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문창우 광주가톨릭대학교 신학연구소 2008 神學展望 Vol.- No.163
1899년 제주 지역에 첫 발을 내디딘 선교사들은 제주도에 대한 사전 지식이 없었고, 또한 제주에는 교민촌도 없었기 때문에, 이들은 현지의 실정에 어두운 조건에서 포교에 나설 수밖에 없었다. 그래서 선교사들은 결혼의 문란함과 무속이 만연되어 있는 제주민의 풍속을 야만적인 것으로 여겼다. 그리하여 교회는 이러한 풍속들을 전교에 방해되는 것으로 판단하여 배척하는 데 주력하였다. 김원영 신부는 결국 1900년대 초 천주교 교리에 입각하여 제주도의 여러 풍속을 교정하기 위해 「修身靈藥」이라는 책을 저술하였다. 「修身靈藥」은 제주도에서 행해지던 각종 제례와 미신의 내용을 소개하고, 이를 이단으로 규정하여 교회의 입장에서 서술하고 있다. 그 중에서 「修身靈藥」에 소개된 제사들은 조선시대 이전부터 지속적으로 이어져 내려온 것들이다. 교회가 제주민의 생활 속에 배어 있는 신앙 형태로서의 제사를 모조리 이단으로 배격한다는 것은 문화적 갈등과 충돌을 예견하는 것이었다. 제2차 바티칸 공의회는 선교의 과제를 검토하면서 교회의 모습을 변화시키려 노력해왔다. 선교하는 인간은 육화하신 하느님 때문에 각 문화를 존중하고, 여러 문화 속에서 하느님이 보여주신 표지들을 읽을 수 있어야 한다. 그리고 인간이 하느님과 교류하여 친교를 맺는 것처럼 그 문화와도 교류하여 친교를 맺어야 한다. 예수 그리스도께서 인간 조건을 당신 자신의 것으로 삼아 그 조건에 합치시키신 것처럼, 선교 및 복음화 역시 다른 문화를 자신의 것으로 삼아 그 문화에 자기 자신을 합치시켜야 한다. 이제 천주교회는 무리한 선교를 일삼던 과거의 교회가 아니다. 1990년 기억의 투쟁과 자체 여과를 통해 유연성을 지닌 주체로 변화하고 있다. 그래서 이러한 변화된 태도는 한국 사회에서 천주교에 대한 호감을 갖게 하는 계기가 되었으나 오늘의 현실 안에서 교회의 역할은 아직도 멀기만 하다. 교회는 문화로 개방되어야 한다. 개방이 의미하는 것은 역사 안에서 절대 시간을 향하여 자신을 포괄적으로 여는 것이다. 또 공간 안에서 다양한 문화적 맥락을 향하여, 다양한 인종과 사회 체계와 계층, 그리고 다양한 언어와 표현방식과 남자와 여자로서 부름 받은 모든 인간을 향하여 가능한 한 넓게 여는 것이다. 지역 문화를 존중하지 않고서는 교회가 그곳 문화의 발전에 기여할 수 없다는 것은 당연하다.
병기 Ⅱb 자궁경부암의 방사선치료에서 온열치료 병용의 원격전이에 대한 영향 및 관련인자 분석
문창우 고신대학교 의학부 2000 高神大學校 醫學部 論文集 Vol.15 No.1
Background/Objective This retrospective study was conducted to analyze effect of addition of hyperthermia on distant metastasis and to determine factor affecting distant metastasis in radiotherapy of stage IIb uterine cervical cancer. Methods From May 1992 to Dec. 1996, among patients treated with radio-thermotherapy in stage Ⅱb uterine cervical cancer at department of Radiation Oncology in Kosin University College, 25 patients without evidence of distant metastasis in initial work-ups by physical examination, computed tomography, magnetic resonance imaging, ultrasonography and radiosotope scan were enrolled. The range of age was 33-71 years (median: 52). Radiotherapy used 6-10MV linear accelerator was performed in whole pelvis with 4 portals technique. Total dose administered was 50-125.5 Gy (median: 77.24) with external irradiation alone or combined with intracavitary brachytherapy by conventional (200 rads/ fraction, 5 fr. / week) or hyperfractionated (120-135 rads / fr., 2 fr. / day, 10 fr. / wk) methods. Hyperthermia used 8 MHz radiofrequency capacitive heating device (CANCERMIA, Green-Cross Corp.) was applied in pelvic area with 2-3 sessions / week, 40-60 minute / session within 15-20 minute after radiotherapy. The range of power was 800-1300 Watt and 2.7-3.5 kv in kvp. Measurement of intratumoral temperature used Teflon-coated cooper constantans microthermocouple was done with once per 2 week. Eleven patients (44%) were received heating less than 7 sessions and 14 (56%) were more than 8 sessions. Statistics was calculated with logistic regression model in SPSS for window and significance was Chi-square test. Duration of follow-up was 9-75 months (median: 36). Results Distant metastasis were found in 8 patients (32%). Among 8 patients, 4 revealed distant metastasis only and 4 showed distant metastasis with locoregional failure. The sites of distant metastasis were retroperitoneal lymph node (3 patients), bone (3), peritoneal cavity (2), supraclavicular lymph node (2), liver (1), brain (1) and lung (1). In univariate and multivariate analyses, there was no significant factor affecting distant metastasis. Conclusions There were no evidence of increase of distant metastasis by radio-thermotherapy compared to radiotherapy alone in stage Ⅱb uterine cervical cancer.
병기 2b 자궁경부암의 방사선 치료에서 온열치료 병용의 원격전이에 대한 영향 및 관련인자 분석
문창우 고신대학교(의대) 고신대학교 의과대학 학술지 2000 고신대학교 의과대학 학술지 Vol.15 No.1
Background/Objective : This retrospective study was conducted to analyze effect of addition of hyperthermia on distant metastasis and to determine factor affecting distant metastasis in radiotherapy of stage 2b uterine cervical cancer. Methods : From May 1992 to Dec. 1996, among patients treated with radio-thermotherapy in stage 2b uterine cervical cancer at department of Radiation Oncology in Kosin Medical College, 25 patients without evidence of distant metastasis in initial work-ups by physical examination, computed tomography, magnetic resonance imaging, ultrasonography and radioisotope scan were enrolled. The range of age was 33-71 years (median : 52). Radiotherapy used 6-10 MV linear accelerator was performed in whole pelvis with 4 portals technique. Total dose administered was 50-125.5 Gy (median: 77.24) with external irradiation alone or combined with intracavitary brachytherapy by conventional (200 rads/ fraction, 5 fr./week) or hyperfractionated (120-135 rads/ fr., 2fr./day, 10 fr. / wk) methods. Hyperthermia used 8 MHz radiofrequency capacitive heating device (CANCERMIA, Green-Cross Corp.) was applied in pelvic area with 2-3 sessions / week, 40-60 minute / session within 15-20 minute after radiotherapy. The range of power was 800-1300 Watt and 2.7-3.5 kv in kvp. Measurement of intratumoral temperature used Teflon-coated cooper constantans microthermocouple was done with once per 2 weeks. Eleven patients (44%) were received heating less than 7 sessions and 14 (56%) were more than 8 sessions. Statistics was calculated with logistic regression model in SPSS for window and significance was Chi-square test. Duration of follow-up was 9-75 months (median : 36). Results : Distant metastasis were found in 8 patients (32%). Among 8 patients, 4 revealed distant metastasis only and 4 showed distant metastasis with locoregional failure. The sites of distant metastasis were retroperitoneal lymph node (3 patients), bone (3), peritoneal cavity (2), supraclavicular lymph node (2), liver (1), brain (1) and lung (1). In univariate and multivariate analyses, there was no significant factor affecting distant metastasis. Conclusions : There were no evidence of increase of distant metastasis by radio-thermotherapy compared to radiotherapy alone in stage 2b uterine cervical cancer.
진행된 위암의 온열 병용치료의 결과 : 59예의 대상환자 In cases of 59 patients
문창우,김영호,정태식,염하용,구자영 고신대학교 의학부 1998 高神大學校 醫學部 論文集 Vol.13 No.1-2
Purpose : This study is conducted to evaluate the local response rates and survival rates with median survival time(MST) following thermoradiotherapy or thermochemotherapy in locally advanced inoperable gastric cancer. Materials and Methods : 7 patients treated with thermoradiotherapy(RT+HT, Group Ⅰ) and 52 patients treated with thermochemotherapy(CTX+ HT, Group Ⅱ) were enrolled in this study. Hyperfractionated radiotherapy(l35cGy/fr., 2fr./day) using 6-10MV Linac was delivered to gastric mass and regional lymph nodes with total doses of 40.5-54Gy(median : 42.5 Gy). Chemotherapy with FI(5FU + Interferon) and EAP(Etoposide+Adriamycin+Cisplatin) regimens was administered. Hyperthermia using 8 MHz RF capacitive equipment (CANCERMIA GHT-8) was performed within 10-15minutes following irradiation, and simultaneously chemotherapy with 2 times/week, 40-60min./time. The estimation for local response rate was used computed tomography(CT) with/without endoscopic examination, and it was divided into complete response(CR), partial response(PR) and no response(NR) groups. The survival rate was calculated by Kaplan-Meier method. Results : Overall local response rate(CR+PR) was 67.8% (40 patients) with 5.1% (3 patients) in CR and 62.7%(37 patients) in PR. The local response rates by treatment modality was 100% (CR 14.3%, PR 85.7 %) in Group I and 63.4 % (CR 3.8%, PR 59.6%) in Group Ⅱ. There was no statistical significance. The local response rate by heating session was 64.2% (CR : 1.9%, PR : 62.3% in less than 7 session group and 100% (CR 33.3 % , PR : 66.7% in more than 8 session group. There was statistically significant difference(p=0.002). However, there were not statistically significant differences in comparison of local response rates by other factors(age, sex, heating temperature, chemotherapy regimen). Overall 1 and 2 years survival rates with MST were 25.4%, 15.9% with 8 months, respectively. The 1 and 2 years survival rates(MST) by treatment modality were 0%, 0% (6 months) in GroupⅠand 28.9%, 17.3% (8 months) in Group Ⅱ. There was statistically significant difference.(p=0.02). The 1 and 2 years survival rates (MST) by age were 0%, 0% (4 months) in less than 49 years Group and 29.4%, 17.7% (9 months) in more than 50 years group. There was statistical significance(p=0.013). However, there were no statistically significant differences in comparison of survival rates and MST by other factors(sex, heating session, heating temperature, chemotherapy regimen, response status). Two patients(3.4%) out of 59 patients experienced complications, and the most serious complication was subcutaneous fat necrosis. Conclusion : From this study we found that the local response rate was high in GroupⅠ, but the survival rate was high in Group Ⅱ. Therefore, it is concluded that thermo-chemo-radiotherapy is strongly recommended to increase local response rate and survival rate in locally advanced inoperable gastric cancer.