Objective: We compared the clinical backgrounds of individuals with a low BMI with those whose BMI was average.

Methods: From 5,013 examinees (3,372 men, 1,641 women), we extracted individuals with an average BMI (Group A), in the range 23.8-24.0 (n=130) for men and 22.0-22.9 (n=183) for women. We also extracted individuals with a BMI less than 18.5 and divided them into three groups - Group B: 18.4-18.0 (men n=22, women n=73), Group C: 17.9-17.0 (men n=40, women n=85), group D: 17.0> (men n=10, women n=45).

Results: Men accounted for 2.1% of examinees with a BMI less than 18.5 and women for 12.4%. TG was significantly higher in Group A than in group B, C and D in women. Creatinine was significantly higher in Group A than in group C in men. HDL-C and LDL-C were significantly lower and higher, respectively, in Group A than in Group B, C, and D in both men and women. Alb was significantly higher in Group C than in Group A in women. In men, in Group C and D, smoking rate tended to be higher, suggesting an influence on blood pressure. In women, in Group A, rates for taking drugs for hypertension and dyslipidemia and history of uterine myoma were significantly higher. Fatty liver was significantly less frequent in Group B, C and D both in men and women.

Conclusion: No association between leanness and health disorders was found in apparently healthy individuals, which suggests that leanness may mainly reflect decreases in skeletal muscle and subcutaneous fat in men and women, respectively.

Objective: The purpose of this study was to reveal the characteristics of participants who underwent examination of cognitive function and medical with exercise prescription and life style educations for prevention of dementia.

Methods: The subjects were 15 persons who underwent examinations for cognitive function as well as for mental and physical health at Kakeyu Hospital. The psychological examinations consisted of standard verbal paired-associate learning test, raven colored progressive matrices test, trail making test and physical examinations consisted of walking speed, grip strength and Timed Up and Go test. The results were obtained from medical records. The state of the brain was determined based on the diagnostic results from Magnetic Resonance Imaging (MRI) and the analytical results from Voxel-based Specific Regional Analysis system for Alzheimer’s disease. The data were organized systematically and compared with diagnostic standards or the results of previous studies.

Results: One examinee was determined to have silent cerebral infarction from MRI but no abnormal signs were found in the other examinees. The results of physical and psychological examinations were considered to be normal based on those in previous studies.

Conclusion: The physical and psychological characteristics of the participants who underwent cognitive function and physical examinations were considered to be normal based on diagnostic standards or the results of previous studies.

Objective: We introduced optical coherence tomography (OCT) as an option in a 2-day health check-up. Afterwards, we compared the results of OCT with those of other examinations.

Methods: Our subjects were 263 individuals (173 men, 90 women) who wished to have OCT from among 1,613 examinees (1,030 men, 583 women) who underwent a 2-day health check-up from October 2017 to March 2018. Those under treatment for glaucoma were excluded. The examinees underwent fundus photography, intraocular pressure measurement and frequency doubling technology (FDT) testing on the same day as OCT and the findings were assessed by 2 ophthalmologists. In the 263 subjects, we compared examinations for suspected glaucoma rates and compared fundus photography and OCT for rates of suspected conditions other than glaucoma. In addition, we divided them into 3 groups based on the exams conducted　for all subjects in the same period and compared suspected glaucoma rates with the results of secondary testing.

Results: The suspected glaucoma detection rates for the 263 subjects who underwent OCT were 7.2% for fundus photography, 2.3% for intraocular pressure measurement, 2.3% for FDT testing and 12.2% for OCT. The suspected glaucoma rates for the 3 groups were 10.3% for fundus photography with intraocular pressure, 9.2% for fundus photography with intraocular pressure and FDT and 15.2% for fundus photography with intraocular pressure, FDT and OCT. In ascending order, the positive predictive values were 32.5%, 43.5% and 50.0%, respectively. Conditions other than glaucoma detected by OCT were macular epithelia, choroidal tumor, choroidal atrophy and macular degeneration.

Conclusion: With OCT, the detection rate for suspected glaucoma was higher than for fundus photography, intraocular pressure and FDT. Also, when performed with other exams, OCT raised the accuracy of assessments. However, there are conditions that are difficult to detect with OCT alone so improved accuracy could be expected by combining it with other ophthalmology exams in such cases.

Objective: The cardio-ankle vascular index (CAVI) is an indicator of arterial stiffness, and its measurement in obese individuals often produces good results. We analyzed CAVI results to determine how to use CAVI effectively in these individuals.

Methods: We investigated CAVI measurements in health check-ups for 3 years. We analyzed the CAVI results for persons with and without obesity and investigated the effect of obesity on CAVI by multiple regression analysis. Vascular ages calculated from CAVI measurements for with and without obesity were also analyzed. In addition, we investigated whether there was an increase in cerebral small vessel diseases (SVDs) on brain MRI in obese individuals with a low vascular age.

Results: We investigated 839 health check-up examinees. Obese examinees had significantly more cardiovascular disease risk factors than non-obese examinees. In addition, the CAVI of obese individuals (7.7) was significantly lower than that of non-obese individuals (8.0). From multiple regression analysis, we estimated that obesity decreased CAVI by 0.36. At 47.6% (99/208), the proportion of obese examinees with a lower vascular age was significantly higher than that for non-obese examinees of 37.2% (235/631). There was no significant difference in the prevalence of SVDs between obese examinees with a low vascular age and non-obese participants with a normal vascular age.

Conclusions: Obesity significantly reduces CAVI. When assessing CAVI in obese individuals, it is necessary to develop plans that do not to disrupt their lifestyles. On the other hand, as there was no increase in SVDs in obese examinees with a low vascular age, this might reflect a healthy obesity status.

Background: Fatty liver is a common disease and NAFLD may develop into liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Therefore, we should be carefully examined for this condition. NAFLD is now thought to be closely associated with obesity and while there have been many studies on NAFLD after it has been diagnosed, few have looked at the condition of the body before NAFLD develops.

Methods: The participants of our study were people who visited our hospital for a Ningen Dock-style health check-up from 2008 to 2016 and underwent abdominal ultrasonography (US) as part of it. From the US images in the Ningen Dock data, those double negative for fatty liver for at least 2 consecutive years and then double positive for at least 2 consecutive years were determined. After excluding those with over 20 g of alcohol consumption, those post-pancreaticoduodenectomy and those with hepatitis type B virus or hepatitis type C virus infection, 215 people remained for our study. We studied their annual changes in bodyweight and BMI.

Result: The average BMI of the 215 subjects was 24.5 ± 2.6 kg/m². They had tended to gain weight compared with five years ago. In investigating changes in weight over the past seven years, the time of lowest weight was found to be five years before fatty liver was detected in US and their average bodyweight had increased by about 6.3% since then.

Conclusion: There is a possibility of people with a BMI of less than 25 kg/m2 developing NAFLD if their weight increases greatly and with a 4-7% bodyweight gain, a normal liver may change to the NAFLD state. However, our data is insufficient to make a definite conclusion so further studies are needed.

  Gossypibomas (gauzeomas) are foreign body granulomas resulting from gauze remaining in the body after surgical operations and are caused by inflammatory reactions. We report a symptomless case of gauzeoma arising from a cholecystectomy performed at another hospital. A 50-year-old male had undergone cholecystectomy for gallstones, which was complicated by peritonitis. Twenty years later, at our health check-up center, a smooth hypoechoic mass (40 × 38 mm) was detected in the inferior space of the liver near the abdominal aorta and stomach, by abdominal ultrasound. There was a partially hyperechoic region in the interior of the mass. The origin of mass was unknown. In our outpatient clinic, a folded fabric appearance was observed in both an abdominal CT scan and MRI. No active region was detected in the mass by PET/CT. Surgery was performed for the mass and subsequent pathological examination produced a diagnosis of gauzeoma.

  According to previous studies, gauzeomas cause various complications, which can be serious. While the incidence of gauzeoma has decreased through the use of opaque markers that are visible on radiographs, the possibility of symptomless gauzeoma requires attention, even in Ningen Dock.