Acupuncture analgesia were successfuly used in dental extraction in some patients who were sensitive to local anesthetics. In this study this technique was applied to daily conservative dental treatment. Acupuncture analgesia can be established by transcutaneous electric acupuncture-like stimuration (TENS) in stead of inserting needles. The TENS were applied in Hoku point and Large Intestine # 10 with 3Hz at the ipsilateral side of the dental treatment.
Apparatus used were Tokki and Neuro-pulse acupuncture stimulator. Wave forms of both apparatus are spike wave with pulse width of 0.1msec. Plate electrodes were conductive rubber size of 3×4cm and were fixed at Hoku point and Large Intestine # 10 with adhesive tape.
Stimuration was continued from 20 to 30min with the strength of producing mild twitch while patients were sitting in the waiting room. 230 patients of dental conservative treatment were given TENS before cavity preparation, gingival plastic, tooth extraction, pulpectomy and others. Treatment was started under TENS alone, and when patient bigan to complain the intolerable pain, then the subperiosteal infiltration of local anesthetic was performed.
(1) Cavity preparation: 78 (85%) out of 92 were performed only with TENS. In 14 (15%) patients local infiltration were added.
(2) Gingival plastic: 29 Patients were given only TENS. Effect of TENS were excellent for the incision of gingiva, and there were no patients who added local infiltration.
(3) Pulpectomy: 60 Patients had pulpectomy. Only 12 (33%) out of 36 of alive pulp were done under TENS alone. As post arsenic treatment, however, in 23 patients out of 24, removal of already dead pulp was performed under TENS with good result.
(4) Dental extraction: In only 5 patients (23%) out of 22 of molar teeth extraction, extraction was performed under TENS. Non molar teeth extraction had poor results, too.
(5) Scaling caliculi: Scaling of the dental caliculi were done under TENS with excellent results. In conclusion, TENS is a simple and easy maneuver for every dentist to alleviate pains in the conservative dental treatments.

A-75-year-old man had refractory late cardiac tamponade after an off-pump coronary artery bypass grafting. He was initially treated by pericardiocentesis with oral nonsteroidal anti-inflammatory drugs, but the treatment failed. Pericardial fenestration was conducted twice for refractory pericardial effusion during his hospitalization. He presented again with recurrence of cardiac tamponade 2 months after the last pericardial fenestration. Therefore, a pleuroperitoneal shunt system was implanted. He recovered well and was discharged without reaccumulation of pericardial effusion.

To determine whether lipopolysaccharide (LPS)-induced prostaglandin (PG) E2 production is responsible for reduced spontaneous physical activity, we measured LPS ( 1 mg/kg, i. v.)-induced changes in voluntary wheel-running activity for 24 hours in both C3H/HeJ (LPS unresponsive due to a mutation in the tlr4 gene) and C3H/HeN (LPS response) mice. We also examined the effect of tlr4-gene mutation on LPS-induced PGE2 production using peritoneal macrophages from the C3H/HeJ and C3H/HeN mice. In addition, the voluntary wheel-running activity of the C3H/HeN mice, which were injected with the PGE2 inhibitor indomethacin (IM ; 0-20 mg/kg, i. p.) 30 min before injection with or without LPS ( 1 mg/kg), was monitored for 24 hours. Wheel-running activity in the C3H/HeJ mice was maintained in spite of LPS injection, but the activity in the C3H/HeN mice was significantly reduced by LPS injection. In vitro experiment showed peritoneal macrophage PGE2 production to be lower in the C3H/HeJ mice than that in the C3H/HeN mice. IM partially, but significantly, attenuated the LPS-induced reduction in wheel-running activity in the C3H/HeN mice. Our results suggest that the transient reduction in physical activity after LPS injection is partially mediated by LPS-induced PGE2 production, and that other factors also play a role.

Quantitative specification of color of the tongue was performed by chroma meter (Minolta CR-100) according to the Commission Internationale de l'Eclarirage 1976 (L*a*b*) Space, the color was analyzed with digital expressions as L* (value), a* (hue of red-green), b* (hue of yellow-blue) and c* (chroma) values.
The difference of the color of the tongue of the patients before and after administration of herbal medicine extracts for 12 weeks was detected by the chroma meter with statistical significance. The change of the color of the tongue of a diabetic female was also able to record on the course of the cerebrovascular accident.
To analyze the correlation between these quantified values and the findings of the tongue by inspection, 116 patients were devided into four groups (whitish, red, dark and violet) according to the color of the tongue by inspection. Most patients in the violet tongue group showed small b* value. As a group the violet group showed significantly smaller b* value than those of the whitish, red and dark groups. In the L*a*b* space as the b* value becomes small the hue becomes blue.
Analyzing the relationship between the diabetic retinopathy and the b* value, color of the tongue of 21 diabetics was examined by the chroma meter. As the result eight patients with diabetic retinopathy indicated significantly smaller b* value than those of 13 patients without retinopathy.
These obsevations suggest that the color of the tongue would be able to specificate quantitatively by chroma meter, the value measured would be correlated to the finding by inspection of the tongue, and that diabetic retinopathy would related with the hue of blue of the tongue detected by this specification system.

We studied cardiac function and outcome long after aortic valve replacement using a 19mm bileaflet valve. The subjects consisted of 10 of 12 patients living 10 or more years after the operation and 7 of 8 living 5-9 years after the operation. We measured the left ventricular ejection fraction (LVEF), %fraction shortening (%FS), left ventricular diastolic dimension (LVDd), systolic dimension (LVDs), PWT, IVST, and LV-aortic pressure gradient (PG) of in 6 patients each in 10 more years after the operation (Group I) and 5-9 years after the operation (Group II) who underwent ultrasonography, and calculated the left ventricular mass index (LVMI). No statistically significant differences were seen in either parameter in either group. Prognosis was 1 cardiac 2 cancer deaths each in 10 or more years after the operation group. The cumulative survival rate was in 85.7% post operative 5-9 years and 72.7% in 10 years. Although cardiac function was maintained in both groups, more observation is needed from now on because the pressure difference or LVMI may increase.

Median sternotomy is commonly used for suture fixation of a myocardial lead. Instead of this conventional technique, we used the technique of resecting the 5th costal cartilage through a small horizontal skin incision at the left 5th sternocostal junction in 33 patients, between 1980 and 2001. Here we describe this procedure, as well as the outcome of patients who underwent this myocardial lead fixation procedure. A skin incision of about 6 to 8cm was made in the left 5th intercostal space. Approximately 5cm of the 5th costal cartilage was resected through the skin incision. Then, a myocardial lead was sutured on to the anterior wall of the right ventricle. The generator was generally placed in the upper subcutaneous space of abdomen. Additional costal cartilages were removed in 7 patients in whom a larger operating field could not be obtained initially. The electrode was sutured to the right ventricular wall in 28 patients, right atrial wall in 6 patients, and the left ventricular wall in 5 patients. The mean operation time was 150min and mean bleeding during operation was 82ml. Long-term results (258 months at the longest, at the time of writing) showed that all the patients did well, except for one adult who suffered cerebral infarction, and one child with pacing failure. Based on these findings, we believe that this procedure is minimally invasive method, and is good for fixation of a myocardial lead.