대량 객혈과 무기폐를 동반한 기관 골연골증

오인재 ( In Jae Oh ),주진영 ( Jin Young Ju ),최유덕 ( Yoo Duk Choi ) 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.3

We treated a rare case of TO that presented with recurrent massive hemoptysis that resulted in total obstruction of the bronchus intermedius by very large blood clots. Bronchoscopic intervention resulted in a full recovery from the atelectasis. However, there are no guidelines for preventing recurrence of the hemoptysis or disease progression. Conservative and expectant management are used to treat these patients and most do well.

키토산 관련 제품 표준화의 규제 현황과 동향

오인재 ( In Jae Oh ),주완택 ( Wan Taek Ju ),김영주 ( Young Ju Kim ),정우진 ( Woo Jin Jung ),박노동 ( Ro Dong Park ) 한국키틴키토산학회 2009 한국키틴키토산학회지 Vol.14 No.1

기독교세계관에 기초한 음악적 리더십: - 하나님 나라를 향한 교향곡: 창조·타락·구속·완성의 패러다임을 중심으로 -

오인재 ( In Jae Oh ) 한국복음주의신학회 2014 성경과신학 Vol.72 No.-

"리더십(Leadership)"은 "하나의 그룹에 비전과 방향성 및 역동성을 가지게한다. 그런데 그러한 리더십은 모호하지 않은 분명한 지침이 있어야 한다. 이러한 리더십에 분명한 방향성과 역동성을 균형 있게 제공하는 도구가 그리스도의 3중직이 될 수 있다. 이러한 3 중직은 불균형하게 발전해 있는 한국교회의 리더십에 건강한 균형성을 제공할 수 있을 것이다. 그리고 이러한리더십을 발휘할 때, 건강한 성경적 틀이 필요한데, 필자는 이것을 ``창조·타락·구속·완성"의 틀 속에서 이러한 건강한 리더십을 성취해야 함을 제안하는 것이다. 하나님 나라를 구속사적 시각에서 구체적으로 설명하는 도구가 기독교세계관에서의 창조·타락·구속·완성이다. 성경에서는 예수님께서 우리의 구속을 위하여 담당하신 직무가 삼중직이라고 여긴다. 또한 우리는 그리스도의 기름 부으심에 참여한 자로서 그의 선지자, 제사장, 왕의직분을 구체적으로 담당하게 되는데 이것을 보편직분이라고 한다. 따라서 본 논문의 목적은 "창조·타락·구속·완성"이라는 도구와 그리스도인의 보편직분 (선지자, 제사장, 왕)이라는 도구의 결합을 통하여 건강한 음악적 리더십의 지침들을 발견 및 제시하기 위함이다. 특별히 그 진행에 있어서 고전교향곡의 제4악장 구조와 "창조·타락·구속·완성"의 4가지 구조를 교향곡의 악장구조의 성격과 대비하며 서술하였다. 각 단계마다 두 개의 부분으로 나누어 설명한다. 전반부는 "창조·타락·구속·완성``의 각 단계에 해당하는 신학적 서술과 문제점을 음악과 함께논하였다. 이것을 바탕으로 후반부에서 보편직분을 구체적으로 적용하여, 한국교회의 음악적 리더십을 위한 문제점들과 그에 대한 해결책을 구체적으로서술하였다. 이것은 선지자, 제사장, 왕적 직분에 따라 설명되고 제안될 것이다. Leadership is to provide a vision and direction and to make its members do its purpose together. But leadership needs a specific, non-superficial sense of direction. The Bible ascribes a threefold office to Christ and it can be a tool for the leader ship in which we can have direction, vision. And it will give the Korean Church good balance in leadership. Also for the leadership, we need good Biblical paradigm, which explain the Biblical Truth in Salvation History. An excellent tool which explains the Kingdom through the salvation history is creation, fall, redemption, consummation. We participate in his office as an anointed one with him, and do the same office what Jesus did. It is called a general office (Prophet, Priest, and King). So the purpose of this study is to find and provide specific direction for the leadership of Korean Church by uniting two tools; “Christian Worldview”(four stages) which explains the Kingdom of God, and “The Universal Office of all believers”(three folds). Especially, in its process, the four folds of world view was explained in comparison of four movements of the classical symphony, because they are similar in character. In each stage, it will be explained in two parts. In the former part, the theological aspect and issues dof Christian worldview were mentioned. In the latter part, the application of our universal office was mentioned through which some suggestions for a leadership of Korean Churches with specific points. It would be suggested and explained according to our prophetic, priestly, and kingly office of our universal office.

단일 폐종괴로 발견된 Wegener 육아종증

오인재 ( In Jae Oh ),정종필 ( Jong Pil Jeong ),김수옥 ( Soo Ok Kim ),손준광 ( Jun Gwang Son ),반희정 ( Hee Jung Ban ),임정환 ( Jung Hwan Lim ),조계중 ( Gye Jung Cho ),주진영 ( Jin Young Ju ),김규식 ( Kyu Sik Kim ),김유일 ( Yu Il K 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.1

Wegener`s granulomatosis is a disease with an unknown etiology that is characterized by necrotizing granulomatous vasculitis involving the upper and lower respiratory tract and the kidneys. The typical pulmonary findings are bilaterally involved multiple variable sized nodules. We report a case of Wegener`s granulomatosis that presented as a single lung mass. A male patient presented with a nasal obstruction, arthralgia, cough, and intermittent dyspnea. The chest radiograph showed a mass, approximately 4.5 cm in diameter, in the right lower lobe. Lung cancer or tuberculosis was initially considered. However, the clinical, laboratory and pathological findings of the mass indicated Wegener`s granulomatosis. The patient was administered prednisolone and cyclophosphamide, and improved temporarily. Unfortunately, the immunocompromised patient expired as a result of respiratory failure with pneumonia. (Tuberc Respir Dis 2007; 63: 88-93)

키토산 가공품의 규제와 규격 비교

오인재 ( In Jae Oh ),고성애 ( Xing Ai Gao ),조경현 ( Gyung Hyun Jo ),김영주 ( Young Ju Kim ),박노동 ( Ro Dong Park ) 한국키틴키토산학회 2009 한국키틴키토산학회지 Vol.14 No.2

In order to input chitin and chitosan into pharmaceutical, biotech, cosmetic, and dietary supplementation, the product consistency and safety will become important for consideration by regulatory authorities. To compare internationally the specification and regulation of chitosan-related products, data has been collected and analyzed in definition, application and function, physicochemical and biological quality criteria, analysis method, and regulatory authority.

근육 내 자극 요법 후 발생한 의인성 기흉 2예

손준광 ( Jun Gwang Son ),오인재 ( In Jae Oh ),정종필 ( Jong Pil Jeong ),김수옥 ( Soo Ok Kim ),주진영 ( Jin Yung Ju ),임정환 ( Jung Hwan Lim ),조계중 ( Gye Jung Cho ),채동렬 ( Dong Ryeol Chae ),김규식 ( Kyu Sik Kim ),김유일 ( Yu Il 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.5

Recently, intra-Muscular Stimulation (IMS) therapy is being increasingly used for musculoskeletal pain. This procedure is generally regarded as a safe procedure for the general public. Some cases of iatrogenic pneumothorax caused by acupuncture have been reported in the medical literature. However, a case of an IMS therapy associated pneumothorax has not reported. We experienced two cases of iatrogenic pneumothorax after IMS therapy. A 62 year-old man received IMS therapy on the right shoulder due to posterior neck pain. After IMS therapy, acute dyspnea and chest discomfort developed. The other patient was a 74 year-old woman who also received IMS therapy. This patient experienced a nonproductive cough and acute dyspnea after the treatment. As the popularity of this form of alternative medicine increases, we might expect to see more cases of iatrogenic pneumothorax. Physicians should be aware of the adverse events associated with IMS therapy. (Tuberc Respir Dis 2007;63:444-448)

재발된 소세포폐암환자에서 이차 약제로 사용되는 Belotecan (CKD-602)의 임상적 효용성

반희정 ( Hee Jung Ban ),오인재 ( In Jae Oh ),김규식 ( Kyu Sik Kim ),주진영 ( Jin Yung Ju ),권용수 ( Yong Soo Kwon ),김유일 ( Yu Il Kim ),임성철 ( Sung Chul Lim ),김영철 ( Young Chul Kim ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.2

연구배경: Belotecan (Camtobell, CKD-602, Chongkundang Pharm., Korea)은 camptothecin의 치환체로 topoisomerase I 효소를 억제하여 항암효과를 나타내는 것으로 알려져 있다. 이에 2차 항암화학요법에 치료제로써 Belotecan의 효과, 생존율 및 부작용에 대해 연구하였다. 방법: 이에 소세포폐암에서 etoposide와 platinum을 사용한 1차 항암화학요법에서 실패한 49명의 환자들을 대상으로 2차 항암화학요법에 Belotecan을 투약하였다. 결과: 전체 반응률은 25%였으며, 11명의 환자에서 partial response를 보였다. 또한 1차 항암화학요법 이후 90일 이내에 재발한 군과 90일 이상 경과한 군간에 유의한 차이는 보이지 않았다. 전체 환자의 중심생존기간은 10.3개월(290일)이었고, 비반응군에서는 186일(95% CI; 67~305)로 반응군의 471일(95% CI; 234~568)에 비해 생존기간의 감소 유의하게 있음을 확인하였다(p=0.07). 결론: 2차 항암화학요법의 치료제로써 Belotecan의 효능과 부작용에 대해서는 향후 무작위 비교 연구가 필요할 것으로 사료된다. Background: Belotecan (Camtobell, CKD-602, Chong-kundang Pharm., Korea), a camptothecin derivative, has anticancer effects by inhibiting topoisomerase I such as topotecan. This study observed the response, survival and toxicity of belotecan monotherapy after the failure of etoposide and platinum (EP). Methods: Forty nine small cell lung cancer (SCLC) patients (M/F=41/8; age, 64.5±7.6 (mean±SD) years), who failed in their first line chemotherapy were enrolled in this study. Twenty one SCLC patients showed relapsed lung cancer more than 90 days after their prior EP chemotherapy (sensitive relapse group, SR) and 28 patients relapsed within 90 days (refractory relapse group, RR). Results: The response rate was 25%. Eleven patients showed partial responses and 5 patients could not be checked. The response rate of the SR and RR patients was similar. The relative dose intensity was lower in the responders (78±15%) than non-responders (83±13%, p=0.03). The median survival time (MST) was 10.3 months (290 days). The MST of the non-responders and responders was 186 days (95% CI; 67~305) and 401 days (95% CI; 234∼568, p=0.07), respectively. The median progression free survival (MPFS) was similar in the SR (79 days) and RR (67 days) patients. Grade 3~4 neutropenia, anemia, and thrombocytopenia were observed in 59.6%, 12.8% and 23.4% of patients, respectively. Conclusion: The efficacy and survival were demonstrated in the second-line setting. However, a randomized comparative trial with topotecan will be needed.

뇌낭미충증과 감별이 어려웠던 폐암의 속립성 뇌전이 1예

이호준 ( Ho Jun Lee ),오인재 ( In Jae Oh ),박상우 ( Sang Woo Park ),반희정 ( Hee Jung Ban ),김영철 ( Young Chul Kim ),김수옥 ( Soo Ok Kim ) 대한결핵 및 호흡기학회 2012 Tuberculosis and Respiratory Diseases Vol.72 No.2

Miliary brain metastasis from the lung is uncommon and has a poor therapeutic response. We report a case pulmonary adenocarcinoma combined with multiple brain cystic lesions that were initially misdiagnosed neurocysticercosis. A 53-year-old male who never smoked was admitted to our hospital with complaints of agitation and cognitive impairment. Brain magnetic resonance imaging showed innumerable, small nodular lesions with central, low signal intensity in whole brain parenchyma. His symptoms were not improved by the empirical praziquantel medication for disseminated neurocysticercosis. After a transbronchial biopsy from the right middle lobe, we could diagnose the primary lung adenocarcinoma with a single nucleotide polymorphism in the epidermal growth factor receptor exon 20 at codon 787 (Q787Q). His neurologic symptoms and imaging findings have been gradually improving with a first-line Gefitinib treatment for five months. We recommend a more active diagnostic approach including biopsy in case of atypical imaging findings.

폐암환자에서 발생한 피하매몰 중심정맥포트 골절 및 색전증 2예

주진영 ( Jin Yung Ju ),조재영 ( Jae Yeong Cho ),임정환 ( Jung Hwan Lim ),조계중 ( Gye Jung Cho ),채동렬 ( Dong Ryeol Chae ),오인재 ( In Jae Oh ),김규식 ( Kyu Sik Kim ),김유일 ( Yu Il Kim ),임성철 ( Sung Chul Lim ),김영철 ( Young C 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.5

Totally implanted central venous access devices for chemotherapy (chemoport) are being used increasingly in lung cancer patients. Vascular catheters are associated with various complications including infection, thrombosis as well as spontaneous fractures and embolization of the catheter, which is known as ``pinch-off syndrome``. ``Pinch-off syndrome`` refers to the compression of a subclavian central venous catheter between the clavicle and first rib resulting in an intermittent or permanent obstruction, which can lead to tears, transection, or embolization. We report two cases of fractured and embolized implanted subclavian venous catheters in which the fragments were removed percutaneously. A 62-year-old man presented with back pain with a duration of a few weeks. The chest radiograph revealed complete transsection and embolization of the catheter into the right atrium. In addition, a 47-year-old woman with a chemoport had a grade 3 pinch-off sign in a chest radiograph demonstrating complete transsection and embolization of the catheter into the pulmonary artery. Both cases were managed by retrieving the embolized distal fragment percutaneously and removing the proximal section of the catheter. (Tuberc Respir Dis 2007;63:449-453)

한국인 폐암 환자에서 RRM1 유전자 Promoter의 다형성

고경행 ( Kyung Haeng Ko ),김은정 ( Eun Joung Kim ),오인재 ( In Jae Oh ),김수옥 ( Soo Ock Kim ),손준광 ( Jun Gwang Son ),정종필 ( Jong Pil Jung ),조계중 ( Gye Jung Cho ),주진영 ( Jin Young Ju ),김규식 ( Kyu Sik Kim ),김유일 ( Yu Il 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.3

연구배경: 약 75%의 비소세포 폐암에서 loss of heterozygosity (LOH)를 보이는 11p15.5에 위치한 ribonucleotide reductase M1 subunit gene(RRM1) 유전자는 ras transformed fibroblast를 이용한 실험에서 암세포의 전이능력을 감소시키는 것으로 보고되어 있어서 암억제 유전자로서의 가능성이 높다. RRM1의 promoter 부위인 exon 1 시작에서 (-)37과 (-)524번째 염기에 A/C 그리고 C/T 다형성이 발견되었는데 이 다형성의 양상에 따라 RRM1 유전자의 발현 정도가 조절될 수 있어서 폐암 발생의 위험도가 다를 수 있다. 대상 및 방법: 전남대학교 병원에 내원한 폐암환자들과 비폐암 대조군 환자 127예와 미국인 폐암 환자 140예의 말초혈액 백혈구로부터 얻은 DNA를 이용하여 미국인과 한국인에서의 유전자 다형성의 분포 및 임상적 의의를 조사하였다. 결과: RRM1 유전자의 Exon 1으로 부터 (-)37 염기에서 A/C 유전자 다형성은 127예 중 CC가 64예(50.4%), AC는 55예(43.3%), 그리고 AA는 8예(6.3%)에서 발견되었다. Allele A의 빈도는 미국인들의 27.9%에 비하여 한국인에서 28.0%로 차이가 없었고, 폐암군과 비폐암군 간에도 유의한 차이는 관찰되지 않았다. RRM1 유전자의 (-)524 염기에서 C 또는 T 유전자 다형성의 양상은 CC가 24예(18.9%), CT는 44예(34.6%), 그리고 TT는 59예(46.5%)에서 발견되었다. Allele C의 빈도는 36.2%로써 미국인의 34.6%와 차이가 없었고, 폐암군과 비폐암군 간에도 차이는 관찰되지 않았다. RRM1 유전자의 (-)37 염기는 인종에 관계없이 70% 이상에서 C 이었고, (-)524 염기는 65% 정도에서 T를 보이고 있었다. 또한 (-)37과 (-)524 염기는 서로 밀접한 상관관계를 보이고 있었다. 즉 (-)37염기가 모두 C인 경우 (-)524 염기도 모두 T인 빈도가 높았고, (-)37 염기가 한 개라도 A를 가지고 있는 경우 (-)524 염기도 C를 가지고 있는 빈도가 높았다 (p<0.001). 결론: RRM1 유전자의 발현을 조절하는 promoter 부위의 두 개의 유전자 다형성의 빈도는 인종 간에 그리고 폐암군과 비폐암군 간에 차이가 없어서 폐암 발생의 위험인자는 아니었다. 그러나 두 유전자 다형성이 서로 특정 조합을 보임으로 그 조합 양상에 따른 promoter 활성도에 대한 연구가 뒤따라야 할 것이다. Background: LOH11A is a region with frequent allele loss (>75%) in lung cancer that is located on the centromeric part of chromosome 11p15.5. Clinical and cell biological studies suggest that this region contains a gene associated with metastatic tumor spread. RRM1 encoding the M1 subunit of ribonucleotide reductase, which is an enzyme that catalyses the rate-limiting step in deoxyribonucleotide synthesis, is located in the LOH11A region. Methods: Polymorphisms were found at nucleotide position (-)37 (C/A) and (-)524 (C/T) from the beginning of exon 1 of the RRM1 gene that might regulate the expression of RRM1. We studied the polymorphisms in 127 Korean individuals (66 lung cancer and 61 normal controls) and compared with those of 140 American patients with lung cancer. Results: CC, AC and AA were found at the (-)37 position in 64(50.4%), 55(43.3%), and 8(6.3%) out of 127 Korean individuals (66 cancer, 61 non-cancer patients), respectively. There was a similar frequency of allele A at (-)37 in the American(27.9%) and Korean population(28.0%). CC, CT and TT was found at the (-)524 position in 24(18.9%), 44(34.6%), and 59(46.5%) out of the 127 Korean individuals, respectively. There was a similar frequency of allele C at (-)524 in the American(34.6%) and Korean population(36.2%). There was no difference in the frequency of the (-)37 and (-)524 genotypes between the cancer and non-cancer group. However there was a significant correlation of the genotypes between (-)37 and (-)524 (p<0.001), which suggests the possible coordination of these polymorphisms in the regulation of the promoter activity of the RRM1 gene. Conclusion: RRM1 promoter polymorphisms were not found to be significant risk factors for lung cancer. However, a further study of the promoter activity and expression of the RRM1 gene according to the pattern of the polymorphism will be needed. (Tuberc Respir Dis 2006; 61: 248-255)