No abstract available.
Selective Estrogen Receptor Modulators*

The antiarrhythmic efficacy if low dose amiodarone treatment was studied in 30 cases of ventricular premature beats(VPBs). Amiodarone was administered 600mg daily in three divided doses for for initial 7-10 days as loadihg dosage,then 100-200mg once daily as maintenance. The results obtained were as follow : 1) The complete control of VPBs was achieved by amiodarone treatment in 90%, 27cases of 30 cases(all 11 cases with simple VPBs and 16 cases of the remainders with complex VPBs). 2) The QT interval and QTc were significantly prolonged, whereas heart rate was reduced significantly after amiodarone treatment. 3) In 27 cases of responder, the frequency of VPBs began to decrease overtly 2-3 days after amiodarone administration, then relatively stablized in 6 days, and complete cnotrol of VPBs was achieved in all cases about 10 days after treatment. 4) No significant side-reaction was observed except the decrease of serm T3 level after treatment.
Amiodarone* ; Arrhythmias, Cardiac* ; Heart Rate ; Selective Estrogen Receptor Modulators

We report five cases of pattern alopecia in female patients who are undergoing hormonal anticancer therapy for the prevention of recurrence of breast cancer after surgery. Three patients demonstrated male pattern alopecia with receding frontal hairlines, and two patients demonstrated female pattern alopecia without receding hairlines. The detailed clinical history showed that the pattern alopecia of the patients developed after the full recovery of global hair loss of the entire scalp due to previous cytotoxic chemotherapy. All of the adjuvant hormonal anticancer drugs that were used in the patients are antiestrogenic agents, either aromatase inhibitors or selective estrogen receptor modulators. Considering androgen effect on the hair follicles of the fronto-parietal scalp, the androgen-estrogen imbalance caused by the drugs was thought to be the reason for the onset of pattern alopecia in the patients. In general, alopecia that develops during cytotoxic chemotherapy is well known to both physicians and patients; however, the diagnosis of pattern alopecia during hormonal anticancer therapy in breast cancer patients seems to be overlooked.
Alopecia* ; Androgens ; Aromatase Inhibitors ; Breast Neoplasms* ; Diagnosis ; Drug Therapy ; Estrogen Receptor Modulators ; Estrogens ; Female ; Hair ; Hair Follicle ; Humans ; Recurrence ; Scalp ; Selective Estrogen Receptor Modulators

OBJECTIVE: To determine the effects of a selective estrogen receptor modulator (SERM), raloxifene, on endometrium in postmenopausal women. METHODS: Double-blind randomized controlled study was designed for 138 healthy postmenopausal women to determine the effects of raloxifene on postmeonopausal endometrium. The women were randomly assigned to receive either placebo, or raloxifene HCl 60 mg/day for 6 months. Transvaginal ultrasound was done at baseline and at 6 months later. RESULTS: Mean endometrial thickness of normal postmenopausal women was 3.4 ( +/- 1.6) mm. Mean endometrial thickness was decreased by 0.2 mm in both groups, but with no statistical significance. CONCLUSION: Raloxifene 60 mg/day did not stimulate the endometrium after 6 months of use in postmenopausal women.
Endometrium* ; Female ; Humans ; Postmenopause ; Raloxifene Hydrochloride* ; Selective Estrogen Receptor Modulators ; Ultrasonography

Since adult human skin can be grown in chernically defined medium without serum, the skin organ culture has gained a great interest as a method for studies concerning skin biology, pharmacology and toxicology. however, serum supplementation has extensively been used to improve the viahility of tissue culture. This study was undertaken to evaluate the effect of serum on the histologic changes ohserved during the organ culture of the normal human skin. The general architecture of the skin was well maintained for 6 days with or without seru. After then, fetal calf serum or autologous human serum was found to enhance the viability of the epidermis. A confluent layer of necrotic spinous ceils was ovserved earlier and more widespread without serum. The addition of serum had an impressive effect on epibolization. In the absenee of serum, the formation of the epibolus was not only minimal, but also, susceptible to degeneration, and no epibolus remained at 10 days rif incubation. No difference can be found between fetal calf serm and autologous human serum in the formation of the epibolus. There was no favorable effect of serum on the formation of new stratum corneum. The thickness of new straturn corneum increased in parallel with the number of parakeratatic cells, increasing most rapidly between 6 and 8 days of incubation. Parakeratosis was more prominent in the presence of serurn.
Adult ; Biology ; Epidermis ; Humans* ; Organ Culture Techniques* ; Parakeratosis ; Pharmacology ; Selective Estrogen Receptor Modulators ; Skin* ; Toxicology

Neurological diseases include a variety of neurodegenerative diseases and other brain damage diseases.The treatment schemes for neurological diseases are still in research.The existing clinical and basic studies have confirmed that traditional estrogen therapy has certain protective effect on the nervous system,while it increases the risk of breast or endometrial cancer.The emergence of the selective estrogen receptor modulators (SERMs) can avoid the above mentioned problems.The available studies have confirmed the protective effect of tamoxifen as a SERM on the nervous system.This paper reviews the role and functioning mechanisms of tamoxifen in the nervous system and cognitive function,aiming to provide guidance for the future application of tamoxifen in the treatment of neurological diseases and the improvement of cognitive function.
Tamoxifen/therapeutic use* ; Selective Estrogen Receptor Modulators/therapeutic use* ; Cognition ; Nervous System

PURPOSE: Extended treatment with aromatase inhibitors (AIs) after tamoxifen has shown effectiveness in postmenopausal patients with breast cancer. However it is very difficult to start on AIs for patients who become postmenopausal after tamoxifen because tamoxifen is a selective estrogen receptor modulator (SERM) that influences menopause, confusing the menopausal status of patients. We assessed the menopausal status and hormone concentrations at the start of letrozole treatment in women with breast cancer who were premenopausal when diagnosed with breast cancer and who became postmenopausal during 5 years of tamoxifen therapy. METHODS: We evaluated 164 patients with breast cancer who received extended letrozole therapy between May 2006 and December 2007. All had been premenopausal at diagnosis but became postmenopausal during 5 years of tamoxifen therapy. Menopause was defined as amenorrhea for >1 year, serum follicle stimulating hormone (FSH) concentration > or =30 mIU/mL or serum estradiol (E2) concentrations < or =20 pg/mL. FSH and E2 concentrations were monitored for 2 years after starting letrozole therapy. RESULTS: The median ages of the 164 patients were 45 years at surgery, 46 years when they became amenorrheic, and 50 years at the start of letrozole treatment. Of the 164 patients, 157 (95.7%) were amenorrheic, 14 (9.3%) had FSH concentrations > or =30 mIU/mL and 113 (70.2%) had E2 concentrations < or =20 pg/mL at the start of letrozole. FSH concentrations > or =30 mIU/mL were observed in 87 patients (57.6%) after 6 months of letrozole and in 133 (88.1%) after 2 years, and E2 concentrations < or =20 pg/mL were observed in 164 patients (100%) after 2 years. Times to reach FSH > or =30 mIU/mL and E2 levels < or =20 pg/mL were not significantly related to age at surgery (p=0.836 and p=0.228, respectively), at start of letrozole (p=0.855 and p=0.357, respectively), or at amenorrhea (p=0.098 and p=0.154, respectively). CONCLUSION: Applying postmenopausal ranges of hormone concentrations observed in normal healthy people to patients who completed 5 years of tamoxifen is inappropriate, because tamoxifen itself may affect FSH concentration. Further studies should focus on identifying an indicator of ovarian function so that these patients can start extended hormone therapy.
Amenorrhea ; Aromatase Inhibitors ; Breast ; Breast Neoplasms ; Estradiol ; Female ; Follicle Stimulating Hormone ; Humans ; Menopause ; Nitriles ; Selective Estrogen Receptor Modulators ; Tamoxifen ; Triazoles

OBJECTIVE: Our purpose was to evaluate potential efficacy of selective estrogen receptor modulators (raloxifene and tamoxifen) to human uterine leiomyoma cells. METHODS: The samples were collected from ten hysterectomized specimen. we evaluated the estrogen-responsive growth of human uterine leiomyoma and normal myometrial cells. The potential efficacy of Selective Estrogen Receptor Modulators (SERMs: raloxifene and tamoxifen) to human uterine leiomyoma cells were conducted by MTS, cell count assay and Western-blot. RESULTS: Human uterine leiomyoma and normal myometrial cells that expressed estrogen receptor (ER) showed increases the cell number in the presence of estrogen compared with ER negative uterine leiomyoma cells. Raloxifene and tamoxifen inhibited estrogen-stimulated proliferation of ER-containing human uterine leiomyoma and normal myometrial cells. Raloxifene was more effective in inhibiting estrogen-induced increases of cell number compared with tamoxifen. CONCLUSION: The effect of SERMs on leiomyoma was inhibited the cell proliferation without apoptosis or cell cycle arrest. These data suggest that SERM should be examined as candidate of nonsurgical therapeutic agents for uterine leiomyoma.
Apoptosis ; Cell Count ; Cell Cycle Checkpoints ; Cell Proliferation ; Estrogens ; Humans* ; Leiomyoma* ; Raloxifene Hydrochloride ; Selective Estrogen Receptor Modulators* ; Tamoxifen

OBJECTIVES: Little is currently known about the issues surrounding management and treatment of severe osteoporosis in South Korea. Our objective was to assess doctors' views on the perception, diagnosis, and treatment of severe osteoporosis. METHODS: Face-to-face interviews were conducted (16 February-13 March 2015) with 100 doctors (specialists in orthopedic surgery, endocrinology, neurosurgery, family medicine, or rheumatology) who treated ≥5 severe osteoporosis (T-score ≤ -2.5, plus fracture) patients per month. Respondent demographic characteristics, their perception of severe osteoporosis, its impact and treatment, and their views on current practice and unmet needs were assessed. RESULTS: Of 416 doctors approached, 100 completed the survey (24% response rate). Most doctors (90%) specialized in orthopedic surgery, endocrinology, or neurosurgery. When diagnosing severe osteoporosis, most doctors (79%) considered both bone mineral density and fracture. Almost all doctors (≥91%) ranked disease impact and seriousness highly, but much fewer (≤25%) doctors thought society agreed. Most doctors (89%) had concerns with current treatments, switching treatments because of the efficacy and safety of bisphosphonates (>89%), the efficacy of selective estrogen receptor modulators (>71%), and the high cost of parathyroid hormone (>73%). Parathyroid hormone was ranked highest for efficacy and was preferentially prescribed to severe osteoporosis patients (mean 32.2% of prescriptions) compared with osteoporosis patients overall (3.7%). "Limitations with reimbursement" was the most commonly cited (76%) unmet need. CONCLUSIONS: There are concerns with the safety, efficacy, and affordability of current treatments for severe osteoporosis in South Korea, as well as a perceived lack of disease awareness amongst patients and doctors.
Bone Density ; Diagnosis ; Diphosphonates ; Endocrinology ; Humans ; Korea* ; Neurosurgery ; Orthopedics ; Osteoporosis* ; Parathyroid Hormone ; Selective Estrogen Receptor Modulators ; Surveys and Questionnaires ; Teriparatide

Osteoporosis is a metabolic bone disease characterized by decreased bone strength, leading to an increased risk of fracture. The World Health Organization (WHO) defines osteoporosis as a bone mineral density (BMD) of 2.5 standard deviations below that of a young adults (T-score of -2.5 or lower). Severe osteoporosis is differentiated from osteoporosis by the presence of one or more fragility fractures in addition to this T-score. However, the current WHO definition may be insufficient to reflect the diverse spectrum of osteoporosis or severe osteoporosis, which can encompass various number and severity of prevalent fractures. To overcome these shortcomings of the WHO definition of osteoporosis, we propose a concept of 'advanced severe osteoporosis', which is defined by the presence of proximal femur fragility fracture or two or more fragility fractures in addition to BMD T-score of -2.5 or less. Based on the previous clinical trials and post-hoc analyses, we recommend selective estrogen receptor modulators, bisphosphonates, receptor activator of nuclear factor kappa-B ligand (RANKL) monoclonal antibody, and parathyroid hormone for the medical treatment of severe osteoporosis. In cases of advanced severe osteoporosis or osteoporosis that does not respond to previous anti-osteoporotic treatments, we also recommend parathyroid hormone, bisphosphonates, and RANKL monoclonal antibody. In conclusion, we need more precise assessment of osteoporosis and further stratification of the disease by number of prevalent fractures in addition to BMD. More aggressive managements should be provided for those with advanced severe osteoporosis.
Bone Density ; Bone Diseases, Metabolic ; Diphosphonates ; Femur ; Humans ; Osteoporosis* ; Parathyroid Hormone ; Selective Estrogen Receptor Modulators ; World Health Organization ; Young Adult