Biomedical subjects

S Baba

Publications and source records attributed to S Baba.

At least 235 records · Page 13Linked to original sources

PubMed1997

Measurement of pancreatic blood flow to prevent pancreatic juice leakage after pancreas-preserving total gastrectomy for gastric cancer.

In patients with gastric cancer, distal pancreatectomy was frequently performed for complete removal of the lymph nodes along the splenic artery, but this procedure sometimes induced pancreatic juice leakage, subphrenic abscess, and postoperative diabetes. To avoid these complications, pancreas-preserving total gastrectomy (PP) was developed by Maruyama et al. [World J Surg 1995; 19:552-536], with which the spleen, splenic artery, and fatty connective tissue including lymph nodes could be removed completely without distal pancreatectomy. From 1988 to 1995, 36 patients underwent PP in our department. Although there were no operative deaths and no patient developed postoperative diabetes, pancreatic juice leakage was observed in 4 patients (11.1%). We assumed that ischemia of the distal pancreas may have caused this pancreatic juice leakage and investigated the relationship between pancreatic blood flow (PBF) and this complication in 12 recent patients. A significant negative correlation between PBF in the pancreatic tail and the peak amylase level (PAL) in the drain fluid was demonstrated. Two patients with PBF values of 4.5 and 5.2 ml/min/100 g tissue, respectively, and a PAL of more than 2 x 10(5) U/l developed pancreatic juice leakage, whereas the 10 patients without this complication had PBF values above 6 ml/min/100 g tissue and a PAL of less than 2 x 10(4) U/l. These results suggest that measurement of PBF may be useful to predict the leakage of pancreatic juice after PP and that distal pancreatectomy may be preferable when PBF is extremely low.

Adult↗

PubMed1997

ACTH-independent bilateral macronodular adrenocortical hyperplasia caused Cushing's syndrome.

A 53-year-old man who had been followed up for the treatment of hypertension presented with a bilateral adrenal mass during a screening CT scan. Other imaging studies and biochemical tests suggested Cushing's syndrome caused by a pituitary-independent and adrenal-dependent bilateral adrenal tumor. A total adrenalectomy was performed and the pathological appearance of the surgical specimen showed adrenal hyperplasia. Therefore, these findings were considered to be consistent with ACTH-independent bilateral macronodular adrenal hyperplasia (AIMAH). This tumor is quite rare and its etiology still remains controversial. We herein report this incidentally found AIMAH and also review the pertinent literature.

Adrenal Glands↗

PubMed1997

Prevalence of asymptomatic carotid atherosclerotic lesions detected by high-resolution ultrasonography and its relation to cardiovascular risk factors in the general population of a Japanese city: the Suita study.

BACKGROUND AND PURPOSE: Because extracranial carotid atherosclerotic lesions have been considered rare, no reports have been published on the prevalence and distribution of these lesions in a general Japanese population. However, recent changes in lifestyle are thought to have caused an increase in these lesions. The aim of this study was to use high-resolution ultrasonography to examine the prevalence of asymptomatic extracranial carotid artery lesions and its relation to cardiovascular risk factors in an urban Japanese population. METHODS: The subjects were 814 men and 880 women aged 50 to 79 years randomly sampled from the residents of Suita, a city located in the second largest urban area of Japan. Asymptomatic carotid lesions were detected and evaluated by a single physician with high-resolution B-mode ultrasonography. RESULTS: We found significant sex differences in the prevalence of atherosclerotic lesions in the extracranial carotid artery; 4.4% of all the subjects, 7.9% of the men, and 1.3% of the women had atherosclerosis accompanied by stenosis of >50%. A strong association between these lesions and the results of a 75-g oral glucose tolerance test was found in both sexes. Multiple regression analysis of carotid atherosclerosis showed significant relationships with age, systolic blood pressure, fasting blood glucose, pack-years of smoking, total serum cholesterol, and HDL cholesterol in men (P<.05) and significant relationships with age, systolic blood pressure, pack-years of smoking, and total serum cholesterol in women (P<.05). CONCLUSIONS: Our data showed that cardiovascular risk factors were strongly related to carotid atherosclerosis and that the proportion of severe carotid atherosclerosis with >50% stenosis was not low and was almost equal to that reported in developed western countries.

Aged↗

PubMed1997

Modification of ciliary beating in sea urchin larvae induced by neurotransmitters: beat-plane rotation and control of frequency fluctuation

The modification of ciliary beating by neurotransmitters in sea urchin larvae at the four-armed pluteus stage was analyzed in terms of the direction of beating and fluctuation in the beat period. Application of dopamine to Pseudocentrotus depressus causes the cilia to turn their beat plane but retain its characteristic planar feature up to the complete 'reversal' of the beat direction. This new type of response was termed the 'beat-plane turning response'. It was also found that neurotransmitters, especially dopamine and serotonin, can modify the length of the beating cycle in P. depressus and Hemicentrotus pulcherrimus. Dopamine decreased and serotonin increased the beat frequency averaged over the ciliated epithelium with the standard deviation from the mean increasing in the presence of dopamine and decreasing with serotonin. The beat-period fluctuation and its modification suggested by this observation was confirmed from measurements of the beating of individual cilia in the presence or absence of these neurotransmitters. Further analysis of the correlation between angular velocity and beat period indicates that variation in the beat period is not controlled by the same processes as those that modulate angular velocity. These findings in sea urchin larvae suggest that both the stability and the direction of ciliary beating is under nervous control.

Journal Article↗

PubMed1997

The rise time of the monophasic action potential--a new index of local use-dependent conductivity by sodium channel blockers in human myocardium.

The kinetics of global use-dependent conduction slowing produced by sodium channel blockers in the human heart, estimated as a change in the QRS width, are known to be similar to those of use-dependent block of the maximum rate of depolarization in in vitro studies. However, the kinetics of the regional use-dependent decrease in conductivity have not been investigated. We examined whether the rise time of the monophasic action potential would be clinically useful as a marker of the local use-dependent decrease in conductivity by sodium channel blockers. In 12 patients without organic heart disease, monophasic action potentials (MAPs) were recorded at the right ventricular endocardium using a contact electrode before and after the administration of disopyramide (n = 6, 2 mg/kg, i.v.) or pilsicainide (class Ic agents, n = 4, 1 mg/kg, i.v., and n = 2, 150 mg, po) while the stimulus frequency was abruptly increased from 100/min to 150/min. The rise time, defined as the interval from the pacing pulse to the first peak deflection of the monophasic action potential, and the ORS width were measured simultaneously. In the absence of the sodium channel blockers, the abrupt increase in heart rate did not alter the QRS width or the rise time. In the presence of the agents, both variables were lengthened exponentially. The rate constants of onset changes in the QRS width and the rise time were 2.1 +/- 0.5 beats and 2.1 +/- 0.4 beats after the administration of disopyramide, and 7.5 +/- 3.0 beats and 8.2 +/- 4.0 beats after pilsicainide, respectively. The rate constant of the rise time was closely correlated with that of the QRS width. The present results are very closely comparable with the onset rate constants of use-dependent block of the maximum rate of depolarization in in vitro studies. These results suggest that (1) the rise time is a good indicator of local use-dependent decrease in conductivity by sodium channel blockers in human hearts and (2) the local use-dependent decrease in conductivity has kinetics similar to those of use-dependent sodium channel blocks.

Action Potentials↗

PubMed1997

Pioglitazone (AD-4833) ameliorates insulin resistance in patients with NIDDM. AD-4833 Glucose Clamp Study Group, Japan.

We evaluated the effect of pioglitazone, a thiazolidinedione compound, on insulin-stimulated glucose disposal (Rd) and its efficacy on carbohydrate and lipid metabolism in patients with non-insulin-dependent diabetes mellitus (NIDDM). Twenty NIDDM subjects (mean age 58.2+/-9.4 year, body mass index (BMI) 23.9+/-3.4 kg/ m2 (mean+/-S.D.], three with diet alone, 17 with sulfonylureas [SU]) participated in this trial from five diabetes clinics. Euglycemic (5.3 mmol/liter) hyperinsulinemic (insulin infusion rate 9 micromoles x kg[-1] x min[-1]) clamp studies were performed before and after oral administration of pioglitazone (30 mg/day) for 87+/-10 days. The Rd significantly improved from 5.5+/-2.5 to 8.3+/-3.1 mg x kg(-1) x min(-1). Fasting plasma glucose (FPG) level significantly decreased from 11.0+/-2.0 mmol/liter to 8.9+/-1.1 mmol/liter with a significant improvement in the hemoglobin A1c level from 9.2+/-1.8% to 8.3+/-1.5%. Fasting serum insulin and C peptide levels decreased from 83+/-36 pmol/liter and 0.62+/-0.21 nmol/liter to 66+/-29 pmol/liter and 0.58+/-0.25 nmol/liter, respectively. Fasting serum triglyceride and free fatty acids levels significantly decreased with concomitant increase of fasting serum HDL-cholesterol levels from 1.2+/-0.2 to 1.5+/-0.3 mmol/liter. The change in Rd between before and after pioglitazone administration correlated with baseline values of FPG (rho=0.633), serum insulin (rho=0.653), BMI (rho=0.456), Rd (rho 0.558) and 1,5-AG (rho=-0.522). These data indicate that pioglitazone enhances the insulin action in NIDDM patients on diet alone or SU, and thereby improves both plasma glucose level and lipid profiles.

Administration, Oral↗

PubMed1997

Central cholinergic regulation of pancreatic polypeptide secretion in conscious dogs.

The secretion of pancreatic polypeptide (PP) is regulated by fluctuations in blood glucose concentrations and food intake, in which vagal-cholinergic mechanisms play an important role, especially for the cephalic phase of PP secretion. In this study, we examined whether central cholinergic mechanisms are also important for PP secretion by relaying information in the brain to the vagus nerve and the muscarinic cholinergic receptors in the pancreas. Atropine sulfate (20-200 micrograms) was administered into the lateral cerebral ventricle and its effects on the basal secretion of PP as well as the secretions stimulated by insulin-induced hypoglycemia (Actrapid MC, 0.25 U/kg) and a mixed meal (243 kcal) were studied in seven dogs. Intralateral cerebroventricular (ILV) atropine (100 and 200 micrograms) abolished the fluctuations in basal PP secretion without appearing in the plasma. Pretreatment with 20, 100, and 200 micrograms ILV atropine significantly decreased the PP response to insulin-induced hypoglycemia, with the integrated PP response to 58, 32, and 26% of that of controls respectively. Atropine (100 micrograms ILV) significantly reduced the postprandial PP secretion in both the cephalic and the gastrointestinal phases, whereas increased insulin and glucose levels were unaffected. Centrally administered atropine was able to suppress the basal secretion of PP as well as the secretions stimulated by hypoglycemia and food intake. These findings suggest that (1) the spontaneous release of PP is governed by an oscillating, central cholinergic tone, and (2) the stimulating PP secretion is, at least in part, regulated by the central cholinergic system.

Animals↗

PubMed1997

[A 26-week oral repeated dose toxicity study of (+/-)-4-diethylamino-1,1-dimethylbut-2-yn-1-yl 2-cyclohexyl-2-hydroxy-2-phenylacetate monohydrochloride monohydrate (NS-21), a novel drug for urinary frequency and incontinence, in rats followed by a 9-week recovery test].

A 26-week oral repeated dose toxicity study of (+/-)-4-diethylamino-1, 1-dimethylbut-2-yn-1-yl 2-cyclohexyl-2-hydroxy-2-phenylacetate monohydrochloride monohydrate (NS-21), a new drug for the treatment of urinary frequency and incontinence, was conducted in Sprague-Dawley rats. Male and female rats were given the drug orally for 26 weeks at doses of 0 (control), 5, 50 and 500 mg/kg. After discontinuation of the treatment, a 9-week recovery test was also conducted. Two cases of death occurred in the 500 mg/kg group. Mydriasis, salivation and lacrimation were seen in the 50 and 500 mg/kg groups. Alopecia, a suppression of body weight gain and an increase in water consumption were seen in the 500 mg/kg group. Food consumption measurement showed no abnormalities attributable to the treatment. Ophthalmologic examination confirmed mydriasis in the 50 and 500 mg/kg groups. Urinalysis showed an increase in urine volume in the 50 and 500 mg/kg groups, and an increase in urinary protein and decreases in Na+, K+ and Cl- excretions in the 500 mg/kg group. Hematological examination showed decreases in hemoglobin, hematocrit, MCV, MCH, MCHC and lymphocytes in the 500 mg/kg group. Blood chemical examination showed increases in total cholesterol, phospholipid and total protein and decreases in glucose, triglyceride, free T3 and T4 in the 500 mg/kg group. Measurements of liver drug-metabolizing enzymes showed an increase in T4UDP-GT activity in the 50 and 500 mg/kg groups, and an increase in cytochrome P-450 in the 500 mg/kg group. Pathological examination disclosed hepatocellular hypertrophy caused by hyperplasia of smooth-ER in the 50 and 500 mg/kg groups, and a decrease in number of glycogen granules in the 500 mg/kg group. Stimulated thyroid follicles were seen in the 50 and 500 mg/kg groups. Increases in incidence and severity of chronic progressive nephropathy were also observed in the 500 mg/kg group. In this dose group, adrenocortical hypertrophy was also observed. The recovery test showed that the above-mentioned changes were satisfactorily reversible. The serum concentrations of NS-21 and its active metabolite, RCC-36, in the treated groups were increased in a dose-dependent manner. No treatment-related effects were seen in the 5 mg/kg group. These results show that the NOAEL (no observed adverse effect level) of NS-21 is 5 mg/kg for 26-week oral toxicity in rats.

Administration, Oral↗

PubMed1997

In vivo absorption of calcium carbonate and magnesium oxide from the large intestine in rats.

This study was conducted to evaluate the ability of the large intestine to absorb calcium (Ca) and magnesium (Mg) from their sparingly water-soluble salts, and also to determine whether fructooligosaccharides (FOS) stimulate the absorption of these minerals in rat large intestine in vivo. Rats were fed Ca- and Mg-free diets with and without 5% FOS. An aqueous suspension of CaCO3 and MgO was infused into the stomach via a gastric tube or into the cecum via an implanted catheter. Coprophagy was prevented by using wire-mesh anal cups throughout the experiment so as to exclude the re-ingestion of feces as an oral mineral source. In rats fed an FOS-free diet, the absorption degrees of Ca and Mg infused into the cecum were the same as those infused into the stomach. The absorption degree of phosphorus (P) was slightly but significantly higher in rats with the infusion of Ca and Mg into the cecum than in rats with the infusion of Ca and Mg into the stomach. FOS-feeding increased the absorption of Mg to a similar extent in either case of infusion via cecal and oral routes, while FOS-feeding did not increase the absorption of Ca in rats with infusion of Ca and Mg into the cecum. We concluded that both CaCO3 and MgO are absorbed in the large intestine, and we ascertained that the increasing effect of FOS on the absorption of Mg took place mainly in the large intestine.

Analysis of Variance↗

PubMed1997

[Suppression of tinnitus by band noise masker--a study of 600 cases].

We performed Band Noise Masker (BNM) therapy for the suppression of tinnitus in 600 patients and measured the pitch, loudness and masking level of tinnitus and residual inhibition (RI). We examined the efficiency of BNM therapy. The purpose of this study was to investigate the mechanism of suppression of tinnitus by BNM. Tinnitus was suppressed in 394 patients (66%) after BNM therapy. In the group of patients in whom we suppressed tinnitus, the loudness of tinnitus was reduced from 7.7 +/- 5.7dBSL to 7.5 +/- 5.5dBSL (p < 0.05) and the pitch of tinnitus did not exhibit a marked change. In the group of patients in whom we did not suppress tinnitus, the loudness and pitch of tinnitus did not exhibit a marked change. The efficiency of BNM therapy was high in the cases of presbyacusis and low in the cases of sudden deafness. There was no significant relationship between RI and the efficiency of BNM therapy. We examined these data and discussed the mechanism of suppression of tinnitus by BNM therapy. In all cases, after BNM therapy, the auditory threshold did not become worse. In 4 cases tinnitus became worse temporarily. In conclusion, BNM therapy is an effective mode for tinnitus control, is easily performed in our outpatient clinic or at home, and has no serious complications.

Adolescent↗

PubMed1997

Percentage changes in serum pepsinogens are useful as indices of eradication of Helicobacter pylori.

OBJECTIVE: Eradication of Helicobacter pylori has been gaining significance for the treatment of gastroduodenal diseases. Establishment of a precise diagnostic method for H. pylori is of great value. The aim of this study was to establish a new method for precisely judging the eradication of this bacteria. METHODS: We measured serum pepsinogen I (PG I) and pepsinogen II (PG II) levels in 105 cases of peptic ulcer with H. pylori infection before and after anti-H. pylori treatment, determined percentage changes in serum PG I:PG II ratios before and 1 month after the treatment, and established cut-off values for them to distinguish success from failure of H. pylori eradication. Cut-off values for percentage changes in serum PG I:PG II ratios were tentatively set as +40%, +25%, and +10% when the serum PG I:PG II ratios before treatment were less than 3.0, not less than 3.0 but less than 5.0, and not less than 5.0, respectively. RESULTS: With these cut-off values, the sensitivity, specificity, and validity for determination of eradication of H. pylori-on the basis of culture, histology, the rapid urease test, and a polymerase chain reaction method-were 100.0%, 93.1%, and 96.2%, respectively. These cut-off values could be applied to both gastric ulcer and duodenal ulcer. CONCLUSION: Our findings suggest that percentage changes in serum PG I:PG II ratios are useful as indices for distinguishing success from failure in eradication therapy for H. pylori.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed1997

[Spontaneous pyeloduodenal fistula: a case report].

A 71-year-old female presented with recurrent episodes of right flank pain and fever for the past several years. No pathogens were detected in the urine culture. Abdominal X-ray revealed staghorn calculi of the right kidney. Computerized tomography revealed pneumopelvis and staghorn stones of the right kidney. A nephrectomy was indicated based on the results of intravenous pyelography (IVP) and renogram which revealed a right non-functioning kidney. The adhesion of the right kidney with the duodenum and a transverse colon was so strong that a nephrectomy, a wedge resection of the duodenum and a transverse colectomy were performed. There was a fistula between the renal pelvis and the second portion of the duodenum. The fistula was speculated to have occurred by the spontaneous rupture of the renal pelvis to the duodenum. To the best of our knowledge, this is the 15th case of spontaneous nephroduodenal fistula in Japan.

Aged↗

PubMed1997

Laparoscopic surgery by abdominal wall lifting using original lifting bars.

Laparoscopic surgery by abdominal wall lifting may be less invasive than by pneumoperitoneum, because the influence of the pneumoperitoneum can be avoided. We have performed laparoscopic surgery without pneumoperitoneum by lifting the full layer of the abdominal wall using two unique kinds of lifting bars that we developed. We have used this method on a total of 154 patients and obtained favorable results. Laparotomy was performed in three of the 104 patients undergoing cholecystectomy. All of them had previously undergone gastrectomy, and laparotomy was performed because of severe intraperitoneal adhesions. There were no severe complications, but insufficient suturing was experienced in one patient who underwent resection of the large intestine. In this article we describe the procedures and results of the lifting method.

Abdominal Muscles↗

PubMed1997

Clinical experience with incidentally discovered pheochromocytoma.

PURPOSE: We reviewed 17 resected pheochromocytomas comprising 7 from symptomatic patients, and 10 unsuspected and incidentally discovered tumors. We compared various parameters concerning these 2 groups and investigated the features of the incidentally discovered pheochromocytoma. MATERIALS AND METHODS: Patient gender and age, clinical symptoms and signs, tumor localization, detection methods, findings on imaging studies, urinary catecholamine concentrations, results of metoclopramide stimulation tests, treatments at operation and tumor size were evaluated. Furthermore, we compared the clinically diverse aspects arising between the symptomatic and incidentally discovered pheochromocytomas. RESULTS: The 24-hour urinary noradrenaline and vanillylmandelic acid levels in the incidental cases tended to be lower than those in the symptomatic cases, while 24-hour urinary dopamine was significantly less (468 +/- 221 compared to 1,558 +/- 899 microg./day, respectively). Typical symptoms of pheochromocytoma were noted in 6 patients (60%) in the incidental tumor group. The incidental cases had a markedly high false-negative rate (71%) as noted by the metoclopramide stimulation test, although the symptomatic cases had a 100% positive rate. On the other hand, the average diameter of incidental tumors was significantly larger than that of the symptomatic lesions (55.5 +/- 19.1 versus 35.9 +/- 12.1 mm., respectively). CONCLUSIONS: Clinical signs and findings in patients with incidental tumors were weaker than those with symptomatic disease although most incidental tumors functioned. Lower urinary catecholamine values in the incidental tumors were consistent with these results. However, the surgical risk for incidental tumors was the same as that for symptomatic lesions. Therefore, patients with incidentally discovered pheochromocytomas scheduled to undergo surgery should be treated accordingly.

Adolescent↗

PubMed1997

[Surgical treatment for Crohn's disease].

No medical on surgical treatment exists that is ideal for the patient afflicted Crohn's disease. During the chronic course of disease various complications or significant side effect of medications will develop. At this point, the patient is offered an operation. Indication for surgery rarely absolute in Crohn's disease with the exception of life threatening emergencies such as free perforation or massive hemorrhage. Common indications are bowel obstruction due to stenosis, fistula in various sites, abscess and perianal complications. It is well known that future likelihood of postoperative "recurrence" of the disease, and to learn various operative procedures described in this article. Therefore surgeon should be alert to understand the pathophysiology of the disease and to learn various operative procedures described in this article. It is important to determine proper indication and to choose best timing for operation and select the appropriate operative procedures.

Abscess↗

PubMed1997

[Prevalence of glucose intolerance, diabetes mellitus, and high serum insulin levels in a Japanese urban population].

An epidemiological study was conducted to investigate the prevalence of diabetes mellitus, glucose intolerance and hyperinsulinemia in an urban population. Twelve thousand two hundred people aged 30 to 79 were randomly selected from residents of S-city in Osaka Prefecture and were urged to attend a cardiovascular examination at the National Cardiovascular Center. In 1992 and 1993, among 5,284 people who received the examination, 75 g oral glucose tolerance tests (OGTT) were performed and plasma glucose and serum insulin concentrations were determined for 2,147 subjects, who participated in the morning course of examination and who were fasting. The prevalence of diabetes and hyperinsulinemia (fasting serum insulin level > or = 15 microU/ml) was higher in older than in the younger generation, and was higher in men than in women. The prevalence of diabetes in those aged 40 and over in S-city was 7.3% in men and 5.6% in women, 17.2% of men and 10.7% of women had impaired glucose tolerance, and 7.5% of men and 5.2% of women had hyperinsulinemia. A comparison of prevalences of diabetes was performed between 4 populations, one being our urban population and others being 3 rural populations where population-based surveys had been accomplished with OGTT but without a screening as ours was with regard to detecting diabetes. The prevalence of diabetes in our urban population did not appear to be higher than in the other 3 rural populations. From a questionnaire survey of responders and non-responders to OGTT, it was considered that the degree of selection bias in this study was small, if any.

Adult↗

PubMed1997

[Mechanism of regression of metastatic liver tumors in rats treated with angiogenesis inhibitor with special reference to apoptosis].

We examined the mechanism of the reduction of metastatic liver tumors in rats treated with angiogenesis inhibitor TNP-470 on the histological basis of patterns of tumor cell death. Metastatic tumors were developed by intravenous injection of AH-130 cell line, followed by a dose of TNP-470. Alteration in the size and number of metastatic liver tumors and its cell death pattern were analyzed. The number and size of the metastatic tumors at 2 weeks in untreated rats were larger than those in treated rats. The number of tumors in untreated rats decreased, whereas their size increased. All rats treated were alive and free from tumors after 4 weeks, although all untreated rats died of metastatic tumors. Necrosis was predominant in the tumors of untreated rats, while most tumors in treated rats showed apoptosis. Consequently, the metastatic tumor in untreated rats might grow faster than its angiogenesis, suggesting the occurrence of central necrosis due to apparent ischemia. On the other hand, the tumor in treated rats might be reduce a by weak ischemic stimulus, which triggers apoptosis.

Animals↗

PubMed1997

[Effects of health examination and follow-up educational programs on awareness and modification of risk factors for cardiovascular disease in a Japanese urban population].

This study in a Japanese urban population evaluated the effects of health examinations and follow-up educational programs on the risk factors for cardiovascular disease (blood pressure, serum total cholesterol, and smoking) and the level of awareness regarding these factors (e.g. having had their blood pressure and serum total cholesterol whether they checked, and knowing whether their level is high or normal, and whether they can state their own level). In both 1990 and 1991, 4,000 adults aged 30 to 79 were randomly selected from residents of S-city in Osaka Prefecture, and urged to attend the baseline health examination for cardiovascular disease at the National Cardiovascular Center. From among 1,879 persons who had received health examinations and follow-up educational programs in 1990, 600 subjects were selected at random and invited to participate in the follow-up examination in the next year. Four hundred forty five persons received the follow-up examination, and in addition, 1,791 persons attended newly the baseline health examination in 1991. Two sets of analyses were conducted. First, the 1990 baseline examination data and the 1991 follow-up examination data of 445 subjects were compared for change of awareness and risk factors. Second, the 1991 follow-up examination data and the 1991 baseline examination data were compared for difference of risk factors level. Initial awareness concerning serum total cholesterol was lower than that concerning blood pressure among people who had attended the 1990 baseline examination. After the health examination and the educational program, awareness for both blood pressure and serum total cholesterol increased significantly. Significant decreases in systolic blood pressure and serum total cholesterol were shown. But, no significant changes were observed for diastolic blood pressure and smoking rate. The means of systolic blood pressure and serum total cholesterol among subjects who received the follow-up examination were significantly lower than subjects who newly participated in the baseline examinations in 1991. Participation in health examinations and follow-up health educational programs can result in positive changes in awareness of risk factors and reduction of these factors.

Adult↗