A case of the cryptococcal meningitis is reported and the literature reviewed. A cryptococcosis is the most common form of fungal infection of the nervous system. The disease may simulate tuberculous meningitis, tumor of the brain, encephalitis and various psychosis. Our case is no significant symptoms and sings before the head trauma which was accompanied by transient loss of consciousness. The patient's symptoms and signs were aggravated by the head trauma (a mild cerebral concussion only). The patient expired on the 10th hospital day. The cryptococcal meningitis was proved by autopsy.
Autopsy ; Brain ; Brain Concussion ; Craniocerebral Trauma ; Cryptococcosis ; Encephalitis ; Humans ; Meningitis, Cryptococcal* ; Nervous System ; Psychotic Disorders ; Tuberculosis, Meningeal ; Unconsciousness

A case of the cryptococcal meningitis is reported and the literature reviewed. A cryptococcosis is the most common form of fungal infection of the nervous system. The disease may simulate tuberculous meningitis, tumor of the brain, encephalitis and various psychosis. Our case is no significant symptoms and sings before the head trauma which was accompanied by transient loss of consciousness. The patient's symptoms and signs were aggravated by the head trauma (a mild cerebral concussion only). The patient expired on the 10th hospital day. The cryptococcal meningitis was proved by autopsy.
Autopsy ; Brain ; Brain Concussion ; Craniocerebral Trauma ; Cryptococcosis ; Encephalitis ; Humans ; Meningitis, Cryptococcal* ; Nervous System ; Psychotic Disorders ; Tuberculosis, Meningeal ; Unconsciousness

Background: Spontaneous pneumopericardium is a very rare condition. Spontaneous pneumothorax and pneumomediastinum have been reported to be associated with an idiopathic pulmonary fibrosis (IPF). However, spontaneous pneumopericardium has not yet been reported in association with IPF. Here we report a case of spontaneous pneumomediastinum and pneumopericardium in a patient with acute exacerbation of IPF with a review of the relevant literature.
Humans ; Idiopathic Pulmonary Fibrosis* ; Mediastinal Emphysema* ; Pneumopericardium* ; Pneumothorax

OBJECTIVE: The primary purpose of this study was a replication of the effectiveness and tolerability of risperidone in the treatment of patients with acute mania in very larger cohort in naturalistic treatment setting to extend the data on the effect and tolerability of risperidone in the treatment of patients with acute mania to Asian population. METHODS: A total of 909 patients with DSM-IV criteria of bipolar disorder current manic and hypomanic episode, entered this large, open, multicentre study. The Young Mania Rating Scale (YMRS), Clinical Global Impression (CGI) and Simpson-Angus Rating Scale (SARS) were measured at baseline and weeks 1, 3 and 6, for the assessment of effectiveness and extrapyramidal symptom (EPS). RESULTS: This study showed statistically significant reduction of scores on the YMRS and CGI-s (mean change=-23.5+/-11.8, p<0.0001;mean change=-2.7+/-1.5, p<0.0001, respectively) from the baseline to the endpoint (week 6). Number of patients with 50% reduction or more in the YMRS and CGI-s scores was 693 (77.8%) and 630 (70.7%) at endpoint, respectively. There were no statistically significant increments of scores on SARS. Risperidone was generally well tolerated. CONCLUSION: The present larger open study demonstrates that risperidone add-on therapy is effective and tolerable in treatment of bipolar disorder, replicating results in various controlled and uncontrolled studies from Western countries.
Asian Continental Ancestry Group ; Bipolar Disorder* ; Cohort Studies ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Risperidone*

A 57-year-old woman scheduled for cochlear implant removal exhibited preoperative electrocardiographic findings of early repolarization (ER). Four episodes of transient ST segment elevations during surgery raised suspicion for vasospastic angina (VA). In the post-anesthetic care unit, the patient complained of chest discomfort and received sublingual nitroglycerin with uncertain effect. The patient refused to proceed with postoperative invasive coronary angiography, resulting in inconclusive diagnosis. Intraoperative circumstances limit the diagnosis of VA, which emphasizes the need for further testing to confirm the diagnosis. When VA is suspected in patients with underlying ER, it is reasonable to consider invasive examination to establish the diagnosis and prevent recurrence of VA. If ST changes are observed during surgery in patients with preoperative ER, careful monitoring is recommended. Due to general anesthesia, the absence of patient symptoms limits the definitive diagnosis of those with suspected VA. Therefore, additional postoperative surveillance is recommended.
Anesthesia, General ; Cochlear Implants ; Coronary Angiography ; Diagnosis ; Electrocardiography ; Female ; Head ; Humans ; Middle Aged ; Neck ; Nitroglycerin ; Recurrence ; Thorax