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나용진 대한의사협회 2019 대한의사협회지 Vol.62 No.3
Menopause is a consequence of loss of ovarian function. Withdrawal of estrogen level cause various menopausal symptoms. Change in the estrogen level can affect large areas of body target, causing atrophy of tissues and metabolic modifications with psychological and sexual changes that are variably experienced by individual woman. Short-term consequences of estrogen deprivation include vasomotor symptoms and urogenital atrophy. Long-term consequences of estrogen deprivation include cardiovascular disease, bone loss and osteoporosis, cognitive decline and Alzheimer’s disease.
자궁내막증에서 중증도와 재발의 예측인자로서 혈청 CA19-9의 임상적 유용성
나용진 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.24
Objective: Because endometriosis is difficult to diagnose and has a high recurrence rate after treatment, a reliable serum marker of endometriosis is necessary. Therefore, the aim of this study is to measure the serum CA19-9 in patients with endometriosis before and after treatment and during recurrence, and to assess the usefulness of these levels in the diagnosis, clinical follow up and prediction of recurrence in endometriosis. Subject and Methods: Eighty-eight patients who visited the department of Obstetrics and Gynecology from January 2006 to December 2007 and were diagnosed as endometriosis by laparoscopy or explo-laparotomy were enrolled. A retrospective analysis of serum CA19-9 levels at 1 month before and 3 to 6 months after initiation of treatment was done. Results: The serum CA19-9 levels of endometriosis group(36.6 ±53.4 mean ± 2SD, U/ml) before treatment was significantly higher than control group(9.4 ±8.6)(p<0.05). Overal sensitivity rate for CA19-9 levels was 53.4%. The sensitivity rate for endometriosis, stage 3 and 4(85.4%, 55.0%) was significantly higher than that, stage 1 and 2(p<0.05). The serum CA 19-9 level in endometriosis group showed a significant increment according to stages(p<0.05) and levels decreased significantly after treatment(p<0.05). The serum CA 19-9 level was also higher at recurrence after treatment(p<0.05). Conclusion: The serum CA19-9 levels are a useful marker for diagnosing severity of disease, monitoring efficacy of treatment and predicting recurrence in endometriosis. 목적: 자궁내막증 환자에서 치료 전 후와 재발시의 CA19-9 혈청값의 동태를 분석함으로써 자궁내막증의 진단 및 임상경과 추적검사와 재발에 대한 예측인자로서의 유용성을 알아보고자 하였다. 연구 방법 : 2006년 1월부터 2007년 12월까지 월경통이나 불임, 골반통 등을 주소로 부산대학교병원 산부인과 외래를 내원한 환자 중, 복강경 및 개복술 시행 후 자궁내막증이 확인된 88명을 대상으로 하였다. 내원시와 치료 개시 후 3-6개월에 추적검사된 CA 19-9을 후향성으로 조사, 분석(retrospective analysis)하였다. 결과 : 자궁내 막증 환자군의 혈청 CA19-9의 치료 전 평균치는 36.6±53.4로 대조군의 9.4±8.6에 비하여 유의하게 높았고, CA19-9의 전체 민감도는 53.4 % 였으며 3, 4기의 경우 각각 85.4% 및 55.0% 로 1, 2기에 비하여 유의하게 증가하였다(p<0.05). 또한 병기에 비레하여 유의한 상승을 확인할 수 있었으며 치료 후 역시 유의한 감소를 확인할 수 있었다(p<0.05). 또한 치료 종결 후 보다 재발 시 혈청 CA19-9의 농도가 유의하게 증가하였다(p<0.05). 결론: 혈청 CA19-9는 자궁내막증 환자에서 진단 시 질환의 중증도를 판정하고 치료 경과 및 재발예측을 위한 추적검사로서 유용하다.
폐경 여성에서 에스트로겐 단독 투여와 안드로겐 병합투여의 효과 비교
나용진 부산대학교 병원 암연구소 2006 부산대병원학술지 Vol.- No.20
Objectives : A retrospective study was performed to clarify the change of lumbar bone mineral density(BMD) and to evaluate the change of sexual function in postmenopausal women according to estrogen and combined estrogen and androgen replacement therapy. Methods : From March, 2001 to December, 2004 we measured lumbar bone mineral density and surveyed change of the sexual desire in 100 postmenopausal women in the department of obstetrics and gynecology, Pusan National University Hospital. These women had been followed up for 2 years with Hormone replacement therapy(HRT). Results : Lumbar BMD was increased 2.7% after one year of HRT but there were no changes of BMD at the 2^(nd) year of HRT. The change of sexual function was not measured quantatively. But there was mild improvement in sexual desire who were treated with combined estrogen and androgen replacement therapy. Conclusion : The bone mass was increased up to 2.7% at the 1^(st) year of HRT but no more progressive increase was observed. There were no differences between estrogen replacement versus combined estrogen and androgen replacement therapy. Androgen replacement therapy may improve sexual function in postmenopausal women. But more investigation should be perfomed to clarify the effect of androgen replacement therapy in postmenopausal women.