BACKGROUND: Infiltration of the skin and subcutaneous tissue with local anesthetic solutions may cause transient pain and discomfort. Heating local anesthetic solutions to body temperature has been suggested as a way of reducing the pain associated with injection. We designed a double blind crossover volunteer study to investigate the effect of warming lidocaine on the pain associated with subcutaneous injection. METHODS: Participants were 40 healthy adult volunteers,22 years of age and older, and they were the medical, nursing stay and medical students. They underwent 1ml subcutaneous injections of the study agent through 25-gauge needles. Following a standard crossover protocol, 'room temperature' lidocaine(20degrees C ) was injected into one midvolar forearm and body temperature' lidocaine(37degrees C ) into the opposite arm. Pain assessed by visual analogue pain scores and 'volunteer's comparison of pain on injection. RESULTS: Twenty-six volunteers thought that lidocaine at 20degrees C was more painful and four thought that lidocaine at 37degrees C was more painful, ten volunteers did not express a difference. Median pain score for injection at 20 degrees C was 37 and at 37 degrees C was 35.5. Difference of two median scores was 6.5. CONCLUSION: The simple procedure of warming to body temperature reduced the pain associated with subcutaneous injection of lidocaine. It is an inexpensive and practical method That should be considered for routine use in the ED.
Adult ; Arm ; Body Temperature* ; Forearm ; Heating ; Hot Temperature ; Humans ; Injections, Subcutaneous ; Lidocaine ; Needles ; Nursing ; Skin ; Students, Medical ; Subcutaneous Tissue ; Volunteers

No abstract available.
Nucleopolyhedrovirus* ; Sequence Analysis*

Vitelliform macular dystrophy, adult type, is a type of pattern dystrophies of the pigment epithelium characterized by autosomal daminant inheritance, mid-life onset and small, round or oval, yellow deposits located at the level of the pigment epithelium. The authors report a case of this dystrophy which showed small yellow round lesion measuring 1/4-1/3 D.D. within the macula, normal electroretinogram, subnormal electrooculogram light-peak/dark-traugh ratio. typical irregular ring-like transmitted fluorescence surrounding the central non-fluorescent Iesion and leakage from perifoveal capillaries on fluorescent angiogram.
Adult* ; Capillaries ; Electrooculography ; Epithelium ; Fluorescence ; Humans ; Vitelliform Macular Dystrophy* ; Wills

Sudoriparous angioma is an unusual form of angioma with pain and hyperhidrosis. We present two cases of typical sudoriparous angioma. Case 1: 9-year-old female showed 0. 8 to 2. 0cm multiple dark brownish tender palpable hypertrichotic masses on the right lower leg after birth. Muscular atrophy and flexion contracture was also developed on the right lower leg for 2 years. Case 2: 4-year-old rnale showed 3 * 3cm tender elevated mass on the left shin after birth. Marked hyperhidrosis was developed when even slight pressure applied on the lesion in these cases. On histologic examination, these two cases showed proliferation of varible sized blood veasels hyperplasia and dilated hyperplastic eccrine glandular and ectopic adipose tissue on the mid and deep dermis. Muscular biopsy from case 1 showed fibrotic and degenerative change. Electromicroscopic examination done from case 1. The secretory epithelial cell of eccrine gland showed cytoplastic degradation and slight dilated intercellular canaliculi (Fig. 11). The lumen of subepithelial capillaries were dilated and some of endothelial cells showed degenerative changes evidenced by RER dilation, mitochondrial swelling and detachment from underlying tissue(Fig. l2). The cutaneous nerve showed many non-myelinated axons enclosed in cytoplasm of Schwann cells.
Adipose Tissue ; Axons ; Biopsy ; Capillaries ; Child ; Child, Preschool ; Contracture ; Cytoplasm ; Dermis ; Eccrine Glands ; Endothelial Cells ; Epithelial Cells ; Female ; Hemangioma* ; Humans ; Hyperhidrosis ; Hyperplasia ; Leg ; Mitochondrial Swelling ; Muscular Atrophy ; Parturition ; Schwann Cells

Unilaterl frontal hyperhidrosis, a rare disorder of the sweat gland with localized hyperhidrosis, ia discribed. A 13-year-old female patient had increased sweating on the left half of the forehead, recurring in summer season for 2 years. Quantitative sweat collection demonstrated that the sweat glands responsive to those stimuli, which were thermal (direct and indirect heat), gustatory and cholinergic stimulation. A marked increase in sweat gland activity was noted on the affected areas as compared to the contaralateral normal sites, in thermal and gustatory effect. But, carbachol stimulation was not responsive. Biosy specimen which taken from the positive site of starch iodine technique showed increase number of sweat glands and ducts with somewhat dilated sweat ducts.
Adolescent ; Carbachol ; Female ; Forehead ; Humans ; Hyperhidrosis* ; Iodine ; Seasons ; Starch ; Sweat ; Sweat Glands ; Sweating

No abstract available.
Airway Resistance*

Laparotomy performed for resection of hepatoma in 34 cases at Seoul National University Hospital for 3 .5years since Oct. 1978. Resection of hepatoma was done in 21 cases, ligation with or without canulation of hepaticartery was performed in 12 cases, and open and closure was made in 1 case. Angiographic findins were analyzed forresectability of hepatoma. The results of hte analysis were as follows; 1. Most reliable signs for resectablehepatoma were peripheral location and confinement in one hepatic lobe. Most reliable signs for non-resectablehepatoma were presence of tumor thrombus in portal vein, bilateral hepatic arterial feeding. 2. Less reliablesigns for resectable hepatoma were absence of portal vein invasion, less than 10cm in size and absence of findingsof liver cirrhosis. Less reliable signs for non-resectable hepatoma were right or left massive type. 3. Presenceof arteriovenous fistula, more than 10cm in size, and presence of findings of liver cirrhosis were no reliablecriteria for resectability of hepatoma. 4. Predictability for resectability with those reliable signs ofangiography was around 80%. 5. In addition to routine celiac angiography, oblique celiac angiography or superiormesenteric arteriography for portal vein opacification will be helpful in order to obtaine highly reliable signsfor resectability of hepatoma.
Angiography ; Arteriovenous Fistula ; Carcinoma, Hepatocellular ; Laparotomy ; Ligation ; Liver Cirrhosis ; Portal Vein ; Seoul ; Thrombosis

The transient acute severe hypertensions with arrhrthmia after intramrometrial injection of Img PGF2 alpha during cesarean section by means of spinal as well as general anestheaia are returned to normal limit of vital sings without special treatment. Ne specific complications were experienced following the episode until discharge.
Cesarean Section ; Dinoprost* ; Female ; Hypertension* ; Pregnancy

PURPOSE: The aim of this study was to determine the role of the CT scan in blunt hepatic injury and the significance of CT degree of hepatic injury in the decision making of treatment plan. MATERIALS AND METHODS: We retrospectively analysed the CT findings of 22 patients with hepatic injury. We graded hepatic injury on CT scan into five according to the severity. Clinical records, type of management and clinical outcome of the patients were also reviewed. RESULTS: Of the 22 patients, 17 had conservative treatment and five had surgery. The numbers of patients treated conservatively were 0, 4, 11, 2 and 0 in the grade 1, 2, 3, 4 and 5, respectively and the numbers of surgically treated cases were 0, 0, 3, 2 and 0 respectively. There was no significant statistical difference between surgically and conservatively treated groups(p-value > 0.05). All patients with conservatively treated group were hemodynamically stable and had no complication during hospitalization. Hemoperitoneum was observed in 11 of 22 patients. CONCLUSION: In blunt hepatic injury, CT plays an important role in the demonstration of location and extent of the hepatic injury, size of hemoperitoneum and the post operative course. However, we believe that physiologic status of the patients may be more important than the extent of CT based hepatic injury for determining a mode of treatment.
Decision Making ; Hemoperitoneum ; Hospitalization ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed

A22-year-old male patient presented with typical features of pachydermoperiostosis. Thickening and oiliness of the facial skin, clubbing of the fingers, and hyperhidrosis of the palms and soles were the most prominent features. Osteosclerosis and hypertrophic osteoarthropathy were present in the bones of the hands, feet and tibia. We administered isotretinoin with the rationale that the drug inhibits sebum and collagen production. The patient was quite satisfied with the reduction of facial oiliness.
Adult ; Case Report ; Clinical Trials ; Human ; Isotretinoin/*therapeutic use ; Male ; Osteoarthropathy, Primary Hypertrophic/diagnosis/*drug therapy