Objective: It is important to have a convenient method of detecting dementia in patients in the early stage. The objective of this study was to evaluate the usefulness of the clock drawing test (CDT) in screening for dementia in Brain Dock (brain health check-up).
Methods: In 42 patients (20 male and 22 female, average age; 78.1±5.4 years) who visited Kanazawa-Nishi Hospital for dementia screening, we conducted the CDT by the Kono method, using automatic judgment by a PC, as well as evaluation by the MMSE, FAB, brain MRI, ECD-SPECT and MIBG scintigraphy. MRI findings were analyzed by VSRAD and those from ECD-SPECT by eZIS.
Results: The score for the CDT was 8.0±1.7 (mean ± SD). The MMSE score was 23.4±4.0 (mean ± SD) and that of FAB was 10.3±1.1 (mean ± SD). The CDT score was correlated with the MMSE (r=0.438, p=0.005) and FAB scores (r=0.423, p=0.007). However the CDT score was not correlated with the VSRAD, eZIS or MIBG results. In two patients with Lewy body disease, the CDT score was much lower than the MMSE and FAB scores.
Conclusion: Our study showed that the CDT with automatic judgment by a PC was a convenient screening technique.We found that the CDT score was correlated with MMSE and FAB scores. Therefore, the CDT is a useful screening tool for dementia in Brain Dock.

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Objective: Since incidental thyroid tumors are frequently observed in carotid ultrasonography, a clinical standard is required to conduct efficient screening for those who would need further examination. In this study, we analyzed the results of ultrasonographic examinations in order to determine the frequency of incidental thyroid tumors.
Methods: We conducted carotid ultrasonography on all persons who underwent Ningen Dock from April, 2009 to March, 2013 at Koyama Memorial Hospital.
Results: Thyroid tumors were detected in 461 subjects (45.3%). Individual category rates were as follows: category A2 in 302 subjects (65.5%), category B in 155 (33.6%), and category C in 4 subjects (0.9%). Among people in need of further examination (i.e. category B and C subjects), 59 (37.1%) underwent examination as outpatients in our hospital and 16 of them (27.1%) underwent fine needle biopsy. However, no malignancy was observed.
Conclusions: The findings of this study suggest that a high rate of incidental thyroid tumors was observed in carotid ultrasonography (over 45%), but fortunately we have detected no malignancy up to now. Ultrasonography surveys of infants following the Fukushima nuclear disaster suggested that the rate of category A2, B, and C was 48.4%. We consider that the high-performance of the ultrasonography system used to be one of the primary reasons for such a high frequency of incidental thyroid tumors.

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Background: AminoIndex^TM Cancer Screening (AICS) was developed as a novel cancer screening test to determine the probabilities of various cancers and is now in being used in practice. The AICS test is based on "AminoIndex Technology", in which a comparative multivariate analysis of the plasma free amino acid (PFAA) concentration is conducted between cancer patients and healthy controls. In this study, we report the sensitivities of AICS for various cancers in comparison with those for the existing tumor markers.
Methods: Plasma amino acid concentrations were measured by liquid chromatography-mass spectrometry and AICS values were calculated in patients with gastric cancer (n = 177), lung cancer (n = 311),colorectal (n = 257) and breast cancer (n = 160), respectively. The sensitivities of AICS for the various cancers were evaluated in comparison with those for the existing tumor markers.
Results: The sensitivities of AICS (gastric), AICS (lung), AICS (colorectal) and AICS (breast) for early stages of the corresponding cancers were 40％, 38％, 32% and 24%, respectively, which were significantly higher than those for the existing tumor markers. Also, slightly higher sensitivities were obtained when the AICS test was used in combination with the existing tumor markers.
Conclusion: These results suggested that AICS would be a useful in cancer screening for the early detection of various cancers as compared with screening using existing tumor markers.

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Objective: We adopted a simultaneous, parallel approach in which upper gastrointestinal tract endoscopy (GE) and a glucose tolerance test based on urinary myoinositol (UMI) measurement were performed in a single-day health check-up, and examined the possibility of using it in screening for patients with impaired glucose tolerance.
Methods: The subjects were 10 volunteers who underwent a 75-gram oral glucose tolerance test, and were classified into the glucose tolerance categories according to WHO criteria (1998) before the health check-up. Subjects classified into the normal glucose tolerance category whose blood glucose level measured one hour after the glucose load exceeded 180 mg/dL were defined as pre-borderline. Their urine samples were collected before the glucose load and two hours later to measure UMI. On the day of the health check-up, they were subjected to the glucose load after urine sampling in the fasting state early in the morning. Then, they underwent GE. Two hours after the glucose load, they underwent urine sampling again. UMI was expressed as the difference between the creatinine-corrected UMI concentrations obtained before and after the glucose load.
Results: There was no influence on the image observed in GE as long as at least 60 minutes had passed since the glucose load. The results of UMI measurement performed after endoscopy were similar to those for measurement performed previously.
Conclusions: These results demonstrated the feasibility of performing the glucose intolerance test by means of UMI measurement and endoscopy simultaneously, in parallel in a single-day health check-up.

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Objective: For the purpose of health guidance concerning chronic kidney disease (CKD), a risk factor for end-stage renal disease and cardiovascular disease, we examined associations between changes in eGFR and various factors in research that compared data obtained at baseline and 9 years later.
Methods: The subjects were 7,550 persons (4,074 males, 3,476 females; average ages 48.3 years, and 47.8 years, respectively) who had undergone a health check-up in both 2003 and 2012 at our facility. Analysis was conducted using eGFRs for 2003 and 2012 and various baseline data in 2003. Regarding changes in eGFR over time, GFR divisions were used in place of severity of CKD.
Results: At -6.4 mL/min/1.73 m² in men and -7.2/min/1.73 m² in women, there had been a significant drop in eGFR. Regarding individual eGFR divisions, G3a had increased by 9.6% in 2012. Regarding change in eGFR, age, eGFR (the higher the greater), urinary protein of 1+ or greater, hypertension and diabetes in 2003 were significant progressive factors, while female gender, serum albumin level, hemoglobin content and HDL-C were inhibitory factors. In logistic regression analysis on whether there had been deterioration in GFR division or not, age, eGFR, urinary protein of 1+ or greater, hypertension, diabetes and uric acid in 2003 were significant progressive factors, while female gender, serum albumin level, and hemoglobin content were inhibitory factors.
Conclusion: Analysis of factors influencing decline in eGFR and progression in eGFR division showed that there were several independent factors other than aging influencing this. In order to prevent progression of CKD, health guidance considering such factors in addition to underlying diseases is necessary.

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Objective: In 2010,we introduced measurement of serum carbohydrate antigen 19-9 (CA19-9) levels into the routine health check-up at our clinic. Here we report on the significance of measuring serum CA19-9 levels during opportunistic screening.
Methods: From April 2010 to March 2011, 15,773 subjects underwent a complete health check-up at our clinic. All subjects underwent measurement of CA19-9 and abdominal ultrasonography. Subjects with elevated CA19-9 levels received further imaging examinations as needed and were followed-up every three months.
Results: Of the 15,773 subjects, 308 had elevated serum CA 19-9 levels (2.0 %), and 90% of them had CA 19-9 levels less than 100 U/mL. Among the 308 subjects, 243 (78.9%) received detailed examinations at our clinic. Malignancies were detected in 10 subjects (4.1%) - consisting of 4 with pancreatic cancer, 1 with cholangiocellular cancer, 2 with bronchogenic cancer, 1 with rectal cancer, 1 with ovarian cancer, and 1 with renal cell cancer. The pancreatic cancer involved the body and tail in two subjects each. Serum CA 19-9 levels in the subjects with malignancies tended to double in three months. Four subjects with endometriosis had wide fluctuations in serum CA19-9 levels, which ranged from 200 up to 700 U/mL. The levels remained relatively constant in other subjects with elevated levels, though the etiologies were unknown. Five subjects with malignancies, including 3 with pancreatic cancer, who were diagnosed only on the basis of elevated serum CA19-9 levels, underwent curative surgery.
Conclusion: Measurement of serum CA19-9 levels as part of routine health check-ups enabled us to detect curable pancreatic cancers. Our findings suggest that benign and malignant diseases can be differentiated by observing the course of serum CA19-9 levels every three months.

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Objective: The optical fiber sleep apnea sensor (F-SAS sensor), a simple sensor that utilizes plastic optical fibers to assess breathing changes using optical signal changes, affords a much needed, easy-to-use non-invasive, completely unrestrained screening technique for sleep apnea syndrome (SAS).
Methods: To evaluate the ability of the F-SAS sensor in screening for SAS, it was used to detect changes in breathing pattern during sleep in 42 subjects during a two-day full health check-up (35 males, 7 females, 55.7 ±7.8 y/o, BMI 25.6 ±4.0, ESS 6.6 ±3.8). Its measurements were compared with those from a pulse oximeter (PLSX attached to a subject’s finger to measure SpO₂.
Results: SAS was suspected in 36 of the 42 subjects, based on a pro-AHI index (number of "apneas of 10 seconds or more and hypopneas with 70% or less of normal breathing") greater than 5/hr from F-SAS sensor measurements. Simultaneous measurement with the PLSX indicated a significant correlation (r = 0.79, p < 0.01) between the pro-AHI and the oxygen desaturation index (ODI3%). Among them, 24 had a pro-AHI≥10 and/or ODI3%≥10 and were recommended to consult a SAS specialist. Five subjects who received detailed examination by polysomnography (PSG) were started on continuous positive airway pressure (CPAP) treatment.
Conclusion: The F-SAS sensor was confirmed to be non-invasive and non-restrictive and did not disturb normal sleep during examination. In this study, the PSG detailed examination indicated that PLSX measurements were correlated with those made by the F-SAS, indicating its effectiveness in SAS screening during a full overnight health check-up.

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