Five patients with isolated stenosis of the left main coronary artery or stenotic ostial lesions underwent direct coronary artery surgery. These surgical approaches included vein patch angioplasty in 2 cases, punch out endarterectomy in 1 case, and resection of the thickened aortic wall and transaortic endarterectomy in 2 cases. Early results were satisfactory, except for one case who died due to severe LOS and MOF. In the late postoperative period, one case of vein patch angioplasty died due to cerebral bleeding, and in the other case, stenosis existed in position of distal patch anastomosis. Since direct coronary artery surgery was successful in both early and late postoperative fidings, it is believed to be useful and safe technique if the candidates are selected properly.

To estimate the blood compatibility during extracorporeal circulation, we designed mock circulation system consisted of a membrane oxygenator and vinyl circuit with roller pump. Primed with 200ml Ringer's acetate and 200ml of fresh whole human blood, mock circulation was worked at flow rate 0.5l/min for 6hr. Heparin was not primed, oxygenator did not fill any gases and circulation was keeping at 37°C. The thrombin-antthrombin complex and fibrinopeptide-A showed progressive increase and fibrinogen correspondingly decrease. Nevertheless, the plasmin α2 plasmin inhibitor complex and D-dimer showed minimal changes within normal range in spite of increasing fibrinopeptide B β 15-42. We can not find any signs of secondary fibrinolytic activity. On the other hand, the platelet was persistently activated as shown statistically significant increase in β-thrombogloblin and platelet factor IV. Significant elevations of complement 3a and 4a were seen with increase of complement 5a and activated oxygen productivity by neutrophilic leucocytes. In conclusion, moderate and limited blood alterations occurred in mock cardiopulmonary bypass circuit.

We report the case of a 36-year-old male who presented with an abdominal complaint after straightening of irregular teeth. He was examined and treated, however, the cause of the abdominal complaint could not be determined and the treatment was ineffective. He was treated in our clinic with yokukansankachinpihange for obvious pulsation in the supraumbilical region following the oral tradition of Kampo medicine, and the symptom gradually disappeared. We discussed the mechanism of the stomachache in Kampo medicine. After treatment, this case was diagnosed as somatoform autonomic dysfunction in psychiatric medicine. Advanced treatment by a psychiatrist was necessary to treat this disease in psychiatric medicine. In this case it is suggested that treatment following the oral tradition of Kampo medicine was effective.