Although cancer is the leading cause of death in Japan, if cardiovascular and cerebrovascular diseases, the 2 forms of atherosclerotic diseases, are added together, their proportion of all causes of death is comparable to that of cancer. Thus, a major objective of Ningen Dock check-ups and routine medical care is prevention of cancer and atherosclerosis but it remains unclear which examinations should be the basic ones performed. The revised health check-up evaluation guidelines published in 2008 set forth a tentative plan for the performance atherosclerosis-related check-ups and its major intent was to firmly establish atherosclerosis-related examinations as basic ones in Ningen Dock health check-ups. Emphasis was placed on the feasibility of adopting individual examinations nationwide in consideration of whether sufficient evidence was available as well as differences in accuracy of equipment and procedures among facilities, the time taken for exams and their cost.
Regarding examinations that should be available for atherosclerosis prevention, the possibility of using the self-paid medical treatment system should be considered and the fact that most optional health check-up examinations are currently performed with local government support or under corporate welfare plans should also be taken into account.
The present review outlines recent trends in examinations thought to be useful for atherosclerosis prevention as well as studies that have been performed at our facility on them, with the focus on those that investigate vascular function and morphological changes. It also looks at biomarker tests that evaluate atherosclerotic risk in these regards.

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Objective: Locomotive syndrome (abbreviated as Locomo) is a novel concept proposed by the Japanese Orthopaedic Association in 2007. Its purpose is to raise the awareness of the general public in order to prevent disorders of the locomotive organs, which appear to be increasing as a result of Japan’s low birth-rate/continually aging society. In the conventional test, subjects are required to self-evaluate locomotive organ disorders using “loco-check”, which consists of seven check items. However, given that the positive rate of loco-check is low in the population under 50, this design was considered insufficiently effective for encouraging prophylaxis from an early age. In order to solve this problem, the Locomotive Syndrome Risk Test was newly introduced in 2014. This test is composed of three parts: Stand-up Test, Two-step Test, and Locomo-25 Questionnaire.
We solicited participants for the Locomotive Syndrome Risk Test at the health check-up center of our hospital in order to collect data from relatively younger people and evaluate the feasibility of using the test for checking the status of locomotive organs at health check-up centers.
Methods and Results: A total of 246 people, ranging in age from 20 to 74 years, applied for the test. Although the results showed functional deterioration with age both in the Two-step Test and the Stand-up Test, the deterioration was more prominent in the Stand-up Test.
Conclusion: Based on the fact that no particular problems occurred during our study, these three tests were considered to be useful options for examining the status of locomotive organs at health check-up centers.

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Background: AICS (lung) was developed based on “AminoIndex Technology“, which involves multivariate analysis of the plasma free amino acid (PFAA) concentration between lung cancer patients and healthy subjects, and has recently been put into use as a screening test for lung cancer. In this study, the sensitivity of AICS (lung) for lung cancer was compared with that of chest X-ray examination.
Methods: Plasma free amino acid concentrations were measured by liquid chromatography-mass spectrometry in lung cancer patients (n = 234) and AICS (lung) values were calculated and determined as rank A, B or C. Also, the detectability of mass shadows in these patients by chest X-ray was evaluated. The sensitivity of AICS (lung) was compared with that of chest X-ray examination.
Results: The sensitivity of AICS (lung) was significantly higher than that of chest X-ray examination in lung cancer patients with tumors of 1.0 cm or less (p < 0.05) and in adenocarcinoma patients with tumors of 1.5cm or less (p < 0.05). Also, in lung cancer patients with tumors of 2.0 cm or less, or in patients at stage IA, the sensitivity of AICS (lung) was equivalent to that of chest X-ray examination and higher sensitivity was observed when both screening methods were combined.
Conclusion: These results suggested that AICS (lung) would be a useful screening test for lung cancer, especially for small tumors undetectable by chest X-ray examination.

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Objective: Gastric cancer is one of the most common cancers in Japan. Advances in esophagogastroduodenoscopy (EGD) have enabled minimal changes in gastric mucosa due to early stage cancer to be detected but opaque gastric mucus covering the surface of gastric lesions hampers precise observation of microlesions. Pronase is able to remove this opaque mucus, providing a clear view of microlesions, so it has been used for a long time as premedication in EGD. Because pronase is activated at neutral to alkaline pH, sodium bicarbonate is added to the pronase solution. However, as measuring the prescribed quantity of sodium bicarbonate each time on the day of EGD is time-consuming, alkali-ion water is used instead of a sodium bicarbonate solution.
Methods: The activity and stability of pronase dissolved in alkali-ion water were assessed in vitro. In vivo, 406 patients were examined using EGD and divided into 4 groups according to the preparation administered, namely pronase in alkali-ion water or sodium bicarbonate solution, alkali-ion water alone, or purified water alone. The degree of opacity of mucus was compared among the 4 groups.
Results: Pronase solution in alkali-ion water removed gastric mucus to a similar degree to pronase in sodium bicarbonate solution. No adverse effects related to the use of pronase in alkali-ion water were observed.
Conclusion: The use of alkali-ion water to dissolve pronase was considered a simple and effective means for achieving precision in EGD.

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Objective: The aim of this study was to cross-sectionally examine factors associated with decreased eGFR in the case of a trace protein readings in urinalysis by dipsticks.
Methods: Associations of trace proteinuria and metabolic syndrome-related factors, such as BMI, abdominal circumference and blood pressure, with decreased eGFR were examined by logistic regression analysis using specimens from 20,340 subjects (men: 11,948, women: 8,392, average age: 52 ± 11) who underwent a health check-up at The Niigata Health Care Association in the period from 2008 to 2013.
Results: Logistic regression analysis including all factors demonstrated that BMI and proteinuria were significantly related to decreased eGFR. In a further study concerning the additional effect of trace proteinuria and BMI ≥ 25 on decreased eGFR, the sex- and age-adjusted odds ratio was 2.04 (95% confidence interval (CI); 1.44, 2.90) in the trace proteinuria positive and BMI ≥ 25 group in comparison with the proteinuria negative and BMI < 25 group.
Conclusion: The co-existence of BMI ≥ 25 with trace proteinuria was shown to increase the prevalence of decreased eGFR.

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Objective: With the aim of achieving a customer satisfaction rate of at least 80%, we have been performing questionnaire surveys of all examinees since our facility opened. However, still at around 70%, the satisfaction target had not been achieved for waiting time. As a strategy to improve waiting time, we introduced a system that enables the number of people waiting, the waiting time for each exam and the location of examinees to be monitored for each exam in real time, and evaluated its usefulness.
Methods: A customized system matched to the health check-up procedures at our facility was created by NEC Networks & System Integration Corporation. IC cards containing examinee data are attached to files and by placing the files on an IC tag reading device (IC reader) installed at each exam, the position of examinees can be monitored and position data management carried out. Questionnaire results for before and after introduction of the system were compared.
Results: By monitoring examinee reception progress status, the waiting time and congestion status for each exam as well as the examination status of each examinee on screens in real time, we could improve waiting time and raise the degree of satisfaction.
Conclusion: We considered the system to be useful as it was smoothly introduced with no change to our current operations and produced good results. Using data from the system, we will continue making efforts to improve examinee satisfaction regarding waiting time by analyzing changes in examinee waiting times and further improving procedures.

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