Cell transformation induced by epidermal growth factor (EGF) and 12-O-tetradecanoylphorbol-13-acetate (TPA) is a critical event in cancer initiation and progression, and understanding the underlying mechanisms is essential for the development of new therapeutic strategies. Licorice extract contains various bioactive compounds, which have been reported to have anticancer and anti-inflammatory effects. This study investigated the cancer preventive efficacy of licochalcone D (LicoD), a chalcone derivative in licorice extract, in EGF and TPA-induced transformed skin keratinocyte cells. LicoD effectively suppressed EGF-induced cell proliferation and anchorage-independent colony growth. EGF and TPA promoted the S phase of cell cycle, while LicoD treatment caused G1 phase arrest and down-regulated cyclin D1 and up-regulated p21 expression associated with the G1 phase. LicoD also induced apoptosis and increased apoptosis-related proteins such as cleaved-caspase-3, cleaved-caspase-7, and Bax (Bcl-2-associated X protein). We further investigated the effect of LicoD on the AKT signaling pathway involved in various cellular processes and found decreased p-AKT, p-GSK3β, and p-NFκB expression. Treatment with MK-2206, an AKT pharmacological inhibitor, suppressed EGF-induced cell proliferation and transformed colony growth. In conclusion, this study demonstrated the potential of LicoD as a preventive agent for skin carcinogenesis.

Purpose: Pembrolizumab is currently used to treat advanced triple-negative breast cancer (TNBC) and high-risk early TNBC with neoadjuvant chemotherapy (NAC). The tumor-infiltrating lymphocyte (TIL) level and programmed cell death ligand 1 (PDL1) status are predictors of response to NAC and immune checkpoint inhibitor treatment. We aimed to investigate whether the PD-L1 status in core needle biopsies (CNBs) could represent the whole tumor in TNBC. Materials and Methods: A total of 49 patients diagnosed with TNBC who received upfront surgery without NAC between January 2018 and March 2021 were included. The PD-L1 expression (SP142 and 22C3 clones) and TIL were evaluated in paired CNBs and resected specimens. The concordance PD-L1 status and TIL levels between CNBs and resected specimens were analyzed. Results: PD-L1 positivity was more frequently observed in resected specimens. The overall reliability of TIL level in the CNB was good [intraclass correlation coefficient (ICC)=0.847, p<0.001]. The agreements of PD-L1 status were good and fair, respectively (SP142, κ=0.503, p<0.001; 22C3, κ=0.380, p=0.010). As the core number of CNB increased, the reliability and agreement also improved, especially from five tumor cores (TIL, ICC=0.911, p<0.001; PD-L1 [22C3], κ=0.750, p=0.028). Regarding PD-L1 (SP142), no further improvement was observed with ≥5 tumor cores (κ=0.600, p=0.058). Conclusion CNBs with ≥5 tumor cores were sufficient to represent the TIL level and PD-L1 (22C3) status in TNBC.

Fibromuscular dysplasia (FMD) of the coronary artery is a rare cause of sudden cardiac death; however, its prevalence and fatality may have been overlooked so far. A 47-year-old man complained of pain in his back and shoulder and became unconscious. Despite resuscitation, he died 3 hours after symptom onset. The heart weight was in the normal range; however, all three major coronary arteries showed intimal thickening without atherosclerosis or inflammatory cell infiltration. Fragmentations and duplications of the internal elastic lamina which are histologic features of intimal fibroplasia, a focal-type FMD, were observed. The prevalence of coronary FMD remains unknown, although it may be related to spontaneous coronary artery dissection and sudden death. The histopathologic confirmation of coronary FMD and exclusion of other possible coronary diseases through autopsy are essential to reveal the nature of the disease and therefore apply the information in dealing with legal problems after death.
Atherosclerosis ; Autopsy ; Cause of Death ; Coronary Disease ; Coronary Vessels ; Death, Sudden ; Death, Sudden, Cardiac ; Fibromuscular Dysplasia ; Heart ; Humans ; Middle Aged ; Prevalence ; Reference Values ; Resuscitation ; Shoulder ; Tunica Intima

Fibromuscular dysplasia (FMD) of the coronary artery is a rare cause of sudden cardiac death; however, its prevalence and fatality may have been overlooked so far. A 47-year-old man complained of pain in his back and shoulder and became unconscious. Despite resuscitation, he died 3 hours after symptom onset. The heart weight was in the normal range; however, all three major coronary arteries showed intimal thickening without atherosclerosis or inflammatory cell infiltration. Fragmentations and duplications of the internal elastic lamina which are histologic features of intimal fibroplasia, a focal-type FMD, were observed. The prevalence of coronary FMD remains unknown, although it may be related to spontaneous coronary artery dissection and sudden death. The histopathologic confirmation of coronary FMD and exclusion of other possible coronary diseases through autopsy are essential to reveal the nature of the disease and therefore apply the information in dealing with legal problems after death.

From January 1, 2016 to December 31, 2016, a total of 1147 postmortem inspection cases in Area 8, Seoul Metropolitan Police Agency (Gangseo, Yangcheon, and Guro police stations) were statistically analyzed. Autopsies were performed in 205 cases (17.9%), and the autopsy rates were 17.6% (75/426 cases) in the Gangseo police station, 9.5% (34/357 cases) in the Yangcheon police station, and 24.3% (82/337 cases) in the Guro police station. For 288 cases with an unknown cause of death, the autopsy rates were 70.0% (60/87 cases) in the Gangseo police station, 28.6% (26/91 cases) in the Yangcheon police station, and 63.1% (65/103 cases) in the Guro police station. For 65 cases due to fall from height, the autopsy rate was 7.7% (n=5). Of the 187 cases due to hanging, 155 cases were classified as suicide at the scene with a 4.5% (n=7) autopsy rate and 32 cases were classified as an undetermined manner of death at the scene with a 15.6% (n=5) autopsy rate. The distribution of the “manner of death” was natural death, 45% (n=516); unnatural death, 29.9% (n=343); and other and undetermined, 25.1% (n=288). Proportions of dispatch times were 50.9% (584 cases) during work hours (09:00–18:00), 13.8% (n=158) during evening hours (18:00–21:00), 13.4% (n=154) at night (21:00–00:00), 11% (n=126) at dawn (00:00–06:00), and 10.9% (n=125) during morning hours (06:00–09:00). The male-to-female ratio was 1.86:1 (746:401). These statistics are valuable for the evaluation of postmortem inspections by experts.
Autopsy ; Cause of Death ; Humans ; Police ; Seoul* ; Suicide

Since March 1, 2015, the National Forensic Service Seoul Institute has commenced postmortem inspections at the death scene in agreement with the Korean National Police Agency. Included regions were mainly Seoul Metropolitan Police Agency Wide Area 8 (Gangseo, Yangcheon, Guro police stations), and several other areas. In total, 837 postmortem inspection cases from March 1 to December 31, 2015, were analyzed statistically. Of these, 168 were autopsy cases, and the rates were 20% (67 cases) in Gangseo Police, 14.5% (30 cases) in Yangcheon Police, and 22% (57 cases) in Guro Police stations. For 269 cases of “unknown cause of death”, the autopsy rates were 44% in Gangseo Police, 36% in Yangcheon Police, and 47% in Guro Police stations. For 82 cases of fall from height, autopsy rates were 17% (n=14). Of the 133 cases of hanging, 121 cases were classified as suicide at the scene with a 2.5% (n=3) autopsy rate. Twelve cases were classified as an undetermined manner of death at the scene with a 33% (n=4) autopsy rate. The distribution of the “manner of death” was natural death for 29% (n=250), unnatural death for 38% (n=318), and other and undetermined manner of death for 32% (n=269) of cases. Proportions of dispatch times were 49.2% (412 cases) during work hours (09:00-18:00), 15.7% (n=131) during evening hours (18:00-21:00), 13% (n=110) at night (21:00-24:00), 10% (n=88) at dawn (24:00-06:00), and 11% (n=96) during morning hours (06:00-09:00). The male to female sex ratio was 1.96:1 (556:281). These statistics are valuable for evaluation of postmortem inspections by experts.
Autopsy ; Cause of Death ; Female ; Humans ; Male ; Police ; Seoul* ; Sex Ratio ; Suicide

We report the case of a 42-year-old woman who died in hospital from severe respiratory failure, 10 days after the onset of symptoms. Autopsy and microscopic examination identified features of diffuse alveolar damage in both lungs including hyaline membranes and intra-alveolar exudate. Gomori's methenamine silver stain of pink frothy materials in these exudates revealed thin-walled and cup-shaped microorganisms and a diagnosis of Pneumocystis jirovecii pneumonia was made. There were small granulomas in the pulmonary interstitium and hepatic lobules representing an unusual inflammatory reaction against Pneumocystis jirovecii. Extrapulmonary involvement with pneumocystis infection is a rare event occurring in 1% to 2% of all pneumocystis cases. Screening and confirmatory tests for human immunodeficiency virus (HIV) detection were positive. There was no information available regarding the patient's medical history or the possibility of HIV infection prior to the autopsy, because the patient was a foreign worker who arrived in Korea 2 months before her death. Medical examiners often perform autopsies with limited information regarding the deceased person, even when person is a Korean national. Therefore, an awareness of protection protocols during autopsy, as well as of the atypical patterns of critical diseases, is crucial.
Adult ; Autopsy* ; Coroners and Medical Examiners ; Diagnosis ; Exudates and Transudates ; Female ; Granuloma ; HIV ; HIV Infections ; Humans ; Hyalin ; Korea ; Liver* ; Lung* ; Mass Screening ; Membranes ; Methenamine ; Pneumocystis Infections ; Pneumocystis jirovecii* ; Pneumocystis* ; Pneumonia* ; Pneumonia, Pneumocystis ; Respiratory Insufficiency

BACKGROUND: To prevent bile duct related complications, exact division of donor bile duct is essential, not only for the recipient, but also for the donor during living donor liver transplantation. Cholangiography has been used for bile duct division during living donor right hemihepatectomy. This study was conducted to determine if bile duct probe could be used to replace cholangiography for bile duct division during living donor right hemihepatectomy. METHODS: Surgical outcomes of 234 donors with right hemihepatectomy and duct to duct biliary anastomosis in living donor liver transplantation between January 2009 and December 2014 were retrospectively analyzed. A total of 85 donors used the bile duct probe for bile duct division during the right hemihepatectomy, whereas 149 donors used cholangiography. All donors underwent preoperative magnetic resonance cholangiopancreatography (MRCP). RESULTS: The expected number of bile duct orifices based on MRCP did not differ significantly from the observed number of bile duct orifices after bile duct division (10 donors and five donors in each group were mismatched, P=0.238). The operation time was 384.7 minutes in the probe group, which was significantly shorter than that of the cholangiography group (400.4 minutes, P=0.041). CONCLUSIONS: Bile duct probing without intraoperative cholangiography might be a feasible procedure for bile duct division during living donor hemihepatectomy.
Bile Ducts* ; Bile* ; Cholangiography ; Cholangiopancreatography, Magnetic Resonance ; Humans ; Liver Transplantation ; Living Donors ; Postoperative Complications ; Retrospective Studies ; Tissue Donors*

A stem cell interacts with the neighboring cells in its environment. To maintain a living organism's metabolism, either cell-cell or cell-environment interactions may be significant. Usually, these cells communicate with each other through biological signaling by interactive behaviors of primary proteins or complementary chemicals. The signaling intermediates offer the stem cell's functionality on its metabolism. With the rapid advent of omics technologies, various specific markers by which stem cells cooperate with their surroundings have been discovered and established. In this article, we review several stem cell markers used to communicate with either cancer or immune cells in the human body.
Human Body ; Metabolism ; Stem Cells*

Humans can be incidentally parasitized by third-stage larvae of Anisakis species following the ingestion of raw or undercooked seafood. Acute gastric anisakiasis is one of the most frequently encountered complaints in Korea. However, duodenal anisakiasis with duodenal ulcer had not been reported in Korea, despite the habit of eating raw fish. In this case, a 47-year-old man was hospitalized because of sharp epigastric pain and repeated vomiting after eating raw fish 3 days previously. On admission, esophagogastroduodenoscopic examination revealed an active duodenal bulb ulcer. At 5 mm away from the ulcer margin, a whitish linear worm was found with half of its body penetrating the duodenal mucosa. Herein, we report this case of duodenal anisakiasis accompanied by duodenal ulcer.
Anisakiasis ; Anisakis ; Duodenal Ulcer ; Duodenum ; Eating ; Humans ; Korea ; Larva ; Middle Aged ; Mucous Membrane ; Seafood ; Ulcer ; Vomiting