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Purpose@#The purpose of this study was to elucidate whether contrast-enhanced ultrasonography (CEUS) can visualize orally administered Sonazoid leaking into the peritoneal cavity in a postoperative stomach leakage mouse model. @*Methods@#Adult female mice (n=33, 9-10 weeks old) were used. Preoperative CEUS was performed after delivering Sonazoid via intraperitoneal injection and the per oral route. A gastric leakage model was then generated by making a surgical incision of about 0.5 cm at the stomach wall, and CEUS with per oral Sonazoid administration was performed. A region of interest was drawn on the CEUS images and the signal intensity was quantitatively measured. Statistical analysis was performed using a mixed model to compare the signal intensity sampled from the pre-contrast images with those of the post-contrast images obtained at different time points. @*Results@#CEUS after Sonazoid intraperitoneal injection in normal mice and after oral administration in mice with gastric perforation visualized the contrast medium spreading within the liver interlobar fissures continuous to the peritoneal cavity. A quantitative analysis showed that in the mice with gastric perforation, the orally delivered Sonazoid leaking into the peritoneal cavity induced a statistically significant (P<0.05) increase in signal intensity in all CEUS images obtained 10 seconds or longer after contrast delivery. However, enhancement was not observed before gastric perforation surgery (P=0.167). @*Conclusion@#CEUS with oral Sonazoid administration efficiently visualized the contrast medium spreading within the peritoneal cavity in a postoperative stomach leakage mouse model.
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Background/Aims@#There have been little research on the cancer risks of patients with Peutz-Jeghers syndrome (PJS) in Korea. We aimed to investigate the clinical features of PJS patients and their cancer incidence rate. @*Methods@#Patients with PJS from nine medical centers were enrolled. In those patients diagnosed with cancer, data obtained included the date of cancer diagnosis, the tumor location, and the cancer stage. The cumulative risks of gastrointestinal cancers and extra-gastrointestinal cancers were calculated using the Kaplan-Meier method. @*Results@#A total of 96 PJS patients were included. The median age at diagnosis of PJS was 23.4 years. Cancer developed in 21 of the 96 patients (21.9%). The age of PJS diagnosis was widely distributed (0.9 to 72.4 years). The most common cancers were gastrointestinal cancer (n = 12) followed by breast cancer (n = 6). The cumulative lifetime cancer risk was calculated to be 62.1% at age 60. The cumulative lifetime gastrointestinal cancer risk was 47.1% at age 70. The cumulative lifetime extra- gastrointestinal cancer risk was 40.3% at age 60. @*Conclusions@#PJS onset may occur at any age and the risks of gastrointestinal and extra-gastrointestinal cancer are high. Thorough surveillance of PJS patients for malignancies is vital.
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Since October 2021, severe acute hepatitis of unknown etiology in pediatric patients has been observed in many countries around the world. Adenovirus (mainly enteric adenovirus) was detected in more than 50% of the cases. Nationwide surveillance on acute hepatitis of unknown etiology in pediatric patients was started in May 2022 in Korea. Taking into account the severity of the illness and the urgency of the epidemiological situation worldwide, we report a summary of changes in adenovirus epidemiology during the past five years and six months in Korea.
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Purpose@#This study aimed to provide a theoretical basis for career anchors of nurses by defining and organizing its concept. @*Methods@#Using the Walker and Avant concept analysis, a total of 29 articles were analyzed through a literature search in this study. @*Results@#The career anchors of nurses are individual career choice motives, a self-concept where in competency and values are harmonized, which act as a desire for growth and development in nursing, and are actions that maintain careers. Additionally, they indicate the direction for achieving individual career goals and act as a core value expected of nurses by nursing organizations, indicating continuous and integrated professional growth and development of the nursing profession. @*Conclusion@#The career anchors of nurses identified in the results contribute to securing patient safety, providing quality care through policies, institutionalizing bases for career development, preventing nurse turnover, and retaining skilled nurses.
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The anti-melanogenic activity of 259 actinomycete strains was tested, and based on the results for the inhibition of mushroom tyrosinase activity and the reduction in melanin content, Micromonospora sp. JCS1 and JCS7 were selected as the strains with the highest anti-melanogenic potential. The activity-guided fractionation of extracts from JCS1 and JCS7 led to the isolation of the dipeptides cyclo(L-Phenyl alanine (Phe)-L-Proline (Pro)) (1) and cyclo(L-Tryptophan (Trp)-L-Proline (Pro)) (2). These two compounds were tested for their inhibition of mushroom tyrosinase by monitoring L-DOPA levels and melanin production. Cyclo(L-Phe-L-Pro) (1) and cyclo(L-Trp-L-Pro) (2) were thus confirmed to have the potential for use in functional whitening cosmetics containing actinomycete-derived secondary metabolites.
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Purpose@#To introduce an intuitive method for measuring conjunctival microvascular blood flow velocity by imaging bulbar conjunctival microvessels using a slit-lamp biomicroscope equipped with a zoom lens and an ultra-high-speed camera. @*Methods@#After obtaining consent from 10 patients (1 male, 9 females) who visited Yeouido St. Mary’s Hospital from August 21, 2020, to June 12, 2021, the patients were examined under a slit lamp microscope equipped with an ultra-high-speed camera and zoom lens. The blood flow in the conjunctival microvessels was photographed. The captured images were analyzed with ImageJ software to measure the blood flow velocity in the conjunctival microvessels, and we investigated whether the blood flow velocity correlated with the vessel diameter and age. @*Results@#The median age of the subjects was 49.0 years. The mean conjunctival blood flow velocity in 53 microvessels was 0.786 ± 0.468 mm/s. The median conjunctival microvascular diameter was 7.06 μm (interquartile range 5.84 to 9.23 μm). The conjunctival microvascular diameter and blood flow velocity were not significantly correlated (Spearman’s p = 0.177), and the subjects’ age and conjunctival microvascular blood flow velocity were also not correlated (Spearman’s p = 0.669). @*Conclusions@#In this study, the blood flow velocity in the bulbar conjunctival microvessels could be measured easily by means of image analysis using a slit-lamp microscope equipped with an ultra-high-speed camera with a zoom lens.
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Objectives@#This study aimed to demonstrate the bone mineral density (BMD) and body composition in postmenopausal women with knee osteoarthritis (OA) who underwent surgical treatment, such as total knee arthroplasty, osteotomy, or meniscectomy. @*Methods@#A total of 254 women with OA aged 50 years who underwent surgical treatment were enrolled in this study. We evaluated obesity-related factors, muscle components, and BMD using dual-energy X-ray absorptiometry. @*Results@#No significant differences were noted in the BMD of the hip joint between the symptomatic side of the leg with knee OA and the contralateral side. However, when comparing the BMD of each component, the results indicated a significantly higher BMD in the obesity group based on body mass index (BMI). When defining sarcopenic obesity (SO) using various indicators of obesity (BMI, the estimated visceral adipose tissue area, android/gynoid ratio, and total body fat percentage), the prevalence of SO in the OA group who underwent surgical treatment ranged from 22.0% to 49.6%. @*Conclusions@#This study investigated obesity-related factors in patients with advanced knee OA who underwent surgery, revealing a high prevalence of overweight/obese individuals, the presence of SO, and a complex relationship between obesity, body composition, and bone density, highlighting the potential protective effects of weight-bearing on bone health while exploring the impact of sarcopenia on bone density differences in the context of OA. Depending on various definitions of obesity, diverse proportions of SO in patients with OA have been observed, and further detailed research is required to understand its impact on the condition.
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Background@#In pediatric patients, the common cold coronavirus (ccCoV) usually causes mild respiratory illness. There are reports of coronavirus causing central nervous system (CNS) infection in experimental animal models. Some immunocompromised patients have also been reported to have fatal CNS infections with ccCoV. The aim of this study was to investigate the clinical characteristics of CNS complications related to ccCoV infection. @*Methods@#From January 2014 to December 2019, a retrospective analysis was performed of medical records from hospitalized patients under 19 years of age whose ccCoV was detected through polymerase chain reaction in respiratory specimens. The CNS complications were defined as clinically diagnosed seizure, meningitis, encephalopathy, and encephalitis. @*Results@#A total of 436 samples from 420 patients were detected as ccCoV. Among the 420 patients, 269 patients were immunocompetent and 151 patients were immunocompromised.The most common type of ccCoV was OC43 (52% in immunocompetent, 37% in immunocompromised). CNS complications were observed in 9.4% (41/436). The most common type of CNS complication was the fever-provoked seizure under pre-existing neurologic disease (42% in immunocompetent and 60% in immunocompromised patients).Among patients with CNS complications, two immunocompetent patients required intensive care unit admission due to encephalitis. Three patients without underlying neurological disease started anti-seizure medications for the first time at this admission. There was no death related to ccCoV infection. @*Conclusion@#ccCoV infection may cause severe clinical manifestations such as CNS complications or neurologic sequelae, even in previously healthy children.
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Roseburia faecis, a butyrate-producing, gram-positive anaerobic bacterium, was evaluated for its usefulness against repeated water avoidance stress (WAS)-induced irritable bowel syndrome (IBS) in a rat model, and the underlying mechanism was explored.We divided the subjects into three groups: one without stress exposure, another subjected to daily 1-hour WAS for 10 days, and a third exposed to the same WAS regimen while also receiving two different R. faecis strains (BBH024 or R22-12-24) via oral gavage for the same 10-day duration. Fecal pellet output (FPO), a toluidine blue assay for mast cell infiltration, and fecal microbiota analyses were conducted using 16S rRNA metagenomic sequencing. Predictive functional profiling of microbial communities in metabolism was also conducted. FPO and colonic mucosal mast cell counts were significantly higher in the WAS group than in the control group (male, P = 0.004; female, P = 0.027). The administration of both BBH024 (male, P = 0.015; female, P = 0.022) and R22-12-24 (male, P = 0.003; female, P = 0.040) significantly reduced FPO. Submucosal mast cell infiltration in the colon showed a similar pattern in males. In case of fecal microbiota, the WAS with R. faecis group showed increased abundance of the Roseburia genus compared to WAS alone. Moreover, the expression of a gene encoding a D-methionine transport system substrate-binding protein was significantly elevated in the WAS with R. faecis group compared to that in the WAS (male, P = 0.028; female, P = 0.025) group. These results indicate that R. faecis is a useful probiotic for treating IBS and colonic microinflammation.
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A chiral derivatization strategy with phenylglycine methyl ester (PGME) was employed to develop a straightforward method to determine the absolute configurations of N,N-dimethyl amino acids. The PGME derivatives were analyzed using liquid chromatography-mass spectrometry to identify the absolute configurations of various N,N-dimethyl amino acids based on their elution time and order. The established method was applied to assign the absolute configuration of the N,N-dimethyl phenylalanine in sanjoinine A (4), a cyclopeptide alkaloid isolated from Zizyphi Spinosi Semen widely used as herbal medicine for insomnia. Sanjoinine A displayed production of nitric oxide (NO) in LPS-activated RAW 264.7 cells.
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A dermatophyte is a zoonotic infection that causes infection on the skin, hair, and nails and is transmitted through contact. The species of Microsporum, Trichophyton, and Epidermophyton are the major dermatophytes that infect humans. Tinea capitis is a dermatophyte infection in the scalp, and it may progress to Kerion celsi, including severe redness, swelling, and pus formation. Kerion celsi is sometimes misdiagnosed as a bacterial infection or a tumor. Trichophyton verrucosum is a zoophilic dermatophyte that mainly causes infection in cattle. It can be spread to dairy farmers or ranchers who have frequent contact with infected cattle. We report a pediatric case who received scalp tumor excision and a split-thickness skin graft for extensive and severe inflammatory scalp tumors that occurred after contact with cattle with ringworm. Finally, the patient was diagnosed with Kerion celsi caused by T. verrucosum infection. This was based on the patient’s medical history, clinical manifestations, and histopathologic findings.
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Purpose@#This study comprehensively examined the experiences of breast cancer survivors' while accessing healthcare facilities for developing nursing intervention programs to enhance and maintain patients' health. @*Methods@#As part of this qualitative study, focus group interviews were conducted with six breast cancer survivors from December 30, 2020, to April 30, 2021. @*Results@#Qualitative data analysis revealed four themes and nine sub-themes using a medical institution after diagnosis in breast cancer survivors. Four themes were ‘burden that individuals still have to bear’, ‘hospital situation that is not patient-centered’, ‘alternative ways to get information and support from the other resources’, and ‘the journey of long-term treatment and management’. Discussion: To improve the quality of life in breast cancer survivors, it is vital to establish medical services that consider the characteristics of each stage of the disease, in addition to support hospitals and social policy programs that can address the unmet needs of the survivors.
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Purpose@#To compare the effects of orthokeratology lens (Ortho‐K lens) and topical cyclopentolate on myopia progression in children. @*Methods@#This retrospective study analyzed the medical records of 36 children who received Ortho‐K lens and 28 who received cyclopentolate (i.e., total of 64 eyes). The following data were recorded: sex, age, age at first intervention, follow‐up duration, and visual acuity and axial length (AL) at the time of first treatment and after 6, 12, and 24 months of treatment. @*Results@#In the Ortho‐K group, the changes of AL significantly decreased by 0.3 ± 0.25 mm at 12 months and 0.52 ± 0.34 mm at 24 months (p for trend < 0.001). In the cyclopentolate group, the changes of AL significantly decreased by 0.36 ± 0.17 mm at 12 months and 0.62 ± 0.29 mm at 24 months (p for trend = 0.022). Compared to the use of cyclopentolate, the use of Ortho‐K lens resulted in smaller changes in AL during follow‐up (p = 0.038). @*Conclusions@#In myopic children, Ortho‐K reduced myopia progression, whereas cyclopentolate significantly less affect myopia progression than Ortho‐K lens.
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Purpose@#This was a descriptive research survey study to assess support for resources, organizational culture, knowledge, and self-confidence in the performance of infection control of multidrug-resistant organism (MDROs) perceived by nurses in long-term care hospitals, and to confirm influencing factors of such perception on self-confidence in performance. @*Methods@#The participants were 192 nurses in 11 long-term care hospitals located in Daejeon Metropolitan City. Data collection was done from January 8 to February 17, 2020. Collected data were analyzed using independent sample t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression analysis with the IBM SPSS statistics 25.0 program. @*Results@#Organizational culture for infection control (β=.22), knowledge on MDROs infection control (β=.19), and experiences in education on MDROs infection control within the last year (β=.15) were found to be the factors most influencing self-confidence in performance of the nurses for MDROs infection control, and explained about 14.5%. @*Conclusion@#In order to increase self-confidence in performance of MDROs infection control, it is suggested a positive organizational culture be developed with regularly monitoring and feedback, and to develop an MDROs infection control theory and practical training intervention program.
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Colonoscopy is commonly used to screen for and diagnose colorectal disease, and adequate bowel preparation is crucial to its quality. As bowel preparation regimens vary, it is important that clinicians understand each and select the proper one for each patient.Accordingly, here we investigated recent studies and describe how to choose the optimal bowel preparation regimen. We detail composition, dosages, efficacy, contraindications, and precautions of commonly used regimens including 4 L polyethylene glycol (PEG), 2 L PEG+ascorbic acid, 1 L PEG+ascorbic acid, trisulfate (oral sulfate solution/ tablets), and sodium picosulfate/magnesium citrate. Here we describe that the most recently introduced 1 L PEG and oral sulfate tablets, which were developed to improve convenience and compliance, differ in composition and efficacy between South Korea and foreign countries. This review presents new evidence of and differences among products to increase clinician understanding.
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Objectives@#The aims of this study were to investigate the expression of Yes-associated protein 1 (YAP1), its prognostic significance, and the correlation between YAP1 and telomerase in various cancers. @*Methods@#The Gene Expression Profiling Interactive Analysis database was used to analyze RNA sequencing data and the survival rate of patients with various cancers in The Cancer Genome Atlas (TCGA) database. PrognoScan was used to analyze the prognostic value of YAP1 expression in various cancers. Tumor Immune Estimation Resource was used to determine the correlation between YAP1 expression and telomerase in various cancer types based on TCGA data. @*Results@#The analysis suggested that YAP1 was differentially expressed between tissues of various cancers and non-tumor tissues. High YAP1 expression was also related to a poor prognosis in adrenocortical carcinoma, bladder urothelial carcinoma, and pancreatic adenocarcinoma. Moreover, YAP1 expression was correlated with the expression of telomerase reverse transcriptase and telomerase RNA component in various cancer types. @*Conclusion@#These results suggest that YAP1 is a potential biomarker with prognostic significance and relevance for oncogene research in various cancer types. The correlation between the expression of YAP1 and telomere-associated genes will help to understand their cancer-promoting mechanisms and interactions.
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Objective@#Osteoporosis is the most common chronic disease that occurs after menopause in women. The purpose of this study was to investigate the current status of use of osteoporosis drugs in Korea by figuring out the size of osteoporosis drugs sold in Korea in 2020. @*Methods@#Data Based on Intercontinental Marketing Services (IMS) data for 5 years from 2016 to 2020, the sales amount of osteoporosis drugs was calculated to determine the usage status of osteoporosis drugs. Specific pharmacologic drugs were analyzed included oral and intravenous bisphosphonate, raloxifene, parathyroid hormone, RANKL inhibitors and others. In November 2019, Romosozumab was newly approved by the Ministry of Food and Drug Safety for use as a treatment for osteoporosis and was included in this analysis. @*Results@#When looking at the market share of non-hormonal drugs in osteoporosis treatment, denosumab, a SERM drug, showed a steep rise from 2% in 2017 to 30% in 2020, and denosumab was the most used drug in 2020. Compared to 2019, the quarterly sales in 2020 also increased by 58.6% from 47.5 billion won to 75.1 billion won compared to the previous year. It was followed by Ibandronate, Alendronate, and Risedronate, and bisphosphonate showed a decreasing trend. In the case of calcitonin and raloxifene, there is a decreasing trend compared to 2016. In the case of newly added Romosozumab, the market share by component was 2%. Although the insurance benefit standard was applied on December 1, 2020 and is not widely used in 2020, considering the mechanism and effect of this drug, it is likely to emerge as the most important treatment for severe osteoporosis patients in the future. @*Conclusion@#Osteoporosis is the most common chronic disease in the elderly, and it will become more serious as we age. However, compared to the seriousness of the disease, there were not many treatments for this disease. As Romosozumab, an anabolic agent, is added as a new treatment for osteoporosis, it will be possible to save many patients from the risk of fracture by using various treatment agents well.
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Objectives@#The aim of this study is to determine whether there is a difference between right and left femur bone mineral density (BMD) in postmenopausal women. @*Methods@#We performed a retrospective chart review of postmenopausal women who underwent bone mineral density (BMD) measurement from 2010 to 2019 at a single center using dual-energy X-ray absorptiometry (DXA). Data, including BMD and T-scores of bilateral hip and lumbar spine, was gathered for all postmenopausal women above the age of 50 years. The continuous variables were expressed as means with standard deviation for normal distribution and analyzed with a two-sample t-test. Multiple regression analysis was used to test the effect of underlying medical conditions on T-score of bilateral hips. For all analyses, a p-value of ＜0.05 was considered significant. @*Results@#346 patients were included in the study with a mean age at imaging of 62 + 9.7 years and body mass index (BMI) of 23.4 + 6.1 kg/m2 . There were no significant differences between right and left femoral BMDs in all patients. There were significant differences in BMD of both total femurs in women in their 60s and women with normal BMD. There was no difference in both femur BMDs between those taking hormone therapy and those not taking hormone therapy. In patients undergoing osteoporosis treatment, there was a difference in the BMD of both femur neck. Calcium and vitamin D intake were not associated with differences between both femur BMD. We found a significant correlation between the BMD measures at lumbar spine and both femur (p ＜ 0.01). @*Conclusion@#There were no significant differences between right and left femoral BMDs in postmenopausal women. Therefore, BMD may be measured at either hip. The correlation of bone density between lumbar spine and femur neck is shown to be statistically meaningful. Based on the knowledge of the correlation coefficients between lumbar spine and femur neck, it seems possible to predict the BMD result of one location through the measurement of another.
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Objective@#The purpose of this study is to determine the risk of breast cancer on women at menopause from postmenopausal hormone therapy using Korea's national health checkup and insurance data.Method: Using the national health checkup and insurance data provided by the National Health Insurance Service (NHIS), we selected women who were over 40 years and confirmed to have menopause during the interview from 2003 to 2011. These women were followed up for breast cancer until December 31, 2019. The control group was defined as women who never used hormone drug during from 2003 to 2019, and the Menopausal Hormone Therapy (MHT) group was defined as women who used menopausal hormone drug for over 6 months. Menopausal hormone drugs were classified tibolone, combined estrogen plus progestin by manufacture (CEPM) (Estradiol Hemihydrate/Drospirenone, Estradiol Hemihydrate/Drospirenone, Estradiol Hemihydrate/Norethisterone Acetate, Cyproterone Acetate/Estradiol Valerate, Estradiol Hemihydrate/Norethisterone Acetate, Estradiol Valerate/Norethisterone Acetate), estrogen (Conjugated Estrogens, Estradiol Valerate, Estradiol Hemihydrate), combined estrogen plus progestin by physician (CEPP) (Estrogen + Progesterone Micronized, Medroxyprogesterone Acetate, Dydrogesterone), Topical estrogen (Estradiol Hemihydrate patch or gel). The variables that may affect breast cancer were adjusted, such as age, body mass index, socioeconomic status, region, Charlson Comorbidity Index, parity, age at menarche, age at menopause, smoking, alcohol, physical exercise, period from menopause to inclusion time. @*Results@#The control group, the tibolone group, CEPM group, the oral estrogen group, CEPP group, and the topical estrogen group were 920,783, 165,222, 107,088, 45,609, 5,633, and 1,729, respectively. In the Cox proportional hazard analysis with adjusted variables, the risk of breast cancer increased in CEPM group. {Hazard ratio [HR] 1.439, 95% confidence interval (CI) 1.374-1.507} However, there were no increase in the risk of breast cancer in the tibolone group, oral estrogen group, CEPP group and the topical estrogen group. (HR 0.968, 95% CI 0.925-1.012) (HR 1.002, 95% CI 0.929-1.081) (HR 0.929, 95% CI 0.75-1.15) (HR 1.139, 95% CI 0.809-1.603) There was no difference in the risk of breast cancer even with doubling the amount of tibolone used. (Over 5 mg: HR 1.306, 95% CI 0.326-5.226) The risk of breast cancer was lower in those in their 50s and 60s than in their 40s. (50s: HR 0.956, 95% CI 0.906-1.008) (60s: HR 0.846, 95% CI 0.776-0.922) As BMI increased, the risk of breast cancer increased. (25-29.9: HR 1.126, 95% CI 1.085-1.169) (30 or more: HR 1.356, 95% CI 1.258-1.462) There was an increased risk of breast cancer when menstrual age was 13 years or older. (HR 1.157, 95% CI 1.109-1.419) A history of smoking increased the risk of breast cancer (HR 1.254, 95% CI 1.109-1.419), and drinking history was not associated with breast cancer. Also, as the inclusion period from menopause increased, the risk of breast cancer decreased. (5-9 years: HR 0.918, 95% CI 0.879-0.959) (10 years or more: HR 0.846, 95% CI 0.791-0.904) @*Conclusion@#CEPM increased the risk of breast cancer. However, tibolone, oral estrogen, CEPP, and topical estrogen were not associated with breast cancer. The risk of breast cancer did not differ depending on the dose of tibolone.
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Menopause is a normal phenomenon in a woman’s life cycle involving multiple health-related issues that contribute to physical instability. Changes in the immune system in postmenopausal women are caused by estrogen deprivation along with age. Increased proinflammatory serum marker levels, cytokine responses in body cells, decreased CD4 T and B lymphocyte levels, and natural killer cell cytotoxic activity are also observed during postmenopause. Moreover, vitamin D, in addition to its classical effects on calcium homeostasis and bone density, plays an important role. Current evidence indicates that vitamin D regulates innate and adaptive immune responses; however, vitamin D deficiency is linked to increased autoimmune activity and infection susceptibility. This review provides an overview of the consequences of immune alterations as an outcome of aging in postmenopausal women and the benefit of vitamin D supplementation.