Methods for the determination of serum total cholesterol have been changing over a long period of time. The purpose of this paper is to verify whether the accuracy of determination changed during the period or not. I investigated the reports of external quality assessment about the change of method and the scientific reports about the accuracy of determination. The accuracy of determination during 1971-1991 was not clear because no report about the accuracy compared with the reference measurement procedure was found. However I found that the accuracy of determination after 1992 have not changed because there are the reference values obtained by use of the reference materials. As a result, I concluded that the change of accuracy was small over the past thirty years.

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Aim: To examine the influence cf smoking cessation on body weight gain and deterioration in blood glucose and lipids levels. Methods: From November 1991 to May 1992,839 male Smokers, who participated in a general Medical checkup of Kyoto First Red Cross Hospital were encouraged to quit smoking. Among them,27 had quitted smoking until next medical checkup one to two years after (Quitters), and they were compared with the selected 81males still smoking (Smokers). They were individually matched (1:3) for their age (within 3 years) and the time of participation (within 4 months). Results: Quitters showed a significant increase in body weight (mean =1.6kg, max=5.6kg) and body mass index (BMI)( mean=0.6) between the initial and repeated checkups. Thinner people (BMI)<22 tended to gain their body weight. Smokers did not change in their body weight (mean=0.3kg, max=6.8kg) and BMI (mean=0.1) during the corresponding period. Blood glucose level increased among Quitters (mean=3.7 mg/dl) and decreased among Smokers (mean=-1.2mg/dl), and the difference was significant between the groups. Among Smokers, an increase in BMI significantly correlated to an increase in blood glucose, total cholesterol, and LDL-cholesterol, and to a decrease in HDL-cholesterol. However, the change in BMI did not correlate to all the markers among Quitters. Conclusion: The weight gain among Quitters did not suggest deterioration in glucose and lipid metabolism, but rather suggested the improvement of thinness by smoking.

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The relationship between life stylerelated health parameters and frequent findings of abdominal ultrasonography other than fatty liver was investigated for 15,545 health checkup examinees. In female subjects, liver cyst was found to be associated with hyperlipidemia, gallstones with hyperlipidemia, obesity and hypertension, renal cyst with heavy smoking, obesity, heavy drinking and hyperlipidemia, and renal stones or liver hemangioma with hypertension. In male subjects, gallstones were associated with hypertension and hyperlipidemia, and gallbladder polyps or liver hemangioma with non-smoking.

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To investigate the relationship between visceral fat accumulation and metabolic and circulatory disorders in 299 middle-aged non-obese Japanese males, we measured visceral fat area (VFA)b y computed tomography (CT), and other metabolic and circulatory parameters. Thirty-one percent of non-obese males with body mass index(BMI) <25 (kg/m²) had a high VFA (>=100cm²). High VFA was also noted in 53.6% in non-obese males with a waist circumference over 85cm. Total cholesterol, triglyceride, glucose, uric acid, and systolic and diastolic blood pressure increased as VFA increased. In many cases of high VFA, total cholesterol, triglyceride and glucose were beyond normal limits. The average number of such disorders in the high VFA group was significantly(p=0.0001)higher than that in the normal VFA group (<100cm²). These findings suggest that, even in non-obese, visceral fat accumulation may play an important role in the occurrence of metabolic and circulatory disorders.

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The number of subjects who underwent funduscopy in our center's human dry dock from April 2000 to March 2001 was 3,087. The incidence of retinal arteriosclerosis was 290 cases (9.4%) (arteiosclerosis group). Compared with normal group which consisted of 300 agematched subjects from the same department, the frequency of hypertension, impaired glucose tolerance were significantly higher. The frequency of obesity and hyperlipidemia were not significantly higher. And the frequency of the subjects which had more than one risk factor of systemic arteriosclerosis were significantly higher, compared with normal group. Therefore, we need to utilize the results of funduscopy in order to prevent arteriosclerotic diseases.

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The number of subjects who underwent our center's health examination of employees from April 1999 to March 2000 was 20,105 (11,041 men and 9,064 women). The incidence of Brugada type electrocardiogram (Brugada ECG) was 20 cases (0.10%) who were 19 men and I woman. They had no symptom.2 cases had hypertension,8 cases had hyperlipidemia,5 cases had obesity, I case had impaired glucose tolerance and 13 cases had the habit of smoking. Other year ECG could be researched in 18 cases of these Brugada ECG. Asymptomatic Brugada ECG in health examination of employees have ECG change, therefore, we need to follow up Brugada ECG carefully.

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In order to raise the rate of further examination consultation of mass screening for colorectal cancer, consultation organization was improved to be able to explain the result of fecal occult blood test and to perform reservation of endoscopy at consultation day. As a result, it became 71% of rates of further examination consultation, and 0.30% of rates of cancer discovery, and good results were acquired from before. The cancer hitting ratio of group with hemorrhoids condition was 8%, that without hemorrhoids condition was 5%. The cancer hitting ratio was 20% in group that fecal occult blood test was two-year continual positive, and 50% in group that test was three-year continual positive.

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A newly discovered TT virus (TTV) has been implicated as a cause of nonAG posttransfusion hepatitis. We investigated the frequency of TTV viremia and the etiological role of TTV in subjects with human dry dock. Subjects were selected from persons with human dry dock(n=210, mean age 48.8 years, males n=152). We detected TTV by seminested PCR using primers from conserved regions in the N22 clone. TTV viremia was detected in 105 (50.0%) of 210 subjects with human dry dock, HCV viremia was in 4 (1.9%)of 210, HBV viremia was in 2 (1.0%) of 210 and HGV viremia was in 0 (0.0%) of 210. TTV viremia was frequent but transmission of TTV through transfusion of blood was rare. Both liver function test and abdominal ultrasonography were normal among TTV positive subjects. We conclude that TTV infection was present and common in subjects with human dry dock. Although the clinical significance of TTV remains unclear, TTVDNA may be helpful in the elucidation of the clinical significance of TTV. As the number of our study was small, further studies are required to determine the role of TTV in the pathogenicity of liver diseases.

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Enzymelinked immunosorbent assay kit (URINELISA, Otsuka, JAPAN), which was recently developed for detection of the antibody to Helicobacter pylori (Hp) in urine, was evaluated for its clinical usefulness in 242 asymptomatic Japanese persons. Serum immunoglobulin G antibody to Hp was concomitantly measured by a commercialized kit (Determiner H. pylori, Kyowa, JAPAN). Results of radiography of the upper gastrointestinal tract and the value of serum pepsinogen I and II were also recorded. The cases with both pepsinogen I≤70, μg/1 and I /II ratio ≤3 were regarded as positive. Additionally, gastrointestinal endoscopy was performed for volunteers to confirm the presence or absence of Hp, using rapid urease test and microscopic examination. The calculated sensitivity, specificity, and consistency of URINELISA against Determiner were 91.9,85.3, and 88.6%, respectively, which seemed satisfactory for clinical use. Those against endoscopic diagnosis were 97.5,30.0, and 84.0 %, respectively. Most of the subjects with negative result in URINELISAw ere also negative in pepsinogen test. In the population with positive in URINELISA, peptic diseases including gastroduodenal ulcers, hyperplastic polyps, gastritis, and duodenitis were found with higher frequency than those in the population with negative result.
In summary, URINELISAse ems suitable not only for the detection of Hp in clinical setting but also as one of screening methods for the upper gastrointestinal disorders.

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Clinical data of our human dock participants all through 2000 were analyzed for their deviations by sexes, ages and seasons. Data of total bilirubin for healthy young adults were found to be higher than expected despite of any liver disfunctions. It was suggested that the high total bilirubin was caused by the high hemoglobin to support the oxygen supply for high physical activities. Most other clinical data were found to move towards regressive changes depending on aging. Seasonal changes were also found for clinical data. Standards of clinical data were estimated by the deviations of the data for healthy and diseased persons. But the standards used now were somewhat unreasonable for healthy men. We proposed our model standards for healthy men from the data of our human dock participants who were judged not to need any medical examinations.

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