Information and communication are very important to emergency medicine and large part of recent developments emergency medicine is related to them. So future development of emergency medicine is supposed to be based on information and communication system. Since 1994, hypertex-based multimedia information called World Wide Web has been served in the internet and east access has been allowed. Many researches about medical application of internet has been done, but articles of this application are mainly about medical information collection or use of electronic mail, and no application to specific part of medicine was suggested. So in this article, possibilities and range of application of internet and information super-highway to emergency medicine, suggestion of using internet to emergency phisician, prediction of the future of emergency medicine in relation to information super-highway will be presented. (continue)
Electronic Mail ; Emergencies* ; Emergency Medicine* ; Internet* ; Multimedia

Spinal extradural angiolipoma is a rare benign tumor containing vascular and mature adipose elements. The most common location of this tumor is the thoracic level with a tendency to involve several spinal segments. Almost all spinal extradural angiolipomas develop on the posterior aspect of the dura. The authors report a case of surgically proven spinal extradural angiolipoma involving the thoracic level and describe its CT findings.
Angiolipoma*

No abstract available.

PURPOSE: To evaluate the correlation between onset of brain infarction and Gd-DTPA enhancing patterns on MRI. MATERIALS AND METHODS: We reviewed MRI of 58 lesions in 45 patients with clinically documented brain infarction retrospectively. Axial, coronal and sagittal T1WI (TR/TE 450-520/20), T2WI (TR/TE 2190/90) and Gd-DTPA enhanced T1WI were performed with a 0.5T superconductive MR system. We analyzed Gd-enhancing patterns lhat were divided into intravascular, meningeal, and parenchymal enhancement. Parenchymal pattern was subdivided into mottled, partial ring like and dense enhancement. RESULTS: lntravascular enhancement was seen at 1-10 days in 30(53%) of 58 infarctions. Meningeal enhancement (13%) was noted at 1--6 days. Parenchymal enhancement (50%) was seen at 2--28 days and subdividing patterns are as follows:The mottled enhancement pattern was seen earlier at 2-8 days and partial ring like or dense enhancement patterns at 5-28 days. CONCLUSION: After reviewing Gd-enhanced MRI of infarction, the intravascular and meningeal enhancement patterns were earlier than parenchymal enhancement. Among parenchymal patterns, the mottled pattern was seen earlier than partial ring like or dense patterns. In conclusion, Gd-enhancing patterns of brain infarction are useful in estimating the age of infarction including acute infarction.
Brain Infarction* ; Brain* ; Gadolinium DTPA* ; Humans ; Infarction* ; Magnetic Resonance Imaging* ; Retrospective Studies

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

PURPOSE: The purpose of this study is to evaluate the gadolinium-enhanced MR imaging findings of cerebral venous angiomas, and to compare those findings with those of cerebral angiography. MATERIALS AND METHODS: We reviewed the findings of gadolinium-enhanced MR images of 11 cases with angiographically proved cerebral venous angiomas. We obtained Tl-and T2-weighted images with gadoliniumenhanced Tl-weighted images at a 0.5 T MR imager with a spin-echo technique. We analyzed the location and signal intensity of the lesion, pattern of contrast enhancement, the distribution of draining veins and medullary veins before and after contrast enhancement, and then compared with the findings of cerebral angiography. RESULTS: The characteristic central tubular signal void structure showed low signal intensity on Tl-weighted images and high signal intensity on T2-weighted images in all cases. After gadolinium enhancement, we could find a characteristic enhancement of all medullary and central veins in 7 cases. CONCLUSION: Gadolinium-enhanced MR image was useful in the diagnosis of venous angiomas especially in the detection of medullary veins. The invasive cerebral angiography could be replaced by this technique in this disease.
Central Nervous System Venous Angioma* ; Cerebral Angiography* ; Diagnosis ; Gadolinium ; Gadolinium DTPA* ; Hemangioma ; Magnetic Resonance Imaging ; Veins

Cervical tuberculous lymphadenitis is a commonly encountered disease, expecially in adults, Differentiation from other lymphadenopathy and benign conditions such as cystic neck masses is important. CT findings of tuberculous lymphadenopathy in the abdomen and thorax are reported in many literatures. But there are only a few articles concerning cervical tuberculous lymphadenopathy. The authors retrospectively analyzed CT findings of 33 cases with cervical tuberculous lymphadenitis regarding distribution, contour, enhancing pattern, changes of adjacent fascial plane, and dermal and subcutaneous manifestations. We concluded that the presence of conglomerated nodal masses with central lucency, thick irregular rim of contrast enhancement and inner nodularity, varying degree of homogenous enhancement in smaller nodes, dermal and subcutaneous manifestations of inflammation such as thickening of overlying skin, engorgement of the lymphatic and thickening of adjacent muscles, and diffusely effaced fascial plane are suggestive of tuberculous lymphadenitis. However, some CT patterns of tuberculous adenitis may be seen in other disease; for example, enhancement can occur in hyperplastic nodes, vascular metastasis(thyroid, melanoma, and hypernephroma), lymphoma, granulomatous disease, and Castleman's disease.
Abdomen ; Adult ; Giant Lymph Node Hyperplasia ; Humans ; Inflammation ; Lymphadenitis ; Lymphatic Diseases ; Lymphoma ; Melanoma ; Muscles ; Neck ; Retrospective Studies ; Skin ; Thorax ; Tuberculosis, Lymph Node* ; Yemen

Aneurysm of the superficial temporal artery is rare. We reviewed seven cases of aneurysm of the superficial temporal artery, which were confirmed surgically and angiographically. The results were as follows: The most common site of aneurysm was left superficial temporal artery, major feeding artery was anterior branch of superficial temporal artery, mean diameter was 7.8mm×12.6mm, and all aneurysms showed lobulated margin with intraluminal filling defects.
Aneurysm* ; Arteries ; Temporal Arteries*

The purpose of this study was to identify side effects of the vesicant chemotherapy. The study was designed to be a descriptive survey. The subjects of this study were 88 patients with various types of cancer, primary lung cancer(25.0%), advanced gastric cancer(25.0%), breast cancer(20.5%), etc. The mean age was 44.8 years old(range: 16-68). The questionnaire was completed by nurses of the outpatient unit and chemotherapy ward, and intravenous nurse specialist. The results of the study were as follows: 1) Chemotherapy was administered with a 23G scalp needle and 24G insyte. Injection site was dorsum of hands (64.7%), cephalic vein(19.3%). Successful rate for the first attempt was 88.6%. The first & second cycle chemotherapy was 29.5% each.. Mainly used drugs were Navelbine(34.1%), Adriamycin(20.5%). 2) Venous problems after chemotherapy were pain(13.6%) incurred by venous, mainly due to the administration of Navelbine; redness at the inravenous site(12.5%) and itching sense 2.3%. Non-venous problems were nausea (18.2%), dullness(14.8%), vomiting(8.0%), facial flushing(6.8%), anxiety(5.7%). Subjective discomforts after chemotherapy were generalized arm pain at the injection side(14.8%), dizziness(6.8%), weakness(5.7%) and general bodyache (5.7%). Systemic anaphylactic reaction and extravasation did not occur. 3) Non-venous problem after chemotherapy were nausea, vomiting & anorexia. Frequency of chemotherapy related to side effects were itching, facial flushing, and nausea(p<0.05). Day of chemothe-rapy related to side effects were nausea & vomiting(p<0.05). Site of chemothe- rapy related to side effects were redness(p<0.05). Frequency of venipuncture related to side effects were redness(p<0.05). Conclusively, cancer chemotherapy patients have had some venous problem. They need appropriate venous access devices for chemotherapy. And other non-venous problem will be managed appropriately. Further research was required to identify the rate of venous complication or side effects of vesicant chemotherapy.
Anaphylaxis ; Anorexia ; Arm ; Breast ; Drug Therapy* ; Flushing ; Hand ; Humans ; Lung ; Nausea ; Needles ; Outpatients ; Phlebotomy ; Pruritus ; Surveys and Questionnaires ; Scalp ; Specialization ; Vomiting

The anti-inflammatory activity of a corticosteroid may mask the contact allergic reaction it is causing. This may be an important reason why contact allergy to corticosteroids has often been missed. A simple persistent aggravation of a dermatitis in a patient treated with one or more topical corticosteroids is sufficient to raise a suspicion of corticosteroid hypersensitivity. A 23-year-old male visited our department for the evaluation of his aggravated pruritic oozing erythematous papules, scales and edema of the face. Previously, he was treated with Dermatop ointment and Plancollotion. A Patch test showed positive reactions to prednicarbate 10%, 1%, hydrocortisone-17-butyrate 10%, and triamcinolone 10%. We conclude prednicarbate in Dermatop ointment, hydrocortisone-17-butyrate in Plancol lotion to be the etiological agents.
Adrenal Cortex Hormones ; Dermatitis ; Dermatitis, Allergic Contact* ; Edema ; Humans ; Hypersensitivity ; Male ; Masks ; Patch Tests ; Triamcinolone ; Weights and Measures ; Young Adult