264 research outputs found

    Persistent Effort to Control Infection after Lung Transplantation in Korea

    Get PDF
    ope

    Development and Roll-Out of A Coronavirus Disease 2019 Clinical Pathway for Standardized Qualified Care in Public Hospitals in Korea

    Get PDF
    Despite the coronavirus disease 2019 (COVID-19) vaccination roll-out, variant-related outbreaks have occurred repeatedly in Korea. Although public hospitals played a major role in COVID-19 patients' care, difficulty incorporating evolving COVID-19 treatment guidelines called for a clinical pathway (CP). Eighteen public hospitals volunteered, and a professional review board was created. CPs were formulated containing inclusion/exclusion criteria, application flow charts, and standardized order sets. After CP roll-out, key parameters improved, such as increased patient/staff five-point satisfaction scores (0.41/0.57) and decreased hospital stays (1.78 days)/medical expenses (17.5%). The CPs were updated consistently after roll-out as new therapeutics drugs were introduced and quarantine policies changed.ope

    ํŒŒํ‚จ์Šจ๋ณ‘ ํ™˜์ž์—์„œ ์„ ์กฐ์ฒด์˜ ๋„ํŒŒ๋ฏผ ๊ฐ์†Œ๊ฐ€ ๋น„์šด๋™ ์ฆ์ƒ์— ๊ธฐ์—ฌํ•˜๋Š”๊ฐ€?

    Get PDF
    ์˜๊ณผ๋Œ€ํ•™/์„์‚ฌBackground : Non-motor symptoms (NMS) has been recognized as a key determinant factor for quality of life in Parkinsonโ€™s disease (PD), but the mechanism underlying NMS in PD has not yet been elucidated well. To investigate whether the pattern of striatal dopamine depletion contributes to NMS in PD, we hypothesized that PD patients with greater NMS might have a different pattern of striatal dopamine depletion, particularly the areas other than the posterior putamen, compared to those with less NMS. Methods : We conducted a survey of the degree of NMS (using non-motor symptoms scale, NMSS) in 151 PD patients who had been initially diagnosed at our hospital by dopamine transporter (DAT) scanning, using a [18F] N-(3-Fluoropropyl)-2ฮฒ-carbon ethoxy-3ฮฒ-(4-iodophenyl) nortropane (FP-CIT) PET scan (from March 2009 to June 2013). Results : Patients with a high NMSS score (above the median) had an older age of PD onset (64.9 ยฑ 9.1 vs 61.5 ยฑ 10.1 years, p = 0.034), a higher initial part III of the Unified Parkinson Disease rating scale (UPDRS-motor, assessed in drug-na๏ผŸve state) (26.9 ยฑ 11.7 vs 20.9 ยฑ 10.3, p = 0.003), a higher levodopa- equivalent dose (636.3 ยฑ 293.0 vs 524.4 ยฑ 196.2, p = 0.007), and a greater Beck Depression Inventory (BDI) score (14.7 ยฑ 8.1 vs 11.5 ยฑ 7.5, p = 0.013), compared to those with a low NMSS score. A general linear model showed that patients with a high NMSS score had significantly higher UPDRS-motor score than those with a low score after controlling for onset age, gender, symptom duration, BDI score, and DAT activity in the posterior putamen (p = 0.034). However, DAT activities in 6 striatal subregions and inter-subregional ratios (ISRs) were comparable between the two groups. There were no correlations between subregional DAT activities and NMSS scores (either total or each domain scores), except for the mood/cognition domain score, which was negatively correlated to the anterior putamen/posterior putamen ISR (r = -0.175, p = 0.032). Conclusion : This study demonstrates that the pattern of striatal dopamine depletion does not contribute to the degree of NMS in early PD, although some clinical features are different between the patients with greater NMS and those with less NMS. This study also suggests that patients with less NMS may have a benign course of motor symptom progression, compared to those with more NMS. NMS in PD may be more likely associated with extra-striatal lesions accompanied in PD than striatal dopaminergic deficits.ope

    ๋ถ„์—ด์„ฑ ํšจ๋ชจ์—์„œ Aconitase-2 ๋‹จ๋ฐฑ์งˆ์˜ ๋‹ค์ค‘๊ธฐ๋Šฅ ์—ฐ๊ตฌ

    Get PDF
    ํ•™์œ„๋…ผ๋ฌธ (๋ฐ•์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ์ƒ๋ช…๊ณผํ•™๋ถ€, 2016. 8. ๋…ธ์ •ํ˜œ.Aconitase functions as an enzyme in TCA cycle (Krebs cycle), converting citrate to isocitrate in bacteria and mitochondria of eukaryotes. In many organisms, aconitase serves additional roles, being a nucleic acids binding protein. In mammals and prokaryots, aconitases are known to bind RNA as well. DNA binding has been demonstrated in Saccharomyces cerevisiae. In fission yeast Schizosaccharomyces pombe, the aco2+ gene encodes a fusion protein between aconitase and a putative mitochondrial ribosomal protein bL21 (Mrpl49). In this study, the expression of the aco2+ gene to transcripts and protein products was analyzed. Two types of aco2+ transcripts were generated via alternative poly (A) site selection, producing both a single aconitase domain protein and the fusion form. The bL21-fused aconitase-2 Aco2 protein resides in mitochondria as well as in cytosol and the nucleus. In mitochondria, Aco2 is needed for mitochondrial translation. The viability defect of aco2 mutation was complemented not by the aconitase domain but by the bL21 domain, which enables mitochondrial translation. This suggests that essentiality of Aco2 protein is due to its role in mitochondrial translation. Based on the localization of Aco2 in the nucleus, novel nuclear functions of Aco2 were investigated. There has been a report from genome-wide genetic screenings that aconitase could be involved in RNAi pathway. Intrigued by this observation, involvement of Aco2 in heterochromatin formation in S. pombe was examined. Genetic and physical interaction of Aco2 with heterochromatin assembly factors and its effect on modulating transcription from the centromeric and subtelomeric regions were investigated. Loss of nuclear Aco2 (aco2ฮ”N) restored the defects of RNAi mutants, such as ฮ”ago1 and ฮ”dcr1, in forming heterochromatin in the centromeric region. However, the aco2ฮ”N mutation did not restore the defect of ฮ”chp1. Chp1, a component of RITS (RNA induced transcriptional silencing) complex, directly interacted with Aco2, especially through the chromodomain as monitored by GST pull-down assay. ChIP analysis demonstrated that Chp1 can recruit Aco2 to the centromeric region. RNA-IP assay showed that Aco2 can bind to the centromeric noncoding RNA from the repeat (dg/dh) region in a Chp1-dependent manner. These results support a model that Aco2 binds Chp1 through the chromodomain and deters Chp1 from being recruited to chromosome in an RITS complex-independent manner, and hence inhibits heterochromatin formation. Actually in the aco2ฮ”N mutant, the H3K9me2 level in the centromere core region that does not form heterochromatin is elevated compared to the wild-type cell. Therefore, it can be postulated that Aco2 inhibits Chp1 recruitment where RITS complex does not exist, so that heterochromatin may form in the right place. To modulate centromeric heterochromatin formation, the full-length Aco2 protein with both aconitase and bL21 domains are required as well as the three cysteine residues for [FeS] ligation. Aco2 (aco2ฮ”N) also restored the phenotype of elevated RNA level in ฮ”swi6 mutant, one of the HP1 protein which can bind to H3K9me2. But unlike RNAi mutants, functional heterochromatin was not restored. Even though interaction between Aco2 and Swi6 was not detected by co-IP. It was monitored that Aco2 directly interacted with Swi6 hinge domain by GST pull-down assay. It is known that the hinge domain of Swi6 has RNA binding activity, so there is a possibility that RNA may interfere interaction between Aco2 and Swi6. Actually when RNase was treated in pull-down assay, interaction between two proteins was enhanced, as expected. Aco2 also interacted with Rrp6, a key component of a RNA exosome, that plays a role in supporting transcription of the dg/dh-like repeat-containing tlh1+ gene in the subtelomeric region. Involvement of Aco2 in the heterochromatin formation in the mating type locus has also been examined by monitoring mating type switch. Iodine staining of the homothallic h90 aco2ฮ”N cells resulted in pale color, suggesting that Aco2 may also function in mating type switching, possibly via the heterochromatin formation. Taken together, this study revealed novel functions of Aco2 in the nucleus, related with heterochromatin formation and transcriptional modulation.CHAPTER I. INTRODUCTION 1 I.1. Biology of Schizosaccharomyces pombe 2 I.1.1. The early research and phylogeny of S. pombe 2 I.1.2. Life cycle of S. pombe 3 I.1.3. Cell cycle of S. pombe 5 I.1.4. Genomic information of S. pombe 5 I.2. The citric acid cycle 9 I.3. Dual localization (dual targeting) proteins 13 I.4. Mitochondrial DNA translation 17 I.5. Heterochromatin silencing 20 I.6. Multiple functions of aconitase 24 I.6.1. General function of aconitase 24 I.6.2. Aconitase in mammalian cells 24 I.6.3. Aconitase in budding yeast 28 I.6.4. Aconitase in bacteria 29 CHAPTER II. MATERIALS AND METHODS 33 II.1. Strains and plasmids 34 II.2. Transformation of Escherichia coli and Yeast 34 II.3. Yeast genomic DNA extraction 34 II.4. Analysis of RNA 34 II.4.1. RNA isolation 34 II.4.2. Northern analysis 35 II.4.3. 5 and 3 RACE 35 II.4.4. Quantitative RT-PCR 35 II.4.5. Small RNA extraction 36 II.5. Analysis of Proteins and their interactions 36 II.5.1. Western blot analysis 36 II.5.2. Co-Immunoprecipitation analysis 37 II.5.3. GST-Pull down assay 37 II.6. Fluorescence microscopy 38 II.7. FACS analysis 38 II.8. Cell survival spotting assay 38 II.9. Mitochondrial translation 38 II.10. Chromatin Immunoprecipitation 39 II.11. RNA Immunoprecipitation 40 CHAPTER III. RESULTS & DISCUSSION 47 III.1. Characteristics of S. pombe aconitases 48 III.1.1. Two kinds of aconitases in S. pombe 48 III.1.2. Localization of Aco2 in mitochondria as well as in the cytosol and the nucleus 48 III.1.3. RNAs and Proteins produced from aco2+ gene 52 III.2. Roles of Aco2 in mitochondria 57 III.2.1. Aco2 is essential for cell viability due to the ribosomal protein domain 57 III.2.2. Aco2 is needed for mitochondrial translation 59 III.2.3. Mitochondrial membrane potential is decreased in nmt42 aco2 mutant 63 III.2.4. Aco2 interacts with Aco1 in mitochondria 63 III.3. Roles of Aco2 in the nucleus 67 III.3.1. Aco2 nuclear function is not essential for cell viability 67 III.3.2. Functions of Aco2 in centromeric heterochromatin maintenance 71 III.3.3. Functions of Aco2 in sub-telomeric heterochromatin maintenance 100 III.3.4. Functions of Aco2 in mating type heterochromatin maintenance 107 III.4. Prospects for future studies 109 III.4.1. Roles of Aco2 in mitochondria 109 III.4.2. Roles of Aco2 in the nucleus 109 REFERENCES 111 ๊ตญ๋ฌธ ์ดˆ๋ก 123Docto

    ์„ ๋ฐ•์—์„œ์˜ ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ์— ๊ด€ํ•œ ์—ฐ๊ตฌ

    Get PDF
    ์ด ์—ฐ๊ตฌ์—์„œ๋Š” ํ•ด์‚ฌ๋…ธ๋™ํ˜‘์•ฝ์—์„œ ์ •ํ•œ ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ์™€ ๊ด€๋ จํ•œ ๊ทœ์ •์„ ์กฐ์‚ฌํ•˜์—ฌ ๋ฌธ์ œ์ ์„ ํ™•์ธํ•œ ํ›„ ์šฐ๋ฆฌ๋‚˜๋ผ๋ฅผ ๋น„๋กฏํ•˜์—ฌ ๋…์ผ, ๋…ธ๋ฅด์›จ์ด, ๋ฆฌ๋ฒ ๋ฆฌ์•„ ๋“ฑ์˜ ์Œ์šฉ์ˆ˜ ๊ณต๊ธ‰ ๊ทœ์ •์„ ๋น„๊ต๋ถ„์„ํ•˜์—ฌ ๊ทธ ๊ฒฐ๊ณผ๋กœ์„œ ์šฐ๋ฆฌ๋‚˜๋ผ ์„ ๋ฐ•์—์„œ์˜ ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ์— ๊ด€ํ•œ ๊ฐœ์„ ๋ฐฉ์•ˆ์„ ์ œ์‹œํ•˜์˜€๋‹ค. ๋จผ์ € ๋ฌธ์ œ์ ์„ ์ •๋ฆฌํ•˜๋ฉด ๋‹ค์Œ๊ณผ ๊ฐ™๋‹ค. ๋จผ์ € ์„ ๋ฐ•์—์„œ๋Š” ์Œ์šฉ์ˆ˜๋ฅผ drinking water' ๋˜๋Š” โ€™portable water'๋ผ๋Š” ์šฉ์–ด์™€ fresh water๋ผ๋Š” ๋ง๊ณผ ํ˜ผ๋™๋˜์–ด ์‚ฌ์šฉ๋˜๊ณ  ์žˆ์œผ๋‚˜ ์ด ๋…ผ๋ฌธ์—์„œ๋Š” ์Œ์šฉ์ˆ˜ ์ฆ‰, โ€˜๋จน๋Š” ๋ฌผ(portable water)โ€™์„ โ€˜์Œ์šฉ์„ ๋ชฉ์ ์œผ๋กœ ๋ฌผ๋ฆฌ์ ์ธ ๋ฐฉ๋ฒ•์—์˜ํ•ด ์ฒ˜๋ฆฌ๋œ ํ›„ ์œก์ƒ์œผ๋กœ๋ถ€ํ„ฐ ์Œ์šฉ์ˆ˜ ์ด์†ก์žฅ์น˜๋ฅผ ํ†ตํ•ด ์„ ๋‚ด ์Œ์šฉ์ˆ˜ ์ €์žฅ์†Œ์— ๋ณด๊ด€๋˜์–ด ์ง€๋Š” ๋ฌผโ€™์ด๋ผ๊ณ  ์ •์˜ํ•˜์˜€๋‹ค. ๋‘˜์งธ๋กœ ํ•ด์‚ฌ๋…ธ๋™ํ˜‘์•ฝ ๋ฐ ๊ฐ๊ตญ์˜ ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ ๊ทœ์ •์€ ๋‹ค์Œ๊ณผ ๊ฐ™์ด ์š”์•ฝํ• ์ˆ˜ ์žˆ๋‹ค. ํ•ด์‚ฌ๋…ธ๋™ํ˜‘์•ฝ์—์„œ์˜ ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ์— ๊ด€ํ•œ ๊ทœ์ •์€ WHO์˜ ์ˆ˜์งˆ ๊ธฐ์ค€์„ ๋”ฐ๋ฅด๋„๋ก ํ•˜์˜€์„ ๋ฟ, ๊ฐ ๊ธฐ๊ตญ๋ณ„ ์ˆ˜์งˆ๊ธฐ์ค€์„ ๋ณ„๋„๋กœ ๊ทœ์ •ํ•˜์ง€ ์•Š๊ณ  ์žˆ๋‹ค. ์šฐ๋ฆฌ๋‚˜๋ผ์˜ ๊ฒฝ์šฐ ์„ ์›๋ฒ• ์‹œํ–‰๊ทœ์น™ ์ œ9์กฐ ์ œ2ํ•ญ์— ๋”ฐ๋ฅด๋ฉด ์„ ๋‚ด ์‹๋Ÿ‰ ๋ฐ ์‹์ˆ˜๋Ÿ‰์˜ ๋ณด์œ ๋Ÿ‰, ์ด๋“ค์˜ ๋ณด๊ด€์žฅ์†Œ์™€ ์„ค๋น„์˜ ์œ„์ƒ ์ƒํƒœ ๋“ฑ์„ ๋งค์›” 1ํšŒ ์ ๊ฒ€ํ•˜๊ณ  ๊ทธ ๊ธฐ๋ก์„ ์œ ์ง€โ€ค๊ด€๋ฆฌํ•˜๋„๋ก ๊ทœ์ •ํ•˜๊ณ  ์žˆ์–ด ๊ตฌ์ฒด์ ์ธ ๊ธฐ์ค€์ด ์—†๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ๋…์ผ, ๋…ธ๋ฅด์›จ์ด, ๋ผ์ด๋ฒ ๋ฆฌ์•„์˜ ๊ฒฝ์šฐ์—๋Š” ๊ตฌ์ฒด์ ์ด๊ณ  ํ‘œ์ค€ํ™”๋œ ์ˆ˜์งˆ๊ฒ€์‚ฌ ๊ธฐ์ค€๊ณผ ๋งค๋‰ด์–ผ์„ ํ†ตํ•ด ์„ ๋ฐ•์—์„œ ์‹ค์งˆ์ ์ธ ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ๋ฅผ ํ•˜๊ณ  ์žˆ๋‹ค. ์…‹์งธ๋กœ ์ ๊ฒ€์ฃผ๊ธฐ๋ฅผ ์‚ดํŽด๋ณด๋ฉด ๋…์ผ์˜ ๊ฒฝ์šฐ ์„ ๋ฐ•์— ์ œ๊ณต๋˜๋Š” ์–‘์ด 3ใŽฅ/day์ดํ•˜์ด๋ฉด ์—ฐ 1ํšŒ, 3ใŽฅ/day ์ด์ƒ์ด๋ฉด ๋งค 3๊ฐœ์›”, ๊ทธ๋ฆฌ๊ณ  ์„ ๋ฐ• ์ž์ฒด์ ์œผ๋กœ ์ƒ์‚ฐ๋˜๋Š” ๊ฒƒ์€ ๋งค 6๊ฐœ์›”๋งˆ๋‹ค ์ˆ˜์งˆ ๊ฒ€์‚ฌ๋ฅผ ํ•˜๋„๋ก ๊ทœ์ •ํ•˜๊ณ  ์žˆ๋‹ค. ํ•œํŽธ ๋…ธ๋ฅด์›จ์ด์˜ ๊ฒฝ์šฐ๋Š” ์„ธ๋ถ€ ๊ฒ€์‚ฌํ•ญ๋ชฉ์„ ์ •ํ•˜๊ณ  ์ตœ์†Œ ์ ๊ฒ€์ฃผ๊ธฐ๋ฅผ ๊ตฌ์ฒดํ™”ํ•˜๊ณ  ์žˆ๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ์šฐ๋ฆฌ๋‚˜๋ผ์˜ ๊ฒฝ์šฐ์—๋Š” ๋งค์›” 1ํšŒ ์ด์ƒ ์ ๊ฒ€ํ•˜๊ณ  ๊ทธ ๊ฒฐ๊ณผ๋ฅผ ๊ธฐ๋ก ์œ ์ง€ํ•˜๋„ ๋ก๋งŒ ์ •ํ•˜๊ณ  ์žˆ๋‹ค. ๋„ท์งธ๋กœ ์ ๊ฒ€ํ•ญ๋ชฉ๊ณผ ์žฅ์†Œ๋ฅผ ์‚ดํŽด๋ณด๋ฉด ๋…์ผ๊ณผ ๋…ธ๋ฅด์›จ์ด๋Š” ์Šค์ฝ”ํ”„๋ฅผ 3๊ฐœ๋กœ๊ตฌ๋ถ„ํ•˜์—ฌ ์ ๊ฒ€ํ•˜๊ณ  ์žˆ๊ณ  ๋ผ๋ฒ ๋ฆฌ์•„๋Š” WHO ์ง€์นจ์„ ๋”ฐ๋ฅด๋„๋ก ์ •ํ•˜๊ณ  ์žˆ๋‹ค. ์šฐ๋ฆฌ๋‚˜๋ผ์˜ ๊ฒฝ์šฐ์—๋Š” ์„ ๋‚ด ์‹๋Ÿ‰๊ณผ ์‹์ˆ˜์˜ ๋ณด์œ ๋Ÿ‰, ์‹๋Ÿ‰๊ณผ ์‹์ˆ˜์˜ ์„ ๋‚ด ์ €์žฅ ๋ฐ ์ทจ๊ธ‰์— ์‚ฌ์šฉํ•˜๋Š” ์žฅ์†Œ์™€ ์„ค๋น„์˜ ์œ„์ƒ ๋ฐ ์ž‘๋™ ์ƒํƒœ ๋“ฑ์„ ์ •ํ•˜๊ณ  ์žˆ์„ ๋”ฐ๋ฆ„์ด๋‹ค. ๋‹ค์„ฏ์งธ๋กœ ์šฐ๋ฆฌ๋‚˜๋ผ ์„ ๋ฐ•์—์„œ์˜ ์‹ค๋ฌด์ฐจ์›์˜ ์Œ์šฉ์ˆ˜๊ด€๋ฆฌ์ƒ ๋ฌธ์ œ์ ์„ ์‚ดํŽด๋ณด๋ฉด ๊ตฌ์ œ์ ์ธ ์ ๊ฒ€ ๊ธฐ์ค€ ๋ฏธ๋น„, ์Œ์šฉ์ˆ˜๊ด€๋ฆฌ์— ๋Œ€ํ•œ ์ธ์‹๋ถ€์กฑ, ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ ์ง€์‹์„ ๊ฐ–์ถ˜ ์ธ๋ ฅ์ด ๋ถ€์กฑํ•˜๋‹ค๋Š” ์ ์ด๋‹ค. ๋‹ค์Œ์œผ๋กœ ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ์ƒ์˜ ๊ฐœ์„  ๋ฐฉ์•ˆ์„ ๋‹ค์Œ๊ณผ ๊ฐ™๋‹ค. ์ฒซ์งธ, ์šฐ๋ฆฌ๋‚˜๋ผ์˜ ์Œ์šฉ์ˆ˜์— ๊ด€ํ•œ ๊ทœ์ •์€ ๋‹จ์ˆœํžˆ ๋งค์›” 1ํšŒ ์ด์ƒ ์ ๊ฒ€ํ•˜๊ณ  ๊ทธ ๊ธฐ๋ก์„ ์œ ์ง€ ๊ด€๋ฆฌํ•˜๋„๋ก ๊ทœ์ •ํ•˜๊ณ  ์žˆ๋Š”๋ฐ ์Œ์šฉ์ˆ˜ ์ ๊ฒ€์ฃผ๊ธฐ, ์ ๊ฒ€ํ•ญ๋ชฉ, ์ ๊ฒ€ ์žฅ์†Œ ๋“ฑ์— ๋Œ€ํ•œ ๊ตฌ์ฒด์ ์ธ ๊ทœ์ •์ด ํ•„์š”ํ•˜๋‹ค. ์ ์–ด๋„ WHO๊ฐ€ ์ •ํ•˜๋Š” ๋‚ด์šฉ์œผ๋กœ ๊ทœ์ •์„ ๊ฐœ์ •ํ•  ํ•„์š”๊ฐ€ ์žˆ๋‹ค. ๋‘˜์งธ, ์„ ๋ฐ•์—์„œ ์Œ์šฉ์ˆ˜๋ฅผ ๊ด€๋ฆฌํ•˜๊ธฐ ์œ„ํ•ด์„œ๋Š” ํ‘œ์ค€ํ™”๋œ ๋งค๋‰ด์–ผ ํ˜น์€ ์ง€์นจ์ดํ•„์š”ํ•˜๊ณ  ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ์™€ ๊ด€๋ จํ•œ ์ฒด๊ณ„์ ์ธ ๊ต์œก์ด ํ•„์š”ํ•˜๋‹ค. ๋งค๋‰ด์–ผ์„ ํ†ตํ•˜์—ฌ ์Œ์šฉ์ˆ˜๋ฅผ ๋ณด๋‹ค ํšจ๊ณผ์ ์ด๋ฉด์„œ ์ฒด๊ณ„์ ์œผ๋กœ ๊ด€๋ฆฌํ•  ์ˆ˜ ์žˆ๋‹ค. ์ด ๋งค๋‰ด์–ผ์—๋Š”์ ๊ฒ€ํ•ญ๋ชฉ, ์ ๊ฒ€ ์žฅ์†Œ, ํ•ญ๋ชฉ๋ณ„ ์ ๊ฒ€ ์ฃผ๊ธฐ ๋“ฑ์ด ์ƒ์„ธํ•˜๊ฒŒ ์ œ์‹œ๋˜์–ด์•ผ ํ•œ๋‹ค. ์…‹์งธ ์„ ๋ฐ•์—์„œ ํšจ์œจ์ ์œผ๋กœ ์Œ์šฉ์ˆ˜๋ฅผ ๊ด€๋ฆฌํ•˜๊ธฐ ์œ„ํ•ด์„œ๋Š” ์Œ์šฉ์ˆ˜ ๊ฐ์‹œ์‹œ์Šคํ…œ์„ ๋„์ž…ํ•˜๊ณ  Portable Water Test Kits๋ฅผ ์ ๊ทน์ ์œผ๋กœ ํ™œ์šฉํ•  ํ•„์š”๊ฐ€ ์žˆ๋‹ค. ์Œ์šฉ์ˆ˜ ๊ฐ์‹œ ์‹œ์Šคํ…œ์€ ์กฐ์ž‘ ์ค‘ ๊ฐ์‹œ, ๊ฒ€์ฆ ๊ฐ์‹œ๋ฅผ ๊ตฌ๋ถ„ํ•˜์—ฌ ์‹œํ–‰ํ•œ๋‹ค. ์œ„์™€ ๊ฐ™์€ ๊ฐœ์„ ์„ ํ†ตํ•˜์—ฌ ๋‹ค์Œ๊ณผ ๊ฐ™์€ ๊ธฐ๋Œ€ํšจ๊ณผ๊ฐ€ ์˜ˆ์ƒ๋œ๋‹ค. ๊ฐ ํ•ญ๋ชฉ๋ณ„ ์ƒ˜ํ”Œ๋ง ์žฅ์†Œ์™€ ์ ๊ฒ€ ์ฃผ๊ธฐ, ํ—ˆ์šฉ์น˜๋ฅผ ๋ช…ํ™•ํžˆ ํ•จ์œผ๋กœ์จ ์†Œ์ •์˜ ์ „๋ฌธ์ ์ธ ๊ต์œก์„๋ฐ›์€ ์‚ฌ๋žŒ์ด ์†์‰ฝ๊ฒŒ ๊ฒ€์‚ฌ๊ฐ€ ๊ฐ€๋Šฅํ•˜๋‹ค. ํŠนํžˆ Portable Water Test Kits์˜ ๋„์ž…์œผ๋กœ ์„ ๋ฐ•์—์„œ ์†Œ์ •์˜ ๊ต์œก์„ ๋ฐ›์€ ์ž๊ฐ€ ์‰ฝ๊ฒŒ ์Œ์šฉ์ˆ˜์— ํฌํ•จ๋œ ๋Œ€์žฅ๊ท ๊ณผ ์žฅ๋‚ด ์„ธ๊ท  ๊ฒ€์‚ฌ๋ฅผ ํ†ตํ•ด ๊ฑด๊ฐ•์— ๋ฐ€์ ‘ํ•œ ์˜ํ–ฅ์„ ๋ผ์น˜๋Š” ๋Œ€์žฅ๊ท  ๊ฒ€์‚ฌ๋ฅผ ํ•  ์ˆ˜ ์žˆ๊ณ  ๋˜ํ•œ, ํœด๋Œ€์šฉ ๋ฐ•ํ…Œ๋ฆฌ์•„ ๋ฐฐ์–‘์„ ํ†ตํ•œ ๊ฒ€์‚ฌ ์‹œ๊ฐ„์„ ๋‹จ์ถ•์‹œํ‚ฌ ์ˆ˜ ์žˆ๋‹ค. PSC๊ฒ€์‚ฌ์— ํšจ์œจ์ ์œผ๋กœ ๋Œ€์‘์ด ๊ฐ€๋Šฅํ•˜๊ณ , ๊ธฐ์กด์— ์œก์ƒ์—์„œ ์ง„ํ–‰๋˜์—ˆ๋˜ ๋ถ€๋ถ„๋“ค์ด ํ˜„์žฅ์—์„œ ์‹ค์‹œ๊ฐ„์œผ๋กœ ์ง„ํ–‰์ด ๋˜๋ฏ€๋กœ ๋น„์šฉ์ ์ธ ์ธก๋ฉด์—์„œ ์ ˆ๊ฐ ํšจ๊ณผ๊ฐ€ ๋ฐœ์ƒํ•˜๊ณ , ์„ ๋ฐ•์— ๊ณต๊ธ‰๋˜๊ฑฐ๋‚˜ ์ €์žฅ ์ค‘์ด๊ฑฐ๋‚˜ ์‚ฌ์šฉ ์ค‘์ธ ์Œ์šฉ์ˆ˜์— ๋Œ€ํ•œ ์˜ค์—ผ๋„์— ๋Œ€ํ•œ ์กฐ๊ธฐ๊ฒฝ๊ณ  ํšจ๊ณผ๋ฅผ ๋ฐœํœ˜ํ•  ์ˆ˜ ์žˆ๋‹ค. ํ•œํŽธ, ๋ณธ ์—ฐ๊ตฌ์˜ ๋ฐฉ๋ฒ•์œผ๋กœ ์„ค์ •ํ•œ ๋ฌธํ—Œ์„ ๊ธฐ์ดˆ๋กœ ํ•˜๋Š” ์ด๋ก ์  ๊ณ ์ฐฐ์„ ์ง„ํ–‰ํ•˜๋ฉด์„œ ์„ ํ–‰์—ฐ๊ตฌ์˜ ๋ถ€์กฑ์œผ๋กœ ์ธํ•ด ๋…์ผ, ๋…ธ๋ฅด์›จ์ด, ๋ผ์ด๋ฒ ๋ฆฌ์•„์˜ ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ ๊ทœ์ •์„ ๊ธฐ์ดˆ๋กœ ์ง„ํ–‰ํ•˜์˜€๋‹ค๋Š” ์ ๊ณผ ์„ ๋ฐ•ํšŒ์‚ฌ๊ฐ€ ์‹ค๋ฌด์ ์œผ๋กœ ๋Œ€์‘ํ•˜๊ธฐ ์œ„ํ•œ ๊ตฌ์ฒด์ ์ธ ๋ฐฉ์•ˆ์„ ์ œ์‹œํ•˜์ง€ ๋ชปํ•œ ๊ฒƒ์€ ์—ฐ๊ตฌ์˜ ํ•œ๊ณ„๋ผ๊ณ  ํ•  ์ˆ˜ ์žˆ๋‹ค. ์ด ์ ์€ ํ–ฅํ›„ ์—ฐ๊ตฌ์—์„œ ๊ฒ€ํ† ํ•˜๊ธฐ๋กœ ํ•œ๋‹ค.๋ชฉ ์ฐจ List of Tables iii List of Figures iii Abstract iv ์ œ 1 ์žฅ ์„œ ๋ก  1.1 ์—ฐ๊ตฌ๋ฐฐ๊ฒฝ๊ณผ ๋ชฉ์  1 1.2 ์„ ํ–‰์—ฐ๊ตฌ์˜ ๊ฒ€ํ† ์™€ ์—ฐ๊ตฌ์˜ ํ•œ๊ณ„ 2 1.3 ์—ฐ๊ตฌ์˜ ๋ฐฉ๋ฒ•๊ณผ ๋‚ด์šฉ 4 ์ œ 2 ์žฅ ์Œ์šฉ์ˆ˜์— ๊ด€ํ•œ ์ด๋ก ์  ๊ณ ์ฐฐ 2.1 ์Œ์šฉ์ˆ˜์˜ ๊ฐœ๋… 6 2.1.1 ์œก์ƒ์—์„œ์˜ ๊ฐœ๋… 6 2.1.2 ์„ ๋ฐ•์—์„œ์˜ ๊ฐœ๋… 7 2.2 WHO ์ˆ˜์งˆ๊ธฐ์ค€๊ณผ ์œ ํ•ด์„ฑ 8 2.2.1 ๋ฏธ์ƒ๋ฌผ์— ์˜ํ•œ ์œ ํ•ด์„ฑ 8 2.2.2 ์œ ํ•ด์˜ํ–ฅ์œ ๊ธฐ๋ฌผ์งˆ์— ์˜ํ•œ ์œ ํ•ด์„ฑ 9 2.2.3. ์‹ฌ๋ฏธ์  ์˜ํ–ฅ๋ฌผ์งˆ์— ์˜ํ•œ ์œ ํ•ด์„ฑ 10 2.2.4. ์œ ํ•ด์˜ํ–ฅ๋ฌด๊ธฐ๋ฌผ์งˆ์— ์˜ํ•œ ์œ ํ•ด์„ฑ 11 2.3 ์šฐ๋ฆฌ๋‚˜๋ผ์™€ ์™ธ๊ตญ์˜ ์ˆ˜์งˆ๊ธฐ์ค€ ๋น„๊ต 11 2.3.1 ์šฐ๋ฆฌ๋‚˜๋ผ์™€ ์™ธ๊ตญ์˜ ๋จน๋Š” ๋ฌผ ์ˆ˜์งˆ๊ธฐ์ค€ ๋น„๊ต 11 2.3.2 ์šฐ๋ฆฌ๋‚˜๋ผ์™€ ์™ธ๊ตญ์˜ ๋จน๋Š” ๋ฌผ ์ˆ˜์งˆ๊ธฐ์ค€ ํ•ญ๋ชฉ ์ˆ˜ ๋น„๊ต 15 ์ œ 3 ์žฅ ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ์— ๊ด€ํ•œ ๋ฌธ์ œ 3.1 ํ•ด์‚ฌ๋…ธ๋™ํ˜‘์•ฝ์— ์ œ์ •๊ณผ ์ฃผ์š”๋‚ด์šฉ 16 3.1.1 ์ œ์ • ๋ฐฐ๊ฒฝ 16 3.1.2 ์ ์šฉ๋Œ€์ƒ ์„ ๋ฐ• 17 3.1.3 ๊ตฌ์„ฑ๊ณผ ํŠน์ง• 18 3.1.4 ํ˜‘์•ฝ์ค€์ˆ˜์™€ ๋ฒ•์ง‘ํ–‰์— ๋”ฐ๋ฅธ ์ฑ…์ž„ 19 3.2 ๊ตญ๊ฐ€๋ณ„ ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ ๊ทœ์ • 22 3.2.1 ํ•œ๊ตญ 22 3.2.2 ๋…ธ๋ฅด์›จ์ด 22 3.2.3 ๋…์ผ 23 3.2.4 ๋ผ์ด๋ฒ ๋ฆฌ์•„ 24 3.3 ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ ๊ทœ์ •์˜ ๋ฌธ์ œ์  25 3.3.1 ์ ๊ฒ€์ฃผ๊ธฐ 25 3.3.2 ์ ๊ฒ€ ํ•ญ๋ชฉ๊ณผ ์žฅ์†Œ 26 3.4 ์‹ค๋ฌด์ฐจ์›์˜ ์Œ์šฉ์ˆ˜๊ด€๋ฆฌ ๋ฌธ์ œ์  27 3.4.1 ๊ตฌ์ฒด์  ์ ๊ฒ€ ๊ธฐ์ค€์˜ ๋ฏธ๋น„ 27 3.4.2 ์Œ์šฉ์ˆ˜๊ด€๋ฆฌ์— ๋Œ€ํ•œ ์ธ์‹์˜ ๋ถ€์กฑ 28 3.4.3 ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ์— ๊ด€ํ•œ ์ง€์‹์„ ๊ฐ–์ถ˜ ์ธ๋ ฅ์˜ ๋ถ€์กฑ 29 ์ œ 4์žฅ ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ์˜ ๋ฌธ์ œ์— ๋Œ€ํ•œ ๊ฐœ์„  ๋ฐฉ์•ˆ 4.1 ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ ๊ทœ์ •์ƒ์˜ ๊ฐœ์„  ๋ฐฉ์•ˆ 31 4.1.1 ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ ๊ทœ์ •์˜ ๊ฐœ์„ ์˜ ํ•„์š”์„ฑ 31 4.1.2 ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ ๊ทœ์ •์˜ ๊ฐœ์„  ๋ฐฉ์•ˆ 32 4.2 ์„ ๋ฐ•์—์„œ ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ ๊ฐœ์„  ๋ฐฉ์•ˆ 35 4.2.1 ๋ชจ๋‹ˆํ„ฐ๋ง์„ ํ†ตํ•œ ์Œ์šฉ์ˆ˜ ๊ด€๋ฆฌ ๋ฐฉ๋ฒ• 35 4.2.2 Portable Water Test Kits์˜ ํ™œ์šฉ 37 4.3 ๊ฐœ์„ ๋ฐฉ์•ˆ์˜ ๊ธฐ๋Œ€ํšจ๊ณผ 39 ์ œ 5์žฅ ๊ฒฐ ๋ก  ๊ฐ ์‚ฌ ์˜ ๊ธ€ 44 ์ฐธ ๊ณ  ๋ฌธ ํ—Œ 4

    Environmental disinfection with photocatalyst as an adjunctive measure to control transmission of methicillin-resistant Staphylococcus aureus: a prospective cohort study in a high-incidence setting

    Get PDF
    BACKGROUND: Environmental disinfection with continuously antimicrobial surfaces could offer superior control of surface bioburden. We sought to decide the efficacy of photocatalyst antimicrobial coating in reducing methicillin-resistant Staphylococcus aureus (MRSA) acquisition in high incidence setting. METHODS: We performed prospective cohort study involving patients hospitalized in medical intensive care unit. A titanium dioxide-based photocatalyst was coated on high touch surfaces and walls. Five months of pre-intervention data were compared with five months of post-intervention data. The incidence rates of multidrug-resistant organism acquisition and the rates of hospital-acquired blood stream infection, pneumonia, urinary tract infection, and Clostridium difficile-associated diseases were compared using Cox proportional hazards regression analysis. RESULTS: In total, 621 patients were included. There was significant decrease in MRSA acquisition rate after photocatalyst coating (hazard ratio, 0.37; 95% confidence interval, 0.14-0.99; pโ€‰=โ€‰0.04). However, clinical identification of vancomycin-resistant Enterococcus spp. and multidrug-resistant Acinetobacter baumannii did not decrease significantly. The hazard of contracting hospital-acquired pneumonia during the intervention period compared to baseline period was 0.46 (95% confidence interval, 0.23-0.94; pโ€‰=โ€‰0.03). CONCLUSIONS: In conclusion, MRSA rate was significantly reduced after photocatalyst coating. We provide evidence that photocatalyst disinfection can be an adjunctive measure to control MRSA acquisition in high-incidence settings. TRIAL REGISTRATION: ISRCTN Registry ( ISRCTN31972004 ). Registered retrospectively on November 19, 2018.ope

    The Practice Guideline for Vaccinating Korean Patients with Autoimmune Inflammatory Rheumatic Disease

    Get PDF
    To develop a clinical practice guideline for vaccination in patients with autoimmune inflammatory rheumatic disease (AIIRD), the Korean College of Rheumatology and the Korean Society of Infectious Diseases developed a clinical practice guideline according to the clinical practice guideline development manual. Since vaccination is unlikely to cause AIIRD or worsen disease activities, required vaccinations are recommended. Once patients are diagnosed with AIIRD, treatment strategies should be established and, at the same time, monitor their vaccination history. It is recommended to administer vaccines when the disease enters the stabilized stage. Administering live attenuated vaccines in patients with AIIRD who are taking immunosuppressants should be avoided. Vaccination should be considered in patients with AIIRD, prior to initiating immunosuppressants. It is recommended to administer influenza, Streptococcus pneumoniae, hepatitis A, hepatitis B, herpes zoster, measles-mumps-rubella virus, human papillomavirus, and tetanus-diphtheria-pertussis vaccines in patients with AIIRD; such patients who planned to travel are generally recommended to be vaccinated at the recommended vaccine level of healthy adults. Those who live in a household with patients with AIIRD and their caregivers should also be vaccinated at levels that are generally recommended for healthy adults.ope

    Safety and immunogenicity of a SARS-CoV-2 recombinant protein nanoparticle vaccine (GBP510) adjuvanted with AS03: A randomised, placebo-controlled, observer-blinded phase 1/2 trial

    Get PDF
    Background: Vaccination has helped to mitigate the COVID-19 pandemic. Ten traditional and novel vaccines have been listed by the World Health Organization for emergency use. Additional alternative approaches may better address ongoing vaccination globally, where there remains an inequity in vaccine distribution. GBP510 is a recombinant protein vaccine, which consists of self-assembling, two-component nanoparticles, displaying the receptor-binding domain (RBD) in a highly immunogenic array. Methods: This randomised, placebo-controlled, observer-blinded phase 1/2 study was conducted to evaluate the safety and immunogenicity of GBP510 (2-doses at a 28-day interval) adjuvanted with or without AS03 in adults aged 19-85 years at 14 hospital sites in Korea. This study was consisted of two stages (stage I, healthy adults aged 19-55 years; stage II, 240 healthy adults aged 19-85 years). Healthy participants who did not previously receive any vaccine within 4 weeks (2 weeks for flu vaccine) prior to the study, no history of COVID-19 vaccination/medication, and were naรฏve to SARS-CoV-2 infection at screening were eligible for the study enrollment. Participants were block-randomized in a 2:2:1 ratio to receive 2 doses of 10 ยตg GBP510 adjuvanted with AS03 (group 1), 10 ยตg unadjuvanted GBP510 (group 2) or placebo intramuscularly in stage I, while they were block-randomized in a 2:2:1:1 ratio to receive 10 ยตg GBP510 adjuvanted with AS03 (group 1), 25 ยตg GBP510 adjuvanted with AS03 (group 3), 25 ยตg unadjuvanted GBP510 (group 4) or placebo in stage II. The primary safety outcomes were solicited and unsolicited adverse events, while primary immunogenicity outcomes included anti-SARS-CoV-2 RBD IgG antibodies; neutralizing antibody responses; and T-cell immune responses. Safety assessment included all participants who received at least 1 dose of study intervention (safety set). Immunogenicity assessment included all participants who completed the vaccination schedule and had valid immunogenicity assessment results without any major protocol deviations (per-protocol set). This study was registered with ClinicalTrials.gov (NCT04750343). Findings: Of 328 participants who were enrolled between February 1 and May 28, 2021, 327 participants received at least 1 dose of vaccine. Each received either 10 ยตg GBP510 adjuvanted with AS03 (Group 1, n = 101), 10 ยตg unadjuvanted GBP510 (Group 2, n = 10), 25 ยตg GBP510 adjuvanted with AS03 (Group 3, n = 104), 25 ยตg unadjuvanted GBP510 (Group 4, n = 51), or placebo (n = 61). Higher reactogenicity was observed in the GBP510 adjuvanted with AS03 groups compared to the non-adjuvanted and placebo groups. The most frequently reported solicited local adverse event (AE) was injection site pain after any vaccination: (88ยท1% in group 1; 50ยท0% in group 2; 92ยท3% in group 3; 66ยท7% in group 4). Fatigue and myalgia were two most frequently reported systemic AEs and more frequently reported in GBP510 adjuvanted with AS03 recipients (79ยท2% and 78ยท2% in group 1; 75ยท0% and 79ยท8% in group 3, respectively) than in the unadjuvanted vaccine recipients (40ยท0% and of 40ยท0% in group 2; 60ยท8% and 47ยท1% in group 4) after any vaccination. Reactogenicity was higher post-dose 2 compared to post-dose 1, particularly for systemic AEs. The geometric mean concentrations of anti-SARS-CoV-2-RBD IgG antibody reached 2163ยท6/2599ยท2 BAU/mL in GBP510 adjuvanted with AS03 recipients (10 ยตg/25 ยตg) by 14 days after the second dose. Two-dose vaccination of 10 ยตg or 25 ยตg GBP510 adjuvanted with AS03 induced high titres of neutralizing antibody via pseudovirus (1369ยท0/1431ยท5 IU/mL) and wild-type virus (949ยท8/861ยท0 IU/mL) assay. Interpretation: GBP510 adjuvanted with AS03 was well tolerated and highly immunogenic. These results support further development of the vaccine candidate, which is currently being evaluated in Phase 3. Funding: This work was supported, in whole or in part, by funding from CEPI and the Bill & Melinda Gates Foundation Investment ID OPP1148601. The Bill & Melinda Gates Foundation supported this project for the generation of IND-enabling data and CEPI supported this clinical study.ope

    ๊ฐ•ํ™” ์™ธํฌ๋ฆฌ ์ƒ‰์ฑ„์‹œ๋ฒ”์‚ฌ์—…์˜ ์ถ”์ง„๊ณผ์ •๊ณผ ์„ฑ๊ณผ

    Get PDF
    ํ™˜๊ฒฝ ์ƒ‰์ฒด๋ฅผ ํ™œ์šฉํ•œ ๊ฒฝ๊ด€์‚ฌ์—…์€ ๋„์‹œํ™˜๊ฒฝ์ •๋น„์˜ ํšจ์œจ์ ์ธ ์ˆ˜๋‹จ ์ค‘์˜ ํ•˜๋‚˜์ด๋‹ค. ๊ฐ ์ง€๋ฐฉ์ž์น˜๋‹จ์ฒด์—์„œ ์ถ”์ง„ํ•˜๊ณ  ์žˆ๋Š” ๊ฐ์ข… ๊ณต๊ณต๋””์ž์ธ์‚ฌ์—…์ด๋‚˜ ๊ฒฝ๊ด€์‚ฌ์—…์€ 10์—ฌ ๊ฐœ ์ด์ƒ์ด๋ฉฐ, ํŠนํ™”๊ฐ€๋กœ ์กฐ์„ฑ, ์•ผ๊ฐ„๊ฒฝ๊ด€ ์กฐ์„ฑ ๋“ฑ์„ ๋น„๋กฏํ•œ ๋‹ค์–‘ํ•œ ๋ถ„์•ผ๋ฅผ ํฌํ•จํ•˜๊ณ  ์žˆ๋‹ค. ํ™˜๊ฒฝ์ƒ‰์ฑ„๋Š” ๋„์‹œํ™˜๊ฒฝ์„ ๊ตฌ์„ฑํ•˜๋Š” ๋‹ค์–‘ํ•œ ๋ถ„์•ผ ๊ฐ€์šด๋ฐ์—์„œ๋„ ์ „๋ฌธ์„ฑ์ด ๋†’๊ณ , ์ทจํ–ฅ ๋“ฑ์˜ ๋‹ค์–‘ํ•œ ์‹ฌ๋ฆฌ์ ์ธ ์š”์ธ์— ์˜ํ•ด ์˜ํ–ฅ์„ ๋ฐ›๋Š” ํŠน์ˆ˜ํ•œ ์„ฑ๊ฒฉ ๋•Œ๋ฌธ์— ๋‹ค๋ฃจ๊ธฐ ์–ด๋ ต๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ์ƒ๋Œ€์ ์œผ๋กœ ์ ์€ ๋น„์šฉ์œผ๋กœ ๋„์‹œํ™˜๊ฒฝ์„ ์ •๋น„ํ•  ์ˆ˜ ์žˆ๊ธฐ ๋•Œ๋ฌธ์— ๊ฐ์ข… ๋„์‹œ๊ตฌ์กฐ๋ฌผ์˜ ์ •๋น„์˜ ์ˆ˜๋‹จ์œผ๋กœ ํ™œ์šฉ๋˜๊ณ  ์žˆ๋‹ค. 2010๋…„ ํ–‰์ •์•ˆ์ „๋ถ€(ํ˜„, ์•ˆ์ „ํ–‰์ •๋ถ€)์˜ ๏ฝขํฌ๋ง๋งˆ์„ํ”„๋กœ์ ํŠธ๏ฝฃ ๋“ฑ ๋ถˆ๋Ÿ‰์ฃผ๊ฑฐ์ง€๋ฅผ ๋Œ€์ƒ์œผ๋กœ ๋ฒฝํ™”๊ทธ๋ฆฌ๊ธฐ ์ง€์› ์‚ฌ์—…๋“ค์ด ํ™œ๋ฐœํ•˜๊ฒŒ ์ง„ํ–‰๋˜๋Š” ๋“ฑ ์ „๊ตญ ๊ฐ์ฒ˜์—์„œ ๋ฒฝํ™”๊ทธ๋ฆฌ๊ธฐ ์‚ฌ์—…์˜ ์œ ํ–‰์„ ๊ฐ€์ ธ์™”๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ๋ฒฝํ™”์‚ฌ์—…์˜ ๊ฒฐ๊ณผ๋กœ ๋งˆ์„ํ™˜๊ฒฝ์ด ์ •๋น„๋˜๊ณ  ๋ฐฉ๋ฌธ๊ฐ์ด ์ฆ๊ฐ€ํ•˜์ง€๋งŒ ์ด๋Ÿฌํ•œ ํ˜„์ƒ์ด ๋งˆ์„์˜ ์†Œ๋“ ์ฆ๊ฐ€์™€ ์—ฐ๊ฒฐ๋˜์ง€ ์•Š๋Š”๋‹ค. ๋˜ํ•œ ํ›ผ์†๋˜๊ธฐ๊ฐ€ ์‰ฝ๊ณ , ๋น„๋ฐ”๋žŒ์— ์น ์ด ๋–จ์–ด์ ธ ๋‚˜๊ฐ€๋Š” ๋“ฑ ์ง€์†์ ์ธ ์œ ์ง€๊ด€๋ฆฌ๊ฐ€ ํ•„์š”ํ•˜๋‹ค. ์ด๋Ÿฌํ•œ ๊ฒฝ์šฐ์—๋Š” ์ฃผ๋ฏผ๋“ค์˜ ์ง€์†์ ์ธ ๊ด€์‹ฌ๊ณผ ์ฐธ์—ฌ๊ฐ€ ํ•„์š”ํ•œ๋ฐ, ๊ด€์—์„œ ์ฃผ๋„ํ•œ ์‚ฌ์—…์ผ ๊ฒฝ์šฐ ์ง€์—ญ์ฃผ๋ฏผ์˜ ์ž๋ฐœ์ ์ธ ์ฐธ์—ฌ๊ฐ€ ์‰ฝ๊ฒŒ ์ด๋ฃจ์–ด์ง€์ง€ ์•Š์œผ๋ฉฐ, ์ง€์ž์ฒด์—์„œ๋„ ์˜ˆ์‚ฐ๋ถ€์กฑ์œผ๋กœ ์ธํ•˜์—ฌ ๊ด€๋ฆฌ์‚ฌ๊ฐ์ง€๋Œ€์— ๋†“์ด๊ฒŒ ๋œ๋‹ค. ๊ฐ•ํ™”๋„ ์™ธํฌ๋ฆฌ ์ƒ‰์ฑ„์‹œ๋ฒ”์‚ฌ์—…์€ ๋ฒฝํ™”์กฐ์„ฑ ์‚ฌ์—…์ด ์•„๋‹ˆ๋ผ ์ƒ‰์ฑ„๋ผ๋Š” ์ˆ˜๋‹จ์„ ํ†ตํ•˜์—ฌ ํ™˜๊ฒฝ๊ตฌ์„ฑ์š”์†Œ๋“ค์„ ์žฌ์กฐํ•ฉํ•˜๊ณ  ์ง€์†๊ฐ€๋Šฅํ•œ ํ™˜๊ฒฝ์„ ์กฐ์„ฑํ•˜๋Š” ์‹œ๋ฒ”์‚ฌ์—…์œผ๋กœ ๋งŒ๋“ค๊ธฐ ์œ„ํ•ด ๋…ธ๋ ฅํ–ˆ๋‹ค. ๋ณธ ๋…ผ๋ฌธ์—์„œ๋Š” ์ด๋Ÿฌํ•œ ์ƒ‰์ฑ„์‹œ๋ฒ”์‚ฌ์—…์˜ ์ถ”์ง„๊ณผ์ •๊ณผ ์ฃผ์š”๋‚ด์šฉ์„ ์‚ดํŽด๋ณด๊ณ  ๊ทธ ์ถ”์ง„๊ณผ์ •์˜ ํŠน์ˆ˜ํ•œ ๋ถ€๋ถ„๋“ค์„ ๋„์ถœํ•˜์—ฌ ์•ž์œผ๋กœ ์ด์™€ ์œ ์‚ฌํ•œ ์‚ฌ์—… ์ถ”์ง„ ์‹œ์— ์ฐธ๊ณ ์ž๋ฃŒ๋กœ ํ™œ์šฉํ•  ์ˆ˜ ์žˆ๋Š” ๊ธฐ์ดˆ์ž๋ฃŒ๋ฅผ ์ œ๊ณตํ•˜๊ณ ์ž ํ•œ๋‹ค

    Efficacy and Gut Dysbiosis of Gentamicin-Intercalated Smectite as a New Therapeutic Agent against Helicobacter pylori in a Mouse Model

    Get PDF
    Helicobacter pylori eradication rate with conventional standard therapy is decreasing owing to antibiotic resistance, necessitating novel antibacterial strategies against H. pylori. We evaluated the efficacy of a gentamicin-intercalated smectite hybrid (S-GM)-based treatment and analyzed fecal microbiome composition in H. pylori-infected mice. To evaluate anti-H. pylori efficacy, mice were divided into eight groups, and H. pylori eradication was assessed by a Campylobacter-like organism (CLO) test and PCR assay of H. pylori in gastric mucosa. One week after H. pylori eradication, pro-inflammatory cytokine levels and atrophic changes in gastric mucosa were examined. Stool specimens were collected and analyzed for microbiome changes. The S-GM-based triple regimen decreased bacterial burden in vivo, compared with that in untreated mice or mice treated with other regimens. The therapeutic reactions in the CLO test from gastric mucosa were both 90% in the standard triple therapy and S-GM therapy group, respectively. Those of H. pylori PCR in mouse gastric mucosa were significantly lower in standard triple therapy and S-GM therapy groups than in the non-treatment group. Toxicity test results showed that S-GM therapy reduced IL-8 level and atrophic changes in gastric mucosa. Stool microbiome analysis revealed that compared with mice treated with the standard triple therapy, mice treated with the S-GM therapy showed microbiome diversity and abundant microorganisms at the phylum level. Our results suggested that S-GM is a promising and effective therapeutic agent against H. pylori infection.ope
    • โ€ฆ
    corecore