The objectives of treatment for diabetes mellitus are to prevent complications and to inhibit or reduce the progression of disease. For these purposes, a physiological blood glucose level must be maintained. Cramps in both legs and other symptoms believed to be complications of diabetes mellitus were treated by acupunctural therapy. A diagnosis of diabetes mellitus was made by internists in all patients evaluated in this study. We investigated whether our treatments had any effect on the diabetic status of these patients. Our records were kept on diabetes charts devised by members of the local branch of the Japanese Society of Acupuncture and Moxibustion Therapy. After beginning acupunctural treatment, the fasting blood glucose levels and levels of hemoglobin A_1C were improved. Both the fasting blood glucose level and the hemoglobin A_1C level serve as important indicators of symptoms and complications in patients with diabetes mellitus. Our findings have shown that acupunctural therapy is effective in treating diabetes mellitus. Treatment of diabetes by acupuncture also lead to the amelioration of symptoms due to its complications.

The number of diabetics is now on the increase in Japan. It was said several ten years ago that diabetics could not live long. Now, however, they can live as long as healthy people with advanced medical care.
The recent treatment of diabetes is done chiefly to prevent complications. Nevertheless, there are no effective treatments to prevent complications except for basic therapy such as diet or exercise. In the 51st conference of the Japan Endocrinological Society (1978), we reported the effects of acupuncture on alloxan-induced pancreatic island injury of DDY mice. We report here a clinical study on a patient with diabetes: Acupuncture therapy was applied to the patient, and observation on changes in the diabetic condition such as subjective symptoms or blood sugar value, and in some phisical and chemical findings which indicate complications, was undertaken.
CASE REPORT
A patient with a long history of diabetes, who had been diagnosed in 1959, showed drastically changed symptoms since that time. When first examined in our clinic, fasting blood sugar (FBS) was 328mg/dl. The patient complained of amblyopia caused by diabetic cataract, malaise, anorexia, shoulder stiffness, a sensation of fullness in the abdomen, etc. On and after July 31, 1981, acupuncture therapy was applied everyday or every other day.
After the institution of acupuncture therapy, the subjective symptoms were gradually improved. FBS fell into the normal level (105mg/dl) on Aug. 17, 1982. The influence of another therapy which the patient concurrently underwent was also discussed.

According to the recent advanced studies on diabetes mellitus, the types of the disease are complecated. So it is too difficult to do treatments for the patients. And then, it is important that the patients themselves must do self-controls such as taking special diet or doing specific exercise. And the purpose of treatment of diabetes is chiefly to prevent the advancement of the complications of the diseases.
The authors report here the curative effect of the acupuncture therapy on the patients suffering from diabetes mellitus with its complications in a various advanced stages. Three patients were done the acupuncture therapy who had clinically diagnosed as diabetes mellitus and the acupuncture therapy was applied everyday or several times a week. We observed clinically the changes of the diabetic conditions such as subjective symptoms or FBS (Fasting Blood Sugar Level).
Following the acupuncture therapy, the patients of three cases were reduced gradually the subjective symptoms and controled FBS to the normal level. However, when the intervals of acupuncture therapy were elongated or acupuncture therapy was postoponed, blood sugar levels showed an unstable tendency.
Therefore, the authors concluded that it was necessary to treat the diabetic patients with more longer and frequently with.

Mitral valve reoperation through a median sternotomy is technically challenging and carries higher postoperative morbidity and mortality than the primary operation, especially for a patient with patent coronary bypass grafts. We here present 3 cases of mitral valve reoperation using the beating heart technique under normothermic cardiopulmonary bypass via a mini-thoracotomy. The reasons that precluded sternal reentry were as follows : previous coronary bypass and patent internal mammary artery grafts in 2 cases, and a history of mediastinal wound infection at the initial operation in 1 case. All cases were carried out via right mini-thoracotomy and cardiopulmonary bypass using arterial cannulation via the ascending aorta or the femoral artery, and venous cannulation via the femoral vein and the superior vena cava. Mitral valve repair was performed for 1 case, and valve replacement for 2 cases. Transfusion was not necessary, except for 1 case that had anemia due to hemolysis preoperatively. All patients were discharged without major complications. This technique is a safe and feasible option for a mitral valve reoperation that excludes re-sternotomy, extensive pericardial dissection and aortic clamping, thereby minimizing risks of bleeding, graft injury and myocardial damage.

An increase of aortic valvular disease associated with congenital bicuspid aortic valve is observed due to the relative decrease of rheumatic valvular diseases. A total of 24 patients with aortic valvular disease associated with congenital bicuspid aortic valve underwent surgical treatment at our institution during the period from January, 1997 to December, 1999. These 24 patients constituted 46.2% (24/52) of all cases of surgical operations for aortic valvular disease. The age of the patients ranged from 17 to 83 years (mean 62 years). They consisted of 16 men (66.7%) and 8 women. Two patients had infective endocarditis. The classification of congenital bicuspid aortic valve was right-left cusp type in 15 patients (raphe+: 11), anterior-posterior cusp type in 9 patients (raphe+: 9). We performed aortic valve replacement in 22 patients, aortic root replacement in 1 patient and aortic root remodeling in 1 patient in combination with mitral valve plasty in 3 patients, coronary artery bypass grafting in 3 patients and closure of the atrial septal defect (ASD) in 1 patient. We detected ASD in 1 patient, ventricular septal defect in 1 patient and high-posterior take-off right coronary artery in 1 patient. Patients with stenosis often have a small aortic annulus and severe post-stenotic aortic dilation. Preoperative and intraoperative evaluation is important in cases of aortic valvular disease associated with congenital bicuspid aortic valve.

Although the efficacy of acupuncture in treatment of various diseases has been empirically established, systematic demonstration of this point has been rarely made. Our animal experiments designed to prove the efficacy of acupuncture on a scientific basis are reviewed here.
Each of the following experiments was carried out on two to five groups of mice. Mice in acupuncture group (A-animals) were acupunctured at four to seventeen points on every second or third day beginning with the first experimental day.
Exp. I. The preventive effect of acupuncture on acute poisoning by carbon tetrachloride-With carbon tetrachloride (4.16g/kg body weight) injected in the abdominal cavity on the 18th exp. day, all the non-acupunctured mice (N-animals) died in 72 hours after the administration, while 16% of the A-animals survived.
Exp. II. The curative effect of acupuncture on subacute liver injury induced by carbon tetrachloride. -Carbon tetrachloride (3.47g/kg b. w.) was administered on the 17th exp. day in the same manner as Exp. I. Levallorphan tartrate (antagonist to narcotics) was given to half of the A-animals (L+A-animals) and control animals (L-animals) before each session of acupuncture. Electron microscopic examination revealed severely injured liver cells in the N-animals and very little changes in the A-animals. The liver of L+A-animals was injured to some extent. Since the explanation of toxicity of levallorphan was refuted by the L-animals, this result suggests that some narcotic substances play a role in the process.
Exp. III. The effect of acupuncture on alloxan diabetes. -Alloxan (6mg) was administered on the 8th exp. day, and the animals were sacrificed on the 30th or 46th exp. day for examination. The N-animals showed extremely high blood sugar, though the A-animals did not. Ultrastructural study revealed that characteristic changes of alloxan diabetes in the pancreas had almost disappeared from the A-animals.
Exp. IV. The effect of acupuncture on renal injury induced by mercuric chloride. -With mercuric chloride (0.2mg/100g b. w.) administered three times a week, 10% of the N-animals and none of the A-animals died during the three-month period. Fairly heavy proteinuria (30-100mg/ml) was detected in the N-animals, though uria of A-animals was almost normal. After a one-month period, the N-animals showed a significant weight loss compared to the A-animals. Through the use of the electron microscope, severe injuries were seen in the epithelium of the renal tubules of the N-animals, and healed injuries in that of the A-animals.
Ultrastructural evidence has been presented that acupuncture is effective in (1) preventing and curing liver injury induced by carbon tetrachloride, (2) curing alloxan diabetes, (3) curing nephritis induced by mercuric chloride. Our hypothesis suggesting the possible mechanism that underlies these effects produced by acupuncture has been briefly explained.