A 64-year old man was admitted to our hospital with a diagnosis of aortic stenosis. Pre-operative chest CT revealed pseudocoarctation of the aorta with a hypoplastic aortic arch, elongation and kinking of the aortic arch and proximal descending aorta. There was also a large aneurysm from the distal arch to descending aorta. We performed a single-stage repair of the aortic lesion from the ascending to the descending aorta with aortic valve replacement. For the surgical approach, transverse clamshell incision was applied safely. Concomitant aortic valve replacement in surgical repair of pseudocoarctation and thoracic aneurysm was rare, and clamshell incision seemed beneficial in such single-stage repair from the aortic root to the descending aorta.

Metastasis to the heart is not so rare, but it is not diagnosed easily during patient's lifetime because clinical symptoms are not related to the nature of the tumor. We present a rare case of resection of cardiac metastasis of liposarcoma. A 37-year-old man suffered from dyspnea on effort was given a diagnosis of heart failure. He had already suffered from primary liposarcomas of the right heel which had been resected at age 28 and 32. Echocardiography revealed pericardial effusion and a tumor exiting from the apex. The mass grew rapidly and was excised using a cardiopulmonary bypass. The pathophysiological diagnosis was metastatic liposarcoma to the heart. The surgical margins of tumor were positive and cancer cells were exposed on the epicardial surfaces on some places. Adjuvant chemotherapy was therefore performed for 6 months. The patient was discharged after a good post-operative course and has been in good health for 40 months since the operation. Despite the generally poor prognosis of metastatic liposarcoma to the heart, combination of surgical treatment and chemotherapy yield a long period of survival in this case. It is important not only to establish the therapeutic strategy for metastatic tumor to the heart but also to detect it at an early stage.

We investigated tte effects of Bukuryoshigyaku-to on cxperimental hemorrhagic shock. Twelve mongrel dogs, which were anesthetized with 26mg/kg of pentobarbital were used, Bukuryoshigyaku-to was given to six dogs and saline solution alone was given to six dogs as a control. Under artificial respiration management, a hemorrhagic shock model was created by modified Wiggers method. The drug was administered by enema immediately after the compensatory phase. Bukuryoshigyaku-to, consistied of 4g Bukuryo (Hoelen), 2g of Kanzo (Glycyrrhizae Radix), 2g Kankyo (Zingiberis Siccatum Rhizoma), 2g of Ninjin (Ginseng Radix) and 2g of Bushi (Aconiti Tuber), which were extracted by boiling for approximately 30 minutes.
The results showed no statistical differences in the changes in the mean arterial pressure and central venous pressure between the two groups. However, the cardiac index was significantly higher in the observation phase in the Bukuryoshigyaku-to group than in the control group. A drop in body pressure was prevented in the traditional Bukuryoshigyaku-to group.
These findings suggest the effectiveness of Bukuryoshigyaku-to in the treatment of hemorrhagic shock.