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Lymphangioleiomyomatosis in Korea (한국의 폐 림프관평활근종증)

  • Mo, Eun-Kyung;Jung, Man-Pyo;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Im, Jung-Gi;Seo, Jeong-Wook;Lee, Seung-Sook;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.519-531
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    • 1993
  • Background: Lymphangioleiomyomatosis(LAM) is a very rare disease occurring in women of reproductive age and leading to progressive respiratory failure despite therapy. But the natural history of this disease is uncertain and although anti-estrogenic agents have been used for more than twenty years, it's efficacy is still in debate. This study was performed to enhance understanding of this fatal disease in Korea by examining clinical, radiological, and pathologic findings of all the previously reported cases of LAM on Korea along with four new cases of LAM whom we report in this paper. Method: Out of twlve cases of LAM previously unpublished and published in domestic papers, two cases whose diagnoses were considered doubtful after review of clinical, radiological, and pathologic findings at "Asian Congress on Lymphangioleiomyomatosis" at Kyoto, Japan in feburary of 1993 were excluded from this study. Six cases which were reported previously and four new cases of LAM whom we report in this paper were analysed for the clinical, radiological, and pathologic characteristics. Results: All ten patients were women with mean age of $33{\pm}7$. The most common symptom was exertional dyspnea and most patients had history of pneumothoraces. Pulmonary function tests showed decreased diffusing capacity. on high resolution computed tomography(HRCT), all the cases had characteristic cysts. Most of the patients did not respond to hormonal therapy. Conclusion: In women of reproductive age, presenting with dyspnea who has a history of pneumothorax, LAM should always be considered as one of the diagnostic possibilities. If suspected, HRCT should be done to look for characteristic cysts and if needed, open lung biopsy should be done to confirm the diagnosis.

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Value of Health, Multidimensonal Health Locus of Control and Level of Self-esteem in Low Income Mothers (도시빈곤여성의 건강가치, 건강통제위성격 및 자아존중감과의 관계)

  • Lee, Kwang-Ok;Yang, Soon-Ok
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.52-68
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    • 1996
  • As a product of poverty, health means the physical, mental and social instability caused by poverty. High mortality, high morbidity, and unsatisfied needs for medical care indicate the health condition of poor people. These indicators are related to the social and psychological property. This study is to develop an effective method of nursing in the poor family which is an essential unit in the nursing field of the community and to which a fundamental approach is need as a top priority. We can make such a study, though partially, by revealing the relationship among the Health-value, Health Locus of Contol, and the Level of Self esteem. We randomly sampled 243 women who are participating in the nursing department of the comnnity nursing centers in Seoul. We investigated by using questionaries and made an analysis on the result by SAS program. The result of this investigation can summarized as follows : 1. The average age of the subjects investigated is 43.4 and the participation rate in the economic activity is as high as 49.4%. Most of them are paid daily. The average members of the family are 4.28 persons, and 80.2% of which are nuclear families. The type of housing is as follows:51.4% are monthly-rent houses. Rent houses represent 23.5%. And 43.6% of the subjects graduate the high schools 2. The level of self-esteem possessed by the subjects is 37.17. The quality of task performance(3.46) and the morality(3.53) are low as compared with the other qualities. 3. In relation to the locus of control, internality is 22.39, the influence of powerrful others represents 20.24, and the effect of chance occurance is 16.41. 4. The orderings of value scale are the physical and mental health, comfortable life, happiness, mental peace, and pleasure. The lowest order is social recognition. 5. Considering in relation to the self-esteem and the locus of control, we found out that there is a negative relationship among the self-esteem, the influence of powerful others. The lower the level of self-esteem is, the higher the influence of powerful others is. There is also a negative relationship among the detailed items such as the qualities, and the positive attitude. 6. In a significant test in the general characters of the subjects and in the level of self-esteem, we can obtain the follwing results. The higher the economic level is, the higher the level of self-esteem is. And the higher the level of satisfaction with life is, the higher the level of self-esteem is. 7. In the locus of control, the higher the economic level is, the higher the internality is. 8. In the health-level, 75.72% represent the high health -level. And the group which has the low satisfaction with life represents the high level of health-value(81.6%). With these results, we can conclude that the level of self-esteem possessed by the poor women living in the city is high and that they have the multi-dimemsional health-value even though they are living in the poor condtions. Traditionally, the poverty has been recognized as an unfavorale factor in the health care. But this study shows that the poverty is no longer an unfavorale factor and, on the contrary, it has a potential power with which people can improve their health by possessing the high self-esteem and the high health value. The ultimate purpose which the nursing task of the community has is to make the patients keep and improve their own health. So, when the nurses approach the poor patients, the nurses should put an emphasis on the individual responsibilities of the patients, and respect their own health value.

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Effect of xylobiose-sugar mixture on defecation frequency and symptoms in young women with constipation (자일로바이오스를 함유한 설탕이 젊은 여성의 변비 개선에 미치는 효과)

  • Lee, Jung-Sug;Kim, A-Reum;Nam, Hye-kyoung;Kyung, Myungok;Jo, Sung-Eun;Chang, Moon-Jeong
    • Journal of Nutrition and Health
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    • v.50 no.1
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    • pp.41-52
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    • 2017
  • Purpose: The objective of the study was to investigate the effects of xylobiose-sugar mixture intake on defecation frequency and constipation symptoms in 31 young women with constipation. Methods: Thirty-one subjects were assigned to two groups, and subjects in each group were administered 10 g of a 7% xylobiose-sugar mixture (Experiment 1: XBS, n = 15) or 10 g of a 7% xylobiose-sugar mixture containing coffee mix (Experiment 2: XBS coffee mix, n = 16) twice per day for 6 weeks. During the study, clinical efficacy was assessed by a daily diary record. The subjects recorded their defecation frequency and fecal characteristics. Results: During pretreatment week, mean defecation frequency of XBS subjects was 2.13 times/week, whereas that of XBS coffee mix subjects was 1.56 times/week. The mean defecation frequencies of XBS and XBS coffee mix subjects increased significantly to 3.73 times/week (p < 0.05) and 3.56 times/week by week 6 (p < 0.05), respectively. After treatment with either XBS or XBS coffee mix, patients presented significant improvements in their amounts of stool, feelings of residual stool leftness, and abdominal pain symptoms (p < 0.05). The total constipation scoring system (CSS) for diagnosing constipation symptoms significantly decreased in the XBS group (10.53 score vs 7.22 score) and in the XBS coffee mix group (10.75 score vs 6.51 score) after 6 weeks. Improvement due to intake of 7% xylobiose-containing sugar seemed to last during the experimental period. Conclusion: The addition of approximately 7% xylobiose to commercially available sweeteners has been shown to improve constipation.

Reduced Ovarian Cancer Incidence in Women Exposed to Low Dose Ionizing Background Radiation or Radiation to the Ovaries after Treatment for Breast Cancer or Rectosigmoid Cancer

  • Lehrer, Steven;Green, Sheryl;Rosenzweig, Kenneth E
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2979-2982
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    • 2016
  • Background: High dose ionizing radiation can induce ovarian cancer, but the effect of low dose radiation on the development of ovarian cancer has not been extensively studied. We evaluated the effect of low dose radiation and total background radiation, and the radiation delivered to the ovaries during the treatment of rectosigmoid cancer and breast cancer on ovarian cancer incidence. Materials and Methods: Background radiation measurements are from Assessment of Variations in Radiation Exposure in the United States, 2011. Ovarian cancer incidence data are from the Centers for Disease Control and Prevention. Standardized incidence ratios (SIR) of ovarian cancer following breast cancer and rectosigmoid cancer are from Surveillance, Epidemiology, and End Results (SEER) data. Obesity data by US state are from the Centers for Disease Control and Prevention. Mean ages of US state populations are from the United States Census Bureau. Results: We calculated standardized incidence ratios (SIR) from Surveillance, Epidemiology, and End Results (SEER) data, which reveal that in 194,042 cases of breast cancer treated with beam radiation, there were 796 cases of ovarian cancer by 120+ months of treatment (0.41%); in 283, 875 cases of breast cancer not treated with radiation, there were 1,531 cases of ovarian cancer by 120+ months (0.54%). The difference in ovarian cancer incidence in the two groups was significant (p < 0.001, two tailed Fisher exact test). The small dose of scattered ovarian radiation (about 3.09 cGy) from beam radiation to the breast appears to have reduced the risk of ovarian cancer by 24%. In 13,099 cases of rectal or rectosigmoid junction cancer treated with beam radiation in the SEER data, there were 20 cases of ovarian cancer by 120+ months of treatment (0.15%). In 33,305 cases of rectal or rectosigmoid junction cancer not treated with radiation, there were 91 cases of ovarian cancer by 120+ months (0.27%). The difference in ovarian cancer incidence in the two groups was significant (p = 0.017, two tailed Fisher exact test). In other words, the beam radiation to rectum and rectosigmoid that also reached the ovaries reduced the risk of ovarian cancer by 44%. In addition, there was a significant inverse relationship between ovarian cancer in white women and radon background radiation (r = - 0.465. p = 0.002) and total background radiation (r = -0.456, p = 0.002). Because increasing age and obesity are risk factors for ovarian cancer, multivariate linear regression was performed. The inverse relationship between ovarian cancer incidence and radon background was significant (${\beta}=-0.463$, p = 0.002) but unrelated to age (${\beta}=-0.080$, p = 0.570) or obesity (${\beta}=-0.180$, p = 0.208). Conclusions: The reduction of ovarian cancer risk following low dose radiation may be the result of radiation hormesis. Hormesis is a favorable biological response to low toxin exposure. A pollutant or toxin demonstrating hormesis has the opposite effect in small doses as in large doses. In the case of radiation, large doses are carcinogenic. However, lower overall cancer rates are found in U.S. states with high impact radiation. Moreover, there is reduced lung cancer incidence in high radiation background US states where nuclear weapons testing was done. Women at increased risk of ovarian cancer have two choices. They may be closely followed (surveillance) or undergo immediate prophylactic bilateral salpingo-oophorectomy. However, the efficacy of surveillance is questionable. Bilateral salpingo-oophorectomy is considered preferable, although it carries the risk of surgical complications. The data analysis above suggests that low-dose pelvic irradiation might be a good third choice to reduce ovarian cancer risk. Further studies would be worthwhile to establish the lowest optimum radiation dose.

Identification and Fermentation Characteristics of Lactic Acid Bacteria Isolated from Dongchimi as Starter for Radish Juice (무 쥬스 제조를 위한 starter로써 동치미에서 분리한 유산균의 동정 및 발효 특성)

  • Kim, Jung-Hee;Kim, Jong-Il
    • Korean Journal of Microbiology
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    • v.35 no.4
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    • pp.307-314
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    • 1999
  • This study was aimed at the investigation of the possibility of the addition of lactic acid bacteria as "starter"for the preparation of radish juice. Forty strains of lactic acid bacteria were isolated from dongchimi that was fermented by a traditional method. The isolates were assorted into 5groups, Leuconostoc mesenteroides subsp. mesenteroides (J-9), Lacobacillus brevis (J-12), Lactobacillus fermentum (J-7), Lactobacillus sake (J-20), and Lactobacillus plantarum (J-39). Leuconostoc mesenteroides was predominated in the sample of dongchimi with frequency of 52.5%. Each of the strain, which exhibited the beat growth in the species, was selected in the 5species, and investigation of the fermentation characteristcis was carried out. The fermentation were performed for 9 days at 25${\circ}C$ after the inoculation of 0.3% ($10^{6}$ cfu/㎖) to each ultra-filtrated radish juice. The pH, total acidity, content of non-volatile organic acids were examined during the fermentation period. Lactobacillus plantarum showed the highest growth rate and the growth rate of Lactobacillus sake was the lowest. The pH (6.3-6.36) and total acidity (0.09-1.0 %) fo the ultrafiltrated radish juice before fermentation were changed to 3.2-4.3 and 0.65-1.2% after 9days, respectively. The changes of the pH and total acidity were related with the growth of the lactic acid bacteria; the better growth of lactic acid bacteria, the more rapid decrease of pH and increase of the total acidity. when the amount of non-volatile organic acids were estimated during fermentation, citric acid, malic acid, malonic acid, and succinic acid were decreased in all cases. However, the content of lactic acid increased with the progression of fermentation. L. mesenteroides (J-9), L. brevis (J-12) and L. fermentum (J-7) were chosen for the candidates of the starter for the lactic fermentation of radish juice based on the biochemical analysis and sensory evaluation.

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The Effect of Acetylcholine on the Intracellular $Ca^{2+}$ Increase of the Mouse Early 2-cell Embryos (생쥐 초기 2-세포 배의 세포내 칼슘 증가에 미치는 Acetylcholine의 영향)

  • Yoon S. Y.;Kang D. W.;Bae I. H.
    • Journal of Embryo Transfer
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    • v.20 no.3
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    • pp.191-200
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    • 2005
  • Many studies have shown that the development of mouse early 2-cell embryos in vitro is related with the intracellular $Ca^{2+}$ changes. In ICR strain mouse, the development of embryos arrests at early 2-cell stage, but the arrested early 2-cell embryos can be rescued by the addition of $Ca^{2+}$-related materials. Acetylcholine (ACh) increases intracellular $Ca^{2+}$ concentration ([$Ca^{2+}$]i) via the mAChR-PLC-IP3 pathway in mouse oocytes. We examined whether ACh rescues 2-cell block in mouse. In early 2-cell embryos, ACh increased [$Ca^{2+}$]i in a dose-dependent manner (p<0.001), and had an effect on rescue of 2-cell block and embryonic development. To identify the signal pathway involved in ACh-induced rescue of 2-cell block, we first applied an agonist of ACh receptor (AChR). Like ACh, carbachol increased intracellular $Ca^{2+}$ concentration ([$Ca^{2+}$]i) and atropine, an antagonist of ACh receptor, blocked the ACh-induced $Ca^{2+}$ increase. In $Ca^{2+}$-free medium, ACh also increased [$Ca^{2+}$]i, indicating that $Ca^{2+}$ increased by ACh is mainly released from the intracellular $Ca^{2+}$ store. The ACh-induced $Ca^{2+}$ increase was blocked by PLC inhibitor (U73122), ryanodine receptor (RyR) antagonist (dantrolene), and CaM KII inhibitor (KN-93), but not by IP3R antagonists (xestospongin C). These results show that ACh increases intracellular $Ca^{2+}$ concentration via mAChR/PLC/RyR, and this contributes to the rescue of 2-cell block.

A Study on the Successful Case of Brand Renewal through American National Brand 'C' Company's Marketing Strategy (미국(美國) 내셔널브랜드 C사(社)의 마케팅전략(戰略)을 통한 브랜드리뉴얼 성공사례(成功事例) 연구(硏究))

  • Koh, Hee-Sook
    • Journal of Fashion Business
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    • v.6 no.1
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    • pp.137-154
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    • 2002
  • It's not easy to renew old brand of over 50 years history to the tastes of new consumer of our time. Most of national brands that has a history of some 20 years in Korea have strove for continuation and growth of brand to no avails, which can be taken as a good example of current situation. For instance, C company, one of the National brand of US which has a history of 51 years, has made its position secure as a fashion group and based itself on a sound foundation by establishing new marketing strategy and completing successful brand renewal in the process of strategic M&A with Italian company. Those successful marketing strategies are as follows. 1) they regarded both market and consumer oriented marketing activity as company's highest priority strategy and put great emphasis upon concentration on target market and reestablishment of brand image of business casual wear. 2) Setting up and operating planning team composed of merchandizer alone in Milano, they set the direction of plan on the basis of concentrated research on potential item in market according to thorough market research done by buying office in Korea, branch office in Hong Kong and buyer in US prior to blueprint planning for season. 3) Great emphasis was placed on business which focused on intensive presentation of basic key item for apparel career women who are main consumer group in the midium-low prices market in US and on supplementation of size and color. they named this line 'collectibles' and helped their customer develop their own clothes plan without worrying about the change of color and fabric by supporting same fabric and color throughout the year and enabled them to add variation easily by supplementing new trend item. 4) Company set black as a main color that lots of apparel career women find easy to care and to express their own image and presented them with pebble which belongs to navy and beige and added fashion color such as wine and brown etc as season goes by. They constructed basic line in order for their customers to coordinate purchased item with new one or to add them to present collection, and to achieve efficient sale by setting up strategy which allows this cross coordination and changing pattern occasionally. 5) Though basic jacket for 99$, short slim skirt for 49$ are products within midium-low prices range, in the material planning stage aiming at production of item that has both resonable function appealing to consumer and is fashionable, synthetic material had to be used as a main source due to price competitiveness. Despite this situation, considering comfortable sense of fit and refined drape of silhouette that has no sign of cheap material, whole collectible line was divided into two items, which contributed to reduction of cost. In case of material that is composed of triacetate and polyester in 70 to 30 ratio, was used up to 4 million yard, which allowed drastic curtailment of cost accompanied by concentration. In case of 'collectibles' line, using Korean material mainly, C company chose to have their product sewed in Southeast Asian countries where transportation is well developed and both productivity and quality verified by operating global production system which aiming at cutdown of cost through outsourcing production from the country where labor cost is low and getting finished product. Polarization between present consumers telling us that consumers with the mind of middle classes in the past no longer exists between consumers who seek after only fine article of highest quality and wise consumers who are sensible enough to judge bubble on correlation between price and quality. To cope with this change in new consumer mind, apparel makes changing their policy so as to produce item that has reasonable quality and falls within affordable price range anywhere in the world. and they're striving to get out of difficult situation by operating global marketing strategy which stresses separation of planning, production and sale and sensibility of fashion shared worldwide. The marketing strategy of C company can be exemplified as a successful one.

Comparative Analysis of $\alpha$-STAT and pH-STAT Strategies During Deep Hypothermic Circulatory Arrest in the Young Pig (초저체온 순환정지시 $\alpha$-STAT와 pH-STAT 조절법의 비교분석 -어린돼지를 이용한 실험모델에서-)

  • Kim, Won-Gon;Lim, Cheong;Moon, Hyun-Jong;Won, Tae-Hee;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.553-559
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    • 1998
  • Introduction: The most dramatic application of hypothermia in cardiac surgery is in deep hypothermic circulatory arrest(DHCA). Because man in natural circumstances is never exposed to this extreme hypothermic condition, one of the controversial aspects of clinical hypothermia is appropriate acid-base management($\alpha$-stat versus pH-stat). This study aims to compare $\alpha$-stat with pH-stat for: (1) brain cooling and re-warming speed during hypothermia induction and re-warming by cardiopulmonary bypass (CPB); (2) cerebral perfusion, metabolism, and their coupling; and (3) the extent of development of cerebral edema after circulatory arrest, in young pigs. Materials & Methods: Fourteen young pigs were assigned to one of two strategies of gas manipulation. Cerebral blood flow was measured with a cerebral venous outflow technique. After a median sternotomy, CPB was established. Core cooling was initiated and continued until nasopHaryngeal temperature fell below $20^{\circ}C$. The flow rate was set at 2,500 ml/min. Once their temperatures were below $20^{\circ}C$, the animals were subjected to DHCA for 40 mins. During cooling, acid-base balance was maintained according to either $\alpha$-STAT or pH-STAT strategies. After DHCA, the body was re-warmed to normal body temperature. The animals were then sacrificed, and their brains measured for edema. Cerebral perfusion and metabolism were measured before the onset of CPB, before cooling, before DHCA, 15 mins after re-warming, and upon completion of re-warming. Results & Conclusion: Cooling time was significantly shorter with $\alpha$-stat than with pH-stat strategy, while there were no significant differences in rewarming time between the two groups. Nosignificant differences were found in cerebral blood flow, metabolic rate, or flow/ metabolic rate ratio between two groups. Temperature-related differences were significant in cerebral blood flow, metabolic rate, and flow/metabolic rate ratio within each group. Brain water content showed no significant differences between two groups.

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Evaluation of the combination of Bone Scan Image and Pelvic X-ray Image (뼈 검사 영상과 골반 X선 영상의 결합 유용성 평가)

  • Lee, Choong Woon;You, Yeon Wook;Kim, Yong Keun;Weon, Woo Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.1
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    • pp.23-27
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    • 2018
  • Purpose The introduction of bone scan has been reported as a useful tool in the diagnosis, treatment, and treatment response of skeletal disease. The purpose of this study is to improve the anatomical information and tolerance of the bone by combining bone scan and pelvic X-ray without additional radiation exposure. Materials and Methods From November 2015 to August 2016, 236 patients(64 men and 172 women, average age $50.96{\pm}15.39years$) take Bone scan and Pelvis AP(Anteroposterior) X-ray scan at the National Cancer Center. The scan equipment was a gamma camera, Symbia Ecam (SIEMENS, Germany), and a digital x-ray, DRS-800 (Listem, Korea). Osirix version 3.8.1 (Osirix, USA) and Stata/SE version 14.0 (StataCorp, USA) were used for image combination and analysis. The patient was intravenously injected with $^{99m}Tc-DPD$ (740 MBq), and the scan was performed 2 to 4 hours later. Gamma camera image acquisition were Matrix size $256{\times}1024$, Zoom 1.00, and scan speed 17 cm/min. The digital X-ray was made with a collimator size of $14^{{\prime}{\prime}}{\times}17^{{\prime}{\prime}}$, 77 kVp (60 to 97 kVp) and an average of 30 mAs (20 to 48). ASIS and pubic symphysis Select virtual points then Combine three virtual points and pelvic contour lines. The acquired images were evaluated by three radiologists who worked for more than 5 years in the nuclear medicine department. Results Of the total 236 patients, 216 (91.53%) were matched. The median and range (min~max) of the age were 67 (46~81) years old in the unmatched group and 52 (22~87) years old in the matched group, The Wilcoxon rank-sum test was performed to determine whether age was different between the two groups. As a result, the age difference between the two groups was statistically significant at p < 0.0001. Of the 64 men, 60 (93.75%) were match and of the 172 women, 156 (93.75%) were match. There was no statistically significant difference according to gender(p = 0.4542). Of the 54 patients without pelvic lesions, 54 (100.00%) were match, and 162 (89.01%) of 182 patients with pelvic lesions were match. There was a statistically significant difference according to the presence of pelvic lesions. Conclusion There are many variables in the combination of bone scan and pelvic X-ray imaging, and the patient's age and pelvic lesion may have some effect on the image combination. This study is expected to be useful for the diagnosis of pelvic osteosarcoma of children without radiation exposure. It is expected that this combination of images will help to develop the nuclear medicine image.

A Study on the Frequency of Occurrence of the Aortic Dissection using CT (CT 검사에서 대동맥박리(aortic dissection)의 발생빈도에 관한 고찰)

  • Dong, Kyung-Rae;Choi, Sung-Kwan;Jang, Young-Ill;Ro, Sang-Ho
    • Journal of radiological science and technology
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    • v.31 no.2
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    • pp.115-121
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    • 2008
  • Purpose: Aortic Dissection is very dangerous, prognostic disease, which the bloodstream flow out of the true lumen of the aorta by the bursting of aortic intima resulting in a rapid dissociation of inner and outer layer from the media. It is difficult to diagnose aortic dissection clinically by normal X-ray. This study was to investigate the occurrence frequency by age and number of patients who are identified to be aortic dissection by CT (Computed Tomography) scan. Materials and methods: We investigated the trend of yearly fluctuation, gender, age, and department of clinical research of the 112 patients who conducted CT scan in C- University Hospital for two years from January 2005 to December 2006. The MIP and SSD which reconstructed CT image and the VRT image were obtained for the accurate observation. The result was investigated by comparing normal X-ray and CT scan. Results and Conclusion: 1. The yearly check of 112 patients conducted CT scan showed 37 people (41.9%) in 2005, and it was increased to 65 (58.1%) in 2006 by 1.4 times. 2. The gender distribution of patients given a CT scan showed 45 males (40.1%), and female 67 (59.9 %). The aortic dissection patients were 9 (20%) out of 45 males, 21 (31.3%) out of 67 females and women were 1.6 times more than men. Women are also 1.5 times more than men in the number of examinee. 3. The age distribution of patient's who conducted CT scan revealed that there was no patient under 30 years old while 88.3% of all patients were through 41 to 80 years old. The higher the age was, the higher the occurrence of aortic dissection was. The difference in the occurrence frequency of age was statistically significant (p<0.01). 4. The departments that requested CT scan were the emergency department 46 (41.1%), circulatory internal medicine 37 (33.0%), chest surgery 13 (11.6%), and others 6 (14.3%). The combined ratio of emergency medicine and circulatory internal medicine was 74.1% of all. The results show that the aortic dissection is a very dangerous disease whose patients visit mainly via the emergency room. 5. The aortic dissection patients had normal X-ray readings in 22 (73.3%) out of 30, and only 8 (26.7 percent) are abnormal in the X-ray diagnosis. Therefore, the CT scan needs to be enforced in order to assess accurately the disease of aortic dissection.

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