ABSTRACT
It is not a common case for neurosurgery department and the other departments to perform joint operation at the same time. Patients with severe head injury are a condition in which vital signs are unstable due to severe brain swelling and increased intracranial pressure, and emergency surgery is required. A 44-year-old man visited the trauma center with a motorcycle accident. The Glasgow Coma Scale score at the time of emergency department was 3 points, and the pupil was fixed at 6 mm on both sides. His medical history was unknown. His vital signs including blood pressure (BP), heart rate, respiratory rate and oxygen saturation were stable. Associated injuries included multiple fractures of whole body. Brain computed tomography revealed subarachnoid hemorrhage, intraventricular hemorrhage and severe cerebral edema. During the preparation of the craniectomy, abdominal ultrasonography performed because of decreased BP resulted in a large amount of hemoperitoneum. The bi-coronal craniectomy and splenectomy were performed simultaneously for about 4 hours. After fifty days of treatment, he was discharged with Glasgow Outcome Scale-extended 4 points and is undergoing rehabilitation. In severe polytrauma patients, active concurrent surgery is a good method to save their lives.
Subject(s)
Adult , Humans , Blood Pressure , Brain , Brain Edema , Craniocerebral Trauma , Emergencies , Emergency Service, Hospital , Fractures, Multiple , Glasgow Coma Scale , Head , Heart Rate , Hemoperitoneum , Hemorrhage , Intracranial Pressure , Joints , Methods , Motorcycles , Multiple Trauma , Neurosurgery , Oxygen , Pupil , Rehabilitation , Respiratory Rate , Splenectomy , Subarachnoid Hemorrhage , Trauma Centers , Ultrasonography , Vital SignsABSTRACT
OBJECTIVES: Virtual reality has been increasingly used in the psychiatric field. Presence, the sense of "being there," is an essential concept in terms of the effectiveness of the virtual reality. The present study aimed to investigate the characteristics of the presence-related brain regions in patients with schizophrenia. METHODS: Using fMRI, brain activities were measured while performing the virtual reality tasks in fifteen healthy normal subjects and fifteen patients with schizophrenia. The tasks consisted of listening to some stories and inferring the content of the previous events. Ambiguous information was given for the experimental task, whereas clear information was given for the control task. Correlations between the image contrast values and the presence scores were analyzed. RESULTS: The presence-related brain regions in healthy controls were identified in the two discrete region groups that could be referred to as the cognitive neural correlates and the perceptual neural correlates. The former included the anterior cingulate, the left inferior temporal gyrus, the right lingual gyrus, and the right cuneus, whereas the latter consisted of the right posterior cingulate, the left lingual gyrus and the right fusiform gyrus. Compared with healthy controls, regional correlation patterns were different in patients with schizophrenia, including that the posterior cingulate had significant correlations. CONCLUSION: These results suggest that patients with schizophrenia utilize perceptual apparatus for the presence more than the cognitive aspect. A peculiar pattern of the presence in schizophrenia may be related to increased correlations between the posterior cingulate and other brain regions.
Subject(s)
Humans , Brain , Gyrus Cinguli , Magnetic Resonance Imaging , SchizophreniaABSTRACT
Emphysematous prostatitis is characterized by pockets of gas within the prostate due to gas-forming organisms. Although only one case of emphysematous prostatitis had been reported in the literature, it was incidental finding associated with emphysematous cystitis. We consider that it is the result of aerobic urinary tract infections or may be caused by gastrointestinal fistula or iatrogenic surgical and diagnostic instrumentation. We report a case of emphysematous prostatitis in a 66 years old male with diabetes mellitus.
Subject(s)
Aged , Humans , Male , Cystitis , Diabetes Mellitus , Fistula , Incidental Findings , Prostate , Prostatitis , Urinary Tract InfectionsABSTRACT
Emphysematous prostatitis is characterized by pockets of gas within the prostate due to gas-forming organisms. Although only one case of emphysematous prostatitis had been reported in the literature, it was incidental finding associated with emphysematous cystitis. We consider that it is the result of aerobic urinary tract infections or may be caused by gastrointestinal fistula or iatrogenic surgical and diagnostic instrumentation. We report a case of emphysematous prostatitis in a 66 years old male with diabetes mellitus.