We examined visualization ability of fine network pattern considered to be the index of evaluation of imaging ability, paying attention to osmotic pressure and imaging ability.
The change of osmotic pressure was observed by adding additives to the barium sulfate suspension for lower GI tract examination.
The difference was observed in the visualization ability of the fine network pattern of the barium sulfate suspensions by changing the combination of additives.

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The aim of this study is to investigate the relationship between the issues of questionnaire items and the results of serum pepsinogen test or Helicobacter pylori antibody test conducted at periodic health check-up in the workplace. We compared questionnaire items to the results of these tests to see whether risk factors identified by questionnaire items influence the results of the tests. As a result, risk factors that can affect pepsinogen value were attributed predominantly to tobacco smoking, whi le those factors that can affect Helicobacter pylori antibody were associated with previous digestive diseases, digestive symptoms, previous H. pylori-positive and a family history which are known as the most likely causes. Accordingly, the results of this study suggest anyone undergoing such tests should have been informed of these causative factors when serum pepsinogen test and Hel icobacter pylori ant ibody test combined with health check-up are conducted.

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Duodenal lesions, except ulcers, were examined in 2352 clients of medical check-ups in Mitsubishi Kyoto Hospital from January to December 2001. Although most duodenal lesions needed no treatment, one case of adenocarcinoma in the ampulla of Vater and one case of duodenal amyloidosis were detected with endoscopy. Both patients were asymptomatic. As the cl ients, who take endoscopic examinations, increase, more duodenal lesions are likely to be discovered as well as esophageal and gastric lesions. We laid emphasis on importance of endoscopic observation for the descending portion of duodenum by these case reports.

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In 350 outpatients, we conducted a questionnaire survey regarding drinking of oral intestinal lavage agents in our hospital, as performed as pretreatment for colonoscopy, and investigated drinking of oral intestinal lavage agents at home. Two hundred and seventy-four patients (78%) responded. Sixty-seven percent of the patients wanted to drink in our hospital, while 22% of the patients wanted to drink at home. Among both males and females, relatively young patients wanted to drink at home. In addition, the most common reason for wanting to drink in our hospital was that being in our hospital leads to relief due to anxiety about intestinal lavage agent-related changes in the condition. Furthermore, in patients who wanted to drink at home, the most common reason was that hours can be effectively utilized. In the future, a system that facilitates selection of the appropriate pretreatment method after sufficient explanation should be considered, introducing home drinking and utilizing the merits of hospital/home drinking. In addition, it may be important to consolidate the hospital environment so that the patient can undergo colonoscopy at ease in a comfortable environment.

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The incidence of chronic obstructive pulmonary disease (COPD) has been rapidly increasing throughout the world. In Japan, COPD is ranking the tenth cause of death. We examined the incidence of COPD in 4,132 middle-aged males who underwent heath examination between April 2000 and March 2001 in our hospital. The percentade of the subjects showing a one-second rate of forced expiratory volume below 70% while smoking was 14%, in whom the percentage of the subjects with severe COPD was 6 %. Since COPD has not been regarded as a target disease in health examination, COPD may have been aggravated in many patients without being recognized.

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The accuracy of smoking habit answers through a questionnaire was examined. Smoking habit was examined using a questionnaire in 100 subjects who underwent health examination, and the concentration of urinary cotinine was measured. The concenration of expiratory carbon monoxide was measured in 9 subjects who had quit smoking after a program. Five of the 80 subjects who said they were non-smokers (20%) were judged to be smokers based on the concentration of urinary cotinine. Two of the 9 subjects were judged to be smokers based on the concentration of expiratory carbon monoxide. In both examinat ions, some male subjects considered “less smoking” as “no smoking”, and some female subjects concealed their smoking habit. Since one in 5 smokers would not report smoking habit, it is necessary to examine biological parameters, and to prepare a comprehensive questionnaire.

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In order to estimate the incidence of diabetes mellitus among hyperglycemic subjects participating in an intensive health check-up, the results of oral glucose tolerance test (OGTT) and annual measurement of fasting plasma glucose level (FBS: fasting blood sugar)were reviewed. Eighty-one patients with hyperglycemia (FBS of 120 to 139mg/dl) received 75gOGTT at Tokushima Health Screening Center between April 1996 and March 2002. The percentages of diabetic, borderline and normal subjects were 34.6,58.0 and 7.4respectively. A total of 147 subjects had FBS of 120-139mg/dl without ahistoryof diabetes between April 1996 and March 1997. Their annual FBS levels were traced until March 2002and the number of subjects developing diabetes mellitus was recorded. FBS of 1404/dl or more at least once or consecutive yearly FBS of 126mg/dl or more were criteria for diagnosis. Fifty-two (34.9%) were diagnosed with diabetes by annual FBS measurement over 5years. The mean observation period was 3.2 years and mean interval between the first measurement and the diagnosis was 1.5years. Since the risk of diabetes mellitus was high in hyperglycemic attendants, they should be made fully aware of the risk. The results of our study may be useful in explaining the risk of diabetes to patients with hyperglycemia.

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We investigated the relationship between insulin resistance and remnant-like particle lipoprotein (RLP) cholesterol levels in middle-aged males with normal blood pressure and total cholesterol (TC) and triglyceride (TG) levels. Insulin resistance was evaluated with homeostasis model assessment-insulin resistance (HOMA-IR). The subjects were divided into two groups; normal glucose tolerance (NGT) and impaired glucose tolerance (IGT) according to their fasting blood glucose levels. It was found that in the NGT group there was a correlation between HOMA-IRan d triglyceride>high density lipoprotein(HDL)cholesterol>RLP cholesterol. In the IGT group there was a correlation between HOMA-IR and total cholesterol>RLP cholesterol. When fasting blood glucose was normal or slightly increased there was a correlation between HOMA-IRan d RLP cholesterol, and it was noted that RLP cholesterol is a good marker for insulin resistance.

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The cost-effectiveness of the thyroid medical checkup We investigated the cost-effectiveness of the thyroid cancer medical checkup by the thyroid ultrasound test and the diagnosis of hyperthyroidism and (sub-clinical)hypothyroidism with TSH measurement. The expense of one example of thyroid functional disorder was 125,000 yen and the expense of one example of thyroid cancer was 3,420,000yen, and it was thought that the TSH measurement was more effective than an examination for cancer by ultrasound checkup.

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Eighty cases of breast cancer were found during a course of breast cancer screening with combined usage of ultrasonography (US) and mammography (MMG), but 11 cases were undetectable by screening US only. For 10 of the 11 undetectable cases, a secondary extended examination were carried out by US and found 6 cases were positive for US detection, but remaining 4 cases were still negative for US examination. By histological examination, non-invasive or minimally invasive cancers were often undetectable by screening US examination. In summary, the combined usage of US and MMGm ay enhance the sensitivity of breast cancer screening for about 10% rather than carried out by US only.

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While instituting primary and secondary prevention of diseases, which is the principal purpose of the human dry dock examination, we have performed a multivariate analysis (canonical discriminant analysis) of numerous quantitative data obtained from subjects at the time of their human dry dock examination. On the basis of this analysis, we have developed a new system which endows us with the ability to appraise a subject' s state of health at present and to predict that in the near future.
Subjects of this study included two groups. One consisted of ‘healthy subjects'’ who were examined in the Center for Preventative Medical of the St. Luke's International Hospital and found to be normal in all of the items examined. The other consisted of ‘patients’ who visited this center, and were admitted to this hospital within two years of the first visit and given a definitive diagnosis. The diseases considered in this study were life-style related, with the exception of carcinoma-in particular the following diseases: ‘cerebrovascular diseases’, ‘myocardial infarct ion’ and ‘diabetes mellitus’. These three diseases were selected from various chronic diseases whose occurrence was considered to be amenable to primary prevention. Items analyzed by the canonical discriminant analysis were age, plus 34 other variables which were measured physiologically or by examination of specimens, and could be expressed as quantitative data
When the first canonical variate and the second canonical variate were plotted on a plane with two-dimensional coordinates, points representing the healthy subjects had a propensity to lie in the third quadrant. On the other hand, points for the patients tended to fall in the first and fourth quadrants. In particular, points for patients with diabetes mellitus tended to fall mainly in the fourth quadrant. In addition, we found that by plotting data obtained from repeated human dry dock examinees in the plane on which data from the healthy subjects and the patients were plotted, it was possible to appraise their state of health at present and to predict that in the near future.

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The aim of this investigation is to develop the way of guiding the examinees of human dry dock or mass screening for the primary prevention of disease.
We analyzed and revalued the personal data checked in the table Al of Health Assessment model by our original way programmed in personal computer.
There are graphs of past three year data of examination and the personal habitual ways which should be reformed by medical examinee in this original chart. The examinees have to decid the practical goal for health and it is registered in the computer. It is able to see the personal goal registered this year in the next year's chart.
Owing to this new method, we can guide the examinees more effectively in limited time, and it is able to see the relationship of this time's data and the previous data. Furthermore, it is possible for us to evaluate the effectiveness of our method of medical guidance.

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To support behavior modification and its continuation in people undergoing a physical examination, we wrote the content of guidance and patient's decision as “life guidance sentences” in the report. We conducted a questionnaire survey in people undergoing a physical examination and our staff. The results showed that this trial motivated behavior modification. To further improve the guidance, after-the-fact guidance and follow-up plans that give a sense of self-efficacy should be developed for people undergoing a physical examination to recognize the necessity of behavior modification and perform/continue it. It is suggested that a system that utilizes them effectively should be developed and employed.

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CYP1A1 (Ile462val), ALDH2 (glu487lys), β3ADR (trp64arg) gene polymorphism-single nucleotide polymorphism (SNP) related with life style factor-smoking, drinking, obesity are detected in 128 Japanese subjects who are willing to have the health check. Each frequencies of atypical zygote are 35%,59%,35% respectively and normal homozygote on the three genes is only 20%, but atypical zygote more than two is 45%. That indicates existence of personal predisposition of sensibility for the lifestyle factor. Furthermore we need personalized medical intervention for health management.

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We investigated 11, 734 Japanese examinees (7774 male, 3960 female) at Toma HospitalHealth-checkups Center in 1999 to elucidate association between shoulder stiffness andlumbago, mental stress and physical exercise.
28. 5% male examinees complained the shoulder stiffness, and 50. 0% female examineescomplained.
Proportion of complaining shoulder stiffness was much higher in the person with mentalstress, lack of exercise and lumbago.

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To develop a brief inventory to measure male sexual function in a health screening, we compared 11 items based on the Sapporo Medical University sexual function questionnaire in the three viewpoints,(1) the results of the factor analysis,(2) the grade people expect the treatment for erectile dysfunction, and (3) the international index of erectile function (IIEF), and developed a brief questionnaire to measure male sexual function in a health screening. Factor analysis revealed that 11 questions could be clearly separated into 5 components. The five components cover sexual intercourse, sexual drive, overall sex life, treatment for erectile dysfunction, and morning erection. The brief male sexual function inventory consists of 5 questions as follows: (1) Overall, how satisfied are you with your current sex life ? (2) Do you ever notice having an erection when you wake up in the morning ? (3) How would you rate your level of sexual desire ? (4) Does your penis get hard when you are going to have sex or when you masturbate ? (5) Does your penis stay hard for a sufficiently long period of time ? In conclusion, after an initial set of questions was refined and reduced through this study, we developed a brief inventory to measure male sexual function in a health screening. Further research will be needed to evaluate the validity of this scale.

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Changes of risk factors for lifestyle related diseases in 101 human dry dock obese patients, who were not entered an weight control program, were studied in two years. Body weight, HbA1c, uric acid and HDL cholesterol levels were improved significantly in two years, while systolic and diastolic blood pressures, fasting blood glucose and total cholesterol levels were not changed. Those human dry dock patients visiting every year controlled their body weight for themselves, if only convinced their over weight.

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In 43males who underwent visceral fat computed tomography(CT)during a medical checkup, we compared the relationship to their lifestyles besed on blood biochemistry data and questionnaire sheets. In patients with visceral fat-type obesity, the HDL level was low, while the neutral fat level was high. According to the questionnaire sheets, exercise was insufficient, and the percentage who ate out was high in patients with visceral fat-type obesity. These findibgs suggest that evaluation of the visceral fat area in addition to standard indices such as BMI and body fat is useful for evaluating obesity and guiding the subsequent lifestyle.

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