Mechanism of resistance acquisition and treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children

양현종,송대진,심정연 대한소아청소년과학회 2017 Clinical and Experimental Pediatrics (CEP) Vol.60 No.6

Mycoplasma pneumoniae pneumonia (MPP) is one of the most common forms of community-acquired pneumonia in children and adolescents. Outbreaks of MPP occur in 3- to 7-year cycles worldwide; recent epidemics in Korea occurred in 2006–2007, 2011, and 2015–2016. Although MPP is known to be a mild, self-limiting disease with a good response to macrolides, it can also progress into a severe and fulminant disease. Notably, since 2000, the prevalence of macrolide-resistant MPP has rapidly increased, especially in Asian countries, recently reaching up to 80%–90%. Macrolide-resistant Mycoplasma pneumoniae (MRMP) harbors a point mutation in domain V of 23S rRNA with substitutions mainly detected at positions 2063 and 2064 of the sequence. The excessive use of macrolides may contribute to these mutations. MRMP can lead to clinically refractory pneumonia, showing no clinical or radiological response to macrolides, and can progress to severe and complicated pneumonia. Refractory MPP is characterized by an excessive immune response against the pathogen as well as direct injury caused by an increasing bacterial load. A change of antibiotics is recommended to reduce the bacterial load. Tetracyclines or quinolones can be alternatives for treating MRMP. Otherwise, corticosteroid or intravenous immunoglobulin can be added to the treatment regimen as immunomodulators to downregulate an excessive host immune reaction and alleviate immune-mediated pulmonary injury. However, the exact starting time point, dose, or duration of immunomodulators has not been established. This review focuses on the mechanism of resistance acquisition and treatment options for MRMP pneumonia.

면역조직화학염색법을 이용한 인회충(Ascaris lumbricoides) 충체내의 신경폡타이드의 분포

양현종,백영한 慶熙大學校 醫科大學 1992 慶熙 醫大 論文集 Vol.17 No.1

미세먼지/황사 건강피해 예방 및 권고지침: 천식

양현종,김상헌,장안수,김상훈,송우정,김태범,유영,유진호,윤종서,지혜미,서동인,김철우,예영민 대한의사협회 2015 대한의사협회지 Vol.58 No.11

Particulate matter (PM) and specifically, Asian dust (or yellow dust), have been identified as critical causes of health problems. Recent increases in the levels of ambient PM are closely associated with adverse health effects in susceptible populations, such as the elderly, children, and patients with asthma or allergic disorders, and this is cause for recent concern in Korea. The establishment of strategies for the reduction of ambient PM by the government and industry, the development of practical guidelines and recommendations to protect susceptible individuals, and an action program for implementation in the general population, will be essential to minimize adverse health impacts of PM and yellow dust. However, guidelines for the proper prevention and management of PM/yellow dust-induced effects on asthma are unclear. In the present study, we aimed to develop evidence-based practice guidelines and recommendations for pediatric or adult patients with asthma and for general physicians who care for asthmatic patients, in order to provide protection from adverse health effects of PM exposure.

제주도 고등학교 학생의 톡소포자충 항체 양성률 및 감염 위험요인

양현종,배종면,최현식,황환식,오훈규,윤동헌,홍성철,Yang, Hyun-Jong,Bae, Jong-Myon,Choi, Hyun-Sik,Hwang, Hwan-Sik,Oh, Hoon-Kyu,Yun, Dong-Hyun,Hong, Seong-Chul 대한예방의학회 2000 예방의학회지 Vol.33 No.3

Objectives : To assess the seroprevalence and risk factors of toxoplasmosis in high school students in Cheju Province, Korea. Methods : A total of 4,570 high school students from 18 schools in Cheju Province were investigated for Toxoplasma gondii antibodies(IgG) by enzyme linked immunosorbent assay (ELISA). Risk factors for toxoplasmosis, such as place of residence, type of house, contact with cats and other pets, and rare meat consumption, were examined by questionnaire. Results . The overall antibody positive rate was 5.5% and ranged from 2.6 to 11.5% by school. There was no significant difference between males and females. Statistical analyses of the questionnaire data indicated that the risk factors for seropositivity were: (1) birth place (Cheju/others), (2) place of residence (rural/urban), (3) dietary habits (vegetarian/non vegetarian), (4) eating rare meat, (5) exposure to pets and (6) hepatitis B. Conclusion : We confirmed that the prevalence of the anti-Toxoplasma gondii antibody in a population of high school students in Cheju Province was to the previously reported prevalence.

Unmet Primary Physicians’ Needs for Allergic Rhinitis Care in Korea

양현종,김영효,이보라,공도윤,김동규,김미애,김봉성,김원영,김정희,박양,박소연,배우용,송기재,양민석,이상민,이영목,이현종,조재홍,지혜미,최정희,유영,고영일 대한천식알레르기학회 2017 Allergy, Asthma & Immunology Research Vol.9 No.3

Allergic rhinitis (AR) is one of the most common chronic allergic respiratory diseases worldwide. Various practical guidelines for AR have been developed and updated to improve the care of AR patients; however, up to 40% patients remain symptomatic. The unmet need for AR care is one of the greatest public health problems in the world. The gaps between guideline and real-world practice, and differences according to the region, culture, and medical environments may be the causes of unmet needs for AR care. Because there is no evidence-based AR practical guideline reflecting the Korean particularity, various needs are increasing. The purpose of the study was to evaluate whether existing guidelines are sufficient for AR patient management in real practice and whether development of regional guidelines to reflect regional differences is needed in Korea. A total of 99 primary physicians comprising internists, pediatricians, and otolaryngologists (n=33 for each) were surveyed by a questionnaire relating to unmet needs for AR care between June 2 and June 16 of 2014. Among 39 question items, participants strongly agreed on 15 items that existing guidelines were highly insufficient and needed new guidelines. However, there was some disagreement according to specialties for another 24 items. In conclusion, the survey results demonstrated that many physicians did not agree with the current AR guideline, and a new guideline reflecting Korean particularity was needed.

Efficacy of Probiotic Therapy on Atopic Dermatitis in Children: A Randomized, Double- blind, Placebo-controlled Trial

양현종,민택기,이해원,편복양 대한천식알레르기학회 2014 Allergy, Asthma & Immunology Research Vol.6 No.3

Purpose: To evaluate a therapeutic efficacy of probiotics mixture (probiotics) in the treatment of children with mild-to-moderate atopic dermatitis(AD). Methods: Randomized, double-blind, placebo-controlled, parallel trial with a washout period of 2 weeks and an intervention period for 6 weeks,conducted from November 2010 to October 2011. One hundred children with mild to moderate AD (2-9 years old) were randomly allocated to theprobiotics (Lactobacilluss casei, Lactobacillus rhamnosus, Lactobacillus plantarum, and Bifidobacterium lactis) or placebo groups. The assessment ofefficacy was based on the change in eczema area severity index (EASI), visual analogue scale for pruritus (VASP), fecal cell counts of each strains(log10[cell counts/g stool]), and serum cytokine levels (Interleukin-4 [IL-4]; IL-10; Tumor necrosis factor alpha, [TNF-α]) in weeks 0 and 6. Results: Demographicsand baseline characteristics at the week 0 were not significantly different between the 2 groups. The significant increments in fecal-cellcounts were observed in the probiotcs group at week 6 (P=0.00), while the cytokine levels between the 2 groups were not significantly different inweek 6 (IL-4, P=0.50; IL-10, P=0.58; TNF-α, P=0.82). The probiotics significantly improved clinical severity after 6 weeks’ intervention of probiotics;however, the placebo group also showed significant improvement (EASI; P=0.00, VASP; P=0.00). Conclusions: Our findings showed that probioticssuccessfully colonized in the intestine after 6 weeks’ intervention; nevertheless, we could not find an additional therapeutic or immunomodulatoryeffects on the treatment of AD. Further long-term studies will be necessary to clarify the therapeutic efficacy of probiotics.

가습기살균제 판매중지 전후의 소아 간질성폐렴 발생 양상 추세분석

양현종 환경독성보건학회 2017 한국독성학회 심포지움 및 학술발표회 Vol.2017 No.10

부모화의 두 요인과 대인관계문제의 관계: 자기침묵의 매개효과

양현종,허재홍 한국청소년상담복지개발원 2022 청소년상담연구 Vol.30 No.2

The purpose of this study was to examine the mediating effects of self-silencing on the relationship between two factors of parentification and interpersonal problems. For this purpose, a self-report questionnaire was conducted with 295 college students attending local universities, using scales that measure caregiving, unfiarness, interpersonal problems, and self-silencing. Data were analyzed using SPSS 26.0 and AMOS 26.0. Results are as follows. First, correlation analyses showed that caregiving, unfairness, interpersonal problems, and self-silencing were all significantly positively corrected with one another. Second, caregiving had negative direct effects on interpersonal problems, and self-silencing mediated the relationship between caregiving and interpersonal problems. Third, self-silencing mediated the relationship between unfairness and interpersonal problems. Based on the results of this study, counseling intervention strategies for parentified children who experience interpersonal problems in college were discussed, particularly related to the two factors of parentification, self-silencing, and interpersonal problems. Suggestions for follow-up research were also addressed. 본 연구는 부모화의 두 요인과 대인관계문제의 관계에서 자기침묵의 매개효과를 검증하고자 하였다. 이를 위해 지방 소재 대학에 재학 중인 대학생 295명을 대상으로 부모화, 대인관계문제, 자기침묵을 측정하는 자기보고식 설문지를 실시하고 SPSS 26.0과 AMOS 26.0을 사용하여 분석하였다. 먼저, 상관분석 결과 부모화돌봄, 불공평, 대인관계문제, 자기침묵은 모두 유의한 정적상관을 보였다. 둘째, 부모화돌봄과 대인관계문제의 관계에서 자기침묵이 매개하는지 검증한 결과, 부모화돌봄은 대인관계문제에 부적으로 직접적인 영향이 있었고, 부모화돌봄과 대인관계문제의 관계를 자기침묵이 정적으로 매개하는 비일관적 매개효과가 있었다. 셋째, 불공평과 대인관계문제의 관계에서 자기침묵이 매개하는지 검증한 결과 자기침묵은 불공평과 대인관계문제간의 관계를 부분 매개하였다. 본 연구 결과를 바탕으로 대학생 시기에 대인관계문제를 경험하는 부모화된 자녀를 위한 상담적 개입방법을 부모화의 두 요인과 자기침묵 대인관계문제의 측면에서 논의하였고 후속연구를 위한 제언을 하였다.

진료 현장에서 소아 마이코플라스마 폐렴을 어떻게 치료할 것인가?

양현종 대한 소아알레르기 호흡기학회 2020 Allergy Asthma & Respiratory Disease Vol.8 No.2

. 마크로라이드 내성 소아 마이코플라스마 폐렴의 최선의 치료는 무엇인가? 매 3–4년 주기의 대유행으로 인한 심각한 보건학적 문제 극복을 위해 우리는 무엇을 어떻게 하여야 하는가? 마크로라이드제로 쉽게 치료되던 마이코플라스마 폐렴 치료는 2000년을 기점으로 치료하기 어려운 질환으로 패러다임의 변화를 맞이하고 있다. 마이코플라스마 폐렴은 소아청소년 연령에서 가장 흔한 세균성폐렴으로, 2000년대 이후 전 세계적인 마크로라이드 내성 마이코플라스마 균주의 출현으로 심각한 보건학적 문제가 되고 있다.1 마이코플라스마 폐렴은 일반적으로 생명을 위협하지 않는 경증 질환이나, 직접적인 기도 상피 손상 또는 이차적인 숙주 면역 반응을 통한 과도한 염증 반응을 통해 0.5%–2.0%에서 심각한 질환으로 진행할 수 있다.2 이러한 기전을 기반으로 국내외 치료지침에서는 마크로라이드제를 일차 치료제로, 마크로라이드제에 내성인 중증 폐렴에 한하여 이차적으로 이차 항생제(플루오로퀴놀론제 또는 테트라사이클린제) 또는 코르티코스테로이드제 치료를 권고하고 있다.3

차세대 멀티미디어 서비스를 위한 기술

양현종 대한전자공학회 2015 전자공학회지 Vol.42 No.5