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

Sheehans syndrome is a known complication of pregnancy, It was described as a syndrome of hypopituitarysm due to acute ischemic necrosis of the anterior pituitary gland secondary to severe postpartum bleeding and shock. The neurophysis is usually preserved. But it can be involved in severe cases manifesting as diabetes insipidus. Because of its rare coexistence with Sheehans syndrome, diabetes insipidus is seldom recognized as a potential postpartum complication. The report describes a patient who developed Sheehans syndrome and diabetes insipidus immediately following delivery. Diabetes insipidus resolved spontaneously after 15 months, while panhypopituitarysm is persistent.
Diabetes Insipidus ; Hemorrhage ; Humans ; Hypopituitarism ; Necrosis ; Pituitary Gland, Anterior ; Postpartum Hemorrhage ; Postpartum Period ; Pregnancy ; Shock

Two cases are herein reported involving patients with ectopic gallstones which were discharged into the stomach and duodenum through a cholecystoduodenal fistula and successfully removed by endoscopic therapy. In the first case, a 75-year-old man was admitted with epigastric pain. Simple abdomen film demonstrated a round laminated calcification and air biliarygram in the RUQ. Endoscopic examination revealed a fistula on the posterior wall of the duodenal bulb and a brown stone (about 5 cm in diameter) was found in the second portion of the duodenum, It was demolished through endoscopic electrohydraulic lithotripsy (EEH1) and discharged with the stool. In the second case, a 55-year-old man was admitted with epigastric pain. A CT scan revealed an ovoid laminated calcification in the dependent portion of the stomach. Endoscopic examination revealed a fistula on the anterior wa11 of' the duodenal bulb and a black pigmented stone (about 2.5 cm in diameter) was found in the stomach. This stone was removed orally by an endoscopic snare. These patients were discharged and remained asymptomatic.
Abdomen ; Aged ; Duodenum ; Fistula ; Gallstones* ; Humans ; Intestinal Fistula ; Lithotripsy ; Middle Aged ; SNARE Proteins ; Stomach ; Tomography, X-Ray Computed

OBJECTIVE: This study aimed to investigate the adolescent brain activation patterns in response to performance feedback (PF), social reward (SR) and monetary reward (MR) and their association with psychological factors. METHODS: Functional magnetic resonance imaging (fMRI) was performed while middle school boys (n=15) performed tests pertained to PF, SR and MR. The brain activation pattern in each condition was investigated, and the extent of brain activation in each of the three conditions was compared at once. RESULTS: The caudate and the dorsal prefrontal area were activated in all three conditions. Furthermore, the cuneus showed significantly greater activation in the PF condition than the SR or MR condition. And the self - related areas, such as the right precentral gyrus and paracenral lobule, were more activated in the SR condition than the PF or MR condition. The left middle frontal gyrus was more activated in the MR condition than the PF or SR condition. CONCLUSION: Not only various reward stimuli but also feedback stimulus might commonly activate dorsal prefrontal and subcortical area in adolescents. Moreover, several different brain activation patterns were also observed in each condition. The results of this study could be applied to planning of learning and teaching strategy for adolescents in various ways.
Adolescent ; Brain ; Humans ; Learning ; Magnetic Resonance Imaging ; Reward

PURPOSE: Important advances in the treatment of acute myelogenous leukemia have been made with the introduction of cytosine arabinoside (ara-C) and anthracyclines (daunorubicin) over the past 20 years. Currently, 60 to 80% of patients with acute myelogenous leukemia achieve complete remission with induction chemotherapy consisting of ara-C and daunorubicin (adriamycin) AD ("7+3"). The one-fourth of complete responders will have extended long-term survival and may be cured. Therefore wetreated patients with acute myelogenous leukemia admitted to our hospital with AD ("7+3") regimen. METHODS: Induction therapy; Thirty four patients with previously untreated acute myelogenous leukemia received AD ("7+3") regimen (ara-C, 200 mg/m2/d by continuous infusion for seven days, and daunorubicin, 45 mg/m2/d for 3 days). The second course of therapy was AD ("5+2"), if the patients failed to enter remission. Consolidation therapy; three cycles of consolidation chemotherapy were administered with at least 4 week interval following remission. Course 1; ara-C at 100 mg/m2 by subcutaneous injection every 12 hour for seven days, 6-thioguanine at every 12 hour 100 mg/m2 orally every 12 hour for 7 days). Course 2; ara-C (same as course 1) at 100 mg/m2 by subcutaneous injection every 12 hour for seven days, vincristine at 1.5 mg/m2 (maximum 2 mg) by bolus injection for 1 day, prednisolone at 40 mg/m2 (maximum 60 mg) orally for 7 days. Course 3; ara-C (same as course 1) daunorubicin at 45 mg/m2 by 1 hour infusion for 3 dyas. RESULTS: Sixty-eight percent of the 34 patients entered complete remission. The remission duration for all patients in complete remission ranged from 4 weeks to 3122+ weeks, with the median of 50 weeks. The median duration of survival in complete responder group was 62 weeks. Twenty-Six percent of patients with complete remission are alive at 5 years. Cases with extramedullary leukemic involvement were found in four patients; M2 with orbital mass, M3 and M4 with CNS leukemia, M5a with subcutaneous nodules. Among the potential prognostic variables including age, initial WBC count, percent of blast in peripheral blood,none was statistically related to prognosis. CONCLUSION: Combination chemotherapy with cytosine arabinoside and daunorubicin is a effective regimen for acute myelogenous leukemia as much as other regimen. Futher clinical trials for effective treatment regimen and method are necessary to raise the complete remission rate.
Anthracyclines ; Consolidation Chemotherapy ; Cytarabine* ; Cytosine* ; Daunorubicin* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Induction Chemotherapy ; Injections, Subcutaneous ; Leukemia ; Leukemia, Myeloid, Acute* ; Orbit ; Prednisolone ; Prognosis ; Thioguanine ; Vincristine