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김탁 대진대학교 대순사상학술원 2024 대순사상논총 Vol.48 No.-
동학교는 김주희가 세운 동학계 신종교단이다. 동학교가사에 나타난 사상의 요체는 용어의 빈도수와 읊어진 구절의 내용을 고려하여 ‘도로 선천(先天)’사상이라고 볼 수 있다. 동학의 시운관(時運觀)이 ‘다시 개벽(開闢)’사상이라면, 동학교의 시운관은 ‘도로 선천(先天)’사상이다. 동학교에서는 선천이라는 용어를 특히 강조했고, 역학(易學)을 활용하여 노래했으며, ‘음양의 마주 봄’으로 개벽의 상황을 읊었다. 동학교에서는 후천의 운수마저 다한 다음에야 비로소 ‘도로 선천’이 이루어지리라고 강조한다. 이 ‘도로 선천’의 운수가 회복되면 목덕(木德)으로 상징되는 ‘봄<춘(春)>’이 다시 돌아올 것이라고 노래한다. 동학교에서는 새로운 운수(運數)의 전개를 ‘역(易)의 회복’으로 설명한다. 새로운 질서와 규범이 전개될 새 세상을 ‘도로 선천’으로 부르는데, 이때가 되면 ‘도덕세계’가 이루어져 도덕 문명이 전개될 것이라고 주장한다. ‘도로 선천’을 회복하는 운수가 바로 천도(天道)가 회복되는 일과 같다고도 노래한다. ‘도로 선천’사상의 특성은 첫째, 복고적 체계를 지향한다. 둘째, 과거지향적 사상이다. 셋째, ‘도로’는 ‘근원으로 돌아가자.’, ‘근본을 회복하자.’라는 실제의 행동을 유발하고 권유하는 생각이다. 동학교의 ‘도로 선천’사상은 당대의 여러 신종교와는 다르게 선천(先天)에 대해 독창적인 관념과 인식을 부여했으며, 새로운 해석의 틀을 제시했다. 선천을 폐기해야만 할 낡은 시대로 규정했던 일에서 벗어나 지향해야 할 새 시대로 이해했다. 따라서 동학교의 ‘도로 선천’사상은 동양 전통의 과거로의 회귀와 복귀를 추구하던 일을 계승한 사상의 하나로 재평가되어야 하겠다. 하지만 ‘도로 선천’사상에 구체적 방법론이 매우 부족하다는 점은 단점으로 지적될 수 있다. 그리고 동학교의 ‘도로 선천’사상에는 윤리의식이나 도덕적 덕목이 부족하며, 정작 선천(先天)에 대한 설명이 부족하다. 따라서 동학교의 ‘도로 선천’사상은 선언적 구호에 그친 감이 있다.
김탁,박진,추은주,정혜민,전찬홍,황재필,박정미 대한감염학회 2018 Infection and Chemotherapy Vol.50 No.1
Prognosis has not been known for patients with fever of unknown origin (FUO) whose 18fluoro-deoxyglucose (18F-FDG) positron emission tomography/computerized tomography (PET/CT) finding is non-diagnostic. A total of eight patients with FUO that underwent 18F-FDG PET/CT were retrospectively identified January 2016-June 2017 in a tertiary hospital in Korea. Of these, two patients were diagnosed with microscopic polyangitis and Kikuchi’s disease and one patient was transferred to another hospital. Of five patients whose diagnoses were not confirmed, four patients received non-steroidal anti-inflammatory drug and/or low dose steroid and symptoms disappeared. Our study suggests that outcome of patients with FUO whose 18F-FDG PET/CT finding is non-diagnostic would be favorable.
김탁,성형섭,정용필,김성한,추은주,최상호,김태형,우준희,김양수,이상오 대한감염학회 2018 Infection and Chemotherapy Vol.50 No.2
Background: Trimethoprim/sufamethoxazole (TMP/SMX) is the recommended treatment for Pneumocystis jirovecii pneumonia (PCP). However, the efficacy and the safety of alternative salvage treatments are less guarauteed especially when patient experiences treatment failure and/or an adverse drug reactions (ADR). The purpose of this study is to recognize potential risk factors imitating successful treatment with TMP/SMX among PCP patients. Materials and Methods: Ninety one adult patients diagnosed with PCP were included after searching electronical medical records from January 2013 through July 2015 at Asan Medical Center Seoul, Korea. We compared clinical characteristics and laboratory findings including bronchoalveolar lavage (BAL) fluid analysis in patients who experienced TMP/SMX treatment failure or ADR (the case group) versus those who did not (the control group). Results: Among the enrolled PCP patients, 39 (42.9%) required salvage treatment owing to either treatment failure (28, 28.6%) and/or ADR (17, 18.7%). The BAL lymphocyte percentage (25% [IQR, 8–40%] vs. 47% [IQR, 15–62%]; P = 0.005) was lower in the case group. Diabetes mellitus (adjusted odds ratio [aOR] 4.98, 95% confidence interval [95% CI] 1.20–18.58), glomerular filtration rate ≤50 mL/min (aOR 4.48, 95% CI 1.08–18.66), and BAL lymphocyte percentage ≤45% (aOR 9.25, 95% CI 2.47–34.58) were independently associated with the case group in multivariate analysis. Conclusion: This study suggests that BAL lymphocyte count may play some role during PCP treatment. Further studies should be followed to reveal what the role of BAL lymphocyte is in the PCP treatment.
김탁,박기호,유시내,박성연,박세윤,이유미,전민혁,추은주,김태형,이미숙,이은정 대한의학회 2019 Journal of Korean medical science Vol.34 No.39
Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) infection is associated with high mortality. One of the strategies to reduce the mortality in patients with CRAB infections is to use intravenous colistin early but the effect of this strategy has not been proven. Therefore, we investigated the association of early colistin therapy with 28-day mortality in patients with CRAB bacteremia. Methods: This retrospective multicenter propensity score-matching analysis was conducted in the Korea by reviewing the medical records of adult patients with CRAB bacteremia between January 2012 and March 2015. Early colistin therapy was defined as intravenous colistin administration for > 48 hours within five days after the blood culture collection. To identify the risk factors associated with the 28-day mortality in CRAB bacteremia, the clinical variables of the surviving patients were compared to those of the deceased patients. Results: Of 303 enrolled patients, seventy-six (25.1%) patients received early colistin therapy. The 28-day mortality was 61.4% (186/303). Fatal or rapidly-fatal McCabe classifications, intensive care unit admission, Sequential Organ Failure Assessment scores ≥ 8, vasopressor use, and acute kidney injury were statistically independent poor prognostic factors. Catheter- related infection and early colistin therapy (adjusted odds ratio [aOR], 0.45; 95% confidence interval [CI], 0.21–0.94) were independent favorable prognostic factors associated with 28- day mortality in patients with CRAB bacteremia. Early colistin therapy was still significantly associated with lower 28-day mortality in the propensity score-matching analysis (aOR, 0.31; 95% CI, 0.11–0.88). Conclusion: This study suggests that early colistin therapy might help reduce the mortality of patients with CRAB bacteremia.