No abstract

Social cost of insomnia in modern society is gradually increasing. Due to various social phenomena and lifestyles that take away the opportunity of good quality of sleep, problems of insomnia cannot be easily figured out. Prescription of sleeping pills for insomnia patients can cause other inconveniences due to their side effects beyond their intended purposes. On the other hand, Passiflora incarnata L. (PI) has been widely used in South America for several centuries, showing effectiveness for sleep, sedation, anxiety, and so on in the civilian population. However, reports on the treatment efficacy of this herbal medicinal plant for insomnia patients through standardization as a sleeping agent have been very rare. Therefore, we obtained leaves and fruits of PI (8:2 by weight) as powder to prepare an extract. It was then applied to C6 rat glioma cells to quantitate mRNA expression levels of GABA receptors. Its sleep‐inducing effect was investigated using experimental animals. PI extract (6 μg/ml) significantly decreased GABA receptors at 6 hr after treatment. Immobility time and palpebral closing time were significantly increased after single (500 mg/kg) or repeated (250 mg/kg) oral administration. In addition, blood melatonin levels were significantly increased in PI extract‐treated animals after both single and repeated administrations. These results were confirmed through several repeated experiments. Taken together, these results confirmed that PI extract had significant sleep‐inducing effects in cells and animals, suggesting that PI extract might have potential for treating human insomnia.

Mucinous borderline tumors (MBT) of the ovary with mild to moderately atypical epithelial cells that produce mucin rarely recur and very rarely become malignant after surgery. Due to their low malignant potential and large tumor size, most cases are diagnosed in stage I and have a good prognosis. The authors reported a case of MBT, which had been left untreated after diagnosis, progressed to stage IV, and caused massive pleural effusion (>3,000 mL) resulting in death. Grossly, severe abdominal swelling, a huge multiloculated cystic mass in the left ovary, and a metastatic mucinous mass in the pleura and peritoneum were observed. Histological findings include gastrointestinal type epithelial cells with mucin secretion, degenerative and autolytic nuclei, and occasional infiltration of inflammatory cells. Because sufficient sections cannot be made according to the clinical pathology criteria in forensic autopsy, efficient decisions are required during autopsy for diagnosis.

Congenital absence of the pericardium, also known as pericardial agenesis, is an extremely rare anomaly. Although most cases are asymptomatic, some experience chest pain, dyspnea, dizziness, and syncope. A few sudden death cases have been reported. We report a case of congenital complete left-sided absence of the pericardium that is not related to the cause of death. In the autopsy of a skinny 45-year-old deceased man, there was no left pericardium, and the heart had direct contact with the left lung. Inflammation and adhesion around the heart, torsion of great vessels, structure abnormality of the heart, and histologic lesion of the myocardium were absent. Due to the chemical analysis result and morphology, we suspected that the cause of death was related to starvation. The congenital absence of the pericardium is usually accompanied by myocardial infarction, aortic dissection, and variable congenital anomalies in the heart and other organs. Additionally, both complete and partial defects can cause myocardial infarction. Therefore, we suggest that precise gross examination should be performed to determine the ischemic lesions in the heart and other anomalies if congenital absence of the pericardium is noted in the autopsy.