Experimental allergic encephalomyelitis (EAE) has been a well established animal model of postvaccinatal demyelinating diseases occurring in humans. Therefore elucidation of its pathogenesis would be very critical for the understanding of various human demyelinating diseases including multiple sclerosis. This study was performed to characterize the infiltrating cells in inflammatory sites and analyze the nature of the damage of blood brain barrier in experimental allergic encephalomyelitis. Experimental allergic encephalomyelitis was produced by administering homologous spinal cord homogenate together with complete Freund's adjuvant in guinea pigs. Immunostainings on guinea pig IgG, IgM, IgA and muramidase were performed by peroxidase-antiperoxidase or indirect immunofluorescent methods. The blood-brain barrier change was assessed by administering fluorescent Evans blue. Following results were made. In juvenile animals, both clinical findings and histopathologic changes were first noted by 3 weeks after injection and progressed during the whole experimental period. However, these findings were delayed in onset and low in incidence in adult animals. The clinical and pathologic changes started from the caudal portions and extended rostrally. The blood-brain barrier (BBB) was damaged and progressed starting also from the caudal portion of the spinal cord. The BBB changes were more severe in young animal than adult animals. Those changes preceded th histologic alterations. It is suggested that the BBB susceptibility is responsible for the caudal onset of histologic changes. Although the lesion has been thought to be induced by T-cell mediated hypersensitivity, infiltrating cells consisted mainly of muramidase positive histiocytes. A few immunoglobulin positive B cells or plasma cells could also be demonstrated in the lesion. The former usually infiltrated the parenchyme and the latter remained around the small or medium-sized vessels.
Adult ; Male ; Female ; Humans ; Animals ; Incidence

BACKGROUND: Hydrops fetalis is defined as abnormal accumulation of serous fluid in two or more fetal compartments, and this malady is known to be associated with various pathologic conditions. METHODS: We collected 149 cases of hydrops fetalis out of 2,312 autopsies, and we tried to elaborate the underlying causes of hydrops fetalis. The diagnosis was based on the material from either antenatal termination or intrauterine death. RESULTS: The relative incidence of hydrops fetalis was 6.44% of all the pediatric autopsies we performed. The gestational age was evenly distributed from 18 to 33 weeks, except for 30 to 31 weeks. There was no sex difference in the incidence of hydrops fetalis. The main causes were cardiovascular diseases (30.9%), cystic hygroma (13.4%), chromosomal anomaly (8.05%), thoracic conditions (7.38%), followed by urinary tract malformation (4.03%), infection (4.03%) and anemia (3.36%). The most common chromosomal anomaly was Turner syndrome and the second one was Down syndrome. CONCLUSION: Since various conditions can be the cause of hydrops fetalis, pathologists should pay attention to elaborate the underlying causes in every single autopsy.
Anemia ; Autopsy* ; Cardiovascular Diseases ; Diagnosis ; Down Syndrome ; Edema* ; Fetus ; Gestational Age ; Hydrops Fetalis* ; Incidence ; Lymphangioma, Cystic ; Sex Characteristics ; Turner Syndrome ; Urinary Tract

BACKGROUND: Along with the recent greater number of medical devices for the elderly in the market, there has been a parallel increase in the number of clinical trials for these devices. It is uncertain, though, whether the target population has the awareness and understanding of these clinical trials and the possible adverse events of the devices. METHODS: A total of 147 elderly subjects (mean age, 65.8+/-8.3 years; 39 males) responded to the questionnaire. A pilot study during the development of the questionnaire was conducted in 2009 with the actual survey taking place from June to November 2011. The questionnaire included 22 items-10 items on awareness and understanding of the clinical trial; 4 items on the understanding of adverse events; and 8 items on demographical characteristics. RESULTS: Of the responders, 62.5% had participated in at least one clinical trial and had heard about the clinical trials through a doctor, newspaper, or television. And 63.3% of the responders understood that the purpose of the trial was to show efficacy and safety for the medical device. There were significant differences on the awareness of the trial by gender and life level. However, there was no statistically significant difference in adverse events awareness. CONCLUSION: Although elderly subjects participate in clinical trials, it seems they do not receive enough information when involved in clinical trials of medical devices. In the future, before these trials are carried out, medical device companies need to ensure that they provide their elderly subjects with better education and information.
Aged ; Dietary Sucrose ; Health Services Needs and Demand ; Humans ; Hypogonadism ; Mitochondrial Diseases ; Periodicals ; Ophthalmoplegia ; Pilot Projects ; Surveys and Questionnaires ; Television

No abstract available.
Scimitar Syndrome*

An appreciation of the radiation changes in the brain adjacent to radiated glioma is of considerable importance from both clinical and pathological standpoint because the alteration in the brain parenchyma may result in a picture that mimics recurrence of the neoplasm. A 35 years old woman was admitted because of deterioration of consciousness which has started about 20 days ago. Past history revealed removal of left frontal brain tumor 4 years earlier and the diagnosis was grade II astroma. Postoperative radiation was done at that time. Sine then, she has been doing well. Computerized tomogram showed an ill defined huge low density mass at right frontal and left posterior parietal areas, which was irregularly enhanced in postcontrast study. Unlikely to the usual brain tumors, there was no mass effect on adjacent structures. Histologically acellular necrotic zone was alternating with hypercellular zone and most striking changes were vascular and glial reaction. Most of the vessels showed acellular hyliane thickening of their wall and some vessels were almost completely occluded. There was marked glial proliferation with considerable cellular and nuclear irregularities. Gemistocytic astrocytes were frequently seen and some were multinucleated.
Female ; Humans

Osteogenesis imperfecta is a hereditary condition characterized by fragility of bone, deafness, blue sclera, laxity of joints and a tendency to improvement with age. Authors experienced osteogenesis imperfecta that develped over 3 generations in one pedigree. A 28 years old female exhibited severe anterior bowing deformity of left tibia. She has a past history of many times of bone fractures. She was treated with corrective osteotomy, plate fixation for correction of bowing deformity of left tibia and medullary nailing with fibular graft for paeudarthrosis of Rt. forearm bone.
Congenital Abnormalities ; Deafness ; Family Characteristics ; Female ; Forearm ; Fractures, Bone ; Humans ; Joints ; Osteogenesis Imperfecta ; Osteogenesis ; Osteotomy ; Pedigree ; Sclera ; Tibia ; Transplants

Pulmonary thromboembolism (PTE) is a serious postoperative complication. Prompt diagnosis of PTE is important but it is difficult because clinical manifestations of PTE are not obvious in most cases. A 59 year-old woman received cholecystectomy and choledocholithotomy under general anesthesia. At the 9th postoperative day, syncope, hypoxemia and hypotension were developed suddenly and the patient was transfered to intensive care unit. PTE was suspected with hemodynamic monitoring from pulmonary arterial catheter and echocardiography and diagnosed with lung perfusion scan and venogram of lower extremities. Proper cardiopulmonary support was done and the patient was recovered and discharged in improved condition. In conclusion, if a patient have syncopal attack with shock in postoperative period, PTE must be thought to be an one of possible causes of syncope and thoroughly investigated.
Anesthesia, General ; Anoxia ; Catheters ; Cholecystectomy ; Diagnosis ; Echocardiography ; Female ; Hemodynamics ; Humans ; Hypotension ; Intensive Care Units ; Lower Extremity ; Lung ; Middle Aged ; Perfusion ; Postoperative Complications ; Postoperative Period ; Pulmonary Embolism* ; Shock ; Syncope

In order to investigate the validity of the Steel's gluteus medius and minimus advancement, we reviewed 21 hips in 14 spastic cerebral palsy patients, who had advancement of the gluteus medius and minimus insertion for the correction of in-toeing gait between November 1985 and February 1992. The procedure was limited to those patients who had moderate to severe in-toeing gait with positive Steel's stretch reflex. There were eight boys and six girls. The average age at the time of surgery was 6.7 years(2.9 years-11.9 years). The procedure was performed on both hips in seven patients. Of the 14 patients, nine had diplegia, three hemiplegia, and two paraplegia. The average follow-up time was 4.3 years(1 year-8.5 years). In-toeing gait was converted to neutral or physiologic out-toeing gait in 17 hips(81%), excessive out-toeing in 2 cases(9.5%), and mild residual in-toeing in 2 cases(9.5%), Steel's stretch reflex, which was present in all cases preoperatively, disappered in 19 hips(90.5%) postoperatively, Abductor power, however, decreased from 4+ to 4− in average postoperatively, Among the 16 hips, which had no Trendelenburg sign or gait preoperatively, 8 hips(50%) showed positive Trendelenburg sign and gait postoperatively. In conclusion, Steel's gluteus medius and minimus advancement appears to be effective in the correction of in-toeing gait, but there is high risk of weakening the abductor power.
Cerebral Palsy ; Female ; Follow-Up Studies ; Gait ; Hemiplegia ; Hip ; Humans ; Muscle Spasticity ; Paraplegia ; Reflex, Stretch

Pure, nongestational ovarian choriocarcinomas is extremely rare. Most ovarian choriocarcinoma are combined with other malignant germ cell tumors or can arise as a metastaais from a primnry gestational choriocarcinoma. We experienced a case of primary ovarian choriocarcinoma that probably was associated with a past history of the mixture of germ cell tumor and present it with a review of literature.
Choriocarcinoma* ; Female ; Neoplasms, Germ Cell and Embryonal ; Pregnancy

Beta-fluoroethylacetate has been extensively used as the rodenticide in Korea. In some patients with acute poisoning, beta-fluoroethylacetate caused cerebellar dysfunction as a single and persistent neurologic sequela after a period of an acute neurological disorder which is characterized by mental deterioration, seizures, and respiratory failure. But there has been no report of pathological findings to explain neurological deficit. We tried to verify the histologic changes of the central nervous systems in beta-fluoroethylacetate poisoned rats. Silver staining(Gallyas) was used to evaluate the histology. In acute intoxication experiment with LD50(7mg/Kg), beta-fluoroethylacetate elicited acute onset of consciousness deterioration, generalized tonic-clonic seizures and large amplitude tremulous activity involving whole body with full recovery after 24 hours. There was no discernible pathologic change in CNS in acutely poisoned rats. However, when poisoned with sublethal dose(5mg/Kg) daily for five days, a moderate degree of nerve cell degeneration was found selectively in dentate nucleus, Purkinie cell layer, vestibulo-cochlear nucleus and striatum. This change was not seen in hippocampus, cerebral cortex or cerebellar cortex. These findings were well correlated with the previous reports of selective pathology in human 5-FU intoxication cases. Our preliminary results suggest that beta-fluoroethylacetate, a kind of cellular metabolism inhibitor may induce selective neuropathology mainly involving cerebellar output pathway in rats.
Humans ; Rats ; Animals ; Poisons