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- 저자 : 박형무 ( Hyoung (검색결과 94 건)
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박형무,Park, Hyoung-Moo 한국정신신체의학회 1996 정신신체의학 Vol.4 No.1
Korean women are now living almost 1/3 of their life after menopause. Sex-steroid hormone deficiency adversely affect various fields of physical & mental activity and quality of life during this period. Therefore, replacement of deficient hormone is thought to be natural therapeutic modality. Postmenopausal syndrome is recently redefined as an endocrinopathy with both short-and long-term sequelae, as a result of cessation of ovarian function. Hormone replacement therapy taken at or near time of menopause alleviates shot-term acute menopausal symptoms such as vasomotor disturbances and psychological problems. HRT also beneficially affects some of intermediate symptoms such as urogenital atrophy and cutaneous problems. The major benefits of long-term use were reductions in risk of long-term sequelae, that is, total fracture by 50-60%, cardiovascular disease by 50% and cerebrovascular disease by 30-40%, respectively. In addition, HRT may also positively influence Alzheimer's disease, reduce the colorectal cancer risk and increase longevity of the life. In conclusion, all postmenopausal women should consider preventive HRT when there are no contraindications.
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박형무(Hyoung Moo Park),허민(M. Hur) 대한폐경학회 2000 대한폐경학회지 Vol.6 No.2
N/A Objective: Hormone replacement therapy(HRT) with estrogen, either alone or in cambination with progestogen has been well established for preservation of postmenopausal bone loss, However actual decrease in bone mineral density(BMD) is observed in some proportion of postmenopausal woman in practice, even though the use of bone-conserving doses of estrogen. The purpose of this study is to find out the incidence of the postmenopausal women with decreased BMD on HRT, the difference in incidence of the subjects with decreased BMD between natural and surgical menopause, and whether the factors such as duration of menopause, initial BMD and mode of HRT are influencing on the incidence of subjects with decreased BMD. Methods: One hundred-twenty one natural and thirty one surgical postmenopausal women on HRT were checked spine and femur BMD by dual energy X-ray absorptiometry at 1 year interval from Jan 1995 to May 1997. Results: The incidence of the subjects with decreased and significanly decreased spinc BMD in natural menopause was 24,8% and J7.5% respectively, At femur, the incidence of decrease and significant decrease in BMD was 33,0% and 22.9%, which was not statistically different from the incidence in spine BMD. In surgical menopause, the subjects with decreased and significantly decreased spine and femur BMD were markedly increased up to around 70% and over 50% respectively, which showed significant decrease compared with natural menopause. Duration of menopause, initial BMD and mode of HRT did not influence the incidence of significant decrease in BMD in natural menopause. Incidence of significant decrease in spine BMD was elevated within first 5 years of postmenopausal period in surgical menopause, but initial BMD did not influence this incidence. Conclusion: About 20% of natural and 50% of surgical postmenopausal women suffered from significant decrease in BMD even though conventional HRT. The incidence of decrease and significant decrease in femur BMD was not significantly different from incidence in spine BMD, and duration of menopause, initial BMD, and mode of HRT did not influence these incidence in menopause, except menopausal duration which was inversely associated with these incidence in surgical menopause.
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박형무 ( Hyoung Moo Park ),송민석 ( Min Seok Song ),허민 ( Min Hur ) 대한폐경학회 2003 대한폐경학회지 Vol.9 No.1
목적 : 이중 방사선 흡수법을 이용하여 전신 및 부위별 골밀도를 측정해서 이들 사이의 상관관계를 관찰하고, 특정부위를 골밀도를 이용하여 골의 상태를 정의시, 다른 부위에서의 일치도를 관찰하여 보고자 하였다. 대상 및 방법 : 2000년 12월부터 2002년 5월까지 중앙대학교 용산병원 산부인과 외래를 방문한 폐경 혹은 폐경 주변기 여성 147명(평균연령 53.5±6.9세)을 대상으로 DXA(Lunar DTX-IQ)를 이용하여 전신 및 상지, 하지, 몸통 부위와 부위별 골밀도(대퇴골, 요추골)를 동일한 날에 측정하였다. 측정된 골밀도 사이의 상관계수를 구하였으며, 전신, 대퇴골, 요추골(L2-4)을 기준으로 삼아 기준이 각각 정상, 골감소증, 골다공증일때 다른 부위들에서의 일치도를 구하여 보았다. 결과 : 각 부위별로 측정된 골밀도 사이의 상관계수는 0.66에서 0.90사이였다. 전신 골밀도와 하지 사이의 상관계수가 0.99으로 가장 높았고, 상지와 요추골, 상지와 몸통부위 사이에 상관계수가 0.66으로 가장 낮은 상관관계를 보이고 있었다. 전신 골밀도와 부위별 골밀도에 의한 골상태 사이의 일치도는 67.3%에서 89.1%로서 다양한 관계를 보였다. 전신 골밀도를 기준으로 삼았을 때는 전신 골밀도에 의한 골상태 정상일 경우 다른 부위들에서의 골상태는 대부분 정상이었으며 상지에서 측정된 골밀도와의 일치도가 가장 높았고, 요추골과의 일치도가 가장 낮았다. 대퇴골 전체를 기준으로 보았을때는 대퇴골에서의 골밀도가 골다공증 소견을 보일 경우 다른 부위에서 측정된 골밀도 모두 골다공증 소견을 보였다. 또한 대태골에서 측정된 골밀도에 의한 골상태는 전신 골밀도에 의한 골상태와 가장 높은 일치도를 보였고 요추골의 골상태와 일치도가 가장 낮았다. 요추골을 기준으로 설정했을때는 요추골의 골상태가 정상일때 다른 부위에서 측정된 골상태 역시 대부분 정상이었으며 요추골에서의 골밀도가 골감소증이나 골다공증의 소견을 보여도 다른 부위들은 그보다 적은 골소실 정도를 보였고, 요추골의 골상태는 대퇴골 전체와 상지에서 보여준 골상태와 일치도가 높았으며 하지의 골상태와 일치도가 가장 낮았다. 결론 : 골다공증의 진단을 위한 골밀도의 측정에 있어 전신 골밀도와 부위별 골밀도를 비교할 때 높은 상관관계를 가지고 일치하는 면을 보여 어떤 부위에서 측정한 골밀도 값이라고 하여도 다른 부위들 골밀도 상태의 예측을 어느정도 가능하게 해주나 알고자 하는 부위가 있다면 다른 부위의 측정으로 이를 대체할 수 없으며 특정 부위별 골밀도의 측정이 필요할 것이다. Objectives : Whole body bone mineral density(BMD) measurement were compared with regional BMD using dual energy X-ray absorptiometry to determine relationship among BMD values obtained from different sites, and to know concordant rate among bone status of different sites. Materials and Methods : From December 2000 to May 2002, whole body and regional(femer, lumbar spine) BMD were measured simultaneously on 147 peri or postmenopausal women who visited the Department of Obstetrics and Gynecology, Chung-Ang University. The relationships among BMD of different sites were analyzed using correlation coefficients and concordant rate of bone status among different sites were assessed according to WHO definition. Results : The correlation coefficients among BMDs of different sites were ranging from 0.66 to 0.90. The highest degree of correlation(r=0.90) was shown on the whole body and legs, the lowest correlation(r=0.66) was on trunk and arms. Variable degrees of concordant rate were found ranging from 67.3% to 89.1%. When the bone status of whole body was normal, all other sites were almost normal in bone status. The concordant rate in bone status of whole body showed highest degree when assessed with bone status of arms, and lowest with lumbar spine(L2-4). When the bone status of total femur were osteoporotic, bone status of all other sites showed osteoporosis. The bone status of total femur were highly concordant with that of whole body, and poorly with spine. When the bone status of lumbar spine were normal, all other sites showed mostly normal and highly concordant with that of arms and total femur, but discordant with legs. Conclusion : In measurement of BMD to diagnose osteoporosis, the whole body ad regional BMD showed highly correlated, so measurement of BMD at any site is a competent predictor of all other sites, however, to know bone status at specific site, site-specific measurement is needed.
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박형무 ( Hyoung Moo Park ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.2
Objective: Postmenopausal osteoporosis is a common skeletal disease with serious consequences due to fracture, leading to increased morbidity and mortality. This study was carried out to evaluate the changes of national osteoporosis markets during the last 5 years and to estimate the trends of national osteoporosis market in the future. Methods: The use of the medications for osteoporosis treatment was evaluated in terms of sales of drugs for osteoporosis treatment. The sales audit of drugs for osteoporosis treatment from Intercontinental Marketing Services (IMS) were used to analyse the sales of specific drugs. Results: The total national osteoporosis market has been increased progressively and markedly during the last 5 years and was valued at 167.4 billion Korean won (KRW) in 2008. The use of hormone therapy was decreased markedly by 40% after reporting of WHI results and the reduction of hormone therapy has been continuing during the recent 5 years. The market size of the non-hormonal osteoporosis drugs has been grown by 73% during the last 5 years and was valued at 134.5 billion KRW in 2008. This non-hormonal drug market was dominated by bisphosphonates. which account for over 80% of total sales. The use of bisphosphonates and active vitamin D metabolites has been increasing but raloxifene and calcitonin, decreasing. Conclusion: The survery of recent national osteoporosis market using IMS sales audit showed that the use of drugs for osteoporosis treatment has been markedlly increasing during last 5 years from 2004 to 2008. This has been attributed to non-horomonal pharmacological drugs, especially bisphosphonate.
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