The effect of Vitamin D(3)addition on bone mineral density in postmenopausal hormone replacement / 대한산부인과학회잡지

OBJECTIVE: To determine the effect of the addition of Vit. D3 (1,25-Dihydroxychole calciferol D3) to the conventional postmenopausal hormone replacement therapy on bone mineral density(BMD) DESIGN: A 2-year retrospective , randomized study Setting : Department of Obstetrics and Gynecology of Catholic university hospital Patients : 388 postmenopausal women were recruited and divided into 5 groups according to treatment regimen; A: conjugated estrogens only treated group(n=146), B : conjugated estrogens and progesterone treated group(n=103), C : conjugated estrogens and Vit.D3 treated group (n=36), D : conjugated estrogens, progesterone and Vit.D3 treated group (n=41), E : control group (n=60). METHODS: The bone mineral density of the lumbar spines and femoral neck were determined by dual-energy X-ray absorptiometry(DEXA) every 2 years. STATISTICS: The difference between before and after treatment was determined by paired t-test. The comparison among the groups were determined by one way ANOVA test and student's t-test. RESULTS: The addition of progesterone to estrogen showed insignificant increase in the lumbar and femoral neck BMD. The addition of Vit. D3 compared with conventional hormone replacement therapy insignificantly influened bone density in women with initially normal BMD, but definitely increase in women with initially osteopenic and osteoporotic BMD of femoral neck rather than lumar spine(p<0.05). CONCLUSIONS: The use of Vit. D3 combined with postmenopausal estrogen replacement effects the increase of BMD in low bone density than normal bone density, especially femoral neck.

The Correlation of Combined Biochemical Markers of Bone Turnover for Bone Mineral Density in Postmenopausal women / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to assess the usefulness of combination of bone formation and resorption markers in predicting the bone mineral density (BMD), and to see there was a correlation with years since menopause(YSM) and BMD according to the combination of bone turnover marker and bone sites. METHOD: BMD and bone turnover marker(serum osteocalcin and urine deoxypyridinoline) was assessed in 266 healthy postmenopausal women at the time of first visiting in postmenopausal clinic and were divided into six groups based on combination of their reference range in bone turnover markers. RESULTS: We evaluated the discrimination power of the combination of bone turnover marker in assessing BMD among the six gorups, there was no statistically significant difference in BMD of Lumbar2-4 and Femur (Neck, Ward. Trochanter). In case of both higher than reference range of osteocalcin and deoxypyridinoline(D-pyr), BMD of Lumbar2-4 and Femur in postmenopausal women had a negative correlation with YSM. In case of higher than normal reference range of D-pyr and within the reference range of osteocalcin, BMD of Femur had a negative correlation with YSM. CONCLUSION: Thus each bone site had its own good combination of bone marker levels to correlate the BMD according to the YSM.

Ovarian Recovery after Bone Marrow Transplantation in Aplastic Anemia / 대한산부인과학회잡지

OBJECTIVE: Ovarian failure is often common complication by the conditioning protocol used for bone marrow transplantation (BMT). To determine the frequency of recovery of ovarian function after allo-BMT and the major factor that predict recovery, we monitored ovarian function in 24 premenopausal women METHOD: Twenty-four women met the inclusion criteria, which were (1) moderate to severe aplastic anemia before BMT, (2) disease-free at least 18 month after transplantation, (3) age younger than 40 years and more than 3 years after menarche at transplantation and (4) regular menstrual periods before transplantation. Recovery of ovarian function was determined by regular menses without menopausal symptom and sign. we divided conditioning regimen to two groups, Group I : cytoxan alone(n=17), Group II : cytoxan plus total body irradiation (TBI)(n=7). RESULTS: All women became amenorrhea after BMT and the clinical characteristics were not significant between two groups. 17 patients who received only cytoxan all recovered ovarian function between 1 to 14 months(median : 7.28) after BMT. The median age at BMT of women with regained ovarian function was 26 years (range, 21 to 33) versus 30 (range, 21 to 37) for those who did not. The age at transplantation was not significant between two groups in our study and the most predictive independent factor in ovarian recovery is the presence of total body irradiation. None of women who received TBI regained ovarian function during 19-49 month follow up. CONCLUSION: Gonadal insufficiency due to pre-BMT conditioning is more severe in radiation based regimen than cytoxan alone. therefore, we recommend early hormone replacement therapy in radiation treated women to prevent the complication of premature menopause.

Expression of Epidermal Growth Factor, Transforming Growth Factor-alphaand Epidermal Growth Factor Receptor in Human Trophoblast and Decidua / 대한산부인과학회잡지

OBJECTIVE: We studied the expression of epidermal growh factor(EGF) and transforming growth factor(TGF)-a and epidermal growth factor receptor(EGFR) in human trophoblast and decidua at the first and third trimester. METHODS: To confirm the expression of EGF, TGF-a and EGFR immunohisochemically in human trophoblast and decidua, we used monoclonal antibodies to EGF, TGF-a and EGFR. RESULTS: Immunohistochemical stainings using anti-EGF, anti-TGF- a and anti-EGFR antibodies showed a specific stainings in human trophoblast and decidua at the first and third trimester. The staining intensity of EGF in the trophoblast was light to moderate at the first trimester and moderate at the third trimester, and that in the decidua was light to moderate at the first trimester and light at the third trimester. The patterns of expression of TGF- a in the trophoblast and decidua were similar to that seen with EGF in the trophoblast and that of EGFR in trophoblast and decidua were similar to that seen with EGF in decidua. CONCLUSION: These findings suggest that EGF, TGF-a and EGFR may play an important role in human trophoblast and decidua during gestation.