A 9-year-old boy was first noted to have a heart murmur on the 7th postnatal day. Cardiac catheterization at the age of 4 months showed combined valvular and supravalvular aortic stenosis, bicuspid aortic valve and hypoplastic aortic annulus. Emergency open aortic valvotomy was performed. At the age of 6 years, he had infectious endocarditis which was treated medically. Echo-cardiography at this time showed a 90mmHg pressure gradient across the aortic valve. In August 1992 and in March 1993, ballon valvuloplasties were done but without a significant reduction in the pressure gradient. In July 1993, when the patient was 7 years old, repeated surgical valvotomy and Doty's aortoplasty were performed. Two years later the boy had exertional dyspnea, and a cardiac catheterization showed pulmonary artery pressure of 60/27mmHg, and a 110mmHg pressure gradient across the aortic value. In July 1995, he underwent aortic valve replacement with Konno's aortoventriculoplasty, and a SJM 19mm AHP valve was implanted. One year after surgery, he is without any symptoms. Although the end result was acceptable, earlier AVR with Konno procedure may have spared the child from one extra surgical procedure. Strategic options in the surgical therapy of this condition are discussed.

This study investigated the population prevalence of chronic arterial occlusion (CAO) using the ankle pressure index (API) of patients with lower back pain in an acupuncture clinic. The API was measured in 60 lumbago patients ≥ 50 years old at the Meiji College of Oriental Medicine Acupuncture Center. There were 19 patients (31.7%) with unilateral or bilateral API < 0.9, which was presumed to indicate CAO. Thirty-four patients had symptoms in the lower limbs, and 17 of 34 patients showed an API below 0.9. In all but 4 patients (13 of 17, or 76.5%), laterality of the lower API and the symptoms were noted. In conclusion, API measured noninvasively might be useful as a predictor of CAO in acupuncture clinics.

Finger dermatitis among perilla workers have been reported since 1970 in Japan. The agricultural chemicals used for perilla culture and the allergic effects of the perilla itself are discussed as for the causative factors of the dermatitis.
In this report, epidemiological survey and dermatological examination were carried out, with special concern for the prevalence of hazards of each fingers of the workers in relation to their work process, especially picking perilla leaves. Subjects were all of 152 workers who engaged in perilla culture in 2 area in Nankoku, Kochi Prefecture. And the skin patch testing for 32 workers (17 ones with dermatitis and 15 ones without dermatitis) and 20 controls was done using samples of the leaves cultivated without agricultural chemicals for more than 3 weeks and perilla oil extracted from them.
Results were as follows.
1. Skin hazards of the fingers, such as erosion, fissure, desquamation, thickening or bleeding were observed among about half of the workers.
2. The hazards were more frequently observed among the workers whose working hours for perilla culture and picking perilla leaves were longer.
3. The hazards were more frequently observed in the fingers touching the reverse sides of the leaves which had the secreting glands than in those touching the surface sides, on which might be contaminated by agricultural chemicals.
4. The perilla oil acted as the irritating substance for almost all of the examinee, and the skin patch testing demonstrated that both the perilla leaves and their oil caused allergic reactions to the workers with dermatitis.
5. It was considered that the perilla leaves and their oil had played an important role of a cause of the dermatitis among the perilla workers.