer screening rates in female healthcare workers.
Methods: Subjects were all female healthcare workers working in the Takeda Hospital Group who agreed to participate in the survey. The survey was carried out using a question sheet and responses were anonymous, It asked for information concerning the following; 1) age and type of job, 2) receiving cervical cancer screening or not and the reasons, 3)knowledge of 10 items containing cervical cancer and the HPV test, 4) knowledge of 5 items concerning HPV vaccine.
Results: Question sheets were distributed to about 2,000 female healthcare workers. Of them 1,872 responded and the number of effective responses was 1,846 (98.6%). Among these respondents, 517 were in their twenties, and 508 in their thirties, accounting for more than half of the total. As for occupation, 758 (41.1%) were nursing staff. Of the effective respondents,1009 (54.7%) had undergone cervical cancer screening As for the reasons, health management was given by 467 workers (46.3%) and 230 (22.8%) gave availability of examination assistance system. As reasons for not receiving screening, 644 (76.9%) said they had no opportunity to undergo screening and 497 (59.4%) gave absence of subjective symptoms. Awareness of the examination assistance system was higher among subjects receiving cervical cancer screening than in those not receiving it.
Conclusion: Awareness of the examination assistance system was higher in subjects receiving cervical cancer screening than in those not receiving it.

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Background: AminoIndex^TM Cancer Screening (AICS) was developed as a novel cancer screening test for evaluating the probability of 6 types of cancers (lung, gastric, colorectal, prostate, breast and uterine/ovarian) and is now being applied in practice for this purpose. AICS is based on “AminoIndex Technology” which compares plasma free amino acid (PFAA) concentrations between cancer patients and healthy controls by multivariate analysis. In this study, we report the results of AICS for Ningen Dock examinees as well as those for detailed examinations for those determined to be rank C in AICS.
Methods: AICS was conducted for 799 Ningen Dock subjects (494 men, 305 women, average age: 59±11) at Mitsui Memorial Hospital. Rank C subjects were given detailed examinations for each cancer: chest CT for lung, gastro-intestinal fiberscope for gastric, lower intestinal fiberscope for colorectal, PSA and abdominal ultrasonography for prostate, mammography and mammary ultrasonography for breast and cytology and transvaginal sonography for uterine/ovarian cancers, respectively.
Results: One case each of gastric, prostate and breast cancer were diagnosed by detailed examinations on rank C subjects. The detection rate of cancer by AICS was 0.38%, which was superior to that of 0.26%, reported for the national survey conducted by Japan Society of Ningen Dock in 2011. Also, many precancerous lesions were detected; such as nodular lung lesions, atrophic gastritis with interstitial metaplasia, high-grade colorectal adenoma and high PSA levels.
Conclusion: These results suggested that AICS could be a novel cancer screening test. More study is recommended to further clarify its usefulness.

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Objective: When collecting blood during health check-ups, various incidents or accidents may occur and their prevention is important for maintaining safety and quality in health check-ups. We recently examined the causes of such incidents and accidents, measures to prevent their recurrence and points to be noted when collecting blood.
Methods: We searched information published on the website of the Japan Council for Quality Health Care for cases of incidents and accidents occurring in blood collection, and examined their causes and prevention measures based on case summaries.
Results: Ninety-six cases of incidents or accidents as of April 2012 were examined. Seventy-six cases had occurred at the time of blood collection, 8 cases after blood collection, 11 cases at the time of evaluating test results or reporting and 1 case came under the category of others. Thus, most incidents or accidents occurred at the time of blood collection. Cases included mistakes regarding patients or samples, peripheral nerve disorders, errors in reporting examination results, delay in reporting and forgetfulness in reporting. Patients had been affected in various ways. Prevention measures reported included system level ones which were considered effective.
Conclusions: In order to perform a high safety, high quality blood testing service for health check-ups, consideration should be given to the characteristics of service processes and establishment of an integrated incident/accident prevention system in healthcare facilities. This should include the preparation of various manuals, staff training and its evaluation, as well as the checking and maintenance of equipment.

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Objective: It has been shown that Helicobacter pylori infection is a critical risk factor for gastric cancer. This study was conducted to clarify the usefulness of gastro fluoroscopy for the diagnosis of Helicobacter pylori infection.
Methods: We investigated 200 examinees (118 males, 82 females) who visited our health care center for health check-ups between April, 2011 and March, 2012. We evaluated the usefulness of gastro fluoroscopy for the diagnosis of Helicobacter pylori infection by comparing gastro fluoroscopy images with serum Helicobacter pylori antibody titers. We considered that subjects had Helicobacter pylori infection when a diagnosis of atrophic gastritis was made on the basis of f gastro fluoroscopy images.
Results: Chronic gastritis (including atrophic gastritis) was observed in 96.8% of subjects who were serum Helicobacter pylori antibody positive. Chronic gastritis was noted in 100% of subjects both serum Helicobacter pylori antibody positive and pepsinogen positive. On the other hand, chronic gastritis was observed only in 10.6% of subjects both serum Helicobacter pylori antibody negative and pepsinogen negative. Thus, on the basis of gastro fluoroscopy, diagnosis of Helicobacter pylori infection had a sensitivity of 91.5%, specificity of 93.3% and an accuracy of 92.3%.
Conclusions: Our results suggest that gastro fluoroscopy is a useful tool for the diagnosis of Helicobacter pylori infection.

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