We assessed the concomitant impact of cigarette smoking and alcohol consumption in men presenting for primary couple's infertility. Data from 189 infertile men were analyzed. Semen analysis, serum hormones, and sperm DNA fragmentation (SDF) were obtained. Smoking status was categorized as follows: current nonsmoker (-S), moderate smoker (+MS), and heavy smoker (+HS). Alcohol consumption was categorized as follows: abstainer (-D), moderate drinker (+MD), and heavy drinker (+HD). Descriptive statistics and logistic regression models were applied. Among all the participants, 132 (69.8%), 30 (15.9%), and 27 (14.3%) patients were -S, +MS, and +HS, respectively. In addition, 67 (35.4%), 77 (40.7%) and 45 (23.8%) men were -D, +MD and +HD, respectively. Regarding concomitant habits, 52 (27.5%) patients were nonsmokers and abstainers (-S/-D: Group 1), 91 (48.1%) had at least one recreational habit (-S/+D or +S/-D: Group 2), and 46 (24.3%) were both smokers and drinkers (+S/+D: Group 3). Sperm concentration and progressive motility were lower in +HS and +HD, compared with -S and -D (all P < 0.05), respectively. Similarly, both parameters were significantly lower in Group 3 than Groups 1 and 2 (all P < 0.05). SDF values were higher in Group 3 than Groups 1 and 2 (both P < 0.05). In multivariate analysis, follicle-stimulating hormone (FSH) levels and concomitant +S/+D status were independent predictors of impaired sperm concentration and progressive motility (all P < 0.05). Heavy smoking and heavy drinking were associated with worse seminal parameters than moderate smoking/drinking and nonsmoking/abstaining. When concomitant, +S/+D status has an even greater detrimental effect on semen parameters.
Adult ; Alcohol Drinking/adverse effects* ; Alcoholism/complications* ; Cigarette Smoking/adverse effects* ; Cohort Studies ; Female ; Follicle Stimulating Hormone/blood* ; Humans ; Infertility, Male/pathology* ; Male ; Middle Aged ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa/ultrastructure*

Objective: To investigate the correlation of intermittent androgen-deprivation therapy (IADT) and continuous androgen-deprivation therapy (CADT) for advanced prostate cancer (PCa) with the risks of secondary diabetes mellitus (DM) and impaired glucose tolerance (IGT). METHODS: We conducted a retrospective case-control study of the advanced PCa patients treated by IADT or CADT in our hospital from January 2013 to December 2015. Based on the levels fasting blood glucose and 2-hour postprandial blood glucose, results of oral glucose tolerance test, and clinical symptoms of the patients, we statistically analyzed the IADT- or CADT-related risk factors for DM and IGT and the relationship of the body mass index (BMI), hypertension, smoking, and alcohol consumption with secondary DM and IGT. RESULTS: IADT was given to 53 (46.5%) of the patients, aged (69.1 ± 4.3) years, and CADT to 61 (53.5%), aged (70.2 ± 5.7) years. No statistically significant differences were observed in clinical characteristics between the two groups of patients (P > 0.05). BMI, blood pressure, smoking and drinking exhibited no significant influence on the development of DM or IGT either in the IADT (P > 0.05) or the CADT group. The incidence of IGT was significantly lower in the IADT than in the CADT group (P = 0.03), but that of DM showed no statistically significant difference between the two groups (P = 0.64). CONCLUSIONS Compared with CADT, IADT has a lower risk of IGT and a higher safety in the treatment of advanced prostate cancer.
Aged ; Alcohol Drinking ; adverse effects ; Androgen Antagonists ; adverse effects ; therapeutic use ; Blood Glucose ; metabolism ; Body Mass Index ; Case-Control Studies ; Diabetes Mellitus ; chemically induced ; Glucose Intolerance ; chemically induced ; Glucose Tolerance Test ; Humans ; Hypertension ; complications ; Male ; Prostatic Neoplasms ; drug therapy ; pathology ; Retrospective Studies ; Risk Factors ; Smoking ; adverse effects

OBJECTIVETo investigate the cumulative effect regarding the family history of cardiovascular disease and smoking on ischemic stroke events in population with Mongolian ethnicity.

METHODSBased on data gathered from the baseline investigation, a 10-year prospective cohort follow-up project was conducted among 2 589 participants with Mongolian ethnicity. Ischemic stroke events were defined as the outcomes of the study. All the 2 589 participants were categorized into four subgroups: without family history of cardiovascular disease/nonsmokers, without family history of cardiovascular disease/smokers, with family history of cardiovascular disease/nonsmokers and with family history of cardiovascular disease/smokers, according to family history of cardiovascular disease and smoking status. Cumlative incidence rates of events among the four subgroups was described with Kaplan-Meier curves. Cox proportional hazards model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (95%CI) of ischemic stroke events among the four subgroups.

RESULTSData from the Kaplan-Meier curves showed that the cumulative incidence rates of ischemic stroke were 1.17% (15/1 278), 3.83% (37/967), 5.70% (9/158) and 8.33% (15/180) for the groups of no family history of cardiovascular disease/nonsmokers, no family history of cardiovascular disease/smokers, with family history of cardiovascular disease/nonsmokers and with family history of cardiovascular disease/smokers, respectively. By cox proportional hazards model, after adjusting for age, male, drinking status, systolic and diastolic blood pressure, body mass index, fasting glucose, total cholesterol, triglycerides, LDL cholesterol factors, the HRs (95% CI) of ischemic stroke were 2.26 (1.19-4.28) and 2.45 (1.13-5.33) in the no family history of cardiovascular disease/smokers group, with family history of cardiovascular disease/smokers group when compared to the no family history of cardiovascular disease/nonsmokers group, respectively. The risk of ischemic stroke appeared the highest in the group with family history of cardiovascular disease/smokers (all P<0.05).

CONCLUSIONSmoking may increase the risk of ischemic stroke events among the population with family history of cardiovascular disease.

Alcohol Drinking ; Asian Continental Ancestry Group ; ethnology ; genetics ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; ethnology ; genetics ; Cholesterol ; Cholesterol, LDL ; Genetic Predisposition to Disease ; Humans ; Incidence ; Male ; Mongolia ; epidemiology ; Population Surveillance ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Smoking ; adverse effects ; epidemiology ; Stroke ; epidemiology ; genetics

OBJECTIVETo study the impact of preoperative fasting plasma glucose(FPG) on postoperative morbidity and outcome following surgical resection of esophageal squamous cell carcinoma (ESCC), and to analyze the risk factor of postoperative complication in ESCC.

METHODSClinicopathological data of 314 ESCC patients undergoing esophagectomy in our center between January 2011 and December 2012 were retrospectively collected. Patients were divided into two groups according to their preoperative FBG: normal FPG group (FPG<6.1 mmol/L, 252 cases) and high FBG group (FPG≥6.1 mmol/L, 62 cases, including 14 diabetes cases). Clinicopathological data and postoperative morbidity were analyzed and compared between two groups. Multivariate logistic regression analysis was used to evaluate risk factors for postoperative complications.

RESULTSThere were 278 male and 36 female patients with a median age of 59 years (range 42-83 years). As compared to normal FPG group, high FBG group had higher ratio of female [22.6%(14/62) vs. 8.7%(22/252), P=0.000], older median age (66 years vs. 59 years, P=0.010), lower ratio of smoking and alcohol drinking [48.4%(30/62) vs. 73.8%(186/252), 38.7%(24/62) vs. 69.0%(174/252), both P=0.000], higher ratio of comorbid diabetes and hypertension [51.6%(32/62) vs. 15.1%(38/252), 16.1%(10/62) vs. 1.6%(4/252), both P=0.000]. Pathology results showed 206 patients in normal FPG group (81.7%, 206/252) were moderate-poor differentiation, which was obviously lower than 93.5%(58/62) in high FPG group(P=0.023). Patients of two groups completed their operations successfully. Perioperative overall complication morbidity was 24.2%(76/314), and the most common was lung lesions (24 cases of pneumonia, 10 cases of respiratory failure), then was anastomotic leakage (28 cases) and incision infection (18 cases). Differences in overall and other complication morbidity were not significant between two groups (all P>0.05). Multivariate logistic regression analysis revealed that operation time was an independent risk factor of postoperative complications (P=0.047), anastomosis site was an independent risk factor of anastomotic leakage (P=0.036), and FPG was not a risk factor of postoperative complications(respectively, P=0.683, P=0.836, P=0.784, P=0.637).

CONCLUSIONSPreoperative control of FBG does not increase the postoperative complication morbidity. Shortening operation time and choosing appropriate surgical procedure are important to decrease postoperative complications.

Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking ; adverse effects ; Anastomotic Leak ; etiology ; Blood Glucose ; physiology ; Carcinoma, Squamous Cell ; complications ; surgery ; Comorbidity ; Diabetes Complications ; epidemiology ; Diabetes Mellitus ; Esophageal Neoplasms ; complications ; surgery ; Esophagectomy ; adverse effects ; Female ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Operative Time ; Pneumonia ; epidemiology ; etiology ; Postoperative Complications ; epidemiology ; Respiratory Insufficiency ; epidemiology ; etiology ; Retrospective Studies ; Risk Factors ; Smoking ; adverse effects ; Surgical Wound Infection ; epidemiology ; Treatment Outcome

BACKGROUND/AIMS: Recently, many cases of vitamin K-dependent coagulopathy of unknown origin have been reported. Such patients lack any relevant family history and have no systemic disease, raising suspicion of superwarfarin intoxication. We evaluated individual risk factors causing coagulopathy and hemorrhagic symptoms in patients with suspected superwarfarin intoxication. In addition, we determined how to effectively treat vitamin K-dependent coagulopathy caused by suspected superwarfarin intoxication. METHODS: Seven patients with suspected superwarfarin intoxication who lacked any definitive history of rodenticide ingestion were included. Thirty-one patients initially diagnosed with rodenticide poisoning were also included. We performed a retrospective chart review of all subjects and examined clinical data including patient demographics and medical histories. RESULTS: Patients initially diagnosed with rodenticide poisoning were divided into two groups, one of which had a laboratory abnormality (prothrombin time [PT] > 13 seconds) and another group with PTs in the normal range. There was no significant difference between the two groups in any of age, gender, the extent of chronic alcohol consumption, the causative rodenticide, psychiatric problems, ingestion of drugs interacting with warfarin, the extent of intoxication, or the type of ingestion attempt. The albumin level of the former group was significantly lower than that of the latter group (p = 0.014). Furthermore, a significant difference between the two groups was evident in terms of simultaneous ingestion of rodenticide and alcohol (p = 0.023). CONCLUSIONS: Most patients with superwarfarin poisoning did not exhibit any complication. When such complications were evident, they were associated with serum albumin level and coingestion of rodenticide and alcohol.
4-Hydroxycoumarins/*poisoning ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking/adverse effects/blood ; Anticoagulants/*poisoning ; Blood Coagulation/*drug effects ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Partial Thromboplastin Time ; Prothrombin Time ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Rodenticides/*poisoning ; Serum Albumin/metabolism ; Vitamin K/*blood ; Vitamin K Deficiency Bleeding/blood/*chemically induced/diagnosis/therapy ; Young Adult

BACKGROUND/AIMS: The clinical implications of hypocholesterolemia have not been well studied, although some studies have revealed an association between hypocholesterolemia and intracerebral hemorrhage (ICH). We evaluated the clinical characteristics of subjects with very low-density lipoprotein cholesterol (LDL-C) and compared the risk for ICH using various clinical parameters. METHODS: Using hospital records, we evaluated the clinical characteristics of subjects with LDL-C levels < or = 40 mg/dL (very low LDL-C group). We also evaluated the risk for ICH in this very low LDL-C group and in subjects with low LDL-C < or = 70 mg/dL (low LDL-C group). RESULTS: Among 34,415 subjects who presented at the laboratory for serum LDL-C measurements, 250 subjects had a very low serum LDL-C level (< or = 40 mg/dL). About half of the subjects were statin users; the very low LDL levels in the other subjects were likely attributable to alcohol consumption or a various chronic illness such as liver disease or end-stage renal disease (ESRD). ICH occurred in three subjects with very low LDL-C, all of whom had no history of statin use. ESRD tended to be associated with ICH in subjects with serum LDL-C < or = 70 mg/dL. CONCLUSIONS: About 1% of the subjects whose LDL-C was measured in the hospital had a LDL-C level < or = 40 mg/dL, and about half of these subjects had no history of hypolipidemic therapy. ICH incidence was not related to LDL-C level or statin use.
Aged ; Alcohol Drinking/adverse effects/epidemiology ; Biological Markers/blood ; Cerebral Hemorrhage/blood/*epidemiology ; Cholesterol, LDL/*blood ; Down-Regulation ; Dyslipidemias/blood/*epidemiology ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Incidence ; Kidney Failure, Chronic/epidemiology ; Liver Diseases/epidemiology ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors

BACKGROUND/AIMS: Whether alcohol intake increases the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection remains controversial. The aim of this study was to determine the effect of alcohol intake on the development of HCC. METHODS: Between January 2006 and August 2008, 146 patients with an initial diagnosis of HCC who were hospitalized in 3 major hospitals in the Incheon area were enrolled as cases. Another 146 cirrhotic patients, who matched the cases by age and sex, were enrolled as controls. All cases and controls were HBsAg positive, and had a history of lifetime alcohol intake. RESULTS: The cases and controls were aged 53+/-8 and 53+/-9 years (mean+/-SD), respectively, with each group comprising 118 males and 28 females. The basal laboratory data, distribution of Child-Pugh class, HBeAg positivity (31.5% vs. 37.7%), HBV DNA level (5.74+/-2.35 vs. 5.98+/-2.29 log(10) copies/mL), and proportion with a lifetime alcohol intake of more than 292 kg (30.8% vs. 34.9%) did not differ between cases and controls. The cumulative alcohol intake and the proportion of heavy drinkers did not differ between the two groups in male patients. CONCLUSIONS: Alcohol intake might not increase the risk of HCC in patients with HBV infection.
Adult ; Alcohol Drinking/*adverse effects ; Carcinoma, Hepatocellular/epidemiology/*etiology ; Case-Control Studies ; Cross-Sectional Studies ; DNA, Viral/blood ; Female ; Hepatitis B Surface Antigens/blood ; Hepatitis B, Chronic/*complications ; Humans ; Liver Cirrhosis/*complications/epidemiology ; Liver Neoplasms/epidemiology/*etiology ; Male ; Middle Aged ; Risk Factors

PURPOSE: The goal of this study is to assess the interactions among alcohol consumption, cigarette smoking, and aspartate aminotransferase (AST) / alanine aminotransferase (ALT) ratios on esophageal cancer. MATERIALS AND METHODS: Alcohol and the risk of incidence and death from esophageal cancer were examined in a 14-year prospective cohort study of 782,632 Korean men, 30 to 93 years of age, who received health insurance from the National Health Insurance Corporation and had a medical evaluation from 1992 to 1995. RESULTS: Smoking, alcohol intake, and AST/ALT ratios were associated with the increased risk of esophageal cancer in a dose-dependent manner independent of each other. Smoking was associated with an increased risk of incidence [Hazard ratio (HR) = 2.2, 95% CI = 1.8 to 2.5] and mortality (HR = 2.5, 2.0 to 3.1). Combined HR of incidence for alcohol consumption (> 25 g/day) and smoking was 4.5 (3.8-5.5); for alcohol (> 25 g/day) and the AST/ALT ratio (> or = 2.0), it was 5.8 (4.6-7.2); for smoking and the AST/ALT ratio (> or = 2.0), it was 6.3 (5.1-7.5). Similar results were seen for mortality from esophageal cancer. Subjects who drank > or = 25 g/day with an AST/ALT ratio > or = 2 had a higher risk of esophageal cancer incidence (HR = 6.5, 4.8 to 8.7) compared with those who drank > or = 25 g/day with an AST/ALT ratio < 2 (HR = 2.2, 1.9 to 2.6). CONCLUSION: Alcohol, smoking, and the AST/ALT ratio are independently associated with increased risk of esophageal cancer but did not interact synergistically. The combination of the AST/ALT ratio with a questionnaire for alcohol consumption may increase the effectiveness for determining the risk of esophageal cancer.
Adult ; Aged ; Aged, 80 and over ; Alanine Transaminase/*blood ; Alcohol Drinking/*adverse effects ; Asian Continental Ancestry Group ; Aspartate Aminotransferases/*blood ; Esophageal Neoplasms/*enzymology/*epidemiology/etiology ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Risk Factors ; Smoking/*adverse effects

PURPOSE: The goal of this study is to assess the interactions among alcohol consumption, cigarette smoking, and aspartate aminotransferase (AST) / alanine aminotransferase (ALT) ratios on esophageal cancer. MATERIALS AND METHODS: Alcohol and the risk of incidence and death from esophageal cancer were examined in a 14-year prospective cohort study of 782,632 Korean men, 30 to 93 years of age, who received health insurance from the National Health Insurance Corporation and had a medical evaluation from 1992 to 1995. RESULTS: Smoking, alcohol intake, and AST/ALT ratios were associated with the increased risk of esophageal cancer in a dose-dependent manner independent of each other. Smoking was associated with an increased risk of incidence [Hazard ratio (HR) = 2.2, 95% CI = 1.8 to 2.5] and mortality (HR = 2.5, 2.0 to 3.1). Combined HR of incidence for alcohol consumption (> 25 g/day) and smoking was 4.5 (3.8-5.5); for alcohol (> 25 g/day) and the AST/ALT ratio (> or = 2.0), it was 5.8 (4.6-7.2); for smoking and the AST/ALT ratio (> or = 2.0), it was 6.3 (5.1-7.5). Similar results were seen for mortality from esophageal cancer. Subjects who drank > or = 25 g/day with an AST/ALT ratio > or = 2 had a higher risk of esophageal cancer incidence (HR = 6.5, 4.8 to 8.7) compared with those who drank > or = 25 g/day with an AST/ALT ratio < 2 (HR = 2.2, 1.9 to 2.6). CONCLUSION: Alcohol, smoking, and the AST/ALT ratio are independently associated with increased risk of esophageal cancer but did not interact synergistically. The combination of the AST/ALT ratio with a questionnaire for alcohol consumption may increase the effectiveness for determining the risk of esophageal cancer.
Adult ; Aged ; Aged, 80 and over ; Alanine Transaminase/*blood ; Alcohol Drinking/*adverse effects ; Asian Continental Ancestry Group ; Aspartate Aminotransferases/*blood ; Esophageal Neoplasms/*enzymology/*epidemiology/etiology ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Risk Factors ; Smoking/*adverse effects

Gastroesophageal reflux disease (GERD) is caused by abnormal reflux of gastric contents into the esophagus. GERD can be divided into two groups, erosive esophagitis and non-erosive reflux disease (NERD). The aim of this study was to compare the clinical characteristics of patients with erosive esophagitis to those with NERD. All participating patients underwent an upper endoscopy during a voluntary health check-up. The NERD group consisted of 500 subjects with classic GERD symptoms in the absence of esophageal mucosal injury during upper endoscopy. The erosive esophagitis group consisted of 292 subjects with superficial esophageal erosions with or without typical symptoms of GERD. Among GERD patients, male gender, high body mass index, high obesity degree, high waist-to-hip ratio, high triglycerides, alcohol intake, smoking and the presence of a hiatal hernia were positively related to the development of erosive esophagitis compared to NERD. In multivariated analysis, male gender, waist-to-hip ratio and the presence of a hiatal hernia were the significant risk factors of erosive esophagitis. We suggest that erosive esophagitis was more closely related to abdominal obesity.
Adult ; Alcohol Drinking ; Body Mass Index ; Esophagitis, Peptic/complications/*diagnosis ; Female ; Gastroesophageal Reflux/complications/*diagnosis ; Gastroscopy ; Hernia, Hiatal/complications ; Humans ; Male ; Middle Aged ; Obesity/complications ; Republic of Korea ; Risk Factors ; Sex Factors ; Smoking/adverse effects ; Triglycerides/blood ; Waist-Hip Ratio