Objective: We investigated the factors for improving serum LDL-cholesterol (s-LDL-C) levels from the perspective of physical characteristics and lifestyles of male medical examinees.

Subjects and Methods: Subjects were the 340 male medical examinees of our medical clinic during the same period in 2017 and 2018. We classified them into four groups (maintained, improved, worsened and non-improved) based on the change in s-LDL-C levels. χ² tests were conducted to compare factors among the four groups and pairwise comparisons with Bonferroni adjustment were conducted for each statistically significant factor. Logistic regression analysis was also performed to examine the association between s-LDL-C levels and each factor.

Results: There were significant differences among the four groups in BMI, body fat percentage, fatty liver, long-term weight gain, physical activities and snacking between meals. The non-improved group had higher proportions of BMI above 25 kg/m² (obesity), body fat percentage over 25%, fatty liver and long-term weight gain than the maintained group. The maintained and improved groups had a higher proportion of physical activities than the non-improved group. The worsened group was more likely to snack between meals than the maintained and non-improved groups. In logistic regression analysis stratified by s-LDL-C level in the previous year, snacking between meals showed a negative association with improved s-LDL-C levels in the <140 mg/dL group, and non-obesity and physical activities showed positive associations in the ≥140 mg/dL group.

Conclusion: Examinees who snacked between meals increased their levels to ≥140 mg/dL, while those who were not obese or who engaged in physical activity decreased their s-LDL-C levels to <140 mg/dL.

Objective: The objective of this study was to develop risk models for predicting the 6-year risk of lifestyle-related diseases (diabetes, obesity, hypertension, dyslipidemia, and hepatic dysfunction) based on annual health checkup data and medical prescriptions to identify high-risk individuals.

Methods: The participants were 191,458 individuals who received annual health checkups between 2010 and 2016. Data of 79,414 and 39,778 individuals were used for training and validation of the diabetes risk model, respectively. Risk models, based on random survival forests which were trained using health checkup data and medical prescriptions, were supplementally used to define incident cases. Learning parameters such as the number of trees, maximum depth allowed for a tree, number of variables, and minimum size of terminal nodes were optimized to improve performance.

Results: The area under the curve (AUC) for predicting the 3-year risk score was 0.963 (95%CI, 0.956–0.969) for diabetes, 0.935 (95%CI, 0.931–0.939) for obesity, 0.864 (95%CI, 0.858–0.871) for systolic hypertension, 0.940 (95%CI, 0.928–0.950) for dyslipidemia (high triglycerides), and 0.852 (95%CI, 0.838–0.864) for hepatic dysfunction (high aspartate aminotransferase).

Conclusion: Risk models of lifestyle-related diseases were developed to make predictions based on annual health checkup data. These models showed fair to excellent performance, suggesting they are useful for risk stratification.

Objective: We evaluated risk factors and their prophylactic significance of sinus rhythm in case with non-valvular atrial fibrillation (NVAF) detected in records of “Ningen Dock” medical examinations.

Method: Of the 90 cases in which NVAF was recorded on standard 12-lead ECG of 3,186 Ningen Dock examinees (2,212 males, 974 females between April 2020 and March 2021), sinus rhythm was demonstrated in the past time-series records of 30 confirmed cases (29 males, 1 female) <pre-AF sinus rhythm group>. The control group consisted of 172 consecutive sinus rhythm groups (SR) (169 males and 3 females) who underwent Ningen Dock medical examinations within the same period and were adjusted for age and sex.

Results: Significant items in the logistic analysis of 30 patients with pre-symptomatic sinus rhythm before the onset of NVAF were BMI (≧29), blood pressure, cardiothoracic ratio (CTR≧50), silhouette signs on chest X-ray, and left atrial load on electrocardiogram (negative P in precordial V₁). The newly devised NVAF prediction score was higher in the pre-AF sinus rhythm group than in the control (8.1 ± 1.7 vs 3.8 ± 1.7, p<0.0001). The cutoff value based on the NVAF prediction score was 6 (area under the curve AUC 0.961), with a high sensitivity and specificity (0.86, 0.967).

Conclusions: Obesity, cardiac enlargement, left atrial load, and silhouette signs are useful risk factors for the development of NVAF. There are expected to prevent and enlight the onset of NVAF.

  We present a case of Wellens’ syndrome that was detected at an early stage and treated successfully. A man in his late 60s, with a history of angina and chronic kidney disease, visited our center for an annual medical checkup. An electrocardiogram showed biphasic T-waves in the leads V3-5, which were not seen in his previous records. Although there was no chest pain at the time of his medical checkup, he had become aware of chest pain in the last month. According to these findings, Wellens’ syndrome was suspected, and it was recommended that he consult his doctor as soon as possible. He was admitted to the hospital and coronary angiography conducted revealed a 99% occlusion of the proximal left anterior descending (LAD) coronary artery. He underwent a percutaneous coronary intervention (PCI) and was successfully revascularized. He progressed favorably after the PCI, and the electrocardiogram normalized after 2 months.

  Wellens’ syndrome is a type of unstable angina, characterized by a deep inverted or biphasic T-wave in leads V2-3. These T-wave changes are observed during the chest pain free period. The changes are caused by critical stenosis of the proximal LAD coronary artery and are warning signs of an extensive anterior myocardial infarction. These warning signs should not be overlooked as a nonspecific T-wave change, even in the case of a medical checkup.

  This case report underlines the importance of checking medical examinees’ symptoms and comparing present electrocardiograms with previous ones.

  A highly elevated serum CA125 level (CA125) suggests the presence of ovarian carcinoma, primary peritoneal carcinoma (PPC), or advanced malignancy of the uterine body. On the other hand, rare cases of highly elevated CA125 have been reported in patients with benign uterine tumors, such as uterine fibroids and uterine adenomyosis (UA), as well as coexisting stage II PPC with a large uterine myoma.

  A 50-year-old woman underwent molecular tumor marker screening and abdominal ultrasonography in a part of Ningen Dock. The examination revealed a highly elevated CA125 and an enlarged uterus measuring 8 cm in diameter that underwent a detailed examination using MRI. MRI revealed a diagnosis of UA; however, a laparoscopic total hysterectomy was performed to evaluate the patient for PPC and to detect an increase in the size of the uterus to over 8 cm despite postmenopausal age. Peritoneal cancer was ruled out, and CA125 recovered within standard values postoperatively.

  In postmenopausal women with UA of 5 cm or more and highly elevated CA125, the option of less invasive total hysterectomy with specular observation of the adnexa, including the retroperitoneum, is acceptable with informed consent of the patient.