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Osteoporosis and Fracture among Patients with Type 1 and Type 2 Diabetes
홍서유,박은주 대한골다공증학회 2010 Osteoporosis and Sarcopenia Vol.8 No.1
Diabetes mellitus is a major risk factor for osteoporotic fractures. The occurrence of Osteoporosis among patients who have diabetes mellitus further increases both economically and physically their burden of disease. Nevertheless, osteoporotic screening or prophylactic treatment for all patients with type 1 and type 2 diabetes mellitus is not being recommended at present. The reason is that neither the relationship between diabetes and osteoporosis and nor differences between type 1 and type 2 diabetes mellitus are clear. At present, while low bone mineral density (BMD) is consistently observed in type 1 diabetes mellitus, the relationship is less clear for type 2 diabetes mellitus, with some studies reporting modestly increased or an unchanged BMD. Both type 1 and type 2 diabetes mellitus have been associated with a higher risk of fractures. The presence of micro- and macro-vascular diabetic complications as a result of long standing poor glycemic control, rather than long duration predict low BMD in patients with type 1 diabetes mellitus. In type 2 diabetes mellitus patients, obesity protects bone loss and increases BMD. Nevertheless, hypoglycemic episodes under insulin therapy with commonly established risk factors of falls such as advanced age, impaired balance, a history of coronary heart disease or arthritis and peripheral neuropathy may have contributed to the increased risk for falls and result in fractures. We suggest that osteoporosis screening and prophylactic treatment for all patients with type 1 and 2 diabetes mellitus needs to be recommended along with considerations of each individual’s risk profile for osteoporotic fractures.
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홍서유,유철모,박내형,이태원,정연실 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.3
1987년 9월부터 1988년 8월까지 본 병원 산부인과에서 기능장애성 자궁출혈 환자 113례의 임상 및 자궁내막생검에 대한 연구로 다음과 같은 결과를 얻었다. 1. 연령분포는 40대에서 50%, 30대에서 23%, 50대에서 17%였다. 2. 평균 임신횟수는 56회였고, 분만횟수는 23회였다. 3. 출혈양상은 과다월경과 월경간 출혈이 동반되는 경우가 35%, 월경간 출혈이 27%, 폐경후 출혈은 166%였다. 4. 자궁내막의 조직소견은 증식기 내막이 63.7%, 분비기 내막이 23.9%, 내막 증식증이 8.8% 순이었다. 5. 표준화한 월경주기 14일후 자궁내막생검을 시행한 66례중 배란성출혈을 의미하는 분비기 내막은 20례(33%)로서 주로 무배란성출혈이 많았다. Dysfunctional uterine bleeding is defined as bleeding from the uterine endometrium unrelated to anatomic lesions of the uterus. According to definition, the diagnosis of dysfunctional uterine bleeding seems to be a diagnosis of exclusion. Dysfunctional uterine bleeding is the most frequent problem of all gynecologic disease and occurs more frequently during puberty and in the perimenopausal period and is less common during the reproductive period. Pathologically, the endometrium of DUB patients represents the proliferative pattern most commonly. We performed the clinical and pathologic studies of DUB patients in order to evaluate the abnormal uterine bleeding and brief review of literature was made. 113 cases of dysfunctional uterine bleeding obtained by endometrial biopsy. The results were follows: 1. Age distribution of uterine bleeding was mainly 5th decade. 2. Dysfunctional uterine bleeding patients were mainly multigravidas and showed 5 ~ 6 times of pregnancy and 2 ~ 3 times of pregnancy. 3. Among variable bleeding patterns, menorrhagia with intermenstrual bleeding was the most common pattern. 4. The histologic findings of endometrium were proliferative phase, secretory phase, hyperplasia irregular shedding, atrophic endometrium in order of frequency. 5. According to endometrial biopsy, the incidence of anovulatory DUB was 67 % (46 cases out of 66 cases) and ovulatory DUB was 33 % (20 cases out of 66 cases).
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姙産婦 및 胎兒 臍帶血中의 Somatomedin-C와 成長 호르몬値에 關한 硏究
洪瑞裕,姜宰成,洪性鳳 고려대학교 의과대학 1989 고려대 의대 잡지 Vol.26 No.1
The mechanism responsible for intrauterine fetal growth is poorly understood despite the impressive progress made in understanding how hormone and growth factors regulate postnatal growth Recently the isolation of the insulin-like growth factor Ⅰ and Ⅱ shed some light on this important subjects and insulin-like growth factor Ⅰ is similar to the somatomedin-C in structuies. It has been shown that the growth hormone may augment the action of the insulin on the liver to form somatomedins which might augment fetal growth. This study was undertaken to determine the relationship between growth hormone and somatomedin-C in mothers and their infants, and to evaluate the correlation of these hormones to birth weights in newborn infants in 45 term pregnant women and their infants, and 10 non-pregnant healthy women. The results were as follows; 1. Maternal plama growth hormone levels were significantly higher in non-pregnant women than women who delivered average for gestational age, small for gestational age and large for gestational age infants and the birth weights were not affected by maternal plasma growth hormone. 2. Maternal plasma somatomedin-C levels were significantly higher in pregnant women who delivered average for gestational age, small for gestational age and large for gestational age infants than non-pregnant women and the birth weights were influenced by maternal plasma somatomedin-C. 3. Fetal cord plasma growth hormone levels were significantly higher in small for gestational age infants than average or large for gestational age infants. 4. Fetal cord plasma somatomedin-C levels were significantly lower in small for gstational age infants than average or large for gestational age infnats. The birth weights were correlated to fetal cord plasma somatomedin-C. The present study suggests that the birth weights of all infants studied had a significant overall effect on maternal and fetal somatomedin-C and somatomedin-C may be involved in fetal growth in utero.
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