[summery]
  Our hospital appointed a pharmacist to be safety control manager of drugs.  With the aim of promoting an appropriate use of drugs, the safety control manager of drugs ensures the appropriate storage, the expiration, and the use record with control drugs following the business procedure every month.  These requirements were confirmed at all divisions of hospital, and then the nonconformity was recorded following the procedure.
  The largest number of nonconformity were entry on drugs unseal date and an exceeded the cutoff point of inventory.  We couldn’t gain sufficient improvement about an appropriate use of drugs.  The causes of this nonconformity were dispersion of drugs at each division and insufficient inventory control of drugs.  We attempted to gather and to keep drugs into one group.  As a result, the number of nonconformity greatly decreased at all divisions.  The amount of money of stock in hospital was decreased by about 20%.
  These results suggested that the confirmation of requirements with business procedure by the safety control manager’s rounds of hospital was extremely helpful method with an appropriate use of drugs.

A 14-year-old boy who underwent aortic valve-sparing operation for annuloaortic ectasia at the age of 9 was referred to our service with a diagnosis of acute type A aortic dissection. Emergency total arch replacement with the elephant trunk technique was done successfully and the postoperative course was uneventful. However, computed tomography (CT) 2 weeks after the operation showed a new dissection and enlargement in left subclavian artery and folded elephant trunk. Dilatation in coronary buttons were also seen since the time of surgery. No residual dissection was found in the aorta. Careful follow up is necessary for this case due to multiple aneurysmal changes and a new dissection lesion in a short period. Loeys-Dietz syndrome (LDS) is characterized by vascular findings (aortic aneurysm and dissection) and skeletal manifestations. Due to aortic dissection occurring in smaller diameter aortas in LDS patients than in Marfan syndrome, early and aggressive surgery is recommended for patients with LDS.