A 61-year-old man with aortic regurgitation was found to have a quadricuspid aortic valve during operation. The aortic valve consisted of four equal sized cusps with an accessory cusp located between the left and right coronary cusps. The right coronary ostium was placed in a lower position. Aortic replacement with a St. Jude Medical prosthesis was performed successfully. Quadricuspid aortic valve is a rare anomaly and 14 cases of quadricuspid aortic valves in the Japanese literature which were corrected surgically are reviewed.

In von Recklinghausen's disease vascular involvement is rare, especially rupture of peripheral arterial aneurysms. A 65-year-old man with previously diagnosed neurofibromatosis was admitted because of left lateral neck and left shoulder pain. Computed tomography and selective left subclavian angiography revealed ruptured aneurysm of left costocervical artery, and therefore an emergency operation was performed. Left costocervical artery was exposed and proximal ligation of the aneurysm was performed. Angiography is a most useful and important procedure in operations for vascular involvement in von Recklinghausen's disease.

Introduction
Taking the GSR to acupoints in rheumatoid arthritis, we observed the following 3 points: the comparison between rheumatoid arthritis and osteoarthritis, the relativity between the clinical symptoms and acupoints, and the effect of acupuncture on the pathema.
Method
Using an apparatus “Memorador Model F-532”, we measured the GSR to SP-3, LV-3, BL-64, GB-40, ST-42, ST-36 and SP-6 together with a check on this symptom and hemanalysis.
Effect
The GSR in rheumatoid arthritis was higher than the other. The GSR in active rheumatoid arthritis was lower than the inactive. It was showed that there were significant differences in KI-3 (significance level under 5%) and SP-6 (under 1%).
Conclusion
We assumed that the pathema might be dependent on the condition of their acupoints. Acupuncture gave a good effect on rheumatoid arthritis.