P-58 Rat 모델을 이용한 폐신경세포에서 TLRs 및 TRP channel 발현

정원재,오지연,최수인,이영석,김영,이은주,민경훈,허규영,이승헌,이승룡,김제형,신철,심재정,강경호,인광호,이상엽 대한결핵 및 호흡기학회 2016 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.121 No.-

배경 및 목적: Toll Like receptor (TLR)은 패턴인식수용체로 면역반응 조절에 큰 역할을 할 뿐 아니라 여러 신경세포에도 발현이 되는 것이 밝혀지고 있다. 하지만 폐에서 기인하는 감각 신경세포에서 TLR의 발현이나 TLR이 기침 등의 호흡기증상과의 관련성에 대한 연구는 없었다. 이 연구에서는 bleomycin fibrosis model를 이용하여 폐의 신경세포에서 TLR의 발현의 증가를 확인하고자 하였다. 또한 폐신경세포에서 TLR과 TPR channel의 연관성을 탐색하고자 하였다. 방법: Rat을 이용한 bleomycin fibrosis model를 만들었다. Nodose(ND), jugular ganglion(J) 및 Dorsal root ganglion(DRG) nerve에서 폐에서 기인하는 감각신경을 분리하였으며 이를 single cell RT PCR를 이용하여 수용체들을 분석하였다. 결과: TLRs(TLR1-9)중 TLR2, TLR 5만이 발현을 보였으며 정상군에 비해 model에서 더욱 발현이 증가하였다. TLR2는 N,J nerve의 43%, DRG nerve의 44%에서 발현이 되었으며 TLR5는 각각의 nerve에서 52%, 47.9%에서 발현되었다. 또한 같은 model에서 TRPA1, TRPV1, TRPM8의 발현(22.8%, 37.7%, 34,6%)이 관찰되었으며 TRPM8 양성 신경세포의 58.8 %, TRPV1 양성 세포의 63.4% 이상에서 TLR5가 공동 발현되었다. 앞으로 폐신경세포에서의 TLR의 기능과 역할에 대한 추가적인 연구가 필요하겠다.

이이, 임성주, 기정진의 본체론

정원재 철학연구회 2002 哲學硏究 Vol.57 No.-

서경덕과 그 학파의 선천 이론

정원재 서울대학교철학과 1990 哲學論究 Vol.18 No.-

Tuberculosis and gastrectomy : A Nationwide Population-based Matched Cohort Study

정원재,최수인,김병근,이은주,이상엽,인광호 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.-

The objective of this study was to examine the incidence and risk of tuberculosis in patients who underwent gastrectomy. This population-based matched cohort study was conducted to analyze the sample database of the National Health Insurance Coporation. There were 2223 subjects with having gasgtrectomy as the gastrectomy group between 2008 and 2012, and 8892 randomly selected subjects without gastrectomy as the non-gastrectomy group. Subjects with history of pulmonary tuberculosis or gastric cancer before the index date 1year were excluded. Both gastrectomy and non-gastrectomy groups were matched with sex, age, Diabetes, end stage renal disease, transplantation, Chronic obstructive pulmonary disease and pneumoconiosis. The incidence of tuberculosis was assessed in both groups. The multivariable Cox proportional hazards regression model was used to assess the hazard ratio and 95% confidence interval for risk of tuberculosis associated with gastrectomy. The overall incidence of tuberculosis was 1.11-fold greater in the gastrectomy group than that in the non-gastrectomy group. After adjusting for confounding factors, the adjusted hazard ratio of tuberculosis was 1.1 for the gastrectomy group, compared with the non-gastrectomy group, but it was not significant. Old age, chronic obstructive pulmonary disease, low economic status were other factors that could be related to pulmonary tuberculosis. Further study using census data will be required.

만성 결핵성 농흉과 동반된 흉벽 악성 육종 −1예 보고−

정원재,이성호,김광택,강문철,정재호,손호성,손국희,선경 대한흉부외과학회 2008 Journal of Chest Surgery (J Chest Surg) Vol.41 No.6

A 50 year old male patient was admitted due to fever and left upper-quadrant abdominal pain. He had a history of previous treatment for pulmonary TB and splenectomy due to aplastic anemia. A large peritoneal abscess with connection to a chronic left side tuberculous empyema thoracis was diagnosed on admission. Chest CT also revealed a soft tissue lesion on the left anterior chest wall. Staged drainage of the peritoneal lesion followed by left side pleuropneumonectomy with chest wall resection was performed. The pathologic studies showed a high grade sarcoma of the chest wall.

기관지 천식에 있어서의 피부단자시험 결과

정원재,정은택,최인선,박경옥 대한천식알레르기학회 1985 추계학술대회 초록집 Vol.1985 No.-

구절주의와 심판관의 태도

정원재 예문동양사상연구원 2003 오늘의 동양사상 Vol.- No.8

원발성 폐암에서 냉동수술의 치료 효과

정원재,김광택,이은주,이성호,정재호,함수연,조성범,강문철 대한흉부외과학회 2009 Journal of Chest Surgery (J Chest Surg) Vol.42 No.2

배경: 2004년 11월 저자들이 국내에서는 처음으로 냉동치료를 시작한 이후 원발성 폐암에 대한 냉동수술의 국소 치료 효과를 분석하여 그 효과와 합병증 등을 분석하여 차후 냉동치료의 방향을 살펴보고자 하였다. 대상 및 방법: 2004년 11월부터 2007년 3월까지 17명의 환자를 대상으로 17개의 악성 폐종괴에 대한 냉동치료를 시행한 결과를 의무기록과 영상자료를 이용하여 후향적으로 분석하였다. 남자가 14명, 여자가 3명이었으며 연령은 중앙값이 64세(범위; 54∼77세)였다. 폐종괴의 평균 직경(장경)은 48.8 mm (범위; 36∼111 mm)였다. 추적검사로써 흉부전산화단층촬영을 술후 7일, 1개월, 3개월, 6개월에, 양전자단층촬영을 약 6개월에서 9개월 사이에 각각 시행하여, RECIST (Response Evaluation Criteria in Solid Tumors) 기준을 이용하여 분석하였다. 결과: 술후 6개월에 시행한 흉부전산화단층촬영 및 술후 6개월에서 9개월 사이에 시행한 양전자단층촬영을 기준으로 17명의 원발성 폐암 환자 중 6명(35.3%)은 완전관해를, 4명(23.5%)은 부분관해를, 3명(17.6%)은 무변화를, 4명(23.5%)은 진행성 병변을 보였다. 직경 4 cm 이하의 10명의 원발성 폐암에서 5명(50.0%)은 완전관해를, 3명(30.0%)은 부분관해를, 2명(20.0%)은 무변화를 보였다. 4 cm 이상의 경우는 부분관해 이상이 2명(11.8%), 무변화 및 진행성 병변이 5명(29.4%)로 통계상 뚜렸한 차이를 보였다(χ2-test; p-value= 0.034). 술후 합병증으로는 소량의 혈성객담이 1예에서 발생하였으나 술후 1∼2일째 소실되었고 자연 소실된 피하기종이 1예 그리고 발열이 있었던 환자가 1명 있었다. 시술과 관련한 사망은 없었다. 냉동 치료 후 평균재원일수는 6.3일이었다. 결론: 이상의 연구 결과에서 원발성 폐암을 냉동수술로 치료할 경우 특히 장경의 평균이 4 cm 이하인 종양에서 좋은 효과를 기대할 수 있다는 것을 알 수 있다. 냉동 수술이 비침습적이며 합병증이 경미하고 반복 치료가 가능하다는 점에서 수술 고위험 환자군의 폐암 치료에 중요한 역할을 할 수 있을 것으로 생각된다. Background: Cryosurgery has been used to treat primary malignant pulmonary tumors at our institute since November 2004. In this study we analyzed our treatment results and complication rates. Material and Method: A retrospective study using medical charts and imaging data was conducted involving 17 patients with a total of 17 malignant pulmonary tumors who were treated between November 2004 and March 2007. Fourteen patients were males and 3 were females. The median age of the patients was 64 years (range, 54∼77 years). The average size of the tumors was 48.8 mm (range, 36∼111 mm) in diameter. The patients were followed with chest CT scans 7 days, 1 month, 3 months, and 6 months postoperatively. PET scans were obtained between 6 and 9 months postoperatively. The treatment response was analyzed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Result: Six months after treatment, 6 tumors (35.3%) showed a complete response, 4 (23.5%) had a partial response, 3 (17.6%) had stable disease, and 4 (23.5%) showed disease progression. In tumors <4 cm in diameter, a complete response was reported in 50% of the tumors. A χ2-test showed that in tumors <4 cm in diameter, the p-value for results better than a partial response was 0.034. With respect to procedural complications, there was 1 case of blood-tinged sputum which resolved spontaneously within 1 or 2 days, a spontaneously relieved case of subcutaneous emphysema, and 1 patient with a fever. There were no mortalities and the average hospital stay was 6.3 days. Conclusion: The effects of cryosurgery on primary lung cancer is greatest in patients with small tumors. Considering the facts that cryosurgery is minimally invasive, has a low complication rate, and can be performed repetitively, we believe that it may play an important role in the treatment of high risk lung cancer patients.

Risk Stratification in Pneumonia for Identifying Patients with MRSA

정원재,박선철,강영애,홍지영,송주한,정경수,김송이,이상국,김은영,박무석,김영삼,김세규,장준,정지예 대한결핵 및 호흡기학회 2012 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.114 No.0

Background: Methicillin-resistant Staphylococcus aureus (MRSA) has been recognized as an important cause of not only hos-pital acquired pneumonia but also community acquired or healthcare associated pneumonia (HCAP). The objectives of this study was to identify factors associated with MRSA. Methods: We retrospectively evaluated patients hospitalized to Severance Hospital with culture positive pneumonia developed outside of the hospital from January 2009 to December 2010. Results: Of 451 patients, MRSA was identified in 37 (8.2%) patients. The mean age was higher in MRSA than non-MRSA groups (72.8 years old vs 66.7 years old; P<0.001). Male was more dominant in both groups (75.7.% in MRSA vs 65.2% in non-MRSA; P=0.198). Comparing the treatments and outcomes, the frequency of initial treatment with glycopeptide antibiotic was similar between the groups (16.2% in MRSA vs 13.5% in non-MRSA, P=0.649). However, 14 (37.8%) patients in MRSA and 86 (20.8%) in non-MRSA died (P=0.017). In a logistic regression, previous history of MRSA infection (OR=5.87, P<0.001), prior hospitalization within 90 days (OR=3.92, P=0.003), Multiple infiltrates on chest radiograph (OR=2.29, P=0.046), and age (OR=1.05, P=0.021) were independently associated with MRSA pneumonia. Conclusions: Empiric therapy with coverage for MRSA should be considered in patients with non hospital-acquired pneumonia having risk factors such as previous history of MRSA infection, prior hospitalization within 90 days of pneumonia, multiple infiltrates on chest radiography and old age.

氣管枝喘息 患者의 起因性 抗原에 關한 硏究

鄭原在,崔仁善,朴炅玉 全南大醫大 1986 전남의대학술지 Vol.23 No.2