한국인 폐경 여성에서 Drospirenone 2 mg과 17β-estradiol 1 mg 투여의 혈압, 체중, 지질의 영향

신유정 ( You Jung Shin ),이선주 ( Sun Joo Lee ),권수경 ( Su Kyeong Kwon ),유래미 ( Rae Mi Yu ),강혁재 ( Hyuk Jae Kang ),김성훈 ( Sung Hoon Kim ),채희동 ( Hee Dong Chae ),김정훈 ( Chung Hoon Kim ),강병문 ( Byung Moon Kang ) 대한폐경학회 2011 대한폐경학회지 Vol.17 No.2

연구목적: 현재 17β-estradiol/drospirenone 혼합제제는 폐경 여성의 호르몬 치료로 사용되고 있다. 하지만 아직 한국여성에서의 drospirenone 제제의 심혈관에 대한 영향 및 부작용에 대한 연구가 부족하며 논란이 있는 실정이다. 따라서 본 연구에서는 현재 이용되고 있는 17β-estradiol/drospirenone 혼합제제의 혈압 강하 및 지질수치 변화에 대한 효과를 24개월에 걸쳐 평가하고 약제에 대한 부작용에 대하여 살펴 보고자 한다. 연구재료 및 방법: 2007년 12월부터 2010년 10월까지 울산의대 서울아산병원 산부인과에 방문하여 폐경이 진단되고 drospirenone/17β-estradiol 혼합제제를 처음으로 처방받은 총 417명의 여성을 대상으로 후향적으로 의무 기록을 검토하였다. 혈압 측정을 시행한 125명의 환자를 이들의 혈압에 따라 그룹 1 (정상 혈압군, n = 76)과 그룹 2 (고혈압전기 또는 고혈압 1기 환자, n = 49)로 나누어 호르몬 복용 이전에 혈압과 체중, 혈액검사를 시행하고 복용 시작 1, 2, 3, 6, 9, 12, 18, 24개월 후에 측정한 값들과의 비교를 시행하였다. 그리고 지질 수치는 복용 전과 복용 시작 6, 12, 24개월 후의 총 콜레스테롤, 저밀도 지단백, 고밀도 지단백 그리고 중성 지방 수치를 비교하였다. 또한 drospirenone/17β-estradiol 혼합제제의 안정성을 평가하기 위해 중단 및 약제 변경의 사유와 투약 후 나타난 부작용에 대해 평가하였다. 통계는 기준선의 특징에 대해서는 SPSS version 12.0 (SPSS Inc., Chicago, IL, USA)를 사용하고 투여 전후 혈압, 체중, 지질 수치 변화에 대해서는 Statistical Analysis System (SAS) version 9.1 (SAS Institute Inc., Cary, NC, USA)을 사용하였다. 결과: 최초 진단 후 처방 당시 환자 평균 연령은 52.4 ± 3.9 세였으며, 복용 일의 중앙값은 279 일이었다. 폐경여성에서 drospirenone/17β-estradiol 혼합제제의 투여 후, 그룹 1과 2에서 혈압이 통계적으로 유의하게 감소하였다. 하지만 체중의 변화는 통계적으로 유의한 감소는 없었으며, 지질 수치의 변화는 측정한 값 중 중성지방만이 의미있는 감소가 있었으나, 각 측정시기만을 고려했을 때는 복용 후 18개월 후 저밀도 지단백 그리고 중성 지방 수치의 의미있는 감소가 있었다. Drospirenone/17β-estradiol 혼합제제 복용 중단 또는 약물 변경한 주요 이유로는 점상 질출혈 (28%), 부작용에 대한 두려움 (27%), 증상에 효과가 없었던 경우 (26%)의 순으로 나타났다. 결론: Drospirenone/17β-estradiol 혼합제제 복용은 폐경 여성의 수축기와 이완기 혈압을 의미있게 감소시켰으며 체중 감소는 있었으나 통계적 유의성을 보이지는 않았다. 그리고 지질 수치 중 중성지방이 유의하게 감소하였으며 심각한 부작용은 관찰되지 않았다. Objectives: The objective of the present study was to determine the effects of the widely used combination hormone therapy, drospirenone and 17β-estradiol on the blood pressure, body weight, lipid profiles, and major side effects in postmenopausal Korean women. Methods: Four hundred seventeen menopausal patients who were being treated with drospirenone/17β-estradiol at the Asan Medical Center between December 2007 and October 2010 underwent a retrospective chart review. One hundred twenty-five patients were divided into 2 groups based on blood pressure, as follows: group 1 (normal blood pressure, n = 76); and group 2 (stage 1 hypertension and pre-hypertension, n = 49). The systolic and diastolic blood pressure and the body weight were checked before the treatment, and 1, 2, 3, 6, 9, 12, 18 and 24 months after taking the medication. Results: The median days of administration were 279. The combination of drospirenone and 17β-estradiol had a blood pressure-lowering effect in groups 1 and 2. However, the body weight did not show a statistically significant change. Only the level of triglycerides decreased with time and the change was statistically significant. The low density lipoprotein (LDL)-cholesterol and triglycerides levels had a statistically significant decrease 18 months after the medication. The most common reasons for discontinuouing medication were vaginal spotting (28%), fear of side effects (27%), and ineffectiveness (26%). Conclusion: The combination of drospirenone/17β-estradiol caused a decrease in systolic and diastolic blood pressure and the body weight showed no statistically significant decrease. Furthermore, triglycerides showed statistically significant decrease and there were no severe side effects of the medication reported. (J Korean Soc Menopause 2011;17:102-109)

MR 댐퍼를 이용한 철도차량 승차감 반능동 제어

신유정(Yu-Jeong Shin),유원희(Won-Hee You),정흥채(Heung-Chae Jung) 한국철도학회 2011 한국철도학회 학술발표대회논문집 Vol.2011 No.10

Recently the maximum speed becomes the most important performance in high speed train. But the speed up of train will not give the passenger good riding comfort. The semi-active suspension system by using variable damper with hydraulic solenoid valve is used to solve this problem. But the variable damper with hydraulic solenoid valve requires tank for supplying fluid. In this study the MR(Magneto Rheological) damper was considered instead of hydraulic variable damper in order to improve riding comfort. Dynamic simulation was conducted for semi-active suspension system with MR damper was made by using Matlab-Simulink S/W. According to control strategy of MR damper for improving ride comfort in railway vehicle The riding comfort of the railway vehicle with semi-active suspension system was analyzed and compared with conventional suspension system by using the program.

임신 중 위암의 전이성 난소 병변과 동반된 가성 메이그스 증후군

유래미 ( Rae Mi You ),신유정 ( You Jung Shin ),김민균 ( Min Gyun Kim ),심재윤 ( Jae Yoon Shim ),원혜성 ( Hye Sung Won ),이필량 ( Pil Ryang Lee ),김암 ( Ahm Kim ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.7

Pseudo-Meigs` syndrome is a syndrome that includes hydrothorax and ascites secondary to ovarian tumors other than solid benign fibroma. In this report, we present the case of a 29-years-old female who complained of abdominal distension with peripheral edema during her third trimester. Two solid masses of 15 cm dimension in the left abdomen and 7 cm dimension in the right abdomen were detected by ultrasound and chest X-ray revealed right pleural effusion. Magnetic resonance imaging (MRI) confirmed the ovarian masses and ascites. As the patient had regular uterine contractions, we decided to perform emergency cesarean section because of previous cesarean section history. A laparotomy was performed and pathologists confirmed the presence of a metastatic adenocarcinoma. Four days following the surgery, gastroduodenoscopy revealed a huge ulcerofungating mass was visible in greater curvature of stomach. The final diagnosis was metastatic adenocarcinoma from gastric cancer. Although pseudo-Meigs` syndrome is very rare, it should be carefully considered when evaluating female complaining with ascites in ovarian tumor.

난소의 양성 기형종에서 유래된 원발성 악성 흑색종

문제원 ( Jei Won Moon ),김지영 ( Ji Young Kim ),신유정 ( You Jung Shin ),이미영 ( Mi Young Lee ),최혁재 ( Hyuck Jae Choi ),박정열 ( Jeong Yeol Park ),남주현 ( Joo Hyun Nam ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.9

Primary malignant melanoma arising from the ovarian mature cystic teratoma is extremely rare, with only 31 cases have been described in the literature. It is one of the rarest forms of malignant transformation of ovarian mature cystic teratoma and usually develops unilaterally after menopause. Recently, we experienced a case of primary malignant melanoma arising from ovarian mature cystic teratoma in 71-year-old woman. The diagnosis was confirmed by positive immunohistochemical results of S-100 protein and HMB 45. Here we report the rare case with review of literature.

뮐러관 기형 환자에 대한 임상적 고찰: 서울아산병원 20년 (1990~2009년) 간의 경험

전균호 ( Gyun Ho Jeon ),박유란 ( Yu Ran Park ),신유정 ( You Jung Shin ),김성훈 ( Sung Hoon Kim ),채희동 ( Hee Dong Chae ),김정훈 ( Chung Hoon Kim ),강병문 ( Byung Moon Kang ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.7

목적: 뮐러관 기형 환자의 임상양상과 생식력에 대하여 알아보고자 하였다. 연구 방법: 1990년부터 2009년까지 20년간 서울아산병원에서 뮐러관 기형으로 진단받은 186명의 환자들의 임상적 특징과 생식력을 분석하였다. 결과: 뮐러관 기형은 1,326환자당 1명 (0.075%)의 빈도로 대부분 성인기에 발견되었고, 청소년기와 소아기에 발견된 경우는 15.1%에 불과하였다. 약 40% 이상의 환자들은 증상이 없이 우연히 발견되었지만, 그 외 상당수의 환자들은 무월경, 생리통, 이상 생리 등의 증상을 호소하였다. 본 연구에서 자궁 기형 중 가장 흔한 유형은 쌍자궁 (30.6%)이었고, 다음으로 두뿔 자궁(19.4%), Mayer-Rokitansky-Kuster-Hauser 증후군, 중격 자궁, 단각 자궁의 순이었다. 이들 환자들에서 확인된 251예의 임신의 예후는 자연 유산과 조산이 55.8%로 매우 흔하였고, 총 생존아 출산율은 48.6%였다. 각 자궁 기형별로 분석하였을 때 궁상자궁과 쌍자궁의 생존아 출산률이 각각 60.0%, 58.0%였고, 단각 자궁과 두뿔 자궁은 각각 42.1%, 46.7%로 비슷하게 나타난 반면, 중격 자궁은 32.4%로 상대적으로 낮은 생존아 출산율을 보였다. 결론: 대부분의 뮐러관 기형은 성인기에 발견되지만 많은 수의 환자들은 청소년기 이후부터 생리 이상, 생리통 등의 증상을 보일 수 있다. 본 연구에서 중격 자궁 환자들의 생식력에 대한 예후는 궁상 자궁과 쌍자궁 환자들에 비해 나쁜 것으로 나타났다. Objective: To investigate the clinical characteristics and reproductive outcomes of women with Mullerian anomalies. Methods: One hundred and eighty-six patients were diagnosed with Mullerian anomalies at the Asan Medical Center from 1990 to 2009 and their clinical characteristics and reproductive outcomes were analyzed. Mullerian anomalies were categorized according to the classification by the American Fertility Society (1988). Results: Mullerian anomaly was noticed in 1 in 1,326 patients (0.075%). Most cases were found in adulthood (84.9%) whereas only 15.1% cases in adolescent or pediatric period. More than 40% of cases were asymptomatic and found incidentally but others suffered from amenorrhea (12.4%), dysmenorrhea (10.8%), abnormal menstruation (10.2%), etc. Most common type of uterine anomalies was uterine didelphys (30.6%), followed by bicornuate uterus (19.4%), Mayer-Rokitansky-Kuster-Hauser syndrome (10.8%), septate uterus (9.1%) and unicornuate uterus (8.6%). On the reproductive outcomes of 251 pregnancies identified, spontaneous miscarriages and preterm labor were quite common (55.8%), and the overall live birth rate was 48.6%. When each anomaly was individually analyzed, the live birth rate was 60.0% in the arcuate uterus and 58.0% in the uterine didelphys. The unicornuate and bicornuate uterus presented a similar chance of having a living child (42.1%, 46.7%), while the septate uterus showed a relatively lower live birth rate (32.4%). Conclusion: Although most cases of Mullerian anomalies are diagnosed in adulthood, many patients may suffer from menstrual abnormalities, dysmenorrhea or recurrent miscarriages since adolescence. The reproductive outcomes of the arcuate uterus and uterine didelphys were better, while those of septate uterus were poor in our study.

목질바닥재 적용을 위한 Microencapsulated PCM의 성능평가

정수광(Jeong Su-Gwnag),전지수(Jeon Jisoo),서정기(Seo Junki),신유정(Shin You Jung),김수민(Kim Sumin) 한국건축친환경설비학회 2011 한국건축친환경설비학회 학술발표대회 논문집 Vol.2011 No.10

Thermal energy storage systems using Microencapsulated phase change material (MPCM) have been recognized as one of the most advanced energy technologies in enhancing the energy efficiency and sustainability of buildings. We studied to incorporate MPCMs with building materials through application for adhesive of wood-based flooring. Wood-based flooring is common used for floor finish materials of residential building in Korea. This study is aimed at making high thermal efficiency wood-based flooring by increasing its heat storage using MPCM which has 27-31℃ phase change temperature range. To increasing the heat storage of wood-based flooring, MPCM was used with adhesive for surface bonding of wood-based flooring. MPCM of 3, 6, 7, 10wt% was added to adhesive which was made by the 1:1 ratio mixed epoxy resin consist base with hardener. MPCM/adhesive composite were prepared by the stirring of MPCM in liquid state adhesive. As a result, scanning electron microscopy (SEM) morphology showed uniform dispersion of MPCM in the adhesive. This MPCM/adhesive composite has the characteristic of heat storage by analyzing differential scanning calorimetry (DSC) measurement. And we analyzed this composition was formed by physical combination through the Fourier transform infrared (FT-IR).

고속제동 설계인자와 제동력의 수치계산에 관한 연구

최경진(Choi Kyung-Jin),송문석(Song Mun-Suk),신유정(Shin You-Jung) 한국철도학회 2004 한국철도학회 학술발표대회논문집 Vol.- No.-

Since the braking system of rolling stock is directly linked to it"s safety, ensuring reliability of braking system and evaluation of performance of it are very important. To develope the performance of braking system, it is required advanced technology and gradually various factors in the field test result This study is designed to analyze various factors about braking force in rolling stock, also, by comparing braking force of KTX with that of high speed train. The study suggests to establish a method of computation of braking force suitable for high speed train having a lot of trouble in calculating braking distance by diversification of patterns of braking system such as the train of speed up and introduction of electric and pneumatic braking system.

신장내과 조기의뢰가 혈액투석 예후에 미치는 영향 : 단일 임상 기관 연구

강우헌 ( Woo Heon Kang ),오하영 ( Ha Young Oh ),신유정 ( You Jung Shin ),설정숙 ( Jeong Sook Seol ),강문자 ( Moon Ja Kang ),탁은영 ( Eun Young Tak ),이남선 ( Nam Sun Lee ),이미경 ( Mi Kyoung Lee ),류로사 ( Ro Sa Ryu ),송영혜 ( You 대한신장학회 2006 Kidney Research and Clinical Practice Vol.25 No.2

답면 브레이크 슈의 마찰계수와 제동성능향상을 위한 평가기술

최경진(Choi Kyung-Jin),이동형(Lee Dong-Hyung),이회성(Lee hisung),송문석(Song Mun-Suk),신유정(Shin You-Jung) 한국철도학회 2003 한국철도학회 학술발표대회논문집 Vol.- No.-

In tread braking of freight cars, braking force is produced by the friction between the wheel and the braking shoe. Friction coefficients such as the brake power, weight variation and brake shoe types should be sensitively treated as the design parameters. The conditions of the car, empty and weighted, should also be taken into consideration in brake force design and the control of brake force has some limitations in terms of the brake system design so that the brake materials selection should be considered as important measures to solve that difficulties. Friction characteristics of brake materials should remain within the range of maximum and minimum value and the friction performance should remain stable regardless of braking time and temperature. This study presented an experimental evaluation method to secure optimum braking performance by keeping safe braking effect and braking distance by the friction coefficient of the brake shoe of the freight cars.