This study demonstrates transmission of 12-lead electrocardiography (ECG) in an ambulance to the cell phone of the attendant emergency medical technician and then to the hospital and to cell phones of off-site cardiologists. The emergency medical technician cell phone receives Extensible Markup Language files generated by a Phillips Extensible Markup Language ECG instrument via Wi-Fi-based wireless network and then sends them to an ECG-processing server at the hospital over the mobile telephone network. After reducing ECG noises and artifacts, the server converts files to Digital Imaging and Communications in Medicine-based ECG reports stored in Picture Archiving and Communication System. These reports are sent to the cell phones of off-site cardiologists. Consequently, on-site Emergency Department physicians and off-site cardiologists can discuss ECG reports via Picture Archiving and Communication System on their computers or cell phones to prepare for the most appropriate treatment while the patient is on the way to the hospital. In conclusion, this 12-lead ECG transmission e-technology expands the functions of a 12-lead ECG instrument and facilitates more efficient prehospital cardiac care.

No abstract

Although primary gastrointestinal lymphoma is a rare malignancy, it can cause an intussusception in adults and can be a clinically challenging condition to manage. Intussusception could progress to life-threatening complications if left untreated or could delay chemotherapy if inappropriate surgical management is used. We report a 31-year-old man diagnosed with human immunodeficiency virus who was being treated with antiretroviral therapy. He presented with nausea, vomiting, poor appetite, and intermittent, cramping abdominal pain for over 1 wk. Abdominal computed tomography revealed a well-defined homogeneous mass in the mesenteric root region, together with a long segmental wall thickening in the ileum with ileocolic-type intussusception, which was suspected to be caused by a lymphoma. The intussusception was successfully laparoscopically reduced, and the tumor involvement of the appendix was confirmed by appendectomy with intraoperative frozen section. Systemic chemotherapy was immediately initiated after surgery without the need for bowel resection.

Patient: Male, 67Final Diagnosis: Torsion of a giant antimesenteric lipoma of the ileumSymptoms: Acute abdomenMedication: —Clinical Procedure: En bloc segmental resection with end-to-end anastomosisSpecialty: SurgeryObjective:Rare diseaseBackground:Torsion of an intra-abdominal lipoma is rarely the cause of acute abdominal pain. Most of the previously reported cases of intra-abdominal lipoma torsion originated in the mesentery or omentum. However, an antimesenteric lipoma of the ileum with torsion has not been reported before.Case Report:A 67-year-old man presented to the emergency department with acute abdominal pain. Contrast-enhanced computed tomography (CECT) of the abdomen and pelvis only showed a giant fat-containing, soft-tissue, intra-abdominal tumor, suspected to be a lipoma. Laparotomy was performed, and the presence of torsion of the antimesenteric lipoma of the ileum was confirmed. Beside tumor resection, en bloc segmental resection of the ileum with end-to-end anastomosis was performed to avoid bowel stricture and obtain tumor-free margins.Conclusions:CECT is the modality of choice to detect an intra-abdominal lipoma. Urgent surgical intervention should be considered if the symptoms persist and torsion cannot be excluded. If simple excision is not adequate because of poor accessibility of the tumor stalk, en bloc segmental resection with end-to-end anastomosis should be considered.