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18세기 영국 병원의 발전과 존 웨슬리의 의술활동: 정신질환을 중심으로
박창훈 한국교회사학회 2024 韓國敎會史學會誌 Vol.67 No.-
이 논문은 18세기 잉글랜드 병원의 발전에서 존 웨슬리를 비롯한 목회자들이 끼친 영향에 대한 연구이다. 연구를 통하여 얻은 결론은 다음과 같다. 첫째, 잉글랜드 병원사에서 정신질환은 비교적 마지막까지 목사들의 영향력 아래에 남아있었다. 특별히 잉글랜드의 독특한 형태인 목회자-의사들 가운데는 정신질환자를 개인적으로 돌보는 경우가 있었으며, 공식적으로 정신병원에 대한 지원과 후원, 운영, 감독 등에 목회자들이 참여하였다. 둘째, 웨슬리는 근대적 의미의 의술활동을 통하여, 목회는 영혼과 함께 육체를 돌보는 통전적인 형태가 되어야 한다는 점을 강조하였다. 셋째, 웨슬리 자신이 목회자-의사로서의 역할을 담당하면서, 진료기록의 형식을 갖춘 저널을 통해 환자들의 경과를 면밀히 기록했다. 특별히 정신질환과 관련하여 그 혜택의 수혜자는 대개 여성들이었다. 마지막으로, 저널을 통해서 웨슬리의 부흥운동의 역동적인 현장을 살펴볼 수 있다. 웨슬리는 변화하는 의학기술을 인정하면서, 인간에게는 여전히 본질적인 치료가 필요한 부분이 있음을 드러내고 있다. 특별히 정신질환자들을 격리하고 감금하는 당시의 방법과는 다르게, 그들이 열린 공간(광장)에서 종교적 열정을 발산하여 건강함을 회복하도록 도왔다고 할 수 있다. This paper is a study on the influence exerted by pastors, including John Wesley, on the development of 18th century English hospitals. The conclusions drawn from the research are as follows. First, in the history of the English hospitals, the treatment of mental illness remained in the hands of the pastors to a large extent until relatively late. Particularly among the unique pastor–physicians in England, there were many pastors personally caring for mentally ill patients, and pastors participated in the support, sponsorship, operation, and supervision of mental institutions. Second, Wesley emphasized through modern medical work that pastoral care should become a holistic form of caring for both the soul and the body. Third, Wesley, while fulfilling his role as a pastor–physician, meticulously recorded the progress of his patients through journals, which resembled medical records in their form. Particularly in the mental illness cases, women were usually the beneficiaries. Lastly, through the journal, people can see the dynamic scenes of Wesley’s revival movement. Wesley acknowledged that changing medical technologies were needed, while still revealing the need for essential healing for humans. Especially in contrast to the methods of isolation and confinement of mentally ill patients at the time, it can be said that he helped them to recover by encouraging them to express their religious passion in open spaces.
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박창훈,장미애,안윤희,황유연,기창석,이남용 대한진단검사의학회 2011 Annals of Laboratory Medicine Vol.31 No.3
Bacillus Calmette-Guërin (BCG) has been traditionally used as a vaccine against tuberculosis. Further, intravesical administration of BCG has been shown to be effective in treating bladder cancer. Although BCG contains a live attenuated strain of Mycobacterium bovis, complications such as M. bovis BCG infection caused by BCG administration are extremely rare. Here, we report a case of BCG infection occurring after intravesical BCG therapy. A 67-yr-old man presented with azotemia and weight loss. He had been diagnosed with bladder cancer 4 yr back, and had undergone transurethral resection of the bladder tumor and intravesical BCG (Tice strain) therapy at that time. An acid-fast bacterial strain was isolated from his urine sample. We did not detect Mycobacterium tuberculosis protein 64 (MPT-64) antigen in the isolates obtained from his sample, and multiplex PCR and PCR-reverse blot hybridization assay indicated that the isolate was a member of the M. tuberculosis complex, but was not M. tuberculosis. Finally, sequence analysis of 16S ribosomal RNA and DNA gyrase, subunit B (gyrB) suggested that the organism was M. bovis or M. bovis BCG. Although we could not confirm that M. bovis BCG was the causative agent, the results of the 3 molecular methods and the MPT-64 antigen assay suggest this finding. This is an important finding, especially because M. bovis BCG cannot be identified using common commercial molecular genetics tools.
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박창훈,이승태,기창석,김종원 대한진단검사의학회 2010 Annals of Laboratory Medicine Vol.30 No.3
The human apolipoprotein E (APOE) gene contains several single-nucleotide polymorphisms (SNPs) that are distributed across the gene. The genotype of the APOE gene has important implications as a risk factor for various diseases. We observed 2 cases in which the results of allele-specific PCR (AS-PCR) of the APOE gene were not consistent with those of fluorescence resonance energy transfer (FRET) or sequencing analysis. In these cases, genotyping by AS-PCR showed that patients were ε2 homozygotes, while sequencing analysis and FRET showed that they were ε2/ε3 heterozygotes. Herein, we describe the causes of the errors in genotyping and describe the significance of these errors. (Korean J Lab Med 2010;30:325-8)
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박창훈,김영은,이기오,김선희,오국환,김인호,오도연,김희진 대한진단검사의학회 2019 Laboratory Medicine Online Vol.9 No.4
MYH9-related disorders (MYH9RD) are autosomal-dominant disorders characterized by macrothrombocytopenia with or without leukocyte inclusion bodies or extra-hematological features, such as sensorineural deafness and renal impairment. MYH9RD can be misdiagnosed as an acquired form of thrombocytopenia including immune thrombocytopenic purpura (ITP). This leads to delayed diagnosis or administration of ineffective treatment. In the present study, we investigated the clinical and molecular characteristics of five unrelated Korean patients with MYH9RD and their family members, from four institutions. We reviewed clinical and laboratory data including extra-hematological manifestations. MYH9 pathogenic variants were detected by direct sequencing in all probands and the affected family members (N=10): two probands with c.5521G>A (p.Glu1841Lys) and one proband each with c.99G>T (p.Trp33Cys), c.287C>T (p.Ser96Leu), and c.3493C>T (p.Arg1165Cys). All patients had macrothrombocytopenia. Only the proband with Ser96Leu had extra-hematological manifestations. Past history revealed that two patients had been misdiagnosed with ITP and one of them had received a splenectomy. We validated the frequency of misdiagnosis (~20%) and genotype-phenotype correlations through a comprehensive review of previously reported cases of MYH9RD in Korea. It is important to suspect MYH9RD in patients with thrombocytopenia, and timely identification of macrothrombocytopenia and MYH9 pathogenic variants is required for early and accurate diagnosis of MYH9RD.
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