경구용 비스포스포네이트의 사전 투여는 졸레드로네이트의 급성이상반응을 줄일 수 있는가?

박일형,서성화,조환성,천상호,정혜미 대한골대사학회 2011 대한골대사학회지 Vol.18 No.1

Objective: Bisphosphonates are the most commonly prescribed medications for the treatment of osteoporosis. This study was designed to analyze the rate of acute phase reaction (APR) following Zoledronate 5 mg administration in patients with osteoporosis who were treated with prior oral bisphosphonate for at least 2 weeks and to compare naïve IV 5 mg Zoledronate. Methods: Between July 2009 and October 2010, 27 patients with osteoporosis who were treated with prior oral bisphosphonate for at least 2 weeks, and maximum 52 weeks (average 18.5 weeks) and were between 42-and 85-year-old at the time of study participation. We prospectively evaluated APR, including fever, flu-like symptoms,headache, arthralgia, and myalgia, after 5 mg zoledronate by questionnaire. Additionally we assessed a visual analogue scale (VAS) by 4-point categorical scale. Results: In this study of 27 patients with osteoporosis, the frequency of APR, flu-like symptom and myalgia were 14.8% and 7.4% and fever, arthralgia, and headache were 3.7% respectively. In VAS, all reactions were mild. The rate of APR rate in this study was statistically decreased compared to previous reports with zoledronate 5 mg IV in bisphosphonate-naïve patients. Conclusion: Prior oral bisphosphonate administration for at least 2 weeks could significantly reduce the APR of IV zoledronate 5 mg. [Korean Journal of Bone Metabolism, 18(1): 49-54, 2011] 연구목적: 정주용 비스포스포네이트인 졸레드로네이트를 투여하기 전에 최소 2주 이상 경구용 비스포스포네이트를 사전투여하는 방법에서의 급성이상반응 (acute phase reaction, APR)의 발생율을 분석하고, 이를 기존 투여방법과 비교분석하였다. 연구방법: 경북대학교병원에서 2009년 7월부터 2010년 10월까지 골다공증으로 진단을 받은 환자 중 최소 2주 이상 최대52주 (평균 18.5주) 동안 경구용 비스포스포네이트를 사전 복용한 후 휴지기 없이 5 mg 졸레드로네이트를 정주 투여 받은 27명 (42~85세, 평균 70.8세)을 대상으로 APR 발생율을 조사하였다. APR에는 발열 (fever), 플루와 같은 증상 (무력감 포함), 두통, 관절통 (arthralia) 그리고 근육통 (myalgia)을 세부항목으로 정하였고, 추가적으로 시각적 통증척도 (visual analogue scale, VAS)를 통하여 통증의 정도를 포함한 설문조사를 하였다. 결 과: APR을 5그룹으로 세분하고 VAS scale까지 포함된 설문조사에서 27명의 환자 중 독감과 같은 증상과 근육통은 각각 14.8%와 7.4%이었으며, 발열, 관절통, 그리고 두통은 각각 3.7%이었다. VAS에서는 모든 반응은 경미한 단계이었다. 이는 기존에 보고된 졸레드로네이트의 APR 발생비율보다 통계학적으로 유의하게 감소된 결과이었다. 결 론: 골다공증을 치료하기 위하여 5 mg 졸레드로네이트를 정맥주사하기 전에 경구용 비스포스포네이트 제제를 2주이상 사전 투여한 후 졸레드로네이트를 정맥 투여하는 방법은 졸레드로네이트의 급성이상반응을 경감할 수 있는 좋은대안으로 판단된다.

동종골 이식이 골결손 치유에 미치는 영향

박일형,박찬식,손경락 경북대학교 병원 2002 경북대학교병원의학연구소논문집 Vol.6 No.1

Frozen bone allografts have been frequently used as substitute materials for autografts, since they were considered to be nonantigenic.However, experimental and clinical findings demonstrate that bone immumogenicity was at least partially retained. The odjective of this study is to compare the difference of linear bap healing of long bone between frozen cancellous chip allograft group and control group in chicken tibia. We made cortical defect on the anterior aspect of both tibia with saw.It was about one milimeter in width, three milimeter in depth. Chickens were sacrificed at 1,2,3,4 and 5 weeks and preiodically evaluated by radiographs and histology. The results were as follows; 1. Both allograft and control groups showed primary gap healing process mainly with intramedullary callus formation. 2. Apparent callus formation was more predominant in group on plain radiographs than in control group. 3. the gap healing process and internal remodelling on histologic slide were more predominant in control group. It suggested that, in linear cortical gap healing, frozen cancellouse chip allograft seemend to pro-duce more unhealthy intramedullay callus at first,but later,because of the persistent unabsorbed allograft particle, the gap healing and inter nal remodelling process in allograft group was delayed than in control group.

급성 심근 경색증의 일차적 관동맥 중재술시 Percusruge GuardWire 시술의 유용성

박일형,김승년,이길원 대한방사선사협회 2003 대한방사선사협회지 Vol.29 No.1

베케트의 자전극, 타자 혹은 죽음에 관한 기록: 「난 아니야」와 「그 시절」을 중심으로

박일형 한국현대영미드라마학회 2004 현대영미드라마 Vol.17 No.2

骨折治癒에 있어서 血管新生에 關한 超微形態學的 硏究

박일형,손윤경,채종민,손태중 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.1

목적 : 골절 치유시 신생 혈관의 분포 양상을 관찰하고 혈관 증식 작용이 있다고 알려진 활성화된 대식세포를 골절 부위에 주입하여 골절 주위의 연부 조직 및 골막 혈관의 증식을 유도함으로서 혈관 신생이 골절 치유에 어떤 역할을 하는 가를 규명하고져 한다. 대상 및 방법 : Sprague-Dawley계 흰쥐의 경골 앞쪽 전반을 실톱으로 골결손을 만들고 활성화된 탐식세포를 국소에 주입한 다음 골결손 후 제 1 주, 제 2 주, 제 3 주 및 제 4 주에 경골을 절취하여 광학현미경, 투과전자현미경 및 주사전자 현미경으로 관찰하고 복부 대동맥을 통하여 혈관 주형제를 주입하여 만들어진 혈관 주형을 주사전자현미경으로 관찰하였다. 결과 : 골견손만을 일으킨 대조군에서는 치유가 진행됨에 따라 새로운 혈관의 증식으로 골수 혈류 및 골막혈류의 발달이 증가되었으며 비교적 적은 양의 가골이 형성되었다. 골절 3 주 후부터 가골이 흡수되어 골절 부위가 유합되었다. 그러나 골절 후 활성된 탐식세포를 국소에 투여한 실험군에서는 골절 1주 후부터 연부조직 및 골막의 혈관이 매우 많이 발달하면서 연골을 포함한 많은 양의 가골이 형성되었다. 3 주 후에는 골수에서 올라온 혈관과 연결되면서 연골이 골조직으로 대체되었고 4 주 후에는 외부가골의 혈관이 규칙적으로 배열하였다. 결론 : 골절에서 외부 가골 형성에는 골막혈관을 포함한 주변 혈관의 증식이 매우 중요하며 활성화된 탐식세포의 투여는 혈관 증식을 유도함으로서 가골의 형성을 증가시킨 것으로 생각된다. 따라서 주변혈류의 장애를 동반한 골절에서 혈관 증식의 유도가 골절 차단에 어느 정도 도움이 될 것으로 기대된다. An ultrastructural study was carried out to investigate the microvascular response on fracture healing and effect of angiogenetic factor(s) on the healing bone. An incomplete cortical fracture of the tibia in the rat was produced by partial osteotomy with electric bone saw. And then activated macrophages were injected at the fracture site as a stimulating factor of angiogenesis. The animals were sacrified at 1, 2, 3 and 4 weeks after bone fracture. The tibial bones were extirpated and examined by light, scanning and transmission electron microscopy. And a rapid, easy and reproducible method to prepare plastic corrosion casts of the tibial microcirculation was employed as Mercox CL-2B. The results obtained were summarized as follows! In the control groups, with the advancement of healing, both medullary and periosteal circulations increased greatly by the development of new blood vessels. The bone healed directly by the formation of new bone, with the formation of little periosteal callus. At 4 weeks after fracture, almost complete healing was accomplished. Treatment with activated macrophages after fracture induced extensive proliferation of the vessels from the tissues surrounding the fracture area and excess external callus formation. As healing progressed, reparative osteo-genesis of the external callus was intimately related to ingrowing vessels which come from the medullary circulation. The vasculature of the subsequent remodeled external callus revealed regularly anastomosing framework. It can be concluded, therefore! The peripheral circulation plays a important role in supplying of external provisional callus at the fracture site. It may be suggested that the activated macrophages induced active vascular proliferation at the fracture site, thus enhancing external callus fromation. Induction of angiogenesis may be helpful to treat the fracture healing which has inadequate blood supply.

대퇴골 원위부 골간단의 피질골 결손에 대한 방사선학적 분류 및 그에 따른 임상적 경과관찰

박일형,오창욱,민우기,Park, Il-Hyung,Oh, Chang-Wug,Min, Woo-Kie 대한근골격종양학회 1999 대한골관절종양학회지 Vol.5 No.1

Over 60 cases were enlisted, but only 31 cases among 24 patients were eligible with a minimum follow-up of 1 year and complete medical documents with imaging data. There were 18 boys and 6 girls, and 7 patients had bilateral lesions. The age of the patients ranged from 2 to 20 years(mean:10.5 years). At their first visit, most lesions had a highly characteristic location and radiographic appearance of radiolucent lesion(s) ranging from 1 to 3cm, except for one case of 5.5 cm in the posteromedial comer of distal femoral metaphysis. The margins were generally well-defined, although some were ill-defined. After reviewing our cases from the viewpoint of clinical course and radiographic patterns, we divided these lesions into two types. Type I is the osteolytic lesion excavated into the posteromedial aspect of the distal femur without cortical defect; and type II is the buldged out lesion of the femur with cortical irregularity into the surrounding soft tissues. Both types have distinctive clinical courses. Type I lesions were easy to make a definite diagnosis with plain radiographs alone, but in type II, it was sometimes very difficult to differentiate it from malignant tumors or chronic localized osteomyelitis. For this lesion, Gd-enhanced MRI was the most effective method for differential diagnosis. In this study, biopsy was not necessary to confirm the diagnosis. Clinical symptoms of type I were very minor or even absent. Many of them were accidentally found after minor trauma around the knee joint. Clinical symptoms disappeared far earlier than radiographical lesions. No treatment such as restriction of activity or drugs was necessary. For type II, the clinical symptoms were more accentuated and lasted longer, and it was necessary to restrict the activity for a certain period in many cases. However, all were self-limited.

대상/사물의 변증법: 『행복한 날들』의 소품들

박일형 국제언어인문학회 2023 인문언어 Vol.25 No.1

Characters in Samuel Beckett’s works are absorbed in speaking of numerous objects and are always keen to develop their stories into an inventory even in his late works where possessions are reduced to an unnameable voice. Among Beckett’s oeuvre, Happy Days, written in 1961, is the work that epitomizes the passionate obsession of objects and the narrative as an inventory of possessions. In this play, middle-aged Winnie brings out a series of objects from a black bag that she holds dear. She goes on to talk about each object purely to pass the dreadful present time. What is central to the play is the relationship between props and the hysterized female protagonist. The thesis shall approach the issue by reflecting on the simultaneous dialectic of object/thing manifested by the props. This dialectic summons the irreducible excess of the feminine body and discloses the failure of semiotic saturization. The sharp tension between the intelligible and the unknowable reveals the feminine at the limit which is neither here nor elsewhere.

“모든 것은 그 자체로 나뉜다”: 베케트의 『말론 죽다』와 소진의 기술

박일형 한국중앙영어영문학회 2016 영어영문학연구 Vol.58 No.4

The narrator and narrated of Samuel Beckett’s Malone Dies announces his mission to be “making an inventory.” Malone’s inventory has been mentioned consistently within Beckett studies but in-depth scrutiny has not been given. It was not Beckett scholars but Gilles Deleuze who concentrated on this fundamental problematics. There are myriads of references to Beckett in Deleuze’s works throughout his publishing career. One of Deleuze’s favorite lines appears in Malone Dies, “Everything divides into itself”, which Deleuze develops into the central theme of his long essay on Beckett’s television drama, “The Exhausted.” The sentence forms a formula that epitomizes “inclusive disjunction”, one of the main concepts behind Deleuze’s philosophy. According to Deleuze, Malone’s inventory is a form of writing that plays with this inclusive disjunction as well as an art of exhausting. For Deleuze, exhausting accompanies the exhaustion of the exhausted. Consequently, exhausting is an art joined or rather disjoined with “a fantastic decomposition of the self.” This study attempts to analyze the significance of writing as an inventory focusing on Malone Dies based on Deleuze’s visionary interpretation of Malone’s enigmatic line.

선물(膳物)의 덫에 갇힌 여성: 라스 폰 트리에의 <브레이킹 더 웨이브>를 중심으로

박일형 문학과영상학회 2005 문학과영상 Vol.6 No.2

Von Trier who had evolved a dissection of masculinity through “Europa Trilogy” approached the issue of feminity in “Goldheart Trilogy.” The transition seems to be an attempt to find certain exit by overcoming the ethical dead end of modern male subject. Von Trier searches for the exit in the theme of woman as a sacrifice or as a pure gift in “Goldheart Trilogy.” In particular, Breaking the Waves is a representative film that unravels such a theme. The protagonist in the film sells her body as a prostitute, is subject to physical violence and finally loses her life for her husband. Such a radical sacrifice can be compared to a pure gift which transgresses the logic of exchange. However, representing woman as a gift contains fundamental problems. It camouflages the phallic economy that has been established primarily by exchanging woman as a commodity. Furthermore, it overlooks the system of value that returns any negative and transgressive action into the system of exchange, into the economy. The female protagonist in Breaking the Waves turns out to be a victim caught in the notion of a pure gift. If Von Trier's film can be an analysis and criticism of patriarchal order, then that can be possible only by unveiling the illusion and violence of such a gift.

고객 불평행동에 대한 대응 전략 연구 : 제일건설사의 사례를 중심으로

박일형,김민정 조선대학교 지식경영연구원 2022 기업과 혁신연구 Vol.45 No.4

본 사례 연구는 제일건설의 공동주택 브랜드인 제일풍경채의 효과적인 고객 불평행동 관리 프로그램을 제시하고자 한다. 특히 제일건설사는 하자 보수 처리의 과정을 효과적으로 운영함으로써, 고객 불평행동에 대한 적극적인 대응을 하고 있으며, 실제 수요 고객의 니즈를 잘 충족시켜 높은 고객 만족도를 형성하고 있다. 또한 향후 건설 사업에도 이전 사업의 고객 니즈와 하차 보수 처리의 경험을 선제적으로 반영 및 시공함으로써, 우호적 브랜드 이미지를 형성하고 있다. 또한 이와 같은 효과적 대응 전략은 높은 기업 신뢰도와 시공 능력 평가로 나타나고 있다. 즉 제일건설의 우수한 시공 능력과 효과적인 고객 관계 관리는 각종 표창으로 인정받고 있으며, 이는 회사 이미지 개선 및 매출 증대, 사업 규모의 확장 등의 긍정적 성과로 나타나고 있다. 제일건설의 우수한 사례를 통해 타 건설사에게 입주 후에도 고객과의 관계 관리에 있어서 그 중요성을 알리고자 함이며, 이에 따라 효과적인 고객 관계 관리가 필요함을 제시하고자 한다.