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갱년기 여성에서 호르몬 대치요법에 대한 요추 및 대퇴 근위부 (proximal femur) 골밀도 변화
박철우,백경돈,김종철,길명도,권상칠,형남규 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.7
본원 산부인과 외래를 방문하여 호르몬 대치요법을 시행받은 폐경기 환자 171명을 대상으로 요추, 대퇴 경부 대퇴 대전자 및 Ward 삼각부의 골밀도를 측정하여 다음과 같은 결론을 얻었다. 1) 총 171명이 1년간 호르몬 대치요법을 시행받았으 며, 50명이 2년간 호르몬 대치요법을 시행받았다. 2) 호르몬 대치요법을 시행받은 환자(171명)에서 Ward 삼각의 골밀도와 대퇴 대전자의 골밀도가 치료 전 보다 치료 1년과 2년 후 통계적으로 유의하게 증가하였 다(p<0.05). 3) 폐경 기간이 3년 이하(98명)인 경우 대퇴 경부의 골 밀도가 치료 전보다 치료 1년과 2년 후 유의하게 증가하 였다(p<0.05). 4) HRT-A를 투여 받았던 환자 중(82명)에서 폐경기간 이 3년 이하(49명)인 경우 모든 부위(요추, 대퇴 경부, 대 퇴 대전자, Ward 삼각)의 골밀도가 치료 1년 후 치료 전 보다 유의하게 증가하였고(p<0.05), 치료 2년 후에는 요추 부위를 제외한 다른 부위(대퇴 경부, 대퇴 대전자, Ward 삼각)에서 유의하게 증가하였다(p<0.05). 5) HRT-B를 투여 받았던 환자 중(89명)에서 폐경기간 이 4년 이상(49명)인 경우 모든 부위(요추, 대퇴 경부, 대 퇴 대전자, Ward 삼각)의 골밀도가 치료 1년 후 치료 전 보다 유의하게 증가하였고(p<0.05), 치료 2년 후에는 요 추 부위를 제외한 다른 부위(대퇴 경부, 대퇴 대전자, Ward 삼각)에서 유의하게 감소하였다(p<0.05). 6) 호르몬 대치요법을 시행받기 전의 골밀도 젊은 연 령의 정상 골밀도 백분율치가 90% 미만인 환자의 경우 요추, 대퇴 경부, 대퇴 대전자 그리고 Ward 삼각 등 모든 부위에서 치료 전에 비해 치료 1년 및 2년 후 젊은 연령 의 정상 골밀도 백분율치가 통계적으로 유의하게 증가 하였다(p<0.05). 이상의 결과로 HRT-A는 폐경 기간이 3년 이하인 환자에서 효과가 있을 것으로 사료되나 요추의 골밀도가 치료 2년 후 감소된 결과로 나왔고, HRT-B는 폐경기간 이 4년 이상인 환자에 효과가 있을 것으로 사료되나 치 료 2년 후 요추를 제외한 부위에서 골밀도가 감소하였으 므로 앞으로 더 많은 관찰 보고가 있어야 할 것으로 사 료된다. 그리고 환자의 순응도(compliance)와 더불어 호 르몬 대치요법의 투여 양상이 골밀도에 영향을 줄 수 있 을 것으로 사료되며, 또한 투여 전 골밀도가 낮을수록 높은 증가율을 보일 것으로 사료된다. 결론적으로 호르몬 대치요법으로 얻을 수 있는 효과는 골소실의 예방과 함께 안면홍조나 수면장애 등 폐경기 증상들을 완화 시켜 줌으로써 삶의 질을 향상시킬 수 있을 것으로 사료된다. To estimate the effect of hormone replace therapy (HRT) for 2 years on bone mineral denstiy (BMD) of the lumbar spine and proximal femur in perimenopausal women. The HRT was designed as a combined estrogen/progestogen regimen. A total of 171 women were enrolled in the study, 82 of these women who wanted cyclic menstruation-like bleeding received HRT-A[cyclic sequential regimen of oral conjugated equine estrogen(premarin) 0.625 mg/day for 25 days and medroxyprogesterone acetate (provera) 10 mg/day for 12 days], with the remaining 89 receiving HRT-B[contiuous combined regimen of premarin 0.625 mg/day and provera 2.5 mg/day for 30 days]. Most of these women showed no contra-indications of therapy. BMD was measured (DEXA, LUNAR DPZ. USA) at the lumbar spine(L2-L4), femoral neck, femoral trochanter and Ward` triangle before the initiation of therapy and at 12 months and 24 months thereafter. The results were as follows : 1) Of the 171 patients enrolled in this study, 171 patients completed the 1 year of therapy and 50 completed the 2-year study. 2) The bone mineral densities in the femoral trochanter and Ward`s triangle were significantly elevated at 12 months and 24 months in HRT-A and HRT-B group (p<0.05). 3) The bone mineral densities in the femoral neck were significantly elevated in the sub-group of patients who received therapy within 3 years after menopause at 12 months and 24 months in both group (p<0.05). 4) The bone mineral densities in the lumbar spines, femoral neck, femoral trochanter and Ward`s triangle were significantly elevated in the sub-group of patients who received therapy within 3 years after menopause at 12 months in HRT-A group (p<0.05). But the bone mineral densities in the lumbar spines were significantly decreased at 24 months (p<0.05). In addition, the bone mineral densities in the femoral neck, femoral trochanter and Ward`s triangle were significantly increased at 24 months (p<0.05). 5) The bone mineral densities in the lumbar spines, femoral neck, femoral trochanter and Ward`s triangle were significantly elevated in the sub-group of patients who received therapy beyond 3 years after menopause at 12 months in HRT-B group (p<0.05). But the bone mineral densities in femoral neck, femoral trochanter and Ward`s triangle were significantly decreased at 24 months (p<0.05). 6) The % changes of % young-adult values of bone mineral densities in the lumbar spines, femoral neck, femoral trochanter and Ward`s triangle at 12 months and 24 months in HRT-A and HRT-B group were significantly elevated in sub-group of patients who had pretreatment % young-adult values <90 (p<0.05). From the above results, it might be suggested that HRT-A appears to be more effective in increasing the BMD of the lumbar spines and proximal femurs for patients who received therapy within 3 years after menopause at 1 year therapy and that HRT-B for patients who received therapy beyond 3 years after menopause at 1 year therapy. Thus, it might be suggested that in addition to patient`s compliance, the type of HRT may affect the response of BMD. And it also might be suggested that HRT appears to be better response for patients with low BMD than with high BMD.
2009 Historical Consideration of Hanji Used as Art Materials
이지영,이영록,백경길,이희진,곽혜정,김성호,강하련,김철환 한국가구학회 2009 한국가구학회지 Vol.20 No.3
Traditional Korean paper called Hanji using bast fibers from mulberry tree is made through complicated handmade works. This made Hanji very strong and exceedingly durable. Therefore it is said to last a thousand years. Such incomparable features of Hanji come from the unique sheet forming method called ouibalttugi using a bamboo screen. Excellent physical properties of Hanji reflect the wide variety of use, all central to everyday life. Despite its Excellency, the papermaking practice of traditional handmade paper, Hanji, from Korea is little known outside its country. This might be due to public apathy on Hanji in modern times. Without future apprentices dedicated to the craft, the Korean tradition able to make its soul is in danger of extinction in its homeland. Therefore more concern and more affection on Hanji is required immediately. It must be kept in mind that Hanji is our cultural heritage in pride over time.
김주원,김철,길명도,고영훈,백경돈 대한부인종양 콜포스코피학회 1996 Journal of Gynecologic Oncology Vol.7 No.4
This study was performed to evaluate the diagnostic value of colposcopy by comparing colposcopic findings with cytology, histology of colposcopically directed biopsy and final biopsy result on hysterectomy. From January 1, 1988 to August 31, 1996, the colposcopic examinations was undertaken in 1200 patients, excluding grossly visible carcinoma of the cervix. The result were as follows : 1. Colposcopic examinations were satisfactory in 95.4% and unsatisfactory in 4.58%. 2. The accuracy rate of cytologic diagnosis was 73.1% and colposcopic impression was 93.1%. 3. The false negative rate of colposcopic impression was 2.6%, much less than 24,7% of cytologic examination. 4. The cytologic accuracy rate in cervicitis was higher than that of colposcopic impression but the accuracy rate of colposcopic impression in diagnosis of cervical intraepithelial neoplasia was higher than that of cytology. 5. Among 97 cases in which colposcopically directed biopsy were performed, more advanced lesion were disclosed in 12 cases(12.4%).