Objective: The incidence of reflux esophagitis is increasing due to increased gastric acid output, a decreased Helicobacter pylori infection rate, increased interest in diseases, and westernization of lifestyles. Reflux esophagitis has been reported to lower the quality of life (QOL) due to the severity of symptoms. However, assessments of a relationship between reflux esophagitis and QOL have been mostly at the hospital level, and few studies have considered this in health check-ups. Therefore, we examined relationships between reflux esophagitis and gastrointestinal symptoms and QOL in health check-up examinees.

Methods: Our subjects were 366 individuals (207 men and 159 women, aged 33–81 years, mean age 58 ± 11 years) who underwent health check-ups. Relationships between reflux esophagitis and gastrointestinal symptoms and health-related QOL were evaluated using the Gastrointestinal Symptom Rating Scale and Short Form-8 questionnaire, respectively.

Results: Reflux esophagitis was not necessarily associated with gastrointestinal symptoms and there was no clear association with reduced health-related QOL.

Conclusion: It is difficult to predict the presence of reflux esophagitis based solely on subjective symptoms. Therefore, it is necessary to perform endoscopies with the possibility of reflux esophagitis in mind even in patients who do not complain of symptoms.

Objective: Pancreatic cystic lesions (PCLs) should be carefully followed up because they are transabdominal ultrasound (TAUS) findings indicating a high-risk of pancreatic cancer. The aim of this study was to investigate the usefulness of follow-up TAUS for PCL surveillance, with reference to previous magnetic resonance imaging (MRI).

Methods: The hospital database for 781 subjects who underwent a health check-up including MRI was searched. The PCL detection rate and the size of their maximum dimension in follow-up TAUS after MRI were examined. Subjects with and without detected PCLs in follow-up TAUS were statistically compared for clinical characteristics.

Results: The detection rate for PCLs that were invisible in the initial TAUS was 21.9% in follow-up TAUS after MRI and 68.7% of these PCLs were under-measured, with a size difference of –1.8 ± 3.7 mm. Multivariate logistic regression analysis showed that visualization of PCLs by follow-up TAUS was significantly associated with PCL size and the presence of fatty liver (OR, 95% CI, p: 1.477, 1.252–1.741, 0.000; 0.252, 0.088–0.725, 0.011). On the other hand, with a detection rate of 97.5% for the visible PCLs in the initial TAUS, the reproducibility of follow-up TAUS was very high, although 51.3% of these PCLs were under-measured, with a size difference of –1.3 ± 2.3 mm.

Conclusions: The PCL detection rate for follow-up TAUS after MRI improved in approximately 20% of subjects with invisible PCLs in the initial TAUS, and high reproducibility was demonstrated for TAUS. It should be noted that PCL size could be under-measured in TAUS, after MRI.

Objective: We retrospectively compared the ability of abdominal ultrasound (US) and magnetic resonance cholangiopancreatography (MRCP) to depict intraductal papillary mucinous neoplasms (IPMN), which can be precursors of pancreatic cancer.

Methods: In 170 patients with IPMN, lesion detection by US was examined according to site and size of cysts. Additionally, clinical and imaging features associated with need for surgery during follow-up were determined.

Results: Relative to lesion depiction with MRCP as the standard, cyst detection by US was significantly better in the body of the pancreas than in the head or tail. For small cysts (< 10 mm), US detection was significantly better in the body than in the tail. Among 170 patients, 12 (7.1%) underwent surgical resection during follow-up. A widening main pancreatic duct (MPD; diameter increase ≥ 0.2 mm/year) and greater age (≥ 70 years) were significantly and independently associated with need for surgical resection.

Conclusion: The ability of US to detect cysts in the head and tail of the pancreas is limited, particularly in the latter. Since multiple cysts are relatively frequent in these regions, MRCP should also be performed when a cyst is detected in the body by US. Older individuals and those with relatively rapid widening of the MPD should be considered carefully for surgical resection.

Background and Aims: Lipid pathways play a crucial role in multiple aspects of the hepatitis C virus (HCV) life cycle. As treatment for HCV infection, direct-acting antivirals (DAAs) can achieve a high rate for sustained virological response (SVR). The aim of this study was to compare lipid marker changes between SVR and non-SVR patients.

Methods: We compared clinical and lipid markers as well as changes in Japanese “Ningen Dock” health check-up categories.

Patients: This study enrolled 340 patients (154 men, median age: 71 years) who had received DAAs for comparisons of clinical and lipid markers between 333 SVR (97.9%) and 7 non-SVR (2.1%) patients.

Results: Baseline clinical markers were comparable between the SVR and non-SVR groups apart from platelet count (p = 0.049). SVR patients exhibited significant decreases in AST, ALT, and AFP and increases in platelet count and albumin (ALB) (all p <0.001) under DAA treatment, while non-SVR patients did not. The SVR group also had significant increases in TC, LDL-C, HDL-C, and non-HDL-C lipid markers (all p <0.001). Regarding Ningen Dock criteria, the proportion of patients in category D-low (Medical care needed) for LDL-C and non-HDL-C decreased significantly, while that of patients in category B (Slightly abnormal), C (Requires follow-up), and D-high for LDL-C and non-HDL-C increased significantly in SVR patients. In addition, the proportion in category C and D-low for HDL-C dropped significantly.

Conclusion: HCV eradication by DAAs can produce significant changes in both lipid profiles and Ningen Dock categories. Clinicians should consider HCV eradication history for patients with abnormal lipid profiles. Further studies are needed on the long-term effect of lipid changes after achieving an SVR for HCV.

Objective: Cross-sectional surveys have shown blood hemoglobin (Hb) levels to be low in women in their 30s and 40s. This study investigated secular transitions in blood Hb levels and relevant laboratory data in women aged in their 30s to mid-60s.

Methods: We included the data of 1,370 women who underwent at least six periodic health check-ups, including those for blood Hb level, mean corpuscular volume (MCV), and platelet count. The transitions in and mutual relationships of these data were investigated.

Results: In women who did not receive anemia treatment at any health check-up, blood Hb levels began to decrease when they were in their mid-30s, remained low during their 40s, and increased again in their 50s. This tendency was stronger in women with anemia history than in those without anemia history. MCV decreased and platelet count increased in women in their 40s, but returned to previous levels in their 50s. The average age of menopause during the study period was 50.9 ± 3.1 (SD) years. Platelet count exceeded the reference value in 17.1% of women with blood Hb levels≤ 11.0 g/dL. A strong negative correlation was observed between individual blood Hb level and platelet count over time, especially with blood Hb level fluctuations ≥ 3 g/dL.

Conclusions: The blood Hb level of women decreased when the women were in their 40s and recovered during their 50s. These changes were small in those without previous anemia history. As the blood Hb level decreased, the proportion of women with platelet counts exceeding the reference value slightly increased.

Objective: Young workers using visual display terminals (VDTs) commonly suffer from lumbago. During general health check-ups, chest X-ray photographs (Xps) of examinees complaining of lumbago and/or knee pain often show spinal distortion. We therefore quantified this observation for workers using VDTs. Since it is difficult to measure the Cobb angle commonly used in orthopedics solely from routine health check-up data, we measured the distance from the spinous process to the center of the bronchus on chest Xp frontal images, and defined it as an index of spinal distortion. We examined the statistical significance of this index to examine its usefulness as a means of explaining the cause of lumbago in general health check-ups.

Methods: The subjects were 91 VDT (visual display terminal) workers (age 43.6± 11.0 years, 63 men; 28 women). Chest Xps were taken using a CXDI system (Canon, Tokyo). We excluded those with marked aortic sclerosis and aberrant azygous interlobar fissures. Correct posture was achieved by placing both shoulders on the chest Xp board. The deviation from the central bronchus to the spinous process was measured using a function for measuring the distance between two points in DICOM (Digital Imaging and Communications in Medicine) images.

Results: Based on questionnaire responses, subjects with headaches had significantly larger spinal distortion than subjects without headaches (p <0.02), and those with lumbago had a significantly larger spinal distortion than those without lumbago (p <0.05).

Conclusion: Lumbago and headache stemming from physical fatigue in VDT workers could be associated with spinal distortion.