A clinical review of 34 cases of aortic dissection which were admitted to Yeungnam University hospital between March 1983 and April 1992. The results are as follows: 1. The peak incidence was in 5th, 6th decade and male to female ratio was 1.83:1. 2. The most common cause of aortic dissection was atherosclerosis and hypertension (79%). 3. The most common presenting symptom was pain (73%). but dyspnea, palpable mass, murmur, shock were also observed. 4. Abnormal electrocardiographic finding was myocardial ischemia in 6 cases, arrhythmia in 5 cases, LVH in 5 cases. 5. The X-ray findings showed abnormal aortic contour in 10 cases but normal X-ray finding was observed in 63% of DeBaKey Type III. 6. The most common diagnostic procedure was echocardiogram and abdominal Ultrasonography. 7. The mortality of all cases was 20%, operation mortality was 18% but no death of medically treatment in medical indication.
Arrhythmias, Cardiac ; Atherosclerosis ; Dyspnea ; Electrocardiography ; Female ; Humans ; Hypertension ; Incidence ; Male ; Mortality ; Myocardial Ischemia ; Shock ; Ultrasonography

BACKGROUND/AIMS: Obstructive jaundice is developed from the cholangiocarcinoma, biiliary tract stone, biliary benign stricture and pancreatic head cancer and is rapidly progress to cholangitis or sepsis. So early decompression, accurate diagnosis and treatment are very important. Percutaneous transhepatic choledocoscopy (PTCS) and endoscopic retrograde choledocoscopy (ERCS) have been used for evaluation of the obstructive jaundice. We performed, through the PTCS, electrohydraulic lithotripsy (EHL) for biliary tract stone rernoval, biopsy for diagnosis of biliary stric and self expandible metalic coil stent (EndocoilTM stent, Instent Co.) insertion on biliary stricture to evaluate the usefullness of PTCS in patients with obstructive jaundice. METHODS: Between Auguest 1994 and September 1995, PTCS was performed in 37 patients with obstructive jaundice. First, percutaneous transhepatic biliary drainage (PTBD) with 7Fr. drainage tube was done. Three days later, we exchainged the 7Fr. drainage tube with 16Fr.. Seven days later, through the PTCS, we performed EHL, biopsy and EndocoilTM stent insertion.
Biliary Tract ; Biopsy ; Cholangiocarcinoma ; Cholangitis ; Constriction, Pathologic ; Decompression ; Diagnosis ; Drainage ; Head and Neck Neoplasms ; Humans ; Jaundice, Obstructive ; Lithotripsy ; Sepsis ; Stents

OBJECTIVE: The purpose of this study was to determine the perinatal outcome in monoamniotic twin pregnancies and to review the recently published literature about the topic. METHODS: This retrospective study examined the records of prenatally diagnosed monoamniotic twin pregnancy casese in our institution between January 1997 and April 2010. RESULTS: Among 1,112 twin pregnancies, there were 15 (1.3%) monoamnionic twins, including 2 conjoined twin pregnancies. Twelve (80%), 9 (60%), 5 (33.3%), and 4 pregnancies (26.7%) delivered after 20, 30, 32, and 34 weeks, respectively. Among 12 pregnancies that continued after 20 weeks of gestation, three cases showed one-fetal death and one, both-fetal death. The perinatal mortality rate (from 20 weeks of gestation to 28 days after birth) was 37.5%. The incidence of lethal anomalies and congenital heart anomalies was 20% and 23.3%, respectively. The mean gestational age at delivery was 31.4+/-4.53 weeks; 16 of 18 neonates (84.2%) were admitted to the neonatal intensive care unit (NICU). Three neonates expired on the first day after birth. The mean duration of the NICU stays for 13 live neonates was 32.0+/-29.3 days (range, 3 to 114 days). The main causes of perinatal deaths were preterm birth, congenital anomalies, pregnancy loss before 20 weeks, and intrauterine fetal demise that might have resulted form cord entanglement. CONCLUSION: Perinatal mortality in monoamniotic twins was still very high and the survival rate after 32 weeks of gestation is approximately one-third. Further studies are needed to improve the perinatal mortality.
Gestational Age ; Heart ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Parturition ; Perinatal Mortality ; Pregnancy ; Pregnancy, Twin ; Premature Birth ; Retrospective Studies ; Survival Rate ; Twins ; Twins, Conjoined