Quantitative analysis of red color sign in the endoscopic evaluation of esophageal varices.

BACKGROUND AND STUDY AIMS: Bleeding due to esophageal variceal rupture is associated with an extremely high mortality rate. Variceal bleeding is frequent in patients who have a red color sign on endoscopy. However, the red color sign is subjectively evaluated on the basis of color tone and the shape of the varices. To allow standardization and facilitate consensus, an objective method of assessing the red color sign is needed. In this study, a system was established for quantifying the red color sign during endoscopic evaluation. PATIENTS AND METHODS: Between July 1995 and February 1997, 55 untreated patients with portal hypertension and esophageal varices identified on upper gastrointestinal endoscopy were enrolled in the study. Images obtained about 5 cm oral to the esophagogastric junction during endoscopy were stored on magnetic optical disks using an endoscopic image processor. The still images were transmitted to a computer and analyzed using computer software. The RGB components (R, red; G, green; B, blue) were measured at points showing flare consistent with the red color sign. The endoscopic assessment was based on the Japanese Research Society for Portal Hypertension's general rules for recording endoscopic findings in esophagogastric varices. RESULTS: The ratio of the red color area to the variceal area increased with increasing red color grade. There were significant positive correlations between the R and G, and G and B components. This suggests that comparing the R components alone would allow assessment of the color differences in the red color area and in the varices. The R value was significantly higher in the red color area (115 +/- 20) than in the varices (57 +/- 19). An R value of 90 was found at the boundary between the two parts (P < 0.001). CONCLUSIONS: The red color area can be automatically calculated and quantified using the analysis program. Improvements in data storage methods may allow real-time evaluation during endoscopy in the future.

A cross-sectional population-based study on senile dementia in a rural city.

All residents aged 65 or over in a rural city (n=5340) were studied with a self-administered questionnaire on psychiatric symptoms, physical health status, medical history, and environmental factors. After the screening, the clinical diagnosis of senile dementia was made by psychiatrists. The overall prevalence was 4.0% among responders staying at home (201/4969). The prevalence increased with age for both males and females and tended to be higher for females than males. The multilogistic analysis of the above variables showed that in the cerebrovascular type, stroke and inactive physical status might be risk factors for both gender groups. For the Alzheimer's type, age and inactive physical status might be risk factors. For overall dementia, age, stroke, and inactive physical status might be risk factors.

[Relationship of hypertension prevalence in companies to business type and scale--from an analysis of health examination results in Fukui prefecture].

The results of health examinations of 89,299 examines from companies in Fukui Prefecture conducted pursuant to the Occupational Safety and Health Act were analyzed to study the relationship between the prevalence in these companies of hypertension, and company size business type. The Mantel-Haenszel method was utilized to adjust for age structure of the examinees according to gender and the type of business of their companies to compare prevalence of hypertension. The results of the analysis indicated that the prevalence of hypertension was significantly higher in small-scale companies for the female examinees working in pulp/paper processing and motor freight transport business than in large-scale companies, but no significant difference was seen for scale of business when the female examinees were grouped without regard to the business type of their companies. In the case of the male examinees, the analysis results revealed that the prevalence of hypertension was significantly higher in small-scale companies for those working in ceramic/earth/rock, motor passenger transport and hotel/restaurant business than in large-scale industry while the prevalence of hypertension was significantly higher in large-scale companies for those working in non-ferrous metal industry, financial and other types of business. Moreover, the analysis results for the male examinees grouped without regard to the type of business of their companies indicated that the prevalence of hypertension remained significantly higher in small-scale companies. The above also suggests the need for measures for health care of workers that considers business type and scale for the purpose of primary prevention of hypertension.

[Changes in physique and obesity of school children in an elementary school observed from the Meiji era to the Showa era].

Data on height and weight were collected at an elementary school in Fukui Prefecture from 1889 through 1934 (observation period). During the observation period, the school area, consisting of a mountainous region and a plain region, was not changed. Using these data, analysis showed that there were: (1) differences in physique between children from the mountainous region and those from the plain region, which was suggested by the school teachers during the observation period, (2) chronological changes in physique, (3) chronological changes in the features of the height velocity curve in the analysis when school children at the same school born in the 1980s were used as a control, (4) chronological changes in the balance of weight to height and (5) changes in the prevalence of obesity. The results were as follows: (1) during the observation period, the physiques of children in the mountainous region were consistently inferior to those in the plain region, (2) during the period, the average physique of the school children aged 12 was consistently inferior to the overall average for Japanese pupils of the same age, (3) during the observation period, the onset of the adolescent growth spurt was later by one year compared with that of current controls, (4) the ratio of weight to height stratified by 3cm intervals during the observation period was almost the same as that in current controls, (5) during the observation period, the prevalence of obesity in boys (6%) was lower than that in current controls (10%). However, the obesity prevalence in girls during the period was higher than that in the controls. However, this findings might be associated with wearing kimono during measurement. By contrast, these differences have recently disappeared. These results suggest that there were consistent differences in physique that persisted between regions in the school area and in Japan as a whole across several eras.