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폐경전 자궁적출술을 시행받은 여성과 자연폐경 여성에서 에스트로겐 단독투여와에스트로겐+프로게스틴의 지속적 병합투여시 지질 및 고밀도의 변화에 대한 연구
김희옥(Hee Ok Kim),유민영(Min Young Yoo),김연정(Youn Jung Kim),박지은(Ji Eun Park),양훈진(Hoon Jin Yang),유은희(Eun Hee Yoo),전선희(Sun Hee Chun),김종일(Chong Il Kim),유한기(Han Ki Yu) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.10
목적 : 폐경전 자궁적출술을 시행받은 여성과 자연폐경 여성에서 에스트로겐 단독투여시와 에스트로겐과 프로게스테론의 지속적 병합투여시 지질 및 골밀도의 변화에 대한 차이를 비교하기 위한 연구이다. 연구방법 : 총 80명의 환자중 치료 1군(50명)은 폐경전 자궁적출술을 시행받은 환자로 접합 에스트로겐 0.625mg을 48개월간 지속적으로 투여받았고, 치료 2군(30명)은 접합 에스트로겐 0.625mg과 MPA 2.5mg을 지속적으로 병합 투여 받았다. 투여전과 투여후 6개월, 12개월, 24개월, 36개월, 48개월 후에 혈청 지질 및 지단백과 골밀도의 변화를 측정하였다.결과 : 총콜레스테롤치는 두 군에서 각각 치료 48개월후 9.9%, 10.8% 감소하였고, LDL-콜레스테롤치는 20.1%, 16.3% 감소하였다. HDL-콜레스테롤치는 각각 21%, 31.9% 증가하였다. 척추골 골밀도는 두 군에서 각각 치료 48개월후 11.6%, 14.9% 증가하였고, 대퇴골 골밀도는 12.9%, 14.9% 증가하였다.두 군 사이의 통계적 유의한 차이는 없었다.결론 : 에스트로겐 단독 투여와 에스트로겐과 프로게스테론의 지속적 병합 투여는 모두 심혈관질환과 골다공증에 유익한 효과가 있다. 자연 폐경 여성에서는 에스트로겐 단독 투여보다 에스트로겐과 프로게스테론의 지속적 병합 요법이 더 바람직하다고 할 수 있다. Objective : Our purpose was to investigate the effect of single estrogen and continuous combined estrogen + progestin on lipid profile and bone mineral density.Method : We have treated two groups of menopausal women for 4 years, ; Group 1(hysterectomised women) received conjugated equine estrogen(CEE) 0.625mg per day for 30 days ; Group 2(natural menopausal women) received continuous combined therapy(CEE 0.625mg and MPA 2.5mg per day) for 30 days.We compared pre-and poststudy serum lipid profile and bone mineral density in two groups.Result : The data demonstrated a beneficial effect in lipoprotein profile that total cholestrol decreased in two groups by 9.9% and 10.8% from the baseline values. Low density lipoproten(LDL)-cholesterol decreased in two groups by 20.1% and 16.3% in post HRT 48 months, high density lipoproten(HDL)-cholesterol increased in two groups by 21% and 31.9%. And HRT shows the beneficial effect in bone mineral densities. Lumbar BMD increased in two groups by 11.6% and 14.9% and femur BMD increased in two groups by 12.9% and 14.9% from the baseline value.Conclusion : Our result suggest that single estrogen therapy and continuous combined estrogen-progestin therapy has beneficial effect on cardiovascular disease and osteoporosis. Their effects were not significantly different among two groups. So we suggest that continuous combined estrogen-progestin therapy is preferable to single estrogen therapy.
유두상 한관선종과 병리조직학적 유사성을 보인 유두 유두상 선종
김희옥(Hee Ok Kim),최연상(Yeon Sang Choi),유희준(Hee Joon Yu),손숙자(Sook Ja Son),양정현(Jung Hyun Yang) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.6
A 24-year-old woman was seen for evaluation of an skin lesion on thiright nipple. Examination revealed a solitary 1.5 x 1cm-sized, erythematous, oozing, eroded andruted, verrucous nodule on the right nipple. A small amount of serous discharge was found but there was no pain or tenderness. Histopathologic findings showed cystic invaginations extending down vard from the epidermis and papillary projections extending into the lumina of the invagination. Pupiae were lined by two rows of cells. In stroma, there were marked inflammatory infiltrates containing any plasma cells. The overlying dermis showed an adenomatous growth pattern with a prolifertion of round, oval or irregular shaped ducts and fibrotic stroma. (Kor J Dermatol 1994; 32(6): 1123-1126)
김희옥(Hee Ok Kim),유희준(Hee Joon Yu),손숙자(Sook Ja Son),유태연(Tae Yun Yoo) 대한피부과학회 1993 대한피부과학회지 Vol.31 No.2
Background : The differentiation of syphilids from other skin decreases is frequently difficult due to considerable variations of clinical and histologic pattern. The most common histologic changes in secondary syphilis are swelling & proliferation of endothelial cells and the presence of a perivascular infiltrate containing plasmia cells. But often, these findings are absert or inconspicuous. Objectlve : We examined the histopathologic findings of secondary syphilis in relation to the clinical types of the skin lesion. Methods : 36 biopsy specimens from twenty-nine serologically and clinically confirmed cases of secondary syphilis (15 macules, 8 papules, 2 condylomata latas and 11 papulosquamous lesions) were examined. Raeults : The histopath,ologic findings of secondary syphilis showed comparative differences according to the clinical types of the skin lesion. The plasms cell infltrates were absent or sparse in 14 csses(39%) and the plasma cell infiltration was significantly correhted with the age of skin lesions(p=0.02197). Vascular changes were seen in 32 cases (89%), but the incidence of endothelial proliferation was less(25%). Conclvsion : This study demonstrates the histopathologic findirigs of secondary syphilis in accordance to the clinical morphology of the eruption and thus, help to differentiate syphilids from other skin diseases. (Kor J Dermatol 1993; 31(2): 197-203)
모세혈관 확장성 윤상 자반병양 피부 병변을 보인 매독진
김희옥(Hee Ok Kim),최연상(Yeon Sang Choi),유희준(Hee Joon Yu),손숙자(Sook Ja Son) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.5
The skin manifestations of secondary syphilis, termed syphilid, show macular, papular and papulosquamous rashes in most cases, but may show lots of other clinical findings. We report a case of syphitid simulating purpura annulsris telangieitodes in 25-year-old male who had a history of genital ulcer 2 months ago. The skin lesion showed diffuse erythematous, 1-3 cm sized, telangiectatic annular patchea and purpuric plaques on both lower extremities and discrete papulosquamous rashes on both soles. The results of the serologic test for syphili was found to be reactive to 32 dilution in serum VDRL test and positive in serum TPHA test. Histovathologically, we could observe the obscuring of dermoepidermal juction, coat-sleeve-like perivascular infiltrate composed of mononuclear cells and a few plasma cells, and endothelial swellings. Afte the treatment with benzathine penicillin G, the titer of serurn VDRL test was decreased abruptly to 4 dilution and the skin lesions disappeared completely. (Kor J Dermatol 1994;32(5):926-930)
김희옥(Hee Ok Kim),백영곤(Young Gon Baik),유희준(Hee Joon Yu),손숙자(Sook Ja Son) 대한피부과학회 1993 대한피부과학회지 Vol.31 No.4
Barts syndrome was desrribed by Bart(Bart et al, 1966) with hereditary congenital localized absence of skin from the lovrer legs associated with blistering of the sun and mouth and nail abnormalities. A newborn girl presented with a congenital localized absence of skn over both shins & dorsa of both feet which were covered with the thin, translucent, brown red glistening membranes. A number of blisters were seen on the back, thighs upper extremities, and both 2rd toe nails were absent. Electron microscopic examination of defected skin revealed dermo-epidermal . paration with focal disruption of basal lamina. (Kor J Dermatol 1993;31(4):620-623)