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갱년기 골다공증 환자의 HRT와 Alendronate 1년 병합치료 효과
오한진(Han Jin Oh),임창훈(Chang Hun Lim),정호연(Ho Yeon Chung),한기옥(Ki Ok Han),장학철(Hak Chul Jang),윤현규(Hyun Koo Yoon),한인권(In Kwon Han) 대한폐경학회 2000 대한폐경학회지 Vol.6 No.1
N/A Background; Rate of bone loss should be increased after menopause and then formation coupled with resoprtion also be increased. Alendronate (Fosamax ;MSD, Rahway, NJ, USA), an antiresorptive drug known to be helpful to prevent bone loss. Alendronate is one of antiresorptive drug for treatment of osteoporosis and resulted in a decrease of bone turnover, There are no available data about Korean people, So, we wanted to determine the effects of alendronate in Korean postmenopausal osteoporosis patients after 1- year treatment Subjects and Methods; We studied 42 women with postmenopausal osteoporosis (bone mineral density[BMD] T score<2.5) who visited osteoporosis clinic in Samsung Cheil Hospital from Jan. 1999 to Apr. 2000, Subjects were stratified in 2 groups. Group 1 treated with alendronate 10mg/day and estrogen, and Group 2 treated with estrogen alone. BMD at the lumbar spine were measured at baseline and 1-year after treatment. We also measured serum marker of bone formation (total alkaline phosphatase[Alk]), and marker of bone resorption (deoxypyridinoline [DPYD]) from urine at baseline, 3months and I-year after treatment. Results; The mean differences in changes of markers after 3 months and 1 year of treatment were remarked significantly (3-Month; delta Alk:-28,7±3.6%, delta DPYD:-31.0±5,4% vs 1-Year; delta Alk:-32.2±3.1%, delta DPYD:-23.0±3.5%). Markers of bone metabolism showed no significant responses between two groups at 3 months and 1year after treatment, Also, Bone mineral density at lumbar spine was significantly increased in Group treated with alendronatc and estrogen than estrogen only group (9.6±0,7% vs 5.3±0.6%, P<0,001). Conclusion; Our data showed that using alendronate with estrogen to the patients of Korean women with osteoporosis increase bone mineral density more, So, we concluded that alendronate therapy with estrogen was helpful to manage postmenopausal osteoporosis patients.
장학철(Hak Chul Jang),박경수(Kyong Soo Park),홍성관(Sung Kwan Hong),신찬수(Chan Soo Shin),한은경(Eun Kyung Han),이문규(Moon Kyu Lee),김성연(Seong Yeun Kim),이홍규(Hong Kyu Lee),고창순(Chang Soon Koh),민헌기(Hun Ki Min),이병두(Byoung 대한내과학회 1990 대한내과학회지 Vol.39 No.5
N/A Several differences in phospholipid fatty acid composition of the erythrocyte membrane have been reported in diabetes mellitus, and these remain controversial. To evaluate the dietary fat intake pattern and the fatty acid metabolism in Korean diabetic patients, fatty acids in the erythrocyte membrane were determined by gas-liquid chromatography in 10 subjects with IDDM, 36 subjects with NIDDM, and 37 control subjects. Significant increases in palmitic acid (p<0.01) and oleic acid (p <005) were observed in erythrocytes from IDDM patients. Significant increases in myristric acid (p<0. 05), palmitic acid (p<0.01), and oleic acid (p<0.05), along with significant decreases in docosahexaenoic acid (p<0.01), were observed in erythrocytes from nonobese NIDDM patients, Similar fatty acid compositions in erythrocytes were noticed in obese NIDDM patients, except for eicosadienoic acid. The P/S ratios in the erythrocyte membrane fatty acids were significantly lower in diabetic patients than in the controls (0.92±0.03 vs 1.01±0.02, p<0.05 in IDDM; 0.85±0.03 vs 0.99±0.02, p<0.01 in nonobese NIDDM; 0.81±0.07 vs 0.99±0.02, p<0.05 in obese NIDDM). The arachidonic: linoleic acid ratio and oleic: stearic acid ratio in the erythrocyte membrane were not different between the diabetic patients and the controls, but the eicosapentaenoic: docosahexaenoic acid ratio was lower in the NIDDM patients than in the controls. These results suggest that an increase in the peroxidation of fatty acids in the erythrocyte membrane might result in a decrease of polyunsaturated fatty acids, especially DHA, and since membrane fatty acids are modified by receut dietary fat intake, we should be concerned about diet therapy, especially fat intake in diabetes. Fish oil supplements in diabetic patients should also be used with caution.
폐경후 여성에서 경피적 에스트라디올 겔과 경구영 프로게스테론 주기적 병합요법의 임상적 유효성에 관한 연구
정호연 ( Ho Yeon Chung ),최규홍 ( Kyu Hong Choi ),이창욱 ( Chang Uk Lee ),김해성 ( Hae Sung Kim ),임창훈 ( Chang Hoon Yim ),한기옥 ( Ki Ok Han ),장학철 ( Hak Chul Jang ),윤현구 ( Hyun Koo Yoon ),한인권 ( In Kwon Han ) 대한폐경학회 2001 대한폐경학회지 Vol.7 No.1
N/A Objectives: The purpose of our study was to evaluate the effects of transdermal 17β -estradiol gel combined with oral progestogen in terms of serum lipid, bone markers and bone mineral density in Korean postmenopausal women Subjects and methods: Nine healthy postmenopausal women were asked to volunteer for pharmacokinetic analysis of estradiol gel. Subjects received daily application of 1.5 ㎎ of estrogen gel in the morning. Peripheral venous samples were drawn at 0, 0.5, 1, 2, 4, 8, 24, 48, 72 hours after the daily gel application and serum E2 levels were analyzed. 41 postmenopausal women with intact uterus and no menstruation for more than 12 months were treated with 1.5 ㎎ of estradiol gel (day 1-25) sequentially combined with 2.5㎎ of medroxyprogesterone acetate (day 16-25) orally for 1 year. Results: Although one volunteer showed increment of serum E2 one hour after application of estrogen gel, pharmacokinetic study showed increase of serum E2 after 24 hours in the most volunteers. The mean serum E2 level at 72 hour after application was 59.6±58.8 pg/㎖. The acceptability of the combined treatment was 73.2%. Only 1 (3.3%) woman complained skin irritation during treatment. The combined estradiol gel and oral progestogen therapy significantly decreased serum cholesterol levels by 7.8%, LDL by 8.5%. Markers of bone turnover significantly decreased 3 months after treatment. The increase of the annual percent change in bone density was 4.8% at the lumbar spine and 4.4% at the femoral neck. Conclusion: The combined estradiol gel with oral progestogen therapy is acceptable and effective treatment in postmenopausal women.
정상 및 임신성 당뇨병 임신부의 임신 중 체중 증가량와 신생아 체중
김문영(Moon Young Kim),양재혁(Jae Hyug Yang),장학철(Hak Chul Jang),박정은(Jung Eun Park),임창훈(Chang Hoon Yim),정호연(Ho Yeun Chung),한기옥(Ki Ok Han),윤현구(Hyun Koo Yoon),한인권(In Kwon Han),김미정(Mi Jeong Kim),한혜경(Hye Kyung H 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.4
N/A Objective : The purpose of this study was to determine the independent factors that predict neonatal birthweight and find the relationship between maternal weight gain and neonatal birthweight in women with normal glucose tolerance (NGT) and gestational diabetes mellitus (GDM). Methods : Forty-six women with GDM and one hundred fifty women with NGT were included in the study. All subjects had singleton pregnancies and no medical diseases that may affect the fetal growth and were certain of gestational age by early ultrasonography. Maternal weight at each prenatal visit was recorded and neonatal anthropometic measurement was done within 2 days of birth. Results : The average rate of weight gain (kg/week) in NGT was lowest during the first trimester (0.09±0.10), peaked during the second trimester (0.52±0.14), and slowed after 34 gestational weeks (0.46±0.26). In women with GDM, the average rate of weight gain was also lowest during the first trimester (0.18±0.23), but it was twofold higher compared with women with NGT. There was a significant decrease of the rate of weight gain after 28 gestational weeks in women with GDM. Total weight gain during pregnancy was 3.4 kg less in women with GDM. Neonatal birthweight was correlated with maternal weight gain and the rate of weight gain during 14-27 and 28-33 weeks in NGT. However, birthweight was correlated with maternal weight gain and the rate of weight gain during the first trimester and 14-27 weeks in GDM. Conclusion : This result suggests that the women with GDM who have greater weight gain during the first and the second trimester have a increased risk of excessive fetal growth. Thus strict glycemic control during pregnancy is needed especially in these women.
증례 : 내분비-대사 ; 제1형 당뇨병이 발생하여 진단된 MELAS 증후군 1예
정찬현 ( Chan Hyeon Jung ),노은 ( Eun Roh ),안창호 ( Chang Ho Ahn ),김이경 ( Lee Kyung Kim ),임수 ( Soo Lim ),장학철 ( Hak Chul Jang ),최성희 ( Sung Hee Choi ) 대한내과학회 2015 대한내과학회지 Vol.88 No.6
저자들은 정신지체, 발작성 두통, 의식 소실, 소뇌 위축에 의한 운동실조 등 여러 신경학적 이상 증상 및 WPW 증후군으로 치료 중이던 환자가 갑자기 발생한 고혈당에 대한 검사 결과 제1형 당뇨병의 임상 양상을 보여 MELAS 증후군을 의심하였고, 분자유전학적 검사를 통해 A3243G 사립체 유전자 점 돌연변이를 확인하였기에 이를 보고하는 바이다. Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome presents with various clinical features, including seizures, stroke-like episodes, encephalopathy, myopathy, cardiac involvement, and diabetes. However, due to its clinical heterogeneity, the diagnosis of MELAS syndrome is complex and difficult. The present report describes an 18-year-old male who was diagnosed with MELAS syndrome following the onset of type 1 diabetes. The patient had suffered from ataxia, mental retardation, and recurrent headaches for several years; following hospitalization for loss of consciousness, he was treated for cerebellar atrophy and Wolf-Parkinson-White (WPW) syndrome. Although the patient had no history of lactic acidosis, the recent onset of type 1 diabetes and his medical history of encephalopathy and WPW syndrome suggested MELAS syndrome. The diagnosis of MELAS syndrome was confirmed by molecular genetic testing, which revealed a point mutation (A3243G) in the patient’s mitochondrial DNA. (Korean J Med 2015;88:706-710)
유리지방산이 원형질막 Na+ , K+ - ATPase 에 미치는 효과에 대한 알부민의 역할
이병두(Byoung Doo Rhee),임성희(Sung Hee Ihm),장학철(Hak Chul Jang),박경수(Kyong Soo Park),김성연(Seong Yeon Kim),조보연(Bo Youn Cho),이홍규(Hong Kyu Lee),고창순(Chang Soon Koh),민헌기(Hun Ki Min) 대한내과학회 1988 대한내과학회지 Vol.35 No.1
N/A There is increasing evidence that free fatty acids (FFA) inhibit the activity of plasma membrane Na+, K+-ATPase in vitro and thereby could be a control agent of metabolism. However, in several recent studies, physiological conclusion were drawn from the effect of FFA in systems in which albumin was absent. To explore the role of albumin in modulating the effect of FFA on the activity of this enzyme, the activities plasma membrane Na+, K+-ATPase were measured in the presence of various concentrations of FFA and/or albumin. 1) The activities of Na+, K+-ATPase in the presence of 4% bovine serum albumin (BSA) were inhibited by oleic and linoleic acid at concentrations ranging from 0.05 to 2.0mM. 2) The inhibitory effects of oleic acid at each concentration on the activities of Na+, K+-ATPase were increased as the concentration of BSA was decreased from 4% to 0%. 3) The activities of Na+, K+-ATPase were not inhibited when the FFA to albumin molar ratio was less than 1.0 but were inhibited to less than 50% when the ratio exceeded 3.5. The above results shows that, in vitro, the activities of plasma membrane Na+, K+-ATPase are inhibited by unsaturated FFA and albumin has a protective role on this inhibition. This suggests that in vivo unsaturated FFA could be a regulator of cellular metabolism by inhibition of Na+, K+-ATPase under the pathologic condition in which the FFA to albumin molar ratio is increased markedly.