OBJECTIVES: To evaluate the histologic effects of tamoxifen on the endometrium using hysteroscopy in postmenopausal women with breast cancer. METHODS: The study included 46 postmenopausal patients who were referred from another clinic due to thickening or bleeding of the endometrium after taking tamoxifen for breast cancer. All patients underwent transvaginal sonography (TVS) and hysteroscopic endometrial biopsy with a 5-mm, continuous-flow, operating hysteroscope. RESULTS: The incidence of malignancy was high (20%) in cases of abnormal uterine bleeding (AUB) after taking tamoxifen. However, in the non-AUB group with thick endometrium after taking tamoxifen, the incidence of adenocarcinoma was 3.2%. CONCLUSIONS: Our findings confirm the estrogen-like effect of tamoxifen on the endometrium. Endometrial evaluation with TVS suggests further diagnostic procedures; moreover, histologic examination is necessary under hysteroscopy, especially in cases of endometrial bleeding after taking tamoxifen.
Adenocarcinoma ; Biopsy ; Breast Neoplasms ; Endometrium ; Female ; Hemorrhage ; Humans ; Hysteroscopes ; Hysteroscopy ; Incidence ; Postmenopause ; Tamoxifen ; Uterine Hemorrhage

BACKGROUND: Oxidative stress is implicated in the pathogenesis and development of lifestyle-related diseases. In the present study, we evaluated the correlation between the serum uric acid (UA) levels and oxidative status in Korean adults. METHODS: The subjects were 5,093 individuals (2,041 women and 3,052 men) who underwent a health checkup between June 2012 and December 2016. Oxidative stress levels (derivatives of reactive oxygen metabolites [d-ROMs]) and antioxidant potential (biological antioxidant potential [BAP]) were measured. Metabolic markers, including UA, were also examined. RESULTS: Higher serum UA levels were associated with decreased levels of d-ROMs (P < 0.05). The UA levels were positively associated with BAP levels (P < 0.001). CONCLUSION: Serum UA is related to oxidative status, especially antioxidant capacity, in Korean adults; UA may play a role in antioxidant defense systems in humans.
Adult* ; Antioxidants ; Female ; Humans ; Oxidative Stress* ; Oxygen ; Reactive Oxygen Species ; Uric Acid*

PURPOSE: Changes in human body composition can affect the accuracy of spine bone mineral density (BMD) measurements. The purpose of this study was to evaluate whether fat and water in the soft tissue of the abdomen influence lumbar spine BMD measurements obtained using dual energy X-ray absorptiometry (DXA). MATERIALS AND METHODS: Duplicate BMD measurements were carried out on healthy volunteers (10 men and 10 women) and the Hologic anthropomorphic spine phantom had on the same day before and after placement of following 3 materials in the abdominal area: lard 900 g, 1.5 cm thick; oil 1.4 liters in a vinyl bag; and water 1.2 liters in a vinyl bag. RESULTS: In the case of human participants, following the placement of exogenous water to mimic extracellular fluid (ECF), there was a significant decrease in lumbar spine BMD (-0.012 g/cm2, p=0.006), whereas the placement of exogenous lard and oil to mimic abdominal fat produced a slight increase in lumbar spine BMD (0.006 g/cm2, p=0.301; 0.008 g/cm2, p=0.250, respectively). The average percentage of lumbar spine BMD change with and without exogenous lard, oil, and water showed increase of 0.51%, and 0.67%, and decrease of 1.02%, respectively. Using the phantom, BMD decreased with the placement of both lard (-0.002 g/cm2, p=0.699) and water (-0.006 g/cm2, p=0.153); however, there was no difference in BMD after oil placement. CONCLUSION: These results suggest that in cases where changes in fat and ECF volume are similar, ECF exerts a greater influence than fat on DXA lumbar BMD measurements.
Absorptiometry, Photon ; Adult ; Bone Density/*drug effects ; Dietary Fats/pharmacology ; Fats/*pharmacology ; Female ; Humans ; Lumbar Vertebrae/*drug effects/*metabolism ; Male ; Water/*pharmacology

BACKGROUND: Combined therapy with alendronate and calcitriol may have additive effects on bone density. An observational study was performed to evaluate the efficacy and safety of Maxmarvil, a combinative agent of alendronate (5 mg) and calcitriol (0.5 microg), and to identify factors associated with efficacy. METHODS: A total of 568 postmenopausal women with osteoporosis were enrolled by family physicians in 12 hospitals. The study subjects took Maxmarvil daily for 12 months. Questionnaires about baseline characteristics, socioeconomic status, and daily calcium intake were completed at the first visit. Adverse events were recorded every 3 months and bone mineral density (BMD) in the lumbar spine was measured using dual-energy X-ray absorptiometry at baseline and after 12 months. We evaluated the efficacy and safety of Maxmarvil, and the factors related to BMD improvement. RESULTS: A total of 370 patients were included in final analysis. The median BMD was 0.81 +/- 0.12 g/cm2 at pre-treatment and 0.84 +/- 0.13 g/cm2 after one year. The average BMD improvement was 3.4% +/- 6.4% (P < 0.05), and 167 (45.1%) patients showed improvement. Factors associated with improved BMD were continuation of treatment (odds ratio [OR], 2.41; 95% confidence interval [CI], 1.15 to 5.07) and good compliance (OR, 2.54; 95% CI, 1.29 to 5.00). Adverse events were reported by 35 of the 568 patients, with the most common being abdominal pain and dyspepsia. CONCLUSION: Maxmarvil was found to be safe, well tolerated and effective in osteoporosis treatment. Continuation of treatment and good compliance were the factors associated with efficacy.
Abdominal Pain ; Absorptiometry, Photon ; Alendronate ; Bone Density ; Calcitriol ; Calcium ; Compliance ; Drug Combinations ; Female ; Humans ; Osteoporosis ; Osteoporosis, Postmenopausal ; Physicians, Family ; Social Class ; Spine ; Surveys and Questionnaires

Little is known about hair mineral status in fibromyalgia patients. This study evaluated the characteristics of hair minerals in female patients with fibromyalgia compared with a healthy reference group. Forty-four female patients diagnosed with fibromyalgia according to the American College of Rheumatology criteria were enrolled as the case group. Age- and body mass index-matched data were obtained from 122 control subjects enrolled during visit for a regular health check-up. Hair minerals were analyzed and compared between the two groups. The mean age was 43.7 yr. General characteristics were not different between the two groups. Fibromyalgia patients showed a significantly lower level of calcium (775 microg/g vs 1,093 microg/g), magnesium (52 microg/g vs 72 microg/g), iron (5.9 microg/g vs 7.1 microg/g), copper (28.3 microg/g vs 40.2 microg/g) and manganese (140 ng/g vs 190 ng/g). Calcium, magnesium, iron, and manganese were loaded in the same factor using factor analysis; the mean of this factor was significantly lower in fibromyalgia group in multivariate analysis with adjustment for potential confounders. In conclusion, the concentrations of calcium, magnesium, iron, and manganese in the hair of female patients with fibromyalgia are lower than of controls, even after adjustment of potential confounders.
Adult ; Body Height ; Body Mass Index ; Calcium/analysis ; Female ; Fibromyalgia/*metabolism ; Hair/*chemistry ; Humans ; Iron/analysis ; Magnesium/analysis ; Manganese/analysis ; Metals/*analysis ; Middle Aged

There are inconsistent findings on the effects of vitamin K on bone mineral density (BMD) and undercarboxylated osteocalcin (UcOC). The present intervention study evaluated the effect in subjects over 60-yr-old. The vitamin K group (vitamin K + vitamin D + calcium supplement; 15 mg of vitamin K2 [menatetrenone] three times daily, 400 IU of vitamin D once a day, and 315 mg of calcium twice daily) and the control group (vitamin D + calcium supplement) were randomly assigned. During the six months of treatment, seventy eight women participated (38 in the vitamin K group and 40 in the control group) and 45 women completed the study. The baseline characteristics of study participants did not differ between the vitamin K and the control groups. In a per protocol analysis after 6 months, L3 bone mineral density has increased statistically significantly in the vitamin K group compared to the control group (0.01 +/- 0.03 g/cm2 vs -0.008 +/- 0.04 g/cm2, P = 0.049). UcOC concentration was also significantly decreased in the vitamin K group (-1.6 +/- 1.6 ng/dL vs -0.4 +/- 1.1 ng/dL, P = 0.008). In conclusion, addition of vitamin K to vitamin D and calcium supplements in the postmenopausal Korean women increase the L3 BMD and reduce the UcOC concentration.
Aged ; Bone Density/*drug effects ; Calcium/*administration & dosage ; Dietary Supplements ; Female ; Humans ; Middle Aged ; Osteocalcin/*blood ; Postmenopause ; Republic of Korea ; Vitamin D/*administration & dosage ; Vitamin K/*administration & dosage

Carcinoembryonic antigen (CEA) levels can be affected by many factors and metabolic syndrome is also a candidate. This study examined the relationship between CEA levels and metabolic syndrome using the data of 32,897 healthy Koreans. Fecal occult blood tests were also performed. Subjects with colorectal carcinoma were excluded. Subjects were classified by their smoking status, metabolic syndrome and its components. Prevalence of metabolic syndrome and its all components showed a significant increase according to the quartile of serum CEA concentration (P < 0.001). Increased numbers of metabolic syndrome components showed a positive association with CEA levels (P-trend < 0.001). The odds ratios for the highest CEA quartile vs the lowest serum CEA quartile significantly increased in the presence of metabolic syndrome and its components. After adjusting for age, gender and smoking status, metabolic syndrome, low high density lipoprotein cholesterol and elevated blood pressure had higher odds ratios (OR) of the highest CEA quartile compared with the lowest serum CEA quartile (OR = 1.125, 95% CI = 1.030 to 1.222, P = 0.009; OR = 1.296, 95% CI = 1.195 to 1.405, P < 0.001; OR = 1.334, 95% CI = 1.229 to 1.448, P < 0.001, respectively). These results indicate that metabolic syndrome is associated with CEA value, which may lead to a misunderstanding of the CEA levels.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blood Pressure ; Carcinoembryonic Antigen/*blood ; Child ; Cholesterol, LDL/blood ; Female ; Humans ; Male ; Metabolic Syndrome X/*blood/epidemiology/pathology ; Middle Aged ; Occult Blood ; Odds Ratio ; Prevalence ; Smoking

BACKGROUND: Elevated plasma total homocysteine causes the risk of cardiovascular diseases. By reducing plasma total homocysteine may prevent cardiovascular diseases. Many studies showed that vitamin B12 and folic acid decrease homocysteine level when taken with calcium fortified drinking water. Our aim of this study was to demonstrate the association between plasma homocysteine concentrations and daily calcium intake. METHODS: Among 636 adults aged 40-69 years who visited a health promotion center of a university hospital from May 2006 to April 2007, the study subjects were 567 who completed self-reported questionnaire. Self-reported calcium intake amount and their baseline health questionnaire were obtained. We measured height and weight by physical examination. Through blood test, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, plasma creatinine and homocysteine level were evaluated. RESULTS: The mean daily calcium intake of entire subjects was 770.1 +/- 266.3 mg. The mean plasma homocysteine concentration was 10.6 +/- 4.3 micromol/L. The multiple regression analysis showed significant correlations between plasma homocysteine level and body mass index, plasma creatinine level and calcium intake. Plasma homocysteine level was inversely associated with dietary calcium intake. CONCLUSION: We found the calcium was inversely associated and homocysteine level an independent risk factor of cardiovascular diseases. However, further studies should be established to confirm if greater calcium intake may lower plasma homocysteine level.
Adult ; Aged ; Body Mass Index ; Calcium ; Calcium, Dietary ; Cardiovascular Diseases ; Cholesterol ; Creatinine ; Drinking Water ; Folic Acid ; Health Promotion ; Hematologic Tests ; Homocysteine ; Humans ; Lipoproteins ; Physical Examination ; Plasma ; Risk Factors ; Vitamin B 12

BACKGROUND: The social problems of cigarette smoking and obesity are increasing and they threaten the health and daily life of the both the young and old adults. Therefore, we evaluated the relationship between cigarette smoking and obesity. METHODS: The study subjects were recruited from the middle and high school located in Ansan city. We used the self-questionnaire to evaluate their general information including cigarette smoking at enrollment and 8,589 students informations were gathered. Data were classified into three groups (normal body weight, over weight and obesity). Smoking status was classified into past, current, and non smoker and analyzed the relationship with obesity and some life-style patterns. RESULTS: Body weight and body mass index of the girls were significantly higher in the current smokers (52.4 +/- 12.2 kg, 19.8 +/- 3.5 kg/m2) than in the non-smokers (49.5 +/- 7.7 kg, 19.3 +/- 2.6 kg/m2) and in the boys, body weight was higher in the current smokers (60.3 +/- 10.7 kg, 20.4 +/- 3.1 kg/m2) than in the non-smokers (57.5 +/- 12.1 kg, 20.3 +/- 3.3 kg/m2), which was not significant. The odds ratios of having obesity were 2.33 (P < 0.001; 95% confidence interval [CI], 1.24 to 3.34) in the current smokers and 2.04 (P < 0.001; 95% CI, 1.36 to 4.0) in the past smokers compared with the non-smokers in the girls. In the boys, there were no significance. Also, all students of the dietary pattern (breakfast, fast food, instant noodle, snack, soft drink) were associated with smoking status significantly. CONCLUSION: The current smokers showed higher prevalence of obesity and obesity-related dietary pattern than in the non-smokers. Cigarette smoking may be associated with obesity in the school girls.
Adolescent ; Adult ; Body Mass Index ; Body Weight ; Fast Foods ; Humans ; Life Style ; Obesity ; Odds Ratio ; Prevalence ; Smoke ; Smoking ; Snacks ; Social Problems ; Tobacco Products

BACKGROUND: The social problems of cigarette smoking and obesity are increasing and they threaten the health and daily life of the both the young and old adults. Therefore, we evaluated the relationship between cigarette smoking and obesity. METHODS: The study subjects were recruited from the middle and high school located in Ansan city. We used the self-questionnaire to evaluate their general information including cigarette smoking at enrollment and 8,589 students informations were gathered. Data were classified into three groups (normal body weight, over weight and obesity). Smoking status was classified into past, current, and non smoker and analyzed the relationship with obesity and some life-style patterns. RESULTS: Body weight and body mass index of the girls were significantly higher in the current smokers (52.4 +/- 12.2 kg, 19.8 +/- 3.5 kg/m2) than in the non-smokers (49.5 +/- 7.7 kg, 19.3 +/- 2.6 kg/m2) and in the boys, body weight was higher in the current smokers (60.3 +/- 10.7 kg, 20.4 +/- 3.1 kg/m2) than in the non-smokers (57.5 +/- 12.1 kg, 20.3 +/- 3.3 kg/m2), which was not significant. The odds ratios of having obesity were 2.33 (P < 0.001; 95% confidence interval [CI], 1.24 to 3.34) in the current smokers and 2.04 (P < 0.001; 95% CI, 1.36 to 4.0) in the past smokers compared with the non-smokers in the girls. In the boys, there were no significance. Also, all students of the dietary pattern (breakfast, fast food, instant noodle, snack, soft drink) were associated with smoking status significantly. CONCLUSION: The current smokers showed higher prevalence of obesity and obesity-related dietary pattern than in the non-smokers. Cigarette smoking may be associated with obesity in the school girls.
Adolescent ; Adult ; Body Mass Index ; Body Weight ; Fast Foods ; Humans ; Life Style ; Obesity ; Odds Ratio ; Prevalence ; Smoke ; Smoking ; Snacks ; Social Problems ; Tobacco Products