Sirenomelia is a severe form of caudal regression syndrome that results in a fusion of the lower extremities, which is not compatible with life. A various spectrum of anomalies affecting primarily the musculoskeletal, genitourinary and gastrointestinal systems also can occur. This rare malformation has a reported incidence rate of approximately 1 in 60,000 births, with a range of 1 to 1 percent of all malformed infants. We experienced a sirenomelic case with combined anomalies of genitourinary, cardiovascular and gastrointestinal systems. Maternal obstetric history revealed oligohydramnios and intrauterine fetal growth retardation, and the baby was spontaneously delivered at 37 weeks of gestational age, but died I hour after birth.
Infant ; Male ; Female ; Humans ; Incidence

Hemangiopericycic maningioma is clinically and pathologically similar to peripheral Hemangiopericytoma and now tends to be terned as hemangiopericytoma of central nervous system. The authors studied 3 cases of hemangiopericytic meningioma obtained from 3 patients, 1 case of meningotheliomatous meningioma, angioblastic meningioma and transitional meningioma, and 2 cases of peripheral hemangiopericytoma, which had operated from November 1988 to May 1989 at the department of neurosurgery, Pusan Inje University Hospital. The authors analysed and compared the immunohistochemical finding and light microscopic apearance. The results obtained were summarized as follows; 1) Classic maningioma (meningotheliomatous meningioma, transitional meningioma and angioblastic meningioma) shows reactivity to both EMA and vimentin. 2) Hemangiopercicytic meningioma and peripheral hemangiopericytoma are reactive only to vimentin, so the two tumors are suggested as same type of tumor. 3) One of 3 cases of hemangiopericytic meningioma shows whorling and interlacing bundles of spindle cells, the peculiar light microscopic features of transitional meningioma, suggesting transitional or mixed form of hemangiopericytic meningioma and transitional meningioma.
Meningioma

Hemangiopericycic maningioma is clinically and pathologically similar to peripheral Hemangiopericytoma and now tends to be terned as hemangiopericytoma of central nervous system. The authors studied 3 cases of hemangiopericytic meningioma obtained from 3 patients, 1 case of meningotheliomatous meningioma, angioblastic meningioma and transitional meningioma, and 2 cases of peripheral hemangiopericytoma, which had operated from November 1988 to May 1989 at the department of neurosurgery, Pusan Inje University Hospital. The authors analysed and compared the immunohistochemical finding and light microscopic apearance. The results obtained were summarized as follows; 1) Classic maningioma (meningotheliomatous meningioma, transitional meningioma and angioblastic meningioma) shows reactivity to both EMA and vimentin. 2) Hemangiopercicytic meningioma and peripheral hemangiopericytoma are reactive only to vimentin, so the two tumors are suggested as same type of tumor. 3) One of 3 cases of hemangiopericytic meningioma shows whorling and interlacing bundles of spindle cells, the peculiar light microscopic features of transitional meningioma, suggesting transitional or mixed form of hemangiopericytic meningioma and transitional meningioma.
Meningioma

We investigated trends of obesity prevalence among adult Koreans. Data from 110,280,952 participants who underwent medical examination provided by the National Health Insurance System from 2002–2013 were analyzed. The prevalence of moderate obesity (body mass index [BMI] 25.0–29.9 kg/m2) was slightly increased from 2002 (30.7%) through 2010 (33.1%) and reached a plateau since 2010 among men but continuously decreased from 22.5% in 2002 to 20.9% in 2013 among women. However, severe obesity (BMI ≥ 30.0 kg/m2) was rapidly increased and the prevalence in 2013 (4.2%) was almost doubled the prevalence in 2002 (2.5%). We observed a steep rise of severe obesity as well as potentially right shifting of the obese category.
Adult ; Body Mass Index* ; Female ; Humans ; Korea* ; Male ; National Health Programs* ; Obesity ; Obesity, Morbid ; Prevalence

Normal and abnormal follicular growth and steroidogenesis depend on gonadotropins as well as intraovarian peptides, which may mediate or potentiate gonadotropin action. Inhibin also affect follicular development and steroidogenesis and may play a role in dominant follicle selection and follicular atresia. Therefore, we studied the differences of serum inhibin, gonadotropin and androgen levels in the women with only the ultrasound findings and no disorder, and polycystic ovary (PCO) with ovulatory disturbance. We prospectively analysed forty-three women with PCO. The diagnosis of PCO was based on typical appearance of the ovaries on TVS. Twelve women with regular menstrual cycle and normal ovarian morphology were selected as control. Basal levels of inhibin, luteinizing hormone(LH), follicle stimulating hormone(FSH), estradiol(E2), testosterone(T), androstenedione(ADD), dehydroepiandrosterone-sulfate(DS), prolactin and TSH in serum were determined. There were significant differences in basal LH levels and LH/FSH ratio between the control and the women with PCO. The basal levels of inhibin and E2 in the oligo-amenorrheic PCO (N=34) were significantly higher than those in the control. There was higher negative correlation between the inhibin and T levels in the oligo-amenorrheic PCO, but, not in the regular cycling PCO. Also, there was higher positive correlation between the LH and T levels in the oligo-amenorrheic PCO, but not in the regular cycling PCO. These data presume that the initial event of PCO is elevated pituitary LH secretion. Elevated levels of LH may down-regulate LH receptors on granulosa cells and also cause hypertrophy of the thecal layer. High level of androgen secreted by the hypertrophied thermal layer may stimulate inhibin secretion from granulosa cells and can be converted to estrogen by extraovarian tissues and could serve to augment pituitary sensitivity to GnRH with a resultant secretion of more LH follicular development and dominant follicle selection resulted in ovulatory disturbance.
Diagnosis ; Estrogens ; Female ; Follicular Atresia ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Granulosa Cells ; Humans ; Hypertrophy ; Inhibins* ; Lutein ; Menstrual Cycle ; Ovary* ; Peptides ; Prolactin ; Prospective Studies ; Receptors, LH ; Ultrasonography

OBJECTIVE: The involvement of IGF system in hyperandrogenism and abnormal follicular development is controversial. This study is to assess whether IGF system contribute to it in the women with polycystic ovary(PCO). METHODS: Baseline serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), testosterone (T), androstenedione (ADD), prolactin, thyroid stimulating hormone (TSH), free insulin-like growth factor(IGF)-I, free IGF-II, insulin-like growth factor binding protein(IGFBP)-1, and IGFBP-3 were measured in twelve healthy regularly cycling volunteers and forty-two women with PCO then, the changes of baseline serum levels were evaluated after laparoscopic ovarian electrocauterization in nine PCO patients. In addition, the expression pattern of IGF-I and IGF-II was examined in the ovary of control and PCO group. RESULTS: Baseline levels of LH, ADD, free IGF-II, and IGFBP-3 were significantly higher in PCO group. However, there were no significant differences in the levels of free IGF-I and IGFBP-1, although free IGF-I showed decreasing tendency in PCO group. And there was a significant positive correlation between the LH and free IGF-II level in the PCO(P=0.011, r2=0.3899), but not in the control. After ovarian electrocauterization, LH, T, and ADD levels decreased, and free IGF-I and IGFBP-3 level increased. While free IGF-II and IGFBP-1 level showed no significant changes. In the ovary, expression of both IGFs showed similar pattern in normal and PCO ovaries. CONCLUSIONS: The elevated IGFBP-3 level may alter the bioavailability of IGF(s) in the PCO. The change in IGF-I level and resumption of ovulation after electrocauterization, suggest a possible role of IGF system in the impairment of follicular development in the PCO.
Androstenedione ; Biological Availability ; Carrier Proteins* ; Estradiol ; Female ; Follicle Stimulating Hormone ; Humans ; Hyperandrogenism ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Luteinizing Hormone ; Ovary* ; Ovulation ; Prolactin ; Somatomedins* ; Testosterone ; Thyrotropin ; Volunteers

Abdominal obesity is associated closely with insulin resistance, diabetes, and cardiovascular disease. Waist circumference (WC) is a useful surrogate marker commonly used for abdominal adiposity. The determination of WC cutoff levels is important in the prevention and treatment of obesity, type 2 diabetes, and related cardiovascular diseases. Recent epidemiological evidence suggested that appropriate optimal cutoffs for Koreans ranged over 80 to 89.8 cm in males and 76.1 to 86.5 cm in females. We analyzed the data from two large cohorts using receiver operating characteristic curve analysis with the incidences of diabetes, hypertension, dyslipidemia, cerebrovascular disease, myocardial infarct, angina, coronary artery disease, and multiple metabolic risk factors as outcome variables. Optimal WC cutoff points for Koreans were 85 cm in males and 80 cm in females. However, considering the prevalence of abdominal obesity and the health costs for its prevention and management, 90 cm in males and 85 cm in females are probably more appropriate thresholds for abdominal obesity. These values may be modified once better research is performed through prospective studies using representative populations, common health outcomes, and proper analytical approaches.
Adiposity ; Adult* ; Cardiomyopathies ; Cardiovascular Diseases ; Cohort Studies ; Coronary Artery Disease ; Diagnosis* ; Dyslipidemias ; Female ; Health Care Costs ; Humans ; Hypertension ; Incidence ; Insulin Resistance ; Male ; Obesity ; Obesity, Abdominal* ; Prevalence ; Risk Factors ; ROC Curve ; Sensitivity and Specificity ; Waist Circumference* ; Biomarkers

Systemic lupus erythematosus(SLE), a rheumatic disease of unknown causes, is characterized by autoantibodies directed against self-antigens, resulting in inflammatory damages to target organs including kidney, blood-forming cells, and central nervous system. The prevalence rates are higher in Native Americans, Asians, Latin Americans and black people. A female to male ratio of approximately 2 : 1 occurs before puberty, and 4 : 1 after puberty. Children of SLE most frequently present with fever, fatigue, arthralgia or arthritis, and rashes. The diagnosis is confirmed by clinical and also laboratory manifestations satisfying at least 4 out of 11 criteria. A central nervous system is not rarely involved in children of SLE with the prevalence rate of 23-44%. However, cerebral infarcts are not a common phenomenon and can be seen only for 6% of children with SLE. There have been no cases reported in Korea. This is why we present a case of basal ganglia infarct associated with SLE in a 19-month old girl. We report this case with a brief review of related literature.
Adolescent ; Arthralgia ; Arthritis ; Asian Continental Ancestry Group ; Autoantibodies ; Autoantigens ; Basal Ganglia* ; Central Nervous System ; Child ; Diagnosis ; Exanthema ; Fatigue ; Female ; Fever ; Humans ; Indians, North American ; Infant ; Kidney ; Korea ; Lupus Erythematosus, Systemic ; Male ; Prevalence ; Puberty ; Rheumatic Diseases

BACKGROUND/OBJECTIVES: This study examined the association of depressive symptoms, stress perception, and suicidal ideation with overall dietary quality using the newly developed Korean healthy eating index (KHEI). SUBJECTS/METHODS: This study included 9,607 adults (3,939 men and 5,668 women, ≥ 19 years) who participated in the 6th Korea National Health and Nutrition Examination Survey 2013 and 2015. The KHEI scores were calculated using the food frequency questionnaire data. Survey logistic regression analyses were performed to analyze the association between psychiatric distress and dietary quality. RESULTS: The percentage of subjects with experience of depressive mood, higher stress perception, and suicidal ideation was 8.2%, 25.0%, and 3.7% in men and 15.4%, 27.3%, and 6.0% in women, respectively. The mean KHEI score was 61.5 ± 0.29 in men and 64.8 ± 0.24 in women (P < 0.001). The present study found a difference in the adherence to specific dietary components of the KHEI between sexes. Men experiencing depressive symptoms were less likely to eat meat, fish, eggs, and beans, while depressed women showed lower vegetable intake. Both men and women with suicidal ideation showed a lower intake of vegetables. The men with stress had a lower breakfast eating score than those without stress (7.21 vs. 6.77, P = 0.016). The multivariate-adjusted odds ratios for depressive symptoms, stress perception, and the suicidal idea in women with the highest quartile of KHEI scores compared to the lowest quartile was 0.69 (95% confidence interval, 0.51–0.92), 0.73 (0.58–0.82), and 0.52 (0.33–0.82), respectively and significant dose-response associations were observed (P for trends < 0.05 for all). On the other hand, these associations were not observed in men after adjusting for the confounding variables (P for trends > 0.05 for all). CONCLUSIONS Poor adherence to dietary recommendations is associated with psychological distress, especially in women.

BACKGROUND/OBJECTIVES: This study examined the association of depressive symptoms, stress perception, and suicidal ideation with overall dietary quality using the newly developed Korean healthy eating index (KHEI). SUBJECTS/METHODS: This study included 9,607 adults (3,939 men and 5,668 women, ≥ 19 years) who participated in the 6th Korea National Health and Nutrition Examination Survey 2013 and 2015. The KHEI scores were calculated using the food frequency questionnaire data. Survey logistic regression analyses were performed to analyze the association between psychiatric distress and dietary quality. RESULTS: The percentage of subjects with experience of depressive mood, higher stress perception, and suicidal ideation was 8.2%, 25.0%, and 3.7% in men and 15.4%, 27.3%, and 6.0% in women, respectively. The mean KHEI score was 61.5 ± 0.29 in men and 64.8 ± 0.24 in women (P < 0.001). The present study found a difference in the adherence to specific dietary components of the KHEI between sexes. Men experiencing depressive symptoms were less likely to eat meat, fish, eggs, and beans, while depressed women showed lower vegetable intake. Both men and women with suicidal ideation showed a lower intake of vegetables. The men with stress had a lower breakfast eating score than those without stress (7.21 vs. 6.77, P = 0.016). The multivariate-adjusted odds ratios for depressive symptoms, stress perception, and the suicidal idea in women with the highest quartile of KHEI scores compared to the lowest quartile was 0.69 (95% confidence interval, 0.51–0.92), 0.73 (0.58–0.82), and 0.52 (0.33–0.82), respectively and significant dose-response associations were observed (P for trends < 0.05 for all). On the other hand, these associations were not observed in men after adjusting for the confounding variables (P for trends > 0.05 for all). CONCLUSIONS Poor adherence to dietary recommendations is associated with psychological distress, especially in women.