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Abstract Background Humidifier disinfectants (HDs) were commonly used household chemicals to prevent microbial growth in a humidifier water tank in South Korea. A growing body of evidence has indicated that its airborne exposure can induce severe lung injury. However, there has been low awareness of other health outcomes in HD users. This study aimed to evaluate health conditions appealed by claimants for compensation in relation with an increased exposure to HD. Methods From survey data of personal HD exposure assessment of claimants for compensation in Korea, we included a total of 4,179 subjects [cases in each dataset were defined by nine reported health conditions, i.e., pneumonia, asthma, cardiovascular disease, respiratory disease, otorhinolaryngologic disease, brain disease (including cerebrovascular disease), dermatological disease, lung cancer, and all cancers]. HD exposures was considered as the following exposure criteria: exposure duration, exposure proximity, exposure direction, chemical type, cumulative exposure time, indoor air concentration, and cumulative exposure level. Logistic regression models were used to evaluate the associations between HD exposure and health conditions. Results After adjusting for sociodemographic and health behavioral factors and other chemical exposures (households, environmental, and occupational exposures), an increase in cumulative HD exposure time was significantly associated with risks of all nine diseases (all p-trends

Background: Insulin resistance and compensatory hyperinsulinemia play a critical role in the development of hyperandrogenism (HA) in polycystic ovary syndrome (PCOS) patients. To the best of our knowledge, however, few studies have determined the optimal fasting insulin cutoff value to predict HA in PCOS patients. Through this study, we aimed to investigate the optimal cutoff values for insulin and homeostatic model assessment for insulin resistance (HOMA-IR) to predict HA in women with PCOS. Methods: One hundred forty-eight women whose menarche occurred over eight years ago and were newly diagnosed with PCOS with irregular menstrual cycles (IM) and polycystic ovaries (PCO) using ultrasound after ruling out other etiologies were enrolled in this study. In this study, participants were categorized into two groups: those with clinical or biochemical HA (the IM/PCO/HA group) and those without HA (the IM/PCO group). To assess the relationship between androgen levels, including total testosterone (TT) and free testosterone (FT), and fasting glucose and insulin levels and HOMA-IR values, we performed correlation analysis using Spearman’s rank correlation coefficient. We used receiver operating characteristic (ROC) analysis to identify the optimal cutoff values for fasting insulin and HOMA-IR to predict HA in PCOS patients. Results: Fasting glucose and insulin levels and HOMA-IR values were significantly different between the IM/PCO/HA and IM/PCO groups. TT and FT levels exhibited significant correlations with fasting glucose and insulin levels and HOMA-IR values. The ROC analysis identified the most suitable fasting insulin cutoff value of 9.85 µU/mL with an area under the ROC curve (AUC) of 0.817 (60.7% sensitivity and 91.3% specificity) for predicting HA in women with PCOS. The ROC analysis also showed a HOMA-IR value of 2.22 as the optimal cutoff value for predicting HA (AUC, 0.820; 60.7% sensitivity, and 92.4% specificity). Conclusions: Our results support the classical concept that hyperinsulinemia contributes to HA in PCOS patients. Women with PCOS with fasting insulin levels of 9.85 µU/mL or higher (approximately ≥10 µU/mL) are strongly suspected to have HA.

Abstract Background Lung disease caused by exposure to chemical substances such as polyhexamethylene guanidine (PHMG) used in humidifier disinfectants (HDs) has been identified in Korea. Several researchers reported that exposure classification using a questionnaire might not correlate with the clinical severity classes determined through clinical diagnosis. It was asserted that the lack of correlation was due to misclassification in the exposure assessment due to recall bias. We identified the cause of uncertainty to recognize the limitations of differences between exposure assessment and clinical outcomes assumed to be true value. Therefore, it was intended to check the availability of survey using questionnaires and required to reduce misclassification error/bias in exposure assessment. Methods HDs exposure assessment was conducted as a face-to-face interview, using a questionnaire. A total of 5245 applicants participated in the exposure assessment survey. The questionnaire included information on sociodemographic and exposure characteristics such as the period, frequency, and daily usage amount of HDs. Based on clinical diagnosis, a 4 × 4 cross-tabulation of exposure and clinical classification was constructed. When the values of the exposure rating minus the clinical class were ≥ 2 and ≤ − 2, we assigned the cases to the overestimation and underestimation groups, respectively. Results The sex ratio was similar in the overestimation and underestimation groups. In terms of age, in the overestimation group, 90 subjects (24.7%) were under the age of 10, followed by 52 subjects (14.2%) in their 50s. In the underestimation group, 195 subjects (56.7%) were under the age of 10, followed by 80 subjects (23.3%) in their 30s. The overestimation group may have already recovered and responded excessively due to psychological anxiety or to receive compensation. However, relatively high mortality rates and surrogate responses observed among those under 10 years of age may have resulted in inaccurate exposure in the underestimation group. Conclusions HDs exposure assessment using a questionnaire might not correlate with adverse health effects due to recall bias and various other causes such as recovery of injury and psychological anxiety. This study revealed exposure misclassification and characteristics affected by HDs and proposed a questionnaire-based exposure assessment methodology to overcome the limitations of past exposure assessment.

(1) Background: Humidifier disinfectant (HD) is a biocidal chemical to keep the water tank inside a humidifier clean. Thousands of Koreans have experienced HD-related lung injuries. Of them, 6.9% were exposed to HD in hospitals. (2) Methods: This study investigated changes of diseases in patients (or caregivers) who experienced HD exposures during hospitalization and also investigated characteristics of hospital exposure using data from all HD-related lung injury enrollment in Korea. (3) Results: Of a total of 162 subjects, 139 subjects were hospitalized for non-lung diseases, and 23 people were hospitalized for lung diseases at the time of hospitalization. During hospital exposure, 99 (71.2%) of those hospitalized with non-lung disease experienced a new-onset of lung disease, and 15 (65.2%) of those hospitalized with lung diseases experienced exacerbation of their existing lung diseases. When we compared their exposure characteristics, those exposed in hospitals (vs. non-hospital, mostly home) were exposed for shorter periods, at closer distances, at higher HD indoor concentrations, constantly all day, and directly in the facial direction. (4) Conclusion: In conclusion, HD exposures in hospital with a high intensity even for a short term were associated with new-onset or exacerbation of lung diseases. Our findings suggest that acute exposures to HD can cause lung diseases.

Objective: Endometrial cancer is the most common gynecologic malignancy worldwide, and lymph node metastasis is a major prognostic factor for patients with this cancer. Mismatch repair (MMR) deficiency is known to play a critical role in the development of endometrial cancer, but its association with lymph node metastasis and recurrence remains unclear. In this study, we aimed to investigate the correlation between MMR status and lymph node metastasis/recurrence rate in endometrial cancer. Methods: We retrospectively analyzed 59 patients with endometrial cancer who underwent surgery and received MMR testing at out institution between 2010 and 2022. Immunohistochemistry was performed to assess the expression of MMR, including MLH1, PMS2, MSH2, and MSH6. Results: Of these patients, 14 (23.7%) had MMR deficiency. The MMR deficient group had a higher proportion of early stage (stage I and II) compared to the MMR proficient group (78.6% vs. 64.4%). However, lymph node metastasis was more common in the MMR deficient group (21.4%) compared to the MMR proficient group (13.3%) (p=0.038). Furthermore, the recurrence rate was higher in the MMR deficient group (21.4% vs. 15.6%). Conclusion: Therefore, MMR status may serve as a useful biomarker to predict the risk of lymph node metastasis and recurrence in patients with endometrial cancer. Based on our findings, knowing the MMR status before surgery may help in determining an appropriate surgical plan, which could potentially improve the prognosis and quality of life of the patients. Further studies with larger sample sizes are needed to validate our findings. [ABSTRACT FROM AUTHOR]