Analysis of Cases of Infants and Children Asphyxia at Day Care Center: Cases of Asphyxia in the Process of Teachers Putting the Infants and Children to Sleep / 대한법의학회지

In the cases of infants and children, there is a special form of accidental asphyxia that occurs in an unsafe sleeping environment. Rarely, some infants and children unexpectedly die in the day care centers. This also occurs during the process when teachers put the infants and children to sleep. This analysis was performed on national forensic autopsy cases from January 1, 2001, to October 31, 2022. The 97,402 cases were selected to provide their incident overview, the cause of death and the manner of death. The cases of infants and children asphyxia at day care centers were 43 cases (0.04%). The major cause of death was sudden infants and children death syndrome which included the possibility of accidental asphyxia (31 cases). This was followed by chocking (8 cases), complicated asphyxia (2 cases), smothering (1 case), and positional asphyxia (1 case). Two cases were a result of homicide, 10 cases were accidents, and 31 cases had unknown manner of death. There were four cases of asphyxia that occurred in the process of teachers putting infants and children to sleep. In all cases, there were no specific findings in the autopsy and there were CCTV footage including contact with the day care center teacher while taking a nap. Reporting these results provides information and awareness to social members related with infants and children, specially day care centers, and serves as basis for establishing social systems such as mandatory of CCTVs, helping to reduce the occurrence of similar death on infants and children.

Suicidal Death by Nicotine Poisoning / 대한법의학회지

Nicotine is a water-soluble alkaloid extracted from tobacco plants, and most frequently encountered in snuff, chewing tobacco, cigarettes, cigars and pipe tobacco or in a limited number of pesticides. Nicotine overdose or poisoning might be serious or fatal and lead to death; caused by cardiovascular arrest, respiratory muscle paralysis, and/or central respiratory failure due to its toxic effect. Suicide by nicotine ingestion has been rarely reported due to emetic response. We present a case of suicidal nicotine poisoning. A 56-year-old man was found dead and the postmortem examination revealed no injury or disease. We confirmed a high concentration of nicotine in the toxicological test. Through scene investigation, we determined this case as a suicidal nicotine poisoning.

The Glycolytic Phenotype is Correlated with Aggressiveness and Poor Prognosis in Invasive Ductal Carcinomas / 한국유방암학회지

PURPOSE: Glucose uptake and glycolytic metabolism are enhanced in cancer cells, and increased expression of glucose transporter 1 (GLUT1) has also been reported. The aim of this study was to investigate GLUT1 expression in human breast tissues and invasive ductal carcinomas. METHODS: We used tissue microarrays consisting of normal breast tissue, ductal hyperplasia, ductal carcinoma in situ, invasive ductal carcinoma, and lymph node metastases. We examined GLUT1 expression in the microarrays by immunohistochemistry, reviewed the medical records and performed a clinicopathological analysis. RESULTS: Membranous GLUT1 expression was observed in normal and tumor cells. GLUT1 expression was higher in ductal carcinoma in situ, invasive ductal carcinoma, and lymph node metastasis than in normal tissue and ductal hyperplasia (p=0.002). Of 276 invasive ductal carcinomas, 106 (38.4%) showed GLUT1 expression. GLUT1 expression was correlated with higher histologic grade (p<0.001), larger tumor size (p=0.025), absence of estrogen receptor (p<0.001), absence of progesterone receptor (p<0.001), and triple-negative phenotype (p<0.001). In univariate survival analysis, patients with GLUT1 expression had poorer overall survival and disease-free survival (p=0.017 and p=0.021, respectively, log-rank test). In multivariate survival analysis with the Cox proportional hazards model, GLUT1 expression was an independent prognostic factor of poorer overall survival and disease-free survival (p=0.017 and p=0.019, respectively). CONCLUSION: GLUT1 expression seems to play an important role in malignant transformation, and the glycolytic phenotype in invasive ductal carcinoma may indicate aggressive biological behavior and a worse prognosis.

Castleman's Disease of the Renal Sinus Presenting as a Urothelial Malignancy: A Brief Case Report

Castleman's disease is a rare benign lymphoproliferative disorder that frequently affects lymph nodes of the mediastinal thorax and the neck. It very rarely affects the renal sinus. We report a case of Castleman's disease arising in the renal sinus in a 64-year-old man. The patient visited the hospital with the chief complaint of hematuria. Abdominal computed tomography revealed a homogeneous mass in the sinus of the left kidney, radiologically interpreted as a malignant urothelial tumor. Subsequently, nephroureterectomy was performed, after which microscopic examination of the specimen revealed a diffuse lymphoproliferative lesion with reactive lymphoid follicles of various sizes and prominent plasma cell infiltration of interfollicular spaces, highlighted by immunohistochemical staining for CD138. The lesion was diagnosed as Castleman's disease of the plasma cell type. Although preoperative diagnosis of Castleman's disease is difficult and the incidence is exceedingly rare, it should be considered in the differential diagnosis of renal sinus tumors.

Parotid Gland Carcinosarcoma with Osteosarcoma as a Sarcomatous Component: A Case Report with Fine Needle Aspiration Cytologic Findings

Carcinosarcoma of the salivary glands is a rare malignant tumor showing both malignant epithelial and mesenchymal components. Herein, we present a carcinosarcoma of the parotid gland in a 67-year-old man consisting of osteosarcoma and adenocarcinoma components with fine needle aspiration cytological findings. The tumor was composed predominantly of osteosarcoma and small areas of adenocarcinomatous components and a hyalinized nodule reminiscent of pleomorphic adenoma. The tumor showed infiltrative growth features with perineural, lymphatic, and vascular invasion. Despite postoperative adjuvant radiation therapy, multiple metastatic lesions occurred in the both lungs 5 months after surgery. As salivary gland carcinosarcoma has been known to demonstrate highly aggressive behavior, an accurate pathological diagnosis is prerequisite for appropriate treatment.

Asymptomatic Solitary Renal Metastasis Detected during Surveillance after Curative Surgery for Squamous Cell Carcinoma of Lung / 결핵및호흡기질환

Non small cell lung cancer (NSCLC) frequently metastasizes to brain, bone, liver, and adrenal glands. While an autopsy of NSCLC reveals some cases of metastasis to the kidney, clinical detection of renal metastases is extremely rare. Furthermore, metastases to the kidney usually present as multifocal or bilateral lesions and solitary renal metastases are usually suspected to be renal cell carcinoma. We now report a case of asymptomatic solitary renal metastasis from a primary squamous cell carcinoma, which was detected by routine surveillance with abdominal CT after curative surgery.

A Case of Gastric Carcinosarcoma with Neuroendocrine and Smooth Muscle Differentiation

Carcinosarcoma of the stomach is a rarely occurring malignant biphasic tumor that consists of both carcinomatous and sarcomatous components simultaneously in a single tumor. The common carcinoma component is tubular or papillary adenocarcinoma and the mesenchymal sarcomatous components are variable and these include leiomyosarcoma, rhabdomyosarcoma, osteosarcoma and chondrosarcoma. However, neuroendocrine carcinomatous differentiation in the carcinomatous component is extremely rare. We present here a rare gastric carcinosarcoma that demonstrated neuroendocrine carcinomatous and leiomyosarcomatous differentiation in a 47-year-old man.

Cystic Lymphangioma of the Breast in an Adult Woman

Cystic lymphangioma is also known as cystic hygroma, and this is a congenital malformation of the lymphatic system. Most lymphangiomas are present at birth and they are diagnosed by the age of 2. They are mostly located in the neck or axillary region. The breast as a site of origin is an extremely unusual location, and especially in adults. We report here on a case of cystic lymphangioma in a 36-year-old woman. Physical examination revealed a tender cystic mass in the upper outer quadrant of the right breast. Ultrasonography revealed an irregular hypoechoic mass lesion that was associated with irregular duct dilatation and several enlarged axillary lymph nodes. After the operation, the mass was revealed to be a cystic lymphangioma. Although it is very rare, cystic lymphangioma should be considered in the differential diagnosis of a breast mass in adults.

Myxoma of the Larynx Presenting As a Nodule

We describe herein a rare case of a laryngeal myxoma presenting as a nodule. Laryngeal myxomas involving the neck region, especially the laryngeal area, are quite rare. A 36-year-old male patient presented with a 2 month history of hoarseness. On laryngoscopic examination, there was a myxoid homogeneous transparent mass on the right vocal cord. On microscopic examination, the lesion was hypocellular and myxoid. The lesion showed stellate or spindle cells which were evenly dispersed in the poorly vascularized myxoid stroma. Although the incidence is extremely rare, a laryngeal myxoma should be considered in the differential diagnosis of laryngeal masses.

Changes of Calretinin-Immunoreactivities in the Rat Superior Collicuclus after Eye Enucleation / 체질인류학회지

Calcium-binding proteins play an important role in the protection, differentiation, and reorganization of the central nervous system. The effects of neonatal retinal deafferentiation on calretinin, and tracing of retinotectal pathway were examined immunohistochemically in the superficial layer of the rat superior colliculus. Tracing with cholera toxin was revealed on the superior colliculus contralateral to the ocular injection. On the contralateral side of superior colliculus, the calretinin-immunoreactive (IR) cells were dramatically increased, calretinin-IR fibers were markedly decreased in the superficial layer. These results show that retinal deafferentation results in an increase of calretinin-immunoreactive cells within the superficial layers of the superior colliculus, which suggest reorganization of neurons in superior colliculus.