We report the rare case of a 68-year-old man, who was admitted to our hospital with a diagnosis of aortic arch anastomotic pseudoaneurysm, with concomintant aortic root enlargement and coronary artery stenosis. Eleven years previously, at age 56, he underwent total arch replacement with island reconstruction for chronic aortic dissection. We performed redo total arch replacement, aortic root replacement and coronary artery bypass, making use of a cardiopulmonary bypass with cannulation through the right subclavian artery, femoral artery and femoral vein before resternotomy. We also used selective cerebral perfusion. Postoperatively, the patient temporarily required reintubation ; however, he was discharged in good condition on the 50th post-operative day. The case suggests that island reconstruction has the potential to cause an aortic arch pseudoaneurysm, particularly after a long postoperative period of time. Therefore, thorough postoperative care strategy is required. We also need to consider surgical reconstructive techniques which eliminate vascular lesions as much as possible at the time of the primary surgery, particularly in cases of chronic aortic dissection.

Objective：This study aimed to examine the effect of experiencing parent-child separation on the social adaptive skills of children with cerebral palsy.Methods：The subjects were children with cerebral palsy who belonged to special schools. They were divided into two groups based on whether or not they would experience parent-child separation by participating in the camp activity. Asahide-shiki Social Adaptability (ASA) was used to evaluate their social adaptive skills. ASA consists of four specified sub-scales, namely “language,” “daily living,” “social life,” and “interpersonal relationship”．The data were analyzed using two-way repeated-measures ANOVA with the group and the time of evaluation as the independent variables. The simple main effect test was used, following the Bonferroni method.Results：Interaction was observed at the total skills scores and “Social life” of the sub-scales items, while the time of evaluation was found to have a main effect on the subscale scores of social life and interpersonal relationship. As a result of the simple main effect, improvements in social life, interpersonal relationship and the total skills scores were recognized in the group experiencing parent-child separation.Conclusion：Cerebral palsy children who experienced parent-child separation improved their social adaptive skills, particularly social life and interpersonal relationship skills. For children with cerebral palsy, who lack experience of social participation, extraordinary experiences are an opportunity to review their relationships with people in daily life, and it leads to improvement in their social adaptive skills.