Background/Aims: Infliximab (IFX) has proven effective as rescue therapy in steroid-refractory acute severe ulcerative colitis (ASUC), however, the long-term real-world data are scarce. Our study aimed to assess the long-term treatment outcomes of IFX in a real-life cohort. Methods: We established a multicenter retrospective cohort of hospitalized patients with ASUC, who met Truelove and Witt’s criteria and received intravenous corticosteroid (IVCS) or IFX during index hospitalization between 2006 and 2016 in 5 university hospitals in Korea. The cohort was systematically followed up until colectomy, death or last follow-up visit. Results: A total of 296 patients were followed up for a mean of 68.9 ± 44.0 months. During index hospitalization, 49 patients were treated with IFX; as rescue therapy for IVCS failure in 37 and as first-line medical therapy for ASUC in 12. All patients treated with IFX avoided colectomy during index hospitalization. The cumulative rates of rehospitalization and colectomy were 20.4% and 6.1% at 3 months and 39.6% and 18.8% at the end of follow-up, respectively. Patients treated with IFX presented with significantly shorter colectomy-free survival than IVCS responders (P= 0.04, log-rank test). Both cytomegalovirus colitis and Clostridioides difficile infection (CDI) were the significant predictors of colectomy in the overall study cohort (hazard ratios of 6.57 and 4.61, respectively). There were no fatalities. Conclusions Our real-world cohort study demonstrated that IFX is an effective therapeutic option in Korean patients with ASUC, irrespective of IFX indication. Aggressive vigilance for cytomegalovirus colitis and CDI is warranted for hospitalized patients with ASUC.

Background/Aims: Infliximab (IFX) has proven effective as rescue therapy in steroid-refractory acute severe ulcerative colitis (ASUC), however, the long-term real-world data are scarce. Our study aimed to assess the long-term treatment outcomes of IFX in a real-life cohort. Methods: We established a multicenter retrospective cohort of hospitalized patients with ASUC, who met Truelove and Witt’s criteria and received intravenous corticosteroid (IVCS) or IFX during index hospitalization between 2006 and 2016 in 5 university hospitals in Korea. The cohort was systematically followed up until colectomy, death or last follow-up visit. Results: A total of 296 patients were followed up for a mean of 68.9 ± 44.0 months. During index hospitalization, 49 patients were treated with IFX; as rescue therapy for IVCS failure in 37 and as first-line medical therapy for ASUC in 12. All patients treated with IFX avoided colectomy during index hospitalization. The cumulative rates of rehospitalization and colectomy were 20.4% and 6.1% at 3 months and 39.6% and 18.8% at the end of follow-up, respectively. Patients treated with IFX presented with significantly shorter colectomy-free survival than IVCS responders (P= 0.04, log-rank test). Both cytomegalovirus colitis and Clostridioides difficile infection (CDI) were the significant predictors of colectomy in the overall study cohort (hazard ratios of 6.57 and 4.61, respectively). There were no fatalities. Conclusions Our real-world cohort study demonstrated that IFX is an effective therapeutic option in Korean patients with ASUC, irrespective of IFX indication. Aggressive vigilance for cytomegalovirus colitis and CDI is warranted for hospitalized patients with ASUC.

The inhalation of naphthalene used as deodorant balls in public toilets could be an important cancer risk factor. The atmospheric concentration of naphthalene in public toilets (C(in)) was estimated both by a polyurethane foam passive air sampler (PUF-PAS) deployed in nine public toilets in Seoul, Korea and by a steady-state indoor air quality model, including emission estimation using Monte-Carlo simulation. Based on the estimated C(in), cancer risk was also assessed for cleaning workers and the general population. The steady-state C(in) estimated using the estimated emission rate, which assumed that air exchange was the only process by which naphthalene was removed, was much greater than the C(in) value measured using PUF-PAS in nine public toilets, implying the importance of other removal processes, such as sorption to walls and the garments of visitors, as well as decreased emission rate owing to wetting of the naphthalene ball surface. The 95 percentile values of cancer risk for workers based on the estimation by PUF-PAS was 1.6×10⁻⁶, whereas those for the general public were lower than 1×10⁻⁶. The results suggested that naphthalene deodorant balls in public toilets may be an important cancer risk factor especially for the cleaning workers.
Air Pollution, Indoor ; Clothing ; Deodorants ; Inhalation Exposure ; Inhalation ; Korea ; Polyurethanes ; Risk Assessment ; Risk Factors ; Seoul

The inhalation of naphthalene used as deodorant balls in public toilets could be an important cancer risk factor. The atmospheric concentration of naphthalene in public toilets (C(in)) was estimated both by a polyurethane foam passive air sampler (PUF-PAS) deployed in nine public toilets in Seoul, Korea and by a steady-state indoor air quality model, including emission estimation using Monte-Carlo simulation. Based on the estimated C(in), cancer risk was also assessed for cleaning workers and the general population. The steady-state C(in) estimated using the estimated emission rate, which assumed that air exchange was the only process by which naphthalene was removed, was much greater than the C(in) value measured using PUF-PAS in nine public toilets, implying the importance of other removal processes, such as sorption to walls and the garments of visitors, as well as decreased emission rate owing to wetting of the naphthalene ball surface. The 95 percentile values of cancer risk for workers based on the estimation by PUF-PAS was 1.6×10⁻⁶, whereas those for the general public were lower than 1×10⁻⁶. The results suggested that naphthalene deodorant balls in public toilets may be an important cancer risk factor especially for the cleaning workers.
Air Pollution, Indoor ; Clothing ; Deodorants ; Inhalation Exposure ; Inhalation ; Korea ; Polyurethanes ; Risk Assessment ; Risk Factors ; Seoul

The inhalation of naphthalene used as deodorant balls in public toilets could be an important cancer risk factor. The atmospheric concentration of naphthalene in public toilets (C(in)) was estimated both by a polyurethane foam passive air sampler (PUF-PAS) deployed in nine public toilets in Seoul, Korea and by a steady-state indoor air quality model, including emission estimation using Monte-Carlo simulation. Based on the estimated C(in), cancer risk was also assessed for cleaning workers and the general population. The steady-state C(in) estimated using the estimated emission rate, which assumed that air exchange was the only process by which naphthalene was removed, was much greater than the C(in) value measured using PUF-PAS in nine public toilets, implying the importance of other removal processes, such as sorption to walls and the garments of visitors, as well as decreased emission rate owing to wetting of the naphthalene ball surface. The 95 percentile values of cancer risk for workers based on the estimation by PUF-PAS was 1.6×10⁻⁶, whereas those for the general public were lower than 1×10⁻⁶. The results suggested that naphthalene deodorant balls in public toilets may be an important cancer risk factor especially for the cleaning workers.

Oxidative stress was evaluated for anthracene (Ant) and alkyl-Ants (9-methylanthracene [9-MA] and 9,10-dimethylanthracene [9,10-DMA]) in Caenorhabditis elegans to compare changes in toxicity due to the degree of alkylation. Worms were exposed at 1) the same external exposure concentration and 2) the maximum water-soluble concentration. Formation of reactive oxygen species, superoxide dismutase activity, total glutathione concentration, and lipid peroxidation were determined under constant exposure conditions using passive dosing. The expression of oxidative stress-related genes (daf-2, sir-2.1, daf-16, sod-1, sod-2, sod-3 and cytochrome 35A/C family genes) was also investigated to identify and compare changes in the genetic responses of C. elegans exposed to Ant and alkyl-Ant. At the same external concentration, 9,10-DMA induced the greatest oxidative stress, as evidenced by all indicators, except for lipid peroxidation, followed by 9-MA and Ant. Interestingly, 9,10-DMA led to greater oxidative stress than 9-MA and Ant when worms were exposed to the maximum water-soluble concentration, although the maximum water-soluble concentration of 9,10-DMA is the lowest. Increased oxidative stress by alkyl-Ants would be attributed to higher lipid-water partition coefficient and the π electron density in aromatic rings by alkyl substitution, although this supposition requires further confirmation.
Alkylation ; Ants ; Caenorhabditis elegans* ; Caenorhabditis* ; Cytochromes ; Gene Expression ; Glutathione ; Humans ; Lipid Peroxidation ; Oxidative Stress* ; Polycyclic Hydrocarbons, Aromatic ; Reactive Oxygen Species ; Superoxide Dismutase

Oxidative stress was evaluated for anthracene (Ant) and alkyl-Ants (9-methylanthracene [9-MA] and 9,10-dimethylanthracene [9,10-DMA]) in Caenorhabditis elegans to compare changes in toxicity due to the degree of alkylation. Worms were exposed at 1) the same external exposure concentration and 2) the maximum water-soluble concentration. Formation of reactive oxygen species, superoxide dismutase activity, total glutathione concentration, and lipid peroxidation were determined under constant exposure conditions using passive dosing. The expression of oxidative stress-related genes (daf-2, sir-2.1, daf-16, sod-1, sod-2, sod-3 and cytochrome 35A/C family genes) was also investigated to identify and compare changes in the genetic responses of C. elegans exposed to Ant and alkyl-Ant. At the same external concentration, 9,10-DMA induced the greatest oxidative stress, as evidenced by all indicators, except for lipid peroxidation, followed by 9-MA and Ant. Interestingly, 9,10-DMA led to greater oxidative stress than 9-MA and Ant when worms were exposed to the maximum water-soluble concentration, although the maximum water-soluble concentration of 9,10-DMA is the lowest. Increased oxidative stress by alkyl-Ants would be attributed to higher lipid-water partition coefficient and the π electron density in aromatic rings by alkyl substitution, although this supposition requires further confirmation.
Alkylation ; Ants ; Caenorhabditis elegans ; Caenorhabditis ; Cytochromes ; Gene Expression ; Glutathione ; Humans ; Lipid Peroxidation ; Oxidative Stress ; Polycyclic Hydrocarbons, Aromatic ; Reactive Oxygen Species ; Superoxide Dismutase

PURPOSE: We prospectively investigated clinical changes and long-term outcomes after administration of the drugs recommended by the Age-Related Eye Disease Study-2 to patients with intermediate age-related macular degeneration (AMD). METHODS: This prospective multicenter study enrolled 79 eyes of 55 patients taking lutein and zeaxanthin. The primary endpoint was contrast sensitivity; this was checked every 12 months for a total of 36 months after treatment commenced. The secondary endpoints were visual acuity, central macular thickness, and drusen volume; the latter two parameters were assessed using spectral domain optical coherence tomography. RESULTS: The mean patient age was 72.46 ± 7.16 years. Contrast sensitivity gradually improved at both three and six cycles per degree. The corrected visual acuity was 0.13 ± 0.14 logMAR and did not change significantly over the 36 months. Neither the central macular thickness nor drusen volume changed significantly. CONCLUSIONS: Contrast sensitivity markedly improved after treatment, improving vision and patient satisfaction. Visual acuity, central retinal thickness, and drusen volume did not deteriorate. Therefore, progression of AMD and visual function deterioration were halted.
Contrast Sensitivity ; Eye Diseases ; Humans ; Lutein ; Macular Degeneration ; Patient Satisfaction ; Prospective Studies ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Acuity ; Zeaxanthins

BACKGROUND: This study was performed to evaluate the associations between sleep duration and smoked cigarettes per day, prevalence of heavy smoking. METHODS: This study was based on the data of 9,893 subjects who are currently smoking, from the 4th to 6th Korea National Health and Nutrition Examination Survey. Based on appropriate sleep duration from National Sleep Foundation, study subjects were categorized into short, appropriate and over sleep group. Multiple regression analysis was performed to evaluate the association between sleep duration and smoked cigarettes per day, prevalence of heavy smoking. Age, gender, household income, education, marital status, occupation, alcohol use, body weight, hypertension, diabetes mellitus, depression, and level of stress were controlled. RESULTS: Compared with appropriate sleep group, smoked cigarettes per day and prevalence of heavy smoking were higher in short sleep group, and lower in over sleep group. CONCLUSIONS: There is association between sleep duration and smoked cigarettes per day, prevalence of heavy smoking.
Body Weight ; Depression ; Diabetes Mellitus ; Dyssomnias ; Education ; Family Characteristics ; Hypertension ; Korea ; Marital Status ; Nutrition Surveys ; Occupations ; Prevalence ; Smoke ; Smoking ; Tobacco Products

BACKGROUND: This study was performed to evaluate the associations between sleep duration and smoked cigarettes per day, prevalence of heavy smoking. METHODS: This study was based on the data of 9,893 subjects who are currently smoking, from the 4th to 6th Korea National Health and Nutrition Examination Survey. Based on appropriate sleep duration from National Sleep Foundation, study subjects were categorized into short, appropriate and over sleep group. Multiple regression analysis was performed to evaluate the association between sleep duration and smoked cigarettes per day, prevalence of heavy smoking. Age, gender, household income, education, marital status, occupation, alcohol use, body weight, hypertension, diabetes mellitus, depression, and level of stress were controlled. RESULTS: Compared with appropriate sleep group, smoked cigarettes per day and prevalence of heavy smoking were higher in short sleep group, and lower in over sleep group. CONCLUSIONS There is association between sleep duration and smoked cigarettes per day, prevalence of heavy smoking.