• Journal of Preventive Medicine and Public Health
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• 제36권4호
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• pp.303-313
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• 2003

다이옥신은 단일 화학물질이 아니라 비슷한 화학적 구조와 독성작용을 갖는 화학물질들의 그룹이다. 다이옥신 중에 가장 많은 연구가 이루어졌고 독성도 강한 물질이 2,3,7,8-tetrachlorodibenzo-p-dioxin(TCDD)인데, 다이옥신 혼합체의 독성을 평가할 때는 각 물질 별로 TCDD에 대한 상대독성을 고려하여 독성등가계수(TEQ)라는 지표를 만들어 사용한다. 일반인들의 평균적인 혈중 다이옥신에 대한 기준값은 명확하게 제시되지는 않고 있으나 관련 연구들을 종합할 때 대략 10-20 ppt $I-TEQ_{DF}$ 범위를 일반인의 평균적인 수준으로 볼 수 있다. 오염 가능지역의 주민들의 혈중 다이옥신 값은 지역에 따라 차이가 있으나 대부분 20ppt $I-TEQ_{DF}$ 이상의 값을 나타내고 있으며 특히 오염이 심한 지역의 주민들의 경우에는 직업적인 노출이 없는 일반 주민들임에도 불구하고 혈중 다이옥신 농도가 약 50 ppt $I-TEQ_{DF}$까지 상승할 수 있다. 다이옥신의 건강영향에 관해서는 수많은 역학적 연구들이 수행되었지만 혈액내에서 TCDD를 직접 측정하여 인체 노출을 비교적 정확하게 평가한 사업장 코호트나 세베소 지역 주민 코호트에서 나온 결과들이 보다 많은 신뢰를 받고 있다. 다이옥신 노출에 따른 건강영향은 크게 암발생과 암을 제외한 건강영향으로 구분할 수 있다. 국제암연구기구(IARC)나 미국 환경보호청(EPA) 모두 TCDD를 인체 발암물질로 분류하고 있으나 역학적 증거들이 충분한 상태는 아니다. TCDD를 제외한 나머지 다이옥신에 대해서는 IARC에서 발암성의 증거가 불충분한 물질(Group 3)로 분류하고 있다. 대부분의 장기에서 다이옥신의 건강영향에 대한 조사가 이루어져 왔다. 현재까지 비교적 다이옥신 노출과 관련성이 높은 것으로 평가되고 있는 것은 염소성여드름, 간 효소의 하나인 GGT의 상승, 그리고 생식호르몬의 변화 등이다. 그밖에 지질농도, 당뇨, 면역학적 영향, 심혈관계에 대한 영향, 갑상선기능, 신경계에 대한 영향, 소아 발달에 대한 영향 등에 대해서는 역학 연구들이 일관된 결과를 보여주지 못하고 있기 때문에 계속적인 연구를 필요로 하고 있다. 다이옥신의 독성은 수많은 동물실험을 통해 증명이 되었으나 인간을 대상으로 한 역학적 연구는 아직 기대만큼 명료한 결과들을 제시해주지 못하고 있다. 그러나 IARC나 EPA모두 인체발암물질로 분류하였고 다양한 건강영향에 대한 증거들이 있는 것은 분명한 만큼 다이옥신 노출을 최소화하려는 노력을 게을리 해서는 안 될 것이다.

• 대한치과의사협회지
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• 제51권9호
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• pp.501-510
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• 2013

This paper reviews a current view regarding the association between periodontitis and atherosclerotic cardiovascular diseases (ACVD). Many evidences have suggested that there exist biological mechanisms by which periodontitis can lead to ACVD. Periodontal infection can lead to direct bacterial invasion into endothelial tissues through the blood stream, then the bacteria can activate the host inflammatory response followed by atheroma formation, maturation and exacerbation. Also, chronic periodontal infections may indirectly induce endothelial activation or dysfunction through a state of systemic inflammation as evidenced by elevated plasma acute proteins, IL-6 and fibrinogen as well. There is moderate evidence that periodontal treatment can reduce systemic inflammation and improvement of both clinical surrogate markers. But there is no periodontal intervention study available on primary ACVD prevention. There is consistent and strong epidemiologic evidence, including in vitro, animal and clinical studies, that periodontitis imparts increased risk for future ACVD. However, evidences from intervention trials to date are not sufficient to confirm the multi directional causality of periodontitis in ACVD etiology. Well-designed intervention trials on the impact of periodontal treatment on the prevention of ACVD outcomes are needed.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.156-160
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• 2015

Severe sepsis and septic shock is a life-threatening disease. It is combined with multi-organ failure. In the past decade, early goal directed therapy has been proposed as an effective treatment strategy for better outcome. Recent epidemiologic studies showed that the outcome of sepsis has been improved with the introduction of early goal directed therapy. However, it is unclear which elements of early goal directed therapy contributed to the better outcome. Recent prospective and randomized trials suggested that some elements of early goal directed therapy did not have any effect on the outcome benefit. In this paper, recent articles about early goal directed therapy will be reviewed and the effectiveness of individual elements of early goal directed therapy will be discussed.

• Molecules and Cells
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• 제37권11호
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• pp.777-784
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• 2014

Epidemiologic studies have shown that low-density lipoprotein cholesterol (LDL-C) is a strong risk factor, whilst high-density lipoprotein cholesterol (HDL-C) reduces the risk of coronary heart disease (CHD). Therefore, strategies to manage dyslipidemia in an effort to prevent or treat CHD have primarily attempted at decreasing LDL-C and raising HDL-C levels. Cholesteryl ester transfer protein (CETP) mediates the exchange of cholesteryl ester for triglycerides between HDL and VLDL and LDL. We have published the first report indicating that a group of Japanese patients who were lacking CETP had extremely high HDL-C levels, low LDL-C levels and a low incidence of CHD. Animal studies, as well as clinical and epidemiologic evidences, have suggested that inhibition of CETP provides an effective strategy to raise HDL-C and reduce LDL-C levels. Four CETP inhibitors have substantially increased HDL-C levels in dyslipidemic patients. This review will discuss the current status and future prospects of CETP inhibitors in the treatment of CHD. At present anacetrapib by Merck and evacetrapib by Eli Lilly are under development. By 100mg of anacetrapib HDL-C increased by 138%, and LDL-C decreased by 40%. Evacetrapib 500 mg also showed dramatic 132% increase of HDL-C, while LDL-C decreased by 40%. If larger, long-term, randomized, clinical end point trials could corroborate other findings in reducing atherosclerosis, CETP inhibitors could have a significant impact in the management of dyslipidemic CHD patients. Inhibition of CETP synthesis by antisense oligonucleotide or small molecules will produce more similar conditions to human CETP deficiency and may be effective in reducing atherosclerosis and cardiovascular events. We are expecting the final data of prospective clinical trials by CETP inhibitors in 2015.

• Journal of Korean Neurosurgical Society
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• 제42권3호
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• pp.191-194
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• 2007

Objective : Homeless patients probably have epidemiologic features that are different from those of general population. However, there have been no published articles about clinical characteristics of neurosurgical homeless patients. The authors tried to assess the clinical characteristics and treatment outcome of homeless neurosurgical patients. Methods : We retrospectively reviewed the medical records and radiological films of 76 homeless patients and 72 non-homeless patients following head trauma who were admitted to our neurosurgical department between June 2001 and June 2005. We compared two groups of the patients with the demographics, the clinical and laboratory characteristics. Also, 3D-day mortality was determined according to Glasgow Coma Scale (GCS) score. Results : Age of homeless patients was younger than that of non-homeless patients. Homeless patients had previous craniotomy evidences in skull x-rays more frequently (10.5% vs. 1.4%). Acute subdural hematoma was the most common type of head injury in the two groups. Moderate and severe head injury, based on GCS score on admission was more frequent in homeless patients (64% vs. 39%). Fifty percent of homeless patients underwent operation for traumatic head injury. However, 3D-day mortality according to GCS score was not significantly higher in homeless patients. Conclusion : Most homeless neurological patients were relatively young men. Also, moderate or severe brain injuries were observed more frequently. However, mortality rate of homeless patients in neurosurgical field is not significantly higher in the present study.

• International Journal of Oral Biology
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• 제41권4호
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• pp.217-223
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• 2016

Porphyromonas gingivalis, a foremost periodontal pathogen, has been known to cause periodontal diseases. Epidemiologic evidences have indicated the involvement of P. gingivalis in the development of cardiovascular diseases. In this study, we show that the P. gingivalis lipopolysaccharide increases the mRNA expression and protein secretion of interleukin-6 in vascular smooth muscle cells. We demonstrate that P. gingivalis LPS activates the extracellular signal-regulated kinase 1/2 (ERK1/2), p38 mitogen-activated protein kinase (MAPK), and Akt, which mediate the IL-6 expression in vascular smooth muscle cells. Also, P. gingivalis LPS stimulates the vascular smooth muscle cell migration, which is a critical step for the progression of atherosclerosis. Moreover, neutralization of the IL-6 function inhibits the migration of vascular smooth muscle cells induced by P. gingivalis LPS. Taken together, these results indicate that P. gingivalis LPS promotes the expression of IL-6, which in turn increases the migration of vascular smooth muscle cells.

• Journal of Medicine and Life Science
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• 제17권1호
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• pp.29-32
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• 2020

As respiratory syncytial virus(RSV) is transmitted either via directly contact with an infected case or via indirectly contaminated fomites or skin, the major preventive measures are strict hand hygiene, early detection of transmitted sources, and rapid isolation of RSV patients. Especially early detection of hidden cases is the most critical control measure when an index case was notified in a postpartum center. The Guideline of Korea Centers for Diseases Control and Prevention defines potential contacts in an epidemiologic survey as admitted newborns, parents of index cases, center's workers, and visitors for 10 days before the first diagnosis day of index case. However, it needs to classify potential contacts in more detail in order to conduct a successful survey. Authors conducted to search related literatures and appraise the evidences. Firstly, potential contacts would be classified into RSV-related symptomatic contacts(SxC) and asymptomatic contacts. And then, mother, caring workers, and visitors of the index cases among asymptomatic contacts would be defined as the asymptomatic close contacts(ASCC). Finally, the rest would be defined as the asymptomatic regular contacts(ASRC). The defined test using reverse transcription-PCR is applied to SxC and ASCC, and decision of isolation or regular activities are made according to the results. The rapid antigen detection test kits are applied to ASRC. These suggestions might be helpful to detect hidden cases earlier and prevent a further infection.

• 셀메드
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• 제8권4호
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• pp.20.1-20.5
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• 2018

Cancer is considered one of the deadly diseases in the world. According to WHO cancer now causes more deaths than all coronary heart disease. The incidence and mortality of the worldwide major cancers are now available in the GLOBOCAN series of the International Agency for Research on Cancer. The transition of global demographic and epidemiologic shows that burden of cancer will increase particularly in low and middle income countries, with over 20 million new cancer cases expected annually as early as 2025. Medicinal plants made known to be prospective and useful job for the treatment of several diseases and disorders from prehistoric days to nowadays. One of the commonly used plants, which have supporting evidences from the recent scientific data for the different types of cancers, is Carica papaya. Papaya (Carica papaya) is widely used as folk caloric herbal medicine, being a powerhouse of nutrients and accessible throughout the year. It is a rich source of three powerful antioxidants, the minerals, vitamins and contains high content of fibre. Carica papaya has provided many remedies for various diseases from ancient days to nowadays, and is regarded as a Nutraceutical. Because of this comprehensive medicinal value of Carica papaya, we are trying here to convey the reports studied especially for the anticancer activities of the age-old fruit, which will help researchers to pull in concert data and may be a "lead" for the one of the dangerous disease in the world.