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

No abstract available.

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

Angioedema is a disorder characterized by well-demarcated nonpitting edema involving the tongue, floor of the mouth, larynx, lips, and face. The incidence of angiotensin converting enzyme(ACE) inhibitor related angioedema has been reported to be about 0.1% to 0.2%, and the time of onset is usually during the first week of therapy. These ACE inhibitors include captopril, enalapril, and lisinopril. A 53-year old man with an 8 month history of hypertension previously controlled with atenolol, was presented to the dermatologic department with angioedema of the face and tongue. He had begun therapy with captopril one day before this episode. Even though he was treated with epinephrine and methylprednisolone sodium succinate, the edema gradually progressed and finally dyspnea developed. He was urgently intubated and treated with steroids and pheniramine maleate in the intensive care unit. The edema resolved after 24 hours.
Angioedema* ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Atenolol ; Captopril* ; Dyspnea ; Edema ; Enalapril ; Epinephrine ; Humans ; Hypertension ; Incidence ; Intensive Care Units ; Larynx ; Lip ; Lisinopril ; Methylprednisolone Hemisuccinate ; Middle Aged ; Mouth ; Pheniramine ; Steroids ; Tongue

Transcatheter hepatic arterial embolization (THAE) is one of the treatment modalities that can be applied to hepatocellular carcinomas (HCC) and metastatic tumors of the liver. Complications such as cholecystitis and gallbladder necrosis, are common with THAE, but liver and peripheral bile duct necrosis are rare, and intrahepatic stones with main bile duct necrosis have never been reported. To prevent intrahepatic spread during operative manupulation and to decrease the vascularity and size of the tumor, we performed a THAE on a huge-sized HCC five times before performing the hepatectomy. We succesfully undertook a right lobectomy after the THAE with lipiodol, gelform, and adriamycin. However, severe bile duct stricture and intrahepatic stones were confirmed during the operation.
Bile Ducts* ; Bile* ; Carcinoma, Hepatocellular ; Cholecystitis ; Constriction, Pathologic* ; Doxorubicin ; Ethiodized Oil ; Gallbladder ; Hepatectomy ; Liver ; Necrosis

No abstract available.
Barium* ; Child* ; Diatrizoate Meglumine* ; Humans ; Intussusception*

Intussusception is a condition of invagination of the proximal segment of bowel into the more distal receiving bowel. Intussusception is one of the common pediatric and surgical emergencies of infancy and childhood in Korea. Intussusception is the most common cause of acquired intestinal obstruction in infancy and childhood, and it needs emergency treatment. 1) On the age and sex distribution, the age under 15 month was the most common(70.6%), and the peak incidence was 3-12 months of age(60.1%). In sex distribution, male to female ratio was 1.25:1. 2) The seasonal distribution was summer(27.4%), spring, autumn and winter in order of frequency. 3) As to the etiology of Intussusception treated by surgery, idiopathic was the most common(75%). 4) The cardinal symptoms and signs were vomiting(72.5%), bloody or bloody mucoid stool(57.5%), abdominal pain(49.7%), abdominal distention(20.9%), abdominal mass(19.6%) and others in order of frequency. 5) On the hematologic finding, 60.8% revealed leukocytosis above 10,000/mm3. 6) As to the duration from the onset of the symptom to admission, 84.2% was within 24 hours, 9.8% was from 24 hours to 48 hours, and 5% was over 48 hours. 7) The common anatomical types were ileocolic(73.2%), and ileocecal(17.0%). 8) The success rate of air reduction was 84.3%. 9) In the method of operation, manual reduction was performed in 91.7% and intestinal resection in 8.3%. 10) The recurrence rate after air reduction was 12.4% and after operative manual reduction was 8.3%.
Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Female ; Humans ; Incidence ; Intestinal Obstruction ; Intussusception* ; Korea ; Leukocytosis ; Male ; Recurrence ; Seasons ; Sex Distribution

Diabetic nephropathy is characterized by one or a combination of the following lesions: (1) glomerular involvement with three distinctive patterns: diffuse glomerulosclerosis, nodular glomerulosclerosis, and exudative lesions; (2) arteriolo sclerosis; (3) urinary tract bacterial infection with pyelonephritis and sometimes emphysematous pyelonephritis. Emphysematous pyelonephritis is an uncommon life-threatening and acute suppurative infection of the kidney, and usually occurs in diabetic female patients. It is characterized by the production of intraparenchymal gas. Glucose fermentation has been considered the main cause of the gas formation. We presented two illustrative nephrectomy cases of emphysematous pyelonephritis in addition to the typical pathologic features of diabetic nephropathy.
Bacterial Infections ; Diabetic Nephropathies* ; Female ; Fermentation ; Glucose ; Humans ; Kidney ; Nephrectomy ; Pyelonephritis* ; Sclerosis ; Urinary Tract

PURPOSE: Problem-based learning(PBL) experiences applied in the field of screening for chronic disease during the course of Community Medicine for the 3rd grade medical students were summarized. This study was aimed to train medical students the health appraisal ability and also the ability for public health education and promotion with health-oriented concept rather than disease-oriented one. And also it was aimed to train students to know what to learn and how to search the informations they need for themselves. STUDY SUBJECT AND METHOD: Three to four students in one team spent one and half days(Friday and Saturday) of one-week practical course of Community Medicine. Assigned materials were the medical records which are the files with the results of automated multiphasic screening tests which were applied to generally healthy people. Students were supposed to find, evaluate, solve or manage the real problems encountered from the multiphasic screening test results. RESULTS: The students accepted this self-directed learning process and small group discussion and also health-oriented human approach as new experiences and stimulants.
Chronic Disease* ; Community Medicine ; Education ; Humans ; Learning ; Mass Screening* ; Medical Records ; Multiphasic Screening ; Problem-Based Learning ; Public Health ; Students, Medical

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