To estimate the postmortem interval (PMI) by using entomological evidence, species identification of forensically important flies is mandatory. However, the traditional species identification method, which relies on the key morphological features of adult flies, is not always available to investigators and has limitations to the immature samples. Because of these limitations, species identification using DNA sequences has long been an issue in the field of forensic entomology. In this review, I have briefly described the basic principles of molecular species identification and phylogenetic analysis and their applications in forensic entomology. I also recommend an experimental and statistical method to identify unknown fly samples obtained from the field.
Adult ; Base Sequence ; Diptera* ; DNA Barcoding, Taxonomic ; Entomology ; Forensic Sciences ; Humans ; Korea* ; Research Personnel ; Species Specificity

Chronic perineal pain is an often encountered problem, which produces a great degree of functional impairment and frustration to the patient and a challenge to the treating physician. The reason for this problem is that the region contains diverse anatomic structures with mixed somatic, visceral and autonomic innervations affecting bladder and bowel control and sexual function. A blockade of nociceptive and sympathetic supply to the perineal region, supplied through the ganglion impar has been shown to benefit patients with chronic perineal pain. Several options to this block have been described that chemical neurolysis, radiofrequency ablation etc. Although the analgesic effect of Botulinum toxin type A (BoNT-A) has long been considered secondary to its action for muscle relaxation, BoNT-A also affects the release of the neurotransmitters that are involved in pain perception. We describe a patient who was successfully given ganglion impar block with BoNT-A.
Botulinum Toxins ; Botulinum Toxins, Type A ; Frustration ; Ganglion Cysts ; Humans ; Muscle Relaxation ; Nerve Block ; Neurotransmitter Agents ; Pain Perception ; Urinary Bladder

The prognosis of distal pancreatic cancer is even poorer than that of pancreatic head cancer because of its late symptom onset and tendency of aggressive retroperitoneal invasion at diagnosis. Since the first Appleby's operation in 1952, it has been performed in stomach cancer by several surgeons. But the survival benefit is still controversial. Appleby's operation includes total gastrectomy, splenectomy, distal pancreatectomy, celiac trunk division with ligation of common hepatic artery(CHA) and retroperitoneal lymph node dissection. In 1976, Nimura first adopted this method for distal pancreatic cancer. We report a case of modified Appleby's operation for distal pancreatic cancer. The patient was 44- year old female. Her chief complaint was epigastric pain for 2 weeks. Preoperative liver function test was within normal range and CA19-9 was elevated to 200 U/ml. Preoperative CT angiography showed 4.5x3cm sized, pancreatic mass in body and tail area invading splenic artery and celiac trunk from its left side. In operation, splenectomy and distal pancreatectomy was initially performed. After ligation of CHA, we confirmed intact proper hepatic artery(PHA) flow by doppler and then divided CHA. After confirmation of intact gastric blood flow, left gastric artery(LGA) was divided. Celiac axis(CA) was divided near its origin. Then we dissected retroperitoneal lymph nodes. There was minor pancreatic leakage controlled by conservative management. CA19-9 was normalized to 33 U/ml on the 16th postoperative day. She was discharged on the 28th postoperative day and underwent adjuvant chemotherapy and radiotherapy. There is no evidence of recurrence for 15 months of follow-up. We suggest that modified Appleby's operation should be considered for radical resection of distal pancreatic cancer which is invading CA or major CA branch but not involving PHA and superior mesenteric artery(SMA), if the CA root is resectable and PHA flow is intact from SMA after ligation of CHA.
Angiography ; Chemotherapy, Adjuvant ; Diagnosis ; Female ; Follow-Up Studies ; Gastrectomy ; Head and Neck Neoplasms ; Humans ; Ligation ; Liver Function Tests ; Lymph Node Excision ; Lymph Nodes ; Pancreatectomy ; Pancreatic Neoplasms* ; Prognosis ; Radiotherapy ; Recurrence ; Reference Values ; Splenectomy ; Splenic Artery ; Stomach Neoplasms

Orthostatic hypotension (OH) is associated with symptoms including headache, dizziness, and syncope. The incidence of OH increases with age. Attenuation of the vestibulosympathetic reflex (VSR) is also associated with an increased incidence of OH. In order to understand the pathophysiology of OH, we investigated the physiological characteristics of the VSR in the disorder. We applied sodium nitroprusside (SNP) to conscious rats with sinoaortic denervation in order to induce hypotension. Expression of pERK in the intermediolateral cell column (IMC) of the T4~7 thoracic spinal regions, blood epinephrine levels, and blood pressure were evaluated following the administration of glutamate and/or SNP. SNP-induced hypotension led to increased pERK expression in the medial vestibular nucleus (MVN), rostral ventrolateral medullary nucleus (RVLM) and the IMC, as well as increased blood epinephrine levels. We co-administered either a glutamate receptor agonist or a glutamate receptor antagonist to the MVN or the RVLM. The administration of the glutamate receptor agonists, AMPA or NMDA, to the MVN or RVLM led to elevated blood pressure, increased pERK expression in the IMC, and increased blood epinephrine levels. Administration of the glutamate receptor antagonists, CNQX or MK801, to the MVN or RVLM attenuated the increased pERK expression and blood epinephrine levels caused by SNP-induced hypotension. These results suggest that two components of the pathway which maintains blood pressure are involved in the VSR induced by SNP. These are the neurogenic control of blood pressure via the RVLM and the humoral control of blood pressure via epinephrine release from the adrenal medulla.
6-Cyano-7-nitroquinoxaline-2,3-dione ; Adrenal Medulla ; alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid ; Animals ; Blood Pressure ; Denervation ; Dizocilpine Maleate ; Dizziness ; Epinephrine ; Excitatory Amino Acid Antagonists ; Glutamic Acid ; Headache ; Hypotension* ; Hypotension, Orthostatic ; Incidence ; N-Methylaspartate ; Nitroprusside ; Rats* ; Receptors, Glutamate ; Reflex* ; Spinal Cord Lateral Horn ; Syncope ; Vestibular Nuclei

OBJECTIVE: To investigate the relationship between activities of daily living (ADL) dependence and psychological parameters in the adult hemiplegic stroke patients. METHODS: The subjects were total 122 stroke patients who underwent rehabilitation therapy. Patients were surveyed with questionnaires for anxiety, stress, and depression. Cognitive functions were assessed by mini-mental status examination and their ADL functions were evaluated by modified Barthel index. The correlation between ADL function and psychological parameters was statistically analyzed by Pearson's correlation test. RESULTS: Results were as follows: The average stress score of stroke patients was 76.7 which was relatively high. Fourty-seven percent of stroke patients suffered from depression, and it was more frequent in the left hemiplegics. As the result of the Pearson's correlation test, ADL function is closely correlated with intrapersonal stress level, but not with the level of anxiety or depression. The cognitive function has correlation with intrapersonal stress level, but not with depression. CONCLUSION: Understanding of the relationship between psychological status and ADL function in the stroke patients will be helpful to the physician for conducting efficient rehabilitation of these patients.
Activities of Daily Living* ; Adult ; Anxiety* ; Depression* ; Humans ; Surveys and Questionnaires ; Rehabilitation ; Stroke*

To estimate postmortem interval, it is essential to obtain information regarding fly growth. Analyzing the relationship between growth period and body length using a sigmoid function is widely accepted in animal science. However, in forensic entomology, it is difficult to find studies related to growth period and body length. Therefore, we compared growth curve models for forensically important flies using sigmoid functions. we used the data from flour fly species (Calliphora lata, Calliphora vicina, Chrysomya pinguis, and Lucilia illustris) and fited these against five sigmoid functions: quadratic-plateau model, logistic model, Gompertz model, von Bertalanffy model, and Brody model. Model evaluation criteria were, R2 mean squared error (MSE), Akaike information criterion (AIC), and Bayesian information criterion (BIC). The von Bertalanffy model yielded the highest R2 value and the lowest MSE, AIC, and BIC values for C. lata, whereas the logistic model was the best fit for the data from the other three species C. vicina, Ch. pinguis, and L. illustris.

BACKGROUND: Keloids and hypertrophic scars are benign growths of dermal collagen that usually cause major physical, psychological, and cosmetic problems. Numerous treatment modalities have been used to treat keloids and hypertrophic scars, but the optimal treatment has not been established. OBJECTIVE: The purpose of this study is to investigate whether bleomycin intralesional injection has an therapeutic effect on both keloids and hypertrophic scars. METHODS: Thirteen patients with keloids or hypertrophic scars were administered with intralesional injection of bleomycin (1.5 IU/ml). Scar height was measured, and scar pliability and erythema were scored at baseline and then monthly during the treatment and follow-up period. Patient's self-assessments of subjective symptoms (pruritus and pain) were also scored. Pre- and post-treatment mean values for scar height, scar pliability, erythema, pruritus and pain were statistically compared. RESULTS: The clinical response was positive in all cases: highly significant flattening in one case, significant flattening in one case, moderate flattening in five cases and minimal flattening in six cases. The mean scores for pruritus and pain also improved. The observed side-effects were hyperpigmentation (two cases), hypopigmentation (one case) and skin infection (one case). No exacerbation was noted during follow-up period of 4 months. CONCLUSION: Bleomycin intralesional injecton may be one of the effective and safe method of treating keloids and hypertrophic scars.
Bleomycin ; Cicatrix ; Cicatrix, Hypertrophic ; Collagen ; Cosmetics ; Erythema ; Follow-Up Studies ; Humans ; Hyperpigmentation ; Hypopigmentation ; Injections, Intralesional ; Keloid ; Pliability ; Pruritus ; Self-Assessment ; Skin

Abdomianl pregnancy is rare, occurring 9.2 cases per 1,000 ectopic pregnancies and encountered in 1 in 10,000-25,000 births. Omental pregnancy is extremely rare form of abdominal pregnancy that may cause life-threatening massive hemorrhage in case of rupture. The clinical characteristics is variable and physical examination by itself may be insufficient for diagnosis. Early and accurate diagnosis is necessary to decrease fetal and maternal mortality and morbidity, serious complications. We report a case of ruptured early omental pregnancy with a review of literature.
Diagnosis ; Female ; Hemorrhage ; Maternal Mortality ; Parturition ; Physical Examination ; Pregnancy* ; Pregnancy, Abdominal ; Pregnancy, Ectopic ; Rupture

PURPOSE: The purpose of this study was to evaluate the clinicopathological significance of the microvessel density and macrophage and mast cell counts in invasive breast carcinomas. MATERIALS AND METHODS: 45 invasive breast carcinomas were immunohistochemically stained with the endothelial antigen, CD34, and macrophage marker, CD68. 0.1% toluidine blue was used to highlight mast cells. The microvessel and mast cell counts were performed at x200 magnification and the macrophages at x400 magnification. RESULTS: With the 45 invasive breast carcinomas, there were no statistically significant associations between the mast cell, macrophage and microvessel counts and the tumor size and lymph node status. ER and PR negative mast cells infiltrated more than in cases of positive stati, with statistical significance (p-value=0.010 and 0.005, respectively). The macrophage counts were negatively correlated with the PR status (p-value=0.030). With respect to the c-erbB-2 status, there was no significance correlation with the mast cell, macrophage and microvessel counts. The mast cell counts showed significantly positive correlation with the microvessel counts in the invasive breast carcinomas (p-value=0.015). In a comparison of the macrophage counts with the microvessel counts, a positive tendency for both parameters, but without statistical significance (p-value=0.310). CONCLUSION: Increasing numbers of mast cells and macrophages were recruited in invasive breast carcinomas, which contribute to angiogenesis. The microvessel density in invasive breast carcinomas had no statistically significant association with the tumor size, lymph node status, and histological grade, presence of DCIS component, estrogen/progesterone receptor status and cerbB-2 status. The evaluation of angiogenesis using these methods is not thought to provide an independent clinicopathological factor in invasive breast carcinomas.
Antigens, CD34 ; Breast Neoplasms ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Lymph Nodes ; Macrophages* ; Mast Cells* ; Microvessels* ; Tolonium Chloride

BACKGROUND/AIMS: Nuclear factor-kappa B p65 (NF-kappa B p65), nuclear factor-kappa B1 p50 (NF-kappa B p50) have been shown to play a role in cell proliferation, apoptosis, cytokine production, and oncogenesis. Recently, p38 mitogen-activated protein kinase (MAPK)/ NF-kappa B/ cyclin D1 signaling pathway has been shown to play an important part in the pathogenesis of human cancers. This study was designed to investigate the expression of NF-kappa B p65, NF-kappa B p50, p38 MAPK alpha, and cyclin D1 proteins in premalignant lesions of colon and colorectal adenocarcinoma. METHODS: Paraffin sections of 20 normal mucosa, 20 low-grade tubular adenoma, 20 high-grade tubular adenoma and 64 adenocarcinoma tissues were analysed immunohistochemically for the expression of NF-kappa B p65, NF-kappa B p50, p38 MAPK alpha, and cyclin D1 proteins. RESULTS: The expression of NF-kappa B p65, NF-kappa B p50, and p38 MAPK alpha proteins were significantly higher in adenocarcinoma tissue in comparison with that in normal mucosa, low-grade tubular adenoma, and high-grade tubular adenoma tissues. Expression of NF-kappa B p50 was more frequent in poorly differentiated histologic grade, presence of nodal metastasis, and advanced stage. Expression of p38 MAPK alpha protein was higher in advanced tumor stage, presence of nodal metastasis and advanced stage. Synchronous expression of NF-kappa B p65, NF-kappa B p50, p38 MAPK alpha, and cyclin D1 proteins were significantly higher in adenocarcinoma tissue. CONCULSIONS: With the increased expression of NF-kappa B p65, NF-kappa B p50, and p38 MAPK alpha proteins, p38 MAPK/ NF-kappa B/ cyclin D1 signaling pathway may play a role in the pathogenesis of colorectal carcinoma.
Adenocarcinoma/enzymology/*metabolism/pathology ; Colorectal Neoplasms/enzymology/*metabolism/pathology ; Cyclin D1/immunology/*metabolism ; Data Interpretation, Statistical ; Female ; Humans ; Immunohistochemistry ; Intestinal Mucosa/metabolism ; Male ; Middle Aged ; NF-kappa B/immunology/*metabolism ; NF-kappa B p50 Subunit/immunology/metabolism ; Neoplasm Staging ; Precancerous Conditions/enzymology/*metabolism ; Transcription Factor RelA/immunology/metabolism ; p38 Mitogen-Activated Protein Kinases/*metabolism