No abstract available.
Adult* ; Humans ; Risk Factors*

Neuroleptic malignant syndrome is a rare, but potentially life-threatening adverse event associated with the use of neuroleptic agents. We describe the case of a 47-year-old schizophrenic woman who was treated with clozapine for years. The patient developed acute renal failure with pulmonary edema, and underwent mechanical ventilation and hemodialysis.
Acute Kidney Injury ; Antipsychotic Agents ; Clozapine* ; Female ; Humans ; Middle Aged ; Neuroleptic Malignant Syndrome* ; Pulmonary Edema ; Renal Dialysis ; Respiration, Artificial ; Rhabdomyolysis

No abstract available.
Mass Screening* ; Prospective Studies*

Primary malignant lymphoma of lung is a very rare disease, only 0.34% of all malignant lymphomas. In our case, a 76 year old male patient had a solitary mass without lympha-denopathy at chest CT scan. He underwent right middle lobectomy through a posterolateral thoracotomy incision. Pathologic study confirmed a diagnosis of malignant lymphoma and chemotherapy was started by an oncologist.
Aged ; Diagnosis ; Drug Therapy ; Humans ; Lung Neoplasms ; Lung* ; Lymphoma* ; Male ; Rare Diseases ; Thoracotomy ; Tomography, X-Ray Computed

Acute infarcts of the anterior inferior cerebellar artery (AICA) territory are unusual. Furthermore incomplete AICA infarcts are perplexing because of its variations of vascular anatomy and inconsistent clinical features. We present a case with clinical features of AICA infarction, which consist of ipsilateral peripheral-type facial palsy, vertigo, and contralateral facial and upper limb sensory changes without motor weakness. The patient had hypertension and was a current smoker. The high signal intensity on inferior pontine tegmental area was found on MRI and the R2 interneuronal dysfunction was note on Blink reflex. The angiographic findings didn't show any focal vascular lesions, which is contrary to the pathogenesis of AICA infarction published previously. On the clinical ground, the present case reserves to attention in that patients with peripheral-type facial palsy should be properly evaluated and with thorough neurological examination and we could differentiate between the incomplete AICA infarcts such as Gasperini syndrome and Bell's palsy.
Arteries ; Bell Palsy ; Blinking ; Facial Paralysis* ; Humans ; Hypertension ; Infarction ; Interneurons ; Magnetic Resonance Imaging ; Neurologic Examination ; Upper Extremity ; Vertigo

Due to the increasing use of the internet, various social problems have been emerging, and one of them is internet gaming disorder (IGD). The purpose of this study was to investigate whether low internal motivation was present in IGD and basic psychological needs affected internal motivation. Twenty-one individuals with IGD and 21 healthy controls performed a ‘motivation task’ in which the avatar in virtual reality asked whether they would accept an activity in two conditions stimulating intrinsic or extrinsic motivation. The task performance was compared between the two groups, and was correlated with the Basic Psychological Needs Scale scores. Patients had a significantly lower acceptance rate of the proposal in the intrinsic motivation condition than controls, and this intrinsic motivated tendency was correlated with the satisfaction in their basic psychological needs. As with other substance use disorders, IGD was associated with a lower level of internal motivation, which was related to the dissatisfaction of basic psychological needs such as autonomy, competence, and relationship.
Humans ; Immunoglobulin D ; Internet* ; Mental Competency ; Motivation* ; Social Problems ; Substance-Related Disorders ; Task Performance and Analysis

Ketamine is used widely in emergency departments for a variety of purposes, including procedural sedation for facial laceration in pediatric patients. The major benefits are its rapid onset of effects, relatively short half-life, and lack of respiratory depression. The known side effects of ketamine are hallucinations, dizziness, nausea, and vomiting. Seizure is not a known side effect of ketamine in patients without a seizure history. Here, we present the case of a patient in whom ketamine likely induced a generalized tonic-clonic seizure when used as a single agent in procedural sedation for facial laceration repair. The aim of this article is to report a rare and unexpected side effect of ketamine used at the regular dose for procedural sedation. This novel case should be of interest to not only emergency physicians but also plastic surgeons.

Ketamine is used widely in emergency departments for a variety of purposes, including procedural sedation for facial laceration in pediatric patients. The major benefits are its rapid onset of effects, relatively short half-life, and lack of respiratory depression. The known side effects of ketamine are hallucinations, dizziness, nausea, and vomiting. Seizure is not a known side effect of ketamine in patients without a seizure history. Here, we present the case of a patient in whom ketamine likely induced a generalized tonic-clonic seizure when used as a single agent in procedural sedation for facial laceration repair. The aim of this article is to report a rare and unexpected side effect of ketamine used at the regular dose for procedural sedation. This novel case should be of interest to not only emergency physicians but also plastic surgeons.

Shoulder arthroscopic surgeries are an accepted technique for many shoulder disease and have many advantages over open surgeries4,6). To date, shoulder arthroscopic surgery have been rare complications that compromise patient airway, caused by the leakage of irrigation fluid out of the shoulder joint space into the surrounding soft tissues and then the neck and the pharynx. This report presents a case of life-threatening airway obstruction due to extra-articular saline collection during arthroscopic rotator cuff repair. In concluding we should hourly check the patient's neck swelling undergoing shoulder arthroscopic surgery, because anesthetized patients cannot complain of the airway problem may progress until it becomes life-threatening.
Airway Obstruction ; Arthroscopy ; Edema* ; Humans ; Neck ; Pharynx ; Rotator Cuff* ; Shoulder ; Shoulder Joint

PURPOSE: To assess the usefulness of breath-hold fast MR imaging of liver with fat suppression (FS) by application of chemical saturation technique in the diagnosis of regional fatty changed suspected in sonography. MATERIALS AND METHODS: Thirteen patients who had focal lesions with diffuse, homogeneous signal changes after FS through chemical saturation technique without additional changes of imaging parameter during MR imaging of liver were selected. T1-weighed fast low-angle shot and T2-weighted turbo spin-echo sequences were obtained with or without FS during each single breath-holding session. Subjective changes of signal intensity between the pre-FS and the FS images were compared with the sonographic findings in each lesion. RESULTS: Seven lesions of decreased signal intensity after FS on T1 or T2-weighted images, including three lesions only at FS T1 images, were regarded as focal fat infiltration. All seven lesions had compatible sonographic findings as homogenously echogenic areas. Another six lesions of subjectively increased signal intensity including two lesions only at FS T2 images were regarded as focal fat sparing. All six lesions had sonographic findings as homogenous echo poor areas suggesting focal fat sparing. In cases regarded as fat infiltration, score changes were more prominent at FS T1 images than FS T2 images(p=0.0002). In cases regarded as fat sparing, score changes were more prominent at FS T2 images than FS T1 images(p=0.042). CONCLUSION: Breath-hold fast T1 and T2-weighted MR imaging with and without chemical saturation pre-pulse may be sufficient for characterization of regional fatty changes in the different ferential diagnosis of focal hepatic lesion found at sonography.
Diagnosis ; Humans ; Liver* ; Magnetic Resonance Imaging* ; Ultrasonography