We describe the case of a 60-year-old woman with severe aortic stenosis and severe calcification of the thoracic aorta, who underwent an apico-aortic conduit bypass using an aortic valved graft. Because of stenosis of the annulus of the aortic valve and severe calcification of the thoracic aorta (porcelain aorta), we did not perform ordinary aortic valve replacement. Instead, apico-aortic conduit bypass surgery was performed using a St. Jude Medical Aortic Valved Graft (19-20 mm : St. Jude Medical, St. Paul, MN, USA) and cardiopulmonary bypass (CPB) surgery was performed using descending aortic perfusion and left pulmonary artery drainage, while the subject was in the right decubitus position. The descending aorta was clamped and a 20-mm graft (Hemashield Platinum ; Boston Scientific/Medi-tech, Natick, MA, USA) was sutured to it. Under ventricular fibrillation, the left ventricular apex was circularly resected using a puncher with a diameter identical to that of the 20-mm graft, in order to create a new outflow for the conduit bypass. The graft was sutured to the outflow, and a torus-shaped equine pericardial sheet was used to reinforce the suture line. After recovery of the heartbeat, the aortic valved graft was first sutured to the graft at the outflow and then to the graft at the descending aorta. The CPB time was 285 min and ventricular fibrillation time was 36 min. Therefore, the benefits of using an aortic valved conduit for apico-aortic conduit bypass are reduced operation time, since there is no need to prepare a handmade valve conduit, and easy management of the grafts which are made of the same material.

Our previous principal component analysis conducting on reference points, lines and angles, and a vectordeveloped polar coordinate system has elucidated that the components of eigenvectors had positive relationships in the curvature of anterior teeth segment, between the protrusion of canines and degree of arch roundness, and in the length-to-width ratio of 62 maxillary dentitions, which were preliminarily classified with reference to the conventional Thompson's morphological descriptions for dental arch forms. In the present study on morphological characters of the maxillary dentitions, we conducted a Fourier analysis on the previously obtained data. We observed that the amplitude of 2nd, 3rd and 4th Fourier harmonics were closely correlated with the length-to-width ratio, curvature of the anterior teeth segment, and the curvilinear contour of maxillary dental arches. In addition, the relationships between previously estimated data and the constant value and the amplitude of the Fourier series were examined by analysis of correlation coefficients (p<0.01). The results of the present study suggest that the morphology of maxillary dentitions consists of three essentials-the length-to-width ratio, the curvature of anterior teeth and the curvilinear contour of dental arches.
Dental Arch ; Dentition ; Fourier Analysis ; Principal Component Analysis ; Tooth

Objective: We examined the effects of low frequency electro-acupuncture therapy (EAT) in young women with‘Hie’symptoms, which were classified according to the presence of the vasomotor dysfunction as determined by the postural change test. Subjects and Methods: Subjects were 43 women (mean age, 21.2 years) who exhibited‘Hie’symptoms. The postural change test was performed in five-minute-loads in a standing position after a rest period of 10 minutes in a spine position. The skin temperature in the lower limbs was measured before and after the test. A stainless steel acupuncture needle (length, 40 mm; diameter, 0.2 mm) was inserted approximately 15 mm in depth at SP6 (Sanyinjiao, Saninko). EAT using an active electrode (needle) at SP6 and a reference electrode (surface electrode) at the lateral-anterior aspect of the lower leg were carried out at a frequency of 1 Hz for 20 minutes. The therapy was provided in a total of 5 sessions, with 1 session per week, and the postural change test was performed after 5 sessions. Thermal images from the medial aspect of the foot to the tibial aspect of the lower leg were captured using a thermography device, and mean skin temperature was calculated in selected regions of the toes and tibial aspect of the lower leg. Effects of the therapy were also evaluated using an original questionnaire (‘Hie’diary) concerning‘Hie’symptoms, which consists of six categorical scales of 14 symptoms including‘Hie’and severity of‘Hie’on a Visual Analogue Scale (VAS) was used. Moreover, changes in health-related quality of life by acupuncture were evaluated using the SF-8 Standard Edition. Results: Subjects were classified according to the results of the postural change test: 23 people (no vasomotor dysfunction group; non-vd group) whose skin temperature in the toe decreased after the postural change and 20 people (vasomotor dysfunction group; vd group) whose skin temperature in the toe increased after the load or showed a different reaction between right and left. In the vd group, the total score of 14 symptoms in the‘Hie’diary was significantly higher, and subjective‘Hie’symptoms showed a more severe score than that in the non-vd group. The bodily pain score in the SF-8 in vd group was significantly lower than a national reference value. After an EAT session, the vd group’s skin temperature on the tibial aspect of the lower leg at 20 minutes after completion of the load was significantly higher than that before the load. Moreover, changes in the VAS score and SF-8 score showed no statistical significant in both groups, but the total score of 14 symptoms decreased significantly in the vd group. Conclusions: We suggested that normalization in the blood vessel reaction in lower limbs by EAT at SP6 contributed to the improvement in the systemic condition that was determined by the postural test. The issue of further investigation is to elucidate the pathogenesis andor establishment of the treatment in the subjects with‘Hie’symptom whose vasomotor function was within normal limits.

Objective: We examined the effects of ontokyu (warm tube moxibustion) medical treatment of GB33 and SP6 on young women with a chilly constitution (‘Hie’ symptoms). Methods: The subjects were 13 female university students (mean age: 20.7± 1.3years). They were assigned to either a GB33 group or an SP6 group in consideration of height for the determinate method by the discriminant analysis of Sakaguchi et al. After a one-week pre-observation period, 1 or 2 ontokyu treatments (Choan NEO, Yamasho) twice a week for four weeks were conducted. The follow-up period was two weeks. Effects of the therapy were evaluated using an original questionnaire (‘Hie’ diary), which consisted of six categorical scales of 14 symptoms and Visual Analogue Scale (VAS) of the severity of ‘Hie’. Results: Three subjects dropped out before 1st week therapy among the 13 subjects, so the number of subjects in both groups became five. There was no significant difference between the 2 groups in terms of age, height, weight, BMI, VAS, and total score for 14 symptoms at the baseline. There was no interaction between the groups for VAS or total score for the 14 symptoms. For both groups, no significant changes could be found in VAS during the intervention period and follow-up period compared with that during the pre-observation period. Although the total score for the 14 symptoms in both groups decreased gradually from the start of intervention for the GB33 group, it significantly decreased in after the 3rd and 4th weeks therapy compared with that in the pre-observation period. For the SP6 group, it significantly decreased in after the 4th week therapy and the 2nd week after finished therapy. For each item of the 14 symptoms, the GB33 group showed significant differences in stiff neck and shoulders and feeling thirsty when their scores between the pre-observation period and the intervention period were compared. In addition, the SP6 group showed a significant difference in stiff neck and shoulders, feeling thirsty, and nervousness when their scores between the pre-observation period and the intervention period were compared. Specifically, stiff neck and shoulders for the GB33 group was significantly reduced in the 1st and 2nd weeks after finished therapy, and feeling thirsty showed significant reduction in after the 3rd and 4th weeks therapy. On the other hand, for the SP6 group, stiff neck and shoulders significantly decreased in after the 2nd and 4th weeks therapy and the 1st and 2nd after finished therapy, as did feeling thirsty in the 4th week therapy and in the 2nd week after finished therapy, as well as becoming nervous in after the 1st, 2nd and 4th weeks therapy. Conclusion: It was suggested that ontokyu medical treatment to GB33 and SP6 for young women with a chilly constitution did not appear to exacerbate the severity of ‘Hie’ after reductions in air temperature, while improving the total score for 14 symptoms similarly.

OBJECTIVEHie (cold sensation) is one of the most common health complaints in Japan. Those who suffer from severe hie are considered as having hiesho (cold disorder). However, exact hiesho symptoms have not been defined clearly and the decision as to whether a person suffers from hiesho is subjective and based on self-awareness. The study was conducted in attempt to develop a standardized hiesho diagnostic scale.

METHODSSubjects comprised 1 146 students. From the self-awareness of hiesho symptoms, males and females were divided into hiesho and non-hiesho groups. Physical, behavioral and adaptive characteristics were compared using the 24-item questionnaire (four-grade survey) and indicators for hiesho symptoms were extracted. Based on the scores, a receiver operating characteristic curve was drawn for the total ordinal scale score of the extracted items in relation to the presence and absence of hiesho symptoms, and an optimal cutoff value was determined.

RESULTSThe self-awareness of having hiesho was found in 23.2% males and in 55.6% females. The sensitivity was 84.5% for males and 83.3% for females in the hiesho groups, and the specificity was 86.0% for males and 85.2% for females in the non-hiesho groups.

CONCLUSIONA questionnaire consisting of the extracted items may be useful to identify hiesho in young males and females with a high level of accuracy.

Adult ; Cold Temperature ; Female ; Humans ; Male ; Surveys and Questionnaires ; Thermosensing

OBJECTIVEHie (cold sensation) is one of the most well-known health complaints in Japan and elsewhere in East Asia. Those who suffer from severe hie are considered to have hiesho (cold disorder). This study was conducted to determine symptoms associated with hie in young females using a survey consisting of the hie scale and hie diary.

METHODSTwo hundred and seventy-one participants were included for the analysis. Survey forms were distributed to the participants. Diagnosis of hiesho was determined by using the hie scale. A discriminant score of over -0.38 was considered hiesho. The Short Form-8 Health Survey Standard Version (SF-8) was used to measure health-related quality of life (QOL). The participants were also asked to respond to the questionnaire evaluating 14 physical and emotional symptoms, utilizing a six-level Likert scale item.

RESULTSThe 1st factor (hie factor) was correlated with hie (r = 0.546), dry mouth (r = 0.332), lower-extremity edema (r = 0.450), headrushes (r = 0.470), shoulder stiffness (r = 0.311), headrushes with chills (r = 0.726), and fatigue (r = 0.359). Cronbach's α of the 1st factor was 0.748, which indicated reliability between the items. When hie factor was the dependent variable, standardized partial regression coefficient was β = -0.387 for physical component score (P < 0.001) and β = -0.243 for mental component score (P < 0.001).

CONCLUSIONThis study indicated that hiesho symptoms among young female adults were associated with bodily pain and general health perceptions of the SF-8 QOL survey.

Objective  We examined the effects of low frequency electro-acupuncture therapy (EAT) on young women who suffered from‘Hie’symptoms, which were judged according to the national normal value of bodily pain (BP) scores from a ”Medical Outcomes Study Short-Form-8 Survey“ (SF-8). Subjects and Methodology  The experimental subjects were 20 women (mean age: 21.2 years old; range: 18-26 years old) who exhibited symptoms of ‘Hie’ symptoms (vasomotor dysfunction) and whose toes’skin temperature increased or showed a different reaction between right and left during a postural change test. A stainless steel acupuncture needle (length: 40 mm; diameter: 0.2 mm) was inserted approximately 15 mm deep at SP6 (Sanyinjiao, Saninko). EAT using an active electrode (the needle) at SP6 and a reference electrode (surface electrode) at the lateral-anterior aspect of the lower leg was applied at a frequency of 1 Hz for 20 minutes. The therapy was provided one session per week for a total of five sessions. Effects of the therapy were evaluated by using an original questionnaire (‘Hie’diary), which consisted of six categorical of 14 symptoms (including of‘Hie’) and Visual Analogue Scale (VAS) of‘severity of Hie’. Moreover, changes in health-related quality of life (HRQOL) by acupuncture were evaluated by using the SF-8 Standard Edition. Results  Subjects were grouped according to their SF-8 BP scores before the therapy: 12 subjects (L group) whose scores were less than the national normal value (42.75 points), and eight subjects (H group) whose scores were more than the national normal value. For both groups VAS levels showed no statistically significant changes, but for the L group the total score of 14 symptoms significantly decreased after the second therapy session compared with scores before the therapy. Moreover, the statistically significant decrease in the total score lasted for one month after the therapy had been finished. Compared with before therapy, the score of ‘vitality’ (VT) significantly increased for the L group one month after the therapy, and those of BP and ‘mental health’ (MH) significantly increased for the L group just after and one month after the therapy. Conclusions  EAT at SP6 on young women with ‘Hie’ symptoms (vasomotor dysfunction) contributes to improvement in overall condition and health-related QOL, and it is occluded that the effect of the EAT was high, because HRQOL was low (the score of BP was low).