• 한국발생생물학회지:발생과생식
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• 제13권4호
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• pp.207-215
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• 2009

시상하부-뇌하수체-생식소(hypothalamus-pituitary-gonad, HPG) 호르몬 축의 활성에 영향을 미치는 수많은 인자들은 생식 기능을 조절하고, 사춘기 개시와 폐경기 진입과 같은 뚜렷한 생식 능력의 단계 전이를 초래한다. 지방세포로부터 분비되는 다기능적 호르몬인 leptin의 발견 이후, 곧 이어 생식과 신체의 에너지 균형 사이의 긴밀한 관계에 대한 증거들이 밝혀졌다. 위장관으로부터 분비되는 또 다른 다기능 호르몬인 ghrelin은 이미 알려져 있던 growth hormone secretagogue receptor(GHSR)의 내인성 리간드이며, 에너지 항상성의 조절에서 leptin에 상응하는 물질로 알려졌다. 예상대로, ghrelin 또한 HPG 축의 활성의 조절을 통해 생식 능력을 조절함이 증명되었다. 이 논문은 ghrelin의 발견과 유전자 구조, 조직 내의 분포, 그리고 역할과 HPG 축에서의 생식 호르몬 분비 조절에 대한 포유동물의 생식에서의 ghrelin-GHSR 신호에 관한 최신 정보를 요약한 것이다. 뇌하수체에서의 POMC 유전자 발현과 유사하게, preproghrelin 유전자는 alternative splicing과 번역 후 변형(posttranslational modification)을 거치는 복잡한 레퍼토리의 전사체들과 펩티드 산물을 만들어 낸다. 에너지 항상성을 제외한 신체 생리 기능의 조절에서의 preproghrelin 유전자 산물의 역할에 관한 정보는 제한적이지만, 신진 대사와 생식 사이에서의 ghrelin의 상호작용에 관해서는 충분한 증거들이 있다. 흰쥐와 인간에서, ghrelin 수용체인 GHSRs(GHSR1a와 GHSR1b)의 분포는 본래 ghrelin의 표적으로 여겨진 시상하부와 뇌하수체뿐만 아니라 정소와 난소에서도 확인되었다. 뇌와 생식소에서도 preproghrelin 유전자 발현이 확인되었는데, 이것은 HPG 축에서 ghrelin이 국부적인 역할을 담당할 가능성을 시사한다. 비록 뇌하수체에서의 기능은 아직 확실치 않지만, ghrelin은 시상하부의 GnRH, 뇌하수체의 생식소자극호르몬과 생식소의 성 스테로이드 호르몬 분비에 대한 음성적인 조절자로서의 역할을 수행하는 것으로 보인다. 최근의 연구들은 사춘기 개시, 그리고 아마도 폐경기 진입의 조절에서 ghrelin의 관여를 시사한다. 이제 ghrelin이 '뇌-위장관' 축의 필수적인 호르몬 요인이며, 신 진 대사와 생식 사이를 연결하는 조절 물질이라는 가능성은 매우 높다. '배부름'을 반영하는 leptin 신호와는 정반대인 ghrelin 신호는 신체 에너지 균형 상태로 볼 때 '배고픔'을 표현하는 것으로 생각되며, 항상성의 유지에서 최우선 사항으로 고려되지 않는 생식으로의 에너지 투자가 이루어지지 않도록 하는데 필수적일 것으로 사료된다. 생식능력 조절에 있어서 ghrelin의 보다 명확한 작용 메커니즘과 역할에 대한 깊은 통찰력을 얻고 성공적인 생의학적 적용을 위해서는 향후 더 많은 연구들이 필요하다.

• 여성건강간호학회지
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• 제7권4호
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• pp.536-546
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• 2001

The purposes of this descriptive study were to identify the prevalence rate of urinary incontinence(UI) and the differences in frequency of incontinent and normal women by general characteristics, obstetrical history, and the conditional events for urinary incontinence of the elderly women in a community. By the results of this study, it is intended to provide nursing practice guidelines for incontinent women. The research design of this study was a preliminary descriptive study. The 173 subjects were 55 years old and over, and resided in a small city area. Data were collected from June 20 to July 20, 2001, by an interview or a self-report with questionaire. The questionaire was composed of items of general characteristics, obstetrical characteristics, and conditions of UI by the modified Henderickon's Stress Incontinence Scale(1981). The results were summariezed as follows: 1. The UI prevalence rate of the sample was 64.2%. Of the incontinent women, 31.5% had experienced UI for a period of three to five years, and 84.7% had never treated or managed their UI. Frequency of UI was once or twice times per month(46.8%). 2. The total mean of UI on the scale in the incontinent women was 25.50 of 85, ranging from 18 to 41. 3. The most frequent condition of UI was coughing, followed by laughing, sneezing, heavy exercise, and preparation of urination in descending order. 4. There were significant differences in age, education, social activity, and urinary difficulty between the incontinent women and the normal women. 5. There were significant differences in frequency of spontaneous abortion, age of menopause between the incontinent women and the normal women. 6. There were no significant differences in number of delivery, frequency of artificial abortion, age of the last delivery, and postal health management between the incontinent women and the normal women. In conclusion, the incidence of UI in this study was high, but there were no effective treatments or management. It is suggested to provide the adult women with knowledge about UI, and to educate preventive behavior and control skill of urinary incontinence. Also episodes of urinary incontinence were high in the situation of sudden increase of abdominal pressure. This data can be used for the prevention strategy of urinary incontinence, In future research it is recommended to identify comprehensive factors related to urinary incontinence including psychosocial factors, and effective strategies of urinary incontinence.

• 대한간호학회지
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• 제30권1호
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• pp.18-28
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• 2000

The Purpose of this study is to extend the understanding and knowledge of menopause by comparing menopausal symptoms of married women and nuns in order to improve health and the quality of life for women. In this study a questionnaires were distributed to 116 nuns and 121 married women, from forty to fifty nine years old in Daegu metropolitan city. This study used the measurement of menopausal symptoms (Cronbach's Alpha=0.96) corrected and complemented by this student with consideration of various literature centered around menopausal symptoms, suggested by Janette M. Perz as 51 questions including 4 realms; [mental psychological factors], [physical physiological factors], [eyesight factors], and [urinary generative factors] in order to measure the degree of menopausal symptoms. The results are as follows : 1. There was a significant difference between educational background, religion, occupation, leisure time, satisfaction of marriage or ascetic life, existence of hormonal treatment, name of medical operation, and existence of counselling about menstruation as general and physiological characteristics of the nuns' group and the married women's group. 2. The menopausal symptoms of the nuns' group and the married women's group according to order in which they were presented were; 'feeling tired and lacking in energy(1.71 points)' 'vision not clear or clouded(1.69 points)', and 'be forgetful (1.57 points)' in nuns' group. 'be forgetful (1.87 points)', 'vision not clear or clouded(1.83 points)' and 'feeling tired and lacking in energy(1.76 points)' in the married women's group. The symptoms which showed the highest rank of menopausal symptoms had a maximum score of 4 points. 3. There was a statistical a significance (t=-3.9807, p<.0001) between the two groups which showed, on an average, 57.92 points in the married women's group and 43.03 points in the nuns' group from 0 to 196 of the possible points of menopausal symptoms. In difference of menopausal symptoms by menstrual aspect of the nuns' group and the married women's group, there was statistically significant difference between the two groups, showing 44.81±26.07 score in the nuns' group and 72.33±35.29 score in the married women's group as the mean score of the groups with no menstruation(t=-4.1132, p=0.0001). 4. The differences in menopausal symptoms with respect to the general and physiological characteristics of the nuns' group and the married women's group were that the nuns' group showed less menopausal symptoms on all the items than that of the married women's group. Finally, in these results, the married women's group showed higher menopausal symptoms than that of the nuns' group. Especially as the score of menopausal symptoms since the climacteric was very high it is confirmed to be a new phenomenon. Accordingly, it is considered to be necessary to carry out an indepth study of the factors related to establishing a strategy for nursing service.

• 대한예방한의학회지
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• 제24권1호
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• pp.1-14
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• 2020

Objectives : The purpose of this systematic review was to investigate the efficacy and safety of Sanjoin-tang (Suanzaoren decoction, SZRD) for insomnia in menopausal syndromes. Method : We searched the following databases: PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Science and Technique Journals Database (VIP), Wanfang, Research Information Service System (RISS), OASIS, Korean studies Information Service System (KISS), and National Digital Science Library (NDSL) databases. Randomized controlled trials (RCTs) or quasi-RCTs that used SZRD for women in menopause were included. The methodological quality of each RCT was assessed using the risk of bias tool. Results : In total, nine RCTs were finally included. The included RCTs had a high risk of bias across their domains. Three RCTs examined the effects of SZRD compared with western medicine (WM) in insomnia. Three RCTs showed favorable effects of SZRD with insomnia. Infrastructure also showed that SZRD resulted in better clinical WM (RR 1.19, 95% CI 1.07 to 1.32, P=0.001, I²=0%). Four RCTs showed favorable effects of Modified SZRD with insomnia. Infrastructure also showed that Modified SZRD resulted in better clinical WM (RR 1.13, 95% CI 1.04 to 1.23, P=0.004, I²=0%). Among the 4 RCTs, three RCTs showed an equivalent effect on the total Pittsburh Sleep Quality Index (PSQI). The meta-analysis also showed that Modified SZRD had a superior effect on the total of PSQI (total of PSQI : MD -2.55, 95% CI -3.72 to -1.37, P<0.0001, I²=85%). Only 2 trials reported adverse events and none reported severe adverse events. Conclusion : SZRD appears to be safe, but there is insufficient evidence to make a definitive conclusion because only a few studies reported adverse events. Due to the poor methodological quality of the included studies and the small number of trials included, the evidence cannot be reproduced and assessed. Well-designed RCTs with a larger sample size are needed in the future.

• Journal of Preventive Medicine and Public Health
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• 제43권3호
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• pp.213-221
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• 2010

Objectives: Plasma lipid profiles and Apolipoprotein E (ApoE) are established risk factors for cardiovascular disease (CVD). The knowledge of lipid profile may estimate the potential victims of cardiovascular disease before its initiation and progression and offers the opportunity for primary prevention. The most common ApoE polymorphism has been found to influence plasma lipid concentrations and its correlation with CVD has been extensively investigated in the last decade. Methods: The ApoE polymorphism and its influence on plasma lipid were investigated in healthy woman workers. The information on confounding factors was obtained through a self-administered questionnaire and ApoE polymorphism was investigated using PCR. Results: The relative frequencies of alleles E2, E3 and E4 for the study population (n = 305) were 0.127, 0.750 and 0.121, respectively. ApoE polymorphism was associated with variations in plasma HDL-cholesterol lipid profile. In order to estimate the independent effects of alleles E2 and E4, as compared with E3, on lipid profile, multiple regression was performed after adjustment for confounding variables such as age, BMI, blood pressure, education status, insulin, fasting glucose, HOMA-IR, menopause. ApoE2 had a negative association with HDL cholesterol and ApoE4 had a positive association with LDL cholesterol. Conclusions: This study identified that the ApoE and CVD risk factors contribute to the lipid profiles, similar to other studies. The analysis including dietary intake and other gene in further studies may help to identify clear effects on lipid profiles as risk factor for CVD.

• Journal of Nutrition and Health
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• 제51권3호
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• pp.228-241
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• 2018

본 연구는 선행연구로 개발된 고혈압 관리를 위한 식생활 영양교육 프로그램의 효과를 평가하고자 서울의 3개 지역 보건소에서 50세 이상의 여성을 대상으로 영양교육 8주와 추후관리 8주로 구성된 16주간의 교육을 실시하고 정상혈압군 (71명)과 정상혈압을 초과한 고혈압군 (44명)으로 나누어 분석하였다. 교육시작 전, 8주 교육 후, 프로그램이 종료된 16주 후에 실시한 혈압 측정 및 신체계측, 혈액분석, 설문조사를 분석한 결과는 다음과 같다. 고혈압군의 혈압강하제 복용 비율은 86.4%였고 체중, BMI, 체지방비율, 허리둘레가 정상혈압군에 비해 높았다. 영양교육 8주 후 고혈압군과 정상혈압군의 수축기혈압이 감소되었고 (p < 0.05), 체중 (p < 0.001), BMI (p < 0.001), 허리둘레 (p < 0.001), 체지방비율 (p < 0.01)이 감소하였다. 혈액검사결과 고혈압군은 프로그램이 종료된 16주 후 HDL-콜레스테롤 증가 (p < 0.001)와 중성지방 감소 (p < 0.01), LDL-콜레스테롤 감소 (p < 0.05)가 나타났고, 정상혈압군도 HDL-콜레스테롤 (p < 0.001)과 중성지방 (p < 0.01)의 유의미한 변화가 나타났다. 일반식습관 총점수와 규칙적인 식습관, 균형 잡힌 식습관, 건강을 의식한 식습관의 항목 소계, 나트륨 관련 영양지식 총점이 두 군 모두 교육 후 유의적인 상승을 나타냈다 (p < 0.001). 또한 정상혈압군의 나트륨 관련 식행동 총점이 상승되었고 (p < 0.001) 고혈압군에서도 향상되는 경향을 나타냈다. 이와 부합하여 고나트륨 함유음식의 섭취빈도 총점이 교육 후 유의적으로 감소하였고 두 집단 모두 국수류, 찌개와 탕류, 김치류와 음료류의 섭취빈도가 낮아졌다. 혈압관리를 위한 자기효능감점수의 총점이 고혈압군과 정상혈압군 모두 유의적으로 상승하였는데 (p < 0.001) 특히 고혈압군은 자아효능감의 모든 문항점수가 향상되었다. 종합하면 50대 이상 여성을 대상으로 실시한 본 식생활영양교육은 혈압이 높은 군과 정상혈압군 모두에서 혈압관리 뿐만 아니라 신체계측지표 및 혈액지표에 긍정적인 변화를 유도하고 저나트륨 관련 식행동을 비롯한 일반식습관의 전반적 개선효과를 보였다. 이는 건강위험에 대한 각성, 식생활 변화를 유도할 수 있는 계기와 모니터링을 통한 실천 관리를 제공한 프로그램이 대상자의 요구에 부합한 결과로 생각된다. 본 연구는 건강위험이 높아지는 50대 이상 여성의 혈압관리 및 만성질환 예방과 식생활 관리를 위해 보건소에 기반한 지역사회 교육 프로그램의 유효한 모델을 제시한 점에 의의가 있다.