<b>Effectiveness of the Japanese Herbal Shakuyakukanzoto for </b><b>Pain Relief in an Outpatient Emergency Setting</b> / 日本東洋医学雑誌

<b>Purpose </b>: Shakuyakukanzoto (SKT ; peony and licorice decoction) is a Japanese herbal medicine that is useful in the treatment of acute pain.<br>We investigated the effects of SKT on pain in patients who visited to an outpatient emergency department for painful conditions such as acute gastroenteritis.<br><b>Methods </b>: Thirty patients were enrolled. All participants received 2.5 grams of SKT powder. Pain intensity was measured at baseline and 30 minutes after SKT administration using a visual analog scale (VAS). Patients were asked to rate their pain on a scale from 0 to 100 (0, no pain ; 100, excruciating pain).<br><b>Results </b>: The overall mean VAS score was 71.03 ± 19.42 at baseline and significantly improved to 34.86 ± 34.89 at 30 minutes after SKT administration (P < 0.01).<br><b>Conclusions </b>: SKT was highly effective in managing pain-related emergencies in an outpatient setting. Patients with acute gastroenteritis and tension headache experienced the greatest pain relief.

Preoperative Risk Factors for Residual Aortic Regurgitation after Valve Re-Suspension Procedure in Acute Type A Aortic Dissection / 日本心臓血管外科学会雑誌

This study evaluated factors influencing residual aortic regurgitation (AR) after valve re-suspension surgery for acute type A aortic dissection. From January 1996 through December 2002, 63 patients were treated for acute type A dissection at our institution. Among these 63 patients, pre-and postoperative echocardiograms were available in 38 patients who underwent surgery combined with native aortic valve re-suspension. These 38 patients were divided into 2 groups according to the postoperative AR grade, i. e.: AR group: AR grade≥II (<i>n</i>=6), no-AR group: AR grade≤I (<i>n</i>=32). The severity of pre and postoperative AR was assessed by transthoracic or transesophageal echocardiography. The preoperative diameters of mid ascending aorta and sinotubular junction, and the percentage of the circumference of the dissection at the sinotubular junction level was measured by enhanced CT scan. Preoperative patient backgrounds were similar in both groups. The preoperative AR grade in the AR group was significantly greater than that of the no-AR group (2.25±1.17: 0.69±0.91, <i>p</i><0.001). The tear was more frequently located in the ascending aorta in the AR group than in the no-AR group (66.7%: 37.5%, <i>p</i><0.05). The percentage of circumference of the dissection at the sinotubular junction level did not affect the preoperative AR grade, but it did show a tendency to influence the severity of postoperative AR, though the difference was not significant. Three patients (7.9%) had AR grade III at the time of discharge, but did not clinically require further surgical intervention. Preoperative significant AR and the location of the tear in the ascending aorta are associated with postoperative residual AR after aortic valve re-suspension. The percentage of circumference of the dissection at the sinotubular junction level might influence the severity of postoperative AR.