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Achalasia is a disease characterized by primary esophageal dysmotility, and its etiology remains unknown. Some population-based studies have suggested that achalasia patients have a higher risk of esophageal adenocarcinoma, but most studies have not evaluated the association between achalasia and esophageal squamous cell carcinoma (ESCC). The aims of the study were to examine the possible association between achalasia and ESCC in a national cohort and to compare the rates of ESCC development among achalasia patients and controls. This study was based on a large-scale national cohort consisting of more than 3.7 million patients. All the patients with primary achalasia diagnosis (ICD-10: ICD-10:M3239) or secondary achalasia diagnosis (ICD-10: ICD-10:M3385) identified between 1998 and 2006 from the Taiwan National Health Insurance Research Database were enrolled in this study. The date of diagnosis of achalasia and the date of diagnosis of ESCC were defined as the index date. The ESCC cohort consisted of 462 achalasia patients (ICD-10: ICD-10: C16) who were enrolled in the 1996-2005 period of time. The cancer-free cohort comprised of 3,091,117 subjects identified from the 2001 Registry for Catastrophic Illness Patient Database as the control cohort. The incidence density rate of ESCC for achalasia patients was 2.13 times higher than that for control subjects (95% confidence interval [CI]: 1.79, 2.54). In addition, the cumulative proportion of the patients with ESCC was 1.5% higher in the achalasia cohort than in the control cohort. The subgroup analysis showed that the highest incidence rate of esophageal cancer was observed at year 2005 (1.23, 95% CI: 0.99, 1
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The aim of this study was to assess the effect of several TRO-antagonists on ovulation induction therapy in women with polycystic ovary syndrome (PCOS). A total of 30 women with PCOS participated in the study. They were treated with intranasal (IN) recombinant TRO-antagonist and subcutaneous (SC) TRO-antagonist and followed up for twelve cycles. The primary outcomes were ovulation rate, pregnancy rate and incidence of hyperstimulation syndrome (HSS). Serum LH, FSH, E2 and P levels were evaluated before and during the study period. The secondary outcomes were the endometrial thickness, and measured on ultrasound images by using the transvaginal route. The PCOS group was treated with trospium chloride 0.1% and tibolone 0.5 mg/day and the SC group with dydrogesterone 10 mg/day. The IN group was treated with IN trospium chloride 0.5% and SC dydrogesterone 10 mg/day. SC administration of dydrogesterone was more effective in inducing ovulation than trospium chloride (42.7 vs 15.0%, P = 0.018). There was no significant difference between groups in follicular development, ovulation rate, pregnancy rate and HSS. Serum LH, FSH and E2 levels were significantly lower in the SC group, while P levels were significantly higher in the SC group. The