Prenatal development of the thoracic aorta of the human during the period ranging from gestation weeks 7 (C-R length 20mm) to 30 (C-R length 260mm) was examined by transmission electron microscopy and the following results were obtained. The early form of cuboidal or columnar endothelial cells at 7-9 weeks of gestation changed gradually to typical flat endothelial cells at 12-14 weeks of gestation. At 9 weeks of gestation, the mesenchymal cells begin to differentiate to myoblasts, which have small clusters of myofilaments with dense bodies and rough endoplasmic reticulum. And from 14 weeks the differentiating cells begin to form a parallel concentric lamellar structure. At 12th week of gestation, elastic fibers were first seen in subendothelial connective tissue and the intercellular spaces between smooth muscle cells. Elastic fibers appeared as small globular shape which composed of a central core of elastic and peripheral microfibrils. From this period the amount of elastic fibers and their aggregation increases gradually in both the subendothelial space and the intercellular spaces between smooth muscle cells. At 30th week of gestation, subendothelial elastic fibers almost completed the internal elastic lamina and also well formed elastic laminae were seen between the smooth muscle cells adjacent to endothelial cells. However, in the space between the smooth muscle cells near the adventitia the elastic lamina formation is delayed. In the adventitia elastic fiber were scanty but collagen fibers are abundant.
Adventitia ; Aorta, Thoracic* ; Collagen ; Connective Tissue ; Elastic Tissue ; Endoplasmic Reticulum, Rough ; Endothelial Cells ; Extracellular Space ; Fetus* ; Humans* ; Microfibrils ; Microscopy, Electron, Transmission ; Myoblasts ; Myocytes, Smooth Muscle ; Myofibrils ; Pregnancy

PURPOSE: Delirium in the elderly is common in the postoperative period but there are only few reports on detailed studies of this condition. Number of urologic patients with postoperative delirium was increas ed in our hospital for recent 24 months. The clinical characteristics of patients with postoperative delirium was analyzed retrospectively. MATERIALS AND METHODS: We selected the patients with postoperative delirium from 1010 patients who had undergone urological surgery under general or spinal anesthesia in the period from Jan. 1997 to Dec. 1999. Diagnosis of postoperative delirium was established with Diagnostic and Statistical Manual of Mental Disorders(DAM-III-R) by psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric disorder, relationship with anesthesia, drugs, and surgical procedures, concomittant medical conditions, and complications were retrospectively reviewed. RESULTS: Postoperative delirium was observed in 13 patients (1.3%). All patients were male and mean age was 70.4 years (46-86 years). Surgical procedures included TURP(8 patients), cystectomy (3 patients), nephroureterectomy (1 patient), and bladder rupture repair (1 patient). Delirium became apparent between one day and two days after the operation (mean 32.2 hours) and lasted for up to 7 days (mean 53 hours). Several factors such as older age (>65 years), male patient, longterm medication, past history of CVA, memory impairment, hearing difficulty, traumatic brain contusion, and obsessive personality were thought to be risk factors of postoperative delirium. Treatment with Haloperidol(R) intramuscular injection (2.5-5mg, every 30 minutes, 2-4 times until symptom resolution was achieved) with or without Ativan(R) intravenous injection (2mg) were effective. Complete symptom recovery was seen in 92.3% (12/13) of patients. One patient (7.7%) with previous history of dementia had persistent memory disturbance and disorientation during follow-up periods. CONCLUSIONS: Generally, postoperative delirium is an acute transient confusional state without considerable sequeles. Treatment is sedation and prevention of inadvertent accident associated with confusional state. Urologic surgeon must be attentive to the development of this illness especially when high risk factors were present.
Aged ; Anesthesia ; Anesthesia, Spinal ; Brain Injuries ; Cystectomy ; Delirium* ; Dementia ; Diagnosis ; Follow-Up Studies ; Hearing ; Humans ; Injections, Intramuscular ; Injections, Intravenous ; Male ; Memory ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Rupture ; Urinary Bladder

Trichorrhexis nodosa is a distinctive response of the hair shaft to physical or chemical trauma, characterized by the development of node-like swelling, through which the shaft readily fractures. We have described here a case of trichorrhexis nodosa with scanning electron microscopic findings. Nodular swelling of the affected hair showed longitudinal fissures and fractures in the cortex with loss of cuticular scales. At the site of fracture, a paintbrush-like effect was seen.
Hair ; Weights and Measures

Eruptive vellus hair cysts and steatocystoma multiplex have clinical similarities in terms of age of onset, location and appeararice of the lesions, but histopathologic feitures are distinctively differen-tiated. We present herein a 37-year-old woman with eruptive vellus hair cyst and steatocystoma multiplex as well. The histopathologic sections from 2 different lesions showed features of both eruptive vellus hair cyst with sebaceous gland in and near the cyst wall, and steatocy toma multiplex with rudimentary hair follicle near the cyst wall. This case may support the premie that eruptive vellus hair cyst and steatocystoma multiplex have a common developmental origin.
Adult ; Age of Onset ; Female ; Hair Follicle ; Hair* ; Humans ; Sebaceous Glands ; Steatocystoma Multiplex*

No abstract available.
Aged* ; Humans ; Infant, Newborn*

Adult Clonorchis sinensis were collected from the biliary passage of nine cases of medico-legal autopsies. The worms were washed repeatedly with tap water and rinsed twice with physiological saline. Incubation took place in Tyrode's medium in order to recover live worms. The number of worms surviving in the medium was determined. The rate of surviving worms showed an unexpectedly high percentage (22.8%) in those cases autopsied 2 days after death. The surviving worm burden dropped sharply to 6.3 and 9.2 percent for those samples taken 5 days after death.
parasitology-helminth-trematoda ; Clonorchis sinensis ; autopsy

Scleroderma is an incidious and chronic disease of unknown cause. The clinical picute of scleroderma is characterized by the apperance of circumscribed of diffuse, hard, smooth, ivory colored areas that are immobile upon upon the underlying tissues. It may be classified to as a localized form (morphea) and a systemic scleroderma or progressive systemic sclerosis (PSS) which is characterized by diffuse involvment of the connective tissue of the skin and certain intemal organs. The authors observed 3 cases of PSS and 6 cases of morphea. They have complained of marked sclerosis or thickening of skin or slowly developing dyspneadue to interstitial pulmonary fibrosis which were confirmed by chest X-ray. Recently, penicillamine-D has been advocated as a beneficial agent in scleroderma by Asboe-Hansen. therefore, penicillamine-D was administered to the above patients. Two of PSS were markedly improved with normal skin softness. Two of morphea were also moderately improved. Other patients remained stationary or no effect.
Chronic Disease ; Connective Tissue ; Humans ; Pulmonary Fibrosis ; Scleroderma, Diffuse ; Scleroderma, Localized ; Scleroderma, Systemic ; Sclerosis ; Skin ; Thorax

Toxoplasma gondii, an intracellular coccidian protozoan, is the causative agent of toxoplasmosis, a widespread infection affecting various birds and mammals including humans. In immunocompetent hosts, the infection is usually asymptomatic and benign. Toxoplasmosis is either congenital or acquired. In general prenatal therapy of congenital toxoplasmosis is beneficial in reducing the ncy of infant infection. Therapies are based primarily on spiramycin because of the relative lack of toxicity and high concentration achieved in the placenta. Clindamycin is the standard drug for chemoprophylaxis in newborn infants, and is directed at preventing the occurrence of retinochoroiditis as a late sequel to congenital infection. The standard treatment for acquired toxoplasmosis in both immunocompetent and immunodeficient patients is the synergistic combination of pyrimethamine and sulphonamides. Toxoplasmic encephalitis is tbe most common manifestation of acquired toxoplasmosis in immunocompromised patients and if not treated is fatal. However, because of toxicity, the therapeutic efficacy of pyrimethamine sulphonamide combinations may be seriously limited in immunodeficient patients. We have experienced a case of toxoplasmosis during the workup of habitual aborter. So we report this case with a brief review of literatures.
Birds ; Chemoprevention ; Clindamycin ; Encephalitis ; Humans ; Immunocompromised Host ; Infant ; Infant, Newborn ; Mammals ; Placenta ; Pyrimethamine ; Spiramycin ; Toxoplasma ; Toxoplasmosis* ; Toxoplasmosis, Congenital

Systemic lupus erythematosus(SLE) is a multisystem disorder with a peak age of onset in the second and fourth decades of life predominantly occuring in females who will usually have the potential to become pregnant. This female to male predominance is greatest during childbearing years approaching a ratio of 13:1, after the menopause it declines to a ratio of 3:1, the ratio also seen in prepubertal years. In practice, despite the higher prevalence of rheumatiod arthritis, pregnancy in SLE is the most common management problem confronting physician and obstetrician amongst the connective tissue disorders and it is particularly important as the outcome of pregnancy is more unpredictable in this disease. As well as having clinical consequences for the health of both mother and fetus, pregnancy in lupus provides a model for studying the importance of other biological phenomena characterizing the disease. For example, the transplacental passage of maternal antibodies to Ro(SSA) and La(SSB) and their strong association with the neonatal lupus syndrome suggests a pathogenetic role for these autoantibodies. Other relevant issues are feto-meternal immunological tolerance and hormonal interaction with the immune system. We have experienced a case of recurrent pregnancy loss associated with systemic lupus erythematosus. So we report this case with a brief review of literatures.
Age of Onset ; Antibodies ; Arthritis ; Autoantibodies ; Biological Phenomena ; Connective Tissue ; Female ; Fetus ; Humans ; Immune System ; Lupus Erythematosus, Systemic* ; Male ; Menopause ; Mothers ; Pregnancy* ; Prevalence

BACKGROUND: Thromboembolism is the major complication in patients with the insertion of cardiac prosthetic valves. The purpose of this study is evaluate the risk factors about the formation of left atrial thrombi after cardiac valve replacement. METHOD: Transesophageal(TEE) and transthoracic echocardiography(TTE) were done to evaluate postoperative cardiac condition in 98 patients with cardiac prosthetic valves from Jan. 1991 to Oct 1991. Several clinical and echocardiographic parameters were analyzied to evaluate the relationship with the formation of left atrial thrombi. RESULT: In univariate analysis, important factors related to the formation of left atrial thrombi are type of operation (p=0.027), postoperative left ventricular function(p=0.003), preoperative(p=0.037) and postoperative systolic ventricular size(p=0.024). However, in multivariate analysis postoperative left ventricular size(p=0.017), presence of previous thrombi(p=0.014), preoperative left atrial size(p=0.014) and postoperative left atrial size(p=0.014) are significant factors. CONCLUSION: Patients with high risk and low risk for the formation of left atrial thrombi after valve replacement can be identified by readily available clinical and echocardiographic variables.
Echocardiography ; Heart Valves ; Humans ; Multivariate Analysis ; Risk Factors* ; Thromboembolism