자연 폐경 및 수술적 폐경 여성에서 티볼론이 지질대사에 미치는 영향

허준용 ( Jun Young Hur ),정유아 ( Yu A Jeong ),송승훈 ( Seung Hun Song ),이재관 ( Jae Kwan Lee ),오민정 ( Min Jeong Oh ),서호석 ( Ho Suk Saw ),박용균 ( Yong Kyun Park ),조수용 ( Soo Yong Chough ) 대한폐경학회 2003 대한폐경학회지 Vol.9 No.4

연구목적: 자연 폐경 및 수술적 폐경 여성에서 티블론이 지질대사에 미치는 영향을 알아보기 위한 연구이다. 연구 방법: 폐경 증상의 치료를 위해서 내원하여 1년간 티블론을 투여받은 25명의 자연 폐경 여성과 20명의 수술적 폐경 여성을 대상으로 후향적 연구를 시행하였다. 연구 결과: 티블론을 1년간 투여한 후 혈중 중성지방과 총 콜레스테롤, 저밀도 지단백 콜레스테롤 농도는 각각 22.72%, 10.37%, 19.68% 감소하여 통계적으로 유의한 감소를 보였고, 저밀도 지단백 콜레스테롤은 8.57% 증가하였으나 통계적으로 유의한 변화를 보이지 않았다. 자연 폐경 여성과 수술적 폐경 여성에서의 변화를 비교한 결과 자연 폐경 여성에서, 총 콜레스테롤 농도가 통계적으로 유의하게 더 많이 감소하였고, 중성 지방과 저밀도 지단백 콜레스테롤, 고밀도 지단백 콜레스테롤 농도는 통계적 의의는 없었으나 더 많이 감소하는 양상을 보였다. 결론: 1년간의 티블론 치료는 자연 및 폐경 여성에서 지질대사에 영향을 미치며, 이러한 변화는 자연 폐경 여성에서 수술적 폐경 여성에서보다 뚜렷하였다. 이러한 변화가 실제로 심혈관 질환의 일차 또는 이차 예방 효과가 있는지는 향후 연구를 통해서 밝혀져야 할 것이다. Objective: To evaluate the effects of tibolone on the lipid metabolism in natural and surgical menopausal women. Methods: In a retrospective study by the medical record review, the effects of tibolone 2.5 mg/day(N=45) for a 12 month period on lipid profiles between natural and surgical(oophorectomized)menopausal women were compared. Results : women treated with tibolone for 12 months experienced the decreases in TG(triglycerides), TC(total cholesterol), and HDL-C(high density lipoprotein-cholesterol) levels by 22.72%, 10.67%, and 19.68%, respectively, compared with baseline level, but no significant increase in LDL-C(low density lipoprotein-cholesterol) level. Between natural and surgical menopausal women, there was statistically significant difference in change of total cholesterol level, whereas no marked difference in changes of HDL-C, LDL-C and triglyceride levels. conclusion: Tibone treatment for 12 months is associated with a marked and significant decrease in triglyceride, total cholesterol and HDL-C level and significant difference in change of total cholesterol level between natural and surgical menopausal women, Clearly, further studies are necessary to establish the definite risk/benefit ratio of tibolone with respect to its overall effect on lipid metabolism.

한국 성인 여성의 월경지수에 관한 연구

지현준(Hyun Jun Jee),정화경(Hwa Kyung Jung),조수용(Soo Yong Chough),박용균(Yong Kyun Park),서호석(Ho Suk Saw),오민정(Min Jeong Oh),허준용(Jun Young Hur) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.10

목적 : 우리나라 성인 여성의 월경양상과 월경과다 시 쉽게 이용할 수 있는 진단방법, 월경 과다에 대한 인식정도에 대하여 알아보고자 하였다. 대상 및 방법 : 초등학교 여교사 77명을 대상으로 정기 신체검사시 설문지를 통해 월경양상과 월경과다에 대한 인식정도를 조사하였고 그림표를 사용하여 월경지수를 계산하고 신체검사시 시행한 혈색소량을 조사 하였다. 월경지수와 혈색소량을 Spearman correlation test를 시행하여 상관관계를 알아보았다. 결과 : 조사 대상 여성들의 월경주기는 29.8일 (SD±5.1), 월경기간은 평균 5.6일 (SD±1.3)이었고, 월경지수는 평균 170 (SD±89.2)으로 12에서 411의 분포를 보였고, 혈색소량은 평균 12.3 g/dL 이었다. 월경지수와 혈색소량 간에는 통계적으로 유의하게 선형관계를 보였다 (r=-0.29, p=0.01). 혈색소량이 12 g/dL 이하로 빈혈이 있는 여성은 20명 (26%) 중 17명 (85%)과 월경지수가 200 이상으로 월경과다인 여성 26명 (34%) 중 25명 (96%)이 본인의 생리가 정상이라고 생각하고 있었다. 결론 : 월경과다나 이로 빈혈이 있는 여성들 중 많은 경우에서 심각성을 느끼지 못하고 있으므로 보다 간편하고 정확하게 여성 스스로가 월경과다를 의심하고 병원을 찾을 수 있게 하는 방법이 필요하고 그림표를 이용하여 스스로 작성하는 월경일지가 이를 위한 유용한 방법이 될 수 있다. Objective : This study was designed to evaluate the patterns of menstruation including menorrhagia using menstrual index, to find out correlations between patient`s own judgement and actual patterns of menstruation in Korean women, and to develop the menstrual diary using menstrual index as a screening of menstrual disorders. Methods : Seventy-seven women teachers of elementary school undergoing routine health screening test were asked to complete a pictorial blood loss assessment chart and a set of interview sheets regarding menstrual history and their subjective judgement on their amount of menstruation. Spearman correlation test was used to assess the correlation between menstrual index which was obtained from pictorial chart and serum hemoglobin concentration. Results : The mean menstrual intervals were 29.8 days (SD±5.1), the mean menstrual duration was 5.6 days (SD±1.3), the mean value of menstrual index was 170.3 (SD±89.2) which varied from 12 to 411, the mean serum hemoglobin concentration was 12.3 g/dL. Significant correlation was found between the serum hemoglobin concentration and the menstrual index (r=-0.29, p=0.01). Seventeen of 20 women who had anemia (serum hemoglobin concentration below 12.0 g/dL) and 25 of 26 women who had menorrhagia (menstrual index above 200) considered her menstruation as `normal`. Conclusion : Many women who have anemia due to menorrhagia are not aware of the serious consequences of menorrhagia. Writing a ‘menstrual diary` using menstrual index would be easier and more practical method in predicting menorrhagia.

저위험 산모군에서 주산기 예후의 예측인자로서 양수과소증의 의의

민주영 ( Joo Young Min ),오민정 ( Min Jeung Oh ),조금준 ( Geun Joon Cho ),이재관 ( Jae Kwan Lee ),이경주 ( Kyung Ju Lee ),김해중 ( Hai Joong Kim ),허준용 ( Jun Young Hur ),서호석 ( Ho Suk Saw ),박용균 ( Yong Kyun Park ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.9

목적 : 자궁내 태아성장지연 등의 다른 특이소견이 없이 임신 37주 이후 양수과소증으로 진단된 저위험 산모군과 양수량이 정상인 산모군 사이에서 주산기 예후를 비교하여 만삭에 진단된 양수과소증이 다른 동반되는 위험인자가 없을 경우 불량한 주산기 예후를 나타내는 독립적 인자로 작용하는지 확인하고자 하였다. 연구 방법 : 2001년 3월부터 2003년 7월까지 고려대학교 부속병원 산부인과에서 산전 진찰을 받은 단태 임신중 임신 37주 이후 초음파 검사상 양소 Objective : The aim of our study was to assess whether isolated oligohydramnios is associated with adverse perinatal outcomes in low-risk term pregnancy. Methods : Women delivered between March 2001 and July 2003, who underwent ultrasonography from 37 to

자궁내막에 발생한 투명세포암 1 예

지현준(Hyun Jun Jee),정화경(Hwa Kyung Jung),조수용(Soo Yong Chough),박용균(Yong Kyun Park),서호석(Ho Suk Saw),오민정(Min Jeong Oh),허준용(Jun Young Hur) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.10

Clear cell carcinoma of the endometrium is a relatively rare malignancy that is considered to be one of the most aggressive types of endometrial carcinoma. It is an infrequent variant sharing a common Mullerian origin, accounting for 1 to 5 percent of all endometrial cancers. Histologically, these tumors consists of hobnail cells which have translucent or slightly eosinophilic cytoplasm and protrude to lumen of gland. These tumors occur predominantly in postmenopausal women and carry a relatively unfavorable prognosis comparing with other histologic types of endometrial cancer. We experienced a case of clear cell carcinoma of endometrium in a 81-year old women and this case is presented with a brief review of the literaturs.

복강경하 양측 자궁 동맥 결찰술을 이용한 자궁 근종 치료 후 발생한 자궁내 임신의

민주영 ( Joo Young Min ),송승훈 ( Seung Hun Song ),이경주 ( Kyeung Ju Lee ),이재관 ( Jae Kwan Lee ),오민정 ( Min Jung Oh ),서호석 ( Ho Suk Saw ),박용균 ( Yong Kyun Park ),조수용 ( Soo Young Chough ),허준용 ( Jun Young Hur ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.6

Uterine artery ligation or embolization is a minimally invasive alternative for treatment of symptomatic leiomyoma. However, the experience with pregnancy management and outcome after ablating uterine blood flow is still unknown. We have recently experien

도플러 초음파를 이용한 제대동맥 및 하강흉부 대동맥 혈류속도 파형에 따른 주산기 합병율 고찰

이재관(Jae Kwan Lee),허준용(Jun Young Hur),서호석(Ho Suk Saw),박용균(Yong Kyun Park),조수용(Soo Yong Chough) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.10

목적: 산과영역에서의 도플러 초음파는 산전 태아건강 평가방법으로서 많은 연구가 진행되어 현재 비침윤성 태아 안녕 평가 검사(noninvasive fetal well-being test)로 많은 연구가 이루어 지고 있다. 임신성 고혈압 산모의 예후판정과 주산기 예후를 예측하는데 있어 제대동맥, 태아 흉부 대동맥 도플러 파형분석의 유용성을 알아보고자 본연구를 시행하였다. 연구방법: 1995년 5월부터 96년 3월까지 고려대학교 의과대학 부속 구로병원 산부인과에 산전진찰을 위해 내원한 산모 35명과 임신성 고혈압 환자 18명을 대상으로 태아 제대동맥, 하강 흉부 대동맥의 수축/이완비와 주산기 예후를 비교 분석하였다. 결과: 연구 결과 정상임신군의 제대동맥의 수축/이완비는 평균 2.97 ± 0.52로 나타났으며, 임신성 고혈압 군에서는 3.8 ± 0.81로 정상임신군에 비해 높게 나타났다. 불량한 주산기 예후를 예측하는데 있어 제대동맥의 민감도, 특이도, 양성 예측도, 음성예측도는 57%, 87%, 75%, 75%로 하강 흉부 대동맥과 비교할 경우 제대동맥이 민감도, 양성 예측도, 음성 예측도가 높게 나타났으며 특이도는 비슷하였다. 결론: 불량한 주산기 예측에 제대동맥 도플러 파형분석이 유용하게 사용될 수 있음을 보여주었으며 낮은 민감도를 개선할 필요성이 대두되었다. Objectives: Early diagnosis of intrauterine growth retardation is important to ensure optimal monitoring and delivery with the introduction of real-time and Doppler ultrasound systems, a noninvasive method of measuring human fetal blood flow has become available. The aim of this study is to compare blood flow velocity waveforms at the fetal descending aorta and umbilical artery in normal and in patients with pregnancy induced hypertension. Methods: Using a combination of linear array real-time and pulsed Doppler ultrasound, blood flow velocity measurements were carried out at the fetal descending aorta and umbilical artery in 35 normal pregnancies and 18 cases of pregnancy induced hypertensive patients. Results: The mean systolic/diastolic ratio of umbilical artery and aorta was significantly higher in PIH patients than in normal pregnancies(3.8 ± 0.81 versus 2.97 ± 0.52, p<0.05) and to predict perinatal morbidity, umbilical velocimetry is more sensitive than that of descending thoracic aorta. Conclusion: This study suggests that umbilical artery velocimetry could be used as a marker to predict adverse perinatal outcome.

Drospirenone의 약리학적 특성

이경욱 ( Kyong Wook Yi ),허준용 ( Jun Young Hur ) 대한폐경학회 2008 대한폐경학회지 Vol.14 No.1

In postmenopausal women, hormone therapy (HT) relives the part of postmenopausal symptoms, such as vasomotor symptoms (hot flushes, palpitation), psychological well-being, and osteoporosis. As with estrogens, the various progestogens used in HT for protection of the endometrium may differ as to their pharmacological properties. Drospirenone (DRSP) is an analogue to spironolactone, aldosterone antagonist, and is unique progestogen. The pharmacological profile of DRSP resembles that of the natural progesterone, especially with regard to anti-mineralocorticoid and anti-aldosterone activities. Recent clinical trials have been confirmed that DRSP/estradiol combination provides effective relief of menopausal symptoms, such as hot flushes, genitourinary atropy, and improves bone mineral density; thus reducing the risk of osteoporosis. In addition, the anti-aldosterone activityof DRSP counteracts sodium and water retention contributes to the maintenance of stable body weight, and has potential benefits for blood pressure in postmenopausal women. The DRSP/estradiol combination offers a new choice beyond the effective management of menopausal symptoms, with additional favorable effects due to its anti-aldosterone properties.

폐경 여성에서 티볼론과 에스트로겐 대체요법이 지질대사에 미치는 영향에 관한 비교연구

정유아 ( Yu A Jeong ),허준용 ( Jun Young Hur ) 대한폐경학회 2004 대한폐경학회지 Vol.10 No.1

남성에서 Mycoplasma 감염이 정액검사소견에 미치는 영향에 관한 연구

김선행,김영호,김탁,허준용,박용균,구병삼,Kim, Sun-Haeng,Kim, Young-Ho,Kim, Tak,Hur, Jun-Yong,Park, Yong-Kyun,Ku, Pyung-Sham 대한생식의학회 1996 Clinical and Experimental Reproductive Medicine Vol.23 No.3

Mycoplasmas have long been suspected of contributing to involuntary infertility in couples. However considerable disagreement exits concerning the role of genital mycoplasma infection in human infertility. Several investigators have noted abnormalities in the semen analysis of men with positive mycoplasma cultures, and early epidemiologic studies indicated that Ureaplasma urealyticum was linked to human reproductive failure on the basis of higher frequencies of isolation from infertile versus fertile couples and successful pregnancies in infertile couples after doxycycline therapy. However, subsequent investigators have questioned these findings because there are many studies in which treatment for mycoplasma in the male or female did not demonstrate an improved pregnancy rate, and semen samples from unexplained infertile men containing ureaplasmas have not revealed poorer motility, fewer spermatozoa and more aberrant forms. The objective of this study were to investigate the incidence rate of mycoplasma in semen and to investigate whether the presence of mycoplasma in semen makes significant difference to the semen volume, sperm motility and sperm counts. The results were that the rate of isolation of mycoplasma species was 70.3%. Semen volume is $2.84{\pm}1.01ml$ for culture negative and $3.15{\pm}1.42ml$ for culture positive group. Sperm motility is $46.23{\pm}15.80%$ for culture negative and $50.09{\pm}15.69%$ for culture positive group, and sperm count is $95.47{\pm}47.14({\times}(P)10^6/ml)$ for culture negative and $86.73{\pm}47.59({\times}10^6/ml)$ for culture positive group. In conclusion, we suggest that the presence of mycoplasma in semen makes no significant differences to the sperm parameters.

부인과 악성종양 환자에서 복합 항암화학요법에 따른 세포독성에 대한 Amifostine 의 임상효과에 관한 연구

이린화(Lynn Hwa Lee),지현준(Hyun Jun Jee),정화경(Hwa Kyung Jung),정유아(Yu A Jung),신정호(Jung Ho Shin),오희숙(Hee Suk Oh),박용균(Yong Kyun Park),허준용(Jun Young Hur),조수용(Soo Yong Chough),서호석(Ho Suk Saw) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.11

N/A Objective : Amifostine (Ethyol(R)), an organic thiophosphate, has shown the ability to protect normal, but not neoplastic, tissues from the damaging effects of chemotherapy and radiotherapy in various kinds of cancers. This study was designed to determine ifostine could reduce the serious hematologic and nephrologic toxicities associated with cisplatin based combination chemotherapy in gynecologic cancer patients. Patients and Methods : Forty patients who received cisplatin-based combination chemotherapy were randomized into two groups. They received chemotherapy with or without pretreatment of amifostine before each course. The occurrence of hematologic and renal toxicities were evaluated. Stastical analysis was done by independent t-test and Chi-square test. Results : Hematologic toxicity was evaluated with nadir count of neutrophil and platelet. The nadir count of neutrophil was 2034.2±1199.20/μl in group with pretreatment using amifostine vs 1070.85±472.66/μl in control group (p<0.01). Platelet count was not statistically different. (p<0.16) Grade 3 neutropenia was observed in nine (45%) patients in pretreatment group vs four (20%) patients with control group (p<0.09). Grade 4 neutropenia occurred in one patient only in control group. Renal toxicity was evaluated by serum creatinine and creatinine clearance. Protracted serum creatinine elevation was not significant in both groups. (p<0.14) Reduction of creatinine clearance was less in patients with pretreatment (p<0.01). There were no significant side reactions in subjects using amifostine. Conclusion : Pretreatment with amifostine reduces the neutropenia and nephrotoxicity associated with cisplatin-based combination chemotherapy with gynecologic cancer patients.