Fetus papyraceus, also called fetus compressus, is a mummified and compressed fetus as a result of fetal death during pregnancy. It is always associated with twin pregnancy, and the other litter is usually alive to compress the dead feuts. The cause of death of the fetus is not always clear. Recently we had a case of fetus papyraceus from a 25-year-old woman, which we thought most probably caused by velamentous insertion of the umbilical cord into the dividing membrane of the placenta, resulting fetal death and subsequently becoming fetus papyraceus.
Pregnancy ; Female ; Humans

Invasive infection of the Streptococcus bovis group in a neonate is rare. In cases reported to date, the pathogen of neonatal S. bovis infections is usually Streptococcus gallolyticus subsp. pasteurianus (S. bovis biotype II/2). Streptococcus lutetiensis (S. bovis biotype II/1) was identified using 16S rRNA and tuf gene sequence analysis of the isolates from blood and cerebrospinal fluid (CSF) of a fever-presenting 28-day-old male. Blood culture analysis was performed using automatic equipment (VITEK 2) and identified Streptococcus infantarius supsp. infantarius, yet we were unable to get accurate results from the CSF culture. The fever subsided on the second day of hospitalization, and the patient was discharged without neurologic complication after 14 days of antibiotic therapy. In this case, we were able to accurately identify the pathogen using molecular genetic methods. To our knowledge, this is the first case of late onset neonatal bacteremia and meningitis caused by S. lutetiensis.
Bacteremia* ; Cerebrospinal Fluid ; Fever ; Hospitalization ; Humans ; Infant, Newborn ; Male ; Meningitis* ; Molecular Biology ; Sequence Analysis ; Streptococcus bovis ; Streptococcus*

Infantile myofibromatosis with systemic involvement is a very rare disease and is characterized by numerous nodules composed of spindle cells of a myofibroblastic nature. There are often disseminated throughout the subcutis, muscle, skeleton and viscera. We report an autopsy case of infantile myofibromatosis in a stillborn female fetus of 32 weeks of gestation. The nodules, Imm to 2 cm, were found over the whole body and viscera. The involved viscera were the heart, tongue, esophagus, gastrointestinal tract, portal areas of the liver, spleen anc pancreas. There were also associated malformations, viz., frontal meningoencephalocele, flexion defer-mities, syndactyly, cleft palate, agenesis of corpus callosum, pachygyria, diaphragmatic hemia, renal hypoplasia, etc. Multiple basaloid follicular hamartomas of the skin were noted on the face and extremeties. There are no previous reports in the literature of infantile myofibromatosis in conjunction with the above skin lesion and congenital malformations.
Infant ; Male ; Female ; Humans ; Hamartoma

Professional nurse Autonomy is an essential attribute of a discipline striving for full professional status. PURPOSE: This study was to clarify the concept of professional nurse autonomy to provide basic data needed for development of professional autonomy enhancing strategies. METHOD: This study use the process of Walker & Avante's concept analysis based on Wade's research (1999), and field data of 21 nurses. RESULTS: Professional nurse autonomy is defined as competency and creative performance of the professional nurse in practice, to decide independently or interdependently nursing activities and to be had accountable for results of decisions, that reflect advocacy and caring. It was identified that critical attributes include responsible discretionary decision making, collegial interdependence, initiative, creativity, and caring, advocacy, cooperative relationship with clients, receptive capacity to others, activeness, self confidence, and devotion and responsibility to their profession. Antecedents include personal characteristics, educational background, experience and structural characteristics that enhance professional nurse autonomy. Consequences of professional nurse autonomy are feelings of self-efficacy, empowerment, job satisfaction, reduction of intention to leave their job. CONCLUSION: According to these results, it is recommended that the curriculum provides an environment for learning professional nurse autonomy, and that is used as basic data to develope strategies to enhance professional autonomy of nurse in practice and it's effects.
Creativity ; Curriculum ; Decision Making ; Humans ; Intention ; Job Satisfaction ; Learning ; Nursing ; Power (Psychology) ; Professional Autonomy

A 42-year-old man presented with severe pancytopenia and uncontrolled epistaxis. The diagnosis of SLE was made and the pancytopenia was found to be due to myelofibrosis. The pulse therapy with methylprednisolone and maintenance therapy with prednisolone reversed both pancytopenia and myelofibrosis. Although myelofibrosis has been described in SLE, this coexistence must be very rare since there has been only 19 cases showing this combination. We report a case of SLE with myelofibrosis which was reversed by the treatment with glucocorticoid.
Adult ; Diagnosis ; Epistaxis ; Humans ; Lupus Erythematosus, Systemic* ; Methylprednisolone ; Pancytopenia ; Prednisolone ; Primary Myelofibrosis*

To determine the neuromuscular effect of mivacurium and its reversals in combination with gentamicin or magnesium, pharmacodynamic studies were done using a common peroneal nerve-anterior tibialis muscle preparation in 18, either sex, adult cats(weight, 2.5-4 kg). The ED50 or ED95 of mivacurium obtained by the cumulative dose-response study was 28.2+/-8.5 or 44.7+/-7.3 ug/kg, respectively. The onset of mivacurium under the pretreatment of magnesium (2.8+/-0.4 min.) was slower than that under the pretreatment of gentamicin (1.8+/-0.5 min.). The duration of mivacurium was prolonged. significantly with either gentamicin or magnesium compared to mivacurium alone. However, neostigmine facilitated the recovery of the neuromuscular block induced by mivacurium, even if gentamicin or magnesium was previously treated, and the antagonism effects of neostigmine and spontaneous recovery were always 100%. These results suggest that the neuromuscular blocking actions of mivacurium were potentiated by the pretreatment of gentamicin or magnesium, and mivacurium-induced neuromuscular block with gentamicin or magnesium was reversed completely.
Adult ; Animals ; Cats* ; Gentamicins* ; Humans ; Magnesium* ; Neostigmine ; Neuromuscular Agents ; Neuromuscular Blockade*

Interferon-alpha is an established therapy for the patients with myeloproliferative disease. Unusual immune-mediated side effects have been reported during treatment. Among them, renal and cardiac toxicities are rare complications. Recently we experienced a case of hemolytic uremic syndome found in a 40-year old male undergoing interferon-alpha therapy for chronic myelogenous leukemia, chronic phase. On admission, his chief complaints were generalized edema and azotemia. Bone marrow biopsy revealed transformation into accelerated phase. bcl/abl gene was positive. Peripheral blood smear showed hemolytic anemia. Despite prompt diagnosis, institution of plasmapheresis, and steroid, his renal function did not recover, as expected. Hemolytic uremic syndrome was a chronic form of renal toxicity due to interferon-alpha. In this case, renal function did not recovered to normal level. However, early detection of renal toxicity such as proteinuria or acute tubular necrosis, and the discontinuation of interferon-alpha could achieve the recovery of normal renal function. Therefore, periodic examination of renal function should be performed in the patients with the use of long-term interferon-alpha.
Adult ; Anemia, Hemolytic ; Azotemia ; Biopsy ; Bone Marrow ; Diagnosis ; Edema ; Hemolytic-Uremic Syndrome ; Humans ; Interferon-alpha* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Male ; Necrosis ; Plasmapheresis ; Proteinuria

BACKGROUND: Hepatitis C virus (HCV) RNA quantification is necessary for predicting the therapeutic response and assessing treatment results in patients with chronic HCV infection. Recently, real-time PCR technology for HCV RNA quantification displayed good linearity within the dynamic range. Thus, it is gradually replacing branched-DNA (bDNA) and PCR- hybridization assays. In this study, we evaluated the performance of the Real-QTM HCV quantification kit (biosewoom. Inc., Seoul, Korea) developed in Korea. METHODS: We evaluated the HCV quantification kit for detection limit, specificity, linearity, accuracy, and recovery rate of HCV RNA standard material. The results were analyzed for a correlation with those of Cobas Amplicor HCV Monitor 2.0. RESULTS: The HCV quantification kit showed a high recovery rate of HCV RNA standard material of various concentrations and amplication of HCV RNA equally in all genotypes. Hepatitis B virus and human immunodeficiency virus showed no cross-reactivity with HCV. Within-run and between-run coefficients of variation (CV) were 9.52~15.84% and 9.40~17.53%, respectively. Between-day coefficients of variation were 11.62~18.04%, and detection limit was 44 IU/mL. It showed a good correlation with Cobas Amplicor HCV Monitor 2.0 (R2=0.8954). CONCLUSION: The Real-Q HCV quantification kit showed a good specificity, sensitivity, linearity, and accuracy; therefore, we propose that it is fully adequate for monitoring antiviral therapy in patients with chronic HCV infection.
Chimera ; Genotype ; Hepacivirus ; Hepatitis B virus ; HIV ; Humans ; Limit of Detection ; Organothiophosphorus Compounds ; Real-Time Polymerase Chain Reaction ; RNA ; Sensitivity and Specificity

To investigate resistance to lamivudine (3TC), we examined the incidence of M184V in 20 HIV-1 patients treated with 3TC for 13.1 +/- 9 months. Fourteen of 20 patients had been exposed to zidovudine (ZDV) or didanosine (ddl) prior to 3TC therapy. Nested PCR targeting to reverse transcriptase (RT) and direct sequencing were performed for peripheral blood mononuclear cells sampled serially. There were resistance mutations to ZDV in at least 9 patients at baseline, although there was no resistance mutation to 3TC. We could detect M184V in 6 (30%) out of 20 patients. The incidence of M184V increased as the duration of therapy prolongs (13% in samples<12 months; 47% in samples gtoreq 12 months). The frequency of mutation M184V was higher in patients with previous mutation to ZDV than in patients with wild type. Resistance mutation was not detected in 7 patients. This study shows that resistance to 3TC tends to develop rapidly in patients with baseline mutations or two drugs combination therapy than in those treated simultaneously with triple drugs. This report is the first on resistance to 3TC in Korean AIDS patients.
Didanosine ; HIV-1* ; Humans ; Incidence ; Lamivudine* ; Polymerase Chain Reaction ; RNA-Directed DNA Polymerase ; Zidovudine

Mixed falciparum-vivax infection accounts for 5% of all malaria cases seen in endemic region. However, a larger proportion of mixed malaria cases develop cerebral complication. We report one case of mixed infection resulted in cerebral malaria.
Coinfection ; Malaria* ; Malaria, Cerebral