We retrospectively investigated the effects of acupuncture on refractory peripheral facial paralysis. Among patients with Bell's palsy or Ramsay Hunt syndrome (type II) who underwent acupuncture between August 1996 and June 2004, were 29 patients with a minimum electroneuronography (ENoG) percent response of 0%, and NET scale-out (14 patients with Bell's palsy, 15 with Ramsay Hunt syndrome). Demographically, they 21 males and 8 females, with a mean age of 44.3±12.8 years. Their disease duration, and paralysis score assessed using the 40-point method (Yanagihara's method) were 43.2±23.9 days and 10.2±2.7 points, respectively. To evaluate treatment response, we employed the paralysis score, and a sequela score assessed using a modification of the sequela evaluation method designed by Nishimoto and Murata et al. The paralysis score exceeded 36 points within 6 months after onset. Five patients (17.2%) without sequelae were regarded as having achieved complete recovery, and 24 (82.8%) as having achieved incomplete recovery. When the minimum ENoG is 0%, recovery within 6 months beyond onset is considered impossible. The results suggest, however, the efficacy of acupuncture.
seconds ; Paralysis ; Acupuncture ; Sequela ; month

We report a 74-year-old woman who developed right-sided Hunt syndrome on July 3, XXXX, and who received stellate ganglion block and an infusion of aciclovir while hospitalized. Steroids were not used due to her diabetes. After discharge, she continued taking vitamin B₁₂, and received stellate ganglion block three times a week, but the paralysis did not show a tendency toward recovery. Following a combination of acupuncture and rehabilitation starting on October 6 (post-onset day 95), the paralysis score, which was 4 points on day 95, showed a tendency toward recovery : 32 points on day 186, and 36 points or more (within the normal range) on day 246. No apparent synkinesis was seen one year after the onset. Although Hunt syndrome appeared to be refractory due to her advanced age, presence of diabetes, unused steroids, complete paralysis with a paralysis score of 8 points or less, and no tendency to recover for three months or more, the results suggested that she responded to the combination of acupuncture and rehabilitation.

We retrospectively compared the treatment effects of electro-acupuncture against in situ acupuncture, in 15 Hunt's Syndrome patients who underwent acupuncture therapy in our institution between August 1996, and June 2004, and who had fulfilled 3 electroneurography (ENoG) criteria with a value of 0% within 90 days after onset, had a paralysis score of <20, and could be followed up for 6 months after onset. Electroacupuncture therapy was performed on the paralysis side of the faces of 8 patients (the electro-acupuncture group), while in situ acupuncture therapy was performed on the remaining 7 (the in situ acupuncture group). No significant differences were observed in the background factors between the two groups. Treatment results were evaluated using the 40-point paralysis score described by Yanagihara, as well as a sequela score, which was a modified method of the sequela assessment developed by Nishimoto and Murata et al. Changes in paralysis scores from first acupuncture therapy, out to 6 months post-onset were compared using repeated ANOVA measures, and Mann-Whitney U tests respectively. Recovery of paralysis scores did not significantly differ between the two groups (p=0.0507), although slightly better recovery was observed in the electroacupuncture group, as compared with the in situ acupuncture group. Additionally, sequelae scores did not significantly differ between the two groups (p=0.51). In recent years, many have been of the opinion that lowfrequency stimulation is contraindicated. In this study, however, the incidence of sequelae did not differ significantly between the electro-acupuncture therapy and the in situ acupuncture therapy groups, although slightly better paralysis recovery was observed in the former.

Coix lacryma-jobi L. var.ma-yuen Stapf (Coix seed) is a grass crop that has long been used in traditional medicine as a nourishing food. However, high-intake safety of the extract of the husks, pellicles and astringent skin of Coix seed has rarely been evaluated. We performed a safety test of hot water extract of all parts of Coix seed (CRD extract) in rats. CRD extract showed no significant toxicity on body weight, blood analyses, urinalysis and histopathological examination in acute toxicity tests.

Coix lacryma-jobi L. var.ma-yuen Stapf (coix seed) is a grass crop that has long been used in traditional medicine as a nourishing food. However, high-intake safety of the extract of the husks, pellicles and astringent skin of coix seed has rarely been evaluated. We performed a 28-day repeated dose oral toxicity test of hot water extract of all parts of Coix seed in rats. The extract showed no significant toxicity on body weight, blood analyses, urinalysis and histopathological examination in acute toxicity tests.

OBJECTIVE: To investigate the clinical feasibility of dual energy subtraction (DES) imaging to improve the delineation of the vocal cord and diagnostic accuracy of vocal cord paralysis as compared with the anterior-posterior view of flat panel detector (FPD) neck radiography. MATERIALS AND METHODS: For 122 consecutive patients who underwent both a flexible laryngoscopy and conventional/DES FPD radiography, three blinded readers retrospectively graded the radiographs during phonation and inspiration on a scale of 1 (poor) to 5 (excellent) for the delineation of the vocal cord, and in consensus, reviewed the diagnostic accuracy of vocal cord paralysis employing the laryngoscopy as the reference. We compared vocal cord delineation scores and accuracy of vocal cord paralysis diagnosis by both conventional and DES techniques using kappa statistics and assessing the area under the receiver operating characteristic curve (AUC). RESULTS: Vocal cord delineation scores by DES (mean, 4.2 +/- 0.4) were significantly higher than those by conventional imaging (mean, 3.3 +/- 0.5) (p < 0.0001). Sensitivity for diagnosing vocal cord paralysis by the conventional technique was 25%, whereas the specificity was 94%. Sensitivity by DES was 75%, whereas the specificity was 96%. The diagnostic accuracy by DES was significantly superior (kappa = 0.60, AUC = 0.909) to that by conventional technique (kappa = 0.18, AUC = 0.852) (p = 0.038). CONCLUSION: Dual energy subtraction is a superior method compared to the conventional FPD radiography for delineating the vocal cord and accurately diagnosing vocal cord paralysis.
Absorptiometry, Photon/*instrumentation/*methods ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Observer Variation ; Reproducibility of Results ; Sensitivity and Specificity ; Subtraction Technique ; Vocal Cord Paralysis/*radiography ; Vocal Cords/radiography ; *X-Ray Intensifying Screens ; Young Adult