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이병익 ( Byoung Ick Lee ) 대한폐경학회 2007 대한폐경학회지 Vol.13 No.1
Women undergoing stem cell transplantation (SCT) are mostly young and have more than 90% probability of ovarian failure, which is often permanent. A woman`s age, use of radiotherapy, alkylating chemotherapy, and the allogeneic type of transplant are associated with a higher rate of premature ovarian failure (POF) and worse residual ovarian function. POF has serious systemic and psychological effects that may need treatment and should be managed by practitioners trained to treat this particular population of women. Ultrasonographic evidence of ovarian follicles is often associated with a future resumption of cycles, but there are no serum markers to predict the return of ovarian function in these patients. There are no guidelines on how to manage POF induced by myeloablative treatments followed by SCT. Because of the likelihood of the need for long-lasting estrogen plus progestin therapy (EPT) and the increased risk of secondary neoplasia after SCT, the EPT should be as physiological as possible. The cyclical sequential combination of EPT was associated with excellent compliance because of its simple administration and few adverse effects. Such a treatment led to a dramatic improvement in vasomotor, urogenital, and psychological symptoms related to estrogen deficiency. However, in the allogeneic transplantation setting, up to 25% of women may suffer from gynecological chronic graft-versus-host disease (GVHD), which may become apparent as hematocolpometra after introduction of EPT. Thus, accurate pretreatment evaluation and frequent monitoring during treatment are required. Moreover, EPT absorption may be reduced in patients who received allotransplants and have gastrointestinal or skin chronic GVHD.
폐경기증상 치료에서 승마추출물과 호르몬보충요법의 비교연구
이병익(Byoung Ick Lee),고승권(Seung Kwon Koh),황성욱(Seong Ook Hwang),박지현(Jee Hyun Park),김종화(Chong Wha Kim) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.8
목적 : 폐경 증상에 대한 장기간의 호르몬 보충 요법은 유방암에 대한 공포와 부작용으로 말미암아 새로운 대체요법에 대한 관심이 절실히 요구되는 실정이다. 이에 본 연구는 승마추출물이 폐경 여성에 있어서 폐경 증상을 완화시키는데 호르몬 보충 요법의 대체요법으로 사용될 수 있는 지 알아보고자 시행하였다. 연구 방법 : 폐경 증상을 호소하는 폐경 여성 74명을 위약군 (Placebo: 12명), 승마추출물군 (Feramin: 32명), 호르몬보충요법군 (Premarin: 30명)으로 나누어 3개월간 약물을 투여하였다. 총 3회 (약물 투여전, 투여 1개월, 투여 3개월)에 걸쳐 폐경 증상의 변화는 Kupperman index의 변화로, 골대사의 변화는 Osteocalcin과 Deoxrpyridinoline을 측정하여, 지질대사의 변화는 총 콜레스테롤, 중성지방 및 고밀도 콜레스테롤을 측정하여 계량화 하였다. 약물투여에 대한 부작용은 투여 3개월 후 조사하였다. 결과 : 위약군과 비교하여 승마추출물은 Kupperman index를 낮추는데 있어서 호르몬 보충 요법만큼 효과적이었다 (투여 1개월: p<0.05, 투여 3개월: p<0.01). 골대사 및 지진대사의 변화에 있어서 위약군에 비하여 약간의 긍정적인 효과를 보이나 통계학적으로 유의하지 않았다. 부작용은 호르몬보충요법에 비하여 훨씬 적었다. 결론 : 승마추출물은 폐경 증상을 완화시키기 위한 목적으로 호르몬 보충 요법을 대치할 수 있는 안전하고 효과적인 치료제이며 특히 호르몬 보충 요법의 부작용이나 장기간투여에 따른 유방암에 대한 공포로 말미암아 투여를 거부하는 경우 새로운 대체요법으로 생각된다. Objective : The fears and side effects of a prolonged hormone replacement therapy on the postmenopausal symptoms reinforce a growing interest about alternatives. The present study was performed to investigate whether black cohosh root extract (BCRE) can be used or not as an alternative to hormone replacement therapy (HRT) in order to relieve postmenopausal symptoms. Material & Methods : Randomized, double-blind prospective clinical trial examined the effects of BCRE and HRT on Kuppetman index, biochemical bone markers, lipid profiles, and side effects in 74 women with postmenopausal symptoms. Treatments included placebo (Festal^??) (n=12), BCRE (Feramin^??) (n=32) and HRT (Premarin^??) (n=30) for 3 months. Kupperman index, biochemical bone markers (osteocalcin and deoxypyridinoline), and lipid profiles (total cholesterol, triglyceride and HDL-cholesterol) were measured at 0, I and 3 months. Side effects were checked at 3 months. Results : BCRE was significantly effective in lowering of Kupperman index as much as HRT at two control times (1 month: p<0.05, 3 months: p<0.001). It also showed slightly favorable effects on biochemical bone markers and lipid profiles but not statistically significant. Fewer side effects were seen in BCRE than HRT. Conclusion : BCRE appears to be a safe and effective alternative to HRT for early postmenopausal symptoms and may be especially useful in women with intolerances or contraindications to traditional HRT.
난소 종양으로 오진된 신장 무형성을 동반한 우측 흔적 자궁각
이기은 ( Ki Eun Lee ),권혜진 ( Hye Jin Kwon ),정현재 ( Hyun Jae Jeong ),박정우 ( Jung Woo Park ),최효성 ( Hyo Seong Choi ),이춘수 ( Choon Soo Lee ),황성욱 ( Sung Ook Hwang ),송은섭 ( Eun Seop Song ),이병익 ( Byoung Ick Lee ),이우 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.1
Rudimentary uterus with ipsilateral renal agenesis is a very rare Mullerian duct malformation. The most common clinical presentation is pelvic pain and dysmenorrhea shortly after menarche, in associated with the finding of a vaginal or pelvic mass. An appropriate and prompt diagnosis and treatment will prevent unnecessary procedures and offer relief of symptoms. We report one case of rudimentary uterine horn with ipsilateral renal agenesis with a brief review of concerned literatures.
자궁경부이형상피증과 자궁경부암에서의 claudin-1과 claudin-7의 발현 증가 양상
송은섭 ( Eun Seop Song ),이병익 ( Byoung Ick Lee ),김준미 ( Joon Mee Kim ),이건영 ( Keon Young Lee ),안경신 ( Kyung Sin An ),성승미 ( Seung Mi Sung ),권혜진 ( Hye Jin Kwon ),박지현 ( Jee Hyun Park ),한지영 ( Jee Young Han ),최석진 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.5
세포진 검사상 ASCUS/LSIL이 나온 환자의 치료에 있어서 HPV DNA 검사의 임상적 유용성
이정례 ( Jeong Rye Lee ),송은섭 ( Song Eun Seop ),이정헌 ( Heong Hun Lee ),김세련 ( Se Ryun Kim ),박지현 ( Jee Hyun Park ),황성욱 ( Sung Ook Hwang ),고승권 ( Seung Kwon Koh ),임문환 ( Moon Whan Im ),이병익 ( Byoung Ick Lee ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.2
목적 : PCR을 이용한 HPV DNA 검사법이 비정상 세포진 (ASCUS/LSIL)이 나온 환자에서 고위험 병변을 알아내기 위한 보조적인 수단으로서 임상적인 효용성이 있는지 알아보고자 하였다. 연구 방법 : 1996년 9월 1일부터 2000년 5월 31일까지 인하대병원 산부인과에 내원하여 자궁경부 세포진 검사를 받은 여성 중에서 비정상 세포진 (ASCUS/LSIL)의 결과를 보여 HPV DNA 검사와 질확대경하 조직 생검을 시행 받은 61명을 대상으로 Objective : This study was performed to evaluate the clinical efficacy of high risk HPV DNA test using PCR for the detection of high-grade CIN or invasive cancer from patients with ASCUS or LSIL on Papanicolaou smear. Methods : Sixty one patients with a P
승마 (black cohosh)의 폐경 후 단기간 투여시 질 위축에 대한 효과와 안전성
이동규 ( Dong Kyu Lee ),박형무 ( Hyoung Moo Park ),강병문 ( Byung Moon Kang ),김정구 ( Jung Gu Kim ),윤병구 ( Byung Koo Yoon ),이병익 ( Byoung Ick Lee ),조수현 ( Soo Hyun Cho ),최훈 ( Hoon Choe ),유범희 ( Bum Hee Yu ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.2
목적: 중등도 이상의 갱년기 증상을 가진 자연 폐경여성에서 승마의 단기간 투여시 질 위축에 대한 효과와 안전성을 검증하고자 하였다. 연구 방법: 폐경 여성 80명을 대상으로 위약과 승마복합제를 각각 40명에게 무작위로 배정하였다. 12주 투여 후 질 성숙지표를 측정하여 두 군간에 질 상피세포의 변화를 비교함으로써 질 위축에 대한 효과를 평가하였다. 안전성은 시험약을 배정받아 한번이라도 투약받은 피험자에 대하여 이상반응, 실험실 검사치 (일반혈액검사, 일반화학검사, 소변검사), 생체징후, 이학적 검사 자료를 수집하여 평가하였다. 결과: 승마복합제 12주간의 투여 후 질 성숙지표의 변화는 위약군과 비교하여 유의한 차이가 나타나지 않았다. 그리고 승마복합제와 위약의 두 군에서 생체징후, 실험실 검사, 이학적 검사의 모든 항목에서 정상수치의 변화는 모두 통계학적으로 유의하지 않았다. 이상반응률에서도 두 치료군 사이에 통계학적 유의한 차이가 없었으며, 이상반응의 종류도 동일하여 이상반응의 원인이 승마복합제와 관련성이 없는 것으로 나타났다. 결론: 승마는 질 상피의 위축에 호전효과를 보이지 않았고, 폐경여성에서 단기간 사용시 유의한 이상반응을 유발하지 않음을 확인하였다. Objective: To evaluate the short-term therapeutic effect of black cohosh on vaginal atrophy and safety in postmenopausal women. Methods: A total of 80 postmenopausal women having moderate to severe degree of climacteric symptoms were randomly allocated to receive black cohosh combined preparation (n=40) or placebo (n=40) daily for 12 weeks. Fifty eight subjects completed this clinical study. The effect of black cohosh on vaginal atrophy in postmenopausal women was evaluated by measuring Maturation Value. Maturation Value was determined from vaginal smear at 0 and 12 weeks of treatment. Safety assessment included vital signs, physical examinations, adverse events, and routine laboratory parameters (hematology, biochemistry and urinalysis). It was carried out at the beginning, and after 4, 8, 12 weeks of treatment. Results: The mean (±standard deviation) Maturation Value decreased 0.18 (0.47±0.32 to 0.29±0.23) in black cohosh group and 0.13 (0.43±0.30 to 0.30±0.21) in placebo group. There was no statistical difference in change of Maturation Value from the baseline between the groups after 12 weeks. No serious adverse events were seen. Adverse events were observed in 7 (17.5%) patients in black cohosh group and 6 (15%) patients in placebo group. Prevalence of the adverse events did not differ statistically in the two treatment groups. No significant effects were seen on blood pressure, heart rate, body temperature, physical findings and laboratory values. Black cohosh was well tolerated. Conclusion: Black cohosh did not exert estrogenic effects on the vaginal atrophy but appears to be a safe alternative medicine for postmenopausal short-term use.
복식 자궁적출술 후 질단부로 발생한 난관 탈출증 1 예
박지현(Jee Hyun Park),이정례(Jeong Rye Lee),황성욱(Sung Ook Hwang),고승권(Seung Kwon Koh),임문환(Moon Whan Im),이병익(Byoung Ick Lee) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.2
Prolapse of the fallopian tube into the vaginal vault after hysterectomy is a rare phenomenon and it occurs more frequently after vaginal hysterectomy than abdominal hysterectomy. The exact incidence of tubal prolapse is unknown, because most of cases remain undiagnosed and may resolve before detection. The tubal prolapse may be suspected when granulation tissue or tender friable tissue are detected in vaginal cuff in women complaining lower abdominal pain, dysparenunia, vaginal discharge, or postcoital spotting. The definitive diagnosis of fallopian tube prolapse is made only by histologic confirmation. Reported methods of treatment have included transvaginal excision or transabdominal excision, cautery, and combined vaginal and laparoscopic salpingectomy. We experienced a case of fallopian tube prolapse after abdominal hysterectomy in a 40-year-old woman. We present this case with a brief review of the literature.
김태희 ( Tae Hee Kim ),이해혁 ( Hae Hyeog Lee ),정수호 ( Soo Ho Chung ),곽정자 ( Jeong Ja Kwak ),이병익 ( Byoung Ick Lee ),홍연표 ( Yeon Pyo Hong ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.4
Endometriosis is estrogen dependent disease in reproductive age. Endometriosis is a chronic inflammatory gynecologic disease. Problems associated with endometriosis include dysmenorrhea, dyspareunia, and infertility. Postmenopausal endometriosis is rare. Also, malignant transformation in endometriosis is rare. There is no report in Korea about serous adenocarcinoma arising from endometriosis after menopause. The authors present a case of serous adenocarcinoma arising from endometriosis after menopause with brief review of the literature.