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

There have been reports that hyperammonemia and amino acid disturbance can cause loss of consciousness in patients with multiple myelomas and normal liver function. We experienced a case of a 71-years-old female patient with amyloidosis, who had shown disturbance of consciousness. At that time, the serum ammonia level was elevated; serum amino acids disturbance was also noted. In particular, the decrease in branched-chain amino acids and increase in aromatic amino acids results in a low Fisher ratio. The Fisher ratio, the ratio of branched-chain to aromatic amino acids, has been suggested as an important indicator of consciousness disturbance. We report, for the first time in Korea, a case of amyloidosis, with mental disturbance due to serum amino acid disturbance.
Amino Acids ; Amino Acids, Aromatic ; Amino Acids, Branched-Chain ; Ammonia ; Amyloidosis* ; Consciousness ; Female ; Humans ; Hyperammonemia* ; Korea ; Liver ; Multiple Myeloma ; Unconsciousness

BACKGROUNDS/AIMS: The fine-needle aspiration (FNA) is a useful method for diagnosis of hepatocellular carcinoma (HCC). The aims of our study are to assess diagnostic accuracy of FNA, to define proper indications of FNA for diagnosis of HCC, and to evaluate the complications of FNA. SUBJECTS AND METHODS: To assess diagnostic accuracy we compared the results of preoperative FNA with postoperative pathology in 38 resected cases with primary liver cancer. To define proper indications and complications of FNA, we prospectively followed 138 patients received FNA for their liver tumors which were suspicious of primary liver tumor. RESULTS: The sensitivity, specificity, positive and negative predictive values of FNA were 100%, 97%, 100% and 66% respectively. All patients with serum alpha-fetoprotein (AFP) level over 1000 ng/ml were having HCC on FNA result. Among 36 patients with AFP level ranged 15-1000 ng/ml and hypervascular mass on angiography, 96% were having HCC. Among 50 patients with normal AFP level and hypervascular mass on angiography, 92% were having HCC. The major complications after FNA such as hemoperitoneum, pneumothorax, and iatrogenic arterioportal shunt developed in 2%, 2%, and 7% of subjects, respectively. We did not find any case of needle-tract seeding of cancer during a mean 4.7 months of follow-up. CONCLUSIONS: Although the FNA is an accurate method for diagnosis of HCC, FNA was usually not indicated for patients with serum AFP level over 1000 ng/ml or patients with hypervascular mass on angiography when they were suspected of having primary liver cancer. Major complications were hemoperitoneum, pneumothorax and iatrogenic arterioportal shunt. Iatrogenic arterioportal shunt may influence the efficacy of subsequent transcatheter arterial embolization.
alpha-Fetoproteins ; Angiography ; Biopsy, Fine-Needle* ; Carcinoma, Hepatocellular* ; Diagnosis* ; Follow-Up Studies ; Hemoperitoneum ; Humans ; Liver ; Liver Neoplasms ; Pathology ; Pneumothorax ; Prospective Studies ; Sensitivity and Specificity