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장윤석,노경록,최영민,김정구,김석현,신창제 문신용,이진용 대한폐경학회 1996 대한폐경학회지 Vol.2 No.1
Questionnaires were mailed to 1000 Korean gynaecologists in order to obtain their views on the use of hormone replacement therapy(HRT). A total of 401 gynaecologists responded. Most of gynaecologists(91.3%) were prescribing HRT to the perimenopausal or postmenopausal women. The most common indication of HRT was the treatment of vasomotor symptoms(84.0%) in symptomatic postmenopausal women and the prevention of osteoporosis(61.6%) in asymptomatic postmenopausal women. The most common routes of HRT were the oral(85.8%) administration. About two third of respondents prescibed HRT by cyclic estrogen-progestogen combined therapy(67.3%), and 43.4% of respondents by the continuous estrogen-progestogen combined therapy. About 90% of respondents thought that HRT must be started within 5 years after menopause. The duration of HRT was variable and 16.6-42.6% of respondents thought that HRT should be continued through the life. This survey suggests that most of Korean gynaecologists favors the use of HRT in postmenopausal women but varies in the length of time they would prescribe it. $quot;
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폐경기 여성에서 Ipriflavone 이 혈청 지질농도에 미치는 영향
이경순,장윤석,노재숙,최영민,김정구,김석현,신창제,문신용,이진용 대한폐경학회 1996 대한폐경학회지 Vol.2 No.1
We have previously demonstrated that ipriflavone(synthetic isoflavone) enhances the protective effect of estrogens on bone mineral density in postmenopausal women. The purposes of this study were to evaluate the effect of ipriflavone on serum lipid levels in postmenopausal women and to compare the effect of ipriflavone alone with that of premarin or premarin plus ipriflavone. Thirty seven postmenopausal women were randomly allocated to 3 groups of treatment with; 600mg of ipriflavone divided in 3 doses daily by oral administration(Group I), 0.625mg of premarin once a day for 30days with 10mg medroxyprogesterone acetate(MPA) for 12 days (Group II), and 0.625mg of premarin once a day with 10mg MPA for 12 days plus 600mg of ipriflavone divided in 3 doses daily by oral administration (Group III). All groups were supplemented with 1 g of calcium daily. In all women, serum total cholesterol, high density lipoprotein(HDL) cholesterol, triglyceride and low density lipoprotein(LDL) cholesterol levels were measured in fasting state before and after 3 and 6 months of treatment.
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폐경 후 여성의 에스트로젠 보충요법시 병합 투여된 프로제스테론이 골밀도에 미치는 영향
채희동,김광례,서창석,최영민,김석현,신창제,김정구,문신용,이진용 대한폐경학회 1997 대한폐경학회지 Vol.3 No.1
It is well established that estrogen replacement therapy prevents the bone loss associated with postmenopausal state. And progestogens used alone, given in larger amount than that in estrogen replacement therapy, have been shown to reduce the postmenopausal bone loss. However, the impacts of added progestogen during estrogen replacement therapy on the bone mineral densities(BMD) are not well known. For this purpose, we analysed the changes in BMD of 104 postmenopausal women who underwent estrogen replacement therapy at least for 12 months: 36 women received estrogen only(Premarin 0.625mg/day), 41 women received estrogen with cyclic addition of progestogen(medroxyprogesterone, MPA, 10mg/day for 12 days per month), 27 women received estrogen with daily addition of progestogen(MPA 2.5mg daily). Our data revealed that continuous use of MPA in addition to estrogen for one year significantly increased the BMD of lumbar spines(L2-4) by 7.6±1.9% compared to that of before treatment while therapy with estrogen only did not(1.7±1.0%). Also cyclic addition of MPA for one year increased the BMD of lumbar spines by 6.2±1.3% compared to that of before treatment. And the increases in BMD of lumar spines derived from continuous or cyclic use of MPA in addition to estrogen were significantly greater than that from therapy with estrogen only. There was no significant difference in increases in BMD of lumbar spines between cyclic use and continuous use of MPA. And there was no significant difference in increases in BMD of femur neck among three groups. The patients who showed a decrease in BMD by more than 3% at 12 months of treatment compared to pretreatment were as follows: In BMD of lumbar spines, 16.7%(6/36) in therapy with estrogen-only, 2.4%(1/41) in the cyclic use of MPA, 3.7%(1/27) in the continuous use of MPA; In BMD of femur neck, 25.0%(9/36) in therapy with estrogen-only, 22.0%(9/41) in the cyclic use of MPA, 11.1%(3/27) in the continuous use of MPA. The unine calcium/creatinine ratio decreased during therapy in all gropus without a significant difference among three groups. These data showed that added progestogen(MPA) during estrogen replacement therapy significantly increased the bone mineral densities(BMD) of lumbar spines, and suggest that the continuous combined regimen of estrogen and progestogen may be the regimen of choice for the prevention or treatment of postmenopausal osteoporosis
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폐경후 여성에서 경구용 에스트로젠을 이용한 호르몬 보충요법이 골대사에 미치는 영향
이경순,이성구,장윤석,이진용,최영민,김석현,신창제,김정구,문신용 대한폐경학회 1995 대한폐경학회지 Vol.1 No.1
$quot;Estrogen replacement therapy confers many beneficial effects to postmenopausal women, such as slowing the rate of bone loss and decreasing the risk of coronary artery disease. Many studies have demonstrated the benefit of estrogen therapy in prevention of osteoporosis, but the studies to evaluate the long-term effects of estrogen replacement therapy on bone/mineral metabolism in Korean postmenopausal women are rare. Thus we conducted a 1-year study of 40 patients to evaluate the longterm effects of conjugated estrogen(Premarin at the dose of 0.625 mg per day) with the additional calcium (1,000mg per day)(group I) on bone/mineral metabolism in Korean postmenopausal women. We also conducted G month study of 15 patients who receive placebo and daily 1,000mg calcium suppliment only(group II). Bone densities of spine(L2-IA) and femoral neck were measured using dual photon absorptiometry before treatment and every 6 month during treatment, and urinary calcium/creatinine ratio in first fasting urine was measured before treatment and every 3 month during treatment. The values of post-treatment assesment were compared with the values of pre-treatment. The results were as follows. 1. The bone mineral density of spine(L2-L4) increased significantly at the 6th and 12th month of treatment. 2. We bone mineral density of femaral neck decreased at the 6th and 12th month of txeatment in group I but in the group II, the density of femoral neck decreased more than the group I . 3. The urinary calcium/creatinine ratio decreased significantly in group I at the 3rd month of treatment and so thereafter. These data suggest that conjugated estrogen(Premarin) at the dose of 0.625 mg per day with the additional intake of calcium(1,000 mg per day) exerts a favorble effect on bone metabolism of postmenopausal women, particularly in trabecular bone. $quot;
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