Introduction: Aortic dissection (AD) is the most common aortic emergency, result in a catastrophic outcome. Patients usually asymptomatic, some of them present with sudden severe, tearing or sharp back or anterior chest pain and haemodynamic disturbance. Early and accurate diagnosis and treatment determine the patient outcome.Case Report: A case of 40 years old man complained of acute, sharp, chest pain since 4 days before admission which worsen instead of medical treatment, with a history of smoking since a few years ago. A vital sign was within normal limit. Laboratory result showed high CKMB, troponin T, LDH result. Occasional ventricular extrasystoles and inferior ischaemic was found in the ECG examination. From echocardiography, the patient suspected to have aortic dissection Stanford type A since an intimal flap on ascending aorta was found, with left ventricle hypertrophy, dilatation of right atrium and right ventricle, severe aortic regurgitation, moderate mitral regurgitation, severe tricuspid regurgitation, moderate pulmonary regurgitation and moderate pulmonary hypertension. From plain radiography, the patient showed mediastinum widening and cardiomegaly, CT angiography showed Stanford type A aortic dissection (DeBakey type I).  The patient refused to seek further treatment for operation as suggested.Conclusion: It is still challenging to differentiate aortic dissection (AD) and another acute chest emergency. Since clinical presentation and laboratory result may be similar between those illnesses. Therefore careful history taking and further imaging examination should be considered to increase the patient outcome.

Information technology is a necessity that can be used to increase the speed, flexibility, integration and accuracy of the resulting information. Accounting information systems provide opportunities for business people to increase efficiency and effectiveness in decision making so as to allow companies to gain a competitive advantage. The use of computers in some cooperatives is still ineffective which is driven by the factor of the lack of ability of employees in the processing of the systems used. This problem may be an obstacle to the performance of the accounting information system for Savings and Loans Cooperatives in Gianyar Regency.                This study aims to determine the effect of personal capabilities, technology use and top management support on the performance of the accounting information system in savings and loan cooperatives in Gianyar regency. The research method used is quantitative research methods with primary data obtained from questionnaire data which is measured using a Likert scale. This research was conducted at the Savings and Loans Cooperative in Gianyar Regency. The population in this study were 155 KSPs in Gianyar Regency. The sample used in this study amounted to 28 KSP which was determined by the nonprobability sampling method, namely purposive sampling which uses certain considerations. The data testing technique uses multiple linear regression analysis using the SPSS version 21 for windows program.                Based on the results of the research by distributing questionnaires to 93 respondents, it can be concluded that the factors of personal capability, technology utilization, and top management support have a positive and significant effect on AIS performance. This shows that if AIS users want to achieve satisfaction with the system used, they must pay attention to the factors that influence it.

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