Effects of Jerusalem Artichoke Extract and Inulin on Blood Glucose Levels and Insulin Secretion in Streptozotocin Induced Diabetic Mice / 임상당뇨병

Background@#To determine the effects of Jerusalem Artichoke extract (JAE) and inulin on blood glucose levels and insulin secretion in streptozotocin (STZ)-induced diabetic mice. @*Methods@#Thirty four mice were divided into a normal control group and three experimental groups: diabetic control, JAE, and inulin. STZ (50 mg/kg) was injected intraperitoneally to induce diabetes in the three experimental groups. The JAE and inulin groups were fed 10 g/kg JAE or fed 1 g/kg inulin, respectively, for 6 weeks. Fasting glucose was checked weekly. After 6 weeks, the oral glucose tolerance test (OGTT) was performed, and the insulin level was checked. @*Results@#Four mice from the JAE group (n = 9) died and autopsies revealed inflammation and ulceration of skin lesions on the chest areas. Fasting glucose levels were not decreased in the inulin or JAE group relative to diabetic control group. In the OGTT at 60 minutes and 120 minutes, the serum glucose levels were significantly higher in the inulin group (572.6 ± 52.0 mg/dL and 555.8 ± 72.9 mg/dL, respectively) than in diabetic control group (484.3 ± 81.6 mg/dL and 467.3 ± 111.1 mg/dL, respectively). Insulin levels were not increased in the inulin group relative to the diabetic control group. @*Conclusion@#These results indicate that JAE and inulin might not be useful therapeutic strategies for diabetes mellitus and indiscreet intake of Jerusalem Artichoke could exacerbate to diabetes.

New monoclonal antibody-based test for Helicobacter pylori urease in gastric tissue

BACKGROUND/AIMS: To evaluate a new monoclonal antibody for Helicobacter pylori urease in gastric tissue. METHODS: A total of 107 volunteers were enrolled. All subjects underwent a 13C-urea breath test and esophagogastroduodenoscopy. Gastric aspirates were analyzed for pH and ammonia. Six biopsy specimens in the gastric antrum and body were obtained for a rapid urease test and histology. The new monoclonal antibody-based H. pylori urease test (HPU) was performed to rapidly and qualitatively detect urease in two biopsy specimens. RESULTS: H. pylori infection was diagnosed in 73 subjects. The sensitivity and specificity of the HPU was 89% and 74%, respectively. The subjects were divided into two groups: one with true-positive and true-negative HPU results (n = 90) and the other with false-positive and false-negative HPU results (n = 17). Across all subjects, ammonia levels were 900.5 +/- 646.7 and 604.3 +/- 594.3 mumol/L (p > 0.05), and pH was 3.37 +/- 1.64 and 2.82 +/- 1.51 (p > 0.05). Sensitivity was higher in the presence of atrophic gastritis or intestinal metaplasia. CONCLUSIONS: HPU detected H. pylori in approximately 10 min. Gastric aspirate ammonia and pH levels did not affect the test results. Sensitivity was good in the presence of atrophic gastritis or intestinal metaplasia.

Analysis of Death due to Poisoning in Gwangju and Jeollanam-do Areas / 대한법의학회지

This study examined 190 cases of confirmed poisoning, as determined by autopsy findings, as well as alcohol and toxicant concentrations in post-mortem specimens. Judicial autopsies were performed from January 2007 to December 2014 at Department of Legal Medicine, Chonnam National University Medical School, the National Forensic Service Gwangju Institute, and St. Carollo Hospital. We analyzed the incidence of poisoning according to region and season in terms of year, sex, age, and classification of toxicants. In the regional classification, the number of deaths due to poisoning in Jeollanam-do and Gwangju areas was similar when considering autopsy numbers. The incidence was higher in autumn and spring than in summer and winter, and a large number of deaths occurred in 2008 and 2014. Additionally, the number of male deaths was approximately twice the number of female deaths, with the age of 50-59 being the most common age group. Pesticides comprised the largest number of deaths due to poison, followed by alcoholism, carbon monoxide, treatment drugs, and cyanic acid, in that order.

Non-infected and Infected Bronchogenic Cyst: The Correlation of Image Findings with Cyst Content / 결핵및호흡기질환

We hereby report a case on bronchogenic cyst which is initially non-infected, then becomes infected after bronchoscopic ultrasound (US)-guided transesophageal fine-needle aspiration (FNA). The non-infected bronchogenic cyst appears to be filled with relatively echogenic materials on US, and the aspirate is a whitish jelly-like fluid. Upon contrast-enhanced MRI of the infected bronchogenic cyst, a T1-weighted image shows low signal intensity and a T2-weighted image shows high signal intensity, with no enhancements of the cyst contents, but enhancements of the thickened cystic wall. The patient then undergo video-assisted thoracic surgery 14 days after the FNA. The cystic mass is known to be completely removed, and the aspirate is yellowish and purulent. To understand the image findings that pertain to the gross appearance of the cyst contents will help to diagnose bronchogenic cysts in the future.

Evaluation of Protein Expression in Housekeeping Genes across Multiple Tissues in Rats

BACKGROUND: Housekeeping genes, which show constant protein expression patterns between different tissue types, are very important in molecular biological studies as an internal control for protein research. METHODS: The protein expression profiles of seven housekeeping genes (HPRT1, PPIA, GYS1, TBP, YWHAZ, GAPDH and ACTB) in various rat tissues (cerebrum, cerebellum, cardiac ventricle and atrium, psoas muscle, femoral muscle, liver, spleen, kidney, and aorta) were analyzed by Western blot and compared by coefficient of variation (CV). RESULTS: HPRT1 was stably expressed (CV< or =10%) in six tissues (cerebrum, cerebellum, ventricle, femoral muscle, spleen, and kidney), PPIA was stably expressed in five tissues (cerebrum, cerebellum, ventricle, spleen and kidney), YWHAZ was stably expressed in three tissues (cerebrum, cerebellum, and kidney), and GAPDH was stably expressed in four tissues (cerebrum, ventricle, psoas muscle, and kidney). In comparison, GYS1, TBP, and ACTB were found to have CV values over 10% in all tissues. Of the seven genes examined, four (HPRT1, PPIA, YWHAZ, and GAPDH) were found to be stably expressed across multiple organs, with low CV values (< or =10%). CONCLUSIONS: These results will provide fundamental information regarding internal controls for protein expression studies and can be used for analysis of postmortem protein degradation patterns in forensic medicine.

Detection of Helicobacter pylori in Gastric Aspirates Using a Monoclonal Antibody-Based Test

BACKGROUND/AIMS: The objective of this study was to evaluate a monoclonal antibody-based test to detect Helicobacter pylori-specific antigen in gastric aspirates from humans. METHODS: Sixty-one volunteers were enrolled in the study. All of the subjects underwent a 13C-urea breath test (UBT) before esophagogastroduodenoscopy. Gastric aspirates were analyzed for pH and ammonia and used for polymerase chain reaction (PCR), culture, and monoclonal antibody-based detection of H. pylori. Multiple biopsies of the gastric antrum and body were obtained for a rapid urease test (RUT) and histological evaluation. RESULTS: Thirty-six subjects were H. pylori-positive and 25 were H. pylori-negative according to the UBT results. Compared with the H. pylori-negative subjects, H. pylori-positive subjects had a higher pH (4.77+/-1.77 vs 3.49+/-1.30, p<0.05) and ammonia level (1,130.9+/-767.4 vs 184.2+/-126.3, p<0.0001). The sensitivities and specificities of the PCR test, RUT, culture test, and monoclonal antibody-based test were 100% and 72%, 89% and 100%, 47% and 100%, and 78% and 100%, respectively. CONCLUSIONS: The monoclonal antibody-based test for diagnosing H. pylori infection in gastric aspirates has increased sensitivity compared with the culture test and specificity as high as that of the RUT. The test may be useful as an additive test for examining gastric aspirates.

A Case of Alveolar Soft Part Sarcoma of the Pleura

Alveolar soft part sarcoma (ASPS) is a rare malignant soft-tissue neoplasm of unknown histogenesis. The two main sites of occurrence are the lower extremities in adults and the head and neck in children. We report the first case of pleural ASPS occurring in a 58-yr-old man who presented with progressive dyspnea. A computed tomographic scan of the thorax revealed a large enhancing pleural mass with pleural effusion in the left hemithorax. Wide excision of the pleural mass was performed. Histologically, the tumor consisted of organoid nests of large polygonal cells, the cytoplasm of which had eosinophilic and D-PAS positive granules. Immunohistochemical staining showed that the tumor cell nuclei were positive for transcription factor 3 (TFE3). The pleural ASPS with multiple bone metastases recurred 1 yr after surgery and the patient died of acute pulmonary embolism 1.5 yr after diagnosis.

Discrepant Causes of Death between Medical Death Certificates and Autopsy Reports (II) / 대한법의학회지

The postmortem examination certificate and death certificate provide proof of death and supply important data used to establish health statistics. However, the format of the form and the accuracy of postmortem examination and death certificates yield errors that must be corrected by comparison with postmortem studies. We reviewed 401 autopsies performed in the Department of Forensic Medicine of Chonnam National University Medical School from January 1, 2009 to December 31, 2011 and compared the reports with their postmortem examination certificates and death certificates. Of the 252 cases submitted with death certifications, 60 cases were concordant with the cause of death on the autopsy report. Eighty-nine cases had clear descriptions of the cause of death. Of these cases, 47 were from postmortem examination, 42 were from death certificates; 17 were natural deaths, 72 were unnatural. Concordance in each group was 59.6% (28/47 cases), 76.2% (32/42 cases), 41.2% (7/17 cases), and 73.6% (53/72 cases). We thus identified various types of errors in postmortem examination and death certificates. This study reveals a high rate of discrepancy between causes of death reported on death certificates and postmortem examination certificates. There are a few useful death certificate and postmortem examination certificates that can be used as a model, based on which we propose several remedies to increase the accuracy of death and postmortem examination certificates.

The Significance of Ventricular Volume in the Evaluation of Secondary Cardiomyopathy at Autopsy

BACKGROUND: The weight, shape and consistency of the heart, and the thickness of the ventricular wall are used as parameters for evaluating postmortem heart and diagnosing cardiomyopathy at autopsy. METHODS: The weight and volume of the ventricles and the thickness of the left ventricular wall of 58 hearts were measured and analyzed. RESULTS: In the group of dilated hearts, the ventricular weight, ventricular volume, ventricular volume/ventricular weight, and left ventricular volume/right ventricular volume increased, whereas ventricular wall thickness decreased. In the group of hypertrophied hearts, the ventricular weight, ventricular volume, and thickness of the ventricular wall increased but ventricular volume/ventricular weight and left ventricular volume/right ventricular volume did not change significantly. In the group of undetermined hearts, it was later found that four of the cases should have been included in the dilated heart group and another two cases in the hypertrophied heart group. CONCLUSIONS: In addition to conventional methods, the measuring ventricular volume is useful for evaluating a postmortem heart and may suggest postmortem differential diagnoses of dilated or hypertrophied forms of secondary cardiomyopathies.

The Statistical Analysis on the Legal Autopsy Cases in Gwang-ju and Chonnam Area of Korea in 2009 and 2010 / 대한법의학회지

Analyzing the data associated with the causes and manners of death in each region is important to make policies for the national public health, because it can be basis for prevention of future crimes and treatment of diseases. To establish regional basic data of the 245 autopsy cases performed at the department of Forensic Medicine of Chonnam National University Medical School in 2009 and 2010, each case was statistically analyzed according to the causes of death and the manners of death. The results are as follows; 1) the total number of legal autopsy was 245 (178 males and 67 females). The number of the 5th decade (64 cases) and the 6th decade (51 cases) occupied near 50 percent (46.9%) of total cases. 2) unnatural deaths were 154 cases (62.9%), and natural deaths were 91 cases (37.1%). In 154 cases of unnatural deaths, suicides were 27 cases (11.0%), homicides were 52 cases (21.2%), accidental deaths were 43 cases (17.6%), and undetermined deaths were 32 cases (13.1%). 3) Among 91 natural deaths, deaths of cardiac origin were 57 cases (62.6%) and it was a leading cause of death in natural deaths. Deaths due to disease of cerebral vascular system were 11 cases (12.1%), deaths due to respiratory system were 9 cases (9.9%). 4) Child deaths under the age of 10 were 9 cases (3.6%). Four cases were homicide, 2 cases were accident, and 3 cases were natural deaths. Conclusively, in these area victims between thirties and forties are taking the most proportion, unnatural deaths are more than natural deaths. In unnatural deaths, the order of frequency is homicide, accidental death, suicide, in natural death, neurocardiovacular disease is predominant.

The Statistical Analysis of the Forensic Autopsy Cases of the Deaths Associated with Alcohol in Gwangju and Chonnam Area, Korea / 대한법의학회지

Alcohol is very popular and readily available among the population but is also known to be a toxic substance. Excessive alcohol ingestion can lead to death induced by acute intoxication. In addition, chronic alcohol ingestion can cause many diseases such as alcoholic liver disease and cardiomyopathy. Alcohol consumption is associated with many social incidents. For example, traffic accidents, murders, incendiary crimes and so on. Hence, alcohol should be considered as a significant and socially relevant substance. However, there is currently no statistical analysis about deaths associated with alcohol consumption in forensic autopsy cases. We analyzed forensic autopsy cases involving alcohol during 2007 to 2009 in Gwangju city and Jeollanamdo province, Korea. The following is the summary of the results. 1. The number of total cases in our department from 2007 to 2009 was 329. 2. Among the 329 cases, 314 cases were checked to have alcohol concentration levels. Alcohol related deaths were 118 cases (35.9%). 3. Among 118 cases, natural deaths were 27 (22.9%) and unnatural deaths were 91 cases (77.1%). 4. Deaths caused by alcohol intoxication were 9 cases (7.6%). The remaining 82 cases of unnatural deaths were as follows: suicides (18 cases, 22.0%), homicides (32 cases, 39.0%), accidents (24 cases, 29.3%), and undetermined (8 cases, 9.8%).

Intravenous Pyogenic Granuloma in Sentinel Vein: A Case Report

PURPOSE: Lobular capillary hemangioma is a vascular tumor that commonly occurs as a cutaneous lesion. Intravenous pyogenic granuloma is a rare form of lobular capillary hemangioma that usually occurs in the veins of the neck and the upper extremities. METHODS: A 41-year-old man presented with 3 months history of nodules on the left temporal area and these lesions were clinically mistaken for a typical lipoma or epidermal cyst, but the nodules appeared unusually vascular with sentinel veins on excision. RESULTS: On the histopathologic examination, the excised tissue was observed as an intraluminal polypoid mass, which was attached to the vein via a fibrovascular stalk and capillaries in a loose edematous fibromyxoid stroma, and so the lesions were confirmed to be intravenous pyogenic granuloma. At 6 months after excision, there has been no recurrence and the patient is asymptomatic. CONCLUSION: Intravenous pyogenic granuloma is a rare variant of lobular capillary hemangioma. This article describes the surgical and histopathological findings of treating pyrogenic granuloma.

A Probable Community-Acquired Pneumonia due to Acinetobacter baumannii Infection Presenting the Positive Pneumothorax Test at Autopsy / 대한법의학회지

We report on a 56-year-old male laborer who injured his thorax in a construction field and complained of chest pain. About 3 weeks later, he was diagnosed as multiple rib fractures and hemothorax and found dead 3 days later at his house. At autopsy, the pneumothorax test was positive, due to not pulmonary parenchymal rupture but pleural adhesion and cavitary abscess from Acinetobacter baumannii pneumonia. Acinetobacter baumannii often causes hospital-acquired pneumonia, but rarely causes community-acquired pneumonia. This is the first report in Korea of a positive pneumothorax test at autopsy caused by community-acquired pneumonia due to Acinetobacter baumannii.

Fatal Pulmonary Thromboembolism Following Cast Immobilization of Fibular Shaft Fracture / 대한법의학회지

Pulmonary thromboembolism (PTE) is one of the most common and dangerous complications in orthopedic surgery. We experienced a fatal PTE in a 29-year-old man who had a simple fibular shaft fracture and cast immobilization for about one month. Despite simple fibular shaft fracture in patient with low risk for venous thromboembolism (VTE), a terrible outcome occurred. During immobilization, thromboprophylaxis such as low molecular weight heparin should be always considered. We report a rare case of PTE after simple fibular shaft fracture.

A Case of Amblyomma testudinarium Tick Bite in a Korean Woman

A case of tick bite was found in the inguinal region of a 74-year-old Korean woman. She was attacked by the tick while working in her vegetable garden in the vicinity of mountain located in Suncheon City, the southern coastal area of the Korean Peninsula. On admission she complained of mild discomfort and itching around the bite area. The causative tick was 23 mm long and had slender pedipalps. The scutum was quite ornate and had eyes at the edge. The genital aperture was located anterior to the level of the coxa II. The spiracular plate was comma-shaped and the anus was surrounded posteriorly by the anal groove. The coxa I had subequal 2 spurs; the external one slightly larger. The spur of coxa IV was slightly longer than those of coxae II and III. The tarsus IV had 2 distinct subapical ventral spurs. It was identified as the fully engorged adult female of Amblyomma testudinarium. This is the first human case of Amblyomma bite in Korea.

The Discrepancy of the Causes of Death between Medical Death Certificates and Autopsy Reports / 대한법의학회지

BACKGROUND: The Postmortem examination certificate and death certificate prove deaths of human and supply important data used to establish health statistics. However, not only the format of the form itself, but the accuracy of postmortem examination certificate and death certificate has errors which needs further study such as comparing with the postmortem study such as autopsy. METHODS: We reviewed 206 autopsies which were performed in the Department of Forensic Medicine of Chonnam National University Medical School from January 1, 2007 to December 31, 2008 and compared with their postmortem examination certificates and death certificates for analysis. RESULTS: Of the 174 cases submitted with death certifications, total 67 cases accorded with cause of death on the autopsy report. Eighty six cases had clear descriptions of cause of death. Of those 86 cases, 46 were from postmortem examination, 40 were from death certificates and 23 were natural deaths, 63 were unnatural deaths. Each of them, the accordant rates were 63.0% (29 cases/46cases), 77.5% (31 cases/40 cases), 43.5% (10 cases/23 cases), and 79.4% (50 cases/63 cases). From these results, we found various erroneous types in postmortem examination certificates and death certificates. CONCLUSIONS: This study brings into realization there is a high rate of discrepancy between causes of death on the death certificates and postmortem examination certificates. And also, there are a few useful death certificate and postmortem examination certificate. Therefore, we want to propose several remedies to increase the accuracy of death certificate and postmortem death certificate.

The Statistical Analysis on the Legal Autopsy Cases in Gwang-ju and Chonnam Area of Korea in 2007 and 2008 / 대한법의학회지

The overall data associated with the causes and the manners of death of individuals are necessary to make policies for the public health or judicial system in the society. To obtain basic data of the causes and the manners of death, the 206 autopsy cases performed at the Department of Forensic Medicine of Chonnam National University Medical School in 2007 and 2008 were statistically analyzed according to the cause of death and the manner of death. The results are as follows ; 1. The total number of forensic-legal autopsy was 206 (139 males and 67 females). The number of the 5th decade (58 cases) and the 6th decade (54 cases) occupied over 50 percent (54.4%) of total cases. 2. Unnatural deaths were 127 cases (61.7%), and natural deaths were 79 cases (38.3%). Of 127 cases of unnatural deaths, suicides were 33 cases (26.0%), homicides were 46 cases (36.2%), accidental deaths were 37 cases (29.1%), and undetermined deaths were 11 cases (8.7%). 3. Among 79 natural deaths, deaths of cardiac origin were 46 cases (58.2%) and it was a leading cause of death in natural deaths. Deaths due to disease of vascular system were 10 cases (12.7%), deaths due to respiratory system were 8 cases (10.1%), deaths due to digestive system were 6 cases (7.6%), and other causes were 10 cases (12.4%). 4. Child deaths under the age of 10 were 8 cases (3.9%). Three cases were homicide, 3 cases were accident, and 2 cases were natural deaths.

A Case of Giant Rhinophyma Showing Difficulty in Nasal Respiration

Rhinophyma is characterized by a disfiguring soft tissue hypertrophy of the nose. Severe cosmetic deformity and impairment of breathing may coexist, making the surgical treatment necessary. We present a case of giant rhinophyma, who had difficulty in nasal breathing and took preventive aspirin for CVA. We treated this patient with scalpel tangential excision and skin graft. A giant rhinophyma involved two thirds of nasal dorsum, nasal tip, and both alae. The patient withdrew aspirin 7 days prior to surgery, and rhinophyma was excised with scalpel. The defect was covered with full-thickness skin graft from right supraclavicular area. Five days after surgery, the patient resumed to take aspirin. A skin graft was taken completely and a pathologist confirmed an excised specimen to be a rhinophyma. Within 1 month postoperatively, the patient showed more natural nasal contour and improvement of nasal respiration. Six months after the operation, the nose represented a good appearance without recurrence of rhinophyma. We present a case of giant rhinophyma which had bleeding tendency because of preventive aspirin. We treated this case with scalpel excision and full-thickness skin graft, instead of secondary intention wound healing.

Abnormally High Blood Ethanol Concentration of Heart Blood : A Case Report and Review of Literatures / 대한법의학회지

A 48 years old man was sent to hospital through emergency room immediately after head injuries. He was arrived at hospital being dead and autopsy was done sixty hours later after insult. Multiple skull fractures and brain parenchymal contusions, subarachnoid hemorrhage, stem hemorrhage were noted, and these injuries were considering as a cause of death. Interestingly, blood alcohol concentration (BAC) using cardiac blood was very high (0.738%) in this case. Here in, we report abnormally high BAC in heart blood which is not a cause of death and we review the general aspects about alcohol concentration interpretation.

Immunohistochemical comparison of the telomerase expression between low-grade and high-grade gastric dysplasia / 대한내과학회지

BACKGROUND: Telomeres are simple repeats elements located at each end of the chromosomes of eukaryotic cells. The main function of telomeres is to cap the chromosome end and protect it from enzymatic attack. Telomerase that facilitates the synthesis of telomere has been detected in not only cancer, but also in precancerous lesion. In this study, we compared the telomerase expression between low-grade and high-grade gastric dysplasia. METHODS: The telomerase expression of 43 patients with gastric dysplasia (22 low-grade and 21 high-grade) was evaluated by immunohistochemical staining in tissues. RESULTS: The telomerase expression was much higher in the tissues from the patients with high-grade gastric dysplasia than in those tissues of the patients with low-grade gastric dysplasia. CONCLUSIONS: Activation of telomerase may be related with the malignant potentiality in gastric cells. Further studies are needed to define the role of telomerase in gastric tumorigenesis.