Objective: Excessive accumulation of visceral fat is considered to be associated with lifestyle-related diseases including diabetes mellitus, hyperlipidemia, and hypertension. If the quantity of visceral fat can be measured easily in human dry dock examinations, it is expected to contribute to early prevention of these disorders. We have, therefore, developed a new method for the measurement of visceral fat using the bioelectrical impedance (abdominal bioelectrical impedance); this method will be an alternative to conventional abdominal CT. The aim of this study was to confirm on the basis of clinical data the principles and the accuracy of this method in estimating the quantity of visceral fat. Methods: We examined using multivariate analysis the correlations of the abdominal impedance measured by this method with the visceral fat area (VFA), subcutaneous fat area (SFA), and total fat area determined by abdominal CT and the correlations of the residual error (difference between the VFA determined by abdominal CT and the VFA estimated by this method) with the VFA, SFA, VFA/SFA ratio, height, body weight, body mass index, waist girth, and age. Results: The correlation between the abdominal impedance determined by this method with the SFA was small, indicating that this method effectively excludes the effects of subcutaneous fat on the estimation of the VFA. A correlation between the residual error and age was observed. This suggests that the accuracy of estimation of the VFA can be improved by incorporating the age in the estimation equation and, thus, canceling the correlation. Conclusions: This body-fat measuring apparatus is expected to provide support to human dry dock examinations as a new obesity testing instrument.

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Objective and Methods To access the effectiveness of health education for clients of the human dry dock, changes of risk factor for lifestyle disease such as body mass index (BMI), blood pressure (BP), serum total cholesterol (TC), and blood sugar (BS) were analyzed among a total of 354 human dry dock participants (299 men and 55 women) who visit our health care center 3 years successively. Results Average of BMI, systolic BP, TC and fasting blood sugar (FBS) were not improved in three years. Clients of normal category after continual improvement (improvement group) were lower than clients of abnormal category after continual deterioration (deteriorated group) in BP, TC, and BS. Deteriorated group in BP, BS and improvement group in BS were overweighted (BMI 25). Clients of decreased BMI were higher in improvement group than deteriorated group in all risk factors for lifestyle disease. Changes of BS were affected by lifestyle and family history, BP by exercise, and TC by menopause. Conclusions The result of this study suggested importance of weight control. In addition, we considered family history of diabetes mellitus and menopause when we provided health education for client with abnormal glucose tolerance and hyperlipidemia.

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Objectives: Detection of eye lesions was attempted in 2002 the Nara City Screening for Adult Diseases, but the percentage of those who received secondary examinations according to the results of primary screening was low. Therefore, we carried out a questionnaire survey in those who were screened in 2003. Methods: In 2002, ophthalmoscopic images were photographed without mydriasis in those who underwent primary screening, and those who were judged by ophthalmologists to need secondary examinations were invited to receive them at our Ophthalmology Department. In 2003, a questionnaire survey was performed in those who underwent primary screening. Results: In 2002, photographs of the eyegrounds were generally dark and primary evaluation was difficult in 15% of those screened. The detection rate of macular lesions was 0.41%, and that of peripheral eyeground lesions was 0.50%, which were both lower than the reported values on ophthalmoscopy with mydriasis. Of those who were judged to need secondary examinations, only 21.7% received secondary examinations. In 2003,81.4% of those who received primary screening had also been screened in 2002, and the response rate to the questionnaire was 94%. Of these respondents,40.3% answered that they were regularly examined by an ophthalmologist. Also,25.8% of the respondents answered that they decided to take the primary screening because of the invitation from our hospital by mail or telephone. Conclusions: A system in which all those who undergo primarily screening receive ophthalmoscopic examination by an ophthalmologist should be established. Those who are considered to need secondary examinations are not followed-up in the present system, and the introduction of electronic charts is expected to make complete follow-up possible. This will also improve the efficiency of our appeals to the public to receive screening

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Objective The incidence of obstructive sleep apnea syndrome (OSAS) was studied in examinee of human dry dock by a simple test, and the effectiveness of an interview for the diagnosis of OSAS was evaluated. Methods A simple test of OSAS using an Auto Set Portable II (Teijin) was performed in 207 male examinee of two days human dry dock aged 30-76 years (mean 53.1 years). Results The apnea hyponea index (AHI) was 5 or higher in 76.7% of the examinee and 10 or higher in 50.0% of the examinee. The abnormalities were mild or severer in 50.0%, moderate or severer in 16.0%, and severe in 6.8% of the examinee. Concerning the relationship between interview findings and the results of sleep apnea testing, the frequency of examinee with an AHI of 10 or higher was significantly high among those who answered “Yes”to 4 question items including “snore every night” and “stop breathing during sleep”. Concerning the relationship between the AHI and the epworth sleepness scale (ESS) score, the frequency of examinee with an abnormal ESS score (≥11) was or only 3.5%. Conclusions The percentage of the examinee of human dry dock who had severe OSAS (AHI≥30) was unexpectedly high at 6.8%. This high percentage indicates the necessity for reevaluation of the cut-off value between normal and abnormal AHIs. Thirty-five (34%) of those with an AHT of 10 or higher (abnormal) and 9 (9%) of those with an AHI of 9 or lower (normal) answered that they had been told that they stopped breathing during sleep. Since the ESS score suggested that many patients with OSAS did not feel sleepy during the daytime, further evaluation is needed concerning the testing procedure and the determination of the normal range. Since interviewing and examination of the ESS score were insufficient for the prediction of sleep disordered breathing (SDB), a simple test is essential.

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The number of subjects who underwent pulse wave velocity (PWV) measurement, echography and funduscopy in our center's human dry dock in 2003 was 194. The incidence of atherosclerosis using PWV measurement was 113 cases (P (+) group). Compared with normal group (P (-) group) which consisted of 81 subjects, the age and the frequency of hypertension and hyperlipidemia were significantly higher. And the frequency of the subjects which had more than two risk factors of atherosclerosis was significantly higher, compared with P (-) group. The incidence of atherosclerosis using echography was 33 cases (E (+) group). The incidence of atherosclerosis using funduscopy was 26 cases (R (+)group). The difference of the age and the frequency of risk factors of atherosclerosis was not significant among P (-) group, E (+) group and R (+) group.85.7% of E (+) group and/or R (+) group was P (+) group. Therefore, PWV measurement was thought to be useful in screening of atherosclerosis. We need to utilize the result of PWV measurement in order to prevent atherosclerotic diseases.

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Objective and Methods: The prevalence, clinical background and the reproducibility of Brugada-type electrocardiogram (ECG) in cases that received regular check-ups in our institute in 2001 were studied. Results: Among electrocardiograms of 13,525 cases (7,844men,5,681 women; age 15-84 years),95 cases (0.70%; 86 men,9 women) showed the pattern of Brugada-type ECG. Coved type and saddle-back type were found in 10 and 83cases respectively. Coexistence of both types was found in 2 cases. The prevalence of Brugada-type ECG was higher in the older groups (60s: 1.06%, P<0.05; 70s: 1.72%, P<0.01; 80s: 11.1%, P<0.001) than in the younger group (30s: 0.46%). Seven cases experienced syncope. The cause of syncope in three cases seemed to be due to arrhythmias. One case with syncope had a family history of sudden death. No sudden death was found in two years. Among 67 cases in whom ECGs were recorded for 2 to 3 years consecutively,41 cases (61.1%) maintained the pattern of Brugada-type ECG. Conclusions: The prevalence of Brugada-type ECG varies greatly between reports. This may be due to differences in objects studied, the proportions of genders and the criteria of Brugada-type ECG. The prevalence of Brugada-type ECG was higher in the older groups than in the younger group, although the cause as well as its universality remains unknown. Repeated ECG recording is necessary to detect the Brugada-type ECG, because the reproducibility of Brugada type ECG is not high.

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We investigated influence of smoking on serum pepsinogen reaction (PG) at health check-up in a workplace. Because it had been found a higher level of negative PG in smokers in our previous publication which was studies of the relation between PG, the serum Helicobacter pylori antibodies and each factors like digestive anamnesis, digestive symptoms, familial disease, smoking, drinking. It was necessary to study more thoroughly. Our study suggests that smoking makes PG false negative. It seems that negative PG rate is more than true. When we evaluate PG, we must identify the true negative PG, and consider the false negative PG which might conceal a serious illness.

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To assess the clinical characteristics and course of gallstone cases diagnosed in human dry dock, we analyzed and followed up our gallstone cases retrospectively. The incidence of gallstone was 3.2% between January 1992 and December 2002 in our hospital. We examined body mass index, fasting blood sugar, total serum cholesterol, triglyceride and HDL cholesterol level of the gallstone cases in comparison with the non-gallstone cases. Serum fasting blood sugar in male subjects and triglyceride in female subjects of gallstone were significantly high compared with the non-gallstone cases. The follow-up study of sixty-five gallstone cases was revealed the ultrasonic finding parameters; stone size, number, wall thickness and acoustic shadow, were almost not changed from one to ten years (mean period; 3.8 years). Nineteen cases (8.3%) were experienced cholecystectomy in the follow-up period.

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The purpose of this study is to find out the relation of maximum oxygen uptake (direct)and Kato's indirected method. This system is designed by the next order of priority.1. Be in the medical check,2. A great number can be measured,3. Put to practical use,4. At one's own pace walking,5. Safty measurement,6. Reliable index,7. Interesting for a subject.
Kato's method is as follows: {(220-age)/HR of during walking × (40m × 60min)/ track time (min) × 12min-1000}× 0.029+ 14ml=VO₂max(ml/kg·min)Only the total mean significant positive correlation was seen at the maximum oxygen and Kato's indirected method.

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Objective: To promote a quality of life, we prescribed sildenafil and nicotine patch to those human dry dock patients who needed them, for which health insurance are not available. Methods: We prescribed nicotine patch for the current smokers, and sildenafil for ED patients. Results: Smoking indices of those who received prescription of nicotine patch were 950±400, and smoking habit had continued to be ceased in 50% of the patients three months after the prescription. The average age of the patients who had been given a prescription of sildenafil was 58±6 years old, younger than that in out patient clinic. The average of International Index of Erectile Function was 14±5, higher than that in out patient clinic. Conclusions: Through the prescription of sildenafil and nicotine patch for which health insurance are not available, human dry dock could contribute to their convenience, resulted in promotion of quality of life.

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Objective and Methods Stomach X-rays examinations were carried out to 14hearing-impaired persons using the information presentation system which Showa University and Hitachi Ltd. have developed jointly. Eight hearing-normal persons were compared as control about examination time, fluoroscopy time, and the number of times of entrance into a room. Results Although a hearing-impaired person's examination time and the number of times of entrance into a room became long as compared with a hearing-normal person, a difference was not seen at fluoroscopy time. Conclusions By giving the contents of examination to a hearing-impaired person, and explanation of a procedure in advance, shortening of examination time and reduction of the number of times of entrance into a room are possible, and it was thought by using this system that a hearing-impaired person's mass screening was possible.

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Objective and Methods: We investigated 10 couples of examinees by questionnaires to assess the effects after the guidance of diet and the changes of eating habit and sense of life style at six months later. Results: Six of 10 couples (60%) answered these questionnaires. Five examinees diminished the intakes of alcohol and amount of tastes to reduce the total consumption energy and body weight. One gained the total nutritions and weight. Four of 6couple appreciated the usefulness of diet guidance, and they were assessed to be at the stage of putting ideas into actions after setting definite aim by our adequate directions at the stage of preparations of doing. One at the poor action stage had over diet and his wife cooked too much dishes. Conclusions: Therefore, we conclude that it is useful to improve examinees couple's diet styles by our directing the changes of eating habits to urge their awareness and share of the problems about their diet style.

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Objective and Methods We assessed individual health guidance in the human dry dock at our center by dividing the examinee of two days human dry dock into those who had achieved 70 or more goals set up at the previous examinations and those who had achieved less goals concerning improvements in laboratory data and lifestyle, and comparing changes after 1 year. Reasons for failing to improve the lifestyle were also investigated. Results Concerning the reasons for failing to improve the lifestyle, significant differences were observed in the frequency of those who mentioned “I had no time” and “I did not feel like doing it” between those who showed high accomplishment rates and those who showed low accomplishment rates but not according to the degree of improvement in laboratory data or lifestyle. When the states 1-6 months after human dry dock were compared, the percentage of those who showed high accomplishment rates was significantly higher, and the percentage of those who showed improvements in laboratory data was also high. Conclusions Therefore, support and assessment at shorter intervals are needed to maintain a state of high empowerment in the examinee. A system to support and assess human dry dock examinee whom we have no opportunity for guidance until the next human dry dock must be evaluated.

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