Application of local flaps for releasing postburn scar contracture has been limited because of a problem of invisible loss, difficulty to obtain the satisfactory result against correction of limitation of motion and possibility of contour deformity. However, proper use of local flaps, accurate designs and complete wound compression for a long term after operation enable to obtain good results in correction of some cases of postburn scar contracture. It will be related to reduce unsightly scaring when contractures are released. For this purpose, we have used a modified planimetric Z-plasty, a subcutaneous pedicle flap, a new classification V-Y plasties which was proposed based on the new concept and their combination. Proper application of local flaps corresponding to the degree of contracture and shape of burn scar have enabled to increase the use of local flaps against correction of postburn scar contracture during our past 15 years, from 1982 to 1997, we treated 235 cases of postburn scar or scar contracture in various regions except for the face. Of these, 177 cases were applicated with local flaps and we could have a good results in both aspects of function and appearance. We report our operative methods, a criterion to application of local flaps and representative results.
Burns ; Cicatrix* ; Classification ; Congenital Abnormalities ; Contracture* ; Wounds and Injuries

A 84-year-old woman underwent aortic root replacement with stentless bioprosthesis and coronary artery bypass grafting. Four years later, she presented with dyspnea. Transthoracic echocardiography revealed aortic regurgitation, dilation and dissection of the sinus of Valsalva. A Bentall operation was performed by using prosthetic graft and bioprosthetic valve. Intimal tear caused the aortic wall dissection and aneurysm of the Freestyle valve.

Japanese version of the Constitution in Chinese Medicine Questionnaire (CCMQ-J) in Chinese consists of 60 items for 9 sub-scales called Gentleness, Qi-deficiency, Yang-deficiency, Yin-deficiency, Phlegm-wetness, Wet-heat, Blood-stasis, Qi-depression, and Special diathesis. Each question is answered by choosing one form 5 grades of a Likert scale where the grades from 1 to 5 corresponding to Never, Rarely, Sometimes, Often and Always, respectively. In the present study, we examined the relationship of scores based on 597 respondents to 60 items. We tentatively classified 60 items into 12 groups by utilizing the Ward’s hierarchical clustering method and discussed similarity of items and 9 body conditions. Body Mass Index (BMI) and age can be explained by the score of 60 items by partial least square model. Significantly high correlation coefficients between real and estimated values were obtained for BMI (0.81 for male and 0.82 for female) and age (0.82 for male and 0.83 for female). Those results indicate that the answers to the 60 items can reflect aging and BMI properties and CCMQ-J can be used to assess the situation of health for evaluating the actual aging conditions in human.

With the cooperation of Kurobe City, we conducted a basic survey using the nine classification of constitution and an intervention survey using a constitutional guidance program. The basic survey was conducted by the Kurobe group (Kurobe River alluvial fan spring water drinker n=155, 60.6±10.4 years old) and the non-Kurobe group (normal tap water drinker n=99, 50.7±12.8 living in the Hokuriku region without Kurobe City). A total of three surveys were conducted using the constitution Questionnaire (CCMQ-J). As a result, the Gentleness type, which is usually called the healthy constitution, was clearly higher in the Kurobe group, with 44.6 % in the Kurobe group and 22.5 % in the non-Kurobe group. In the proportion of each biased constitution(Mibyo constitution), the Kurobe group had less Wet-heat type (4.5 % vs 11.8 %), Qi-depression type (5.4 % vs 10.7 %), Yin-deficiency type (7.1 % vs 12.3 %) , and Phlegm-wetness type (5.8 % vs 9.6 %) than the non-Kurobe group. After the basic survey was completed, the Kurobe group was randomly divided into two groups, an intervention group (n=65, 62.3±9.3 years old) and a non-intervention group (n=68, 62.7±9.8 years old), and compared with the non-Kurobe group (control group) (n=80, 51.9±13.6 years old). The survey design was a simple comparative study, and the primary endpoint was a comparative study of changes in constitutional scores before and after intervention. As a result, in the Yang-deficiency type, a significant difference was observed between the intervention group, the non-intervention group and the control group at the first time after the intervention (One-way ANOVA p=0.04). No change was seen in the second survey after the intervention. In the comparison of Phlegm-wetness type between the three groups, there was a tendency in the amount of change in the constitutional score (One-way ANOVA p=0.087). From the above, it was suggested that the constitutional survey can not only grasp the health and the pre-symptomatic state, but also improve the pre-symptomatic by combining the guidance methods according to the constitution.

We examined the association of 9 types of the Constitution in Chinese Medicine and body mass index (BMI) and/or the energy intake, which are considered to relate with lifestyle diseases. We obtained data on the Constitution in Chinese Medicine Questionnaire, height, weight, a Food Frequency Questionnaire, age, and exercise habits from 729 subjects through the Internet. We performed multiple comparison tests on the BMIs, the energy intake or the adjusted energy intake for age, height, weight, and exercise habits between types of the Constitution in Chinese Medicine. In women, the BMIs were not significantly different between personality types of the Constitution in Chinese Medicine. In men, the BMI of the yang-deficiency group was significantly lower than the ones of the gentleness, qi-deficiency, or phlegm-dampness groups (p = 0.0098, 0.029, or 0.040, respectively). No significant relationship was found between energy intake or adjusted energy intake and types of the Constitution in Chinese Medicine in men or women. Further studies are required to determine whether the Constitution in Chinese Medicine are useful for reducing risk factors for lifestyle diseases.

In this study, we proposed an approach to interpret the classification of body constitution based on the Japanese Version of Constitution in Chinese Medicine Questionnaire (CCMQ-J) in terms of an augmented questionnaire combining seven independent questionnaires. The augmented questionnaire consists of 254 questions in terms of seven categories of attributes, which are the (i) basic information (BI), (ii) disease (DI), (iii) social factors (SO), (iv) mental factors (ME), (v) dietary habits (DH), (vi) sleeping state (SL), and (vii) sub-health (SH). The partial least square (PLS) regression has been adopted to model the correlations between the scores of body constitutions and the questions, and their results show that the body constitution can be represented by the linear combination of the questions substantially (correlation coefficients between the true and predicted constitutions are all above 0.7). Moreover, by using the crowdsourcing technique in data collection, a total of 851 samples (350 males and 501 females between 20 and 85 years old) samples with diverse geographical backgrounds in Japan have been collected, from which new medical implications have been extracted through the discussion in a Traditional Chinese Medicine standpoint. This study serves as a crucial step for validating the philosophy of ancient Chinese medicine by the state-of-the-art information science techniques and facilitating the use of the CCMQ-J in public healthcare.

Chinese Medicine Questionnaire (CCMQ-J) consists of sixty independent questionnaires and 9 physical constitutions called subscales. One type is balanced constitution (i.e., gentleness), and the following eight types represent unbalanced constitution: Qi-deficiency constitution, Yang-deficiency constitution, Yin-deficiency constitution, Phlegm-dampness constitution, Damp-heat constitution, Stagnant Blood constitution, Stagnant Qi constitution, and Inherited Special constitution. In this study, we proposed to determine optimal number of groups in 851 participants recruited from crowdsourcing answered CCMQ-J questionnaire consisting of 60 questions. In the present study, we applied k-means clustering with gap statistics to the questionnaire data and the number of optimal groups was estimated by five. The five groups are mainly characterized by 3 subscales in CCMQ-J, i.e. (i) two subscales corresponding to Yang-deficiency and Qi-depress, (ii) three subscales corresponding to gentleness, Yang-deficiency and Qi-depress (iii) Yang-deficiency, (iv) gentleness, and (v) Qi-depress. In the crowdsourcing survey, two subscales, Yang-deficient and Qi-depress are the most frequently occurred in current Japanese people.

Variety of accessibility to edible species in different regions has climatic and historical roots. In the present study, we try to systematically analyze 28,064 records of relationships between 11,752 edible species and 228 geographic zones by hierarchical clustering. The 228 geographic regions were classified into 11 super groups named as A to K, which were further divided into 39 clusters (CLs). Of them, at least one member of each of 28 CLs is associated to 20 or more edible species according to present information of KNApSAcK DB (http://kanaya.naist.jp/KNApSAcK_World/top.jsp). We examined those 28 CLs and found that majority of the members of each of the 27 CLs (96%) have specific type of climate. Diversity of accessibility to edible species makes it possible to separate 8 geographic regions on continental landmasses namely Mediterraneum, Baltic Sea, Western Europe, Yucatan Peninsula, South America, Africa and Arabian Peninsula, Southeast Asia, and Arctic Ocean; and three archipelagos namely, Caribbean Islands, Southeast Asian Islands and Pacific Islands. In addition, we also examined clusters based on cultural exchanges by colonization and migration and mass movement of people and material by modern transportation and trades as well as biogeographic factors. The era of big data science or data intensive science make it possible to systematically understand the content in huge data and how to acquire suitable data for specific purposes. Human healthcare should be considered on the basis of culture, climate, accessibility of edible foods and preferences, and based on molecular level information of genome and digestive systems.