[Health examinations--still mainly in doubt. Health promotion for cost control?].
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Liver function abnormalities are often found on routine chemical profiles. Abnormal test results are often false positive in asymptomatic patients. Repeat testing and confirmation that the liver is the source of the abnormality are the first steps of evaluation. A thorough history and physical examination may suggest reasons for the abnormalities. If no etiology for the abnormal test result is found, further testing is indicated.
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From June 1975 through December 1983, 48,604 individuals consisting of 34,535 males and 14,069 females underwent health examinations at the Automated Multiphasic Health Testing and Services (AMHTS) Center in Tokai University Hospital. There were five patients with renal cell carcinoma and three with bladder cancer. We reviewed the clinical courses of these patients and discussed the early detection of urological cancers in AMHTS. Patients with renal cell carcinoma were brought to the urology department with various findings in AMHTS. A 44-year-old male was referred to us for the investigation of multiple metastatic shadows in the chest X-P and left renal tumor was diagnosed by intravenous pyelography (IVP) and computed tomography (CT). Renal tumor of a 57-year-old male was diagnosed by the investigations of abnormal renal calcifications found in AMHTS. A 39-year-old female had undergone health check-ups several times but was not found to have a renal tumor. The diagnosis of left renal tumor was made by the abdominal CT carried out after the operation on cerebellar hemangioblastoma. The fourth patient was a 60-year-old female with microscopic hematuria found in AMHTS and the diagnosis was confirmed by calyceal deformity shown in IVP. The last patient was a 64-year-old male and was accidentally demonstrated to have a right renal mass by ultrasonography when he was reexamined for the hepatic abnormality found in AMHTS. He showed microscopic hematuria in the AMHTS urinalysis. The diagnosis was confirmed by IVP, CT and renal angiography.(ABSTRACT TRUNCATED AT 250 WORDS)
The results of automated multiphasic health testing (AMHT) in a randomly selected population of 664 subjects are reported. AMHT revealed a number of conditions that had not been diagnosed previously. A total of 535 newly diagnosed conditions in 301 patients could be attributed to the survey. The yield of new diagnoses by AMHT was not affected by previous surgery attendance or by attendance intervals. Follow-up over one year revealed that treatment was recommended for 342 of the 535 newly diagnosed conditions and that the response was satisfactory in 189 (55%), but the "uncertain" response of 124 (36%) should be investigated by more thorough follow-up in future projects. It is concluded that AMHT is beneficial because of the amount of information that is revealed, because of the financial value and because of the benefit to patients.
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