The aim of this study was to investigate necrophagous blowflies to confirm their forensic importance in criminal investigations and to produce a pictorial key to easily identify blowflies that are likely to be present at the scene of death. Of the 26 calliphorid species recorded in Korea, 16 species were sampled from 103 animal cadavers including 63 rabbits and 40 pigs. We identified 13 species in Calliphorinae, Aldrichina grahami (Aldrich), Calliphora nigribarbis Vollenhoven (= C. lata Coquillett), C. subalpina (Ringdahl), C. vicina (Robineau-Desvoidy), C. vomitoria (L.), Hemipyrellia ligurriens (Wiedemann), Lucilia ampullacea Villeneuve, L. caesar (L.), L. cuprina (Wiedemann), L. illustris (Meigen), L. papuensis Macquart, L. porphyrina (Walker), and L. sericata (Meigen), and three species in Chrysomyinae, Chrysomya megacephala (F.), Ch. pinguis (Walker), and Ch. rufifacies (Macquart). They were repeatedly recorded from various localities in different habitats and seasons. These species should be given importance in approaches to forensic science particularly as their ecological implications are well understood. An identification key for these forensically essential species is prepared in a user-friendly manner using characteristics easily visible to the bare eye or at least under a magnifying glass.

Surgical endarterectomy has been shown to be superior to medical treatment in the management of severe carotid stenosis. Endarterectomy, although effective, does have limitations, and percutaneous transluminal angioplasty with stent may offer an alternative modality of treatment. We report on a patient with severe coronary disease that femoral arterial cannulation was not possible due to aorto-femoral shunt operation and absent pulse. The transradial approach was used for aortography, bilateral carotid angiography and successful elective stent deployment in the left internal carotid artery. The transradial approach might be useful alternative in case of problems with femoral approach.
Angiography ; Angioplasty* ; Aortography ; Carotid Arteries* ; Carotid Artery, Internal ; Carotid Stenosis* ; Catheterization ; Coronary Disease ; Endarterectomy ; Humans ; Stents*

Coronary stent embolization is a rare event but may result in clinically relevant cardiac ischemia or peripheral embolization during the procedure. We report a case of systemic embolizations of two coil stents during the primary PTCA in acute myocardial infarction, who were treated successfully with a double wire helix technique and a gooseneck snare. Although in our experience this rare complication did not produce any clinical complications, care should be taken to prevent this possibility, especially in patients with significant vessel tortuosity, calcification, total occlusion, or mild stenosis proximal to the target lesion.
Constriction, Pathologic ; Humans ; Iliac Artery* ; Ischemia ; Myocardial Infarction ; SNARE Proteins ; Stents*

STUDY DESIGN: Case report. OBJECTIVES: We report a case of Ogilvie's syndrome following posterior decompression surgery in a spinal stenosis patient who presented with acute abdominal distension, nausea, and vomiting. SUMMARY OF LITERATURE REVIEW: Ogilvie's syndrome is a rare and potentially fatal disease that can easily be mistaken for postoperative ileus, and is also known as acute colonic pseudo-obstruction. Early recognition and diagnosis enable treatment prior to bowel perforation and requisite abdominal surgery. MATERIALS AND METHODS: An 82-year-old woman presented with 6 months of worsening back pain with walking intolerance due to weakness in both legs. She had hypertension, asthma, and Cushing syndrome without bowel or bladder symptoms. Further workup demonstrated the presence of central spinal stenosis on magnetic resonance imaging. The patient underwent an L2-3 laminectomy and posterior decompression. Surgery was uneventful. RESULTS: The patient presented with acute abdominal distension, nausea, and vomiting on postoperative day 1. The patient was initially diagnosed with adynamic ileus and treated conservatively with bowel rest, reduction in narcotic dosage, and a regimen of stool softeners, laxatives, and enemas. Despite this treatment, her clinical course failed to improve, and she demonstrated significant colonic distension radiographically. Intravenous neostigmine was administered as a bolus with a rapid and dramatic response. CONCLUSION: Ogilvie's syndrome should be included in the differential diagnosis of postoperative ileus in patients developing prolonged unexplained abdominal distension and pain after lumbar spinal surgery. Early diagnosis and initiation of conservative management can prevent major morbidity and mortality due to bowel ischemia and perforation.
Aged, 80 and over ; Asthma ; Back Pain ; Colon ; Colonic Pseudo-Obstruction ; Cushing Syndrome ; Decompression ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Enema ; Female ; Humans ; Hypertension ; Ileus ; Ischemia ; Laminectomy ; Laxatives ; Leg ; Magnetic Resonance Imaging ; Mortality ; Nausea ; Neostigmine ; Spinal Stenosis ; Urinary Bladder ; Vomiting ; Walking

OBJECTIVES: We report a case of Ogilvie's syndrome following posterior decompression surgery in a spinal stenosis patient who presented with acute abdominal distension, nausea, and vomiting.SUMMARY OF LITERATURE REVIEW: Ogilvie's syndrome is a rare and potentially fatal disease that can easily be mistaken for postoperative ileus, and is also known as acute colonic pseudo-obstruction. Early recognition and diagnosis enable treatment prior to bowel perforation and requisite abdominal surgery. MATERIALS AND METHODS: An 82-year-old woman presented with 6 months of worsening back pain with walking intolerance due to weakness in both legs. She had hypertension, asthma, and Cushing syndrome without bowel or bladder symptoms. Further workup demonstrated the presence of central spinal stenosis on magnetic resonance imaging. The patient underwent an L2-3 laminectomy and posterior decompression. Surgery was uneventful. RESULTS: The patient presented with acute abdominal distension, nausea, and vomiting on postoperative day 1. The patient was initially diagnosed with adynamic ileus and treated conservatively with bowel rest, reduction in narcotic dosage, and a regimen of stool softeners, laxatives, and enemas. Despite this treatment, her clinical course failed to improve, and she demonstrated significant colonic distension radiographically. Intravenous neostigmine was administered as a bolus with a rapid and dramatic response. CONCLUSION Ogilvie's syndrome should be included in the differential diagnosis of postoperative ileus in patients developing prolonged unexplained abdominal distension and pain after lumbar spinal surgery. Early diagnosis and initiation of conservative management can prevent major morbidity and mortality due to bowel ischemia and perforation.

PURPOSE: To evaluate the usefulness of combination therapy composed of percutaneous ethanol injection treatment and subsequent transarterial chemoembolization in the treatment of single nodular hepatocellular carcinoma(HCC). MATERIALS AND METHODS: A total of eight patients with single nodule hepatocellur carcinoma (+/-5cm)were treated with a combination of initial percutaneous ethonol injection therapy(PEIT) and, a week later, transcatether arterial embolization(TAE). CT was performed 3 weeks after TAE to assess whether or not lipidol uptake had occurred. If lipiodol was accumulated in the nodule, the necrotic rate of the tumor was calculated by the following equation: (initially observed tumor volume - volume of nodule in which lipidol uptake occurred)x100/Initially observed tumor volume. Follow-up CT scan was performed every third or fourth month to evaluate tumor growth or recurrence. RESULTS: A nodule in which lipidol uptake occurred was seen in four of the eight patients; in one of these, a tumor-confirmed by angiogaphic examination and laboratory data-recurred twelve months later. The mean necrotic rate of a tumor treated PEIT alone was 83%(range, 37%-100%). CONCLUSION: Although limited in numbers of cases we studied, use of combination therapy composed of PEIT and subsequent TAE, appears to be effective in achieving the high rate of tumor necrosis as well as in the evaluation of the tumor during follow-up.
Carcinoma, Hepatocellular* ; Ethanol* ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Necrosis ; Recurrence ; Tomography, X-Ray Computed ; Tumor Burden

BACKGROUND AND OBJECTIVES: Nasolabial cysts are relatively rare and are sometimes confused with tumors due to progressive enlargement. Treatment of a nasolabial cyst consists of sublabial excision or endonasal endoscopic marsupialization (EEM). The purpose of this study was to investigate the clinical features of nasolabial cysts in order to provide a basis for correct diagnosis and treatment. MATERIALS AND METHODS: Sixty-four patients with a nasolabial cyst were surgically treated between December, 1989 and January, 2010 at the Department of Otolaryngology, Asan Medical Center. Their clinical features, radiologic and histopathologic findings, and treatment and outcomes were retrospectively analyzed. RESULTS: The patients comprised 51 (80%) women and 13 men (20%), with ages ranging from 16 to 69 years with a mean of 43 years. Swelling of the nasolabial fold was the most frequently experienced symptom. There was no right or left side preponderance. Sublabial excision was applied in 57 cases (89%), while seven cases (11%) were treated via the endonasal approach. There was no case of recurrence. CONCLUSION: Nasolabial cysts should be suspected in patients with swelling of the nasolabial area and nasal obstruction. Enhanced CT may be needed to differentiate from tumors, odontogenic cysts, or other inflammatory lesions. Nasolabial cysts can be successfully treated via sublabial or endonasal approaches. Postoperative complications or recurrence is very rare.
Female ; Humans ; Male ; Nasal Cavity ; Nasal Obstruction ; Nasolabial Fold ; Nose ; Odontogenic Tumors ; Otolaryngology ; Postoperative Complications ; Recurrence ; Retrospective Studies

Neurilemmoma, like other non-epithelial tumors, seldom occurs in the thyroid gland. We present a case of a 61-year-old woman with a neurilemmoma of her left thyroid lobe. She was clinically and biochemically euthyroid, and underwent a left thyroid lobectomy without complications. The tumor was an encapsulated solid mass, 34x23x1 5mm in size and was diagnosed as neurilemmoma. Neurilemmoma of the thyroid gland tends to develop in the right lobe, but this case was in the left.
Female ; Humans ; Middle Aged ; Neurilemmoma* ; Thyroid Gland*

BACKGROUND AND OBJECTIVES: Practical concerns about transradial approach are increasing in consideration of high procedural success rate, low local complications, and patient's convenience. There was no available data about repeated-use of radial artery for coronary procedures. We evaluate the changes of radial arterial diameter and procedural outcomes of repeated transradial procedure. MATERIALS AND METHOD: Of consecutive 1771 transradial coronary procedures, 117 patients received repeated transradial procedures through the same radial artery. Radial arterial diameter, vascular access time and procedural outcomes were evaluated in between the group of first-use and repeated-use of radial artery. RESULTS: Among 117 patients of second transradial coronary procedure in the repeated-use group, 47 patients (41.6%) underwent coronary intervention and 66 patients (58.4%) underwent coronary angiography. The right radial approach was used in 82.9% of the cases. There was no significant difference in radial artery mean diameter between pre-procedure and 1 day after procedure in patients with first-use and repeated-use group. There was no significant change of radial arterial diameter after first-use depending on the SAR (the ratio of sheath outer diameter to radial artery inner diameter). However, after repeated-use of radial artery, there was significant reduction of radial arterial diameter 1 day after procedure in the patients with SAR more than 0.9 (p<0.05). In repeated-use group, the mean radial arterial diameter was 2.63 +/- 0.35mm mm before the procedure and 2.51 +/- 0.29mm during follow-up (136 +/- 123 days) (p<0.05). There was no significant difference of the vascular access time between the first-use and repeated-use procedures (2.9+/-3.1 vs 3.3+/-3.6 minutes, p<0.05). The procedural success and vascular complication rate of repeated-use of radial artery were as similar to those of the first-use, but total occlusion of radial artery was higher in the repeated-use group (2.6% vs 0.7%, p<0.05). CONCLUSION: The diameter of radial artery after transradial procedures was significantly reduced during follow-up and the incidence of asymptomatic radial artery occlusion was more frequent after repeated-use. However, repeated-use of radial artery was feasible in most patients with high procedural success rate and low vascular complications.
Coronary Angiography ; Follow-Up Studies ; Humans ; Incidence ; Radial Artery*

BACKGROUND AND PURPOSE: To evaluate changes in cortical excitability induced by zonisamide (ZNS) in focal epilepsy patients. METHODS: Twenty-four drug-nasmall yi, Ukrainianve focal epilepsy patients (15 males; overall mean age 29.8 years) were enrolled. The transcranial magnetic stimulation parameters obtained using two Magstim 200 stimulators were the resting motor threshold, amplitude of the motor-evoked potential (MEP), cortical silent period, short intracortical inhibition, and intracortical facilitation. These five transcranial magnetic stimulation parameters were measured before and after ZNS, and the findings were compared. RESULTS: All 24 patients were treated with ZNS monotherapy (200-300 mg/day) for 8-12 weeks. After ZNS, MEP amplitudes decreased (-36.9%) significantly in epileptic hemispheres (paired t-test with Bonferroni's correction for multiple comparisons, p<0.05), whereas the mean resting motor threshold, cortical silent period, short intracortical inhibition, and intracortical facilitation were unchanged (p>0.05). ZNS did not affect cortical excitability in nonepileptic hemispheres. CONCLUSIONS: These findings suggest that ZNS decreases cortical excitability only in the epileptic hemispheres of focal epilepsy patients. MEP amplitudes may be useful for evaluating ZNS-induced changes in cortical excitability.
Epilepsies, Partial ; Humans ; Isoxazoles ; Transcranial Magnetic Stimulation