England grindcore band Carcass are most widely associated with the birth of gore metal, but Illinois underground sickos Impetigo were slashing their own crimson trail in America around the same time. The band's first offering, 1990's Ultimo Mondo Cannibale, blends gurgling down-tuned guitars with savage thrash- and death-metal rhythms, and vocals that range from sepulchral roars to agonized shrieks. Inspired by Italian horror movies, the lyrics are graphically violent, addressing such fare as cannibalism, dismemberment and torture; samples from horror flicks further enhance the grisly package. While Impetigo weren't as skilled as Carcass or Slayer, their somewhat sloppy playing nonetheless matched their ugly subject matter. Ultimo Mondo Cannibale was one of the most extreme manifestations of the early gorecore movement, and influenced numerous bands including Impaled and Exhumed. These and other bands may be faster or more gruesome, but few are as genuinely stomach-turning.