Natural killer T cell and pathophysiology of asthma

장광천 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.2

Natural killer T (NKT) cell is a special type of T lymphocytes that has both receptor of natural killer (NK) cell (NK1.1, CD161c) and T cell (TCR) and express a conserved or invariant T cell receptor called Vα14Jα18 in mice or Va24 in humans. Invariant NKT (iNKT) cell recognizes lipid antigen presented by CD1d molecules. Marine-sponge-derived glycolipid, α- galactosylceremide (α-GalCer), binds CD1d at the cell surface of antigen-presenting cells and is presented to iNKT cells. Within hours, iNKT cells become activated and start to secrete Interleukin-4 and interferon-γ. NKT cell prevents autoimmune diseases, such as type 1 diabetes, experimental allergic encephalomyelitis, systemic lupus erythematous, inflammatory colitis, and Graves' thyroiditis, by activation with α-GalCer. In addition, NKT cell is associated with infectious diseases by mycobacteria, leshmania, and virus. Moreover NKT cell is associated with asthma, especially CD4+ iNKT cells. In this review, I will discuss the characteristics of NKT cell and the association with inflammatory diseases, especially asthma.

가와사끼병에서 혈청 IL-18 수치의 변화

장광천,이승연,김동수 대한 소아알레르기 및 호흡기학회 2001 소아알레르기 및 호흡기학회지 Vol.11 No.2

폐구균의 질병양상 및 항균제 내성률의 변화

장광천,신경미,용동은,이경원,김동수,Jang, Gwang-Cheon,Shin, Kyoung Mi,Yong, Dong-Eun,Lee, Kyung-Won,Kim, Dong-Soo 대한소아감염학회 2003 Pediatric Infection and Vaccine Vol.10 No.1

목 적 : 폐구균은 중이염, 폐렴등의 흔한 원인이며 패혈증 및 뇌수막염 등 중증감염을 일으킬 수 있다. 최근 폐구균의 항균제 내성률이 증가하는 추세를 보이며, 예방접종이 개발되어 우리나라에서도 곧 시행될 전망이다. 이에 본 연구에서는 폐구균에 의한 질병분포 및 내성률에 대한 변화 등을 알아보고자 하였다. 방 법 : 1991년 1월부터 2000년 12월까지 연세대학교 신촌세브란스병원 소아과에서 시행한 배양검사상 폐구균이 확인된 환아 306명을 대상으로 임상양상과 진단명을 의무기록을 통해 후향적으로 조사하였고, 선천성 심질환이나 혈액종양질환을 앓고 있는 환아는 조사대상에서 제외하였다. 월별 빈도와 연도별 내성률의 변화 및 연령에 따른 중증감염의 정도를 비교하였다. 결 과 : 1) 검사 당시 연령은 2개월부터 15세까지의 분포를 보이며 평균연령은 7.9세이었고, 연령별로는 6세 미만이 77%로 대부분을 차지하고 2세 미만이 42%이었다. 남녀 비는 1.6 : 1이었다. 2) 월별 분포는 봄에 해당하는 3월과 4월이 42%로 높았고 여름에 해당하는 8월과 9월이 6%로 낮았다. 3) 질병별로는 폐렴 29.2%, 중이염 19.3%, 패혈증 17.6%, 뇌막염 9.5%순이었고, 연령별 차이는 없었다. 4) 페니실린에 대한 내성률은 1991년 65%에서 2000년에 84%로 점차 증가하는 추세였다. 다제내성의 경우도 1991년 10%에서 2000년 78.3%로 점차 증가하는 추세를 보였다. 결 론 : 6세 미만의 어린 소아에서 중증감염을 일으키는 원인의 하나인 폐구균은 점차 내성률 및 다제내성 빈도가 증가하는 추세로 전국적 조사가 필요하며, 이의 예방을 위해 폐구균의 예방접종에 대한 검토가 필요하다. Purpose : Streptococcus pneumoniae remains a leading cause of meningitis, sepsis, pneumonia, and otitis media in children worldwide. Emergence of drug-resistant organism has substantially complicated the therapy of these infections. This study was conducted to determine the clinical features and changing patterns of antibiotic-resistant rates of Streptococcus pneumoniae. Methods : We have retrospectively examined 306 cases of culture proven patients who were admitted to the Department of Pediatrics, Severance hospital, from the year 1991 to year 2000. The type of culture specimen used, presence of penicillin resistance, characteristics according to various presenting diseases and their prevailing year were also examined. Results : The mean age of cases was 7.9 year and the ratio of male to female was 1.6 : 1. The main age group of pneumococcal infection was under 2 years(42%). Systemic infections associated with pneumococci were sepsis(19.3%) and meningitis(9.5%), while local infections presented as pneumonia(29.2%), otitis media(19.3%), exudative tonsillitis(13.3%), and sinusitis(9.2%) in the order of frequency. Seasonal variation was seen in the incidence of pneumococcal infection: high incidence of infection was seen in Spring(Mar.~Apr; 32%), while the incidence was low during summer(Aug.~Sep.; 6%). Penicillin-resistant rate of pneumococci was steadily on the increase since the year 1991(65%) to year 2000(84%). Conclusion : Antibiotic-resistant pneumococci increased during the past decade. For effective prevention of pneumococcal infections, national survey of pneumococcal infections and expanded use of pneumococcal vaccination would be needed.

한국 아나필락시스의 진료

장광천 ( Gwang Cheon Jang ),장윤석 ( Yoon Seok Chang ),최선희 ( Sun Hee Choi ),송우정 ( Woo Jung Song ),이수영 ( Soo Young Lee ),박해심 ( Hae Sim Park ),강혜련 ( Hye Ryun Kang ),예영민 ( Yeong Min Ye ),진현정 ( Hyun Jung Jin ) 대한천식알레르기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.3

Anaphylaxis is a medical emergency and all healthcare professionals need to be familiar with its diagnosis, acute management, long-term management including prevention of future episodes, and plan for patient education. Correct diagnosis and management for anaphylaxis is critical, but it is not easy in clinical setting. Up to the present, several practical guidelines for anaphylaxis are available for the practitioners. Among them, World Allergy Organization guideline for the assessment and management has recently been released and widely used. In this article, we reviewed and summarized the epidemiology, risk factors, diagnosis, management, prevention, and education based on case reports and studies of anaphylaxis in Korean and other countries. Although there are many controversies, this practical overview for anaphylaxis would provide a clinical guidance for Korean healthcare professionals. (Allergy Asthma Respir Dis 2013;1:181-196)

학동기 및 청소년 천식 소아들의 임상 양상과 천명 시작 시기와의 관련성

장광천 ( Gwang Cheon Jang ),심정연 ( Jung Yeon Shim ),안영민 ( Young Min Ahn ),정진아 ( Jin A Jung ),김성원 ( Sung Won Kim ),정혜리 ( Hai Lee Chung ) 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.5

Purpose: We aimed to investigate the clinical characteristics and their relationship with the onset age of wheeze in school-age children and adolescents with asthma. Methods: Three hundred twenty-six patients, aged 6 to 19 years, diagnosed with asthma at 6 hospitals from Seoul, Gyeonggi, Daegu, and Busan were enrolled. They were categorized into 3 groups by the onset age of wheeze: group A, early onset (age <3 years); group B, preschool onset (age 3-6 years); group C, late onset (age ≥6 years). Clinical characteristics including atopic sensitization, family history, combined allergic diseases, severity of asthma, and influence of asthma on daily life were examined. A history of hospitalization for early lower respiratory infection (LRI) and environmental tobacco smoking were studied and lung function tests were also performed. Results: There was no difference in demographics, prevalence of atopy, combined allergic diseases, and family history of allergy between 3 groups. A history of sever LRI in early life was more common in groups A and B compared with group C. Sensitization to Dermatophagoides pteronyssinus was more prevalent in groups A and B than in group C. Forced expiratory flow between 25% to 75% (FEF25%-75%) was lower in groups A and B than in group C, and methacholine PC20 (provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second) was lowest in group B. Significantly lower FEF25%-75% and methacholine PC20 were observed in the patients who had been hospitalized with LRI in early life. Conclusion: Our study shows significant difference in lung function and atopic sensitization in relation to the onset age of wheeze in school-age children and adolescents with asthma, and suggests that early LRI might contribute to the development of asthma in early life. (Allergy Asthma Respir Dis 2015;3:326-333)

Respiratory Syncytial Virus 재감염에 의한 기도과민성과 기도염증에 대한 Cytosine-phosphate-Guanine Oligodeoxynucleotides의 효과

장광천 ( Gwang Cheon Jang ),이용원 ( Yong Won Lee ),김규언 ( Kyu Earn Kim ),홍천수 ( Chein Soo Hong ),박중원 ( Jung Won Park ) 대한천식알레르기학회 2010 천식 및 알레르기 Vol.30 No.2

Background: Severe respiratory syncytial virus (RSV) infection in neonate has been reported as a risk factor for the development of allergic asthma or early transient wheezing. RSV can induce reinfection by the same strain. Reinfection after neonatal RSV infection can induce eosinophilic inflammation and aggravate airway hyperresponsiveness (AHR) in a BALB/C mouse model. Objective: We evaluated whether cytosine-phosphate- guanine oligodeoxynucleotides (CpG ODNs) administration at initial RSV infection could prevent the aggravation of AHR and eosinophilic inflammation with repeated RSV infection in a mouse model. Method: Mice were infected shortly after birth and were reinfected 5 weeks later by the intranasal administration of RSV (106 pfu) and followed by the assessment of airway function, airway inflammation, and lung histopathology. Phosphorothioate CpG (1,826s; 2 mcg/mouse) was also administered intranasally 2 days after initial RSV infection. Result: Repeated RSV infection induced methacholine (Mch) AHR, eosinophilic inflammation and goblet cell hyperplasia in the control ODN group. CpG ODN administration at initial RSV infection attenuated Mch AHR and eosinophilic inflammation, and decreased levels of IL-13 and IL-5, but increased IFN-γ in BAL fluid and RSV- IgG2a in sera. Conclusion: These findings suggest that CpG ODN can be used to prevent of airway allergic inflammation by RSV reinfection. (Korean J Asthma Allergy Clin Immunol 2010;30:123-130)

한국 아나필락시스의 진료

장광천 ( Gwang Cheon Jang ),장윤석 ( Yoon Seok Chang ),최선희 ( Sun Hee Choi ),송우정 ( Woo Jung Song ),이수영 ( Soo Young Lee ),박해심 ( Hae Sim Park ),강혜련 ( Hye Ryun Kang ),예영민 ( Yeong Min Ye ),진현정 ( Hyun Jung Jin ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1991 소아알레르기 및 호흡기학회지 Vol.1 No.3

Anaphylaxis is a medical emergency and all healthcare professionals need to be familiar with its diagnosis, acute management, longterm management including prevention of future episodes, and plan for patient education. Correct diagnosis and management for anaphylaxis is critical, but it is not easy in clinical setting. Up to the present, several practical guidelines for anaphylaxis are available for the practitioners. Among them, World Allergy Organization guideline for the assessment and management has recently been released and widely used. In this article, we reviewed and summarized the epidemiology, risk factors, diagnosis, management, prevention, and education based on case reports and studies of anaphylaxis in Korean and other countries. Although there are many controversies, this practical overview for anaphylaxis would provide a clinical guidance for Korean healthcare professionals. (Allergy Asthma Respir Dis 2013;1:181-196)

안경원 정기 휴무제 시행에 따른 안경사의 감정조절능력 조사연구

홍경희,장광천,김세진 대한시과학회 2019 대한시과학회지 Vol.21 No.1

Purpose : The purpose of this study was to examine optometrists’ emotional regulation ability, by analyzing the actual condition of optical shops’ regular day off. Methods : The questionnaires about the establishment of optical shops and their enforcement of regular day off were administered to 478 optometrists working in optical shops located in Chungnam and Gangwon areas, from April to December, 2018. Then, a comparative analysis on differences in their emotional labor and burnout, self-care for coping with stress and psychological well-being was conducted. Results : Emotional labor and burnout of employees were more than those of owners, while self-care for coping with stress and psychological well-being of the former were less than those of the latter. Emotional labor and burnout and psychological well-being in some optical shops which enforced regular day off were more than those in others which did not, while self-care for coping with stress in the former was less than that in the former. Conclusion : The enforcement of regular day off decreased the degree of optometrists’ emotional labor and burnout and increased the degree of their self-care for coping with stress and psychological well-being. This study can be usefully used to understand optometrists’ emotional regulation ability and psychological well-being and is thought to contribute to reducing job stress derived from management of optical shops and job performance of optometrists. 목적 : 본 연구의 목적은 안경원 정기 휴무제 실태를 분석하여 안경사의 감정조절능력을 알아보고자 하였다. 방법 : 2018년 4월부터 12월까지 충남과 강원지역 안경원에 근무하는 안경사 478명을 대상으로 안경원 개설유무 및 안경원 정기 휴무제 시행을 설문 조사하였다. 이에 따른 안경사의 감정노동, 스트레스 대처에 대한 자기관리, 심리적 안녕감의 차이를 비교 분석하였다. 결과 : 종사자는 개설자보다 감정노동과 감정소진은 높았고, 스트레스 대처에 대한 자기관리와 심리적 안녕감은 낮게 나타났다. 안경원 정기 휴무제를 시행하지 않는 안경사는 정기 휴무제를 시행하는 안경사보다 감정노동과감정소진이 높았고, 심리적 안녕감과 스트레스 대처에 대한 자기관리는 낮았다. 결론 : 정기 휴무제를 시행하는 안경사는 감정노동, 감정소진이 낮았으며, 스트레스 대처에 대한 자기관리와 심리적 안녕감은 높았다. 본 연구는 안경사의 감정조절능력과 심리적 안녕감을 이해하는데 유용하게 활용될 수 있으며, 향후 안경원 경영 및 안경사 직무수행 시 발생하는 직무스트레스를 줄이는데 기여하리라 생각된다.

복수를 동반한 Epstein-Barr바이러스 연관성 혈구탐식증후군 1례

최예나,장광천,김동수,박영년,Choi, Ye-Na,Jang, Gwang-Cheon,Kim, Dong-Soo,Park, Young-Nyun 대한소아감염학회 2002 Pediatric Infection and Vaccine Vol.9 No.1

저자들은 내원 1개월 전부터의 고열 복통을 주소로 전원되어 복수를 동반한 EBV 연관성 VAHS로 진단된 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Hemophagocytic syndrome(HPS) has four subgroup, sporadic disorder, associated with acute infection, familial form seen in children, and associated with malignant disorders, immunodeficiencies, defective leukocyte function. Histologically, Hemopoietic cells are actively ingested by moncytes/macrophages in various organs, including lymph nodes, bone marrow, liver, and spleen. Epstein-Barr virus(EBV) is now thought to be one of the major causes for the virus-associated hemophagocytic syndrome(VAHS). Epstein-Barr(EB) virus infection is common, with up to 90% of individuals demonstrating positive titiers by age 20. Although elevated liver function tests commonly occur, severe hepatitis is rare. Only seven cases of ascites complicating Epstein-Barr infection are reported, but none clearly demonstrate the abscence of other causes of hepatic dysfunction. We are reporting a case of Epstein-Barr Virus-associated hemophagocytic syndrome with ascites.

안경사의 온라인 보수교육 인식에 관한 연구

김세진,장광천 대한시과학회 2019 대한시과학회지 학술대회 Vol.2019 No.07