A case of a 51-year old male with pulmonary valve endocarditis accompanied by aortic regurgitation, and ruptured aneurysm of Valsalva sinus was reported. Repeated blood cultures grew α-streptococcus on a single occasion. After medical treatment, resection of pulmonary valve vegetation, resection and patch closure of aneurysm, and aortic valve replacement were performed successfully. Twenty one cases of pulmonary valve endocarditis reported in Japan, including our case, were collected and reviewed. Causative organism was streptococcus in 93% of cases. No case of intravenous drug abuse was found in this series. A variety of preexisting heart diseses were found in 20 cases out of 21 (95%). All these diseases were congenital ones, such as ven-tricular septal defect, patent ductus arteriosus, pulmonary stenosis and ruptured aneurysm of Valsalva sinus. This fact means that jet lesion of pulmonary valve is a major predisposing factor of pulmonary valve endocarditis. Surgical procedures were reported in 12 cases: resection of vegetation in 4 cases, resection of pulmonary valve in 2, and pulmonary valve replacement in 5. Appropriate surgical procedures should be chosen, depending upon the activity of infective endocarditis, severity of destruction of the valve, and pulmonary vascular resistance.

A 70 year-old male with nodular multiple angiitis visited our outpatient clinic because of cold sensation and dysthesia. Although the vascular disease went into remission with steroid and immunosuppressant use, dysthesia continued. An improvement in subjective symptoms was evaluated with a visual analogue scale, after Gosha jinki-gan extract was administered on the basis of Kampo diagnosis. Furthermore, this beneficial effect increased when Syuchibushi matsu administration was added. Thus far, there are no such reports on Goshajinkigan as being useful for nodular multiple angiitis. Although the direct effect was not seen on the peripheral nerve conduction velocity, Goshajinkigan might be useful for the treatment of subjective cold sensation and dysthesia symptoms, in patients with nodular multiple angiitis. The mechanism of the above effect is considered to be similar to that in diabetic peripheral neuropathy.