• Applied Microscopy
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• v.30 no.2
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• pp.213-232
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• 2000

The development of the knee joint was studied by electron microscopy in human fetuses ranging from 20 mm to 260 mm crown-rump length ($7\sim30$ weeks of gestational age). The appearance of the primordium of the meniscus and cruciate ligament was conspicuous as the mesenchymal cells , preceeding that of joint space at 30 mm fetus. The primitive joint cavity was first seen in the interzone from the 40 mm fetus and its intermediate layer proceeded developing as a narrow cleft which was closely incorporated with two chondrogenic layers. Poorly differentiated mesenchymal cells of the meniscus at 40 mm fetus containing predominantly free ribosomes differentiated into fibroblasts at 60 mm fetus. By 100 mm fetus, the fibroblast in inner zone of the meniscus presented as oval profiles with a short cell processes, whereas middle and peripheral zones presented as elongated cells. Differentiation of the synovial membrane coincided with clarification of the joint cavity When dilatation of the synovial cavity occurred, the two types of synovial cells were identified at 60 mm fetus. By 100 mm fetus a majority of the intimal cells were B-type. B-type cells were clearly distinguishable from A-type cells by their content of extensive rough endoplasmic reticula and well developed Golgi complexes. In contrast, A-type cells had numerous filopodia, pinocytotic vesicles, lysosomes and large vacuoles. At 260 mm fetus the B-type cells were also a majority of intimal cells. At 260 mm fetus the inner zone of the meniscus was filled with parallel oriented fascicles of collagenous fibers and oval fibroblasts. The middle zone was constituted of parallel and radially arranged fibers and fibroblasts. The outer zone was populated by elongated fibroblasts encircled by crossed collagenous fibers with the blood vessels. At 30 mm fetus the fibroblasts of the cruciate ligament contained rough endoplasmic reticula and mitochondria. Collagen fibrils were noted within narrow cytoplasmic processes which were continued with the extracellular space. Collagen fibrils of ligament were filled in the bulk of extracellular space at 100 mm fetus. By $150\sim260mm$ fetus, the cruciate ligaments were constituted of longitudinally oriented bundle of collagen fibrils with irregular rows of round cells between.

• Childhood Kidney Diseases
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• v.4 no.1
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• pp.77-83
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• 2000

Purpose: Pregnancy in transplanted mother is considered as a high-risk pregnancy, and significant incidences of prematurity and low-birthweight(LBW) infants have been reported. The objective of this study is to examine the outcome of pregnancy in transplanted mothers and to evaluate the current growth status in their children. Patients and Methods: We retrospectively reviewed 54 pregnancies in 40 kidney recipients until June 1999. Outcomes of pregnancy were reviewed and assessment of the current growth status in children was performed. Results: 54 pregnancies in 40 recipients were identified; 22 ended in termination of pregnancy because of unwanted pregnancy or therapeutic purposes. And of the other 32, 29 livebirths resulted in 28 recipients. The mean age of conception was $30.3{\pm}3.8$ years, with a mean interval from transplantation to conception of $35.9{\pm}23.2$ months. All patients were maintained on immunosuppressive regimens. Incidence of drug-treated hypertension(HTN) prior to pregancy was $52\%$, HTN during pregnancy, $48\%$; preeclampsia, $41\%$; urinary tract infection, $48\%$; oligohydramnios $4\%$; and no rejection during pregnancy and up to 3month post delivery. Of the 29 liveborn infants, prematurity(<37wk) occurred in $52\%$, LBW(<2500g) in $62\%$, VLBW(<1500g) in $7\%$ and $48\%$ born intrauterine growth retardation(IUGR). Mean gestational age was $36.3{\pm}3.0\;wk$; a mean birthweight, $2.23{\pm}0.6\;kg$; a mean birth-height, $45.1{\pm}3.6cm$. Current mean height standard deviation score (height SDS) was $0.29{\pm}0.91$ and mean weight SDS was $0.62{\pm}1.34$. Only one child($4\%$) under 1 year of age was below 10 percentile in height. Most of children had no medical problems except for 4 children; cleft palate(1), tuberous sclerosis(1), essential hematuria(1), and one child expired due to sepsis. Conclusion: This study showed similar incidence of premaure birth($57\%$) and low birth weight infants($62\%$), but lower incidence of spontaneous abortion($5.6\%$) was observed and compared to other studies. Postnatal growth in majority of children($96\%$) achieved catch-up growth before 1 year. Present study supports a more optimistic view of pregnancy in renal transplant mother and normal growth in their children.