Optional Examinations

Note : We do not accept optional examinations only

Examinations with * mark are included in the overnight basic examination package

• Brain
• Heart
• Lungs
• Liver
• Pancreas
• Colon
• Gynecology
• Mammary
• Bones
• Tumor markers
• HIV antibody
• Helicobacter Pylori antibody
• Allergy test
• PET examination

Brain Screening

Brain MRI/MRA and Cervical MRA

Brain MRI/MRA and cervical MRA are performed to find any aneurysms that may cause subarachnoid hemorrhage and screen for the presence of small cerebral infarction. Although rare, the examination is also helpful in detecting brain tumors. Visualization of the cerebral arteries and the carotid arteries enable us to find any narrowed area in these blood vessels. We will ask you to simply lie down while the examination is conducted, which will take about 30 minutes. There is absolutely no pain. The images are created by magnetic fields so you will not be exposed to radiation. We can also perform test on your cognitive function upon request. This test measures the degree of atrophy of the region of the brain associated with memory called the hippocampus using MRI images.

Carotid Artery Ultrasonography

This is an examination to visualize the carotid arteries by ultrasound. When arteriosclerosis progresses it leads to hyperplasia and constriction of the vessel walls.

Note:

The following persons cannot receive this examination.

• Those who have metal implants (magnetic substances) such as a pacemaker for your heart and dental implants in your body (denture and dental prosthesis are fine)
• Those who are suspected to be pregnant
• Those who are extremely claustrophobic
• Those who have had craniotomy

Please be aware that the following person may not be able to receive this examination.

• Those who have received a dental implant treatment.

Heart Screening

Cardiac Ultrasonography

This examination is to check the movement of the heart by ultrasound. Generally, if the cardiac muscles become impaired, caused by an infarction, the function of the affected part of the heart deteriorates leading to inhibition of the heart to contract in a unified manner. The heart is separated into four chambers and circulates blood to the lungs and the rest of the body. This examination enables us to assess the condition of the valves that divide these chambers. For those who have been told by a physician that you have a murmur by an auscultation we recommend you to undergo an assessment.

Carotid Artery Ultrasonography

This is an examination to visualize the carotid arteries by ultrasound. When arteriosclerosis progresses it leads to hyperplasia and constriction of the vessel walls.

PWV (Pulse Wave Velocity)

This is an examination to check the speed of pulse waves transmitted from the artery. Blood circulation slows down when the arteries become stiff. This examination is known to be an important examination since stiffness of the peripheral arteries forecast the possibility of vascular impairment of the heart and the brain. We recommend those who have lifestyle diseases（hypertension, diabetes, hyperlipidemia) to undergo this assessment.

BNP

BNP is a type of hormone secreted from the heart. The more the heart is under strain the higher the value for BNP. This examination could be helpful in detecting potential illnesses of the heart that cannot be detected by electrocardiogram alone. Those who are concerned with shortness of breath on exertion or swelling of feet, please consider taking this examination.

Lung Screening

Sputum Cytology

Chest CT Examination*

The main purpose of the lung screening is to detect an early-stage lung cancer. We recommend this course to those who have been smoking for a long time or who have someone in their family with a lung cancer.

Note:

The following person may not be able to receive a chest CT examination.

• Those who have a pacemaker implanted in their heart.

Liver Screening

Besides the hepatic-cystic system enzymes that we normally measure, we also perform fibrilization marker (the value of the marker increases as the liver becomes stiffer by inflammation) and immuno-related examination (antinuclear antibody, anti-mitochondria antibody, IgG, IgA, IgM). We recommend this examination to those who have been pointed out by a physician about his/her liver disorder but hasn’t improved or have never received a clear explanation about its cause from his/her physician.

Besides various blood analyses we also measure the hardness of the liver in this screening. When the liver undergoes prolonged inflammation it tends to get fibrilized and hard (this progressed condition is called cirrhosis). We can measure the hardness of the liver with an advanced abdominal ultrasonic device. The test doesn’t take long and there is no pain. Liver is an important organ having diverse roles. The cause of the chronic liver disorder vary from nutritional conditions or drugs (including alcohol), immuno-abnormality, viral infection, abnormal thyroid function, cardiac dysfunction to congenital metabolic disorder; therefore, the cause of the disorder cannot be determined by a single examination or assessment. Besides the examination, history taking on lifestyle habits often becomes the key in finding the cause. For this reason, we ask cooperation of those who are taking this optional examination to answer to the questions on the liver for the history taking. This is due to the fact that the detailed information such as oral medicine and supplements could become a trigger in determining the cause of the liver disorder. Providing a definitive answer is not always easy but our liver specialists will support in giving you the explanation.

Pancreas Screening

Pancreatic diseases are known to be uneasy to detect and quite difficult to lead one’s life to longevity even after they are found. Examination by the MRI visualize the main pancreatic duct that is where the digestive juice produced by pancreas is released into. If a tumor is present, changes to this pancreatic duct is common and if the main pancreatic duct is constricted or dilated a further detailed examination is required. Moreover, understanding such conditions as the abnormality of confluence with the bile duct (where the digestive juice produced by the liver is released into duodenum) and the characteristics of the bile duct could allow us to search for potential diseases around the pancreatic region. In this screening we use the blood samples to also measure for markers prone to increase with pancreatic cancer. We recommend this examination to those who have concerns over their back pain suspecting a pancreatic disease, those that have someone in the family with a pancreatic disease, or those who consume a lot of alcohol and/or smoke excessively.

Colon Screening

Colonoscopy (or a barium enema examination) *

The purpose of this screening is to detect colon cancer at an early stage. Colonoscopy is a procedure where an endoscope is inserted from the anus and the mucous membrane of the colon is directly observed. So far, this procedure is known to
be the most definitive way to diagnose a colon cancer at an early stage. This examination is also helpful in detecting ulcer and polyp in addition to the colon cancer. For those who are undergoing an overnight screening, the barium enema examination, a procedure where the barium is inserted from the anus and the colon is observed under the X-ray fluoroscopy, is also available.

Colon CT Examination (colonography)

After the colon is emptied by a laxative it is then distended by carbon dioxide before being examined using a CT, which will create an image similar to those photographed by colonoscopy examinations. You can receive an examination by the CT device simply
by lying on your stomach or on your back; therefore it is a very convenient test. We recommend this examination to those who are interested in receiving a colonoscopy but afraid to do so. The negative aspects are that you will be exposed to radiation, that good images cannot be obtained for those who were not able to empty their colon completely, and that small polyp and smooth
lesions are difficult to detect. Please feel free to consult us upon your understanding of these shortcomings.

Gynecology

Corpus uteri (Uterine Body) Cytology

Corpus uteri cytology is an examination that collects the cells from a deeper part of your uterus by inserting an instrument to retrieve the cells. This procedure may cause some pain, irritation and a small amount of bleeding. We recommend this examination to those who are over 40 years old and have concerns over postmenopausal bleeding and abnormal vaginal bleeding.

Breast Checkup*

Surgical consultation, mammography, breast ultrasonic

The purpose of this screening is to detect small undetectable breast cancer that cannot be found simply by palpation by using a mammography X-ray combined with an ultrasonography. We particularly recommend to the following people:

• Those with a mother or a sister who have a history of breast cancer
• Those with a history of breast cancer or other breast disorders
• Those that gave birth for the first time after the age of 35 (primipara) or who have not given birth (nulliparous)
• Who are considered to be obese due to over-nutrition

Note:

Please be aware that the following persons cannot receive the mammography examination.

• Those with breast implants
• Those who are suspected of being pregnant
• Those who are breastfeeding

Bone Screening

Bone mineral quantity examination

Marker for bone metabolism

There are bone-building cells（bone formation）and bone-breaking cells (bone resorption) inside the bones working continuously to metabolize.

It is well known that our bone mass decline from aging. This is associated with bone aging and it is considered that the balance between the bone formation and bone resorption become more prone to inclining towards the negative balance. Moreover those who have reached menopause are more likely to develop osteoporosis（condition where the reduced bone mass increases the risks of fracture）since production of the female hormone ‘estrogen’ that aids bone formation and resorption declines with age. The purpose of bone screening is to help prevent osteoporosis by measuring the amount of calcium in the bone. The amount of bone calcium is measured by using a special device on the X-ray photograph of the lumbar vertebra. The time required for the measurement is approximately 10-15 minutes and there is absolutely no pain.  By performing a further measurement of the bone metabolism marker you will be able grasp the current condition of your bone metabolism. You will also be able to make appropriate decisions regarding treatment if you develop osteoporosis.

Bone metabolism marker
Bone formation marker	Bone resorption marker
Blood work Bone (specific) alkaline phosphatase：BAP	Urine analysis Type I collagen crosslink N- telopeptide : NTX, deoxypyridinoline : DPD

Note:

Please note that the following person cannot receive this examination.

• Those who have metal implements（magnetic substances）such as pacemakers for your heart and dental implants in your body（denture and dental prosthesis are fine）
• Those who are suspected to be pregnant

Tumor marker

When cells become cancerous they produce specific substances or they produce some substances that already exist in a large amount. These substances escape into the blood and urine; therefore, we can learn about the existence of the cancer by measuring these substances.

Tumor marker for cancer of the digestive system

CA19-9

It is considered that the positive rate is high for cancers of the digestive system, particularly for a pancreatic cancer, gallbladder cancer and bile duct cancer. For women the presence of ovarian cancer and endometrial cancer could mark a high value in this measurement.

AFP

This is a typical tumor marker for hepatoma. Measurement for this marker is available especially for those who are hepatitis B and hepatitis C virus careers and suffer chronic liver disorders caused by these viruses.

Tumor marker for lung cancer

It is known that different tumor markers are produced for the lung cancer depending on the type of primary cell. It is considered that the positive rate is high in CEA for adenocarcinoma, CYFRA for squamous cell carcinoma and ProGRP for small cell carcinoma.

The tumor markers mentioned above are the typical markers available for the optional examination.

As shown in the results of the blood work, these markers are not specific to cancer. A marker could be positive even if you don't have a cancer (such as inflammation). Cancer is often indicated as negative at an early stage of cancer and could be indicated as negative even for a progressive cancer.  Please note that tumor markers are nothing more than a rough indication.

HIV antibody

This examination is to screen for the presence of AIDS virus infection.

Helicobacter pylori antibody

We check for the presence of Helicobacter Pylori virus by examining blood samples. The result of a previously infected person（past infection）will also be positive. Pylori virus is a bacteria living in the human stomach and is associated with the outbreak of gastritis, stomach and duodenum ulcers and gastric cancer. Obviously not all people who are infected by Pylori virus develop gastric cancer and stomach and duodenum ulcers. However, if you undergo an eradication therapy, your chances of inhibiting the outbreak and recurrence of such diseases increase; therefore, generally those who are infected are recommended to undergo this therapy.

Allergy test

This test is to find out what are the causes and potential antigen of allergy disorders (generally, antigen is considered to be an external substance entering the body). We collect blood samples then screen the allergic reaction of the suspected antigen.

PET Examination